Objective:To investigate the prevalence of infertility and the factors affecting it in women of reproductive age in Qinghai Province.Methods:From July to December 2024, a multi-stage stratified cluster random sampling approach was used to recruit women aged 20-49 years in 10 districts across 8 cities in Qinghai Province for a questionnaire survey assessing the prevalence of infertility. Univariate and multivariate binary logistic regression analyses were then performed to identify factors associated with infertility in Qinghai Province.Results:A total of 3 925 questionnaires were distributed, with 3 837 valid responses ultimately collected. Preliminary screening identified 581 infertility cases, yielding an infertility rate of approximately 15.1%. Among these, 170 cases were primary infertility and 411 were secondary infertility, accounting for 29.26% and 70.74% of infertility cases, respectively. The highest infertility rate was observed in Yushu City, Yushu Prefecture, at 26.1% (71/272), followed by Chengxi District, Xining City at 25.3% (174/688). The lowest infertility rate was recorded in Delingha City, Haixi Prefecture, at only 2.9% (9/311). Univariate analysis revealed that household registration status ( P<0.001), age ( P=0.016), age at marriage ( P=0.001), highest educational attainment ( P<0.001), per capita annual income ( P=0.001), body mass index (BMI, P=0.005), altitude ( P<0.001), age at menarche ( P=0.011), menstrual regularity ( P<0.001), menstrual cycle ( P=0.001), menstrual duration ( P<0.001), presence of blood clots ( P<0.001),whether the women smoking ( P=0.008), whether the women staying up late ( P=0.022), and whether the husband staying up late ( P<0.001) were independent factors for infertility. Multivariate binary logistic regression analysis revealed that non-agricultural household registration ( OR=1.637, 95% CI: 1.304-2.054, P<0.001), BMI≥24.0 kg/m2 ( OR=1.326, 95% CI: 1.077-1.632, P=0.008), age at menarche >14 years ( OR=1.405, 95% CI: 1.158-1.705, P=0.001), irregular menstrual cycles ( OR=1.512, 95% CI: 1.127-2.029, P=0.006), menstrual cycle <21 d ( OR=1.572, 95% CI: 1.237-1.998, P<0.001), menstrual duration <7 d ( OR=2.080, 95% CI: 1.529-2.831, P<0.001), and smoking ( OR=2.359, 95% CI: 1.056-5.271, P=0.036) were independent risk factors for infertility. Age and altitude were not independent risk factors for infertility in Qinghai Province. Conclusion:The prevalence of infertility in Qinghai Province is approximately 15.1%. Non-agricultural household registration, BMI≥24.0 kg/m2, age at menarche >14 years, irregular menstrual cycles, menstrual cycle <21 d, menstrual duration <7 d, and smoking are factors influencing infertility, while high altitude does not increase the risk of infertility among women in Qinghai Province.

Purpose To investigate the clinicopathological characteristics of the gastric oxyntic gland adenoma(GOGA).Methods We collected 18 samples of GOGA,histopathological features and immunohistochemical staining were assessed.Main features of pathological diagnosis,treatment methods and follow-up were retrospectively analyzed.Results There were 18 patients,including 9 females and 9 males,aged from 36 to 86 years old.The endoscopic im-age showed a flat lesion with whitish in color or a polypoid protrusions.The size ranged from 0.3 cm to 0.8 cm.Hema-toxylin and eosin staining showed irregular glandular structures in the mucosal lamina propria,with branched and anas-tomosed patterns.The tumour demonstrating composed of chief cells hyperplasia with mild nuclear atypia.All lesions were confined to the mucous lamina propria.There was no atrophic within the peripheral gastic mucosa.Immunohisto-chemical examination showed positive for Pepsinogen-Ⅰ and MUC6.Gene mutation were analyzed in 2 cases using next generation sequence technology,and no KRAS and GNAS mutation had been detected.Endoscopic surgical treatment was performed in 11 cases,and biopsy forceps removal was carried out in 7 cases.No recurrence or metastasis was ob-served during the follow-up period of 1 to 58 months.Conclusion GOGA is a rare lesion,and appears to behave bio-logically benign.A full understanding of its histological morphology and biological behavior can improve the diagnostic ability of clinincans,and facilitate further research in the future.

