ObjectiveTo investigate the differential expression of LEFTY1 in peritoneal dialysis （PD）-associated peritoneal fibrosis （PF） and its clinical value. MethodsLevels of LEFTY1， transforming growth factor-β （TGF-β）， and fibronectin （FN） in peritoneal dialysis effluent were measured in 72 PD patients， and clinical data were collected. Differences in these indicators were compared among groups with different dialysis durations， and the correlation between LEFTY1 and clinical parameters was analyzed to evaluate its predictive value for ultrafiltration insufficiency. ResultsLEFTY1 levels decreased progressively with longer dialysis duration： short-term group ［（2 262.49±270.47） ng/mL］ > mid-term group ［（1 853.52±226.06） ng/mL］ > long-term group ［（1 767.24±264.57） ng/mL］， with significant differences among groups （P<0.001）. TGF-β and FN levels increased with prolonged dialysis duration （P<0.05）. Correlation analysis revealed that LEFTY1 was significantly negatively correlated with FN （r=-0.327， P=0.004）， dialysis duration （r=-0.496，P<0.001）， peritoneal Kt/V （r=-0.333， P=0.004）， peritoneal creatinine clearance （r=-0.239， P=0.043）， and serum calcium （r=-0.410， P<0.001）， while positively correlated with total creatinine clearance （r=0.283， P=0.016）. The area under the ROC curve for LEFTY1 combined with peritoneal Kt/V and peritoneal Ccr in predicting ultrafiltration insufficiency was 0.739. Multivariate regression analysis identified dialysis duration as an independent influencing factor for LEFTY1 expression （P=0.001）. ConclusionThe expression of LEFTY1 in the peritoneal dialysis effluent of PD patients decreases with prolonged dialysis duration and is negatively correlated with pro-fibrotic indicators， suggesting that it may play a potential anti-fibrotic role in the progression of PF. The combined detection of LEFTY1 and solute removal indicators holds value for the early identification of ultrafiltration dysfunction.

Objective To investigate the knowledge,attitude,and behavior(Knowledge-Attitude/belief-Practice,KAP)of residents in Hezhou City regarding the safety risks of using traditional Chinese medicine(TCM).Methods A stratified cluster random sampling method was used to select residents from different areas of Hezhou City.A questionnaire based on the KAP model was designed for the survey.Descriptive analysis,univariate analysis,and multiple linear regression analysis were conducted to explore the factors influencing the KAP of TCM safety behavior.Results Among the 2 000 questionnaires distribu-ted,all were conducted online.Of these,98 were incomplete,resulting in a total of 1 902 valid responses,with a valid response rate of 95.10％.In the survey of 2 000 residents of Hezhou City,the average knowledge score was(54.34±2.50),the average behavior score was(64.32±2.44),and the average attitude score was(62.44±3.07).The differences in knowledge scores among residents with different places of residence,educational levels,medical insurance status,monthly incomes,and other de-mographic characteristics were statistically significant(P＜0.05).The differences in behavior scores among residents with differ-ent medical insurance status and occupations were statistically significant(P＜0.05).The differences in attitude scores among residents with different monthly incomes and medical insurance status were also statistically significant(P＜0.05).Results of multiple linear regression analysis indicated that place of residence,medical insurance(self-paid),educational level(junior high school and below),and monthly income(below 2 000 yuan,2 001-4 000 yuan)were influencing factors for the knowledge score on safe use of proprietary Chinese medicines(P＜0.05).Medical insurance(self-paid)and occupation(enterprise work-er,freelancer,student)were influencing factors for the behavioral risk score regarding safe use of proprietary Chinese medicines(P＜0.05).Medical insurance(self-paid)and monthly income(below 2 000 yuan)were influencing factors for the attitudinal risk score regarding safe use of proprietary Chinese medicines(P＜0.05).Conclusion The overall KAP level regarding the safety of using traditional Chinese medicine among residents in Hezhou City is relatively low,and medication safety is closely re-lated to place of residence,medical insurance,monthly income,occupation,etc.

