ObjectiveTo elucidate the chemical composition of the reference sample of Jinshui Liujunjian and its distribution characteristics in blood and tissues of rats. MethodsUltra performance liquid chromatography-quadrupole-time-of-flight tandem mass spectrometry（UPLC-Q-TOF-MS/MS） was used to detect the reference sample solution， plasma， and tissue samples of Jinshui Liujunjian under positive and negative ion modes， respectively. Qualitative Analysis 10.0 software and a self-constructed database were employed for primary mass spectrum matching.Compound identification was further validated by comparing retention times， secondary mass spectral fragments， reference standards， and literature data to deduce fragmentation pathways. ResultsA total of 122 compounds were identified in the reference sample of Jinshui Liujunjian， including 47 flavonoids， 5 amino acids， 13 iridoids， 16 triterpenoid saponins， etc.， of which 42 compounds were confirmed by comparison with reference substances. A total of 21 prototype components were identified in blood components； 50 prototype components were identified in different tissues， among which 13， 10， 7， 21， 11， 6， 14， and 40 prototype components were identified in the heart， liver， spleen， lung， kidney， brain， large intestine， and stomach， respectively. Among them， 7 compounds such as ferulic acid， glycyrrhizic acid， and nobiletin were exposed in the target organs of lung and kidney. ConclusionThis study elucidates the material basis of the reference samples of Jinshui Liujunjian， primarily composed of flavonoids and triterpenoid saponins， along with their in vivo distribution characteristics. These findings provide a scientific basis for establishing quality evaluation indicators and offer references for subsequent pharmacodynamic and pharmacokinetic investigations.

ObjectiveTo elucidate the chemical composition of the reference sample of Jinshui Liujunjian and its distribution characteristics in blood and tissues of rats. MethodsUltra performance liquid chromatography-quadrupole-time-of-flight tandem mass spectrometry（UPLC-Q-TOF-MS/MS） was used to detect the reference sample solution， plasma， and tissue samples of Jinshui Liujunjian under positive and negative ion modes， respectively. Qualitative Analysis 10.0 software and a self-constructed database were employed for primary mass spectrum matching.Compound identification was further validated by comparing retention times， secondary mass spectral fragments， reference standards， and literature data to deduce fragmentation pathways. ResultsA total of 122 compounds were identified in the reference sample of Jinshui Liujunjian， including 47 flavonoids， 5 amino acids， 13 iridoids， 16 triterpenoid saponins， etc.， of which 42 compounds were confirmed by comparison with reference substances. A total of 21 prototype components were identified in blood components； 50 prototype components were identified in different tissues， among which 13， 10， 7， 21， 11， 6， 14， and 40 prototype components were identified in the heart， liver， spleen， lung， kidney， brain， large intestine， and stomach， respectively. Among them， 7 compounds such as ferulic acid， glycyrrhizic acid， and nobiletin were exposed in the target organs of lung and kidney. ConclusionThis study elucidates the material basis of the reference samples of Jinshui Liujunjian， primarily composed of flavonoids and triterpenoid saponins， along with their in vivo distribution characteristics. These findings provide a scientific basis for establishing quality evaluation indicators and offer references for subsequent pharmacodynamic and pharmacokinetic investigations.

