Objective To explore the correlation between lymph node metastasis and clinicopathological features of lung adenocarcinoma with diameter≤3 cm. Methods The clinicopathologic data of the patients with lung adenocarcinoma≤3 cm in diameter were retrospectively analyzed. The relationship between lymph node metastasis and age, gender, smoking history, pathological subtype, tumor diameter, pleural invasion, vascular invasion and other factors was analyzed. The risk factors of lymph node metastasis were analyzed by univariate and multivariate logistic regression. Results Finally 1 718 patients were collected, including 697 males and 1 021 females with an average age of (58.89±9.85) years. The total lymph node metastasis rate was 12.9%, among whom 452 patients of adenocarcinoma in situ and minimally invasive adenocarcinoma did not have lymph node metastasis, and the lymph node metastasis rate of invasive lung adenocarcinoma was 17.5%. Multivariate analysis showed that tumor diameter, micropapillary subtype, solid subtype, micropapillary component, solid component, vascular invasion and pleural invasion were independent risk factors for lymph node metastasis of invasive lung adenocarcinoma with diameter≤3 cm (P<0.05). While age, lepidic subtype and lepidic component were independent protective factors for lymph node metastasis (P<0.05). Conclusion Clinicopathological features can help predict lymph node metastasis of lung adenocarcinoma with diameter≤3 cm.

Objective: To explore the barriers to physical activity behavior among overweight and obese children and adolescents, so as to provide evidence for developing physical activity intervention programs. Methods: From March to April 2025, 13 overweight or obese children and adolescents from one primary school and one secondary school in Nanjing were selected by purposive sampling for semi structured interviews. Guided by the capability, opportunity and motivation-behavior model, data were coded, categorized and analyzed using content analysis. Results: A total of 13 interviews were completed, with a cumulative duration of 358 minutes. Three themes and eight subthemes were identified:capability factors, including physical discomfort and limited physical fitness, weak exercise skills and insufficient behavioral regulation ability, and insufficient psychological capability; opportunity factors, including insufficient family support and negative influence, pressure from school and peer environments, and limited time resources and exercise conditions; and motivation factors, including low self efficacy and situations prone to giving up, and insufficient positive feedback and lack of attractiveness of exercise forms. Conclusions Barriers to physical activity among overweight and obese children and adolescents result from the combined effects of capability, opportunity and motivation. It is necessary to lower the threshold for initiating exercise, strengthen positive experiences and feedback, and build integrate family-school support environments to promote the initiation and maintenance of physical activity behaviors in children and adolescents.

Objective: To explore the interrelationships between mental vulnerability, cognitive emotion regulation strategies, and positive psychological capital in medical postgraduates, so as to provide precise intervention targets for mental health services in universities. Methods: From April to June 2025, a convenience sampling method was used to select 1 461 medical postgraduates from three colleges in Hubei Province. Participants were assessed using the Mental Vulnerability Questionnaire (MVQ), the Cognitive Emotion Regulation Questionnaire-Chinese Version (CERQ-C) and the Positive Psychological Capital Questionnaire (PPQ). The network analysis model was constructed using a Gaussian graphical model. Results: The network analysis revealed that the edge connection between somatic symptoms and mental symptoms was the strongest, followed by the connection between refocus on planning and positive reappraisal within cognitive emotion regulation, with edge weights of 0.69 and 0.59, respectively. Interpersonal problems within psychological vulnerability exhibited the highest expected influence( EI =1.27), serving as the core node of the network. Rumination within cognitive emotion regulation demonstrated the highest bridge expected influence( BEI =0.33), playing a critical connecting role among psychological vulnerability, cognitive emotion regulation, and positive psychological capital. Conclusion In the mental health network of medical postgraduates, mental vulnerability, cognitive emotion regulation, and positive psychological capital interact through their respective key dimensions, jointly affect overall mental health.

