最新刊期
卷 51 ， 期 6 ， 2026
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摘要：Acute abdomen is common critical and severe condition encountered in the emergency department. Owing to its complex etiologies, abrupt onset, rapid progression, and high risk of misdiagnosis and missed diagnosis, standardized evaluation and timely management remain major focuses and difficulties in clinical practice. This expert consensus was jointly developed by the Chinese Medical Doctor Association Emergency Medical Branch, Chinese PLA Emergency Medicine Professional Committee, Beijing Emergency Medicine Society, Emergency Surgery Alliance, Emergency Physicians Branch of Hubei Medical Doctor Association. Focusing on key clinical issues in the diagnosis and treatment of acute abdomen in adults, a systematic literature search was conducted based on the "6S" evidence model, with the search period extending from database inception to October 13, 2025. The quality of evidence and strength of recommendations were graded using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. This consensus covers epidemiological characteristics, early recognition and risk stratification, laboratory and imaging evaluation, initial resuscitation and analgesia, anti-infective therapy, selection of surgical timing and methods, as well as diagnosis and treatment strategies for special populations including elderly patients, immunocompromised patients, and tumor patients. It emphasizes the important role of multidisciplinary collaboration in optimizing the diagnosis and treatment process, improving therapeutic efficiency and patient prognosis, and aim to provide emergency physicians with evidence-based, practical, and standardized clinical guidance.关键词：acute abdomen;adult;diagnosis;treatment;multidisciplinary team;expert consensus1745|0|0更新时间：2026-07-15
Guideline and Consensus
- 摘要：Inflammatory vitreoretinal disease (IVRD) is a group of blinding disorders with significant heterogeneity, which is based on the common pathological basis of immune-inflammatory injury in the posterior segment. Its clinical spectrum includes infectious and noninfectious uveitis, as well as some retina/choroid disorders driven by inflammation. In recent years, the diagnosis and treatment model of IVRD has been shifting from empirical inflammation control to mechanism-based precision management. On the diagnostic side, methods such as polymerase chain reaction, metagenomic sequencing, cytokine profiling, and immunogenetic markers have significantly improved the ability of etiologic identification and immune phenotyping. On the therapeutic side, sustained-release corticosteroids, suprachoroidal drug delivery, anti-tumor necrosis factor α (anti-TNF-α), anti-interleukin 6 receptor (anti-IL-6R) biologics, and Janus kinase (JAK) inhibitors have improved the control rate of refractory disease, while exosomes, nanocarriers, and gene-editing delivery systems are promoting the development of posterior segment therapy toward long-acting, minimally invasive, and targeted directions. The main bottlenecks at this stage are the lack of unified disease naming and stratification, insufficient clinical translation of biomarkers, and most innovative therapies remaining in the early research stage. This review aims to systematically summarize the latest advances in the diagnosis and treatment of IVRD, focusing on the application progress of molecular diagnosis, immune marker testing, and emerging therapeutic technologies. Meanwhile, it addresses the main challenges in the current treatment of IVRD, such as the lack of unified disease classification and insufficient clinical translation of biomarkers, and proposes that the future direction of precision medicine should focus on constructing evidence-based pathways around "precise stratification-targeted drug delivery-long-term safety evaluation" to improve visual function outcomes and reduce the risks of recurrence and blindness.关键词：inflammatory vitreoretinal disease;immune markers;targeted therapy;biological agents1604|0|0更新时间：2026-07-15
Expert Review
- 摘要：ObjectiveTo investigate the association between life's essential 8 (LE8) score and cognitive impairment in elderly patients with H-type hypertension, as well as the correlation and interactive role of high-sensitivity C-reactive protein (hs-CRP).MethodsClinical data of 512 elderly patients with H-type hypertension admitted to the Second Medical Center of Chinese PLA General Hospital in Beijing from June 2020 to June 2025 were retrospectively analyzed. Patients were divided into cognitive impairment group (n=225) and control group (n=287) according to their cognitive status. Baseline characteristics were compared between the two groups. Multivariate logistic regression was performed to identify independent risk factors for cognitive impairment. Patients were further stratified by hs-CRP levels, and weighted stepwise logistic regression was applied to analyze the association between LE8 score and cognitive impairment across different strata.ResultsRisk factors for cognitive impairment in elderly patients with H-type hypertension included age increases (OR=1.087, 95%CI 1.006-1.172), comorbid hyperlipidemia (OR=1.739, 95%CI 1.125-3.994), low LE8 score (OR=0.864, 95%CI 0.621-0.953), and high hs-CRP (OR=1.215, 95%CI 1.052-1.403, P<0.05). Correlation analysis revealed a significant negative association between LE8 score and hs-CRP level (β=-0.148, 95%CI -0.209 to -0.087, P<0.001). After stratifying patients into low and high hs-CRP groups and adjusting for confounders, each 10-point increase in LE8 score was associated with a significant reduction in the risk of cognitive impairment in both groups (low hs-CRP group: OR=0.66, 95%CI 0.59-0.75; high hs-CRP group: OR=0.85, 95%CI 0.66-0.94, P<0.05). Moreover, the protective effect was 19% greater in low hs-CRP group than high hs-CRP group.ConclusionBoth LE8 score and hs-CRP are associated with cognitive impairment in elderly H-type hypertension patients. The inverse association between LE8 score and cognitive impairment is more pronounced in patients with lower hs-CRP levels.关键词：hypertension;homocysteine;cognitive impairment;life's essential 8 score;high-sensitivity C-reactive protein1368|0|0更新时间：2026-07-15
