Xiaoaiping (XAP) Injection demonstrates the anti-prostate cancer (PCa) effects, yet the underlying mechanism remains unclear. This study aims to investigate the impact of XAP on PCa and elucidate its mechanism of action. PCa cell proliferation was evaluated using a cell counting kit-8 (CCK-8) assay. Cell apoptosis was assessed through Hoechst staining and Western blotting assays. Proteomics technology was employed to identify key molecules and significant signaling pathways modulated by XAP in PCa cells. To further validate potential key genes and important pathways, a series of assays were conducted, including acridine orange (AO) staining, transmission electron microscopy, and immunofluorescence assays. The molecular mechanism of XAP against PCa in vivo was examined using a PC3 xenograft mouse model. Results demonstrated that XAP significantly inhibited cell proliferation in multiple PCa cell lines. In C4-2 and prostate cancer cell line-3 (PC3) cells, XAP induced cellular apoptosis, evidenced by reduced B-cell lymphoma 2 (Bcl-2) levels and elevated Bcl-2-associated X (Bax) levels. Proteomic, immunofluorescence, and quantitative reverse transcription-polymerase chain reaction (qRT-PCR) investigations revealed a strong correlation between forkhead box O3a (FoxO3a) autophagic degradation and the anti-PCa action of XAP. XAP hindered autophagy by reducing the expression levels of autophagy-related protein 5 (Atg5)/autophagy-related protein 12 (Atg12) and enhancing FoxO3a expression and nuclear translocation. Furthermore, XAP exhibited potent anti-PCa action in PC3 xenograft mice and triggered FoxO3a nuclear translocation in tumor tissue. These findings suggest that XAP induces PCa apoptosis via inhibition of FoxO3a autophagic degradation, potentially offering a novel perspective on XAP injection as an effective anticancer therapy for PCa.
Male ; Humans ; Prostatic Neoplasms/physiopathology* ; Autophagy/drug effects* ; Animals ; Drugs, Chinese Herbal/pharmacology* ; Proteomics ; Mice ; Apoptosis/drug effects* ; Cell Line, Tumor ; Cell Proliferation/drug effects* ; Forkhead Box Protein O3/genetics* ; Xenograft Model Antitumor Assays ; Mice, Nude ; Mice, Inbred BALB C

Tooth absorption can be divided into physiological absorption and pathological absorption.Root absorp-tion of mature deciduous teeth is physiological absorption.Pathological absorption includes internal absorption and ex-ternal absorption.Internal absorption,also known as intramedullary absorption,includes inflammatory absorption and al-ternative absorption.External tooth absorption originates from the outer surface of the root or the neck of the tooth and can be divided into inflammatory absorption,alternative absorption,pressure resorption and invasive cervical resorption.Invasive cervical resorption(ICR)is pathological damage caused by many factors,which usually begins in the cemento-enamel junction and extends peripherally or horizontally in the dentin.It hardly invades the pulp.Orthodontic devices,trauma,bleaching,systemic diseases,and the use of certain medications can all lead to invasive cervical resorption.The clinical manifestations of ICR are usually asymptomatic or not obvious,and most of which are found in imaging examina-tions.Because caries and internal absorption are often misdiagnosed through plain apical radiography,cone beam com-puted tomography(CBCT)can help to better understand the situation of invasive cervical resorption.Because the patho-genesis and etiology of invasive cervical resorption are not fully understood,clinical negligence and inadequate treat-ment of invasive cervical resorption can even cause unnecessary tooth loss.This article reviews the latest research prog-ress on the histopathologic features,pathogenic mechanism,susceptibility factors,diagnosis and treatment of ICR,with special emphasis on susceptibility factors and their mechanisms.

Patients with chronic kidney disease (CKD) have a relatively high risk of cardiovascular disease (CVD). Risk stratification guided by CVD risk prediction models is essential for managing CKD populations. We reviewed the outcome events, predictive variables, modeling methods, and predictive performance of CVD risk prediction models in CKD populations. We found a large variability in predictive outcomes, number of predictors, and sample sizes across studies. The models tended to overestimate the CVD risk of CKD populations. There are few independently validated or constructed CVD risk prediction models for CKD populations in developing countries, and in particular, there is a lack of independent external validation studies of model calibration. Future studies should comply with the reporting standards of risk prediction models to better support the application of CVD risk prediction models for CKD populations.

