Objective To analyze the clinical characteristics and risk factors of extreme thrombocytosis caused by piperacillin sodium and tazobactam sodium injection, and provide reference for medical treatment and pharmaceutical care of such patients. Methods Extreme thrombocytosis of a patient treated with piperacillin sodium and tazobactam sodium injection was found by clinical pharmacists, who participated in clinical diagnosis and treatment by analyzing of the adverse drug reaction, optimization of the medical treatment and pharmaceutical care. Results After correlation analysis, the patient's extreme thrombocytosis was likely to be an adverse reaction caused by the piperacillin sodium and tazobactam sodium injection. The medication was immediately discontinued, and antiplatelet therapy with aspirin was administered. Two weeks later, the patient's platelet count had significantly decreased compared to before. Conclusion Clinical pharmacists participated in patients’ clinical diagnosis and treatment, carried out pharmaceutical care and assisted physicians in adjusting treatment plans, which ensured the safety and effectiveness of patients' clinical drug therapy.

Mass spectrometry imaging （MSI） is an emerging molecular imaging technique that combines high spatial resolution and the ability to acquire molecular information. This technology can directly obtain spatial distribution maps of metabolites, proteins, lipids and other molecules in tumor tissues, reveal the abnormal molecular changes during the occurrence and development of liver cancer, and make up for the deficiency of information at the molecular level in traditional imaging （such as CT, MRI）. In liver cancer research, MSI has demonstrated unique advantages and application potential in early diagnosis and screening, precise classification, tumor heterogeneity analysis, and exploration of molecular mechanisms. The principle characteristics of MSI technology and its latest progress in the early diagnosis, classification and molecular mechanism research of liver cancer were reviewed, and the current challenges and future development directions were discussed, which aimed to provide a new perspective and theoretical basis for an in-depth understanding of the pathological mechanism of liver cancer and promoted its precise diagnosis and treatment.

OBJECTIVE To evaluate the efficacy and safety of cadonilimab plus chemotherapy in patients with advanced gastric adenocarcinoma or adenocarcinoma of gastroesophageal junction （AEG） with intermediate， low， or no human epidermal growth factor receptor 2 （HER2） expression. METHODS Patients with advanced gastric adenocarcinoma or AEG with intermediate， low， or no HER2 expression who were treated at Liaoning Cancer Hospital between October 1， 2024 and June 30， 2025 were retrospectively included. According to the treatment regimen received， the patients were divided into group A [cadonilimab plus oxaliplatin and capecitabine （XELOX）， n ＝54 ] ， group B （sintilimab plus XELOX， n ＝68）， and group C （tislelizumab plus XELOX， n ＝49）. Short-term efficacy after 4 cycles of treatment， survival outcomes， and adverse events were compared among the three groups. Cox regression and Logistic regression analyses were further performed to evaluate the effects of the treatment regimen and baseline data on survival outcomes and the risk of grade 3-4 treatment related adverse events （TRAEs）. RESULTS No statistically significant differences in objective response rate or disease control rate were observed among the three groups （ P ＞0.05）. The median progression-free survival was 7.56 （5.62， 8.11） months in group A， 7.23 （5.33， 8.23） months in group B， and 7.33 （5.42， 8.19） months in group C， with no statistically significant difference among the three groups （ P ＞0.05）. The median overall survival （mOS） was 11.67 （8.82， 13.88） months in group A， 9.78 （6.82， 12.73） months in group B， and 9.69 （6.78， 12.66） months in group C. The mOS was significantly longer in group A than in group B and group C （ P ＜0.05）， whereas no statistically significant difference was observed between group B and group C （ P ＞0.05）. The correlation analysis indicated that treatment regimen， Eastern Cooperative Oncology Group performance status （ECOG PS）， number of metastatic organs， and peritoneal metastasis may be associated with overall survival （OS）. No significant association was observed between treatment regimen and the risk of grade 3-4 TRAEs. The incidences of grade 1-2 or grade 3-4 TRAEs did not differ significantly among the three groups （ P ＞0.05）. CONCLUSIONS In patients with advanced gastric adenocarcinoma or AEG with intermediate， low， or no HER2 expression， cadonilimab plus XELOX may provide a more significant OS benefit with a safety profile comparable to that of sintilimab or tislelizumab plus XELOX. Further studies with larger sample sizes are required to validate these findings.

