ObjectiveTo investigate the mechanism by which Jianpi Xiao'ai prescription （JPXAP） inhibits colorectal cancer progression by regulating the inducible nitric oxide synthase-arginase 1 （iNOS-ARG1） metabolic axis and inducing mitochondrial reactive oxygen species （mito-ROS）-mediated mitochondrial structural and functional impairment. MethodsAn arginine metabolism disorder model of human colorectal cancer HCT116 cells was established by combined treatment with recombinant human interferon-γ （IFN-γ， 10 μg·L^-1） and N（ω）-hydroxy-L-arginine （Nor-NOHA， 200 μmol·L^-1） for 24 h， followed by intervention with 5%， 10%， or 20% JPXAP-containing serum. Cell proliferation was assessed using cell counting kit-8 （CCK-8）， 5-ethynyl-2′-deoxyuridine （EdU） staining， and colony formation assays. Cell invasion and migration were evaluated using Transwell chamber and wound healing assays. Mitochondrial membrane potential （MMP） and ROS levels were assessed by JC-1 and MitoSOX staining， respectively. Mitochondrial ultrastructure was observed by transmission electron microscopy （TEM）. The expression of iNOS， ARG1， and mitochondrial dynamics-related proteins， including mitofusin 2 （MFN2） and dynamin-related protein 1 （DRP1）， was analyzed by Western blot and immunofluorescence. The levels of L-arginine， citrulline， and urea were determined by colorimetric methods and enzyme-linked immunosorbent assay （ELISA）. ResultsCompared with the blank group， the model group exhibited significantly upregulated iNOS expression， downregulated ARG1 expression， a decreased ARG1/iNOS ratio， reduced L-arginine and urea levels， and increased citrulline levels （P<0.05）. Meanwhile， mito-ROS accumulation was significantly increased， the JC-1 red/green fluorescence ratio was decreased， and mitochondria showed swelling and cristae disruption， indicating that metabolic disorder induced mitochondrial injury. Compared with the model group， all JPXAP-treated groups further decreased the ARG1/iNOS ratio， enhanced nitric oxide （NO） and reactive nitrogen species accumulation， further reduced L-arginine and urea levels， and increased citrulline levels （P<0.01）. EdU-positive rate， colony formation rate， wound healing rate， and Transwell invasion number all decreased significantly with increasing serum concentration （P<0.01）. Mito-ROS levels were further elevated， and the JC-1 red/green ratio further decreased. TEM revealed aggravated mitochondrial swelling and vacuolization. MFN2 expression was downregulated and DRP1 expression was upregulated （P<0.01），in a dose-dependent manner. ConclusionJPXAP further activates NO-mediated oxidative/nitrosative stress under arginine metabolism imbalance， inducing mito-ROS accumulation， MMP collapse， and mitochondrial dynamics imbalance， thereby inhibiting colorectal cancer cell proliferation and migration. These findings reveal an antitumor mechanism of JPXAP based on coordinated targeting of the "metabolism-mitochondria" axis.

