OBJECTIVE To study the ameliorative effect and mechanism of Forsythia suspensa-Lonicera japonica herb pair on acute lung injury （ALI） based on serum exosomal microRNA （miRNA）. METHODS The rats were randomly divided into a blank group （normal saline）， model group （nomal saline）， and F. suspensa-L. japonica herb pair group （2.55 g/kg）， with 10 rats in each group. Except for the blank group， the other groups were used to establish an ALI model by intratracheal dripping of 5 mg/ mL lipopolysaccharides. After modeling， each group was given relevant medicine/normal saline intragastrically， once a day， for 3 consecutive days. After the last medication， the pathological status of lung tissue was observed； lung wet-to-dry weight ratio and leukocyte counts in bronchoalveolar lavage fluid （BALF） were determined. The levels of inflammatory factors [tumor necrosis factor-α（TNF-α）， interleukin-1β （IL-1β）， IL-10] in BALF were determined. Exosomes were isolated from rat serum， and high- throughput sequencing technology was employed to screen differentially expressed miRNA within the exosomes， followed by Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analysis. Based on the screened differentially expressed miRNA and the enriched KEGG pathways， in vitro cellular experiments were conducted for validation. RESULTS The animal experimental results demonstrated that after intervention with the F. suspensa-L. japonica herb pair， the wet-to-dry weight ratio， the number of leukocytes in BALF， as well as the levels of TNF-α and IL-1β in BALF of ALI rats were all significantly reduced （P＜0.01）， while the level of IL-10 was significantly increased （P＜0.01）. The results of high-throughput sequencing experiments revealed that the F. suspensa-L. japonica herb pair could significantly up-regulate the expressions of miR-345-3p， miR-194-5p， miR-653-5p， and others in exosomes. Among them， the KEGG pathways involved in the target genes of differentially expressed miRNA included the hypoxia-inducible factor-1（HIF-1） signaling pathway， among others. The results of cellular E-mail：huang.haiying@126.com validation experiments showed that overexpressed miR-345-3p could significantly elevate the level of IL-10 in the cell supernatant （P＜0.01）， while significantly reducing the levels of TNF-α and IL-1β in the cell supernatant， as well as the mRNA and protein expression levels of protein kinase B1， phosphatidylinositol 3- kinase， and HIF-1α （P＜0.01）. CONCLUSIONS F. suspensa-L. japonica herb pair can alleviate inflammatory responses and thereby exert a therapeutic effect in improving ALI by up-regulating the expression of miR-345-3p in serum exosomes and inhibiting the activity of the HIF-1 signaling pathway.

Objective To analyze the status quo and identification efficiency of metabolic-associated fatty liver disease (MAFLD) in patients with chronic hepatitis C (CHC). Methods A total of 407 patients with CHC who were admitted to the hospital between January 2022 and January 2025 were collected as study subjects. According to whether MAFLD was newly diagnosed during the study period, all enrolled patients were classified into two groups, including MAFLD group (CHC with MAFLD, n=143) and CHC group (CHC, n=264). The general data [gender, age, place of residence, body mass index (BMI), systolic blood pressure, diastolic blood pressure, course of chronic hepatitis C (CHC), history of diabetes mellitus], liver function indicators [alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), γ-glutamyl transferase (GGT)], glucose metabolism indicators [fasting blood glucose (FBG), fasting insulin (FINS), hemoglobin A1c (HbA1c), homeostasis model assessment of insulin resistance (HOMA-IR)], lipid metabolism indicators [total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C)], serum specific protein markers {serum 25-hydroxyvitamin D [25(OH)D], adipocyte fatty acid binding protein (A-FABP), retinol binding protein 4 (RBP4), sterol regulatory element binding protein-1c (SREBP-1c)}were compared between both groups. Binary logistic regression analysis was performed for multivariate regression analysis. ROC curve was utilized to evaluate the identification value. Results The levels of ALT, AST, ALP, GGT, FBG, FINS, HbA1c, TC, TG, LDL-C, A-FABP, RBP4 and SREBP-1c in the MAFLD group were higher than those in the CHC group (P<0.05) while the levels of HDL-C and 25(OH)D were lower compared to the CHC group (P<0.05). Multivariate logistic regression analysis results suggested that TG, 25(OH)D, RBP4, HbA1c and HOMA-IR were independent related factors influencing MAFLD occurrence (P<0.05). ROC curve analysis results revealed that the identification efficiency of combined prediction (AUC=0.854, 95% CI : 0.812-0.887)was better than that of TG (AUC=0.653, 95% CI: 0.607-0.720), 25(OH)D (AUC=0.685, 95% CI: 0.607-0.715), RBP4 (AUC=0.649, 95%CI: 0.633-0.741), HbA1c (AUC=0.718, 95% CI: 0.657-0.755) or HOMA-IR (AUC=0.726, 95% CI: 0.654-0.757), and combined prediction had the best identification efficiency (P<0.05). Conclusion CHC patients with MAFLD have significant metabolic disorders and changes in specific protein markers. TG, 25(OH)D, RBP4, HbA1c and HOMA-IR are independent related factors, and combined prediction model of multiple indicators exhibits good identification efficiency.

