Objective To systematically review the studies on predictive models for delayed graft function (DGF) after kidney transplantation. Methods Databases including China Biology Medicine Database, China National Knowledge Infrastructure, Wanfang Database, VIP Database, PubMed, Web of Science and CINAHL were searched to collect studies on predictive models for DGF after kidney transplantation published from the establishment of each database to June 29, 2025. Two researchers screened the literatures according to the inclusion and exclusion criteria, evaluated the quality of the literatures using the prediction model risk of bias assessment tool (PROBAST), and conducted a meta-analysis of the common predictors of the models using R software. Results A total of 12 literatures were included, involving 14 predictive models with sample sizes ranging from 103 to 24 653 cases. Donor serum creatinine level, cold ischemia time, donor age and donor body mass index were the top four common predictors. All the predictive models were at high risk of bias and low in applicability. The results of meta-analysis showed that abnormal donor body mass index, advanced donor age, prolonged cold ischemia time and elevated donor serum creatinine level were all associated with an increased risk of DGF after transplantation (all P<0.01), but there was high heterogeneity among the studies. Fixed-effect model and random-effect model were used to re-pool the effect sizes separately. The results indicated that the fixed-effect model and random-effect model had good consistency in terms of donor body mass index, donor age and cold ischemia time, while there was a significant difference in the effect sizes of the two models for donor serum creatinine level. Conclusions The predictive models for DGF risk after kidney transplantation have good predictive performance, but the overall risk of bias is high. In the future, large-sample, multicenter and high-quality prospective clinical studies should be carried out to optimize the predictive models, so as to improve their predictive ability and clinical application value.

AIM: To analyze the factors influencing total corneal surgically induced astigmatism(SIA)following implantable collamer lens(ICL)implantation.METHODS:This prospective study enrolled 162 patients(162 eyes)who underwent ICL implantation at our hospital between July 2023 and January 2024. Based on preoperative assessment of anticipated postoperative residual astigmatism, different incisions were selected. Superior incision was selected for patients with expected residual astigmatism with the rule in 75 eyes, and temporal incision was selected for patients with expected residual astigmatism againist the rule in 87 eyes. Parameters including total corneal refractive power, incision length, internal ostium-to-visual axis distance, central corneal thickness, preoperative total corneal astigmatism, and corneal diameter were measured using the Pentacam anterior segment analyzer before and at 3 mo after surgery. Postoperative total corneal SIA was calculated based on the changes in total corneal refractive power. Multiple linear regression analysis was performed to assess the influence of the above parameters on postoperative total corneal SIA.RESULTS:A total of 162 cases(162 eyes)that implanted with ICL were included in the analysis, and 8 cases were lost to follow-up, with a loss rate of 4.9%. Eventually 154 cases(154 eyes)completed the research. The superior incision group comprised 72 cases(72 eyes), including 17 males and 55 females, with a mean age of 25.96±6.17 years, while the temporal incision group comprised 82 cases(82 eyes), including 20 males and 62 females, with a mean age of 27.79±6.47 years. No significant difference in postoperative total corneal SIA was observed between the two groups [0.31(0.21, 0.49)D vs. 0.27(0.13, 0.485)D, P=0.159]. Multiple linear regression analysis revealed that internal ostium-to-visual axis distance and preoperative total corneal astigmatism significantly influenced postoperative total corneal SIA in the superior incision group(P=0.001). The regression equation was: postoperative total corneal SIA=0.71-0.381×internal ostium-to-visual axis distance+0.16×preoperative total corneal astigmatism. No significant influencing factors for postoperative total corneal SIA were identified in the temporal incision group.CONCLUSION: During ICL implantation, the magnitude of total corneal SIA is comparable between superior and temporal incisions. For patients receiving a superior incision, the internal ostium-to-visual axis distance and preoperative total corneal astigmatism value can be used to quantitatively predict postoperative total corneal SIA to a certain extent, thereby aiding in the optimization of postoperative visual quality.

