ObjectiveTo evaluate the therapeutic effects of modified Banxia Xiexintang（MBXT） on polycystic ovary syndrome with insulin resistance（PCOS-IR） rats and reveal its potential mechanisms based on the integrated analysis of transcriptomics and metabolomics. MethodsFemale SD rats were selected， and a PCOS-IR model was established by intragastric administration of letrozole combined with a high-fat diet for 21 days. The modeled rats were randomly divided into the model group， MBXT low-， medium-， and high-dose groups（6.62， 13.23， 26.46 g·kg^-1）， and metformin group（0.158 g·kg^-1）， with a normal group set up separately. After 14 days of administration， the estrous cycle was observed， ovarian morphology was examined by hematoxylin-eosin（HE） staining， and the levels of testosterone（T）， estradiol（E₂）， follicle-stimulating hormone（FSH）， and luteinizing hormone（LH） in serum were detected by enzyme-linked immunosorbent assay（ELISA）. Serum metabolites and ovarian tissue gene expression were detected using ultra-performance liquid chromatography-quadrupole-electrostatic orbitrap mass spectrometry（UPLC-Q-Orbitrap-MS） and RNA-Seq technology， respectively， followed by multi-omics integrated analysis. ResultsPharmacodynamic findings revealed that all MBXT dose groups could reversed abnormal estrous cycles in PCOS-IR rats， improve polycystic ovarian lesions， and normalize dysregulated serum hormone levels（T， LH， E₂， FS， P<0.05， P<0.01）. Metabolomic analysis revealed that compared with the model group， MBXT reversed 278 differential metabolites such as estrone and S-formylglutathione， mainly involving pathways such as steroid hormone biosynthesis， glutathione metabolism， and lipid peroxidation regulation. Transcriptomic analysis identified 434 differentially expressed genes， and enrichment analysis revealed that MBXT significantly regulated lipid peroxidation defense systems， including glutathione metabolism， peroxisome function， and fatty acid metabolism， thereby intervening in ferroptosis processes. It also engaged in inflammation-related pathways such as the chemokine signaling pathway. Integrated analysis revealed that both metabolomics and transcriptomics co-enriched metabolic pathways associated with ferroptosis and fatty acid metabolism. And key Hub genes［such as Ras-related C3 botulinum toxin substrate 2 gene（Rac2） and Fas ligand gene（Faslg）］ showed significant correlations with differential metabolites. ConclusionMBXT can effectively ameliorate reproductive dysfunction and metabolic disorders in PCOS-IR rats. Its mechanism may be related to remodeling the immune-metabolism network， particularly by regulating MHC-mediated immune responses， inhibiting local ovarian ferroptosis， and enhancing steroid hormone synthesis pathways.

ObjectiveTo investigate the mechanism of modified Banxia Xiexintang（MBXT） in improving ovarian dysfunction in polycystic ovary syndrome with insulin resistance（PCOS-IR） rats by inhibiting ferroptosis through the adenosine monophosphate（AMP）-activated protein kinase（AMPK）/fatty acid synthase（FASN）/glutathione peroxidase 4（GPX4） signaling pathway. MethodsSeventy-six female SD rats were randomly divided into a normal group（n=13） and a modeling group（n=63）. The modeling group established a PCOS-IR model by intragastric administration of letrozole combined with a high-fat diet for 21 days. After successful modeling， these rats were randomly divided into the model group， MBXT low-， medium-， and high-dose groups（6.62， 13.23， 26.46 g·kg^-1）， metformin group（0.158 g·kg^-1）， and high-dose of MBXT combined with ferroptosis inducer Erastin group（15 mg·kg^-1）， with 10 rats in each group. After 14 days of intervention， ovarian pathological morphology was observed by hematoxylin-eosin（HE） staining， the mitochondrial ultrastructure of granulosa cells was observed by transmission electron microscopy（TEM）， ovarian reactive oxygen species（ROS） levels were detected by dihydroethidium（DHE） probe， biochemical methods were used to detect Fe²⁺， malondialdehyde（MDA）， glutathione（GSH） and other indicators in ovarian tissues， serum sex hormone and insulin levels were measured by