ObjectiveTo investigate the mechanism of action of Jiedu Huayu granules in improving liver injury in mice with acute liver failure （ALF） by observing its effect on a mouse model of ALF after prophylactic administration， and to provide a basis for clinical medication. MethodsA total of 60 specific pathogen-free male C57BL/6J mice were divided into normal group， model group， Jiedu Huayu granules group （JDHY group）， and farnesoid X receptor （FXR） agonist （GW4064） group using a random number table， with 15 mice in each group. The model of ALF was induced by a single intraperitoneal injection of D-galactosamine combined with lipopolysaccharide. The mice in the JDHY group were given prophylactic administration of 0.3 g/mL drug solution of Jiedu Huayu granules by gavage for 3 days before modeling， those in the normal group and the model group were given 0.9% NaCl solution by gavage， and those in the GW4064 group were given intraperitoneal injection of GW4064 for 3 consecutive days before modeling. The mice were sacrificed after modeling， and serum and liver tissue samples were collected. A veterinary automatic biochemical analyzer was used to measure the serum levels of total bilirubin （TBil）， total bile acids （TBA）， gamma-glutamyl transferase （GGT）， alanine aminotransferase （ALT）， and aspartate aminotransferase （AST） in mice from each group； HE staining was used to observe liver pathological changes； RT-PCR was used to measure the mRNA expression levels of FXR， fibroblast growth factor 15 （FGF15）， fibroblast growth factor receptor 4 （FGFR4）， small heterodimer partner （SHP）， and bile salt export pump （BSEP） in mice， and Western blot was used to measure the protein expression levels of FXR， FGF15， FGFR4， SHP， and BSEP. A one-way analysis of variance was used for comparison between groups， and the Dunett method was used for further comparison between two groups. ResultsCompared with the normal group， the model group had significant increases in the serum levels of TBil， ALT， AST， TBA， and GGT （all P<0.01）， and compared with the model group， the JDHY group and the GW4064 group had significant reductions in the serum levels of TBil， ALT， AST， TBA， and GGT （all P <0.01）. HE staining showed that compared with the model group， the JDHY group and the GW4064 group had milder pathological injury， a reduction in the area of hepatocyte necrosis， and alleviation of cellular swelling and edema. Compared with the normal group， the model group had significant reductions in the mRNA and protein expression levels of FXR， FGF15， FGFR4， SHP， and BSEP in liver tissue （all P <0.01）， and compared with the model group， the JDHY group and the GW4064 group had significant increases in the mRNA and protein expression levels of FXR， FGF15， FGFR4， SHP， and BSEP in liver tissue （all P <0.05）. ConclusionJiedu Huayu granules may alleviate liver injury in mice with ALF through the FXR/SHP axis.

BACKGROUND: In the interim analysis of MONARCH plus, adding abemaciclib to endocrine therapy (ET) improved progression-free survival (PFS) and objective response rate (ORR) in predominantly Chinese postmenopausal women with HR+/HER2- advanced breast cancer (ABC). This study presents the final pre-planned PFS analysis. METHODS: In the phase III MONARCH plus study, postmenopausal women in China, India, Brazil, and South Africa with HR+/HER2- ABC without prior systemic therapy in an advanced setting (cohort A) or progression on prior ET (cohort B) were randomized (2:1) to abemaciclib (150 mg twice daily [BID]) or placebo plus: anastrozole (1.0 mg/day) or letrozole (2.5 mg/day) (cohort A) or fulvestrant (500 mg on days 1 and 15 of cycle 1 and then on day 1 of each subsequent cycle) (cohort B). The primary endpoint was PFS of cohort A. Secondary endpoints included cohort B PFS (key secondary endpoint), ORR, overall survival (OS), safety, and health-related quality of life (HRQoL). RESULTS: In cohort A (abemaciclib: n  = 207; placebo: n  = 99), abemaciclib plus a non-steroidal aromatase inhibitor improved median PFS vs . placebo (28.27 months vs . 14.73 months, hazard ratio [HR]: 0.476; 95% confidence interval [95% CI]: 0.348-0.649). In cohort B (abemaciclib: n  = 104; placebo: n  = 53), abemaciclib plus fulvestrant improved median PFS vs . placebo (11.41 months vs . 5.59 months, HR: 0.480; 95% CI: 0.322-0.715). Abemaciclib numerically improved ORR. Although immature, a trend toward OS benefit with abemaciclib was observed (cohort A: HR: 0.893, 95% CI: 0.553-1.443; cohort B: HR: 0.512, 95% CI: 0.281-0.931). The most frequent grade ≥3 adverse events in the abemaciclib arms were neutropenia, leukopenia, anemia (both cohorts), and lymphocytopenia (cohort B). Abemaciclib did not cause clinically meaningful changes in patient-reported global health, functioning, or most symptoms vs . placebo. CONCLUSIONS: Abemaciclib plus ET led to improvements in PFS and ORR, a manageable safety profile, and sustained HRQoL, providing clinical benefit without a high toxicity burden or reduced quality of life. TRIAL REGISTRATION ClinicalTrials.gov (NCT02763566).
Humans ; Female ; Fulvestrant/therapeutic use* ; Breast Neoplasms/metabolism* ; Aminopyridines/therapeutic use* ; Benzimidazoles/therapeutic use* ; Middle Aged ; Aromatase Inhibitors/therapeutic use* ; Aged ; Receptor, ErbB-2/metabolism* ; Adult ; Letrozole/therapeutic use* ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Anastrozole/therapeutic use*