Objective To investigate the changes in the density of Aedes albopictus across different regions and different breeding habitats in Baoshan District, Shanghai Municipality from 2018 to 2024, so as to inform evidence-based control strategies for mosquito-borne infectious diseases in Shanghai Municipality. Methods Ae. albopictus surveillance sites were deployed in 12 subdistricts (towns) of Baoshan District, Shanghai Municipality from 2018 to 2024, and the surveillance on the density of Ae. albopictus was performed in each surveillance site once weekly during the peak activity period of Aedes mosquitoes from May to October each year from 2018 to 2024. Mosquito ovitraps were deployed in various breeding habitats in each surveillance site according to geographical locations, including residential areas, schools, government institutions, hospitals, recycling stations, and construction sites, and regularly collected, and the mosquito ovitrap index (MOI) was calculated. The changes in the Ae. albopictus density were analyzed based on MOI across years, regions, and breeding habitats. Additionally, from May to October each year between 2018 and 2024, monthly risk assessments of Aedes albopictus density were conducted in every subdistrict (town) of Baoshan District, Shanghai. Results The annual mean MOI values of Ae. albopictus were 5.88 ± 2.29, 8.19 ± 4.46, 7.43 ± 3.40, 5.44 ± 2.52, 3.97 ± 2.72, 3.82 ± 1.57, and 2.56 ± 1.11 in Baoshan District from 2018 to 2024, respectively (F = 75.886, P < 0.05), and the MOI appeared a rise followed by a reduction each year and peaked during the period between June and August. There was a significant difference in the 7-year mean MOI of Ae. albopictus across the 12 subdistricts/towns (F = 26.558, P < 0.05), and there were 6 subdistricts/towns with a 7-year mean MOI of over 5, including Songnan Town (8.44 ± 4.68), Dachang Town (7.71 ± 5.28), Gucun Town (7.13 ± 3.57), Yuepu Town (5.74 ± 1.69), Gaojing Town (5.51 ± 3.44), and Wusong Subdistrict (5.41 ± 2.04). There was a significant difference in the MOI of Ae. albopictus across breeding habitats (F = 3.843, P < 0.05), with the highest MOI seen in recycling stations (9.86 ± 4.61), which was significantly higher than in other habitats (P < 0.05), and the lowest seen in construction sites (4.90 ± 2.95), which was significantly lower than in other habitats (P < 0.05). The proportion of frequency with Ae. albopictus density transmission risk decreased from 54.17% in 2018 to 11.11% in 2024 in all subdistricts (towns) of Baoshan District, and the frequency of outbreak risks peaked in 2019 (18 instances) and declined substantially in 2021 (6 instances), with no records of outbreak or transmission risk documented across the district in 2024. Conclusions There were substantial seasonal variations in the Ae. albopictus density in Baoshan District, Shanghai Municipality from 2018 to 2024. The Ae. albopictus density peaked during the period between June and August in Baoshan District each year from 2018 to 2024, with a relatively higher density in Songnan Town and Dachang Town, and in recycling stations. Precision control measures and intensified seasonal interventions are recommended in high-risk settings in Baoshan District to reduce the transmission risk of Aedes-borne infectious diseases.

Xuefu zhuyu decoction is a classic formula for promoting blood circulation and resolving blood stasis， characterised by its remarkable ability to treat different diseases with the same approach. Qi stagnation and blood stasis， the primary syndrome for which this formula is indicated， has been found through modern medical research to be intrinsically linked to a wide range of pathophysiological processes， including microcirculatory disorders， abnormalities in hemorheology， inflammatory responses and endothelial dysfunction； which opens up vast scope for the innovative application of traditional formulas. In terms of pharmacological effect and mechanism， the formula exerts a synergistic regulatory effect across multiple key pathological pathways， including the regulation of coagulation function， the maintenance of vascular structure and function， anti-inflammatory and immunomodulatory actions， the mitigation of oxidative stress， and the modulation of programmed cell death （such as pyroptosis and ferroptosis）. This systematically demonstrates its scientific rationale， which is based on integrated regulation through multiple constituents， multiple targets and multiple pathways. In terms of clinical application， the formula has expanded from cardiovascular diseases to multiple disciplines， including gastroenterology， respiratory medicine， urology， neurology， endocrinology， gynaecology and andrology， with evidence-based medical evidence continuing to accumulate. Current research still faces bottlenecks such as a relatively low level of clinical evidence， insufficient systems biology analysis of the mechanisms underlying the compound’s formulation， and a weak correlation between quality control indicators and therapeutic efficacy. Future efforts should focus on conducting multicentre randomised controlled trials for conditions where the formula demonstrates particular efficacy， deepening research into the relationship between integrated pharmacology and spectrum-efficacy relationship， and promoting the precise application and formulation innovation of classical herbal formulas.

