ObjectiveTo evaluate the effects of Tongnaoyin on the blood-brain barrier status and neurological impairment in acute ischemic stroke （AIS） patients with the syndrome of phlegm-stasis blocking collaterals by dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI）. MethodsA total of 63 patients diagnosed with AIS in the Jiangsu Province Hospital of Chinese Medicine from October 2022 to December 2023 were enrolled in this study. According to random number table method，the patients were assigned into a control group （32 cases） and an observation group （31 cases）. The control group received conventional Western medical treatment，and the observation group took 200 mL Tongnaoyin after meals，twice a day from day 2 of admission on the basis of the treatment in the control group. After 7 days of treatment，the patients were examined by DCE-MRI. The baseline data for two groups of patients before treatment were compared. The National Institute of Health Stroke Scale （NIHSS） score and modified Rankin Scale （mRS） score were recorded before treatment and after 90 days of treatment for both groups. The rKtrans，rKep，and rVe values were obtained from the region of interest （ROI） of the infarct zone/mirror area and compared between the two groups. ResultsThere was no significant difference in the NIHSS or mRS score between the two groups before treatment. After 90 days of treatment，the NIHSS and mRS scores declined in both groups，and the observation group had lower scores than the control group （P<0.05）. After treatment，the rKtrans and rVe in the observation group were lower than those in the control group （P<0.01）. ConclusionCompared with conventional Western medical treatment alone，conventional Western medical treatment combined with Tongnaoyin accelerates the repair of the blood-brain barrier in AIS patients，thereby ameliorating neurological impairment after AIS to improve the prognosis.

Colorectal cancer (CRC) is one of the leading causes of cancer-related morbidity and mortality worldwide, highlighting the urgent need for novel preventive and therapeutic strategies. Emerging research highlights the crucial role of the gut microbiota, including bacteria, fungi, viruses, and their metabolites, in the pathogenesis of CRC. Dysbiosis, characterized by an imbalance in microbial composition, contributes to tumorigenesis through immune modulation, metabolic reprogramming, and genotoxicity. Specific bacterial species, such as Fusobacterium nucleatum and enterotoxigenic Bacteroides fragilis , along with fungal agents like Candida species, have been implicated in CRC progression. Moreover, viral factors, including Epstein-Barr virus and human cytomegalovirus, are increasingly recognized for their roles in promoting inflammation and immune evasion. This review synthesizes the latest evidence on host-microbiome interactions in CRC, emphasizing microbial metabolites, such as short-chain fatty acids and bile acids, which may act as both risk factors and therapeutic agents. We further discuss the latest advances in microbiota-targeted clinical applications, including biomarker-assisted diagnosis, next-generation probiotics, and microbiome-based interventions. A deeper understanding of the role of gut microbiome in CRC pathogenesis could pave the way for diagnostic, preventive, and personalized therapeutic strategies.
Humans ; Dysbiosis/microbiology* ; Colorectal Neoplasms/metabolism* ; Gastrointestinal Microbiome/physiology* ; Animals

Objective:To construct and evaluate the predictive performance of a multiphase ultrasound radiomics model for microvascular invasion（MVI）in hepatocellular carcinoma（HCC）.Methods:A total of 126 patients with pathologically confirmed HCC were retrospectively enrolled from 4 medical centers between May 2018 and July 2025，including the First Hospital of Shanxi Medical University，Shanxi Province Third People's Hospital，Changzhi People's Hospital，and the Organ Transplant Center of the Affiliated Hospital of Qingdao University. A total of 630 ultrasound images of the lesions in different phases were collected，from which 1 561 radiomic features were extracted. The patients from medical institutions in Shanxi Province were chosen as the training set（ n=91），and the patients from the Organ Transplant Center of the Affiliated Hospital of Qingdao University were chosen as the validation set（ n=35）. In the training set，37.4%（34/91）patients presented MVI（+），whereas in the validation set，54.3%（19/35）patients presented MVI（+）. Radiomics features were extracted from ultrasound images，and features related to the MVI（+）were selected through dimensionality reduction analysis. Five multiple machine learning algorithms were used to construct predictive models，which were then evaluated using an external validation set. The Radscore was calculated，and a nomogram was constructed combining Radscore with ultrasound and clinical characteristics to predict MVI. Results:The model combining radiomics features from the portal venous phase and the delay phase showed the best predictive performance in both the training and validation sets，with area under curve（AUC）values of 0.835 and 0.727，respectively. The prediction model developed using radiomics Radscore and clinical indicators could be represented and presented as a nomogram.Conclusions:The radiomics model based on multi-phase ultrasound offers a novel approach for non-invasive preoperative prediction of MVI in liver cancer. Furthermore，its integration with clinical features aids in optimizing clinical treatment strategies.

