ObjectiveTo investigate the influence of platelet-albumin-bilirubin （PALBI） score on the textbook outcome （TO） of patients with hepatocellular carcinoma （HCC） after hepatectomy， as well as the association of different PALBI scores before surgery with the achievement of TO after hepatectomy in HCC patients. MethodsA retrospective analysis was performed for the data of HCC patients who underwent hepatectomy in West China Hospital of Sichuan University and Ziyang Central Hospital from January 2013 to January 2022. TO was defined as no serious complication within 30 days after surgery， no death within 90 days， no rehospitalization within 30 days after discharge， no blood transfusion in the perioperative period， RO resection， and no prolongation of hospital stay. The chi-square test was used for comparison of categorical data between two groups. The univariate and multivariate Logistic regression analyses were used to investigate the influencing factors for the achievement of TO after hepatectomy in HCC patients. The Kaplan-Meier method was used to plot the survival curves of HCC patients， and the Log-rank test was used for comparison. ResultsA total of 3 599 patients were included in this study， among whom 2 369 （65.8%） achieved TO. The multivariate Logistic regression analysis showed that PALBI grade （PALBI grade 2： odds ratio ［OR］=1.562， 95% confidence interval ［CI］： 1.308‍ ‍—‍ ‍1.864， P<0.001； PALBI grade 3： OR=2.216， 95%CI： 1.463‍ ‍—‍ ‍3.359， P<0.001） was an independent risk factor for achievement of TO after surgery in HCC patients. The proportion of patients achieving TO decreased with the increase in PALBI grade. Among the patients with PALBI grade 1， 2 or 3， the patients achieving TO accounted for 70.2%， 54.2%， and 38.4%， respectively （χ²=106.295， P<0.001）. The incidence rate of serious complications within 30 days， the mortality rate of patients within 90 days after hepatectomy， readmission rate within 30 days after discharge， perioperative blood transfusion rate， and the rate of prolonged hospital stay all increased with the increase in PALBI grade （all P<0.05）. For the patients achieving TO， the 1-， 3-， and 5-year relapse-free survival rates were 79.5%， 60.6%， and 51.5%， respectively， and the overall survival rates were 92.1%， 80.0%， and 71.1%， respectively； for those who did not achieve TO， the 1-， 3-， and 5-year relapse-free survival rates were 68.5%， 52.7%， and 46.2%， respectively， and the overall survival rates were 83.3%， 66.0%， and 57.1%， respectively. The patients who achieved TO had significantly better relapse-free survival rate and overall survival rate than those who did not achieve TO （χ²=18.936 and 79.371， both P<0.001）. ConclusionPreoperative PALBI grade can affect the achievement of TO after hepatectomy in HCC patients， and it is more difficult for patients with a higher PALBI grade to achieve TO. Preoperative PALBI score can be used to early identify the patients with a high risk of postoperative complications， provide early intervention， and enhance perioperative management， thereby improving the perioperative safety and long-term prognosis of HCC patients after hepatectomy.

Objective To investigate the influence of platelet-albumin-bilirubin(PALBI)score on the textbook outcome(TO)of patients with hepatocellular carcinoma(HCC)after hepatectomy,as well as the association of different PALBI scores before surgery with the achievement of TO after hepatectomy in HCC patients.Methods A retrospective analysis was performed for the data of HCC patients who underwent hepatectomy in West China Hospital of Sichuan University and Ziyang Central Hospital from January 2013 to January 2022.TO was defined as no serious complication within 30 days after surgery,no death within 90 days,no rehospitalization within 30 days after discharge,no blood transfusion in the perioperative period,RO resection,and no prolongation of hospital stay.The chi-square test was used for comparison of categorical data between two groups.The univariate and multivariate Logistic regression analyses were used to investigate the influencing factors for the achievement of TO after hepatectomy in HCC patients.The Kaplan-Meier method was used to plot the survival curves of HCC patients,and the Log-rank test was used for comparison.Results A total of 3 599 patients were included in this study,among whom 2 369(65.8%)achieved TO.The multivariate Logistic regression analysis showed that PALBI grade(PALBI grade 2:odds ratio[OR]=1.562,95%confidence interval[CI]:1.308-1.864,P<0.001;PALBI grade 3:OR=2.216,95%CI:1.463-3.359,P<0.001)was an independent risk factor for achievement of TO after surgery in HCC patients.The proportion of patients achieving TO decreased with the increase in PALBI grade.Among the patients with PALBI grade 1,2 or 3,the patients achieving TO accounted for 70.2%,54.2%,and 38.4%,respectively(χ2=106.295,P<0.001).The incidence rate of serious complications within 30 days,the mortality rate of patients within 90 days after hepatectomy,readmission rate within 30 days after discharge,perioperative blood transfusion rate,and the rate of prolonged hospital stay all increased with the increase in PALBI grade(all P<0.05).For the patients achieving TO,the 1-,3-,and 5-year relapse-free survival rates were 79.5%,60.6%,and 51.5%,respectively,and the overall survival rates were 92.1%,80.0%,and 71.1%,respectively;for those who did not achieve TO,the 1-,3-,and 5-year relapse-free survival rates were 68.5%,52.7%,and 46.2%,respectively,and the overall survival rates were 83.3%,66.0%,and 57.1%,respectively.The patients who achieved TO had significantly better relapse-free survival rate and overall survival rate than those who did not achieve TO(χ2=18.936 and 79.371,both P<0.001).Conclusion Preoperative PALBI grade can affect the achievement of TO after hepatectomy in HCC patients,and it is more difficult for patients with a higher PALBI grade to achieve TO.Preoperative PALBI score can be used to early identify the patients with a high risk of postoperative complications,provide early intervention,and enhance perioperative management,thereby improving the perioperative safety and long-term prognosis of HCC patients after hepatectomy.

