1.Surveillance results of common diseases among primary and secondary school students in Yichang City in 2019 - 2022
Yi LIANG ; Zaoxia WANG ; Chi HU ; Xiaoyan MING ; Man XIAO ; Qian WU ; Zhongcheng YANG
Journal of Public Health and Preventive Medicine 2025;36(4):98-101
Objective To investigate the prevalence of common diseases among primary and secondary school students in Yichang City from 2019 to 2022, and to provide a scientific basis for formulating effective intervention measures in the future. Methods By random cluster sampling , 7 schools in urban areas and 5 schools in suburban counties were selected to screen common diseases such as myopia, dental caries, obesity and abnormal spinal curvature. Descriptive epidemiological methods were employed for statistical analysis. Results A total of 17 023 primary and secondary school students were screened from 2019 to 2022. The overall detection rate of common diseases from high to low was myopia (54.12%), caries (36.75%), overweight (15.17%), obesity (11.88%), malnutrition (5.80%), and abnormal spinal curvature (3.49%). The detection rates of myopia and abnormal curvature of the spine showed an increasing trend with years and school stages, while the detection rates of malnutrition and dental caries showed a decreasing trend with years and school stages. The detection rates of overweight and obesity showed no trend difference with years, and the detection rates of obesity showed a decreasing trend with school stages. The rates of myopia, overweight and obesity were higher in urban areas than those in suburban counties, and the rate of dental caries was higher in suburban counties than that in urban areas. The prevalence of overweight, obesity, and malnutrition in boys was higher than that in girls. The prevalence of myopia and dental caries in girls was higher than that in boys. The above differences were statistically significant (all P<0.05). Conclusion Myopia, dental caries, obesity, and abnormal curvature of the spine are the current focus of the prevention and treatment of common diseases in students. There are great differences between different regions, school stages, and genders. The “tripartite linkage” of schools, families, and communities should be achieved with the joint efforts of the education and health departments to actively take targeted intervention measures to reduce the prevalence.
2.Association between mental health and muscle strength among Chinese adolescents aged 13-18
Chinese Journal of School Health 2025;46(9):1232-1236
Objective:
To explore the association between mental health and muscle strength among Chinese adolescents aged 13- 18, providing a theoretical foundation and intervention strategies for mental health promotion.
Methods:
Data were obtained from the 2019 Chinese National Survey on Students Constitution and Health, including 98 631 Chinese adolescents aged 13- 18. Psychological distress was assessed by using the Kessler Psychological Distress Scale (K10), and mental well being was measured with the Warwick-Edinburgh Mental Well being Scale (WEMWBS). Based on the gender and age specific Z scores of various test items [grip strength, standing long jump, pull ups (for males), and sit ups (for females)], muscle strength index (MSI) was constructed to evaluate the comprehensive level of muscle strength in adolescents. According to the Dual factor Model (DFM) of mental health, participants were categorized into four groups:troubled, symptomatic but content, vulnerable, and complete mental health. Gender differences were analyzed by using Chi-square tests, trends were tested with Cochran-Armitage tests, and multinomial Logistic regression models were applied to assess associations between muscle strength and mental health among adolescents.
Results:
In 2019, 37.4% of Chinese adolescents aged 13-18 were reported of high mental distress, and 59.9% were reported of low mental well being. Boys had significantly lower rates of high mental distress (35.3%) and low mental well being (55.6%) compared to girls (39.4%, 64.3%), and the differences were of statistical significance ( χ 2=176.13, 780.42, both P <0.05). In 2019, the rate of complete mental health among adolescents showed a downward trend with increasing age ( χ 2 trend = 258.47) and a gradual upward trend with increasing muscle strength levels ( χ 2 trend =123.14),and both boys and girls exhibited similar trends ( χ 2 trend =103.83, 168.46; 57.00 , 67.34) (all P <0.05). The results of the unordered multiclass Logistic regression model showed that after controlling for confounding factors such as age and gender, when the completely pathological group as a reference, for every 1 unit increase in MSI in adolescents, the likelihood of being in a completely mental health state increased by 29% ( OR = 1.29); for every unit increase in the Z-score for pull ups, the likelihood of being in a completely mental health state increased by 6% ( OR =1.06) among boys; for every 1 unit increase in sit up Z score, the likelihood of being in a completely mental health state increased by 19% ( OR =1.19) among girls (all P <0.05).
