Objective To analyze survival outcomes and influencing factors among patients with colorectal cancer in Yunnan Province. Methods Clinical data were retrospectively collected from 4 892 patients with colorectal cancer. Survival data were obtained through follow-up. Overall survival (OS) was calculated by using the Kaplan-Meier method. Univariate analysis was performed by applying the log-rank test. Meanwhile, multivariate analysis employed the Cox proportional hazards regression model. Results The 1-, 3-, 5-, and 10-year OS rates for the entire cohort were 91.90%, 74.40%, 64.40%, and 28.70%, respectively. Univariate analysis revealed that age, ethnicity, region, differentiation grade, TNM stage, clinical stage, metastatic status, histological type, and treatment modality (chemotherapy, radiotherapy, and surgery) were associated with patient prognosis (all P<0.05). Multivariate analysis identified age (HR=1.250), region (HR=1.262), differentiation grade (HR=0.761), clinical stage (HR=3.128), and treatment modality (chemotherapy, HR=0.644; radiotherapy, HR=1.605; surgery, HR=0.384) as independent factors affecting survival prognosis in patients with colorectal cancer (all P<0.001). Conclusion Age, region, clinical stage, and treatment modality are independent factors influencing survival among patients with colorectal cancer in Yunnan Province. In clinical practice, these factors should be integrated to develop individualized prevention and treatment strategies, thereby improving patient outcomes.

ObjectiveTo elucidate the efficacy connotation of Shudi Qiangjin pills （SQP） against liver and kidney deficiency in steroid-induced osteonecrosis of femoral head （SONFH） from the perspective of the "disease-syndrome-formula" association and to clarify the underlying mechanisms based on in vivo and in vitro experiment validation. MethodsThe chemical components and the corresponding putative targets of SQP were collected from the Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine （TCMIP） v2.0， the Encyclopedia of Traditional Chinese Medicine （ETCM） v2.0， and HERB databases. The SONFH-related genes were identified based on the differential expression profiles of peripheral blood of patients with SONFH compared to the healthy volunteers， and the disease phenotype-related targets were collected from the TCMIP v2.0 database. Then， the interaction network of "SONFH-related genes and candidate targets of SQP" was constructed based on "gene-gene interaction information"， and the major network targets were screened by calculating the topological characteristic values of the network followed by the functional mining according to the Kyoto Encyclopedia of Genes and Genomes （KEGG） database and the SoFDA database. After that， the SONFH rat model was prepared by lipopolysaccharide combined with methylprednisolone injection， and 2.5， 5， 7.5 g·kg^-1 SQP （once per day， equivalent to 1， 2， and 3 times the clinical equivalent dose， respectively） or 7.3×10^-3 g·kg^-1 of alendronate sodium （ALS， once per week， equivalent to the clinical equivalent dose） was given for 8 weeks. The effect characteristics of SQP and ALS in the treatment of SONFH were evaluated by micro-computed tomography scanning， hematoxylin and eosin staining， alkaline phosphatase （ALP） staining， immunohistochemical staining， enzyme-linked immunosorbent assay， and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling（TUNEL）staining， and a comparative efficacy analysis was conducted with ALS. In addition， SONFH cell models were prepared by dexamethasone stimulation of osteoblasts， and the intervention was carried out with the medicated serum of SQP at the aforementioned three doses. Cell counting kit-8， ALP staining， ALP activity assay， alizarin red staining， and flow cytometry were employed to investigate the regulatory effect of SQP on osteoblasts. The expression levels of osteogenesis-related proteins and key factors of the target signaling axis were detected by quantitative real-time polymerase chain reaction and Western blot. ResultsThe network analysis results demonstrated that the candidate targets of SQP primarily exerted their therapeutic effects through key signaling pathways， including phosphoinositide 3-kinase（PI3K）/protein kinase B（Akt）， lipid metabolism and atherosclerosis， prolactin， chemokines， and neurotrophic factors pathways. These pathways were significantly involved in critical biological processes such as muscle and bone metabolism and the regulation of the "neuro-endocrine-immune" network， thereby addressing both modern medical symptoms （e.g.， delayed skeletal maturation and recurrent fractures） and traditional Chinese medicine （TCM） symptoms （e.g.