ObjectiveTo explore the effect and mechanism of Jianpi Xiaoai prescription （JPXA） in ameliorating the 5-fluorouracil （5-FU） resistance of colon cancer. MethodsA HCT116/5-FU resistant cell line was established. Different concentrations （10%， 15%， 20%） of JPXA-containing serum and drug-free serum were used for intervention， and 10% fetal bovine serum （10% FBS）， fibroblast growth factor receptor （FGFR） inhibitor （AZD4547）， and recombinant fibroblast growth factor 2 （FGF2） were set as the control groups. Sensitive HCT116 cells were used in the FGF2 group， while HCT116/5-FU cells were used in other groups. Drug resistance， the level of FGF2 in the cell culture medium， the mRNA level of FGF2 in cells， and the protein levels of FGF2/FGFR and phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt） were determined. The drug-resistant cells were transplanted into the axilla of nude mice to establish a tumor model. The modeled mice were allocated into model， JPXA （15 g·kg^-1）， 5-FU （0.02 g·kg^-1）， JPXA+5-FU （15 g·kg^-1+0.02 g·kg^-1）， AZD4547 （0.012 5 g·kg^-1）， and AZD4547+5-FU （0.012 5 g·kg^-1+0.02 g·kg^-1） groups. The tumor growth and the protein levels of FGF/FGFR and PI3K/Akt in each group were observed. ResultsThe survival rate of HCT116/5-FU cells decreased in all the JPXA groups with different concentrations. The cell survival rate was decreased most obviously in the 20% JPXA group. The level of FGF2 in the cell culture medium and the mRNA level of FGF2 in cells of each JXPA group decreased， and the decrease was the most significant in the 20% group （P<0.01）. HCT116/5-FU cells showed up-regulated protein levels of FGF2 and phosphorylated fibroblast growth factor receptor 1 （p-FGFR1）， but down-regulated protein level of FGFR1 （P<0.01）. JPXA down-regulated the expression of FGF2 and p-FGFR1 and up-regulated the expression of FGFR1 （P<0.05）. In addition， JPXA down-regulated the expression levels of phosphorylated protein kinase B （p-Akt） and phosphorylated mammalian target of rapamycin （p-mTOR）， while up-regulating the expression levels of Akt and Bcl-2-asociated death promoter （Bad） （P<0.05）. Animal experiments showed that the JPXA combined with 5-FU significantly inhibited the growth of drug-resistant tumors， reduced the protein levels of FGF2， p-FGFR1， phosphorylated phosphatidylinositol-3-kinase （p-PI3K）， p-Akt， and p-mTOR， and increased the expression of Bad. It indicated that JPXA can inhibit the FGF2/FGFR1 signaling in colon cancer and regulate PI3K/Akt and downstream signaling pathways. ConclusionJPXA can ameliorate the chemotherapy resistance of colon cancer through down-regulating FGF2 expression and inhibiting the activation of the PI3K/Akt signaling pathway.

"Dietary inquiry" is a core component of the diagnostic system in traditional Chinese medicine （TCM）， which can be divided into three aspects including appetite， eating capacity， and food preference. Abnormalities in appetite are mainly attributed to dysfunction of the mind and impaired regulatory mechanisms. Clinical inquiry should focus on hunger sensation and the willingness to eat voluntarily. Treatment should aim to soothe the liver， regulate the spleen， nourish and calm the mind. Abnormalities in eating capacity are related to disorders of qi movement and structural dysfunction， for which inquiry should focus on whether food descends smoothly and on postprandial reactions， and the corresponding treatment is descending qi， relieving fullness， and promoting bowel movement and digestion. Abnormalities in food preference arise from damage caused by the five flavors and imbalance of visceral qi， for which inquiry should focus on dietary preferences and whether eating brings comfort. It is important to distinguish between "stomach preference" and "oral preference"， and treatment should carefully differentiate flavor tendencies and correct imbalances through appropriate dietary flavors. By refining the content of dietary inquiry， this study explores how different dimensions of eating status reflect the holistic concept and syndrome differentiation-based treatment in TCM， providing a reference for the clinical diagnosis and treatment of spleen and stomach diseases and related disorders.

"Dietary inquiry" is a core component of the diagnostic system in traditional Chinese medicine （TCM）， which can be divided into three aspects including appetite， eating capacity， and food preference. Abnormalities in appetite are mainly attributed to dysfunction of the mind and impaired regulatory mechanisms. Clinical inquiry should focus on hunger sensation and the willingness to eat voluntarily. Treatment should aim to soothe the liver， regulate the spleen， nourish and calm the mind. Abnormalities in eating capacity are related to disorders of qi movement and structural dysfunction， for which inquiry should focus on whether food descends smoothly and on postprandial reactions， and the corresponding treatment is descending qi， relieving fullness， and promoting bowel movement and digestion. Abnormalities in food preference arise from damage caused by the five flavors and imbalance of visceral qi， for which inquiry should focus on dietary preferences and whether eating brings comfort. It is important to distinguish between "stomach preference" and "oral preference"， and treatment should carefully differentiate flavor tendencies and correct imbalances through appropriate dietary flavors. By refining the content of dietary inquiry， this study explores how different dimensions of eating status reflect the holistic concept and syndrome differentiation-based treatment in TCM， providing a reference for the clinical diagnosis and treatment of spleen and stomach diseases and related disorders.

