Objective To investigate the role of cellular autophagy in medullary thyroid carcinoma (MTC) under doxorubicin (DOX)-induced stress and chemoresistance and to evaluate the synergistic antitumor effect of combining the autophagy inhibitor chloroquine (CQ) with DOX. Methods The human MTC cell line TT was used as an in vitro model and assigned to four groups: control, DOX, CQ, and DOX+CQ combination. Autophagy flux was assessed by Western blot analysis of LC3-Ⅱ protein expression, whereas autophagic structures were observed through transmission electron microscopy (TEM). An MTC xenograft model was established in nude mice, and tumor-bearing mice were randomly allocated to corresponding treatment groups. Tumor growth volume and weight were monitored, and autophagy levels in tumor tissues were detected. Results In vitro experiments showed that DOX treatment considerablyincreased LC3-Ⅱ levels, indicating autophagy induction. The combination of DOX and CQ led to further LC3-Ⅱaccumulation, and TEM revealed numerous undegraded autophagosomes and abnormal autolysosomes, confirming the successful blockade of autophagic flux. In vivo, the DOX+CQ combination therapy inhibited tumor growth significantly more effectively than any single-agent treatment (tumor inhibition rate: 60.0%, P<0.01) without causing considerable systemic toxicity. Marked accumulation of LC3-Ⅱ in tumor tissues from the combination group indicated the effective inhibition of autophagic flux in vivo. Conclusion Functional autophagy flux is a key mechanism underlying DOX chemoresistance in MTC. CQ can effectively reverse this resistance by blocking autophagic flux, and its combination with DOX exhibits a considerable synergistic antitumor effect. These findings suggest a promising therapeutic strategy for the management of advanced MTC.

Objective To investigate whether Danshen injection (DSI) can protect human brain organoids from oxidative stress damage by regulating the Nrf2 signaling pathway and its mechanism. Methods A Nrf2 plasmid was constructed, lentivirus was packaged and transfected into human induced pluripotent stem cell (hiPSC) to form a stable cell line. Brain organoids with Nrf2 overexpression (LV-Nrf2 group) and knockdown (sh-Nrf2 group) were constructed using kit. The transfection efficiency was verified by real-time fluorescence quantitative polymerase chain reaction. An oxidative stress injury model was established by inducing hydrogen peroxide (H₂O₂). Intervention was performed either in combination or without DSI pre-treatment. Cell viability was detected by Cell Counting Kit-8 (CCK-8), and the expression levels of Nrf2, malondialdehyde (MDA), interleukin (IL)-1β, sex-determining region Y-box protein 2 (SOX2) and neuronal-specific nuclear protein (NeuN) were detected by Western blot and immunofluorescence staining. Total RNA from human brain organoids was extracted for transcriptome sequencing and analysis. Results LV-Nrf2 group and sh-Nrf2 group brain organoid models were successfully constructed. The CCK-8 results determined that the oxidative stress model was established with 32 mmol/L H₂O₂ intervention conditions. The fluorescence expression of Nrf2 in LV-Nrf2 group was higher than that in control group, and the fluorescence expressions of MDA and IL-1β were lower than those in control group; sh-Nrf2 group showed a damage phenotype of low Nrf2 expression, high MDA and IL-1β expression (all P < 0.05). Compared with H₂O₂ group, the Nrf2 signal in DSI + H₂O₂ group was stronger, and the levels of MDA and IL-1β were lower. Among them, the protective effect of LV-Nrf2 was the most significant. H₂O₂ treatment could down-regulate the protein levels of Nrf2, SOX2 and NeuN, and DSI intervention could effectively reverse the downward trend of these indicators. Sh-Nrf2 could weaken the recovery effect of DSI on SOX2 and NeuN, while LV-Nrf2 could synergistically enhance the regulatory effect of DSI. Conclusions DSI may antagonize oxidative stress damage in human brain organoids through the Nrf2 signaling pathway, and maintaining the stability of the neural cell lineage is its core therapeutic characteristic.

