Rheumatoid arthritis （RA） is a chronic systemic autoimmune disease characterized by symmetrical polyarthritis， which may lead to joint deformity and loss of joint function in the long term， severely impairing patients' quality of life. Danggui Niantongtang， originated from Medical Revelations by Zhang Yuansu in the Jin Dynasty， has the effects of clearing heat and draining dampness， dispelling wind and alleviating pain， and serves as a classic formula for treating RA damp-heat stagnation syndrome. By searching CNKI， Wanfang， PubMed and other databases， the author systematically reviewed the clinical efficacy and experimental research of Danggui Niantongtang in the treatment of RA， and elucidated its mechanisms of action， so as to provide a valuable reference for future clinical and basic research of Danggui Niantongtang in the field of RA. Clinical studies demonstrated that Danggui Niantongtang can improve core symptoms in RA patients with the damp-heat stagnation syndrome， including joint swelling and pain， morning stiffness and limited joint mobility， decrease inflammatory markers such as C-reactive protein （CRP） and erythrocyte sedimentation rate （ESR）， and facilitate postoperative rehabilitation in RA patients undergoing total knee arthroplasty （TKA）. When combined with Western medicines such as methotrexate， it can enhance the anti-inflammatory efficacy and mitigate adverse reactions， including gastrointestinal discomfort and hepatic injury. Experimental studies revealed that this formula can modulate the inflammatory cytokine network， promote synoviocyte apoptosis， inhibit abnormal synoviocyte autophagy， suppress synovial angiogenesis， and maintain intestinal flora homeostasis. However， several limitations exist in current research， such as insufficient clinical quality， unclear interaction between mechanisms and networks， and insufficient research on dosage form optimization. In the future， high-quality clinical research， multi-omics mechanistic studies， and dosage form improvement are needed to provide scientific basis for its clinical promotion and in-depth research.

Patients with lung cancer experience a heavy symptom burden during the perioperative period, which seriously affects their recovery and quality of life. Traditional symptom management models rely mainly on scheduled ward rounds during hospitalization and outpatient follow-up after discharge. However, they have limitations such as delayed symptom recognition, lack of post-discharge monitoring, and non-quantitative symptom assessment, which often lead to delayed interventions and low patient satisfaction. In recent years, the symptom management model based on electronic patient-reported outcomes (ePRO) has been increasingly valued in clinical practice. Existing high-level evidence from both domestic and international studies indicates that, through proactive monitoring, real-time alerts, and remote interventions, this model enables dynamic and continuous symptom management and helps improve patient recovery and healthcare experience. As a supplement to routine medical care, the ePRO-based symptom management model aims to enhance the quality of care rather than replace existing medical processes. To promote the standardized application of this model in perioperative lung cancer care, this consensus integrates domestic and international evidence. After multiple rounds of voting by more than 50 experts, it formulates 12 consensus statements covering the three core components, symptom monitoring, alerting, and intervention, to provide scientific and practical recommendations for clinical practice.

Objective:Systematic evaluation and integration of the real experience of dietary restriction in patients with inflammatory bowel disease, providing reference for the development of targeted intervention strategies.Methods:Qualitative studies on the dietary restriction experience of patients with inflammatory bowel disease retrieved from PubMed, Cochrane Library, Web of Science, Embase, CINAHL, China National Knowledge Infrastructure, Wanfang, VIP, and Chinese Biomedical Literature Database using computer search. The search period was from the establishment of the database to May 31, 2024. According to the Australian Joanna Briggs Institute Evidence Based Healthcare Center Qualitative Research Quality Evaluation Criteria, the quality of included literature was evaluated, and the results were subjected to meta-analysis using a pooled integration method.Results:A total of 9 studies were included, and 36 research results were extracted and summarized into 9 categories. Then, three integrated results were further synthesized, namely physical and mental impairment and social limitation; change attitude and actively explore; seeking external support to promote beneficial growth.Conclusions:Dietary restrictions for inflammatory bowel disease have various impacts on patients. Medical staff should focus on the nutritional status and emotional needs of patients, and provide multidimensional social support based on their actual dietary management experience. They should develop patient-centered personalized intervention measures to help patients achieve more scientific and effective dietary management and improve their overall quality of life.

