ObjectiveTo investigate the association between the maintenance treatment of modified Yiqi Huoxue Jiedu Formula （益气活血解毒方） or poly ADP ribose polymerase （PARP） inhibitors and the recurrence and metastasis of advanced ovarian cancer. MethodsA case-control study design was employed， dividing patients with advanced ovarian cancer into two groups based on the occurrence of recurrence and metastasis following first-line maintenance treatment. Patients with recurrence and metastasis comprised the case group， while those without recurrence and metastasis served as the control group. The previous first-line maintenance treatment method was set as the exposure factor in the study （with the use of modified Yiqi Huoxue Jiedu Formula defined as exposed and PARP inhibitors defined as unexposed）. Basic information was collected for both groups， including the achievement of satisfactory R0 surgery， age， stage， neoadjuvant chemotherapy， lymph node metastasis， germline BRCA1/2 mutations， homologous recombination deficiency positivity， first-line maintenance treatment method （modified Yiqi Huoxue Jiedu Formula or PARP inhibitors）， and CA125 levels after the last chemotherapy. The baseline data of the two groups were assessed for differences. If there exists difference， a 1∶1 nearest neighbor matching method was used for propensity score matching. Univariate and multivariate logistic regression analyses were employed to evaluate the association between the modified Yiqi Huoxue Jiedu Formula or PARP inhibitors and the recurrence and metastasis of ovarian cancer. ResultsA total of 201 patients with advanced ovarian cancer were included， with 97 in the case group and 104 in the control group. Both groups showed statistically significant differences in R0 surgery， stage， neoadjuvant chemotherapy， and CA125 levels after the last chemotherapy （P＜0.05）， indicating baseline imbalance. After propensity score matching， there were 71 patients in both the case and control groups， achieving baseline balance （P＞0.05）. Univariate logistic regression analysis indicated that the achievement of satisfactory R0 surgery （P = 0.006）， disease stage （P = 0.001）， the use of neoadjuvant chemotherapy （P = 0.024）， treatment modality （P = 0.006）， and CA125 levels after the last chemotherapy （P = 0.013） were associated with the recurrence and metastasis of ovarian cancer. Multivariate logistic regression analysis revealed that disease stage was an independent influencing factor for the recurrence and metastasis of ovarian cancer （P = 0.030）， whereas the P-value for the correlation between first-line maintenance treatment and ovarian cancer was 0.188. ConclusionFirst-line maintenance treatment of ovarian cancer patients with the use of modified Yiqi Huoxue Jiedu Formula or PARP inhibitors does not correlate with the recurrence and metastasis of ovarian cancer.

Objective To investigate the five-circuit and six-qi features at conception and at birth in the patients with endometrial cancer.Methods From June 2020 to August 2024,the information about the conception time and birth time of 1 099 patients with endometrial cancer admitted to Guang'anmen Hospital of China Academy of Chinese Medical Sciences was collected from the electronic medical record system.The circuit-qi information at conception and at birth of the patients was statistically analyzed,and then the congenital endowment characteristics of the patients were explored.Results The results showed that most of the patients suffering endometrial cancer were born in winter,and the dominant qi at birth of the patients was predominated by taiyang cold-water,and the differences of the distribution of dominant qi at birth were statistically significant(P＜0.05).There were no significant differences in the distribution of yearly circuit,guest qi,and sitian-zaiquan at birth,and in the distribution of seasons,yearly circuit,dominant qi,guest qi,and sitian-zaiquan at conception(P＞0.05),and only an obvious trend of differences was presented.Conclusion There is a certain correlation between the prevalence of endometrial cancer and the five-circuit and six-qi features at conception and at birth.The congenital endowment of patients with endometrial cancer is characterized by yang deficiency with predominant coldness,and the prevalence is related to jueyin wind wood.

