To evaluate the features of carotid web (CW) by ultrasonography.

A total of 66 patients with CW were retrospectively enrolled from January 2018 to June 2019 at Xuanwu Hospital, Capital Medical University. All patients were examined by both ultrasonography and CTA, and were divided into either a<50% stenosis group (54 cases) or a ≥50% stenosis group (12 cases). The ultrasonographic characteristics of CW, including the length, thickness, direction (forward or backward to the flow), acute angle between the web and carotid wall, and thrombus between the web and carotid wall were compared between the two groups. The stenosis degrees of carotid artery were compared between patients with and without ischemic stroke.

Forty-two (42/66, 63.6%) patients were diagnosed with CW by initial CDFI examination, of whom 21 (21/66, 31.8%) were diagnosed with ulcerative plaque and 3 (3/66, 4.5%) were diagnosed with carotid dissection at first but confirmed by second examination. There were no differences in the web length, thickness, direction, or thrombus detected between the two groups (P>0.05). The angle between the web and carotid wall in the<50% stenosis group was significantly smaller than that of the ≥50% stenosis group (median angel 39o vs 73o, P=0.002), and the percentage of patients with an angle≤ 60o in the<50% stenosis group was significantly higher than that of the ≥50% stenosis group (74.1% vs 41.7%, P=0.042). The diameter of the residual carotid artery at CW location in the<50% stenosis group was significantly larger and peak systolic velocity was significantly higher in the<50% stenosis group than in the≥50% stenosis group (P<0.001). The stenosis degrees of carotid artery were not statistically different between patients with and without ischemic stroke (P=0.321).

Ultrasonography can be used to evaluate the characteristics of carotid web in 2D and color mode. When the angle between the CW and carotid wall is large, the carotid artery stenosis ≥ 50% is more likely to happen, but carotid artery stenosis is not the main cause of ischemic stroke.

The aim of the present study was to evaluate the efficiency of sling exercise, therapeuticultrasound, therapeuticultrasound and sling exercise in patients to alleviate pain and improve lumbar function with lumbar disc herniation.

Individuals were selected from a list of patients being followed at the department of Rehabilitation in the third hospital of Hebei Medical University. 30 patients who were diagnosed with lumbar disc herniation were collected, the diagnoses were established upon medical history, physical examination, and results of imaging studies. The patients were randomly divided into three groups: therapeuticultrasound group received 14 sessions of ultrasonic therapy to the lumbar region, Sling exercise group received 14 sessions of sling exercise, and therapeuticultrasound and sling exercise group received therapeuticultrasound and sling exercise therapy 14 sessions of therapeuticultrasound to the lumbar region,7 sessions per week, 2 weeks. The VAS and ODI were compared with the assessment of the patients before and at the end of the therapy.

At the end of treatment, three groups VAS scores (F=3.069, P=0.043) and ODI scores (t=12.676, P<0.001) was lower than that at the beginning of treatment (P<0.05), at the end of treatment the VAS scores (F=59.400, P<0.001) and of the ODI scores (t=12.737, P<0.001) of ultrasonic and sling exercise therapy group was lower than the other group, the difference is significantly.

All three groups could reduce pain and improve lumbar function, and the ultrasonic and sling exercise therapy was most effective for lumbar disc herniation treatment in the three groups.

To analyze the treatment of different types of traumatic cerebral infarction in children, and explore its pathogenesis in combination with literature so as to improve the cure rate and reduce disability rate.

The clinical data of 42 cases of traumatic cerebral infarction in children were retrospectively analyzed in The Hospital of 81^st Group Army PLA from January 2015 to December 2019. The diagnosis of traumatic cerebral infarction in children was made by CT scan and MRI scan. According to different conditions, children with traumatic cerebral infarction were classified, and different treatment strategies were selected. Children with lacunar infarction were treated with calcium antagonists and neurotrophic drugs, supplemented by hyperbaric oxygen and exercise rehabilitation. The children of focal cerebral infarction and complex cerebral infarction treated by junior dehydrant and hormone also included the calcium antagonist and nutritional nerve drugs. The therapeutic regimen perhaps adjusted by the evolution of the disease. The children of extensive cerebral infarction underwent emergency cranial decompression, and was treated by reducing intracranial pressure and preventing complications after operation. The treatment results and recovery were observed.

