[Purpose]To analyze the trends of cancer incidence and mortality from 1991 to 2020 in Jiashan County of Zhejiang Province,and to predict trends from 2021 to 2035.[Methods]Cancer cases and deaths from 1991 to 2020 in Jiashan County were collected.The crude inci-dence rate and mortality rate,age-standardized rate(ASR)were calculated.The annual percentage change(APC)and average annual percentage change(AAPC)were calculated by Joinpoint model to analyze the trend of cancer incidence and mortality.The age-period-cohort model was used to predict the trends of cancer incidence and mortality from 2021 to 2035 and the estimated annual percentage change(EAPC)was calculated.[Results]The age-standardized incidence rates by Chinese standard population(ASIRC)in Jiashan were 159.06/105,187.25/105,and 254.37/105 during 1991-2000,2001-2010,and 2011-2020,respectively.The trends in young and middle-aged women and people above 65 years old were more predominant.Lung,stomach,colorectal,liver and female breast cancers were major incident cancers for the period from 1991 to 2020.The cancer incidence showed an increasing trend from 1991 to 2020(AAPC=2.17％,P＜0.05)and is expect-ed to continue to increase over 2021 to 2035(EAPC=3.03％,P＜0.05).The age-standardized mor-tality rates by Chinese standard population(ASMRC)in Jiashan were 119.74/105,117.79/105,and 100.11/105 during 1991-2000,2001-2010,and 2011-2020,respectively.Lung,liver,stomach,colorectal,esophageal,and pancreatic cancers were leading causes of cancer deaths from 1991 to 2020.The cancer mortality showed a decreasing trend from 1991 to 2020(AAPC=-1.00％,P＜0.05)and is expected to continue to decline over 2021 to 2035(EAPC=-1.67％,P＜0.05).[Conclusion]The mortality rate from cancers has been gradually declined in Jiashan County,while the incidence rate has increased significantly and will continue to increase in the next 15 years.High incidence of lung cancer,liver cancer,gastric cancer and colorectal cancer makes it crucial to pay close attention to key groups and strengthen the control of risk factors of high inci-dence cancer.

Objective To investigate the therapeutic efficacy of artesunate(AS)on polycystic ovary syndrome(PCOS)in mice and explore the potential mechanism primarily.Methods Twenty-five female C57BL/6J mice were randomly divided into Control group,model group(PCOS group),low-and high-dose AS groups(AS15 and AS30 groups)and metformin group(Met group).In addition to the Control group,the mouse model of PCOS was established by subcutaneous injection of dehydroepiandrosterone(DHEA,60 mg/kg)following by a high-fat diet for 21 d.After modeling,AS of 15 and 30 mg/kg was intraperitoneally injected into the mice of the AS 15 and AS30 groups,respectively,and 200 mg/kg Met was given to those of the Met group by gavage,once per day,for 6 weeks.ELISA was used to detect serum testosterone(T),fasting insulin(FINS),luteinizing hormone(LH)and follicle-stimulating hormone(FSH),and the LH/FSH ratio was calculated.The levels of fasting blood glucose(FBG),triglyceride(TG)and total cholesterol(TC)were detected by automatic biochemical analyzer,and the homeostasis model assessment of insulin resistance(HOMA-IR)was calculated.The estrous cycle was observed,and HE staining was performed for pathological changes in the ovary and uterus.Immunofluorescence assay was employed to measure the expression of p-eIF2α,ATF4 and CHOP in the ovarian tissue.After steroidogenic human granulosa-like tumor cell line KGN were exposed to 100 μmol/L DHEA to simulate the hyperandrogen environment of PCOS,and then treated with 5 and 10 μg/mL AS for 24 h,the protein levels of endoplasmic reticulum stress signaling pathway was detected by Western blotting.Results Compared with the Control group,the PCOS mice had disturbed estrous cycle,polycystic changes in the ovaries,and significantly increased serum T level and LH/FSH ratio(P＜0.05),and obviously elevated HOMA-IR,TC and TG levels in terms of metabolism(P＜0.01).The expression levels of p-eIF2α,ATF4 and CHOP were notably up-regulated in the ovarian granulosa cells of PCOS mice and KGN cells after DHEA exposure(P＜0.05).Additionally,AS treatment attenuated the pathological changes of ovary and uterine expression,decreased the serum T level and the LH/FSH ratio(P＜0.05),and reduced HOMA-IR,TC and TG levels(P＜0.05)when compared with the PCOS mice.Moreover,the expression levels of p-eIF2α,ATF4 and CHOP were significantly down-regulated after AS treatment in both ovarian granulosa cells of PCOS mice and KGN cells(P＜0.05).Conclusion AS significantly improves glycolipid metabolic disorder and reproductive dysfunction in PCOS mice,which may be associated with its suppressing endoplasmic reticulum stress by inhibiting the PERK/eIF2α/ATF4/CHOP pathway.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To observe the influence of antibacterial photodynamic therapy combined with scaling and root planning(SRP)on the periodontal condition,oral flora and C-reactive protein(CRP),prostaglandin E2(PGE2),and interleukin-8(IL-8)in gingival crevicular fluid of patients with chronic periodontitis.Methods:102 patients with chronic periodontitis who were admitted to Fengdu County People's Hospital of Chongqing from January 2023 to October 2024 were prospectively selected,they were divided into control group(received SRP treatment,51 cases)and study group(received antibacterial photodynamic therapy combined with SRP treatment,51 cases)according to random number table method.The clinical efficacy,periodontal condition,oral flora,oral health impact profile-14(OHIP-14)scores,and CRP,PGE2 and IL-8 levels in gingival crevicular fluid between two groups were compared.Result:The clinical total effective rate of the study group was higher than that of the control group(P＜0.05).Clinical attachment loss(CAL),gingival index(GI),probing depth(PD),bleeding index(BI),aggregated bacilli with release lines,fusobacterium nucleatum,porphyromonas gingivalis,OHIP-14 score,CRP,PGE2 and IL-8 levels in gingival crevicular fluid 4 weeks after treatment and 12 weeks after treatment in the study group were lower than those in the control group(P＜0.05).Conclusion:Antibacterial photodynamic therapy combined with SRP can effectively improve the periodontal condition,oral flora and CRP,PGE2,IL-8 levels in gingival crevicular fluid of patients with chronic periodontitis,and enhance clinical efficacy.

