Esophageal cancer is a prevalent malignant tumor of the digestive tract in China, and radical surgery remains the cornerstone of its comprehensive treatment. However, multifactorial challenges such as postoperative gastrointestinal tract reconstruction, traumatic stress, and tumor-related metabolic disturbances render esophageal cancer patients highly susceptible to malnutrition. Perioperative nutritional support therapy plays a crucial role in enhancing surgical safety, improving clinical outcomes, and elevating patients' quality of life by regulating metabolic homeostasis, preserving organ function, and optimizing the immune microenvironment. This article reviews the mechanisms underlying malnutrition in esophageal cancer, methods for nutritional status assessment, and precision intervention pathways based on multi-omics evaluations. The aim is to strengthen clinicians' awareness of standardized perioperative nutritional management for esophageal cancer patients and promote its clinical implementation, thereby facilitating postoperative recovery and improving long-term quality of life.

ObjectiveTo investigate the mechanism of Yijing decoction to inhibit oxidative stress induced by chronic iron overload and improve ovarian reserve hypofunction in mice. MethodsSeventy-two female C57BL/6J mice with normal estrous cycles were randomly divided into six groups （n=12 per group）：blank group，model group，Yijing decoction（YJD） low-dose group，medium-dose group，high-dose group，and dehydroepiandrosterone （DHEA） group. Mice in the blank group received intraperitoneal injections of normal saline，while those in all other groups were administered iron dextran （Sigma-Aldrich） at a dose of 0.5 g·kg^-1 once weekly for 8 weeks to establish a chronic iron overload model. Following the final injection，interventions were initiated and continued for 4 weeks. The low，medium，and high dose groups of YJD received oral gavage of Yijing decoction aqueous solution at doses of 18.165， 36.33，and 72.66 g·kg^-1·d^-1，respectively. The DHEA group received DHEA aqueous solution at 10.812 5 mg·kg^-1·d^-1. The blank and model groups received an equivalent volume of distilled water by gavage once daily. Body weight was recorded weekly，and food intake was monitored throughout the treatment period. Vaginal smears were collected daily and stained with hematoxylin-eosin （HE） to assess estrous cycle regularity. At the end of the experiment，mice were euthanized，and bilateral ovaries and uteri were rapidly excised and weighed to calculate ovarian and uterine indices （mg·g^-1）. Ovarian tissues were fixed，embedded，and sectioned for hematoxylin and eosin （HE） staining to evaluate histopathological changes. Iron deposition in ovarian tissue was visualized using Prussian blue staining. Serum levels of follicle-stimulating hormone （FSH），luteinizing hormone （LH），estradiol （E₂），and anti-Müllerian hormone （AMH） were measured by enzyme-linked immunosorbent assay （ELISA）. Malondialdehyde （MDA） content and superoxide dismutase （SOD） activity in ovarian homogenates were determined using commercial biochemical assay kits. Reactive oxygen species （ROS） levels in ovarian tissue were assessed by ROS fluorescence staining on frozen sections. Mitochondrial ultrastructure in ovarian tissue was examined by transmission electron microscopy （TEM）. Total RNA was extracted from ovarian tissue for real-time quantitative polymerase chain reaction （Real-time PCR） to quantify mRNA expression of ferritin heavy chain 1 （Fth1），ferritin light chain （Ftl），transferrin （Tf），transferrin receptor 1 （Tfr1），catalase （Cat），and glutathione peroxidase 1 （GPX1）. Protein expression levels of Fth1，Ftl，Tf，Tfr1，and glutathione peroxidase 4 （GPX4） were analyzed by Western blot. ResultsCompared with the blank group，mice in the model group exhibited significantly reduced body weight and severe estrous cycle disruption （P<0.01），a markedly increased uterine index （P<0.01），and a significantly decreased ovarian index （P<0.01）. The number of antral follicles was significantly reduced，while atretic follicles were markedly increased，accompanied by pronounced iron deposition in the ovarian stroma. Serum levels of AMH and E₂，as well as ovarian SOD activity，protein and mRNA expression of Tf and Tfr1，and mRNA levels of GPX1 and Cat were all significantly downregulated （P<0.05，P<0.01）. Conversely，serum FSH and LH levels，MDA content，protein and mRNA expression of Fth1 and Ftl，and ROS fluorescence intensity were significantly elevated （P<0.05，P<0.01），along with a marked decrease in GPX4 protein expression （P<0.01）. TEM revealed an increased number of damaged mitochondria in ovarian tissue，characterized by loss or disappearance of mitochondrial cristae. Compared with the model group，treatment with low，medium，and high doses of YJD and DHEA significantly improved body weight and ameliorated estrous cycle irregularities （P<0.05，P<0.01），decreased the uterine index （P<0.05），and increased the ovarian index （P<0.05，P<0.01）. These groups also showed increased numbers of antral follicles，reduced atretic follicles，and significantly diminished iron deposition in the ovarian stroma. Serum AMH and E₂ levels，ovarian SOD activity，protein and mRNA expression of Tf and Tfr1，and mRNA levels of GPX1 and Cat were all significantly upregulated （P<0.05，P<0.01）. In contrast，serum FSH and LH levels，MDA content，protein and mRNA expression of Fth1 and Ftl，and ROS fluorescence intensity were significantly reduced （P<0.05，P<0.01），while GPX4 protein expression was markedly increased （P<0.01）. Moreover，mitochondrial damage was alleviated，and mitochondrial ultrastructure was notably restored in ovarian tissue. ConclusionYijing decoction ameliorates ovarian reserve function in mice with chronic iron overload by upregulating the expression of Tf，Tfr1，and GPX4，downregulating the expression of Ft，Fth1，and Ftl，thereby alleviating systemic iron metabolism disorders，reducing oxidative stress in ovarian tissue，and restoring mitochondrial morphology and structure.