In 42 cases of traumatic cerebral infarction in children, 35 cases (83.3%) were good recovery, 4 cases (9.5%) were moderate disability, 2 cases (4.8%) were severe disability, 1 case (2.4%) died, and no vegetative state. The good recovery rate of lacunar infarction was 100%, that of focal cerebral infarction was 62.5%, that of mixed cerebral infarction was 60%, and that of extensive cerebral infarction was 50%.

It is of great significance to improve the therapeutic effect and prognosis of children with traumatic cerebral infarction to adopt different treatment schemes for different types of cerebral infarction.

To characterize the patients with supratentorial hypertensive intracerebral hemorrhage (ICH) in the Tibetan Plateau over an altitude of 4000 meters.

A total of 68 cases with supratentorial hypertensive ICH were retrospectively included in Ali Regional People’s Hospital from January 2017 to September 2018. The clinical and laboratory data were collected. A simple linear correlation analysis was applied to analyze the correlation between the amount of bleeding and sex, age, nationality, time from onset , systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum triglyceride (TG), and cholesterol. According to computed tomography (CT) findings, 68 cases were divided into the basal ganglia ICH group (33 cases) and the lobar ICH group (35 cases). The characteristics between two groups were analyzed using t-test or χ² test.

The data of sex, age, nationality, time from onset, SBP, DBP, Hb, TG, and cholesterol of 68 cases on admission did not show any definitive correlation with the hematoma volumes (P＞0.05). The SBP and DBP of patients in the basal ganglia ICH group were significantly higher than that in the lobar ICH group, respectively [(184.9±28.5) mmHg vs (164.6±24.4) mmHg; (113.0±18.1) mmHg vs (103.0±18.4) mmHg] (t=0.499, 0.486; P=0.002, 0.033).

The relevant factors of hematoma volumes in patients with ICH in plateau area were not yet clear. Diastolic and systolic blood pressure of patients in the basal ganglia ICH group was higher than that in those in lobar ICH group.

To compare the efficacy evaluation of electrospun composite biomaterials and a porcine small intestine submucosa mesh for hernia repair.

A randomized, single-blind, controlled multicenter trial was performed in 3 hospitals in Shanghai. Eligible adult patients with primary unilateral reducible groin hernias were randomly assigned (1∶1) to electrospun composite biomaterials (experimental group) or porcine small intestine submucosa (control group) mesh groups. Patients were treated with the tARB technique and assessed at 1,3 and 6 months after the surgery. The primary endpoint was hernia recurrence. The secondary endpoints were postoperative complications including groin pain and operative site infections.

172 patients were assigned to experimental (n=86) and control (n=86) groups. At 6 months follow-up, postoperative complications occurred in 5 patients (5/86, 5.95%) and 2 (2/86, 2.35%) patients in the control and experimental groups, respectively (P>0.05). There was no significant difference in VAS or SVS score between the two groups.

We demonstrate that electrospun composite biomaterial mesh can be used as a ideal choice for inguinal hernia repair. Electrospun composite biomaterial has the characteristics of low recurrence rate, absorbability and long-term comfort.It can be further applied in clinical practice in the future.

Pancreaticoduodenectomy(PD)remains one of the most complicated hepatobiliary operations. The development of minimally invasive surgery for PD has always been an hot spot. Laparoscopic pancreaticoduodenectomy(LPD) has not been widespread carried out due to its difficulty and long learning curve. LPD accounts for 9% of all PD, according to the National Cancer Data base. Compared with laparoscopic surgery, robotic surgery system has significant advantages in the field of minimally invasive PD, including stereotactic amplified vision, filtering hand tremor and simulating the wrist. The article would review the surgical techniques and notes, which could provide clinical reference for other surgeons.

To determine whether microRNA (miR)-129 regulating colon cancer cell proliferation by targeting the cationic amino acid transporter 1(CAT-1) and thus modulating arginine metabolism.

Expression of CAT-1 and miR-129 was examined in 93 paired colon cancer tissues using real-time fluorogenic quantitative PCR (qPCR) and immunohistochemistry (tissue microarray) from Shanghai East Hospital. Bioinformatics predicted their targeting relationship. In RKO cells, gain-and loss-of-function models for miR-129 were established. Western blotting, enzyme-linked immunosorbent assay (ELISA), and CCK-8 assays were used to assess CAT-1 protein, intracellular arginine, and proliferation.

