Natural killer （NK） cells are essential components of the innate immune system， characterized by their ability to identify and eliminate abnormal cells through receptors that operate independently of major histocompatibility complex （MHC） restriction. As a result， NK cells play a critical role in anti-tumor， antiviral， and immune regulatory responses. Chimeric antigen receptor NK cell therapy （CAR-NK） enhances the targeting specificity and functional activity of NK cells， thereby augmenting their cytotoxic potential and opening new avenues for cancer treatment. To date， numerous clinical trials have evaluated NK cell therapy for anti-tumor， antiviral， and autoimmune diseases. This article summarizes the current research status of NK cell therapy in clinical applications， highlighting its promising efficacy and safety as an innovative immunotherapy. Despite challenges such as limited cell persistence and tumor microenvironment suppression， the prospects for further development in this field remain promising.

As a symbiotic microbial community within the human body， the gut microbiota plays a crucial role in modulating various physiological processes， including metabolism， immunity， and endocrine function. During allogeneic hematopoietic stem cell transplantation （allo-HSCT）， the hematopoietic and immune systems undergo significant changes， which are also influenced by the gut microbiota. Specifically， regarding hematopoietic function， the gut microbiota facilitates the multi-lineage differentiation of hematopoietic stem cells via NOD1-STATs and TLRs-MyD88 signaling pathways， and promotes rapid granulomonocytic lineage differentiation under infection stress. Consequently， early-stage primary graft dysfunction following transplantation may be associated with gut microbiota dysbiosis. In terms of immune function， the gut microbiota enhances the expression of antigen-presenting molecules on intestinal epithelial cells， thereby initiating acute graft-versus-host disease （aGVHD） in the gastrointestinal tract. Moreover， the gut microbiota regulates intestinal immune function through metabolites such as short-chain fatty acids， bile acids， and indole derivatives. Dysbiosis of the gut microbiota can lead to disruption of the intestinal mucus barrier and immune barrier functions， further promoting the onset and progression of aGVHD in the gastrointestinal tract. Therefore， targeting the gut microbiota has emerged as an attractive therapeutic strategy and has been clinically applied. Notably， fecal microbiota transplantation combined with immunosuppressive therapy has shown significant efficacy in alleviating clinical severity and improving prognosis in steroid-refractory aGVHD， demonstrating high safety and manageable adverse reactions， representing a novel breakthrough in its treatment.

Allogeneic haematopoietic stem cell transplantation （allo-HSCT） is the most effective curative treatment for hematologic malignancies. Its efficacy hinges on eliminating primary hematological disorders and restoring bone marrow hematopoiesis during conditioning， as well as leveraging the graft-versus-leukemia （GVL） effect. However， acute graft-versus-host disease （aGVHD） remains a significant complication following allo-HSCT， substantially affecting patient survival and quality of life. Current preclinical studies focus on strategies to mitigate aGVHD while preserving adequate GVL effects to improve transplant outcomes. This review summarizes recent preclinical research findings in this field， emphasizing the regulatory roles and specific molecular mechanisms of T cells， antigen-presenting cells， myeloid-derived suppressor cells， and mesenchymal stem cells in aGVHD. It further highlights the latest therapeutic strategies for aGVHD from preclinical studies， aiming to provide valuable insights for researchers and clinicians to develop more effective therapeutic targets and strategies.

Allogeneic hematopoietic stem cell transplantation （allo-HSCT） is a therapeutic approach that restores hematopoietic and immune functions in recipients through the infusion of allogeneic hematopoietic stem cells. It has evolved into an effective form of adoptive cellular immunotherapy， offering curative potential for various diseases， including malignant hematologic disorders， hematopoietic failure syndromes， congenital immunodeficiencies， and genetic metabolic disorders. Immunology plays a pivotal role in allo-HSCT， as post-transplant immunobiology is uniquely characterized by the potential for immune recognition and attack between donor and host cells. This review elucidates the distinctive features of immune reconstitution following allo-HSCT， examines the immunological underpinnings of graft-versus-host disease （GVHD） and the graft-versus-leukemia （GVL） effect， and evaluates how novel therapeutic strategies modulate these immune responses to improve the management of transplant-related complications and enhance patient outcomes. Additionally， the review addresses the challenges in balancing GVHD and GVL effects and outlines potential directions for future research.

Circadian rhythms， a result of the long-term evolution of organisms adapting to the Earth's environment， play a crucial regulatory role in biological activities. Disruptions in circadian rhythms have been identified as potential carcinogenic risk factors， closely linked to the pathological states of digestive system diseases， and significantly contribute to the occurrence and progression of digestive system tumors. These rhythms not only influence the regulation of cell cycles， proliferation， and apoptosis of tumor cells but also profoundly affect their migratory abilities， immune functions， and drug resistance. This article focuses on the specific regulatory mechanisms of circadian rhythm genes in relation to digestive system tumors and comprehensively summarizes research findings on the anti-tumor effects of traditional Chinese medicine targeting these circadian clock genes. The aim is to provide new avenues for target selection and prognostic evaluation in the treatment of digestive system tumors.

