OBJECTIVE To explore the mechanism of the active ingredient compatibility（quercetin， quercitrin and kaempferol at a mass ratio of 2∶9∶3）of Dimocarpus longan Lour. leaves（abbreviated as CDL） on ameliorating glucose and lipid metabolism disorders in type 2 diabetes mellitus （T2DM） rats. METHODS SD rats were randomly divided into blank control group， model group， metformin hydrochloride group （100 mg/kg）， and CDL high-， medium- and low-dose groups （280， 140， 75 mg/kg）， with 10 rats in each group. Rats in the blank control group were fed with standard chow， while rats in the other groups were given high-sugar and high-fat diet combined with intraperitoneal injection of streptozotocin to establish the T2DM rat model. After successful modeling， rats in each administration group were given corresponding drug solution， and rats in the blank control group and model group were intragastrically administered with equal volume of pure water， once a day， for consecutive 4 weeks. Fasting blood glucose （FBG） was detected at fixed time every week. The curves of oral glucose tolerance test （OGTT） and intraperitoneal insulin tolerance test （IPITT） were plotted， and the area under curve （AUC） was calculated. The pancreatic islet function indexes [fasting insulin （FINS）， homeostasis model assessment of insulin resistance （HOMA-IR）， insulin sensitivity index （ISI）]，blood lipid indexes [total cholesterol （TC）， triglyceride （TG）， low-density lipoprotein cholesterol （LDL-C）， high-density lipoprotein cholesterol （HDL-C）] and hepatic glycogen content were determined. The pathological morphological changes of liver and pancreatic tissues were observed. The protein and mRNA expression levels of molecules related to phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway in liver tissues were detected. RESULTS Compared with the blank control group， the FBG， AUC of IPITT curve， AUC of OGTT curve， HOMA-IR， the levels of FINS， TC， TG and LDL-C， as well as the protein and mRNA expression of phosphatase and tensin homolog， forkhead box protein O1 and glycogen synthase kinase-3β in liver tissues were significantly increased in the model group （ P ＜0.05）. ISI， the levels of HDL-C and hepatic glycogen content， along with the protein and mRNA expression of PI3K， insulin receptor substrate-1， Akt and protein expression of phosphorylated Akt in liver tissues were markedly decreased （ P ＜0.05）. In model group rats， the arrangement of hepatocytes was irregular， the overall structure of pancreatic lobules was disordered， and a large number of inflammatory cell infiltration was observed. Compared with the model group， most of the above quantitative indexes were significantly reversed in the CDL high-dose group （ P ＜0.05）， and the pathological lesions of liver and pancreas were obviously alleviated. CONCLUSIONS CDL can regulate glucose and lipid metabolism disorders， elevate insulin sensitivity and relieve insulin resistance in T2DM rats. Its mechanism may be related to the activation of the PI3K/Akt signaling pathway.

OBJECTIVE To explore the mechanism of the active ingredient compatibility（quercetin， quercitrin and kaempferol at a mass ratio of 2∶9∶3）of Dimocarpus longan Lour. leaves（abbreviated as CDL） on ameliorating glucose and lipid metabolism disorders in type 2 diabetes mellitus （T2DM） rats. METHODS SD rats were randomly divided into blank control group， model group， metformin hydrochloride group （100 mg/kg）， and CDL high-， medium- and low-dose groups （280， 140， 75 mg/kg）， with 10 rats in each group. Rats in the blank control group were fed with standard chow， while rats in the other groups were given high-sugar and high-fat diet combined with intraperitoneal injection of streptozotocin to establish the T2DM rat model. After successful modeling， rats in each administration group were given corresponding drug solution， and rats in the blank control group and model group were intragastrically administered with equal volume of pure water， once a day， for consecutive 4 weeks. Fasting blood glucose （FBG） was detected at fixed time every week. The curves of oral glucose tolerance test （OGTT） and intraperitoneal insulin tolerance test （IPITT） were plotted， and the area under curve （AUC） was calculated. The pancreatic islet function indexes [fasting insulin （FINS）， homeostasis model assessment of insulin resistance （HOMA-IR）， insulin sensitivity index （ISI）]，blood lipid indexes [total cholesterol （TC）， triglyceride （TG）， low-density lipoprotein