ObjectiveTo explore effect of Xianlian Jiedu prescription on the recurrence of colorectal cancer （CRC） and investigate the related mechanisms. MethodsA postoperative recurrence model was established in 25 Balb/c mice by injecting CT26 cells subcutaneously into the armpit， followed by surgical removal of 99% of the subcutaneous tumor. The mice were randomly divided into model group， low-dose Xianlian Jiedu prescription （XLJDP-L） group （6.45 g·kg^-1·d^-1）， medium-dose Xianlian Jiedu prescription （XLJDP-M） group （12.9 g·kg^-1·d^-1）， high-dose Xianlian Jiedu prescription （XLJDP-H） group （25.8 g·kg^-1·d^-1）， and 5-fluorouracil （5-FU） group （1×10^-3 g·kg^-1·d^-1）. The mice were euthanized after 14 days of continuous intervention， and recurrent tumor tissue was harvested. Hematoxylin and eosin （HE） staining was used to observe pathological and morphological changes in the recurrent tumor tissue. Immunohistochemistry （IHC） was employed to assess the expression of proliferating cell nuclear antigen （Ki67）， vascular endothelial growth factor （VEGF）， and platelet-endothelial cell adhesion molecule （CD31） in recurrent tumor tissue. The Western blot was used to detect the protein expression levels of angiopoietin-2 （ANG-2）， VEGF， phosphorylated-protein kinase B （p-Akt）， protein kinase B （Akt）， phosphorylated-phosphatidylinositol 3-kinase （p-PI3K）， and phosphatidylinositol 3-kinase （PI3K） in recurrent tumor tissue. ResultsBefore treatment， there were no statistical differences in tumor volume， tumor weight， and body mass among the XLJDP-L， XLJDP-M， and XLJDP-H groups and the 5-FU group compared to the model group， indicating model stability. After treatment， compared with those in the model group， the tumor volume and tumor weight in the XLJDP-L， XLJDP-M， and XLJDP-H groups and the 5-FU group were significantly reduced （P<0.01）， showing dose dependency. Meanwhile， there were no significant differences in body weight among the XLJDP-L， XLJDP-M， and XLJDP-H groups and the 5-FU group compared to the model group. HE staining showed that compared with that in the model group， tumor tissue in the XLJDP-L， XLJDP-M， and XLJDP-H groups and the 5-FU group had loosely arranged cells， increased intercellular spaces， small and shriveled nuclei， light staining， fewer mitotic figures and atypical nuclei， and increased necrotic areas. IHC showed that compared with those of the model group， the positive rates of Ki67， VEGF， and CD31 in the recurrent tumor tissue of the XLJDP-L， XLJDP-M， and XLJDP-H groups and the 5-FU group were significantly reduced （P<0.01） in a dose-dependent manner. Western blot results showed that compared with those of the model group， the protein expression levels of ANG-2 and VEGF in the recurrent tumor tissue of the XLJDP-L， XLJDP-M， and XLJDP-H groups and the 5-FU group were significantly downregulated （P<0.05， P<0.01）， and the p-Akt/Akt and p-PI3K/PI3K ratios were significantly decreased in a dose-dependent manner （P<0.05， P<0.01）. ConclusionXianlian Jiedu prescription significantly inhibits the recurrence of CRC in mice after subcutaneous tumor surgery. The mechanism may involve regulating the PI3K/Akt pathway and downregulating key angiogenic proteins such as ANG-2， VEGF， and CD31.

Objective:To investigate the effect of polystyrene microplastics(PS-MPs)combined with high-fat treatment on vascular endothelial cells.Methods:Human umbilical vein endothelial cells(HUVECs)were cultured in the DMEM medium containing 5%fe-tal bovine serum.HUVECs were treated with conventional culture,high-fat treatment,and PS-MPs combined with high-fat treatment.The experiment was conducted in the three groups of control group,high-fat treatment group and PS-MPs+high-fat treatment group.CCK-8 assay was used to measure cell viability,F-actin staining was used to observe cell morphological changes,and flow cytometry,scratch assay,and tube formation assay were used to measure the apoptosis,migration,and tube-forming ability of cells.Results:After HUVECs were exposed to the high-fat environment,there was a significant reduction in cell viability,shrinkage of cells,a signifi-cant increase in cell apoptosis,and significant reductions in cell migration and tube-forming ability.Compared with the high-fat treat-ment group,there were no significant changes in cell viability,cell morphology,cell apoptosis,and cell migration ability after PS-MPs combined with high-fat treatment,but the tube-forming ability of cells was further impaired.Conclusion:High-fat treatment will affect cell viability,change cell morphology,and damage vascular endothelial cell function,and PS-MPs combined with high-fat treat-ment can aggravate the damage of vascular endothelial cell function.