Conclusions
The mental health status of Chinese adolescents is not good enough. Muscle strength is positively associated with mental health.
3.Rapid health technology assessment of toripalimab combined with chemotherapy in the treatment of locally advanced or metastatic non-small cell lung cancer
Yuping YANG ; Yuan ZHOU ; Qirui TAI ; Mili SHI ; Yijie SHI ; Jieya WANG ; Huan HU ; Yuan ZHANG ; Yi LIU ; Yue WANG
China Pharmacy 2025;36(20):2593-2598
OBJECTIVE To evaluate the efficacy, safety and cost-effectiveness of toripalimab (Tor) combined with chemotherapy (CT) in the treatment of locally advanced or metastatic non-small cell lung cancer (NSCLC). METHODS PubMed, the Cochrane Library, Embase, Web of Science, CBM, CNKI, Wanfang Data, and Health Technology Assessment (HTA) related websites were searched to collect the HTA reports, systematic reviews/meta-analyses and pharmacoeconomic studies of Tor+CT in the treatment of locally advanced or metastatic NSCLC from database/website inception to March 31, 2025. After data extraction and quality evaluation, the results of the included studies were analyzed descriptively. RESULTS A total of eleven studies were included, involving five systematic reviews/meta-analyses, and six pharmacoeconomic studies. Among the five systematic reviews/ meta-analyses, two were of high quality, while there was one each of moderate, low, and very low quality. All six pharmacoeconomic studies were of good quality. In terms of efficacy, compared with CT, Tor+CT significantly improved patients’ progression-free survival (PFS) and overall survival (P<0.05). In addition, compared with ipilimumab+CT, durvalumab, durvalumab+tremelimumab and sugemalimab+CT, Tor+CT could also improve the PFS (P<0.05). In terms of safety, there was no significant difference in the incidence of grade≥3 adverse events between patients receiving Tor+CT and CT (P>0.05); while Tor+CT had a lower incidence of grade≥3 adverse E-mail: events, compared with camrelizumab+CT, pembrolizumab+ 3233255290@qq.com ipilimumab, nivolumab+CT and atezolizumab+CT (P<0.05).In terms of cost-effectiveness, Tor+CT treatment had certain cost-effectiveness advantages, compared with CT. CONCLUSIONS Compared with CT, other programmed death-1/programmed death-ligand 1 inhibitors alone, or their combination with CT, Tor+CT for the treatment of locally advanced or metastatic NSCLC has good efficacy, safety and cost-effectiveness.
4.Tongxie Yaofang Regulates Expression of NKG2DL to Enhance Anti-tumor Effect of NK Cells in Colon Cancer under Chronic Stress
Yan'e HU ; Yuqing HUANG ; Yi YANG ; Yifang JIANG ; Xi FU ; Fengming YOU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(1):103-111
ObjectiveTo observe the effect of Tongxie Yaofang on the function of tumor-related natural killer (NK) cells under chronic stress and explore the possible molecular mechanism. MethodFifty SPF-grade BABL/C male mice were randomized into normal, model, and low-, medium-, and high-dose (6.825, 13.65, and 27.3 g·kg-1, respectively) Tongxie Yaofang groups, with 10 mice in each group. Other groups except the blank group were subjected to 7 days of chronic restraint stress, and then forced swimming and tail suspension tests were carried out to evaluate the modeling performance. After the successful modeling, rats in Tongxie Yaofang groups were administrated with low-, medium-, and high-doses of Tongxie Yaofang by gavage, while those in the other groups were administrated with normal saline by gavage. After 14 days, each group of mice was inoculated with subcutaneous colon cancer to establish the model of colon cancer under chronic stress. The pathological changes of the tumor tissue in each group of mice were observed using hematoxylin-eosin (HE) staining. The content of CD49b-positive cells in the peripheral blood and tumor tissue of mice was measured by flow cytometry. Enzyme-linked immunosorbent assay (ELISA) was employed to measure the content of molecules associated with NK cell activation in the peripheral blood. Western blot was employed to determine the protein levels of major histocompatibility complex class Ⅰ polypeptide-related sequences A and B (MICA+MICB) and UL-16-binding protein 1 (ULBP1) in the tumor tissue. ResultCompared with the