ObjectiveAbnormal lipids in neurons can cause the accumulation of α-synuclein（α-syn）. This study aimed to explore the mechanism of Acanthopanacis Senticosi Radix et Rhizoma seu Caulis extract （ASH） in treating Parkinson's disease （PD） mice using lipidomics combined with network pharmacology. MethodsMice were divided into the blank group， model group and ASH （45.5 mg·kg^-1） group. Motor ability was evaluated by pole climbing time and autonomous activity count； The oxidative stress indicators were detected by enzyme-linked immunosorbent assay （ELISA）. Lipid biomarkers in brain tissues were screened and identified by ultra-performance liquid chromatography-tandem mass spectrometry （UPLC-MS/MS）， and metabolic pathway analysis was conducted. The key targets of ASH for PD treatment were explored using network pharmacology. The Kyoto Encyclopedia of Genes and Genomes （KEGG） database was used for pathway enrichment analysis， and the "compound-reaction-enzyme-gene" network was constructed using the MetScape plugin. The protein expression levels of glutathione S-transferase P1 （GSTP1）， glutathione S-transferase Mu 2 （GSTM2）， prostaglandin peroxide synthase 1 （PTGS1）， prostaglandin peroxide synthase 2 （PTGS2）， and prostaglandin E synthase （PTGES） were validated by Western blot. ResultsCompared with the blank group， the model group showed significantly prolonged pole climbing time and reduced autonomous activity count （P<0.01）. Compared with the model group， the ASH group demonstrated significantly faster pole climbing and increased autonomous activity count （P<0.01）. The model group exhibited significantly decreased superoxide dismutase （SOD） and glutathione peroxidase （GSH-Px） levels， and increased malondialdehyde （MDA） level in brain tissues compared with the blank group （P<0.01）. The ASH group showed increased SOD and GSH-Px levels and decreased MDA level compared with the model group （P<0.05， P<0.01）. Lipidomics analysis identified 10 differential metabolites and 8 differential metabolic pathways. Network pharmacological analysis revealed 213 intersection targets between ASH components and PD， with KEGG enrichment involving the sphingolipid signaling pathway， lipid arteriosclerosis， phosphoinositide 3-kinase/protein kinase B（PI3K/Akt） signaling pathway， mitogen-activated protein kinase（MAPK） signaling pathway， and hypoxia inducible factor-1（HIF-1） signaling pathway. Integrated lipidomics and network pharmacology analysis highlighted the central role of the arachidonic acid metabolic pathway. The Western blot results showed that ASH effectively up-regulated GSTP1， GSTM2， and PTGS1 protein expression， and down-regulated PTGS2 and PTGES protein expression. ConclusionASH can ameliorate behavioral deficits， exert antioxidant effects， regulate lipid differential metabolites and the arachidonic acid metabolic pathway， thereby exerting therapeutic effects in PD model mice.

Parkinson's disease （PD）， with its incidence increasing year by year and its onset age gradually becoming younger， has become a major chronic multisystem movement disorder that threatens public health. The microbiota-gut-brain axis （MGBA） is a bidirectional communication system connecting the enteric nervous system and the central nervous system. Its core functions rely on the synergistic interactions among gut microbiota， neural signal transmission， endocrine regulation， and immune interactions， and it plays an indispensable role in maintaining gut-brain dynamic homeostasis， regulating neurotransmitter metabolism， and modulating inflammatory responses. Current studies have found that the gut microbiota of patients with PD exhibits dual dysbiosis characterized by the enrichment of opportunistic pathogens and beneficial bacteria， accompanied by abnormal metabolite levels， which accumulate and trigger neuroinflammation， demonstrating the pivotal regulatory role of the MGBA in the early pathology of PD. Furthermore， this article summarizes Chinese medicines， their active components， and compound formulas that may prevent and treat PD through intervention in the MGBA. These agents can modulate microbial composition， suppress inflammation and oxidative stress， protect the intestinal barrier， and ameliorate dopaminergic neuron damage. By systematically summarizing the central mechanisms of the MGBA in PD and reviewing the research progress of traditional Chinese medicine （TCM） mediated regulation of this pathway in PD intervention， this article aims to provide a theoretical reference for the clinical prevention and treatment of PD and scientific research design.

Diffuse large B-cell lymphoma(DLBCL)is the most common subtype of non-Hodgkin lymphoma,which demonstrates significant heterogeneity.Some DLBCL exhibit poor responses to chemotherapy,highlighting the urgent need for precise prognostic evaluation methods.As a critical biological parameter,tumor burden closely associated with disease progression and unfavorable prognosis,but representing tumor burden of DLBCL only with anatomical parameters was not enough to comprehensively reflect its biology features.Multiple parameters derived from 18F-FDG PET/CT could characterize metabolic features of tumors,hence enabling accurate quantification of tumor burden and providing a theoretical basis for individualized treatment of DLBCL.The research progresses of 18 F-FDG PET/CT for assessing tumor burden of DLBCL were reviewed in this article.

