Somatostatin receptor 1 (SSTR1) is a crucial therapeutic target for various neuroendocrine and oncological disorders. Current SSTR1-targeted treatments, including the first-generation somatostatin analog lanreotide (Lan) and the second-generation analog pasireotide (Pas), show promise but encounter challenges related to selectivity and efficacy. This study presents high-resolution cryo-electron microscopy structures of SSTR1 complexed with Lan or Pas, revealing the distinct mechanisms of ligand-binding and activation. These structures illustrate unique conformational changes in the SSTR1 orthosteric pocket induced by each ligand, which are critical for receptor activation and ligand selectivity. Combined with the biochemical assays and molecular dynamics simulations, our results provide a comparative analysis of binding characteristics within the SSTR family, highlighting subtle differences in SSTR1 activation by Lan and Pas. These insights pave the way for designing next-generation therapies with enhanced efficacy and reduced side effects through improved receptor subtype selectivity.

Objective To assess the risk of human Spirometra mansoni infections and investigate the knowledge, attitude and practice (KAP) towards sparganosis mansoni among residents in Henan Province, so as to provide insights into formulation of the sparganosis mansoni control measures. Methods Qinling Village in Fugou County of Zhoukou City, Bali Village in Yancheng District of Luohe City, Duzhai Village in Puyang County of Puyang City and Doushan Village in Luoshan County of Xinyang City were sampled as survey sites in Henan Province from July to August 2023, and more than 40 frogs were sampled from ponds or streams in each survey site for detection of Sparganum mansoni infections. At least 150 residents were sampled using a cluster sampling method from each survey site, and the sero-prevalence of anti-S. mansoni IgG antibody was estimated. In addition, a questionnaire survey was conducted on the KAP towards sparganosis mansoni among participants, and the proportion of eligible KAP, rate of correct KAP and KAP scores were calculated. Results A total 229 frogs were collected from 4 survey sites in 2023, and the overall prevalence of S. mansoni infection was 4.37% (10/229) in frogs, with 7.75% (10/129) prevalence in wild frogs and 0 in farm-bred frogs. A questionnaire survey was performed among 649 residents sampled from 4 survey sites, and 649 serum samples were collected. The seroprevalence of anti-S.mansoni IgG antibody was 0.15% (1/649) and the overall proportion of eligible KAP was 23.73% (154/649) among participants. There were age- (χ² = 30.905, P = 0.000), educational level- (χ² = 41.011, P = 0.000), and occupation-specific proportions of eligible KAP among participants (χ² = 10.721, P = 0.005), and the proportion of eligible KAP decreased with age (χ² _trend = 22.717, P = 0.000) and increased with education levels (χ² _trend = 40.025, P = 0.000). The rates of correct KAP towards sparganosis mansoni were 40.81% (2 119/5 192), 96.66% (1 882/1 947) and 63.81% (3 727/5 841) (χ² = 1 913.731, P = 0.000) among residents, respectively. The rates of correct KAP towards sparganosis mansoni varied significantly among survey sites (χ² = 136.872, 42.347 and 255.157; all P values= 0.000, with the highest rate of correct knowledge (51.94%, 748/1 440) and practices (75.86%, 1 229/1 620) in Yancheng District of Luohe City and the highest rate of correct attitudes in Puyang County of Puyang City (99.11%, 446/450) (all P values< 0.05). Conclusions There is still a high transmission risk of sparganosis mansoni in Henan Province, and the KAP towards sparganosis mansoni is required to be improved among residents.

Objective: To develop a health literacy evaluation scale for Chinese high school students, providing a tool for dynamic monitoring of health literacy among high school students and evaluating the effectiveness of health school construction. Methods: Through theoretical research, an evaluation index system for health literacy of Chinese high school students was constructed. Two rounds of Delphi expert consultations were conducted to quantitatively screen the items, and the item pool was revised based on expert opinions to compile the health literacy evaluation scale for Chinese students. Two focus group interviews were held to collect suggestions from health educators, high school teachers, and high school students regarding optimized scale length, question types, difficulty and wording of the scale. The scale was revised accordingly. A pilot survey was conducted in Beijing and Tianjin in November 2024, and the reliability and validity of the scale were evaluated based on the pilot survey data. Results: The response rate in both rounds of Delphi expert consultations was over 80%, and the expert authority coefficient was over 0.70. The expert opinions were highly concentrated, and the dispersion was small. The revised item pool based on expert opinions contained 39 items. The revised scale based on the suggestions and opinions collected from the focus group interviews had a moderate number of questions and difficulty level. The pilot survey obtained 800 valid responses, with the response rate of 89.39%. The Cronbach α coefficient of the scale was 0.911, χ 2/df =3.321, the root mean square error of approximation was 0.054, the adjusted goodness-of-fit index was 0.991 , and the factor loadings of some items were less than 0.40. Conclusion The health literacy evaluation scale for Chinese high school students demonstrates scientific rigor and practical applicability, with good internal consistency and structural validity.