Objective To analyze the technical essentials of single-microport assisted micro-uni-port thoracoscopic surgery, and to investigate its surgical efficacy and promotional value. Methods Clinical data of patients who consecutively underwent radical upper lobectomy in the Department of Thoracic Surgery of Xi'an International Medical Center Hospital from March 2023 to June 2024 were retrospectively analyzed. According to the surgical approach, patients were divided into two groups: the single-microport assisted group (underwent upper lobectomy via single-microport assisted micro-uni-port thoracoscopy) and the traditional uniportal group (underwent traditional uniportal thoracoscopic lobectomy). Clinical outcomes were compared between the two groups. Results A total of 62 patients were enrolled. There were 30 patients in the single-microport assisted group, with a mean age of (57.4±10.8) years, and 32 patients in the traditional uniportal thoracoscopic group, with a mean age of (57.6±8.7) years. The baseline data were comparable between the two groups. All patients in both groups successfully underwent minimally invasive surgery without conversion to thoracotomy. The operative time in the single-microport assisted group was significantly shorter than that in the traditional uniportal group [(146.03±30.79) min vs. (171.41±36.41) min, P=0.004]. However, there were no statistically significant differences between the two groups in intraoperative blood loss, number of dissected lymph nodes, duration of chest tube drainage, postoperative pain score, postoperative hospital stay, hospitalization cost, or incidence of postoperative complications (all P>0.05). Conclusion Single-microport assisted micro-uni-port thoracoscopic surgery for upper lobectomy can maximally integrate the advantages of three-port and uni-port VATS while effectively avoiding their disadvantages. It significantly shortens the operative time without increasing postoperative pain or complications, and represents a more minimally invasive, safer, and more convenient surgical approach.

Objective: To investigate the dynamic influence mechanism of the interaction between physical exercise and pre-sleep screen time on sleep quality among college students, so as to provide a theoretical basis for sleep health interventions in the population. Methods: From March to April 2025, a convenience sample of 2 075 students was recruited from eight universities in Jiangsu Province to participate in an online survey. Physical exercise was assessed using the Physical Activity Rating Scale-3 (PARS-3), sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI), and pre-sleep screen time behaviors were recorded using a self-designed structured questionnaire. Binary Logistic regression was used to examine the independent associations of physical activity level and pre-sleep screen time with sleep disorders. An interaction effect model was then applied to plot the dose-response relationship among the three variables. Results: The overall prevalence of sleep disorder among college students was 50.3%. Significant differences in the prevalence of sleep disorder were observed across groups of sex, academic discipline, grade, pre-sleep screen time, and physical exercise ( χ 2=42.45, 14.81, 18.99, 113.23, 40.61, all P <0.05). Binary Logistic regression showed that pre-sleep screen time was associated with the risk of sleep disorders (≤15 min: OR =1.70; 16- 30 min : OR =1.91; 31-60 min: OR =3.31; >60 min: OR =5.32), while both moderate ( OR =0.44) and high ( OR =0.57) physical exercise were associated with a reduced risk (all P <0.05). The interaction effect was statistically significant (Wald χ 2= 6.82 , P <0.01). The dose-response curves revealed that, in the low-exercise group, sleep quality deteriorated sharply with increasing screen time (the predicted mean dropped to 28% at the >60 min threshold, P <0.01); in the moderate exercise group, an inverted U-shaped trend was observed, with an optimal window of 16-30 min; and in the high exercise group, a significant buffering effect was found, with the predicted mean remaining at 43% even under >60 min screen exposure, representing a decrease of only 4% compared with the no-screen use group ( P >0.05). Conclusions High screen exposure combined with low physical exercise represents the primary behavioral pattern associated with a high prevalence of sleep disorders. Regular physical exercise can partially offset the negative effects of excessive screen time on sleep.