BACKGROUND:Ferroptosis is a programmed cell death caused by iron dependent lipid peroxidation,involving various processes such as iron overload,lipid peroxidation,and endoplasmic reticulum stress.Research has found that ferroptosis is closely related to the occurrence and development of myocardial ischemia-reperfusion injury,and has become a new target and perspective for MIRI treatment.Traditional Chinese medicine has advantages such as multi-target,multi-level,and fewer adverse reactions,and has significant effects in the treatment of myocardial ischemia-reperfusion injury,with a far-reaching impact.OBJECTIVE:Taking ferroptosis as the starting point,to systematically elaborate and summarize the research progress in the modulation of ferroptosis against myocardial ischemia-reperfusion injury by monomers of traditional Chinese medicines such as puerarin,resveratrol,ligustrazine,and astragaloside IV in recent years.METHODS:Using the search terms"iron death,myocardial injury,myocardial ischemia-reperfusion injury,signaling pathways,traditional Chinese medicine monomers,flavonoids,polyphenols,alkaloids,terpenes,quinones"in Chinese and English from January 2013 to June 2024,literature retrieval was performed in the CNKI and PubMed respectively for literature related to ferroptosis,myocardial ischemia-reperfusion injury,and the regulatory mechanism of traditional Chinese medicine monomers.Literature that is not highly correlated,repetitive,or outdated was excluded.A total of 1 524 relevant articles were retrieved,and 76 articles were ultimately included for review.RESULTS AND CONCLUSION:Numerous animal and cell experiments have shown that ferroptosis plays an important role in the occurrence and progression of myocardial ischemia-reperfusion injury.Traditional Chinese medicine monomers such as baicalin,resveratrol,and ligustrazine can regulate iron metabolism,reduce iron deposition,and inhibit ferroptosis in myocardial cells.Pectin,quercetin,and salidroside can improve mitochondrial function,enhance cellular antioxidant capacity,and alleviate myocardial ischemia-reperfusion injury.Traditional Chinese medicine monomers can regulate ferroptosis-related signaling pathways,such as solute carrier family 7 member 11/glutathione peroxidase 4,dihydrolactate dehydrogenase/coenzyme Q10,cyclooxygenase 2/prostaglandin E2,and adenosine monophosphate-activated protein kinase,resist myocardial ischemia-reperfusion injury,and reduce ferroptosis in myocardial cells.

