Breast cancer， as one of the major cancers threatening women's health globally， is characterized by high aggressiveness， high malignancy， and poor prognosis. In 2022， according to the World Health Organization， breast cancer ranked second in the incidence of female cancers globally， accounting for 11.6% of all new cancer cases. Western medical doctors mainly use surgery， chemotherapy， radiotherapy， endocrine therapy， and molecular targeted therapy to treat breast cancer， which can effectively improve the recurrence rate and death rate of breast cancer patients and prolong the survival period of patients. However， its treatment process is often accompanied by a series of side effects， which bring challenges to patients' quality of life. However， traditional Chinese medicine （TCM） has demonstrated significant therapeutic effects in inhibiting the proliferation and metastasis of breast cancer cells， reducing toxic side effects produced by chemotherapy， and improving patients' survival rate and quality of life. It is therefore particularly necessary to investigate the pharmacological effects and mechanisms of TCM in breast cancer treatment. The authors combed the pharmacological effects and mechanisms of the etiology and pathogenesis of breast cancer， identification and treatment of breast cancer， TCM compound， TCM single medicine， TCM monomer， and external treatment of TCM to prevent and control breast cancer and found that TCM has a therapeutic effect on breast cancer. It can play a role in increasing the effectiveness， reducing the toxicity， and alleviating the adverse reactions. It can inhibit breast cancer cell proliferation， cell cycle， migration， invasion， immune escape， epithelial-mesenchymal transition （EMT）， aerobic glycolysis， mitochondrial biosynthesis， aminoacyl-tRNA biosynthesis， reduce drug resistance， promote apoptosis， ferroptosis， cell autophagy， and regulate the tumor immune microenvironment by regulating signaling pathways. This paper aims to provide new ideas and methods for experimental research and clinical treatment of breast cancer.

OBJECTIVE To study effects of Jinshui Liujun decoction(JLD) on pulmonary water metabolism and TNF-α/NF-κB signaling pathway in asthmatic mice. METHODS After 1 week of acclimatization, 10 mice were randomly selected by body weight as a blank control group, and the rest of the mice were sensitized by intraperitoneal and subcutaneous injections of ovalbumin sensitizing solution on the 1st, 8th, and 15th day of the experiment. On the 22nd day, they were randomly divided into model control group, positive control group and JLD low, medium and high dose(4.1, 8.2, 16.4 g·kg−1) group, and replicated the asthma mouse model by inhaling nebulized excitation solution(1% ovalbumin) once every other day for 2 consecutive weeks, and at the same time, were given atomized excitation solution(1% ovalbumin) every other day for two weeks to replicate the asthmatic mouse model, and were given the test drug by gavage daily. The effects of JLD on the behavior, lung wet-dry weight ratio, AQP1, AQP5, TNF-α, NF-κB, and NF-κB mRNA expression in asthmatic mice were observed. RESULTS JLD reduced the number of animals with asthma attacks, alleviated asthma symptoms, decreased the lung index and lung wet-to-dry weight ratio, increased the expression level of AQP1 and AQP5 in lung tissues, reduced the content of TNF-α in bronchoalveolar lavage fluid and lung tissues, and down-regulated the expression level of NF-κB and its genes in lung tissues(P<0.05 or P<0.01). CONCLUSION JLD has an anti-asthma effect and its mechanism of action is partially due to its inhibition of the TNF-α/NF-κB signaling pathway, upregulation of AQP1 and AQP5, and improvement of pulmonary water metabolism.

Objective:To explore the genetic background for a patient with refractory myelodysplastic/myeloproliferative neoplasm (MDS/MPN) with co-morbid neutrophilia patient.Methods:A MDS/MPN patient who was admitted to the First Affiliated Hospital of Nanjing Medical University in May 2021 was selected as the study subject. RNA sequencing was carried out to identify fusion genes in his peripheral blood mononuclear cells. Fusion gene sequence was searched through transcriptome-wide analysis with a STAR-fusion procedure. The novel fusion genes were verified by quantitative real-time PCR and Sanger sequencing.Results:The patient, a 67-year-old male, had progressive thrombocytopenia. Based on the morphological and molecular examinations, he was diagnosed as MDS/MPN with co-morbid neutropenia, and was treated with demethylating agents and Bcl-2 inhibitors. Seventeen months after the diagnosis, he had progressed to AML. A novel fusion gene NCOR1: : GLYR1 was identified by RNA-sequencing in his peripheral blood sample, which was verified by quantitative real-time PCR and Sanger sequencing. The patient had attained morphological remission after a DCAG regimen (a combinatory chemotherapy of decitabine, cytarabine, aclarubicin and granulocyte colony-stimulating factors) plus Chidamide treatment. A significant decrease in the NCOR1: : GLYR1 expression was revealed by quantitative real-time PCR at post-chemotherapy evaluation. Conclusion:NCOR1: : GLYR1 gene is considered as the pathogenic factor for the MDS/MPN patient with neutropenia.

