Objective To visually analyze the research literature of traditional Chinese medicine （TCM） herbal compresses in China by CiteSpace software, sort out the development process and direction changes of research, reveal cutting-edge hotspots, predict research trends, and provide reference for in-depth research and application of TCM herbal compresses. Methods Literature related to TCM herbal compresses were retrieved from databases including China National Knowledge Infrastructure （CNKI）, Wanfang Data Knowledge Service Platform, VIP Journal Integration Platform （VJIP）, covering the period from September 1, 2002 to November 15, 2024. CiteSpace software was used for visualization analysis. Results A total of 508 documents were included, and the annual publication volume showed a fluctuating growth. The number of publications was higher in northern regions than in southern regions, with Jilin and Henan provinces being the majority. The institution with the highest number of publications was Changchun University of TCM. The authors with the highest number of publications were Xing Linbo and Hou GuiHong. Collaboration among authors and institutions was generally suboptimal, with limited cross-regional cooperation. The top three high-frequency keywords were nursing, （clinical） efficacy, and pain. The emerging keywords indicated that adverse reactions, clinical efficacy, and traditional Chinese medicine rubbing were hot topics in the study of Chinese medicine herbal compresses. Conclusion The research on TCM herbal compresses in China was in a steady development stage, with research hotspots focused on clinical efficacy observation and adverse reactions of multiple therapies combined. In the future, cross institutional cooperation and in-depth research need to be strengthened to promote further development in this field.

Objective To visually analyze the research literature of traditional Chinese medicine （TCM） herbal compresses in China by CiteSpace software, sort out the development process and direction changes of research, reveal cutting-edge hotspots, predict research trends, and provide reference for in-depth research and application of TCM herbal compresses. Methods Literature related to TCM herbal compresses were retrieved from databases including China National Knowledge Infrastructure （CNKI）, Wanfang Data Knowledge Service Platform, VIP Journal Integration Platform （VJIP）, covering the period from September 1, 2002 to November 15, 2024. CiteSpace software was used for visualization analysis. Results A total of 508 documents were included, and the annual publication volume showed a fluctuating growth. The number of publications was higher in northern regions than in southern regions, with Jilin and Henan provinces being the majority. The institution with the highest number of publications was Changchun University of TCM. The authors with the highest number of publications were Xing Linbo and Hou GuiHong. Collaboration among authors and institutions was generally suboptimal, with limited cross-regional cooperation. The top three high-frequency keywords were nursing, （clinical） efficacy, and pain. The emerging keywords indicated that adverse reactions, clinical efficacy, and traditional Chinese medicine rubbing were hot topics in the study of Chinese medicine herbal compresses. Conclusion The research on TCM herbal compresses in China was in a steady development stage, with research hotspots focused on clinical efficacy observation and adverse reactions of multiple therapies combined. In the future, cross institutional cooperation and in-depth research need to be strengthened to promote further development in this field.

Objective To explore the predictive role of pathological risk score of gastric cancer (PRS_GC) in the prognosis of gastric cancer patients, and to further investigate the correlation between PRS_GC and tumor biological behavior. Methods Clinicopathological data were retrospectively collected from 1 120 patients with gastric cancer who underwent surgical resection at Zhongshan Hospital, Fudan University, between April 2006 and November 2019. PRS_GC was calculated using the previously established DeepRisk model, and patients were divided into high and low PRS_GC groups (560 patients per group) based on the median PRS_GC value. The proportions and spatial distances of immune cell subsets in gastric cancer tissues were assessed between the two groups. Data from stomach adenocarcinoma samples in The Cancer Genome Atlas was integrated to analyze PRS_GC-associated genetic mutations and signaling pathways. Results The survival rate of the high PRS_GC group was lower than that of the low PRS_GC group, and the recurrence rate was higher than that of the low PRS_GC group (P<0.000 1). Compared with the low-PRS_GC group, the high-PRS_GC group exhibited increased infiltration of regulatory T cells (Tregs) and neutrophils within the tumor region (P＜0.05), while the infiltration levels of natural killer T cells and cytotoxic T cells were markedly decreased (P＜0.05). Spatial analysis revealed that a shortened spatial distance between CD4⁺ T cells and Tregs was closely associated with poor prognosis in the high-PRS_GC group (P＝0.03). Furthermore, in the high-PRS_GC group, the number of TIM3⁺ cells showed a positive correlation with the infiltration levels of Tregs (r＝0.69, P＝0.01), CD8⁺ T cells (r＝0.61, P＝0.04), and CD4⁺ T cells (r＝0.67, P＝0.02). Gene set enrichment analysis indicated that a high PRS_GC was associated with the activation of pathways related to actin cytoskeleton regulation, the cGMP-PKG pathway, the Hippo pathway, and tumor proteoglycans. Conclusion A high PRS_GC is associated with an immunosuppressive tumor microenvironment, as well as tumor invasion and metastasis. It effectively predicts the prognosis of patients with gastric cancer and, by doing so, provides a potential theoretical basis for developing individualized strategies that combine targeted therapy with immunotherapy.