OBJECTIVE To evaluate the cost-effectiveness of the first-line treatment using the combination therapy of sugemalimab and chemotherapy （hereinafter referred to as the “combination therapy”） for advanced esophageal squamous cell carcinoma （ESCC） with high programmed death-ligand 1 （PD-L1） expression from the perspective of the Chinese healthcare system. METHODS A partitioned survival model was constructed based on data from the GEMSTONE-304 study. The model cycle was set at 3 weeks， with a study duration of 10 years and a discount rate of 5%. The primary output parameters of the model included total costs， quality-adjusted life year （QALY）， incremental costs， and incremental cost-effectiveness ratio （ICER）. Cost- utility analysis was employed to assess the economic feasibility of the combination therapy compared to chemotherapy alone. The robustness of the base case analysis results was evaluated through univariate sensitivity analysis， probabilistic sensitivity analysis， and scenario analysis. RESULTS The ICER of the combination therapy compared to chemotherapy alone was 288 430.35 yuan/QALY， significantly exceeding the willingness-to-pay （WTP） threshold of 173 354.52 yuan/QALY which was set at 1.94 times the per capita gross domestic product （GDP） in 2023. The price of sugemalimab was the primary factor influencing the ICER. When the WTP threshold was set at 1.94 times the per capita GDP （173 354.52 yuan/QALY）， the probability of the combination therapy being cost-effective compared to chemotherapy alone was 0. The combination therapy only became cost-effective compared to chemotherapy alone when the price of the drug dropped to 6 107.41 yuan per box （600 mg）. CONCLUSIONS From the perspective of the Chinese healthcare system， the combination therapy for first-line treatment of advanced ESCC with high PD-L1 expression is not cost-effective； the combination therapy is cost-effective when the price of sugemalimab decreas by 50.65%.

Objective:To evaluate the health benefits and intervention efficiency of different strategies of initiating antihypertensive therapy for the primary prevention of cardiovascular diseases in a community-based Chinese population from the Chinese electronic health records research in Yinzhou(CHERRY)study.Methods:A decision-analytic Markov model was used to simulate and compare different antihy-pertensive initiation strategies,including:Strategy 1,initiation of antihypertensive therapy for Chinese adults with systolic blood pressure(SBP)≥140 mmHg(2020 Chinese guideline on the primary preven-tion of cardiovascular diseases);Strategy 2,initiation of antihypertensive therapy for Chinese adults with SBP≥130 mmHg;Strategy 3,initiation of antihypertensive therapy for Chinese adults with SBP ≥140 mmHg,or with SBP between 130 and 140 mmHg and at high risk of cardiovascular diseases(2017 American College of Cardiology/American Heart Association guideline for the prevention,detection,evaluation,and management of high blood pressure in adults);Strategy 4,initiation of antihypertensive therapy for Chinese adults with SBP≥ 160 mmHg,or with SBP between 140 and 160 mmHg and at high risk of car-diovascular diseases(2019 United Kingdom National Institute for Health and Care Excellence guideline for the hypertension in adults:Diagnosis and management).The high 10-year cardiovascular risk was de-fined as the predicted risk over 10％based on the 2019 World Health Organization cardiovascular disease risk charts.Different strategies were simulated by the Markov model for ten years(cycles),with parame-ters mainly from the CHERRY study or published literature.After ten cycles of simulation,the numbers of quality-adjusted life years(QALY),cardiovascular events and all-cause deaths were calculated to evaluate the health benefits of each strategy,and the numbers needed to treat(NNT)for each cardiovas-cular event or all-cause death could be prevented were calculated to assess the intervention efficiency.One-way sensitivity analysis on the uncertainty of incidence rates of cardiovascular disease and probabilis-tic sensitivity analysis on the uncertainty of hazard ratios of interventions were conducted.Results:A to-tal of 213 987 Chinese adults aged 35-79 years without cardiovascular diseases were included.Com-pared with strategy 1,the number of cardiovascular events that could be prevented in strategy 2 increased by 666(95％UI:334-975),while the NNT per cardiovascular event prevented increased by 10(95％UI:7-20).In contrast to strategy 1,the number of cardiovascular events that could be prevented in strategy 3 increased by 388(95％UI:194-569),and the NNT per cardiovascular event prevented decreased by 6(95％UI:4-12),suggesting that strategy 3 had better health benefits and intervention efficiency.Compared to strategy 1,although the number of cardiovascular events that could be prevented decreased by 193(95％UI:98-281)in strategy 4,the NNT per cardiovascular event prevented decreased by 18(95％UI:13-37)with better efficiency.The results were consistent in the sensitivity analyses.Conclusion:When initiating antihypertensive therapy in an economically developed area of China,the strategy combined with cardiovascular risk assessment is more efficient than those purely based on the SBP threshold.The cardiovascular risk assessment strategy with different SBP thresholds is suggested to balance health benefits and intervention efficiency in diverse populations.

