Abstract:Objective To explore the degree of cancer-related fatigue in patients with colorectal cancer after chemoradiotherapy and its relationship with perceived control and hope level.Methods A total of 152 patients with colorectal cancer after chemoradiotherapy admitted to Huai'an First Hospital Affiliated to Nanjing Medical University from June 2022 to October 2024 were enrolled.The cancer fatigue scale(CFS),cancer experience and efficacy scale(CEES),and Herth hope index(HHI)were used to assess cancer-related fatigue,perceived control,and hope level.Pearson correlation analysis was used to analyze the correlations among the scores of each scale.Multiple linear regression was used to identify independent factors associated with cancer-related fatigue.Results In patients with colorectal cancer after chemoradiotherapy,the CFS score was(36.88±5.85).The scores for the cancer experience and control efficacy subscales of the CEES were(49.79±8.42)and(36.42±4.55),respectively.The HHI score was(26.26±3.66).The CFS score was positively correlated with the cancer experience score of the CEES(P<0.05),while both were negatively correlated with the control efficacy score of the CEES and the HHI score(P<0.05).Patients who were aged≥55 years,had a high school education or below,lived alone,had TNM stage Ⅳ disease,or experienced grade 3-4 adverse reactions had significantly higher CFS scores than their counterparts(aged<55 years,college education or above,not living alone,TNM stage Ⅲ,grade 0-2 adverse reactions)(P<0.05).Multiple linear regression analysis showed that age,educational level,living status,TNM stage,adverse reactions,and the scores of cancer experience,control efficacy,and hope level were independent factors influencing the degree of cancer-related fatigue in patients after chemoradiotherapy(P<0.05),explaining 64.40%of the total variance.Conclusion The degree of cancer-related fatigue is relatively high in patients with colorectal cancer after chemoradiotherapy.It is significantly correlated with patients'cancer experience,control efficacy,and hope level,and is influenced by multiple factors such as age and educational level.Targeted clinical interventions should be implemented to improve patients'cancer experience,enhance their control efficacy and hope level,aiming to alleviate cancer-related fatigue.

Abstract:Objective To explore the relationship between the expression of POU domain class 5 transcription factor 1(POU5F1)and pre-B-cell leukemia homeobox transcription factor 1(PBX1)in diffuse large B-cell lymphoma(DLBCL)tissues and the clinicopathological features and prognosis of patients.Methods A total of 102 patients with DLBCL admitted to Nanjing First Hospital from March 2019 to February 2022 were selected as the research subjects.DLBCL tissues and adjacent tissues obtained surgically were designated as the DLBCL group and the adjacent tissue group,respectively.The expression of POU5F1 and PBX1 was detected by immunohistochemistry.Clinicopathological data of the patients were collected,and the relationship between POU5F1/PBX1 expression and the clinicopathological characteristics of DLBCL patients was analyzed using the χ2 test.All patients were followed up for 3 years and were divided into a survival group(71 cases)and a death group(31 cases)based on their survival status at the end of follow-up.Univariate and multivariate Cox regression analyses were used to analyze the factors influencing the prognosis of DLBCL patients.Results The positive expression rates of POU5F1 and PBX1 in the DLBCL group were higher than those in the adjacent tissue group(P<0.05).DLBCL patients with clinical stage Ⅲ-Ⅳ,bone marrow infiltration,or extranodal involvement≥2 had higher positive expression rates of POU5F1 and PBX1 than patients with clinical stageⅠ-Ⅱ,no bone marrow infiltration,or extranodal involvement<2(P<0.05).The positive expression rates of POU5F1 and PBX1 in the death group were higher than those in the survival group(P<0.05).Multivariate Cox regression analysis showed that bone marrow infiltration(HR=2.250,95%CI:1.544-3.278),extranodal involvement≥2(HR=2.330,95%CI:1.590-3.415),positive expression of POU5F1(HR=2.804,95%CI:1.854-4.240),and positive expression of PBX1(HR=2.465,95%CI:1.662-3.655)were risk factors for death in DLBCL patients(P<0.05).Conclusion POU5F1 and PBX1 are aberrantly highly expressed in DLBCL tissues.Their expression is associated with clinical stage,bone marrow infiltration,and the number of extranodal involvement sites,and they may serve as potential prognostic biomarkers for DLBCL patients.

Abstract:Gastric cancer is one of the most common malignant tumors worldwide,which is characterized by insidious onset,difficult early diagnosis,rapid progression and high metastasis and recurrence rates,and it seriously threatens the life and health of patients.With the development of liquid biopsy technology in recent years,exosomes,a key medium for intercellular communication,have shown great potential in the field of tumor diagnosis.Among them,long non-coding RNA(lncRNA)has attracted much attention due to its significant role in the epigenetic regulation of gene expression.More and more studies have shown that exosomal lncRNA can participate in malignant biological processes such as the occurrence,development,proliferation,invasion,and chemotherapy resistance of gastric cancer by regulating downstream target genes and related signaling pathways.Meanwhile,due to the stable existence and easy detection of exosomal lncRNA in body fluids,it has become a highly promising new diagnostic and prognostic biomarker for gastric cancer.Therefore,this study aims to systematically integrate research on the diagnostic value and molecular mechanism of exosomal lncRNA,and to comprehensively review the role of exosomal lncRNA in the onset and progression of gastric cancer.

