Breast cancer (BC) is a female malignant tumor with high incidence rate worldwide, and its disease burden continues to grow. Previous studies have demonstrated that there is a close association between changes of glucolipid metabolism indicators and risk of BC. Abnormal glucolipid metabolism may affect the occurrence and development of breast cancer by mediating chronic inflammatory states, affecting signaling pathways, promoting oxidative stress, affecting sex hormone levels and their biological activities, and driving endocrine dysfunction in adipose tissue. This paper systematically reviews the relationship between glucolipid metabolism indicators and risk of BC, aiming to point out the direction for further research on the relationship between glucolipid metabolism and BC, and to provide a reference basis for breast cancer risk assessment, early diagnosis, and prevention and treatment strategies.

Objective: To understand the current status and associated factors of sleep problems among preschool children in Hainan Province, so as to provide scientific evidence for improving sleep health in this population. Methods: From January 2021 to June 2022, a total of 4 105 preschool children aged 3-6 years from 62 kindergartens in Hainan Province were selected using stratified cluster random sampling method. Demographic information and lifestyle habits were collected through the Hainan Province Child Growth and Development Survey Questionnaire. The Children s Sleep Habits Questionnaire (CSHQ) was employed to assess sleep status. Unconditional binary Logistic regression model was applied to investigate the associated factors of sleep problems among preschool children. Results: The overall CSHQ score for children was 58.03±18.84, with 80.95% of preschool children exhibiting sleep related issues. The top three most prevalent sleep problem domains were bedtime resistance (72.42%), sleep anxiety ( 54.88 %), and parasomnias (38.86%). Logistic regression analysis revealed that higher family annual income ( OR=0.60, 95%CI = 0.45-0.79), higher maternal education level ( OR=0.53, 95%CI =0.32-0.89), regular or daily vitamin D supplementation ( OR=0.77, 95%CI =0.60-0.99), and fully self initiated eating behavior ( OR=0.71, 95%CI =0.59-0.85) were negatively related with children s sleep problems; in addition, screen exposure ( OR=1.27, 95%CI =1.06-1.51) and picky eating ( OR= 1.47 , 95%CI =1.21-1.78) were positively related to children s sleep problems (all P <0.05). Conclusion The high detection rate of sleep problems among preschool children in Hainan Province is multifactorially associated with family environment, dietary habits, and lifestyle behaviors.

ObjectiveTo investigate the mechanism by which Anmei Dan （AMD） regulates recombinant sirtuin 3/nuclear factor erythroid 2-related factor 2（SIRT3/Nrf2） signaling to ameliorate mitochondrial oxidative stress and improve the cognitive function in aged sleep-deprived mice. MethodsSixty aged C57 mice were randomly assigned to a control group， a model group， a melatonin （1.3 mg·kg^-1·d^-1） group， and high-， medium-， and low-dose （26.26， 13.13， 6.565 g·kg^-1·d^-1， respectively） AMD groups， with ten mice per group. Continuous sleep deprivation was administered for 4 weeks via a custom-built sleep deprivation chamber. The cognitive function of mice was assessed via the Morris water maze test. Hematoxylin-eosin （HE） staining was performed to observe morphological alterations in pyramidal neurons. Biochemical assays were carried out to measure the hippocampal and serum levels of superoxide dismutase （SOD）， malondialdehyde （MDA）， glutathione peroxidase （GSH-Px）， catalase （CAT）， and total antioxidant capacity （T-AOC）. Transmission electron microscopy was adopted to examine mitochondrial pathological alterations in the hippocampus. Immunohistochemical assay was conducted to examine the expression of nuclear factor E₂-related factor 2 （Nrf2）， sirtuin 3 （SIRT3）， peroxisome proliferator-activated receptor gamma coactivator-1α （PGC-1α）， mitochondrial transcription factor A （TFAM）， and brain-derived neurotrophic factor （BDNF） in the mouse hippocampus. The protein levels of Nrf2， SIRT3， heme oxygenase-1 （HO-1）， and NAD（P）H：quinone oxidoreductase 1 （NQO1） in mouse hippocampal tissue were determined by Western blot. Immunofluorescence double labeling was employed to determine the protein levels of SIRT3/Nrf2 in mouse hippocampal tissue. ResultsCompared with the control group， the model group exhibited prolonged latency to navigate， increased total swimming distance， reduced number of platform crossings， and shortened time spent in the target quadrant （P<0.05， P<0.01）， disorganized morphology and arrangement of hippocampal neurons， with increased damaged mitochondria， mitochondrial swelling， reduced cristae， and vacuolization， declined levels of SOD， GSH-Px， CAT， and T-AOC and elevated levels of MDA in the hippocampus and serum （P<0.01）， and downregulated protein levels of SIRT3， Nrf2， PGC-1α， TFAM， BDNF， HO-1， and NQO1 （P<0.01）. Compared with the model group， the melatonin group and AMD groups exhibited shortened spatial navigation latency， reduced total swimming distance， increased number of platform crossings， and prolonged activity time in the target quadrant （P<0.05， P<0.01）， reduced neuronal damage and mitochondrial damage in the hippocampal tissue， declined level of MDA and elevated levels of SOD， GSH-Px， CAT， and T-AOC in the hippocampus and serum （P<0.05， P<0.01）， and upregulated protein levels of SIRT3， Nrf2， PGC-1α， TFAM， BDNF， HO-1， and NQO1 in the hippocampus （P<0.05， P<0.01）. ConclusionAMD may improve the learning and memory in aged sleep-deprived mice by mediating mitochondrial oxidative damage through the SIRT3/Nrf2 signaling pathway.

