Objective: To understand the hydration status and related factors of rural boarding primary school students, so as to provide a scientific basis for drinking water health intervention for primary school students. Methods: In November 2023, a convenience sampling approach was employed to conduct a hydration status survey among 144 boarding students in grades 5 and 6 of a rural primary school in Guangxi. The Duplicate meal method and weighing method were utilized to measure the food derived water intake over three consecutive days. Urine osmolarity of students was measured on site for three days, and a simple physical examination was also carried out. A self administered questionnaire was used to investigate students drinking water literacy, daily water intake, and physical activity levels. Meanwhile, a drinking water literacy survey was conducted among 21 substitute teachers and 144 parents of the boarding students in grades 5 and 6. Logistic regression was used to identify factors associated with students hydration status. Results: The median daily total water intake of students was 2 043.55 mL, and 54.86% of the students did not reach the recommended Adequate Intake (AI). The median food derived water intake was 1 149.24 mL, accounting for 53.94% of the total water intake. Univariate analysis revealed that the daily drinking frequency, daily water intake, and food derived water intake of students were related factors of hydration status ( β =-1.60, -1.01, -0.00, all P <0.05). Multivariate Logistic regression analysis showed that primary school students with a daily drinking frequency of ≥7 times were more likely to maintain an adequate hydration status ( OR =0.28, 95% CI =0.09-0.93, P ＜0.05). Conclusions The water intake from food is the main source of water in the body for boarding primary school students in a certain rural school in Guangxi. Primary school students should increase their water intake frequency appropriately to maintain an adequate hydration status.

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by synovial inflammation, joint destruction, and functional impairment. Angiogenesis plays a key role in the pathological progression of RA with dysfunction of endothelial cells to promote synovial inflammation, sustain pannus formation, subsequently leading to joint damage. Colquhounia Root Tablets (CRT), a Chinese patent drug, has shown a satisfying clinical efficacy in treating RA, while the underlying mechanism by which CRT inhibits RA-associated angiogenesis remains unclear. In this study, we applied a research approach combining transcriptomic data analysis, bio-network mapping, and in vivo and in vitro experiments to explore the molecular mechanisms of CRT in suppressing angiogenesis in RA. Animal welfare and experimental procedures follow the regulations of the Animal Ethics Committee of Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Sciences (ratification number: IBTCMCACMS21-2307-06). Network analysis identified that key genes such as nucleotide-binding oligomerization domain-containing protein 2 (NOD2), SMAD family member 3 (SMAD3), and vascular endothelial growth factor A (VEGFA) significantly enriched in pathways related to NOD-like receptor signaling and VEGF signaling, indicating that CRT may inhibit angiogenesis by regulating vascular endothelial cell function with modulating angiogenesis-related pathways. In vivo data showed that CRT significantly reduced the positive expression of CD31 and VEGF in the ankle joint of adjuvant-induced arthritis (AIA) rats. In vitro data further confirmed that CRT effectively inhibited VEGF-induced migration, invasion, and tube formation in HUVECs, while significantly reduced the expression of angiogenesis-related factors VEGF/CD31/Ang-1, as well as the positive expression of VEGF and CD31 in HUVECs. Furthermore, CRT markedly decreased the protein expression of NOD2, VEGFA, and SMAD3. In conclusion, these findings indicate that CRT may inhibit the RA-related angiogenesis by targeting the NOD2/SMAD3/VEGF signaling axis to improve endothelial cell function, enriching the scientific connotation of CRT in inhibiting pathological angiogenesis in RA and also offer new insights for clinical prevention and treatment of RA.