Objective To analyze the characteristics of hearing loss at different frequencies among noise-exposed workers in a lithium battery manufacturing enterprise. Methods A total of 1 954 noise-exposed workers from a large lithium battery manufacturing enterprise were selected as the study subjects using the judgmental sampling method. Pure-tone audiometry, individual noise exposure level monitoring, and workplace noise intensity measurement were conducted. Results The overall detection rate of hearing loss among the study subjects was 39.0%. The detection rates of unilateral and bilateral hearing loss were 21.0% (410/1 954) and 18.0% (352/1 954), respectively. The detection rate of hearing loss in the right ear was higher than that in the left ear (30.1% vs 26.9%, P<0.05). The detection rates of elevated hearing thresholds at high frequencies and speech frequencies were 38.8% and 1.1%, respectively. Comparisons of the detection rates of elevated hearing thresholds across different frequencies between the left and right ears showed significant differences (all P<0.01); specifically, the detection rate at 4.0 kHz in the right ear was higher than that in the left ear (P<0.01). The detection rates of elevated hearing thresholds at 2.0, 4.0, and 6.0 kHz increased with longer duration of noise exposure (all P<0.05). Except at 1.0 kHz, the detection rates of elevated hearing thresholds at 0.5, 2.0, 3.0, 4.0, and 6.0 kHz showed increasing trends with age (all P<0.05). Conclusion Hearing loss among noise-exposed workers in the lithium battery manufacturing industry is predominant in the high-frequency type, with the highest sensitivity at 4.0 kHz and greater susceptibility in the right ear. The detection rate of high frequency hearing loss increases with longer noise exposure duration and advacing age. Health surveillance should focus on workers with longer noise exposure duration and older age. Noise control measures should be strengthened.

Increasing evidence has underscored the significance of post-stroke alterations along gut-brain axis, while its role in pathogenesis and treatment of ischemic stroke (IS) remains largely unexplored. This study aimed to elucidate the therapeutic effects and action targets of Panax notoginseng saponins (PNS) on IS and explore a novel pathogenesis and treatment strategy of IS via profiling the microbial community and metabolic characteristics along gut-brain axis. Our findings revealed for the first time that the therapeutic effect of PNS on IS was microbiota-dependent. Ischemia/reperfusion (I/R) modeling significantly down-regulated Lactobacilli in rats, and PNS markedly recovered Lactobacilli, particularly Lactobacillus reuteri (L.Reu). Metabolomics showed a significant reduction in serum histidine (HIS) in clinical obsolete IS patients and rehabilitation period I/R rats. Meanwhile, the L.Reu colonization in I/R rats exhibited significant neuroprotective activity and greatly increased HIS in serum, gut microbiota, and brain. Moreover, exogenous HIS demonstrated indirect neuroprotective effects through metabolizing to histamine. Notably, vagus nerve severance in I/R rats was performed to investigate HIS's neuroprotective mechanism. The results innovatively revealed that PNS could promote HIS synthesis in gut by enhancing L.Reu proportion, thereby increasing intracerebral HIS through peripheral pathway. Consequently, our data provided novel insights into HIS metabolism mediated by L.Reu in the pathogenesis and treatment of IS.

