Objective To investigate the effect of fraxetin(FXT)on the malignant biological behavior of ovarian cancer cells by regulating Toll-like receptor 4(TLR4)/signal transducer and activator of transcription 3(STAT3)pathway.Methods Ovarian cancer cell lines SKOV3 and SW626 and ovarian epithelial cell line IOSE80 were treated with different concentrations of FXT(0,10,20,40,60,80 and 100 μmol/L),and the cytotoxicity of FXT was detected by methylthiazolyl diphenyl-tetrazolium bromide(MTT)assay.SKOV3 and SW626 cells were randomly divided into control group,FXT low,medium,high dose(40,60,80 μmol/L)group and FXT(80 μmol/L)+colivelin(STAT3 agonist,0.5 μmol/L)group.Colony formation assay and Transwell assay were used to detect cell proliferation,invasion and migration.The expressions of epithelial-mesenchymal transition and TLR4/STAT3 pathway related proteins were measured by Western blot.Results Compared with IOSE80 cells,SKOV3 and SW626 cell survival gradually decreased with increasing FXT concentration,and the differences were statistically significant(F=134.283,146.831,P<0.001).Compared with the control group,the relative colony lineage rates of SKOV3 and SW626 cells in the FXT low-,medium-and high-dose groups,invasion rate and mobility were reduced(t=4.433～45.909),E-cadherin were increased(t=5.879～17.345),and the expression of N-cadherin,zinc finger transcription factors(snail),vimentin,TLR4,phosphorylated(p)-STAT3/STAT3,cell cycle protein D1(Cyclin D1)and MYC oncogenes(Cancer-myc,C-myc)expression were sequentially reduced(t=7.348～50.117),and the differences were statistically significant(all P<0.01),respectively.Compared with the high-dose FXT group,the relative colony formation rate,cell invasion rate and migration rate of SKOV3 and SW626 cells in the FXT+colivelin group increased(t=9.224～20.703),while the expression of E-cadherin protein decreased(t=3.104,5.041),the expression of N-cadherin,snail,vimentin,TLR4,p-STAT3/STAT3,Cyclin D1,and C-myc increased(t=8.403～42.175),and the differences were statistically significant(all P<0.05),respectively.Conclusion FXT may exert antitumor effects by antagonizing the activation of TLR4/STAT3 signaling pathway and inhibiting ovarian cancer cell proliferation,migration,invasion and epithelial mesenchymal transition.

Purpose To investigate the prenatal ultrasound features and prognosis of fetal patent urachal.Materials and Methods The prenatal ultrasound characteristics of six cases with patent urachal diagnosed in Women and Children's Hospital of Chongqing Medical University from September 2018 to March 2023 were retrospectively analyzed,their pregnancy and postnatal conditions were followed up.Results In the first and second trimester of pregnancy,the prenatal ultrasonography of six fetuses showed that the epurachus was occluded.Among them,two cases were diagnosed as bladder diverticulum.The ultrasonography showed that the bladder was malformed,the top of the bladder was changed like a beak,and was connected to the umbilical cord entrance of the abdominal wall through an abnormal tube.Four cases were diagnosed as urachal fistula with allantoic cyst.Ultrasound showed that the cyst was at the root of the umbilical cord,and the cyst communicated with the bladder through an abnormal duct.The size of the cyst changed with the filling and emptying of the bladder.Color Doppler showed that the cysts were surrounded by the umbilical artery.None of the six fetuses were abnormal by chromosome examination.Among them,two fetuses with simple urachal fistula and allantoic cyst were born with good prognosis,and the remaining four fetuses were induced by other malformations.One of the six fetuses was female,and five fetuses were male.Conclusion Prenatal ultrasound of patent urachus has typical features and low correlation with chromosomal abnormalities.It is more common in males clinically and has a good prognosis without other structural abnormalities.

