Background and purpose:Approximately 30%of patients with metastatic colorectal cancer(CRC)develops pulmonary metastasis,yet less than 10%are eligible for surgical resection.Radiofrequency ablation(RFA)serves as an alternative therapy for non-surgical candidates,but the relationship between its efficacy and tumor diameter remains controversial.This study aimed to investigate the impact of tumor size on survival outcomes and local progression risk in CRC patients with pulmonary metastasis after RFA,and to validate the clinical utility of a 3 cm threshold for prognosis.Methods:This retrospective study included CRC patients with pulmonary metastasis who underwent RFA at Fudan University Shanghai Cancer Center between January 2016 and December 2024.Patients were stratified into two groups based on maximum lesion diameter:≤3 cm(Small group)and 3-5 cm(Large group).Patient inclusion criteria:⑴ pathologically confirmed lung metastases originating from CRC,with metastases limited to the lungs or extra-pulmonary metastatic lesions having been radically treated;⑵ maximum lesion diameter<5 cm;⑶complete clinical data available;⑷ complete imaging data available,including computed tomography(CT)images during ablation and contrast-enhanced CT images during postoperative follow-up;⑸ follow-up time of at least＞6 months after RFA;⑹ technical complete ablation;⑺ fewer than 3 pulmonary metastatic lesions.Exclusion criteria:⑴ target lesions previously treated with local therapies such as RFA or radiotherapy;⑵ patients unable to tolerate RFA;⑶ patients with follow-up time＜6 months after RFA.Three senior interventional physicians performed percutaneous RFA under guidance of a 64-slice spiral CT scanner.Chest contrast-enhanced CT scans obtained 1 month after RFA were used as the baseline,followed by contrast-enhanced CT scans every 3 months for 1 year,then every 6 months for subsequent follow-up.This study was approved by the medical ethics committee of Fudan University Shanghai Cancer Center(ethical approval number:2108241-11).Primary endpoints included overall survival(OS),progression-free survival(PFS),and local tumor progression(LTP).Kaplan-Meier analysis and multivariate COX regression were employed to evaluate the independent prognostic value of tumor size.Results:A total of 134 patients who met the inclusion criteria were ultimately enrolled,including 77 in the Small group and 57 in the Large group.With a median follow-up of 35 months,the≤3 cm group demonstrated superior 1-,3-,and 5-year OS rates(100.0%,95.1%,74.2%)compared to the 3-5 cm group(94.7%,36.8%,27.0%,P＜0.0001),and the≤3 cm group demonstrated superior 1-,3-,and 5-year PFS rates(90.9%,34.4%,23.3%)compared to the 3-5 cm group(13.8%,0.0%,0.0%,P＜0.000 1).The≤3 cm group also exhibited significantly lower 1-,3-,and 5-year LTP rates(0.0%,19.7%,33.6%)compared to the 3-5 cm group(46.0%,75.5%,75.5%,P＜0.000 1).Multivariable analysis identified tumor diameter＞3 cm as an independent predictor of worse OS[hazard ratio(HR)=6.49,95%CI:3.18-13.24,P＜0.001],while elevated preoperative carcinoembryonic antigen(CEA)(≥5 ng/mL)correlated with shorter OS(HR=1.82,P=0.033).Conclusion:CRC patients with pulmonary metastasis and tumor diameters of 3-5 cm exhibited significantly inferior survival outcomes after RFA compared to the≤3 cm group.A tumor diameter of 3 cm can serve as a critical threshold for selecting RFA indications,and combining preoperative CEA levels can optimize patient stratification.

OBJECTIVE To explore the clinical efficacy of the Yushen Yangluan Formula in treating diminished ovarian reserve(DOR)with kidney essence deficiency based on mitochondrial energy metabolism and oxidative stress.METHODS A total of 70 pa-tients diagnosed with DOR due to kidney essence deficiency,who visited the gynecology department of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine from September 2023 to June 2024,were selected.The patients were randomly divided into two groups according to the random number table method.The treatment group(35 cases)received the Yushen Yangluan Formula,while the control group(35 cases)received a Chinese herbal placebo,with treatment lasting for 3 months,and during the treatment pe-riod,one case dropped out from each group.Antral follicle count(AFC),traditional Chinese medicine(TCM)syndrome scores,and serum levels of anti-Mullerian hormone(AMH),follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),re-active oxygen species(ROS),and adenosine triphosphate(ATP)levels were compared between the two groups.RESULTS After treatment,the TCM syndrome scores for kidney deficiency in both groups decreased compared to before treatment(P<0.05,P<0.01),with the experimental group showing greater improvement than the control group(P<0.01).Following treatment,the FSH levels in the experimental group decreased compared to before treatment(P<0.05),while AMH levels increased(P<0.05),and the antral follicle count(AFC)also increased significantly(P<0.01),with the experimental group outperforming the control group(P<0.05,P<0.01).After treatment,serum ROS levels in the experimental group decreased(P<0.01),and ATP levels increased(P<0.01),with the experimental group showing superior results compared to the control group(P<0.01).CONCLUSION Yushen Yangluan Formu-la can improve the ovarian function and TCM syndrome score of patients with DOR of kidney essence deficiency type,which may be re-lated to improving mitochondrial energy metabolism and reducing oxidative stress.

