The inflammatory microenvironment is closely associated with the initiation and progression of osteoarthritis （OA）， specifically manifesting as macrophage activation， dysregulation of inflammatory cytokines， and redox imbalance. Following an overview of the pathological characteristics of the OA inflammatory microenvironment， this paper reviews the research progress on the mechanism of traditional Chinese medicine （TCM） intervening in OA by modulating the inflammatory microenvironment. It has been found that TCM monomers/active ingredients （such as total alkaloids from Strychnos nux-vomica ， quercetin， triptolide， etc.）， herb pairs （e.g. Angelica pubescens - Gentiana macrophylla ， Carthami Flos-Lycopodii Herba）， and TCM formulas （such as Zhuanggu jianxi formula， Duhuo jisheng decoction and Rongjin niantong formula， etc.） can inhibit macrophage activation， reduce the release of proinflammatory cytokines and the generation of reactive oxygen species by inhibiting multiple signaling pathways， including nuclear factor-κB， Wnt/ β -catenin， and mitogen-activated protein kinase， thereby alleviating the articular inflammatory microenvironment， restoring local joint homeostasis， and slowing the progression of OA.

Objective:The actor-partner interdependence model was used to explore the subject-object effect of family care on disease acceptance in maintenance hemodialysis (MHD) patients and their primary caregivers, and to provide empirical research support for formulating intervention strategies to improve the quality of life of MHD patients and their primary caregivers at the dyadic coping perspective.Methods:This study was a cross-sectional study. A convenience sampling method was used to select 223 pairs of MHD patients and their primary caregivers who received treatment at three hospitals from December 2023 to May 2024, namely the Second Affiliated Hospital of Guizhou Medical University, Qiandongnan People′s Hospital and Qiandongnan Traditional Chinese Medicine Hospital. The General Information Questionnaire, Family APGAR Index (APGAR) and the Acceptance of Illness Scale (AIS) were used to conduct the survey. An actor-partner interdependence model of the impact of family care levels on disease acceptance was constructed.Results:There were 223 patients with MHD, 134 males and 89 females, aged (48.41 ± 14.41) years. Among the 223 primary caregivers of MHD patients, 83 were males and 140 were females, aged (49.44 ± 12.40) years. The scores of APGAR and AIS for MHD patients were (7.92 ± 1.94), (20.45 ± 4.66) points, and (8.16 ± 1.67), (21.86 ± 3.54) points for their primary caregivers. There were statistically significant differences in scores ( t = - 2.28, - 7.69, both P<0.05). The results of correlation analysis showed that there was a significant positive correlation between the degree of family care of MHD patients and the disease acceptance of MHD patients, the family care of primary caregivers, and the disease acceptance of primary caregivers ( r = 0.454, 0.625, 0.515, all P<0.05). There was a significant positive correlation between the disease acceptance of MHD patients and the family care of their primary caregivers, the disease acceptance of primary caregivers, and the family care of primary caregivers and the disease acceptance of primary caregivers ( r = 0.442, 0.813, 0.495, all P<0.05). In terms of the actor effect, the level of family care positively influenced the disease acceptance for both MHD patients and their primary caregivers ( β = 0.715, 0.603, both P<0.001), the actor effect was significant. In terms of partner effect, there was a positive correlation between the family care levels of MHD patients and their primary caregivers and the disease acceptance of the other party ( β = 0.628, 0.725, both P<0.001), the partner effect was significant. Conclusions:There is an interactive effect between the disease acceptance of maintenance hemodialysis patients and their primary caregivers and their levels of family care.

Hepatocellular carcinoma (HCC) is one of the most prevalent malignant tumors worldwide. The traditional early screening modality of ultrasound,when combined with the biomarker alpha-fetoprotein (AFP),is deficient in sensitivity and specificity. In recent years,HCC risk assessment models based on statistical methods have been widely developed and validated due to advantages such as good efficacy,non-invasiveness,and ease of generalization. Currently,HCC risk assessment models adapted to the characteristics of patients with chronic liver disease,patients with hepatitis B and C,patients with cirrhosis,and the general population have been developed. The purpose of this review is to assist clinical diagnosis treatment,and scientific research by analyzing the current research status and development of liver cancer risk assessment models.

