ObjectiveTo explore the effects of Wumeiwan on liver metastasis and lung metastasis of colorectal cancer and its potential mechanism. MethodsFirstly， mice were randomized into control， low-dose （20 g·kg^-1） Wumeiwan， high-dose （40 g·kg^-1） Wumeiwan， and paclitaxel （10 mg·kg^-1） groups. Secondly， liver metastasis and lung metastasis models of colorectal cancer were established in mice. After 4 weeks of intervention， the body weight of each mouse was recorded， and the lung weight， liver weight， and survival time of mice with metastatic colorectal cancer were determined. Hematoxylin-eosin （HE） staining was employed to detect the effects of Wumeiwan on liver metastasis and lung metastasis. Real-time PCR was employed to determine the mRNA levels of M1 and M2 macrophage markers in the liver tissue. Finally， the content of M1 macrophage markers CD80 and CD86 in the liver tissue was measured by flow cytometry. ResultsCompared with the control group， Wumeiwan and paclitaxel reduced the body weight （P<0.01） and liver weight （P<0.01） and prolonged the survival of the mouse model of liver metastasis of colorectal cancer （P<0.01）. In the mouse model of lung metastasis of colorectal cancer， Wumeiwan and paclitaxel also reduced the body weight （P<0.01） and lung weight （P<0.01） and extended the survival time （P<0.01）. Histopathological results showed that compared with the control group， Wumeiwan inhibited the liver and lung metastases of colorectal cancer. Real-time PCR results showed that compared with the control group， Wumeiwan upregulated the mRNA levels of M1 macrophage markers IL-1β， IL-6， tumor necrosis factor-α （TNF-α）， inducible nitric oxide synthase （iNOS）， and prostaglandin-endoperoxide synthase 2 （PTGS2） in the liver and lung tissue of mice with liver metastasis and lung metastasis of colorectal cancer （P<0.01）. Meanwhile， Wumeiwan downregulated the mRNA levels of M2 macrophage markers Arg1， CD163， and CD206 （P<0.01）. Meanwhile， the flow cytometry results showed that compared with the control group， Wumeiwan increased the content of CD86 and CD80 （P<0.01）. In addition， immunohistochemical results showed that Wumeiwan promoted the expression of CD86 and inhibited the expression of CD206 in the liver and lung tissue of mice with liver metastasis and lung metastasis. ConclusionWumeiwan can inhibit the liver metastasis and lung metastasis of colorectal cancer by promoting the M1 polarization of macrophages in the liver and lung of the model mice.

Objective:To establish an arsenic free fully automatic online digestion iodine analyzer detection method for urinary iodine (hereinafter referred to as the method).Methods:Based on the principle of iodine catalyzed antimony cerium redox reaction, a fully automatic online digestion iodine analyzer was used to determine the iodine content in urine. The effectiveness of the method in terms of detection limit, precision, accuracy (determination of urinary iodine primary standard reference materials GBW09108z and GBW09110f and spiked recovery experiment), and interference experiments was validated. The method was compared with the arsenic cerium catalytic spectrophotometry method recommended by the National Reference Laboratory for Iodine Deficiency Disorders.Results:The linear range of the method was 0 - 300 μg/L, with a correlation coefficient │ r│> 0.999 5. The qualitative and quantitative detection limits were 7.41 and 18.01 μg/L, respectively. The relative standard deviation ( RSD) of urine samples with different iodine concentrations ranged from 1.0% to 1.7%. The results of the determination of iodine concentrations in urine using standard substances GBW09108z and GBW09110f were within the given standard range, with RSD < 2.5%. The range of spiked recovery rates for urine samples with different iodine concentrations was 101.3% to 104.8%, with an overall average spiked recovery rate of 103.0%. The average concentration of the baseline iodine standard solution was determined to be 116.21 μg/L, and the relative error of the concentration determination with the addition of interfering substances was less than 5.0%. The comparison results showed that there was no statistically significant difference in the measurement results between the two methods ( t = - 0.06, P = 0.952). Conclusions:The method adopts automated detection, which is simple to operate, labor-saving, and does not require the use of arsenic trioxide. It has high precision and accuracy, and is suitable for detection of large quantities of samples.

