Objective: To understand the current status, international cooperation, research hotspots, and development trends of nutritional studies on patients with head and neck cancer from 2014 to 2024, and to predict future research trends. Methods: The Web of Science Core Collection database was searched to retrieve nutritional studies on patients with head and neck cancer from January 2014 to March 2024. The type of studies were “articles,” the language was English, CiteSpace 6.1 R6 software was used to conduct the bibliometric analysis, and the results were visualized to form a scientific knowledge map. Results: A total of 1 528 documents were retrieved, with a linear increase in the number of annual publications. The country with the highest number of publications was the United States, and the institution with the highest number of publications was the University of Queensland, with closer collaboration between authors and institutions. The most frequently cited publication was a set of nutrition guidelines, and the highest-impact articles were mainly concerned with performing percutaneous endoscopic gastrostomy. Keyword analysis showed that quality of life, radiotherapy, and weight loss were the keywords of highest interest. The keyword cluster analysis resulted in 17 clusters, which were divided into five main categories: head and neck cancer, treatment, outcome results, intervention modalities, and rehabilitation. Body composition, enteral nutrition, and accelerated postoperative rehabilitation were persistent research hotspots. Keyword highlighting revealed that “enhanced recovery after surgery” has been the focus of research in the last two years, with “index” and “model” emerging as theme words. Conclusion The number of publications in the literature related to nutrition for patients with head and neck cancer has increased annually over the past 10 years. The research hotspots mainly focus on the quality of life and weight loss during radiotherapy, the content and application prospect of body composition assessment, different modes of nutritional support interventions and enteral nutritional tube feeding routes, and perioperative nutritional management in enhanced recovery after surgery. The potential clinical value of preoperative nutritional intervention under the concept of enhanced recovery and the construction of new types of nutritional index are the trends of future research.

Objective To systematically evaluate the published models in prediction of the risk of lung infections in elderly patients with hip fracture so as to provide a guidance for medical workers in selection or development of suitable risk prediction models.Methods Relevant studies were searched from databases including CNKI,Wanfang Data,VIP,SinoMed,PubMed,Web of Science,Cochrane Library,Embase and CINAHL,from the inception to 31st January,2024.Data were extracted from the selected literature and a bias assessment tool of risk predictive model was used to evaluate the risk of bias and applicability of the included literature.Results A total of 1,035 articles were retrieved,of which seven studies involving 13 predictive models were finally included after screening.The sample sizes ranged from 305 to 2,669 cases and lung infection rates ranged from 5.40%to 20.02%.The repeatedly reported predictors included age,gender,chronic obstructive pulmonary disease,hypoproteinaemia,American Society of Anesthesiologists(ASA)Physical Status Classification and white blood cell count.In the 13 models constructed,the reported area under the curve(AUC)of subjects'job characteristics ranged from 0.667 to 0.996.Five out of seven studies had good overall applicability,but all with high risk of bias.Conclusion The predictive models for lung infections in elderly patients with hip fracture are still in the stage of development.Although the predictive models show some predictive performance,however they are still deficient,and all studies have been found with a high risk in bias.

Objective To systematically evaluate the published models in prediction of the risk of lung infections in elderly patients with hip fracture so as to provide a guidance for medical workers in selection or development of suitable risk prediction models.Methods Relevant studies were searched from databases including CNKI,Wanfang Data,VIP,SinoMed,PubMed,Web of Science,Cochrane Library,Embase and CINAHL,from the inception to 31st January,2024.Data were extracted from the selected literature and a bias assessment tool of risk predictive model was used to evaluate the risk of bias and applicability of the included literature.Results A total of 1,035 articles were retrieved,of which seven studies involving 13 predictive models were finally included after screening.The sample sizes ranged from 305 to 2,669 cases and lung infection rates ranged from 5.40%to 20.02%.The repeatedly reported predictors included age,gender,chronic obstructive pulmonary disease,hypoproteinaemia,American Society of Anesthesiologists(ASA)Physical Status Classification and white blood cell count.In the 13 models constructed,the reported area under the curve(AUC)of subjects'job characteristics ranged from 0.667 to 0.996.Five out of seven studies had good overall applicability,but all with high risk of bias.Conclusion The predictive models for lung infections in elderly patients with hip fracture are still in the stage of development.Although the predictive models show some predictive performance,however they are still deficient,and all studies have been found with a high risk in bias.

Toxic Chinese herbal medicines(TCHMs)both represent a unique class of therapeutic agents that exhibit both potent efficacy("using toxins to combat pathogens and often curing critical con-ditions")and pose safety concerns("potentially causing severe harm").Balancing clinical effectiveness with safe applications remains a priority of research for these substances.This review summarizes the hepatotoxic mechanisms,research progress,detoxification strategies and clinical challenges associated with TCHMs documented in the 2025 Pharmacopoeia of the People's Republic of China(Volume Ⅰ)in the hope of providing evidence-based insights into the safe and rational clinical use of these hepatotoxic herbs.