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Nomogram for overall survival in elderly patients with pancreatic cancer and liver metastasis 增强出版 AI导读
摘要：ObjectiveTo establish a nomogram prediction model for predicting the overall survival (OS) of elderly patients (≥60 years old) with pancreatic cancer and liver metastasis.MethodsClinical data of all elderly patients with pancreatic cancer and liver metastasis from 2010 to 2020 were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. The patients were randomly divided into a training set and a verification set at a ratio of 7:3. Univariate and multivariate Cox regression analyses were performed to identify independent prognostic factors for OS in these patients, which were further verified by Kaplan-Meier survival analysis with survival curves plotted. A nomogram was constructed based on the identified independent prognostic factors to predict the 6-month, 12-month and 18-month survival probabilities of elderly patients with pancreatic cancer and liver metastasis. The discrimination ability of the model was evaluated using the receiver operating characteristic (ROC) curve and area under the curve (AUC). Calibration curves were used to assess the accuracy of the model, and decision curve analysis (DCA) was conducted to evaluate its potential clinical application value.ResultsA total of 1424 elderly patients with pancreatic cancer and liver metastasis were enrolled, including 356 survivors (25.0%) and 1068 non-survivors (75.0%). They were randomly divided into a training set (n=996) and a validation set (n=428) at a 7:3 ratio, with balanced and comparable baseline characteristics between the two groups (P>0.05). Multivariate Cox regression analysis showed that T stage, N stage, surgery, chemotherapy, lung metastasis, and other distant metastases were independent prognostic factors for OS (P<0.05): the risk of death in T2 and T3 stages was 1.83 times (95%CI 1.30-2.58) and 1.88 times (95%CI 1.34-2.64) higher than that in T1 stage, respectively; the risk of death in N1 stage was reduced by 47% compared with N0 stage (HR=0.53, 95%CI 0.37-0.78); surgery and chemotherapy could reduce the risk of death by 59% and 70%, respectively (HR=0.41, 95%CI 0.25-0.68; HR=0.30, 95%CI 0.25-0.35); the risk of death was increased by 51% and 28% in patients with lung metastasis and other distant metastases, respectively (HR=1.51, 95%CI 1.22-1.87; HR=1.28, 95%CI 1.05-1.55). The nomogram constructed based on the above factors was used to predict OS at 6, 12, and 18 months. The AUC values of training set were 0.83, 0.82, and 0.80, respectively, while those of validation set were 0.84, 0.80, and 0.78, respectively, indicating good discriminative ability. Calibration curves showed a high consistency between predicted and actual survival probabilities. DCA indicated that the model yielded positive net benefits within the risk threshold of 0.40-0.95, which was superior to the strategies of full intervention or no intervention, suggesting favorable potential clinical application value.ConclusionThe established nomogram can be used to predict the OS of elderly patients with pancreatic cancer and liver metastasis, which will be useful for individualized survival assessment and clinical management of these patients.关键词：elderly patients;pancreatic cancer;liver metastasis;overall survival;nomogram1272|1088|0更新时间：2026-07-15 -
摘要：ObjectiveTo investigate the correlation between neutrophil percentage-to-albumin ratio (NPAR) and the risk of acute myocardial infarction (AMI) and the severity of coronary artery stenosis in patients with type 2 diabetes mellitus (T2DM).MethodsFrom January 2022 to March 2024, 205 patients with T2DM and AMI who presented with chest pain at the Second Hospital of Shanxi Medical University were enrolled in AMI group. Propensity score matching was performed at a 1:1 ratio to select 205 T2DM patients without AMI as non-AMI group. Baseline characteristics and laboratory indicators were collected from both groups, including routine blood tests (for calculating neutrophil percentage) and biochemical indicators (such as albumin), and NPAR was subsequently calculated. All patients underwent coronary angiography, and the Gensini score was used to assess the severity of coronary artery stenosis. Multivariate logistic regression analysis was conducted to evaluate the correlation of NPAR with the risk of AMI and the severity of coronary artery stenosis (Gensini score). Patients were stratified into low, medium, and high NPAR groups based on tertiles of NPAR values, and multivariate logistic regression was used to analyze differences in risk. Receiver operating characteristic (ROC) curve analysis was performed to assess the predictive value of NPAR for the risk of AMI in T2DM patients. Restricted cubic spline (RCS) analysis was used to examine the nonlinear relationship and threshold effect between NPAR and the Gensini score.ResultsThe NPAR level in AMI group was significantly higher than that in non-AMI group (P<0.001). Multivariate logistic regression analysis showed that NPAR was an independent risk factor for AMI in T2DM patients (OR=1.12, 95%CI 1.08-1.19, P<0.01). ROC curve analysis indicated an area under the curve (AUC) of 0.68 (95%CI 0.63-0.73) for NPAR in predicting AMI in T2DM patients, with a sensitivity of 0.68 and a specificity of 0.65. Multivariate logistic regression based on NPAR tertiles further revealed that, after