OBJECTIVE To conduct a reevaluation of the systematic review （SR）/meta-analysis on the use of Xianling gubao capsules （XLGBC） for knee osteoarthritis （KOA）， and provide evidence-based support for the clinical use of the drugs. METHODS Computerized searches including CNKI， Wanfang Data， VIP， China Biomedical Literature Database， the Cochrane Library， PubMed， Embase and Web of Science were conducted to collect systematic reviews （SR） or meta-analyses of XLGBC for the treatment of KOA from the inception to May 31st， 2024. The report quality， methodological quality， risk of bias and evidence quality were assessed using the PRISMA 2020 statement， AMSTAR 2 scale， ROBIS tool and GRADE tool， respectively. A comprehensive quality analysis of the quantitative results from the SR/meta-analysis was also performed. RESULTS A total of five SR/meta-analyses were included. The evaluation results based on the PRISMA 2020 statement showed that one study report was relatively complete （21 points）， while four studies had deficiencies （18-20 points）. The assessment using the AMSTAR 2 scale indicated that the methodological quality of all five studies was rated as very low. According to the ROBIS tool evaluation， the risk of comprehensive bias in all five studies was classified as high. GRADE tool evaluation revealed that among 49 outcome indicators， 5 （10.2%） were rated as moderate-quality evidence （10.2%）， 12 as low-quality evidence （24.5%）， and 32 as very low-quality evidence （65.3%）. The results of comprehensive quality analysis showed that the clinical efficacy， visual analogue scale score， pain relief time， comprehensive indexes of knee joint function， the levels of inflammatory factors and the incidence of adverse events in patients with XLGBC combined with conventional treatment were significantly better than conventional treatment alone （P＜0.05）. CONCLUSIONS Compared with conventional treatment， XLGBC in combination with conventional treatment for KOA may have some efficacy and safety advantages. However， due to the low quality of evidence for the outcome indicators included in the studies， the conclusions should be interpreted with caution.

OBJECTIVE To conduct a reevaluation of the systematic review （SR）/meta-analysis on the use of Xianling gubao capsules （XLGBC） for knee osteoarthritis （KOA）， and provide evidence-based support for the clinical use of the drugs. METHODS Computerized searches including CNKI， Wanfang Data， VIP， China Biomedical Literature Database， the Cochrane Library， PubMed， Embase and Web of Science were conducted to collect systematic reviews （SR） or meta-analyses of XLGBC for the treatment of KOA from the inception to May 31st， 2024. The report quality， methodological quality， risk of bias and evidence quality were assessed using the PRISMA 2020 statement， AMSTAR 2 scale， ROBIS tool and GRADE tool， respectively. A comprehensive quality analysis of the quantitative results from the SR/meta-analysis was also performed. RESULTS A total of five SR/meta-analyses were included. The evaluation results based on the PRISMA 2020 statement showed that one study report was relatively complete （21 points）， while four studies had deficiencies （18-20 points）. The assessment using the AMSTAR 2 scale indicated that the methodological quality of all five studies was rated as very low. According to the ROBIS tool evaluation， the risk of comprehensive bias in all five studies was classified as high. GRADE tool evaluation revealed that among 49 outcome indicators， 5 （10.2%） were rated as moderate-quality evidence （10.2%）， 12 as low-quality evidence （24.5%）， and 32 as very low-quality evidence （65.3%）. The results of comprehensive quality analysis showed that the clinical efficacy， visual analogue scale score， pain relief time， comprehensive indexes of knee joint function， the levels of inflammatory factors and the incidence of adverse events in patients with XLGBC combined with conventional treatment were significantly better than conventional treatment alone （P＜0.05）. CONCLUSIONS Compared with conventional treatment， XLGBC in combination with conventional treatment for KOA may have some efficacy and safety advantages. However， due to the low quality of evidence for the outcome indicators included in the studies， the conclusions should be interpreted with caution.

The incidence and mortality rates of lung cancer remain high, making it the leading cause of cancer-related deaths. In women, the predominant histological subtype is lung adenocarcinoma, commonly associated with epidermal growth factor receptor (EGFR) mutations, and EGFR-tyrosine kinase inhibitors (EGFR-TKIs) can significantly improve patient prognosis. Metastasis of primary lung cancer to the endometrium is extremely rare and is often misdiagnosed as a primary reproductive system tumor, and its occurrence indicates poor prognosis. This article reports a case of an advanced lung adenocarcinoma patient with EGFR mutation, who developed abnormal vaginal bleeding after EGFR-TKIs treatment failure, and biopsy confirmed endometrial metastasis. A review of similar cases is also presented.
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Humans ; Female ; ErbB Receptors/metabolism* ; Endometrial Neoplasms/genetics* ; Lung Neoplasms/genetics* ; Protein Kinase Inhibitors/therapeutic use* ; Adenocarcinoma of Lung/drug therapy* ; Treatment Failure ; Middle Aged ; Adenocarcinoma/genetics*

