OBJECTIVE To investigate the relationship between the expression level of endotoxin and soluble interleukin-2 receptor(sIL-2R)and the occurrence of suppurative otitis media in patients with nasopharyngeal carcinoma after radiotherapy.METHODS Seventy-nine nasopharyngeal cancer patients who received radiotherapy in Nanyang Downtown Hospital between January 2022 and July 2023 were selected as the study subjects,and they were followed up for a period of 1 year,and then grouped according to the occurrence of suppurative otitis media during the follow-up period,i.e.,21 cases in the occurringgroup and 58 cases in the non-occurring group,and the baseline data of patients in the two groups were compared,and the levels of endotoxin and sIL-2R were detected at the end of radiotherapy and analyze the relationship between endotoxin,sIL-2R and the occurrence of purulent otitis media after radiotherapy for nasopharyngeal carcinoma.RESULTS A total of 21 cases(26.58%)of 79 nasopharyngeal carcinoma patients developed suppurative otitis media after radiotherapy.Compared with the non-occurrence group,the radiotherapy time,endotoxin,sIL-2R,TNM stage Ⅲ,Eustachian tube involvement,nasal cavity structural abnormality,inflammatory reaction,and palatal sail tensor atrophy degree≥30%were high in the occurrence group,and the difference was statistically significant(all P<0.05).The results of logistic multifactorial analysis showed that inflammatory reaction,endotoxin,abnormal nasal structure,TNM stage(Ⅲ),sIL-2R,Eustachian tube involvement,duration of radiotherapy,and degree of atrophy of palatofacial tensor atrophy≥30%were all risk factors for suppurative otitis media.The results of Spearman's rank correlation analysis showed that endotoxin and sIL-2R were positively correlated with the occurrence of septic otitis media(r=0.493,0.516,P<0.001).Analysis using the ROC curve showed that:endotoxin:AUC value:0.657,sensitivity:61.90%,specificity:72.41%,accuracy:69.62%,95%CI=0.523-0.791;sIL-2R:AUC value:0.697,sensitivity:71.43%,specificity:67.24%,accuracy:68.35%,95%CI=0.566-0.829;combined test:AUC value:0.804,sensitivity:95.24%,specificity:65.52%,accuracy:73.42%,95%CI=0.705-0.903,the best value of the two combined tests.CONCLUSION The elevated levels of endotoxin and sIL-2R in patients with nasopharyngeal carcinoma after radiotherapy may be associated with suppurative otitis media.

Objective:To evaluate the perioperative application effect of enhanced recovery after surgery (ERAS) clinical pathway in percutaneous vertebro plasty (PVP).Methods:The clinical data of 274 patients who underwent PVP treatment for osteoporotic vertebral compression fracture (OVCF) in Beijing Friendship Hospital, Capital Medical University from May 2023 to August 2024 were retrospectively analyzed. The patients were divided into two groups according to the different numbers of surgical segments: the single-segment group ( n=211) and the multisegment group ( n=63). Patients in the single-segment group underwent single-segment surgery, while patients in the multisegment group underwent surgery on ≥2 segments. The core points of the ERAS clinical pathway adopted in this study include perioperative education, pain management, early mobilization, application of "outfast", and joint guidance from the departments of nutrition and rehabilitation. Comparison was made between the two groups of patients in terms of visual analog scale (VAS) scores for low back pain at preoperative, 2 h, 6 h, 24 h postoperatively, and on the day of discharge; Oswestry disability index (ODI) scores preoperatively and on the day of discharge; time to first ambulation postoperatively, total length of hospital stay, postoperative length of stay, perioperative complications, and perioperative application of Opioid consumption. Measurement data were expressed as mean±standard deviation ( ± s), and the independent sample t-test was used for comparison between groups; count data were expressed as cases and percentage, and the Chi-square test was used for comparison between groups. The VAS pain scores at each stage of the perioperative period were evaluated using repeated measures analysis of variance or generalized estimating equations. Results:Compared with that before the operation [(6.17±0.93) points, (6.29±0.83) points], the VAS scores of low back pain of patients in the single-segment group and the multisegment group at 2 hours after surgery [(3.09±0.82) points, (3.27±0.65) points], 6 hours after surgery [(2.60±0.79) points, (2.62±0.55) points], and 24 hours after surgery [(1.89±0.77) points, (1.97±0.72) points] and on the day of discharge [(1.72±0.71) points, (1.81±0.64) points] were significantly decreased, and the differences were statistically significant ( P<0.05). At the same stage, the VAS scores of low back pain in both groups were not statistically significant ( P>0.05). The ODI scores of patients in the single-segment group and the multisegment group on the day of discharge [(24.21±2.35) points, (24.63±3.31) points] were significantly lower than those before the operation [(64.50±4.81) points, (65.52±4.08) points], and the differences were statistically significant ( P<0.05). There were no statistically significant differences in perioperative complications and the proportion of Opioid drug application between the two groups of patients ( P>0.05). Conclusion:For patients with single-segment or multisegment OVCF, PVP surgical treatment under ERAS clinical pathway management can achieve immediate pain relief, early ambulation exercise, and satisfactory perioperative efficacy.