normal group, the model group showed a decrease in 5-hydroxytryptamine (5-HT) content and an increase in corticosterone (CORT) content in the serum (P<0.05). Compared with the model group, Tongxie Yaofang increased the 5-HT content and decreased the CORT content (P<0.05, P<0.01). Compared with the normal group, the modeling increased the tumor volume and weight (P<0.05), while Tongxie Yaofang inhibited such increases with no statistical significance. The tumor cells in the model group presented neat arrangement, irregular shape, uneven size, obvious atypia, common nuclear division, and small necrotic area, and blood vessels were abundant surrounding the tumor cells. Compared with the model group, Tongxie Yaofang groups showed sparse arrangement of tumor cells, different degrees of patchy necrosis areas in the tumor, and karyorrhexis, dissolution, and nuclear debris in the necrotic part. Compared with the normal group, the model group showed reduced CD49b-positive cells in the peripheral blood and tumor tissue (P<0.01). Compared with the model group, Tongxie Yaofang increased CD49b-positive cells (medium dose P<0.01, high dose P<0.05, P<0.01). Compared with the normal group, the modeling lowered the serum levels of granzymes-B (Gzms-B), perforin (PF), interferon (IFN)-γ, and tumor necrosis factor (TNF)-α (P<0.05, P<0.01). Compared with the model group, low-dose Tongxie Yaofang elevated the serum levels of PF, Gzms-B, and TNF-α (P<0.05, P<0.01), and medium-dose Tongxie Yaofang elevated the serum levels of Gzms-B, PF, IFN-γ, and TNF-α (P<0.05, P<0.01). In addition, high-dose Tongxie Yaofang elevated the serum levels of PF, IFN-γ, and TNF-α (P<0.01). Compared with the normal group, the model group presented down-regulated protein level of ULBP1 (P<0.05). Compared with the model group, low-, medium-, and high-dose Tongxie Yaofang up-regulated the protein level of ULBP1 (P<0.05, P<0.01), and medium- and high-dose Tongxie Yaofang up-regulated the protein level of MICA+MICB (P<0.05, P<0.01). ConclusionTongxie Yaofang may promote NK cell activation by up-regulating the expression of MICA+MICB and ULBP1, thereby delaying the progression of colon cancer under chronic stress.
5.Effect of palmatine inhibiting migration,invasion and epithelial mesenchymal transformation in human oral cancer KB cells
Xue-Yun CHENG ; Guang-Yao HU ; Hong-Li LIU ; Chen-Guang LIU ; Yuan-Li DING ; Hui-Ning YANG ; Yi-An ZHAO ; Zhi-Guang SUN
The Chinese Journal of Clinical Pharmacology 2024;40(12):1749-1753
Objective To investigate the effects of palmatine on migration,invasion and epithelial mesenchymal transformation(EMT)in human oral cancer KB cells.Methods KB cells were divided into control group and palmatine-L,-M,-H groups,cultured with 0,4,8 and 16 μmol·L-1 palmatine.After incubation for 48 h,scratch assay was used to detect migration;Traswell assay was used to detect invasion;matrix metalloproteinase 2(MMP-2),MMP-9 and fibronectin(FN)contents were detected by enzyme-linked immunosorbent assay;the expression of Vimentin,N-cadherin and E-cadherin mRNA were detected by real-time quantitative polymerase chain reaction;the expression of Vimentin,N-cadherin,E-cadherin,Wnt3 and β-catenin protein were detected by Western blot.Results Cell mobility in control group and palmatine-L,-M,-H groups were(69.27±8.62)%,(52.94±4.49)%,(45.22±5.05)%and(37.63±4.88)%;the number of transmembrane cells were 197.33±20.26,125.33±12.01,97.00±9.17 and 62.67±7.51;the content of MMP-2 were(2.93±0.21),(1.49±0.13),(1.16±0.15)and(0.95±0.09)ng·mL-1;the content of MMP-9 were(3.51±0.36),(2.37±0.23),(2.06±0.35)and(1.72±0.16)ng·mL-1;the content of FN were(41.28±4.02),(24.03±3.17),(20.67±2.63)and(13.82±2.19)ng·mL-1;the above indexes in palmatine-L,-M,-H groups were compared with the control group,and the differences were statistically significant(P<0.05,P<0.01).The mRNA and protein expressions of Vimentin,N-cadherin and E-cadherin,and the expressions of Wnt3 and β-catenin protein in palmatine-L,-M,-H groups were statistically significant compared with those in control group(P<0.05,P<0.01).Conclusion Palmatine can inhibit the migration,invasion and EMT of human oral cancer KB cells,and its mechanism is related to the regulation of Wnt/β-catenin signaling pathway.
