ObjectiveTo investigate the mechanism of action of remifentanil （RMZL） in alleviating lung ischemia-reperfusion injury （LIRI） in rats by inhibiting pyroptosis through modulating hypoxia inducible factor-1α （HIF-1α）/NOD-like receptor thermal protein domain associated protein 3 （NLRP3） pathway. MethodsRats were stochastically assigned into Control group， LIRI group， RMZL low-dose group， RMZL medium-dose group， RMZL high-dose group， and RMZL high-dose+HIF-1α activator dimethyloxallyl glycine （DMOG） group， with 18 rats in each group. Rats in Control group only had their left pulmonary hilum free and did not undergo ischemia-reperfusion treatment. Except for the Control group， LIRI models were constructed in all other groups. Rats in LIRI group were intraperitoneally injected with an equal amount of physiological saline 15 minutes before constructing LIRI model； rats in Control group were intraperitoneally injected with an equal amount of physiological saline 15 minutes before freeing left pulmonary hilum； rats in other groups were intraperitoneally injected with corresponding dose of drug 15 minutes before constructing LIRI model. The wet/dry weight ratio of lungs was calculated. HE staining was used to study lung tissue pathology. Immunofluorescence staining was used to detect the relative fluorescence intensity of gasdermin D （GSDMD） and NLRP3 double positive cells in lung tissue. ELISA was used to detect interleukin-1β and IL-18 in lung tissue. Western blot was used to detect HIF-1α， NLRP3， cysteine-aspartic protease-1 （Cleaved caspase-1）， and gasdermin D-N （GSDMD-N） proteins in lung tissue. ResultsCompared to the Control group， the LIRI group showed disordered alveolar structure， thickened alveolar septa， and abundant inflammatory cell infiltration in rats. The lung wet/dry weight ratio， relative fluorescence intensity of GSDMD and NLRP3 double positive cells in lung tissue， IL-1β， IL-18 levels， and HIF-1α， NLRP3， Cleaved caspase-1， and GSDMD-N proteins increased （P0.05）. For the LIRI group， rats in the RMZL low， medium， and high-dose groups displayed attenuated alveolar septal thickening and reduced inflammatory cell infiltration. The lung wet/dry weight ratio， relative fluorescence intensity of GSDMD and NLRP3 double positive cells in lung tissue， IL-1β， IL-18 levels， and HIF-1α， NLRP3， Cleaved caspase-1， and GSDMD-N proteins declined， and the RMZL high-dose group showed the most prominent trend （P0.05）. Compared with the RMZL high-dose group， rats in the RMZL high-dose+DMOG group exhibited thickened alveolar septa and more inflammatory cell infiltration， along with increased lung wet/dry weight ratio， relative fluorescence intensity of GSDMD and NLRP3 double positive cells in lung tissue， levels of IL-1β and IL-18， and protein expression of HIF-1α， NLRP3， Cleaved caspase-1， and GSDMD-N （P0.05）. ConclusionRMZL may inhibit pyroptosis in LIRI rats by suppressing HIF-1α/NLRP3 pathway.

Hepatocellular carcinoma (HCC) is a leading cause of cancer-associated death globally. Liver transplantation (LT) has emerged as a key treatment for patients with HCC, and the Milan criteria have been adopted as the cornerstone of the selection policy. To allow more patients to benefit from LT, a number of expanded criteria have been proposed, many of which use radiologic morphological characteristics with larger and more tumors as surrogates to predict outcomes. Other groups developed indices incorporating biological variables and dynamic markers of response to locoregional treatment. These expanded selection criteria achieved satisfactory results with limited liver supplies. In addition, a number of prognostic models have been developed using clinicopathological characteristics, imaging radiomics features, genetic data, and advanced techniques such as artificial intelligence. These models could improve prognostic estimation, establish surveillance strategies, and bolster long-term outcomes in patients with HCC. In this study, we reviewed the latest findings and achievements regarding the selection criteria and post-transplant prognostic models for LT in patients with HCC.

