Breast cancer prevention and treatment have become major issues that urgently need to be addressed in the field of global public health. As a key pathological transitional stage in the progression of breast cancer， preneoplastic breast cancer （PBC） carries a significant risk of clinical transformation. Effective intervention in the progression of PBC is of great clinical significance in preventing the occurrence of breast cancer. Pathological studies have shown that abnormal angiogenesis is a key mechanism driving the transformation of PBC into breast cancer. Vascular endothelial growth factor （VEGF）， as a core regulatory molecule that promotes angiogenesis， plays a pivotal role in this process. The malignant transformation of PBC is closely associated with the abnormal activation of the VEGF-mediated pro-angiogenic network. Although modern medicine has achieved certain therapeutic effects through surgery and endocrine therapy， clinical limitations such as invasiveness， drug resistance， and adverse reactions still exist. Recent studies have demonstrated that the VEGF signaling system mediates the phosphatidylinositol 3-kinase-protein kinase B （PI3K/Akt） signaling pathway and the mitogen-activated protein kinase （MAPK） pathway. In addition， the hypoxia-inducible factor-1α （HIF-1α）/VEGF signaling pathway and the delta-like ligand 4 （DLL4）/Notch receptor 1 （Notch1） signaling pathway， together with other pathways， form a complex regulatory network that plays a central role in angiogenesis during PBC. Traditional Chinese medicine （TCM）， characterized by multi-component synergy， multi-pathway regulation， and high safety， demonstrates significant advantages in inhibiting pathological angiogenesis and blocking PBC progression by targeting the VEGF signaling pathway. From the perspective of VEGF pathway regulation， this paper systematically reviews the latest research progress on TCM in inhibiting angiogenesis and intervening in PBC， and discusses its mechanisms and application value in the early prevention and treatment of PBC， with the aim of providing references for optimizing clinical intervention strategies for PBC.

Objective:To summarize the medication law and academic experience of Professor Yuan Jinsheng in the treatment of angina pectoris (AP) of coronary heart disease (CHD) through R language data mining technique.Methods:The effective outpatient medical records of Professor Yuan Jinsheng in the treatment of AP of CHD from January 1, 2016 to September 30, 2023 were selected, and the R 4.2.3 was used for frequency statistics, association rule analysis, systematic clustering analysis and correlation analysis of prescription drugs.Results:A total of 292 prescriptions were included, including 268 patients, involving 204 kinds of Chinese materia medica, and the total frequency of Chinese materia medica was 4 253 times. The main properties were warm and neutral, the main tastes were bitter, pungent and sweet, and the main meridians were spleen, lung and liver meridians. The analysis of association rules obtained 125 core TCM combinations, and the commonly used drug pair was Trichosanthis Fructus-Aurantii Fructus Immaturus. The core prescription composed of Aurantii Fructus Immaturus, Chuanxiong Rhizoma, Trichosanthis Fructus, Citri Reticulatae Pericarpium and Salviea Miltiorrhizae Radix et Rhizoma. Seven TCM groups of were obtained by systematic clustering analysis. Correlation analysis showed that the drug pairs with phi coefficient greater than 0.6 were in 8 groups.Conclusions:Studies suggest that AP of CHD is located in the heart, which is related to lung, spleen, liver and kidney, deficiency in root and excess in superficiality, phlegm, blood stasis and qi stagnation are important pathological factors. The treatment is based on the basic principles of tonifying qi, promoting yang, relieving rheumatism, resolving phlegm, activating blood circulation, and promoting qi circulation. It embodies Professor Yuan's academic thoughts and principles of differentiation and treatments of "taking fluency as the main point, regulating the five internal organs and weighing the root and superficiality".

