Objective To evaluate the short-term effects of comprehensive health management interventions for stroke high-risk population screening on the prevention and treatment of ischemic stroke, and to provide reference and basis for improving and exploring health management and prevention strategies for stroke high-risk population. Methods From 2018 to 2022, 13 community health service centers in Jiading District, Shanghai were selected in the present study. Based on information push platform, stroke risk assessment and health intervention follow-up were conducted for community residents through convenience sampling. The residents were divided into a full course intervention group (intervention group) and a routine intervention group (control group) according to different health intervention measures and forms. The incidence of ischemic stroke in the two groups of survey subjects was tracked within 36 months. Results A total of 52144 subjects were included in the study. The total number of patients in the full course intervention group was 14227, with an incidence density of 577.32/100 000 (556.49/100 000-598.12/100 000), which was lower than that of the conventional intervention group (37 917), with an incidence density of 1 485.47/100 000 (1 464.99/100 000-1 505.94/100 000) (χ²=2490.212, P<0.001). The relative risk of the full course intervention group was 0.39, and the relative risk of stroke risk factors in the full course intervention group from low to high was 0.33, 0.43, 0.45, and 0.49, respectively. The incidence density of males in the full course intervention group was 660.76 (627.46/100 000 - 694.05/100 000), with a relative risk of 0.43, and the incidence density of female patients was 509.71/100 000 (483.37/100 000 - 536.05/100 000), with a relative risk of 0.35. The overall incidence density of the population under 62 years old gourp, 62-75 years old group and over 75 years old group was 197.45/100 000 (173.09/100 000 -221.80/100 000), 608.36/100 000 (580.19/100 000-636.54/100 000), and 1 025.06/100 000 (958.51/100 000-1 091.61/100 000), with relative risks of 0.51, 0.44, and 0.38, respectively. Conclusion Comprehensive health management measures can effectively reduce the short-term risk of ischemic stroke, and should be further promoted and improved to enhance the effectiveness of stroke prevention and control.

The molecular mechanisms underlying the develop-ment and metastasis of prostate cancer remain elusive.This comprehensive review delves into the intricate role of cofilin,an actin-binding protein,in the pathogenesis and progression of prostate cancer.Cofilin is a significant protein in cytoskeletal dynamics,and any dysregulation may result in the morphological changes in normal cells and the invasion and metastasis of tumor cells.Research has revealed that the activity of cofilin is regula-ted by various mechanisms,including phosphorylation/dephos-phorylation and interactions with other molecules.Moreover,this review discusses promising therapeutic interventions,such as co-filin inhibitors and gene therapy,which have demonstrated effica-cy in preclinical models.The challenge of clinically preventing the transition to castration-resistant prostate cancer and tumor metastasis is widely recognized,necessitating the development of precise drug treatments and biomarker identification.As a key regulatory protein,cofilin provides a more comprehensive refer-ence for the prevention and treatment of prostate diseases.

Objective To investigate the relationship between the expression of discoidin,CUB and LCCL domain containing protein 1(DCBLD1)and cytoskeleton associated protein 2(CKAP2)in cervical cancer(CC)tissues and epithelial mesenchymal transition(EMT)and clinical prognosis.Methods 94 CC patients diagnosed and treated in Shiyan Hospital of Traditional Chinese Medicine from February 2017 to February 2019 were selected.The expression of DCBLD1 messenger ribonucleic acid(mRNA),CKAP2 mRNA,N-cadherin(N-cad)mRNA,vimentin(Vim)mRNA and TWIST mRNA in tissues was detected by real-time fluorescence quantitative PCR(qRT-PCR).The expressions of DCBLD1 and CKAP2 were detected by immunohistochemistry(IHC).Pearson correlation analysis was used to analyze the relationship between DCBLD1 mRNA,CKAP2 mRNA and EMT-related indicators.Kaplan-Meier survival curve was drawn to compare the prognosis of CC patients with different DCBLD1 mRNA and CKAP2 mRNA expression.COX regression analysis was used to analyze the prognostic factors of CC patients.Results The expression of DCBLD1 mRNA,CKAP2 mRNA,N-cad mRNA,Vim mRNA and TWIST mRNA in CC cancer tissues was higher than that in adjacent tissues,and the differences were statistically significant(t=32.763～52.824,all P<0.05).The positive rates of DCBLD1 protein(89.36%)and CKAP2 protein(87.23%)in CC cancer tissues were higher than those in adjacent normal tissues(7.45%,6.38%),and the differences were statistically significant(χ2=126.278,123.396,all P<0.001).The expression of DCBLD1 mRNA and CKAP2 mRNA in CC cancer tissues were positively correlated with the expression of N-cad mRNA,Vim mRNA and TWIST mRNA(r=0.655～0.744,all P<0.001).The expression of DCBLD1 mRNA and CKAP2 mRNA in patients with FIGO stage IB2～IIB and lymph node metastasis were higher than those in patients with stage IA～IB1 and without lymph node metastasis(t=25.644～35.674,all P<0.05).The 5-year progression free survival rates of the high expression groups of DCBLD1 mRNA and CKAP2 mRNA were 63.04%and 62.22%,respectively,which were lower than those of the low expression groups of DCBLD1 mRNA and CKAP2 mRNA(91.67%and 91.84%),respectively,and the differences were statistically significant(Log-Rank χ2=7.181,6.527,all P<0.05).FIGO stage IB2～IIB,high DCBLD1 mRNA and high CKAP2 mRNA were risk factors affecting the prognosis of CC patients(Wald χ2=8.277,15.877,10.927,all P<0.05).Conclusion The expression of DCBLD1 and CKAP2 in CC cancer tissues is significantly increased,which is related to EMT related indicators and plays a promoting role in the progression of CC tumors.They are new prognostic markers for CC.

