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.

Cerebral ischemia-reperfusion injury (CIRI) is a complex pathophysiological process characterized by exacerbated brain tissue damage and related functional impairments following the restoration of blood flow after transient cerebral ischemia. Studies indicate that safflower alleviates ischemia-reperfusion injury through multiple mechanisms, including regulating hemodynamics, dilating blood vessels, improving hypoxia, counteracting free radical damage, exerting anti-inflammatory effects, and modulating neuronal autophagy. However, the precise molecular mechanisms underlying its therapeutic effects remain unclear. This review focuses on the neuroprotective roles of safflower in CIRI and its molecular mechanisms. By comprehensively analyzing the recent research advances, we find that bioactive components of safflower can mitigate CIRI through multiple pathways. This work aims to provide theoretical foundations for investigating the molecular mechanisms of traditional Chinese medicine in CIRI management and guide clinical rational drug utilization.

At present, the prevalence of type 2 diabetes mellitus (T2DM) continues to rise, and the prevention and treatment of its multi-system complications have become a major public health challenge. In addition to traditional risk factors such as abnormal glucose and lipid metabolism, abnormal cortisol secretion levels and rhythm disorders caused by hypothalamic-pituitary-adrenal axis dysfunction have increasingly attracted attention in the onset and progression of T2DM and its complications. The authors systematically review the clinical evidence on the impact of abnormal cortisol levels and rhythm disorders on the risk of T2DM, summarize the typical changes in cortisol levels and rhythms in T2DM patients, and focus on elaborating the associations between the two and the cerebrovascular diseases, microvascular diseases, and musculoskeletal system diseases related to T2DM, with the aim of providing a theoretical basis for deeply revealing its mechanism and exploring prevention and treatment strategies that take cortisol levels and rhythms as dual assessment targets.

To investigate the safety and feasibility of improving incision suture and drainage tube fixation after thoracoscopic surgery.

A total of 210 patients who underwent thoracoscopic surgery for pulmonary or mediastinal diseases from January 2025 to January 2026 were prospectively included. They were divided into Group 1, Group 2, and Group 3 according to the different incision suture and drainage tube fixation methods. Group 1 (70 patients) received layered suture with double-layer barbed suture combined with fixation under the suture of the deep tissue within the incision (method 1); Group 2 (70 patients) received layered suture combined with fixation in the Trocar tunnel independent of the incision (method 2); Group 3 (70 cases) received traditional interrupted suture combined with fixed catheter placement at the same incision skin layer (method 3). The incision healing time, total postoperative drainage volume, pain Visual Analog Score (VAS) in the first 3 days after surgery, scar score [Vancouver Scar Scale (VSS) and Observer Scar Assessment Scale (OSAS)] at one month after surgery and the incidence of postoperative incision complications were analyzed and compared among the three groups.

Finally, 185 patients were included in the study—Group 1 (58 patients), Group 2 (62 patients), and Group 3 (65 patients). There were no statistical differences between Group 1 and Group 2 in terms of scar scores (OSAS, VSS) and the incidence of complications such as suture knot reaction, early incision infection, subcutaneous emphysema, and poor incision healing (P>0.05), but both groups were lower than Group 3 (P<0.05). In terms of the incidence of incision exudation or the number of days of incision healing, Group 2 < Group 1 < Group 3 (P<0.05). For postoperative days 1 and 2, the VAS pain scores followed a pattern of Group 1 < Group 3 < Group 2 (P<0.05). There were no statistically significant differences among the three groups on postoperative day 3 (P>0.05), nor in total postoperative drainage volume (P>0.05) or the incidence of complications such as fat liquefaction (P>0.05) and tube dislodgement (P>0.05).

Compared with traditional suture and fixation methods, methods 1 and 2 have better safety and effectiveness, reduce the incidence of related incision complications, reduce excessive scar hyperplasia, and promote primary healing of the incision. Among them, method 2 has advantages in reducing the incidence of incision exudation and accelerating incision healing time, but it has poor postoperative pain control, and still needs further exploration and improvement. To sum up, the first two suture and fixation methods proposed in this study are effective, feasible and worthy of application in clinical practice in specific environments.

To analyze the causes, clinical characteristics and key points of reoperation for thoracic deformity.

