Lung cancer is the leading cause of cancer-related deaths worldwide， and tumor metastasis is a key factor contributing to the mortality of most lung cancer patients. Aberrant activation of epithelial-mesenchymal transition （EMT） is a major driver of lung cancer progression and metastasis. EMT is characterized by the loss of apical-basal polarity and intercellular adhesion in highly differentiated， polarized， and organized epithelial cells， which acquire motility， migratory potential， and invasive properties. During this process， cells undergo cytoskeletal remodeling and transform into a mesenchymal phenotype， accompanied by associated changes in cellular markers. The EMT process is highly complex and is tightly regulated by intricate networks involving multiple transcription factors， post-translational controls， epigenetic modifications， and non-coding RNAs. Therefore， therapies targeting the mechanisms of malignant transformation and their associated pathways in lung cancer are of significant clinical importance. In recent years， EMT has attracted increasing attention as a potential target for cancer therapy. Chinese medicine， with its characteristics of multi-target action， low side effects， and good therapeutic efficacy， has demonstrated an important role in anticancer treatment. A series of studies have investigated the role of Chinese medicine in inhibiting EMT in lung cancer. Active ingredients of Chinese medicine， including flavonoids， glycosides， phenols， terpenoids， saccharides， and alkaloids， as well as Chinese medicine compound formulas， have shown significant regulatory effects on EMT. Their mechanisms mainly involve multiple pathways， targets， and links， including signaling pathways， exosomes， microRNAs （miRNAs）， and the tumor-associated immune microenvironment. This article summarizes the mechanisms by which EMT promotes malignant tumor progression and reviews the current research on how Chinese medicine active ingredients， monomers， and compound formulas inhibit EMT and suppress lung cancer cell migration and invasion. This study is expected to provide comprehensive theoretical information for basic and translational research on lung cancer.

OBJECTIVE To investigate the application and influencing factors of sodium-dependent glucose transporters 2 inhibitors（SGLT-2i） in patients with heart failure with preserved ejection fraction（HFpEF） in the real world. METHODS Data from 358 patients with HFpEF who were hospitalized at the First Affiliated Hospital of Chongqing Medical University from May 2023 to May 2024 were retrospectively collected. The patients were divided into the SGLT-2i group and the non-SGLT-2i group based on whether they were prescribed SGLT-2i upon discharge. Baseline characteristics， comorbidities， and differences in drug treatment were compared between the two groups. Based on univariate analysis， multivariate Logistic regression analysis was performed to identify independent influencing factors of SGLT-2i use in patients with HFpEF， followed by further stratified analysis. RESULTS Among 358 HFpEF patients， the overall utilization rate of SGLT-2i was 33.5%. Combined with type 2 diabetes [OR＝9.063，95%CI（4.924-16.679） ] ， atrial fibrillation [OR＝3.135，95%CI（1.590-6.178） ] ， coronary artery heart disease [OR＝1.888，95%CI（1.072-3.327） ] and the use of loop diuretics [OR＝3.822， 95%CI （1.588-9.200） ] were all independent influencing factors for the use of SGLT-2i in patients with HFpEF （ P ＜0.05）. The results of the stratified descriptive analysis were consistent with those of the multivariate analysis， showing a higher utilization rate of SGLT-2i among patients with concomitant T2DM，atrial fibrillation， coronary artery heart disease， and those receiving loop diuretics （ P ＜0.05）； whereas the utilization rate of SGLT-2i was comparable across patients with different levels of renal function （ P ＞0.05）. CONCLUSIONS In the real-world clinical practice， the utilization of SGLT-2i in patients with HFpEF remains suboptimal， and treatment coverage still needs to be improved. Their use of SGLT-2i is primarily influenced by the presence of type 2 diabetes， atrial fibrillation， coronary artery heart disease， and the use of loop diuretics.

BACKGROUND:Exosomes,as a type of extracellular vesicle,have become a key medium for cell-to-cell communication due to their nanoscale size and enrichment of various bioactive substances.The study of exosome secretion regulation not only has important scientific value,but also has broad application prospects in clinical practice,and is of great significance for promoting medical progress and improving human health.OBJECTIVE:To review the biological characteristics,biological functions,biogenesis process and biochemical regulation mechanism of exosomes,and to explore the application prospects of exosomes in disease diagnosis,treatment and vaccine development,so as to provide theoretical basis and reference for basic research and clinical transformation of exosomes.METHODS:The first author searched PubMed and CNKI databases in October 2024 for relevant literature published from January 2010 to October 2024.Key words were"exosomes,biological functions,biogenesis,secretion or release,regulatory mechanisms,application prospects"in Chinese and English.Finally,92 articles were included for analysis.RESULTS AND CONCLUSION:The secretion level of exosomes can be regulated through physical or biochemical means.Exosomes show broad application prospects in the fields of disease diagnosis,treatment,and vaccine development,and may play a key role in the treatment of cardiovascular and cerebrovascular diseases as well as cancer.This review provides valuable information for the clinical translation and application research of exosomes,helping to promote future progress in exosome research and application.

