Objective To evaluate the impact of an integrated management mode of prenatal diagnosis-postnatal treatment for congenital heart disease (CHD) on perioperative and long-term outcomes of the arterial switch operation (ASO), and to analyze the efficacy of ASO in a single center. Methods This retrospective study analyzed the clinical data of 183 children who underwent ASO at Guangdong Provincial People’s Hospital from 2018 to 2024. The cohort included 106 (57.9%) patients of transposition of the great arteries with intact ventricular septum (TGA/IVS), 61 (33.3%) patients of transposition of the great arteries with ventricular septal defect (TGA/VSD), and 16 (8.7%) patients of Taussig-bing anomaly (TBA). Perioperative indicators were compared between 91 patients in the prenatal-postnatal integrated management group (an integrated group) and 92 patients in the traditional management group (a non-integrated group). Long-term survival and reoperation rates were analyzed using Kaplan-Meier curves. Results The overall perioperative mortality rate was 4.9% (9/183), showing a downward trend year by year. The primary cause of perioperative mortality was low cardiac output syndrome (LCOS), which occurred in 12 patients (6.6% incidence) with a mortality rate of 75.0%. The integrated group had a higher proportion of males (89.0% vs. 72.8%, P<0.05) and lower body weight [3.1 (2.7, 3.3) kg vs. 3.3 (3.0, 3.7) kg, P<0.05] compared to the non-integrated group. The age at surgery was significantly earlier in the integrated group [7 (3, 10) d vs. 14 (9, 48) d, P<0.05], and all children in the integrated group underwent ASO within the optimal surgical window (100.0% vs. 82.6%, P<0.05). Intraoperatively, cardiopulmonary bypass time [173 (150, 207) min vs. 186 (159, 237) min, P<0.05] and aortic cross-clamp time [100 (90, 117) min vs. 116 (97, 142) min, P<0.05] were significantly shorter in the integrated group. Although the integrated group had longer postoperative mechanical ventilation time [145 (98, 214) h vs. 116 (77, 147) h, P<0.05] and higher 48-hour maximum vasoactive inotropic score [15 (10, 21) points vs. 12 (8, 16) points, P<0.05], there was no statistically significant difference in the incidence of severe complications (LCOS, necrotizing enterocolitis, extracorporeal membrane oxygenation) or mortality rate (3.3% vs. 6.5%, P=0.51) between the two groups, despite earlier surgical intervention and a higher proportion of critically ill cases in the integrated group. The length of hospital stay in the emergency surgery group was significantly shorter than that in the elective surgery group [20 (15, 28) d vs. 25 (21, 30) d, P<0.05], suggesting that early surgery may be of potential benefit. A total of 163 patients were successfully followed up for a median of 4.7 years, with a 5-year survival rate of 95.1% and a freedom from reintervention survival rate of 95.1%. There were no late deaths, and the most common postoperative complication was pulmonary artery stenosis. Conclusion The integrated management model allowed critically ill children with lower body weights to safely undergo surgery, significantly optimizing the timing of surgery and shortening intraoperative times. The long-term risk of reoperation after ASO is primarily concentrated on pulmonary artery stenosis, necessitating long-term follow-up and monitoring.

As an innovative form of combining traditional aromatherapy with modern nasal medicine delivery technology， "olfactory administration of Chinese medicine" carries the theoretical essence of traditional Chinese medicine （TCM）， which is "moving and channeling Qi and fragrance， dredging and awakening the mind". Based on the systematic records of olfactory therapies in ancient books in emergency care， disorders of consciousness， lung system， and gynecological diseases， this paper examines the historical evolution of its clinical application， and elucidates the profound historical basis and theoretical feasibility of "olfactory administration of Chinese medicine" as a new form. Combined with the innovation and precise application of modern Chinese medicine olfactory agents in multi-system diseases such as nervous， respiratory， and cardiovascular diseases， this paper further analyzes the multi-dimensional mechanism of olfactory receptor pathway， olfactory brain pathway， nasal mucosal blood vessels， and lymphatic channels， and demonstrates its advantages of rapid onset， targeted brain entry， and systemic regulation. Under the background of continuous growth in the demand for external TCM treatment， continuous breakthroughs in the technology of nasal dosage forms， and increasingly accurate drug delivery paths， Chinese medicine olfactory agents have shown significant practical applicability and development potential. This study aims to provide theoretical support and practical direction for the system construction of this form.