adjusting for confounding factors, Patients in medium and high NPAR groups had 1.88-fold (95%CI 1.09-3.24, P=0.002) and 3.02-fold (95%CI 1.68-5.42, P<0.001) increased risks of AMI, respectively, compared with those in low NPAR group. RCS results demonstrated a threshold effect in the association between NPAR and Gensini score (P<0.001). Overall, NPAR was positively correlated with Gensini score (β=1.87, 95%CI 0.97-2.77). When NPAR<23.931, NPAR remained positively correlated with Gensini score (β=3.97, 95%CI 2.56-5.39). However, when NPAR≥23.931, no statistically significant positive correlation was observed between NPAR and Gensini score.ConclusionNPAR is an independent risk factor for AMI in patients with T2DM and exhibits a nonlinear relationship with the severity of coronary artery disease. Before the threshold of 23.931, NPAR is significantly positively correlated with the severity of coronary artery stenosis, suggesting that NPAR may serve as a novel biomarker for cardiovascular risk stratification in patients with T2DM.关键词：acute coronary syndrome;Acute myocardial infarction;diabetes mellitus, type 2;neutrophil percentage-to-albumin ratio24|0|0更新时间：2026-07-15 -
摘要：ObjectiveTo investigate the longitudinal association between long-term remnant cholesterol (RC) levels and the incidence of new-onset cardiometabolic multimorbidity (CMM) in middle-aged and elderly Chinese individuals, so as to provide evidence for the early prevention and intervention of new-onset CMM.MethodsA prospective cohort study was performed using three waves of survey data from the China Health and Retirement Longitudinal Study (CHARLS), with a total of 3525 participants enrolled. According to the tertiles of the mean RC levels in 2011 and 2015, the participants were divided into three groups: low-level group (Q1, n=1178), middle-level group (Q2, n=1174), and high-level group (Q3, n=1173). New-onset CMM in the 2020 survey was used as the outcome indicator. One-way analysis of variance (ANOVA) and Chi-square tests were used to analyze the differences in baseline characteristics among the three groups, so as to describe the distribution characteristics of populations with different RC levels. Multivariate logistic regression models were employed to analyze the relationship between exposure and outcome, with restricted cubic spline (RCS) analysis used to explore its nonlinear relationship. The participants were further divided into a high-level group (Q3) and a non-high-level group (Q1+Q2), and a causal mediation analysis based on the counterfactual framework was applied to investigate the mediating effect of BMI.ResultsUnivariate analysis revealed significant differences in baseline characteristics including age, gender, and BMI among the three groups (P<0.05). After adjusting for various covariates, multivariate logistic regression showed that compared with low-level RC group, high-level RC group had an increased risk of CMM (OR=1.599, 95%CI 1.061-2.438). RCS analysis revealed a nonlinear relationship between long-term RC level and CMM (Pnon-linear<0.05). Mediation analysis indicated that BMI mediated approximately 12% of the effect in the association between long-term RC level and CMM.ConclusionsLong-term RC level is significantly associated with the risk of CMM in middle-aged and elderly individuals. High RC levels markedly increase the incidence risk of CMM, and BMI plays an important mediating role in this relationship.关键词：middle-aged and elderly people;remnant cholesterol;cardiometabolic multimorbidity;longitudinal studies;mediation analysis1125|0|0更新时间：2026-07-15 -
摘要：ObjectiveTo establish a point-of-care testing system for respiratory syncytial virus subtype A (RSV-A) based on one-tube recombinase polymerase amplification combined with CRISPR/Cas12a, and to evaluate its detection performance and potential for clinical application.MethodsPrimers, CRISPR/Cas12a guide RNA (crRNA), and probes were designed and synthesized targeting the conserved gene sequence encoding the M protein of RSV-A. A one-tube RPA-CRISPR/Cas12a detection platform was established and optimized. Two instant readout schemes were developed with real-time fluorescence PCR instrument reading or lateral flow dipstick reading: one-tube RPA-CRISPR/Cas12a fluorescence point-of-care testing, and one-tube RPA-CRISPR/Cas12a lateral flow dipstick point-of-care testing. The sensitivity and specificity of both schemes were analyzed using plasmid and pseudovirus templates. A total of 39 clinical samples containing RSV-A or 3 other febrile respiratory syndrome viruses were tested to assess the Kappa consistency between the established point-of-care testing system and the gold standard RT-qPCR.ResultsThe one-tube RPA-CRISPR/Cas12a fluorescence point-of-care testing detected as low as 6.1×10-1 copies/μl of pseudoviruses within 30 min at a constant temperature of 37 ℃, and the one-tube RPA-CRISPR/Cas12a lateral flow dipstick point-of-care testing achieved a detection limit of 6.1×101 copies/μl in 35 min under the same conditions. No cross-reactivity was observed with the other three febrile respiratory syndrome viruses for both schemes. In clinical sample testing, both schemes exhibited 100.0% specificity (15/15), with sensitivities of 95.8% (23/24) and 91.7% (22/24), respectively. The Kappa agreement with RT-qPCR was 94.7% and 89.4%, respectively.ConclusionThe established RSV-A point-of-care testing system demonstrates high sensitivity and specificity, and can serve as an effective tool for the clinical diagnosis and epidemiological surveillance of RSV-A infection.关键词：respiratory syncytial virus subtype A;recombinase polymerase amplification;CRISPR/Cas12a system;lateral flow dipstick26|0|0更新时间：2026-07-15 -
