Objective To elucidate the molecular mechanism of sirtuin-3 (SIRT3) in regulating mitochondrial biogenesis in human renal tubular epithelial cells. Methods Cells were stimulated with different concentrations of H₂O₂ and divided into four groups: control (NC), 50 μmol/L H₂O₂, 110 μmol/L H₂O₂ and 150 μmol/L H₂O₂. SIRT3 protein expression was then measured. SIRT3 was knocked down with siRNA, and cells were further assigned to five groups: control (NC), negative-control siRNA (NCsi), SIRT3-siRNA (siSIRT3), NCsi+H₂O₂, and siSIRT3+H₂O₂. After 24 h, cellular adenosine triphosphate (ATP) and mitochondrial superoxide anion (O₂•⁻) levels were determined, together with mitochondrial expression of SIRT3, peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α), nuclear respiratory factor 1 (NRF1), mitochondrial transcription factor A (TFAM), superoxide dismutase 2 (SOD2), acetylated-SOD2 and adenosine monophosphate activated protein kinase α1 (AMPKα1). Results The 110 and 150 μmol/L H₂O₂ decreased SIRT3 protein (both P<0.05). ATP and mitochondrial O₂•⁻ did not differ between NC and NCsi groups (both P>0.05). Compared to the NCsi group, the siSIRT3 group exhibited elevated O₂•⁻ level, decreased SIRT3 protein and increased expression levels of SOD2 and acetylated SOD2 protein (all P<0.05). Compared to the NCsi group, the NCsi+H₂O₂ group exhibited decreased cellular ATP levels, elevated mitochondrial O₂•⁻ levels, and reduced protein expression levels of SIRT3, SOD2, TFAM, AMPKα1, PGC-1α and NRF1 (all P<0.05). Compared with the siSIRT3 group, the siSIRT3+H₂O₂ group showed a decrease in cellular ATP levels, an increase in mitochondrial O₂•⁻ levels, a decrease in SIRT3, SOD2, TFAM, AMPKα1, PGC-1α and NRF1 protein expression levels and a decrease in acetylated SOD2 protein expression levels (all P<0.05). Compared with the NCsi+H₂O₂ group, the siSIRT3+H₂O₂ group showed a decrease in cellular ATP levels, an increase in mitochondrial O₂•⁻ levels, a decrease in SIRT3, AMPKα1, PGC-1α and NRF1, TFAM protein expression levels, and an increase in SOD2 and acetylated SOD2 protein expression levels (all P<0.05). Conclusions SIRT3 promotes mitochondrial biogenesis in tubular epithelial cells via the AMPK/PGC-1α/NRF1/TFAM axis, representing a key mechanism through which SIRT3 ameliorates oxidative stress-induced mitochondrial dysfunction.

Objective To evaluate the diagnostic performance of the minimum-cost-path-based CT angiography-derived fractional flow reserve(MCP-FFR)and the deep learning-driven CT angiography-derived fractional flow reserve(DeepCL-FFR),and to particularly explore the potential value of the DeepCL algorithm in improving diagnostic accuracy within the"gray zone."Methods A retrospective analysis was conducted on 151 coronary vessels from 109 patients with coronary artery disease,who were hospitalized at the General Hospital of the People's Liberation Army between January 2020 and June 2021.Pearson correlation and Bland-Altman plots were employed to assess the correlation and agreement of the two CT-FFR methods with invasive FFR.A CT-FFR range of 0.70-0.80 was defined as the diagnostic"gray zone."The accuracy,sensitivity,specificity,positive predictive value,and negative predictive value for detecting hemodynamic abnormalities were calculated and analyzed.The DeLong test was used to compare the areas under the receiver operating characteristic curves(AUC)between the two CT-FFR calculation methods.Results Both CT-FFR methods exhibited a positive correlation with invasive FFR(MCP-FFR:r=0.75,P＜0.001;DeepCL-FFR:r=0.86,P＜0.001)and showed good agreement(MCP-FFR:mean difference=0.010,P=0.351;DeepCL-FFR:mean difference=-0.003,P=0.772).Both DeepCL-FFR(AUC 0.97,95％CI 0.94-0.99)and MCP-FFR(AUC 0.92,95％CI 0.88-0.97)demonstrated favorable diagnostic performance for detecting hemodynamic abnormalities(P=0.122).In the"gray zone"for hemodynamic abnormality,the diagnostic accuracy of MCP-FFR was 68.8％,whereas DeepCL-FFR increased it to 89.7％.DeepCL-FFR also exhibited superior diagnostic performance(AUC 0.89,95％CI 0.73-0.99)within the"gray zone,"which was significantly higher than that of MCP-FFR(AUC 0.71,95％CI 0.54-0.87)(P＜0.001).Conclusions The deep learning-driven coronary centerline extraction algorithm,DeepCL,demonstrates superior diagnostic performance in CT-FFR for detecting hemodynamic abnormalities,particularly by significantly improving diagnostic accuracy in the"gray zone."

