Objective To investigate the effect of tetrandrine tablets on inflammatory cytokines and acute phase response following the first-dose of zoledronic acid in postmenopausal osteoporosis patients. Methods 80 postmenopausal osteoporosis patients receiving the first-dose of zoledronic acid admitted in the Affliated Xuzhou Municipal Hospital of Xuzhou Medical University from June, 2022 to December, 2024 were selected as study objects, and the patients were randomly divided into control group （40 cases, prophylactic treatment with acetaminophen tablets） and study group （40 cases, prophylactic treatment with tetrandrine tablets and acetaminophen tablets）. The high-sensitivity C-reactive protein （hs-CRP）, interleukin-1β （IL-1β）, IL-6, tumor necrosis factor-α （TNF-α） and the occurrence of acute phase reactions （fever, muscle and joint pain, gastrointestinal discomfort） between two groups were compared. Results The levels of serum hs-CRP, IL-1β, IL-6, and TNF-α in both groups significantly increased on day 1 and day 3 after infusion of zoledronic acid （all P values <0.05）. The levels of serum hs-CRP, IL-6, and TNF-α in the control group were higher than those in the study group on day 1 and 3 after infusion of zoledronic acid, with statistical significance （all P values <0.05）. In terms of acute phase reactions, the incidence of fever, muscle and joint pain in the control group after infusion of zoledronic acid were higher than those in the study group, with statistical significance （P<0.05）. No statistically significant difference in the incidence of gastrointestinal discomfort between the two groups （P>0.05）. Conclusion Tetrandrine tablets could reduce the expression levels of hs-CRP, IL-1β, IL-6, and TNF-α following the first-dose of zoledronic acid in postmenopausal osteoporosis patients, reduce the incidence of acute phase reactions, and alleviate adverse reactions.

In recent years,significant breakthroughs have been achieved in the immunotherapy for Alzheimer's disease.In line with global advancements,two anti-amyloid-β monoclonal antibodies have been approved and successfully launched in China for clinical use.Lecanemab and Donanemab were officially used in June 2024 and April 2025 in China,respectively.In order to standardize the rational and safe application of anti-amyloid-β monoclonal antibodies for Alzheimer's disease in China,this article integrates recom-mendations from the clinical trials and real-world experience from the author's team and domestic peers to further update the recom-mendations for the clinical use of anti-amyloid-β monoclonal antibody based on the 2024 version.It includes indications for therapy,pre-treatment evaluation and preparation,administration protocols and safety measures during treatment,and post-treatment monitor-ing strategies.

Objective:To find out about the sentiment about the current physical training among Air Force pilots (cadets), propose methods for optimizing their programs of physical training, and to enhance the effectiveness of training in order to improve flight adaptability.Methods:A total of 1 135 pilots (cadets) were randomly selected as the subjects and divided into 3 groups according to types of aircraft and types of personnel: group A (pilots of fighters, bombers and advanced trainers), group B (pilots of fighter bombers, transporters, helicopters, special aircraft and junior trainers), and group C (flying cadets). A questionnaire survey was conducted to collect data on current physical training among pilots and flying cadets.Results:A total of 1 135 questionnaires were distributed, with 1 086 valid responses collected, yielding an effective response rate of 95.68%. Of the 1 086 participating pilots (cadets), 209 were in Group A, 499 in Group B, and 378 in Group C.There was statistically significant difference in the frequency and duration of weekly physical training between the 3 groups ( χ2=82.23, 61.56, both P<0.001). The proportion of participants engaging in >3 h weekly physical training sessions was significantly higher in group C (71.7%) than in group A (38.8%) and group B (44.9%). Significant differences were observed in weekly training durations between group C and group A (all P<0.05), as well as between group C and group B in the training durations of <3 h and 5-7 h (all P<0.05). The percentage of subjects who trained for 5-7 h per week was the highest in group C (41.5%). In groups A and B, pilots mostly trained