Background: High-mobility group box protein 1 (HMGB1) is a chromatin-binding protein involved in arthritis, ischemia, sepsis, atherosclerosis, neurodegenerative disorders, meningitis, and cancer. HMGB1 exhibits dual roles in cancer, acting as either a tumor suppressor or oncoprotein depending on context. Objective: This research aimed to elucidate HMGB1’s functional significance in cutaneous squamous cell carcinoma (cSCC). Methods: We overexpressed HMGB1 in cSCC cell lines using recombinant adenovirus and examined its effects on cell proliferation, colony formation, and cell migration. Results: Immunohistochemical analysis revealed elevated HMGB1 expression levels in cSCC tissue relative to normal epidermis. To assess the influence of HMGB1, we employed recombinant adenoviruses expressing HMGB1 to transduce SCC cell lines (SCC12 and SCC13). Enhanced HMGB1 expression significantly promoted cellular proliferation and colony formation capacity.Notably, HMGB1 overexpression elevated the levels of proliferation regulators, including P63, SOX2, CDK4 and CDK6. Furthermore, HMGB1 overexpression substantially enhanced tumor invasiveness, accompanied by upregulation of epithelial-mesenchymal transition (EMT) biomarkers. Mechanistically, overexpression of HMGB1 enhanced transforming growth factor-β signaling by increasing phosphorylation of SMAD2/3, the key mediators of EMT. Conclusion These data imply that HMGB1 acts as a tumor-promoting factor in cSCC.

Objective To explore the predictive value of automated breast ultrasound(ABUS)features combined with Ki-67 in predicting pathological complete response(pCR)after neoadjuvant chemotherapy(NAC)in triple-negative breast cancer(TNBC).Methods A retrospective analysis was conducted on 127 female TNBC patients treated at Xijing Hospital,Air Force Medical University from March 2019 to December 2023.All patients underwent NAC and surgical treatment after ABUS examination.Based on postoperative pathological results,patients were divided into pCR group(n=60)and non-pathological complete response(npCR)group(n=67).Differences in various parameters before NAC were compared between the two groups.LASSO regression was used to identify independent factors influencing pCR after NAC in TNBC patients,and a predictive model was constructed using multivariate logistic regression.The prediction model was internally validated using the Bootstrap method(1000 resamples).The discriminative ability of the model was evaluated using receiver operating characteristic(ROC)curves,and the area under the curves(AUCs)of different prediction models were compared using De-long's test.The accuracy of the model was assessed using calibration curves,and the clinical benefit of the model was evaluated using clinical decision curve analysis(DCA).Results Significant differences were observed between two groups in terms of age,Ki-67,menopausal status,tumor type,posterior echo,coronal plane convergence sign,coronal plane skip sign,and coronal plane white wall sign before NAC(P<0.05).LASSO regression analysis showed that Ki-67,coronal plane convergence sign,and coronal plane white wall sign were independent influencing factors of pCR after NAC in TNBC patients(P<0.05).The AUC of the multivariate logistic regression model based on Ki-67 was 0.733(95%CI 0.646-0.819),the AUC of ABUS model was 0.777(95%CI 0.695-0.858),and the AUC of ABUS combined with Ki-67 model was 0.816(95%CI 0.741-0.890).De-long's test showed that the AUC of the combined model was higher than those of ABUS feature model and Ki-67 model,with statistically significant differences(P<0.05).There was no significant difference in the AUC between ABUS feature model and Ki-67 model(P=0.40).Hosmer-Lemeshow test indicated that the combined model had a good fit(P=0.304).Internal validation results showed that the combined model had a good stability with a consistency index(C-index)of 0.820(95%CI 0.726-0.879).The calibration curve demonstrated good consistency between the predicted and actual probabilities of the combined prediction model,and the DCA curve indicated that the model had favorable clinical benefit.Conclusion The combined ABUS feature and Ki-67 model can be used to predict the probability of pCR after NAC in TNBC patients,providing a reference for the formulation of clinical treatment plans in TNBC patients.