Objective: To investigate the epidemiological characteristics of pertussis in Jiaxing City from 2004 to 2023 and spatio-temporal clustering characteristics from 2022 to 2023, so as to provide insights into formulation of pertussis control measures. Methods: Data of pertussis cases in Jiaxing City from 2004 to 2023 were collected through the Infectious Disease Report Information System of Chinese Disease Prevention and Control Information System. The epidemiological characteristics of pertussis cases in Jiaxing City from 2004 to 2023 were descriptively analyzed, and the spatio-temporal clustering characteristics from 2022 to 2023 were analyzed using spatio-temporal scanning. Results: A total of 478 pertussis cases were reported in Jiaxing City from 2004 to 2023, with an average annual reported incidence of 0.53/105. The reported incidence showed an upward trend from 2004 to 2023 (P<0.05), with the highest in 2022 (3.17/105). Higher incidence of pertussis was reported in June to August (149 cases, 31.17%) and November to December (112 cases, 23.43%). There was no statistically significant difference in the reported incidence between males and females (0.56/105 vs. 0.50/105, P>0.05). The cases aged under one year accounted for the highest proportion, with 199 cases (41.63%). Haining City (0.68/105), Jiashan County (0.64/105) and Tongxiang City (0.60/105) ranked the top three in the reported incidence of pertussis. Spatio-temporal scanning analysis showed that from 2022 to 2023, the primary clustering area of pertussis was centered in Daqiao Town of Nanhu District, covering 27 towns (streets) in Nanhu District, Jiashan County, Xiuzhou District and Pinghu City, and the clustering time was from November to December, 2023. Conclusions The reported incidence of pertussis was at a low level in Jiaxing City, but showed an upward trend from 2004 to 2023. The incidence of pertussis was higher among infants under one year of age, peaked in June to August and November to December, and was concentrated in Nanhu District and its surrounding areas.

Objective To identify genetic regulators of ionizing radiation(IR)sensitivity through clustered regularly interspaced short palindromic repeats(CRISPR)/CRISPR-associated nuclease 9(Cas9)genome-wide screening.Methods A specialized single guide RNA(sgRNA)library was developed targeting 987 stress-response regulatory genes identified through Kyoto Encyclopedia of Genes and Genomes(KEGG),Reactome and gene ontology(GO)databases,followed by construction of sgRNA plasmids and packaging into a lentiviral library.Using colon adenocarcinoma Caco-2 cells as a model system,the Cas9-stable transgenic line was established via lentiviral transduction and antibiotic selection.Library-transduced cells underwent puromycin selection,followed by γ-irradiation(dose optimized via preliminary experiments).Post-irradiation phenotypic selection was conducted after 14 days,with subsequent next-generation sequencing of surviving cell populations to identify enriched/depleted sgRNAs.Candidate genes were functionally validated through orthogonal assays:cell counting kit-8(CCK-8)proliferation analysis,clonogenic survival assays and flow cytometric quantification of reactive oxygen species(ROS)and apoptotic markers.Results The optimized screening platform identified 281 radiation response genes(165 radiosensitive and 116 radioprotective candidates).Functional validation revealed Bcl2-associated athanogene 3(BAG3)knockdown significantly enhanced radioresistance.Proliferation was increased 1.2-1.5 fold,clonogenic survival improved 1.5-2.0 fold,and ROS was reduced by 13％-25％coupled with 32％-73％apoptosis attenuation compared to control groups.Conclusion The integrated CRISPR/Cas9 screening platform effectively identifies novel radiation response regulators,as evidenced by the discovery of BAG3 as a critical radiosensitivity determinant.This high-throughput functional genomics approach provides a robust methodology for systematically mapping molecular determinants of cellular radiation response,with potential applications in both mechanistic studies and therapeutic target discovery.

ObjectiveTo evaluate the efficacy of Sanhua essential oil inhalation as aromatherapy in patients with breast cancer-related depression.MethodsIn total, 144 patients with breast cancer-related depression who underwent postoperative chemotherapy were recruited. The participants in the control group (n = 52) were offered a placebo (sunflower oil) daily, whereas those in the essential oil group (n = 52) were administered Sanhua essential oil. This study evaluated depression improvement, Hamilton Depression Scale score, scores of symptoms in traditional Chinese medicine (TCM), Pittsburgh Sleepiness Quotient Index score, incidence of nausea and vomiting, and signal changes on functional magnetic resonance imaging.ResultsDepression improved by 48.1% and 21.2% in the essential oil and control groups, respectively (P = .010). The Hamilton Depression Scale score (P = .017), scores for symptoms in TCM (P = .002), and the incidence of nausea and vomiting in the acute and delayed phases were lower in the essential oil group than in the control group (nausea in the acute phase, P = .017; nausea in the delayed phase, P = .039; vomiting in the acute phase, P = .008; vomiting in the delayed phase, P = .081). The Pittsburgh Sleepiness Quotient Index score was lower in the essential oil group than in the control group (P = .005). Significant differences existed between the two groups in the left superior parietal gyrus, right precuneus, left dorsolateral superior frontal gyrus, and right precentral gyrus according to functional connectivity on functional magnetic resonance imaging.ConclusionInhalation of Sanhua essential oil alleviated depression in patients undergoing chemotherapy for breast cancer, improved sleep quality, relieved TCM symptoms, reduced nausea and vomiting, and regulated activities in the brain regions.