Endodontic diseases are a kind of chronic infectious oral disease.Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha.However,it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy(RCT).Recent research,encompassing bacterial etiology and advanced imaging techniques,contributes to our understanding of the root canal system's anatomy intricacies and the technique sensitivity of RCT.Success in RCT hinges on factors like patients,infection severity,root canal anatomy,and treatment techniques.Therefore,improving disease management is a key issue to combat endodontic diseases and cure periapical lesions.The clinical difficulty assessment system of RCT is established based on patient conditions,tooth conditions,root canal configuration,and root canal needing retreatment,and emphasizes pre-treatment risk assessment for optimal outcomes.The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT.These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.

Objective To investigate the effect of esketamine combined with erector spinae plane block(ESPB)on the quality of early postoperative recovery in patients undergoing thoracoscopic pulmonary surgery.Methods Ninety patients who underwent thoracoscopic lung surgery(thoracoscopic radical resec-tion of lung cancer,thoracoscopic lobectomy or segmentectomy)from May 2022 to July 2023 were selected,47 males and 43 females,aged 18-64 years,BMI 18-25 kg/m2,ASA physical statusⅠorⅡ.According to random number table method,the patients were divided into two groups:the ESPB group(group C)and the esketamine combined with ESPB group(group D),45 patients in each group.Patients in the two groups completed ultrasound-guided ESPB,followed by sufentanil anesthesia induction and patient-controlled intra-venous analgesia(PCIA)in group C,while esketamineanesthesia induction,maintenance,and PCIA in group D.The intraoperative dosage of anesthetics,numerical rating scale(NRS)score during activity 1 hour,6,12,24,and 48 hours after operation,the number of PCIA compressions within 24 hours after op-eration,the number of rescue analgesia after operation,the recovery time of anesthesia,the incidence of postoperative nausea and vomiting within 2 days after operation and the adverse reactions related to esket-amine were recorded.The 40-item recovery quality scale(QoR-40)score was used to evaluate the quality of recovery of patients 1 day before operation and 2 days after operation.The hospital anxiety and depression scale(HADS)was used to assess patients anxiety and depression 1 day before surgery and at discharge.Results Compared with group C,the dosage of propofol and remifentanil intraoperatively,the incidence of postoperative nausea and vomiting were decreased(P＜0.05),the QoR-40 score was increased 2 days after operation,HADS score at discharge was decreased in group D(P＜0.05).Conclusion Esketamine combined with ESPB is safe and effective for patients undergoing thoracoscopic lung surgery.The periopera-tive analgesia is perfect,the adverse reactions are few,and the quality of early recovery is high,which pro-vides a new anesthesia choice for such surgery.

Purpose To investigate the clinicopathological features and prognosis of alpha-fetoprotein-producing colorectal carcinoma(AFPCRC).Methods 42 cases of AFPCRC from 2 012 colorectal carcinomas of preoperative serum AFP detected and surgically resected were identified.The clinicopathological data of AFPCRC and other 42 cases of conventional colorectal carcinoma exactly matched for age,gender,stage were also col-lected.Immunohistochemical EnVision method was performed to detect the expression of HER2,MMR,p53,AFP,Glypican3,and SALL4.Cases presenting HER2 2+were further analyzed by fluorescence in situ hybridization.Elastic staining was per-formed in cases with ambiguous extramural venous invasion.The clinicopathlogical features and prognosis between two groups were compared.Cases with AFPCRC were divided into high-AFP group and low-AFP group.The clinicopathological features and prognosis of the two groups were compared.Results AF-PCRC accounted for 2.1％(42/2 012)of colorectal carcinoma in the same period.The frequency of extramural vascular inva-sion and moderate/high grade of tumor budding of AFPCRC was 35.7％and 61.9％,while that of control group was 14.3％and 40.5％respectively.The 5-year survival rate of AFPCRC and control group was 66.8％and 85.1％respectively.The differ-ence of aforementioned clinicopathological features between 2 groups was significant(P＜0.05).The proportion of tumor in rectum in the high-AFP group was significantly higher than that in the low-AFP group(61.9％vs 23.8％,P＜0.05).Conclu-sion AFPCRC is a rare subset of colorectal carcinoma,which has a propensity for extramural vessel invasion,moderate-or high-grade of tumor budding and poor prognosis.

