OBJECTIVE To explore the mechanism of action of Qingre huatan huoxue decoction against atherosclerosis （AS）based on macrophage polarization. METHODS Using atorvastatin served as the positive control， the drug-containing serum of the Qingre huatan huoxue decoction was prepared to treat RAW264.7 macrophages. Macrophage viability， apoptosis rate， and the fluorescence intensities of CD86 and CD206 were measured， along with the levels of tumor necrosis factor-α （TNF-α） and interleukin-1β （IL-1β）. Apolipoprotei n E-deficient （ApoE －/－ ） mice （AS model mice） fed with a high-fat diet were randomly assigned to model group， atorvastatin group （2.6 mg/kg）， and low-， medium- and high-dose groups of Qingre huatan huoxue decoction （90， 180， 360 mg/kg）， respectively. C57BL/6J mice fed with a standard diet served as the normal control group， with 10 mice per group. The treatment group mice were administered the corresponding drugs intragastrically， once daily， for 8 consecutive weeks. Serum levels of TNF-α and IL-1β were measured in all groups. Lipid deposition in the aorta （assessed by the percentage of plaque in the entire aorta and aortic root） and morphological changes in the aortic root were observed. Expression levels of CD86 and CD206 in aortic tissue， as well as the protein expression levels of inducible nitric oxide synthase （iNOS）， arginase-1 （Arg-1）， AMP-activated protein kinase （AMPK）， phosphorylated AMPK （p-AMPK）， and peroxisome proliferator-activated receptor γ （PPAR-γ） in aortic tissues were all detected. RESULTS Cell experiment results showed that， at concentrations of 5-100 μg/mL， the drug-containing serum of the Qingre huatan huoxue decoction significantly increased RAW264.7 cell viability （ P ＜0.05）. The drug-containing serum of the Qingre huatan huoxue decoction at concentrations of 10， 50， and 100 μg/mL， along with atorvastatin， significantly reduced apoptosis rates， CD86 fluorescence intensity， and TNF-α and IL-1β levels in RAW264.7 cells， while markedly enhancing CD206 fluorescence intensity （ P ＜0.05）. Animal experiment results showed that， compared with the model group， all dosage groups of Qingre huatan huoxue decoction and the atorvastatin group showed significantly reduced/down-regulated levels of TNF-α and IL-1β in serum， along with decreased aortic total and root plaque percentages， CD86 expression， and iNOS protein expression. CD206 expression and Arg-1， p-AMPK/AMPK， PPAR-γ protein expression were significantly up-regulated （ P ＜0.05）. Pathological morphology of the aorta showed varying degrees of improvement. CONCLUSIONS The formula of Qingre huatan huoxue decoction exerts its anti-AS effects by regulating macrophage polarization， increasing the proportion of M2 macrophages， thereby effectively inhibiting AS plaque formation and reducing inflammatory responses.

The choroidal vascularity index(CVI)is a quantitative structural parameter derived from optical coherence tomography(OCT)images. It is defined as the ratio of the luminal area to the total choroidal area, which characterizes alterations in the structural proportion between choroidal vascular lumens and stroma, and indirectly indicates changes in choroidal status to a certain extent. With the development of enhanced depth imaging optical coherence tomography(EDI-OCT), CVI has been increasingly applied in ophthalmic research and clinical practice.Measurements of CVI exhibit excellent repeatability and reliability. Combined with the noninvasive nature of EDI-OCT, CVI is an extremely valuable assessment tool for clinical ophthalmic research and routine clinical practice. CVI can quantify proportional changes between the choroidal luminal area and total choroidal area, and better reflects relative variations in choroidal vascular and stromal components compared with choroidal thickness alone. In recent years, CVI has been widely applied to multiple ocular diseases including age-related macular degeneration(ARMD), central serous chorioretinopathy(CSC), diabetic retinopathy(DR), and high myopia. In addition to the diseases themselves, various ocular surgeries and procedures can also affect CVI. Current evidence suggests that changes in CVI may be associated with factors such as postoperative inflammatory response, choroidal hemodynamic alterations, vascular permeability changes, and intraocular pressure fluctuations. However, discrepancies remain among studies regarding the direction and duration of these changes and their relationship with visual outcomes. This review summarizes the effects of ocular surgeries and procedures on CVI and further discusses its clinical interpretation, existing controversies, and future research directions, aiming to provide a reference for perioperative assessment of choroidal structural changes and prognostic evaluation.

