Metabolic associated fatty liver disease （MAFLD） is the main type of chronic liver disease in the world， with an increasingly higher incidence rate and a younger age of onset. At present， the treatment of MAFLD mainly depends on lifestyle intervention and comorbidity management， and there is still a lack of effective drugs for MAFLD itself. As a classic nonsteroidal anti-inflammatory drug of the salicylic acid family， aspirin can intervene in the pathological process of MAFLD by regulating lipid metabolism， relieving insulin resistance， reducing liver inflammation and oxidative stress response， exerting an anti-liver fibrosis effect， and inhibiting hepatocellular carcinoma， and therefore， it has the value of preventing disease onset， delaying disease progression， and reversing disease condition. This article systematically reviews the mechanism of action and safety of aspirin in the treatment of MAFLD， in order to provide more drug treatment options for MAFLD patients.

Hepatocellular carcinoma （HCC） is a malignant tumor with high incidence and mortality rates in China， and advanced HCC is a difficult issue in current treatment. Immune checkpoint inhibitor （ICI）， as an emerging treatment regimen， has shown a certain effect in clinical practice， but there are still problems such as low overall response rate and a high incidence rate of immune-related adverse events （irAEs）. Traditional Chinese medicine exhibits unique advantages in the treatment of advanced HCC. Through a retrospective analysis of related studies in recent years， this article shows that traditional Chinese medicine combined with ICI can control disease progression， prolong survival time， and reduce irAEs in the treatment of advanced HCC through the synergistic effect between multiple components， targets， and pathways. The potential mechanism of this treatment modality may involve various aspects such as the direct inhibition of tumor cells and the regulation of immune system and intestinal flora.

Objective To compare the efficacy and safety of perioperative chemotherapy regimens based on docetaxel administered in different cycles for locally advanced gastric cancer(LAGC)and gastroesophageal junction cancer(GEJC)through a network Meta-analysis.Methods PubMed,Embase,Cochrane Library,and Web of Science databases were electronically searched to collect randomized controlled trials(RCTs)evaluating docetaxel-based perioperative regimens for the treatment of LAGC and GEJC from inception to February 28,2025.Two researchers independently screened the literature,extracted relevant data,and assessed the risk of bias in the included studies.Subsequently,a network Meta-analysis was performed using R 4.5.0 software.Results A total of 10 RCTs involving 2,064 patients were included.The results of the network Meta-analysis showed that,compared with three cycles of epirubicin,cyclophosphamide,and fluorouracil(ECF regimen)and four cycles of platinum and fluorouracil(PF regimen),both three-cycle and four-cycle docetaxel,platinum,and fluorouracil(TPF regimen)significantly increased the complete tumor resection rate(R0 resection rate).Compared with surgery alone,the three-cycle TPF regimen significantly improved the R0 resection rate.Additionally,the four-cycle TPF regimen significantly improved 3-year and 5-year progression-free survival(PFS)compared with the two-cycle PF regimen,and significantly improved overall survival(OS)at 3 and 5 years compared with the three-cycle ECF regimen.Compared with surgery alone,the three-cycle TPF regimen also significantly increased the pathological complete response rate(pCR rate).Furthermore,compared with the two-cycle TPF and three-cycle ECF regimens,the four-cycle TPF and PF regimens were associated with a lower risk of surgical complications.Conversely,the two-cycle TPF and three-cycle ECF regimens significantly increased the risk of surgical complications compared with surgery alone.No statistically significant differences were observed in the incidence of grade 3 to 4 adverse events among the treatment regimens(P＞0.05).Based on the surface under the cumulative ranking curve(SUCRA)plot and pairwise comparisons,the three-cycle PF regimen appeared to be the most effective in achieving the highest R0 resection rate,the three-cycle TPF regimen appeared to be the most effective in achieving the highest pCR rate,while the four-cycle TPF regimen was associated with the best outcomes in terms of 3-year and 5-year PFS and OS.Conclusion The four-cycle TPF regimen may be associated with the optimal PFS and OS among perioperative chemotherapy regimens.No statistically significant differences were observed between the four-cycle TPF and the three-cycle PF in terms of R0 resection rate,between the four-cycle TPF and the three-cycle TPF in terms of pCR rate,or between the four-cycle TPF and the other seven regimens included in the study in terms of safety assessment.The four-cycle TPF regimen may represent the optimal perioperative chemotherapy regimen for patients with LAGC and GEJC.

