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With a needle-free syringe, 100 µL of insulin or saline were injected into alternate nostrils for a total administration volume of 400 µL

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Upon binding to its receptor, mature IL-18 activates the NF-κB signaling pathway, promoting the secretion of pro-inflammatory factors such as TNF-α and IL-6, thereby amplifying the local inflammatory response in the joint and exacerbating synovial damage (80)