In recent years， pancreatic adenosquamous carcinoma （PASC） has drawn growing attention owing to its rarity and highly aggressive characteristics. As a distinct subtype defined by the co-existence of adenocarcinoma and squamous carcinoma components， PASC is linked to substantially worse prognoses compared to pancreatic ductal adenocarcinoma， with a median survival period of merely six months. This review outlines the key molecular mechanisms underlying PASC， such as the inactivation of the TP53/NOTCH pathways， the up-regulation of the transcriptional regulator ΔNp63 and the transcription factor SRY-box transcription factor 2 （SOX2）， along with enhancer of zeste homolog 2 （EZH2）-mediated epigenetic remodeling， and deliberates on their functions in lineage transdifferentiation and tumor plasticity. We further synthesize findings from high-throughput sequencing and single-cell multi-omics studies to depict the immunosuppressive traits of the PASC tumor microenvironment and their implications for therapeutic resistance. Current challenges are also addressed， including the scarce number of reported cases， the absence of high-level clinical evidence， and the disparity between mechanistic studies and clinical translation. Finally， we suggest that future research ought to concentrate on establishing multicenter clinical cohorts and molecular stratification approaches， and on exploring novel therapeutic strategies like combining epigenetic inhibitors with immunotherapy， with the ultimate aim of enhancing patient outcomes.

Objective To investigate the application of CT perfusion （CTP） parameters， carcinoembryonic antigen （CEA）， and alpha-fetoprotein （AFP） in monitoring recurrence after transcatheter arterial chemoembolization （TACE） in patients with primary hepatocellular carcinoma （HCC）. Methods A retrospective analysis was conducted on 203 HCC patients who underwent TACE at the hospital from September 2022 to September 2023. CTP parameters ［blood flow （BF）， blood volume （BV）， hepatic arterial perfusion index （HAI）， portal venous perfusion （PVP）］， CEA， and AFP levels were measured before and one month after TACE. Patients were followed up for one year and divided into recurrence and non-recurrence groups based on tumor status. Differences in BF， BV， HAI， PVP， CEA， and AFP levels between the two groups were compared. Receiver operating characteristic （ROC） curves were plotted to evaluate the predictive value of these indicators for post-TACE recurrence， and logistic regression was used to analyze influencing factors. Results Compared with pre-TACE levels， BF， BV， HAI， CEA， and AFP decreased one month after TACE， while PVP increased （P < 0.05）. Among the 203 patients， 75 （36.95%） experienced recurrence， while 128 （63.05%） remained recurrence-free. Compared with the non-recurrence group， the recurrence group exhibited higher BF， BV， HAI， CEA， and AFP levels and lower PVP （P < 0.05）. The AUC values for BF， BV， HAI， PVP， CEA， and AFP in predicting recurrence were 0.771， 0.787， 0.787， 0.735， 0.771， and 0.795， respectively. The combined detection of these indicators yielded an AUC of 0.968 （P < 0.05）. Logistic regression identified BF， BV， HAI， PVP， CEA， and AFP as independent risk factors for post-TACE recurrence （P < 0.05）. Conclusion CTP combined with serum tumor markers can effectively predict early recurrence in HCC patients after TACE.

Objective To explore the efficacy of sintilimab in combination with concurrent chemoradiotherapy （CCRT） for the treatment of oligometastatic non-small cell lung cancer （NSCLC） and its impact on the levels of serum vascular endothelial growth factor （VEGF）， nuclear transcription factor κB （NF-κB）， and programmed cell death protein ligand-1 （PD-L1） in patients. Methods From April 2020 to July 2024， a total of 150 patients with oligometastatic NSCLC who received treatment at Zhangjiagang First People's Hospital were randomly assigned to the control group （n = 75， CCRT） and the observation group （n = 75， sintilimab + CCRT） using the random number table method. The short-term therapeutic effects， serum tumor markers， immune function， VEGF， NF-κB， and PD-L1 levels of the two groups were compared before and after treatment. Additionally， the toxic and side effects and prognosis were evaluated. Results The observation group exhibited significantly higher objective response rate and disease control rate （59.72% and 83.33% respectively） compared to the other group （40.00% and 68.57% respectively） （P < 0.05）. After treatment， the serum levels of tumor markers， including VEGF， NF-κB， and PD-L1， in the observation group were all significantly lower （P < 0.05）， whereas the levels of CD4⁺ and the ratio of CD4⁺/CD8⁺ were significantly higher （P < 0.05）. After treatment， the observation group achieved significantly higher scores in the total health status and functional dimension of the Quality of Life scale developed by the European Organization for Research and Treatment of Cancer than the other group （P < 0.05）， while having a significantly lower score in the symptom domain （P < 0.05）. The observation group exhibited a higher incidence of immune-related adverse reactions （15.28% vs. 0.00%） （P < 0.05）. There was no statistically significant difference in other toxic and side effects between the two groups （P > 0.05）. The observation group demonstrated better overall survival and progression-free survival functions （P < 0.05）. Conclusions Compared with CCRT， the combination of sintilimab and CCRT can enhance the short-term efficacy in NSCLC patients with oligometastasis， boost their immune function， down-regulate tumor markers as well as the levels of serum VEGF， NF-κB， and PD-L1. This is beneficial for improving the patients' prognosis and does not significantly increase severe adverse effects.

