OBJECTIVE:Postoperative recurrence is a common complication of percutaneous endoscopic lumbar discectomy for lumbar disc herniation,which can significantly increase the risk of reoperation.A well-performing risk prediction model can help identify high-risk groups early and prevent postoperative recurrence.This study systematically evaluated the risk prediction model for postoperative recurrence after percutaneous endoscopic lumbar discectomy to provide a reference for surgical decision-making.METHODS:The PubMed,Embase,Web of Science,CNKI,WanFang Data,VIP,and CBM were electronically searched to collect studies on the recurrence risk prediction models after percutaneous endoscopic lumbar discectomy from inception to July 1,2024.Two reviewers independently screened the literature and extracted data.The models' risk of bias,applicability,and report quality were assessed using prediction model risk of bias assessment tool(PROBAST)and Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis(TRIPOD)tools,respectively.Meta-analysis of postoperative recurrence rate of percutaneous endoscopic lumbar discectomy and related predictors was performed using Revman 5.4 software.RESULTS:(1)A total of 15 studies were included,all of which were retrospective studies,including 24 models for predicting the risk of recurrence after percutaneous endoscopic lumbar discectomy.(2)The PROBAST evaluation results indicated that all 15 studies exhibited a high risk of bias.Regarding applicability,two studies demonstrated a low risk,while 13 presented a high risk.(3)Regarding the TRIPOD reporting quality,the overall quality across the 15 studies was low.The primary reasons for this low compliance included the failure to report blinding,a lack of explanation for the sample size calculation method,lack of detailed description of missing data processing methods,and lack of information such as introduction to the model used.(4)Furthermore,the area under the receiver operating characteristic curve for the model ranged from 0.684 to 0.972,with the number of potential predictor variables varying from 15 to 28.(5)The results of meta-analysis showed that the postoperative recurrence rate of lumbar disc herniation patients treated with percutaneous endoscopic lumbar discectomy was 12％(95％CI=9.0％-15.0％),Modic changes(OR=6.72,95％CI=3.90-11.59),body mass index(OR=1.28,95％CI=1.10-1.49),work intensity(OR=3.22,95％CI=1.85-5.59),age(OR=2.28,95％CI=1.50-3.48),and smoking history(OR=2.65,95％CI=1.75-4.00)were independent influencing factors for postoperative recurrence of percutaneous endoscopic lumbar discectomy(all P＜0.05).CONCLUSION:The overall predictive performance of the recurrence risk prediction models after percutaneous endoscopic lumbar discectomy is satisfactory;however,the model exhibits a high overall risk of bias and applicability,coupled with low reporting quality.Additionally,there is a lack of prospective research and external validation.Future,risk prediction models should consider factors such as Modic changes,body mass index,work intensity,age,and smoking history as potential predictors.