cholesterol （LDL-C）， high-density lipoprotein cholesterol （HDL-C）] and hepatic glycogen content were determined. The pathological morphological changes of liver and pancreatic tissues were observed. The protein and mRNA expression levels of molecules related to phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway in liver tissues were detected. RESULTS Compared with the blank control group， the FBG， AUC of IPITT curve， AUC of OGTT curve， HOMA-IR， the levels of FINS， TC， TG and LDL-C， as well as the protein and mRNA expression of phosphatase and tensin homolog， forkhead box protein O1 and glycogen synthase kinase-3β in liver tissues were significantly increased in the model group （ P ＜0.05）. ISI， the levels of HDL-C and hepatic glycogen content， along with the protein and mRNA expression of PI3K， insulin receptor substrate-1， Akt and protein expression of phosphorylated Akt in liver tissues were markedly decreased （ P ＜0.05）. In model group rats， the arrangement of hepatocytes was irregular， the overall structure of pancreatic lobules was disordered， and a large number of inflammatory cell infiltration was observed. Compared with the model group， most of the above quantitative indexes were significantly reversed in the CDL high-dose group （ P ＜0.05）， and the pathological lesions of liver and pancreas were obviously alleviated. CONCLUSIONS CDL can regulate glucose and lipid metabolism disorders， elevate insulin sensitivity and relieve insulin resistance in T2DM rats. Its mechanism may be related to the activation of the PI3K/Akt signaling pathway.

Objective To investigate the effect of miR-129-1-3p on the osteogenic differentiation of human bone marrow mesenchymal stem cells(hBMSCs)and its potential mechanism.Methods Negative control group,the miR-129-1-3p mimic group,the miR-129-1-3p inhibitor group and the corresponding negative control were constructed and transfected into hBMSCs.The formation of calcium-mineralized nodules was observed by alkaline phosphatase staining and alizarin red S staining.The expression levels of miR-129-1-3p and osteogenic differentiation markers were detected by qRT-PCR.Western blot detected the protein expressions of bone mor-phogenetic protein 2(BMP2),SMAD1 and p-SMAD1.Results After transfection,the expression level of miR-129-1-3p in mimic group was significantly increased(P＜0.05),the number of mineralized nodules was significantly decreased,and the expression levels ofBMP2,Runt-related transcription factor 2(RUNX2),osteocalcin(OCN)mRNA were significantly down-regulated(P＜0.05).BMP2 and p-SMAD1 protein were also significantly down-regulated(P＜0.05)compared with Mimic-NC group.The expression levels of BMP2,RUNX2,OCN mRNA were significantly up-regulated in inhibitor group(P＜0.05)compared with Inhibitor-NC group.BMP2 and p-SMAD1 protein were significantly up-regulated in inhibitor group(P＜0.05).Conclusion miR-129-1-3p can inhibit the osteo-genic differentiation of human bone marrow mesenchymal stem cells by suppressing BMP2/SMAD1 signaling pathway.

Objective To investigate the effect of miR-129-1-3p on the osteogenic differentiation of human bone marrow mesenchymal stem cells(hBMSCs)and its potential mechanism.Methods Negative control group,the miR-129-1-3p mimic group,the miR-129-1-3p inhibitor group and the corresponding negative control were constructed and transfected into hBMSCs.The formation of calcium-mineralized nodules was observed by alkaline phosphatase staining and alizarin red S staining.The expression levels of miR-129-1-3p and osteogenic differentiation markers were detected by qRT-PCR.Western blot detected the protein expressions of bone mor-phogenetic protein 2(BMP2),SMAD1 and p-SMAD1.Results After transfection,the expression level of miR-129-1-3p in mimic group was significantly increased(P＜0.05),the number of mineralized nodules was significantly decreased,and the expression levels ofBMP2,Runt-related transcription factor 2(RUNX2),osteocalcin(OCN)mRNA were significantly down-regulated(P＜0.05).BMP2 and p-SMAD1 protein were also significantly down-regulated(P＜0.05)compared with Mimic-NC group.The expression levels of BMP2,RUNX2,OCN mRNA were significantly up-regulated in inhibitor group(P＜0.05)compared with Inhibitor-NC group.BMP2 and p-SMAD1 protein were significantly up-regulated in inhibitor group(P＜0.05).Conclusion miR-129-1-3p can inhibit the osteo-genic differentiation of human bone marrow mesenchymal stem cells by suppressing BMP2/SMAD1 signaling pathway.