Background and purpose:Accurately locating pulmonary nodules is the key to the success of thoracoscopic surgery.This study aimed to investigate the strategy and evaluate the feasibility,safety,and clinical value of thoracoscopic surgical treatment for pulmonary nodules located beneath the interlobar pleura and close to the pulmonary hilum.Methods:The patients who underwent pulmonary nodule surgery at Liaocheng Tumor Hospital from May 2023 to November 2024 were enrolled,and the patients who did not meet the inclusion criteria were excluded.This study was approved by the Ethics Committee of Liaocheng Tumor Hospital(EC-20240112-1020)and informed consent was obtained from the patients.The research was designed as a prospective single-arm study.The patients were treated with wedge resection,which was performed following CT-guided localization,where the location needle was inserted through the interlobar pleura.The feasibility of the procedure was evaluated by analyzing the success rate of preoperative localization and perioperative complications.Results:A total of 28 patients who met the inclusion criteria were included in this study.There were 5 male and 23 female patients with an average age of(56.0±8.5)years(range 38-69 years).In all,28 patients with 28 nodules underwent thoracoscopic wedge resection,and the preoperative CT-guided localization was successfully performed in all patients,without urgent complications.The mean operation time of thoracoscopic surgery was(15.6±4.0)min,intraoperative bleeding was(20.9±14.3)mL,and postoperative drainage was(214.3±62.2)mL.No cases of postoperative air leaks or conversion to thoracotomy were observed.The average length of hospital stay was(5.4±0.9)days.The postoperative histological diagnosis revealed 3 benign lesions(pulmonary fibrosis in 2 cases,atypical adenomatous hyperplasia in 1 case)and 25 malignant lesions(adenocarcinoma in situ in 5 cases,minimally invasive adenocarcinoma in 16 cases,and invasive adenocarcinoma in 4 cases).Conclusion:Thoracoscopic wedge resection following CT-guided nodule localization through the interlobar pleura is a feasible approach for nodules located beneath the interlobar pleura and close to the pulmonary hilum.The method ensures precise tumor localization,adequate margin,and minimal loss of normal lung tissue,with a low incidence of postoperative complication,which has important guiding significance for the surgical treatment of pulmonary nodules in such special locations.

Objective To investigate the knowledge,attitude,and behavior(Knowledge-Attitude/belief-Practice,KAP)of residents in Hezhou City regarding the safety risks of using traditional Chinese medicine(TCM).Methods A stratified cluster random sampling method was used to select residents from different areas of Hezhou City.A questionnaire based on the KAP model was designed for the survey.Descriptive analysis,univariate analysis,and multiple linear regression analysis were conducted to explore the factors influencing the KAP of TCM safety behavior.Results Among the 2 000 questionnaires distribu-ted,all were conducted online.Of these,98 were incomplete,resulting in a total of 1 902 valid responses,with a valid response rate of 95.10％.In the survey of 2 000 residents of Hezhou City,the average knowledge score was(54.34±2.50),the average behavior score was(64.32±2.44),and the average attitude score was(62.44±3.07).The differences in knowledge scores among residents with different places of residence,educational levels,medical insurance status,monthly incomes,and other de-mographic characteristics were statistically significant(P＜0.05).The differences in behavior scores among residents with differ-ent medical insurance status and occupations were statistically significant(P＜0.05).The differences in attitude scores among residents with different monthly incomes and medical insurance status were also statistically significant(P＜0.05).Results of multiple linear regression analysis indicated that place of residence,medical insurance(self-paid),educational level(junior high school and below),and monthly income(below 2 000 yuan,2 001-4 000 yuan)were influencing factors for the knowledge score on safe use of proprietary Chinese medicines(P＜0.05).Medical insurance(self-paid)and occupation(enterprise work-er,freelancer,student)were influencing factors for the behavioral risk score regarding safe use of proprietary Chinese medicines(P＜0.05).Medical insurance(self-paid)and monthly income(below 2 000 yuan)were influencing factors for the attitudinal risk score regarding safe use of proprietary Chinese medicines(P＜0.05).Conclusion The overall KAP level regarding the safety of using traditional Chinese medicine among residents in Hezhou City is relatively low,and medication safety is closely re-lated to place of residence,medical insurance,monthly income,occupation,etc.

