OBJECTIVE To develop the evaluation system for the readability of drug instructions based on Chinese patient needs， and to provide scientific evidence for improving the readability of drug instructions in China. METHODS The literature review and expert consultation were adopted to establish the evaluation index system for the readability of drug instructions. Then， by the analytic hierarchy process， the index weight in the evaluation system was determined， and the evaluation system for the readability of drug instructions was established. Fuzzy comprehensive evaluation was used to test the evaluation system， taking drug instruction of Dexamethasone acetate cream as an example. RESULTS The evaluation system for the readability of drug instructions was established with 5 primary criteria such as text expression， numerical application， content design， behavioral suggestions， and layout design， as well as 17 sub-criteria such as easy-to-understand words and appropriately long sentences. The reliability and validity tests met the requirements. The result of 100 respondents evaluating the readability of the drug instructions of Dexamethasone acetate cream showed that the readability of drug instructions was scored as good as 4.24. CONCLUSIONS Established evaluation system for the readability of drug instructions in the study can be used to evaluate the quality and readability of drug instructions in China.

Objective: To explore the neural processing differences in inhibitory control and cognitive flexibility associated with motor development levels in preschool children, so as to provide a basis for motor learning and cognitive development in preschool children. Methods: From March 20 to 31 in 2023, a total of 84 preschool children aged 4-6 were recruited from two kindergartens in Xi an City. The MOBAK-KG Motor Development Assessment Scale was used to assess the children s motor development levels. The Go/no go task paradigm was employed to test inhibitory control ability, and the Dimensional Change Card Sort (DCCS) task paradigm was utilized to evaluate cognitive flexibility. Functional near infrared spectroscopy (fNIRS) was used to monitor the preschool children s prefrontal cortex oxygenation dynamics during inhibitory control and cognitive flexibility tasks. Malab software and Homer 2 plugins were used to calculate prefrontal oxygenated hemoglobin concentration of preschool children during the tasks. Results: The high motor skills group exhibited significantly higher task accuracy during inhibitory control and cognitive flexibility tasks [0.95(0.92, 0.97),(0.54±0.12)] compared to the low motor skill group[0.93(0.85, 0.97),(0.45±0.13)] ( Z/t =-2.09, 3.14 , P <0.05). During the inhibitory control task, the high motor skill group [0.24(0.10,0.41), 0.34(0.16,0.62), 0.30(0.07, 0.52 ), 0.26(0.09, 0.53), 0.15(0.01, 0.43), 0.34(0.10, 0.67)mol/L] showed significantly higher oxygenated hemoglobin concentrations in the left and right dorsolateral prefrontal cortices (L-DLPFC, R-DLPFC), left and right pars triangular Broca s areas ( L- PTBA, R-PTBA), and left and right frontopolar areas (L-FPA, R-FPA) compared to the low motor skill group [0.04( -0.13 , 0.15), 0.00(-0.12, 0.11), -0.01(-0.17, 0.14), 0.04(-0.14, 0.16), -0.01(-0.16, 0.12), -0.03(-0.21, 0.15) mol/L ] ( Z=-4.83, -5.57, -4.77, -4.10, -3.45, -5.74, P ＜0.01). During the cognitive flexibility task, the high motor skill group[0.21(0.03, 0.36), 0.28(0.15, 0.45), 0.15(0.05, 0.30), 0.20(0.05, 0.37), 0.04(-0.17, 0.26), 0.14(-0.08, 0.40) mol/L ] exhibited significantly higher oxygenated hemoglobin concentrations in the L-DLPFC, R-DLPFC, L-PTBA, R-PTBA, L- FPA, R-FPA brain regions compared to the low motor skill group [0.02(-0.20, 0.23), 0.02(-0.12, 0.21), 0.00(-0.22, 0.16 ), 0.00(-0.16, 0.15), -0.05(-0.25, 0.06), 0.01(-0.23, 0.20)mol/L] ( Z=-3.63, -4.45, -3.58, -3.75, -2.18, -1.98 , P ＜0.05). Conclusions The motor development level in preschool children is closely related to inhibitory control and cognitive flexibility. It is crucial to emphasize motor learning in early childhood to further promote holistic development of both mind and body.

This article reports a patient with extensive high-pressure injection injury of the hand combined with deep chemical burn caused by high-pressure injection of industrial cement materials was diagnosed and treated in the Department of Hand Surgery, Xiaolan Hospital Affiliated to Southern Medical University in 2022. The nerves, tendons and blood vessels of the left hand were involved, and the ulnar skin of the left thumb was extensively necrosis, and a large number of extensive cement foreign bodies remained under the skin. Part of the cement was inserted into the joint capsule of the interphalangeal joint. After emergency surgical treatment, the patient was saved successfully, and the wound healed well without chemical poisoning and other related complications, which created conditions for the second stage of flap repair.