Objective To explore the effects of long non-coding RNA LINC01772 on cell cycle， apoptosis and radiotherapy sensitivity of A549. Methods A549 cells were resuscitated and cultured for experimental purpose. The effects of LINC01772 knockdown on cell viability， cell cycle progression， and apoptosis were assessed using CCK-8 assays and flow cytometry， and apoptosis-related proteins were analyzed using western blotting. CCK-8 and clonogenic assays were used to measure the changes in the sensitivity of A549 cells to radiotherapy following various radiation doses， and flow cytometry to examine alterations in the cell cycle and apoptosis post-radiation treatment. Results Following lentiviral transfection that reduced LINC01772 levels in A549 cells， a significant decrease in cell viability （P < 0.01） was observed alongside an increase in apoptosis （P < 0.01）. Notably， expressions of Bad and Cleaved Caspase-3 were significantly elevated （P < 0.01）， while Bcl-2 expression was markedly decreased （P < 0.01）. After exposure to different radiation doses， a dose-dependent reduction in A549 cell viability was noted （P < 0.01）， accompanied by a significant impairment of clonogenic ability （P < 0.01）， G2/M phase arrest within the cell cycle （P < 0.01）， and an increased incidence of apoptosis （P < 0.01）. Conclusion Inhibiting long non-coding RNA LINC01772 expression substantially diminishes cellular viability in A549 cells， enhances apoptotic processes， disrupts their cycling mechanisms， and augments their sensitivity to radiotherapy， suggesting that this non-coding RNA may serve as a potential target for enhancing lung cancer radiotherapy.

Objective The study aimed to investigate whether montelukast sodium could alleviate airway inflammatory responses in asthmatic mice by affecting the PHD2/HIF?1α pathway. Methods An allergic asthma model was established by ovalbumin （OVA） induction， and 18 female BALB/c mice were randomly divided into a control group （Con group）， an asthma group （OVA group）， and an asthma group with montelukast sodium intervention （30 mg/kg montelukast sodium by oral administration 1 h before OVA challenge， Mon group）. HE staining was used to analyze the pathological changes in the lungs of mice. Blood cell analyzer and kits were used to determine the number of inflammatory cells and the levels of cytokines， the content of lactic acid and pyruvic acid in the lungs， respectively. RT?PCR and Western blot were used to detect the mRNA and protein expression of HIF?1α， PHD2， E?cad and p120 in the lungs of mice. Results Compared with the Con group， there was a significant increase in the number of eosinophils， lymphocytes， neutrophils and monocytes， the levels of IL?5， IL?13， complement factor D （CFD） and contents of lactate and pyruvate in the lungs of mice in the OVA group. Lung HIF?1α， PHD2， p120 and E?cad mRNA levels were reduced， meanwhile HIF?1α and PHD2 protein expression were upregulated but E?cad and p120 protein expression were downregulated （all with P < 0.05）. After montelukast sodium intervention， the number of eosinophils and monocytes and CFD expression were significantly decreased in the lungs of Mon group， the contents of lactate and pyruvate were basically restored to normal， and the mRNA and protein expression of HIF?1α， PHD2， p120 and E?cad were effectively improved. Conclusion Montelukast sodium could alleviate the airway inflammatory responses in the lungs of asthmatic mice by regulating the PHD2/ HIF?1α signaling pathway.

Objective To investigate the effects of safflower polysaccharide on tumor growth and the Phosphoinositide 3?kinase （PI3K）/Protein Kinase B （Akt）/Mammalian Target of Rapamycin （mTOR） signaling pathway in colorectal cancer mice. Methods The mouse model of colorectal cancer was established by inoculating SW480 colorectal cancer cells. The successfully modeled mice were divided into five groups： the control group， the low?dose safflower polysaccharide group 15 mg/（kg·day）， the medium?dose safflower polysaccharide group 45 mg/（kg·day）， and the high?dose safflower polysaccharide group 135 mg/（kg·day）. After treatment， tumor volume， mass， and tumor inhibition rate were measured. Immunohistochemistry was used to detect the expression of Proliferating Cell Nuclear Antigen （PCNA） protein. Apoptosis was assessed using the Terminal deoxynucleotidyl Transferase?Mediated Nick End Labeling （TUNEL） method. Hematoxylin?Eosin （HE） staining was performed to observe the morphology of tumor tissues. Real?time polymerase chain reaction （RT?PCR） was employed to measure the expression levels of PI3K， Akt， and mTOR in tumor tissues from each group. Western blot analysis was conducted to evaluate the expression levels of c?Myc， Bcl?2?associated X protein （Bax）， and proteins related to the PI3K/Akt/mTOR pathway. Results Compared with the model group， the safflower polysaccharide （low， medium， and high） dose groups exhibited significantly decreased tumor mass and volume， as well as reduced mRNA levels of PI3K， Akt， and mTOR. Additionally， the expression ratios of p?PI3K/PI3K， p?Akt/Akt， p?mTOR/mTOR， and c?Myc protein were notably decreased， while the expression of Bax protein was significantly increased （P < 0.05）. As the concentration of safflower polysaccharide increased， the tumor inhibition rate also increased （P < 0.05）. In the model group， tumor tissue from mice showed a higher number of PCNA?positive cells； TUNEL staining revealed minimal green fluorescence， indicating low apoptosis rates. The tumor cells were closely packed， large in size， and poorly differentiated. Conversely， in the different dosage safflower polysaccharide groups， the expression of PCNA in tumor tissues was markedly reduced， and TUNEL staining positive cells （green） were significantly increased， leading to higher apoptosis rates （P < 0.05）. The tumor tissue cells were loosely arranged， with shrunken nuclei and numerous necrotic cells. Conclusion Safflower polysaccharide potentially inhibits the growth of colorectal cancer in mice through suppression of the PI3K/Akt/mTOR signaling pathway.

