[摘 要] 目的：探讨lncRNA DLEU2通过EZH2/H3K27me3途径调控IKKα介导甲状腺癌（TC）放射性碘抵抗的作用机制。方法：利用TCGA数据库分析TC中DLEU2的表达及其与EZH2的相关性。构建放射性碘抵抗的TPC-1细胞（RR-TPC-1细胞）模型及裸鼠移植瘤模型，通过敲低或过表达DLEU2（si-DLEU2/OE-DLEU2）、抑制EZH2（UNC1999）、过表达IKKα（OE-IKKα）进行干预，采用qPCR、WB、RIP、ChIP、CCK-8、流式细胞术、TUNEL染色及体内成瘤实验检测基因与蛋白表达、表观修饰、细胞增殖、凋亡及肿瘤生长。结果：TCGA分析显示，DLEU2在TC组织中显著上调（P < 0.001），与患者不良预后相关（P = 0.008 4），且与EZH2表达呈正相关（r = 0.390, P < 0.001）；RIP证实EZH2与DLEU2存在相互作用/结合（P < 0.05）。体外实验表明，敲低DLEU2可显著下调RR-TPC-1细胞中EZH2、IKKα表达及H3K27me3修饰水平，抑制NF-κB通路活化（P < 0.05或P < 0.01），抑制细胞增殖、促进凋亡（均P < 0.05）。联合敲低DLEU2与抑制EZH2进一步增强上述效应，而过表达IKKα则可部分逆转上述效应（P < 0.05或P < 0.01）。体内实验进一步证实，敲低DLEU2联合抑制EZH2可显著抑制移植瘤生长，增加肿瘤细胞凋亡（均P < 0.01）；IKKα过表达则部分逆转上述抗肿瘤效应（P < 0.05或P < 0.01）。结论：lncRNA DLEU2通过招募EZH2催化H3K27me3修饰，间接激活IKKα/NF-κB信号并形成正反馈环路，介导TPC-1细胞131I抵抗。

The "theory of Zangqi method" in Huangdi Neijing the "Tangye Jingfa picture" in Dunhuang's posthumous book Fuxingjue both contain the relationship between the five medicinal tastes and the reinforcing-reducing treatment of the five Zang organs. This article made a systematic comparative analysis of the two methods from the aspects of narrative methods， specific content， mathematical logic， clinical experience， and real treatment effect. From the perspective of narrative methods， they both adopted the expression structure of three medicinal tastes corresponding to one organ， which were respectively described as tonic， laxative， and urgent tastes， with the same way of thinking and the narrative frame shared. From the perspective of reinforcing-reducing content， out of a total of 15 attributes related to the corresponding tonic， laxative， and urgent tastes of the five organs involved in the two methods， there were seven inconsistencies between the two methods. In terms of medicinal taste distribution， the "Tangye Jingfa Tu" presented the order of "liver， heart， spleen， lung， and kidney"， Whether tonic， laxative， or transforming tastes， they were all pungent， salty， sweet， sour， or bitter. However， the "theory of Zangqi method" showed no such pattern. From the perspective of mathematical modeling analysis， the distribution of medicinal tastes in the "Tangye Jingfa Tu" conformed to the mathematical logic of the outer product of a five-dimensional space vector， while the "theory of Zangqi method" had no such law. From the perspective of clinical experience， the effect of removing the heart-fire with a bitter taste in the "Tangye Jingfa Tu" was more consistent with the clinical cognition of clearing heat and detoxification effects of traditional Chinese medicine （TCM） with a sweet taste in the "theory of Zangqi method". From the perspective of understanding prescriptions and solving prescriptions， the combination and compatibility principle of 160 common classical prescriptions in the Formulas of Traditional Chinese Medicine can be analyzed by using the "Tangye Jingfa Tu". Therefore， the authors believed that the relationship between the five medicinal tastes and the reinforcing-reducing treatment of the five zang organs in the Fuxingjue was more rigorous and logical， in line with clinical empirical cognition than the relevant records in the Yellow Emperor's Canon of Medicine.