for 3-<5 h per week (51.7% and 39.9%, respectively). The survey on the willingness to adjust training programs revealed statistically significant differences between the 3 groups in their willingness to engage in muscle strength training, coordination training, specific ability training, and adjustment of intensities of core training ( H=46.23, 16.12, 22.03, 60.68, all P<0.001). No significant difference was observed in their willingness to have aerobic training programs adjusted ( P>0.05). Group C was significantly different from groups A and B in their preference for adjustment in training programs related to muscle strength, coordination, specific abilities, and in core training programs (all P<0.01). Group C was mostly in favor of "increasing" muscle strength, coordination, and core training while opting for "no change" in aerobic training and specific ability training. Groups A and B preferred "no change". Regarding their willingness to have training intensities revised, statistically significant differences were observed between the 3 groups ( H=15.58, 19.08, 8.17, 58.01, P<0.001, <0.001, =0.017, <0.001), but no significant difference was found in their preference for adjustment of aerobic training intensities ( P>0.05). Group C showed much more preference for intensity adjustment related to muscle strength, coordination, specific abilities, and core training programs than groups A and B (all P<0.05 or 0.01). All the 3 groups predominantly favored "no change" in training intensities. Conclusions:Pilots of different aircraft types generally meet the requirements of the current physical training programs. However, the frequency of physical training for pilots (cadets) requires more rigorous supervision. Flying cadets can adaptively engage in targeted training programs. Pilots of fighters, fighter bombers and advanced trainers should care about the intensity of aerobic training while giving more weight to load resistance physical training. Pilots of other types of aircraft should devote more effort to core training programs.

Objective:To evaluate the efficacy and safety of high-frequency repetitive transcranial magnetic stimulation (hrTMS) in postherpetic neuralgia (PHN).Methods:A prospective randomized controlled trial was performed; 63 PHN patients treated in Department of Neurology and Department of Dermatology and Venereology of Anqing Municipal Hospital from June 2024 to March 2025 were enrolled; they were randomly assigned to 2 groups: an hrTMS group ( n=32) received hrTMS (frequency: 10 Hz; total pulses: 2,400; intensity: 90% of resting motor threshold) to the contralateral primary motor cortex (M1), and a sham stimulation group ( n=31) received sham stimulation using a sham figure-of-eight coil generating no actual magnetic field. Scores of short-form McGill pain questionnaires (pain rating index [PRI] total score, PRI sensory subscore, PRI affective subscore, visual analogue scale [VAS] score, present pain intensity [PPI] score) and N100 amplitude were collected before treatment and at 1, 2, 3, and 4 weeks after treatment. Adverse events during treatment were recorded. Results:At 2 weeks after treatment, significant difference was observed between the hrTMS group and sham stimulation group in PRI total score, VAS score, and N100 amplitude ( P<0.05). At 3 and 4 weeks after treatment, significant differences were found between the two groups in PRI total score, PRI sensory subscore, PRI affective subscore, VAS score, PPI score and N100 amplitude (3 weeks after treatment: 8.59±1.13 vs. 9.61±1.20, 5.34±0.79 vs. 5.90±0.94, 3.25±0.57 vs. 3.71±0.46, 5.78±0.66 vs. 6.42±0.92, 2.16±0.37 vs. 2.55±0.51, and [2.53±0.51] μV vs. [2.13±0.34] μV; 4 weeks after treatment: 7.53±0.92 vs. 9.68±1.35, 4.94±0.62 vs. 6.00±1.07, 2.59±0.56 vs. 3.68±0.60, 5.06±0.67 vs. 6.23±1.06, 1.97±0.17 vs. 2.52±0.51, and [2.81±0.40] μV vs. [2.16±0.52] μV, P<0.05). In the hrTMS group, PRI total score, PRI sensory subscore, PRI affective subscore, VAS score, PPI score and N100 amplitude were significantly different at 2, 3, and 4 weeks after treatment compared with those before treatment ( P<0.05). Incidence of adverse events (headache, dizziness or tinnitus) did not differ significantly between the two groups ( P>0.05). Conclusion:The hrTMS applied to the M1 region in PHN patients is effective by obviously reducing pain intensity and improving negative emotional states, with favorable safety profile.

