Purpose: Lung cancer is frequently observed as a second primary malignancy following gastric cancer, yet the genetic causality between them remains uncertain. This study aims to evaluate the causal relationship between gastric and lung cancers using Mendelian randomization (MR) analysis. Materials and Methods: Single nucleotide polymorphisms associated with gastric and lung cancers were selected from genome-wide association study in East Asian and European populations as instrumental variables. The causal effects between gastric and lung cancers were evaluated using univariable and multivariable MR analysis, with the inverse variance weighted (IVW) method serving as the primary criterion. Heterogeneity and sensitivity analyses were performed to ensure the robustness of the findings. Results: Univariable MR analysis demonstrated that genetic susceptibility to gastric cancer in the European population was significantly associated with an increased risk of lung cancer (IVW: odds ratio [OR], 1.285; 95% confidence interval [CI], 1.072 to 1.541; p=6.83E-03), which was consistently validated in the East Asian population (IVW: OR, 1.356; 95% CI, 1.114 to 1.651; p=2.40E-03). Multivariable MR analysis further indicated that the significant positive causal relationship between gastric cancer and lung cancer persisted in both populations after adjusting for confounding factors (all p < 0.05). Conversely, no significant causal relationship was observed for the risk of developing gastric cancer following the diagnosis of lung cancer in either population (p > 0.05). Conclusion This study confirms that genetic susceptibility to gastric cancer increases the risk of lung cancer. This finding provides a theoretical basis for exploring the underlying biological mechanisms and suggests that enhancing lung cancer screening in patients with gastric cancer may be necessary to improve patient prognosis.

Objective To explore the correlation between plasma T cell subsets,serum interleukin-6(IL-6)levels and CT imaging characteristics in children with mycoplasma pneumoniae pneumonia(MPP),as well as its predictive value for clinical prognosis.Methods A total of 98 children with MPP were selected as the research subjects and divided into the good prognosis group(n=62)and the poor prognosis group(n=36)according to the clinical prognosis.The correlations between plasma T cell subsets,IL-6 levels,CT imaging characteristics and prognosis were analyzed.The predictive efficacy of plasma T cell subsets and IL-6 levels for poor progno-sis was analyzed.Results The levels of C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),IL-6,CD8+and CD19+in the poor prognosis group were significantly higher than those in the good prognosis group,while the levels of CD3+,CD4+,CD4+/CD8+and CD16+/CD56+were significantly lower than those in the good prognosis group(P＜0.05).The statistical conditions of CT ima-ging characteristics such as pulmonary consolidation,ground-glass change,involvement of lung lobes ≥ 2,patchy consolidation shad-ows,grid nodular shadows,bronchial wall thickening,hilar lymph node enlargement,pleural effusion,and atelectasis in the poor prognosis group were significantly higher than those in the good prognosis group(P＜0.05).CD3+,CD4+,CD8+,CD4+/CD8+,CD19+,CD16+/CD56+and IL-6 had independent correlations with the above CT imaging characteristics.IL-6,CD8+and CD19+were positively correlated with the risk of poor prognosis,while CD3+,CD4+,CD4+/CD8+and CD16+/CD56+were negatively correlated with the risk of poor prognosis(P＜0.05).Individual detection of CD3+,CD4+,CD8+,CD4+/CD8+,CD19+,CD16+/CD56+,IL-6 and the combined detection of the seven indicators had certain predictive value for the occurrence of poor prognosis in patients[area under the curve(AUC)＞0.7].Conclusion Plasma T cell subsets and serum IL-6 levels are important factors influencing the prognosis of children with MPP and are independently related to the CT imaging characteristics.