BACKGROUND:Research suggests that exercise interventions may be more advantageous than pharmacologic treatments or dietary restriction alone for fat loss,but fewer studies have simultaneously examined the effects of training modalities and training cycles on visceral and subcutaneous fat in obese populations. OBJECTIVE:To investigate the impact of training modalities and training cycles on visceral and subcutaneous fat in recessive obesity female college students. METHODS:Sixty-three female college students with hidden obesity(body mass index<24 kg/m2 and body fat content percentage≥30%)were recruited from Zhengzhou College of Commerce and Industry,and were randomly divided into a high-intensity intermittent training group(n=32)and a moderate-intensity continuous training group(n=31)using the lottery method.Subjects in both groups performed exercise training of corresponding intensity on a running platform and ensured that the exercise volume of both groups was equal,3 times per week,every 4 weeks as one training cycle for 16 weeks.Before training and at the end of each training cycle,subjects'visceral fat,subcutaneous fat,and overall fat were measured using the corresponding test devices. RESULTS AND CONCLUSION:The repeated measures F results indicated that the main effects of training cycles on visceral fat area,visceral fat index,abdominal subcutaneous fat thickness,percentage of body fat and body mass index were significant,while the main effects of training modalities were significant for subcutaneous fat thickness in the triceps brachii and scapula regions.All the interaction effects between training modalities and training cycles were significant(P<0.05).Results from the simple effect tests revealed that the significant simple effects of training modalities at the 4th and 12th weeks for visceral fat area and visceral fat index,at the 8th and 12th weeks for subcutaneous fat thickness in the triceps brachii,scapula region,and abdominal regions,and at the 8th week for the percentage of body fat and body mass index.Simple effects of training cycles were significant for all measures within each group.(3)The results of multiple comparison tests indicated that in the high-intensity intermittent training group,visceral fat area,visceral fat index,percentage of body fat,body mass index and abdominal subcutaneous fat thickness decreased sequentially at the 4th,8th,12th,and 16th weeks,and subcutaneous fat thickness of the triceps brachii and scapula decreased sequentially at the 8th,12th,and 16th weeks(P<0.05).In the moderate-intensity continuous training group,visceral fat area,visceral fat index,subcutaneous fat thickness of the triceps brachii and scapula,percentage of body fat and body mass index decreased successively at the 8th,12th,and 16th weeks,while abdominal subcutaneous fat thickness decreased successively at the 4th,8th,12th,and 16th weeks(P<0.05).To conclude,both training modalities and training cycles are factors influencing visceral and subcutaneous fat in recessive obesity female college students.Training modality primarily affects subcutaneous fat in the triceps brachii and scapular region,but the fat loss effects may converge over a longer training cycle;training cycle primarily affects visceral fat area,visceral fat index,abdominal subcutaneous fat,body fat content,and body mass index.

Objective To report the diagnosis and treatment processes of a fungal keratitis case caused by Lasio-diplodia theobromae(L.theobromae),and enhance the diagnosis and treatment experience on fungal keratitis caused by this rare pathogen.Methods Corneal scraping specimen from a patient with fungal keratitis was collec-ted.Gram-staining and fluorescence staining were conducted on specimen,followed with direct microscopic observa-tion and isolation culture.The strain was identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry(MALDI-TOF MS)technology and targeted DNA sequencing.Antimicrobial susceptibility testing was conducted.Literatures were summarized and clinical data on fungal keratitis caused by this pathogen were sorted out.Results Septal fungal hyphae could be seen on the corneal scraping specimen microscopically.The strain was identified as L.theobromae by both MALDI-TOF MS and targeted DNA sequencing after culture.Antimicrobial susceptibility testing(microdilution method)showed that the minimal inhibitory concentrations(MICs)of ampho-tericin B,vorionazole,itraconazole,posaconazole,fluconazole,5-fluorocytosine,micafungin,caspofungin,and anidulafungin against this strain were 1,0.25,＞8,0.25,＞256,8,16,2,and 0.25 μg/mL,respectively.Pa-tient recovered well after antifungal treatment plan was adjusted according to antimicrobial susceptibility testing re-sults.Conclusion L.theobromae is a rare pathogen that causes fungal keratitis.Laboratory tests provide rapid mi-croscopic examination results,and take MALDI-TOF MS and targeted DNA sequencing identification techniques as effective means to detect rare pathogen.In vitro antimicrobial susceptibility testing result can provide reference for clinicians to correctly use antifungal agents for treatment of infection due to this pathogen.

