Objective To analyze survival outcomes and influencing factors among patients with colorectal cancer in Yunnan Province. Methods Clinical data were retrospectively collected from 4 892 patients with colorectal cancer. Survival data were obtained through follow-up. Overall survival (OS) was calculated by using the Kaplan-Meier method. Univariate analysis was performed by applying the log-rank test. Meanwhile, multivariate analysis employed the Cox proportional hazards regression model. Results The 1-, 3-, 5-, and 10-year OS rates for the entire cohort were 91.90%, 74.40%, 64.40%, and 28.70%, respectively. Univariate analysis revealed that age, ethnicity, region, differentiation grade, TNM stage, clinical stage, metastatic status, histological type, and treatment modality (chemotherapy, radiotherapy, and surgery) were associated with patient prognosis (all P<0.05). Multivariate analysis identified age (HR=1.250), region (HR=1.262), differentiation grade (HR=0.761), clinical stage (HR=3.128), and treatment modality (chemotherapy, HR=0.644; radiotherapy, HR=1.605; surgery, HR=0.384) as independent factors affecting survival prognosis in patients with colorectal cancer (all P<0.001). Conclusion Age, region, clinical stage, and treatment modality are independent factors influencing survival among patients with colorectal cancer in Yunnan Province. In clinical practice, these factors should be integrated to develop individualized prevention and treatment strategies, thereby improving patient outcomes.

Objective::To examine the impact of hypertensive disorders of pregnancy (HDP) on offspring metabolomics.Methods::We searched five databases: PubMed, Ovid Embase, MEDLINE, Web of Science, and China National Knowledge Infrastructure, and included studies that reported metabolomics among human offspring born to HDP-complicated pregnancies.Results::Database search yielded 4054 articles, and after full-text screening, ten observational studies met inclusion criteria. Half of the studies had a sample size of less than 100 and were all observational studies in preeclampsia (PE) and gestational hypertension.Neonates were the most focused group in all included studies. Offspring born to HDP-complicated pregnancies exhibited statistically significant variations in blood metabolomics compared to their counterparts, characterized by amino acids, lipids, carnitine, and others (e.g., 1α,25-(OH) 2-D). Most studies reported a significant increase in differential metabolites of offspring born to HDP-complicated pregnancies. Four studies ( n = 1109) measured lipids-related metabolites, and all consistently showed that offspring born to PE-complicated pregnancies had significantly higher concentrations than non-PE exposed offspring. Conclusion::The existing evidence suggests an intergenerational effect of HDP on offspring metabolomics. Long-term follow-up studies are needed to advance the health effects of related adverse health outcomes and inform the prevention of offspring’s health.

Objective:To investigate the factors influencing the delayed onset of intrapartum fever following epidural labor analgesia and their impact on maternal and neonatal outcomes.Methods:Select parturients who experienced intrapartum fever following labor analgesia(T≥38.0℃,age≥18 years,singleton pregnancy,ASA classification Ⅱ)between January 1,2021,and December 31,2023.Group them based on the median time of intra-partum fever onset after labor analgesia:those with onset times less than the median were classified as the ear-ly-onset fever group,and those with onset times greater than the median were classified as the late-onset fever group.Using univariate and multivariate Logistic regression analysis to explore factors influencing the delay in in-trapartum fever onset and the pregnancy outcomes of the mothers and newborns in both groups.Results:A total of 253 parturients were included,and the time range of onset of intrapartum fever following epidural labor analgesi-a was 1.83-28.42 hours,with a median fever onset time of 8.00 hours.There were 126 cases in the early-onset group and 127 in the late-onset group.Multivariate Logistic regression analysis indicated that primiparous women,artificial membrane rupture,and neonatal birth weight were independent risk factors for delayed fever onset(OR＞1,P＜0.05),whereas the administration of oxytocin prior to labor analgesia was found to be a protective factor(OR＜1,P＜0.05).The late-onset group exhibited higher levels of white blood cells(WBC),C-reactive pro-tein,longer hospital stays,higher hospitalization costs,greater diagnosis rates of chorioamnionitis,higher NICU ad-mission rates,as well as a higher incidence of neonatal pneumonia,for newborns compared to the early-onset group(P＜0.05).Conclusions:Primiparous women,artificial membrane rupture,and higher neonatal birth weight may be associated with delayed onset of intrapartum fever,while oxytocin administration prior to labor analgesia may offer some protective benefit.The later the onset of intrapartum fever,the worse the clinical outcomes for both mother and infants.

