OBJECTIVE To evaluate the efficacy， safety and cost-effectiveness of deucravacitinib in the treatment of moderate- to-severe plaque psoriasis. METHODS Rapid health technology assessment （HTA） reports， systematic reviews （SR）/meta- analyses， and pharmacoeconomic studies on deucravacitinib for the treatment of moderate-to-severe plaque psoriasis were identified by searching PubMed， Web of Science， Embase， CNKI， Wanfang data and official HTA websites. The search time frame spanned from database inception to July 2025. After literature screening， data extraction， and quality assessment， the study results were subjected to descriptive analysis and synthesis. RESULTS A total of 14 articles were finally included， consisting of 1 HTA report， 10 SR/meta-analyses， and 3 pharmacoeconomic studies. Regarding efficacy， deucravacitinib demonstrated superior efficacy to both placebo and apremilast， with significantly higher response rates for Psoriasis Area and Severity Index 50/75/90/100， Static Physician’ s Global Assessment 0/1， and Dermatology Life Quality Index 0/1， as well as greater reduction in Psoriasis Symptoms and Signs Diary Score （P＜0.05）. Regarding safety， deucravacitinib was well-tolerated. Although the overall incidence of adverse events （AEs） was higher than placebo， it was not significantly different from apremilast. Moreover， the incidence of serious AEs and the rate of discontinuation due to AEs did not differ significantly from placebo （P＞0.05）. Regarding cost-effectiveness， deucravacitinib proved to be more cost-effective than apremilast across multiple healthcare system perspectives， including those of the United States， Japan， and China. CONCLUSIONS Deucravacitinib exhibits favorable efficacy， safety， and cost-effectiveness in the treatment of moderate-to-severe plaque psoriasis. Additional real-world studies are warranted to further refine its evaluation.

ObjectiveTo systematically identify the chemical constituents of Xuefu Zhuyutang（XFZY） and quantitatively determine its main components， aiming to elucidate its pharmacodynamic material basis and provide a scientific foundation for improving its quality control standards. MethodsUltra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry（UPLC-Q-TOF-MS/MS） was employed for qualitative analysis of XFZY， and the identification of compounds was accomplished by comparing their retention times， secondary MS fragment ion information， 52 reference standards and relevant databases， followed by attribution of their herbal sources. A total of 22 representative compounds were screened out， and UPLC-quadrupole-linear ion trap mass spectrometry（UPLC-Q-TRAP-MS/MS） was applied for quantitative analysis of the compounds in the formula. ResultsA total of 77 compounds were identified in XFZY， including 31 flavonoids mainly derived from Aurantii Fructus， Glycyrrhizae Radix et Rhizoma， Persicae Semen， Carthami Flos， Bupleuri Radix， Paeoniae Radix Rubra and Achyranthis Bidentatae Radix， 24 terpenoids mainly derived from Platycodonis Radix， Glycyrrhizae Radix et Rhizoma， Paeoniae Radix Rubra and Rehmanniae Radix， 9 phenylpropanoids and their derivatives mainly derived from Chuanxiong Rhizoma， Angelicae Sinensis Radix and Rehmanniae Radix， 4 phenolic acids mainly derived from Chuanxiong Rhizoma， Angelicae Sinensis Radix and Paeoniae Radix Rubra， 3 saccharides mainly derived from Rehmanniae Radix and Achyranthis Bidentatae Radix， and 6 other compounds mainly derived from Persicae Semen， Rehmanniae Radix and Angelicae Sinensis Radix. The results of quantitative analysis showed that the contents of protocatechuic acid， hydroxypaeoniflorin， amygdalin， vanillic acid， paeoniflorin， liquiritin apioside， liquiritin， isoquercitrin， naringin， cosmosiin， hesperidin， neohesperidin， isoliquiritin， liquiritigenin， naringenin， benzoylpaeoniflorin， hesperetin， isoliquiritigenin， formononetin， glycyrrhizic acid， nobiletin and ligustilide in XFZY were determined to be 0.12， 1.57， 54.53， 0.29， 36.17， 4.29， 4.84， 0.09， 46.67， 0.04， 3.44， 31.95， 0.82， 0.10， 0.11， 0.43， 0.07， 0.03， 0.01， 8.24， 0.13， 1.81 mg·g^-1. ConclusionThe qualitative method established in this study enables rapid and sensitive analysis of the chemical constituents in XFZY. Among the identified compounds， 52 are confirmed by reference standards， ensuring the accuracy of identification. The quantitative analysis of 22 key components provides a reliable experimental basis for the pharmacodynamic material basis research and quality control standard improvement of XFZY.