Diffuse large B-cell lymphoma(DLBCL)is the most common subtype of non-Hodgkin lymphoma,which demonstrates significant heterogeneity.Some DLBCL exhibit poor responses to chemotherapy,highlighting the urgent need for precise prognostic evaluation methods.As a critical biological parameter,tumor burden closely associated with disease progression and unfavorable prognosis,but representing tumor burden of DLBCL only with anatomical parameters was not enough to comprehensively reflect its biology features.Multiple parameters derived from 18F-FDG PET/CT could characterize metabolic features of tumors,hence enabling accurate quantification of tumor burden and providing a theoretical basis for individualized treatment of DLBCL.The research progresses of 18 F-FDG PET/CT for assessing tumor burden of DLBCL were reviewed in this article.

Objective:To identify latent profile types of self-acceptance among newly diagnosed young and middle-aged patients with type 2 diabetes mellitus (T2DM), and to analyze the influencing factors.Methods:A convenience sampling method was used to recruit 162 patients with T2DM who visited the Department of Endocrinology at the First Affiliated Hospital of Zhengzhou University between March 2023 and August 2024. A general information questionnaire was used to collect demographic and clinical data. The Acceptance and Action Diabetes Questionnaire (AADQ), Type 2 Diabetes Stigma Assessment Scale (DSAS-2), Diabetes Knowledge Test 2 (DKT2), and e-Health Literacy Scale (eHEALS) were used to assess self-acceptance, diabetes-related stigma, diabetes knowledge, and electronic health literacy, respectively. Latent profile analysis (LPA) was performed to identify categories of self-acceptance based on AADQ scores. Logistic regression analysis was conducted to examine the influencing factors of self-acceptance profiles in young and middle-aged patients with T2DM. A total of 162 questionnaires were distributed, and 157 valid responses were collected, with an effective response rate of 96.91% (157/162) .Results:The mean AADQ score of the 157 patients was (46.64±10.34), ranging from 20 to 63, with a mean item score of (4.24±1.16). Three latent profile categories of self-acceptance were identified: the "high avoidance-low self-acceptance group" (28.66%, 45/157), the "moderate self-acceptance group" (47.13%, 74/157), and the "low avoidance-high self-acceptance group" (24.20%, 38/157). Logistic regression analysis showed that age, body mass index (BMI), diabetes-related stigma, diabetes knowledge, and electronic health literacy were significant influencing factors of self-acceptance profiles in young and middle-aged patients with T2DM ( P<0.05) . Conclusions:The level of self-acceptance in newly diagnosed young and middle-aged patients with type 2 diabetes mellitus remains suboptimal. Particular attention should be paid to patients who are younger, have a BMI below 24.0 kg/m 2, experience high levels of diabetes-related stigma, and have low levels of diabetes knowledge and electronic health literacy. Targeted education and management should be implemented based on patient characteristics.

Objective:To explore the mediating effect of chronic disease resource utilization between health promotion behaviors and disease control in patients with type 2 diabetes mellitus (T2DM) .Methods:Convenience sampling was used to select T2DM patients who attended the Department of Endocrinology and Metabolism of the First Affiliated Hospital of Zhengzhou University from September 2023 to October 2024 for the study. The survey was conducted using the General Information Questionnaire, Chronic Illness Resources Survey (CIRS), Health Promoting Lifestyle Profile-Ⅱ (HPLP-Ⅱ), and Control Status Scale for Diabetes (CSSD). Pearson correlation was used to analyze the relationship between chronic disease resource utilization, health promotion behaviors, and disease control. Structural equation modeling and mediating effect validation were performed using AMOS 21.0.Results:A total of 310 questionnaires were distributed, 292 valid questionnaires were recovered, with a valid recovery rate of 94.19%. The CIRS, HPLP-Ⅱ, and CSSD scores of 292 patients were (53.45±12.83), (145.85±28.40), and (89.41±24.57), respectively. CIRS scores were positively correlated with HPLP-Ⅱ scores and CSSD scores ( P<0.05), and HPLP-Ⅱ scores were positively correlated with CSSD scores ( P<0.05), with statistically significant differences. Mediating effect analysis showed that health promotion behaviors had a direct positive effect on disease control ( P=0.001), and chronic disease resource utilization had a partial mediating effect between health promotion behaviors and disease control ( P=0.001), with statistically significant differences and mediating effect accounting for 26.88% of the total effect (0.157/0.584) . Conclusions:Chronic disease resource utilization, health promotion behaviors, and disease control among T2DM patients are suboptimal, and there is room for improvement. Chronic disease resource utilization has a partial mediating effect between health promotion behaviors and disease control, which may guide clinical nursing practice.