ObjectiveTo investigate the prognostic role of radiotherapy in women aged 70 years or older with breast cancer. MethodsA total of 311 women aged 70 years or older with breast cancer undergoing breast-conserving surgery in the Second Affiliated Hospital of Nanchang University between February 28， 2011 and February 28， 2021， were divided into two groups： 183 patients in the control group were given postoperative radiotherapy， and 128 patients in the case group were not treated by radiotherapy. The nonparametric Mann-Whitney U test or χ² test was used to compare the general clinicopathological data of the two groups， the Kaplan-Meier method and log-rank test to analyze the disease-free survival （DFS） and overall survival （OS）， multivariate Cox proportional hazards regression model to examine the factors affecting DFS and OS. Additional subgroup analysis was performed. ResultsThere were no statistically significant differences between the control and case groups in age， T-stage， N-stage， tumor clinical stage， estrogen receptor （ER）， progesterone receptor （PR） and human epidermal growth factor receptor type 2 （HER2） statuses， Ki-67， tumor histological grade， tumor pathological type， and whether they received adjuvant chemotherapy or postoperative endocrine therapy （all P > 0.05）. The median follow-up was 110.0 （95%CI： 98.9， 121.1） months for the control group and 93.0 （95% CI： 86.1， 100.0） months for the case group. Differences between the two groups in DFS rate were significant （92.9% vs. 85.2%， P = 0.024）， but in OS rate insignificant （92.3% vs. 88.3%， P=0.199）. Multivariate Cox proportional hazards regression analysis showed that T-stage， N-stage （N2 and N3）， HER2 status， Ki-67， tumor histological grade （grade Ⅱ and Ⅲ）， and no radiotherapy were independent risk factors for DFS in elderly breast cancer patients （all P < 0.05）， while ER status was an independent protective factor （P < 0.05）. The independent risk factors for OS in elderly breast cancer patients included tumor stage， N-stage （N2 and N3）， HER2 status， and Ki-67 （all P < 0.05）， and ER status was an independent protective factor （P < 0.05）. Subgroup analysis revealed that in elderly hormone receptor （HR）-negative breast cancer patients， the median follow-ups of the control and case groups were 123.0 （95% CI： 116.8， 129.2） months and 88.0 （95% CI： 75.2， 100.8） months， respectively， with a statistically significant difference both in DFS （91.3% vs. 68.6%， P=0.008） and OS rates （89.1% vs. 71.4%， P=0.027）. ConclusionsPost-breast-conserving radiotherapy provides a limited survival benefit in the overall elderly breast cancer patients， but a significant survival benefit in the elderly HR-negative breast cancer patients， which suggests the need for a prospective randomized controlled trial of a stratified step-down strategy for radiotherapy in elderly breast cancer patients.

This study identified blood-entering components of Anshen Dropping Pills and explored their anti-insomnia effects and mechanisms. The main blood-entering components of Anshen Dropping Pills were detected and identified by UPLC-Q-TOF-MS/MS. The rationality of the formula was assessed by using enrichment analysis based on the relationship between drugs and symptoms, and core targets of its active components were selected as the the potential anti-insomnia targets of Anshen Dropping Pills through network pharmacology analysis. Furthermore, protein-protein interaction(PPI) network, Gene Ontology(GO) enrichment analysis, and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway analysis were performed on the core targets. An active component-core target network for Anshen Dropping Pills was constructed. Finally, the effects of low-, medium-, and high-dose groups of Anshen Dropping Pills on sleep episodes, sleep duration, and sleep latency in mice were measured by supraliminal and subliminal pentobarbital sodium experiments. Moreover, total scores of the Pittsburgh sleep quality index(PSQI) scale was used to evaluate the changes before and after the treatment with Anshen Dropping Pills in a clinical study. The enrichment analysis based on the relationship between drugs and symptoms verified the rationality of the Anshen Dropping Pills formula, and nine blood-entering components of Anshen Dropping Pills were identified by UPLC-Q-TOF-MS/MS. The network proximity revealed a significant correlation between eight components and insomnia, including magnoflorine, liquiritin, spinosin, quercitrin, jujuboside A, ginsenoside Rb_3, glycyrrhizic acid, and glycyrrhetinic acid. Network pharmacology analysis indicated that the major anti-insomnia pathways of Anshen Dropping Pills involved substance and energy metabolism, neuroprotection, immune system regulation, and endocrine regulation. Seven core genes related to insomnia were identified: APOE, ALB, BDNF, PPARG, INS, TP53, and TNF. In summary, Anshen Dropping Pills could increase sleep episodes, prolong sleep duration, and reduce sleep latency in mice. Clinical study results demonstrated that Anshen Dropping Pills could decrease total scores of PSQI scale. This study reveals the pharmacodynamic basis and potential multi-component, multi-target, and multi-pathway effects of Anshen Dropping Pills, suggesting that its anti-insomnia mechanisms may be associated with the regulation of insomnia-related signaling pathways. These findings offer a theoretical foundation for the clinical application of Anshen Dropping Pills.
Animals ; Drugs, Chinese Herbal/administration & dosage* ; Tandem Mass Spectrometry/methods* ; Sleep Initiation and Maintenance Disorders/metabolism* ; Mice ; Network Pharmacology ; Male ; Chromatography, High Pressure Liquid ; Humans ; Protein Interaction Maps/drug effects* ; Sleep/drug effects* ; Female ; Adult

