Objective To explore the value of oral contrast-enhanced ultrasonography (OCEUS) combined with contrast-enhanced CT in predicting preoperative T staging in patients with gastric cancer. Methods A retrospective analysis was conducted on 80 patients with gastric cancer confirmed via endoscopic biopsy or postoperative pathology at the First People’s Hospital of Jining from January 2021 to November 2024. The cohort included 56 males and 24 females, aged 38-79 years, with a median age of 55.9 years. All patients underwent both OCEUS and contrast-enhanced CT within one week prior to surgery. T staging of gastric cancer was determined using OCEUS, contrast-enhanced CT, or their combination. The results were compared with pathological T staging, and statistical differences in accuracy were analyzed. Results Pathological T staging identified T1 in 9 cases, T2 in 16 cases, T3 in 42 cases, and T4 in 13 cases. OCEUS indicated T1 in 6 cases, T2 in 14 cases, T3 in 50 cases, and T4 in 10 cases, with an accuracy rate of 80.0%. Contrast-enhanced CT indicated T1 in 4 cases, T2 in 12 cases, T3 in 52 cases, and T4 in 12 cases, with an accuracy rate of 75.0%. The combination of OCEUS and contrast-enhanced CT indicated T1 in 6 cases, T2 in 15 cases, T3 in 47 cases, and T4 in 12 cases, with an accuracy rate of 87.5%. The combined approach demonstrated significantly higher accuracy in preoperative T staging compared to either method alone (P < 0.05). Conclusion The combination of OCEUS and contrast-enhanced CT improves the accuracy of preoperative T staging in gastric cancer patients, providing valuable support for their diagnosis and treatment.

Objective To explore the time-varying pattern of potential symptoms in breast cancer patient before and after chemotherapy,and further analyze its influencing factors,aims to provide reference for clinical nursing practice.Methods 233 cases of breast cancer in a tertiary A hospital in Ningxia from June to October,2023 were selected as the research subjects.By the general information questionnaire and the Chinese version of Anderson Symptom Assessment Scale,the potential change of symptoms of breast cancer patients undergoing chemotherapy 1-3 days before the first chemotherapy(T1,233 cases)and 7-14 days after the third or fourth chemotherapy(T2,225 cases)was analyzed.Results 225 cases of breast cancer patients completed 2 surveys,and their symptom characteristics before and after chemotherapy can be divided into 2 categories:a high symptom troubled group and a low symptom troubled group.The high-symptom troubled group has strong stability,and the probability of maintaining the original group is 85.20％,while the low-symptom troubled group is more inclined to change to the high-symptom troubled group,and the transition probability is 26.60％.Logistic regression analysis showed that the mass was located on the left side,and the patients who obtained disease knowledge mainly through the Internet were more likely to change from the high symptom troubled group to the low symptom troubled group,while the patients who were employed,with unsatisfactory sleep at night,and never exercised were more likely to change from the low symptom troubled group to the high symptom troubled group.Conclusion The symptoms of breast cancer patients before and after chemotherapy are heterogeneous.Patients who are on the job,have unsatisfied sleep at night and never exercise are more likely to change from the low-symptom troubled group to the high-symptom troubled group,which suggests that medical staff should identify potential high-risk groups at an early stage,and make full use of the predictive function of symptom characteristics to carry out individualized management based on the dynamic monitoring of symptoms according to different types of population characteristics,so as to reduce the burden of symptoms and improve their quality of life.

