Gastrointestinal (GI) cancers are prevalent globally, with leading incidence and mortality rates among malignant tumors. Despite notable advancements in surgical resection, radiotherapy, and chemotherapy, the overall survival rates remain low. Hence, it is imperative to explore alternative approaches that enhance patient outcomes. Cluster of differentiation 47 (CD47), serving as an early diagnostic marker, is predominantly overexpressed in GI cancers and associated with poor prognosis. Targeting the CD47-signal regulatory protein alpha (SIRPα) signaling pathway may provide a novel strategy for GI cancers treatment. This study summarizes current knowledge of the structure and function of CD47 and SIRPα, their roles in signaling pathways, the prognostic significance of CD47, therapeutic strategies targeting the CD47-SIRPα signaling pathway in GI cancer, and highlights key issues for future investigations.

[Objective]To investigate the depression status and its influencing factors in HIV/AIDS patients receiving antiviral therapy.[Methods]From July 2022 to September 2022,successive sampling method was used to recruit HIV/AIDS patients receiving antiviral therapy from antiviral treatment institutions in Nanjing,and they were instructed to fill out anonymous questionnaires.The questionnaire collected the basic information of patients,and depression,HIV stigma score and social support level were investigated by Patient Health Questionnaire-9(PHQ-9),Berger HIV stigma scale(BHSS)and Multidimensional Scale of Perceived Social Support(MSPSS).Multivariate Logistic regression was used to an-alyze the influencing factors of depression.[Results]A total of 1879 valid questionnaires were collected in this study,and the detection rate of depression was 50.1%.The results of multivariate logistic analysis showed that compared with patients with middle school or below,the risk of depression was lower for those with postgraduate or above[OR=0.534,95%CI(0.341,0.835),P=0.006].Compared with antiviral therapy duration<1 year,antiviral therapy duration for 1 to 5 years[OR=0.729,95%CI(0.536,0.991)],>5 to 10 years[OR=0.516,95%CI(0.379,0.702)],>10 years[OR=0.603,95%CI(0.375,0.969)]was associated with a lower risk of depression.High level of social support was a protective factor for depression in HIV/AIDS patients compared with middle and low level of social support[OR=0.430,95%CI(0.349,0.530),P<0.001].There was a higher risk of depression with side effects than without side effects[OR=2.260,95%CI(1.833,2.786),P<0.001].The higher the score on the HIV stigma scale,the higher the possibility of depression was.[Conclusion]The detection rate of depression of patients receiving antiviral therapy in Nanjing is high.After starting antivi-ral therapy,we should strengthen the monitoring of side effects and psychological status of patients,carry out psychologi-cal intervention,alleviate psychological problems,and improve the quality of life of patients receiving antiviral therapy.

Objective To investigate the effects of terahertz(THz)radiation on mouse testicular tissue and its potential molecular mechanisms.Methods A total of 125 male C57BL/6J mice(6～8 weeks old)were randomly divided into control group and low-,medium-and high-radiation power groups.The mice of the latter 3 groups were exposed to THz radiation at a frequency of 2.5 T,with an average power density of 38,115,or 318 mW/cm2,for 5 or 10 min.The detection time was immediately or 24 h after exposure.HE staining was used to observe pathological damage.ELISA was employed to detect the expression of inflammatory factors in testicular tissue.RNA-seq was utilized to detect the global changes of gene expression.The differentially expressed genes(DEGs)were screened and bioinformatics was used to cluster them.The screened genes were further analyzed with RT-qPCR to determine the time-dependent and dose-dependent relationships of the expression with THz exposure.Finally,sperm quality was evaluated morphologically using a microscope.Results Three doses of THz radiation exposure did not cause significant pathological damages to mouse testicular tissue.TNF-α expression was increased immediately after exposure at average power density of 115 mW/cm2(P＜0.01),and the expression of IL-1β and TNF-α were both increased when the dose reached 318 mW/cm2(P＜0.01).However,all the 3 factors returned to normal levels in 24 h after exposure.RNA-seq results showed that THz radiation exposure caused abnormal expression of 56 genes.Cluster analysis indicated that these DEGs were mainly enriched in immune and inflammatory responses,enzyme activity,sperm development and capacitation functions.Then for 5 selected key genes,Crisp1,Adam7,Ltf,Rnase9,and Bsph1,the expression of Crisp1 and Rnase9 was decreased immediately after exposure to 115 mW/cm2 THz radiation,the dose of 318 mW/cm2 resulted in obvious changes in the expression of the 5 genes(P＜0.05),and their expression returned to normal levels in 24 h after exposure.Morphological observation displayed that exposure to all the 3 doses of THz had no influence on sperm quality.Conclusion THz radiation exposure causes temporary inflammatory response in testicular tissue and abnormal expression of sperm functions-related genes.However,these changes return to normal 24 h after exposure,and additionally,do not impair sperm quality.

