Pain modulation encompasses a complex neurobiological process, in which the lateral habenula (LHb) plays a crucial role in integrating, regulating and modulating pain signals. It is also involved in pain-related memory functions associated with perception, transmission and regulation of pain. Furthermore, the LHb collaborates with structures such as the spinal dorsal horn, forebrain, and amygdala to form an essential neural circuit that contributes to sensitization, development of tolerance, and adaptation processes related to pain. However, there remains limited understanding regarding the specific roles and interactions among different neuron subtypes within the LHb concerning pain regulation. Additionally, further investigation is warranted to explore functional changes and plasticity within both the LHb and its associated neural circuits in chronic pain models. Future research endeavors should utilize advanced neuroimaging techniques alongside optogenetics and gene editing technologies to elucidate intricate neural circuits, cellular architecture, and molecular mechanisms governing LHb function in pain regulation. In conclusion, this paper aims to comprehensively review existing literature on the involvement of the LHb and its neural circuits in modulating pain, thereby enhancing our understanding of their neurobiological mechanisms while providing novel targets for precise therapeutic strategies aimed at alleviating pain.

Pain modulation encompasses a complex neurobiological process, in which the lateral habenula (LHb) plays a crucial role in integrating, regulating and modulating pain signals. It is also involved in pain-related memory functions associated with perception, transmission and regulation of pain. Furthermore, the LHb collaborates with structures such as the spinal dorsal horn, forebrain, and amygdala to form an essential neural circuit that contributes to sensitization, development of tolerance, and adaptation processes related to pain. However, there remains limited understanding regarding the specific roles and interactions among different neuron subtypes within the LHb concerning pain regulation. Additionally, further investigation is warranted to explore functional changes and plasticity within both the LHb and its associated neural circuits in chronic pain models. Future research endeavors should utilize advanced neuroimaging techniques alongside optogenetics and gene editing technologies to elucidate intricate neural circuits, cellular architecture, and molecular mechanisms governing LHb function in pain regulation. In conclusion, this paper aims to comprehensively review existing literature on the involvement of the LHb and its neural circuits in modulating pain, thereby enhancing our understanding of their neurobiological mechanisms while providing novel targets for precise therapeutic strategies aimed at alleviating pain.

Objective To investigate the changes in interleukin-34 (IL-34)levels in serum and bronchoalveolar lavage fluid (BALF) of patients with severe pneumonia and their prognostic value. Methods A total of 66 patients with severe pneumonia (severe pneumonia group), 35 patients with non-severe pneumonia (non-severe pneumonia group), and 27 healthy adults (control group) were enrolled. The severe pneumonia group was further divided into survival group of 38 patients and non-survival group of 28 patients based on 28-day survival. Clinical data of all subjects were analyzed. Receiver operating characteristic (ROC) curves were plotted to assess the predictive power of serum IL-34 and relative IL-34 gene expression in BALF for 28-day mortality in patients with severe pneumonia, as well as the predictive power of serum IL-34 for severe pneumonia. Kaplan-Meier survival curves were plotted, and the Log-rank test was used to compare cumulative survival rates. Cox regression analysis was conducted to explore risk factors for 28-day mortality in patients with severe pneumonia. Pearson correlation analysis was used to assess the correlation between serum IL-34 levels and relative IL-34 gene expression in BALF of patients with severe pneumonia. Results Serum IL-34 levels were higher in the severe pneumonia group than those in the non-severe pneumonia group, and were higher in the non-severe pneumonia group than in the control group (P < 0.05). Serum IL-34 levels and relative IL-34 gene expression in BALF were higher in the non-survival group than in the survival group (P < 0.05). ROC curve analysis showed that the areas under the curve for predicting 28-day mortality in patients with severe pneumonia were 0.908 for serum IL-34 levels and 0.878 for relative IL-34 gene expression in BALF. The optimal cutoff value for serum IL-34 levels in predicting severe pneumonia was 129.9 pg/mL. Multivariate Cox regression analysis showed that increased serum IL-34 levels and increased relative IL-34 gene expression in BALF were independent risk factors for 28-day mortality in patients with severe pneumonia (P < 0.05). The Kaplan-Meier survival analysis results indicate that, with a cutoff value of 129.9 pg/mL, patients with severe pneumonia who had high serum levels of IL-34 exhibited a lower cumulative survival rate compared to those with low IL-34 level(Log-rank P < 0.001). Conclusion Serum IL-34 levels are significantly increased in patients with severe pneumonia, and relative IL-34 gene expression in BALF is positively correlated with serum IL-34 levels. Both can be used as indicators for predicting the prognosis of 28-day mortality in patients with severe pneumonia.