Toxic Chinese herbal medicines(TCHMs)both represent a unique class of therapeutic agents that exhibit both potent efficacy("using toxins to combat pathogens and often curing critical con-ditions")and pose safety concerns("potentially causing severe harm").Balancing clinical effectiveness with safe applications remains a priority of research for these substances.This review summarizes the hepatotoxic mechanisms,research progress,detoxification strategies and clinical challenges associated with TCHMs documented in the 2025 Pharmacopoeia of the People's Republic of China(Volume Ⅰ)in the hope of providing evidence-based insights into the safe and rational clinical use of these hepatotoxic herbs.

Objective:To study the inhibitory effect of endothelial progenitor cells (EPCs) on aortic injury in mice with systemic lupus erythematosus (SLE) arteriosclerosis.Methods:APOE -/- mice were injected with norphytane and high fat diet to establish lupus vascular injury model. Then the mice were divided into normal control group (ND group), high fat diet group (HFD group), high fat diet+ SLE vascular injury group (HFD+ SLE group), high fat diet+ SLE vascular injury+ hydroxychloroquine treatment group (HFD+ SLE+ Hydro group), high fat diet+ SLE vascular injury+ EPCs treatment group (HFD+ SLE+ EPCs group). At the end of the experiment, urine, blood and aortic tissues of mice in each group were collected, and the content of urinary protein and the depth of serum type I interferon (IFN-Ⅰ) were detected by enzyme linked immunosorbent assay (ELISA). The activation of cyclic guanosine monophosphate synthase/interferon gene stimulating factor/type I interferon (cGAS/STING/IFN-Ⅰ) pathway, the levels of inflammatory factors, adhesion fractions and chemokines in the aorta of mice in each group were detected by immunohistochemistry and Western blotting (WB). The lipid deposition in the aorta was detected by oil red staining. Results:The results of ELISA showed that the levels of urinary protein and serum IFN-Ⅰ in HFD+ SLE group were higher than those in normal control group. EPCs treatment could reduce the levels of urinary protein and serum IFN-Ⅰ in SLE atherosclerotic mice. WB results showed that the expression of CD19, CD68, CD34, chemokine, cGAS, p-STING, phosphorylated TANK binding kinase 1 (p-TBK1), phosphorylated interferon regulatory factor 3 (p-IRF3) and IFN-Ⅰ increased in HFD+ SLE group, and hydroxychloroquine and EPCs decreased the levels of these factors. CGAS/STING/IFN-Ⅰ signal pathway is involved in the occurrence and development of atherosclerosis in SLE patients; both EPCs and hydroxychloroquine can inhibit the activation of cGAS/STING/IFN-Ⅰ signal, thus reducing atherosclerosis in SLE mice.Conclusions:cGAS/STING/IFN-Ⅰ pathway is involved in the development of SLE atherosclerosis. EPCs can inhibit the activation of cGAS/STING signal, reduce the expression and secretion of IFN-Ⅰ, and then reduce vascular inflammation and inhibit the development of SLE-related atherosclerosis.

Objective:To report on a case of Kabuki syndrome (KS) due to a novel variant of KMT2D gene. Methods:A child diagnosed with KS at the Fujian Children′s Hospital on July 25, 2022 was selected as the study subject. Whole exome sequencing was carried out for the child and her parents. Candidate variant was validated by Sanger sequencing and bioinformatic analysis.Results:The child, a 4-month-old female, had presented with distinctive facial features, growth retardation, cardiac malformations, horseshoe kidney, hypothyroidism, and recurrent aspiration pneumonia. Whole exome sequencing revealed that she has harbored a heterozygous c. 6285dup (p.Lys2096Ter) variant of the KMT2D gene. Sanger sequencing confirmed that neither of her parents had carried the same variant. The variant was previously unreported, and may result in a truncated protein and loss of an enzymatic activity region. The corresponding site of the variant is highly conserved. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was classified as pathogenic (PVS1+ PS2+ PM2_Supporting). Conclusion:The c. 6285 dup variant of the KMT2D gene probably underlay the KS in this child.

