IL-32 is a multifunctional cytokine with both pro-inflammatory and anti-inflammatory properties.It has been proved that expression of IL-32 increases with progression of gastric mucosal diseases and severity of gastric cancer(GC),thus participating in process of gastric"inflammation-cancer"transformation.However,how IL-32 affects malignant transformation of gastric"inflamma-tion-cancer"and finally leads to adverse outcome of GC invasion and migration is still controversial.In order to better clarify regulatory effect and possible mechanism of abnormal expression of IL-32 on different histopathological stages of gastric"inflammation-cancer"transformation,and to explore new directions and breakthroughs in molecular mechanism of early truncation and treatment of gastric precancerous lesion(GPL),we searched literatures related to IL-32 in six authoritative databases at home and abroad,such as Pubmed,Web of Science and CNKI,in past 30 years.It was found that pathogenicity or protective function of IL-32 in different histo-pathological stages of gastric"inflammation-cancer"transformation depended on its different subtypes,secretory forms,surrounding cytokine environment,disease status and genetic factors.IL-32 may regulate polarization of macrophages through NF-κB,MAPK,COX2,PR3,IDO,NOD,PKCδ,FAK and STAT3,amplify or inhibit chronic inflammatory stimulation of gastric mucosa,and thus participate in process of gastric"inflammation-cancer"transformation.Our new understanding of role of IL-32 in different stages of Cor-rea cascade may contribute to development of cytokine-directed therapy,and therapy aimed at regulating different alternative splicing subtypes of IL-32 and targeting IL-32 signals can be used as a new strategy for medical treatment of GPL and GC in future.

Objective To analyze the influence path of medical students'professional identity on positive defensive medical behaviors and examine the mediating effect of medical risk perception between the two,aiming to provide theoretical support and practical reference for medical education to actively adapt to the demands of the medical and health system reform and promote the scientific guidance of positive defensive medical behaviors.Methods ln 2020,a questionnaire survey was conducted among medical students from four medical colleges in Heilongjiang Province using cluster sampling method,and data analysis was performed using SPSS 27.0 software.Results Medical students'professional identity showed a significant positive correlation with their positive defensive medical behavior(β=0.225,P＜0.001),with medical risk perception acting as a partial mediator(indirect effect accounting for 19%of the total effect).Professional identity(β=0.183,P＜0.001)and medical risk perception(β=0.195,P＜0.001)exerted direct positive effects on positive defensive medical behavior.Conclusion Medical students'professional identity drives them to adopt positive defensive medical behaviors by strengthening their sense of responsibility ethics and risk cognition ability,and medical risk perception is a key mediating variable in this process.Educational management should integrate policy-oriented clinical decision-making training and balance medical safety and efficiency through the collaborative mechanism of"professional identity-risk perception-behavioral practice".

Obesity, as a chronic recurrent disease, has become a major public health challenge in China. To implement the requirements of the Healthy China Initiative (2019—2030), under domestic guidelines or consensus statements on overweight and obesity, and in alignment with the latest scientific advances globally, the Quality control protocol for adult overweight and obesity screening in health management (examination) institutions (2025 edition) was developed. This protocol was drafted by the Health Management Center of Shanghai Changzheng Hospital and formulated through multiple rounds of deliberation by experts in China’s health examination quality control field. The protocol establishes unified standards for screening facilities, personnel qualifications, and measurement or testing procedures. It defines specific screening items, outlines a standardized screening pathway, and sets requirements for the final medical review, ensuring the scientific validity, effectiveness, and safety of the screening process. The implementation of this protocol will enhance the consistency of weight management practices for adults across health examination institutions and strengthen the quality control of overweight and obesity screening programs.

Objective To investigate the effects of evolocumab in the early postoperative period after percutaneous coronary intervention(PCI)on blood lipids and inflammatory cytokines in the patients with ul-tra-high-risk atherosclerotic cardiovascular disease(ASCVD).Methods A total of 65 patients with ultra-high-risk ASCVD treated by PCI in this hospital from October 2022 to March 2023 were selected as the study subjects and divided into the observation group(n=33)and control group(n=32)according to the used drugs.The patients in the control group received the treatment of oral rosuvastatin 10 mg;on the basis of the treatment in the control group,the observation group was treated with subcutaneous injection of evolocumab 140 mg immediately after PCI.The fasting blood samples were collected before surgery,on postoperative 3 d,1,3,6 months,and the levels of inflammation and blood lipid indexes were detected and recorded.The occur-rences of cardiovascular adverse events(MACE)and other complications in postoperative 6 months were re-corded.Results The levels of LDL-C,Lp-PLA2 and lipoprotein a on postoperative 3 d,1,3,6 months in the observation group were gradually decreased,moreover were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of IL-6,homocysteine and hs-CRP on postoper-ative 3 d,1,3,6 months in the two groups were decreased,moreover the levels of various indexes in the obser-vation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence rate of MACE in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05);the difference in the incidence rates of other complications between the two groups was not statistically significant(P>0.05).According to the Log Rank test,the sur-vival rate of the observation group was higher than that of the control group,and the difference was statistical-ly significant(P<0.05).Conclusion The early application of evolocumab after PCI could reduce the blood lipid level and inflammatory cytokines levels of the patients with ultra-high-risk ASCVD,and increase their survival rate.

