[摘 要] 目的：探讨m6A调控因子在宫颈癌预后评估、免疫微环境特征及治疗反应中的作用，构建基于m6A调控因子的预后风险模型，并分析其与免疫浸润、药物敏感性及细胞间通信的关系。方法：基于TCGA和GEO数据库中宫颈鳞癌及腺癌（CESC）转录组数据，分析22个m6A调控因子的表达与突变情况；采用LASSO‑Cox回归构建m6A相关预后风险模型，并依据风险评分将患者分为高、低风险组。利用CIBERSORT和ESTIMATE算法评估两组免疫细胞浸润及微环境特征；通过oncoPredict预测抗肿瘤药物敏感性。整合单细胞转录组数据（E-MTAB-12305），采用CellChat分析细胞间通信网络。结果：共鉴定出12个在宫颈癌中差异表达的m6A调控因子。高风险组患者总生存期缩短（P < 0.05），免疫评分降低，且对紫杉醇、氟尿嘧啶、多柔比星等抗肿瘤药物敏感性较差（IC50较高）。单细胞分析显示宫颈癌组织中细胞间通信网络发生改变，其中T细胞与内皮/上皮细胞间的相互作用可能主要由CCL5‑ACKR1和MIF‑（CD74 + CXCR4）配体‑受体介导。在临床样本中，对关键的m6A调控因子进行mRNA和蛋白水平的验证，结果显示部分调控因子在宫颈癌组织中的表达水平高于正常宫颈组织（P < 0.05）。结论：m6A调控因子特征可有效预测宫颈癌患者预后，其风险评分与肿瘤免疫浸润、药物敏感性及细胞通信密切相关，为宫颈癌的预后分层及个体化治疗提供了新的分子依据。

Objective: To explore the feasibility of synthetic magnetic resonance imaging (syMRI) combined with clinicopathological characteristics for the pre-treatment prediction of chemoradiotherapy (CRT) response in advanced nasopharyngeal carcinoma (ANPC). Materials and Methods: Patients with ANPC treated with CRT between September 2020 and June 2022 were retrospectively enrolled and categorized into response group (RG, n = 95) and non RGs (NRG, n = 32) based on the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. The quantitative parameters from pre-treatment syMRI (longitudinal [T1] and transverse [T2] relaxation times and proton density [PD]), diffusion-weighted imaging (apparent diffusion coefficient [ADC]), and clinicopathological characteristics were compared between RG and NRG. Logistic regression analysis was applied to identify parameters independently associated with CRT response and to construct a multivariable model. The areas under the receiveroperating characteristic curve (AUC) for various diagnostic approaches were compared using the DeLong test. Results: The T1, T2, and PD values in the NRG were significantly lower than those in the RG (all P < 0.05), whereas no significant difference was observed in the ADC values between these two groups. Clinicopathological characteristics (Epstein–Barr virus [EBV]-DNA level, lymph node extranodal extension, clinical stage, and Ki-67 expression) exhibited significant differences between the two groups. Logistic regression analysis showed that T1, PD, EBV-DNA level, clinical stage, and Ki-67 expression had significant independent relationships with CRT response (all P < 0.05). The multivariable model incorporating these five variables yielded AUC, sensitivity, and specificity values of 0.974, 93.8% (30/32), and 91.6% (87/95), respectively. Conclusion SyMRI may be used for the pretreatment prediction of CRT response in ANPC. The multivariable model incorporating syMRI quantitative parameters and clinicopathological characteristics, which were independently associated with CRT response, may be a new tool for the pretreatment prediction of CRT response.