6.Application of bio-inks for 3D printing in tissue repair and regenerative medicine
Jie YANG ; Haolei HU ; Shuo LI ; Wei YUE ; Tao XU ; Yi LI
Chinese Journal of Tissue Engineering Research 2024;28(3):445-451
BACKGROUND:With the right bio-inks,3D printing can be used to create replacements for human tissues and organs that work inside the body.In recent years,3D printing technology has developed rapidly and has great application potential in regenerative medicine. OBJECTIVE:To introduce the types of bio-inks for 3D printing,and review the classification,application,advantages and disadvantages of bio-inks,as well as the future vision. METHODS:With"3D printing,biological ink,tissue engineering,hydrogel,synthetic material,cytoactive factor"as search terms,relevant articles published on PubMed and CNKI databases from 2000 to 2022 were searched by computer and finally 83 articles were included for review. RESULTS AND CONCLUSION:3D bioprinting technology has developed rapidly over the past few decades and has received great attention in various fields,including tissue engineering and biomedicine.Compared with the limitations of traditional biological scaffold manufacturing methods in terms of function and structure,3D printing can better simulate the complex structure of biological tissues and has appropriate mechanical,rheological and biological characteristics.Bio-ink is an essential part of 3D printing.Bioscaffolds produced by printing bio-ink prepared by biological materials have great scientific potential and clinical significance in tissue repair and regenerative medicine.The research of the materials itself is also getting more and more attention from experts.Bio-inks for 3D printing come in a variety of materials,from natural to synthetic,to aggregations of cells that do not require any additional biomaterials,and their usefulness in practical use varies.In the future,more and more bio-inks will be developed for tissue engineering.It is necessary to analyze the printability of bio-inks through sufficient experimental simulation and equipment testing to meet the actual medical needs.
7.Correlation between insomnia,gastrointestinal symptoms,and glycated hemoglobin in patients with type 2 diabetes:a cross-sectional study based on the co-management platform of three disciplines of diabetes
Bo LI ; Qi YUAN ; Yongfa WANG ; Youjian FENG ; Guimiao WANG ; Weidong NIAN ; Yi ZHOU ; Tianchi HU ; Sisi MA ; Liyan JIA ; Zhihai ZHANG ; Jin LI ; Bing YAN ; Nengjiang ZHAO ; Shuyu YANG
Journal of Beijing University of Traditional Chinese Medicine 2024;47(7):989-997
Objective To investigate the relationship between insomnia,gastrointestinal symptoms,and glycosylated hemoglobin(HbA1c)levels in individuals diagnosed with type 2 diabetes mellitus(T2DM),as well as the related influencing factors.Methods A total of 910 T2DM patients treated in our multicenter from January 2022 to December 2022 were enrolled in this study.General information(gender,age,smoking and drinking history,exercise,course of disease,treatment and complications),HbA1c,Athens Insomnia Scale(AIS)scores and Gastrointestinal Symptoms Rating Scale(GSRS)scores of patients were collected.The differences of sleep and gastrointestinal symptoms between groups were analyzed,and the correlation between the differences and HbA1c was analyzed.Furthermore,the risk factors for non-standard HbA1c were analyzed.Results The AIS score and GSRS score in the HbA1c control group were less than those in the non-standard group(P<0.01).Insomnia was reported by 37.0%of T2DM patients,and the HbA1c level in the insomnia group was significantly higher than that in the non-insomnia group(10.00%±2.38%vs.8.26%±1.73%,P<0.01).Gastrointestinal symptoms were present in 57.5%of T2DM patients,and the HbA1c levels in the group with gastrointestinal symptoms were significantly higher than those in the group without gastrointestinal symptoms(9.26%±2.23%vs.8.43%±1.98%,P<0.01).Furthermore,26.3%of T2DM patients experienced both insomnia and gastrointestinal symptoms.Remarkably,the HbA1c levels in the group with both insomnia and gastrointestinal symptoms were significantly higher than those in the group without either condition(10.18%±2.44%vs.8.45%±1.86%,P<0.01).Correlation analysis demonstrated a significant association between sleep quality,gastrointestinal function,and HbA1c levels(P<0.01).The logistic regression analysis result revealed that age,GSRS score,AIS score,and the presence of insomnia combined with gastrointestinal symptoms were independent risk factors for predicting HbA1c≥6.5%(P<0.01).Having both insomnia and gastrointestinal symptoms concurrently was the strongest risk factor for substandard HbA1c control,and the risk of blood sugar control may increase about 5 times when both appear together.Conclusion Insomnia and gastrointestinal symptoms are common comorbidities in T2DM patients,showing a cross-interfering relationship,and they appear together with poor blood sugar control,interact causally,and amplify each other.
