Objective To investigate the post-discharge exercise behavior and factors influencing moderate to vigorous intensity physical activity (MVPA) in patients undergoing lung surgery. Methods A total of 2874 patients from the large prospective, observational perioperative lung symptom study cohort (CN-PRO-Lung 3) in the Department of Thoracic Surgery at Sichuan Cancer Hospital between April 7, 2021, and January 31, 2024, were selected as the survey subjects. A survey was conducted using the Investigation of Exercise Behavior after Lung Surgery questionnaire and the International Physical Activity Questionnaire-Short Form (IPAQ-SF) among patients who underwent lung surgery. Binary logistic regression was used to analyze the factors influencing patients’ engagement in MVPA. Results A total of 702 patients were surveyed, including 252 males and 450 females, with an average age of (52.4±10.2) years. Patients with lung cancer accounted for 85.9%. Only 36.0% of the patients had regular exercise habits, while 42.3% did not engage in any physical activity. The three main barriers for postoperative exercise were physical discomfort (pain, coughing, shortness of breath, etc, 54.7%), lack of professional guidance (41.7%), and concerns about the surgical wound (28.9%). The proportions of patients engaging in vigorous, moderate, and low-intensity physical activity were 5.7%, 28.2%, and 66.1%, respectively. Multivariate analysis showed that patients with a personal annual income ≥50000 yuan (OR=1.52, 95%CI 1.01-2.29, P=0.044), high school education or above (OR=1.92, 95%CI 1.33-2.76, P<0.001), and lobectomy (OR=1.44, 95%CI 1.02-2.03, P=0.037) engaged in more MVPA. Conclusion Patients undergoing lung surgery have inadequate physical activity after discharge, particularly lacking in MVPA. Patients with higher income, higher educational levels, and lobectomy are more frequently engaged in MVPA. Measures such as symptom control, providing exercise guidance, and enhancing education on wound care may potentially improve the inadequate physical activity in lung surgery patients after discharge.

With the accelerating trend of population aging, the number of elderly patients with lung cancer continues to rise, and the disease burden is becoming increasingly heavy. The clinical management of these patients faces severe challenges due to their decreased physiological reserve, complex comorbidities, and significant individual heterogeneity. Consequently, under traditional diagnosis and treatment models, doctors often struggle to identify the individualized risks of elderly patients in a timely and comprehensive manner, which can easily lead to decision biases such as undertreatment or overtreatment. In view of this, this study advocates for the establishment of an umbrella decision-making model specifically tailored for elderly lung cancer patients. Grounded in a multidisciplinary team (MDT) platform, this model deeply integrates oncological indicators with the comprehensive geriatric assessment (CGA) system. By holistically considering multidimensional variables including tumor burden, organ function, frailty index, cognitive status, and social support, the model establishes an operational mechanism characterized by "single entry, precise stratification, and targeted selection". Accordingly, patients can be scientifically triaged into distinct intervention tiers, such as active surveillance, minimally invasive surgery, drug therapy, radiotherapy, and best supportive care, thereby achieving real-time alignment between treatment intensity and patient fitness. This article elaborates on the construction logic and key operational procedures of this novel decision-making framework, aiming to guide clinical practice beyond the limitations of a tumor-centric perspective toward a holistic, dynamic, whole-course management strategy. This transition seeks to ensure optimal quality of life and clinical net benefit for elderly patients alongside survival prolongation.