Hematologic malignancies arise from hematopoietic or immune system tissues and are characterized by abnormal cellular growth.Ferroptosis,a newly recognized form of cell death,is driven by mechanisms such as iron me-tabolism,oxidative defense,and lipid peroxidation.Increasing evidence has highlighted a significant link between ferrop-tosis and various hematologic cancers.Traditional Chinese medicine(TCM)has shown particular promise in the treatment of these cancers,offering unique therapeutic approaches.This article explores the role of ferroptosis modulation in hemato-logic malignancies and reviews the current understanding of how TCM's bioactive compounds and monomers exert their ef-fects in managing hematologic cancers,including leukemia,lymphoma,and multiple myeloma,through the induction of ferroptosis.The objective is to provide insight into potential strategies for targeting ferroptosis as a treatment approach for these malignancies.

One hundred 1-day-old HY-LINE VARIETY BROWN were randomly divided into 5 groups:the blank group,the model group,the Baihuang Zhili decoction low-dose treatment group(1 g/kg),the Baihuang Zhili decoction medium-dose treatment group(2 g/kg)and the Baihuang Zhili decoction high-dose treatment group(4 g/kg).The results showed that:(1)Compared with the model group,Baihuang Zhili decoction could restore the integrity of intestinal mucosal barrier structure and reduce inflammation.It significantly increased the expression of tight junction pro-teins ZO-1,Claudin-1 and Occludin in small intestine(P＜0.05),and significantly decreased the levels of DAO(diamine axidase)and D(-)-lactic acid(P＜0.05).(2)Compared with the model group,Baihuang Zhili decoction could significantly increase the number of goblet cells(P＜0.05).Baihuang Zhili decoction could significantly increase the MUC2 levels of duodenum,and the MUC2 level of ileum in 1 g/kg group and 4 g/kg group was significantly increased(P＜0.05),the MUC2 levels of jejunum in 2 g/kg group were significantly increased(P＜0.05).(3)Compared with the model group,Baihuang Zhili decoction significantly decreased the sIgA level in duodenum and jeju-num(P＜0.05),and the sIgA level in ileum in 1 g/kg group was significantly decreased(P＜0.05).The IgG level in serum was significantly decreased(P＜0.05).Baihuang Zhili decoction could significantly reduce the expression levels of intestinal immune-related genes(IL-1β,IL-2,IL-6,IL-8,TNF-α)(P＜0.05).It could significantly decrease the expression levels of immune-related factors(TNF-α,IFN-γ,IL-1β,IL-2)in tonsil of cecum(P＜0.05).(4)Compared with the model group,Baihuang Zhili decoction could increase Ace,Chao and Shannon index of intestinal flora,reduce Simpson index of intestinal flora,and increase alpha diversity of intestinal microbes.It significantly decreased the relative abundance of Proteobacteria(P＜0.05),and significantly increased the rela-tive abundance of Campylobacterota(P＜0.05).It also significantly decreased the relative abun-dance of Lactobacillus(P＜0.05).In summary,Baihuang Zhili decoction can improve the damage of intestinal mechanical barrier,chemical barrier,immune barrier and microbial barrier caused by pul-lorum disease,and enhance the intestinal immunity.

