Breast cancer is a malignant tumor that occurs in the glandular epithelium of the breast, and it is one of the most common tumors that seriously affect the physical and mental health of women. With the aggravation of population aging, the incidence of breast cancer in the elderly has increased year by year in recent years. Elderly patients with breast cancer often have a variety of underlying diseases, and their prognosis is usually related to many factors such as cancer staging, cancer classification, treatment status and health status, with a significant difference in survival rate among patients. Due to the unique clinical and pathological characteristics of elderly patients with breast cancer compared to young and middle-aged patients, there are many studies on the treatment of elderly breast cancer patients in the past, and there are few reviews on the influencing factors of prognosis in elderly patients. This paper reviews the research progress of influencing factors of prognosis in elderly patients with breast cancer from the aspects of clinicopathological factors, treatment options and prognosis factors, in order to provide a reference for clinical determination of treatment options for elderly patients with breast cancer in the future.

Objective:To estimate the radiation dose to caregivers and the public from 177Lu- peptide receptor radionuclide therapy (PRRT) for pediatric neuroblastoma patients and determine the duration of contact restrictions, in order to provide a reference for relevant radiation protection measures. Methods:A retrospective study was conducted by collecting data from 18 pediatric neuroblastoma patients, aged between 3 and 13 (6.72±2.72), who received 177Lu-1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid-D-Phe1-Tyr3-Thr8-octreotide (DOTATATE) treatment at the Nuclear Medicine Department of Shandong Cancer Hospital from June 2023 to July 2023. Absorbed dose rate in air at 0, 0.1, 0.5, 1 and 2 m from the patients was measured using a radiation-survey at 1, 4, 24, 48 and 96 h after administration. The whole-body region of interest was delined using HERMES software. Subsequently, curve regression fitting was performed using a biexponential function model. By incorporating hypothesized social contact durations, the effective doses received by family members and the public in contact with patients were estimated. Additionally, MIM software was used to outline the whole-body VOI to obtain the total volume of lesions, and the Pearson or Spearman correlation coefficient was employed to analyze the relationship between the absorbed dose rate in air and clinical indicators as well as the total volume of lesions. Results:The 177Lu-DOTATATE administration dose was (4 353.42±1 451.51) MBq. All patients were discharged from hospital 24 h after 177Lu-DOTATATE administration. At the time of discharge, patients had excreted (76.70±3.99)% of the administered activity, and the absorbed dose rate in air at 0.1, 1 and 2 m from the patients were (32.74±6.98), 3.68(3.01, 4.70) and (1.22±0.51) μSv/h, respectively. After being discharged, the radiation doses to caregivers from children aged 2-5 years and 5-13 years were (2.47±1.80) mSv and (0.88±0.47) mSv, respectively. The contact restriction duration was 2 d for nighttime sleeping with family members and 1 d for contact with other children. On the day of discharge, patients should limit their time on public transportation within 4 h and do not need to restrict private transportation. Conclusions:To ensure the effective dose kept within the safety limits stipulated by current regulations, it is necessary to implement contact restrictions for patients’ family members and the public. After implementing preventive measures, 177Lu-DOTATATE treatment is a safe radionuclide therapeutic option.

