Objective To investigate the relationship between symptom burden and nutritional status under Traditional Chinese Medicine (TCM) constitution classification in patients undergoing chemotherapy. Methods Data on the physical constitution, symptom burden, and nutritional status of 640 patients with malignant tumors within the 21st–28th days of chemotherapy treatment were collected and analyzed. Results Symptom burden was found to have a positive correlation with nutritional risk and TCM bias (except for idiosyncrasies), suggesting that constitution bias may be an important internal factor for the aggravation of clinical symptoms and malnutrition in patients with cancer. Conclusion The relationship between symptom burden and nutritional status in chemotherapy under the guidance of TCM constitution can be studied to predict the nutritional status and symptom burden of patients after chemotherapy to guide the symptom and nutritional management of patients with cancer in the chemotherapy stage.

Objective To explore the research hotspots and development trends in the field of cancer treatment in the past decade. Methods The CNKI and Web of Science Core Collection databases were searched for Chinese and English articles related to cancer treatment published over the last 10 years. Bibliometric research methods were employed, including keyword cluster analysis of published literature. Results A total of 45 455 Chinese articles and 866 958 English articles were retrieved. Combining the visualization analysis results and the current research dilemma of tumor treatment revealed that the current research hotspots of tumor treatment domestically and internationally can primarily focus on four key areas. In the realm of targeted therapy, efforts are directed towards the discovery of new drug targets, overcoming resistance to targeted therapy, and the development of monoclonal antibodies and antibody–drug conjugates. In the field of immunotherapy, the emphasis lies in enhancing the response rate to immune checkpoint inhibitors, determining the mechanisms behind resistance to immunotherapy, and improving the safety of treatment. The research in traditional Chinese medicine (TCM) covers evidence-based evaluation studies on TCM treatment, the identification of populations that can gain the most benefit from TCM, and strategies for improving the quality of life. In the area of novel drug development, cutting-edge technologies, such as organoid-based screening for anticancer drugs, synthetic biology, and artificial intelligence, are under investigation. Conclusion New targeted drugs, immune efficacy improvement, multidisciplinary integration, nano-delivery, and TCM innovation are the key research directions in the field of tumor therapy in the future.

OBJECTIVES: To elucidate the underlying mechanisms of macrophage-mediated inflammation and tissue injury in diabetic foot ulcer (DFU). METHODS: Skin tissue samples were collected from patients with DFU and with non-DFU. A total of 79 272 high-quality cell transcriptomes were obtained using single-cell RNA sequencing. An unbiased clustering approach was employed to identify cell subpopulations. Seurat functions were used to identify differentially expressed genes between DFU and non-DFU groups, and gene ontology (GO) enrichment analysis was used to reveal gene function. Furthermore, cell-cell communication network construction and ligand-receptor interaction analysis were performed to reveal the mechanisms underlying cellular interactions and signaling regulation in the DFU microenvironment from multiple perspectives. RESULTS: The results revealed a significant expansion of myeloid cells in DFU tissues, alongside a marked reduction in structural cells such as endothelial cells, epithelial cells, and smooth muscle cells. Major cell types underwent functional reprogramming, characterized by immune activation and impaired tissue remodeling. Specifically, macrophages in DFU skin tissues exhibited a shift toward a pro-inflammatory M1 phenotype, with upregulation of genes associated with inflammation and oxidative stress. Cell communication analysis further demonstrated that M1 macrophages served as both primary signal receivers and influencers in the COMPLEMENT pathway mediated communication network, and as key signal senders and mediators in the secreted phosphoprotein 1 (SPP1) pathway mediated communication network, actively shaping the inflammatory microenvironment. Key ligand-receptor interactions driving macrophage signaling were identified, including C3-(ITGAM+ITGB2) and SPP1-CD44. CONCLUSIONS This study establishes a comprehensive single-cell atlas of DFU, revealing the role of macrophage-driven cellular networks in chronic inflammation and impaired healing. These findings may offer potential novel therapeutic targets for DFU treatment.
Humans ; Macrophages/immunology* ; Diabetic Foot/pathology* ; Single-Cell Analysis ; Transcriptome ; Gene Expression Profiling ; Inflammation ; Skin ; Cell Communication ; Signal Transduction ; Cellular Reprogramming