Objective:To explore the regulatory mechanism of OIP5-AS1 in chronic periodontitis(CP).Methods:Human perio-dontal ligament stem cells(PDLSC)were treated with LPS to establish an in vitro model of CP.Real-time quantitative polymerase chain reaction(qRT-PCR)was performed to detect the expression of OIP5-AS1,miR-143-3p and fibroblast growth factor 1(FGF1)mRNA in periodontal ligament tissues and PDLSCs of CP patients and healthy volunteers.3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide(MTT)method was performed to detect cell viability.Enzyme-linked immunosorbent assay(ELISA)was performed to measure the levels of inflammatory cytokines interleukin-1 β(IL-1 β),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α).Western blot was performed to detect Bax,Bcl-2 and FGF1 protein levels.A dual-luciferase reporter assay was performed to validate the targeting relationship between miR-143-3p and OIP5-AS1/FGF1.Results:The expression of OIP5-AS1 and FGF1 were decreased,and the expression of miR-143-3p was increased in CP patients and LPS-treated PDLSCs(P＜0.05).In LPS-treated PDLSCs,OIP5-AS1 overexpression promoted cell viability and inhibited inflammation and apoptosis(P＜0.05).In addition,OIP5-AS1 targeted miR-143-3p and negatively regulated miR-143-3p expression(P＜0.05).In LPS-treated PDLSCs,up-regulation of miR-143-3p attenuated the inhibitory effect of OIP5-AS1 overexpression on LPS-induced PDLSC dam-age(P＜0.05).miR-143-3p targeted FGF1 and negatively regulated FGF1 expression(P＜0.05).FGF1 overexpression attenuated the effect of co-overexpression of miR-143-3p and IP5-AS1 on LPS-induced damage(P＜0.05).Conclusion:OIP5-AS1 may at-tenuate LPS-induced PDLSC inflammatory response and apoptosis and enhance cell viability by regulating the miR-143-3p/FGF1 axis,which may provide a new target for CP therapy.

The 2022 WHO classification of endocrine and neuroendocrine tumors (5th edition) categorizes thyroid follicular cell-derived tumors into benign, low-risk, and malignant types. Benign tumors now include thyroid follicular nodular lesions. A newly added category previously termed "borderline tumors" have been revised to low-risk follicular cell-derived tumors, which encompass non-invasive follicular thyroid neoplasm with papillary-like nuclear features, thyroid tumors of uncertain malignant potential, and hyalinizing trabecular tumors. The new WHO classification stratifies malignant follicular cell-derived tumors based on molecular characteristics and invasiveness: papillary thyroid carcinoma (PTC) with various histological subtypes represents BRAF-like malignancies; invasive encapsulated follicular variant PTC and follicular thyroid carcinoma represent RAS-like malignancies. Oncocytic carcinoma is now recognized as a distinct entity, specifically referring to tumors composed of ≥75% oncocytic follicular cells lacking PTC nuclear features and high-grade characteristics (necrosis and mitotic figures ≥3/2 mm²). A new category termed "high-grade follicular cell-derived thyroid carcinoma" has been added, encompassing traditional poorly differentiated thyroid carcinoma and differentiated high-grade thyroid carcinoma. Anaplastic thyroid carcinoma(ATC) remains the most undifferentiated type, with thyroid squamous cell carcinoma now classified as a subtype of ATC. The term "papillary thyroid microcarcinoma" is no longer recommended as a distinct subtype. Cribriform-morular thyroid carcinoma is no longer classified as a subtype of PTC, but is instead categorized as a tumor of uncertain histogenesis.

Objective To analyze the influencing factors of symptom clusters during chemoradio-therapy in patients with cervical cancer.Methods A retrospective analysis was conducted on the clini-cal data of 776 patients diagnosed with cervical cancer during chemoradiotherapy.The M.D.Anderson Symptom Inventory(MDASI-D)was used to assess common symptoms and their severity in cancer pa-tients.Exploratory factor analysis was employed to extract symptom clusters.Univariate and multiple linear regression analyses were performed to screen for influencing factors of the major symptom clus-ters.Results Among 776 cervical cancer patients undergoing chemoradiotherapy,the five most prevalentsymptoms were fatigue,nausea,dry mouth,disturbed sleep and vomiting.Through explora-tory factor analysis,a total of four symptom clusters,namely the digestive tract symptom cluster,the somatic symptom cluster,the side effect symptom cluster and the emotional symptom cluster were ex-tracted.Multiple linear regression analysis revealed that age and Eastern Cooperative Oncology Group(ECOG)score were influencing factors for gastrointestinal symptom cluster(P＜0.05);age,educa-tional level,disease stage and ECOG performance status were influencing factors for physical symptom cluster(P＜0.05);age,educational level,monthly household income per capita,ECOG performance status and disease stage were influencing factors for the emotional symptom cluster(P＜0.05);the ECOG performance status,disease stage and comorbid chronic diseases were influencing factors for the side effect symptom cluster(P＜0.05).Conclusion Patients with cervical cancer frequently experi-ence gastrointestinal,emotional,physical and side effect symptom clusters during chemoradiotherapy.