AIM To investigate the effects of Xuesaitong Capsules(Panax notoginseng saponins)on ischemia/reperfusion injury in a mouse model of skin frostbite.METHODS The mice were randomly divided into the control group,the model group,the dexamethasone group(1 mg/kg),and the low-dose,medium-dose,and high-dose Xuesaitong Capsules groups(0.036,0.072,and 0.144 g/kg),with eight mice in each group.A frostbite model was established using a dry ice-cooled ceramic(ferrite)magnet.On the 2nd day after modeling,each group started its corresponding dosing by gavage for 14 consecutive days.The wound healing,histopathological changes,and serum levels of high-sensitivity C-reactive protein(hs-CRP),thromboxane B2(TXB2),6-keto-prostaglandin F1α(6-K-PGF1α),nitric oxide(NO)and endothelin(ET)were assessed using ELISA.The superoxide dismutase(SOD)activity and malondialdehyde(MDA)levels in skin tissues were measured biochemically.The protein expressions of tumor necrosis factor(TNF)-α,interleukin(IL)-1β,IL-6,Toll-like receptor(TLR)4 and phosphorylated nuclear factor-KB p65(p-NF-κB p65)in skin tissues were determined by Western blot.Additionally,LncRNA H19 mRNA expression in skin tissues was evaluated using RT-qPCR.RESULTS After the final administration,compared with the control group,the model group exhibited partial scab detachment,wound healing,and larger wound areas;hyperkeratosis with incomplete keratinization,detachment of the dermis and subcutaneous tissue,partial loss of appendages,subcutaneous edema,and dilated,congested,and hemorrhagic stromal vessels with extensive lymphocyte infiltration revealed by the histopathological examination;elevated serum levels of hs-CRP,TXB2,and ET(P＜0.05,P＜0.01);decreased 6-K-PGF1α and NO levels(P＜0.05,P＜0.01);reduced SOD activity in skin tissues(P＜0.01);increased MDA levels(P＜0.01);and upregulated protein expressions of TNF-α,IL-1β,IL-6,TLR4 and p-NF-κB p65,as well as LncRNA H19 mRNA expression(P＜0.05,P＜0.01).Compared with the model group,the group intervened with high-dose Xuesaitong Capsules displayed reduced wound areas(P＜0.01);decreased serum levels of hs-CRP,TXB2 and ET(P＜0.05,P＜0.01);increased 6-K-PGF1α and NO levels(P＜0.05,P＜0.01);enhanced SOD activity(P＜0.05,P＜0.01);reduced MDA level in skin tissues(P＜0.05,P＜0.01);and down-regulated TNF-α,IL-1β,IL-6,TLR4 and p-NF-κB p65 protein expressions and suppressed LncRNA H19 mRNA expression in skin tissues as well(P＜0.05,P＜0.01).CONCLUSION Xuesaitong Capsules alleviate ischemia/reperfusion injury in frostbite-injured mice by exerting anti-inflammatory and anti oxidative stress effects and restoring vascular endothelial function mediated by the downregulation of LncRNA H19 expression and inhibition of the TLR4/NF-κB signaling pathway.

Objective To investigate the factors affecting cerebral vasospasm in elderly patients af-ter interventional embolization of intracranial aneurysms,and to develop a nomogram prediction model.Methods A total of 307 elderly patients with intracranial aneurysms who underwent inter-ventional embolization in our hospital from May 2021 to May 2023 were recruited,and according to the occurrence of postoperative cerebral vasospasm or not,they were divided into a cerebral vasospasm group(n=63)and a non-cerebral vasospasm group(n=244).The general clinical data were compared between two groups.Univariate and multivariate logistic regression analyses were used to identify the risk factors for postoperative cerebral vasospasm in elderly patients with in-tracranial aneurysms,and then a nomogram prediction model was constructed.Results There were significant differences between the two groups in terms of age,Hunt-Hess grade,Fisher grade,and time window for surgical treatment(P＜0.01).The cerebral vasospasm group had sig-nificantly higher WBC count and IL-1β and Caspase-3 levels than the non-cerebral vasospasm group(P＜0.01).Univariate logistics regression analysis showed that seven indicators,that is,aged≥65 years,Hunt-Hess grade Ⅲ-Ⅵ,Fisher grade Ⅲ-Ⅵ,later surgical start time and in-creased WBC count and IL-1β and Caspase-3 levels were risk factors for postoperative cerebral vasospasm(P＜0.05).Multivariate logistics regression analysis indicated that above seven indica-tors were still independent risk factors for postoperative cerebral vasospasm(OR=11.372,95％CI:4.032-32.073,P=0.000;OR=12.415,95％CI:4.979-30.959,P=0.000;OR=9.568,95％CI:3.945-23.206,P=0.000;OR=2.898,95％CI:1.217-6.901,P=0.016;OR=1.762,95％CI:1.125-2.761,P=0.013;OR=1.153,95％CI:1.035-1.283,P=0.009).ROC curve analysis re-vealed that the AUC value of the nomogram model in predicting postoperative cerebral vasospasm was 0.934,with a sensitivity of 85.40％and a specificity of 90.50％.Conclusion Aged≥65 years,Hunt-Hess grade Ⅲ-Ⅵ,Fisher grade Ⅲ-Ⅵ,later surgical start time and increased WBC count and IL-1β and Caspase-3 levels have adverse effects on postoperative cerebral vasospasm in in eld-erly patients after interventional embolization of intracranial aneurysms.The nomogram model based on these factors shows certain efficacy in evaluating the occurrence of cerebral vasospasm.

