Objective: To compare the consistency between bioelectrical impedance analysis (BIA) and dual energy X ray absorptiometry (DXA) in measuring body composition among Tibetan children and adolescents and to explore the applicability of BIA in plateau region, so as to provide scientific and convenient body composition measurement support among children and adolescents. Methods: From May to June, 2022, a total of 344 Tibetan children and adolescents aged 6-17 years were selected from Golmud Municipal National Middle School and Changjiangyuan Nationality Primary School in Qinghai Province by cluster sampling method, and their fat mass, fat mass percentage and lean mass were measured by DXA and BIA. The consistency and correlation between the two methods were assessed by using the Wilcoxon rank-sum test, Spearman correlation analysis, intraclass correlation coefficient (ICC), and Bland-Altman analysis. Results: DXA measured fat mass and fat mass percentage were significantly higher than those obtained by BIA (6-12 years old: Z =9.91, 11.28; 13-17 years old: Z =9.02, 10.21), while lean mass and lean mass percentage were significantly lower than BIA results (6-12 years old: Z =-11.60, -11.30; 13-17 years old: Z =-10.77, -10.36) (all P < 0.05 ). The two methods showed strong correlations in fat mass and lean mass (all r >0.80, all ICC >0.90), but exhibited poor agreement in fat mass percentage and lean mass percentage (6-12 years old: Lin s CCC =0.64, 0.41; 13-17 years old: Lin s CCC = 0.79 , 0.35). Bland-Altman analysis showed that the difference between the two methods was negatively correlated with the average value in FM%(6-12 years old: r =-0.75, 13-17 years old: r =-0.79, both P <0.01). Conclusion BIA and DXA show high consistency in measuring body fat mass and lean body mass in Tibetan children and adolescents, although some bias is still present in certain individuals.

ObjectiveTo investigate the role of interleukin （IL）-8 secreted by tumor-associated macrophages （TAMs） in colorectal cancer （CRC） metastasis and its potential therapeutic value. MethodsThe TAMs model was constructed by phorbol ester （PMA） combined with IL-4/IL-13， and the model phenotype was verified by flow cytometry， RT-qPCR and ELISA. Human CRC HCT116 cells were treated with conditioned medium （CM） from M0 macrophages and TAMs， and the metastatic capacity of HCT116 cells was evaluated by wound-healing assay and Transwell assay. The expression levels of IL-8 in M0 macrophages and TAMs were detected by Western blot， RT-qPCR and ELISA. The expression level of epithelial-mesenchymal transition （EMT） markers （E-cadherin， N-cadherin） in HCT116 cells treated with CM-M0 and CM-TAMs were detected by Western blot and RT-qPCR. HCT116 cells were stimulated with CM-TAMs supplemented with IL-8 receptor inhibitor Reparixin. The HCT116 cells metastasis ability was evaluated by wound-healing assay and Transwell assay， and the expression levels of E-cadherin and N-cadherin were detected by Western blot and RT-qPCR. Finally， a splenic injection liver metastasis model was established using murine CRC cells CT26-LUC， and the effect of Reparixin on this animal model was observed by in vivo imaging. ResultsFlow cytometry showed that the proportion of M2 macrophages （CD11b⁺CD206⁺ cells） was elevated in the TAMs model. RT-qPCR and ELISA assays revealed that the levels of M2 macrophage markers IL-10 and TGF-βsignificantly increased. Wound-healing assay and Transwell assay demonstrated that CM-TAMs significantly enhanced the migration and invasion ability of HCT116 cells. Western blot， RT-qPCR and ELISA assays showed that TAMs highly expressed IL-8 and simultaneously induced downregulation of E-cadherin and upregulation of N-cadherin in HCT116 cells. Reparixin not only reversed the pro-metastatic effects of CM-TAMs， but also upregulated the expression level of E-cadherin and downregulated that of N-cadherin in HCT116 cells. Furthermore， it reduced the bioluminescence signal intensity of liver metastatic lesions in the splenic injection liver metastasis model. ConclusionThe TAMs promote CRC metastasis by secreting IL-8 to induce EMT. Inhibiting IL-8 secretion in TAMs or blocking the binding of IL-8 to its receptor may provide a new strategy for CRC treatment.