ObjectiveTo investigate whether Anmei Dan （AMD） improves cognitive function and alleviates circadian rhythm disorders in an aged mouse model of sleep deprivation by inhibiting the erythropoietin-producing hepatocellular receptor A4 （EphA4）/Eph receptor-interacting protein A3 （EphrinA3） signaling pathway and its downstream Ras homolog family member A （RhoA）/Rho-associated coiled-coil containing protein kinase （ROCK） signaling， and to analyze its multi-target regulatory characteristics. MethodsAn aged C57 mouse model of sleep deprivation was established by the modified multiple platform water environment method. The mice were randomized into blank， model， rhynchophylline （Rhy， antagonist， 50 mg·kg^-1·d^-1）， and antagonist plus AMD （26.26 g·kg^-1·d^-1） groups. Spontaneous activity was assessed by the open field test， and circadian rhythm activity was monitored. Hematoxylin-eosin （HE） staining and Nissl staining were conducted to observe neuronal morphology in the hippocampal CA1/CA3 regions. Western blot and immunofluorescence assay were employed to determine the protein levels of EphA4， EphrinA3， Neuronal Nuclei Antigen （NEUN）， glial fibrillary acidic protein （GFAP）， phosphorylated （p）-EphA4， RhoA， Rho-associated coiled-coil containing protein kinase 1 （ROCK1）， Rho-associated coiled-coil containing protein kinase 2 （ROCK2）， brain-derived neurotrophic factor （BDNF）， synaptophysin （SYN）， postsynaptic density protein 95 （PSD95）， and growth-associated protein 43 （GAP43）. The mRNA levels of EphA4 and EphrinA3 were determined by real-time PCR. ResultsCompared with the blank group， the model group showed decreased spontaneous activity （P<0.01）， circadian rhythm disruption （P<0.01）， hippocampal neuron disarrangement and reduced Nissl bodies， upregulated protein levels of EphA4， EphrinA3， NEUN， p-EphA4， RhoA， ROCK1， ROCK2， and GFAP （P<0.01）， and downregulated protein levels of NEUN， BDNF， SYN， PSD95， and GAP43 （P<0.01）. Compared with the model group， both the antagonist group and the antagonist plus AMD group showed recovery in the above indicators （P<0.05， P<0.01）， with the combination group outperforming the antagonist group in behavioral， pathological， and molecular expression aspects （P<0.05， P<0.01）. ConclusionAMD can alleviate cognitive and rhythm disorders caused by sleep deprivation by inhibiting the EphA4/EphrinA3 signaling pathway and its downstream RhoA/ROCK signaling， and upregulating the expression of synapse-related proteins such as BDNF. Its combination with an EphA4 antagonist exhibits a synergistic effect， which suggests that the mechanism involves multi-link synergistic intervention.