Background and purpose:Approximately 30%of patients with metastatic colorectal cancer(CRC)develops pulmonary metastasis,yet less than 10%are eligible for surgical resection.Radiofrequency ablation(RFA)serves as an alternative therapy for non-surgical candidates,but the relationship between its efficacy and tumor diameter remains controversial.This study aimed to investigate the impact of tumor size on survival outcomes and local progression risk in CRC patients with pulmonary metastasis after RFA,and to validate the clinical utility of a 3 cm threshold for prognosis.Methods:This retrospective study included CRC patients with pulmonary metastasis who underwent RFA at Fudan University Shanghai Cancer Center between January 2016 and December 2024.Patients were stratified into two groups based on maximum lesion diameter:≤3 cm(Small group)and 3-5 cm(Large group).Patient inclusion criteria:⑴ pathologically confirmed lung metastases originating from CRC,with metastases limited to the lungs or extra-pulmonary metastatic lesions having been radically treated;⑵ maximum lesion diameter<5 cm;⑶complete clinical data available;⑷ complete imaging data available,including computed tomography(CT)images during ablation and contrast-enhanced CT images during postoperative follow-up;⑸ follow-up time of at least＞6 months after RFA;⑹ technical complete ablation;⑺ fewer than 3 pulmonary metastatic lesions.Exclusion criteria:⑴ target lesions previously treated with local therapies such as RFA or radiotherapy;⑵ patients unable to tolerate RFA;⑶ patients with follow-up time＜6 months after RFA.Three senior interventional physicians performed percutaneous RFA under guidance of a 64-slice spiral CT scanner.Chest contrast-enhanced CT scans obtained 1 month after RFA were used as the baseline,followed by contrast-enhanced CT scans every 3 months for 1 year,then every 6 months for subsequent follow-up.This study was approved by the medical ethics committee of Fudan University Shanghai Cancer Center(ethical approval number:2108241-11).Primary endpoints included overall survival(OS),progression-free survival(PFS),and local tumor progression(LTP).Kaplan-Meier analysis and multivariate COX regression were employed to evaluate the independent prognostic value of tumor size.Results:A total of 134 patients who met the inclusion criteria were ultimately enrolled,including 77 in the Small group and 57 in the Large group.With a median follow-up of 35 months,the≤3 cm group demonstrated superior 1-,3-,and 5-year OS rates(100.0%,95.1%,74.2%)compared to the 3-5 cm group(94.7%,36.8%,27.0%,P＜0.0001),and the≤3 cm group demonstrated superior 1-,3-,and 5-year PFS rates(90.9%,34.4%,23.3%)compared to the 3-5 cm group(13.8%,0.0%,0.0%,P＜0.000 1).The≤3 cm group also exhibited significantly lower 1-,3-,and 5-year LTP rates(0.0%,19.7%,33.6%)compared to the 3-5 cm group(46.0%,75.5%,75.5%,P＜0.000 1).Multivariable analysis identified tumor diameter＞3 cm as an independent predictor of worse OS[hazard ratio(HR)=6.49,95%CI:3.18-13.24,P＜0.001],while elevated preoperative carcinoembryonic antigen(CEA)(≥5 ng/mL)correlated with shorter OS(HR=1.82,P=0.033).Conclusion:CRC patients with pulmonary metastasis and tumor diameters of 3-5 cm exhibited significantly inferior survival outcomes after RFA compared to the≤3 cm group.A tumor diameter of 3 cm can serve as a critical threshold for selecting RFA indications,and combining preoperative CEA levels can optimize patient stratification.