Abstract:Objective To analyze the influencing factors of frailty and prognosis in elderly patients with heart failure(HF).Methods A total of 160 elderly patients with HF admitted to Mianyang Central Hospital were conveniently enrolled as the research subjects between March 2023 and August 2024.According to the evaluation results of the Fried frailty phenotype,they were divided into the frailty group(89 cases)and the non-frailty group(71 cases).General data were compared between the two groups.Independent risk factors for frailty were analyzed by multivariate Logistic regression analysis.After 12 months of follow-up,the incidence of major adverse cardiovascular events(MACE)was compared between the two groups.Results Age,proportion of New York Heart Association(NYHA)functional class Ⅲ-Ⅳ,levels of brain natriuretic peptide(BNP)and high-sensitivity C-reactive protein in the frailty group were significantly higher than those in the non-frailty group(P<0.05),while levels of hemoglobin and albumin(Alb),estimated glomerular filtration rate,and distance in the 6-minute walk test were significantly lower than those in the non-frailty group(P<0.05).Advanced age,NYHA functional class Ⅲ-Ⅳ,and low Alb level were independent risk factors for frailty in elderly patients with HF(P<0.05).During follow-up,the incidence of MACE in the frailty group(41.57%)was significantly higher than that in the non-frailty group(16.90%)(P<0.05).Conclusion The prevalence of frailty is high among elderly patients with HF.Advanced age,NYHA functional class Ⅲ-Ⅳ,and low Alb level are independent risk factors for frailty in elderly patients with HF,all of which have adverse effects on prognosis.

Abstract:Objective To investigate the efficacy of pimecrolimus in treating children with mild to moderate atopic dermatitis(AD)and its influence on the T helper 17 cells(TH17)/regulatory T cells(Treg)balance.Methods A retrospective analysis was conducted on the clinical data of 150 children with mild to moderate AD admitted to Sichuan Jinxin Xinan Women and Children's Hospital from June 2024 to June 2025.The patients were divided into two groups based on different treatment methods:78 children in the control group received basic treatment plus hydrocortisone butyrate cream,and 72 children in the study group received basic treatment plus 1%pimecrolimus cream.The efficacy,adverse reactions,and changes in clinical symptom scores and immunological indicators before and after treatment were compared between the two groups.Results The total clinical effective rate of the study group was 94.44%,significantly higher than that of the control group(83.33%)(P<0.05).After treatment,the improvements in scoring atopic dermatitis,eczema area and severity index,and pruritus visual analogue scale scores in the study group were significantly better than those in the control group(P<0.05).After treatment,the improvements in the proportion of peripheral blood Th17 cells,the Th17/Treg ratio,the proportion of Treg cells,and the levels of IL-17 and IL-10 in the study group were also significantly better than those in the control group(P<0.05).The total incidence of adverse reactions in the study group(9.72%)was significantly lower than that in the control group(21.79%)(P<0.05).Conclusion Pimecrolimus has a good clinical effect in the treatment of children with mild to moderate AD,effectively improving clinical symptoms such as pruritus and skin lesions,correcting Th17/Treg imbalance,and shows high safety.

Abstract:Objective To construct a risk prediction model and nomogram for intraoperative hypothermia in transurethral resection of the prostate.Methods A total of 203 patients with benign prostatic hyperplasia who underwent transurethral resection of the prostate at Minhang Central Hospital in Shanghai and Jiangsu Second Hospital of Traditional Chinese Medicine from January 2022 to June 2025 were selected.Patients were divided into a hypothermia group(n=51)and a normothermia group(n=152)based on the occurrence of intraoperative hypothermia.Multivariate logistic stepwise regression analysis was used to explore the influencing factors of intraoperative hypothermia during transurethral resection of the prostate.A nomogram was constructed,and the predictive value of the nomogram model for intraoperative hypothermia was evaluated using the ROC curve.Results The hypothermia group had higher age,longer operation time,and longer anesthesia time compared to the normothermia group.The proportions of patients with BMI<18.5 kg/m²,preoperative anemia,preoperative hypoproteinemia,intraoperative blood loss≥400 mL,total irrigation fluid volume≥15 L,irrigation fluid temperature<34 ℃,intraoperative fluid infusion volume≥1 500 mL,and prostate weight≥80 g were all greater in the hypothermia group than in the normothermia group,while the proportion of patients receiving intraoperative warming measures was lower(P<0.05).Multivariate analysis showed that advanced age(OR=1.582,95%CI:1.268-1.975),BMI<18.5 kg/m²(OR=2.396,95%CI:1.457-3.943),increased anesthesia time(OR=1.415,95%CI:1.149-1.742),and total irrigation fluid volume≥15 L(OR=3.010,95%CI:1.415-6.402)were independent risk factors for intraoperative hypothermia(P<0.05),while the use of intraoperative warming measures(OR=0.347,95%CI:0.182-0.665)was an independent protective factor(P<0.05).The nomogram model showed a consistency index of 0.884(95%CI:0.834-0.936).The area under the curve(95%CI)of the nomogram model for predicting intraoperative hypothermia was 0.878(0.826-0.925),with a specificity of 67.76%and a sensitivity of 92.16%.Conclusion Age,BMI,anesthesia time,total irrigation fluid volume,and the use of intraoperative warming measures are influencing factors for intraoperative hypothermia in patients undergoing transurethral resection of the prostate.The constructed nomogram model has high predictive value for intraoperative hypothermia.

