Chronic post-surgical pain (CPSP) is a common long-term complication following lung surgery. Its high incidence significantly impacts patients’ quality of life and functional recovery, and imposes a substantial socioeconomic burden. This consensus aims to systematically establish a standardized integrated Chinese and Western medicine diagnostic and treatment framework for chronic post-lung surgery pain (CPLSP). Based on the latest domestic and international evidence-based medical research and multidisciplinary clinical experience, the working group comprehensively elaborates on core issues regarding CPLSP, including its definition, epidemiology, pathogenesis, clinical assessment, Western medical treatment, traditional Chinese medicine (TCM) treatment, and integrated strategies. The consensus emphasizes a patient-centered approach, adhering to the principles of multimodality, individualization, and stepwise management, highlighting the synergistic advantages of integrating Chinese and Western medicine throughout the entire perioperative management cycle encompassing "perioperative anti-inflammation, acute analgesia, and chronic rehabilitation." Through systematic literature retrieval and evidence integration, a total of 9 core recommendations were established to provide scientifically sound and clinically practical guidance.

Objective To investigate the temporal changes in pathological damage and macrophage polarization in liver and spleen tissues of mice infected with Angiostrongylus cantonensis, and to preliminarily unravel the peripheral immune responses during the early stage of A. cantonensis infection. Methods Forty female BALB/c mice at ages of 6 to 8 weeks were randomly divided into four groups, including the control group and 7-, 14-, and 21-day infection groups, with 10 mice in each group. Each mouse in the infection groups was inoculated with 30 third-stage (L3) larvae of A. cantonensis by oral gavage, and five mice were randomly selected from each infection group on days 7, 14, and 21 post-infection, while mice in the control group were given the same volume of physiological saline and five mice were randomly selected from the control group on the day of oral gavage. Mouse liver and spleen tissues were sampled. The histopathological changes of mouse liver and spleen tissues were observed using hematoxylin and eosin (HE) staining, and the percentage of positive staining area and the co-localization positive rates of the macrophage surface antigens F4/80, CD86, and CD206 were quantified in mouse liver and spleen tissues using immunohistochemical and immunofluorescence staining. In addition, five mice were collected from each infection group on days 7, 14, and 21 post-infection, and five mice were collected from the control group on the day of oral gavage. Mouse liver and spleen tissues were sampled for detection of macrophage markers CD86 and CD206 and macrophage phenotyping using flow cytometry, and the expression of M1 macrophage markers, including inducible nitric oxide synthase (Nos2), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and M2 markers, including arginase 1 (Arg1), mannose receptor C-type 1 (Mrc1) and chitinase-like protein 3 (Chil3) was quantified in mouse liver and spleen tissues using real-time quantitative PCR (RT-qPCR) assay. Results Proliferative lesions of the hepatocyte were observed in mouse liver tissues and the follicular structures of the mouse spleen white pulp were disrupted 21 days post-infection with A. cantonensis. Immunohistochemical staining showed that there were significant differences in the percentages of F4/80, CD86 and CD206 positive staining areas in the liver and spleen tissues among the four groups of mice (F = 242.40, 197.14, 183.19, 157.65, 242.35 and 146.24; all P values < 0.001), and the percentages of positive staining in the liver and spleen tissues of mice in the 14-day infection group [(4.45 ± 0.51)%, (3.74 ± 0.67)%, (8.32 ± 0.72)%, (16.56 ± 1.14)%, (11.62 ± 0.52)%, and (8.29 ± 0.72)%, respectively] and the 21-day infection group [(3.70 ± 0.11)%, (3.22 ± 0.43)%, (11.53 ± 1.03)%, (12.59 ± 1.05)%, (9.02 ± 0.83)%, and (11.67 ± 1.10)%, respectively] were higher than in the control group [(0.35 ± 0.16)%, (0.40 ± 0.02)%, (0.93 ± 0.05)%, (2.78 ± 0.26)%, (2.33 ± 0.20)%, and (1.85 ± 0.20)%, respectively] (all P values < 0.05). Immunofluorescence staining showed significant differences in the positive rates of F4/80 co-localization with CD86 and CD206 in mouse liver and spleen tissues among the four groups (F = 24.42, 25.28, 54.51 and 130.55; all P values < 0.001). Flow cytometry detected significant differences in the proportions of CD86⁺ and CD206⁺ macrophages in mouse liver and spleen tissues among the four groups (F = 67.98, 18.41, 29.77, 172.80; all P values < 0.001), and the proportions of CD206⁺ macrophages in the liver and spleen of the 21-day infection group were significantly higher than those in the control group [(9.25 ± 2.55)% vs (3.83 ± 0.72)%, and (4.22 ± 0.56)% vs (0.47 ± 0.18)%, respectively] (both P values < 0.05). In addition, RT-qPCR assay quantified significant differences in the relative mRNA expression of M1 macrophage markers (IL-1β, TNF-α and Nos2) and M2 macrophage markers (Arg1, Chil3 and Mrc1) in mouse liver and spleen tissues among the four groups (F = 41.30, 31.82, 199.33, 19.96, 62.01, 119.76, 23.67, 95.90, 72.27, 82.59, 123.41 and 29.75; all P values < 0.05). Conclusions A. cantonensis infection may cause progressive pathological damage in mouse liver and spleen tissues, accompanied by dynamic temporal changes in macrophage polarization. M1 macrophage polarization predominates at the early stage of A. cantonensis infection and shifts towards M2 polarization at the later stages, suggesting that M2 polarization may participate in immune regulation at late stages of A. cantonensis infection by suppressing excessive inflammatory responses and promoting tissue repair.

Objective To explore the clinical efficacy of different mucosal incision methods in endoscopic submucosal dissection(ESD)for the treatment of gastric submucosal tumors.Methods A retrospective analysis was conducted on the clinical data of 30 patients with gastric submucosal tumors treated with ESD from July 2022 to March 2024.They were divided into a circular group(n=15)and a longitudinal group(n=15)based on different mucosal incision methods.Then compare the pathological data,clinical efficacy,surgical outcomes,and complications between the two groups.Results There were no statistically significant differences between the two groups in length of hospital stay,hospitalization costs,lesion diameter,lesion location and lesion nature(P＞0.05).The surgical time of the longitudinal group was significantly shorter than that of the circular group,and the difference was statistically significant(P＜0.05);There was no statistical significant in the incidence of intraoperative complications in the longitudinal group and the circular group(P＞0.05);The complete resection rate of the longitudinal group was lower than that of the circular group,but the difference was not statistically significant(P＞0.05).Conclusion ESD treatment for gastric submucosal tumors is safe and effective,and the longitudinal incision can shorten the surgical time compared to the circular incision.Both methods have the characteristics of low incidence of complications and high complete resection rate,and are worthy of clinical application.

Objective:To investigate the expression and clinical significance of Prohibitin 2(PHB2)in the kidney tissue of patients with Diabetic Kidney Disease(DKD).Methods:From March 2015 to May 2024,samples were collected from 16 patients diagnosed with diabetic nephropathy through renal biopsy,who met the inclusion criteria(referred to as the DKD group).Additionally,20 patients with renal tumors undergoing nephrectomy,who had partially normal kidney tissue,were selected to serve as the control group(NC group).The pathological changes of the two groups of samples were evaluated by HE and PAS staining.Immunohistochemistry was utilized to analyze the differences in PHB2 protein expression between the two groups.Pearson or Spearman correlation methods were applied for statistical analysis.Results:PHB2 was expressed in renal tubules,and its expression level in the diabetic kidney disease(DKD)group was significantly lower than that in the normal control(NC)group(P＜0.05).Additionally,the expression level of PHB2 in diabetic nephropathy was found to be negatively correlated with glycated hemoglobin,serum creatinine,cystatin C,and blood urea nitrogen(P＜0.05).In contrast,there was a positive correlation between PHB2 expression and the estimated glomerular filtration rate(eGFR)(P＜0.05).Therefore,PHB2 expression serves as a negative correlation factor for serum creatinine,cystatin C,and blood urea nitrogen,while being a positive correlation factor for eGFR.Conclusions:In patients with diabetic nephropathy,the expression of PHB2 in renal tissue significantly decreases.This reduction in PHB2 levels closely correlates with glucose metabolism and renal function.Low levels of PHB2 may worsen glucose metabolism disorders,renal function damage,and proteinuria.Therefore,PHB2 serves as a potential biomarker for assessing prognosis and offers new insights into the treatment of diabetic kidney disease.