Objective To observe the value of CT radiomics nomogram for predicting Ki-67 expression of thymus epithelial tumors.Methods Totally 163 patients with thymus epithelial tumor,including 114 patients in training set and 49 patients in validation set were retrospectively enrolled.The patients were further divided into low expression(＜50％)and high expression(≥50％)subgroups according to Ki-67 index.Multivariate logistic regression analysis was performed to screen independent predicting factors of Ki-67 expression in thymus epithelial tumors,and clinical-CT model was constructed.The optimal radiomics features were extracted and screened based on chest plain and venous phase enhanced CT images,respectively.Then radiomics modelplain and radiomics modelenhanced were constructed,and Radscoreplain and Radscoreenhanced were calculated,respectively.The nomogram model was constructed based on clinical-CT model,Radscoreplain and Radscoreenhanced.Receiver operating characteristic curves were drawn,and the area under the curves(AUC)were calculated to evaluate the efficacy of each model for predicting Ki-67 expression of thymus epithelial tumors.Results Patient's gender and enhanced CT value of lesion were both independent predicting factors of Ki-67 expression in thymus epithelial tumors(both P＜0.05).The AUC of clinical-CT model,radiomics modelplain,radiomics modelenhanced and nomogram model for predicting Ki-67 expression was 0.736,0.814,0.836 and 0.857 in training set,which was 0.746,0.746,0.750 and 0.799 in validation set,respectively.Conclusion CT radiomics nomogram could be used to predict Ki-6 7 expression of thymus epithelial tumors.

Objective To observe the effect of Jinshui Liujun decoction on airway lesions in mice with COPD and explore its possible mechanism.Methods 48 C57BL/6 mice were randomly divided into blank group,model group,Jinshui Liujun decoction group and NAC group,with 12 in each group.The COPD mouse model was established by intranasal drip of LPS and smoking,and the corresponding drugs were given intragastric administration for 14 days after the model was established.Observe the general condition of the mice,measure the MV,PEF and PIF of the mice with the small animal lung function instrument,semi quantitatively evaluate the inflammation of the lung tissue,the thickness of the alveolar septum and the thickness of the airway wall with HE staining,and observe the airway mucus secretion and goblet cell proliferation with PAS staining.The content of MPO,SA and Urea in BALF was detected by the kit,and the ratio of SA and Urea was calculated.The content of MUC5AC in BALF was detected by ELISA.The levels of ROS,GSH,GSSG and GR in lung tissue were detected with the kit,and the ratio of GSH and GSSG was calculated.The expression level of CFTR mRNA in lung tissue was detected by qRT-PCR.Western blot was used to detect the expression level of CFTR protein in lung tissue.Results Compared with the control group,the growth of mice in the model group was poor.The body weight at each time point during the modeling period decreased(P<0.01),and the indexes of MV,PEF and PIF decreased(P<0.01).The lung tissue pathological score,alveolar septal thickness,airway wall thickness,airway mucus and goblet cell increased(P<0.01).The levels of SA,SA/Urea,MUC5AC and MPO in BALF increased(P<0.01),and the level of Urea decreased(P<0.01),The levels of ROS and GSSG in lung tissue increased(P<0.01),and the levels of GSH,GSH/GSSG,and GR decreased(P<0.01).The expression levels of CFTR mRNA and protein in lung tissue decreased(P<0.01).Compared with the model group,the growth condition of COPD mice improved,the body weight increased at each time point during the modeling period(P<0.05,P<0.01),the indexes of MV,PEF and PIF improved significantly(P<0.01),the pathological score of lung tissue,the thickness of alveolar septa,the thickness of airway wall,airway mucus and goblet cell decreased(P<0.01,P<0.05),and the levels of SA,SA/Urea,MUC5AC and MPO in BALF decreased(P<0.01),And an increase in Urea levels(P<0.01),a decrease in ROS and GSSG levels in lung tissue(P<0.01),and an increase in GSH,GSH/GSSG,and GR levels(P<0.01).The expression levels of CFTR mRNA and protein in lung tissue increased(P<0.01).Conclusion Jinshui Liujun decoction can correct CFTR acquired defects through antioxidant effects to improve airway lesions in COPD.