Xuefu zhuyu decoction is a classic formula for promoting blood circulation and resolving blood stasis， characterised by its remarkable ability to treat different diseases with the same approach. Qi stagnation and blood stasis， the primary syndrome for which this formula is indicated， has been found through modern medical research to be intrinsically linked to a wide range of pathophysiological processes， including microcirculatory disorders， abnormalities in hemorheology， inflammatory responses and endothelial dysfunction； which opens up vast scope for the innovative application of traditional formulas. In terms of pharmacological effect and mechanism， the formula exerts a synergistic regulatory effect across multiple key pathological pathways， including the regulation of coagulation function， the maintenance of vascular structure and function， anti-inflammatory and immunomodulatory actions， the mitigation of oxidative stress， and the modulation of programmed cell death （such as pyroptosis and ferroptosis）. This systematically demonstrates its scientific rationale， which is based on integrated regulation through multiple constituents， multiple targets and multiple pathways. In terms of clinical application， the formula has expanded from cardiovascular diseases to multiple disciplines， including gastroenterology， respiratory medicine， urology， neurology， endocrinology， gynaecology and andrology， with evidence-based medical evidence continuing to accumulate. Current research still faces bottlenecks such as a relatively low level of clinical evidence， insufficient systems biology analysis of the mechanisms underlying the compound’s formulation， and a weak correlation between quality control indicators and therapeutic efficacy. Future efforts should focus on conducting multicentre randomised controlled trials for conditions where the formula demonstrates particular efficacy， deepening research into the relationship between integrated pharmacology and spectrum-efficacy relationship， and promoting the precise application and formulation innovation of classical herbal formulas.

OBJECTIVE To provide a reference for pharmaceutical care in patients with decompensated cirrhosis complicated with Clostridioides difficile splenic abscess. METHODS Clinical pharmacists participated in the whole-process pharmaceutical care of one patient with the above complex conditions. Retrieved from CNKI， Wanfang Data， VIP， PubMed， Embase and Web of Science databases，relevant literature about C. difficile splenic abscess was collected and analyzed. RESULTS Based on the results of metagenomic next-generation sequencing，imaging characteristics， and tissue penetration of antimicrobial agents， the clinical pharmacist suggested switching from ceftriaxone combined with metronidazole to intravenous vancomycin combined with metronidazole. For the hypokalemia that developed in the patient， the clinical pharmacist suggested discontinuing Furosemide tablets and adding Potassium citrate granules. When the p atient requested hospital discharge， the clinical pharmacist developed a post-discharge medication education plan. The physician adopted the clinical pharmacist’s recommendations. The patient improved after treatment without renal injury. Results of the literature analysis showed that among 11 involved patients，there were 9 males and 2 females，aged 32 to 90 years old，8 patients had a history of C. difficile infection. Vancomycin and metronidazole constituted the primary anti-infective regimens， and 3 patients died after treatment. CONCLUSIONS The clinical pharmacists ensured patients’ medication safety through pharmaceutical interventions including identifying the pathogen， optimizing anti-infective regimens， monitoring adverse drug reactions， and formulating a discharge medication education plan.

