OBJECTIVE To evaluate the therapeutic effects and safety of everolimus combined with letrozole and conventional chemotherapy for metastatic or recurrent endometrial carcinoma （EC）. METHODS The clinical and follow-up data of 156 patients with metastatic or recurrent EC admitted to Nanyang Central Hospital from January 2020 to January 2024 were analyzed retrospectively. They were divided into a control group （77 cases） and an observation group （79 cases） according to different therapeutic regimens. The control group received paclitaxel+carboplatin/cisplatin regimen， and concurrently took Letrozole tablets at a dose of 2.5 mg orally once daily； the observation group took Everolimus tablets 10 mg orally， once a day， in addition to the treatment regimen given to the control group. Each treatment cycle lasted 21 days， and both groups of patients underwent continuous treatment for 6 to 8 cycles. The short-term efficacy indicators （objective response rate and disease control rate）， the levels of serum tumor markers [carbohydrate antigen 125， human epididymis protein 4， vascular endothelial growth factor and matrix metalloproteinase-9] and medium- to long-term efficacy indicators [progression-free survival （PFS） and overall survival （OS）] were compared between the two groups. Additionally， the occurrence of toxic and side effects in both groups of patients was recorded. RESULTS The objective response rate （53.16%）， disease control rate （89.87%）， median PFS （6.47 months） and median OS （10.79 months） of the observation group were significantly higher or longer than those （22.08%， 68.83%， 4.63 months， 8.84 months） of the control group （P＜0.05）. Compared with before treatment， the levels of serum tumor markers in both groups decreased significantly after 6 cycles of treatment； the above indexes of the observation group were significantly lower than those of the control group （P＜0.05）. The proportion of patients with stomatitis in the observation group was significantly higher than that of the control group （P＜0.05）， and there was no statistically significant difference in the proportions of patients experiencing other toxic and side effects， such as leukopenia， between the two groups （P＞0.05）. CONCLUSIONS The everolimus combined with letrozole and conventional chemotherapy can effectively improve the short-term efficacy and prolong the survival period in patients with metastatic or recurrent EC， but attention should be paid to the occurrence of toxic and side effects， especially stomatitis.

: To analyze the prevalence of anemia and iron deficiency among primary and secondary school students in Rural Nutrition Improvement Program areas of Guizhou Province in 2023, and to explore the related factors, so as to provide evidence for Rural Nutrition Improvement Program optimization. Methods: In September 2023, a stratified random cluster sampling strategy was used to select 40 rural compulsory education schools with rural nutrition improvement program in five counties of Guizhou Province. School level questionnaire was employed to collect information of basic characteristics and school meal implementation. A total of 7 826 primary and secondary school students aged 6-16 underwent anthropometry and hemoglobin (Hb) determination; serum ferritin (SF) was additionally measured in a random subsample of 1 795 pupils. Students in Grade 3 and above also completed a questionnaire covering demographic characteristics, dietary behaviours and nutrition knowledge. Group comparisons were conducted by Chi square test or Fisher s exact test, and multivariable Logistic regression models were constructed to identify factors associated with anemia and iron deficiency. Results: The overall Hb level was (133.21±12.95)g/L, with an anemia prevalence of 7.17%. The overall SF level was (69.58±59.01)μg/L, with an iron deficiency prevalence of 2.73%. Multivariable analysis showed that stunting ( OR =1.88), school menus without nutrient calculation ( OR =1.61) and absence of menu planning software in the current semester ( OR =2.34) independently increased anemia risk, whereas obesity reduced it ( OR =0.54) (all P <0.05). Girls ( OR =4.16) and Grades 7-9 ( OR =5.93) increased iron deficiency risk (both P <0.05). Compared with rarely eating fresh vegetables, students with consuming <3 kinds per day ( OR =0.08) or exactly 3 kinds per day ( OR =0.06) had lower iron deficiency risks (both P <0.05). Conclusions Anemia and iron deficiency are prevalent among primary and secondary school students in Guizhou. Targeted intervention measures should be implemented for key populations to enhance the effectiveness of nutrition improvement program.

