Objective:To investigate the expression characteristics and clinical significance of FOXC1 in colon cancer,and decipher its mo-lecular mechanism in regulating tumor cell proliferation and apoptosis.Methods:The GEPIA database was employed to analyze the expres-sion of FOXC1 and its correlation with prognosis in colon cancer.Differential expression of FOXC1 was detected by qRT-PCR and Western blot in colon cancer cells(HCT116 and SW620)and normal colon epithelial cells(NCM460),and stable FOXC1-knockdown(sh-FOXC1)cell lines were established.Western blot,flow cytometry,CCK-8,and plate colony formation assays were performed to analyze the effects of FOXC1 knockdown on cell proliferation,cell cycle,and apoptosis.Furthermore,the downstream signaling pathway was verified using Rap1 overexpression rescue experiments.Results:FOXC1 mRNA expression was significantly higher in colon cancer tissues than in normal tissues(P<0.001).FOXC1 overexpression was nearing significance in relation to tumor staging(P=0.053),and patients with high FOXC1 expression had a shorter overall survival(Log-rank P=0.013).After FOXC1 knockdown,the expression of CyclinD1 and Bcl-2 decreased,whereas the ex-pression of Bax increased(P<0.01).The proportion of cells in the G0/G1 phase increased,while the proportion of cells in the S phase de-creased(P<0.001),and the cell proliferation activity and number of colonies formed decreased(P<0.001).Mechanistic studies demonstrated that after FOXC1 knockdown,Rap1 expression was reduced,while the expression of Rap1GAP increased(P<0.05).After restoration of Rap1 expression in FOXC1-knockdown cells,the downregulation of CyclinD1 and Bcl-2 expression and the increase in Bax expression were re-versed(P<0.05),the S phase ratio was increased(P<0.05),and cell proliferation activity and colony formation abilities were also re-scued.Conclusion:FOXC1 promotes colon cancer progression by facilitating Rap1 expression and downregulating Rap1GAP.Targeted inter-vention of the FOXC1-Rap1 signaling axis may emerge as a potential therapeutic strategy.

Objective To investigate the efficacy and safety of tirofiban in the treatment of branch atheromatous disease(BAD)in elderly patients.Methods A retrospective analysis was conducted on 215 elderly BAD patients admitted to our department from June 2021 to June 2023.According to their treatment,they were divided into tirofiban group 1(55 cases)and control group 1(160 ca-ses).Using propensity score matching in a ratio of 1∶1 algorithm for adjustment,the differences in baseline features between the two groups were eliminated,and there were finally 53 cases in the tirofiban group 2 and 53 cases in the control group 2 after matching.The NIHSS scores before treatment and at 24 h and 7 d after treatment were collected.All of them were followed up for 90 d,and modified Rankin scale(mRS)was applied to evaluate the prognosis.Results The tirofiban group 1 had significantly lower NIHSS score at 24 h and 7 d after treatment and shorter length of hospital stay than the control group 1(P＜0.05,P＜0.01),so were in the tirofiban group 2 than the control group[3(1,4)vs 3(2,6),1(0,3)vs 1(1,4),8(6,10)d vs 9(8,11)d,P＜0.05].The proportion of mRS score ≤1 was obviously larger in the tirofiban group 1 than the control group 1(P＜0.01).The tirofiban group 2 obtained notably larger proportions of mRS score≤1 and≤2(71.7％vs 43.4％,P=0.003;79.2％vs 60.4％,P=0.034),and smaller proportion of mRS≥4(5.7％vs 20.8％,P=0.045)when compared with the control group 2.Logistic regression analysis indicated that in the patients without diabetes and those non-smoking,tirofiban was associated with increased good outcomes(OR=0.266,95％CI:0.090-0.788,P=0.017;OR=0.341,95％CI:0.107-0.931,P=0.046).Conclusion Tirofiban may effectively improve the clinical outcomes in the elderly BAD patients.But further randomized controlled trials are needed for verification.

This report described a case of hereditary thrombotic thrombocytopenic purpura (TTP) with neonatal onset. The infant presented with facial petechiae, jaundice, progressive thrombocytopenia, and persistent bleeding at puncture sites shortly after birth. Plasma ADAMTS13 activity was<1%. Whole-exome sequencing identified heterozygous variants in ADAMTS13: c.3121C>T and c.1869delT, inherited from the father and mother, respectively. The infant improved following exchange transfusion and phototherapy. Post-discharge, prophylactic fresh frozen plasma infusion was administered every 3-4 weeks. At the 2-year follow-up, no abnormalities were observed. This case highlights the importance of early recognition and intervention in neonates with unexplained thrombocytopenia, severe non-hemolytic jaundice, and anemia to ensure survival and improve prognosis.

