ObjectiveTo investigate the effects of Liuwei Dihuangwan on mammalian target of rapamycin （mTOR）-mediated synaptic plasticity in the prefrontal cortex-hippocampus circuit in the rat model of valproic acid （VPA）-induced autism spectrum disorder （ASD） and to explore its potential mechanism for reducing behavioral abnormalities in ASD rats. MethodsThirteen SD pregnant rats were randomized into the VPA group （10 rats） and the control group （3 rats）. On gestational day 13， the VPA group was intraperitoneally injected with VPA solution （600 mg·kg^-1）， while the control group was injected with an equal volume of normal saline. Male pups of 21 days old from both groups underwent behavioral tests to screen the ASD model rats （32 rats）. These rats were then randomly assigned to the model （distilled water）， vitamin D （1 480 U·kg^-1）， low-dose （0.75 g·kg^-1） Liuwei Dihuangwan， and high-dose （1.5 g·kg^-1） Liuwei Dihuangwan groups， and normal male pups were selected as the blank group （distilled water）， with 8 rats in each group. Each group was treated with the corresponding drug or an equal volume of distilled water via gavage daily. After drug administration， behavioral tests were conducted again， followed by anesthesia and tissue collection. Nissl staining was carried out to observe the morphological changes of neurons in the prefrontal cortex and hippocampus. Transmission electron microscopy was used to observe changes in hippocampal synaptic structure. Immunohistochemistry and Western blot were employed to determine the expression of mTOR， phosphatidylinositol 3-kinase （PI3K）， and protein kinase B （Akt） in the prefrontal cortex， as well as synaptophysin-1 （SYP-1）， postsynaptic density 95 （PSD95）， and N-methyl-D-aspartate receptors （NMDARs） in the hippocampus. ResultsCompared with the control group， the model group exhibited severe growth retardation and developmental deformities， with abnormal behavioral performance and pathological damage to neurons and synapses in the prefrontal cortex and hippocampus. Compared with the model group， all treatment groups showed reduced behavioral abnormalities and pathological damage to neurons and synapses in the prefrontal cortex and hippocampus， with the most significant effects in the high-dose Liuwei Dihuangwan group. Immunohistochemistry and Western blotting results showed that compared with the control group， the model group exhibited significantly increased protein levels and phosphorylation ratios of p-mTOR， p-Akt， and p-PI3K in the prefrontal cortex （P<0.05， P<0.01）， and decreased protein levels of SYP-1 and PSD95 and increased protein level of NMDARs in the hippocampus （P<0.01）. Compared with those in the model group， the protein levels of p-mTOR， p-Akt， and p-PI3K in the prefrontal cortex decreased in the vitamin D and high-dose Liuwei Dihuangwan groups （P<0.05）， and the p-mTOR/mTOR， p-Akt/Akt， and p-PI3K/PI3K ratios in the prefrontal cortex declined in the vitamin D group （P<0.05）. The high-dose Liuwei Dihuangwan group showed a reduction in p-PI3K/PI3K ratio （P<0.05）. The protein level of SYP-1 and PSD95 in the hippocampus increased in the vitamin D， low-dose Liuwei Dihuangwan， and high-dose Liuwei Dihuangwan groups （P<0.05， P<0.01）， while the protein level of NMDARs decreased in the vitamin D and high-dose Liuwei Dihuangwan groups （P<0.01）. ConclusionLiuwei Dihuangwan significantly reduces VPA-induced ASD-like behaviors and enhances the regeneration and repair of neurons in the prefrontal cortex and synaptic structures in the hippocampus by downregulating of PI3K/Akt/mTOR expression in the prefrontal cortex， upregulating SYP-1 and PSD95 expression in the hippocampus， and inhibiting NMDARs expression.

To analyze the characteristics of outpatient rare disease admissions at Xi′an Children′s Hospital based on the two batches of the China′s Rare Disease Catalogs.

According to the latest GLOBOCAN data released in 2024, esophageal cancer ranks the 11th in global cancer incidence and represents the 7th leading cause of cancer-related mortality worldwide. In 2022, there were approximately 511000 newly diagnosed cases of esophageal cancer and 445000 deaths globally. On February 28, 2025, the National Comprehensive Cancer Network (NCCN) published updated clinical practice guidelines for esophageal and esophagogastric junction cancers (version 1.2025). This article provides a comprehensive analysis of the major diagnostic and therapeutic updates in the guidelines compared to the version 5.2024, encompassing key domains including screening stratification protocols, perioperative treatment optimization strategies, dynamic efficacy evaluation systems, molecular subtyping-guided therapeutic approaches, and immunotherapy expansion algorithms. The findings aim to provide references for esophageal cancer treatment in China.