enzyme-linked immunosorbent assay（ELISA）， and the protein expressions of AMPK， FASN， acyl-CoA synthetase long-chain family member 4（ACSL4）， GPX4， and solute carrier family 7 member 11（SLC7A11） in ovarian tissues were detected by Western blot. ResultsCompared with the normal group， the model group showed polycystic changes in the ovaries， with atrophy of mitochondria in granulosa cells and increased membrane density. Serum levels of testosterone（T）， luteinizing hormone（LH）， and insulin were significantly increased（P<0.01）. The levels of ROS， MDA， 4-hydroxynonenal（4-HNE）， and Fe²⁺ in ovarian tissues were significantly elevated（P<0.01）， while adenosine triphosphate（ATP）， GSH， and reduced nicotinamide adenine dinucleotide phosphate （NADPH） levels were significantly decreased（P<0.01）. The phosphorylation levels of AMPK and acetyl-CoA carboxylase （ACC）， as well as the protein expressions of SLC7A11， GPX4， and ferroptosis suppressor protein 1（FSP1） were significantly downregulated（P<0.01）， whereas the expressions of FASN， ACSL4， and nuclear receptor coactivator 4（NCOA4） were significantly upregulated（P<0.01）. Compared with the model group， MBXT intervention at various doses improved the above pathological changes and biochemical indicators in a dose-dependent manner， with the high-dose group showing the most significant effect（P<0.01）. Compared with the MBXT high-dose group， the high-dose of MBXT combined with ferroptosis inducer Erastin group restored ovarian ferroptosis characteristics in rats， with increased ROS and lipid peroxidation products， and altered expressions of key proteins（P<0.05， P<0.01）. ConclusionMBXT can effectively improve ovarian function and metabolic disorders in PCOS-IR rats. Its mechanism may be related to activating the AMPK/ACC signaling pathway， downregulating FASN and ACSL4 to reduce lipid peroxidation substrates， and restoring glucose-6-phosphate dehydrogenase/phosphoglycerate dehydrogenase（G6PD/PHGDH） metabolic flux to enhance the GPX4/FSP1 antioxidant defense system， thereby inhibiting ferroptosis in ovarian granulosa cells.

Objective To systematically reconstruct the evolution of schistosomiasis prevalence in China from 1950 to 2024, so as to fill the gap of national data on schistosomiasis prevalence in China before 1986. Methods Schistosomiasis control data were collected from schistosomiasis-endemic areas of China before 1986, which mainly included statistical data on schistosomiasis, compilations of control records, annual work reports, and academic papers. Data pertaining to the prevalence of schistosomiasis from each province (autonomous region, municipality) were collected and summarized annually, and integrated into national annual work reports for schistosomiasis control in China from 1986 to 2024 to build a national schistosomiasis epidemic database covering schistosomiasis patients, cattle with schistosomiasis, and Oncomelania hupensis snails. The provincial-level epidemic data of schistosomiasis were summarized annually from 1986 to 2024 with pivot tables, and then the national epidemic data of schis tosomiasis were summarized. The temporal trends in key epidemic indicators of schistosomiasis were analyzed in China from 1950 to 2024. Results A complete time-series dataset of schistosomiasis was established in China from 1950 to 2024 through systematic reconstruction of multi-source historical documents and materials. A total of 1.97 million newly detected schistosomiasis cases were recorded in China from 1950 to 2024, and the actual number of schistosomiasis patients was all more than 1 million each year from 1955 to 1978. There were only more than 20 000 advanced schistosomiasis patients in China by the end of 2024, and the prevalence of Schistosoma japonicum human infections reduced from 34.6% in 1950 to below 1.0% after 1996. A total of 2.47 million cattle were tested positive for schistosomiasis, and the prevalence of S. japonicum infections reduced from 21.4% in bovines since 1950. The area of emerging O. hupensis snail habitats was concentrated during the period between 1956 and 1958, accounting for 49.8% of total