Objective To construct a combined model integrating ultrasonic features and radiomics derived from ultrasound images,and to evaluate its diagnostic performance in re-assessing the benign or malignant nature of Bethesda Ⅲ nodules.Methods A retrospective study was carried out on 442 patients with thyroid nodules classified as Bethesda Ⅲ after fine-needle aspiration biopsy(FNAB)between January 2019 and September 2024.All patients had undergone surgical pathology.The patients were randomly allocated into a training set and a testing set at a ratio of 7∶3.Relevant clinical characteristics were gathered,and regions of interest(ROI)were outlined on the most suspicious slice of the lesion prior to biopsy.Ultrasound radiomics features were extracted,key radiomics features were selected,and radiomics scores(Rad-score)were computed.The ultrasound model,radiomics model,and combined model were constructed.Subsequently,the diagnostic efficacy and clinical application value of each model were evaluated using the area under the receiver operating characteristic curve(AUC)and decision curve analysis(DCA).Results Univariate analysis and multivariate logistic regression analysis findings indicated that microcalci-fication,irregular margin,and Rad-score were independent risk factors for the malignant transformation of BethesdaⅢ nodules.In the testing set,the AUC values of the ultrasound model,radiomics model,and combined model were 0.76,0.71,and 0.81,respectively.The calibration curve of the combined model revealed a good consistency between the predicted values and the actual outcomes.The DCA of the testing set demonstrated that the combined model exhibited high clinical utility.Conclusion The combined model,established based on ultrasonic features and ultrasound radiomics,provides a higher predictive value for evaluating the malignancy risk of Bethesda Ⅲ nodules.

Objective:To analyze the changes in the prevalence characteristics of multimorbidity among adolescents aged 13-18 in Inner Mongolia Autonomous Region from 2019 to 2022 and to explore the association between multimorbidity and moderate to high-intensity physical activity among them.Methods:A stratified random cluster sampling method was used to select students aged 13-18 in Inner Mongolia Autonomous Region every September from 2019 to 2022. Physical examinations, demographic characteristics, and depression-related surveys were conducted to analyze the multimorbidity of overweight, obesity, high blood pressure, myopia, spinal curvature abnormality, and depression. A logistic regression model was used to analyze the association between multimorbidity and moderate to high-intensity physical activity.Results:From 2019 to 2022, 70 972, 62 923, 80 254, and 78 288 study subjects were included, with the rates of multimorbidity being 56.4%, 55.4%, 57.2%, and 55.8%, respectively. The rates of multimorbidity remained relatively stable from 2019 to 2022 ( χ2=0.06, P=0.950). The incidence of multimorbidity among girls was significantly higher than that among boys ( P<0.001). The incidence of multimorbidity among urban students was significantly higher than that among suburban students ( P<0.001). The incidence of multimorbidity among high school students was higher than that among middle school students ( P<0.001). The top three multimorbidity combinations were myopia and overweight/obesity (26.4%), myopia and high blood pressure (24.4%), and myopia and depression (19.8%), while the least common combination was depression and spinal curvature abnormality (1.1%). The multimorbidity patterns showed no significant differences between years ( χ2=0.03, P=0.999). The multimorbidity status was significantly associated with the status of meeting the standard of moderate to high-intensity physical activity ( OR=0.83, 95% CI: 0.80-0.86). The association was stronger in boys ( OR=0.77, 95% CI: 0.73-0.81) compared with girls ( OR=0.90, 95% CI: 0.85-0.96), with a significant interaction term ( P<0.001). Conclusion:From 2019 to 2022, the incidence of multimorbidity among adolescents aged 13 to 18 in Inner Mongolia Autonomous Region is relatively high, mainly due to the co-occurrence of myopia and other health problems. Adequate physical activity is an important factor in reducing multimorbidity.