Objective To observe CT manifestations of Fitz-Hugh-Curtis syndrome(FHCS).Methods Data of 23 patients with FHCS were retrospectively analyzed,and non-enhanced and enhanced abdominal and pelvic CT manifestations were observed.Results All 23 cases were found with pelvic inflammation,peritonitis,perihepatic inflammation,as well as abdominal and pelvic adhesion.The main manifestations of pelvic inflammation included pelvic effusion(23/23,100％),inflammatory changes of uterus and accessories(17/23,73.91％),and the latter presented as tubal thickening(8/17,47.06％)or tubal cystic dilatation and effusion(9/17,52.94％),with ovarian enlargement(8/9,88.89％)or nodules on uterine surface(1/9,11.11％).The main CT manifestations of peritonitis were peritoneal thickening(23/23,100％)and peritoneal nodules(15/23,65.22％),of perihepatic inflammation were mainly liver capsule enhancement(23/23,100％),subcapsular transient perfusion abnormality(16/23,69.57％),perihepatic effusion(20/23,86.96％)and perihepatic"violin-string sign"(16/23,69.57％).No inflammation in the bare area of liver was noticed.Among 23 cases,3 cases(3/23,13.04％)complicated with mechanical ileus,19 cases(19/23,82.61％)were accompanied by mesenteric or retroperitoneal lymph nodes enlargement with uniform or circular enhancement.Conclusion The main CT manifestations of FHCS included pelvic inflammation,peritonitis,perihepatic inflammation,as well as abdominal and pelvic adhesion,having certain characteristics.

Objective::To systematically study the mechanisms by which Yinzhihuang (YZH), a traditional Chinese medicine, ameliorates intrahepatic cholestasis of pregnancy (ICP), a liver disorder associated with significant maternal and fetal complications.Methods::This experimental study was conducted from January 2024 to August 2024, utilizing data from public databases (Traditional Chinese Medicine Systems Pharmacology, GeneCards, Online Mendelian Inheritance in Man, DisGeNET, Proteome Xchange) alongside in vitro cell culture experiments. Network pharmacology identified active components of YZH and potential therapeutic targets for ICP. Ultra-performance liquid chromatography–mass spectrometry characterized YZH oral liquid, and its effective doses were evaluated in taurocholic acid (TCA)-induced HTR-8/SVneo cells, an in vitro ICP model. ICP-related targets were gathered from multiple databases, and hub genes were selected through bioinformatics and previously identified differentially expressed proteins. Functional annotation and pathway enrichment analyses were conducted, with validation in TCA-induced cells treated with various YZH concentrations (0.1%–5.0%) compared to controls. Molecular docking confirmed predicted interactions.Results::Using network pharmacology, 104 active compounds and 241 potential targets of YZH were identified. Integration of multiple databases yielded 1897 YZH-related therapeutic targets and 3783 ICP-associated genes. Proteomic analysis identified 227 differentially expressed proteins, from which 10 hub genes were selected; among these, APOA2, COL1A1, and ADIPOQ were significantly upregulated in ICP samples. UPLC-ESI-MS/MS detected 2022 compounds, predominantly flavonoids (25.07%, 507/2022) and phenolic acids (14.44%, 292/2022). Molecular docking demonstrated strong binding affinities between several active compounds and the hub genes. In TCA-induced HTR-8/SVneo cells, 0.5% YZH treatment significantly enhanced cell viability and modulated hub gene expression, supporting a potential multi-target mechanism.Conclusion::This study systematically explored the active components and potential targets of YZH in ICP through network pharmacology, proteomics, and in vitro validation. The findings suggest that YZH may act via the PPAR signaling pathway by modulating genes such as PPARA, PPARG, ADIPOQ, and APOA2.

