The recombinant human thyroid-stimulating hormone (rhTSH) can be used for differentiated thyroid cancer (DTC) preparation before ¹³¹I therapy, and follow-up. Since its approval by the American Food and Drug Administration (FDA) in 1998, rhTSH has been clinically used in European countries, the United States, and other countries for nearly 30 years. In April 2024, China’s first independently developed rhTSH agent was approved. Based on clinical experience and evidence from domestic and international studies, an expert consensus on the application of rhTSH has been developed following thorough consultations among experts. The consensus offers evidence-based recommendations to guide the appropriate use of rhTSH in clinical practice.

Objective: The CT/MRI Liver Imaging Reporting and Data System (LI-RADS) demonstrates high specificity with relatively limited sensitivity for diagnosing hepatocellular carcinoma (HCC) in high-risk patients. This study aimed to explore the possibility of improving sensitivity by combining CT/MRI LI-RADS v2018 with second-line contrast-enhanced ultrasound (CEUS) LI-RADS v2017 using sulfur hexafluoride (SHF) or perfluorobutane (PFB). Materials and Methods: This retrospective analysis of prospectively collected multicenter data included high-risk patients with treatment-naive hepatic observations. The reference standard was pathological confirmation or a composite reference standard (only for benign lesions). Each participant underwent concurrent CT/MRI, SHF-enhanced US, and PFB-enhanced US examinations. The diagnostic performances for HCC of CT/MRI LI-RADS alone and three combination strategies (combining CT/ MRI LI-RADS with either LI-RADS SHF, LI-RADS PFB, or a modified algorithm incorporating the Kupffer-phase findings for PFB [modified PFB]) were evaluated. For the three combination strategies, apart from the CT/MRI LR-5 criteria, HCC was diagnosed if CT/MRI LR-3 or LR-4 observations met the LR-5 criteria using LI-RADS SHF, LI-RADS PFB, or modified PFB. Results: In total, 281 participants (237 males; mean age, 55 ± 11 years) with 306 observations (227 HCCs, 40 non-HCC malignancies, and 39 benign lesions) were included. Using LI-RADS SHF, LI-RADS PFB, and modified PFB, 20, 23, and 31 CT/MRI LR-3/4 observations, respectively, were reclassified as LR-5, and all were pathologically confirmed as HCCs. Compared to CT/MRI LI-RADS alone (74%, 95% confidence interval [CI]: 68%–79%), the three combination strategies combining CT/MRI LI-RADS with either LI-RADS SHF, LI-RADS PFB, or modified PFB increased sensitivity (83% [95% CI: 77%–87%], 84% [95% CI: 79%–89%], 88% [95% CI: 83%–92%], respectively; all P < 0.001), while maintaining the specificity at 92% (95% CI: 84%–97%). Conclusion The combination of CT/MRI LI-RADS with second-line CEUS using SHF or PFB improved the sensitivity of HCC diagnosis without compromising specificity.

Pancreatic cancer has emerged as one of the most challenging malignancies worldwide,with its high resistance to chemotherapy being the primary cause of treatment failure.Therefore,enhancing the chemosensitivity of pancreatic cancer has become a major focus of current research.In this study,we in-vestigated how Bufotaline,a bufadienolide extracted from the traditional Chinese medicine toad venom,exhibits its antitumor activity.Specifically,we explored the potential of Bufotaline to enhance the chemo-sensitivity of pancreatic cancer cells to Adriamycin and elucidated its underlying molecular mechanisms.Using CCK-8 and colony formation assays,we demonstrated that Bufotaline enhances the inhibitory effect of Adriamycin on the survival of pancreatic cancer cell lines Patu-8988T,Aspc-1,and Patu-8988S.No-tably,Bufotaline treatment reduced the IC50 of Adriamycin in drug-resistant pancreatic cancer cells to lev-els comparable to those in non-resistant cells.Results from Western blot,immunofluorescence,comet as-say,and TUNEL assays revealed that Bufotaline promotes Adriamycin-induced DNA damage in pancreatic cancer cells.RNA-seq analysis of Patu-8988T cells treated with Adriamycin alone or in combination with Bufotaline showed significant changes in gene expression,and qRT-PCR analysis further confirmed that Bu-fotaline downregulates the expression of DNA damage repair proteins NBS1 and RAD50.Moreover,Western blot analysis revealed that Bufotaline reduces the levels of DNA damage response repair proteins,and Im-munofluorescence experiments indicated that Bufotaline inhibits the activation of the ATM/CHK2 signaling pathway.Finally,in a subcutaneous xenograft mouse model,the combination of Adriamycin and Bufotaline treatment significantly suppressed pancreatic cancer cell growth.In conclusion,Bufotaline enhances Adria-mycin-induced chemosensitivity in pancreatic cancer cells;the combination of Adriamycin and Bufotaline downregulates the expression of DNA damage response repair proteins NBS1 and RAD50,and inhibits the ATM/CHK2-mediated DDR signaling pathway,thereby delaying DNA damage repair.