areas, while the area of emerging O. hupensis snail habitats significantly decreased since 1992, indicating a stable distribution pattern of O. hupensis snails. Data validation results showed that the cumulative variation in areas of O. hupensis snail habitats was 1.6%, and the cumulative variation in the number of schistosomiasis cases was 1.4%. Join-point regression analysis revealed four turning points in the prevalence of S. japonicum infections in humans and seven turning points in the prevalence of S. japonicum infections in livestock across China from 1955 to 2024. Conclusions Through the joint efforts of the Communist Party of China and government leadership, interdepartmental collaboration, professional teams, scientific and technological innovation, and public participation, the schistosomiasis epidemic has been effectively controlled in China following active control for more than 70 years. This study builds, for the first time, a complete time-series dataset on schistosomiasis in China, which provides insights into assessment of the effectiveness of schistosomiasis control programmes and refinement of the experience from schistosomiasis control programmes in China.

Objective:To retrospectively analyze the results of auditory examination,vestibular function examination and laboratory examination of 63 patients diagnosed as vestibular neuritis.Methods:A total of 63 patients diagnosed with vestibular neuritis hospitalized in the Department of Otolaryngology, Head and Neck Surgery of the Third Affiliated Hospital of Sun Yat-sen University, from October 2012 to December 2022 were recruited. All patients met the diagnostic criteria for the 2022 Bárány association vestibular neuritis. Clinical data and the results of pure tone audiometry, electrocochleogram, video electronystagmogram, caloric test, cervical vestibuloevoked myogenic potential（cVEMP）, ocular vestibuloevoked myogenic potential（oVEMP）, video head impulse test（vHIT） was collected.A total of 63 age-and sex-matched healthy subjects in the physical examination center were randomly selected as the control group. The differences of blood indexs and lipid metabolism indexes between the two groups were compared. Results:In patients with vestibular neuritis, 50 out of 63 patients presented normal threshold in pure tone audiometry, 8 out of 63 patients had bilateral high-frequency sensorineural hearing loss and 5 out of 63 patients had unilateral mild high-frequency sensorineural hearing loss, 56 out of 63 cases completed the electrocochleogram, of which 3 cases had a binaural-SP/AP amplitude ratio≥0.4, 5 cases had monaural amplitude ratio ≥0.4. Fifty-five out of 63 patients completed the caloric test with CP values greater than 30% in all. The ratio of patients completed cVEMP, oVEMP and vHIT were 46 cases, 22 cases and 30 cases, respectively. 17 out of 63 cases completed all the four vestibular function tests. According to these tests, 49 patients could determine the extent of injury，including 27 cases with unilateral superior vestibular nerve injury, 21 cases with unilateral superior and inferior vestibular nerve injury and 1 case with unilateral inferior vestibular nerve injury. There were significant differences in neutrophil value（P<0.001）, lymphocyte value（P<0.005）, neutrophil/lymphocyte ratio（P<0.001） and apolipoprotein A1（P<0.001） between patient group and control group. Inflammatory markers were risk factors for patients with vestibular neuritis. The OR values of neutrophil value and blood neutrophil/lymphocyte ratio were 1.81（1.38-2.37, P<0.001） and 2.11（1.41-3.16, P<0.001）, respectively. Apolipoprotein A1 was a protective factor for patients with vestibular neuritis, and the OR value was 0.004（0.001-0.042, P<0.001）. Conclusion:Electrocochleogram could be used in vestibular neuritis patients with normal pure tone threshold to test whether there is hidden hearing loss in these patients. Neutrophil value, lymphocyte value, neutrophil/lymphocyte ratio and apolipoprotein A1 were correlated with vestibular neuritis. The Neutrophil value and neutrophil/lymphocyte ratio were risk factors for morbidity.
