Objective: To investigate the current status of latent tuberculosis infection (LTBI) among freshmen in junior and senior high schools in Lanzhou, so as to provide scientific basis for improving the tuberculosis prevention and control strategy in schools. Methods: The screening results of 74 516 freshmen in senior and boarding junior high schools in Lanzhou during 2023 and 2024 were collected. The Chi square test and multivariate Logistic regression model were applied to analyze LTBI level, strongly positive risk for tuberculin skin test (TST) and related factors of the freshmen. Results: During 2023 and 2024, the screening rate of tuberculosis among freshmen in senior and boarding junior high schools in Lanzhou was 93.45%, of which the positive rate for TST was 5.71%, the infection rate for LTBI was 3.80%, and the strongly positive rate for TST was 1.24%. There were statistically significant differences in the screening rate of tuberculosis among freshmen in different years, grades, regions, school types and districts ( χ 2=5.34, 2 463.88, 3 516.13, 132.34, 4 436.56, all P <0.05). Multivariate Logistic regression analysis showed that senior high schools ( OR =1.62, 2.18) and urban areas ( OR =2.08, 3.07 ) were all related factors for LTBI and strong positivity for TST among freshmen; schools located in Xigu District, Honggu District, Yongdeng County, Yuzhong County, and Lanzhou New Area ( OR =3.57, 5.67, 9.12, 3.70, 3.64) were related factors of strong positivity for TST among freshmen (all P <0.05). Conclusions The LTBI level among freshmen in senior and boarding junior high schools in Lanzhou is relatively low. Grades and regions are related factors for LTBI and strong positivity for TST.

Objective To analyze the overall characteristics, research hotspots, and development trends of immune cell-related studies in radiotherapy for rectal cancer. Methods A systematic search was conducted by using Web of Science Core Collection to retrieve articles related to radiation therapy and immune cells in rectal cancer published from 1991 to 2024. Advanced bibliometric tools, such as VOSviewer and CiteSpace, were utilized to facilitate analysis and describe publication trends, geographic contributions, institutional affiliations, journal prominence, author collaboration, and prominent keywords. Results The annual number of relevant publications has increased steadily, showing remarkable growth over the past five years. Studies focusing on adaptive immune cells (T and B cells) account for the largest proportion of works and form the most extensive collaboration networks, reflecting the central role of T cell–mediated antitumor immunity in radiotherapy. Meanwhile, innate immune cells, including myeloid-derived suppressor cells, macrophages, monocytes, and neutrophils, are increasingly investigated for their regulatory roles in shaping the tumor immune microenvironment and influencing therapeutic responses. Among countries, China and the United States have contributed the highest number of publications and demonstrated strong academic influence. While several stable research groups have been formed, intergroup collaboration remains limited. Keyword analysis revealed that radiotherapy-induced immune modulation, tumor immune microenvironment remodeling, and treatment response have emerged as major research hotspots. Conclusion Research on immune cells in rectal cancer radiotherapy has progressed rapidly in recent years. The emphasis of this field has gradually shifted from single-treatment approaches to mechanistic studies investigating the interaction between radiotherapy and the tumor immune microenvironment. The field still demonstrates considerable potential for future research and clinical translational applications.