BACKGROUND:Exosomes,as a type of extracellular vesicle,have become a key medium for cell-to-cell communication due to their nanoscale size and enrichment of various bioactive substances.The study of exosome secretion regulation not only has important scientific value,but also has broad application prospects in clinical practice,and is of great significance for promoting medical progress and improving human health.OBJECTIVE:To review the biological characteristics,biological functions,biogenesis process and biochemical regulation mechanism of exosomes,and to explore the application prospects of exosomes in disease diagnosis,treatment and vaccine development,so as to provide theoretical basis and reference for basic research and clinical transformation of exosomes.METHODS:The first author searched PubMed and CNKI databases in October 2024 for relevant literature published from January 2010 to October 2024.Key words were"exosomes,biological functions,biogenesis,secretion or release,regulatory mechanisms,application prospects"in Chinese and English.Finally,92 articles were included for analysis.RESULTS AND CONCLUSION:The secretion level of exosomes can be regulated through physical or biochemical means.Exosomes show broad application prospects in the fields of disease diagnosis,treatment,and vaccine development,and may play a key role in the treatment of cardiovascular and cerebrovascular diseases as well as cancer.This review provides valuable information for the clinical translation and application research of exosomes,helping to promote future progress in exosome research and application.

Objective To evaluate the performance of lightweight Chinese large language models (LLMs) in answering specialized lung cancer questions, and to explore the impact of retrieval-augmented generation (RAG) on model performance. Methods Eleven lightweight Chinese LLMs with parameter sizes ranging from 7B to 32B were included. A lung cancer-specific evaluation dataset consisting of 200 questions [100 A1-type (basic knowledge) and 100 A2-type (clinical case) questions], constructed based on clinical guidelines and thoracic surgery textbooks, was used for assessment. Model performance was evaluated under two conditions (with and without RAG). Accuracy was used to assess model performance, and response latency was recorded to reflect inference efficiency. An accuracy–latency scatter plot was constructed for descriptive analysis of overall model performance. Results All models successfully completed the evaluation. With the introduction of RAG, the overall average accuracy improved from 61.68% to 76.36%. Smaller models demonstrated the most significant improvement (e.g., the accuracy of DeepSeek-7B increased from 32.50% to 60.00%, P<0.001). The average response latency increased from 12.58 s to 13.80 s. The Qwen3 series showed the best overall performance, and Qwen3-32B achieved the highest accuracy under both conditions (76.50% and 84.00%, respectively). After RAG integration, performance differences among model families were markedly reduced. Based on the accuracy-latency trade-off, Qwen3-32B achieved the best balance between accuracy and response latency under the baseline condition, whereas Qwen3-14B demonstrated superior overall performance in terms of accuracy, latency, and computational cost after RAG integration. Conclusion The integration of RAG technology improves the ability of lightweight Chinese LLMs to answer specialized lung cancer questions. Under the dual practical constraints of limited computational resources and medical data security requirements, the "lightweight model+RAG" technical framework may represent a promising deployment solution.

Pulmonary hypertension （PH） is a life-threatening condition characterized by a progressive elevation in pulmonary vascular pressure， ultimately leading to right ventricular dysfunction and failure. The core pathological features of PH include abnormal contraction of small pulmonary arteries and vascular remodeling. In recent years， endoplasmic reticulum stress （ERS）， a critical adaptive response of cells to internal and external stressors， has been shown to play a key role in the development and progression of PH. Through the activation of major signaling pathways such as protein kinase R-like endoplasmic reticulum kinase （PERK）， inositol-requiring enzyme 1α （IRE1α）， and activating transcription factor 6 （ATF6）， ERS is directly involved in regulating aberrant cellular behaviors and vascular remodeling in PH. This review systematically discusses the specific role of ERS in the pathogenesis of PH and evaluates its potential as a therapeutic target， aiming to provide a theoretical foundation for novel clinical interventions in PH.