Humans ; Vestibular Neuronitis/physiopathology* ; Retrospective Studies ; Female ; Male ; Audiometry, Pure-Tone ; Hearing Loss, Sensorineural/physiopathology* ; Middle Aged ; Adult ; Vestibular Function Tests ; Vestibular Evoked Myogenic Potentials ; Aged

Background and Aims:Elderly patients undergoing laparoscopic radical resection of colon cancer often experience decreased sleep quality,which may hinder postoperative recovery.Although pharmacological interventions are commonly used in clinical practice to improve postoperative sleep,conventional medications may lead to adverse effects such as delirium and dependence.This study aimed to evaluate the effect of a non-pharmacological intervention—buccal acupuncture combined with ultrasound-guided stellate ganglion block(SGB)—on postoperative sleep quality in elderly patients.Methods:A total of 60 elderly patients who underwent laparoscopic radical resection of colon cancer at the Forth Hospital of Changsha from February to August 2024 were enrolled.Using a random number table,the patients were divided into two groups:30 in the control group(SGB alone)and 30 in the study group(SGB combined with buccal acupuncture).Perioperative mean arterial pressure(MAP),heart rate(HR),postoperative visual analogue scale(VAS)scores,Pittsburgh Sleep Quality Index(PSQI)scores,and the incidence of adverse events were recorded and analyzed.Results:There were no statistically significant differences in baseline characteristics between the two groups(all P>0.05).The study group showed significantly lower intraoperative and postoperative HR and MAP compared to the control group(all P<0.05).VAS scores at 6,24,and 48 h postoperatively,as well as PSQI scores on postoperative days 1,3,and 5,were significantly lower in the study group(all P<0.05).Additionally,the incidence of drowsiness was significantly reduced(P<0.05).No significant differences were found between the two groups in terms of nausea,vomiting,or agitation(all P>0.05).Conclusion:The combination of buccal acupuncture and SGB during the perioperative period can effectively improve postoperative sleep quality,alleviate pain,and reduce adverse reactions in elderly patients undergoing laparoscopic radical resection of colon cancer.This safe and effective non-pharmacological intervention holds promising clinical application value.

Background and Aims:Elderly patients undergoing laparoscopic radical resection of colon cancer often experience decreased sleep quality,which may hinder postoperative recovery.Although pharmacological interventions are commonly used in clinical practice to improve postoperative sleep,conventional medications may lead to adverse effects such as delirium and dependence.This study aimed to evaluate the effect of a non-pharmacological intervention—buccal acupuncture combined with ultrasound-guided stellate ganglion block(SGB)—on postoperative sleep quality in elderly patients.Methods:A total of 60 elderly patients who underwent laparoscopic radical resection of colon cancer at the Forth Hospital of Changsha from February to August 2024 were enrolled.Using a random number table,the patients were divided into two groups:30 in the control group(SGB alone)and 30 in the study group(SGB combined with buccal acupuncture).Perioperative mean arterial pressure(MAP),heart rate(HR),postoperative visual analogue scale(VAS)scores,Pittsburgh Sleep Quality Index(PSQI)scores,and the incidence of adverse events were recorded and analyzed.Results:There were no statistically significant differences in baseline characteristics between the two groups(all P>0.05).The study group showed significantly lower intraoperative and postoperative HR and MAP compared to the control group(all P<0.05).VAS scores at 6,24,and 48 h postoperatively,as well as PSQI scores on postoperative days 1,3,and 5,were significantly lower in the study group(all P<0.05).Additionally,the incidence of drowsiness was significantly reduced(P<0.05).No significant differences were found between the two groups in terms of nausea,vomiting,or agitation(all P>0.05).Conclusion:The combination of buccal acupuncture and SGB during the perioperative period can effectively improve postoperative sleep quality,alleviate pain,and reduce adverse reactions in elderly patients undergoing laparoscopic radical resection of colon cancer.This safe and effective non-pharmacological intervention holds promising clinical application value.

