Objective To study the five-year survival status and influencing factors of elderly patients with lung cancer complicated with chronic obstructive pulmonary disease (COPD). Methods A cohort study was conducted to follow up 450 patients with lung cancer and chronic obstructive pulmonary disease who were hospitalized in our hospital from January 2018 to December 2023. The endpoint of the follow-up was the end of a five-year period or death. The Life Tables method was used to calculate survival rates and plot survival curves. The Cox proportional hazards model was used to analyze the influencing factors of five-year survival. Results The results indicated that the overall five-year survival rate of patients was 4.89%, and it decreased year by year. Cox regression analysis showed that age, gender, family functioning, and psychological status significantly influenced patient survival rate (all P<0.05). Stratified analysis found that the smoking status, family functioning, and psychological status of male patients all had an impact on survival rate (all P<0.05), while the psychological status of female patients had a more significant impact on survival (P=0.008). Conclusion This study provides a scientific basis for comprehensive intervention of elderly lung cancer patients with COPD. It is recommended that clinical attention should be paid to psychological and family factors to improve patient prognosis.

BackgroundWith the intensification of population aging， the prevalence of Alzheimer's disease （AD） has been increasing， and 10% to 20% of AD patients also suffer from chronic obstructive pulmonary disease （COPD）. Compared to patients with a single disease， those with comorbid AD and COPD show more severe cognitive impairment， reduced quality of life， and a greater disease burden. Both AD and COPD patients exhibit abnormal levels of neurotransmitters， which affect cognitive function. However， the alterations in neurotransmitter levels in patients with comorbid AD and COPD and their association with cognitive function remain unclear. ObjectiveTo analyze the relationship between neurotransmitter levels and cognitive function in patients with AD combined with COPD， and to provide references for improving the cognitive function in this population. MethodsA total of 120 patients who were hospitalized at The Third Hospital of Mianyang from January to September 2024 were divided into three groups： 40 patients meeting the International Classification of Diseases， tenth edition （ICD-10） diagnostic criteria for AD were defined as AD group， 40 patients meeting the diagnostic criteria for COPD according to the Global Initiative for Chronic Obstructive Lung Disease （GOLD） 2023 guidelines were defined as COPD group， another 40 patients meeting the diagnostic criteria for both conditions were defined as AD combined with COPD group. Additionally， 40 healthy individuals undergoing physical examination at the same hospital during the same period were selected as the control group. Encephalofluctuograph was used to detect the levels of γ-aminobutyric acid （GABA）， glutamate （Glu）， norepinephrine （NE）， 5-hydroxytryptamin （5-HT）， acetylcholine （Ach）， and dopamine （DA）. Cognitive function of the subjects was assessed using the Mini-Mental State Examination （MMSE） and the Montreal Cognitive Assessment （MoCA）. Spearman correlation analysis was used to investigate the correlation between neurotransmitter levels and cognitive function in AD combined with COPD patients. Multiple linear regression analysis was adopted to investigate the influencing factors of cognitive function in this population. Results①Significant differences were observed in MMSE and MoCA scores across all four groups （H=126.323， 128.489， P<0.01）. The AD combined with COPD group demonstrated significantly lower MMSE and MoCA scores compared with COPD group， AD group， and control group （P<0.05）. ②Statistically significant differences were found in the levels of GABA， Glu， Ach， NE，and DA among the four groups （H=61.094， 46.665， 135.289， 15.089， 129.636， P<0.01）. Compared with the COPD group， AD group， and control group， the AD combined with COPD group showed significantly lower levels of GABA， Ach， and DA， but higher Glu levels， with all differences being statistically significant （P<0.05）. ③In the AD combined with COPD group， the levels of GABA， Ach， and DA showed positive correlations with MMSE scores （r=0.633， 0.876， 0.580， P<0.05）， while Glu levels were negatively correlated with MMSE scores （r=-0.377， P=0.013）. ④The levels of Ach （B=0.253， 95% CI： 0.153–0.352）， GABA （B=0.137， 95% CI： 0.013–0.261）， age （B=-0.212， 95% CI： -0.356–-0.069） and education duration （B=-0.367， 95% CI： -0.608–-0.126） were the influencing factors of cognitive function in patients with AD combined with COPD. ConclusionCompared with the COPD group， AD group， and control group， patients with AD combined with COPD exhibited more severe cognitive impairment， along with lower levels of GABA， ACh， and DA， but higher Glu levels. Ach and GABA levels are potential influencing factors of cognitive function in AD combined with COPD patients.