OBJECTIVE To explore the mechanism of action of Qingre huatan huoxue decoction against atherosclerosis （AS）based on macrophage polarization. METHODS Using atorvastatin served as the positive control， the drug-containing serum of the Qingre huatan huoxue decoction was prepared to treat RAW264.7 macrophages. Macrophage viability， apoptosis rate， and the fluorescence intensities of CD86 and CD206 were measured， along with the levels of tumor necrosis factor-α （TNF-α） and interleukin-1β （IL-1β）. Apolipoprotei n E-deficient （ApoE －/－ ） mice （AS model mice） fed with a high-fat diet were randomly assigned to model group， atorvastatin group （2.6 mg/kg）， and low-， medium- and high-dose groups of Qingre huatan huoxue decoction （90， 180， 360 mg/kg）， respectively. C57BL/6J mice fed with a standard diet served as the normal control group， with 10 mice per group. The treatment group mice were administered the corresponding drugs intragastrically， once daily， for 8 consecutive weeks. Serum levels of TNF-α and IL-1β were measured in all groups. Lipid deposition in the aorta （assessed by the percentage of plaque in the entire aorta and aortic root） and morphological changes in the aortic root were observed. Expression levels of CD86 and CD206 in aortic tissue， as well as the protein expression levels of inducible nitric oxide synthase （iNOS）， arginase-1 （Arg-1）， AMP-activated protein kinase （AMPK）， phosphorylated AMPK （p-AMPK）， and peroxisome proliferator-activated receptor γ （PPAR-γ） in aortic tissues were all detected. RESULTS Cell experiment results showed that， at concentrations of 5-100 μg/mL， the drug-containing serum of the Qingre huatan huoxue decoction significantly increased RAW264.7 cell viability （ P ＜0.05）. The drug-containing serum of the Qingre huatan huoxue decoction at concentrations of 10， 50， and 100 μg/mL， along with atorvastatin， significantly reduced apoptosis rates， CD86 fluorescence intensity， and TNF-α and IL-1β levels in RAW264.7 cells， while markedly enhancing CD206 fluorescence intensity （ P ＜0.05）. Animal experiment results showed that， compared with the model group， all dosage groups of Qingre huatan huoxue decoction and the atorvastatin group showed significantly reduced/down-regulated levels of TNF-α and IL-1β in serum， along with decreased aortic total and root plaque percentages， CD86 expression， and iNOS protein expression. CD206 expression and Arg-1， p-AMPK/AMPK， PPAR-γ protein expression were significantly up-regulated （ P ＜0.05）. Pathological morphology of the aorta showed varying degrees of improvement. CONCLUSIONS The formula of Qingre huatan huoxue decoction exerts its anti-AS effects by regulating macrophage polarization， increasing the proportion of M2 macrophages， thereby effectively inhibiting AS plaque formation and reducing inflammatory responses.