Objective To identify potential biomarkers and establish a prediction model for chemotherapy-related hepatotoxicity susceptibility based on plasma endogenous metabolites of colorectal cancer(CRC)patients before chemotherapy.Methods The plasma samples of 50 CRC patients before capecitabine chemotherapy and the records of their chemotherapy-related hepatotoxicity during the follow-up were collected.An ultra-high-performance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry(UHPLC-Q-TOF-MS)was used to perform untargeted metabolomic analysis.Based on bioinformatics analysis,differential analysis,correlation analysis,and random forest were used to screen for hepatotoxicity-related plasma endogenous metabolites.All samples were randomly assigned(7∶3)to training set or test set.A multivariate logistic regression model was established to predict the hepatotoxicity of capecitabine chemotherapy based on the training set data.The prediction effects of the model in the training,test and entire sets were evaluated by receiver operating characteristic(ROC)curve analysis.Results The endogenous metabolites related to hepatotoxicity in the plasma of CRC patients before chemotherapy were mainly lipid endogenous metabolites.A series of potentially important predictive biomarkers for hepatotoxicity susceptibility were identified,including sphingamine-1-phosphate,ceramide,galactose,arachidonic acid,tyrosine,biliverdin,myristic acid,phosphatidylcholine(35∶1),phosphatidylethanolamine(36∶1),and hexadecanoic acid.The area under curve values of the prediction model based on the above biomarkers in the training,test and entire sets were 0.946(95%confidence interval[CI]0.842-1.000),0.920(95%CI 0.720-1.000),and 0.912(95%CI 0.810-0.982),respectively.Conclusion The endogenous metabolites in the plasma of CRC patients before chemotherapy can effectively predict the hepatotoxicity of capecitabine chemotherapy.These hepatotoxicity biomarkers indicate that susceptible patients have characteristics related to lipid metabolism disorders.

Self-aid and buddy-aid are primary steps in battlefield first aid,offering the timeliest treatment effectiveness.Medications are indispensable key supplies in battlefield first aid,playing a crucial role in the timely treatment of the injured.This review provides an overview of medication preparation for battlefield first aid both domestically and internationally,aiming to provide reference for the medication preparation for self-aid and buddy-aid of naval combat injuries,so as to enhance the Navy's first-aid capability and medical support capability.

kidney deficiency and blood stasis are believed to be the key pathogenesis of recurrent implantation failure （RIF）， and therefore， it is proposed to take kidney-supplementing and blood-invigorating as the basic treatment method， and use it by stages to assist the controlled superovulation program of in vitro fertilization-embryo transfer （IVF-ET）. The focus should be put on nourishing kidney yin， soothing the liver and invigorating blood during down-regulation period， using kidney yin-nourishing medicinals and modified Qinghao Biejia Decoction （青蒿鳖甲汤）. During the ovulation induction period， the focus should be put on nourishing kidney yang， replenishing blood， and promoting blood circulation， with self-made Bushen Culuan Formula （补肾促卵方） in modifications. After transplantation， it is suggested to put focus on tonifying the kidneys and replenishing essence， and self-made Wuzi Yanzong Guchong Decoction （五子衍宗固冲汤） in modifications can be used. At the same time， fetal protection treatment should be carried out for pregnant women， and modified Shou Tai Pill （寿胎丸） can be used to tonify the kidneys and calm the fetus.