Objective To investigate the impact of pomegranate peel polyphenols （PPP） on the malignant biological behavior of colon cancer cells through modulation of the miR?138?5p/hypoxia?inducible factor?1α （HIF?1α） pathway. Methods Quantitative real?time PCR （qRT?PCR） was employed to measure the expression levels of miR?138?5p and HIF?1α mRNA in the normal colon epithelial cell line FHC and three colorectal cancer cell lines： SW480， HCT116， and Caco?2. SW480 cells were divided into six groups： a blank control group， a negative control （mimics NC） group， a miR?138?5p mimics group， three different concentrations of PPP treatment groups （0.5 mg/mL， 1 mg/mL， and 2 mg/mL）， a PPP + inhibitor NC group at 2 mg/mL， and a PPP + miR?138?5p inhibitor group at 2 mg/mL. The effects on cell proliferation， invasion， and migration， as well as changes in apoptosis and related proteins including B?cell lymphoma 2 （Bcl?2）， migration invasion enhancer 1 （MIEN1）， and Cyclin D1， were evaluated separately. Additionally， the targeting relationship between miR?138?5p and HIF?1α was validated. The expression levels of miR?138?5p， HIF?1α mRNA， and protein were assessed in each experimental group. Results The expression levels of miR?138?5p were highest in FHC cells and lowest in SW 480 cells， while the expression levels of HIF?1α mRNA showed an opposite trend， being lowest in FHC cells and highest in SW 480 cells （P < 0.05）. Compared with the control group， different concentrations of PPP significantly promoted cell apoptosis， upregulated miR?138?5p expression， inhibited cell proliferation， invasion， and migration， and downregulated the expression of HIF?1α mRNA， Bcl?2， MIEN1， CyclinD1， and HIF?1α protein， with significant differences between groups （P < 0.05）. Compared with the mimics NC group， the miR?138?5p mimics group significantly enhanced cell apoptosis， upregulated miR?138?5p expression， inhibited cell proliferation， invasion， and migration， and downregulated the expression of HIF?1α mRNA， Bcl?2， MIEN1， CyclinD1， and HIF?1α protein （P < 0.05）. Compared with the 2 mg/mL PPP + inhibitor NC group， the 2 mg/mL PPP + miR?138?5p inhibitor group significantly suppressed cell apoptosis， downregulated miR?138?5p expression， promoted cell proliferation， invasion， and migration， and upregulated the expression of HIF?1α mRNA， Bcl?2， MIEN1， CyclinD1， and HIF?1α protein （P < 0.05）. These results indicate a targeted relationship between miR?138?5p and HIF?1α （P < 0.05）. Conclusion PPP inhibits the malignant biological behavior of colon cancer cells through upregulation of the miR?138?5p/HIF?1α pathway.

Objective To investigate the influencing factors of antibiotic-associated diarrhea （AAD） following congenital heart disease （CHD） surgery in pediatric patients， develop a nomogram-based predictive model， and validate its efficacy. Methods A retrospective analysis was conducted on the clinical data of pediatric patients who underwent CHD surgery in the Pediatric Intensive Care Unit （PICU） of a tertiary hospital in Guangdong Province from July 2022 to July 2024. Patients were categorized into an AAD group and a non-AAD group. Univariate and multivariate logistic regression analyses were performed to identify risk factors for AAD occurrence following CHD surgery. A risk prediction model was developed， and a nomogram was constructed. The predictive performance of the model was evaluated using the Receiver Operating Characteristic （ROC） curve to calculate the area under the curve （AUC）， the Hosmer-Lemeshow goodness-of-fit test， calibration curves， and clinical decision curve analysis. External validation of the model was conducted using data from patients in the Surgical Intensive Care Unit （SICU）. Results The incidence of AAD following CHD surgery was 48.52% （229 out of 472 cases）. Risk factors for AAD included the combined use of antibiotics， mechanical ventilation， elevated C-reactive protein levels， prolonged surgical duration， and extended antibiotic usage time （all with OR > 1， P < 0.05）. Conversely， probiotic administration was identified as a protective factor （OR < 1， P < 0.05）. The predictive model demonstrated excellent discrimination， as evidenced by the ROC curve areas： 0.922 （95% CI： 0.894 ~ 0.951） in the modeling group， 0.886 （95% CI： 0.838 ~ 0.915） in the internal validation group， and 0.862 （95% CI： 0.784 ~ 0.941） in the external validation group. Additionally， the model exhibited satisfactory calibration， as indicated by the Hosmer-Lemeshow test results： χ² = 7.96， P = 0.538 in the modeling group； χ² = 4.24， P = 0.895 in the internal validation group； and χ² = 9.923， P = 0.270 in the external validation group. Furthermore， the model provided significant clinical utility. Conclusions Combined antibiotic use， duration of antibiotic therapy， mechanical ventilation， surgical duration， C-reactive protein （CRP） levels， and probiotic administration are key factors influencing the occurrence of AAD. The risk prediction model developed based on these variables demonstrates robust predictive performance and can serve as a valuable reference for the development and implementation of preventive and therapeutic strategies in clinical practice.