Objective:To explore the prognostic factors of seroma after endoscopic thyroidectomy by breast ap-proach,and construct a nomogram to predict the possibility of cervical seroma.Methods:Data of patients undergoing endoscopic thyroid surgery in Dongguan Tungwah Hospital from January 2022 to May 2024 and Dongguan Songshan Lake Tungwah Hospital from May 2023 to August 2024 were retrospectively analyzed,and 1493 patients meeting the in-clusion criteria were selected.Among them,there were 1048 patients in Dongguan Tungwah Hospital as the training co-hort,1015 patients without seroma group and 33 patients with seroma group.There were 445 patients in Dongguan Songshan Lake Tungwah Hospital as the verification cohort,including 424 patients without seroma and 21 patients with seroma.Multivariate logistic regression analysis was used to obtain relevant independent prognostic factors,and R soft-ware established a nomogram model.Calibration curves,Hosmer-Lemeshow goodness of fit,ROC curves were used to evaluate the calibrability of the nomogram model,and clinical utility was assessed by clinical decision curves.Results:Multivariate logistic regression analysis showed that central lymph node dissection,diabetes,hyperthyroidism,and nod-ule size were independent prognostic factors related to seroma.Based on the prognostic factors,the nomogram of se-roma after ETBA was constructed.The calibration curves of the training and the verification group were in good agree-ment with the observed results,and the Hosmer-Lemeshow goodness of fit test was good,with the training cohort P=0.244 and the verification cohort P=0.803.The ROC curve of the training cohort showed that the area under the curve was 0.810(95%CI:0.740～0.879),and the ROC curve of the verification cohort showed that the area under the curve was 0.815(95%CI:0.722～0.909).Conclusion:The nomogram model based on the relevant prognostic factors ob-tained by multivariate logistic regression analysis has a good prediction effect on the seroma after ETBA,and can provide reasonable and individualized treatment plan for patients.

Objective To analyze the characteristics of colorectal adenoma onset,traditional Chinese medicine(TCM)syndromes,and factors influencing advanced colorectal adenoma.Methods A cross-sectional study was conducted to retrospectively analyze the data of 480 patients with colorectal adenoma admitted to the Department of Gastroenterology of Wangjing Hospital,China Academy of Chinese Medical Sciences,between January 2024 and January 2025 who met the inclusion and exclusion criteria.The hospital case system was used to collect demographic information,basic medical history,general conditions associated with colorectal adenoma,and records of TCM syndrome types,which were compiled into a clinical information Excel spreadsheet.Descriptive statistics were calculated to determine the distribution of demographic information,basic medical history,and TCM syndrome types.The chi-square test or Monte Carlo simulation method was used to analyze the differences in the number,size,pathological type and location of colorectal adenomas,as well as the distribution of TCM syndrome types.Univariate chi-square test was used to analyze the related factors of patients with advanced colorectal adenoma,and the statistically significant variables were included in the multivariate logistic regression analysis to analyze the influencing factors of advanced colorectal adenoma.Results Among the 480 patients with colorectal adenoma,296 were male with an onset age of(60.51±11.17)years,and 184 were female with age of(61.65±11.87)years.There were 233 patients(46.46％)aged 45 to 64.There were 269 cases(56.04％)of overweight individuals.Adenomas smaller than 1 cm accounted for 73.33％(352/480).Among the number of adenomas,single adenomas accounted for 66.46％(319/480).Among the pathological types,tubular adenoma accounted for 86.67％(416/480).The left colon accounted for 80.0％(384/480)of the affected sites.The main clinical manifestations included abdominal distension(20.63％,99/480),abdominal pain(16.25％,78/480),diarrhea(9.79％,47/480),among others.The main syndrome types in traditional Chinese medicine are damp-heat syndrome of the large intestine(25.83％,124/480)and spleen deficiency with excessive dampness syndrome(22.94％,110/480).There was a statistically significant difference in the distribution of TCM syndrome types among patients of different age groups(P=0.010).Multitype adenoma(OR=4.504,95％CI:2.819～7.198,P<0.001)and the right colon site(OR=2.166,95％CI:1.146～4.092,P<0.05)are independent risk factors for advanced colorectal adenoma.Conclusion Colorectal adenomas are more common in men and tend to occur in middle-aged people.Adenomas under 1 cm are the most common.Single adenomas and tubular adenomas are more common.The left half of the colon is a common site of occurrence.Common clinical symptoms include abdominal distension,abdominal pain,diarrhea,etc.Damp-heat syndrome of the large intestine is the most common type of syndrome in traditional Chinese medicine.The number of multiple adenomas and the location of the right colon are independent risk factors for advanced colorectal adenomas.