Objective To develop a predictive model for postoperative mortality risk in patients with acute aortic dissection(AAD)using the Extreme Gradient Boosting(XGBoost)algorithm combined with Shapley Additive Explanation(SHAP),and to establish a prediction website to serve as a diagnostic and therapeutic support platform for clinicians and patients.Methods A retrospective cohort study design was adopted.Data from 782 AAD patients who underwent surgical treatment at the Fourth Hospital of Hebei Medical University from January 2013 to December 2023 were collected,including basic information and initial serum biomarker test results.Patients were randomly divided into training and test sets at a 7:3 ratio.An external validation set consisting of 313 AAD patients admitted to the Second Hospital of Hebei Medical University from January 2020 to December 2023 was also established for further model validation.Variables were screened using LASSO regression,and an XGBoost machine learning model was constructed and interpreted using SHAP.The predictive performance of the model was evaluated using receiver operating characteristic(ROC)curve analysis.Using the Shiny package,the XGBoost model was deployed to shinyapps.io to create a prediction website for postoperative mortality risk in AAD patients.One patient was selected by simple random sampling from the test set and the external validation set respectively for the prediction example on the Shiny webpage.Results The XGBoost model demonstrated high predictive performance for postoperative mortality in AAD patients,with area under the ROC curve(AUC)values of 0.928(95%CI 0.901-0.956)in the training set,0.919(95%CI 0.891-0.949)in the test set,and 0.941(95%CI 0.915-0.967)in the external validation set.SHAP values indicated the following order of variable importance in the model(from highest to lowest):"lactate dehydrogenase""blood chlorine""multiple organ injury""carbon dioxide combining power""prothrombin time""α-hydroxybutyric acid""creatine kinase isoenzyme""Stanford classification""combined use of bedside blood purification""gender""acute kidney injury""gastrointestinal bleeding""brain injury"and"shock".A risk prediction website for adverse postoperative outcomes in AAD patients was developed using XGBoost-SHAP method(https://dun-dunxiaolu.shinyapps.io/document/)and validated with examples.One randomly selected patient from each of the test and external validation sets was applied:the predicted mortality risk value for patient 1(who died postoperatively)was 0.9539,and that for patient 2(who survived postoperatively)was 0.0206.Conclusions The XGBoost-SHAP model demonstrates high accuracy in predicting postoperative mortality risk for AAD patients.The online prediction tool established based on this model enhances the identification efficiency of high-risk postoperative mortality patients.

Objective To investigate the neuroprotective effects and mechanisms of abscisic acid(ABA)in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP)-induced Parkinson's disease(PD)mouse models.Methods Eight-week-old C57BL/6J mice were randomly divided into three groups,control group(Ctrl),MPTP group,and MPTP+ABA group,12 mice in each group.Except for the control group,mice in the other groups were intraperitoneally injected with MPTP 25 mg/kg daily for 8 consecutive days to establish a subacute PD model.The MPTP+ABA group received intraperitoneal injections of ABA 25 mg/kg daily for 11 consecutive days,starting 3 days prior to MPTP administration.Behavioral tests were performed 24 hours after the last administration.On day 3,the expression of tyrosine hydroxylase(TH)and glial fibrillary acidic protein(GFAP)in the substantia nigra pars compacta(SNc)and striatum(STR)was analyzed by Western blotting,and mRNA levels of inflammatory factors were measured by Real-time PCR.Immunofluorescent staining was used to detect the expression of TH,GFAP,and ionized calcium-binding adapter molecule 1(Iba1).Results Compared with the control group,MPTP-treated mice exhibited impaired motor function,a reduced number of TH-positive dopaminergic neurons in the SNc,down-regulated TH protein expression in both the SNc and striatum,up-regulated GFAP protein expression,increased numbers of GFAP-and Iba1-positive cells,and elevated levels of pro-inflammatory factors.In contrast,the MPTP+ABA group showed improved motor function,increased TH-positive neurons in the SNc,up-regulated TH protein expression,down-regulated GFAP protein expression,reduced numbers of GFAP-and Iba1-positive cells,and decreased pro-inflammatory factor levels compared to the MPTP group.Conclusion ABA ameliorates motor dysfunction in MPTP-induced PD model mice,reduces degeneration and death of dopaminergic neurons in the SNc,suppresses the proliferation and activation of astrocytes and microglia in the SNc and striatum,and alleviates neuroinflammation.These results suggest that ABA exerts neuroprotective effects in MPTP-induced PD model mice.

