Objective To develop and validate a machine learning model based on preoperative clinical characteristics, laboratory indices, and radiological features for the non-invasive prediction of spread through air spaces (STAS) in patients with early-stage lung adenocarcinoma. Methods Preoperative data from patients with early-stage lung adenocarcinoma who underwent surgical resection at Northern Jiangsu People's Hospital between January 2020 and August 2025 were retrospectively collected. The data included clinical characteristics, laboratory indices, and radiological features. Patients were divided into a STAS-positive and a STAS-negative group based on postoperative pathological findings. The dataset was randomly split into a training set and a testing set at a 7 : 3 ratio. Feature variables were selected using the maximum relevance and minimum redundancy (mRMR) algorithm and the least absolute shrinkage and selection operator (LASSO) regression. Five machine learning models were constructed: logistic regression (LR), random forest (RF), support vector machine (SVM), light gradient boosting machine (LightGBM), and extreme gradient boosting (XGBoost). Model performance was evaluated using the area under the receiver operating characteristic curve (AUC) and decision curve analysis (DCA). The shapley additive explanations (SHAP) method was employed to interpret the optimal prediction model. Results A total of 377 patients were included, comprising 177 (46.9%) males and 200 (53.1%) females, with a mean age of (63.31±9.73) years. There were 261 patients in the training set and 116 patients in the testing set. In the training set, statistically significant differences were observed between the STAS-positive group (n=130) and STAS-negative group (n=131) across multiple features, including age, sex, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), clinical T stage, and maximum solid component diameter (P<0.05). A final set of 10 feature variables was selected by combining mRMR and LASSO regression, and five machine learning models (LR, RF, SVM, LightGBM, XGBoost) were developed. The XGBoost model demonstrated optimal performance in both the training and testing sets, achieving AUCs of 0.947 [95%CI (0.920, 0.975)] and 0.943 [95%CI (0.894, 0.993)], respectively. DCA indicated that the XGBoost model provided a high net clinical benefit across a wide range of threshold probabilities. SHAP analysis revealed that the vessel convergence sign, clinical T stage, age, consolidation-to-tumor ratio (CTR), and MLR were the features with the highest contributions to STAS prediction. Conclusion The XGBoost model effectively predicts preoperative STAS status in early-stage lung adenocarcinoma, exhibiting excellent discriminative performance and good clinical interpretability. Key predictors such as the vessel convergence sign, clinical T stage, age and CTR provide a crucial reference for preoperative risk assessment and the individualized selection of surgical strategies, ultimately benefiting patients.

Objective:To study the effects of TCM ointment rubbing technique on pain, swelling, and knee joint function in patients with knee osteoarthritis (KOA) after total knee arthroplasty (TKA).Methods:A randomized controlled trial was conducted. In this study, 80 patients with KOA who underwent TKA treatment in the Department of Sports Medicine I, Wangjing Hospital, China Academy of Traditional Chinese Medicine from October 2022 to March 2024 were taken as the study subjects. They were divided into two groups with random number table method, with 40 cases in each group. Both groups were treated with conventional Western medicine + rehabilitation training after surgery, and the observation group was combined with TCM paste mo technique on this basis. VAS score was used to assess the degree of pain at different time points, and skin fold was used to measure the circumference of the upper knee circumference and the circumference of the lower knee circumference, and knee Injury and osteoarthritis outcome score (KOOS) was used to assess the degree of knee joint function recovery.Results:After treatment, the observation group after surgerythe at 7 d (2.57 ± 0.84 vs. 4.00 ± 0.85, t=7.54) and 14 d (0.80 ± 0.93 vs. 2.70 ± 1.04, t=8.56) VAS scores were lower than those in the control group ( P<0.001). After treatment, the observation group after surgerythe at 7 d the superior circumference [(48.32 ± 4.57) cm vs. (50.53 ± 3.97) cm, t=2.32], and inferior circumference [(36.71 ± 2.95) cm vs. (39.21 ± 6.86) cm, t=2.12], at 14 d the superior circumference [(45.68 ± 4.69) cm vs. (47.96 ± 3.89) cm, t=2.37], and inferior circumference [(34.96 ± 2.96) cm vs. (36.70 ± 4.35) cm, t=2.10] were lower than those in the control group ( P<0.05). The observation group after surgerythe at 14 d the the knee joint mobility [(115.32 ± 2.12) ° vs. (113.34 ± 2.16) °, t=4.14] and KOOS scores (85.52 ± 0.82 vs. 80.32 ± 1.13, t=23.56) were higher than those in the control group ( P<0.01). Conclusion:TCM ointment rubbing technique has significant advantages in improving pain, swelling and knee joint mobility after artificial knee arthroplasty, which can effectively restore knee joint function.