Objective To investigate the influencing factors for chronic pancreatitis(CP)complicated by pancreatogenic portal hypertension(PPH),and to establish a predictive model.Methods A retrospective analysis was performed for the clinical data of 99 patients with CP complicated by PPH who were hospitalized in The First Affiliated Hospital of Kunming Medical University,Chuxiong Yi Autonomous Prefecture People's Hospital,Wenshan People's Hospital,and Puer People's Hospital from January 2017 to December 2022,and these patients were enrolled as PPH group.The incidence density sampling method was used to select 198 CP patients from databases as control group.The independent-samples t test was used for comparison of normally distributed continuous data between two groups,and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups;the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups.The Least Absolute Shrinkage and Selection Operator(LASSO)regression model was used to identify the potential predictive factors for CP complicated by PPH,and the predictive factors obtained were included in the multivariate Logistic regression analysis to obtain independent risk factors,which were used to establish a nomogram prediction model.The receiver operating characteristic(ROC)curve,the calibration curve,and the Hosmer-Lemeshow goodness-of-fit test were used to perform internal validation of the model,and the clinical decision curve was used to assess the clinical practicability of the model.Results There were significant differences between the two groups in sex,history of recurrent acute pancreatitis attacks,acute exacerbation of CP,bile duct stones,peripancreatic fluid accumulation,pseudocysts,pulmonary infection,elevated C-reactive protein(CRP),elevated procalcitonin,fibrinogen(FIB),neutrophil-lymphocyte ratio(NLR),gamma-glutamyl transpeptidase,total bilirubin,direct bilirubin,low-density lipoprotein(LDL),serum amylase,D-dimer,and serum albumin(all P<0.05).The predictive variables obtained by the LASSO regression analysis included sex,recurrent acute pancreatitis attacks,bile duct stones,peripancreatic fluid accumulation,pulmonary infection,pseudocysts,CRP,NLR,FIB,and LDL.The multivariate Logistic regression analysis showed that sex(odds ratio[OR]=2.716,P<0.05),recurrent acute pancreatitis attacks(OR=2.138,P<0.05),peripancreatic fluid accumulation(OR=2.297,P<0.05),pseudocysts(OR=2.805,P<0.05),and FIB(OR=1.313,P<0.05)were independent risk factors for CP complicated by PPH.The above factors were fitted into the model,and the Bootstrap internal validation showed that the nomogram model had an area under the ROC curve of 0.787(95%confidence interval:0.730—0.844),and the calibration curve was close to the reference curve.The Hosmer-Lemeshow goodness-of-fit test showed that the model had a good degree of fitting(χ2=7.469,P=0.487).The clinical decision curve analysis showed that the prediction model had good clinical practicability.Conclusion Male sex,recurrent acute pancreatitis attacks,peripancreatic fluid accumulation,pseudocysts,and FIB are independent risk factors for CP complicated by PPH,and the nomogram model established has good discriminatory ability,calibration,and clinical practicability.

Objective: To investigate the status of passive smoking among pregnant women in Jinshan District, Shanghai Municipality, so as to provide insights into developing targeted smoking control measures and promoting maternal and infant health. Methods: Pregnant women who had early pregnancy registration at Jinshan District Community Health Service Center from April 2021 to December 2023 were selected as subjects. The basic information, passive smoking and awareness of passive smoking hazards among pregnant women were collected through questionnaire surveys, and passive smoking rate and awareness rate of passive smoking hazards were analyzed. Results: Totally 8 273 questionnaires were allocated, and 8 216 valid questionnaires were recovered, with an effective rate of 99.31%. The mean age of participants was (29.52±4.60) years. There were 4 991 participants with an education of college degree or above, accounting for 60.75%; 3 565 participants with the first pregnancy, accounting for 43.39%; 3 990 primiparas, accounting for 48.56%; 3 193 participants living with smokers, accounting for 38.86%. A total of 3 710 participants passively smoked, with a passive smoking rate of 45.16%. There were 2 817 participants passively smoked in public places, accounting for 75.93%; 2 253 participants passively smoked in workplaces, accounting for 60.73%; 1 563 participants that passively smoked at home, accounting for 42.13%. The awareness rates regarding the hazards of passive smoking to health, causing lung cancer in adults, causing lung diseases in children, causing preterm birth and low birth weight infants, and causing heart diseases in adults were 92.13%, 88.85%, 87.99%, 82.05% and 62.56%, respectively. Conclusion The rate of passive smoking among pregnant women in Jinshan District is comparatively high, while their awareness regarding non-respiratory diseases emanating from passive smoking is comparatively low.

