ObjectiveTo systematically evaluate the effect of whole body vibration training (WBV) at different vibration frequencies on balance and walking function in individuals with stroke. MethodsRandomized controlled trials (RCT) about the effect of WBV on post-stroke balance and walking function were retrieved from CNKI, VIP, Wanfang Data, CBM, PubMed, Embase and Cochrane Library databases from inception to April, 2026. Outcome measures included Berg Balance Scale (BBS), Functional Ambulation Category (FAC), and Timed Up and Go Test (TUGT). The methodological quality of the included studies was appraised using the Cochrane Risk of Bias Tool and the PEDro scale. Meta-analysis was performed using Stata 18.0. ResultsA total of 22 RCT comprising 1 335 stroke patients were included, with PEDro scores ranging from five to nine. Meta-analysis demonstrated that compared with control interventions, WBV significantly improved BBS scores (WMD = 4.761, 95%CI 3.220 to 6.302, P < 0.001) and FAC scores (WMD = 0.537, 95%CI 0.239 to 0.835, P < 0.001), and significantly reduced the time of TUGT (WMD = -2.329, 95%CI -3.889 to -0.769, P = 0.003). Subgroup analyses revealed that low-frequency WBV (≤ 20 Hz) produced significant improvement in both balance and walking function relative to controls, whereas high-frequency WBV (> 20 Hz) did not reach statistical significance. Low-frequency WBV intervention was superior to high-frequency WBV in FAC scores (Q = 8.070, P = 0.005), whereas no statistically significant difference was observed between the low- and high-frequency subgroups in BBS and TUGT (P > 0.05). Meta-regression suggested that vibration frequency was not the primary source of heterogeneity; rather, the total number of training sessions and time since stroke might be potential influencing factors. Adverse events were mild and occurred exclusively in the high-frequency group. ConclusionWBV can effectively improve post-stroke balance and walking function. Based on the limited available evidence, low-frequency WBV (≤ 20 Hz) is super to high-frequency WBV in both efficacy and safety. In addition, attention should be paid to the cumulative effect of total training volume, and the timing of intervention should be tailored to the patient's disease duration.

ObjectiveTo investigate the intervention effect of modified Xiangsha Liujunzitang （M-XSLJZ） on insulin resistance-regulated fatty acid synthesis via Lon protease 1 （Lonp1） in the liver of spleen-deficiency hyperlipidemia rats. MethodsA total of 70 male SD rats were randomly allocated into seven groups （n=10）： blank control group， high-fat diet （HFD） group， spleen-deficiency hyperlipidemia （PX-HFD） model group， low-， medium-， and high-dose Modified Xiangsha Liujunzitang （JW-L， JW-M， JW-H）， and rosuvastatin group. The spleen-deficiency model was induced in the PX-HFD， JW-L， JW-M， JW-H， and rosuvastatin groups by irregular diet combined with exhaustive swimming. Except for the control group， all groups were fed an HFD for 10 weeks to establish a hyperlipidemia rat model. Following modeling， the rats in the JW-L， JW-M， and JW-H groups received the decoction by gavage at 3.51， 7.02， 14.04 g·kg^-1， respectively， while the rosuvastatin group received 9×10^-4 g·kg^-1. After 8 weeks of administration， samples were collected. D-xylose excretion rate was quantified using the phloroglucinol method. Serum levels of total cholesterol （TC）， triglycerides （TG）， high-density lipoprotein cholesterol （HDL-C）， and low-density lipoprotein cholesterol （LDL-C） were measured by an automatic biochemical analyzer. Hepatic TG content was quantified by the glycerol phosphate oxidase-peroxidase anti-peroxidase （GPO-PAP） method. Serum insulin （INS）， fasting blood glucose （FBG）， hepatic reactive oxygen species （ROS） levels， and mitochondrial complex Ⅰ activity were assessed by enzyme-linked immunosorbent assay （ELISA）. The mRNA levels of Lonp1， and acetyl-CoA carboxylase 1 （ACC1） were determined by real-time quantitative PCR （Real-time PCR）. Protein expression levels of Lonp1， c-Jun N-terminal kinase （JNK）， phosphorylated （p）-JNK， insulin receptor substrate 1 （IRS1）， p-IRS1， and ACC1 in liver tissues were analyzed by Western blot. ResultsCompared with the control group， the HFD group showed a significant increase in