Objective To detect the characteristics of whole-brain functional changes in patients with subjective tinnitus(ST)after"frontal-temporal"dual-site repetitive transcranial magnetic stimulation(rTMS)by resting-state functional magnetic resonance imaging(rs-fMRI).Methods A total of 45 ST patients were enrolled,and assessments of tinnitus severity and rs-fMRI scans were performed before and 2 weeks after treatment with"frontal-temporal"dual-site rTMS.Regional homogeneity(ReHo),fractional amplitude of low-frequency fluctuations(fALFF),degree centrality(DC)and seed-based functional connectivity(FC)were analyzed before and after treatment in ST patients.Results Tinnitus handicap inventory(THI)score of ST patients 2 weeks after treatment was significantly decreased compared with that before treatment(P<0.001).ReHo values of the right inferior parietal lobule decreased,fALFF values of the right temporal pole increased,fALFF values of the right superior temporal gyrus decreased,and DC(weighted)and DC(Binarized)values of the right medial temporal gyrus all decreased in ST patients 2 weeks after treatment compared with those before treatment(P<0.05,GRF correction).Using the above differential brain regions as seed points for FC analysis,FC values between right superior temporal gyrus(fALFF)and right middle temporal gyrus reduced,FC values between right middle temporal gyrus[(DC(weighted)]and right superior occipital gyrus reduced,and FC values between right middle temporal gyrus[DC(Binarized)]and right superior occipital gyrus reduced 2 weeks after treatment compared with those before treatment(P<0.05,GRF correction).Conclusion"Frontal-temporal"dual-site rTMS is initially effective for ST patients,and the auditory and non-auditory brain regions of ST patients showed different degrees of regional and interbrain function changes,mainly involving default mode network and visual-auditory network.

AIM To compare the chemical constituents in traditional decoction and formula granule decoction of classical famous prescription Wendan Decoction.METHODS The HPLC fingerprints were established,after which the contents of adenosine,synephrine,liquiritin,naringin,hesperidin,6-gingerol and adenosine cyclophosphate were determined,cluster analysis,principal component analysis and multidimensional scaling analysis were adopted in the investigation of component differences,and the equivalent of formula granules was adjusted.RESULTS The similarities of HPLC fingerprints for 10 batches of traditional decoctions were higher than those of HPLC fingerprints for 9 batches of formula granule decoctions(P＜0.01).Adenosine,synephrine,liquiritin,hesperidin and cyclic adenosine monophosphate demonstrated higher contents in traditional decoctions than those in formula granule decoctions(P＜0.05),6-gingerol displayed lower content than that in the latter produced by manufacturers A,C(P＜0.05),which was higher than that in the latter produced by manufacturer B(P＜0.01).Various batches of traditional decoctions and formula granule decoctions could be obviously distinguished,adenosine,synephrine and hesperidin exhibited great influences on the classification of principal component analysis,and the quality of formula granule decoctions produced by manufacturer C was closer to that of traditional decoctions.After equivalent correction,the contents of various constituents in formula granule decoctions produced by manufacturers A,C showed no significant differences as compared with those in traditional decoction(P＞0.05).CONCLUSION The formula granules of Wendan Decoction from different manufacturers exist quality differences,so the preparation process and extraction process of this preparation should be optimized to improve quality,and equivalent ratio should be adjusted according to actual requirements to ensure its scientific and rational clinical application.