BACKGROUND:Traditional therapies for temporomandibular joint disorders are limited by the severity of the condition and individual differences.In contrast,tissue engineering,as an emerging therapeutic approach,offers personalized treatment options tailored to the specific needs of patients,reducing uncertainties during surgical procedures,and enhancing clinical outcomes.OBJECTIVE:To summarize the latest research achievements and advancements in tissue engineering for temporomandibular joint repair.METHODS:Literature searches were conducted on PubMed and China National Knowledge Infrastructure(CNKI)databases using the Chinese and English search terms"temporomandibular joint,tissue engineering,seed cell,scaffold,growth factor,animal model."The search period covered the inception of each database up to March 2024.Literature screening was performed by analyzing and reviewing relevant articles according to exclusion criteria,ultimately including 57 articles for review.RESULTS AND CONCLUSION:(1)With advancements in biology,materials science,and engineering,significant progress has been made in temporomandibular joint tissue engineering,including the selection of seed cells,development of novel scaffolds,exploration of growth factor mechanisms,and construction of various animal models.Most studies are still in the in vitro experimental stage,and in vivo studies such as animal experiments are not yet widely conducted.The clinical application of tissue engineering in repairing the temporomandibular joint requires more evidence.(2)Despite the remaining challenges and issues to be addressed in temporomandibular joint tissue engineering research,it still presents vast clinical application prospects and is poised to become an excellent and efficient treatment modality for temporomandibular joint disorders in the future.

AIM To compare total sugar,total protein,total phenol,total flavonoid,calycosin-7-O-β-D-glucoside,liquiritin,lobetyolin,quercetin,isoferulic acid,hesperidin,glycyrrhizic acid contents and their antioxidant activities,hypoglycemic activities of big honey pill,small honey pill,water pill,concentrated pill,granule,mixture and decoction of Buzhong Yiqi Recipe.METHODS Anthraquinone-sulfuric acid method,Coomassie brilliant blue method,Folin-phenol colorimetry method,sodium nitrite-aluminum nitrate method and HPLC were adopted in the content determination of total sugar,total protein,total phenol,total flavonoid and seven constituents,respectively,after which the scavenging capacities,reducing powers on DPPH·free radical,ABTS+free radical,hydroxyl free radical,and inhibition capacity on α-glucosidase activity were detected.Subsequently,correlation analysis was performed.RESULTS Total sugar,total protein,total phenol and total flavonoid contents demonstrated significant differences among different dosage forms(P＜0.05,P＜0.01).Calycosin-7-O-β-D-glucoside,glycyrrhizin,codonoside and quercetin displayed the highest contents in the decoction,while those of isoferulic acid,hesperidin and glycyrrhizin were observable in the mixture.The water pill exhibited the strongest antioxidant activity,while those of the concentrated pill and mixture were weak;the big honey pill exhibited the strongest hypoglycemic activity,while that of the decoction was the weakest.Total protein,total phenol,total flavonoid and liquiritin contents displayed significant positive correlations between antioxidant activity(P＜0.05,P＜0.01),while hesperidin content displayed significant negative correlation between the latter(P＜0.05);total protein,calycosin-7-O-β-D-glucoside,codonoside and quercetin contents displayed significant negative correlations between hypoglycemic activity(P＜0.05,P＜0.01).CONCLUSION Active constituent contents and their biological activities of Buzhong Yiqi Recipe with different dosage forms exist differences,total sugar,total protein,total flavonoids,calycosin-7-O-β-D-glucoside,licorice glycoside,hesperidin,codonoside and quercetin can be taken as quality control indices for this prescription.