Objective: To develop the Adolescent Peer Bullying Knowledge-Attitude-Practice (KAP) Questionnaire and to evaluate its reliability and validity, so as to provide an effective tool for evaluating the KAP level regarding peer bullying among adolescents. Methods: A preliminary framework was developed through literature review, expert consultation, and group discussions. In September 2024, 2 203 students in grades 7 to 9 from two regular junior high schools in Anhui Province were selected using cluster sampling for a preliminary survey aimed at questionnaire development, including item screening and reliability and validity testing. Results: The initial KAP questionnaire on adolescent peer bullying consisted of 25 items: two items, "Behavior 6" and "Behavior 7", were excluded as their correlation coefficients with the total KAP score being only 0.08 and 0.05, respectively, falling below the preset criteria(0.4). The final questionnaire comprised 23 items, divided into three dimensions: knowledge, attitude, and behavior. Reliability testing showed that the overall Cronbach α coefficient of the questionnaire was 0.89, with Cronbach α coefficients for the knowledge, attitude, and behavior dimensions being 0.91, 0.67 and 0.79, respectively. The overall splithalf reliability of the questionnaire was 0.87, with split half reliabilities for the knowledge, attitude, and behavior dimensions being 0.82, 0.64 , and 0.66, respectively. Testretest reliability ranged from 0.82 to 0.97. Confirmatory factor analysis results indicated that the questionnaire had RMSEA=0.062, NFI=0.924, CFI =0.931, with good discriminant validity. Conclusion The developed KAP questionnaire on adolescent peer bullying demonstrates good reliability and validity and can be used as an assessment tool for evaluating the KAP level regarding peer bullying among adolescents.

Objective: To evaluate the effectiveness of a family-school-community integrated intervention based on the microsystem theory in reducing peer bullying among junior high school students, so as to provide empirical evidence and feasible pathways for junior high school students bullying prevention and control in China. Methods: A combining convenience with clustering method was employed to select 6 268 students from three regular junior high schools in Fuyang and Anqing cities, Anhui Province, as the study subjects in October 2024, and randomly assigned by drawing lots to three groups: family-school-community integrated intervention ( n =2 063), school only intervention ( n =1 864), and control group ( n =2 341). From October 10, 2024, to January 10, 2025, the intervention was implemented for three months using posters, brochures, and videos, with one session every half month, each lasting 40 minutes. The family-school-community integrated intervention group received multi level interventions involving families, schools, and communities, while the school only intervention group received only school based interventions. The control group received routine school health education but no other interventions. Before and after the intervention, data on peer bullying among junior high school students were collected using the Peer Bullying Scale, and comparison of detection rate of peer bullying by Chi square test. Results: After the intervention,group comparison results showed that the incidence rates of various types of peer bullying in the family-school-community integrated intervention group, the school only intervention group, and the control group all showed statistically significant differences ( χ 2=28.61-66.85, all P <0.05). The detection rates of verbal bullying ( 7.51 %), relational bullying (5.62%), physical bullying (3.34%), cyberbullying (1.75%), being bullied (10.81%), verbal bullying others (2.67%), relational bullying others (1.55%), physical bullying others (1.36%), cyberbullying others (1.41%), and overall peer bullying (3.64%) in the family-school-community integrated intervention group were all lower than those in the control group (12.52%, 11.58%, 6.24%, 5.00%, 19.14%, 7.56%, 4.49%, 4.53%, 3.80%, 9.40%); additionally, the detection rates of verbal bullying others, overall peer bullying , verbal bullying, and being bullied , in the family-school-community integrated intervention group were all lower than those in the school only intervention group (4.67%, 6.65%, 13.14%, 16.42%), with statistically significant differences ( χ 2=30.04, 48.49, 19.75, 34.60, 58.89, 52.65, 31.32, 37.37, 24.14, 58.26; 11.25, 18.53, 33.93, 26.41, all P <0.016 7). Group comparison showed that in both intervention groups, the majority of peer bullying behaviors decreased after the intervention ( χ 2=4.86-171.01, all P <0.05). Conclusions The family-school-community integrated intervention based on the microsystem can effectively reduce peer bullying among junior high school students, with better efficacy than the single school intervention. The model can serve as a practical reference for establishing a multi level prevention and intervention system for junior high school students bullying in China.