This consensus will introduce the characteristics of fillers used in the surgical cavities of domestic nasal surgery patients based on relevant literature and expert opinions. It will also provide recommendations for the selection of cavity fillers for different nasal diseases, with chronic sinusitis as a representative example.
Humans ; Nasal Cavity/surgery* ; Nasal Surgical Procedures ; China ; Consensus ; Sinusitis/surgery* ; Dermal Fillers

Objective:To explore the value of the vesical imaging-reporting and data system (VI-RADS) score based on multiparametric MRI (mpMRI) combined with quantitative tumor MRI parameters in assessing the muscle invasion of bladder cancer.Methods:The study was a case-control study. The data of 87 bladder cancer patients confirmed by pathology who underwent mpMRI of the bladder were retrospectively collected from the First Medical Center of Chinese PLA General Hospital between January 2019 and April 2023 The pathological findings were used as the gold standard to categorize them into the muscle invasive bladder cancer (MIBC) group (29 cases) and non-muscle invasive bladder cancer (NMIBC) group (58 cases). Quantitative parameters were measured based on preoperative mpMRI images, including the length of tumor bladder wall contact, the perpendicular distance between the bladder tumor and the tangent of the bladder wall, the maximal diameter of the bladder tumor, and the volume of the bladder tumor. Bladder cancer was classified according to the VI-RADS scoring criteria. The Mann-Whitney U test was used for intergroup comparisons. Multivariate logistic regression analysis was performed to obtain the independent risk factors related to muscle invasion of bladder cancer and to establish the model. The receiver operating characteristic curves were analyzed for MRI quantitative parameters and logistic regression models, and area under the curve (AUC) comparisons were performed using the DeLong test. Results:The differences in tumor bladder wall contact length, perpendicular distance from the tumor to the tangent line of the bladder wall, maximum diameter, bladder tumor volume, and the VI-RADS scores were statistically significant between the MIBC group and the NMIBC group ( P<0.05). Multifactorial logistic regression analysis showed that tumor bladder wall contact length ( OR=21.07, 95% CI 3.56-124.89, P=0.001) and VI-RADS score ( OR=11.90, 95% CI 3.53-40.12, P<0.001) were the independent risk factors for evaluating the muscle invasion of bladder cancer. The difference between the VI-RADS score and the tumor bladder wall contact length for assessing muscular infiltration of bladder cancer had AUCs of 0.802 (95% CI 0.704-0.899) and 0.759 (95% CI 0.652-0.865). The combined model of VI-RADS score combined with tumor bladder wall contact length had an AUC of 0.891 (95% CI 0.812-0.970), which was higher than the diagnostic efficacy of applying tumor bladder wall contact length or VI-RADS score alone ( Z=3.05, 2.37, P=0.002, 0.018). Conclusion:Tumor contact length with the bladder wall is an independent risk factor for assessing muscle invasion of bladder cancer and the combination of VI-RADS score may enhances diagnostic accuracy.

Objective To investigate the factors influencing the natural outcome of low-grade squamous intraepithelial lesions(LSIL)of the cervix.Methods A total of 154 patients who underwent colposcopic cervical biopsy in the Third Affiliated Hospital of Zhengzhou University from January 2022 to January 2023 were selected and divided into negative conversion group(55 cases),continuous group(70 cases)and upgraded group(29 cases)according to the follow-up results.Logistic regression was used to analyze the influence of related factors on the outcome of LSIL.Results There were statistically significant differences in the number of vaginal births,the results of thin-prep cytology test,human papilloma virus(HPV)typing,whether vaginal LSIL was combined,whether there were symptoms,and vaginal microecology among three groups(P＜0.05).Multivariate Logistic analysis showed that combined vaginal LSIL,vaginal microecological abnormalities,atypical squamous cell-cannot exclude high-grade squamous intraepithelial lesion(ASC-H)/high-grade squamous intraepithelial lesion(HSIL),HPV 16/18 positive or mixed positive were independent risk factors for persistent infection(P＜0.05),combined vaginal LSIL,symptomatic,vaginal microecological abnormalities,ASC-H/HSIL,HPV 16/18 positive or mixed positive were all independent risk factors for escalation of lesions(P＜0.05).Conclusion Patients with vaginal LSIL,vaginal microecological abnormalities,ASC-H/HSIL,HPV 16/18 positive or mixed positive should be followed up and early intervention to reduce the risk of disease escalation.