This study aims to screen epitope antigens targeting the receptor binding domain(RBD)of porcine epidemic diarrhea virus(PEDV)based on its amino acid sequence(GenBank accession number:AKN45969.1),prepare PEDV RBD polyclonal antibody,and perform their identification.Bioinformatics analysis software was used to predict the potential antigenic epitopes of PEDV RBD and sequence comparison with porcine coronavirus strains was performed,the selected dominant antigen epitopes were then conjugated with keyhole limpet hemocyanin(KLH),to synthesize pep-tides directly and immunize mice to generate specific antibody,Western blot technique and indirect immunofluorescence assay were utilized to identify the specificity of the antibodies,and indirect ELISA method was further applied to determine the antibody potency.Results showed the selected PEDV RBD dominant epitope sequence shared 100％similarity with 18 other PEDV strains,while exhibiting low sequence similarity with 11 TGEV strains(27.8％—29.3％)and 16 PDCoV strains(10.5％—13.4％),indicating good epitope conservation.Western blot showed that the specificity of the prepared peptide antibody specifically recognized the PEDV RED protein overexpressed in Ex-pi293F cells and overexpressed in baculovirus system,and at the same time,the antibody was still able to detect the PEDV S protein expressed in PEDV-infected Vero cells at a 1∶2 000 dilution,while it did not react with TGEV-and PDCoV-infected ST cells,indicating that the good specificity of the peptide antibody.ELISA revealed that the potency of specific antibodies in mouse serum could reach up to 1∶25 600.The above results indicate that bioinformatics techniques were suc-cessfully utilized to predict antigenic epitopes of PEDV RBD protein,and specific PEDV RBD pep-tide antibodies were prepared.

Objective To develop and validate a risk prediction model for non-cuffed catheter(NCC)dysfunction in hemodialysis patients,aiming to provide a reference for early clinical identification and warning.Methods A prospective study design was adopted.A total of 569 patients with indwelling NCC from the hemodialysis center of a tertiary hospital in Nanchang between December 1,2023 to May 20,2024,were included as a modeling cohort.An additional 172 patients from the hemodialysis center of a tertiary hospital in Changsha,enrolled between May 30 to October 20,2024,formed a validation cohort.Data were collected on general patient characteristics,dialysis information,catheterization details,and clinical parameters.The risk prediction model was constructed using a combination of variables identified through univariate analysis,Lasso regression,logistic regression,and the Boruta algorithm.Model performance was evaluated accordingly.Results The incidence of NCC dysfunction in hemodialysis patients was 44.94％.A total of 5 common predictors were identified by both algorithms,including age,ultrafiltration volume,catheter insertion site,catheter indwelling time,and C-reactive protein.The area under the receiver operating characteristic curve(AUC)was 0.720 for internal validation and 0.766 for external validation.The Brier scores for curve calibration were 0.213 and 0.203,respectively.The decision curve analysis showed clinical benefit within risk threshold ranges of 22％～82％and 22％～96％,respectively.Conclusion The risk prediction model developed in this study demonstrates good predictive performance and can serve as a screening and assessment tool for identifying the risk of NCC dysfunction in hemodialysis patients.

Retinopathy caused by myopia is the first cause of irreversible blinding eye disease in China.The TCM methods to prevent and control myopia mainly include Chinese materia medica and TCM appropriate techniques,which have the advantages of good efficacy,simple operation,and few adverse reactions.This paper believed that internal and external pathogenic factors act on the brain and eyes,breaking their homeostasis,leading to rhythmic disorders,and imbalance of essence,qi and blood is the main pathogenesis of myopia.Based on the idea of"nature and human in the same rhythm"and"the same treatment for common diseases",targeting the above pathogenesis,the method of"brain-eye synchronization"was proposed to restore the homeostasis of the brain and eyes to prevent and control myopia in children and adolescents,and the treatment rules were to regulate the rhythms of the time,harmonize the qi and blood,nourish the blood to soften the tendons,and replenish the essence and blood,so as to achieve the effect of brain-eye synchronization and the treatment of the spirit and the body together.This article summarized the theoretical basis of"brain-eye synchronization"and its clinical application in traditional Chinese and Western medicine,with a view to providing new ideas for the prevention and control of myopia in children and adolescents.

