OBJECTIVE To evaluate the efficacy， safety， and cost-effectiveness of posaconazole for the prevention of invasive fungal infections （IFIs）. METHODS PubMed， Embase， CNKI， Wanfang data and other Chinese and English databases were searched， as well as the official websites of related health technology assessment （HTA）. Systematic review （SR）/meta-analysis， pharmacoeconomic studies， and HTA reports of posaconazole for the prevention of IFIs were collected. The retrieval time limit was from the establishment of the database to November 1， 2025. After screening the literature， extracting the data， and evaluating the quality of the literature， the results of the included studies were descriptively analyzed. RESULTS A total of 45 studies were included， involving 17 SR/meta-analyses， 26 pharmacoeconomic studies， 1 SR/meta-analysis combined with a pharmacoeconomic study， and 1 HTA report. In terms of effectiveness， posaconazole was significantly superior to other antifungal drugs （eg.， fluconazole， itraconazole） in reducing the incidence of IFIs， the incidence of invasive aspergillosis， all-cause mortality， and IFI-related mortality （ P ＜0.05）. In terms of safety， posaconazole was significantly superior to other antifungal drugs in the incidence of total adverse reactions （ P ＜0.05）， but there was no significant difference in the incidence of serious adverse reactions， the incidence of gastrointestinal advers e reactions， drug-induced liver injury， and the withdrawal rate due to adverse drug reactions （ P ＞0.05）. In terms of cost-effectiveness， most studies have shown that posaconazole possesses more cost-effectiveness advantages. CONCLUSIONS Posaconazole demonstrates favorable efficacy， safety， and cost-effectiveness in preventing IFIs.

OBJECTIVE To evaluate the efficacy and safety of cholesterol absorption inhibitors （ezetimibe and hybutimibe） combined with statins for the treatment of dyslipidemia. METHODS Randomized controlled trials （RCTs） about above-mentioned drug combination in patients with dyslipidemia were retrieved from CNKI，PubMed and other Chinese and English databases. The retrieval time limit was from the establishment of the database to October 2025. After screening the literature，extracting the data，and evaluating the quality of the literature，network meta-analysis was performed using R software. RESULTS A total of 36 RCTs were included. Results showed that in reducing low-density lipoprotein cholesterol （LDL-C） and total cholesterol （TC）， ezetimibe+statins and hybutimibe+statins were significantly superior to statins+placebo and placebo alone （ P ＜0.05）. The top two interventions according to surface under the cumulative ranking curve （SUCRA） rankings were both ezetimibe+statins and hybutimibe+statins. In terms of triglyceride （TG） lowering， both hybutimibe+statins and ezetimibe+statins were significantly better than statins alone， statins+placebo and placebo alone （ P ＜0.05）， with hybutimibe+statins and ezetimibe+statins ranking top two by SUCRA. For apolipoprotein B （ApoB） reduction， ezetimibe+statins was significantly superior to statins alone and placebo alone （ P ＜0.05）， and the top two SUCRA rankings were ezetim ibe+statins and statins+placebo. In terms of high-density lipoprotein cholesterol （HDL-C） increase， placebo was significantly better than statins alone， hybutimibe+statins， statins+placebo， and ezetimibe+statins （ P ＜0.05）， and the top two SUCRA rankings were placebo alone and statins alone.There was no statistically significant difference in the overall incidence of adverse reactions among the interventions （ P ＞0.05）. CONCLUSIONS Ezetimibe combined with statins shows significant advantages in reducing LDL-C， TC and ApoB， while the hybutimibe combined with statins may have potential advantages in lowering TG； both combination regimens have good safety.