Objective To report the diagnosis,treatment,and verification process of a patient with sex development disorder whose chromosomal karyotype and genetic test results are inconsistent,and conduct a literature review to improve the understanding of the mosaic status of sexual development disorders.Methods A 14-year-old patient presented with primary amenorrhea on April 3,2020,at the First Affiliated Hospital of Hebei North University,exhibiting female sexual characteristics.The patient underwent ultrasonic/magnetic resonance imaging of gonads,assessment of gonadal axis function,chromosomal karyotype,and molecular genetic testing,as well as pelvic exploration,malignant gonads resection,and hormone replacement therapy,resulting in drug-induced menstruation.During the diagnosis and treatment,it was found that the patient's chromosomal karyotype analysis was inconsistent with the molecular genetic test results.Subsequently,samples from the three germ layer cells were taken,and fluorescence in situ hybridization(FISH)was used to detect the sex chromosomes in each germ layer cell.XY probes were used to label the gonadal pathological sections to explore the distribution differences of the Y chromosome in the gonads,and changes in anti-Müllerian hormone(AMH)levels before and after surgery were compared.Databases such as Wanfang and PubMed were searched to summarize relevant cohort study literature and understand the current status of research on this disease.Results The patient's body exhibited a significant differences between the 45,X and 46,XY cell lines in different germ layers and within the same layer tissues.The proportion of 45,X in buccal mucosal cells derived from the ectoderm was 30%(6/20),in peripheral blood lymphocytes derived from the mesoderm was 9.7%(11/114),and in bladder shed cells derived from endoderm was 20.4%(22/108).The gonadal pathological sections labeled with XY probes indicated a mosaic state with a reduced Y-chromosome;where the epididymal structure area had a 45,X cell line mosaic of 50.0%,and the malignant area had a normal"Y"content.After gonadal resection,AMH levels significantly dropped from 7.28 pmol/L to＜0.07 pmol/L.Literature review revealed that patients with 45,X/46,XY have a complex phenotype spectrum,most with features of Turner syndrome,and female phenotypes are at risk of gonadal tumors.Conclusions In the diagnosis of difficult cases of sex development disorders,when performing peripheral blood karyotype testing,the number of counted cells and analyzed cells should be increased as much as possible,and multi-germ layer cell sampling should be performed.Gonads with a high"Y"mosaic rate are more prone to malignancy in the abdominal cavity.Detecting AMH levels can distinguish cryptorchidism and anorchidism in sexual development disorders with Y chromosomes.

Objective:To evaluate the efficacy and safety of eculizumab in treating acute attacks of aquaporin-4 antibody(AQP4-IgG)positive neuromyelitis optica spectrum disorder(NMOSD).Methods:Six patients with AQP4-IgG-positive NMOSD treated with eculizumab at the Affiliated Hospital of Qingdao University from August 2023 to April 2024 were included.The patients' clinical characteristics, changes in scores of neurological function, pain and spasm before and after eculizumab treatment, and adverse drug reactions during the treatment period were described, and the data were subjected to Friedman test using SPSS 25.0.Results:The median score of expanded disability status scale in the six patients decreased from 3.25 before treatment to 1.25 after treatment, and the difference was statistically significant ( F=44.77, P<0.01).The functional status score showed noticeable improvement as early as week 1, demonstrating greater sensitivity to treatment response.Three patients experienced moderate to severe pain before treatment, with a mean pain score of 6, which reduced to 4.67 and 1.33 at week 2 and 6, respectively( F=29.17, P<0.05).Two patients reported spasms before treatment, with a mean score of 3.00, which decreased to 2.00, 1.50, and 1.00 at week 2, 3, and 6 after treatment, respectively( F=18.00, P>0.05).No serious adverse reactions were reported during the treatment. Conclusion:Eculizumab can effectively improve the neurological function and alleviate pain in patients with AQP4-IgG-positive NMOSD during acute attacks, and demonstrate good safety.

Left atrial enlargement and impaired function are significant imaging markers for predicting adverse cardiovascular outcomes,particularly in patients with atrial fibrillation and left ventricular diastolic dysfunction.Left atrial reverse remodeling(LARR)refers to the process by which the size,morphology,and function of the left atrium are restored through therapeutic interventions or spontaneous recovery.Accurate assessment of LARR is crucial for improving clinical outcomes in patients with cardiovascular diseases.Imaging techniques such as echocardiography,cardiac magnetic resonance,and nuclear medicine imaging play a key role in evaluating left atrial structure and function.These modalities assess the anatomical features of the left atrium from multiple perspectives and under various pathological conditions,quantify functional parameters,and hold significant value in monitoring disease progression,evaluating treatment efficacy,and predicting prognosis.This review summarizes recent advances in the application of multimodal imaging for LARR assessment and discusses its prospects and challenges in clinical practice.