8.Inflammatory and Immunomodulatory Effects of Tripterygium wilfordii Multiglycoside in Mouse Models of Psoriasis Keratinocytes.
Shuo ZHANG ; Hong-Jin LI ; Chun-Mei YANG ; Liu LIU ; Xiao-Ying SUN ; Jiao WANG ; Si-Ting CHEN ; Yi LU ; Man-Qi HU ; Ge YAN ; Ya-Qiong ZHOU ; Xiao MIAO ; Xin LI ; Bin LI
Chinese journal of integrative medicine 2024;30(3):222-229
OBJECTIVE:
To determine the role of Tripterygium wilfordii multiglycoside (TGW) in the treatment of psoriatic dermatitis from a cellular immunological perspective.
METHODS:
Mouse models of psoriatic dermatitis were established by imiquimod (IMQ). Twelve male BALB/c mice were assigned to IMQ or IMQ+TGW groups according to a random number table. Histopathological changes in vivo were assessed by hematoxylin and eosin staining. Ratios of immune cells and cytokines in mice, as well as PAM212 cell proliferation in vitro were assessed by flow cytometry. Pro-inflammatory cytokine expression was determined using reverse transcription quantitative polymerase chain reaction.
RESULTS:
TGW significantly ameliorated the severity of IMQ-induced psoriasis-like mouse skin lesions and restrained the activation of CD45+ cells, neutrophils and T lymphocytes (all P<0.01). Moreover, TGW significantly attenuated keratinocytes (KCs) proliferation and downregulated the mRNA levels of inflammatory cytokines including interleukin (IL)-17A, IL-23, tumor necrosis factor α, and chemokine (C-X-C motif) ligand 1 (P<0.01 or P<0.05). Furthermore, it reduced the number of γ δ T17 cells in skin lesion of mice and draining lymph nodes (P<0.01).
CONCLUSIONS
TGW improved psoriasis-like inflammation by inhibiting KCs proliferation, as well as the associated immune cells and cytokine expression. It inhibited IL-17 secretion from γ δ T cells, which improved the immune-inflammatory microenvironment of psoriasis.
Male
;
Animals
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Mice
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Tripterygium
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Psoriasis/drug therapy*
;
Keratinocytes
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Skin Diseases/metabolism*
;
Cytokines/metabolism*
;
Imiquimod/metabolism*
;
Dermatitis/pathology*
;
Disease Models, Animal
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Mice, Inbred BALB C
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Skin/metabolism*
9.Synthesis and identification of RGD-modified tumstatin peptide 19 and its inhibitory effect on proliferation, migration, and invasion of liver cancer SK-Hep-1 cells
WANG Shun1a,2 ; YU Jiaqi1b ; HU Yue1a ; ZHAO Zhenglin1a ; NIU Shudong1c ; JIA Di1a ; YANG Chao1a ; YI Tonghui1d ; LI Shuyan1a
Chinese Journal of Cancer Biotherapy 2024;31(9):849-856
[摘 要] 目的:探讨精氨酸-甘氨酸-天冬氨酸(RGD)修饰对肿瘤抑素19肽(T-19)抗肝癌活性的影响,比较分析T-19及RGD修饰的T-19(RGD-T-19)对肝癌SK-Hep-1细胞增殖、侵袭和迁移能力的影响。方法:用Fmoc固相法合成T-19及RGD-T-19,用高效液相色谱仪和质谱进行分离、鉴定。常规培养SK-Hep-1细胞,用0、50、100、150、200、250 mg/mL的T-19及RGD-T-19分别处理细胞,分为0 mg/mL(对照)组、50 mg/mL组、100 mg/mL组、150 mg/mL组、200 mg/mL组、250 mg/mL组。CCK-8法、克隆形成实验、划痕愈合实验和Tanswell小室实验、WB法和qPCR法分别检测SK-Hep-1细胞的增殖、迁移、侵袭能力,以及环氧合酶-2(COX-2)、基质金属蛋白酶-2(MMP-2)、MMP-9、组织基质金属蛋白酶抑制剂-1(TIMP-1)、TIMP-2蛋白和MMP-1、MMP-2 mRNA的表达。结果:经质谱鉴定,用Fmoc固相法合成的T-19及RGD-T-19纯度高。T-19和RGD-T-19均能显著抑制SK-Hep-1细胞的增殖、迁移、侵袭能力,抑制COX-2蛋白、MMP-2和MMP-9蛋白及mRNA的表达、促进TIMP-1、TIMP-2蛋白的表达(P < 0.05, P < 0.01, P < 0.001),RGD-T-19的抑制或促进效应均明显强于T-19(均P < 0.05)。结论:利用Fmoc固相法合成了纯度高、活性好的T-19及RGD-T-19,两种肽均能抑制SK-Hep-1细胞增殖、侵袭和迁移能力,RGD-T-19作用明显强于T-19。
