ObjectiveTo investigate the effects of Yifei Zhuji formula （YFZJF） on epithelial-mesenchymal transition （EMT） in non-small cell lung cancer （NSCLC） through regulation of phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）/mammalian target of rapamycin （mTOR） signaling pathway. MethodsThe Lewis lung carcinoma mouse model and human lung adenocarcinoma PC-9 cell model were used in this study. In the animal experiments， 60 C57BL/6 mice were randomized into a blank group and a Lewis lung carcinoma modeling group. The modeled mice were further randomized into model， low-， medium-， and high-dose （7.475， 14.95， 29.9 g·kg^-1·d^-1， respectively） YFZJF， and cisplatin groups， with 10 mice in each group. Mice in YFZJF groups were administrated with YFZJF at different doses by gavage， and those in the cisplatin group received intraperitoneal injection of cisplatin at 6 mg·kg^-1. Mice in the blank group and model group were administrated with equal volumes of normal saline by gavage every day. All the groups were treated for 14 consecutive days， and samples were collected for analysis after completion of treatment. Changes in body mass， tumor volume， and tumor mass were measured. Hematoxylin-eosin （HE） staining was performed to observe pathological changes in the lung tissue. Immunohistochemistry， Real-time PCR， and Western blot were employed to determine the expression of proliferating cell nuclear antigen （Ki-67）， PI3K/Akt/mTOR signaling pathway-related molecules， and EMT-related molecules in the tumor tissue. In the cell experiments， human lung adenocarcinoma PC-9 cells were allocated into control， YFZJF-containing serum， and cisplatin groups， which were treated with 20% blank rat serum， 20% YFZJF-containing rat serum， and 5.4 μmol·L^-1 cisplatin for 48 h， respectively. The cell counting kit-8 （CCK-8） assay was adopted to detect cell proliferation and determine drug concentration. Cell scratch assay and Transwell assay were employed to evaluate cell migration and invasion. Immunofluorescence staining and Real-time PCR were used to analyze changes in expression of EMT markers. ResultsCompared with those in the model group， the tumor volume and tumor mass were reduced in the high-dose YFZJF group （P<0.01）. Immunohistochemical results showed that compared with the model group， the medium- and high-dose YFZJF groups exhibited reduced Ki-67 expression in the tumor tissue （P<0.01）. HE staining results showed that YFZJF alleviated the pathological injury of the lung tissue to different degrees. Real-time PCR results in the tumor tissue showed that compared with the model group， the high-dose YFZJF group displayed downregulated mRNA levels of protein kinase B1 （Akt1） and N-cadherin （P<0.05）， phosphatidylinositol 3-kinase p85 regulatory subunit （p85） （P<0.01）， mTOR （P<0.01）， and Vimentin （P<0.01）， and an upregulated mRNA level of E-cadherin （P<0.01）. Western blot results showed that compared with the model group， the high-dose YFZJF group exhibited downregulated protein levels of phosphorylated （p）-PI3K/PI3K， p-Akt/Akt， p-mTOR/mTOR， Vimentin， and N-cadherin （P<0.01）， and an upregulated protein level of E-cadherin （P<0.01） in the tumor tissue. The cell experiment results showed that compared with the blank serum group， YFZJF-containing serum inhibited the proliferation， migration， and invasion of PC-9 cells （P<0.05， P<0.01）. Immunofluorescence results showed that compared with the control group， YFZJF-containing serum downregulated the protein levels of N-cadherin and Vimentin and upregulated the protein level of E-cadherin （P<0.01）. Real-time PCR results showed that compared with the control group， YFZJF-containing serum upregulated the mRNA level of E-cadherin （P<0.05） and downregulated the mRNA levels of N-cadherin， Vimentin， P85， Akt1， and mTOR （P<0.05， P<0.01）. ConclusionYFZJF can significantly inhibit the progression of non-small cell lung cancer and reduce the migration and invasion of tumor cells by inhibiting the abnormal activation of PI3K/Akt/mTOR signaling pathway and reversing EMT.

