Precancerous lesions of gastric cancer （PLGC） are a group of pathological changes caused by abnormalities in the structure， morphology， and differentiation of gastric mucosal epithelial cells. Since the early symptoms are hidden and non-specific， PLGC is not easy to be diagnosed and it has often developed into intermediate or advanced gastric cancer once being diagnosed and missed the best time for treatment. Accordingly， the incidence of this disease is increasing year by year， which lifts a heavy burden on the patients. The pathogenesis of PLGC is complex， involving inflammatory microenvironment， bile reflux， glycolysis， autophagy， and apoptosis. Currently， PLGC is mainly treated with anti-inflammatory and endoscopic therapies， which are difficult to curb the development of PLGC. Therefore， seeking a safe and effective therapy is an important topic of modern research. Traditional Chinese medicine （TCM）， characterized by treatment based on syndrome differentiation and a holistic view， exerts effects via multiple pathways， mechanisms， and targets. Recent studies have confirmed that TCM can regulate the phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin （PI3K/Akt/mTOR）， Wnt/β-catenin， Sonic Hedgehog， nuclear factor-κB （NF-κB）， Janus kinase/signal transducer and activator of transcription （JAK/STAT）， hypoxia-inducible factor-1α （HIF-1α）， neurogenic locus notch homolog protein （Notch）， nuclear factor E₂-related factor 2 （Nrf2） and other signaling pathways. By targeting these pathways， TCM can inhibit aerobic glycolysis， reduce oxidative stress， repair the inflammatory microenvironment， regulate cellular autophagy， and promote vascular normalization， thereby delaying or reversing PLGC. However， few researchers have systematically summarized the TCM regulation of PLGC-associated pathways. By reviewing the relevant articles at home and abroad， this paper summarized the roles of the above signaling pathways in the development of PLGC and the research progress in the regulation of signaling pathways by TCM in the treatment of PLGC， with a view to providing a new theoretical basis for the clinical research on PLGC and the drug development for this disease.

Adenomyosis is a common gynecological disease characterized by the invasion of endometrial glands and stroma into the myometrium of uterus, the pathological mechanism of which remains unclear yet. Disturbed lipid metabolism extensively affects abnormal cell proliferation and invasion in various diseases. However, the lipidome signature of human myometrium, which could be crucial in the development of adenomyosis, remains unknown. In this study, we generated the first lipidome profiling of human myometrium using a high-coverage and quantitative lipidomics approach based on ultra-performance liquid chromatography (UPLC) coupled with triple quadrupole (QqQ)-mass spectrometry (MS). A total of 317 lipid species were successfully quantified in the myometrial tissues from women with (n = 38) or without (n = 65) adenomyosis who underwent hysterectomy at Peking Union Medical College Hospital (Bejing, China). Up to 83 lipid species showed significant alternations in content between the two groups. These lipid aberrations involved multiple metabolic pathways, and emphasized inflammation, cell migration, and immune dysregulation upon adenomyosis. Moreover, receiver operating characteristic (ROC) curve analysis found that the combination of five lipid species could accurately distinguished the myometrial samples from women with and without adenomyosis with an area under the curve (AUC) of 0.906. Desorption electrospray ionization MS imaging (MSI) further underscored the heterogeneous distributions of these lipid markers in the adenomyosis lesion and adjacent myometrial tissue. Collectively, these results extremely improved our understanding on the molecular basis of adenomyosis, and could shed light on developing potential biomarkers and new therapeutic directions for adenomyosis.

Standardized training of newly recruited nurses is crucial for enhancing their clinical competencies and facilita-ting rapid adaptation to clinical environments.This approach aims to develop nursing professionals with advanced clinical skills and expertise.This paper reviews and analyzes the training paradigms for new nurses globally,focusing on the challenges faced in the standardized training of new nurses in China,to provide insights and references for future training programs.

Objective To evaluate the effectiveness of WeChat group integrating with BOPPPS instructional model in the standardized training of nurses in an orthopedics department.Methods A total of 56 nurses in orthopedical standardized training from a hospital were selected and divided into a control group(28 nurses from September 2022 to August 2023)and an interven-tion group(28 nurses trained via WeChat groups and the BOPPPS model from September 2023 to August 2024).The two groups were compared in terms of their final assessment scores,critical thinking,and self-directed learning capabilities.Results After training,the intervention group had significantly higher scores in the final assessment,all items of the California Critical Thinking Disposition Inventory,and all dimensions of the Learning Ability Assessment Scale compared to the control group(all P＜0.05).Conclusion WeChat groups combined with the BOPPPS teaching mode effectively improves the self-directed learning ability,critical thinking skills,and assessment results of orthopedic nurses.