This article reports a patient with extensive high-pressure injection injury of the hand combined with deep chemical burn caused by high-pressure injection of industrial cement materials was diagnosed and treated in the Department of Hand Surgery, Xiaolan Hospital Affiliated to Southern Medical University in 2022. The nerves, tendons and blood vessels of the left hand were involved, and the ulnar skin of the left thumb was extensively necrosis, and a large number of extensive cement foreign bodies remained under the skin. Part of the cement was inserted into the joint capsule of the interphalangeal joint. After emergency surgical treatment, the patient was saved successfully, and the wound healed well without chemical poisoning and other related complications, which created conditions for the second stage of flap repair.

Objective To observe the role of dried tangerine peel in Yigong Powder improves iron metabolism and promotes red blood cell generation in anemia of chronic disease (ACD).Methods With a two-by-two factorial design,the Yigong Powder was divided into dried tangerine peel and Chenpi absent Decoction. According to the random number table method,32 zymosan-induced generalized inflammation (ZIGI) mice were randomly divided into the model group,the dried tangerine peel group,the Chenpi absent Decoction group,and the Yigong Powder group. The dried tangerine peel group,Chenpi absent Decoction group and the Yigong Powder group were given dried tangerine peel(3.083 g/kg),Chenpi absent Decoction(12.33g/kg),and Yigong Powder(15.413g/kg)by gavage to the corresponding group of mice. The model group was given an equal amount of physiological saline by gavage,and treated continuously for 7 days. After the completion of administration,the body weight of each group of mice was recorded. The hemoglobin content of each group of mice was detected using a fully automatic cell counter,the serum iron content was detected using colorimetry,the serum ferritin content was detected using enzyme-linked immunosorbent assay (ELISA),and the spleen index was calculated. The liver tissue inflammatory factors interleukin-1β (IL-1β),interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α),interferon-γ (IFN-γ),interleukin-4 (IL-4),and interleukin-10 (IL-10) levels were detected using Luminex method. The mRNA expressions of liver tissue hepcidin gene (HAMP) and membrane iron transporter ( Fpn) were detected using real-time fluorescence PCR method. Results Dried tangerine peel and Chenpi absent Decoction both showed interactive effects in regulating hemoglobin,serum iron,serum ferritin content,improving spleen index,and regulating the mRNA expressions of HAMP,Fpn,as well as IL-1β and IFN-γ (P<0.05). Compared with the model group,dried tangerine peel significantly increased hemoglobin,serum iron content,and Fpn mRNA expression in ZIGI model mice,while decreasing ferritin content,spleen index,HAMP mRNA expression,and the levels of IL-1β,IL-6,TNF-α,and IFN-γ (P<0.05). Chenpi absent Decoction significantly increased serum iron content and Fpn mRNA expression in ZIGI model mice,while reducing spleen index,ferritin content,HAMP mRNA expression,and the levels of IL-1β and IFN-γ、IL-4 (P<0.05). Conclusion The effects of dried tangerine peel on inflammatory factors (IL-6 and TNF-α) and Fpn may play a key role in the improvement effects of Yigong Powder on ACD and iron metabolism.

Objective:To identify the factors associated with the care needs of the older adults aged 65-105 by age groups,and to compare these factors across different age groups.Methods:A total of 12 244 older adults from the Chinese longitudinal healthy longevity survey(CLHLS)conducted in 2018 were included in the analyses.The participants were categorized into three age groups:young-old(aged 65-79),middle-old(aged 80-89),and oldest-old(aged 90-105).The level of disability was measured by the disability index(DI)in four dimensions,reflecting their care needs.Potential factors associated with care needs were selected based on the health ecological model(HEM),including per-spectives of personal characteristics,behavioral characteristics,interpersonal network,living and working conditions,and policy environment.Multifactor analysis was performed using multinomial Logistic regres-sion.Results:Among China's 12 244 older adults,43.4％had medium or high care needs.Factors for higher care needs of older adults included higher age,higher number of chronic diseases,no exercise habit,excessive sleep duration(≥9 h/d),depressive tendency,living with children or spouse,and un-educated(all P＜0.05).In addition,the young-old group who were past smokers(OR=2.009,95％CI:1.019-3.959),were past drinkers(OR=2.213,95％CI:1.141-4.291),and reported self-per-ceived poverty(OR=2.051,95％CI:1.189-3.540),had higher level of care needs.The middle-old group who were female(OR=1.373,95％CI:1.038-1.817),never drank alcohol(OR=1.551,95％CI:1.059-2.269),and were lack of medical insurance(OR=1.598,95％CI:1.053-2.426),and had higher level of care needs.The oldest-old group who were female(medium care needs vs.low care needs:OR=1.412,95％CI:1.062-1.878;high care needs vs.low care needs:OR=1.506,95％CI:1.137-1.993),reported self-perceived poverty(OR=2.064,95％CI:1.282-3.323),and were lack of medical insurance(OR=1.621,95％CI:1.148-2.291),and had higher level of care needs.Conclusion:The identical factors associated with care needs across different age groups include age,chronic disease,exercise,sleep,depression,living arrangement,and education.Smoking,alcohol consumption,and economic status are specific factors among the young-old group of the older adults,while gender and medical insurance are specific factors among the middle-old and the oldest-old group of the older adults.We recommend conducting prospective cohort studies and intervention studies among specific age groups on the above factors to provide reliable evidence for policy formulation.

