ObjectiveTo explore the potential mechanism of Shenqi Jianxin Formula （参芪健心方） in the treatment of chronic heart failure （CHF） from the perspective of regulating mitochondrial autophagy via the PTEN-induced kinase 1 （PINK1）/E3 ubiquitin ligase （Parkin） pathway. MethodsMale SD rats were subjected to abdominal aortic constriction to establish the CHF model. Twenty-four successfully modeled rats were randomly divided into the model group， sacubitril/valsartan group， and low- and high-dose Shenqi Jianxin Formula groups， with 6 rats in each group. Six other rats were set as the sham surgery group， which were only separated the abdominal aorta and then closed the abdomen. Rats in the low-dose and high-dose Shenqi Jianxin Formula groups were given intragastric administration of Shenqi Jianxin Formula suspension at doses of 4.41 g/（kg·d） and 17.64 g/（kg·d）， respectively； the sacubitril/valsartan group received intragastric administration of sacubitril/valsartan sodium tablet suspension at 10 mg/（kg·d）； the sham surgery group and the model group were given normal saline at 10 ml/（kg·d） via intragastric gavage. The intervention lasted for 4 consecutive weeks. Cardiac function indices including left ventricular ejection fraction （LVEF） and left ventricular fractional shortening （LVFS） were detected， and serum brain natriuretic peptide （BNP） content was measured. HE staining and Masson staining were used to observe myocardial histopathological changes. Transmission electron microscopy was employed to examine the ultrastructure of cardiac tissues. Quantitative real-time polymerase chain reaction （Rt-qPCR） was performed to determine the mRNA expressions of PINK1/Parkin pathway-related factors and autophagy-associated proteins including Beclin-1， p62， and microtubule-associated protein 1 light chain 3 （LC3） in myocardial tissues. ResultsCompared with the sham surgery group， the model group showed significant decreases in LVEF and LVFS levels， an increase in serum BNP content， down-regulated mRNA and protein expressions of PINK1， Parkin and Beclin-1 in cardiac tissues， up-regulated mRNA and protein expressions of p62， as well as significant reductions in LC3B mRNA expression， phosphorylated PTEN-induced kinase 1 （p-PINK1） and phosphorylated E3 ubiquitin ligase （p-Parkin） protein levels， and the ratio of microtubule-associated protein 1 light chain 3-Ⅱ to microtubule-associated protein 1 light chain 3-Ⅰ （LC3Ⅱ/LC3Ⅰ） （P＜0.05）. Pathological results revealed obvious myocardial cell edema， necrosis and degeneration， increased disorder of myocardial fiber arrangement， extensive inflammatory cell infiltration， moderate to severe mitochondrial swelling， a few mitochondrial vacuolar changes， and no obvious autophagy in the field of vision in the model group. Compared with the model group， all the above indicators were significantly improved in the high-dose Shenqi Jianxin Formula group and the sacubitril/valsartan group （P＜0.05）. Moreover， the improvement of each index in the high-dose Shenqi Jianxin Formula group was superior to that in the low-dose group （P＜0.05）. In the high-dose Shenqi Jianxin Formula group， myocardial myofibrils were arranged regularly with orderly orientation， the striated structure was clear， and necrotic cells significantly reduced. ConclusionShenqi Jianxin Formula can activate the PINK1/Parkin signaling pathway in myocardial tissues， enhance mitochondrial autophagy， and clear dysfunctional mitochondria， thereby improving cardiac function and delaying the progression of CHF.

Objective To comparatively evaluate the clinical efficacy of liposomal bupivacaine and ropiva-caine in transversus abdominis plane(TAP)block combined with intravenous patient-controlled analgesia(PCA)following cesarean section,and to explore the analgesic advantages of liposomal bupivacaine.Methods Eighty parturients scheduled for elective cesarean section were recruited and randomly allocated into two groups via a random number table:the liposomal bupivacaine group and the ropivacaine group.At the conclusion of the surgical procedure,both groups underwent ultrasound-guided bilateral TAP block.In the ropivacaine group,20 mL of 0.5%ropivacaine was administered per side.In the liposomal bupivacaine group,266 mg of liposomal bupivacaine was dissolved in 0.9%normal saline to a total volume of 40 mL,with 20 mL injected per side.The following parameters were compared between the two groups:Visual Analog Scale(VAS)scores at rest and during movement at various postop-erative time points,the overall scores of the 15-item Quality of Recovery(QoR-15)scale,postoperative opioid consumption,the time to first ambulation,the time to first flatus,and the incidence of adverse drug reactions such as nausea,vomiting,constipation,and pruritus.Results In comparison with the ropivacaine group,the liposomal bupivacaine group exhibited significantly lower Visual Analogue Scale(VAS)scores both at rest and during move-ment at 12 hours,24 hours,and 48 hours postoperatively(P<0.001).Significantly higher Quality of Recovery-15(QoR-15)scores were recorded in the liposomal bupivacaine group at 24 hours and during the 24-48-hour period postoperatively(P<0.001).The postoperative opioid consumption within 48 hours was markedly lower in the liposo-mal bupivacaine group(P<0.001).The time to first flatus was significantly shorter in the liposomal bupivacaine group(P<0.001).No significant differences were detected in the incidence of nausea,vomiting,or constipation between the two groups(P>0.05),and no cases of pruritus or other severe adverse reactions were observed.Conclusion Liposomal bupivacaine used for TAP block following cesarean section offers extended analgesia,reduces the need for opioids,enhances the quality of postoperative recovery,promotes gastrointestinal motility,and demonstrates excellent safety.