Objective: To investigate the efficacy and safety of centrifugal and membrane double plasma molecular adsorption systems (DPMAS) combined with low-dose plasma exchange in the treatment of liver failure. Methods: A retrospective analysis was performed on 60 patients with liver failure treated in our hospital from April 2024 to June 2025. Based on different plasma separation methods, they were divided into the centrifugal DPMAS group (n=30) and the conventional membrane DPMAS group (n=30). The operational parameters, laboratory indicators, and adverse reactions were compared between the two groups. Results: Under the same plasma volume for adsorption and exchange (P>0.05), the centrifugal group showed lower total circulating blood volume, total blood flow rate, and treatment duration compared to the membrane group [10 794 (9 532, 12 637) vs 19 000 (19 000, 21 000) mL, 60 (60, 65) vs 125 (120, 130) mL/min, 169 (141, 193) vs 207 (183, 210) min, P<0.001]. The centrifugal group also had a lower rate of central venous catheter use [(24/30, 80.00%) vs (30/30, 100.00%), P=0.024] and required more calcium supplementation due to sodium citrate anticoagulation [6 (6, 8) vs 2 (2, 2) g, P<0.001]. No significant changes were observed in WBC, Hb, HCT, and PLT levels before and after treatment with the centrifugal group (P>0.05). There was no statistically significant difference in WBC levels before and after membrane group treatment (P=0.199), but the values of Hb, HCT, and PLT showed significant decreases post-treatment compared to pre-treatment [106.50 (102.75, 126.75) vs 123.00 (109.75, 132.00) g/L, 33.20 (29.90, 34.92) vs 34.85 (31.55, 37.52)%, 85.00 (43.25, 139.50) vs 93.00 (61.50, 145.00)×10 /L, P<0.05]. There was no significant difference in coagulation function indexes before and after treatment with centrifugal group (P>0.05). The membrane group showed reduction in fibrinogen (Fib) levels post-treatment [1.50 (1.20, 1.60) vs 1.60 (1.25, 1.80) g/L, P=0.033]. Both groups demonstrated significant decreases in total bilirubin (TBil) and direct bilirubin (DBil) levels after treatment (centrifugal group: 194.70 (107.50, 276.00) vs 239.15 (173.00, 304.17) μmol/L, 101.00 (64.00, 182.30) vs 157.00 (101.00, 195.00) μmol/L; membrane group: 211.50 (118.00, 240.00) vs 263.50 (204.75, 314.00) μmol/L, 188.00 (122.75, 232.25) vs 219.00 (178.50, 267.25) μmol/L, P<0.05]. The incidence of catheter-related complications was lower in the centrifugal group [(2/30, 6.67%) vs (8/30, 26.67%), P=0.038]. Conclusion: The centrifugal DPMAS system demonstrates advantages such as lower blood flow velocity requirements, shorter treatment duration, minimal impact on platelets, and reduced adverse event rates, indicating promising clinical applications.

Objective To explore the changes in symptom clusters and core symptoms at different stages in col-orectal cancer patients undergoing postoperative chemotherapy,and to provide a reference for developing precise symptom management strategies in clinical practice.Methods 300 colorectal cancer patients who underwent post-operative chemotherapy at 2 tertiary hospitals in Tianjin from August 2023 to May 2024 were conveniently selected as the study subjects.General information questionnaires and the Chinese version of the MD Anderson Symptom In-ventory for Colorectal Cancer were used to survey patients during the first chemotherapy cycle(T1)and the third chemotherapy cycle(T2).Exploratory factor analysis was used to extract symptom clusters;R language was used to construct symptom networks.Results 300 questionnaires were distributed and collected at T1,and 264 question-naires were distributed and collected at T2,with a recovery rate of 88.00％.Colorectal cancer patients undergoing postoperative chemotherapy had 5 symptom clusters at T1,and 4 symptom clusters at T2.In the symptom network,distress was the symptom with the highest strength(rs=1.188),closeness centrality(rc=0.004),and betweenness centrality(rb=36)at T1.Distress was the symptom with the highest strength(rs=1.397),while decreased appetite had the highest closeness centrality(rc=0.004)and betweenness centrality(rb=39)at T2.Conclusion The symptom clusters in colorectal cancer patients undergoing postoperative chemotherapy remain stable over time.Distress is a stable core symptom during chemotherapy,while decreased appetite is a bridging symptom in the mid-chemotherapy phase.Healthcare providers should prioritize interventions for decreased appetite while addressing emotional symptoms to improve the efficiency of symptom management.