Abstract:Objective To explore the effect of vitrectomy(PPV)combined with internal limiting membrane peeling(ILMP)on visual acuity and macular edema in patients with refractory diabetic macular edema(DME).Methods A retrospective study was conducted on 185 patients with refractory DME admitted to Meishan People's Hospital from January 2018 to January 2025.Based on the treatment methods in the data,they were divided into a control group(n=91)and a combined group(n=94).The control group received PPV alone,and the combined group received PPV combined with ILMP.Best corrected visual acuity,central macular thickness(CMT),severity of macular edema at 6 months postoperatively,and adverse reactions were compared between the two groups.Results The logMAR values and CMT in both groups at 1,3,and 6 months after surgery were significantly lower than those before surgery(P<0.05),and they showed a continuous downward trend over time(P<0.05).The logMAR values of the combined group at 1,3,and 6 months after surgery were significantly lower than those of the control group at the same time points(P<0.05).The distribution of macular edema severity grades in the combined group was significantly better than that in the control group(P<0.05),with milder edema in the combined group.Within 6 months after surgery,there was no statistically significant difference in the total incidence of adverse reactions between the combined group and the control group(6.38%vs 9.89%,P>0.05).Conclusion PPV combined with ILMP is more effective than PPV alone in treating refractory DME.It can not only effectively improve visual function but also reduce the degree of macular edema,with a favorable safety profile.

Abstract:Objective To analyze the efficacy of 4D digital orthoptics combined with conventional therapy for anisometropic amblyopia in children and its impact on visual acuity and accommodative function of the amblyopic eye.Methods A retrospective analysis was conducted on the clinical data of 150 children with anisometropic amblyopia admitted to Women's Hospital of Nanjing Medical University(Nanjing Women and Children's Healthcare Hospital)from October 2021 to November 2024.The patients were divided into the combined group(76 cases)and the control group(74 cases).The control group was treated with conventional therapy,while the combined group was treated with 4D digital orthoptics combined with conventional therapy.The clinical efficacy,the rate of abnormal stereoscopic vision turning normal,and the best corrected visual acuity,refractive error,and accommodative function(accommodative amplitude,accommodative facility,and accommodative lag)before and after treatment were compared.Results The total effective rate in the combined group was significantly higher than that in the control group(94.74%vs 83.78%,P<0.05).After treatment,the rate of abnormal stereoscopic vision turning normal in the combined group was significantly higher than that in the control group(85.53%vs 56.76%,P<0.05).After treatment,the best corrected visual acuity of children in both groups significantly increased,and the spherical equivalent refraction significantly decreased,with the combined group showing better outcomes in these indicators than the control group(P<0.05).After treatment,the accommodative amplitude and accommodative facility of children in both groups significantly increased,and the accommodative lag significantly decreased,with the combined group demonstrating superior results in these parameters compared to the control group(P<0.05).Conclusion 4D digital orthoptics combined with conventional therapy shows significant clinical efficacy in children with anisometropic amblyopia.It not only effectively improves the visual acuity of the amblyopic eye but also enhances the accommodative function of the amblyopic eye,indicating certain clinical application value.

Abstract:Objective To analyze the efficacy of the"three-step method"versus traditional ureteroscopic holmium laser lithotripsy(UHLL)in the treatment of ureteral calculi.Methods A total of 204 patients with ureteral calculi admitted to the Department of Urology,South Campus of Fengxian District Central Hospital,Shanghai from July 2022 to January 2025 were prospectively selected and divided into a control group(108 cases)and a study group(96 cases)according to the surgical method.The control group was treated with traditional UHLL,while the study group was treated with the"three-step method"using an occlusion catheter,holmium laser,and stone extraction basket.Perioperative indicators,stone escape rate,stone clearance rate,complications,and recurrence were compared between the two groups.Results In the study group,operation time,intraoperative blood loss,urinary catheter removal time,double-J stent removal time,and hospital stay were significantly lower/shorter than those in the control group[(22.85±3.06)min vs(26.33±3.47)min,P<0.001;(24.62±3.22)mL vs(27.04±3.91)mL,P<0.001;(3.14±0.52)d vs(4.96±1.05)d,P<0.001;(18.11±2.87)d vs(24.83±3.22)d,P<0.001;(5.36±1.25)d vs(6.92±1.46)d,P<0.001].The stone escape rate in the study group was lower than that in the control group,while the stone clearance rates at 1,2,and 3 months after surgery were higher(P<0.05).The complication incidence and recurrence rate in the study group were 6.25%and 4.17%,respectively,lower than the 15.74%and 12.04%in the control group(P<0.05).Conclusion Compared with traditional UHLL,the"three-step method"of occlusion catheter,holmium laser,and stone extraction basket can shorten operation and recovery time,reduce stone escape,improve stone clearance rate,and lower the risk of postoperative complications and recurrence in patients with ureteral calculi.