CAT-1 was upregulated and miR-129 downregulated in tumors. miR-129 was bioinformatically predicted to bind the 3'-UTR of CAT-1. Functionally, cell proliferation was arginine-dependent. Overexpression of miR-129 suppressed CAT-1, decreased intracellular arginine, and inhibited proliferation, while miR-129 knockdown had opposing effects.

miR-129 functions as a tumor suppressor in colon cancer by targeting CAT-1, thereby negatively regulating arginine uptake and cell proliferation. This defines a critical miR-129/CAT-1/arginine metabolic axis.

To analyze the clinical features and prognosis of patients with early-onset gastric cancer (EOGC).

A retrospective study was conducted, including 4 712 patients with gastric cancer who underwent surgical treatment in the First Affiliated Hospital of Anhui Medical University from January 2012 to December 2018. The difference in clinicopathological features between the patients with EOGC and those with non-EOGC was compared by propensity score matching. Follow-up data and survival curves were used to analyze the prognosis of patients, and the prognosis factors between the two groups was analyzed by univariate and multivariate regression analysis, ultimately establishing a nomogram model to predict overall survival in EOGC patients.

There were 298 EOGC patients and 4 414 non-EOGC patients. After propensity score matching analysis, 229 patients in the EOGC group and 458 patients in the non-EOGC group were enrolled. Vascular invasion and differentiation showed significantly differences between the two groups (P<0.05). The median survival time for the EOGC group was 56.06 months (1 682 days), significantly shorter than 69.1 months (2 073 days) for the non-EOGC group. Multivariate analysis results indicated that age, maximum tumor diameter, the number of lymph nodes retrieved, the number of positive lymph node, TNM staging, and history of stroke were the prognsic factors for EOGC patients (all P<0.05). Based on the the above factors, a nomogram model was established to predict the overall survival of EOGC patients. The AUC for the nomogram model predicting 1, 5, and 8-year survival rates were 0.770 (95% CI: 0.724-0.816), 0.791 (95% CI: 0.750-0.831), 0.802 (95% CI: 0.730-0.875), respectively, showing good prognostic accuracy.

EOGC is a rare disease with obviously worse prognosis than that of non-EOGC patients, warranting further clinical attention. The established nomogram model can effectively predict the prognosis of EOGC patients.

To analyze the expression of Netrin-1 (NTN1) in gastric adenocarcinoma and investigate its role in triggering the epithelial-mesenchymal transition (EMT) process.

Bioinformatics analysis was conducted on the GSE49051 dataset to investigate the expression and functional enrichment of NTN1 in gastric adenocarcinoma. Sixty-four samples of gastric adenocarcinoma and adjacent normal tissues were collected, and the expression of NTN1 was detected by real-time fluorogenic quantitative PCR (qPCR) and immunohistochemical staining. The correlation between NTN1 expression and clinicopathological characteristics was analyzed. By knockdown or overexpression of NTN1, MTS assay, colony formation assay, wound healing assay, and Transwell invasion assay, the proliferation, migration, and invasion abilities of gastric adenocarcinoma cells were evaluated. Additionally, the effects of knockdown and overexpression of NTN1 on the expression of EMT-related markers in gastric adenocarcinoma cells were analyzed.

Bioinformatics analysis showed that NTN1 was overexpressed in gastric adenocarcinoma tissues. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses revealed that NTN1 was involved in biological processes such as extracellular matrix construction and cell migration regulation. qPCR and immunohistochemistry results showed that the expression of NTN1 in gastric adenocarcinoma tissues was significantly higher than that in adjacent normal tissues, and was closely correlated with pathological characteristics such as lymph node metastasis and nerve invasion. Functional experiments indicated that knocking down NTN1 significantly inhibited the proliferation, migration, and invasion abilities of gastric adenocarcinoma cells, while overexpressing NTN1 enhanced these abilities. Knockdown of NTN1 inhibited the EMT process in gastric adenocarcinoma cells, specifically manifested as increased expression of E-Cadherin and decreased expression of mesenchymal markers such as Vimentin and N-Cadherin. Conversely, overexpression of NTN1 promoted the EMT process.

NTN1 is overexpressed in gastric adenocarcinoma and intervenes in the malignant progression of gastric adenocarcinoma by the EMT process. NTN1 is expected to become a novel target for molecular typing and targeted therapy of gastric adenocarcinoma, providing substantial theoretical support for the development of new treatment strategies.

To investigate the clinicogenomic characteristics, post-ESR1 alteration treatment patterns and prognostic factors for progression-free survival (PFS) in patients with ESR1-altered advanced breast cancer in a real-world cohort.

