Objective To investigate the causal relationship between gut microbiota and idiopathic pulmonary fibrosis (IPF). Methods Genome-wide association studies (GWAS) data of gut microbiota and IPF were obtained from MiBioGen and IEU OpenGWAS, respectively. Instrumental variables were screened by means of significance, linkage disequilibrium, weak instrumental variable screening, and removal of confounding factors (genetics, smoking, host characteristics). Inverse variance weighted (IVW) was used as the main Mendelian randomization (MR) analysis method, and the weighted median, simple mode, MR-Egger, and weighted mode were used to perform MR to reveal the causal effect of gut microbiota and IPF. The Cochrane's Q, leave-one-out, MR-Egger-intercept, and Mendelian randomization pleiotropy residual sum and outlier (MR-PRESSO) and Steiger tests were used to analyze the heterogeneity, horizontal pleiotropy, outliers, and directionality, respectively. Results IVW analysis results showed that Actinobacteria [OR=1.773, 95%CI (1.323, 2.377), P<0.001], Erysipelatoclostridium [OR=2.077, 95%CI (1.107, 3.896), P=0.023], and Streptococcus [OR=1.35, 95%CI (1.100, 1.657), P=0.004] could increase the risk of IPF. Bifidobacterium [OR=0.668, 95%CI (0.620, 0.720), P<0.001], Ruminococcus [OR=0.434, 95%CI (0.222, 0.848), P=0.015], and Tyzzerella [OR=0.479, 95%CI (0.304, 0.755), P=0.001] could reduce the risk of IPF. No significant heterogeneity, horizontal pleiotropy, outliers, and reverse causality were found. Conclusion Actinobacteria, Erysipelatoclostridium and Streptococcus may increase the risk of IPF, while Bifidobacterium, Ruminococcus and Tyzzerella may reduce the risk of IPF. Regulation of the above gut microbiota may become a new direction in the study of the pathogenesis of IPF.

Tuberculosis (TB), a chronic infectious disease caused by Mycobacterium tuberculosis, is primarily airborne and remains a global health problem, especially in resource-limited countries and regions. The emergence of drug resistance in M. tuberculosis has rendered the existing means ineffective in the treatment of TB. Therefore, research in new therapeutic directions has become imperative. In this review, we outline functional peptides in terms of the mechanisms of action, anti-TB attempts, advantages and disadvantages, and latest advances, aiming to analyze the research progress in anti-TB peptides. Furthermore, we investigate the potential applications of bioactive compounds found in traditional Chinese Medicine within the context of peptides.

OBJECTIVE: To investigate the effectiveness of endoscopic-assisted median nerve decompression with one-stage extensor indicis proprius (EIP) tendon transfer for reconstruction of thumb abduction in patients with severe carpal tunnel syndrome (CTS). METHODS: The clinical data of 12 patients with severe CTS who met the selection criteria between December 2019 and December 2024 were retrospectively analyzed. There were 2 males and 10 females with an average age of 55.4 years ranging from 35 to 67 years. The symptom duration of CTS was 12-120 months (mean, 48.7 months) and the thenar muscle atrophy duration was 6-48 months (mean, 13.4 months). The median nerve was released with the help of endoscope, and the EIP tendon was transferred to reconstruct the abduction function of the thumb. The operation time and complications were recorded. Two-point discrimination, palmar abduction angle of the thumb, radial abduction angle of the thumb, and pinch force of the thumb were measured and compared before operation and at last follow-up, and the effectiveness was evaluated by Kapandji score and Disabilities of the Arm, Shoulder and Hand (DASH) score. The satisfaction of the operation was evaluated at last follow-up. RESULTS: All surgeries were successfully completed with a mean operation time of 54 minutes (range, 45-68 minutes). All patients were followed up 6-50 months, with an average of 15.3 months. There was no complications such as wound infection, scar pain of wrist, or tendon rupture of transposition, and there were 3 cases of mild limitation of finger extension in the donor site of index finger. At last follow-up, two-point discrimination, palmar abduction angle of the thumb, radial abduction angle of the thumb, Kapandji score, and DASH score were significantly better than those before operation ( P<0.05), but there was no significant difference in thumb pinch force between pre- and post-operation ( P>0.05). The evaluation of surgical satisfaction showed that 7 cases were very satisfied and 5 cases were satisfied. CONCLUSION The combination of endoscopic-assisted median nerve decompression and one-stage EIP tendon transfer effectively improves hand function and quality of life in patients with severe CTS by restoring thumb abduction and alleviating neurological symptoms.
Humans ; Tendon Transfer/methods* ; Male ; Middle Aged ; Carpal Tunnel Syndrome/physiopathology* ; Female ; Decompression, Surgical/methods* ; Aged ; Adult ; Thumb/physiopathology* ; Endoscopy/methods* ; Retrospective Studies ; Median Nerve/surgery* ; Treatment Outcome ; Plastic Surgery Procedures/methods*