The "theory of Zangqi method" in Huangdi Neijing the "Tangye Jingfa picture" in Dunhuang's posthumous book Fuxingjue both contain the relationship between the five medicinal tastes and the reinforcing-reducing treatment of the five Zang organs. This article made a systematic comparative analysis of the two methods from the aspects of narrative methods， specific content， mathematical logic， clinical experience， and real treatment effect. From the perspective of narrative methods， they both adopted the expression structure of three medicinal tastes corresponding to one organ， which were respectively described as tonic， laxative， and urgent tastes， with the same way of thinking and the narrative frame shared. From the perspective of reinforcing-reducing content， out of a total of 15 attributes related to the corresponding tonic， laxative， and urgent tastes of the five organs involved in the two methods， there were seven inconsistencies between the two methods. In terms of medicinal taste distribution， the "Tangye Jingfa Tu" presented the order of "liver， heart， spleen， lung， and kidney"， Whether tonic， laxative， or transforming tastes， they were all pungent， salty， sweet， sour， or bitter. However， the "theory of Zangqi method" showed no such pattern. From the perspective of mathematical modeling analysis， the distribution of medicinal tastes in the "Tangye Jingfa Tu" conformed to the mathematical logic of the outer product of a five-dimensional space vector， while the "theory of Zangqi method" had no such law. From the perspective of clinical experience， the effect of removing the heart-fire with a bitter taste in the "Tangye Jingfa Tu" was more consistent with the clinical cognition of clearing heat and detoxification effects of traditional Chinese medicine （TCM） with a sweet taste in the "theory of Zangqi method". From the perspective of understanding prescriptions and solving prescriptions， the combination and compatibility principle of 160 common classical prescriptions in the Formulas of Traditional Chinese Medicine can be analyzed by using the "Tangye Jingfa Tu". Therefore， the authors believed that the relationship between the five medicinal tastes and the reinforcing-reducing treatment of the five zang organs in the Fuxingjue was more rigorous and logical， in line with clinical empirical cognition than the relevant records in the Yellow Emperor's Canon of Medicine.

OBJECTIVE To investigate the effects of alirocumab combined with atorvastatin on clinical efficacy and safety of patients with acute coronary syndrome （ACS） who underwent percutaneous coronary intervention （PCI）. METHODS A total of 207 patients with ACS who underwent PCI in our hospital from January 2021 to December 2023 were randomly divided into alirocumab group， ezetimibe group and control group， with 69 cases in each group. All patients received routine thrombosis prevention and antihypertensive treatment after PCI. On this basis， patients in the control group were treated with atorvastatin （20 mg/time， once a day）； patients in the ezetimibe group were treated with ezetimibe （10 mg/time， once a day） + atorvastatin （20 mg/time， once a day）； patients in the alirocumab group were treated with alirocumab （75 mg/time， once every 2 weeks） + atorvastatin （20 mg/time， once a day）. All patients in the three groups were treated for 8 weeks and followed up for another 6 months after treatment. The levels of cardiac function and lipid metabolism indices before and after treatment， as well as the occurrence of major adverse cardiovascular event （MACE） and other adverse drug reaction （ADR） during the follow-up period were compared among the three groups. RESULTS After treatment for 8 weeks， the levels of cardiac function and lipid metabolism indices in the three groups were significantly improved compared with those before treatment （P＜0.05）. Compared with the control group and ezetimibe group， the left ventricular ejection fraction in the alirocumab group was significantly increased， and the left ventricular end-diastolic diameter （LVEDD） was significantly shortened （P＜0.05）. Compared with control group， LVEDD of ezetimibe group was significantly shortened （P＜0.05）， the levels of total cholesterol， triglyceride and low-density lipoprotein cholesterol in the alirocumab group and ezetimibe group were significantly decreased （P＜0.05）. During the follow-up period， there was no significant difference in the total incidence of MACE and the total incidence of other ADR such as headache and abdominal pain among the three groups （P＞0.05）. CONCLUSIONS Alirocumab combined with atorvastatin can significantly improve cardiac function and regulate lipid metabolism indices in patients with ACS after PCI without increasing the risk of MACE or other ADR.

