OBJECTIVE To compare the efficacy and safety of tildrakizumab versus secukinumab in the treatment of moderate-to-severe plaque psoriasis. METHODS A retrospective analysis was conducted on 141 patients with moderate-to-severe plaque psoriasis treated at the First Affiliated Hospital of Nanyang Medical College from January 2024 to April 2025. According to the treatment regimen，the patients were divided into tildrakizumab g roup （ n ＝61） and secukinumab group （ n ＝80）. The PASI 75，PASI 90，and PASI 100 response rates， the Psoriasis Area and Severity Index （PASI） and Dermatology Life Quality Index （DLQI） scores， skin barrier function （sebum content and stratum corneum water content）， inflammatory factor levels [interleukin-17 （IL-17）， tumor necrosis factor-α （TNF-α）， and IL-23 ] before and after treatment， and the incidence of adverse drug reactions during treatment were compared between the two groups. RESULTS After 12 weeks of treatment， the PASI 75， PASI 90， and PASI 100 response rates in the tildrakizumab group were significantly higher than those in the secukinumab group （ P ＜0.05）. After treatment， PASI and DLQI scores as well as serum levels of IL-17， TNF-α， and IL-23 in both groups were significantly reduced compared to before treatment in the same group； sebum content and stratum corneum water content were significantly increased compared to before treatment in the same group （ P ＜0.05）； the tildrakizumab group showed better results than the secukinumab group （ P ＜0.05）. The overall incidence of adverse drug reactions was also significantly lower in the tildrakizumab group compared with the secukinumab group （ P ＜0.05）. CONCLUSIONS Compared with secukinumab， tildrakizumab demonstrates superior efficacy in the treatment of moderate-to-severe plaque psoriasis， providing improved symptom relief， enhanced skin barrier function， reduced levels of inflammatory factors， and higher safety.

ObjectiveTo observe the effect of heat-sensitive moxibustion on quality of life and immune function in non-small cell lung cancer （NSCLC） patients undergoing chemotherapy. MethodsSeventy NSCLC patients with qi deficiency and phlegm stasis syndrome were randomly divided into an intervention group and a control group， with 35 cases in each group. The control group received chemotherapy combined with routine symptomatic treatment， while the intervention group additionally received heat-sensitive moxibustion since the first day of chemotherapy. Acupoints included Dazhui （GV14）， bilateral Feishu （BL13）， Zhongwan （CV12）， Qihai （CV6）， and Guanyuan （CV4）. The site exhibiting the strongest heat-sensitization response was selected for moxibustion. Treatment was administered for 45 minutes per session， three times weekly for three consecutive weeks， totaling nine sessions. Before and after treatment， quality of life was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire （EORTC QLQ-C30）， and traditional Chinese medicine （TCM） syndrome scores were evaluated. Peripheral blood levels of natural killer （NK） cells and T-lymphocyte subsets including CD3⁺， CD4⁺， and CD8⁺， and CD4⁺/CD8⁺ ratio were measured. Levels of programmed cell death protein-1 （PD-1）， including PD-1⁺CD4⁺ and PD-1⁺CD8⁺ cells， were also assessed. Liver and renal function were monitored before and after treatment， and adverse events were recorded. ResultsIn the intervention group， 1 participant withdrew and 1 was excluded， while in the control group， 2 participants withdrew. Ultimately， 33 participants in each group were included in the final analysis. The intervention group showed significant improvements in physical， role， emotional， cognitive， and social functioning， as well as global health status after treatment， while scores for fatigue， nausea and vomiting， dyspnea， appetite loss， diarrhea， and TCM syndrome scale were significantly decreased （P＜0.05）. Moreover， the intervention group demonstrated higher scores in physical functioning， role functioning， and global health status， as well as lower scores for fatigue， nausea and vomiting， dyspnea， appetite loss， diarrhea， and the TCM syndrome scale than the control group （P＜0.05）. After treatment， the levels of peripheral NK cells and PD-1⁺CD8⁺ T cells in the intervention group increased significantly； furthermore， the intervention group exhibited higher peripheral NK cell levels and lower PD-1⁺CD8⁺ T cell levels than the control group （P＜0.05）. No significant differences were found in liver or renal function between the two groups （P＞0.05）. In addition， no adverse events such as burns or moxibustion-induced syncope occurred during the study. ConclusionHeat-sensitive moxibustion as an adjunctive therapy may enhance immune function， alleviate clinical symptoms， and improve quality of life， while demonstrating a favorable safety profile in NSCLC patients with qi deficiency and phlegm stasis.

