Objectives: . The prognostic value of the pretreatment albumin-to-alkaline phosphatase ratio (AAPR) in head and neck cancer (HNC) remains uncertain. This meta-analysis aimed to evaluate the predictive role of AAPR for survival outcomes in patients with HNC. Methods: . A comprehensive search of the Cochrane Library, PubMed, and Embase databases was conducted to identify relevant studies published up to July 30, 2024. We included studies on AAPR and survival outcomes in HNC patients. Results: . Eight studies comprising 1,737 HNC patients were analyzed using random-effects models. Lower AAPR values were significantly correlated with worse overall survival (hazard ratio [HR], 2.08), progression-free survival (HR, 2.00), and disease-free survival (HR, 2.18). Sensitivity analyses confirmed the robustness of these results, with no significant publication bias detected. Conclusion . Our findings suggest that pretreatment AAPR could serve as a valuable and cost-effective prognostic indicator in HNC, potentially aiding clinicians in risk stratification and treatment decision-making. However, additional validation studies are warranted to confirm its clinical applicability.

Processed electroencephalogram (EEG) indices, such as the Bispectral Index, have markedly influenced anesthesia practice as they translate brain activity into simple numerical indices. Nevertheless, as the manufacturing algorithms are not disclosed, the underlying neurophysiology remains obscured. Additionally, these indices are often affected by electromyographic contamination, pharmacological variability, and patient-specific EEG heterogeneity. In contrast, an EEG spectrogram, or density spectral array, preserves the frequency- and time-resolved structures of cortical oscillations. This information is presented in a form that is both physiologically meaningful and clinically interpretable. In this review, we trace the evolution of anesthesia from an index-based to a spectrogram-guided approach, and summarize the clinical rationale for adopting the latter. Key applications of this approach include the use of frontal alpha power as a biomarker of cortical stability and postoperative brain health, the identification of nociceptive arousal through alpha dropout and beta or delta arousal patterns, and individualized titration of multimodal or age-specific anesthetic management. Although current devices lack standardized quantitative alpha metrics and have limited sensitivity for low-frequency brain wave components, structured EEG education programs have proven to be effective in terms of fostering spectrogram literacy among anesthesiologists. By combining neurophysiological precision with bedside practicality, the EEG spectrogram represents a pivotal advance toward individualized, mechanism-based, and brain-protective anesthesia, transforming anesthetic monitoring from mere algorithmic abstraction to cortical insight.

ObjectiveTo investigate the risk factors for rebleeding after endoscopic therapy for esophageal and gastric varices in liver cirrhosis patients， to construct a clinical predictive model， and to provide a reference for predicting rebleeding in the early stage， reducing the incidence rate of rebleeding， and improving the clinical outcome of patients. MethodsA retrospective analysis was performed for the clinical data of 194 liver cirrhosis patients with gastroesophageal variceal bleeding who received initial endoscopic therapy at Department of Gastroenterology， The Second People’s Hospital of Lanzhou， from January 1， 2021 to May 31， 2025. According to whether rebleeding occurred within 1 year after endoscopic therapy， the patients were divided into rebleeding group and non-rebleeding group. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. The patients enrolled were randomly divided into a training set and a validation set at a ratio of 7∶3. In the training set， the Lasso regression analysis was used to obtain optimal predictive variables， and the factors that might affect prognosis were included in the univariate and multivariate Logistic regression analyses to identify independent predictive factors for rebleeding after endoscopic therapy for esophageal and gastric varices in liver cirrhosis patients， which were used to construct a nomogram model. In both the training set and the validation set， the receiver operating characteristic （ROC） curve and the calibration curve were used to assess the discriminatory ability and calibration of the model， and decision curve analysis and the clinical impact curve were used to assess the clinical practicability of the model. ResultsAmong the 194 liver cirrhosis patients with esophageal and gastric varices， 116 （59.79%） experienced rebleeding within 1 year after endoscopic therapy， with 76 patients in the training set and 40 patients in the validation set. In the training set， the Lasso regression analysis and the univariate and multivariate Logistic regression analyses showed that etiology of liver cirrhosis （odds ratio ［OR］=3.540， 95% confidence interval ［CI］： 1.520 — 7.150， P<0.001）， Child-Pugh class （OR=3.560， 95%CI： 1.380 — 9.500， P=0.019）， severity of esophageal and gastric varices （OR=8.190， 95%CI： 3.568 — 17.850， P=0.026）， and main portal vein diameter （OR=2.954， 95%CI： 1.349 — 15.030， P=0.044） were independent predictive factors for rebleeding of esophageal and gastric varices in liver cirrhosis patients. A nomogram model was constructed based on the above independent predictive factors. The ROC curve analysis showed that this model had an area under the ROC curve of 0.845 （95%CI： 0.778 — 0.912） in the training set and 0.801 （95%CI： 0.798 — 0.868） in the validation set. The model had an index of concordance of 0.832 in the training set and 0.820 in the validation set， suggesting that the model had a good discriminatory ability. The Hosmer-Lemeshow test showed P values of 0.320 and 0.550 in the training set and validation set， respectively， the calibration curve indicated that the predicted probabilities of the nomogram model were in good concordance with the actual observed probabilities， suggesting that the model had good calibration. The decision curve analysis and the clinical impact curve showed that the model had good clinical utility. ConclusionThe nomogram model based on etiology of liver cirrhosis， Child-Pugh class， severity of esophageal and gastric varices， and main portal vein diameter has a certain clinical value in predicting the risk of rebleeding from esophageal and gastric varices in liver cirrhosis.