Objective Through visual analysis of literatures related to the treatment of chronic glomerulonephritis(CGN),the research hotspots and trends in this field were discussed.Methods Relevant literatures from CNKI,Wanfang Data Knowledge Service Platform,VIP,SinoMed,PubMed from 2010 to 2024 were retrieved,and analyzed using CiteSpace 6.2.R4 software.Results A total of 8887 articles in Chinese and 117 articles in English were included.The countries,institutions and authors who published most were China,the Affiliated Hospital for Liaoning University of Traditional Chinese Medicine and Wang Yiping.The research hotspots mainly focued on therapeutic drugs and clinical efficacy,and the research trend tended to be the treatment mechanism.Conclusion To further strengthen collaboration among different countries,institutions and authors,and to delve deeper into the mechanistic studies of CGN,will effectively promote the research progress in this field.

6-Shogaol is an active component of gingerol in zingiber,which can be converted from 6-Gingerol under acidic and heating conditions.Modern research shows that 6-Shogaol has rich pharmacological activities,and it is found that 6-Shogaol has stronger anti-inflammatory,anti-tumor and antioxidant activities than 6-Gingerol.In this article,the preparation technology and pharmacological effects of 6-Shogaol were reviewed,and the extraction and separation methods of 6-Shogaol,as well as the targets and pathways involved in the process of exerting its pharmacological effects,were summarized,which could lay the foundation for the comprehensive development and clinical application of 6-Shogaol.

Accurate assessment of pulp status is crucial for formulating treatment strategies for affected teeth. Traditional assessment methods include subjective symptoms, clinical examination, and imaging findings, despite their diagnostic accuracy is controversial. In recent years, new technologies such as pulp blood flow testing, pulp inflammation biomarkers and artificial intelligence-assisted diagnosis have been introduced, providing more objective and precise diagnostic tools. This review systematically examines pulp status assessment methods now available, explores their clinical diagnostic effectiveness and limitations, and reviews current pulpitis diagnosis systems to optimize the treatment process for pulp diseases and explore future research directions and technological advancements.

Objective:To compare the biomechanical differences among modular total sacral prosthesis, integrated total sacral prosthesis and screw-rod system for lumbosacral reconstruction after total sacrectomy by finite element analysis.Methods:Three finite element models of reconstruction after total sacrectomy were established: six-rod plus anterior column, integrated total sacral prosthesis, and modular total sacral prosthesis. A vertical load of 600 N was applied to the L 3 vertebra, and the bilateral acetabula were fixed in all degrees of freedom to restrict their movement, simulating a bipedal standing posture. The maximum stress, stress distribution on the iliac screws, stress distribution on the longitudinal rods, the shift-down displacement of the L 5 vertebra, and the stress direction on the contact surface between the prosthesis and the ilium on all implant components (including prosthesis, screws, and connecting rods) were compared. Results:Finite element analysis results show that the average maximum stress of the six-rod plus anterior column reconstruction on all implant instrumentation was 217.9±10.2 MPa, the integrated total sacral prosthesis reconstruction was 185.7±21.1 MPa, and the modular total sacral prosthesis reconstruction was 157.4±31.2 MPa. The differences were statistically significant ( F=12.357, P<0.001). Among them, the difference between the modular total sacral prosthesis reconstruction and the six-rod plus anterior column reconstruction was statistically significant ( P<0.001), while the difference between the modular total sacral prosthesis reconstruction and the integrated total sacral prosthesis reconstruction was not statistically significant ( P=0.051). The maximum stress on the iliac bone screws and longitudinal connecting rods: for the six-rod plus anterior column reconstruction, it was 157.2 MPa and 105.4 MPa respectively; for the integrated total sacral prosthesis reconstruction, it was 59.2 MPa and 97.8 MPa respectively; for the modular total sacral prosthesis reconstruction, it was 58.4 MPa and 35.6 MPa respectively. The distance of L 5 vertebral body downward displacement: for the six-rod plus anterior column reconstruction, it was 1.05±0.06 mm; for the integrated total sacral prosthesis reconstruction, it was 0.34±0.02 mm; for the modular total sacral prosthesis reconstruction, it was 0.40±0.05 mm. The difference was statistically significant ( F=357.730, P<0.001), among which the differences between the modular total sacral prosthesis reconstruction and the six-rod plus anterior column reconstruction and that between the integrated total sacral prosthesis reconstruction and the six-rod plus anterior column reconstruction were all statistically significant ( P<0.05), while the difference between the modular total sacral prosthesis reconstruction and the integrated total sacral prosthesis reconstruction was not statistically significant ( P=0.145). The stress on the iliac bone contact surface of the integrated total sacral prosthesis was 34.2° and manifested as shear force; the stress on the iliac bone contact surface of the modular total sacral prosthesis was 88.9° and manifested as compressive stress. Conclusions:This modular total sacral prosthesis exhibits lower peak stress compared with the integrated total sacral prosthesis and screw-rod system. The spinal stability of the modular total sacral prosthesis is comparable to that of the integrated total sacral prosthesis and superior to that of the screw-rod system.