Helicobacter pylori （H.pylori） infection is a prevalent global health issue that can lead to indigestion， peptic ulcer disease， and gastric cancer. With ongoing research advancements， significant progress has been made in the eradication of H.pylori. Based on these important findings from North America， the American College of Gastroenterology （ACG） has released updated clinical practice guideline （CPG）， published in the American Journal of Gastroenterology in September 2024. Compared to previous guidelines， key updates include： increased resistance rates to critical antibiotics used for H.pylori treatment， such as clarithromycin and levofloxacin， which have reduced the efficacy of common treatment regimens containing these antibiotics； and research on novel treatment options for newly diagnosed patients， including new antibiotic alternatives （e.g.， rifampicin） or more potent next?generation gastric acid inhibitors （e.g.， potassium?competitive acid blockers， PCABs）. These updates provide the latest evidence and reference for the clinical management of H.pylori infection.

Esophageal stenosis primarily refers to the narrowing of the esophageal lumen caused by intrinsic esophageal diseases or their complications， categorized into benign and malignant types. Benign esophageal stenosis can arise from congenital factors or secondary conditions such as postoperative changes following esophageal cancer surgery， esophagitis， and other inflammatory processes. This condition is characterized by dysphagia， significantly impacting patients′ quality of life and imposing substantial economic and medical burdens on society. Effective prevention and management of benign esophageal stenosis have emerged as an urgent medical challenge. With advancements in endoscopic techniques， various interventions including endoscopic dilation， endoscopic mucosal resection， endoscopic stenting， and regenerative medicine have been applied to treat benign esophageal stenosis， achieving promising therapeutic outcomes. In recent years， regenerative medicine has gained prominence， promoting early re?epithelialization through the structural and functional reconstruction of normal tissues， offering potential applications in the prevention and treatment of benign esophageal stenosis. However， selecting an appropriate treatment method for benign esophageal stenosis requires a comprehensive evaluation of the patient′s condition， therapeutic efficacy， potential complications， recurrence rates， and other relevant factors. This review aims to summarize the current progress in endoscopic treatments for benign esophageal stenosis， providing valuable insights for clinical practice.

Objective To investigate the regulatory effect of PU.1 on apoptosis resistance of aging macrophages under in vitro inflammatory stimulation simulated by lipopolysaccharide （LPS） of Porphyromonas. Methods The expression of PU.1 in periodontitis gingival tissue and normal gingival tissue was analyzed by GEO database. Mouse macrophage cell line RAW264.7 was divided into control group， P.g-LPS group， H₂O₂ group and PU.1 inhibitor group. mRNA expression of senescence associated secretory phenotype （IL-6， IL-1β， TNF-α） and PU.1 were detected by RT?qPCR； The protein expressions of p21， p16， BAX， caspase-3， Bcl-2， Bcl-xl and PU.1 were detected by Western blot. The number of senescent cells was detected by senescence?associated?galactosidase （SA?β?gal） staining. The apoptosis rate was detected by flow cytometry. Results Compared with control group， the expression of p21， p16 protein and mRNA of IL-6， IL-1β and TNF-α were up-regulated in P.g-LPS group and H₂O₂ group， the number of senescent cells was increased， the expression of Bcl-2 and Bcl-xl was up-regulated， the expression of BAX and caspase-3 was decreased， and the apoptosis rate was decreased. Meanwhile， the mRNA and protein expression of PU.1 were increased （P < 0.05）. Compared with P.g-LPS group， mRNA and protein expression of PU.1 in PU.1 inhibitor group were down-regulated， Bcl-2 and Bcl-xl were down-regulated， BAX and caspase-3 expressions were increased， apoptosis rate was increased， the number of senescent cells was decreased， and mRNA levels of IL-6， IL-1β and TNF-α were decreased. The expression of p21 and p16 proteins were down-regulated. （P < 0.05）. Conclusion Under inflammatory stimulation in vitro， increased expression of PU.1 induced apoptosis resistance of aging macrophages， inhibition of PU.1 promoted apoptosis of aging macrophages， reduced the number of aging macrophages， and down-regulated the secretion of inflammatory factors.

Objective To screen for differentially expressed apoptosis-related circular RNAs （circRNAs） in osteoblasts from steroid-induced osteonecrosis of the femoral head （SONFH） and to investigate their roles and mechanisms in osteoblast apoptosis. Methods MC3T3-E1 cells were cultured and divided into two groups： Control and DEX-treated. Western blot analysis was employed to evaluate the expression levels of BCL2-Associated X protein （Bax） and B-cell lymphoma 2 （Bcl-2）. Cell apoptosis was assessed using TUNEL staining and flow cytometry. RNA was extracted from both normal and DEX-treated MC3T3-E1 cells， followed by RNA-seq to identify differentially expressed circular RNAs （circRNAs）. The functions and pathways of these circRNAs were analyzed using Gene Ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG）. The differentially expressed mmu_ circ_0000818 was selected for further verification at the cellular level. Its chromosomal location and conservation were examined using the UCSC Genome Browser Gateway and circBase. Overexpression plasmids and small interfering RNAs （siRNAs） targeting mmu_circ_0000818 were constructed and transfected into the cells. Subsequently， apoptosis in MC3T3-E1 cells from each group was evaluated by flow cytometry. Results Compared with the control group， the apoptosis rate of MC3T3-E1 cells was significantly increased in the DEX group （P < 0.01）. Differentially expressed circRNAs were identified based on log₂foldchange （≥ 2） and P value （P < 0.05）. Relative to the control group， there were 234 differentially expressed circRNAs in the DEX group， including 138 up-regulated and 96 down-regulated circRNAs. GO and KEGG enrichment analyses of the target genes of these differentially expressed circRNAs revealed significant associations with apoptosis and the PI3K-Akt signaling pathway. qRT-PCR results demonstrated that the expression level of mmu_circ_0000818 was markedly higher in the DEX group compared to the control group （P < 0.01）. Analysis using the UCSC Genome Browser and CircBase indicated that mmu_circ_0000818， located at chromosome 17：78712463-78715086， is formed by the cyclization of exons 6-7 of the Crim1 gene and exhibits high conservation across species. Flow cytometry results indicated that knockdown of mmu_circ_0000818 attenuated DEX-induced apoptosis in MC3T3-E1 cells， while overexpression of mmu_circ_0000818 exacerbated apoptosis. Conclusions CircRNA mmu_circ_0000818 was significantly upregulated in DEX-treated MC3T3-E1 cells， and its downregulation mitigated DEX-induced apoptosis. Consequently， mmu_circ_0000818 may represent a promising therapeutic target for the prevention and treatment of SONFH.

