Nasopharyngeal carcinoma （NPC） is a malignant tumor originating from the mucosal epithelium of the nasopharynx. In recent years， its incidence and mortality rates have shown a continuous upward trend， and there is still a lack of therapeutic regimens with both favorable efficacy and safety in clinical practice. Mitogen-activated protein kinase （MAPK） signaling pathway plays a key regulatory role in biological processes such as cell proliferation， differentiation， apoptosis and invasion. It is widely involved in the occurrence and progression of NPC， and serves as an important target in the research field of anti-NPC therapy. This article systematically elaborates on the mechanism of action of the MAPK signaling pathway in NPC， and reviews the research status regarding the anti-NPC effect of active components of traditional Chinese medicine （TCM） and TCM compound prescriptions by regulating this signaling pathway. The results show that TCM active components， including flavonoids （luteolin， maackiain， baicalein， etc.）， alkaloids （picrasidine Ⅰ， tetrandrine， etc.）， terpenoids （bakuchiol， cantharidic acid）， as well as traditional Chinese medicine compound formulas （such as Biyan jiedu capsules and Yiqi jiedu formula） can exert effects including inducing autophagy and apoptosis of NPC cells， promoting pyroptosis， reversing drug resistance， blocking epithelial-mesenchymal transition， weakening cell stemness and arresting cell cycle progression by regulating the MAPK signaling pathway， thereby inhibiting the occurrence and development of NPC through multiple pathways.

ObjectiveTo investigate the effects of modified Xiaoyaosan （JJXYS） on behavioral abnormalities and hippocampal mitochondrial quality control （MQC） in the rat model of post-myocardial infarction depression （PMD） and preliminarily explore its potential mechanism. MethodsA rat model of PMD was established by left anterior descending coronary artery ligation combined with chronic unpredictable mild stress （CUMS）. Rats were randomized into a control group， a model group， a fluoxetine （FLX， 10 mg·kg^-1） group， and low-， medium-， and high-dose JJXYS （JJXYS-L/M/H， 1.12， 2.24， 4.48 g·kg^-1， respectively） groups. Depressive-like behaviors were evaluated by body weight monitoring， sucrose preference test， open field test， and forced swimming test. Hematoxylin-eosin staining and Nissl staining were used to observe hippocampal histomorphology and neuronal changes. Enzyme-linked immunosorbent assay was conducted to determine the serum levels of 5-hydroxytryptamine （5-HT）， dopamine （DA）， interleukin-1 beta （IL-1β）， interleukin-6 （IL-6）， and tumor necrosis factor-alpha （TNF-α）. The mRNA levels of MQC-related genes including peroxisome proliferator-activated receptor-gamma coactivator-1 alpha （PGC-1α）， nuclear respiratory factor 1 （Nrf1）， and transcription factor A， mitochondrial （TFAM） in the hippocampal tissue were measured by real-time PCR. The expression of proteins related to the dynamin-related protein 1 （Drp1）/PTEN-induced putative kinase 1 （PINK1）/Parkin signaling pathway was determined by Western blot. ResultsCompared with the control group， the model group showed restricted body weight gain， aggravated depressive-like behaviors， declined serum 5-HT and DA levels， evident hippocampal neuronal damage and reduced Nissl bodies， as well as downregulated expression of MQC-related genes and proteins （P<0.05）. Compared with the model group， both FLX and JJXYS alleviated the above changes to varying degrees. Moreover， the JJXYS-M and JJXYS-H groups showed more pronounced effects， improving behavioral performance， restoring 5-HT and DA levels， alleviating hippocampal pathological injury， and upregulating the expression of PGC-1α/Nrf1/TFAM mRNA and Drp1/PINK1/Parkin signaling pathway-related proteins （P<0.05）. ConclusionJJXYS can significantly alleviate depressive-like behaviors and neurotransmitter imbalance in the rat model of PMD by regulating hippocampal MQC and upregulating the Drp1/PINK1/Parkin-related pathway. This study provides experimental evidence for the intervention of PMD with JJXYS.

