Objective To explore the correlation between serum iron levels and granulomatous lobular mastitis(GLM).Methods A total of 102 patients with GLM were admitted from May 2022 to May 2023.According to the disease course stage at the time of the patients' visit,they were divided into the mass stage group(29 cases),the abscess stage group(48 cases),and the remission stage group(25 cases).Compare the serum iron levels of patients with GLM at different stages.Spearman correlation analysis was used to analyze the correlation between serum iron levels and inflammatory indicators,and the changes in serum iron levels of patients before and after treatment remission were compared through follow-up.Results All the 102 GLM patients were female.The serum iron levels of patients in the abscess stage group,the mass stage group and the remission stage group were 12.8(10.20,17.50)μmol/L,12.8(10.20,17.50)μmol/L and 15.4(13.65,18.50)μmol/L,respectively.The abscess stage group was lower than the mass stage group and the remission stage group,and the difference was statistically significant(P＜0.001).The results of bivariate Spearman correlation analysis showed that the serum iron levels were moderately negatively correlated with white blood cell count,neutrophil count and the percentage of neutrophils(r=-0.336,P=0.001;r=-0.361,P=0.001;r=-0.334,P＜0.01),low intensity negative correlation with monocyte count(r=-0.214,P=0.031),moderately positively correlated with the percentage of lymphocytes,the levels of interleukin(IL)-2,IL-4,IL-10(r=0.328,P＜0.01;r=0.494,P=0.023;r=0.514,P=0.017;r=0.478,P=0.028).Serum iron levels in 45 GLM follow-up patients after treatment remission were higher than those before remission[(15.09±4.78)μmol/L vs.(10.64±4.47)μmol/L,P＜0.001].Conclusion Serum iron level is associated with disease severity,inflammatory markers such as immune cells and cytokines,and disease outcome of GLM.

Objective To explore the new mechanism of Escin inhibiting the progression of breast cancer cells.Methods Escin treatment groups with different concentrations(0,10,20,30,40μg/ml)were set up,and BC cells were treated with corresponding concentrations of Escin,then CCK8,clonal formation,flow cytometry,transmission electron microscopy and protein immunoblotting were used to evaluate the cell phenotype and possible mechanisms.Control group,Escin group and Escin+VX-765 group were set up,to determine the role of Caspase-1/GSDMD signaling pathway in Escin-induced pyroptosis of BC cells,cells were pretreated with Caspase-1 inhibitor VX-765.The cells in control group,Escin group and Escin+NAC group were pretreated with the reactive oxygen species(ROS)scavher N-Acetylcysteine(NAC),to determine the role of ROS in Escin induced pyroptosis of BC cells.Results Compared with the control group,different concentrations of Escin inhibited the proliferation and colony formation of BC cells in a concentration dependent manner(P＜0.05).Compared with the control group,the ROS and pyroptosis rate were increased in Escin-treated group(P＜0.05).The protein expression levels of FL-GSDMD and pro-Caspase-1 were significantly decreased in the Escin-treated group,while N-GSDMD,cleaved Caspase-1 and IL-18 protein expression were significantly increased(P＜0.05).Compared with the Escin-treated group,the proliferation rate of Escin+VX-765 group was increased(P＜0.05),and the expression of pyroptosis protein was decreased(P＜0.05).Compared with the Escin-treated group,the proliferation rate of Escin+NAC group was increased(P＜0.05),and the ROS,pyroptosis rate and pyroptosis protein expression were decreased(P＜0.05).Conclusion The inhibitory effect of Escin on the progression of breast cancer cells may be related to its regulation of ROS/Caspase-1/GSDMD signaling pathway to promote cell pyroptosis.