Objective::To systematically study the mechanisms by which Yinzhihuang (YZH), a traditional Chinese medicine, ameliorates intrahepatic cholestasis of pregnancy (ICP), a liver disorder associated with significant maternal and fetal complications.Methods::This experimental study was conducted from January 2024 to August 2024, utilizing data from public databases (Traditional Chinese Medicine Systems Pharmacology, GeneCards, Online Mendelian Inheritance in Man, DisGeNET, Proteome Xchange) alongside in vitro cell culture experiments. Network pharmacology identified active components of YZH and potential therapeutic targets for ICP. Ultra-performance liquid chromatography–mass spectrometry characterized YZH oral liquid, and its effective doses were evaluated in taurocholic acid (TCA)-induced HTR-8/SVneo cells, an in vitro ICP model. ICP-related targets were gathered from multiple databases, and hub genes were selected through bioinformatics and previously identified differentially expressed proteins. Functional annotation and pathway enrichment analyses were conducted, with validation in TCA-induced cells treated with various YZH concentrations (0.1%–5.0%) compared to controls. Molecular docking confirmed predicted interactions.Results::Using network pharmacology, 104 active compounds and 241 potential targets of YZH were identified. Integration of multiple databases yielded 1897 YZH-related therapeutic targets and 3783 ICP-associated genes. Proteomic analysis identified 227 differentially expressed proteins, from which 10 hub genes were selected; among these, APOA2, COL1A1, and ADIPOQ were significantly upregulated in ICP samples. UPLC-ESI-MS/MS detected 2022 compounds, predominantly flavonoids (25.07%, 507/2022) and phenolic acids (14.44%, 292/2022). Molecular docking demonstrated strong binding affinities between several active compounds and the hub genes. In TCA-induced HTR-8/SVneo cells, 0.5% YZH treatment significantly enhanced cell viability and modulated hub gene expression, supporting a potential multi-target mechanism.Conclusion::This study systematically explored the active components and potential targets of YZH in ICP through network pharmacology, proteomics, and in vitro validation. The findings suggest that YZH may act via the PPAR signaling pathway by modulating genes such as PPARA, PPARG, ADIPOQ, and APOA2.

Objective To observe CT manifestations of Fitz-Hugh-Curtis syndrome(FHCS).Methods Data of 23 patients with FHCS were retrospectively analyzed,and non-enhanced and enhanced abdominal and pelvic CT manifestations were observed.Results All 23 cases were found with pelvic inflammation,peritonitis,perihepatic inflammation,as well as abdominal and pelvic adhesion.The main manifestations of pelvic inflammation included pelvic effusion(23/23,100％),inflammatory changes of uterus and accessories(17/23,73.91％),and the latter presented as tubal thickening(8/17,47.06％)or tubal cystic dilatation and effusion(9/17,52.94％),with ovarian enlargement(8/9,88.89％)or nodules on uterine surface(1/9,11.11％).The main CT manifestations of peritonitis were peritoneal thickening(23/23,100％)and peritoneal nodules(15/23,65.22％),of perihepatic inflammation were mainly liver capsule enhancement(23/23,100％),subcapsular transient perfusion abnormality(16/23,69.57％),perihepatic effusion(20/23,86.96％)and perihepatic"violin-string sign"(16/23,69.57％).No inflammation in the bare area of liver was noticed.Among 23 cases,3 cases(3/23,13.04％)complicated with mechanical ileus,19 cases(19/23,82.61％)were accompanied by mesenteric or retroperitoneal lymph nodes enlargement with uniform or circular enhancement.Conclusion The main CT manifestations of FHCS included pelvic inflammation,peritonitis,perihepatic inflammation,as well as abdominal and pelvic adhesion,having certain characteristics.

Objective Explore a comprehensive and multi-level set of passive defensive medical governance strate-gies.Methods Literature related to passive defensive medical governance was retrieved,and the Ucinet social net-work analysis software was utilized to calculate indicators such as the frequency and centrality of passive defensive medical governance strategies,thereby understanding the importance of these strategies.Results The formed set of negative defensive medical governance strategies covers three levels social cogniton,institutional mechanisms and doctor-patient relationship.Among them,there are 5 governance strategies at the social cognition level,24 governance strategies at the institutional mechanism level,and 12 governance strategies at the doctor-patient rela-tionship level,totaling 41 governance strategies.Conclusion The constructed set of passive defensive medical governance strategies is scientific,practical,and comprehensive in content,providing a reference framework for medical institutions to govern passive defensive medical behaviors.

Objective Based on the WSR methodology,a three-dimensional integrated perspective of Wuli,Shi-li,and Renli dimensions was used to sort out the logical relationships and architectures among negative defensive medical governance strategies,forming the priority governance strategies for improving negative defensive medical care.Methods Based on the literature research method and the expert consultation method,the governance strate-gy and the conceptual connotation of WSR are classified into items,and the role relationship in the complex sys-tem of passive defensive medical governance is clarified through the WSR methodology.Results A collection of 40 negative defensive medicine governance strategies has been developed,comprising 8 strategies in the Wuli dimen-sion,23 strategies in the Shili dimension,and 9 strategies in the Renli dimension.Conclusion The WSR methodology provides a three-dimensional systemic perspective for governance strategies against negative defen-sive medicine.Addressing this issue requires comprehensive and systematic governance strategies.