Objective:To explore the effect of Danggui Shaoyao Powder(DGSYP)on the Toll-like receptor 4(TLR4)/Myeloid differen-tiation factor 88(MyD88)/Nuclear factor-κB(NF-κB)signaling pathway in ulcerative colitis(UC)rats.Methods:Forty-eight male SD rats were randomly divided into 6 groups:normal group,model group,DGSYP low-dose group(11.61 g/kg),medium-dose group(23.22 g/kg),high-dose group(46.44 g/kg)and salazosulapyridine group(0.36 g/kg).There were 8 rats in each group.In addition to the normal group,the rats in other groups were induced by 5%sodium trinitrobenzene sulfonate(TNBS)to establish a UC rat model.After successful modeling,each drug treatment group continued to administer the intervention for 14 days.At the same time,the rats in the normal group and the model group were given equal volume of nor-mal saline.The disease activity index(DAI)score was calculated.hematoxylin-eosin(HE)staining was used to observe the histo-pathological changes in the colon of rats.The levels of interleukin-6(IL-6),IL-1β,and tumor necrosis factor α(TNF-α)in colon tissue were measured by enzyme-linked immunosorbent assay(ELISA).Real-time fluorescence quantitative polymerase chain re-action(RT-qPCR)was used to detect the mRNA expression levels of TLR4,MyD88 and NF-κB p65 in colon tissues.The expression levels of TLR4,MyD88 and NF-κB in colon tissues were detected by Western blot(WB).Results:Compared with the normal group,the DAI score of the model group was increased,the colon was shortened,the histopathological changeswere obvious.The levels of in-flammatory factors IL-6,IL-1β and TNF-α in colon tissue of model group were significantly increased(P<0.01),the mRNA and pro-tein expressions of TLR4,MyD88 and NF-κB p65 were also significantly increased(P<0.05,P<0.01).Compared with the model group,the above disease-related conditions of rats in each treatment group of DGSYP were improved to varying degrees,DAI fraction decreased significantly(P<0.05),colon growth,no obvious edema or edema degree decreased,the histopathological changes of colon were improved to varying degrees.The levels of inflammatory factors IL-6,IL-1β and TNF-α in colon tissues were significantly de-creased(P<0.01),and the mRNA and protein expressions of TLR4,MyD88 and NF-κB p65 were significantly decreased(P<0.05,P<0.01).Conclusion:DGSYP can regulate the TLR4/MyD88/NF-κB signaling pathway,thereby reducing the release of inflammatory fac-tors,and then alleviating the degree of inflammatory damage in the colon of UC rats.

Objective To investigate the efficacy of combined prediction of postpartum hypertension using 24-h urinary protein quantification(24-hUP),hematocrit and plasma albumin difference(HCT-ALB),and brain natriuretic peptide(BNP)in patients with severe preeclampsia at the end of pregnancy.Methods A retrospective study was conducted using cluster sampling to select 540 patients with severe preeclampsia from the University City Hospital affiliated to Chongqing Medical University between January 2018 and December 2022.Patients were divided into a hypertension group(n=98)and a non-hypertension group(n=442)based on the occurrence of postpartum hypertension.Clinical data[age,body mass index(BMI),maternal type,abortion history,family history of hypertension,smoking history,total cholesterol(TC),triglyceride(TG),fasting blood glucose(FBG),systolic blood pressure(SBP),diastolic blood pressure(DBP)]and levels of 24-hour urinary protein excretion(UP),hematocrit-albumin(HCT-ALB),and BNP in the third trimester of pregnancy were compared between the two groups to analyze the predictive value of these indicators for postpartum hypertension.Results The levels of BMI,family history of hypertension,TC,TG,FBG,SBP and DBP in hypertensive group were higher than those in non-hypertensive group[(25.63±1.37)kg/m2 vs(23.05±1.23)kg/m2,70.41%vs 30.54%].(5.32±1.14)mmol/L vs(3.91±0.95)mmol/L,(3.48±0.82)mmol/L vs(1.66±0.43)mmol/L,(7.24±1.60)mmol/L vs(4.83±1.22)mmol/L,(148.27±13.29)mmHg vs(127.65±10.71)mmHg,(92.36±5.17)mmHg vs(84.20±4.35)mmHg],the difference was statistically significant(P<0.05).The levels of urinary protein,HCT,HCT-ALB and BNP at 24 h at the end of pregnancy in hypertension group were also higher than those in non-hypertension group[(7.82±2.18)g/24 h vs(6.15±1.26)g/24 h,(34.22±3.15)%vs(32.80±1.77)%].(6.19±2.01)vs(3.46±0.90),(646.43±170.59)pg/mL vs(523.81±134.62)pg/mL],while ALB level was lower than that of the non-hypertension group[(28.03±1.13)g/L vs(29.34±1.44)g/L],with statistically significant differences(P<0.05).There was a positive correlation between 24-hUP,HCT,HCT-ALB,BNP and SBP,DBP,while ALB was negatively correlated with SBP and DBP,the difference was statistically significant(P<0.05).24-hUP,HCT-ALB and BNP at the end of pregnancy were independent risk factors for postpartum hypertension,with a combined prediction AUC of 0.930(95%CI:0.905～0.950),a Jordon index of 0.719,sensitivity of 85.71%,the specificity of 86.20%.The AUC of the combined prediction was significantly greater than that of each individual predictor,with statistically significant differences(P<0.05).Conclusion 24-hUP,HCT-ALB,and BNP at the end of pregnancy are independent risk factors for postpartum hypertension.Their combined predictive efficacy is significantly superior to that of individual indicators and can be used as an optimal clinical method for predicting whether patients with severe preeclampsia will develop postpartum hypertension.

