ObjectiveTo investigate the efficacy of selective internal radiation therapy （SIRT） in patients with unresectable hepatocellular carcinoma， and to provide a reference for the selection of clinical treatment regimens. MethodsA retrospective analysis was performed for the clinical data of 73 patients with unresectable hepatocellular carcinoma who received yttrium-90 microsphere SIRT in Eastern Hepatobiliary Surgery Hospital from May 1， 2023 to September 1， 2024. According to tumor characteristics， physical status， liver reserve function， laboratory tests， and SIRT treatment strategy， the patients were divided into radiation segmentectomy group with 9 patients， conversion therapy group with 47 patients， and palliative treatment group with 17 patients. Based on the results of postoperative follow-up， modified Response Evaluation Criteria in Solid Tumors were used to assess radiographic images. A one-way analysis of variance was used for comparison of normally distributed continuous data between three groups， and the chi-square test was used for comparison of categorical data between three groups； the Logistic regression model was used to perform the multivariate analysis. ResultsThere was a significant difference in postoperative outcome between the radiation segmentectomy group， the conversion therapy group， and the palliative treatment group （χ²=30.060， P<0.001）. The disease control rate was 100.0% （9/9） in the radiation segmentectomy group， 83.0% （39/47） in the conversion therapy group， and 29.4% （5/17） in the palliative treatment group， with a significant difference between the three groups （χ²=19.575， P<0.001）， and there was also a significant difference in objective response rate between the three groups （χ²=17.749， P<0.001）. The multivariate Logistic regression analysis showed that the number of tumors （odds ratio ［OR］=0.085， 95% confidence interval ［CI］： 0.008 — 0.906， P=0.041） and combined targeted immunotherapy （OR=18.808， 95%CI： 1.704 — 207.616， P=0.017） were independent influencing factors for achieving complete response. ConclusionThe number of tumors is an independent influencing factor for the efficacy of SIRT and is an important basis for selecting different treatment goals. SIRT combined with targeted immunotherapy may achieve better efficacy.

OBJECTIVES: To investigate the synergistic mechanism of the traditional Chinese medicine Rosa laevigata Michx. (RLM) for treatment of pulmonary arterial hypertension (PAH). METHODS: Network pharmacological analysis was carried out to screen the active ingredients of RLM and PAH disease targets and construct the "component-target-disease" interaction network, followed by gene enrichment analysis and molecular docking studies. In the cell experiments, primary cultures of rat pulmonary arterial smooth muscle cells were exposed to hypoxia for 24 h and treated with solvent or 100, 200 and 300 mg/mL RLM, and the changes in cell proliferation were detected using Western blotting for PCNA and immunofluorescence staining. In the animal experiment, male SD rats were randomized into 5 control group, monocrotaline (MCT) solvent group, and MCT with RLM (100, 200 and 300 mg/mL) treatment groups. HE staining and immunofluorescence staining were used to observe histopathological changes in the pulmonary blood vessels of the rats. RESULTS: Seven core active ingredients (including β-sitosterol and kaempferol) in RLM and 39 key disease targets were identified, and molecular docking showed that SRC was a high-affinity target. KEGG enrichment analysis showed that the differential genes were significantly enriched in calcium signaling and PI3K-AKT pathways. In rat pulmonary arterial smooth muscle cells, hypoxic exposure significantly up-regulated cellular expression of PCNA and phosphorylation levels of Src and AKT1, which were obviously lowered by RLM treatment. In RLM-treated rat models, the mean pulmonary artery pressure and right ventricular hypertrophy index (Fulton index) were significantly reduced, the tricuspid annular plane systolic excursion (TAPSE) was improved, and pulmonary vascular wall thickening and fibrosis were obviously ameliorated. CONCLUSIONS RLM inhibits pulmonary arterial smooth muscle cell proliferation in rat models of hypertension possibly by regulating the Src-AKT1 axis, suggesting the potential of RLM as a new natural drug for treatment of pulmonary hypertension.
Animals ; Cell Proliferation/drug effects* ; Proto-Oncogene Proteins c-akt/metabolism* ; Rats, Sprague-Dawley ; Pulmonary Artery/cytology* ; Male ; Rats ; Myocytes, Smooth Muscle/cytology* ; Hypertension, Pulmonary/pathology* ; Drugs, Chinese Herbal/pharmacology* ; Signal Transduction/drug effects* ; Muscle, Smooth, Vascular/cytology* ; src-Family Kinases/metabolism* ; Cells, Cultured

