Objective To evaluate the effectiveness of thermal tomography in breast cancer (BC) screening. Methods We conducted a general population-based BC screening in three regions of Hubei Province (Xiantao, Hongan, and Yangxin Districts). Participants underwent a questionnaire-based interview for baseline data collection. They then received a physical examination, thermal tomography, and ultrasound from doctors and technicians. We compared the efficacies, including sensitivity, specificity, and false-positive rates, of ultrasound and thermal tomography in BC screening. Results A total of 59 712 eligible women were included in this screening program. The BI-RADS 1, 2, 3, 4, and 5 accordance rates between the two screening methods were 0.9549, 0.8047, 0.9037, 0.3352, and 0, respectively. The overall accordance rate was 0.933 1. The kappa consistency results showed that the Cicchetti-Allison and Fleiss-Cohen kappa values were 0.7970 and 0.8583, respectively. Although the two methods had equal sensitivities, specificity was higher in thermal tomography than in ultrasound. The false-positive rate was lower in thermal tomography than in ultrasound. The area under the receiver operating characteristic (ROC) curve of thermal tomography was significantly larger than that of ultrasound. Conclusion The general consistency between thermal tomography and ultrasound in BC screening was high. Thermal tomography outperformed ultrasound in terms of specificity and diagnostic efficiency. Therefore, thermal tomography has a high application value for general population-based BC screening.

BACKGROUND:With the continuous advancement of medical technology,stem cell therapy has been used to treat a variety of diseases,including amyotrophic lateral sclerosis. OBJECTIVE:To review the research progress of stem cell therapy for amyotrophic lateral sclerosis,and prospect the development trend of this field. METHODS:PubMed,China National Knowledge Infrastructure(CNKI),and WanFang Data were searched for articles published from 1995 to 2024 using the key words"amyotrophic lateral sclerosis,mesenchymal stem cells,neural stem/progenitor cells,pluripotent stem cells."A total of more than 1 700 articles were retrieved,and 58 articles were finally included in this review. RESULTS AND CONCLUSION:Amyotrophic lateral sclerosis is a neurodegenerative disease that affects lower motor neurons in the brainstem and spinal cord and upper motor neurons in the motor cortex.The related research of stem cells in the treatment of amyotrophic lateral sclerosis has become a research hotspot.In this review,we summarize the application of different types of stem cells in amyotrophic lateral sclerosis research,including mesenchymal stem cells,neural stem progenitor cells,and induced pluripotent stem cells,and evaluate the key points of preclinical research such as stem cell source,cell volume,stem cell modification methods,and drug delivery routes,which lays the foundation for the future application of stem cell therapy.

OBJECTIVE To establish drug utilization evaluation （DUE） criteria for pyrotinib to promote its appropriate application in clinical practice. METHODS Based on the label of Pyrotinib maleate tablets， with relevant guiding principles and diagnostic and treatment guidelines as the evaluation basis， DUE criteria for pyrotinib were determined through the Delphi method. Attribute hierarchical model （AHM） and entropy weight method （EWM） were used to combine and assign weights to each indicator within the DUE criteria. Additionally， the weighted technique for order preference by similarity to an ideal solution （TOPSIS） method was applied to perform rationality evaluation of medication in archived medical records from Hainan Provincial Tumor Hospital and Hainan Western Central Hospital regarding the use of pyrotinib from November 2019 to November 2023. RESULTS The established DUE criteria for pyrotinib included 4 primary indicators （prescription authority， indications for use， medication process， and medication outcomes） and 11 secondary indicators. The secondary indicators with higher weights were the route of administration and dosage （0.257） and indications in the label （0.241）. Among the 88 archived cases included， there were 28 cases of inappropriate medication （31.82%）， 43 cases of generally appropriate medication （48.86%）， and 17 cases of appropriate medication （19.32%）. The main issues related to inappropriate medication involved off-label use （42.05%） and inappropriate routes of administration and dosage （43.18%）. CONCLUSIONS DUE criteria for pyrotinib established using the AHM-EWM-weighted TOPSIS method is highly operational and results in quantifiable evaluation outcomes. The overall rationality of the use of pyrotinib in the above hospitals remains to be improved， and there are some issues， like the off-label use，and inappropriate routes of administration and dosage being liaoyylyy@163.com unreasonable.

