OBJECTIVE To explore the improvement effect and potential mechanism of modified Yanghe decoction on bone destruction in rats with breast cancer bone metastasis based on the receptor-interacting serine/threonine-protein kinase 1 （RIPK1）/RIPK3 pathway. METHODS The rat model of breast cancer bone metastasis was established by injecting a suspension of breast cancer cells into the bone marrow cavity. The rats with successful modeling were randomly divided into a model group （intragastric administration of equal volume of normal saline）， modified Yanghe decoction low-， medium-， and high-dose groups （intragastric administration of corresponding decoction at 1.30， 2.60 and 5.20 g/kg， calculated by the dosage of crude drug）， high-dose modified Yanghe decoction+si-RIPK1 group （intragastric administration of corresponding decoction at 5.20 g/kg， calculated by the dosage of crude drug； simultaneous injection of small interfering RNA for RIPK1 via the tail vein）， and high-dose modified Yanghe decoction+si-NC group （intragastric administration of corresponding decoction at 5.20 g/kg， calculated by the dosage of crude drug； simultaneous injection of small interfering RNA for negative control via the tail vein）， with 12 rats in each group. Another 12 healthy rats were selected as the control group and were given the same volume of normal saline intragastrically， once a day， for 14 consecutive days. Body weight was measured before administration and at the end of the last administration. The mechanical pain threshold and thermal pain threshold were measured， and the bone destruction， pathological changes and osteoclast formation of the tibia were observed. The positive expression of receptor activator of nuclear factor-κB （RANK） and receptor activator of nuclear factor-κB ligand （RANKL） in the tibial tissue， as well as the phosphorylation levels of RIPK1， RIPK3 and mixed lineage kinase domain-like protein （MLKL） were detected. RESULTS Compared with the control group， the tumor cells of tibia tissues in rats of the model group showed significant proliferation and diffuse infiltration into the bone marrow cavity. Extensive areas of tumor necrosis of cells， severe bone destruction， thinning of the bone cortex， and damage to the bone trabeculae were observed. The body weight （before administration and at the end of the last administration）， mechanical pain threshold， thermal pain threshold， and the phosphorylation levels of RIPK1， RIPK3 and MLKL were decreased significantly； the tumor volume， the proportion of bone destruction area， the number of osteoclasts， and the positive expressions of RANK and RANKL were increased/up-regulated significantly （P＜0.05）. Compared with the model group， the above pathological changes in the tibial tissues of rats in modified Yanghe decoction low-， medium- and high-dose groups were all alleviated， and all quantitative indicators showed dose-dependent improvement （P＜0.05）. After silencing RIPK1， the aforementioned beneficial effects of high-dose modified Yanghe decoction were significantly weakened （P＜0.05）.CONCLUSIONSModified Yanghe decoction can alleviate bone destruction in rats with breast cancer bone metastasis. The above effect is related to the activation of the RIPK1/RIPK3 pathway.

To investigate the association between the systemic inflammatory response index (SIRI) and lung cancer prevalence based on the National Health and Nutrition Examination Survey (NHANES) database.

Objective: To investigate the association between uric acid level and elevated blood pressure among children and adolescents in Guangzhou, so as to provide a scientific basis for prevention and control of hypertension in the pediatric population. Methods: From March to December 2019, using stratified cluster random sampling, 3 626 children and adolescents aged 6-17 years without elevated blood pressure at baseline were recruited from 6 primary and secondary schools in Guangzhou. Serum uric acid levels were measured at baseline, and divided into four groups ( Q1-Q 4) based on age and sex specific quartiles for analyses. Two waves of follow up were carried out from October 2020 to May 2021 and from October 2021 to May 2022, respectively. Multilevel robust Poisson regression was used to evaluate the association between uric acid level and elevated blood pressure among children and adolescents. The additive interaction between high uric acid level and sugar sweetened beverage (SSB) intake on elevated blood pressure was assessed by stratification analysis and calculation of the relative excess risk due to interaction (RERI). Results: A total of 1 131 new cases of elevated blood pressure were identified during the two follow ups, with an incidence density of 130.5 cases 1 000 person years. Multilevel robust Poisson regression analysis showed that after adjusting for confounders such as gender, age and annual family income, compared with those in the uric acid Q 1 level, the risk of elevated blood pressure in individuals in the Q 4 level increased by 25% ( RR=1.25, 95%CI =1.08-1.44), and the risk of elevated systolic blood pressure increased by 20% ( RR=1.20, 95%CI =1.05-1.36) (both P <0.05); no statistical association was observed between uric acid and elevated diastolic blood pressure (all P >0.05). In the stratified analysis, the statistical associations of uric acid Q 4 level with elevated blood pressure ( RR=1.34, 95%CI =1.13-1.58) and elevated systolic blood pressure ( RR=1.33, 95%CI =1.14-1.55) were only observed in the group with SSB intake ≥ 250 mL/week (both P <0.05). The RERI values for the effect of uric acid Q 4 and Q 3 levels with SSB intake ≥ 250 mL/week on elevated systolic and diastolic blood pressure were 0.29 and 0.44 (both P <0.05). Conclusions High uric acid level is a risk factor for elevated blood pressure among children and adolescents, with a predominant effect on systolic blood pressure. High uric acid level and SSB intake synergistically promote the increase of blood pressure of children and adolescents.