AIM: To investigate the mechanism of Hexue Mingmu Tablets(HXMMT)in improving diabetic retinopathy(DR)based on transcriptomics.METHODS: Zebrafish DR models were established by 3-day glucose induction(130 mmol/L)starting at 3 days post-fertilization(dpf). Larvae were randomized into four groups: control group(CG; aquaculture water), model group(MG; 130 mmol/L glucose), low-dose HXMMT treatment group(L-HX; 130 mmol/L glucose +7.5 mg/L HXMMT), and high-dose HXMMT treatment group(H-HX; 130 mmol/L glucose +75 mg/L HXMMT), with a 3-day intervention period until 6 dpf. The area and length of eyes, and body length of zebrafish were observed by stereomicroscopy, retinal morphology was observed by hematoxylin-eosin staining(HE), and retinal vessel diameter was observed under fluorescence microscope. Differentially expressed genes(DEGs)were identified by RNA-sequencing(RNA-seq)technology to further elucidate the molecular mechanism of HXMMT in improving DR in zebrafish, and the sequencing accuracy was validated through quantitative real-time polymerase chain reaction(qRT-PCR).RESULTS: HE staining demonstrated that the intervention with HXMMT significantly improved the disordered cell arrangement, widened gaps, and thickened inner nuclear layer(INL)in ganglion cell layer GCL); retinal vascular diameter quantification revealed that the retinal vessel diameter of the MG significantly increased compared with the CG, and it was significantly changed after the intervention of HXMMT, with significant efficacy in the H-HX(P<0.05); transcriptomics profiling identified 1 470 reversed DEGs, predominantly enriched in the AMPK signaling pathway, FoxO signaling pathway, retinal developmental processes, and tight junction regulation. Technical validation confirmed strong correlation between qRT-PCR and RNA-seq data(R2=0.8571, P<0.05).CONCLUSION: HXMMT may improve retinal vascular microcirculation disorders in DR by regulating core targets including vsx1, pde6c, arr3a, plk1, fbp1b, foxo1a, pcna, and cdk1, as well as synergistically modulating processes such as retinal development in camera-type eyes, visual perception, microtubule cytoskeletal organization, tight junctions, and the AMPK signaling pathway, Foxo signaling pathway.

Objective To investigate the correlation between the expression level of absent in melanoma 2(AIM2)in serum and the severity of acute cerebral infarction(ACI),and to evaluate the value of AIM2 in predicting early neurological deterioration(END)after intravenous thrombolysis with alteplase in ACI patients.Methods A total of 150 ACI patients were enrolled in ACI group,and an-other 30 healthy individuals physical examination were selected as control group.ACI patients were further divided into mild,moderate and severe groups according to the National Institutes of Health Stroke Scale(NIHSS)score at admission,and they were also divided into END and non-END groups based on the occurrence of END after intravenous thrombolysis.Clinical materials of ACI patients were collected;the expression level of serum AIM2 was measured by enzyme-linked immunosorbent assay(ELISA);the Logistic regression analysis was performed to identify the factors influencing END after intravenous thrombolysis in ACI patients;the receiver operating characteristic(ROC)curve was plot-ted to analyze the clinical performance of serum AIM2 expression level in predicting END after intravenous thrombolysis in ACI patients.Results The serum AIM2 expression level in the ACI group and the control group was(58.29±5.97)and(36.81±3.03)ng/mL respectively,with a significant be-tween-group difference(t=43.23,P＜0.05).The serum AIM2 expression level gradually in-creased in the mild,moderate and severe groups,with significant differences between each pair of groups(P＜0.01).The serum AIM2 expression level in ACI patients was positively correlated with the NIHSS score(r=0.941,P＜0.01).The NIHSS score,time from admission to thrombolysis,low-density lipoprotein cholesterol(LDL-C),C-reactive protein,and AIM2 level in the END group were significantly higher or longer than those in the non-END group(P＜0.05).The results of mul-tivariate Logistic regression analysis showed that NIHSS score(OR=3.871,P＜0.001),time from admission to thrombolysis(OR=2.885,P=0.002),LDL-C(OR=3.118,P＜0.001)and AIM2(OR=3.761,P＜0.001)were influencing factors for END after intravenous thrombolysis in ACI patients.ROC curve showed that the area under the curve(AUC)for predicting END after in-travenous thrombolysis based on the serum AIM2 expression level at admission in ACI patients was 0.911;when the cut-off value of AIM2 was 66.56 ng/mL,the diagnostic sensitivity and specificity were 91.23％and 90.15％,respectively.Conclusion The expression level of serum AIM2 is sig-nificantly increased in ACI patients,and AIM2 expression level has certain advantages in predicting END after intravenous thrombolysis in ACI patients.

