ObjectiveTo explore the possible mechanism of Yigan Fupi Prescription （抑肝扶脾方， YFP） in treating diarrhea-type irritable bowel syndrome （IBS-D） by investigating the AKT/mTOR signaling pathway. MethodsSixty SD rats were randomly divided into control group， model group， YFP low-， medium-， and high-dose group， and pinaverium bromide group， with 10 rats in each group. All groups but the control group， were subjected to 21 days of tail-clamping stimulation and 14 days of senna leaf gavage to establish a liver stagnation and spleen deficiency-type IBS-D rat model. After successful modeling， the YFP low-， medium-， and high-dose group were administered 0.96， 1.93， and 3.87 g/（kg·d） of the prescription， respectively. The pinaverium bromide group was given 13.5 mg/（kg·d）， while the control and model groups were given 10 ml/（kg·d） distilled water. All groups were administered once daily for 14 consecutive days. General conditions of the rats were recorded during the experiment， and after modeling and drug administration， body weight， Bristol stool score， abdominal withdrawal reflex （AWR） score， and histo pathology of colon tissue were observed under HE staining. ELISA was used to detect serum levels of tumor necrosis factor α （TNF-α）， interleukin-1β （IL-1β）， and interleukin-6 （IL-6）. Immunofluorescence was employed to detect the levels of AKT/mTOR pathway-related proteins including phosphorylated AKT （p-AKT）/AKT and phosphorylated mTOR （p-mTOR）/mTOR in the colon tissue. Western Blotting was used to detect the levels of autophagy-related proteins， including UNC-51-like kinase 1 （ULK1）， Beclin1 and LC3， and tight junction proteins including Occludin and ZO-1 in the colon tissue. ResultsAfter modeling， compared to the control group， the body weight of rats in the other groups decreased， and Bristol stool scores， as well as AWR scores under 20， 40， 60， and 80 mmHg increased （P＜0.05 or P＜0.01）. After drug administration， compared to the control group， the model group showed reduced body weight， decreased ULK1， Beclin1， LC3Ⅱ/LC3Ⅰ， Occludin， and ZO-1 protein levels in the colon tissue （P＜0.05 or P＜0.01）， and increased Bristol stool scores， AWR scores， serum TNF-α， IL-1β， and IL-6 levels， as well as p-AKT/AKT and p-mTOR/mTOR protein relative expression levels （P＜0.05 or P＜0.01）. Pathological results showed a significant reduction in goblet cells in the upper part of the glandular layer of the colon， with mild inflammatory cell infiltration. The submucosal collagen fibers were dissolved， with unclear boundaries， pale staining， and microvascular congestion and dilation. Compared with the model group， the YFP low-， medium-， and high-dose group and the pinaverium bromide group showed increased body weight， Beclin1， Occludin， and LC3Ⅱ/LC3Ⅰ protein levels （P＜0.05 or P＜0.01）， and decreased Bristol stool scores， AWR scores under 40， 60， and 80 mmHg， serum IL-1β， IL-6， TNF-α levels， and p-AKT/AKT， p-mTOR/mTOR protein relative expression levels （P＜0.05 or P＜0.01）. The pathological morphology of the rats in the YFP groups and pinaverium bromide group showed varying degrees of improvement. Compared with the pinaverium bromide group， the YFP low- and medium-dose group showed increased AWR scores under 20， 40， and 60 mmHg （P＜0.05）. The YFP low-dose group had reduced TNF-α， IL-1β， and IL-6 levels， and increased p-mTOR/mTOR protein relative expression levels occured in all YFP groups （P＜0.05）. Compared with the YFP low-dose group， the YFP high-dose group and pinaverium bromide group showed decreased AWR scores under different pressure levels and reduced p-AKT/AKT protein relative expression levels， while the YFP medium- and high-dose group had elevated serum TNF-α， IL-1β levels and reduced p-mTOR/mTOR protein relative expression levels （P＜0.05）. ConclusionYFP can effectively improve the pathological injury of colon tissue in IBS-D model rats with liver stagnation and spleen deficiency， reduce Bristol stool and AWR scores， and its mechanism may be related to reducing level of inflammatory factors and inhibiting AKT/mTOR pathway-related proteins in colon tissue， thereby enhancing the expression of autophagy-related proteins in the colon tissue.

