OBJECTIVE To investigate the clinical effectiveness of triptorelin combined with Biejiajian pill in the treatment of adenomyosis （AM）. METHODS Totally 186 patients with AM admitted to Nanyang First People’s Hospital from January 2022 to October 2024 were selected as subjects and randomized into control group （n＝93） and observation group （n＝93） using the random number table method. Patients in the control group received subcutaneous injections of triptorelin acetate around the umbilicus. In addition to the treatment of control group， patients in the observation group orally administered Biejiajian pill. Both groups underwent treatment for 12 weeks and were followed up for 6 months post-treatment. The clinical efficacy， recurrence and the occurrence of adverse drug reactions were compared between the two groups. Traditional Chinese medicine （TCM） symptoms， endometrial receptivity indicators （endometrial thickness， uterine volume， endometrial resistance index and vascular index）， laboratory indexes （serum luteinizing hormone， follicle stimulating hormone， estradiol， carbohydrate antigen 125， insulin-like growth factor-1， and matrix metalloproteinase 9） were compared between the two groups before and after treatment. RESULTS A total of 164 patients completed the treatment and follow-up， among whom 80 cases were in control group and 84 cases in the observation group. The overall effective rate in the observation group was significantly higher than that in the control group， while the incidence of low estrogen levels and recurrence rate were significantly lower in the observation group compared to the control group （P＜0.05）. There were no statistically significant differences in the incidence of nausea or abnormal liver and kidney function between the two groups （P＞0.05）. After treatment， the pain Visual Analogue Scale scores， Pictorial Blood Loss Assessment Chart， TCM symptoms scores， endometrial thickness， uterine volume， endometrial resistance index， and laboratory indicators in both groups were significantly lower than those before treatment within the same group （P＜0.05）. Moreover， these values were significantly lower in the observation group compared to the control group （except for follicle stimulating hormone） （P＜0.05）. The endometrial vascular index of the two groups was significantly higher than that in the same group before treatment， and the observation group was significantly higher than the control group （P＜0.05）. CONCLUSIONS Triptorelin combined with Biejiajian pill has a definite therapeutic effect on AM， which can effectively improve the degree of dysmenorrhea and menstrual flow， improve endometrial receptivity， lower the recurrence rate in patients， and demonstrate good safety.

OBJECTIVE To provide an experimental basis for quality control， clinical application and development of hepatoprotective drugs derived from Thesium chinense Turcz.METHODS Network pharmacology was adopted to predict and screen potential hepatoprotective constituents and their action targets of T. chinense Turcz. A liver-injured model of transgenic zebrafish Tg （ fabp10a ： dsRed ） with fluorescent-labeled liver was induced by 4 mmol/L isoniazid. The relative liver fluorescence area and relative fluorescence intensity of zebrafish larvae， as well as the levels of aspartate aminotransferase （AST）， alanine aminotransferase （ALT）， glutathione （GSH） and interleukin-6 （IL-6） were taken as indexes to evaluate the hepatoprotective activity of potential active constituents. High-performance liquid chromatography was used to determine the contents of hepatoprotective active constituents in 17 batches of T. chinense Turcz. medicinal materials from different producing areas.RESULTS Four potential hepatoprotective constituents including kaempferol-3- O -glucorhamnoside （KOG）， kaempferol-3，7-di- O -glucoside （KDG）， buddleoside （BUD） and apigenin-5- O -neohesperidoside （AON） were screened out via network pharmacology， and their core targets involved mitogen-activated protein kinase 1， nuclear factor-κB subunit 1， etc. Pharmacodynamic verification results showed that 25 μmol/L KOG， BUD， AON and 50 μmol/L KDG could significantly increase the relative liver fluorescence area and relative fluorescence intensity of liver-injured model larvae （ P ＜0.05）， reduce the levels of AST， ALT and IL-6 （ P ＜0.05）， and elevate the GSH level （ P ＜0.05）. Content determination results indicated that KOG could be detected in all 17 batches of T. chinense Turcz. medicinal materials， with contents ranging from 0.097 0 to 8.082 0 mg/g；KDG， AON and BUD were not detected in partial batches of samples， and their contents in detectable batches were 0.019 3-0.123 2 mg/g， 0.018 4-0.109 1 mg/g and 0.385 1-1.189 3 mg/g， respectively.CONCLUSIONS KOG， KDG， AON and BUD in T.chinense Turcz. may be its potential hepatoprotective active constituents. Among them， KOG can be detected in T.chinense Turcz. medicinal materials from different producing areas with relatively high content， which can be used as the main marker constituent for evaluating the hepatoprotective effect of T.chinense Turcz.

