IgA nephropathy （IgAN） is one of the most prevalent forms of primary glomerulonephritis globally and a leading cause of end?stage renal disease （ESRD）. The exact pathogenesis and progression mechanisms of IgAN remain unclear. Its clinical manifestations are diverse， with varying degrees of kidney involvement reflected in both clinical presentations and pathological changes. Consequently， responses to treatment and prognoses differ significantly among patients. Currently， renal needle biopsy serves as the gold standard for diagnosing IgAN； however， this invasive procedure is often not well?accepted by patients， limiting its widespread clinical application and complicating disease diagnosis. Therefore， non?invasive biomarkers are crucial for assisting in the diagnosis of IgAN and evaluating the risk of disease progression. Below， we will focus on various serum and urinary biomarkers associated with IgAN at both protein and nucleic acid levels.

Objective To investigate the expression pattern of IQGAP2 in renal cell carcinoma tissues and cell lines， and to analyze its effects on the proliferation and migration of renal cell carcinoma cells. Methods Firstly， GEO database was used to screen differentially expressed genes between renal cell carcinoma tissues， and GEPIA， TIMER2.0 were used to analyze the expression level of IQGAP2 in renal cell carcinoma tissue. Subsequently， knockdown （siRNA） and overexpression plasmids of IQGAP2 were constructed and transfected into ACHN and 786-O cell lines to perform a series of functional experiments to evaluate the effect of IQGAP2 on the malignant biological behavior of renal carcinoma cells. qRT-PCR and Western Blot were used to detect the expression of EMT （epithelial-mesenchymal transition） related proteins after knockdown and overexpression of IQGAP2. Results In renal cell carcinoma tissues， the relative expression of IQGAP2 was significantly lower than in adjacent normal tissues （P < 0.001）. Transfection of si-IQGAP2 in ACHN and 786-O cells effectively downregulated the mRNA and protein expression levels of IQGAP2 （P < 0.01）， while transfection with an overexpression plasmid significantly upregulated its mRNA and protein expression （P < 0.001）. Further studies revealed that overexpression of IQGAP2 significantly inhibited the proliferation （P < 0.05） and migration （P < 0.01） of ACHN and 786-O cells， whereas knockdown of IQGAP2 enhanced their proliferation （P < 0.05， P < 0.001） and migration （P < 0.01）. Through qRT-PCR and Western blot analyses of EMT-related proteins， it was found that reduced expression of IQGAP2 promoted the epithelial-mesenchymal transition （EMT） process in renal cancer cells. Conclusions The expression of IQGAP2 is low in renal cell carcinoma tissues and cells， and the decrease of the expression level can promote the EMT process of renal cell carcinoma cells， and then enhance the proliferation and migration of renal cell carcinoma cells. IQGAP2 plays an important tumor suppressor role in renal cell carcinoma.

Objective To investigate the effect and mechanism of miR-155-5p targeting suppressor of cytokine signaling 1 （SOCS1） in regulating the Janus kinase 2 （JAK2）/signal transducer and activator of transcription 3 （STAT3） signaling pathway in renal injury associated with lupus nephritis （LN）. Methods Thirty female MRL-faslpr lupus model mice were randomly divided into five groups （n = 6 per group）： the model group， the antagomir NC group， the miR-155-5p antagomir group， the miR-155-5p antagomir + shRNA control group， and the miR-155-5p antagomir + SOCS1 shRNA group. The mice were treated with adeno-associated virus vectors carrying miR-155-5p antagomir， antagomir NC， SOCS1 shRNA， or shRNA control. Additionally， six age-matched C57BL/6 mice served as a control group and received an equivalent volume of saline. Serum blood urea nitrogen （BUN） and creatinine （Scr） levels， renal histopathological changes， and the expression levels of miR-155-5p， SOCS1， phosphorylated JAK2 （p-JAK2）， and phosphorylated STAT3 （p-STAT3） in renal tissues were evaluated. Results Compared with the normal group， the model group exhibited significantly elevated levels of BUN， Scr， miR-155-5p， p-JAK2， and p-STAT3 proteins in the kidneys （P < 0.01）， while the expression level of SOCS1 was markedly reduced （P < 0.01）. Compared with both the model group and the antagomir NC group， the miR-155-5p antagomir group showed decreased levels of BUN， Scr， miR-155-5p， p-JAK2， and p-STAT3 proteins （P < 0.01）， along with a significant increase in SOCS1 expression （P < 0.01）. Similarly， compared with the miR-155-5p antagomir group and the miR-155-5p antagomir + shRNA control group， the miR-155-5p antagomir + SOCS1 shRNA group demonstrated significantly higher levels of BUN， Scr， miR-155-5p， p-JAK2， and p-STAT3 proteins （P < 0.01）， while SOCS1 expression was notably decreased （P < 0.01）. Renal pathology analysis revealed that， compared to the normal group， the model group exhibited glomerular atrophy， extensive infiltration of inflammatory cells in the renal tubulointerstitial region， and partial renal tubular necrosis. In contrast， the miR-155-5p antagomir group showed marked improvements in glomerular atrophy， tubular necrosis， and inflammatory cell infiltration compared with the model group and antagomir NC group. Furthermore， compared with the miR-155-5p antagomir group and the miR-155-5p antagomir + shRNA control group， the miR-155-5p antagomir + SOCS1 shRNA group exhibited more severe glomerular atrophy， tubular necrosis， and inflammatory cell infiltration. Conclusion MiR-155-5p exacerbates renal damage in MRL-faslpr lupus model mice by targeting SOCS1， potentially through the activation of the JAK2/STAT3 signaling pathway.