OBJECTIVE To explore the clinical efficacy of the Yushen Yangluan Formula in treating diminished ovarian reserve(DOR)with kidney essence deficiency based on mitochondrial energy metabolism and oxidative stress.METHODS A total of 70 pa-tients diagnosed with DOR due to kidney essence deficiency,who visited the gynecology department of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine from September 2023 to June 2024,were selected.The patients were randomly divided into two groups according to the random number table method.The treatment group(35 cases)received the Yushen Yangluan Formula,while the control group(35 cases)received a Chinese herbal placebo,with treatment lasting for 3 months,and during the treatment pe-riod,one case dropped out from each group.Antral follicle count(AFC),traditional Chinese medicine(TCM)syndrome scores,and serum levels of anti-Mullerian hormone(AMH),follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),re-active oxygen species(ROS),and adenosine triphosphate(ATP)levels were compared between the two groups.RESULTS After treatment,the TCM syndrome scores for kidney deficiency in both groups decreased compared to before treatment(P<0.05,P<0.01),with the experimental group showing greater improvement than the control group(P<0.01).Following treatment,the FSH levels in the experimental group decreased compared to before treatment(P<0.05),while AMH levels increased(P<0.05),and the antral follicle count(AFC)also increased significantly(P<0.01),with the experimental group outperforming the control group(P<0.05,P<0.01).After treatment,serum ROS levels in the experimental group decreased(P<0.01),and ATP levels increased(P<0.01),with the experimental group showing superior results compared to the control group(P<0.01).CONCLUSION Yushen Yangluan Formu-la can improve the ovarian function and TCM syndrome score of patients with DOR of kidney essence deficiency type,which may be re-lated to improving mitochondrial energy metabolism and reducing oxidative stress.

Objective:To construct the impact factor model of primary traditional Chinese medicine (TCM) health management service quality, and put forward corresponding policy suggestions.Methods:In this cross-sectional study, the typical sampling and random sampling method were used to select 39 insiders of primary TCM health management service from 15 communities in Zhejiang Province from August to October in 2022. Interviews on service projects, implementation effects and impact factors were conducted, the three-level coding of interview record was carried out using the grounded theory research method, a model of impact factor for health management service quality of basic TCM was constructed, and the corresponding policy recommendations were put forward.Results:Based on the open coding of 39 original interview data, a total of 516 reference points were obtained, and 53 initial concepts related to the topic were formed and summarized into 17 first-level categories. Through the summary of main axis coding, 6 main categories of “policy environment”，“health literacy”，“community orientation”，“capacity building”，“health preference” and “conflict of interest” were extracted. The logical correlation between the six main categories were analyzed with selective coding, an impact factor model was constructed in accordance with the story line of factors affecting service quality. The story line of this model was as follows: first, the policy environment was the external guarantee of community TCM service quality; second, as the demand-side of the services, the health literacy and requirement of residents was the regulatory factor for service quality; in addition, the community played the role of the supply-side of the services, the service ability construction was the key factor, and the community functions and target orientation was the internal driving factor, meanwhile, the internal/external conflicts of interest had a negative constraint on the service quality.Conclusions:The guarantee intensity of external policy environment is limited, the service demand side pays insufficient attention, and the service supply side functions are absent at the present stage. It is necessary to improve the external policy environment, deepen the connection between supply and demand sides in the field of TCM health service, promote the capacity building of TCM service at the grass-roots level, balance the interests of relevant departments of TCM service, in order to improve the quality of TCM health management service at the grass-roots level.

Objective To study the mechanism of Puerariae Radix in the treatment of ischemic stroke by using molecular docking technology. Methods The small molecules of Puerariae Radix based on molecular docking technology docked with 21 key targets protein of cerebral ischemic stroke, and multi-component protein target network was established by Cytoscape 3.1.1 software. Results Through virtual screening of molecular docking technology, 28 active small molecules of Puerariae Radix were chosen, 12 of which were novel small molecules, and it identified that 11 of those compounds had strong interactions with no less than 10 targets. Conclusion The molecular docking can be used to find the active components of Puerariae Radix in treatment of cerebral ischemic stroke, which provide a new reference of studying on the multiple ingredients and targets of Chinese materia medica compounds.

Objective To evaluate the diagnostic value of diffusion tensor imaging(DTI)and diffusion kurtosis imaging(DKI)in marchiafava bignami disease(MBD)of chronic alcoholism.The ROC curve was used to analyze the diagnostic significance of each parameter (FA,ADC and MK values).Methods Sixty-eight patients with chronic alcoholism were enrolled in this study,sixty normal middle-aged people were selected as the control group.The ROC curves of differentparameters in the diagnosis of chronic alcoholism were drawn,after whichthe thresholds were determined to evaluate the clinical significance of FA,ADC and MK values in the diagnosis of the disease.Results The FA and MK values of patients with chronic alcoholism were found to be significantly lower than those of the normal control group(P<0.01).ROC curve analysis showed that the critical values for the FA,ADC and MK parameters were 0.274,5.55 and 0.874,respectively.Conclusion Compared with the ADC and MK parameters,FA parameter has a high clinical significance in the diagnosis of MBD.

