Objective: To enhance the recognition of necrotizing sialometaplasia (NS) by elucidating its clinical, pathological characteristics and key diagnostic points, providing a basis for the diagnosis and treatment of the disease. Methods: This study has been reviewed and approved by the Medical Ethics Committee, and informed consent has been obtained from patients. Review the data of a patient with NS occurring at the junction of the right soft and hard palate, and comprehensively analyze its diagnostic process based on its clinical manifestations, imaging, and histopathological examination results. And review the relevant literature on the disease. Results: This study describes a 24-year-old male patient with a documented betel nut habit (2 pieces/day for >6 months), who presented with a bone-deep, irregular crateriform ulcer (3 mm × 6 mm × 5 mm) localized to the right hard-soft palate junction. Spiral CT showed a local soft tissue defect with no apparent underlying bone destruction. Histopathology demonstrated chronic inflammation of the mucosal and minor salivary gland tissues, with no evidence of malignancy. A final diagnosis of NS was established. The ulcer healed completely three weeks after initiation of local anti-inflammatory therapy. A literature review indicates that NS is a rare, benign salivary gland disorder, typically occurring at the hard-soft palate junction in middle-aged men (40-60 years). Its etiology remains unclear, but it is widely attributed to salivary lobe infarction following mechanical trauma-induced ischemia. Due to its clinical resemblance to malignancy, it is often misdiagnosed. Treatment entails local anti-inflammatory measures and meticulous wound care aimed at promoting mucosal healing. Conclusion NS is a self-limiting, benign condition that poses a significant diagnostic challenge due to its close clinical simulation of malignancy. Thus, accurate diagnosis requires a combined assessment of clinical presentation, radiological features, and pathological findings. Treatment is predicated based on a conservative strategy with an emphasis on symptomatic management.

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.

With the accelerating trend of population aging, the number of elderly patients with lung cancer continues to rise, and the disease burden is becoming increasingly heavy. The clinical management of these patients faces severe challenges due to their decreased physiological reserve, complex comorbidities, and significant individual heterogeneity. Consequently, under traditional diagnosis and treatment models, doctors often struggle to identify the individualized risks of elderly patients in a timely and comprehensive manner, which can easily lead to decision biases such as undertreatment or overtreatment. In view of this, this study advocates for the establishment of an umbrella decision-making model specifically tailored for elderly lung cancer patients. Grounded in a multidisciplinary team (MDT) platform, this model deeply integrates oncological indicators with the comprehensive geriatric assessment (CGA) system. By holistically considering multidimensional variables including tumor burden, organ function, frailty index, cognitive status, and social support, the model establishes an operational mechanism characterized by "single entry, precise stratification, and targeted selection". Accordingly, patients can be scientifically triaged into distinct intervention tiers, such as active surveillance, minimally invasive surgery, drug therapy, radiotherapy, and best supportive care, thereby achieving real-time alignment between treatment intensity and patient fitness. This article elaborates on the construction logic and key operational procedures of this novel decision-making framework, aiming to guide clinical practice beyond the limitations of a tumor-centric perspective toward a holistic, dynamic, whole-course management strategy. This transition seeks to ensure optimal quality of life and clinical net benefit for elderly patients alongside survival prolongation.

ObjectiveTo observe the clinical efficacy of Gandouling decoction combined with neuromuscular electrical stimulation （NMES） in the treatment of dysphagia in Wilson disease （WD） with combined phlegm and stasis. MethodsA total of 80 WD patients with dysphagia due to combined phlegm and stasis treated in the Department of Encephalopathy， the First Affiliated Hospital of Anhui University of Chinese Medicine were randomized into a control group and an observation group， with 40 patients in each group. In addition， 40 healthy volunteers were recruited as the normal group. The control group was treated with basic copper drainage combined with NMES. The observation group was treated with Gandouling Decoction on the basis of the therapy in the control group. Each course of treatment lasted for 8 days， and the patients were treated for a total of 4 courses. All subjects underwent video fluoroscopic swallowing study （VFSS） before and after treatment. During the examination， contrast agents with 4 different characters were used for the swallowing action， and the passing time was recorded. The TCM syndrome score， water swallow test score， standard swallowing assessment （SSA） score， and 24-h urinary copper level before and after treatment were analyzed. ResultsWhen performing VFSS， the passing time of contrast agents of different characters in the oral stage was longer in the WD group than in the normal group （P<0.01）， while it had no significant difference in the pharyngeal stage. After treatment， the passing time in the oral stage shortened in the control and observation groups （P<0.01）， and the observation group outperformed the control group （P<0.01）. After treatment， both the control and observation groups showed declines in TCM syndrome score and SSA score （P<0.01） and an increase in water swallow test score （P<0.01）， and the changes were more obvious in the observation group than in the control group （P<0.01）. In addition， the treatment in the control and observation groups elevated the 24-h urinary copper level （P<0.01）， and the elevation in the observation group was more obvious than that in the control group （P<0.01）. Neither group showed obvious adverse reaction. ConclusionGandouling decoction combined with NMES can significantly ameliorate dysphagia in WD patients with the syndrome of combined phlegm and stasis regarding the TCM syndrome score， water swallow test score， and SSA score， demonstrating definite clinical efficacy and high safety.

