Metabolic reprogramming， as one of the core hallmarks of malignant tumors， plays a key role in the occurrence， development and treatment of breast cancer （BC）. Abnormal changes in glucose metabolism， amino acid metabolism， lipid metabolism， as well as the tricarboxylic acid （TCA） cycle and oxidative phosphorylation （OXPHOS） pathways significantly influence the pathogenesis and progression of BC. Studies have shown that various active components of traditional Chinese medicine （TCM） （such as berberine， matrine， quercetin， curcumin， etc.） and their compound formulations （e.g. Xihuang pill， Danzhi xiaoyao powder， Yanghe decoction， etc.） can inhibit the proliferation and migration of BC cells and induce apoptosis by regulating key metabolic pathways such as glycolysis， lipid synthesis， and amino acid metabolism. TCM demonstrates multi-target and holistic regulatory advantages in intervening in BC metabolic reprogramming， showing significant potential in modulating key molecules like hypoxia inducible factor-1α， hexokinase-2， pyruvate kinase M2， lactate dehydrogenase A， glucose transporter-1， fatty acid synthase， and signaling pathways such as AKT/mTOR. However， current researches still focus predominantly on glucose metabolism， with insufficient mechanistic studies on lipid metabolism， amino acid metabolism， the TCA cycle， and OXPHOS. The precise targets， molecular mechanisms， and clinical translation value of these interventions require further validation and clarification through more high-quality experimental studies and clinical trials.

Objective:To investigate the clinical and neuroelectrophysiological characteristics of NOTCH2NLC gene-related neuronal intranuclear inclusion disease (NIID). Methods:One hundred and forty patients with NOTCH2NLC gene-related NIID diagnosed in the Department of Neurology and Department of Geriatrics, Xiangya Hospital, Central South University from January 2018 to June 2024 were selected as the research subjects. Their clinical data as well as neuroelectrophysiological results were collected. Their clinical and neuroelectrophysiological characteristics were summarized. Results:The onset age of 140 patients with NOTCH2NLC gene-related NIID was 56.00 (45.25, 62.75) years. Among them, 55.0% (77/140) of patients with NIID presented with peripheral nerve symptoms, but up to 98.6% (138/140) of patients with NIID had peripheral nerve involvement. Out of the patients studied, 97.1% (136/140) exhibited a reduction in motor nerve conduction velocity and 66.4% (93/140) showed a decrease in sensory nerve conduction velocity. Furthermore, 53.6% (75/140) of patients had mild decrease in compound muscle action potential, and 55.7% (78/140) of patients showed mild reduction in sensory nerve action potential. Motor nerve involvement was more severe than sensory nerve impairment, and lower limb involvement was more severe than upper limb involvement. The nerve conduction abnormalities in the muscle weakness type ( n=32) of NIID patients were more severe than those in the non-muscle weakness type (cognitive impairment type, n=41; movement disorder type, n=43; paroxysmal symptom type, n=24), showing mixed demyelinating and axonal sensorimotor neuropathy, while the non-muscle weakness type of NIID patients mostly showed mild demyelinating sensorimotor neuropathy. There was no significant difference in nerve conduction related electrophysiological results among the patients with 3 non-muscle weakness phenotypes. Conclusions:Peripheral neuropathy is common in NIID patients. The neuroelectrophysiological characteristics of NIID patients include slight demyelinating sensorimotor neuropathy, and some of NIID patients are also accompanied by mild axonal damage. Neuroelectrophysiological evaluation is helpful for the diagnosis of NIID.

Using clinical physicians as an example,this article describes the current status of evaluation models for sen-ior health technical personnel in China.It explores the professional title assessment mechanism-an important system reflecting the evaluation of clinical technical capabilities-as well as practical experiences and advanced practices adopted in various re-gions.The existing problems are summarized,including insufficient refinement in the classification of assessment systems,diffi-culties in quantifying clinical practice,lack of standardization in evaluation informatization,and disconnection between evaluation results and their application.Recommendations are proposed:optimizing the hierarchical and categorized evaluation mechanism,improving the evaluation system and standards,exploring quantitative assessment of clinical capabilities,innovating evaluation tools,and establishing a virtuous cycle between talent evaluation and talent utilization to promote the sustainable development of the healthcare sector.