AIM:This study aims to investigate the mechanism by which Zhilianwan(ZLW)decoction affects dextran sodium sulfate(DSS)-induced ulcerative colitis(UC)in mice,focusing on the Toll-like receptor 4(TLR4)/myeloid differentiation factor 88(MyD88)/nuclear factor-κB(NF-κB)signaling pathway.METHODS:Fifty male C57BL/6J mice were allowed ad libitum access to food for 1 week before the experiment.They were randomly divided into 5 groups:control group,model group,mesalazine(ME)group,high-dose ZLW(ZLW-H)group,and low-dose ZLW(ZLW-L)group,with ten mice in each group.All mice,except those in control group that received distilled water,were given a 3%DSS solution for seven consecutive days,starting the intervention on the first day of modeling.Each group re-ceived their respective treatments via gavage at volume of 20 μL/g for ten consecutive days.The mice in control and model groups received an equivalent volume of distilled water,while those in ME,ZLW-H,and ZLW-L groups were adminis-tered 0.2 g·kg-1·d-1 of ME,10.92 g·kg-1·d-1 of ZLW,and 2.73 g·kg-1·d-1 of ZLW,respectively.Body weight and dis-ease activity index(DAI)scores were recorded daily.At the end of the intervention,colon length was measured,and he-matoxylin-eosin staining was performed to assess pathological changes in colon tissues.ELISA and qPCR were employed to measure serum levels of interleukin-1β(IL-1β),IL-6,tumor necrosis factor-α(TNF-α)and IL-10,as well as the mRNA expression levels in colon tissues.Western blot analysis was conducted to evaluate the protein levels of TLR4,MyD88,cytosolic NF-κB and nuclear NF-κB in colon tissues.RESULTS:Compared with model group,the mice treated with ZLW exhibited an increase in body weight and colon length(P＜0.05),along with a decrease in DAI and colon histo-pathological scores(P＜0.05).Serum levels of IL-1β,IL-6,and TNF-α were significantly lower(P＜0.05),while IL-10 levels increased(P＜0.05).The mRNA expression levels of these inflammatory factors in colonic tissues reflected similar trends.Additionally,levels of TLR4,MyD88,and nuclear NF-κB proteins were reduced(P＜0.05),whereas cytosolic NF-κB protein expression was elevated(P＜0.05)in the colon tissues of treated mice.CONCLUSION:ZLW exerts at-tenuating effects on DSS-induced intestinal injury in UC mice,though modulation of the TLR4/MyD88/NF-κB signaling pathway.

Moloney leukemia virus 10(MOV10)gene knockout(MKO)mouse neuro 2a(N2a)cell lines was constructed by CRISPR/Cas9(clustered regularly interspaced short palindromic repeat/CRISPR-associated protein 9)gene editing technology.First,a recombinant plasmid pMD18T-U6-sgRNA expressing MOV10 gene-specific guide RNA(sgRNA)was constructed,and then pMD18T-U6-sgRNA and pMJ920-Cas9-eGFP were co-transfected into N2a.The results showed that the MKO N2a cell line had normal cell activity and cell proliferation ability.The infection test of the MKO N2a cell line was carried out using the rabies virus(RABV)and vesicular stomatitis virus(VSV)of the Rhabdoviridae family.The results showed that the replication level of the Rhabdoviridae virus in the MKO N2a cell line was significantly enhanced.The results showed that a MKO N2a cell line was successfully constructed in this study,which provided a preliminary basis for the exploration of the biological function and antiviral mechanism of MOV10 and the develop-ment of a recombinant viral vector vaccine with RABV/VSV as the vector.