As a multifactorial chronic metabolic disorder with complex causes and serious health risks, obesity has drawn significant societal and medical attention. This article systematically reviewed the latest advancements in the clinical diagnosis and treatment of obesity. A disease-centered diagnosis and treatment concept has been proposed, which combines BMI and introduces a brand-new clinical diagnosis and treatment standard centered on fat content and functional disorders, such as new diagnostic markers like adipose tissue distribution, visceral adiposity, and waist-to-height ratio, to conduct a comprehensive assessment and lifespan management of patients. In recent years, novel biomarkers and artificial intelligence (AI)-assisted diagnosis have provided new tools for the diagnosis and treatment of obesity. In terms of treatment, combined therapy based on lifestyle and behavioral intervention has been widely recognized. The advent of new weight-loss drugs, such as glucagon-like peptide-1(GLP-1), minimally invasive techniques such as endoscopic sleeve gastrectomy(ESG), which reduced surgical risks, have provided possibilities for the treatment of obesity. The current concept of obesity management has become increasingly mature, feasible, and standardized. The construction principles of a weight management center, characterized by centralized management and individualized treatment, ensure the long-term stability of body weight and promote a healthy quality of life for patients with obesity.

Hepatocellular carcinoma (HCC) is a leading cause of cancer-associated death globally. Liver transplantation (LT) has emerged as a key treatment for patients with HCC, and the Milan criteria have been adopted as the cornerstone of the selection policy. To allow more patients to benefit from LT, a number of expanded criteria have been proposed, many of which use radiologic morphological characteristics with larger and more tumors as surrogates to predict outcomes. Other groups developed indices incorporating biological variables and dynamic markers of response to locoregional treatment. These expanded selection criteria achieved satisfactory results with limited liver supplies. In addition, a number of prognostic models have been developed using clinicopathological characteristics, imaging radiomics features, genetic data, and advanced techniques such as artificial intelligence. These models could improve prognostic estimation, establish surveillance strategies, and bolster long-term outcomes in patients with HCC. In this study, we reviewed the latest findings and achievements regarding the selection criteria and post-transplant prognostic models for LT in patients with HCC.

The inflammatory response is a natural defense mechanism of the body that occurs in response to infection or injury,serving as a critical starting point for the onset and progression of various diseases.Glycolysis,an essential pathway for energy production within the body,plays a pivotal role in both the initiation and advancement of the inflammatory response.Pyruvate kinase M2(PKM2),recog-nized as a key rate-limiting enzyme in glycolysis,not only contributes to the inflammatory process by mediating glycolysis and lactylation modifications through such mechanisms as nuclear translocation and dimer formation,but also regulates the inflammatory response by modulating immune responses in B cells,T cells,macrophages,and neutrophils.This review aims to summarize the mechanisms involved in targeting PKM2 to suppress inflammation,providing new insights into the prevention and treatment of inflammatory reactions.

Objective To develop a platform for reporting medication near miss events and evaluate its application effectiveness,aiming to enhance medication safety of patients.Methods Based on literature review,qualitative interviews,and expert group meetings,a medication near-miss event reporting platform was constructed,including 4 modules:event content filling,event risk grading,event handling,and statistical analysis.50 nurses were conveniently selected from the pediatric ward of a tertiary grade A hospital in Henan Province as the application subjects.The reporting situation and filling duration of medication near miss events,the score of the Medication Near Miss Reporting Disorder Scale,and the incidence of medication near miss events were compared after the application of the platform(from March to August 2023)and before the application(from September 2022 to February 2023).Results The reporting rate of medication near miss events after the application of the platform was higher than that before the application of the platform,and the comparison of the distribution of event nature and occurrence links showed statistically significant differences(P＜0.05).After the application of the platform,the reporting duration of medication near miss events was shorter than that before the application of the platform,and the score of the Medication Near Miss Reporting Disorder Scale was lower than that before the application of the platform.The differences were statistically significant(P＜0.001).There was no statistically significant difference in the incidence of medication near miss events before and after the application of the platform(P=0.241).Conclusion Using this platform can help improve the reporting rate of medication near miss events,reduce the time taken to fill out reports,and minimize reporting barriers for nurses.