Objective:To investigate the prevalence of infertility and the factors affecting it in women of reproductive age in Qinghai Province.Methods:From July to December 2024, a multi-stage stratified cluster random sampling approach was used to recruit women aged 20-49 years in 10 districts across 8 cities in Qinghai Province for a questionnaire survey assessing the prevalence of infertility. Univariate and multivariate binary logistic regression analyses were then performed to identify factors associated with infertility in Qinghai Province.Results:A total of 3 925 questionnaires were distributed, with 3 837 valid responses ultimately collected. Preliminary screening identified 581 infertility cases, yielding an infertility rate of approximately 15.1%. Among these, 170 cases were primary infertility and 411 were secondary infertility, accounting for 29.26% and 70.74% of infertility cases, respectively. The highest infertility rate was observed in Yushu City, Yushu Prefecture, at 26.1% (71/272), followed by Chengxi District, Xining City at 25.3% (174/688). The lowest infertility rate was recorded in Delingha City, Haixi Prefecture, at only 2.9% (9/311). Univariate analysis revealed that household registration status ( P<0.001), age ( P=0.016), age at marriage ( P=0.001), highest educational attainment ( P<0.001), per capita annual income ( P=0.001), body mass index (BMI, P=0.005), altitude ( P<0.001), age at menarche ( P=0.011), menstrual regularity ( P<0.001), menstrual cycle ( P=0.001), menstrual duration ( P<0.001), presence of blood clots ( P<0.001),whether the women smoking ( P=0.008), whether the women staying up late ( P=0.022), and whether the husband staying up late ( P<0.001) were independent factors for infertility. Multivariate binary logistic regression analysis revealed that non-agricultural household registration ( OR=1.637, 95% CI: 1.304-2.054, P<0.001), BMI≥24.0 kg/m2 ( OR=1.326, 95% CI: 1.077-1.632, P=0.008), age at menarche >14 years ( OR=1.405, 95% CI: 1.158-1.705, P=0.001), irregular menstrual cycles ( OR=1.512, 95% CI: 1.127-2.029, P=0.006), menstrual cycle <21 d ( OR=1.572, 95% CI: 1.237-1.998, P<0.001), menstrual duration <7 d ( OR=2.080, 95% CI: 1.529-2.831, P<0.001), and smoking ( OR=2.359, 95% CI: 1.056-5.271, P=0.036) were independent risk factors for infertility. Age and altitude were not independent risk factors for infertility in Qinghai Province. Conclusion:The prevalence of infertility in Qinghai Province is approximately 15.1%. Non-agricultural household registration, BMI≥24.0 kg/m2, age at menarche >14 years, irregular menstrual cycles, menstrual cycle <21 d, menstrual duration <7 d, and smoking are factors influencing infertility, while high altitude does not increase the risk of infertility among women in Qinghai Province.

Colorectal cancer is the third leading cause of cancer-related mortality worldwide.Hepatic resection is the standard treatment for colorectal cancer liver metastasis.Microwave ablation(MWA),as a minimally invasive therapeutic approach,offers an alternative treatment option for these patients.But the clinical efficacy of hepatic resection and MWA in treating colorectal cancer liver metastasis patients is still inconclusive.Literatures were retrieved on comparative studies about the treatment of colorectal cancer liver metastasis with hepatic resection and MWA from multiple databases,including sinoMed,PubMed,Web of Science,EMBASE,CNKI,Wanfang,etc.The cutoffdate of retrieval was September 2024.Finally,a total of 13 studies comprising 2 057 patients,were included in this study.The papers were assessed using the Newcastle-Ottawa Scale and Jadad Scale.All included studies were of high quality.Data extraction focused on postoperative complications,length of hospital stay,surgical duration,hospitalization costs,and patient survival outcomes,including overall survival(OS)and disease-free survival(DFS).A meta-analysis was performed using Review Manager 5.4 software.There were no significant differences in OS(HR=1.03,95%CI:0.85-1.25,P=0.77)and DFS(HR=1.27,95%CI:0.94-1.71,P=0.13)between the MWA group and the hepatic resection group.In the subgroup analysis of patients with≤5 liver metastases and size of metastases≤3 cm,there were no statistically significant differences in OS and DFS between the MWA group and the hepatic resection group.The MWA group exhibited shorter hospital stay,reduced hospitalization costs,decreased surgical duration,less intraoperative blood loss,and lower incidence of complications compared to the hepatic resection group(P＜0.05).Therefore,for patients with colorectal liver metastases characterized by a number of liver metastases≤5 and size of metastases≤3 cm,MWA serves as an effective alternative to hepatic resection,with a lower morbidity associated with treatment.Further validation of these findings is warranted through additional randomized controlled trials and cohort studies.The registration number of this Meta-analysis on the PROSPERO platform is CRD42024610278.