OBJECTIVE To explore the effect and mechanism of Zhiqiao gancao decoction （ZQGCD） on pathological angiogenesis of degenerative intervertebral disc. METHODS The rats were randomly divided into sham operation group （normal saline）， model group （normal saline）， hypoxia inducible factor-1α （HIF-1α） inhibitor （YC-1） group [2 mg/（kg·d）， tail vein injection]， and ZQGCD low-dose， medium-dose and high-dose groups [3.06， 6.12， 12.24 g/（kg·d）]， with 8 rats in each group. Except for sham operation group， lumbar disc degeneration model of rat was constructed in all other groups. After modeling， they were given relevant medicine once a day， for consecutive 3 weeks. After the last medication， pathological changes and angiogenesis of the intervertebral disc tissue in rats were observed； the levels of inflammatory factors [interleukin-1β （IL-1β）， IL-6， tumor necrosis factor-α （TNF-α）] and the expressions of angiogenesis-related proteins [HIF-1α， vascular endothelial growth factor （VEGF）， VEGF receptor 2 （VEGFR2）， angiotensin 1（Ang 1）， Ang 2] in the com intervertebral disc tissue in rats were all determined. In cell experiment， the primary nucleus pulposus cells were isolated and cultured from rats， and cellular degeneration was induced using 50 ng/mL TNF-α. The cells were divided into blank control group （10% blank control serum）， TNF-α group （10% blank control serum）， YC-1 group （10% blank control serum+0.2 mmol/L YC-1）， and 5%， 10%， 15% drug-containing serum group （5%， 10%， 15% drug-containing serum）. After 24 hours of intervention， the nucleus pulposus cells were co-cultured with HUVEC. The expressions of Collagen Ⅱ， matrix metalloproteinase-3 （MMP-3） in nucleus pulposus cells were detected. HUVEC proliferation， migration and tube forming ability were detected， and the expression levels of the HIF-1α/VEGF/Ang signal axis and angiogenesis- related proteins （add MMP-2， MMP-9） in HUVEC were detected. RESULTS Animal experiments had shown that compared with model group， the positive expression of CD31 in the intervertebral disc tissues of rats in each drug group was down-regulated （P＜ 0.05）， the levels of inflammatory factors and angiogenesis-related proteins were decreased significantly （P＜0.05）， and the pathological changes in the intervertebral disc were alleviated. Cell experiments had shown that compared with TNF-α group， the expression of Collagen Ⅱ in nucleus pulposus cells of all drug groups was significantly up-regulated （P＜0.05）， and the expression of MMP-3 was significantly down-regulated （P＜0.05）； the proliferation， migration and tubulogenesis of HUVEC were significantly weakened （P＜0.05）. The mRNA and protein expressions of HIF-1α， VEGF， Ang 2 as well as the expression of angiogenesis-related proteins （except for the expression of Ang 2 mRNA and HIF-1α， VEGFR2， Ang 2 protein in 5% drug- containing serum group） were significantly down-regulated （P＜0.05）. CONCLUSIONS ZQGCD may inhibit the HIF-1α/VEGF/ Ang signal axis to weaken the angiogenic ability of vascular endothelial cells， improve pathological angiogenesis in the intervertebral disc， and delay the degeneration of the intervertebral disc.

Objective:To investigate the changes of T lymphocyte subsets in patients with stage Ⅰ and Ⅱ cervical cancer after surgery and their relationship with postoperative lymph node metastasis according to the International Federation of Gynecology and Obstetrics (FIGO) stage (2014) .Methods:A total of 192 patients with FIGO stage ⅠA, ⅠB1, ⅠB2 and ⅡA1 who received radical cervical cancer resection and pelvic lymph node dissection in People's Hospital of Yuechi County of Sichuan Province and West China Guang'an Hospital of Sichuan University from November 2018 to November 2020 were selected for this study. According to FIGO stage, patients were divided into stage Ⅰ group ( n=85) and stage Ⅱ group ( n=107) . The dynamic changes of T lymphocytes subsets in patients with different FIGO stages were compared before and after surgery. Repeated measurement of variance was used to analyze the levels of T lymphocytes subsets in patients of different stages during treatment. Logistic regression was used to analyze the influencing factors of postoperative lymph node metastasis in patients with cervical cancer. Multivariate logistic regression was used to analyze the relationship between T lymphocytes subsets and postoperative lymph node metastasis. Receiver operator characteristic (ROC) curve was used to analyze the predictive efficacy of T lymphocytes level in postoperative lymph node metastasis. Results:The postoperative lymph node metastasis rate in stage Ⅱ patients [32.71% (35/107) ] was higher than that in stage Ⅰ patients [14.12% (12/85) ], with a statistically significant difference ( χ2=8.86, P=0.003) . Compared with the stage Ⅱ group, the levels of CD3 +, CD4 + T lymphocytes and CD4 +/CD8 + ratio were significantly higher in the stage Ⅰ group 1 day before surgery (all P<0.001) , and the level of CD8 + T lymphocytes was significantly lower ( P<0.001) . The levels of CD3 +, CD4 +, CD8 + T lymphocytes and the ratio of CD4 +/CD8 + showed dynamic changes at different stages after surgery. On 1, 7 and 30 days after surgery, the levels of CD3 +, CD4 + T lymphocytes and the ratio of CD4 +/CD8 + in stage Ⅰ group were higher than those in stage Ⅱ group (all P<0.001) , CD8 + T cell levels were lower than those in stage Ⅱ group (all P<0.001) . There were statistically significant differences in T lymphocytes subsets CD3 +, CD4 +, CD8 + and CD4 +/CD8 + time effect, intergroup effect and interaction effect between the two groups (all P<0.001) . Univariate analysis showed that the pathological type ( OR=1.85, 95% CI: 1.14-2.33, P=0.015) , differentiation degree ( OR=1.93, 95% CI: 1.18-2.67, P=0.024) , depth of myometrial invasion ( OR=2.08, 95% CI: 1.26-2.59, P=0.012) , tumor morphology ( OR=2.17, 95% CI: 1.57-2.63, P=0.009) , parametrial invasion ( OR=1.95, 95% CI: 1.43-2.76, P=0.036) and lymphovascular space invasion ( OR=2.03, 95% CI: 1.28-2.57, P=0.021) were the influencing factors for postoperative lymph node metastasis in patients with FIGO stage Ⅰ and Ⅱ cervical cancer. Multivariate analysis showed that the degree of differentiation ( OR=1.75, 95% CI: 1.08-2.03, P=0.015) , depth of myometrial invasion ( OR=2.30, 95% CI: 1.43-2.84, P=0.021) , parametrial invasion ( OR=2.50, 95% CI: 1.76-2.97, P=0.018) and lymphovascular space invasion ( OR=1.96, 95% CI: 1.03-2.51, P=0.033) were independent factors for postoperative lymph node metastasis in patients with FIGO stage Ⅰ and Ⅱ cervical cancer. Multivariate logistic regression analysis showed that the levels of CD3 +, CD4 +, CD8 + T cells and the ratio of CD4 +/CD8 + in patients with stage Ⅰ and stage Ⅱ cervical cancer 1 day before surgery were independent influencing factors for postoperative lymph node metastasis (all P<0.05) . ROC curve analysis showed that the areas under the curve of CD3 +, CD4 +, CD8 + T lymphocytes levels and the ratio of CD4 +/CD8 + in stage Ⅰ patients 1 day before surgery for predicting postoperative lymph node metastasis were 0.86, 0.82, 0.83, 0.89, respectively, and those in stage Ⅱ patients were 0.90, 0.93, 0.87, 0.95, respectively. CD4 +/CD8 + ratio was significantly more effective in predicting postoperative lymph node metastasis than other indexes (all P<0.001) . Conclusions:The levels of CD3 +, CD4 + T lymphocytes, and the CD4 +/CD8 + ratio in patients with FIGO stage Ⅰ and Ⅱ cervical cancer are significantly higher in 1-30 days after surgery than before, while the level of CD8 + T lymphocytes is significantly lower than before. There is a significant correlation between T lymphocytes subsets and lymph node metastasis after surgery. In addition, low differentiation, depth of myometrial invasion ≥1/2, parametrial invasion, and lymphovascular space invasion are independent risk factors for postoperative lymph node metastasis.

This study investigates the pharmacokinetics and metabolic characteristics of three marine-derived piericidins as potential drug leads for kidney disease: piericidin A (PA) and its two glycosides (GPAs), glucopiericidin A (GPA) and 13-hydroxyglucopiericidin A (13-OH-GPA). The research aims to facilitate lead selection and optimization for developing a viable preclinical candidate. Rapid absorption of PA and GPAs in mice was observed, characterized by short half-lives and low bioavailability. Glycosides and hydroxyl groups significantly enhanced the absorption rate (13-OH-GPA > GPA > PA). PA and GPAs exhibited metabolic instability in liver microsomes due to Cytochrome P450 enzymes (CYPs) and uridine diphosphoglucuronosyl transferases (UGTs). Glucuronidation emerged as the primary metabolic pathway, with UGT1A7, UGT1A8, UGT1A9, and UGT1A10 demonstrating high elimination rates (30%-70%) for PA and GPAs. This rapid glucuronidation may contribute to the low bioavailability of GPAs. Despite its low bioavailability (2.69%), 13-OH-GPA showed higher kidney distribution (19.8%) compared to PA (10.0%) and GPA (7.3%), suggesting enhanced biological efficacy in kidney diseases. Modifying the C-13 hydroxyl group appears to be a promising approach to improve bioavailability. In conclusion, this study provides valuable metabolic insights for the development and optimization of marine-derived piericidins as potential drug leads for kidney disease.