Objective:To investigate the current prevalence and control status of coal-burning-borne endemic fluorosis in key areas of the disease in Zhenxiong County of Yunnan Province, thereby providing scientific basis for formulating subsequent prevention strategies and measures.Methods:From October to November 2023, a simple random sampling method was used to conduct a survey in three key townships (towns) in Zhenxiong County, Chishuiyuan Town, Yanyuan Town, and Linkou Yi and Miao Ethnic Township. Three administrative villages were selected from each township (town) as survey sites, and dental fluorosis examination on children aged 8 - 12 years who were born and lived in the local area was conducted. Thirty households were selected from each survey site, the use of household stoves and the formation of related healthy living behaviors were investigated. At the same time, a survey was conducted among primary school students and housewives to investigate their knowledge of coal-burning-borne endemic fluorosis prevention and control. The control and elimination of endemic areas were evaluated according to the "Assessment Protocol for Control and Elimination of Key Endemic Diseases (2019 Edition)".Results:A total of 1 172 children were examined, and the detection rate of dental fluorosis was 7.76% (91/1 172), with a dental fluorosis index of 0.11. A total of 295 households were investigated, and the qualified improved stoves rate and the correct use rate of qualified improved stoves were 95.59% (282/295) and 100% (282/282), respectively. The correct drying rate of edible corn and chili peppers was 79.66% (235/295). The awareness rates of coal-burning-borne endemic fluorosis prevention and control knowledge among housewives and primary school students were 46.69% (409/876) and 82.49% (440.5/534), respectively. Among the 9 villages investigated, two villages had met the criteria for eliminating endemic disease areas, two villages had met the criteria for controlling endemic disease areas, and the remaining 5 villages were uncontrolled.Conclusions:After implementing the comprehensive prevention and control measures mainly based on changing stoves, coal-burning-borne endemic fluorosis condition in Zhenxiong County has been effectively controlled, but there is still a significant gap between the elimination goals of some endemic fluorosis areas. Therefore, it is necessary to continue to strengthen prevention and control measures and promote health education.

Objective:To establish a chain management model for blood glucose in critically ill patients after cardiac surgery and analyze its clinical effectiveness, and to provide a reference for related clinical nursing practices.Methods:A quasi-experimental study design was adopted. Using convenience sampling, 120 critically ill patients after cardiac surgery admitted to Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were selected as study subjects. They were divided into groups based on the time of admission to the intensive care unit after surgery. Sixty patients admitted from March to May 2024 were assigned to the control group and received conventional blood glucose management. Another 60 patients admitted from June to August 2024 were assigned to the observation group and received the chain management model for blood glucose control in addition to the conventional approach. Blood glucose levels and quality indicators of blood glucose management (including maximum blood glucose fluctuation, time in target glucose range, duration of insulin use, incidence of hypoglycemia, etc.) were compared between the two groups.Results:The control group included 27 males and 33 females, with an age of 63.00(59.00, 69.25) years; the observation group included 28 males and 32 females, with an age of 66.00(60.00, 70.00) years. The blood glucose levels of the observation group on postoperative days 2, 3, 4 were 9.10(8.68, 9.90), 8.90(8.40, 10.00), 8.75(7.38, 9.03) mmol/L, respectively, which were lower than those of the control group [10.30(9.80, 11.00), 9.95(9.40, 11.05), 9.30(8.10, 10.02) mmol/L], with a statistically significant difference ( Z=-5.85, -4.95, -3.50, all P<0.05). The maximum blood glucose fluctuation in the observation group was (4.09 ± 2.45) mmol/L, lower than that of the control group [(5.19 ± 2.47) mmol/L], with a statistically significant difference ( t=2.46, P<0.05). The time in the target glucose range was 67.00(60.00, 75.00)% in the observation group, higher than that of the control group 52.00(45.00, 60.00)%, with a statistically significant difference ( Z=-6.57, P<0.05). The duration of insulin use was 6.00(5.00, 7.00) h in the observation group, shorter than that of the control group [13.00(9.75, 15.32) h], with a statistically significant difference ( Z=-8.68, P<0.05). The incidence of hypoglycemia was 3.33%(2/60) in the observation group and 15.00%(9/60) in the control group, with a statistically significant difference ( χ2=4.90, P<0.05). The mechanical ventilation time, ICU stay, and total hospital stay in the observation group were 42.00(37.00, 89.25) h, 6.00(5.00, 7.00) d, and 12.00(11.75, 13.00) d, respectively, which were shorter than those of the control group [96.00(86.25, 98.00) h, 7.00(7.00, 10.00) d, and 13.00(11.75, 15.00) d], with a statistically significant difference ( Z=8.67, 17.57, 4.73, all P<0.05). Conclusions:The implemented chain management model for blood glucose control meets the comprehensive requirements of blood glucose management. It not only reduces blood glucose fluctuations and decreases the incidence of hypoglycemia but also effectively improves the quality of blood glucose management in critically ill patients after cardiac surgery, enhances the safety of blood glucose control, and promotes patient recovery.

