ObjectiveTo investigate the effects of Qizhujianwei granules （QZJW） on abnormal proliferation and malignant transformation of gastric mucosal cells in rats with gastric intraepithelial neoplasia （GIN） and to explore the related mechanisms. MethodsA total of 80 SPF male Wistar rats were used. A GIN rat model was established using a four-factor comprehensive method consisting of methylnitronitrosoguanidine （MNNG）， ranitidine， irregular feeding patterns， and sodium salicylate. Except for the normal group， after successful modeling， the rats were randomly divided according to body weight into a model group， a Moluodan group （0.55 g·kg^-1）， and a QZJW group （7.34 g·kg^-1）， with 12 rats in each group. All groups were treated for 8 weeks. The general characteristics of the rats and morphological changes of the gastric mucosa were observed. Histopathological changes of the gastric mucosa were examined by hematoxylin-eosin （HE） staining. Enzyme-linked immunosorbent assay （ELISA） was used to detect serum levels of pepsinogenⅠ （PGⅠ）， pepsinogenⅡ （PGⅡ）， and gastrin （G-17）， as well as the expression level of transforming growth factor-β₁ （TGF-β₁） in gastric mucosal tissue， and the PGⅠ/PGⅡ ratio was calculated. Immunohistochemistry （IHC） was used to detect the localization and expression levels of proliferating cell nuclear antigen （Ki-67） and Vimentin in gastric mucosal tissue. Western blot analysis was used to determine the protein expression levels of Wnt family member 3A （Wnt3a）， β-catenin， CyclinD₁， proto-oncogene Cmyc， transforming growth factor-β receptor Ⅰ （TGFβRⅠ）， intracellular signaling transducers Smad2/3， phosphorylated （p）-Smad2/3， twist family transcription factor （Twist1）， and Vimentin in gastric mucosal tissue. ResultsCompared with the normal group， the model group showed characteristic changes including dim eyes， pale ears and claws， dark-red tongue， and reduced luster of the tail. The gastric mucosa appeared pale， with surface congestion and erosion. The gastric mucosal glands were disordered， the nuclear-to-cytoplasmic ratio increased， and local tumor cells were observed. Serum PGⅠ and PGⅡ levels and the PGⅠ/PGⅡ ratio were significantly decreased （P<0.01）， while the level of G-17 was significantly increased （P<0.01）. The protein expression levels of Ki-67， Wnt3a， β-catenin， CyclinD₁， Cmyc， TGF-β₁， TGFβRⅠ， Smad2/3， Twist1， and Vimentin in gastric mucosal tissue were significantly increased （P<0.05， P<0.01）， whereas the ratio of p-Smad2/3 to Smad2/3 was significantly decreased （P<0.05）. Compared with the model group， the general characteristics and gastric mucosal conditions of rats in the Moluodan group and the QZJW group were improved. HE staining showed that QZJW could effectively block the malignant progression of GIN. Serum PGⅠ and PGⅡ levels and the PGⅠ/PGⅡ ratio were significantly increased （P<0.05， P<0.01）， while the level of G-17 was significantly decreased （P<0.01）. The protein expression levels of Ki-67， Wnt3a， β-catenin， CyclinD₁， Cmyc， TGF-β₁， TGFβRⅠ， Smad2/3， Twist1， and Vimentin in gastric mucosal tissue were significantly decreased （P<0.05， P<0.01）. ConclusionQZJW have a therapeutic effect on rats with GIN. The mechanism may involve inhibition of the Wnt/β-catenin signaling pathway to regulate the cell cycle and suppress abnormal cell proliferation. Meanwhile， it may inhibit epithelial-mesenchymal transition by suppressing the TGF-β₁/Smad/Twist1 signaling pathway， thereby blocking the malignant progression of GIN.

