Impaired glucose regulation （IGR） is an intermediate state between normal blood glucose and diabetes， falling under the category of splenic pure heat in traditional Chinese medicine （TCM）. The core pathogenesis is believed to be the dysfunction of the zang-fu （脏腑） organs， leading to metabolic abnormalities of subtle essence and the generation of "turbid pathogen". Its accumulation can block qi movement， damage the vessel collaterals， and promote the disease progression toward diabetes. The concept of "turbid pulse" is proposed as an early sign of IGR， characterized by full and heavy sensation with stagnated and astringent circulation， which can serve as an effective supplement to clinical screening. The differentiation and treatment approach in clinical practice is summarized as follows. If the ascending and descending mechanisms of qi movement in the middle jiao （焦） are disrupted， with mutual interference between the clear and the turbid， treatment should focus on harmonizing the ascending and the descending， and transforming dampness with aromatic medicinals. For spleen-stomach qi deficiency due to long-term restriction of the spleen and stomach's function of transportation and transformation， it is suggested to fortify spleen and harmonize stomach， and transport turbid with sweet-warm medicinals. For spleen deficiency and liver constraint induced by internal generation of damp-heat in the middle jiao， the treatment should focus on soothing the liver and opening constraint， and directing the turbid downward with sour-sweat medicinals. For solid accumulation and stagnation caused by liver qi constraint， it is recommended to unblock intestine and remove stagnation， and discharge turbid with bitter-cold medicinals. When the disease is transmitted to the lower jiao， and the kidneys are affected， the treatment should be regulating spleen and kidney， and rectifying turbid with salty-sour medicinals. In conclusion， it is emphasized to promote the transformation of turbid pathogen to restore metabolic homeostasis， providing methods for the clinical diagnosis and treatment of IGR.

Objective To establish a prediction model for the occurrence of non-occupational carbon monoxide poisoning events in Beijing, and to provide scientific basis and theoretical support for the prevention and warning of poisoning events. Methods Based on the monitoring data of non-occupational carbon monoxide poisoning events in Beijing from 2016 to 2024, the seasonal ARIMA model and seasonal index model were established to analyze the data and predict the occurrence of events. Results Between 2016 and 2024, a total of 436 cases of non-occupational carbon monoxide poisoning were reported in Beijing, showing a downward trend. The established SARIMA model and seasonal index model were SARIMA (1,0,0) (1,1,0) 12, Yt = (-0.0339t+5.8863) × St, and the average relative errors were 65.42% and 29.19%, respectively. In terms of months, the SARIMA model had better predictive performance during April and summer (June to August), while the seasonal index model was superior in other months. By combining the two models, the predicted number of events in 2025 was as follows: 3, 2, 2, 3, 1, 5, 2, 7, 1, 1, 1, and 2. Conclusion The seasonal index model has the best prediction effect on the non-occupational carbon monoxide poisoning events in Beijing throughout the year, and the number of summer events predicted by SARIMA model is closer to the actual values. The two models can be combined to predict the trend of non-occupational carbon monoxide poisoning, which provides a scientific basis for the prevention and control of carbon monoxide poisoning in the future.

Objective:To explore the mechanism of how neurocognition affects social functioning through fa-cial emotion recognition in individuals with schizophrenia.Methods:Totally 203 patients with schizophrenia meet-ing the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-IV)diagnostic criteria were re-cruited,with an age of(40±12)years,an initial onset age of(24±8)years,scored(60.4±16.1)points on the Positive and Negative Syndrome Scale.Using the Personal and Social Performance Scale(PSP),the MATRICS Consensus Cognitive Battery(MCCB),and the Facial Emotion Recognition Test(FERT)to assess patients'social functioning,neurocognition,and facial emotion recognition abilities.Results:In the relationship between MCCB fac-tor scores and PSP dimensions scores,happy face recognition showed a mediating effect in socially useful activities dimension(ACME=0.021,P＜0.01),sad(ACME=-0.026,P＜0.05)and surprised face recognition(ACME=-0.017,P＜0.05)showed mediating effects in self-care dimension.Additionally,sad(ACME=-0.025,P＜0.05)and fearful face recognition(ACME=-0.025,P＜0.001)played a mediating role in disruptive and aggres-sive behavior dimensions.Conclusion:Facial emotion recognition in patients with schizophrenia may play a media-ting role in the neurocognitive mechanisms of social dysfunction,with different dimensions of social dysfunction be-ing associated with specific categories of emotions.

