With the deepening of molecular biology and cell biology research,the regulatory mechanism of autophagy has been gradually revealed,providing new ideas for the treatment of numerous diseases.Autophagy may be closely related to pathological changes such as apoptosis resistance of fibroblast-like synoviocytes,disturbances in bone metabolic homeostasis,and antigen presentation,the regulation of autophagy homeostasis may be an important approach for the treatment of rheumatoid arthritis(RA).In this paper,we provide a review on the pathological mechanism of autophagy in RA,with a view to providing a theoretical basis for later studies.

Objective:To evaluate the effects of the Chinese visceral adiposity index(CVAI)and the Triglyceride-Glucose(TyG)index on the risk of hypertension among the elderly in the Zhengxiangbai Banner community of Inner Mongolia.Methods:This study selected elderly individuals who underwent physical examinations at the community health service center in Zhengxiangbai Banner, Inner Mongolia, from January 2024 to July 2024 as the study population.Based on the diagnostic criteria for hypertension, participants were divided into hypertensive and non-hypertensive groups.Data on demographics, body mass index(BMI), waist circumference(WC), fasting blood glucose(FSG), and blood lipids were collected.The CVAI, TyG, Triglyceride Glucose-Body Waist Circumference(TyG-WC), and Triglyceride Glucose-Body Mass Index(TyG-BMI)were calculated.Subjects were categorized into quartiles(1st to 4th)based on CVAI, TyG, TyG-WC, and TyG-BMI.Multivariate logistic regression analysis was employed to explore the relationship between these indicators and the risk of hypertension in the elderly.Results:This study included a total of 3, 319 elderly subjects, comprising 1, 743 individuals in the hypertensive group and 1, 576 in the non-hypertensive group.Multivariate logistic regression analysis indicated that the fourth quartile of the CVAI was a risk factor for hypertension when compared to the first quartile.Additionally, the second, third, and fourth quartiles of the TyG-BMI were identified as risk factors for hypertension relative to the first quartile.The analysis of the correlation strength between various obesity indexes and hypertension revealed that CVAI, TyG-WC, and TyG-BMI were independently correlated with the risk of hypertension.Notably, TyG-BMI exhibited a stronger association with hypertension( OR=1.006, 95% CI: 1.004-1.008).ROC curve analysis demonstrated that TyG-BMI possessed superior predictive ability for hypertension, with an AUC of 0.587(95% CI: 0.568-0.607).Furthermore, Decision Curve Analysis(DCA)also indicated that TyG-BMI had enhanced predictive capability.Further stratification by gender revealed that TyG-BMI in elderly men was independently correlated with the risk of hypertension( P<0.001), while CVAI in elderly women was independently correlated with the risk of hypertension( P<0.05).ROC curve analysis indicated that TyG-BMI in elderly men had better predictive ability for hypertension(AUC=0.582, 95% CI: 0.554~0.610).The difference in AUC compared to CVAI was statistically significant( P<0.01).DCA analysis further confirmed that TyG-BMI exhibited superior predictive ability. Conclusions:Our findings suggest that both CVAI and TyG-BMI exhibit superior predictive value for hypertension, with TyG-BMI demonstrating a particularly strong predictive capability in elderly men.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

Objective:To comprehensively evaluate the application of Common Data Model (CDM) of Observational Medical Outcomes Partnership (OMOP) in China, and provide reference for the implementation of data standardization and evidence sharing in China.Methods:PubMed, Embase, Web of Science, CNKI, VIP, WanFang and SinoMed databases were used for literature retrieval to collect the research papers of OMOP CDM application for data standardization in China until March 15, 2023. The information about institutions, types and numbers of patients were extracted.Results:A total of 14 research papers, including 9 in English and 5 in Chinese, were selected. The research papers published since 2018 were collected, which focused on patients with hypertension, diabetes, and depression. A total of 12 institutions or platforms transformed data into OMOP CDM. Jiangsu Provincial People's Hospital was the first one to apply the CDM and demonstrated its feasibility in China. Additionally, the regional information system in Yinzhou District of Ningbo, Zhejiang Province, standardized the multi-dimensional data of patients with diabetes and hypertension. Based on this platform, a series of prediction models for complications in patients with diabetes were constructed. Another major database in Beijing Anding Hospital applied OMOP CDM to analyze the characteristics of patients with late-life depression and dementia.Conclusions:This study analyzed the application of OMOP CDM in China. Through in-depth analysis of specific cases, the study provided guidance for the future cross-regional evidence sharing and collaboration.

Family with sequence similarity 3 member A(FAM3A),a novel mitochondrial protein,plays a pivotal role in hepatic glucose and lipid metabolism by enhancing ATP synthesis and secretion and mod-ulating the ATP-P2 receptor-Akt signaling pathway.Dysregulation of FAM3A is closely associated with the pathogenesis of non-alcoholic fatty liver disease(NAFLD)and type 2 diabetes mellitus(T2DM).In this study,targeting FAM3A as a therapeutic candidate,we conducted virtual screening to identify 47 small-molecule compounds with potential binding activity.Surface plasmon resonance(SPR)analysis re-vealed three compounds exhibiting high binding affinity to FAM3 A.Further structural characterization of the FAM3A-compound complexes,combined with intermolecular interaction analysis,elucidated the binding mode of the lead compound Index 2(taxifolin)to FAM3A at atomic resolution.These findings provide critical insights into the molecular mechanisms underlying ligand-FAM3A interactions and deliver valuable chemical scaffolds for the development of therapeutics targeting NAFLD and T2DM.This work establishes a foundation for advancing drug discovery efforts focused on FAM3A-mediated metabolic disor-ders.

Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P＜0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P＞0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.