From January 2019 to January 2025, the clinicopathological and molecular data were retrospectively collected from patients with ESR1 alterations (including point mutations, amplifications, rearrangements and other ESR1-related abnormalities) in advanced breast cancer. Variables included age, disease-free survival (DFS), recurrence status, metastasis site, prior CDK4/6 inhibitor exposure (duration and lines of therapy), PIK3CA/TP53 co-mutations, tumor mutation burden (TMB) and post-ESR1 alteration treatment groups. Kaplan-Meier analysis was used to estimate PFS. Univariate and multivariable Cox proportional hazards models were used to identify variables associated with PFS exploratively.

A total of 36 patients were included in the analysis. The median real-world progression-free survival (rwPFS) was 9.0 months (95% CI: 4.0-12.0 months). In the univariate Cox regression, prior CDK4/6 inhibitor exposure was associated with shorter PFS (HR=2.47, 95% CI: 1.12-5.44, P=0.025), and bone metastasis showed a borderline association with shorter PFS (HR=1.88, 95% CI: 0.90-3.97, P=0.095). In the exploratory multivariate model, bone metastasis (adjusted HR=2.35, 95% CI: 1.08-5.11, P=0.030) and prior CDK4/6 inhibitor exposure (adjusted HR=3.11, 95% CI: 1.35-7.14, P=0.008) were associated with shorter PFS. No significant difference was observed among treatment groups (log-rank P=0.584).

ESR1-altered advanced breast cancer shows substantial clinical and molecular heterogeneity. This study suggests that bone metastasis and prior CDK4/6 inhibitor exposure may be associated with shorter PFS after detection of ESR1 alterations. The subsequent treatment strategy needs to be comprehensively judged in combination with transfer burden, prior treatment exposure and molecular features.

To explore the effect of optimized common ostium closure technique in Overlap anastomosis for 3D laparoscopic radical resection of right-sided colon cancer, and clarify its impact on surgical efficiency, postoperative complications and patient recovery.

The clinical data of 211 patients who underwent 3D laparoscopic radical resection of right-sided colon cancer (Overlap anastomosis) from July 2019 to December 2024 were retrospectively analyzed. The patients were divided into observation group (100 cases, barbed suture continuous suture + seromuscular reinforcement) and control group (111 cases, linear cutting stapler + seromuscular reinforcement) according to different common ostium closure methods. Intraoperative indicators, postoperative recovery, total costs, quality of life (QoL) score and complications were compared between the two groups.

Intraoperative blood loss, time to first flatus, postoperative hospital stay and total hospitalization costs in the observation group were significantly better than those in the control group (P<0.001). There were no significant differences in operation duration, QoL scores 1-6 months after surgery and complication rates between the two groups.

The optimized technique can reduce blood loss, accelerate recovery, reduce costs, and does not increase the risk of complications, which is worthy of promotion.

To develop and compare multiple risk prediction models for postoperative hypocalcemia in patients with thyroid cancer, identify core predictive factors, and provide a scientific tool for early clinical warning and precision intervention to optimize perioperative management.

A total of 767 patients who underwent surgery for differentiated thyroid cancer were retrospectively enrolled from April 1, 2022 to August 31, 2025 in Huizhou First People’s Hospital, with the occurrence of postoperative hypocalcemia as the primary outcome. Core predictors were selected using least absolute shrinkage and selection operator (LASSO) regression. Based on these predictors, three prediction models-a multivariate nomogram, a decision tree, and an extreme gradient boosting (XGBoost) model-were constructed. The dataset was split into training and testing sets at an 8∶2 ratio using stratified sampling. Model performance was evaluated using accuracy, precision, recall, F1 score, and the area under the receiver operating characteristic curve (AUC). SHapley additive explanations (SHAP) values were employed to interpret feature contributions in the XGBoost model.

Among the 767 patients, 233 (30.4%) developed postoperative hypocalcemia. LASSO regression identified nine core predictors: age, body mass index (BMI), postoperative parathyroid hormone (PTH) level, extent of surgery, recurrence risk, presence of papillary microcarcinoma, number of tumors, history of diabetes mellitus, and thyroiditis. All three models demonstrated good discriminative ability (AUC≥0.828). The XGBoost model achieved the highest AUC (0.851) but the lowest recall (0.435). The decision tree model showed the best recall (0.587) and F1 score (0.651). The nomogram model yielded the highest accuracy (0.816) and precision (0.781), and enabled convenient, visualized individualized risk assessment. SHAP analysis confirmed that postoperative PTH level and extent of surgery were the most influential predictors.

