Objective: To analyze the correlation between serum homocysteine (Hcy) and both folic acid (FA) and sperm DNA fragmentation index (DFI), so as to provide the evidence for male fertility assessment. Methods: Males who visited and measured the serum Hcy in the Reproductive Medicine Center of Huzhou Maternal and Child Health Care Hospital from September 2022 to September 2023 were selected as the study subjects. Sperm quality parameters and sperm DFI were analyzed by collecting sperm. Hcy and FA were measured by collecting venous blood. Participants were stratified into a high Hcy group (Hcy≥15.0 μmol/L) and a normal group (Hcy<15.0 μmol/L). The correlations between serum Hcy and FA and sperm DFI were evaluated using linear regression models. Results: A total of 173 participants were enrolled, including 39 in the high Hcy group and 134 in the normal group. The sperm concentration in the high Hcy group was significantly lower than that in the normal group [(91.77±61.11)×106/mL vs. (144.21±106.82)×106/mL, P<0.05]. No statistically significant differences were observed in semen volume, sperm motility, curvilinear velocity, straight-line velocity, average path velocity, or sperm morphology normal rate (all P>0.05). The FA level in the high Hcy group was lower than that in the normal group [(4.44±1.79) nmol/L vs. (7.64±3.68) nmol/L, P<0.05]. The sperm DFI in the high Hcy group was higher than that in the normal group [(19.21±8.85)% vs. (13.07±6.43)%, P<0.05]. Serum Hcy level showed a negative correlation with FA level (r=-0.369, P<0.05) and a positive correlation with sperm DFI (r=0.351, P<0.05). Conclusion Serum Hcy level is associated with sperm concentration, FA and sperm DFI, suggesting that serum Hcy may affect sperm quality.

Tuberculosis (TB) remains a major global public health threat. The World Health Organization (WHO) 2020–2024 global TB reports provide a comprehensive overview of the TB situation from 2019 to 2023. In 2023, TB re-emerged as the world's leading infectious killer, with an estimated 10.8 million new cases. While the growth in the incidence rate slowed, the number of deaths decreased to 1.25 million. The COVID-19 pandemic significantly disrupted TB control efforts in 2020–2021. As control measures are gradually restored, a positive trend in TB control is emerging. However, significant regional disparities in incidence persist, with eight high-burden countries, including India and China, accounting for over two-thirds of the global total. In 2023, global treatment coverage for drug-resistant TB (DR-TB) was 44.00% with a treatment success rate of 68.00%; yet, with 400 000 new drug-resistant cases, the control situation remains severe. China has achieved remarkable progress in TB control: new cases fell to 741 000 in 2023 (an incidence of 52 per 100 000); mortality decreased significantly; its share of the global DR-TB burden dropped from 14.00% to 7.30%; and the TB/HIV co-infection rate declined from 1.68% in 2019 to 0.66% in 2023, outperforming the global average. Globally, control measures continue to be optimized: treatment coverage increased from 70.00% in 2019 to 75.00% in 2023, the number of people receiving preventive therapy grew to 4.7 million, and rapid diagnostic coverage reached 48.00%. In China, the number of patients treated recovered to 565 000 in 2023, and rapid diagnostic coverage rose to 74.00%. Although technological innovations have enhanced the efficiency of prevention, screening, diagnosis, treatment, and management, achieving the 2030 End TB Strategy goals will require strengthening TB management, building primary healthcare capacity, and targeting interventions for high-risk populations, while balancing resource allocation with technological innovation to address the challenges of a heterogeneous global epidemic.

To review the clinical characteristics, short-term outcomes, and risk factors of patients with infective endocarditis(IE) who underwent surgical treatment at a single center, and to summarize treatment experience.