Objective To investigate the feasibility,efficacy and safety of cold snare polypectomy(CSP)and endoscopic mucosal resection(EMR)in treatment of colonic adenoma in proximity to the orifice of appendix.Methods Clinical data of 41 cases of colonic adenoma in the orifice of appendix treated with CSP(CSP group)and 15 cases treated with EMR(EMR group)from January 2018 to January 2023 were collected.The clinicopathological features and outcomes were analyzed.The main outcome was postoperative complications,including bleeding,perforation and postoperative appendicitis,while the secondary outcome was the total resection rate,block resection rate and local recurrence rate.Results The operation time and treatment cost of CSP group were shorter than EMR group,and the differences were statistically significant(P<0.05).The diameter of applicable lesions in CSP group was smaller than that in EMR group,and the proportion of lesions with tubular adenoma was significantly higher than that in EMR group.There were no significant differences in the time of admission,intestinal preparation score,length of stay,lesion morphology and lesion type between the two groups(P>0.05).Perforation and postoperative appendicitis were not observed in both groups,and delayed postoperative hemorrhage occurred in 1 case in the CSP group,but it could heal itself after surgery without endoscopic intervention.The complete resection rate was 100.0%in both groups.The total removal rate of CSP group was 100.0%,which was significantly higher than that of EMR group(86.7%),and the difference was statistically significant(P<0.05).The local recurrence rate was 2.4%(1/41)in CSP group,and no local recurrence was observed in EMR group(0/15),with no statistical significance(P>0.05).Conclusion CSP and EMR are safe and effective in the treatment of colonic adenoma in proximity to the orifice of appendix,and they are trustworthy.Compared with EMR,CSP is more applied to small diameter tubular adenomas,which has the characteristics of economy and time saving,but at the same time there is the risk of recurrence.EMR obviously has a wider application range,but there is a disadvantage in price and time,and individual cases need to be segmented resection.

BACKGROUND:Wolff's law points out that the lack of mechanical stress in the body will lead to the degradation of the microstructure of bone tissue,mass loss,and metabolic disorders,and eventually lead to osteoporosis,which suggests that mechanical stress plays an important role in the growth,reconstruction,and formation of bone tissue.At present,the relevant studies concerning mechanical stress on osteoblasts mainly focus on fluid shear force,but it is difficult to intervene in vivo.Meanwhile,some studies have found that compressive stress can also play a similar role in fluid shear force to a certain extent.Exploring the mode of action and influence of compressive stress on cells in vitro experiments can enrich the interaction relationship between mechanical stress and cells.It helps provide a theoretical basis for studies of metabolic bone diseases,including osteoporosis,and other diseases.OBJECTIVE:To review in vitro experiments,the application of compressive stress to cells,different biological behaviors caused by cells,the possible signaling pathways,and possible future applications.METHODS:We searched PubMed,Web of Science,CNKI,and WanFang databases from January 2000 to March 2024 to include all articles related to compressive stress on cells,including basic research and microscopic mechanism studies,using search terms"compressive stress,mechanical stress,hydrostatic pressure,cell"in Chinese and English.Finally,the 63 included articles were reviewed.RESULTS AND CONCLUSION:(1)There are various ways to apply compressive stress,and different experimental equipment has different ways of pressurizing cells,so it is necessary to further standardize the experimental equipment,standardize the pressurization unit,reduce the confounding factors,and make the reference and comparability between different experimental groups.(2)Compressive stress can cause changes in cell proliferation,differentiation,autophagy,apoptosis,migration,etc.,and the effect of compressive stress is time-or dose-dependent in most cases.(3)At present,most in vitro experimental studies have shown that compressive stress may mainly act on osteoblasts through MAPK signaling pathway and Wnt/β-catenin signaling pathway,causing osteoblasts to produce different responses.(4)The effect of compressive stress on different cells is not the same,and its possible biological effects need to be studied.(5)Further research on compressive stress is helpful to provide a theoretical basis for treatment in orthopedics,stomatology,tumors and other fields,and gentle disinfection using hydrostatic pressure is a promising disinfection method.