Objective To detect the isocenter of a medical linear accelerator using an optical surface monitoring system (OSMS) combined with a self-made 3D-printed phantom, and compare with the conventional front pointer measurement method. Methods A phantom that could be fixed to the front pointer of the accelerator was fabricated using 3D printing technology. The front pointer method and OSMS were used to detect the rotation isocenter deviations of the accelerator. During the experiments, the collimator, gantry, and couch linear displacement readings were recorded at different angles. We also recorded the measurement time of different surveyors. Results Compared to the front pointer measurement method, the OSMS method showed lower standard deviations. The reductions in standard deviations showed statistical significance in the Lat direction for the collimator rotation isocenter as well as in the Lat and Vrt directions for the gantry rotation isocenter. The mean deviation of Mag values for the collimator rotation isocenter using the OSMS method was 0.50 mm, which was larger than the 0.42 mm using the front pointer method. However, the standard deviation was 0.06 using the OSMS method, which was smaller than the 0.18 using the front pointer method. The mean deviation and standard deviation of Sag values for the gantry rotation isocenter using the OSMS method were 1.03 mm and 0.12, respectively, which were both larger than 0.47 mm and 0.06 using the front pointer method. For the couch rotation isocenter, the mean deviation and standard deviation using the OSMS method were 0.32 mm and 0.04, respectively, which were both smaller than the 0.55 mm and 0.20 using the front pointer method. All surveyors spent less time in isocenter measurements using the OSMS method compared to the front pointer method. Conclusion Compared with the front pointer method, the OSMS method significantly reduces the standard deviation among surveyors, effectively reduces the influence of the angle deviation of the accelerator on the measurement results, reduces detection time, improves detection efficiency, and provides a powerful practical basis for the application of OSMS in detecting the mechanical accuracy of the linear accelerator.

Objective To detect the isocenter of a medical linear accelerator using an optical surface monitoring system (OSMS) combined with a self-made 3D-printed phantom, and compare with the conventional front pointer measurement method. Methods A phantom that could be fixed to the front pointer of the accelerator was fabricated using 3D printing technology. The front pointer method and OSMS were used to detect the rotation isocenter deviations of the accelerator. During the experiments, the collimator, gantry, and couch linear displacement readings were recorded at different angles. We also recorded the measurement time of different surveyors. Results Compared to the front pointer measurement method, the OSMS method showed lower standard deviations. The reductions in standard deviations showed statistical significance in the Lat direction for the collimator rotation isocenter as well as in the Lat and Vrt directions for the gantry rotation isocenter. The mean deviation of Mag values for the collimator rotation isocenter using the OSMS method was 0.50 mm, which was larger than the 0.42 mm using the front pointer method. However, the standard deviation was 0.06 using the OSMS method, which was smaller than the 0.18 using the front pointer method. The mean deviation and standard deviation of Sag values for the gantry rotation isocenter using the OSMS method were 1.03 mm and 0.12, respectively, which were both larger than 0.47 mm and 0.06 using the front pointer method. For the couch rotation isocenter, the mean deviation and standard deviation using the OSMS method were 0.32 mm and 0.04, respectively, which were both smaller than the 0.55 mm and 0.20 using the front pointer method. All surveyors spent less time in isocenter measurements using the OSMS method compared to the front pointer method. Conclusion Compared with the front pointer method, the OSMS method significantly reduces the standard deviation among surveyors, effectively reduces the influence of the angle deviation of the accelerator on the measurement results, reduces detection time, improves detection efficiency, and provides a powerful practical basis for the application of OSMS in detecting the mechanical accuracy of the linear accelerator.