Intestinal fibrosis is a significant clinical challenge in inflammatory bowel diseases, but no effective anti-fibrotic therapy is currently available. Glucagon receptor (GCGR) and glucagon-like peptide 1 receptor (GLP1R) are both peptide hormone receptors involved in energy metabolism of epithelial cells. However, their role in intestinal fibrosis and the underlying mechanisms remain largely unexplored. Herein GCGR and GLP1R were found to be reduced in the stenotic ileum of patients with Crohn's disease as well as in the fibrotic colon of mice with chronic colitis. The downregulation of GCGR and GLP1R led to the accumulation of the metabolic byproduct lactate, resulting in histone H3K9 lactylation and exacerbated intestinal fibrosis through epithelial-to-mesenchymal transition (EMT). Dual activating GCGR and GLP1R by peptide 1907B reduced the H3K9 lactylation in epithelial cells and ameliorated intestinal fibrosis in vivo. We uncovered the role of GCGR/GLP1R in regulating EMT involved in intestinal fibrosis via histone lactylation. Simultaneously activating GCGR/GLP1R with the novel dual agonist peptide 1907B holds promise as a treatment strategy for alleviating intestinal fibrosis.

By establishing a complete data organizational structure,technical architecture,quality control framework,and concept framework,hospitals can effectively regulate data management,data security,and quality monitoring,achieving full-cycle monitoring of data management.Breaking down the resource barriers of data systems,improving the efficiency of data usage and circulation,and promoting the increase in data value.It drives the hospital's scientific research innovation,medical insurance cost control,data value monetization,and the improvement of high-quality capabilities.Through the establishment of a sustainable digital culture and operational philosophy,it integrates data with hospital assets,continuously enhancing the value realization of hospital data in operations,management,diagnosis and treatment,and scientific research.

Objective:To evaluate the elbow joint function of patients with endemic skeletal fluorosis based on Mayo elbow joint function score and to study its application value.Methods:Based on the monitoring results of drinking water-borne endemic fluorosis in Gansu Province from 2018 to 2023, and the results of the 2019 survey on the current cases of endemic diseases, 8 typical endemic counties were selected from 48 counties with drinking water-borne endemic fluorosis. A cluster sampling method was used to investigate all adult skeletal fluorosis patients over 25 years old in the endemic fluorosis villages under the jurisdiction of the 8 counties. A total of 1 096 skeletal fluorosis patients were included as study subjects. By extracting demographic basic information, follow-up records, elbow joint X-ray films, diagnostic information, and the Mayo elbow joint function score scale of patients, a retrospective analysis was conducted on the distribution characteristics of the Mayo elbow joint function score in different genders, ages, clinical grades, disease duration, and Kellgren-Lawrence (K-L) grading of osteoarthritis.Results:(1) The distribution of total scores on the scale: 638 cases (58.21%) were rated as "poor" (< 60 points), 345 cases (31.48%) were rated as "fair" (60 - 74 points), 96 cases (8.76%) were rated as "good" (75 - 89 points), and 17 cases (1.55%) were rated as "excellent" (≥90 points). There were statistically significant differences in the total score grading of the scale among patients with different genders, ages, clinical grades, disease duration, and K-L grading of osteoarthritis (χ 2 = 44.90, 147.20, 264.41, 211.96, 262.85, P < 0.001). (2) The scores of each dimension of the scale: the joint stability dimension scores were compared among different ages, clinical grades, disease duration, and K-L grading of osteoarthritis, and the differences were statistically significant ( P < 0.05). The scores of joint pain, range of motion, and daily living ability dimensions were compared among different genders, ages, clinical grades, disease duration, and K-L grading of osteoarthritis, and the differences were statistically significant ( P < 0.05). Conclusions:Based on the Mayo elbow joint function score scale, patients with endemic skeletal fluorosis have relatively poor elbow joint function. The scores of each dimension of the scale are influenced by factors such as genders, ages, clinical grades, disease duration, and joint degeneration. The distribution of scale scores is consistent with the clinical reality of endemic skeletal fluorosis and has certain application value in assessing disease condition.

