This comprehensive review synthesizes the latest advancements in understanding inflammatory disorders affecting cerebral small vessels, a distinct yet understudied category within cerebral small vessel diseases (SVD). Unlike classical SVD, these inflammatory conditions exhibit unique clinical presentations, imaging patterns, and pathophysiological mechanisms, posing significant diagnostic and therapeutic challenges. Highlighting their heterogeneity, this review spans primary angiitis of the central nervous system, cerebral amyloid angiopathy-related inflammation, systemic vasculitis, secondary vasculitis, and vasculitis in autoinflammatory diseases. Key discussions focus on emerging insights into immune-mediated processes, neuroimaging characteristics, and histopathological distinctions. Furthermore, this review underscores the importance of standardized diagnostic frameworks, individualized immunomodulation approaches, and novel targeted therapies to address unmet clinical demands.
Humans ; Cerebral Small Vessel Diseases/pathology* ; Inflammation/pathology* ; Cerebral Amyloid Angiopathy/pathology* ; Vasculitis, Central Nervous System/pathology* ; Vasculitis/pathology*

ObjectiveBased on literature data mining， this study explores the modeling elements of diarrhea-predominant irritable bowel syndrome （IBS-D） animal models in China and abroad， providing references and suggestions for improving modeling methods and evaluation indicators. MethodsRelevant literature on IBS-D animal experiments from 2014 to 2024 was retrieved through computer searches in databases such as China National Knowledge Infrastructure （CNKI）， Wanfang Data， VIP， Chinese Medical Journals Full-text Database， and PubMed. Information on experimental animal species， gender， body weight， modeling methods， modeling periods， intervention controls， modeling standards， and detection indicators was organized. Microsoft Excel 2021 software was used to establish a database and perform statistical analysis to examine the characteristics of IBS-D animal models. ResultsA total of 398 articles that met the inclusion criteria were reviewed. The IBS-D animal models were predominantly established using SD rats， Wistar rats， and C57BL/6 mice. Male animals were more commonly used， with rats typically aged 6-8 weeks and mice aged 4-6 weeks. In terms of interventions， piverium bromide was the main Western medicine， Tongxieyaofang was the primary Chinese medicine， and electroacupuncture was the primary acupuncture method. Among the modeling methods， the multi-factor combined composite modeling approach was the most common. Modeling periods were mainly concentrated between 1-14 days and 15-30 days. The success criteria for modeling were mainly evaluated based on the animal's general condition， fecal appearance， visceral sensitivity， gastrointestinal motility， behavior， and pathology. Detection indicators included apparent indexes， pathological markers， biochemical indicators， oxidative stress， brain-gut peptides， neurotransmitters， inflammatory factors， immune function， intestinal permeability， autophagy， apoptosis， proteins related to relevant signaling pathways， intestinal microbiota and its metabolites， etc. ConclusionThere are various methods for establishing IBS-D animal models， but no unified and universally accepted method has been established. The operation of the same modeling methods and the evaluation standards of the models vary across studies. Based on the results of data mining， the authors suggest that the multi-factor combined composite modeling approach most closely reflects the pathophysiological processes of IBS-D， better simulating the complex clinical symptoms of IBS-D patients， such as abdominal pain and diarrhea， and has a high degree of clinical relevance. This method is relatively recommended. While animal models in general align with Western medicine standards， models incorporating traditional Chinese medicine （TCM） syndromes are relatively few. Therefore， one of the future directions for research is to establish IBS-D animal models that meet the combined clinical disease and syndrome requirements of both Western and Chinese medicine.

Objectives:This study aims to investigate the features of retrograde cricopharyngeal dysfunction (RCPD) and to evaluate the effectiveness and safety of Botulinum toxin-A as a treatment for RCPD.Methods:Twenty-two RCPD patients admitted between February 2024 and November 2024 were included through online and offline methods in The Sixth Medical Centre of Chinese PLA General Hospital (15 males, 7 females, age range, 14-34 years; mean age 25.0±5.2 years). The general condition, symptoms, severity scores, and auxiliary examinations were summarized and analyzed. Operative results and postoperative complications of RCPD patients treated with Botulinum toxin-A were analyzed.Results:All patients could not burp since early childhood, followed by gurgling noises, abdominal flatulence, laryngopharyngeal foreign body sensation, and cervical constriction. The most severe symptom was the inability to burp with a mean score of 4.8. Seven patients who received botulinum toxin injections under the supporting laryngoscopes started burping six days post-operation. With a median follow-up of 5 months, all patients achieved the ability to belch. In none of these seven cases, intraoperative complications were noted including hoarseness, choking cough when drinking water, or dyspnea. One patient experienced laryngopharyngeal reflux and six patients had dysphagia, which were relieved at 1 week and 24.8 days postoperatively.Conclusion:RCPD is a disease characterized by the inability to burp, cricopharyngeal muscle injection by Botulinum toxin-A is effective and safe.