Objective:To investigate the effect of mild moxibustion on transient receptor potential vanilloid type 1(TRPV1)channel expression in primary dysmenorrhea(PD)rats and explore its mechanism in alleviating central pain sensitization.Methods:Thirty-two female non-pregnant Wistar rats were randomized into a blank group,a model group,a mild moxibustion group,and a capsazepine group,with 8 rats in each group.Except for the blank group,the other three groups used estradiol benzoate,ice-water bath,and oxytocin to establish the rat PD model of cold-dampness stagnation pattern.The interventions began on day 1 of modeling,once a day,and lasted 10 d.The mild moxibustion group received mild moxibustion at Shenque(CV8)and Guanyuan(CV4),20 min/time;in the capsazepine group,capsazepine was injected at a dose of 2 mg/(kg·bw).The abdominal pain threshold was measured 10-30 min after oxytocin injection on day 11;enzyme-linked immunosorbent assay was used to detect serum prostaglandin F2α(PGF2α)level;the expression of TRPV1,cluster of differentiation 11B(CD11B),and proto-oncogene c-Fos in the spinal dorsal horn and hypothalamus was detected by immunofluorescence and Western blotting.Results:Compared to the blank group,the model group showed a decreased pain threshold(P<0.05)and an increased serum PGF2α level with elevated TRPV1,CD11B,and c-Fos protein expression in the spinal dorsal horn and hypothalamus(P<0.05).Compared to the model group,both the mild moxibustion group and capsazepine group showed significantly increased pain thresholds(P<0.05),along with decreased serum PGF2α levels and reduced protein expression levels of TRPV1,CD11B,and c-Fos in the spinal dorsal horn and hypothalamus(P<0.05).Rat pain threshold in the capsazepine group was higher than that in the mild moxibustion group(P<0.05).Serum PGF2α level,the expression levels of CD11B and c-Fos proteins in the spinal dorsal horn,as well as TRPV1,CD11B,and c-Fos proteins in the hypothalamus of the capsazepine group were lower than those in the mild moxibustion group(P<0.05).Conclusion:Mild moxibustion at Shenque(CV8)and Guanyuan(CV4)may alleviate the central pain sensitization in PD rats by down-regulating TRPV1 channel expression in the spinal dorsal horn and hypothalamus,thus playing an analgesic effect.

As one of the major public health challenges globally, tuberculosis requires epidemiological research for its control and prevention. With the advent of the big data era, machine learning has advantages over traditional methods in handling complex, high-dimensional datasets and providing accurate predictive results. This paper introduces the application of machine learning in the discovery and diagnosis of tuberculosis cases, risk factor analysis, predictive modeling, and evaluation of intervention strategies, providing new means for more in-depth exploration of the value in tuberculosis epidemiological research.

Objective To understand the current status of stigma among lung cancer patients in Yunnan and analyze its influencing factors.Methods A convenience sampling method was employed to select 248 lung cancer patients from a tertiary cancer hospital in Yunnan from July 2022 to July 2023.A demographic questionnaire and the Chinese version of the Lung Cancer Patient Stigma Scale were used to investigate their demographic characteristics and stigma levels.Results The total score of stigma in lung cancer patients was(96.92±14.87).Multiple linear regression analysis showed that education level,long-term residence,ethnicity and family relationship were the influencing factors of stigma score in lung cancer patients(P<0.05).Conclusion The stigma level among lung cancer patients is relatively high.Patients with higher education levels,those living in rural areas for a long time,ethnic minorities,and those with better family relationships exhibited higher stigma levels.Enhancing the accessibility of medical resources,establishing a comprehensive social support system,and paying attention to and respecting the cultural differences and beliefs of lung cancer patients can provide them with greater understanding,support,and encouragement,thereby reducing the stigma levels.

As one of the major public health challenges globally, tuberculosis requires epidemiological research for its control and prevention. With the advent of the big data era, machine learning has advantages over traditional methods in handling complex, high-dimensional datasets and providing accurate predictive results. This paper introduces the application of machine learning in the discovery and diagnosis of tuberculosis cases, risk factor analysis, predictive modeling, and evaluation of intervention strategies, providing new means for more in-depth exploration of the value in tuberculosis epidemiological research.

Objective:To explore how nurses respond to and experience task uncertainty in prehospital emergency care.Methods:Using purposive sampling, 13 prehospital emergency nurses from two tertiary hospitals in Shandong Province were selected between June and August 2024. Semi-structured interviews were conducted face-to-face. The interview data were analyzed using Colaizzi's seven-step method.Results:Four main themes were identified: a certain degree of task uncertainty exists in prehospital emergency care; nurses have varied emotional and cognitive responses to such uncertainty; nurses adopt diverse coping strategies; organizational-level interventions are essential to improving nurses' experiences.Conclusions:Nurses recognize the presence of task uncertainty in prehospital emergency care and demonstrate different responses and coping strategies. This highlights the need for both nurses and healthcare managers to acknowledge this characteristic of emergency work, help nurses alleviate negative experiences, foster positive coping mechanisms, and ensure the quality of prehospital emergency nursing services.