Background: and Purpose Live cell-based assays (LCBA) are increasingly used for serological antibody detection due to their ability to preserve antigen conformation, offering moderately higher sensitivity than fixed cell-based assays. However, the clinical necessity of prioritizing LCBA for the detection of aquaporin-4 immunoglobulin G (AQP4-IgG) in neuromyelitis optica spectrum disorder (NMOSD) remains unclear, especially when compared to its established role in diagnosing myelin oligodendrocyte glycoprotein antibody-associated disease. Methods: We compared the performance of live cell-based assays using immunofluorescence (LCBA-IF) and fixed cell-based assays using immunofluorescence (FCBA-IF) in detecting AQP4-IgG in 90 cases of NMOSD meeting 2015 International Panel for Neuromyelitis Optica Diagnosis criteria, alongside 40 controls. Additionally, we further investigated the relationship between AQP4-IgG titers as measured by LCBA-IF and FCBA-IF and clinical parameters in NMOSD patients. Results: Results showed 96.9% agreement between LCBA-IF and FCBA-IF (Cohen’s κ=0.935), with a strong Spearman correlation (0.977, p<0.001). Both methods demonstrated 100% specificity, with LCBA-IF showing slightly higher sensitivity compared to FCBA-IF. Within LCBAIF-tested groups, statistically significant differences in annualized relapse rates were observed across all pairwise comparisons (low-titer vs. moderate-titer, low-titer vs. high-titer, and moderate-titer vs. high-titer; all p<0.050). However, this association reached statistical significance in some FCBA-IF-tested groups. Conclusions Overall, there is a strong concordance between LCBA-IF and FCBA-IF in detecting AQP4-IgG, where LCBA-IF shows slightly higher sensitivity. Furthermore, there is a potential link between elevated AQP4-IgG titers and an increased risk of relapse, and this correlation may appear more pronounced when using LCBA-IF.

OBJECTIVE To develop a pharmaceutical service model for discharge medication order review and medication education （hereinafter referred to as the “proactive pharmaceutical service model”）， and evaluate its effects. METHODS The data of discharged patients were collected retrospectively from Rheumatology and Immunology Department of our hospital during January to June 2023 and January to June 2024. Patients discharged from January to June 2024 were classified as the intervention group （489 cases）， while patients discharged from January to June 2023 were classified as the control group （535 cases） based on the different pharmaceutical service models they received. The control group received traditional service model， and the intervention group additionally got proactive pharmaceutical service model based on the control group. The primary outcome measures [the number of discharge medications， the number of medication errors， and the occurrence of adverse drug-drug interaction （DDI）] and follow-up outcome measures （the adjustment of medication regimen due to intolerance， unplanned hospital admissions， and proactive seeking of pharmaceutical services after discharge） were compared between the two groups. The discharge medication order review status， the occurrence of adverse DDI in patients with polypharmacy， and bedside medication education status for patients receiving the proactive pharmaceutical service model were all recorded. RESULTS From January to June 2024， a total of 1 052 discharge medication order review for inpatients were reviewed， and 174 instances of medication errors were identified. Polypharmacy was observed in 579 patients， with an incidence rate of 55.04%. The incidence of adverse DDI was significantly higher in patients with polypharmacy compared to those without polypharmacy （P＜0.001）. Pharmacists completed medication guidance for 394 instances of high-risk patients prone to the incidence rate of medication errors at home. The number of discharge medications， the incidence rate of medication errors， instances of medication not matching the diagnosis， dosage and administration errors， adverse DDI， and the incidence rate of patients who required adjustment of medication regimen due to intolerance were all significantly lower in the intervention group compared to the control group （P＜0.05）. Additionally， the incidence rate of patients who proactive seeking of pharmaceutical services after discharge was significantly higher in the intervention group compared to the control group （P＜0.05）. However， there was no significant difference in the incidence rate of unplanned hospital admissions between the two groups （P＞0.05）. CONCLUSIONS The established proactive pharmaceutical service model can reduce medication errors， enhance patient recognition of pharmaceutical services， and ensure medication safety for discharged patients at home.