Objective:To investigate the correlations between primary location and other clinical characteristics of papillary thyroid carcinoma (PTC) with cervical lymph node metastasis, providing evidence for optimizing surgical strategies.Methods:A total of 805 patients with unifocal PTC who underwent surgical treatment at the Sixth Medical Center of PLA General Hospital from January 1, 2015 to March 16, 2025, were included. Data on gender, age, tumor location and size, preoperative ultrasound findings, and postoperative pathological diagnosis were collected. The associations between clinical characteristics and lymph node metastasis in the central compartment (Level Ⅵ) and lateral neck (Levels Ⅱ-Ⅳ) were analyzed. Chi-square tests and multivariate logistic regression were used to identify independent risk factors for lymph node metastasis.Results:Among the 805 PTC patients, 363 (45.1%) had lymph node metastasis, including 44 (5.5%) in Level Ⅱ, 64 (8.0%) in Level Ⅲ, 79 (9.8%) in Level Ⅳ, and 345 (42.9%) in Level Ⅵ, with Level Ⅵ showing the highest metastasis rate. Multivariate logistic regression analysis revealed that male sex ( OR=1.43, P=0.031), age <55 years ( OR=2.02, P<0.001), tumor located in the lower pole ( OR=1.88, P<0.001), and tumor size >1.0 cm ( OR=3.15, P<0.001) were independent risk factors for Level Ⅵ metastasis. Male sex ( OR=4.20, P=0.006) and tumor located in the upper pole ( OR=6.78, P<0.001) were independent risk factors for Level Ⅱ metastasis. Tumor size >1.0 cm ( OR=2.77, P=0.006) was an independent risk factor for Level Ⅳ metastasis. Age <55 years ( OR=6.00, P=0.003), tumor located in the upper pole ( OR=2.17, P=0.002), and tumor size >1.0 cm ( OR=3.65, P<0.001) were independent risk factors for metastasis involving >5 lymph nodes. Patients with tumors in the isthmus had a significantly higher Level VI metastasis rate (85.7%, 12/14) compared to those with tumors in the thyroid lobes (42.2%, 334/791, P=0.001), and a higher rate of bilateral Level Ⅵ metastasis (35.7%, 5/14 vs. 5.1%, 40/791, P<0.001). Conclusions:Lymph node metastasis in PTC is closely associated with tumor location and size. Tumors in the lower pole primarily metastasize to Level Ⅵ, whereas those in the upper pole are more likely to metastasize to Level Ⅱ. For low-risk PTC confined to the thyroid lobe, lobectomy with isthmusectomy and central lymph node dissection is recommended. For isthmic tumors, total thyroidectomy with bilateral central lymph node dissection is advised. Male patients with upper pole tumors require careful preoperative evaluation of Level Ⅱ lymph node involvement. For patients aged <55 years with tumors >1.0 cm in the upper pole, individualized treatment strategies should be formulated based on additional high-risk factors.