Objective:To evaluate preoperative malnutrition risk in patients with osteoporotic vertebral compression fracture (OVCF) based on mini nutritional assessment short form (MNA-SF) and analyze the related clinical risk factors.Methods:A cross-sectional study was conducted using clinical data from 129 OVCF patients who underwent percutaneous vertebroplasty at Beijing Friendship Hospital, Capital Medical University, between May 2023 and December 2023. The cohort included 26 males and 103 females, aged (74.71±9.13) years(ranging from 48-98 years). According to MNA-SF scoring method, they were divided into three groups, the malnutrition group ( n=6), the nutritional risk group ( n=40), and the good nutrition group ( n=83). Nutritional risk and malnutrition rates were evaluated using the MNA-SF score. Measurement data with normal distribution were expressed as mean±standard deviation ( ± s) and compared using one-way ANOVA. The comparison between groups of count data was conducted using chi-square test. Univariate analysis and multivariate logistic regression were performed to identify independent risk factors for malnutrition and nutritional risk. Results:According to the MNA-SF score, among 129 patients, the malnutrition rate was 4.7%, the nutritional risk rate was 31.0%, and 64.3% exhibited adequate nutrition based on MNA-SF scores. The results of one-way ANOVA showed that gender ( P=0.023) and BMI ( P<0.001) were significantly correlated with malnutrition and nutritional risk; Logistic regression analysis suggested that the influencing factors of nutritional risk included gender ( P=0.002) and BMI ( P<0.001), while the only dangerous factor of malnutrition was BMI ( P<0.001). Conclusions:Bsed on MNA-SF, OVCF patients undergoing percutaneous vertebroplasty have a higher incidence of malnutrition and nutritional risk. The risk factors for nutritional risk in patients are gender and BMI, while the risk factor for malnutrition is only BMI.

Obesity and overweight remain major global public health challenges.In this paper,we examine current applications of digital nutrition technologies in weight management using the scoping review framework of Arksey and O'Malley.Visual recognition technologies have evolved from early-stage food image recognition into more advanced systems,although the vast diversity of food types continues to pose challenges for accuracy and generalizability.The combination of wearable devices and non-wearable sensors has increased the diversity of collected data and improved user comfort.Data integration and analysis tools,such as digital virtual twins,support personalized interventions by integrating multidimensional data.In addition,emerging applications have demonstrated encouraging clinical outcomes.However,existing studies have limitations,such as small sample sizes,high levels of information bias,and low evidence quality.Barriers,such as limited accessibility and high initial costs,further constrain the scalability of digital nutrition tools.Future studies should focus on expanding sample sizes,improving population diversity,and developing effective assessment methods and adjustments for specific target populations.Privacy and data security concerns must also be addressed to ensure safe implementation.Overall,digital nutrition technologies offer a promising approach to weight management,but continuous efforts in research and cost reduction are needed to fully realize their potential in weight management and to promote health for all.