摘要：ObjectiveTo explore the clinical efficacy of Gandouling tablets (GDL) in treating dyslipidemia in adolescent patients with hepatolenticular degeneration (Wilson's disease, WD) based on change of gut microbiota.MethodsA total of 82 WD patients with dyslipidemia and phlegm-stasis interminglement syndrome admitted to the First Affiliated Hospital of Anhui University of Chinese Medicine from August 2024 to January 2025 were prospectively enrolled. Participants were randomly divided into control group (n=41) and observation group (n=41) using a random number method. Control group received copper-chelating therapy with sodium dimercaptopropanesulfonate (DMPS), while the observation group received DMPS plus GDL. After 4 courses of treatment, the levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (ApoB), total bile acid (TBA), Traditional Chinese Medicine Syndrome Score (TCMSS), and 24-hour urinary copper (24 hUC) were observed in both groups. Changes in α- diversity and β-diversity of gut microbiota and related signaling pathways were also analyzed. Multiple linear regression was performed to assess the correlation between gut microbiota and other clinical indicators.ResultsCompared with pre-treatment values within the same group, both groups showed a significant increase in 24 hUC (P<0.01), significant decreases in TC, TG, LDL-C, ApoB, TBA, and TCMSS (P<0.01), and an increase in the relative abundance of gut microbiota. After treatment, compared with control group, observation group had a higher overall effective rate (82.9% vs. 56.1%, P<0.01) and higher 24 hUC (P<0.05), along with significantly lower TCMSS and levels of TC, TG, LDL-C, and ApoB (P<0.01). The Shannon and Simpson indices of gut microbiota increased significantly (P<0.05), and the structure of gut microbiota was significantly altered (P<0.05). Multivariate correlation analysis showed that at the phylum level, reduced LDL-C was associated with increased Firmicutes (β=-0.038, P=0.020), decreased TG with increased Bacteroidetes (β=-0.050, P=0.041), and decreased 24hUC with increased Proteobacteria (β=-0.002, P=0.015). At the genus level, decreased TG was associated with increased Bacteroides (β=-0.067, P=0.050), increased 24hUC with decreased Alistipes (β=-0.002, P=0.012), and both increased 24hUC (β=0.002, P=0.023) and TG (β=0.143, P=0.021) were associated with increased Parabacteroides. Tax4Fun functional prediction showed that GDL might regulate gut microbiota in WD patients via pathways including the endocrine and metabolic system, lipid metabolism, and energy metabolism.ConclusionGDL may improve copper and lipid metabolism and delay the progression of hepatic fibrosis in adolescent WD patients by modulating the relative abundance of gut microbiota.关键词：Wilson's disease;gandouling tablets;gut microbiota;lipid metabolism;hepatic steatosis23|0|0更新时间：2026-07-15 -
摘要：ObjectiveTo report the clinical and imaging features of a rare case of iatrogenic diaphragmatic hernia with hepatic herniation following microwave ablation (MWA) of rectal cancer liver metastases, and to provide a reference for clinical practice through a literature review.MethodsClinical data of one patient with iatrogenic diaphragmatic hernia with hepatic herniation following MWA of rectal cancer liver metastases were retrospectively analyzed. Relevant databases in Chinese and English were searched, and the literature was reviewed to summarize the clinical characteristics of iatrogenic diaphragmatic hernia following liver tumor ablation.ResultsA 57-year-old female patient with rectal cancer liver metastases underwent ultrasound-guided MWA for liver metastases combined with laparoscopic radical resection of rectal cancer after conversion therapy. Ten months postoperatively, computed tomography (CT) revealed a diaphragmatic defect (3.0 cm) corresponding to the ablation zone in hepatic segment 8, accompanied by hepatic tissue herniation, with no obvious clinical symptoms. During 23 months of postoperative follow-up, the diaphragmatic defect gradually enlarged to 5.8 cm with increased herniated hepatic tissue, yet the patient remained asymptomatic, and was followed up regularly due to tumor progression. A total of 39 patients, including the present case, were identified from the literature. The mean age at diagnosis was 66.6 years, with 25 males. Thirty-seven cases had primary liver cancer (94.6% with liver cirrhosis), and 2 had rectal cancer liver metastases. Tumors located in hepatic segment 8 accounted for 71.8%. Regarding treatment, 89.7% underwent ultrasound-guided ablation, among which radiofrequency ablation was predominant (87.2%). The mean interval from ablation to diagnosis of diaphragmatic hernia was 22.5 months. Abdominal pain was the main symptom (56.4%), while 23.1% of patients were asymptomatic. The hernia contents were mostly colon and small intestine (76.9%), and hepatic herniation was rare (only 2 cases, 5.1%). Among patients with liver cirrhosis, the incidence of intestinal herniation was high (90.3%); 67.9% required emergency surgery, and 32.1% underwent intestinal resection due to perforation or necrosis. Surgical treatment was performed in 33 cases (simple diaphragmatic suture in 29, mesh reinforcement in 4), and 6 cases were managed with follow-up observation.ConclusionIatrogenic diaphragmatic hernia following liver tumor ablation mostly occurs in tumors near the diaphragmatic surface of hepatic segment 8. The hernia contents are most frequently intestinal organs, while hepatic herniation is extremely rare. Patients with primary liver cancer complicated by liver cirrhosis are at high risk of intestinal herniation, and early surgical intervention is recommended.关键词：Hepatic tumor;radiofrequency ablation;microwave ablation;diaphragmatic hernia;hepatic herniation21|0|0更新时间：2026-07-15 -