Objective:To analyze the correlation between 24-hour urinary sodium excretion and early renal function impairment in patients with primary hypertension.Methods:This cross-sectional study included patients with primary hypertension who were admitted to the Department of Cardiology of the Chinese People′s Liberation Army General Hospital between January 2021 and October 2024. Patients were divided into low-sodium, medium-sodium, and high-sodium groups based on their 24-hour urinary sodium excretion. General clinical data were collected using the electronic medical record system. Urinary sodium, protein, and microalbumin excretion were analyzed from 24-hour urine samples. Spearman correlation analysis was used to explore the relationship between 24-hour urinary sodium excretion and urinary microalbumin excretion. A multiple linear regression model was used to further assess the independent association between these variables. Subgroup analyses were conducted based on age were performed to determine whether age influenced the relationship between urinary sodium excretion and renal function impairment.Results:A total of 1 065 patients with primary hypertension were included, with a mean age of (55.26±14.06) years, including 568(53.33%) males. The low-sodium, medium-sodium, and high-sodium groups included 223, 579, and 263 patients, respectively. The 24-hour urinary microalbumin excretion in the high-sodium group was significantly higher than in the medium-sodium and low-sodium groups, and this trend remained consistent across different age groups (all P<0.05). Spearman correlation analysis showed a positive correlation between 24-hour urinary sodium excretion and urinary microalbumin excretion ( r=0.220, P<0.001), and this relationship was observed in all age groups (all P<0.05). Multiple linear regression analysis confirmed an independent association between 24-hour urinary sodium excretion and urinary microalbumin excretion (all P<0.001), which persisted across different age groups (all P<0.05). Conclusion:In patients with primary hypertension, 24-hour urinary sodium excretion is closely associated with microalbumin excretion, suggesting a potential link to early renal function impairment.

Perioperative drug-related rare adverse reactions are often characterized by acute onset,high risk,and unpredictable,involving complex physiological and genetic factors.Currently,most perioperative pharmacovigilance relies on clinical monitoring and real-time data reporting by medical teams.However,due to scattered data and the masking of symptoms by anesthetics and pain medications,it is difficult to predict rare adverse reactions accurately and promptly.This paper systematically reviews the latest advancements in the integration of digital and intelligent technologies across various fields.Based on real-world data,our research team had leveraged digital-intelligence fusion technologies to deeply integrate big data with artificial intelligence,thereby constructing a standardized anesthesia-specific database.This enabled dynamic monitoring of vital signs,individualized risk prediction,and comprehensive analysis of multimodal data in real-world studies,providing an innovative solution for perioperative pharmacovigilance.The aim of this paper is to enhance the personalization and intelligence of perioperative drug safety management,thereby offering more effective protection for patient medication safety during the perioperative period.