Animals ; Male ; Mice ; Aquatic Organisms/chemistry* ; Biological Availability ; Cytochrome P-450 Enzyme System/metabolism* ; Glucuronosyltransferase/metabolism* ; Microsomes, Liver/metabolism* ; Molecular Structure ; Biological Products/pharmacokinetics* ; Pyridines/pharmacokinetics*

This study aimed to comprehensively examine the association of gallstones, cholecystectomy, and cancer risk. Multivariable logistic regressions were performed to estimate the observational associations of gallstones and cholecystectomy with cancer risk, using data from a nationwide cohort involving 239 799 participants. General and gender-specific two-sample Mendelian randomization (MR) analysis was further conducted to assess the causalities of the observed associations. Observationally, a history of gallstones without cholecystectomy was associated with a high risk of stomach cancer (adjusted odds ratio (aOR)=2.54, 95% confidence interval (CI) 1.50-4.28), liver and bile duct cancer (aOR=2.46, 95% CI 1.17-5.16), kidney cancer (aOR=2.04, 95% CI 1.05-3.94), and bladder cancer (aOR=2.23, 95% CI 1.01-5.13) in the general population, as well as cervical cancer (aOR=1.69, 95% CI 1.12-2.56) in women. Moreover, cholecystectomy was associated with high odds of stomach cancer (aOR=2.41, 95% CI 1.29-4.49), colorectal cancer (aOR=1.83, 95% CI 1.18-2.85), and cancer of liver and bile duct (aOR=2.58, 95% CI 1.11-6.02). MR analysis only supported the causal effect of gallstones on stomach, liver and bile duct, kidney, and bladder cancer. This study added evidence to the causal effect of gallstones on stomach, liver and bile duct, kidney, and bladder cancer, highlighting the importance of cancer screening in individuals with gallstones.
Humans ; Mendelian Randomization Analysis ; Gallstones/complications* ; Female ; Male ; Cholecystectomy/statistics & numerical data* ; Middle Aged ; Risk Factors ; Aged ; Adult ; Neoplasms/etiology* ; Stomach Neoplasms/epidemiology*

Objective:To analyze the levels of thrombin generation and activated protein C resistance (APC-R) in lupus anticoagulant (LA)-positive patients, and to assess their effectiveness in predicting thrombotic risk in these patients.Methods:Retrospective case-control study. A total of 185 patients with positve LA [91 males, 94 females; age (47.59±19.14) years] in Ruijin Hospital of Shanghai Jiaotong University School of Medicine from November 1st, 2024 to March 31st, 2025 were included. Patients were stratified into thrombotic ( n=91) and non-thrombotic groups ( n=94) based on clinical diagnosis and imaging evidence of thrombosis. The basic characteristics and routine laboratory coagulation levels of LA-positive patients were analyzed. Post-test plasma samples were collected from 43 cases with positive or strongly positive LA, categorized into thrombotic ( n=23) and non-thrombotic ( n=20) groups. Additionally, plasma was collected from 80 healthy controls [40 males and 40 females, age (38.37±15.74) years]. Using simple random sampling method, plasma samples from 10 selected males and 10 selected females were mixed to make 1 group of healthy control, thus accordingly resulted in a total of 4 healthy control groups. Thrombin generation assays (TGA) were then employed to measure prothrombin generation and activated protein C resistance (APC-R) levels in the healthy control, non-thrombotic, and thrombotic groups. One-way analysis of variance was utilized to compare thrombin generation and APC-R levels across these groups. Results:Among the routine laboratory coagulation indexes, the median levels of activated partial thromboplastin time (APTT), fibrin degradation product (FDP) and protein C (PC) in thrombotic group were 30.9 (28.8, 35.5) s, 2.5 (1.3, 2.8) mg/L, and 107.0 (93.0, 127.0)%, respectively, which were significantly higher compared with the non-thrombosis group (all P<0.05). However, between the thrombotic and non-thrombotic group, no statistically significant differences were observed for the levels of prothrombin time (PT), thrombin time (TT), fibrinogen (Fg), or D-dimer (D-D) ( P>0.05). The TGA results showed that the total thrombin generation, the maximal thrombin generation and APC-R levels of patients in the thrombotic group were (1 118.72±387.34) nmol/L·min, (106.01±59.00) nmol/L and (0.33±0.22), respectively, which were significantly higher compared with those in the non-thrombotic group (all P<0.05). Conclusion:Significantly increased thrombin generation and enhanced APC-R were present in the LA-positive patients with thrombosis, indicating the important values of thrombin generation and APC-R in assessing thrombosis risk among this population.