Traditional Chinese medicine upholds the unity of nature and humanity as its fundamental principle,asserting that man is in harmony with heaven and earth and corresponds to the sun and moon.Human life processes align with the circadian rhythms of nature,exhibiting periodic temporal changes-concepts that Western medicine defines as biological rhythms.The"opening-closing-pivot"of the three yin and three yang meridians represents the primary mode of interaction between nature and humanity.This mechanism regulates the transformation of yin and yang to qi within the body,ensuring synchronization with the circadian rhythm.Building upon this foundation,the concept of"the harmony of rhythms and states"was proposed to explain human growth and aging."Rhythms"encompass not only circadian cycles but also the movement of qi and blood,as well as the contraction rhythm of muscle fascia,among other physiological processes."States"refer to the dynamic evolution and transformation of qi during the"opening-closing-pivot"stages in both time and space."Harmony"pertains not only to the individual physiological balance of"rhythms"or"states"but also to their coherent interaction.The fundamental cause of myopia is"the disharmony of rhythms and states",considering that rhythm disorders,qi and blood disorders,and fascia imbalances contribute to this disease.Based on this understanding,myopia prevention and treatment should center on"regulating rhythms and states",with adjusting the pivot to brighten the eyes as the core therapeutic principle throughout the entire cycle of myopia.Treatment should be tailored to different disease stages and supplemented with methods such as time-based regulation,qi and blood harmonization,tendon relaxation and collateral dredging,and essence and blood nourishment to prevent and manage myopia effectively.

Aim To study the effect of p-benzoyl sali-droside(pOBz)on angiogenesis after ischemic stroke and to explore the underlying mechanism.Methods The MCAO model was prepared by suture method.Rats were divided into four groups:sham,MCAO,pOBz administration,and edaravone positive control,treated for seven days.The mNSS was used to assess the neurological impairment.Western blotting was em-ployed to detect CD31,NICD,and Hes-1 protein ex-pression,while immunofluorescence staining was ap-plies to quantify CD31-positive cells in ischemic brain tissue.In vitro an OGD/R model was established in HUVECs.Following treatment with varying pOBz con-centrations(0.01,0.1,1 μmol·L-1),the CCK-8 as-say was uses to measure cell viability,and in vitro tube formation assay was utilized to evaluate angiogenesis.Western blotting was employed again to assess CD31,NICD and Hes-1 protein levels.To further elucidate the mechanism,HUVEC were treated with the Notch inhibitor DAPT prior to grouping and pOBz administra-tion,and the same parameters were evaluated.Results pOBz significantly reduced the mNSS score of MCAO rats,increased CD31-positive cell counts,and upregu-lated CD31,NICD,and Hes-1 protein expression(P＜0.01).In vitro results further showed that pOBz could dose-dependently increase the survival rate and angio-genesis ability of HUVEC induced by OGD/R,and promote CD31,NICD and Hes-1 proteins(P＜0.01),and Notch inhibitor DAPT could reverse the above effects of pOBz.Conclusion pOBz promotes angio-genesis in HUVEC,and its mechanism involves activa-tion of the Notch signaling pathway.

Objective This study aimed to explore the ability of ultrasonographic radiomics in predicting the occurrence of in-stent restenosis(ISR)after carotid artery stenting(CAS)by analyzing the correlation between radiomic features of responsible plaques in carotid artery stenosis and the incidence of ISR.Methods A retrospective collection was conducted on 206 cases that underwent CAS treatment at our hospital.The enrolled patients were randomly split into a training set(144 cases)and a test set(62 cases)at a 7∶3 ratio.We utilized the Darwin Intelligent Research Platform to extract radiomic features from each region of interest,and then screened 1125 ultrasonographic radiomic features.Different machine learning algorithms were employed to construct diagnostic models,and the best-performing classifier was selected.Various prediction models were established,including a clinical-ultrasonographic feature model,a radiomic model,and a combined clinical-ultrasonographic-radiomic model.Results Multivariate logistic regression analysis in the training set revealed that hypertension,hyperuricemia,triglycerides,and plaque location were independent risk factors for ISR after CAS.For the clinical-ultrasonographic model,the area under the curve(AUC)values for the training and validation sets were 0.896 and 0.644,respectively.The corresponding AUC values for the radiomic model were 0.961 and 0.715,while those for the combined model were 0.947 and 0.727.Conclusion The radiomic model demonstrates superior performance in predicting ISR compared to the traditional clinical-ultrasonographic model.The combined model exhibited an enhanced ability to predict ISR occurrence,thereby improving the diagnostic performance of traditional assessments.