Objective To explore the changes in symptom clusters and core symptoms at different stages in col-orectal cancer patients undergoing postoperative chemotherapy,and to provide a reference for developing precise symptom management strategies in clinical practice.Methods 300 colorectal cancer patients who underwent post-operative chemotherapy at 2 tertiary hospitals in Tianjin from August 2023 to May 2024 were conveniently selected as the study subjects.General information questionnaires and the Chinese version of the MD Anderson Symptom In-ventory for Colorectal Cancer were used to survey patients during the first chemotherapy cycle(T1)and the third chemotherapy cycle(T2).Exploratory factor analysis was used to extract symptom clusters;R language was used to construct symptom networks.Results 300 questionnaires were distributed and collected at T1,and 264 question-naires were distributed and collected at T2,with a recovery rate of 88.00％.Colorectal cancer patients undergoing postoperative chemotherapy had 5 symptom clusters at T1,and 4 symptom clusters at T2.In the symptom network,distress was the symptom with the highest strength(rs=1.188),closeness centrality(rc=0.004),and betweenness centrality(rb=36)at T1.Distress was the symptom with the highest strength(rs=1.397),while decreased appetite had the highest closeness centrality(rc=0.004)and betweenness centrality(rb=39)at T2.Conclusion The symptom clusters in colorectal cancer patients undergoing postoperative chemotherapy remain stable over time.Distress is a stable core symptom during chemotherapy,while decreased appetite is a bridging symptom in the mid-chemotherapy phase.Healthcare providers should prioritize interventions for decreased appetite while addressing emotional symptoms to improve the efficiency of symptom management.

Isotretinoin is a highly effective and commonly used drug in the clinical treatment of severe acne, but its significant reproductive toxicity limits its clinical application. Current literature studies have shown that isotretinoin exerts widespread effects on the reproductive system through multiple pathways, including interference with the retinoic acid signaling pathway, induction of oxidative stress, and apoptosis. Therefore, in-depth dissection of its reproductive toxicity mechanisms, optimization of clinical risk management strategies, and development of safer alternative drugs are of great clinical and practical significance. Future research may focus on deepening mechanisms under the framework of precision medicine, individualized prevention and control strategies, and drug innovation to balance drug efficacy and safety.This article systematically reviews the toxic effects of isotretinoin on the reproductive system, including teratogenicity, its impact on female and male reproductive function , and explores in depth its molecular mechanisms, and clinical risk management strategies.

Isotretinoin is a highly effective and commonly used drug in the clinical treatment of severe acne, but its significant reproductive toxicity limits its clinical application. Current literature studies have shown that isotretinoin exerts widespread effects on the reproductive system through multiple pathways, including interference with the retinoic acid signaling pathway, induction of oxidative stress, and apoptosis. Therefore, in-depth dissection of its reproductive toxicity mechanisms, optimization of clinical risk management strategies, and development of safer alternative drugs are of great clinical and practical significance. Future research may focus on deepening mechanisms under the framework of precision medicine, individualized prevention and control strategies, and drug innovation to balance drug efficacy and safety.This article systematically reviews the toxic effects of isotretinoin on the reproductive system, including teratogenicity, its impact on female and male reproductive function , and explores in depth its molecular mechanisms, and clinical risk management strategies.

Objective The objective of this study was to provide methodological references for the inheritance of the experience of well-known Chinese medicine doctors in the treatment of kidney disease.Methods The study collected medical case data for IgA nephropathy,diagnosed and treated by Professor Yang Nizhi's outpatient department at Guangdong Provincial Hospital of Traditional Chinese Medicine from 2010 to 2020.The data was standardized and divided into three groups:urine and blood,urine turbidity,and renal failure groups.The study utilized the FangNet platform to apply the PageRank algorithm and calculate the THScore of different subgroups of core herbs for IgA nephropathy.The distribution pattern of syndrome differentiation and corresponding herb use regulations were visualized through Python(SciPy package,Clusterheatmap package),and the study explored and verified the drug prescription through exploratory and confirmatory factor analysis based on Pearson correlation coefficient.The weighted least squares estimation mean and variance adjusted(WLSMV)and the oblique rotated GEOMIN method were used with the Mplus software.Results The study included a total of 548 treatments for 145 patients with IgA nephropathy,with heamturia group(54 cases),urine turbidity group(51 cases),and renal failure group(40 cases).Results showed 9 basic syndromes such as Qi deficiency syndrome(91.79%),blood stasis syndrome(77.01%),damp-heat syndrome(66.06%),and Yin deficiency syndrome(38.69%).There are 24 core drugs in total,23 in the urine and blood group,21 in the urine turbidity group,and 16 in the renal failure group.These drugs mainly include qi-tonifying and yang-invigorating drugs,nourishing yin and blood drugs,promoting blood circulation and removing blood stasis drugs,and clearing heat and cooling blood drugs.The regulations for the differentiation and medication of IgA nephropathy(Z-Score>0.5 and P<0.05)were as follows:Huangqi,Shan Zhu Yu,and Tusizi were commonly used in Qi deficiency syndrome;Danshen,Ze Lan,and Shan Zhu Yu were commonly used in blood stasis syndrome;Pu Gong Ying,Shi Wei,Tao Ren,and Tu Fu Ling were commonly used in damp-heat syndrome;and Mo Han Lian,Tai Zi Shen,and Nv Zhen Zi were commonly used in Yin deficiency syndrome.Through exploratory and confirmatory factor analysis,the core drug combination factors for the treatment of IgA nephropathy by Professor Yang Nizhi were obtained as follows:F1(Tusizi,Shan Zhu Yu,Huangqi);F2(White Mao Gen,Xiao Ji,Qian Cao);F3(Nv Zhen Zi,Mo Han Lian,Tai Zi Shen);and F4(Ze Lan,Tao Ren).Conclusion This study analyzed the diagnosis and treatment experience of Professor Yang Nizhi in the treatment of IgA nephropathy by grouping,defining the core syndrome of"Qi deficiency and blood stasis,damp-heat and Yin deficiency",and the core treatment methods of"tonifying Qi,promoting blood circulation,clearing heat,and nourishing Yin"using the PageRank algorithm and Mplus factor analysis.The study provided methodological references for the inheritance of the experience of famous Chinese medicine doctors and promoted the development and utilization of traditional Chinese medicine.

