The spine is the most common site of skeletal metastasis in lung cancer, which frequently leads to severe complications such as pathological fracture and neurological compromise and is associated with poor prognosis. The development and progression of spinal metastasis from lung cancer are linked to the unique local microenvironment and tumor microenvironment (TME) of the vertebral column. During metastatic evolution, the dense vascular network of the spine and a plethora of signaling molecules, together with the complex cellular constituents and their intricate interactions within the TME, all cooperate to facilitate the tumor invasion and colonization of the vertebral compartment. Mechanistic studies delineating the role of the TME in spinal metastasis from lung cancer have markedly expanded, fostering the emergence of innovative therapeutic strategies—including nanomedicines, sono-photodynamic therapy, gene therapy, and combination regimens. These strategies demonstrate remarkably potential for clinical translation and offer new directions for the precision management of spinal metastasis from lung cancer.

Based on the concept of "regulating the five zang organs and harmonizing the spleen and stomach"， globus hystericus is believed to originate from dysfunction of the five zang organs and disharmony of the spleen and stomach. Treatment primarily focuses on regulating the spleen and stomach while also considering other affected organs， with a self-prescribed Anpiwei Jingyan Formula （安脾胃经验方） for harmonizing the spleen and stomach as the foundational treatment. Additionally， syndrome-based modifications are applied according to imbalances in the heart， lung， kidney， or liver. For heart-yang deficiency， modified Linggui Zhugan Decoction （苓桂术甘汤） could be combined； for heart-yin deficiency， modified Tianwang Buxin Pill （天王补心丹） could be combined. For lung failing to disperse and descend and fluid retention， modified Sanao Decoction （三拗汤） could be combined； for lung and stomach yin deficiency， modified Shashen Maidong Decoction （沙参麦冬汤） could be combined. For kidney-yang deficiency with ascending counterflow of cold water， modified Jingui Shensi Pill （金匮肾气丸） could be combined； for kidney-yin deficiency， modified Liuwei Dihuang Pill （六味地黄丸） could be combined. For liver constraint and spleen deficiency， modified Sini Powder （四逆散） could be combined； for liver-yin deficiency or liver stagnation transforming into fire and attacking the stomach， modified Yiguan Decoction （一贯煎） could be combined.

We report a 30-year-old woman who presented with intermittent gross hematuria and left flank pain，and CT revealed a left staghorn stones. The initial percutaneous nephrolithotomy（PCNL）left a 6 mm fragment，and both stone and urine cultures yielded extended-spectrum β-lactamase（ESBL）-producing Escherichia coli. Seven months later，the stone increased to 6 cm and urine culture revealed Proteus mirabilis. Endoscopic combined intrarenal surgery（ECIRS）achieved complete clearance. At 6-month follow-up，the patient remained asymptomatic，culture-negative，and stone-free. This case highlights that small residual fragments after PCNL may rapidly enlarge with secondary urease-producing infection，underscoring the need for early re-intervention and standard follow-up.

Objective:To investigate the prevalence of infectious diarrhea among older adult patients with schizophrenia, identify the influential factors, and construct a nomogram prediction model for infectious diarrhea.Methods:This study is a prospective cohort study that used convenience sampling to select 160 older patients with schizophrenia from three psychiatric hospitals in Wenzhou (85 cases from Wenzhou Seventh People's Hospital, 40 cases from Lucheng Third People's Hospital, and 35 cases from The Affiliated Kangning Hospital of Wenzhou Medical University) who were admitted between January 2022 and December 2023. The prevalence of infectious diarrhea and its influential factors were statistically analyzed. Regression analysis was conducted to develop a risk prediction model for infectious diarrhea, which was presented using a nomogram.Results:A total of 160 older adult patients with schizophrenia were aged between 61 and 79 years, with an average age of (67.82 ± 7.56) years. Among these patients, 53 were female (33.13%), and 107 were male (66.87%). Thirty-four patients experienced infectious diarrhea, with an incidence rate of 21.25%. Univariate analysis revealed significant differences in body mass index ( χ2 = 9.36, P = 0.009), history of diarrhea ( χ2 = 4.52, P = 0.033), disinfection of tableware ( χ2 = 4.16, P = 0.04), handwashing before and after meals ( χ2 = 6.11, P = 0.013), intestinal flora disorder ( χ2 = 19.43, P < 0.001), CD 4+/CD 8+ ratio ( t = 12.37, P < 0.001), interleukin-17 ( t = 15.86, P < 0.001), and fecal secretory IgA ( t = 20.18, P < 0.001) in older adult patients with schizophrenia. Multifactorial analysis indicated that body mass index ( OR = 0.733), disinfection of tableware ( OR = 0.733), handwashing before and after meals ( OR = 0.452), CD 4+/CD 8+ ratio ( OR = 0.359), interleukin-17 ( OR = 0.563), and fecal secretory IgA ( OR = 0.455) were protective factors against infectious diarrhea in older adult patients with schizophrenia (all P < 0.05). Conversely, a history of diarrhea ( OR = 1.774) and intestinal flora disorder ( OR = 1.528) were identified as risk factors for infectious diarrhea in this population (both P < 0.05). Conclusions:The influential factors for the occurrence of infectious diarrhea in older adult patients with schizophrenia include body mass index, history of diarrhea, disinfection of tableware, handwashing before and after meals, intestinal flora disorder, CD 4+/CD 8+ ratio, interleukin-17, and fecal secretory IgA levels. Future studies should conduct longitudinal research to optimize the prediction model and establish a dynamic nomogram model. This will provide nurses with a reliable tool for dynamically predicting the occurrence of infectious diarrhea in older adult patients with schizophrenia, with the aim of reducing the incidence of infectious diarrhea and improving the patients' quality of life.