Objective To investigate the relationship between lumbosacral Modic changes(MCs)and their types and osteoporosis in patients with low back pain.Methods A total of 204 female patients with low back pain who were treated in Xuzhou City Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from January 2021 to September 2024 were selected as study objects.According to magnetic resonance imaging results,the patients were divided into MCs group(139 cases)and non-MCs group(65 cases).MCs group was divided into type Ⅰ group(33 cases),type Ⅱgroup(90 cases)and type Ⅲ group(16 cases)according to MCs type.The age,hip bone mineral density(BMD)and T value of all groups were compared.Results There was no significant difference in age,hip BMD and T value between MCs group and non-MCs group(P＞0.05).Hip BMD and T values of four groups were type Ⅲ group＞non-MCs group＞type Ⅱ group＞typeⅠ group.Most of patients in type Ⅲ group had normal bone mass,and most of patients in other three groups had decreased bone mass or osteoporosis.There was no significant difference in hip BMD and T value between type Ⅱ group and non-MCs group(P＞0.05).The hip BMD and corresponding T values of patients in group Ⅲ significantly higher than the other three groups(P＜0.05).The hip BMD and corresponding T values of type Ⅰ patients were significantly lower than those of the other three groups(P＜0.05).Conclusion Patients with low back pain have different tendency of MCs with different bone mass.High bone mass(normal bone mass)is more likely to develop type Ⅲ MCs,and low bone mass or osteoporosis is more likely to develop type Ⅰ MCs.Anti-osteoporosis therapy for patients with type Ⅰ MCs should be emphasized.

Objective::To examine the impact of hypertensive disorders of pregnancy (HDP) on offspring metabolomics.Methods::We searched five databases: PubMed, Ovid Embase, MEDLINE, Web of Science, and China National Knowledge Infrastructure, and included studies that reported metabolomics among human offspring born to HDP-complicated pregnancies.Results::Database search yielded 4054 articles, and after full-text screening, ten observational studies met inclusion criteria. Half of the studies had a sample size of less than 100 and were all observational studies in preeclampsia (PE) and gestational hypertension.Neonates were the most focused group in all included studies. Offspring born to HDP-complicated pregnancies exhibited statistically significant variations in blood metabolomics compared to their counterparts, characterized by amino acids, lipids, carnitine, and others (e.g., 1α,25-(OH) 2-D). Most studies reported a significant increase in differential metabolites of offspring born to HDP-complicated pregnancies. Four studies ( n = 1109) measured lipids-related metabolites, and all consistently showed that offspring born to PE-complicated pregnancies had significantly higher concentrations than non-PE exposed offspring. Conclusion::The existing evidence suggests an intergenerational effect of HDP on offspring metabolomics. Long-term follow-up studies are needed to advance the health effects of related adverse health outcomes and inform the prevention of offspring’s health.

Anhedonia is one of the core features of major depressive disorder (MDD) and is associated with poor functional outcomes in MDD patients. Psychosocial functional recovery is an important goal for achieving MDD remission. Although longitudinal studies have found association between anhedonia and impaired psychosocial function, there is still a lack of neurobiological biomarkers that can indicate this relationship. In this review, brain structural and functional changes associated with anhedonia and impaired psychosocial function in MDD patients are reviewed from the perspective of magnetic resonance imaging. It finds that anhedonia and psychosocial dysfunction in MDD may share common neuroimaging changes, manifested in abnormal brain regions such as the nucleus accumbens, caudate nucleus, putamen nucleus, orbitofrontal cortex, insula, amygdala, anterior cingulate cortex, dorsolateral prefrontal cortex, superior parietal lobe, inferior frontal gyrus and temporal lobe. These findings help to better understand the pathophysiology of the disease and offer potential insights for developing new treatment strategies.