OBJECTIVE:Postoperative recurrence is a common complication of percutaneous endoscopic lumbar discectomy for lumbar disc herniation,which can significantly increase the risk of reoperation.A well-performing risk prediction model can help identify high-risk groups early and prevent postoperative recurrence.This study systematically evaluated the risk prediction model for postoperative recurrence after percutaneous endoscopic lumbar discectomy to provide a reference for surgical decision-making.METHODS:The PubMed,Embase,Web of Science,CNKI,WanFang Data,VIP,and CBM were electronically searched to collect studies on the recurrence risk prediction models after percutaneous endoscopic lumbar discectomy from inception to July 1,2024.Two reviewers independently screened the literature and extracted data.The models' risk of bias,applicability,and report quality were assessed using prediction model risk of bias assessment tool(PROBAST)and Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis(TRIPOD)tools,respectively.Meta-analysis of postoperative recurrence rate of percutaneous endoscopic lumbar discectomy and related predictors was performed using Revman 5.4 software.RESULTS:(1)A total of 15 studies were included,all of which were retrospective studies,including 24 models for predicting the risk of recurrence after percutaneous endoscopic lumbar discectomy.(2)The PROBAST evaluation results indicated that all 15 studies exhibited a high risk of bias.Regarding applicability,two studies demonstrated a low risk,while 13 presented a high risk.(3)Regarding the TRIPOD reporting quality,the overall quality across the 15 studies was low.The primary reasons for this low compliance included the failure to report blinding,a lack of explanation for the sample size calculation method,lack of detailed description of missing data processing methods,and lack of information such as introduction to the model used.(4)Furthermore,the area under the receiver operating characteristic curve for the model ranged from 0.684 to 0.972,with the number of potential predictor variables varying from 15 to 28.(5)The results of meta-analysis showed that the postoperative recurrence rate of lumbar disc herniation patients treated with percutaneous endoscopic lumbar discectomy was 12％(95％CI=9.0％-15.0％),Modic changes(OR=6.72,95％CI=3.90-11.59),body mass index(OR=1.28,95％CI=1.10-1.49),work intensity(OR=3.22,95％CI=1.85-5.59),age(OR=2.28,95％CI=1.50-3.48),and smoking history(OR=2.65,95％CI=1.75-4.00)were independent influencing factors for postoperative recurrence of percutaneous endoscopic lumbar discectomy(all P＜0.05).CONCLUSION:The overall predictive performance of the recurrence risk prediction models after percutaneous endoscopic lumbar discectomy is satisfactory;however,the model exhibits a high overall risk of bias and applicability,coupled with low reporting quality.Additionally,there is a lack of prospective research and external validation.Future,risk prediction models should consider factors such as Modic changes,body mass index,work intensity,age,and smoking history as potential predictors.

The incidence and mortality rates of lung cancer remain high, making it the leading cause of cancer-related deaths. In women, the predominant histological subtype is lung adenocarcinoma, commonly associated with epidermal growth factor receptor (EGFR) mutations, and EGFR-tyrosine kinase inhibitors (EGFR-TKIs) can significantly improve patient prognosis. Metastasis of primary lung cancer to the endometrium is extremely rare and is often misdiagnosed as a primary reproductive system tumor, and its occurrence indicates poor prognosis. This article reports a case of an advanced lung adenocarcinoma patient with EGFR mutation, who developed abnormal vaginal bleeding after EGFR-TKIs treatment failure, and biopsy confirmed endometrial metastasis. A review of similar cases is also presented.
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Humans ; Female ; ErbB Receptors/metabolism* ; Endometrial Neoplasms/genetics* ; Lung Neoplasms/genetics* ; Protein Kinase Inhibitors/therapeutic use* ; Adenocarcinoma of Lung/drug therapy* ; Treatment Failure ; Middle Aged ; Adenocarcinoma/genetics*

Objective: To develop the Adolescent Peer Bullying Knowledge-Attitude-Practice (KAP) Questionnaire and to evaluate its reliability and validity, so as to provide an effective tool for evaluating the KAP level regarding peer bullying among adolescents. Methods: A preliminary framework was developed through literature review, expert consultation, and group discussions. In September 2024, 2 203 students in grades 7 to 9 from two regular junior high schools in Anhui Province were selected using cluster sampling for a preliminary survey aimed at questionnaire development, including item screening and reliability and validity testing. Results: The initial KAP questionnaire on adolescent peer bullying consisted of 25 items: two items, "Behavior 6" and "Behavior 7", were excluded as their correlation coefficients with the total KAP score being only 0.08 and 0.05, respectively, falling below the preset criteria(0.4). The final questionnaire comprised 23 items, divided into three dimensions: knowledge, attitude, and behavior. Reliability testing showed that the overall Cronbach α coefficient of the questionnaire was 0.89, with Cronbach α coefficients for the knowledge, attitude, and behavior dimensions being 0.91, 0.67 and 0.79, respectively. The overall splithalf reliability of the questionnaire was 0.87, with split half reliabilities for the knowledge, attitude, and behavior dimensions being 0.82, 0.64 , and 0.66, respectively. Testretest reliability ranged from 0.82 to 0.97. Confirmatory factor analysis results indicated that the questionnaire had RMSEA=0.062, NFI=0.924, CFI =0.931, with good discriminant validity. Conclusion The developed KAP questionnaire on adolescent peer bullying demonstrates good reliability and validity and can be used as an assessment tool for evaluating the KAP level regarding peer bullying among adolescents.