We report a 30-year-old woman who presented with intermittent gross hematuria and left flank pain，and CT revealed a left staghorn stones. The initial percutaneous nephrolithotomy（PCNL）left a 6 mm fragment，and both stone and urine cultures yielded extended-spectrum β-lactamase（ESBL）-producing Escherichia coli. Seven months later，the stone increased to 6 cm and urine culture revealed Proteus mirabilis. Endoscopic combined intrarenal surgery（ECIRS）achieved complete clearance. At 6-month follow-up，the patient remained asymptomatic，culture-negative，and stone-free. This case highlights that small residual fragments after PCNL may rapidly enlarge with secondary urease-producing infection，underscoring the need for early re-intervention and standard follow-up.

Objective To analyze risk factors of acute cardio-cerebrovascular accidents in elderly patients with lower extremity fracture,and to construct a risk prediction diagram model.Methods A retrospective analysis was conducted on the clinical data of 510 elderly patients with lower extremity fractures,and the patients were divided into the occurrence group and the non-occurrence group based on the occurrence of acute cardiovascular and cerebrovascular accidents during the postoperative hospitalization.Univariate and multivariate Logistic regression analysis was used to analyze risk factors affecting acute cardiovascular and cerebrovascular accidents in elderly patients with lower extremity fracture,and the risk prediction model was constructed and verified.Results A total of 52 cases of acute cardio-cerebrovascular accidents occurred during hospitalization in 510 patients(10.20%).Age,ASA grade Ⅲ ratio,preoperative concurrent cerebrovascular disease,postoperative pneumonia ratio and postoperative bed time≥5 days ratio were higher in the occurrence group than those in the non-occurrence group(P＜0.05).Multivariate Logistic regression analysis showed that age,ASA grade Ⅲ,preoperative concurrent cardiovascular and cerebrovascular disease,and postoperative pneumonia were risk factors for acute cardio-cerebrovascular accidents in elderly patients with lower limb fracture(P＜0.05).Multivariate Logistic regression analysis was used to screen risk factors as predictive variables to build a risk early warning histogram model for acute cardio-cerebrovascular accidents.The total score ranged from 103 to 168 points,corresponding to a risk range of 0.1 to 0.9 points.Receiver operating characteristic curve(ROC)curve results showed that the area under the curve(AUC)of this model for predicting acute cardiovascular and cerebrovascular accidents was 0.980(95%CI:0.964-1.000),and discrete choice approach(DCA)showed that when the risk threshold was 0.2-0.6,the prediction model of this column graph had a good clinical advantage.Conclusion The risk diagram model constructed based on risk factors has good predictive value for the occurrence of acute cardio-cerebrovascular accidents after lower extremity fracture in elderly patients.

New Medical Sciences, as a crucial initiative in transforming and upgrading medical education and healthcare services in China, has promoted deep integration of public health with multiple disciplines. However, the public health discipline still faces numerous challenges such as disease prevention system reconstruction, insufficient technological innovation, and the shortage of professional talents. To address these issues, this paper discusses the current status, challenges, and development of the public health discipline in the context of New Medical Sciences, and proposes strategies including reforming talent cultivation models, enhancing practical capabilities, strengthening faculty development, promoting the innovation of scientific research and social service, actively utilizing artificial intelligence technology, and optimizing international cooperation. These measures aim to achieve innovative development in the public health discipline, and better serve the Healthy China strategy and global public health initiatives.

