Triple-negative breast cancer (TNBC) represents a distinctive subtype, characterized by the absence of estrogen receptors, progesterone receptors, and human epidermal growth factor receptor 2 (HER2). Due to its high inter-tumor and intra-tumor heterogeneity, TNBC poses significant chanllenges for personalized diagnosis and treatment. The advant of clustered regular interspaced short palindromic repeats (CRISPR) technology has profoundly enhanced our understanding of the structure and function of the TNBC genome, providing a powerful tool for investigating the occurrence and development of diseases. This review focuses on the application of CRISPR/Cas technology in the personalized diagnosis and treatment of TNBC. We begin by discussing the unique attributes of TNBC and the limitations of current diagnostic and treatment approaches: conventional diagnostic methods provide limited insights into TNBC, while traditional chemotherapy drugs are often associated with low efficacy and severe side effects. The CRISPR/Cas system, which activates Cas enzymes through complementary guide RNAs (gRNAs) to selectively degrade specific nucleic acids, has emerged as a robust tool for TNBC research. This technology enables precise gene editing, allowing for a deeper understanding of TNBC heterogeneity by marking and tracking diverse cell clones. Additionally, CRISPR facilitates high-throughput screening to promptly identify genes involved in TNBC growth, metastasis, and drug resistance, thus revealing new therapeutic targets and strategies. In TNBC diagnostics, CRISPR/Cas was applied to develop molecular diagnostic systems based on Cas9, Cas12, and Cas13, each employing distinct detection principles. These systems can sensitively and specifically detect a variety of TNBC biomarkers, including cell-specific DNA/RNA and circulating tumor DNA (ctDNA). In the realm of precision therapy, CRISPR/Cas has been utilized to identify key genes implicated in TNBC progression and treatment resistance. CRISPR-based screening has uncovered potential therapeutic targets, while its gene-editing capabilities have facilitated the development of combination therapies with traditional chemotherapy drugs, enhancing their efficacy. Despite its promise, the clinical translation of CRISPR/Cas technology remains in its early stages. Several clinical trials are underway to assess its safety and efficacy in the treatment of various genetic diseases and cancers. Challenges such as off-target effects, editing efficiency, and delivery methods remain to be addressed. The integration of CRISPR/Cas with other technologies, such as 3D cell culture systems, human induced pluripotent stem cells (hiPSCs), and artificial intelligence (AI), is expected to further advance precision medicine for TNBC. These technological convergences can offer deeper insights into disease mechanisms and facilitate the development of personalized treatment strategies. In conclusion, the CRISPR/Cas system holds immense potential in the precise diagnosis and treatment of TNBC. As the technology progresses and becomes more costs-effective, its clinical relevance will grow, and the translation of CRISPR/Cas system data into clinical applications will pave the way for optimal diagnosis and treatment strategies for TNBC patients. However, technical hurdles and ethical considerations require ongoing research and regulation to ensure safety and efficacy.