Objective To explore the diagnostic performance of prostate imaging reporting and data system(PI-RADS)V2.1 score combined with prostate specific antigen(PSA)-related parameters in transition zone prostate cancer(PCa)in patients with PSA levels of 4-20 ng/mL.Methods The clinical data of 129 patients who underwent prostate biopsy were retrospectively analyzed,including age,total prostate specific antigen(tPSA),free prostate specific antigen(fPSA),f/t PSA,prostate volume(PV),and prostate specific antigen density(PSAD).Among 129 patients,52 were diagnosed with transition zone PCa and 77 with benign prostate hyperplasia.The MRI images of all patients were scored according to the PI-RADS V2.1 criteria.The clinical and imaging parameters between transition zone PCa and benign prostate hyperplasia were compared using univariate logistic regression analysis.Independent predic-tors were identified via multivariate logistic regression,and a combined predictive model was constructed.Diagnostic performance of the model was evaluated using the receiver operating characteristic(ROC)curves.Results Univariate logistic regression analysis showed that the transition zone PCa exhibited significantly higher PI-RADS V2.1 score,tPSA,and PSAD than the benign prostate hyperplasia(P＜0.05).Multivariate logistic regression analysis identified PI-RADS V2.1 score and PSAD were independent predictors for predicting transition zone PCa(P＜0.05).Optimal diagnostic thresholds were PI-RADS V2.1 score＞3 points and PSAD＞0.23 ng/mL2.The combined prediction model achieved an area under the curve(AUC)of 0.863,outperforming PI-RADS V2.1 score(AUC=0.821)and PSAD(AUC=0.779)alone(P＜0.05).Conclusion The combination of PI-RADS V2.1 score and PSAD has a high predictive value for transition zone PCa in patients with PSA levels of 4-20 ng/mL.Thresholds of PI-RADS V2.1 score＞3 points and PSAD＞0.23 ng/mLL2 significantly improve diagnostic accuracy.

Objective To explore the diagnostic performance of prostate imaging reporting and data system(PI-RADS)V2.1 score combined with prostate specific antigen(PSA)-related parameters in transition zone prostate cancer(PCa)in patients with PSA levels of 4-20 ng/mL.Methods The clinical data of 129 patients who underwent prostate biopsy were retrospectively analyzed,including age,total prostate specific antigen(tPSA),free prostate specific antigen(fPSA),f/t PSA,prostate volume(PV),and prostate specific antigen density(PSAD).Among 129 patients,52 were diagnosed with transition zone PCa and 77 with benign prostate hyperplasia.The MRI images of all patients were scored according to the PI-RADS V2.1 criteria.The clinical and imaging parameters between transition zone PCa and benign prostate hyperplasia were compared using univariate logistic regression analysis.Independent predic-tors were identified via multivariate logistic regression,and a combined predictive model was constructed.Diagnostic performance of the model was evaluated using the receiver operating characteristic(ROC)curves.Results Univariate logistic regression analysis showed that the transition zone PCa exhibited significantly higher PI-RADS V2.1 score,tPSA,and PSAD than the benign prostate hyperplasia(P＜0.05).Multivariate logistic regression analysis identified PI-RADS V2.1 score and PSAD were independent predictors for predicting transition zone PCa(P＜0.05).Optimal diagnostic thresholds were PI-RADS V2.1 score＞3 points and PSAD＞0.23 ng/mL2.The combined prediction model achieved an area under the curve(AUC)of 0.863,outperforming PI-RADS V2.1 score(AUC=0.821)and PSAD(AUC=0.779)alone(P＜0.05).Conclusion The combination of PI-RADS V2.1 score and PSAD has a high predictive value for transition zone PCa in patients with PSA levels of 4-20 ng/mL.Thresholds of PI-RADS V2.1 score＞3 points and PSAD＞0.23 ng/mLL2 significantly improve diagnostic accuracy.

Virus-related lymphoma exhibits a dual nature as both a hematologic malignancy and a viral infectious disease， making it more resistant to treatment and associated with poorer prognosis. This paper analyzes the understanding and therapeutic advantages of traditional Chinese medicine （TCM） in virus-related lymphoma. It proposes a TCM-based approach centered around syndrome differentiation， using standardized measurements of the overall TCM condition， multi-omics research of hematologic tumors， and artificial intelligence technologies to identify the "pre-condition" of virus-related lymphoma. A risk warning model will be established to early identify high-risk populations with viral infections that may develop into malignant lymphoma， thereby establishing a risk warning system for virus-related lymphoma. At the same time， a TCM health management approach will be applied to manage and regulate virus-related lymphoma， interrupting its progression and forming a human-centered， comprehensive， continuous health service model. Based on this， a standardized， integrated clinical prevention and treatment decision-making model for virus-related lymphoma， recognized by both Chinese and western medicine， will be established to provide TCM solutions for primary prevention of major malignant tumors.