Objective To investigate traditional Chinese medicine(TCM)syndrome characteristics associated with immunotherapy efficacy in cervical cancer using propensity score matching(PSM),aiming to identify the population benefiting from immunotherapy.Methods A retrospective analysis was conducted in 253 cervical cancer patients,who received the treatment with programmed death receptor 1(PD-1)inhibitors at Guang'anmen Hospital,China Academy of Chinese Medical Sciences from January 2020 to October 2024.Clinical data and TCM four-examination data were collected.After balancing the confounders via PSM(1∶1 matching)and with therapeutic efficacy as the dependent variable,multivariate logistic regression was performed to analyze the characteristics of TCM syndrome in the immunotherapy-response group and then a predictive model was constructed.Results(1)After matching with PSM,198 cases were included,99 cases in response group and 99 cases in non-response group.(2)Analysis of the distribution of TCM syndrome elements showed that the differences in the pathogenic syndrome elements of qi deficiency,qi stagnation,blood stasis,heat and phlegm between the two groups were statistically significant(P＜0.05 or P＜0.01),while there were no statistically significant differences in the disease-location syndrome elements of uterus,kidneys,lungs,spleen,liver,and heart,as well as in the pathogenic syndrome elements of blood deficiency,yin deficiency,yang deficiency,cold,and dampness(P＞0.05).The main pathogenic syndrome elements in the response group were qi deficiency,blood deficiency and heat,while those in the non-response group were qi stagnation,heat and phlegm.(3)The results of univariate regression analysis showed that targeted therapy(P=0.040),programmed cell death-ligand 1(PD-L1)expression level(P＜0.001),qi deficiency(P=0.009),blood deficiency(P＜0.001),yang deficiency(P＜0.001),yin deficiency(P＜0.001),qi stagnation(P=0.003),blood stasis(P＜0.001),cold(P＜0.001),cold(P＜0.001),heat(P＜0.001),phlegm(P＜0.001),and dampness(P＜0.001)were the factors associated with the efficacy of PD-1 inhibitors.(4)The results of multivariate logistic regression analysis showed that previous targeted therapy(OR=0.36,95%CI:0.16-0.83)and pathogenic syndrome elements of qi stagnation(OR=0.23,95%CI:0.10-0.49),phlegm(OR=0.28,95%CI:0.13-0.61)were the risk factors of associated with the efficacy of PD-1 inhibitors,while PD-L1 expression level(OR=15.27,95%CI:2.60-89.63),and pathogenic syndrome element qi deficiency(OR=2.90,95%CI:1.42-5.89)were the protective factors associated with the efficacy of PD-1 inhibitors in cervical cancer.(5)Receiver operating characteristic(ROC)curve analysis demonstrated that the area under the ROC curve(AUC)of the predictive model for evaluating PD-1 inhibitor efficacy in cervical cancer was 0.78(95%CI:0.71-0.84),indicating certain predictive value.Conclusion PD-L1 expression level and TCM pathogenic syndrome elements such as qi deficiency,qi stagnation,and phlegm are the independent factors influencing PD-1 inhibitor efficacy in cervical cancer,providing insights for optimizing integrated TCM-western medicine treatment strategies.

Cancer toxin is a specific pathogenesis leading to the heterogeneity of breast cancer.The nature and virulence of the cancer toxin determine the differences in the heterogeneity of breast cancer,which can dynamically evolve over time and space,resulting in varying invasion abilities and characteristics of the tumor.Cancer cells in the primary lesion possess"toxicity"that targets specific organs for metastasis,and cancer toxins can influence the metastatic propensity of different types of breast cancer.Therefore,breast cancer treatment strategies based on the theory of cancer toxins emphasize the continuous eradication of the cancer toxin,focusing on differentiating its strength and nature,protecting unaffected areas first,identifying the state based on symptoms,and targeting accordingly to combat resistance arising from tumor heterogeneity.This article aims to provide a new theoretical basis for the treatment strategies of different types of breast cancer.

Objective: To investigate the relationships among psychological resilience, parental control, and behavioral problems in middle school students, aiming to provide evidencebased recommendations for the prevention and intervention of behavioral issues in middle school students, as well as for the development of related policies. Methods: A stratified cluster sampling method was used to select 2 745 participants from three cities in Guizhou Province with different levels of economic development from August to December 2021. The Child Behavior Checklist (CBCL), Parental Control Questionnaire, and Psychological Resilience Questionnaire were administered to junior high school students and their parents. A network analysis method was employed to construct a network analysis model of factors influencing behavioral problems. Results: The detection rate of behavioral problems among junior high school students in Guizhou Province was 22.62%. The scores for psychological resilience (goal focus, emotional control, positive cognition, family support, and interpersonal assistance) and proactive inquiry in behavior control were higher in the group without behavioral problems than in the group with behavioral problems. Scores for psychological control (inducing guilt, with drawing affection, and asserting authority) were higher in the group with behavioral problems than in the group without behavioral problems, with statistically significant differences (t=9.80, 17.76, 6.21, 12.20, 13.18, 6.28, 11.58, 11.10, 10.74, P<0.05). The network model showed that among the same variable factors, the strongest connection weight was between inducing guilt and withdrawing affection, with a weight of 0.79. Between different variables, there were negative correlation between behavioral problems and psychological resilience (goal focus, emotional control, positive cognition, family support, interpersonal assistance) and behavior control (proactive inquiry, behavioral restraint) with correlation coefficients (r=-0.25, -0.42, -0.16, -0.31, -0.33, -0.17, -0.03, P<0.05), respectively. There were positive correlation between psychological control factors (inducing guilt, withdrawing affection, and asserting authority) and behavioral problems (r=0.29, 0.27, 0.27), and a negative correlation between these psychological control factors and psychological resilience factors (goal focus, emotional control, positive cognition, family support, interpersonal assistance)(r=-0.53--0.13)(P<0.05). The strongest connection weight was between withdrawing affection and family support, with a connection weight of -0.53. Family support was an important bridge symptom connecting the entire behavioral problem network model, with a high centrality. Conclusions The detection rate of behavioral problems among junior high school students in Guizhou Province is relatively high. Assisting adolescents in establishing a supportive family environment facilitates the cultivation of their psychological resilience, thereby mitigating the occurrence of behavioral problems.