Objective: To investigate the nutritional status and influencing factors among Tibetan and Mongolian children and adolescents aged 7-18 years in high-altitude regions, so as to provide evidence for early prevention and control of malnutrition in this population. Methods: From May to June 2022, a cluster sampling method was employed to recruit 1 019 Tibetan and Mongolian children and adolescents aged 7-18 years from two primary and secondary schools in Golmud City. Physical examinations, dietary frequency questionnaires, and physical activity assessments were conducted. Nutritional status was classified as obesity, combined overweight/obesity, underweight, or central obesity according to national standards including Screening for Overweight and Obesity among School-age Children and Adolescents, Screening Standard for Malnutrition of School-age Children and Adolescents, Blue Book on Obesity Prevention and Control in China. Chi-square tests, t-test and Logistic regression analyses were performed to identify factors associated with different nutritional statuses. Results: The detection rates of obesity, combined overweight/obesity, underweight, and central obesity were 8.0%, 18.1%, 5.2%, and 19.7%, respectively. The height of children and adolescents across all age groups was generally lower than the national standard values. Tibetan participants exhibited significantly lower height-for-age Z-scores (HAZ)(9-10, 13-17 years, Z =2.01, 2.78, 4.16, 3.38, 4.12, 3.63, 3.00) and BMI-for-age Z-scores (BAZ) compared to Mongolian participants ( Z =-2.95, -2.47, -2.31, -2.89, -2.14, -2.17)( P < 0.05 ). Multivariate Logistic regression revealed that Mongolian children and adolescents had higher risks of obesity ( OR =2.20) and combined overweight/obesity ( OR = 2.18 ) ( P <0.05). Additionally, insufficient moderate-to-vigorous physical activity (MVPA) was associated with an increased risk of central obesity ( OR =1.48, P <0.05), compared with children and adolescents who meet the standard of MVPA. Conclusions The rates of overweight and obesity among Tibetan and Mongolian children and adolescents in Golmud City are higher, influenced by multiple factors. Nutrition interventions and physical activity strategies tailored to ethnic characteristics should be implemented, with emphasis on promoting MVPA to improve nutritional outcomes in this population.

Background and Aims:Microsatellite-stable(MSS)colorectal cancer(CRC)generally exhibits poor responsiveness to immune checkpoint inhibitors(ICIs),and effective immunotherapy strategies remain lacking.Anti-angiogenic agents such as bevacizumab(BEV)can improve the tumor immune microenvironment and act synergistically with ICIs.This multicenter real-world study compared the efficacy of different immunotherapy-based combination regimens in patients with MSS/MSI-L/pMMR advanced CRC,aiming to identify the optimal treatment strategy.Methods:A total of 100 patients with MSS/MSI-L/pMMR advanced CRC who received systemic treatment between November 2019 and February 2025 at four tertiary hospitals in Hunan,China,were retrospectively enrolled.Patients were classified into six treatment groups:chemotherapy alone,chemotherapy+targeted therapy,immunotherapy alone,immunotherapy+chemotherapy,immunotherapy+targeted therapy,and immunotherapy+chemotherapy+targeted therapy.The primary endpoints were overall survival(OS)and progression-free survival(PFS),while secondary endpoints were objective response rate(ORR)and disease control rate(DCR).Additionally,among patients receiving immunotherapy,subgroup analysis was performed according to BEV administration.Results:Among all 100 patients,the immunotherapy+chemotherapy+targeted therapy group achieved the highest ORR(32.0%)and DCR(76.0%)and was the only regimen yielding a complete response(CR).Compared with chemotherapy or immunotherapy alone,the triplet regimen significantly improved OS(P<0.05);although PFS improvement did not reach statistical significance,a clear late-stage separation of survival curves was observed.In the immunotherapy subgroup,BEV-containing regimens achieved markedly better outcomes than non-BEV regimens,with DCR of 75.0%vs.48.8%,median OS of 18.9 vs.11.5 months,and median PFS of 13.8 vs.7.2 months(all P<0.001).Cox regression analysis showed that compared with chemotherapy alone,the triplet regimen significantly reduced the risk of death(HR=0.11)and disease progression(HR=0.25)(both P=0.002).Vascular invasion was identified as an adverse prognostic factor for PFS(HR=3.0,P=0.007).Conclusion:This multicenter real-world study demonstrated that combining immunotherapy with chemotherapy and targeted therapy significantly improves DCR and survival outcomes in patients with MSS/MSI-L/pMMR advanced CRC,with BEV-containing triplet regimens providing the most pronounced benefit.BEV may enhance immune responsiveness by modulating the tumor microenvironment and promoting effector T-cell infiltration,offering a promising therapeutic direction for"immune-cold"CRC.Prospective randomized studies are warranted to further validate its clinical value and define appropriate patient populations.