Objective To investigate the role of CCCTC-binding factor （CTCF） in the development of oxaliplatin （OXA）-induced gastric cancer drug-tolerant cells （DTCs） and to preliminarily elucidate its underlying mechanisms. Methods The DTCs model of gastric cancer was established by treating MGC803 cells with OXA. Overexpression and knockdown of CTCF in MGC803 cells were performed to observe their effects on the formation of DTCs in gastric cancer. Additionally， Bcl2-like protein 1 （BCL2L1） was knocked down in CTCF-overexpressing cells， and its impact on DTCs formation was evaluated. Flow cytometry was used to analyze the effects of varying CTCF/BCL2L1 expression levels on the apoptosis of gastric cancer cells under OXA treatment. Immunohistochemistry （IHC） was employed to detect the expression levels of CTCF/BCL2L1 in gastric cancer tissues， and the therapeutic outcomes of neoadjuvant chemotherapy in patients with different CTCF/BCL2L1 expression levels were assessed. Results Gastric cancer DTCs can be obtained following a regimen of continuous treatment of MGC803 cells with a specific concentration of oxaliplatin （OXA， 1.5 μmol/L） for 5 days， followed by an additional 5-day culture period post-treatment cessation. The upregulation of CTCF has been shown to facilitate the formation of DTCs in gastric cancer， whereas its downregulation inhibits this process （P < 0.05）. In MGC803 gastric cancer cells， the expression level of BCL2L1 is positively correlated with that of CTCF. Knockdown of BCL2L1 in MGC803 cells overexpressing CTCF can reverse the pro-DTC formation effect of CTCF （P < 0.05）. Overexpression of CTCF confers resistance to OXA-induced apoptosis in gastric cancer cells， and this anti-apoptotic effect can be reversed by BCL2L1 knockdown in MGC803 cells overexpressing CTCF （P < 0.05）. In the tumor tissues of the majority of gastric cancer patients， the expression levels of BCL2L1 are positively correlated with those of CTCF， and the efficacy of neoadjuvant chemotherapy is notably reduced in patients with high expression of the CTCF/BCL2L1 axis compared to those with low expression （P < 0.05）. Conclusion CTCF promotes the formation of OXA-related gastric cancer DTCs by upregulating BCL2L1 expression and inhibiting apoptosis， making the CTCF/BCL2L1 axis a potential therapeutic target for DTCs in gastric cancer.

Objective To investigate the effects of aloperine （ALO） on bone metabolism in osteoporosis （OP） mice via Wnt/β?catenin signaling pathway?mediated autophagy and apoptosis. Methods Sixty mice were randomly allocated into six groups （n = 10 per group）： Sham group （sham?operated mice）， OP group （osteoporosis model induced by bilateral ovariectomy）， L?ALO group （OP mice intraperitoneally injected with 10 mg/kg aloperine）， M?ALO group （OP mice intraperitoneally injected with 20 mg/kg aloperine）， H?ALO group （OP mice intraperitoneally injected with 30 mg/kg aloperine）， and EV group （OP mice administered 0.09 mg/kg estradiol valerate）. Bone mineral density and microstructure of the tibia were assessed. Hematoxylin and eosin （HE） staining was performed to examine the morphology of tibial bone tissue. Serum levels of OCN， OPG， ALP， Ca， and P were measured using ELISA. Protein expression levels of LC3-Ⅱ， LC3-Ⅰ， Beclin?1， P62， Caspase?3， Caspase?9， Bax， Wnt3a， β?catenin， and C?Myc were analyzed by Western blot. Autophagosomes were visualized using immunofluorescence. Results Compared with the Sham group， the bone mineral density （BMD） and trabecular thickness in the OP group were significantly reduced， while trabecular separation， bone surface area， and volume were significantly increased （P < 0.05）. The levels of OPG， OCN， Ca， and P were significantly downregulated， whereas ALP levels were significantly upregulated （P < 0.05）. Additionally， the LC3?Ⅱ/LC3?Ⅰ ratio and expression levels of Beclin?1， Wnt3a， β?catenin， and C?Myc proteins were significantly decreased， while the expression levels of P62， Caspase?3， Caspase?9， and Bax proteins were significantly increased （P < 0.05）. Compared with the OP group， the L?ALO， M?ALO， and H?ALO groups exhibited significant increases in BMD and trabecular thickness， along with significant decreases in trabecular separation， bone surface area， and volume （P < 0.05）. The levels of OPG， OCN， Ca， and P were significantly upregulated， while ALP levels were significantly downregulated （P < 0.05）. Furthermore， the LC3?Ⅱ/LC3?Ⅰ ratio and expression levels of Beclin?1， Wnt3a， β?catenin， and C?Myc proteins were significantly increased， while the expression levels of P62， Caspase?3， Caspase?9， and Bax proteins were significantly decreased （P < 0.05）. In contrast， compared with the OP group， the EV group showed significant increases in BMD and trabecular thickness， as well as significant decreases in trabecular separation， bone surface area to volume ratio （P < 0.05）. The levels of OPG， OCN， Ca， and P were significantly upregulated， while ALP levels were significantly downregulated （P < 0.05）. Moreover， the LC3?Ⅱ/LC3?Ⅰ ratio and expression levels of Beclin?1， Wnt3a， β?catenin， and C?Myc proteins were significantly increased， while the expression levels of P62， Caspase?3， Caspase?9， and Bax proteins were significantly decreased （P < 0.05）. Conclusions Peanine may promote autophagy in osteoblasts and inhibit their apoptosis， thereby improving bone metabolism in OP mice. This effect may be mediated through the activation of the Wnt/β?catenin signaling pathway.