ObjectiveBased on the theory of "gut-prostate" axis， this study explored the effects and mechanisms of Zishen Tongguan formula and Cinnamomi Cortex in the formula in treating rats with chronic non-bacterial prostatitis（CNP） by detecting the levels of inflammatory factors， and the composition and structure of intestinal flora in CNP rats. MethodsEight out of 42 SD rats were randomly selected as the normal group， and the remaining rats were injected with carrageenan to prepare the CNP model. After successful modeling， 32 rats were randomly divided into the model group， Ningmitai capsule group（0.50 g·kg^-1）， Zishen Tongguan formula group（2.00 g·kg^-1）， and the Phellodendri Chinensis Cortex-Anemarrhenae Rhizoma pair group（PCC-AR group， 2.00 g·kg^-1）， with 8 rats in each group. The administered groups were given the corresponding medicinal solution by gavage， and the normal and model groups were intragastrically administered with an equal volume of normal saline， once a day for 14 consecutive days. The prostate tissues of rats were collected and subjected to hematoxylin-eosin（HE） staining and Masson staining to observe the pathological changes of the tissues in each group. Enzyme-linked immunosorbent assay（ELISA） was used to detect the levels of related inflammatory factors in rat serum， and 16S rDNA sequencing was used to analyze the abundance and diversity changes of gut microbiota before and after administration， and species difference analysis was performed. ResultsAll the administered groups could alleviate the inflammatory symptoms of CNP rats， increase the expression levels of anti-inflammatory factors and decrease the expression levels of pro-inflammatory factors， with the most sIgnificant effect observed in the Zishen Tongguan formula group. Compared with the normal group， the expression levels of interleukin（IL）-8， hypersensitive C-reactive protein（hs-CRP）， immunoglobulin（Ig）M， secretory IgA （sIgA）， and inducible nitric oxide synthase（iNOS） were sIgnificantly increased in the model group（P<0.01）. Compared with the model group， the expression levels of the above inflammatory factors in all administered groups were significantly reduced（P<0.01）. When compared with the PCC-AR group， the Zishen Tongguan formula group showed a significant decrease in transforming growth factor（TGF）-β₁ expression level（P<0.05） and a significant increase in IgM expression level（P<0.01）. The results of gut microbiota analysis showed that， compared with the PCC-AR group， at the order level， the Zishen Tongguan formula group significantly reduced the relative abundance of conditional pathogens such as Bacteroidales， Acidaminococcales， Rhodospirillales， Clostridiales， and Elusimicrobiales（P<0.01）. And at the genus level， the Zishen Tongguan formula group significantly decreased the relative abundance of pathogenic microbiota such as Lachnospira and Bacteroides（P<0.01） and significantly increased the relative abundances of beneficial microbiota such as Ruminococcus and Lactobacillus（P<0.01）. ConclusionZishen Tongguan formula can reduce the level of harmful intestinal bacteria， increase the level of beneficial intestinal bacteria， down-regulate the expression of serum inflammatory factors， and the small amount of Cinnamomi Cortex in the formula may play a key role in the treatment of CNP with this formula.

ObjectiveBased on the theory of "gut-prostate" axis， this study explored the effects and mechanisms of Zishen Tongguan formula and Cinnamomi Cortex in the formula in treating rats with chronic non-bacterial prostatitis（CNP） by detecting the levels of inflammatory factors， and the composition and structure of intestinal flora in CNP rats. MethodsEight out of 42 SD rats were randomly selected as the normal group， and the remaining rats were injected with carrageenan to prepare the CNP model. After successful modeling， 32 rats were randomly divided into the model group， Ningmitai capsule group（0.50 g·kg^-1）， Zishen Tongguan formula group（2.00 g·kg^-1）， and the Phellodendri Chinensis Cortex-Anemarrhenae Rhizoma pair group（PCC-AR group， 2.00 g·kg^-1）， with 8 rats in each group. The administered groups were given the corresponding medicinal solution by gavage， and the normal and model groups were intragastrically administered with an equal volume of normal saline， once a day for 14 consecutive days. The prostate tissues of rats were collected and subjected to hematoxylin-eosin（HE） staining and Masson staining to observe the pathological changes of the tissues in each group. Enzyme-linked immunosorbent assay（ELISA） was used to detect the levels of related inflammatory factors in rat serum， and 16S rDNA sequencing was used to analyze the abundance and diversity changes of gut microbiota before and after administration， and species difference analysis was performed. ResultsAll the administered groups could alleviate the inflammatory symptoms of CNP rats， increase the expression levels of anti-inflammatory factors and decrease the expression levels of pro-inflammatory factors， with the most sIgnificant effect observed in the Zishen Tongguan formula group. Compared with the normal group， the expression levels of interleukin（IL）-8， hypersensitive C-reactive protein（hs-CRP）， immunoglobulin（Ig）M， secretory IgA （sIgA）， and inducible nitric oxide synthase（iNOS） were sIgnificantly increased in the model group（P<0.01）. Compared with the model group， the expression levels of the above inflammatory factors in all administered groups were significantly reduced（P<0.01）. When compared with the PCC-AR group， the Zishen Tongguan formula group showed a significant decrease in transforming growth factor（TGF）-β₁ expression level（P<0.05） and a significant increase in IgM expression level（P<0.01）. The results of gut microbiota analysis showed that， compared with the PCC-AR group， at the order level， the Zishen Tongguan formula group significantly reduced the relative abundance of conditional pathogens such as Bacteroidales， Acidaminococcales， Rhodospirillales， Clostridiales， and Elusimicrobiales（P<0.01）. And at the genus level， the Zishen Tongguan formula group significantly decreased the relative abundance of pathogenic microbiota such as Lachnospira and Bacteroides（P<0.01） and significantly increased the relative abundances of beneficial microbiota such as Ruminococcus and Lactobacillus（P<0.01）. ConclusionZishen Tongguan formula can reduce the level of harmful intestinal bacteria， increase the level of beneficial intestinal bacteria， down-regulate the expression of serum inflammatory factors， and the small amount of Cinnamomi Cortex in the formula may play a key role in the treatment of CNP with this formula.