Objective To investigate the expression correlation of PD-L1 and Her-2 in invasive urothelial carcinoma （IUC） and their impact on patient prognosis， providing a basis for precise stratified treatment and prognostic evaluation. Methods A total of 60 IUC patients were included from May 2021 to May 2024. Immunohistochemistry was used to detect the expression levels of Her-2 and PD-L1 in tumor tissues. The correlation between their expressions and clinicopathological parameters （tumor differentiation grade， TNM stage， lymph node metastasis， etc.） was analyzed. Kaplan-Meier method and Log-rank test were used to compare progression-free survival （PFS） and overall survival （OS） among patients with different expression statuses. Cox proportional hazard regression model was applied to identify independent prognostic risk factors. Additionally， the diagnostic efficacy of combined Her-2 and PD-L1 detection for poor prognosis was evaluated. Results The positive rate of Her-2 was 38.33% （23/60）， and the high expression rate of PD-L1 was 41.67% （25/60）. Both expressions were positively correlated with low tumor differentiation （r = 0.360/0.280， P < 0.05） and clinical stage Ⅲ—Ⅳ （r = 0.395/0.325， P < 0.05）. Multivariate analysis revealed that Her-2 positivity （HR = 1.878， P = 0.042） and high PD-L1 expression （HR = 1.822， P = 0.039） were independent risk factors for poor prognosis. The AUC of combined Her-2 and PD-L1 detection was 0.830 （P < 0.001）， with a sensitivity of 82.14% and specificity of 81.25%， which was significantly better than single indicators （P < 0.05）. Conclusions Her-2 positivity and high PD-L1 expression are independent risk factors for tumor progression and poor prognosis in IUC patients. Combined detection of the two can improve the efficacy of prognostic evaluation and provide a new biomarker combination for precise stratified treatment of IUC.

Objective To explore the role of circ_0001126 in homocysteine （Hcy）-induced ferroptosis of Mouse Podocyte Cell line-5 （MPC-5） cells. Methods MPC-5 cells were cultured in vitro and divided into a control group （0 μmol/L Hcy） and an Hcy group （80 μmol/L Hcy）. After 48 hours of cell intervention， the expressions of glutathione peroxidase 4 （GPX4） and solute carrier family 7 member 11 （SLC7A11） proteins were detected by Western blot. The levels of malondialdehyde （MDA） and glutathione （GSH） were measured using a kit， and the level of Fe2? was observed using a fluorescence assay kit. High-throughput sequencing was employed to screen specific circular RNA （circRNA） in podocytes from the control group and the Hcy group， and quantitative reverse transcription polymerase chain reaction （qRT-PCR） was used for validation. Bioinformatics was used to predict chromosome location and conservation. After transfection with si-circ_0001126 and its negative control （si-NC）， the expressions of GPX4 and SLC7A11 proteins and their mRNAs were detected by Western blot and qRT-PCR， respectively. The intracellular MDA level was measured by a malondialdehyde assay kit， the intracellular GSH level was measured by a GSH assay kit， and the intracellular Fe2? level was observed by a fluorescence assay kit. Results Compared with the Control group， the Hcy group exhibited a significant decrease in the expression of ferroptosis related proteins GPX4 and SLC7A11（P < 0.001）， a notable increase in the expression levels of Fe²⁺ and MDA（P < 0.001）， and a marked decrease in GSH levels（P < 0.001）； High throughput sequencing revealed a total of 12 circRNAs with differential expression in the Hcy group， including 8 up-regulated and 4 down-regulated. Based on |log₂foldchange| （≥ 2） and P value （P < 0.05）， circ_0001126 was screened out， and qRT-PCR was used to verify its upregulation in the Hcy group， which is consistent with the sequencing results（P < 0.001）. Analysis using the UCSC Genome Browser Gateway and circbase showed that circ_0001126 is primarily located at chr3：51659420-51660998， formed by the cyclization of the second exon of the Maml3 gene and is highly conserved. Transfection of si-circRNAs demonstrated that si-circ_0001126-309 had the optimal interference efficiency （P < 0.001）. Compared with the Hcy + si-NC group， the Hcy + si-circ_0001126 group showed a significant increase in the expression of ferroptosis-related proteins GPX4 and SLC7A11 （P < 0.001）， a notable decrease in Fe²⁺ and MDA expression levels（P < 0.001）， and an marked increase in GSH levels（P < 0.001）. Conclusion circ_0001126 shows a significant up-regulation in MPC-5 cells treated with Hcy， and down-regulating its expression can inhibit Hcy-induced ferroptosis in MPC-5 cells.

Objective To investigate the mechanism of minocycline in acne Inflammation by regulating peroxisome proliferator-activated receptor γ （PPARγ）/STAT3 signaling pathway. Methods An acne-like model was established by intradermal injection of Cutibacterium acnes into mice， followed by oral administration of minocycline or sterile water. Skin lesions were observed， and hematoxylin?eosin staining， immunohistochemistry， and immunofluorescence were performed to assess inflammatory cell infiltration and pathway-related factor expression. In parallel， SZ95 human sebocytes were stimulated with peptidoglycan （PGN） and treated with minocycline， with or without the PPARγ antagonist T0070907. Inflammatory cytokines （IL-1α， IL-1β， IL-6， IL-8） were quantified， and PPARγ and STAT3 expression were analyzed. Results Minocycline treatment significantly alleviated skin inflammation in mice， reduced inflammatory cell infiltration， enhanced PPARγ expression， decreased IL-1β and MPO-positive cells， and significantly attenuated p-STAT3 immunoreactivity （P < 0.05）. In SZ95 sebocytes， PGN induced robust cytokine production and STAT3 phosphorylation. Minocycline treatment significantly suppressed pro-inflammatory cytokines， upregulated PPARγ， and inhibited STAT3 activation， whereas the presence of T0070907 partially reversed these effects. Conclusions Minocycline exerts anti-inflammatory effects in acne by activating the PPARγ/STAT3 pathway， thereby dampening cytokine release and neutrophil infiltration. These findings highlight PPARγ as a potential therapeutic target and provide mechanistic insight into the anti-inflammatory benefits of minocycline in acne management.

