Phytochemicals are natural products derived from nature.Numerous studies have demonstrated that they can inhib-it the occurrence and development of different tumors through various pathways.Recent studies have revealed that the tumor microen-vironment is a key regulatory target that drives the malignant progression of tumors,and its synergistic anti-tumor effects with phyto-chemicals has become a research focus.Therefore,this article reviews the current status and progress of research on the role of phyto-chemicals in the tumor microenvironment and its possible mechanisms in recent years.

Objective To observe the clinical efficacy of Yishen Huoxue Decoction combined with acupuncture in treating premature ovarian insufficiency(POI)with kidney deficiency and blood stasis syndrome.Methods A total of 116 patients diagnosed with POI of kidney deficiency and blood stasis syndrome who attended the outpatient department of Sichuan North Medical College Affiliated Nanchong Traditional Chinese Medicine Hospital between April 2023 and October 2024 were selected as study subjects.Patients were randomly divided into an observation group and a control group using a random number table,with 58 cases in each group.The control group received sequential therapy with estrogen and progesterone,while the observation group received Yishen Huoxue Decoction combined with acupuncture in addition to the control group's treatment.The treatment was administered continuously for three menstrual cycles.After three months of treatment,the clinical efficacy of both groups was evaluated.Changes in TCM syndrome scores,serum hormone levels[follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),anti-Müllerian hormone(AMH)],immune factors[interleukin-2(IL-2),tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ)],and protein expression levels of the PI3K/AKT signaling pathway were observed and compared between the two groups before and after treatment.Safety and adverse reactions were also evaluated.Results(1)The total effective rate was 91.38％(53/58)in the observation group and 74.14％(43/58)in the control group.The efficacy of the observation group was significantly superior to that of the control group,with a statistically significant difference(P＜0.05).(2)After treatment,TCM syndrome scores were significantly improved in both groups(P＜0.05),and the improvement in the observation group was significantly greater than that in the control group,with a statistically significant difference(P＜0.05).(3)After treatment,serum levels of FSH,E2,LH,and AMH were significantly improved in both groups(P＜0.05),and the improvement in the observation group was significantly greater than that in the control group,with a statistically significant difference(P＜0.05).(4)After treatment,levels of IFN-γ,TNF-α,and IL-2 were significantly improved in both groups(P＜0.05),and the improvement in the observation group was significantly greater than that in the control group,with a statistically significant difference(P＜0.05).(5)After treatment,the protein expression levels of PI3K and AKT were significantly improved in both groups(P＜0.05),and the improvement in the observation group was significantly greater than that in the control group,with a statistically significant difference(P＜0.05).(6)During treatment,the incidence of adverse reactions was 10.34％(6/58)in the observation group and 8.62％(5/58)in the control group.There was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Based on the theory of"waxing and waning transformation of yin and yang",Yishen Huoxue Decoction combined with acupuncture significantly improves clinical symptoms,regulates the immune microenvironment,activates the PI3K/AKT signaling pathway,and effectively enhances ovarian function in patients with POI of kidney deficiency and blood stasis syndrome,demonstrating notable clinical efficacy.

Phytochemicals are natural products derived from nature.Numerous studies have demonstrated that they can inhib-it the occurrence and development of different tumors through various pathways.Recent studies have revealed that the tumor microen-vironment is a key regulatory target that drives the malignant progression of tumors,and its synergistic anti-tumor effects with phyto-chemicals has become a research focus.Therefore,this article reviews the current status and progress of research on the role of phyto-chemicals in the tumor microenvironment and its possible mechanisms in recent years.