Objective We investigated the clinical features and the potential risk factors of malnutrition in patients with chronic heart failure （CHF） ， and constructed the risk prediction model of malnutrition. Methods A total of459 CHF patients admitted between January 2023 and July 2024 were classified into a normal nutrition group and a malnutrition group based on the geriatric Nutrition Risk Index （GNRI） score upon admission. The patient?related data were gathered， and single?variable and multi?variable logistic analyses were first carried out to identify the risk factors associated with the malnutrition risk. Subsequently， the stepwise regression approach was employed to define the inclusion criteria and construct a malnutrition nomogram model for CHF patients. The diagnostic efficacy and calibration of this model were appraised using the ROC curve and calibration curve， and its clinical utility was assessed via the clinical decision curve. A P value less than 0.05 signified statistically significant differences. Results Anxiety （OR = 1.1902，95%CI： 1.0217 ~ 1.3865）， urea nitrogen（OR= 1.4842， 95%CI：1.1187 ~ 1.9691）， low body weight （OR = 0.8463， 95%CI：0.7852 ~ 0.9121）， and low albumin （OR = 0.0467， 95%CI：0.0172 ~ 0.1268） were risk factors for malnutrition. The optimal model inclusion factors were selected by stepwise regression， including： Body weight， 7 items of Generalized Anxiety Disorder Scale （GAD?7）， urea nitrogen， uric acid， albumin， total cholesterol， high density lipoprotein cholesterol （HDL?L）， low density lipoprotein cholesterol （LDL?L）， D?dimer. The area under the ROC curve （AUC） of the column chart model based on the above factors is 0.996 （95%CI： 0.971 ~ 0.978）， with a sensitivity of 97.8% and a specificity of 97.1%. The C?index validated internally in the calibration curve was 0.824. The calibration chart and validation results demonstrate good consistency and applicability. Conclusion The column chart prediction model created in this study based on nine factors including body weight， GAD?7， urea nitrogen， uric acid， albumin， total cholesterol， HDL?L， LDL?L， and D?dimer had good calibration and prediction performance， and had good clinical practicality， which was helpful for clinicians to make diagnosis and treatment decisions for malnutrition in CHF patients.

Objective The effect of intra?aortic balloon counterpulsation combined with recombinant human brain natriuretic peptide （rhBNP） treatment on ventricular remodeling after percutaneous coronary intervention （PCI） in elderly patients with acute anterior wall myocardial infarction. Methods A retrospective analysis was conducted on 66 elderly patients with acute anterior myocardial infarction who underwent emergency PCI in our hospital from January 2018 to June 2023. They were divided into a control group （n = 32） who underwent PCI + rhBNP， and a study group （n = 32） who underwent PCI+rhBNP+intra?aortic balloon counterpulsation. Blood pressure， lactic acid level， mechanical complications， ventricular remodeling， inflammatory factors， myocardial enzymology， ox?LDL level were detected and compared between the two groups. Results Before treatment， Lactic acid， diastolic blood pressure， systolic blood pressure， left ventricular end?systolic diameter （LVESD）， left ventricular end?diastolic diameter （LVEDD）， left ventricular posterior wall thickness （LVPWT）， left ventricular remodeling index （LVRI）， left ventricular ejection fraction （LVEF）， homocysteine （Hcy）， interleukin?6 （IL?6） and myocardial troponin were compared between the two groups. Myocardial troponin T （cTnT）， lactate dehydrogenase （LDH）， creatine kinase isoenzyme （CK?MB）， oxidized low density lipoprotein （ox?LDL） levels （P > 0.05）； At 3 months follow?up after discharge， the levels of lactic acid， LVESD， LVEDD， LVPWT， LVRI， Hcy， IL?6， cTnT， LDH， CK?MB and ox?LDL were decreased， and the levels were lower in the study group， and the levels of diastolic blood pressure， systolic blood pressure and LVEF were increased， and the levels were higher in the study group （P < 0.05）. The proportion of mechanical complications between the two groups before and after treatment were compared （P > 0.05）. Conclusion In elderly patients with acute anterior myocardial infarction after emergency PCI， intra?aortic balloon counterpulsation combined with rhBNP could alleviate ventricular remodeling， myocardial injury， reduce inflammatory injury， improve oxidative stress response， and regulate tissue perfusion.

