Objective To summarize and analyze the efficacy and influencing factors of second allogeneic hematopoietic stem cell transplantation (allo-HSCT) for acute leukemia relapsing after the first allo-HSCT. Methods Clinical data of 17 patients with acute leukemia who underwent second allo-HSCT at Peking University First Hospital from January 2005 to December 2024 were retrospectively analyzed. Results Among the 17 patients, 7 achieved long-term disease-free survival after second transplantation. The median progression-free survival after successful second transplantation was 7 months (range 8 days to 69 months). The relapse fatality was 24%, and the transplant-related fatality was 35%. Conclusions Second transplantation is an effective treatment for relapsed and refractory acute leukemia, but the relapse fatality and transplant-related fatality remain high. Patient age, time of relapse after the first transplantation and disease status before second transplantation are all factors that affect the efficacy of second transplantation. Younger age, late relapse and complete remission of disease before second transplantation are all beneficial for long-term disease-free survival after second transplantation.

OBJECTIVE: To explore the application value of artificial intelligence (AI)-assisted chromosomal karyotype analysis in the diagnosis of prenatal chromosomal mosaicism. METHODS: A retrospective analysis was conducted on 172 pregnant women who underwent amniocentesis at the Department of Medical Genetics and Prenatal Diagnosis, the Third Affiliated Hospital of Zhengzhou University between January 2019 and December 2024. All cases whose fetuses were diagnosed with chromosomal mosaicism via karyotype analysis and stratified into two groups based on the analytical software employed: the conventional analysis group (n = 70), which utilized Leica analysis software for karyotype image recognition and cell counting; and the AI-assisted analysis group (n = 102), which utilized AI-assisted software for the same procedures. The clinical performance of AI-assisted karyotype analysis in diagnosing chromosomal mosaicism was comprehensively evaluated by comparing the types of mosaic karyotypes, distribution of mosaic ratios, and verification outcomes of different detection modalities between the two groups. This study was approved by the Medical Ethics Committee of the Third Affiliated Hospital of Zhengzhou University (Ethics No.: 2024-406-01). RESULTS: No statistically significant difference was observed in baseline characteristics (maternal age, gestational week, and indications for prenatal diagnosis) between the two groups. Regarding the detection efficacy for numerical and structural mosaicisms, no significant difference was found in the detection of numerical mosaicism. However, the conventional analysis group exhibited a significantly higher detection rate of autosomal structural mosaicism compared to the AI-assisted group (11.43% vs. 0.98%, P < 0.05). Numerical mosaicism cases were further verified using copy number variation sequencing (CNV-seq) and/or fluorescence in situ hybridization (FISH). The AI-assisted group demonstrated a significantly lower inconsistency rate (5.56% vs. 20.41%, P < 0.05) compared to the conventional group. For low-proportion (< 10%) chromosomal mosaicism, the AI-assisted group had a significantly lower detection rate (13.25% vs. 29.69%, P < 0.05). Subsequent validation of low-proportion mosaicism by CNV-seq and/or FISH showed a higher consistency rate in the AI-assisted group (81.82% vs. 54.55%), though the difference did not reach statistical significance (P = 0.360). CONCLUSION For the karyotyping analysis of prenatal chromosomal mosaicism, AI-assisted karyotype analysis shows high accuracy and consistency in identifying numerical chromosomal mosaicism, particularly in reducing the detection of low-proportion (< 10%) mosaicism while improving verification accuracy. AI-assisted analysis can significantly improve the detection accuracy of numerical mosaicism and mitigate the risk of misclassification for low-proportion (< 10%) mosaicism, thereby providing more precise clinical evidence for the prenatal diagnosis of chromosomal mosaicisms.
Humans ; Female ; Mosaicism ; Pregnancy ; Karyotyping/methods* ; Artificial Intelligence ; Prenatal Diagnosis/methods* ; Adult ; Retrospective Studies ; Chromosome Disorders/genetics* ; Amniocentesis

Aromatic Chinese medicinal essential oils are volatile oils extracted from aromatic Chinese herbs， which can prevent and treat respiratory infectious diseases through multiple synergistic mechanisms including pathogen inhibition， immune regulation， and inflammatory response regulation. Essential oils are primarily used externally on the body to prevent infections and alleviate symptoms through methods like inhalation， smearing， topical application， bathing， gargling or as a suppository. They can also be utilized in the environment for disinfection and air purification， through methods like diffusion， vaporization， or spraying. The external application of essential oils extracted from Chinese aromatic herbs has the advantages of convenience， quick absorption， and simultaneous influence on both the body and mind. However， there are still challenges and deficiencies in aspects such as the positioning of functions， indications， safety， and the research on the mechanism of action. It has been proposed to combine the theory of aromatic Chinese medicinals with the characteristics of essential oils， and formulate prescriptions of Chinese medicinal essential oils under the principles of traditional Chinese medicine syndrome differentiation， and prevent and treat respiratory infectious diseases efficiently， accurately， and safely， thereby expanding the clinical application of aromatic Chinese medicinals and the preventive theory of traditional Chinese medicine.