Objective To explore the changes in early serum calcium,serum phosphorus,and calcium-phosphorus product levels in patients with fractures and analyze their correlation with the fracture site.Methods 1 049 patients with fractures admitted to Sichuan Province Orthopedic Hospital from January 2021 to November 2023 were selected as the research subjects.According to the fracture location,they were roughly divided into two groups:upper body fracture(n=478)and lower body fracture(n=571).Carefully divided into ten groups:vertebral fracture(n=108),clavicle fracture(n=109),upper limb fracture(n=106),hand fracture(n=104),femoral neck fracture(n=103),femoral intertrochanteric fracture(n=106),patella fracture(n=101),lower limb fracture(n=103),foot fracture(n=105)and other fractures(n=104).Another 110 cases of healthy physical examination people during the same period were selected as the control group.Venous blood was drawn from all patients twice on the day of emergency within 24 to 48 hours after admission,serum calcium and serum phosphorus were measured,and the calcium-phosphorus product was calculated.Compare the changes in the levels of the three and analyzed their correlation with the fracture site.Results Compared with the control group,the serum calcium(2.27±0.12 mmol/L,2.19±0.12 mmol/L vs 2.35±0.10mmol/L),serum phosphorus(1.00±0.20mmol/L,1.08±0.19mmol/L vs 1.15±0.15mmol/L),and calcium-phosphorus product(28.10±6.00mg/dl,29.30±5.85mg/dl vs 33.41±4.87mg/dl)of fracture patients were all reduced on the day of emergency and 24 to 48 hours after admission,and the differences were statistically significant(t=6.804,12.501;7.475,3.722;8.964,7.115,all P＜0.01).Comparing upper and lower body fractures,serum calcium,serum phosphorus,and calcium-phosphorus product on the emergency day was lower in lower body fracture than in upper body fracture(t=4.129,5.931,6.660,all P＜0.01),24 to 48 hours after admission,only the serum calcium and calcium-phosphorus product were lower in lower body fracture than in upper body fracture(t=6.432,1.990,all P＜0.05),and the differences were statistically significant,respectively.Comparing along the time axis,24 to 48 hours after admission compared with the emergency day,both upper and lower body fractures showed a decrease in serum calcium and an increase in serum phosphorus(t=12.779,-5.730;16.919,-14.358),calcium-phosphorus product only increased in lower body fracture(t=-8.860),and the differences were statistically significant(all P＜0.01),respectively.Compared with the day of emergency,24 to 48 hours after admission for patients with fractures in different parts,except for vertebral fracture,serum calcium in the other nine groups decreased(t=6.233～11.349,all P＜0.01),except for upper limb fracture and hand fracture,the serum phosphorus in the other eight groups increased(t=-7.770～-3.327,all P＜0.01),the calcium-phosphorus product of vertebral fracture,femoral neck fracture,femoral intertrochanteric fracture,lower limb fracture,foot fracture,and other fractures increased(t=-5.819～-2.927,all P＜0.01),and the differences were statistically significant,respectively.Conclusion The serum calcium,serum phosphorus,and calcium-phosphorus product of patients with fractures all decreased on the day of emergency.24 to 48 hours later,the serum calcium of most patients continued to decrease while the serum phosphorus and calcium-phosphorus product gradually increased.The degree of change in their levels was related to the fracture site.