BACKGROUND:Traditional Chinese medicine has unique advantages in preventing and treating spleen-deficiency and hyperlipidemia.In basic studies,models of spleen-deficiency and hyperlipidemia are commonly found in rats,pigs,and other animals.This has limitations for medical research that can only use mouse models.It is urgent to establish and evaluate mouse models of spleen-deficiency and hyperlipidemia to support basic research on traditional Chinese medicine in preventing and treating spleen-deficiency and hyperlipidemia.OBJECTIVE:To establish a mouse model of spleen-deficiency hyperlipidemia.METHODS:Totally 24 C57BL/6J mice were randomly divided into normal group(n=12)and spleen-deficiency hyperlipemia group(n=12).Mice in normal group were fed basic diet.Mice in the spleen-deficiency hyperlipemia group were prepared with a diet disorder+fatigue internal injury+high-fat feeding method to establish a spleen-deficiency high-fat model.In the first 2 weeks,the mice were forced to swim to their endurance limit on a single day and were only fed cabbage,with free access to water.They were also gavaged with refined lard+high-fat feed on two-day intervals.After 2 weeks,the mice were fed a high-fat diet every day and the diet continued until 12 weeks.The mice were fed with a high-fat diet for 4 and 12 weeks,and their body weight,food intake,gripping strength,fecal water content,small intestinal charcoal propulsion rate,serum D-xylose and gastrin levels,spleen index and thymus index,blood lipid level,total body fat mass,body fat percentage,and liver lipid deposition were tested.RESULTS AND CONCLUSION:(1)Compared with the normal group,the body weight,fecal water content,total body fat mass,body fat percentage,triglyceride and total cholesterol levels of the mice in the spleen-deficiency hyperlipemia group fed with high-fat diet for 4 and 12 weeks were increased(P＜0.05);the daily food intake,gripping force,and D-xylose level of the mice fed with high-fat diet for 4 and 12 weeks were decreased(P＜0.05);the spleen index of the mice fed with high-fat diet for 4 weeks was increased(P＜0.05);the small intestinal carbon propulsion rate,gastrin level,spleen index,and thymus index of the mice fed with high-fat diet for 12 weeks were decreased(P＜0.05);the low-density lipoprotein cholesterol level of the mice fed with high-fat diet for 12 weeks was increased(P＜0.05).(2)The results of liver oil red O staining showed that the lipid deposition in the spleen-deficiency hyperlipemia group after 4 weeks of high-fat diet feeding was slightly more than that in the normal group,and the lipid deposition in the high-fat diet feeding for 12 weeks was significantly more than that in the normal group.(3)The results show that a stable spleen deficiency and hyperlipidemia mouse model can be prepared by the compound method of eating disorders,exhaustion,and high-fat feeding.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective To evaluate the relationship between systemic inflammation makers and bone mineral density(BMD)in male patients with type 2 diabetes(T2DM).Methods A total of 261 male patients with T2DM were selected and divided into three groups based on diagnostic criteria:the normal bone mass group(96 cases),the reduced bone mass group(111 cases)and the osteoporosis group(54 cases).Differences in systemic inflammation markers and bone metabolic markers were compared between the three groups.Multivariate ordered Logistic regression analysis was used to investigate factors influencing the progression from normal bone mass to osteoporosis in male patients with T2DM.Receiver operating characteristic(ROC)curves were used to evaluate the predictive value of inflammatory markers for osteoporosis in male patients with T2DM.Correlation analysis was conducted to investigate the correlation between inflammatory markers and BMD and bone turnover markers(BTM)in male patients with T2DM.Results Platelet count(PLT),platelet-to-lymphocyte ratio(PLR),systemic inflammatory index(SII)and neutrophil-to-lymphocyte ratio(NLR)were significantly higher in the osteoporosis group than those in the normal bone mass group(P＜0.05).Multivariate ordered Logistic regression analysis showed that PLR and SII were risk factors for the progression from normal bone mass to osteoporosis in male patients with T2DM(P＜0.05).The area under the ROC curve of PLR was 0.590,and the cut-off value was 96.67.The area under the curve of SII was 0.613,with a cut-off value of 307.9,and the area under the combined curve of the above two indicators was 0.612.In patients with osteoporosis and osteopenia,SII,PLR and PLT were negatively correlated with L1-4 BMD and left hip BMD(P＜0.05).SII was also negatively correlated with left femoral neck BMD(P＜0.05).Conclusion Inflammatory markers PLR and SII have predictive values for the progression from normal bone mass to bone loss and osteoporosis in male patients with T2DM.

Objective:To explore the association between macrosomia delivery history and adverse pregnancy outcomes in subsequent pregnancies under different stratification of gestational weight gain(GWG).Methods:A retrospective study was conducted on 500 multiparous women with a history of macrosomia delivery who gave birth at The Second Hospital of Jilin University from January 2020 to November 2023.Meanwhile,1500 multiparous women without a history of delivering macrosomic infants were selected as the control group through 1∶3 matc-hing based on age(±1 year).The differences in general characteristics,GWG,and pregnancy outcomes be-tween the two groups were compared.According to the appropriate GWG values recommended by Chinese health industry standards,pregnant women in both groups were classified into insufficient GWG,appropriate GWG,and excessive GWG.Multivariate Logistic regression analysis was used to compare the relationship be-tween a history of macrosomia delivery and adverse pregnancy outcomes under different GWG stratifications.Re-sults:The History of macrosomia group had significantly higher rates of excessive GWG(50.60%vs.48.13%),incidence of gestational diabetes mellitus(GDM)(23.40%vs.17.07%),rate of cesarean section(60.20%vs.45.33%),and rate of macrosomia(26.60%vs.7.87%)compared to the control group(P<0.05).Multivariate Logistic regression analysis showed that a history of macrosomia delivery was an independent risk factor for GDM,cesarean section,and macrosomia in subsequent pregnancies(aOR>1,P<0.05).Stratified analysis based on GWG revealed that,compared with the control group,regardless of the GWG status,the risk of cesare-an section and macrosomia was higher in women with a history of macrosomia delivery(aOR>1,P<0.05).Mo-reover,for those with a history of macrosomia delivery and excessive weight gain during pregnancy,the risk of preeclampsia(aOR 3.167,P<0.05)and GDM(aOR 1.661,P<0.05)was significantly increased.When the GWG was appropriate for pregnant women with a history of macrosomia delivery,there was no significant correla-tion between a history of macrosomia delivery and preeclampsia or GDM(P>0.05).Conclusions:A history of macrosomia delivery increased the risk of multiple adverse pregnancy outcomes,such as GDM,cesarean section,and macrosomia.For multiparous women at different GWG levels,the risk of cesarean section and macrosomia was significantly increased in those with a history of macrosomia delivery.When GWG was appropriate,a history of macrosomia delivery was not found to be an independent risk factor for preeclampsia and GDM.

