Animal experimentation constitutes a critical link between basic research and clinical application, making its research quality and translational efficiency paramount. Although considerable progress has been made in standardizing operational procedures and ethical guidelines, the standardization of outcome evaluation systems has significantly lagged, creating a key bottleneck that constrains the quality of biomedical research and evidence synthesis. This deficiency is manifested by pronounced heterogeneity in outcome selection across similar studies, incomplete methodological reporting, and disparate criteria for result interpretation, which severely impairs the comparability of findings and the evidence integration. To cope with this challenge, this paper systematically introduces a mature methodological tool from clinical research–the core outcome set (COS)–and explores its construction strategies and application potential in the field of animal experimentation. Given the extensive diversity of animal experiments, a pragmatic strategy of "focusing on key areas, implementing phased pilots, and promoting gradual expansion" should be adopted. This approach prioritizes the development of domain-specific COS for disease areas characterized by high research volume, urgent translational needs, and well-established animal models. A multi-source integration pathway for COS development is detailed, comprising systematic literature searches, methodological appraisals, and expert consensus, with the feasibility of leveraging artificial intelligence (AI) to enhance efficiency also being examined. The development and promotion of such COS are not intended to restrict scientific exploration; rather, they aim to establish a new, tiered evaluation paradigm consisting of "core outcomes" (mandatory), "recommended outcomes" (encouraged), and "exploratory outcomes" (optional). This framework is expected not only to enhance research quality through standardization and to adhere to the "3R" principles but also to accelerate the accumulation of high-quality evidence. This, in turn, provides a solid foundation for higher-level evidence synthesis, ultimately facilitating the effective translation of basic research findings into clinical practice and providing an essential methodological framework for scientific advancement in relevant disciplines.

Abstract To improve adolescent health behavior, the study summarizes and analyzes the performance, pathways of transmission, and influencing factors of the intergenerational transmission of adolescent health behaviors from the perspective of intergenerational transmission. The study emphasizes the need to deepen research on the intergenerational transmission of adolescent health behaviors, promote multidisciplinary and cross team collaboration, and shift adolescent health care from individual focused care to a holistic approach that prioritizes family and community culture. Simultaneously, an action framework should be established to block the intergenerational transmission of health risk behaviors, with a focus on childhood and adolescence. Additionally, parent-child participatory health education and health promotion activities should be carried out under a tripartite coordinated intervention model involving the community, school, and family, collectively fostering the development of healthy behaviors among adolescents.

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 analyze the occupational medical examination (OME) conclusions for noise-exposed workers issued by OME institutions in Shijiazhuang City. Methods A total of 1 111 noise-exposed workers, whose OME reports were issued by 32 OME institutions in Shijiazhuang City from 2022 to 2024, were selected as the study subjects using the convenience sample method. Expert review was conducted to re-evaluate the initial OME conclusions for noise-exposed workers, and reasons for inconsistencies between the initial and reviewed conclusions were analyzed. Results Initial OME conclusions included occupational contraindications, re-examination, other diseases or abnormalities, and no abnormal findings, with 109, 286, 378, and 338 cases, respectively. After expert review, the consistency rate for occupational contraindication conclusions was 91.7%, with two suspected cases of occupational noise-induced deafness (ONID) and seven cases of other diseases or abnormalities identified. For other diseases or abnormalities, the consistency rate was 95.5%, with one cases of suspected ONID and 16 occupational contraindications detected. In terms of no abnormal findings, the consistency rate was 70.4%, with 100 cases reclassified as other diseases or abnormalities. Regarding the 286 re-examination cases, experts identified 72 cases of suspected occupational diseases, 99 cases of occupational contraindications, and 115 cases of other diseases or abnormalities. Conclusion The chief physicians of OME institutions demonstrate insufficient rigor in determining noise-related target diseases, ambiguous understanding of OME conclusions, and inadequate follow-up on cases recommended for re-examination.

Objective To explore the efficacy and safety of a zanubrutinib-based combination regimen as first-line treatment for patients with B-cell chronic lymphoproliferative disorder (B-CLPD). Methods A retrospective analysis was performed on 26 patients with B-CLPD, including indolent B-cell non-Hodgkin lymphoma (B-iNHL), mantle cell lymphoma (MCL), and other unclassifiable B-CLPD, who were newly diagnosed and treated at the Department of Hematology, Zhongshan Hospital (Xiamen), Fudan University between January 2021 and January 2025. Patients were divided into two groups according to the treatment regimen: BR (bendamustine plus rituximab) and ZBR (zanubrutinib combined with BR regimen). Baseline characteristics, treatment responses, and the incidence of treatment-related adverse events (TRAE) were compared between the two groups. Results No statistically significant differences in baseline characteristics were observed between the two groups. All patients completed at least four cycles of treatment. There were no significant differences between the BR and ZBR groups in partial response rate (46.2% vs 53.8%), complete response rate (53.8% vs 15.4%), overall response rate (100.0% vs 84.6%), or TRAE incidence. After the first cycle, the lymphocyte count was higher in the ZBR group than in the BR group (P＝0.002); no other statistically significant differences in other hematologic parameters were observed at any treatment cycle. Conclusions In patients with B-iNHL, MCL, and other unclassifiable B-CLPD, the ZBR regimen demonstrates similar safety and response rates to the BR regimen. These findings support further investigation into the clinical value of ZBR as first-line treatment regimen in a limited course for indolent lymphoid malignancies.