With the accelerating trend of population aging, the number of elderly patients with lung cancer continues to rise, and the disease burden is becoming increasingly heavy. The clinical management of these patients faces severe challenges due to their decreased physiological reserve, complex comorbidities, and significant individual heterogeneity. Consequently, under traditional diagnosis and treatment models, doctors often struggle to identify the individualized risks of elderly patients in a timely and comprehensive manner, which can easily lead to decision biases such as undertreatment or overtreatment. In view of this, this study advocates for the establishment of an umbrella decision-making model specifically tailored for elderly lung cancer patients. Grounded in a multidisciplinary team (MDT) platform, this model deeply integrates oncological indicators with the comprehensive geriatric assessment (CGA) system. By holistically considering multidimensional variables including tumor burden, organ function, frailty index, cognitive status, and social support, the model establishes an operational mechanism characterized by "single entry, precise stratification, and targeted selection". Accordingly, patients can be scientifically triaged into distinct intervention tiers, such as active surveillance, minimally invasive surgery, drug therapy, radiotherapy, and best supportive care, thereby achieving real-time alignment between treatment intensity and patient fitness. This article elaborates on the construction logic and key operational procedures of this novel decision-making framework, aiming to guide clinical practice beyond the limitations of a tumor-centric perspective toward a holistic, dynamic, whole-course management strategy. This transition seeks to ensure optimal quality of life and clinical net benefit for elderly patients alongside survival prolongation.

Chikungunya virus (CHIKV), which is primarily transmitted by Aedes aegypti and Ae. albopictus, has recently rapidly spread across the world, which poses a huge threat to public health. Chikungunya fever (CHIKF), caused by CHIKV infection, typically manifests as acute febrile illness with severe polyarthralgia that may persist for months to years. A few severe CHIKF cases may be accompanied by serious neurological complications, even resulting in death. The accelerating global expansion of CHIKV is closely associated with genetic variations of the virus, and mutated genes in CHIKV may augment the virus adaptability to Aedes vectors and transmission efficiency. Currently, the diagnosis of the CHIKV infection primarily relies on molecular and serological assays; however, there are still multiple challenges for early and differential diagnosis of CHIKV infections due to co-infections with arboviruses and nonspecific early symptoms. The first prophylactic vaccine for CHIKF has been recently approved in the United States; however, the large-scale application still awaits further validations. More importantly, there are no licensed antiviral therapies against CHIKV until now. This review describes the structure and pathogenesis of CHIKV, summarizes the latest epidemiology and advances in the diagnosis of CHIKV infections, and depicts the current status and prospects of antiviral agents and vaccine development, so as to inform evidence-based prevention and control strategies.