BackgroundMigraine is a common chronic neurological disease， and patent foramen ovale （PFO） has been closely associated with migraine. Current research primarily focuses on the pathological mechanism and the therapeutic effects of interventional closure， with limited attention paid to the impact of PFO on sleep quality in migraine patients. ObjectiveTo compare the difference in sleep quality between PFO-positive and PFO-negative migraine patients， and to analyzes influencing factors of sleep quality in PFO-positive migraine patients， so as to provide references for clinical interventions to improve sleep quality in PFO-positive migraine patients. MethodsA total of 673 migraine patients who met the diagnostic criteria of migraine in the International Classification of Headache Disorders， third edition （ICHD-3）， and all patients underwent contrast-enhanced transcranial Doppler （c-TCD） and transthoracic echocardiographic right heart contrast echocardiography （cTTE） in the Third Hospital of Mianyang from January 2020 to October 2024. Basic demographic data were collected using a self-designed questionnaire， headache severity was assessed with the Visual Analogue Scale （VAS）， and sleep quality was invaluated using the Pittsburgh Sleep Quality Index （PSQI）. PFO patients was diagnosed through c-TCD combined with c-TTE. Binary logistic regression analysis was employed to examine the influencing factors of sleep quality in PFO-positive migraine patients. ResultsA total of 673 （100.00%） migraine patients were enrolled， including 223 PFO-positive cases （33.14%） and 450 PFO-negative cases（66.86%）. The PFO-positive group showed significantly more severe headache severity （χ²=15.799， P<0.01） and poorer sleep quality （χ²=14.377， P<0.01） compared with PFO-negative group. PFO-positive patients demonstrated significantly higher barrier factor scores of sleep quality， sleep latency， sleep efficiency， sleep disturbance， hypnotic medication use， and daytime dysfunction compared with PFO-negative counterparts （t=3.634， 3.269， 2.785， 3.428， 2.907， 3.637， Bonferroni adjust P<0.05/7=0.007）.By contrast， no significant difference was noted in sleep duration scores between the two groups（t=2.349， Bonferroni adjust P>0.05/7=0.007）.The Binary Logistic regression analysis revealed that age （OR=1.021， 95% CI： 1.001~1.041）， headache severity （OR=6.030， 95% CI： 4.085~8.901）， and PFO grade （OR=1.893，95% CI： 1.288~2.784）were significant influencing factors for sleep quality in migraine patients with PFO. ConclusionMigraine patients with PFO-positive exhibited poorer sleep quality compared wtih PFO-negative patients. Older age， higher headache servity， and more severe PFO grade are identified as risk factors for impaired sleep quality in PFO-positive migraine patients.

Objective To evaluate the protective effect of radiation protection safety education (RPSE) on patients with differentiated thyroid carcinoma (DTC) undergoing iodine-131 (¹³¹I) treatment. Methods The DTC patients who undergo ¹³¹I treatment were divided into the control group and the RPSE group using the convenience sampling method, with 142 patients in each group. Patients in the control group received routine health education, while the RPSE group received routine health education combined with RPSE. Dose equivalent rate (DER) on pillows, bed sheets, quilt covers, and household waste of patients were compared between the two groups upon discharge. Results The median (M) DERs of patients' pillows, bed sheets, quilt covers and household waste were 3.86, 3.63, 3.91 and 56.59 times higher in the control group compared with the environmental background level, respectively. The M DERs of patients' pillows, bed sheets, quilt covers were 2.23, 2.18, and 2.55 times higher in the RPSE group compared with the environmental background level, while the M DER of household waste was equivalent to the environmental background level. The DERs of patients' pillows, bed sheets, quilt covers, and household waste in the RPSE group were significantly lower than those in the control group (all P<0.001). The DERs of the above four items were lower in both male and female patients in RPSE group compared with same-gender patients in the control group (all P<0.001). The patients' DERs of the above indicators had no significant difference among different gender in both control group and RPSE group (all P>0.05), except for higher DER of household waste in female patients than that of male patients in the control group (P<0.05). There were no significant differences in the DERs of pillows, bed sheets, quilt covers, and household waste across subgroups, where patients received different treatment doses, of both the control group and the RPSE group (all P>0.05). Conclusion RPSE for DTC patients treated with ¹³¹I, reduces the DERs of pillows, bed sheets, quilt covers, and particularly household waste.