The nine core predictors identified in this study hold significant value for predicting postoperative hypocalcemia in thyroid cancer patients. Among the models evaluated, the nomogram offers the best balance of accuracy, usability, and clinical interpretability, making it the optimal tool for clinical application. It can effectively assist clinicians in identifying high-risk patients and implementing personalized interventions, thereby improving patient outcomes.

As the human body’s “second genome”, intestinal microecology plays a core role in maintaining host metabolic homeostasis, immune function and intestinal barrier integrity. Gastrointestinal surgery profoundly remodels the composition and function of gut microbiota through multiple approaches, including anatomical reconstruction, changes in digestive physiology and perioperative interventions. In recent years, with the rapid advancement of high-throughput sequencing technology, multi-omics analysis and clinical translational research, the effects of different gastrointestinal surgical procedures on intestinal microecology and their correlations with postoperative complications have been gradually clarified. This article systematically reviews domestic and international research progress on the relationship between major gastrointestinal surgical procedures (such as bariatric and metabolic surgery, radical gastrectomy, colorectal resection and ileostomy) and intestinal microecology. The review is conducted from four aspects: alterations in gut microbial composition, remodeling of metabolic functions, microecological mechanisms of surgical complications, and targeted intervention strategies, aiming to provide microecology-based evidence for clinical practice in gastrointestinal surgery.

To explore the current status and progress of immunotherapy for colorectal cancer (CRC), with “Colorectal Cancer”, “Immunotherapy”, and corresponding MeSH terms for various therapeutic modalities as core search keywords to retrieve literature published between 2015 and 2025 from databases including PubMed, with relevant studies on immune checkpoint inhibitors (ICIs), adoptive cell transfer (ACT), and tumor vaccines included for screening. Finally, 51 studies meeting the criteria were selected to comprehensively evaluate the efficacy, safety, and factors influencing the therapeutic effects of the aforementioned immunotherapeutic approaches. The results showed that ICIs exhibited significant efficacy in immunotherapy for patients with microsatellite instability-high/deficient mismatch repair (MSI-H/dMMR) metastatic CRC or those undergoing neoadjuvant therapy for CRC, while their therapeutic effect was limited in patients with microsatellite stability/proficient mismatch repair (MSS/pMMR) CRC, and the combined application of ICIs with chemotherapy, radiotherapy, or targeted therapy is expected to become a breakthrough direction for immunotherapy in MSS/pMMR CRC patients. Tumor vaccines demonstrated a certain ability to stimulate the body’s immune response but had not yet achieved the desired clinical efficacy. ACT showed promising prospects in preliminary studies yet required further optimization in terms of technology and safety. Additionally, various factors such as the tumor microenvironment and gene mutation status had significant impact on the efficacy of immunotherapy, and the rational combination of immunotherapy with other treatment methods may enhance its therapeutic effect. Currently, certain achievements have been made in CRC immunotherapy and therapeutic modalities are continuously developing, but in-depth research on therapeutic mechanisms, screening of populations with potential benefits, and optimization of treatment regimens is still necessary to promote CRC immunotherapy to a new stage and bring greater benefits to patients.

To explore the potential mechanism of the rhubarb-Salvia miltiorrhiza herb pair in the intervention of diabetic kidney disease (DKD) by integrating Gene Expression Omnibus (GEO) data mining, network pharmacology, and molecular docking techniques.

Active ingredients and potential targets of rhubarb-Salvia miltiorrhiza were obtained through the Traditional Chinese Medicine Systems Pharmacology (TCMSP) database combining with the Chinese Pharmacopoeia and relevant literature. The glomerular dataset GSE30528 and the tubular dataset GSE30529 related to DKD were retrieved from the GEO database, and differential analysis was performed in the two types of tissues to screen exploratory candidate targets. Protein-protein interaction analysis was performed using the STRING database, and the target network was constructed with Cytoscape software, while GO functional annotation and KEGG pathway enrichment analysis of key targets were conducted via R language. Finally, molecular docking verification was carried out using AutoDock Vina.

