Objective To explore the mechanism of modified maimendong decoction (MMD) in inhibiting lung cancer metastasis from the perspective of immune regulation. Methods CTC-TJH-01 and LLC cells were intervened with different concentrations of modified maimendong decoction. The cell proliferation was detected with a CCK-8 kit, apoptosis was detected with an Annexin V-FITC/PI kit, and cell migration was detected through Transwell assays. A lung metastasis model was established through the tail vein injection of LLC cells into C57BL/6 mice, and body weight change and lung tumor metastasis in the mice were evaluated after continuous gavage intervention with MMD. HE staining, immunohistochemistry, and immunofluorescence were employed to observe the histomorphology, Ki-67 protein level, and NK and T cell levels of metastatic lesions. The levels of NK and T cells in the peripheral blood of mice were detected throughflow cytometry. Results MMD had no significant inhibitory effect on the proliferation, apoptosis, and migration of CTC-TJH-01 and LLC cells in vitro. In mice, MMD could significantly inhibit the lung metastasis of LLC cells, increase the proportion of NK and CD8⁺ T cells in peripheral blood and tumor microenvironment (P<0.05), and reduce the expression of Ki-67 protein in metastatic tumor tissues (P<0.05). Conclusion MMD may inhibit the growth of metastatic tumors by upregulating the expression levels of NK and CD8⁺ T cells in peripheral blood to promote the elimination of circulating tumor cells, and regulating the infiltration of NK and CD8⁺ T cells in the immune microenvironment of metastatic tumors, then play an antimetastatic role in lung cancer.

Hemiplegic migraine （HM） is a specific subtype of migraine with aura and is difficult to diagnose due to its low incidence rate and diverse clinical symptoms. This article reports a case of HM with hemiplegia as the initial presentation. This patient had a long course of disease and critical conditions and was comorbid with intractable epileptic seizures. A literature review is performed to improve the understanding of this disease among clinicians.
Stroke

Cardiovascular diseases and psychological disorders represent two major threats to human physical and mental health. Research on electrocardiogram (ECG) signals offers valuable opportunities to address these issues. However, existing methods are constrained by limitations in understanding ECG features and transferring knowledge across tasks. To address these challenges, this study developed a multi-resolution feature encoding network based on residual networks, which effectively extracted local morphological features and global rhythm features of ECG signals, thereby enhancing feature representation. Furthermore, a model compression-based continual learning method was proposed, enabling the structured transfer of knowledge from simpler tasks to more complex ones, resulting in improved performance in downstream tasks. The multi-resolution learning model demonstrated superior or comparable performance to state-of-the-art algorithms across five datasets, including tasks such as ECG QRS complex detection, arrhythmia classification, and emotion classification. The continual learning method achieved significant improvements over conventional training approaches in cross-domain, cross-task, and incremental data scenarios. These results highlight the potential of the proposed method for effective cross-task knowledge transfer in ECG analysis and offer a new perspective for multi-task learning using ECG signals.
Humans ; Electrocardiography/methods* ; Mental Health ; Algorithms ; Signal Processing, Computer-Assisted ; Machine Learning ; Arrhythmias, Cardiac/diagnosis* ; Cardiovascular Diseases ; Neural Networks, Computer ; Mental Disorders

Colorectal cancer is one of the most common malignant tumors, which is a great threat to human life and health. The change of bile acid homeostasis can activate their corresponding receptors to regulate the immune functions, which is closely related to the occurrence of colorectal cancer. In addition, some bile acids can directly induce colorectal cancer and play an important role in the development of colorectal cancer. In this paper, the metabolic process of bile acids in vivo and the immunomodulatory role of bile acid receptors were reviewed, and the evidence of associations between bile acids and colorectal cancer were summarized, which showed the rebalancing the bile acid levels might play a role in the prevention or treatment of colorectal cancer.