Objective:To analyze the epidemiological, etiological characteristics and transmission of an imported D8 genotype measles case in a child in Shandong Province, August 2023.Methods:A study was conducted on a measles case and 16 contacts in Shandong Province in August 2023. Field epidemiological surveys, including recent exposure and immunization history, were conducted. Serum and throat swab samples were collected from all 16 subjects. Measles IgM and IgG antibody levels and avidity were measured by ELISA, while virus detection and genotyping were performed using fluorescence quantitative PCR and RT-PCR. Genetic evolutionary analysis of the obtained sequences was conducted using MEGA and Beast software.Results:The case was an 11-year-old boy, a fifth-grade student, who developed symptoms on August 28, 2023. A total of five close contacts were investigated, including three family members (grandfather, father and sister) and two playmates. Additionally, 11 classmates who had close contact with the case′s sister during the infectious period (within five days after the rash onset) were also investigated. Among the 16 serum samples tested, only one case was positive for IgM, while the other 15 samples were negative for IgM. The results of the serum antibody avidity test showed that among the 16 serum samples, 14 were positive for IgG. Of these, eight had a relative avidity index >55%, indicating high-avidity antibodies; one had a relative avidity index <45%, indicating low-avidity antibodies; and five had an avidity index between 45% and 55%. The IgG detection OD values for the case′s sister and grandfather were higher than those of the other contacts. Based on the vaccination history of the subjects and the results of IgM and IgG tests, it was preliminarily determined that the case had a recent wild-type measles virus infection. The case′s sister and grandfather had a history of measles wild-type virus infection, while the high-avidity antibodies in the other contacts were likely induced by the measles vaccine. The results of the pharyngeal swab tests showed that only the case was positive for measles virus nucleic acid, while the remaining 15 samples were negative for measles virus. The genetic evolutionary analysis revealed that the viral sequence of this case (Mvs/Shandong.CHN/38.23) had a 100% homology with the Hong Kong strain sequence from August 2023. It belonged to a different transmission chain from the D8 genotype strains that appeared in Shandong Province between 2018 and 2019, with sequence homology ranging from 98.0% to 98.8%. The sequence homology within the transmission chain of this case was between 99.1% and 100%. The evolutionary rate of this transmission chain was approximately 8.38×10 -3 sub/site/year, and the most recent common ancestor was estimated to have emerged around the year 2011. Conclusion:This case is the first imported D8 genotype measles case in Shandong Province. There is no spatio-temporal correlation between this case and adult cases of D8 genotype imported from Shandong Province in 2018-2019, indicating a new D8 genotype imported epidemic.

Objective:To analyze the epidemiological, etiological characteristics and transmission of an imported D8 genotype measles case in a child in Shandong Province, August 2023.Methods:A study was conducted on a measles case and 16 contacts in Shandong Province in August 2023. Field epidemiological surveys, including recent exposure and immunization history, were conducted. Serum and throat swab samples were collected from all 16 subjects. Measles IgM and IgG antibody levels and avidity were measured by ELISA, while virus detection and genotyping were performed using fluorescence quantitative PCR and RT-PCR. Genetic evolutionary analysis of the obtained sequences was conducted using MEGA and Beast software.Results:The case was an 11-year-old boy, a fifth-grade student, who developed symptoms on August 28, 2023. A total of five close contacts were investigated, including three family members (grandfather, father and sister) and two playmates. Additionally, 11 classmates who had close contact with the case′s sister during the infectious period (within five days after the rash onset) were also investigated. Among the 16 serum samples tested, only one case was positive for IgM, while the other 15 samples were negative for IgM. The results of the serum antibody avidity test showed that among the 16 serum samples, 14 were positive for IgG. Of these, eight had a relative avidity index >55%, indicating high-avidity antibodies; one had a relative avidity index <45%, indicating low-avidity antibodies; and five had an avidity index between 45% and 55%. The IgG detection OD values for the case′s sister and grandfather were higher than those of the other contacts. Based on the vaccination history of the subjects and the results of IgM and IgG tests, it was preliminarily determined that the case had a recent wild-type measles virus infection. The case′s sister and grandfather had a history of measles wild-type virus infection, while the high-avidity antibodies in the other contacts were likely induced by the measles vaccine. The results of the pharyngeal swab tests showed that only the case was positive for measles virus nucleic acid, while the remaining 15 samples were negative for measles virus. The genetic evolutionary analysis revealed that the viral sequence of this case (Mvs/Shandong.CHN/38.23) had a 100% homology with the Hong Kong strain sequence from August 2023. It belonged to a different transmission chain from the D8 genotype strains that appeared in Shandong Province between 2018 and 2019, with sequence homology ranging from 98.0% to 98.8%. The sequence homology within the transmission chain of this case was between 99.1% and 100%. The evolutionary rate of this transmission chain was approximately 8.38×10 -3 sub/site/year, and the most recent common ancestor was estimated to have emerged around the year 2011. Conclusion:This case is the first imported D8 genotype measles case in Shandong Province. There is no spatio-temporal correlation between this case and adult cases of D8 genotype imported from Shandong Province in 2018-2019, indicating a new D8 genotype imported epidemic.