Objective ? To elucidate the mechanism by which tauroursodeoxycholic acid （TUDCA） alleviates oxygen-glucose deprivation （OGD）-induced cardiomyocyte injury through specific regulation of TBC1D15 protein expression and subcellular localization to restore mitophagy function. Methods ? Primary cardiomyocytes were subjected to OGD and treated with TUDCA at low （20 μmol/L）， medium （40 μmol/L）， or high （80 μmol/L） doses. TBC1D15 subcellular localization and expression were assessed by immunofluorescence. Cell apoptosis/necrosis was evaluated using YO-PRO-1/PI double staining. Lysosome staining is used to detect lysosome function. Autophagy dual-labeling adenovirus HBAD-mcherry-EGFP-LC3 is used to detect the efficiency of autophagy flow.Western blot was performed to analyze autophagy-related proteins （Beclin-1， LC3-Ⅱ/Ⅰ， p62） and the anti-apoptotic protein Bcl-2. Results Compared with the normal control group， the model group showed a significant decrease in TBC1D15 expression and disordered distribution. After TUDCA intervention， the expression of TBC1D15 was restored in a dose-dependent manner. In the high-dose group， the fluorescence intensity was close to that of the normal control group， and the localization at the cell membrane was significantly enhanced. Regarding autophagy-related indicators， the medium- and high- dose TUDCA groups significantly promoted autophagy activation， which was manifested as an increase in the LC3-Ⅱ/Ⅰ ratio， accelerated degradation of p62， and increased expression of Beclin-1. The results of cell apoptosis/necrosis detection showed that cell apoptosis/necrosis was significantly increased in the model group， while it was significantly alleviated after TUDCA intervention. Meanwhile， the expression of the anti - apoptotic protein Bcl-2 was up-regulated， and this ameliorative effect was most significant in the high- dose group. Conclusion TUDCA restores TBC1D15 membrane localization in a dose-dependent manner， subsequently activating the mitophagy pathway， and ultimately synergistically inhibits apoptosis/necrosis.

Objective To explore the efficacy of gestrinone combined with leuprolide in the treatment of endometriosis （EMs） and its effects on sex hormones， inflammatory indicators and peripheral blood carbohydrate antigen 125 （CA125）， endometrial antibody （EMAb） and anti-Müllerian hormone （AMH）. Methods 120 patients with EMs admitted to our hospital from November 2019 to November 2022 were selected. All patients were divided into control group and study group according to the random number table method， with 60 cases in each group. Control group was treated with gestrinone， and study group was additionally given leuprolide on the basis of control group. The clinical efficacy after 6 months of treatment， sex hormones indicators ［estradiol （E₂）， luteinizing hormone （LH）， follicle stimulating hormone （FSH）］， inflammatory indicators ［interleukin-6 （IL-6）， IL-8， tumor necrosis factor α （TNF-α）， hypersensitivity C-reactive protein （hs-CRP）］ and serum-related indicators （CA125， EMAb， AMH） before treatment and after 6 months of treatment were compared between the two groups， and the occurrence of adverse drug reactions during medication. Results After 6 months of treatment， the total effective rate of treatment in study group was significantly higher than that in control group （91.67% vs. 76.67%） （P < 0.05）. After 6 months of treatment， the levels of E₂， LH， FSH， IL-6， IL-8， TNF-α， hs-CRP， CA125 and EMAb in the two groups were significantly decreased compared with those before treatment while the level of AMH was increased （P < 0.05）， and the above indexes in study group were significantly different from those in control group during the same period （P < 0.05）. During 6 months of medication， there were no differences in the incidence rates of adverse drug reactions between the two groups （P > 0.05）. Conclusion Gestrinone combined with leuprolide has a significant effect in the treatment of patients with endometriosis， and it can significantly improve the endocrine， relieve inflammatory response and improve serum-related indicators， and it has high safety and good application value.

Objective To explore the application of serum interleukin-7 （IL-7）， lactate dehydrogenase/albumin （LDH/ALB）， and soluble leukocyte differentiation antigen subtype 14 （sCD14-ST） in the diagnosis and disease assessment of chronic obstructive pulmonary disease （COPD） with pulmonary infection （PI）. Methods A total of 109 patients with COPD complicated by PI admitted to the hospital from June 2022 to June 2024 were included in the infection group. Additionally， 100 patients with uncomplicated COPD who visited the outpatient department during the same period were included in the control group. Both groups were incorporated into the training set. We compared the general characteristics， IL-7 levels， LDH/ALB ratios， and sCD14-ST levels between the infection group and the control group. Receiver operating characteristic （ROC） curve analysis was performed to evaluate the diagnostic value of these indicators in COPD complicated with PI. Patients in the Infection Group were divided into mild （n = 27）， moderate （n = 49） and severe （n = 33） subgroups based on the pneumonia severity index （PSI）. The IL-7， LDH/ALB， sCD14-ST levels and PSI of the three subgroups were compared， and Pearson's correlation analysis was conducted to analyze the relationship between IL-7， LDH/ALB， and sCD14-ST levels and PSI. Additionally， 59 patients with COPD complicated by PI and 50 patients with COPD alone admitted to the hospital between July 2024 and December 2024 were selected for the validation set to construct a nomogram model. Results The age， duration of COPD， history of diabetes， long-term use of antibiotics， mechanical ventilation status and length of hospital stay in the infection group were all higher than those in the conventional group （P < 0.05）. The levels of IL-7， LDH/ALB and sCD14-ST in the infection group were all higher than those in the conventional group （t = 4.551， 4.510， 4.329， P < 0.05）. The results of multivariate logistic regression analysis showed that IL-7， LDH/ALB， and sCD14-ST were all independent risk factors for COPD combined with PI （P < 0.05）. The combined diagnostic value of IL-7， LDH/ALB， and sCD14-ST for COPD combined with PI is higher than that of a single indicator diagnosis. The AUCs of serum IL-7， LDH/ALB， and sCD14-ST for COPD combined with PI alone and in combination are 0.711， 0.666， 0.700， and 0.856， respectively. The AUC of combined diagnosis was higher than that of individual diagnosis （Z_{IL-7~combined} = 4.877， Z_{LDH/ALB~combined} = 5.279， Z_{sCD14-ST~combined} = 4.371， P < 0.05）. The Kappa test showed that the Kappa values of IL-7， LDH/ALB， sCD14-ST and the combined diagnosis were 0.405， 0.265， 0.311 and 0.551 respectively. Levels of IL-7， LDH/ALB， and sCD14-ST in the severe subgroup were significantly higher than those in the moderate and mild subgroups， and levels in the moderate subgroup were significantly higher than those in the mild subgroup （P < 0.05）. PSI was higher in the severe group than in the mild and moderate groups， and was higher in the moderate group than in the mild group （P < 0.05）. Pearson correlation analysis revealed positive correlations between the levels of IL-7， LDH/ALB， sCD14-ST and disease severity in COPD patients with PI （r = 0.390， 0.444， 0.372， P < 0.001）. The risk factor selection model based on multifactor logistic regression demonstrated good predictive value for COPD with pulmonary infection. The AUC values for the training and validation sets were 0.82 （0.75 ~ 0.88） and 0.78 （0.66 ~ 0.90）， respectively. Calibration curves indicated that predicted values closely matched actual outcomes （P > 0.05）. The decision curve indicated a high positive net benefit at thresholds ranging from 50% to 100%. Conclusions The combination of IL-7， LDH/ALB， and sCD14-ST has high diagnostic value for COPD complicated with pulmonary infection. Furthermore， the levels of these three indicators are positively correlated with disease severity， which may provide a basis for clinical assessment of patient condition.