OBJECTIVE To observe the clinical efficacy， safety and recurrence of Kuntai capsules combined with Estradiol tablets/Estradiol dydrogesterone tablets in the treatment of diminished ovarian reserve （DOR） as well as their effects on ovarian reserve function， sex hormones， and lymphocyte subsets. METHODS A retrospective analysis was conducted on the clinical data of 165 DOR patients in Nanyang First People’s Hospital. Among them， 80 patients who received Estradiol tablets/Estradiol dydrogesterone tablets （take one tablet per day according to the medication sequence on the instruction） were included in the control group， while 85 patients who additionally took Kuntai capsules （2.0 g per dose， three times daily） were included in the observation group. The treatment duration for both groups was three months. Clinical efficacy， the incidence of adverse drug reaction （ADR）， recurrence rate， and changes in Traditional Chinese Medicine （TCM） syndrome scores， ovarian reserve function indicators [anti-Müllerian hormone （AMH）， inhibin B （INHB）， antral follicle count （AFC）， endometrial thickness， and ovarian volume]， sex hormones [follicle-stimulating hormone （FSH）， luteinizing hormone （LH）， and estradiol （E2）]， and T lymphocyte subsets （CD3 +， CD4 +， CD8 +， and CD4 +/CD8 +） were compared before and after treatment. RESULTS The cure and significant improvement rate in the observation group was significantly higher than in the control group （82.35% vs. 65.00%， P＜0.05）. Compared to baseline levels， both groups showed significant reductions in TCM syndrome scores， FSH， LH， CD3+ and CD8+ levels after treatment， while AMH， INHB， E2， CD4 +， CD4 +/CD8 +， AFC， endometrial thickness， and ovarian volume significantly increased （P＜0.05）. The degree of improvement in these indicators was significantly greater in the observation group than in the control group （P＜0.05）. There was no significant difference in the total incidence of ADR between the two groups（P＞ 0.05）. However， the recurrence rate within six months post-treatment was significantly lower in the observation group compared to the control group （5.88% vs. 21.25%， P＜0.05）. CONCLUSIONS Kuntai capsules combined with Estradiol tablets/ Estradiol dydrogesterone tablets have a significant therapeutic effect on DOR， which can improve ovarian reserve function of the patient， regulate sex hormone levels and T lymphocyte subsets， and reduce recurrence rates， with a high safety profile.

Objective To address the current blind spots in quality control and the risk of data distortion in radiological health technical service institutions, overcome the limitations of low efficiency and insufficient anomaly identification in manual verification, establish an automatic anomaly early warning mechanism based on AI algorithms, provide accurate clues for health supervision and law enforcement, and significantly enhance the efficiency of industry supervision. Methods On-site inspection data were collected via photographic imaging. Advanced image processing and object detection algorithms were employed to automatically extract and analyze key information from the images. Through data analysis, the system was used to calculate and assess the inspection results. A dynamic early warning engine was developed to automatically trigger alerts upon detection of deviations from standard thresholds or regulatory violations in radiological health technical services. These alerts were delivered through a regulatory information system. Results Following AI model training, the accuracy of the image processing and object detection algorithms reached 99% and the early warning accuracy reached 93%. Compared with the traditional supervision mode, the efficiency of anomaly detection was improved and the average response time was shortened. Conclusion The full-process supervision information system constructed in this study has realized the triple mechanism of pre-event standardization, in-event monitoring, and post-event traceability for radiological health technical services. In particular, the system has established a four-level quality control chain of “institutional self-inspection, intelligent recheck, expert judgment, and administrative action”, providing a technological innovation path for ensuring the radiation protection and safety of medical staff, patients, and the public.