Objective To explore the mechanism of Huoxin pill(HXP)in the prevention and treatment of heart failure(HF)based on transcriptomics and network pharmacology.Methods The mice were randomly divided into the normal control group,model control group,positive control group treated with sacubitril/valsartan(60 mg·kg-1),low-dose group treated with HXP(31.2 mg·kg-1),and high-dose group treated with HXP(62.4 mg·kg-1).The model control group and each drug treat-ment group were subcutaneously injected with an equal volume of ISO(5 mg·kg-1)for modeling,while the normal control group was given an equal volume of sterile saline.Six hours later,each drug administration group was gavaged with the corresponding drug for intervention,and the normal control and model control groups were gavaged with an equal volume of sterile water.The modeling and drug administration were continued for 21 days.The cardiac function parameters of the mice were measured using color Doppler ultrasound imaging;ELISA was used to detect the levels of mouse serum cAMP,NT-proBNP,and BNP;HE staining and Masson's trichrome staining were used to evaluate the pathological morphology of cardiac tissue,and the CVF was calculated.Network pharmacology combined with transcriptomics was used to predict potential targets and signaling pathways of HXP in the prevention and treatment of HF,and molecular biology methods were used for validation.Results Compared with the normal control group,the model control group showed an increase in LVESd and LVEDd(P＜0.01),and a decrease in LVEF and LVFS(P＜0.01);BNP,NT-proBNP,and cAMP levels were increased(P＜0.01);myocardial collagen fibers increased and CVF in-creased(P＜0.01).Compared with the model control group,the HXP low-dose group,HXP high-dose group,and positive control groups showed a decrease in LVESd and LVEDd(P＜0.01),and an increase in LVEF and LVFS(P＜0.01);serum levels of BNP,NT-proBNP,and cAMP decreased(P＜0.05);the degree of myocardial fibrosis decreased and CVF decreased(P＜0.01).Network pharmacology combined with transcriptomics predicted 10 key targets for HXP in the prevention and treatment of HF:CACNA1H,SCN10A,FGF12,PVALB,ACAN,LGALS3,SERPINE1,MMP3,GSTM1,VDR.Western blot results showed that the protein activation levels of PKA and CREB in myocardial tissue were increased in the model control group compared with the nor-mal control group(P＜0.01).Compared with the model control group,HXP low-dose group、HXP high-dose group,and positive control groups showed a decrease in the protein activation levels of PKA and CREB in myocardial tissue(P＜0.05).Conclusion HXP has an improvement effect on ISO-induced HF in mice,which may involve numerous targets and the cAMP/PKA signaling pathway.

Objective To identify potential biomarkers for proliferative diabetic retinopathy(PDR)using proteomics and transcriptomics data.Methods In this study,the proteomics dataset(PXD046630)and two transcriptomics datasets(GSE60436 and GSE102485)were derived from the aqueous humor samples and fibrovascular membranes of PDR patients,respectively.Differentially expressed genes(DEGs)were identified via R software,specifically the limma and edgeR pack-ages.The shared DEGs between PXD046630 and GSE60436 were analyzed via protein-protein interaction(PPI),Gene On-tology(GO)enrichment,and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analyses.The key DEGs were validated in GSE102485 via receiver operating characteristic(ROC)curve analysis.A quantitative polymerase chain reaction(qPCR)assay was used to confirm the mRNA of these candidate biomarkers in human retinal microvascular endothelial cells(HRMECs)cultured in high glucose and low oxygen conditions.Results A total of 59 shared DEGs and 26 hub genes were identified from the PXD046630 and GSE60436 datasets.KEGG analysis revealed that six pathways,inclu-ding extracellular matrix-receptor interaction,proteoglycans in cancer,and complement and coagulation cascades,were enriched in 12 key DEGs.Fibronectin 1(FN1),tissue inhibitor of metalloproteinase 3(TIMP3),complement factor H(CFH),decorin(DCN),and lipoprotein receptor-related protein-2(LRP2)were identified as potential biomarkers on the basis of their AUC values being greater than 0.900(CI≥95％).The mRNA expression levels of FN1,CFH,and LRP2 were significantly increased in HRMECs cultured in high glucose and low oxygen conditions.Conclusion FN1,CFH,and LRP2 are potential biomarkers for PDR,and further studies are needed to explore their roles and therapeutic potential in PDR.