Objective Guided by"Medical Record Management Quality Control Indicators(2021 Edition)"(hereafter regarded as Medical Record Quality Indicators),this study aims to evaluate the quality of inpatient hospice medical records at a tertiary hospital in Guangzhou.Methods A total of 1,071 inpatient hospice medical records from the year 2023 in a tertiary gen-eral hospital in Guangzhou were selected for evaluation.The evaluation focused on three aspects:documentation compliance of documentation of critical examinations(including CT/MRI,pathology,and pathogen examinations),the compliance rate of treat-ment behavior records(encompassing antibiotic usage,chemotherapy or radiotherapy or targeted or immunotherapy for malignant tumors,and surgical records),and the incidence of unreasonable duplication within medical record.Results The compliance rate for major examination records ranged from 47.7％to 100.0％,with the lowest compliance rate(47.7％)observed in docu-mentation of pathogen culture analysis.Treatment behavior documentation compliance varied from 49.1％to 100.0％,with the lowest compliance rate of 49.1％observed in the recording of antibiotic usage.Rates of inappropriate duplication ranged from 1.0％to duplication(63.1％),with the highest rate of 63.1％occurring when initial progress notes replicated admission histo-ries without synthesis(63.1％).Conclusion The Medical Record Management Quality Control Indicators serves as an effective tool for evaluating the dimensions of medical record quality and offers a systematic framework for enhancing documentation integri-ty within hospitals.

Objective:To analyze the efficacy and safety of standard chemotherapy and immune checkpoint inhibitors (CI) combined with radiotherapy (RT) in driver-gene negative (wild-type) oligometastatic non-small cell lung cancer (NSCLC) patients with central nervous system involvement.Methods:In this multicenter retrospective cohort study, oligometastatic NSCLC patients receiving first-line chemo-immunotherapy-based therapy were analyzed. Between January 2017 and January 2023, a total of 98 eligible patients were enrolled from the National Cancer Center/Cancer Hospital (Beijing/Shenzhen) and Shanxi Province Cancer Hospital. All participants were divided into chemo-immunotherapy (CI) group (28.6%, n=28) and chemo-immuno-radiotherapy (CIR) group (71.4%, n=70) according to whether receiving radiotherapy. Baseline characteristics were well-balanced between two groups, with no statistically significant differences (all P>0.05). The primary endpoint of the study was overall survival (OS), while progression-free survival (PFS) was designated as a key secondary endpoint. Qualitative data were compared by Chi-square test. Survival analysis was conducted using Kaplan-Meier method, and prognostic analysis was performed by multivariate Cox regression models. Results:The median PFS in the CIR and CI groups was 21.8 and 11.5 months, respectively, and the difference was not statistically significant ( P=0.211). The median OS in the CIR group was significantly better ( P=0.036) than 25.3 months in the CI group. The median OS in the CIR group was not reached. The 2-year local regional control rates for the whole brain radiotherapy patients, stereotactic radiotherapy / stereotactic radiosurgery patients and CI groups were 33.3% ,100% and 83.4%, respectively. Multivariate analysis showed that brain radiotherapy was an independent protective factor for OS in patients with oligometastatic brain metastases at baseline ( HR=0.47, 95% CI=0.22-0.99, P=0.047). Subgroup analysis revealed that patients with 1-3 metastatic lesions benefited from radiotherapy (PFS: HR=0.47, 95% CI=0.22-1.03, P=0.060; OS: HR=0.34, 95% CI=0.12-0.98, P=0.046). Conclusions:For central nervous system involved oligometastatic NSCLC patients, the integration of chemo-immunotherapy with radiotherapy is well tolerated and can improve the efficacy, particularly among those with a limited number of metastatic lesions.