Objective This study sought to establish a diarrhea-predominant irritable bowel syndrome(IBS-D)mouse model by gavage different mass concentrations sennae folium combined with chronic restraint stress,and to determine the appropriate mass concentration of sennae folium to establish IBS-D mouse model.Methods The mass concentration of sennae folium used for the IBS-D mouse model followed suggested amounts in the literature and on that basis,the mass concentration gradient was established prior to conducting the experiment.Female C57BL/6 mice were divided into a normal group(Group N),a low-dose group(Group L;0.25 g/mL sennae solution),a medium-dose group(Group M;0.50 g/mL sennae solution),and a high-dose group(Group H;1.0 g/mL sennae solution),with 10 mice per group.After 14 days,the defecation,diarrhea index,visceral sensitivity,and morphological changes in the colonic tissue in each group were observed and recorded to compare the differences among models established with varying mass concentrations of sennae folium.Results Compared with Group N(42.90±11.90)%,Group L(80.30±5.77)%,Group M(80.50±3.44)%,and Group H(81.90±2.68)%had significantly higher 6 h fecal water content(P＜0.01).Compared with Group N(0.00±0.00),the diarrhea index of mice in Group L(0.57±0.16),Group M(0.62±0.23),and Group H(0.60,0.23)also increased significantly(P＜0.01).Compared with Group N(0.65(0.60,0.65)),Group M(0.32(0.24,0.39))and Group H(0.34(0.27,0.47))had significantly lower visceral pain threshold and higher visceral sensitivity(P＜0.01).Additionally,the first blue stool time in Group M(98.15(93.41,100.44)min)was significantly shorter than that in Group N(186.81(109.28,192.05)min)(P＜0.01),and the total number of stools in Group M(22.4±3.73)was significantly higher than that in Group N(17.90±4.48)(P＜0.05).Conclusions Compared with 0.25 and 1.0 g/mL,0.50 g/mL sennae folium gavage,combined with chronic restraint stress,can better simulate the clinical symptoms of IBS-D.

Irritable bowel syndrome(IBS)is a prevalent functional gastrointestinal disorder characterized by a complex etiology involving multiple interacting factors.Accumulating evidence in recent years has indicated that intestinal barrier dysfunction may play a crucial role in the pathogenesis of IBS.This review systematically ex-amines the impact of intestinal barrier dysfunction on IBS,analyzing its associations with the mechanical,im-mune,chemical,and microbial components of the gut barrier,as well as current clinical treatment approaches.Moreover,this paper highlights the potential of intestinal barrier repair mechanisms as therapeutic targets,which may provide novel insights and directions for understanding the underlying pathophysiological mechanisms and de-veloping effective interventions for IBS.

Objective This study sought to establish a diarrhea-predominant irritable bowel syndrome(IBS-D)mouse model by gavage different mass concentrations sennae folium combined with chronic restraint stress,and to determine the appropriate mass concentration of sennae folium to establish IBS-D mouse model.Methods The mass concentration of sennae folium used for the IBS-D mouse model followed suggested amounts in the literature and on that basis,the mass concentration gradient was established prior to conducting the experiment.Female C57BL/6 mice were divided into a normal group(Group N),a low-dose group(Group L;0.25 g/mL sennae solution),a medium-dose group(Group M;0.50 g/mL sennae solution),and a high-dose group(Group H;1.0 g/mL sennae solution),with 10 mice per group.After 14 days,the defecation,diarrhea index,visceral sensitivity,and morphological changes in the colonic tissue in each group were observed and recorded to compare the differences among models established with varying mass concentrations of sennae folium.Results Compared with Group N(42.90±11.90)%,Group L(80.30±5.77)%,Group M(80.50±3.44)%,and Group H(81.90±2.68)%had significantly higher 6 h fecal water content(P＜0.01).Compared with Group N(0.00±0.00),the diarrhea index of mice in Group L(0.57±0.16),Group M(0.62±0.23),and Group H(0.60,0.23)also increased significantly(P＜0.01).Compared with Group N(0.65(0.60,0.65)),Group M(0.32(0.24,0.39))and Group H(0.34(0.27,0.47))had significantly lower visceral pain threshold and higher visceral sensitivity(P＜0.01).Additionally,the first blue stool time in Group M(98.15(93.41,100.44)min)was significantly shorter than that in Group N(186.81(109.28,192.05)min)(P＜0.01),and the total number of stools in Group M(22.4±3.73)was significantly higher than that in Group N(17.90±4.48)(P＜0.05).Conclusions Compared with 0.25 and 1.0 g/mL,0.50 g/mL sennae folium gavage,combined with chronic restraint stress,can better simulate the clinical symptoms of IBS-D.

Irritable bowel syndrome(IBS)is a prevalent functional gastrointestinal disorder characterized by a complex etiology involving multiple interacting factors.Accumulating evidence in recent years has indicated that intestinal barrier dysfunction may play a crucial role in the pathogenesis of IBS.This review systematically ex-amines the impact of intestinal barrier dysfunction on IBS,analyzing its associations with the mechanical,im-mune,chemical,and microbial components of the gut barrier,as well as current clinical treatment approaches.Moreover,this paper highlights the potential of intestinal barrier repair mechanisms as therapeutic targets,which may provide novel insights and directions for understanding the underlying pathophysiological mechanisms and de-veloping effective interventions for IBS.