Objective:To explore and compare the clinical application value of 8-channel head phased-array coil, an 8-channel temporomandibular joint (TMJ)-specific surface coil, and a single-channel surface coil in TMJ MRI examinations.Methods:A total of 600 temporomandibular disorders (TMD) patients (1 200 joints) who underwent TMJ MRI examination in the First People′s Hospital of Jinzhong from June 2020 to January 2025 were retrospectively screened. Based on inclusion/exclusion criteria, 120 TMD patients (240 joints) with closed-mouth oblique sagittal proton density weighted imaging (OSag PDWI), coronal T2 fat-suppression weighted imaging (OCor fs T2WI) and open-mouth oblique sagittal proton density weighted imaging (OSag PDWI) were included. Patients were divided into groups A, B, and C, with 40 cases in each group. Group A (31female, 9male, median age 24 years old), underwent 8-channel head phased-array coil imaging. Group B (29 female, 11male, median age 23.5 years old) underwent TMJ imaging with an 8-channel surface coil. Group C (29 female, 11male, median age 22.5 years old) underwent single-channel surface coil imaging. There were no significant differences in age, gender, type or disease types among groups ( P>0.05). Six healthy volunteers without TMD (4 female, 2 male, range 19 to 45 years old) underwent imaging with all three coils as self-control. The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and image quality were compared for five regions of interest (ROI) in both patients and volunteers. Results:Under the same sequence and the same parameters, SNR and CNR in group B were higher than those in group A, and SNR and CNR in group C were also higher than those in group A, the differences were statistically significant ( P<0.05). However, there were significant differences in SNR and CNR between group B and group C in the closed and open positions of ROI1, the open positions of ROI3 and the open positions of ROI5 ( P<0.05), and there were no significant differences in other positions ( P>0.05). Group B had the best image quality, followed by group C and group A had the worst image quality. There were significant differences in the visualization of OSag PDWI in the closed mouth position, OCor T2WI in the coronal position, and OSag PDWI in the open mouth position, such as condyle, anterior attachment, joint disc, double lamina area, joint cavity and lateral pterygoid muscle ( P<0.05). There were significant differences between group B and group C in showing the joint cavity in the closed mouth position and showing the structure of the bilaminar area in the open mouth position ( P<0.05). There was no significant difference in other regions of interest ( P>0.05). The subjective scores of condyle, anterior attachment, articular disc, bilaminar area, articular cavity, lateral pterygos muscle and other structures were medium to high in group A, high in group B, and high or high in group C by two radiologists independently. In the five rois, the 8-channel TMJ surface coil showed more details, especially in the articular disc, condyle and lateral pterygoid muscle regions, and had more advantages in both volunteers and patients. Conclusions:The 8-channel TMJ-specific surface coil provides significantly clearer visualization of critical anatomical details within the ROIs, demonstrating the highest clinical application value and is recommended as the preferred choice.

Objective To investigate the role of ginsenoside Rh1 in regulating the changes of characteristic differential metabolites in rat models of exercise-induced fatigue by gas chromatography-mass spectrometry(GC-MS)and multidimensional statistical analysis,and to clarify the metabolic pathways,so as to provide experimental basis and theoretical support for the effective alleviation of exercise-induced fatigue through Rh1.Methods A total of 27 SPF SD rats were randomly divided into blank control group,model group,and ginsenoside Rh1 group,with 9 rats in each group.A rat exercise-induced fatigue model was established by treadmill exercise.After blood sampling,GC-MS technology,Principal Component Analysis(PCA)and Orthogonal Partial Least Squares(PLS-DA)were used for the identification and screening of differential metabolites,which were further structurally identified in KEGG and HMDB databases.MetPA database was used to construct metabolic pathways and enrich for topological analysis.Results The time to exhaustion in the ginsenoside Rh1 group was significantly longer than that in the model group.Significant differential expression of 8 metabolites(6 significantly decreased and 2 significantly increased)was found in the model group as compared to the blank control group,and 5 metabolic pathways were involved.In the ginsenoside Rh1 group,there were 3 metabolites with significant changes compared with the model group.Citric acid and fatty acid were significantly increased,α-D-glucosamine 1-phosphate was decreased,and the main pathway involved was tricarboxylic acid cycle.Conclusion Rh1 can significantly prolong the time to exhaustion and relieve exercise-induced fatigue in rats,which is closely related to the metabolic pathway of tricarboxylic acid cycle.