Objective To investigate the impact of noise isolation through the use of noise-cancelling headphones on the quality of postoperative recovery following esophageal or gastric endoscopic submucosal dissection. Methods This is a prospective， parallel-group， randomized controlled clinical trial. Patients aged 18 years or older， regardless of gender and with ASA physical status Ⅰ- Ⅳ， who underwent elective esophageal or gastric endoscopic submucosal dissection under general anesthesia with endotracheal intubation from August 2023 to February 2024 were randomly assigned to either a control group or an observation group using a random number table. In the observation group， noise-cancelling headphones were used to reduce intraoperative noise intensity during general anesthesia， while the control group did not receive any noise isolation measures. The study recorded the average noise intensity during surgery and the proportion of intraoperative time with noise intensity ≥ 70 dB. The primary outcome was the quality of recovery at 24 hours postoperatively， assessed using the 15-item Quality of Recovery Scale （QoR-15）. Secondary outcomes included QoR-15 scores at 48 hours postoperatively， resting and movement-evoked pain scores measured by the Visual Analog Pain Scale （VAS） immediately after extubation， upon leaving the resuscitation room， and at 24 and 48 hours postoperatively， as well as analgesic drug consumption during surgery and within 48 hours postoperatively. Additionally， sleep quality was evaluated using the Pittsburgh Sleep Quality Index （PSQI） at 48 hours postoperatively. Results Compared with the control group， the observation group exhibited a significant increase in QoR-15 score at 24 hours post-surgery ［（123.43 ± 5.92） vs. （119.75 ± 6.62）， t = 3.211， P = 0.002］. The resting VAS score ［1（0，3） vs. 2（2，3）， Z = -3.755， P < 0.001］ and movement-evoked VAS score ［2（1，3） vs. 3（2，3）， Z = -2.959， P = 0.003］ of the observation group immediately after extubation were significantly lower than those of control group. There was no significant difference in resting and movement-evoked VAS scores between the two groups when leaving the resuscitation room or at 24 and 48 hours after surgery （P > 0.05）. The intraoperative fentanyl consumption was significantly lower in the observation group compared to the control group ［（0.23 ± 0.05） vs. （0.27 ± 0.06）， t = 3.515， P = 0.01］. There were no significant differences in remifentanil consumption during surgery or in the frequency of rescue analgesia with flurbiprofen axetil within 48 hours post-surgery （P > 0.05）. Postoperative PSQI scores were significantly lower in the observation group compared to the control group ［（5.40 ± 2.57） vs. （6.63 ± 3.23）， t = 2.313， P = 0.022］. Conclusion The use of noise-cancelling headphones for intraoperative noise isolation is a safe and effective strategy that enhances postoperative recovery quality， alleviates postoperative pain， and decreases the overall consumption of analgesic drugs in patients undergoing endoscopic submucosal dissection of esophageal and gastric lesions under general anesthesia.

Objective To assess the clinical efficacy and safety of rectal mucosal columnar suturing （Block technique） in combination with lauromacrogol injection for the treatment of female rectocele. Methods This retrospective study analyzed 90 female patients with rectocele who were treated at Sir Run Run Hospital， Nanjing Medical University， from January 2022 to December 2023. Patients were categorized into three groups according to their surgical treatments： Block combined with lauromacrogol injection （BP group， n = 30）， Block alone （B group， n = 30）， and Procedure for Prolapse and Hemorrhoids （PPH， H group， n = 30）. The study compared general clinical data， perioperative indicators， Longo′s Obstructed Defecation Syndrome （Longo′s ODS） scores， the degree of rectocele before and after surgery， anorectal manometry parameters， surgical efficacy， and perioperative complications among the three groups. Results The intraoperative blood loss in Group H was significantly higher compared to Groups B and BP （P < 0.05）. In terms of the 24?hour postoperative VAS score and hospital stay duration， Group BP demonstrated superior outcomes relative to Groups H and B （P < 0.05）. Preoperatively， there were no significant differences among the three groups regarding Longo′s ODS score， rectocele depth， resting anal pressure， or residual anal pressure （P > 0.05）. Postoperatively， Group BP exhibited significantly better Longo′s ODS scores and rectocele depth compared to Groups B and H （P < 0.05）. Although no significant differences were observed in postoperative resting and residual anal pressures among the three groups （P > 0.05）， the values in Group BP were closer to the normal range. The overall efficacy rate in Group BP was 93.3%， which was higher than the 73.3% in Group B and 66.7% in Group H （P < 0.05）. There was no significant difference in the complication rate across the three groups （P > 0.05）. Conclusions Block combined with lauromacrogol injection is a safe and effective treatment for female rectocele， demonstrating superior efficacy compared to both PPH and Block alone. This method not only effectively restores the physiological anatomy of the female rectum but also significantly improves clinical symptoms.