Objective To analyze the composition characteristics and biological functions of tumor cell subpopulations in glioblastoma(GBM)through multi-transcriptomics sequencing technology,and explore the hypoxia characteristics and spatial localization features of the mesenchymal-like(MES-like)tumor cell subpopulation in GBM and the influence on malignant biological behaviors.Methods Multi-transcriptomics sequencing data,including single-cell RNA sequencing(scRNA-seq)data(18 patients),bulk RNA sequencing(bulk RNA-seq)and spatial transcriptomics(ST)data of GBM,were employed to define cell subpopulations in GBM,and Gene Ontology(GO)and Gene Set Enrichment Analysis(GSEA)were utilized to analyze their functions.The proportions and locations of cell subpopulations in bulk RNA-seq data were evaluated with BayesPrism deconvolution.Immunofluorescence assay was conducted for verification on 12 paraffin samples of GBM from patients who visited the neurosurgical department of our hospital from 2015 to 2023 and met the pathological diagnostic criteria for GBM(10 males and 2 females,at an average age of 53.50 years and a median age of 54.50 years).pySCENIC was applied to predict specific transcription factors of tumor cell subpopulations.Results Tumor cells in GBM were highly heterogeneous,and could be mainly divided into 4 subpopulations:astrocyte-like(AC-like),neural progenitor-like(NPC-like),oligodendrocyte progenitor-like(OPC-like)and MES-like.Differential gene analysis found that the MES-like tumor cells highly expressed vascular endothelial growth factor A(VEGFA),adrenomedullin(ADM),N-myc downstream regulated 1(NDRG1),insulin like growth factor binding protein 5(IGFBP5),and A-kinase anchoring protein 12(AKAP12)(P<0.001).pySCENIC transcription factor prediction found that the high-active transcription factors of the MES-like tumor cells were AT-rich interaction domain 3A(ARID3A),FOS like 2,AP-1 transcription factor subunit(FOSL2),endothelial PAS domain protein 1(EPAS1),CCAAT enhancer binding protein delta(CEBPD),and CCAAT enhancer binding protein beta(CEBPB)(P<0.05).GO and GSEA enrichment analyses found that the MES-like tumor cells were enriched in hypoxia-related pathways,especially the pathway of cell responses to hypoxia levels(NES=2.437,P<0.001).BayesPrism deconvolution showed that the MES-like tumor cells mainly existed in PAN(Pseudopalisading cells around necrosis)and perinecrotic zone.Immunofluorescence assay confirmed CD44+(CD44 antigen)MES-like tumor cells were mainly located in hypoxia areas with highly expression of hypoxia inducible factor 1 subunit alpha(HIF1α)(P<0.01).Multivariate Cox regression analysis indicated that the MES-like tumor cells were significantly correlated with the adverse prognosis of GBM patients(HR=1.71,95%CI:1.38～2.11,P<0.001).Conclusion Tumor cells in GBM are of highly heterogeneity.They could be mainly divided into 4 subpopulations:AC-like,NPC-like,OPC-like and MES-like.MES-like tumor cells,mainly locating in PAN and perinecrotic zone,are characterized by hypoxia,which can promote the malignant progression of GBM.

Objective:To evaluate the value of ultrasound radiomics combined with machine learning for early diagnosis of seronegative Hashimoto’s thyroiditis (SN-HT) .Methods:This retrospective study included 164 patients from Liaoning Provincial People’s Hospital , Lixin County People’s Hospital, Linghai Dalinghe Hospital, Fengcheng Phoenix Hospital, who underwent thyroidectomy for solitary nodules with normal thyroid function between Nov. 2016 and Jan. 2024. Postoperative pathology confirmed Hashimoto’s thyroiditis (HT) in some cases, who were further categorized into antibody-positive and antibody-negative groups based on serum antibody status. Patients without Hashimoto’s thyroiditis served as the control group. A total of 298 ultrasound images were analyzed. Radiomics features were extracted from hypoechoic non-nodular areas within 0.5 cm surrounding the tumor. Two senior pathologists and two senior ultrasound physicians independently assessed lymphocytic infiltration, eosinophilic changes of follicular epithelium, and the proportion of hypoechoic areas in pathology and ultrasound images, respectively. A machine learning model, CCH-NET, was developed using linear regression and t-distributed stochastic neighbor embedding (t-SNE) techniques. The dataset was divided into a training set (80%) and a validation set (20%) to compare the diagnostic accuracy of CCH-NET with that of senior ultrasound physicians. Results:In internal validation, CCH-NET achieved a diagnostic accuracy of 88.89% for both antibody-positive and antibody-negative groups, significantly higher than the 66.67% accuracy of senior ultrasound physicians ( P<0.01). In external validation, CCH-NET achieved 75.00% and 66.67% accuracy for the two groups, compared to 50.00% by senior ultrasound physicians. For the control group, both methods achieved 93.33% accuracy. The AUC of CCH-NET was 0.848, outperforming senior ultrasound physicians (0.681) ,demonstrating superior diagnostic performance. Conclusion:The radiomics-based CCH-NET model, using non-nodular hypoechoic areas as a specific indicator, can accurately identify early SN-HT in euthyroid patients. It significantly outperforms senior ultrasound physicians, improving diagnostic accuracy and reducing missed diagnoses.