Objective To explore the impact of the TINCR-MAF：MAFB transcription factor network on the expression of proliferation and differentiation-related genes in keratinocytes， to verify the role of this network in the occurrence and development of psoriasis and its potential mechanisms. Methods Employed RNA interference technology to knock down TINCR gene expression， and the proliferation ability of keratinocytes was assessed using the CCK-8 method. Additionally， qRT-PCR and Western blot analyses were conducted to evaluate the RNA and protein expression levels of TINCR， MAFB， and KLF4 genes. Immunohistochemical methods were used to detect the expression of KLF4 protein in psoriasis tissues. Results After TINCR gene siRNA interference， the proliferation ability of keratinocytes significantly decreased at 24， 48， and 72 hours （P < 0.001）， indicating that the TINCR gene plays a critical role in cell proliferation. The results of qRT-PCR and Western blot analyses showed that the RNA and protein expression levels of TINCR， MAFB， and KLF4 genes were significantly reduced （P < 0.001）， suggesting that TINCR may influence the differentiation of keratinocytes by regulating the expression of MAFB transcription factor and KLF4 differentiation-related genes. Furthermore， immunohistochemical results indicated that the expression of KLF4 protein was significantly elevated in psoriasis tissues compared to normal skin tissues， suggesting that KLF4 plays an important role in the pathogenesis of psoriasis. Conclusions The TINCR-MAF：MAFB transcription factor network may participate in the occurrence and development of psoriasis by affecting the proliferation and differentiation of keratinocytes. This finding provides a new perspective on the pathogenesis of psoriasis and potential targets for future therapeutic strategies.

Objective To evaluate retinal vascular and neural changes in patients with coronary artery disease with depression （CADD） and to investigate their association with depression severity. Methods A total of 40 patients with CADD， 56 patients with CAD without depressive disorder （CADND）， and 31 healthy controls were included in this study. The vessel density of superficial capillary plexus （SCP） and deep capillary plexus （DCP）， and the thickness of the retinal nerve fiber layer （RNFL） and ganglion cell complex （GCC）， were quantified using optical coherence tomography angiography （OCTA） to analyze the differences between the groups and their correlation with PHQ-9 scores. Results Compared with the healthy control group， SCP and DCP were significantly decreased in both CADD and CADND groups （P < 0.05）. Both superior hemi in RNFL thickness and GCC thickness （including mean， superior hemi， and inferior hemi） were significantly increased in patients with CADD compared with patients with CADND （P < 0.05）. PHQ-9 scores were negatively correlated with the mean and inferior RNFL thickness （P < 0.05）. Conclusion Both retinal vascular neural structures were altered in patients with CADD， and the neural alterations were strongly correlated with the severity of the patient's depression symptom.

Objective To compare plantar dynamic and static pressure parameters between patients with type 2 diabetes mellitus （T2DM） and those with combined diabetic peripheral neuropathy （DPN）， and to analyze associated factors. Methods A retrospective analysis was conducted on 47 cases in the pure T2DM group and 57 cases in the T2DM combined with DPN group. The plantar dynamic and static pressure parameters， along with relevant clinical data， were recorded for each group. Results Age， BMI， cholesterol， and triglycerides were significantly higher in the combined DPN group compared to the T2DM group （P < 0.05）. The average pressure on both feet and the axial angle of the left foot were also significantly greater in the combined DPN group than in the simple T2DM group （P < 0.05）. A larger axial angle suggests an impact on gait or foot function. Additionally， the forefoot loading ratio， hindfoot loading ratio， and medial?lateral loading ratio of the left foot were all significantly higher in the combined DPN group compared to the simple T2DM group （P < 0.05）. For static pressure parameters， no statistically significant differences were observed between the two groups in terms of foot area， load， maximum pressure， or average pressure （P > 0.05）. Spearman's univariate analysis revealed that plantar dynamic and static maximum pressure， mean pressure， and total plantar pressure area were significantly and positively correlated with BMI and triglycerides. Multiple linear regression analysis indicated that the axial angle of the left foot during dynamic pressure was associated with triglyceride levels （P < 0.05）， the load ratio of the left anterior and posterior foot was related to the duration of diabetes mellitus （P < 0.05）， and the bipedal area， maximal pressure， and mean pressure during static pressure were all associated with BMI. Conclusions Dynamic plantar pressure mean compression， left foot axis angle， and loading ratio had a greater influence on foot function in the combined DPN group compared to the T2DM group alone. Regardless of the presence of DPN， attention should be paid to measuring plantar pressure in patients. early intervention using indicators associated with plantar dynamic and static pressures， such as BMI and triglycerides， can provide a clinical reference for preventing diabetic foot complications.