Objective:To investigate the influencing factors and perinatal outcomes associated with monozygotic twins (MZT) following elective single embryo transfer (eSET) via in vitro fertilization or intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET). Methods:A retrospective cohort study was conducted on 12 079 patients who achieved pregnancy after undergoing IVF/ICSI-eSET at Reproductive Health Hospital of the Third Affiliated Hospital of Zhengzhou University between January 2015 and September 2023. Patients were stratified into two groups based on ultrasound findings 30 d post-transfer: singleton pregnancy group and MZT pregnancy group. Finally, 300 MZT and 1 500 single pregnancies, which were randomly matched according to 1∶5 were included by study period. General patients' characteristics, embryo-related factors, and perinatal outcomes were compared between the two groups. A multivariate logistic regression model was employed to identify risk factors for MZT after single embryo transfer, adjusting for potential confounding variables.Results:The incidence of twin pregnancy following single embryo transfer was 2.48% (300/12 079), which was higher than that of naturally conceived monozygotic twin pregnancy. No significant difference was found in baseline characteristics between the two groups (all P>0.05). The blastocyst transfer rate was higher in the MZT pregnancy group [93.3% (280/300)] than in the singleton pregnancy group [88.8% (1 332/1 500), P=0.022]. Multivariate logistic regression analysis also showed that blastocyst transfer was associated with an increased risk of MZT ( OR=0.552, P=0.016, 95% CI: 0.341-0.894). Analysis of blastocyst cycles showed that the risk of MZT was higher when transferring high-quality blastocysts [79.6% (223/280) vs. 67.8% (903/1 332), P<0.001], where as a trophectoderm (TE) grading of C [20.4% (57/280) vs. 32.2% (429/1 332), P<0.001] had a lower risk of MZT. After adjusting for confounding factors, the risk of MZT was found to increase with the transfer of blastocysts with a B-grade inner cell mass (ICM) ( OR=0.601, P=0.001, 95% CI: 0.442-0.819) and A/B grade TE (grade A: OR=2.951, P<0.001, 95% CI: 1.980-4.399; grade B: OR=1.840, P<0.001, 95% CI: 1.315-2.576). The risk of complications during pregnancy [47.7% (143/300) vs. 19.3% (289/1 500), P<0.001], preterm labor [55.1% (140/254) vs. 7.4% (101/1 368), P<0.001], and the risk of stillbirth [3.7% (11/300) vs. 1.5% (22/1 500), P=0.016] were significantly higher in the MZT pregnancy group than in the singleton pregnancy group. Conclusion:Assisted reproductive technology may contribute to the risk of MZT. Transfer of blastocysts, particularly those with loose ICM arrangement and dense TE arrangement, appears to increase the risk of MZT in patients undergoing eSET.

Objective To investigate the regulatory effect of PU.1 on apoptosis resistance of aging macro-phages under in vitro inflammatory stimulation simulated by lipopolysaccharide(LPS)of Porphyromonas.Methods The expression of PU.1 in periodontitis gingival tissue and normal gingival tissue was analyzed by GEO database.Mouse macrophage cell line RAW264.7 was divided into control group,P.g-LPS group,H2O2 group and PU.1 inhibitor group.mRNA expression of senescence associated secretory phenotype(IL-6,IL-1β,TNF-α)and PU.1 were detected by RT-qPCR;The protein expressions of p21,p16,BAX,caspase-3,Bcl-2,Bcl-xl and PU.1 were detected by Western blot.The number of senescent cells was detected by senescence-associated-galactosidase(SA-β-gal)staining.The apoptosis rate was detected by flow cytometry.Results Compared with control group,the expression of p21,p16 protein and mRNA of IL-6,IL-1β and TNF-α were up-regulated in P.g-LPS group and H2O2 group,the number of senescent cells was increased,the expression of Bcl-2 and Bcl-xl was up-regulated,the expression of BAX and caspase-3 was decreased,and the apoptosis rate was decreased.Meanwhile,the mRNA and protein expression of PU.1 were increased(P<0.05).Compared with P.g-LPS group,mRNA and protein expression of PU.1 in PU.1 inhibitor group were down-regulated,Bcl-2 and Bcl-xl were down-regulated,BAX and caspase-3 expressions were increased,apoptosis rate was increased,the number of senescent cells was decreased,and mRNA levels of IL-6,IL-1β and TNF-α were decreased.The expression of p21 and p16 proteins were down-regulated.(P<0.05).Conclusion Under inflammatory stimulation in vitro,increased expression of PU.1 induced apoptosis resistance of aging macrophages,inhibition of PU.1 promoted apoptosis of aging macrophages,reduced the number of aging macrophages,and down-regulated the secretion of inflammatory factors.