ObjectiveTo investigate the effects of Qizhujianwei granules （QZJW） on abnormal proliferation and malignant transformation of gastric mucosal cells in rats with gastric intraepithelial neoplasia （GIN） and to explore the related mechanisms. MethodsA total of 80 SPF male Wistar rats were used. A GIN rat model was established using a four-factor comprehensive method consisting of methylnitronitrosoguanidine （MNNG）， ranitidine， irregular feeding patterns， and sodium salicylate. Except for the normal group， after successful modeling， the rats were randomly divided according to body weight into a model group， a Moluodan group （0.55 g·kg^-1）， and a QZJW group （7.34 g·kg^-1）， with 12 rats in each group. All groups were treated for 8 weeks. The general characteristics of the rats and morphological changes of the gastric mucosa were observed. Histopathological changes of the gastric mucosa were examined by hematoxylin-eosin （HE） staining. Enzyme-linked immunosorbent assay （ELISA） was used to detect serum levels of pepsinogenⅠ （PGⅠ）， pepsinogenⅡ （PGⅡ）， and gastrin （G-17）， as well as the expression level of transforming growth factor-β₁ （TGF-β₁） in gastric mucosal tissue， and the PGⅠ/PGⅡ ratio was calculated. Immunohistochemistry （IHC） was used to detect the localization and expression levels of proliferating cell nuclear antigen （Ki-67） and Vimentin in gastric mucosal tissue. Western blot analysis was used to determine the protein expression levels of Wnt family member 3A （Wnt3a）， β-catenin， CyclinD₁， proto-oncogene Cmyc， transforming growth factor-β receptor Ⅰ （TGFβRⅠ）， intracellular signaling transducers Smad2/3， phosphorylated （p）-Smad2/3， twist family transcription factor （Twist1）， and Vimentin in gastric mucosal tissue. ResultsCompared with the normal group， the model group showed characteristic changes including dim eyes， pale ears and claws， dark-red tongue， and reduced luster of the tail. The gastric mucosa appeared pale， with surface congestion and erosion. The gastric mucosal glands were disordered， the nuclear-to-cytoplasmic ratio increased， and local tumor cells were observed. Serum PGⅠ and PGⅡ levels and the PGⅠ/PGⅡ ratio were significantly decreased （P<0.01）， while the level of G-17 was significantly increased （P<0.01）. The protein expression levels of Ki-67， Wnt3a， β-catenin， CyclinD₁， Cmyc， TGF-β₁， TGFβRⅠ， Smad2/3， Twist1， and Vimentin in gastric mucosal tissue were significantly increased （P<0.05， P<0.01）， whereas the ratio of p-Smad2/3 to Smad2/3 was significantly decreased （P<0.05）. Compared with the model group， the general characteristics and gastric mucosal conditions of rats in the Moluodan group and the QZJW group were improved. HE staining showed that QZJW could effectively block the malignant progression of GIN. Serum PGⅠ and PGⅡ levels and the PGⅠ/PGⅡ ratio were significantly increased （P<0.05， P<0.01）， while the level of G-17 was significantly decreased （P<0.01）. The protein expression levels of Ki-67， Wnt3a， β-catenin， CyclinD₁， Cmyc， TGF-β₁， TGFβRⅠ， Smad2/3， Twist1， and Vimentin in gastric mucosal tissue were significantly decreased （P<0.05， P<0.01）. ConclusionQZJW have a therapeutic effect on rats with GIN. The mechanism may involve inhibition of the Wnt/β-catenin signaling pathway to regulate the cell cycle and suppress abnormal cell proliferation. Meanwhile， it may inhibit epithelial-mesenchymal transition by suppressing the TGF-β₁/Smad/Twist1 signaling pathway， thereby blocking the malignant progression of GIN.

Ferroptosis is a form of programmed cell death,which plays a crucial driving role in the onset and progression of diabetic nephropathy(DN).Ferroptosis is closely related to the damage of renal intrinsic cells in patients with diabetes.Chinese materia medica can improve DN by regulating the ferroptosis of renal intrinsic cells,with a good research and application prospect.This article reviewed the key regulatory factors and regulatory pathways of ferroptosis in DN,explained the"imbalance between yin and yang"of ferroptosis in DN based on TCM theories,and combed the research status of targeted inhibition of ferroptosis by active components of Chinese materia medica.The regulation of active components of Chinese materia medica on ferroptosis in DN has the characteristics of multiple targets,multiple links and integrity,which can provide a reference for the mechanism research and drug development of Chinese materia medica in treating DN.

Ferroptosis is a form of programmed cell death,which plays a crucial driving role in the onset and progression of diabetic nephropathy(DN).Ferroptosis is closely related to the damage of renal intrinsic cells in patients with diabetes.Chinese materia medica can improve DN by regulating the ferroptosis of renal intrinsic cells,with a good research and application prospect.This article reviewed the key regulatory factors and regulatory pathways of ferroptosis in DN,explained the"imbalance between yin and yang"of ferroptosis in DN based on TCM theories,and combed the research status of targeted inhibition of ferroptosis by active components of Chinese materia medica.The regulation of active components of Chinese materia medica on ferroptosis in DN has the characteristics of multiple targets,multiple links and integrity,which can provide a reference for the mechanism research and drug development of Chinese materia medica in treating DN.