To review the research status, assessment tools, influencing factors and intervention measures of social grooming in patients with gynecological malignant tumors, so as to provide a theoretical basis for improving the social alienation of patients with gynecological malignant tumors and better integrating into society.

Objective:To explore the quality of working life and its related factors in patients with breast canc-er returned to work after surgery.Methods:A total of 316 patients with breast cancer who had returned to work af-ter surgery were selected,and they were investigated with the General information questionnaire,Quality of Working Life Questionnaire for Cancer Survivors(QWLQ-CS),Breast Cancer Survivors Resilience Scale(BCRS)and Strat-egies Used by People to Promote Health(SUPPH).Multivariate linear regression analysis was used to analyze the related factors of quality of working life.Results:Multiple linear regression analysis showed that the QWLQ-CS score was positively correlated with education level,per capita monthly income of family,work pattern,return to work time,personal protection and social protection score of BCRS,and positive attitude scores of SUPPH(β=1.05,1.23,2.26,0.69,0.95,1.00,0.13),while negatively correlated with the complications(β=-3.83).Con-clusion:The quality of working life for patients with breast cancer after surgery needs to be improved after they re-turn to work,psychological resilience and self-efficacy are positively correlated with quality of working life.

Objective Based on the scoping review framework,we collected cancer-related cognitive impairment(CRCI)assessment tools from home and abroad to provide references for the standardized use of such assessment tools.Methods Chinese and English databases,such as Pubmed,Embase,Web of Science Core Collection database,CNIK,Wanfang database,and VIP database,were systematically searched from the establishment of the database to April 12,2024,to extract the basic information of evaluation tools,and the search results were standardized.Results 31 articles were included,of which 26 were about the development or validation of assessment tools,and 5 were about the localization and application of assessment tools,involving 19 subjective assessment tools and 8 objective assessment tools.Most of the subjective assessment tool reliability and validity tests were internal consistency reliability tests and concurrent validity tests;14 subjective assessment tools were multidimensional scales;6 objective assessment tools measured retest reliability;4 were unidimensional measures.Conclusion The assessment tools chosen for the current studies vary.It is recommended to choose the evaluation tools and judgment standards recommended by the International Cognitive and Cancer Working Group to carry out relevant research.In the future,the existing CRCI assessment tools should be further verified and improved,and a localized CRCI assessment tool should be continuously introduced or developed.