Objective To understand the current situation and dynamic changing trends of healthcare-associated infection(HAI)in a tertiary first-class hospital in the northwest of Hunan Province from 2015 to 2024,and provide scientific basis for optimizing infection control strategies.Methods A single-day cross-sectional survey method was employed to investigate the HAI prevalence rates of hospitalized patients on the given survey day each year from 2015 to 2024.The standardized survey protocol on prevalence rate issued by the National Medical Institution Infec-tion Surveillance Network was strictly adhered,lanqingting real-time HAI monitoring management platform was adopted to retrieve cases from the hospital information system,and R4.2.2 was applied for statistical analysis.Results From 2015 to 2024,the prevalence rate of HAI decreased from 3.03％in 2015 to 1.76％in 2024(Z=-3.37,P＜0.001),and the HAI case prevalence rate decreased from 3.55％in 2015 to 2.20％in 2024(Z=-2.81,P=0.005).Department of critical care medicine continuously had the highest HAI case prevalence rate,which presented a downward trend over time(Z=-2.84,P=0.004).The main site of HAI was lower respiratory tract,accounting for 39.36％to 48.15％,bloodstream infection increased from 3.57％in 2015-2016 to 10.60％in 2023-2024(Z=2.41,P=0.016).A total of 302 strains of HAI pathogens were detected,including 212 strains(70.20％)of Gram-negative bacteria,mainly Pseudomonas aeruginosa(n=55,18.21％),Escherichia coli(n=45,14.90％),Acinetobacter baumannii(n=33,10.93％),and Klebsiella pneumoniae(n=31i,10.26％).65 strains(21.52％)of Gram-positive bacteria were identified,with Enterococcus faecium(n=19,6.29％)and Staphylococcus aureus(n=18,5.96％)accounting for the highest proportions.25 fungal strains(8.28％)were detected,mainly Candi-da albicans(n=11,3.64％).The use rate of antimicrobial agents showed a downward trend over the past decade(Z=-4.01,P＜0.001).Therapeutic antimicrobial use accounting for 82.42％,and its proportion increased over time(Z=6.02,P＜0.001).Prophylactic antimicrobial use accounted for 16.42％,showing a decreasing trend(Z=-2.75,P＜0.001).The pathogen detection rate presented an upward trend over the past decade(Z=13.01,P＜0.001).Conclusion The prevalence rate and case prevalence rate of HAI present a downward trend in this hospi-tal.In the future,it is necessary to establish a monitoring data-based dynamic analysis mechanism,achieve timely feedback and intervention in data monitoring,pay attention to high-risk links in department of critical care medicine,implement precise prevention and control mearsures,perform targeted prevention and control for lower respiratory tract,urinary tract,and bloodstream infection,optimize diagnosis and treatment processes,use antimicrobial agents rationally,and pay attention to the prevalence trend of Gram-negative bacteria.

This study investigated the types and distribution of rodents,and the infection status of eight pathogens in the high-altitude areas of western Sichuan,to provide a basis for control of rodent-borne diseases and pathogen surveillance in rodents in the area.From August to November of 2023,rodents were captured through the night method in high-altitude areas of western Sichuan.Nucleic acids were collected from the rodents'livers and lungs,and eight important pathogens were detected:Dabie bandavirus,Han-tavirus,Bartonella,Francisella tularensis,Anaplasma phagocytophilum,Rickettsia mooseri,Orientia tsutsugamushi,and Leptospira interrogans.The chi-square test was used to compare the composition ratios of rodent species and the difference in pathogen positivity rates among groups.A total of 114 rodents of nine species were captured.The dominant species in this area were Apodemus agrarius(22.81%),Apodemus chevrieri(18.42%),Niviventer confucianus(17.54%),Apodemus latronum(16.67%),and Apodemus peninsu-lae(13.16%).Other rodent species included Rattus nitidus(4.39%),Neodon irene(4.39%),Chodsigoa hypsibia(1.75%),and Nivi-venter excelsior(0.88%).Statistically significant differences in rodent species composition were observed among regions,altitudes,and habitats(χ2Region=112.358,P<0.05;χ2Altitude=96.843,P<0.05;χ2Habitat=48.842,P<0.05).The liver and lung pathogen results showed that the positivity rate of Bartonella was highest(29/114),whereas those of the other seven pathogens were 0%-4.39%.Five rodents were co-infected with two or more pathogens,and the composite positivity rate was 4.36%(5/114).Statistically significant differences in the positivity rates were observed for Leptospira interrogans among species(χ2=6.568,P=0.028)and Anaplasma phagocytophilum among habitats(χ2=7.596,P=0.027);however,no significant differences in the positivity rates of other pathogens were found among rodent species,regions,altitudes,habitats,and sexes(P>0.05).Thus,rodent species were abundant in the high-altitude areas of western Sichuan and carried a variety of pathogens.Multiple pathogens showed compound infections,among which the positivity rate of Bartonella was relatively high.The total infection rate of pathogens in living areas was relatively high,and the risk of pathogenesis to the population is greater.Therefore,rodent control and disease monitoring efforts should be strengthened.