Objective:To analyze the willingness and related factors of pregnant women in Shanghai City to receive influenza vaccines during pregnancy.Methods:An online questionnaire survey was conducted among pregnant women who registered in maternal and child health hospitals in 16 districts of Shanghai. The basic information, health status during pregnancy, attitude towards influenza vaccination, and knowledge of influenza and influenza vaccine were collected, and χ2 test and multivariate logistic regression analysis were used to analyze the willingness and related factors of pregnant women to receive influenza vaccines during pregnancy. Results:A total of 3 219 valid questionnaires were received, with 10.90% of pregnant women willing to receive influenza vaccination during pregnancy, 57.50% unwilling to receive vaccination and 31.59% holding an uncertain attitude. Among the pregnant women who were willing to receive the vaccine, 82.91% would take the initiative to know the relevant information about the influenza vaccine, and 87.18% understood the transmission routes of the flu. 32.09% believed that pregnant women could receive the influenza vaccination at any stage of pregnancy. Among those who were unwilling and held an uncertain attitude, the proportions of the above three questions were 47.06%, 83.95% and 17.80%, respectively. Among pregnant women who were unwilling to receive vaccination and held an uncertain attitude, the main reason for their vaccine hesitation was the concern about the safety of the vaccine for pregnant women and fetuses during pregnancy. Multivariate logistic regression analysis showed that pregnant women with higher education ( OR=3.278, 95% CI: 1.678-6.406, P=0.001), second trimester ( OR=1.542, 95% CI: 1.159-2.054, P=0.003), third pregnancy ( OR=2.318, 95% CI: 1.008-5.331, P=0.048), and previous influenza vaccination ( OR=1.552, 95% CI: 1.119-2.152, P=0.008) had a higher willingness to receive influenza vaccines during pregnancy. Conclusion:Pregnant women in Shanghai have a relatively low willingness to receive influenza vaccines during pregnancy, mainly due to concerns about vaccine safety.

Objective:To evaluate the efficacy of defocus incorporated multiple segments (DIMS) on spherical equivalent (SE) and axial length (AL) in myopic children.Methods:Clinical studies on the progress of DIMS lens intervention in myopia reported in CNKI, Wanfang Data, VIP, China Biomedical Literature Database, PubMed, Embase, Cochrane Library, and Web of Science from the establishment of the database to June 2023 were searched.The experimental group and control group used DIMS lens and single vision lens (SVL) for intervention, respectively.Two researchers independently conducted the literature search, screening and data extraction based on the inclusion and exclusion criteria.Literature quality and risk of bias were evaluated in accordance with the requirements of the Cochrane Manual.Meta-analysis was performed using Revman 5.4 software.Results:A total of 7 clinical studies using DIMS lenses to intervene in the development of myopia were included .Seven studies provided complete SE data for analysis, with sample sizes of 1 164 eyes and 1 140 eyes for the DIMS group and SVL group, respectively.Five studies provided complete AL data for analysis, with sample sizes of 339 eyes and 315 eyes for the DIMS group and SVL group, respectively.There were statistically significant differences in SE and AL between DIMS group and SVL group (SE: WMD=0.40, 95% CI: 0.32-0.47, P<0.001; AL: WMD=-0.14, 95% CI: -0.17--0.11, P<0.001).DIMS lens could effectively delay SE progression and AL growth in myopic patients. Conclusions:DIMS lenses could delay the increase of SE and AL to a certain extent.

