Hyperthyroidism （HT） is frequently complicated by atrial fibrillation （AF） in clinical practice. Based on traditional Chinese medicine （TCM） zang-xiang （藏象） theory and clinical experience， both HT and AF are closely associated with dysfunction of the liver. The pathogenesis is initiated by the liver failing to govern the free flow of qi， and liver constraint and qi stagnation， with the key turning points being liver constraint transforming into fire and the internal stirring of liver wind， ultimately leading to liver blood depletion and insufficient nourishment of the heart spirit. Thus， it is proposed to treat the disease from the liver， with stage-specific therapeutic approaches according to the evolution of the disease. In the early stage， the treatment should focus on soothing the liver and relieving constraint to reduce goiter and calm the heart， while in the progressive stage， the method of clearing liver and draining fire is suggested to subdue yang and stabilize palpitations. In the acute stage， the strategy is calming the liver and nourishing yin to subdue yang and extinguish wind. In the later stage， it is suggested to soften the liver and benefit qi， so as to nourish yin and restore pulse. These methods are sequentially applied to synergistically reduce goiter and stabilize palpitations， providing a therapeutic approach for HT complicated by AF.

Objective:To investigate the status of sedentary behavior and its influencing factors among inpatients with stable schizophrenia, providing empirical evidence for developing interventions to reduce sedentary behavior.Methods:A cross-sectional survey design was used to prospectively collect clinical data from 166 inpatients with stable schizophrenia (97 males, 69 females, mean age 56.4±8.4 years) hospitalized at the Shanghai Mental Health Center affiliated with Shanghai Jiao Tong University School of Medicine from February 2024 to May 2024. Sedentary behavior time was assessed using the Sedentary Behavior Questionnaire (SBQ), daily step count was measured via pedometers, and negative schizophrenic symptoms were evaluated using the Scale for the Assessment of Negative Symptoms (SANS). Patients were divided into a non-sedentary behavior group (≥5 000 steps/day, 66 cases) and a sedentary behavior group (<5 000 steps/day, 100 cases). Clinical variables were compared between the two groups, and binary logistic regression was used to identify influencing factors of sedentary behavior.Results:Stable inpatients with schizophrenia exhibited high levels of sedentary behavior, with an average daily sedentary time of (8.03±2.33) hours and a median daily step count of 3 352 (1 258-5 506) steps. Significant differences were observed between sedentary and non-sedentary behavior groups in Age ( t=-2.38),hospitalization duration ( Z=-1.53),blunted affect ( t=-8.37),poverty of thought ( t=-2.45),avolition ( t=-2.45),impoverished interests/social engagement ( t=-2.41),abdominal obesity ( χ2=9.18),and open vs. restricted hospital/wards environment ( χ2=8.88)(all P<0.05). Binary logistic regression analysis identified that hospital/wards environment ( OR=0.314, 95 %CI: 0.125-0.787),hospitalization duration ( OR=1.001, 95 %CI: 1.000-1.001),and the negative symptom of blunted affect ( OR=3.256, 95 %CI: 1.960-5.407)(all P<0.05) were significantly influencing factors for sedentary behavior in patients with stable schizophrenia. Conclusion:Hospitalized patients with stable schizophrenia exhibit high levels of sedentary behavior. Hospital/wards environment and blunted affect are significant factors influencing sedentary behavior.

Objective To investigate the efficacy of externally applied mirabilite combined with infrared irradiation in promoting wound healing following biliary tract surgery.Methods Patients who underwent open surgery for biliary tract disease in our department between January 2022 and April 2025 were randomly assigned to one of three groups:(1)Combination group(n=60),which received postoperative wound treatment with mirabilite application combined with infrared irradiation;(2)Mirabilite group(n=60),treated with mirabilite application alone;and(3)Infrared group(n=60),treated with infrared irradiation alone.The primary outcomes included wound healing grade on postoperative day 7,pain intensity measured on days 3,5,and 7,and wound healing status up to discharge.For cases with suboptimal healing,the duration required for complete healing following intervention was documented.Secondary outcomes encompassed length of postoperative hospital stay and Vancouver Scar Scale(VSS)scores—assessing scar pigmentation,thickness,vascularity,and pliability—evaluated at 3 months postoperatively.Results The combination group exhibited significantly lower rates of poor wound healing,shorter postoperative hospital stays,improved VSS scores—particularly in terms of scar thickness and pliability—and reduced pain levels on the 3rd and 5th postoperative days compared to the other two groups(P<0.05).Conclusions The combined use of mirabilite and infrared irradiation for surgical incisions following biliary tract surgery represents an effective,economical,and readily accessible adjuvant therapy.It significantly reduces the incidence of impaired wound healing and effectively alleviates early postoperative pain,thereby demonstrating strong potential for clinical promotion.