OBJECTIVE To investigate and analyze the protective effect of Huayu Jiedu Decoction(HYJD)on the inflammatory injury of cardiomyocytes induced by bacterial lipopolysaccharide(LPS),and its molecular mecha-nism of inhibitory effect on inflammatory response.METHODS H9c2 cells were cultured in vitro and divided into:the blank control group(Control group),the model control group(LPS group),the drug treatment group(HYJD group)and the combined treatment group(LPS+HYJD group).H9c2 cells were treated with different concentrations of HYJD(2.5,5,10,20 and 40 mg/ml)for 24 h,and the activity of H9c2 cells was detected by MTT assay.Additionally,H9c2 cells were treated with LPS-induced myocardial inflammatory injury cell model after 24 h of HYJD intervention at each concentration gradients to detect the cell proliferation changes,as well as to detect the levels of apoptosis of cardiomyocytes and the levels of interleukin(IL)-1β,IL-6,IL-8,IL-10 and tumor necrosis factor(TNF)-α in the culture supernatant of experimental groups,the changes in the protein ex-pression of NO production and the expression changes of iNOS and TLR4/NF-κB signaling pathway protein,and Real-time fluorescence quantitative PCR(qRT-PCR)was used to detect mRNA expression of IL-7R,P38(MAPK)and CXCR2.RESULTS Compared with the Control group,low-concentration HYJD had no significant effect on H9c2 cell viability and did not induce cytotoxic effect,and HYJD increased the survival rate of H9c2 cells in the LPS-induced myocardial inflammatory injury model,and effectively reversed the inhibitory effect of the pro-liferative activity of H9c2 cells induced by LPS.Compared with the control group,the difference in apoptosis level of H9c2 cells in the HYJD monotherapy group was not statistically significant,while the levels of inflammatory apoptosis of H9c2 cells induced by LPS was elevated(P＜0.05).Compared with the LPS group,HYJD inhibited the levels of inflammatory apoptosis in H9c2 cells induced by LPS(P＜0.05),reduced the production of pro-in-flammatory cytokines such as IL-1β,IL-6,IL-8 and TNF-α in the supernatant of the LPS-induced myocardial in-flammatory injury H9c2 cell culture,and upregulated the anti-inflammatory cytokine IL-10.Additionally,com-pared with the Control group,the LPS group showed an increased level of NO release(P＜0.05),while the difference in NO release in the low-concentration(5 mg/ml)HYJD was not statistically significant.Compared with the LPS group,the NO release levels in each HYJD intervention group showed a concentration-dependent de-crease(all P＜0.05).Furthermore,compared with the control group,whereas the expression levels of iNOS and TLR4/NF-κB signaling pathway proteins in the LPS-induced H9c2 cells were both elevated(P＜0.05).CONCLUSION HYJD exhibits protective effects against LPS-induced septic myocardial injury and can exert an in-hibitory effect on inflammatory response,and the molecular mechanisms may be related to the inhibition of the ac-tivation of the TLR4/NF-κB signaling pathway and the down-regulation of the expression of inflammatory genes,etc.,and it may have a good biological activity in the prevention and treatment of septic myocardial injury.

Jasmonic acid (JA) is a common plant hormone with regulatory effects on plant growth and development. The jasmonate ZIM-domain (JAZ) proteins (JAZs), as key regulators in the JA signaling pathway, are involved in multiple biological processes such as anthocyanin accumulation, flowering time modulation, and secondary metabolite synthesis in plants. JAZs are essential components of many regulatory signaling networks. The JAZ genes, members of the plant-specific TIFY family, have been identified in the genomes of a variety of horticultural plants. Here, we summarized the research progress in the roles of JAZs in horticultural plants, aiming to give insights into the further study of the biological functions and regulatory networks of JAZ genes in plants.
Horticulture ; Repressor Proteins/metabolism* ; Plant Proteins/metabolism* ; Cyclopentanes/metabolism* ; Oxylipins/metabolism* ; Plants/metabolism* ; Plant Development

