BACKGROUND: Double-stranded RNA-specific adenosine deaminase 1 (ADAR1) binds to double-stranded RNA and catalyzes the deamination of adenosine (A) to inosine (I). The functional mechanism of ADAR1 in non-small cell lung cancer (NSCLC) remains incompletely understood. This study aimed to investigate the prognostic significance of ADAR1 in NSCLC and to elucidate its potential role in regulating tumor cell proliferation and migration. METHODS: Data from The Cancer Genome Atlas (TCGA) and cBioPortal were analyzed to assess the correlation between high ADAR1 expression and clinicopathological features as well as prognosis in lung cancer. We performed Western blot (WB), cell proliferation assays, Transwell invasion/migration assays, and nude mouse xenograft modeling to examine the phenotypic changes and molecular mechanisms induced by ADAR1 knockdown. Furthermore, the ADAR1 p150 overexpression model was utilized to validate the proposed mechanism. RESULTS: ADAR1 expression was significantly elevated in lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC) tissues compared with adjacent non-tumor tissues (LUAD: P=3.70×10-15, LUSC: P=0.016). High ADAR1 expression was associated with poor prognosis (LUAD: P=2.03×10-2, LUSC: P=2.81×10-2) and distant metastasis (P=0.003). Gene Set Enrichment Analysis (GSEA) indicated that elevated ADAR1 was associated with mitogen-activated protein kinase/extracellular signal-regulated kinase (MAPK/ERK) pathway activation, matrix metalloproteinase-9 (MMP-9) expression, and cell adhesion. ADAR1 and MMP-9 levels showed a strongly positive correlation (P=6.45×10-34) in 10 lung cancer cell lines, highest in H1581. Knockdown of ADAR1 in H1581 cells induced a rounded cellular morphology with reduced pseudopodia. Concomitantly, it suppressed cell proliferation, invasion, migration, and in vivo tumorigenesis. It also suppressed ERK phosphorylation and downregulated cellular Finkel-Biskis-Jinkins murine osteosarcoma viral oncogene homolog (c-FOS), MMP-9, N-cadherin, and Vimentin. Conversely, ADAR1 p150 overexpression in PC9 cells enhanced ERK phosphorylation and increased c-FOS and MMP-9 expression. CONCLUSIONS High ADAR1 expression is closely associated with poor prognosis and distant metastasis in NSCLC patients. Mechanistically, ADAR1 may promote proliferation, invasion, migration, and tumorigenesis in lung cancer cells via the ERK/c-FOS/MMP-9 axis.
Humans ; Lung Neoplasms/physiopathology* ; Adenosine Deaminase/genetics* ; Matrix Metalloproteinase 9/genetics* ; Cell Proliferation ; Carcinoma, Non-Small-Cell Lung/physiopathology* ; Cell Movement ; Animals ; Mice ; RNA-Binding Proteins/genetics* ; Female ; Male ; Cell Line, Tumor ; Proto-Oncogene Proteins c-fos/genetics* ; Middle Aged ; MAP Kinase Signaling System ; Gene Expression Regulation, Neoplastic ; Mice, Nude ; Extracellular Signal-Regulated MAP Kinases/genetics*