OBJECTIVES: Wild-caught Microtus fortis (M. fortis) at the age of 9-15 months can develop epithelial ovarian cancers similar to human epithelial ovarian cancers under natural conditions during experimental animal breeding, but its pathological types and biological characteristics remain unclear. This study aims to analyze the biological characteristics of spontaneous ovarian cancer in M. fortis, intending to develop M. fortis as an animal model for human epithelial ovarian cancer. METHODS: The female M. fortis (9-15 months old) with spontaneous ovarian cancer were selected as the experimental group, and healthy M. fortis from the same litter were selected as the control group. The ovarian pathological changes of the two groups were observed by dissection. Blood routine and biochemical indicators were measured by biochemical analysis. Hematoxylin and eosin (HE) staining was performed to observe the pathological changes in the ovarian cancer tissue of M. fortis. Immunohistochemical staining was used to detect the protein expression of common ovarian cancer markers, and real-time RT-PCR was used to analyze the transcription levels of ovarian cancer-related genes. RESULTS: Spontaneous ovarian cancer in M. fortis mainly affects both ovaries, with tumors appearing solid or cystic. HE staining and histopathological analysis confirmed that the ovarian tumors originated from ovarian surface epithelium. Compared to the control group, the experimental group showed significantly decreased hemoglobin (P<0.01), hematocrit (P<0.05), albumin (P<0.05), and blood glucose levels (P<0.01), while lymphocyte percentage (P<0.05), monocyte percentage (P<0.05), cholesterol (P<0.01), and progesterone (P<0.01) levels were significantly increased. Expression of ovarian cancer-related genes, including ID3, CDC42, RHOA, RB1CC1, NF1, PIN1, MIB1, PDS5A, MCM7, and MLH1, was significantly downregulated (all P<0.05), while PAX8 gene expression was significantly upregulated (P<0.05). Immunohistochemical results showed that Wilms' tumor gene 1 (WT1) protein was mainly distributed throughout the cell, with significantly higher expression in ovarian cancer M. fortis. Tumor protein 53 (TP53) was expressed in both healthy and ovarian cancer M. fortis and was distributed throughout the cell. Hepatocyte nuclear factor 1 beta (HNF1B) and progesterone receptor (PR) protein were highly expressed in the ovarian tissue of healthy M. fortis but were significantly reduced in the ovarian cancer M. fortis, though both were located in the cytoplasm. CONCLUSIONS Spontaneous ovarian cancer in M. fortis is serous ovarian cancer. Compared to healthy M. fortis, significant differences were observed in ovarian tissue morphology, biochemical indicators, ovarian cancer-related gene expression, and protein expression, which show similarity to the biological characteristics of human serous ovarian cancer. This suggests that M. fortis could be an ideal animal model for studying human serous ovarian cancer.
Female ; Ovarian Neoplasms/metabolism* ; Animals ; Carcinoma, Ovarian Epithelial ; Disease Models, Animal ; Humans ; Neoplasms, Glandular and Epithelial/metabolism* ; Ovary/pathology*

With the rapid development of population aging in various countries around the world,the health and elderly care industry has been paid high attention.The standardization of smart health and elderly care technology and services is particularly important.This paper firstly reviewed the policies related to healthy elderly care in China.By analyzing the industrial standards and provincial standards issued,this paper focused on the policies proposed by the Shanghai Municipal Government for the standardization of smart health and elderly care,as well as the researches on the standard system and the construction of standard families.Shanghai group standards in the field of smart health and elderly care were summarized,including the guidelines for the construction of standard systems,elderly care service platforms,community elderly cafeterias,portable health monitoring terminals,indoor sports services,and home-based elderly care safety monitoring.A series of case analyses of the standardized implementation of the above aspects were also provided.Through standardization research and practice in recent years,it has been fully demonstrated that the standard research plays an important leading role in the field of smart health and elderly care.

Objective To investigate the current situation and risk factors of"socialized hospitalization"in elderly stroke patients.Methods A total of 329 elderly stroke patients who were admitted to No.971 Hospital of PLA Navy from January 2022 to December 2022 were enrolled in this retrospective study.The patients without"socialized hospitalization"were assigned to the control group(n=258),and those with"socialized hospitalization"were assigned to observation group(n=71).The age,gender,admission route,department transfer during hospitalization,hospital-acquired infection,depressive symptoms,cognitive impairment,activity of daily living(ADL)level at discharge were compared between the two groups.Multivariate logistic regression analysis was used to analyze the risk factors of"socialized hospitalization"in elderly stroke patients.Results There were no significant differences in gender,age,route of admission,or department transfer during hospitalization between the two groups(P>0.05).The proportions of patients with hospital-acquired infections,cognitive impairment,depressive symptoms and ADL meeting discharge standards in the observation group were higher than those in the control group(P<0.05).Multivariate logistic regression analysis showed that hospital-acquired infections,depressive symptoms and severe ADL level at discharge were independent risk factors for"socialized hospitalization"in elderly stroke patients(P<0.05).Conclusion There is a high proportion of"socialized hospitalization"in elderly patients with stroke.The main risk factors are hospital-acquired infection,cognitive impairment,depressive symptoms and ADL level at discharge.Active and effective measures should be taken to deal with them.