Objective The objective of this study was to analyze the longitudinal trend of multidimensional treatment quality of breast cancer based on the latent growth mixture model(LGMM),identify potential change patterns and influencing factors,and pro-vide scientific basis for improving treatment quality and patient prognosis.Methods The quality monitoring data of breast cancer from four consecutive years were obtained in the National"Quality Monitoring System for Specific(single)Disease";Based on the item response theory(IRT),the treatment quality of breast cancer in the three dimensions of preoperative examination,treatment,and out-come was calculated;LGMM was constructed to analyze the independent and joint change trend of breast cancer treatment quality in all dimensions,and the optimal model was determined based on practical significance and statistical indicators.Results In the inde-pendent trend analysis,2 potential categories were identified for preoperative examination,treatment,and outcome dimensions.Among them,9%showed a rapid upward trend in the preoperative examination dimension,and 91%showed a relatively stable trend;The sta-ble growth accounted for 23%and slow decline accounted for 77%in the treatment dimension;13%of the outcome dimensions showed an upward trend,while 87%showed a downward trend.In the joint trend analysis of changes,2 potential categories were identified:the first category accounted for about 8%,and the preoperative examination dimension of this category had a good treatment quality,with mean intercepts and slopes of 3.326 and 3.367,respectively.The treatment quality in the treatment and outcome dimensions had steadily improved;The second category accounted for about 92%,and the treatment quality in this dimension was relatively good.Its mean intercept and slope were 0.548 and 0.018,respectively.There is still room for improvement in the treatment quality of the pre-operative examination and outcome dimensions;BMI and M stage in patient characteristics are important influencing factors on the trend of combined changes in treatment quality.Conclusion The treatment quality of breast cancer during this study period has im-proved to varying degrees in all dimensions of preoperative examination,treatment and outcome;In the joint trend analysis of the three dimensions,the improvement of treatment quality in the preoperative examination dimension can provide feasible references for subse-quent treatment and achieve the goal of reducing complications.

Objective Based on polynomial logistic regression model,this study aimed to analyze the optimal length of hospi-tal stay for patients with non-small cell lung cancer(NSCLC)at different stages to achieve the best treatment quality,providing refer-ence for improving treatment quality and formulating relevant policies.Methods The data of NSCLC cases were collected and 16 di-agnosis and treatment process indicators were selected.Patients were stratified according to the stage of lung cancer.A polynomial lo-gistic regression model was constructed,including patient characteristics to analyze the impact of first hospitalization days on the quali-ty of comprehensive treatment.Results A total of 10,053 patients with NSCLC were collected in this study,with a median compre-hensive treatment quality score of 0.60.According to the staging of lung cancer,patients were divided into the early stage group(stageⅠ-Ⅱ),locally advanced stage group(stage Ⅲ),and advanced stage group(stage Ⅳ).The first hospitalization days and treatment quality of each subgroup showed a non-linear relationship.The polynomial model results showed that after adjusting the characteristics of patients,the length of hospitalization day and the quadratic term of hospital stay had a statistically significant impact on treatment quality in each subgroup:early patients had a first hospital stay of 18 days,and locally advanced and advanced patients had a first hos-pital stay of 22 days,with the highest probability of achieving high treatment quality.Conclusion Patients in different stages have va-rying degrees of illness and treatment plans,resulting in different first hospitalization days corresponding to the highest probability of obtaining high-quality treatment.Hospitals can improve the treatment quality and medical efficiency by implementing standardized di-agnosis and treatment guidelines,strengthening the management of the diagnosis and treatment process,and reasonably controlling the first hospitalization time of patients in different stages.

Objective The aim of this study was to estimate the causal effects of non-small cell lung cancer(NSCLC)treat-ment process on in-hospital mortality based on the double robust estimation(DR)method,and provide a reference basis for reducing in-hospital mortality of NSCLC.Methods According to the quality evaluation system of NSCLC treatment,the utilization rate of treatment process indicators was calculated,and patients were divided into the high-quality or low-quality groups based on the aver-age score of treatment process quality.In-hospital mortality was used as the outcome indicator,Kaplan-Meier method and Cox regres-sion adjusted for propensity score inverse probability of treatment weighting(IPTW)correction were used to analyze the impact of treat-ment process quality on in-hospital mortality in NSCLC.DR was combined to estimate the causal effects of the treatment process on in-hospital mortality.Results The median utilization rate of treatment process indicators was 66.88%,and the mean and standard de-viation of patients′ treatment process quality scores were 0.270±0.124,including 0.358±0.069 in the high-quality group,and 0.158±0.081 in the low-quality group.After the IPTW weighting,the standardized mean difference(SMD)of patients′baseline characteris-tics decreased;The difference in survival curves between the two groups of patients before and after ITPW was statistically significant(P<0.05),and the prognosis of patients in the high-quality group was better than that of patients in the low-quality group(pre-IPTW:HR=0.367,95%CI:0.275-0.491;post-IPTW:HR=0.228,95%CI:0.167-0.312).Compared with the low-quality group,the average causal effect of treatment process on in-hospital mortality was-0.026 in the high-quality group.Conclusion DR can compensate for the shortcomings of logistic or IPTW,avoid the risk of model error,and obtain for the causal effect of treatment process on in-hospital mortality.In medical practice,the utilization rate of treatment process indicators should be increased to improve patient prognosis;The study of causal effects suggests that besides the treatment process,other factors that affect in-hospital mortality cannot be ignored.