OBJECTIVES: To determine the pharmacological impact of hesperidin, the main component of Citri Reticulatae Pericarpium, on depressive behavior and elucidate the mechanism by which hesperidin treats depression, focusing on the gut-brain axis. METHODS: Fifty-four Sprague Dawley male rats were randomly allocated to 6 groups using a random number table, including control, model, hesperidin, probiotics, fluoxetine, and Citri Reticulatae Pericarpium groups. Except for the control group, rats in the remaining 5 groups were challenged with chronic unpredictable mild stress (CUMS) for 21 days and housed in single cages. The sucrose preference test (SPT), immobility time in the forced swim test (FST), and number in the open field test (OFT) were performed to measure the behavioral changes in the rats. Enzyme-linked immunosorbent assay was used to determine the levels of 5-hydroxytryptamine (5-HT) and brain-derived neurotrophic factor (BDNF) in brain tissue, and the histopathology was performed to evaluate the changes of colon tissue, together with sequencing of the V3-V4 regions of 16S rRNA gene on feces to explore the changes of intestinal flora in the rats. RESULTS: Compared to the control group, the rats in the model group showed notable reductions in body weight, SPF, and number in OFT (P<0.01). Hesperidin was found to ameliorate depression induced by CUMS, as seen by improvements in body weight, SPT, immobility time in FST, and number in OFT (P<0.05 or P<0.01). Regarding neurotransmitters, it was found that at a dose of 50 mg/kg hesperidin treatment upregulated the levels of 5-HT and BDNF in depressed rats (P<0.05). Compared to the control group, the colon tissue of the model group exhibited greater inflammatory cell infiltration, with markedly reduced numbers of goblet cells and crypts and were significantly improved following treatment with hesperidin. Simultaneously, the administration of hesperidin demonstrated a positive impact on the gut microbiome of rats treated with CUMS, such as Shannon index increased and Simpson index decreased (P<0.01), while the abundance of Pseudomonadota and Bacteroidota increased in the hesperidin-treated group (P<0.05). CONCLUSION The mechanism responsible for the beneficial effects of hesperidin on depressive behavior in rats may be related to inhibition of the expressions of BDNF and 5-HT and preservation of the gut microbiota.
Animals ; Hesperidin/therapeutic use* ; Rats, Sprague-Dawley ; Depression/drug therapy* ; Male ; Stress, Psychological/drug therapy* ; Brain/metabolism* ; Brain-Derived Neurotrophic Factor/metabolism* ; Serotonin/metabolism* ; Gastrointestinal Microbiome/drug effects* ; Behavior, Animal/drug effects* ; Rats ; Brain-Gut Axis/drug effects* ; Chronic Disease ; Colon/drug effects*

Abdominal aortic aneurysm(AAA)is a degenerative vascular disease occurring in the lower segment of the aortic diaphragm,mainly manifested by irreversible dilatation of the entire artery,preferably in the elderly population.The pathogenesis of AAA is complex and involves multiple factors,with genetic variations and immune imbalances playing important roles.Its pathological changes mainly include inflammatory cell infiltration,degradation of stromal elastin,and smooth muscle cell death.Rupture of AAA is the most dangerous complication,with a high mortality.Surgery remains the only effective intervention,but carries certain risks and postoperative complications.Early intervention for small abdominal aortic aneurysms to slow down aneurysm expansion and achieve long-term survival is currently a focus of drug and technology research.This article reviews the pathogenesis of AAA and its intervention strategies,and summarizes the research on existing drugs and the use of new targets and technologies,so as to provide insights for better understanding and treatment of AAA.

