Ovarian cancer （OC） is one of the most common malignant tumors in women， with the mortality rate being the highest among gynaecological malignant tumors. As the atypical symptoms of OC are difficult to be detected in the early stage， most patients are already in the advanced stage when being diagnosed. As a result， the clinical treatment has limited effects. Currently， the main therapies for OC are surgery and chemotherapy， while their drug resistance and adverse reactions seriously reduce the quality of life of patients. In recent years， traditional Chinese medicine （TCM） has attracted the attention of clinicians and researchers because of its high efficacy， low toxicity， and mild side effects. According to the TCM philosophy of treatment based on syndrome differentiation， the Chinese medicines with multiple targets， wide range， and mild side effects can be screened based on the molecular targets involved in the occurrence and development of OC， which can bring out the unique advantages of TCM in the treatment of OC. Modern studies have shown that the occurrence and development of OC are closely related to the abnormal expression of multiple signaling pathways. The continued abnormal activation of the signal transducer and activator of transcription 3 （STAT3） signaling pathway can lead to abnormal proliferation and malignancy of OC. cause abnormal proliferation and malignant transformation of OC， which is closely related to the development of OC. In addition， studies have shown that Chinese medicine can inhibit the proliferation， angiogenesis， invasion， and metastasis and promote the autophagy and apoptosis of OC cells by regulating the Janus kinase 2 （JAK2）/STAT3 signaling pathway， providing new therapeutic strategies and ideas for the prevention and treatment of OC. This paper summarizes the role of JAK2/STAT3 signaling pathway in OC development by reviewing the relevant articles and reviews the mechanism and research progress of active components and compound prescriptions of Chinese medicine intervening in OC development by regulating the JAK2/STAT3 signaling pathway. This review is expected to provide a systematic reference for clinical research and drug development of OC.

Objectives To construct frailty risk prediction models based on logistic regression anal-ysis,decision tree and random forest algorithm in elderly patients with heart failure(HF),and to compare the predictive performance of three models.Methods A total of 426 elderly HF patients hospitalized in the Affiliated Hospital of Nantong University from September 2022 to October 2023 were selected using convenience sampling.Based on the results of frailty assessment,194 of them were classified into the frail group and the other 232 into the non-frail group.The 426 patients were divided into training(299 casses)and testing sets(127 cases)in a 7∶3 ratio.Three prediction models were then constructed in the training set,while the test set was used to validate the results.Area under curve and confusion matrix were used to measure performance of the mod-els.The optimal model was then selected by evaluating the performance on the testing set.Results The area under curve value of the logistic regression model,decision tree model and random forest model in the testing set was 0.898,0.825 and 0.903,with a classification accuracy of 84.25％,77.95％and 83.46％,a sensitivity of 82.76％,68.97％and 82.76％,a specificity of 85.51％,85.51％and 84.06％,a positive predictive value of 82.76％,80.00％and 81.36％,and a negative predictive value of 85.51％,76.62％and 85.29％,respectively.The factors that ultimately affecting frailty in elderly HF patients were age,left atrial diameter,depression,albumin,physical activity level and social support.Conclusion Among the three prediction models,the logistic regression model demonstrates best predictive performance for frailty risk in elderly HF patients than the decision tree and random forest models.

Objective:To calculate the reference intervals of immune globulinG (IgG), IgA, IgM, complement 3 (C3) and C4 for adults using Hoffmann and refineR methods, and to compare them with the reference interval reported by WS/T 645 of the People′s Republic of China, exploring the clinical application value of the indirect methods.Methods:Cross-sectional study. The physical examination data were collected at Peking Union Medical College Hospital from 2013 to 2023. Box-Cox was used to normalize the data distribution, and the Tukey method was used to remove outliers. Mann-Whitney test and Kruskal-Wallis test were used to compare the differences between gender and age, respectively. Quantile regression analysis was used to examine the effects of age and gender. Hoffmann and refineR methods were employed to calculate RIs of the five parameters.Results:There were 82 251, 82 483, 49 236, 20 027 and 19 942 test results for IgG, IgA, IgM, C3 and C4, respectively. Gender was significantly correlated with IgG, IgA, IgM, C3, and C4 levels, and age was significantly correlated with IgA, IgM, C3, and C4 levels. Reference intervals were calculated using both Hoffmann and refineR methods, yielding comparable results: IgG (7.58-16.85 g/L; 7.54-16.88 g/L), IgA (0.97-4.26 g/L; 0.97-4.34 g/L), C3 (0.73-1.43 g/L; 0.73-1.44 g/L), and C4 (0.11-0.32 g/L). Gender-specific intervals were established for IgM: women (0.44-2.57 g/L; 0.44-2.62 g/L) and men (0.33-1.91 g/L; 0.31-1.87 g/L). Gender and/or age-specific reference intervals were further calculated according to the bias ratio values. The reference intervals calculated by Hoffmann and refineR are in good agreement. The upper and lower limits of reference intervals for IgA and C3, the lower limits of IgG, the upper limits of IgM and C3 calculated by the indirect methods have good comparability with those reported by standards.Conclusions:The total and gender/age-specific reference intervals of IgG, IgA, IgM, C3 and C4 in our hospital population were established by Hoffmann and refineR methods, and the reference intervals established by the two indirect methods were comparable. The reference intervals calculated using these indirect methods were also comparable with those established using the direct method reported in current health standards.

