ObjectiveTo evaluate the antitumor activity of Periplaneta americana extract（PAE） against human-derived lung adenocarcinoma organoids（LUAD-PDOs） and to elucidate its potential mechanism based on transcriptomics. MethodsFresh tumor and adjacent normal tissues from patients with LUAD were collected to construct LUAD-PDOs and normal lung organoid（Nor-PDOs） models using 3D organoid culture technology. The effective intervention concentration of PAE was determined using the cell counting kit-8（CCK-8） assay. Experimental groups included the model group（LUAD-PDOs）， normal group， model administration group（LUAD-PDOs+PAE）， and normal administration group（Nor-PDOs+PAE）. Hematoxylin-eosin（HE） staining was used to observe the pathological structures of PDOs， immunohistochemistry（IHC） was performed to detect the expressions of the proliferation marker Ki-67 and lung adenocarcinoma differentiation markers cytokeratin-7（CK-7） and Napsin A， TUNEL staining was applied to detect cell apoptosis. RNA sequencing（RNA-Seq） was conducted to identify differentially expressed genes（DEGs）， followed by Gene Ontology（GO）， Kyoto Encyclopedia of Genes and Genomes（KEGG）， and Gene Set Enrichment Analysis（GSEA）， alongside protein-protein interaction（PPI） network analysis to screen core mechanisms. Finally， key targets were validated by integrating external database analysis with immunofluorescence（IF）. ResultsNor-PDOs and LUAD-PDOs that highly recapitulated the pathological characteristics of the primary tissues were successfully established. The CCK-8 assay determined that the effective intervention concentration of PAE was 16 g·L^-1. Morphological observation showed that Nor-PDOs exhibited lumen-forming structures， whereas LUAD-PDOs displayed dense， solid structures. CCK-8 and TUNEL assays revealed that， compared with the model group， PAE intervention inhibited the proliferation of LUAD-PDOs and promoted apoptosis in LUAD cells， while showing no significant effect on the viability of Nor-PDOs. Transcriptomic analysis identified 719 DEGs that were significantly reversed after PAE intervention（347 up-regulated and 372 down-regulated）（P<0.05）. GO enrichment analysis indicated that DEGs in the model administration group were significantly enriched in biological processes related to cell cycle regulation compared to the model group. KEGG pathway analysis revealed that PAE affected pathways related to proliferation and metabolism， including pathways in cancer and the p53 signaling pathway. GSEA further confirmed that PAE significantly enhanced the activity of the p53 signaling pathway（P<0.05）. PPI network analysis indicated that breast cancer type 1 susceptibility protein（BRCA1） and checkpoint kinase 1（CHEK1） were the core down-regulated targets in the p53 pathway. IF verified the high expression of BRCA1 and CHEK1 in LUAD-PDOs and their significant downregulation after PAE intervention（P<0.05）. Furthermore， survival analysis based on The Cancer Genome Atlas（TCGA） database indicated that low expression of BRCA1 and CHEK1 was significantly associated with prolonged overall survival in patients with LUAD（P<0.05）. ConclusionPAE effectively inhibits proliferation of LUAD-PDOs and promotes their apoptosis， its anti-tumor mechanism is potentially associated with the activation of the p53 signaling pathway， with BRCA1 and CHEK1 genes likely serving as key downstream targets for the effects of PAE.