Objective: To analyze the surveillance data of schistosomiasis and snail status in Jiaxing City, Zhejiang Province from 2001 to 2024, so as to provide the reference for prevention and control of schistosomiasis in jiaxing City. Methods: Data on schistosomiasis and snail surveillance in Jiaxing City from 2001 to 2024 were collected through schistosomiasis control work reports and the Zhejiang Provincial Schistosomiasis (Parasitic Diseases) Control Information Management System. These data included serological testing results, stool etiological examination (stool examination) results, area surveyed for snails, snail-infested areas, number of snail-positive frames, and number of live snails. Indicators, including the positive rate of serological testing, the positive rate of stool examinations, the rate of snail-positive frames, and the density of live snails were analyzed. The Prophet time series model was employed to forecast the schistosomiasis epidemic in Jiaxing City from 2025 to 2029. Results: A total of 636 493 serological testing were conducted in Jiaxing City from 2001 to 2024, with a positive rate of 1.532%, showing a decreasing trend (P<0.05). Among 7 582 stool examinations, positive cases were all imported, resulting in a positivity rate of 0.066%. During the same period, snail surveys covered a cumulative area of 30 545.999 hm2, with snail-infested areas totaling 69.355 hm2; no significant trend was observed (P>0.05). All snail habitats were identified as recurrent foci within hydrographic network regions, primarily distributed across Xiuzhou District, Nanhu District, Pinghu City, Jiashan County, and Tongxiang City, with snail-infested areas of 39.588, 12.538, 10.728, 4.315, and 2.186 hm2, respectively. From 2009 to 2024, a total of 35 692 134 frames of snails were surveyed, of which 16 543 were snail-positive, yielding a snail-positive frame rate of 0.046%. A total of 33 175 live snails were collected, with a mean density of 0.000 98 snails per frame. No infected Oncomelania snails were detected. The projection results indicated that from 2025 to 2029, the positive rate of serological testing rate in Jiaxing City would range between 0.253% to 0.389%, the snail-infested areas would range from 0.025 to 1.818 hm2, and the density of live snails would vary from 0.001 56 to 0.001 66 snails per frame. None of these indicators showed a significant trend (all P>0.05). Conclusions From 2001 to 2024, the positive rate of serological testing rate of schistosomiasis in Jiaxing City showed a declining trend, with no new autochthonous cases or infected Oncomelania snails detected. However, imported cases were still reported. All identified snail habitats were recurrent foci within hydrographic network regions. It is recommended to enhance schistosomiasis and snail status surveillance in high-risk areas.

ObjectiveThis study aims to develop and validate a novel multimodal predictive model， termed criss-cross network（CCNet）-directed graph neural network（DGNN）（CGN）， for accurate assessment of pulmonary nodule progression in high-risk individuals for lung cancer， by integrating longitudinal chest computed tomography（CT） imaging with both traditional Chinese and western clinical evaluation data. MethodsA cohort of 4 432 patients with pulmonary nodules was retrospectively analyzed. A twin CCNet was employed to extract spatiotemporal representations from paired sequential CT scans. Structured clinical assessment and imaging-derived features were encoded via a multilayer perceptron， and a similarity-based alignment strategy was adopted to harmonize multimodal imaging features across temporal dimensions. Subsequently， a DGNN was constructed to integrate heterogeneous features， where nodes represented modality-specific embeddings and edges denoted inter-modal information flow. Finally， model optimization was performed using a joint loss function combining cross-entropy and cosine similarity loss， facilitating robust classification of nodule progression status. ResultsThe proposed CGN model demonstrated superior predictive performance on the held-out test set， achieving an area under the receiver operating characteristic curve（AUC） of 0.830， accuracy of 0.843， sensitivity of 0.657， specificity of 0.712， Cohen's Kappa of 0.417， and F₁ score of 0.544. Compared with unimodal baselines， the CGN model yielded a 36%-48% relative improvement in AUC. Ablation studies revealed a 2%-22% increase in AUC when compared to simplified architectures lacking key components， substantiating the efficacy of the proposed multimodal fusion strategy and modular design. Incorporation of traditional Chinese medicine （TCM）-specific symptomatology led to an additional 5% improvement in AUC， underscoring the complementary value of integrating TCM and western clinical data. Through gradient-weighted activation mapping visualization analysis， it was found that the model's attention predominantly focused on nodule regions and effectively captured dynamic associations between clinical data and imaging-derived features. ConclusionThe CGN model， by synergistically combining cross-attention encoding with directed graph-based feature integration， enables effective alignment and fusion of heterogeneous multimodal data. The incorporation of both TCM and western clinical information facilitates complementary feature enrichment， thereby enhancing predictive accuracy for pulmonary nodule progression. This approach holds significant potential for supporting intelligent risk stratification and personalized surveillance strategies in lung cancer prevention.