Objective To evaluate the predictive value of the Systemic Inflammation Response Index （SIRI） for non?curative resection during endoscopic submucosal dissection （ESD） treatment of early?stage colorectal cancer （CRC）， and to develop a nomogram?based prediction model. Methods Retrospective data were collected from 235 patients diagnosed with early?stage CRC who underwent ESD at our hospital between January 2016 and August 2024. Receiver operating characteristic （ROC） curves were constructed to evaluate the predictive performance of inflammatory markers， such as the SIRI， for non?curative resection following ESD. Logistic regression analysis was conducted to identify independent risk factors associated with non?curative resection， and a prediction model was developed based on these factors. The model was internally validated. Results The incidence of non?curative resection in the study population was 26.38% （62 out of 235 cases）. Inflammatory markers， specifically SIRI and SII， demonstrated predictive value for non?curative resection following ESD in patients with early?stage CRC， with SIRI exhibiting a higher predictive accuracy （AUC = 0.704）. Logistic regression analysis identified age， family history， CEA， SIRI， and SII as independent risk factors for non?curative resection （all P < 0.05）. Based on these findings， a nomogram prediction model incorporating age， family history， CEA， and SIRI was developed， achieving a C?index of 0.741 （95% CI： 0.675 ~ 0.806）. The model's performance was validated using the Bootstrap method， and the decision curve analysis indicated satisfactory predictive accuracy. Conclusions SIRI demonstrates superior predictive value compared to SII for non?curative resection following ESD in patients with early?stage CRC. Independent risk factors for non?curative resection after ESD include age， family history， CEA levels， SIRI， and SII. A nomogram prediction model constructed using these risk factors?specifically age， family history， CEA levels， and SIRI?can effectively predict the likelihood of non?curative resection after ESD.

Objective To investigate the association between intraoperative dexamethasone administration and long-term survival outcomes. Methods A total of 1 629 NSCLC patients who underwent lung tumor resection between January 2008 and December 2014 were included in this study. A propensity score-matched cohort was generated at a ratio of 1∶2 to compare patients who received dexamethasone with those who did not. This matching process resulted in a cohort of 532 patients in the non-DEX group and 283 patients in the DEX group. Within this propensity score-matched cohort， disease-free survival （DFS） and overall survival （OS） were compared between the non-DEX and DEX groups using the Kaplan?Meier method. Additionally， Cox proportional hazards regression analysis was used to evaluate the associations between intraoperative administration of dexamethasone and high-risk factors for postoperative nausea and vomiting （PONV）， as well as their impact on DFS and OS. Results After propensity score matching， intraoperative dexamethasone was significantly associated with worse OS （P = 0.005）， while no significant correlation was observed between intraoperative dexamethasone and DFS. Multivariate Cox regression analyses indicated that intraoperative dexamethasone was associated with poorer overall survival （HR =1.233， 95% CI： 1.002 ~ 1.516， P = 0.048）. In subgroup analyses， intraoperative dexamethasone was significantly associated with shorter OS in the female， video-assisted thoracoscopic surgery （VATS）， prolonged anesthetic time， and inhalation anesthesia subgroups. Conclusions There was a significant correlation between intraoperative dexamethasone administration and overall survival in NSCLC patients following curative surgery. In high-risk subgroups for PONV， including females， those undergoing VATS， patients with prolonged anesthetic duration， and those under inhalation anesthesia， the administration of intraoperative dexamethasone was associated with a potentially poorer prognosis compared to patients who did not receive intraoperative dexamethasone.

Objective To evaluate the effects of lysine inositol vitamin B12 oral solution in conjunction with recombinant human growth hormone （rhGH） on bone mineral density （BMD） and insulin-like growth factor-1 （IGF-1） levels in children with idiopathic short stature. Methods A total of 92 children diagnosed with idiopathic dwarfism at the Affiliated Hospital of Chengde Medical College between August 2021 and March 2024 were recruited and randomly divided into two groups using a random number table method. The rhGH group received recombinant human growth hormone （rhGH） at a dose of 0.15 U/kg/day， while the comprehensive treatment group received lysyl myo-inositol and vitamin B₁₂ oral solution in addition to rhGH. Growth and development indices， IGF-1 levels， bone metabolism markers， serum calcium， serum phosphorus， and vitamin D levels were compared between the two groups. Additionally， adverse reactions were monitored and recorded for both groups. Results Comparison of growth and development indicators in children with idiopathic dwarfism before treatment between the two groups showed no significant difference （P > 0.05）. After 12 months of treatment， both groups exhibited increased growth rates， height standard deviation scores， and body mass indices compared to pre-treatment levels， with the combined group showing significantly higher values than the rhGH group （P < 0.05）. Similarly， there was no significant difference in IGF-1 levels between the two groups before treatment （P > 0.05）. However， at 6 and 12 months post-treatment， IGF-1 levels were significantly higher in both groups compared to baseline， with the combined group demonstrating significantly greater increases than the rhGH group （P < 0.05）. Regarding bone metabolism parameters， blood calcium， blood phosphorus， and vitamin D levels， no significant differences were observed between the two groups prior to treatment （P > 0.05）. At 12 months post-treatment， bone mineral density， bone alkaline phosphatase （BAP）， typeⅠprocollagen amino-terminal propeptide （PINP）， blood calcium， blood phosphorus， and vitamin D levels were significantly higher in both groups compared to pre-treatment levels， with the combined group showing significantly greater improvements than the rhGH group （P < 0.05）. Cumulative adverse effects did not differ significantly between the integrated group and the rhGH group （P > 0.05）. Conclusion The combination of lysine， inositol， vitamin B₁₂ oral solution and rhGH enhances bone metabolism and promotes growth in children with idiopathic short stature.

