Objective:To assess the influencing factors of glycemic control among type 2 diabetes mellitus (T2DM) patients, in particular the correlations between peripheral blood eosinophils and metabolic indicators such as glucose, lipids, and uric acid (UA) in these patients.Methods:T2DM patients who were regularly followed up in the Intensive Diabetes Mellitus Clinic of Peking Union Medical College Hospital from January 2016 to September 2024 were prospectively selected as the research subjects. The clinical data of these patients at their first visit and at the 3rd, 6th, 9th, and 12th months of follow-up were collected. The potential correlations of peripheral blood eosinophils with blood glucose control, lipid metabolism, UA metabolism, and inflammation as well as their influencing factors were analyzed.Results:A total of 161 T2DM patients were included. The glycated hemoglobin A1c (HbA1c) compliance rate was significantly higher during the follow-up visits (3, 6, 9, and 12 months) than baseline (all P<0.05) but showed no significant correlation with the count or percentage of peripheral blood eosinophils. Spearman correlation analysis showed that the percentage of peripheral blood eosinophils was negatively correlated with Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) ( P=0.049) and high-density lipoprotein cholesterol (HDL-C) ( P=0.002) and positively with serum triglyceride (TG) ( P=0.034) and UA levels ( P<0.001). A further linear regression model analysis of these four variables and the percentage of eosinophils revealed that the percentage of peripheral blood eosinophils was only linearly correlated with serum UA level ( P<0.001). Conclusion:The percentage of peripheral blood eosinophils in T2DM patients is independently correlated with serum UA level, and monitoring serum UA level is important in T2DM management. Early identification and intervention of hyperuricemia can help provide more comprehensive and precise medical interventions for T2DM patients.

Metastasis is a pivotal and intricate process in the progression of malignant tumors,strongly correlating with poor prognosis.Approximately 90%of cancer-related mortality is attributed to metastasis,with the five-year survival rate for patients with metastatic solid tumors ranging from 5%to 30%.Consequently,a comprehensive understanding of the underlying biological mechanisms driving metastasis is essential for unraveling its core processes and developing novel therapeutic strategies.The metastatic cascade involves tumor cells navigating numerous biological barriers,including detachment from the primary tumor,invasion of blood vessels or lymphatics,survival in circulation,extravasation into distant organs and subsequent adaptation to the microenvironment.To surmount these challenges,tumor cells undergo phenotypic changes,genetic mutations and dysregulating signaling pathways.Additionally,microenvironmental factors(such as angiogenesis,matrix remodeling and immune evasion)play a critical role,orchestrating the initiation and growth of metastatic lesions in an interdependent manner.Organ-specific metastasis,a distinct subset of metastasis,involves dynamic bidirectional interactions between tumor cells and the microenvironment of target organs.These interactions determine the selectivity of metastatic spread and drive the adaptive evolution of both the tumor and the organ,which encompasses multiple layers of cellular interactions,including cell-cell and cell-matrix signaling.Tumor cell mutations,the release of specific signaling molecules,the capacity to withstand circulatory pressures,and signaling exchanges with target organs collectively govern the selective nature of organ-specific metastasis.Furthermore,factors intrinsic to the target organ-such as its regenerative potential,metabolic profile,immune surveillance mechanisms and matrix stiffness-further facilitate the adaptive remodeling of metastatic cells within these environments.Thus,the bidirectional selection and adaptation between tumor cells and target organs form a dynamic,complex system that reshapes our understanding of metastatic tumor development.While current research emphasizes shared biological features in metastasis,the successful formation of metastatic tumors depends not only on these common mechanisms but also on the unique characteristics governing organ-specific metastasis.The interplay between generalizable and organ-specific mechanisms profoundly influences the metastatic outcome.This review aimed to consolidate our current knowledge of these shared and distinct processes,analyze the evolving understanding of the bidirectional selection between tumor cells and target organs,and assess the current status of metastatic risk prediction models for patients without metastasis.Furthermore,the paper discussed the challenges and opportunities in managing advanced-stage metastatic tumors,offering new insights and potential clinical strategies to improve prognosis and treatment outcomes.

