Objective:To explore influence of fenofibrate on plasma level of brain natriuretic peptide (BNP) and heart rate variability (HRV) in aged patients with acute coronary syndrome (ACS) .Methods :A total of 150 aged ACS patients undergoing treatment in our hospital were selected ,randomly and equally divided into routine treat‐ment group and fenofibrate group .Changes of plasma BNP level ,HRV parameters , blood lipid levels ,and chest pain were compared between two groups before and after treatment .Results:After treatment ,BNP level signifi‐cantly reduced ,and HRV , blood lipid levels significantly improved in both groups , P<0.01 all .Compared with routine treatment group ,plasma BNP level significantly reduced [ (132.5 ± 22.1) pg/ml vs .(91.2 ± 13.7) pg/ml] ( P<0.01);there were significant rise in standard deviation of normal to normal RR intervals calculated over the 24 h period (SDNN) ,adjacent normal RR interval difference > 50ms stroke accounted for a percentage of 24h total RR interval (PNN50) ,root‐mean square of differences between successive normal to normal intervals (rMSSD) and high frequency (HF) ,and significant reduction in low frequency (LF) ,P<0.05 all;significant reductions in levels of TC ,TG and LDL‐C ,and significant rise in HDL‐C level ( P<0.01 all);there were significant reductions in on‐set duration [ (9.53 ± 5.34) min vs .(6.32 ± 2.13) min] and frequency [ (3.87 ± 1.13) times/d vs .(2.99 ± 1.14) times/d] of chest pain after treatment in fenofibrate group , P<0.01 both .Conclusion:Routine therapy combined fenofi‐brate can significantly reduce BNP level ,regulate blood lipid and autonomic nervous function in aged ACS patients .

Objective To observe the variety of liver and kidney function during lung transplantation and discuss its reference value of diagnosis and therapy in clinical acute rejection(AR).Methods The variety of TBIL, ALT and CRE were dynamically studied and analyzed before and after lung transplantation in 2 cases shared one same donor's lung block.Results During the use of CSA,TBIL diversely procedurally raised and it got right when AR was under control; when illness was worsen,ALT abnormally raised and CRE had no remarkably change.Conclusion TBIL is the sensitivity index of hepatotoxicity of immunity inhibitor CSA after lung transplantation. The abnormal change of ALT is the index of disease turnover.

The International Agency for Research on Cancer (IARC) defines shift work as any arrangement of daily working hours other than the standard daylight hours (typically 7:00/8:00 am–5:00/6:00 pm). To meet the needs of rapid socioeconomic development, shift work is becoming more and more common. The impact of shift work, especially night shift work, on human health cannot be ignored. Female's health is not only important to the well-being of themselves, but also has a far-reaching impact on their children and even their entire family. Increasing epidemiological studies have focused on the effects of night shift work on female's reproductive health. This article reviewed epidemiological evidence of the associations between night shift work and reproductive outcomes, e.g. menstrual cycle, endometriosis, pregnancy rate, adverse pregnancy outcomes, and ovarian cancer. The potential biological mechanisms connecting night shift work to female reproductive health were also introduced, e.g. melatonin regulation, clock gene regulation, and sex hormone regulation. Through this review, we propose to provide a reference for determining occupational risk factors, conducting subsequent relevant studies, and formulating rational health promotion strategies.

Objective:To investigate the effects of TRIB3 activation of Wnt/β-catenin signaling pathway on the growth and pro-liferation of laryngeal carcinoma TU686 cells in vitro and expression of peripheral immunosuppressive molecules in transplanted mice.Methods:Protein and RNA expressions of TRIB3 were detected in vitro cells(human immortalized epidermal cell line HaCat and laryngeal carcinoma cell line TU686)and tissues(laryngeal carcinoma and adjacent tissues),respectively.Laryngeal carcinoma TU686 cells were cultured in vitro and divided into negative control group(NC group)and TRIB3 knockdown group(sh-TRIB3 group),total protein and RNA of cells were extracted to verify the expression level of TRIB3 in two groups.After successful verifica-tion,proliferation ability of TU686 cells was detected by CCK-8,colony cloning and flow cytometry.Protein expression levels of Wnt,Cyclin-D1,C-myc,β-catenin and p-β-catenin in two groups were detected by Western blot.Correlation analysis verified the correla-tion between TRIB3 and Wnt,Cyclin-D1,C-myc,β-catenin,p-β-catenin protein expressions.TRIB3-low expressing nude mouse transplanted tumor model(TRIB3 sgRNA group)was constructed by knockdown the TRIB3 core plasmid,and a parallel control group(Control sgRNA group)was set up,tumor growth volume and weight were observed,and serum immunosuppressive molecules expres-sions was determined by ELISA.Results:Compared with HaCat cells and normal paracarcinoma tissues,TRIB3 was highly expressed in TU686 cells and laryngeal carcinoma tissues.Compared with negative control group,proliferation ability of TU686 cells was signifi-cantly inhibited after TRIB3 knockdown,and cell growth was blocked in G1/S phase.Expressions of Wnt,Cyclin-D1,C-myc andβ-catenin protein in Wnt/β-catenin signaling pathway were decreased significantly,while expression of p-β-catenin was increased significantly.TRIB3 was significantly correlated with protein expression levels of Wnt,Cyclin-D1,β-catenin and p-β-catenin.The in vivo results showed that compared with Control sgRNA group,tumor growth volume and weight of mice in TRIB3 sgRNA group were significantly decreased,and expressions of serum immunosuppressive molecules IL-4,IL-6,IL-10,TGF-β and PGE2 were signifi-cantly decreased.Conclusion:TRIB3 is highly expressed in TU686 cells,and TRIB3 can inhibit growth and proliferation of TU686 cells and transplanted tumors by activating Wnt/β-catenin-related signaling pathways,and reverse tumor immunosuppressive microen-vironment,suggesting that TRIB3 may be an effective target for laryngeal cancer.

