Objective: To understand the hydration status and related factors of rural boarding primary school students, so as to provide a scientific basis for drinking water health intervention for primary school students. Methods: In November 2023, a convenience sampling approach was employed to conduct a hydration status survey among 144 boarding students in grades 5 and 6 of a rural primary school in Guangxi. The Duplicate meal method and weighing method were utilized to measure the food derived water intake over three consecutive days. Urine osmolarity of students was measured on site for three days, and a simple physical examination was also carried out. A self administered questionnaire was used to investigate students drinking water literacy, daily water intake, and physical activity levels. Meanwhile, a drinking water literacy survey was conducted among 21 substitute teachers and 144 parents of the boarding students in grades 5 and 6. Logistic regression was used to identify factors associated with students hydration status. Results: The median daily total water intake of students was 2 043.55 mL, and 54.86% of the students did not reach the recommended Adequate Intake (AI). The median food derived water intake was 1 149.24 mL, accounting for 53.94% of the total water intake. Univariate analysis revealed that the daily drinking frequency, daily water intake, and food derived water intake of students were related factors of hydration status ( β =-1.60, -1.01, -0.00, all P <0.05). Multivariate Logistic regression analysis showed that primary school students with a daily drinking frequency of ≥7 times were more likely to maintain an adequate hydration status ( OR =0.28, 95% CI =0.09-0.93, P ＜0.05). Conclusions The water intake from food is the main source of water in the body for boarding primary school students in a certain rural school in Guangxi. Primary school students should increase their water intake frequency appropriately to maintain an adequate hydration status.

OBJECTIVE To assess the bleeding risk signals associated with the concomitant use of direct oral anticoagulants （DOACs） and triazole antifungals， and to provide pharmacovigilance evidence for the safety evaluation and monitoring of combined clinical use. METHODS Adverse event reports involving the concomitant use of DOACs and triazole antifungals were extracted from the US FDA Adverse Event Reporting System （FAERS） from the first quarter of 2004 to the third quarter of 2025. Nine bleeding-related preferred terms （PTs） were selected. The Ω shrinkage measure， additive model， multiplicative model， and combined risk ratio method were employed to detect drug-drug interaction signals. The strength of positive signals was further analyzed based on the Ω shrinkage measure. RESULTS A total of 790 adverse event reports involving the concomitant use of DOACs and triazole antifungals were included， among which 229 reports involved nine bleeding-related PTs. A total of 13 signals were consistently identified as posit ive by all four methods. These signals involved six drug combinations： apixaban-fluconazole， apixaban-posaconazole， rivaroxaban-itraconazole， dabigatran etexilate-fluconazole， apixaban-voriconazole， and dabigatran etexilate-itraconazole. The Ω shrinkage measure showed that the apixaban-posaconazole combination exhibited stronger signals for bleeding （ Ω ＝2.73， Ω 025 ＝2.05） and hemoptysis （ Ω ＝2.17， Ω 025 ＝0.83）； the apixaban-fluconazole combination exhibited stronger signals for hematoma （ Ω ＝2.30， Ω 025 ＝1.47） and hematuria （ Ω ＝1.71， Ω 025 ＝0.74）； the rivaroxaban-itraconazole combination exhibited stronger signals for epistaxis （ Ω ＝2.01， Ω 025 ＝0.90） and hematoma （ Ω ＝1.93， Ω 025 ＝0.42）； no positive Ω signals were observed for intracranial hemorrhage or upper gastrointestinal hemorrhage. CONCLUSION S This study suggests that the concomitant use of DOACs and triazole antifungals may increase the risk of bleeding-related events， with differences in signal strength and signal distribution across various drug combinations. In clinical practice， particular attention should be paid to the concomitant use of apixaban or rivaroxaban with strong cytochrome P450 3A4 or P-glycoprotein inhibitors such as posaconazole and itraconazole. For other DOAC-triazole antifungal combinations， close monitoring for bleeding-related manifestations and timely adjustment of anticoagulation or antifungal regimens are also warranted.