Notum, a negative feedback regulator of the Wnt signaling, has emerged as a promising target for treating glucocorticoid-induced osteoporosis (GIOP). This study showcases an efficient strategy for discovering the anti-Notum constituents from herbal medicines (HMs) as novel anti-GIOP agents. Firstly, a rapid-responding near-infrared fluorogenic substrate for Notum was rationally engineered for high-throughput identifying the anti-Notum HMs. The results showed that Bu-Gu-Zhi (BGZ), a known anti-osteoporosis herb, potently inhibited Notum in a competitive-inhibition manner. To uncover the key anti-Notum constituents in BGZ, an efficient strategy was adapted via integrating biochemical, phytochemical, computational, and pharmacological assays. Among all identified BGZ constituents, three furanocoumarins were validated as strong Notum inhibitors, while 5-methoxypsoralen (5-MP) showed the most potent anti-Notum activity and favorable safety profiles. Mechanistically, 5-MP acted as a competitive inhibitor of Notum via creating strong hydrophobic interactions with Trp128 and Phe268 in the catalytic cavity of Notum. Cellular assays showed that 5-MP remarkably promoted osteoblast differentiation and activated Wnt signaling in dexamethasone (DXMS)-challenged MC3T3-E1 osteoblasts. In dexamethasone-induced osteoporotic mice, 5-MP strongly elevated bone mineral density (BMD) and improved cancellous and cortical bone thickness. Collectively, this study constructs a high-efficient platform for discovering key anti-Notum constituents from HMs, while 5-MP emerges as a promising anti-GIOP agent.

OBJECTIVES: To evaluate the protective effect of Bufei Yishen Formula (BYF) against cigarette smoke extract (CSE)-induced injuries in human bronchial epithelial BEAS-2B cells and explore the underlying mechanism. METHODS: BEAS-2B cells exposed to CSE were treated with normal rat serum, BYF-medicated rat serum at low or high doses, pyrrolidine dithiocarbamate (PDTC, a NF-κB inhibitor), PDTC combined with high-dose BYF-medicated serum, or S-carbomethyloysteine (S-CMC, as the positive control). CCK-8 assay was used to determine the optimal concentration and treatment time of CSE, BYF-medicated serum and S-CMC. The treated cells were examined for inflammatory factor levels in the supernatant and cellular expressions of MUC5AC and MUC5B using ELISA, cell ultrastructural changes with transmission electron microscopy, and cell apoptosis rate using flow cytometry. The expression levels of TLR4/NF‑κB pathway-associated mRNAs and proteins were determined by qRT-PCR and Western blotting. RESULTS: CSE exposure significantly increased secretions of IL-1β, IL-6 and TNF-α, mRNA and protein expressions of MUC5AC and MUC5B, and early and total apoptosis rates in BEAS-2B cells, where the presence of apoptotic bodies was detected. CSE also significantly enhanced the mRNA and protein expressions of TLR4, I-κB, and NF-κB and reduced mRNA and protein expressions of AQP5. Treatments of the CSE-exposed cells with BYF-medicated serum, PDTC and S-CMC all significantly lowered inflammatory factor levels, MUC5AC and MUC5B expressions, and early and total cell apoptosis rates, and partly reversed the changes in cellular ultrastructure and mRNA and protein expressions of the TLR4/NF-κB pathway, and the effects were the most conspicuous following the combined treatment with high-dose BYF-medicated serum and PDTC. CONCLUSIONS BYF can inhibit cell apoptosis, inflammation and mucus hypersecretion in CSE-induced BEAS-2B cells by inhibiting the TLR4/NF-κB signaling pathway.
Humans ; Epithelial Cells/cytology* ; Drugs, Chinese Herbal/pharmacology* ; NF-kappa B/metabolism* ; Bronchi/cytology* ; Smoke/adverse effects* ; Apoptosis/drug effects* ; Mucin 5AC/metabolism* ; Cell Line ; Toll-Like Receptor 4/metabolism* ; Mucin-5B/metabolism* ; Signal Transduction/drug effects* ; Nicotiana ; Rats ; Thiocarbamates/pharmacology* ; Animals

