Breast cancer is a common clinical gy-necological tumor.According to the 2022 global cancer data statistics,breast cancer ranks second in terms of incidence among newly diagnosed cancer cases worldwide.Modern medicine often adopts surgical operation,chemotherapy,and other meth-ods,which have certain efficacy but also many problems such as high drug resistance rates and sig-nificant adverse reactions.Chinese patent medi-cines exhibit extensive anticancer effects.The study found that Shenyi Capsule,Pingxiao Capsule,and Zhenqi Fuzheng Granules were widely used in the treatment of breast cancer,exerting therapeu-tic effects on breast cancer by inhibiting cell prolif-eration,invasion,and metastasis,suppressing an-giogenesis,reversing cellular drug resistance,and inhibiting precancerous lesions.Meanwhile,the oral administration of Chinese patent medicines in combination with other traditional Chinese medi-cine(TCM)compounds,TCM decoctions,or mod-ern medical treatments can improve patients' quali-ty of life and reduce adverse reactions.Currently,there are numerous studies on the treatment of breast cancer with Chinese patent medicines,but a systematic summary is lacking.Therefore,this study conducted a systematic review of the mecha-nisms of action and clinical applications of Chinese patent medicines as adjuvant therapy for breast cancer,aiming to provide guidance for clinical medi-cation.

Malignant tumor is a serious and difficult disease threatening human health， which has a high morbidity and mortality rate worldwide. Traditional Chinese medicine has unique advantages in improving the therapeutic effect of malignant tumors and alleviating adverse reactions. Traditional Chinese medicine believes that Qi deficiency and blood stasis are important pathogeneses in the development of malignant tumors， and the method of supplementing Qi and activating blood is an effective strategy for treating malignant tumors. Astragali Radix， sweet in taste and warm in nature， has effects of tonifying Qi and rising Yang， strengthening the exterior and reducing sweat， promoting fluid and nourishing blood. Curcumae Rhizoma， acrid and bitter in taste and warm in nature， has the effects of promoting Qi and breaking blood stasis， eliminating mass， and relieving pain. Astragali Radix-Curcumae Rhizoma， as the classic herb pair of invigorating Qi and activating blood， has a clear effect on inhibiting tumor growth and metastasis. Studies have shown that Astragali Radix-Curcumae Rhizoma contains astragalus polysaccharide， astragaloside， calycosin， formononetin， curcumin， β-elemene， curcumenol， curcumenone， curcumendione， gemacrone， and other anti-tumor active ingredients. It can significantly inhibit the occurrence and development of liver cancer， colorectal cancer， gastric cancer， lung cancer， ovarian cancer， cervical cancer， breast cancer， and other cancers and has the advantages of superposition effect， synergistic complementarity， and increased dissolution compared with single herb and monomer of Chinese traditional herbs and has been widely valued in the field of TCM anti-cancer. Its anti-tumor mechanism includes inhibition of tumor cell proliferation， promotion of tumor cell apoptosis and autophagy， anti-invasion and metastasis， regulation of immune function， and enhancement of anti-tumor drug sensitivity. By combining Chinese and foreign literature， the compatibility effect and anti-tumor mechanism of Astragali Radix-Curcumae Rhizoma were summarized， and then scientific compatibility of these two herbs was expounded， in order to provide a useful reference for clinical application and future research of Astragali Radix-Curcumae Rhizoma.

Chemotherapy is an important treatment for tumors， but most patients experience varying degrees of chemotherapy- induced myelosuppression. Four properties theory of traditional Chinese medicine （TCM） has unique advantages in improving chemotherapy-induced myelosuppression. The monomers from TCM with different properties and flavors， such as cold-natured （e.g. Scutellaria baicalensis， Rhus chinensis）， cool-natured （e.g. Ligustrum lucidum， Ophiopogon japonicus）， warm-natured （e.g. Panax ginseng， Epimedium brevicornu， Curcuma longa， Angelica sinensis）， hot-natured （e.g. Cinnamomum cassia， Aconitum carmichaeli）， and neutral-natured （e. g. donkey-hide gelatin， Lycium barbarum， Rhodiola rosea， fungi）， can exert anti- myelosuppressive effects by reducing damage to hematopoietic stem/progenitor cells， improving the bone marrow hematopoietic microenvironment， inhibiting the oxidative stress response， regulating signaling pathways， so as to ultimately repaire inflammatory damage and improve hematopoietic function， thereby playing an anti-myelosuppressive role.