Objective:To compare the clinical efficacy between microscopic varicocelectomy and laparoscopic varicocelectomy in the treatment of varicocele(VC)with male infertility.Methods:A total of 307 patients who were diagnosed with VC complicated with male infertility and admitted to the Affiliated Hospital of Qingdao University from October 2018 to October 2022 were recruited for retrospective analysis.The patients were divided into the microscopic group(180 cases)and laparoscopic group(127 cases)according to the surgery method.The pre-and postoperative clinical data of these two groups were analyzed,including the degree of dilatation and reflux time of internal spermatic vein,hemodynamic parameters of testicular capsular artery,proportion of progressive motility spermato-zoa(PR),concentration of spermatozoa,proportion of normal morphology sperm,the pregnancy outcome of spouses and the incidence of complications related with surgery within 2 years postoperatively.Results:All the surgeries for the 307 patients in this study were successful.There was no significant difference in operation time,hospitalization time and management expenses between the microscop-ic group and the laparoscopic group(P＞0.05).Compared to the patients in laparoscopic group,the patients in the microscopic group received a better improvement in venous diameter,reflux time of spermatic veins and hemodynamic parameters of testicular capsular ar-tery(P＜0.05).Moreover,the semen analysis showed that the PR,spermatozoa concentration and proportion of normal morphology sperm in the microscopic group were also obviously increased than those in the laparoscopic group(P＜0.05).During the 2-year fol-low-up period,the conception rate of spouses in the microscopic group was 67.2％,while only 47.2％in the laparoscopic group,in which the difference was statistically significant(P＜0.05).Besides,the time-to-pregnancy(TTP)within 2 years postoperatively in the microscopic group was significantly shorter than that in the laparoscopic group(P＜0.05).Meanwhile,the incidence of adverse pregnancy outcomes in the microscopic group was also significantly lower than that in the laparoscopic group(P＜0.05).It is worth mentioned that the spontaneous conception rate of spouses with successful pregnancy in the microscopic group was also significantly higher than that in the laparoscopic group(P＜0.05).Severe complication such as testicular atrophy,bleeding and infection did not appear in both of two groups.However,the incidences of testicular hydrocele and recurrence of VC postoperatively in the laparoscopic group were significantly higher than those in the microscopic group(P＜0.05).Conclusion:Both microscopic varicocelectomy and laparoscopic varicocelectomy can be applied to the management of VC combined with male infertility.But microscopic varicocelectomy showed better clinical efficacy in improving the testicular hemodynamic parameters,semen quality,pregnancy outcome and postopera-tive complications,which is worthy of further clinical applications.

Berberine is a kind of isoquinoline alkaloid extracted from the roots and rhizomes of many medicinal plants,such as Coptis chinensis of Ranunculus family,Phellodendron chinensis of rutaceae family,and Berberine Sanacanthus family.In recent years,with the deepening of research,berberine has shown re-markable prevention and treatment effect in a variety of neuro-psychiatric disease models.This paper summarizes the research progress of berberine in neuropsychiatric diseases and provides theoretical support for further clinical prevention and treatment of neuropsychiatric diseases.

Objective To explore the potential categories of health risk behaviors among students aged 11 to 18 years in Minhang District,Shanghai in order to identify the influencing factors of health risk behaviors among different categories of students.Methods Using stratified cluster sampling techniques,a random selection of 1 690 middle school students from Minhang District,Shanghai,were chosen as the study sample.Data was collected using the"Shanghai Adolescent Health-Related Behavior Survey Questionnaire"to assess participants'scores on six categories of health risk behaviors.Latent profile analysis(LPA)was employed to cluster students'health risk behaviors,and a multifactorial Logistic regression model was used to analyze the related influencing factors.Results The health risk behaviors of students aged 11 to 18 in Minhang District,Shanghai,were categorized into 3 groups:Class 1,comprising 915 students(54.14%),with moderate to low scores in health risk behaviors,named"the group with moderately low levels of various health risk behaviors";Class 2,comprising 539 students(31.89%),with higher scores in psychological addiction,named"the group with psychological addiction as the prominent health risk behavior";Class 3,comprising 236 students(13.97%),with higher scores in substance addiction,named"the group with substance addiction as the prominent health risk behavior".The results of the univariate analysis for the three potential categories of student health risk behaviors show that there are statistically significant differences in the 3 potential categories of health risk behaviors among students of different schools,ages,ethnicities,and boarding situations(P<0.05).The analysis results of the multivariate Logistic regression indicate that compared to junior high school students,both senior high school students and vocational high school students have a higher risk of exhibiting unhealthy behaviors characterized by psychological addiction and substance addiction,with all differences being statistically significant(P<0.05).Conclusion The latent profile analysis reveals three distinct categories of health risk behaviors among students aged 11 to 18 years in Minhang District,Shanghai,with significant distribution differences among students from diverse backgrounds.Consequently,it is recommended that tailored health education and intervention measures be implemented for students with different school characteristics and at various educational stages.