One hundred 1-day-old HY-LINE VARIETY BROWN were randomly divided into 5 groups:the blank group,the model group,the Baihuang Zhili decoction low-dose treatment group(1 g/kg),the Baihuang Zhili decoction medium-dose treatment group(2 g/kg)and the Baihuang Zhili decoction high-dose treatment group(4 g/kg).The results showed that:(1)Compared with the model group,Baihuang Zhili decoction could restore the integrity of intestinal mucosal barrier structure and reduce inflammation.It significantly increased the expression of tight junction pro-teins ZO-1,Claudin-1 and Occludin in small intestine(P＜0.05),and significantly decreased the levels of DAO(diamine axidase)and D(-)-lactic acid(P＜0.05).(2)Compared with the model group,Baihuang Zhili decoction could significantly increase the number of goblet cells(P＜0.05).Baihuang Zhili decoction could significantly increase the MUC2 levels of duodenum,and the MUC2 level of ileum in 1 g/kg group and 4 g/kg group was significantly increased(P＜0.05),the MUC2 levels of jejunum in 2 g/kg group were significantly increased(P＜0.05).(3)Compared with the model group,Baihuang Zhili decoction significantly decreased the sIgA level in duodenum and jeju-num(P＜0.05),and the sIgA level in ileum in 1 g/kg group was significantly decreased(P＜0.05).The IgG level in serum was significantly decreased(P＜0.05).Baihuang Zhili decoction could significantly reduce the expression levels of intestinal immune-related genes(IL-1β,IL-2,IL-6,IL-8,TNF-α)(P＜0.05).It could significantly decrease the expression levels of immune-related factors(TNF-α,IFN-γ,IL-1β,IL-2)in tonsil of cecum(P＜0.05).(4)Compared with the model group,Baihuang Zhili decoction could increase Ace,Chao and Shannon index of intestinal flora,reduce Simpson index of intestinal flora,and increase alpha diversity of intestinal microbes.It significantly decreased the relative abundance of Proteobacteria(P＜0.05),and significantly increased the rela-tive abundance of Campylobacterota(P＜0.05).It also significantly decreased the relative abun-dance of Lactobacillus(P＜0.05).In summary,Baihuang Zhili decoction can improve the damage of intestinal mechanical barrier,chemical barrier,immune barrier and microbial barrier caused by pul-lorum disease,and enhance the intestinal immunity.

Objective: This study aimed to compare outcomes and adverse events of patients with locally advanced cervical cancer (LACC) undergoing concurrent chemoradiotherapy (CCRT) with cisplatin single-agent chemotherapy vs. CCRT with cisplatin combined with paclitaxel dualagent therapy. The primary outcomes are overall survival (OS), progression-free survival (PFS), local recurrence (LR), distant metastasis (DM) and the occurrence of adverse events. Methods: This retrospective cohort study included patients with FIGO 2009 stage IB1-IVA cervical squamous cell carcinoma undergoing radical CCRT. Patients were divided into groups A and B, treatment outcomes were compared between the two groups after 1:1 proportional propensity score matching. Results: Medical records of 1,203 patients were reviewed and 572 patients were finally included for propensity score matching. After propensity score matching, 121 pairs of patients were selected for analysis. The OS, PFS, LR and DM rates were 78.5% and 83.5% (p=0.417), 73.3% and 78.5% (p=0.312), 6.6% and 2.5% (p=0.123), 19% and 15.7% (p=0.497) for groups A and B, respectively. Further subgroup analysis according to stage and lymph node metastatic status showed no difference in survival between the two groups. The incidence of grade 3–4 acute haematological toxicities was different between the two groups (p<0.05). Conclusion Cisplatin combined with paclitaxel CCRT couldn’t improve the survival rates of patients with LACC. However, the hematological toxicity of combination chemotherapy is more severe but controllable. Cisplatin single-agent therapy remains the first choice for CCRT. Further prospective studies are indicated to provide evidence for the efficacy of cisplatin plus paclitaxel in dual-agent concurrent therapy.