Objectives: . Branchio-oto syndrome (BOS) primarily manifests as hearing loss, preauricular pits, and branchial defects. EYA1 is the most common pathogenic gene, and splicing mutations account for a substantial proportion of cases. However, few studies have addressed the structural changes in the protein caused by splicing mutations and potential pathogenic factors, and several studies have shown that middle-ear surgery has limited effectiveness in improving hearing in these patients. BOS has also been relatively infrequently reported in the Chinese population. This study explored the genetic etiology in the family of a proband with BOS and provided clinical treatment to improve the patient’s hearing. Methods: . We collected detailed clinical features and peripheral blood samples from the patients and unaffected individuals within the family. Pathogenic mutations were identified by whole-exome sequencing and cosegregation analysis and classified according to the American College of Medical Genetics and Genomics guidelines. Alternative splicing was verified through a minigene assay. The predicted three-dimensional protein structure and biochemical experiments were used to investigate the pathogenicity of the mutation. The proband underwent middle-ear surgery and was followed up at 1 month and 6 months postoperatively to monitor auditory improvement. Results: . A novel heterozygous EYA1 splicing variant (c.1050+4 A>C) was identified and classified as pathogenic (PVS1(RNA), PM2, PP1). Skipping of exon 11 of the EYA1 pre-mRNA was confirmed using a minigene assay. This mutation may impair EYA1-SIX1 interactions, as shown by an immunoprecipitation assay. The EYA1-Mut protein exhibited cellular mislocalization and decreased protein expression in cytological experiments. Middle-ear surgery significantly improved hearing loss caused by bone-conduction abnormalities in the proband. Conclusion . We reported a novel splicing variant of EYA1 in a Chinese family with BOS and revealed the potential molecular pathogenic mechanism. The significant hearing improvement observed in the proband after middle-ear surgery provides a reference for auditory rehabilitation in similar patients.

Objective To evaluate the risk of recurrence or metastasis of breast cancer by LNG-IUS via meta-analysis. Methods We searched literature in the PubMed, Web of Science, Cochrane, EMBASE, CBM, CNKI, VIP, and WanFang database.The retrieval period was from January 2014 to October 2021.Data extraction and quality evaluation were conducted for the included randomized controlled study (RCT) to analyze whether LNG-IUS can increase the risk of recurrence or metastasis of breast cancer. Results A total of 1309 Chinese and English studies were retrieved; 5 RCTs were included in this study, and 446 patients were enrolled.The combined total effect value in the fixed-effect model with RD (95%CI)0.03(-0.03-0.08), Z=1.05, P=0.29) indicated that the LNG-IUS+tamoxifen group did not increase the risk of recurrence or metastasis of breast cancer compared with the tamoxifen group.The funnel diagram was basically symmetrical, suggesting that the publication bias was small. Conclusion Wearing the LNG-IUS does not increase the risk of relapse or metastasis of breast cancer significantly, and it provides certain safety for patients with breast cancer.