Objective To investigate the protective effect of Huishen Suxing decoction on intestinal mucosal barrier in rats with acute-on-chronic liver failure(ACLF)and elucidate its possible mechanism.Methods The rats were randomly divided into control group(Con group),model group,Bifico group(positive control),and HSD-L,M and H groups(low,medium and high dose of Huishen Suxing decoction).The ACLF model was established by CCl4 combined with D-galactosamine(D-Gal N).Intragastric administration of CCl4 was started on the 6th week of intraperitoneal injection,once daily for 6 weeks,and continued until the acute challenge with D-Gal N injection.The liver function of rats was detected by kits.HE staining was used to observe the pathological changes of liver tissue and ileum tissue.The levels of endotoxin(ET),diamine oxidase(DAO),IL-1β,IL-6,TNF-α in serum and secretory immunoglobulin A(sIgA)in ileum were detected by ELISA.Intestinal mucosal permeability was detected by FITC-Dextran tracer.Selective medium was used to detect the amount of intestinal flora.Western blotting was used to detect the protein expression levels of HMGB1,TLR4,NF-κB p65,p-NF-κB p65,Occludin and ZO-1 in ileum tissue of each group.Results Compared with the Con group,the liver tissue and ileum tissue of the Model group showed obvious pathological damage.The levels of ALT,AST,TBIL,ET,DAO,IL-1β,IL-6 and TNF-α in serum significantly increased(P<0.01).The content of sIgA in ileum tissue significantly decreased(P<0.01).The permeability of intestinal mucosa and the number of Enterobacter and Enterococcus in the intestine significantly increased(P<0.01).The amount of Bifidobacterium and Lactobacillus significantly decreased(P<0.01).The expressions of HMGB1,TLR4 protein and p-NF-κB p65/NF-κB p65 protein ratio in ileum tissue significantly increased(P<0.01),and the expressions of Occludin and ZO-1 protein significantly decreased(P<0.01).Compared with the model group,the Bifico group and HSD-L,M,H groups had significantly alleviated liver and ileum injury.The levels of ALT,AST,TBIL,ET,DAO,IL-1β,IL-6 and TNF-α in serum significantly decreased(P<0.01).The permeability of intestinal mucosa and the amount of Enterobacteriaceae and Enterococcus in the intestine significantly decreased(P<0.01),while the amount of Bifidobacterium and Lactobacillus significantly increased(P<0.01).The expressions of HMGB1,TLR4 protein and p-NF-κB p65/NF-κB p65 protein ratio in ileum tissue significantly decreased(P<0.01),and the expressions of Occludin and ZO-1 protein significantly increased(P<0.01).Conclusion Huishen Suxing decoction can reduce inflammatory response,regulate the structure of intestinal flora,improve the intestinal mucosal barrier,and thus alleviate liver injury in ACLF rats.The mechanism may be associated to the inhibition of HMGB1/TLR4/NF-κB signaling pathway activation.

Objective:To explore the impact of a comprehensive intervention program that integrates transitional care with personalized discharge preparation services on discharge preparedness on the growth, development, and motor development in premature infants, providing guidance and reference for clinical practice.Methods:The 90 pairs of premature infants and their main caregivers who were treated in the neonatal department, Children ′s Hospital, Quanzhou Maternal and Child Health Hospital were studied from February 2023 to February 2024 by randomized control method. Used the table of random numbers, they were divided into the control group and the observation group, with 45 pairs in each group. The control group routinely administered care, while the observation group was implemented a transitional care combined with personalized discharge preparation services. The discharge preparedness, growth and motor development, and the disease uncertainty of caregivers were observed between the 2 groups. Results:There were 27 males and 18 females of the 45 preterm infants,with gestational age of 30.86 (29.36, 31.50) weeks in the control group, 24 males and 21 females with gestational age of 30.29(29.00, 31.07) weeks in the observation group. The main caregiver identities 43 were mothers and 2 were other identities in the control group, 42 were mothers and 3 were other identities in the observation group, with them being 31.00(28.00, 35.00) years old. There were 97.78% (44 /45) caregivers who thought the child was ready to go home in the observation group, while the control group were 84.44% (38 /45), these differences were statistically significant ( χ2=4.88, P<0.05). The total score of discharge readiness in the observation group were 240.00(237.00, 242.50) points, higher than in the control group 226.00(219.00, 229.50) points, these differences were statistically significant ( Z=-6.23, P<0.05). The head circumference and body weight of the observation group were (34.82 ± 1.14) cm and (3.60 ± 0.55) kg, while the control group were (34.25 ± 1.22) cm and (3.35 ± 0.53) kg, there were statistically significant between the two groups ( t=-2.29, -2.22, all P<0.05). The Test of Infant Motor Performance score in the observation group was 50.00(46.00, 52.00) points, while the control group was 45.00(42.00, 48.00) points, there were statistically significant between the two groups ( Z=-3.65, P<0.05). The total score of disease uncertainty in the observation was 52.00(45.50, 60.00) points, while the control group was 61.00(58.50, 65.00) points, there was statistically significant between the two groups ( Z=-4.62, P<0.05). Conclusions:The discharge preparedness of the caregivers of preterm infants was improved because of the use of transitional care combined with personalized discharge preparation services, and the growth and motor development of preterm infants were promoted, and the uncertainty of the family caregivers of preterm infants about the disease was reduced.