Objective To assess the survival vulnerability of Oncomelania hupensis in Jiangxi Province under future climate scenarios, and to identify low-vulnerability areas for its survival in this province. Methods Village-level O. hupensis snail survey and O. hupensis snail control with chemical treatments in Jiangxi Province from 2016 to 2024 were captured from the Parasitic Disease Prevention and Control Information Management System of China Disease Prevention and Control Information System. Climatic data were primarily sourced from the Resource and Environmental Science Data Platform, Chinese Academy of Sciences (http://www.resdc.cn/), including annual average temperature, annual average precipitation, annual accumulated temperature above 10 °C, annual accumulated temperature above 0 °C, annual maximum temperature, annual minimum temperature, and annual average relative humidity, and nineteen bioclimatic variables were downloaded from the WorldClim website (https://www.worldclim.org/), including mean diurnal range, isothermality, temperature seasonality, and so on. Elevation and normalized difference vegetation index were catprued from the Resource and Environmental Science Data Platform, Chinese Academy of Sciences (http://www.resdc.cn/), and distance to rivers was downloaded from the WorldPop website (http://www.worldpop.org), and land use and land cover (LULC) data were downloaded from the Big Earth Data Center, Chinese Academy of Sciences (https://data.casearth.cn/), and nature reserve data were obtained from the China Nature Reserve Specimen Resource Sharing Platform (http://www.papc.cn/). Three Shared Socioeconomic Pathways (SSPs) from the Beijing Climate Center-Climate System Model version 2-Medium Resolution (BCC-CSM2-MR) global climate model were employed as future climate scenarios, including SSP126, SSP245, SSP585, and the biomod2 ensemble model in R package was used to simulate suitable habitats for O. hupensis snails in Jiangxi Province in 2050 and 2070 under these scenarios. A snail survival vulnerability index was constructed based on the area of suitable snail habitats, area covered by snail control through chemical treatment, area covered by nature reserves, and changes in snail habitat fragmentation, and a map of snail survival vulnerability distribution was plotted. Results The real area of snail habitats ranged from 78 486.76 to 85 309.47 hm², and the area of snail control with chemical treatment ranged from 10 138.98 to 13 240.16 hm² in Jiangxi Province from 2016 to 2024. There were 429 to 531 villages detected with snails during the nine-year period, and the number of actually snail-infested villages ranged from 645 to 686. A total of 818 snail-present points and 1 996 snail-absent points were obtained from snail survey records. The best performance of the biomod2 ensemble model was achieved if a weighted mean approach was used as the ensemble strategy, with a true skill statistic value of 0.799 and an area under the receiver operating characteristic curve of 0.957, and modeling identified annual average relative humidity and annual average precipitation as two most influencing climatic variables for snail distribution. Relative to the current areas of suitable snail habitats under present climate conditions, the area of suitable snail habitats was projected to expand by 24.49% to 46.28% in Jiangxi Province under future climate scenarios, and the proportion of nature reserves areas in the areas of suitable snail habitats was projected to decrease slightly from the current 2.77% to approximately 2.52%, while the proportion of areas of snail control through chemical treatment in areas of suitable snail habitats varied from 0.64% to 19.57%, and the percentage of changes in snail habitat fragmentation ranged from 3.86% to 12.23%. Based on these four indicators, the snail survival vulnerability index was estimated to range from –1.96 to 0.62 in Jiangxi Province. The arithmetic mean of the snail survival vulnerability index differed under three SSP scenarios (SSP126, SSP245 and SSP585), with the highest mean value (–0.69) in 2070 under SSP126, and the lowest mean value (–0.78) in 2070 under SSP585. Conclusions The snail survival vulnerability index ranges from –1.96 to 0.62 in Jiangxi Province under future climate scenarios, and the suitable habitats for O. hupensis snails appear an overall tendency towards expansion. Low-vulnerability snail habitats are mainly distributed along the shores of Poyang Lake and the Yangtze River in Jiangxi Province, partially overlapping with nature reserves. Intensified surveillance of O. hupensis snails is recommended in these areas in the future.

Schistosomiasis was once highly prevalent in Jiangxi Province, and currently, the schistosomiasis control program is moving from transmission interruption to elimination in this province. As a zoonotic parasitic disease, schistosomiasis transmission is closely linked to human activities, animal hosts, Oncomelania snail distribution, and ecological environmental changes, which highly aligns with the One Health concept. Based on the One Health concept, this paper systematically reviews the evolution and major strategies of schistosomiasis control programs in Jiangxi Province, summarizes practical experiences including the Communist Party of China and government leadership, multi-sectoral collaboration, case screening, treatment and health management, prevention and control of animal hosts, management of Oncomelania snail-infested environments, and health education and promotion, and analyzes the challenges after achieving the target of transmission interruption, such as climate change, population mobility, resurgence of livestock breading, potential transmission risks from wildlife, and insufficient capacity of surveillance and early warning. It is recommended to further improve the collaborative prevention and control mechanism based on the One Health concept, establish a multi-channel surveillance and early warning system covering humans, animals, Oncomelania snails, and environments, implement a strategy for management of sources of Schistosoma japonicum infections with an emphasis on livestock management and wild animals monitoring, and facilitate the shift of schistosomiasis control programs from morbidity control to “human-animal-environment” coordinated governance, with aims to provide insights into achieving the target of schistosomiasis elimination in Jiangxi Province and China in 2030.