Purpose: This Phase II trial was objected to evaluate the efficacy and safety of adding fulvestrant to neoadjuvant chemotherapy in patients with estrogen receptor (ER)+/human epidermal growth factor receptor 2 (HER2)– locally advanced breast cancer (LABC). Additionally, the study aimed to investigate the association of 16α-18F-fluoro-17β-fluoroestradiol (18F-FES) positron emission tomography (PET)–computed tomography (CT) and metabolites with efficacy. Materials and Methods: Fulvestrant and EC-T regimen were given to ER+/HER2– LABC patients before surgery. At baseline, patients received 18F-FES PET-CT scan, and plasma samples were taken for liquid chromatography–mass spectrometry analysis. The primary endpoint was objective response rate (ORR). Secondary endpoints included total pathologic complete response (tpCR) and safety. Results: Among the 36 patients enrolled, the ORR was 86.1%, the tpCR rate was 8.3%. The incidence of grade ≥ 3 treatment-emergent adverse events was 22%. The decrease in ER value in sensitive patients was larger than that in non-sensitive patients, as was Ki-67 (p < 0.05). The maximum standardized uptake value, mean standardized uptake values, total lesion ER expression of 18F-FES PET-CT in sensitive patients were significantly higher than those in non-sensitive patients (p < 0.05). Moreover, these parameters were significantly correlated with Miller and Payne grade and the change in ER expression before and after treatment (p < 0.05). Thirteen differential expressed metabolites were identified, which were markedly enriched in 19 metabolic pathways. Conclusion This regimen demonstrated acceptable toxicity and encouraging antitumor efficacy. 18F-FES PET-CT might serve as a tool to predict the effectiveness of this therapy. Altered metabolites or metabolic pathways might be associated with treatment response.

Objective To investigate the efficacy and safety of compound cantharidis capsule combined with pemetrexed and platinum-based drugs in the treatment of elderly patients with advanced lungadenocarcinoma.Methods A total of 80 patients with advanced lung adenocarcinoma were retro-spectively selected as the study subjects.According to the treatment regimen,they were divided into chemotherapy group(treated with pemetrexed and platinum-based drugs)and traditional Chinese med-icine combined with chemotherapy group(treated with compound cantharidis capsule combined with-pemetrexed and platinum-based drugs),with 40 cases in each group.The short-term efficacy,serum tumor marker[carcinoembryonic antigen(CEA),carbohydrate antigen 72-4(CA72-4),carbohydrate antigen 125(CA125)]levels,and the incidence of adverse reactions were observed and compared between the two groups.The patients were followed up,and the progression-free survival(PFS)and overall survival(OS)of the two groups were recorded.Results The objective response rate(ORR)and disease control rate(DCR)in the traditional Chinese medicine combined with chemotherapy group were higher than those in the chemotherapy group,with statistically significant differences(P＜0.05).After treatment,the serum CEA,CA72-4 and CA125 levels in both groups were lower than those before treatment,and the levels in the traditional Chinese medicine combined with chemotherapy group were lower than those in the chemotherapy group,with statistically significant differences(P＜0.05).There was no statistically significant difference in the incidence of grade 3 to 4 adverse reac-tions between the two groups(P＞0.05).The progression-free survival rate and overall survival rate in the traditional Chinese medicine combined with chemotherapy group were higher than those in the chemotherapy group,with statistically significant differences(P＜0.05).Conclusion Compound cantharidis capsule combined with pemetrexed and platinum-based drugs can significantly improve the ORR and DCR,reduce serum tumor marker levels,prolong the survival of patients with ad-vanced lung adenocarcinoma,and has good safety.