Objective To investigate the association between the Chinese visceral adiposity index (CVAI) and diabetes mellitus, hypertension, diabetes mellitus or hypertension, and diabetes with hypertension among elderly people in Hebei Province. Methods In 2020, a stratified multi-stage random sampling was used to conduct questionnaire survey, physical examination and laboratory detection among permanent residents of 10 monitoring sites in Hebei Province. Logistic regression was used to analyze the association between CVAI and diabetes mellitus, hypertension, diabetes mellitus or hypertension, and diabetes with hypertension. The area under the ROC curve (AUC) was used to evaluate the predictive value of CVAI for diabetes mellitus, hypertension, diabetes mellitus or hypertension, and diabetes with hypertension. Results The detection rates of diabetes mellitus, hypertension, diabetes mellitus or hypertension, and diabetes with hypertension were 19.8%, 74.6%, 78.2%, and 16.2%, respectively. Multivariate logistic regression analysis showed that compared with the lowest quartile of CVAI group Q1, the OR (95% CI) of diabetes mellitus, hypertension, diabetes mellitus or hypertension, and diabetes with hypertension in the highest quartile Q4 group were 3.55 (2.58~4.89), 2.52 (1.92~3.31), 3.09 (2.31~4.12), and 4.92 (3.40~7.12), respectively. The ROC curve results showed that CVAI had the best predictive value in the diagnosis of diabetes with hypertension, and the optimized critical values in males and females were 128.54 and 141.88, respectively. Conclusion The detection rates of diabetes mellitus and hypertension are high in the elderly population in Hebei Province. CVAI is positively associated with the risk of diabetes mellitus, hypertension, diabetes mellitus or hypertension, and diabetes with hypertension among the elderly in Hebei. CVAI has the strongest prediction ability for diabetes with hypertension.

Objective To investigate the correlations of interleukin-1 β(IL-1β)level and per-centage of CD16+CD56+natural killer(NK)cells in peripheral blood with severity of disease in pa-tients with pulmonary tuberculosis.Methods A total of 150 patients with active pulmonary tubercu-losis(APTB)in the Suqian First People's Hospital from January 1,2021 to September 1,2023 were selected as APTB group,and 150 patients with inactive pulmonary tuberculosis(IPTB)in the same period were selected as IPTB group.Level of IL-1 β and percentage of CD16+CD56+NK cells in pe-ripheral blood of patients with different disease severities were compared,and their correlations with severity of disease were analyzed.Results In the APTB group,level of IL-1 β in the peripheral blood was significantly higher than that in the IPTB group,while the percentage of CD16+CD56+NK cells was significantly lower(P＜0.001).In the mild,moderate,and severe groups,level of IL-1 βshowed a significant gradual increasing trend in peripheral blood,while the percentage of CD16+CD56+NK cells showed a significant gradual decreasing trend(P＜0.001).After treatment,the level of IL-1β in the peripheral blood decreased significantly,while the percentage of CD16+CD56+NK cells increased significantly in the APTB group(P＜0.001).Correlation analysis revealed that level of IL-1β in the peripheral blood of patients with pulmonary tuberculosis was positively correlated with severity of disease(r=0.732,P＜0.001),while the percentage of CD16+CD56+NK cells was negatively correlated with severity of disease(r=-0.612,P＜0.001).Conclusion Level of IL-1β in the peripheral blood is elevated while the percentage of CD16+CD56+NK cells is de-creased in patients with pulmonary tuberculosis,which is closely related to the severity of APTB.