Objective:To investigate the expression and clinical significance of Prohibitin 2(PHB2)in the kidney tissue of patients with Diabetic Kidney Disease(DKD).Methods:From March 2015 to May 2024,samples were collected from 16 patients diagnosed with diabetic nephropathy through renal biopsy,who met the inclusion criteria(referred to as the DKD group).Additionally,20 patients with renal tumors undergoing nephrectomy,who had partially normal kidney tissue,were selected to serve as the control group(NC group).The pathological changes of the two groups of samples were evaluated by HE and PAS staining.Immunohistochemistry was utilized to analyze the differences in PHB2 protein expression between the two groups.Pearson or Spearman correlation methods were applied for statistical analysis.Results:PHB2 was expressed in renal tubules,and its expression level in the diabetic kidney disease(DKD)group was significantly lower than that in the normal control(NC)group(P＜0.05).Additionally,the expression level of PHB2 in diabetic nephropathy was found to be negatively correlated with glycated hemoglobin,serum creatinine,cystatin C,and blood urea nitrogen(P＜0.05).In contrast,there was a positive correlation between PHB2 expression and the estimated glomerular filtration rate(eGFR)(P＜0.05).Therefore,PHB2 expression serves as a negative correlation factor for serum creatinine,cystatin C,and blood urea nitrogen,while being a positive correlation factor for eGFR.Conclusions:In patients with diabetic nephropathy,the expression of PHB2 in renal tissue significantly decreases.This reduction in PHB2 levels closely correlates with glucose metabolism and renal function.Low levels of PHB2 may worsen glucose metabolism disorders,renal function damage,and proteinuria.Therefore,PHB2 serves as a potential biomarker for assessing prognosis and offers new insights into the treatment of diabetic kidney disease.

BACKGROUND:Wolff's law points out that the lack of mechanical stress in the body will lead to the degradation of the microstructure of bone tissue,mass loss,and metabolic disorders,and eventually lead to osteoporosis,which suggests that mechanical stress plays an important role in the growth,reconstruction,and formation of bone tissue.At present,the relevant studies concerning mechanical stress on osteoblasts mainly focus on fluid shear force,but it is difficult to intervene in vivo.Meanwhile,some studies have found that compressive stress can also play a similar role in fluid shear force to a certain extent.Exploring the mode of action and influence of compressive stress on cells in vitro experiments can enrich the interaction relationship between mechanical stress and cells.It helps provide a theoretical basis for studies of metabolic bone diseases,including osteoporosis,and other diseases.OBJECTIVE:To review in vitro experiments,the application of compressive stress to cells,different biological behaviors caused by cells,the possible signaling pathways,and possible future applications.METHODS:We searched PubMed,Web of Science,CNKI,and WanFang databases from January 2000 to March 2024 to include all articles related to compressive stress on cells,including basic research and microscopic mechanism studies,using search terms"compressive stress,mechanical stress,hydrostatic pressure,cell"in Chinese and English.Finally,the 63 included articles were reviewed.RESULTS AND CONCLUSION:(1)There are various ways to apply compressive stress,and different experimental equipment has different ways of pressurizing cells,so it is necessary to further standardize the experimental equipment,standardize the pressurization unit,reduce the confounding factors,and make the reference and comparability between different experimental groups.(2)Compressive stress can cause changes in cell proliferation,differentiation,autophagy,apoptosis,migration,etc.,and the effect of compressive stress is time-or dose-dependent in most cases.(3)At present,most in vitro experimental studies have shown that compressive stress may mainly act on osteoblasts through MAPK signaling pathway and Wnt/β-catenin signaling pathway,causing osteoblasts to produce different responses.(4)The effect of compressive stress on different cells is not the same,and its possible biological effects need to be studied.(5)Further research on compressive stress is helpful to provide a theoretical basis for treatment in orthopedics,stomatology,tumors and other fields,and gentle disinfection using hydrostatic pressure is a promising disinfection method.