， fatigue， aversion to cold， cold limbs， and pain in the limbs and joints in patients with SONFH characterized by liver and kidney deficiency syndrome. Among these pathways， the PI3K/Akt signaling pathway exhibited the highest degree of enrichment. The in vivo experimental results demonstrated that starting from the 4^th week after modeling， the modeling group exhibited a significant reduction in body weight compared to the control group （P<0.05）. After six weeks of treatment， all dosage groups of SQP showed significantly higher body weights compared to the model group （P<0.01）. Compared with the normal group， the model group exhibited significant decreases in bone mineral density （BMD）， bone volume fraction （BV/TV）， trabecular number （Tb.N）， osteocalcin （OCN）， alkaline phosphatase （ALP） levels in femoral head tissue， and serum bone-specific alkaline phosphatase （BALP） （P<0.01）， along with significant increases in trabecular separation （Tb.Sp）， empty lacunae rate in tissue， and apoptosis rate （P<0.01）. In comparison to the model group， the SQP intervention groups showed significant improvements in BMD， BV/TV and Tb.N （P<0.01）， significant reductions in Tb.Sp， empty lacunae rate and apoptosis rate （P<0.05）， and significant increases in protein levels of OCN and ALP as well as BALP content （P<0.05）. The in vitro experimental results revealed that all dosage groups of SQP medicated serum showed no toxic effects on osteoblast. Compared with the normal group， the model group displayed significant suppression of osteoblast proliferation activity， ALP activity， and calcified nodule formation rate （P<0.01）， significant decreases in mRNA transcription levels of OCN and Runt-related transcription factor 2 （RUNX2） （P<0.01）， significant reductions in protein content of osteopontin （OPN）， typeⅠ collagen （ColⅠ）A1， B-cell lymphoma-2 （Bcl-2）， PI3K， and phosphorylated （p）-Akt （P<0.01）， and a significant increase in apoptosis rate （P<0.01）. Compared with the model group， the SQP medicated serum intervention groups exhibited significant increases in proliferation activity， ALP activity， calcified nodule formation rate， mRNA transcription levels of OCN and RUNX2， and protein content of OPN， ColⅠA1， Bcl-2， PI3K， and p-Akt （P<0.05）， along with a significant decrease in apoptosis rate （P<0.01）. ConclusionSQP can effectively reduce the disease severity of SONFH with liver and kidney deficiency syndrome and improve bone microstructure， with the therapeutic effects exhibiting a dose-dependent manner. The mechanism may be related to its regulation of key processes such as muscle and bone metabolism and the correction of imbalances in the "neuro-endocrine-immune" network， thereby promoting osteoblast differentiation and inhibiting osteoblast apoptosis. The PI3K/Akt signaling axis is likely one of the key pathways through which this formula exerts its effects.

Objective: To conduct screening for rare blood types within important blood group systems for the Chinese population, such as Rh, Duffy, Kidd, P1Pk, Diego, and MNS, in the Guangzhou region, and to establish a corresponding rare blood type database and physical repository. Methods: The saline medium microplate method was used to screen blood donors with the ccDEE phenotype combined with either Jk(a-) or Jk(b-). The polybrene microplate method was employed to screen for donors with Fy(a-), s(-), Lu(b-), Di(b-), k(-), and p phenotypes. The urea lysis microplate method was applied to screen for the Jk(a-b-) phenotype. A high-resolution melting (HRM) curve method was established for screening some donors with the Di(b-) phenotype. Subsequently, expanded phenotyping of antigens in the Rh, Kidd, MNS, Duffy, P1Pk, Lewis, Kell, and Lutheran blood group systems was performed on identified rare blood type donors using monoclonal antibodies. The test results are entered into the Rare Blood Type Bank Management System of the Guangzhou Blood Center, enabling functions such as confirmation reminders and cryopreservation storage when the donor donates again. Red blood cells of rare blood types are processed into frozen red blood cells for long-term storage. Results: Among voluntary blood donors, 16 cases of the ccDEE combined with Jk(a-) phenotype were identified (0.221 7%, 16/7 216); 10 cases of the ccDEE combined with Jk(b-) phenotype (0.138 6%, 10/7 216); 78 cases of the Fy(a-) phenotype (0.169 5%, 78/46 012); 39 cases of the Lu(b-) phenotype (0.138 2%, 39/28 214); 31 cases of the s(-) phenotype (0.081 8%, 31/37 913); 22 cases of the Di(b-) phenotype (0.029 9%, 22/73 691); 30 cases of the Jk(a-b-) phenotype (0.010 1%, 30/298 250); and 1 case of the k(-) phenotype (0.001 3%, 1/77 382), which was further identified as KELnull phenotype (K0). No p phenotype donors were identified (0/88 528). A total of 228 units of frozen red blood cells were prepared. The screening results were compared and analyzed with rare blood type data from other regions. Conclusion: This study, through a combination of different screening methods, significantly improved the efficiency of rare blood type screening while remaining cost-effective. By conducting large-scale screening and performing data informatization processing, a database and physical repository of rare blood types in the Guangzhou region were successfully established. This provides a strong guarantee for the timely supply of blood to patients with difficult-to-match and rare blood types in the region, effectively enhances the level of transfusion safety in the region, and offers a practical paradigm for constructing a comprehensive blood transfusion support system.