Objective To investigate the effect of a modified chest drainage management protocol on rapid recovery in patients undergoing thoracoscopic lung resection.Methods A retrospective analysis was conducted on clinical data of 218 patients who underwent segmentectomy,lobectomy,or combined lobectomy surgeries between July 2022 and December 2023 in our department.One medical group utilized the traditional chest drainage management protocol(control group,109 cases),while the other medical group employed the modified chest drainage management protocol(modified group,109 cases).The control group had a large chest tube(20-24F)placed at the mid-axillary line of the 7th intercostal space leading to the apex of the pleural cavity(removed when drainage volume＜300 ml/24 h and air leak＜20 ml/min).In contrast,the modified group had a large tube placed from the anterior axillary line between the 3rd and 4th intercostal spaces leading to the apex of the pleural cavity(removed when air leak＜20 ml/min),and a small tube(7F)placed at the posterior axillary line between the 7th and 8th intercostal spaces near the diaphragm surface(removed when drainage volume＜300 ml/24 h).Comparisons were made between the two groups regarding duration of large tube placement and total duration tube placement,total drainage volume,postoperative hospital stay,and postoperative complications.The pain scores,number of cases with moderate to severe pain(pain score ≥4),analgesic pump drug usage,and functional activity score(FAS)were recorded on the 1st and 2nd day after surgery.Results The duration of large tube placement was shorter in the modified group than in the control group[(2.1±1.6)dvs.(2.7±1.8)d,t=-2.715,P=0.007].and the total duration of tube placement was longer in the modified group than in the control group[(3.3±2.0)dvs.(2.7±1.8)d,t=2.308,P=0.022].without increasing postoperative hospital stay[(4.2±2.2)dvs.(4.1±2.1)d,t=0.247,P=0.805].On the postoperative day 2,the modified group showed lower pain scores during activity than the control group[(2.1±1.1)points vs.(2.6±1.3)points,t=-2.885,P=0.004].fewer cases with moderate to severe pain(5 cases vs.14 cases,x2=4.670,P=0.031),and less analgesic pump drug usage[(17.9±16.2)ml vs.(27.4±29.4)ml,t=-2.951,P=0.004].No significant differences were observed in other indicators between the two groups(P＞0.05).Additionally,the proportion of patients with FAS grade A(no activity limitation due to pain)was higher in the modified group than in the control group on the postoperative day 2[61.5％(67/109)vs.46.8％(51/109),Z=-2.170,P=0.030].There were no significant differences in postoperative complications and incision healing rates between the two groups(P＞0.05).Conclusion The modified chest drainage management protocol not only ensures adequate drainage but also reduces the degree of pain and improves activity status,aligning with the principles of enhanced recovery after surgery(ERAS).

AIM:This study aimed to explore the mechanism by which Bufei-Yishen formula(BYF)mitigates mitochondrial damage in rats with chronic obstructive pulmonary disease(COPD)by regulating the AMPK/PGC-1α signal-ing pathway.METHODS:Forty rats were randomly divided into four groups,each containing ten rats each:control group,COPD group,BYF group,and N-acetylcysteine(NAC)group.The COPD model was established through chronic cigarette smoke exposure combined with periodic bacterial inoculations over an eight-week induction phase.During the subsequent eight-week treatment period(i.e.,weeks 9～16),rats in the control and COPD groups received an isovolumet-ric saline solution via oral gavage,at a standardized daily dose of 2 mL per animal.Moreover,rats in the BYF and NAC groups were given Bufei Yishen formula(11.61 g·kg-1·d-1)or N-acetylcysteine(54 mg·kg-1·d-1)by gavage,once per day.At week 16,samples were collected and the general condition of the rats was observed.Body weight was recorded weekly.We also obtained data characterizing rat lung function,lung pathology,ATP content,and mitochondrial ultra-structure,as well as the levels of interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α),interleukin-1β(IL-1β),se-rum transforming growth factor-beta 1(TGF-β1)and the enzymatic activities of mitochondrial electron transport chain complexes I(NADH dehydrogenase)and III(cytochrome c reductase).Finally,we quantified the mRNA and protein lev-els of AMPK and PGC-1α in lung tissue.RESULTS:Compared to the control group,the COPD group exhibited yellow-ish hair color,reduced gloss,slower weight gain,and a disordered respiratory rhythm.We also observed significant de-creases(P<0.01)in pulmonary function tidal volume(TV),minute ventilation(MV),peak expiratory flow(PEF),expi-ratory flow at 50%of tidal volume(EF50),forced vital capacity(FVC),forced expiratory volume in 0.1 s(FEV0.1),and FEV0.1/FVC.Histopathological analysis showed alveolar cavity enlargement,bullous changes in lung morphology,smooth muscle hypertrophy in the tracheal wall,ciliary destroyed,mucosal shrinking and thickening,and a large number of in-flammatory cells gathered around the tube.Moreover,the mean linear intercept(MLI)and bronchial wall thickness(BWt)had both significantly increased(P<0.01).Electron microscopic analysis of the lungs revealed a reduction in the number of mitochondria in alveolar epithelial cells,a swollen and deformed lung morphology overall.We observed that the mitochondrial cristae were broken,dissolved or vacuolated,accompanied by a significant reduction in the number of lamel-lar bodies and lung volume,along with a disordered internal lipid layer structure.Furthermore,some lung samples were vacuolated or had content leakage.Further quantitative analyses showed statistically significant increases(P<0.01)in the levels of serum pro-inflammatory mediators,including IL-6,TNF-α,IL-1β,and TGF-β1.At the same time we observed substantial reductions in the enzymatic activities of mitochondrial electron transport chain complexes I and III(P<0.01).Moreover,we found that metabolic impairment correlated with significantly attenuated ATP production(P<0.01)in exper-imental subjects.Moreover,the expression levels of AMPK and PGC-1α mRNA and proteins in lung tissue were signifi-cantly decreased(P<0.01).Moreover,compared to the COPD group,the BYF group showed significant improvements in several of the above indicators,albeit to different degrees(P<0.01 or P<0.05).Moreover,BYF was more effective than NAC in improving minute ventilation and up-regulating PGC-1α expression(P<0.05).CONCLUSION:Bufei-Yishen formula may ameliorate mitochondrial damage in rats with chronic obstructive pulmonary disease by regulating the AMPK/PGC-1α signaling pathway.