Objective:To explore the stratified treatment plan process for neonatal congenital chylothorax by summarizing its clinical treatment characteristics.Methods:A retrospective analysis was conducted on the clinical data of 36 neonates with congenital chylothorax treated at the Department of Neonatology of Beijing Children's Hospital, Capital Medical University, from January 1, 2010, to December 31, 2021. Based on different treatment methods and initial drainage volumes, the cases were divided into the conservative treatment group [initial drainage volume<20 ml/(kg·d), n=20], octreotide group [initial drainage volume ≥20-<30 ml/(kg·d), n=4], erythromycin group [initial drainage volume ≥30-<50 ml/(kg·d), n=6], and octreotide plus erythromycin group [initial drainage volume≥50 ml/(kg·d), n=6]. The clinical characteristics and treatment effects of the children in different treatment groups, as well as the choice of further treatment plans, were summarized to determine the timing of different treatment methods. A more standardized stratified treatment plan was formulated by combining the literature. Results:Among the 36 cases of congenital chylothorax, 18 cases (50.0%) were diagnosed in utero, with no intrauterine intervention. In the conservative treatment group, 20 cases were treated with respiratory support, thoracic drainage, and nutritional therapy. Except for one case who was discharged after abandoning treatment, the remaining 19 cases were cured. In the octreotide group, four children received continuous intravenous infusion of octreotide at doses ranging from 1 to 10 μg/(kg·h), with three cases improving and one case being cured. No adverse effects such as hypoglycemia, thyroid dysfunction, or neonatal necrotizing enterocolitis occurred. In the group of six children who received intrapleural erythromycin injections, the dosage of erythromycin was 25-30 mg/kg, and the median thoracic drainage volume was reduced to approximately 50% of the pre-treatment volume after 3-5 injections, with four cases improving and two cases being cured. In the group of six children who received octreotide combined with erythromycin, treatment involved the intravenous infusion of octreotide along with intrapleural erythromycin injections. Four cases showed improvement, and two cases were cured. Based on previous treatments and a comprehensive review of the literature, a stratified treatment flowchart with invasiveness ranging from low to high was finally formed. Conclusions:For congenital chylothorax, a stratified treatment approach is recommended based on initial drainage volume and the response to treatment. This approach ranges from conservative treatment to pharmacological treatment (intravenous infusion of octreotide). For children with poor outcomes, surgical treatment (intrapleural erythromycin injection or other surgical interventions) can be added.

Acute-on-chronic liver failure （ACLF） refers to severe liver dysfunction that occurs on the basis of chronic liver diseases， and it is characterized by rapid disease progression， poor prognosis， and high mortality rate. In recent years， inflammatory markers have become a research hotspot due to their significant role in assessing the prognosis of ACLF. This article reviews the advances in the application of inflammatory markers in assessing the prognosis of ACLF， such as systemic immune inflammatory index， lymphocyte-white blood cell ratio， neutrophil-lymphocyte ratio， and C-reactive protein， and discusses their clinical value and future research directions， in order to provide a theoretical basis for the early intervention and prognosis management of ACLF patients.