Objective To explore the impact of tumor-associated myeloid cell infiltration signatures on postoperative overall survival (OS) in patients with gastric cancer. Methods A retrospective analysis was performed on patients who underwent radical gastrectomy at Zhongshan Hospital, Fudan University from January 2005 to December 2019. Patients were randomly divided into a training set (n＝167) and an internal validation set (n＝168) at a 1:1 ratio. Meanwhile, 147 patients with gastric cancer treated at Zhongshan Hospital (Xiamen), Fudan University during the same period were enrolled as the external validation set (n＝147). Immunohistochemistry was used in all patients to evaluate the distribution characteristics of 18 immune markers in three regions of gastric cancer tissues, namely primary tumor (PT), invasive margin (IM), and normal tissue (NT). These markers include 11 myeloid cell markers (CD11b, CD33, CD11c, CD14, CD15, CD16, CD68, CD86, CD163, CD206, and CD66b) and 7 immune checkpoints (CD73, IDO, LAG3, PD-1, SIGLEC9, SIRPA, and TIM3). LASSO regression and Cox proportional hazards model were applied to screen immune markers associated with postoperative OS in gastric cancer patients, and a predictive model for 1-, 3-, and 5-year postoperative OS was established. Data from the internal and external validation set were used for internal and external verification of the predictive model. Receiver operating characteristic (ROC) curves were plotted and the area under the curve (AUC) was calculated to assess the discriminative ability of the model. Results In the training set, LASSO regression and Cox proportional hazards model identified 4 immune marker signatures (CD14_PT, CD15_PT, CD206_PT, and SIGLEC9_PT) to construct the predictive model. ROC curve analysis showed that the AUCs of the model for predicting 1-, 3-, and 5-year postoperative OS were 0.74, 0.75, and 0.84, respectively. When the model was applied to the internal and external validation sets, the AUCs for 1-, 3-, and 5-year postoperative OS were 0.74, 0.72, 0.72 (internal validation set) and 0.72, 0.71, 0.74 (external validation set), respectively. Cox multivariate regression analysis showed that the risk score was an independent risk factor for postoperative OS in patients with gastric cancer. Conclusion The model constructed based on LASSO-Cox regression exhibits good predictive performance and can effectively predict postoperative OS in gastric cancer patients, which may serve as a basis for intensive treatment of high-risk patients after surgery.