BACKGROUND: The main cause of restenosis after percutaneous transluminal angioplasty (PTA) is the excessive proliferation and migration of vascular smooth muscle cells (VSMCs). Lin28a has been reported to play critical regulatory roles in this process. However, whether CCAAT/enhancer-binding proteins β (C/EBPβ) binds to the Lin28a promoter and drives the progression of restenosis has not been clarified. Therefore, in the present study, we aim to clarify the role of C/EBPβ-Lin28a axis in restenosis. METHODS: Restenosis and atherosclerosis rat models of type 2 diabetes ( n   =  20, for each group) were established by subjecting to PTA. Subsequently, the difference in DNA methylation status and expression of C/EBPβ between the two groups were assessed. EdU, Transwell, and rescue assays were performed to assess the effect of C/EBPβ on the proliferation and migration of VSMCs. DNA methylation status was further assessed using Methyltarget sequencing. The interaction between Lin28a and ten-eleven translocation 1 (TET1) was analysed using co-immunoprecipitation (Co-IP) assay. Student's t -test and one-way analysis of variance were used for statistical analysis. RESULTS: C/EBPβ expression was upregulated and accompanied by hypomethylation of its promoter in restenosis when compared with atherosclerosis. In vitroC/EBPβ overexpression facilitated the proliferation and migration of VSMCs and was associated with increased Lin28a expression. Conversely, C/EBPβ knockdown resulted in the opposite effects. Chromatin immunoprecipitation assays further demonstrated that C/EBPβ could directly bind to Lin28a promoter. Increased C/EBPβ expression and enhanced proliferation and migration of VSMCs were observed after decitabine treatment. Further, mechanical stretch promoted C/EBPβ and Lin28a expression accompanied by C/EBPβ hypomethylation. Additionally, Lin28a overexpression reduced C/EBPβ methylation via recruiting TET1 and enhanced C/EBPβ-mediated proliferation and migration of VSMCs. The opposite was noted in Lin28a knockdown cells. CONCLUSION Our findings suggest that the C/EBPβ-Lin28a axis is a driver of restenosis progression, and presents a promising therapeutic target for restenosis.
Animals ; Cell Proliferation/genetics* ; Cell Movement/genetics* ; Muscle, Smooth, Vascular/metabolism* ; Rats ; DNA Methylation/physiology* ; CCAAT-Enhancer-Binding Protein-beta/genetics* ; Male ; Myocytes, Smooth Muscle/cytology* ; Rats, Sprague-Dawley ; RNA-Binding Proteins/genetics* ; Cells, Cultured ; Coronary Restenosis/metabolism*

Objective:To investigate the effect of Lulongzaisheng decoction on ferroptosis in aplastic anemia (AA) model mice and its potential mechanism of action on AA.Methods:Using female BALB/c mice as controls (control group), a mouse model of AA was established by intraperitoneal injection of interferon-γ (IFN-γ) combined with oral gavage of busulfan. The AA group was treated with continuous oral gavage of Lulongzaisheng decoction for 10 days. The effects on the Jak2/Stat3/Acsl4 signaling pathway were assessed. Bone marrow biopsy and histopathological examination were performed to observe the degree of AA in each group of mice. Flow cytometry was used to detect the production of lipid reactive oxygen species (ROS) in the bone marrow cells. Immunohistochemical staining was performed to observe the expression of 4-HNE in the sternum. Western blot analysis was conducted to determine the protein expression levels of Jak2, p-Jak2, Stat3, p-Stat3, and Acsl4. ELISA was used to measure the levels of interleukin-6 (IL-6) in the peripheral blood plasma.Results:Compared with the control group, mice in the AA group exhibited a reduction in hematopoietic tissues within the bone marrow cavity and significant fatty infiltration. In contrast, mice in the AA+Lulongzaisheng decoction group showed partial recovery of the bone marrow and a decrease in fatty infiltration. The lipid ROS proportions in the control, AA, and AA+Lulongzaisheng decoction groups were (47.01±3.07) %, (53.81±1.99) %, and (49.50±3.98) %, respectively ( P<0.05), indicating that the AA + Lulongzaisheng decoction group had a slightly lower accumulation of lipid ROS than the AA group. The expression areas of 4-HNE in the bone marrow cavity for the control, AA, and AA+Lulongzaisheng decoction groups were (6.34±1.07) %, (35.26±3.68) %, and (16.97±1.30) %, respectively ( P<0.05), demonstrating a significant reduction in 4-HNE accumulation in the bone marrow in the AA + Lulongzaisheng decoction group compared with that in the AA group. Compared with the control group, the AA group exhibited upregulated expression of the ferroptosis-related protein Acsl4, along with increased expression of p-Stat3 and p-Jak2. In the AA+ Lulongzaisheng decoction group, the expression of Acsl4 was downregulated, whereas those of p-Stat3 and p-Jak2 were inhibited ( P<0.05). The levels of IL-6 in the peripheral blood plasma were (65.60±6.01), (166.50±3.32), and (119.37±4.29) pg/ml in the control, AA, and AA+Lulongzaisheng decoction groups, respectively ( P<0.05). Compared with the AA group, the AA + Lulongzaisheng decoction group exhibited a significant decrease in IL-6 levels. Conclusion:This study shows that Lulongzaisheng decoction has a significant therapeutic effect on AA model mice by regulating the Jak2/Stat3/Acsl4 pathway. The mechanism of action of this traditional Chinese medicine involves inhibiting the Jak2/Stat3 signaling pathway and regulating the expression of Acsl4, thereby improving hematopoietic function in AA model mice. These findings provide new drug targets and treatment strategies for the treatment of AA.