From January 2018 to December 2025 in The Affiliated Guangdong Second Provincial General Hospital of Jinan University, the clinical data of patients with thoracic deformity who underwent reoperation after failed surgery outside the hospital were retrospectively analyzed, including general information of patients, deformity characteristics, imaging results, operation time, intraoperative blood loss, postoperative hospital stay, and postoperative complications. The above results were statistically analyzed.

A total of 312 patients were enrolled, including 258 males and 54 females, aged from 3 to 49 (19.98±9.83) years old. There were 270 cases of pectus excavatum, 18 cases of pectus carinatum, 9 cases of compound deformity, and 15 cases of unknown type. The patients were treated with Wang procedure, Wung procedure, Wenlin procedure, Wang + Wung procedure, Wang + Wenlin procedure, Wung + Wenlin procedure and comprehensive procedure, respectively. The total operation time was 55–285 (134.21±52.04) min, the intraoperative blood loss was 2–500 (74.63±114.48) mL, and the postoperative hospital stay was 4–60 (10.54±6.78) days. The longest follow-up time was 93 months, in which the steel plate had been removed in 126 cases, and there was no obvious recurrence of deformity during the follow-up after removal of the steel bars.

Once the thoracic deformity surgery fails, the risk of reoperation is high, and the procedure is technically difficult. Special methods are required for reoperation.

To explore the associations between changes in skeletal muscle index (SMI) and subcutaneous adipose index (SAI) during neoadjuvant immunotherapy combined with chemotherapy and treatment response, treatment-related adverse events, and perioperative outcomes in patients with locally advanced esophageal squamous cell carcinoma (ESCC).

This retrospective study included 109 patients with locally advanced ESCC who received neoadjuvant immunotherapy combined with chemotherapy followed by radical surgery between January 2020 and January 2025 at The First Affiliated Hospital of Suchow University and The Fourth Affiliated Hospital of Suchow University. SMI and SAI were measured on abdominal computed tomography (CT) images at the third lumbar vertebra (L3) level before and after neoadjuvant treatment. Percentage changes (ΔSMI% and ΔSAI%) were calculated, and patients were stratified according to body composition changes. Radiological response, pathological tumor regression grade (TRG), treatment-related adverse events, and perioperative outcomes were compared among groups.

Baseline clinical characteristics were comparable across different ΔSMI% and ΔSAI% groups. No significant associations were observed between changes in SMI or SAI and radiological response or TRG. Patients with decreased SMI experienced a significantly higher incidence and severity of leukopenia. Regarding perioperative outcomes, the group with decreased SMI had a significantly longer postoperative hospital stay and a higher incidence of pleural effusion and pneumonia. Although the overall complication rate tended to be higher in this group, the difference did not reach statistical significance. In contrast, changes in SAI were not significantly associated with perioperative outcomes or complication rates.

Dynamic changes in SMI during neoadjuvant immunotherapy combined with chemotherapy are closely associated with perioperative recovery and postoperative complications in patients with locally advanced ESCC, whereas their correlation with radiological and pathological response is limited. Changes in SAI show limited predictive value for perioperative outcomes. Monitoring skeletal muscle dynamics during neoadjuvant treatment may aid in preoperative risk stratification and optimization of perioperative management.

To establish and compare three prediction models for pulmonary infection after thoracoscopic surgery in lung cancer patients based on multivariate logistic regression, decision tree, and neural network.

Patients with lung cancer who underwent thoracoscopic lung resection in Zhenjiang Third People’s Hospital, Jurong People’s Hospital, and Danyang Third People’s Hospital from October 1, 2022 to March 31, 2025 were selected. Data on patient demographics, physical examination findings, past medical history, pulmonary function indices, surgical conditions, and tumor conditions of the patients were collected. The patients were divided into a pulmonary infection group and a non-pulmonary infection group based on the occurrence of pulmonary infection. The differences between the two groups were compared through univariate analysis. The variables with statistical significance in the univariate analysis were selected as independent variables for multivariate logistic regression, decision tree, and neural network to construct the prediction models, and the sensitivity, specificity, Youden index, and area under the receiver operating characteristic (ROC) curve (AUC) of the three models were compared.