Objective: To explore the current status and influencing factors of eating behaviors in adolescents, so as to provide a theoretical foundation for health promotion education among adolescents. Methods: Based on the database from Survey of Chinese Family Health Index (2021), by a random number table method, 1 065 teenagers were selected from the provincial capitals of 22 provinces and 5 autonomous regions in China, as well as 4 municipalities directly under the central government. A general characteristic questionnaire, Patient Health Questionnaire-9 (PHQ-9), Short Form of the Family Health Scale (FHS-SF), 10-item Short Version of the Big Five Personality(BFP-10), Content-based Media Exposure Scale (CM-E) and Sakata Eating Behavior Scale Short Form(EBS-SF) were used to collect information. Multivariate stepwise linear regression analysis was employed to identify and analyze related factors of eating behaviors among adolescents. Receiver operating characteristic was used to validate the predictive ability of the EBS-SF score for overweight and obesity among adolescents. Results: The average scores of BFI-10,C-ME, FHS-SF, PHQ-9 and EBS-SF were (33.08±4.64)(19.20±4.55)(38.48±6.65)(6.09±5.63)(16.75±4.36), respectively. Multivariate linear regression showed that family type (other types), agreeableness, conscientiousness, family health and depression were the main related factors of EBS-SF scores among adolescents( B =2.61,-0.42,0.20,-0.11,0.23, P <0.05).The analysis of receiver operating characteristic curve showed that the EBS-SF scores had a good ability in predicting obesity among male adolescents ( AUC= 0.73, P <0.01). Conclusions Family type, big five personality, family health,depression are the related factors of eating behaviors among adolescents. EBS-SF scores are predictive of obesity in adolescents, which would provide a new perspective for promoting healthy eating habits among adolescents.

Objective To understand the driver gene mutation status in patients with non-small cell lung cancer (NSCLC) in Xi'an City, and to analyze the association with environmental exposure factors. Methods A total of 305 NSCLC patients admitted to the First Affiliated Hospital of the Air Force Medical University from January 2019 to December 2023 were included. The driver gene mutation status was observed, and the relationship with environmental exposure factors was analyzed. Results The driver gene mutation rate of 305 patients was 46.89%, with EGFR gene mutation accounting for the highest proportion, and 4 cases of gene co-mutations were detected. There was a difference in gender among patients with different single drive gene mutations (P<0.05), and the proportion of EGFR in women was significantly higher (P<0.05). Univariate analysis showed that there were statistical differences in family history, smoking history, long-term cooking history, and fried smoked food intake between patients with driver gene mutation and patients without driver gene mutation (P<0.05). Logistic regression analysis suggested that long-term cooking history (OR=2.392), and fried smoked food intake (OR=2.849) were the environmental exposure factors affecting EGFR gene mutation (P<0.05), and smoking history (OR=1.377) was an environmental exposure factor of KRAS gene mutation (P<0.05). Conclusion EGFR gene mutation accounts for the highest proportion of NSCLC patients in Xi'an City, and is mainly female. Long-term cooking history, and fried smoked food intake are related to EGFR gene mutation. There is a certain association between smoking history and KRAS gene mutation.

Objective To evaluate the efficacy and safety of a subanesthetic dose of esketamine in prevent-ing postoperative nausea and vomiting following carboprost administration during cesarean section.Methods One hundred thirty-five full-term singleton parturients,ASAⅠ-Ⅱ,aged 20-40 years,scheduled for elective cesarean section,were recruited.They were randomly assigned to three groups(n=45):the normal saline group(Group C),the palonosetron group(Group P),and the esketamine group(Group E).All parturients received combined spinal-epidural anesthesia,achieving a sensory level of T5-7.Following umbilical cord clamping,carboprost tromethamine was injected into the uterine body.Concurrently,Group C received intravenous normal saline,Group P received palonosetron,and Group E received esketamine.The incidence of nausea,vomiting,and chest discomfort was recorded from the time of carboprost administration until the parturients left the operating theater.Additionally,mean arterial pressure(MAP),heart rate(HR),oxygen saturation(SpO2),and Ramsay sedation scores were mea-sured at six time points:upon entering the room(T0),1 minute before intervention(T1),2 minutes(T2),5 min-utes(T3),15 minutes(T4),and 30 minutes(T5)post-intervention.Maternal satisfaction was evaluated as the parturients left the operating room.Results Compared with group C,the incidence of nausea,vomiting,and chest discomfort in group E was significantly lower(all P<0.05).Additionally,group E showed a significantly lower incidence of nausea and chest discomfort compared to group P(all P<0.05).In terms of maternal satisfaction,group E reported significantly higher levels than both group C(P<0.05)and group P(P<0.05).No significant differences were observed in the incidence of nausea,vomiting,chest discomfort,or satisfaction between the other groups(P>0.05).Conclusion The administration of subanesthetic doses of esketamine significantly decreases the incidence of adverse effects such as nausea,vomiting,and chest tightness that are commonly associated with carboprost tromethamine use during cesarean sections,thereby enhancing patient satisfaction in the perioperative period.