Objective To compare the safety and efficacy of various brachial plexus block techniques using local anesthesia （LA） in patients undergoing their first radiocephalic arteriovenous fistula （RCAVF） surgery. Methods Patients were randomly allocated into three groups： LA， interscalene brachial plexus block （ISBPB）， and axillary brachial plexus block （ABPB）. Ultrasound was utilized to evaluate the pre- and post-anesthesia changes in vessel diameter and blood flow. Postoperative follow-up assessments were performed at three days and three months to determine fistula patency. Results Immediate patency rates were 92.52% （LA）， 96.26% （ISBPB）， and 95.33% （ABPB）， with no statistically significant differences among the groups （χ2 = 1.615， P = 0.446）. However， at three months， primary patency rates differed significantly among the groups （χ2 = 22.691， P < 0.001）. Specifically， the ISBPB group （83.18%） exhibited significantly higher patency compared to the LA group （57.01%） （χ2 = 17.477， P < 0.001）. Similarly， the ABPB group （80.37%） demonstrated better patency than the LA group （χ2 = 13.580， P < 0.001）. Regarding respiratory complications， they were more prevalent in the ISBPB group （15.89%） compared to the LA group （2.80%） （χ2 = 9.761， P = 0.002） and the ABPB group （0.93%） （χ2 = 14.377， P < 0.001）. No significant difference was observed between the LA and ABPB groups in terms of respiratory complications （χ2 = 1.019， P = 0.313）. Conclusions Both ISBPB and ABPB demonstrated superior primary patency compared to LA. Nevertheless， ABPB exerted a lesser impact on respiratory function and provided a more comfortable surgical experience for ESRD patients.

Objective To investigate the role and molecular mechanisms of bladder cancer-derived exosomal long non-coding RNA （lncRNA） CIAT1 in mediating collective invasion and to evaluate its clinical significance and potential therapeutic value. Methods High-throughput sequencing was used to identify lncRNAs that are highly expressed in exosomes from bladder cancer and lymph node metastatic tissues. CIAT1 was selected for further validation in clinical bladder cancer samples. By constructing CIAT1-overexpressing and knockdown bladder cancer cells， we demonstrated in vitro that CIAT1-contained exosomes target cancer-associated fibroblasts （CAFs） to induce collective invasion. The underlying mechanism of CIAT1 in bladder cancer collective invasion was explored through RNA pull-down， RNA immunoprecipitation （RIP）， dual-luciferase reporter assays， chromatin isolation by RNA purification （ChIRP） and chromatin immunoprecipitation （ChIP）. Results CIAT1 was significantly upregulated in exosomes derived from bladder cancer tissues compared to adjacent normal tissues by High-throughput sequencing （fold change > 1.5， P < 0.05） and clinical sample validation （P < 0.01）. In vitro experiments， exosomal CIAT1 was selectively internalized by cancer-associated fibroblasts （CAFs）， significantly enhancing collective invasion of bladder cancer via regulating CAFs. In co-culture models， CIAT1 overexpression group showed increased total number and total length of collective invasion chains compared to the control group （P < 0.01 for both）. Mechanistically， CIAT1 was packaged into exosomes via binding to hnRNPA2B1， and internalized by CAFs， where it activated N-cadherin transcription by modulating H3K4me3 histone modification at the N-cadherin promoter. Consistently， the CIAT1 overexpression group exhibited elevated collective invasion chain numbers and lengths compared to the control group （P < 0.01 for both）. However， blocking N-cadherin reversed the pro-invasive effects of CIAT1， with no significant differences in chain numbers or lengths between the CIAT1 overexpression + N-cadherin blockade group and controls （P > 0.05 for both）. Further clinical correlation analysis confirmed that CIAT1-regulated N-cadherin is closely associated with collective invasion in bladder cancer patients （P < 0.01）. Conclusions Exosomal CIAT1 derived from bladder cancer cells targets CAFs to activate N-cadherin transcription， thereby promoting bladder cancer collective invasion.

Objective To investigate the mechanism of autophagy induced by House dust mites （HDM） on airway epithelial tight junction through β-catenin-Snail signaling pathway. Methods Human bronchial epithelial cells （16HBE） were stimulated with HDM at different time points （0， 3， 6， 12， 24， 48 h） and different concentrations （0， 40， 100， 200 μg/mL） to screen the appropriate stimulation concentration and stimulation time. 16HBE cells were treated with oxidative stress inhibitor N-acetylcysteine （NAC）， autophagy inhibitor 3-methyladenine （3-MA）， HDM， and their combinations. Cells were transfected with mCherry-EGFP-LC3B， Beclin-1-siRNA， and ATG14-siRNA lentivirus and then stimulated with NAC and HDM. Immunofluorescence was used to detect the expression levels of autophagy-related protein LC3B， tight junction-related proteins Occludin， and ZO-1 in airway epithelial cells. The level of reactive oxygen species （ROS） was detected by using DCFH-DA in each group. The protein expression levels of Occludin， ZO-1， LC3B， Beclin-1， ATG5， ATG14， P62， Snail， β-catenin and p-β-catenin were detected by Western blot method. Results Immunofluorescence results showed that compared with the control group， 200 μg/mL HDM stimulation induced cellular autophagy， increased the expression level of LC3B protein， and promoted the level of ROS， all with statistical significances（all P < 0.05）. Compared with the HDM group， the HDM + 3-MA， HDM + ATG14-si， and HDM + Beclin-1-si groupsall showed significantincreases in the expression levels of tight junction-related proteins Occludin and ZO-1 （P < 0.05）. The HDM + NAC group demonstrated significant decreases both in the level of ROS andin the expression level of LC3B protein.Western blot results revealed that compared with HDM， 3-MA and autophagy protein low-expression beads （Beclin-1-si， ATG14-si） attenuated HDM-induced cellular autophagy （P < 0.05）， inhibited HDM-induced upregulation of Snail and p-β- catenin expression， and improved HDM-induced decreases in Occludin and ZO-1（P < 0.05）. Moreover， compared with the HDM group， the NAC + HDM group exhibited significant decreases both in the conversion of LC3BⅠ to LC3BⅡ （P < 0.001） in the protein levels of Snail， p-β-catenin， Beclin-1 and ATG14 （P < 0.01）， but significant increases in the protein levels of Occludin and ZO-1 （P < 0.05）. Conclusion HDM affects the tight connections between airway epithelial cells by inducing autophagy， which may be attributed to the β-catenin-Snail signaling pathway.