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.

The application of sensors to the monitoring of spinal morphology and motion was reviewed in terms of the research object and monitoring index.The present situation of the application of sensors was introduced,such as inertial sensor,stretchable strain sensor and electromagnetic sensor.The deficiencies of sensors applied to the monitoring of spinal morphology and motion were analyzed,and the future directions of the application were pointed out.[Chinese Medical Equipment Journal,2025,46(6):105-110]

Objective:To analyze the baseline characteristics and prognostic factors of Pneumocystis carinii pneumonia (PCP) in patients with liver diseases (LD), and to develop the nomogram prognosis model. Methods:The patients with liver diseases complicated with PCP (LD-PCP) who admitted to Beijing Youan Hospital, Capital Medical University from January 1st, 2021 to October 31st, 2024 were enrolled in this study. This study was a retrospective case-control study. Data were collected, including baseline characteristics at admission and clinical outcomes. Multivariate logistic regression analysis was employed to identify the independent risk factors of poor prognosis in LD-PCP patients. Subsequently, a nomogram was developed to construct the prognostic model. The performance of this model was evaluated using the receiver operater characteristic (ROC) curve and calibration curve.Results:A total of 61 patients with LD-PCP were enrolled, including 21 in the death group and 40 in the survival group. Multivariate logistic regression analysis revealed that co-infection with Aspergillus and elevated lactate dehydrogenase (LDH) levels were independent risk factors for mortality in patients with LD-PCP (odds ratio ( OR)=12.802, 95% confidence interval ( CI) 1.334 to 122.845, P=0.027; OR=1.009, 95% CI 1.002 to 1.016, P=0.014). The predictive value of prognostic model based on the nomogram was better evidenced by the ROC curve, which yielded an area under the curve (AUC) of 0.835 (95% CI 0.725 to 0.944), with the sensitivity of 71.4% and the specificity of 87.5%. The predictive accuracy of the model was further validated by the calibration curve, and the Brier value was 0.151, the model fitting line had a high degree of agreement with the standard reference line ( P=0.953). Conclusions:Co-infection with Aspergillus and LDH levels are independent risk factors for the poor prognosis of patients with LD-PCP. The prognosis model based on the nomogram has better predictive value and clinical practicality, which could identify high-risk patients in the early stage, and provide theoretical guidance on the patient management.

Objective:To investigate the underlying mechanism behind the significant reduction in intracellular virus loads after respiratory syncytial virus (RSV) and influenza viruses infect respiratory epithelial cells overexpressing the chemokine (C-C motif) receptor 1 (CCR1).Methods:A549 cells were infected with respiratory syncytial virus (RSV), influenza A viruses (H1N1, H3N2), or influenza B virus (FluB), and the expression of chemokine (C-C motif) ligand 5 (CCL5) and CCR1 were detected by qRT-PCR, ELISA, and Western blot. After overexpressing or knocking down CCR1 in A549 cells, these cells were infected with RSV, H1N1, H3N2, or FluB, and the expression of CCR1, heat shock protein 90 (HSP90), cyclin-dependent kinase 1 (CDK1), and viral proteins were detected by qRT-PCR and Western blot. After stimulating CCR1-overexpressed A549 cells with CCL5, Western blot was used to detect the expression of HSP90 and CDK1, and co-immunoprecipitation was used to detect the interaction between HSP90 and CCR1. CCR1 -/- mice were infected with RSV, H1N1, or H3N2 to observe the changes in the expression of HSP90, CDK1, and viral proteins with Western blot, and the inflammation in lung tissues with HE staining. One-way analysis of variance and t test were used for statistical analysis. Results:RSV, H1N1, H3N2, and FluB infections induced high expression of CCL5 in A549 cells ( P<0.05), but the expression of CCR1 showed an overall downward trend. After activating its receptor CCR1, CCL5 inhibited the replication of RSV and influenza viruses by suppressing the activity of HSP90 ( P<0.05). The experiments conducted on CCR1 -/- mice confirmed that the enhanced activity of HSP90 facilitated the replication of RSV and influenza viruses. Conclusion:RSV and influenza viruses may reduce the binding of CCL5 to CCR1 by downregulating the expression of CCR1 in respiratory epithelial cells, thereby weakening the inhibitory effect of CCR1 on HSP90 activity, which enables them to evade host immune defense.