Lung cancer is one of the most prevalent malignancies globally,with the highest incidence and mortality rates.Non-small cell lung cancer(NSCLC)accounts for 85%of all lung cancer cases.In China,both the incidence and mortality of lung cancer rank first among all ma-lignancies.Interstitial lung abnormalities(ILA)are non-dependent abnormalities incidentally detected on chest computed tomography(CT)scans.Some NSCLC patients may present with concurrent ILA at diagnosis,and ILA may significantly impact survival outcomes and treatment-related complications in NSCLC patients.However,the relationship between ILA and NSCLC remains under investigation.The integration of artificial intelligence(AI)technologies with multimodal data to develop novel and efficient comprehensive assessment models for ILA repres-ents a promising research frontier.This review aims to provide a comprehensive analysis of the correlation between ILA and NSCLC,the pro-gnostic implications of ILA in NSCLC patients,and the current advancements in AI-based technologies for ILA evaluation.The findings may of-fer valuable insights to guide future research directions on ILA in China.

Using clinical physicians as an example,this article describes the current status of evaluation models for sen-ior health technical personnel in China.It explores the professional title assessment mechanism-an important system reflecting the evaluation of clinical technical capabilities-as well as practical experiences and advanced practices adopted in various re-gions.The existing problems are summarized,including insufficient refinement in the classification of assessment systems,diffi-culties in quantifying clinical practice,lack of standardization in evaluation informatization,and disconnection between evaluation results and their application.Recommendations are proposed:optimizing the hierarchical and categorized evaluation mechanism,improving the evaluation system and standards,exploring quantitative assessment of clinical capabilities,innovating evaluation tools,and establishing a virtuous cycle between talent evaluation and talent utilization to promote the sustainable development of the healthcare sector.

Lung cancer is one of the most prevalent malignancies globally,with the highest incidence and mortality rates.Non-small cell lung cancer(NSCLC)accounts for 85%of all lung cancer cases.In China,both the incidence and mortality of lung cancer rank first among all ma-lignancies.Interstitial lung abnormalities(ILA)are non-dependent abnormalities incidentally detected on chest computed tomography(CT)scans.Some NSCLC patients may present with concurrent ILA at diagnosis,and ILA may significantly impact survival outcomes and treatment-related complications in NSCLC patients.However,the relationship between ILA and NSCLC remains under investigation.The integration of artificial intelligence(AI)technologies with multimodal data to develop novel and efficient comprehensive assessment models for ILA repres-ents a promising research frontier.This review aims to provide a comprehensive analysis of the correlation between ILA and NSCLC,the pro-gnostic implications of ILA in NSCLC patients,and the current advancements in AI-based technologies for ILA evaluation.The findings may of-fer valuable insights to guide future research directions on ILA in China.

Objective:To investigate the clinical and neuroelectrophysiological characteristics of NOTCH2NLC gene-related neuronal intranuclear inclusion disease (NIID). Methods:One hundred and forty patients with NOTCH2NLC gene-related NIID diagnosed in the Department of Neurology and Department of Geriatrics, Xiangya Hospital, Central South University from January 2018 to June 2024 were selected as the research subjects. Their clinical data as well as neuroelectrophysiological results were collected. Their clinical and neuroelectrophysiological characteristics were summarized. Results:The onset age of 140 patients with NOTCH2NLC gene-related NIID was 56.00 (45.25, 62.75) years. Among them, 55.0% (77/140) of patients with NIID presented with peripheral nerve symptoms, but up to 98.6% (138/140) of patients with NIID had peripheral nerve involvement. Out of the patients studied, 97.1% (136/140) exhibited a reduction in motor nerve conduction velocity and 66.4% (93/140) showed a decrease in sensory nerve conduction velocity. Furthermore, 53.6% (75/140) of patients had mild decrease in compound muscle action potential, and 55.7% (78/140) of patients showed mild reduction in sensory nerve action potential. Motor nerve involvement was more severe than sensory nerve impairment, and lower limb involvement was more severe than upper limb involvement. The nerve conduction abnormalities in the muscle weakness type ( n=32) of NIID patients were more severe than those in the non-muscle weakness type (cognitive impairment type, n=41; movement disorder type, n=43; paroxysmal symptom type, n=24), showing mixed demyelinating and axonal sensorimotor neuropathy, while the non-muscle weakness type of NIID patients mostly showed mild demyelinating sensorimotor neuropathy. There was no significant difference in nerve conduction related electrophysiological results among the patients with 3 non-muscle weakness phenotypes. Conclusions:Peripheral neuropathy is common in NIID patients. The neuroelectrophysiological characteristics of NIID patients include slight demyelinating sensorimotor neuropathy, and some of NIID patients are also accompanied by mild axonal damage. Neuroelectrophysiological evaluation is helpful for the diagnosis of NIID.