Objective To investigate the protective effect of LncRNA MEG3 on the retina in early-stage diabetic rats through regulation of the COX-2/PGE2/VEGF signaling pathway. Methods 50 male SD rats of SPF grade were selected for the study. Among them， 10 rats were assigned to the control group， while 40 rats were used to establish diabetic retinopathy models. A total of 32 rats successfully underwent modeling and were subsequently divided into four groups （n = 8 per group）： model group， negative control group， MEG3 overexpression group， and MEG3 overexpression + COX-2 inhibitor group. Histopathological changes， vascular permeability， glucose and lipid metabolism， inflammatory factors， oxidative stress indices， PGE2 levels， as well as the relative mRNA and protein expression levels of COX-2 and VEGF were evaluated in each group. Results Compared with the control group， HDL-C， CAT， GSH-PX， and SOD levels were significantly decreased， whereas the mRNA and protein expression levels of vascular permeability， TG， TC， LDL-C， IL-6， IL-1β， TNF-α， MDA， PGE2， COX-2， and VEGF were significantly increased in the model group （P < 0.05）. Compared with the negative control group， HDL-C， CAT， GSH-PX， and SOD levels were significantly increased in the MEG3 overexpression group， while the mRNA and protein expression levels of vascular permeability， TG， TC， LDL-C， IL-6， IL-1β， TNF-α， MDA， PGE2， COX-2， and VEGF were significantly decreased （P < 0.05）. Compared with the MEG3 overexpression group， HDL-C， CAT， GSH-PX， and SOD levels were further increased in the MEG3 overexpression + COX-2 inhibitor group， and the mRNA and protein expression levels of vascular permeability， TG， TC， LDL-C， IL-6， IL-1β， TNF-α， MDA， PGE2， COX-2， and VEGF were further decreased （P < 0.05）. Conclusion LncRNA MEG3 is capable of regulating the COX-2/PGE2/VEGF pathway， enhancing glucose and lipid metabolism in rats， suppressing the expression of inflammatory factors， attenuating stress responses， and alleviating diabetic retinopathy.

Objective To investigate the effect of tissue-resident memory T cells （TRM） on imiquimod-induced psoriatic-like skin lesions in mice， and to elucidate the underlying mechanisms of TRM involvement in this process. Methods Forty female BALB/c mice were procured and randomly allocated into four groups： ten in the blank control group， and thirty for the establishment of a psoriasis mouse model. Following successful modeling， the thirty mice were further randomized into three groups： the model control group， the methotrexate-treated group， and the imiquimod-treated group， with ten mice in each group. Mice in the blank control group and model control group were uniformly treated with Vaseline for intervention. The methotrexate group and the imiquimod group were treated with 62.5mg of 5% imiquimod cream. The methotrexate group was administered by gavage at a dose of 1 mg/kg， and the gavage volume of each group was 10 mL/kg.The model control group， blank group and imiquimod group were gavaged with the same volume of normal saline. Treatment was conducted over six consecutive days. Subsequently， comparisons were made across groups regarding the psoriasis area and severity index （PASI）， histopathological findings， inflammatory cytokine levels， and T_RM cell levels. Results （1） The imiquimod group exhibited significantly lower scores for erythema （2.54 ± 0.32）， skin thickening （2.59 ± 0.25）， and scaling （2.52 ± 0.29） compared to the methotrexate group， model control group， and blank control group （P < 0.05）. Additionally， the methotrexate group demonstrated reduced scores for erythema， skin thickening， and scaling compared to the model control group （P < 0.05）. （2）Hematoxylin-eosin （HE） staining revealed that the epidermis in the methotrexate group became thinner， with fewer parakeratotic cells and increased hair follicles. Conversely， the imiquimod group displayed abnormal cell morphology and relatively thicker white skin after modeling. （3） The imiquimod group showed significantly lower levels of TNF-α （51.63 ± 4.39 pg/mL）， IL-1β （35.53 ± 4.15 pg/mL）， IFN-γ （23.43 ± 3.41 pg/mL）， and IL-23 （15.24 ± 2.95 pg/mL） compared to the methotrexate and model control groups （P < 0.05）. Similarly， the methotrexate group exhibited reduced levels of TNF-α， IL-1β， IFN-γ， and IL-23 compared to the model control group （P < 0.05）. （4） The imiquimod group had significantly lower levels of CD8⁺CD103⁺ cells （15.39 ± 2.31） than the methotrexate and model control groups （P < 0.05）. Furthermore， the methotrexate group demonstrated lower levels of CD8⁺CD103⁺ cells compared to the model control group （P < 0.05）. Conclusion Miquimod induces heavier skin lesions， faster response， and more epidermal thickening in psoriasis like mice. CD8⁺ CD103⁺ T_RM cells and inflammatory factors may be involved in the recurrence of psoriasis.