Objective To explore and analyze the clinical application of combination of empowerment theory-based intervention model and Baduanjin exercise in patients with chronic pulmonary heart disease （CPHD）， and to analyze the influence on health belief and rehabilitation of patients. Methods A retrospective cohort study was conducted on 310 patients with CPHD admitted to the hospital from January 2021 to January 2025. They were grouped according to different intervention methods （propensity score matching method was used to include samples at a 1∶1 ratio， and regression analysis was used to control confounding factors）. The conventional group was only given clinical routine intervention. The study group adopted the intervention model based on the empowerment theory combined with Baduanjin training. The two groups were observed after intervention in terms of psychological state， health beliefs， compliance with exercise rehabilitation and rehabilitation conditions. Results After intervention， the depression score and anxiety score of hospital anxiety and depression scale were decreased in both groups， and the scores in the study group were lower （P < 0.05）. The scores of dimensions of Champion health belief scale were increased in both groups， and the above scores were higher in the study group （P < 0.05）. The scores of dimensions of behavior， psychology and environment of exercise rehabilitation compliance scale were enhanced in the two groups， and the scores in the study group were higher compared to the conventional group （P < 0.05）. The forced expiratory volume in 1 second in the study group and right ventricular ejection fraction and 6min walking distance in the two groups were elevated， and the above indexes were higher in the study group compared to the conventional group （P < 0.05）. Conclusion Empowerment theory-based intervention model combined with Baduanjin exercise for CPHD patients can alleviate anxiety and depression， increase rehabilitation belief and rehabilitation exercise compliance， and thus contribute to the rehabilitation of cardiopulmonary function to a certain extent.

Objective To investigate the value of acupuncture therapy in restoring immune homeostasis， reducing the levels of inflammatory markers， and improving the activities of daily living in patients recovering from ischemic stroke. Methods This research is a single-center， randomized controlled clinical trial. A total of 100 patients with ischemic stroke who were undergoing rehabilitation between August 2023 and January 2025 were enrolled. By using a random number table， the participants were randomly allocated to either a rehabilitation control group （n = 50）， which received integrated Chinese-Western rehabilitation therapy， or an acupuncture experimental group （n = 50）， which received acupuncture in addition to the standard integrated rehabilitation. The immune parameters （T， B， NK cell counts and CD4⁺/CD8⁺ ratio）， inflammatory markers， Barthel Index （BI）， and Fugl-Meyer Assessment （FMA） scores were compared before and after treatment. A cohort of 50 healthy individuals served as the healthy control group for assessing the baseline immune and inflammatory status. Results At baseline， the patient groups exhibited significant immune dysregulation when compared to the healthy control group. This was manifested by lower counts of total T cells， CD4⁺ cells， and CD8⁺ cells， as well as higher levels of B cells and NK cells （P < 0.05）. After the intervention， the acupuncture experimental group demonstrated a substantial increase in total T cells， CD4⁺ cells， and the CD4⁺/CD8⁺ ratio. Moreover， there was a more marked reduction in B and NK cell levels in the acupuncture experimental group compared to the rehabilitation control group. Inflammatory markers decreased in both groups after treatment， but the reduction amplitude was significantly greater in the acupuncture experimental group. Similarly， although both groups exhibited enhanced BI and FMA scores before and after treatments， the improvements were statistically more significant in the acupuncture experimental group （P < 0.05）. The acupuncture group showed significantly higher overall therapeutic efficacy compared to the rehabilitation control group， with overall therapeutic efficacy rates of 96.0% and 72.0%， respectively （P < 0.05）. There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion Adjunctive acupuncture significantly promotes immune rebalancing， alleviates inflammation， and enhances functional independence in rehabilitation patients with ischemic stroke.