Objectives:This study aims to investigate the features of retrograde cricopharyngeal dysfunction (RCPD) and to evaluate the effectiveness and safety of Botulinum toxin-A as a treatment for RCPD.Methods:Twenty-two RCPD patients admitted between February 2024 and November 2024 were included through online and offline methods in The Sixth Medical Centre of Chinese PLA General Hospital (15 males, 7 females, age range, 14-34 years; mean age 25.0±5.2 years). The general condition, symptoms, severity scores, and auxiliary examinations were summarized and analyzed. Operative results and postoperative complications of RCPD patients treated with Botulinum toxin-A were analyzed.Results:All patients could not burp since early childhood, followed by gurgling noises, abdominal flatulence, laryngopharyngeal foreign body sensation, and cervical constriction. The most severe symptom was the inability to burp with a mean score of 4.8. Seven patients who received botulinum toxin injections under the supporting laryngoscopes started burping six days post-operation. With a median follow-up of 5 months, all patients achieved the ability to belch. In none of these seven cases, intraoperative complications were noted including hoarseness, choking cough when drinking water, or dyspnea. One patient experienced laryngopharyngeal reflux and six patients had dysphagia, which were relieved at 1 week and 24.8 days postoperatively.Conclusion:RCPD is a disease characterized by the inability to burp, cricopharyngeal muscle injection by Botulinum toxin-A is effective and safe.

Objective:To investigate the correlations between primary location and other clinical characteristics of papillary thyroid carcinoma (PTC) with cervical lymph node metastasis, providing evidence for optimizing surgical strategies.Methods:A total of 805 patients with unifocal PTC who underwent surgical treatment at the Sixth Medical Center of PLA General Hospital from January 1, 2015 to March 16, 2025, were included. Data on gender, age, tumor location and size, preoperative ultrasound findings, and postoperative pathological diagnosis were collected. The associations between clinical characteristics and lymph node metastasis in the central compartment (Level Ⅵ) and lateral neck (Levels Ⅱ-Ⅳ) were analyzed. Chi-square tests and multivariate logistic regression were used to identify independent risk factors for lymph node metastasis.Results:Among the 805 PTC patients, 363 (45.1%) had lymph node metastasis, including 44 (5.5%) in Level Ⅱ, 64 (8.0%) in Level Ⅲ, 79 (9.8%) in Level Ⅳ, and 345 (42.9%) in Level Ⅵ, with Level Ⅵ showing the highest metastasis rate. Multivariate logistic regression analysis revealed that male sex ( OR=1.43, P=0.031), age <55 years ( OR=2.02, P<0.001), tumor located in the lower pole ( OR=1.88, P<0.001), and tumor size >1.0 cm ( OR=3.15, P<0.001) were independent risk factors for Level Ⅵ metastasis. Male sex ( OR=4.20, P=0.006) and tumor located in the upper pole ( OR=6.78, P<0.001) were independent risk factors for Level Ⅱ metastasis. Tumor size >1.0 cm ( OR=2.77, P=0.006) was an independent risk factor for Level Ⅳ metastasis. Age <55 years ( OR=6.00, P=0.003), tumor located in the upper pole ( OR=2.17, P=0.002), and tumor size >1.0 cm ( OR=3.65, P<0.001) were independent risk factors for metastasis involving >5 lymph nodes. Patients with tumors in the isthmus had a significantly higher Level VI metastasis rate (85.7%, 12/14) compared to those with tumors in the thyroid lobes (42.2%, 334/791, P=0.001), and a higher rate of bilateral Level Ⅵ metastasis (35.7%, 5/14 vs. 5.1%, 40/791, P<0.001). Conclusions:Lymph node metastasis in PTC is closely associated with tumor location and size. Tumors in the lower pole primarily metastasize to Level Ⅵ, whereas those in the upper pole are more likely to metastasize to Level Ⅱ. For low-risk PTC confined to the thyroid lobe, lobectomy with isthmusectomy and central lymph node dissection is recommended. For isthmic tumors, total thyroidectomy with bilateral central lymph node dissection is advised. Male patients with upper pole tumors require careful preoperative evaluation of Level Ⅱ lymph node involvement. For patients aged <55 years with tumors >1.0 cm in the upper pole, individualized treatment strategies should be formulated based on additional high-risk factors.