Objective:To analyze the genetic variations and clinical phenotypic characteristics of epilepsy associated with CSNK2B gene mutations. Methods:A case series summary study.Clinical data of 15 epileptic children with CSNK2B gene mutations diagnosed and treated at the Third Affiliated Hospital of Zhengzhou University and the Peking University First Hospital from February 2016 to October 2023 were retrospectively analyzed.The clinical manifestations, genotypes, and electroencephalography (EEG) results were summarized. Results:Among the 15 children (8 boys and 7 girls), 14 cases had de novo mutations in the CSNK2B gene, and 1 case had hereditary variations.There were 5 missense variants, 4 splice-site variants, 3 frameshift variants, and 3 nonsense variants.Ten mutation sites had not been previously reported (c.326G>A/p.Cys109Tyr, c.485A>G/p.His162Arg, c.368-1G>A, c.464A>C/p.Asp155Ala, c.301T>G/p.Tyr101Asp, c.342T>A/p.Cys114*, c.198del/p.Asn67Thrfs*5, c.292-10T>G, c.573-574del/p.Lys191Asnfs*54, and c. 11C>G/p.Ser4*).The age of onset of seizures ranged from 14 days to 6 years, with 13 cases starting within 2 years old.The types of seizures included focal seizures in 9 cases, generalized tonic-clonic seizure (GTCS) in 5 cases, myoclonic seizures in 1 case, atonic seizures in 1 case, atypical absence seizures in 1 case, and epileptic seizures in 1 case.Three cases had multiple seizures, and 4 cases had cluster seizures.The EEG showed slow background activity in 1 case.Epileptiform discharges were observed in 13 cases during the interictal phase, including generalized discharges in 6 cases, multifocal discharges in 3 cases, and focal discharges in 5 cases.Two cases had normal EEG findings.Brain magnetic resonance imaging results were normal in 10 cases.The age of the last follow-up ranged from 1 year and 1 month to 13 years and 10 months.Seizures were controlled in 12 cases treated with 1 or 2 antiepileptic drugs, while seizures persisted in 2 cases treated with multiple antiepileptic drugs, and 1 case suffered no seizures for 1 year and 3 months, without antiepileptic drug treatment.Oxcarbazepine was effective in 5 cases (5/7), Valproate sodium was effective in 6 cases (6/8), and Levetiracetam was effective in 3 cases (3/9). Conclusions:CSNK2B gene mutations are mainly de novo mutations, and epilepsy triggered by them typically starts within 2 years of age.GTCS and focal seizures are the most common types.The seizures of most children are easily controlled with the effective treatment of Oxcarbazepine, Valproate sodium, and Levetiracetam.

The aim of the present study was to investigate the protective mechanism of Forsythia suspensa extracts(FSE)on S.aureus-induced inflammatory injury of rat mammary epithelial cells.Fifty lactating rats were selected and randomly divided into five groups with 10 rats each:the blank control group(the fourth pair of mammary glands were injected with saline),the model group(the fourth pair of mammary glands were injected with 100 pL of S.aureus bacterial solution),the high-dose group(the fourth pair of mammary glands were injected with S.aureus bacterial solu-tion for 24 h,and then the rats were administered by gavage of 3.750 g/(kg·d)FSE for 1-7 d),the medium-dose group(24 h after the fourth pair of mammary injections,the rats were adminis-tered by gavage 1.875 g/(kg·d)FSE for 1-7 d),and in the low-dose group(24 h after the fourth pair of mammary injections,the rats were administered by gavage 0.935 g/(kg·d)FSE for 1-7 d),blood samples were collected 24 h after the last administration of the drug and then the rats were executed.The results showed that the mammary tissue of the model group was severely dam-aged,and the mRNA expression of IKKβ,MyD88,NF-κB,and TLR4 was significantly increased in the mammary tissue(P＜0.05).The relative expression of IKKβ,MyD88,NF-κB,and TLR4 pro-teins in the mammary tissue of the model group was significantly decreased(P＜0.05)by medium and high doses of FSE compared with the model group.Therefore,FSE may play an anti-inflammatory role by inhibiting the Toll-like signaling pathway to improve S.aureus-induced inflammatory re-sponse in rat mammary epithelial cells and decrease the expression of the downstream pathway proteins IKKβ,MyD88,NF-κB,and TLR4.