BACKGROUND:In clinical practice,the anterior superior iliac spine and posterior superior iliac spine are usually located by palpation,and the tilt of the pelvis is determined by visual observation method or photogrammetry.Among them,the visual observation method can only have qualitative conclusions,and its reliability is poor.The photogrammetry is not only more convenient and fast,but also can give more accurate quantitative data,which is one of the best clinical evaluation methods.However,there are no studies on the reliability of pelvic posture assessment using photogrammetry in China. OBJECTIVE:To evaluate the pelvic posture by visual observation method and photogrammetry,and to compare the reliability level of the two methods to guide clinical application. METHODS:Forty-five healthy subjects were selected and red marks were made at the bilateral anterior superior iliac spine and posterior superior iliac spine.Pelvic posture was photographed from the front,back(coronal plane),left,and right(sagittal plane).The left and right pelvic tilt angles(α,β angles)were selected from the front and back views,which represented the angle between the bilateral anterior superior iliac spine line or the bilateral posterior superior iliac spine line and the horizontal line.The anterior and posterior pelvic tilt angles(γ,θ angles)were selected from the side view,which represented the angle between the ipsilateral anterior superior iliac spine and posterior superior iliac spine line and the horizontal plane,indicating the sagittal plane pelvic tilt.Evaluation methods included visual observation method and photogrammetry.Two evaluators independently evaluated the pelvic α,β,γ,θ angles using the visual observation method first,and then recorded the pelvic α,β,γ,θ angles using the photogrammetry.After a one-month interval,the visual observation method and photogrammetry were performed again,and the pelvic α,β,γ,θ angles were recorded.The intraclass correlation coefficients were used to analyze the data obtained from the two evaluation methods and the before-and-after measurements:0.90-0.99 as an excellent correlation,0.80-0.89 as a good correlation,0.70-0.79 as a moderate correlation,and≤0.69 as a poor correlation.The standard error of measurement and the minimal detectable change with 95%confidence intervals were calculated to evaluate the inter-rater and intra-rater reliability. RESULTS AND CONCLUSION:(1)The interrater intraclass correlation coefficients of the visual observation method and photogrammetry were as follows:anterior view:0.682 and 0.718,posterior view:0.513 and 0.867,left view:0.739 and 0.960,and right view:0.756 and 0.971.The visual observation method showed poor correlation between the anterior and posterior views and moderate correlation between the left and right views,while the photogrammetry showed moderate correlation for the anterior view,good correlation for the posterior view,and excellent correlation for the left and right views.The standard error values of measurement were as follows:anterior view:3.266 and 1.625,posterior view:4.278 and 1.763,left view:5.935 and 1.787,and right view:5.723 and 1.698.The minimal detectable change values with 95%confidence intervals were as follows:anterior view:9.053 and 4.504,posterior view:11.858 and 4.887,left view:16.451 and 4.953,and right view:15.863 and 4.707.(2)The interrater intraclass correlation coefficients of the visual observation method and photogrammetry were as follows:anterior view:0.452 and 0.723,posterior view:0.483 and 0.904,left view:0.518 and 0.955,and right view:0.657 and 0.968.The visual observation method showed poor correlation in all four directions,while the photogrammetry showed moderate correlation for the anterior view and excellent correlation for the other three directions.The standard error values of measurement were as follows:anterior view:5.651 and 1.610,posterior view:4.237 and 1.523,left view:7.322 and 1.891,and right view:6.509 and 1.781.The minimal detectable change values with 95%confidence intervals were as follows:anterior view:15.664 and 4.463,posterior view:11.744 and 4.222,left view:20.296 and 5.242,and right view:18.042 and 4.937.(3)These results confirm that the sagittal and coronal plane photogrammetries have good intrarater and interrater reliability for evaluating pelvic posture,especially with the use of the photogrammetry,which has good data stability.This method is simple,fast,efficient,accurate,low-cost,and does not cause X-ray damage,and can qualitatively and quantitatively reflect the actual situation of the patient's pelvis,making it suitable for clinical use.

