Breast cancer prevention and treatment have become major issues that urgently need to be addressed in the field of global public health. As a key pathological transitional stage in the progression of breast cancer， preneoplastic breast cancer （PBC） carries a significant risk of clinical transformation. Effective intervention in the progression of PBC is of great clinical significance in preventing the occurrence of breast cancer. Pathological studies have shown that abnormal angiogenesis is a key mechanism driving the transformation of PBC into breast cancer. Vascular endothelial growth factor （VEGF）， as a core regulatory molecule that promotes angiogenesis， plays a pivotal role in this process. The malignant transformation of PBC is closely associated with the abnormal activation of the VEGF-mediated pro-angiogenic network. Although modern medicine has achieved certain therapeutic effects through surgery and endocrine therapy， clinical limitations such as invasiveness， drug resistance， and adverse reactions still exist. Recent studies have demonstrated that the VEGF signaling system mediates the phosphatidylinositol 3-kinase-protein kinase B （PI3K/Akt） signaling pathway and the mitogen-activated protein kinase （MAPK） pathway. In addition， the hypoxia-inducible factor-1α （HIF-1α）/VEGF signaling pathway and the delta-like ligand 4 （DLL4）/Notch receptor 1 （Notch1） signaling pathway， together with other pathways， form a complex regulatory network that plays a central role in angiogenesis during PBC. Traditional Chinese medicine （TCM）， characterized by multi-component synergy， multi-pathway regulation， and high safety， demonstrates significant advantages in inhibiting pathological angiogenesis and blocking PBC progression by targeting the VEGF signaling pathway. From the perspective of VEGF pathway regulation， this paper systematically reviews the latest research progress on TCM in inhibiting angiogenesis and intervening in PBC， and discusses its mechanisms and application value in the early prevention and treatment of PBC， with the aim of providing references for optimizing clinical intervention strategies for PBC.

Objective： The aim of this study is to explore the predictive value of biparametric magnetic resonance imaging(bpMRI)for pelvic lymph node metastasis in prostate cancer patients with PSA≤20 μg/L and establish a nomogram. Methods： The imaging data and clinical data of 363 patients undergoing radical prostatectomy and pelvic lymph node dissection in the First Affiliated Hospital of Nanjing Medical University from July 2018 to December 2023 were retrospectively analyzed. Univariate analysis and multivariate logistic regression were used to screen independent risk factors for pelvic lymph node metastasis in prostate cancer, and a nomogram of the clinical prediction model was established. Calibration curves were drawn to evaluate the accuracy of the model. Results： Multivariate logistic regression analysis showed extrocapusular extension (OR=8.08,95%CI=2.62－24.97, P<0.01), enlargement of pelvic lymph nodes (OR=4.45,95%CI=1.16－17.11,P=0.030), and biopsy ISUP grade(OR=1.97,95%CI=1.12－3.46, P=0.018)were independent risk factors for pelvic lymph node metastasis. The C-index of the prediction model was 0.834, which indicated that the model had a good prediction ability. The actual value of the model calibration curve and the prediction probability of the model fitted well, indicating that the model had a good accuracy. Further analysis of DCA curve showed that the model had good clinical application value when the risk threshold ranged from 0.05 to 0.70.Conclusion： For prostate cancer patients with PSA≤20 μg/L, bpMRI has a good predictive value for the pelvic lymph node metastasis of prostate cancer with extrocapusular extension, enlargement of pelvic lymph nodes and ISUP grade≥4.
Humans ; Male ; Prostatic Neoplasms/diagnostic imaging* ; Lymphatic Metastasis ; Retrospective Studies ; Nomograms ; Prostate-Specific Antigen/blood* ; Lymph Nodes/pathology* ; Pelvis ; Predictive Value of Tests ; Prostatectomy ; Lymph Node Excision ; Risk Factors ; Magnetic Resonance Imaging ; Logistic Models ; Middle Aged ; Aged