Objective:To investigate the correlation between clinical outcomes of congenital diaphragmatic hernia (CDH) and chromosomal abnormalities.Methods:This was a retrospective study involving 101 fetuses who underwent invasive prenatal diagnosis and chromosomal analysis for CDH at the Prenatal Diagnosis Center of Guangzhou Medical University Affiliated Women and Children's Medical Center from January 1, 2010, to December 31, 2021. According to ultrasound results, they were divided into the isolated CDH group and the complex CDH group. The results of chromosomal karyotype analysis or chromosomal microarray analysis (CMA) and birth outcomes were analyzed. For live-born children, follow-up results were analyzed. Statistical analysis was performed using t-test or Chi-square (or Fisher's exact) test. Results:(1) The mean age of the mothers of the 101 fetuses was (29.6±5.3) years, ranging from 20 to 47 years, and 16 mothers (15.8%) were over 35 years old. The mean gestational age at invasive prenatal diagnosis was (27.1±5.0) weeks, ranging from 13 weeks and 3 days to 38 weeks and 3 days; the mean gestational age at first diagnosis of CDH was (26.6±4.8) weeks, ranging from 13 weeks and 3 days to 38 weeks and 3 days. (2) The 101 fetuses were divided into isolated CDH group (81 cases, 80.2%) and complex CDH group (20 cases, 19.8%) based on whether they had other ultrasound abnormalities. Among the 20 complex cases, 13 had more than two types of malformations, with cardiovascular system malformations being the most common (11 cases, including seven chromosomal abnormalities). The highest proportion of chromosomal abnormalities was found in fetuses with central nervous system malformations (3/4). (3) Among the 101 CDH fetuses, 31 (30.7%) underwent chromosomal karyotype analysis alone, 39 (38.6%) underwent CMA alone, and 31 (30.7%) underwent both tests. The rate of chromosomal abnormalities was 13.9% (14/101). The detection rates of abnormalities by chromosomal karyotype analysis and CMA were 16.1% (10/62) and 14.3% (10/70), respectively. The additional detection rate by CMA was 2.8% (2/70). (4) The gestational age at diagnosis in the complex CDH group was earlier than that in the isolated CDH group [(22.7±4.2) weeks vs. (27.7±4.6) weeks, t=4.47, P<0.001]. The total detection rate, as well as the detection rates by chromosomal karyotype analysis and CMA, were higher in the complex CDH group than those in the isolated CDH group [45.0% (9/20) vs. 6.2% (5/81), χ2=17.13; 7/15 vs. 6.4% (3/47), χ2=10.82; 5/11 vs. 8.8% (5/57), χ2=7.55; all P<0.01]. (5) Among the 101 CDH fetuses, two were lost to follow-up, and 99 (98.0%) were successfully followed up. Among these 99 cases, 48 were terminated, and 51 were live births. The chromosomal abnormality rate in the 48 terminated fetuses was 25.0% (12/48), including 28 isolated cases and 20 complex cases. All 51 live births were isolated cases, with 45 (88.2%) cured by postnatal surgery and six (11.8%) having adverse clinical outcomes (including two preoperative deaths, three postoperative deaths, and one postoperative recurrence). Conclusions:The rate of chromosomal abnormalities in CDH is high, and it is higher in complex CDH than in isolated CDH. When prenatal diagnosis reveals fetal CDH, invasive prenatal diagnosis is recommended to exclude chromosomal karyotype abnormalities, with CMA recommended as the preferred chromosomal testing method.

Objective:To investigate the correlation between clinical outcomes of congenital diaphragmatic hernia (CDH) and chromosomal abnormalities.Methods:This was a retrospective study involving 101 fetuses who underwent invasive prenatal diagnosis and chromosomal analysis for CDH at the Prenatal Diagnosis Center of Guangzhou Medical University Affiliated Women and Children's Medical Center from January 1, 2010, to December 31, 2021. According to ultrasound results, they were divided into the isolated CDH group and the complex CDH group. The results of chromosomal karyotype analysis or chromosomal microarray analysis (CMA) and birth outcomes were analyzed. For live-born children, follow-up results were analyzed. Statistical analysis was performed using t-test or Chi-square (or Fisher's exact) test. Results:(1) The mean age of the mothers of the 101 fetuses was (29.6±5.3) years, ranging from 20 to 47 years, and 16 mothers (15.8%) were over 35 years old. The mean gestational age at invasive prenatal diagnosis was (27.1±5.0) weeks, ranging from 13 weeks and 3 days to 38 weeks and 3 days; the mean gestational age at first diagnosis of CDH was (26.6±4.8) weeks, ranging from 13 weeks and 3 days to 38 weeks and 3 days. (2) The 101 fetuses were divided into isolated CDH group (81 cases, 80.2%) and complex CDH group (20 cases, 19.8%) based on whether they had other ultrasound abnormalities. Among the 20 complex cases, 13 had more than two types of malformations, with cardiovascular system malformations being the most common (11 cases, including seven chromosomal abnormalities). The highest proportion of chromosomal abnormalities was found in fetuses with central nervous system malformations (3/4). (3) Among the 101 CDH fetuses, 31 (30.7%) underwent chromosomal karyotype analysis alone, 39 (38.6%) underwent CMA alone, and 31 (30.7%) underwent both tests. The rate of chromosomal abnormalities was 13.9% (14/101). The detection rates of abnormalities by chromosomal karyotype analysis and CMA were 16.1% (10/62) and 14.3% (10/70), respectively. The additional detection rate by CMA was 2.8% (2/70). (4) The gestational age at diagnosis in the complex CDH group was earlier than that in the isolated CDH group [(22.7±4.2) weeks vs. (27.7±4.6) weeks, t=4.47, P<0.001]. The total detection rate, as well as the detection rates by chromosomal karyotype analysis and CMA, were higher in the complex CDH group than those in the isolated CDH group [45.0% (9/20) vs. 6.2% (5/81), χ2=17.13; 7/15 vs. 6.4% (3/47), χ2=10.82; 5/11 vs. 8.8% (5/57), χ2=7.55; all P<0.01]. (5) Among the 101 CDH fetuses, two were lost to follow-up, and 99 (98.0%) were successfully followed up. Among these 99 cases, 48 were terminated, and 51 were live births. The chromosomal abnormality rate in the 48 terminated fetuses was 25.0% (12/48), including 28 isolated cases and 20 complex cases. All 51 live births were isolated cases, with 45 (88.2%) cured by postnatal surgery and six (11.8%) having adverse clinical outcomes (including two preoperative deaths, three postoperative deaths, and one postoperative recurrence). Conclusions:The rate of chromosomal abnormalities in CDH is high, and it is higher in complex CDH than in isolated CDH. When prenatal diagnosis reveals fetal CDH, invasive prenatal diagnosis is recommended to exclude chromosomal karyotype abnormalities, with CMA recommended as the preferred chromosomal testing method.