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

Objective:To analyze the effect of zirconium-based pigments with different mass fractions on the colorimetric properties of fused deposition modeling (FDM) polyetheretherketone (PEEK) composites, and to investigate the feasibility of using these pigments for computer color matching of PEEK composites.Methods:Specimens were fabricated using FDM technology, comprising two control groups [Pure PEEK group, PEEK-TiO 2 group (PEEK compounded with 20% TiO 2)] and nine experimental groups based on the type of zirconium-based pigment (zirconium praseodymium yellow, zirconium iron red, zirconium vanadium blue) and mass fraction (0.1%, 0.5%, 1.0%). The experimental group specimens consisted of PEEK blended with 20% TiO 2 and the respective zirconium-based pigment. The spectral reflectance curve and chromaticity values of all specimens were measured using a spectrophotometer. The relationship between the chromaticity values of each colored PEEK composite in the experimental groups and the pigment mass fraction was determined. Shade guide tabs mimicking clinically used tooth shades were fabricated using a light-curing resin (Filtek Z350XT Body). The full-spectrum color matching method was employed to calculate the PEEK composite formulations (PEEK, 20% TiO 2, blends of the three zirconium-based pigments) required to match these target tooth shades. Verification group specimens based on these calculated recipes were then fabricated. The color difference between each verification group specimen and its corresponding target shade tab was calculated. Color differences between the target shade tabs and the two control groups (Pure PEEK, PEEK-TiO 2) were also calculated. Results:The spectral reflectance curves of PEEK composite specimens containing different types of zirconium-based pigments exhibited distinct characteristic features. The chromaticity values were significantly affected by the mass fraction of the same zirconium-based pigment. Based on computer color matching calculations, the color differences between the verification group specimens and the target shade tabs ranged from 1.59 to 14.55.Conclusions:This study demonstrates the feasibility of utilizing the three zirconium-based pigments (zirconium praseodymium yellow, zirconium iron red, zirconium vanadium blue) for full-spectrum computer color matching of PEEK-TiO 2 composites.

Objective:To investigate the association between different types of lung nodules and the risk of lung cancer in a population at high risk of lung cancer and to provide an epidemiologic basis for the comprehensive management of lung nodules.Methods:Using the free lung cancer screening program of low-dose CT (LDCT) in Wenling, Zhejiang Province, we collected baseline and imaging information of high-risk groups for lung cancer who underwent LDCT screening from April 2019 to October 2021 and patients with previous history of lung cancer, tuberculosis, pneumoconiosis, and silicosis were excluded. A total of 28 539 study subjects were included in the analysis, and the follow-up ended on 31 December 2023. Based on the characteristics of the detected pulmonary nodules, the study subjects were classified with no nodules, with solid nodules, with pure ground glass nodules, and with part solid nodules groups. The association between different characteristics of lung nodules and the risk of lung cancer development was analyzed using the Cox proportional hazard regression model with a new diagnosis of lung cancer during the follow-up period as the outcome.Results:The overall detection rate of lung nodules with a mean diameter of ≥3 mm was 76.5%, of which 53.7%, 18.2%, and 4.6% were detected in the solid nodule, pure ground glass nodule, and partially solid nodule groups, respectively. There were statistically significant differences between the different nodule groups in terms of age, gender, BMI, history of toxic exposure education level, smoking status, history of lung disease, and family history of lung cancer (all P<0.05). The median follow-up time of the study population was 3.4 years, and 485 new lung cancer cases were diagnosed during the follow-up period. After adjusting for covariates, the results of multifactorial Cox proportional hazard regression model analysis showed that the risk of lung cancer was higher in pure ground glass nodules and part solid nodules compared with solid nodules, with HR values (95% CI) of 1.89 (1.52-2.35) and 6.49 (5.18-8.14), respectively. The results of subgroup analysis showed that patients in the group of part solid nodules had the highest risk of lung cancer in all strata of the population, followed by patients with pure ground glass nodules. Patients in the solid nodule group who were older or had previous lung disease had a higher risk of lung cancer, and the risk of lung cancer in the part solid nodule group differed between genders. Conclusions:The proportion of lung nodules detected is high in the high-risk group of lung cancer, and among them, patients with pure ground glass and part solid nodules have a higher risk of developing lung cancer. Attention should be paid to the annual follow-up management for patients with solid nodules who are older or who have had lung diseases, as well as for female patients with part solid nodules.