Objective To analyze the correlation between lesion volume,lesion mass,and maximum lesion diameter in the assessment of advanced hepatocarcinoma with lung metastasis,and to evaluate the application value of total volume response and total mass response of lung metastatic lesions in efficacy assessment.Methods A retrospective analysis was conducted on the CT imaging data of 20 patients clinically confirmed with hepatocarcinoma and lung metastases,followed by subsequent follow-up to monitor their survival outcomes.Volume measurement software was used to measure the volume of lesions before and after treatment.We recored lesion diameter,volume measurements and CT values,calculated the mass of the lesions.The correlation between lesion volume,mass and diameter was analyzed,as well as the correlation between the change rates of volume,mass and lesion diameter.Additionally,the total volume and total mass of all lesions were calculated.The correlation between the change rates of total volume/total mass and the change rate of pulmonary lesion diameter under the RECIST 1.1 criteria,as well as the correlation with changes in patients'tumor markers,were analyzed.Furthermore,the overall volume response and overall mass response of lesions were evaluated based on changes in total volume and total mass,and their consistencies with the RECIST 1.1 criteria for efficacy evaluation were analyzed.Finally,univariate Cox regression analysis was performed to explore the association between these variables and patient survival outcomes.Results There was strong correlation between lesion volume,mass and tumor diameter(r=0.771,0.775),between the rate of change in mass and the rate of change in lesion diameter(r=0.846),and between the rates of change in total volume/total mass and the rate of change in pulmonary lesion diameter under the RECIST 1.1 criteria(r=0.800,0.896).The correlation between the rates of change in total volume/total mass and patients'tumor markers was not statistically significant.There was moderate correlation between the rate of change in volume and the rate of change in lesion diameter(r=0.692).The evaluation results of total volume response and total mass response for pulmonary lesions in advanced hepatocarcinoma with lung metastasis were generally consistent with the RECIST 1.1 criteria(Kappa=0.486,0.426).Univariate Cox regression analysis revealed that total lesion volume(P=0.047)and total lesion mass(P=0.049)were independent prognostic factors for survival outcomes.Conclusion Lesion volume,mass,and diameter,as well as their respective change rates,were found to be interrelated.Furthermore,total lesion volume and total lesion mass were identified as independent prognostic factors for survival outcomes.The total volume response and total mass response are promising evaluation methods in evaluating the efficacy of lung metastasis of hepatocarcinoma,which are different from the RECIST 1.1 evaluation criteria.

Multiple myeloma (MM) is a malignant disease characterized by clonal plasma cell proliferation, with metabolic reprogramming. Abnormal metabolism of amino acids, glucose, lipids and nucleotides plays a crucial role in various pathological processes in MM, such as proliferation, metastasis, immune escaping and drug resistance. This review summarized the application of metabolomics technology in identifying biomarkers for MM and targeting related metabolic pathways. The objective is to guide further investigations into the metabolic mechanisms underlying MM and encourage innovation in clinical diagnosis and treatment strategies for this disease.

Objective To analyze the characteristics of death cases in a certain tertiary hospital,providing references for hospital management decisions and the evaluation of the effectiveness of medical services.Methods The information of death ca-ses of inpatients in the hospital from 2019 to 2023 was extracted through the inpatient medical records information system,and the medical records of inpatients were retrospectively analyzed by clinical epidemiological methods.Results The cumulative number of inpatients admitted to the hospital from 2019-2023 was 459 821,with 3 250 deaths and a case-fatality rate of 0.71％.There was a decreasing trend in the case fatality rate from 0.71％in 2019 to 0.63％in 2023,but the difference was not statistically significant(APC=-3.17,P＞0.05).The case fatality rate was 0.97％for males and 0.45％for females,with males having a higher case fatality rate than females(x2=435.206,P＜0.05).The mean age of the deceased cases was(69.59±17.70)years,and the case fatality rate increased gradually with age,and the highest case fatality rate was 2.98％in the age group of ≥80 years.The difference in case fatality rate between patients of different age groups was statistically significant(x2=3 502.991,P＜0.05).The top 5 causes of death of hospitalized patients were tumor,circulatory diseases,respiratory diseases,some infec-tious and parasitic diseases and injuries,poisoning and external causes,accounting for 87.33％of the total deaths.The main causes of death in neoplasms were bronchial and pulmonary malignancies,hepatic and intrahepatic biliary malignancies,and gas-tric malignancies;in the circulatory diseases,cerebral infarction,acute myocardial infarction,and intracerebral haemorrhage;and in the respiratory diseases,pathogens unspecified pneumonias,bacterial pneumonias,and other chronic obstructive pulmona-ry diseases.Conclusion The case fatality rate of male and ≥80 years old patients in this hospital is higher.Tumor,circulatory diseases and respiratory diseases are the main causes of death.The hospital should allocate medical resources in a scientific and reasonable way according to the age,gender and disease characteristics of the patients;strengthen the prevention and treatment of tumors,circulatory diseases and respiratory diseases according to the cause of death and their distribution,improve the diagnosis and treatment level,and reduce the inpatient morbidity and fatality rate.