A total of 1 262 patients were included in the study, of whom 230 cases had pulmonary infection, with an incidence of 18.22%. Multivariate logistic regression showed that age (≥60 years), gender, smoking history, history of chronic pulmonary diseases, and hospitalization time (≥10 days) were independent risk factors for postoperative pulmonary infection. The decision tree model obtained 4 explanatory variables: age (≥60 years), serum albumin level (<35 g/L), hospitalization time (≥10 days), and smoking history. The neural network model suggested that the top five risk factors were age (≥60 years), serum albumin level (<35 g/L), history of chronic pulmonary diseases, hospitalization time (≥10 days), and smoking history. The accuracy of the three models was 84.9%, 81.5%, and 86.7%, respectively. The sensitivity was 77.2%, 73.2%, and 75.4%; specificity was 80.3%, 76.8%, and 82.7%; Youden index was 0.575, 0.520, and 0.581; and the AUC was 0.831, 0.796, and 0.857, respectively (all P<0.05).

Compared with the multivariate logistic regression model and the decision tree model, the neural network model has better predictive performance for pulmonary infection after thoracoscopic surgery in lung cancer patients.

To explore the application effect of the BOPPPS model integrated with multimedia surgical videos in the clinical teaching of minimally invasive esophageal carcinoma surgery, clarify the auxiliary role of this teaching mode in enhancing students’ mastery of key concepts and provide practical basis for the optimization of teaching strategies in thoracic surgery.

Students from two parallel classes of clinical medicine majors from the School of Medicine of Sun Yat-sen University were selected as the research objects, and the students were divided into the experimental group and the control group respectively. This study employed a single-blind design, and all participating students were unaware of their assigned group. Minimally invasive esophageal carcinoma surgery thematic teaching with the core focus on "lymph node dissection in radical esophageal carcinoma surgery" and "endoscopic submucosal dissection (ESD)" was carried out in both groups. The control group adopted the traditional teaching model, which combined anatomical atlases with theoretical explanations. The experimental group applied the BOPPPS teaching model with the aids of surgical videos, with the course designed into pre-class, in-class and post-class stages. Pre-class quizzes were used to identify students’ knowledge weaknesses on esophageal carcinoma TNM staging, related treatments and lymph node dissection. During the course, additional multimedia videos of lymph node dissection in radical esophageal carcinoma surgery and ESD surgery were introduced to assist teaching by dynamically demonstrating the surgical operation process, anatomical structure and key operational points. After the course, students from both the experimental group and the control group took a unified post-class test, an Objective Structured Clinical Examination (OSCE) after one week, and another post-class test after one month to evaluate their mastery of knowledge of esophageal carcinoma TNM staging, related treatments and lymph node dissection. At the same time, anonymous questionnaires were used to collect feedback on teaching satisfaction.

There were 70 students each in both the experimental group and the control group. Short-term teaching effectiveness evaluation: the scores of the post-class quiz in the experimental group were significantly higher than those in the control group (P<0.01). In addition, the post-class quiz scores of the experimental group were significantly higher than the pre-class quiz scores (P<0.01). Furthermore, the scores of the experimental group in the TNM staging and lymph node dissection sections of the post-class quiz were significantly higher than those in the pre-class quiz (P<0.01), but there was no significant difference in the ESD section scores between pre-class and post-class quizzes (P=0.47). Objective comprehensive evaluation: the OSCE scores of the experimental group were significantly higher than those of the control group (P=0.015). Long-term teaching effectiveness evaluation: the quiz scores of the experimental group one month after class were significantly higher than those of the control group (P<0.01), but neither in the experimental group nor the control group was there a significant difference between the post-class quiz scores and the quiz scores one month after class. Teaching satisfaction survey: Most students in the experimental group affirmed the teaching model, believing that it had positive impact on helping them master the theoretical knowledge comprehensively and was conducive to constructing a systematic knowledge system.

The application of multimedia surgical videos combined with the BOPPPS model in minimally invasive esophageal carcinoma surgery teaching can significantly enhance students’ comprehension and mastery of complex surgical procedures, leading to markedly improved teaching outcomes. This approach provides a valuable reference for innovating and optimizing clinical teaching models in thoracic surgery.