Objective:To analyze the correlation between the grouping and weighting of two sets of disease combination systems, namely diagnosis-related groups(DRG) and diagnosis-intervention packet(DIP), and to establish a multidimensional analysis and evaluation mode by applying DRG, DIP, and clinical pathway to guide the standardized diagnosis and treatment and management of disease types.Methods:DRG grouping and DIP simulation full enrollment were applied to patients discharged from a tertiary Grade A general hospital in 2019. The correlation analysis between DRG, DIP, and clinical pathway inclusion(entry), correlation analysis between relative weight of DRG group and DIP standard score, and correlation analysis between clinical pathway entry and cost structure of the two disease groups were conducted by using chi-square test, Pearson correlation analysis, t-test, structural change value, degree of structural change, and incremental contribution rate. Results:Among the 130 395 patients, 41 460 cases entered the clinical pathway, 127 535 cases were enrolled in DRG, and 104 227 cases were enrolled in DIP. There was a correlation between the enrollment of DRG, DIP, and clinical pathway( P<0.05), and there was also a correlation between the relative weight of DRG groups and the enrollment of clinical pathway. The relative weight of the DRG disease group was positively correlated with the DIP standard score( r2=0.761 7, P<0.001). There was a significant difference in hospitalization costs between patients with and without clinical pathway access for some diseases( P<0.05), and different cost categories had different impacts on the total costs. Conclusions:The weight assignment and value orientation of DRG and DIP disease types are consistent, and the multi-dimensional fusion evaluation mode for DRG-DIP-clinical pathway is feasible. The correlation analysis of DRG, DIP, and clinical pathways can serve as the basis for disease classification and cost structure evaluation, which could help to carry out hospital′s refined management and optimize disease structure.

As the pace of society increases and lifestyles change， the incidence and mortality rates of breast cancer continue to rise. Targeted therapies are now promising in the treatment of breast cancer， and a variety of protein targets have been identified to play an important role in the development of breast cancer. Among them， signal transducer and activator of transcription （STAT） proteins constitute a crucial group that serves as important targets for transducing cellular transcriptional information， which can regulate downstream cell proliferation， apoptosis， cell migration， invasion， angiogenic factors， etc. and then affect the progression of breast cancer. The STAT family is closely associated with the inflammatory response to tumors and plays a landmark role in tumor development as well as in diagnosis and prognosis. The "inflammation-cancer" transformation refers to the process in which the inflammatory microenvironment caused by uncontrolled inflammation promotes normal cells to become cancerous. According to the theory of Chinese medicine， "heat toxicity" in "cancer toxicity" corresponds to inflammation， which is closely related to tumor development. As a major link associated with the inflammatory response， the STAT family has a promising role in the development and treatment of a variety of tumors， but its relevance to breast cancer remains inadequately explored. Chinese medicine has been shown to have good efficacy in the prevention and treatment of breast cancer， and some current studies have shown that the active ingredients and compounds of Chinese medicine have certain intervention effects on breast cancer-related STAT proteins， but there has not been a systematic review. In order to better sort out and summarize the studies on the effects of Chinese herbal medicines based on the STAT family interventions in breast cancer， this paper reviewed the studies on Chinese herbal medicines acting on the STAT family in recent years， aiming to provide new ideas for clinical applications in breast cancer and to provide thoughts for the development of STAT protein-based drugs.

The Omicron family of SARS-CoV-2 variants are currently driving the COVID-19 pandemic. Here we analyzed the clinical laboratory test results of 9911 Omicron BA.2.2 sublineages-infected symptomatic patients without earlier infection histories during a SARS-CoV-2 outbreak in Shanghai in spring 2022. Compared to an earlier patient cohort infected by SARS-CoV-2 prototype strains in 2020, BA.2.2 infection led to distinct fluctuations of pathophysiological markers in the peripheral blood. In particular, severe/critical cases of COVID-19 post BA.2.2 infection were associated with less pro-inflammatory macrophage activation and stronger interferon alpha response in the bronchoalveolar microenvironment. Importantly, the abnormal biomarkers were significantly subdued in individuals who had been immunized by 2 or 3 doses of SARS-CoV-2 prototype-inactivated vaccines, supporting the estimation of an overall 96.02% of protection rate against severe/critical disease in the 4854 cases in our BA.2.2 patient cohort with traceable vaccination records. Furthermore, even though age was a critical risk factor of the severity of COVID-19 post BA.2.2 infection, vaccination-elicited protection against severe/critical COVID-19 reached 90.15% in patients aged ≽ 60 years old. Together, our study delineates the pathophysiological features of Omicron BA.2.2 sublineages and demonstrates significant protection conferred by prior prototype-based inactivated vaccines.
Humans ; Aged ; Middle Aged ; COVID-19/prevention & control* ; SARS-CoV-2 ; Pandemics/prevention & control* ; China/epidemiology* ; Disease Outbreaks/prevention & control* ; Vaccination