body weight （P<0.01）. The PX-HFD group showed a significant decrease in D-xylose excretion rate （P<0.01）. Both the HFD and PX-HFD groups exhibited significantly elevated serum levels of TC， TG， HDL-C， LDL-C， FBG， INS， and HOMA-IR （P<0.01）， along with increased orange-red lipid droplets， prominent fatty vacuoles， and significantly elevated hepatic TG level （P<0.01）. Mitochondrial complex Ⅰ activity significantly decreased （P<0.05）， while ROS level， Lonp1 mRNA and protein expression， and ACC1 mRNA and protein expression significantly increased （P<0.05， P<0.01）. The p-IRS1/IRS1 protein expression ratio significantly decreased （P<0.01）， whereas the p-JNK/JNK protein expression ratio significantly increased （P<0.01）. Compared with the HFD group， the PX-HFD group showed significantly reduced D-xylose excretion rate and serum HDL-C level （P<0.01）， significantly decreased hepatic TG level （P<0.05）， and significantly increased HOMA‑IR index （P<0.01）. Hepatic Lonp1 mRNA and protein expression significantly decreased （P<0.05， P<0.01）， p‑IRS1/IRS1 protein expression ratio was significantly decreased （P<0.01）， while ACC1 mRNA and protein expression and p‑JNK/JNK protein expression ratio were significantly increased （P<0.01）. Compared with the PX-HFD group， all treatment groups showed significantly reduced serum TC， TG， LDL-C levels， and HOMA-IR index （P<0.05， P<0.01）， with ameliorated orange‑red lipid droplet deposition and significantly reduced hepatic TG and ROS levels （P<0.05， P<0.01）. The JW-M， JW-H， and rosuvastatin groups exhibited significantly decreased body weight （P<0.05， P<0.01）， significantly increased D‑xylose excretion rate （P<0.01）， significantly decreased HDL‑C level （P<0.05， P<0.01）， significantly increased mitochondrial complex I activity， Lonp1 mRNA and protein expression， and p-IRS1/IRS1 protein expression ratio （P<0.05， P<0.01）， as well as significantly decreased p-JNK/JNK protein expression ratio （P<0.01）. ConclusionM-XSLJZ may exert its lipid‑lowering effect by regulating Lonp1 expression in rat liver， thereby improving insulin resistance and subsequently inhibiting hepatic lipid synthesis.

Objective:To design two kinds of intensity modulated radiotherapy (IMRT) plans with different radiation field distributions,and to compare the dose differences of that at the dose of target region and organs at risk (OAR) for middle and lower esophageal cancer,so as to provide a reference for the design of IMRT plan. Methods:The data of 17 patients with middle and lower esophageal cancer who received IMRT at Shangluo Central Hospital from November 2022 to May 2023 were retrospectively analyzed. IMRT plans with different radiation fields for Plan 1 and Plan 2 were designed for each patient. The angles of radiation field for Plan 1 were 0°,80°,120°,160° and 200°,and those for Plan 2 were 30°,130°,180°,230° and 330°,respectively. The prescribed dose to the planning target volume (PTV) was 60 Gy/30 F. The differences in dosimetric parameters between the two plans were compared. Results:There were no statistically significant differences in the dose parameters of 2％,98％,50％ target dose (D2％,D98％,D50％),homogeneity index (HI),conformity index (CI) and monitor unit between the two groups (P>0.05). There were no significant differences in V5 of dual lungs,the mean dose (Dmean) of heart,and the maximum dose (Dmax) of spinal-cord between two groups (P>0.05). The volume percentage (V10,V20,V30) of dual lungs received radiation doses of 10,20 and 30 Gy,and the mean dose (Vmean) of lung in the Plan1 group reduced respectively 7.44％,21.16％,10.09％ and 5.31％ than those in the Plan2 group,and the differences of them were statistically significant (t=-5.845,-7.729,-2.247,-3.960,P<0.05). Heart V10 and V20 in the Plan1 group decreased respectively by 7.23％ and 5.78％,with statistical significance (t=-4.376,-3.523,P<0.01),while V30 and V40 of Plan 1 increased respectively by 2.7％ and 4.92％,without statistical significance (P>0.05). There was no significant difference in heart Dmean between the Plan1 group and the Plan2 group (P>0.05). Conclusion:Both two methods of distribution field can meet the clinical requirements,and Plan1 has more advantages in protecting organs at risk under the premise of meeting the requirements of target region.