Objective:To investigate the clinical value of 18F-NaF PET/CT coronary plague imaging in evaluating the long-term prognosis of patients with coronary artery disease (CAD). Methods:A retrospective cohort study was conducted among 54 patients (37 males and 17 females, aged (57.2±9.8) years) diagnosed with CAD from a multicenter study between September 2015 and October 2022. All patients underwent 18F-NaF PET/CT and coronary angiography (CAG) within 1 week, and the PET/CT imaging was performed at the First Hospital of Shanxi Medical University. Major adverse cardiovascular events (MACE) were followed up. ROC curves were established to obtain the optimal thresholds of SUV max and accumulated SUV max of all lesions of main coronary artery branches (S-SUV max) for predicting MACE. Cox proportional risk model and Kaplan-Meier method (log-rank test) were used to analyze the predictive value of PET parameters for MACE. Differences in metabolic parameters between 2 groups were compared by Mann-Whitney U test. Results:The median follow-up time of the 54 patients was 6.0(1.8, 6.6) years, and 13(24.1%) patients developed MACE, including 7 deaths, 5 myocardial infarction and 1 severe arrhythmia. S-SUV max in MACE group was significantly higher than that in the non-MACE group (2.64(2.08, 4.49) vs 1.83(0.95, 2.90); Z=-2.04, P=0.041). ROC curve showed that the optimal threshold of S-SUV max for MACE prediction was 2.05 (AUC=0.690). Multivariate Cox analysis showed that S-SUV max was a strong predictor of MACE (hazard ratio ( HR)=2.434(95% CI: 1.547-3.828), P<0.001). ROC curve showed that the optimal threshold of SUV max to predict MACE was 0.55 (AUC=0.659), and univariate Cox analysis showed that SUV max was a factor to predict MACE ( HR=10.192 (95% CI: 2.667-38.953), P=0.001). In 25 patients with incomplete revascularization (ICR), Kaplan-Meier analysis showed that the incidence of MACE in patients with positive 18F-NaF uptake (single medium stenosis (40%-70%) with SUV max≥0.55) was significantly higher than that in patients with negative 18F-NaF uptake (5/14 vs 0/11; χ2=6.07, P=0.014). Conclusions:18F-NaF PET/CT can be used as an independent predictor of MACE in patients with CAD and can quantitatively assess the long-term progression of moderate coronary artery stenosis. In the future, it is expected to be a new non-invasive way to guide the revascularization treatment decision of multi-vessel CAD.

This study proposes a "two-stage" theoretical model for the thermal ablation treatment of thyroid diseases，highlighting its significant value in clinical practice. This theory categorizes thermal ablation treatment into two distinct stages：the treatment intervention stage and the clearance and absorption stage. The treatment intervention stage centers on ablation efficacy，with efficacy quantified by the ablation volume ratio（AVR），which is assessed immediately during the procedure. The clearance and absorption stage focuses on the immune-mediated clearance of necrotic tissue post-operation，with the absorption process characterized by the volume reduction rate（VRR）of the ablation area，evaluated repeatedly over an extended period. Additionally，the study introduces two key concepts：the immediate lesion volume（V 0）prior to ablation and the initial volume（V 1）of the ablation area immediately following the operation. It further develops and optimizes calculation methods for AVR and VRR. By analyzing the essential characteristics of both stages and identifying errors in traditional calculation methods，the study establishes an efficacy evaluation system and an absorption prognosis evaluation framework for thyroid thermal ablation treatment.

Chronic rhinosinusitis(CRS)is a common chronic inflammation of nasal cavity and sinus mucosa,involving multiple pathogenesis mechanisms such as infection,allergic reactions,and immune abnormalities.Its main symptoms include nasal obstruction,rhinorrhea,and hyposmia,sig-nificantly affecting patients' quality of life.Seeking safe and effective long-term treatment methods is crucial for managing CRS.Traditional Chinese medicine(TCM)has a long history of treating CRS and has gained attention due to its profound theoretical basis,high safety,and low recurrence rate.According to TCM,CRS is mostly caused by the invasion of wind-cold-damp pathogens,heat accumu-lation in the Lung meridian,or spleen-stomach weakness.Various therapies such as oral administra-tion of Chinese herbal medicines,nasal drops,acupuncture,and moxibustion are employed to adjust the body's balance and achieve therapeutic goals.This article comprehensively analyzed recent do-mestic and international literature and reviewed the research progress on pathogenesis of CRS and its treatment with TCM,with particular emphasis on roles and mechanisms of active ingredients in Chi-nese herbal medicines.The aim of the study is to provide scientific evidence and technical support for prevention and treatment of CRS.