Objective To evaluate the clinical efficacy of high-flow nasal cannula oxygen therapy （HFNC） versus non-invasive positive pressure ventilation （NPPV） in elderly patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD） accompanied by mild to moderate hypercapnia. Methods The study included 92 AECOPD patients with hypercapnia treated at the second medical center of Chinese PLA General Hospital from August 2021， to October 2023， with 49 in the NPPV group and 43 in the HFNC group. The two groups were compared in terms of 28-day intubation rate， 90-day mortality， and arterial blood gases. Results The NPPV group showed a significantly higher 28-day intubation rate compared to the HFNC group （28.57% vs. 11.63%， P < 0.05）， but no significant differences in the 90-day mortality rate （36.73% vs. 23.26%， P > 0.05）. The Kaplan-Meier curve indicated that the HFNC group had a significantly lower 28-day intubation rate compared to the NPPV group （Log-Rank test： χ² = 4.257， P = 0.039）， but no significant difference in 90-day mortality rate （Log-Rank test： χ² = 2.596， P = 0.107）. A Cox proportional hazards model， which incorporated APACHE II score and baseline PaCO₂， demonstrated that the risk of 28-day intubation in the HFNC group was reduced by 69% as compared to the NPPV group （HR = 0.31， 95%CI：0.10 ~ 0.93， P = 0.037）， but the risk of 90-day mortality did not show a significant decrease （HR = 0.61， 95%CI：0.27 ~ 1.37， P = 0.232）. PaCO₂ in both groups decreased gradually and pH increased simultaneously. PaCO₂， pH， and PaO₂ at 2h and 48h against the baseline values did not differ significantly between the two groups （P > 0.05）. Conclusion In elderly AECOPD patients with mild-to-moderate hypercapnia， HFNC reduces intubation rates compared to NPPV， without increasing mortality， and shows similar improvements in arterial blood gas indicators， making it a suitable respiratory support option.

Objective To investigate the therapeutic effect of repeated transcranial magnetic stimulation （rTMS） combined with hydrogel feeding training on patients with dysphagia following subacute cerebral infarction， as well as its impact on swallowing function. Methods From February 2022 to February 2024， 102 patients with dysphagia after subacute cerebral infarction treated in our hospital were selected and divided into control group， sham stimulation group and observation group， with 34 cases in each group. The control group received hydrogel feeding training， the sham stimulation group received sham stimulation on the basis of the control group， and the observation group received repeated transcranial magnetic stimulation on the basis of the control group. The swallowing function， quality of life， nerve function， neurotrophic factor， nutritional status， respiratory function， cerebral blood flow signal and clinical efficacy of the two groups were measured and compared. Results Compared with pre-treatment， the leak-aspiration score scale （PAS）， NIHSS score， and pulse index （PI） were significantly reduced in all groups after treatment. Moreover， the observation group exhibited lower values than both the control group and the pseudostimulation group （P < 0.05）. In contrast， functional oral intake scale （FOIS）， dysphagia-specific quality of life （SWAL-QOL） score， brain-derived neurotrophic factor （BDNF）， nerve growth factor （NGF）， insulin-like growth factor 1 （IGF-1）， hemoglobin （Hb）， albumin （ALB）， forced vital capacity （FVC）， one-second forced expiratory volume （FEV1）， peak expiratory flow （PEF）， peak systolic velocity （PSV）， end-diastolic velocity （EDV）， and mean velocity （MV） were significantly increased after treatment compared to pre-treatment. The observation group demonstrated higher values for these parameters compared to the control group and pseudostimulation group （P < 0.05）. Additionally， the clinical efficacy in the observation group was significantly higher （P < 0.05）. Conclusion The combination of repeated transcranial magnetic stimulation and hydrogel feeding training for patients with dysphagia following subacute cerebral infarction can effectively enhance swallowing function， mitigate nerve damage， and improve both nutritional status and quality of life.

Objective To evaluate the effect of optical body surface monitoring system （OSMS） in setup of intensity modulated radiotherapy （IMRT） for thoracic tumorsand to analyze its relationship with BMI. Methods Thesetup errors of CBCT and location CT with body membrane and the registration errors of OSMS and first body surface reference image without body membrane were obtained in 49 patients with thoracic tumor who received routine intensity modulated radiotherapy. The paired t-test was used to analyze the difference of registration errors between the two image guidance methods. Pearson′s correlation analysis was used to analyze the correlation between CBCT errors and OSMS errors， and Bland-Altman analysis was employed to evaluatethe agreement of the two errors. The correlation and consistency of the two registration errors in patients with different BMI index were analyzed. PTV external marginsby the two registration methods were calculated using Van Herk formula. Results The OSMS and CBCT groups demonstrated significant differences in setup errors in the ventrodorsal direction （P < 0.05）， while no significant differences were found in the left-right， head-foot translation directions， or RTN rotation directions （P > 0.05）. Although the two methods showed a significant correlation in setup errors （P < 0.05）， this correlation was only moderate in the head-foot and left-right directions （r = 0.500， 0.408）， weak in the RTN rotation direction （r = 0.339）， and very weak in the ventrodorsal direction （r = 0.152）. The limits of agreement （LOA， 95% CI） between the two methods were ［-0.45， 0.45］ cm in the left-right direction， ［-0.59， 0.57］ cm in the head-foot direction， and ［-0.48， 0.40］ cm in the ventrodorsal direction， with （-2.08° ~ 2.19°） in the RTN rotation direction.Different BMI levels influenced the results of the two registration methods， particularly in patients with a BMI of 18.5 ~ 23.9 kg/m2. In this group， OSMS and CBCT exhibited a strong correlation in the head-foot direction （r = 0.731）， a moderate correlation in the left-right direction （r = 0.512）， and weak correlations in the ventrodorsal and RTN rotation directions （r = 0.345， 0.267）. The absolute difference in setup errors between the two imaging systems was 0.4 ~ 0.5 cm/2°. Using CBCT and OSMS image guidance， the margins in the left-right， head-foot， and ventrodorsal directions were ［0.5 cm， 0.7 cm， 0.3 cm］ for CBCT， and ［0.5 cm， 0.7 cm， 0.5 cm］ for OSMS. Conclusion In chest tumor patients with a BMI of 18.5 ~ 23.9 kg/m2， OSMS and CBCT image guidance methods show good correlation in the head-foot and left-right directions， but their limits of agreement exceed the clinically acceptable range. OSMS cannot yet replace CBCT for image guidance in chest tumor intensity-modulated radiotherapy. Further improvements to tumor motion surrogates are necessary to enhance the accuracy of OSMS image guidance.