Therapeutic drug monitoring （TDM） is the core approach for individualized precision medication in clinical practice. Based on pharmacokinetics, it quantitatively measures in vivo drug concentrations using modern analytical techniques, mainly applied to drugs with a narrow therapeutic window, significant adverse reactions, and large interindividual pharmacokinetic variability across multiple categories. TDM plays an irreplaceable role in optimizing therapeutic regimens, reducing drug toxicity, and enhancing rational clinical drug use. TDM-applicable drugs were systematically reviewed in this paper, focusing on the working principles, clinical applications, advantages and limitations of mainstream analytical techniques （immunoassay, liquid chromatography tandem mass spectrometry，LC-MS/MS） and emerging ones （surface plasmon resonance and biolayer interferometry）, which provided a valuable reference for the standardized clinical application of TDM, rational selection of analytical methods, and subsequent technological research and development.

Objective To evaluate the clinical efficacy of transumbilical extracorporeal laparoscopic-assisted appendectomy(TUELAA)for pediatric uncomplicated appendicitis.Methods A retrospective analysis was conducted on 38 cases treated with TUELAA between January2019 and October2024.The median age was7.5 years old(range,2.4-16.3 years old).The duration of abdominal pain before admission was(20.6±10.6)h.Preoperative ultrasound revealed an average appendiceal diameter of(0.92±0.15)cm,with appendicoliths identified in15 cases.A vertical umbilical incision approximately1.5 cm in length was made,through which a 5 mm trocar(15 cm in length)with a 30° laparoscope and a 5 mm short trocar(9 cm in length)with grasping forceps were inserted.The abdominal cavity was explored,adhesions were dissected,and the appendiceal tip was grasped.The tissue between the two trocars was incised,and the appendix was extracted through the umbilical incision for extracorporeal ligation and excision.Results Among the 38 cases,31 had no significant adhesions around the appendix,and the appendectomy was successfully performed with smooth extraction of the appendix.In the remaining 7 cases with adhesions around the appendix,blunt laparoscopic dissection was used to release the adhesions.After the appendix tip was freed,it was extracted through the umbilical incision for complete excision.The surgical time was(27.1±8.6)min,and the postoperative hospitalization was1-3 d.Pathological diagnoses revealed32 cases of acute suppurative appendicitis and 6 cases of gangrenous appendicitis.No intravenous analgesics were used postoperatively.No discomfort such as abdominal pain was noted during telephone follow-ups for 2-68 months(median,58 months).Conclusion TUELAA demonstrates definite efficacy and favorable cosmetic outcomes for the treatment of pediatric uncomplicated appendicitis.

Alzheimer's disease(AD), a neurodegenerative disorder associated with aging, is the most prevalent form of dementia.As the aging population continues to expand, AD presents significant health and caregiving challenges for families and society, making it a pressing international public health concern.In recent years, numerous countries have implemented dementia prevention and treatment strategies that emphasize community-based comprehensive approaches.Currently, the community-based AD prevention and treatment model in China is still in the exploratory phase, with community efforts lacking organization.In alignment with China's action plan for advancing dementia prevention and treatment, and to achieve the strategic objective of "healthy aging, " this consensus is based on the principle of three-level prevention and is tailored to the characteristics of AD disease progression.It aims to develop a comprehensive prevention and treatment strategy for AD that is suitable for communities in China, providing technical guidance and support to establish a scientific basis for formulating community AD prevention and treatment models.