Objective To explore the effects of intracavitary radiofrequency ablation combined with sclerotherapy injection on symptom improvement and lower limb hemodynamics in patients with lower limb varicose veins.Methods Clinical data of 100 patients with lower extremity varicose veins treated in our hospital from January 2022 to January 2023 were retrospectively selected.According to the surgical method,the patients were divided into R group and S group,50 cases in each group.Traditional high ligation of great saphenous vein+exfoliation was performed in group S,intracavity radiofrequency ablation closure+ultrasound guided injection of foam sclerosing agent+spot exfoliation was performed in group R.The clinical status,lower extremity hemodynamic indexes before and after surgery,therapeutic effect 3 months after surgery,venous clinical severity score(VCSS),venous classification system(CEAP)grading before,3 months after and 6 months after surgery,and the occurrence of complications 6 months after surgery were compared between the two groups.Results Three months after surgery,the total effective rate in group R(90.00％)was obviously higher than that in group S(74.00％)(P＜0.05).The hospital stay,bedtime,and intraoperative bleeding in group R were obviously lower than those in group S,and the VAS score within 72 hours after surgery was obviously higher than that in group S(P＜0.05).Compared with preoperative,postoperative blood flow velocity of femoral deep vein,popliteal vein and external iliac vein in 2 groups was significantly increased(P＜0.05).The R group was higher(P＜0.05).The difference of VCSS score and CEAP score 3 months and 6 months after surgery between the two groups was statistically significant(P＜0.05).There was no statistically obvious difference in the incidence of adverse reactions between group R and group S at 6 months after surgery(P＞0.05).Conclusion Intraluminal radiofrequency ablation combined with hardener injection has a good therapeutic effect on patients with lower limb varicose veins,which can effectively improve the patient's condition,reduce hemodynamic effects,maintain hemodynamic stability,and have high safety.

OBJECTIVE To analyze the factors affecting the inclusion of Chinese patent medicines in China’s National reimbursement drug list （NRDL）， and assist these medicines in fully reflecting their actual value in the reimbursement admission process. METHODS From the official website of the China’s National Healthcare Security Administration， the application materials of Chinese patent medicines outside the list that passed the formal review from 2021 to 2023 were obtained， including basic information on the medicines， safety， efficacy， innovation and heritage information， and supplemented with references from the pharmacopeia and the Yaozhi Database. Economic information and enterprise information were obtained through websites such as the Yaozhi Database. Univariate analysis， multivariate Logistic regression analysis and stepwise regression analysis were conducted on the initial application information and admission outcomes of the medicines. Sensitivity analysis was also performed on medicines that applied multiple times in different years as independent samples. RESULTS & CONCLUSIONS There were 27 Chinese patent medicines that passed the formal review from 2021 to 2023， involving 37 applications. The univariate analysis results showed that medicines with descriptions of traditional Chinese medicine （TCM） syndrome types， clear adjustment information for medication plans for specific population groups， short time to market in the indications of the package insert， registered as Class 1 to 6 following or class Ⅰ innovative TCM/class Ⅲ ancient classic prescription compound TCM registered， and those produced by enterprises listed in the “Top 100 Chinese Pharmaceutical Industry Enterprises” list for the current year were more likely to be included in the NRDL （P＜0.05）. The results of the multivariate Logistic regression analysis were not statistically significant， but the stepwise regression results indicated good consistency with the univariate analysis. The results of the sensitivity analysis were consistent with the trend of basic analysis. It is recommended that Chinese patent medicine enterprises further clarify the description of product instructions， expand innovation capabilities， inherit and develop ancient classic prescriptions， and promptly complete clinical trial evidence.