Objective To evaluate the diagnostic performance of the minimum-cost-path-based CT angiography-derived fractional flow reserve(MCP-FFR)and the deep learning-driven CT angiography-derived fractional flow reserve(DeepCL-FFR),and to particularly explore the potential value of the DeepCL algorithm in improving diagnostic accuracy within the"gray zone."Methods A retrospective analysis was conducted on 151 coronary vessels from 109 patients with coronary artery disease,who were hospitalized at the General Hospital of the People's Liberation Army between January 2020 and June 2021.Pearson correlation and Bland-Altman plots were employed to assess the correlation and agreement of the two CT-FFR methods with invasive FFR.A CT-FFR range of 0.70-0.80 was defined as the diagnostic"gray zone."The accuracy,sensitivity,specificity,positive predictive value,and negative predictive value for detecting hemodynamic abnormalities were calculated and analyzed.The DeLong test was used to compare the areas under the receiver operating characteristic curves(AUC)between the two CT-FFR calculation methods.Results Both CT-FFR methods exhibited a positive correlation with invasive FFR(MCP-FFR:r=0.75,P＜0.001;DeepCL-FFR:r=0.86,P＜0.001)and showed good agreement(MCP-FFR:mean difference=0.010,P=0.351;DeepCL-FFR:mean difference=-0.003,P=0.772).Both DeepCL-FFR(AUC 0.97,95％CI 0.94-0.99)and MCP-FFR(AUC 0.92,95％CI 0.88-0.97)demonstrated favorable diagnostic performance for detecting hemodynamic abnormalities(P=0.122).In the"gray zone"for hemodynamic abnormality,the diagnostic accuracy of MCP-FFR was 68.8％,whereas DeepCL-FFR increased it to 89.7％.DeepCL-FFR also exhibited superior diagnostic performance(AUC 0.89,95％CI 0.73-0.99)within the"gray zone,"which was significantly higher than that of MCP-FFR(AUC 0.71,95％CI 0.54-0.87)(P＜0.001).Conclusions The deep learning-driven coronary centerline extraction algorithm,DeepCL,demonstrates superior diagnostic performance in CT-FFR for detecting hemodynamic abnormalities,particularly by significantly improving diagnostic accuracy in the"gray zone."

BACKGROUND:Traditional therapies for temporomandibular joint disorders are limited by the severity of the condition and individual differences.In contrast,tissue engineering,as an emerging therapeutic approach,offers personalized treatment options tailored to the specific needs of patients,reducing uncertainties during surgical procedures,and enhancing clinical outcomes.OBJECTIVE:To summarize the latest research achievements and advancements in tissue engineering for temporomandibular joint repair.METHODS:Literature searches were conducted on PubMed and China National Knowledge Infrastructure(CNKI)databases using the Chinese and English search terms"temporomandibular joint,tissue engineering,seed cell,scaffold,growth factor,animal model."The search period covered the inception of each database up to March 2024.Literature screening was performed by analyzing and reviewing relevant articles according to exclusion criteria,ultimately including 57 articles for review.RESULTS AND CONCLUSION:(1)With advancements in biology,materials science,and engineering,significant progress has been made in temporomandibular joint tissue engineering,including the selection of seed cells,development of novel scaffolds,exploration of growth factor mechanisms,and construction of various animal models.Most studies are still in the in vitro experimental stage,and in vivo studies such as animal experiments are not yet widely conducted.The clinical application of tissue engineering in repairing the temporomandibular joint requires more evidence.(2)Despite the remaining challenges and issues to be addressed in temporomandibular joint tissue engineering research,it still presents vast clinical application prospects and is poised to become an excellent and efficient treatment modality for temporomandibular joint disorders in the future.