Breast cancer is one of the most common cancers in the world， and its incidence rate is also rising in China and tends to happen in younger age groups. The classical Wnt/β-catenin signaling pathway is an important target in the treatment of breast cancer， playing a key role in the whole process of breast cancer development by regulating the expression of related signal proteins and genes. Traditional Chinese medicine has a profound history and practical experience in the treatment of malignant tumors， and the development of modern technology further highlights the therapeutic advantages of traditional Chinese medicine， which has multiple targets and components. Research shows that Chinese medicine can effectively slow down the proliferation of breast cancer cells by regulating the Wnt/β-catenin signaling pathway， and has a significant inhibitory effect on the development of breast cancer. Based on this， this paper summarized domestic and foreign relevant studies on the regulation of the Wnt/β-catenin signaling pathway with traditional Chinese medicine in the treatment of breast cancer， analyzed the mechanism of traditional Chinese medicine treating breast cancer by intervening in this signaling pathway， and summarized 44 different types of traditional Chinese medicine monomers， including terpenes （triptolide， andrographolide， etc.）， flavonoids （scutellarin， sinensetin， etc.）， polysaccharides （Angelica sinensis polysaccharides， etc.）， phenols （curcumin， polydatin， etc.）， and alkaloids （lycorine， etc.）. In addition， there are 3 traditional Chinese medicines （Ganoderma lucidum， Radix actinidia chinensis， and Antrodia camphorata）， 1 group of medicine pairs （Trionycis Carapax-Zedoary Turmeric）， and 8 traditional Chinese medicine formulas （Compound Tubeimu， Huangqi Jiedu Tang， Xihuang Wan， Liuwei Dihuang Wan， Jiazhu Tang， Aiduqing Fang， Sini San， and compound Kushen injection）. By regulating the Wnt/β-catenin signaling pathway and its key molecules， these single herbs， monomers， and compound herbs can reverse the epithelial mesenchymal transformation process， reduce the activity of stem cells， and inhibit the growth and metastasis of cancer cells. Besides， it can also enhance the sensitivity of drugs and radiotherapy and combat breast cancer， providing a new perspective for drug development and treatment strategies for breast cancer.

ObjectiveWith the development of society and the increasing demand for pregnancy at an advanced age， diminished ovarian reserve （DOR） has attracted wider attention. This disease affects the normal menstruation of women and poses a threat to their mental health. Current research on DOR is still in the initial stage， and advancing research progress in DOR necessitates the construction of effective and clinically relevant animal models. Building on existing literature and integrating the diagnosis criteria of DOR in traditional Chinese medicine （TCM） and Western medicine， this study summarized， analyzed， and evaluated existing models， providing a reference for optimizing DOR animal models. MethodsA retrospective analysis of literature on DOR-related animal models was conducted， and the diagnostic criteria of DOR in TCM and Western medicine were sorted out. By means of evaluation methods of animal models， the clinical relevance of each model to TCM and Western medicine was assessed. ResultsDOR animal models included those based on natural factors， iatrogenic factors， immune factors， metabolic factors， and environmental factors. Among them， the model based on iatrogenic factors， especially models induced by Tripterygium wilfordii preparations， cyclophosphamide， and cisplatin， had a high degree of relevance to both Western medical diseases and TCM syndromes and was confirmed as the optimal modeling method for studying DOR at present. ConclusionThe existing DOR modeling methods mostly have a high degree of clinical relevance to Western medical diseases， while the number of DOR animal models with clear TCM syndromes is very limited. TCM plays an indispensable role in exploring DOR treatment methods. Therefore， the development of DOR animal models related to TCM syndromes should be strengthened， further exploring the potential of TCM and providing strong theoretical support for the application of TCM in DOR treatment.