Objective:To investigate the application of the parameters of multimodal ultrasound elastography in differential diagnosis for thyroid nodules of patients with diffuse thyroid lesions.Methods:A total of 103 patients with diffuse thyroid lesions who underwent treatment at Affiliated Baoji Hospital of Xi′an Medical University from January 2023 to January 2024 were retrospectively selected,whose thyroid nodules were confirmed by fine needle aspiration biopsy or surgical pathology.They were grouped according to the benign or malignant nodules.56 patients with benign nodules were included in the benign nodule group,while the other 47 patients were included in the malignant nodule group.All patients were examined by conventional ultrasound and multimodal ultrasound elastography,and the relevant parameters were recorded to compare the differences between the two groups.The value of each indicator in diagnosing benign and malignant thyroid nodules was investigated.Results:There were no statistically significant differences between the benign and malignant nodule groups in terms of gender,length diameter of nodule,nodule location,functional abnormalities of thyroid,exposure history of radiation,and the presence of acoustic halos(P＞0.05),the age of patients in the malignant nodule group was lower than that of the benign nodule group(t=-3.121,P＜0.05),and the percentage of nodules with blood flow(14.89%),the percentage of aspect ratio＜1(74.47%),and the percentage of nodules with clear boundary(27.66%)in the malignant nodule group were all lower than those of the benign nodule group,with statistically significant differences(x2=25.634,5.112,12.465,P＜0.05).The ratio of lymphatic metastasis(27.66%)and that of calcification(65.96%)in the malignant nodule group were lower than those in the benign nodule group,and the differences were all statistically significant(x2=11.917,9.350,P＜0.05).The ratios of centripetal enhancement(76.60%),inhomogeneous enhancement(68.09%),low/equal enhancement(87.23%),early obvious discharge(63.83%),unclear boundary after enhancement(91.49%),and fast discharge(59.57%)in the malignant nodule group were higher than that of the benign nodule group,and the differences were statistically significant(x2=33.409,26.695,9.079,12.853,17.798,12.649,P＜0.05),respectively.The intensity and time to peak of the malignant nodule group were respectively lower and long than these of the benign nodule group,and the differences were statistically significant(t=-12.381,4.958,P＜0.05).However,the mean passage time of the two groups was not statistically significant(P＞0.05).The maximum value,minimum value and mean value of Young's modulus,the maximum value of vertical section,mean value of vertical section,maximum value of cross section,mean value of cross section in the malignant nodule group were all higher than those in the benign nodule group,and the differences were statistically significant(t=13.997,9.100,12.191,7.616,6.310,4.679,5.355,P＜0.05).The result of receiver operating characteristic(ROC)curve analysis indicated that both ultrasonography parameters and shear wave elastography(SWE)parameters had higher diagnostic value for the benign and malignant nature of thyroid nodules in patients.The area under curve(AUC)values of intensity to peak,time to peak,and the maximum value,minimum value and mean value of Young's modulus,and the maximum value of vertical section,mean value of vertical section,maximum value of cross section,mean value of cross section were respectively 0.976,0.759,0.974,0.837,0.989,0.872,0.805,0.732 and 0.749.Conclusion:Multimodal ultrasound elastography parameters has significant application value in differential diagnosis for thyroid nodules in patients with diffuse thyroid lesions.In these parameters,the diagnostic AUC values of intensity to peak,time to peak,and the maximum value and mean value of Young's modulus are higher for malignant thyroid nodules of patients,which have higher diagnostic efficiency.It can effectively help clinical doctor to accurately identify the benign and malignant nodules for patients with diffuse thyroid lesions.