Hepatocellular carcinoma (HCC) develops within a profoundly immunosuppressive tumor immune microenvironment (TIME), which limits the efficacy of immunotherapy. Polarization of tumor-associated macrophages (TAMs) toward a pro-tumorigenic M2 phenotype is a major driver of immune escape. Ferroptosis, an iron-dependent regulated cell death program, intersects with hepatic iron metabolism and immune regulation and thus offers promising points of therapeutic intervention. This review systematically elucidates the mechanistic role of TAM ferroptosis in HCC immune evasion and highlights a “bidirectional regulation” intervention strategy grounded in the Traditional Chinese medicine (TCM) principle of “fortifying healthy qi and eliminating pathogens” (Fuzheng Quxie). This strategy employs “eliminating pathogens” (Quxie) approaches to exploit the metabolic vulnerability of M2-like TAMs and precisely induce their ferroptosis. Moreover, it utilizes “fortifying healthy qi” (Fuzheng) approaches to protect M1-like TAMs and CD8⁺ T cells from oxidative damage. This parallel “induction-protection” paradigm demonstrates the unique advantages of TCM in systemically remodeling TIME through multitarget synergistic actions. Accordingly, precision regulation of TAM ferroptosis based on the Fuzheng Quxie theory represents a promising integrative Chinese-Western medicine strategy for overcoming current bottlenecks in HCC immunotherapy, although its clinical translational potential warrants further validation.

OBJECTIVE To investigate the equivalence of different decoction processes based on rat model of hypertension with liver-yang hyperactivity. METHODS Inductively coupled plasma mass spectrometry （ICP-MS） was used to compare the dissolution differences of inorganic elements in the powder-directly-decocted decoction versus the pieces-decocted-first decoction of Ostreae Concha- Haliotidis Concha- Margaritifera Concha drug pair. Six SD rats were included in the normal group. The spontaneously hypertensive rats were given Aconite decoction for six weeks to induce the hypertension model with liver-yang hyperactivity. After successful modeling， 48 rats were randomly divided into the model group， the captopril group [positive control， 8 mL/（kg·d） ] ， as well as low-， medium-， and high-dose groups of pieces decocted first or directly powder decocted [2.02， 4.05， 8.10 mL/（kg·d） ] ， with 6 rats in each group. Each group received the corresponding drug or equal volume of pure water intragastrically， once a day， for two consecutive weeks. After the last administration， the degree of irritability， facial temperature， pressure pain threshold， blood pressure， and pathological changes of the thoracic aorta were observed in each group. Serum nitric oxide （NO） and plasma angiotensin Ⅱ （Ang Ⅱ）， renin， and aldosterone （ALD） levels were also measured. RESULTS ICP-MS analysis results showed statistically significant differences in the contents of macroelements Li， Na， Mg， Ca， Mn， Ga， Sr， Mo， Cd， Sn， and Sb， between the powder-directly-decocted decoction and the pieces-decocted-first decoction （ P ＜0.05） ，the elements P， Cr， Fe， Ni， Zn， Hg， Tl， and Pb were not detected in either decoction. Animal experiments showed that after two weeks of administration， compared with the model group， the facial temperature， and blood pressure decreased in all treatment groups， while the pressure pain threshold increased； plasma levels of Ang Ⅱ， renin and ALD， as well as the serum level of NO were all decreased， and thoracic aortic media thickness was significantly reduced， most of the differences in the above indicators were statistically significant （ P ＜0.05 or P ＜0.01 or P ＜0.001）. Pathological observation showed improvement in thoracic aortic pathological injury. CONCLUSIONS The powder-directly-decocted process for the Ostreae Concha- Haliotidis Concha- Margaritifera Concha drug pair significantly promotes the dissolution of key elements such as Ca， Mg， and Sr without increasing the dissolution of harmful elements. It is equivalent to the traditional pieces-decocted-first in alleviating liver-yang hyperactivity syndrome， lowering blood pressure， and protecting the vascular endothelium， and even shows better performance in some indicators.