Objective:To evaluate the effectiveness and safety of minimally invasive anchoring hook intraocular lens (IOL) interscleral suture fixation surgery.Methods:A cohort study was conducted.A total of 74 patients (74 eyes) with aphakia, artificial lens dislocation, or lens dislocation were included at Tengzhou Central People's Hospital from 2021 to 2022.According to the surgical method, the patients were divided into conventional fixation group (39 cases, 39 eyes) undergoing conventional intraocular lens suspension surgery and anchoring hook fixation group (35 cases, 35 eyes) undergoing minimally invasive anchoring hook type IOL interscleral suture fixation surgery.Surgical time, preoperative best corrected visual acuity (BCVA) before surgery and at 1 day and 1 month after surgery, corneal endothelial cell density before and at 1 month after surgery, mislocation of the artificial IOL and the incidence of complications were recorded.This study was reviewed and approved by the Ethics Committee of Tengzhou Central People's Hospital (No.2019-20), and all patients signed the informed consent form.Results:One day and 1 month after surgery, the BCVA of the anchoring hook fixation group was better than that of the conventional fixation group, and the differences were statistically significant (both P<0.05). The preoperative corneal endothelial cell densities of the anchor hook fixation group and conventional fixation group were (2 431±556) and (2 406±625)cells/mm 2, and the postoperative 1-month corneal endothelial cell densities were (2 012±703) and (2 004±759)cells/mm 2, respectively, without statistically significant difference (both P>0.05). The average surgical time of the anchoring hook fixation group was (67.1±7.2) minutes, which was significantly shorter than (93.1±17.9) minutes of the conventional fixation group, and the difference was statistically significant ( t=13.654, P<0.001). During the 1-month follow up, no IOL mislocation occurred in the two groups, and two eyes in the routine fixation group developed anterior chamber hemorrhage, accounting for 5.1%, no anterior chamber bleeding occurred in the anchoring hook fixation group.Corneal edema was observed in 6 eyes and 1 eye of the conventional fixation group and anchor hook fixation group, accounting for 15.4% and 2.9%, respectively.Macular edema was observed in 2 eyes of the conventional fixation group, accounting for 5.1%, and no macular edema occurred in the anchoring hook fixation group.Throughout the entire follow-up, there was no case of low intraocular pressure, ciliary detachment, exposed sutures, or requiring secondary surgical intervention in either group. Conclusions:Both minimally invasive anchoring hook IOL intrascleral suture fixation and conventional IOL suspension are safe and effective.Compared with conventional IOL suspension surgery, anchoring hook IOL intrascleral suture fixation surgery has more advantages in postoperative visual recovery, shorter surgical operation time and a lower incidence of postoperative complications.

Percutaneous coronary intervention(PCI),as one of the primary approaches for revascularization,still faces complications such as restenosis,myocardial ischemia-reperfusion injury and no-reflow/slow-flow phenomena,with no currently effective interventions ensuring long-term efficacy.Based on Li Dongyuan's theory that"fire and original qi cannot coexist",this article inherited Academician Chen Keji's academic perspective on"toxin-stasis pathogenesis"and the hemodynamic characteristics of coronary arteries to propose a"four-stage pathological progression"in post-PCI patients,namely spleen-stomach impairment-original qi deficiency-endogenous yin-fire-toxin-stasis accumulation.It emphasized that the heart vessels rely on qi and blood for nourishment and patency for function,elucidated the therapeutic rationale of Danggui Buxue Decoction,and presented the self-formulated Yixin Hemai Prescription,modified through syndrome differentiation,and performed simultaneous reinforcement and dredging,in order to provide diagnosis and treatment ideas for coronary heart disease after PCI treated with TCM.