Objective To explore the application effect of vertebroplasty(PVP)combined with precise personalized vertebral stent implantation based on 3D biomechanical modeling in the repair of thoracolumbar fractures.Methods A total of 98 patients with thoracolumbar vertebral fractures treated at our hospital from September 2021 to December 2022 were selected for this study.Patients were divided into two groups based on the surgical method:the conventional group(n=50)and the combined group(n=48).The conventional group received PVP treatment,while the combined group was treated with PVP combined with 3D-printed personalized vertebral body stents.The length of incision,operation time,blood loss,drainage volume and hospital stay of the two groups were recorded.The Oswestry Disability Index(ODI)was used to assess the improvement of thoracolumbar function in patients before surgery and one month after the surgery.Cobb angle,anterior height of injured vertebra and sagittal position index were measured.Visual Analog Scale(VAS)for pain and Short Form-36(SF-36)questionnaire for quality of life were used to evaluate low back pain,lower extremity pain and quality of life of patients before surgery and one month after surgery.Postoperative complications were also recorded.Results The length of incision,operation time,blood loss,drainage volume and hospital stay were lower in the combination group than those of the conventional group(P＜0.05).ODI score and Cobb angle were lower 1 month after surgery than those before surgery in both groups,and the combined group was lower than the conventional group(P＜0.05).One month after operation,the anterior height and sagittal position index of injured vertebrae were higher than those before surgery,and the combined group was higher than the conventional group(P＜0.05).VAS scores were lower and SF-36 scores were higher in both groups one month after operation compared to those before the operation,with the combined group showing lower VAS scores and higher SF-36 scores compared to the conventional group(P＜0.05).The total complication rate was lower in the combined group(2.08％)than that in the conventional group(16.00％,P＜0.05).There was no significant difference in the overall postoperative satisfaction between the conventional group and the combined group.Conclusion The treatment of thoracolumbar fractures with PVP combined with 3D printed personalized vertebral stenting has a remarkable effect.The pain and quality of life of patients have been significantly improved,and the surgical safety is relatively good.

Objective:To analyze the implementation and effectiveness of standardized training for medical aesthetic practitioners in Guangdong province from 2015 to 2023.Methods:Training data from 2015 to 2023 were retrospectively collected from programs organized by the Guangdong Medical Association, including sessions in aesthetic surgery, dermatology, dentistry, traditional Chinese medicine, laser aesthetics, and injectable aesthetics. The training implementation was summarized. A random sample of 120 trainees was selected to complete a questionnaire to assess training outcomes.Results:A total of 45 offline standardized training sessions were held, covering both theoretical and practical instruction. The total training duration reached 180 days, involving 6 776 participant attendances. Aesthetic surgery accounted for the highest number (1 701 attendances), followed by aesthetic dermatology (1 197 attendances). Among specialized technical programs, laser aesthetics (1 708 attendances) and injectable aesthetics (1 578 attendances) had the most participants. Most trainees (5 705 attendances) were physicians from tertiary public general hospitals. A total of 116 questionnaires were collected, with 115 participants expressing satisfaction with the course content, teaching arrangement, and training materials. All trainees passed the skills assessment and received training certificates.Conclusions:The standardized training for medical aesthetic practitioners in Guangdong province from 2015 to 2023 has been well implemented and shows favorable outcomes. It contributes to improving the technical competence of professionals in the medical aesthetics field.

OBJECTIVES: To explore the molecular mechanism of Jiangzhi Huaban Decoction (JZHBD) for improving atherosclerosis through the "qi meridian-blood channels" pathway. METHODS: ApoE^-/- mouse models of atherosclerosis were established by high-fat diet feeding for 8 weeks, with C57BL/6 mice on a normal diet as the controls. Forty ApoE^-/- mouse models were randomized into model group, low-, medium-, and high-dose JZHBD treatment groups, and atorvastatin treatment group (n=8) for their respective treatments for 8 weeks. The changes in body weight and overall condition of the mice were monitored weekly. After the treatments, serum levels of TC, TG, HDL-C, LDL-C, TBA, ALT, and AST of the mice were measured, pathological changes in the liver and aortic root plaques were examined with HE staining, and lipid accumulation in the liver and aortic wall was assessed using Oil Red O staining. The core molecular mechanism was studied through transcriptomics, and the expressions of the key pathway proteins were confirmed using Western blotting and immunohistochemistry. RESULTS: Treatment with JZHBD significantly reduced blood lipid and total bile acid levels, improved liver function and hepatic steatosis, and decreased aortic lipid deposition and plaque area in the mouse models of atherosclerosis. Transcriptomic analysis suggested that the therapeutic mechanism of JZHBD involved reverse cholesterol transport, PPAR signaling, and the inflammatory pathways. In atherosclerotic mice, JZHBD treatment obviously up-regulated hepatic expressions of PPARγ, LXRα, ABCA1, ABCG1, and CYP7A1, down-regulated hepatic expressions of p-p65/p65, IL-6, IL1β in the liver, increased ABCG5 and ABCG8 expressions in the intestines, and decreased ICAM-1 and VCAM-1 expressions in the aortic plaques. CONCLUSIONS JZHBD improves atherosclerotic vascular damage and plaque formation possibly by regulating hepatic reverse cholesterol transport and inflammation via modulating the hepatic PPARγ/LXRα/NF-κB signaling pathway.
Animals ; Drugs, Chinese Herbal/therapeutic use* ; Mice, Inbred C57BL ; Plaque, Atherosclerotic/metabolism* ; Liver/metabolism* ; Mice ; Atherosclerosis/metabolism* ; Cholesterol/metabolism* ; PPAR gamma/metabolism* ; Male ; Diet, High-Fat ; Biological Transport