Objective To investigate the clinical efficacy of lingual frenectomy combined with Twin-block orthodontic appliances in patients with mandibular retraction during the growth spurt. Methods Forty-two patients with osseous ClassⅡ malocclusion， characterized by mandibular retraction and short lingual frenulum， who were admitted to our hospital between August 2023 and August 2024， were randomly divided into a control group and an observation group， each consisting of 21 patients. The control group was treated with Twin-block orthodontic appliances alone， while the observation group received treatment combining lingual frenuloplasty with Twin-block orthodontic appliances. Pre- and post-treatment comparisons were made between the two groups regarding treatment duration， Simplified Hazelbaker Assessment Tool for Lingual Frenulum Function （HATLFF） scores， and lingual frenulum length measurements. Oral cone-beam computed tomography （CBCT） was performed in both groups before and after treatment， and three-dimensional reconstruction and cephalometric analyses were utilized to evaluate indicators related to the tongue and hyoid bone， upper airway， maxilla and mandible， and temporomandibular joint. Results The corrective time in the control group （10.14 ± 1.06 months） was significantly longer than that in the observation group （8.00 ± 1.41 months） （P < 0.05）. Before treatment， there were no statistically significant differences between the control and observation groups in terms of simplified HATLFF scores， tongue tie lengths， or indicators related to the tongue and hyoid bone， upper airway， maxillomandibular complex， and temporomandibular joints （P > 0.05）. After treatment， the simplified HATLFF scores and tongue tie lengths in the observation group were significantly higher than pre-treatment values （P < 0.05）. Additionally， IP-CP， IP-RP， ANB， U1-SN， U1-NA angle， and U1-NA distance were significantly reduced in both the control and observation groups compared to pre-treatment levels （P < 0.05）. Conversely， T-S， H-NP， H-CVP， H-Or， H-PP， H-MP， H-FH， H-PNS， total upper airway volume， palatopharyngeal volume， lingual pharyngeal volume， CL-CR， ML-MR， SNB， GoGn-SN， Go-Gn， Co-Gn， Co-Go， Ar-Go， L1-NB angle， L1-NB distance， L1-MP angle， L1-MP distance， SL， SE， Z， UI-PP， L6-MP， articular fossa width， condylar apical sagittal area， condylar height， and condylar apical coronal area were significantly increased post-treatment compared to pre-treatment levels （P < 0.05）. Notably， after treatment， the ANB difference in the observation group was significantly lower than that in the control group （P < 0.05）， while the differences in simplified HATLFF scores， tongue tie length， T-S， H-Or， H-PP， H-FH， total upper airway volume， palatopharyngeal volume， lingual pharyngeal volume， CL-CR， ML-MR， Go-Gn， Ar-Go， L1-NB angle， L1-NB distance， SL， SE， and L6-MP were significantly greater in the observation group compared to the control group （P < 0.05）. Conclusion Lingual tie-plasty combined with the Twin-block appliance demonstrates superior efficacy compared to the single Twin-block appliance in terms of treatment duration and clinical outcomes for patients exhibiting mandibular retraction during the growth spurt..

Objective Compare the efficacy and safety of Transcatheter Aortic Valve Replacement （ViV TAVR） versus Secondary Surgical Aortic Valve Replacement （redo SAVR） in patients with structural valve deterioration. Methods A retrospective analysis of clinical data was performed on 61 patients with valve failure who underwent ViV TAVR or redo SAVR treatment at the hospital between January 2020 and June 2022. Based on the differing treatment modalities， the patients were categorized into two groups： the ViV TAVR group （n = 31） and the redo SAVR group （n = 30）. The study compared perioperative-related indicators （surgical time， hospital stay duration， mechanical ventilation time， and intensive care unit observation period）， echocardiographic parameters at four time points： preoperatively （T₁）， 1 month postoperatively （T₂）， 3 months postoperatively （T₃）， and 6 months postoperatively （T₄）， as well as primary and secondary endpoint events. Results The ViV-TAVR group had shorter operation time and hospital stay， and less extracorporeal circulation assistance compared to the redo-SAVR group， with statistically significant differences （P < 0.05）. Intra-group comparisons showed that at 1 month （T2）， 3 months （T₃）， and 6 months （T₄） after surgery， the left ventricular ejection fraction （LVEF）， aortic valve peak flow velocity （AVmax）， peak transvalvular pressure gradient （PGmax）， and PGmean in both groups were lower than those at the preoperative （T₁） time point. At T₃ and T₄， the left ventricular end-diastolic diameter （LVEDD） in both groups was lower than that at T₁ and T₂， with statistically significant differences （P < 0.05）. The mortality rate within 30 days in the ViV-TAVR group was lower than that in the redo-SAVR group， with a statistically significant difference （P < 0.05）. However， there was no statistically significant difference in all-cause mortality within 24 months between the two groups （P > 0.05）. The incidence of acute renal failure in the ViV-TAVR group was lower than that in the redo-SAVR group， with a statistically significant difference （P < 0.05）. Conclusion Compared with redo SAVR， ViV TAVR not only significantly decreases the 30-day mortality risk and the incidence of acute renal failure in patients with bioprosthetic valve dysfunction but also demonstrates comparable long-term mortality rates to redo SAVR.