ObjectiveTo investigate the effects of Anmei Dan （AMD） on the expression of proteins in the C-X3-C motif chemokine ligand 1 （CX3CL1）/C-X3-C chemokine receptor 1 （CX3CR1） signaling pathway， hippocampal inflammation， and learning and memory in an aged sleep-deprived model. MethodsSixty aged C57 mice were randomly assigned into a control group， a model group， a melatonin group （1.3 mg·kg^-1·d^-1）， and high-， medium-， and low-dose AMD groups （26.26， 13.13， 6.565 g·kg^-1·d^-1， respectively）， with 10 mice per group. Continuous sleep deprivation was administered for 4 weeks through a custom-built sleep deprivation chamber. The cognitive function of mice was assessed via the Y-maze test. Histomorphological alterations in pyramidal cells of the hippocampal CA1 and DG regions were examined by hematoxylin-eosin （HE） and Nissl staining. Synaptic morphology in the hippocampus was visualized with Golgi staining. Enzyme-linked immunosorbent assay （ELISA） was employed to measure the levels of inflammatory cytokines interleukin-1β （IL-1β）， interleukin-6 （IL-6）， and tumor necrosis factor-α （TNF-α） in the hippocampal tissue as well as the level of interleukin-10 （IL-10） in the prefrontal cortex. Real-time PCR was performed to detect markers of M1-type ［cluster of differentiation （CD） 86 and inducible nitric oxide synthase （iNOS）］ and M2-type ［CD206 and arginase 1 （Arg1）］ macrophages. Western blot was employed to quantify the protein levels of CX3CL1， CX3CR1， phosphorylated nuclear factor κB p65 subunit （p-NF-κB p65）， and phosphorylated p38 mitogen-activated protein kinase （p-p38 MAPK） in the hippocampus. Immunofluorescence double staining was performed to co-label CX3CR1 with ionized calcium-binding adapter molecule 1 （Iba-1） for observation of the co-localization of target proteins with microglia. ResultsCompared with the control group， the model group exhibited disrupted daily activity patterns with reduced spontaneous alternation rates （P<0.01）， disorganized morphology and arrangement of hippocampal neurons， accompanied by reduced numbers of Nissl bodies and dendritic spines （P<0.01）， upregulated protein levels of IL-6， IL-10， IL-1β， TNF-α， CX3CL1， CX3CR1， p-NF-κB p65， p-p38 MAPK， and Iba-1 and mRNA levels of CD86 and iNOS （P<0.01）， and downregulated mRNA levels of CD206 and Arg1 （P<0.05，P<0.01）. Compared with the model group， the melatonin group and medium- and high-dose AMD groups showed increased spontaneous alternation rates （P<0.01）， improved neuronal morphology， number， and spine density in the hippocampal CA1 and DG regions （P<0.01）， declined levels of IL-6， IL-10， IL-1β， and TNF-α （P<0.05， P<0.01）， downregulated protein levels of CX3CL1， CX3CR1， p-NF-κB p65， p-p38 MAPK， and Iba-1 and mRNA levels of CD86 and iNOS， and upregulated mRNA levels of CD206 and Arg1 （P<0.01）. ConclusionAMD may improve the learning and memory in aged sleep-deprived mice by mediating neuroinflammation through the CX3CL1/CX3CR1 signaling pathway.

Objective To synthesize qualitative studies on the experiences of postoperative lung cancer patients participating in pulmonary rehabilitation,aiming to comprehensively understand the barriers and facilitators influencing their engagement and to provide evidence-based insights for improving rehabilitation adherence.Methods Qualitative studies were retrieved from databases including Web of Science,PubMed,Cochrane Library,Embase,CNKI,Wanfang Data,VIPand Sinomed,with a search period spanning from database inception to January,2025.The methodological quality of eligible studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research.Extracted findings were mapped and synthesized using the Theoretical Domains Framework(TDF)and the Capability-Opportunity-Motivation-Behavior mode(COM-B).Results Ultimately,a total of 11 studies were included,yielding 48 findings.Using the Theoretical Domains Framework(TDF)and COM-B model,facilitators and barriers to pulmonary rehabilitation in postoperative lung cancer patients were mapped and consolidated into 14 categories,culminating in 2 synthesized findings.Conclusion Participation in pulmonary rehabilitation among postoperative lung cancer patients is influenced by multiple factors.Clinicians should develop patient-centered pulmonary rehabilitation plans by considering these factors and incorporating patients' attitudes and perspectives.