Objective To compare the efficacy and safety of perioperative chemotherapy regimens based on docetaxel administered in different cycles for locally advanced gastric cancer(LAGC)and gastroesophageal junction cancer(GEJC)through a network Meta-analysis.Methods PubMed,Embase,Cochrane Library,and Web of Science databases were electronically searched to collect randomized controlled trials(RCTs)evaluating docetaxel-based perioperative regimens for the treatment of LAGC and GEJC from inception to February 28,2025.Two researchers independently screened the literature,extracted relevant data,and assessed the risk of bias in the included studies.Subsequently,a network Meta-analysis was performed using R 4.5.0 software.Results A total of 10 RCTs involving 2,064 patients were included.The results of the network Meta-analysis showed that,compared with three cycles of epirubicin,cyclophosphamide,and fluorouracil(ECF regimen)and four cycles of platinum and fluorouracil(PF regimen),both three-cycle and four-cycle docetaxel,platinum,and fluorouracil(TPF regimen)significantly increased the complete tumor resection rate(R0 resection rate).Compared with surgery alone,the three-cycle TPF regimen significantly improved the R0 resection rate.Additionally,the four-cycle TPF regimen significantly improved 3-year and 5-year progression-free survival(PFS)compared with the two-cycle PF regimen,and significantly improved overall survival(OS)at 3 and 5 years compared with the three-cycle ECF regimen.Compared with surgery alone,the three-cycle TPF regimen also significantly increased the pathological complete response rate(pCR rate).Furthermore,compared with the two-cycle TPF and three-cycle ECF regimens,the four-cycle TPF and PF regimens were associated with a lower risk of surgical complications.Conversely,the two-cycle TPF and three-cycle ECF regimens significantly increased the risk of surgical complications compared with surgery alone.No statistically significant differences were observed in the incidence of grade 3 to 4 adverse events among the treatment regimens(P＞0.05).Based on the surface under the cumulative ranking curve(SUCRA)plot and pairwise comparisons,the three-cycle PF regimen appeared to be the most effective in achieving the highest R0 resection rate,the three-cycle TPF regimen appeared to be the most effective in achieving the highest pCR rate,while the four-cycle TPF regimen was associated with the best outcomes in terms of 3-year and 5-year PFS and OS.Conclusion The four-cycle TPF regimen may be associated with the optimal PFS and OS among perioperative chemotherapy regimens.No statistically significant differences were observed between the four-cycle TPF and the three-cycle PF in terms of R0 resection rate,between the four-cycle TPF and the three-cycle TPF in terms of pCR rate,or between the four-cycle TPF and the other seven regimens included in the study in terms of safety assessment.The four-cycle TPF regimen may represent the optimal perioperative chemotherapy regimen for patients with LAGC and GEJC.

Objective:To investigate the effect of mild moxibustion on transient receptor potential vanilloid type 1(TRPV1)channel expression in primary dysmenorrhea(PD)rats and explore its mechanism in alleviating central pain sensitization.Methods:Thirty-two female non-pregnant Wistar rats were randomized into a blank group,a model group,a mild moxibustion group,and a capsazepine group,with 8 rats in each group.Except for the blank group,the other three groups used estradiol benzoate,ice-water bath,and oxytocin to establish the rat PD model of cold-dampness stagnation pattern.The interventions began on day 1 of modeling,once a day,and lasted 10 d.The mild moxibustion group received mild moxibustion at Shenque(CV8)and Guanyuan(CV4),20 min/time;in the capsazepine group,capsazepine was injected at a dose of 2 mg/(kg·bw).The abdominal pain threshold was measured 10-30 min after oxytocin injection on day 11;enzyme-linked immunosorbent assay was used to detect serum prostaglandin F2α(PGF2α)level;the expression of TRPV1,cluster of differentiation 11B(CD11B),and proto-oncogene c-Fos in the spinal dorsal horn and hypothalamus was detected by immunofluorescence and Western blotting.Results:Compared to the blank group,the model group showed a decreased pain threshold(P<0.05)and an increased serum PGF2α level with elevated TRPV1,CD11B,and c-Fos protein expression in the spinal dorsal horn and hypothalamus(P<0.05).Compared to the model group,both the mild moxibustion group and capsazepine group showed significantly increased pain thresholds(P<0.05),along with decreased serum PGF2α levels and reduced protein expression levels of TRPV1,CD11B,and c-Fos in the spinal dorsal horn and hypothalamus(P<0.05).Rat pain threshold in the capsazepine group was higher than that in the mild moxibustion group(P<0.05).Serum PGF2α level,the expression levels of CD11B and c-Fos proteins in the spinal dorsal horn,as well as TRPV1,CD11B,and c-Fos proteins in the hypothalamus of the capsazepine group were lower than those in the mild moxibustion group(P<0.05).Conclusion:Mild moxibustion at Shenque(CV8)and Guanyuan(CV4)may alleviate the central pain sensitization in PD rats by down-regulating TRPV1 channel expression in the spinal dorsal horn and hypothalamus,thus playing an analgesic effect.