For middle-aged and elderly patients with conditions such as spinal fractures and degenerative spinal diseases, spinal internal fixation is a core surgical procedure for reconstructing spinal stability, heavily relying on the biomechanical stability provided by pedicle screw systems. Whereas, these patients are often complicated by osteoporosis that can significantly compromise the stability of the bone-pedicle screw interface, leading to a marked increase in pedicle screw loosening and surgical failure rates. The bone cement-augmented pedicle screw technique, which involves injecting bone cement into the vertebral body or screw trajectory to optimize the mechanical properties of the bone-pedicle screw composite, has been proven to significantly enhance fixation strength and effectively prevent screw-related failures, thereby reducing the incidence of internal fixation failure in high-risk populations undergoing spinal fusion. However, the widespread clinical application of this technique has faced challenges such as inaccurate clinical decision-making (indication and contraindication selection), non-standardized operative practices, and insufficient awareness of complication prevention, resulting in considerable variability in clinical outcomes and even severe complications. To address this, Prof. Luo Fei from First Affiliated Hospital of Army Medical University initiated the project and the Chinese Association Orthopaedic Surgeons organized relevant experts to develop the Evidence-based clinical practice guideline for bone cement-augmented pedicle screw technique ( version 2025), based on current evidence. The guidelines put forward 8 recommendations regarding the clinical value, scope of application, and operational standards of the technique, aiming to provide evidence-based medical support and technical standardization for clinical decision-making.

Objective:To investigate the effect of Lulongzaisheng decoction on ferroptosis in aplastic anemia (AA) model mice and its potential mechanism of action on AA.Methods:Using female BALB/c mice as controls (control group), a mouse model of AA was established by intraperitoneal injection of interferon-γ (IFN-γ) combined with oral gavage of busulfan. The AA group was treated with continuous oral gavage of Lulongzaisheng decoction for 10 days. The effects on the Jak2/Stat3/Acsl4 signaling pathway were assessed. Bone marrow biopsy and histopathological examination were performed to observe the degree of AA in each group of mice. Flow cytometry was used to detect the production of lipid reactive oxygen species (ROS) in the bone marrow cells. Immunohistochemical staining was performed to observe the expression of 4-HNE in the sternum. Western blot analysis was conducted to determine the protein expression levels of Jak2, p-Jak2, Stat3, p-Stat3, and Acsl4. ELISA was used to measure the levels of interleukin-6 (IL-6) in the peripheral blood plasma.Results:Compared with the control group, mice in the AA group exhibited a reduction in hematopoietic tissues within the bone marrow cavity and significant fatty infiltration. In contrast, mice in the AA+Lulongzaisheng decoction group showed partial recovery of the bone marrow and a decrease in fatty infiltration. The lipid ROS proportions in the control, AA, and AA+Lulongzaisheng decoction groups were (47.01±3.07) %, (53.81±1.99) %, and (49.50±3.98) %, respectively ( P<0.05), indicating that the AA + Lulongzaisheng decoction group had a slightly lower accumulation of lipid ROS than the AA group. The expression areas of 4-HNE in the bone marrow cavity for the control, AA, and AA+Lulongzaisheng decoction groups were (6.34±1.07) %, (35.26±3.68) %, and (16.97±1.30) %, respectively ( P<0.05), demonstrating a significant reduction in 4-HNE accumulation in the bone marrow in the AA + Lulongzaisheng decoction group compared with that in the AA group. Compared with the control group, the AA group exhibited upregulated expression of the ferroptosis-related protein Acsl4, along with increased expression of p-Stat3 and p-Jak2. In the AA+ Lulongzaisheng decoction group, the expression of Acsl4 was downregulated, whereas those of p-Stat3 and p-Jak2 were inhibited ( P<0.05). The levels of IL-6 in the peripheral blood plasma were (65.60±6.01), (166.50±3.32), and (119.37±4.29) pg/ml in the control, AA, and AA+Lulongzaisheng decoction groups, respectively ( P<0.05). Compared with the AA group, the AA + Lulongzaisheng decoction group exhibited a significant decrease in IL-6 levels. Conclusion:This study shows that Lulongzaisheng decoction has a significant therapeutic effect on AA model mice by regulating the Jak2/Stat3/Acsl4 pathway. The mechanism of action of this traditional Chinese medicine involves inhibiting the Jak2/Stat3 signaling pathway and regulating the expression of Acsl4, thereby improving hematopoietic function in AA model mice. These findings provide new drug targets and treatment strategies for the treatment of AA.