Objective:To understand the usage situation of e-cigarettes among residents aged 18-65 in Beijing, explore the relationship between e-cigarette use and cigarette smoking as well as smoking cessation behaviors, and provide scientific support for the developing and improving policies and measures related to e-cigarettes.Methods:Using 19 684 residents data from the Beijing Non-communication Chronic Disease and Risk Factors Surveillance in 2022, complex sampling weighted methods were used to estimate proportions, and complex sampling logistic regression analysis was applied to explore the relationship between e-cigarette use, cigarette smoking, and smoking cessation.Results:Among all study participants, the proportion of those who had ever used e-cigarettes was 3.36%, with the current e-cigarette use at 1.26%. The proportion of current e-cigarette users (1.87%) and the former e-cigarette users (3.47%) were higher ( χ2=64.70, P<0.001) among males compared to females (0.60% and 0.64% respectively). The top three reasons for using e-cigarettes were wanting to quit smoking, perceiving e-cigarettes as less harmful, and enjoying the flavors of e-cigarettes. 83.54% of e-cigarette users started with cigarettes. The results of the complex sampling multivariable logistic regression analysis showed that current smoking ( OR=61.35, 95% CI: 36.98-101.76) and former smoking ( OR=31.20, 95% CI: 15.52-62.71) were positively associated with e-cigarette, while current e-cigarette use ( OR=0.13, 95% CI: 0.04-0.39) was negatively associated with quitting cigarette smoking. Conclusions:The proportion of e-cigarette use in Beijing was relatively low. E-cigarette use was associated with cigarette use and was not conducive to smoking cessation. Therefore, stronger regulatory measures and health education campaigns regarding the risks of e-cigarettes should be implemented.

Objective To compare the efficacy and safety of different cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) combined with endocrine therapy (ET) for the treatment of hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2−) advanced or metastatic breast cancer. Methods Randomized controlled trials (RCTs) on CDK4/6i for the treatment of HR+/HER2− metastatic or advanced breast cancer were retrieved from databases including PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, Wanfang, VIP, and SinoMed, with the search period ranging from database inception to August 2023. Bayesian network meta-analysis was conducted using R 4.2.0 software. Results A total of 18 RCTs from 25 articles, involving 8 031 patients and 11 treatment regimens, were included. There was no significant difference in progression-free survival (PFS) or overall survival (OS) among different CDK4/6i+ET combinations. The highest cumulative probability for PFS was observed with dalpiciclib (DAL)+fulvestrant (FUL), while ribociclib (RIB)+FUL ranked first for OS. In terms of efficacy, abemaciclib (ABE)+aromatase inhibitors (AI) and ABE+FUL ranked first in objective response rate and clinical benefit rate, respectively. Regarding safety, statistically significant difference in grade 3-4 adverse events was observed among certain types of CDK4/6i (P<0.05). Conclusion Current evidence suggests that CDK4/6i+ET is superior to ET alone for the treatment of HR+/HER2− advanced/metastatic breast cancer. Different CDK4/6i+ET combinations demonstrate comparable or similar efficacy; however, the incidence of adverse reactions is higher with combination therapy. Treatment regimens should be selected based on individual conditions.