Objective:To investigate the influencing factors and perinatal outcomes associated with monozygotic twins (MZT) following elective single embryo transfer (eSET) via in vitro fertilization or intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET). Methods:A retrospective cohort study was conducted on 12 079 patients who achieved pregnancy after undergoing IVF/ICSI-eSET at Reproductive Health Hospital of the Third Affiliated Hospital of Zhengzhou University between January 2015 and September 2023. Patients were stratified into two groups based on ultrasound findings 30 d post-transfer: singleton pregnancy group and MZT pregnancy group. Finally, 300 MZT and 1 500 single pregnancies, which were randomly matched according to 1∶5 were included by study period. General patients' characteristics, embryo-related factors, and perinatal outcomes were compared between the two groups. A multivariate logistic regression model was employed to identify risk factors for MZT after single embryo transfer, adjusting for potential confounding variables.Results:The incidence of twin pregnancy following single embryo transfer was 2.48% (300/12 079), which was higher than that of naturally conceived monozygotic twin pregnancy. No significant difference was found in baseline characteristics between the two groups (all P>0.05). The blastocyst transfer rate was higher in the MZT pregnancy group [93.3% (280/300)] than in the singleton pregnancy group [88.8% (1 332/1 500), P=0.022]. Multivariate logistic regression analysis also showed that blastocyst transfer was associated with an increased risk of MZT ( OR=0.552, P=0.016, 95% CI: 0.341-0.894). Analysis of blastocyst cycles showed that the risk of MZT was higher when transferring high-quality blastocysts [79.6% (223/280) vs. 67.8% (903/1 332), P<0.001], where as a trophectoderm (TE) grading of C [20.4% (57/280) vs. 32.2% (429/1 332), P<0.001] had a lower risk of MZT. After adjusting for confounding factors, the risk of MZT was found to increase with the transfer of blastocysts with a B-grade inner cell mass (ICM) ( OR=0.601, P=0.001, 95% CI: 0.442-0.819) and A/B grade TE (grade A: OR=2.951, P<0.001, 95% CI: 1.980-4.399; grade B: OR=1.840, P<0.001, 95% CI: 1.315-2.576). The risk of complications during pregnancy [47.7% (143/300) vs. 19.3% (289/1 500), P<0.001], preterm labor [55.1% (140/254) vs. 7.4% (101/1 368), P<0.001], and the risk of stillbirth [3.7% (11/300) vs. 1.5% (22/1 500), P=0.016] were significantly higher in the MZT pregnancy group than in the singleton pregnancy group. Conclusion:Assisted reproductive technology may contribute to the risk of MZT. Transfer of blastocysts, particularly those with loose ICM arrangement and dense TE arrangement, appears to increase the risk of MZT in patients undergoing eSET.

Objective:To explore the regulatory mechanism of OIP5-AS1 in chronic periodontitis(CP).Methods:Human perio-dontal ligament stem cells(PDLSC)were treated with LPS to establish an in vitro model of CP.Real-time quantitative polymerase chain reaction(qRT-PCR)was performed to detect the expression of OIP5-AS1,miR-143-3p and fibroblast growth factor 1(FGF1)mRNA in periodontal ligament tissues and PDLSCs of CP patients and healthy volunteers.3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide(MTT)method was performed to detect cell viability.Enzyme-linked immunosorbent assay(ELISA)was performed to measure the levels of inflammatory cytokines interleukin-1 β(IL-1 β),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α).Western blot was performed to detect Bax,Bcl-2 and FGF1 protein levels.A dual-luciferase reporter assay was performed to validate the targeting relationship between miR-143-3p and OIP5-AS1/FGF1.Results:The expression of OIP5-AS1 and FGF1 were decreased,and the expression of miR-143-3p was increased in CP patients and LPS-treated PDLSCs(P＜0.05).In LPS-treated PDLSCs,OIP5-AS1 overexpression promoted cell viability and inhibited inflammation and apoptosis(P＜0.05).In addition,OIP5-AS1 targeted miR-143-3p and negatively regulated miR-143-3p expression(P＜0.05).In LPS-treated PDLSCs,up-regulation of miR-143-3p attenuated the inhibitory effect of OIP5-AS1 overexpression on LPS-induced PDLSC dam-age(P＜0.05).miR-143-3p targeted FGF1 and negatively regulated FGF1 expression(P＜0.05).FGF1 overexpression attenuated the effect of co-overexpression of miR-143-3p and IP5-AS1 on LPS-induced damage(P＜0.05).Conclusion:OIP5-AS1 may at-tenuate LPS-induced PDLSC inflammatory response and apoptosis and enhance cell viability by regulating the miR-143-3p/FGF1 axis,which may provide a new target for CP therapy.