Objective To evaluate the effect of donor gender on short-term survival rate of lung transplant recipients. Methods A retrospective analysis was conducted on the data of 1 066 lung transplant recipients. The log-rank test was used to evaluate the differences in short-term fatality among different donor gender groups and donor-recipient gender combination groups. Multivariate Cox regression, propensity score (PS) regression, and propensity score matching (PSM) were employed to control for confounding factors and further assess the differences in fatality. Subgroup analyses were also performed based on donor gender. Results Multivariate Cox regression analysis showed no statistically significant differences in fatality at 30 days, 1 year, 2 years and 3 years postoperatively between male and female donor groups (all P>0.05). After PS regression and PSM, univariate Cox regression analysis indicated that recipients from female donors had a higher fatality at 2 years postoperatively compared to those from male donors, with hazard ratios (95% confidence intervals) of 1.29 (1.01-1.65) and 1.36 (1.03-1.80) respectively. Multivariate Cox regression analysis also revealed no statistically significant differences in fatality at various follow-up time points among different donor-recipient gender combination groups (all P>0.05). Subgroup analyses based on donor sex showed no statistically significant differences in fatality among recipients of different gender within either male or female donor groups (all P>0.05). Conclusions Female donors may reduce the short-term postoperative survival rate of lung transplant recipients, but this negative impact is not sustainable in the long term. At present, there is no evidence to support the inclusion of sex as a factor in lung allocation rules.

19 cinnamamide/ester-triazole compounds were designed, synthesized and evaluated for their anti-Alzheimer's disease (AD) activity. Among them, compound 4f displayed excellent anti-β-amyloid protein (Aβ)-mediated cytotoxicity (EC₅₀ = 2.03 ± 2.45 μmol·L^-1) in APPswe cells and acetylcholinesterase inhibiton (IC₅₀ = 4.88 ± 4.70 μmol·L^-1). Further study indicated that, at dosages of (1, 5 and 25 mg·kg^-1), compound 4f was effective in improving spatial learning and memory deficits in Aβ_1-42-impaired mice, which was achieved by promoting the nonamyloidogenic signaling and inhibiting the amyloidogenic pathway, along with the suppression of Aβ-induced Tau phosphorylation. All animal experiments in this study were approved by the Experimental Animal Care and Use Committee of the Institute of Medicinal Biotechnology (IMB-20220908D701). In conclusion, compound 4f holds promise as a lead candidate for AD treatment, and the present study lays the foundation for its subsequent development.

Cancer cachexia is a complex syndrome caused by multiple factors,which seriously affects the quality of life and prognosis of patients.Its overall pathogenesis is related to the deficiency of spleen qi,insufficiency of kidney essence,internal generation of turbid toxins,and the obstruction of the production of qi,blood and essential qi,which cannot nourish the muscles and bones.Under the guidance of the dynamic diagnosis and treatment system of"spleen and kidney exhaustion as the root cause and internal accumulation of turbid toxins as the manifestation",the overall regulation is carried out from four dimensions:opening and closing the spleen and stomach,nourishing the kidney and promoting transportation,transforming turbid toxins and detoxification,and tonifying qi and nourishing yin.It has shown unique value in the intervention of cancer cachexia and can provide ideas and references for the clinical practice of TCM in treating cancer cachexia.

Objective:To develop a post competence assessment scale for nurses in the health management (physical examination) center and assess its reliability and validity.Methods:This study adopted an empirical approach. A total of 801 nurses from the health management (physical examination) center were recruited to participate in this study. A research team was formed in August 2024. This team transformed the previously constructed core competence evaluation index system for health management specialist nurses in the health management (physical examination) center (comprising 6 first-level indicators and 70 third-level indicators) into a preliminary post competence assessment scale. Seven experts evaluated the content validity of the scale. In September 2024, a pilot survey was conducted among 27 nurses from the health management (physical examination) center of Sichuan Provincial People′s Hospital using convenience sampling. From October to November 2024, the first main survey was administered to 385 nurses of health management (physical examination) center across 54 cities in China using both convenience sampling and snowball sampling methods, followed by exploratory factor analysis (EFA). Subsequently, utilizing the refined scale obtained after eliminating certain items, a second main survey was conducted among 389 nurses in the health management (physical examination) center, followed by a confirmatory factor analysis (CFA). The reliability of the final scale was assessed using Cronbach′s α coefficient, split-half reliability, composite reliability, and test-retest reliability.Results:The finalized scale for nurses′ post competency in health management (physical examination) center comprises five dimensions—basic nursing service competency, health management practice competency, knowledge integration competency, professional development competency, and professional attitude—with a total of 57 items. The item level content validity index (I-CVI) of the items of the content validity display scale ranged from 0.857 to 1.000, and the content validity index of each dimension ranged from 0.984 to 1.000. The scale-level Content Validity index/average (S-CVI/Ave) was 0.995. The contribution rate of the 6 factors extracted by EFA was 74.07%. After group discussion and CFA, the scale of the 5-factor structural equation model was constructed. The total Cronbach′s α coefficient of the scale was 0.986, the split-half reliability was 0.865, the composite reliability was 0.960-0.980, the total table test-retest reliability was 0.762, and the test-retest reliability of each dimension was 0.681-0.731.Conclusion:The developed assessment scale for assessing the post competence of nurses in the health management (physical examination) center demonstrates excellent reliability and validity.

