Plant-derived natural products have long been a vital source for developing therapeutic drugs. Wedelolactone (WDL), a coumestan isolated from Eclipta prostrata, Wedelia calendulacea, Wedelia chinensis, and Sphagneticola trilobata, demonstrates a broad spectrum of therapeutic potential, including anticancer, anti-inflammatory, anti-obesity, anti-myotoxic, antimicrobial, anti-diabetic, and tissue-protective activities. This review synthesizes information on the isolation, total synthesis, pharmacological activity, underlying mechanisms, and pharmacokinetic properties of WDL. Additionally, it offers insights into potential clinical applications and future drug discovery avenues utilizing WDL or its derivatives, either independently or in combination with other pharmaceuticals.
Coumarins/isolation & purification* ; Humans ; Animals ; Biological Products/chemical synthesis* ; Molecular Structure ; Plant Extracts/chemical synthesis* ; Wedelia/chemistry* ; Eclipta/chemistry*

This consensus was developed by the Orthodontic Society of the Chinese Stomatological Association to provide a systematic, scientific, and practical guideline for informed consent in orthodontic care. Orthodontic treatment is typically lengthy, highly individualized, and involves multiple factors such as growth and development, occlusal function, and facial esthetics. Rapid technological advances and diverse risk profiles make the traditional reliance on orthodontist experience or institutional templates insufficient to ensure patients′ full understanding and autonomous decision-making. To address this, the expert panel conducted extensive reviews of domestic and international guidelines, analyzed representative dispute cases, and performed multicenter patient-clinician surveys. Using a multi-round Delphi method, the group established a standardized informed consent framework covering the initial consultation, treatment, and retention phases. The consensus emphasizes that informed consent is not only a fundamental legal and ethical requirement but also a key step in building trust, improving patient compliance, and enhancing treatment satisfaction. Orthodontists should clearly and comprehensively explain treatment plans, potential risks, uncertainties, and associated costs, while respecting the autonomy of patients or guardians, and maintain continuous communication and dynamic evaluation throughout the treatment process. The release of this consensus provides unified and authoritative guidance for clinical orthodontics, helping to standardize informed consent, enhance its transparency, safeguard patient rights, reduce medical risks, and promote high-quality, sustainable development of orthodontic practice.

This consensus was developed by the Orthodontic Society of the Chinese Stomatological Association to provide a systematic, scientific, and practical guideline for informed consent in orthodontic care. Orthodontic treatment is typically lengthy, highly individualized, and involves multiple factors such as growth and development, occlusal function, and facial esthetics. Rapid technological advances and diverse risk profiles make the traditional reliance on orthodontist experience or institutional templates insufficient to ensure patients′ full understanding and autonomous decision-making. To address this, the expert panel conducted extensive reviews of domestic and international guidelines, analyzed representative dispute cases, and performed multicenter patient-clinician surveys. Using a multi-round Delphi method, the group established a standardized informed consent framework covering the initial consultation, treatment, and retention phases. The consensus emphasizes that informed consent is not only a fundamental legal and ethical requirement but also a key step in building trust, improving patient compliance, and enhancing treatment satisfaction. Orthodontists should clearly and comprehensively explain treatment plans, potential risks, uncertainties, and associated costs, while respecting the autonomy of patients or guardians, and maintain continuous communication and dynamic evaluation throughout the treatment process. The release of this consensus provides unified and authoritative guidance for clinical orthodontics, helping to standardize informed consent, enhance its transparency, safeguard patient rights, reduce medical risks, and promote high-quality, sustainable development of orthodontic practice.