Hepatocellular carcinoma(HCC)is the third leading cause of cancer-related deaths,and al-though considerable progress has been made in the clinical diagnosis and treatment of HCC,the prognosis for patients remains poor,with a 5-year survival rate of only about 18％.The development of HCC is driven by the occurrence of mutations in driver genes that can directly promote cell proliferation,survival and metastasis.With the development of molecular biology and genomics technologies,researchers have elucidated that driver mutations that give HCC cells a selective growth advantage,the ability of the cells to resist apoptosis,maintain proliferative signals,initiate invasion and metastasis,induce angiogenesis,enable metabolic remodeling and immune escape.Exploring the key drivers of HCC development to fur-ther elucidate the pathogenesis of HCC may provide new directions for the diagnosis and treatment of HCC as well as improving the prognosis.In this paper,we summarize the driver gene mutations in HCC from various biological pathways such as telomere maintenance,cell cycle,the Wnt signaling pathway,oxida-tive stress,and epigenetic modifications.We also summarize the application prospects of driver gene mu-tations in the diagnosis and treatment of HCC.We aim to provide a reference for the diagnosis,treatment and research of HCC.

Objective:To explore the relationship between suicide attempts,school bullying,and psychological resilience in children and adolescents with major depressive disorder(MDD)and school bullying and psychological resilience.Methods:A total of 784 patients with MDD aged 10 to 18 years were included.The Chinese version of the Olweus Bullying Victimization Questionnaire,Adolescent Psychological Resilience Scale,and a suicide attempt assessment were utilized to evaluate school bullying,psychological resilience,and suicide attempt.Stepwise logistic regression was applied to identify the associated factors of suicide attempts.Results:The occurrence of suicide at-tempts in children and adolescents with MDD was positively associated with physical bullying(OR=1.85,95％CI:1.14-3.02)and indirect bullying(OR=1.48,95％CI:1.06-2.04),and negatively associated with higher levels of goal focus(OR=0.62,95％CI:0.45-0.85)and positive cognition(OR=0.62,95％CI:0.45-0.85)at higher levels.Conclusion:Bullying significantly increases the risk of suicide attempts in children and adolescents with MDD,while higher psychological resilience could mitigate this risk.

Objective:To investigate the effects of paclitaxel combined with Ipatasertib on the proliferation,migration and epitheli-al-mesenchymal transition(EMT)of oral squamous cell carcinoma(OSCC)SCC-9 cells in vitro.Methods:SCC-9 cells were treated with paclitaxel and Ipatasertib repectively and in combination.CCK-8 test and EdU assay were used to detect cell proliferation ca-pacity.Cellular migration was detected by Transwell and scratch method.The protein expressions of E-cad,N-cad,Vimentin,AKT and NF-κB were detected by Western blot.Results:Paclitaxel of 0.5-32 μmol/L combined with Ipatasertib of 2.5 μmol/L(IC50)showed synergistic inhibitory effect on the proliferation of SCC-9 cells,the combination of paclitaxel and ipatasertib more significantly inhibited the migration,down-regulated the protein expression of AKT,NF-κB,N-cad and Vimentin,and up-regulated the protein expression of E-cad.Conclusion:The combination of paclitaxel and Ipatasertib may have synergistic inhibitory effects on the prolif-eration,migration and EMT of OSCC cells,the function may be ralated with the inhibition of PI3K/AKT signaling pathway.