Prostate cancer is a malignant tumor that primarily arises from the epithelial tissue of the prostate in men. With the aggravation of population aging in China， the incidence rate of this disease has been continuously rising. Although the exact cause of prostate cancer remains unclear， it has been proven to be closely related to various factors， including individual genetic susceptibility， genetic mutations， dietary habits， and lifestyle. Research has shown that abnormal activation of the Wnt/β-catenin signaling pathway also plays an important role in the occurrence and development of prostate cancer. Multiple experimental results have revealed that traditional Chinese medicine （TCM）， with its multi-target and multi-stage mechanisms of action， exerts significant regulatory effects on key biological processes such as proliferation， migration， invasion， angiogenesis， and epithelial-mesenchymal transition （EMT） of prostate cancer cells. TCM has shown excellent potential in preventing prostate cancer progression and improving patient prognosis and has become a research focus in prostate cancer treatment in recent years. Based on this， this study reviewed the research on the regulation of the Wnt/β-catenin signaling pathway by TCM in the treatment of prostate cancer at home and abroad. It analyzed the mechanisms by which TCM intervention exerts anti-prostate cancer effects via this signaling pathway， identifying 29 different types of active ingredients in TCM， including alkaloids （e.g.， capsaicin， berberine）， flavonoids （e.g.， icariin and hyperoside）， polyphenols （e.g.， gastrodin and honokiol）， terpenes （e.g.， oridonin）， quinones （e.g.， aloe-emodin）， coumarins （e.g.， agrimonolide）， and saponins （e.g.， saikosaponin-d）. Additionally， one TCM medicinal substance （arsenic）， one drug pair （Danggui - Qieyi combination）， and two TCM formulae （Yishen Tonglong Tang and Guben Qingyuan Formula） were included. The study aims to deepen the understanding of the pathological mechanism of prostate cancer and to explore possible therapeutic targets， thereby providing new perspectives and approaches for clinical research and new drug development， and ultimately promoting the advancement and innovation of prostate cancer treatment strategies.

Prostate cancer is a malignant tumor that primarily arises from the epithelial tissue of the prostate in men. With the aggravation of population aging in China， the incidence rate of this disease has been continuously rising. Although the exact cause of prostate cancer remains unclear， it has been proven to be closely related to various factors， including individual genetic susceptibility， genetic mutations， dietary habits， and lifestyle. Research has shown that abnormal activation of the Wnt/β-catenin signaling pathway also plays an important role in the occurrence and development of prostate cancer. Multiple experimental results have revealed that traditional Chinese medicine （TCM）， with its multi-target and multi-stage mechanisms of action， exerts significant regulatory effects on key biological processes such as proliferation， migration， invasion， angiogenesis， and epithelial-mesenchymal transition （EMT） of prostate cancer cells. TCM has shown excellent potential in preventing prostate cancer progression and improving patient prognosis and has become a research focus in prostate cancer treatment in recent years. Based on this， this study reviewed the research on the regulation of the Wnt/β-catenin signaling pathway by TCM in the treatment of prostate cancer at home and abroad. It analyzed the mechanisms by which TCM intervention exerts anti-prostate cancer effects via this signaling pathway， identifying 29 different types of active ingredients in TCM， including alkaloids （e.g.， capsaicin， berberine）， flavonoids （e.g.， icariin and hyperoside）， polyphenols （e.g.， gastrodin and honokiol）， terpenes （e.g.， oridonin）， quinones （e.g.， aloe-emodin）， coumarins （e.g.， agrimonolide）， and saponins （e.g.， saikosaponin-d）. Additionally， one TCM medicinal substance （arsenic）， one drug pair （Danggui - Qieyi combination）， and two TCM formulae （Yishen Tonglong Tang and Guben Qingyuan Formula） were included. The study aims to deepen the understanding of the pathological mechanism of prostate cancer and to explore possible therapeutic targets， thereby providing new perspectives and approaches for clinical research and new drug development， and ultimately promoting the advancement and innovation of prostate cancer treatment strategies.

ObjectiveTo investigate the distribution of traditional Chinese medicine （TCM） syndrome elements in type 2 diabetes mellitus （T2DM） patients based on maximum body mass index （maxBMI） and explore their association with complication risks. MethodsA retrospective cross-sectional study was used to collect clinical data from hospitalized T2DM patients， extracting age， gender， smoking history， alcohol consumption history， duration of disease， HbA1c level， complications， and TCM syndromes， and extracting the syndrome elements of disease location and disease nature based on their TCM syndromes. MaxBMI was calculated by telephone survey of patients' self-reported maximum body weight； patients with maxBMI ≥24 kg/m² were classified into spleen-heat syndrome group， and those with maxBMI ＜24 kg/m² were classified into consumptive-heat syndrome group. The distribution of TCM syndrome types and syndrome elements of patients in the two groups were analysed. Then the propensity score matching method was used to balance the baseline characteristics between the two groups and compare the differences in the distribution of syndrome types and syndrome elements and the risk of macrovascular and microvascular complications between the two groups. ResultsAmong the 1178 T2DM patients， syndrome elements in spleen-heat patients （1034 cases） were primarily located in the spleen （351 cases， 33.95%）， liver （240 cases， 23.21%）， and stomach （139 cases， 13.44%）， while in consumptive-heat patients （144 cases）， they were concentrated in the spleen （57 cases， 39.58%）， liver （34 cases， 23.61%）， and kidneys （17 cases， 11.81%）； regarding syndrome elements of disease nature， spleen-heat patients were predominantly characterized by qi deficiency （481 cases， 46.52%）， phlegm （353 cases， 22.73%）， and dampness （241 cases， 23.31%）， whereas consumptive-heat patients showed more qi deficiency （84 cases， 58.33%） and yin deficiency （44 cases， 30.56%）. After propensity score matching， 132 cases were included in each group， and no statistically significant differences were observed in the distribution of syndrome elements of disease location between the two groups （P＞0.05）， but the phlegm element was significantly more prevalent in spleen-heat patients than in consumptive-heat patients （P = 0.006）. Regarding the risk of complications， spleen-heat patients had a significantly higher risk of developing macrovascular complications compared to consumptive-heat patients （OR=2.04， P=0.010）， while no significant differences were found between groups in the occurrence of microvascular complications （P＞0.05）. ConclusionThe spleen-heat T2DM patients show a more frequent syndrome element of disease nature of phlegm， and a higher risk of developing macrovascular complications compared to consumptive-heat patients.