Objective:To understand the current situation of occupational internal exposure dose research using direct measurement method in China, and to explore the occupational internal dose level of nuclear medicine staff.Methods:From 2023 to April 2024, search on platforms such as China National Knowledge Infrastructure and Chinese Medical Journal Network, to collect research literature on the internal exposure dose monitoring of nuclear medicine staff and discuss the internal exposure dose assessment method. According to the literature reported thyroid 131I activity level at the measuring time, the internal exposure dose level was estimated using the method recommended by GBZ 129-2016. Results:According to existing research reports on direct measurement using portable γ spectrometers, 6.1% of nuclear medicine workers may receive a 131I dose greater than 1 mSv/a. Conclusion:It is necessary to conduct periodic continuous monitoring for personnel whose internal exposure dose may greater than 1 mSv/a, and it is necessary to explore the feasibility of periodic internal exposure monitoring method carried out by hospitals.

Objective:To evaluate the protective effectiveness (VE) of the acellular pertussis vaccine (aPV) against pertussis in children aged 2 months to 6 years.Methods:A test-negative case-control study was conducted among children aged 2 months to 6 years who sought medical care for cough and underwent pertussis nucleic acid testing at sentinel surveillance hospitals in Zhejiang Province in 2024. Cases were defined as those with positive pertussis nucleic acid test results, while controls were test-negative individuals matched 1∶1 based on propensity scores using the caliper matching method. Conditional logistic regression models were used to calculate odds ratios ( ORs) and VEs. Results:Among the 658 participants, 31.76% (209 cases) tested positive for pertussis. After propensity score matching, 203 cases and 203 controls were included in the analysis. The VE of 1-2, 3, and 4 doses of aPV against pertussis was 52.46% (95% CI:-39.82%-83.84%), 65.22% (95% CI: 6.86%-87.02%), and 72.21% (95% CI: 34.33%-88.24%), respectively. For pertussis-related hospitalization, the VE of 1-3 and 4 doses was 80.95% (95% CI:31.38%-94.71%) and 86.79% (95% CI: 51.89%-96.37%). The VE for those who completed 4 doses of vaccination and had intervals of less than 2 years, 2 years, 3 years, and 4 years or more after vaccination were 91.15% (95% CI: 67.61%-97.58%), 84.70% (95% CI: 43.71%-95.84%),56.23% (95% CI:-47.58%-87.02%), and 49.92% (95% CI:-83.74%-86.35%), respectively. Conclusion:The VE of aPV against pertussis in children aged 2 months to 6 years increases with the number of doses administered, and it is more effective in preventing hospitalization due to pertussis. The VE declines rapidly over time after the last dose. It is recommended to follow the new pertussis immunization program for timely and full vaccination.

Objective:To explore the in vitro radiation levels and in vivo neutron activation after patients receiving boron neutron capture therapy (BNCT). Methods:Totally 29 BNCT treatments were performed for 21 patients with head and neck and brain cancer using the NeuPex accelerator-based boron neutron capture therapy (AB-BNCT) system in Xiamen Humanity Hospital from October, 2022 to April, 2024. The ambient dose equivalent rate around the patients was measured with an X/gamma dose rate survey meter. The gamma radiation dose rates were measured at 0, 0.5, 1.0, and 2.0 m from the irradiation position, at 0, 0.5, 1.0, and 2.0 m from the opposite side of the irradiation position, and at the navel and the affected knee, respectively. Meanwhile, a portable high-purity germanium gamma spectrometer was used to measure the spectrum of activated nuclides in the bodies of patients who had underwent the treatment, and the types of radionuclides generated by neutron activation during each BNCT treatment were analyzed.Results:The radionuclides 24Na, 38Cl, and 49Ca were mainly produced in the bodies of patients treated with BNCT. 20 minutes after BNCT treatment, the ambient dose equivalent rate at a distance of 1.0 m from the irradiation position was lower than 2.5 μSv/h. Conclusions:The dose delivered to the staff and family members by the patients undergoing BNCT is relatively low, and the resulting radiation risk is low. According to the ALARA principle, it is recommended that certain control actions be taken for patients having received BNCT treatment to minimize the exposure doses of both patients and staff as much as possible.