Objective:To explore the design and application effect of a home-based pulmonary rehabilitation checklist for postoperative lung cancer patients and to analyze the feasibility of this innovative rehabilitation approach.Methods:A prospective non-concurrent controlled study was conducted. Eighty postoperative lung cancer patients from the Department of Thoracic Surgery, Henan Provincial People's Hospital, were conveniently selected. According to the time of admission, postoperative lung cancer patients from April to June 2024 ( n=40) were assigned to the control group, while those postoperative lung cancer patients from August to October 2024 ( n=40) were assigned to the experimental group. The control group was given routine home-based pulmonary rehabilitation knowledge education upon discharge, while the experimental group was provided with the application of a home-based pulmonary rehabilitation checklist in addition to the routine home-based pulmonary rehabilitation knowledge education. Assessments were performed on the day of discharge and 1-month post-discharge using the Chinese version-Strategies Used by People to Promote Health (C-SUPPH), the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC-QLQ-C30), the six-minute walk test (6MWT) and the Brog score. Results:A total of 40 patients in each group completed this study. Among them, there were 26 males and 14 females in the control group, aged (51.25 ± 11.39) years, and 23 males and 17 females in the experimental group, aged (53.07 ± 12.21) years. One month after discharge, the scores of positive attitude, self-decision making and self-stress reduction on the C-SUPPH in the experimental group were (44.25 ± 10.29), (30.76 ± 8.31) and (9.51 ± 2.17) points, respectively. They were higher than those in the control group (37.02 ± 7.14), (26.61 ± 6.71) and (7.58 ± 1.09) points, and the differences were statistically significant ( t=-3.65, -2.46, -5.03, all P<0.05). The scores of somatic function, role function, cognitive function and emotional function on the EORTC-QLQ-C30 in the experimental group were (65.77 ± 6.41), (71.46 ± 7.21), (70.11 ± 5.61) and (69.59 ± 5.71) points, respectively. They were higher than those in the control group (57.71 ± 7.01), (64.27 ± 5.25), (62.79 ± 7.18), (61.11 ± 6.25) points, and the differences were statistically significant ( t values were -6.34 to -5.08, all P<0.05). The 6MWT distance in the experimental group was (411.31 ± 35.02) m, which was higher than (376.58 ± 30.26) m in the control group, and the difference was statistically significant ( t=-4.75, P<0.05). The Brog score in the experimental group was (2.12 ± 0.68) points, which was lower than (2.50 ± 0.65) points in the control group, and the difference was statistically significant ( t=2.56, P<0.05). Conclusions:The implementation of home pulmonary rehabilitation list can improve the self-management ability of patients after lung cancer surgery, improve the quality of life, and then enhance the exercise ability, which is worthy of clinical promotion.

Objective To analyze the impact of the National Centralized Drug Procurement Policy(hereinafter referred to as the"centralized procurement policy")on the utilization of breast cancer treatment drugs in a specialized cancer hospital.Methods The defined daily dose(DDD)method was used to compare the daily drug cost(DDC),drug utilization frequency(DDDs),and affordability of letrozole,anastrozole,and capecitabine before and after the implementation of the centralized pro-curement policy in a tertiary specialized cancer hospital in Guangzhou.Results and Conclusion After the policy implementa-tion,the DDC of all three drugs decreased.The out-of-pocket DDC for the selected drugs remained stable or decreased,while the out-of-pocket DDC for both originator drugs and generic drugs increased,with a more pronounced increase for originator drugs.The proportion of DDDs for the selected drugs increased post-policy.The centralized procurement policy not only reduced the prices of selected drugs but also drove down the prices of generic and originator drugs.It is recommended to further expand the scope of centralized procurement for anticancer drugs and the types of cancers covered,as well as to establish a transitional mech-anism for medical insurance payment standards.

Aim To investigate the role of miR-130b-3p in regulating the USP47/NLRP3 inflammasome in airway remodeling associated with asthma and to explore its potential therapeutic value in asthma treat-ment.Methods An OVA-induced asthma mouse mod-el was established,and intervention with miR-130b-3p agomir was performed.Histological staining,quantita-tive real-time PCR,Western blot,immunofluorescence and flow cytometry were used to analyze the effects of miR-130b-3p on the expression of USP47,NLRP3,and related inflammatory factors,as well as the inflamma-some activity.Results miR-130b-3p was significantly downregulated in asthmatic mice,and its intervention significantly inhibited airway epithelial damage,inflam-matory cell infiltration,and collagen deposition.Addi-tionally,miR-130b-3p targeted USP47 and indirectly suppressed NLRP3 expression,leading to reduced in-flammasome activity and alleviated asthma-related in-flammatory responses.Conclusion miR-130b-3p re-duces asthma-related inflammatory responses by down-regulating USP47 expression and indirectly inhibiting NLRP3 inflammasome activity.