ObjectiveTo develop and validate a diagnostic prediction model for differentiating pulmonary tuberculosis from community-acquired pneumonia based on routine blood parameters. MethodsA total of 642 patients with pulmonary tuberculosis and 503 patients with community-acquired pneumonia were retrospectively enrolled from the Seventh Hospital of Tangshan. They were randomly divided into a training set and an internal validation set at a 7∶3 ratio. Additionally， 218 patients from the 981st Hospital were independently included as an external validation set. The Boruta algorithm and recursive feature elimination were employed to select predictors from 82 blood parameters， sex， and age. A multivariate Logistic regression model was established and evaluated using receiver operating characteristic （ROC） curves， calibration curves， and decision curve analysis. ResultsThe final model incorporated eight predictors， namely uric acid， urea nitrogen， alkaline phosphatase， monoamine oxidase， alanine aminotransferase， glutathione， neutrophil percentage， and age. The model achieved areas under the curve （AUCs） of 0.800 （95%CI： 0.769-0.830）， 0.787 （95%CI： 0.738-0.836）， and 0.736 （95%CI： 0.667-0.835） in the training， internal validation， and external validation sets， respectively. The model demonstrated good calibration， and decision curve analysis showed clinical net benefit within the threshold probability range of 10%-80%. ConclusionThe developed model exhibits good discriminative ability and clinical utility， serving as an effective early screening tool for primary healthcare institutions.

Objective:To examine the validity and reliability of the Chinese version of the Transgender Atti-tudes and Beliefs Scale(TABS)in the general adult population.Methods:A total of 1 656 residents aged≥18 years were recruited by convenient sampling method,and were equally divided into sample 1 and sample 2 accord-ing to age group.The total sample was used for item analysis and internal consistency reliability test.Sample 1 was used for exploratory factor analysis,Sample 2 was used for confirmatory factor analysis,and 60 residents were se-lected for retesting at a 2-week interval.Results:The TABS Chinese version included a total of 26 items,with the content validity index(I-CVI)of each item ranging from 0.83 to 1.00,and the content validity index(S-CVI)of the scale being 0.98.Exploratory factor analysis extracted 3 common factors,namely interpersonal comfort,gender beliefs,and human value,with a cumulative total variance of 57.13％.Confirmatory factor analysis showed that the scale fit was acceptable(x2/df=2.95,RMSEA=0.05,GFI=0.92,AGFI=0.90).The Cronbach α coefficients of the total score of the scale and the scores of the 3 factors were 0.95,0.95,0.88 and 0.86.The retest reliabilities were 0.88,0.78,0.65 and 0.91.Conclusion:The Chinese version of the Transgender Attitudes and Beliefs Scale(TABS)has good validity and reliability in assessing general adults'attitudes toward the transgender community.

Objective:To analyze the changes in the incidence trend of liver cancer in Taizhou of Jiangsu Province, from 2012 to 2020 and provide reference for tumor prevention and control and management.Methods:Liver cancer incidence data from 2012 to 2020 were extracted from the Taizhou Center for Disease Control and Prevention's tumor registry system. Demographic data were used to calculate the crude incidence rate, age-standardized incidence rate (ASIR), Chinese age-standardized incidence rate (CASIR; based on China's 2010 standard population), and world age-standardized incidence rate (WASIR; based on Segi's world standard population). The Joinpoint regression model was applied to identify inflection points in liver cancer incidence trends during 2012-2020, and annual percentage change (APC) with average annual percentage change (AAPC) were calculated.Results:In 2020, the crude incidence ratio (CIR) of liver cancer in Taizhou was 34.6 per 100 000, with CASIR and WASIR at 19.6 per 100 000 and 14.9 per 100 000, respectively. From 2012 to 2020, the male-to-female ratio of new liver cancer cases was 2.94∶1 (10 455 males vs. 3 559 females), with male incidence consistently higher than female. Overall liver cancer incidence in Taizhou initially increased and then decreased after 2017 (2012-2017: APC=6.4%, P=0.014; 2017-2020: APC=-9.5%, P=0.035), peaking at a CASIR of 26.2 per 100 000 in 2017. The trend in male incidence mirrored the overall pattern, rising before 2017 and declining thereafter (2012-2017: APC=6.2%, P=0.005; 2017-2020: APC=-9.0%, P=0.016). Female incidence remained relatively stable (2012-2016: APC=11.0%, P=0.054; 2016-2020: APC=-6.5%, P=0.130). Conclusions:Liver cancer incidence in Taizhou increased before 2017 and declined thereafter, with 2017 as the turning point. Amid population aging, liver cancer remains a persistent public health challenge requiring sustained attention.