Objective To construct an optimal risk prediction model for diabetic kidney disease （DKD） in patients with type 2 diabetes mellitus （T2DM） based on routine blood indicators combined with the systemic immune-inflammation index （SII） and systemic inflammation response index （SIRI）， and to compare the predictive performance of different machine learning models， so as to provide an effective tool for the early screening of DKD. Methods A total of 658 T2DM patients hospitalized in the Affiliated Hospital of Traditional Chinese Medicine of Guangzhou Medical University from January 2023 to November 2024 were retrospectively selected as the research subjects. The patient data were divided into a training set （460 cases） and a test set （198 cases） at a ratio of 7∶3 using the computer simple random sampling method. First， LASSO regression was used to screen 12 potential predictive features including SII and SIRI. Then， based on the screened variables， four machine learning algorithms， namely logistic regression （LR）， support vector machine （SVM）， random forest （RF）， and extreme gradient boosting （XGBoost）， were applied to construct risk prediction models for DKD in T2DM patients. Indicators such as AUC value， sensitivity， accuracy， and F1 score were used to comprehensively evaluate the discrimination of the models， and the calibration curve and decision curve analysis （DCA） were used to evaluate the calibration and clinical utility of the models respectively. Finally， the SHAP method was used to conduct interpretability analysis of the optimal model. Results Ten predictive features were screened out by LASSO regression. SHAP values showed that creatinine had high importance in all four risk prediction models. The AUC values of the LR， RF， SVM， and XGBoost models in the test set were 0.914， 0.943， 0.929， and 0.917 respectively， and the F1 scores were 0.627， 0.737， 0.474， and 0.772 respectively. The overall accuracies obtained from the confusion matrix heat maps were 90.4%， 92.4%， 89.9%， and 93.4% respectively. The prediction accuracies of RF and XGBoost for DKD occurrence in the confusion matrix heat maps were relatively high， at 72.4% and 75.9% respectively. DCA showed that all four models had positive clinical net benefits at most threshold probabilities. Conclusion The RF and XGBoost models can accurately predict the risk of DKD in T2DM patients， which is helpful for clinicians to identify high-risk T2DM patients with DKD at an early stage.

The equilibrium of bone homeostasis is crucial for sustaining skeletal health， which depends on the precise regulation between bone formation mediated by osteoblasts and bone resorption mediated by osteoclasts. In recent years， with the progress of osteoimmunology research， more and more attention has been devoted to the role of immune cell?derived factors in bone homeostasis. A growing amount of evidence demonstrates that cytokines such as interleukins （ILs）， tumor necrosis factors （TNFs）， and interferons （IFNs） not only take part in immune responses but also directly or indirectly regulate bone remodeling by affecting osteoblast differentiation， osteoclastogenesis， and osteoclast activity. However， systematic summaries that address the relationship between immune cell-derived cytokines and bone homeostasis are still relatively scarce. This is especially true when it comes to the mechanisms of action， signaling pathways， and pathological roles of different cytokines in bone-related diseases such as osteoporosis， rheumatoid arthritis， and osteoarthritis. This review intends to comprehensively investigate the effects of immune cell-derived cytokines， including interleukins， tumor necrosis factors， and interferons， on bone homeostasis， with an emphasis on their regulatory mechanisms in osteoblast and osteoclast function. Moreover， it will incorporate the latest research progress to analyze the participation of these cytokines in the onset and progression of bone homeostasis-related diseases， thus offering a theoretical foundation and potential therapeutic targets for the prevention and treatment of bone metabolic disorders.

Objective To explore the effects of the Bushen Huoxue traditional Chinese medicine， the compound Shangke Jiuwei Jiangu tablet， on bone healing in the distraction osteogenesis model， and to preliminarily expound its action mechanism at the molecular and cellular levels. Methods The tibial distraction osteogenesis models of rabbits were constructed and then randomly divided into a control group， a low-dose traditional Chinese medicine （TCM） group， a medium-dose TCM group， and a high-dose TCM group. After the intervention， the morphology of the bone callus was evaluated through Micro-CT scanning and three-dimensional reconstruction， and the bone volume fraction （BV/TV） and bone mineral density （BMD） were calculated. HE staining was carried out on tissue sections to observe the histological structure of the callus. In the in-vitro experiment， the effects of drug serum on the migration ability of bone marrow mesenchymal stem cells （MSCs） were detected using the Transwell assay. The tendency of cell directional differentiation was evaluated through osteogenic/adipogenic induction differentiation experiments. The expression levels of Sdf-1， Cxcr4， Runx2， and Ocn mRNA in MSCs were detected by RT-PCR. Results Compared with the control group， Micro-CT revealed that the width of the fracture line decreased and the number of calluses increased in all TCM groups. The effect was most significant in the high-dose group， where continuous calluses were observed and the fracture line basically disappeared. BV/TV and BMD detection indicated that the bone healing indexes were significantly improved in the TCM groups （P < 0.05）， showing a dose-dependent relationship. Histological examination showed that the callus maturity was the highest in the high-dose group， and the transformation from braided bone to lamellar bone was active. In the in-vitro experiment， the migration rate of MSCs was significantly increased in the drug serum group （P < 0.000 1）. Osteogenic differentiation was enhanced while adipogenic differentiation was inhibited， and the expressions of Sdf-1， Cxcr4， Runx2， and Ocn mRNA were all significantly up-regulated （P < 0.000 1）. Conclusions Shangke Jiuwei Jiangu tablets may promote the migration of MSCs by activating the Sdf-1/Cxcr4 signaling axis and induce their osteogenic differentiation. Consequently， this can promote the formation， mineralization， and maturation of new bones during the distraction osteogenesis process both in vivo and in vitro. Its mechanism of action highly aligns with the Bushen Huoxue Jiangu method in TCM.