Objective:To investigate the relationship between intra-abdominal pressure (IAP) and respiratory function in mechanically ventilated children with severe pneumonia and its prognostic value.Methods:A case-series study.Ninety-two children with severe pneumonia who were treated with mechanical ventilation in the Intensive Care Unit of Children′s Hospital Affiliated to Zhengzhou University from May 2019 to May 2021 were taken as the study subjects.The IAP and respiratory function-related indexes of the children were monitored.Those with IAP ≥12 mmHg(1 mmHg=0.133 kPa) were divided into the study group, and those with IAP <12 mmHg were divided into the control group.The difference in respiratory function related indexes between the 2 groups was compared, and the relationship between IAP and respiratory function indexes was analyzed by Pearson correlation.The children were divided into a good prognosis group and a poor prognosis group according to their prognosis.The relevant clinical data of the children in the 2 groups were collected for univariate analysis, and multivariate Logistic regression was used to analyze the risk factors affecting the prognosis of children with mechanical ventilation for severe pneumonia.A receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of IAP on the prognosis of mechanically ventilated children with severe pneumonia.Results:The arterial partial pressure of oxygen (PaO 2) [(80.15±8.23) mmHg], arterial blood oxygen saturation (SaO 2) [(91.32±2.13)%], and oxygenation index (PaO 2/FiO 2) [(198.29±20.25) mmHg] in the study group were lower than those in the control group [(85.74±8.42) mmHg, (97.05±2.47)%, and (234.84±25.24) mmHg], while the respiratory rate (RR) [(56.23±2.16) breaths/min vs. (50.41±2.24) breaths/min], partial pressure of carbon dioxide (PaCO 2) [(36.48±3.72) mmHg vs.(33.29±3.46) mmHg], fraction of inspired oxygen (FiO 2) [(40.42±4.25)% vs.(36.51±3.72)%], mean arterial pressure (MAP) [(55.98±5.69) mmHg vs.(52.79±5.43) mmHg], and positive end expiratory pressure (PEEP) [(5.03±0.52) cmH 2O vs.(4.52±0.47) cmH 2O, 1 cmH 2O=0.098 kPa] were higher than those in the control group, and the differences were all statistically significant (all P<0.05).The IAP of the children in the study group was (14.25±1.83) mmHg, and that in the control group was (10.38±1.14) mmHg.Pearson correlation analysis showed that IAP was negatively correlated with PaO 2, SaO 2, and PaO 2/FiO 2 ( r=-0.615, -0.587, and -0.647, all P<0.05), and was positively correlated with RR, PaCO 2, FiO 2, MAP, and PEEP ( r=0.618, 0.634, 0.579, 0.578, 0.593, all P<0.05).IAP [(14.76±1.58) mmHg], PaCO 2 [(39.95±4.21) mmHg], FiO 2 [(50.29±5.12)%], alanine aminotransferase[(42.08±4.15) U/L], and total bilirubin [(17.92±1.87) μmol/L] in the poor prognosis group were greater than those [(10.75±1.19) mmHg, (35.37±3.64) mmHg, (45.38±4.47)%, (39.87±4.06) U/L, and (17.09±1.75) μmol/L] in the good prognosis group, while PaO 2 [(65.42±7.86) mmHg vs.(76.42±7.51) mmHg], SaO 2 [(90.65±9.26)% vs.(96.21±2.19)%], and PaO 2/FiO 2 [(130.09±15.15) mmHg vs.(168.40±20.17) mmHg] were smaller than those in the good prognosis group, and the differences were statistically significant (all P<0.05).Logistic regression analysis showed that IAP, PaO 2, PaCO 2, and SaO 2 were risk factors affecting the prognosis of mechanically ventilated children with severe pneumonia (all P<0.05).The optimal cut-off point of IAP for predicting a poor prognosis in mechanically ventilated children with severe pneumonia was 14.55 mmHg, and the area under the ROC curve was 0.873, with a sensitivity of 88.10% and a specificity of 76.00%. Conclusions:IAP has a certain relationship with the respiratory function of mechanically ventilated children with severe pneumonia, and has a good predictive value for the prognosis of the children.