Abstract:Objective To investigate the evaluation value of serum complement C3 and C4 levels on disease activity and long-term prognosis of systemic lupus erythematosus(SLE).Methods A total of 108 patients with systemic lupus erythematosus(SLE)who attended Chizhou People's Hospital from February 2020 to June 2024 were selected retrospectively.They were divided into two groups based on prognosis:the good prognosis group(81 cases)and the poor prognosis group(27 cases).According to the SLE disease activity index score,the patients were categorized into the mild activity group(66 cases),the moderate activity group(31 cases),and the severe activity group(11 cases).The serum levels of complement C3 and C4 were compared among the three activity groups;receiver operating characteristic(ROC)curve analysis was used to evaluate the value of serum complement C3 and C4 levels in assessing SLE disease activity.General clinical data were compared between the two prognosis groups;multivariate logistic regression analysis was applied to identify the influencing factors of long-term prognosis in SLE patients;and ROC curve analysis was also used to assess the value of serum complement C3 and C4 levels in predicting the long-term prognosis of SLE patients.Results Compared with the mild activity group,serum complement C3 and C4 levels in the moderate activity group and the severe activity group were decreased(P<0.05).ROC curve analysis revealed that the areas under the curve(AUC)of serum complement C3,complement C4,and their combined detection(parallel mode)for evaluating disease activity in SLE patients were 0.679,0.786,and 0.912,respectively.The AUC of the combined detection was significantly superior to that of C3 or C4 alone(Z=3.210,2.870,P<0.05).Compared with the good prognosis group,the poor prognosis group had a higher incidence of organ involvement,poorer treatment adherence,elevated levels of immunoglobulin G(IgG),immunoglobulin A(IgA),and immunoglobulin M(IgM),as well as lower serum complement C3 and C4 levels(P<0.05).Multivariate logistic regression analysis revealed that the presence of organ involvement,elevated IgG,IgA and IgM levels and decreased complement C3 and C4 levels were independent risk factors for poor prognosis in SLE patients(OR=1.539,95%CI:1.069-2.216,P=0.021;OR=1.078,95%CI:1.030-1.128,P=0.001;OR=1.071,95%CI:1.028-1.116,P=0.001;OR=1.071,95%CI:1.024-1.121,P=0.003;OR=0.931,95%CI:0.887-0.978,P=0.005;OR=0.935,95%CI:0.885-0.988,P=0.017).For the evaluation of long-term prognosis in SLE patients,the AUC values of serum complement C3,complement C4,and their combined detection were 0.560,0.803 and 0.912,respectively.The AUC of the combined detection was significantly better than that of C3 alone(Z=4.010,P<0.001).Conclusion Serum levels of complement C3 and C4 and their combination have good evaluation value for disease activity and long-term prognosis in SLE patients.The presence of organ involvement,elevated IgG,IgA,IgM,and decreased serum complement C3 and C4 levels are risk factors affecting the long-term prognosis of SLE patients.

Abstract:Objective To explore the effectiveness of laparoscopic repair of hiatal hernia(HH)combined with Nissen fundoplication on HH and its impact on the quality of life.Methods A retrospective selection was conducted on 80 patients with HH who were treated at the Affiliated Hospital of Xuzhou Medical University from June 2021 to June 2023.They were divided into a control group(40 cases,treated with conventional open surgery)and an observation group(40 cases,treated with laparoscopic HH repair combined with Nissen fundoplication)based on different surgical methods.The surgical-related indicators,symptom improvement,quality of life,and adverse reactions were compared between the two groups.Results The operation time and hospital stay in the observation group were shorter than those in the control group(P<0.05),and the intraoperative blood loss was less than that in the control group(P<0.05).At 3 months after surgery,the chest pain and reflux scores of the Reflux Disease Questionnaire decreased in both groups(P<0.05),and the observation group was lower than the control group(P<0.05).At 3 months after surgery,the Gastrointestinal Quality of Life Index scores increased in both groups(P<0.05),and the observation group was significantly higher than the control group(P<0.05).The total incidence of adverse reactions in the observation group(5.00%)was significantly lower than that in the control group(30.00%)(P<0.05).Conclusion Laparoscopic HH repair combined with Nissen fundoplication can effectively improve the symptoms and surgical-related indicators of HH patients,improve their quality of life,reduce the incidence of adverse reactions,and has good safety.