Objective:To understand the composition of infectious pathogens and the changes in the epidemic characteristics of inpatients with acute respiratory tract infections in Pudong New Area of Shanghai, from 2018 to 2023.Methods:Specimens of inpatients with acute respiratory infection cases were collected from 14 healthcare institutions in Pudong New Area, Shanghai, from 2018-2023 and tested for eight respiratory pathogens: influenza virus, adenovirus, rhinovirus, parainfluenza virus, respiratory syncytial virus, common coronavirus, metapneumovirus, and bocavirus. The groups were divided into three periods,2018-2019, 2020-2022 and 2023, and the chi-square or Kruskal-Wallis rank sum test was used to compare the group differences. The SPSS 22.0 software was used for statistical analysis.Results:Among the 3 023 inpatients with acute respiratory infection, the positive rate of any virus was 24.25% (733/3 023). The positive rates of any virus in 2018-2019, 2020-2022, and 2023 were 33.40% (336/1 006), 12.01% (116/966), and 26.74% (281/1 051), respectively, and the differences were statistically significant ( χ2=128.20, P<0.001). Among the age groups, in 2018-2019 and 2020-2022, the positive rate of any virus was the highest in the <5 years age group (46.20% and 14.64%), while in 2023, the 15-59 years age group had the highest positive rate (32.97%). The positive rate of any virus in winter was the highest in 2018-2019 (53.21%) and 2020-2022 (17.58%), and the highest in autumn was in 2023 (31.53%). The peak positive rate of respiratory syncytial virus was in winter of 2018-2019 and 2020-2022, as well as the summer of 2023.The positive rates of influenza virus in 2018-2019, 2020-2022 and 2023 were 9.84%, 1.55% and 9.71%, respectively. Conclusions:The pathogen epidemic characteristics of inpatients with acute respiratory infection in Pudong New Area from 2018 to 2023 have shown certain changes. It is necessary to strengthen monitoring. Targeted prevention and control strategies should be developed and implemented in a timely manner.

Objective:To investigate factors influencing frequent episodes (≥ 4 episodes within 1 year) in children with moderate-to-severe atopic dermatitis (AD) in China.Methods:A national multicenter cross-sectional study was conducted. Patients under the age of 18 years diagnosed with moderate-to-severe AD were enrolled at dermatology clinics in 18 medical institutions across 12 provinces and municipalities in China between June 12 and August 8, 2023. At the time of the visit, their guardians completed a structured questionnaire covering demographic characteristics, clinical features of AD, personal and family history, factors associated with frequent episodes of moderate-to-severe AD, compliance with treatment, and disease awareness. Statistical analyses included t tests, one-way analysis of variance, rank-sum tests, and chi-square tests, with multiple-response analysis applied for multiple-choice questions. Results:A total of 965 valid questionnaires were collected, and 965 children with moderate-to-severe AD were included. Among them, there were 531 males and 434 females, 678 (70.3%) were aged 2 - < 12 years, 837 (86.7%) were from urban areas, the age at onset was 2.47 ± 3.03 years, and the median frequency of AD episodes in the past year was 4 times. These children were divided into 2 groups based on the median episode frequency: < 4-episode group (439 cases, 45.5%) and ≥ 4-episode group (526 cases, 54.5%). Compared with the < 4-episode group, children in the ≥ 4-episode group showed younger ages at onset (2.22 ± 2.98 years vs. 2.76 ± 3.06 years, P = 0.006) and higher proportions of patients with comorbid allergic diseases in both the children themselves (82.9% [436/526] vs. 69.7% [306/439], χ2 = 23.42, P < 0.001) and their relatives (66.0% [347/526] vs. 57.4% [252/439], χ2 = 7.46, P = 0.006). Children in the ≥ 4- episode group also had higher monthly usage of moisturizers (150 [30, 300] g vs. 60 [6, 200] g) and daily frequency of moisturizer use, greater disease awareness, but more severe fear of medication use (all P < 0.05). The region and the human development index level were both significantly associated with the episode frequency (both P < 0.001), with the highest proportion of children from South China in the ≥ 4- episode group (36.3%, 191/526). Children in the ≥ 4-episode group also had a longer duration of topical glucocorticoid use than those in the < 4-episode group ( Z = -2.21, P = 0.027). External triggers associated with AD episodes mainly included heat exposure (50.36%, 486/965), hot water bathing (40.73%, 393/965), seafood (23.52%, 227/965), and dust mites (33.37%, 322/965) . Conclusion:In children with moderate-to-severe AD in China, factors influencing frequent episodes may include residence in southern or economically developed regions, earlier age at onset, having a personal or family history of allergic diseases, and fear of medication use.