Chronic kidney disease (CKD) affects 8%-15% of the population globally and can cause renal failure, partly due to lack of effective treatments and drug targets. Three novel cembrane diterpenoids papyifurans A‒C (1-3), in particular of 1 with an unprecedented trioxatetracyclo[10.2.1.1^2,5.1^6,9]heptadecane polyether scaffold, derived from Boswellia papyrifera resin, were found to effectively protect against renal fibrosis in vitro and in vivo. Their structures were fully characterized using a combination of spectroscopic, computational, modified Mosher's, and X-ray crystallographic analysis. In particular, we performed chemical proteomic analyses and found that Elongation factor 2 (EEF2) is the key target of compound 1 for anti-renal fibrosis in vitro. Moreover, previous studies have linked EEF2 with lung fibrosis, while compound 1 was found to inhibit the hallmarks of organ fibrosis in vitro. Such effects were observed to decrease with the knock down of EEF2 in vitro, suggesting that EEF2 might be a universal drug target of organ fibrosis. Collectively, the present study demonstrated an example of identifying drug targets by using structurally novel natural products, which will be beneficial for developing therapeutic agents against organ fibrosis.

Objective:To observe the effects of Bushen Antai Mixture on nuclear transcription factor E2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1)/nuclear transcription factor-κB (NF-κB) in placental tissue of recurrent spontaneous abortion (RSA) mice.Methods:The CBA/J mice (female) and DBA/2 (male), CBA/J mice (female) and BALB/c (male) were caged at a ratio of 2 : 1 to establish RSA and normal pregnant mice, respectively. The next morning, the vaginal plug was found or the sperm was seen under the microscope as the successful modeling, which was counted as the first day of pregnancy. CBA/J×BALB/c mice were set as normal group, and the RSA model pregnant mice were divided into model group, progesterone group, and Bushen Antai Mixture low-, medium-, and high-dosage groups using a random number table method, with 6 mice in each group. The normal group and the model group were given distilled water by gavage. Bushen Antai Mixture low-, medium-, and high-dosage groups were given 3.9 g/kg, 11.7 g/kg and 23.4 g/kg Bushen Antai Mixture by gavage. The progesterone group was given progesterone capsule aqueous solution 26 mg/kg by gavage for 14 consecutive days. The embryo loss rate of mice was calculated. The pathological changes of placental tissues were observed by HE staining. The expressions of Nrf2, HO-1 and NF-κB protein and mRNA in placental tissues were detected by Western blot and RT-qPCR.Results:Compared with the model group, the embryo loss rate of mice in the Bushen Antai Mixture low-, medium-, and high-dosage groups and the progesterone group significantly decreased ( P<0.05, P<0.01); the pathological morphology of placental tissue improved; the expressions of Nrf2, HO-1 protein and mRNA in placental tissue significantly increased ( P<0.05, P<0.01), and the expression of NF-κB protein and mRNA significantly decreased ( P<0.05, P<0.01). Conclusion:Bushen Antai Mixture may may treat RSA by activating the Nrf2/HO-1 pathway, inhibiting NF - κB expression, and improving oxidative stress and inflammatory response in the placental tissue of RSA pregnant mice.

Objective To observe the effects of Bushen Antai Mixture on angiogenesis at the maternal fetal interface in recurrent spontaneous abortion(RSA)mice;To explore its mechanism in treating RSA based on the VEGF/Hippo/YAP pathway.Methods RSA mouse model and normal pregnancy mouse were constructed using Clark classic method.RSA model mice were randomly divided into model group,progesterone group,Bushen Antai Mixture low-,medium-and high-dosage groups,and normal pregnant mice were used as normal group,with 10 mice in each group.Starting from the first day of pregnancy,each medication group was given the corresponding medication by gavage for 15 days.The absorption rate of mouse embryos was calculated,the morphology of decidual tissue were observed by HE staining,the mRNA and protein expression of VEGF and Hippo/YAP pathway-related molecules of decidual tissue were detected by RT-qPCR and Western blot.Results Compared with the normal group,the absorption rate of embryos in the model group significantly increased(P<0.01),the arrangement of decidual tissue cells were disordered,edematous and degenerated,some nuclei disappeared,the vascular density decreased,the mRNA expressions of VEGF,Yes associated protein(YAP),large tumor suppressor factor(LATS)1 and LATS2 in decidual tissue significantly decreased(P<0.01),the protein expression of VEGF decreased(P<0.01),and the protein expressions of p-YAP/YAP and p-LATS/LATS significantly increased(P<0.01).Compared with the model group,the absorption rate of embryos in each dosage group of Bushen Antai Mixture was significantly reduced(P<0.05,P<0.01),the cells in the decidual tissue were arranged in an orderly manner,and edema degeneration was reduced,the mRNA expressions of VEGF,YAP,LATS1 and LATS2 in decidual tissue significantly increased(P<0.05,P<0.01),and the protein expression of VEGF significantly increased(P<0.05,P<0.01),the protein expressions of p-YAP/YAP and p-LATS/LATS decreased(P<0.05,P<0.01).Conclusion Bushen Antai Mixture can promote the expressions of VEGF,YAP,LATS by activating VEGF/Hippo/YAP signaling pathway,promote angiogenesis at the maternal-fetal interface,reduce the pregnancy loss rate,and play a therapeutic effect of RSA.