Objective:To characterize the brain structure of Chinese children with autism spectrum disorder (ASD) using artificial intelligence automatic brain segmentation technique, and to analyze the correlation between the characteristics of the brain structure and the degree of brain development.Methods:A case-control study.The data of 52 children who were diagnosed with ASD according to the diagnostic criteria for ASD in the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition of the United States at the Department of Psychology of Qingdao University Affiliated Women and Children′s Hospital from January 2023 to April 2024 were prospectively analyzed.Meanwhile, 48 gender- and age-matched typically developing (TD) children in Qingdao were also included.The three-dimensional T1 weighted imaging sequences of all patients were obtained using a GE 3.0T magnetic resonance imaging scanner.Automated brain segmentation techniques were used to obtain the standardized volumes of each brain structure (the ratio of the absolute volume of the brain structure to the whole brain volume).Two-independent-samples t and Mann-Whitney U tests were used to compare the standardized volumes of different brain regions between the 2 groups.Pearson and Spearman correlation analyses were used to depict the correlations between volume data of brain areas with significant differences and Gesell Developmental Scale scores. Results:Compared with those in the TD group, the volumes of the left grey matter[25.45%(0.70%) vs.25.16%(1.05%)], the right grey matter [(25.89±0.71)% vs.(25.51±0.73)%], the right lateral orbitofrontal cortex [(0.62±0.03)% vs.(0.59±0.05)%], the right medial orbitofrontal cortex[(0.48±0.04)% vs.(0.46±0.04)%], the right pars triangularis [(0.38±0.07)% vs.(0.35±0.05)%], the left hippocampus [0.22%(0.04%) vs.0.20%(0.02%)], the right hippocampus [0.23%(0.04%) vs.0.22%(0.02%)], the left parahippocampal gyrus [0.15%(0.03%) vs.0.14%(0.02%)], the right parahippocampal gyrus [(0.15±0.02)% vs.(0.14±0.02)%], the left fusiform gyrus [(0.82±0.08)% vs.(0.78±0.08)%], the right superior temporal gyrus [(0.96±0.10)% vs.(0.90±0.09)%], the left insular lobe [(0.54±0.03)% vs.(0.53±0.04)%], the right insular lobe [(0.55±0.03)% vs.(0.53±0.04)%], the right inferior parietal cortex [(1.40±0.16)% vs.(1.33±0.12)%], the right precuneus cortex [(0.99±0.09)% vs.(0.94±0.09)%], the right putamen [(0.37±0.04)% vs.(0.35±0.03)%], the left pallidum [(0.14±0.01)% vs.(0.13±0.01)%], the right pallidum [0.14%(0.02%) vs.0.13%(0.01%)], and the right thalamus [(0.51±0.04)% vs.(0.49±0.03)%] were significantly increased in the ASD group (all P<0.05).Nonetheless, the volumes of the left pericalcarine cortex [(0.19±0.04)% vs.(0.20±0.04)%] and the corpus callosum posterior region [0.05%(0.01%) vs.0.06%(0.01%)] in the ASD group were considerably smaller than those in the TD group (all P<0.05).Correlation analysis showed that the right thalamus volume was negatively correlated with the Gesell-adaptation development quotient in children with ASD ( r=-0.276, P=0.048).The volumes of the left fusiform gyrus and left pericalcarine cortex were negatively correlated with the Gesell-fine motor development quotient in children with ASD ( r=-0.290, P=0.037; r=-0.368, P=0.007). The right precuneus cortex volume was negatively correlated with the Gesell-personal and social competence development quotient in children with ASD ( r=-0.396, P=0.007). Conclusions:Children with ASD show abnormalities in the volumes of multiple brain regions, and some brain regions are related to the degree of brain development.Automatic brain segmentation technology based on artificial intelligence can rapidly and directly measure and display the volume of brain structures in both ASD and TD children.