Cancer incidence in China has been rising steadily,with a particularly heavy burden from several high-prevalence malignancies.Medical examination for cancer plays a critical role in the early detection of cancer,precancerous lesions,and precursor conditions,thereby facilitating timely diagnosis and intervention.Such examination also addresses the growing demand for person-alized cancer screening services among diverse population groups.The development of evidence-based,context-specific cancer screening guidelines is essential to enhance the standardization,quality,and equity of preventive screening practices across the country,ultimately improving out-comes in early cancer detection and treatment.Guided by the Department of Medical Emergency Response of the National Health Commission,the Guidelines for Medical Examination for Cancer in Health Examination Agency(2025 Edition)were developed under the leadership of the National Cancer Center.A multidisciplinary panel of experts formulated the guidelines in accordance with the principles and methodology of the World Health Organization Handbook for Guideline Deve-lopment.The guidelines provide evidence-based recommendations on key clinical domains:target cancers and populations,overall screening workflow,screening protocols,diagnostic technolo-gies,result interpretation,follow-up procedures,and quality control.The primary objective is to standardize cancer screening practices in health examination agency and strengthen China's ca-pacity for prevention and control of high-burden cancers.

Objective:To understand the genetic characteristics of varicella-zoster virus（VZV）prevalent in Qinghai province，China since 2020.Methods:A total of 54 pharyngeal swab specimens were collected from sporadic suspected varicella cases in Qinghai province in 2020，2023，and 2024. Real-time fluorescence quantitative polymerase chain reaction was used for etiological screening of the specimens. Sequencing of three genes，namely ORF22，ORF38，and ORF62，and single-nucleotide polymorphism（SNP）analysis were performed on VZV nucleic acid-positive specimens.Results:All 54 suspected varicella cases were diagnosed with VZV infection，and three gene sequences were successfully obtained from 53 specimens. The results of genotype identification showed that all VZV infection case specimens obtained in this study in Qinghai province were wild strains. Among them，4 specimens in 2020 were of clade 2 type；among 14 specimens in 2023，7 were of clade 2 type and the remaining 7 were of clade 5 type；among 35 specimens in 2024，27 were of clade5 type，5 were of clade 2 type，and 3 were of clade 4 type. The SNP results showed that in 2023 and 2024，one specimen each had an A→G base mutation at position 37 990，and in 2024，3 specimens had a T→C base mutation at position 37946. Among them，the sequences containing the former mutation have been prevalent and spread in multiple regions of China，and the latter has not been reported in other regions of China.Conclusion:From 2020 to 2024 in Qinghai province，at least three genotypes of VZV，namely clade 2 type，clade 5 type，and clade 4 type，co-prevailed，and the clade 5 genotype of VZV may become the dominant prevalent strain.