Objective:To explore expression changes of different vascular endothelial growth factor A (VEGFA) isoforms in human retinal pigment epithelial cell line ARPE-19 cells under high glucose conditions.Methods:ARPE-19 cells were divided into blank control group, control group 1, control group 2, HG1 group, and HG2 group treated with 5.5 mmol/L glucose, 5.5 mmol/L glucose+ 19.5 mmol/L mannitol, 5.5 mmol/L glucose+ 44.5 mmol/L mannitol, 25.0 mmol/L glucose, and 50.0 mmol/L glucose, respectively.The blank control group, control group 1, and control group 2 were treated for 72 hours, while HG1 and HG2 groups were treated for 24, 48, and 72 hours.The relative expression of VEGFA isoforms was detected by fluorescent quantitative PCR.Total VEGFA, SERPINF1 (pigment epithelium-derived factor, PEDF), a negative regulator of VEGF signaling, and VEGF165 (V4, 5, 10) protein expression was measured by Western blot.Results:Total VEGFA mRNA and protein expression in ARPE-19 cells showed statistically significant differences at both 25 mmol/L and 50 mmol/L glucose concentrations across different culture periods (mRNA: F=114.60, 143.60; both P<0.05.protein: F=10.00, 8.04; both P<0.05). Compared to the respective controls, the relative expression of total VEGFA mRNA and protein increased significantly at 24, 48, and 72 hours after treatment (all P<0.05). There was no significant difference in SERPINF1 (PEDF) mRNA or protein expression in ARPE-19 cells across different time points at 25 mmol/L or 50 mmol/L glucose concentrations (mRNA: F=0.86, 0.32; both P>0.05.protein: F=1.25, 0.08; both P>0.05). The mRNA expression levels of VEGFA isoforms in ARPE-19 cells from highest to lowest were VEGF165(V4, 5, 10), VEGF121(V6), VEGF189(V2), VEGF111(V8) and VEGF165b(V7). The relative VEGF111(V8) mRNA expression level was significantly lower in HG1-24 hour group than in control group 1, the relative VEGF189(V2) and VEGF121(V6) mRNA expression levels were significantly higher in HG1-48 hour group than in control group 1, the relative VEGF121(V6) and VEGF165b(V7) mRNA expression levels were significantly higher in HG1-72 hour group than in control group 1, with statistically significant differences (all P<0.05). The relative VEGF111(V8) and VEGF165(V4, 5, 10) mRNA expression levels were significantly higher in the HG2-24 hour group than in control group 2, the relative VEGF165(V4, 5, 10) and VEGF165b(V7) mRNA expression levels were significantly higher in HG2-48 hour group than control group 2, and the relative VEGF189(V2), VEGF111(V8), VEGF165(V4, 5, 10), and VEGF165b(V7) mRNA expression levels were significantly higher in HG2-72 hour group than in control group 2, with statistically significant differences (all P<0.05). The relative VEGF165(V4, 5, 10) protein expression levels in blank control group, control group 1, HG1-24 hour group, HG1-48 hour group, and HG1-72 hour group were 1.01±0.07, 1.05±0.07, 1.16±0.06, 1.37±0.08, and 1.28±0.05, respectively, with a statistically significant overall difference ( F=10.36, P<0.05). The relative VEGF165(V4, 5, 10) protein expression level was significantly higher in HG1-48 hour group than in control group 1 ( P<0.05). The relative protein expression levels of VEGF165(V4, 5, 10) in blank control group, control group 2, HG2-24 hour group, HG2-48 hour group, and HG2-72 hour group were 1.02±0.05, 1.12±0.00, 1.22±0.05, 1.53±0.21, and 1.77±0.04, respectively, with a statistically significant overall difference ( F=16.55, P<0.001). The relative VEGF165(V4, 5, 10) protein levels were significantly higher in HG2-48 hour group and HG2-72 hour group than in control group 2 (both P<0.05). Conclusions:In ARPE-19 cells, mRNA abundance of VEGFA isoforms from highest to lowest were VEGF165(V4, 5, 10), VEGF121(V6), VEGF189(V2), VEGF111(V8), VEGF165b(V7). VEGF121(V6) mRNA expression level is significantly increased at 25 mmol/L high glucose concentration, whereas VEGF165(V4, 5, 10) mRNA expression level shows significant elevation only at 50 mmol/L high glucose.Under both high glucose conditions, isoforms with significantly elevated mRNA expression levels are VEGF189(V2) and VEGF165b(V7), while SERPINF1 (PEDF) expression level does not change significantly.