Objective A study of the therapeutic effect of the treatment of biceps brachii spasticity in hemiplegic patients with stroke by radial extracorporeal shock wave therapy combined with spastic muscle electrical stimulation. Methods Select 98 cases of biceps spasticity hemiplegic patients admitted and intervened in rehabilitation in the Zhongshan Hospital Xiamen University from June 2022 to June 2024， and randomly assign the patients to two different groups， each with 49 cases， using a random method. The controlled group received spastic muscle electrical stimulation treatment for the affected upper limb biceps （the “Controlled Group”） ， while the observation group received radial extracorporeal shock wave therapy combined with spastic muscle electrical stimulation treatment （the “Observation Group”）. After two months of intervention， the changes in muscle tone， activities of daily living， quality of life， improvement in motor function performance， as well as rehabilitation satisfaction and compliance were compared between the two groups. Results After the intervention， the modified Barthel index and the upper limb FMA scores of the Controlled Group were lower than those of the Observation Group （P < 0.05）； the muscle tone assessment MAS scale score of the Controlled Group was higher than that of the Observation Group （P < 0.05）； the rehabilitation satisfaction and compliance of the Controlled Group were lower than those of the Observation Group （P < 0.05）； the quality of life scores in all aspects of the Controlled Group were lower than those of the Observation Group （P < 0.05）. Conclusion The application of radial extracorporeal shock wave therapy combined with spastic muscle electrical stimulation treatment in treating biceps spasticity in hemiplegic patients with stroke can reduce the muscle tone of the patient′s biceps， alleviate spasticity， enhance the patient's motor performance and self-care ability， as well as improve their overall quality of life， and there is no concomitant medication， which is highly safe and worth promoting.

Objective To assess the efficacy of clear lens extraction combined with extended depth of focus （EDOF） intraocular lens （IOL） implantation in enhancing visual quality and concurrently opening peripheral angle structures in patients diagnosed with primary angle closure suspect （PACS） and presbyopia. Methods A total of 80 patients with PACS， presbyopia， and transparent lenses were enrolled and divided into two groups based on the type of implanted lens： a control group （n = 46） and an experimental group （n = 34）. The control group underwent clear lens extraction followed by monofocal intraocular lens implantation， while the experimental group underwent clear lens extraction followed by extended depth of focus （EDOF） intraocular lens implantation. Preoperative and postoperative evaluations at 3 months included visual acuity， intraocular pressure， anterior segment structure， defocus curve， and Catquest 9SF?CN questionnaire scores. Adverse events were recorded to assess safety. Results Regarding the angular structure， after 3 months of treatment， results indicated significant increases in central anterior chamber depth， angle opening distance at 750 μm， angle recess area at 750 μm， trabecular?iris space area at 750 μm， and trabecular?iris angle at 750 μm in both groups compared to preoperative values （all P < 0.01）. However， no significant differences were observed between the two groups （all P > 0.05）. For the defocusing curve， visual acuity in the experimental group improved from +1.0 D to -4.0 D after 3 months of treatment （all P < 0.05）， while the control group showed improvements at +0.5 D， -0.5 D， -1.0 D， -2.0 D， -3.0 D， -3.5 D， and -4.0 D （all P < 0.05）. Postoperatively at 3 months， the experimental group exhibited superior visual acuity to the control group at -1.0 D to -4.0 D （all P < 0.05）. According to the Catquest 9SF?CN scale， scores in both groups significantly improved after 3 months of treatment （P < 0.01）， with the experimental group scoring higher than the control group （P < 0.01）. During the study， transient intraocular pressure elevation occurred in 7 patients （3 in the control group and 4 in the experimental group）， but no serious adverse reactions were reported in either group. Conclusions In patients with pseudoexfoliation glaucoma combined with presbyopia， significant improvements in angle structures were observed following clear lens extraction. The implantation of an EDOF IOL notably enhanced postoperative visual quality compared to monofocal IOLs.

Objective To investigate the distribution， risk factors and prognosis of VA-ECMO patients with capillary leakage syndrome （CLS ）. Methods 115 cases of VA-ECMO were collected in Emergency department， ICU 1 and 2 of Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine from December 2019 to December 2023 for prospective clinical observation study. It was observed the operation time and status of VA-ECMO and whether VA-ECMO patients were complicated with CLS. At the same time， type of disease， blood gas pH， HCO₃^- concentration， lactate value （LAC）， serum albumin and so on were recorded. The influence of various factors on VA-ECMO with CLS was analyzed by binary Logistic regression. T test was used for measurement data and χ ² test was used for counting data. Results Capillary leakage syndrome in VA-ECMO patients were 61 cases， which had accounted for 53.04%. Sepsis， ECPR， pH value and LAC were the risk factors for VA-ECMO with CLS （P < 0.05）. The operation failure rate of ECMO in 24 hours of CLS group was 49.18% higher than that of non-CLS group （P < 0.001）. The mean running time of ECMO in CLS group was 39.53 hours， which was lower than that of non-CLS group （t = 2.318，P < 0.05）. The mortality rate of CLS group was 88.24%， higher than that of non-CLS group （57.69%） （χ ² = 14.18，P < 0.001）. Conclusions The proportion of VA-ECMO combined with CLS was not low. Sepsis， ECPR， pH value and LAC were risk factors for VA-ECMO with CLS， and VA-ECMO combined with CLS seriously affected the operation of ECMO. For patients with VA-ECMO， it should be paid more attention to observe whether they have capillary leakage and its risk factors， and the potential etiology should be treated early to promote the progress of ECMO and improve their prognosis.

