ObjectiveTo conduct a theoretical study on the medical-rehabilitation integration. MethodsStarting from the background, objectives and content of the medical-rehabilitation integration, this study analyzed its innovative points from the dimensions of conceptual innovation, organizational innovation, model innovation and technological innovation. Results and ConclusionThe medical-rehabilitation integration is an innovation in medical services that takes conceptual innovation as the forerunner, organizational innovation as the foundation, model innovation as the carrier and technological innovation as the core.

Childhood simple obesity has become a significant public health issue in China. Modern medicine primarily relies on lifestyle interventions and often suffers from poor long-term compliance， while pharmacological options are limited and associated with potential adverse effects. Traditional Chinese Medicine （TCM） has a long history in the prevention and management of this condition， demonstrating eight distinct advantages， including systematic theoretical foundation， diversified therapeutic approaches， definite therapeutic efficacy， high safety profile， good patient compliance， comprehensive intervention strategies， emphasis on prevention， and stepwise treatment protocols. Additionally， TCM is characterized by six distinctive features： the use of natural medicinal substances， non-invasive external therapies， integration of medicinal dietetics， simple exercise regimens， precise syndrome differentiation， and diverse dosage forms. By combining internal and external treatments， TCM facilitates individualized regimen adjustment and holistic regulation， demonstrating remarkable effects in improving obesity-related metabolic indicators， regulating constitutional imbalance， and promoting healthy behaviors. However， challenges remain， such as inconsistent operational standards， insufficient high-quality clinical evidence， and a gap between basic research and clinical application. Future efforts should focus on accelerating the standardization of TCM diagnosis and treatment， conducting multicenter randomized controlled trials， and fostering interdisciplinary integration， so as to enhance the scientific validity and international recognition of TCM in the prevention and treatment of childhood obesity.

Breast cancer is the leading cause of cancer-related mortality among women worldwide and has drawn extensive research attention.Owing to its molecular heterogeneity,drug resistance,and low therapeutic response,single-modality treatments often fail to achieve satisfactory efficacy or broad applicability.Combination therapy,designed based on the pathophysiological characteristics,related signaling pathways,and biomarkers of breast cancer,has emerged as a promising approach for improving therapeutic outcomes.With the advancement of research on combination strategies,the understanding of their molecular mechanisms—particularly key signaling pathways and biomarkers—has become increasingly important.However,comprehensive reviews addressing these molecular mechanisms and synergistic strategies remain scarce.This article summarizes recent advances in combination therapy for breast cancer,providing a comprehensive review of recent combination therapies for breast cancer and their underlying molecular mechanisms,and focusing on key signaling pathways involved in combination therapy and synergistic strategies,thereby providing theoretical insights and reference for researchers,graduate students,and clinicians engaged in the development of novel combination therapeutic strategies for breast cancer and related malignancies.

Objective:To explore the effectiveness of find-organize-clarify-understand- select-plan-do-check-act (FOCUS-PDCA) cycle management in improving the accuracy of Nutritional Risk Screening 2002 (NRS 2002) scoring in inpatients.Methods:This study was a retrospective study. Data from a continuous quality improvement project, namely Improving the Accuracy of Nutritional Risk Screening for Inpatients from People's Hospital of Longhua in 2021 were selected. The NRS 2002 scores of newly admitted patients from 8 departments with relatively high nutritional risk (departments of gstroenterology, neurology, nephrology, respiratory medicine, oncology and hematology, neurosurgery, gastrointestinal surgery, and critical care medicine) from April 10, 2021 to April 29, 2021 (before intervention) were collected. The NRS 2002 scores were evaluated by a multidisciplinary nutrition support team in terms of accuracy and error types. Possible issues in the process of nutritional screening were analyzed and mitigated using the FOCUS-PDCA cycle management method. The NRS 2002 scores from July 18, 2021 to August 8, 2021 (after intervention) were collected in real time to summary the data on accuracy and error types and to evaluate the effect of FOCUS-PDCA.Results:The accuracy of NRS 2002 score in the 8 departments was increased from 52.97% (294/555) to 81.13% (473/583) after intervention, and the difference was statistically significant ( χ2=102.606, P<0.001). The accuracy of nutritional status impairment score was 64.14% before intervention, compared with 90.57% after intervention ( χ2=114.484, P<0.001). The accuracy of disease severity score was 78.56%, compared with 89.54% after intervention( χ2=25.736, P<0.001). The false-negative rate was 68.02% before intervention and 31.87% after intervention, and the difference was statistically significant ( χ2=31.501, P<0.001). Conclusion:FOCUS-PDCA can improve the accuracy of NRS 2002 scoring in inpatients, reduce the risk of failing to identify patients at nutritional risk, and contribute to further nutritional diagnosis and treatment.