The diagnosis of occupational radiation diseases, with the diagnostic criteria as main technical basis, has always been one of the emphases of China's occupational health work. This study compared the diagnostic standards for occupational radiation diseases between China and the International Labour Organization (ILO) across three aspects—types, classifications/grades, and diagnostic dose requirements—categorizing the diseases into tissue reactions and stochastic effects. ① For tissue reactions, 8 types are included both in China and ILO standards, 13 unique to China's standards, and 4 unique to the ILO standards; significant differences exist in classifaton/grading; China's standards are either consistent with or stricter (i.e., requiring higher diagnostic dose values) than the ILO standards. ② For stochastic effects (radiation-induced cancer), 12 types were included in both standards; China's standards provide more comprehensive coverage for certain malignancies (e.g., bone cancer); while 5 types were unique to the ILO standards have, some (e.g. salivary gland cancer) are primarily observed in non-occupational populations. Overall, China’s standards include more disease types and maintain more stringent diagnostic dose requirements. However, specific discrepancies require further deliberation during future revisions. Finally, based on these results, recommendations were provided for basic research and the evaluation of Chinese diagnostic criteria.

The diagnosis of occupational radiation diseases, with the diagnostic criteria as main technical basis, has always been one of the emphases of China's occupational health work. This study compared the diagnostic standards for occupational radiation diseases between China and the International Labour Organization (ILO) across three aspects—types, classifications/grades, and diagnostic dose requirements—categorizing the diseases into tissue reactions and stochastic effects. ① For tissue reactions, 8 types are included both in China and ILO standards, 13 unique to China's standards, and 4 unique to the ILO standards; significant differences exist in classifaton/grading; China's standards are either consistent with or stricter (i.e., requiring higher diagnostic dose values) than the ILO standards. ② For stochastic effects (radiation-induced cancer), 12 types were included in both standards; China's standards provide more comprehensive coverage for certain malignancies (e.g., bone cancer); while 5 types were unique to the ILO standards have, some (e.g. salivary gland cancer) are primarily observed in non-occupational populations. Overall, China’s standards include more disease types and maintain more stringent diagnostic dose requirements. However, specific discrepancies require further deliberation during future revisions. Finally, based on these results, recommendations were provided for basic research and the evaluation of Chinese diagnostic criteria.

Exportin 1 (XPO1) is aberrantly overexpressed in various malignant tumors and can lead to the loss of anti-tumor effects of important tumor suppressor proteins such as p53, RB1, and FOXO by mediating their nuclear export. Although XPO1 inhibitor Selinexor has entered clinical application, its single-agent anti-tumor activity remains suboptimal, which is closely related to the compensatory activation of multiple signaling pathways in response to XPO1 inhibition. Focusing on the core regulatory role of XPO1 in tumor cells, this article systematically summarizes the current landscape of combination therapies involving XPO1 inhibitors and various targeted agents, including inhibitors of CDK4/6, FLT3, BET, ATR, and BCL2/MDM2, aiming to provide some reference for the development of XPO1-centered combination therapy strategies.

The nose-to-brain pathway refers to a significant drug delivery route through which substances traverse the unique anatomical structures of the nasal cavity to directly access the central nervous system， bypassing the blood-brain barrier. Its core advantage lies in utilizing the olfactory and trigeminal nerves， enabling peripheral drug administration to rapidly and efficiently reach the brain， thereby avoiding the drug loss and bioavailability reduction associated with oral or intravenous routes due to the circulatory system and blood-brain barrier limitations. In recent years， with in-depth research into the neuroanatomy of the olfactory system， nasal mucosal barrier properties， and neural regulatory mechanisms， the potential application of the nose-to-brain pathway in neurological diseases has attracted increasing attention. Traditional Chinese medicine （TCM） essential oils， characterized by strong lipophilicity， small molecular weights， volatility， and diverse chemical components， are highly compatible with the physiological characteristics of the nose-to-brain pathway， thus serving as promising carriers for brain-targeted drug delivery， enhancing drug bioavailability， and exerting neuroprotective effects. On this basis， this review systematically summarizes the anatomical and physiological bases for the delivery of TCM essential oils via the nose-to-brain pathway， the patterns of drug transport and brain distribution， clinical and animal study examples in neurological diseases， the associated molecular mechanisms and signaling pathways， and the progress in the development of novel nasal essential oil formulations. Additionally， the review analyzes the current challenges in this field and proposes strategies for future research and application. By systematically discussing the nose-to-brain pathway and the delivery mechanisms of TCM essential oils， this study aims to provide theoretical support for drug development， mechanism exploration， and formulation innovation in the treatment of neurological diseases， while also offering scientific guidance for further research and clinical applications of the nose-to-brain delivery system.