Objective To explore the effect of rituximab on cellular immunity and cytokines in children with new-onset steroid-sensitive nephrotic syndrome(SSNS).Methods Clinical data of 60 children with new-onset SSNS treated at Xuzhou Children's Hospital from December 2021 to March 2023 were retrospectively analyzed.Children were allocated according to rituximab use into a control group(no rituximab)and an observation group(rituximab).The relapse rate,T-lymphocyte subsets and cytokines before and after treatment,and the incidence of adverse reactions were compared between groups.Results The relapse rate was lower in the observation group than in the control group(27%vs 73%,P<0.05).After treatment,CD3+and CD4+T-lymphocyte counts,the CD4+/CD8+ratio,and serum interleukin-2 increased in the observation group and were higher than in the control group(P<0.05).Interleukin-6 and tumor necrosis factor-α levels decreased after treatment in the observation group and were lower than in the control group(P<0.05).After treatment,CD8+T-lymphocyte counts decreased,interferon-γ increased,and interleukin-10 decreased in both groups,with no significant differences between the two groups(P>0.05).The incidence of adverse reactions did not differ significantly between the two groups(P>0.05).Conclusions Rituximab can reduce the relapse rate in children with new-onset nephrotic syndrome and shows good safety.Its therapeutic effect is achieved by regulating the number and function of T cells and by modulating the anti-inflammatory effects of cytokines.

Peritoneal metastasis is a common form of distant metastasis in patients with colorectal cancer, and it is typically associated with a poor prognosis. The development of peritoneal metastasis involves complex molecular mechanisms and multifactorial regulation of the tumor microenvironment. Due to the presence of the blood-peritoneal barrier, only a small amount of systemic medication reaches the peritoneal cavity, resulting in limited efficacy against peritoneal metastasis. Intraperitoneal administration shows significant therapeutic advantages as it can directly target the tumor microenvironment, maintain high local drug concentrations, and reduce systemic toxicity. Intraperitoneal chemotherapy, especially hyperthermic intraperitoneal chemotherapy, has become a cornerstone therapeutic strategy in the clinical treatment of peritoneal metastasis. When selecting chemotherapy drugs and drug combinations, pharmacokinetic properties, efficacy, and safety must be comprehensively considered to optimize the treatment outcomes. In addition, the unique microenvironment of the peritoneal cavity provides new treatment approaches for biological treatment strategies, including antitoxins, vaccines, immune checkpoint inhibitors, etc. Techniques such as pressurized intraperitoneal aerosol chemotherapy and novel drug delivery systems demonstrate potential for enhanced efficacy, offering promising alternatives to improve patient outcomes. This article will review peritoneal barrier characteristics, intraperitoneal drug transport, intraperitoneal chemotherapy, and intraperitoneal biological therapies, thereby establishing a theoretical framework for precision therapy in colorectal cancer peritoneal metastasis.

Objective:To explore the diagnostic value of shear wave elastography(SWE)for clinically significant prostate cancer(csPCa).Methods:We retrospectively analyzed the clinical data of 359 cases with suspected prostate cancer(PCa)in Baoji Central Hospital from June 2017 to July 2023.All the patients underwent the following examinations in the order of serum prostate-spe-cific antigen(PSA)testing,transrectal ultrasonography(TRUS),measurement of the stiffness of the entire prostate gland by SWE,and TRUS-guided prostate puncture biopsy.The stiffness of the entire prostate gland was defined as the average of Young's modulus at both sides of the base,middle,and apex of the prostate,including the maximum Young's modulus(Emax),mean Young's modulus(Emean),and minimum Young's modulus(Emin).We analyzed the correlation of the parameters of the stiffness of the entire prostate gland with the pathological results,focusing on their diagnostic performance for csPCa.Results:Of the 359 cases,189 were diag-nosed by pathological puncture biopsy as BPH,26 as non-csPCa,and 144 as csPCa.The PSA level,Emax,Emean and Emin were significantly higher in the csPCa than those in the BPH and non-csPCa groups(all P＜0.01),but showed no statistically significant difference between the BPH and non-csPCa groups(all P＞0.05).The area under the receiver operating characteristic curve(AUC),optimal cut-off value,sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV)and accura-cy of Emax in the diagnosis of csPCa were 0.852,143.92 kPa,72.22％,84.65％,75.91％,81.98％and 79.67％;those of Emean were 0.868,82.42 kPa,67.36％,91.16％,83.62％,80.66％and 81.62％;and those of Emin were 0.682,32.73 kPa,47.22％,89.30％,73.91％,71.54％and 72.14％,respectively.In the non-csPCa group,Emax,Emean and Emin were found be-low the optimal cut-off value in 73.08％(19/26),92.31％(24/26)and 88.46％(23/26),respectively.Conclusion:The stiff-ness of the entire prostate gland measured by SWE contributes to the diagnosis of csPCa,reduces unnecessary detection of non-csPCa,and provides some reference for its active surveillance.