Objective To analyze the effect of Midazolam(MID)on visceral pain in diarrheal irritable bowel syndrome(IBS-D)rats based on the forkhead box protein O1/forkhead box transcription factor O3a(FoxO1/FoxO3a)pathway.Methods An IBS-D rat model was constructed,and successfully modeled rats were randomly assigned into IBS-D group,low MID(MID-L)group,high MID(MID-H)group,and MID-H+AS1842856 group,with 12 rats in each group.Additionally,12 normal healthy rats were included as the Control group.The Control group and the IBS-D group were intraperitoneally injected with an equal volume of 0.9%sodium chloride.The MID-L and MID-H groups were intraperitoneally injected with 30 and 90 mg/kg MID respectively,while the MID-H+AS1842856 group was intraperitoneally injected with 90 mg/kg MID and given 50 mg/kg AS1842856 by gavage.Rats in each group were evaluated for abdominal wall withdrawal response(AWR)score.Enzyme-linked immunosorbent assay(ELISA)was applied to detect the levels of oxidative stress and pain factors in serum,and HE staining was applied to detect pathological changes in colonic tissue.Immunohistochemistry was applied to detect the expression of glial fbrillary acidic protein(GFAP)and nerve growth factor(NGF)in colon tissue,and Western Blot method was applied to detect the expression of proteins related to the FoxO1/FoxO3a pathway.Results The pathological damage in the colonic tissue in the IBS-D group was more severe than that in the Control group,and the AWR score,malondialdehyde(MDA),substance P(SP),5-hydroxytryptamine(5-HT),and GFAP and NGF expression elevated,while the superoxide dismutase(SOD)level and the expression of FoxO1 and FoxO3a decreased(P<0.05).The colonic tissue damage in the MID-L and MID-H groups was less severe compared with the IBS-D group,and the AWR score,MDA,SP,5-HT,and GFAP and NGF expression decreased,while SOD level and the expression of FoxO1,FoxO3a increased;the changes were more significant in the MID-H group(P<0.05).The colonic tissue damage in the MID-H+AS1842856 group was more severe than that in the MID-H group,and the AWR score,MDA,SP,5-HT,and GFAP and NGF expression increased,while SOD level level and the expression of FoxO1,FoxO3a decreased(P<0.05).Conclusion MID can improve visceral pain in IBS-D rats,and its mechanism of action is related to the activation of the FoxO1/FoxO3a pathway.

Objective To investigate the association of cerebral white matter lesions(WMLs)with systolic and diastolic blood pressure.Methods Patients admitted to our department from January 2023 to December 2023 were prospectively recruited for this study.The Fazekas method was used to grade the severity of the periventricular WMLs(P-WMLs)and deep WMLs(D-WMLs).Multivariate logistic regression analyses were performed to examine the association of systolic and diastolic blood pressure with WMLs.Results A total of 966 eligible participants were enrolled in this study.The mean age was 65.96±11.35 years and 487 participants(50.41%)were male.The results indicated that the more severe the P-WMLs and D-WMLs,the higher the systolic blood pressure was[P-WMLs:0:(134.41±19.86)mmHg,1:(136.82±20.47)mmHg,2:(144.52±21.64)mmHg,3:(147.80±20.7)mmHg;D-WMLs:0:(137.49±20.58)mmHg,1:(139.17±21.33)mmHg,2:(144.39±21.20)mmHg,3:(147.50±21.73)mmHg],but not diastolic blood pressure.Multivariate logistic regression analysis showed that an elevated systolic level(P-WMLs:OR=1.02,95%CI:0.009-0.021;D-WMLs:OR=1.01,95%CI:0.005-0.016)was associated with an increased risk of more severe of P-WMLs and deep D-WMLs.No significant association was observed between diastolic blood pressure and WMLs,whether for P-WMLs or D-WMLs.Conclusion The more severe P-WMLs and D-WMLs were,the higher the systolic blood pressure was.Elevated systolic blood pressure was an independent risk factors for more severe of P-WMLs and D-WMLs,but not diastolic blood pressure.