For middle-aged and elderly patients with conditions such as spinal fractures and degenerative spinal diseases, spinal internal fixation is a core surgical procedure for reconstructing spinal stability, heavily relying on the biomechanical stability provided by pedicle screw systems. Whereas, these patients are often complicated by osteoporosis that can significantly compromise the stability of the bone-pedicle screw interface, leading to a marked increase in pedicle screw loosening and surgical failure rates. The bone cement-augmented pedicle screw technique, which involves injecting bone cement into the vertebral body or screw trajectory to optimize the mechanical properties of the bone-pedicle screw composite, has been proven to significantly enhance fixation strength and effectively prevent screw-related failures, thereby reducing the incidence of internal fixation failure in high-risk populations undergoing spinal fusion. However, the widespread clinical application of this technique has faced challenges such as inaccurate clinical decision-making (indication and contraindication selection), non-standardized operative practices, and insufficient awareness of complication prevention, resulting in considerable variability in clinical outcomes and even severe complications. To address this, Prof. Luo Fei from First Affiliated Hospital of Army Medical University initiated the project and the Chinese Association Orthopaedic Surgeons organized relevant experts to develop the Evidence-based clinical practice guideline for bone cement-augmented pedicle screw technique ( version 2025), based on current evidence. The guidelines put forward 8 recommendations regarding the clinical value, scope of application, and operational standards of the technique, aiming to provide evidence-based medical support and technical standardization for clinical decision-making.

Objective To understand the needs dissatisfaction of patients with colorectal cancer(CRC)and their influencing factors,and to analyze the correlation between family environment and the needs dissatisfaction of patients.Methods From November 2022 to October 2023,a total of 206 patients with CRC were investigated by basic data questionnaire,needs dissatisfaction of cancer patients scale and family environment questionnaire in Jinhua Municipal Central Hospital.Univariate analysis and multivariate logistic regression were used to analyze the influencing factors of the needs dissatisfaction of CRC patients,and Pearson correlation was used to analyze the correlation between the needs dissatisfaction of CRC patients and the family environment.Results It were found that there were significant differences in the needs dissatisfaction of CRC patients with different age,education level,family income per capita,tube-carrying status and frequency of chemotherapy(P＜0.05).There was a positive correlation between conflict management and unmet needs(P＜0.05),intimacy,emotional expression,self-determination,knowledge,entertainment and organization were negatively correlated with needs dissatisfaction(P＜0.05).Education level,family income per capita,frequency of chemotherapy and family environment were the main influencing factors of the needs dissatisfaction of patients with CRC.Conclusion The needs dissatisfaction of patients with CRC are still relatively high and closely related to the family environment,suggesting individualized improvement measures around the family environment of patients with CRC,with a focus on the unmet needs of patients,help them adapt to society better.

Objective:To investigate the relationship between serum soluble CD155 (sCD155), soluble CD163 (sCD163) and chemotherapy efficacy and prognosis in patients with diffuse large B-cell lymphoma (DLBCL).Methods:A total of 126 patients with DLBCL admitted to Handan Central Hospital from May 2018 to May 2020 (DLBCL group) and 126 healthy subjects (control group) were prospectively selected to compare serum sCD155 and sCD163 levels. According to the chemotherapy effect of DLBCL patients, they were divided into effective group and ineffective group, and the serum sCD155 and sCD163 levels were compared before and after treatment. The effective rate of chemotherapy in patients with different serum sCD155 and sCD163 levels was compared. Kaplan-Meier method was used to analyze the relationship between serum sCD155 and sCD163 levels and 3-year overall survival (OS) and progression-free survival (PFS) of DLBCL patients. Cox proportional risk regression model was used to analyze the prognostic factors of DLBCL patients.Results:The serum levels of sCD155 and sCD163 in DLBCL group were higher than those in control group before treatment (all P<0.05). The effective rate of chemotherapy in 126 DLBCL patients in this group was 69.8%(88/126). Compared with the effective group, the serum levels of sCD155 and sCD163 were higher in the ineffective group before and after treatment (all P<0.05). Compared with before treatment, serum sCD155 and sCD163 levels in the effective group were decreased after treatment (all P<0.05). The effective rate of DLBCL patients in sCD155 and sCD163 high level groups was lower than that in sCD155 and sCD163 low level groups (all P<0.05). Kaplan-Meier analysis showed that the 3-year OS and PFS of DLBCL patients in the low level group of sCD155 and sCD163 were higher than those in the high level group (all P<0.05). The high level of sCD155 and sCD163 were independent risk factors for 3-year PFS and OS in DLBCL patients (all P<0.05). Conclusions:Abnormal levels of serum sCD155 and sCD163 in DLBCL patients may reduce the efficacy of chemotherapy and lead to poor prognosis.