Objective To investigate the effects and mechanism of Yuyin Qianyang Tongluo Formula on cognitive function in Alzheimer's disease mice.Methods Transgenic negative mice were designated as the normal group,while APP/PS1 double transgenic mice were randomly divided into six groups(ni=6 per group):model group,low-dose Yuyin Qianyang Tongluo Formula group,medium-dose group,high-dose group,and positive drug group.The Yuyin Qianyang Tongluo Formula low-,medium-,high-dose groups correspondingly received intragastric administration of 0.75,1.5,and 3 g·kg-1·d-1,respectively.The positive drug group received 2 mg·kg-1·d-1 donepezil hydrochloride tablets,while the model and normal groups received equal volumes of saline.All groups were treated once daily for 8 weeks.Behavioral tests were conducted using the Morris water maze and Y-maze.Hippocampal β-amyloid(Aβ)1-42 level was measured by enzyme-linked immunosorbent assay(ELISA).Hippocampal CA1 and CA3 neurons were observed hematoxylin-eosin(HE)staining,and Nissl bodies were examined Nissl staining.Protein expression levels of Aβ transporter low-density lipoprotein receptor-related protein 1(LRP-1)and endoplasmic reticulum stress marker glucose-regulated protein 78(GRP78)were detected by Western Blot analysis.Results(1)Compared with the normal group,the model group showed significantly prolonged escape latency(P＜0.000 1),reduced platform crossings,decreased movement distance and time around the platform of Morris water maze test(P＜0.05 or P＜0.01),significantly lower spontaneous alternation percentage in Y-maze test(P＜0.05),and significantly elevated hippocampal Aβ1-42 level(P＜0.000 1).Compared with the model group,all Yuyin Qianyang Tongluo Formula dose groups and the positive drug group exhibited significantly shortened escape latency of Morris water maze test(P＜0.000 1).The high-dose Yuyin Qianyang Tongluo Formula group and positive drug group showed significantly increased platform crossings,movement distance and time around the platform of Morris water maze test(P＜0.05),significantly higher spontaneous alternation percentage in Y-maze test(P＜0.05).All Yuyin Qianyang Tongluo Formula dose groups and the positive drug group showed significantly reduced hippocampal Aβ1-42 level(P＜0.000 1).(2)Compared with the normal group,the model group exhibited disordered and deformed hippocampal neurons and Nissl bodies.Compared with the model group,all Yuyin Qianyang Tongluo Formula groups and positive drug group showed improved neuronal and Nissl body organization,with the improvement degree positively correlated with dosage.(3)Compared with the normal group,the model group showed decreased LRP1 level and increased GRP78 level,but there were no statistically significant differences(P＞0.05).Compared with the model group,the high-dose Yuyin Qianyang Tongluo Formula group and positive drug group showed increased LRP1 level,while all Yuyin Qianyang Tongluo Formula dose groups and positive drug group exhibited decreased GRP78 level,but there were no statistically significant differences(P＞0.05).Conclusion Yuyin Qianyang Tongluo Formula significantly improves cognitive and memory function in model mice in a dose-dependent manner,potentially through reducing Aβ aggregation in the brain via endoplasmic reticulum stress pathway.

Objective To compare the clinical value of TruScreen,an artificial intelligence-based real-time cervical cancer screening system,combined with high-risk human papillomavirus(hr-HPV)test and Thinprep cytology test(TCT)combined with hr-HPV test in cervical cancer screening.Methods A total of 297 women undergoing cervical cancer screening at Panzhihua Central Hospital between June 2020 and December 2023 were enrolled.All participants underwent hr-HPV testing,TCT,and TruScreen test.The diagnostic performance of TruScreen combined with hr-HPV test and TCT combined with hr-HPV test for low-grade squamous intraepithelial lesion positive(LSIL+)and high-grade squamous intraepithelial lesion positive(HSIL+)cervical lesions was evaluated.Results Among the 297 enrolled women,pathology analysis identified 128(43.10%)LSI+cases and 67(22.56%)HSIL+cases.Additionally,there were 110(37.04%)HPV16/18 positive cases,177(59.60%)cases with TCT results≥atypical squamous cells of undetermined significance(ASCUS),and 176(59.26%)cases with abnormal TruScreen results.The area under the curve(AUC)of TruScreen combined with hr-HPV test in diagnosing LSIL+and HSIL+cervical lesions was higher than that of TCT combined with hr-HPV test(P<0.05).Conclusion TruScreen combined with hr-HPV test demonstrates superior performance in cervical cancer screening compared with TCT combined with hr-HPV test.TruScreen combined with hr-HPV test may serve as an alternative to conventional cytology-based methods for cervical cancer screening in China.