Objective To exploring the correlation of serum alkaline phosphatase （ALP） and amyloid A protein（SAA） levels with cerebral microbleeds （CMBs） in patients with cerebral small vascular disease. Methods The study involved 204 patients with cerebral small vascular disease from the neurology department of Anhui No.2 Provincial People's Hospital. According to whether cerebral microbleeds occurred， they were categorized into a CMBs group（n = 117）and a non-CMBs group（n = 87）. The baseline data of two groups of patients were campared. The risk factors of cerebral microbleeds were identified and the serum ALP and SAA leves in the CMBs group across different degrees and locations were compared. Correlation analysis was used to investigate the correlation between the serum ALP， SAA levels， and the severity of cerebral microbleeds.ROC curves was used to evaluate their diagnostic value for cerebral microbleeds. Results Age， hypertension rate， serum ALP and SAA levels in the CMBs group were higher than those in the non-CMBs group （P < 0.05）. Logistic regression analysis showed that age， hypertension， serum ALP， and SAA levels were independent risk factors for cerebral microbleeds （P < 0.05）. ROC curves showed that the AUC values of serum ALP and SAA alone for predicting cerebral microbleeds were 0.801， 0.813.If in combination， the AUC value was 0.914 which is higher. Correlation analysis showed that the serum ALP and SAA levels were positively correlated with the severity of cerebral microbleeds （P < 0.001）， Meanwhile， there was no statistically significant difference between the serum ALP and SAA levels and different locations of cerebral microbleeds （P > 0.05）. Conclusions Elevated serum ALP and SAA levels in patients with cerebral small vessel disease are closely related to cerebral microbleeds. Early combined detection can effectively predict the risk of cerebral microbleeds.

Objective To develop a predictive model for guiding blood transfusion decisions in pediatric patients with traumatic brain injury （TBI） by identifying and analyzing key factors that influence blood transfusion requirements. Methods A retrospective analysis was conducted on the clinical data of 1，535 pediatric patients with TBI admitted to four medical institutions from January 1， 2015， to December 31， 2022. Patients were divided into two groups： those who received red blood cell transfusions during hospitalization and those who did not. Comparative analyses were performed on demographic， clinical， and laboratory data between these two groups. Logistic regression analysis was used to identify risk factors associated with in-hospital blood transfusion， and a predictive model was developed using a nomogram. The performance of this model was evaluated using a receiver operating characteristic （ROC） curve. Results Significant differences were observed between the blood transfusion and non-blood transfusion groups in terms of baseline demographics， clinical indicators， and laboratory test results （all P < 0.05）. Patients in the blood transfusion group exhibited significantly higher in-hospital mortality， complication rates， use of mechanical ventilation， ICU admission rates， and length of stay compared to those in the non-blood transfusion group （all P < 0.05）. Multivariate logistic regression analysis identified heart rate， presence of other fractures， treatment methods， hemoglobin （Hb）， platelet count （Plt）， activated partial thromboplastin time （APTT）， and D-dimer levels as independent risk factors for blood transfusion in TBI patients. The area under the ROC curve for the blood transfusion prediction model， based on these independent risk factors， was 0.95 （95%CI： 0.94 ~ 0.97）， indicating excellent predictive accuracy. Calibration and decision curves further validated the robustness and reliability of the model's predictive capacity. Conclusions Heart rate， presence of other fractures， treatment methods， Hb， Plt count， APTT， and D-dimer levels serve as independent risk factors for blood transfusion in TBI patients. The prediction model developed based on these factors demonstrates excellent predictive performance， thereby guiding clinicians in making informed blood transfusion decisions and enhancing the success rate of patient outcomes.

Objective To study the efficacy of hemoperfusion （HP） in series with continuous renal replacement therapy （CRRT） integrated combined blood purification under extracorporeal citrate anticoagulation in the treatment of severe hypertriglyceridemic acute pancreatitis （HTG-AP）. Methods A total of 62 patients with severe HTG-AP admitted to the Affiliated Hospital of Xuzhou Medical University from June 2022 to May 2024 were selected and randomly divided into control group and observation group， with 31 cases in each group. The control group was treated with conventional medical treatment + HP combined with CRRT staged combined blood purification treatment， and the observation group was treated with conventional medical treatment + HP in series with CRRT integrated combined blood purification treatment under extracorporeal citrate anticoagulation. The indexes and clinical efficacy before and 7 days after treatment were compared between the two groups. Results The single CRRT time of the observation group was longer than that of the control group， and the frequency of CRRT was less than that of the control group （P < 0.05）. There were no significant differences in the total CRRT time， single HP time， HP frequency and total HP time between the two groups （P > 0.05）. The blood routine， inflammatory factors， blood biochemistry and clinical scores of the two groups after treatment were improved compared with those before treatment （P < 0.05）. After treatment， the hemoglobin（Hb） and platelet count（Plt） of the observation group were higher than those of the control group （P < 0.05）， and there were no significant differences in other indexes of blood routine， inflammatory factors， blood biochemistry and clinical scores between the two groups （P > 0.05）. There were no significant differences in clinical indexes， prognosis and complications between the two groups （P > 0.05）. Conclusions Without affecting the efficacy， HP in series with CRRT integrated combined blood purification under extracorporeal citrate anticoagulation in the treatment of severe HTG-AP can prolong the use time of CRRT blood filter and pipeline， reduce the use of consumables， reduce the risk of bleeding， and avoid multiple catheter removal of HP and CRRT operation separately， and reduce the risk of related infection. It is worthy of clinical application.