Objective To explore the protective effect of Bilobalide on retinal ganglion cells(RGCs)in rats with op-tic nerve injury and its mechanism.Methods Sixty rats were randomly selected from 75 Sprague-Dawley rats to establish an optic nerve crush injury model.The 60 successfully modeled rats were then randomly divided into a model group,and low-,medium-,and high-dose Bilobalide groups,with 15 rats in each group.Another 15 rats served as the sham-operated group,undergoing optic nerve exposure without crushing.Rats in the low-,medium-,and high-dose Bilobalide groups were intraperitoneally injected with 5,10 and 20 mg·kg-1 Bilobalide,respectively,once daily for 7 days.Rats in the sham-operated and model groups were intraperitoneally injected with an equal volume of normal saline once daily for 7 days.The superoxide dismutase(SOD)activity and malondialdehyde(MDA)content in the retinal tissue of rats in each group were measured.Immunofluorescence staining was used to assess RGCs proliferation.Hematoxylin-eosin(HE)stai-ning was used to observe histopathological changes in the retinal structure.TUNEL staining was used to detect RGCs apop-tosis.Immunofluorescence staining was used to observe the activation state of retinal microglia.Western blot was used to detect the expression of growth-associated protein 43(GAP43)and proteins related to the extracellular signal-regulated ki-nase 1/2(ERK1/2)pathway.Results Compared with the sham-operated group,the model group showed significantly decreased SOD activity and increased MDA content in the retinal tissue(all P＜0.05),a significant decrease in RGCs densi-ty(P＜0.05),significant increases in the apoptosis rate and microglial activation ratio(all P＜0.05),and significant downregulation of p-ERK1/2 and GAP43 protein expression(all P＜0.05).Histomorphology revealed edema and vacuola-tion in the ganglion cell layer,disordered arrangement of RGCs,and thinning of the inner nuclear layer and outer nuclear layer in the model group.After intervention with various doses of Bilobalide,all the above indices were significantly im-proved(all P＜0.05):SOD activity increased,MDA content decreased,RGCs density recovered,RGCs apoptosis rate and microglial activation decreased,the expressions of p-ERK1/2 and GAP43 were upregulated,the structural damage to each retinal layer was alleviated,showing a dose-dependent recovery.Conclusion Bilobalide can exert a protective effect on RGCs after optic nerve injury through multiple mechanisms,including alleviating oxidative stress,inhibiting apoptosis and microglial overactivation,promoting axonal regeneration,and activating the ERK1/2 signaling pathway.