Objective To explore the effect of a phased rehabilitation training programme to relieve shoulder dys-function in patients after neck dissection and to provide effective solutions for postoperative shoulder joint function recov-ery of patients.Methods This study has been reviewed and approved by the Ethics Committee,and informed consent has been obtained from patients.A phased rehabilitaiton training programme for the shoulder after neck dessection was developed through literature review and discussion,and 70 eligible patients from Hospital of Stomatology,Sun Yat-sen University from December 2020 to April 2021 were selected and randomly divided into the test group and control group(35 patients in each group).The control group underwent motor rehabilitation training from 6 weeks postoperative to 1 year after surgery,such as shoulder mobility and coordination training and small range of motion training of the neck,while the test group took part in a rehabilitation training program that included familiarization maneuver training,protective rehabilitation,exercise rehabilitation,and resistance training in the following four stages:preoperative,postop-erative general anesthesia and awake until the removal of stitches,the removal of stitches until 6 weeks after surgery,and 6 weeks after surgery until 1 year after surgery.The frequency of training in both groups was at least 3 days per week,and the length of each training session was 10-15 min.The intensity of exercise was 2-3 points on the Borg Conscious Ex-ercise Intensity Scale(i.e.,mild-to-moderate tachypnea or fatigue).The neck dissection injury index(NDII)was used to evaluate the quality of life related to shoulder joint function at four time points:preoperative,postoperative 3 months,postoperative 6 months,and postoperative 12 months.The higher the score,the better the quality of life.Results 28 cases in the test group and 32 cases in the control group completed a one-year follow-up.At 3 and 6 months postopera-tive,the NDII of the test group was significantly higher than that of the control group[3 months postoperative:test group(93.48±9.36)vs.control group(80.00±11.34)(P＜0.001),6 months postoperative:test group(98.21±4.76)vs.control group(90.70±9.12)(P＜0.001)];12 months after surgery,the NDII of the test group(97.23±4.88)was still higher than that of the control group(96.33±4.49),but the difference was not statistically significant(P=0.458).The difference in NDII scores among subjects at 3,6,and 12 months after surgery was statistically significant in each group(P＜0.001).Conclusion The application of the phased rehabilitation training method in neck dissection patients has a feasibility and could improve the quality of life of patients'shoulder joint function within 6 months after surgery.

Objective:To explore the clinical manifestations and genotype of an infant with hyperuricemia, pulmonary hypertension, renal failure in infancy, and alkalosis syndrome (HUPRAS).Methods:Clinical data of the patient were collected. Peripheral blood samples from the patient and his parents were acquainted for whole exome sequencing. The filtrated variants were verified by Sanger sequencing. The pathogenicity of the variants was predicted by bioinformatic tools.Results:The patient is a male infant of 6 months old, carrying two missense variants in the SARS2 allele: a paternal inherited c.1205G>A (p. Arg402His) and a maternal inherited c.680G>A (p. Arg227Gln). The two variants were in extremely low population frequencies. The pathogenetic prediction tools categorized them as deleterious. Arg402 and Arg227 were highly conserved in evolution. The variants led to changes in the hydrogen bonds and hydrophobicity of seryl-tRNA synthetase encoded by SARS2.Conclusions:c.1205G>A (p. Arg402His) and c.680G>A (p. Arg227Gln) are the possible causative variants of the HUPRA syndrome.

Objective:To study the inhibitory effect of endothelial progenitor cells (EPCs) on aortic injury in mice with systemic lupus erythematosus (SLE) arteriosclerosis.Methods:APOE -/- mice were injected with norphytane and high fat diet to establish lupus vascular injury model. Then the mice were divided into normal control group (ND group), high fat diet group (HFD group), high fat diet+ SLE vascular injury group (HFD+ SLE group), high fat diet+ SLE vascular injury+ hydroxychloroquine treatment group (HFD+ SLE+ Hydro group), high fat diet+ SLE vascular injury+ EPCs treatment group (HFD+ SLE+ EPCs group). At the end of the experiment, urine, blood and aortic tissues of mice in each group were collected, and the content of urinary protein and the depth of serum type I interferon (IFN-Ⅰ) were detected by enzyme linked immunosorbent assay (ELISA). The activation of cyclic guanosine monophosphate synthase/interferon gene stimulating factor/type I interferon (cGAS/STING/IFN-Ⅰ) pathway, the levels of inflammatory factors, adhesion fractions and chemokines in the aorta of mice in each group were detected by immunohistochemistry and Western blotting (WB). The lipid deposition in the aorta was detected by oil red staining. Results:The results of ELISA showed that the levels of urinary protein and serum IFN-Ⅰ in HFD+ SLE group were higher than those in normal control group. EPCs treatment could reduce the levels of urinary protein and serum IFN-Ⅰ in SLE atherosclerotic mice. WB results showed that the expression of CD19, CD68, CD34, chemokine, cGAS, p-STING, phosphorylated TANK binding kinase 1 (p-TBK1), phosphorylated interferon regulatory factor 3 (p-IRF3) and IFN-Ⅰ increased in HFD+ SLE group, and hydroxychloroquine and EPCs decreased the levels of these factors. CGAS/STING/IFN-Ⅰ signal pathway is involved in the occurrence and development of atherosclerosis in SLE patients; both EPCs and hydroxychloroquine can inhibit the activation of cGAS/STING/IFN-Ⅰ signal, thus reducing atherosclerosis in SLE mice.Conclusions:cGAS/STING/IFN-Ⅰ pathway is involved in the development of SLE atherosclerosis. EPCs can inhibit the activation of cGAS/STING signal, reduce the expression and secretion of IFN-Ⅰ, and then reduce vascular inflammation and inhibit the development of SLE-related atherosclerosis.