Thyroid cancer is caused by multiple factors, including genetics, environment, metabolism, and the immune microenvironment, among which ionizing radiation exposure is an important risk factor for thyroid cancer. As one of the most sensitive target organs of ionizing radiation, the thyroid gland may have different risks of thyroid cancer caused by different types of ionizing radiation exposures, such as medical exposure, occupational exposure, and emergency exposure. The sensitivity of children and adolescents are higher than that of adults. The dose-response relationship still needs to be further explored. The molecular mechanism between ionizing radiation and the increased risk of thyroid cancer is complex, which may involve DNA damage and repair abnormalities, gene mutations, non-coding RNA regulation, DNA methylation, cell cycle regulation imbalance, and immune microenvironment changes. This article reviews the risk and molecular mechanisms associated with different types of ionizing radiation exposure in thyroid cancer, based on literature retrieved from CNKI and PubMed databases. It aims to provide a theoretical basis for the early monitoring, prevention, and intervention of thyroid cancer related to ionizing radiation exposure.

Objective:To analyze the association of sedentary time and physical activity with the risk of developing chronic obstructive pulmonary disease (COPD) in non-smoking women aged 40 years and above in Songjiang District, Shanghai.Methods:Based on a natural population-based cohort in Songjiang, a total of 18 707 non-smoking women who were aged 40 years and above and without COPD at baseline survey were enrolled in the study. Cox proportional risk regression model was used to analyze the associations of the duration of sedentary behavior, physical activity with the risk for COPD at baseline survey, and the hazard ratio ( HR) of risk for COPD and its 95% CI were calculated. Stratified analyses were performed based on age, BMI, history of respiratory diseases and so on. Sensitivity analyses were conducted by excluding the cases diagnosed with COPD within one year after the baseline survey. Results:As of March 31, 2024, a total of 691 new COPD cases had been recorded after a median follow-up time of 6.96 years with an incidence density of 53.22 per 10 000 person-years. After adjusting for relevant confounders, in the tertile subgroups of sedentary time, the risk for COPD reduced by 17% in the short sedentary time group compared with the long sedentary time group ( HR=0.83,95% CI:0.70-0.99). Compared with the low physical activity level and long sedentary time group, the risk for COPD reduced by 24% in the high physical activity level and short sedentary time group ( HR=0.76, 95% CI: 0.61-0.95) and by 23% in the low physical activity level and short sedentary time group ( HR=0.77, 95% CI: 0.60-0.97). Compared with the non-physical exercise and long sedentary time group, the risk for COPD reduced by 28% in the non-physical exercise and short sedentary time group ( HR=0.72, 95% CI: 0.60-0.87). These associations remained when the cases diagnosed with COPD within one year of the baseline survey were excluded. Conclusions:Increasing physical activity and reducing sedentary time have beneficial effects to prevent COPD in non-smoking women, and reducing sedentary time alone may also reduce the risk for COPD if increasing physical exercise or other physical activity is not possible.