Objective:To induce an experimental autoimmune encephalomyelitis(EAE)model by MOG-specific TCR trans-genic mice(2D2TCR transgenic mice),and to investigate effect of exogenous ERMAP on T cells in spleen of MOG35-55-induced 2D2TCR transgenic mice.Methods:EAE models were established in two groups of 2D2TCR transgenic mice(Control-Ig treatment for control group and ERMAP-Ig fusion protein treatment for experimental group),with 9 mice per group.Severity of spinal cord injury of MOG35-55-induced EAE in mice was assessed based on daily clinical scores(DAI),HE and LFB staining results;autoreactive T cells(CD4+Vα3.2+Vβ11+),T cell proliferation activation indicators CD69(CD4+Vα3.2+Vβ11+CD69+)and Ki67(CD4+Vα3.2+Vβ11+Ki67+),Treg(CD4+Vα3.2+Vβ11+CD25+Foxp3+)and Th17 cells(CD4+Vα3.2+Vβ11+IL-17A+)in spleen were detected by flow cytome-try;IL-17A,IL-6,IFN-γ and TGF-β expressions in spinal cord tissues were detected by qRT-PCR.Results:In MOG35-55-induced 2D2TCR transgenic mouse EAE model,ERMAP-Ig fusion protein treatment group showed milder inflammatory infiltration and demye-lination in spinal cord,decreased proportion of autoreactive T cells,decreased proportion of activated and proliferating T cells,increased proportion of Treg,inhibition of Th17 cell differentiation,less inflammatory cell aggregation and cytokine production,and increased expression of anti-inflammatory factors in spinal cord.Conclusion:ERMAP may be involved in development of EAE in 2D2TCR transgenic mice by inhibiting T cell proliferative activation and promoting Treg cell production.

Circular RNAs (circRNAs) are a type of endogenous noncoding RNAs with covalently looped structures. Compared with other noncoding RNAs, circRNAs have the characteristics of stable structures, high abundance and tissue-specific expression. Recent studies have demonstrated that circRNAs can act as sponges, decoys and scaffolds for microRNAs and proteins, and play an important role in skin tumors. This review summarizes recent advances in the functions and mechanisms of action of circRNAs in common skin tumors, in order to understand the way in which they affect skin tumors, and to assess the value of further research on them.

Cancer cachexia is a complex syndrome caused by multiple factors,which seriously affects the quality of life and prognosis of patients.Its overall pathogenesis is related to the deficiency of spleen qi,insufficiency of kidney essence,internal generation of turbid toxins,and the obstruction of the production of qi,blood and essential qi,which cannot nourish the muscles and bones.Under the guidance of the dynamic diagnosis and treatment system of"spleen and kidney exhaustion as the root cause and internal accumulation of turbid toxins as the manifestation",the overall regulation is carried out from four dimensions:opening and closing the spleen and stomach,nourishing the kidney and promoting transportation,transforming turbid toxins and detoxification,and tonifying qi and nourishing yin.It has shown unique value in the intervention of cancer cachexia and can provide ideas and references for the clinical practice of TCM in treating cancer cachexia.