Objective To investigate the cellular characteristics in the development of retinal tumors induced by MY-CN overexpression,and to find the key proteins that play an important role in this process.Methods T-MYCN Y1 and Y2 cells cultured in vitro for 1 year and 2 years were selected for the experiment.The WERI-RB-1 cell line obtained from Shanghai Cell Bank of Chinese Academy of Sciences was taken as the mature retinoblastoma(RB)control(WERI-Rb-1 group).Untreated normal human retinal tissues were used as the control group.Cells were inoculated into a 24-well plate at a density of 1 × 104 cells per well,and the cell morphology was observed under a microscope and images were collected.Cell count was performed on the 4th,8th and 12th day after inoculation.Immunofluorescence staining was employed to de-tect the expression of the proliferation marker Ki67 and cone cell marker L/M opsin in each group.Quantitative real time polymerase chain reaction(qRT-PCR)was utilized to assess the expression of MYCN,CCNB1,CDK1,SYK,and RXRγ in cells across all groups.Proteomics analysis was performed to detect variations in protein expression profiles across groups and to identify key regulatory genes.Subsequently,cell growth and proliferation were evaluated after OTX2 knockdown by lentiviruses.Results The growth curve showed that there were(59.17±4.01)× 104 cells in the T-MYCN Y1 group,(85.14±4.54)× 104 cells in the T-MYCN Y2 group and(100.73±1.99)× 104 cells in the WERI-Rb-1 group on the 12th day of in-vitro culture(all P＜0.05).Compared with those in the control group,the positive cell rates of Ki67 and L/M opsin increased in T-MYCN Y1,T-MYCN Y2 and WERI-Rb-1 groups(all P＜0.001).The relative expression levels of MYCN mR-NAs in T-MYCN Y1,T-MYCN Y2 and WERI-Rb-1 groups were significantly higher than those in the control group(all P＜0.001).The relative expression levels of CCNB1 and CDK1 mRNAs also increased significantly in the three groups,com-pared with those in the control group(all P＜0.01).There was no significant difference in the relative expression of SYK mRNAs between T-MYCN Y1 and control groups(P＞0.05).The relative expression level of RXRγ mRNAs was significantly higher in the T-MYCN Y1 group than that in the control group(P＜0.05).The relative expression levels of SYK and RXRγmRNAs in T-MYCN Y2 and WERI-Rb-1 groups were significantly increased,compared with those in the control group(all P＜0.05).GO enrichment analysis showed that these differentially-expressed proteins were enriched into protein complex assembly and mitochondria pathways.KEGG enrichment analysis revealed that the enriched pathways of these differential-ly-expressed proteins included carbon metabolism,metabolic pathway and fatty acid degradation.Both proteomics and Western blot analyses indicated that OTX2 expression levels were the highest in the WERI-Rb-1 group,second highest in the T-MYCN Y2 group,and the lowest in the T-MYCN Y1 group(all P＜0.01).According to qRT-PCR,the expression levels of OTX2 mRNAs in T-MYCN Y1,T-MYCN Y2 and WRI-Rb-1 cells with OTX2 knockdown were lower than those in empty vec-tor controls(all P＜0.05).The growth curve of cells showed that after knocking down OTX2 in the three groups of cells,both cell growth and proliferation ability decreased significantly(all P＜0.001).Conclusion During the development of retinal tumors induced by MYCN overexpression,cells gradually exhibit characteristics similar to WERI-Rb-1 cells,which are a typical RB cell line.OTX2 plays an important role in MYCN amplification or the growth and proliferation of highly ex-pressed RB.Targeting OTX2 may become a new research direction for the treatment of RB.