BACKGROUND: Neoadjuvant chemoradiotherapy followed by radical surgery has been a common practice for patients with locally advanced rectal cancer, but the response rate varies among patients. This study aimed to develop a ResNet-Vision Transformer based magnetic resonance imaging (MRI)-endoscopy fusion model to precisely predict treatment response and provide personalized treatment. METHODS: In this multicenter study, 366 eligible patients who had undergone neoadjuvant chemoradiotherapy followed by radical surgery at eight Chinese tertiary hospitals between January 2017 and June 2024 were recruited, with 2928 pretreatment colonic endoscopic images and 366 pelvic MRI images. An MRI-endoscopy fusion model was constructed based on the ResNet backbone and Transformer network using pretreatment MRI and endoscopic images. Treatment response was defined as good response or non-good response based on the tumor regression grade. The Delong test and the Hanley-McNeil test were utilized to compare prediction performance among different models and different subgroups, respectively. The predictive performance of the MRI-endoscopy fusion model was comprehensively validated in the test sets and was further compared to that of the single-modal MRI model and single-modal endoscopy model. RESULTS: The MRI-endoscopy fusion model demonstrated favorable prediction performance. In the internal validation set, the area under the curve (AUC) and accuracy were 0.852 (95% confidence interval [CI]: 0.744-0.940) and 0.737 (95% CI: 0.712-0.844), respectively. Moreover, the AUC and accuracy reached 0.769 (95% CI: 0.678-0.861) and 0.729 (95% CI: 0.628-0.821), respectively, in the external test set. In addition, the MRI-endoscopy fusion model outperformed the single-modal MRI model (AUC: 0.692 [95% CI: 0.609-0.783], accuracy: 0.659 [95% CI: 0.565-0.775]) and the single-modal endoscopy model (AUC: 0.720 [95% CI: 0.617-0.823], accuracy: 0.713 [95% CI: 0.612-0.809]) in the external test set. CONCLUSION The MRI-endoscopy fusion model based on ResNet-Vision Transformer achieved favorable performance in predicting treatment response to neoadjuvant chemoradiotherapy and holds tremendous potential for enabling personalized treatment regimens for locally advanced rectal cancer patients.
Humans ; Rectal Neoplasms/diagnostic imaging* ; Magnetic Resonance Imaging/methods* ; Male ; Female ; Middle Aged ; Neoadjuvant Therapy/methods* ; Aged ; Adult ; Chemoradiotherapy/methods* ; Endoscopy/methods* ; Treatment Outcome

Objective To evaluate the reporting quality and influencing factors of patient-reported outcome (PRO) data in randomized controlled trials (RCTs) of lung cancer. Methods RCTs of lung cancer with PRO as either primary or secondary endpoints were searched from PubMed, EMbase, Medline, CNKI, Wanfang Data, and VIP databases between January 1, 2010 and April 20, 2024. Reporting quality of included RCTs were assessed based on the CONSORT-PRO extension. Descriptive statistics and bivariate regression analysis were used to describe the reporting quality and analyze the factors influencing the reporting quality. Results A total of 740 articles were retrieved. After screening, 53 eligible RCTs of lung cancer with 22 780 patients were included. The patients were mainly with non-small cell lung cancer (84.91%), with the median sample size of the included studies was 364.0 (160.5, 599.5) patients. The primary PRO tool used was the EORTC QLQ-C30 (60.38%). There were 52 (98.11%) studies whose PRO measured the domain of "symptom management of cough, dyspnea, fatigue, pain, etc.", and 45 (84.91%) studies measured "health-related quality of life". Multicenter studies accounted for 84.91%, and randomized non-blind trials accounted for 62.26%. PRO was used as the primary endpoint in 33.96% of the studies and as secondary endpoints in 66.04%. The reliability and validity of the PRO tools were explicitly mentioned in 11.32% and 7.55% of the studies, respectively. The average completeness of reporting according to the CONSORT-PRO guidelines was 60.00%, ranging from 25.00% to 93.00%. The main factors affecting the completeness of CONSORT-PRO reporting included sample size and publication year. For every increment in sample size, the completeness of reporting increased by 27.5% (SE=0.00, t=2.040, P=0.046). Additionally, studies published after 2018 had a 67.2% higher completeness of reporting compared to those published in or before 2018 (SE=17.8, t=–3.273, P=0.006). Conclusion The study reveals that the overall reporting quality of PRO in lung cancer RCTs is poor. Particularly, the reporting of PRO measures reliability and validity, PRO assumptions, applicability, and handling of missing data need further improvement. Future research should emphasize comprehensive adherence to the CONSORT-PRO guidelines.