Objective To investigate the clinical efficacy of intracardiac echocardiography （ICE） guidance in transcatheter closure of latent patent foramen ovale（PFO） among divers. Methods From Jan 2023 to Nov 2024， 36 young divers with PFO， who only had right-to-left shunt during Valsalva maneuver on right heart contrast echocardiography， were enrolled from No. 971 Hospital of the PLA Navy. They were divided into ICE group and transthoracic echocardiography （TTE） group based on intraoperative imaging. Clinical data including baseline characteristics， echocardiographic findings， complications， procedure time， and radiation dose were recorded. Results All 36 patients （19 in TTE group and 17 in ICE group） had 100% immediate closure success rate. No vascular complications， postoperative pericardial effusion， device displacement or embolism occurred. ICE could guide wire passage through foramen ovale， significantly reducing total procedure time， fluoroscopy time， and radiation dose （P < 0.05）. Conclusion ICE enables precise closure of potent PFO in divers and decreases fluoroscopy time and radiation dose， showing significant clinical value.

Objective To investigate the effect of intravenous lidocaine on postoperative fatigue syndrome （POFS） in patients undergoing laparoscopic resection for gastric carcinoma. Methods A total of 80 patients who underwent elective laparoscopic resection for gastric carcinoma at Xuzhou Central Hospital between September 2023 and June 2024 were enrolled. Inclusion criteria included age 18 ~ 75 years， ASA physical status classification Ⅰ~Ⅲ， body mass index （BMI） of 18.5 ~ 27.9 kg/m2， preoperative Christensen score ≤4， and estimated operation time ≤ 4 hours. Patients were randomly allocated into either the lidocaine group （Group L） or the saline group （Group C） using a random number table， with 40 patients in each group. Group L received an intravenous infusion of lidocaine at a dose of 1.5 mg·kg?1 over 15 minutes， initiated 30 minutes before anesthesia induction. If no adverse reactions occurred， lidocaine was maintained at a rate of 1.5 mg/（kg·h） throughout the surgery until its conclusion. Group C received an equivalent volume of normal saline administered in the same manner. The Christensen score and Visual Analogue Scale （VAS） scores were recorded on postoperative days 1， 3， 5， and 7， and the time-weighted average （TWA） of the Christensen score was calculated. Postoperative inflammatory markers were measured， and additional outcomes including extubation time， post-anesthesia care unit （PACU） stay duration， postoperative nausea and vomiting （PONV）， consumption of rescue analgesics， time to first flatus and defecation， and length of hospital stay were also documented. Results Compared with Group C， the TWA of the Christensen score in Group L decreased by 0.44 points （95% CI： 0.11 ~ 0.76； P < 0.05）. The VAS scores were significantly lower in Group L on postoperative days 1 and 3 （P < 0.05）. Levels of IL-6 and TNF-α at the end of surgery and 24 hours after surgery were also lower in Group L （P < 0.05）. The time to first flatus and defecation was significantly shorter in Group L （P < 0.05）. There were no significant differences between the two groups regarding extubation time， PACU stay duration， incidence of PONV， postoperative consumption of remedial analgesic drugs， or length of hospital stay （P > 0.05）. Conclusion Intravenous lidocaine may improve POFS in patients following laparoscopic resection for gastric carcinoma by attenuating inflammatory responses， alleviating pain， and facilitating gastrointestinal function recovery， while maintaining a favorable safety profile.

Objective To evaluate the clinical efficacy and safety of vericiguat combined with the new “Quadruple Therapy” for treating heart failure with reduced ejection fraction（HFrEF） and to explore its impact on left ventricular reverse remodeling（LVRR） in patients with different baseline characteristics. Methods A total of 87 patients with chronic heart failure treated with vericiguat at the Department of Cardiology， Nanjing Drum Tower Hospital from June 2022 to March 2024， were consecutively enrolled as the observation group. These patients were matched at 1∶1 by age， sex， and left ventricular ejection fraction（LVEF） with 87 patients who received the standard quadruple therapy without vericiguat as the control group. Propensity score matching was used to further balance confounding factors， resulting in 64 patients in each group for final analysis. Changes in echocardiographic parameters， liver and kidney function， electrolyte levels， and blood pressure were analyzed at baseline and during the 6-month follow-up to assess the efficacy and safety of vericiguat. The primary efficacy endpoint was the occurrence of LVRR. Subgroup analyses were conducted based on baseline characteristics such as age and sex. Interaction analysis was utilized to evaluate the heterogeneity of vericiguat's efficacy. Results After 6 months of treatment， the vericiguat group showed significant improvements in cardiac structure and function compared to the control group. The left ventricular end-diastolic diameter was significantly reduced ［-0.43（-1.00，-0.10） mm vs.-0.22（-0.53，0.02） mm， P = 0.002］， and the LVEF was significantly increased ［8.45%（1.40%，16.50%） vs. 2.75%（0，11.00%）， P = 0.002］. The percentage of patients in the vericiguat group who achieved LVRR was significantly larger than in the control group（46.4% vs. 27.4%， P = 0.011）. Multivariate logistic regression revealed that the combination of vericiguat was an independent predictor of LVRR（Model 2： OR = 2.54， 95% CI： 1.29 ~ 5.01， P = 0.007）. The reverse remodeling effect remained consistent across different subgroups and was not significantly influenced by specific baseline characteristics（P_interaction > 0.05）. Vericiguat did not affect blood pressure， liver and kidney function， or electrolyte levels， achieving satisfactory safety， despite its significantly higher incidence of gastrointestinal reactions（16.1% vs. 5.7%， P < 0.001）. Conclusion The addition of vericiguat to the quadruple therapy significantly improves cardiac function and promotes left ventricular reverse remodeling in HFrEF patients while maintaining a favorable safety profile.