Objective: To evaluate the effectiveness of a family-school-community integrated intervention based on the microsystem theory in reducing peer bullying among junior high school students, so as to provide empirical evidence and feasible pathways for junior high school students bullying prevention and control in China. Methods: A combining convenience with clustering method was employed to select 6 268 students from three regular junior high schools in Fuyang and Anqing cities, Anhui Province, as the study subjects in October 2024, and randomly assigned by drawing lots to three groups: family-school-community integrated intervention ( n =2 063), school only intervention ( n =1 864), and control group ( n =2 341). From October 10, 2024, to January 10, 2025, the intervention was implemented for three months using posters, brochures, and videos, with one session every half month, each lasting 40 minutes. The family-school-community integrated intervention group received multi level interventions involving families, schools, and communities, while the school only intervention group received only school based interventions. The control group received routine school health education but no other interventions. Before and after the intervention, data on peer bullying among junior high school students were collected using the Peer Bullying Scale, and comparison of detection rate of peer bullying by Chi square test. Results: After the intervention,group comparison results showed that the incidence rates of various types of peer bullying in the family-school-community integrated intervention group, the school only intervention group, and the control group all showed statistically significant differences ( χ 2=28.61-66.85, all P <0.05). The detection rates of verbal bullying ( 7.51 %), relational bullying (5.62%), physical bullying (3.34%), cyberbullying (1.75%), being bullied (10.81%), verbal bullying others (2.67%), relational bullying others (1.55%), physical bullying others (1.36%), cyberbullying others (1.41%), and overall peer bullying (3.64%) in the family-school-community integrated intervention group were all lower than those in the control group (12.52%, 11.58%, 6.24%, 5.00%, 19.14%, 7.56%, 4.49%, 4.53%, 3.80%, 9.40%); additionally, the detection rates of verbal bullying others, overall peer bullying , verbal bullying, and being bullied , in the family-school-community integrated intervention group were all lower than those in the school only intervention group (4.67%, 6.65%, 13.14%, 16.42%), with statistically significant differences ( χ 2=30.04, 48.49, 19.75, 34.60, 58.89, 52.65, 31.32, 37.37, 24.14, 58.26; 11.25, 18.53, 33.93, 26.41, all P <0.016 7). Group comparison showed that in both intervention groups, the majority of peer bullying behaviors decreased after the intervention ( χ 2=4.86-171.01, all P <0.05). Conclusions The family-school-community integrated intervention based on the microsystem can effectively reduce peer bullying among junior high school students, with better efficacy than the single school intervention. The model can serve as a practical reference for establishing a multi level prevention and intervention system for junior high school students bullying in China.

OBJECTIVE To conduct a reevaluation of the systematic review(SR)/meta-analysis on the use of Xianling gubao capsules(XLGBC)for knee osteoarthritis(KOA),and provide evidence-based support for the clinical use of the drugs.METHODS Computerized searches including CNKI,Wanfang Data,VIP,China Biomedical Literature Database,the Cochrane Library,PubMed,Embase and Web of Science were conducted to collect systematic reviews(SR)or meta-analyses of XLGBC for the treatment of KOA from the inception to May 31st,2024.The report quality,methodological quality,risk of bias and evidence quality were assessed using the PRISMA 2020 statement,AMSTAR 2 scale,ROBIS tool and GRADE tool,respectively.A comprehensive quality analysis of the quantitative results from the SR/meta-analysis was also performed.RESULTS A total of five SR/meta-analyses were included.The evaluation results based on the PRISMA 2020 statement showed that one study report was relatively complete(21 points),while four studies had deficiencies(18-20 points).The assessment using the AMSTAR 2 scale indicated that the methodological quality of all five studies was rated as very low.According to the ROBIS tool evaluation,the risk of comprehensive bias in all five studies was classified as high.GRADE tool evaluation revealed that among 49 outcome indicators,5(10.2％)were rated as moderate-quality evidence(10.2％),12 as low-quality evidence(24.5％),and 32 as very low-qualitv evidence(65.3％).The results of comprehensive quality analysis showed that the clinical efficacy,visual analogue scale score,pain relief time,comprehensive indexes of knee joint function,the levels of inflammatory factors and the incidence of adverse events in patients with XLGBC combined with conventional treatment were significantly better than conventional treatment alone(P＜0.05).CONCLUSIONS Compared with conventional treatment,XLGBC in combination with conventional treatment for KOA may have some efficacy and safety advantages.However,due to the low quality of evidence for the outcome indicators included in the studies,the conclusions should be interpreted with caution.