Objective:This study aims to investigate the impact of socioeconomic status on cognitive function in older adults, while analyzing the mediating role of health-related social determinants.The findings will provide a foundation for the implementation of an active aging strategy.Methods:Utilizing data from the China Health and Retirement Longitudinal Study(CHARLS)2020, this study employed multiple linear regression analysis to investigate the relationship between socioeconomic status and cognitive function among older adults.A multiple mediation model was applied to evaluate the mediating effects of health-related social determinants on the association between socioeconomic status and cognitive function, with these mediation effects assessed using the Bootstrap method.Results:The results of the multiple linear regression analysis indicated that socioeconomic status significantly positively influences cognitive function in older adults.Factors such as younger age, male gender, Han ethnicity, and urban residence were associated with higher cognitive scores.The mediation analysis demonstrated that, of the total effect of socioeconomic status on cognitive function, health status accounted for 1.564%, individual lifestyle for 14.820%, social support networks for 2.719%, living conditions for 1.632%, and other social structural factors for 1.496%.In the multiple mediation model, a total of 17.945% of the effect of socioeconomic status on cognitive function in older adults was jointly mediated by health-related social determinants.Conclusions:Socioeconomic status is a critical determinant of cognitive impairment among older adults in China.To address this issue, comprehensive interventions should be implemented to promote the equitable distribution of economic and social resources, reduce socioeconomic disparities, and mitigate health inequalities, thereby enhancing the overall cognitive function of disadvantaged groups.Preventive measures and strategies aimed at improving health status, encouraging healthy lifestyle choices, strengthening social support networks, enhancing living conditions, and optimizing social structural factors could serve as essential intervention points to improve the cognitive function of older adults with lower socioeconomic status.

Objective:To explore the technical key points and vital improvements of single-port robotic prepectoral breast reconstruction.Methods:A retrospective analysis was conducted on the case data of 10 patients with breast cancer who underwent single-port robotic prepectoral breast reconstruction performed in the Department of Breast Surgery, Beijing Chao-Yang Hospital, Capital Medical University from January to March 2025. Technical key points and vital improvements were summarized.Results:All 10 patients underwent surgery using the da Vinci Xi system. During the postoperative follow-up period of (3±1) months, no cases of flap or nipple-areola complex necrosis occurred, with no instances of implant loss. The patients experienced neither severe perioperative nor late postoperative complications, and all were satisfied with the aesthetic outcomes. In single-port robotic prepectoral breast reconstruction, several technical modifications were implemented, including posterior space liposuction, electrocautery-assisted flap dissection, and single-port Trocar connection to robotic arms. These refinements enabled clear intraoperative visualization of the circummammary ligaments, allowing for breast reconstruction to be completed within the fascial anatomical planes.Conclusion:The single-port robotic prepectoral breast reconstruction, achieved through technical refinements including posterior space liposuction, electrocautery-assisted flap dissection, and single-port Trocar connection to robotic arms, demonstrates excellent procedural feasibility and is expected to enable precise glandular resection while achieving favorable breast contour outcomes.

OBJECTIVE: To explore the clinical features and genetic etiology in a child with Hereditary hemorrhagic telangiectasia (HHT) complicated by growth hormone deficiency. METHODS: A child presented at Yantai Yuhuangding Hospital in October 2014 for "short stature for over 4 years" was selected as the study subject. Peripheral venous blood samples were collected from the child and his parents for genomic DNA extraction and whole-exome sequencing (WES). The pathogenicity of the candidate variants was assessed by following the guidelines from the American College of Medical Genetics and Genomics (ACMG). This study was approved by the Medical Ethics Committee of the hospital (Ethics No.: 2025-003). RESULTS: The patient, a 4-year-and-2-month-old male, presented with short stature and recurrent epistaxis since early childhood. Initial diagnosis of GHD was made via growth hormone stimulation testing. During follow-up, telangiectatic macules and polycythemia gradually appeared. WES revealed that he has harbored a heterozygous c.1807G>A (p.Gly603Arg) variant of the ENG gene, which was absent in both parents and classified as likely pathogenic based on ACMG guidelines. Sanger sequencing confirmed the candidate variant to be de novo. CONCLUSION Patients with HHT combined with GHD may exhibit clinical features such as short stature, telangiectasia, and arteriovenous malformations. The heterozygous c.1807G>A (p.Gly603Arg) variant of the ENG gene probably underlay the pathogenesis of the disease in the proband. Above finding has expanded the mutational spectrum of the ENG gene.
Humans ; Telangiectasia, Hereditary Hemorrhagic/complications* ; Male ; Child, Preschool ; Phenotype ; Endoglin/genetics* ; Mutation ; Human Growth Hormone/deficiency* ; Exome Sequencing