Objective To investigate the correlation between glycemic variability metrics and the risk of diabetic foot （DF） in patients with type 2 diabetes mellitus （T2DM） utilizing flash glucose monitoring （FGM） technology. Methods A retrospective analysis was conducted on 233 hospitalized patients with T2DM， with or without DF， who were treated in the Department of Endocrinology at Lianyungang First People's Hospital from January 2021 to May 2022 and monitored using FGM. Patients were categorized into a non?DF group （n = 147） and a DF group （n = 86） based on the presence of DF. The study compared general clinical characteristics， biochemical parameters， and glycemic variability metrics between the two groups and performed subgroup analyses. Binary logistic regression was employed to identify factors associated with the risk of DF， while receiver operating characteristic （ROC） curves were utilized to assess the predictive value of glycemic variability metrics for DF. Results Compared with the non?DF group， patients in the DF group exhibited significantly longer disease duration， higher body mass index （BMI）， glycated hemoglobin （HbA_1c）， urinary albumin?to?creatinine ratio （UACR）， alanine aminotransferase （ALT）， serum uric acid （SUA）， mean amplitude of glycemic excursions （MAGE）， coefficient of variation （CV）， mean of daily differences （MODD）， and mean blood glucose （MBG）， but lower fasting C?peptide （FCP）， fasting insulin （FINS）， high?density lipoprotein cholesterol （HDL?C）， and time in range （TIR）， with statistically significant differences （P < 0.05）. Subgroup analysis revealed that TIR was associated with the incidence of DF and diabetic retinopathy （DR）. Binary logistic regression analysis identified HbA_1c， MAGE， MODD， and MBG as risk factors for DF， while TIR was a protective factor （P < 0.05）. ROC curve analysis demonstrated that the area under the curve （AUC） for predicting DF using HbA_1c， TIR， MAGE， MODD， MBG， and their combination were 0.646， 0.850， 0.868， 0.764， 0.619， and 0.967， respectively， indicating superior performance of the combined prediction model. Conclusions HbA_1c， TIR， MAGE， MODD， and MBG are critical factors associated with the development of DF in patients with T2DM. Targeted early interventions aimed at optimizing these glycemic variability indicators may effectively reduce the incidence of DF.

Objective To evaluate the correlation between the changes of vascular density in deep and shallow layers， retinal hyperreflexia and the therapeutic response of diabetic macular edema （DME）. Methods Retrospectively selected DME patients （45 cases and 59 eyes） who visited the Department of Ophthalmology from April 2020 to November 2023 as the experimental group. Compare the change of deep and superficial blood vessel density and retinal hyperreflective points before and after treatment of the patients. The correlation between each index and poor response to anti-vascular endothelial growth factor （VEGF） treatment with DME was analyzed using the Pearson test. The value of baseline deep retinal capillary plexus （DCP）， central macular retinal thickness （CMT）， number of high-reflective foci （HRF） in the retina， and blood flow density （FD300-VD） in diagnosing poor response to anti-VEGF therapy in DME was analyzed using the subject operating characteristic curve （ROC）. Results Compared with pre-treatment， patients' superficial retinal capillary plexus （SCP）， DCP， FD300-VD， and deep-superficial flow ratio （DSFR） increased and CMT thickness significantly decreased after treatment （P < 0.05）. Pearson's correlation test showed that the outcome of patients with poor response to anti-VEGF therapy was negatively correlated with baseline SCP-VD， DCP-VD， DSFR， and FD300-VD （r = -0.458， -0.433， -0.604， and -0.452， P < 0.05） and positively correlated with CMT （r = 0.427， P < 0.05）. The results of multifactorial logistic regression analysis showed that a rise in SCP， DCP， FD300-VD， and DSFR， and a decrease in CMT were correlates affecting the response to anti-VEGF therapy in DME （OR = 0.285， 0.272， 0.291， 0.268， 2.821， P < 0.05）.The results of ROC curve analysis showed that the AUCs of baseline DCP， CMT， HRF quantity， and FD300-VD were 0.918， 0.934， 0.947， and 0.927， respectively， which were of good value in diagnosing poor response to anti-VEGF therapy in DME. Conclusion Morphologic indicators such as changes in the density of deep and superficial blood vessels and retinal hyperreflective spots have good application value in assessing the response to DME treatment and can assist in clinical treatment.