Objective To investigate the efficacy of externally applied mirabilite combined with infrared irradiation in promoting wound healing following biliary tract surgery.Methods Patients who underwent open surgery for biliary tract disease in our department between January 2022 and April 2025 were randomly assigned to one of three groups:(1)Combination group(n=60),which received postoperative wound treatment with mirabilite application combined with infrared irradiation;(2)Mirabilite group(n=60),treated with mirabilite application alone;and(3)Infrared group(n=60),treated with infrared irradiation alone.The primary outcomes included wound healing grade on postoperative day 7,pain intensity measured on days 3,5,and 7,and wound healing status up to discharge.For cases with suboptimal healing,the duration required for complete healing following intervention was documented.Secondary outcomes encompassed length of postoperative hospital stay and Vancouver Scar Scale(VSS)scores—assessing scar pigmentation,thickness,vascularity,and pliability—evaluated at 3 months postoperatively.Results The combination group exhibited significantly lower rates of poor wound healing,shorter postoperative hospital stays,improved VSS scores—particularly in terms of scar thickness and pliability—and reduced pain levels on the 3rd and 5th postoperative days compared to the other two groups(P<0.05).Conclusions The combined use of mirabilite and infrared irradiation for surgical incisions following biliary tract surgery represents an effective,economical,and readily accessible adjuvant therapy.It significantly reduces the incidence of impaired wound healing and effectively alleviates early postoperative pain,thereby demonstrating strong potential for clinical promotion.

Objective:To investigate the status of sedentary behavior and its influencing factors among inpatients with stable schizophrenia, providing empirical evidence for developing interventions to reduce sedentary behavior.Methods:A cross-sectional survey design was used to prospectively collect clinical data from 166 inpatients with stable schizophrenia (97 males, 69 females, mean age 56.4±8.4 years) hospitalized at the Shanghai Mental Health Center affiliated with Shanghai Jiao Tong University School of Medicine from February 2024 to May 2024. Sedentary behavior time was assessed using the Sedentary Behavior Questionnaire (SBQ), daily step count was measured via pedometers, and negative schizophrenic symptoms were evaluated using the Scale for the Assessment of Negative Symptoms (SANS). Patients were divided into a non-sedentary behavior group (≥5 000 steps/day, 66 cases) and a sedentary behavior group (<5 000 steps/day, 100 cases). Clinical variables were compared between the two groups, and binary logistic regression was used to identify influencing factors of sedentary behavior.Results:Stable inpatients with schizophrenia exhibited high levels of sedentary behavior, with an average daily sedentary time of (8.03±2.33) hours and a median daily step count of 3 352 (1 258-5 506) steps. Significant differences were observed between sedentary and non-sedentary behavior groups in Age ( t=-2.38),hospitalization duration ( Z=-1.53),blunted affect ( t=-8.37),poverty of thought ( t=-2.45),avolition ( t=-2.45),impoverished interests/social engagement ( t=-2.41),abdominal obesity ( χ2=9.18),and open vs. restricted hospital/wards environment ( χ2=8.88)(all P<0.05). Binary logistic regression analysis identified that hospital/wards environment ( OR=0.314, 95 %CI: 0.125-0.787),hospitalization duration ( OR=1.001, 95 %CI: 1.000-1.001),and the negative symptom of blunted affect ( OR=3.256, 95 %CI: 1.960-5.407)(all P<0.05) were significantly influencing factors for sedentary behavior in patients with stable schizophrenia. Conclusion:Hospitalized patients with stable schizophrenia exhibit high levels of sedentary behavior. Hospital/wards environment and blunted affect are significant factors influencing sedentary behavior.