Purpose To achieve intelligent detection of acute pulmonary embolism(APE)in CT pulmonary angiography based on the Res2Net attention mechanism network.Materials and Methods Retrospectively included patients with suspected of APE who underwent CT pulmonary angiography examination and were diagnosed as APE at the First Affiliated Hospital of Henan University of Chinese Medicine from February 2015 to May 2023.The dataset was randomly divided into training,validation and test set in a ratio of 7∶2∶1.The model was trained based on the Res2Net network,combined with atrous spatial pyramid pooling and attention mechanism modules,and was performed five-fold cross internal validation.Using the area under the receiver operator characteristic curve,sensitivity and specificity to assess the diagnostic performance of the model.Dice similarity coefficient,precision and intersection over union(IOU)were used to assess the segmentation performance of thrombus on the test set and plot the corresponding curves.The performance of the Res2Net attention mechanism network was compared with the classic U-Net and CE-Net model.Results A total of 303 patients with APE were included in this study.There were 212,61 and 30 cases in the training set,validation set and test set,respectively.The model's area under the curve was 0.95,sensitivity was 0.90,specificity was 1.00,Dice similarity coefficient was 0.86,precision was 0.90,Pos-IOU was 0.78 and Neg-IOU was 1.00,respectively.The parameter curves and radar chart showed that the Res2Net attention mechanism network performed better than the U-Net and CE-Net models.The visualization results of the segmentation comparison showed that the Res2Net attention mechanism network achieved higher precision in segmenting pulmonary artery thrombus.Conclusion The Res2Net attention mechanism network has good performance for detection of APE.

OBJECTIVE To analyze the homology and drug resistance characteristics of clinical carbapenem-resistant Klebsiella pneumoniae(CRKP)isolates from the children and adults in Kunming area so as to provide guidance for prevention and control of CRKP strains.METHODS Totally 41 strains of clinical CRKP isolates were collected from the children in 4 hospitals of Kunming area in 2023,and 54 strains were collected from the adults.The ho-mology of the strains was analyzed by means of repetitive extragenic palindromic-polymerase chain reaction(REP-PCR);the phenotypes of carbapenemases and the genes in the strains were detected.RESULTS The 95 strains of CRKP were divided into 30 genotypes.There was clustering of genotypes in some strains.The type A enzyme was most common among the strains from the adults(47 strains,87.04％),while the type A enzyme(18 strains,43.90％)and the type B enzyme(23 strains,56.10％)were both detected in the strains from the children.A-mong the strains producing type A enzyme,the strains carrying with KPC gene were both dominant among the strains isolated from the adults(44 strains,81.48％)and the strains isolated from the children(18 strains,43.90％).Among the strains producing type B enzyme,the strains carrying with NDM gene were dominant a-mong the strains from the children(22 strains,53.66％).CONCLUSIONS There is colonization and inter-hospital transmission of CRKP strains in the hospitals of Kunming area.It is necessary for the clinical departments of the children's hospitals to strengthen the active screening of the transferring children and carefully carry out the cleaning and disinfection of nosocomial environment so as to reduce the probability of the CRKP infection among the children.Mean-while,the clinicians of the pediatrics department should comprehensively take all the factors into accounts such as the type of enzyme,formulate the appropriate medication regimens and raise the cure rate of the children with CRKP infection.