Objective To understand the current status and trends of research on the TCM treatment for stable phase of chronic obstructive pulmonary disease(COPD);To provide references for relevant research.Methods Literature about TCM treatment for stable phase of COPD was retrieved from China National Knowledge Infrastructure,Wanfang Data,VIP Information Chinese Journal Service Platform,and SinoMed from the establishment of the databases to Sep 1,2022.NoteExpress 3.4 was used to sort out the basic data of papers.Excel 2016 was employed to count first authors,syndrome type,prescription and draw a run chart of publication,determine the number of journals in the core area according to Bradford law.Core authors statistically were analyzed according to Price law.Author collaboration network and keyword co-occurrence analysis were conducted using VOSviewer 1.6.18.CiteSpace 5.3.R4 was exploited to construct institutional collaboration network and study burst terms,and knowledge map was drawn.Results A total of 3 360 articles were included,involving 445 journals,with 2 691 first authors.The overall number of publications in this field showed an increasing trend,with clinical research being the main research type.There were 21 journals in the core region and the most frequently published journal was New Chinese Medicine.There were 125 core authors,with Li Zhuying and Li Jiansheng posting the most articles.Author collaboration network analysis showed 10 major research teams and the largest of which was Li Jiansheng's team.There were 1 451 institutions,mainly were universities and affiliated hospitals.There were 62 types of syndromes in the stable phase of COPD,the most common of which was the syndrome of qi deficiency of lung and spleen.There were 541 kinds of prescriptions in total,and the most commonly used was Bufei Decoction.Keyword co-occurrence analysis showed 8 subjects,and the high-frequency keywords included lung function,clinical efficacy,quality of life,clinical observation and TCM treatment.22 burst terms were obtained,with Budesonide Fumotro,six-word songs,Yupingfeng Powder and inflammatory factors highly concerned at present.Conclusion The research fever of TCM treatment for COPD in stable period shows an increasing trend,and clinical research accounts for the largest proportion,but the general quality is not high,and basic research is relatively lacking.The research focuses on the inhibition of airway inflammation and immune regulation,and lung function and quality of life are the most commonly used evaluation indicators.

Objective:To evaluate postoperative biochemical and clinical remission rates in patients with unilateral primary aldosteronism and analyze related influencing factors.Methods:A total of 406 patients of primary aldosteronism with confirmed subtyping, who underwent adrenalectomy and completed follow-up in the Department of Endocrinology of the First Affiliated Hospital of Chongqing Medical University from November 2013 to March 2022 were retrospectively enrolled. Clinical and biochemical data were recorded. Postoperative clinical and biochemical outcomes were assessed according to Primary Aldosteronism Surgery Outcome(PASO) consensus.Results:Complete biochemical success was achieved in 391(96.31%) of 406 primary aldosteronism patients, while partial and absent biochemical success in only 4(0.99%) and 11(2.71%) primary aldosteronism patients; Complete clinical success was seen in 217(53.45%) patients, and partial clinical success in 189(46.55%) patients. Compared to the partial clinical success group, the complete clinical success group was younger, had a greater proportion of women, a smaller body mass index, a shorter duration of hypertension, a smaller daily defined dose value for antihypertensive medication, a higher estimated glomerular filtration rate(eGFR), and a lower proportion of family history of hypertension and diabetes mellitus. Multifactorial logistic regression analysis further showed that gender( OR=2.49, 95% CI 1.42-4.35, P=0.001), body mass index( OR=1.16, 95% CI 1.05-1.28, P=0.003), antihypertensive drug daily defined dose( OR=1.83, 95% CI 1.37-2.44, P<0.001), family history of hypertension( OR=2.16, 95% CI 1.22-3.83, P=0.008), history of diabetes( OR=2.47, 95% CI 1.15-5.29, P=0.021), and eGFR( OR=0.98, 95% CI 0.97-0.99, P=0.001) were independent factors influencing clinical prognosis of primary aldosteronism. Conclusion:The postoperative complete biochemical success is higher in patients with unilateral primary aldosteronism, but only about half of all patients achieve complete clinical success.