Objective:To explore the spatial correlation between gray matter volume (GMV) changes and neurotransmitter receptors/transporters in patients with first-episode schizophrenia (FES) .Methods:Fifty-four FES patients(FES group) and fifty-nine healthy controls (HC group) were selected from June 2014 to May 2020 in the Psychiatry Department of Renmin Hospital of Wuhan University. Structural magnetic resonance imaging (sMRI) was conducted on all subjects. Differences of GMV were compared across 400 cortical regions and 32 subcortical regions. Based on the positron emission tomography(PET) data from Neuromaps, which provides the density of 19 different neurotransmitter receptors and transporters, Spearman correlation analysis was performed to evaluate the spatial correlation between GMV changes and neurotransmitter systems.Results:Compared to the HC group, FES group exhibited significant GMV reductions in widespread cortical (90/400) and subcortical (6/32) regions (all FDR-corrected P<0.05). The effect size of GMV reduction (Cohen’s d) showed significant positive correlations with the density of 5-hydroxytryptamine 1a(5HT1a) ( r=0.400, Pspin=0.002), γ-aminobutyric acid type A receptor(GABA A)( r=0.307, Pspin=0.002), and metabotropic glutamate receptor 5(mGluR5) ( r=0.275, Pspin=0.020) receptors (all FDR-corrected P<0.05). Conclusion:GMV reductions in a wide range of brain regions existed in patients with FES. There are significant correlations between 5HT1a, GABA A and mGluR5 receptors and gray matter reduction in patients with FES. The disorder of these neurotransmitter receptors may be the potential neurobiological mechanism of gray matter structural abnormalities in the early stage of schizophrenia.

Objective This research aims to establish a scientific research performance evaluation indicator system for public hospital staff,providing evaluation standards and assessment criteria for their research performances.Methods An indica-tor pool was developed through literature review.The indicators were determined through two rounds of Delphi expert consultations.Analytic Hierarchy Process(AHP)was used to calculate their weights and thus establish an indicator system.Results The indica-tor system consists of 8 primary indicators-research projects(0.193 3),talent cultivation(0.264 3),patents(0.046 2),publica-tions(0.118 5),monographs(0.068 1),awards(0.147 2),standards(0.094 3),and research errors(0.068 1)-encompassing 29 secondary indicators.The response rate of the second-round expert consultation was 0.85;the authority coefficient was 0.94;the importance rating of indicators was 4.44,and Kendall's coefficient was 0.260(P＜0.05).The consistency index(CI)and consistency ratio(CR)values were＜0.1,indicating good results.Conclusion The indicator system demonstrates scientifically good validity and feasibility.Thus it can be used to evaluate the research performances of public hospital staff,providing decision support for resource allocation and the optimization of incentive mechanisms.

Objective:To investigate the status of post-traumatic stress disorder (PTSD) and its influencing factors in postoperative breast cancer patients.Methods:A convenience sampling method was used to select 410 postoperative breast cancer patients from the Provincial Hospital of the First Medical University of Shandong between January 2023 and December 2024. The PTSD Checklist-Civilian Version (PCL-C), the Connor-Davidson Resilience Scale (CD-RISC), and the Simple Coping Style Questionnaire (SCSQ) were used for assessment. Binary Logistic regression analysis was performed to analyze influencing factors.Results:A total of 410 questionnaires were distributed, and 405 valid questionnaires were returned, with an effective recovery rate of 98.78% (405/410). Among them, 150 patients were PTSD-positive. Binary Logistic regression analysis showed that educational level, monthly family income, psychological resilience, and coping style were influencing factors for PTSD in postoperative breast cancer patients ( P<0.05) . Conclusions:Low education level, low income, and negative coping style are risk factors for PTSD in postoperative breast cancer patients; positive coping style and high psychological resilience are protective factors. Clinical practitioners should develop preventive or intervention measures based on these influencing factors to reduce the occurrence of PTSD in postoperative breast cancer patients.