Objective To investigate the prevalence and related factors of sarcopenia among non–bedridden older adults in the community of Baoshan District using the China mini sarcopenia risk assessment 7 (C-MSRA-7) combined with Ishii scoring system. Methods The older individuals consulting at 20 community health stations in Baoshan District between April 2025 and June 2025 were enrolled. Data were collected using a general information questionnaire, a dietary and lifestyle habits survey, the C-MSRA-7, and the mini nutritional assessment-short form (MNA-SF). Handgrip strength and anthropometric measurements were also obtained. Individuals with both Ishii score and C-MSRA-7 results positive were classified into the sarcopenia risk group, while the remaining participants were assigned to the non–sarcopenia risk group. Differences in lifestyle habits, dietary patterns, and nutritional status between the two groups were compared. Results A total of 2 611 valid questionnaires were retrieved. Univariate analysis showed statistically significant differences in alcohol consumption, physical activity frequency, body mass index (BMI), nutritional status, activities of daily living, and regularity of three meals in sarcopenia risk group (n＝486) and non–sarcopenia risk group (n＝2 125, P<0.05). Logistic regression analysis showed that advanced age (75–84 years: OR＝2.55, 95%CI 2.03–3.21; ≥85 years: OR＝3.98, 95%CI 2.24–7.07), underweight status (OR＝2.19, 95%CI 1.50–3.19), weight loss＞2 kg (OR＝4.52, 95%CI 2.68–7.64) past 3 months, lack of regular physical activity (OR＝1.77, 95%CI 1.24–2.52) , and alcohol consumption (OR＝1.48, 95%CI 1.07–2.05) were independent risk factors for sarcopenia (P<0.05). Behaviors related to healthy diet, including daily milk consumption (OR＝0.40, 95%CI 0.30–0.52), regular three meals (OR＝0.56, 95%CI 0.41–0.78), and high-quality protein intake (OR＝0.70, 95%CI 0.52–0.94), were protective factors (P<0.05). Conclusions Sarcopenia among community–dwelling, non–bedridden older adults is closely associated with physical activity levels, dietary habits, and nutritional status. Early identification of individuals at risk, enhanced nutritional education, and timely implementation of nutritional interventions and exercise programs are recommended for this population.

Objective To prepare virus-like particles (VLPs) for yellow fever virus (YFV) using the pACYCDuet-1 single-plasmid dual expression system. Methods Gene fragments including NS1, NS5, and 5' untranslated region (UTR) and 3' UTR fragment of YFV were cloned into the expression plasmid pACYCDuet-1-MS2-TMpac (carrying MS2 coat protein gene) and transformed into E. coli BL21(DE3) for expression. VLPs were observed by TEM. After DNase I/RNase A digestion, RNA was extracted and transcribed into cDNA, which was subjected to fluorescence quantitative PCR detection. Results According to SN/T 3560-2013, double digestion and colony PCR of pACYCDuet-1-MS2-TMpac-YFV both produced expected bands. SDS-PAGE showed a target band at 25-35 kDa. RT-PCR amplified VLPs after enzyme digestion, and TEM revealed VLPs with clear edges and translucent interiors. Thus, the plasmid was successfully constructed, and the phage coat protein packaged YFV genes with nuclease resistance. Conclusion VLPs containing specific gene fragments of yellow fever virus have been successfully prepared. These nuclease-resistant VLPs can serve as safe and stable quality control materials to ensure the reliability of laboratory detection for YFV.

POEMS syndrome is a rare condition associated with plasma cell disorders， and it often involves multiple systems and has diverse clinical manifestations. This article reports two cases of POEMS syndrome with hepatosplenomegaly as the initial manifestation. During the course of the disease， the patients presented with lower limb weakness， hepatosplenomegaly， lymph node enlargement， ascites， hypothyroidism， positive M protein， and skin hyperpigmentation， and ¹⁸F-FDG PET-CT imaging revealed bone lesions mainly characterized by osteolytic changes and plasma cell tumors. There was an increase in the serum level of vascular endothelial growth factor. The patients were finally diagnosed with POEMS syndrome， and the symptoms were relieved after immunomodulatory treatment.