Second Affiliated Hospital of Inner Mongolia Medical University

The prognosis for hepatocellular carcinoma remains grim. Combining radiotherapy with immune checkpoint blockade (ICB) has shown potential to enhance therapeutic outcomes, yet there is a pressing need for further advancements. Our previous research demonstrated that this combined approach suppresses ALKBH5 gene expression and increases m6A modification levels in hepatocellular carcinoma tissues. High-throughput sequencing and detailed molecular analysis revealed that inhibiting ALKBH5 amplifies CIITA m6A modifications post-therapy. This modulation triggers MHC II molecule expression in tumors, facilitating the presentation of tumor-associated antigens to CD4 + T lymphocytes and the recruitment of CD8 + T cells for an anti-tumor immune response. Building on these findings, we engineered a CIITA vector with a specific site mutation to confirm that the regulation of CIITA by the combined radiotherapy and immunotherapy is mediated through m6A methylation. Consequently, we established a comprehensive network involving ALKBH5, CIITA, MHC II, and CD4+ and CD8 + T cells. To elucidate the role and underlying molecular mechanisms of this combined therapy in reshaping the tumor immune microenvironment for hepatocellular carcinoma, we employed multi-omics approaches across in vitro, animal model, and clinical multi-dimensional studies, offering novel insights for enhancing treatment efficacy.

Objective: Post-operative cognitive dysfunction (POCD) is a prevalent consequence of general anesthesia in older individuals (≥60 years) undergoing spine surgery. Factors associated with spinal surgery (prone positioning, prolonged length, and increased bleeding) along with general anesthesia elevate the risk of postoperative complications. Stellate ganglion block (SGB) exhibits neuroprotective effects via enhancing cerebral microcirculation and decreasing inflammation. This study intends to investigate the influence of bilateral SGB on POCD in these patients. Methods: One hundred fourteen elderly spine surgery patients were randomly assigned to a control group (standard general anesthesia) and a study group (ultrasound-guided bilateral SGB 2 hours pre-anesthesia plus general anesthesia). Cognitive function was evaluated by the MMSE/MoCA at T0 (pre-SGB), T1 (one day post-operation), and T3 (three days post-operation); POCD was categorized by severity. Results: One hundred patients were analyzed (14 excluded). Baseline characteristics were similar between groups (p> 0.05). At 2 hours post-op, no difference was found in cognitive impairment between groups. However, the SGB group had fewer moderate and severe cognitive dysfunction cases (p< 0.05). At 72 hours, no difference in mild cognitive impairment was observed, but the SGB group had lower POCD incidence (p< 0.05). Conclusions: Ultrasound-guided bilateral SGB before anesthesia successfully diminishes moderate-to-severe postoperative cognitive dysfunction within 3 days post-operation in elderly spine surgery patients.

Gastric cancer (GC) exhibits marked heterogeneity, patients with identical stage receive divergent outcomes. Metabolic reprogramming and aging are pivotal in reshaping the tumor microenvironment. However, their interplay in GC prognosis remains unexplored. We analyzed RNA-seq and clinical data from The Cancer Genome Atlas Program and Gene Expression Omnibus databases. Using univariate Cox, LASSO, and multivariate Cox regression, we identified candidate genes and constructed a prognostic signature. Immune contexture, genomic alterations and drug sensitivity were compared between high- and low-risk group. The metabolic and aging related risk score, comprising 4 genes (GNAI1, GSTA1, APOC3, and LOX), was developed. Validation across multiple cohorts confirmed its robust prognostic performance. The model also effectively stratified patients into distinct risk subgroups with differential immune profiles and responses to immunotherapy. Notably, high-risk patients showed reduced sensitivity to common chemotherapeutic agents but may benefit from targeting the PI3K/mTOR pathway. Metabolic and aging related risk score serves as a promising tool for individualized risk assessment and therapeutic guidance in GC, warranting further clinical validation.