Purpose To explore the value of 5.0T MRI arterial spin labeling and morphological indexes for staging chronic kidney disease(CKD).Materials and Methods Ninety-five patients with CKD in Chongqing University Three Gorges Hospital from January to August 2024 were collected prospectively,all of whom underwent 5.0T MRI routine and arterial spin labeling examination with calculation of renal blood flow(RBF)and morphological evaluation.According to the estimated glomerular filtration rate(eGFR),the patients were categorized into early CKD group[eGFR 60-89 ml/(min?1.73 m2)]and intermediate-late CKD group[eGFR<59 ml/(min?1.73 m2)]and were further divided into stage 1-5.The differences in RBF between early and intermediate-late CKD patients were compared,and the differences in morphological indexes among different stages of CKD were also analyzed.Binary Logistic regression analysis was used to screen for independent influences on early or intermediate-late CKD staging.Receiver operating characteristic curve was used to evaluate the diagnostic efficacy of RBF values and morphological indexes for early CKD.RBF in CKD stages 1-5 were compared,with Bonferroni pairwise comparisons.The correlation between RBF values and both clinical and morphological indexes were also assessed.Results Whether in CKD stage 2 or 5,morphological factors affecting CKD staging were renal parenchymal signal,renal corticomedullary demarcation,renal volume and renal envelope(χ2=53.715,73.368,36.488,56.688,35.630,39.499,28.520,32.632,all P<0.001).In CKD stage 2,the independent influences screened by multivariate binary Logistic regression analysis were renal parenchymal signal(P<0.001)and renal corticomedullary demarcation(P=0.021).Both renal RBF values in early CKD were significantly higher than that in intermediate-late CKD(Z=-5.975,-5.885,both P<0.001).The areas under the curve for diagnosing early CKD using mean RBF of both kidneys,morphological indexes,and the combination of mean RBF with renal morphological indexes were 0.854,0.932 and 0.951,respectively.RBF values for both kidneys showed statistically significant differences among the five CKD stages(left:H=48.738;right:H=48.102,both P<0.001)and between non-adjacent stages(all P<0.05).Both kidneys RBF values showed a positive correlation with renal parenchymal signal and renal corticomedullary demarcation(left:r=0.600,0.503;right:r=0.550,0.504,both P<0.001).Conclusion The integration of arterial spin labeling and morphological assessment on 5.0T MRI enables a noninvasive and precise functional and morphological evaluation of early renal damage in CKD patients,providing a foundation for subsequent clinical CKD staging.

Purpose To explore the value of 5.0T MRI arterial spin labeling and morphological indexes for staging chronic kidney disease(CKD).Materials and Methods Ninety-five patients with CKD in Chongqing University Three Gorges Hospital from January to August 2024 were collected prospectively,all of whom underwent 5.0T MRI routine and arterial spin labeling examination with calculation of renal blood flow(RBF)and morphological evaluation.According to the estimated glomerular filtration rate(eGFR),the patients were categorized into early CKD group[eGFR 60-89 ml/(min?1.73 m2)]and intermediate-late CKD group[eGFR<59 ml/(min?1.73 m2)]and were further divided into stage 1-5.The differences in RBF between early and intermediate-late CKD patients were compared,and the differences in morphological indexes among different stages of CKD were also analyzed.Binary Logistic regression analysis was used to screen for independent influences on early or intermediate-late CKD staging.Receiver operating characteristic curve was used to evaluate the diagnostic efficacy of RBF values and morphological indexes for early CKD.RBF in CKD stages 1-5 were compared,with Bonferroni pairwise comparisons.The correlation between RBF values and both clinical and morphological indexes were also assessed.Results Whether in CKD stage 2 or 5,morphological factors affecting CKD staging were renal parenchymal signal,renal corticomedullary demarcation,renal volume and renal envelope(χ2=53.715,73.368,36.488,56.688,35.630,39.499,28.520,32.632,all P<0.001).In CKD stage 2,the independent influences screened by multivariate binary Logistic regression analysis were renal parenchymal signal(P<0.001)and renal corticomedullary demarcation(P=0.021).Both renal RBF values in early CKD were significantly higher than that in intermediate-late CKD(Z=-5.975,-5.885,both P<0.001).The areas under the curve for diagnosing early CKD using mean RBF of both kidneys,morphological indexes,and the combination of mean RBF with renal morphological indexes were 0.854,0.932 and 0.951,respectively.RBF values for both kidneys showed statistically significant differences among the five CKD stages(left:H=48.738;right:H=48.102,both P<0.001)and between non-adjacent stages(all P<0.05).Both kidneys RBF values showed a positive correlation with renal parenchymal signal and renal corticomedullary demarcation(left:r=0.600,0.503;right:r=0.550,0.504,both P<0.001).Conclusion The integration of arterial spin labeling and morphological assessment on 5.0T MRI enables a noninvasive and precise functional and morphological evaluation of early renal damage in CKD patients,providing a foundation for subsequent clinical CKD staging.