Objective:To evaluate the effect of implementation of prevention from mother-to-child transmission of syphilis in Minhang district of Shanghai from 2013 to 2019.Methods:The data of 284 pregnant women with syphilis infection diagnosed by 6 midwifery medical institutions in Minhang District from January 2013 to December 2019, were collected from the database of national management information system for prevention of mother to child transmission of AIDS, syphilis and hepatitis B. Among them there were 1 case of spontaneous abortion, 4 cases of ectopic pregnancy, 42 cases of lost follow-up; the remaining 237 parturients were included in this study. The Implementation Program of prevention of mother-to-child transmission of AIDS, syphilis and hepatitis B (2015 edition) has been implemented since 2015 in Minhang district. The maternal and neonatal outcomes between the period of 2013-2015 (before program implemented, 123 cases) and the period of 2016-2019 (after program implemented, 114 cases) were compared. Results:Between 2013 and 2019, the syphilis detection rate of pregnant women remained 100.00% (100 761/100 761). The detection rates during pregnancy before and after program implementation were 95.92% (51 855/54 288) and 98.87% (45 949/46 473); the prevalence rate of syphilis was 2.93‰ (159/54 288) and 2.69‰ (125/46 473), respectively. The rate of anti-syphilis treatment was 62.60% (77/123) and 85.96% (98/114), the standard treatment rate was 20.33% (25/123) and 49.12% (56/114), the neonatal preventive treatment proportion/rate was 1/12 and 94.74% (72/76). The detection rate during pregnancy, anti-syphilis treatment rate, standardized treatment rate and neonatal preventive treatment rate after program implementation were significantly higher than those of before implementation (χ 2=988.88, 16.72, 21.81, 54.72, all P<0.01). The rate of non- Treponema pallidum antigen titer ≥ 1∶8 was 36.89% (38/103) and 17.48% (18/103), respectively in two periods; the incidence of neonatal adverse health problems was 21.49% (26/121) and 6.03% (7/116); congenital syphilis report incidence rate was 152.12/100 000 live births (83/54 562) and 23.46/100 000 live births (11/46 890), respectively. All these indicators showed a significant reduction (χ 2=9.81, 11.80, 45.10, all P<0.01). The treatment rate of pregnant women with previously diagnosed syphilis infection was 63.27% (62/98), which was lower than that of those with initially diagnosed (81.29%, 113/139) ( cOR=2.52, 95 %CI: 1.40-4.56, χ 2=9.672, P<0.01). Among whose with lost follow-up, the floating pregnant women accounted for 92.86% (39/42), 57.14% (24/42) of whom were unable to contact and 30.95% (13/42) refused to be followed up. Conclusions:After the implementation of prevention program, the rates of detection and diagnosis, standardized treatment, neonatal preventive treatment, as well as the maternal and neonatal outcomes of pregnant women with syphilis infection have been significantly improved in Minhang district of Shanghai.

The status of human papillomavirus (HPV) infection and cervical lesions was analyzed among 20 420 postmenopausal women who participated in gynecological disease screening in Shanghai Minhang district 2017.The infection rate of HPV in postmenopausal women was 8.37％(1 710/20 420),and the infection of high-risk HPV 52,58,16,18 accounted for 95.26％(2 029/2 130).The HPV infection rate was 7.37％ in women aged ≥65 years,and that was 8.62％ in women aged＜65 years(x2=6.640,P=0.010).Among 552 cases with pathological results there were 133 cases of cervical lesions.The top 4 HPV infections in patients with cervical lesions were HPV16,52,58 and 33.The rate of cervical lesions was 22.35％ in ≥65 age group,and 24.93％ in ＜65 age group (P＞0.05).The study suggests that HPV genotyping should be taken into account in gynecological disease screening,and the subjects with high-risk HPV infection should be closely followed up;meanwhile,the age limits of screening population should be appropriately extended.