Objective The study aimed to explore the clinical diagnostic value of D?Dimer （D?D） combined with N?terminal pro?B?type natriuretic peptide（NT?proBNP） in the occurrence of renal dysfunction in patients with acute coronary syndrome （ACS）. Methods As a retrospective cohort study， we selected 682 patients as the research subjects. The patients were with acute coronary syndrome who visited the Chest Pain Center of Tianjin First Central Hospital during January 2021 and December 2023. Based on the eGFR values calculated from the creatinine levels before coronary angiography， patients were divided into the renal insufficiency group and the normal renal function group， comprising 102 cases and 580 cases， respectively. Binary logistic regression was adopted to analyze the influence factors of renal dysfunction in ACS patients， and the receiver operating characteristic （ROC） curve was utilized to evaluate the diagnostic value of D?D and NT?proBNP levels for renal dysfunction in ACS patients. Results The levels of D?D and NT?proBNP in the renal insufficiency group were significantly higher than those in the normal renal function group （P < 0.05）. Univariate logistic regression analysis showed that the rise of D?D and NT?proBNP levels were both independent risks for renal dysfunction in ACS patients. Multivariate logistic regression analysis indicated that the combined detection of D?D and NT?proBNP was an independent risk factor for renal dysfunction in ACS patients. The ROC results showed that the AUC， sensitivity， and specificity of the D?D level in diagnosing renal dysfunction in ACS patients were 0.805， 58.82%， and 100%， respectively. The AUC， sensitivity， and specificity of NT?proBNP level in diagnosing renal dysfunction after myocardial infarction in ACS patients were 0.737， 67.65%， and 73.62%， respectively. The AUC， sensitivity， and specificity of D?D combined with NT?proBNP in diagnosing renal dysfunction in ACS patients were 0.838， 68.63%， and 93.28%， respectively. The diagnostic value of combined detection was superior to that of individual testing. Conclusions The levels of D?D and NT?proBNP were significantly elevated in ACS patients with renal dysfunction， which were independent risk factors for the occurrence of renal dysfunction， and the combined detection could help diagnose renal dysfunction.

Objective This study aimed to explore the ability of ultrasonographic radiomics in predicting the occurrence of in-stent restenosis （ISR） after carotid artery stenting （CAS） by analyzing the correlation between radiomic features of responsible plaques in carotid artery stenosis and the incidence of ISR. Methods A retrospective collection was conducted on 206 cases that underwent CAS treatment at our hospital. The enrolled patients were randomly split into a training set （144 cases） and a test set （62 cases） at a 7：3 ratio. We utilized the Darwin Intelligent Research Platform to extract radiomic features from each region of interest， and then screened 1125 ultrasonographic radiomic features. Different machine learning algorithms were employed to construct diagnostic models， and the best-performing classifier was selected. Various prediction models were established， including a clinical-ultrasonographic feature model， a radiomic model， and a combined clinical-ultrasonographic-radiomic model. Results Multivariate logistic regression analysis in the training set revealed that hypertension， hyperuricemia， triglycerides， and plaque location were independent risk factors for ISR after CAS. For the clinical-ultrasonographic model， the area under the curve （AUC） values for the training and validation sets were 0.896 and 0.644， respectively. The corresponding AUC values for the radiomic model were 0.961 and 0.715， while those for the combined model were 0.947 and 0.727. Conclusion The radiomic model demonstrates superior performance in predicting ISR compared to the traditional clinical-ultrasonographic model. The combined model exhibited an enhanced ability to predict ISR occurrence， thereby improving the diagnostic performance of traditional assessments。

Objective To evaluate the diagnostic value of shear wave dispersion （SWD） in preoperative assessment of liver fibrosis in patients with hepatocellular carcinoma （HCC）. Methods A total of 62 patients with HCC who were admitted to the hospital between January 2022 and January 2024 were included in this study. All patients underwent shear wave elastography （SWE） examination prior to hepatectomy. The extent of liver fibrosis was assessed based on surgical and pathological findings. Patients were categorized into two groups： a low?grade fibrosis group （stages S0?S2） and a high?grade fibrosis group （stages S3?S4）. Baseline characteristics and liver parenchymal SWE values were compared between the two groups. Multivariate logistic regression analysis was conducted to identify factors influencing the degree of liver fibrosis in HCC patients. The diagnostic performance of SWE in preoperative evaluation of liver fibrosis was assessed using receiver operating characteristic （ROC） curve analysis. Results Among the 62 patients with HCC， pathological results indicated that there were 11， 13， 20， and 18 cases in fibrosis stages S1， S2， S3， and S4， respectively. The SWD values of liver parenchyma significantly differed among patients with varying degrees of liver fibrosis. As the severity of liver fibrosis increased， the SWD of liver parenchyma also increased （P < 0.05）. Spearman correlation analysis revealed a positive correlation between the SWD value of liver parenchyma and the degree of liver fibrosis in preoperative HCC patients （r = 0.608， P < 0.05）. Platelet count （PLT） was lower in the high?grade fibrosis group compared to the low?grade fibrosis group （P < 0.05）. Additionally， both the S index and SWD value of liver parenchyma were higher in the high?grade fibrosis group than in the low?grade fibrosis group （P < 0.05）. Multivariate logistic regression analysis demonstrated that the S index and SWD value were independent influencing factors for the degree of liver fibrosis in preoperative HCC patients （P < 0.05）. ROC curves showed that the area under the curve （AUC） of the SWD value was greater than that of the S index for assessing the degree of liver fibrosis in preoperative HCC patients （P < 0.05）. The cutoff value， sensitivity， and specificity of the SWD value for assessing the degree of liver fibrosis were 16.25 m/s·kHz?1， 65.79%， and 95.83%， respectively. Conclusion The SWD value of liver parenchyma is closely associated with the extent of liver fibrosis in patients with HCC and provides a highly valuable assessment of the degree of liver fibrosis.