The incidence of breast cancer is increasing year by year,and its pathogenesis is highly complex.The dysregulation of gut microbiota function is closely related to the occurrence and development of breast cancer.The estrogen levels through enterohepatic circulation is regulated by β-glucuronidase produced by the gut microbiota,thereby influencing the occurrence and development of hormone receptor-positive breast cancer and leading to tamoxifen resistance.The metabolites from the gut microbiota,such as short-chain fatty acids(SCFAs)and lithocholic acid(LCA),can participate in regulating the tumor cell cycles and cell proliferation.The colonization of gut microbiota maintains the integrity of the intestinal barrier and regulates the anti-tumor immunity mediated by T lymphocytes.Maintaining gut microbiota homeostasis can enhance the efficacy of tumor chemotherapy and immunotherapy and reduce the adverse reactions in anti-tumor treatments.The targeted action of engineered probiotics in immunotherapy can improve the precision of drug treatment.The effect of gut microbiota on radiotherapy is not yet clear,but regulating gut microbiota can aid in the treatment of radiation enteritis.This review discusses the correlation and effect of gut microbiota on breast cancer and analyzes its role in the treatment of breast cancer.

Objective:To investigate the long-term survival and safety in patients with muscle-invasive bladder cancer (MIBC) who experienced a noninvasive down-staging (≤pT 1)after transurethral resection of bladder tumor (TURBT) plus systemic chemotherapy and received bladder-sparing treatment. Methods:The records of patients with MIBC who underwent maximal TURBT plus systemic chemotherapy-guided bladder-sparing treatment were reviewed retrospectively from Dec 2013 to Dec 2020. Eventually, 22 patients who achieved noninvasive down-staging underwent conservative management. The total patient cohort contained 10 males and 12 females. A majority of patients had single lesion and stage T2 disease. The median age of the patients was 66 years and the median tumor size was 3.0 cm. All patients underwent maximal TURBT to resect all visible diseases and followed by 3-4 cycles platinum-based systemic chemotherapy. After achieving noninvasive down-staging, 14 patients received concurrent chemoradiotherapy, and the other 8 patients underwent surveillance. Overactive bladder symptom score (OABSS) was used to assess the bladder function after treatment.Results:Twelve patients achieved pT 0 and 10 patients were down-staged to cT a-T 1. At a median follow-up of 36.7 months, 90.9%(20/22) patients retained their bladder function successfully. Among the 14 patients who received concurrent chemoradiotherapy, 4 had grade 3 or 4 adverse events. Among the 8 patients who underwent surveillance, 3 had grade 3 or 4 adverse events after systemic chemotherapy.Nine patients experienced tumor recurrence in the bladder, and 2 patients died of bladder cancer. Seven (31.8%) patients experienced Ⅲ/Ⅳ grade complications. The 5-year recurrence-free survival (RFS) and overall survival (OS) in patients achieved pT0 were 66.7% and 100.0%, respectively. The 5-year RFS and OS in patients achieved cTa-T1 were 40% and 72%, respectively. The OABSS score of 20 patients who retained their bladder successfully was (1.00±1.03). Conclusions:MIBC patients who achieved noninvasive down-staging might be candidates for the bladder-sparing treatment with maximum TURBT followed by systemic chemotherapy.The patients who achieved pT 0 might have better prognosis with functional bladder.