Soy is a vital source of plant carbohydrates.However,it poses significant allergenic risks,particularly to young children and animals.Among the various proteins in soy,β-conglycinin,which con-stitutes approximately 30％of total soy carbohydrates,is a primary allergen.Undigested β-conglycinin can lead to intestinal damage by inhibiting cell growth,disrupting the cytoskeleton,and inducing apopto-sis.It can also enter the lymphatic and circulatory systems,triggering allergic reactions.Conventional ELISA methods for detecting β-conglycinin rely on polyclonal or monoclonal antibodies,which are limited by their large molecular weight,difficulty in accessing the protein core,and sensitivity to acidic and bas-ic conditions.To address these limitations,this study aimed to develop nanobodies(Nbs)against β-con-glycinin.Nbs,derived from the variable regions of heavy-chain antibodies found in camelids,have a mo-lecular weight approximately one-tenth that of conventional antibodies.They offer advantages such as small size,stable structure,high specificity,and strong affinity.A female alpacas was immunized five times using β-conglycinin,which showed a heavy chain antibody potency of 1∶16 000 by ELISA.Pe-ripheral blood lymphocytes were subsequently isolated and total RNA was extracted.The variable region of the heavy-chain antibody was amplified via PCR,and recombinant plasmids were constructed and transformed into the E.coli competency strain ER2738.The resulting library contained about 3.5×108 CFU/mL,which increased to 1.15×1012 PFU/mL after phage rescue,with a 100％Nbs gene insertion rate,indicating high diversity.Its Nbs phage output was significantly enriched by four rounds of solid-phase elution with an enrichment rate of 155.9.Four rounds of solid-phase panning yielded 35 positive clones,all of which shared the same amino acid sequence upon sequencing.The selected Nb was ex-pressed in a prokaryotic system,and its binding ability to β-conglycinin was confirmed using Western blotting and ELISA.The results demonstrated excellent specificity and affinity.This research lays the groundwork for developing a rapid and efficient detection method for β-conglycinin using Nbs,potentially enhancing food safety and allergen management.

Objective:To observe the effect of hyperthermia combined with iron overload on the regulation of tumor-associated macrophage polarization and the migration ability of CAL-27 cells and explore its mechanism.Methods:Human monocytic leukemia cell THP-1 was induced and polarized into M2 macrophages. M2 tumor-associated macrophages and CAL-27 cells were divided into the control group (no intervention), hyperthermia group (incubated at 42 ℃ for 1 h, and then incubated at 37 ℃ for 24 h), ferric citrate group (added with 2.5 mg/ml ferric citrate, and cultured in an incubator at 37 ℃for 24 h) and hyperthermia + ferric citrate group (added with 2.5 mg/ml ferric citrate for 1 h, cultured in an incubator at 42℃ for 1 h, and then incubated at 37℃ for 24 h). For M2 macrophage groups, the mRNA relative expression levels of surface markers of M1 macrophage polarization including interleukin (IL)-1β, tumor necrosis factor-α(TNF-α), and those of M2 macrophage polarization including IL-10 and transforming growth factor-β(TGF-β) were detected by real-time reverse transcription polymerase chain reaction. The expression levels of IL-1β and IL-10 were detected by ELISA. The expression levels of CD86 (surface marker of M1 macrophage polarization) and CD206 (surface marker of M2 macrophage polarization) were measured by flow cytometry. The expression levels of signal transducer and activator of transcription 3 (STAT3), Toll-like receptor 4 (TLR4), nuclear factor κB (NF-κB) and phosphorylated (p)-NF-κB were detected by Western blot (WB). The migration ability of CAL-27 cells was assessed by scratch assay.Results:Compared with the control group, the expression levels of IL-1βand TNF-α mRNA, and IL-1βand CD86 proteins were up-regulated, whereas those of IL-10 and TGF-β mRNA, and IL-10 and CD206 proteins were down-regulated in the hyperthermia, ferric citrate and hyperthermia + ferric citrate groups, respectively (all P<0.05). In addition, the changes in the hyperthermia+ferric citrate group were significantly larger than those in the hyperthermia and ferric citrate groups (all P<0.05). WB showed that the expression level of STAT3 protein was down-regulated and those of TLR4, NF-κB and p-NF-κB expression were up-regulated in the hyperthermia + ferric citrate group (all P<0.05). Scratch assay showed that the migration ability of CAL-27 cells was inhibited in the hyperthermia, ferric citrate and hyperthermia + ferric citrate groups ( P<0.001), and the changes in the hyperthermia + ferric citrate group were significantly more pronounced than those in the hyperthermia and ferric citrate groups (both P<0.001). Conclusions:Hyperthermia and iron overload can promote the polarization of M1 macrophages and inhibit the polarization of M1 macrophages into M2 macrophages, thereby suppressing the migration of oral squamous cell carcinoma. The mechanism may be related to inhibiting the expression of STAT3 and activating the TLR4/NF-κB signaling pathway.