Objective:To investigate the value of electrical cardiometry(EC),a noninvasive hemodynamic testing technique,in the di-agnosis of heart failure(HF)in adults.Methods:A prospective study was conducted among the adult patients who were hospitalized in Department of Cardiology,The First Affiliated Hospital of Chongqing Medical University,from September 2022 to May 2024,and the patients who were diagnosed with HF were enrolled as HF group,while those who were excluded from the clinical diagnosis of HF were enrolled as control group.The two groups were compared in terms of general clinical data and related parameters measured by EC,in-cluding stroke volume variation(SVV),systolic time ratio(STR),pre-ejection period(PEP),index of contractility(ICON),ICON varia-tion(VIC),left ventricular ejection time(LVET),and left ventricular ejection fraction(LVEF).A multivariate logistic regression model established by the forward method was used to investigate the factors associated with HF.The receiver operating characteristic(ROC)curve was plotted for the hemodynamic parameters measured by EC in the diagnosis of HF,and the area under the ROC curve(AUC)was calculated.Results:A total of 239 patients were enrolled,with 126 in the HF group and 113 in the control group.Compared with the control group,the HF group had significantly higher SVV,STR,PEP,VIC,and age and significantly lower ICON,LVET,and LVEF(all P<0.001).The multivariate logistic regression model estab-lished by the forward method showed that STR(odds ratio[OR]=1.199,95%CI=1.110-1.294,P<0.001),VIC(OR=1.176,95%CI=1.090-1.269,P<0.001),and age(OR=1.068,95%CI=1.010-1.128,P<0.05)were positively correlated with HF,and ICON(OR=0.968,95%CI=0.941-0.996,P<0.05)and LVEF(OR=0.854,95%CI=0.798-0.913,P<0.001)were negatively correlated with HF.The ROC curve analysis showed that STR,VIC,and ICON had an AUC of 0.887(95%CI=0.848-0.927),0.891(95%CI=0.851-0.932),and 0.718(95%CI=0.654-0.782),respectively,in the diagnosis of HF,with an optimal cut-off value of 37.5%,19.5%,and 49.3,respec-tively,a sensitivity of 91.3%,73.8%,and 50.0%,respectively,and a specificity of 61.4%,93.8%,and 86.7%,respectively.Among these indicators,STR combined with VIC had an AUC of 0.940(95%CI=0.912-0.967)in the diagnosis of HF,with a sensitivity of 83.3%and a specificity of 91.2%.Conclusion:The EC method can effectively assess the cardiac functional status of adult patients,and STR combined with VIC has some clinical value for the diagnosis of heart failure.

Objective:To investigate the efficacy and prognosis of biliary drainage via endoscopic retrograde cholangiopancreatography (ERCP) before steroid therapy in treating autoimmune pancreatitis (AIP) complicated with obstructive jaundice.Methods:A retrospective analysis was performed on clinical data of patients with AIP complicated with obstructive jaundice who received steroid therapy at the First Affiliated Hospital of Naval Medical University from 2010 to 2023. Patients were divided into a drainage group (receiving ERCP biliary drainage before steroid therapy) and a steroid group (receiving only steroid therapy). Short-term efficacy, long-term efficacy, hospitalization costs and postoperative complications of ERCP biliary drainage were compared between the two groups.Results:A total of 69 patients were included, with 32 in the drainage group, aged 62.78±11.21 years, which demonstrated significantly higher costs (34 816.57±11 688.85 yuan VS 16 518.50±6 544.37 yuan, t=7.0, P<0.001), with 25.00% (8/32) experiencing ERCP-related complications, compared with 37 patients in the steroid group, aged 55.41±2.15 years. There was no significant difference in hospitalization duration between the drainage group (10.38±4.56 days) and the steroid group (8.95±4.99 days, t=1.2, P=0.219). After 1 month of treatment, total bilirubin [118.5 (76.2, 309.3) μmol/L VS 48.7 (30.5, 148.4) μmol/L, U=1 728.5, P<0.001] and direct bilirubin [84.5 (47.7, 236.3) μmol/L VS 37.7 (18.3, 105.7) μmol/L, U=1 588.5, P=0.001] levels in the drainage group remained higher than those in the steroid group, while alanine aminotransferase levels were lower [74.0 (46.5,110.5) U/L VS 143.0 (51.0,253.5) U/L, U=769.0, P=0.006]. No significant differences were observed in these biochemical indices between the two groups at 4-month and 12-month follow-ups ( P>0.05). The recurrence rates were 28.1% (9/32) in the drainage group and 21.6% (8/37) in the steroid group, with no significant difference in recurrence rate between groups ( χ2=0.4, P=0.266). Conclusion:ERCP biliary drainage does not significantly improve long-term efficacy or reduce recurrence rates in AIP patients with obstructive jaundice. Instead, it increases the risk of postoperative complications and medical costs. Direct steroid therapy is safe and feasible for confirmed AIP with obstructive jaundice.

