Objective: To understand the awareness of chikungunya fever knowledge and its related factors among medical college students in Baise City, so as to provide a scientific basis to offer relevant courses and special education. Methods: From July to August 2025, 7 286 enrolled medical students were selected by a sampling method from a medical college in Baise City to participate in the questionnaire survey. The questionnaire covered epidemiological characteristics, clinical symptoms, and prevention/control knowledge of chikungunya fever. Statistical analyses including the Chi quare test and multivariate Logistic regression models were performed. Results: The overall awareness rate of chikungunya fever knowledge among the medical students was 18.89%. Among the knowledge items, the awareness rate of "the high incidence season" was the highest (84.05%), while that of "the infectious period" was the lowest (17.80%). Multivariate Logistic regression analysis showed that medical students with female (a OR= 1.37 , 95%CI =1.20- 1.57 ), the age for over 25 years old (a OR=1.76, 95%CI =1.05-2.93), whose father had a middle school educational level (a OR=1.18, 95%CI =1.05-1.31), and majored in preventive medicine (a OR=1.54, 95%CI =1.10-1.67) had relatively higher awareness rates of chikungunya fever knowledge (all P <0.05). In contrast, students of Zhuang ethnicity (a OR= 0.87 , 95%CI =0.76-0.98) and majoring in nursing (a OR=0.74, 95%CI =0.61-0.91) or pharmacy (a OR=0.70, 95%CI =0.52-0.95) had relatively lower awareness rates (all P <0.05). Conclusions The awareness rate of chikungunya fever related knowledge among medical college students in Baise City is relatively low. Schools should take targeted publicity measures to improve medical students awareness.

Sinisan is a classical prescription developed and applied by ancient medical experts and it is first recorded in the Treatise on Cold Damage written by ZHANG Zhongjing in the Eastern Han Dynasty. Later physicians have modified this prescription based on this original one. The bibliometrics methods were used to analyze the key information and research trend of Sinisan. According to the inclusion and exclusion criteria， 69 pieces of effective data were extracted， involving 67 ancient traditional Chinese medicine （TCM） books. The results showed that the name， composition， and decocting methods of Sinisan in later generations were inherited from the original record in the Treatise on Cold Damage. The original plants of medicinal materials used in Sinisan are basically clear. We recommend Bupleuri Radix as the dried root of Bupleurem scorzonerifolium， Paeoniae Radix Alba as the dried root of Paeonia lactiflora， Aurantii Fructus as the dried fruit of Citrus aurantium， Glycyrrhizae Radix et Rhizoma as the dry root and rhizome of Glycyrrhiza uralensis. Raw materials of Bupleuri Radix and Paeoniae Radix Alba， Aurantii Fructus stir-fried with bran， and stir-fried Glycyrrhizae Radix et Rhizoma should be used for preparation of Sinisan. According to measurement system in the Han Dynasty， a bag of Sinisan is composed of 1.25 g Bupleuri Radix， 1.25 g Paeoniae Radix Alba， 1.25 g Aurantii Fructus， and 1.25 g Glycyrrhizae Radix et Rhizoma. The materials should be grounded into coarse powder and taken with a proper amount of rice soup， 3 times a day. Sinisan has the effects of regulating qi movement and harmonizing the liver and spleen. It can be used for treating reversal cold in limbs and cold damage. In modern clinical practice， Sinisan can be used to treat chronic gastritis， irritable bowel syndrome， and dyspepsia. The above research results provide scientific reference for the future research and development of Sinisan.