[Purpose]To analyze the trend of prostate cancer mortality in China from 2011 to 2020,and to predict the prostate cancer mortality trend from 2021 to 2030.[Methods]The data were collected from the National Mortality Surveillance System(NMSS)from 2011 to 2020,the burden of prostate cancer in China from 2011 to 2020 were analyzed by the number of deaths,age-standardized mortality rate(ASMR),years of life lost(YLL)and age-standardized YLL rate.Joinpoint regression model was used to calculate the average annual percentage change(AAPC)to describe the trend of change.The Bayesian age-period-cohort model was used to predict the mor-tality rate of prostate cancer from 2021 to 2030 and estimate the number of deaths of prostate can-cer in the future.Decomposition analysis was carried out to explore the potential drivers of changes of mortality.[Results]The number of prostate cancer deaths in China in 2020 was 30 805 with an ASMR of 5.56/105.The ASMR for prostate cancer in urban and rural areas was 6.56/105 and 4.84/105,respectively.From 2011 to 2020,the number of prostate cancer deaths,ASMR and age-standardized YLL rate of prostate cancer in China showed an upward trend,AAPC was 5.4％(95％CI:4.7％～6.1％),1.5％(95％CI:1.4％～1.6％)and 1.1％(95％CI:1.1％～1.2％),respective-ly.The ASMR of prostate cancer was higher in the eastern region than those in the central and western regions.Prostate cancer deaths increased in both urban and rural areas among people aged 60 years old and above.In 2030,it is predicted the ASMR of prostate cancer would increase to 5.74/105.Population aging,changes in age-specific mortality rates,and natural population growth accounted for 24.75％,2.77％,and 7.45％of the changes in total deaths of prostate can-cer,respectively.[Conclusion]The burden of prostate cancer is increasing in China.Targeted measures should be implemented in high-risk areas and high-risk groups to effectively reduce the disease burden caused by prostate cancer.

Objective To explore the impact of dyadic coping on fear of progression in patients with hematological tumors and their spouses based on the Actor-Partner Interdependence Model(APIM),and to provide references for clinical intervention.Methods By the convenient sampling method,136 pairs of hematological tumor patients and their spouses were selected from October 2023 to January 2024 in 5 tertiary hospitals in Shandong Province.A general information questionnaire,Dyadic Coping Inventory,Fear of Progression Questionnaire Short Form,and Fear of Progression Questionnaire Short Form/Partner Version were used to conduct the investigation.Amos 24.0 software was used to establish the APIM for dyadic coping with fear of progression.Results A total of 280 survey questionnaires were distributed,and 272 valid questionnaires were collected,including 136 from patients and their spouses,with an effective rate of 97.14％.The dyadic coping scores of hematological tumors patients and their spouses were(129.50±20.58)and(132.71±15.70),respectively,while the fear of progression scores were(31.71±3.13)and(29.01±3.05),respectively.Regarding the actors'effects,the level of dyadic coping strategies of patients and their spouses can both predict their own fear of progression,and are negatively correlated(β1=-0.52,β2=-0.41;P＜0.001).Regarding the partners'effects,the degree of fear of progression in patients is negatively correlated with the dyadic coping level of their spouses(β=-0.19,P＜0.001).Conclusion There is an interactive effect between the fear of progression and the level of dyadic coping between hematological tumor patients and their spouses.This suggests that clinical nursing staff should pay attention to the evaluation of fear of progression in patients with hematological tumors and their spouses,and effectively reduce the level of fear of progression on both sides.