Objective:To investigate the promoting effect of individualized instruction combined with a blended learning model (IIBLM) in continuing training of neurology.Methods:A total of 93 trainees who received continuing training in Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, from August 2022 to December 2024 were enrolled as subjects. The 50 trainees registered since January 2024 were enrolled as observation group and received IIBLM teaching, including sub-specialty modular training, a cycle-adaptive cultivation system, a "mutual-selection" mentorship program, an on/off-line dual-track curriculum system, a dynamic course allocation mechanism based on "mutual selection", and a competency growth evaluation system, while the 43 trainees registered before January 2024 were enrolled as control group and received traditional teaching. A questionnaire survey and comprehensive competency assessments were performed to evaluate the effect of teaching, and the t-test, the chi-square test, and the qualitative analysis were used for statistical analysis. Results:Compared with the control group, the experimental group showed systematic improvements in clinical contents, theoretical curriculum, faculty competency, and workflow arrangement during continuing training, with a significant difference in the score of workflow arrangement between the two groups [(9.58±0.67) vs. (9.07±1.44), t=-2.13, P=0.037]. The observation group had a score of (97.70±1.30) for dynamic course allocation, an overall satisfaction rate of 97.15%, and a course benefit rate of 97.55%. The qualitative analysis showed that the trainees in the control group mainly complained of course monotony, while those in the observation group expected to enhance interdisciplinary integration and the cultivation of scientific research abilities. In addition, the results of competency assessment showed a continuous improvement in teaching effect after reform, with no significant difference. Conclusions:IIBLM teaching effectively enhances professional qualities, clinical competency, and the degree of satisfaction with courses among the trainees receiving continuing training, and it also revealed the necessity of interdisciplinary collaborative teaching and the integration of research and clinical practice.

Objective:To investigate the expression of cellular repressor of E1A-stimulated gene 2 (CREG2) in colon adenocarcinoma (COAD) and its relationship with prognosis and tumor immune microenvironment.Methods:CREG2 mRNA expression data and survival data of patients were collected from 23 pan-cancer cohorts including COAD in the University of California, Santa Cruz (UCSC) database. The difference of CREG2 mRNA expression levels in cancer tissues and paracancerous tissues was compared. Univariate Cox proportional risk model was used to analyze the correlation of high and low expressions of CREG2 mRNA in pan-cancer tissues with the overall survival (OS) of patients; taking the pathological results as the gold standard, the optimal cut-off value of CREG2 mRNA expression level in cancerous and paracancerous tissues obtained by receiver operating characteristic (ROC) curve was used to group the high and low expressions. Kaplan-Meier method was used to draw the OS curve of pan-cancer CREG2 mRNA high and low expression groups, and log-rank test was used for comparison between groups. The data of patients with complete clinical data of the COAD cohort were further extracted from the UCSC database. The distribution of patients with high and low CREG2 mRNA expressions stratified by different clinicopathological characteristics of different groups was compared. Kaplan-Meier method was used to analyze the OS of patients with high and low CREG2 mRNA expressions as well as the OS of patients stratified by different clinicopathological characteristics, and log-rank test was used for comparison between groups; multivariate Cox proportional risk model was used to screen the independent factors influencing the OS of COAD patients. The chips of cancer tissues and the corresponding paracancerous tissues from 58 COAD patients were collected for immunohistochemical staining. CREG2 protein expression level between the cancer tissues and paracancerous tissues was compared. The product of the proportion of