Objective The study aimed to investigate the predictive efficacy of contrast?enhanced ultrasound combined with telomerase reverse transcriptase （TERT） promoter mutation in constructing nomogram model for the prediction of concomitant cervical lymph node metastasis （CLNM） in papillary thyroid microcarcinoma （pTMC）. Methods A total of 202 patients with pTMC who underwent partial or total thyroidectomy + lymph node dissection at our hospital from January 2021 to March 2024 were selected. Then， they were divided into the CLNM group （97 patients） and the non?CLNM group （105 patients） according to whether they had concomitant CLNM on postoperative pathological examination. General data and ultrasound （conventional ultrasound and contrast?enhanced ultrasound） characteristics were collected from all patients with pTMC， and Sanger sequencing was used to detect TERT promoter mutations. The influencing factors of pTMC complicated by CLNM were analyzed by single?factor and multifactorial unconditional logistic regression； the nomogram model of pTMC complicating CLNM with contrast?enhanced ultrasound combined with TERT promoter mutation was constructed by RStudio 4.4.1 software， and the consistency and net benefit of the nomogram model were evaluated by using calibration curves， decision curves， and C?indexes， and the Hosmer?Lemeshow test for goodness of fit of the nomogram model； The predictive efficiency of the nomogram model constructed by combining contrast?enhanced ultrasound and TERT promoter mutation for pTMC complicated by CLNM was evaluated by plotting receiver operating characteristic （ROC） curves using MedCalc22.023 software. Results After postoperative pathological examination， the incidence of CLNM in 202 patients with pTMC was 48.02% （97/202）. Univariate analysis showed that thyroglobulin antibodies， number of lesions， aspect ratio， microcalcifications， enhancement time， enhancement mode， enhancement intensity， capsular continuity， and TERT promoter mutations were associated with pTMC complicating CLNM （P < 0.05）. Multifactorial unconditional logistic regression showed that multifocal tumours （OR = 3.487， 95%CI： 1.641 ~ 7.406， P = 0.001）， microcalcifications （OR = 4.484， 95%CI： 2.113 ~ 9.516， P < 0.001）， equal or high enhancement （OR = 3.187， 95%CI： 1.460 ~ 6.957， P = 0.004）， disruption of peritoneal continuity （OR = 2.201， 95%CI： 1.051 ~ 4.608， P = 0.036）， and TERT promoter mutation positivity （OR = 4.460， 95%CI： 2.132 ~ 10.103， P < 0.001） were the independent risk factors for pTMC complicating CLNM. A contrast?enhanced ultrasound combined TERT promoter mutation nomogram model was constructed based on independent risk factors for pTMC complicating CLNM ［Logit （p）= -4.486 + 1.350 × number of foci + 1.399 × microcalcifications + 2.124 × intensity of enhancement + 1.524 × capsular continuity+2.175 × TERT promoter mutations］. The C?index of this nomogram model was 0.899 （95%CI： 0.893 ~ 0.905）， the calibration curve alignment was close to the ideal curve， the decision curve was higher than the two extreme curves， and the Hosmer?Lemeshow test showed a P > 0.05.The ROC curve analysis showed that the nomogram model constructed with contrast?enhanced ultrasound combined with TERT promoter mutations predicted CLNM in pTMC with an area under the curve of 0.899. This was significantly higher than the area under the curves for contrast?enhanced ultrasound alone （0.857） and TERT promoter mutations alone （0.697） （P < 0.05）. Conclusion The contrast?enhanced ultrasound combined with TERT promoter mutations to construct a nomogram model has high predictive efficiency for pTMC complicating CLNM.

Cancer-associated venous thromboembolism （CAT） refers to the presence of venous thromboembolism including deep vein thrombosis and pulmonary embolism in patients with malignant cancer. Studies have indicated that CAT has become the second leading cause of death among cancer patients. Similar to other methods used to prevent and treat venous thromboembolism， anticoagulation remains to be the primary approach for CAT. However， the occurrence of CAT is influenced by various factors such as tumor type， staging， complications， treatment， and prognosis. This complexity makes the prevention and management of CAT more difficult and challenging. This article reviews the classification of commonly used anticoagulant drugs in clinical practice， emphasizing the current status and advancements in their application for the prevention and treatment of cancer-related venous thromboembolism in order to provide valuable reference for clinical medication.