Background and objective Cetuximab is a monoclonal antibody directed against epidermal growth fac-tor receptor. Emerging evidence showed improved effcacy with the addition of cetuximab to chemotherapy in advanced non-small cell lung cancer (NSCLC), but the data in oriental population are limited. hTe aim of this study is to investigate the eff-cacy of cetuximab in combination with chemotherapy in Chinese patients with advanced NSCLC.Methods NSCLC patients receiving cetuximab in combination with chemotherapy in Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College were enrolled and retrospectively analyzed. Clinical characteristic, effcacy, outcome and toxicity data were analyzed.Results A total of 40 patients were enrolled into this study in which 29 were male, 36 with adenocarcinoma. In the 23 patients who had received palliative chemotherapy previously (with a median of 2 prior chemotherapy regimens), the median progression-free survival (PFS) atfer the last prior chemotherapy regimen was 2.3 months. For the overall population, 13 (32.5%) patients achieved partial response atfer cetuximab in combination with chemotherapy. Response rate were 52.9% (9/17) and 17.4% (4/23) in chemotherapy-naive patients and chemotherapy-treated patients, respectively (P=0.018). hTe median PFS was 4.8 months for the overall population. In chemotherapy-naive patients and chemotherapy-treated patients, the median PFS was 8.4 months and 4.1 months, respectively (P=0.062). hTe estimated median overall survival was 17.1 months. Toxicities were generally manageable and no treatment-related deaths occurred.Conclusion Cetuximab in addition to che-motherapy appears to be associated with promising effcacy and acceptable toxicity proifle in Chinese patients with advanced NSCLC. Further validation is needed.

Background Hypoxia is the main factor of retinal neovascularization and is closely associated with retinal ganglial cells (RGCs) degeneration.However, the study of retinal neural tissue lesions is rare.Objective This study was to investigate the influence of hypoxia environment on the expression of annexin A2 (ANXA2) in mouse RGC-5 cells and explore the mechanism of RGCs damage induced by hypoxia.Methods Immortalized mouse RGC-5 cells were cultured in high glucose DMEM with 10％ fetal bovine serum.The cells were identified by detecting the expression of Thy-1 ,a specific biomarker of RGCs.CoCl2 was added into the medium at the final concentrations of 50,100,200 and 300 μmol/L, and the cells without CoCl2 served as the control group.Cell viability (absorbance) was assayed by cell counting kit-8 (CCK-8) method in 12,24 and 48 hours after addition of CoCl2.The hypoxic cell models were established in DMEM with 100 μmol/L CoCl2 and divided into the hypoxic 3-hour group, hypoxic 6-hour group, hypoxic 12-hour group and hypoxic 24-hour group,with the normal cultured cells as the normal control group.Apoptotic cells were determined by using hoechst 33342 stain.The expression levels of ANXA2 mRNA and protein in the cells were detected by real-time quantification PCR and Western blot,respectively.The expression and location of ANXA2 in the cells were examined by using immunofluorescence technique.Results The cultured cells grew well and showed the fusiform and polygonal shape,with positive expression of Thy-1 protein.Compared with the normal control group, the viabilities of the cells were insignificantly changed in the 50 μ mol/L CoCl2 group and 100 μmol/L CoCl2 group (all at P＞0.05) ,but the cell viabilities were significantly reduced in the 200 μμmol/L CoCl2 group and 300 μmol/L CoCl2 group in various time points (all at P＜0.05).Hoechst 33342 staining showed that the apoptotic cells with nuclear condensation and high green fluorescence intensity were obtained in the hypoxia groups.The relative expression levels of ANXA2 mRNA were significantly lower in the hypoxic groups than those in the normal control group (all at P ＜ 0.05).The relative expression levels of ANXA2 protein were significantly lower in the hypoxia 3-,6-, 12-and 24-hour group than those in the normal control group (all at P＜ 0.05).Apoptotic cells were seen in the hypoxic 3-hour group, hypoxic 6-hour group, hypoxic 12-hour group and hypoxic 24-hour group compared with the normal control group, showing the bright blue fluorescence in cellular nucleus for hoechst 33342.The relative expressing levels of ANXA2 mRNA in the cells were 0.80±0.14,0.67±0.33, 0.49±0.17 and 0.39±0.02 in the hypoxic 3-hour group,hypoxic 6-hour group, hypoxic 12-hour group and hypoxic 24-hour group, which were significantly declined in comparison with the normal control group, with a statistically difference among the groups (F=434.354, P =0.000).The relative expression values of ANXA2 protein were 0.552 6±0.012 3,0.425 9± 0.033 4,0.344 9 ± 0.017 8 and 0.382 7 ± 0.022 1 in the hypoxic 3-hour group, hypoxic 6-hour group, hypoxic 12-hour group and hypoxic 24-hour group,which were remarkably lower than 0.602 1 ±0.001 4 in the normal control group, showing considerably difference among the groups (F =3.057, P =0.000).ANXA2 proteins were highly expressed in the cellular nucleus and less expressed in the cell membrane and cytoplasm in the normal cells.Compared with the normal control group, the ANXA2 protein showed weak expression in the hypoxia group and primarily in the cytoplasm.Conclusions The expression of ANXA2 down-regulates in hypoxic mouse RGC-5 cells,which may participate in the apoptosis process of RGCs in high glucose environment.