Objective To establish the characteristic atlas of Shexiang Jiegu Capsule and determine the contents of seven active components （hydroxysafflor Yellow A, paeoniflorin, ferulic acid, naringin, ligustilide, catechin, epicatechin）. Methods Octadecyl silane bonded silica gel was used as the filling agent, the mobile phase was composed of methanol-0.05% phosphoric acid by gradient elution, the detection wavelength was 245 nm, flow rate was 1.0 ml/min, column temperature was 30℃. The similarity of the fifteen batches of sample was evaluated in line with the TCM Chromatographic Fingerprint （2012 edition）, and the contents of seven active components were determined. Results The HPLC fingerprint of Shexiang Jiegu Capsules was established. The similarity of fingerprint between fifteen batches of samples and control fingerprint was between 0.893 and 0.992. The results of methodological investigation for the determination of seven active components in fifteen batches of samples all met the requirements. Conclusion The established characteristic atlas of Shexiang Jiegu Capsules had high specificity and good repeatability, which could provide scientific basis for quality control of Shexiang Jiegu Capsules.

ObjectiveTo investigate the potential mechanisms of Zingiberis Rhizoma in treating inflammatory bowel disease （IBD） by integrating network pharmacology with in vitro and in vivo experiments. MethodsTraditional Chinese Medicine Systems Pharmacology Database And Analysis Platform （TCMSP）， Traditional Chinese Medicine Integrated Database （TCMID） Database were used to obtain the active component targets of Zingiberis Rhizoma. GeneCards was used to obtain the IBD targets. DAVID was used to perform Gene Ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analyses on core targets. Cytoscape 3.10.2 was used to establish the "active component-disease target-signaling pathway" interaction network. Mice were randomly assigned to control， model， and Zingiberis Rhizoma （400 mg·kg^-1） groups. An IBD model was induced via dextran sulfate sodium （DSS）. The colonic tissue was collected post-treatment to assess histology， expression of Ly6C⁺ monocytes/macrophages， and mRNA levels of Toll-like receptor 4 （TLR4）， and inflammatory cytokines. The effect of Zingiberis Rhizoma aqueous extract on RAW264.7 cell viability was evaluated. Furthermore， the effects of the extract at 100， 10， and 1 mg·L^-1 on LPS-induced differentiation of RAW264.7 cells into Ly6C^hi monocytes/macrophages， mRNA levels of TLR4 and inflammatory cytokines， and protein levels of factors in the TLR4/mitogen-activated protein kinase （MAPK） signaling pathway. ResultsA total of 241 targets were identified for Zingiberis Rhizoma and 6 787 for IBD， with 122 shared targets among Zingiberis Rhizoma， ulcerative colitis （UC）， and Crohn's disease （CD）. The enrichment analyses yielded 297 GO terms and 88 KEGG pathways. Associations were noted between Zingiberis Rhizoma's active component targets and IBD targets. In vivo experiments： Compared with the control group， the model group showed decreased body weight and disease activity index （DAI）（P<0.01）， shortened colon length， damaged mucosal epithelium with inflammatory cell infiltration， raised pathological scores （P<0.05）， increased Ly6C^hi and Ly6C^lo monocytes/macrophages （P<0.05）， and up-regulated mRNA levels of TLR4， TNF-α， IL-1β， and IL-6 （P<0.05） and protein levels of TLR4， phosphorylated extracellular signal-regulated protein kinase 1/2 （p-ERK1/2）， and phosphorylated p38 MAPK （p-p38 MAPK） （P<0.05）. Zingiberis Rhizoma