Objective To explore the value of serum long non-coding RNA KCNQl opioid strand transcript 1(lncRNA KCNQ1OT1)and fibroblast growth factor 2(FGF2)in the evaluation of the condition and control level of pediatric bronchial asthma.Methods 96 children with bronchial asthma(Asthma group)and 76 healthy children(Control group)admitted to Yulin Hospital of Traditional Chinese Medicine from March 2021 to March 2023 were selected.According to the severity of bronchial asthma,the children were divided into a mild group(n=54)and a severe group(n=42).According to the disease control status after treatment,the children were divided into an asthma Control group(n=61)and an uncontrolled Asthma group(n=35).The serum levels of lncRNA KCNQ1OT1 and FGF2 were detected in each group.Multivariate Logistic regression analysis was performed to identify the factors affecting bronchial asthma disease control.The performance of lncRNA KCNQ1OT1 and FGF2 in predicting the control of bronchial asthma disease was evaluated using the receiver operating characteristic curve.Results The serum levels of lncRNA KCNQ1OT1(2.35±0.71)and FGF2(27.35±6.29 pg/ml)in the Asthma group were higher than those in the Control group(1.51±0.33,15.32±4.08 pg/ml),and the differences were statistically significant(t=9.527,14.437,all P<0.001).The serum levels of lncRNA KCNQ1OT1(2.59±0.35)and FGF2(28.65±1.03 pg/ml)in the severe group were higher than those in the mild group(2.16±0.41,26.34±1.24 pg/ml),and the differences were statistically significant(t=5.429,9.737,all P<0.001).The serum levels of lncRNA KCNQ1OT1(2.63±0.27)and FGF2(29.02±1.41 pg/ml)in the uncontrolled asthma group were higher than those in the controlled asthma group(2.19±0.35,26.39±1.52 pg/ml),and the differences were statistically significant(t=5.417,8.374,all P<0.001).High lncRNA KCNQ1OT1 and FGF2 levels were risk factors for uncontrolled disease in children with bronchial asthma(all P<0.05).The AUC of lncRNA KCNQ1OT1 and FGF2 combined to predict uncontrolled disease in children with bronchial asthma,which was higher than of lncRNA KCNQ1OT1 and FGF2 alone,and the differences were statistically significant(Z=3.250,2.096,all P<0.05).Conclusion Serum lncRNA KCNQ1OT1 and FGF2 are both elevated in children with bronchial asthma,which is related to the worsening of bronchial asthma and uncontrolled disease.Combining lncRNA KCNQ1OT1 and FGF2 can predict the level of bronchial asthma disease control.

Objective To explore the characteristics of incorrect opinions in re-examination cases,analyze the reasons,characteristics,and commonalities of different forensic opinions in the same injury case during re-examination,and provide references for similar case acceptance,forensic procedures,analysis and argumentation,and the application of relevant provisions.Methods A retrospective analysis was conducted on the re-examination cases of human injury degree accepted by the Forensic Judicial Appraisal Center of Guizhou Medical University and West China Forensic Medical Appraisal Center of Sichuan University from January 2020 to December 2024.Results Among the 81 collected re-examination cases of human injury degree,the injury types mainly included fractures,soft tissue injuries,tendon injuries,craniocerebral injuries,nerve injuries,joint injuries,and organ injuries.Of these,74 cases were entrusted by the public security system,and 72 cases used primary injuries as the basis for assessment.Seven cases had more than 3 appraisals and 74 cases had two appraisals,of which 53 cases had inconsistent opinions between the previous and current appraisals,including 29 cases with an upgraded injury grade and 24 cases with a downgraded injury grade.Conclusion When accepting re-examination cases,forensic experts need to choose relevant objective examination techniques in forensic clinical medicine,such as clinical imaging techniques,to determine whether imaging data serves as key evidence in the case,and seek assistance from experts in related fields when necessary.In the case acceptance stage,it is necessary to collect and review key assessment materials such as medical records,the first assessment opinion,and interrogation records.Forensic experts should also enhance their understanding of legal provisions,timing of assessment,their image-reading ability,and work to standardize the forensic assessment process.