Objective: To analyze the characteristics and safety risks of preservatives and sweeteners in beverages sold near schools in Anshun City, so as to provide a evidence for formulating targeted regulatory strategies in campus. Methods: From December 2023 to July 2024, 834 beverage samples were collected from sales points near primary and secondary schools in Xixiu District and four surrounding townships of Anshun City by a stratified random sampling method. High performance liquid chromatography was used to detect three preservatives (sorbic acid, benzoic acid and dehydroacetic acid) and four sweeteners (sodium saccharin, acesulfame-K, aspartame, and neotame). Differences were analyzed using the Chi-square test. Results: The overall exceedance rate of preservative was 8.6% (72 samples), with dehydroacetic acid showing the highest exceedance rate (7.0%, 58 samples), significantly higher than sorbic acid (0.6%, 5 samples) and benzoic acid (0.4%, 3 samples) ( χ 2=90.85, P <0.01). The overall exceedance rate of sweetener was 10.4% (87 samples), with sodium saccharin having the highest exceedance rate ( 6.2 %, 52 samples),significantly higher than neotame (2.8%, 23 samples), acesulfame-K (0) and aspartame (0) ( χ 2=262.04, P <0.01). Potential risks were identified due to the co occurrence of multiple additive exceedances, including 0.7% (6 samples) for mixed preservatives and 1.6% (13 samples) for mixed sweetener. No statistically significant differences were found in preservative (7.2%, 26 samples) or sweetener (12.3%, 44 samples) exceedance rates between micro enterprises and large, medium and small enterprises ( χ 2=2.67, 5.16, both P >0.05). Conclusion Systemic misuse risk of food additives in beverages sold near school necessitates a risk traceability based regulatory framework, with emphasis on standardizing enterprise production practices and strengthening oversight of sales outlets near campuses.

Objective: To investigate the age, period, and birth cohort effect of the incidence, mortality, and disability-adjusted life years (DALY) of oral cancer among the Chinese elderly from 1992 to 2021. Methods: Data on oral cancer incidence, mortality, and DALY rate in the Chinese population aged ≥60 years from 1992 to 2021 were collected from the Global Burden of Disease 2021 (GBD 2021) database. The trends in the incidence, mortality, and DALY rate of oral cancer were analyzed using the average annual percent change (AAPC) and the age-period-cohort (APC) model. Results: The incidence, mortality, and DALY rates of oral cancer among the Chinese elderly showed increasing trends (AAPC=2.262%, 0.548% and 0.360%, all P<0.05) from 1992 to 2021. The APC model revealed that the incidence, mortality, and DALY rate of oral cancer increased with age, peaking in the 85-<90 age group at 22.31/100 000, 16.69/100 000, and 171.41/100 000, respectively. Using the period 2002-2006 as the reference group, the risks of incidence, mortality, and disability of oral cancer showed increasing trends over time. The highest risk of incidence was observed in 2017-2021 (RR=1.450, 95%CI: 1.398-1.504), while the peak risks of mortality (RR=1.131, 95%CI: 1.097-1.166) and disability (RR=1.146, 95%CI: 1.118-1.175) both occurred in 2012-2016. With the 1925-1929 birth cohort as the reference group, the risk of oral cancer incidence showed an increasing trend with later birth years. The highest risk of incidence was observed in the 1955-1959 birth cohort (RR=1.788, 95%CI: 1.699-1.881). In contrast, the risks of mortality and disability exhibited relatively stable trends overall. Conclusions The disease burden of oral cancer among the Chinese elderly generally exhibited an increasing trend from 1992 to 2021, with particularly high burden observed among the elderly aged 85-<90 years. The incidence risk increased with time and year of birth.