The interplay between psychological pain and physical pain is one of the key issues in the research of non-suicidal self-injury (NSSI). Psychological pain, driven by negative self-perception and difficulties in emotional regulation, activates specific brain regions, such as the anterior cingulate gyrus and insula, areas that overlap with neural networks involved in physical pain. Physical pain can, in turn, activate distinct neural pathways that temporarily alleviate psychological pain. However, repeated self-injury may lead to increased pain tolerance over time, contributing to a vicious cycle. This paper reviews the potential neural network connections and interactions between psychological and physical pain in the context of NSSI behavior. It also summarizes current clinical interventions and their effectiveness in treating NSSI, aiming to offer new insights for future research and clinical practice in preventing and treating NSSI.

Objectives To construct frailty risk prediction models based on logistic regression anal-ysis,decision tree and random forest algorithm in elderly patients with heart failure(HF),and to compare the predictive performance of three models.Methods A total of 426 elderly HF patients hospitalized in the Affiliated Hospital of Nantong University from September 2022 to October 2023 were selected using convenience sampling.Based on the results of frailty assessment,194 of them were classified into the frail group and the other 232 into the non-frail group.The 426 patients were divided into training(299 casses)and testing sets(127 cases)in a 7∶3 ratio.Three prediction models were then constructed in the training set,while the test set was used to validate the results.Area under curve and confusion matrix were used to measure performance of the mod-els.The optimal model was then selected by evaluating the performance on the testing set.Results The area under curve value of the logistic regression model,decision tree model and random forest model in the testing set was 0.898,0.825 and 0.903,with a classification accuracy of 84.25％,77.95％and 83.46％,a sensitivity of 82.76％,68.97％and 82.76％,a specificity of 85.51％,85.51％and 84.06％,a positive predictive value of 82.76％,80.00％and 81.36％,and a negative predictive value of 85.51％,76.62％and 85.29％,respectively.The factors that ultimately affecting frailty in elderly HF patients were age,left atrial diameter,depression,albumin,physical activity level and social support.Conclusion Among the three prediction models,the logistic regression model demonstrates best predictive performance for frailty risk in elderly HF patients than the decision tree and random forest models.

Objective:To calculate the reference intervals of immune globulinG (IgG), IgA, IgM, complement 3 (C3) and C4 for adults using Hoffmann and refineR methods, and to compare them with the reference interval reported by WS/T 645 of the People′s Republic of China, exploring the clinical application value of the indirect methods.Methods:Cross-sectional study. The physical examination data were collected at Peking Union Medical College Hospital from 2013 to 2023. Box-Cox was used to normalize the data distribution, and the Tukey method was used to remove outliers. Mann-Whitney test and Kruskal-Wallis test were used to compare the differences between gender and age, respectively. Quantile regression analysis was used to examine the effects of age and gender. Hoffmann and refineR methods were employed to calculate RIs of the five parameters.Results:There were 82 251, 82 483, 49 236, 20 027 and 19 942 test results for IgG, IgA, IgM, C3 and C4, respectively. Gender was significantly correlated with IgG, IgA, IgM, C3, and C4 levels, and age was significantly correlated with IgA, IgM, C3, and C4 levels. Reference intervals were calculated using both Hoffmann and refineR methods, yielding comparable results: IgG (7.58-16.85 g/L; 7.54-16.88 g/L), IgA (0.97-4.26 g/L; 0.97-4.34 g/L), C3 (0.73-1.43 g/L; 0.73-1.44 g/L), and C4 (0.11-0.32 g/L). Gender-specific intervals were established for IgM: women (0.44-2.57 g/L; 0.44-2.62 g/L) and men (0.33-1.91 g/L; 0.31-1.87 g/L). Gender and/or age-specific reference intervals were further calculated according to the bias ratio values. The reference intervals calculated by Hoffmann and refineR are in good agreement. The upper and lower limits of reference intervals for IgA and C3, the lower limits of IgG, the upper limits of IgM and C3 calculated by the indirect methods have good comparability with those reported by standards.Conclusions:The total and gender/age-specific reference intervals of IgG, IgA, IgM, C3 and C4 in our hospital population were established by Hoffmann and refineR methods, and the reference intervals established by the two indirect methods were comparable. The reference intervals calculated using these indirect methods were also comparable with those established using the direct method reported in current health standards.