Objective To explore the related risk factors of osteosarcopenia (OS) in elderly patients with type 2 diabetes mellitus (T2DM) and to evaluate their predictive value. Methods We selected 409 elderly patients with T2DM from our hospital between June 2021 and December 2024 as the study subjects, and divided them into an OS occurrence group and a non-occurrence group based on whether they were diagnosed with OS. Results Among the 409 elderly patients with T2DM included, 93 were diagnosed with OS, yielding a prevalence rate of 22.73%. Spearman correlation analysis revealed a significant association between lumbar spine BMD and T-scores with age, history of previous fractures, fasting plasma glucose (FPG), procollagen type I N-terminal propeptide (PINP), osteocalcin (OC), and 25-hydroxyvitamin D (25(OH)D). Gender (OR=0.193), Body Mass Index (BMI) (OR=0.254), history of previous fractures (OR=8.883), FPG (OR=0.543), Total Cholesterol (TC) (OR=3.684), High-Density Lipoprotein Cholesterol (HDL-C) (OR=86.024), PINP (OR=0.818), and OC (OR=0.526) are identified as influential factors for the occurrence of OS in elderly patients with T2DM. The combined prediction of these variables yields a sensitivity of 96.5%, a specificity of 97.8%, and an area under the curve (AUC) of 0.992 for the occurrence of OS in elderly patients with T2DM, indicating an excellent predictive performance. Conclusion The following factors—gender, BMI, history of previous fractures, FPG, TC, HDL-C, PINP, and OC—are influential in the occurrence of OS among elderly patients with T2DM. Formulating intervention measures based on these influencing factors can provide assistance in preventing and treating the occurrence of OS.

In recent years, therapeutic monoclonal antibody drugs have developed rapidly and are widely used in fields such as tumors, cancer, and immune diseases. However, most of the currently approved antibodies are full-size IgG1 antibodies,which have disadvantages such as large size and weak tissue penetration. To overcome this deficiency, the solution is to reduce the size without weakening the functionality. The key to the longer half-life of IgG lies in the Fc region. Therefore,engineering modification mainly involves constructing new Fc antibody scaffolds, which combine the characteristics of longer half-life, strong tissue penetration, and access binding ability to spatially restricted binding sites while having a smaller size,thereby improving the therapeutic effect. This paper reviews several Fc-based small molecule antibody fragments as scaffold models and their application prospects.

Purpose To investigate the role of tumor-associated neutrophils(TANs)in the sternness characteris-tics of breast cancer cells.Methods Flow cytometry was used to identify and validate the successful generation of TANs.Breast cancer cell lines were co-cultured with TANs-conditioned supernatant,and their sphere-forming capacity was assessed.Western blot and reverse transcription-quantitative polymerase chain reaction(RT-qPCR)were used to detect the expression of stem cell-associated markers.In breast cancer clinical specimens,immunohistochemistry(IHC)was performed to quantify TANs infiltration and the expression of sternness-related markers.Correlations be-tween TANs infiltration and sternness marker expression,as well as their associations with clinicopathological features of breast cancer patients,were analyzed.Results Flow cytometry results demonstrated a significantly higher survival rate of TANs compared to normal neutrophils(NEUs)(P＜0.05).In vitro,TANs-derived supernatant significantly en-hanced the sphere-forming capacity of breast cancer cells compared to NEU-derived supernatant(P＜0.05).RT-qPCR analysis revealed that the mRNA expression levels of sternness-related markers such as CD133 and SOX9 in tumor cells was significantly increased after TANs supernatant co-cultured with breast cancer cells(P＜0.05).The results of western blot further confirmed that the protein expression levels of CD133 and SOX9 were markedly increased in the TANs supernatant group relative to the NEU supernatant group(P＜0.01).Immunophenotypic analysis showed that the infiltration density of CD66b+TANs in breast cancer tissues was positively correlated with the expression of CD133(r=0.429,P＜0.001)and SOX9(r=0.561,P＜0.001)in tumor cells.Prognostic and clinicopathological analy-ses indicated that patients in the high CD66b+TANs infiltration group,high CD133 expression group,and high SOX9 expression group had significantly shorter progression-free survival(PFS)than those in the corresponding low-expres-sion/infiltration groups(P＜0.05).Furthermore,the infiltration density of CD66b+TANs was significantly associated with patient age,histological grade,and lymph node metastasis status(all with P＜0.05).CD133 expression was cor-related with patient age,lymph node metastasis,and progesterone receptor(PR)status(all with P＜0.05),while SOX9 expression was associated with patient age and lymph node metastasis status(all with P＜0.05).Conclusion TANs can promote the acquisition and maintenance of sternness characteristics in breast cancer cells.These findings may provide novel insights into the development of neutrophil-targeted immunotherapeutic strategies for breast cancer.