Background In recent years, radiation diagnosis and treatment technology has been increasingly applied and popularized in the medical field, and the status of radiation health protection has attracted widespread attention. Objective To understand the knowledge, attitude, and behavior of radiological health protection in radiation workers in Jiading District of Shanghai. Methods Convenience sampling method was used to select 441 radiation workers from 33 medical institutions in Jiading District, Shanghai to conduct a questionnaire survey from May to August 2023. Basic information and radiation protection associated knowledge, attitude, and behavior were collected from the study participants, and the scores of knowledge, attitude, and behavior were calculated. Factors affecting the behavior were evaluated by multiple linear regression. Results A total of 441 subjects were included in this study, with an age range of 22-71 years, 53.06% male and 46.94% female. In terms of knowledge, the correct response rate of the study subjects to the seven questions on the basics of radiation protection ranged from 44.22%-96.60%, with the lowest rate of 44.22% for the question on "radiation stochastic effect diseases". The subjects acquired knowledge about radiation hygiene mainly through vocational training (98.41%), and wanted to acquire knowledge mainly about the basics of nuclear and radiation (76.42%). In terms of attitude, the recognition level (strongly agree/agree) of the study subjects on the six attitude questions ranged from 73.47% to 96.37%, in which only 56.92% of the radiological staff at tertiary hospitals believed that the radiation dose they were exposed to at work would be hazardous to their health, and 73.85% believed that it was necessary to participate in training on knowledge of radiological protection, both lower than those in other levels of hospitals. In terms of behavior, the implementation rate (always/often) of the five behavioral questions by the study participants ranged from 75.28% to 91.84%, and there was a statistically significant difference in the total behavioral scores of the study participants by levels of hospitals (P=0.015). The results of multiple linear regression showed that gender, age, and radiation work permit associated with the behavioral scores of the study subjects. Conclusion In Jiading District, Shanghai, the coginitive rate of radiation workers' basic knowledge of theoretical protection still needs to be improved, and occupational training should be carried out in a targeted manner; the attitude of radiation workers varies by levels of hospitals, and the publicity and education of workers at tertiary hospitals in particular should be strengthened; and the supervision and management of male, senior, and non-certified radiation workers in hospitals of different levels should be enhanced.

Objective:This study aimed to compare the efficacy and safety between high-dose intravenous iron and oral iron in treating iron deficiency anemia (IDA) .Methods:This prospective randomized controlled study (1∶1) enrolled 338 patients with IDA at The First Affiliated Hospital of Soochow University, Suzhou Hongci Hematology Hospital, and Huai’an Second People’s Hospital from June 1, 2022, to January 19, 2024. Of all the patients, 169 received high-dose intravenous iron therapy and 169 received oral iron treatment for 12 weeks of observation. Focus on the hemoglobin (HGB) change from baseline to week 4, secondary focus was on the HGB and iron metabolism parameters (serum iron [SI], transferrin saturation [TSAT], total iron binding force [TIBC], serum ferritin [SF]), and changes in the fatigue score, efficacy, and treatment-related adverse effects were monitored throughout in the two treatment groups.Results:The HGB levels were improved in both treatments, but the HGB improved faster in the intravenous group compared with the oral group. HGB increased from (76.8±15.0) g/L to (118.0±13.3) g/L in the intravenous group and from (77.9±11.6) g/L to (104.3±15.0) g/L in the oral group after 4 weeks of treatment. The increase from baseline in the intravenous group (40.7±17.3) g/L was significantly higher than that in the oral group (27.2±17.5) g/L ( P<0.001). The intravenous group demonstrated a more significant early effect than the oral group in terms of iron metabolism parameter improvement. SI, TSAT, TBIC, and SF increased better from baseline at 4 weeks in the intravenous group than in the oral group ( P<0.001). Additionally, the intravenous group exhibited better fatigue scores for early improvement than the oral group ( P<0.001). The incidence of total adverse effects was similar in the intravenous group as compared to the oral group (3.5% [6/169] vs 5.9% [10/169], P=0.442) . Conclusion:High doses of intravenous iron quickly boost HGB early, causing rapid improvement in SI, TSAT, TBIC, SF, and patient fatigue scores. The patient was well tolerated.

Objective To investigate the current status of military training injuries among aviation cadets in a university,analyze the influencing factors and propose prevention and control measures.Methods Enrolled in the study in December 2021 were 605 male aviation cadets,of whom 192 were freshmen,202 were sophomores and 211 were juniors.A self-made questionnaire form was developed and used to investigate and analyze the occurrence of training injuries among aviation cadets.Results The rate of training injuries among the aviation cadets was 57.19%,of whom 43.75%were freshmen,60.40%were sophomores,and 66.35%were juniors.Injuries sites were mainly in the lower extremities,with freshmen,sophomores and juniors ranking the first,but with a decreasing trend.In injury-causing subjects,3 000 m race ranked the first in the freshmen,single parallel bars ranked the first in the sophomores,other factors ranked the first in the juniors.In terms of medical care,self-diagnosis and care accounted for 34.97%and outpatient medical care accounted for 46.82%,with the sum of them accounting for 81.79%.Conclusion There is a relatively high rate of training injuries among aviation cadets.The number of training injuries,affected injury sites,injury-causing subjects,onset of seasons and adverse factors vary with the advance of grades and display various features.Further emphasis on health education among aviation cadets and the improvement of outpatient medical service are of great importance to the prevention and treatment of training injuries among aviation cadets.