Postherpetic neuralgia(PHN)is a typical chronic neuropathic pain syndrome.Both peripheral and central nervous system mechanisms are believed to be involved in PHN,but the central nervous system-related brain network structure and function are not yet fully elucidated,limiting the study on the clinical analgesic drugs and other intervention strategies.In recent years,the research on pain matrix-related brain networks has helped to reveal the central nervous system regulation mechanism of pain,but there are few reports on the PHN pain matrix.This review summarizes the recent studies on the PHN pain matrix,retrospectively analyzes the functional and structural changes in specific pain-related brain regions,in order to provide the new insights for exploring the effective targeted analgesic treatments.

Objective:To explore the characteristics of glucose and lipid metabolism and intrauterine growth indicators in fetuses with selective intrauterine growth restriction (sIUGR) in twins.Methods:Sixty cases of sIUGR type I twin fetuses who were registered, underwent regular prenatal care, and were hospitalized for delivery at the Fujian Maternity and Child Health Hospital from January 2021 to January 2023 were selected as the research subjects. Selected 30 fetuses with growth restriction from sIUGR pregnant patients were taken as the observation group, while the 30 fetuses with non-growth-restricted served as the control group. During cesarean section, the umbilical vein blood of two fetuses was collected after the fetus was delivered and before the placenta was delivered, and the factors regulating growth, development and metabolism in the umbilical vein blood were detected: adiponectin, leptin, insulin-like growth factor-1 (IGF-1), blood glucose, total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoprotein A1, apolipoprotein B and other indicators. The measurement data of normal distribution are presented as xˉ± s, and the comparison of means between the two groups is performed using paired t-tests. P<0.05 was considered statistically significant. Results:(1) The levels of adiponectin (83.60±8.91) μg/L, leptin (7.11±0.53) μg/L, and IGF-1 (43.43±0.68) μg/L in the umbilical cord blood of the case group were significantly lower than those of the control group (92.50±10.52) μg/L, leptin (12.00±0.66) μg/L, and IGF-1 (70.34±1.44) μg/L, with statistically significant differences ( t-values of 2.94, 31.33, 99.70, respectively; P values of 0.006, <0.001, <0.001, respectively). (2) There was no statistically significant difference in the levels of blood glucose, triglycerides, HDL-C, and apolipoprotein A1 in umbilical cord blood between the two groups of fetuses (all P>0.05). (3) The total cholesterol (2.626±0.764) mmol/L, LDL-C (1.168±0.482) mmol/L, and apolipoprotein B (0.359±0.133) mmol/L in the umbilical cord blood of the case group were significantly higher than those in the control group, with total cholesterol (2.351±0.725) mmol/L and LDL-C (1.043±0.418) mmol/L. Apolipoprotein B was (0.317±0.107) mmol/L, and there was a statistically significant difference between the two groups ( t-values were 3.42, 3.10, and 3.67, respectively; and P values were 0.002, 0.004, and 0.001, respectively). Conclusion:There are abnormalities in lipid metabolism present in the cord blood of growth-restricted infants. Clinically, adiponectin, leptin, IGF-1, total cholesterol, LDL-C, and apolipoprotein B in twin umbilical blood can be served as key indicators for assessing fetal intrauterine development.