OBJECTIVE To investigate the result of human immunodeficiency virus(HIV)screening for the people visiting to a three-A hospital of Sichuan Province and analyze the prevalence of complications with hepatitis B virus(HBV)infection,hepatitis C virus(HCV)infection and Treponema pallidum(TP)infection in the emerging HIV infection patients.METHODS The result of HIV screening for the people who visited to Ziyang Central Hos-pital from Jan.1,2020 to Dec.31,2024 and the test results of HBV,HCV and TP for the emerging HIV infec-tion patients were collected and were summarized and statistically analyzed by SPSS.0 software.RESULTS Totally 289 891 case-times were tested for HIV,1529 cases were previously diagnosed with HIV,465 of whom were tested posi-tive for the first time,there was significant difference in the positive rate of test for the first time among the 5 years(x2=15.998,P=0.003).Totally 353 cases were confirmed positive among the 465 primary positive screening cases.Among the emerging HIV infection patients,the positive rate was higher in the male than in the female(x2=141.141,P＜0.001),and the positive rate was high among the population aged more than 40 year old(x2=11.448,P＜0.001),mi-grant workers(x2=270.110,P＜0.001)and low education level population(x2=25.911,P＜0.001).The detection rate of gp41 was up to 100.00％in strip type testing.The analysis of the ratio of relative light unit(RLU)to Cutoff val-ue(COI)in the initial screening experiment showed that when COI was greater than 50,all of the confirmed tests were positive,when COI ranged between 1 and 5,the false positive rate was 97.06％.The incidence of complica-tion with HBV infection in the emerging HIV infection patients was increased year by year(x2=20.355,P＜0.001),and the incidence of complication with HCV infection was increased in recent two years(x2=10.690,P=0.030).CONCLUSIONS There is no obvious rise of positive rate of HIV screening among the people visiting to the hospital in recent 5 years.The sensitivity of the primary screening of clinical laboratory is high without posi-tive missing test.The positive rates of HBV and HCV are increased among the emerging HIV infection patients.

OBJECTIVE To explore the mechanism of Yishen Qingli Huoxue Formula(YQHF)improving renal fibrosis by inhib-iting HIF1-α using data mining,molecular docking,and in vivo and in vitro experiments.METHODS The expression changes of HIF1-α in renal biopsy tissues of patients with chronic kidney disease(CKD)in the GEO database were analyzed.Molecular docking was used to clarify the interaction mode between YQHF effective monomers and HIF1-α.Thirty SD rats were randomized to sham,model,low-dose YQHF,high-dose YQHF,and losartan potassium groups(n=6 per group).Unilateral ureteral obstruction(UUO)was used to induce renal fibrosis.Serum creatinine(Scr)and blood urea nitrogen(BUN)were measured,and kidney sections were stained with HE and Masson to assess pathology and fibrosis.Renal HIF1-α protein expression was quantified by Western blot.A renal fibro-sis cell model was established by inducing NRK-52E cells with TGF-β1,and the cells were divided into control,model,YQHF,HIF1-α inhibitor,HIF1-α inhibitor+YQHF,HIF1-α agonist,and HIF1-α agonist+YQHF groups.Western blot analysis was used to detect the protein expression levels of HIF1-α,COL-1,and α-SMA,and to observe the mechanism of YQHF-containing serum in protecting renal tubular epithelial cells.RESULTS Data mining showed HIF1-α expression in the CKD group was significantly higher than in the control group(P<0.01).Molecular docking indicated YQHF core components had good binding affinity to HIF1-α.In vivo,com-pared with the sham group,HE staining revealed tubular atrophy and inflammatory-cell infiltration,and Masson staining showed in-creased collagen deposition in UUO model rats(P<0.01).Serum creatinine and blood urea nitrogen were also elevated in the model group(P<0.05),together with up-regulated renal expression of COL-1,α-SMA and HIF-1α(P<0.01).After intervention with either high-dose or low-dose YQHF or losartan potassium,these pathological changes were attenuated:collagen deposition decreased(P<0.01),creatinine and BUN fell to varying degrees(P<0.05),and renal COL-1,α-SMA and HIF-1α levels were down-regulated(P<0.01);immunohistochemistry confirmed reduced HIF-1α in UUO kidneys(P<0.01).In NRK-52E cells,TGF-β1 stimulation mark-edly increased COL-1,α-SMA and HIF-1α protein levels(P<0.01).Both YQHF and chloramphenicol alone down-regulated these proteins(P<0.05,P<0.01),and their combination produced stronger inhibition of HIF-1α than YQHF alone(P<0.05).Conversely,the HIF-1α agonist fenbendazole-d3 reversed YQHF's anti-fibrotic effect,re-elevating COL-1,α-SMA and HIF-1α(P<0.01),with no significant difference versus agonist alone.CONCLUSION YQHF may inhibit extracellular matrix deposition and delay renal fi-brosis progression by suppressing HIF1-α accumulation,providing new theoretical evidence for traditional Chinese medicine in treat-ing renal fibrosis.