Objective: To develop and validate a health literacy assessment scale for junior high school students, providing an effective tool for evaluating and monitoring health literacy among Chinese adolescents. Methods: Based on school health education policy documents, a health literacy assessment framework was constructed, comprising five horizontal and four vertical dimensions. From May to June and August to September in 2024, the framework was refined through Delphi expert consultations and focus group discussions, leading to the development of the Health Literacy Assessment Scale for Junior High School Students. In September 2024, a convenience sample of 625 students from three junior high schools in Beijing and Tianjin completed the questionnaire. Item analysis, reliability, and validity tests were conducted to evaluate the scale. Results: The recovery rate for two rounds of expert consultation questionnaires was 100%. The expert authority coefficients ( Cr ) were 0.86 and 0.87 respectively (both >0.70), with Kendall W values of 0.34 and 0.27 ( P <0.05). The focus group discussions followed a rigorous structure, and after multiple rounds of item screening and revision, the version 3.0 of the junior high school students health literacy assessment scale was developed, comprising 57 items. Three items that failed to meet the comprehensive screening criteria were preliminarily removed, and the final scale contained 54 items. The scale demonstrated excellent reliability, with an overall Cronbach s α coefficient of 0.92 and split half reliability of 0.93. Confirmatory factor analysis [ χ 2/df =2.094, root mean square error of approximation ( RMSEA )=0.042, comparative fit index ( CFI )=0.911, Tucker Lewis index ( TLI )=0.907] indicated good model fit indices. Conclusions The preliminary development of the health literacy assessment scale for junior high school students follows a rigorous item screening process with well designed dimensions, demonstrating good reliability and validity, thus serving as an appropriate evaluation tool for adolescent health literacy.

Objective To explore the efficacy of ozone gas bath on necrotizing fasciitis after debride-ment.Methods Fifty patients with necrotizing fasciitis who underwent debridement in the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from January 2020 to July 2024 were selected and divided into control group(25 cases)and observation group(25 cases)according to random number table method.The control group was given routine dressing change(normal saline,povidone iodine,hydrogen per-oxide,metronidazole sodium chloride injection),and the observation group was treated with ozone gas bath.The clinical efficacy,pain scores,laboratory indicators,postoperative complications,and total hospital days of the two groups were compared before and after treatment.Results Compared with the control group,the ob-servation group had a higher total effective rate(92.0%vs.68.0%),lower numerical rating scale for pain(NRS)scores at 1 week postoperatively,2 weeks postoperatively,and before discharge,as well as lower levels of WBC,C reactive protein(CRP),and procalcitonin(PCT),and a lower total incidence of complications(52.0%vs.80.0%).The hospital stay was shorter[(22.40±2.06)d vs.(29.28±2.28)d)],with statistical-ly significant differences(P<0.05).Conclusion Ozone gas bath can reduce postoperative pain and promote recovery in necrotizing fasciitis after debridement.

Objective To compare the short-term efficacy and safety of transanal natural orifice specimen extraction surgery(Ta-NOSES)and conventional laparoscopic surgery in left-sided colon cancer.Methods A retrospective analysis was conducted on the clinical data of 35 patients with left-sided colon cancer admitted to the anorectal department of the hospital from January 2018 to December 2019.According to the different surgical methods,the patients were divided into experimental group(15 cases)and control group(20 cases).The observation group underwent Ta-NOSES,and the control group underwent conventional laparoscopic surgery.The perioperative related indicators,postoperative complications,postoperative pain scores,postoperative defecation control,short-term postoperative quality of life scores and 5-year postoperative follow-up of the two groups of patients were compared.Results There was no statistically significant difference in the intraoperative blood loss,stoma status and the number of lymph node dissections between the two groups of patients(P>0.05).Moreover,no permanent stoma occurred in either group of patients.The operation time of the experimental group was longer than that of the control group,the first time to get out of bed and move around,the time of the first anal exhaust,the time of the first diet intake and the hospital stay were shorter than those of the control group,the hospitalization cost was significantly lower than that of the control group,the differences were statistically significant(P<0.05).On 1 and 3 days after operation,the VAS scores of the experimental group were significantly lower than those of the control group.At 3 days after operation,the VAS scores of the two groups were significantly lower than those at 1 day after operation,and the differences were statistically significant(P<0.05).There was a statistically significant difference in postoperative Kirwan anal function grading between two groups of patients(P<0.05),with the experimental group having a better grading(higher proportion of grade Ⅰ),the control group had poor grading(with a higher proportion of grades Ⅱ,Ⅲ,and Ⅳ).There was no statistically significant difference in postoperative complications between the two groups of patients(P>0.05).The scores of each item on the Short Form-36(SF-36)in the experimental group were higher than those in the control group at 10 and 20 days after surgery(P<0.05).There was no statistically significant difference in the scores of each item on the SF-36 between the two groups at 30 days after surgery(P>0.05).The distant recurrence rate after surgery in the experimental group was 26.7％,compared with 25.0％in the control group,the difference was not statistically significant(P>0.05).There were no tumor recurrence cases with the original incision site,rectal and intestinal cavity,pelvic cavity and other specimen removal routes in both groups.The 5-year survival rate of the experimental group was 73.3％,which was not statistically significantly different from that of the control group(70.0％)(P>0.05).Conclusion Ta-NOSES in the treatment of left-sided colon cancer can alleviate postoperative pain compared with conventional laparoscopic surgery,promote the recovery of postoperative gastrointestinal function,improve the utilization rate of medical resources,reduce the economic burden of patients,improve the short-term quality of life after surgery,and does not increase the risks of postoperative complications and tumor metastasis and recurrence.It is worthy of clinical promotion and application.