Pulpitis is a common infective oral disease in clinical situations. The regulatory mechanisms of immune defense in pulpitis are still being investigated. Osteomodulin (OMD) is a small leucine-rich proteoglycan family member distributed in bones and teeth. It is a bioactive protein that promotes osteogenesis and suppresses the apoptosis of human dental pulp stem cells (hDPSCs). In this study, the role of OMD in pulpitis and the OMD-induced regulatory mechanism were investigated. The OMD expression in normal and inflamed human pulp tissues was detected via immunofluorescence staining. Intriguingly, the OMD expression decreased in the inflammatory infiltration area of pulpitis specimens. The cellular experiments demonstrated that recombined human OMD could resist the detrimental effects of lipopolysaccharide (LPS)-induced inflammation. A conditional Omd knockout mouse model with pulpal inflammation was established. LPS-induced inflammatory impairment significantly increased in conditional Omd knockout mice, whereas OMD administration exhibited a protective effect against pulpitis. Mechanistically, the transcriptome alterations of OMD overexpression showed significant enrichment in the nuclear factor-κB (NF-κB) signaling pathway. Interleukin-1 receptor 1 (IL1R1), a vital membrane receptor activating the NF-κB pathway, was significantly downregulated in OMD-overexpressing hDPSCs. Additionally, the interaction between OMD and IL1R1 was verified using co-immunoprecipitation and molecular docking. In vivo, excessive pulpal inflammation in Omd-deficient mice was rescued using an IL1R antagonist. Overall, OMD played a protective role in the inflammatory response via the IL1R1/NF-κB signaling pathway. OMD may optimize the immunomodulatory functions of hDPSCs and can be used for regenerative endodontics.
Pulpitis/metabolism* ; NF-kappa B/metabolism* ; Animals ; Signal Transduction ; Humans ; Mice ; Mice, Knockout ; Dental Pulp/metabolism* ; Disease Models, Animal ; Lipopolysaccharides

With the growing emphasis on maternal and child oral health, the significance of managing oral health across preconception, pregnancy, and infancy stages has become increasingly apparent. Oral health challenges extend beyond affecting maternal well-being, exerting profound influences on fetal and neonatal oral development as well as immune system maturation. This expert consensus paper, developed using a modified Delphi method, reviews current research and provides recommendations on maternal and child oral health management. It underscores the critical role of comprehensive oral assessments prior to conception, diligent oral health management throughout pregnancy, and meticulous oral hygiene practices during infancy. Effective strategies should be seamlessly integrated across the life course, encompassing preconception oral assessments, systematic dental care during pregnancy, and routine infant oral hygiene. Collaborative efforts among pediatric dentists, maternal and child health workers, and obstetricians are crucial to improving outcomes and fostering clinical research, contributing to evidence-based health management strategies.
Humans ; Pregnancy ; Female ; Infant ; Consensus ; Mouth Diseases/therapy* ; Pregnancy Complications/therapy* ; Oral Health ; Infant, Newborn ; Delphi Technique ; Oral Hygiene