The interplay between psychological pain and physical pain is one of the key issues in the research of non-suicidal self-injury (NSSI). Psychological pain, driven by negative self-perception and difficulties in emotional regulation, activates specific brain regions, such as the anterior cingulate gyrus and insula, areas that overlap with neural networks involved in physical pain. Physical pain can, in turn, activate distinct neural pathways that temporarily alleviate psychological pain. However, repeated self-injury may lead to increased pain tolerance over time, contributing to a vicious cycle. This paper reviews the potential neural network connections and interactions between psychological and physical pain in the context of NSSI behavior. It also summarizes current clinical interventions and their effectiveness in treating NSSI, aiming to offer new insights for future research and clinical practice in preventing and treating NSSI.

Background Occupational stress is an important public health problem in the military. At present, there are few studies about occupational stress of officers and soldiers of the armed forces in China, especially the effects of plateau related environmental factors on occupational stress. Objective To understand current status and identify influencing factors of occupational stress among officers and soldiers stationed in plateaus, and provide a scientific basis for managing occupational stress. Methods In April 2023, stratified cluster sampling was used to recruit troops by deployed altitudes ranging from 500 to 3000 m into two strata of low altitude (＜2500 m) and high altitude (≥2500 m) based on the medical definition of plateau. Two regimental units were randomly selected from each stratum respectively, and one battalion unit was randomly selected from each regimental unit with all the officers and soldiers. Four selected battalion units were surveyed with a total of 2284 officers and soldiers. We designed a general questionnaire to collect their basic information, and distributed effort-reward imbalance questionnaires to evaluate occupational stress. We used logistic regression to identify potential influencing factors of occupational stress. Results Positive occupational stress was reported in 508 plateau-stationed officers and soldiers, with a prevalence rate of 22.2%. The total effort-reward imbalance score and the dimensional scores of effort, reward, and overcommitment in M (P₂₅, P₇₅) were 0.9 (0.7, 1.0), 16.0 (13.0, 19.0), 36.0 (33.0, 39.0), and 18.0 (15.0, 19.0), respectively. There were significant differences in the positive rate of occupational stress by gender, age, military service length, marital status, only child or not, physical fitness condition, reporting underlying diseases or not, exercise frequency before conscription, psychological changes after entering the plateaus, and having altitude sickness or not (P <0.05). The results of logistic regression showed that being female (OR=1.532, 95%CI: 1.061, 2.213), only child (OR=1.281, 95%CI: 1.038, 1.581), and with underlying diseases (OR=1.950, 95%CI: 1.340, 2.839) were associated with a higher risk of occupational stress. While setting 0 to <3 years of military service as the control group, the risk of occupational stress was higher in subgroups of 3 to 9 years (OR=1.380, 95%CI: 1.113, 1.710) and ≥9 years (OR=2.141, 95%CI: 1.461, 3.137). The participants reporting nervousness or fear (OR=1.728, 95%CI: 1.133, 2.635) and agitation or euphoria (OR=1.380, 95%CI: 1.113, 1.710) had a higher risk of reporting occupational stress than those with no psychological changes after entering the plateaus. Meanwhile, those who had regular exercise (OR=0.670, 95%CI: 0.492, 0.913) before enlistment, good physical fitness condition (OR=0.572, 95%CI: 0.426, 0.767) and excellent physical fitness condition (OR=0.502, 95%CI: 0.366, 0.688) had a lower risk of occupational stress. Conclusion Officers and soldiers in plateaus generally report a high rate of occupational stress. Female, military service length ≥3 years, being only child, with underlying diseases, nervousness/ fear or agitation/ euphoria after entering plateaus are risk factors for elevated occupational stress in this group; while good or excellent physical fitness condition and frequent exercise before enlistment are protective factors for occupational stress. Therefore, it is necessary to pay attention to the occupational stress problems in officers and soldiers stationed in plateaus and provide targeted intervention measures.