BACKGROUND: The global rise in diabetes prevalence is a pressing concern. Despite initiatives like "The Healthy Beijing Action 2020-2030" advocating for increased awareness, treatment, and control, the specific situation in Beijing remains unexplored. This study aimed to analyze the trends in diabetes prevalence, awareness, treatment, and control among Beijing adults. METHODS: Through a stratified multistage probability cluster sampling method, a series of representative cross-sectional surveys were conducted in Beijing from 2005 to 2022, targeting adults aged 18-79 years. A face-to-face questionnaire, along with body measurements and laboratory tests, were administered to 111,943 participants. Data from all survey were age- and/or gender-standardized based on the 2020 Beijing census population. Annual percentage rate change (APC) or average annual percentage rate change (AAPC) was calculated to determine prevalence trends over time. Complex sampling logistic regression models were employed to explore the relationship between various characteristics and diabetes. RESULTS: From 2005 to 2022, the total prevalence of diabetes among Beijing adults aged 18-79 years increased from 9.6% (95% CI: 8.8-10.4%) to 13.9% (95% CI: 13.1-14.7%), with an APC/AAPC of 2.1% (95% CI: 1.1-3.2%, P <0.05). Significant increases were observed among adults aged 18-39 years and rural residents. Undiagnosed diabetes rose from 3.5% (95% CI: 3.2-4.0%) to 7.2% (95% CI: 6.6-7.9%) with an APC/AAPC of 4.1% (95% CI: 0.5-7.3%, P <0.05). However, diabetes awareness and treatment rates showed annual declines of 1.4% (95% CI: -3.0% to -0.2%, P <0.05) and 1.3% (95% CI: -2.6% to -0.2%, P <0.05), respectively. The diabetes control rate decreased from 21.5% to 19.1%, although not statistically significant (APC/AAPC = -1.5%, 95% CI: -5.6% to 1.9%). Overweight and obesity were identified as risk factors for diabetes, with ORs of 1.65 (95% CI: 1.38-1.98) and 2.48 (95% CI: 2.07-2.99), respectively. CONCLUSIONS The prevalence of diabetes in Beijing has significantly increased between 2005 and 2022, particularly among young adults and rural residents. Meanwhile, there has been a concerning decrease in diabetes awareness and treatment rates, while control rates have remained stagnant. Regular blood glucose testing, especially among adults aged 18-59 years, should be warranted. Furthermore, being male, elderly, overweight, or obese was associated with higher diabetes risk, suggesting the needs for targeted management strategies.
Humans ; Adult ; Middle Aged ; Male ; Female ; Aged ; Adolescent ; Young Adult ; Cross-Sectional Studies ; Diabetes Mellitus/epidemiology* ; Beijing/epidemiology* ; Prevalence ; China/epidemiology* ; Surveys and Questionnaires

Objective:To understand the usage situation of e-cigarettes among residents aged 18-65 in Beijing, explore the relationship between e-cigarette use and cigarette smoking as well as smoking cessation behaviors, and provide scientific support for the developing and improving policies and measures related to e-cigarettes.Methods:Using 19 684 residents data from the Beijing Non-communication Chronic Disease and Risk Factors Surveillance in 2022, complex sampling weighted methods were used to estimate proportions, and complex sampling logistic regression analysis was applied to explore the relationship between e-cigarette use, cigarette smoking, and smoking cessation.Results:Among all study participants, the proportion of those who had ever used e-cigarettes was 3.36%, with the current e-cigarette use at 1.26%. The proportion of current e-cigarette users (1.87%) and the former e-cigarette users (3.47%) were higher ( χ2=64.70, P<0.001) among males compared to females (0.60% and 0.64% respectively). The top three reasons for using e-cigarettes were wanting to quit smoking, perceiving e-cigarettes as less harmful, and enjoying the flavors of e-cigarettes. 83.54% of e-cigarette users started with cigarettes. The results of the complex sampling multivariable logistic regression analysis showed that current smoking ( OR=61.35, 95% CI: 36.98-101.76) and former smoking ( OR=31.20, 95% CI: 15.52-62.71) were positively associated with e-cigarette, while current e-cigarette use ( OR=0.13, 95% CI: 0.04-0.39) was negatively associated with quitting cigarette smoking. Conclusions:The proportion of e-cigarette use in Beijing was relatively low. E-cigarette use was associated with cigarette use and was not conducive to smoking cessation. Therefore, stronger regulatory measures and health education campaigns regarding the risks of e-cigarettes should be implemented.