Objective:To examine the impact of varied surgical treatment strategies on the prognosis of patients with initial resectable gastric cancer liver metastases (IR-GCLM).Methods:This is a retrospective cohort study. Employing a retrospective cohort design, the study selected clinicopathological data from the national multi-center retrospective cohort study database, focusing on 282 patients with IR-GCLM who underwent surgical intervention between January 2010 and December 2019. There were 231 males and 51 males, aging ( M(IQR)) 61 (14) years (range: 27 to 80 years). These patients were stratified into radical and palliative treatment groups based on treatment decisions. Survival curves were generated using the Kaplan-Meier method and distinctions in survival rates were assessed using the Log-rank test. The Cox risk regression model evaluated HR for various factors, controlling for confounders through multivariate analysis to comprehensively evaluate the influence of surgery on the prognosis of IR-GCLM patients. A restricted cubic spline Cox proportional hazard model assessed and delineated intricate associations between measured variables and prognosis. At the same time, the X-tile served as an auxiliary tool to identify critical thresholds in the survival analysis for IR-GCLM patients. Subgroup analysis was then conducted to identify potential beneficiary populations in different surgical treatments. Results:(1) The radical group comprised 118 patients, all undergoing R0 resection or local physical therapy of primary and metastatic lesions. The palliative group comprised 164 patients, with 52 cases undergoing palliative resections for gastric primary tumors and liver metastases, 56 cases undergoing radical resections for gastric primary tumors only, 45 cases undergoing palliative resections for gastric primary tumors, and 11 cases receiving palliative treatments for liver metastases. A statistically significant distinction was observed between the groups regarding the site and the number of liver metastases (both P<0.05). (2) The median overall survival (OS) of the 282 patients was 22.7 months (95% CI: 17.8 to 27.6 months), with 1-year and 3-year OS rates were 65.4% and 35.6%, respectively. The 1-year OS rates for patients in the radical surgical group and palliative surgical group were 68.3% and 63.1%, while the corresponding 3-year OS rates were 42.2% and 29.9%, respectively. A comparison of OS between the two groups showed no statistically significant difference ( P=0.254). Further analysis indicated that patients undergoing palliative gastric cancer resection alone had a significantly worse prognosis compared to other surgical options ( HR=1.98, 95% CI: 1.21 to 3.24, P=0.006). (3) The size of the primary gastric tumor significantly influenced the patients′ prognosis ( HR=2.01, 95% CI: 1.45 to 2.79, P<0.01), with HR showing a progressively increasing trend as tumor size increased. (4) Subgroup analysis indicates that radical treatment may be more effective compared to palliative treatment in the following specific cases: well/moderately differentiated tumors ( HR=2.84, 95% CI 1.49 to 5.41, P=0.001), and patients with liver metastases located in the left lobe of the liver ( HR=2.06, 95% CI 1.19 to 3.57, P=0.010). Conclusions:In patients with IR-GCLM, radical surgery did not produce a significant improvement in the overall prognosis compared to palliative surgery. However, within specific patient subgroups (well/moderately differentiated tumors, and patients with liver metastases located in the left lobe of the liver), radical treatment can significantly improve prognosis compared to palliative approaches.