The nose-to-brain pathway refers to a significant drug delivery route through which substances traverse the unique anatomical structures of the nasal cavity to directly access the central nervous system， bypassing the blood-brain barrier. Its core advantage lies in utilizing the olfactory and trigeminal nerves， enabling peripheral drug administration to rapidly and efficiently reach the brain， thereby avoiding the drug loss and bioavailability reduction associated with oral or intravenous routes due to the circulatory system and blood-brain barrier limitations. In recent years， with in-depth research into the neuroanatomy of the olfactory system， nasal mucosal barrier properties， and neural regulatory mechanisms， the potential application of the nose-to-brain pathway in neurological diseases has attracted increasing attention. Traditional Chinese medicine （TCM） essential oils， characterized by strong lipophilicity， small molecular weights， volatility， and diverse chemical components， are highly compatible with the physiological characteristics of the nose-to-brain pathway， thus serving as promising carriers for brain-targeted drug delivery， enhancing drug bioavailability， and exerting neuroprotective effects. On this basis， this review systematically summarizes the anatomical and physiological bases for the delivery of TCM essential oils via the nose-to-brain pathway， the patterns of drug transport and brain distribution， clinical and animal study examples in neurological diseases， the associated molecular mechanisms and signaling pathways， and the progress in the development of novel nasal essential oil formulations. Additionally， the review analyzes the current challenges in this field and proposes strategies for future research and application. By systematically discussing the nose-to-brain pathway and the delivery mechanisms of TCM essential oils， this study aims to provide theoretical support for drug development， mechanism exploration， and formulation innovation in the treatment of neurological diseases， while also offering scientific guidance for further research and clinical applications of the nose-to-brain delivery system.