Objective To investigate the clinical value of circular RNAs （circRNAs） in the diagnosis and disease activity assessment of ankylosing spondylitis （AS） by measuring the expression levels of hsa_circ_0001707 and hsa_circ_0075522 in peripheral blood mononuclear cells （PBMCs） of AS patients. Methods A case?control study was conducted， enrolling 88 newly diagnosed AS patients and 80 healthy controls （HCs） with matched baseline characteristics. The expression of hsa_circ_0001707， hsa_circ_0075522， and HLA?B27 was detected via quantitative polymerase chain reaction （qPCR）. Disease activity was evaluated using the Bath Ankylosing Spondylitis Disease Activity Index （BASDAI）. Erythrocyte sedimentation rate （ESR）， C?reactive protein （CRP）， and complete blood count parameters were measured using automated analyzers. Novel inflammatory indices， including the lymphocyte?to?monocyte ratio （LMR）， neutrophil?to?lymphocyte ratio （NLR）， platelet?to?lymphocyte ratio （PLR）， derived NLR （dNLR）， and systemic immune?inflammation index （SII）， were calculated. Results circRNA analysis revealed significantly upregulated hsa_circ_0001707 and downregulated hsa_circ_0075522 in AS patients （both P < 0.05）. Receiver operating characteristic （ROC） curve analysis demonstrated that hsa_circ_0001707 exhibited moderate diagnostic efficacy for distinguishing AS from HCs （AUC = 0.677， P < 0.001）， which significantly improved when combined with dNLR （AUC = 0.835， P < 0.001）. In disease activity assessment， hsa_circ_0001707 levels were significantly higher in active AS （BASDAI ≥ 4） than in inactive patients and correlated with CRP. Its discriminative power for active AS surpassed that of CRP （AUC： 0.684 vs. 0.674）. Correlation analysis further supported the potential role of hsa_circ_0001707 in AS pathogenesis， showing positive associations with inflammatory markers （NLR， SII， CRP） and BASDAI （ P < 0.05）， but negative correlations with lymphocyte percentage （L%） and LMR. In contrast， hsa_circ_0075522 showed no significant clinical correlations. Conclusions Hsa_circ_0001707 may serve as a promising peripheral blood biomarker for AS diagnosis and disease activity monitoring.

Objective To investigate the efficacy and safety of Oselidine in patient-controlled intravenous analgesia （PCIA） for elderly patients after total knee arthroplasty （TKA）. Methods A prospective， double-blind， single-center， randomized controlled study design was employed. A total of 84 patients who were undergoing elective TKA under general anesthesia were recruited and randomly allocated to either the oseltidine group or the sufentanil group， with 42 cases in each group. All patients received PCIA 48 hours after the operation. The primary endpoint was the static visual analogue scale （VAS） score 24 hours after the operation， while the secondary endpoints were the static and dynamic VAS scores at 6， 12， 24， and 48 hours after the operation. The time of the first PCIA pressing after operation， the effective number of PCIA pressings within 48 h after operation （D1）， the total number of PCIA pressings within 48 h after operation （D2）， the ratio of D1 to D2， and the incidence of remedial analgesia. The Ramsay sedation scores at 5， 10， 20， and 30 min after extubation， the Quality of Recovery-15 （QoR-15） scores at 24 h before operation， 24 h， and 48 h after operation， the Athens Insomnia Scale （AIS） scores on the night before operation， the first night， and the second night after operation， the satisfaction score， and the postoperative hospital stay. Adverse events （such as nausea and vomiting， respiratory depression， urinary retention， dizziness， etc.） that occurred within 48 h after surgery. Results There were no significant differences in VAS score， Ramsay score， analgesia pump pressing - related indexes， and the incidence of remedial analgesia between the two groups at all time points （P > 0.05）. The D1/D2 ratio， QoR-15 scores at 24 and 48 h after operation， and the satisfaction score in the oseltidine group were higher than those in the sufentanil group （P < 0.05）. The AIS score on the first night after operation and the incidence of nausea and vomiting in the oseltidine group were lower than those in the sufentanil group （P < 0.05）. Conclusions This study systematically compared the analgesic efficacy and safety of oxycodone and sufentanil as PCIA drugs in patients with TKA. Results indicate that oxycodone not only provides analgesia comparable to sufentanil but also demonstrates significant advantages in terms of safety and patient comfort. Oxycodone significantly reduced the incidence of postoperative nausea and vomiting， while enhancing the quality of postoperative recovery， sleep quality， and overall patient satisfaction.

Objective To evaluate the effects of different antibiotic regimens applied in orthopedic joint surgery through multi-departmental collaboration on optimizing nursing human resource allocation and reducing medical consumables expenditure， and to verify whether its safety in preventing infection is non-inferior to the traditional regimen. Methods A retrospective cohort study was conducted. A total of 1 948 patients from the Department of Knee Surgery between May 10， 2021， and May 22， 2024， were selected. A subgroup analysis of inflammatory markers was performed on 303 of these patients （44 hip joints， 259 knee joints）. Patients were divided into a single-dose group （972 cases） and a multiple-dose group （976 cases） based on the antibiotic regimen. The single-dose group received only one postoperative dose of antibiotics， while the multiple-dose group received multiple postoperative doses. The primary outcome was the relationship between the number of antibiotic packages used and the incidence of prosthetic joint infection （PJI） within 12 months postoperatively. Secondary outcomes included inflammatory markers： white blood cell count （WBC）， neutrophil count， C-reactive protein （CRP）， and erythrocyte sedimentation rate （ESR）； cost-effectiveness indicators： antibiotic infusion cost （as a single hospitalization expense）； and nursing workload： infusion distance plus needle removal distance. Statistical analyses included logistic regression and the Mann-Whitney U test. Results The overall incidence of prosthetic joint infection （PJI） at 12 months postoperatively was low. The PJI rates in the single-dose and multiple-dose groups were 1.5% （15/972） and 1.3% （13/976）， respectively， with no statistically significant difference （OR = 1.039， 95%CI： 0.927 ~ 1.164， P = 0.512）. Subgroup analysis results： For hip arthroplasty patients using cefuroxime sodium， inflammatory markers （WBC， neutrophils， CRP， ESR） showed statistically significant differences at various time points within each group （P < 0.05）， but no statistically significant intergroup differences were observed （P > 0.05）. For knee arthroplasty patients using cefazolin sodium， inflammatory markers （WBC， neutrophils， CRP， ESR） showed statistically significant differences at various time points within each group （P < 0.05）. The intergroup difference for CRP was not comparable （P < 0.05）， while no statistically significant intergroup differences were found for the remaining markers （P > 0.05）. For knee arthroplasty patients using cefuroxime sodium， inflammatory markers （WBC， neutrophils， CRP， ESR） showed statistically significant differences at various time points within each group （P < 0.05）. The intergroup difference for ESR was not comparable （P < 0.05）， while no statistically significant intergroup differences were observed for the remaining markers （P > 0.05）. Cost-effectiveness analysis： The median antibiotic cost in the single-dose group was significantly lower than that in the multiple-dose group （74.13 RMB vs. 164.16 RMB， Z = -39.090， P < 0.001）. The nursing workload （infusion distance + needle removal distance） was reduced by a median of 67.1% （298.4 meters vs. 907.8 meters， Z = -37.536， P < 0.001）. Conclusions The single-dose antibiotic regimen is comparable to the multiple-dose regimen in preventing infections， while significantly reducing medical costs （by 55%） and nursing workload （by 67%）. Its clinical adoption is recommended. This study is a single-center retrospective investigation， and future multi-center prospective studies are warranted for further validation.