Objective: To study the effect of metformin sensitizing pancreatic cancer cells with radiotherapy, with a focus on elucidating the underlying mechanisms of radiotherapy resistance. In particular, the role of the PERK/P-eIF2/ATF4 signaling pathway in mediating these effects was preliminarily explored. Methods : Pancreatic cancer cell lines(PANC-1 and PANC-2) were categorized into control, radiotherapy, and drug treatment groups. Following the respective treatments, cell proliferation inhibition was assessed using the CCK-8 assay, colony formation assays, and cell death staining. Senescence was quantified by β-galactosidase(SA-β-Gal) staining. The expression of cell cycle regulators(P21, P16, γ-H2AX), apoptosis markers(Bax, Bcl-2, Cleaved caspase-3), and pathway-related proteins(PERK, P-eIF2, ATF4) was evaluated by Western blot and immunofluorescence. To further investigate the role of the PERK/P-eIF2/ATF4 axis in metformin-mediated modulation of pancreatic cancer cell senescence and radiosensitization, selective inhibitors(GSK2606414) and agonists(MK-28) of PERK were employed. Results : Radiotherapy markedly upregulated senescence-associated markers(P21, P16, γ-H2AX, and β-galactosidase activity) in pancreatic cancer cells. Senescent cells exhibited enhanced proliferative activity and increased tumor volume both in vitro and in vivo. Metformin mitigated radiotherapy-induced senescence by reducing the expression of senescence markers and significantly suppressing the clonogenic and proliferative capacity of treated cells. Mechanistically, radiotherapy activated the PERK signaling pathway, leading to increased expression of PERK, P-eIF2, and ATF4, thereby driving cellular senescence. Pharmacological inhibition of PERK reduced β-galactosidase activity, while PERK activation further promoted the expression of senescence-associated proteins—an effect that was reversed by metformin. Conclusion Metformin inhibits the activation of the PERK/P-eIF2/ATF4 signaling pathway in pancreatic cancer cells following radiotherapy, thereby delaying cellular senescence and reducing the associated radiotherapy resistance of senescent cells. This modulation contributes to the sensitization of pancreatic cancer cells to radiotherapy.

ObjectiveTo evaluate the efficacy of Sanhua essential oil inhalation as aromatherapy in patients with breast cancer-related depression.MethodsIn total, 144 patients with breast cancer-related depression who underwent postoperative chemotherapy were recruited. The participants in the control group (n = 52) were offered a placebo (sunflower oil) daily, whereas those in the essential oil group (n = 52) were administered Sanhua essential oil. This study evaluated depression improvement, Hamilton Depression Scale score, scores of symptoms in traditional Chinese medicine (TCM), Pittsburgh Sleepiness Quotient Index score, incidence of nausea and vomiting, and signal changes on functional magnetic resonance imaging.ResultsDepression improved by 48.1% and 21.2% in the essential oil and control groups, respectively (P = .010). The Hamilton Depression Scale score (P = .017), scores for symptoms in TCM (P = .002), and the incidence of nausea and vomiting in the acute and delayed phases were lower in the essential oil group than in the control group (nausea in the acute phase, P = .017; nausea in the delayed phase, P = .039; vomiting in the acute phase, P = .008; vomiting in the delayed phase, P = .081). The Pittsburgh Sleepiness Quotient Index score was lower in the essential oil group than in the control group (P = .005). Significant differences existed between the two groups in the left superior parietal gyrus, right precuneus, left dorsolateral superior frontal gyrus, and right precentral gyrus according to functional connectivity on functional magnetic resonance imaging.ConclusionInhalation of Sanhua essential oil alleviated depression in patients undergoing chemotherapy for breast cancer, improved sleep quality, relieved TCM symptoms, reduced nausea and vomiting, and regulated activities in the brain regions.