Objective To screen the mutations of ABCC8 gene in probands of maturity-onset diabetes of the young pedigrees,and investigate it sgenetic and clinical characteristics.Methods Whole exome sequencing were performed to screen ABCC8 mutations in 56 MODY probands who were admitted to Department of Endocrinology and Metabolism,Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from July 2021 to December 2023.The mutations were verified by Sanger sequencing,and all participants were genotyped.Clinical phenotypes of the mutation carriers were compared with non-DM controls within the families.The identified mutations were evaluated by bioinformatic softwires.Then the pharmacogenomic characteristics of the mutation carriers were analyzed.Results Two heterozygous mutations D655V and R825Q were identified in two MODY probands and their families respectively,and the D655V was a novel mutation.Bioinformatics studies showed that both mutations were deleterious and pathogenic.In comparison with non-DM controls in the two families,mutation carriers with diabetes exhibited significantly lower fasting insulin/fasting plasma glucose,two-hour postprandial insulin/two-hour postprandial insulin plasma glucose,homeostatic model assessment-β(P<0.05).Treatment with oral hypoglycemic agents such as metformin or insulin in these mutation carriers resulted in a moderate reduction in plasma glucose levels.However,switching to targeted Sulfonylurea's(SUs)proved to be more effective.Conclusions In this study,the prevalence of MODY12 is 3.6%in these MODY pedigrees.The remarkable hypoglycemic efficacy of SUs suggests that both D655V and R825Q were activating mutations of ABCC8,and maybe the cause of MODY12 characterized by impaired insulin secretion.

Objective This study aimed to develop an automated method for syndrome element differenti-ation in Traditional Chinese Medicine(TCM).Methods We first constructed and trained an Instruction-tuned Multi-Task TCM text embedding model(Instr-MT-TCM)using four distinct TCM task datasets,including domain knowledge,synonymous terminology,syndrome differentiation and treatment,and TCM case labels.Subsequently,five TCM diagnostics experts holding master's degrees or higher were organized to screen a real-world TCM case dataset and annotate symptoms and signs.The purpose was to evaluate the F1-score of the proposed method—the combination of Instr-MT-TCM and a Large Language Model(LLM)—by comparing its performance against the manual annotation result on the syndrome element differentiation task.Finally,to validate its feasibility in real-world clinical settings,the method was applied to 48 prostate cancer cases to calculate the syndrome element scores.Results The Instr-MT-TCM model showed rapid performance improvement in its early training phase,achieving a Recall@1(R@1)of 0.848.Experts curated a dataset of 1,793 real-world clinical cases,covering 34 common diseases and 66 syndrome patterns.In the syndrome element differentiation task,the collaborative framework of LLM and Instr-MT-TCM achieved a mean F1-score of 0.927,outperforming the 0.512 from manual annota-tion.The syndrome element analysis revealed that the predominant elements of disease nature were fire(heat)and yin deficiency,while the main elements of disease location were bladder and kidney.Conclusion This study proposes and validates a novel method for automated TCM syndrome element dif-ferentiation based on the synergy between LLM and our custom Instr-MT-TCM model.Achieving a high F1-score(0.927)on real-world data,the method demonstrates excellent accuracy and generalization ability.Its application in prostate cancer analysis highlights its significant clinical potential,offering effective technical support,and a new research direction for intelligent TCM syndrome element differentiation.