Abstract:Objective To obtain the multidrug resistance status and the distribution of mutation loci in rifampicin/isoniazid resistance-related genes in clinically isolated strains from tuberculosis patients in Meigu County,Liangshan Yi Autonomous Prefecture,and to understand the transmission relationship of drug-resistant strains among tuberculosis patients in 2024.Methods A total of 378 clinical isolates from culture-positive tuberculosis patients were collected from the Meigu County Center for Disease Control and Prevention in Liangshan Yi Autonomous Prefecture between 2022 and 2024.Drug resistance patterns and resistance gene mutation sites were obtained using the DNA microarray chip method.Whole genome sequencing was performed on clinically isolated strains from patients with drug-resistant tuberculosis identified by the DNA microarray chip method to obtain the clustering rate of drug-resistant clinical isolates and to analyze the transmission patterns of Mycobacterium tuberculosis.Results From 2022 to 2024,the resistance rates of rifampicin,isoniazid,and multidrug resistance all showed an initial increase followed by a decrease.However,only the fluctuation in the isoniazid resistance rate was significant,with a statistically significant difference(χ2=6.277,P=0.043).There were no statistically significant differences in the resistance rates of rifampicin-resistant tuberculosis,isoniazid-resistant tuberculosis(HR-TB),and multidrug-resistant tuberculosis between different genders(P>0.05).The HR-TB resistance rate in patients aged 18-60 years was significantly higher than that in patients aged 0-18 years and>60 years(P<0.05).The chip method detected 31 rpoB mutant drug-resistant strains,including 25 strains with single-site mutations and 6 strains with double-site mutations.Among the 19 isoniazid-resistant strains detected by the chip method,15 had a single mutation at the katG 315 locus and 4 had mutations at the inhA locus.Whole genome sequencing was performed on 8 clinically isolated strains identified as drug-resistant by the chip method in 2024.Two strains with no detected genomic mutations were classified as sensitive strains,and 6 were drug-resistant strains(one of which was inconsistent).The consistency rate between the two methods was 62.50%.The main transmission lineages were lineage 2(East Asian genotype,accounting for 37.50%)and lineage 4(Euro-American genotype,accounting for 62.50%).Conclusion The drug resistance rate among tuberculosis patients in Meigu County shows unstable fluctuations,suggesting the persistence of non-standardized treatment.It is necessary to strengthen the monitoring of treatment compliance,with particular attention to the implementation of isoniazid treatment regimens.Young and middle-aged individuals aged 18-60 years are a high-risk population for drug resistance,and targeted screening and intervention should be implemented.

Abstract:Objective Based on the Global Burden of Disease Study 2021(GBD 2021),this study analyzes the changes and trends in the disease burden of orofacial clefts(OFCs)among children aged 0-14 years in China from 1990 to 2021.Methods Data on the incidence,prevalence,and disability-adjusted life years(DALYs)of OFC in Chinese children aged 0-14 years from 1990 to 2021 were extracted from the GBD 2021 database.The Joinpoint regression model was used to calculate the annual percent change and average annual percent change(AAPC)of OFC,and to analyze its long-term trends.The trend of DALY for OFC among Chinese children from 2022 to 2050 was also predicted.Results From 1990 to 2021,the incidence rate,prevalence rate,and DALY rate of OFC in Chinese children showed a significant downward trend,with the decline in the DALY rate being particularly pronounced.In 2021,the number of incident cases,prevalent cases,and DALYs of OFC in children were 12 000,116 700,and 16 100 person-years,respectively,representing decreases of 71.43%,43.97%,and 97.06%compared with 1990.The age-standardized incidence rate,age-standardized prevalence rate,and age-standardized DALY rate in 2021 were 3.87/100 000,35.25/100 000,and 5.04/100 000,respectively,which decreased by 58.86%,24.76%,and 95.88%compared with 1990.From 1990 to 2021,the disease burden of OFC in Chinese children showed a significant downward trend.The AAPC of the age-standardized incidence rate for boys and girls were-3.04%(95%CI:-3.77%--2.31%,P<0.001)and-2.78%(95%CI:-3.43%--2.12%,P<0.001),respectively;the AAPC of the age-standardized prevalence rate were-1%(95%CI:-1.16%--0.85%,P<0.001)and-0.96%(95%CI:-1.10%--0.81%,P<0.001),respectively;the AAPC of the age-standardized DALY rate were-9.97%(95%CI:-10.51%--9.43%,P<0.001)and-10.24%(95%CI:-10.93%--9.55%,P<0.001),respectively.It is predicted that the DALY rate in the<5 years age group will decrease to 6.05/100 000(3.67/100 000-9.18/100 000)by 2050,a decline of 56.82%compared with 2022;the DALY rate in the 5-14 years age group will decrease to 1.87/100 000(1.13/100 000-2.93/100 000)by 2050,a decline of 2.10%compared with 2022.Conclusion From 1990 to 2021,the incidence and prevalence of OFC in Chinese children showed a significant downward trend,with the DALY rate declining the fastest.Compared with girls,the decline in disease burden was more pronounced in boys.Therefore,greater attention should be paid to the prevention,treatment,and screening of OFC in children in the future,and strategies for the prevention and treatment of birth defects in line with China's national conditions should be further strengthened.The focus of OFC prevention and treatment in China should shift from reducing mortality to comprehensively improving the quality of life of affected children.