摘要：ObjectiveTo analyze the clinicopathological characteristics of patients with hormone receptor-positive (HR+) breast cancer brain metastases (BCBM), and to explore factors influencing survival prognosis through survival analysis.MethodsHR+ BCBM patients treated at the Chinese PLA General Hospital from January 2009 to December 2023 were enrolled. A retrospective cohort analysis was performed using data including clinicopathological characteristics and therapeutic regimens. The total dataset was randomly divided into a training set (n=119) and a validation set (n=52) at a ratio of 7:3. Univariate and multivariate Cox regression analyses were performed to identify factors influencing survival prognosis, and survival analysis was conducted for HR+ BCBM patients. A nomogram was established based on independent prognostic factors to predict 6-month, 1-year, and 3-year survival rates.ResultsA total of 171 HR+ BCBM patients were enrolled. The mean age at diagnosis of BCBM was (50.1±11.5) years. The median time from breast cancer diagnosis to brain metastasis was 61.5 (29.6-100.2) months. Brain was the initial metastatic site in 28 patients (16.4%). At the time of brain metastasis detection, 132 patients (77.2%) had concurrent extracranial metastases (involving >1 organ), and 30 patients (17.5%) had symptomatic brain metastases. The median post-metastasis survival was 15.6 months (95%CI 10.7-23.5). Multivariate COX regression analysis showed that initial brain metastasis (HR=0.38, P<0.001), Eastern Cooperative Oncology Group (ECOG) performance status score <2 (HR=0.32, P<0.001), cranial radiotherapy (HR=0.43, P<0.001), systemic chemotherapy (HR=0.47, P<0.001), and cydin-dependent kinase (CDK)4/6 inhibitor treatment (HR=0.59, P=0.031) were independent prognostic factors. A nomogram was constructed using these independent prognostic factors, and the AUC values for prediction at each time point were all exceeding 0.7 in both training and validation sets. After stratifying patients using the median predicted score into risk groups, low risk group had a significantly longer median overall survival compared to high-risk group (P=0.004).ConclusionPatients with HR+ breast cancer experience a prolonged interval before developing brain metastases, which are often asymptomatic. For treatment strategies, active comprehensive intervention should be emphasized for patients with good general condition and initial brain metastases, especially rational combination of local radiotherapy and systemic therapies (including chemotherapy and CDK4/6 inhibitor treatment).关键词：hormone receptor-positive breast cancer;brain metastases;prognostic factors;survival analysis;nomogram31|0|0更新时间：2026-07-15 - 摘要：ObjectiveTo explore the correlation between the pathogen distribution of urinary tract infection (UTI) following radical prostatectomy for prostate cancer (PCa), and stress urinary incontinence (SUI) as well as changes in inflammatory cytokines.MethodsA total of 213 patients with PCa who underwent robot-assisted radical prostatectomy at Nanyang First People's Hospital Affiliated to Henan University from January 2021 to January 2024 were retrospectively enrolled. The patients were divided into infection group (n=66) and non-infection group (n=147) according to whether postoperative UTI occurred, and further classified into SUI group (n=61) and normal voiding group (n=152) based on the presence or absence of SUI at 3 months postoperatively. Pathogens isolated from patients with postoperative UTI were cultured, separated, and identified to analyze the composition of pathogenic bacteria. General baseline data, levels of interleukin (IL)-1, IL-6, prostaglandin E2 (PGE2), tumor necrosis factor-α (TNF-α), prostate volume, and preoperative urethral length were compared between infection group and non-infection group, as well as between SUI group and normal voiding group. The levels of IL-1, IL-6, PGE2 and TNF-α were compared among four subgroups: non-infection + normal voiding group (n=136), non-infection + SUI group (n=11), infection+normal voiding group (n=16), and infection+SUI group (n=50). Multivariate linear regression analysis was adopted to analyze the correlation of IL-1, IL-6, PGE2, and TNF-α with bladder function. Multivariate logistic regression analysis was performed to identify risk factors for postoperative SUI. Restricted cubic spline model was applied to analyze the dose-response relationship between IL-1, IL-6, PGE2, TNF-α and the risk of UTI. Hayes Process program was used to assess the mediating effect of IL-1, IL-6, PGE2, and TNF-α on the association between postoperative UTI and bladder function.ResultsA total of 85 pathogen strains were detected in 66 PCa patients complicated with UTI following radical prostatectomy, with Escherichia coli and Staphylococcus aureus as the predominant pathogens. Compared with non-infection group, infection group had significantly older age, higher proportions of patients with preoperative SUI history, transurethral indwelling catheter and postoperative urinary retention, longer postoperative indwelling catheter duration and hospital stay, elevated levels of IL-1, IL-6, PGE2, TNF-α, and post-void residual urine volume, but lower proportion of patients with preoperative prophylactic antimicrobial use and lower bladder pressure (P<0.05). Compared with normal voiding group, SUI group had significantly older age, higher body mass index (BMI), larger prostate volume, longer preoperative urethral length, longer operation duration, higher proportions of patients with abdominal surgery history, preoperative SUI, and UTI, as well as higher levels of IL-1, IL-6, PGE2 and TNF-α (P<0.05). IL-1, IL-6, PGE2, and TNF-α were negatively correlated with bladder pressure (P<0.05) and positively correlated with post-void residual urine volume (P<0.05). Age≥58 years old, BMI≥24.69 kg/m2, prostate volume ≥50.06 cm3, preoperative urethral length<14.08 mm, abdominal surgery history, preoperative SUI history, concomitant