Objective To compare the clinical outcomes of the clomiphene citrate（CC） dual stimulation protocol and the luteal phase ovarian stimulation protocol after natural cycle oocytes retrieved in POSEIDON patients with low expected prognosis. Methods The clinical data from patients who underwent in vitro fertilization （IVF） or intracytoplasmic sperm injection （ICSI） at the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from May 2016 to December 2023 were analyzed retrospectively. According to the POSEIDON criteria， including POSEIDON group 3 and group 4， which were treated with the CC dual stimulation protocol（the CC group） and the luteal-phase ovarian stimulation protocol after the natural cycle oocytes retrieval（the natural cycle group）. The basic data and clinical outcomes of the two ovulation protocols were analyzed， and the main observations included the number of oocytes retrieved， the cumulative clinical pregnancy rate and the cumulative live birth rate， and explored the impact of ovulation promotion regimens on clinical outcomes through binary logistic regression. Results On the whole，there was no significant difference in the total number of oocytes retrieved， cumulative clinical pregnancy rate and live birth rate between the CC group and the natural cycle group （all P >0.05）， And in POSEIDON group 4， the numbers of oocytes retrieved in the follicular phase of the CC group were higher than those in the natural cycle group， whereas the number of oocytes retrieved in the luteal phase of natural cycle group were higher， and the difference was statistically significant （P < 0.05）. After logistic regression analysis， the ovulation stimulation protocols did not affect the cumulative clinical pregnancy rate and live birth rate of POSEIDON 3 and 4 group （P > 0.05）. Conclusions For the POSEIDON patients with a low expected prognosis， the clinical effectiveness of the luteal phase ovarian stimulation protocol after natural cycle oocytes retrieved is not inferior to that of the CC dual stimulation protocol. In POSEIDON group 4， on the premise that the AMH levels of patients in the natural cycle group were lower than those in the CC group， who underwent natural cycle ovulation followed by luteal phase induction achieved similar clinical outcomes to those of the CC dual stimulation protocol group. Therefore， the luteal phase ovarian stimulation protocol after natural cycle oocytes retrieved should be more clinically recommended for POSEIDON group 4 patients.

Objective To investigate the association between UGT1A1 inhibitors-induced liver injury （DILI） and UGT1A1 gene polymorphisms through a pharmacogenomics approach. Methods Information on relevant drugs that may induce liver injury， blood routine tests， and liver function tests was collected from hospitalized patients diagnosed with DILI between June 2022 and June 2024. Relevant databases were searched to categorize DILI-associated drugs into UGT1A1 enzyme inhibitors and those without interaction with UGT1A1. Sanger sequencing or MassARRAY SNP typing technology was utilized to detect and genotype the UGT1A1 gene. Results A total of 219 patients with drug-induced liver injury （DILI） were enrolled， including 98 males， with a mean age of 46.32 ± 14.95 years. A literature search of relevant databases revealed that 20 drugs （16.26%， 20/123） associated with DILI had inhibitory effects on the UGT1A1 enzyme. The proportion of DILI cases related to UGT1A1 inhibitors was 60.73% （133/219）. Compared to non-UGT1A1 inhibitor-related DILI group， the UGT1A1 inhibitor-related DILI group exhibited significantly higher levels of ALT， AST， ALP， and GGT （P < 0.05）， while no significant differences were observed in age， gender， TBIL， IBIL， WBC， Hb， PLT， injury type， or injury grade （P > 0.05）. The prevalence of UGT1A1 polymorphisms was significantly higher in the UGT1A1 inhibitor-related DILI group （68.42%） compared to the non-UGT1A1 inhibitor-related DILI group （51.16%）， with an odds ratio （OR） of 2.068 （95% CI： 1.183 to 3.617； χ2 = 6.58， P = 0.010）. There was also a significant difference in the distribution of genotypes between the UGT1A1 inhibitor-related and non-UGT1A1 inhibitor-related DILI groups （χ2 = 9.60， P = 0.022）. Univariate logistic regression analysis indicated that ALT and UGT1A1*6 were associated with UGT1A1 inhibitor-related DILI， while multivariate analysis confirmed that UGT1A1*6 was independently associated with UGT1A1 inhibitor-related DILI ［OR（95%CI） = 3.143 （1.398 to 7.067）， P = 0.006］. Conclusion The UGT1A1*6 allele increases the susceptibility to drug-induced liver injury （DILI） associated with UGT1A1 inhibitory drugs.

Objective To investigate the clinical utility of krebs von den lungen-6 （KL-6）， a sialoglycan antigen， in the auxiliary diagnosis of idiopathic pulmonary hemosiderosis （IPH） in children. Methods A total of 140 children admitted to the First Affiliated Hospital of Guangzhou Medical University from June 2014 to July 2024 were categorized into a case group and a control group. The case group was further subdivided into four subgroups based on disease type： IPH group （n = 32）， interstitial lung disease （ILD） group （n = 22）， pneumonia （PN） group （n = 60）， and non-pulmonary disease （NPD） group （n = 26）. Serum KL-6 levels were measured for all children across these groups， and the differences in KL-6 expression between children with IPH and those without IPH （including the ILD， PN， and NPD groups） were analyzed. Results The positive rates of KL-6 in each group of children， from highest to lowest， were as follows： IPH （68.75%）， ILD （45.45%）， PN （1.69%）， and NPD （0.00%）. The differences in positive rates between groups were statistically significant （χ2 = 66.10， P < 0.001）. The mean serum level of KL-6 in the IPH group was significantly higher than that in the PN group （Z = -6.92， P < 0.001）. Diagnostic test results indicated that the area under the ROC curve was 0.940 （95%CI： 0.89 to 1.00， P < 0.001）， with a cut off value of 392.00 U/mL， sensitivity of 81.30%， and specificity of 95.00%. Conclusions KL-6 demonstrates significant diagnostic value in distinguishing IPH children from those with PN and NPD， making it a promising blood biomarker for aiding in the diagnosis of IPH.