Objective To explore the relationship between serum levels of glycoprotein fibroglycan(SRGN)and secretory CD146(sCD146)and clinicopathological characteristics and prognosis in elderly pa-tients with breast cancer(BC).Methods A total of 128 elderly BC patients treated in the hospital from April 2019 to April 2021 were retrospectively selected as the BC group,and another 70 healthy elderly women were selected as the control group.The serum SRGN and sCD146 levels in BC group and control group,and patients with different clinical and pathological characteristics in BC group were compared.Kaplan-Meier curve and COX regression were used to analyze the effect of serum levels of SRGN and sCD146 on the prognosis of eld-erly BC patients.Receiver operating characteristic curve was used to analyze the predictive value of serum lev-els of SRGN and sCD146 for the prognosis of elderly BC patients.Results The levels of serum SRGN and sCD146 were(13.17±3.35)μg/L,(118.23±20.51)ng/L in the BC group,which were higher than(2.52±0.41)μg/L,(20.03±4.16)ng/L in the control group(t=26.460,39.572,both P<0.001).Compared with elderly BC patients with TNM stage Ⅰ-Ⅱ and histological grade Ⅰ-Ⅱ,serum SRGN and sCD146 levels in elderly BC patients with TNM stage Ⅲ and histological grade Ⅲ were higher(P<0.05).The 3-year progres-sion free survival rates in SRGN high and low expression groups were 66.13%(41/62)and 92.42%(61/66),respectively,and the 3-year progression free survival rate in SRGN high expression group was lower than that in SRGN low expression group(Log Rank χ2=14.180,P<0.001).The 3-year progression free survival rates in sCD146 high and low expression groups were 68.85%(42/61)and 89.55%(60/67),respectively,and the 3-year progression free survival rate in sCD146 high expression group was lower than that in sCD146 low ex-pression group(Log Rank χ2=8.614,P=0.003).TNM stage Ⅲ,histological grade Ⅲ,serum SRGN and sCD146 were risk factors for the poor prognosis of elderly BC patients.The area under the curve(AUC)of the combination of serum SRGN and sCD146 for predicting the prognosis of elderly BC patients was 0.850,which was larger than that of SRGN(AUC=0.798)and sCD146(AUC=0.771)alone(Z=2.057,2.217,P=0.042,0.029).Conclusion Serum levels of SRGN and sCD146 are elevated in elderly BC patients,and both are in-volved in the disease progression of BC.The combination of the two factors has high predictive value for the prognosis of elderly BC patients.

Objective To investigate the predictive value of heparin-binding protein(HBP)in Kawasaki disease complicated with bacterial infection.Methods A total of 148 children with Kawasaki disease in this hospital from April 2021 to June 2022 were selected as Kawasaki disease group.According to the results of pathogen detection during hospitalization,the children were divided into three subgroups:Mycoplasma pneu-moniae group(36 cases),bacteria group(19 cases),and non-infection group(93 cases).In addition,35 chil-dren with fever and upper respiratory tract infection were randomly selected as the case control group.HBP and other inflammatory markers[white blood cell count(WBC),neutrophil percentage(NE％),procalcitonin(PCT),C reactive protein(CRP),interleukin-6(IL-6)]in each group were detected and analyzed.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of HBP and PCT for bacterial infection in children with Kawasaki disease.Results The levels of HBP,WBC,NE％,CRP and IL-6 in the Ka-wasaki disease group were significantly higher than those in the case control group(P＜0.05),while there was no significant difference in PCT level between the two groups(P＞0.05).The levels of HBP,WBC,NE％,PCT,CRP and IL-6 in children with Kawasaki disease after treatment were significantly lower than those at admission(P＜0.05).The levels of HBP and PCT in the bacterial group were higher than those in the Mycoplasma pneumoniae group and the non-infection group,and the differences were statistically signifi-cant(P＜0.05),while there were no statistically significant differences in WBC,NE％,CRP and IL-6 levels a-mong the three groups(P＞0.05).ROC curve results showed that the area under the curve(AUC)and 95％CI of HBP for predicting bacterial infection in children with Kawasaki disease was 0.77(0.68-0.86),when HBP was 499.65 ng/mL,the sensitivity and specificity were 84.2％and 66.7％,respectively.When PCT was 0.85 ng/mL,the AUC(95％CI)for predicting bacterial infection in children with Kawasaki disease was 0.65(0.52-0.78),and the sensitivity and specificity were 63.2％and 65.9％,respectively.Conclusion HBP is associated with Kawasaki disease,and it has certain predictive value for Kawasaki disease complicated with bacterial infection.