The early diagnosis and treatment of pulmonary nodules still faces technical challenges, such as imaging misdiagnosis, inaccurate localization, and difficulties in postoperative evaluation. The application of artificial intelligence (AI) in preoperative assessment, intraoperative navigation, and postoperative monitoring has gradually provided new solutions to address these issues. Preoperatively, AI models significantly improve the accuracy of nodule recognition and risk stratification; intraoperatively, through the integration of virtual reality, augmented reality, and robot-assisted surgery techniques, AI enhances surgical planning and operative stability; postoperatively, AI-based predictive models enable dynamic assessment of complications and the risk of recurrence, promoting the development of personalized rehabilitation strategies. This review summarizes the latest advances in AI applications in pulmonary nodule surgery, aiming to provide insights for the integration of future technological advancements with clinical practice.

Anaplastic lymphoma kinase (ALK)-rearranged non-small cell lung cancer (NSCLC) constitutes 4%–5% of all NSCLC cases and is frequently identified in young, never- or light-smoking patients with lung adenocarcinoma. Although surgical resection offers a curative opportunity for early-stage patients, the risk of postoperative recurrence remains high, particularly in ALK-positive patients due to their more aggressive biological characteristics. In recent years, with the continuous development of ALK tyrosine kinase inhibitors (TKIs), postoperative adjuvant targeted therapy has become a crucial strategy for improving the prognosis of the patient population. This review summarizes recent clinical studies on postoperative adjuvant targeted therapy for ALK-positive NSCLC, with a focus on the QEELIN study. It analyzes the efficacy and safety profiles of drugs such as ensartinib and alectinib in adjuvant settings, addresses current challenges in clinical practice, and aims to provide clinical guidance for the management of ALK-positive NSCLC patients.

To investigate the regulatory role and molecular mechanism of Rab26 in airway epithelial cell senescence induced by cigarette smoke exposure in chronic obstructive pulmonary disease (COPD). Impaired autophagy is a key feature of cellular senescence, characterized by the dysregulation of vesicle transport processes dependent on the Rab GTPase family.

An in vitro senescence model was established by treating human bronchial epithelial cells BEAS-2B with cigarette smoke extract (CSE), COPD mouse models were generated by chronic cigarette smoke exposure. Ten male C57BL/6 mice aged 6~8 weeks were selected and divided into an exposure group (n=5) and a room air control group (n=5). Techniques such as Western blotting, quantitative polymerase chain reaction, and immunohistochemistry were employed to detect the expression of Rab26, ubiquitin-specific protease 13 (USP13), and the senescence marker p21. Gain-of-function (overexpression) and loss-of-function (gene knockdown) experiments were conducted to evaluate the role of Rab26, and transcriptome sequencing was used to screen its downstream targets.

Cigarette smoke exposure successfully induced airway epithelial cell senescence. In mouse lung tissues and BEAS-2B cells, the protein expression of the senescence marker p21 was significantly increased. Specifically, treatment of BEAS-2B cells with 2% CSE for 9 days increased p21 protein levels (1.06 vs. 1.56 )(P<0.01), accompanied by an increase in the proportion of SA-β-gal-positive cells. Compared with control groups, Rab26 expression was decreased at both the mRNA and protein levels in lung tissues from smoke-exposed mice and in BEAS-2B cells treated with 2% CSE for 9 days, with Rab26 protein levels reduced (0.79 vs. 0.33)(P<0.05). In gain-of-function experiments, overexpression of Rab26 under CSE exposure significantly attenuated the upregulation of p21 protein expression (2.27 vs. 1.36) (P<0.01) and reduced the proportion of SA-β-gal-positive cells (P<0.01). Further mechanistic analyses demonstrated that USP13 is an important downstream-associated molecule involved in Rab26-mediated regulation of airway epithelial cell senescence. USP13 protein expression was decreased(0.94 vs. 0.57) in lung tissues of smoke-exposed mice (P<0.01) and (0.90 vs. 0.64)in Rab26-/- mouse lung tissues (P<0.01). Moreover, in vitro overexpression of USP13 significantly suppressed CSE-induced p21 upregulation (P<0.01), thereby alleviating the senescent phenotype.

Rab26 regulates cigarette smoke-induced airway epithelial cell senescence through the USP13 signaling pathway.

To analyze the predictive value of the lung injury prediction score (LIPS) and angiopoietin-2 (Ang-2) for the development of acute respiratory distress syndrome (ARDS) in patients with pulmonary infection.