Chronic obstructive pulmonary disease (COPD), which predominantly affects middle-aged and elderly individuals, is associated with a significantly reduced quality of life and often triggers various other pulmonary conditions. Lung cancer, as one of the most prevalent and deadly pulmonary malignancies worldwide, poses a severe threat to global public health. The risk of developing lung cancer is markedly higher in COPD patients compared to the general population, indicating numerous associations between the two conditions that warrant in-depth investigation. Although a substantial body of research has explored the relationship between COPD and lung cancer, studies focusing on the molecular mechanisms underlying their connection remain limited. This article reviews the latest research progress on the mechanisms of COPD complicated by lung cancer from four perspectives: the role of chronic pulmonary inflammation, programmed cell death, genetic and molecular interactions, and dysbiosis of the pulmonary microbiome. The aim of this article is to provide new insights and references for the prevention and therapeutic strategies of COPD complicated with lung cancer.

Objective To design a high altitude adaptive oxygen generator for the crews to alleviate their high altitude reaction in high altitude environment and meet their requirements for oxygen supply.Methods A high altitude adaptive oxygen generator based on the mature pressure swing adsorption oxygen production method was designed with the key technologies of discharge capacity compensation of air compression pump and airway fusion of molecular sieve tower,which had the components of molecular sieve tower,air compression pump,controller,cooling fan,cooler,solenoid valve,regulator,flow meter and etc.Trials were carried out at the simulated altitude and field plateau environment so as to verify the high altitude adaptive performance of the oxygen generator developed.Results The trial results showed the oxygen generator met the desired objectives and the requirements for oxygen volume fraction in GJB 2799-1996 General specification for medical oxygen generator using molecular sieve method.Conclusion The oxygen generartor provides oxygen supply effectively for vehicle operators in plateau environments or the ones rushing into the plateau.[Chinese Medical Equipment Journal,2025,46(4):29-34]

Objective Under the operation background of Diagnosis-Intervention Packet(DIP),whether there is interaction between reducing medical cost and average length of stay combined with pre-hospitalization mode,and whether there is difference between different departments and diseases in interaction.Methods Based on real-world data from 71 453 patients admitted to Guizhou Provincial People's Hospital from July to December 2021,a two-way analysis of variance was employed.When the interaction effect was statistically significant,parameter estimation was used to determine the magnitude and direction of the interaction effect,followed by subgroup analyses by department and disease.Results Without adjustment,both total medical costs and average length of stay exhibited a negative interaction effect(P＜0.05).Subgroup analyses revealed that in terms of total medical costs,the effect size for the surgical system was 0.18％,lower than that for the internal medicine system(0.70％);for core diseases,it was 6.62％,lower than that for comprehensive diseases(7.71％).Regarding average length of stay,the effect size for the surgical system was 0.55％,better than that for the internal medicine system(0.22％);for core diseases,it was 8.70％,higher than that for comprehensive diseases(2.90％).Conclusion The combination of DIP payment reform and pre-admission management model demonstrates a synergistic effect,effectively reducing patients' medical costs and length of stay.This effect is influenced by disease complexity and the standardization of diagnostic and treatment processes.

Objective To investigate the characteristics of a novel FANCL mutation identified in a patient with premature ovarian insufficiency(POI)and to explore its potential functional impacts in vitro.Methods A novel FANCL heterozygous mutation c.1033G>A(p.Glu345Lys)was screened in a patient with POI using whole exome sequencing(WES),which was found to be inherited from a mother who had undergone early menopause.The authenticity of the mutation was identified by Sanger sequencing and the conserved nature of the mutation site was predicted by software.Overexpressing FANCL mutant and wildtype plasmids were constructed and transiently transfected into HEK293T cell lines,and the effect of the mutation was detected by qPCR,immunofluorescence and Western blot.Results The mutation site of FANCL was located within the Ring domain of FANCL,which was highly conserved across multiple species.The mutant showed no significant change in mRNA expression level,while the protein expression level was significantly down-regulated.In vitro cellular experiments further revealed that the mutation leads to decreased expression levels by reducing protein stability.Conclusion A FANCL c.1033G>A mutation was found and it may cause disease in the POI patient due to decreased protein stability.