Objective To study the level of fall-related self-awareness among the elderly in community and to explore the influence of cognitive reserve and social cohesion on fall-related self-awareness,thereby providing a reference for developing targeted interventions.Methods Toally 500 old people in communities were recruited by convenience sampling in Hengyang between August and September 2024.Data were collected with the general information questionnaire,neighbourhood cohesion scale,self-awareness of falls in elderly scale,and cognitive reserve index questionnaire.Hierarchical multiple linear regression analysis was employed to explore the effects of cognitive reserve and social cohesion on fall-related self-awareness while controlling for demographic variables.Results A total of 467 valid questionnaires were returned.The score of fall-related self-awareness was 54.60±6.64(moderate level).Social cohesion scores was 29.84±5.52(moderate level),and cognitive reserve score was 93.27±10.83(moderate level).The cognitive reserve and social cohesion were both positively correlated with fall-related self-awareness(all P<0.01).Community integration accounted for 9.10%of its total variability,and cognitive reserve accounted for 5.70%of the total variability of fall vigilance,while controlling for variables such as body mass index(BMI),sleep quality,sedentary habits,fear of falling and financial resources.Conclusion The elderly in communities exhibit a low level of fall-related self-awareness.More attention to risk of falling is required along with developing targeted and individualised training programs aiming at improvement of cognitive reserve and social cohesion,thereby reducing the incidence of falls.

Due to the particularity of their disease and medical habits,cancer patients need to make regular appointments with treatment experts for follow-up visits and monitor disease progression,which can easily lead to a shortage of resources in famous experts' offline clinics.The rise of Internet diagnosis and treatment has realized the reasonable diversion of patients and improved the convenience and timeliness of medical services.In recent years,Cancer Hospital Chinese Academy of Medical Sciences has achieved good results by establishing the outpatient mode of"Internet+famous expert team",integrating the advantages of both,releasing offline space.It introduces the construction ideas,main methods,and achievements of this model,aiming to further improve the outpatient system,and provide references for improving patients experience.

Objective To investigate the influence of remifentanil infusion at different speed on propofol injection pain.Methods Totally 200 patients who accepted elective surgery under general anesthesia with tracheal intubation were selected.The patients were divided into C group,R2 group,R3 group,R4 group and R5 group by random number table method,with 40 patients in each group,and they were injected with remifentanil at a constant rate of 0 μg·kg-1·min-1,0.2 μg·kg-1·min-1,0.3 μg·kg-1·min-1,0.4 μg·kg-1·min-1,and 0.5 μg·kg-1·min-1,respectively.After 2 minutes of remifentanil infusion,a target controlled infusion of propofol at an effect-site concentration of 2.5 μg/mL was initiated.The incidence of propofol injection pain,the severity of injection pain,heart rate and mean arterial pressure before remifentanil infusion and before tracheal intubation were compared among the 5 groups.The incidence of complications such as hypotension,bradycardia and chest wall stiffness of patients was recorded.Results The incidence and the severity of propofol injection pain of patients in R2 group,R3 group,R4 group and R5 group were significantly lower than those in C group(P<0.05).The incidence of propofol injection pain of patients in R4 group was significantly lower than those in R2 group and R3 group,and the severity of propofol injection pain of patients in R4 group was significantly lower than that in R2 group(P<0.05).The incidence and the severity of propofol injection pain of patients in R5 group was significantly lower than those in R2 group and R3 group(P<0.05).However,there were no statistically significant differences in the incidence or severity of injection pain between R2 group and R3 group,and between R4 group and R5 group(P>0.05).None of the patients in each group had complications such as hypotension,bradycardia,decreased pulse oxygen saturation,and chest wall stiffness that required drug treatment.And there was no adverse reactions such as pain,edema,redness at the injection site occurred within 24 hours after operation.Conclusion Remifentanil infused at a constant rate of 0.4 μg·kg-1·min-1 and 0.5 μg·kg-1·min-1 starting at 2 minutes before propofol administration is effective in reducing propofol injection pain without causing serious complications.