Objective:To investigate the expression and clinical significance of the complement C3 and the S100 calcium binding protein A10 (S100A10) in children with traumatic brain injury (TBI).Methods:This case-control study included 129 TBI children admitted to the Affiliated Xuzhou Children′s Hospital of Xuzhou Medical University from January 2023 to November 2024.The patients were divided into a mild group (85 cases) and a moderate-to-severe group (44 cases).Thirty children with inguinal hernia but no underlying diseases admitted to the hospital during the same period were enrolled as the control group A. Twenty children whose lumbar puncture examination showed normal cerebrospinal fluid results and imaging tests showed no central nervous system disorder were included in the control group B. The children with moderate-to-severe TBI were followed up for 1 month after injury and further divided into good and poor prognosis groups.One-way (repeated-measures) analysis of variance (ANOVA) and t-tests were used to compare differences in complement C3 and S100A10 levels in serum and cerebrospinal fluid among groups.The correlation analysis was performed using the Spearman rank correlation method.Receiver operating characteristic (ROC) curves were drawn to evaluate the value of complements C3 and S100A10 proteins for predicting TBI severity. Results:The serum complement C3 levels in control group A, mild TBI, and moderate-to-severe TBI groups were (1.15±0.26) g/L, (1.02±0.09) g/L, (0.87±0.15) g/L, respectively.The difference in serum complement C3 levels was statistically significant among these three groups ( F=53.661, P<0.001).The serum S100A10 levels in control group A, mild TBI, and moderate-to-severe TBI groups were (0.09±0.03) μg/L, (0.17±0.04) μg/L, (0.32±0.11) μg/L, respectively.The difference in serum S100A10 levels was statistically significant among these three groups ( F=71.093, P<0.001).The levels of complement C3 and S100A10 in the cerebrospinal fluid (30 min post-operation) of children with severe TBI were significantly higher than those in the control group B, with statistically significant differences (all P<0.01).Correlation analysis revealed that Glasgow Coma Scale scores showed a positive correlation with serum complement C3 levels and a negative correlation with S100A10 levels ( r=0.592, -0.705; all P<0.001).The serum complement C3 and S100A10 levels were (0.90±0.13) g/L and (0.30±0.10) μg/L in the good prognosis group, and (0.74±0.16) g/L and (0.42±0.11) μg/L in the poor prognosis group, respectively.Both serum complement C3 and S100A10 levels were statistically significantly different between good and poor prognosis groups ( t=3.025, -3.014; all P<0.01).The complement C3 level in the cerebrospinal fluid of severe TBI children was (0.093±0.007) g/L 30 min after operation, and it gradually increased to reach the first peak at day 3 and the second peak at day 5 postoperatively[(0.112±0.005) g/L and (0.120±0.010) g/L, respectively].The difference in the complement C3 level in the cerebrospinal fluid of severe TBI children was significant between 30 min and 3-5 d after operation ( F=42.756, P<0.01).The S100A10 level in the cerebrospinal fluid of severe TBI children was (2.56±0.31) μg/L 30 min after operation, and then it showed a sustained increase, reaching (4.09±0.13) μg/L at day 7 postoperatively.The difference in the S100A10 level in the cerebrospinal fluid of severe TBI children was significant between 30 min and 7 d after operation ( F=110.676, P<0.01).ROC curve analysis showed that the areas under the curve for predicting moderate-to-severe TBI based on serum complement C3 and S100A10 levels were 0.802 and 0.889, respectively (all P<0.01). Conclusions:Serum complement C3 levels are significantly decreased whereas serum S100A10 levels are markedly elevated in pediatric TBI patients.The measurement of serum complement C3 and S100A10 levels can aid in the clinical assessment of the severity and prognosis of TBI children.Both complement C3 and S100A10 levels in cerebrospinal fluid show a significant elevation within 7 days after operation in severe pediatric TBI, which is potentially linked to sustained astrocyte activation.

Objective:To investigate variation and correlation of type 2 intrinsic lymphocyte(ILC2)and related factors in acute and chronic brucellosis,to identify immune role of ILC2 in chronic brucellosis.Methods:Forty-three patients with acute brucel-losis and 45 patients with chronic brucellosis were compared with 49 healthy controls.ILC2 level in each group was detected by flow cytometry.mRNA level of GATA3 in PBMC was detected by fluorescence quantitative PCR.Serum IL-33,ST2,IL-4 and IL-13 levels were detected by ELISA.ALT and AST levels were measured by fully automatic biochemical analyzer.Results:ILC2 level,GATA3 mRNA in PBMC,serum IL-33,IL-4 and IL-13 levels in chronic brucellosis group were significantly higher than healthy control group and acute brucellosis group(P<0.01).Correlation analysis showed that ILC2 level was positively correlated with GATA3 mRNA,IL-33,IL-4 and IL-13 levels,while negatively correlated with ST2 level.ROC curve suggested that ILC2,GATA3,IL-33 and ST2 had good predictive ability for severity of brucellosis patients(AUC>0.7).Conclusion:Increase of ILC2 and its related factors are closely related to chronic brucella infection,which may play an important immune role in pathogenesis of brucella infection.