BACKGROUND: The choice of unicompartmental knee arthroplasty (UKA) vs . total knee arthroplasty (TKA) in the surgical treatment of knee osteoarthritis (KOA) remains controversial. This study aimed to perform a systematic review and meta-analysis of randomized controlled trials (RCTs) to compare the clinical results of UKA and TKA for treating unicompartmental KOA. METHODS: PubMed, Embase, and the Cochrane Library were systematically searched for articles published up to January 2, 2023. The literature was rigorously screened to include only RCTs comparing UKA and TKA for unicompartmental KOA. A systematic review and meta-analysis were performed to calculate the mean difference (MD), relative risk (RR), and 95% confidence interval (CI) according to the Cochrane standards. RESULTS: Thirteen publications involving 683 UKAs and 683 TKAs were analyzed. Except for one study with a follow-up period of 15 years, all outcome measures reported were within 5 years of follow-up. Meta-analysis showed better knee recovery (MD: 1.23; 95% CI: 1.01-1.45; P  <0.001), greater knee function (MD: 1.78; 95% CI: 0.34-3.22; P  = 0.020), less pain (MD: 0.75; 95% CI: 0.43-1.06; P  <0.001), and better health status (MD: 3.75; 95% CI: 0.81-6.69; P  = 0.010) after UKA than TKA. However, considering the minimal clinically important difference values for these variables, the findings were not clinically relevant. Moreover, UKA patients had fewer complications (RR: 0.59; 95% CI: 0.45-0.78; P  <0.001) and shorter hospital stays (MD: -0.89; 95% CI: -1.57 to -0.22; P  = 0.009) than did TKA patients. There were no statistically significant differences in terms of postoperative range of movement, revision, failure, operation time, and patient satisfaction. CONCLUSIONS In terms of clinical efficacy, there was no obvious advantage of UKA over TKA in the surgical treatment of knee OA when considering the minimal clinically important difference. The main advantage of UKA over TKA is that it leads to fewer complications and a shorter length of hospital stay. It is ideal to perform prospective studies with longer follow-up periods to fully evaluate the long-term efficacy and safety of the two procedures in the future.
Humans ; Arthroplasty, Replacement, Knee/methods* ; Osteoarthritis, Knee/surgery* ; Randomized Controlled Trials as Topic ; Treatment Outcome

OBJECTIVE To explore the mechanism of Yishen Qingli Huoxue Formula(YQHF)improving renal fibrosis by inhib-iting HIF1-α using data mining,molecular docking,and in vivo and in vitro experiments.METHODS The expression changes of HIF1-α in renal biopsy tissues of patients with chronic kidney disease(CKD)in the GEO database were analyzed.Molecular docking was used to clarify the interaction mode between YQHF effective monomers and HIF1-α.Thirty SD rats were randomized to sham,model,low-dose YQHF,high-dose YQHF,and losartan potassium groups(n=6 per group).Unilateral ureteral obstruction(UUO)was used to induce renal fibrosis.Serum creatinine(Scr)and blood urea nitrogen(BUN)were measured,and kidney sections were stained with HE and Masson to assess pathology and fibrosis.Renal HIF1-α protein expression was quantified by Western blot.A renal fibro-sis cell model was established by inducing NRK-52E cells with TGF-β1,and the cells were divided into control,model,YQHF,HIF1-α inhibitor,HIF1-α inhibitor+YQHF,HIF1-α agonist,and HIF1-α agonist+YQHF groups.Western blot analysis was used to detect the protein expression levels of HIF1-α,COL-1,and α-SMA,and to observe the mechanism of YQHF-containing serum in protecting renal tubular epithelial cells.RESULTS Data mining showed HIF1-α expression in the CKD group was significantly higher than in the control group(P<0.01).Molecular docking indicated YQHF core components had good binding affinity to HIF1-α.In vivo,com-pared with the sham group,HE staining revealed tubular atrophy and inflammatory-cell infiltration,and Masson staining showed in-creased collagen deposition in UUO model rats(P<0.01).Serum creatinine and blood urea nitrogen were also elevated in the model group(P<0.05),together with up-regulated renal expression of COL-1,α-SMA and HIF-1α(P<0.01).After intervention with either high-dose or low-dose YQHF or losartan potassium,these pathological changes were attenuated:collagen deposition decreased(P<0.01),creatinine and BUN fell to varying degrees(P<0.05),and renal COL-1,α-SMA and HIF-1α levels were down-regulated(P<0.01);immunohistochemistry confirmed reduced HIF-1α in UUO kidneys(P<0.01).In NRK-52E cells,TGF-β1 stimulation mark-edly increased COL-1,α-SMA and HIF-1α protein levels(P<0.01).Both YQHF and chloramphenicol alone down-regulated these proteins(P<0.05,P<0.01),and their combination produced stronger inhibition of HIF-1α than YQHF alone(P<0.05).Conversely,the HIF-1α agonist fenbendazole-d3 reversed YQHF's anti-fibrotic effect,re-elevating COL-1,α-SMA and HIF-1α(P<0.01),with no significant difference versus agonist alone.CONCLUSION YQHF may inhibit extracellular matrix deposition and delay renal fi-brosis progression by suppressing HIF1-α accumulation,providing new theoretical evidence for traditional Chinese medicine in treat-ing renal fibrosis.