UTI, IL-1≥2.05 pg/ml, IL-6≥16.43 pg/ml, PGE2≥116.91 pg/ml, and TNF-α ≥1.03 ng/ml were independent risk factors for postoperative SUI (P<0.05). The levels of IL-1, IL-6, PGE2, and TNF-α in non-infection+SUI group and infection+normal voiding group were significantly higher than those in non-infection+normal voiding group (P<0.05). The level of IL-1 in infection+normal voiding group was significantly higher than that in non-infection+SUI group (P<0.05). The levels of IL-1, IL-6, PGE2, and TNF-α in infection+SUI group were significantly higher than those in the other three subgroups (P<0.05). Non-linear dose-response relationships were observed between IL-1, IL-6, PGE2, TNF-α and UTI risk. When IL-1>2.09 pg/ml, IL-6>16.51 pg/ml, PGE2>117.02 pg/ml, and TNF-α >0.97 ng/ml, the risk of UTI increased with the elevation of corresponding inflammatory factor levels (Pnon-linear<0.05, Ptotal<0.05). IL-1, IL-6, PGE2, and TNF-α had significant mediating regulatory effects on the association between postoperative complicated UTI and bladder pressure as well as post-void residual urine volume (P<0.001).ConclusionsThe main pathogens of UTI complicating PCa radical prostatectomy are Escherichia coli and Staphylococcus aureus. Both postoperative UTI and SUI are independently associated with enhanced systemic inflammatory response, and a synergistic effect exists when both conditions coexist. IL-1, IL-6, PGE2, and TNF-α play significant mediating regulatory roles in the relationship between postoperative UTI and bladder function.关键词：prostate cancer;urinary tract infection;bacterial distribution;stress urinary incontinence;inflammatory factor27|0|0更新时间：2026-07-15
Clinical Research
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摘要：ObjectiveTo investigate the effects of DNAJ heat shock protein family member C8 (DNAJC8) on the proliferation, migration, invasion, and apoptosis of hepatocellular carcinoma (HCC) cells and its mechanism, and to explore the possibility of DNAJC8 as a potential drug target for HCC.MethodsThe transcriptome data of liver hepatocellular carcinoma (LIHC) were downloaded from The Cancer Genomic Atlas (TCGA) database to analyze the expression of DNAJC8 in HCC and its impact on the prognosis of HCC patients. Gene sets relate to DNAJC8 expression were obtained and subjected to enrichment analysis using Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Gene Set Enrichment Analysis (GSEA). MHCC97H and Huh7 cells were divided into control group (transfected with siNC sequence) and DNAJC8 knockdown group (transfected with siDNAJC8 sequence). CCK-8 assay, colony formation assay, cell scratch assay, and Transwell migration and invasion assays were used to evaluate the effects of DNAJC8 knockdown on the proliferation, migration, and invasion of HCC cells. Hoechst 33342 assay, JC-1 assay and flow cytometry were used to assess the effect of DNAJC8 knockdown on the apoptosis of HCC cells. Western blotting was employed to verify the expression of protein related to DNAJC8. Drug sensitivity analysis and molecular docking experiments were utilized to explore the potential molecular targets of DNAJC8. HCC cells in control group (control+sorafenib group) and DNAJC8 knockdown group (knockdown+sorafenib group) were treated with different concentrations of sorafenib, and CCK-8 assay were used to detect cell proliferation ability to investigate the effect of DNAJC8 on sorafenib treatment.ResultsThe mRNA expression level of DNAJC8 in HCC tissues was significantly higher than that in normal tissues and adjacent non-tumor tissues (P0.001). Kaplan-Meier survival analysis revealed that patients with high DNAJC8 expression had significantly shorter overall survival and progression-free survival than those with low DNAJC8 expression (P0.01, P0.05). GO functional enrichment analysis indicated that DNAJC8 was primarily involved in biological processes such as cell cycle, enriched in cellular components like gene sets, and associated with molecular functions including RNA binding. KEGG pathway enrichment analysis highlighted pathway such as the spliceosome. GSEA results showed that DNAJC8 correlated with E2F transcription factor (E2F) pathway, MYC target genes (MYC) pathway, and other pathways. Compared with control group, DNAJC8 knockdown group exhibited significantly reduced cell proliferation, migration, and invasion (P0.05 or P0.01), along with significantly enhanced apoptosis (P0.05 or P0.001). Moreover, the expression levels of protein kinase B (Akt) and β-catenin in HCC cells were significantly decreased in DNAJC8 knockdown group (P0.05 or P0.01). Drug sensitivity analysis demonstrated that patients with high DNAJC8 expression were less sensitive to sorafenib than those with low DNAJC8 expression (P0.0001). Molecular docking experiments indicated a free binding energy of -6.35 kcal/mol between DNAJC8 protein and sorafenib. CCK-8 assay results showed that the viability of HCC cells in the knockdown+sorafenib group was significantly lower than that in control+sorafenib group (P0.01 or P0.001).ConclusionsDNAJC8 is associated with the prognosis of HCC patients and serves as a potential molecular target for sorafenib. Knockdown of the DNAJC8 gene can inhibit the proliferation, migration, and invasion of HCC cells while promoting apoptosis, and this effect may be mediated through the Akt/β-catenin signaling pathways.关键词：Hepatocellular carcinoma;DNAJC8;potential target;sorafenib716|228|0更新时间：2026-07-15 -