Osteoporosis(OP)is a refractory metabolic bone disease,with decreased bone mineral mass,weakened bone strength,and systemic bone pain as typical clinical manifestations.Shenzhen Pingle Guo's Orthopedics,an important branch of the Pingle Guo's Orthopedics,has developed their distinct therapeutic approaches to the prevention and treatment of OP:the fifth-generation inheritor,Mr.Guo Chunyuan,advocated for the simultaneous regulation of qi and blood and formulated Shudi Zhuanggu Formula(composed of Rehmanniae Radix Praeparata,Codonopsis Radix,Atractylodis Macrocephalae Rhizoma,Poria,Angelicae Sinensis Radix,Paeoniae Radix Alba,Chuanxiong Rhizoma,Dipsaci Radix,and Achyranthis Bidentatae Radix);the sixth-generation inheritor,Professor Yang Zejin,emphasized zang-fu syndrome differentiation and established Yang's Guwei Formula,which simultaneously tonifies the liver,spleen,and kidney,and simultaneously treats deficiency and blood stasis(composed of Astragali Radix,Rehmanniae Radix Praeparata,Achyranthis Bidentatae Radix,Epimedii Folium,Cistanches Herba,Cuscutae Semen,Drynariae Rhizoma,Angelicae Sinensis Radix,Salviae Miltiorrhizae Radix et Rhizoma,Notoginseng Radix et Rhizoma,Corydalis Rhizoma,and Paeoniae Radix Alba);the seventh-generation inheritor,Professor Gong Chunzhu,proposed a three-stage clinical treatment strategy and stressed the principle of reinforcing acquired foundation of life(i.e.,reinforcing spleen and stomach),and formulated the modified Shudi Zhuanggu Formula with Lingnan characteristics(composed of Rehmanniae Radix Praeparata,Corni Fructus,Dioscoreae Rhizoma,Alismatis Rhizoma,Poria,Moutan Cortex,Astragali Radix,Dipsaci Radix,Cyathulae Radix,Acanthopanacis Cortex,Atractylodis Macrocephalae Rhizoma,Codonopsis Radix,and Chaenomelis Fructus).During the evolution,Shenzhen Pingle Orthopedic Hospital has continuously integrated modern medical achievements,passed down and enriched the clinical experience,and then the theoretical framework of traditional Chinese medicine in the prevention and treatment of OP has been developed.

Objective:To explore behavioral and electrophysiological differences in risky decision-making between depressed patients with and without suicidal ideation.Methods:A total of 61 patients with first-episode untreated depression were enrolled in the depression clinic of Nanjing Brain Hospital from September 2023 to January 2024, which were divided into the suicidal ideation group( n=32) and the non-suicidal ideation group ( n=29).At the same time, healthy controls matched with sex, age and years of education were recruited from the community( n=36).The event-related potentials (ERP) of the participants were detected, and the amplitude and latency of feedback related negative waves (FRN) and P300 during the feedback phase under Iowa gambling task (IGT) were recorded. Statistical analysis was performed using SPSS 26.0 software.The inter-and intra-group differences of ERP indexes were compared using two-way ANOVA, and Spearman correlation analysis was conducted to examine the relationship between ERP indexes and scores of the Beck scale for suicidal ideation. Results:(1)Compared with healthy controls, depressed patients with and without suicidal ideation had both lower net scores in IGT (both P<0.05).(2)When comparing the mean FRN amplitude under different feedback types among the three groups, the main effect of feedback type ( F=8.799, P=0.004), the main effect of group ( F=6.396, P=0.002) and the interaction effect ( F=4.200, P=0.018)were all significant. Under gain feedback conditions, the mean FRN amplitude was lower in both depressed groups compared with healthy controls (both P<0.05). (3)The comparison of the mean P300 amplitude under different feedback types among the three groups showed that the main effect of group ( F=15.719, P<0.001) and the main effect of feedback type ( F=15.949, P=0.001) were both significant, while the interaction effect between group and feedback type was not significant ( F=1.573, P=0.213). The group with suicidal ideation ((0.85±0.21) μV) had a smaller amplitude than both the non-suicidal ideation group ((1.61±0.22) μV) and healthy controls ((2.46±0.20) μV) (both P<0.05). (4)In depressed patients, P300 mean amplitude under both loss and gain feedback conditions were both negatively correlated with suicidal ideation (loss: r=-0.435, P=0.001; gain: r=-0.318, P=0.013). Conclusion:Depressed patients with and without suicidal ideation both exhibit impaired risk decision-making. The decrease of P300 mean amplitude is more significant in depressed patients with suicidal ideation than those without suicidal ideation.P300 mean amplitude may serve as an electrophysiological marker to differentiate depressed patients with suicidal ideation and those without suicidal ideation.