Objective:To compare the clinical efficacy of arthroscopic debridement, transtendon repair and tear completion and repair in treating Ellman II partial articular surface tendon avulsions.Methods:A retrospective case control study was conducted on 45 patients with partial articular surface tendon avulsions admitted to East Division of Shanghai Sixth Hospital Affiliated to Shanghai Jiao Tong University from December 2017 through December 2019. There were 18 males and 27 females, with a mean age of (56.4±5.0)years (range, 38-66 years). The patients were assigned to arthroscopic debridement group ( n=15), arthroscopic transtendon repair group ( n=15), and arthroscopic tear completion and repair group ( n=15). Operation time and complications were recorded. American Shoulder and Elbow Surgeons (ASES) score and University of California, Los Angeles (UCLA) score were measured preoperatively, at postoperative 3 months and at the latest follow-up. Results:All the patients were followed up for 8-32 months [(18.2±6.3)months]. In arthroscopic debridement group, arthroscopic transtendon repair group and arthroscopic tear completion and repair group, the operation time was (43.7±3.1)minutes, (89.1±5.4)minutes, (62.2±3.6)minutes, respectively ( P<0.05). No complications such as nerve injury, infection and arthrofibrosis were observed after operation. In arthroscopic debridement group, arthroscopic transtendon repair group and arthroscopic tear completion and repair group, the ASES score was preoperative (48.7±2.9)points, (49.1±3.0)points, (48.3±3.6)points, respectively ( P>0.05); the UCLA score was preoperative (15.5±1.3)points, (15.4±1.8)points, (15.2±1.4)points, respectively ( P>0.05). In arthroscopic debridement group, arthroscopic transtendon repair group and arthroscopic tear completion and repair group, the ASES score at the latest follow-up was (90.1±1.6)points, (89.3±1.0)points, (89.4±1.0)points, respectively ( P>0.05); the UCLA score at the latest follow-up was (30.3±2.1)points, (29.0±2.3)points, (28.9±2.7)points, respectively( P>0.05). In arthroscopic debridement group, arthroscopic transtendon repair group and arthroscopic tear completion and repair group, the ASES score at postoperative 3 months was (84.4±2.3)points, (73.5±3.6)points, (73.6±3.2)points, respectively; the UCLA score at postoperative 3 months was (26.9±1.4)points, (21.4±1.0)points, (21.1±1.0)points, respectively. In comparison, no significant difference was found between arthroscopic transtendon group and arthroscopic tear completion and repair group ( P>0.05). However, ASES score and UCLA score in arthroscopic debridement group were significantly higher than those in arthroscopic transtendon group and arthroscopic tear completion and repair group ( P<0.05). Conclusions:Arthroscopic debridement, transtendon repair and tear completion and repair are effective techniques for treatment of Ellman II partial articular surface tendon avulsions. However, the operation time and early efficacy of arthroscopic debridement are better than other two techniques.

Objective To evaluate the diagnosis and treatment of acute superior mesenteric venous thrombosis (ASMVT).Methods Clinical data of 36 ASMVT patients admitted to our department from Jan 2014 to Oct 2017 were retrospectively analyzed,the differences of the clinical data and prognosis of nonsurgical group and surgical group were studied.Results All patients received anticoagulation therapy immediately after diagnosis,and recanalization rate was 42％.Surgical group included 21 cases,of which 9 cases received emergency surgery,12 cases received delayed bowel resection.There was significant difference between non-surgical group and surgical group (P ＞ 0.05) in hemoglobin level at admission (124 ±29)g/L vs.(93 ± 13) g/L,t =3.880,P =0.006.Compared with delayed bowel resection group emergency surgery group had longer bowel resection (65 ± 58) cm vs.(13 ± 6) cm,t =2.700,P =0.035,more loop ileostomy (6 vs.1,x2 =7.875,P =0.016),more postoperative complication rate (56％ vs.8％,x2 =5.619,P =0.046),but there was no significant difference in hospitalization time,hospitalization cost,postoperative recurrence and mortality rate (P ＞ 0.05).Conclusions Early anticoagulantion therapy is advised for ASMVT patients to avoid bowel resection or reduce the length of intestinal resection.It is advisable for those who can be tided over to delayed bowel resection with intestinal obstruction.

Objective To explore the effect of the combination of Tuina and treadmill training on denervation skeletal muscle atrophy. Methods A total of 80 Sprague-Dawley rats (one month old) were randomly divided into control group (n=40) and manipulation group (n=40). Their sciatic nerves were transected, and the manipulative group accepted treadmill training and kneading of Tuina, while the control group accepted no intervention. Their muscle wet weight ratio, muscle satellite cells and insulin-like growth factor I (IGF-I) positive cells count were measured, and HE staining of gastrocnemius muscle were observed one, two, three and four months after intervention, ten rats in each group. Results Compared with the control group, the muscle wet weight ratio decreased three months after intervention (F=4.590, P<0.05), muscle satellite cells increased three months after intervention (F=12.466, P<0.01), and IGF-I positive cells increased two, three and four months after intervention (F>6.489, P<0.05). HE staining showed the skeletal muscle injury relieved somehow.Conclusion The combination of Tuina and treadmill training can relieve denervation skeletal muscle injury, but it is not enough for skeletal muscle atrophy, which may associate with promoting the expression of muscle satellite cells and IGF-I.