Objective:To investigate the influence of curative-intent resection with textbook outcomes of liver surgery (TOLS) on long-term prognosis of gallbladder carcinoma (GBC).Methods:The retrospective cohort study was conducted. The clinicopathological data of 824 patients with GBC in the national multicenter database of Biliary Surgery Group of Elite Group of Chinese Journal of Digestive Surgery, who were admitted to 15 medical centers from January 2014 to January 2021, were collected. There were 285 males and 539 females, aged (62±11)years. According to the evalua-tion criteria of TOLS, patients were divided into those who achieved TOLS and those who did not achieve TOLS. Measurement data with normal distribution were represented as Mean± SD, and com-parison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data were conduc-ted using the Mann-Whitney U test. The Kaplan-Meier method was used to calculate survival rate and draw survival curve, and the Log-rank test was used for survival analysis. The COX stepwise regression model with backward Wald method was used for univariate and multivariate analyses. Results:(1) Achievement of TOLS. Of the 824 patients undergoing curative-intent resection for GBC, there were 510 cases achieving TOLS and 314 cases not achieving TOLS. (2) Follow-up. Of the 824 patients undergoing curative-intent resection for GBC, after excluding 112 deaths within 90 days after discharge, 712 cases were included for the survival analysis. The median follow-up time, median overall survival time and 5-year overall survival rate of the 510 patients achieving TOLS were 22.1(11.4,30.1)months, 47.6(30.6,64.6)months and 47.5%. The median follow-up time, median overall survival time and 5-year overall survival rate of the 202 patients not achieving TOLS were 14.0(6.8,25.5)months, 24.3(20.0,28.6)months and 21.0%. There was a significant difference in overall survival between patients achieving TOLS and patients not achieving TOLS ( χ2=58.491, P<0.05). (3) Analysis of factors influencing prognosis of patients. Results of multivariate analysis showed that TOLS, carcinoembryonic antigen (CEA), CA19-9, poorly differentiation of tumor, T2 stage of eighth edition of American Joint Committee on Cancer (AJCC) staging, T3 and T4 stage of eighth edition of AJCC staging, N1 stage of the eighth edition of AJCC staging, N2 stage of the eighth edition of AJCC staging, adjuvant therapy were independent factors influencing overall survival time of patients undergoing curative-intent resection for GBC ( hazard ratio=0.452, 1.479, 1.373, 1.612, 1.455, 1.481, 1.835, 1.978, 0.538, 95% c onfidence interval as 0.352-0.581, 1.141-1.964, 1.052-1.791, 1.259-2.063, 1.102-1.920, 1.022-2.147, 1.380-2.441, 1.342-2.915, 0.382-0.758, P<0.05). Conclusion:Patients under-going curative-intent resection for GBC with TOLS can achieve better long-term prognosis.

Objective:To investigate the influencing of preoperative total bilirubin (TBil) on perioperative complications of hepatolithiasis receiving liver resection.Methods:The retrospective cohort study was conducted. The clinical data of 300 patients with hepatolithiasis who were admitted to 2 medical centers from January 2010 to January 2022 were collected. There were 115 males and 185 females, aged (54±13)years. Measurement data with normal distribution were represented as Mean± SD, and the independent sample t test was used for comparison between groups. Measurement data with skewed distribution were represented as M( Q1, Q3), and the Mann-Whitney U test was used for comparison between groups. Count data were expressed as absolute numbers, and the chi-square test was used for comparison between groups. Variables with P<0.10 in the univariate analysis were included into the multivariate analysis. Univariate analysis was conducted using the Logistic regression model,and multivariate analysis was conducted using the Logistic stepwise regression model with backward Wald method. Continuous variables were converted into categorical variables based on commonly reported cutoff values when conducting Logistic regression analysis. Results:(1) Comparison of clinical data of patients with different preoperative TBil. Of 300 patients with hepatolithiasis, there were 252 cases with low level of preoperative TBil as 14.4(11.1,19.7)μmol/L, and there were 48 cases with high level of preoperative TBil as 44.0(31.3,59.8)μmol/L. Of the pati-ents with low level of preoperative TBil, neutrophils percentage was 62%±10%, cases with intra-operative blood transfusion was 29, and cases undergoing anatomical liver resection was 166. Of the patients with high level of preoperative TBil, neutrophils percentage was 70%±11%, cases with intraoperative blood transfusion was 22, and cases undergoing anatomical liver resection was 15. There were significant differences in cases classified as>grade 2 of ASA classification, neutrophils percentage, cases with intraoperative blood transfusion and cases undergoing anatomical liver resection between patients with low and high level of preoperative TBil ( t=5.182, χ2=33.669, 18.775, P<0.05). (2) Comparison of perioperative complications of patients with different preoperative TBil. Of the 252 patients with low level of TBil, there were 151 cases with complications including 35 cases of serious complications, there was 1 case with postoperative liver failure, the duration of postoperative hospital stay was 13.0(10.0,16.0)days. Of the 48 patients with high level of TBil, there were 32 cases with complications including 17 cases of serious complications, there were 6 cases with postoperative liver failure, the duration of postoperative hospital stay was 14.0(10.0,18.8)days. There were significant differences in cases with serious complications and cases with postoperative liver failure between patients with low and high level of preoperative TBil ( χ2=13.041, 20.879, P<0.05). (3) Analysis of factors influencing postoperative serious complications in patients undergoing liver resection. Results of multivariate analysis showed that age, body mass index (BMI), preoperative TBil and volume of intraoperative blood loss were independent factors influencing postoperative serious complications in patients undergoing liver resection for hepatolithiasis ( odds ratio=3.852, 2.358, 2.935, 5.135, 95% confidence interval as 1.478?9.979, 1.110?5.009, 1.398?6.158, 2.088?12.626, P<0.05). Conclusions:Patients with high level of preoperative TBil have a significantly increased risk of postoperative serious complications and liver failure who receive liver resection for hepatolithiasis. Age, preoperative BMI, TBil and volume of intraoperative blood loss are independent factors influencing postoperative serious complications in patients undergoing liver resection for hepatolithiasis.