Metastasis is a pivotal and intricate process in the progression of malignant tumors,strongly correlating with poor prognosis.Approximately 90%of cancer-related mortality is attributed to metastasis,with the five-year survival rate for patients with metastatic solid tumors ranging from 5%to 30%.Consequently,a comprehensive understanding of the underlying biological mechanisms driving metastasis is essential for unraveling its core processes and developing novel therapeutic strategies.The metastatic cascade involves tumor cells navigating numerous biological barriers,including detachment from the primary tumor,invasion of blood vessels or lymphatics,survival in circulation,extravasation into distant organs and subsequent adaptation to the microenvironment.To surmount these challenges,tumor cells undergo phenotypic changes,genetic mutations and dysregulating signaling pathways.Additionally,microenvironmental factors(such as angiogenesis,matrix remodeling and immune evasion)play a critical role,orchestrating the initiation and growth of metastatic lesions in an interdependent manner.Organ-specific metastasis,a distinct subset of metastasis,involves dynamic bidirectional interactions between tumor cells and the microenvironment of target organs.These interactions determine the selectivity of metastatic spread and drive the adaptive evolution of both the tumor and the organ,which encompasses multiple layers of cellular interactions,including cell-cell and cell-matrix signaling.Tumor cell mutations,the release of specific signaling molecules,the capacity to withstand circulatory pressures,and signaling exchanges with target organs collectively govern the selective nature of organ-specific metastasis.Furthermore,factors intrinsic to the target organ-such as its regenerative potential,metabolic profile,immune surveillance mechanisms and matrix stiffness-further facilitate the adaptive remodeling of metastatic cells within these environments.Thus,the bidirectional selection and adaptation between tumor cells and target organs form a dynamic,complex system that reshapes our understanding of metastatic tumor development.While current research emphasizes shared biological features in metastasis,the successful formation of metastatic tumors depends not only on these common mechanisms but also on the unique characteristics governing organ-specific metastasis.The interplay between generalizable and organ-specific mechanisms profoundly influences the metastatic outcome.This review aimed to consolidate our current knowledge of these shared and distinct processes,analyze the evolving understanding of the bidirectional selection between tumor cells and target organs,and assess the current status of metastatic risk prediction models for patients without metastasis.Furthermore,the paper discussed the challenges and opportunities in managing advanced-stage metastatic tumors,offering new insights and potential clinical strategies to improve prognosis and treatment outcomes.

Objective:To assess the influencing factors of glycemic control among type 2 diabetes mellitus (T2DM) patients, in particular the correlations between peripheral blood eosinophils and metabolic indicators such as glucose, lipids, and uric acid (UA) in these patients.Methods:T2DM patients who were regularly followed up in the Intensive Diabetes Mellitus Clinic of Peking Union Medical College Hospital from January 2016 to September 2024 were prospectively selected as the research subjects. The clinical data of these patients at their first visit and at the 3rd, 6th, 9th, and 12th months of follow-up were collected. The potential correlations of peripheral blood eosinophils with blood glucose control, lipid metabolism, UA metabolism, and inflammation as well as their influencing factors were analyzed.Results:A total of 161 T2DM patients were included. The glycated hemoglobin A1c (HbA1c) compliance rate was significantly higher during the follow-up visits (3, 6, 9, and 12 months) than baseline (all P<0.05) but showed no significant correlation with the count or percentage of peripheral blood eosinophils. Spearman correlation analysis showed that the percentage of peripheral blood eosinophils was negatively correlated with Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) ( P=0.049) and high-density lipoprotein cholesterol (HDL-C) ( P=0.002) and positively with serum triglyceride (TG) ( P=0.034) and UA levels ( P<0.001). A further linear regression model analysis of these four variables and the percentage of eosinophils revealed that the percentage of peripheral blood eosinophils was only linearly correlated with serum UA level ( P<0.001). Conclusion:The percentage of peripheral blood eosinophils in T2DM patients is independently correlated with serum UA level, and monitoring serum UA level is important in T2DM management. Early identification and intervention of hyperuricemia can help provide more comprehensive and precise medical interventions for T2DM patients.