BACKGROUND:Ferroptosis is a programmed cell death caused by iron dependent lipid peroxidation,involving various processes such as iron overload,lipid peroxidation,and endoplasmic reticulum stress.Research has found that ferroptosis is closely related to the occurrence and development of myocardial ischemia-reperfusion injury,and has become a new target and perspective for MIRI treatment.Traditional Chinese medicine has advantages such as multi-target,multi-level,and fewer adverse reactions,and has significant effects in the treatment of myocardial ischemia-reperfusion injury,with a far-reaching impact.OBJECTIVE:Taking ferroptosis as the starting point,to systematically elaborate and summarize the research progress in the modulation of ferroptosis against myocardial ischemia-reperfusion injury by monomers of traditional Chinese medicines such as puerarin,resveratrol,ligustrazine,and astragaloside IV in recent years.METHODS:Using the search terms"iron death,myocardial injury,myocardial ischemia-reperfusion injury,signaling pathways,traditional Chinese medicine monomers,flavonoids,polyphenols,alkaloids,terpenes,quinones"in Chinese and English from January 2013 to June 2024,literature retrieval was performed in the CNKI and PubMed respectively for literature related to ferroptosis,myocardial ischemia-reperfusion injury,and the regulatory mechanism of traditional Chinese medicine monomers.Literature that is not highly correlated,repetitive,or outdated was excluded.A total of 1 524 relevant articles were retrieved,and 76 articles were ultimately included for review.RESULTS AND CONCLUSION:Numerous animal and cell experiments have shown that ferroptosis plays an important role in the occurrence and progression of myocardial ischemia-reperfusion injury.Traditional Chinese medicine monomers such as baicalin,resveratrol,and ligustrazine can regulate iron metabolism,reduce iron deposition,and inhibit ferroptosis in myocardial cells.Pectin,quercetin,and salidroside can improve mitochondrial function,enhance cellular antioxidant capacity,and alleviate myocardial ischemia-reperfusion injury.Traditional Chinese medicine monomers can regulate ferroptosis-related signaling pathways,such as solute carrier family 7 member 11/glutathione peroxidase 4,dihydrolactate dehydrogenase/coenzyme Q10,cyclooxygenase 2/prostaglandin E2,and adenosine monophosphate-activated protein kinase,resist myocardial ischemia-reperfusion injury,and reduce ferroptosis in myocardial cells.

Viral myocarditis(VMC),as the most common type of myocarditis,can progress to chronic myocarditis and even heart failure,ultimately leading to death.Nuclear factor κB(NF-κB)is a multifunctional transcription factor involved in regulating a wide range of biological processes.Existing evidence suggests that the balance between pro-inflammatory and anti-inflammatory factors plays a decisive role in the prognosis of VMC.The NF-κB pathway mediates inflammatory responses and regulates pathways such as cell apoptosis,energy metabolism,oxidative stress,and insulin resistance to participate in the pathological progression of VMC.This article analyzes and summarizes the molecular mechanism of NF-κB signaling pathway regulation in VMC from the above five aspects,to provide a reference for future basic research and for the clinical diagnosis and treatment of VMC.

Dilated cardiomyopathy （DCM） is characterized by the main pathological changes of global cardiac enlargement， especially left ventricular enlargement. Clinical manifestations include decreased heart function， arrhythmia， thromboembolism， and even sudden death. It is one of the refractory cardiovascular diseases. Conservative drug treatment is still the main approach in clinical practice， but due to its unavoidable side effects such as low blood pressure， it is often difficult to achieve a satisfactory prognosis. The combination of traditional Chinese medicine and Western medicine can effectively improve side effects and enhance efficacy. The research has found that nuclear transcription factors-κB （NF-κB）， adenylate activated protein kinase （AMPK）/mammalian rapamycin target protein （mTOR）， transforming growth factor-β （TGF-β）/Smads， Toll like receptors （TLR） 4/c-Jun amino terminal kinase （JNK）， mitogen activated protein kinase （MAPK）， phosphatidylinositol 3-kinase （PI3K）/protein kinase （Akt）， and other signaling pathways play a crucial regulatory role in the occurrence and development of DCM. Traditional Chinese medicine can improve myocardial fibrosis， reverse ventricular remodeling， alleviate oxidative stress， and achieve anti-inflammatory and other effects by regulating the above signaling pathways， thus improving DCM. Due to its multi-target and multi-mechanism characteristics， it has the advantages of high safety and good tolerance and has become an important part of current clinical treatment.

Dilated cardiomyopathy(DCM)has a concealed onset with left or even whole heart enlargement as the main imaging manifestation.It is a common primary disease of heart failure and arrhythmia.With the continuous deepening of research in recent years,the intrinsic molecular mechanism of regulatory cell death(RCD)has gradually become clear.Researchers have found that the RCD mode plays a very important role in the occurrence and development of DCM.At present,the RCD modes involved in DCM mainly include apoptosis,necrotic apoptosis,pyroptosis,iron death,autophagy,and cuproptosis,and a certain correlation exists among them,which interact and regulate each other.This article provides an overview of the current research status on the mechanisms of the six RCD modes involved in DCM to provide a reference for future basic research and clinical applications.