The global burden of obesity continues to rise, and the long-term management of body weight remains a significant challenge. Virtually all current weight loss interventions are associated with varying degrees of weight regain following initial weight reduction, which compromises the long-term benefits for patients with obesity. Multiple complex physiological mechanisms contribute to this phenomenon, including the regulation of body weight " set points" , alterations in energy expenditure and metabolic adaptation, central nervous system control, and the modulatory effects of obesity-associated immune cells. Targeted interventions addressing these regulatory pathways may help mitigate weight regain. In recent years, several novel therapeutic strategies have emerged, such as nutrient-stimulated hormone-based agents, compounds that enhance the efficacy of glucagon-like peptide-1 receptor agonists, leptin-sensitizing agents, and medications that improve body composition. These innovations offer promising opportunities to sustain weight loss and prevent subsequent regain. This review aims to summarize the underlying mechanisms of weight regain and discuss emerging strategies to address this challenge, providing new perspectives for optimizing the long-term clinical management of obesity.

Objective:To investigate the multimorbidity of myopia and obesity, as well as myopia and malnutrition, among children and adolescents aged 7-18 in Guangdong Province and analyze their epidemiological characteristics and related factors.Methods:A stratified random cluster sampling method was used to select 274 939 children and adolescents aged 7-18 from 21 cities in Guangdong Province in 2023. Physical examination information such as height, weight, distance vision, and diopter, as well as questionnaire survey information on dietary behavior, physical activity, screen behavior, sleep time, etc., were collected to analyze the current status and trends of multimorbidity between myopia and obesity, myopia and malnutrition. The multivariate logistic regression model was used to analyze the related factors of multimorbidity.Results:The multimorbidity rates of myopia and obesity, myopia and malnutrition in children and adolescents aged 7-18 in Guangdong Province in 2023 were 4.43% and 6.40%, respectively. The multimorbidity rates for males were 5.44% and 6.88%, respectively, which were higher than those for females, about 3.31% and 5.88% (both P<0.001). The multimorbidity rates of urban students were 5.03% and 6.73%, respectively, which were higher than those of county students at 4.03% and 6.18% (both P<0.001). The multimorbidity rates of myopia and obesity, myopia and malnutrition increased with the increase of academic stage (all P<0.001). The multimorbidity rates of myopia and obesity, as well as myopia and malnutrition, fluctuated with age, with the first decrease occurring at the age of 12. The multivariate logistic regression analysis showed that compared to children and adolescents aged 7-18 who had daily after-school tutoring <2 hours, daily screen time <2 hours, did not consume sugary drinks every day, sleep time that could meet health requirements daily, and exercised≥60 minutes of moderate-to vigorous-physical activity ≥60 minutes for at least 3 days per week, those who had daily after-school tutoring ≥2 hours ( OR=1.18, 95% CI: 1.11-1.26), daily screen time ≥2 hours ( OR=1.09, 95% CI: 1.02-1.16), consumed sugary drinks every day ( OR=1.20, 95% CI: 1.11-1.30), daily sleep time that could not meet the health requirements ( OR=1.16, 95% CI: 1.09-1.23), and no exercise per week ( OR=1.09, 95% CI: 1.01-1.18) had a higher risk of multimorbidity of myopia and obesity. Compared to children and adolescents who exercised≥60 minutes of moderate-to vigorous-physical activity ≥60 minutes for at least 3 days per week, those who exercised <3 days per week ( OR=1.20, 95% CI: 1.17-1.34) had a higher risk of multimorbidity of myopia and malnutrition. Conclusion:The multimorbidity rates of myopia and obesity, as well as myopia and malnutrition, in children and adolescents aged 7-18 in Guangdong Province are relatively low and fluctuate with age. Physical activity, screen time, consumption of sugary drinks, and sleep time may be associated with these multimorbidities.