Objective To explore the risk factors of the stone-free rate after flexible ureteroscopy for lower pole calculi,develop a predictive model based on these identified factors,with subsequent validation and evalua-tion of the established model.Methods A retrospective analysis was conducted on 154 patients with lower pole renal calculi who underwent flexible ureteroscopy(FURS)at Guangdong Provincial Hospital of Traditional Chinese Medicine from 2020 to 2024.Based on postoperative stone clearance status,patients were categorized into a stone-free group and a residual stone group.Univariate analysis was performed to screen potential risk factors,while Pear-son correlation coefficients and variance inflation factor(VIF)were employed to assess multicollinearity,retaining the indicator with the highest area under the curve(AUC).Independent predictors were identified through multi-variate logistic regression analysis,and a nomogram model was constructed.Internal validation was conducd using the bootstrap resampling method.The predictive performance and clinical utility of the model were evaluated using receiver operating characteristic(ROC)curves and decision curve analysis(DCA).Results Univariate analysis demonstrated that largest stone diameter(LSD),cumulative stone diameter(CSD),stone volume(SV),stone surface area(SA),mean stone density(MSDE),and infundibular pelvic angle(IPA)were significantly associated with stone-free rate(SFR)following flexible ureteroscopy(FURS)for lower pole calculi(all P<0.05).After collinearity diagnostics,LSD(area under the curve[AUC]=0.724)was retained as the optimal stone burden parameter.Multivariate logistic regression analysis confirmed LSD,MSDE,and IPA as independent predictors of postoperative SFR.The nomogram model exhibited robust predictive performance with an AUC of 0.786(sensitivity:79.6%,specificity:71.0%).Internal validation via 1000 bootstrap resamples yielded an AUC of 0.792,and deci-sion curve analysis(DCA)confirmed clinical utility with net benefit across threshold probabilities of 4%—75%.Conclusions The nomogram model developed in this study,which incorporates both stone characteristics and renal anatomical parameters,demonstrates effective prediction of stone-free rate(SFR)following flexible ureteros-copy for lower pole calyceal stones.With stable predictive performance and high clinical applicability,this model provides a reliable tool for preoperative personalized decision-making in endourological management.

Objective To explore the mechanism of Huoxin pill(HXP)in the prevention and treatment of heart failure(HF)based on transcriptomics and network pharmacology.Methods The mice were randomly divided into the normal control group,model control group,positive control group treated with sacubitril/valsartan(60 mg·kg-1),low-dose group treated with HXP(31.2 mg·kg-1),and high-dose group treated with HXP(62.4 mg·kg-1).The model control group and each drug treat-ment group were subcutaneously injected with an equal volume of ISO(5 mg·kg-1)for modeling,while the normal control group was given an equal volume of sterile saline.Six hours later,each drug administration group was gavaged with the corresponding drug for intervention,and the normal control and model control groups were gavaged with an equal volume of sterile water.The modeling and drug administration were continued for 21 days.The cardiac function parameters of the mice were measured using color Doppler ultrasound imaging;ELISA was used to detect the levels of mouse serum cAMP,NT-proBNP,and BNP;HE staining and Masson's trichrome staining were used to evaluate the pathological morphology of cardiac tissue,and the CVF was calculated.Network pharmacology combined with transcriptomics was used to predict potential targets and signaling pathways of HXP in the prevention and treatment of HF,and molecular biology methods were used for validation.Results Compared with the normal control group,the model control group showed an increase in LVESd and LVEDd(P＜0.01),and a decrease in LVEF and LVFS(P＜0.01);BNP,NT-proBNP,and cAMP levels were increased(P＜0.01);myocardial collagen fibers increased and CVF in-creased(P＜0.01).Compared with the model control group,the HXP low-dose group,HXP high-dose group,and positive control groups showed a decrease in LVESd and LVEDd(P＜0.01),and an increase in LVEF and LVFS(P＜0.01);serum levels of BNP,NT-proBNP,and cAMP decreased(P＜0.05);the degree of myocardial fibrosis decreased and CVF decreased(P＜0.01).Network pharmacology combined with transcriptomics predicted 10 key targets for HXP in the prevention and treatment of HF:CACNA1H,SCN10A,FGF12,PVALB,ACAN,LGALS3,SERPINE1,MMP3,GSTM1,VDR.Western blot results showed that the protein activation levels of PKA and CREB in myocardial tissue were increased in the model control group compared with the nor-mal control group(P＜0.01).Compared with the model control group,HXP low-dose group、HXP high-dose group,and positive control groups showed a decrease in the protein activation levels of PKA and CREB in myocardial tissue(P＜0.05).Conclusion HXP has an improvement effect on ISO-induced HF in mice,which may involve numerous targets and the cAMP/PKA signaling pathway.