Cold ischemia-reperfusion injury (CIRI) is a major contributor to delayed graft function and long-term graft failure after kidney transplantation.Its pathogenesis involves multiple mechanisms, including energy metabolism disorders, oxidative stress and sterile inflammatory responses.Increasing evidence indicates that immune cells play a central regulatory role in the initiation and progression of CIRI.Damage-associated molecular patterns released during cold ischemia and reperfusion activate innate immunity, leading to the rapid recruitment of neutrophils, macrophages, dendritic cells and amplification of inflammatory cascades.Subsequently, adaptive immune cells, including T cells and B cells, are activated and further contribute to sustained inflammation, disruption of immune tolerance and graft injury.Through cytokine signaling, chemokine-mediated recruitment and antigen presentation, different immune cell subsets form a complex interactive network that ultimately determines the severity and outcome of CIRI.This review summarizes the roles and mechanisms of innate and adaptive immune cells in renal allograft CIRI, highlights their interconnections, and discusses emerging immune cell-targeted therapeutic strategies, aiming to provide a theoretical basis for improving clinical outcomes in kidney transplantation.

The biological characteristics of hepatocellular carcinoma(HCC)lead to a high incidence of portal vein tumor thrombus.It progresses rapidly,and the opportunity for radical surgical resection can be lost in a short term,resulting in poor prognosis.Reasonable down-staging treatment is a research focus for patients with unresectable HCC complicated with portal vein tumor thrombus to achieve a resectable range.This article reviews the potential population of HCC complicated with portal vein tumor thrombus with conversion therapy for HCC,analyzes the application of hepatic artery infusion chemotherapy,transcatheter arterial chemoembolization,radiotherapy,regional and systemic drug therapy in conversion therapy,and points out that the combination of multidisciplinary comprehensive treatments is the key to improve the prognosis of HCC patients with portal vein tumor thrombus.

Objective To conduct an in-depth analysis and feature extraction of the transcriptomics data of 10 types of cancers in order to realize the staging diagnosis of cancer samples.Methods The transcriptomics data of the top 10 cancers having the highest incidence were amassed from the UCSC Xena website,which comprised 4 938 samples and 59 428 genes.With the aid of variational autoencoder,we developed an incremental feature ranking and selection variational autoencoder(IFRSVAE)based on feature importance ranking and incorporating the masking algorithm and the Incremental Feature Selection(IFS).Subsequently,the performance efficiency of our IFRSVAE model was evaluated in conjunction with Random Forest(RF),Support Vector Machine(SVM),and eXtreme Gradient Boosting(XGboost),and it was also compared with other methods.Results Our research extracted 21 features for the ensuing classification.In comparison to the conventional variational autoencoder,recursive feature elimination,and Lasso regression models,the IFRSVAE model attained more favorable performance across all 3 classifiers(highest AUC value,and well performed other indicators).Notably,the IFRSVAE-RF exhibited the most outstanding performance,with an AUC value reaching 85.49%(95%CI:83.24%～87.74%).Moreover,Shapley additive explanations(SHAP)interpretable model illustrated well contributions of the features in our model.Conclusion Our developed IFRSVAE shows certain effectiveness in feature extraction.The constructed IFRSVAE-RF model demonstrates relatively good performance in the task of cancer staging diagnosis,which providing a new and referable idea for research orientation of deep-learning-based diagnostic methods for cancer staging.

AIM: To observe the influence of different intraocular lens implantation methods on visual quality in patients with cataract.METHODS: Retrospective study. Totally 85 patients(113 eyes)with cataract who received phacoemulsification combined with intraocular lens implantation in the hospital June 2020 to December 2023 were selected. According to the different implanted lenses, they were divided into monofocal group(42 cases, 55 eyes)and bifocal group(43 cases, 58 eyes). The uncorrected near visual acuity(UNVA), uncorrected intermediate visual acuity(UIVA), uncorrected distance visual acuity(UDVA), best corrected near visual acuity(BCNVA), best corrected intermediate visual acuity(BCIVA), best corrected distance visual acuity(BCDVA), contrast sensitivity(CS), objective visual quality, National Eye Institute 25-item Visual Function Questionnaire(NEI-VFQ-25)scores and complications were compared between both groups of patients at 3 mo after surgery.RESULTS:At 3 mo after surgery, the UNVA(LogMAR)of the bifocal group was significantly better than that of the monofocal group(0.24±0.06 vs 0.53±0.13, P<0.001), but there were no statistical differences in UIVA, UDVA, BCNVA, BCIVA and BCDVA between the two groups(all P>0.05). The 18 c/d spatial frequency scotopic CS in the bifocal group at 3 mo after surgery was significantly lower than that in the monofocal group(0.84±0.17 vs 0.92±0.22, P<0.05), while the CS in other frequency was not statistically significant(all P>0.05); the objective scatter index(OSI)was higher in the bifocal group than that in the monofocal group(P<0.05), while OV 20% and OV 9% were lower than those in monofocal group(all P<0.05), but there were no statistically significant differences in modulation transfer function cut off(MTFcut off), Strehl ratio(SR)and OV 100% between the two groups(all P>0.05). The scores of overall visual acuity and near visual activity in the bifocal group at 3 mo after surgery were higher than those in the monofocal group(all P<0.001), but there were no statistical differences in the scores of dimensions of overall health, distance visual activity, peripheral visual acuity, color vision, dependence degree, social function, social role and mental health between the two groups(all P>0.05). Furthermore, there were no statistical significance in the incidence of complications in the two groups(P>0.05).CONCLUSION: Phacoemulsification combined with bifocal intraocular lens implantation can provide more ideal near visual acuity and visual-related quality of life for patients with cataract, but its objective visual quality is worse, The two types of intraocular lenses have their own advantages and disadvantages, and it is still necessary to choose the appropriate intraocular lens according to the actual needs of patients.