Background and purpose:Accurately locating pulmonary nodules is the key to the success of thoracoscopic surgery.This study aimed to investigate the strategy and evaluate the feasibility,safety,and clinical value of thoracoscopic surgical treatment for pulmonary nodules located beneath the interlobar pleura and close to the pulmonary hilum.Methods:The patients who underwent pulmonary nodule surgery at Liaocheng Tumor Hospital from May 2023 to November 2024 were enrolled,and the patients who did not meet the inclusion criteria were excluded.This study was approved by the Ethics Committee of Liaocheng Tumor Hospital(EC-20240112-1020)and informed consent was obtained from the patients.The research was designed as a prospective single-arm study.The patients were treated with wedge resection,which was performed following CT-guided localization,where the location needle was inserted through the interlobar pleura.The feasibility of the procedure was evaluated by analyzing the success rate of preoperative localization and perioperative complications.Results:A total of 28 patients who met the inclusion criteria were included in this study.There were 5 male and 23 female patients with an average age of(56.0±8.5)years(range 38-69 years).In all,28 patients with 28 nodules underwent thoracoscopic wedge resection,and the preoperative CT-guided localization was successfully performed in all patients,without urgent complications.The mean operation time of thoracoscopic surgery was(15.6±4.0)min,intraoperative bleeding was(20.9±14.3)mL,and postoperative drainage was(214.3±62.2)mL.No cases of postoperative air leaks or conversion to thoracotomy were observed.The average length of hospital stay was(5.4±0.9)days.The postoperative histological diagnosis revealed 3 benign lesions(pulmonary fibrosis in 2 cases,atypical adenomatous hyperplasia in 1 case)and 25 malignant lesions(adenocarcinoma in situ in 5 cases,minimally invasive adenocarcinoma in 16 cases,and invasive adenocarcinoma in 4 cases).Conclusion:Thoracoscopic wedge resection following CT-guided nodule localization through the interlobar pleura is a feasible approach for nodules located beneath the interlobar pleura and close to the pulmonary hilum.The method ensures precise tumor localization,adequate margin,and minimal loss of normal lung tissue,with a low incidence of postoperative complication,which has important guiding significance for the surgical treatment of pulmonary nodules in such special locations.

Zinc oxide nanoparticles(ZnO NPs)have been gradually introduced into people's lives due to their excellent properties.In daily contact,ZnO NPs can enter the human body in a variety of ways and accumulate in tissues and organs.Inhalation is an important means by which ZnO NPs enter the human body and deposit in lungs.Studies have shown that exposure of lungs to ZnO NPs will cause a range of negative effects.The mechanism of pulmonary toxicity induced by ZnO NPs is related to Zn2+release,oxidative stress,DNA damage,autophagy,inflammation and pulmonary surfactant dysfunction.This paper reviews the pulmonary toxicity and mechanisms of ZnO NPs,and summarizes the prevention and treatment strategies,which provides scientific basis for safer use of nanomaterials,and potential intervention strategies for the prevention and treatment of nanotoxicity.

Objective: To investigate the clinicopathologic features and possible causes of granulomatous lobular mastitis(GLM). Methods: Three hundred cases of GLM were collected from surgical specimens diagnosed at Longhua Hospital, Shanghai University of Traditional Chinese Medicine from January 2015 to November 2017. Morphologic features were reviewed using HE staining. A total of 116 cases were investigated by Gram staining. The expression of CD3, CD20, CD68, IgG, IgG4, CD38 and CD138 was detected by immunohistochemical staining. Results: The age of the patients was 23 to 47 years and the median age was 32 years. All patients were female, 96.7% (290/300) had a history of lactation.There were 143 cases of left breasts, 138 cases of right breast and 19 cases of bilateral breasts. Serum prolactin increased in 39.7%(119/300) patients. Within 15.7%(47/300) of patients were associated with nodular erythema or joint swelling and pain of the lower extremities. Pathological observation showed that lobular-centric suppurative granulomatous inflammation, accompanied by dilatation of intralobular and interlobular ducts. There were 16 cases accompanied with duct ectasia. Immunohistochemistry showed CD3-positive lymphocytes were more than CD20-positive lymphocytes in the peripheral aggregation zone of neutrophils within granulomatous lesions. Gram positive bacteria were found in the lipid vacuoles of the 51.7%(60/116) patients. Conclusions GLM has distinctive histologic features. It may be related to corynebacterium infection, or accompanied by the increase of serum prolactin and erythrocyte sedimentation rate. The age, location and history of the disease are importance in the diagnosis and differential diagnosis.