Objective:To explore expression changes of different vascular endothelial growth factor A (VEGFA) isoforms in human retinal pigment epithelial cell line ARPE-19 cells under high glucose conditions.Methods:ARPE-19 cells were divided into blank control group, control group 1, control group 2, HG1 group, and HG2 group treated with 5.5 mmol/L glucose, 5.5 mmol/L glucose+ 19.5 mmol/L mannitol, 5.5 mmol/L glucose+ 44.5 mmol/L mannitol, 25.0 mmol/L glucose, and 50.0 mmol/L glucose, respectively.The blank control group, control group 1, and control group 2 were treated for 72 hours, while HG1 and HG2 groups were treated for 24, 48, and 72 hours.The relative expression of VEGFA isoforms was detected by fluorescent quantitative PCR.Total VEGFA, SERPINF1 (pigment epithelium-derived factor, PEDF), a negative regulator of VEGF signaling, and VEGF165 (V4, 5, 10) protein expression was measured by Western blot.Results:Total VEGFA mRNA and protein expression in ARPE-19 cells showed statistically significant differences at both 25 mmol/L and 50 mmol/L glucose concentrations across different culture periods (mRNA: F=114.60, 143.60; both P<0.05.protein: F=10.00, 8.04; both P<0.05). Compared to the respective controls, the relative expression of total VEGFA mRNA and protein increased significantly at 24, 48, and 72 hours after treatment (all P<0.05). There was no significant difference in SERPINF1 (PEDF) mRNA or protein expression in ARPE-19 cells across different time points at 25 mmol/L or 50 mmol/L glucose concentrations (mRNA: F=0.86, 0.32; both P>0.05.protein: F=1.25, 0.08; both P>0.05). The mRNA expression levels of VEGFA isoforms in ARPE-19 cells from highest to lowest were VEGF165(V4, 5, 10), VEGF121(V6), VEGF189(V2), VEGF111(V8) and VEGF165b(V7). The relative VEGF111(V8) mRNA expression level was significantly lower in HG1-24 hour group than in control group 1, the relative VEGF189(V2) and VEGF121(V6) mRNA expression levels were significantly higher in HG1-48 hour group than in control group 1, the relative VEGF121(V6) and VEGF165b(V7) mRNA expression levels were significantly higher in HG1-72 hour group than in control group 1, with statistically significant differences (all P<0.05). The relative VEGF111(V8) and VEGF165(V4, 5, 10) mRNA expression levels were significantly higher in the HG2-24 hour group than in control group 2, the relative VEGF165(V4, 5, 10) and VEGF165b(V7) mRNA expression levels were significantly higher in HG2-48 hour group than control group 2, and the relative VEGF189(V2), VEGF111(V8), VEGF165(V4, 5, 10), and VEGF165b(V7) mRNA expression levels were significantly higher in HG2-72 hour group than in control group 2, with statistically significant differences (all P<0.05). The relative VEGF165(V4, 5, 10) protein expression levels in blank control group, control group 1, HG1-24 hour group, HG1-48 hour group, and HG1-72 hour group were 1.01±0.07, 1.05±0.07, 1.16±0.06, 1.37±0.08, and 1.28±0.05, respectively, with a statistically significant overall difference ( F=10.36, P<0.05). The relative VEGF165(V4, 5, 10) protein expression level was significantly higher in HG1-48 hour group than in control group 1 ( P<0.05). The relative protein expression levels of VEGF165(V4, 5, 10) in blank control group, control group 2, HG2-24 hour group, HG2-48 hour group, and HG2-72 hour group were 1.02±0.05, 1.12±0.00, 1.22±0.05, 1.53±0.21, and 1.77±0.04, respectively, with a statistically significant overall difference ( F=16.55, P<0.001). The relative VEGF165(V4, 5, 10) protein levels were significantly higher in HG2-48 hour group and HG2-72 hour group than in control group 2 (both P<0.05). Conclusions:In ARPE-19 cells, mRNA abundance of VEGFA isoforms from highest to lowest were VEGF165(V4, 5, 10), VEGF121(V6), VEGF189(V2), VEGF111(V8), VEGF165b(V7). VEGF121(V6) mRNA expression level is significantly increased at 25 mmol/L high glucose concentration, whereas VEGF165(V4, 5, 10) mRNA expression level shows significant elevation only at 50 mmol/L high glucose.Under both high glucose conditions, isoforms with significantly elevated mRNA expression levels are VEGF189(V2) and VEGF165b(V7), while SERPINF1 (PEDF) expression level does not change significantly.