Objective:To construct a risk prediction model for radiation dermatitis in the perineum of cervical cancer patients undergoing radiotherapy, and verify the predictive effect of the model, so as to provide theoretical basis for reducing the risk of perineal radiation dermatitis in clinical practice.Methods:A prospective study design was used to conveniently select 247 cervical cancer patients who received radiotherapy at Tianjin Medical University Cancer Institute & Hospital from January 2022 to March 2023 as the modeling group. They were divided into a group with perineal radiodermatitis ( n = 130) and a group without perineal radiodermatitis ( n = 117). The data of the two groups were compared, and a risk prediction model was constructed based on the results of logistic regression analysis. Used the area under the receiver operating characteristic (ROC) curve to test the predictive performance of the model. From May to November 2023, 109 patients were selected as the validation group to conduct external validation of the model. Results:Among the 247 patients in the modeling group, the age of the group with perineal radiodermatitis was (45.31 ± 7.25) years old, and the age of the group without perineal radiodermatitis was (46.70 ± 6.43) years old. The incidence of perineal radiation dermatitis during radiotherapy in the modeling group was 52.6% (130/247), while in the validation group it was 44.0% (48/109). The final predictive variables included in the model were high blood sugar or not ( OR = 0.304, 95% CI 0.174-0.530), vaginal bleeding/discharge or not ( OR = 4.338, 95% CI 2.397-7.854), involvement of 1/3 of the vagina or not ( OR = 0.497, 95% CI 0.281-0.879), whether topical skin protectants could be used( OR = 3.479, 95% CI 1.596-7.583), whether skin protectants could be used in a standardized manner ( OR = 2.399, 95% CI 1.201-4.789), whether the skin could be cleaned with the correct cleaning agent ( OR = 3.155, 95% CI 1.603-6.209), and whether the skin could be wiped with the correct method ( OR = 3.325, 95% CI 1.806-6.121), totaling 7 predictive factors (all P<0.05). The area under the ROC curve of the prediction model was 0.866, the sensitivity was 0.735, and the specificity was 0.852, the Youden index was 0.587. Model validation results showed the area under the ROC curve was 0.762, the sensitivity was 0.815, the specificity was 0.717, and the accuracy was 80.73%, indicating good predictive performance. Conclusions:The predictive model constructed in this study had good predictive performance and could provide reference for clinical nursing staff to screen high-risk patients with perineal radiation dermatitis.

Objective:To construct a risk prediction model for radiation dermatitis in the perineum of cervical cancer patients undergoing radiotherapy, and verify the predictive effect of the model, so as to provide theoretical basis for reducing the risk of perineal radiation dermatitis in clinical practice.Methods:A prospective study design was used to conveniently select 247 cervical cancer patients who received radiotherapy at Tianjin Medical University Cancer Institute & Hospital from January 2022 to March 2023 as the modeling group. They were divided into a group with perineal radiodermatitis ( n = 130) and a group without perineal radiodermatitis ( n = 117). The data of the two groups were compared, and a risk prediction model was constructed based on the results of logistic regression analysis. Used the area under the receiver operating characteristic (ROC) curve to test the predictive performance of the model. From May to November 2023, 109 patients were selected as the validation group to conduct external validation of the model. Results:Among the 247 patients in the modeling group, the age of the group with perineal radiodermatitis was (45.31 ± 7.25) years old, and the age of the group without perineal radiodermatitis was (46.70 ± 6.43) years old. The incidence of perineal radiation dermatitis during radiotherapy in the modeling group was 52.6% (130/247), while in the validation group it was 44.0% (48/109). The final predictive variables included in the model were high blood sugar or not ( OR = 0.304, 95% CI 0.174-0.530), vaginal bleeding/discharge or not ( OR = 4.338, 95% CI 2.397-7.854), involvement of 1/3 of the vagina or not ( OR = 0.497, 95% CI 0.281-0.879), whether topical skin protectants could be used( OR = 3.479, 95% CI 1.596-7.583), whether skin protectants could be used in a standardized manner ( OR = 2.399, 95% CI 1.201-4.789), whether the skin could be cleaned with the correct cleaning agent ( OR = 3.155, 95% CI 1.603-6.209), and whether the skin could be wiped with the correct method ( OR = 3.325, 95% CI 1.806-6.121), totaling 7 predictive factors (all P<0.05). The area under the ROC curve of the prediction model was 0.866, the sensitivity was 0.735, and the specificity was 0.852, the Youden index was 0.587. Model validation results showed the area under the ROC curve was 0.762, the sensitivity was 0.815, the specificity was 0.717, and the accuracy was 80.73%, indicating good predictive performance. Conclusions:The predictive model constructed in this study had good predictive performance and could provide reference for clinical nursing staff to screen high-risk patients with perineal radiation dermatitis.