OBJECTIVE To evaluate the cost-effectiveness of capecitabine metronomic chemotherapy combined with aromatase inhibitor(AI)versus AI monotherapy as first-line treatment for hormone receptor-positive(HR+)/human epidermal growth factor receptor 2-negative(HER2-)metastatic breast cancer,thereby providing evidence-based support for clinical therapeutic decision-making and healthcare policy formulation.METHODS Based on the MECCA trial,a partitioned survival model was constructed using a 4-week cycle length to simulate outcomes over patients'lifetime.The model outputs included total costs,quality-adjusted life year(QALY),and incremental cost-effectiveness ratio(ICER).Sensitivity analyses were performed to validate the robustness of base-case results,while scenario analyses examined the cost-effectiveness of both treatment strategies under 10-year,20-year,and lifetime time horizons.RESULTS With the willingness-to-pay(WTP)threshold set at 1 times China's 2024 per capita gross domestic product(GDP)(95 749 yuan/QALY),patients receiving capecitabine metronomic chemotherapy combined with AI regimen gained incremental utility(0.66 QALYs)while incurring higher costs,with ICER of 27 684.85 yuan/QALY.Results of the one-way sensitivity analysis showed that factors with significant impacts on ICER included the cost discount rate,drug costs of the capecitabine metronomic chemotherapy combined with AI group,utility value in the progression-free survival state,follow-up costs,and treatment costs in the subsequent stable phase.Probabilistic sensitivity analysis indicated that when the WTP threshold≥49 250 yuan/QALY,the capecitabine metronomic chemotherapy combined with AI regimen had a 100%probability of being cost-effective.Scenario analysis results demonstrated that capecitabine metronomic chemotherapy combined with AI regimen was more cost-effective than the AI alone regimen across 10-year,20-year,and lifetime study horizons.CONCLUSIONS Under the premise that the WTP threshold is set at 1 times China's per capita GDP in 2024,capecitabine metronomic chemotherapy combined with AI regimen is more cost-effective than the AI alone regimen as the first-line treatment for HR+/HER2-metastatic breast cancer.

Aim To verify the therapeutic effect of the Qushi Huoxue decoction(QSHXF)on a mouse model of non-alcoholic fatty liver disease(NAFLD)using network pharmacology and experimental approaches,to examine the changes in the PI3K-AKT-lipid metabo-lism signaling pathway,and to elucidate its molecular mechanisms.Methods The potential active ingredi-ents and targets of the QSHXF were identified using the TCMSP platform.NAFLD-related genes were sourced from the GeneCards,PharmGkb,TTD,and OMIM data-bases.The intersection of drug targets and NAFLD treatment targets was analyzed to identify the key tar-gets of the QSHXF in treating NAFLD.The STRING database and Cytoscape 3.9.1 software were utilized to construct networks linking traditional Chinese medicine active ingredients to disease targets and PPI networks,allowing for the screening of key active ingredients and core targets.GO and KEGG enrichment analyses of the intersecting targets were conducted using R version 4.2.2.The NAFLD model was established by feeding mice a methionine-choline deficient diet for a duration of five weeks.Following successful modeling,low,me-dium,and high doses of the QSHXF were administered for intervention over a period of six weeks.The efficacy was verified and the underlying mechanisms were ex-plored using methods such as HE staining,Oil Red O staining,and Western blot analysis.Results The net-work pharmacology prediction indicated that QSHXF might effectively treat NAFLD through key components such as quercetin and kaempferol,as well as core tar-gets including STAT3,AKT1,and HIF1A.KEGG en-richment analysis further suggested that QSHXF might exert its therapeutic effects on NAFLD via signaling pathways such as AGE-RAGE and PI3K-AKT.Verifi-cation through animal experiments demonstrated that QSHXF could significantly reduce hepatic steatosis and lipid droplet accumulation in NAFLD mice.Specifical-ly,it markedly decreased serum levels of TC,TG,ALT,AST,and LDL,while increasing HDL levels.Addition-ally,the treatment significantly reduced the protein ex-pression levels of p-PI3K,p-AKT,SREBP-1c,FASN,and ACC1 in the liver.Conclusions QSHXF can sig-nificantly enhance liver function,improve blood lipid levels,and alleviate hepatic steatosis in NAFLD mice,with its mechanism potentially linked to the inhibition of the PI3K-AKT-lipid metabolism signaling pathway.

Tissue resident memory T(TRM)cells are a class of memory T cells with long life span and non-lymphoid resident characteristics.TRM cells are the first line of defense against secondary infections in human.TRM cells can restrict the transmission of viruses as well as combat against viruses.Rapid evolution of severe acute respiratory syn-drome coronavirus 2(SARS-CoV-2)and post-COVID-19 syndrome could lead to a series of symptoms such as pulmonary fi-brosis,resulting in long-term fall in quality of life.Many studies focused on enhancing the ability to cope with the mutation of SARS-CoV-2 and reducing the incidence of post-COVID-19 syndrome.The relationship between TRM cells and SARS-CoV-2 infection or therapy still remain unknown.It is significant to investigate TRM cells divergence and functions for the development of vaccines.We review the functions and residence properties of TRM cells,as well as their roles in SARS-CoV-2 infection and post-COVID-19 syndrome.In this review,we are dedicated to deepen our understanding of the immune process in SARS-CoV-2 infection and provide a new prospect for the prevention and treatment of post-COVID-19 syndrome.