AIM: To observe the influence of different intraocular lens implantation methods on visual quality in patients with cataract.METHODS: Retrospective study. Totally 85 patients(113 eyes)with cataract who received phacoemulsification combined with intraocular lens implantation in the hospital June 2020 to December 2023 were selected. According to the different implanted lenses, they were divided into monofocal group(42 cases, 55 eyes)and bifocal group(43 cases, 58 eyes). The uncorrected near visual acuity(UNVA), uncorrected intermediate visual acuity(UIVA), uncorrected distance visual acuity(UDVA), best corrected near visual acuity(BCNVA), best corrected intermediate visual acuity(BCIVA), best corrected distance visual acuity(BCDVA), contrast sensitivity(CS), objective visual quality, National Eye Institute 25-item Visual Function Questionnaire(NEI-VFQ-25)scores and complications were compared between both groups of patients at 3 mo after surgery.RESULTS:At 3 mo after surgery, the UNVA(LogMAR)of the bifocal group was significantly better than that of the monofocal group(0.24±0.06 vs 0.53±0.13, P<0.001), but there were no statistical differences in UIVA, UDVA, BCNVA, BCIVA and BCDVA between the two groups(all P>0.05). The 18 c/d spatial frequency scotopic CS in the bifocal group at 3 mo after surgery was significantly lower than that in the monofocal group(0.84±0.17 vs 0.92±0.22, P<0.05), while the CS in other frequency was not statistically significant(all P>0.05); the objective scatter index(OSI)was higher in the bifocal group than that in the monofocal group(P<0.05), while OV 20% and OV 9% were lower than those in monofocal group(all P<0.05), but there were no statistically significant differences in modulation transfer function cut off(MTFcut off), Strehl ratio(SR)and OV 100% between the two groups(all P>0.05). The scores of overall visual acuity and near visual activity in the bifocal group at 3 mo after surgery were higher than those in the monofocal group(all P<0.001), but there were no statistical differences in the scores of dimensions of overall health, distance visual activity, peripheral visual acuity, color vision, dependence degree, social function, social role and mental health between the two groups(all P>0.05). Furthermore, there were no statistical significance in the incidence of complications in the two groups(P>0.05).CONCLUSION: Phacoemulsification combined with bifocal intraocular lens implantation can provide more ideal near visual acuity and visual-related quality of life for patients with cataract, but its objective visual quality is worse, The two types of intraocular lenses have their own advantages and disadvantages, and it is still necessary to choose the appropriate intraocular lens according to the actual needs of patients.