OBJECTIVE To analyze the homology and drug resistance characteristics of clinical carbapenem-resistant Klebsiella pneumoniae(CRKP)isolates from the children and adults in Kunming area so as to provide guidance for prevention and control of CRKP strains.METHODS Totally 41 strains of clinical CRKP isolates were collected from the children in 4 hospitals of Kunming area in 2023,and 54 strains were collected from the adults.The ho-mology of the strains was analyzed by means of repetitive extragenic palindromic-polymerase chain reaction(REP-PCR);the phenotypes of carbapenemases and the genes in the strains were detected.RESULTS The 95 strains of CRKP were divided into 30 genotypes.There was clustering of genotypes in some strains.The type A enzyme was most common among the strains from the adults(47 strains,87.04％),while the type A enzyme(18 strains,43.90％)and the type B enzyme(23 strains,56.10％)were both detected in the strains from the children.A-mong the strains producing type A enzyme,the strains carrying with KPC gene were both dominant among the strains isolated from the adults(44 strains,81.48％)and the strains isolated from the children(18 strains,43.90％).Among the strains producing type B enzyme,the strains carrying with NDM gene were dominant a-mong the strains from the children(22 strains,53.66％).CONCLUSIONS There is colonization and inter-hospital transmission of CRKP strains in the hospitals of Kunming area.It is necessary for the clinical departments of the children's hospitals to strengthen the active screening of the transferring children and carefully carry out the cleaning and disinfection of nosocomial environment so as to reduce the probability of the CRKP infection among the children.Mean-while,the clinicians of the pediatrics department should comprehensively take all the factors into accounts such as the type of enzyme,formulate the appropriate medication regimens and raise the cure rate of the children with CRKP infection.

Breast cancer is a common clinical gy-necological tumor.According to the 2022 global cancer data statistics,breast cancer ranks second in terms of incidence among newly diagnosed cancer cases worldwide.Modern medicine often adopts surgical operation,chemotherapy,and other meth-ods,which have certain efficacy but also many problems such as high drug resistance rates and sig-nificant adverse reactions.Chinese patent medi-cines exhibit extensive anticancer effects.The study found that Shenyi Capsule,Pingxiao Capsule,and Zhenqi Fuzheng Granules were widely used in the treatment of breast cancer,exerting therapeu-tic effects on breast cancer by inhibiting cell prolif-eration,invasion,and metastasis,suppressing an-giogenesis,reversing cellular drug resistance,and inhibiting precancerous lesions.Meanwhile,the oral administration of Chinese patent medicines in combination with other traditional Chinese medi-cine(TCM)compounds,TCM decoctions,or mod-ern medical treatments can improve patients' quali-ty of life and reduce adverse reactions.Currently,there are numerous studies on the treatment of breast cancer with Chinese patent medicines,but a systematic summary is lacking.Therefore,this study conducted a systematic review of the mecha-nisms of action and clinical applications of Chinese patent medicines as adjuvant therapy for breast cancer,aiming to provide guidance for clinical medi-cation.

Purpose To achieve intelligent detection of acute pulmonary embolism(APE)in CT pulmonary angiography based on the Res2Net attention mechanism network.Materials and Methods Retrospectively included patients with suspected of APE who underwent CT pulmonary angiography examination and were diagnosed as APE at the First Affiliated Hospital of Henan University of Chinese Medicine from February 2015 to May 2023.The dataset was randomly divided into training,validation and test set in a ratio of 7∶2∶1.The model was trained based on the Res2Net network,combined with atrous spatial pyramid pooling and attention mechanism modules,and was performed five-fold cross internal validation.Using the area under the receiver operator characteristic curve,sensitivity and specificity to assess the diagnostic performance of the model.Dice similarity coefficient,precision and intersection over union(IOU)were used to assess the segmentation performance of thrombus on the test set and plot the corresponding curves.The performance of the Res2Net attention mechanism network was compared with the classic U-Net and CE-Net model.Results A total of 303 patients with APE were included in this study.There were 212,61 and 30 cases in the training set,validation set and test set,respectively.The model's area under the curve was 0.95,sensitivity was 0.90,specificity was 1.00,Dice similarity coefficient was 0.86,precision was 0.90,Pos-IOU was 0.78 and Neg-IOU was 1.00,respectively.The parameter curves and radar chart showed that the Res2Net attention mechanism network performed better than the U-Net and CE-Net models.The visualization results of the segmentation comparison showed that the Res2Net attention mechanism network achieved higher precision in segmenting pulmonary artery thrombus.Conclusion The Res2Net attention mechanism network has good performance for detection of APE.