Objective:To investigate the efficacy of the combination of sintilimab and docetaxel in the treatment of cervical cancer and its impact on laboratory indicators.Methods:A total of 86 patients with advanced cervical cancer treated at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from July 2019 to June 2022 were selected as the study subjects. The patients were divided into a study group ( n=43) and a control group ( n=43) according to the treatment method. The study group was treated with a combination of sintilimab and docetaxel, while the control group was treated with docetaxel. After 6 cycles of treatment, the clinical efficacy, vascular endothelial growth factor receptor (VEGFR) levels, tumor marker levels, immune function indicators, programmed death-1 (PD-1), programmed death-ligand 1 (PD-L1) levels, and adverse reactions during treatment between the two groups were compared. 1-year progression-free survival (PFS) rate and overall survival (OS) rate between the two groups of patients were compared. Results:After 6 cycles of treatment, the objective response rates (ORR) of the study group and the control group were 48.84% (21/43) and 30.23% (13/43), respectively, with no statistically significant difference ( χ2=3.11, P=0.078); the disease control rates (DCR) of the two groups were 86.05% (37/43) and 62.79% (27/43), respectively, with a statistically significant difference ( χ2=6.11, P=0.013). Before treatment, the levels of VEGFR2 and VEGFR3 in the study group were (223.42±57.89), (3.25±1.22) ng/L, respectively, while those in the control group were (220.56±58.45), (3.31±1.17) ng/L, respectively, with no statistically significant differences ( t=0.23, P=0.820; t=0.23, P=0.817). After treatment, the VEGFR2 and VEGFR3 levels in the study group were (123.21±36.97), (0.81±0.21) ng/L, respectively, while those in the control group were (151.22±37.34), (1.33±0.37) ng/L, respectively, with statistically significant differences ( t=3.50, P=0.001; t=8.02, P<0.001). However, the levels of VEGFR2 and VEGFR3 in both groups of patients decreased after treatment compared to before treatment (all P<0.05). Before treatment, the levels of carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), and squamous cell carcinoma antigen (SCC-Ag) in the study group were (8.73±1.02) ng/ml, (29.73±5.88) U/ml, and (7.23±1.34) ng/ml, respectively, while those in the control group were (8.41±1.23) ng/ml, (30.12±5.93) U/ml, and (7.37±1.43) ng/ml, respectively, with no statistically significant differences ( t=1.31, P=0.193; t=0.31, P=0.760; t=0.47, P=0.641). After treatment, the CEA, CA125, and SCC-Ag levels in the study group were (3.52±0.78) ng/ml, (13.28±1.82) U/ml, and (2.33±0.49) ng/ml, respectively, while those in the control group were (3.87±0.62) ng/ml, (14.12±1.72) U/ml, and (2.65±0.54) ng/ml, respectively, with statistically significant differences ( t=2.30, P=0.024; t=2.20, P=0.031; t=2.88, P=0.005). However, the levels of CEA, CA125, and SCC-Ag in both groups of patients decreased after treatment compared to before treatment (all P<0.05). Before treatment, the T cell subsets CD4 +, CD8 +, and CD4 +/CD8 + in the study group were (27.53±2.23) %, (29.34±3.78) %, and 0.93±0.33, respectively, while those in the control group were (28.32±2.31) %, (30.03±3.27) %, and 0.94±0.42, respectively, with no statistically significant differences ( t=1.61, P=0.110; t=0.91, P=0.368; t=0.12, P=0.903). After treatment, the T cell subsets CD4 +, CD8 +, and CD4 +/CD8 + in the study group were (35.33±3.36) %, (44.32±4.33) %, and 0.80±0.22, respectively, while those in the control group were (30.31±3.23) %, (42.21±4.31) %, and 0.71±0.19, respectively, with statistically significant differences ( t=7.06, P<0.001; t=2.27, P=0.026; t=2.03, P=0.046). After treatment, the CD4 + and CD8 + T cell subsets in both groups were higher than before treatment, while the CD4 +/CD8 + was lower than before treatment (all P<0.05). Before treatment, the levels of PD-1 and PD-L1 mRNA in peripheral blood mononuclear lymphocytes of the study group were 1.21±0.21 and 0.73±0.15, respectively, while those in the control group were 1.23±0.25 and 0.79±0.14, respectively, with no statistically significant differences ( t=0.40, P=0.689; t=1.92, P=0.059). After treatment, the levels of PD-1 and PD-L1 mRNA in peripheral blood mononuclear lymphocytes of the study group were 0.77±0.13 and 0.52±0.13, respectively, while those in the control group were 0.93±0.19 and 0.66±0.17, respectively, with statistically significant differences ( t=4.56, P<0.001; t=4.29, P<0.001). However, the levels of PD-1 and PD-L1 mRNA in both groups of patients decreased after treatment compared to before treatment (all P<0.05). The 1-year PFS rate and OS rate of the study group patients were 60.47% and 72.09%, respectively; while those in the control groups were 51.16% and 65.12%, respectively, with no statistically significant differences ( χ2=1.31, P=0.253; χ2=0.82, P=0.365). The incidences of digestive system response, abnormal liver and kidney function, hematuria, bone marrow suppression, and rash in the study group were 39.53% (17/43), 13.95% (6/43), 13.95% (6/43), 23.26% (10/43), and 37.21% (16/43), respectively, while those in the control group were 32.56% (14/43), 9.30% (4/43), 11.63% (5/43), 18.60% (8/43), and 30.23% (13/43), respectively, with no statistically significant differences ( χ2=0.45, P=0.500; χ2=0.45, P=0.501; χ2=0.10, P=0.747; χ2=0.28, P=0.596; χ2=0.47, P=0.494) . Conclusions:Compared with monotherapy with docetaxel, the combination of sintilimab and docetaxel has a higher DCR in the treatment of advanced cervical cancer. To a certain extent, it effectively reduces the expression levels of VEGFR, serum tumor markers, and PD-1, PD-L1 in peripheral blood mononuclear lymphocytes, improves the immune function of patients, and has comparable drug safety. However, the two treatment options have comparable 1-year survival rates.

HDAC7, a member of class IIa HDACs, plays a pivotal regulatory role in tumor, immune, fibrosis, and angiogenesis, rendering it a potential therapeutic target. Nevertheless, due to the high similarity in the enzyme active sites of class IIa HDACs, inhibitors encounter challenges in discerning differences among them. Furthermore, the substitution of key residue in the active pocket of class IIa HDACs renders them pseudo-enzymes, leading to a limited impact of enzymatic inhibitors on their function. In this study, proteolysis targeting chimera (PROTAC) technology was employed to develop HDAC7 drugs. We developed an exceedingly selective HDAC7 PROTAC degrader B14 which showcased superior inhibitory effects on cell proliferation compared to TMP269 in various diffuse large B cell lymphoma (DLBCL) and acute myeloid leukemia (AML) cells. Subsequent investigations unveiled that B14 disrupts BCL6 forming a transcriptional inhibition complex by degrading HDAC7, thereby exerting proliferative inhibition in DLBCL. Our study broadened the understanding of the non-enzymatic functions of HDAC7 and underscored the importance of HDAC7 in the treatment of hematologic malignancies, particularly in DLBCL and AML.