Objective Comparison of the treatment efficacy between percutaneous lauromacrogol injection （PLI） combined with microwave ablation （MWA） and PLI alone for cystic or predominantly cystic thyroid nodules. Methods This study retrospectively analyzed 90 cystic or predominantly cystic thyroid nodules that were treated with either PLI or PLI+MWA at Shanghai Ninth People's Hospital from January 2021 to March 2025. All cases were confirmed to be benign through preoperative ultrasound and fine-needle aspiration. The size of the nodules was assessed by ultrasound at 1， 3， and 6 months after treatment， and the volume reduction rate （VRR） was calculated. Results A total of 81 patients （90 nodules） were incorporated into the analysis， including 20 males （24 nodules） and 61 females （66 nodules）. Among these nodules， 59 received PLI treatment， whereas 31 underwent PLI + MWA. Both PLI and PLI + MWA treatments led to a significant reduction in the volume of thyroid nodules. Although the baseline nodule volumes in the PLI + MWA group were larger than those in the PLI group ［（17.27 ± 10.49） mL vs. （12.12 ± 11.03） mL， P = 0.033］， there were no significant differences in nodule volumes between the two groups at 1， 3， and 6 months after treatment ［（4.02 ± 7.95） mL vs. （7.47 ± 6.93） mL； （2.98 ± 6.31） mL vs. （2.43 ± 2.62） mL； （3.64 ± 8.82） mL vs. （1.09 ± 2.10） mL； all P > 0.05］. Furthermore， at the 3-month ［（14.77 ± 8.48） mL vs. （8.36 ± 9.24） mL， P = 0.025］ and 6-month ［（14.53 ± 6.86） mL vs. （4.79 ± 3.99） mL， P = 0.001］ follow-ups， the PLI + MWA treatment group showed a significantly greater reduction in nodule volume from the baseline compared to the PLI-only group. One month after treatment， the VRR in the PLI group was higher than that in the PLI + MWA group ［83.44% （66.97%， 93.07%） vs. 52.53% （17.62%， 90.66%）， P = 0.011］. However， six months after the operation， the VRR in the PLI + MWA group was significantly higher than that in the PLI group ［83.44% （66.97%， 93.07%） vs. 81.68% （58.43%， 96.96%）， P = 0.019］. Moreover， six months after treatment， the cure rate （VRR > 90%） in the PLI + MWA group was significantly higher than that in the PLI group （87.5% vs. 33.3%， P = 0.024）. Conclusions Both ultrasound-guided PLI and PLI + MWA are effective therapeutic modalities for benign thyroid nodules with cystic or predominantly cystic components. Significantly， at 6 months after treatment， PLI + MWA yielded notably superior therapeutic outcomes compared to PLI monotherapy.

Objective To investigate the relationship between serum long non-coding RNA tumor necrosis factor related heterologous ribonucleoprotein L （lncRNA THRIL） and long non-coding RNA nuclear enriched abundant transcript 1 （lncRNA NEAT1） and the severity and prognosis of neonatal pneumonia. Methods A total of 120 cases of neonatal pneumonia treated at the Fourth Hospital of Hebei Medical University from August 2022 to August 2024 were selected as the observation group. These cases were divided into the mild-disease group （42 cases）， the moderate-disease group （40 cases）， and the severe-disease group （38 cases） based on the severity of the disease. According to the prognosis after 2 weeks of treatment， the pediatric patients were classified into the good-prognosis group （86 cases） and the poor-prognosis group （34 cases）. Meanwhile， 120 healthy neonates who underwent physical examinations at the hospital during the same period were selected as the control group. The serum levels of lncRNA THRIL and lncRNA NEAT1 in the tested neonates were measured using real-time fluorescence quantitative polymerase chain reaction （PCR）. The clinical data of neonates with pneumonia were collected， and the immune inflammatory markers， namely soluble triggering receptor expressed on myeloid cells-1 （sTREM-1） and soluble interleukin-2 receptor （sIL-2R）， were detected. Logistic regression analysis was employed to identify and verify the influencing factors associated with poor prognosis in neonates with pneumonia. Considering the predictive effect of serum lncRNA THRIL and lncRNA NEAT1 on the poor prognosis of these children， receiver operating characteristic （ROC） curve analysis was conducted to evaluate the clinical value of each lncRNA individually and their combined value. Results The serum levels of lncRNA THRIL and lncRNA NEAT1 in the observation group were significantly higher than those in the control group （P < 0.05）. The serum levels of lncRNA THRIL and lncRNA NEAT1 gradually increased as neonatal pneumonia worsened （P < 0.05）. When compared with the good-prognosis group， the proportion of cesarean section and the levels of serum sTREM-1， sIL-2R， lncRNA THRIL， and lncRNA NEAT1 in the poor-prognosis group were significantly elevated （P < 0.05）. Serum sIL-2R， lncRNA THRIL， and lncRNA NEAT1 were identified as independent risk factors for poor prognosis in neonates with pneumonia （P < 0.05）. The area under the curve （AUC） values of serum lncRNA THRIL， lncRNA NEAT1， and their combination in predicting the poor prognosis of neonatal pneumonia were 0.772， 0.808， and 0.930， respectively. Moreover， the AUC of the combination of the two was significantly higher than that of each index alone （Z_{combination-lncRNA THRIL} = 2.347， Z_{combination-lncRNA NEAT1} = 2.217， P = 0.019， 0.027）. Conclusion Serum levels of lncRNA THRIL and lncRNA NEAT1 are significantly elevated in neonates with pneumonia. Both lncRNA THRIL and lncRNA NEAT1 serve as risk factors for the poor prognosis of neonatal pneumonia， and their combination exhibits a favorable predictive effect on the prognosis of neonates with pneumonia.