10.Mechanism prediction and verification of Cistanche deserticola in the treatment of inflammatory bowel disease
Ming QIAO ; Yi ZHU ; Junping HU ; Jianhua YANG
China Pharmacy 2024;35(21):2582-2589
OBJECTIVE To investigate the mechanism of Cistanche deserticola in the treatment of inflammatory bowel disease (IBD). METHODS The active components of C. deserticola were screened based on TCMSP and literature reports. The targets of active ingredients were obtained via Swiss Target Prediction platform. Then the disease targets were obtained by searching GeneCards and OMIM databases. PPI network and “drug-compound-disease-target” network were constructed. The core components and core targets were screened. GO and KEGG enrichment analyses were performed, and molecular docking verification was conducted for core targets and core components. The IBD mice model was established and divided into model group, positive control group (dexamethasone, 0.4 mg/kg) and C. deserticola extract group (100, 200, 400 mg/kg); blank control group was set, with 8 mice in each group. Each group was given relevant medicine, once a day, for 7 consecutive days. Disease activity index (DAI) score and colon length were calculated, and the pathological morphology of the colon of mice was observed. The levels of inflammatory factors [interleukin-6 (IL-6), IL-1β, IL-10, myeloperoxidase (MPO),tumor necrosis factor-α (TNF-α)] in colon tissue, and protein expressions of core targets were detected. RESULTS A total of 39 active ingredients and 232 potential targets of C. deserticola in the treatment of IBD were obtained. The treatment of IBD with C. deserticola might be related to core components such as quercetin, suchilactone, β-sitosterol and cistanoside H, and core targets such as TNF, AKT1, STAT3, EGFR and SRC. GO and KEGG pathway analysis predicted that the biological processes of C. deserticola in the treatment of IBD were mainly related to protein phosphorylation, and negative regulation of apoptosis, mainly involving PI3K/AKT and EGFR tyrosine kinase inhibitor resistance signaling pathways. The results of molecular docking showed that the binding energy between the core components and core target of C. deserticola was less than -4.7 kJ/mol. Animal experiment results showed that after intervention with C. deserticola extract, the body weight and colon length of mice significantly increased (P<0.05 or P<0.01), while DAI decreased significantly (P<0.05 or P<0.01). The congestion and edema of colon mucosa were significantly reduced, and the pathological score of colon tissue was significantly decreased (P<0.05 or P<0.01); the levels of IL-6, IL-1β, MPO and TNF-α, as well as the protein expressions of PI3K, phosphorylated PI3K (p-PI3K), EGFR, TNF- α, STAT3, phosphorylated STAT3 (p-STAT3), AKT1, phosphorylated AKT1 (p-AKT1) and SRC in colon tissue were reduced significantly (P<0.05 or P<0.01), while the level of IL-10 was significantly increased in model group (P<0.01). CONCLUSIONS C. deserticola may alleviate IBD by regulating the SRC/EGFR/PI3K/AKT signaling pathway.


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