Objective To explore the feasibility and clinical outcome of lateral cervical incision via sternocleidomastoid intermuscular approach(SMIA)in the treatment of primary hyperparathyroidism.Methods The clinical data of 64 patients with primary hyperparathyroidism who underwent unilateral parathyroid surgery in the First Affiliated Hospital,School of Medicine of Zhejiang University from January 2019 to June 2022 were retrospectively analyzed.They were divided into lateral cervical incision via sternocleidomastoid intermuscular approach group(SMIA group)and linea alba cervicalis approach group(LACA group)based on the surgical incision and access route.The differences in clinical features,surgery-related outcomes and postoperative functions of the anterior cervical region were compared between the two groups.The EQ-5D-5L scale was used to assess the subjective feeling of postoperative neck discomfort,while the Hollander Wound Assessment Scale was used to assess the clinical outcome of incision healing.Results There were no statistical differences between the two groups of patients in terms of age,gender,intraoperative bleeding,parathyroid hormone or blood calcium levels before and after surgery(P＞0.05).The duration of surgery was significantly shorter in the SMIA group than in the LACA group[(39.77±5.69)min vs.(54.41±4.66)min].There was a statistical difference between the two groups in functional protection of the anterior cervical region at 1 month and 12 months after surgery(1 month,84.67±3.74 vs.79.47±5.38,P＜0.001;12 months,93.80±2.52 vs.89.94±2.39,P＜0.001),and the SMIA group was better than the LACA group.The Hollander Incision Assessment Scale scores of the SMIA group were better than those of the LACA group at 6 months and 12 months after surgery,and the difference was statistically significant(6 months,1.93±0.58 vs.2.41±0.66,P=0.003;12 months,1.03±0.67 vs.1.74±0.62,P＜0.001).Conclusion Parathyroidectomy via sternocleidomastoid intermuscular approach through lateral cervical incision is a simple,safe and effective surgical procedure,which makes it easier to search for parathyroid lesions and shortens the surgical time compared with the traditional incision,and has obvious advantages in the protection of anterior cervical region function.

Objective:To investigate the related factors of pleasure loss in patients with human immunodefi-ciency virus(HIV)/acquired immune deficiency syndrome(AIDS).Methods:Totally 237 patients with HIV/AIDS from a certain infectious disease hospital were selected and surveyed with a self-designed general information ques-tionnaire,the Temporal Pleasure Experience Scale(TEPS),Self Acceptance Scale(SAQ),Discrimination Percep-tion Scale(SIS),and Perceived Social Support Scale(PSSS).Results:The patient's TEPS score was(73.4±16.1).Stepwise linear regression analysis showed that the PSSS total scores,education level,and personal monthly income were positively correlated with the TEPS total scores(β=0.41,5.17,4.63),and age was negatively corre-lated with the TEPS total scores(β=-0.30).Conclusion:It suggests that more attention should be paid to the lack of pleasure in patients with HIV/AIDS,and the lack of pleasure is related to personal monthly income,educa-tion level,age and perceived social support.