Objective To summarize the clinical features,treatment and prognosis of patients with primary central nervous system lymphoma(PCNSL)with clonal bone marrow B cells,and to explore the influence on clinical diagnosis and treatment.Methods PCNSL patients with clonal bone marrow B cells diagnosed by flow cytometry between Jan 2020 and Jul 2023 at Huashan Hospital of Fudan University were enrolled.The auxiliary examination data of these patients were collected,including complete blood count,routine biochemistry,bone marrow aspiration and biopsy,contrast-enhanced brain MRI,and whole-body PET-CT.Kaplan-Meier was used to draw the survival curve,and relevant literature was reviewed.Results A total of 223 newly diagnosed PCNSL patients were included,187 of whom completed bone marrow puncture and biopsy evaluation.We found clonal bone marrow B cells in 16 of 187 cases(8.56%)by flow cytometry.2 patients showed B lymphoma involving the bone marrow.All patients received a high-dose methotrexate based chemotherapy.The median progression free survival(PFS)of 16 patients with clonal bone marrow B cells was 11.1 months,and the median PFS of 171 patients with normal bone marrow was 12.6 months.There was no significant difference in the PFS between the two groups.Conclusion PCNSL with clonal bone marrow B cells had no specific clinical features,but bone marrow flow cytometry showed clonal B cells.High-dose methotrexate treatment regimen is effective.There was no significant difference in PFS for PCNSL patients with clonal B cells and normal findings in bone marrow.Clonal B cells in bone marrow may be caused by monoclonal B-cell lymphocytosis(MBL),lymphoma involves the bone marrow and the presence of common precursor cells.Bone marrow examination should be performed in the initial evaluation of suspected PCNSL.

OBJECTIVE: To evaluate the efficacy and safety of Shexiang Tongxin Dropping Pill (STDP) in treating stable angina patients with phlegm-heat and blood-stasis syndrome by exercise duration and metabolic equivalents. METHODS: This multicenter, randomized, double-blind, placebo-controlled clinical trial enrolled stable angina patients with phlegm-heat and blood-stasis syndrome from 22 hospitals. They were randomized 1:1 to STDP (35 mg/pill, 6 pills per day) or placebo for 56 days. The primary outcome was the exercise duration and metabolic equivalents (METs) assessed by the standard Bruce exercise treadmill test after 56 days of treatment. The secondary outcomes included the total angina symptom score, Chinese medicine (CM) symptom scores, Seattle Angina Questionnaire (SAQ) scores, changes in ST-T on electrocardiogram and adverse events (AEs). RESULTS: This trial enrolled 309 patients, including 155 and 154 in the STDP and placebo groups, respectively. STDP significantly prolonged exercise duration with an increase of 51.0 s, compared to a decrease of 12.0 s with placebo (change rate: -11.1% vs. 3.2%, P<0.01). The increase in METs was significantly greater in the STDP group than in the placebo group (change: -0.4 vs. 0.0, change rate: -5.0% vs. 0.0%, P<0.01). The improvement of total angina symptom scores (25.0% vs. 0.0%), CM symptom scores (38.7% vs. 11.8%), reduction of nitroglycerin consumption (100.0% vs. 11.3%), and all domains of SAQ, were significantly greater with STDP than placebo (all P<0.01). The changes in Q-T intervals at 28 and 56 days from baseline were similar between the two groups (both P>0.05). Twenty-five participants (16.3%) with STDP and 16 (10.5%) with placebo experienced AEs (P=0.131), with no serious AEs observed. CONCLUSION STDP could improve exercise tolerance in patients with stable angina and phlegm-heat and blood stasis syndrome, with a favorable safety profile. (Registration No. ChiCTR-IPR-15006020).
Humans ; Double-Blind Method ; Drugs, Chinese Herbal/adverse effects* ; Male ; Female ; Middle Aged ; Angina, Stable/physiopathology* ; Aged ; Syndrome ; Treatment Outcome ; Placebos ; Tablets