Objective:To investigate the relationship between alterations in dynamic functional connectivity (dFC) and spatial navigation abilities in individuals with subjective cognitive decline (SCD) across different Traditional Chinese Medicine (TCM) constitutions.Methods:Seventy-five participants with SCD, comprising 34 individuals with balanced constitutions and 41 individuals with biased constitutions, were recruited from the Affiliated Drum Tower Hospital of Nanjing University Medical School between August 2022 and January 2025. The participants underwent TCM constitution assessment, spatial navigation ability testing, and neuropsychological scale evaluation. Additionally, each participant was assessed using 3.0 T resting-state functional magnetic resonance imaging (rs-fMRI) and high-resolution T1-weighted imaging scans. Based on prior research, 20 spatial navigation-related regions of interest (ROIs) were defined. Afterwards, rs-fMRI time series were segmented using a sliding time window approach before calculating the dFC within the spatial navigation brain network.Results:Compared to the balanced constitution group, the biased constitution SCD group showed significantly lower scores on the Mini-Mental State Examination (MMSE) ( z=-3.05, P=0.002) and the Auditory Verbal Learning Test (AVLT) measures: immediate recall ( z=-2.12, P=0.035), short-delay recall ( z=-2.22, P=0.026), long-delay recall ( z=-2.88, P=0.004), cued recall ( z=-2.91, P=0.004), and recognition ( z=-2.20, P=0.028). They also exhibited significantly higher average error distances in ego-allocentric navigation ( z=-2.28, P=0.023), egocentric navigation ( z=-2.31, P=0.021), and delayed navigation ( z=-2.02, P=0.043). Participants with SCD who had a biased constitution also demonstrated significantly reduced dFC between the left parahippocampal gyrus (PHG) and left prefrontal cortex (PFC) ( t=2.43), right precuneus and right retrosplenial cortex (RSC) ( t=2.96), and left inferior parietal lobule (IPL) and left hippocampus ( t=2.42) (all P<0.05, Bonferroni-corrected). Conversely, the dFC was significantly increased between the right PHG and left PFC ( t=-2.29, P<0.05, Bonferroni-corrected). Significant correlations were also found in participants with SCD who had biased constitutions: the dFC between the left PHG and left PFC positively correlated with the egocentric navigation average total error ( r=0.34, P=0.030) and negatively correlated with the visuospatial memory cognitive domain ( r=-0.35, P=0.026); the dFC between the left IPL and left hippocampus negatively correlated with the egocentric navigation average total error ( r=-0.32, P=0.043); and the dFC between the right PHG and left PFC positively correlated with the delayed navigation average total error ( r=0.33, P=0.037). The area under the ROC curve for the combined differences in cognitive assessments, spatial navigation behavior, and navigation-related brain network dFC was 0.966 in predicting biased constitution versus balanced constitution in participants with SCD. Conclusions:Individuals with SCD and biased constitutions demonstrated poorer spatial navigation ability, possibly due to altered dFC within the spatial navigation brain network. Furthermore, the integrated model based on spatial navigation behaviors and dFC exhibited a high predictive value in distinguishing between individuals with SCD who had balanced and biased constitutions.