Objective To analyze the risk factors for chronic cough following pulmonary surgery in patients with non-small cell lung cancer (NSCLC). Methods A retrospective analysis was conducted on 427 NSCLC patients who underwent pulmonary surgery in the Department of Thoracic Surgery, The First Affiliated Hospital of the University of Science and Technology of China, between January 2021 and June 2023. Patients were categorized into a chronic cough group (103 patients) and a non-chronic cough group (324 patients) based on the presence of cough at 8 weeks post-surgery. A comparative analysis was performed between the two groups, considering gender, age, smoking history, comorbidities, preoperative pulmonary function indicators, pleural adhesion, anesthesia duration, surgical site, operative techniques, lymph node dissection methods, tumor maximum diameter, and postoperative chest tube duration. Factors showing statistical significance in univariate analysis underwent multivariate logistic regression analysis. Results Among the 427 patients undergoing pulmonary surgery, there were 165 males and 262 females, with an average age of (59.93±12.11) years. The incidence of chronic cough was 24.12%. Univariate analysis revealed significant differences in smoking history, preoperative pulmonary function indicators, pleural adhesion, anesthesia duration ≥135.5 minutes, surgical site, operative techniques, lymph node dissection methods, tumor maximum diameter, and postoperative chest tube duration (P<0.05). Multivariate logistic regression analysis indicated that the surgical site (right upper lung), operative techniques (lobectomy), lymph node dissection, and anesthesia time ≥135.5 minutes were independent risk factors for chronic cough following pulmonary surgery. Conclusion Patients undergoing right upper lung surgery, lobectomy, lymph node dissection, and experiencing anesthesia duration ≥135.5 minutes are at a higher risk of developing chronic cough post-pulmonary surgery.

Objective:To compare the effect of in situ and ex situ liver splitting techniques on the short-term outcomes of complete split liver transplantation.Methods:A retrospective analysis was conducted on the perioperative and follow-up data of 81 adult split liver transplant recipients and 42 donors at Ningbo University's Affiliated Lihuili Hospital from Mar 2021 to Dec 2023. Patients were divided into the ex situ and in situ splitting groups, and short-term complications were compared.Results:As of Dec 2023, the follow-up duration ranged from 1 to 30 months, with a median of 19 months. Cold and warm ischemia times were significantly shorter in the in situ splitting group compared to the ex situ group ( P<0.001). Postoperative peak levels of AST and ALT were also lower in the in situ splitting group ( P<0.01). However, the incidence of biliary complications was higher in the in situ splitting group (13 cases vs. 1 case, P=0.028). Conclusions:Compared to ex situ splitting, in situ splitting significantly reduces cold and warm ischemia times and results in less hepatocellular injury. However, it is associated with a higher incidence of biliary complications.

Thoracolumbar spine fracture often leads to severe pain, functional impairments, and neurological deficits, for which open reduction and internal fixation can effectively restore the spinal structural stability. Open decompression and reduction with internal fixation can help relieve spinal cord compression and improve spinal function in cases of concomitant cord injury. Although spinal stability can be restored through surgery, patients often face chronic pain and functional impairments postoperatively. A postoperative rehabilitation program is critical in optimizing therapeutic outcomes, reducing complications, and minimizing the risk of secondary injuries. However, current rehabilitation methods, such as physical therapy, functional training, and pain management, are confronted with problems in clinical practice, including significant variation in efficacy, poor patient adherence, and prolonged rehabilitation period. There is an urgent need for a unified rehabilitation strategy to address these problems. To this end, the Spinal Trauma Group of the Orthopedic Physicians Branch of the Chinese Medical Association and the Spine Health Professional Committee of the Chinese Human Health Technology Promotion Association organized experts from relevant fields to formulate Evidence-based guidelines for rehabilitation treatment after internal fixation of thoracolumbar spine fracture in adults ( version 2025) by integrating evidences from clinical researches and advanced rehabilitation concepts at home and abroad. A total number of 14 recommendations concerning the rehabilitation treatment with multimodal analgesia, psychological intervention, deep vein thrombosis prevention, core muscle and extremity exercise, appropriate use of braces, early weight-bearing, device-aided rehabilitation exercise, neuroregulatory therapy, rehabilitation team were put forward, aiming to standardize the post-operative rehabilitation process following internal fixation, promote the functional recovery, and enhance patients′ quality of life.