Early postoperative kinesiophobia represents a significant psychological barrier in the rehabilitation trajectory following arthroscopic rotator cuff repair (ARCR). Existing research predominantly focuses on patients in the chronic phase, paying insufficient attention to the heterogeneity within this population. This study aimed to identify potential subtypes of kinesiophobia in patients after rotator cuff injury (RCI), analyze the causes affecting different subtypes of kinesiophobia, and provide a basis for formulating accurate early intervention plans. This study was conducted in the Department of Sports Medicine at the Second Affiliated Hospital of Inner Mongolia Medical University, China, from November 2024 to April 2025 (a duration of 6 months) using convenience sampling. This study included 245 consecutive participants who met the inclusion and exclusion criteria and who underwent arthroscopic ARCR after general anaesthesia. Finally, 237 participants completed this study. The Tampa Scale for Kinesiophobia(TSK,17 items, score range 17–68, ) was used as the primary outcome measure. The Self-Efficacy Scale(SEE; 9 items, 0–9 points), the “Changhai pain scale” Pain Score(0-10points), and the Groningen Orthopedic Social Support Scale (GO-SSS,12 items,0-36points) were used as secondary indicators. Mplus8.0 was used for latent profiling analysis, and the Lo-Mendell-Rubin corrected likelihood ratio test (LMR-LRT, p < 0.05), Bayesian information criterion (BIC), and entropy value > 0.80 were used to ensure the reliability of classification, followed by univariate and multivariate logistic regression analyses of the classification results using SPSS 25.0. 237 patients were surveyed (51.10% male), with an average age of (58.08 ± 8.57) years. There were 89 (37.60%) patients with osteoporosis and 151 (63.70%) patients with full-thickness tears. These patients could be categorized into three latent profile groups: the low kinesiophobia-active group (17.70%), the moderate kinesiophobia-stable group (61.62%), and the high kinesiophobia-avoidance group (20.68%). Educational level（Junior high school and below: p=0.043, 95%CI 1.054–31.436); diabetes mellitus (p=0.033, 95%CI 1.111–12.364); exercise self-efficacy (p=0.022, 95%CI 0.720–0.975); osteoporosis (p=0.044, 95%CI 1.028–9.384); degree of tearing (p=0.015, 95%CI 1.317–13.631); pain level (p=0.002, 95%CI 1.543–7.217). Postoperative kinesiophobia in patients with rotator cuff injuries is at a medium to high level, with group heterogeneity. It is mainly influenced by biological factors (full-thickness tears, osteoporosis), clinical factors (history of revision surgery, pain level, chronic medical history), and psychosocial factors (low self-efficacy, low education). In the future, medical staff should identify patients with kinesiophobia as soon as possible, consider the multifaceted factors affecting this situation, and develop targeted interventions to reduce early postoperative kinesiophobia and enhance rehabilitation outcomes and improve quality of life.

This study examines the causal association between hyperlipidemia and Alzheimer disease (AD) by utilizing a mix of data from the National Health and Nutrition Examination Survey (NHANES) and 2 sample Mendelian randomization (MR) analysis. The NHANES cross-sectional data (2011–2012 and 2013–2014) was used to investigate the correlation between hyperlipidemia and cognitive impairment in individuals with AD, as measured by the consortium to establish a registry for AD word learning (CERAD-WL). This was accomplished by employing multivariable logistic regression models to compute odds ratios (ORs). The MR analysis leveraged summary-level genetic data to assess the causal effects of various cholesterol traits, consisting of total cholesterol, triglycerides, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol, medium HDL cholesterol, and cholesteryl ester levels in small very LDL, on AD risk. There were several MR approaches that were utilized, including the inverse-variance weighted, weighted median, MR-Egger, and weighted mode. The NHANES data showed that participants with low cognition (lowest quartile of CERAD-Total score) had significantly greater incidences of hyperlipidemia in comparison to individuals who possessed normal cognitive abilities. The multivariable-adjusted OR was 2.159 (95% CI: 1.161–4.451, P <.001) for the lowest versus highest CERAD-Total score quartile. The MR analysis provided evidence for causal links between cholesterol traits and AD risk. Higher levels of total cholesterol (OR: 0.867, 95% CI: 0.776–0.968, P = .011), triglycerides (OR:0.870, 95% CI: 0.767–0.985, P = .028) were connected to increased AD risk. Higher HDL cholesterol was protective (OR: 1.045, 95% CI: 1.000–1.092, P = .049). Not a very strong causative effect was found for LDL cholesterol, medium HDL cholesterol or cholesteryl ester in small very LDL and AD. This combined NHANES and MR analysis provides robust evidence that hyperlipidemia, specifically elevated total cholesterol, and triglycerides, is causally associated with increased risk of AD, while higher HDL cholesterol is protective. These data indicate that addressing irregularities in cholesterol levels could be a potential strategy for controlling and preventing AD.