Objective To evaluate the relationship between systemic inflammation makers and bone mineral density(BMD)in male patients with type 2 diabetes(T2DM).Methods A total of 261 male patients with T2DM were selected and divided into three groups based on diagnostic criteria:the normal bone mass group(96 cases),the reduced bone mass group(111 cases)and the osteoporosis group(54 cases).Differences in systemic inflammation markers and bone metabolic markers were compared between the three groups.Multivariate ordered Logistic regression analysis was used to investigate factors influencing the progression from normal bone mass to osteoporosis in male patients with T2DM.Receiver operating characteristic(ROC)curves were used to evaluate the predictive value of inflammatory markers for osteoporosis in male patients with T2DM.Correlation analysis was conducted to investigate the correlation between inflammatory markers and BMD and bone turnover markers(BTM)in male patients with T2DM.Results Platelet count(PLT),platelet-to-lymphocyte ratio(PLR),systemic inflammatory index(SII)and neutrophil-to-lymphocyte ratio(NLR)were significantly higher in the osteoporosis group than those in the normal bone mass group(P＜0.05).Multivariate ordered Logistic regression analysis showed that PLR and SII were risk factors for the progression from normal bone mass to osteoporosis in male patients with T2DM(P＜0.05).The area under the ROC curve of PLR was 0.590,and the cut-off value was 96.67.The area under the curve of SII was 0.613,with a cut-off value of 307.9,and the area under the combined curve of the above two indicators was 0.612.In patients with osteoporosis and osteopenia,SII,PLR and PLT were negatively correlated with L1-4 BMD and left hip BMD(P＜0.05).SII was also negatively correlated with left femoral neck BMD(P＜0.05).Conclusion Inflammatory markers PLR and SII have predictive values for the progression from normal bone mass to bone loss and osteoporosis in male patients with T2DM.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective:To explore the association between macrosomia delivery history and adverse pregnancy outcomes in subsequent pregnancies under different stratification of gestational weight gain(GWG).Methods:A retrospective study was conducted on 500 multiparous women with a history of macrosomia delivery who gave birth at The Second Hospital of Jilin University from January 2020 to November 2023.Meanwhile,1500 multiparous women without a history of delivering macrosomic infants were selected as the control group through 1∶3 matc-hing based on age(±1 year).The differences in general characteristics,GWG,and pregnancy outcomes be-tween the two groups were compared.According to the appropriate GWG values recommended by Chinese health industry standards,pregnant women in both groups were classified into insufficient GWG,appropriate GWG,and excessive GWG.Multivariate Logistic regression analysis was used to compare the relationship be-tween a history of macrosomia delivery and adverse pregnancy outcomes under different GWG stratifications.Re-sults:The History of macrosomia group had significantly higher rates of excessive GWG(50.60%vs.48.13%),incidence of gestational diabetes mellitus(GDM)(23.40%vs.17.07%),rate of cesarean section(60.20%vs.45.33%),and rate of macrosomia(26.60%vs.7.87%)compared to the control group(P<0.05).Multivariate Logistic regression analysis showed that a history of macrosomia delivery was an independent risk factor for GDM,cesarean section,and macrosomia in subsequent pregnancies(aOR>1,P<0.05).Stratified analysis based on GWG revealed that,compared with the control group,regardless of the GWG status,the risk of cesare-an section and macrosomia was higher in women with a history of macrosomia delivery(aOR>1,P<0.05).Mo-reover,for those with a history of macrosomia delivery and excessive weight gain during pregnancy,the risk of preeclampsia(aOR 3.167,P<0.05)and GDM(aOR 1.661,P<0.05)was significantly increased.When the GWG was appropriate for pregnant women with a history of macrosomia delivery,there was no significant correla-tion between a history of macrosomia delivery and preeclampsia or GDM(P>0.05).Conclusions:A history of macrosomia delivery increased the risk of multiple adverse pregnancy outcomes,such as GDM,cesarean section,and macrosomia.For multiparous women at different GWG levels,the risk of cesarean section and macrosomia was significantly increased in those with a history of macrosomia delivery.When GWG was appropriate,a history of macrosomia delivery was not found to be an independent risk factor for preeclampsia and GDM.