Objective:To analyze the efficacy and safety of modified associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in the treatment of patients with primary liver cancer.Methods:Clinical data of 83 patients with hepatocellular carcinoma (HCC) undergoing hemihepatectomy in the Department of Hepatobiliary and Pancreatic Tumor Surgery of Gansu Provincial Cancer Hospital between January 2022 and November 2023 were retrospectively analyzed, including 53 males and 30 females, aged (54.0±6.5) years. According to the treatment protocol, patients were divided into the control group ( n=41), in which patients underwent traditional ALPPS, and the observation group ( n=42), in which patients underwent modified ALPPS (occlusion of portal venous branch using vascular clips, combined with radiofrequency ablation for physical separation of the diseased lobe, without liver mobilization). The completion rate of staged surgery, interval between surgeries, future liver remnant (FLR) growth rate at 7 days after first-stage surgery, alanine transaminase (ALT) and aspartate transaminase (AST) levels at 5 days after fisrt-stage surgery, and postoperative complications (ascites, nausea, and vomiting, etc.) were compared between the groups. Results:The completion rate of staged surgery was 95.2% (40/42) in the observation group and 90.2% (37/41) in the control group ( χ2=0.62, P=0.431). The ALT and AST levels at 5 days after first-stage surgery were (550.4±86.0) U/L and (327.1±52.8) U/L in the observation group, respectively, which were significantly lower than those in the control group (861.6±106.3) U/L and (533.8±73.7) U/L, respectively ( t=13.13 and P<0.001, t=12.93 and P<0.001). The FLR growth rate were higher in the observation group than that in the control group [(80.4±10.3)% vs (49.3±5.7)%; t=13.13, P<0.001] and the interval between procedures were also shorter in the observation group (10.9±2.1 vs 22.4±4.8, d; t=9.65, P<0.001). The intraoperative blood loss of the first-stage surgery was lower in the observation group than that in the control group (350.5±45.2 vs 825.5±21.7, ml; t=21.43, P<0.001). The total complication rates after the first-stage surgery were 11.9% (5/42) in the observation group and 19.5% (8/41) in the control group, while after the second-stage surgery, the complication rates were 7.5% (3/40) and 18.9% (7/37), respectively, with no statistically significant differences ( χ2=0.65 and P=0.419, χ2=1.81 and 0.177, respectively). Conclusion:The modified ALPPS offers better postoperative liver function, reduced surgical trauma, accelerated FLR growth, and a shorter interval between procedures, demonstrating a favorable safety in the treatment of primary liver cancer.

Matrix Gla protein (MGP) is a vitamin K-dependent protein secreted by chondrocytes and vascular smooth muscle cells. It is mainly distributed in cartilage, bone marrow, and arterial walls, and participates in osteogenic differentiation and vascular calcification processes in vascular smooth muscle. Previous studies have suggested that MGP only has inhibitory effects on physiological and ectopic calcification. A new study has found that MGP is highly expressed in various tumor tissues, but the relationship between its expression level and the malignant biological behavior of tumors is not completely consistent in different tumors. The differential expression of MGP may be a result of tumor heterogeneity. This article reviews the research progress of MGP in multi-system malignant tumors, in order to provide new ideas for the diagnosis and treatment of clinical malignant tumors.