The incidence of non-alcoholic fatty liver disease(NAFLD)has been increasing annually.Current primary treatment strategies involve dietary modifications and increased physical activity to allevi-ate symptoms,yet there is a notable lack of targeted pharmacological interventions.Members of the micro RNA-29(miR-29)family(miR-29a,miR-29b,miR-29c)are known to play a critical regulatory role in lipid metabolism within hepatocytes;however,the underlying mechanisms remain to be elucidated.This study aims to identify the target genes and associated signaling pathways of the miR-29 family,thereby providing potential therapeutic targets for the development of NAFLD treatments.Firstly,the human liver cell line HepG2 was utilized as a model for adipogenic induction,and miR-29a/b/c-3p mimics were indi-vidually transfected.Through methods such as Oil Red O staining and triglyceride(TG)quantification,it was observed that the miR-29 family members significantly inhibited lipid accumulation in hepatocytes(P＜0.05).Subsequently,qRT-PCR and Western blot were utilized to detect the expression levels of ad-ipogenic marker genes(fatty acid synthase(FAS),acetyl coa carboxylase(ACACA),stearoyl-coen-zyme a desaturase 1(Scd 1))and autophagy marker genes(sequestosome 1(SQSTM1,also known as p62),autophagy related gene 5(Atg5)),and the results indicated that the members of the miR-29 fam-ily could significantly suppress the expression of FAS,ACACA,Scd1,and p62 genes in hepatocytes,while significantly enhancing the level of the Atg5 gene.Further investigations using signaling pathway activity analysis and dual luciferase reporter assays confirmed that the miR-29a/b/c could suppress the mTOR signaling pathway activity and directly interact with the ten-eleven translocation 2(TET2)gene.Finally,co-transfection experiments were performed to examine the potential synergistic effects among the miR-29-3p family members,and the results demonstrated that co-transfection of miR-29 family members more effectively inhibited lipid droplet accumulation in HepG2 cells and further suppressed the expression of the target gene TET2 compared to individual transfection.In summary,the miR-29 family members may reduce lipid accumulation in hepatocytes by inhibiting the mTOR signaling pathway via the TET2 gene,and they exhibit a positive synergistic effect.

AIM To compare the chemical constituents in traditional decoction and formula granule decoction of classical famous prescription Wendan Decoction.METHODS The HPLC fingerprints were established,after which the contents of adenosine,synephrine,liquiritin,naringin,hesperidin,6-gingerol and adenosine cyclophosphate were determined,cluster analysis,principal component analysis and multidimensional scaling analysis were adopted in the investigation of component differences,and the equivalent of formula granules was adjusted.RESULTS The similarities of HPLC fingerprints for 10 batches of traditional decoctions were higher than those of HPLC fingerprints for 9 batches of formula granule decoctions(P＜0.01).Adenosine,synephrine,liquiritin,hesperidin and cyclic adenosine monophosphate demonstrated higher contents in traditional decoctions than those in formula granule decoctions(P＜0.05),6-gingerol displayed lower content than that in the latter produced by manufacturers A,C(P＜0.05),which was higher than that in the latter produced by manufacturer B(P＜0.01).Various batches of traditional decoctions and formula granule decoctions could be obviously distinguished,adenosine,synephrine and hesperidin exhibited great influences on the classification of principal component analysis,and the quality of formula granule decoctions produced by manufacturer C was closer to that of traditional decoctions.After equivalent correction,the contents of various constituents in formula granule decoctions produced by manufacturers A,C showed no significant differences as compared with those in traditional decoction(P＞0.05).CONCLUSION The formula granules of Wendan Decoction from different manufacturers exist quality differences,so the preparation process and extraction process of this preparation should be optimized to improve quality,and equivalent ratio should be adjusted according to actual requirements to ensure its scientific and rational clinical application.