Objective:To analyze the relationship between folate and thyroid antibody in early pregnancy and adverse pregnancy outcome in pregnant women with hypothyroidism during pregnancy.Methods:The data of 97 pregnant women with hypothyroidism from Jul. 2020 to Mar. 2023 in the Obstetrics Department of Liaocheng Second People’s Hospital were retrospectively analyzed. The levels of folate, thyroglobulin antibody (TGAb) and thyroid peroxidase antibody (TPOAb) were detected in the first trimester. According to whether adverse pregnancy outcome occurred in pregnant women with hypothyroidism during pregnancy, they were divided into occurrence group and non-occurrence group. The clinical data of the occurrence group and the non-occurrence group were compared. Logistic regression was used to analyze the influencing factors of adverse pregnancy outcomes in pregnant women with hypothyroidism during pregnancy, and receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of folic acid, TGAb, TPOAb and their combination on adverse pregnancy outcomes in pregnant women with hypothyroidism during pregnancy.Results:Among 97 pregnant women, the incidence of adverse pregnancy outcome was 14.43% (14/97) .The folate level in the occurrence group was lower than non-occurrence group ( P<0.05) , and the TGAb and TPOAb levels in the occurrence group were higher than non-occurrence group ( P<0.05) . The occurrence group with alanine aminotransferase (ALT) , glutamine transpeptidase (GGT) and aspartate aminotransferase (AST) were all higher than non-occurrence group ( P<0.05) .The folate, TGAb, and TPOAb levels were factors influencing adverse pregnancy outcomes in pregnant women with hypothyroidism ( P<0.05) . The area under the curve (AUC) values of folate, TGAb, TPOAb and their combined prediction of adverse pregnancy outcomes in pregnant women with hypothyroidism during pregnancy were 0.804, 0.843, 0.799, 0.909 ( P<0.05) , while the combined three with AUC values were higher ( P<0.05) . Conclusion:The folate, TGAb and TPOAb levels in early pregnancy can be used to evaluate adverse pregnancy outcomes in hypothyroidism pregnant women, and the combination of the three has a higher evaluation value.

Objective To explore the characteristics of incorrect opinions in re-examination cases,analyze the reasons,characteristics,and commonalities of different forensic opinions in the same injury case during re-examination,and provide references for similar case acceptance,forensic procedures,analysis and argumentation,and the application of relevant provisions.Methods A retrospective analysis was conducted on the re-examination cases of human injury degree accepted by the Forensic Judicial Appraisal Center of Guizhou Medical University and West China Forensic Medical Appraisal Center of Sichuan University from January 2020 to December 2024.Results Among the 81 collected re-examination cases of human injury degree,the injury types mainly included fractures,soft tissue injuries,tendon injuries,craniocerebral injuries,nerve injuries,joint injuries,and organ injuries.Of these,74 cases were entrusted by the public security system,and 72 cases used primary injuries as the basis for assessment.Seven cases had more than 3 appraisals and 74 cases had two appraisals,of which 53 cases had inconsistent opinions between the previous and current appraisals,including 29 cases with an upgraded injury grade and 24 cases with a downgraded injury grade.Conclusion When accepting re-examination cases,forensic experts need to choose relevant objective examination techniques in forensic clinical medicine,such as clinical imaging techniques,to determine whether imaging data serves as key evidence in the case,and seek assistance from experts in related fields when necessary.In the case acceptance stage,it is necessary to collect and review key assessment materials such as medical records,the first assessment opinion,and interrogation records.Forensic experts should also enhance their understanding of legal provisions,timing of assessment,their image-reading ability,and work to standardize the forensic assessment process.