Pleckstrin homology-like domain family A member 1(PHLDA1)is a pro-apoptotic factor as well as a key regulator of metabolic diseases.In obesity-related diseases,PHLDA1 can reduce liver triglyceride production through inhibition of the expression of sterol regulatory?element binding proteins?1(SREBP?1),and reduce fat syn?thesis through inhibition of peroxisome proliferator?activated receptor γ(PPARγ).However,in cardiovascular dis?eases,PHLDA1 increases vascular calcification,dysfunction,thereby aggravates ischemia?reperfusion injury in the heart and brain.The dual role of PHLDA1 has also been confirmed in tumors.In summary,PHLDA1,as a multi?functional factor,plays different functional roles through various mechanisms.

Objective To analyze the effect of Hsa-circ-0101216 on gemcitabine(GEM)chemotherapy resistance in pancreatic cancer and its mechanism.Methods Differentially expressed circRNAs between GEM-resistant pancreatic cancer cells and parent cells were screened using the GEO database.Pancreatic cancer GEM resistant cell lines(BxPC-3-GEM and Capan-1-GEM)were constructed by intermittent concentration gradient method.qRT-PCR was used to detect the expression of Hsa-circ-0101216 in cells.GEM resistant pancreatic cancer cell lines were taken and divided into sh-circ-0101216 group(knockdown of circ-0101216),sh-NC group(transfected with sh-NC),and blank control group(untreated).CCK-8 assay and EdU proliferation assay were used to detect the half inhibitory concentration(IC50)of GEM and proliferation ability of cells in each group.Western blotting was performed to detect the expression of multidrug resistance-related protein 1(MRP1),breast cancer resistance protein(BCRP),and human equilibrative nucleoside transporter-1(hENT-1).A subcutaneous xenograft tumor model of human pancreatic cancer in nude mice was constructed,and sh-NC+GEM group and sh-circ-0101216+GEM group(n=6)were set up.The volume and weight of xenograft tumor in nude mice were compared between the two groups.Western blotting and immunohistochemistry were used to detect the expression of MRP1,BCRP,and hENT-1 proteins in xenograft tumor tissues,and EDU proliferation assay was used to detect the proliferation ability of tumor cells.Results The GEO database screening showed that Hsa-circ-0101216 was up-regulated in GEM-resistant pancreatic cancer cell lines.Pancreatic cancer GEM-resistant cell lines were successfully constructed,and the expression levels of Hsa-circ-0101216 and the IC50 value in GEM-resistant pancreatic cancer cells BxPC-3-GEM and Capan-1-GEM were significantly higher than those in parental cells(P<0.05).In sh-circ-0101216 group,the IC50 values of GEM,cell viability,EdU positivity rate,and the expression levels of MRP1 and BCRP proteins in GEM-resistant pancreatic cancer cells BxPC-3-GEM and Capan-1-GEM were significantly lower than those in blank control group and sh-NC group,while the expression level of hENT-1 protein was significantly higher(P<0.05 or P<0.001).In sh-circ-0101216+GEM group,the weight and volume of subcutaneous xenograft tumors in nude mice,the expression levels and positive expression rates of MRP1 and BCRP proteins in tumor tissues,and the EdU positive rate were significantly lower than those in sh-NC+GEM group,while the expression level and positive expression rate of hENT-1 protein were significantly higher(P<0.05).Conclusions Hsa-circ-0101216 is highly expressed in GEM-resistant pancreatic cancer cell lines.Its knockdown can inhibit the proliferation of pancreatic cancer cells and enhance the chemosensitivity of pancreatic cancer cells to GEM.The mechanism may be related to the regulation of transmembrane transporter protein expression.