Objective: To investigate the distribution of traditional Chinese medicine (TCM) syndromes and syndrome elements in lymphoma, as well as the correlation between TCM syndromes and Western clinical indicators, in order to analyze associations between TCM syndromes and these indicators. Methods: From January 2023 to May 2024, 216 patients with lymphoma who met the inclusion criteria in the Department of Hematology, Third People′s Hospital Affiliated to Fujian University of Traditional Chinese Medicine were enrolled. Four diagnostic methods were applied to perform TCM syndrome differentiation and extract syndrome elements. The correlations between various syndromes and blood test indicators of lactate dehydrogenase (LDH), β2-microglobulin (β2-MG), immunoglobulin G (IgG), immunoglobulin M (IgM), immunoglobulin A (IgA), white blood cell (WBC), hemoglobin (Hb), platelet count (PLT), neutrophil (NEUT), immunohistochemical markers of B-cell lymphoma-6 (BCL6), B-cell lymphoma-2 (BCL2), proto-oncogene MYC, and Ki67 protein expression, Ann Arbor staging, international prognostic index (IPI) score, bone marrow infiltration, concurrent infections during chemotherapy, and post-chemotherapy bone marrow suppression rate were analyzed. Results: Five TCM syndromes, ranked by frequency, were syndromes of yin deficiency with phlegm accumulation(41.67%), qi depression with phlegm obstruction(30.56%), cold-phlegm congelation and stagnation(12.96%), phlegm-blood stasis toxin(12.04%), and lingering pathogen due to deficient vital qi(2.77%). Yin deficiency(50.93%) and phlegm(45.37%) were the more prevalent syndrome elements. The TCM syndromes were correlated with β2-MG, PLT, MYC, BCL2/MYC, Ki67 protein expression, and bone marrow infiltration (P<0.05). No statistically significant differences were observed in Ann Arbor staging or IPI score across the syndromes. Compared to the syndrome of cold-phlegm congelation and stagnation, the syndrome of qi depression with phlegm obstruction exhibited higher levels of NEUT, MYC, BCL2/MYC, and Ki67 protein expression, as well as a higher rate of post-chemotherapy bone marrow suppression (P<0.05); the syndrome of phlegm-blood stasis toxin showed higher MYC and BCL2/MYC protein expression and a higher rate of post-chemotherapy bone marrow suppression rate (P<0.05); the syndrome of yin deficiency with phlegm accumulation demonstrated higher MYC and BCL2/MYC protein expression and bone marrow infiltration rates, whereas PLT level was lower (P<0.05); the syndrome of lingering pathogen due to deficient vital qi had higher MYC, BCL2/MYC, and Ki67 protein expression levels, as well as a higher rate of post-chemotherapy bone marrow suppression rate (P<0.05). Compared to the syndrome of qi depression with phlegm obstruction, the syndrome of phlegm-blood stasis toxin exhibited lower Ki67 protein expression (P<0.05); the syndrome of yin deficiency with phlegm accumulation had higher β2-MG level, bone marrow infiltration rate, and rate of concurrent infections during chemotherapy, whereas PLT and NEUT levels and the rate of post-chemotherapy bone marrow suppression rate were lower (P<0.05). Compared to the syndrome of phlegm-blood stasis toxin, the syndrome of yin deficiency with phlegm accumulation had higher β2-MG level, whereas NEUT and the rate of post-chemotherapy bone marrow suppression were lower(P<0.05); the syndrome of lingering pathogen due to deficient vital qi exhibited a higher Ki67 protein expression (P<0.05). Compared to the syndrome of yin deficiency with phlegm accumulation, the syndrome of lingering pathogen due to deficient vital qi also showed a higher Ki67 protein expression(P<0.05). Conclusion The syndrome of yin deficiency with phlegm accumulation is relatively common in lymphoma. There is a correlation between TCM syndromes and Western medicine clinical indicators. The presence of heat signs in the syndromes may indicate active disease and poor prognosis, while the presence of strong pathogenic factors and weak vital qi in the syndromes may indicate a severer chemotherapy-related bone marrow suppression.