Objective To analyze the influencing factors of health behaviors in stroke patients， and explore the chain mediating effects of self-efficacy and e-health literacy between the perception of stroke recurrence risk and health behaviors in stroke patients， providing a reference for strengthening the health behavior and reducing recurrence risk in stroke patients. Methods 249 stroke patients were selected as the research objects from March to September 2024 in a tertiary hospital in Shanghai， China. Patients were surveyed using General Information Questionnaire， Stroke Recurrence Risk Perception Scale， Stroke Health Behavior Scale（HBS-SP）， Chronic Disease Self-Efficacy Scale （CDSES）， and the e-health Literacy Scale（e-HEALS）. Pearson correlation analysis was used to explore the correlations among various variables， and SPSS 26.0 software macro program Process Model 6 was used to conduct chain mediation model test. Results The scores of Recurrence Risk Perception， HBS-SP， CDSES and e-HEALS of stroke patients were （42.88 ± 6.48） scores， （68.32 ± 14.13） scores， （6.87 ± 1.55） scores and （27.76 ± 6.06） scores， and all the variables were positively correlated （P < 0.01）. The mediating effect model showed that self-efficacy and e-health literacy played a chain mediating role in the recurrence risk perception and health behavior in stroke patients， with an effect size of 0.488， accounting for 37.22% of the total effect. Conclusions The recurrence risk perception and health behavior of stroke patients are both at a moderate level. In the future， we can establish a mobile management platform to provide comprehensive health management for stroke patients. Further exploration of strategies to enhance stroke patients' self-efficacy and channels for online health education could be pursued to improve their health behaviors.

Objective To investigate the efficacy of noninvasive matrix RF technology in promoting functional rehabilitation of the pelvic floor in postpartum women who have undergone natural delivery. Methods A prospective study was conducted on 80 nulliparous women who underwent spontaneous vaginal delivery at the hospital from January 2022 to April 2023. Participants were randomly allocated into a control group and an observation group， each comprising 40 individuals， using the random number table method. The control group received biofeedback electrical stimulation therapy， while the observation group was treated with non?invasive matrix radiofrequency （RF） technology. Both groups were assessed for pelvic floor muscle strength， pelvic floor structural parameters （levator hiatus area， levator muscle thickness）， and levator ani muscle ［measured by the maximum value of Young's modulus （E_max） in both resting and contracting states］ before treatment， after one session， and at the end of the treatment period. At the conclusion of the treatment， vaginal lubrication and vaginal sensitivity were evaluated using the Female Sexual Function Index （FSFI）. Additionally， the incidence of adverse events was compared between the two groups before and after the completion of treatment. Results After one treatment， there were no significant changes in pelvic floor muscle strength， levator ani muscle hiatus area， and levator ani muscle thickness in the control group compared to pre?treatment levels （P > 0.05）. In contrast， the observation group showed significant improvements in pelvic floor muscle strength and levator ani muscle thickness compared to pre?treatment levels， while the levator ani muscle hiatus area was significantly reduced （P < 0.05）. Additionally， at this point， the pelvic floor muscle strength and levator ani muscle thickness in the observation group were significantly higher than those in the control group， whereas the levator ani muscle hiatus area was significantly smaller （P < 0.05）. By the end of the treatment， both groups demonstrated further improvements in pelvic floor muscle strength and levator ani muscle thickness compared to pre?treatment and post?first?treatment levels， with a continued reduction in the levator ani muscle hiatus area. Notably， the observation group consistently exhibited superior outcomes in all three parameters compared to the control group （P < 0.05）. At the end of treatment， the E_max differences in the subpubic branch， abdominal muscles， and posterior hypothalamus were significantly greater than those before and after a single treatment session in both groups （P < 0.05）. Moreover， the E_max differences in these regions were significantly higher in the observation group compared to the control group （P < 0.05）. Post?treatment， both groups showed increased scores for vaginal lubrication， vaginal sensitivity， and FSFI， with more pronounced improvements observed in the observation group （P < 0.05）. Following treatment， no significant differences were noted between the two groups regarding the incidence of urinary incontinence， lumbosacral pain， uterine prolapse， and vaginal wall bulge （P > 0.05）. However， the observation group exhibited a lower frequency of adverse events compared to the control group （P < 0.05）. Additionally， maternal rehabilitation satisfaction was 100% （40/40） in the observation group， which was significantly higher than 85.00% （34/40） in the control group （P < 0.05）. Conclusions The application of noninvasive matrix RF technology in the rehabilitation of pelvic floor muscle function in postpartum women who have undergone vaginal delivery demonstrates rapid efficacy. It can enhance pelvic floor muscle strength within a short period， restore pelvic floor structure， and significantly improve vaginal lubrication and sensitivity， thereby enhancing sexual well?being.

YTHDF2 is a key m6A RNA modification "reader" that plays a crucial role in cell biological processes and tumor development. This review deeply explores the biological role of YTHDF2 and the advances in its application in tumors. The YTHDF2 structures are divided into mRNA procsomes and YTH domains， which recognize and bind m6A modified RNA molecules. It plays a biological role by promoting mRNA degradation， regulating cell signaling pathways and metabolism， and can regulate macrophage function and maintain an immunosuppressive state in the tumor microenvironment. YTHDF2 has the potential to serve as diagnostic markers， therapeutic targets and prognostic evaluation biomarkers in different tumors， but currently relevant studies are insufficient in sample size， molecular mechanism and clinical application. In the future， research can be conducted on comprehensive clinical research， in-depth analysis of molecular mechanisms， and research and development of optimized treatment strategies.