Disruption of the intestinal mucosal barrier caused by gut dysbiosis and metabolic imbalance is the underlying pathology of inflammatory bowel disease (IBD). Traditional Chinese medicine Wuji Wan (WJW) is commonly used to treat digestive system disorders and showed therapeutic potential for IBD. In this interdisciplinary study, we aim to investigate the pharmacological effects of WJW against experimental colitis by combining functional metabolomics and gut-microbiota sequencing techniques. Treatment with WJW altered the profile of the intestinal microbiota and notably increased the abundance of Lactobacillus, thereby facilitating the conversion of tryptophan into indole-3-acetic acid (IAA) and indoleacrylic acid (IA). These indole derivatives activated the aryl hydrocarbon receptor (AhR) pathway, which reduced colonic inflammation and restored the expression of intestinal barrier proteins. Interestingly, the beneficial effects of WJW on gut barrier function improvement and tryptophan metabolism were disappeared in the absence of gut microbiota. Finally, pre-treatment with the AhR antagonist CH-223191 confirmed the essential role of IAA-mediated AhR activation in the therapeutic effects of WJW. Overall, WJW enhanced intestinal barrier function and reduced colonic inflammation in a murine colitis model by modulating Lactobacillus-IAA-AhR signaling pathway. This study provides novel insights into colitis pathogenesis and presents an effective therapeutic and preventive approach against IBD.

Pelvic organ prolapse (POP), whose etiology is influenced by genetic and clinical risk factors, considerably impacts women's quality of life. However, the genetic underpinnings in non-European populations and comprehensive risk models integrating genetic and clinical factors remain underexplored. This study constructed the first polygenic risk score (PRS) for POP in the Chinese population by utilizing 20 disease-associated variants from the largest existing genome-wide association study. We analyzed a discovery cohort of 576 cases and 623 controls and a validation cohort of 264 cases and 200 controls. Results showed that the case group exhibited a significantly higher PRS than the control group. Moreover, the odds ratio of the top 10% risk group was 2.6 times higher than that of the bottom 10%. A high PRS was significantly correlated with POP occurrence in women older than 50 years old and in those with one or no childbirths. As far as we know, the integrated prediction model, which combined PRS and clinical risk factors, demonstrated better predictive accuracy than other existing PRS models. This combined risk assessment model serves as a robust tool for POP risk prediction and stratification, thereby offering insights into individualized preventive measures and treatment strategies in future clinical practice.
Humans ; Female ; Pelvic Organ Prolapse/epidemiology* ; Middle Aged ; Risk Assessment/methods* ; China/epidemiology* ; Multifactorial Inheritance ; Aged ; Risk Factors ; Genome-Wide Association Study ; Genetic Predisposition to Disease ; Case-Control Studies ; Adult ; Polymorphism, Single Nucleotide ; Genetic Risk Score ; East Asian People