Objective To explore an individualized prediction scheme for sepsis patients with moderate to severe acute gastrointestinal injury based on clinical characteristics.Methods A retro-spective analysis was conducted on the clinical data of 316 sepsis patients admitted to Henan Tradi-tional Chinese Medicine Hospital from August 2021 to August 2024,and they were designated as ob-servation group.According to the occurrence of moderate to severe acute gastrointestinal injury during hospitalization,patients in the observation group were divided into complication group(n=165)and non-complication group(n=151).Multivariate logistic regression analysis was used to screen the in-fluencing factors for sepsis patients with moderate to severe acute gastrointestinal injury.An individu-alized nomogram prediction model was constructed,and its predictive efficacy was internally validated.Additionally,the clinical data of 158 sepsis patients admitted to our hospital from January 2020 to July 2021 were retrospectively analyzed and used as external validation group to externally validate the nomogram model.A random forest prediction model was constructed using the data from the ob-servation group,and its predictive efficacy was evaluated using the data from the external validation group.Results The results of multivariate logistic regression analysis showed that mechanical ven-tilation(OR=2.472),multiple organ dysfunction syndrome(MODS)(OR=4.023),high Se-quential Organ Failure Assessment(SOFA)score at admission(OR=3.083),high Acute Physiol-ogy and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score(OR=2.835),high white blood cell(WBC)count(OR=1.610),high blood lactate level(OR=1.893),high C-reactive protein(CRP)level(OR=2.036),high D-lactate level(OR=2.620),high endotoxin level(OR=3.834),high diamine oxidase(DAO)level(OR=3.916),high intestinal fatty acid-binding pro-tein(I-FABP)level(OR=4.175),and high intra-abdominal pressure(OR=3.511)were all risk factors for sepsis with moderate to severe acute gastrointestinal injury(P＜0.05).High levels of glucagon-like peptide-2(GLP-2)(OR=0.825),high gastric motility index(MI)(OR=0.485),and high superior mesenteric artery end-diastolic velocity(VPd)(OR=0.559)at admis-sion were all protective factors(P＜0.05).Based on the above factors,a nomogram prediction model for sepsis with moderate to severe acute gastrointestinal injury was constructed.After internal and external validation,the concordance indices were 0.862 and 0.858,respectively,and the cali-bration curves closely fitted the ideal curves.The receiver operating characteristic(ROC)curve showed thatthe sensitivity,specificity,and area under the curve(AUC)of the model's predictions were 88.48％,86.09％,0.889 and 87.50％,85.90％,0.884,respectively.The decision analy-sis curve showed that the model had a high net benefit when the threshold probability was in the ran-ges of 0.25-0.94 and 0.31-0.98.According to the ranking based on the average decrease in Gi-ni index in the random forest prediction model,MODS,SOFA score,I-FABP,DAO,and endotoxin were the top five indicators,which had a significant impact on the prediction of moderate to severe acute gastrointestinal injury.The ROC curve assessment showed that the sensitivity,specificity,and AUC of the random forest prediction model were 78.75％,83.33％,and 0.816,respectively.The sensitivity and AUC of the individualized nomogram model for predicting sepsis with moderate to se-vere acute gastrointestinal injury were higher than those of the random forest prediction model,and their specificities were basically equivalent.Conclusion Mechanical ventilation,MODS,and SOFA score,APACHE Ⅱ score,WBC count,blood lactate,CRP,GLP-2,D-lactate,endotoxin,DAO,I-FABP,intra-abdominal pressure,MI,and VPd at admission are all influencing factors for sepsis with moderate to severe acute gastrointestinal injury.The constructed individualized nomo-gram prediction model has important guiding value for guiding the early clinical screening of high-risk patients and the timely formulation of appropriate intervention plans.