Objective:To explore and compare the clinical application value of 8-channel head phased-array coil, an 8-channel temporomandibular joint (TMJ)-specific surface coil, and a single-channel surface coil in TMJ MRI examinations.Methods:A total of 600 temporomandibular disorders (TMD) patients (1 200 joints) who underwent TMJ MRI examination in the First People′s Hospital of Jinzhong from June 2020 to January 2025 were retrospectively screened. Based on inclusion/exclusion criteria, 120 TMD patients (240 joints) with closed-mouth oblique sagittal proton density weighted imaging (OSag PDWI), coronal T2 fat-suppression weighted imaging (OCor fs T2WI) and open-mouth oblique sagittal proton density weighted imaging (OSag PDWI) were included. Patients were divided into groups A, B, and C, with 40 cases in each group. Group A (31female, 9male, median age 24 years old), underwent 8-channel head phased-array coil imaging. Group B (29 female, 11male, median age 23.5 years old) underwent TMJ imaging with an 8-channel surface coil. Group C (29 female, 11male, median age 22.5 years old) underwent single-channel surface coil imaging. There were no significant differences in age, gender, type or disease types among groups ( P>0.05). Six healthy volunteers without TMD (4 female, 2 male, range 19 to 45 years old) underwent imaging with all three coils as self-control. The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and image quality were compared for five regions of interest (ROI) in both patients and volunteers. Results:Under the same sequence and the same parameters, SNR and CNR in group B were higher than those in group A, and SNR and CNR in group C were also higher than those in group A, the differences were statistically significant ( P<0.05). However, there were significant differences in SNR and CNR between group B and group C in the closed and open positions of ROI1, the open positions of ROI3 and the open positions of ROI5 ( P<0.05), and there were no significant differences in other positions ( P>0.05). Group B had the best image quality, followed by group C and group A had the worst image quality. There were significant differences in the visualization of OSag PDWI in the closed mouth position, OCor T2WI in the coronal position, and OSag PDWI in the open mouth position, such as condyle, anterior attachment, joint disc, double lamina area, joint cavity and lateral pterygoid muscle ( P<0.05). There were significant differences between group B and group C in showing the joint cavity in the closed mouth position and showing the structure of the bilaminar area in the open mouth position ( P<0.05). There was no significant difference in other regions of interest ( P>0.05). The subjective scores of condyle, anterior attachment, articular disc, bilaminar area, articular cavity, lateral pterygos muscle and other structures were medium to high in group A, high in group B, and high or high in group C by two radiologists independently. In the five rois, the 8-channel TMJ surface coil showed more details, especially in the articular disc, condyle and lateral pterygoid muscle regions, and had more advantages in both volunteers and patients. Conclusions:The 8-channel TMJ-specific surface coil provides significantly clearer visualization of critical anatomical details within the ROIs, demonstrating the highest clinical application value and is recommended as the preferred choice.

OBJECTIVE To analyze the distribution and drug resistance of pathogenic bacteria in hospital-associat-ed infections for patients after renal transplantation,and to provide a reference for the rational selection of antibac-terial drugs for anti-infective treatment in such patients.METHODS Clinical data were collected from 89 hospital-ized patients who underwent renal transplantation and developed hospital-associated infection at Beidaihe Rehabili-tation and Recuperation Center(formerly known as 281 Hospital)from 2017 to 2021.The pathogenic bacteria de-tected in different types of hospital-associated infections and the drug resistance of the main pathogenic bacteria were analyzed.RESULTS A total of 89 pathogenic bacterial strains were isolated from the 89 patients with hospi-tal-associated infection,including 74 gram-negative bacterial strains(83.15％)and 15 gram-positive bacterial strains(16.85％).The predominant pathogenic bacterial strains were Klebsiella pneumoniae,Escherichia coli and Pseudomonas aeruginosa.Respiratory tract infection was the most common.E.coli showed severe drug re-sistance,with high drug resistance rates to various antibacterial drugs(complete drug resistance to piperacillin and ampicillin).K.pneumoniae was generally drug resistant to ampicillin.Enterobacter cloacae showed high sensitivi-ty to carbapenems,amikacin and enzyme inhibitor combinations.P.aeruginosa had low drug resistance rates to imipenem and meropenem.Staphylococcus aureus was completely drug resistant to antibacterial drugs such as penicillin,erythromycin and gentamicin,and no drug-resistant strains to vancomycin and linezolid were found.CONCLUSIONS The gram-negative bacteria are dominant among the bacteria isolated from the renal trans-planted patients with postoperative hospital-associated infections,with a high detection rate of E.coli and a severe drug resistance situation.Therefore,it is necessary to strengthen the monitoring of drug resistance in renal trans-plant recipients and make rational choices of antibacterial drugs.