Objective:To examine the impact of varied surgical treatment strategies on the prognosis of patients with initial resectable gastric cancer liver metastases (IR-GCLM).Methods:This is a retrospective cohort study. Employing a retrospective cohort design, the study selected clinicopathological data from the national multi-center retrospective cohort study database, focusing on 282 patients with IR-GCLM who underwent surgical intervention between January 2010 and December 2019. There were 231 males and 51 males, aging ( M(IQR)) 61 (14) years (range: 27 to 80 years). These patients were stratified into radical and palliative treatment groups based on treatment decisions. Survival curves were generated using the Kaplan-Meier method and distinctions in survival rates were assessed using the Log-rank test. The Cox risk regression model evaluated HR for various factors, controlling for confounders through multivariate analysis to comprehensively evaluate the influence of surgery on the prognosis of IR-GCLM patients. A restricted cubic spline Cox proportional hazard model assessed and delineated intricate associations between measured variables and prognosis. At the same time, the X-tile served as an auxiliary tool to identify critical thresholds in the survival analysis for IR-GCLM patients. Subgroup analysis was then conducted to identify potential beneficiary populations in different surgical treatments. Results:(1) The radical group comprised 118 patients, all undergoing R0 resection or local physical therapy of primary and metastatic lesions. The palliative group comprised 164 patients, with 52 cases undergoing palliative resections for gastric primary tumors and liver metastases, 56 cases undergoing radical resections for gastric primary tumors only, 45 cases undergoing palliative resections for gastric primary tumors, and 11 cases receiving palliative treatments for liver metastases. A statistically significant distinction was observed between the groups regarding the site and the number of liver metastases (both P<0.05). (2) The median overall survival (OS) of the 282 patients was 22.7 months (95% CI: 17.8 to 27.6 months), with 1-year and 3-year OS rates were 65.4% and 35.6%, respectively. The 1-year OS rates for patients in the radical surgical group and palliative surgical group were 68.3% and 63.1%, while the corresponding 3-year OS rates were 42.2% and 29.9%, respectively. A comparison of OS between the two groups showed no statistically significant difference ( P=0.254). Further analysis indicated that patients undergoing palliative gastric cancer resection alone had a significantly worse prognosis compared to other surgical options ( HR=1.98, 95% CI: 1.21 to 3.24, P=0.006). (3) The size of the primary gastric tumor significantly influenced the patients′ prognosis ( HR=2.01, 95% CI: 1.45 to 2.79, P<0.01), with HR showing a progressively increasing trend as tumor size increased. (4) Subgroup analysis indicates that radical treatment may be more effective compared to palliative treatment in the following specific cases: well/moderately differentiated tumors ( HR=2.84, 95% CI 1.49 to 5.41, P=0.001), and patients with liver metastases located in the left lobe of the liver ( HR=2.06, 95% CI 1.19 to 3.57, P=0.010). Conclusions:In patients with IR-GCLM, radical surgery did not produce a significant improvement in the overall prognosis compared to palliative surgery. However, within specific patient subgroups (well/moderately differentiated tumors, and patients with liver metastases located in the left lobe of the liver), radical treatment can significantly improve prognosis compared to palliative approaches.