Objective To explore the correlation between plasma T cell subsets,serum interleukin-6(IL-6)levels and CT imaging characteristics in children with mycoplasma pneumoniae pneumonia(MPP),as well as its predictive value for clinical prognosis.Methods A total of 98 children with MPP were selected as the research subjects and divided into the good prognosis group(n=62)and the poor prognosis group(n=36)according to the clinical prognosis.The correlations between plasma T cell subsets,IL-6 levels,CT imaging characteristics and prognosis were analyzed.The predictive efficacy of plasma T cell subsets and IL-6 levels for poor progno-sis was analyzed.Results The levels of C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),IL-6,CD8+and CD19+in the poor prognosis group were significantly higher than those in the good prognosis group,while the levels of CD3+,CD4+,CD4+/CD8+and CD16+/CD56+were significantly lower than those in the good prognosis group(P＜0.05).The statistical conditions of CT ima-ging characteristics such as pulmonary consolidation,ground-glass change,involvement of lung lobes ≥ 2,patchy consolidation shad-ows,grid nodular shadows,bronchial wall thickening,hilar lymph node enlargement,pleural effusion,and atelectasis in the poor prognosis group were significantly higher than those in the good prognosis group(P＜0.05).CD3+,CD4+,CD8+,CD4+/CD8+,CD19+,CD16+/CD56+and IL-6 had independent correlations with the above CT imaging characteristics.IL-6,CD8+and CD19+were positively correlated with the risk of poor prognosis,while CD3+,CD4+,CD4+/CD8+and CD16+/CD56+were negatively correlated with the risk of poor prognosis(P＜0.05).Individual detection of CD3+,CD4+,CD8+,CD4+/CD8+,CD19+,CD16+/CD56+,IL-6 and the combined detection of the seven indicators had certain predictive value for the occurrence of poor prognosis in patients[area under the curve(AUC)＞0.7].Conclusion Plasma T cell subsets and serum IL-6 levels are important factors influencing the prognosis of children with MPP and are independently related to the CT imaging characteristics.

Objective To investigate the effects of aerobic respiratory training on cardiopulmonary function and hemorheology in patients with chronic pulmonary heart disease(CPHD).Methods A total of 92 CPHD patients treated at our hospital from January 2022 to June 2024 were enrolled as study subjects.They were randomly divided into a control group and a study group using a random number table method,with 46 patients in each group.The control group was treated with conventional therapy,while the study group under-went a standardized aerobic respiratory training program on top of the control group's treatment.Cardiac function indicators,pulmonary function parameters,clinical symptom scores,hemorheological indexes,quality of life,adverse reactions,and treatment efficacy were compared between the two groups.Results After treat-ment,the study group exhibited significantly lower left ventricular end-diastolic dimension(LVEDD),left ventricular end-systolic dimension(LVESD),clinical symptom scores,hematocrit,fibrinogen,high-shear whole blood viscosity,and low-shear whole blood viscosity compared to the control group(P<0.05).Con-versely,left ventricular ejection fraction(LVEF),6-minute walk distance(6MWD),maximal voluntary venti-lation(MVV),forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),scores on the ge-neric quality of life inventory-74(GQOLI-74),and overall treatment efficacy were significantly higher in the study group(P<0.05).No statistically significant differences were observed in the incidence of adverse reac-tions between the two groups(P>0.05).Conclusion Aerobic respiratory training effectively improves car-diopulmonary function,clinical symptoms,hemorheological profiles,and quality of life in patients with CPHD.

Premature ejaculation refers to a sexual dysfunction in which men experience a short intravaginal ejaculation latency and a lack of control over ejaculation during sexual activity. The onset of this condition is often accompanied by anxiety and depression, which can seriously affect the quality of the patient′s sexual life and the relationship between partners. Based on the "integration of body and spirit" theory in traditional Chinese medicine, our team believes that this condition is a comorbidity of physical and spiritual factors. We propose that the core pathogenesis of this disease lies in the "loss of form and essence, impairment of spirit, and depression of the mind, "while the primary treatment principle involves "nourishing form and regulating spirit." As a result, a new diagnosis and treatment approach of "four-dimensional integration" is summarized in this study. The disease is treated through the four dimensions of shape, body, spirit, and emotion. Traditional Chinese medicine is used to adjust the shape in cases where the physical form is damaged. For individuals with depression of heart and liver qi, the treatment focuses on soothing the heart and smoothing liver qi, and the modified Wangyou Powder and Xuanzhi Decoction is used. In cases where the heart and kidney function are compromised, the treatment involves nourishing both the heart and kidney while restoring interaction between the heart and the kidney, and modified Jihuo Yansi Elixir is used. To reduce the sensitivity of the glans penis, the patient′s body is washed with a traditional Chinese medicine formula, and a delicate fumigation formula is decocted for external washing. For those who are not in tune with their god, psychological counseling can be used to regulate their spirit and advocate "self-partner" and psychotherapy. If there are issues with intimacy, partners should focus on cooperating during foreplay, sexual intercourse, and post-coital interactions. Overall, the treatment aims to harmonize the body and spirit, addressing both physical and psychological factors through a comprehensive, multi-dimensional approach. This method provides new perspectives and ideas for the clinical diagnosis and treatment of this condition.