Parkinson′s disease (PD) is a debilitating neurodegenerative disorder that exhibits an escalating prevalence with advancing age. The management of PD adheres to a comprehensive therapeutic approach integrating pharmacological interventions, surgical procedures, rehabilitative exercises, and supportive care measures. In recent years, with the deepened understanding of the pathogenesis underlying PD, non-invasive neuromodulation therapy is heralding a new frontier in the clinical diagnosis and management of PD.

Abstract: Objective　To explore the tolerance of Aedes albopictus to typical insecticides and mutations in its knockdown resistance (kdr) and acetylcholinesterase number one (ace-1) genes in Hainan Province. Methods　Ae. albopictus larvae were collected from Danzhou, Sanya, Qiongzhong, Qionghai, Changjiang, and Wanning in Hainan Province in 2020 and 2021 to assess their resistance to 10 insecticides. Surviving samples from the resistance tests were examined for mutations in genes encoding acetylcholinesterase (AChE) and voltage-gated sodium channel (VGSC) using DNA Sanger sequencing. Results　The 24-hour corrected mortality rates of adult Ae. albopictus in different areas of Hainan to deltamethrin (0.03%), permethrin (0.40%), Beta-cypermethrin (0.40%), Beta-cypermethrin (0.08%), and lambda-cyhalothrin (0.07%) ranged from 5.56% to 83.33%, 29.89% to 92.22%, 26.67% to 97.78%, 11.11% to 88.89%, and 40.00% to 83.33%, respectively. The mortality rates after 24-hour exposure to propoxur (0.05%), bendiocarb (0.20%), malathion (0.50%), fenitrothion (0.20%), and chlorpyrifos (2.00%) ranged from 94.89% to 100.00%, among which the Ae.albopictus population from Changjiang showed a mortality rate of 97.78% to propoxur, and populations from Sanya, Wanning, and Qionghai showed mortality rates of 94.89%, 96.67%, and 96.67% to malathion respectively. The mortality rate of Ae.albopictus populations in Sanya and Qionghai to fenitrothion was 97.78%, while in other populations, it was 100.00%. Sequencing results showed that the kdr gene exhibited a mutation solely at locus 1534, featuring four alleles: wild-type TTC/F and the mutant types TGT(TGC)/C, TCC/S, and TTG/L with the mutation frequencies of 40.47%, 22.25%, 36.44%, and 0.85%, respectively. There are seven types of these mutations: wild-type homozygotes F/F, wild-type/mutant heterozygotes F/C, F/S, and F/L, mutant heterozygotes S/C, and wild-type homozygotes C/C and S/S, with mutation frequencies of 19.92%, 6.78%, 32.63%, 1.69%, 11.44%, 13.14%, and 14.41%, respectively. Notably, No related amino acid mutations were detected at position 119 of the ace-1 gene. Conclusions　The Ae.albopictus populations in various areas of Hainan Province have developed a high resistance to pyrethroid insecticides such as deltamethrin, permethrin, beta-cypermethrin, and beta-cyfluthrin, but are sensitive or possibly resistant to carbamates and organophosphates insecticides. The resistance gene mutations mainly occur at position 1 534 of the kdr gene, suggesting that its mutation frequency could be a significant factor contributing to resistance in Ae. albopictus in Hainan.