Objective To carry out cervical cancer VMAT radiotherapy planning respectively with the single-criteria optimization(SCO)and multi-criteria optimization(MCO)modes of Raystation 4.7 planning system,and to provide references for selecting optimization mode clinically by comparing and analyzing the dosimetric parameters such as target dose distribution,exposure dose to organ at risk(OAR),monitor unit and beam-on time.Methods Ten cervical cancer patients who attended some hospital from February to December 2022 were retrospectively selected,and some VMAT plans were designed for them with the SCO mode of Raystation 4.7 planning system and then enrolled into a SCO group;other VMAT plans were redesigned with the MCO mode under the premise the setup conditions such as machine model and shot field angle were unchanged,and divided into a MCO group.The two groups were compared in terms of maximum dose(D2%),minimum dose(D98%),homogeneity index(HI)and conformity index(CI)of the planning target volume(PTV),beam-on time,monitor unit and exposure doses to OARs including bladder V50 Gy,V40 Gy and V30 Gy,rectum V50 Gy,V40 Gy and V30 Gy,small intestine V50 Gy,V40 Gy and V30 Gy and left and right femur V50 Gy,V40 Gy and V30 Gy.SPSS 22.0 software was used for statistical analysis.Results Both the two groups met clinical requirements.There were no significant differences between the two groups in D98%,CI,small intestine V50 Gy and left and right femur V40 Gy(P>0.05).The MCO group had the values of HI,D2%,V50 Gy,V40 Gy and V30 Gy,rectum V50 Gy,V40 Gy and V30 Gy,small intestine V40 Gy and V30 Gy and left and right femur V30 Gy lower than those of the SCO group,with the differences being statistically significant(P<0.05).The SCO group had less monitor units and shorter beam-on time when compared with the MCO group,with the differences being statistically siginificant(P<0.05).Conclusion When compared with the SCO mode-based VMAT plans,the MCO mode-based VMAT plans significantly decrease the exposure doses and volume to rectum,bladder and small intestine and raise the PTV homogeneity,while lower the treatment efficiency to some extent by increased monitor units and prolonged beam-on time.[Chinese Medical Equipment Journal,2025,46(9):39-44]

Objective To investigate the influence of the and mechanism of liver failing to convey and disperse on age-related changes in attentional search based on ERPs.Methods oddball attention search task was administrated to record and analyze behavioral and EEG data(N2pc、SPCN、N2pc-Ptc components)of 120 subjects.Results Compared with liver controlling conveyance and dispersion group,the accuracy in subjects with liver failing to convey and disperse decreased significantly(P<0.05).The elderly group had a lower accuracy(P<0.001)and a longer reaction time(P<0.001)compared to the young group.The N2pc amplitude in subjects with liver failing to convey and disperse was significantly greater than that in subjects with liver controlling conveyance and dispersion(P<0.05).The interaction effect of SPCN amplitude between age and liver failing to convey and disperse status was significant(P=0.024).And in the elderly group,SPCN amplitude in subjects with liver dysregulation was significantly smaller than that of liver controlling conveyance and dispersion(P=0.042).The N2pc-Ptc peak to peak amplitude interaction effect between age and liver regulation status was marginal significant(P=0.087),and in liver failing to convey and disperse group,N2pc-Ptc peak to peak amplitude of the elderly was significantly smaller than that of the young(P=0.008).Conclusion Attention search ability is impaired in the elderly with liver failing to convey and disperse,and the electrophysiological abnormalities,such as directed attention allocation,spatiotemporal dynamic cohesion and short-term memory maintenance,may be part of the mechanism.

Objective To investigate the effect of Qi stagnation on inhibitory control function and its neuroelectrophysiological mechanism in college students.Methods The population of peace and Qi depression was screened from college students through the scale of"Classification and Judgment Criteria of Traditional Chinese Medicine Constitution",and 35 subjects were included in each group.Combined with event-related potential technology,the two groups were collected to complete the Flanker paradigm behavioral indicators(accuracy,response time)and EEG data indicators(amplitude and latency of N2 and P3 components),and the behavioral differences and neuroelectrophysiological mechanisms between the two groups under the Flanker paradigm were explored.Results Compared with the flat group,the reaction time of the gas depression group was longer(P=0.07).Compared with the consistent dondition,the reaction time was longer under the inconsistent condition(P<0.001),and the accuracy rate was lower under the inconsistent condition significantly(P<0.001).Compared with the peaceful group,the N2 amplitude of the air depression group was higher(P<0.05).There was a statistically significant difference in the main effect of brain regions in the N2 latency period(P<0.001).Frontal lobe zero(Fz)in frontal region was greater than Frontal lobe central zero(FCz)in frontal region and greater than Central zero(Cz)in central region(P<0.05).There was a statistically significant difference in the main effect of brain region(P<0.001).FCz in the frontal central region was significantly greater than that in the frontal region Fz(P<0.001),and the difference was statistically significant in the central region Cz was significantly greater than that in the frontal region(P<0.001).The incubation period of P3 component was significantly smaller than that of inconsistent stimulation(P<0.001).Conclusion Qi stagnation has a negative effect on the inhibitory control function of college students,and the decline of conflict monitoring and control ability is one of the possible mechanisms.

Malignant pleural effusion (MPE) refers to the accumulation of pleural fluid caused by metastasis from primary pleural malignancies or tumors originating elsewhere. It is associated with a poor prognosis. Current treatment strategies primarily include systemic anti-tumor therapy and local management of MPE based on the primary tumor. Numerous studies have documented diverse approaches for the local control of MPE. This review summarizes recent advances in local treatment strategies for primary tumor-related MPE, highlighting emerging pharmacological agents and innovative techniques.
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Humans ; Pleural Effusion, Malignant/drug therapy*