Objective:To investigate the prognosis of patients with initially resectable gastric cancer liver metastasis (GCLM) who were treated by different modalities, and analyze the influencing factors for prognosis of patients.Methods:The retrospective cohort study was conducted. The clinicopathological data of 327 patients with initially resectable GCLM who were included in the database of a nationwide multicenter retrospective cohort study on GCLM based on real-world data from January 2010 to December 2019 were collected. There were 267 males and 60 females, aged 61(54,68)years. According to the specific situations of patients, treatment modalities included radical surgery combined with systemic treatment, palliative surgery combined with systemic treatment, and systemic treatment alone. Observation indicators: (1) clinical characteristics of patients who were treated by different modalities; (2) prognostic outcomes of patients who were treated by different modalities; (3) analysis of influencing factors for prognosis of patients with initially resectable GCLM; (4) screening of potential beneficiaries in patients who were treated by radical surgery plus systemic treatment and patients who were treated by palliative surgery plus systemic treatment. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. The Kaplan-Meier method was used to calculate survival rate and draw survival curve, and Log-Rank test was used for survival analysis. Univariate and multivariate analyses were conducted using the COX proportional hazard regression model. The propensity score matching was employed by the 1:1 nearest neighbor matching method with a caliper value of 0.1. The forest plots were utilized to evaluate potential benefits of diverse surgical combined with systemic treatments within the population. Results:(1) Clinical characteristics of patients who were treated by different modalities. Of 327 patients, there were 118 cases undergoing radical surgery plus systemic treatment, 164 cases undergoing palliative surgery plus systemic treatment, and 45 cases undergoing systemic treatment alone. There were significant differences in smoking, drinking, site of primary gastric tumor, diameter of primary gastric tumor, site of liver metastasis, and metastatic interval among the three groups of patients ( P<0.05). (2) Prognostic outcomes of patients who were treated by different modalities. The median overall survival time of the 327 pati-ents was 19.9 months (95% confidence interval as 14.9-24.9 months), with 1-, 3-year overall survival rate of 61.3%, 32.7%, respectively. The 1-year overall survival rates of patients undergoing radical surgery plus systemic treatment, palliative surgery plus systemic treatment and systemic treatment alone were 68.3%, 63.1%, 30.6%, and the 3-year overall survival rates were 41.1%, 29.9%, 11.9%, showing a significant difference in overall survival rate among the three groups of patients ( χ2=19.46, P<0.05). Results of further analysis showed that there was a significant difference in overall survival rate between patients undergoing radical surgery plus systemic treatment and patients undergoing systemic treatment alone ( hazard ratio=0.40, 95% confidence interval as 0.26-0.61, P<0.05), between patients undergoing palliative surgery plus systemic treatment and patients under-going systemic treatment alone ( hazard ratio=0.47, 95% confidence interval as 0.32-0.71, P<0.05). (3) Analysis of influencing factors for prognosis of patients with initially resectable GCLM. Results of multivariate analysis showed that the larger primary gastric tumor, poorly differentiated tumor, larger liver metastasis, multiple hepatic metastases were independent risk factors for prognosis of patients with initially resectable GCLM ( hazard ratio=1.20, 1.70, 1.20, 2.06, 95% confidence interval as 1.14-1.27, 1.25-2.31, 1.04-1.42, 1.45-2.92, P<0.05) and immunotherapy or targeted therapy, the treatment modality of radical or palliative surgery plus systemic therapy were independent protective factors for prognosis of patients with initially resectable GCLM ( hazard ratio=0.60, 0.39, 0.46, 95% confidence interval as 0.42-0.87, 0.25-0.60, 0.30-0.70, P<0.05). (4) Screening of potentinal beneficiaries in patients who were treated by radical surgery plus systemic treatment and patients who were treated by palliative surgery plus systemic treatment. Results of forest plots analysis showed that for patients with high-moderate differentiated GCLM and patients with liver metastasis located in the left liver, the overall survival rate of patients undergoing radical surgery plus systemic treatment was better than patients undergoing palliative surgery plus systemic treatment ( hazard ratio=0.21, 0.42, 95% confidence interval as 0.09-0.48, 0.23-0.78, P<0.05). Conclusions:Compared to systemic therapy alone, both radical and palliative surgery plus systemic therapy can improve the pro-gnosis of patients with initially resectable GCLM. The larger primary gastric tumor, poorly differen-tiated tumor, larger liver metastasis, multiple hepatic metastases are independent risk factors for prognosis of patients with initial resectable GCLM and immunotherapy or targeted therapy, the treatment modality of radical or palliative surgery plus systemic therapy are independent protective factors for prognosis of patients with initially resectable GCLM.

ObjectiveTo observe the clinical efficacy of Shentong Zhuyutang combined with Dilongtang in the treatment of lumbar disc herniation （LDH） with Qi stagnation and blood stasis syndrome， and its effect on nucleus pulposus reabsorption and immune-inflammatory factors， exploring its therapeutic mechanism from the perspective of reabsorption. MethodsA total of 120 patients with LDH from the Fourth Clinical Medical College of Guangzhou University of Chinese Medicine， treated between June 2020 and January 2023， were randomly divided into the control group （52 cases， with 8 dropouts） and the observation group （49 cases， with 11 dropouts） according to a random number table. The control group received routine treatment， while the observation group was treated with Shentong Zhuyutang combined with Dilongtang in addition to routine treatment. Visual Analogue Scale （VAS）， Oswestry Disability Index （ODI）， Japanese Orthopaedic Association （JOA） score， and traditional Chinese medicine （TCM） syndrome score were measured before treatment and after 3 courses of treatment. Venous blood samples were collected for the determination of serological indexes. MR examination was performed during the 6-month follow-up to calculate the absorption rate. ResultsAfter treatment， both groups showed significant reductions in VAS， ODI， TCM syndrome score， serum tumor necrosis factor （TNF）-α， matrix metalloproteinase （MMP）-9， and vascular endothelial growth factor （VEGF） levels， and a significant increase in JOA score compared with pre-treatment values （P<0.05）. Compared with the control group， the observation group showed significantly lower VAS， ODI， TCM syndrome score， serum TNF-α， MMP-9， and VEGF levels， and a significantly higher JOA score （P<0.05）. The proportion of nucleus pulposus reabsorption in the observation group was 57.14% （28/49）， significantly higher than 21.15% （11/52） in the control group （χ²=6.161， P<0.05）. ConclusionShentong Zhuyutang combined with Dilongtang can effectively relieve pain， improve lumbar function， and alleviate TCM clinical symptoms in LDH patients with Qi stagnation and blood stasis syndrome. Imaging findings suggest that the treatment promotes the reabsorption of nucleus pulposus protrusion， while laboratory testing shows reduced serum levels of TNF-α， MMP-9， and VEGF， which contribute to the rehabilitation of patients.