AIM: To evaluate the postoperative clinical efficacy of non-diffractive extended depth of focus intraocular lens(EDOF IOL)in patients with highly myopic cataract(HMC).METHODS:A retrospective analysis was conducted on the clinical data of patients diagnosed with HMC at the hospital from January 2022 to December 2024. Patients were divided into an observation group [undergoing femtosecond laser-assisted cataract surgery(FLACS)combined with non-diffractive EDOF IOL implantation] and a control group(undergoing FLACS combined with aspheric monofocal IOL implantation)according to the type of implanted IOL. Postoperative visual acuity(LogMAR), visual quality, and patient satisfaction were compared between the two groups.RESULTS: A total of 33 patients(47 eyes)were finally included in this study, including 10 patients(17 eyes)in the observation group and 23 patients(30 eyes)in the control group. The observation group had a median age of 59.0(52.8, 63.8)y, with 8 males(13 eyes)and 2 females(4 eyes). The control group had a median age of 56.0(53.5, 60.0)y, with 13 males(17 eyes)and 10 females(13 eyes). At 3 mo postoperatively, the best-corrected distance visual acuity(BCDVA)was 0.10(0.08, 0.12)in the observation group and 0.20(0.10, 0.40)in the control group(P=0.586). However, the best-corrected intermediate visual acuity(BCIVA)[0.10(0.10, 0.10)vs 0.50(0.40, 0.90), P=0.032] and best-corrected near visual acuity(BCNVA)[0.20(0.18, 0.20)vs 0.60(0.45, 1.45), P=0.044] in the observation group were significantly better than those in the control group. The defocus curve showed that the uncorrected visual acuity(UCVA)in the observation group was relatively stable within the range of -2.00 to +1.00 D, which was superior to that in the control group. Postoperative questionnaires showed that the spectacle independence rate(76%)and overall satisfaction(88%)in the observation group were significantly higher than those in the control group(10% and 60%, respectively).CONCLUSION: Non-diffractive EDOF IOL significantly improves intermediate and near visual acuity, reduces spectacle dependence, and maintains distance visual acuity by extending the depth of focus, providing better postoperative visual quality and life satisfaction for HMC patients.

Bronchiolar adenoma (BA) is a rare type of lung tumor characterized by bilayered epithelial cells having a continuous basal layer and a luminal layer. It resembles mucinous adenocarcinoma (MA) on frozen section, with difficulty in distinguishing the basal layer. Immunohistochemistry is the best choice for verifying the diagnosis. This study aimed to comprehensively characterize three cases of BA-combined carcinoma using clinical, histopathological, and genetic features. BA and carcinoma sections were subjected to next-generation sequencing, respectively. It was hypothesized that while different mutation forms matched different regions, BA and lung adenocarcinoma shared the same gene mutation when they co-occurred in the same location. BA with extensive carcinoma is extremely rare and presents diagnostic challenges due to its overlap with conditions such as MA. Because of its distinctive morphological characteristics, BA may be regarded as a low-grade malignancy, particularly during a confusing evaluation. A multifaceted examination of clinical, radiological, immunohistochemical, and genetic data is necessary for an accurate diagnosis.

Objective To compare and analyze malaria epidemic trends and characteristics of initial confirmed cases before and after malaria eliminating in Qingjiangpu District, Huai′an City, and to provide a scientific basis for improving strategies to prevent imported malaria retransmission. Methods Malaria case data from Qingjiangpu District were obtained from the National Infectious Disease Information Reporting System for 2010-2023. Case investigation and epidemiological data were summarized and analyzed for the pre-elimination period (2010-2016)and post-elimination period(2017-2023). Results A total of 185 malaria cases were reported between 2010 and 2023, with one locally acquired case in both 2010 and 2011; the remainder were imported, primarily falciparum malaria. Post-elimination cases decreased from 140 to 45, showing a statistically significant difference in case distribution ratios(χ2=9.642, P<0.05). Seasonal peaks occurred in early January and mid-July before elimination but showed no distinct pattern afterward. Malaria cases were mainly imported from Africa countries, and most patients were young adult males. Post-elimination, the proportion of migrant workers decreased, while technical and business personnel increased significantly(χ2=17.855, P<0.05). Both time-to-diagnosis and time-to-certification changed markedly after elimination, with township health centers showing improved diagnostic accuracy at initial visits. All confirmed patients were treated at designated municipal medical institutions. Conclusions After malaria elimination in Qingjiangpu District, imported malaria remains a serious concern, with cases reported each year. Therefore, it is necessary to continue strengthening the malaria monitoring system, enhance screening and evaluation of key populations, improve health education, raise diagnostic and treatment capacity across all medical institutions, and consolidate the achievements of malaria elimination.