Purpose: Reduced quality of life after cystectomy has made bladder preservation a popular research topic for muscle-invasive bladder cancer (MIBC). Previous research has indicated significant tumor downstaging after neoadjuvant chemotherapy (NAC). However, maximal transurethral resection of bladder tumor (TURBT) was performed before NAC to define the pathology, impacting the real evaluation of NAC. This research aimed to assess real NAC efficacy without interference from TURBT and apply combined modality therapies guided by NAC efficacy. Materials and Methods: Patients with cT2-4aN0M0 MIBC were confirmed by cystoscopic biopsy and imaging. NAC efficacy was assessed by imaging, urine cytology, and cystoscopy with multidisciplinary team discussion. Definite responders (≤ T1) underwent TURBT plus concurrent chemoradiotherapy. Incomplete responders underwent radical cystectomy or partial cystectomy if feasible. The primary endpoint was the bladder preservation rate. Results: Fifty-nine patients were enrolled, and the median age was 63 years. Patients with cT3-4 accounted for 75%. The median number of NAC cycles was three. Definite responders were 52.5%. The complete response (CR) was 10.2%, and 59.3% of patients received bladder-sparing treatments. With a median follow-up of 44.6 months, the 3-year overall survival (OS) was 72.8%. Three-year OS and relapse-free survival were 88.4% and 60.0% in the bladder-sparing group but only 74.3% and 37.5% in the cystectomy group. The evaluations of preserved bladder function were satisfactory. Conclusion After stratifying MIBC patients by NAC efficacy, definite responders achieved a satisfactory bladder-sparing rate, prognosis, and bladder function. The CR rate reflected the real NAC efficacy for MIBC. This therapy is worth verifying through multicenter research.

Objective:To investigate the expressions of CD200 and inducible costimulator (ICOS) protein in angioimmunoblastic T-cell lymphoma (AITL) and the relationship with prognosis as well as their significances in the differential diagnosis of AITL.Methods:A total of 39 AITL patients in the First People's Hospital of Chenzhou, the Fourth People's Hospital of Chenzhou, Xiangnan College Affiliated Hospital and Chenzhou 3rd People's Hospital from June 2012 to December 2019, and 10 patients with classic Hodgkin lymphoma (CHL) and 10 patients with peripheral T cell lymphoma, not otherwise specified (PTCL-NOS) from August 2016 to July 2019 in the First People's Hospital of Chenzhou were selected. Immunohistochemistry was used to detect the expressions of CD200, ICOS, CD10, programmed death 1 (PD-1), bcl-6 and CXC chemokine receptor-13 (CXCL13) proteins, and the correlation of CD200 and ICOS with clinicopathological features and prognosis of AITL patients was analyzed, and the diagnostic significance of both in differentiating AITL from PTCL-NOS and CHL was also analyzed.Results:The positive rates of CD200 and ICOS in 39 AITL patients were 71.79% (28/39) and 61.54% (24/39), respectively. There were 7 cases of CD200 weak and moderate positive in 10 CHL patients, and ICOS proteins were all negative. Among 10 PTCL-NOS patients, 4 patients had CD200 positive and 1 patient had ICOS positive. The differences in positive rates of ICOS protein between AITL patients and CHL, PTCL-NOS patients were statistically significant (all P < 0.05); the differences in positive rates of CD200 protein between AITL patients and CHL, PTCL-NOS patients were not statistically significant ( χ2=0.013, P=0.911; χ2=3.551, P=0.060). The positive rate of CD200 in AITL patients with elevated lactate dehydrogenase (LDH) and international prognostic index (IPI) score of 3-4 was higher than that in AITL patients with normal LDH and IPI score of 0-2 (both P < 0.05); The positive rate of ICOS in AITL patients with elevated LDH and PD-1 positive was higher than that in AITL patients with normal LDH and PD-1 negative (both P < 0.05). CD200 negative AITL patients had better 3-year overall survival (OS) rate (4.2% vs. 66.7%) and 3-year progression-free survival (PFS) rate (5.3% vs. 77.1%) compared with those in CD200 positive AITL patients, and the differences between both groups were statistically significant (both P < 0.01); there was a statistically significant difference in 3-year OS rate between ICOS positive AITL patients and ICOS negative AITL patients (15.3% vs. 38.6%, P=0.011), while there was no statistically significant difference in 3-year PFS rate of both groups (18.6% vs. 41.5%, P=0.059). Multivariate analysis showed CD200 ( HR=0.076, 95% CI 1.555-79.497, P=0.001), extranodal involvement or not ( HR=11.117, 95% CI 1.555-79.497, P=0.016) and LDH ( HR=2.147, 95% CI 0.844-5.459, P=0.109) were independent influencing factors of OS in AITL patients; CD200 ( HR=0.075, 95% CI 0.016-0.357, P=0.001) and LDH ( HR=2.335, 95% CI 0.929-5.870, P=0.071) were independent influencing factors of PFS in AITL patients. Conclusions:CD200 and ICOS can be used as immunohistochemical indicators to assist the diagnosis of AITL patients. ICOS protein helps to differentiate AITL from CHL and PTCL-NOS; CD200 can be used as indicators to judge the prognosis and deterioration of AITL patients.