Objective: To understand the impact of left behind experience on the mental health of secondary vocational school students, so as to provide theoretical basis for the psychological health education of secondary vocational school students. Methods: From September to December in 2019, a total of 3 401 students from Duyun, Guiding and Pingtang County were selected by multi stage cluster random sampling method. Self designed questionnaire and Symptom Check List-90(SCL-90) were used to investigate mental health status. A total of 1 415 left behind students and 1 415 non left behind students were matched by using propensity score matching (PSM). Wilcoxon test and Logistic regression analysis were conducted. Results: Before the matching of propensity score, there were statistically significant differences in the distribution of family structure, mother s educational level, family residence,family harmony and children s past health among the students with or without left behind experience ( χ 2=28.17, 52.40, 96.31, 29.75 , 19.10, P <0.05). After the matching, there were no statistically significant differences in the distribution of the above variables among the students with or without left behind experience ( χ 2=0.02-4.32, P >0.05). Before the matching of propensity scores, there were significant differences in the scores of 10 dimensions of SCL-90, including somatization (1.67,1.58), interpersonal sensitivity (2.00,1.89), anxiety (1.90,1.70), obsessive compulsive symptoms (2.20, 2.10), depression (2.00, 1.85), hostility (1.83, 1.67), terror (1.85, 1.71), paranoia (1.83, 1.67), psychotic (1.70, 1.60) and other (1.85, 1.71) dimensions among secondary vocational school students with or without left behind experience ( Z=-5.15 to -2.84, P <0.05). After propensity score matching, there were significant differences in scores remained only in three factors for interpersonal sensitivity [(2.00(1.56,2.67)，2.00(1.44,2.56)], paranoia [1.83(1.33,2.50)，1.83(1.33,2.33)] and psychoticism [1.70(1.30,2.30)，1.70(1.20,2.20)] in SCL- 90 among secondary vocational students with or without left behind experience ( Z=-2.45, -2.12, -2.23, P <0.05). Conclusion The impact of left behind experience on the mental health of vocational school students is mainly reflected in interpersonal sensitivity, paranoia, and psychoticism, which should be identified as key areas of psychological education for secondary vocational school students.

Background and aims:Metabolic dysfunction-associated fatty liver disease(MAFLD)is a common chronic condition that can lead to cancer due to its complex pathogenesis.Therapeutic agents targeting AMP-activated protein kinase(AMPK)activation have been suggested as potential treatments for metabolic disorders such as metabolic dysfunction-associated steatohepatitis(MASH).Rhizoma Atractylodis Mac-rocephalae(RAM)has been clinically used to treat obesity-related health problems,but its therapeutic effects on MAFLD and the underlying mechanism remain unclear.Therefore,this study was conducted to evaluate the function and underlying mechanism of RAM in the treatment of MAFLD.Methods:The effect of RAM decoction on MAFLD was evaluated using a high-fat diet(HFD)-induced MAFLD mouse model.In vitro studies were conducted using a palmitic acid/oleic acid-induced lipid accumulation model in the alpha mouse liver 12 cells and RAM-containing serum.The underlying mechanisms were elucidated through a combination of network pharmacology analysis,immunohis-tochemistry,western blotting,and polymerase chain reaction analysis.Results:Administration of RAM decoction significantly reduced body weight gain in MAFLD mice without changing food intake.The weights of the liver and inguinal adipose tissues were also reduced after RAM treatment.Additionally,RAM administration decreased serum levels of alanine aminotrans-ferase,aspartate transaminase,total cholesterol,triglyceride,low-density lipoprotein cholesterol,and glucose,while reducing lipid droplet accumulation in the liver tissues of MAFLD mice.The underlying mechanisms included the activation of the phosphorylation of AMPK and acetyl-CoA carboxylase(ACC),and inhibition of the expression of sterol regulatory element binding protein 1(SREBP1).However,RAM did not alter the protein expression levels of peroxisome proliferator-activated receptor α and carnitine palmitoyltransferase-1α.Furthermore,the RAM-induced upregulation of phosphorylated AMPK,phos-phorylated ACC,and SREBP1 expression,as well as the downregulation of fatty acid synthase expression,were reversed by using an AMPK inhibitor.Conclusions:Through a combination of network pharmacology and experimental validation,we demonstrated that RAM may exert therapeutic effects on MAFLD by inhibiting lipid synthesis and activating phosphorylated AMPK pathways.