Objective:To analyze the characteristics of electroencephalogram microstate parameters in first-episode drug-naive patients with major depressive disorder (MDD), so as to provide electrophysiological evidence for the pathogenesis and early diagnosis of MDD.Methods:Eighty-four first-episode, drug-naive outpatients diagnosed with MDD(MDD group) and 82 healthy controls(healthy group) participated in this study. Resting-state EEG data (5-6 min, with eyes closed) were recorded for all participants. Data preprocessing and microstate analysis were performed using MATLAB and EEGLAB software. Temporal parameters of resting-state brain network microstates were compared using SPSS 26.0.Results:This study identified four typical microstates: Class A microstate(auditory network), Class B microstate(visual network), Class C microstate(salient network), and Class D microstate(attention and control network). The coverage rate (0.16±0.06, 0.21±0.06), duration (67.72±7.07, 72.28±8.59), and incidence rate (2.38±0.68, 2.82±0.67) of microstate A in MDD group were significantly lower than those in healthy group ( F=22.115, 13.368, 18.779, all P<0.001), while the above indexes of microstate B in MDD group were significantly higher than those in healthy group(coverage rate: 0.24±0.07 vs 0.18±0.06, duration: 76.35±11.28 vs 69.46±8.52, incidence rat: 3.16±0.52 vs 2.52±0.57) ( F=41.287, 18.999, 52.245, all P<0.001). Additionally, the microstate D in MDD group showed significantly lower coverage rate(0.33±0.08, 0.36±0.08) and duration (89.66±15.38, 95.46±16.79)compared with healthy group( F=3.932, 4.215, both P<0.05). Notably, significant differences were observed in the transition probabilities between the following microstates: A→B, A→D, B→A, C→A, C→B, D→A and D→B (all P<0.05). Conclusion:First-episode drug-naive depressive patients are characterized by alterations in microstate A, microstate B, and microstate D, which may be the potential pathogenesis of MDD and may serve as electrophysiological indicators for early diagnosis of MDD.

Objective:To observe the changes in choroidal morphology and blood perfusion in patients with macular edema secondary to retinal vein occlusion (RVO) after intravitreal injections of ranibizumab.Methods:A cohort study was performed.A total of 157 patients (157 eyes) with macular edema secondary to monocular acute retinal vein occlusion (RVO) were enrolled in the Third People's Hospital of Dalian from January 2022 to March 2023.There were 66 cases (66 eyes) with central retinal vein occlusion (CRVO) and 91 cases (91 eyes) with branch retinal vein occlusion (BRVO).All patients were treated with 3+ pro re nata (PRN) regimen of ranibizumab.Before and 1 month after each injection, the central retinal thickness of the macula was measured by optical coherence tomography (OCT).Clear images of the choroid were obtained using the OCT enhanced depth scan mode.Subfoveal choroidal thickness (SFCT), the nasal choroidal thickness at 1 500 μm of macula (CT N1.5 mm), the temporal choroidal thickness at 1 500 μm of macula (CT T1.5 mm) were measured and mean macular thickness (CT Mean) was calculated.Binarization of choroidal images processed by ImageJ software was used to analyze luminal area (LA), stromal area (SA) and total choroidal area (TCA), and choroidal vascularity index (CVI) was calculated.This study adhered to the Declaration of Helsinki and was approved by the Ethics Committee of the Third People's Hospital of Dalian (No.2023-145-001).Results:SFCT, CT T1.5 mm, CT N1.5 mm, CT Mean, LA, SA, TCA and CVI of RVO eyes were higher than those of the contralateral eyes and the differences were statistically significant (all P<0.01).CT Mean in CRVO group was (326.99±64.92)μm, which was higher than (299.80±73.08)μm in BRVO group, with a statistically significant difference ( t=2.41, P=0.02).Baseline CVI values in CRVO group and BRVO group were (72.50±5.62)% and (72.33±5.85)%, respectively, with no significant difference ( t=0.187, P=0.85).In eyes with RVO, CRVO and BRVO, SFCT, CT T1.5 mm, CT N1.5 mm, CT Mean, LA, SA, TCA and CVI after every injection were lower than the baseline and the differences were statistically significant (all P<0.05).In eyes with CRVO, there