Objective:To identify latent profile types of self-acceptance among newly diagnosed young and middle-aged patients with type 2 diabetes mellitus (T2DM), and to analyze the influencing factors.Methods:A convenience sampling method was used to recruit 162 patients with T2DM who visited the Department of Endocrinology at the First Affiliated Hospital of Zhengzhou University between March 2023 and August 2024. A general information questionnaire was used to collect demographic and clinical data. The Acceptance and Action Diabetes Questionnaire (AADQ), Type 2 Diabetes Stigma Assessment Scale (DSAS-2), Diabetes Knowledge Test 2 (DKT2), and e-Health Literacy Scale (eHEALS) were used to assess self-acceptance, diabetes-related stigma, diabetes knowledge, and electronic health literacy, respectively. Latent profile analysis (LPA) was performed to identify categories of self-acceptance based on AADQ scores. Logistic regression analysis was conducted to examine the influencing factors of self-acceptance profiles in young and middle-aged patients with T2DM. A total of 162 questionnaires were distributed, and 157 valid responses were collected, with an effective response rate of 96.91% (157/162) .Results:The mean AADQ score of the 157 patients was (46.64±10.34), ranging from 20 to 63, with a mean item score of (4.24±1.16). Three latent profile categories of self-acceptance were identified: the "high avoidance-low self-acceptance group" (28.66%, 45/157), the "moderate self-acceptance group" (47.13%, 74/157), and the "low avoidance-high self-acceptance group" (24.20%, 38/157). Logistic regression analysis showed that age, body mass index (BMI), diabetes-related stigma, diabetes knowledge, and electronic health literacy were significant influencing factors of self-acceptance profiles in young and middle-aged patients with T2DM ( P<0.05) . Conclusions:The level of self-acceptance in newly diagnosed young and middle-aged patients with type 2 diabetes mellitus remains suboptimal. Particular attention should be paid to patients who are younger, have a BMI below 24.0 kg/m 2, experience high levels of diabetes-related stigma, and have low levels of diabetes knowledge and electronic health literacy. Targeted education and management should be implemented based on patient characteristics.

Objective:To explore the mediating effect of chronic disease resource utilization between health promotion behaviors and disease control in patients with type 2 diabetes mellitus (T2DM) .Methods:Convenience sampling was used to select T2DM patients who attended the Department of Endocrinology and Metabolism of the First Affiliated Hospital of Zhengzhou University from September 2023 to October 2024 for the study. The survey was conducted using the General Information Questionnaire, Chronic Illness Resources Survey (CIRS), Health Promoting Lifestyle Profile-Ⅱ (HPLP-Ⅱ), and Control Status Scale for Diabetes (CSSD). Pearson correlation was used to analyze the relationship between chronic disease resource utilization, health promotion behaviors, and disease control. Structural equation modeling and mediating effect validation were performed using AMOS 21.0.Results:A total of 310 questionnaires were distributed, 292 valid questionnaires were recovered, with a valid recovery rate of 94.19%. The CIRS, HPLP-Ⅱ, and CSSD scores of 292 patients were (53.45±12.83), (145.85±28.40), and (89.41±24.57), respectively. CIRS scores were positively correlated with HPLP-Ⅱ scores and CSSD scores ( P<0.05), and HPLP-Ⅱ scores were positively correlated with CSSD scores ( P<0.05), with statistically significant differences. Mediating effect analysis showed that health promotion behaviors had a direct positive effect on disease control ( P=0.001), and chronic disease resource utilization had a partial mediating effect between health promotion behaviors and disease control ( P=0.001), with statistically significant differences and mediating effect accounting for 26.88% of the total effect (0.157/0.584) . Conclusions:Chronic disease resource utilization, health promotion behaviors, and disease control among T2DM patients are suboptimal, and there is room for improvement. Chronic disease resource utilization has a partial mediating effect between health promotion behaviors and disease control, which may guide clinical nursing practice.