Objective To investigate the therapeutic effects and underlying mechanisms of Ganluqingwen formula on lipopolysaccharide(LPS)-induced acute lung injury/acute respiratory distress syndrome(ALI/ARDS)in mice.Methods Fifty ICR mice were randomly divided into five groups:control,model,and Ganluqingwen formula(GLQW)low dose(7.10 g/kg),medium dose(15.21 g/kg),and high dose(30.42 g/kg)groups,with 10 mice per group.On days 1-3,mice in GLQW groups were daily gavaged with the corresponding dose of GLQW,while control and model groups received equal volumes of saline.On day 4,ALI/ARDS was induced in model and GLQW groups using intraperitoneal injection of LPS(20 mg/kg),while control group received an equal volume of PBS.At 24 h post-treatment,survival rate,wet-to-dry weight ratio(W/D)and lung histological changes(HE staining)were observed.Serum levels of tumor necrosis factor(TNF)-α,interferon gamma(IFN-γ),interleukin(IL)-4,IL-10,IL-12,as well as lung tissue levels of TNF-α,IFN-γ,IL-1β,IL-4,IL-6,IL-10 were measured by ELISA.Western blotting was used to determine the expression levels of NOD-like receptor thermal protein domain associated protein 3(NLRP3),cystatinase-1(Caspase-1),apoptosis-associated speck-like protein(ASC),and membrane perforating protein Gasdermin D(GSDMD)in lung tissue.Results No significant differences in survival rates were observed among the groups(P>0.05).Compared with control group,ELISA and Western blotting results showed that lung tissue W/D,IFN-γ,TNF-α,IL-4,IL-12,IL-1β,IL-6,NLRP3,ASC,and Caspase-1,GSDMD and serum IFN-γ,TNF-α,IL-4,IL-12 levels were significantly higher(P<0.05),and IL-10 levels in lung tissue and serum were significantly lower in mice of model group(P<0.05).Compared with model group,lung tissue W/D,IFN-γ,TNF-α,IL-1β,IL-4,IL-6,IL-12,NLRP3,ASC,Caspase-1,and GSDMD,and serum IFN-γ,TNF-α,IL-4,and IL-12 levels were significantly lower(P<0.05),and lung tissue IL-10 levels were significantly higher(P<0.05)in GLQW low,medium,and high dose groups,with high-dose group showing significantly higher level in serum IL-10(P<0.05).Compared with GLQW low-dose group,the lung tissue levels of IFN-γ,IL-6,NLRP3,ASC,Caspase-1,and GSDMD,and serum TNF-α were significantly lower(P<0.05),and lung and serum IL-10 levels were significantly higher in GLQW high-dose group(P<0.05).HE staining results showed that lung structure was clear and normal in control group;part of the lung interstitium was congested and hemorrhagic,and some of the fine bronchial periphery was infiltrated with inflammatory cells in model group;the phenomena of lung interstitial congestion and hemorrhage were reduced,and the degree of infiltration of inflammatory cells was alleviated in GLQW low-,medium-,and high-dose groups.Conclusion Ganluqingwen formula can delay the development of ALI/ARDS in mice by inhibiting NLRP3/Caspase-1/GSDMD pathway,thereby suppressing cellular pyroptosis.

Objective To analyze the relationship between obesity indicators,muscle mass indices and hypertension in Dongxiang adults,and establish and evaluate a Nomogram model based on these indicators used to predict the risk of hypertension in this population.Methods A total of 1209 Dongxiang adults from Linxia Prefecture,Gansu Province were selected,11 obesity indicators and 5 muscle mass indicators,including neck circumference(NC),waist-to-hip ratio(WHR),BMI,ponderal index(PI),conicity index(CI),a body shape index(ABSI),body roundness index(BRI),abdominal volume index(AVI),hip index(HI),body adiposity index(BAI),and the ratio of limb fat mass to body weight(LFWR),appendicular skeletal muscle mass(ASM),appendicular skeletal muscle mass index(ASMI),appendicular skeletal muscle mass to BMI ratio(ASMBMI),skeletal muscle index(SMI),and trunk muscle mass to body weight ratio(TMWR)were measured.Logistic regression analysis was used to explore the relationship between each indicator and hypertension.Nomogram prediction model was constructed and validated by using R language.Results Among Dongxiang males,the NC,BMI,PI,WHR,CI,AVI,BRI,BAI,ASM,ASMI,and LFWR were lower in the normal and high-normal blood pressure groups compared to the hypertensive group,while SMI,ASMBMI,and TMWR were higher.Among females,similar trends were observed,with lower NC,BMI,PI,WHR,CI,AVI,BRI,BAI,and LFWR in the normal blood pressure and high-normal blood pressure groups compared to the hypertensive group,but SMI,ASMBMI,and TMWR higher than the hypertensive group(P＜0.05).Results of multivariate Logistic regression analysis indicated that age,NC,and WHR were risk factors for hypertension in Dongxiang adults,while was protective factor(P＜0.05).The area under curve(AUC)of the Nomogram model constructed based on these factors was 0.796,and the Bootstrap internal validation C-index was 0.7957,indicating good calibration of the model.Conclusion The Nomogram model constructed based on obesity and muscle mass indicators has good predictive efficiency for predicting the risk of hypertension in Dongxiang adults.