Background Retinal neovascularization is pathological basis of a variety of fundus diseases,but its pathogenesis is unclear.Studies showed that the expression level of radixin in retina is remarkably increased in retinal neovascularization-related diseases.It is presumed that silencing or down-regulating the abnormal expression of radixin is helpful for curing retinal neovascularization-related diseases.Objective This study was to investigate the inhibitory effect of radixin short hairpin RNA (shRNA) plasmid on expression of radixin gene in retina of oxygen-induced retinopathy (OIR) mice.Methods Sixty-four 7-day-old C57BL/6J mice were randomly divided into normal control group, model control group, radixin shRNA plasmid group and shRNA plasmid group by random number table.There were 16 mice in every group.OIR models were established by exposing the mice in an environment of (75±2) ％ oxygen for 5 days and then returned to the normal air in the model control group,radixin shRNA plasmid group and shRNA plasmid group,while the mice of the normal control group were fed in the normal air environment.Radixin shRNA plasmid or control shRNA plasmid at the dose of 1 μg was intravitreally injected in 12-day-old mice of the radixin shRNA plasmid group or shRNA plasmid group, respectively.Five days later, FD-2000S angiography was performed on the mice of each group and then retinal flatmounts were prepared for the observation of retinal vessels.The mice from various groups were sacrificed and retinal sections were prepared.The vascular endothelial nucleus and new blood vessels extending inner limiting membrane (ILM) were examined by hematoxylin and eosin staining;the expression of radixin in the retinas was detected using immunochemistry;the relative expression levels of radixin mRNA and protein were quantitative assayed by real-time quantitative RCR and Western blot, respectively.The use and care of the animals adhered to the Association for Research in Vision and Ophthalmology Statement for the Use of Animals in Ophthalmic and Vision Research.Results The distribution of retinal vessels was normal in the normal control group.Non-perfusion zone at the posterior pole of retina, circuity of blood vessels,leakage of vessel wall and new blood vessels were found in the mice of the model control group.Non-perfusion zone and microaneurysms were also exhibited in the shRNA plasmid group.However,these findings were slight in the radixin shRNA plasmid group.The surface of ILM was in discontinuity in the model mice and shRNA-injected mice with more vascular endothelial cell nucleus and more tubes extending ILM than that in the radixin shRNA plasmid group.The immunochemistry results showed that the expressions of radixin in the normal control group and radixin shRNA plasmid group were weaker than those in the model control group and control shRNA plasmid group.The relative expression levels of radixin mRNA were 1.002±0.043,2.236-±0.093,0.556±0.015 and 2.272±0.096 in the normal control group, model control group,radixin shRNA plasmid group and control shRNA plasmid group,and those in the radixin shRNA plasmid group were significantly reduced in comparison with the normal control group, model control group and the shRNA plasmid group (all at P＜0.01).The relative expression levels were 1.000±0.082,1.193±0.021,0.263± 0.016 and 1.235±0.005 in the normal control group,model control group,radixin shRNA plasmid group and shRNA plasmid,with the lowest expression level in the radixin shRNA plasmid group (all at P＜0.01).Conclusions Radixin shRNA can downregulate the expression of radixin gene in the retinas of OIR mice and further inhibit pathological retinal neovascularization.