Tripterygium wilfordii is a traditional Chinese medicinal herb with a long history of therapeutic use but remains controversial in modern medicine because of its potent toxicity. Among its diverse chemical constituents, the diterpenoid triptolide and the triterpenoid celastrol have emerged as prominent compounds due to their remarkable pharmacological activities, including antitumor, immunosuppressive, anti-obesity, and neuroprotective effects. However, their clinical translation is limited by toxicity concerns and restricted natural availability. This review summarizes the medicinal history and chemical constituents of T. wilfordii, with particular emphasis on the pharmacological mechanisms, structural modification strategies, and recent advances in the biosynthesis of triptolide and celastrol. In addition, we discuss perspectives on toxicity mitigation and lead compound development, aiming to provide theoretical guidance and valuable references for modern drug development and the green manufacturing of T. wilfordii-derived resources.

Background: Maturity-onset diabetes of the young (MODY) due to variants of hepatocyte nuclear factor 1-beta (HNF1β) (MODY5) has not been well studied in the Chinese population. This study aimed to estimate its prevalence and evaluate the application of a clinical screening method (Faguer score) in Chinese early-onset diabetes (EOD) patients. Methods: Among 679 EOD patients clinically diagnosed with type 2 diabetes mellitus (age at diagnosis ≤40 years), the exons of HNF1β were sequenced. Functional impact of rare variants was evaluated using a dual-luciferase reporter system. Faguer scores ≥8 prompted multiplex ligation-dependent probe amplification (MLPA) for large deletions. Pathogenicity of HNF1β variants was assessed following the American College of Medical Genetics and Genomics (ACMG) guidelines. Results: Two rare HNF1β missense mutations (E105K and G454R) were identified by sequencing in five patients, showing functional impact in vitro. Another patient was found to have a whole-gene deletion by MLPA in 22 patients with the Faguer score above 8. Following ACMG guidelines, six patients carrying pathogenic or likely pathogenic variant were diagnosed with MODY5. The estimated prevalence of MODY5 in Chinese EOD patients was approximately 0.9% or higher. Conclusion MODY5 is not uncommon in China. The Faguer score is helpful in deciding whether to perform MLPA analysis on patients with negative sequencing results.

Objective To investigate the correlation between serum vitamin D level and heart failure based on cross-sectional analysis.Methods A total of 10,411 subjects included in the Na-tional Health and Nutrition Examination Survey(NHANES)database from 2013 to 2016 were select-ed as the study population.The serum 25-hydroxyvitamin D[25(OH)D]levels of all subjects were measured.According to the quartiles of serum vitamin D levels,the subjects were divided into four groups.Multivariate logistic regression analysis and restricted cubic spline regression analysis were employed to explore the correlation between serum vitamin D level and heart failure.Results There were statistically significant differences among the four groups in terms of age,gender,educational at-tainment,race,diabetes,hypertension,alcohol consumption,physical activity,and body mass index(P＜0.05).The incidence rates of heart failure in the four vitamin D quartile groups(from low to high)were 3.9％,2.7％,2.9％and 4.1％respectively,with a statistically significant difference(P＜0.05).The results of multivariate logistic regression analysis revealed that,compared with the subjects in the first quartile group of vitamin D,the odds ratios(OR)and 95％confidence intervals(CI)of heart failure in the second,third,and fourth quartile groups of vitamin D were 0.64(0.46 to 0.89),0.53(0.38 to 0.73)and 0.48(0.35 to 0.66)respectively,and the trend test showed P was less than 0.001.The results of restricted cubic spline regression analysis indicated that serum vitamin D level was non-linearly negatively correlated with heart failure(non-linear test P=0.005).At the initial stage,the risk of heart failure decreased with the increase in vitamin D level;when the vitamin D level reached a certain level,the risk of heart failure tended to stabilize or even increase slightly.Con-clusion Serum vitamin D level is non-linearly negatively correlated with the risk of heart failure.