Multiple myeloma(MM)remains an incurable disease,with most patients experiencing multiple relapses before ultimately progressing to refractory stage.Extramedullary infiltration is a common manifestation of relapse.However,distinguishing synchronous multifocal extramedullary infiltration from secondary malignancies poses significant diagnostic challenges.This study presents a case of relapsed refractory MM with multifocal extramedullary infiltration,diagnosed as coexistence of multiple myeloma extramedullary infiltration and pulmonary adenocarcinoma through multidisciplinary team(MDT)collaboration.Such coexistence is exceedingly rare in clinical practice and introduces substantial complexity in diagnosis and treatment planning.Through a comprehensive case report and literature review,this paper explores the diagnostic and therapeutic approaches to managing multifocal extramedullary infiltration coexisting with secondary malignancies in MM,highlighting the pivotal role of MDT in achieving precise diagnosis and optimizing patient outcomes.

Objective To investigate a cluster of healthcare-associated infection(HAI)of carbapenem-resistant Klebsiella pneumoniae(CRKP)in intensive care unit(ICU)of a traditional Chinese medicine hospital,and provide evidence for the prevention and control of multidrug-resistant organisms in hospitals.Methods From January to Ju-ly 2023,multiple cases of CRKP infection in the ICU of a traditional Chinese medicine hospital occurred,surpassing the number in the same period of previous years.Through collection of patients'clinical information,epidemiologi-cal investigation and environmental hygiene monitoring,the isolated CRKP strains were identified by pulsed-field gel electrophoresis(PFGE),possible causes of transmission were found out,and corresponding control measures were taken.Results During the study period,a total of 13 patients were confirmed to have developed CRKP infection,mainly respiratory tract infection,bloodstream infection,and abdominal infection.Environmental monitoring showed that only 2 out of 131 environmental object surfaces specimens and staff's hand specimens tested positive for CRKP.PFGE identification showed that the 2 CRKP strains isolated from the sink specimens were highly homolo-gous to the strains isolated from 2 recently admitted patients.Some strains isolated from patients were highly ho-mologous,indicating a possibility of cross transmission.Conclusion CRKP is prone to be cross-transmission among ICU patients and contaminates the environment.Early warning and investigation should be conducted to prevent the occurrence of HAI outbreaks.

Aim To explore the influence of demethy-lase fat mass and obesity-related genes(FTO)on the abnormal contractile function of diabetic coronary smooth muscle.Methods Smooth muscle specific FTO knockout mice(FTOSMKO)were prepared by Cre-loxP recombinant technology.They were divided into four groups:control(WT)group,diabetes model group(DM),FTO knockout group(FTOSMKO),and FTOSMKO diabetic group(FTOSMKO-DM),with 15 mice in each group.Diabetic mice were prepared by intraperitoneal injection of streptozotocin(STZ);the remaining mice were injected with an equal amount of citric acid-sodi-um citrate buffer.The effects of 5-HTon the contractile response of coronary artery smooth muscle in the four groups of mice were observed by the technique of small-vessel ring tensiometry.Western blot and Dot blot were used to detect the changes of FTO protein and N6-methyladenine(m6A)methylation modification levels in mouse vascular tissues.Results Compared with the WT group,the DM group had significantly higher blood glucose(P＜0.01)and lower body weight(P＜0.05);the level of FTO protein in aorta of DM group increased(P＜0.01),and the level of m6A methylation modification decreased(P＜0.01).The 5-HT-induced contractile response significantly de-creased in the DM group compared with the WT group(P＜0.01),whereas the contractile response signifi-cantly increased in the FTOSMKO-DM group compared with the DM group(P＜0.01);the non-L-type calci-um channel-mediated vascular smooth muscle contrac-tile response was enhanced in the FTOSMKO-DM group,among which,the contractions induced by 1,4,5-triphosphate inositol receptor(IP3R)and caffeine-ac-tivated ranine receptor(RyR)mediated by sarcoplas-mic reticulum calcium release both significantly in-creased(P＜0.05).Conclusions Specific knock-down of smooth muscle FTO improves coronary artery responsiveness to the vasoconstrictor 5-HT in diabetic mice,which may be related to abnormalities in the FTO-mediated 5-HT receptor signaling pathway.