Objective:To design two kinds of intensity modulated radiotherapy (IMRT) plans with different radiation field distributions,and to compare the dose differences of that at the dose of target region and organs at risk (OAR) for middle and lower esophageal cancer,so as to provide a reference for the design of IMRT plan. Methods:The data of 17 patients with middle and lower esophageal cancer who received IMRT at Shangluo Central Hospital from November 2022 to May 2023 were retrospectively analyzed. IMRT plans with different radiation fields for Plan 1 and Plan 2 were designed for each patient. The angles of radiation field for Plan 1 were 0°,80°,120°,160° and 200°,and those for Plan 2 were 30°,130°,180°,230° and 330°,respectively. The prescribed dose to the planning target volume (PTV) was 60 Gy/30 F. The differences in dosimetric parameters between the two plans were compared. Results:There were no statistically significant differences in the dose parameters of 2％,98％,50％ target dose (D2％,D98％,D50％),homogeneity index (HI),conformity index (CI) and monitor unit between the two groups (P>0.05). There were no significant differences in V5 of dual lungs,the mean dose (Dmean) of heart,and the maximum dose (Dmax) of spinal-cord between two groups (P>0.05). The volume percentage (V10,V20,V30) of dual lungs received radiation doses of 10,20 and 30 Gy,and the mean dose (Vmean) of lung in the Plan1 group reduced respectively 7.44％,21.16％,10.09％ and 5.31％ than those in the Plan2 group,and the differences of them were statistically significant (t=-5.845,-7.729,-2.247,-3.960,P<0.05). Heart V10 and V20 in the Plan1 group decreased respectively by 7.23％ and 5.78％,with statistical significance (t=-4.376,-3.523,P<0.01),while V30 and V40 of Plan 1 increased respectively by 2.7％ and 4.92％,without statistical significance (P>0.05). There was no significant difference in heart Dmean between the Plan1 group and the Plan2 group (P>0.05). Conclusion:Both two methods of distribution field can meet the clinical requirements,and Plan1 has more advantages in protecting organs at risk under the premise of meeting the requirements of target region.

Acute lateral ankle sprain (ALAS) is one of the most common sport injuries, with high incidence, recurrence and disability rates. Currently, exercise rehabilitation-based non-surgical treatment is the primary management approach for ALAS. However, there remain improper practices such as excessive immobilization or uncontrolled activity, which contribute to recurrent sprains and chronic ankle instability, significantly impairing patients′ athletic function and quality of life. To standardize the non-surgical management of ALAS, improve the cure rates, and reduce the recurrence and disability rates, Chinese Sports Rehabilitation Medicine Training Project of Chinese Medical Association, Foot and Ankle Basics and Orthopedics Group, Orthopedic Branch of Chinese Medical Doctor Association, and Sports Medicine Branch of Jiangsu Medical Association organized relevant experts to formulate Expert consensus on non-surgical treatment for acute lateral ankle sprain ( version 2025), following the principles of scientific vigor, practicality, and innovation. Thirteen recommendations were proposed for standardized treatment protocols across different healing phases, aiming to provide references for standard management of ALAS and improve the therapeutic outcomes.