Objective To explore the new mechanism of Escin inhibiting the progression of breast cancer cells.Methods Escin treatment groups with different concentrations(0,10,20,30,40μg/ml)were set up,and BC cells were treated with corresponding concentrations of Escin,then CCK8,clonal formation,flow cytometry,transmission electron microscopy and protein immunoblotting were used to evaluate the cell phenotype and possible mechanisms.Control group,Escin group and Escin+VX-765 group were set up,to determine the role of Caspase-1/GSDMD signaling pathway in Escin-induced pyroptosis of BC cells,cells were pretreated with Caspase-1 inhibitor VX-765.The cells in control group,Escin group and Escin+NAC group were pretreated with the reactive oxygen species(ROS)scavher N-Acetylcysteine(NAC),to determine the role of ROS in Escin induced pyroptosis of BC cells.Results Compared with the control group,different concentrations of Escin inhibited the proliferation and colony formation of BC cells in a concentration dependent manner(P＜0.05).Compared with the control group,the ROS and pyroptosis rate were increased in Escin-treated group(P＜0.05).The protein expression levels of FL-GSDMD and pro-Caspase-1 were significantly decreased in the Escin-treated group,while N-GSDMD,cleaved Caspase-1 and IL-18 protein expression were significantly increased(P＜0.05).Compared with the Escin-treated group,the proliferation rate of Escin+VX-765 group was increased(P＜0.05),and the expression of pyroptosis protein was decreased(P＜0.05).Compared with the Escin-treated group,the proliferation rate of Escin+NAC group was increased(P＜0.05),and the ROS,pyroptosis rate and pyroptosis protein expression were decreased(P＜0.05).Conclusion The inhibitory effect of Escin on the progression of breast cancer cells may be related to its regulation of ROS/Caspase-1/GSDMD signaling pathway to promote cell pyroptosis.

Objective To explore the correlation between serum iron levels and granulomatous lobular mastitis(GLM).Methods A total of 102 patients with GLM were admitted from May 2022 to May 2023.According to the disease course stage at the time of the patients' visit,they were divided into the mass stage group(29 cases),the abscess stage group(48 cases),and the remission stage group(25 cases).Compare the serum iron levels of patients with GLM at different stages.Spearman correlation analysis was used to analyze the correlation between serum iron levels and inflammatory indicators,and the changes in serum iron levels of patients before and after treatment remission were compared through follow-up.Results All the 102 GLM patients were female.The serum iron levels of patients in the abscess stage group,the mass stage group and the remission stage group were 12.8(10.20,17.50)μmol/L,12.8(10.20,17.50)μmol/L and 15.4(13.65,18.50)μmol/L,respectively.The abscess stage group was lower than the mass stage group and the remission stage group,and the difference was statistically significant(P＜0.001).The results of bivariate Spearman correlation analysis showed that the serum iron levels were moderately negatively correlated with white blood cell count,neutrophil count and the percentage of neutrophils(r=-0.336,P=0.001;r=-0.361,P=0.001;r=-0.334,P＜0.01),low intensity negative correlation with monocyte count(r=-0.214,P=0.031),moderately positively correlated with the percentage of lymphocytes,the levels of interleukin(IL)-2,IL-4,IL-10(r=0.328,P＜0.01;r=0.494,P=0.023;r=0.514,P=0.017;r=0.478,P=0.028).Serum iron levels in 45 GLM follow-up patients after treatment remission were higher than those before remission[(15.09±4.78)μmol/L vs.(10.64±4.47)μmol/L,P＜0.001].Conclusion Serum iron level is associated with disease severity,inflammatory markers such as immune cells and cytokines,and disease outcome of GLM.