Objective To investigate the expression of Nucleophosmin 3(NPM3)in lung adenocarcinoma and its impact on the biological functions of the lung adenocarcinoma cell line H 292,with the goal of providing innovative insights for the diagno-sis and therapeutic strategies of lung adenocarcinoma.Methods The differential expression of the NPM3 gene between lung ad-enocarcinoma and normal controls was analyzed,along with its correlation with the clinicopathological characteristics and prog-nosis of lung adenocarcinoma patients,using the TCGA bioinformatics database.A cell model with reduced NPM3 expression(si-NPM3-H292)was developed by gene interference technology,and the efficiency of this knockdown was assessed by real-time fluorescence quantitative PCR(qRT-PCR)and Western blotting.The impact of NPM3 knockdown on the proliferative capacity of lung adenocarcinoma cells was evaluated by using CCK-8 and plate clone formation assays.The scratch and Transwell assays were employed to assess the effect of NPM 3 knockdown on the migratory potential of H 292 cells.The mRNA and protein ex-pression levels of markers associated with epithelial-mesenchymal transition(EMT)were determined by qRT-PCR and Western blotting.Additionally,the expression levels of proteins involved in the PI3K/Akt signaling pathway were examined by Western blotting.Results Analysis of the TCGA database indicated that NPM 3 is highly expressed in lung adenocarcinoma and is sig-nificantly associated with the clinicopathological classification of lung adenocarcinoma patients.The survival outcomes for pa-tients with high NPM 3 expression were notably worse than those with low expression(P＜0.05).The knockdown cell model was successfully established,and the proliferation and migration capabilities of H292 cells were significantly diminished after NPM3 knockdown(P＜0.05).Compared to the control group,mRNA and protein levels of E-cadherin were increased in si-NPM 3-H292 cells,while the expression level of N-cadherin was reduced at both mRNA and protein levels(P＜0.05).Although no significant change was observed in the protein expressions of Akt and PI3K in si-NPM3-H292 cells compared to the control,there was a decrease in phosphorylation levels,accompanied by an increase in protein expression of PTEN(P＜0.05).Conclusion NPM3 is highly expressed in lung adenocarcinoma,which is associated with poor prognosis of patients.NPM3 may facilitate the proliferation and migration of lung adenocarcinoma cells through regulation of the PI 3K/Akt signaling pathway.

Dental implantology has developed rapidly for over half a century,since pure titanium(99.7％)dental cylindrical threaded implants were exploited and osseointegration was introduced in 1960s by Prof.Br?nemark.The long term retention rates of 10 years or more are over 95％.However,the biological complications jeopardize the long term effects of dental implant treatment seriously.The prevalence of dental implant biological complications varies greatly among different reports resulting from the disparities on the defini-tions of dental implant biological complications.After analyzing and summarizing the major opinions proposed internationally in recent years,the consensus for the definition of dental implant biological complications has been reached.Generally the dental implant biologi-cal implications can be classified into early stage(before restoration)biological complications and late stage(after restoration)biological complications.The early stage biological complications include acute and chronic infections,pain,soft tissue deficiency,and osseointegration failure,etc.The late stage complications include peri-implant diseases(peri-implant mucositis and peri-implantitis),soft tissue deficiency around implant,implant loosening and dropping off,etc.The various risk factors related to different dental implant biological complications,the strategies of the prevention and treatment for the dental implant biological complications have been discussed comprehensively,and the consensus has been reached.It is aimed to advocate the dentist to pay more attention to the early prevention of the biological implant complications,to promote more researches on the implant biological complications,and to help elevate the level of dental implantology in our country.