Cucumber (Cucumis sativus L.) is one of the most widely cultivated vegetables in the world. High temperature and other stress conditions can affect the growth and development of this plant, even leading to the decreases in yield and quality. The mitogen-activated protein kinase (MAPK) family plays a crucial role in plant stress responses. However, the role of MPK4 in the stress response of cucumber remains to be reported. In this study, we cloned CsMPK4, which encoded 383 amino acid residues. The qRT-PCR results showed that the expression level of CsMPK4 was the highest in leaves and flowers, moderate in roots, and the lowest in stems and tendrils. CsMPK4 was located in the nucleus and cytoplasm, and it had a close relationship with CmMPK4 in muskmelon. The cucumber plants overexpressing CsMPK4 became stronger and shorter, with reduced length and quantity of tendrils. Moreover, the transgenic seedlings were more resistant to high temperatures, with decreased malondialdehyde (MDA) content and increased activities of peroxidase (POD) and superoxide dismutase (SOD) in young leaves. Furthermore, the protein-protein interaction between CsMPK4 and CsVQ10, a member of the valine-glutamine family, was confirmed by yeast two-hybrid and bimolecular fluorescence complementation (BiFC) assays. The results suggested that CsVQ10 cooperated with CsMPK4 in response to the high temperature stress in cucumber. This study laid a foundation for the further study on the stress response mechanism of CsMPK4 and the breeding of stress-resistant cucumber varieties.
Cucumis sativus/metabolism* ; Mitogen-Activated Protein Kinases/physiology* ; Plant Proteins/metabolism* ; Plants, Genetically Modified/metabolism* ; Gene Expression Regulation, Plant ; Stress, Physiological/genetics* ; Cloning, Molecular

Flowering and bolting are important agronomic traits in cruciferous crops such as Brassica juncea. Timely flowering can ensure the crop organ yield and quality, as well as seed propagation. The WRKY family plays an important role in regulating plant bolting and flowering, while the function and mechanism of WRKY12 in B. juncea remain unknown. To explore its function and mechanism in bolting and flowering of B. juncea, we cloned and characterized the BjuWRKY12 gene in B. juncea and found that its expression levels were significantly higher in flowers and inflorescences than in leaves. BjuWRKY12 belonged to the Ⅱc subfamily of the WRKY family, and subcellular localization indicated that the protein was located in the nucleus. Ectopic overexpression of BjuWRKY12 in transgenic lines promoted bolting and flowering, leading to significant increases in the expression levels of flowering integrators SOC1 and FUL. Furthermore, yeast one-hybrid and dual luciferase reporter system assays confirmed that BjuWRKY12 directly bound to the promoters of BjuSOC1 and BjuFUL, undergoing protein-DNA interactions. This discovery gives new insights into the regulation network and molecular mechanisms of BjuWRKY12, laying a theoretical foundation for the breeding of high-yield and high-quality varieties of B. juncea.
Mustard Plant/metabolism* ; Flowers/growth & development* ; Plant Proteins/physiology* ; Promoter Regions, Genetic/genetics* ; Gene Expression Regulation, Plant ; Plants, Genetically Modified/genetics* ; Transcription Factors/metabolism* ; MADS Domain Proteins/metabolism*

Congenital musculoskeletal and limb deformities (CMLD) seriously affect the physical and mental health of patients, and pose great challenges to healthcare systems worldwide. We explored the specific situation and changes of incidence, prevalence, disability-adjusted life years rates, and mortality of CMLD in under-5 children from 1990 to 2021 in different groups, including different regions, periods, genders and socio-demographic indices (SDI), through corresponding analytical models. Overall, the global disease burden of CMLD in under-5 children has decreased from 1990 to 2021. The disease burden of CMLD in under-5 children varied significantly among different regions and countries, and there was a strong correlation between the corresponding burden of disease and the level of SDI. In addition, cross-country inequality analysis showed that while absolute inequalities in the disease burden of CMLD in under-5 children have improved, relative inequalities have worsened. It is essential to reduce the global health impact of CMLD by implementing targeted interventions to improve health care in underdeveloped areas.
Humans ; Global Burden of Disease/trends* ; Child, Preschool ; Global Health/statistics & numerical data* ; Infant ; Male ; Prevalence ; Limb Deformities, Congenital/mortality* ; Musculoskeletal Abnormalities/mortality* ; Female ; Disability-Adjusted Life Years ; Incidence ; Infant, Newborn ; Cost of Illness ; Socioeconomic Factors