Objective:To investigate the completion rate of tumor evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients in the national multicenter real-world database.Methods:The prospective real-world study was conducted. The clinicopathological data of 1 074 patients who underwent surgical treatment for mid and low rectal cancer in 47 national medical institutions, including Peking Union Medical College Hospital et al, from May 12,2023 to May 11,2024 were collected. Observation indicators: (1) clinical characteristics of patients with mid and low rectal cancer; (2) initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer; (3) initial imaging evaluation of patients with mid and low rectal cancer; (4) imaging evaluation after neoadjuvant therapy for patients with mid and low rectal cancer. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M( Q1, Q3). Count data were described as absoluter numbers and/or percentages. Results:(1) Clinical characteristics of patients with mid and low rectal cancer. Of the 1 074 patients, there were 713 males and 361 females, aged 63(56,70)years. The body mass index of 1 074 patients was 24(21,26)kg/m 2.For American Society of Anesthesiologists classification, there were 147 cases of stage Ⅰ, 641 cases of stage Ⅱ, 157 cases of stage Ⅲ, 2 cases of stage Ⅳ, and there were 127 cases missing data. (2) Initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer. Of the 1 074 patients, there were 787 cases (73.28%) undergoing complete colonoscopy, and there were only 197 cases (18.34%) undergoing immunohistochemical evaluation of all four mismatch repair proteins. (3) Initial imaging evaluation of patients with mid and low rectal cancer. Of the 1 074 patients, there were 842(78.40%) patients completing magnetic resonance imaging (MRI) or ultrasound evaluation, and there were 914(85.10%) patients completing chest, abdomen, and pelvis enhanced computed tomography (CT) evaluation. In the 149 patients completing rectal ultrasound evaluation, there were 122 cases (81.88%) comple-ting T staging evaluation, and there were 81 cases (54.36%) completing N staging evaluation. In the 808 patients completing rectal MRI evaluation, there were 708 cases (87.62%) completing T staging evaluation, and there were 590 cases (73.02%) completing N staging evaluation. (4) Imaging evalua-tion after neoadjuvant therapy for patients with mid and low rectal cancer. Of the 388 patients with neoadjuvant therapy, there were 332 patients (85.57%) completing MRI or ultrasound evaluation, and there were 327 patients (84.28%) completing chest, abdomen, and pelvis enhanced CT evalua-tion. In the 70 patients completing rectal ultrasound evaluation, there were 65 cases (92.86%) com-pleting T staging evaluation, and there were 49 cases (70.00%) completing N staging evaluation. In the 327 patients completing rectal MRI evaluation, there were 246 cases (75.23%) completing T staging, and there were 228 cases (69.72%) completing N staging evaluation. Conclusion:The com-pletion rate of tumor imaging evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients on a national scale is relatively good.