Rheumatoid arthritis(RA)is a chronic,systemic,autoimmune inflammatory disease.Bone destruction caused by RA is a key factor in disability,involving abnormal activation of immune cells,overproduction of inflammatory factors,and imbalances in bone remodeling process.Ferroptosis,a form of cell death associated with disturbed iron metabolism,inactivation of the antioxidant system and lipid peroxidation,plays a complex role in RA bone destruction.Traditional Chinese medicine(TCM),with its multi-targeted intervention properties,has shown significant potential and advantages in treatment of RA bone destruction.A variety of TCM can regulate the ferroptosis pathway and influence osteoblast function,which has an important role in slowing down RA bone destruction.This review focuses on the latest research progress in the regulation of ferroptosis pathway by TCM to alleviate RA bone destruction,aiming to provide new perspectives and theoretical basis for the treatment of RA bone destruction.

Objective To understand the trends in availability and usage for four non-statin lipid-lowering drugs between 2020 and 2023 in China,and to explore the impact of centralized drug procurement and national drug price negotiation policy on the accessibility and utilization trends of these medications.Methods Data processing was performed on four non-statin lipid-lowering drugs(ezetimibe,hybutimibeh,evolocumab,alirocumab)from over 1 000 hospitals within the China Pharmaceutical Association network units from 2020 to 2023 was performed on.SPSS 27.0 was employed for descriptive statistical analysis and x2 tests regarding drug availability,sales revenue,defined daily dose system(DDDs),and cost per DDD(DDDc).Results The availability and DDDs of four cholesterol absorption inhibitors or PCSK9-mAbs increased year by year during the study period,with the most significant increase observed in the first year after centralized drug procurement or national drug price negotiation policy.After the national drug price negotiation policy,alirocumab had the highest availability among the three negotiated drugs.The sales volume of ezetimibe,which was included in the centralized drug procurement program,increased before the negotiation but decreased significantly afterwards,with its share of sales declining year by year.During the study period,the sales volumes and market shares of the three negotiated drugs all increased annually,with evolocumab showing notably higher sales values and percentages than both hybutimibe and alirocumab after the negotiation.The DDDc for all four drugs continued to decrease during the survey period,with the first-year post-centralized drug procurement or national drug price negotiation policy witnessing the largest drop.Conclusion Both of the centralized drug procurement and the national drug price negotiation policy can significantly increase the accessibility to non-statin lipid-lowering drugs and promote their clinical application,however,there is a mismatch between the growth in usage and accessibility for certain varieties.

Rheumatoid arthritis(RA)is a chronic,systemic,autoimmune inflammatory disease.Bone destruction caused by RA is a key factor in disability,involving abnormal activation of immune cells,overproduction of inflammatory factors,and imbalances in bone remodeling process.Ferroptosis,a form of cell death associated with disturbed iron metabolism,inactivation of the antioxidant system and lipid peroxidation,plays a complex role in RA bone destruction.Traditional Chinese medicine(TCM),with its multi-targeted intervention properties,has shown significant potential and advantages in treatment of RA bone destruction.A variety of TCM can regulate the ferroptosis pathway and influence osteoblast function,which has an important role in slowing down RA bone destruction.This review focuses on the latest research progress in the regulation of ferroptosis pathway by TCM to alleviate RA bone destruction,aiming to provide new perspectives and theoretical basis for the treatment of RA bone destruction.

Objective To understand the trends in availability and usage for four non-statin lipid-lowering drugs between 2020 and 2023 in China,and to explore the impact of centralized drug procurement and national drug price negotiation policy on the accessibility and utilization trends of these medications.Methods Data processing was performed on four non-statin lipid-lowering drugs(ezetimibe,hybutimibeh,evolocumab,alirocumab)from over 1 000 hospitals within the China Pharmaceutical Association network units from 2020 to 2023 was performed on.SPSS 27.0 was employed for descriptive statistical analysis and x2 tests regarding drug availability,sales revenue,defined daily dose system(DDDs),and cost per DDD(DDDc).Results The availability and DDDs of four cholesterol absorption inhibitors or PCSK9-mAbs increased year by year during the study period,with the most significant increase observed in the first year after centralized drug procurement or national drug price negotiation policy.After the national drug price negotiation policy,alirocumab had the highest availability among the three negotiated drugs.The sales volume of ezetimibe,which was included in the centralized drug procurement program,increased before the negotiation but decreased significantly afterwards,with its share of sales declining year by year.During the study period,the sales volumes and market shares of the three negotiated drugs all increased annually,with evolocumab showing notably higher sales values and percentages than both hybutimibe and alirocumab after the negotiation.The DDDc for all four drugs continued to decrease during the survey period,with the first-year post-centralized drug procurement or national drug price negotiation policy witnessing the largest drop.Conclusion Both of the centralized drug procurement and the national drug price negotiation policy can significantly increase the accessibility to non-statin lipid-lowering drugs and promote their clinical application,however,there is a mismatch between the growth in usage and accessibility for certain varieties.