ObjectiveTo observe the clinical efficacy and safety of Yanghe Xiaonang Decoction （阳和消囊汤， YXD） in the treatment of polycystic ovarian syndrome （PCOS）-related infertility with healthy qi deficiency and phlegm stasis syndrome. MethodsA total of 120 PCOS-related infertility participants with healthy qi deficiency and phlegm stasis syndrome were randomly divided into a treatment group and a control group in a 1∶1 ratio， with 60 cases in each group. The treatment group started taking YXD on the first day of the menstrual cycle， one dose daily， until the day of sexual intercourse when follicles matured and were released. Those without mature follicles or ovulation could take it until the 14th to 28th day. The control group was given oral letrozole at 2.5 mg daily starting on the 5th day of the menstrual cycle for 5 consecutive days. If the basal body temperature curve remained monophasic on the 28th day of the menstrual cycle， and no dominant follicle was detected by color Doppler ultrasound， estrogen plus progesterone or progesterone alone was administered for withdrawal bleeding， followed by a new treatment cycle. The treatment lasted for three consecutive menstrual cycles. Patients were followed up for 3 months upon confirmed pregnancy or after the completion of the 3rd treatment cycle. The clinical pregnancy rate， total effective rate， pregnancy rate， biochemical pregnancy rate， embryonic arrest rate， and ectopic pregnancy rate between the two groups were compared. Transvaginal color Doppler ultrasound was used for monitoring endometrial thickness， cyclic ovulation status， number of follicles between 2-9 mm， and the difference in transverse and longitudinal diameters of dominant follicles. The levels of endocrine hormone indicators including serum testosterone （T）， prolactin （PRL）， luteinizing hormone （LH）， follicle-stimulating hormone （FSH）， progesterone （P）， estradiol （E₂）， free testosterone （F-T）， androstenedione （ASD）， inhibin B （INH-B）， and anti-Müllerian hormone （AMH）， as well as the total traditional Chinese medicine （TCM） symptom scores before and after treatment were compared between the two groups. ResultsA total of 58 patients in each group were included in the statistical analysis. The clinical pregnancy rate in the treatment group was 39.66% （23/58）， higher than 22.41% （13/58） in the control group （P＜0.05）. The total effective rate in the treatment group was 96.55% （56/58）， higher than 79.31% （46/58） in the control group （P＜0.05）. The biochemical pregnancy rate and embryonic arrest rate in the treatment group were lower than those in the control group （P＜0.05）. The treatment group was superior to the control group in increasing endometrial thickness and reducing the number of 2-9 mm follicles at the 2nd and 3rd cycles， as well as in improving the cyclic ovulation status and the difference in transverse and longitudinal diameters of dominant follicles at the 3rd cycle （P＜0.05）. After treatment， the treatment group exhibited significant reductions in serum T， LH， F-T， ASD， INH-B， and AMH levels （P＜0.05）. The control group also showed significant decreases in LH， F-T， INH-B， and AMH levels （P＜0.05）. The levels of F-T， INH-B， and AMH in the treatment group after treatment were lower than those in the control group （P＜0.05）. The improvement of the total TCM symptom score in the treatment group was superior to that in the control group （P＜0.05）. ConclusionYXD can significantly improve the clinical pregnancy rate， reduce the rates of biochemical pregnancy and embryonic arrest， alleviate clinical symptoms， increase endometrial thickness， enhance dominant follicles， and improve endocrine hormone levels in PCOS-related infertility with healthy qi deficiency and phlegm stasis syndrome， showing good safety.

Mosquito-borne diseases pose a major threat to global public health. The gut microbiota colonizing the mosquito intestinal tract plays a critical role in regulating pathogen infection, replication, and transmission. This review summarizes the effects of mosquito gut microbiota on the transmission potential of mosquito-borne pathogens, explores the interaction mechanisms between gut microbial communities and pathogens, and discusses the potential of microbiome-based strategies to reduce mosquito-borne disease transmission.