Objective:To investigate the clinical outcomes of arthroscopic suture anchor fixation for acute bony Bankart lesions.Methods:Data of 49 patients with acute bone Bankart injury treated with suture anchor fixation under arthroscopy at the Affiliate Nanjing Drum Tower Hospital of Nanjing University School of Medicine from February 2019 to July 2024 were retrospectively analyzed, including 34 males and 15 females, aged 46.4±17.7 years (range, 18-81 years). Body mass index was 26.3±4.2 kg/m 2 (range, 19.8-37.9 kg/m 2). There were 17 patients with left shoulder and 32 patients with right shoulder. The time from injury to operation was 12.6±10.5 d (range, 1-50 d). CT three-dimensional reconstruction showed that the area of bone defect accounted for 20.1%±11.4% (range, 8%-49%) of the glenoid area. According to the degree of bone defect, there were 38 cases in the bone defect area ≤25% group and 11 cases in the bone defect area >25% group. All 49 patients received shoulder arthroscopic fixation with wire anchor. All 49 the patients were treated under shoulder arthroscopy using suture anchor technique. Using American Shoulder & Elbow Surgeon (ASES) score, University of California, Los Angeles (UCLA) score, Rowe score as well as shoulder range of motion to evaluate shoulder function. The position and healing of the fracture mass were evaluated with shoulder joint CT and three-dimensional reconstruction at immediate and final follow-up. Results:The incision healed in one stage and no infection occurred in all patients. All 49 patients were followed up for a period of 3 to 81 months, with an average follow-up of 23.8±20.2 months. At the final follow-up, the mean forward elevation, external rotation, and internal rotation improved from 126.1°±20.3°, 36.9°±14.0°, and 10±2 preoperatively to 167.1°±15.5°, 66.8°±8.3°, and 6±1 at the last follow-up, respectively ( P<0.05). At the final follow-up, the mean ASES score, UCLA score, and Rowe score were all significantly improved from 41.3±11.9, 14.2±6.1 and 46.9±14.7 preoperatively to 89.7±7.8, 31.5±3.6 and 92.4±7.4, respectively ( P<0.05). The differences between the final follow-up and preoperative values for forward elevation in the bone defect area >25% group and the bone defect area ≤25% group were 43°±20° and 41°±21°, respectively. The differences in lateral external rotation were 34°±8° and 29°±18°, while the differences in internal rotation (measured by hand-behind-back reach) were 5±2 and 4±2, respectively. None of these differences were statistically significant. The differences between the final follow-up and preoperative scores in the bone defect area >25% fracture fragment group and the bone defect area ≤25% group were as follows: ASES score, 50.9±14.4 vs. 47.7±12.8; UCLA score, 18.4±3.2 vs. 17.0±6.9; and Rowe score, 40.5±13.5 vs. 46.9±15.0. None of these differences were statistically significant. CT examination at the last follow-up showed that all fractures were healed, all patients in the bone defect area ≤25% group achieved good reduction, and 3 patients in the bone defect area >25% group had step-offs on the glenoid surface. Postoperative shoulder adhesion occurred in 5 patients, which was improved after intensive abduction and external rotation exercise. Conclusions:Arthroscopic suture anchor fixation is effective for the bone defect area ≤25% bony Bankart lesions, offering advantages of minimal invasiveness and rapid recovery. For lesions involving more than the bone defect area 25% of the glenoid surface, enhanced fixation strength is recommended to prevent fracture fragment displacement.

Objective:To analyze the epidemiological characteristics of severe fever with thrombocytopenia syndrome (SFTS) in Beijing in 2024, to investigate the infection status of reservoir hosts, vector organisms, and baseline human populations, and provide a scientific basis for formulating prevention and control strategies.Methods:Epidemiological surveys were conducted on all confirmed cases. Serum samples from healthy populations and reservoir hosts were collected for SFTSV antibody detection. Questing ticks were monitored using the flagging method. Real-time fluorescent quantitative PCR was employed to detect SFTSV in cases, reservoir hosts, and ticks. Positive samples underwent whole-genome sequencing and genetic evolution analysis.Results:In 2024, Beijing reported 15 locally infected cases with 4 deaths. The age of onset ranged from 50 to 80 years (median: 66 years). Cases showed a certain degree of geographical clustering, with June being the peak month of onset. The affected population was predominantly farmers, with a male-to-female ratio of 3∶2. Animal contact history emerged as a significant risk factor alongside tick bites. Parthenogenetic tick populations were identified in Pinggu district, while SFTSV-carrying ticks were detected in endemic areas (Mentougou, Shijingshan, and Fengtai Districts). Viral presence was also confirmed in ticks or dogs from non-endemic areas. Sequencing and phylogenetic analysis revealed stable clustering of strains into two distinct genotypes (A and B). Antibody-positive individuals were identified in healthy populations from non-endemic areas.Conclusions:The incidence of SFTS in Beijing is increasing, with natural viral circulation already established in non-endemic regions. Enhanced surveillance and adjusted prevention strategies are urgently needed.