Objective To construct a combined model integrating ultrasonic features and radiomics derived from ultrasound images,and to evaluate its diagnostic performance in re-assessing the benign or malignant nature of Bethesda Ⅲ nodules.Methods A retrospective study was carried out on 442 patients with thyroid nodules classified as Bethesda Ⅲ after fine-needle aspiration biopsy(FNAB)between January 2019 and September 2024.All patients had undergone surgical pathology.The patients were randomly allocated into a training set and a testing set at a ratio of 7∶3.Relevant clinical characteristics were gathered,and regions of interest(ROI)were outlined on the most suspicious slice of the lesion prior to biopsy.Ultrasound radiomics features were extracted,key radiomics features were selected,and radiomics scores(Rad-score)were computed.The ultrasound model,radiomics model,and combined model were constructed.Subsequently,the diagnostic efficacy and clinical application value of each model were evaluated using the area under the receiver operating characteristic curve(AUC)and decision curve analysis(DCA).Results Univariate analysis and multivariate logistic regression analysis findings indicated that microcalci-fication,irregular margin,and Rad-score were independent risk factors for the malignant transformation of BethesdaⅢ nodules.In the testing set,the AUC values of the ultrasound model,radiomics model,and combined model were 0.76,0.71,and 0.81,respectively.The calibration curve of the combined model revealed a good consistency between the predicted values and the actual outcomes.The DCA of the testing set demonstrated that the combined model exhibited high clinical utility.Conclusion The combined model,established based on ultrasonic features and ultrasound radiomics,provides a higher predictive value for evaluating the malignancy risk of Bethesda Ⅲ nodules.

Extranodal NK/T-cell lymphoma (ENKTL) is an Epstein-Barr virus (EBV)-associated extranodal lymphoma derived from NK or T cells. It exhibits strong geographical and ethnic predispositions and is relatively prevalent in China, making it one of the common lymphoma types in our country. Most cases of this tumor exhibit aggressive biological behavior, and timely, accurate pathological diagnosis is crucial for improving cure rates and patient prognosis. However, the tumor has a broad histopathological spectrum, diverse morphological features, and lacks specific immunomarkers, which can lead to misdiagnosis or underdiagnosis in some cases. Additionally, it is necessary to integrate clinical, imaging, and laboratory findings to differentiate ENKTL from a range of EBV-positive lymphoproliferative disorders. In recent years, with the continuous advancement of molecular biology technologies, significant progress has been made in the molecular genetic research of ENKTL. This article aims to summarize the latest advances in the pathological research of ENKTL, emphasizing the diagnostic challenges, pitfalls, and strategies to avoid them, thereby enhancing pathologists′ understanding of this tumor and enabling precise diagnostic stratification.

Objective:To evaluate the effects of different volumes of ropivacaine for iliopsoas muscle plane block on quadriceps strength in patients undergoing hip arthroplasty.Methods:In this prospective study, 75 patients of either sex, aged 40-80 yr, with a body mass index of 18.5-30.0 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ, undergoing elective hip arthroplasty from June to December 2023 at Baoding First Central Hospital, were randomized into 3 groups ( n=25 each) by using a computer-generated randomization sequence: ropivacaine 5 ml group (group Ⅰ), ropivacaine 10 ml group (group Ⅱ), and ropivacaine 15 ml group (group Ⅲ). Before induction of anesthesia, iliopsoas muscle plane block was performed with 0.5% ropivacaine 5, 10 and 15 ml in Ⅰ, Ⅱ and Ⅲ groups, respectively. The lateral femoral cutaneous nerve block was carried out using 0.5% ropivacaine 5 ml in all the three groups. The quadriceps muscle strength and status of quadriceps motor block in the affected limb were assessed on admission to postanesthesia care unit (PACU) and at 2, 4, 6, 24 and 48 h after surgery. The consumption of dezocine, score for patient′s satisfaction with analgesia, and occurrence of complications were recorded. Results:Compared with group Ⅰ, the quadriceps muscle strength scores were significantly decreased on admission to PACU and at 2, 4 and 6 h postoperatively in group Ⅲ, the rate of quadriceps motor block was significantly increased on admission to PACU in group Ⅱ, and the rate of quadriceps motor block was significantly increased on admission to PACU and at 2 and 4 h postoperatively in group Ⅲ ( P<0.05), and the consumption of dezocine was significantly decreased in group Ⅱ and group Ⅲ ( P<0.05). Conclusions:The recommended volume of ropivacaine for iliopsoas plane block is 10 ml in patients undergoing hip arthroplasty.