Objective: To investigate the preventive and reparative mechanisms of platelet-rich plasma-biodegradable quick setting spray (PRP-BQSS) on solar dermatitis, thereby providing a safe and effective novel therapeutic approach for clinical application. Methods: PRP-BQSS was prepared. A ultraviolet B (UVB)-induced solar dermatitismodel was established in SPF-grade male SD rats. The rats were divided into the prevention experiment (treated with PRP-BQSS, L' Oréal SPF 50+sunscreen, Nature's Hall SPF 50+sunscreen, or saline) and the treatment experiment (treated with PRP-BQSS, Jingwanhong ointment, Green ointment, or saline). The effects were evaluated by measuring epidermal thickness (HE staining) and quantifying the integrated optical density (IOD) of inflammatory cells (CD11b staining). One-way ANOVA and Tukey's HSD test were performed using GraphPad Prism 9.4.0. Results: The PRP-BQSS exhibited significant efficacy in both prevention and repair. In the prevention experiment, the PRP-BQSS prevention group (Group A) showed only mild pale red erythema on the dorsal skin of rats, without significant swelling or desquamation. Histological analysis revealed that epidermal thickness in Group A (36.55±6.58 μm) was comparable to Groups B (L' Oréal, 34.84±6.59 μm) and C (Natural Hall, 34.59±8.20 μm)(P>0.05), but significantly lower than that in Group D (control group, 47.82±11.69 μm). Skin sections from Group A demonstrated intact epidermal structure with clear stratification and no significant inflammatory cell infiltration. The CD11b-positive cell count (24.30±7.43) was significantly lower than that in Group D (33.65±8.47, P<0.05). In the treatment experiment, HE staining of Group A (PRP-BQSS treatment group) showed intact epidermal structure with orderly arrangement of the basal layer, spinous layer, and granular layer, thin and uniform stratum corneum, and regular collagen fiber arrangement. The epidermal thickness of Group A (37.10±6.41 μm) showed no significant difference from Groups B (Jingwanhong ointment group, 38.66±9.07 μm) or C (Green ointment group, 35.72±4.98 μm)(P>0.05), but was significantly lower than that in Group D (control group, 48.35±8.99 μm)(P<0.05). The integral optical density value of CD11b-positive cells in Group A (32.82±11.01) was significantly lower than that in Group D (47.25±13.52, P>0.05). Moreover, the degree of inflammatory infiltration in Group A was relatively lower compared to Group B (37.14±9.20) and Group C (34.32±16.87), suggesting a superior repair capacity. However, the intergroup differences were not statistically significant (P>0.05). Conclusion: PRP-BQSS hydrogel dressing possesses dual preventive and reparative functions. It exerts its effects by reducing CD11b-positive cell infiltration (inflammation suppression) and promoting the orderly arrangement of the basal layer-epidermal layer-granular layer (epidermal reconstruction). This material holds promise as a novel and effective therapeutic approach for the prevention and treatment of solar dermatitis, particularly suitable for high-risk populations such as children, individuals with sensitive skin, and those engaged in outdoor activities.

ObjectiveHeadspace solid-phase microextraction-gas chromatography-mass spectrometry（HS-SPME-GC-MS） and GC-triple quadrupole MS（GC-QqQ-MS） in combination with non-targeted and targeted metabolomics were employed to systematically analyze the chemical composition differences of Xihuangwan prepared with natural musk and artificial musk， and establish an identification system for them. MethodsThe volatile components of 9 batches of Xihuangwan samples from 8 manufacturers were analyzed by HS-SPME-GC-MS non-targeted metabolomics， and identified by comparing their MS data with the National Institute of Standards and Technology（NIST） spectral library. Orthogonal partial least squares-discriminant analysis（OPLS-DA） was used to identify differential volatile components of Xihuangwan prepared with natural musk and artificial musk. Additionally， GC-QqQ-MS targeted metabolomics was applied to quantify the levels of α-pinene， β-elemene， muscone， dehydroepiandrosterone， bornyl acetate， and octyl acetate in 27 batches of samples from 9 manufacturers. Cluster analysis， principal component analysis（PCA）， and partial least squares-discriminant analysis（PLS-DA） were conducted to further explore the differences in volatile components between Xihuangwan samples prepared with natural musk and artificial musk. ResultsNon-targeted metabolomics identified 291 volatile compounds in Xihuangwan， including alkanes， esters， alkanes， alcohols， ketones， naphthalenes and others. OPLS-DA analysis revealed distinct separation between Xihuangwan samples containing artificial musk（A1， C1， D1， E1， F1， G1， I1） and those containing natural musk（H1， H3）. A total of 30 differential metabolites were identified. The relative contents of these 30 differential metabolites were visualized using a radar chart， revealing significant differences in the levels of octanol， borneol acetate and muscone. Cluster analysis and PCA results from targeted metabolomics indicated that Xihuangwan could be classified into two distinct groups：one composed of natural musk（H1， H3） and the other of artificial musk， sample H2. PLS-DA identified muscone， octyl acetate， and dehydroepiandrosterone as key differential volatile components. Although no significant difference was observed in the content of octyl acetate between the two groups， statistically significant differences were found for muscone and dehydroepiandrosterone（P<0.05）. ConclusionMuscone and dehydroepiandrosterone can be used for the differentiation of Xihuangwan samples containing natural musk from those containing artificial musk. This study systematically and comprehensively analyzed the differences in the types and contents of major volatile components in Xihuangwan prepared with natural musk and artificial musk， providing a scientific basis for quality evaluation and control of Xihuangwan.