Objective:To analyze the time to reach full enteral feedings (TFEF) among preterm infants with gestational age (GA)<32 weeks admitted to the neonatal intensive care unit (NICU) of Chinese Neonatal Network (CHNN).Methods:This was a retrospective analysis based on the database from the CHNN 89 participating centers between January 1 st, 2019 and December 31 st, 2022. All 16 155 preterm infants with a GA <32 weeks and a birth weight <1 500 g, admitted to the NICU within 24 h after birth, hospitalization for at least 7 d and achieved full enteral feedings before discharge were included. According to the birth weight, these infants were divided into extremely low birth weight (ELBW) group and very low birth weight (VLBW) group. The practice characteristics of TFEF across different GA, the severity of neonatal admission, the NICU interventions before reaching full enteral feeding, and relevant neonatal diseases were described. Mann-Whitney U tests or Kruskal-Wallis H tests was used for comparison between groups. Results:Among the 16 155 preterm infants with a GA <32 weeks, 8 505 case (52.6%) were male. The TFEF in 3 374 cases of ELBW groups was 32 (22, 46) d, 351 cases (10.4%) with TFEF ≤2 weeks, 1 050 cases (31.1%) with TFEF >2-4 weeks, 964 cases (28.6%) with TFEF >4-6 weeks, and 1 009 cases (29.9%) with TFEF >6 weeks. The TFEF in 12 781 cases of VLBW group was 22 (15, 32) d, 439 cases (3.4%) with TFEF ≤1 week, 2 565 cases (20.1%) with TFEF >1-2 weeks, 5 526 cases (43.2%) with TFEF >2-4 weeks, and 4 251 cases (33.3%) with TFEF >4 weeks. The TFEF was 36(23, 52) d of 625 preterm infants at a GA ≤25 weeks and 20 (13, 28) d of 2 606 preterm infants at a GA 31 weeks. Inborn infants had a shorter TFEF than those outborn infants and the infants with breast-fed achieved shorter than formula and mixed feeding both in ELBW and VLBW groups (all P<0.001). The earlier enteral feeding started, the shorter TFEF will be both in ELBW and VLBW groups (both P<0.001). The TFEF of preterm infants who were treated before full enteral feeding like peripherally inserted central catheters, and blood transfusions and blood product providers were all longer than those who were not treated (all P<0.001). The TFEF of preterm infants with complications like hemodynamically significant patent ductus arteriosus, necrotizing enterocolitis, late onset sepsis, severe retinopathy of prematurity and bronchopulmonary dysplasia were all longer than those without (all P<0.001). Conclusions:The distribution of TFEF in VLBW and ELBW has a large difference. The TFEF of preterm infants varies with different GA, treatment measures and complications. Further quality improvement is required to shorten TFEF.

Objective To investigate the status of population dynamics and distribution changes of Aedes aegypti in Guangdong Province.Methods Continuous monitoring was conducted from May 2018 to July 2024 in Wushi Town and Qishui Town,Leizhou City,Zhanjiang City,Guangdong Province.Additionally,a survey of the distribution of Ae.aegypti along the Leizhou Peninsula coast was carried out.Results The density of Ae.aegypti in Zhanjiang showed a gradual decline from 2018 to 2024.The last detection of adult Ae.aegypti in Wushi Town was in September 2021,and the last larva was found in October 2023.No Ae.aegypti was detected in Qishui Town during surveys from 2021 to 2024.A survey of 18 coastal villages in the Leizhou Peninsula revealed no detections of Ae.aegypti.Conclusions This study provides a basis for understanding the distribution and population density fluctuations of Ae.aegypti,assessing its invasion risk,and scientifically conducting relevant prevention and control efforts.