A total of 90 patients with pulmonary infection who were admitted to the Respiratory Intensive Care Unit (RICU) and Emergency Intensive Care Unit (EICU) of the Second, First, and Third Affiliated Hospitals of Army Medical University between March 2013 and May 2022 were enrolled. Thirty-one patients who developed ARDS within one week were assigned to the observation group, and fifty-nine patients who did not develop ARDS were assigned to the control group. Clinical data were collected from both groups, including age, sex, smoking and drinking history, comorbidities (hypertension, diabetes, coronary heart disease), underlying respiratory diseases(chronic obstructive pulmonary disease and bronchiectasis), oxygenation index, APACHE Ⅱ score, LIPS score, ARDS incidence, and the expression levels of four biomarkers. Receiver operating characteristic (ROC) curves were plotted to evaluate and compare the predictive value of LIPS, Ang-2, and their combination for ARDS in patients with pulmonary infection.

The oxygenation index in the observation group was lower than that in the control group [(167.88±74.99)mmHg vs. (265.94±96.91) mmHg, P<0.05]. Fourteen patients (45.16%) died in the observation group compared with eight patients (13.56%) in the control group, with a significantly higher mortality in the observation group (P<0.05). The observation group also had higher APACHE Ⅱ scores (19.68±7.69 vs. 15.81 ±6.25), higher LIPS scores [6.50(5.50~7.50) vs. 3.50(2.50~5.50)], higher Ang-2 levels [6.01(2.50~12.32) vs. 1.64(0.75~3.29)ng/ml], and higher IL-8 levels [54.43(3.9~118.11) vs. 3.91(3.91~44.78)pg/ml], with statistically significant differences (P<0.05). Multivariate logistic regression analysis showed that LIPS and Ang-2 were independent risk factors for ARDS in patients with pulmonary infection (P<0.05). Both LIPS and Ang-2 had predictive value for ARDS, with no significant difference between the two (AUROC: 0.82 vs. 0.77, P=0.518). The combined use of LIPS and Ang-2 achieved a higher area under the curve (AUC=0.90, 95%CI: 0.82~0.96, P=0.000), which was significantly greater than that of either LIPS or Ang-2 alone (Z=2.65, P=0.008; Z=2.44, P=0.015, respectively). The combined model yielded a positive predictive value of 76.46%.

LIPS and Ang-2 can serve as predictive indicators for ARDS in patients with pulmonary infection. The combined application of LIPS and Ang-2 provides a identification of high-risk patients for developing ARDS.

To explore the impact of mechanical injury on the growth of airway epithelial cells by simulating mechanical damage through mechanical scratches, and to investigate the role of the miR-766-3p/PNCK/m-TOR pathway in this process.

The airway epithelial cells were transfected with has-miR-766-3p mimics, inhibitors, and corresponding negative control(NC), and the airway epithelial cells were mechanically scratched to create a damage model; cell counting kit-8(CCK8) method was used to detect cell viability; hematoxylin-eosin staining(HE) staining analysis of cell morphology; Transwell method for detecting cell migration ability; Western blot(WB) was used to detect protein expression levels; Quantitative reverse transcription polymerase chain reaction(RT qPCR)was used to detect RNA expression levels.

After modeling, the hsa-miR-766-3p RNA expression of cells decreased (1.01 vs. 0.31), the invasion ability decreased (180 vs. 123), and the cell activity decreased (0.97 vs. 0.72). The differences were statistically significant (P<0.05). After cell modeling, overexpression of miR-766-3p decreased cell invasion ability (127 vs. 94.5) and cell activity (0.7 vs. 0.52). After inhibitory expression of miR-766-3p, cell invasion ability (118 vs. 217) and activity (0.69 vs. 0.87) increased. The differences were statistically significant (P<0.05). After inhibitory expression of miR-766-3p, the expression of Pregnancy-upregulated nonubiquitous calmodulin kinase(PNCK)(0.34 vs. 0.84) and mammalian Target of rapamycin(mTOR)(0.45 vs. 1.05) increased, and the difference was statistically significant (P<0.05).

Through in vitro cell studies, it is believed that mechanical injury can affect the expression of miR-766-3p, and miR-766-3p further influences the activity and migration ability of airway epithelial cells by affecting the expression of PNCK and mTOR.