BACKGROUND:In recent years,epidemiological studies have shown that sleep patterns are risk factors for osteoarthritis,but the causal relationship between sleep characteristics and osteoarthritis remains unknown. OBJECTIVE:To investigate the causal relationship between seven sleep phenotypes and osteoarthritis,thereby providing a theoretical foundation for clinical prevention and intervention of osteoarthritis. METHODS:Seven sleep-related features,namely sleep duration,wake-up time,daytime napping,morning/evening preference,snoring,insomnia,and hypersomnia,were selected from published genome-wide association studies.Instrumental variables for these sleep-related features were extracted.Instrumental variables for knee osteoarthritis and hip osteoarthritis were obtained from publicly available genome-wide association studies.Causal relationships between sleep characteristics and outcome risks were evaluated using two-sample and multivariable Mendelian randomization analyses.The inverse variance weighted method was employed as the primary Mendelian randomization approach.Various methods,including weighted median,weighted mode,Mendelian randomization-Egger regression,Mendelian randomization pleiotropy-residual sum and outlier,were utilized to detect and correct for the presence of pleiotropy. RESULTS AND CONCLUSION:The results of the inverse variance-weighted method in the two-sample Mendelian randomization study revealed a detrimental causal association between the duration of sleep and the incidence risk of knee osteoarthritis[odds ratio(OR)=0.621,95%confidence interval(CI):0.470-0.822,P=0.001].Concurrently,insomnia displayed a positive causal connection with hip osteoarthritis risk(OR=2.016,95%CI:1.249-3.254,P=0.005).Sensitivity analysis affirmed the robustness of these causal relationships,and Mendelian randomization-Egger intercept analysis found no evidence of potential horizontal pleiotropy(knee osteoarthritis:P=0.468,hip osteoarthritis:P=0.551).Moreover,the results from the multivariable Mendelian randomization analysis showed that the causal association between insomnia and hip osteoarthritis lacked statistical significance(P=0.715).In contrast,sleep duration exhibited a direct negative causal relationship with the incidence risk of knee osteoarthritis(OR=0.526,95%CI:0.336-0.824,P=0.005).Reverse Mendelian randomization analysis indicated that knee osteoarthritis did not influence sleep duration(P=0.757).These findings indicate a negative correlation between sleep duration and incidence risk of knee osteoarthritis,suggesting that correcting insufficient sleep might mitigate the incidence risk of knee osteoarthritis.

Knee osteoarthritis （KOA） is a common degenerative joint disease characterized primarily by the degeneration and damage of knee joint cartilage， accompanied by osteophyte formation and inflammation. In recent years， the prevalence of KOA has been increasing globally， significantly impacting the quality of life patients. However， the pathogenesis of KOA remains not fully understood， and current treatment methods are limited. Therefore， finding new therapeutic strategies is a research hotspot. Previous studies have found that the onset of KOA is related to abnormal mitochondrial regulation. Mitochondria， functioning as secondary messengers， play crucial roles in cellular respiration， reactive oxygen species （ROS） generation， and adenosine triphosphate （ATP） production through oxidative phosphorylation. Mitochondrial quality control is a pivotal mechanism for maintaining the morphology， quantity， and quality of mitochondria. The connection between mitochondrial quality control and the pathogenesis of KOA involves several factors， such as mitochondrial oxidative stress， mitophagy， imbalances in mitochondrial biogenesis， abnormal mitochondrial dynamics （fission and fusion）， and dysregulation of calcium ions. Metabolic abnormalities in the body lead to mitochondrial structural damage， which in turn contributes to the onset and progression of KOA. Traditional Chinese medicine （TCM） has made some progress in intervening in mitochondrial quality control， employing multi-faceted， multi-pathway， and multi-target strategies to treat KOA. Several studies have shown that mitochondrial quality control may be one of the therapeutic targets of TCM in treating KOA. However， there is currently a lack of comprehensive reviews summarizing the TCM interventions in mitochondrial quality control for treating KOA. This paper systematically reviewed the research progress in TCM treatment of KOA based on five aspects of mitochondrial quality control， aiming to provide a theoretical basis for the clinical prevention and treatment of KOA.