Objective To establish a human luminal breast cancer stem cell(BCSC)model and investigate the inhibitory effects of astragaloside Ⅳ(AS-Ⅳ)on BCSC growth.Methods MCF-7 breast cancer cells were cultured in stem cell-specific medium to induce BCSC formation.The BCSCs were then divided into a blank control group and an AS-Ⅳ treatment group,both groups were given PBS or AS-Ⅳ treatment.Morphological changes were observed after intervention.The therapeutic efficacy of AS-Ⅳ was evaluated using 3D spheroid formation and cell viability assays.Transcriptomic profiling and gene expression analysis were performed to elucidate the underlying mechanisms.Results Compared with the MCF7 breast cancer cells,MCF7 breast cancer stem cell mammospheres exhibited accelerated growth(P＜0.01)and significantly increased expression of the stemness marker ALDH1A1(P＜0.01).Further comparison with the blank control group revealed that astragaloside Ⅳ(AS-Ⅳ)treatment significantly inhibited MCF7 breast cancer stem cell proliferation(P＜0.001)and slowed mammosphere growth(P＜0.01).Transcriptomic analysis demonstrated that differentially expressed genes(DEGs)induced by stem cell modeling and AS-Ⅳ intervention were enriched in the cellular senescence signaling pathway.AS-Ⅳ intervention substantially increased the number of SA-β-gal-positive cells(P＜0.01).RT-PCR analysis confirmed that AS-Ⅳsignificantly upregulated mRNA expression of IL-1α(P＜0.01),P21(P＜0.001),and P53(P＜0.05)in MCF7 breast cancer stem cells.Conclusion Astragaloside Ⅳ suppresses the growth of human luminal breast cancer stem cells by inducing cellular senescence.

Objective To investigate the composition of symptom clusters in early postoperative breast cancer patients and analyze the sentinel symptoms of each cluster of symptoms. Methods A total of 309 patients who underwent mastectomy were conveniently sampled and surveyed using the Chinese version of the Anderson Symptom Inventory. Principal component analysis and varimax orthogonal rotation were employed to analyze the symptom clusters, and their associations were analyzed using the Apriori algorithm model to identify the sentinel symptoms of each cluster of symptoms. Results Three symptom clusters were identified in early postoperative breast cancer patients: neuro-sleep symptom cluster [fatigue (weakness)-distress-pain-sleepiness-restless sleep], sensory-perception symptom cluster (numbness-forgetfulness-shortness of breath-sadness-dry mouth), and digestive system symptom cluster (nausea-vomiting-loss of appetite). Fatigue was the sentinel symptom of the neuro-sleep symptom cluster, numbness was the sentinel symptom of the sensory-perception symptom cluster, and nausea was the sentinel symptom of the digestive system symptom cluster. Conclusion Early postoperative breast cancer patients experience multiple symptom clusters, with sentinel symptoms existing in each cluster. Healthcare staff should develop intervention measures based on sentinel symptoms to improve the efficiency of symptom management and reduce the degree of symptom distress for patients.

Objective:To explore the risk factors for malnutrition after a tracheotomy and to construct a predictive model useful for its prevention through early intervention.Methods:Clinical data describing 440 tracheotomy patients were subjected to a retrospective analysis. The variables examined were age, sex, etiology, Glasgow Coma Score (GCS), activities of daily living (ADL) score, age-corrected Charlson comorbidity index (aCCI), food intake, swallowing function, incidence of infections, as well as any history of diabetes mellitus, hypertension, smoking or alcohol consumption. Patients identified as being at risk of malnutrition (NRS-2002≥3) were screened using the Nutritional Risk Screening tool (NRS-2002) and the European Society of Clinical Nutrition and Metabolism′s ESPEN2015 criteria. The subjects were thus categorized into a malnutrition group of 343 and a control group of 97. Unifactorial and multifactorial logistic regression analyses were performed, and stepwise regression was applied to include the factors found significant in the unifactorial analysis into the multifactorial logistic regression analysis, and to construct a column-line graph prediction model. The clinical utility of the model was assessed by applying the receiver operator characteristics (ROC) curves, calibration plots and decision curve analysis (DCA).Results:Of the 440 persons studied, 343 (78%) were malnourished. The multivariate logistic regression analysis showed that pulmonary infection, dysphagia, low GCS score and high aCCI score were significant risk factors for malnutrition after a tracheotomy. A prediction nomograph was constructed. After fitting and correcting, the area under the curve (AUC) of the prediction model′s ROC curve was 0.911, the specificity was 80.4%, and the sensitivity was 91.3%. That was significantly higher than the AUCs for pulmonary infection (0.809), dysphagia (0.697), aCCI (0.721) and GCS (0.802). Bootstrap self-sampling was used to verify the model internally. After 1000 samples the average absolute error between the predicted risk and the actual risk was 0.013, indicating good prediction ability. The DCA results demonstrated that the model has substantial clinical applicability across a range of nutritional interventions, particularly for threshold probability values ranging from 0 to 0.96.Conclusion:Pulmonary infection, dysphagia, low GCS score, and high aCCI score are risk factors for malnutrition among tracheotomy patients. The nomogram model constructed in this study has good predictive value for the occurrence of malnutrition among such patients.