【Objective】 To evaluate the safety and effectiveness of Perioperative Transfusion Trigger Score (POTTS) in guiding surgical patients blood transfusion intraoperatively and postoperatively. 【Methods】 A total of 900 patients(perioperative Hb 60~100 g/L) from December 2017 to March 2021 were collected, including 251 males and 649 females, with ASA grading Ⅰ~Ⅳ, and randomly divided into experimental group and controls. In the experimental group, the allogeneic RBC transfusion trigger(Hb threshold) and transfusion units in anemia patients was determined by POTTS. While those in the controls were decided by physicians according to current guidelines concerning transfusion. The proportion and units of allogeneic RBC transfusion, the incidence of postoperative complications, the mortality of hospitalization and discharge for 4 weeks, Hb value, healing of surgical incision, ICU admission rate and ICU length of stay, length of hospitalization, etc were recorded. 【Results】 The proportion of allogeneic RBC transfusion in the experimental group(35.3%)were less than the controls(42.2%)(P<0.05). The units of allogeneic RBC transfused, incidence of postoperative complications and mortality in hospital and 4 weeks after surgery, healing of surgical incision (grade A/ grade B/ grade C), the Hb level 24 h after surgery and at discharge, the ICU admission rate and ICU length of stay, length of hospitalization were not significantly different between the groups. 【Conclusion】 The peri-operative allogeneic red blood cells transfusion guided by POTTS can reduce the proportion of allogeneic RBC transfusion, and is safe and effective.

Objective To investigate the effect of low level laser treatment combined with periodontal therapy on interleukin-8 (IL-8), basic fibrobast growth factor (b-FGF) and interleukin-1β (IL-1β) level in gingival crevicular fluid on peri-implantitis , so as to evaluate the curative effect . Methods A total of 38 patients (50 implants) with early peri-implantitis were randomly divided into experimental group and control group, with 19 patients (25 implants) in each group. The patients in the experimental group were underwent level laser treatment combined with periodontal initial, and in the control group were only treated with periodontal initial. The implant gingival crevicular fluid was collected before the treatment (baseline), and 4 weeks and 12 weeks after the treatment. The levels of IL-8, b-FGF and IL-1βwere determined by enzyme-linked immunosorbent assay (ELISA). The SPSS19.0 software was used for the statistically analysis. Results The levels of IL-8, b-FGF and IL-1β of the experimental group and the control group were both improved at 4 weeks and 12 weeks after treatment comparing with that at the baseline, and the differences were statistically significant (all P<0.01). The differences in IL-8 and b-FGF levels in the gingival crevicular fluid were statistically significant at different time points for each group (all P<0.01). For the two groups, the differences in IL-1βwere not statistically significant at 4 weeks and 12 weeks after the treatment (all P>0.05). The levels of IL-8 and IL-1βof the experimental group were lower than those of the control group at 4 weeks after treatment, and the differences were statistically significant (all P<0.05). The level of b-FGF of the experimental group was higher than that of the control group at 12 weeks after the treatment, and the difference was statistically significant (P<0.05). Conclusions Low-energy laser can affect the level of cytokines in the gingival crevicular fluid on peri-implantitis. The combination of low level laser treatment and periodontal initial therapy is effective for treating peri-implantitis.

Objective To study the effectiveness of basic therapy combined with low energy laser irradiation therapy to the patients with peri-implantitis, and to clarify the effect of laser irradiation in the treatment process. Methods A total of 38 patients (50 implants) who were diagnosed with early peri-implantitis from September 2017 to March 2018 in the Department of Stomatology, Tianjin First Central Hospital were randomly divided into the laser treatment group (n=25) and the conventional treatment group (n=25). The control group received basic treatment, and the laser treatment group received basic treatment combined with low energy laser irradiation (808 nm GaAlAs semiconductor continuous laser, average output power 80 mw, energy density 4 J/cm2, facula area 0.28 cm2, 15 seconds irradiation for each implant bag). The GIgingival index (GI), plaque index (PLI), sulcus bleeding index (SBI) and probe depth (PD) were examined before and 2 weeks and 8 weeks after the treatment. Results At 2 weeks and 8 weeks after the treatments, the indexes of the two groups were both improved compared with the baseline, and the differences were statistically significant (all P<0.05). Compared with the control group, the GI was significantly decreased (P=0.018) at 2 weeks after the treatment, and the GI, PD, and SBI were significantly decreased at 8 weeks after the treatment (P<0.001, P=0.018, and P<0.001, respectively). Conclusions At an energy density of 4 J/cm2, low energy laser irradiation at a wavelength of 808 nm can accelerate tissue healing of peri-implant inflammation after basic treatments.

Objective To compare the Barcelona clinic liver cancer staging classification (BCLC), the Japan integrated staging score (JIS), the cancer of the liver Italian program score (CLIP) and Chinese staging system in terms of their ability to predict outcomes and to guide option of therapy in patients with hepatocellular carcinoma (HCC) in China.Methods Clinical data of 861 HCC patients from Zhongshan Hospital between 2001 and 2002 were retrospectively analyzed. Patients were classified acccording to different staging systems. Survival for patients in different stages and the effects of therapeutic methods on survival time were compared. Results BCLC, JIS and Chinese staging system showed the ability in predicting survival for patients in different staging. CLIP failed to show significant difference in survival rates for each subgroup. There was no significant difference in survival rate between surgery and transarterial chemoembolization (TACE)/transarterial embolization (TAE) for patients classified as BCLC stage C, CLIP scores more than 3 or Chinese stage Ⅲ a.The survival rate, however, was higher in patients received operation than those received TACE/TAE if they were classified as earlier stages. Conclusions The BCLC, JIS and Chinese staging systems show prospective ability for Chinese HCC patients in prediction outcomes, whereas the BCLC and the Chinese staging systems are better at both predicting outcomes and guiding the option of treatment.