Objective To explore the correlation between neuron specific enolase(NSE)levels and recurrence after percutaneous balloon compression(PBC)in patients with trigeminal neuralgia(TN).Methods 166 TN patients who underwent PBC at the Second People's Hospital of Huai'an City,Jiangsu Province from July 2018 to April 2021 were selected as the study subjects.According to the recurrence rate after 2 years of surgery,patients were divided into a recurrence group(n=22)and a non-recurrence group(n=144).The general information of the two groups of patients was compared,and the serum biomarker levels before and after PBC in TN patients were analyzed,as well as the postoperative efficacy of TN patients with PBC.Compared the difference changes(T2-T1)between various inflammatory markers and nerve injury markers before surgery(T1)and 2 days after surgery(T2),and perform correlation analysis(Spearman correlation and Logistic regression)between the significantly changed difference indicators and prognosis recurrence to explor the predictive value of serum NSE for recurrence after PBC in TN patients.Results The serum NSE level of TN patients on the first day of PBC was 12.39±3.15 ng/ml,were compored with those on the second day after PBC was 16.27±4.03ng/ml,and the difference was statisically significant(t=14.922,P<0.01).The difference in serum NEC levels before and after PBC in the recurrent group was 5.72(5.25,7.58)ng/ml,while the difference in serum NSE levels before and after PBC in the non-recurrent group was 3.01(2.63,3.37)ng/ml,the difference between the two groups was statistically significant(Z=3.925,P<0.001).Logistic regression results showed that the difference in serum NSE levels(T2-T1)before and after PBC was a rish factor for postoperative recurrence in TN patients at two-years(OR=1.602,Wald χ2=12.252,P<0.05).ROC analysis tesults:the predictive power of serum NSE difference(T2-T1)before and after PBC for two-year recurrence in TN patients AUC(95%CI)was 0.777(0.587～0.954),and the prediction threshold was 4ng/ml.The corresponding sensitivity and specificity was 0.727 and 0.806,respectively.Conclusion Serum NSE may become a biomarker for predicting the recurrence of TN patients after PBC treatment.

Xiaoji Yinzi is one of the classic prescriptions for treating urinary diseases， originated from the Yan's Prescriptions to Aid the Living （Yan Shi Ji Sheng Fang） written by YAN Yonghe in the Song dynasty. Xiaoji Yinzi is composed of Rehmanniae Radix， Cirsii Herba， Talcum， Akebiae Caulis， Typhae Pollen， Nelumbinis Rhizomatis Nodus， Lophatheri Herba， Angelicae Sinensis Radix， Gardeniae Fructus， and Glycyrrhizae Radix et Rhizoma and has the effects of cooling blood and stopping bleeding， draining water and relieving stranguria. The medical experts of later generations have inherited the original prescription recorded in the Yan's Prescriptions to Aid the Living， while dispute has emerged during the inheritance of this prescription. In this study， the method of bibliometrics was employed to review and analyze the ancient documents and modern clinical studies involving Xiaoji Yinzi. The results showed that Xiaoji Yinzi has two dosage forms： powder and decoction. According to the measurement system in the Song Dynasty， the modern doses of hers in Xiaoji Yinzi were transformed. In the prepration of Xiaoji Yinzi powder， 149.2 g of Rehmanniae Radix and 20.65 g each of Cirsii Herba， Talcum， Akebiae Caulis， stir-fried Typhae Pollen， Nelumbinis Rhizomatis Nodus， Lophatheri Herba， wine-processed Angelicae Sinensis Radix， stir-fried Gardeniae Fructus， and stir-fried Glycyrrhizae Radix et Rhizoma are grounded into fine powder with the particle size of 4-10 meshes and a decocted with 450 mL water to reach a volume of 240 mL. After removal of the residue， the decoction was taken warm before meals， 3 times a day （i.e.， 7.77 g Rehmanniae Radix and 0.97 g each of the other herbs each time）. In the preparation of Xiaoji Yinzi decoction， 20.65 g each of the above 10 herbs are used， with stir-fried Typhae Pollen， wine-processed Angelica Sinensis Radix， stir-fired Gardeniae Fructus， stir-fired Glycyrrhizae Radix et Rhizoma， and raw materials of other herbs. Xiaoji Yinzi is specialized in treating hematuresis and blood stranguria due to heat accumulation in lower energizer， which causes injury of the blood collaterals of gallbladder and dysfunction of Qi transformation. In modern clinical practice， Xiaoji Yinzi is specifically used for treating urinary diseases and can be expanded to treat diseases of the cardiovascular system and other systems according to pathogenesis. The comprehensive research on the key information could provide a scientific reference for the future development of Xiaoji Yinzi.