ObjectiveHeadspace solid-phase microextraction-gas chromatography-mass spectrometry（HS-SPME-GC-MS） and GC-triple quadrupole MS（GC-QqQ-MS） in combination with non-targeted and targeted metabolomics were employed to systematically analyze the chemical composition differences of Xihuangwan prepared with natural musk and artificial musk， and establish an identification system for them. MethodsThe volatile components of 9 batches of Xihuangwan samples from 8 manufacturers were analyzed by HS-SPME-GC-MS non-targeted metabolomics， and identified by comparing their MS data with the National Institute of Standards and Technology（NIST） spectral library. Orthogonal partial least squares-discriminant analysis（OPLS-DA） was used to identify differential volatile components of Xihuangwan prepared with natural musk and artificial musk. Additionally， GC-QqQ-MS targeted metabolomics was applied to quantify the levels of α-pinene， β-elemene， muscone， dehydroepiandrosterone， bornyl acetate， and octyl acetate in 27 batches of samples from 9 manufacturers. Cluster analysis， principal component analysis（PCA）， and partial least squares-discriminant analysis（PLS-DA） were conducted to further explore the differences in volatile components between Xihuangwan samples prepared with natural musk and artificial musk. ResultsNon-targeted metabolomics identified 291 volatile compounds in Xihuangwan， including alkanes， esters， alkanes， alcohols， ketones， naphthalenes and others. OPLS-DA analysis revealed distinct separation between Xihuangwan samples containing artificial musk（A1， C1， D1， E1， F1， G1， I1） and those containing natural musk（H1， H3）. A total of 30 differential metabolites were identified. The relative contents of these 30 differential metabolites were visualized using a radar chart， revealing significant differences in the levels of octanol， borneol acetate and muscone. Cluster analysis and PCA results from targeted metabolomics indicated that Xihuangwan could be classified into two distinct groups：one composed of natural musk（H1， H3） and the other of artificial musk， sample H2. PLS-DA identified muscone， octyl acetate， and dehydroepiandrosterone as key differential volatile components. Although no significant difference was observed in the content of octyl acetate between the two groups， statistically significant differences were found for muscone and dehydroepiandrosterone（P<0.05）. ConclusionMuscone and dehydroepiandrosterone can be used for the differentiation of Xihuangwan samples containing natural musk from those containing artificial musk. This study systematically and comprehensively analyzed the differences in the types and contents of major volatile components in Xihuangwan prepared with natural musk and artificial musk， providing a scientific basis for quality evaluation and control of Xihuangwan.

Objective To explore the impact of number of positive regional lymph nodes (nPRLN) in N1 stage on the prognosis of non-small cell lung cancer (NSCLC) patients. Methods Patients with TxN1M0 stage NSCLC who underwent lobectomy and mediastinal lymph node dissection from 2010 to 2015 were screened from SEER database (17 Regs, 2022nov sub). The optimal cutoff value of nPRLN was determined using X-tile software, and patients were divided into 2 groups according to the cutoff value: a nPRLN≤optimal cutoff group and a nPRLN>optimal cutoff group. The influence of confounding factors was minimized by propensity score matching (PSM) at a ratio of 1 : 1. Kaplan-Meier curves and Cox proportional hazards models were used to evaluate overall survival (OS) and lung cancer-specific survival (LCSS) of patients. Results A total of 1316 patients with TxN1M0 stage NSCLC were included, including 662 males and 654 females, with a median age of 67 (60, 73) years. The optimal cutoff value of nPRLN was 3, with 1165 patients in the nPRLN≤3 group and 151 patients in the nPRLN>3 group. After PSM, there were 138 patients in each group. Regardless of before or after PSM, OS and LCSS of patients in the nPRLN≤3 group were superior to those in the nPRLN>3 group (P<0.001). N1 stage nPRLN>3 was an independent prognostic risk factor for OS [HR=1.52, 95%CI (1.22, 1.89), P<0.001] and LCSS [HR=1.72, 95%CI (1.36, 2.18), P<0.001]. Conclusion N1 stage nPRLN>3 is an independent prognostic risk factor for NSCLC patients in TxN1M0 stage, which may provide new evidence for future revision of TNM staging N1 stage subclassification.