Objective:To explore the potential profiles of health literacy in patients with chronic atrophic gastritis (CAG) and analyze their influencing factors.Methods:A cross-sectional study was conducted to select CAG patients admitted to Nanjing Hospital of Traditional Chinese Medicine or attending outpatient clinics from January 2023 to June 2024 by convenience sampling method, and all patients participated in this study two months after treatment. The General Information Questionnaire, the General Self-Efficacy Scale, and the All-around Health Literacy Measurement Scale (AAHLS) were used to conduct the questionnaire survey. The three dimensions of AAHLS were used as exogenous indicators for potential profile analysis, to compare the differences in general information and self-efficacy of patients with different potential profiles, and to analyze the influencing factors of different potential profiles of health literacy in CAG patients by multi classification Logistic regression.Results:The recovery rate of valid questionnaires was 97.71%(256/262). Among the 256 patients, there were 164 males and 92 females, with 86 patients aged 18-44 years old, 110 patients aged 45-59 years old, and 60 patients aged ≥ 60 years old. The health literacy of CAG patients was categorized into 3 potential profiles, including the high health literacy-appraisal and application competence group (14.84%, 38/256), the medium health literacy-appraisal and application competence group (32.81%, 84/256), and the low health literacy-appraisal and application competence group (52.34%, 134/256). The results of multi classification Logistic regression analysis showed that when the low health literacy-appraisal and application competence group was used as a reference, aged 18-44 years old ( OR=8.954, 95% CI 2.049-39.127), poor self-efficacy ( OR=0.089, 95% CI 0.027-0.293), duration of disease <5 years ( OR=0.049, 95% CI 0.014-0.169), per capita monthly household income<3 000 yuan ( OR=0.072, 95% CI 0.018-0.299), and primary school education or below ( OR=0.016, 95% CI 0.003-0.088) were independent influences in the the high health literacy-appraisal and application competence group (all P<0.05); poorer self-efficacy ( OR=0.458, 95% CI 0.251-0.834) and per capita monthly household income<3 000 yuan ( OR=0.212, 95% CI 0.100-0.453) were independent influences in the medium health literacy-appraisal and application competence group (both P<0.05). Conclusions:The health literacy of CAG patients is obviously heterogeneous, and healthcare professionals in clinical work should adopt targeted assessment and intervention according to the different characteristics of each category in order to improve the health literacy of CAG patients.

Objective To investigate the prevalence of comorbidity of oral frailty and sarcopenia in elderly inpatients,and to explore their influencing factors,so as to provide a basis for formulating targeted interventions for patients with oral frailty and sarcopenia.Methods A total of 515 elderly patients hospitalized in 3 tertiary hospitals in Zhengzhou City and 1 second-class hospital in Shangqiu City from January 2024 to April 2024 were selected as the research subjects by convenience sampling,and the general information questionnaire,Oral Frailty Index-8,Sarcopenia Screen Questionnaire,Mini Nutritional Assessment Short Form,Social Support Rating Scale and Hospital Anxiety and Depression Scale(HADS)were used for investigation.Logistic regression was used to analyze the influencing factors of oral frailty and sarcopenia comorbidities in elderly inpatients.Results 508 valid questionnaires were collected.The prevalence of sarcopenia and oral frailty in elderly inpatients was 22.8％,and age,dysphagia,number of chronic diseases,and history of hypertension or stroke,multiple drug use,depression,bad nutrition and low level of social support were the risk factors(P＜0.05).Conclusion The incidence of oral frailty combined with sarcopenia was higher in elderly hospitalized patients.Nurses should take nursing measures according to its influencing factors to prevent and control the development of oral frailty combined with sarcopenia.