Objective To explore the clinical effect of stereotactic body radiotherapy(SBRT)combined with dendritic cell-cytokine-induced killer cell(DC-CIK)immunotherapy in the treatment of centrally-located locally advanced non-small cell lung cancer(LA-NSCLC).Methods A total of 113 patients with centrally-located LA-NSCLC admitted from January 2022 to March 2024 were divided into the observation group(n=56)and the control group(n=57)by using the random number table method.The observation group was treated with SBRT combined with DC-CIK immunotherapy,while the control group was treated with SBRT.The clinical efficacy of the two groups after treatment,as well as the levels of tumor markers,immune function indicators and inflammatory indicators before and after treatment,was compared.The adverse reactions during the treatment period and the short-term survival during the 12-month follow-up of the two groups were recorded.Results Compared with the control group,both objective response rate and disease control rate of the observation group were higher(P<0.05).After treatment,the levels of serum carcinoembryonic antigen,cytokeratin 19 fragment and cancer antigen 125 in both groups were lower than those before treatment,and lower in the observation group than in the control group(P<0.05,P<0.01).After treatment,the levels of CD3+,CD4+,and CD4+/CD8+in the control group were lower than those before treatment,while the level of CD8+was higher than that before treatment(P<0.05).After treatment,the levels of CD3+,CD4+and CD4+/CD8+in the observation group were higher than those before treatment and also higher than those in the control group,while the level of CD8+was lower than that before treatment and also lower than that in the control group(P<0.05,P<0.01).After treatment,the interferon-γ level in the observation group was higher than that before treatment and also higher than that in the control group,while the levels of tumor necrosis factor-α and interleukin-6 were lower than those before treatment and also lower than those in the control group(P<0.05,P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups during the treatment period(P>0.05).The overall survival rate of the observation group at 12-month follow-up was higher,and the median survival time was longer,as compared with the control group(P<0.05).Conclusion SBRT combined with DC-CIK immunotherapy has a definite effect in the treatment of patients with centrally-located LA-NSCLC.It can significantly improve the immune function of patients,reduce the levels of tumor markers,alleviate inflammatory responses,increase short-term survival rates,prolong survival time,and does not significantly increase adverse reactions,offering good safety and reliability.

Objective To synthesize qualitative studies on the experiences of postoperative lung cancer patients participating in pulmonary rehabilitation,aiming to comprehensively understand the barriers and facilitators influencing their engagement and to provide evidence-based insights for improving rehabilitation adherence.Methods Qualitative studies were retrieved from databases including Web of Science,PubMed,Cochrane Library,Embase,CNKI,Wanfang Data,VIPand Sinomed,with a search period spanning from database inception to January,2025.The methodological quality of eligible studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research.Extracted findings were mapped and synthesized using the Theoretical Domains Framework(TDF)and the Capability-Opportunity-Motivation-Behavior mode(COM-B).Results Ultimately,a total of 11 studies were included,yielding 48 findings.Using the Theoretical Domains Framework(TDF)and COM-B model,facilitators and barriers to pulmonary rehabilitation in postoperative lung cancer patients were mapped and consolidated into 14 categories,culminating in 2 synthesized findings.Conclusion Participation in pulmonary rehabilitation among postoperative lung cancer patients is influenced by multiple factors.Clinicians should develop patient-centered pulmonary rehabilitation plans by considering these factors and incorporating patients' attitudes and perspectives.