Intellectual disability (ID) is a kind of neurodevelopmental disorder with high clinical and genetic heterogeneity, which seriously endangers the physical and mental health of children. Its etiology is complex, many genetic and environmental factors can participate in the pathogenesis, and metabolic disorders are one of the important etiology. Targeted assays such as plasma amino acids and acylcarnitine and urinary organic acids are of limited use in helping to diagnose and manage these patients. Non-targeted metabolomics has become a tool to explore changes in the metabolites of organisms and a means to study possible biomarkers of such diseases. In recent years, metabolomics technology has made some progress in the etiology and mechanism of ID, providing new ideas and methods for its early recognition, treatment and improvement of prognosis. This paper reviews the progress of non-targeted metabolomics in ID.

Intellectual disability (ID) is a kind of neurodevelopmental disorder with high clinical and genetic heterogeneity, which seriously endangers the physical and mental health of children. Its etiology is complex, many genetic and environmental factors can participate in the pathogenesis, and metabolic disorders are one of the important etiology. Targeted assays such as plasma amino acids and acylcarnitine and urinary organic acids are of limited use in helping to diagnose and manage these patients. Non-targeted metabolomics has become a tool to explore changes in the metabolites of organisms and a means to study possible biomarkers of such diseases. In recent years, metabolomics technology has made some progress in the etiology and mechanism of ID, providing new ideas and methods for its early recognition, treatment and improvement of prognosis. This paper reviews the progress of non-targeted metabolomics in ID.

Objective To investigate the role of p300 in lipid metabolism disorders.Methods Bioinformatics analysis was performed to analyze the expression patterns of p300 in lipid metabolism disorder-related diseases and its correlation with SREBP-1c and downstream lipid metabolic enzymes.Immunofluorescence assay was used to detect the expression of p300 in the liver tissues of the patients with varying disease severity of non-alcoholic fatty liver disease(NAFLD).A mouse model of lipid metabolism disorder was established in male C57BL/6J mice by feeding high-fat diet(HFD)for 12 weeks.Western blotting was employed to assess p300 expression level in the liver tissues of HFD-fed mice.A cell model of lipid metabolism disorder was established in HepG2/AML-12 cells induced with free fatty acid(FFA).The effects of siRNA-mediated knockdown of p300 was observed to measure the levels of intracellular total cholesterol(TC)and triglyceride(TG),lipid deposition,and production of reactive oxygen species(ROS).Results Clinically,p300 was highly expressed in lipid metabolism disorders,and its level was positively correlated with NAFLD severity(P<0.05).Gene Set Enrichment Analysis(GSEA)revealed that p300 expression was significantly associated with fatty acid metabolism,cholesterol homeostasis,lipogenesis,PPAR signaling pathway,and peroxisome pathway.In vivo,p300 was significantly up-regulated in the livers of HFD-fed mice(P<0.01).In vitro,FFA stimulation markedly increased p300 expression in both HepG2 and AML-12 cells(P<0.01),whereas p300 knockdown significantly reduced intracellular TG and TC levels(P<0.01),attenuated lipid droplet accumulation,and reversed FFA-induced ROS elevation(P<0.01).Furthermore,p300 expression was positively correlated with the expression of SREBP-1c and its downstream key lipid synthesis enzymes.Conclusion p300 may promote hepatic lipid accumulation by acetylating and activating SREBP-1c and regulating downstream lipid metabolic enzymes,thereby affecting lipid synthesis and oxidative stress.These findings suggest that p300 may be a potential therapeutic target for lipid metabolism disorder-related diseases.

Esophagectomy is an effective treatment for esophageal cancer,and there has been growing attention on the importance of postoperative pain management in patients undergoing the surgery.Epidural analgesia is the preferred analgesic approach for open esophagectomy.With the development of surgical technology,minimally invasive esophagectomy(MIE)has become the mainstream surgical approach.However,no conclusion has been reached concerning whether epidural analgesia is still the preferred analgesic approach for MIE.Herein,we analyzed the relevant literature published in recent years and found that epidural analgesia continued to be an important analgesic approach for MIE,offering the best analgesic effect.Epidural analgesia can reduce postoperative pulmonary complications,improve the quality of life,and reduce the stress response.Adverse effects can be minimized through accurate selection of epidural puncture segments,individualized medication,and multimodal analgesia strategies.In the future,precision-based multimodal analgesia can be achieved using emerging technologies such as big data analytics and artificial intelligence.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.