Objective To observe the therapeutic effect of Qiwei Tangmaishu capsules on type 2 diabetes mice,and explore the mechanisms of its treatment of type 2 diabetes based on network pharmacology.Methods TCMSP,ETCM databases were used to query all components and of Qiwei Tangmaishu capsules and their targets.OMIM and DrugBank databases were used to search for targets of type 2 diabetes.The targets of type 2 diabetes and Qiwei Tangmaishu capsules were intersected by Venny 2.1.0.to perform GO and KEGG pathway enrichment analysis on those intersecting targets using the Metascape website.Then,a mouse model of type 2 diabetes was established,and Qiwei Tangmaishu capsules were given to low,medium,and high dose groups(234,468,and 936 mg/kg,respectively),and metformin(MET)group(200 mg/kg)for 2 weeks.The weight of each mouse was measured before and after treatment,and fasting blood glucose was also measured.After the 2 weeks,fasting insulin was measured;ELISA was used to detect levels of inflammatory factors IL-1β,TNF-α,IL-6,TLR4,and NF-κB in serum;Hematoxylin eosin staining was used to observe the morphology of pancreatic islets;and Caspase 3 and INS immunofluorescence were used to detect apoptosis of pancreatic islet cells and the number of pancreatic beta cells.Western Blot assay was used to detect the expression levels of pancreatic tissue proteins such as p-Akt,Akt,p-PI3K,PI3K,Bax,Bcl2.Results 1260 active ingredient targets were identified in Qiwei Tangmaishu capsules;1205 targets of type 2 diabetes were found.Of these,312 targets were intersected by Venny,with core targets involving Akt1,TNF,IL-6,TLR4,among others.Enrichment analysis identified 240 KEGG pathways,among which"insulin resistance""PI3K/Akt signaling pathway"were the key pathways enriched.The animal experiment result showed that compared with the model group,the intervention of Qiwei Tangmaishu capsules and metformin significantly improved blood glucose and insulin resistance;the content of inflammatory factors in serum decreased,and the apoptosis rate of pancreatic islet cells significantly decreased;the number of pancreatic beta cells significantly increased;the expression of pro-apoptotic protein Bax decreased,the expression of anti-apoptotic protein Bcl2 significantly increased,and the expression of p-PI3K and p-Akt was upregulated.Conclusions Qiwei Tangmaishu capsules can significantly reduce blood glucose levels,restore insulin sensitivity,and reduce islet cell apoptosis in type 2 diabetic mice.The mechanism may be related to the activation of the PI3K/Akt signaling pathway.

Objective:To investigate potential factors associated with nephrocalcinosis in children with X-linked hypophosphatemic rickets (XLH).Methods:A case-control study was conducted involving XLH children who were regularly followed up at Children′s Hospital of Nanjing Medical University, from January 2016 to January 2024.Patients diagnosed with nephrocalcinosis were assigned to the case group, and those without nephrocalcinosis served as controls.A retrospective analysis was performed to examine the correlation between nephrocalcinosis and laboratory parameters, as well as the diagnostic value of relevant factors.Multivariable Logistic regression was used to identify factors associated with nephrocalcinosis in children with XLH.Receiver operating characteristic (ROC) curves were plotted for the significant factors, and the areas under the curve (AUC) were compared using Delong′s test to evaluate differences in predictive performance.Results:Univariate analysis revealed significant differences between the case and control groups in serum calcium, urinary calcium, urinary calcium/creatinine ratio, urinary phosphorus, and renal tubular maximum reabsorption rate of phosphate/glomerular filtration rate (TmPi/GFR) (all P<0.05).However, multivariate logistic regression analysis identified only urinary calcium ( B=0.489, P=0.001) and TmPi/GFR ( B=-0.886, P=0.007) as independent predictors, while the urinary calcium/creatinine ratio was not statistically significant.The sensitivity, specificity, optimal cutoff value, and AUC for urinary calcium in predicting nephrocalcinosis were 0.842, 0.833, 0.614 mmol/L, and 0.851 ( P<0.01), respectively.For TmPi/GFR, the corresponding values were 0.900, 0.877, 0.573 mmol/L, and 0.875 ( P<0.01).The Delong test showed no significant difference in AUC between the combined indicator and TmPi/GFR ( Z=-1.555, P=0.120) or urinary calcium alone ( Z=-1.598, P=0.110). Conclusions:Urinary calcium and TmPi/GFR are significantly associated with nephrocalcinosis in children with XLH and demonstrate good predictive performance for early detection.The combination of these two indicators does not outperform either individual marker in diagnostic accuracy.