Objective To investigate the occurrence of liver function abnormalities in patients with follicular lymphoma(FL)treated with the G-CDOP regimen in the real world.Methods Using the hospital information system,a retrospective collection of clinical data was conducted on inpatients diagnosed with FL and treated with at least four courses of the G-CDOP regimen in the Department of Hematology,the First Affiliated Hospital of Soochow University from September 2021 to August 2023.The analysis focused on the incidence,severity,and types of liver function abnormalities,as well as the timing of these occurrences in relation to medication use and other relevant clinical characteristics.Results The study encompassed a total of 55 patients with FL,out of which 30 patients encountered liver function abnormalities during the G-CDOP regimen treatment,yielding an incidence rate of 54.5%.There were 23 cases(41.8%)of grade 1,3 cases(5.5%)of grade 2,and 4 cases(7.3%)of grade 3 liver function abnormalities.Among them,12 cases(21.8%)were hepatocellular injury type,while the cholestasis type was observed in 4 cases(7.3%),and the mixed type was found in 14 cases(25.5%).Liver function abnormalities appeared in 21 patients(38.2%)during the first cycle of the G-CDOP regimen treatment,5 patients(9.1%)in the second cycle,and 1 patient(1.8%),2 patients(3.6%),and 1 patient(1.8%)in the third,fourth,and fifth cycles.Conclusion The G-CDOP regimen has the potential to impact liver function indicators in FL patients,but most are mild and reversible.However,there are also cases of severe liver injury that need to attract clinical attention.

Objective:To explore the relationship between autistic trait and pain empathy among college students, as well as the mediating role of personal pain perception.Methods:From October to December 2023, a cross-sectional survey was conducted among 1 195 college students using the autism spectrum quotient, pain sensitivity questionnaire, fear of pain questionnaire, pain catastrophizing scale and empathy for pain scale.SPSS 27.0 software was used for descriptive statistics and correlation analysis.A structural equation model was constructed using Mplus 8.3 to examine the mediating effect of personal pain perception, which was composed of pain sensitivity, fear and catastrophizing cognition.Results:Autistic trait(22.00(18.00, 26.00))was significantly positively correlated with pain sensitivity (55.00(43.00, 70.00)), fair of pain (69.00(60.00, 78.00)), and pain catastrophizing cognition (16.00(8.00, 23.00)) ( r=0.112, 0.154, 0.204, all P<0.001).Autistic trait was also significantly positively correlated with affective distress(62.00(46.00, 80.00), r=0.162, P<0.001) and vicarious pain (14.00(8.00, 20.00), r=0.096, P<0.001) of pain empathy.Pain sensitivity, fear of pain and pain catastrophizing cognition were significantly positively correlated with affective distress( r=0.244, 0.332, 0.375, all P<0.001) and vicarious pain ( r=0.210, 0.232, 0.285, all P<0.001) of pain empathy.The effects of autistic trait on affective distress and vicarious pain dimensions of pain empathy were fully mediated by personal pain perception, with the mediating effects of 0.115( P<0.001, 95% CI=0.073-0.165) and 0.085( P<0.001, 95% CI=0.053-0.124). Conclusions:The autistic trait of college students can predict the affective distress and vicarious pain of pain empathy indirectly through personal pain perception.

Objective To investigate the occurrence of liver function abnormalities in patients with follicular lymphoma(FL)treated with the G-CDOP regimen in the real world.Methods Using the hospital information system,a retrospective collection of clinical data was conducted on inpatients diagnosed with FL and treated with at least four courses of the G-CDOP regimen in the Department of Hematology,the First Affiliated Hospital of Soochow University from September 2021 to August 2023.The analysis focused on the incidence,severity,and types of liver function abnormalities,as well as the timing of these occurrences in relation to medication use and other relevant clinical characteristics.Results The study encompassed a total of 55 patients with FL,out of which 30 patients encountered liver function abnormalities during the G-CDOP regimen treatment,yielding an incidence rate of 54.5%.There were 23 cases(41.8%)of grade 1,3 cases(5.5%)of grade 2,and 4 cases(7.3%)of grade 3 liver function abnormalities.Among them,12 cases(21.8%)were hepatocellular injury type,while the cholestasis type was observed in 4 cases(7.3%),and the mixed type was found in 14 cases(25.5%).Liver function abnormalities appeared in 21 patients(38.2%)during the first cycle of the G-CDOP regimen treatment,5 patients(9.1%)in the second cycle,and 1 patient(1.8%),2 patients(3.6%),and 1 patient(1.8%)in the third,fourth,and fifth cycles.Conclusion The G-CDOP regimen has the potential to impact liver function indicators in FL patients,but most are mild and reversible.However,there are also cases of severe liver injury that need to attract clinical attention.