Objective To explore the impact of dyadic coping on fear of progression in patients with hematological tumors and their spouses based on the Actor-Partner Interdependence Model(APIM),and to provide references for clinical intervention.Methods By the convenient sampling method,136 pairs of hematological tumor patients and their spouses were selected from October 2023 to January 2024 in 5 tertiary hospitals in Shandong Province.A general information questionnaire,Dyadic Coping Inventory,Fear of Progression Questionnaire Short Form,and Fear of Progression Questionnaire Short Form/Partner Version were used to conduct the investigation.Amos 24.0 software was used to establish the APIM for dyadic coping with fear of progression.Results A total of 280 survey questionnaires were distributed,and 272 valid questionnaires were collected,including 136 from patients and their spouses,with an effective rate of 97.14％.The dyadic coping scores of hematological tumors patients and their spouses were(129.50±20.58)and(132.71±15.70),respectively,while the fear of progression scores were(31.71±3.13)and(29.01±3.05),respectively.Regarding the actors'effects,the level of dyadic coping strategies of patients and their spouses can both predict their own fear of progression,and are negatively correlated(β1=-0.52,β2=-0.41;P＜0.001).Regarding the partners'effects,the degree of fear of progression in patients is negatively correlated with the dyadic coping level of their spouses(β=-0.19,P＜0.001).Conclusion There is an interactive effect between the fear of progression and the level of dyadic coping between hematological tumor patients and their spouses.This suggests that clinical nursing staff should pay attention to the evaluation of fear of progression in patients with hematological tumors and their spouses,and effectively reduce the level of fear of progression on both sides.

[Purpose]To analyze the trend of prostate cancer mortality in China from 2011 to 2020,and to predict the prostate cancer mortality trend from 2021 to 2030.[Methods]The data were collected from the National Mortality Surveillance System(NMSS)from 2011 to 2020,the burden of prostate cancer in China from 2011 to 2020 were analyzed by the number of deaths,age-standardized mortality rate(ASMR),years of life lost(YLL)and age-standardized YLL rate.Joinpoint regression model was used to calculate the average annual percentage change(AAPC)to describe the trend of change.The Bayesian age-period-cohort model was used to predict the mor-tality rate of prostate cancer from 2021 to 2030 and estimate the number of deaths of prostate can-cer in the future.Decomposition analysis was carried out to explore the potential drivers of changes of mortality.[Results]The number of prostate cancer deaths in China in 2020 was 30 805 with an ASMR of 5.56/105.The ASMR for prostate cancer in urban and rural areas was 6.56/105 and 4.84/105,respectively.From 2011 to 2020,the number of prostate cancer deaths,ASMR and age-standardized YLL rate of prostate cancer in China showed an upward trend,AAPC was 5.4％(95％CI:4.7％～6.1％),1.5％(95％CI:1.4％～1.6％)and 1.1％(95％CI:1.1％～1.2％),respective-ly.The ASMR of prostate cancer was higher in the eastern region than those in the central and western regions.Prostate cancer deaths increased in both urban and rural areas among people aged 60 years old and above.In 2030,it is predicted the ASMR of prostate cancer would increase to 5.74/105.Population aging,changes in age-specific mortality rates,and natural population growth accounted for 24.75％,2.77％,and 7.45％of the changes in total deaths of prostate can-cer,respectively.[Conclusion]The burden of prostate cancer is increasing in China.Targeted measures should be implemented in high-risk areas and high-risk groups to effectively reduce the disease burden caused by prostate cancer.