Background: Twenty-four-hour urinary free cortisol (UFC) measurement is the initial diagnostic test for Cushing’s syndrome (CS). We compared UFC determination by both direct and extraction immunoassays using Abbott Architect, Siemens Atellica Solution, and Beckman DxI800 with liquid chromatography-tandem mass spectrometry (LC-MS/MS). In addition, we evaluated the value of 24-hr UFC measured by six methods for diagnosing CS. Methods: Residual 24-hr urine samples of 94 CS and 246 non-CS patients were collected.A laboratory-developed LC-MS/MS method was used as reference. UFC was measured by direct assays (D) using Abbott, Siemens, and Beckman platforms and by extraction assays (E) using Siemens and Beckman platforms. Method was compared using Passing–Bablok regression and Bland–Altman plot analyses. Cut-off values for the six assays and corresponding sensitivities and specificities were calculated by ROC analysis. Results: Abbott-D, Beckman-E, Siemens-E, and Siemens-D showed strong correlations with LC-MS/MS (Spearman coefficient r = 0.965, 0.922, 0.922, and 0.897, respectively), while Beckman-D showed weaker correlation (r = 0.755). All immunoassays showed proportionally positive bias. The areas under the curve were 0.975 for Abbott-D, 0.972 for LCMS/MS, 0.966 for Siemens-E, 0.948 for Siemens-D, 0.955 for Beckman-E, and 0.877 for Beckman-D. The cut-off values varied significantly (154.8–1,321.5 nmol/24 hrs). Assay sensitivity and specificity ranged from 76.1% to 93.2% and from 93.0% to 97.1%, respectively. Conclusions Commercially available immunoassays for measuring UFC show different levels of analytical consistency compared to LC-MS/MS. Abbott-D, Siemens-E, and Beckman-E have high diagnostic accuracy for CS.

Objective:To observe any effects of contralateral repeated transcranial magnetic stimulation (rTMS) of the swallowing motor cortex on the swallowing and brainstem auditory evoked potentials (BAEPs) of stroke survivors with dysphagia.Methods:A total of 83 stroke survivors with dysphagia were randomly divided into an ipsilesional stimulation group ( n=22), a contralesional stimulation group ( n=21), a bilateral stimulation group ( n=20), and a control group ( n=20). In addition to their conventional dysphagia training, those in the three stimulation groups received 3Hz rTMS while the control group was given fake stimulation. The treatment was administered daily for 20 minutes, 6 days a week, for 5 consecutive weeks. Before and after the treatment, swallowing function was assessed videofluoroscopically and using the Dysphagia Outcome and Severity Scale (DOSS). The oral and pharyngeal stages of swallowing were evaluated using the videofluoroscopic dysphagia scale (VDS). Brain stem conduction was assessed using BAEPs. Results:After treatment the average DOSS scores of all 4 groups were significantly better than before the treatment. The average DOSS scores of the contralesional and bilateral sti-mulation groups were then significantly better than those of the other two groups. The sub-item and total VDS scores of all 4 groups had decreased significantly, but the average score of the bilateral stimulation group was significantly lower than the control group′s average. Ipsilesional stimulation significantly improved the VDS sub-item scores for the triggering of pharyngeal swallowing, laryngeal elevation, and pharyngeal transit time compared with the control group. In the contralesional stimulation group the average total score and the VDS sub-item scores for apraxia, premature bolus loss, oral transit times, the triggering of pharyngeal swallowing, vallecular residue, laryngeal elevation, coating on the pharyngeal wall, and pharyngeal transit time were significantly lower than those of the control group, on average. After the treatment the latencies of BAEP waves I, III and V and the I-III, III-V and I-V interpeak intervals had decreased significantly in all four groups, but the average latencies and intervals of the bilateral and contralesional groups were significantly shorter than those of the control group. The latencies and intervals of the bilateral stimulation group were then significantly shorter than those in the ipsilesional stimulation group on average. The average latency of wave V in the bilateral stimulation group (6.53±0.73ms) was significantly shorter than that in the contralesional stimulation group after the treatment.Conclusion:Bilateral rTMS over the swallowing motor cortex combined with conventional dysphagia training can significantly improve the swallowing of dysphagic stroke survivors.