OBJECTIVE: Varied acupoint selections represent a potential cause of the uncertainty surrounding the efficacy of acupuncture for knee osteoarthritis (OA). Skin temperature, a guiding factor for acupoint selection, may help to address this issue. This study explored thermal sensitization of acupoints used for the treatment of knee OA. METHODS: This cross-sectional case-control study enrolled cases aged 45-75 years with symptomatic knee OA and age- and gender-matched non-knee OA controls in a 1:1 ratio. All participants underwent infrared thermographic imaging. The primary outcome was the relative skin temperature of acupoint (STA), and the secondary outcome was the absolute STA of 11 acupoints. The Z test was used to compare the relative and absolute STAs between the groups. Principal component analysis was used to extract the common factors (CFs, acupoint cluster) in the STAs. A general linear model was used to identify factors affecting the STA in the knee OA cases. For the group comparisons of relative STA, P < 0.0045 (adjusted for 11 acupoints through Bonferroni correction) was considered to indicate statistical significance. For other analyses, P < 0.05 was used as the threshold for statistical significance. RESULTS: The analysis included 308 participants, consisting of 151 cases (mean age: [64.58 ± 6.67] years; male: 25.83%; mean body mass index: [25.70 ± 3.16] kg/m²) and 157 controls (mean age: [63.37 ± 5.96] years; male: 26.11%; mean body mass index: [24.47 ± 2.84] kg/m²). The relative STAs of ST34 (P = 0.0001), EX-LE2 (P < 0.0001), EX-LE5 (P = 0.0006), SP10 (P < 0.0001), BL40 (P = 0.0012) and GB39 (P = 0.0037) were higher in the knee OA group. No difference was found in the STAs of ST35, ST36, SP9, GB33 and GB34. Four CFs were identified for relative STA in both groups. The acupoints within each CF were consistent between the groups. The mean values of the relative STAs across each CF were higher in the knee OA group. In the knee OA cases, no factors were observed to affect the relative STA, while age and gender were found to affect the absolute STA. CONCLUSION Among patients with knee OA, thermal sensitization occurs in the acupoints of the lower extremity, exhibiting localized and regional thermal consistencies. The thermally sensitized acupoints that we identified in this study, ST34, SP10, EX-LE2, EX-LE5, GB39 and BL40, may be good choices for the acupuncture treatment of knee OA. Please cite this article as: Tu JF, Wang XZ, Yan SY, Wang YR, Yang JW, Shi GX, Zhang WZ, Jing LN, Yang LS, Liu DH, Wang LQ, Mi BH. Thermal sensitization of acupoints in patients with knee osteoarthritis: A cross-sectional case-control study. J Integr Med. 2025; 23(3): 289-296.
Humans ; Osteoarthritis, Knee/physiopathology* ; Male ; Cross-Sectional Studies ; Middle Aged ; Female ; Acupuncture Points ; Case-Control Studies ; Aged ; Skin Temperature ; Acupuncture Therapy

Objective To analyze the influencing factors of feeding intolerance in the patients with se-vere traumatic brain injury(STBI).Methods The clinical data in 96 patients with STBI in this hospital from January 2023 to December 2023 were retrospectively analyzed.The patients were divided into the tolerance group and non-tolerance group according to whether the intolerance developed during the feeding process.The general condiction,laboratory detection,treatment measures and enteral nutrition implementation condition were recorded.The multivariate logistic regression was used to analyze the influencing factors of feeding intol-erance in STBI patients.Results Among 96 patients,43 cases(44.79％)developed the feeding intolerance.The results of univariate analysis showed that GCS score,blood glucose,serum albumin,starting time of en-teral nutrition,sedative drugs use,mechanical ventilation,antacids use,combined use of antibiotics,vasoactive drugs use,mild hypothermia therapy and prone position ventilation were related with the feeding intolerance in STBI patients.The multivariate logistic regression analysis showed that combined use of antibiotics(OR=43.628,P=0.002),use of vasoactive drugs(OR=140.211,P=0.004),delayed initiation of enteral nutrition(OR=44.529,P=0.009),mild hypothermia treatment(OR=439.599,P=0.001)and prone position venti-lation(OR=288.702,P=0.014)were the independent influencing factors of feeding intolerance in STBI pa-tients.Conclusion STBI patients are prone to develop the feeding intolerance.If there is no contraindication,the enteral nutrition should be initiated as early as possible,and the personalized prevention and treatment measures aiming at various influencing factors should be formulated.