Viral myocarditis(VMC),as the most common type of myocarditis,can progress to chronic myocarditis and even heart failure,ultimately leading to death.Nuclear factor κB(NF-κB)is a multifunctional transcription factor involved in regulating a wide range of biological processes.Existing evidence suggests that the balance between pro-inflammatory and anti-inflammatory factors plays a decisive role in the prognosis of VMC.The NF-κB pathway mediates inflammatory responses and regulates pathways such as cell apoptosis,energy metabolism,oxidative stress,and insulin resistance to participate in the pathological progression of VMC.This article analyzes and summarizes the molecular mechanism of NF-κB signaling pathway regulation in VMC from the above five aspects,to provide a reference for future basic research and for the clinical diagnosis and treatment of VMC.

Objective: To investigate the imaging features of adult bones Langerhans cell histiocytosis (LCH). Methods: The DR, CT, and MRI findings of 25 adults patients with LCH from January 2008 to June 2019 in Yueqing Sixth People′s Hospital of Zhejiang Province (3 cases), Yueqing Third People′s Hospital of Zhejiang Province (7 cases) and Wenzhou People′s Hospital of Zhejiang Province (15 cases) were retrospectively analyzed. Results: Among the 25 patients, the lesions located in the skull in 5 cases, in the spine in 5 cases, in the long bones in 10 cases, in the other flat bones in 3 cases, and in multiple bones in 2 cases. DR features (17 cases) showed: cystic destruction in 11 cases (6 cases with dilated changes), osteolytic damage in 6 cases; peripheral bone cortex thickening in 5 cases, bone lesions with less smooth inner edge in 4 cases, soft tissue mass around the lesion in 12 cases; 'hole set cave sign' in 2 cases, 'flat vertebra' in 2 cases, and 'button-like dead bone' in 1 case. CT features (15 cases) showed: cystic destruction in 9 cases (5 cases with dilated changes), osteolytic damage in 6 cases; 'hole set cave sign' in 2 cases, 'flat vertebra' in 2 cases, and 'button-like dead bone' in 1 case. MRI features (14 cases) showed: cystic destruction in 9 cases (5 cases with dilated changes), osteolytic damage in 5 cases; in the bone destruction area, 8 cases had low T₁WI signal and high T₂WI signal, 4 cases had equal T₁WI signal and higher mixed T₂WI signal, 2 cases had slightly higher T₁WI signal and higher mixed T₂WI signal; STIR lipoprotein sequence showed high signal in 11 cases, and isointense signal in 3 cases; DWI showed high signal. Conclusions The imaging performance of adults LCH has certain characteristics, and the diagnostic accuracy can be improved according to the imaging performance and the clinic.

Objective: To investigate the CT features of primary mediastinal neuroendocrine carcinoma and improve the diagnostic accuracy. Methods: CT findings of 12 patients with primary mediastinal neuroendocrine carcinoma diagnosed by clinic and pathology were retrospectively analyzed. The location, size, growth pattern, density, degree of enhancement, invasion of surrounding tissues and metastasis of the tumor were observed, a control analysis was performed. Results: Among the 12 cases, 4 cases were located in the anterior superior mediastinum, 4 cases in the middle superior mediastinum and 4 cases in the middle mediastinum. There were 5 cases on the left side, 4 cases on the right side and 3 cases in the middle. The maximum diameter of the tumor ranged from 1.5 cm to 12.0 cm, with an average of (6.74±3.65) cm. The tumors were round or quasi-round in 6 cases, irregular in 6 cases, clear boundary in 9 cases and unclear in 3 cases. Uniform density was found in 6 cases. The density was heterogeneous in 6 cases, including necrosis and cystic degeneration in 4 cases, and fine-grained calcification in 1 case. The average CT value of plain scan was (38±4.8) HU. There was 1 case of perivascular growth, 2 cases of adjacent vascular compression, 3 cases of adjacent pleural invasion, and 6 cases of infiltrating the surrounding fat space. After contrast enhancement, all cases showed mild and moderate enhancement, including 4 cases with homogeneous enhancement and 8 cases with heterogeneous enhancement. After contrast enhancement, the mean CT value was (55±7.7) HU. There were 9 cases with mild enhancement and 3 cases with moderate enhancement. There were 3 cases with small linear abnormally enhanced vascular shadow in the tumor, and 4 cases with no enhancement both in the central necrosis and the cystic areas. There were 7 cases of typical carcinoid, 2 cases of atypical carcinoid, 2 cases of small cell carcinoma and 1 case of large cell neuroendocrine carcinoma. Conclusion Primary mediastinal neuroendocrine carcinoma is mainly located in the anterior-mediastinum. When the tumor is large, necrosis, cystic degeneration and invasive growth are easy to occur. The enhanced scan shows mild and moderate enhancement. Combined with clinical history, it can improve the accuracy of diagnosis.