OBJECTIVE To analyze occupational exposure to sharps injuries among medical staff in different posi-tions in a three-A hospital.METHODS A retrospective collection of all sharps injury cases reported from 2018 to 2023 in a general hospital was conducted.The basic characteristics,high-risk links,involved instruments,post-exposure emergency treatment and follow-up situations were analyzed,while sharps injury characteristics of medi-cal staff in different positions were classified and discussed.RESULTS Over six years,340 sharps injuries occurred with the highest incidence among interns(2.70 cases/100 FTE·year)and the lowest among logistics staff(1.05 cases/100 FTE·year).Jun.was the month with the highest incidence,averaging 7.33 cases.High-risk links in-cluded instruments handling,placing instruments into sharp containers and removing needles from rubber or other barriers,accounting for 76.47%.Nurses experienced injuries mostly occurred in general wards and were related to scalp needles;doctors mostly occurred in operating rooms and were due to surgical instruments;interns were pri-marily injured by blood collection needles;pharmacists and medical technicians were related to ampoule handling;while logistical staff were mostly injured by hollow needles and glass fragments from waste disposal.Nurses and doctors were the main injured groups,with a higher incidence among females(25-<35 years)and males(less than five years of work experience).The exposure source was mainly hepatitis B virus(HBV)infection.Post-ex-posure treatment was primarily standardized emergency treatment,but a higher proportion of non-standardized treatment was observed among logistics staff.Follow-up reports showed that interns and logistical staff had lower submission rates and lower training coverage.CONCLUSIONS Significant differences exist in sharps injury charac-teristics among medical staff in different positions.Attention should be paid to position-specific high-risk links and instruments.Targeted training and occupational health management should be strengthened to effectively prevent occupational exposure.

OBJECTIVE The non-volatile and volatile chemical components in Yin-Qiao-Qing-Re Tablets were analyzed sepa-rately using ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF-MS/MS)and Gas Chromatography Mass Spectrometry(GC-MS).METHODS The non-volatile components were analyzed using a Waters ACQUITY UPLC BEH C18 column(2.1 mm×100 mm,1.7 μm),with a mobile phase consisting of 0.1％formic acid aqueous solution(A)and acetonitrile(B)for gradient elution,a flow rate of 0.35 mL·min-1,an injection volume of 5 μL,and a column temperature of 30 ℃;the volatile components were analyzed using an Agilent SH-I-5MS column(5％Phenyl Methyl Silox,30 m×250 μm,0.25 μm);the procedure was temperature-programmed,with an injection volume of 1 μL,a split ratio of 10∶1,a flow rate of 1.0 mL·min-1,and an inlet temperature of 200 ℃.RESULTS A total of 134 non-volatile chemical components and 23 volatile components were analyzed and identified from Yin-Qiao-Qing-Re Tablets,among which 49 compounds were confirmed through comparison with reference stand-ards.The non-volatile components mainly include 27 flavonoids,21 organic acids,15 lignans,14 iridoids,12 phenylethanoid glyco-sides,11 saponins,10 alkaloids,5 terpenes,4 amino acids,3 phenylpropanoids,3 nucleosides,3 xanthones,3 phenolic glycosides,2 chromones and 1 carbohydrate.The volatile components mainly include 11 monoterpenes,5 alcohols and phenols,3 alkenes,2 ke-tones,1 ester,and 1 hydrocarbon.CONCLUSION This study rapidly identifies the chemical components of Yin-Qiao-Qing-Re Tablets,laying a preliminary foundation for research on the pharmacodynamic substances of Yin-Qiao-Qing-Re Tablets and the im-provement of quality control standards.