Objective:To explore the clinical efficacy of three different surgical timings of modified cervical cerclage in twin pregnant women with cervical insufficiency.Methods:The clinical data of 73 twin pregnant women who underwent modified cervical cerclage and had pregnancy outcomes in Qilu Hospital of Shandong University (Qingdao) from April 2014 to July 2023 were retrospectively analyzed. According to the different timings of surgery, they were divided into prophylactic cerclage group, ultrasound-indicated cerclage group (further divided into cervical length (CL)≤15 mm and 15 mm10 mg/L was a risk factor for preterm birth before 34 weeks of gestation ( OR=5.230, 95% CI: 1.616-16.929; P=0.006). Conclusions:In twin pregnant women with cervical insufficiency, prophylactic cerclage has the same surgical effect as ultrasound-indicated cerclage, while both prophylactic cerclage and ultrasound-indicated cerclage could significantly improve maternal and fetal outcomes compared with emergency cerclage. Twin pregnancies with CL≤15 mm might benefit from cervical cerclage. Postoperative CRP>10 mg/L is an independent risk factor for preterm birth before 34 weeks of gestation.

Objective:To investigate the efficacy of radiotherapy in patients with advanced esophageal cancer receiving first-line chemoimmunotherapy.Methods:A retrospective analysis was conducted on the data of 137 patients with Stage Ⅳ esophageal squamous cell carcinoma (ESCC) treated at our hospital from January 2018 to May 2023. These patients were divided into two groups: a group treated with first-line chemoimmunotherapy combined with radiotherapy (chemoimmunotherapy + radiotherapy group, n = 43) and a group treated with only chemoimmunotherapy ( n = 94). Inverse probability of treatment weighting (IPTW) was applied to balance baseline characteristics between the groups. With overall survival (OS) and progression-free survival (PFS) as study endpoints, the survival data were analyzed using the Kaplan-Meier method, the log-rank test, and the Cox regression method. Results:Before calibration, the chemoimmunotherapy + radiotherapy group significantly outperformed the sole chemoimmunotherapy group in median PFS (13.6 months vs. 7.0 months; HR: 0.501, 95% CI: 0.309-0.811, P = 0.005). After calibration using the COX proportional-hazards model for age, gender, Eastern Cooperative Oncology Group (ECOG) performance status, smoking history, T/N/M stage, and tumor location, the chemoimmunotherapy + radiotherapy group still had significant advantages in PFS (14.7 months vs. 7.0 months; HR: 0.441, 95% CI: 0.261-0.745, P = 0.002). IPTW analysis further confirmed this trend (13.9 months vs. 7.0 months; HR: 0.492, 95% CI: 0.304-0.795, P < 0.001). Specifically, the median OS of the chemoimmunotherapy + radiotherapy group demonstrated significant improvement in all analyses: pre-calibration (29.5 months vs. 18.0 months; HR: 0.507, 95% CI: 0.297-0.867, P = 0.013), after calibration using the Cox model (27.5 months vs. 16.7 months; HR: 0.470, 95% CI: 0.266-0.830, P = 0.009), and after calibration using IPTW (29.5 months vs. 16.9 months; HR: 0.448, 95% CI: 0.262-0.764, P < 0.001). Conclusions:The combination of radiotherapy and first-line chemoimmunotherapy can significantly improve survival outcomes of patients with advanced ESCC, suggesting its potential as a standard treatment strategy.

Objective:To explore the latent class characteristics of demoralization in severely disabled stroke patients, and analyze the differences and influencing factors of each class by latent class analysis.Methods:Convenience sampling was used to select 335 patients in the Neurointensive Care Unit of three Class Ⅲ Grade A hospitals in Anhui Province from October 2023 to March 2024, and were confirmed to be with post-stroke disability through follow-up as research subjects. General Information Questionnaire and Demoralization Scale-Ⅱ were used for a survey. Latent class analysis was used to identify latent classes of demoralization, and multiple logistic regression was used to analyze the influencing factors of different latent classes.Results:A total of 335 questionnaires were distributed, and 321 valid questionnaires were retrieved. The effective recovery rate of the questionnaires was 95.8%. Demoralization of severe stroke patients with disability was classified into four categories of low demoralization (40.2%, 129/321), moderate demoralization with coping loss (12.1%, 39/321), moderate demoralization with goal loss (21.2%, 68/321), and high disability (26.5%, 85/321). Multiple Logistic regression analysis showed that age, gender, per capita monthly income of the family, whether was the economic pillar of the family, long-term residence, and relationship with cohabitants were the influencing factors of demoralization in severe stroke patients with disability (all P<0.05) . Conclusions:There are four latent classes of demoralization in stroke patients with disability, and age, gender, per capita monthly income of the family, whether they are the economic pillar of the family, long-term residence, and relationship with cohabitants are the influencing factors of demoralization in severe stroke patients with disability.