Objective To construct a nursing registry platform for percutaneous coronary intervention(PCI)to provide data support for subsequent real-world research on PCI nursing.Methods From April to December 2023,we established a variable list and data dictionary based on literature review and expert discussion,and constructed a web-based PCI nursing registry platform based on registry-related standards.Results A total of 191 variables were screened in this study,and a corresponding data dictionary was developed for each variable according to the variable name,variable code,variable definition,variable type,variable value range,data source and data collection node.Three levels of account privileges has been set up in the platform,which can realize different data management privileges,and the data can be saved only after filling in and reviewing at each level.The platform is also equipped with automatic data checking function,which reduces data filling errors and improves data quality.Conclusion The constructed PCI nursing registration platform has strong scientific and professional characteristics,and can provide data support for subsequent research,and the content and functions of the platform can be further optimized in the future.

Objective To provide basis for the formation of acute exacerbation of chronic obstructive pulmonary disease(AECOPD-STES),the item weight of the syndrome therapeutic evaluation scale for AECOPD-STES was determined.Methods Based on the clinical survey data of 387 AECOPD patients,the random forest method was adopted,and the Spyder integrated development environment.Anaconda navigator software was used to call the"random forest Classifier"in the sklearn package to establish the initial random forest model and calculate the item weights.Factor analysis was used to extract common factors with cumulative variance contribution>80%,and the item weight was calculated according to the cumulative variance contribution and component score coefficient of common factors.The percentage weight method was used to calculate the item weight based on the importance score of each item by 29 experts.Finally,40%,30%and 30%of the above three methods were given respectively to determine the final weight of the items.Results The random forest method showed that the weights of wind cold syndrome,cold Yin syndrome,phlegm heat syndrome,phlegm dampness syndrome and blood stasis syndrome were 0.014-0.170,0.076-0.194,0.017-0.183,0.010-0.183 and 0.069-0.298,respectively.Factor analysis showed that the weights of wind cold syndrome,cold yin Syndrome,phlegm heat syndrome,phlegm dampness syndrome and blood stasis syndrome were 0.030-0.111,0.100-0.182,0.037-0.095,0.022-0.141 and 0.054-0.185,respectively.The percentage weight method shows that the weight ranges of wind cold syndrome,cold yin Syndrome,phlegm heat syndrome,phlegm dampness syndrome and blood stasis syndrome were 0.072-0.102,0.146-0.182,0.057-0.077,0.075-0.111 and 0.115-0.185,respectively.According to the three methods,the weights of wind cold syndrome,cold yin Syndrome,phlegm heat syndrome,phlegm dampness syndrome and blood stasis syndrome were 0.050-0.121,0.117-0.174,0.040-0.117,0.056-0.130 and 0.092-0.188,respectively.Conclusion This study determined the weight of each item of AECOPD-STES,providing a basis for the calculation of syndrome score.

Objective To construct a nursing registry platform for percutaneous coronary intervention(PCI)to provide data support for subsequent real-world research on PCI nursing.Methods From April to December 2023,we established a variable list and data dictionary based on literature review and expert discussion,and constructed a web-based PCI nursing registry platform based on registry-related standards.Results A total of 191 variables were screened in this study,and a corresponding data dictionary was developed for each variable according to the variable name,variable code,variable definition,variable type,variable value range,data source and data collection node.Three levels of account privileges has been set up in the platform,which can realize different data management privileges,and the data can be saved only after filling in and reviewing at each level.The platform is also equipped with automatic data checking function,which reduces data filling errors and improves data quality.Conclusion The constructed PCI nursing registration platform has strong scientific and professional characteristics,and can provide data support for subsequent research,and the content and functions of the platform can be further optimized in the future.