Objective　To analyze the treatment outcomes and influencing factors of elderly pulmonary tuberculosis patients in Henan Province, so as to provide a scientific basis for formulating relevant prevention and control measures as well as effective treatment strategies for elderly tuberculosis patients. Methods　A retrospective research method was conducted to extract the case information of pulmonary tuberculosis patients aged ≥65 years in Henan Province from January 1, 2017, to December 31, 2022, from the subsystem "Tuberculosis Information Management System" under the "National Health Insurance Information Project - China Disease Control and Prevention Information System". Percentage (%) was used to characterize the distribution characteristics, a chi-square trend test was used to describe time variation trends, and a chi-square test along with multivariate logistic regression model was used to analyze the influencing factors. Results　From 2017-2022, the successful treatment rate of elderly pulmonary tuberculosis patients in Henan Province was 94.89%（60 016/63 252）, while the rate of adverse outcomes was 5.12%（3 236/63 252）. The rate of adverse outcomes showed a fluctuating upward trend (χ2 trnd=50.577, P<0.01). Regarding regional distribution, Xuchang City had the lowest rate of adverse outcomes (3.71%) and Luoyang City had the highest rate (9.66%), with a statistically significant difference (χ2=78.531, P<0.01). Influencing factor analysis showed that, in comparison to females, those aged 65-<70, farmers, without comorbidities, newly treated, and pathology negative, the following were identified as risk factors for unsuccessful treatment outcomes: males (OR=1.332, 95% CI: 1.231-1.441), age 70-<75 (OR=1.302, 95% CI: 1.188-1.427), age 75-<80 (OR=1.659, 95% CI: 1.510-1.822), ≥80 years (OR=2.705, 95% CI: 2.479~2.952), those engaged in housework or unemployed (OR=1.408, 95% CI: 1.240-1.599), comorbidities (OR=1.327, 95% CI: 1.198-1.470), retreatment (OR=1.431, 95% CI: 1.297-1.579), and positive pathology (OR=1.562, 95% CI: 1.460-1.670). Conclusions　The rate of successful treatment of elderly pulmonary tuberculosis patients in Henan Province from 2017 to 2022 met the planned target (90%), but the rate of adverse outcomes showed a fluctuating upward trend with uneven geographical distribution. It is necessary to focus on high-risk populations, including males, comorbidities, retreatment, positive pathology, and advanced-age individuals (especially ≥80 years).

Objective Based on magnetic resonance imaging(MRI)indexes and clinical characteristics to analyze the factors affecting the curative effect of percutaneous transforaminal endoscopic discectomy(PTED)in patients with lumbar disc herniation(LDH).Methods 302 patients with LDH from December 2019 to May 2022 were included in the study,all of whom received PTED with 1-year follow-up data.Among of them,272 cases had excellent curative effect and were included in the good prognosis group,while 30 cases had reasonable curative effect and were included in the poor prognosis group.General data,MRI indexes and clinical features of the subjects were collected retrospectively.Univariate analysis and multivariate Logistic regression analysis were used to analyze the influencing factors of curative effect in patients with LDH after PTED.Results In 302 cases of LDH,the excellent in 205 cases,good in 67 cases,fair in 30 cases and poor in 0 case,the prognosis rate was 9.93％.Compared with the good prognosis group,the poor prognosis group had higher proportions of smoking,disc degeneration,longer operation time,higher absolute difference in cross-sectional area(CSA)of psoas major and multifidi,and lower intervertebral foramen area,with statistical significance(P＜0.05).There was no significant difference in age,body mass index(BMI),gender,alcohol consumption,diabetes mellitus,hypertension,hyperlipidemia,annulus fibrosus rupture,lesion segment,Lee zone,Modic change,intraoperative blood loss,incision length,surgical approach,and arthroscopic model between the two groups(P＞0.05).The multivariate Logistic analysis showed that:Smoking(OR=4.179,95％CI:1.035～16.865),gradeⅣ disc degeneration(OR=6.863,95％CI:2.049～22.983),the difference of CSA of psoas major＞1.63 cm2(OR=19.084,95％CI:3.566～102.130)and the difference of CSA of multifidi＞1.02 cm2(OR=482.525,95％CI:19.538～12 137.347)were risk factors for poor prognosis of patients with LDH after PTED,the differences were statistically significant(P＜0.05).The intervertebral foramen area＞118.31 mm2(OR=0.750,95％CI:0.721～0.862)was protective factor for poor prognosis of patients with LDH after PTED,and the difference was statistically significant(P＜0.05).Conclusion Smoking,grade Ⅳ intervertebral disc degeneration,greater than 1.63 cm2 absolute difference in psoas major CSA,and greater than 1.02 cm2 absolute difference in multifidi CSA are risk factors for poor prognosis of PTED in LDH patients.Intervertebral foramen area＞118.31 mm2 is a protective factor for poor prognosis of PTED in LDH patients.Clinically,high-risk patients with poor prognosis can be screened and corresponding intervention strategies can be taken.