AIM To compare total sugar,total protein,total phenol,total flavonoid,calycosin-7-O-β-D-glucoside,liquiritin,lobetyolin,quercetin,isoferulic acid,hesperidin,glycyrrhizic acid contents and their antioxidant activities,hypoglycemic activities of big honey pill,small honey pill,water pill,concentrated pill,granule,mixture and decoction of Buzhong Yiqi Recipe.METHODS Anthraquinone-sulfuric acid method,Coomassie brilliant blue method,Folin-phenol colorimetry method,sodium nitrite-aluminum nitrate method and HPLC were adopted in the content determination of total sugar,total protein,total phenol,total flavonoid and seven constituents,respectively,after which the scavenging capacities,reducing powers on DPPH·free radical,ABTS+free radical,hydroxyl free radical,and inhibition capacity on α-glucosidase activity were detected.Subsequently,correlation analysis was performed.RESULTS Total sugar,total protein,total phenol and total flavonoid contents demonstrated significant differences among different dosage forms(P＜0.05,P＜0.01).Calycosin-7-O-β-D-glucoside,glycyrrhizin,codonoside and quercetin displayed the highest contents in the decoction,while those of isoferulic acid,hesperidin and glycyrrhizin were observable in the mixture.The water pill exhibited the strongest antioxidant activity,while those of the concentrated pill and mixture were weak;the big honey pill exhibited the strongest hypoglycemic activity,while that of the decoction was the weakest.Total protein,total phenol,total flavonoid and liquiritin contents displayed significant positive correlations between antioxidant activity(P＜0.05,P＜0.01),while hesperidin content displayed significant negative correlation between the latter(P＜0.05);total protein,calycosin-7-O-β-D-glucoside,codonoside and quercetin contents displayed significant negative correlations between hypoglycemic activity(P＜0.05,P＜0.01).CONCLUSION Active constituent contents and their biological activities of Buzhong Yiqi Recipe with different dosage forms exist differences,total sugar,total protein,total flavonoids,calycosin-7-O-β-D-glucoside,licorice glycoside,hesperidin,codonoside and quercetin can be taken as quality control indices for this prescription.

Objective:To explore the short-term clinical effects of deep cervical lymph node-venous anastomosis in the treatment of Alzheimer’s disease (AD).Methods:A prospective exploratory study was conducted on the treatment of AD patients using the cervical deep lymph node-venous anastomosis technique in Scar and Wound Treatment Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, from September to October 2024. The patients underwent high-frequency ultrasound to locate deep cervical lymph nodes and the external jugular vein. Under general anesthesia, bilateral deep cervical lymph node-venous anastomoses were performed. Indocyanine green (ICG) lymphography was conducted via subcutaneous injection behind the ear to visualize lymph nodes in levels Ⅱ and Ⅲ. After making a skin incision along the posterior margin of the sternocleidomastoid muscle, the external jugular vein, internal jugular veins, and associated lymph nodes were exposed. Adjacent veins were selected for anastomosis of lymph node. Using microsurgical techniques, end-to-side or end-to-end anastomosis was completed for lymph nodes in levels Ⅱ and Ⅲ. Preoperative assessments included the mini-mental state examination (MMSE, a higher score indicates better cognitive function), Alzheimer’s disease assessment scale-cognitive subscale (ADAS-Cog, a higher score indicates greater impairment of cognitive function), Alzheimer’s disease cooperative study scale for activities of daily living (ADCS-ADL, a higher score indicates better ability to perform daily activity), and neuropsychiatric inventory (NPI, a higher score indicates more severe behavioral and emotional symptom). Postoperative follow-up included the same scales to observe changes in cognitive function, activities of daily living, and emotional communication.Results:Four patients (1 male, 3 females, aged 58-79 years) with AD were included. All were diagnosed based on cerebrospinal fluid biomarkers. All patients successfully underwent bilateral deep cervical lymph node-venous anastomoses. On average, 4.3 (2-7 per person) anastomoses were performed per patient. Surgical procedures lasted an average of 6.5 h (5.5-8.5 h) with minimal blood loss (less than 50 ml). Patients resumed normal activity within 6 hours postoperatively and were discharged after an average of 4.1 d (3.5-5.0 d). Postoperative complications included one case each of aspiration pneumonia, lower limb venous thrombosis, and transient delirium, all of whom resolved without long-term effects. Clinical symptoms, including memory decline, mood swings, and anxiety, showed varying degrees of improvement. Patients reported enhanced quality of life, emotional stability, and social engagement, confirming the procedure’s safety and potential cognitive benefits. At one month postoperatively, the MMSE scores of the four patients increased by an average of 0.8 points compared to preoperative levels. Additionally, the two patients who completed the ADAS-Cog assessments showed a decrease in their scores (reduced by 1.0 points and 11.3 points, respectively, compared to preoperative scores), indicating a certain degree of improvement in cognitive function during this period. The ADCS-ADL and NPI scores of four patients varied significantly, without showing any clear pattern.Conclusion:Lymphovenous anastomosis of the deep cervical lymph node-venous anastomosis may provide a new surgical intervention approach for AD, but further large-scale studies and long-term follow-up are needed to validate its safety and effectiveness.