Objective:To summarize clinical and genotypic features, treatment, and prognosis of children with Dent disease.Methods:A retrospective case-series study was conducted on 15 children with Dent disease at the Nephrology Department of Beijing Children′s Hospital, Capital Medical University from January 2008 to June 2024.The patients were divided into a type Ⅰ Dent disease group and a type Ⅱ Dent disease group according to the type of mutated genes.The clinical and genotypic characteristics, treatment, and prognosis were described.Then, the treatment effect of the disease was analyzed using the t-test or Wilcoxon rank-sum test. Results:All 15 children were boys, and the average onset age was 4.45 years.The illness struck each child insidiously at first, and it was complicated by nephrolithiasis/nephrocalcinosis (66.7%), short stature (46.7%), and rickets (20.0%).There was no significant difference in urine protein or calcium levels between the 2 groups.However, the type Ⅰ Dent group had more severe clinical symptoms than the type Ⅱ Dent group.Renal biopsy results indicated that lesions affected both tubules and glomeruli.The children were diagnosed with thylakoid hyperplasia, glomerulosclerosis, and in certain cases, glomerular adhesions, pedunculated fusions, and crescents.Of the 15 children, 11 had CLCN5 gene variations, and 4 had OCRL gene variations.Five mutants found in this study were reported for the first time.Up to the end of the follow-up, 24-hour urinary calcium[0.26 (0.22, 0.36) mmol/(kg·d) vs.(0.12±0.05) mmol/(kg·d), P<0.001], Ratio of urine calcium to creatinine[(0.36±0.16) mg/mg vs.(0.26±0.13) mg/mg, P=0.043], 24-hour urinary protein[74.34 (65.63, 79.26) mg/(kg·d) vs.59.88 (56.77, 64.23) mg/(kg·d), P=0.002], and urinary β2-microglobulin/creatinine levels[33.85 (12.26, 43.37) vs.(10.47±7.55) mg/mg, P=0.001] after treatment were significantly lower than those before treatment.The differences in urinary protein/creatinine and urinary α1-microglobulin/creatinine levels were not significant before and after treatment.Two children in the type Ⅰ Dent group experienced a progressive deterioration in renal function during follow-up, and they progressed to chronic kidney disease (CKD) stages 3 and 5, respectively. Conclusions:Dent disease can affect both tubules and glomeruli.The clinical symptoms of type Ⅰ Dent disease are severer than type Ⅱ Dent disease.Dent disease, mainly brought on by mutations in the CLCN5 gene.Whole-exon gene testing is an effective method of validating a diagnosis and helps in early detection, classification, and treatment of Dent disease.There is currently no specific treatment available for this disease.Symptomatic treatment can reduce urine calcium and protein levels and rectify electrolyte imbalances, but it may not prevent further impairment of renal function.Most children have normal kidney function and a good prognosis, with a small percentage progressing to CKD.

AIM:To investigate the effects of total flavonoids of Pterocarya hupehensis Skan(PHSTF)on dex-tran sulfate sodium(DSS)-induced ulcerative colitis(UC)mouse model and lipopolysaccharide(LPS)-stimulated RAW264.7 macrophages.METHODS:Thirty-six male C57BL/6J mice(6 to 8 weeks old,SPF grade)were randomly di-vided into 6 groups:negative control(NC)group,3%DSS-induced model group,mesalazine(300 mg·kg-1·d-1)group,and low-dose(62.5 mg·kg-1·d-1),medium-dose(125 mg·kg-1·d-1)and high-dose(250 mg·kg-1·d-1)PHSTF treatment groups,with 6 mice in each group.The mice in NC group received distilled water,while those in other groups were treated with a 3%DSS solution for 7 d to induce the UC model.On the 1st day of DSS administration,the mice in treatment groups received the corresponding agents via oral gavage for 10 d,while those in NC and model groups were gavaged with distilled water.Throughout the study,the effects of PHSTF on body weight,fecal blood,and colon length were measured and recorded daily.Histopathological changes in colon tissues were assessed using hematoxylin-eosin staining.The levels of the pro-inflammatory cytokine interleukin-1β(IL-1β)and the anti-inflammatory cytokine IL-10 in colon tissues were quantified using ELISA.The LPS-induced RAW264.7 macrophage model was employed to evaluate the cellular effects of PHSTF.Cell viability was assessed by CCK-8 assay,and cell morphology was observed under a microscope.The mRNA expression of inflammatory markers[IL-1β,inducible nitric oxide synthase(iNOS),IL-10 and arginase-1(Arg-1)]was measured by RT-qPCR.Western blot and immunofluorescence double labeling were used to detect the protein expression of macrophage polarization markers(iNOS,CD206 and Arg-1).Finally,immunohistochemistry(IHC)was utilized to as-sess protein expression of iNOS in colon tissues.RESULTS:Compared to the DSS-induced UC model group,PHSTF sig-nificantly improved several parameters,including weight loss(P<0.05),rectal bleeding,and colon shortening in DSS-treated mice.PHSTF also reduced histopathological damage and inflammatory cell infiltration in the colon.It decreased IL-1β levels(P<0.05)and increased IL-10 levels(P<0.05)in colon tissues.In LPS-induced RAW264.7 cells,PHSTF reduced the mRNA expression of IL-1β and iNOS(P<0.01),while upregulating the mRNA expression of IL-10 and Arg-1(P<0.01).Additionally,PHSTF decreased iNOS protein expression(P<0.01)and elevated the expression of Arg-1 and CD206 proteins(P<0.01).IHC analysis further confirmed that PHSTF downregulated iNOS protein expression in colon tissues.CONCLUSION:Treatment with PHSTF promotes the polarization of macrophages from the pro-inflammatory M1 phenotype to the anti-inflammatory M2 phenotype,thereby alleviating inflammation in colon tissue and ameliorating ulcer-ative colitis in mice.