Objective:To evaluate the efficacy and safety of albumin bound paclitaxel(nab-PTX)and solvent based paclitaxel(sb-PTX)in neoadjuvant chemotherapy(NACT)for advanced epithelial ovarian cancer(EOC).Methods:A retrospective analysis was conducted on the clinical data of 107 patients with advanced EOC who un-derwent preoperative NACT in the First Affiliated Hospital of Xi'an Jiaotong University from June 11,2018 to Sep-tember 19,2023.Among them,52 patients were treated with nab-PTX combined with carboplatin intravenous chemotherapy(nab-PTX group),and 55 with sb-PTX combined with carboplatin intravenous chemotherapy(sb-PTX group).The clinical indicators after NACT,intraoperative conditions of cytoreductive surgery and ad-verse events during the NACT were compared in two groups.Results:The maximum tumor diameter(3.7 cm vs.3.8 cm),CA125(28.9 U/ml vs.31.6 U/ml)and HE4(102.5 U/ml vs.119.0 U/ml)levels in the nab PTX group after NACT were significantly lower than those in the sb-PTX group,and the differences were statistically significant(P＜0.001).After NACT,the total input(2580 ml vs.2100 ml),the proportion of surgical complexity score(36.54％vs.18.18％),and lymph node resection rate(57.69％vs.29.09％)in the nab-PTX group were significantly higher than those in the sb-PTX group(P＜0.05).There was no statistically significant difference(P＞0.05)in the amount of ascites,clinical efficacy evaluation,ORR,DCR,surgical time,intraoperative bleeding,total output,postoperative hospital stays,surgical satisfaction,pathological complete response rate(pCR),transfu-sion of blood products,lymph node metastasis and adverse effects during NACT between the two groups.Con-clusions:Nab-PTX has a better clinical disease control effect than sb-PTX in NACT,in order to achieve better cy-toreductive surgery,but it has no significant effect on pathological remission.The safety of the two drugs is similar.

Objective:To evaluate the efficacy and safety of albumin bound paclitaxel(nab-PTX)and solvent based paclitaxel(sb-PTX)in neoadjuvant chemotherapy(NACT)for advanced epithelial ovarian cancer(EOC).Methods:A retrospective analysis was conducted on the clinical data of 107 patients with advanced EOC who un-derwent preoperative NACT in the First Affiliated Hospital of Xi'an Jiaotong University from June 11,2018 to Sep-tember 19,2023.Among them,52 patients were treated with nab-PTX combined with carboplatin intravenous chemotherapy(nab-PTX group),and 55 with sb-PTX combined with carboplatin intravenous chemotherapy(sb-PTX group).The clinical indicators after NACT,intraoperative conditions of cytoreductive surgery and ad-verse events during the NACT were compared in two groups.Results:The maximum tumor diameter(3.7 cm vs.3.8 cm),CA125(28.9 U/ml vs.31.6 U/ml)and HE4(102.5 U/ml vs.119.0 U/ml)levels in the nab PTX group after NACT were significantly lower than those in the sb-PTX group,and the differences were statistically significant(P＜0.001).After NACT,the total input(2580 ml vs.2100 ml),the proportion of surgical complexity score(36.54％vs.18.18％),and lymph node resection rate(57.69％vs.29.09％)in the nab-PTX group were significantly higher than those in the sb-PTX group(P＜0.05).There was no statistically significant difference(P＞0.05)in the amount of ascites,clinical efficacy evaluation,ORR,DCR,surgical time,intraoperative bleeding,total output,postoperative hospital stays,surgical satisfaction,pathological complete response rate(pCR),transfu-sion of blood products,lymph node metastasis and adverse effects during NACT between the two groups.Con-clusions:Nab-PTX has a better clinical disease control effect than sb-PTX in NACT,in order to achieve better cy-toreductive surgery,but it has no significant effect on pathological remission.The safety of the two drugs is similar.