Objective:To compare the safety, number of lymph nodes removed, rate of lymph node metastasis, and prognosis between proximal gastrectomy (PG) and total gastrectomy (TG) in patients with Siewert types II and III adenocarcinoma of the esophagogastric junction.Methods:In this retrospective cohort study, clinical data of patients diagnosed with adenocarcinoma of the esophagogastric junction at Changzhi People's Hospital, affiliated with Changzhi Medical College, between December 2019 and November 2022, were collected. Patients who had received neoadjuvant therapy, had multiple malignant lesions in the stomach, had concomitant malignancies in other organs, had incomplete clinical data, or had been lost to follow-up were excluded. The study cohort comprised 308 patients, 99 in the PG group and 209 in the TG group. To reduce confounding bias, propensity score matching was performed, matching patients for age, sex, body mass index, tumor diameter, and pathological stage in a 1:1 ratio, resulting in 73 patients in each group. The primary outcomes assessed were operative details, number of lymph nodes dissected, rate of lymph node metastasis, postoperative complications, duration of hospital stay, and follow-up and survival outcomes.Results:The PG group had a significantly shorter median operative time than did the TG group (250 vs. 280 minutes, Z = -4.970, P<0.001), with fewer cases of intraoperative blood loss >100 mL (30.1%[22/73] vs. 46.6%[34/73], χ2=4.171, P=0.041), and a smaller number of lymph nodes removed (median 33 vs. 46, Z =-4.774, P<0.001); all of these differences are statistically significant (all P<0.05). Differences between the two groups in postoperative hospital stay and postoperative complications were not statistically significant (both P>0.05). Furthermore, no statistically significant differences were found between the PG and TG groups in the number of lymph nodes dissected or the lymph node metastasis rates at stations No. 1, No. 2, No. 3, No. 4sa, No. 4sb, and No. 7 (all P> 0.05). Among the 209 patients in the TG group, analysis of risk factors for metastasis to distal perigastric lymph nodes (No.4d, No.5, and No.6) showed that patients with tumor diameters ≤4 cm and T1–T3 stage disease had significantly lower rates of metastasis to these lymph nodes than did patients with tumor diameters >4 cm and/or T4 stage disease (0/78 vs. 12/131 [9.2%]); these differences are statistically significant ( P=0.014). The median duration of follow-up for the entire cohort was 26 months. The 3-year overall survival rates for the PG and TG groups were 62.5% and 63.3%, respectively; this difference is not statistically significant (χ 2=0.330, P = 0.565). Multivariate analysis showed that older age ( P = 0.035) and advanced pathological stage ( P = 0.018) were significant independent risk factors that affected overall survival in patients with Siewert type II and III adenocarcinoma of the esophagogastric junction. Conclusions:PG is safe and feasible for patients with Siewert types II and III adenocarcinoma of the esophagogastric junction. The number of lymph nodes dissected and metastasis status were similar in the TG and PG groups.