ObjectiveTo understand the utilization of preconception healthcare services and the influencing factors among the women expecting additional childbirth in Jiading District， Shanghai， and to provide references for promoting the utilization of preconception healthcare services under the new population policy. MethodsA questionnaire survey on the utilization of preconception healthcare services and related influencing factors was carried out among 682 women expecting additional childbirth across six subdistricts in Jiading District， Shanghai. The results were statistically analyzed. ResultsThe average age of the women was （31.7±4.5） years， 30.2% of whom were ≥35 years old. The proportion of women having their third or subsequent children was low， at 16.4%. A significant majority， 92.4%， were found to have various risk factors during initial pregnancy screening. The utilization rate of preconception healthcare services among women seeking additional childbirth was relatively low at 26.7%. Awareness of the free preconception check-up program in Jiading District was also low at 28.6%， and the utilization rate for these services was even lower at 7.69%. Unplanned pregnancies were the primary reason for not utilizing preconception healthcare services， accounting for 63.6%. The results of multifactorial binary logistic regression analysis showed that the utilization rate of preconception healthcare services before the current pregnancy was higher for women aged between 35 and 39 compared to women aged ≤29 years old （OR=1.789， 95%CI： 1.033‒3.099）. Women with planned pregnancies had a higher utilization of preconception healthcare services prior to this pregnancy （OR=4.164， 95%CI： 2.627‒6.602）. Women who had received preconception care prior to their first birth had a higher utilization rate of preconception care prior to the current pregnancy （OR=7.534， 95%CI： 4.954‒11.456）. Women without a family history of chronic diseases had a higher utilization rate of preconception healthcare services （OR=1.903， 95%CI： 1.083‒3.345）. ConclusionUnder the context of three-child policy， the proportion of women seeking three or more children in Jiading District is low. Most of these women have risk factors identified during initial pregnancy screenings. The utilization rate of preconception healthcare services and the awareness of the free preconception screening program in Jiading District are both low. Unplanned pregnancies remain the primary reason for failing to receive timely preconception healthcare services. Age， whether the pregnancy was planned， whether the women had received preconception healthcare services before their first baby and family history of chronic diseases are the main factors affecting the utilization of preconception healthcare services. Relevant departments should enhance the promotion of preconception healthcare service programs， especially for women of childbearing age who have not yet given birth， so as to improve the utilization rate of preconception health care services.

【Objective】 To investigate the effects of miR-126-3p targeting chemokine receptor 1 (CCR1) in exosomes derived from bone marrow mesenchymal stem cells (BMSC) on the proliferation, migration, and invasion of lung cancer cells. 【Methods】 BMSC cells were cultured; exosomes were extracted and identified by the exosomal marker proteins CD63 and TSG101. After exosome culture of A549 cells for different durations (0, 24, 48, and 72 h), cell survival rate was detected by CCK-8, mRNA levels of miR-126-3p and CCR1 were detected by qRT-PCR, and cell migration and invasion abilities were detected by Transwell assay. The relative expressions of CCR1, epithelial cadherin (E-cad), neural cadherin (N-cadherin), and Vimentin were detected by Western blotting. 【Results】 Exosomes had round or oval cup-shaped structures with bright edges and dark middle, with a particle size distribution of about 152 nm, expressing CD63 and TSG101 proteins. The expression of miR-126-3p in exosomes was higher than that in A549 cells. The expression of miR-126-3p was low in A549 cells and that of CCR1 mRNA was high. However, after co-culture with exosomes, the expression of miR-126-3p in A549 cells was increased, while the expression of CCR1 was decreased. A549 cells were cocultured with exosomes for 0, 24, 48, and 72 h. The survival rate, migration and invasion abilities, CCR1 gene and protein expression levels, and N-cad and Vimentin protein expression levels of A549 cells decreased gradually with the extension of culture time. The level of miR-126-3p and the expression of E-cad protein increased gradually with the extension of culture time. 【Conclusion】 The co-culture of exosomes derived from bone marrow mesenchymal stem cells with A549 cells can increase the expression level of miR-126-3p, and miR-126-3p can reduce the proliferation, migration, and invasion of A549 cells by targeting the inhibition of CCR1 expression.