Objective The objective of this study was to analyze the disease burden trend of leukemia in children and ado-lescents aged 0-19 years in China from 1990 to 2021,and to provide a scientific evidence for the disease prevention and control strat-egy of this population.Methods The disease burden of leukemia in children and adolescents in China(excluding Taiwan)was ana-lyzed using the Global Burden of Disease Database 2021(GBD 2021),including incidence,prevalence,mortality,and disability-ad-justed life year(DALY).DALY consisted of two parts:years of life lost(YLL)and years lived with disability(YLD).The average an-nual percentage change(AAPC)was used to comprehensively evaluate the changing trends of various indicators from the disease bur-den of childhood leukemia in China from 1990 to 2021.Results In 2021,the age-standardized incidence,prevalence,mortality and DALY rates of the 0-19 years old population in China were 7.33/100,000,51.46/100,000,1.72/100,000,and 142.14/100,000,respectively.Among them,the age-standardized incidence,prevalence,mortality and DALY rates of males were higher than those of females.The incidence,prevalence,mortality and DALY rates of the 0-years old group were higher than those of other age groups.The age-standardized incidence,prevalence,mortality and DALY rates of acute lymphoblastic leukemia(ALL)were higher than those of other leukemia subtypes.From 1990 to 2021,the leukemia age-standardized incidence in the population aged 0 to 19 years did show a significant increase or decrease(AAPC=-0.32%,95%CI:-0.66%-0.02%);the age-standardized prevalence showed a sig-nificant increase(AAPC=3.05%,95%CI:2.68%-3.42%).While age-standardized mortality and DALY rates showed a downward trend(AAPC=-4.27%,95%CI:-4.53%-4.01%;AAPC=-4.3%,95%CI:-4.56%-4.05%).Conclusion From 1990 to 2021,the disease burden of leukemia in children and adolescents aged 0 to 19 years in China is increasing,the burden of death is de-creasing,and the total DALY is decreasing.The burden of leukemia in this group varies greatly among different ages,genders,and leu-kemia subtypes.

Objective The objective of this study was to analyze the disease burden trend of leukemia in children and ado-lescents aged 0-19 years in China from 1990 to 2021,and to provide a scientific evidence for the disease prevention and control strat-egy of this population.Methods The disease burden of leukemia in children and adolescents in China(excluding Taiwan)was ana-lyzed using the Global Burden of Disease Database 2021(GBD 2021),including incidence,prevalence,mortality,and disability-ad-justed life year(DALY).DALY consisted of two parts:years of life lost(YLL)and years lived with disability(YLD).The average an-nual percentage change(AAPC)was used to comprehensively evaluate the changing trends of various indicators from the disease bur-den of childhood leukemia in China from 1990 to 2021.Results In 2021,the age-standardized incidence,prevalence,mortality and DALY rates of the 0-19 years old population in China were 7.33/100,000,51.46/100,000,1.72/100,000,and 142.14/100,000,respectively.Among them,the age-standardized incidence,prevalence,mortality and DALY rates of males were higher than those of females.The incidence,prevalence,mortality and DALY rates of the 0-years old group were higher than those of other age groups.The age-standardized incidence,prevalence,mortality and DALY rates of acute lymphoblastic leukemia(ALL)were higher than those of other leukemia subtypes.From 1990 to 2021,the leukemia age-standardized incidence in the population aged 0 to 19 years did show a significant increase or decrease(AAPC=-0.32%,95%CI:-0.66%-0.02%);the age-standardized prevalence showed a sig-nificant increase(AAPC=3.05%,95%CI:2.68%-3.42%).While age-standardized mortality and DALY rates showed a downward trend(AAPC=-4.27%,95%CI:-4.53%-4.01%;AAPC=-4.3%,95%CI:-4.56%-4.05%).Conclusion From 1990 to 2021,the disease burden of leukemia in children and adolescents aged 0 to 19 years in China is increasing,the burden of death is de-creasing,and the total DALY is decreasing.The burden of leukemia in this group varies greatly among different ages,genders,and leu-kemia subtypes.