Heart failure (HF) is the terminal stage of a variety of cardiovascular diseases. Mitochondrial dysfunction is a key factor in the development of HF. Yang deficiency and water stagnation is the core TCM pathogenesis of HF. Mitochondrial dysfunction leads to energy deficiency, produces reactive oxygen species (ROS), and accelerates cardiomyocyte injury, which is similar to the pathogenesis of "yang deficiency" in TCM; mitochondrial dysfunction leads to water and sodium retention and edema, which is consistent with the TCM pathogenesis of "water stagnation". Mitochondrial dysfunction may explain the syndrome of "yang deficiency and water stagnation" in HF at the micro level, while the method of warming yang and diuresis or regulating mitochondrial function through multiple targets can improve HF. This provides a new research idea and theoretical basis for the treatment of HF with integrated traditional Chinese and Western medicine.

ObjectiveThe study aims to investigate the intervention effect of modified Xiangsha Liujunzitang （M-XSLJZ） on intestinal-derived lipopolysaccharide （LPS）-activated Kupffer cell inflammation in rats with hyperlipidemia spleen deficiency syndrome. MethodsSeventy male SD rats were randomly divided into seven groups （n=10）： blank control （CON）， high-fat diet without spleen deficiency （HFD）， high-fat diet with spleen deficiency （SD-HFD）， M-XSLJZ low-， medium-， and high-dose groups （XS-L， XS-M， XS-H）， and western medicine control （R）. Spleen deficiency was induced in SD-HFD， XS-L， XS-M， XS-H， and R groups via irregular diet combined with exhaustive swimming for 15 days. The CON group received a standard diet， while other groups were fed a high-fat diet for 10 weeks to establish the hyperlipidemia model. After successful modeling， rats were treated for 8 weeks： M-XSLJZ was administered at 3.51， 7.02， 14.04 g·kg^-1 in XS-L， XS-M， and XS-H groups， respectively. The R group received 9×10^-4 g·kg^-1 of a reference drug. D-xylose excretion rate was measured by the phloroglucinol method. Blood lipids were assessed using an automated biochemical analyzer. Hematoxylin-eosin （HE） staining was used to evaluate the pathological conditions of the liver， and oil red O staining was used to observe the lipid deposition in the liver. The levels of LPS， portal vein serum LPS， LPS-binding protein （LBP）， serum interleukin-6 （IL-6）， IL-1β， and tumor necrosis factor-α （TNF-α） were detected by enzyme-linked immunosorbent assay （ELISA）. Immunofluorescence was used to evaluate CD86 expression and CD68/TLR4 co-localization in the liver. Protein levels of TLR4， MyD88， NF-κB p65， and p-NF-κB p65 in Kupffer cells were analyzed via Western blot automated protein analysis. Hepatic IL-6， TNF-α， and IL-1β mRNA and protein levels were measured using Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot. ResultsCompared with the CON group， the SD-HFD group showed a decrease in D-xylose excretion （P<0.01）. TC， TG， HDL-C， and LDL-C increased （P<0.05， P<0.01）. A large number of hepatic lipid vacuoles and orange-red lipid droplet deposition appeared in the liver. Ileal LPS， portal LPS， and LBP increased （P<0.05， P<0.01）. The levels of serum IL-6， TNF-α， and IL-1β increased （P<0.01）. The expression of CD86 was upregulated （P<0.01）， and the co-expression of CD68 and TLR4 was enhanced. The protein levels of TLR4， MyD88， and p-p65 in Kupffer cells increased （P<0.01）. The mRNA and protein levels of IL-6， TNF-α， and IL-1β increased （P<0.05， P<0.01）. Compared with the HFD group， the SD-HFD group exhibited decreased D-xylose excretion （P<0.01）， higher HDL-C， LDL-C （P<0.05）， increased portal LBP and LPS （P<0.05）， increased serum IL-6 and TNF-α （P<0.01）， upregulated CD86 （P<0.01）， enhanced CD68/TLR4 co-expression， and higher TNF-α mRNA/protein （P<0.05）. Compared with the SD-HFD group， all M-XSLJZ treatment groups showed reduced TC， TG， and LDL-C （P<0.05， P<0.01）. XS-H and R groups displayed improved hepatic lipid deposition. XS-H and R groups had lower ileal LPS， portal LPS， and LBP levels （P<0.05， P<0.01）. All M-XSLJZ treatment groups exhibited reduced serum IL-6， IL-1β， and TNF-α （P<0.01）. The XS-H group showed downregulated CD86 （P<0.01） and weakened CD68/TLR4 co-expression. The XS-H group had reduced TLR4， MyD88， and p-NF-κB p65 in Kupffer cells （P<0.01）. XS-H and R groups showed lower IL-6， TNF-α， and IL-1β mRNA/protein （P<0.05， P<0.01）. ConclusionM-XSLJZ may exert its lipid-lowering effects by inhibiting intestinal-derived LPS and alleviating Kupffer cell inflammation in the liver.