Objective To detect the isocenter of a medical linear accelerator using an optical surface monitoring system (OSMS) combined with a self-made 3D-printed phantom, and compare with the conventional front pointer measurement method. Methods A phantom that could be fixed to the front pointer of the accelerator was fabricated using 3D printing technology. The front pointer method and OSMS were used to detect the rotation isocenter deviations of the accelerator. During the experiments, the collimator, gantry, and couch linear displacement readings were recorded at different angles. We also recorded the measurement time of different surveyors. Results Compared to the front pointer measurement method, the OSMS method showed lower standard deviations. The reductions in standard deviations showed statistical significance in the Lat direction for the collimator rotation isocenter as well as in the Lat and Vrt directions for the gantry rotation isocenter. The mean deviation of Mag values for the collimator rotation isocenter using the OSMS method was 0.50 mm, which was larger than the 0.42 mm using the front pointer method. However, the standard deviation was 0.06 using the OSMS method, which was smaller than the 0.18 using the front pointer method. The mean deviation and standard deviation of Sag values for the gantry rotation isocenter using the OSMS method were 1.03 mm and 0.12, respectively, which were both larger than 0.47 mm and 0.06 using the front pointer method. For the couch rotation isocenter, the mean deviation and standard deviation using the OSMS method were 0.32 mm and 0.04, respectively, which were both smaller than the 0.55 mm and 0.20 using the front pointer method. All surveyors spent less time in isocenter measurements using the OSMS method compared to the front pointer method. Conclusion Compared with the front pointer method, the OSMS method significantly reduces the standard deviation among surveyors, effectively reduces the influence of the angle deviation of the accelerator on the measurement results, reduces detection time, improves detection efficiency, and provides a powerful practical basis for the application of OSMS in detecting the mechanical accuracy of the linear accelerator.

Objective: To investigate the current status of hyperopic reserve among preschool children and to determine the associations with genetic and behavioral factors, so as to provide evidence for early intervention strategies and the development of working protocols for myopia prevention with a forward shift of the prevention threshold. Methods: A total of 924 preschool children (3-6 years of age) from 6 kindergartens in Jiading District of Shanghai were enrolled by stratified random sampling from March to June 2024. Cycloplegic refraction using 1% atropine eye drops was performed to obtain accurate spherical equivalent (SE) values. Questionnaires were used to collect the genetic history and daily behavioral habits of the children. Refractive status was classified into three categories based on the SE:sufficient hyperopic reserve, relatively insufficient hyperopic reserve, and pre myopia. Results: The overall detection rate of insufficient hyperopic reserve among preschool children was 82.25%, consisting of 72.29% for relatively insufficient hyperopic reserve and 9.96% for pre myopia. Multivariate Logistic regression analysis showed that parental bilateral myopia was independently and positively associated with relatively insufficient hyperopic reserve ( OR =2.13) and pre myopia ( OR =4.35) compared to children with sufficient hyperopic reserve; electronic screen exposure time ≥2 h/d on school days was an independent and positive risk factor for pre myopia ( OR =2.83); all of the above associations were statistically significant (all P <0.05). No statistically significant association was noted between outdoor activity and hyperopic reserve (all P >0.05). Conclusions The insufficient hyperopic reserve detection rate is relatively high among preschool children in Jiading District, Shanghai. Early management of electronic device use with regular screening and monitoring for preschool children with a family history of myopia should be strengthened to shift the prevention threshold earlier and prevent childhood myopia.

Respiratory tract infection is the most common infectious disease in children and has an impact on children's health worldwide.As a key iron storage protein，ferritin not only participates in maintaining the balance of iron metabolism in the body，but also plays an important role in the pathogenesis of various respiratory infections.In the infected state，ferritin can block pathogens' acquisition of iron，reduce excess iron damage to organelles，maintain blood sugar homeostasis，and affect inflammatory response and immune function.Therefore，when infection occurs，the body's ferritin level affects the prognosis of the disease.This article aims to explore the mechanism of ferritin in respiratory tract infections and provide new directions for future treatment strategies.