Objective:To develop a post competence assessment scale for nurses in the health management (physical examination) center and assess its reliability and validity.Methods:This study adopted an empirical approach. A total of 801 nurses from the health management (physical examination) center were recruited to participate in this study. A research team was formed in August 2024. This team transformed the previously constructed core competence evaluation index system for health management specialist nurses in the health management (physical examination) center (comprising 6 first-level indicators and 70 third-level indicators) into a preliminary post competence assessment scale. Seven experts evaluated the content validity of the scale. In September 2024, a pilot survey was conducted among 27 nurses from the health management (physical examination) center of Sichuan Provincial People′s Hospital using convenience sampling. From October to November 2024, the first main survey was administered to 385 nurses of health management (physical examination) center across 54 cities in China using both convenience sampling and snowball sampling methods, followed by exploratory factor analysis (EFA). Subsequently, utilizing the refined scale obtained after eliminating certain items, a second main survey was conducted among 389 nurses in the health management (physical examination) center, followed by a confirmatory factor analysis (CFA). The reliability of the final scale was assessed using Cronbach′s α coefficient, split-half reliability, composite reliability, and test-retest reliability.Results:The finalized scale for nurses′ post competency in health management (physical examination) center comprises five dimensions—basic nursing service competency, health management practice competency, knowledge integration competency, professional development competency, and professional attitude—with a total of 57 items. The item level content validity index (I-CVI) of the items of the content validity display scale ranged from 0.857 to 1.000, and the content validity index of each dimension ranged from 0.984 to 1.000. The scale-level Content Validity index/average (S-CVI/Ave) was 0.995. The contribution rate of the 6 factors extracted by EFA was 74.07%. After group discussion and CFA, the scale of the 5-factor structural equation model was constructed. The total Cronbach′s α coefficient of the scale was 0.986, the split-half reliability was 0.865, the composite reliability was 0.960-0.980, the total table test-retest reliability was 0.762, and the test-retest reliability of each dimension was 0.681-0.731.Conclusion:The developed assessment scale for assessing the post competence of nurses in the health management (physical examination) center demonstrates excellent reliability and validity.

Objective:To investigate the operation of water improvement projects in villages affected by drinking-water-borne endemic arsenic poisoning in Shaanxi Province, the arsenic level in both internal and external environments, the trend of disease development and patient management, and evaluate the effectiveness of prevention and control measures.Methods:From March to December 2023, in accordance with the requirements of the "Notice of the Office of Shaanxi Provincial Health Commission on Issuing the Monitoring Plan for Key Endemic Diseases such as Kashin-Beck Disease" and the "Monitoring Plan for Endemic Fluorosis and Arsenism in Shaanxi Province", all villages affected by drinking-water-borne arsenic disease were monitored. Water arsenic testing was carried out in accordance with the "Standard Test Methods for Drinking Water Inorganic Nonmetallic Indicators" (GB/T 5750.5-2006), and the evaluation of whether water arsenic exceeded the standard was conducted based on the "Sanitary Standards for Drinking Water" (GB 5749-2022). According to the "Diagnosis of Endemic Arsenism" (WS/T 211-2015), the arsenic poisoning status of all population in the disease affected areas was investigated. In 5 villages of 3 monitoring counties, 358 people were randomly selected to determine the urinary arsenic level, and the determination was made according to the "Safety Guideline Value of Urinary Arsenic for Human Population" (WS/T 665-2019). According to the "Notice of the National Health Commission on Issuing the Evaluation Measures for Control and Elimination of Key Endemic Diseases (2019 Edition)", elimination evaluation was conducted.Results:A total of 2 cities, 3 counties, 9 towns, and 13 endemic villages were monitored, with a water improvement rate of 100% (13/13), and all were operating normally. The arsenic level in residents' drinking water was < 0.01 mg/L. A total of 12 688 people were examined, and 338 cases of arsenic poisoning were detected, all of whom were historical cases. There were no new cases of arsenic poisoning or skin cancer patients. The geometric mean of urinary arsenic was 0.026 0 mg/L, which was lower than the safety guideline value of 0.032 mg/L for urinary arsenic in the population. All 338 existing arsenic poisoning patients had received family doctor contract services and implemented follow-up management. The drinking-water-borne endemic arsenic poisoning areas counties in Shaanxi Province have reached the elimination standard.Conclusions:The water improvement project in drinking-water-borne endemic arsenic poisoning areas in Shaanxi Province is operating normally. The arsenic content in both the internal and external environments of the population meets the standard. The condition is stable and no new cases have been detected. Follow up management has been implemented for all current cases. All affected counties have reached the elimination standard.