Objectives To explore the route of ESBL producing bacteria in neonatal faeces, and to investigate the gene and drug resistance of ESBL producing bacteria in intestinal tract of neonates. Methods Fecal samples of healthy newborns and their mothers were collected, and bacterial cultures were carried out using selective ESBL medium. The positive strains were identified by Time-of-flight mass spectrometry. ESBL genotyping and resistance gene detection were performed by whole genome sequencing technique. Results In 146 neonatal fecal specimens, the positive rate of ESBL producing bacteria was 8.90％,and the positive rate in the first time stool was 3.23％. Seventy-two hours after birth, the positive rate of fecal ESBL producing bacteria was 13.10％. Among the 13 ESBL producing strains, there were 9 strains of CTX type, 3 strains of TEM type and 1 strain of SHV type. Nine strains of CTX include five types such as CTX-M-24, CTX-M-18, CTX-M-27, CTX-M-42 and CTX-M-15. The positive rate of ESBL producing bacteria was 21.6％ in 167 mothers' fecal specimens. The ESBL genotype included 24 strains of CTX type, 6 strains of TEM type, 4 strains of SHV type and 2 strains of QnrS type. Twenty-four strains of CTX include CTX-M-24, CTX-M-14, CTX-M-18, CTX-M-27, CTX-M-42 and CTX-M-15. There were 2 or 3 ESBL genotypes in 12 maternal and neonatal specimens. It was detected to have 6 types of resistance gene such as aadA5, strA, strB, sul1, sul2 and dfrA17 in 49 strains of ESBL producing bacteria in maternal and neonatal strains. Resistance genes were exactly the same in the neonates as in mothers who were detected to have ESBL producing bacteria. A variety of resistance genes were detected in feces in 7 neonates and 23 mothers. Conclusions The neonates in hospital may be detected to have ESBL produing bacteria in the intestinal tract at the same time as their mothers or separately. However, there are many ways for neonates to have ESBL producing bacteria in intestinal tract. There are many genotypes and resistance genes of ESBL producing bacteria.

Objective To provide the scientific basis prevention of HIV infection in clinic,we studied the infection status and tendency of HIV among outpatients and inpatients in a large teaching hospital of southwest China.Methods From 2008 to 2013,the third generation Merieux enzyme-linked immunosorbent method of antibody or the fourth generation Roche electrochemiluminescence immunoassay were adopted in 644208 clinic patients for HIV antibody screening.The original detection method and Livzon enzyme-linked immunosorbent method of antibody were used for re-detection,and the positive specimens were sent to the local Center for Disease Control and Prevention or West China Hospital HIV confirmation laboratory for confirmation using western blot assay.Results A total of 1917 patients (0.30％) were confirmed as HIV-1 antibodies positive,of which,599 cases were outpatients (0.75％),1318 cases were inpatients (0.23％).These patients were mainly distributed in the department of outpatient service,department of infection center,department of dermatology,department of pneumology,department of integrated Chinese and western medicine.1917 including 1534 male cases and 383 female cases,most of HIV positive patients were distributed in young adults (1383 cases).Patients living with HIV were mainly infected through heterosexual transmitted route (1228 cases),an increasing trend of proportion of Homosexual transmission was noticed.Conclusion Rate of HIV infection was increasing year by year.Heterosexual transmission is the main way to spread and homosexual transmission gradually increased.Medical staff should enhance consciousness of self-protection,reduce hospital-acquired infection due to occupational exposure,avoid occurrence of medical dispute.National health education on HIV knowledge should be popularized.

GPCR proteins represent the largest family of signaling membrane proteins in eukaryotic cells. Their importance to basic cell biology, human diseases, and pharmaceutical interventions is well established. Many crystal structures of GPCR proteins have been reported in both active and inactive conformations. These data indicate that agonist binding alone is not sufficient to trigger the conformational change of GPCRs necessary for binding of downstream G-proteins, yet other essential factors remain elusive. Based on analysis of available GPCR crystal structures, we identified a potential conformational switch around the conserved Asp2.50, which consistently shows distinct conformations between inactive and active states. Combining the structural information with the current literature, we propose an energy-coupling mechanism, in which the interaction between a charge change of the GPCR protein and the membrane potential of the living cell plays a key role for GPCR activation.
Binding Sites ; GTP-Binding Proteins ; chemistry ; genetics ; metabolism ; Humans ; Hydrogen Bonding ; Membrane Potentials ; Models, Molecular ; Protein Conformation ; Receptors, G-Protein-Coupled ; chemistry ; genetics ; metabolism ; Signal Transduction