Objective To investigate the anti-tumor effect of Job's tears oral solution on lung cancer mice.Methods Observe the histopathological morphology of the tumor;Flow cytometry detected the changes in the levels of CD4+T and CD8+T in splenic lymphocytes;Elisa detected the contents of immunoglobulins IgA,IgG,IL-2 and IFN-γ;Blood routine was detected;the kit determined the levels of liver and kidney glutathione peroxidase(GSH-Px),superoxide dismutase(SOD)and malondialdehyde(MDA)content;Serum alanine aminotransferase(ALT),alkaline phosphatase(ALB),azelaic transaminase(AST),urea nitrogen(BUN),and blood creatinine(CRE)were measured in each group of mice.The transcriptome was found differential genes and pathway enrichment was performed.Western blot was used to detect the expression of proteins related to IL-17 signaling pathway(STAT3,NF-κB,VEGF)and TNF signaling pathway(PI3K/AKT,MAPK,JNK).Results Tumor histopathological and morphological changes were obvious in each administration group,and the heterogeneity was gradually reduced.Compared with the cisplatin group,the levels of CD4+T,CD8+T,CD4+T/CD8+T,IL-2,IFN-γ,and IgG in the Job's tears group were significantly increased(P<0.01).The blood routine results:compared with the model group,WBC,RBC,HGB,PLT,Lym%and GR%in the Job's tears group decreased significantly(P<0.01);Compared with the cisplatin group,WBC,RBC,PLT,HGB and Lym%in the Job's tears group increased significantly(P<0.01).The antioxidant indexes of liver and kidney showed that the levels of GSH and SOD in the liver and kidney tissues of the Job's tears group increased significantly(P<0.01),and the level of MDA decreased significantly(P<0.01).Effects on liver and kidney function indexes in mice AST,ALT,BUN and CRE decreased significantly in the Job's tears group(P<0.01),and ALB level increased significantly in the Job's tears group(P<0.01).Transcriptome results,Job's tears high-dose group mainly exerted anti-tumor effects by affecting TNF signaling pathway and IL-17 signaling pathway.Western blot results,in the IL-17 signaling pathway,S-TAT3 and VEGF decreased in the cisplatin group and the Job's tears group compared with the model group(P<0.01),and NF-κB decreased in the Job's tears high-dose group(P<0.01);Compared with the cisplatin group,STAT3 and NF-κB were decreased in the Job's tears group(P<0.01);VEGF was decreased in the Job's tears low-dose group(P<0.01);In the TNF signaling pathway,PI3K and MAPK were decreased in the cisplatin group and Job's tears group(P<0.01);AKT and P-AKT were decreased in the Job's tears group(P<0.01).Compared with the cisplatin group,the Job's tears group AKT,PI3K,and MAPK decreased(P<0.01);P-AKT decreased in the high dose group of Job's tears(P<0.01).Conclusion High-dose Job's tears oral solution inhibits tumor proliferation,attenuates inflammatory response,enhances immunity,improves blood routine and reduces liver and kidney injury in lung cancer mice mainly by inhibiting IL-17 and TNF signaling pathway.

Perioperative drug-related rare adverse reactions are often characterized by acute onset,high risk,and unpredictable,involving complex physiological and genetic factors.Currently,most perioperative pharmacovigilance relies on clinical monitoring and real-time data reporting by medical teams.However,due to scattered data and the masking of symptoms by anesthetics and pain medications,it is difficult to predict rare adverse reactions accurately and promptly.This paper systematically reviews the latest advancements in the integration of digital and intelligent technologies across various fields.Based on real-world data,our research team had leveraged digital-intelligence fusion technologies to deeply integrate big data with artificial intelligence,thereby constructing a standardized anesthesia-specific database.This enabled dynamic monitoring of vital signs,individualized risk prediction,and comprehensive analysis of multimodal data in real-world studies,providing an innovative solution for perioperative pharmacovigilance.The aim of this paper is to enhance the personalization and intelligence of perioperative drug safety management,thereby offering more effective protection for patient medication safety during the perioperative period.

Objective To investigate the anti-tumor effect of Job's tears oral solution on lung cancer mice.Methods Observe the histopathological morphology of the tumor;Flow cytometry detected the changes in the levels of CD4+T and CD8+T in splenic lymphocytes;Elisa detected the contents of immunoglobulins IgA,IgG,IL-2 and IFN-γ;Blood routine was detected;the kit determined the levels of liver and kidney glutathione peroxidase(GSH-Px),superoxide dismutase(SOD)and malondialdehyde(MDA)content;Serum alanine aminotransferase(ALT),alkaline phosphatase(ALB),azelaic transaminase(AST),urea nitrogen(BUN),and blood creatinine(CRE)were measured in each group of mice.The transcriptome was found differential genes and pathway enrichment was performed.Western blot was used to detect the expression of proteins related to IL-17 signaling pathway(STAT3,NF-κB,VEGF)and TNF signaling pathway(PI3K/AKT,MAPK,JNK).Results Tumor histopathological and morphological changes were obvious in each administration group,and the heterogeneity was gradually reduced.Compared with the cisplatin group,the levels of CD4+T,CD8+T,CD4+T/CD8+T,IL-2,IFN-γ,and IgG in the Job's tears group were significantly increased(P<0.01).The blood routine results:compared with the model group,WBC,RBC,HGB,PLT,Lym%and GR%in the Job's tears group decreased significantly(P<0.01);Compared with the cisplatin group,WBC,RBC,PLT,HGB and Lym%in the Job's tears group increased significantly(P<0.01).The antioxidant indexes of liver and kidney showed that the levels of GSH and SOD in the liver and kidney tissues of the Job's tears group increased significantly(P<0.01),and the level of MDA decreased significantly(P<0.01).Effects on liver and kidney function indexes in mice AST,ALT,BUN and CRE decreased significantly in the Job's tears group(P<0.01),and ALB level increased significantly in the Job's tears group(P<0.01).Transcriptome results,Job's tears high-dose group mainly exerted anti-tumor effects by affecting TNF signaling pathway and IL-17 signaling pathway.Western blot results,in the IL-17 signaling pathway,S-TAT3 and VEGF decreased in the cisplatin group and the Job's tears group compared with the model group(P<0.01),and NF-κB decreased in the Job's tears high-dose group(P<0.01);Compared with the cisplatin group,STAT3 and NF-κB were decreased in the Job's tears group(P<0.01);VEGF was decreased in the Job's tears low-dose group(P<0.01);In the TNF signaling pathway,PI3K and MAPK were decreased in the cisplatin group and Job's tears group(P<0.01);AKT and P-AKT were decreased in the Job's tears group(P<0.01).Compared with the cisplatin group,the Job's tears group AKT,PI3K,and MAPK decreased(P<0.01);P-AKT decreased in the high dose group of Job's tears(P<0.01).Conclusion High-dose Job's tears oral solution inhibits tumor proliferation,attenuates inflammatory response,enhances immunity,improves blood routine and reduces liver and kidney injury in lung cancer mice mainly by inhibiting IL-17 and TNF signaling pathway.