Abstract:Objective To investigate the value of nano-carbon tracer sentinel lymph node(NCT-SLN)biopsy and microRNA(miR)-3613,miR-29a in the risk stratification of early endometrial cancer(EC).Methods A 1:1 matched case-control study was conducted.Patients with early intermediate-high risk EC admitted to Chenzhou No.1 People's Hospital from October 2022 to July 2024 were selected as the observation group(146 cases),and patients with early low-risk EC during the same period were selected as the control group(100 cases).General data,conventional tumor markers[carbohydrate antigen 125(CA125),carcinoembryonic antigen(CEA),human epididymis protein 4(HE4)],NCT-SLN positive rate,and levels of miR-3613 and miR-29a were compared between the two groups.The NCT-SLN positive rate and levels of miR-3613 and miR-29a were compared among observation group patients with different pathological characteristics.Contingency correlation coefficient was used to analyze the correlation between NCT-SLN positivity and clinicopathological characteristics.Spearman rank correlation was used to analyze the correlation of miR-3613 and miR-29a with clinicopathological characteristics.ROC curve analysis was used to evaluate the predictive value of miR-3613,miR-29a,NCT-SLN,CA125,CEA,and HE4 for early EC risk stratification.Results The observation group had higher age,serum CA125,CEA,HE4 levels and NCT-SLN positive rate than the control group,and lower serum miR-3613 and miR-29a levels than the control group(P<0.05).Intermediate-high risk EC patients with tumor diameter≥5 cm,low differentiation,FIGO stage Ⅱ,and deep myometrial invasion had a higher NCT-SLN positive rate and lower miR-3613 and miR-29a levels than those with tumor diameter<5 cm,moderate-high differentiation,FIGO stage Ⅰ,and superficial myometrial invasion(P<0.05).Correlation analysis showed that tumor diameter,FIGO stage,and myometrial invasion were positively correlated with NCT-SLN positive rate(P<0.001),and negatively correlated with miR-3613 and miR-29a(P<0.001).Differentiation degree was negatively correlated with NCT-SLN positive rate(P<0.001),and positively correlated with miR-3613 and miR-29a(P<0.001).ROC curve analysis showed that the AUC of M1 for predicting early EC risk stratification was 0.948,which was better than M2 and individual detection(P<0.05).Conclusion NCT-SLN biopsy combined with serum levels of miR-3613,miR-29a,CA125,CEA,and HE4 has certain predictive value for early EC risk stratification,which can serve as a new protocol for early clinical risk stratification and guide clinical decision-making.

Abstract:Objective To systematically evaluate the efficacy and safety of GLP-1 receptor agonist(GLP-1RA)fixed-dose combination or combination with insulin in patients with poorly controlled type 2 diabetes mellitus(T2DM).Methods Databases including PubMed,Embase,Cochrane Library,CNKI,Sinomed,VIP,and Wanfang were searched from inception to October 20,2024.Randomized controlled trials(RCT)involving T2DM patients with poor glycemic control treated with GLP-1RA fixed-dose combinations or GLP-1RA combined with insulin were strictly screened according to inclusion and exclusion criteria.Data were extracted and a network meta-analysis was conducted.Results A total of 40 RCTs involving 18 215 T2DM patients were included.Compared with GLP-1RA,Tirzepatide and Semaglutide combined with insulin showed superior effects in reducing HbA1c(WMD:-1.38,95%CI:-2.03--0.73;WMD:-1.30,95%CI:-2.02--0.58)and fasting plasma glucose(WMD:-3.30,95%CI:-4.17--2.43;WMD:-2.93,95%CI:-3.90--1.96).There was no significant difference in reducing 2-hour postprandial blood glucose(the 95%CI of WMD included 0).Tirzepatide demonstrated excellent weight loss effect(WMD:-6.23,95%CI:-9.45--3.01).No significant differences were observed in the risks of total adverse events,severe hypoglycemia,pancreatitis,or major adverse cardiovascular events(the 95%CI of OR included 1).Semaglutide combined with insulin had a higher risk of discontinuation due to adverse events(OR=6.76,95%CI:1.50-30.49).Conclusion In patients with poorly controlled T2DM,Tirzepatide provides the best glycemic control and weight management effects with high safety;Semaglutide combined with insulin offers excellent glycemic control and high safety,but carries a higher risk of discontinuation due to adverse events.Although GLP-1RA combined with insulin enhances glycemic control,the complexity of treatment requires careful consideration.This study provides evidence-based insights for clinical treatment strategies.