OBJECTIVES: To fabricate an injectable composite microsphere hydrogel reinforced with silk fibroin/hyaluronic acid microspheres, achieving synergistic enhance-ment of mechanical robustness and biofunctionality. METHODS: Methacrylated hyaluronic acid (HAMA) and thiolated silk fibroin (TSF) were synthesized. Monodisperse microspheres generated via microfluidics were UV-cured (420 nm) through thiol-ene click reaction. These microspheres were embedded in a TSF/HAMA matrix to form photo-cured composites. The grafting rate of TSF and HAMA was characterized by H1-NMR; particle size distribution of microsphere hydrogels in soybean oil was observed by optical microscopy; gel point of composite microsphere hydrogels was determined by advanced extensional rheometer; microscopic morphology of microsphere hydrogels was observed by scanning electron microscopy; elemental distribution of microsphere hydrogels was detected by X-ray energy dispersive spectroscopy; tunability of composite microsphere hydrogels was observed by inverted confocal microscopy; mechanical properties of composite microsphere hydrogels were tested by compression testing; swelling ratio, degradation rate and water retention rate of composite microsphere hydrogels were measured by gravimetric method. Cytotoxicity of the composite microsphere hydrogels was determined by Calcein-AM/propidium iodide dual staining and CCK-8 assay; cell migration capability was observed by scratch assay. RESULTS: The grafting rates of HAMA and TSF was 48.03% and 17.99%, respectively. Microsphere hydrogels with particle sizes of (43.3±1.2), (78.1±3.0), and (130.8±1.9) μm were prepared. The gel time of the composite microsphere hydrogels was 48-115s. The laser confocal imaging confirmed dynamic regulation characteristics of the composite microsphere hydrogels. The compressive strength of the composite microsphere hydrogels reached 22.7 kPa and maintained structural integrity at 40% strain after 20 compression cycles. The composite microsphere hydrogels exhibited differential deswelling behaviors in simulated physiological environments, and reducing microsphere particle size could significantly enhance its stability under moist conditions. The degradation rate of the composite microsphere hydrogels was (49.1±0.9)% after 200 h, and water retention rate was maintained at 40%-60% after 96 h. Biocompatibility assays confirmed >95% cell viability and unimpaired cell migration abilities. CONCLUSIONS The TSF/HAMA composite microsphere hydrogel developed in this study has characteristics of rapid fabrication, adjustable mechanical properties, enhanced environmental stability and excellent biocom-patibility, thus providing a new material solution for tissue repair and regenerative medicine.
Fibroins/chemistry* ; Hydrogels/chemistry* ; Microspheres ; Hyaluronic Acid/chemistry* ; Humans

Objective To investigate the efficacy and safety of scar core excision combined with injection of botulinum toxin type A in the treatment of patients with keloids.Methods A total of 186 patients with keloids in the Affiliated Hospital of Hebei University of Engineering from January 2021 to December 2023 were randomly divided into control group and study group,with 93 cases in each group.The control group was treated with scar core excision,while the study group was treated with scar core excision combined with injection of botulinum toxin type A.The Vancouver Scar Scale(VSS)score,the Visual Analogue Scale(VAS)score,scar area,scar thickness,laboratory indica-tors[transforming growth factor-β1(TGF-βi),basic fibroblast growth factor(bFGF),bone morpho-genetic protein 7(BMP-7)],clinical efficacy,and adverse reactions were compared between the two groups.The patients were followed up for one year,and the recurrence rate of the two groups was com-pared.Results At 3 and 12 months after treatment,the VSS score,the VAS score,scar area,and scar thickness in both groups decreased significantly,and those in the study group were significantly lower than those in the control group(P＜0.001).At 3 and 12 months after treatment,TGF-β1 decreased significantly,while bFGF and BMP-7 increased significantly in both groups,and TGF-β1 in the study group was significantly lower than that in the control group,while bFGF and BMP-7 were significantly higher than those in the control group(P＜0.001).The total effective rate in the study group was significantly higher than that in the control group(94.62％versus 76.34％,P＜0.001).The incidence of adverse reactions in the study group was significantly lower than that in the control group(2.15％versus 17.20％,P＜0.001).There was 1 case of recurrence in the study group,with a recurrence rate of 1.08％;6 cases of recurrence in the control group,with a re-currence rate of 6.45％.The recurrence rate in the study group was lower than that in the control group(P＞0.05).Conclusion Scar core excision combined with injection of botulinum toxin type A has a good efficacy in the treatment of keloids,which can alleviate patients' symptoms,shorten scar area and thickness,improve laboratory indicators,reduce the recurrence rate,and has few ad-verse reactions.