Objective:To investigate the operation of water improvement projects in villages affected by drinking-water-borne endemic arsenic poisoning in Shaanxi Province, the arsenic level in both internal and external environments, the trend of disease development and patient management, and evaluate the effectiveness of prevention and control measures.Methods:From March to December 2023, in accordance with the requirements of the "Notice of the Office of Shaanxi Provincial Health Commission on Issuing the Monitoring Plan for Key Endemic Diseases such as Kashin-Beck Disease" and the "Monitoring Plan for Endemic Fluorosis and Arsenism in Shaanxi Province", all villages affected by drinking-water-borne arsenic disease were monitored. Water arsenic testing was carried out in accordance with the "Standard Test Methods for Drinking Water Inorganic Nonmetallic Indicators" (GB/T 5750.5-2006), and the evaluation of whether water arsenic exceeded the standard was conducted based on the "Sanitary Standards for Drinking Water" (GB 5749-2022). According to the "Diagnosis of Endemic Arsenism" (WS/T 211-2015), the arsenic poisoning status of all population in the disease affected areas was investigated. In 5 villages of 3 monitoring counties, 358 people were randomly selected to determine the urinary arsenic level, and the determination was made according to the "Safety Guideline Value of Urinary Arsenic for Human Population" (WS/T 665-2019). According to the "Notice of the National Health Commission on Issuing the Evaluation Measures for Control and Elimination of Key Endemic Diseases (2019 Edition)", elimination evaluation was conducted.Results:A total of 2 cities, 3 counties, 9 towns, and 13 endemic villages were monitored, with a water improvement rate of 100% (13/13), and all were operating normally. The arsenic level in residents' drinking water was < 0.01 mg/L. A total of 12 688 people were examined, and 338 cases of arsenic poisoning were detected, all of whom were historical cases. There were no new cases of arsenic poisoning or skin cancer patients. The geometric mean of urinary arsenic was 0.026 0 mg/L, which was lower than the safety guideline value of 0.032 mg/L for urinary arsenic in the population. All 338 existing arsenic poisoning patients had received family doctor contract services and implemented follow-up management. The drinking-water-borne endemic arsenic poisoning areas counties in Shaanxi Province have reached the elimination standard.Conclusions:The water improvement project in drinking-water-borne endemic arsenic poisoning areas in Shaanxi Province is operating normally. The arsenic content in both the internal and external environments of the population meets the standard. The condition is stable and no new cases have been detected. Follow up management has been implemented for all current cases. All affected counties have reached the elimination standard.