Objective:To explore the differences on contraindication information for children in domestic and foreign drug instructions, and provide reference for improving the relevant information in Chinese drug insert sheets.Methods:Chinese drug insert sheets of chemicals and biological products contained in the China Pharmacopoeia 2020 and those of the western medicines in the 2023 China′s Basic Medical Insurance, Work-related Injury Insurance and Childbirth Insurance Drug Catalog were collected; drugs that were marked as contraindication for children were selected and relevant contraindication information in the Chinese drug insert sheets was collected. Instructions of the above-mentioned drugs approved by the U.S. Food and Drug Administration (English labels) were also collected, and the information on pediatric medication was reviewed and compared with the Chinese drug insert sheets. Results:A total of 222 drugs were labeled as contraindication for children in the Chinese drug insert sheets, of which 149 were available for their English labels; 123 drugs (17.5%) were not labeled as contraindication for children in English labels, and 26 (82.5%) were labeled. The 123 drugs that were not labeled as contraindication for children in the English labels included the following conditions: 58 were labeled as contraindication for children of some age in the Chinese drug insert sheets but not in the English labels, and relevant medication information was provided; 40 were labeled as contraindication for children of some age group in the Chinese drug insert sheets but was described as the effectiveness and safety of the use for children have not yet been determined for this age group in the English labels; 13 were labeled as contraindication for children in the Chinese drug insert sheets, but the medication information on children in the English labels was not clear or missing; 12 were labeled as contraindicated for children in Chinese drug insert sheets but not in the English labels, only expressed as not yet determined or not recommended for use, etc., with inconsistent age group. Among the 26 drugs labeled as contraindication for children in both Chinese and English instructions, the contraindication age group were the same in above 2 instructions for 20 drugs, and were inconsistent for the other 6 drugs; reasons for contraindication were described in both the 2 instructions for 17 drugs (13 were consistent, 4 were inconsistent), only in English labels for 8 drugs, and only in Chinese drug insert sheets for 1 drug.Conclusions:Many drugs are labeled as contraindication for children in Chinese drug insert sheets, but reasons for contraindication are rarely explained. Differences in children′s age in contraindications exist for some drugs between the Chinese drug insert sheets and English labels. The information on contraindications for children in Chinese drug insert sheets still needs to be further improved.

Objective:To evaluate the effectiveness and safety of minimally invasive anchoring hook intraocular lens (IOL) interscleral suture fixation surgery.Methods:A cohort study was conducted.A total of 74 patients (74 eyes) with aphakia, artificial lens dislocation, or lens dislocation were included at Tengzhou Central People's Hospital from 2021 to 2022.According to the surgical method, the patients were divided into conventional fixation group (39 cases, 39 eyes) undergoing conventional intraocular lens suspension surgery and anchoring hook fixation group (35 cases, 35 eyes) undergoing minimally invasive anchoring hook type IOL interscleral suture fixation surgery.Surgical time, preoperative best corrected visual acuity (BCVA) before surgery and at 1 day and 1 month after surgery, corneal endothelial cell density before and at 1 month after surgery, mislocation of the artificial IOL and the incidence of complications were recorded.This study was reviewed and approved by the Ethics Committee of Tengzhou Central People's Hospital (No.2019-20), and all patients signed the informed consent form.Results:One day and 1 month after surgery, the BCVA of the anchoring hook fixation group was better than that of the conventional fixation group, and the differences were statistically significant (both P<0.05). The preoperative corneal endothelial cell densities of the anchor hook fixation group and conventional fixation group were (2 431±556) and (2 406±625)cells/mm 2, and the postoperative 1-month corneal endothelial cell densities were (2 012±703) and (2 004±759)cells/mm 2, respectively, without statistically significant difference (both P>0.05). The average surgical time of the anchoring hook fixation group was (67.1±7.2) minutes, which was significantly shorter than (93.1±17.9) minutes of the conventional fixation group, and the difference was statistically significant ( t=13.654, P<0.001). During the 1-month follow up, no IOL mislocation occurred in the two groups, and two eyes in the routine fixation group developed anterior chamber hemorrhage, accounting for 5.1%, no anterior chamber bleeding occurred in the anchoring hook fixation group.Corneal edema was observed in 6 eyes and 1 eye of the conventional fixation group and anchor hook fixation group, accounting for 15.4% and 2.9%, respectively.Macular edema was observed in 2 eyes of the conventional fixation group, accounting for 5.1%, and no macular edema occurred in the anchoring hook fixation group.Throughout the entire follow-up, there was no case of low intraocular pressure, ciliary detachment, exposed sutures, or requiring secondary surgical intervention in either group. Conclusions:Both minimally invasive anchoring hook IOL intrascleral suture fixation and conventional IOL suspension are safe and effective.Compared with conventional IOL suspension surgery, anchoring hook IOL intrascleral suture fixation surgery has more advantages in postoperative visual recovery, shorter surgical operation time and a lower incidence of postoperative complications.