Abstract: Objective　To understand the level of Aedes aegypti resistance in Hainan and to provide a reference for developing local preventive and control measures against the dengue vector Ae. aegypti. Methods In 2020, Aedes aegypti larvae and pupae were collected from Danzhou and Changjiang in Hainan Province and reared to the first filial generation (F1). The adult mosquito contact tube method was used to determine the resistance of Aedes aegypti to commonly used insecticides. The allele-specific PCR (AS-PCR) was used to detect the mutations in V1016G and F1534C knockdown resistance (kdr) gene in Aedes aegypti. Results There was no significant difference in the knockdown rate of Ae. aegypti from Changjiang and Danzhou after 1 hour of exposure to four pyrethroids insecticides, namely deltamethrin (0.03%), permethrin (0.40%), beta-cypermethrin (0.04%) and lambda-cyhalothrin (0.02%). However, the 24-hour mortality rates of Ae. aegypti from Changjiang and Danzhou city were 95.56%, 85.56%, 81.11%, 48.89% and 94.44%, 68.60%, 61.11%, 30.00%, respectively. Except for deltamethrin (0.03%), the other differences were statistically significant. Aedes aegypti in Changjiang showed 100.00% mortality to propoxur (0.03%) and bendiocarb (0.20%), while in Danzhou, these rates were 100.00% and 98.89%, respectively. Ae. aegypti both from Changjiang and Danzhou showed 100.00% mortality to malathion (1.50%) and chlorpyrifos (0.80%), and mortality rates to 0.25% fenthion were 100.00% and 98.89%, respectively. V1016G and F1534C mutations were found in Ae. aegypti from Danzhou and Changjiang with mutation frequencies of 12.50% (20/160) and 97.50% (156/160), showing significant differences (χ2=233.54, P<0.001). In Changjiang, Aedes aegypti exhibited both V1016G and F1534C mutations with frequencies of 20.00% and 100.00%, respectively, whereas in Danzhou, only F1534C mutations occurred with a frequency of 98.75%. Conclusions Ae. aegypti in Hainan Province exhibited varying levels of resistance to four insecticides: deltamethrin, permethrin, beta-cypermethrin, and lambda-cyhalothrin, but showed sensitivity to propoxur, bendiocarb, malathion, and chlorpyrifos. The primary knockdown resistance gene mutation was F1534C.

Objective To investigate whether there are sex differences in inflammatory bowel disease(IBD)among the offspring of mice with IBD.Methods BALB/c female mice were randomly divided into Na?ve and DSS groups.The mice in the Na?ve group drank autoclaved water freely,and the DSS group freely drank 2％dextran sodium sulfate(DSS)for 7 days before it was replaced with autoclaved water for 10 days.A total of 3～4 cycles were applied,and the IBD female mice were paired with healthy male mice in cages.When the pups were 8 weeks old,they were divided into the Con group and IBD group.The Con group drank autoclaved water freely for 7 days,and the IBD group drank 3％DSS for 7 days.During the modeling period,disease activity index was scored by monitoring body weight,fecal consistency,and the presence of blood in stool every day.Pathological sections were taken to observe changes in goblet cells and the mucus layer of colon tissues.The concentrations of interleukin(IL)-6,IL-1β,IL-33,and IL-10 in the colon were detected by enzyme-linked immunosorbent assay.Real-time quantitative PCR was used to determine the mRNA expression levels of tight-junction proteins and MUC-2 in the colon.Results Compared with female IBD mice,male IBD mice had higher DAI scores,significantly shorter colons,larger amounts of inflammatory infiltrate,more crypt abnormalities,and a higher absence of goblet cells in the colon;their relative mRNA expression of occludin mRNA was significantly reduced,levels of IL-6 and IL-33 were significantly increased,and level of IL-10 was significantly decreased.Conclusions The symptoms of colitis in the offspring of IBD mice were more severe in male than in female mice,a result that was mainly attributed to the more severely impaired intestinal epithelial barrier function in males.