was no significant difference in LA and CVI between first and second injections (both P>0.05), and SFCT, CT T1.5 mm, CT N1.5 mm, CT Mean, SA and TCA after second injection were lower than those after first injection with statistically significant differences (all P<0.05).In eyes with BRVO, there was no significant difference in SA and CVI between first and second injections (both P>0.05), and SFCT, CT T1.5 mm, CT N1.5 mm, CT Mean, LA and TCA after second injection were lower than those after first injection with statistically significant differences (all P<0.05).In eyes with RVO, CRVO and BRVO, there was no significant difference in SFCT, CT T1.5 mm, CT N1.5 mm, CT Mean, SA, TCA and CVI between second and third injections (all P>0.05). Conclusions:After intravitreal injection of ranibizumab, the choroidal thickness becomes thinner and CVI decreases in eyes with macular edema secondary to RVO, and remain relatively stable after the second injection.

Objective:To analyze the differences between subjective refraction and autorefraction in myopic children and adolescents under different ciliary muscle functional states.Methods:A cohort study was conducted.A total of 98 myopic children and adolescents (196 eyes) aged 7-15 years who visited the Shanghai Eye Disease Prevention and Treatment Center from November 2023 to February 2024 were included by random sampling.All participants underwent cycloplegia with 1.0% cyclopentolate and completed both subjective refraction and autorefraction before cycloplegia, after cycloplegia and after recovery from cycloplegia.The spherical equivalent (SE) differences and differences in SE(ΔSE) between different conditions were compared.Proportion of ΔSE, differences in spherical power (ΔS), and differences in cylindrical power (ΔC) of objective and subjective refraction between different conditions within the clinically acceptable error range (-0.25 to 0.25 D) was calculated and compared.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Shanghai Eye Diseases Prevention & Treatment Center (No.2021SQ021).Written informed consent was obtained from guardian of each subject before any medical examination.Results:The SE values obtained from autorefraction before cycloplegia, after cycloplegia, and after recovery from cycloplegia were -2.44(-3.47, -1.63), -2.13(-3.25, -1.50), and -2.38(-3.50, -1.66)D, respectively, with a statistically significant overall difference ( χ2=148.36, P<0.001) and statistically significant differences in pairwise comparisons at different time points (all P<0.001); for subjective refraction, the SE values were -2.25(-3.50, -1.50), -2.19(-3.47, -1.45), and -2.28(-3.50, -1.50)D, respectively, with a statistically significant overall difference ( χ2=43.48, P<0.001) and statistically significant differences in pairwise comparisons at different time points (all P<0.001).Subjective refraction ΔSE between before and after cycloplegia, after cycloplegia and after recovery from cycloplegia were significantly smaller than those of autorefraction ( t=2.84, 1.82; both P<0.001).There was no significant difference in ΔSE between subjective refraction and autorefraction between before cycloplegia and after recovery from cycloplegia ( t=-0.43, P=0.070).The proportions of subjective refraction ΔSE within the acceptable error range between before and after cycloplegia, before cycloplegia and after recovery from cycloplegia, and after cycloplegia and after recovery from cycloplegia were significantly higher than those of autorefraction ( χ2=28.32, 11.82, 25.55; all P<0.001).The proportion of subjective refraction ΔS and ΔC both within the acceptable error range between before cycloplegia and after recovery from cycloplegia was 81.63%(160/196) and 79.59%(156/196) between after cycloplegia and after recovery from cycloplegia. Conclusions:Subjective refraction is less affected by different ciliary muscle functional states.The differences in subjective refraction results under different ciliary muscle functional states are mostly within the acceptable error range.The subjective refraction results before or after cycloplegia can be used to better predict the subjective refraction results after recovery from cycloplegia.