Objective:To evaluate the efficacy and safety of albumin bound paclitaxel(nab-PTX)and solvent based paclitaxel(sb-PTX)in neoadjuvant chemotherapy(NACT)for advanced epithelial ovarian cancer(EOC).Methods:A retrospective analysis was conducted on the clinical data of 107 patients with advanced EOC who un-derwent preoperative NACT in the First Affiliated Hospital of Xi'an Jiaotong University from June 11,2018 to Sep-tember 19,2023.Among them,52 patients were treated with nab-PTX combined with carboplatin intravenous chemotherapy(nab-PTX group),and 55 with sb-PTX combined with carboplatin intravenous chemotherapy(sb-PTX group).The clinical indicators after NACT,intraoperative conditions of cytoreductive surgery and ad-verse events during the NACT were compared in two groups.Results:The maximum tumor diameter(3.7 cm vs.3.8 cm),CA125(28.9 U/ml vs.31.6 U/ml)and HE4(102.5 U/ml vs.119.0 U/ml)levels in the nab PTX group after NACT were significantly lower than those in the sb-PTX group,and the differences were statistically significant(P＜0.001).After NACT,the total input(2580 ml vs.2100 ml),the proportion of surgical complexity score(36.54％vs.18.18％),and lymph node resection rate(57.69％vs.29.09％)in the nab-PTX group were significantly higher than those in the sb-PTX group(P＜0.05).There was no statistically significant difference(P＞0.05)in the amount of ascites,clinical efficacy evaluation,ORR,DCR,surgical time,intraoperative bleeding,total output,postoperative hospital stays,surgical satisfaction,pathological complete response rate(pCR),transfu-sion of blood products,lymph node metastasis and adverse effects during NACT between the two groups.Con-clusions:Nab-PTX has a better clinical disease control effect than sb-PTX in NACT,in order to achieve better cy-toreductive surgery,but it has no significant effect on pathological remission.The safety of the two drugs is similar.

Purpose: The prevalence of psychological distress is frequently observed among old adults with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). However, current researches are insufficient to clarify the correlation among these relevant factors. This study examined the effects of symptom burden, psychological resilience, coping styles, and social support on psychological distress. Methods: Two hundred fifty five elderly patients with AECOPD were conveniently selected in Taian, Shandong Province. The General Information Questionnaire, Distress Thermometer, The Revised Memorial Symptom Assessment Scale, Connor-Davidson Resilience Scale, Simplified Coping Style Questionnaire, Perceived Social Support Scale were used to investigate. The relationship among factors was estimated by using a structural equation model. Results: Psychological distress score of elderly patients with AECOPD was (5.25 ± 1.01); coping styles, psychological resilience, symptom burden, and social support directly affected psychological distress (thedirect effects were À.93, .17, .17, and À.09); coping styles had the largest total effect on psychological distress (the total effect was À.93); psychological resilience indirectly affected psychological distress through coping styles (the indirect effect was À.74); symptom burden indirectly affected psychologicaldistress through psychological resilience (the indirect effect was .25); social support indirectly affected psychological distress through symptom burden, psychological resilience, and coping styles (the indirecteffect was À.80). Conclusion The psychological distress of elderly patients with AECOPD is at a moderate level; coping styles, psychological resilience, and social support have positive effects on alleviating the psychological distress of elderly patients with AECOPD; symptom burden is negatively correlated with psychological distress.Healthcare professionals should pay more attention to elderly patients with AECOPD who are particularly prone to experience higher levels of psychological distress, especially in the presence of low coping style, limited psychological resilience, inadequate levels of social support, and high symptom burden.