Objective:To evaluate the expression characteristics of the FBJ murine osteosarcoma viral oncogene homolog B(FOSB)gene in immunoglobulin A nephropathy(IgAN)and common chronic kidney diseases(CKDs),and to determine its value as a potential key candidate gene or biomarker.Methods:The RNA sequencing datasets for IgAN,diabetic kidney disease(DKD),membranous nephropathy(MN),and minimal change disease(MCD)glomerular samples were downloaded from the Gene Expression Omnibus(GEO)database.The feature genes for CKD were identified using machine learning methods including least absolute shrinkage and selection operator(LASSO)regression,random forest(RF),and support vector machine(SVM).Gene Ontology(GO)functional enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG)signaling pathway enrichment analyses were performed on the identified IgAN feature genes.The"pROC"package was used to plot the receiver operating characteristic(ROC)curves to evaluate the diagnostic efficacy of IgAN feature genes.The gene with the highest diagnostic value was selected for Gene Set Enrichment Analysis(GSEA)and correlation analysis with core immune cells in IgAN.Clinical correlation analysis between the FOSB expression level in kidney tissue and renal function was performed using the Nephroseq v5 platform.Kidney tissue samples were collected from 5 cases of IgAN patients,DKD patients,MCD patients,and MN patients,respectively,along with 5 samples of adjacent normal kidney tissues(control group).Immunohistochemistry staining method was used to detect the expression levels of FOSB protein in tissue samples in various groups.Results:A total of 110 differentially expressed genes(DEGs)were identified in IgAN glomeruli,among which FOSB,NR4A2,and DUSP1 were identified as the feature genes.Compared with control group,the expression level of FOSB mRNA in IgAN group was significantly decreased(P＜0.05).The GO fuctional enrichment analysis results revealed that these IgAN feature genes were primarily enriched in biological processes related to dopamine biosynthesis,midbrain dopaminergic neuron differentiation,peptidyl-serine/threonine dephosphorylation,and response to corticosterone.The KEGG signaling pathway enrichment analysis results showed that the DEGs were significantly enriched in cocaine addiction,amphetamine addiction,interleukin 17(IL-17)signaling pathway,aldosterone synthesis and secretion,and serotonergic synapse.The ROC curve analysis results demonstrated that FOSB showed high diagnostic accuracy for IgAN.GSEA analysis revealed that arginine and proline metabolism,butyrate metabolism,erythroblastic leukemia viral oncogene homolog(ERBB)signaling pathway,mitogen-activated protein kinase(MAPK)signaling pathway,and fructose and mannose metabolism pathways were enriched in FOSB high-expression group,while allograft rejection,extracellular matrix receptor interaction,and type 1 diabetes pathways were significantly enriched in FOSB low-expression group.The immune cell infiltration analysis results identified natural killer cells,neutrophils,and M1 macrophages as core immune cells in IgAN,and the expression of FOSB gene was positively correlated with neutrophil infiltration(r=0.42,P＜0.05).The immunohistochemistry analysis results demonstrated that compared with control group,the expression level of FOSB protein in glomeruli of the patients in IgAN,DKD,MN,and MCD groups were significantly decreased(P＜0.05).Conclusion:The expressions of FOSB gene in the glomeruli tissue of IgAN,DKD,MN,and MCD patients ware decreased,suggesting FOSB may represent a potential biomarker for IgAN.