Objective To investigate the clinicopathologic features and possible causes of granulomatous lobular mastitis(GLM). Methods Three hundred cases of GLM were collected from surgical specimens diagnosed at Longhua Hospital, Shanghai University of Traditional Chinese Medicine from January 2015 to November 2017. Morphologic features were reviewed using HE staining. A total of 116 cases were investigated by Gram staining. The expression of CD3, CD20, CD68, IgG, IgG4, CD38 and CD138 was detected by immunohistochemical staining. Results The age of the patients was 23 to 47 years and the median age was 32 years. All patients were female, 96.7% (290/300) had a history of lactation.There were 143 cases of left breasts, 138 cases of right breast and 19 cases of bilateral breasts. Serum prolactin increased in 39.7%(119/300) patients. Within 15.7%(47/300) of patients were associated with nodular erythema or joint swelling and pain of the lower extremities. Pathological observation showed that lobular?centric suppurative granulomatous inflammation, accompanied by dilatation of intralobular and interlobular ducts. There were 16 cases accompanied with duct ectasia. Immunohistochemistry showed CD3?positive lymphocytes were more than CD20?positive lymphocytes in the peripheral aggregation zone of neutrophils within granulomatous lesions. Gram positive bacteria were found in the lipid vacuoles of the 51.7%(60/116) patients. Conclusions GLM has distinctive histologic features. It may be related to corynebacterium infection, or accompanied by the increase of serum prolactin and erythrocyte sedimentation rate. The age, location and history of the disease are importance in the diagnosis and differential diagnosis.

AIM To observe the effects of Guhoukang Granules (Eucommiae Cortex,Dipsaci Radix,Corni Fructus,etc.) on bone metabolism indexes of the geriatric femoral intertrochanteric fracture.METHODS A total of eighty patients meeting the inclusion criteria,cured with fixed operation of proximal femoral anti-rotation nail and given basic care,were divided randomly and equally into two groups:experiment group (Guhoukang Granules ) and control group (calcium carbonate D3 tablets).Three months made a course.Osteocalcin (OC),calcitonin (CT),bone-specific alkaline phosphatase (BALP),total procollagen type 1 aminoterminal propeptide (tPINP),β isomer of the C-terminal telopeptide of type Ⅰ collagen (β-CTX),and intact parathyroid hormone (iPTH),were examined before and after three months,respectively.RESULTS There were no significant statistical difference in the levels of OC,CT,BALP,tPINP,β-CTX and iPTH before operation in both groups.The levels of OC,CT,BALP,tPINP in the experiment group obviously increased and the levels of β-CTX,iPTH markedly decreased after the operation,and were better than those in the experiment group pre-operation and in the control group after the operation.The control group had no improvement in bone metabolism indexes pre-and post-operation.CONCLUSION Guhoukang Granules can improve bone metabolism of the geriatric femoral intertrochanteric fracture and facilitate the recovery of the fracture.

Objectives To compare the clinical features between rhinovirus and respiratory syncytial virus infection in lower respiratory tract in children. Methods From December 2012 to May 2013, direct immunofluorescence assay was per-formed to test RSV in 1 037 nasal aspirate specimens with LRTIs. RT-PCR method was used to test HRV RNA. The medical re-cords of patients with a positive test of HRV or RSV were reviewed and compared. Results The isolating rate for HRV and RSV was 8.78%(91/1 037) and 17.16%(178/1 037) respectively. The frequency of co-infection of HRV with other virus was 18.68%, higher than that of RSV (7.30%,χ2=7.867, P=0.005). The age distribution had significant difference between children infected with HRV and RSV (Z=5.40, P<0.001). 78.38% patients with HRV infection were younger than 3 years old, and 83.03%patients with RSV infection were younger than 1 year old. Dyspnea, hyoxemia and wheezing were more common in pa-tients with RSV infection. Admission occurred much later in the course of the HRV infection (P<0.01). Leukocytosis, eosinophi-lia, and an elevated total serum IgE were more common in patients with HRV infection (P<0.05). Conclusions HRV is one of the important causes of LRTIs in Suzhou. The susceptible population, clinical presentation and laboratory results of HRV infec-tions are different from that of RSV infections.