Objective To establish a gas chromatography-mass spectrometry (GC-MS) method for the simultaneous determination of four carbonate compounds (CCs), including ethyl methyl carbonate (EMC), diethyl carbonate (DEC), vinylene carbonate (VC), and ethylene carbonate (EC) in workplace air. Methods Vapor-phase EMC, DEC, VC, and EC in workplace air were collected using activated carbon tubes. After desorption with dichloromethane, the samples were analyzed by GC-MS. Qualitative identification was performed based on retention times and characteristic ions, while quantitative analysis was conducted using peak areas of selected characteristic ions. Results The quantitative determination ranges for the four CCs were from 0.57×10⁻³ to 200.00 mg/L, with correlation coefficients ≥0.999 45. The detection limit ranged from 0.17 to 1.60 μg/L, and the lower limit of quantification ranged from 0.57 to 5.33 μg/L. The minimum detection concentration and minimum quantitation concentration were 0.11-1.07 and 0.38-3.55 μg/m³, respectively. Mean spiked recoveries ranged from 85.70% to 111.65%. The intra- and inter-batch relative standard deviations were 0.11%-2.04% and 1.27%-5.18%, respectively. Mean desorption efficiencies of the method ranged from 74.70% to 118.20%. EMC, DEC, and EC samples were stable for up to five days at 4 °C, while VC samples were stable for up to three days at 4 °C. Conclusion The GC-MS method is suitable for the simultaneous determination of the four CCs including EMC, DEC, VC, and EC in workplace air.

Gestational trophoblastic neoplasia(GTN)patients can be classified into low-risk and high-risk patients based on the International Federation of Gynecology and Obstetrics(FIGO)staging and scoring system.High-risk patients have a higher risk of resistance to single-agent chemotherapy and require combination chemotherapy.Even worse,there are some high-risk patients who develop resistance to combination chemother-apy or experience recurrence after cure.These patients exhibit strong heterogeneity and pose significant challen-ges to subsequent treatment,thus attracting considerable attention in recent years.Therefore,this article aims to review the risk factors and treatment strategies for high-risk resistant and recurrent GTN patients,in order to provide a basis for early identification of high-risk patients and their precise treatment.

Currently,there are practical and technical difficulties in the construction of clinical ques-tions in the development of clinical practice guidelines.Clinicians or guideline developers seldom construct clin-ical questions based the actual case scenario,leading to some information loss between structured and actual clinical connotation.To overcome this challenge,we proposed a case-guided questions construction approach,and carried out case research and verification in the formulation of the guideline.We found that this method could more efficiently and scientifically assist the formulation of clinical questions,and provide reference for clinicians or guideline developers.

Objective To explore the mechanisms of Qingre Lidan Jiedu Recipe(QLJR)for improving cognitive dysfunction in rats with high copper load.Methods Seventy-five male SD rats were randomized into normal control group,model group,QLJR group,penicillamine(PCA)group,and QLJR+PCA group.Except for those in the control group,all the rats were fed a high-copper diet for 12 weeks.The effects of the treatments on cognitive function of the rats were assessed using the Barnes maze and passive avoidance tests.Hippocampal expressions of NIX,FUNDC1 and LC3 of the rats were detected using Western blotting and immunofluorescence staining,and changes in mitochondrial morphology were observed with transmission electron microscopy.Results Behavioral tests showed prolonged target hole latency,shortened latency to enter the dark chamber,and increased error counts of the rats in the model group,which were significantly improved in QLJR+PCA group;the error counts were significantly lower in QLJR+PCA group than in either QLJR or PCA group.Among all the groups,the hippocampal expressions of NIX and FUNDC1 were the lowest and LC3 I/II expression the highest in the model group;NIX and FUNDC1 expressions were significantly higher and LC3 I expression was lower in QLJR+PCA group than in QLJR group and PCA group.Immunofluorescence staining revealed weakened NIX and FUNDC1 expressions and enhanced LC3 expression in the hippocampus of the rats in the model group as compared with those in the normal control and QLJR+PCA groups,but their expressions did not differ significantly between QLJR and PCA groups.The rats in the model group showed obvious structural disarray of the mitochondria,which were improved in all the treatment groups.Conclusion QLJR improves cognitive dysfunction in rats with high copper load possibly by regulating mitophagy.