摘要：ObjectiveTo explore the expression of insulin-like growth factor 2 mRNA-binding protein 2 (IGF2BP2) in cervical cancer and its effect on the malignant phenotype of cervical cancer cells.MethodsThe Cancer Genome Atlas (TCGA), Genotype-Tissue Expression (GTEx), and Gene Expression Omnibus (GEO) databases were used to compare IGF2BP2 expression between cervical cancer and normal tissues, and to analyze its correlation with tumor stage and patient survival. Immunohistochemistry (IHC), quantitative real-time PCR (qRT-PCR), and Western blotting were performed to detect IGF2BP2 expression in cervical cancer tissue. Cervical cancer cell lines SiHa and Caski were infected with lentivirus to establish IGF2BP2 knockdown group, IGF2BP2 overexpression group, and their respective control groups. The effects of altered IGF2BP2 expression on cell proliferation, apoptosis, migration, invasion, and the expression of epithelial-mesenchymal transition (EMT)-related proteins were then observed.ResultsIGF2BP2 expression was significantly higher in cervical cancer tissues and cells than that in normal counterparts (P<0.05). The expression level of IGF2BP2 in cervical cancer was not significantly correlated with tumor stage or overall survival (P>0.05), but was associated with median survival (P<0.05). Compared with knockdown control group, IGF2BP2 knockdown group showed significantly inhibited proliferation and colony-forming ability, an increased apoptosis rate, decreased migration and invasion capacities, downregulated expression of N-cadherin and Vimentin, and upregulated expression of E-cadherin, with statistically significant differences (P<0.05). Compared with overexpression control group, IGF2BP2 overexpression group exhibited enhanced proliferation and colony-forming ability, a decreased apoptosis rate, increased migration and invasion capacities, upregulated expression of N-cadherin and Vimentin, and downregulated expression of E-cadherin (P<0.05).ConclusionIGF2BP2 is upregulated in cervical cancer and enhances the malignant phenotype of cervical cancer cells.关键词：cervical cancer;IGF2BP2;proliferation;migration;invasion27|0|0更新时间：2026-07-15 -
摘要：ObjectiveTo synthesize ultrasmall soluble ruthenium nanoparticles (sRuNPs) with favorable water solubility and biocompatibility, and to evaluate their protective effects against H2O2-induced oxidative stress injury in lung epithelial cells as well as the underlying mechanism.MethodssRuNPs were synthesized via thermal decomposition combined with ligand exchange. Transmission electron microscopy, particle size analysis, and X-ray photoelectron spectroscopy (XPS) were used to characterize the morphology, particle size, elemental composition, valence states, and surface chemical features, as well as the in vitro dispersion stability in normal saline and complete RPMI-1640 medium. Cell counting kit-8 (CCK-8) assay was used to examine the effect of different concentrations of sRuNPs on the viability of A549 lung epithelial cells. A549 cells were divided into three groups: control group, H2O2 group, and H2O2+sRuNPs (10 μg/ml) group. Cell death was assessed by Calcein-AM/PI double staining. Commercial kits were employed to measure malondialdehyde (MDA) content and superoxide dismutase (SOD) activity. The expression levels of acetylated SOD2 (ac-SOD2) and total SOD2 were detected using Western blotting.ResultsThe prepared sRuNPs had a particle size of (2.00±0.18) nm. XPS results showed distinct characteristic peaks of ruthenium (Ru), carbon, and oxygen in the sRuNPs samples; Ru existed predominantly in Ru0 and Ru4+ states. High-resolution spectra of specific electron orbitals demonstrated that the C 1s and O 1s spectra confirmed organic ligand modification on the particle surface. No obvious precipitation was observed for sRuNPs at 0, 4, 40, and 400 μg/ml in normal saline at 25 ℃ for 24 h, or at 0, 1, and 10 μg/ml in complete RPMI-1640 medium at 37 ℃ for 24 h. Treatment with 1 μg/ml and 10 μg/ml sRuNPs for 24 h showed no significant difference in A549 cell viability compared with control group (P>0.05). Compared with control group, H2O2 group exhibited significantly increased cell death, elevated MDA content, reduced SOD activity, and a higher ac-SOD2/SOD2 ratio (P<0.05). Compared with H2O2 group, H2O2+sRuNPs group showed significantly decreased cell death, lower MDA content, higher SOD activity, and a lower ac-SOD2/SOD2 ratio (P<0.05).ConclusionssRuNPs at 10 μg/ml exhibit good in vitro stability and biosafety and exert a significant antioxidant effect on lung epithelial cells; inhibition of SOD2 acetylation may be the underlying molecular mechanism.关键词：ultrasmall ruthenium nanoparticles;oxidative stress;acute lung injury;lung epithelial cells;acetylated superoxide dismutase 229|0|0更新时间：2026-07-15
Basic Research
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摘要：Colorectal cancer (CRC) is a highly prevalent malignant tumor worldwide, with metastasis, recurrence, and drug resistance posing significant challenges in clinical treatment. Colorectal cancer stem cells (CCSCs), due to their self-renewal and tumor-initiating capabilities, are considered key drivers in CRC progression. CD133 is one of the most extensively studied surface markers in CCSCs, and its expression is closely associated with CRC invasion, metastasis, and poor prognosis. In recent years, immunotherapy strategies targeting CD133+ CCSCs have gradually become a research focus in precision medicine for CRC. This article reviews the mechanistic role of CD133+ CCSCs in CRC progression, their mediation of the tumor microenvironment, and immune evasion mechanisms. Future research will focus on the diagnostic and therapeutic potential of CD133 isoforms and glycosylation modifications, and leveraging single-cell sequencing to decipher CCSC heterogeneity, aiming to provide a molecular foundation for developing personalized treatment strategies for CRC patients.关键词：colorectal cancer;colorectal cancer stem cells;CD133+;targeted immunotherapy34|275|0更新时间：2026-07-15 -