Objective:To investigate the effect of asparagine synthetase (ASNS) knockdown on the senescence of retinal pigment epithelial (RPE) cells and its potential molecular mechanism.Methods:Human ARPE-19 RPE cells were divided into four groups: control group, short hairpin RNA targeting ASNS (shASNS) group, control+ (Janus kinase) JAK inhibitor group, and shASNS+ JAK inhibitor group, which were treated with short hairpin RNA control+ dimethyl sulfoxide (DMSO), shASNS+ DMSO, control+ JAK inhibitor and shASNS+ JAK inhibitor for 12 hours, respectively.An RPE cell senescence model was established by cell treatment with 500 μmol/L H 2O 2 for 24 hours.The mRNA and protein levels of ASNS and JAK were detected by real-time fluorescent quantitative PCR and Western blot, respectively.Reactive oxygen species (ROS) level within cells was measured using a kit.Cell cycle phase distribution and apoptosis rates were analyzed by flow cytometry.Cell viability from day 1 to day 5 of culturing was assessed via MTT assay.Senescent cell ratio was determined by β-galactosidase staining.Cellular damage was evaluated via immunofluorescence staining.Senescence-associated proteins (p16, pRb), and RPE markers (KRT18, CTNNB1, TJP1, BEST1) were quantified by Western blot. Results:Compared with the control group, mRNA and protein expression levels of ASNS and JAK were significantly reduced in the shASNS group, control+ JAK inhibitor group, and shASNS+ JAK inhibitor groups (all P<0.05).DCFH-DA staining revealed significantly lower ROS level in the shASNS group, control+ JAK inhibitor group, and shASNS+ JAK inhibitor group than in the control group (all P<0.05).Flow cytometry showed that there were more G2-phase cells and significantly reduced apoptosis rate in the shASNS group, control+ JAK inhibitor group, and shASNS+ JAK inhibitor group compared with the control group (all P<0.01).MTT assay indicated higher cell viability at all time points in the shASNS group, control+ JAK inhibitor group, and shASNS+ JAK inhibitor group compared with the control group, with statistically significant differences (all P<0.01).β-galactosidase-positive cell ratios in the shASNS, control+ JAK inhibitor, and shASNS+ JAK inhibitor groups were (42.36±1.28)%, (43.20±1.89)%, (25.97±1.13)%, respectively, which were significantly lower than (52.25±0.64)% in the control group (all P<0.001).p16 and pRb protein expression were decreased and γ-H2AX fluorescence intensity was attenuated in the shASNS group, control+ JAK inhibitor group, and shASNS+ JAK inhibitor group compared with the control group (all P<0.01).KRT18 and CTNNB1 expressions were upregulated, whereas TJP1 and BEST1 were downregulated in the shASNS group, control+ JAK inhibitor group, and shASNS+ JAK inhibitor group compared with the control group (all P<0.05).The shASNS+ JAK inhibitor group exhibited higher KRT18 and CTNNB1 expressions and lower TJP1 and BEST1 expressions than the shASNS and control+ JAK inhibitor groups (all P<0.05). Conclusions:ASNS knockdown can promote RPE cell proliferation, mitigate cellular damage, and delay senescence by suppressing the JAK pathway.