Objective Changes in relevant indexes in the mouse model of early-onset ovarian insufficiency caused by Tripterygium wilfordii polyglycoside were analyzed,and the optimal time point for intervention was determined.Methods Forty female ICR mice were randomly divided into control and A,B,C,and D model groups with eight mice in each group.The control group was gavaged with purified water for 14 days(0.01 mL/10 g),and the remaining groups were administered a Tripterygium wilfordii polyglycoside suspension(80 mg/kg,0.01 mL/10 g)for 1 day(A model group),3 days(B model group),7 days(C model group),or 14 days(D model group),and samples were collected.Body weight and wet weights of the uterus and bilateral ovaries of mice were determined in each group.Serum FSH,LH,E2,P,AMH,INH-B,and T contents were measured using enzyme-linked immunoassays.HE staining was used to observe the number and developmental status of follicles and corpus luteum at all levels in mice of each group.TUNEL staining was used to detect the apoptosis in the ovaries of mice in each group.IHC detected expression of VEGFA,CD34,and EPO proteins in the ovaries of mice in each group.mRNA expression of HIF-1α,SDF-1,and CXCR4 in each group of mice was detected by PCR.Results Compared with the control group,changes in indicators in model A mice did not meet the POI modeling standard.The ovarian index,uterine index,and body weight of mice in the B model group were decreased significantly(P＜0.01),the weight of the C model group was decreased significantly(P＜0.01),and the ovarian index of the D model group was decreased significantly(P＜0.05).Serum contents of FSH and LH in B,C,and D model groups were increased(P＜0.05,P＜0.01),the E2,PROG,AMH,INH-B,and T contents were decreased(P＜0.01).The numbers of basal follicles,pre-sinus follicles,sinusoidal follicles,antral follicles,preovulatory follicles,and corpus luteum were decreased significantly(P＜0.05,P＜0.01)and the number of atresia follicles was increased significantly(P＜0.01)in B,C,and D model groups.The apoptotic area of TUNEL staining in A,B,C,and D model groups was increased significantly(P＜0.05,P＜0.01).Expression of CD34,VEGFA,and EPO in B,C,and D model groups was decreased significantly(P＜0.05,P＜0.01).mRNA expression of HIF-1α,SDF-1,and CXCR4 in A and B model groups was significantly increased(P＜0.05,P＜0.01).Compared with the B model group,the relevant indexes of C and D model groups were changed significantly,indicating that C and D models were more serious and tended to develop POF.Conclusions The B model group is the turning point of ovarian function from impaired POI to irreversible POF,suggesting that 3 days of administrating Tripterygium wilfordii polyglycoside is optimal to induce a POI disease model for effective drug intervention.

Objective To analyze the health management situation of non-communicable chronic disease(NCD)in Chongqing City and Guizhou Province and its influencing factors.Methods A stratified random sampling method was used to select 16 representative primary medical and health institutions from Chongqing City and Guizhou Province as the research sites,and the data were collected through the combination method of qualitative and quantitative research.Results A total of 760 patients with NCD were surveyed,and the awareness rate,utilization rate and satisfaction rate of the NCD health management program all exceeded 84.2％,while the awareness rate,utilization rate and satisfaction rate of follow-up and categorical intervention were the lowest.The awareness rate of hypertension physical examination in the patients with＜60 years old was lower than that in the patients with 60-＜70 years old(OR=4.28,95％CI:1.43-12.81)and the pa-tients with ≥70 year sold(OR=3.16,95％CI:1.12-8.91);the utilization rate of diabetes screening in the patients with＜60 years-old was lower than that in the patients with ≥70 years old(OR=2.70,95％CI:1.08-6.76)and the awareness rate of hypertension physical examination was lower than that of the patients with 60-＜70 years old(OR=4.24,95％CI:1.01-17.75);the awareness rate of hypertension physical ex-amination in the patients in Chongqing City was higher than that in Guizhou Province(OR=0.15,95％CI:0.04-0.54)and the utilization situation was better than that in Guizhou Province(OR=0.13,95％CI:0.05-0.34).Conclusion The overall situation of NCD management services in Chongqing City and Guizhou Province is good,but the service quality of follow-up and classified intervention projects needs to be further improved.