Abstract:Objective To investigate the expression levels and clinical significance of serum microRNA-143(miR-143)and microRNA-155(miR-155)in children with recurrent oral ulcer(ROU).Methods Ninety-six children with ROU admitted to Beijing Children's Hospital Baoding Hospital,Capital Medical University from January 2020 to August 2023 were selected as the observation group,and 96 healthy children undergoing physical examination during the same period were selected as the control group.Serum levels of miR-143 and miR-155 were detected and compared between the two groups.Children in the observation group were followed up for 6 months after treatment.Those with recurrence frequency<2 times were included in the non-recurrence group(n=53),and those with recurrence frequency≥2 times were included in the recurrence group(n=43).Serum miR-143,miR-155 levels and clinical data were compared between the recurrence and non-recurrence groups.Logistic regression was used to analyze the influencing factors for recurrence in children with ROU.Receiver operating characteristic(ROC)curve was used to analyze the value of serum miR-143 and miR-155 in predicting recurrence in children with ROU.Results The serum miR-143 level in the observation group before treatment was significantly lower than that after treatment and that in the control group(P<0.05),while the serum miR-155 level before treatment was significantly higher than that after treatment and that in the control group(P<0.05).The proportion of ulcer diameter≥5 mm,the level of tumor necrosis factor-α(TNF-α),and the miR-155 level in the recurrence group were significantly higher than those in the non-recurrence group(P<0.05),while the miR-143 level was significantly lower than that in the non-recurrence group(P<0.05).Serum miR-143 in children with ROU was positively correlated with CD4+and CD8+,and negatively correlated with interleukin(IL)-2,IL-6,and TNF-α(P<0.05).Serum miR-155 was negatively correlated with CD4+and CD8+,and positively correlated with IL-2,IL-6,and TNF-α(P<0.05).MiR-143 was a protective factor against recurrence in children with ROU(P<0.05),while miR-155 was a risk factor for recurrence(P<0.05).The area under the curve(AUC)of serum miR-143 and miR-155 for predicting recurrence in children with ROU was 0.823 and 0.833,with sensitivity of 67.44%and 72.09%,and specificity of 84.91%and 83.02%,respectively.The AUC of the combination prediction was 0.917,with a sensitivity of 90.70%and a specificity of 83.02%.The combined prediction was superior to either marker alone(Z combination vs miR-143=2.153,P=0.031;Z combination vs miR-155=2.294,P=0.022).Conclusion Serum miR-143 level decreased and miR-155 level increased in children with ROU,and the combination of the two has high prognostic value for ROU.

Abstract:Cervical cancer is a common malignancy that seriously threatens women's health.Cisplatin-based chemotherapy is an important treatment for cervical cancer,but the development of drug resistance often leads to treatment failure.Autophagy plays a dual role in tumor development,and its abnormal activation is a key mechanism mediating cisplatin resistance in cervical cancer.Traditional Chinese medicine monomers offer advantages such as multi-target effects,low toxicity,and synergistic benefits,demonstrating great potential in reversing tumor drug resistance.This article aims to review recent advances in three categories of traditional Chinese medicine monomers—flavonoids,alkaloids,and terpenoids—in reversing cisplatin resistance in cervical cancer by regulating key signaling pathways such as PI3K/Akt/mTOR,AMPK,and MAPK,and intervening in autophagy processes.The article will focus on the mechanisms of action of each type of monomer,with the goal of providing a theoretical reference for understanding the molecular mechanisms of traditional Chinese medicine monomers in reversing drug resistance and developing new clinical combination drug strategies.

Abstract:Objective To explore the effect of digital occupational therapy training system combined with electrical stimulation in the treatment of patients with stroke hemiplegia.Methods A total of 126 patients with stroke hemiplegia admitted to Anhui Province Wannan Rehabilitation Hospital(Wuhu Fifth Hospital)from January 2023 to June 2025 were selected as subjects and divided into a control group and a combined group using a random number table,with 63 cases in each group.The control group received electrical stimulation on the basis of routine rehabilitation training,while the combined group received additional digital occupational therapy training system treatment based on the control group's regimen.Both groups were treated continuously for 1 month.Surface electromyography parameters,upper limb function[Fugl-Meyer assessment scale upper extremity(FMA-UE),action research arm test(ARAT)],motor function[Wolf motor function test(WMFT)],cognitive function[Montreal cognitive assessment scale(MoCA)],self-care ability[modified Barthel index(MBI)],and quality of life[stroke-specific quality of life scale(SS-QOL)]were compared between the two groups before and after treatment.Results After treatment,both groups showed increases in surface electromyography parameters—including average electromyography amplitude,root mean square,and mean power frequency—as well as in FMA-UE,ARAT,WMFT,MoCA,MBI,and SS-QOL scores compared with those before treatment.The combined group showed higher values than the control group,and all differences were statistically significant(P<0.05).Conclusion electrical stimulation combined with Digital occupational therapy training system is effective in improving upper limb function,cognitive function,self-care ability,and quality of life in patients with stroke hemiplegia.