Objective To investigate the expression of Midkine(MDK)in cholangiocarcinoma(CCA)and its value in predicting the prognosis of CCA,as well as the potential mechanism of the effect of MDK on the progression of CCA.Methods The data of CCA samples were obtained from TCGA database to analyze the difference in the expression of MDK between cancer tissue and paracancerous tissue and its association with clinical features,and the data collected from GEO database and 11 CCA patients who underwent surgical resection in The Fifth Medical Center of Chinese PLA General Hospital from June 2018 to September 2021 were used for validation.STRING and Cytoscape were used to construct a protein-protein interaction network,and gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses were used to investigate the biological functions and tumor-related pathways involving MDK-related genes.In addition,TIMER and TISIDB databases were used to analyze the correlation between MDK expression and immune cell infiltration in CCA tissue.The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups,and the Fisher's exact test was used for comparison of categorical data between two groups.The Kaplan-Meier method was used to plot survival curves,and the Log-rank test was used for comparison between groups.The Spearman correlation analysis was used to investigate the correlation between two variables.Results The expression level of MDK in cancer tissue and paracancerous tissue of CCA patients was compared based on TCGA database,and the results of the non-paired and paired analyses showed that the expression level of MDK in CCA tumor tissue was significantly higher than that in paracancerous tissue(P<0.001).Transcriptome sequencing was performed for the tumor tissue and its corresponding paracancerous tissue from 11 CCA patients,and the results showed that the expression level of MDK in CCA tumor tissue was significantly higher than that in corresponding paracancerous tissue(P<0.01).High expression of MDK was associated with lymph node metastasis(P=0.045)and vascular invasion(P=0.044).Survival analysis showed that compared with the CCA patients with low MDK expression,the CCA patients with high MDK expression had significantly shorter overall survival time(χ2=5.30,P=0.028)and disease-specific survival time(χ2=6.25,P=0.019).The GO and KEGG enrichment analyses showed that the 30 MDK-related genes were closely associated with ubiquitin-mediated proteolysis and affected the prognosis of CCA patients.The TIMER analysis showed that the expression level of MDK was positively correlated with the infiltration of B cells(r=0.356,P=0.035 6)and dendritic cells(r=0.409,P=0.014 7)in tumor microenvironment of CCA;the TISIDB analysis showed that the expression level of MDK was positively correlated with CXCL16(r=0.465,P=0.004 67)and was negatively correlated with CXCL12(r=-0.389,P=0.019 7)and CXCR5(r=-0.393,P=0.018 5),and it was also negatively correlated with the immune checkpoint regulators VTCN1(r=-0.393,P=0.018 3),LTA(r=-0.380,P=0.022 7),and PVR(r=-0.350,P=0.037 3).Conclusion High expression of MDK is associated with poor prognosis in CCA patients,and MDK has the potential of being used as a molecular marker for predicting the prognosis of CCA.MDK may promote the development and progression of CCA by regulating ubiquitin-mediated proteolysis and the infiltration of B cells and dendritic cells.

Objective:To evaluate the clinical efficacy of nasal pedicle tissue flap based on nasal blood supply in the reconstruction of nasal skull base defects.Methods:A retrospective analysis was conducted on 138 clinical cases of skull base tumors and cerebrospinal fluid rhinorrhea treated at the Department of Otolaryngology, Head and Neck Surgery at Xiangya Hospital of Central South University from March 2017 to March 2023. A total of 79 males and 59 females were enrolled, aged from 8 to 82 years, with a median age of 51 years, including 108 patients (78.3%) with skull base tumors and 30 patients (21.7%) with cerebrospinal fluid rhinorrhea (and/or meningoencephalocele). During the surgery, 88 cases (63.8%) were repaired with nasal septal mucosal flaps pedicled with the posterior nasal septal artery, 14 cases (10.1%) with mucosal flaps pedicled with the anterior ethmoidal artery on the lateral wall of the nasal cavity, 6 cases (4.3%) with mucosal flaps pedicled with the posterior lateral nasal artery on the lateral wall and nasal floor, 12 cases (8.7%) with mucosal flaps pedicled with the anterior ethmoidal artery and posterior ethmoidal artery, and 18 cases (13.0%) with nasal septal mucosal extension flaps pedicled with the sphenopalatine artery or internal maxillary artery. Patients were followed up for 12 to 72 months postoperatively. Endoscopic examination or skull base enhanced MRI was performed to assess the growth and tumor recurrence in the skull base repair area. The t-test was used for statistical analysis.Results:Among 138 patients, primary repair was successful in 133 patients (96.4%), while 5 patients (3.6%) experienced postoperative cerebrospinal fluid rhinorrhea. These 5 patients all underwent nasal septal mucosal flap repair with the posterior nasal septal artery as the pedicle. Complications included 1 case of mucosal flap necrosis, 1 case of mucosal flap central perforation, and 3 cases of mucosal flap survival peripheral leakage, of which were all successfully treated with a second repair.Conclusion:The use of nasal pedicle mucosal flap based on nasal blood supply is a reliable, safe, and effective technique for repairing skull base defects.