Objective To investigate the changes in eosinophil counts and the activation of microglial cells in the brain tissues of mice at different stages of Angiostrongylus cantonensis infection, and to examine the role of microglia in regulating the progression of angiostrongyliasis and unravel the possible molecular mechanisms. Methods Fifty BALB/c mice were randomly divided into the control group and the 7-d, 14-d, 21-day and 25-d infection groups, of 10 mice in each group. All mice in infection groups were infected with 30 stage III A. cantonensis larvae by gavage, and animals in the control group was given an equal amount of physiological saline. Five mice were collected from each of infection groups on days 7, 14, 21 d and 25 d post-infection, and 5 mice were collected from the control group on the day of oral gavage. The general and focal functional impairment was scored using the Clark scoring method to assess the degree of mouse neurological impairment. Five mice from each of infection groups were sacrificed on days 7, 14, 21 d and 25 d post-infection, and 5 mice from the control group were sacrificed on the day of oral gavage. Mouse brain tissues were sampled, and the pathological changes of brain tissues were dynamically observed using hematoxylin and eosin (HE) staining. Immunofluorescence staining with eosinophilic cationic protein (ECP) and ionized calcium binding adaptor molecule 1 (Iba1) was used to assess the degree of eosinophil infiltration and the counts of microglial cells in mouse brain tissues in each group, and the morphological parameters of microglial cells (skeleton analysis and fractal analysis) were quantified by using Image J software to determine the morphological changes of microglial cells. In addition, the expression of M1 microglia markers Fcγ receptor III (Fcgr3), Fcγ receptor IIb (Fcgr2b) and CD86 antigen (Cd86), M2 microglia markers Arginase 1 (Arg1), macrophage mannose receptor C-type 1 (Mrc1), chitinase-like 3 (Chil3), and phagocytosis genes myeloid cell triggering receptor expressed on myeloid cells 2 (Trem2), CD68 antigen (Cd68), and apolipoprotein E (Apoe) was quantified using real-time quantitative reverse transcription PCR (RT-qPCR) assay in the mouse cerebral cortex of mice post-infection. Results A large number of A. cantonensis larvae were seen on the mouse meninges surface post-infection, and many neuronal nuclei were crumpled and deeply stained, with a large number of bleeding points in the meninges. The median Clark scores of mouse general functional impairment were 0 (interquartile range, 0), 0 (interquartile range, 0.5), 6 (interquartile range, 1.0), 14 (interquartile range, 8.5) points and 20 (interquartile range, 9.0) points in the control group and the 7-d, 14-d, 21-d and 25-d groups, respectively (H = 22.45, P < 0.01), and the median Clark scores of mouse focal functional impairment were 0 (interquartile range, 0), 2 (interquartile range, 2.5), 7 (interquartile range, 3.0), 18 (interquartile range, 5.0) points and 25 (interquartile range, 6.5) points in the control group and the 7-d, 14-d, 21-d and 25-d groups, respectively (H = 22.72, P < 0.01). The mean scores of mice general and focal functional impairment were all higher in the infection groups than in the control group (all P values < 0.05). Immunofluorescence staining showed a significant difference in the eosinophil counts in mouse brain tissues among the five groups (F = 40.05, P < 0.000 1), and the eosinophil counts were significantly higher in mouse brain tissues in the 14-d (3.08 ± 0.78) and 