Objective:To observe the clinical characteristics and prognosis of patients with acute respiratory distress syndrome (ARDS) in sepsis combined with acute gastrointestinal injury (AGI) of different grades, and to further explore the risk factors associated with the poor prognosis of patients.Methods:The clinical data of patients with septic ARDS admitted to the intensive care unit (ICU) of Tianjin First Central Hospital from March to October 2023 were collected. According to the 2012 European Association of Critical Care Medicine AGI definition and grading criteria, the patients were categorized into AGI grade 0-Ⅳ groups. The clinical characteristics and 28-day clinical outcomes of the patients were observed; the risk factors related to the prognosis of patients with septic ARDS combined with AGI were analyzed by using univariate and multivariate Logistic regression; and the receiver operator characteristic curve (ROC curve) and calibration curves were plotted to evaluate the predictive value of each risk factor on the prognosis of patients with septic ARDS combined with AGI.Results:A total of 92 patients with septic ARDS were enrolled, including 7 patients in the AGI 0 group, 20 patients in the AGIⅠgroup, 38 patients in the AGIⅡ group, 23 patients in the AGIⅢ group, and 4 patients in the AGI Ⅳ group. The incidence of AGI was 92.39%. With the increase of AGI grade, the ARDS grade increased, and acute physiology and chronic health evaluationⅡ(APACHEⅡ), sequential organ failure assessment (SOFA), intra-abdominal pressure (IAP), white blood cell count (WBC), neutrophil count (NEU), lymphocyte count (LYM), lymphocyte percentage (LYM%), and 28-day mortality all showed a significant increasing trend, while the oxygenation index (PaO 2/FiO 2) showed a significant decreasing trend (all P < 0.05). Pearson correlation analysis showed that APACHEⅡscore, SOFA score, and ARDS classification were positively correlated with patients' AGI grade (Pearson correlation index was 0.386, 0.473, and 0.372, respectively, all P < 0.001), and PaO 2/FiO 2 was negatively correlated with patients' AGI grade (Pearson correlation index was -0.425, P < 0.001). Among the patients with septic ARDS combined with AGI, there were 68 survivors and 17 deaths at 28 days. The differences in APACHEⅡscore, SOFA score, ARDS grade, AGI grade, PaO 2/FiO 2, IAP, AGI 7-day worst value, length of ICU stay, and total length of hospital stay between the survival and death groups were statistically significant. Univariate Logistic regression analysis showed that SOFA score [odds ratio ( OR) = 1.350, 95% confidence interval (95% CI) was 1.071-1.702, P = 0.011], PaO 2/FiO 2 ( OR = 0.964, 95% CI was 0.933-0.996, P = 0.027) and AGI 7-day worst value ( OR = 2.103, 95% CI was 1.194-3.702, P = 0.010) were the risk factors for 28-day mortality in patients with septic ARDS combined with AGI. Multivariate Logistic regression analysis showed that SOFA score ( OR = 1.384, 95% CI was 1.153-1.661, P < 0.001), PaO 2/FiO 2 ( OR = 0.983, 95% CI was 0.968-0.999, P = 0.035) and AGI 7-day worst value ( OR = 1.992, 95% CI was 1.141-3.478, P = 0.015) were the independent risk factors for 28-day mortality in patients with septic ARDS combined with AGI. ROC curve analysis showed that SOFA score, PaO 2/FiO 2 and AGI 7-day worst value had predictive value for the 28-day prognosis of patients with septic ARDS combined with AGI. The area under the ROC curve (AUC) was 0.824 (95% CI was 0.697-0.950), 0.760 (95% CI was 0.642-0.877) and 0.721 (95% CI was 0.586-0.857), respectively, all P < 0.01; when the best cut-off values of the above metrics were 5.50 points, 163.45 mmHg (1 mmHg≈0.133 kPa), and 2.50 grade, the sensitivities were 94.1%, 94.1%, 31.9%, respectively, and the specificities were 80.9%, 67.6%, 88.2%, respectively. Conclusions:The incidence of AGI in patients with septic ARDS is about 90%, and the higher the AGI grade, the worse the prognosis of the patients. SOFA score, PaO 2/FiO 2 and AGI 7-day worst value have a certain predictive value for the prognosis of patients with septic ARDS combined with AGI, among which, the larger the SOFA score and AGI 7-day worst value, and the smaller the PaO 2/FiO 2, the higher the patients' mortality.