Objective To investigate the efficacy of extracorporeal shock wave therapy （ESWT） combined with ultrasound-guided corticosteroid injection （CSI） for the treatment of primary frozen shoulder （PFS）. Methods Ninety-nine patients with PFS who visited the pain department of the Affiliated Hospital of Xuzhou Medical University between April 2024 and July 2024 were enrolled and randomly divided into three groups according to the randomized number table method： ESWT group （T group）， CSI group （I group）， and combined treatment group （TI group）， with 33 patients in each group. Visual analogue scale （VAS） scores， shoulder range of motion （SROM）， and Constant-Murley shoulder scores （CMS） were recorded before treatment and at 1， 4， 8， and 12 weeks post-treatment. Additionally， the patients' Ascens Insomnia Scale （AIS） scores were recorded before treatment and 1 month after treatment. The occurrence of adverse effects and the use of remedial medications during the treatment period were also documented. Results Compared with pre-treatment， VAS scores decreased， and SROM and CM scores improved at all time points after treatment in all three groups （P < 0.05）. AIS scores also decreased in all three groups at 1 month post-treatment （all P < 0.05）. Intergroup comparisons revealed that the TI group exhibited significantly lower VAS pain scores， greater SROM （forward flexion and backward extension）， and higher CM scores at 4， 8， and 12 weeks post-treatment compared to the T and I groups （Bonferroni-corrected P < 0.05）. No statistically significant differences were observed between the T and I groups for these measures （Bonferroni-corrected P > 0.05）. Additionally， there were no statistically significant differences in AIS scores or adverse effects occurrence among the three groups at 1 month post-treatment （P > 0.05）. Conclusion The combined treatment demonstrated greater efficacy compared to trigger point extracorporeal shock wave therapy alone and periapical steroid injection alone， resulting in significant improvement in the patient's clinical symptoms and quality of life.

Objective To investigate the effects of Semaglutide injection on glycolipid metabolism and adipokine levels in the treatment of type 2 diabetes mellitus （T2DM） patients with varying body mass index （BMI）. Methods A total of 143 patients with T2DM admitted to our hospital between May 2022 and May 2024 were enrolled in this study. Based on their BMI， the patients were categorized into three groups： the normal-weight group （31 cases， 18.5 kg/m² ≤ BMI < 24 kg/m²）， the super-recombinant group （49 cases， 24 kg/m² ≤ BMI < 28 kg/m²）， and the obese group （63 cases， 28 kg/m² ≤ BMI）. 28 kg/m² ≤ BMI）. All participants received standard guideline-based conventional treatment and were additionally administered semaglutide injections for a duration of 12 weeks. The study compared glucose metabolism， islet β-cell function， lipid metabolism， body composition， adipokine levels before treatment and at 12 weeks post-treatment， as well as safety profiles during the treatment period across the three groups. Results After 12 weeks of treatment， the levels of fasting blood glucose （FPG）， 2-hour postprandial blood glucose （2 h PG）， glycated hemoglobin （HbA1c）， insulin resistance index （HOMA-IR）， serum triglycerides （TG）， total cholesterol （TC）， and low-density lipoprotein cholesterol （LDL-C） decreased in all three groups. Specifically， the reductions were more pronounced in the obesity group compared to the normal group and the super-reorganization group， and the super-reorganization group showed intermediate reductions between the obesity and normal groups （P < 0.05）. Conversely， fasting C-peptide （FCP）， 2-hour postprandial C-peptide （2 h CP）， irisin， adipsin， and omentin-1 levels increased in all three groups after treatment， with the greatest increases observed in the obesity group， followed by the super-reorganization group， both of which were significantly higher than the normal group （P < 0.05）. Additionally， high-density lipoprotein cholesterol （HDL-C） levels increased in all three groups after 12 weeks of treatment （P < 0.05）. BaselineBMI and total body fat mass （WBFM） were significantly higher in the obesity group compared to the super-reorganization group， which in turn were higher than the normal group （P < 0.05）. After treatment， BMI and WBFM decreased in both the obesity and super-reorganization groups， but remained significantly higher than in the normal group （P < 0.05）. The incidence of adverse reactions during treatment was 12.90% （4/31）， 10.20% （5/49）， and 11.11% （7/63） in the normal， super-reorganization， and obesity groups， respectively， with no statistically significant differences among the groups （P > 0.05）. Conclusion Smiglutide injection can improve glucose and lipid metabolism， islet function， and adipokine levels in T2DM patients across different BMI categories， while also regulating body composition. It demonstrates a particularly strong improvement effect on glucose and lipid metabolism， islet function， and adipokine levels in overweight and obese T2DM patients. Additionally， smiglutide does not increase safety risks.