Objective:To present an evaluation indicator system for access to cancer screening services.Methods:The evaluation indicator pool was constructed through a scoping review. The theoretical framework was constructed based on the multi-source indicators, and the qualitative expert consultation method was employed to form the initial version of the three-level evaluation indicator system. Delphi expert consultation method was conducted in two rounds to evaluate the relevance, importance, and availability of the proposed evaluation indicator system. The expert positive coefficient, authority coefficient, coordination degree of expert opinions, and concentration of expert opinions were subjected to analysis. Subsequently, the three-level evaluation indicator system for access to cancer screening services was adjusted and determined based on the boundary value method and the open opinions of experts. Finally, the combination weight method was employed to determine the weight.Results:The initial version of the indicator system comprised 3 primary (first-level) indicators, 11 secondary (second-level) indicators, and 46 tertiary (third-level) indicators. Delphi expert consultation was conducted for the initial version, and 17 experts ultimately completed it, exhibiting a positive coefficient of 100% and an authority coefficient of 0.87. In comparison to the initial round of consultation, Kendall's W coefficient ranges (0.15-0.43, all P<0.05) of relevance, importance, and availability scores for each tertiary indicator in the second round exhibited an improvement. The analysis of the importance dimension indicates that expert opinions are also more concentrated, as evidenced by an increase of 8.5% and 7.0% in the proportion of the tertiary indicators with an arithmetic mean above 8 and a full mark ratio above 0.5, respectively. The final evaluation indicator system comprises three primary indicators, with the weights of structure evaluation, process evaluation, and outcome evaluation being 0.338, 0.378, and 0.285, respectively. It also comprises 11 secondary indicators and 45 tertiary indicators. Conclusions:The evaluation indicator system developed in this article can be an effective evaluation tool for quantitative comparison of access to cancer screening services across different populations, cancer types, and before and after intervention. Furthermore, it is recommended that the system undergo continuous optimization concerning its application.

Objective:To summarize the clinical characteristics and key points of diagnosis and treatment in children with TCF3::HLF fusion gene-positive acute lymphoblastic leukemia (ALL).Methods:A case series study was conducted. Clinical data of 8 children diagnosed with TCF3::HLF positive ALL at the Hematology Center of Beijing Children′s Hospital, Capital Medical University and the Hematology Oncology Department of Henan Children′s Hospital between January 2019 and January 2024 were collected. Descriptive analysis was performed on their clinical features, laboratory findings, treatment regimens and prognosis.Results:The cohort included 8 children (3 males and 5 females) with the age of 5.5 (3.5, 7.0) years. Bone pain was the primary clinical manifestation in 4 cases, with multi-site skeletal involvement in 4 cases, hypercalcemia in 5 cases, and coagulation abnormalities in 6 cases. Immunophenotyping revealed common B-cell lineage with myeloid markers in 7 cases and common B-cell phenotype in 1 case. All 8 children were positive for the TCF3::HLF fusion gene. Regarding treatment, 1 case abandoned therapy after diagnosis, while the remaining 7 cases received chemotherapy following the Chinese Children′s Leukemia Group-ALL2018 high-risk protocol. Only 1 case achieved minimal residual disease (MRD) negativity by day 33 of induction therapy. Among the 3 cases with MRD negativity before consolidation therapy, 1 case achieved it via conventional chemotherapy, while 2 cases required additional agents (venetoclax or blinatumomab). One case failed to achieve MRD negativity after consolidation therapy and later discontinued treatment (survival periods: 7months).Of the 4 cases who achieved MRD negativity after consolidation, 2 cases received conventional chemotherapy and 2 cases achieved negativity following chimeric antigen receptor T-cell therapy (CART). All 4 cases underwent hematopoietic stem cell transplantation (HSCT). Two cases in the CART combined with HSCT group survived as of the last follow-up (survival periods: 22 and 13 months). In the conventional chemotherapy combined HSCT group, 1 case relapsed and died (survival: 38 months), and 1 case died from transplant complications (survival: 11 months). The other 2 cases achieved MRD negativity before consolidation therapy but did not receive regular subsequent chemotherapy. After MRD recurrence, they underwent CART therapy without HSCT and remained alive at the last follow-up (survival periods: 49 and 12 months).Conclusions:Children with TCF3::HLF positive ALL often present with bone destruction accompanied by hypercalcemia and coagulopathy at initial diagnosis. This subtype of ALL shows poor response to conventional chemotherapy regimens, characterized by low early remission rates and high relapse risk even after HSCT. Better therapeutic outcomes have been observed with small molecule targeted drugs, immunotherapy and CART therapy.