Objective:To evaluate the efficacy and safety of chimeric antigen receptor T-cell (CAR-T) therapy followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with Ph-like acute lymphoblastic leukemia (Ph-ALL) .Methods:Patients with Ph-ALL who underwent CAR-T therapy followed by allo-HSCT from March 2018 to August 2023 at the First Affiliated Hospital of Soochow University were included, and their clinical data were retrospectively analyzed.Results:Of the 21 patients, 14 were male and 7 were female. The median age at the time of CAR-T therapy was 22 (6-50) years. Seven patients had ABL1-like rearrangements, and 14 had JAK-STAT rearrangements. Prior to CAR-T therapy, 12 patients experienced hematologic relapse; 7 were multiparameter flow cytometry minimal residual disease (MFC-MRD) -positive and 2 were MFC-MRD-negative. CAR-T cells were derived from patients’ autologous lymphocytes. Nine patients were treated with CD19 CAR-T cells, and 12 were treated with CD19/CD22 CAR-T cells. After assessment on day 28 after CAR-T therapy, 95.2% of the patients achieved complete remission, with an MRD-negative remission rate of 75%. Nineteen patients developed grade 0–2 cytokine release syndrome (CRS) and 2 patients suffered grade 3 CRS, all cases of which resolved after treatment. All patients underwent allo-HSCT after CAR-T therapy. The median time from CAR-T therapy to allo-HSCT was 63 (38-114) days. Five patients experienced relapse after CAR-T therapy, including four with hematologic relapse and one with molecular relapse. The 3-year overall survival (OS) rates in the ABL1 and JAK-STAT groups were (83.3±15.2) % and (66.6±17.2) %, respectively ( P=0.68) . The 3-year relapse-free survival (RFS) rates were (50.0±20.4) % and (55.6±15.4) % in the ABL1 and JAK-STAT groups, respectively. There was no significant difference in 3-year OS or RFS between the two groups. Conclusions:CAR-T therapy followed by allo-HSCT leads to rapid remission in most patients with Ph-ALL and prolongs leukemia-free survival.

Background::Although overnight fasting is recommended prior to endoscopic retrograde cholangiopancreatography (ERCP), the benefits and safety of high-carbohydrate fluid diet (CFD) intake 2 h before ERCP remain unclear. This study aimed to analyze whether high-CFD intake 2 h before ERCP can be safe and accelerate patients’ recovery.Methods::This prospective, multicenter, randomized controlled trial involved 15 tertiary ERCP centers. A total of 1330 patients were randomized into CFD group ( n = 665) and fasting group ( n = 665). The CFD group received 400 mL of maltodextrin orally 2 h before ERCP, while the control group abstained from food/water overnight (>6 h) before ERCP. All ERCP procedures were performed using deep sedation with intravenous propofol. The investigators were blinded but not the patients. The primary outcomes included postoperative fatigue and abdominal pain score, and the secondary outcomes included complications and changes in metabolic indicators. The outcomes were analyzed according to a modified intention-to-treat principle. Results::The post-ERCP fatigue scores were significantly lower at 4 h (4.1 ± 2.6 vs. 4.8 ± 2.8, t = 4.23, P <0.001) and 20 h (2.4 ± 2.1 vs. 3.4 ± 2.4, t= 7.94, P <0.001) in the CFD group, with least-squares mean differences of 0.48 (95% confidence interval [CI]: 0.26–0.71, P <0.001) and 0.76 (95% CI: 0.57–0.95, P <0.001), respectively. The 4-h pain scores (2.1 ± 1.7 vs. 2.2 ± 1.7, t = 2.60, P = 0.009, with a least-squares mean difference of 0.21 [95% CI: 0.05–0.37]) and positive urine ketone levels (7.7% [39/509] vs. 15.4% [82/533], χ2 = 15.13, P <0.001) were lower in the CFD group. The CFD group had significantly less cholangitis (2.1% [13/634] vs. 4.0% [26/658], χ2 = 3.99, P = 0.046) but not pancreatitis (5.5% [35/634] vs. 6.5% [43/658], χ2 = 0.59, P = 0.444). Subgroup analysis revealed that CFD reduced the incidence of complications in patients with native papilla (odds ratio [OR]: 0.61, 95% CI: 0.39–0.95, P = 0.028) in the multivariable models. Conclusion::Ingesting 400 mL of CFD 2 h before ERCP is safe, with a reduction in post-ERCP fatigue, abdominal pain, and cholangitis during recovery.Trail Registration::ClinicalTrials.gov, No. NCT03075280.