Objective:To evaluate the effects of different exercises on executive function, moter skills and core symptoms in children with attention deficit hyperactivity disorder (ADHD) using network Meta-analysis, and to provide evidence-based basis for the treatment of children with ADHD.Methods:The randomized controlled trails(RCTs)of exercises on children with ADHD were searched in Web of Science, PubMed, Cochrane Library, Embase, PsycINFO, CNKI, Wanfang Data, VIP and CBM databases.The retrieval time limit was from the establishment of each database to May 2023.The Cochrane quality review manual was used to evaluate the quality of the included literatures.Stata 17.0 software was used to perform network Meta-analysis.Results:Finally, twenty-four studies were enrolled including five types of exercise intervention, such as aerobic exercise, multicomponent exercise, exergaming, high intensity interval training (HIIT) and traditional low-to-moderate intensity exercise therapy (TRAD).The results of network Meta-analysis showed that: in terms of improving executive function(working memory, inhibitory control, and cognitive flexibility), motor skills and core symptoms of children with ADHD, the optimal exercise intervention was aerobic exercises (surface under the cumulative ranking were 78.9%, 73.0%, 88.7%, 77.9% and 69.9% respectively).Conclusion:Exercises can improve executive function, improve motor skills, and alleviate ADHD core symptoms.Aerobic exercise has a better effect on improving executive function, motor skills and core symptoms of ADHD children.

Objective To investigate the regulatory mechanism of Notch signaling pathway by YAP in non-alcoholic steatohep-atitis(NASH)liver fibrosis,and assess the intervention effect of Cigu Xiaozhi prescription in detoxification and phlegm treatment.Methods C57BL/6J mice were randomly divided into different groups,including a normal group,NASH liver fibrosis model group,verteporfin(VP)intervention group,VP+Chinese medicine(Cigu Xiaozhi prescription)low-dose group,VP+Chinese medicine high-dose group,and dimethyl sulfoxide control group.The methionine/choline-deficient diet combined with low-dose CCl4 was used to construct the NASH liver fibrosis model.The degree of liver fibrosis was evaluated using hematoxylin and eosin(HE)and Masson staining.Four protein factors associated with liver fibrosis were detected using enzyme-linked immunosorbent assay,and hydroxyproline levels in the mouse liver was determined using the alkaline water method.The localization of α-SMA,ColⅠ,YAP,and Notch1 proteins in the liver was determined using immunohistochemistry.Additionally,the mRNA and protein expression levels of the Notch signaling pathway molecules,namely Notch1/2,J agged1,and DLL4,were assessed using real-time quantitative PCR and Western blotting analyses,respectively.Results The HE and Masson staining results revealed that the liver cells of NASH liver fibrosis mice were swollen and the cytoplasm was transparent.Additionally,evident fibrosis was observed in the hepatic lobule,portal area,and sinus;it was accompanied by heightened levels of inflam-matory cell infiltration,a large number of fat droplets,and instances of local hepatocyte necrosis,dissolution,and cirrhosis.The four factors associated with liver fibrosis showed a substantial increase(P<0.01).α-SMA,ColⅠ,YAP,and Notch1 were localized in the cytoplasm of hepatocytes.YAP,Notch1/2,and Jagged1 were highly expressed in the liver(P<0.01)but were downregulated after intervention with VP and VP+high and low doses of Cigu Xiaozhi prescription(P<0.05).Meanwhile,DLL4 factor was upregulated in the VP+high-dose of Cigu Xiaozhi prescription group(P<0.05).Conclusion YAP may inhibit activation of the Notch pathway by downregulating Notch1/2 and Jagged1 and upregulating DLL4,thereby interfering with the occurrence of liver fibrosis in NASH.Treatment with Cigu Xiaozhi pre-scription may inhibit Notch signaling pathway activation by downregulating YAP,Notch1/2,and Jagged1 and upregulating DLL4 through its multi-components and multi-targets properties,ultimately slow the progression of liver fibrosis in NASH.