Objective:To analyze the epidemiological and clinical characteristics of pertussis cases identified through active surveillance.Methods:Active surveillance for pertussis was conducted in three sentinel hospitals in Yiwu, Zhejiang Province, and Yongcheng, Henan Province. The study population included cases that met the surveillance case definition and sought medical care at outpatient/emergency departments or were hospitalized between June 1, 2021, and May 31, 2022. Samples were collected for bacterial culture and PCR detection. Case information and clinical data were collected. Differences in rates were assessed using the chi-square test or Fisher's exact probability test, and the differences in cough time were compared using the Mann-Whitney U test. Results:Among 1 423 cases of pertussis surveillance, the positive rate of pertussis was 28.11% (400/1 423), with a median age of 5 years (interquartile range: 2, 8). The positive rate in Yongcheng, Henan Province, and Yiwu, Zhejiang Province were 39.27% (216/550) and 21.08% (184/873), respectively; the positive rate of pertussis was highest in July 2021, and the highest positive rate of pertussis was among those aged 10-14. The positive rate of pertussis in hospitalized cases was higher than in outpatient/emergency cases (26.68%) ( χ2=4.16, P=0.041). Among the 400 laboratory test-positive cases, the highest proportion of atypical symptom cases was in adults aged 20-59 (43.33%, 13/30). The specificity rates of apnea and worsening nocturnal cough in monitored cases under 3 months of age were 100.00% and 73.81%, respectively. Among monitored cases aged 3 months to 9 years, the proportions of symptoms including worsening nighttime cough (63.00%) and night sweats (4.59%) in test-positive cases were significantly higher than those in the test-negative group (47.77% and 0.56%, respectively), with statistically significant differences (both P<0.05). The specificity rates of worsened nighttime coughing and night sweats were 52.23% and 99.44%, respectively. Conclusions:The active surveillance results for pertussis showed that the 10-14 age group exhibited the highest positivity rate. Active surveillance enhanced the detection rate of pertussis. Among laboratory-confirmed cases, the proportion of atypical symptoms was the highest in adults, suggesting that laboratory testing should be combined to diagnose programs of pertussis. For infants under 3 months, worsening nighttime cough and apnea increase the diagnostic specificity, while for individuals aged 3 to 9 years old, worsening nighttime cough and night sweats increase the diagnostic specificity.

Objective To observe the effectiveness and safety of DiaSphere embolized microsphere TACE for treating primary hepatocellular carcinoma(HCC).Methods Totally 188 patients with HCC were prospectively enrolled and randomly assigned to research group(n=93)and control group(n=95),who underwent TACE with DiaSphere embolized microspheres and Embosphere embolized microspheres,respectively.The incidence of TACE-related adverse events were recorded.The therapeutic efficacy 1 month after the first TACE,also 1 and 3 months after the last TACE,and liver functions 1 month after the first and last TACE were compared between groups.Results In research group,there were 69 cases underwent 1 time TACE,22 cases underwent 2 times and 2 cases underwent 3 times TACE,while in control group,there were 82 cases underwent 1 time and 13 cases underwent 2 times TACE,respectively.No statistical difference of the incidence of adverse events was found between groups(77.42%[72/93]vs.76.84%[73/95],P=1.000).One month after the first TACE,7 cases in research group and 11 cases in control group were lost to follow-up,respectively.One month after the last TACE,12 cases were lost to follow-up in both groups,and 3 months after the last TACE,28 cases were lost to follow-up in both groups.No significant difference of objective response rate nor disease control rate was found between groups at the above time points(all P＞0.05).One month after the first and last TACE,liver function indicators were not different between groups(all P＞0.05).Conclusion Both the short-term efficacy and safety of TACE with DiaSphere embolized microspheres for treating HCC were good.