Objective:To analyze the clinical features and prognosis of acute B lymphoblastic leukemia (B-ALL) children carrying a TCF3: : PBX1 fusion gene and to evaluate the prognostic value of this gene.Methods:Retrospective cohort study.A total of 2 164 B-ALL children aged 0-18 years diagnosed and treated at 19 pediatric centers from October 2016 to June 2022 were enrolled.They were divided into the positive group and the negative group according to whether they carried a TCF3: : PBX1 fusion gene.The clinical characteristics, treatment response, adverse reactions, and prognosis of the 2 groups of patients were analyzed.The rank sum and Kruskal-Wallis tests were used to compare two and more than two groups of numerical variables, respectively.Fisher′s exact test was used to compare categorical variables.Results:Among the 2 164 patients, 116 (5.4%) were TCF3: : PBX1 positive, of which 70 patients were female, accounting for 60.3%.There were 840 female patients in the TCF3: : PBX1-negative group, accounting for 41.0%.There was a significant difference in the ratio of females between the TCF3: : PBX1-positive and TCF3: : PBX1-negative groups ( P<0.001).No significant difference was observed in age of onset between the two groups( P>0.05).The proportion of bone marrow naive cells [54.00 (14.00, 76.50)% vs.29.00 (3.00, 68.00)%], white blood cell counts [25.30 (10.46, 60.94)×10 9/L vs.9.03 (4.38, 30.73)×10 9/L] and hemoglobin counts [82.00(63.00, 101.00) g/L vs.74.00(60.00, 90.00) g/L] in the TCF3: : PBX1-positive group were significantly higher than those in the negative group at the onset (all P<0.05).In terms of treatment response, the proportion of peripheral blood naive cells on Day 8 in the TCF3: : PBX1-positive group was significantly higher than that in the negative group [2.00 (0, 9.00)% vs.0 (0, 2.00)%, P<0.001].The proportion of minimal residual disease <0.1% on Day 15 in the TCF3: : PBX1-positive group was significantly higher than that in the negative group ( P=0.038).There were no significant differences in cumulative recurrence rate, treatment-related mortality (TRM), and overall survival (OS) between the TCF3: : PBX1-positive group and TCF3: : PBX1-negative group (all P>0.05).The cumulative recurrence risk of TCF3: : PBX1-positive patients was 9.646 times higher than that of ETV6: : RUNX1-positive patients with better prognosis( HR=9.646, 95% CI: 1.026-90.700, P=0.047).There were no significant differences in TRM and OS between TCF3: : PBX1-positive and ETV6: : RUNX1-positive patients (all P>0.05).A significant enrichment of PAX5 mutations was detected in TCF3: : PBX1-positive patients.Among the 7 high-risk TCF3: : PBX1-positive patients in a single center, 4 patients had PAX5 mutations, and this proportion was significantly higher than that in other patients ( P<0.001). Conclusions:B-ALL children carrying a TCF3: : PBX1 fusion gene have a high remission rate and good long-term prognosis after intensive chemotherapy.It is suggesting that TCF3: : PBX1-positive B-ALL patients should be rated at intermediate risk to receive intensive chemotherapy.

OBJECTIVE The non-volatile and volatile chemical components in Yin-Qiao-Qing-Re Tablets were analyzed sepa-rately using ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF-MS/MS)and Gas Chromatography Mass Spectrometry(GC-MS).METHODS The non-volatile components were analyzed using a Waters ACQUITY UPLC BEH C18 column(2.1 mm×100 mm,1.7 μm),with a mobile phase consisting of 0.1％formic acid aqueous solution(A)and acetonitrile(B)for gradient elution,a flow rate of 0.35 mL·min-1,an injection volume of 5 μL,and a column temperature of 30 ℃;the volatile components were analyzed using an Agilent SH-I-5MS column(5％Phenyl Methyl Silox,30 m×250 μm,0.25 μm);the procedure was temperature-programmed,with an injection volume of 1 μL,a split ratio of 10∶1,a flow rate of 1.0 mL·min-1,and an inlet temperature of 200 ℃.RESULTS A total of 134 non-volatile chemical components and 23 volatile components were analyzed and identified from Yin-Qiao-Qing-Re Tablets,among which 49 compounds were confirmed through comparison with reference stand-ards.The non-volatile components mainly include 27 flavonoids,21 organic acids,15 lignans,14 iridoids,12 phenylethanoid glyco-sides,11 saponins,10 alkaloids,5 terpenes,4 amino acids,3 phenylpropanoids,3 nucleosides,3 xanthones,3 phenolic glycosides,2 chromones and 1 carbohydrate.The volatile components mainly include 11 monoterpenes,5 alcohols and phenols,3 alkenes,2 ke-tones,1 ester,and 1 hydrocarbon.CONCLUSION This study rapidly identifies the chemical components of Yin-Qiao-Qing-Re Tablets,laying a preliminary foundation for research on the pharmacodynamic substances of Yin-Qiao-Qing-Re Tablets and the im-provement of quality control standards.