ObjectiveTo construct a rat model of psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type）， and evaluate the macroscopic manifestations and microscopic indicators of the model. MethodsTwenty-two SD rats were divided into normal group （n=3）， common psoriasis group （n=5）， spleen deficiency and dampness obstruction syndrome （external dampness type） group （n=7）， and psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type） group （n=7）. The spleen deficiency and dampness obstruction syndrome （external dampness type） rat model was established through 32-week exposure to an artificially simulated high-humidity environment， while the common psoriasis model was developed via 7-day topical application of imiquimod cream， and these two approaches were combined to construct a composite model of psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type）. Rats in the normal group were housed under normal humidity conditions. The general state， tongue manifestation of rats were observed to evaluate the macroscopic syndrome manifestations； the microscopic syndrome manifestations of rats were evaluated through adipose tissue and liver tissue changes； the severity of psoriasis in rats was evaluated through skin pathological changes， psoriasis area and severity index （PASI）， proliferating cell nuclear antigen （PCNA） expression and spleen tissue changes； changes in rat CD4⁺ interferon-γ⁺ cells （CD4⁺IFN-γ⁺ cells）， CD4⁺ tumour necrosis factor-α+ cells （CD4⁺ TNF-α⁺ cells）， and forkhead framing protein P3⁺ regulatory T cells （CD3⁺CD4⁺FoxP3⁺ Treg cells） were detected by flow cytometry. ResultsMacroscopically， both the spleen deficiency and dampness obstruction syndrome （external dampness type） group and psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type） group exhibited manifestations of spleen deficiency and dampness obstruction， including lethargy， huddling behavior， dull and disheveled fur， as well as soft or loose stools and perianal soiling in some individuals； both these two groups displayed enlarged tongue， swollen， and moist tongue texture， accompanied by slippery tongue surface. Microscopically， compared to the common psoriasis group， the psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type） group showed increased epididymal fat index （P＜0.05）； compared to the normal group and spleen deficiency and dampness obstruction syndrome （external dampness type） group， the psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type） group demonstrated significantly elevated spleen mass （P＜0.05）， while hepatic gross morphology and HE staining revealed no significant histopathological changes across all groups. Dorsal skin lesions were markedly exacerbated in the psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type） group when compared to those in common psoriasis group. Both the common psoriasis group and psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type） group exhibited significantly higher erythema scores， scaling scores， infiltration scores， PASI total scores， and proportions of CD3⁺CD4⁺FoxP3⁺Treg cells compared to the normal group and spleen deficiency and dampness obstruction syndrome （external dampness type） group （P＜0.05）， with pronounced PCNA-positive expression observed in the epidermal basal layer and dermis； the psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type） group displayed significantly increased proportions of CD4⁺TNF-α⁺cells compared to the spleen deficiency and dampness obstruction syndrome （external dampness type） group （P＜0.05）； whereas no significant differences were detected in CD4⁺IFN-γ⁺cell proportions among groups （P＞0.05）. ConclusionThe rat model of psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type） can be successfully constructed by artificially simulating a high-humidity environment combined with imiquimod induction.

Objective: To investigate the mental health status and related factors among primary and secondary school students in western Yunnan Province, so ao to provide scientific evidences for advancing mental health education. Methods: In June 2024, a stratified cluster sampling method was employed to select 4 584 students from 18 schools across Diqing Tibetan Autonomous Prefecture, Lincang City and Baoshan City three regions in western Yunnan Province. The Mental Health Test (MHT) was used for assessment. Latent class analysis (LCA) and Logistic regression were applied for data classification and related factor analysis respectively. Results: The overall positive detection rate of MHT was 11.81%, with a mean total score of 40.50±19.25. The predominant issues were learning anxiety (58.4%), hypersensitivity tendency (31.1%), and self blame tendency (23.1%). LCA categorized students into four groups:severe psychological problems group (74.4% detection rate), learning anxiety hypersensitivity group ( 16.4 %), learning anxiety physical symptoms group (9.2%), and healthy group (0). Logistic regression revealed that compared with the healthy group, the severe problems group showed higher risks among females ( OR =3.01), junior/senior high school students ( OR =1.88/4.02), and those with authoritarian parenting ( OR =3.54); the anxiety hypersensitivity group had higher risks for females ( OR =1.87), senior high students ( OR =1.54), boarders ( OR =1.31), and authoritarian parenting recipients ( OR = 1.85 ); the anxiety physical symptoms group demonstrated increased risks among females ( OR =2.22), senior high students ( OR =2.58), and authoritarian parenting recipients ( OR =2.74), while lower risks were observed for students with parent/grandparent guardians ( OR =0.38) and non only children ( OR =0.58) (all P <0.05). Conclusions Mental health problems are prominent among students in western Yunnan, with gender, grade level, boarding status, guardian type, and parenting style being key determinants. Recommendations include strengthening mental health education, prioritizing left behind children s psychological well being and promoting healthy development.