OBJECTIVE To investigate the improvement effect and mechanism of desloratadine citrate disodium in mice with hypersensitivity pneumonitis(HP).METHODS Sixty mice were randomly divided into blank control group(normal saline),model group(normal saline),prednisone group(positive control,20 mg/kg)and desloratadine citrate disodium low-,medium-and high-dose groups(0.5,1,2 mg/kg),with 10 mice in each group.Except for the blank control group,mice in other groups were intraperitoneally injected with ovalbumin(OVA)and exposed to OVA inhalation to establish the HP model.On day 22 post-modeling,mice in each group were administered the corresponding drugs or normal saline,once a day,for 11 consecutive days.After the last administration,lung function and airway hyperreactivity were assessed.The levels of interleukin-1β(IL-1β),IL-4 and IL-6 in serum as well as the levels of IL-8,IL-13 and IL-17A in bronchoalveolar lavage fluid were determined.Pathological changes in lung tissue of mice were evaluated using Masson staining.Furthermore,the expressions of fibrosis-related proteins,including transforming growth factor β1(TGF-β1),type Ⅲ collagen(Col-Ⅲ)and fibronectin(FN)were determined in lung tissues.RESULTS Compared with the blank control group,the model group showed significant deterioration in lung function(P＜0.01),while airway resistance and serum levels of IL-1β,IL-4,IL-6 and the levels of IL-8,IL-13 and IL-17A in the bronchoalveolar lavage fluid were increased significantly(P＜0.01).The lung tissues exhibited alveolar collapse,atrophy,and structural disarray,along with the formation of extensive deposits of blue collagen fibers,the percentage of positive staining increased significantly(P＜0.01).Additionally,the expression levels of TGF-β1,Col-Ⅲ,and FN proteins in the lung tissues were also increased significantly(P＜0.01).After intervention with desloratadine citrate disodium,the pathological changes in the lung tissues of mice in each dosage group of desloratadine citrate disodium showed varying degrees of improvement,and most of the aforementioned indicator levels were significantly reversed(P＜0.05 or P＜0.01).CONCLUSIONS Desloratadine citrate disodium can improve the lung function and airway hyperreactivity of HP mice,inhibit the release of inflammatory factors in serum and bronchoalveolar lavage fluid,and reduce the deposition of collagen fibers.Its mechanism of action may be related to anti-inflammatory,immunomodulatory,and antifibrotic effects.

AIM:To analyze the expression of se-creted phosphoprotein 1(SPP1)and programmed cell death-ligand 1(PD-L1)in SMARCA4-deficient non-small cell lung cancer,and to provide a scientif-ic basis for the study of the follow-up treatment of this rare pathological type of lung cancer.METH-ODS:The clinical and pathological characteristics of 12 patients with this disease were analyzed retro-spectively,and the patients were divided into two groups of adenocarcinomas and poorly differentiat-ed carcinomas according to their morphological characteristics,and the relationship between the expression of SPP1 and PD-L1 was analyzed in the two groups.RESULTS:SPP1 expression was detect-ed in all patients and Its expression level was signif-icantly higher in the poorly differentiated carcino-ma group compared with the adenocarcinoma group(P=0.015);PD-L1 expression was found in 6/7 patients(5 cases were not measured),compared with the adenocarcinoma group,PD-L1 was also highly expressed in the poorly differentiated carci-noma group(P=0.048)and the PD-L1 difference be-tween the two groups suggested that the results were similar to those of SPP1.CONCLUSION:SMARCA4-deficient non-small cell lung cancer has high positive expression of SPP1 and PD-L1.It was more pronounced in patients with poorly differenti-ated carcinoma.There may be a positive correla-tion between SPP1 and PD-L1 expression in SMAR-CA4-deficient non-small cell lung cancer and the mechanism of the correlation needs to be further verified in subsequent studies.

Objective To explore the effect of Omaha system continuity nursing on the degree of pain and quality of life in patients undergoing arthroscopic rotator cuff repair.Methods A total of 110 patients who underwent arthroscopic rotator cuff repair at the First Affiliated Hospital of Wenzhou Medical University from September 2022 to May 2023 were selected.They were divided into intervention group and control group according to the random number table method,with 55 cases in each group.Patients in control group were given conventional continuous nursing,while patients in intervention group were given Omaha system continuity nursing.Both groups of patients were intervened for 6 months.The range of motion of shoulder joint,shoulder joint function,degree of pain and quality of life of two groups of patients before and after the intervention were compared.Results After the intervention,the range of motion of shoulder joint in intervention group was significantly greater than that in control group,University of California,Los Angeles shoulder joint score and the 8-item short form health survey were significantly higher than those in control group,and numerical rating scale score of pain was significantly lower than that in control group(P＜0.05).Conclusion Omaha system continuity nursing can improve shoulder joint mobility and function,alleriate pain,and improve quality of life for patients undergoing arthroscopic rotator cuff repair surgery.