OBJECTIVES: We propose a novel deep learning segmentation algorithm (DSRF) based on multi-scale supervision and residual feedback strategy for precise segmentation of the optic chiasm and optic nerves in CT images of nasopharyngeal carcinoma (NPC) patients. METHODS: We collected 212 NPC CT images and their ground truth labels from SegRap2023, StructSeg2019 and HaN-Seg2023 datasets. Based on a hybrid pooling strategy, we designed a decoder (HPS) to reduce small organ feature loss during pooling in convolutional neural networks. This decoder uses adaptive and average pooling to refine high-level semantic features, which are integrated with primary semantic features to enable network learning of finer feature details. We employed multi-scale deep supervision layers to learn rich multi-scale and multi-level semantic features under deep supervision, thereby enhancing boundary identification of the optic chiasm and optic nerves. A residual feedback module that enables multiple iterations of the network was designed for contrast enhancement of the optic chiasm and optic nerves in CT images by utilizing information from fuzzy boundaries and easily confused regions to iteratively refine segmentation results under supervision. The entire segmentation framework was optimized with the loss from each iteration to enhance segmentation accuracy and boundary clarity. Ablation experiments and comparative experiments were conducted to evaluate the effectiveness of each component and the performance of the proposed model. RESULTS: The DSRF algorithm could effectively enhance feature representation of small organs to achieve accurate segmentation of the optic chiasm and optic nerves with an average DSC of 0.837 and an ASSD of 0.351. Ablation experiments further verified the contributions of each component in the DSRF method. CONCLUSIONS The proposed deep learning segmentation algorithm can effectively enhance feature representation to achieve accurate segmentation of the optic chiasm and optic nerves in CT images of NPC.
Humans ; Tomography, X-Ray Computed/methods* ; Optic Chiasm/diagnostic imaging* ; Optic Nerve/diagnostic imaging* ; Algorithms ; Nasopharyngeal Carcinoma ; Deep Learning ; Nasopharyngeal Neoplasms/diagnostic imaging* ; Neural Networks, Computer ; Image Processing, Computer-Assisted/methods*

This review systematically summarizes the unique metabolic mechanisms of breast cancer,their interac-tions with the tumor microenvironment(TME),and the latest advances in targeted therapies.The interplay between metabolic reprogramming and the TME underpins malignant progression and therapeutic resistance.Breast cancer cells reshape energy supply through the Warburg effect,aberrant fatty acid synthesis,and amino acid metabolism,while immune cells,fibroblasts,and the acidic milieu within the TME promote immune evasion and drug resistance via metabolic coupling.Although traditional strategies targeting key metabolic enzymes remain valuable,they are often insufficient to overcome metabolic adaptability.In recent years,combined metabolic and immunotherapeutic approaches have emerged as promising strategies:by reducing lactate accumulation,restoring T-cell function,and reprogramming tumor-associated macrophages and cancer-associated fibroblasts,these therapies can remodel the immunosuppressive microenvironment and enhance immunotherapy efficacy.The application of metabolomics and single-cell sequencing further elucidates breast cancer heterogeneity,providing a basis for individualized precision treatment.Future challenges include deciphering resistance mechanisms,developing highly selective metabolic in-hibitors,and designing integrated multi-omics-based therapeutic regimens.

Objective To explore the correlation between neuron specific enolase(NSE)levels and recurrence after percutaneous balloon compression(PBC)in patients with trigeminal neuralgia(TN).Methods 166 TN patients who underwent PBC at the Second People's Hospital of Huai'an City,Jiangsu Province from July 2018 to April 2021 were selected as the study subjects.According to the recurrence rate after 2 years of surgery,patients were divided into a recurrence group(n=22)and a non-recurrence group(n=144).The general information of the two groups of patients was compared,and the serum biomarker levels before and after PBC in TN patients were analyzed,as well as the postoperative efficacy of TN patients with PBC.Compared the difference changes(T2-T1)between various inflammatory markers and nerve injury markers before surgery(T1)and 2 days after surgery(T2),and perform correlation analysis(Spearman correlation and Logistic regression)between the significantly changed difference indicators and prognosis recurrence to explor the predictive value of serum NSE for recurrence after PBC in TN patients.Results The serum NSE level of TN patients on the first day of PBC was 12.39±3.15 ng/ml,were compored with those on the second day after PBC was 16.27±4.03ng/ml,and the difference was statisically significant(t=14.922,P<0.01).The difference in serum NEC levels before and after PBC in the recurrent group was 5.72(5.25,7.58)ng/ml,while the difference in serum NSE levels before and after PBC in the non-recurrent group was 3.01(2.63,3.37)ng/ml,the difference between the two groups was statistically significant(Z=3.925,P<0.001).Logistic regression results showed that the difference in serum NSE levels(T2-T1)before and after PBC was a rish factor for postoperative recurrence in TN patients at two-years(OR=1.602,Wald χ2=12.252,P<0.05).ROC analysis tesults:the predictive power of serum NSE difference(T2-T1)before and after PBC for two-year recurrence in TN patients AUC(95%CI)was 0.777(0.587～0.954),and the prediction threshold was 4ng/ml.The corresponding sensitivity and specificity was 0.727 and 0.806,respectively.Conclusion Serum NSE may become a biomarker for predicting the recurrence of TN patients after PBC treatment.