Objective To investigate the feasibility of breast-conserving surgery(BCS)after neoadjuvant chemotherapy(NC)for triple-negative breast cancer(TNBC).Methods One hundred and thirty-two TNBC patients who were admitted to The Second Affiliated Hospital of Nanchang University from Jun.2014 to Jun.2017 were divided into NC group(62 patients who received NC followed by BCS)and control group(70 patients who received only conventional standard BCS).The response rate was calculated for patients in the NC group.The general clinicopathological data of the 2 groups were compared.The disease-free survival(DFS)of the 2 groups was analyzed using the Kaplan-Meier method,and the effect of NC followed by BCS on the DFS was analyzed using Cox proportional hazards regression method.Results The response rate of patients in the NC group was 96.8%(60/62).There were no differences in age,histological grade,axillary lymph node status or Ki67 index between the 2 groups(all P＞0.05),and the maximum tumor diameter after NC in the NC group was similar to that of the control group(P＞0.05).The ratio of intraventricular cancerous thrombus invasion cases was higher in the NC group than in the control group(P＜0.01).The 1-,3-,and 5-year DFS rates in the NC group were 100%(62 cases),93.5%(58 cases),and 69.4%(43 cases),respectively,with a mean of 55.5 months;the 1-,3-,and 5-year DFS rates in the control group were 100%(70 cases),95.7%(67 cases),and 72.9%(51 cases),respectively,with a mean of 55.6 months;and there was no difference in DFS between the 2 groups(P＞0.05).Cox proportional hazards regression analysis showed that BCS after NC was not a risk factor for DFS in patients with TNBC(hazard ratio=1.133,95%confidence interval 0.600-2.139,P=0.701).Conclusion The response rate to NC is high in TNBC patients,and the treatment strategy of BCS after NC is feasible.

Objective To explore the roles of transfer RNA-derived small RNAs(tsRNAs)in the oncogenesis and progression of lung adenocarcinoma by analyzing the differential expression of tsRNAs in lung adenocarcinoma and the relationship between the expression levels of tsRNAs in lung adenocarcinoma and the prognosis of patients in order to further screen and validate the tsRNAs associated with lung adenocarcinoma.Methods The differential expression of tsRNAs between lung adenocarcinoma tissues and normal tissues was analyzed based on the database of the Computational Medicine Center.The effects of tsRNAs expression levels on the prognosis of lung adenocarcinoma patients were analyzed based on the Cancer Genome Atlas(TCGA)database(TCGA-LUAD).The target genes were predicted based on TRFtarget2.0 and tRFTar databases.Gene ontology(GO)enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis were performed based on DAVID and KOBA KEGG online websites.The expression levels of target genes in lung adenocarcinoma tissues and normal tissues were analyzed based on the University of ALabama at Birmingham CANcer data analysis Portal(UALCAN)database.In vitro cell proliferation,migration,and invasion assays were performed to investigate the biological functions of tRF-19-69M8LOJX in lung adenocarcinoma cells.Results Compared with the normal tissues,tRF-19-69M8LOJX was up-regulated in lung adenocarcinoma tissues(log2FC=4.28,FDR＜0.05).High expression level of tRF-19-69M8LOJX was associated with shorter progression-free survival(HR=1.565,95％CI=1.142-2.145,P=0.005).And its overexpression promoted cell proliferation and migration(P＜0.001),and invasion(P=0.009)of A549 cells,and up-regulated COL1A1(P=0.002)and VCAN(P=0.022)significantly in the tRF-19-69M8LOJX overexpression cell model.Conclusion tRF-19-69M8LOJX is up-regulated in lung adenocarcinoma tissues.And its high expression is closely associated with poor prognosis.The tsRNA may play an important role in the pathogenesis and development of lung adenocarcinoma.