Objective:To explore the static and dynamic improvement effects of dual nerve transfer (hypoglossal nerve-temporal bone trunk end-to-side anastomosis, masseteric nerve-buccal branch end-to-end anastomosis) in the treatment of peripheral facial paralysis after acoustic neuroma resection surgery.Methods:A retrospective analysis was conducted on the clinical data of patients with peripheral facial paralysis after acoustic neuroma surgery who underwent dual nerve transfer surgery in the Department of Plastic Surgery of China-Japan Friendship Hospital from January 2022 to January 2024. The clinical data included standardized photographs and videos before and 1 year after surgery. House-Brackmann (H-B) grading of facial paralysis (Grade Ⅰ to Ⅵ, higher grade indicates worse facial nerve function), electronic facial assessment by computer evaluation (eFACE) (0 to 100 points, higher scores indicate better facial function), facial disability index-physical (FDIP) (-25 to 100 points, higher scores indicate better facial function), facial clinimetric evaluation (FaCE) (0 to 100 points, higher scores indicate better facial function) were used as the effectiveness evaluation indicator, and safety data were collected through patient reports. The measurement data of normal distribution were expressed as Mean±SD and the paired t-test was used. The grade data were analyzed using the Wilcoxon signed-rank test. When conducting correlation tests, the Pearson correlation test was used for normally distributed data. Results:A total of 20 patients were enrolled, including 7 males and 13 females, with an average age of (33.4 ± 6.5) years (22 to 44 years). The duration of facial paralysis was (10.3 ± 4.5) months (1 to 20 months). Before the operation, the H-B grades of all patients were grade Ⅵ. At the 1-year follow-up after the operation, all patients showed significant improvement in facial static tension and smile movement. The H-B grades of the affected sides of all patients improved. Among them, 18 cases decreased from grade Ⅵ to grade Ⅲ, and 2 cases decreased from grade Ⅵ to grade Ⅱ. The differences in H-B grades of the affected sides before and after the operation were statistically significant ( P < 0.01). Compared with those before the operation, the static eFACE scores [(64.55±12.62) points vs. (84.25±9.08) points], dynamic eFACE scores [(34.85±9.31) points vs. (68.70±5.36) points], FDIP scores [(28.50±8.13) points vs. (59.50±5.36) points], and FaCE scores [(23.33±9.23) points vs. (61.92±9.65) points] of the affected sides significantly increased, and the differences were statistically significant (all P<0.01). Correlation analysis showed that there was a negative correlation between age and the postoperative eFACE static score ( r=-0.61, P < 0.01). Five patients complained of mild chewing weakness and bilateral chewing asymmetry, which did not affect their daily lives, no patients had tongue atrophy, tongue extension weakness, speech or swallowing disorders. Conclusion:Dual nerve transfer surgery provides both facial static tension and smile dynamics, and has remarkable clinical efficacy in treating peripheral facial paralysis after acoustic neuroma surgery.

Hepatocellular carcinoma (HCC) is a leading cause of cancer-associated death globally. Liver transplantation (LT) has emerged as a key treatment for patients with HCC, and the Milan criteria have been adopted as the cornerstone of the selection policy. To allow more patients to benefit from LT, a number of expanded criteria have been proposed, many of which use radiologic morphological characteristics with larger and more tumors as surrogates to predict outcomes. Other groups developed indices incorporating biological variables and dynamic markers of response to locoregional treatment. These expanded selection criteria achieved satisfactory results with limited liver supplies. In addition, a number of prognostic models have been developed using clinicopathological characteristics, imaging radiomics features, genetic data, and advanced techniques such as artificial intelligence. These models could improve prognostic estimation, establish surveillance strategies, and bolster long-term outcomes in patients with HCC. In this study, we reviewed the latest findings and achievements regarding the selection criteria and post-transplant prognostic models for LT in patients with HCC.