Objective:To construct a transcultural nursing competency framework for master of nursing specialist, providing reference for the cultivation and evaluation of transcultural nursing competency for master of nursing specialist.Methods:From December 2022 to March 2023, based on the cultural awareness, cultural skill, cultural knowledge, cultural encounter and cultural desire (ASKED) model of cultural competency and the group discussion, a preliminary pool of transcultural nursing competency elements for master of nursing specialist was formed using literature analysis, questionnaire survey, and semi-structured interviews. From April to July 2023, purposive sampling was used to select 20 nursing experts from universities and their affiliated hospitals in seven provinces, autonomous regions, and municipalities including Guangdong Province, Guangxi Zhuang Autonomous Region, Beijing City, Zhejiang Province, Hebei Province, Hunan Province, and Shaanxi Province as consultant experts. The transcultural nursing competency framework for master of nursing specialist was established using the Delphi method.Results:A total of 17 experts completed two rounds of consultation. The positive coefficients of the two rounds of expert consultation were 85.00% (17/20) and 100.00% (17/17), respectively. The authority coefficients of the two rounds of consultant experts were 0.826 and 0.878, respectively. The Kendall harmony coefficients for the first and second level elements in the second round of expert consultation were 0.302 ( P<0.01) and 0.304 ( P<0.01). After two rounds of expert consultations, a transcultural nursing competency framework for master of nursing specialist was established, which included five first-level elements of cultural awareness, cultural attitude, cultural knowledge, cultural skills, and cultural interaction, as well as 21 second-level elements. Conclusions:The transcultural nursing competency framework for master of nursing specialist is scientific and reliable, which can provide reference for formulating transcultural nursing competency standards for master of nursing specialist and lay a foundation for improving their cross-cultural nursing competency.

The prevalence of diabetes mellitus is increasing globally,which has contributed to a surge in diabetic reti-nopathy(DR)patients.DR has become the leading cause of visual impairment and blindness in the working-age popula-tion.The progressive development of DR involves many molecular and biochemical mechanisms,which interact with each other to affect the homeostasis of retinal blood vessels and cells.With the further study of the pathogenesis of DR,more and more molecular targets have been discovered.Studying the pathogenesis of DR and seeking potential therapeutic targets are of great clinical significance for the early prevention and treatment of DR and the prevention of its progression.In this paper,the latest developments in pathogenesis and potential therapeutic targets of DR are briefly reviewed.

Objective:To analyze the results of the practice test and formal test of the annual professional proficiency test for residents in 2022, to investigate related influencing factors and the effectiveness of the practice test, and to propose the measures for improving the results of the annual professional proficiency test.Methods:The scores of the annual professional proficiency test were analyzed for 202 residents who participated in the test in 2022, and the data on sex, education background, type of personnel, whether they passed the medical licensing examination, and practice test scores were analyzed to investigate related influencing factors. SPSS 23.0 and GraphPad Prism 8 were used for the chi-square test, the t-test, the one-way of variance, and the Fisher's exact test. A multiple linear regression analysis was used to identify influencing factors, and a Pearson correlation analysis was also performed. Results:The scores of the annual professional proficiency test for 202 residents were normally distributed with the highest number of the residents with a score of 90-99 points and the lowest number of the residents with a score of <70 points. The residents who passed the medical licensing examination had a significantly higher score of the annual professional proficiency test than those who failed the examination ( t=2.87, P=0.005), and the residents who passed the three practice tests had a significantly higher score of the annual professional proficiency test than those who failed the practice tests ( P<0.05). The score of the second practice test, the score of the third practice test, and the passing of medical licensing examination were independent influencing factors for the score of annual professional proficiency test ( R2=0.236, R2=0.201, F=6.60, P<0.05). The correlation analysis showed that the scores of the three practice tests were positively correlated with the final score ( r=0.189, 0.373, and 0.311, P<0.05). Conclusions:Improving the passing rate of medical licensing examination and strengthening pre-examination practice tests can help to improve the score of annual professional proficiency test. At the same time, it is necessary to improve the quality of training through the measures such as strengthening the homogenization management of different types of students, improving the attention and enthusiasm of all levels, and accelerating the construction of question banks.