Objective:To investigate the role of Gasdermin E (GSDME) -mediated keratinocyte pyroptosis induced by Cutibacterium acnes ( C.acnes) in the pathogenesis of acne. Methods:The human immortalized keratinocyte HaCaT cells were stimulated with heat-inactived C.acnes for 15 minutes to 24 hours, and Western blot analysis was performed to determine the expression of cleaved GSDME (GSDME-NT) in HaCaT cells at different time points. Skin tissue samples were collected from 5 acne patients and 4 healthy controls, who visited the Hospital for Skin Diseases, Chinese Academy of Medical Sciences from January 2 to December 1, 2024; additionally, 3 samples of acne cyst contents and 3 samples of normal follicle contents were collected. Immunohistochemical study and Western blot analysis were conducted to determine GSDME-NT expression in the epidermis. Enzyme-linked immunosorbent assay (ELISA) was performed to detect levels of interleukin (IL) -1β and tumor necrosis factor (TNF) -α in acne cyst or normal follicle contents. GSDME-knockdown HaCaT cells were constructed by transfection with lentivirus carrying GSDME-shRNA, and HaCaT cells transfected with lentivirus carrying the nonsense sequence control (NC) served as controls; ELISA was performed to detect the levels of IL-1β and TNF-α in GSDME-knockdown HaCaT cells after C. acnes stimulation ( C. acnes + GSDME knockdown group) , as well as in the phosphate-buffered saline (PBS) + NC group, C. acnes + NC group, and PBS + GSDME knockdown group. Western blot analysis was conducted to determine the GSDME-NT expression in HaCaT cells pretreated with or without retinol after C. acnes stimulation. Results:The cleavage of GSDME in HaCaT cells began at 1 hour after in vitro C. acnes stimulation, and GSDME-NT could be detected at this time. Compared with the control epidermis, the proportion of GSDME-NT-positive HaCaT cells (9.34% ± 2.92% vs. 3.05% ± 1.14%, t = -3.47, P = 0.026) and GSDME-NT protein expression levels ( t = -3.51, P = 0.025) significantly increased in the lesional epidermis of acne patients. The levels of IL-1β and TNF-α were significantly higher in the acne cyst contents than in the normal follicle contents (IL-1β: 1 337.24 [1 182.32, 2 230.61] pg/ml vs. 0.00 [0.00, 108.21] pg/ml, Z = 1.99, P = 0.046; TNF-α: 811.31 [438.26, 817.73] pg/ml vs. 46.67 [12.41, 53.21] pg/ml, Z = 1.96, P = 0.049) . ELISA showed that the levels of IL-1β and TNF-α were significantly higher in the C. acnes + NC group (12.12 ± 3.07 pg/ml, 26.06 ± 1.57 pg/ml, respectively) than in the PBS + NC group (3.73 ± 2.24 pg/ml, 10.14 ± 0.79 pg/ml, P = 0.003, < 0.001, respectively) ; compared with the C. acnes + NC group, the levels of IL-1β and TNF-α significantly decreased in the C. acnes + GSDME knockdown group (3.38 ± 0.93 pg/ml, 12.67 ± 2.10 pg/ml, P = 0.003, < 0.001, respectively) . The GSDME-NT expression was significantly lower in the retinol + C. acnes group than in the C. acnes group ( P = 0.029) . Conclusion:C. acnes may induce GSDME-mediated pyroptosis in keratinocytes, thereby promoting the release of inflammatory factors and aggravating the inflammatory response in acne, while retinol may be able to inhibit this process.

Objective:To induce an experimental autoimmune encephalomyelitis(EAE)model by MOG-specific TCR trans-genic mice(2D2TCR transgenic mice),and to investigate effect of exogenous ERMAP on T cells in spleen of MOG35-55-induced 2D2TCR transgenic mice.Methods:EAE models were established in two groups of 2D2TCR transgenic mice(Control-Ig treatment for control group and ERMAP-Ig fusion protein treatment for experimental group),with 9 mice per group.Severity of spinal cord injury of MOG35-55-induced EAE in mice was assessed based on daily clinical scores(DAI),HE and LFB staining results;autoreactive T cells(CD4+Vα3.2+Vβ11+),T cell proliferation activation indicators CD69(CD4+Vα3.2+Vβ11+CD69+)and Ki67(CD4+Vα3.2+Vβ11+Ki67+),Treg(CD4+Vα3.2+Vβ11+CD25+Foxp3+)and Th17 cells(CD4+Vα3.2+Vβ11+IL-17A+)in spleen were detected by flow cytome-try;IL-17A,IL-6,IFN-γ and TGF-β expressions in spinal cord tissues were detected by qRT-PCR.Results:In MOG35-55-induced 2D2TCR transgenic mouse EAE model,ERMAP-Ig fusion protein treatment group showed milder inflammatory infiltration and demye-lination in spinal cord,decreased proportion of autoreactive T cells,decreased proportion of activated and proliferating T cells,increased proportion of Treg,inhibition of Th17 cell differentiation,less inflammatory cell aggregation and cytokine production,and increased expression of anti-inflammatory factors in spinal cord.Conclusion:ERMAP may be involved in development of EAE in 2D2TCR transgenic mice by inhibiting T cell proliferative activation and promoting Treg cell production.