Objective:To evaluate the effect of sirtuin 3 (SIRT3) overexpression on hypoxia-reoxygenation (H/R) injury to hippocampal neurons of mice exposed to high glucose and its relationship with SOD2.Methods:The normally cultured HT22 neurons at the logarithmic phase were selected and divided into 3 groups ( n=12 each) using a random number table method: high-glucose normoxia group (HG group), high glucose+ H/R group (HHR group) and high glucose+ H/R+ SIRT3 overexpression group (HHR+ SIRT3 group). To establish high glucose model, the neurons in 3 groups were cultured in high-glucose culture medium (glucose concentration of 50 mmol/L) for 8 h. In HHR and HHR+ SIRT3 groups, the cells were exposed to glucose-free and hypoxia for 6 h and then cultured in the high-glucose normoxic environment for 24 h to establish the high glucose and HR injury model.In HHR+ SIRT3 group, the neurons were transfected with SIRT3 overexpressed lentivirus.The cell viability was recorded by the cell counting kit-8 assay, reactive oxygen species (ROS) content was detected by flow cytometry, mitochondrial malonaldehyde (MDA) content, superoxide dismutase (SOD) activity, catalase (CAT) activity and adenosine triphosphate (ATP) content were determined by colorimetry, mitochondrial membrane potential (MMP) was detected by JC-1 probe, and the expression of nuclear respiratory factor 1 (NRF1), mitochondrial transcription factor A (TFAM), SIRT3, SOD2 and acetylated SOD2 (ac-SOD2) was detected by Western blot. Results:Compared with HG group, cell viability, SOD activity, CAT activity, ATP content, MMP, NRF1 and the expression of TFAM and SIRT3 were significantly decreased, and ROS content, MDA content and ac-SOD2/SOD2 ratio were increased in group HHR and group HHR+ SIRT3 ( P<0.05). Compared with HHR group, cell viability, SOD activity, CAT activity, ATP content, MMP, NRF1 and the expression of TFAM and SIRT3 were significantly increased, and ROS content, MDA content and ac-SOD2 /SOD2 ratio were decreased in HHR+ SIRT3 group ( P<0.05). Conclusion:SIRT3 overexpression can alleviate hypoxia-reoxygenation (H/R) injury to hippocampal neurons of mice incubated in high glucose medium, and the mechanism is related to activation of SOD2 deacetylation.

In this article,the nursing devices alocation information of 294 hospitals, including the origin, purchase time, funding sources, failure rate and satisfaction with the performance, efficiency, and after-sales services, is surveyed by convenient sampling. The confi guration and application of nursing devices in Liaoning Province is known. It is hoped to be helpful for providing a reference for the demand of nursing device market.

Objective To investigate the etiology and risk factors of stroke in young adults from Southern Sichuan, China to provide a basis for prevention and treatment of stroke. Methods The data of 398 young patients with first-ever stroke (aged 18 to 44) admitted to department of Neurology, the Affiliated Hospital of Luzhou Medical College from 2009 to 2013 was retrospectively analyzed. Four hundred twenty-five cases of stroke (aged greater than or equal to 45) were re?cruited by stratified random sampling to analyze its causes and risk factors in the same period. Results ① Young stroke accounted for 6.09% of all hospitalized stroke patients in which 78.39% of young stroke was ischemic, 64.57%was male and 58.04% aged from 40 to 44. ② According to TOAST etiology classification group, the percentage of large-artery atherosclerosis, small-vessel, cardioembolism, other determined and undetermined reasons were 56.09%, 17.95%, 9.93%, 10.90% and 5.13% in young stroke, respectively. Compared with the elderly group, other determined and undetermined reasons were higher, and the small-vessel was lower in young stroke (P<0.05). Hypertensive cerebral hemorrhage accounted for 50%of Hemorrhage in young group, and the type of Hemorrhage between two groups was no statistically significant.(P>0.05).③ Risk factors analysis revealed that the constituent ratio of smoking (34.92%), hyper?lipidemia (31.41%), alcohol (20.10%), obesity (13.07%), rheumatic heart disease (6.03%) in youth group were higher whereas hypertension(66.12%), diabetes(20.47%)and coronary heart disease(10.82%)were lower in young stroke com?pared with the elderly group (P<0.05). Conclusion ①Large-artery atherosclerosis is the most common etiology of youth ischemic stroke. ② Hypertensive cerebral hemorrhage is the most frequent type in Hemorrhagic stroke. ③ Hyperten?sion, smoking and hyperlipidemia are the most common risk factors to stroke.