From rhubarb-Salvia miltiorrhiza, a total of 90 active ingredients, 150 potential targets, and 3, 592 candidate differential targets for DKD were screened out, yielding a total of 43 intersecting targets. Topological analysis identified the core targets as EGFR, CASP3, ICAM1, KDR, and MAPK1, and the core components as emodin, aloe-emodin, danshensu, and tanshinone ⅡA. Go enrichment involved epithelial cell proliferation and apoptosis, ERK1/2 cascade reaction, and collagen-containing extracellular matrix. KEGG enrichment was mainly observed in PI3K/Akt, MAPK, integrin, and HIF-1 signaling pathway. Molecular docking showed that the binding energies of emodin and tanshinone ⅡA to the core target EGFR were -9.32 and -9.59 kcal/mol, respectively, both exhibiting favorable theoretical binding activity.

The rhubarb-Salvia miltiorrhiza herb pair may participate in the pathological processes associated with DKD through a multi-component, multi-target, and multi-pathway network. The signal networks related to emodin, tanshinone ⅡA, and EGFR can serve as candidate directions for subsequent in-vivo and in-vitro verification.

To explore the influence of dulaglutide combined with dapagliflozin on renal function and fibrosis in patients with type 2 diabetic kidney disease (T2DKD).

This study was a prospective randomized controlled trial. Consecutive patients with T2DKD admitted to our hospital from January 2024 to December 2024 were enrolled and randomly assigned to an observation group and a control group. All patients received basic routine treatment for diabetes. The control group was treated with dapagliflozin monotherapy, while the observation group received additional intervention with dulaglutide injection on the basis of dapagliflozin. Levels of renal function, renal fibrosis markers, and inflammatory factors were measured and compared between the two groups at baseline and 12-month follow-up. Adverse events during treatment were also recorded. Inter-group comparisons were performed using the t-test and Pearson χ² test.

A total of 94 patients with T2DKD were enrolled in this study, with 47 patients in the observation group and 47 in the control group. All the patients completed 12-month standardized treatment. After treatment, the estimated glomerular filtration rate (eGFR) was significantly increased in both groups compared with baseline, and post-treatment eGFR in the observation group was markedly higher than that in the control group (P<0.05). After treatment, the urine albumin-to-creatinine ratio (UACR), serum creatinine (Scr), blood urea nitrogen (BUN), renal fibrosis markers including transforming growth factor-β1 (TGF-β1), connective tissue growth factor (CTGF), kidney injury molecule-1 (KIM-1), as well as inflammatory factors including high-sensitivity C-reactive protein (hs-CRP), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) were obviously decreased in both groups relative to baseline; moreover, these indicators in the observation group were significantly lower than those in the control group (P<0.05). Glycated hemoglobin (HbA1c) and fasting plasma glucose (FPG) were significantly reduced in both groups after treatment (P<0.05), whereas no statistically significant inter-group differences in HbA1c and FPG were observed after treatment. There was no significant difference in the incidence of adverse events between the two groups during the treatment period.

Dulaglutide combined with dapagliflozin can better preserve renal function, inhibit renal fibrosis, and reduce systemic inflammatory response in patients with T2DKD. Its glucose-lowering efficacy is comparable to dapagliflozin monotherapy, with favorable safety profile.

Diabetic kidney disease (DKD), as the leading cause of end-stage renal disease, involves complex pathophysiological mechanisms. In recent years, macrophage-mediated immune metabolic dysregulation has been identified as a critical driver of DKD progression, where the phenotypic switching between M1 and M2 macrophages is governed by specific metabolic reprogramming (glycolysis versus oxidative phosphorylation). Nuclear factor erythroid 2-related factor 2 (Nrf2), a core transcription factor for cellular antioxidant response, not only regulates redox homeostasis but also influences macrophage polarization, thereby exerting renoprotective effects. However, the precise molecular mechanisms by which Nrf2 modulates macrophage metabolic reprogramming to affect polarization within the DKD microenvironment remain elusive. This review aims to systematically elucidate the molecular mechanisms of Nrf2 in regulating metabolic reprogramming and polarization of macrophage in DKD, providing new insights and potential therapeutic targets for the precision treatment of DKD.

Volume status assessment plays a central role in the clinical management of hemodialysis patients, and its accuracy directly affects patients′ prognosis and survival rate. In recent years, relevant research on artificial intelligence models in this field has demonstrated application potential. Precise assessment of volume status can be achieved by analyzing multi-dimensional clinical data, providing a basis for personalized treatment. This paper reviews the application of artificial intelligence and its combination with traditional volume assessment methods in volume evaluation for hemodialysis patients, and discusses their advantages, limitations, and development directions.