OBJECTIVE To analyze the distribution and drug resistance of pathogenic bacteria in hospital-associat-ed infections for patients after renal transplantation,and to provide a reference for the rational selection of antibac-terial drugs for anti-infective treatment in such patients.METHODS Clinical data were collected from 89 hospital-ized patients who underwent renal transplantation and developed hospital-associated infection at Beidaihe Rehabili-tation and Recuperation Center(formerly known as 281 Hospital)from 2017 to 2021.The pathogenic bacteria de-tected in different types of hospital-associated infections and the drug resistance of the main pathogenic bacteria were analyzed.RESULTS A total of 89 pathogenic bacterial strains were isolated from the 89 patients with hospi-tal-associated infection,including 74 gram-negative bacterial strains(83.15％)and 15 gram-positive bacterial strains(16.85％).The predominant pathogenic bacterial strains were Klebsiella pneumoniae,Escherichia coli and Pseudomonas aeruginosa.Respiratory tract infection was the most common.E.coli showed severe drug re-sistance,with high drug resistance rates to various antibacterial drugs(complete drug resistance to piperacillin and ampicillin).K.pneumoniae was generally drug resistant to ampicillin.Enterobacter cloacae showed high sensitivi-ty to carbapenems,amikacin and enzyme inhibitor combinations.P.aeruginosa had low drug resistance rates to imipenem and meropenem.Staphylococcus aureus was completely drug resistant to antibacterial drugs such as penicillin,erythromycin and gentamicin,and no drug-resistant strains to vancomycin and linezolid were found.CONCLUSIONS The gram-negative bacteria are dominant among the bacteria isolated from the renal trans-planted patients with postoperative hospital-associated infections,with a high detection rate of E.coli and a severe drug resistance situation.Therefore,it is necessary to strengthen the monitoring of drug resistance in renal trans-plant recipients and make rational choices of antibacterial drugs.

Objective:To analyze the effects of fertilization methods, quality of inner cell mass (ICM) and trophectoderm (TE) on the sex ratio at birth (SRB) during single blastocyst transfer cycles.Methods:5 367 single blastocyst transfer cycles in in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) of patients with successful pregnancy and delivery in Reproductive Medical Center of Zhanjiang Jiuhe Hospital from January 2010 to December 2022 were included in this retrospective cohort study. According to different types of embryos, the cycles were divided into fresh embryo group ( n=1 487, total population; n=1 258, ≤35 years old) and frozen-thawed embryo group ( n=3 880, total population; n=3 199, ≤35 years old). According to different fertilization methods, the cycles were divided into IVF group ( n=4 424, total population; n=3 667, ≤35 years old) and ICSI group ( n=943, total population; n=780, ≤35 years old). Chi-square test was used to analyze the differences of SRB among all the patients and the patients aged ≤35 years who underwent different embryo types and fertilization methods, and logistic regression was used to analyze the effects of ICM and TE ratings on SRB in each group of blastocysts. Results:There were 917 male infants (61.7%, 917/1 487) in the fresh embryo transfer group and 2 317 male infants (59.7%, 2 317/3 880) in frozen-thawed embryo transfer group. The SRB of the fresh embryo transfer group (160.9∶100) was slightly higher than that in frozen-thawed embryo