Objective Based on the scoping review framework,we collected cancer-related cognitive impairment(CRCI)assessment tools from home and abroad to provide references for the standardized use of such assessment tools.Methods Chinese and English databases,such as Pubmed,Embase,Web of Science Core Collection database,CNIK,Wanfang database,and VIP database,were systematically searched from the establishment of the database to April 12,2024,to extract the basic information of evaluation tools,and the search results were standardized.Results 31 articles were included,of which 26 were about the development or validation of assessment tools,and 5 were about the localization and application of assessment tools,involving 19 subjective assessment tools and 8 objective assessment tools.Most of the subjective assessment tool reliability and validity tests were internal consistency reliability tests and concurrent validity tests;14 subjective assessment tools were multidimensional scales;6 objective assessment tools measured retest reliability;4 were unidimensional measures.Conclusion The assessment tools chosen for the current studies vary.It is recommended to choose the evaluation tools and judgment standards recommended by the International Cognitive and Cancer Working Group to carry out relevant research.In the future,the existing CRCI assessment tools should be further verified and improved,and a localized CRCI assessment tool should be continuously introduced or developed.

Objective:To explore the risk factors of overactive bladder(OAB)syndrome in older women with stress urinary incontinence(SUI).Methods:In this cross-sectional study, 157 elderly women with SUI, aged 60-88(65.6±5.4)years, were recruited from Qingshan District Maternal and Child Health Hospital and areas serviced by Fozuling Community Service Center in Wuhan between October to November 2020.Data collection included a questionnaire covering general information, dietary habits, childbirth history, medical history, the urogenital distress inventory(UDI-6)and the overactive bladder symptom score(OABSS), and physical examinations on curvature of the spine, pelvic floor muscle strength and pelvic floor ultrasound imaging.Results:A total of 157 elderly women with SUI were included in the study and the prevalence of OAB was 17.2%(27 cases). The prevalence of OAB was 17.6%(25 cases)among 142 patients with mild SUI and 13.3%(2 cases)among 15 patients with moderate or severe SUI, but SUI severity was not correlated with the prevalence of OAB( χ2=0.003, P>0.05). The UDI-6 score was 2.39±2.04 and the OABSS score was 3.70±2.48, with a positive correlation between OABSS and UDI-6( r=0.254, P<0.01), suggesting that OAB had a negative effect on the quality of life of patients with SUI.Multivariate Logistic regression analysis on factors with P<0.3 in the univariate analysis showed that number of pregnancies( P<0.01), anterior vaginal wall prolapse( P<0.05), and abnormal inclination of the pelvis( P=0.05)were associated with the prevalence of OAB.Regarding the number of pregnancies, the risk of OAB increased with 2-3 pregnancies( OR=1.46, 95% CI: 0.25-8.56)and with 3 pregnancies or more( OR=4.29, 95% CI: 0.79-23.18), compared with the prevalence at no more than 1 pregnancy.Compared with patients without anterior vaginal wall prolapse, Ⅰ-Ⅱ degree prolapse increased the risk of OAB( OR=4.21, 95% CI: 1.40-12.63), and third-degree prolapse further increased the risk( OR=11.48, 95% CI: 1.37-96.17). Compared with patients with normal inclination of the pelvis, anterior or posterior pelvis inclination promoted the occurrence of OAB( OR=3.46, 95% CI: 1.23-9.73; OR=2.62, 95% CI: 0.54-12.71). Conclusions:OAB has a negative impact on the quality of life of elderly women with SUI.Pregnancy, anterior vaginal prolapse and abnormal inclination of the pelvis promote the occurrence of OAB.