Purpose: This Phase II trial was objected to evaluate the efficacy and safety of adding fulvestrant to neoadjuvant chemotherapy in patients with estrogen receptor (ER)+/human epidermal growth factor receptor 2 (HER2)– locally advanced breast cancer (LABC). Additionally, the study aimed to investigate the association of 16α-18F-fluoro-17β-fluoroestradiol (18F-FES) positron emission tomography (PET)–computed tomography (CT) and metabolites with efficacy. Materials and Methods: Fulvestrant and EC-T regimen were given to ER+/HER2– LABC patients before surgery. At baseline, patients received 18F-FES PET-CT scan, and plasma samples were taken for liquid chromatography–mass spectrometry analysis. The primary endpoint was objective response rate (ORR). Secondary endpoints included total pathologic complete response (tpCR) and safety. Results: Among the 36 patients enrolled, the ORR was 86.1%, the tpCR rate was 8.3%. The incidence of grade ≥ 3 treatment-emergent adverse events was 22%. The decrease in ER value in sensitive patients was larger than that in non-sensitive patients, as was Ki-67 (p < 0.05). The maximum standardized uptake value, mean standardized uptake values, total lesion ER expression of 18F-FES PET-CT in sensitive patients were significantly higher than those in non-sensitive patients (p < 0.05). Moreover, these parameters were significantly correlated with Miller and Payne grade and the change in ER expression before and after treatment (p < 0.05). Thirteen differential expressed metabolites were identified, which were markedly enriched in 19 metabolic pathways. Conclusion This regimen demonstrated acceptable toxicity and encouraging antitumor efficacy. 18F-FES PET-CT might serve as a tool to predict the effectiveness of this therapy. Altered metabolites or metabolic pathways might be associated with treatment response.

Objective: To evaluate the effects of a multidisciplinary weight management intervention, so as to provide a reference for the formulation of overweight and obesity intervention measures. Methods: From April to September 2025, overweight and obese residents aged 18-60 years who participated in a weight loss competition at the Health Management Center of Beilun People's Hospital in Ningbo City were selected as study subjects. They were divided into a control group and an intervention group. The control group received conventional weight management, while the intervention group received the multidisciplinary integrated weight management in addition to the conventional weight management, for a total intervention period of 8 weeks. Weight, body mass index (BMI), waist circumference, hip circumference, waist-to-hip ratio, fasting blood glucose (FBG), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and blood pressure were collected before and after the intervention through physical examinations and laboratory tests. The generalized estimating equations (GEE) method was employed to analyze the differences in indicators between the two groups before and after the intervention. Results: The control group comprised 241 participants, including 161 females (66.80%), with a mean age of (35.66±7.80) years. The intervention group consisted of 127 participants, including 86 females (67.72%), with a mean age of (36.80±7.05) years. No statistically significant differences were observed between the two groups at baseline in terms of age, gender, weight, BMI, or waist-to-hip ratio (all P>0.05). Results from the GEE analysis indicated significant interactions between group and time for weight, BMI, waist circumference, and hip circumference (all P<0.05) with greater reductions in these parameters observed in the intervention group compared to the control group before and after the intervention. Similarly, significant interactions between group and time were observed for FBG, TG, TC, and LDL-C (all P<0.05), with the intervention group demonstrating larger decreases in these markers compared to the control group. However, no statistically significant interactions between group and time were observed for waist-to-hip ratio, HDL-C, systolic blood pressure, and diastolic blood pressure (all P>0.05). Following the intervention, a weight loss exceeding 10% was achieved by 13 participants (5.39%) in the control group and 62 participants (48.82%) in the intervention group. The proportion of individuals with a weight loss exceeding 10% was significantly higher in the intervention group compared to the control group (P<0.05). Conclusion Compared to conventional weight management, multidisciplinary integrated weight management demonstrated greater efficacy in improving weight-related indicators and blood glucose, blood lipids, and enhancing weight loss outcomes among overweight and obese residents.

Objective:To understand the current situation of occupational internal exposure dose research using direct measurement method in China, and to explore the occupational internal dose level of nuclear medicine staff.Methods:From 2023 to April 2024, search on platforms such as China National Knowledge Infrastructure and Chinese Medical Journal Network, to collect research literature on the internal exposure dose monitoring of nuclear medicine staff and discuss the internal exposure dose assessment method. According to the literature reported thyroid 131I activity level at the measuring time, the internal exposure dose level was estimated using the method recommended by GBZ 129-2016. Results:According to existing research reports on direct measurement using portable γ spectrometers, 6.1% of nuclear medicine workers may receive a 131I dose greater than 1 mSv/a. Conclusion:It is necessary to conduct periodic continuous monitoring for personnel whose internal exposure dose may greater than 1 mSv/a, and it is necessary to explore the feasibility of periodic internal exposure monitoring method carried out by hospitals.