transfer group (148.2∶100), but the difference was not statistically significant ( P=0.201). There were 2 732 male infants (61.8%, 2 732/4 424) in IVF group and 502 male infants (53.2%, 502/943) in ICSI group. The SRB of IVF group (161.5∶100) was significantly higher than that of ICSI group (113.8∶100), and the difference was statistically significant ( P<0.001). In female patients aged ≤35 years, the effects of different embryo transfer methods and different fertilization methods on SRB were consistent with the results of total population. Univariate logistic regression analysis showed that the SRB of patients with ICSI was lower than that of patients with IVF, except for 3-6AA. There were significant differences in SRB between ICSI cycles patients (88.8∶100; 72.8∶100; 156.1∶100) and IVF cycles patients (130.7∶100; 124.8∶100; 206.3∶100) when the blastocyst grade was 3-6BB ( OR=0.679, 95% CI: 0.516-0.896, P=0.006), 3-6AB( OR=0.583, 95% CI: 0.421-0.809, P=0.001) and 3-6BA OR=0.757, 95% CI: 0.585-0.979, P=0.034). Taking 3-6BB blastocysts as reference, the SRB of 3-6AA and 3-6BA blastocysts were higher (IVF: OR=1.527, 95% CI: 1.258-1.854, P<0.001; OR=1.579,95% CI: 1.341-1.859, P<0.001; ICSI: OR=2.566, 95% CI: 1.661-3.966, P<0.001; OR=1.758, 95% CI: 1.250-2.472, P=0.001). Compared with 3-6BA, the SRB of 3-6BC blastocysts was lower (IVF: OR=0.621, 95% CI: 0.447-0.862, P=0.004; ICSI: OR=0.442, 95% CI: 0.238-0.818, P=0.009). Taking 3-6AB as reference, the SRB of 3-6AA blastocysts was higher (IVF: OR=1.600, 95% CI: 1.307-1.958, P<0.001; ICSI: OR=3.130, 95% CI: 1.964-4.987, P<0.001). Conclusion:The SRB of fresh embryo group is slightly higher than that of frozen-thawed group in single blastocyst transfer cycles. Different fertilization methods can affect SRB, and the SRB in IVF is significantly higher than that in ICSI group. The quality of blastocysts can affect SRB, and blastocysts with higher quality TE have significantly increased SRB, while ICM quality have no significant effect on SRB.

Objective:To evaluate the accuracy of p53 immunohistochemistry for predicting the mutational status of TP53 in gliomas.Methods:A retrospective study was conducted on 242 diffuse gliomas diagnosed at the Department of Pathology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China from June 2022 to March 2023. All cases underwent next-generation sequencing (NGS) and p53 immunohistochemical staining. The best threshold in the percentage of p53 immunohistochemical expression was assessed as an alternative to testing for TP53 mutation.Results:Among the 242 diffuse gliomas (WHO grade 2-4), 94 cases had a TP53 mutation. The p53 immunohistochemistry results revealed a significantly increased probability of TP53 mutation when the p53 immunohistochemical positivity rate (based on strongly positive cell count) was ≥20% ( P<0.05). The sensitivity and specificity of p53 immunohistochemistry for predicting TP53 gene mutations were 75.6% and 90.4%, respectively. When p53 immunohistochemical stain was totally negative, the probability of TP53 mutation increased significantly, and the mutation ratio of TP53 gene was 6/17 in all negative cases. Conclusions:When the percentage of p53 positive cells (based on strongly positive cell count) in glioma is ≥20%, p53 immunohistochemistry can be used as a reliable alternative method for TP53 mutation detection. When p53 immunohistochemistry is completely negative, the mutation rate of TP53 gene is higher, and further gene sequencing is recommended to determine the mutation status.