Objective To provide basis for the formation of acute exacerbation of chronic obstructive pulmonary disease(AECOPD-STES),the item weight of the syndrome therapeutic evaluation scale for AECOPD-STES was determined.Methods Based on the clinical survey data of 387 AECOPD patients,the random forest method was adopted,and the Spyder integrated development environment.Anaconda navigator software was used to call the"random forest Classifier"in the sklearn package to establish the initial random forest model and calculate the item weights.Factor analysis was used to extract common factors with cumulative variance contribution>80%,and the item weight was calculated according to the cumulative variance contribution and component score coefficient of common factors.The percentage weight method was used to calculate the item weight based on the importance score of each item by 29 experts.Finally,40%,30%and 30%of the above three methods were given respectively to determine the final weight of the items.Results The random forest method showed that the weights of wind cold syndrome,cold Yin syndrome,phlegm heat syndrome,phlegm dampness syndrome and blood stasis syndrome were 0.014-0.170,0.076-0.194,0.017-0.183,0.010-0.183 and 0.069-0.298,respectively.Factor analysis showed that the weights of wind cold syndrome,cold yin Syndrome,phlegm heat syndrome,phlegm dampness syndrome and blood stasis syndrome were 0.030-0.111,0.100-0.182,0.037-0.095,0.022-0.141 and 0.054-0.185,respectively.The percentage weight method shows that the weight ranges of wind cold syndrome,cold yin Syndrome,phlegm heat syndrome,phlegm dampness syndrome and blood stasis syndrome were 0.072-0.102,0.146-0.182,0.057-0.077,0.075-0.111 and 0.115-0.185,respectively.According to the three methods,the weights of wind cold syndrome,cold yin Syndrome,phlegm heat syndrome,phlegm dampness syndrome and blood stasis syndrome were 0.050-0.121,0.117-0.174,0.040-0.117,0.056-0.130 and 0.092-0.188,respectively.Conclusion This study determined the weight of each item of AECOPD-STES,providing a basis for the calculation of syndrome score.

OBJECTIVE To explore the mechanism of Yishen Qingli Huoxue Formula(YQHF)improving renal fibrosis by inhib-iting HIF1-α using data mining,molecular docking,and in vivo and in vitro experiments.METHODS The expression changes of HIF1-α in renal biopsy tissues of patients with chronic kidney disease(CKD)in the GEO database were analyzed.Molecular docking was used to clarify the interaction mode between YQHF effective monomers and HIF1-α.Thirty SD rats were randomized to sham,model,low-dose YQHF,high-dose YQHF,and losartan potassium groups(n=6 per group).Unilateral ureteral obstruction(UUO)was used to induce renal fibrosis.Serum creatinine(Scr)and blood urea nitrogen(BUN)were measured,and kidney sections were stained with HE and Masson to assess pathology and fibrosis.Renal HIF1-α protein expression was quantified by Western blot.A renal fibro-sis cell model was established by inducing NRK-52E cells with TGF-β1,and the cells were divided into control,model,YQHF,HIF1-α inhibitor,HIF1-α inhibitor+YQHF,HIF1-α agonist,and HIF1-α agonist+YQHF groups.Western blot analysis was used to detect the protein expression levels of HIF1-α,COL-1,and α-SMA,and to observe the mechanism of YQHF-containing serum in protecting renal tubular epithelial cells.RESULTS Data mining showed HIF1-α expression in the CKD group was significantly higher than in the control group(P<0.01).Molecular docking indicated YQHF core components had good binding affinity to HIF1-α.In vivo,com-pared with the sham group,HE staining revealed tubular atrophy and inflammatory-cell infiltration,and Masson staining showed in-creased collagen deposition in UUO model rats(P<0.01).Serum creatinine and blood urea nitrogen were also elevated in the model group(P<0.05),together with up-regulated renal expression of COL-1,α-SMA and HIF-1α(P<0.01).After intervention with either high-dose or low-dose YQHF or losartan potassium,these pathological changes were attenuated:collagen deposition decreased(P<0.01),creatinine and BUN fell to varying degrees(P<0.05),and renal COL-1,α-SMA and HIF-1α levels were down-regulated(P<0.01);immunohistochemistry confirmed reduced HIF-1α in UUO kidneys(P<0.01).In NRK-52E cells,TGF-β1 stimulation mark-edly increased COL-1,α-SMA and HIF-1α protein levels(P<0.01).Both YQHF and chloramphenicol alone down-regulated these proteins(P<0.05,P<0.01),and their combination produced stronger inhibition of HIF-1α than YQHF alone(P<0.05).Conversely,the HIF-1α agonist fenbendazole-d3 reversed YQHF's anti-fibrotic effect,re-elevating COL-1,α-SMA and HIF-1α(P<0.01),with no significant difference versus agonist alone.CONCLUSION YQHF may inhibit extracellular matrix deposition and delay renal fi-brosis progression by suppressing HIF1-α accumulation,providing new theoretical evidence for traditional Chinese medicine in treat-ing renal fibrosis.