Intracranial seminoma is a rare malignant tumor originating from the germ cells,usually occurring in the pineal gland or pituitary gland.In June 2020,the Department of Endocrinology at the First Affiliated Hospital of Army Military Medical University admitted a 20-year-old male patient with an intracranial germ cell tumor and spinal metastases.The patient presented with headache,dizziness,and visual impairment.Enhanced magnetic resonance imaging(MRI)of the head indicated thickening of the pituitary stalk.After multidisciplinary consultation,the patient underwent endonasal transsphenoidal resection of the tumor,with the pathological diagnosis confirming germ cell tumor.The patient received regular radiotherapy postoperatively.One year later,the tumor recurred and metastasized,leading to a second surgery for tumor resection in the thoracic spinal canal,followed by continued chemotherapy.The patient's clinical symptoms,such as headache and visual disturbances,improved,but he continued to experience panhypopituitarism and required long-term hormone replacement therapy.Early diagnosis of intracranial germ cell tumors is challenging,and they are prone to metastasis and highly sensitive to radiotherapy and chemotherapy.Early diagnosis and multidisciplinary comprehensive treatment can help improve the quality of life and prognosis for patients.

Objective:To study the current status of longitudinal extrauterine growth restriction (EUGR) in extremely preterm infants (EPIs) and to develop a prediction model based on clinical data from multiple NICUs.Methods:From January 2017 to December 2018, EPIs admitted to 32 NICUs in North China were retrospectively studied. Their general conditions, nutritional support, complications during hospitalization and weight changes were reviewed. Weight loss between birth and discharge > 1SD was defined as longitudinal EUGR. The EPIs were assigned into longitudinal EUGR group and non-EUGR group and their nutritional support and weight changes were compared. The EPIs were randomly assigned into the training dataset and the validation dataset with a ratio of 7∶3. Univariate Cox regression analysis and multiple regression analysis were used in the training dataset to select the independent predictive factors. The best-fitting Nomogram model predicting longitudinal EUGR was established based on Akaike Information Criterion. The model was evaluated for discrimination efficacy, calibration and clinical decision curve analysis.Results:A total of 436 EPIs were included in this study, with a mean gestational age of (26.9±0.9) weeks and a birth weight of (989±171) g. The incidence of longitudinal EUGR was 82.3%(359/436). Seven variables (birth weight Z-score, weight loss, weight growth velocity, the proportion of breast milk ≥75% within 3 d before discharge, invasive mechanical ventilation ≥7 d, maternal antenatal corticosteroids use and bronchopulmonary dysplasia) were selected to establish the prediction model. The area under the receiver operating characteristic curve of the training dataset and the validation dataset were 0.870 (95% CI 0.820-0.920) and 0.879 (95% CI 0.815-0.942), suggesting good discrimination efficacy. The calibration curve indicated a good fit of the model ( P>0.05). The decision curve analysis showed positive net benefits at all thresholds. Conclusions:Currently, EPIs have a high incidence of longitudinal EUGR. The prediction model is helpful for early identification and intervention for EPIs with higher risks of longitudinal EUGR. It is necessary to expand the sample size and conduct prospective studies to optimize and validate the prediction model in the future.