Cantharidin(CTD),a natural compound used to treat multiple tumors in the clinic setting,has been limited due to acute kidney injury(AKI).However,the major cause of AKI and its underlying mechanism remain to be elucidated.Serum creatinine(SCr)and blood urea nitrogen(BUN)were detected through pathological evaluation after CTD(1.5 mg/kg)oral gavage in mice in 3 days.Kidney lipidomics based on ultra-high performance liquid chromatography-tandem mass spectrometry(UPLC-MS/MS)was used to investigate lipids disorder after CTD exposure in mice.Then,spatial metabolomics based on matrix-assisted laser desorption/ionization-mass spectrometry imaging(MALDI-MSI)was used to detect the kidney spatial distribution of lipids.Integrative analysis was performed to reveal the spatial lipid disorder mechanism and verify key lipids in vitro.The results showed that the levels of SCr and BUN were increased,and tubular necrosis was observed in mouse kidneys,resulting in acute tubular necrosis(ATN)in CTD-induced AKI.Then,lipidomics results revealed that after CTD exposure,232 differential lipid metabolites and 11 pathways including glycerophospholipid(GP)and sphingolipid(SL)metabolism were disrupted.Spatial metabolomics revealed that 55 spatial differential lipid metabolites and nine metabolic pathways were disturbed.Subsequently,integrative analysis found that GP metabolism was stimulated in the renal cortex and medulla,whereas SL metabolism was inhibited in the renal cortex.Up-regulated lysophosphatidylcholine(LysoPC)(18∶2(9Z,12Z)),LysoPC(16∶0/0∶0),glycerophosphocholine,and down-regulated sphingomyelin(SM)(d18∶0/16:0),SM(d 18∶1/24:0),and SM(d42∶1)were key differential lipids.Among them,LysoPC(16∶0/0∶0)was increased in the CTD group at 1.1196 μg/mL,which aggravated CTD-induced ATN in human kidney-2(HK-2)cells.LysoPC acyltransferase was inhibited and choline phos-photransferase 1(CEPT1)was activated after CTD intervention in mice and in HK-2 cells.CTD induces ATN,resulting in AKI,by activating GP metabolism and inhibiting SL metabolism in the renal cortex and medulla,LysoPC(16:0/0:0),LysoPC acyltransferase,and CEPT1 may be the therapeutic targets.

Objective:To conduct a comprehensive review on the current research status of postpartum follow-up for patients with hypertensive disorders of pregnancy (HDP), and provide a basis and guidance for the management of postpartum follow-up for HDP patients.Methods:Guided by the methodological framework of the scoping review, the literatures on postpartum follow-up of HDP patients in Cochrane Library, PubMed, Web of Science, Embase, China Biomedical Literature Database, China National Knowledge Infrastructure, VIP and Wanfang databases were retrieved, and search for relevant literature by the snowballing method. The search time range is from the establishment of the database to February 1, 2025. The included literature was analyzed and summarized.Results:A total of 32 literatures were included, including 31 in English and 1 in Chinese. The participation rate of postpartum follow-up for HDP patients is generally low, and the disease has a significant impact on long-term health. In addition, there is considerable variation in the content, format and time of follow-up. The follow-up content includes the patient's physical health status, long-term health risks and the availability of medical resources, etc.Conclusions:There are still deficiencies in the current implementation of postpartum follow-up for HDP patients. Existing follow-up studies lack high-quality randomized controlled trials as evidence support, and the influencing factors are complex and diverse. In the future, it is necessary to strengthen cooperation among multiple disciplines, closely integrate clinical guidelines with practical needs, and systematically evaluate the effectiveness of follow-up in clinical practice to enhance the scientific and effectiveness of follow-up and provide better health management support for HDP patients.