BACKGROUND:Chondrocyte apoptosis is an important factor in the development of osteoarthritis,and Complanatoside A has a flavonoid effect,which can inhibit apoptosis of various cells,but its effect on chondrocyte apoptosis and the mechanism of action are not clear. OBJECTIVE:To investigate the intrinsic association and mechanism of Complanatoside A in chondrocyte apoptosis based on the Wnt/β-catenin signaling pathway. METHODS:(1)The cartilage tissues of the femur and tibia transected during knee arthroplasty were collected,and chondrocytes were isolated,cultured in vitro,and identified.(2)Cell counting kit-8 was used to detect the optimal intervention concentration of Complanatoside A in the concentration range of 0-160 μmol/L.(3)Chondrocytes were divided into blank group,sodium nitroprusside(1.5 mmol/L)-induced group,and sodium nitroprusside(1.5 mmol/L)+Complanatoside A(5 μmol/L)group.The viability and apoptosis rate of the cells in each group were detected by cell counting kit-8 and flow cytometry.The expression of type Ⅱ collagen and SOX9 was detected by immunofluorescence staining.The expression of apoptosis-related proteins and Wnt/β-catenin pathway proteins was detected by western blot assay. RESULTS AND CONCLUSION:The cells extracted in vitro were cultured and stained,and were clearly identified as chondrocytes.Complanatoside A had no obvious cytotoxicity to chondrocytes in the concentration range of 0-80 μmol/L,and significantly improved the chondrocyte viability in the concentration range of 2.5-10 μmol/L,especially when the concentration was 5 μmol/L.The apoptotic rate of chondrocytes was higher in the sodium nitroprusside-induced group than the blank control group,while the apoptotic rate was lower in the sodium nitroprusside+Complanatoside A group than the sodium nitroprusside-induced group.The fluorescence intensity of type Ⅱ collagen and SOX9 in chondrocytes was weaker in the sodium nitroprusside-induced group than the blank control group,while the fluorescence intensity of type Ⅱ collagen and SOX9 in the sodium nitroprusside+Complanatoside A group was higher than that of the sodium nitroprusside-induced group.In the sodium nitroprusside-induced group,the protein expression of Bax,Caspase-3,matrix metalloproteinase 13,Wnt3a,Wnt5a and β-catenin was higher than that of the blank control group,while the protein expression of Bcl-2 was lower than that of the blank control group.In the sodium nitroprusside+Complanatoside A group,except for the protein expression of Bcl-2 which was higher than that of the sodium nitroprusside-induced group,the expression of the other aforementioned proteins was lower than that of the sodium nitroprusside-induced group.To conclude,Complanatoside A has a certain inhibitory effect on chondrocyte apoptosis,which could regulate apoptosis-related proteins and promote the expression of chondrocyte regulatory factors,and presumably might play a role through inhibiting the Wnt/β-catenin signaling pathway.

ABSTRCT AIM:To verify the effect of polygona-tum polysaccharide(PSP)combined with TGF-β3 in inducing the differentiation of rat tendon-derived stem cells(TDSCs)into chondrocytes by activating the TGF-β3/Smad2 pathway.METHODS:TDSCs were extracted from rat tail tendons using enzyme digestion,purified,passaged,and identified via flow cytometry.TDSCs were treated with different concentrations of PSP,and the optimal growth con-centration was determined using the CCK-8 assay.TDSCs were divided into four groups:PSP,TGF-β3,PSP+TGF-β3,and Control for differentiation induc-tion.Chondrogenic differentiation was evaluated using morphological observations,toluidine blue staining,immunofluorescence staining,and West-ern blot analysis to detect COLⅡ,SOX9,and AGG.Western blot was also used to measure the expres-sion levels of Smad2 and p-Smad2 to evaluate the activation of the TGF-β3/Smad2 pathway after chondrogenic induction.RESULTS:Flow cytometry analysis showed that TDSCs highly expressed CD90 and CD29,while CD11b and CD45 expression was low.The CCK-8 assay indicated that 5 μmol/L PSP was the optimal intervention dose.Toluidine blue staining revealed that the blue staining area in the PSP,PSP+TGF-β3,and TGF-β3 groups was larger compared to the Control group.Immunofluores-cence analysis demonstrated that COLⅡ expression was significantly increased in the PSP,TGF-β3,and PSP+TGF-β3 groups,with the highest expression in the PSP+TGF-β3 group(P＜0.05).Western blot analy-sis showed that the levels of p-Smad2/Smad2,COLⅡ,SOX9,and AGG were elevated in the PSP,TGF-β3,and PSP+TGF-β3 groups,with the highest ex-pression in the PSP+TGF-β3 group(P＜0.05).Compared to the Control group,the TGF-β3 and PSP groups also showed significantly increased expression(P＜0.05).CONCLUSION:PSP promotes the proliferation and chondrogenic differentiation of TDSCs,possibly by activating the TGF-β3/Smad2 pathway.

Objective The aim of this study is to systematically analyze the therapeutic mechanisms of Wuzi Yuye Decoction in diabetic oligoasthenozoospermia based on network pharmacology and animal experiments.Methods Active components and therapeutic targets of Wuzi Yuye Decoction were screened by integrating multiple databases,and their inter-section with diabetic oligoasthenozoospermia-related targets was obtained.Common targets were identified using the Venny platform,and protein-protein interaction(PPI)networks were constructed via the STRING database.And key targets were screened through topological analysis with Cytoscape.Gene Ontology(GO)functional enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analyses were performed using the DAVID platform.A mouse model of diabetic oligoasthenozoospermia was established by high-fat diet combined with streptozotocin induction,followed by intervention with Wuzi Yuye Decoction.Body weight,testicular index,and sperm quality were assessed,while histopathological changes were evaluated by HE staining and transmission electron microscopy(TEM).In addition,ELISA,oxidative stress assays and Western blot were used to verify the changes in key pathway-related proteins.Results A total of 36 common targets were identified,including key nodes such as TNF,IL6 and IL1B.Enrichment analysis indicated that these targets were sig-nificantly involved in inflammatory responses,oxidative stress,autophagy-apoptosis regulation and reproduction-related pathways.Animal experiments confirmed that Wuzi Yuye Decoction markedly improved testicular mass and sperm motility in diabetic mice,reduced the levels of AGE,TNF-α,IL-6 and IL-1β in testicular tissues,alleviated oxidative stress damage,and restored autophagic flux and blood-testis barrier function by inhibiting the RAGE/NF-κB/mTOR signaling axis.Conclusion Wuzi Yuye Decoction improves the pathological progression of diabetic oligoasthenozoospermia by synergistically modulating multiple targets,including inflammation inhibition,antioxidant effects,autophagy regulation,and related pathways.