Objective:To compare the dose-response effects of single-fraction ultra-high dose rate (FLASH) and conventional dose rate (CONV) whole abdominal irradiation (WAI) with X-rays on acute radiation-induced intestinal injury in mice, in order to identify optimal dose parameters and potential mechanisms.Methods:A total of 186 male C57BL/6J mice were randomly assigned to a non-irradiation group ( n=6), FLASH irradiation groups ( n=90), and CONV irradiation groups ( n=90). Acute radiation-induced intestinal injury models were established using single-fraction WAI with 11, 12, 13, 14, and 15 Gy X-rays (200 Gy/s for FLASH and 4 Gy/min for CONV). Changes in body weight, stool characteristics, and disease activity index (DAI) scores were assessed at 9 d post-irradiation. At 7 d post-irradiation at 11, 12, and 13 Gy, the intestines were collected for macroscopic examination and length measurement. The small intestine was selected for HE staining and quantitative analysis of intestinal crypt number and mucosal epithelial thickness. The survival of mice was assessed at 15 d post-WAI across all dose groups. Results:After single-fraction WAI at 11, 12, and 13 Gy, the body weight was higher in the FLASH group than that in the CONV group ( t=10.17, 12.65, 10.16, P<0.05). The DAI scores for the FLASH group were 1.00±1.10, 3.17±0.75, and 2.83±1.17, respectively, which were lower than those of the CONV group (4.33±0.52, 7.00±0.00, 8.60±0.55; t=8.70, 11.71, 14.99, P<0.05). However, after WAI at 14 Gy and 15 Gy, there were no significant differences in body weight and DAI between the FLASH group and the CONV group ( P>0.05). At 7 d after single-fraction WAI at 11, 12, and 13 Gy, mice in the FLASH group exhibited less intestinal congestion, edema, and shortening compared with the CONV group. The difference between the FLASH and CONV groups were statistically significant in small intestine length at 11 and 13 Gy ( t=4.42, 3.78, P<0.05), and in colorectal length at 11 and 12 Gy ( t=3.97, 3.12, P<0.05). Small intestine HE staining revealed superior preservation of intestinal architecture in the FLASH group compared with the CONV group, characterized by longer villi, increased crypt numbers, thicker mucosal epithelium, and enhanced structural integrity. The differences in crypt number and mucosal epithelial thickness were statistically significant ( tcrypt=13.10, 23.80, 11.90; tmucosal=5.75, 2.64, 7.74; P<0.05). At 15 d post-irradiation, the survival rate in the 15 Gy FLASH group was higher than that in the CONV group (50% vs. 10%, χ2=5.39, P<0.05), with a median survival extension of 6 d ( HR=0.340, 95% CI: 0.115 4-0.999 9). No significant survival differences were observed between the FLASH group and the CONV group at 11, 12, 13, and 14 Gy ( P>0.05). Conclusions:FLASH irradiation significantly alleviated acute radiation-induced intestinal injury from medium single-fraction WAI with 11, 12, and 13 Gy X-rays compared with CONV irradiation, and showed potential to improve mouse survival after single-fraction WAI at 15 Gy. This effect is likely associated with the preservation of intestinal crypts and exhibits a dose-dependent relationship.

Aim To evaluate the bioequivalence of two oral preparations of rivaroxaban tablets(test preparation T and refe-rence preparation R)in fasting/postprandibular state in healthy Chinese subjects.Methods A randomized,open,single-dose,four-cycle,completely repeated crossover experiment was used in this study.A total of 70 healthy male and female subjects were enrolled,including 38 subjects in the fasting group and 32 sub-jects in the postprandial group.Rivaroxaban tablets(2.5 mg/tablet)were taken orally once per cycle and their reference preparations were tested.The plasma rivaroxaban concentration was determined by LC-MS/MS method.The pharmacokinetic parameters of rivaroxaban tablets were calculated by WinNonlin software,and the parameters were analyzed and processed.Re-sults The PK parameters of rivaroxaban tablets and reference preparations in fasting group were as follows:Cmax was(72.48±17.08)and(66.36±15.64)μg·L-1,respectively.AUC0-t were(383.49±101.06)and(370.43±102.16)h·ng·mL-1,and AUC0-inr were(389.58±102.28)and(375.84±103.01)h·μg·L-,respectively.Main PK parameters of subjects taking rivaroxaban tablets orally after meals:Cmax were(66.48±15.64 and 60.87±13.44)μg·L-1,AUC0-t were(404.44±72.58)and(381.80±79.93)h·μg·L-1,re-spectively.AUC0_inf was(410.88±73.55)and(393.64±69.71)h·μg·L-1,respectively.Under fasting and postmeal conditions,subjects took rivaroxaban test and reference prepara-tion orally,one tablet(2.5 mg/tablet)each time.The geometric mean of the main pharmacokinetic parameters of rivaroxaban in plasma(Cmax,AUC0-t,AUC0-inf)and their corresponding values had a 90％confidence interval ranging from 80.00％to 125.00％.No serious adverse events or unexpected adverse e-vents occurred in both groups.Conclusion Rivaroxaban tablets are bioequivalent and safe in vivo under fasting and postprandial conditions.