Objective To evaluate the short-term outcomes of near-infrared fluorescence imaging (NIRF) technique in minimally invasive McKeown esophagectomy for esophageal cancer. Methods Patients who consecutively underwent minimally invasive McKeown esophagectomy for esophageal cancer performed by a single surgical team in the Department of Thoracic Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, between July 2020 and December 2023 were included. Patients were categorized into an NIRF group and a control group based on whether NIRF was employed to assess gastric conduit blood flow. We compared the clinical characteristics, operative parameters, major postoperative complications, and short-term quality of life between the two groups. Results A total of 246 patients were included. The NIRF group comprised 132 patients (85 males, 47 females) with a mean age (62.6±6.7) years, and the control group included 114 patients (78 males, 36 females) with a mean age (64.4±3.8) years. There were no significant differences in operative time, intraoperative blood loss, number of harvested lymph nodes, or hospital stay between the two groups (P>0.05). Similarly, the rates of recurrent laryngeal nerve injury or cardiopulmonary complications did not differ significantly between the groups (P>0.05). No chylothorax or 90-day mortality occurred in either group. Anastomotic leakage occurred in 5 (3.79%) patients in the NIRF group and 9 (7.89%) patients in the control group. The difference in anastomotic leakage rates was not statistically significant (P=0.098), showing only a trend towards a lower incidence in the NIRF group. Receiver operating characteristic curve analysis indicated that maximum fluorescence intensity (MFI) was correlated with gastric conduit perfusion, with an MFI of 20.5 identified as the cutoff value for predicting anastomotic leakage (P=0.039). Further analysis showed that in the NIRF group, an indocyanine green fluorescence imaging time >95 s and a blood flow velocity <1.7 cm/s were significantly associated with an increased risk of anastomotic leakage (P<0.05). The SF-36 quality of life score at 3 months postoperatively was significantly better in the NIRF group than in the control group (P<0.001); however, there was no significant difference in scores between the two groups at 12 months postoperatively (P=0.704). Conclusion In minimally invasive esophagectomy for esophageal cancer, NIRF can effectively assess gastric conduit blood perfusion using quantitative parameters, demonstrates a trend towards reducing anastomotic leakage rates, and contributes to accelerated early postoperative recovery and improved short-term quality of life.

Objective:To investigate the clinical and genetic characteristics of patients with amyotrophic lateral sclerosis (ALS) caused by FUS gene mutations. Methods:A retrospective analysis was conducted on 7 families diagnosed with FUS gene related ALS in the Department of Neurology of Henan Provincial People′s Hospital from January 2018 to June 2024. Clinical data and neuroelectrophysiological results of the probands and family members were collected. Next generation sequencing or whole exome sequencing was conducted on the probands. The detected variants of the FUS gene were confirmed by Sanger sequencing. Results:Among the 7 probands, 4 were with familial ALS and 3 with sporadic ALS, including 6 males and 1 female. The average age of onset was 24.6 years (ranging from 21 to 30 years). The onset site included bulbar muscles in 1 case, proximal upper limbs in 3 cases, proximal lower limbs in 2 cases, and both upper and lower limbs in 1 case. Four patients presented both upper and lower motor neurons involvement on examination, and 3 had only lower motor neuron syndrome. Muscle atrophy and fasciculation were observed in 6 patients respectively, and dyspnea in 3 patients. Bilateral muscle strength was asymmetric in 5 patients. Proximal muscle weakness was predominant in 6 of the 7 patients with upper limb weakness, and 3 of the 5 patients with lower limb weakness. Electromyography showed neurogenic damage in all 7 cases. Five heterozygous variants of the FUS gene were detected in 7 patients, including 2 patients with c.1574C>T(p.P525L), 2 with c.1552A>G(p.R518G), 1 with c.1561C>T(p.R521C), 1 with c.1441delC(p.R481Efs *48), and 1 with both c.1574C>T(p.P525L) and c.430_447del(p.G144_Y149del) variants. The variant c.1441delC(p.R481Efs *48) had not been previously reported. During follow-up, 6 patients died of respiratory failure 6-18 months after onset, with an average of 11.8 months. Conclusions:Patients with FUS gene related ALS have an early age of onset, rapid progression, short survival period, asymmetric limb weakness, and more severe involvement of proximal limbs. The c.1574C>T(p.P525L) is a hotspot mutation, and the novel variant c.1441delC(p.R481Efs *48) enriches the mutation spectrum of the FUS gene.