Fractures requiring surgical intervention during pregnancy is rarely seen in clinic,and these patients need special treatment and nursing,necessitating the consideration of both maternal fracture repair and fetal safety.For patients in late pregnancy,they have higher risk of complications,such as premature birth,placental abruption,venous thromboembolism(VTE),and anesthesia-relat-ed manifestations during the perioperative period.This article reported a case of a patient at 28 weeks of gestation with medial and lateral malleolar fractures accompanied by ankle joint subluxation and summarized the successful experience of collaboration by a multidisciplinary team(MDT).In terms of nursing,personalized body position management was implemented to relieve inferior vena cava com-pression;a phased analgesic strategy combining nerve block with drugs safe for the fetus was adopted;continuous electronic fetal heart rate and uterine contraction monitoring were carried out to ensure fetal stability during surgery;VTE prevention was strengthened by combining intermittent pneumatic com-pression devices with low-molecular-weight heparin;nutritional support and psychological counseling were provided.No complications such as infection,thrombosis,or fetal distress occurred after surgery.The Patient's ankle Kofoed score reached 88 points three months after surgery,indicating good func-tional recovery.Finally,the patient delivered a healthy male infant at full term,with a good Apgar score,and both the mother and the infant were safe.The case indicates that refined perioperative nursing combined with multidisciplinary collaboration can effectively reduce risks and improve the clinical outcomes of pregnant patients with fractures.

Sennoside A(SA),a typical prodrug,exerts its laxative effect only after its transformation into rhei-nanthrone catalyzed by gut microbial hydrolases and reductases.Hydrolases have been identified,but reductases remain unknown.By linking a photoreactive group to the SA scaffold,we synthesized a photoaffinity probe to covalently label SA reductases and identified SA reductases using activity-based protein profiling(ABPP).From lysates of an active strain,Bifidobacterium pseudocatenulatum(B.pseu-docatenulatum),397 proteins were enriched and subsequently identified using mass spectrometry(MS).Among these proteins,chromate reductase/nicotinamide adenine dinucleotide(NADH)phosphate(NADPH)-dependent flavin mononucleotide(FMN)reductase/oxygen-insensitive NADPH nitroreductase(nfrA)was identified as a potent SA reductase through further bioinformatic analysis and The Universal Protein Resource(UniProt)database screening.We also determined that recombinant nfrA could reduce SA.Our study contributes to further illuminating mechanisms of SA transformation to rheinanthrone and simultaneously offers an effective method to identify gut bacterial reductases.

OBJECTIVE To evaluate the clinical value of dose-escalated postoperative radiotherapy(PORT)in improving local control and survival outcomes for head and neck adenoid cystic carcinoma(ACC)patients.METHODS This retrospective study analyzed 336 ACC patients treated with surgery plus PORT at Beijing Tongren Hospital from January 2015 to January 2021.Cohort stratification compared high-dose(>60 Gy,n=146)and conventional-dose(≤60 Gy,n=190)regimens.Survival analysis employed Kaplan-Meier estimates with log-rank testing,complemented by multivariate Cox regression for risk adjustment.RESULTS The cohort demonstrated 39.29%(132/336)cumulative local failure rate.The overall survival rates at 1,3,and 5 years after surgery were 98.81%,94.05%,and 90.48%,respectively.Dose-response relationships revealed:1.Significantly reduced local recurrence with high-dose PORT(28.08%vs.47.89%,P<0.001),corresponding to 41.37%lower recurrence risk(a HR=0.59,95%CI=0.38-0.91;P=0.041);2.Superior progression-free survival in the high-dose group(3-year:86.99%vs.76.32%;5-year:82.19%vs.66.32%,all P<0.05);3.Comparable overall survival between groups(median OS:200 vs.160 months,P=0.292).CONCLUSION Dose escalation beyond 60 Gy significantly enhances locoregional control and progression-free survival in head and neck ACC without conferring overall survival advantage,likely reflecting the disease's characteristic indolent metastatic progression.These results establish>60 Gy as an optimal dose threshold for PORT in high-risk ACC management.