Objective:To explore the impact of sleep duration, physical exercise, and their interactions on the risk of dyslipidemia in older adults aged ≥80 (the oldest old) in China.Methods:The study subjects were the oldest old from four rounds of Healthy Aging and Biomarkers Cohort Study (2008-2009, 2011-2012, 2014 and 2017-2018). The information about their demographic characteristics, lifestyles, physical examination results and others were collected, and fasting venous blood samples were collected from them for blood lipid testing. Competing risk model was used to analyze the causal associations of sleep duration and physical exercise with the risk for dyslipidemia. Restricted cubic spline (RCS) function was used to explore the dose-response relationship between sleep duration and the risk for dyslipidemia. Additive and multiplicative interaction model were used to explore the interaction of sleep duration and physical exercise on the risk for dyslipidemia.Results:The average age of 1 809 subjects was (93.1±7.7) years, 65.1% of them were women. The average sleep duration of the subjects was (8.0±2.5) hours/day, 28.1% of them had sleep duration for less than 7 hours/day, and 27.2% had sleep for duration more than 9 hours/day at baseline survey. During the 9-year cumulative follow-up of 6 150.6 person years (follow-up of average 3.4 years for one person), there were 304 new cases of dyslipidemia, with an incidence density of 4 942.6/100 000 person years. The results of competitive risk model analysis showed that compared with those who slept for 7-9 hours/day, the risk for dyslipidemia in oldest old with sleep duration >9 hours/day increased by 22% ( HR=1.22, 95% CI: 1.07-1.39). Compared with the oldest old having no physical exercise, the risk for dyslipidemia in the oldest old having physical exercise decreased by 33% ( HR=0.67, 95% CI: 0.57-0.78). The RCS function showed a linear positive dose-response relationship between sleep duration and the risk for hyperlipidemia. The interaction analysis showed that physical exercise and sleep duration had an antagonistic effect on the risk for hyperlipidemia. Conclusion:Physical exercise could reduce the adverse effects of prolonged sleep on blood lipids in the oldest old.

Objective To evaluate the analgesic effects of ultrasound-guided hip capsule block and fascia iliaca block in elderly patients undergoing hip replacement surgery and their impacts on postoperative rehabilitation.Methods A total of 44 patients who underwent total hip replacement in the Second Affiliated Hospital of Wenzhou Medical University from May to December in 2023 were selected and divided into fascia iliaca block group(group F)and hip capsule block group(group H)according to the random number table,with 22 cases in each group.All patients were anesthetized by lumbar anesthesia combined with nerve block.The primary indicators included the recovery of lower limb muscle strength at 8h,24h,48h after operation and the rest and movement visual analogue scale(VAS)scores at each observation point.The secondary indicators were sufentanil consumption of analgesic pump,the number of compressions,the use rates of additional parecoxib sodium in ward,the length of hospital stay and the occurrence of adverse reactions.Results The recovery of lower limb muscle strength in group H was better than that in group F at 8h and 24h after operation,and the difference was statistically significant(P<0.05).The rest and movement VAS scores at 30min after block and 4h after operation in group H were significantly lower than those in group F(P<0.05),while there were no significant differences in the rest and movement VAS scores between two groups at other time points(P>0.05).The rest and movement VAS scores at each time point after blockade were lower than those before blockade in two groups(P<0.05).The sufentanil consumption in analgesic pump and the number of compressions in group H was lower than that in group F at 4h after operation(P<0.05),and there were no significant differences in analgesic pump data and the use rates of parecoxib sodium between two groups at subsequent time points(P>0.05).There were no statistically significant difference in the incidence of nausea within 48h after operation and hospital stay between two groups(P>0.05).Conclusion Both fascia iliaca block and hip capsule block can be safely and effectively used in elderly patients with hip replacement,but the analgesic effect of hip capsule block is faster,the early postoperative analgesic effect is better,and the impact on lower limb movement is less.