Abstract:Objective To evaluate the quality of life in patients with inflammatory bowel disease(IBD)with fatigue,and to explore its multidimensional influencing factors.Methods A total of 138 IBD patients with fatigue admitted to The First Affiliated Hospital of Nanjing Medical University from January 2023 to June 2024 were selected.The Inflammatory Bowel Disease Questionnaire(IBDQ),Multidimensional Fatigue Inventory(MFI),Symptom Checklist-90(SCL-90),and Self-rating Anxiety Scale(SAS)scores were assessed,along with daily diarrhea frequency;C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)levels were measured.Pearson correlation analysis was used to analyze the correlation between IBDQ scores and MFI,SCL-90,SAS scores,CRP,ESR,and daily diarrhea frequency.IBDQ scores were compared among IBD patients with fatigue having different clinical characteristics,and multiple linear regression analysis was used to identify the influencing factors of quality of life in these patients.Results The scores of IBDQ,MFI,SCL-90 and SAS in IBD patients with fatigue were(154.82±22.07),(53.41±11.24),(139.75±18.54)and(46.29±7.36),respectively.The levels of CRP and ESR in IBD patients with fatigue were(29.63±7.21)mg/L and(25.45±6.08)mm/h,respectively.Single sample t-test showed that the mean values of CRP and ESR in patients were significantly higher than the normal reference ranges(P<0.05).There were 104 cases with abnormal CRP,with an abnormal rate of 75.36%,and 112 cases with abnormal ESR,with an abnormal rate of 81.16%.The daily diarrhea frequency in IBD patients with fatigue was(8.71±1.39)times.Correlation analysis revealed that IBDQ scores were negatively correlated with MFI,SCL-90,SAS scores,CRP,ESR,and daily diarrhea frequency in IBD patients with fatigue(P<0.05).There were statistically significant differences in IBDQ scores among IBD patients with fatigue of different ages,disease activity,disease severity,extraintestinal manifestations,SCL-90 scores,and SAS scores(P<0.05).Multiple linear regression analysis indicated that age,disease activity,disease severity,MFI score,extraintestinal manifestations,SCL-90 score,and SAS score were independent influencing factors for quality of life in IBD patients with fatigue(P<0.05).Conclusion The quality of life is at a lower-middle level in IBD patients with fatigue,and is mainly associated with age,disease activity and severity,complications,fatigue degree,and psychological factors.

Abstract:Objective To investigate the association between serum calcium levels at ICU admission and the occurrence of acute kidney injury(AKI)in patients with heart failure(HF).Methods This retrospective study included 5 112 HF patients from the Medical Information Mart for Intensive Care(MIMIC)-Ⅲ(2001-2012)and MIMIC-Ⅳ(2008-2019)databases who were admitted to the ICU for the first time,had a hospital stay of≥2 days,and were not diagnosed with AKI within 24 hours of admission.Based on the first serum calcium level measured within 24 hours of ICU admission,patients were categorized using three methods:(1)Quartile groups:≤7.20 mg/dL,(7.21,8.20)mg/dL,(8.21,8.80)mg/dL,and>8.80 mg/dL;(2)Clinical significance groups:hypocalcemia group(≤8.40 mg/dL),normal group(8.50-10.50 mg/dL),hypercalcemia group(>10.50 mg/dL);(3)K-means clustering groups:K-means cluster analysis was performed using the cluster package in R software,and patients were divided into C1(≤7.30 mg/dL),C2(7.30-8.70 mg/dL),and C3(>8.70 mg/dL)groups based on the distribution characteristics of serum calcium data.The primary outcome was the occurrence of AKI.Univariate and multivariate logistic regression analyses were used to assess the strength of association.Restricted cubic spline(RCS)curves were employed to analyze nonlinear relationships.Receiver operating characteristic(ROC)curves were used to evaluate predictive performance.Subgroup analyses were conducted based on age(≥65 years and<65 years)and Charlson Comorbidity Index(CCI≥5 and<5).Results During the follow-up period,2,424 patients(47.42%)developed AKI.After multivariate adjustment,compared with the serum calcium(7.21,8.20)mg/dL group,the≤7.20 mg/dL group had a significantly increased risk of AKI(OR=1.242,95%CI:1.050-1.460,P=0.011).This association remained significant in patients aged≥65 years(OR=1.30,95%CI:1.06-1.58)and in patients with CCI<5(OR=1.39,95%CI:1.07-1.81).The RCS curve showed an approximately U-shaped relationship between serum calcium and AKI risk.The area under the ROC curve was 0.609(95%CI:0.592-0.626).The AUC of the combined prediction model incorporating serum calcium and estimated glomerular filtration rate(eGFR)increased to 0.687(95%CI:0.671-0.703).Conclusion Serum calcium≤7.20 mg/dL at ICU admission is an independent risk factor for AKI in HF patients.Its predictive efficacy alone is limited,but it can improve predictive value when combined with eGFR.It can serve as a convenient and economical preliminary screening indicator for AKI risk in HF patients in the ICU,particularly suitable for elderly HF patients and those with fewer comorbidities,providing a key time window for precise monitoring and early intervention in the ICU.