Objective:To analyze the changes in the prevalence characteristics of multimorbidity among adolescents aged 13-18 in Inner Mongolia Autonomous Region from 2019 to 2022 and to explore the association between multimorbidity and moderate to high-intensity physical activity among them.Methods:A stratified random cluster sampling method was used to select students aged 13-18 in Inner Mongolia Autonomous Region every September from 2019 to 2022. Physical examinations, demographic characteristics, and depression-related surveys were conducted to analyze the multimorbidity of overweight, obesity, high blood pressure, myopia, spinal curvature abnormality, and depression. A logistic regression model was used to analyze the association between multimorbidity and moderate to high-intensity physical activity.Results:From 2019 to 2022, 70 972, 62 923, 80 254, and 78 288 study subjects were included, with the rates of multimorbidity being 56.4%, 55.4%, 57.2%, and 55.8%, respectively. The rates of multimorbidity remained relatively stable from 2019 to 2022 ( χ2=0.06, P=0.950). The incidence of multimorbidity among girls was significantly higher than that among boys ( P<0.001). The incidence of multimorbidity among urban students was significantly higher than that among suburban students ( P<0.001). The incidence of multimorbidity among high school students was higher than that among middle school students ( P<0.001). The top three multimorbidity combinations were myopia and overweight/obesity (26.4%), myopia and high blood pressure (24.4%), and myopia and depression (19.8%), while the least common combination was depression and spinal curvature abnormality (1.1%). The multimorbidity patterns showed no significant differences between years ( χ2=0.03, P=0.999). The multimorbidity status was significantly associated with the status of meeting the standard of moderate to high-intensity physical activity ( OR=0.83, 95% CI: 0.80-0.86). The association was stronger in boys ( OR=0.77, 95% CI: 0.73-0.81) compared with girls ( OR=0.90, 95% CI: 0.85-0.96), with a significant interaction term ( P<0.001). Conclusion:From 2019 to 2022, the incidence of multimorbidity among adolescents aged 13 to 18 in Inner Mongolia Autonomous Region is relatively high, mainly due to the co-occurrence of myopia and other health problems. Adequate physical activity is an important factor in reducing multimorbidity.

In the special periods of puberty,menstruation,pregnancy,postpartum,and perimenopause of the female life,the drastic changes in qi and blood of the women cause the redistribution of qi,blood,yin and yang in those periods,which easily leads to various disordered states of disharmony between nutrient qi and defensive qi,disharmony between qi and blood,and imbalance of yin and yang.By analyzing the mechanism of the disharmony between nutrient qi and defensive qi in the special periods of puberty,menstruation,pregnancy,postpartum,and perimenopause of the female life,this paper proposes the approach of harmonizing nutrient qi and defensive qi to treat menstrual disorders,leukorrheal disease,gravid trouble,and parturition problems.Moreover,It is recommended that Guizhi Tang(Cinnamomi Ramulus Decoction),the chief of ZHANG Zhong-Jing's prescriptions and having the actions of releasing muscles and harmonizing nutrient qi and defensive qi,and activiting qi and harmonizing yin and yang,can be used to treat gynecological diseases through the modification.The utilization of Guizhi Tang for the treatment of gynecological diseases at various periods of women's lives will expand the application of classical prescriptions in treating gynecological diseases.

Objective To investigate the bidirectional causal relationship between endometriosis and thyroid cancer using bidirectional two-sample Mendelian randomization(MR).Methods Ge-nome-wide association study(GWAS)data for endometriosis were obtained from the FinnGen R11 database,and GWAS data for thyroid cancer were sourced from the European Bioinformatics Institute(EMBL-EBI).Single nucleotide polymorphisms(SNPs)that met the requirements were selected as instrumental variables.The inverse variance weighted(IVW)method was employed as the primary analytical approach,supplemented by MR-Egger regression,weighted median method,simple model,and weighted model results.Cochran's Q test,MR-Egger regression intercept analysis,and the leave-one-out method were used to assess the robustness of the results.Results Ultimately,25 SNPs high-ly associated with endometriosis and 3 SNPs highly associated with thyroid cancer were included in this study.The IVW analysis results of the forward MR analysis indicated no significant causal rela-tionship between endometriosis and the risk of thyroid cancer(P=0.50,OR=1.06,95％CI:0.88 to 1.29).This result was also supported by MR-Egger regression,simple model,weighted model,and weighted median analyses(P＞0.05).The IVW analysis results of the reverse MR analysis similarly showed no significant causal relationship between thyroid cancer and the risk of endometrio-sis(P=0.09,OR=1.03,95％CI,0.99 to 1.06).The findings from MR-Egger regression,sim-ple model,weighted model,and weighted median analyses all supported this conclusion(P＞0.05).Conclusion The MR analysis doesn't show a significant bidirectional causal relationship between endometriosis and thyroid cancer.