Background::Programmed death 1 (PD-1) blockade plus chemotherapy has become the new first-line standard of care for patients with advanced non-small-cell lung cancer (NSCLC). Yet not all NSCLC patients benefit from this regimen. This study aimed to investigate the predictors of PD-1 blockade plus chemotherapy in untreated advanced NSCLC.Methods::We integrated clinical, genomic, and survival data from 287 patients with untreated advanced NSCLC who were enrolled in one of five registered phase 3 trials and received PD-1 blockade plus chemotherapy or chemotherapy alone. We randomly assigned these patients into a discovery cohort ( n = 125), a validation cohort ( n = 82), and a control cohort ( n = 80). The candidate genes that could predict the response to PD-1 blockade plus chemotherapy were identified using data from the discovery cohort and their predictive values were then evaluated in the three cohorts. Immune deconvolution was conducted using transcriptome data of 1014 NSCLC patients from The Cancer Genome Atlas dataset. Results::A genomic variation signature, in which one or more of the 15 candidate genes were altered, was correlated with significantly inferior response rates and survival outcomes in patients treated with first-line PD-1 blockade plus chemotherapy in both discovery and validation cohorts. Its predictive value held in multivariate analyses when adjusted for baseline parameters, programmed cell death ligand 1 (PD-L1) expression level, and tumor mutation burden. Moreover, applying both the 15-gene panel and PD-L1 expression level produced better performance than either alone in predicting benefit from this treatment combination. Immune landscape analyses revealed that tumors with one or more variation in the 15-gene panel were associated with few immune infiltrates, indicating an immune-desert tumor microenvironment.Conclusion::These findings indicate that a 15-gene panel can serve as a negative prediction biomarker for first-line PD-1 blockade plus chemotherapy in patients with advanced NSCLC.

OBJECTIVE To explore the effect of silencing RNA-373(mir-373)on the proliferation and apoptosis of laryngeal cancer cells and its mechanism.METHODS Laryngeal cancer cells were divided into control group,overexpression group and silence group.Stable overexpression group and silence group were established by cell transfection.MTT assay was used to detect cell proliferation,TUNEL method was used to detect the apoptotic ability,cell invasion was detected by Transwell chamber,cell migration was detected by cell scratch test,Western blot was used to detect the expression of β-Catenin,c-myc,CyclinD1,MMP-9,bc1-2 and Bax in Wnt/β-catenin signaling pathway.RESULTS Compared with over expression group,the expression of mir-373 in silence group was significantly decreased(t=15.062,P<0.05).Compared with the overexpression group,the apoptosis rate was higher and the proliferation rate was lower in the silencing group at different time points(t=31.025,16.453,22.475,29.672,P<0.05).Compared with overexpression group,the invasion ability and migration number of cells in silencing group were lower(t=35.254,37.205,P<0.05).Compared with overexpression group,the expression levels of β-Catenin,c-myc,CyclinD1,MMP-9,bc1-2 protein in silencing group were lower,and Bax protein was higher(t=4.218,5.307,4.609,5.005,4.328,3.984,P<0.05).CONCLUSION Silencing mir-373 may promote apoptosis and inhibit invasion,proliferation and migration of laryngeal cancer cells by promoting Bax expression,inhibiting the expression of β-Catenin,c-myc,CyclinD1,MMP-9 and bc1-2,and blocking Wnt/β-catenin signaling pathway.