Objective To explore the mechanism of Kangliu Zengxiao Jiandu Prescription(KLJD)in enhancing the efficacy of cisplatin chemotherapy in non-small cell lung cancer(NSCLC)through network pharmacology and in vivo/in vitro experiments.Methods Components of KLJD were screened via the TCMSP database to identify active components and potential targets.Lung cancer-related genes were obtained from the GeneCards and OMIM databases.GO and KEGG pathway enrichment analysis was performed on drug-disease intersection targets using the Metascape database;molecular docking was performed between core target proteins and main active components.A Lewis lung cancer mouse model was established,and intervened with KLJD and cisplatin.Organ indexes and tumor inhibition rate were counted,and Western blot and RT-PCR were used to detect the expressions of key pathway target proteins and mRNA;A549 and H1299 cells were intervened with KLJD,and Western blot was used to detect key target protein expressions.Results Network pharmacology identified 74 active components and 20 key targets of KLJD,primarily involved in biological processes such as cell proliferation and inflammatory response,and pathways in cancer and PI3K/AKT signaling pathway;molecular docking revealed stable binding between EGFR and major compounds.Animal experiments demonstrated that,compared with the model group,the KLJD group showed significantly higher tumor inhibition rate(P<0.01)and downregulation of EGFR,AKT and PI3K protein and mRNA expression in tumor tissues(P<0.05).Compared with the cisplatin group,the combination group exhibited significantly enhanced tumor inhibition rate(P<0.01),elevated thymic and splenic indices(P<0.01),and decreased EGFR,PI3K and AKT protein and mRNA expressions(P<0.01).Cell experiments showed that KLJD concentration-dependently inhibited A549 and H1299 cell proliferation(IC50:14.72 mg/mL and 14.68 mg/mL,respectively).Combined with cisplatin,KLJD synergistically down-regulated EGFR PI3K and AKT protein expressions(P<0.01).Conclusion KLJD effectively enhances cisplatin's chemotherapeutic efficacy in NSCLC by inhibiting the EGFR/PI3K/AKT pathway while improving immune organ function.Its mechanism likely involves multi-target regulation,including suppression of tumor proliferation,promotion of apoptosis,and modulation of the immune microenvironment.

Objective To investigate the characteristics of intestinal flora and its correlation with peripheral blood microinflammatory factors in patients with pulmonary tuberculosis complicated with diabetes mellitus(PTB-DM).Methods A total of 162 patients with PTB-DM admitted to the hospital from September 2022 to September 2024 were selected as the PTB-DM group,and another 150 healthy subjects who underwent physi-cal examinations during the same period in the hospital were selected as the control group.The clinical data of all research subjects was collected.The composition of intestinal flora of the research subjects was analyzed by using 16S rRNA gene sequencing technology.The levels of peripheral blood microinflammatory factors[inter-feron-γ(IFN-γ),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)]in all research subjects were detected.The clinical data,composition of intestinal flora and levels of microinflammatory factors of the PTB-DM group were compared with those of the control group.Spearman correlation analysis was used to analyze the correlation between the relative abundance of intestinal flora and the levels of peripheral blood microin-flammatory factors in patients with PTB-DM.Results The relative abundances of Bacteroidales and Clostridi-ales in the PTB-DM group were significantly lower than those in the control group,while the relative abun-dances of Enterobacterales and Actinobacteriales were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).The levels of IFN-γ,IL-6 and TNF-α in the PTB-DM group were significantly higher than those in the control group,and the differences were statistically signifi-cant(P<0.05).The relative abundances of Bacteroidales and Clostridiales in the PTB-DM group were nega-tively correlated with the levels of IFN-γ,IL-6 and TNF-α.The relative abundances of Enterobacterales and Actinobacteriales were positively correlated with the levels of IFN-γ,IL-6 and TNF-α(all P<0.05).Conclu-sion There is a significant imbalance of intestinal flora in patients with PTB-DM,and the levels of microin-flammatory factors IFN-γ,IL-6 and TNF-α in peripheral blood are significantly increased,and are closely re-lated to the relative abundance of specific flora.