Objective:To explore the potential categories of symptom characteristics of early breast cancer patients undergoing postoperative chemotherapy, analyze the differences of symptoms among different categories of patients, and compare their quality of life according to different categories.Methods:This was a cross-sectional study. From January to June 2023, 240 patients with early breast cancer who received chemotherapy after surgery in General Hospital of Ningxia Medical University were selected by convenience sampling. They were investigated by general information questionnaire, Memory Symptom Assessment Scale, and Functional Assessment of Caner Therapy-Breast Cancer. Mplus 8.3 was used to carry out potential profile analysis and identify the potential categories of symptom characteristics of early breast cancer patients undergoing postoperative chemotherapy. Binary Logistic regression analysis was used to determine the influencing factors of symptom characteristics. SPSS 26.0 software was used to compare the differences in quality of life scores of patients undergoing postoperative chemotherapy for different categories of early breast cancer.Results:Totally 233 valid questionnaires were ultimately collected, with an age of 50.85 ± 8.09. There were two potential categories of postoperative chemotherapy patients with early breast cancer: low symptom troubled group (159 cases, 68.2%) and high symptom troubled group (74 cases, 31.8%). The quality of life score of the high symptom distress group was (76.84 ± 13.15) points, which was significantly lower than (89.56 ± 11.29) points of the low symptom distress group, and the difference was statistically significant ( t=7.18, P<0.01). Logistic regression analysis showed that patients with early breast cancer who had financial burden after postoperative chemotherapy were more likely to belong to the group with high symptoms [ OR (95% CI) was 3.028 (1.434-6.394), P<0.01]. Postoperative chemotherapy patients with early breast cancer who had satisfactory sleep at night are more likely to belong to the group with low symptoms [ OR(95% CI) was 0.446 (0.217-0.920), P<0.05]. Conclusions:There is population heterogeneity in the symptom characteristics of patients with early breast cancer undergoing postoperative chemotherapy. and economic burden and night sleep are the influencing factors of symptom distress categories of breast cancer patients. It is suggested that medical staff should give individualized and targeted intervention measures centered on patients′ needs according to different types of population characteristics, so as to reduce the symptom burden and improve their quality of life.

Objective:To explore the potential categories of symptom characteristics of early breast cancer patients undergoing postoperative chemotherapy, analyze the differences of symptoms among different categories of patients, and compare their quality of life according to different categories.Methods:This was a cross-sectional study. From January to June 2023, 240 patients with early breast cancer who received chemotherapy after surgery in General Hospital of Ningxia Medical University were selected by convenience sampling. They were investigated by general information questionnaire, Memory Symptom Assessment Scale, and Functional Assessment of Caner Therapy-Breast Cancer. Mplus 8.3 was used to carry out potential profile analysis and identify the potential categories of symptom characteristics of early breast cancer patients undergoing postoperative chemotherapy. Binary Logistic regression analysis was used to determine the influencing factors of symptom characteristics. SPSS 26.0 software was used to compare the differences in quality of life scores of patients undergoing postoperative chemotherapy for different categories of early breast cancer.Results:Totally 233 valid questionnaires were ultimately collected, with an age of 50.85 ± 8.09. There were two potential categories of postoperative chemotherapy patients with early breast cancer: low symptom troubled group (159 cases, 68.2%) and high symptom troubled group (74 cases, 31.8%). The quality of life score of the high symptom distress group was (76.84 ± 13.15) points, which was significantly lower than (89.56 ± 11.29) points of the low symptom distress group, and the difference was statistically significant ( t=7.18, P<0.01). Logistic regression analysis showed that patients with early breast cancer who had financial burden after postoperative chemotherapy were more likely to belong to the group with high symptoms [ OR (95% CI) was 3.028 (1.434-6.394), P<0.01]. Postoperative chemotherapy patients with early breast cancer who had satisfactory sleep at night are more likely to belong to the group with low symptoms [ OR(95% CI) was 0.446 (0.217-0.920), P<0.05]. Conclusions:There is population heterogeneity in the symptom characteristics of patients with early breast cancer undergoing postoperative chemotherapy. and economic burden and night sleep are the influencing factors of symptom distress categories of breast cancer patients. It is suggested that medical staff should give individualized and targeted intervention measures centered on patients′ needs according to different types of population characteristics, so as to reduce the symptom burden and improve their quality of life.