OBJECTIVE: To explore the changes of CKLF-like MARVEL transmembrane domain-containing 6 (CMTM6) and programmed death-ligand 1 (PD-L1) expression in gastric mucosal epithelial cells after Helicobacter pylori infection and the regulation of CMTM6 on PD-L1, and to analyze the mRNA expression differences before and after CMTM6 gene knock-out in helicobacter pylori infected gastric epithelial cells by microarray analysis. METHODS: The standard Helicobacter pylori strain ATCC 26695 was co-cultured with human gastric epithelial cell GES-1 for 6, 24 and 48 hours, and the mRNA and protein levels of CMTM6 and PD-L1 were detected by real-time quantitative PCR and Western blot. Using CRISPR/Cas9 to construct CMTM6 gene knockout plasmid and knockout CMTM6 gene of GES-1 cells. Helicobacter pylori was co-cultured with CMTM6 gene knockout and wild type GES-1 cells for 48 hours to detect PD-L1 transcription and protein level changes, and CMTM6 gene knockout GES-1 cells were treated with the proteasome inhibitor MG-132 to detect the changes in PD-L1 protein levels. Agilent Human ceRNA Microarray 2019 was used to detect the differentially expressed genes in CMTM6 gene knockout and wild-type GES-1 cells co-cultured with Hp for 48 hours, and the signal pathway of differentially expressed genes enrichment was analyzed by Kyoto Encyclopedia of Genes and Genomes (KEGG) database. RESULTS: The mRNA and protein levels of CMTM6 and PD-L1 in GES-1 cells were significantly up-regulated after Helicobacter pylori infection, and CMTM6 mRNA was most significantly up-regulated 48 hours after infection. After CMTM6 gene knockout, the CD274 gene transcription level of Helicobacter pylori infected GES-1 cells did not change significantly, but PD-L1 protein level was significantly down-regulated, and the PD-L1 level increased after the application of proteasome inhibitor MG-132. After CMTM6 gene knockout, 67 genes had more than two times of differential expression. The transcription levels of TMEM68, FERMT3, GPR142, ATP6V1FNB, NOV, UBE2S and other genes were significantly down-regulated. The transcription levels of PCDHGA6, CAMKMT, PDIA2, NTRK3, SPOCK1 and other genes were significantly up-regulated. After CMTM6 gene knockout, ubiquitin-conjugating enzyme E2S (UBE2S) gene expression was significantly down-regulated, which might affect protein ubiquitination degradation. After CMTM6 gene knockout, adrenoceptor alpha 1B (ADRA1B), cholinergic receptor muscarinic 1 (M1), CHRM1, platelet activating factor receptor (PTAFR) gene expression was significantly up-regulated. CONCLUSION Helicobacter pylori infection up-regulates the expression level of CMTM6 in gastric mucosa cells, and CMTM6 can stabilize PD-L1 and maintain the protein level of PD-L1. CMTM6 gene knockout may affect biological behaviors such as protein ubiquitination and cell surface receptor expression.
Humans ; MARVEL Domain-Containing Proteins/metabolism* ; Helicobacter pylori/physiology* ; B7-H1 Antigen/genetics* ; Helicobacter Infections/metabolism* ; Epithelial Cells/metabolism* ; Gastric Mucosa/metabolism* ; Chemokines/metabolism* ; Cell Line ; Gene Knockout Techniques ; Myelin Proteins

Taxifolin (TAX) is a natural compound known for its liver protection effect, but the mechanism remains unknown. Phosphorylated proteomics analyses discovered that the phosphorylation level of NDRG1 at T328 was a key event of TAX-improved liver fibrosis. We established models with NDRG1 knockout (KO) in vivo and in vitro, demonstrating that NDRG1 KO attenuated the development of hepatocyte injury, and combining NDRG1 KO and TAX administration did not result in a reduction in protection against liver injury. Cellular thermal shift assay and surface plasma resonance analysis showed that TAX directly binds to NDRG1 rather than its upstream kinase, subsequently demonstrating that TAX regulated phosphorylation of NDRG1 at T328 through binding to its C289 site. NDRG1 T328A (phosphorylated mutation) and T328E (mimic phosphorylation) in vivo and in vitro confirmed that pNDRG1_T328 exacerbates hepatocyte injury along with DNA damage, inflammatory response, and apoptosis, thereby contributing to hepatic stellate cells (HSCs) activation. In contrast, TAX can inhibit the above pathological abnormalities and block hepatocyte injury-triggered HSCs activation and fibrosis. Overall, TAX is a potent liver protection drug primarily targeting NDRG1 and inhibiting pNDRG1_T328 in hepatocytes.