Objective To analyze the respective abnormal brain regions and commonly altered brain regions of spontaneous brain ac-tivity in post-stroke aphasia(PSA)and post-stroke depression(PSD),and to explore the potential pathological mechanisms underlying single disease and comorbidity.Methods Literatures were retrieved from PubMed,Embase,Web of Science,Cochrane Library,CNKI,Wanfang data,VIP and SinoMed,from establishment to April 19th,2025.Resting-state functional magnetic resonance imaging(fMRI)studies were included if they focused on patients with PSA or PSD,with healthy controls(HC)serving as control group,and amplitude of low-frequency fluctuation(ALFF),fractional amplitude of low-frequency fluctu-ation(fALFF)and regional homogeneity(ReHo)were adopted as outcome indicator.Data regarding differential brain regions were extracted from the original studies,and a neuroimaging meta-analysis was conducted using SDM-PSI V6.23 beta.Results A total of 17 articles on PSA(339 patients and 351 HC)and five articles on PSD(102 patients and 149 HC)were included.The spontaneous brain activity in the left cerebellar area 9,right middle temporal gyrus and right insula was significantly higher in PSA patients than in HC(P<0.05),while activity in the right cerebellar area 6,left medial superior frontal gyrus(SFGmed),left middle frontal gyrus and right anterior cingulate/paracingulate gyrus was lower(P<0.05).For PSD,spontaneous brain activity was elevated in the right cuneus gyrus and right superior occipital gyrus compared to HC(P<0.05),while it was reduced in the left SFGmed and left inferior pa-rietal lobe(P<0.05).Additionally,spontaneous brain activity in the left medial superior frontal gyrus was lower in both diseases compared to HC(P<0.05).Conclusion The pathological mechanism of PSA may involve a pattern of right-sided compensatory hyperfunction and left-sided inhibitory damage within the language-related network,accompanied by cross-hemispheric synergistic activity of the cerebellum.The occurrence of PSD may be attributed to hyperactivity of the right occipital net-work,and functional inhibition involving the left inferior parietal lobe.The inhibition observed in the left SFG-med(MNI coordinates x=0,y=26,z=44)likely represents the language-emotion integration hub,mediating the co-occurrence of PSA and PSD.

Objective:To evaluate the value of ultrasound radiomics combined with machine learning for early diagnosis of seronegative Hashimoto’s thyroiditis (SN-HT) .Methods:This retrospective study included 164 patients from Liaoning Provincial People’s Hospital , Lixin County People’s Hospital, Linghai Dalinghe Hospital, Fengcheng Phoenix Hospital, who underwent thyroidectomy for solitary nodules with normal thyroid function between Nov. 2016 and Jan. 2024. Postoperative pathology confirmed Hashimoto’s thyroiditis (HT) in some cases, who were further categorized into antibody-positive and antibody-negative groups based on serum antibody status. Patients without Hashimoto’s thyroiditis served as the control group. A total of 298 ultrasound images were analyzed. Radiomics features were extracted from hypoechoic non-nodular areas within 0.5 cm surrounding the tumor. Two senior pathologists and two senior ultrasound physicians independently assessed lymphocytic infiltration, eosinophilic changes of follicular epithelium, and the proportion of hypoechoic areas in pathology and ultrasound images, respectively. A machine learning model, CCH-NET, was developed using linear regression and t-distributed stochastic neighbor embedding (t-SNE) techniques. The dataset was divided into a training set (80%) and a validation set (20%) to compare the diagnostic accuracy of CCH-NET with that of senior ultrasound physicians. Results:In internal validation, CCH-NET achieved a diagnostic accuracy of 88.89% for both antibody-positive and antibody-negative groups, significantly higher than the 66.67% accuracy of senior ultrasound physicians ( P<0.01). In external validation, CCH-NET achieved 75.00% and 66.67% accuracy for the two groups, compared to 50.00% by senior ultrasound physicians. For the control group, both methods achieved 93.33% accuracy. The AUC of CCH-NET was 0.848, outperforming senior ultrasound physicians (0.681) ,demonstrating superior diagnostic performance. Conclusion:The radiomics-based CCH-NET model, using non-nodular hypoechoic areas as a specific indicator, can accurately identify early SN-HT in euthyroid patients. It significantly outperforms senior ultrasound physicians, improving diagnostic accuracy and reducing missed diagnoses.