In June 2021, the Registered Nurses' Association of Ontario (RNAO) released the best practice guideline Promoting 2SLGBTQI+ Health Equity. This article interprets the recommendations made in the guideline on five key areas: inclusive communication, safe spaces, risk assessment and screening, population-based interventions, and education within academic and healthcare organizations. The goal is to provide evidence-based advice for nurses, interdisciplinary teams, healthcare services, and academic institutions to enhance the equity of healthcare services for the 2SLGBTQI+ community, promoting access to inclusive and safe care.

Objective:To Analysis of the current status of occupational hazard factors of 1, 2-dichloroethane (1, 2-DCE) in workplaces of enterprises in a certain district of Chongqing City, to provide a basis for its prevention and control.Methods:In January 2024, the monitoring data from the 2023 key occupational disease survey in the district were collected and organized. Qualitative analysis was conducted on the organic solvents used by enterprises in their production processes, and the detection results of 1, 2-DCE were statistically analyzed.Results:A total of 88 organic solvent samples were collected, with a qualitative detection rate of 21.6% (19/88) for 1, 2-DCE. A total of 30 enterprises using organic solvents were surveyed and tested, with an enterprise detection rate of 36.7% (11/30) for 1, 2-DCE. The workplace exceedance rate for 1, 2-DCE was 37.0% (34/92), and the post exceedance rate was 15.4% (4/26) .Conclusion:The degree of occupational exposure hazard related to 1, 2-DCE remains severe. It is necessary to strengthen the management of organic solvents used by enterprises and implement effective measures to prevent acute and chronic poisoning caused by 1, 2-DCE.

Objective:To investigate the changes in brain functional network and structural-functional network coupling in children with drug-resistant epilepsy (DRE), and to analyze their correlation with cognitive function, disease duration, and age of onset.Methods:This study was a cross-sectional study. Clinical and imaging data of 19 children with DRE who received consultation and treatment at the Affiliated Hospital of Zunyi Medical University from August 2021 to August 2023 (DRE group) were prospectively included. Another 27 age-and sex-matched healthy children were collected as the healthy control group. All subjects had 3D-T 1WI, T 2 fluid-attenuated inversion recovery, diffusion tensor imaging (DTI), resting-state functional magnetic resonance imaging (rs-fMRI) scans and Wechsler Intelligence Scale assessments. Independent sample t-test and Mann-Whitney U test were used to analyze the global and local topological attributes, as well as the structural-functional coupling (SFC) values at the whole brain and modular levels in two groups. Correlations between abnormal resting state brain functional network indicators and the Wechsler Intelligence Scale score [verbal comprehension index (VCI), perceptual reasoning index (PRI), working memory index (WMI), processing speed index (PSI), full scale intelligence quotient (FSIQ)], disease duration and age of onset was evaluated using a Spearman or Pearson correlation analysis. Results:Compared to the healthy control group, DRE group exhibited decreased VCI, PRI, WMI, PSI, FSIQ and the differences were all statistically significant (all P<0.05). Both brain functional networks had small world attributes. There was a statistically significant difference in the area under the curve of sparsity of degree centrality (DC) in the left pallidum between the DRE group and healthy control group (2.998±0.942, 4.992±1.945, t=-4.07, FDR corrected P<0.05). Compared with the control group, the DRE group had decreased SFC within the limbic network (LN) ( P<0.05), increased SFC within the sensorimotor (SMN) ( P<0.05), decreased SFC between the default mode network-LN ( P<0.05), and increased SFC between the SMN-attentional network (AN) ( P<0.05). There was no statistically significant difference in SFC at the whole brain level between the two groups. Correlation analysis indicated that DC in left pallidum in DRE group negatively correlated with the PSI ( r=-0.537, P=0.018), and SFC between the SMN and AN demonstrated a negative correlation with age of onset ( r=-0.537, P=0.018). Conclusion:The altered DC in left pallidum may be related to cognitive impairment in children with DRE, providing biomarker information for the study of neural mechanisms in children with DRE.