ObjectiveTo understand the influencing factors of women’s intention to utilize preconception health care services， so as to promote the utilization of preconception care among women with future pregnancy plan. MethodsThe study was conducted at 8 outpatient health clinics of medical institutions providing perinatal health care in Jiading District of Shanghai. Women who had fertility intention for another child were invited to complete an electronic questionnaire from November 2020 to February 2021. ResultsWomen with better pregnancy and birth care behaviors during the last periconception were more likely to utilize preconception care service before the next conception than those with previous poorer behaviors （OR=1.980， 95%CI= 1.061‒3.694， P=0.032）. Women with higher preconception care knowledge scores had better pregnancy and birth care behaviors during the last periconception than those with lower knowledge scores （OR=1.362， 95%C1= 1.004‒1.846， P=0.047）. ConclusionsIn order to improve the utilization of preconception care among the population with future pregnancy plan， it is necessary to further strengthen health education and social mobilization to promote the preconception eugenic knowledge， planned pregnancy and pregnancy and birth care behaviors.

The application of big data and artificial intelligence technology in the medical field is key to hospital informatization. In October 2018, a tertiary hospital launched a clinical intelligent application platform. The platform took AI assistant as the carrier of intelligent application, supported the role expansion, function expansion and connotation expansion of intelligent application, and layed the foundation for the construction of clinical intelligence. As of July 2022, the platform had been embedded into the outpatient, emergency and inpatient business systems with the help of AI assistant, realizing such intelligent applications as auxiliary diagnosis, auxiliary treatment, risk warning, AI medical record quality control, research entry group and infectious disease management, as well as enriching the connotation of such specialty applications as orthopedics and ear, nose and throat. The platform satisfied the integration and integration of hospital information construction and provided convenient and effective intelligent auxiliary tools for clinical use.

欧阳洋，李娟娟，涂毅，孙圣荣（武汉大学人民医院 乳腺甲状腺外科，湖北 武汉 430060） [摘 要] 目的：借助多种癌症生物信息数据库研究乳腺癌组织中缺氧诱导因子1亚基α（HIF1A）的表达水平及其与乳腺癌患者预后及肿瘤免疫细胞浸润的关系。方法：利用Oncomine、人类蛋白质图谱、基因表达谱交互式分析（GEPIA）及TCGA数据库分析HIF1A基因在乳腺癌组织中的表达及其与患者预后、临床病理特征的关系，并在中国人乳腺癌组织标本（选用2011年1月至2015年12月中国武汉大学人民医院手术切除的93例乳腺癌组织和14例良性乳腺疾病组织）中进行验证。对HIF1A高低表达组间的差异基因进行基因本体（GO）和京都基因与基因组百科全书（KEGG）富集分析，用Cibersort R软件评估HIF1A高低表达样本中免疫细胞浸润丰度差异。结果：生物信息数据显示，HIF1A在乳腺癌组织中高表达，预示着患者DFS预后更好（P<0.05）。HIF1A的表达与雌激素受体（ERP）、孕激素受体（PR）和人表皮生长因子受体2（HER2）表达相关（均P<0.05）。GO生物功能及KEGG通路富集分析结果提示，HIF1A可能参与肿瘤免疫调节等生物活动。使用Cibersort分析结果显示，HIF1A与肿瘤免疫细胞浸润之间具有相关性（均P<0.01），发现活化记忆CD4 + T细胞、M0和M1型巨噬细胞与HIF1A表达呈正相关，在乳腺癌组织中高表达，Treg细胞、活化NK细胞、M2型巨噬细胞与HIF1A表达呈负相关（均P<0.01）。结论：HIF1A参与调节肿瘤微环境的免疫活性，与乳腺癌患者DFS相关，其可能成为乳腺癌分级诊断、免疫治疗和预后判断的生物标志物。

With the application of high throughput sequencing and other technologies, in recent years people have found that bacteria are not only the causative factors of common breast diseases such as mastitis, but also may be involved in the occurrence and development of breast cancer. There are unique bacterial communities in the internal tissues of the breast, and their existence may be related to the incidence of breast cancer. Recent studies have found that intestinal flora may also affect the incidence of breast cancer by regulating estrogen and other pathways. Further exploration of the influence of bacteria on breast cancer will provide new ideas for diagnosis and treatment of breast cancer.