Objective To study the level of fall-related self-awareness among the elderly in community and to explore the influence of cognitive reserve and social cohesion on fall-related self-awareness,thereby providing a reference for developing targeted interventions.Methods Toally 500 old people in communities were recruited by convenience sampling in Hengyang between August and September 2024.Data were collected with the general information questionnaire,neighbourhood cohesion scale,self-awareness of falls in elderly scale,and cognitive reserve index questionnaire.Hierarchical multiple linear regression analysis was employed to explore the effects of cognitive reserve and social cohesion on fall-related self-awareness while controlling for demographic variables.Results A total of 467 valid questionnaires were returned.The score of fall-related self-awareness was 54.60±6.64(moderate level).Social cohesion scores was 29.84±5.52(moderate level),and cognitive reserve score was 93.27±10.83(moderate level).The cognitive reserve and social cohesion were both positively correlated with fall-related self-awareness(all P<0.01).Community integration accounted for 9.10%of its total variability,and cognitive reserve accounted for 5.70%of the total variability of fall vigilance,while controlling for variables such as body mass index(BMI),sleep quality,sedentary habits,fear of falling and financial resources.Conclusion The elderly in communities exhibit a low level of fall-related self-awareness.More attention to risk of falling is required along with developing targeted and individualised training programs aiming at improvement of cognitive reserve and social cohesion,thereby reducing the incidence of falls.

Objective To investigate the influence of remifentanil infusion at different speed on propofol injection pain.Methods Totally 200 patients who accepted elective surgery under general anesthesia with tracheal intubation were selected.The patients were divided into C group,R2 group,R3 group,R4 group and R5 group by random number table method,with 40 patients in each group,and they were injected with remifentanil at a constant rate of 0 μg·kg-1·min-1,0.2 μg·kg-1·min-1,0.3 μg·kg-1·min-1,0.4 μg·kg-1·min-1,and 0.5 μg·kg-1·min-1,respectively.After 2 minutes of remifentanil infusion,a target controlled infusion of propofol at an effect-site concentration of 2.5 μg/mL was initiated.The incidence of propofol injection pain,the severity of injection pain,heart rate and mean arterial pressure before remifentanil infusion and before tracheal intubation were compared among the 5 groups.The incidence of complications such as hypotension,bradycardia and chest wall stiffness of patients was recorded.Results The incidence and the severity of propofol injection pain of patients in R2 group,R3 group,R4 group and R5 group were significantly lower than those in C group(P<0.05).The incidence of propofol injection pain of patients in R4 group was significantly lower than those in R2 group and R3 group,and the severity of propofol injection pain of patients in R4 group was significantly lower than that in R2 group(P<0.05).The incidence and the severity of propofol injection pain of patients in R5 group was significantly lower than those in R2 group and R3 group(P<0.05).However,there were no statistically significant differences in the incidence or severity of injection pain between R2 group and R3 group,and between R4 group and R5 group(P>0.05).None of the patients in each group had complications such as hypotension,bradycardia,decreased pulse oxygen saturation,and chest wall stiffness that required drug treatment.And there was no adverse reactions such as pain,edema,redness at the injection site occurred within 24 hours after operation.Conclusion Remifentanil infused at a constant rate of 0.4 μg·kg-1·min-1 and 0.5 μg·kg-1·min-1 starting at 2 minutes before propofol administration is effective in reducing propofol injection pain without causing serious complications.