Objective To investigate the relationship between microRNA(miR)-425-5p/patched homolog 1(PTCH1)axis molecules and clinical pathological parameters and prognosis in cancer tissues of primary laryngeal cancer(PLC)patients.Methods 102 PLC patients admitted to Mianyang Central Hospital from March 2020 to March 2021 were selected.The relative expression level of miR-425-5p and PTCH1 positive expression rate in PLC cancer tissues and adjacent normal tissues were compared,and the relationship between miR-425-5p relative expression level,PTCH1 positive expression rate and PLC clinical pathological parameters was analyzed.Kaplan-Meier curve and Log-Rank were used χ2 tests were conducted to analyze the 3-year cumulative survival rate of miR-425-5p and PTCH1 positive/negative expression groups,and COX regression model was used to analyze the influencing factors of PLC prognosis.Results Compared with normal tissue adjacent to cancer,the relative expression level of miR-425-5p in PLC cancer tissue was significantly increased(2.12±0.52 vs 0.98±0.17),and the positive expression rate of PTCH1 was significantly reduced(27.45%vs 61.76%),with statistical significance(t/χ2=21.045,24.302,all P＜0.05).Compared with patients with T1-T2,N0,and high differentiation of tumors,patients with T3-T4,N1-N3,and low differentiation of tumors showed a significant increase in the relative expression of miR-425-5p(t=3.647,2.900,3.029),and a significant decrease in the positive expression rate of PTCH1(χ2=5.842,4.011,5.136),the differences were statistically significance(all P<0.05).The 3-year cumulative survival rate of the miR-425-5p high expression group was 64.52%(20/31),which was significantly lower than that of the low expression group at 84.06%(58/69).The 3-year cumulative survival rate of the PTCH1 high expression group was 80.00%(28/35),which was significantly higher than that of the low expression group at 64.62%(42/65),and the differences were statistically significant(Log-Rank χ2=4.287,4.548,all P<0.05).Elevated T taging,cervical lymph node recurrence,elevated N staging,pharyngeal recurrence,elevated miR-425-5p,and negative PTCH1 expression were risk factors for poor prognosis of PLC(all P<0.05).Conclusion High expression of miR-425-5p and low expression of PTCH1 in cancer tissues of primary laryngeal cancer patients are significantly correlated with elevated T stage,low tumor differentiation,elevated N stage,and low 3-year cumulative survival rate.

This paper reports a case of a 59-year-old female patient who presented with sudden aphasia and left-sided weakness.After emergency cerebral angiography and intracranial artery thrombectomy,the left subclavian artery was accidentally punctured during left subclavian vein catheterization.Three-dimensional reconstruction and preoperative simulation using Mimics software and 3dsMAX were performed to determine the subcutaneous tunnel length and the applicability of the Angioseal closure device.Preoperative simulation showed a tunnel length of 74.6 mm,satisfying the condition of subcutaneous tunnel＜compression tube＜Angioseal introducer.Angioseal closure was then performed.Postoperative angiography showed satisfactory occlusion,and the patient had no complications.This paper discusses the challenges in managing accidental subclavian artery punctures and the application conditions of the Angioseal closure device,emphasizing the importance of preoperative three-dimensional reconstruction and simulation for ensuring surgical success.For accidental subclavian artery punctures with tunnel lengths not exceeding 88 mm,the Angioseal closure device is a safe and effective method.