21-d infection groups (5.97 ± 1.37) than in the control group (1.00 ± 0.28) (both P values < 0.05). Semi-quantitative analysis of microglia immunofluorescence showed a significant difference in the counts of microglial cells among the five groups (F = 17.66, P < 0.000 1), and higher Iba1 levels were detected in mouse brain tissues in 14-d (5.75 ± 1.28), 21-d (6.23 ± 1.89) and 25-d infection groups (3.70 ± 1.30) than in the control group (1.00 ± 0.30) (all P values < 0.05). Skeleton and fractal analyses showed that the branch length [(162.04 ± 34.10) μm vs. (395.37 ± 64.11) μm; t = 5.566, P < 0.05] and fractal dimension of microglial cells (1.30 ± 0.01 vs. 1.41 ± 0.03; t = 5.266, P < 0.05) were reduced in mouse brain tissues in the 21-d infection group relative to the control group. In addition, there were significant differences among the 5 groups in terms of M1 and M2 microglia markers Fcgr3 (F = 48.34, P < 0.05), Fcgr2b (F = 55.46, P < 0.05), Cd86 (F = 24.44, P < 0.05), Arg1 (F = 31.18, P < 0.05), Mrc1 (F = 15.42, P < 0.05) and Chil3 (F = 24.41, P < 0.05), as well as phagocytosis markers Trem2 (F = 21.19, P < 0.05), Cd68 (F = 43.95, P < 0.05) and Apoe (F = 7.12, P < 0.05) in mice brain tissues. Conclusions A. cantonensis infections may induce severe pathological injuries in mouse brain tissues that are characterized by massive eosinophil infiltration and persistent activation of microglia cells, thereby resulting in progressive deterioration of neurological functions.

Insulin-like growth factor 2 (IGF2) is a critical endocrine mediator implicated in male reproductive physiology. To investigate the correlation between IGF2 protein levels and various aspects of male infertility, specifically focusing on sperm quality, inflammation, and DNA damage, a cohort of 320 male participants was recruited from the Women's Hospital, Zhejiang University School of Medicine (Hangzhou, China) between 1 st January 2024 and 1 st March 2024. The relationship between IGF2 protein concentrations and sperm parameters was assessed, and Spearman correlation and linear regression analysis were employed to evaluate the independent associations between IGF2 protein levels and risk factors for infertility. Enzyme-linked immunosorbent assay (ELISA) was used to measure IGF2 protein levels in seminal plasma, alongside markers of inflammation (tumor necrosis factor-alpha [TNF-α] and interleukin-1β [IL-1β]). The relationship between seminal plasma IGF2 protein levels and DNA damage marker phosphorylated histone H2AX (γ-H2AX) was also explored. Our findings reveal that IGF2 protein expression decreased notably in patients with asthenospermia and teratospermia. Correlation analysis revealed nuanced associations between IGF2 protein levels and specific sperm parameters, and low IGF2 protein concentrations correlated with increased inflammation and DNA damage in sperm. The observed correlations between IGF2 protein levels and specific sperm parameters, along with its connection to inflammation and DNA damage, underscore the importance of IGF2 in the broader context of male reproductive health. These findings lay the groundwork for future research and potential therapeutic interventions targeting IGF2-related pathways to enhance male fertility.
Humans ; Male ; Insulin-Like Growth Factor II/metabolism* ; Infertility, Male/genetics* ; DNA Damage ; Adult ; Inflammation/metabolism* ; Spermatozoa/metabolism* ; Semen Analysis ; Semen/metabolism* ; Tumor Necrosis Factor-alpha/metabolism* ; Histones/metabolism* ; Interleukin-1beta/metabolism*