Objective:To compare the clinical efficacy and effects on cognitive function of magnetic seizure therapy (MST) and modified electroconvulsive therapy (MECT) in the treatment of major depressive episode (MDE).Methods:From January 1, 2019 to December 31, 2021, 40 patients who met the MDE diagnostic criteria in the fifth edition of the Diagnostic Statistical Manual of Mental Disorders (DSM-5) were selected in Shanghai Mental Health Center. Participants were randomly assigned to MECT therapy group (20 patients) and MST therapy group (20 patients) using the random number table method. Both groups received MECT or MST while using serotonin reuptake inhibitors (SSRIs), 3 times a week for 4 weeks. The 17-items Hamilton Depression Rating Scale (HAMD 17) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) were performed before and after treatment. HAMD 17 reduction rate and effective rate were the main assessment indicators, while RBANS total score and factor scores were considered as the secondary assessment indicators. T-test was used to compare the reduction rate of HAMD 17 between the two groups, and corrected Chi-square test or Fisher′s exact probability method was used to compare the effective rate of treatment between the two groups. HAMD 17 scores and RBANS scores before and after treatment were compared using two-factor repeated measure ANOVA. Results:There were no significant differences in baseline HAMD 17 scores and RBANS scores between 2 groups( t=0.29, P=0.773; t=0.67, P=0.509). The treatment effective rate in the MECT group was 90% (18/20), and the average reduction rate of HAMD 17 was 67.9%. Meanwhile, the effective rate of MST group was 75% (15/20), and the average reduction rate of HAMD 17 was 60.9%. There was no significant difference in the reduction rate and effective rate of HAMD 17 between the two groups ( t=0.69, P=0.493; χ2=0.16, P=0.693). The total scores and factor scores of RBANS after treatment were lower than those before treatment, with statistical significance(total scores: F=19.29, P<0.001;immediate memory score: F=6.22, P=0.020; language function score: F=9.13, P=0.006;attention score: F=5.23, P=0.031;delayed memory score: F=35.90, P<0.001). There was no significant difference in the total scores and factor scores of RBANS before and after treatment in MST group(total scores: F=0.49, P=0.490;immediate memory score: F=2.25, P=0.147;language function score: F=1.22, P=0.280;attention score: F=0.23, P=0.640;delayed memory score: F=0.02, P=0.887). Conclusions:The efficacy of MST treatment and MECT treatment in treating MDE patients seems to be comparable. MDE patients receiving MST had less impact on cognitive function compared to those treated with MECT.

As a physical treatment technique, modified electro-convulsive therapy (MECT) is used to treat mental and certain neurological disorders by causing seizures with short, suitable electrical currents applied to the brain while the patient is under general anesthesia and muscle relaxants. MECT is recognized for its therapeutic efficacy and clinical safety, rendering it one of the most prevalent interventions in psychiatric care. To enhance clinical outcomes and minimize adverse effects, this consensus document delineates the indications, therapeutic parameters, therapeutic procedures, potential adverse effects, and associated management strategies for MECT. These guidelines are informed by the latest clinical research and expert consensus, integrating evidence-based medicine methodologies. The objective is to furnish clinicians with precise operational guidelines and to advance the standardization of MECT practices in clinical settings.

Objective To explore the potential cross-sectional categories of health promotion behaviors in patients after PCI and analyze their influencing factors,so as to provide a reference for formulating targeted interventions to improve health promotion behaviors in patients after PCI.Methods A total of 242 patients who underwent PCI surgery in the Department of Cardiovascular Medicine of a tertiary hospital in Sichuan Province from February to May 2024 were selected by convenience sampling method.The general information questionnaire,the health promotion lifestyle scale,the health literacy scale for patients with chronic diseases,and the perceived social support scale were used to conduct the survey.The potential profile analysis of health promotion behaviors in patients after PCI was carried out,and the influencing factors were explored by univariate analysis and multiple logistic regression analysis.Results A total of 230 patients after PCI completed the study.The results of potential profile analysis showed that the health promotion behaviors of patients after PCI could be divided into three potential profiles:"low health promotion-poor behavior group"(n=71,30.9%),"medium health promotion behavior group"(n=53,23.0%),and"high health promotion-positive behavior group"(n=106,46.1%).Logistic regression analysis showed that medical payment methods,the number of chronic diseases,whether they had received chronic disease-related knowledge guidance,health literacy,and social support were the influencing factors of the potential profile of health promotion behaviors of patients after PCI(all P<0.05).Conclusion The health promotion behaviors of patients after PCI have obvious categorical characteristics.Nursing staff should formulate personalized intervention strategies according to the characteristics and influencing factors of each category,improve the health literacy and comprehension of social support of patients after PCI,and then improve their health promotion behaviors.