Objective To construct a hybrid decision-making model that integrates knowledge-driven and data-driven approaches,and to apply it to the etiological diagnosis of ventricular tachycardia(VT).Methods Clinical practice guidelines,expert consensus documents,and medical literature in the field of ar-rhythmia diseases from 2018 to 2023 were retrieved as knowledge sources.Retrospective electronic medical re-cord data of VT patients from Fuwai Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College,from 2013 to 2023 were collected as the dataset.A knowledge-driven model was constructed using a knowledge-rule-based approach to establish clinical pathways.A three-class machine learning model for VT eti-ology diagnosis was developed based on real-world data,and the best-performing model was selected as the rep-resentative of the data-driven approach.The machine learning model was embedded into the decision nodes of the clinical pathway in the form of custom operators,forming the hybrid model.The precision,recall,and F1 score of the three models were evaluated.Results Three clinical practice guidelines were included as knowl-edge sources for the knowledge-driven model.A total of 1305 patient records were collected as the dataset,and five machine learning models were constructed,with the XGBoost model performing the best.The hybrid model adopted a knowledge-driven decision-making framework,embedding the XGBoost model into the decision nodes of a two-level classification.The precision,recall,and F1 scores of the three models were as follows:the knowledge-driven model achieved 80.4％,79.1％,and 79.7％;the data-driven model achieved 88.4％,88.5％,and 88.4％;and the hybrid model achieved 90.4％,90.2％,and 90.3％.Conclusions The hybrid model integrating knowledge-driven and data-driven approaches demonstrated higher accuracy,and all its deci-sion outcomes were based on evidence-based practices,aligning more closely with the actual diagnostic reason-ing of clinicians.Further rigorous validation is needed to assess the feasibility of widely applying the hybrid model in the medical field.

BACKGROUND:Spinal cord injury is a serious neurological disease that often results in severe neurological impairment. Oxidative stress is an important link in the pathological process after spinal cord injury,leading to neuronal cell death and loss of function. In recent years,natural products have shown potential application values in the treatment of oxidative stress after spinal cord injury due to their wide range of sources,diverse structures and rich biological activities. OBJECTIVE:To discuss the therapeutic effects of some natural products on oxidative stress after spinal cord injury and the related mechanisms,in order to provide new ideas and directions for antioxidant therapy of spinal cord injury. METHODS:"Spinal cord injury,oxidative stress,anti-oxidation,natural products,natural compounds,polyphenols" were used as the English and Chinese keywords in PubMed,Web of Science,Embase,Cochrane,VIP,CBM,WanFang,and CNKI databases to search relevant articles published from database inception to May 2024. Inclusion and exclusion criteria were developed,and 97 relevant articles were selected by reading titles,abstracts,and full texts. RESULTS AND CONCLUSION:Natural products such as polyphenols can directly scavenge oxidative free radicals by the phenol hydroxyl group in their structure,and alleviate oxidative stress after spinal cord injury. Some natural products can enhance the activity of relevant antioxidant enzymes in vivo and reduce oxidative stress by regulating certain signal transduction pathways. Some natural products can reduce oxidative stress after spinal cord injury by enhancing autophagy. The use of natural products to regulate oxidative stress may become an effective tool for the future clinical treatment of spinal cord injury.

This study investigated the prevalence of hepatitis E virus(HEV)in rodents within the Inner Mongolia Autonomous Region.In 2024,liver,spleen,kidney,and lung tissue samples were collected from rodents in 11 leagues and cities across the Inner Mongolia Autonomous Region,including Hohhot,Baotou,Hulunbuir,Xing'an League,Tongliao,Chifeng,Xilin Gol League,Ulan-qab,Ordos,Bayannur,and Wuhai.Nested PCR(RT-PCR)was used to detect the conserved regions of the HEV open reading frame 1(ORF1)gene.The RT-PCR-positive products were sequenced,and phylogenetic and homology analysis of the obtained sequences was performed.A total of 816 rodents were captured in this investigation,including 319 Rattus norvegicus(39.09%,319/816),206 Musmusculus(25.25%,206/816),and 140 Mongolian gerbils(17.16%,140/816).The HEV infection rate among rodents in the In-ner Mongolia region was 3.68%(30/816).Sequencing of the RT-PCR-positive results and analysis of the nucleotide sequences yielded 30 HEV-positive rodent samples.Phylogenetic analysis identified these sequences as belonging to the HEV-C1 genotype.The prevalence of HEV was observed in brown rats(Rattus norvegicus)in five leagues and cities within the Inner Mongolia region,includ-ing Xing'an League,Chifeng City,Hulunbuir City,Xilin Gol League,and Tongliao City,with infection rates of 16.67%,10.00%,5.98%,3.30%,and 2.50%,respectively.Brown rats,a species of house rats,frequently inhabit areas near human residences and have close interactions with humans and livestock.Studies have shown that multiple subtypes of HEV can cause zoonotic infections.Therefore,strengthening the monitoring of pathogens carried by rodents in residential environments and optimizing the prevention and control of rodent-borne diseases will be essential.Timely dissemination of relevant infectious disease knowledge to local communities will also be crucial,to decrease the risk of human infection.