Objective To investigate the predictive value of serum low-density lipoprotein cholesterol（LDL-C） and high-sensitive C-reactive protein（hs-CRP） in combination with carotid ultrasound parameters for assessing the risk of coronary heart disease（CHD）in patients with suspected cases. Methods A total of 260 patients who underwent coronary angiography（CAG） in the Department of Cardiology at Wujin Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from August 2022 to August 2024 due to suspected CHD were enrolled in this study. Based on CAG results， patients were categorized into a non-CHD group（n = 110） and a CHD group（n = 150）. General clinical characteristics， serum LDL-C， hs-CRP levels， and carotid ultrasound arameters-including carotid intima-media thickness （CIMT） and Crouse score of carotid artery plaque-were compared between the two groups. Spearman correlation analysis and multivariate logistic regression analysis were conducted to evaluate the associations among these parameters. The predictive value of individual and combined markers for suspected CHD was assessed by using receiver operating characteristic（ROC） curve analysis. Results （1）The coronary heart disease（CHD） group had higher age， smoking，fasting plasma glucose（FPG）， and blood pressure compared to the non-CHD group（P > 0.05）. No significant difference was observed in the gender ratio， alcohol consumption rates， and body mass index（BMI）， between the two groups（P > 0.05）. （2） Total cholesterol（TC）， LDL-C， hs-CRP levels， and carotid ultrasound parameters were significantly higher in the CHD group than those in the non-CHD group （P < 0.05）. （3） Spearman correlation analysis and multivariate logistic regression analysis revealed that serum LDL-C，hs-CRP，and carotid ultrasound parameters were significantly correlated with coronary heart disease（P < 0.05）. （4） ROC curve analysis demonstrated that the combined assessment of serum LDL-C， hs-CRP， and carotid ultrasound parameters achieved the highest area under the curve （AUC）， sensitivity， and specificity， with statistically significant differences compared to individual markers（P < 0.05）. Conclusions Serum LDL-C，hs-CRP，and carotid ultrasound parameters individually have predictive value for coronary heart disease， while their combined assessment offers superior predictive accuracy. The enhanced diagnostic performance of the combined valuation provides valuable guidance for the diagnosis and management of patients with suspected coronary heart disease.

Objective To investigate the expression levels and clinical significance of B7 homolog 3（B7-H3）， peroxiredoxin 1 （PRDX1）， and thioredoxin （TRX） in the serum and tissues of patients with ulcerative colitis （UC） and UC-associated colorectal cancer （UC-CRC）. Methods A total of 108 patients with UC who underwent examination in our hospital between January 2019 and December 2023 were enrolled in the UC group. Additionally， 108 patients with UC-CRC who were examined in our hospital were included in the UC-CRC group. Furthermore， 108 individuals without any abnormalities detected during colonoscopy were recruited as the control group. The serum levels of B7-H3， PRDX1， and TRX were quantified using enzyme-linked immunosorbent assay （ELISA）. The expression of B7-H3， PRDX1， and TRX in tissues from UC-CRC and UC patients was assessed by immunohistochemistry. The diagnostic performance of serum B7-H3， PRDX1， and TRX levels for UC-CRC was evaluated by constructing receiver operating characteristic （ROC） curves. Results Compared with the control group， the serum expression levels of B7-H3， PRDX1， and TRX in both the UC group and the UC-CRC group were significantly elevated in sequence （P < 0.05）. In comparison to the resting UC group， the serum expression levels of B7-H3， PRDX1， and TRX in the episodic UC group also increased significantly （P < 0.05）. Furthermore， compared with UC patients， the positive expression rates of B7-H3， PRDX1， and TRX in the tissues of UC-CRC patients were markedly higher （P < 0.05）. The combination of serum B7-H3， PRDX1， and TRX demonstrated the highest AUC for diagnosing UC-CRC patients， outperforming the individual diagnostic performance of each biomarker （Z_{combination-B7-H3} = 2.829， P = 0.005， Z_{combination-PRDX1} = 2.544， P = 0.011， Z_{combination-TRX} = 3.673， P < 0.001）. Conclusion B7-H3， PRDX1， and TRX are significantly overexpressed in both the serum and tissues of UC-CRC patients， and their combined evaluation holds potential as a diagnostic tool for detecting the development of UC-CRC.

Alzheimer's disease （AD）， a neurodegenerative disorder， manifests pathological changes in the brain even during the asymptomatic stage. As the pathological burden intensifies， patients experience functional decline in multiple cognitive domains， including memory， language， spatial perception， executive function， and calculation， and may also exhibit emotional abnormalities. Once AD progresses， treatment becomes extremely challenging. Therefore， early diagnosis and accurate prediction of disease conversion are core tasks in the prevention and treatment of AD， and they are also urgent scientific research challenges to be overcome. Deep learning （DL） models demonstrate considerable advantages in the diagnosis， prediction， classification， and feature extraction of AD， offering new hope for solving this challenging problem. This research commences with a concise introduction to the outcomes of AD and the fundamental knowledge of deep learning. Subsequently， it offers an overview of the imaging studies on the utilization of deep learning for predicting disease transformation from two perspectives. Firstly， it systematically summarizes the existing DL models that have demonstrated innovation in the classification and prediction performance of AD. Secondly， it provides a comprehensive outline of the DL fusion models applied to the diagnosis， classification， and prediction of AD. Finally， this paper expounds upon the impending challenges in the research of this domain. This article demonstrates that deep learning models is cutting-edge trends in the exploration of AD research.

Scarring is a key issue in plastic surgery research and there are limitations in the clinical outcomes of existing scar treatments. Autologous fat grafting is a new method that has been clinically proven to be effective in the treatment of pathological scarring. Autologous fat grafts contain adipose-derived mesenchymal stem cells and a variety of active factors that can effectively improve the appearance， texture and local symptoms of keloid scars through the mechanisms of immunomodulation of the inflammatory response， pro-angiogenesis， pro-cellular differentiation， extracellular matrix remodelling and resistance to oxidative stress damage， etc. It has the advantages of fewer complications and better therapeutic effect， and is a brand new field of keloid scar， which provides a new therapeutic direction for the keloid scar. The new field of scar treatment provides a new direction for scar treatment. The application and mechanism of autologous fat grafting in keloid scar is now reviewed， with the aim of providing a theoretical basis for the treatment of keloid scar and summarising the progress of its application in keloid scar treatment.