Abstract: Objective　To explore the tolerance of Aedes albopictus to typical insecticides and mutations in its knockdown resistance (kdr) and acetylcholinesterase number one (ace-1) genes in Hainan Province. Methods　Ae. albopictus larvae were collected from Danzhou, Sanya, Qiongzhong, Qionghai, Changjiang, and Wanning in Hainan Province in 2020 and 2021 to assess their resistance to 10 insecticides. Surviving samples from the resistance tests were examined for mutations in genes encoding acetylcholinesterase (AChE) and voltage-gated sodium channel (VGSC) using DNA Sanger sequencing. Results　The 24-hour corrected mortality rates of adult Ae. albopictus in different areas of Hainan to deltamethrin (0.03%), permethrin (0.40%), Beta-cypermethrin (0.40%), Beta-cypermethrin (0.08%), and lambda-cyhalothrin (0.07%) ranged from 5.56% to 83.33%, 29.89% to 92.22%, 26.67% to 97.78%, 11.11% to 88.89%, and 40.00% to 83.33%, respectively. The mortality rates after 24-hour exposure to propoxur (0.05%), bendiocarb (0.20%), malathion (0.50%), fenitrothion (0.20%), and chlorpyrifos (2.00%) ranged from 94.89% to 100.00%, among which the Ae.albopictus population from Changjiang showed a mortality rate of 97.78% to propoxur, and populations from Sanya, Wanning, and Qionghai showed mortality rates of 94.89%, 96.67%, and 96.67% to malathion respectively. The mortality rate of Ae.albopictus populations in Sanya and Qionghai to fenitrothion was 97.78%, while in other populations, it was 100.00%. Sequencing results showed that the kdr gene exhibited a mutation solely at locus 1534, featuring four alleles: wild-type TTC/F and the mutant types TGT(TGC)/C, TCC/S, and TTG/L with the mutation frequencies of 40.47%, 22.25%, 36.44%, and 0.85%, respectively. There are seven types of these mutations: wild-type homozygotes F/F, wild-type/mutant heterozygotes F/C, F/S, and F/L, mutant heterozygotes S/C, and wild-type homozygotes C/C and S/S, with mutation frequencies of 19.92%, 6.78%, 32.63%, 1.69%, 11.44%, 13.14%, and 14.41%, respectively. Notably, No related amino acid mutations were detected at position 119 of the ace-1 gene. Conclusions　The Ae.albopictus populations in various areas of Hainan Province have developed a high resistance to pyrethroid insecticides such as deltamethrin, permethrin, beta-cypermethrin, and beta-cyfluthrin, but are sensitive or possibly resistant to carbamates and organophosphates insecticides. The resistance gene mutations mainly occur at position 1 534 of the kdr gene, suggesting that its mutation frequency could be a significant factor contributing to resistance in Ae. albopictus in Hainan.

Abstract: Objective　To understand the level of Aedes aegypti resistance in Hainan and to provide a reference for developing local preventive and control measures against the dengue vector Ae. aegypti. Methods In 2020, Aedes aegypti larvae and pupae were collected from Danzhou and Changjiang in Hainan Province and reared to the first filial generation (F1). The adult mosquito contact tube method was used to determine the resistance of Aedes aegypti to commonly used insecticides. The allele-specific PCR (AS-PCR) was used to detect the mutations in V1016G and F1534C knockdown resistance (kdr) gene in Aedes aegypti. Results There was no significant difference in the knockdown rate of Ae. aegypti from Changjiang and Danzhou after 1 hour of exposure to four pyrethroids insecticides, namely deltamethrin (0.03%), permethrin (0.40%), beta-cypermethrin (0.04%) and lambda-cyhalothrin (0.02%). However, the 24-hour mortality rates of Ae. aegypti from Changjiang and Danzhou city were 95.56%, 85.56%, 81.11%, 48.89% and 94.44%, 68.60%, 61.11%, 30.00%, respectively. Except for deltamethrin (0.03%), the other differences were statistically significant. Aedes aegypti in Changjiang showed 100.00% mortality to propoxur (0.03%) and bendiocarb (0.20%), while in Danzhou, these rates were 100.00% and 98.89%, respectively. Ae. aegypti both from Changjiang and Danzhou showed 100.00% mortality to malathion (1.50%) and chlorpyrifos (0.80%), and mortality rates to 0.25% fenthion were 100.00% and 98.89%, respectively. V1016G and F1534C mutations were found in Ae. aegypti from Danzhou and Changjiang with mutation frequencies of 12.50% (20/160) and 97.50% (156/160), showing significant differences (χ2=233.54, P<0.001). In Changjiang, Aedes aegypti exhibited both V1016G and F1534C mutations with frequencies of 20.00% and 100.00%, respectively, whereas in Danzhou, only F1534C mutations occurred with a frequency of 98.75%. Conclusions Ae. aegypti in Hainan Province exhibited varying levels of resistance to four insecticides: deltamethrin, permethrin, beta-cypermethrin, and lambda-cyhalothrin, but showed sensitivity to propoxur, bendiocarb, malathion, and chlorpyrifos. The primary knockdown resistance gene mutation was F1534C.

Parkinson′s disease (PD) is a debilitating neurodegenerative disorder that exhibits an escalating prevalence with advancing age. The management of PD adheres to a comprehensive therapeutic approach integrating pharmacological interventions, surgical procedures, rehabilitative exercises, and supportive care measures. In recent years, with the deepened understanding of the pathogenesis underlying PD, non-invasive neuromodulation therapy is heralding a new frontier in the clinical diagnosis and management of PD.