Objective:To explore the differences on contraindication information for children in domestic and foreign drug instructions, and provide reference for improving the relevant information in Chinese drug insert sheets.Methods:Chinese drug insert sheets of chemicals and biological products contained in the China Pharmacopoeia 2020 and those of the western medicines in the 2023 China′s Basic Medical Insurance, Work-related Injury Insurance and Childbirth Insurance Drug Catalog were collected; drugs that were marked as contraindication for children were selected and relevant contraindication information in the Chinese drug insert sheets was collected. Instructions of the above-mentioned drugs approved by the U.S. Food and Drug Administration (English labels) were also collected, and the information on pediatric medication was reviewed and compared with the Chinese drug insert sheets. Results:A total of 222 drugs were labeled as contraindication for children in the Chinese drug insert sheets, of which 149 were available for their English labels; 123 drugs (17.5%) were not labeled as contraindication for children in English labels, and 26 (82.5%) were labeled. The 123 drugs that were not labeled as contraindication for children in the English labels included the following conditions: 58 were labeled as contraindication for children of some age in the Chinese drug insert sheets but not in the English labels, and relevant medication information was provided; 40 were labeled as contraindication for children of some age group in the Chinese drug insert sheets but was described as the effectiveness and safety of the use for children have not yet been determined for this age group in the English labels; 13 were labeled as contraindication for children in the Chinese drug insert sheets, but the medication information on children in the English labels was not clear or missing; 12 were labeled as contraindicated for children in Chinese drug insert sheets but not in the English labels, only expressed as not yet determined or not recommended for use, etc., with inconsistent age group. Among the 26 drugs labeled as contraindication for children in both Chinese and English instructions, the contraindication age group were the same in above 2 instructions for 20 drugs, and were inconsistent for the other 6 drugs; reasons for contraindication were described in both the 2 instructions for 17 drugs (13 were consistent, 4 were inconsistent), only in English labels for 8 drugs, and only in Chinese drug insert sheets for 1 drug.Conclusions:Many drugs are labeled as contraindication for children in Chinese drug insert sheets, but reasons for contraindication are rarely explained. Differences in children′s age in contraindications exist for some drugs between the Chinese drug insert sheets and English labels. The information on contraindications for children in Chinese drug insert sheets still needs to be further improved.

Percutaneous coronary intervention(PCI),as one of the primary approaches for revascularization,still faces complications such as restenosis,myocardial ischemia-reperfusion injury and no-reflow/slow-flow phenomena,with no currently effective interventions ensuring long-term efficacy.Based on Li Dongyuan's theory that"fire and original qi cannot coexist",this article inherited Academician Chen Keji's academic perspective on"toxin-stasis pathogenesis"and the hemodynamic characteristics of coronary arteries to propose a"four-stage pathological progression"in post-PCI patients,namely spleen-stomach impairment-original qi deficiency-endogenous yin-fire-toxin-stasis accumulation.It emphasized that the heart vessels rely on qi and blood for nourishment and patency for function,elucidated the therapeutic rationale of Danggui Buxue Decoction,and presented the self-formulated Yixin Hemai Prescription,modified through syndrome differentiation,and performed simultaneous reinforcement and dredging,in order to provide diagnosis and treatment ideas for coronary heart disease after PCI treated with TCM.