Atherosclerosis(As)poses a serious threat to human health,and modern medicine still faces many limi-tations in its treatment of this disease.However,components and compounds of traditional Chinese medicine(TCM)have unique advantages in anti-atherosclerosis by regulating macrophage autophagy,they exert anti-inflammatory,anti-oxi-dation,lipid metabolism-regulating and plaque-stabilizing effects.This paper reviews the application of TCM in regulating macrophage autophagy to prevent and treat atherosclerosis,and provides new insights into the application of TCM compo-nents and compounds in the treatment of As.

Objective To quantitatively assess the correlation between the skeletal muscle index(SMI)of patients and the occur-rence of anastomotic leakage(AL)in rectal cancer patients after surgery,and to analyze the risk factors for AL in rectal cancer patients and the influencing factors of sarcopenia.Methods The clinical,pathological,and related imaging data of 362 patients who under-went radical surgery for rectal cancer were retrospectively analyzed.All patients underwent pelvic MRI and abdominal CT scans(plain/enhanced)within one month before surgery,and the third lumbar vertebra skeletal muscle area(L3-SMA)was measured from the images.All patients were divided into AL group(56 cases)and control group(306 cases)based on the presence or absence of postoperative complications.The differences in clinical characteristics and imaging parameters between the two groups were analyzed.A logistic risk prediction model was established.Results Significant differences were observed between the two groups in sarcopenia,type of surgery,surgical approach,serum albumin level,operation duration,stoma type,and extramural vascular invasion(EMVI)(P＜0.05).These factors were incorporated in a multivariate logistic regression analysis model,the area under the curve(AUC)of receiver operating characteristic(ROC)curve of the model was 0.810[95％confidence interval(CI)0.743-0.876,P＜0.001],with a sensitivity of 0.865 and specificity of 0.669.Conclusion Sar-copenia is a significant risk factor for AL after rectal cancer surgery.It enhances the predictive efficacy for postoperative AL and serves as a basis for identifying high-risk populations for AL in clinical practice.

Purpose To develop and validate a nomogram incorporating high-resolution MRI and clinicopathological indicators for predicting distant metastasis after curative resection of mid-low rectal cancer.Materials and Methods This retrospective study analyzed 219 patients with pathologically confirmed mid-low rectal cancer from Tianjin Union Medical Center(December 2016 to December 2021).Patients were categorized into metastasis(n=46)and non-metastasis(n=173)groups based on postoperative distant metastasis occurrence.All patients underwent preoperative pelvic MRI with measurement of posterior mesangial thickness(PMT),mesentery fat area(MFA)and mesenteric fascia envelopment volume(MFEV)on high-resolution T2WI.Clinicopathological and imaging data were collected.Cox proportional hazards model identified predictive factors for distant metastasis,and a risk probability nomogram was constructed.Predictive performance,goodness-of-fit and clinical applicability were evaluated.Results Kaplan-Meier analysis demonstrated significantly higher distant metastasis risk in patients with PMT≤1.43 cm,MFA≤19.31 cm2 and MFEV≤137.46 cm3 compared to those with higher values(χ2=29.07,8.71,19.05;all P<0.05).Cox regression identified tumor differentiation(HR=0.536,95％CI 0.290-0.990),pathological N stage(HR=0.397,95％CI 0.210-0.747),perirectal structure invasion(HR=0.242,95％CI 0.068-0.865)and PMT(HR=0.334,95％CI 0.168-0.664)as independent predictors.The nomogram achieved a concordance index of 0.775 with good calibration.Decision curve analysis demonstrated substantial net benefit across wide probability thresholds,indicating excellent clinical applicability.Conclusion Patients with PMT≤1.43 cm,MFA≤19.31 cm2 and MFEV≤137.46 cm3 exhibit elevated distant metastasis risk.The nomogram incorporating tumor differentiation,pathological N stage,perirectal structure invasion and PMT effectively predicts distant metastasis after curative resection of mid-low rectal cancer.