Objective:To explore the changes of the Curative Care Expenditure(CCE)of outpatient and inpatient among local cancer patients and foreign cancer patients before and after the comprehensive reform of medical-pharmaceutical Separation and linkage of medical consumption in Beijing.Methods:According to A System of Health Accounts 2011(SHA 2011),multi-stage stratified sampling and multi-stage stratified sampling were used to analyze the CCE of cancer patients in Beijing from 2016 to 2019.Results:Compared with 2016,the proportion of drugs in the CCE of local residents in secondary hospitals and tertiary hospitals in 2019 decreased by 8.62 and 9.26 percentage points,respectively,and the proportion of drugs in the CCE of foreign patients in secondary hospitals and tertiary hospitals decreased by 5.60 and 5.66 percentage points,respectively.The consumption of local and nonlocal patients in tertiary hospitals decreased by 6.89 and 8.86 percentage points.In Beijing,the proportion of outpatient services in local secondary hospitals for patients increased from 30.32%to 35.09%,and the proportion of inpatient services increased from 43.25%to 52.27%.The proportion of in-patient services in tertiary hospitals for patients with external medical treatment increased to 91.91%after the comprehensive reform of linkage of medical consumption.Conclusion:The comprehensive reform on drug standard and consumption proportion are remarkable,and the flow of patients from different sources of cancer was optimized by comprehensive medical reform,but it is necessary to strengthen the role of primary medical institutions in cancer prevention and treatment and focus on the medical burden of non-local patients in Beijing.

Triple-negative breast cancer (TNBC) remains a refractory subtype of breast cancer due to its resistance to various therapeutic strategies. In this study, we introduce a "brake-release and accelerator-pressing" approach to engineer a microneedle patch embedded with copper-doped Prussian blue nanoparticles (Cu-PB) and the ferroptosis inducer sorafenib (SRF) for raised chemodynamic (CDT)/photothermal (PTT) combination therapy against TNBC. Upon transdermal insertion, the dissolving microneedles swiftly disintegrate and facilitate the release of SRF. Under gentle external light exposure, copper ions (Cu²⁺) and iron ions (Fe³⁺) were liberated from Cu-PB. The direct chelation of Cu²⁺ and the indirect suppression by SRF, collectively attenuate glutathione peroxidase 4 (GPX4) enzymatic function, destabilizing the cellular redox equilibrium (referred to as the "brake-release" strategy). The release of Cu²⁺ and Fe³⁺ ions instigates a Fenton/Fenton-like reaction within tumor cells, further yielding hydroxyl radicals and elevating reactive oxygen species (ROS) concentrations (referred to as the "accelerator-pressing" strategy). This overwhelming ROS accumulation, coupled with the impaired clearance of resultant lipid peroxides (LPO), ultimately triggers a robust ferroptosis cell death response. In summary, this study presents an innovative combinatorial therapeutic strategy based on dual-ferroptosis induction for TNBC, implying a promising therapeutic platform for developing ferroptosis-centered treatments for this aggressive breast cancer subtype.

To summarize the nursing care of a case of thrombotic microangiopathy complicated late pregnancy with intrahepatic cholestasis of pregnancy resulting in fetal demise.Nursing interventions include:to optimize the maternal status,reduce the risk of induction of labor;to assess the cervical conditions,and complete the preparations for childbirth;to ensure the safety of childbirth and prevent and treat postpartum hemorrhage;to standardize blood purification,promote the recovery of renal function;to pay attention to breast conditions and be vigilant against the occurrence of mastitis;to provide grief care for perinatal loss.After careful treatment and care,the patient was discharged after 25 d of hospitalization,and the prognosis was good at 1-month follow-up after discharge.