Soy is a vital source of plant carbohydrates.However,it poses significant allergenic risks,particularly to young children and animals.Among the various proteins in soy,β-conglycinin,which con-stitutes approximately 30％of total soy carbohydrates,is a primary allergen.Undigested β-conglycinin can lead to intestinal damage by inhibiting cell growth,disrupting the cytoskeleton,and inducing apopto-sis.It can also enter the lymphatic and circulatory systems,triggering allergic reactions.Conventional ELISA methods for detecting β-conglycinin rely on polyclonal or monoclonal antibodies,which are limited by their large molecular weight,difficulty in accessing the protein core,and sensitivity to acidic and bas-ic conditions.To address these limitations,this study aimed to develop nanobodies(Nbs)against β-con-glycinin.Nbs,derived from the variable regions of heavy-chain antibodies found in camelids,have a mo-lecular weight approximately one-tenth that of conventional antibodies.They offer advantages such as small size,stable structure,high specificity,and strong affinity.A female alpacas was immunized five times using β-conglycinin,which showed a heavy chain antibody potency of 1∶16 000 by ELISA.Pe-ripheral blood lymphocytes were subsequently isolated and total RNA was extracted.The variable region of the heavy-chain antibody was amplified via PCR,and recombinant plasmids were constructed and transformed into the E.coli competency strain ER2738.The resulting library contained about 3.5×108 CFU/mL,which increased to 1.15×1012 PFU/mL after phage rescue,with a 100％Nbs gene insertion rate,indicating high diversity.Its Nbs phage output was significantly enriched by four rounds of solid-phase elution with an enrichment rate of 155.9.Four rounds of solid-phase panning yielded 35 positive clones,all of which shared the same amino acid sequence upon sequencing.The selected Nb was ex-pressed in a prokaryotic system,and its binding ability to β-conglycinin was confirmed using Western blotting and ELISA.The results demonstrated excellent specificity and affinity.This research lays the groundwork for developing a rapid and efficient detection method for β-conglycinin using Nbs,potentially enhancing food safety and allergen management.

Objective:To observe the effect of hyperthermia combined with iron overload on the regulation of tumor-associated macrophage polarization and the migration ability of CAL-27 cells and explore its mechanism.Methods:Human monocytic leukemia cell THP-1 was induced and polarized into M2 macrophages. M2 tumor-associated macrophages and CAL-27 cells were divided into the control group (no intervention), hyperthermia group (incubated at 42 ℃ for 1 h, and then incubated at 37 ℃ for 24 h), ferric citrate group (added with 2.5 mg/ml ferric citrate, and cultured in an incubator at 37 ℃for 24 h) and hyperthermia + ferric citrate group (added with 2.5 mg/ml ferric citrate for 1 h, cultured in an incubator at 42℃ for 1 h, and then incubated at 37℃ for 24 h). For M2 macrophage groups, the mRNA relative expression levels of surface markers of M1 macrophage polarization including interleukin (IL)-1β, tumor necrosis factor-α(TNF-α), and those of M2 macrophage polarization including IL-10 and transforming growth factor-β(TGF-β) were detected by real-time reverse transcription polymerase chain reaction. The expression levels of IL-1β and IL-10 were detected by ELISA. The expression levels of CD86 (surface marker of M1 macrophage polarization) and CD206 (surface marker of M2 macrophage polarization) were measured by flow cytometry. The expression levels of signal transducer and activator of transcription 3 (STAT3), Toll-like receptor 4 (TLR4), nuclear factor κB (NF-κB) and phosphorylated (p)-NF-κB were detected by Western blot (WB). The migration ability of CAL-27 cells was assessed by scratch assay.Results:Compared with the control group, the expression levels of IL-1βand TNF-α mRNA, and IL-1βand CD86 proteins were up-regulated, whereas those of IL-10 and TGF-β mRNA, and IL-10 and CD206 proteins were down-regulated in the hyperthermia, ferric citrate and hyperthermia + ferric citrate groups, respectively (all P<0.05). In addition, the changes in the hyperthermia+ferric citrate group were significantly larger than those in the hyperthermia and ferric citrate groups (all P<0.05). WB showed that the expression level of STAT3 protein was down-regulated and those of TLR4, NF-κB and p-NF-κB expression were up-regulated in the hyperthermia + ferric citrate group (all P<0.05). Scratch assay showed that the migration ability of CAL-27 cells was inhibited in the hyperthermia, ferric citrate and hyperthermia + ferric citrate groups ( P<0.001), and the changes in the hyperthermia + ferric citrate group were significantly more pronounced than those in the hyperthermia and ferric citrate groups (both P<0.001). Conclusions:Hyperthermia and iron overload can promote the polarization of M1 macrophages and inhibit the polarization of M1 macrophages into M2 macrophages, thereby suppressing the migration of oral squamous cell carcinoma. The mechanism may be related to inhibiting the expression of STAT3 and activating the TLR4/NF-κB signaling pathway.