positive cells and the staining intensity score was treated as the CREG2 protein expression level in the tissues; taking pathological results as the gold standard, the ROC curve was used to analyze the therapeutic efficacy of CREG2 protein level in judging cancer tissues and paracancerous tissues. Based on the tumor immune assessment resource (TIMER) database, Pearson function was used to analyze the correlation between the CREG2 mRNA expression and the degree of immune cell infiltration in COAD tissues. ESTIMATE algorithm was used to obtain each immune infiltration score, and the immune infiltration score was compared between the CREG2 mRNA high and low expression groups.Results:In the 23 pan-cancer cohorts of UCSC database, the CREG2 mRNA expression level in 17 cohort cancer tissues including COAD was higher than that in paracancerous tissues, and the CREG2 mRNA expression level in 3 cohort cancer tissues including glioma was lower than that in paracancerous tissues, and the differences were statistically significant (all P < 0.05). Univariate Cox regression analysis showed that the OS of patients with high CREG2 mRNA expression was worse than that in those with low CREG2 mRNA expression in 5 cohort cancer tissues including COAD (236 cases, HR = 1.13, 95% CI: 1.01-1.26, P = 0.030), and in glioma cohorts (553 cases, HR = 0.90, 95% CI: 0.85-0.95, P < 0.001), the OS of patients with low CREG2 mRNA expression was worse than that in those with high CREG2 mRNA expression. Kaplan-Meier analysis also showed that the OS of COAD, lung adenocarcinoma, renal papillary cell carcinoma, and hepatocellular carcinoma patients with high CREG2 mRNA expression was worse than that of those with low CREG2 mRNA expression, and the OS of glioma patients with high CREG2 mRNA expression was better than that of those with low CREG2 mRNA expression. In the UCSC database, CREG2 mRNA expression level in 222 COAD patients with complete clinical data was higher than that in paracancerous normal tissues. The proportion of patients with high CREG2 mRNA expression in mismatch repair deficient patients with COAD was higher than that in mismatch repair normal patients [87.2% (34/39) vs. 69.4% (127/183)], and the difference was statistically significant ( P = 0.024). There were no statistically significant differences in the proportion of patients with high CREG2 mRNA expression among patients stratified by age, gender and pathological stage (all P > 0.05). Kaplan-Meier analysis showed that patients with pathological stage Ⅲ-Ⅳ, stage T 4, lymph node metastasis, distant metastasis, and high CREG2 mRNA expression had poor OS, and the differences were statistically significant (all P < 0.05); and multivariate Cox regression analysis showed that distant metastasis ( HR = 3.61, 95% CI: 1.81-7.23, P < 0.01) and high CREG2 mRNA expression ( HR = 4.29, 95% CI: 1.69-10.93, P < 0.01) were independent risk factors for poor OS in COAD patients. The result of immunohistochemistry method detection of clinical samples showed that in cancer and paracancerous tissues, CREG2 protein was mainly expressed in the cytoplasm, and the expression level of CREG2 protein in COAD tissues was higher than that in corresponding paracancerous tissues (164±23 vs. 146±24, P < 0.001). ROC curve analysis showed that CREG2 protein expression in COAD tissues could be used to judge cancer and paracancerous tissues (the area under the curve = 0.720, 95% CI: 0.628-0.814, P < 0.001). The analysis of the data in TIMER database showed that CREG2 expression level in COAD tissues was correlated with infiltration levels of CD8 + T cells ( R = 0.158, P = 0.001), CD4 + T cells ( R = 0.125, P = 0.012), macrophages ( R = 0.202, P < 0.001), neutrophils ( R = 0.248, P < 0.001), and dentritic cells ( R = 0.265, P < 0.001). The matrix score and estimated score in the high CREG2 expression group were higher than those in the low expression group, and the differences were statistically significant (all P < 0.05). Conclusions:CREG2 gene is highly expressed in COAD tissues, and its high expression may be related to the poor prognosis of COAD patients. The microenvironment of COAD with high CREG2 expression has a higher abundance of stromal cells, and CREG2 may be involved in immune regulation and immune response.