ObjectiveTo develop a scientifically rigorous and contextually appropriate instrument for evaluating the health service experience of pulmonary tuberculosis patients in China, to enable systematic assessment of core medical care dimensions, and to provide quantitative evidence for service improvement. MethodsGrounded in the theoretical framework of healthcare accessibility and the clinical care pathway for tuberculosis patients, the tool was developed through a systematic literature review and the Delphi expert consultation method. A multi-stage cluster sampling strategy was employed to survey pulmonary tuberculosis patients who had been receiving treatment for more than two months, aimed to explore the scale’s applicability in real-world settings. Reliability was assessed using Cronbach’s α and split-half reliability coefficients. Validity was evaluated through content validity, structural validity, convergent validity, and discriminant validity. ResultsThe tool was composed of 21 items across four dimensions: awareness, accessibility, affordability, and acceptability of tuberculosis medical care. It demonstrated a Cronbach’s α coefficient of 0.838 and a split-half reliability coefficient of 0.859. Exploratory factor analyses extracted six factors: satisfaction with healthcare services, supportive role of nurses, affordability of treatment costs, doctor-patient communication, waiting time for medical appointments, and transportation cost. The goodness-of-fit index (GFI) and other indices met the recommended standards, with the loading matrix indicating robust structural validity of the tool. The constructed factor model exhibited satisfactory content validity and discriminant validity. ConclusionThe scale for assessing patients’ experiences with tuberculosis-related medical care developed in this study demonstrates good reliability and validity and serves as a practical tool for evaluating patient experiences of tuberculosis medical care in China.

HDAC7, a member of class IIa HDACs, plays a pivotal regulatory role in tumor, immune, fibrosis, and angiogenesis, rendering it a potential therapeutic target. Nevertheless, due to the high similarity in the enzyme active sites of class IIa HDACs, inhibitors encounter challenges in discerning differences among them. Furthermore, the substitution of key residue in the active pocket of class IIa HDACs renders them pseudo-enzymes, leading to a limited impact of enzymatic inhibitors on their function. In this study, proteolysis targeting chimera (PROTAC) technology was employed to develop HDAC7 drugs. We developed an exceedingly selective HDAC7 PROTAC degrader B14 which showcased superior inhibitory effects on cell proliferation compared to TMP269 in various diffuse large B cell lymphoma (DLBCL) and acute myeloid leukemia (AML) cells. Subsequent investigations unveiled that B14 disrupts BCL6 forming a transcriptional inhibition complex by degrading HDAC7, thereby exerting proliferative inhibition in DLBCL. Our study broadened the understanding of the non-enzymatic functions of HDAC7 and underscored the importance of HDAC7 in the treatment of hematologic malignancies, particularly in DLBCL and AML.