Objective To analyze the respective abnormal brain regions and commonly altered brain regions of spontaneous brain ac-tivity in post-stroke aphasia(PSA)and post-stroke depression(PSD),and to explore the potential pathological mechanisms underlying single disease and comorbidity.Methods Literatures were retrieved from PubMed,Embase,Web of Science,Cochrane Library,CNKI,Wanfang data,VIP and SinoMed,from establishment to April 19th,2025.Resting-state functional magnetic resonance imaging(fMRI)studies were included if they focused on patients with PSA or PSD,with healthy controls(HC)serving as control group,and amplitude of low-frequency fluctuation(ALFF),fractional amplitude of low-frequency fluctu-ation(fALFF)and regional homogeneity(ReHo)were adopted as outcome indicator.Data regarding differential brain regions were extracted from the original studies,and a neuroimaging meta-analysis was conducted using SDM-PSI V6.23 beta.Results A total of 17 articles on PSA(339 patients and 351 HC)and five articles on PSD(102 patients and 149 HC)were included.The spontaneous brain activity in the left cerebellar area 9,right middle temporal gyrus and right insula was significantly higher in PSA patients than in HC(P<0.05),while activity in the right cerebellar area 6,left medial superior frontal gyrus(SFGmed),left middle frontal gyrus and right anterior cingulate/paracingulate gyrus was lower(P<0.05).For PSD,spontaneous brain activity was elevated in the right cuneus gyrus and right superior occipital gyrus compared to HC(P<0.05),while it was reduced in the left SFGmed and left inferior pa-rietal lobe(P<0.05).Additionally,spontaneous brain activity in the left medial superior frontal gyrus was lower in both diseases compared to HC(P<0.05).Conclusion The pathological mechanism of PSA may involve a pattern of right-sided compensatory hyperfunction and left-sided inhibitory damage within the language-related network,accompanied by cross-hemispheric synergistic activity of the cerebellum.The occurrence of PSD may be attributed to hyperactivity of the right occipital net-work,and functional inhibition involving the left inferior parietal lobe.The inhibition observed in the left SFG-med(MNI coordinates x=0,y=26,z=44)likely represents the language-emotion integration hub,mediating the co-occurrence of PSA and PSD.

Alzheimer′s disease (AD) is an incurable disease in the field of major chronic diseases. Subjective cognitive decline (SCD) is a clinical risk factor for AD. The standardized screening and intervention in individuals with SCD are of great importance in early prevention and treatment of AD. According to the clinical criteria proposed by The characterisation of subjective cognitive decline, which was published online in Lancet Neurology, the article summarized the definition of SCD, the latest perspective of clinical standards in SCD, and the results of AD preclinical SCD research. The purpose of this work was to provide concrete guidance and recommendations for making clinical decisions in diagnosis and scientific research on SCD.

Objective: To observe the analgesic and sedative effect of epidural dexmedetomidine injection in patients undergoing transurethral resection of prostate (TURP) and its effect on postoperative cognitive function. Methods: A total of 60 patients undergoing TURP under combined spinal-epidural anesthesia (CSEA) were randomly divided into dexmedetomidine group and normal saline group. Patients in the dexmedetomidine group were given 0.1 μg/kg of dexmedetomidine injection after epidural anesthesia, and 0.9 μg/kg of dexmedetomidine was added into epidural analgesia pump after operation; patients in the normal saline group were given the same dose of normal saline. The vital signs, visual analogue scale (VAS) and Ramsay sedation score of patients in the two groups at different time points[before intervention (T₀), after intervention for 15 min (T₁), after intervention for 30 min (T₂), after intervention for 45 min (T₃), after intervention for 60 min (T₄), after surgery for 12 h (T₅), after surgery for 36 h (T₆)] were recorded. The mini mental state examination (MMSE) of patients in the two groups 1 d before operation and 3 d after operation were recorded. Results: Compared with normal saline group, the VAS scores of patients in dexmedetomidine group were significantly lower at T₁-T₆ (P < 0.05), and the Ramsay scores were significantly higher (P < 0.05). There was no significant difference of MMSE total score [25.00(23.50, 27.50) scores] in the patients of dexmedetomidine group 3 d after operation but the memory ability score [4.00(3.00, 5.00) scores] was significantly decreased (P < 0.05), and the language ability score [9.00(8.00, 9.00) scores] was significantly increased (P < 0.05). There was no significant difference in MMSE score between the two groups in comparison with that 1 d before operation. Conclusions Epidural dexmedetomidine injection (1 μg/kg) enhancesd the analgesic effect of ropivacaine and producesd sedative effect. Although there was is no significant effect on the overall cognitive function, it might have some effect on memory function.