Objective To observe the value of intraoperative ultrasound(IOUS)for microsurgical resection of primary supratentorial glioblastoma.Methods Totally 130 cases of central nervous system WHO grade 4 primary supratentorial glioblastoma confirmed by postoperative pathology were retrospectively enrolled and divided into IOUS group and control group(each n=65)based on whether IOUS was used during operation.The general information,resection related indicators and postoperative complications were compared between groups,and the application value of IOUS was analyzed.Results In IOUS group,the tumor depth was greater,while the intraoperative bleeding,duration of hospitalization and operation-duration were all less than those in control group(all P＜0.05).Postoperative complications occurred in 28 cases of IOUS group and 29 cases of control group,and the incidence of subdural effusion in IOUS group was lower than that in control group(P＜0.05).Conclusion IOUS could effectively reduce intraoperative bleeding,duration of hospitalization,operation-duration and incidence of postoperative subdural effusion in microsurgical resection of primary supratentorial glioblastoma.

OBJECTIVE To determine the species,quantity,and dispersion patterns of airborne pollen in two districts and five counties of Handan City,Hebei Province.METHODS The gravity sedimentation method was employed from October 1,2023,to September 30,2024,for daily and consecutive pollen exposure slides in two districts(Congtai District and Yongnian District)and five counties(Qiu County,Daming County,Cheng'an County,Cixian County,and She County)of Handan City,Hebei Province.The types of pollen were counted and identified under an optical microscope,and the pollen data were statistically analyzed.RESULTS The annual pollen quantity in the two districts and five counties of Handan City ranged from 24 031 grains/1 000 mm2 to 85 131 grains/1 000 mm2.The dissemination of major allergenic pollen presented two peaks.The first peak occurred in spring(March to April),mainly composed of Platanus(25.15％),Broussonetia(13.61％),Pinus(8.48％);the second peak occurred in(August to September),mainly consisting of Humulus/Cannabis(13.71％)and Artemisia(8.44％).Pollen in spring was significantly higher than that in summer and autumn.CONCLUSION The major allergenic airborne pollen in the two districts and five counties of Handan City exhibited two peaks in spring and summer-autumn,with Platanus pollen,Broussonetia pollen,Pinus pollen,Humulus/Cannabis pollen,and Artemisia pollne being the dominant pollen types.Among them,Platanus pollen was the absolute dominant pollen in this region.

Objective To investigate the serum C-C motif chemokine ligand 27(CCL27)and laminin sub-unit gamma-2(LAMC2)levels and prognostic value before transurethral resection of bladder tumor(TURBT)in patients with non-muscle-invasive bladder cancer(NMIBC).Methods A total of 104 patients with NMIBC who underwent primary TURBT at the First Affiliated Hospital of Air Force Medical University from February 2019 to February 2021 were retrospectively selected as the NMIBC group,and another 50 healthy individuals who underwent physical examinations at the same hospital during the same period were se-lected as the control group.The levels of serum CCL27 and LAMC2 before TURBT in the two groups were detected by enzyme-linked immunosorbent assay.Kaplan-Meier curve was used to analyze the effect of serum CCL27 and LAMC2 before TURBT on the prognosis of NMIBC patients.COX regression was used to analyze the prognostic factors of patients with NMIBC.The receiver operating characteristic(ROC)curve was used to analyze the value of serum CCL27 and LAMC2 before TURBT in evaluating the prognosis of NMIBC pa-tients.Results The levels of serum CCL27 and LAMC2 in the NMIBC group before TURBT were higher than those in the control group,and the difference was statistically significant(P<0.05).The levels of serum CCL27 and LAMC2 before TURBT in patients with NMIBC at tumor stage T1 and high-grade pathological grade were higher than those in patients with tumor stage Ta/Tis and low-grade pathological grade,and the difference was statistically significant(P<0.05).The 3-year progression-free survival rate of patients in the high-level CCL27 group was lower than that in the low-level CCL27 group,and the difference was statistically significant(χ2=20.021,P<0.001).The 3-year progression-free survival rate of patients in the high-level LAMC2 group was lower than that in the low-level LAMC2 group,and the difference was statistically signifi-cant(χ2=11.012,P<0.001).Tumor stage T1,high-grade pathological grade,high level of serum CCL27,and high level of serum LAMC2 were risk factors affecting the prognosis of patients with NMIBC(P<0.05).The results of ROC curve analysis showed that the area under the curve and 95%CI of the combined serum CCL27 and LAMC2 before TURBT for the prognosis assessment of NMIBC patients were 0.901(0.881-0.925),which were larger than those of the single detection,and the difference was statistically significant(Z=4.620,4.912,P<0.001).Conclusion The elevated levels of serum CCL27 and LAMC2 before TURBT in NMIBC patients are related to the degree of tumor malignancy,and can serve as prognostic markers for in-dividualized treatment strategies.

Lymphoma is a highly heterogeneous malignancy characterized by complex molecular regulatory mechanisms that result in significant differences in aggressiveness and prognosis across its subtypes.Gene copy number alteration(CNA)analysis,an emerging technology,has become a pivotal tool in the precision re-search and management of lymphoma.By detecting DNA deletions,amplifications,and chromosomal copy number changes,CNA analysis addresses the limitations of traditional cytogenetic techniques,enhances the ac-curacy of subtype classification,and aids in evaluating tumor heterogeneity and disease progression.This re-view provides a comprehensive summary of CNA detection methods and their applications in lymphoma,with a focus on recent advancements in the field.It offers a comparative analysis of CNA detection techniques and discusses their role in precision diagnosis,subtype classification,monitoring disease progression,predicting therapeutic resistance,and assessing prognosis.Additionally,the review explores the potential applications of CNA analysis in uncovering molecular regulatory mechanisms,optimizing therapeutic strategies,and impro-ving patient survival outcomes.