intervention reversed these changes and reduced Ly6C^hi monocytes/macrophages （P<0.01）. In vitro experiments： compared with the control， LPS increased the proportion and number of Ly6C^hi monocytes/macrophages and mRNA levels of TLR4， TNF-α， IL-1β， and IL-6 （P<0.01） and enhanced the expression of TLR4， p-ERK1/2， and p-p38 MAPK （P<0.05）. Zingiberis Rhizoma reduced Ly6C^hi monocytes/macrophages （P<0.05）， down-regulated the mRNA levels of inflammatory cytokines （P<0.05）， and suppressed the TLR4/MAPK pathway （P<0.05）. ConclusionZingiberis Rhizoma alleviates IBD by suppressing the TLR4/ERK/p38 MAPK signaling pathway and reducing inflammatory cytokine levels in Ly6C^hi monocytes/macrophages.

ObjectiveTo clarify the repair effect of Mume Fructus on the intestinal mucosal epithelial barrier in the mouse model of inflammatory bowel disease （IBD） and explore the repair mechanism. MethodsThirty-six male C57BL/6 mice were randomly assigned into six groups： normal， model， low-， medium-， and high-dose （200， 400， and 800 mg·kg^-1） Mume Fructus， and sulfasalazine （300 mg·kg^-1）. Except the normal group， the rest groups had free access to 2% dextran sulfate sodium （DSS） solution for seven days to establish the IBD model， followed by a seven-day drug intervention. The body weight change and disease activity index （DAI） were recorded. After the last administration， spleen and colon tissue samples were collected to analyze the differences in colon length and spleen index. Hematoxylin-eosin staining was used to observe the morphology of the colon tissue. The level of diamine oxidase （DAO） in the serum was measured by the DAO assay kit. Immunohistochemistry was employed to determine the expression of tight junction proteins such as Claudin-1， Occludin， and zonula occludens-1 （ZO-1） in the colon tissue. Real-time PCR was performed to measure the mRNA levels of tumor necrosis factor-α （TNF-α） and interleukin-1β （IL-1β） in the colon tissue. Finally， Western blot was employed to determine the protein levels of mitogen-activated protein kinase kinase （MEK）， extracellular signal-regulated kinase （ERK）， phosphorylated （p）-MEK， and phosphorylated ERK in the colon tissue. ResultsCompared with the normal group， the model group exhibited decreases in body weight and colon length （P<0.01）， increases in DAI， spleen index， and serum DAO level （P<0.01）， damaged colonic epithelium and goblet cells， and obvious infiltration of inflammatory cells. In addition， the model group exhibited higher positive expression of Claudin-1， Occludin， and ZO-1 （P<0.01）， higher mRNA levels of TNF-α and IL-1β （P<0.01）， and higher protein levels of p-MEK and p-ERK （P<0.05， P<0.01） than the normal group. However， sulfasalazine and three doses of Mume Fructus markedly decreased the body weight and DAI （P<0.05）， recovered the colon length and spleen index， alleviated colon tissue damage， lowered the level of DAO in the serum （P<0.01）， and down-regulated the mRNA levels of TNF-α and IL-1β （P<0.01） and the protein levels of p-MEK and p-ERK （P<0.05）. Sulfasalazine and low- and medium-dose Mume Fructus increased the positive expression of Occludin， Claudin-1， and ZO-1 （P<0.05， P<0.01）. Furthermore， high-dose Mume Fructus elevated the protein expression of Occludin （P<0.05）. ConclusionMume Fructus can restore the expression of intestinal epithelial tight junction proteins by inhibiting the phosphorylation of proteins in the MEK/ERK signaling pathway and down-regulating the levels of TNF-α and IL-1β， thus repairing the intestinal mucosal barrier in the mouse model of IBD.