Objective:To analyze the correlation between 24-hour urinary sodium excretion and early renal function impairment in patients with primary hypertension.Methods:This cross-sectional study included patients with primary hypertension who were admitted to the Department of Cardiology of the Chinese People′s Liberation Army General Hospital between January 2021 and October 2024. Patients were divided into low-sodium, medium-sodium, and high-sodium groups based on their 24-hour urinary sodium excretion. General clinical data were collected using the electronic medical record system. Urinary sodium, protein, and microalbumin excretion were analyzed from 24-hour urine samples. Spearman correlation analysis was used to explore the relationship between 24-hour urinary sodium excretion and urinary microalbumin excretion. A multiple linear regression model was used to further assess the independent association between these variables. Subgroup analyses were conducted based on age were performed to determine whether age influenced the relationship between urinary sodium excretion and renal function impairment.Results:A total of 1 065 patients with primary hypertension were included, with a mean age of (55.26±14.06) years, including 568(53.33%) males. The low-sodium, medium-sodium, and high-sodium groups included 223, 579, and 263 patients, respectively. The 24-hour urinary microalbumin excretion in the high-sodium group was significantly higher than in the medium-sodium and low-sodium groups, and this trend remained consistent across different age groups (all P<0.05). Spearman correlation analysis showed a positive correlation between 24-hour urinary sodium excretion and urinary microalbumin excretion ( r=0.220, P<0.001), and this relationship was observed in all age groups (all P<0.05). Multiple linear regression analysis confirmed an independent association between 24-hour urinary sodium excretion and urinary microalbumin excretion (all P<0.001), which persisted across different age groups (all P<0.05). Conclusion:In patients with primary hypertension, 24-hour urinary sodium excretion is closely associated with microalbumin excretion, suggesting a potential link to early renal function impairment.

Objective To investigate the clinical application of three-dimensional intracavitary/free-hand interstitial brachytherapy technique in radical radiotherapy for cervical cancer. Methods A retrospective study was conducted on the clinical data of patients with cervical cancer who underwent radical radiotherapy using CT-guided three-dimensional intracavitary/free-hand interstitial brachytherapy technique in The Affiliated Cancer Hospital of Nanjing Medical University from April 2019 to September 2021. The short-term efficacy and adverse reactions were analyzed, and the independent predictors affecting short-term efficacy were evaluated by logistic risk regression model. Results A total of 182 patients were included, and all patients successfully completed the treatment. Clinical efficacy assessment performed 3 months after treatment revealed an overall response rate of 90.65%; the incidence of grade 3 and 4 adverse reactions in the lower gastrointestinal tract was 4.4% during treatment. After reclassifying stage IIIC patients according to the International Federation of Gynecology and Obstetrics (FIGO) 2009 staging system and including factors affecting the stage, it was found that the tumor volume before brachytherapy was the main factor affecting the clinical efficacy of patients at this stage (P = 0.004). Conclusion As a key method in radical radiotherapy for cervical cancer, three-dimensional intracavitary/free-hand interstitial brachytherapy technique is safe and effective and can be quickly popularized in primary hospitals beyond regional cancer centers for cervical cancer brachytherapy.