Lung cancer is a leading cause of cancer-related morbidity and mortality worldwide. Coupled with the substantial workload, the clinical management of lung cancer is challenged by the critical need to efficiently and accurately process increasingly complex medical information. In recent years, large language models (LLMs) technology has undergone explosive development, demonstrating unique advantages in handling complex medical data by leveraging its powerful natural language processing capabilities, and its application value in the field of lung cancer diagnosis and treatment is continuously increasing. The paper systematically analyzes that the exceptional potential of LLMs in lung cancer auxiliary diagnosis, tumor feature extraction, automatic staging, progression/outcome analysis, treatment recommendations, medical documentation generation, and patient education. However, they face critical technical and ethical challenges including inconsistent performance in complex integrated decision-making (e.g., TNM staging, personalized treatment suggestions) and "black box" opacity issues, along with dilemmas such as training data biases, model hallucinations, data privacy concerns, and cross-lingual adaptation challenges ("data colonization"). Future directions should prioritize constructing high-quality multimodal corpora specific to lung cancer, developing interpretable and compliant specialized models, and achieving seamless integration with existing clinical workflows. Through dual drivers of technological innovation and ethical standardization, LLMs should be prudently advanced for holistic lung cancer management processes, ultimately promoting efficient, standardized, and personalized diagnosis and treatment practices.

Objective To explore the feasibility of using high-definition thoracoscopy to identify sympathetic ganglia during thoracic sympathicotomy for primary palmar hyperhidrosis. Methods The clinical data of patients with primary palmar hyperhidrosis who underwent high-definition thoracoscopic sympathicotomy in Taikang Xianlin Drum Tower Hospital from June to July 2023 were retrospectively analyzed. Intraoperative visualization rates and anatomical variations of sympathetic ganglia were recorded, and the consistency between white-light thoracoscopy and near-infrared fluorescence imaging was compared. Additionally, surgical videos from previous fluorescence-guided procedures were reviewed. Results Finally 100 patients were collected, including 54 females and 46 males, with an average age of (21.92±6.56) years. All patients underwent endoscopic thoracic sympathicotomy at R3 level. The overall intraoperative ganglion visualization rate was 92.5% (740/800), with G2-G5 rates of 95.5% (191/200), 94.0% (188/200), 94.0% (188/200), and 86.5% (173/200), respectively. Ganglion variations occurred in 32.0% (237/740), predominantly at G3 (29.8%) and G4 (42.6%). In 5 indocyanine green-enhanced patients, the concordance rate between white-light and near-infrared fluorescence imaging was 100.0% (38/38). Video analysis of 14 near-infrared fluorescence-guided surgeries demonstrated a 99.1% (107/108) consistency rate. Postoperative palmar hyperhidrosis improvement reached 100.0% (100/100) with no Horner’s syndrome. Conclusion With the wide clinical application of high-definition thoracoscopy, accurate thoracic sympathicotomy has the feasibility of clinical application.

Renal fibrosis represents the core pathway through which chronic kidney disease progresses to end-stage renal failure. Therapeutic strategies targeting renal fibrosis provide an important approach for clinically mitigating the transition from acute kidney injury to chronic kidney disease. Macrophages, owing to their high heterogeneity in origin and phenotype, play a significant role in various stages of acute inflammation, tissue repair, and fibrosis, thereby holding substantial promise for the treatment of renal fibrosis. This review summarizes the pivotal role of renal macrophages in the transition from acute kidney injury to chronic kidney disease, with a focus on their temporal phenotypic reprogramming characteristics and the fibrotic microenvironment interaction network constituted by injured tubules, macrophages, and fibroblasts. On this basis, we systematically outline four core categories of macrophage-targeted intervention strategies: modulation of upstream signaling pathways, induction of macrophage phenotypic reprogramming, blockade of profibrotic factors and their downstream pathways, and selective depletion or engineered modification of profibrotic macrophage subsets. This review aims to provide new insights for future exploration of the timing, precision, and efficacy of macrophage-targeted therapies.