Objective To clarify the clinical characteristics of patients with gestational diabetes mellitus （GDM） complicated by group B streptococcus （GBS） infection and its impact on pregnancy outcomes， and to analyze the predictive value of glycated hemoglobin （HbA_1c）， neutrophil-to-lymphocyte ratio （NLR）， and platelet-to-lymphocyte ratio （PLR） in GDM patients complicated by GBS infection and its complication， chorioamnionitis. Methods A retrospective selection was conducted on 277 inpatients diagnosed with GDM who were admitted to the NanhaiMaternal and Child Health Hospital， Foshan City from January 2023 to December 2024. Among these patients， those with GDM combined with GBS infection were assigned to the positive group （n = 75）， while those with GDM but without GBS infection were assigned to the control group （n = 202）. The differences in clinical data， including age， and pregnancy outcomes between the two groups of pregnant women were compared. Multivariate logistic regression analysis was employed to explore the risk factors for GBS infection in GDM patients and the risk factors for chorioamnionitis in GDM patients with GBS infection. The predictive value of the relevant indicators was assessed using the receiver operating characteristic curve （ROC）. Results In the positive group， the levels of HbA_1c， NLR， and PLR were significantly elevated. Moreover， the incidences of premature rupture of membranes and intrauterine distress also showed a significant increase， and these differences were statistically significant （all P < 0.05）. The results of multivariate logistic regression analysis indicated that HbA1c （OR = 2.574， 95%CI： 1.355 ~ 4.889） and NLR （OR = 1.545， 95%CI： 1.318 ~ 1.811） were independent risk factors for GBS infection in patients with GDM （all P < 0.05）. Meanwhile， NLR （OR = 1.694， 95%CI： 1.242 ~ 2.190） was identified as an independent risk factor for chorioamnionitis in GDM patients with GBS infection. The ROC curve results demonstrated that the area under the curve （AUC） of the combined prediction model constructed based on HbA_1c and NLR for predicting GBS infection in GDM patients was 0.800 （95%CI： 0.741 ~ 0.859）， and the AUC of NLR for predicting chorioamnionitis was 0.855 （95%CI： 0.760 ~ 0.951）. The PLR had no significant correlation with GBS infection and its complications （P > 0.05）. Conclusions GBS infection in patients with GDM elevates the risk of adverse pregnancy outcomes among pregnant women. Elevated levels of glycated HbA_1c and NLR are independent risk factors for GBS infection in GDM patients. The NLR holds predictive value for chorioamnionitis in GDM patients with GBS infection. It is advisable to enhance the management of high-risk pregnancies to prevent adverse pregnancy outcomes and mitigate the risk of maternal and infant infections during the perinatal period.

Objective To investigate the application effect of graded intervention based on Rockall risk score in patients with acute non-variceal upper gastrointestinal bleeding （ANVUGIB）. Methods A total of 218 patients with ANVUGIB admitted to the hospital between January 2021 and January 2025 were selected， and randomly assigned to the study group （n = 110） and the control group （n = 108）. The control group received conventional treatment and intervention measures. On this basis， the study group was given graded intervention based on Rockall risk score. Comparisons were made between the two groups on rebleeding rates under different Rockall risk levels， hemoglobin （Hb） levels， platelet count （PLT）， clinical symptom improvement time， ANVUGIB self-management scores， Self-Rating Anxiety Scale （SAS） and Self-Rating Depression Scale （SDS） scores， and clinical outcomes. Results After intervention， the rebleeding rates of patients at intermediate Rockall risk and high risk in the study group （12.90% and 17.65%） were lower than those in the control group （28.57% and 53.85%） （P < 0.05）. The total rebleeding rate in the study group （10.00%） was lower than that in the control group （25.93%） （P < 0.05）. After 1 week and 1 month of intervention， Hb levels and PLT in the study group were higher than those in the control group （P < 0.05）. The time to stopping bleeding， hematemesis or melena disappearing， blood pressure returning to normal， and heart rate returning to normal was shorter in the study group than in the control group （P < 0.05）. After 1 week and 1 month of intervention， ANVUGIB self-management scores of the study group were higher than those of the control group. The SAS and SDS scores were lower than those of the control group （P < 0.05）. The blood transfusion rate and complication rate during hospitalization were comparable between the two groups of patients （P > 0.05）. Hospital stay of the study group was shorter than that of the control group （P < 0.05）. Conclusion Graded intervention based on Rockall risk score can improve bleeding symptoms， reduce rebleeding rate， enhance self-management ability， alleviate anxiety， and improve clinical outcomes in patients with ANVUGIB.