Objective:To investigate the appropriate cut-off for diagnosis of primary aldosteronism (PA) by seated saline suppression test (SSST) based on liquid chromatography with tandem mass spectrometry (LC-MS/MS).Methods:In this cross-sectional study, patients who underwent SSST for suspected PA in the First Affiliated Hospital of Chongqing Medical University from January 2018 to March 2022 were evaluated. Briefly, 300 patients with PA and 119 with essential hypertension (EH) were included. Plasma aldosterone concentration (PAC) after SSST was determined by LC-MS/MS. Primary aldosteronism confirmatory testing (PACT) score was used as the reference standard for diagnosis of PA, and receiver operating characteristic (ROC) curve was used to explore the cut-off value.Results:The average age of the PA group was (50.8±10.5) years, and males accounted for 53.00% ( n=159); the average age of the EH group was (49.4±11.2) years, and males accounted for 26.89% ( n=32). The area under the ROC curve of PAC post-SSST was 0.819 (95% CI 0.775-0.862). When 40 pg/ml (110.8 pmol/L) was selected as the appropriate cut-off for diagnosis of PA, the sensitivity was 83.67% (95% CI 78.88%-87.56%) and specificity was 60.50% (95% CI 51.10%-69.21%). Thus, 95.09% (155/163) of patients with unilateral PA could be identified. Conclusion:PAC after SSST determined by LC-MS/MS has high efficacy for diagnosis of PA, and 40 pg/ml is recommended as the appropriate cut-off value.

Parkinson′s disease (PD) is a neurodegenerative disorder, and the abnormal levels of its pathological marker ɑ-synuclein (ɑ-syn) are often accompanied by imbalanced heavy metal homeostasis. However, the underlying mechanisms remain unclear, with limited research. This review explores the interactions between iron, copper, zinc, and manganese with pathological ɑ-syn′s abnormal expression, aggregation, and degradation in development and progression of PD. It also discusses potential therapeutic directions for addressing heavy metal imbalances in PD patients.

The purpose of this research was to compare the therapeutic efficacy of multiple-rod constructs vis-a-vis 2-rod constructs in the treatment of adult spinal deformity. A systematic review and meta-analysis were performed to determine whether the multiple-rod construct outperformed the 2-rod construct. We initially retrieved 357 papers, but only 12 were chosen for further meta-analysis. The rod breakage rates in the multiple-rod and the 2-rod groups were 10.66% and 29.87%, respectively. The multiple-rod construct inhibited rod breakage (odds ratio [OR], 0.28; 95% confidence interval [CI], 0.19–0.41; p<0.001), pseudarthrosis (OR, 0.30; 95% CI, 0.18–0.50; p<0.001) and rod fracture at the osteotomy site (OR, 0.34; 95% CI, 0.13–0.89; p=0.03). Furthermore, the multiple-rod construct reduces the risk of revision surgery (OR, 0.38; 95% CI, 0.20–0.73; p=0.04) as well as the revision risk of pseudarthrosis/rod fracture in the multiple- rod group (OR, 0.31; 95% CI, 0.18–0.52; p<0.001), but increases the risk of caudal screw loosening (OR, 4.99; 95% CI, 1.87–13.30; p=0.001). There was no statistically significant difference in proximal junctional kyphosis (PJK) parameters (p=0.85), cerebrospinal fluid leakage (p=0.09), wound infection (p =0.71), age at surgery (p=0.62), gender distribution (p=0.93), body mass index (p =0.86), smoking status (p=0.05), hospital stay (p=0.09), osteoporosis (p=0.95), CoCr rod material (p=0.15), bone morphogenetic protein-2 (p=0.58), L5/S1 interbody fusion (p=0.07), high-grade osteotomies (p=0.07), the number of fusion levels (p=0.11), operation time (p=0.30), and blood loss volume (p=0.34). Regarding radiographic parameters, only preoperative sagittal vertical axis was found to be higher (weight means difference [WMD], 25.60; 95% CI, 15.43–35.77; p<0.001) in the multiple-rod group. There was no difference in preoperative Oswestry Disability Index (ODI) (WMD, −3.32; 95% CI, −7.38 to 0.73; p=0.11), but the multiple-rod group had a lower ODI at follow-up (WMD, −7.71; 95% CI, −11.62 to −3.86; p<0.001). Multiple-rod constructs could prevent rod breakage and pseudarthrosis while also lowering the revision rate, resulting in a better clinical outcome than the 2-rod construct. Nonetheless, due consideration should be given to PJK and screw loosening in multiple-rod constructs, possibly due to the increased stiffness caused by the multiple-rod structure.