Objective:To investigate the dose characteristics of the Zeiss INTRABEAM system in air and water, providing dose reference for electronic brachytherapy.Methods:A Monte Carlo program was used to establish a three-dimensional model of a miniature X-ray source vacuum drift tube and a 4 cm spherical applicator. The process of electron beam bombardment on a gold target to generate X-rays was simulated, and parameters such as photon fluence spectrum, percentage depth dose, and half-value layer were calculated. Additionally, the radial dose uniformity in water was measured.Results:The average energy of X-rays at 3 cm in air was 20.8 keV, with a half-value layer of 0.08 mm Al. Under the influence of the applicator, the spectrum becomes hardened, with axial and radial average energies of 28.7 and 29.0 keV, respectively. In water, the percentage depth dose (PDD) curve follows an inverse cubic decay with depth, indicating strong dose concentration and rapid fall-off in near-field irradiation. The radial dose uniformity in water exceeded 99.5%.Conclusions:The INTRABEAM device emits low-energy X-rays characterized by shallow penetration depth, and concentrated dose delivery. Its highly uniform dose distribution ensures comprehensive coverage of the target area, making it particularly suitable for treating superficial tumors and for intraoperative radiotherapy at close range.

Objective In this study,2,4-dinitrochlorobenzene(DNCB)was used to induce the establishment of an atopic dermatitis(AD)model in BALB/c homozygous mice to simulate the skin inflammatory complications in patients with clinical malignancies.Methods BALB/c mice were divided into different groups:negative control group(NC group),model group(MODEL group),atopic dermatitis group(AD group),and dexamethasone group(DEX group).After the mice in MODEL group and DEX group were inoculated with S-180 tumor cells in the axilla,MODEL group,AD group and DEX group were stimulated with DNCB on the dorsal skin and the ear to establish an animal model of atopic dermatitis in tumor-bearing mice.Changes in body weight were observed and recorded,the dorsal skin condition of mice was assessed after the last administration of the drug,the spleen was taken to calculate the spleen coefficient,the difference in the mass of mouse ear slices was determined to calculate the degree of auricular swelling and the rate of inhibition of swelling,and histopathological tests were performed on the dorsal skin tissues to detect the levels of IgE,TNF-α,IL-4,and IL-17 in the serum using an ELISA assay.Results Compared with the NC group,the skin of mice in the MODEL and AD groups showed erythematous,papular,scaly and mossy changes,accompanied by weight loss,and a significant increase in splenic coefficient and auricular swelling.Pathologic findings showed an incomplete skin structure,a significant increase in skin thickness,a large infiltration of inflammatory cells,and an increase in the number of mast cells.Serum levels of IgE,TNF-α,IL-4 and IL-17 were increased.Compared with the MODEL group,the DEX group showed an improvement in all the assays.Conclusions DNCB excitation can successfully establish an animal model of AD in hormonal mice,which is drug-controllable,which provides a useful scientific tool for conducting scientific research related to malignant tumors and skin inflammation.