BACKGROUND:Cervical disc herniation can cause pain in the neck and shoulder area,as well as radiating pain in the upper limbs.The incidence rate is increasing year by year and tends to affect younger individuals.Fully understanding the biomechanical characteristics of the cervical spine in adolescents is of great significance for preventing and delaying the onset of cervical disc herniation in this age group. OBJECTIVE:To reconstruct cervical spine models for both healthy adolescents and adolescent patients with cervical disc herniation utilizing finite element analysis techniques,to analyze the motion range of the C1-T1 cervical vertebrae as well as the biomechanical characteristics of the annulus fibrosus,nucleus pulposus,endplates,and the cartilage of the small joints. METHODS:A normal adolescent's cervical spine and an adolescent patient with cervical disc herniation were selected in this study.The continuous scan cervical spine CT raw image data were imported into Mimics 21.0 in DICOM format.The C1-T1 vertebrae were reconstructed separately.Subsequently,the established models were imported into the 3-Matic software for disc reconstruction.The perfected models were then imported into Hypermesh software for meshing of the vertebrae,nucleus pulposus,annulus fibrosus,and ligaments,creating valid geometric models.After assigning material properties,the final models were imported into ABAQUS software to observe the joint motion range of the C1-C7 cervical vertebrae segments under different conditions,and to analyze the biomechanical characteristics of the annulus fibrosus,nucleus pulposus,endplates,and small joint cartilage of each cervical spine segment. RESULTS AND CONCLUSION:(1)In six different conditions,the joint motion range of the C1 vertebra in the cervical spine models of both normal adolescent and adolescent patient with cervical disc herniation was higher than that of the other vertebrae.Additionally,the joint motion range of each cervical spine segment in normal adolescent was greater than that in adolescent patient with cervical disc herniation.(2)In the cervical spine model of normal adolescent,the maximum stress values in the annulus fibrosus and nucleus pulposus were found on the left side during C2-3 flexion conditions(0.43 MPa and 0.17 MPa,respectively).In the cervical spine model of adolescent patient with cervical disc herniation,the maximum stress values were found on the left side during C7-T1 flexion conditions(0.54 MPa and 0.18 MPa,respectively).(3)In the cervical spine model of normal adolescent,the maximum stress value on the endplate was found on the left side of the upper endplate of C3 during flexion conditions(1.46 MPa).In the model of adolescent patient with cervical disc herniation,the maximum stress value on the endplate was found on the left side of the lower endplate of C7 during flexion conditions(1.32 MPa).(4)In the cervical spine model of normal adolescent,the maximum stress value in the small joint cartilage was found in the C2-3 left rotation conditions(0.98 MPa).In adolescent patient with cervical disc herniation,the stress in the small joint cartilage significantly increased under different conditions,especially in C1-2,with the maximum stress found during left flexion(3.50 MPa).(5)It is concluded that compared to normal adolescent,adolescent patient with cervical disc herniation exhibits altered cervical curvature and a decrease in overall joint motion range in the cervical spine.In adolescent with cervical disc herniation,there is a significant increase in stress on the annulus fibrosus,nucleus pulposus,and endplates in the C7-T1 segment.The stress on the left articular cartilage of the C1-2 is notable.Abnormal cervical curvature may be the primary factor causing these stress changes.

Objective: This study aimed to compare outcomes and adverse events of patients with locally advanced cervical cancer (LACC) undergoing concurrent chemoradiotherapy (CCRT) with cisplatin single-agent chemotherapy vs. CCRT with cisplatin combined with paclitaxel dualagent therapy. The primary outcomes are overall survival (OS), progression-free survival (PFS), local recurrence (LR), distant metastasis (DM) and the occurrence of adverse events. Methods: This retrospective cohort study included patients with FIGO 2009 stage IB1-IVA cervical squamous cell carcinoma undergoing radical CCRT. Patients were divided into groups A and B, treatment outcomes were compared between the two groups after 1:1 proportional propensity score matching. Results: Medical records of 1,203 patients were reviewed and 572 patients were finally included for propensity score matching. After propensity score matching, 121 pairs of patients were selected for analysis. The OS, PFS, LR and DM rates were 78.5% and 83.5% (p=0.417), 73.3% and 78.5% (p=0.312), 6.6% and 2.5% (p=0.123), 19% and 15.7% (p=0.497) for groups A and B, respectively. Further subgroup analysis according to stage and lymph node metastatic status showed no difference in survival between the two groups. The incidence of grade 3–4 acute haematological toxicities was different between the two groups (p<0.05). Conclusion Cisplatin combined with paclitaxel CCRT couldn’t improve the survival rates of patients with LACC. However, the hematological toxicity of combination chemotherapy is more severe but controllable. Cisplatin single-agent therapy remains the first choice for CCRT. Further prospective studies are indicated to provide evidence for the efficacy of cisplatin plus paclitaxel in dual-agent concurrent therapy.

Hepatocellular carcinoma (HCC) is one of the most prevalent malignant tumors worldwide. The traditional early screening modality of ultrasound,when combined with the biomarker alpha-fetoprotein (AFP),is deficient in sensitivity and specificity. In recent years,HCC risk assessment models based on statistical methods have been widely developed and validated due to advantages such as good efficacy,non-invasiveness,and ease of generalization. Currently,HCC risk assessment models adapted to the characteristics of patients with chronic liver disease,patients with hepatitis B and C,patients with cirrhosis,and the general population have been developed. The purpose of this review is to assist clinical diagnosis treatment,and scientific research by analyzing the current research status and development of liver cancer risk assessment models.