This study compared the clinical characteristics of brucellosis,tuberculosis,and their co-infections,to improve dif-ferential diagnosis and disease management.A retrospective analysis was conducted on 41 patients with brucellosis,38 co-infected pa-tients,and 95 patients with tuberculosis admitted to Beijing Chest Hospital,Capital Medical University,between January 2017 and December 2024.Clinical manifestations,laboratory findings,and complications were analyzed statistically.Brucellosis and tuberculo-sis shared clinical similarities,such as presentation with prolonged fever.However,patients with brucellosis tended to exhibit muscle pain,night sweats,and loss of appetite,whereas patients with tuberculosis frequently presented with cough,sputum production,and lymphadenopathy.Co-infected patients had a higher fever incidence,and elevated hs-CRP and ESR levels.Whereas spinal spondyli-tis was more frequent in brucellosis,pulmonary infections and pleural effusion were predominant in tuberculosis.Co-infected patients exhibited characteristics of both diseases,and showed more severe systemic inflammation and prolonged illness.In conclusion,al-though elevated hs-CRP and ESR might aid in differentiation,pathogen detection is crucial for accurate diagnosis.Strengthening screening in patients with persistent fever and systemic inflammation may improve early identification,optimize treatment,and en-hance outcomes.

This study explored whether Astragalus polysaccharide(APS)can regulate the VEGF/VEGFR signaling pathway to affect the proliferative activity of rat intestinal mucosal microvascu-lar endothelial cells(RIMMVECs).RIMMVECs were isolated from newborn rats,then purified and treated with APS at concentrations of 0.1,1.0,10.0,100.0,1 000.0,and 10 000.0 mg/L.MTT was used to determine the effect of APS on RIMMVECs proliferation and screen for the optimal concentration of APS.Subsequently,flow cytometry was used to detect the changes in cell cycle to evaluate the stage of action of APS on the cell cycle in RIMMVECs.Then,the ELISA was used to detect the changes of VEGFA in cell supernatant to evaluate the potential of cell proliferation and angiogenesis.The changes in fluorescence intensity of Fluo-8AM was observed using fluorescence microscopy to evaluate intracellular Ca2+levels.Finally,Western blot was used to detect the ex-pression of PERK in RIMMVECs to analyze the possible mechanism of APS.The results showed that 100 mg/L APS significantly enhanced the proliferative activity of RIMMVECs,increased the content of VEGFA in the cell supernatant,the intracellular Ca2+levels,and the expression of PERK protein,indicating that APS promotes the proliferation of RIMMVECs,which may be a-chieved by promoting the expression of VEGFA and activating the ERK pathway.