摘要：Since low-intensity pulsed ultrasound (LIPUS) was approved by the U.S. Food and Drug Administration (FDA) for fracture treatment in 1994, it has become an important physical intervention for promoting bone tissue repair and regeneration in clinical practice owing to its advantages of noninvasiveness, safety, rapid onset and high compliance. Numerous basic and clinical studies have confirmed that LIPUS can regulate the entire process of fracture healing through mechanotransduction, significantly improving the local microenvironment, accelerating angiogenesis, promoting endochondral ossification, and enhancing the efficiency of bone remodeling. This review systematically summarizes the effects of LIPUS on various stages of fracture repair, elaborates the processes by which it regulates cells, angiogenesis, inflammatory responses and osteogenic differentiation through acoustic streaming, cavitation effects and other mechanisms, and summarizes the current research progress of related mechanisms. Future perspectives call for further clarification of the precise molecular pathways by which LIPUS modulates bone repair, the development of intelligent and parameterized ultrasound diagnosis and treatment equipment, and the implementation of precise treatment based on individual patient differences. These advances will provide new insights and directions for deepening fundamental research and promoting standardized clinical application of LIPUS in the field of fractures.关键词：fracture;low-intensity pulsed ultrasound;locomotor system injuries;osteoblasts;osteoclasts;bone remodeling21|0|0更新时间：2026-07-15 - 摘要：MicroRNA (miRNA) is a class of small non-coding RNAs consisting of 18-25 nucleotides, which regulates the expression of certain genes at both transcriptional and post-transcriptional levels, thereby influencing cellular processes such as proliferation, differentiation, and apoptosis. miR-126 is highly expressed in endothelial cells involved in regulating angiogenesis. By targeting multiple target genes including phosphoinositide 3-kinase regulatory subunit 2 (PIK3R2), vascular endothelial growth factor (VEGF), Sprouty-related EVH1 domain containing 1 (SPRED1), phosphatase and tensin homolog (PTEN), and ADAM metallopeptidase domain 9 (ADAM9), miR-126 is involved in regulating malignant tumor cell proliferation, differentiation, apoptosis, drug resistance, invasion, and metastasis. Therefore, investigating how miR-126 regulates the core biological behaviors of tumor cells, such as proliferation, differentiation, apoptosis, drug resistance, invasion, and metastasis, through the regulation of target genes in different types of cancers will not only further clarify the molecular regulatory network of tumor progression but also provide a theoretical and experimental basis for the development of antitumor drugs targeting miR-126. This holds promise for promoting the development of miR-126 as a highly promising novel intervention strategy in clinical cancer therapy. Moreover, miR-126 can serve as a tumor biomarker for the diagnosis and prognosis of patients with malignant tumors, indicating promising clinical application prospects. This review summarizes the research progress of miR-126 in human malignant tumors, aiming to provide a reference for tumor therapy.关键词：miR-126;expression regulation;malignancy;target genes31|82|0更新时间：2026-07-15
- 摘要：Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have been shown to play an important role in weight loss and metabolic diseases. Beinaglutide, a short-acting GLP-1RA independently developed in China, can enable weight reduction and improvement in insulin resistance (IR) to be achieved. With the advantage of a fully human amino acid sequence, a new localized option has been provided for clinical practice. Therefore, this review systematically summarizes the pathological relationship between overweight/obesity and related metabolic diseases, the mechanisms of weight loss and metabolic improvement of Beinaglutide, as well as its differences from other GLP-1RAs in terms of mechanisms of action and safety, and the evidence on Beinaglutide's weight-loss efficacy and comprehensive metabolic benefits, with the aim of providing a theoretical basis for its clinical application and references for the future exploration of its therapeutic advantages and optimization strategies.关键词：glucagon-like peptide-1 receptor agonists;Beinaglutide;weight loss;insulin resistance34|403|0更新时间：2026-07-15
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摘要：Chronic pain and sleep disorders are two closely related public health issues that not only seriously affect patients' quality of life and psychophysical health, but also increase the economic burden on families and society. At least 50% of patients with chronic pain also suffer from sleep disorders; long-term pain and sleep deprivation can lead to depression, anxiety, and even increase the risk of suicide. In recent years, with the application of advanced technologies such as functional magnetic resonance imaging and optogenetics, research into the pathogenesis of chronic pain and sleep disorders has been continuously advancing. These two conditions share multiple overlapping mechanisms involving neurobiology, immune, endocrine, and psychological dimensions. They are closely associated pathogenically and thus form a vicious cycle. This review summarizes the comorbid mechanisms of chronic pain and sleep disorders from five aspects: changes in brain region structure and function, neurotransmitter imbalance, neuroinflammation, autonomic nervous system and hypothalamic-pituitary-adrenal (HPA) axis dysfunction, as well as genetic and epigenetic changes. By integrating interdisciplinary perspectives, this review aims to clarify the comorbid mechanisms and provide references for future research on comorbidity-specific therapeutic targets and personalized treatment.关键词：chronic pain;sleep disorders;neuroinflammation;epigenetics46|835|0更新时间：2026-07-15
Review
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