Brucellosis,a zoonotic infectious disease caused by Brucella,leads to persistent infections in both animals and humans.This disease not only substantially affects the health and development of the livestock industry,but also poses a major threat to human health and public safety.Currently,vaccination remains the most effective method for preventing animal bru-cellosis.Compared with smooth strains,rough Brucella strains lack the O-chain antigens,thus offering advantages such as lower virulence,higher safety,and no interference with clinical diagnostics.Consequently,rough Brucella vaccines have prom-ising potential for brucellosis prevention and control.Researchers are now focusing on the development of Brucella abortus vac-cines as an important direction in brucellosis vaccine research and development.An urgent need exists for the development of Brucella abortus vaccines.This article provides a brief review of current research on vaccines for rough Brucella and candidate strains,and summarizes developed vaccine applications and their effectiveness,to provide insights for brucellosis prevention and control,and further development of vaccines for rough Brucella.

Formulating a well-defined research question and developing a scientifically sound study protocol is important for ensuring the quality of pharmacoepidemiological research.Based on the Guide on Methodological Standards in Pharmacoepidemiology in China(2nd edition),this research provided an interpretation of the sections related to the formulation of research questions and the development of study protocols.First,it clarified the sources and scope of research questions,outlining a two-step approach—question generation and definition—and introduces relevant evaluation tools and defining frameworks.Furthermore,it systematically explained the key elements of a study protocol and provides an in-depth explanation of the research methodology and its critical aspects.Finally,the paper highlighted the importance of feasibility assessment,emphasizing that the process of defining research questions and study protocols is dynamic and iterative.Compared with the previous edition,the 2nd edition of the guidelines offers more detailed and updated guidance on question formulation and protocol development.It added three new elements—such as protocol archiving or registration—and three new content items,including study objectives.The 2nd edition also expanded the methodological framework and strengthens feasibility assessments,thereby enhancing the comprehensiveness and rigor of its practical guidance.By integrating guideline content with practical experience,this paper provided insights into its implications for pharmacoepidemiological research and serves as a reference for researchers in the field.

OBJECTIVE: Aloin, the main active component in Aloe vera (L.) Burm. f., has shown promising anti-tumor effects. This study investigated the impact of aloin in lung squamous cell carcinoma (LUSC) and explored its functional mechanism. METHODS: We analyzed the viability, migration, invasion, proliferation, and apoptosis of two LUSC cell lines after treatment with aloin. Target molecules of aloin and downstream target transcripts of nuclear receptor subfamily 3 group C member 2 (NR3C2) were predicted by bioinformatics. The biological functions of NR3C2 and metallothionein 1 M (MT1M) in the malignant properties of LUSC cells were determined. A co-culture system of LUSC cells with monocyte-derived macrophages was constructed. Mouse xenograft tumor models were generated to analyze the functions of aloin and NR3C2 in the tumorigenic activity of LUSC cells and macrophage polarization in vivo. RESULTS: Aloin suppressed malignant properties of LUSC cells in vitro. However, these effects were negated by the silencing of NR3C2. NR3C2 was found to activate MT1M transcription by binding to its promoter. Additional upregulation of MT1M suppressed the malignant behavior of LUSC cells augmented by NR3C2 silencing. Analysis of the M1 and M2 markers/cytokines in the macrophages or the culture supernatant revealed that aloin treatment or MT1M overexpression in LUSC cells enhanced M1 polarization while suppressing M2 polarization of macrophages, whereas NR3C2 silencing led to reverse trends. Consistent findings were reproduced in vivo. CONCLUSION This study demonstrated that aloin activates the NR3C2/MT1M axis to suppress the malignant behavior of LUSC cells and M2 macrophage polarization. Please cite this article as: Chen YN, Lu JY, Gao CF, Fang ZR, Zhou Y. Aloin blocks the malignant behavior of lung squamous cell carcinoma cells and M2 macrophage polarization by modulating the NR3C2/MT1M axis. J Integr Med. 2025; 23(2): 195-208.
Lung Neoplasms/metabolism* ; Humans ; Animals ; Cell Line, Tumor ; Carcinoma, Squamous Cell/metabolism* ; Mice ; Macrophages/drug effects* ; Emodin/analogs & derivatives* ; Metallothionein/genetics* ; Cell Proliferation/drug effects* ; Cell Movement/drug effects* ; Apoptosis/drug effects* ; Receptors, Glucocorticoid/genetics*