Objective:To explore the relationship between tumor necrosis factor-like weak inducer of apoptosis(TWEAK),kidney injury molecule 1(KIM-1),RBC distribution width/platelet ratio(RPR)and disease activity,renal injury in children with sys-temic lupus erythematosus(SLE).Methods:A total of 42 children with newly diagnosed SLE in Xiangyang Central Hospital were en-rolled as SLE group between February 2020 and February 2022,while another 40 healthy children undergoing physical examination during the same period were enrolled as control group.According to scores of systemic lupus erythematosus disease activity index(SLEDAI),SLE children were divided into low disease activity group(≤9 points)24 cases and high disease activity group(>9 points)18 cases.According to presence or absence of renal injury,SLE children were divided into LN group 31 cases and non-LN group 11 cases.The red blood cell distribution width(RDW)and platelet count(PLT)in all objects were detected.RPR was calculated.The levels of serum TWEAK and KIM-1 were detected by ELISA.Results:The levels of serum TWEAK,KIM-1 and RPR in SLE group were significantly higher than those in control group(P<0.05).The levels of serum TWEAK,KIM-1 and RPR in high disease activity group were significantly higher than those in low disease activity group(P<0.05),which were significantly higher in LN group than non-LN group(P<0.05).Correlation analysis showed that RPR was significantly positively correlated with SLEDAI score(P<0.05),TWEAK and KIM-1 were significantly positively correlated with 24 h urinary protein(P<0.05).AUC of RPR for assessing high disease activity of SLE was 0.744(95%CI:0.657～0.818),significantly greater than that of TWEAK and KIM-1[0.678(95%CI:0.588～0.760),0.598(95%CI:0.505～0.686),P<0.05].AUC values of TWEAK and KIM-1 for predicting LN 0.847(95%CI:0.773～0.905)and 0.773(95%CI:0.690～0.842),significantly greater than that of RPR AUC values[0.645(95%CI:0.555～0.727),P<0.05].Conclusion:The levels of TWEAK,KIM-1 and RPR are changed in children with SLE.RPR has higher diagnostic efficiency for SLE activity,while TWEAK and KIM-1 have higher predictive value for LN.

Background and Aims:Laparoscopic transcystic bile duct exploration(LTCBDE)has become the preferred method for treating secondary bile duct stones due to its advantages of minimal trauma,fast recovery,and low complication rates.However,challenges remain in the dilation of the cystic duct,the insertion of the choledochoscope,and the exploration of the common hepatic duct and intrahepatic bile ducts.This study was performed to explore the clinical application and effectiveness of the programmed modified LTCBDE in the treatment of gallbladder stones combined with common bile duct stones.Methods:A retrospective analysis was conducted on the clinical data of 248 patients who underwent programmed modified LTCBDE at the Affiliated Suzhou Ninth Hospital of Soochow University from January 2018 to January 2024.The surgical strategies and treatment outcomes were summarized.Data from 913 patients who underwent laparoscopic common bile duct exploration(LCBDE)during the same period were also collected to compare surgical outcomes and postoperative complications between the two groups.Results:Through programmed surgical steps,the innovative"diaphragm"incision technique,and improved bile duct probe application,244 patients(98.4%)successfully underwent LTCBDE,while 4 patients were converted to LCBDE due to failure to insert a 4.9 mm choledochoscope through the cystic duct.After operation,1 patient(0.4%)had residual bile duct stones,which were successfully removed through T-tube tract stone extraction(this patient was converted to LCBDE during the procedure).Additionally,1 case of bile leakage and 1 case of abdominal infection(each 0.4%)occurred,both of which resolved with conservative treatment.No cases of intra-abdominal bleeding,bile duct stenosis,or bile duct injury were reported.The average operative time in the programmed modified LTCBDE group was comparable to that of the LCBDE group(85.2 min vs.88.0 min,P=0.398),but the postoperative hospital stay was significantly shorter(6.2 d vs.8.3 d,P<0.001),and the incidence of complications was lower(1.6%vs.4.7%,P=0.044).Conclusion:The programmed modified LTCBDE is a standardized,safe,and effective procedure with a low complication rate.It is worthy of further clinical promotion and application.