Non-classical congenital adrenal hyperplasia (NCCAH), an autosomal recessive disorder, stems from genetic mutations affecting the enzymes and cofactors integral to adrenal steroidogenesis. These mutations may result in diminished activity or a complete loss of function for critical enzymes, such as 21-hydroxylase, 11β-hydroxylase, 3β-hydroxysteroid dehydrogenase, 17α-hydroxylase, and the steroidogenic acute regulatory protein (StAR). The impairment of these enzymatic processes has profound implications for reproductive health in females, mediated through both genetic and endocrine pathways. This review aims to explore the pathogenesis of various enzyme defects in different types of NCCAH, their clinical features, and their impact on female fertility. It is hoped that this will help refine the diagnostic strategies for infertility associated with NCCAH, thereby enhancing fertility of patients and providing new directions and opportunities for further research in this field.

OBJECTIVE To assess the correlation between the steady-state minimal concentration （cmin） and 24 h area under the drug concentration-time curve （AUC24）/minimal inhibitory concentration （MIC） ratio （AUC24/MIC） of vancomycin in pediatric patients， and analyze independent risk factors for treatment failure. METHODS Data of hospitalized children treated with vancomycin and receiving therapeutic drug monitoring in our hospital from January 2021 to July 2024 were retrospectively collected and divided into success group and failure group according to whether the treatment was successful or not. Spearman correlation analysis was used to analyze the correlation between cmin and AUC24/MIC of vancomycin， and one-way and multifactorial Logistic regression analyses were used to screen the independent risk factors for vancomycin treatment failure. RESULTS A total of 59 children were included， with 41 in the success group and 18 in the failure group. Compared with the failure group， AUC24/MIC of vancomycin was significantly higher in the success group （P＝0.038）， but there was no statistically significant difference in the cmin of the two groups （P＞0.05）； cmin of vancomycin was significantly positively correlated with AUC24/MIC （r＝0.499， P＜0.001）， but it has a certain efficacy in predicting the achievement of the AUC24/MIC standard （≥400） （area under the receiver operator characteristic curve＝0.696）， with an optimal cutoff value of 6.05 mg/L determined by the Youden index. The efficacy of AUC24/ MIC in predicting treatment failure was superior to cmin （areas under the receiver operator characteristic curve were 0.671 vs. 0.523， P were 0.038 vs. 0.684）， with higher sensitivity （83.3% vs. 66.7%）. Hypoproteinemia and AUC24/MIC≤369.1 were independent risk factors for vancomycin treatment failure （P＜0.05）. The incidence of nephrotoxicity was 3.4%. CONCLUSIONS There is a significant positive correlation between cmin and AUC24/MIC of vancomycin in pediatric patients； hypoproteinemia and AUC24/MIC≤369.1 are independent risk factors for vancomycin treatment failure in children.

Human NAD(P)H: quinone oxidoreductase 1 (NQO1) is a flavoenzyme expressed at high levels in multiple solid tumors, making it an attractive target for anticancer drugs. Bioactivatable drugs targeting NQO1, such as β-lapachone (β-lap), are currently in clinical trials for the treatment of cancer. β-Lap selectively kills NQO1-positive (NQO1⁺) cancer cells by inducing reactive oxygen species (ROS) via catalytic activation of NQO1. In this study, we demonstrated that cryptotanshinone (CTS), a naturally occurring compound, induces NQO1-dependent necrosis without affecting NQO1 activity. CTS selectively kills NQO1⁺ cancer cells by inducing NQO1-dependent necrosis. Interestingly, CTS directly binds to NQO1 but does not activate its catalytic activity. In addition, CTS enables activation of JNK1/2 and PARP, accumulation of iron and Ca²⁺, and depletion of ATP and NAD⁺. Furthermore, CTS selectively suppressed tumor growth in the NQO1⁺ xenograft models, which was reversed by NQO1 inhibitor and NQO1 shRNA. In conclusion, CTS induces NQO1-dependent necrosis via the JNK1/2/iron/PARP/NAD⁺/Ca²⁺ signaling pathway. This study demonstrates the non-enzymatic function of NQO1 in inducing cell death and provides new avenues for the design and development of NQO1-targeted anticancer drugs.

Apical microsurgery is accurate and minimally invasive, produces few complications, and has a success rate of more than 90%. However, due to the lack of awareness and understanding of apical microsurgery by dental general practitioners and even endodontists, many clinical problems remain to be overcome. The consensus has gathered well-known domestic experts to hold a series of special discussions and reached the consensus. This document specifies the indications, contraindications, preoperative preparations, operational procedures, complication prevention measures, and efficacy evaluation of apical microsurgery and is applicable to dentists who perform apical microsurgery after systematic training.
Microsurgery/standards* ; Humans ; Apicoectomy ; Contraindications, Procedure ; Tooth Apex/diagnostic imaging* ; Postoperative Complications/prevention & control* ; Consensus ; Treatment Outcome