Mycophenolic acid (MPA), the active moiety of both mycophenolate mofetil (MMF) and enteric-coated mycophenolate sodium (EC-MPS), serves as a primary immunosuppressant for maintaining solid organ transplants. Therapeutic drug monitoring (TDM) enhances treatment outcomes through tailored approaches. This study aimed to develop an evidence-based guideline for MPA TDM, facilitating its rational application in clinical settings. The guideline plan was drawn from the Institute of Medicine and World Health Organization (WHO) guidelines. Using the Delphi method, clinical questions and outcome indicators were generated. Systematic reviews, Grading of Recommendations Assessment, Development, and Evaluation (GRADE) evidence quality evaluations, expert opinions, and patient values guided evidence-based suggestions for the guideline. External reviews further refined the recommendations. The guideline for the TDM of MPA (IPGRP-2020CN099) consists of four sections and 16 recommendations encompassing target populations, monitoring strategies, dosage regimens, and influencing factors. High-risk populations, timing of TDM, area under the curve (AUC) versus trough concentration (C₀), target concentration ranges, monitoring frequency, and analytical methods are addressed. Formulation-specific recommendations, initial dosage regimens, populations with unique considerations, pharmacokinetic-informed dosing, body weight factors, pharmacogenetics, and drug‍-‍drug interactions are covered. The evidence-based guideline offers a comprehensive recommendation for solid organ transplant recipients undergoing MPA therapy, promoting standardization of MPA TDM, and enhancing treatment efficacy and safety.
Mycophenolic Acid/administration & dosage* ; Drug Monitoring/methods* ; Humans ; Organ Transplantation ; Immunosuppressive Agents/administration & dosage* ; Delphi Technique

Sepsis is a life-threatening organ dysfunction caused by the host's dysregulated response to infection, with a complex pathogenesis and high mortality rate. Currently, there are no clear and effective treatment drugs available. Epigenetic modification serves as a major mechanism regulating gene expression under pathological and physiological conditions, and it has been shown to play a critical role in regulating the occurrence and development of sepsis. Histone acetylation modification, as a sophisticated epigenetic modification mechanism, plays a crucial regulatory role in many aspects of life. It can jointly regulate the acetylation status of histones through histone acetyltransferase (HAT) and histone deacetylase (HDAC), thereby changing DNA expression and dynamically regulating sepsis related gene expression at the epigenetic level. Previous studies have shown that histone acetylation can participate in the progression of sepsis by regulating inflammatory mediators, nuclear factor-ΚB (NF-ΚB) signaling pathway, autophagy, efferocytosis, ferroptosis, pyroptosis. These mechanisms are promising targets for novel sepsis treatments. In addition, with the deepening of research, it has been found that various selective/non selective histone deacetylase inhibitors (HDACI) can regulate histone acetylation status by acting on different HDAC targets, which has been shown to alleviate organ damage caused by sepsis and improve prognosis in septic animal models. This article further summarizes the role and potential applications of histone acetylation in sepsis, providing new ideas for the treatment of sepsis.
Sepsis/metabolism* ; Acetylation ; Humans ; Histones/metabolism* ; Histone Acetyltransferases/metabolism* ; Histone Deacetylase Inhibitors ; Epigenesis, Genetic ; Histone Deacetylases/metabolism* ; Signal Transduction ; NF-kappa B/metabolism* ; Animals