Objective:To explore the application value of Superb microvascular imaging(SMI)technique in diagnosing diffuse thyroid disease with thyroid nodules,and the assessment for treatment efficacy.Methods:A total of 100 patients with diffuse thyroid disease with thyroid nodules(132 nodules),who were treated at the Baoji Hospital Affiliated to Xi'an Medical University from March 2020 to November 2024,were selected.The dual examination of SMI and conventional Color Doppler Flow Imaging(CDFI)were conducted on them.The nature of the nodules was confirmed by pathological examination.The diagnostic sensitivity,specificity and predictive value of SMI and CDFI were analyzed by using the receiver operating characteristic(ROC)curve.A series of conventional indicators,including blood flow volume,blood flow velocity,pattern of blood flow distribution,and vascular morphology,between the two imaging techniques were compared and analyzed.Results:In the 132 thyroid nodules that were detected by pathological examination,SMI identified 94 benign lesions(71.21%)and 38 malignant lesions(28.79%).The sensitivity and specificity of SMI were respectively 94.68%and 89.47%in diagnosing diffuse thyroid disease with thyroid nodules,both of them were higher than those(84.05%and 78.95%)of CDFI,and the sensitivity of SMI diagnosis was significantly higher than that of CDFI diagnosis,and the difference was statistically significant(x2=5.595,P<0.05).The nodule size as SMI diagnosis was(14.62±2.36)mm,which was significantly smaller than(16.35±4.45)mm as CDFI diagnosis,and the difference was statistically significant(x2=3.330,P<0.05).Blood flow velocity and blood flow volume of SMI diagnosis were significantly higher than those of CDFI diagnosis,and the differences were statistically significant(t=5.718,6.567,P<0.05).The detection rates of blood flow distribution mode and vascular morphology of SMI mode were significantly higher than those of CDFI mode,and the differences were statistically significant(x2=9.192,4.776,P<0.05).However,there were not statistically significant differences were observed between the two imaging techniques in terms of the shape,echo type and internal calcification of nodules(P>0.05).Conclusion:SMI technique has a significant advantage in diagnosis and assessment for diffuse thyroid disease with thyroid nodules.It can more accurately assess the hemodynamic changes of the nodules,and provide more reliable diagnostic information for clinical treatment.

Chemiluminescence,as a self-luminous phenomenon that does not require light,heat,acoustic,electric and magnetic excitation,has been widely used in the fields of analytical chemistry,cold light source and bio-imaging because of its advantages including high sensitivity,wide linear range,simple equipment and fast detection speed compared with other analytical techniques.Carbon dots(CDs)are a class of nanomaterials with excellent photoluminescence properties and high biocompatibility.CDs are stable,easy to prepare and abundant in types,and researchers have introduced many types of CDs into different chemiluminescence systems.In this paper,the applications of CDs in common chemiluminescence systems and the possible mechanisms of action were discussed,and the research progresses on the application of CDs in different chemiluminescence detection fields in recent years were summarized.Finally,the development trend of CDs in chemiluminescence was analyzed.

Integrated metabolomic and lipidomic profiling,utilizing liquid chromatography coupled with high-resolution mass spectrometry(LC-HRMS),has emerged as a pivotal strategy for biomarker discovery.However,the inherent polarity disparity between metabolites and lipids complicates simultaneous analysis.To address this,a dual-stationary phase polarity-extended liquid chromatography(PELC)system was developed,which surpassed conventional one-dimensional LC(1D-LC)by enabling comprehensive coverage of both polar and non-polar compounds within a single injection.This system enhanced chromatographic resolution,peak capacity,and throughput while minimizing analytical variability.Extracellular vesicles(EVs),lipid bilayer-enclosed nanoparticles ubiquitously present in biofluids,had gained prominence as reservoirs of cancer biomarkers due to their cargo stability and pathophysiological relevance.Herein,the application of PELC-HRMS for concurrent metabolome-lipidome profiling in EVs was pioneered.A total of 193 metabolites were identified using this technique coupled with MS-DIAL software and Human Metabolome Database.Subsequently,this technique was employed to explore potential biomarkers for prostate cancer(PCa).Multivariate analysis identified 17 differentially abundant metabolites in PCa,implicating dysregulated pathways including purine metabolism,starch and sucrose metabolism,galactose metabolism,cysteine and methionine metabolism,and biosynthesis of unsaturated fatty acids.Notably,creatine(AUC=0.92)and DG 42:5(AUC=0.80)demonstrated robust diagnostic efficacy,attributable to their broad polarity ranges and EV-specific enrichment.This study established PELC as a high-fidelity platform for multi-omics integration in complex biospecimens,advancing mechanistic insights into metabolic rewiring and disease pathophysiology.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.