As an increasing number of emerging anti-tumor drugs are approved and marketed,the imperative for clinical safety monitoring and risk information management has grown significantly.Drug-induced neuropathy associated with these drugs exhibit characteristics such as insidious onset,rapid progression,and challenging treatment,ultimately leading to treatment failures.Therefore,a comprehensive understanding of the risk of neuropathy induced by emerging anti-tumor drugs,coupled with risk surveillance and early warning,as well as management and reporting,can significantly reduce the incidence and severity of drug-related diseases.This paper provides a review of the neuropathy caused by emerging anti-tumor drugs,introduces the pharmacovigilance system and risk information management measures in clinical usage,aiming to provide a reference for guiding the rational clinical use and minimizing the incidence of drug-induced diseases.

Objective To assess the predictive value of computed tomography pulmonary angiography(CTPA)cardiovascular parame-ters for chronic thromboembolic pulmonary hypertension(CTEPH)under the 2022 European Society of Cardiology/European Respiratory Society(ESC/ERS)guidelines,and to compare with the 2021 Chinese guidelines.Methods A total of 201 suspected CTEPH patients were retrospectively selected.All patients underwent right heart catheterization(RHC)and CTPA evaluation.According to the Euro-pean guidelines,they were divided into three groups:mean pulmonary artery pressure(mPAP)≤20 mmHg control group(63 cases)(1 mmHg=0.133 kPa),mPAP＞20 mmHg CTEPH group(138 cases),and mPAP≥25 mmHg CTEPH group(123 cases).Inter-group comparison of CTPA cardiovascular parameters was performed,and receiver operating characteristic(ROC)curve analysis was performed for each parameter.Results Under the 2022 European guidelines,the diagnostic efficacy of the diameter of the main pulmonary artery trunk(MPAd)was the highest[area under the curne(AUC)was 0.933].The binary logistic regression analysis revealed that the MP Ad,right ventricular free wall thickness(RVWT),and interventricular septal angle(IVSA)were inde-pendent risk factors for the diagnosis of CTEPH(P＜0.05).Under both the Chinese and European guidelines,the MPAd,the transverse diameter and area of the right atrium,the transverse diameter and area of the bi-ventricle,the RVWT,and the IVSA showed significant statistical differences in CTEPH and control groups(P＜0.05).Conclusion Under both the Chinese and European guidelines,the MP Ad measured by CTPA has the highest diagnostic efficacy for CTEPH,while the IVSA has the strongest correlation with clinical prognostic indicators.The right atrium structure also has evaluation value.