Osteoarthritis (OA) is a chronic degenerative joint disease whose main characteristic is the destruction of articular cartilage, causing pain and disability in patients and seriously affecting their quality of life. OA can be induced by a variety of causes, and pathological changes in articular cartilage are considered to be one of the key driving factors for the occurrence of OA. High mobility group box-1 protein (HMGB1), as a non-histone protein in eukaryotic cells, can participate in regulating the inflammation and apoptosis process of OA chondrocytes, thus leading to the occurrence of OA. This article reviews the research on the mechanism of HMGB1 in OA chondrocytes, with a view to providing new ideas for the clinical prevention and treatment of OA.

Objective To evaluate the effect of preoperative metabolic syndrome on early function of renal allografts in allogeneic kidney transplant recipients.Methods Clinical data of 117 kidney transplant recipients were retrospectively analyzed.According to the renal allograft function,they were divided into the delayed graft function(DGF)group(n=29)and non-DGF group(n=88).Relevant risk factors of DGF in recipients undergoing allogeneic kidney transplantation were assessed by univariate and multivariate regression analyses.The effect of preoperative metabolic syndrome on early function of renal allografts was analyzed.Results Among 117 kidney transplant recipients,47 cases were complicated with preoperative metabolic syndrome,and 29 cases developed postoperative DGF.In the DGF group,83％of the recipients were complicated with preoperative metabolic syndrome,higher than 74％in the non-DGF group(P＜0.05).Univariate analysis showed that the body mass index(BMI)and terminal serum creatinine(Scr)level of the donors,and BMI,blood glucose level,triglyceride level and the proportion of preoperative metabolic syndrome of the recipients in the DGF group were higher than those in the non-DGF group(all P＜0.05).Multivariate logistic regression analysis revealed that high Scr levels of the donors,high hemoglobin levels of the recipients and preoperative metabolic syndrome of the recipients were the independent risk factors for DGF after kidney transplantation(all P＜0.05).Conclusions Preoperative metabolic syndrome is an independent risk factor for DGF in allogeneic kidney transplant recipients.Corresponding measures should be taken to lower the incidence of DGF and other metabolic complications.

Objective To investigate the effect of auditory brainstem response(ABR)in clinical detection and severity assessment of autism spectrum disorder(ASD)in children with normal hearing.Methods ① A total of 55 autistic children(110 ears)with normal hearing and 55 children(110 ears)with typical development(TD)who did not differ in sex composition ratio and average monthly age were divided into four sub-groups according to age:≤24 months group(22 ears),25～36 months group(40 ears),37～48 months group(28 ears)and＞48 months group(20 ears).The ABR latencies and interpeak latencies were compared between ASD children and age-matched TD children.② ASD children were graded by severity according to the Diagnostic and Statistical Manual of Mental Dis-orders(DSM-V),and the correlations between the ABR latencies and interpeak latencies in autistic children with normal hearing and the severity grading were studied.Results ① No statistically significant differences in ABR wave latencies and interpeak latencies were found in autistic children with normal hearing under 24 months of age compared to age-matched TD children(P＞0.05).② Compared with children with TD,autistic children with nor-mal hearing at 25～36 months of age had significantly longer wave Ⅲ latencies and the interpeak latencies of Ⅰ-Ⅲ andⅠ-Ⅴ;the significantly longer wave Ⅲ,Ⅴ latencies,the interpeak latencies of Ⅰ-Ⅲ,Ⅲ-Ⅴ and Ⅰ-Ⅴ in autistic chil-dren with normal hearing at 37～48 months of age.Autistic children with normal hearing in the＞48 months group had significantly longer wave Ⅴ latencies and interpeak latencies of Ⅲ-Ⅴ,Ⅰ-Ⅴ than age-matched TD children(P＜0.05).③ The higher the ASD severity grading the longer the wave Ⅲ and V latencies and the longer interpeak latencies of Ⅰ-Ⅲ,Ⅲ-Ⅴ,and Ⅰ-Ⅴ(P＜0.05).Conclusion Differences in the level of auditory brainstem pathway de-velopment emerged at 25 months of age,and autistic children with normal hearing had significantly lower levels of auditory brainstem development than age-matched TD children.There were correlations between the latencies and interpeak latencies of ABR in autistic children with normal hearing and the severity grading.