Objective:To investigate the effect of peripheral white blood cell(WBC) count on adverse pregnancy outcomes.Methods:A retrospective analysis was conducted on pregnant women who delivered at Minhang Hospital affiliated with Fudan University between January 2013 and June 2020. Demographic data, WBC counts, and diagnostic information on gestational diabetes mellitus(GDM), gestational hypertension, and preeclampsia/eclampsia were extracted from electronic medical records. Logistic regression models were used to evaluate the association between WBC counts in the first(WBC-1) and second trimesters(WBC-2) and metabolically related pregnancy outcomes.Results:A total of 24 143 pregnant women were included, with a mean age of(29.1±4.9) years and a mean pre-pregnancy body mass index(BMI) of(21.1±2.8) kg/m 2. The mean WBC counts in the first and second trimesters were 8.1×10 9/L and 8.9×10 9/L, respectively. The incidence rates of GDM, gestational hypertension, and preeclampsia/eclampsia were 5.6%, 4.8%, and 1.8%, respectively. After adjusting for relevant confounders, a core standard deviation( s) increase in WBC-1 was associated with a 6%, 18%, and 14% increased risk of GDM, gestational hypertension, and preeclampsia/eclampsia, respectively( P<0.001). Similarly, a one s increase in WBC-2 was associated with a 10% increased risk for all three adverse outcomes( P<0.001). Conclusion:Elevated peripheral WBC levels in the first and second trimesters are independently associated with increased risk of adverse pregnancy outcomes, independent of traditional risk factors.

Objective:To investigate the dietary iodine intake of students at Mudanjiang Medical University, Heilongjiang Province.Methods:From September 2023 to June 2024, a two-stage sampling method was used to investigate students at Mudanjiang Medical University. In stage one, 250 students were selected and investigated on their dietary iodine intake using the Iodine Specific Food Frequency Questionnaire (I-FFQ). In stage two, 55 students were selected and the double-meal method was used to investigate the dietary iodine intake of students. Iodine content in food samples was determined by inductively coupled plasma mass spectrometry. Curve estimation (power function, S-shaped curve, cubic equation, growth curve) was applied to analyze the dietary iodine intake of I-FFQ and double-meal method, the regression equation was used to adjust I-FFQ.Results:A total of 237 students were enrolled in I-FFQ, with a dietary iodine intake [ M( Q1, Q3)] of 342.61 (203.77, 399.26) μg/d. The dietary iodine intake of males and females was 361.82 (235.56, 428.98) and 330.87 (190.47, 366.11) μg/d, respectively, and the difference between the two was statistically significant ( Z = - 3.06, P = 0.002). The proportions of insufficient iodine intake, appropriate iodine intake, and excessive iodine intake were 13.92% (33/237), 82.70% (196/237), and 3.38% (8/237), respectively. A total of 52 students were enrolled in the double-meal method, with an average dietary iodine intake of 645.22 (435.91, 960.50) μg/d over 3 days. The proportion of appropriate iodine intake and excessive iodine intake was 44.23% (23/52) and 55.77% (29/52), respectively. After adjusting for I-FFQ, the dietary iodine intake was 650.13 (441.68, 728.53) μg/d, with the proportions of appropriate iodine intake and excessive iodine intake being 35.02% (83/237) and 64.98% (154/237), respectively. Conclusion:More than half of the students at Mudanjiang Medical University in Heilongjiang Province are in a state of excessive iodine intake, and dietary iodine intake should be appropriately controlled.

Standardized training of newly recruited nurses is crucial for enhancing their clinical competencies and facilita-ting rapid adaptation to clinical environments.This approach aims to develop nursing professionals with advanced clinical skills and expertise.This paper reviews and analyzes the training paradigms for new nurses globally,focusing on the challenges faced in the standardized training of new nurses in China,to provide insights and references for future training programs.