Objective To explore the association and diagnostic performance of liver imaging reporting and data system(LI-RADS)CT signs with hepatocellular carcinoma(HCC)both in the LI-RADS target population and patients without LI-RADS-defined HCC risk factors.Methods A retrospective analysis was conducted on the data of 435 patients with 482 hepatic lesions confirmed by pathology.Of these,306 cases were assigned to the HCC group(327 HCC lesions),and other 129 cases were assigned to the non-HCC group(77 malignancies and 78 benign lesions).Receiver operating characteristic(ROC)curve analysis assessed the diagnostic performance of LI-RADS v2018 CT signs for HCC,and logistic regression analyses determined the association of CT signs with HCC.Results The asso-ciation of CT signs with all HCC lesions was statistically significant for non-peripheral washout[odds ratio(OR)15.1;95％ confi-dence interval(CI)5.6-40.4;P＜0.01]and non-rim arterial phase hyperenhancement(APHE)(OR 12.4;95％ CI 7.5-20.5;P＜0.01)higher than enhanced capsule(OR 9.9;95％ CI 2.8-34.8;P＜0.01;OR 2.4;95％ CI 1.4-3.8;P=0.01).The sensitivity,specificity,positive predictive value(PPV),and area under the curve(AUC)for diagnosing HCC were 85％,83％,91％,and 0.84,respectively for non-peripheral washout;82％,77％,88％ and 0.79,respectively for non-rim APHE;and 31％,98％,97％ and 0.65,respectively for enhanced capsule.Sensitivity(88％ vs 87％),specificity(83％ vs 82％),PPV(92％ vs 91％)and AUC(0.90 vs 0.87)were all slightly higher when non-peripheral washout,non-rim APHE,enhanced capsule,and ancillary features were combined for the diagnosis of HCC compared to combining the three major features.Enhanced capsule(OR 13.3;95％ CI 3.6-48.9;P＜0.01),blood products in mass(OR 20.3;95％ CI 2.4-171.4;P＜0.01),and mosaic appearance(OR 37.7;95％ CI 4.2-340.0;P＜0.01)were associations with HCC presenting with atypical imaging features and provided high specificity from 98％ to 99％.Conclusion In theLI-RADS target population and patients without LI-RADS-defined HCC risk factors,LI-RADS v2018 CT signs show excellent diag-nostic performance for HCC.Two ancillary features,blood products in mass and mosaic appearance,show good specificity for HCC with atypical imaging features.

Severe congenital neutropenia(SCN)is a rare disease characterized by the absolute neutrophil count(ANC)less than 0.5× 109/L in peripheral circulating blood.Due to the low neutrophil count,there is an increased risk of bacterial infection.And the most common oral manifestations are severe periodontitis and recurrent oral ulcer.This paper reports a 5-year-old girl with SCN and severe pe-riodontitis.On the basis of systemic treatment,the periodontal inflammation was controlled to a certain extent through periodontal non-sur-gical treatment and regular plaque control by using the WeChat platform for follow-up and oral hygiene.

Objective To compare the induction effects of direct treatment with low-temperature plasma(LTP)and treatment with plasma-activated medium(PAM)on immunogenic cell death(ICD)of melanoma cells.Methods After direct treatment of melanoma cell line B16F10 with LTP and treatment of it with PAM for 24 hours,cell viability was detected by MTT assay.Flow cytometry was used to detect cell apoptosis and the expression of calreticulin(CRT)on the cell surface.The adenosine triphosphate(ATP)content in the culture medium was detected by an ATP detection kit.The content of high-mobility group box 1(HMGB1)in the cell culture medium was detected by ELISA.B16F10 cells treated with LTP were co-cultured with immature dendritic cells(DC)DC2.4 cell line,and flow cytometry was used to detect DC surface molecules CD80 and CD86.Results Compared with the control group,both direct treatment and indirect treatment could lead to a decrease in the viability of B16F10 cells,an increase in the apoptosis rate,an increase in intracellular ROS,an increase in CRT expression,and an increase in the secretion of ATP and HMGB1(P＜0.05).At the same treatment time,the expression of CRT and the release of ATP in B16F10 cells directly treated with LTP were higher than those indirectly treated with PAM(P＜0.05).Compared with the DC2.4 group,the expression proportion of the DC cell maturation marker molecule CD80 was significantly increased in LTP-120s group,LTP-180s group,PAM-120s group,and PAM-180s group.The expression proportion of the DC cell maturation marker molecule CD86 was significantly increased in LTP-120s group,LTP-180s group,and PAM-180s group,and the difference was statistically significant(P＜0.05).Conclusion Both direct treatment with LTP and indirect treatment with PAM can induce ICD in melanoma cells.The direct treatment with LTP has a better induction effect.