Under stress,the cold-inducible RNA-binding protein(CIRP)is translocated from the nucleus to the cytoplasm and subsequently released outside the cell.Extracellular CIRP(eCIRP),acting as a damage-associated mo-lecular pattern,amplifies inflammation through various mechanisms and leads to an uncontrolled inflammatory response,thereby contributing to the occurrence and progression of sepsis and other critical pathological processes.Certain CIRP-tar-geting drugs have demonstrated promising anti-sepsis effects through the reduction of CIRP expression,the decrease of eCIRP release,the neutralization of eCIRP,or the intervention in receptor binding.This review examines the release mechanism of CIRP and the role of eCIRP in the development of sepsis,with the aim of providing new insights for the pre-vention and treatment of sepsis by targeting eCIRP.

Objective To investigate the relationship between the mean platelet volume(MPV)to platelet count(PLT)ratio(MPV/PLT),blood urea nitrogen(BUN)to lipoprotein a[Lp(a)]ratio[BUN/Lp(a)]and the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods A total of 106 patients with acute exacerbation of COPD admitted to the hospital from January 2021 to January 2024 were selected as the research objects.According to the prognosis,they were divided into sur-vival group(72 cases)and death group(34 cases).The results of routine laboratory tests,blood lipid and lipo-protein levels were compared between the two groups.Multivariate Logistic regression was used to analyze the influencing factors of death in patients with acute exacerbation of COPD.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of MPV/PLT and BUN/Lp(a)for the prognosis of pa-tients with acute exacerbation of COPD.Results Compared with the survival group,the invasive ventilation rate,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,C reactive protein(CRP),white blood cell count(WBC),MPV,BUN,MPV/PLT and BUN/Lp(a)were significantly increased in the death group(P＜0.05).The non-invasive ventilation rate,lymphocyte count,PLT and Lp(a)levels were signifi-cantly decreased(P＜0.05).Multivariate Logistic regression analysis showed that APACHE Ⅱ score,CRP,WBC,lymphocyte count,MPV,PLT,MPV/PLT,BUN,Lp(a)and BUN/Lp(a)were the influencing factors of death in patients with acute exacerbation of COPD(P＜0.05).ROC curve results showed that the sensitivity and specificity of MPV/PLT combined with BUN/Lp(a)for predicting the prognosis of patients with acute exacerbation of COPD were 88.2％and 84.7％,respectively,and the area under curve was 0.887.Conclusion MPV/PLT and BUN/Lp(a)are closely related to the prognosis of patients with acute exacerbation of COPD.The combination of MPV/PLT and BUN/Lp(a)has a high predictive value for the prognosis of patients.