Objective:To establish and validate a clinical and CT radiomics combined model for predicting lymph node metastasis (LNM) risk in patients with hilar cholangiocarcinoma (HCCA).Methods:This was a case-control study. Data from 158 pathologically confirmed HCCA patients between January 2016 and January 2022 at the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. Using stratified random sampling, the patients were randomly divided into a training set ( n=95) and an internal validation set ( n=63) at a 6∶4 ratio. According to postoperative pathology, 31 LNM-positive cases and 64 LNM-negative cases were in the training set, and 22 LNM-positive cases and 41 LNM-negative cases were in the internal validation set. A cohort of 50 HCCA patients was retrospectively collected from West China Hospital of Sichuan University between October 2018 and June 2021 as an external validation set, including 21 LNM-positive and 29 LNM-negative cases. Clinical features were selected by multivariate logistic regression analysis to establish a clinical model. Radiomics features were extracted from portal venous phase CT images using 3D Slicer software. A radiomics model was developed using the least absolute shrinkage and selection operator regression algorithm. A clinical-radiomics model was constructed by integrating clinical features and Radscore, and a nomogram was developed. The prediction performance of models was evaluated by the area under the receiver operating characteristic curve (AUC). The AUC values were compared using the DeLong test. Calibration curves and decision curves were plotted to assess calibration and clinical net benefit. Results:Clinical N (cN) staging was an independent risk factor for LNM ( OR=6.86, 95% CI 2.70-18.49, P<0.001). Totally 12 optimal features were selected to construct the radiomics model, and the clinical-radiomics nomogram model was constructed by combining cN staging and Radscore. In the external validation set, the AUC (95% CI) of the clinical model, radiomics model, and clinical-radiomics nomogram were 0.706 (0.576-0.836), 0.768 (0.637-0.899), and 0.803 (0.680-0.926), respectively. The nomogram achieved higher AUC than clinical and radiomics models with statistical significance ( Z=2.01, 2.21; P=0.044, 0.027). The calibration and decision curves demonstrated good model fit, providing clinical net benefits for patients. Conclusion:The clinical-radiomics nomogram model combining cN staging and CT radiomics features can effectively predict LNM risk in HCCA patients.

Periodontitis imparting the increased risk of atherosclerotic cardiovascular diseases is partially due to the immune subversion of the oral pathogen, particularly the Porphyromonas gingivalis (P. gingivalis), by inducing apoptosis. However, it remains obscure whether accumulated apoptotic cells in P. gingivalis-accelerated plaque formation are associated with impaired macrophage clearance. Here, we show that smooth muscle cells (SMCs) have a greater susceptibility to P. gingivalis-induced apoptosis than endothelial cells through TLR2 pathway activation. Meanwhile, large amounts of miR-143/145 in P.gingivalis-infected SMCs are extracellularly released and captured by macrophages. Then, these miR-143/145 are translocated into the nucleus to promote Siglec-G transcription, which represses macrophage efferocytosis. By constructing three genetic mouse models, we further confirm the in vivo roles of TLR2 and miR-143/145 in P. gingivalis-accelerated atherosclerosis. Therapeutically, we develop P.gingivalis-pretreated macrophage membranes to coat metronidazole and anti-Siglec-G antibodies for treating atherosclerosis and periodontitis simultaneously. Our findings extend the knowledge of the mechanism and therapeutic strategy in oral pathogen-associated systemic diseases.
Animals ; Mice ; Endothelial Cells ; Toll-Like Receptor 2 ; Macrophages ; Apoptosis ; Atherosclerosis ; Myocytes, Smooth Muscle ; MicroRNAs