Background Liver cancer is one of the common malignant tumors. Phthalates (PAEs), as a widely used class of plasticizers, can participate in the occurrence and progression of liver diseases through multiple pathways. Objective To explore the association between PAEs exposure and liver cancer risk and to provide a scientific basis for the prevention of environment-related tumor risk events. Methods Chi-square test and logistic regression were employed to analyze data from the National Health and Nutrition Examination Survey (NHANES) database between 2001 and 2018, to investigate the association between PAEs exposure and liver cancer. Network toxicology combined with machine learning was used to screen independent prognostic genes associated with PAEs and liver cancer, and to evaluate their correlations with tumor immunity, tumor pathway activation, and tumor drug resistance. Finally, the prediction results were validated using GEO datasets, molecular docking, and molecular dynamics simulations. Results After screening, 11378 eligible samples were obtained from the NHANES database, including 108 patients with liver cancer and 11270 healthy controls. The logistic regression analysis revealed that exposure to nine types of PAEs was positively correlated with liver cancer (OR > 1, P < 0.05). The network toxicology analysis indicated that the association between PAEs exposure and liver cancer was related to three independent prognostic genes: uridine-cytidine kinase 2 (UCK2), glucose-6-phosphate dehydrogenase (G6PD), and albumin (ALB). These three independent prognostic genes were significantly associated with the tumor immune microenvironment, tumor pathway activation, and tumor drug resistance, and exhibited complex interactions with each other. All three independent prognostic genes showed significant differential expression in the validation datasets GSE58043 and GSE115469 (P < 0.05). The results of both molecular docking and molecular dynamics simulations confirmed that these three independent prognostic genes can freely bind to PAEs and form stable complexes. Conclusion Exposure to PAEs is positively correlated with liver cancer. The intrinsic association between the two may involve metabolic disorders, immunosuppression, and activation of inflammatory and tumor-related pathways.

ObjectiveTo explore the effect of blood flow restriction training (BFRT) under different intensities combined with low-intensity resistance training (LIRT) on motor function in stroke patients with frailty. MethodsFrom August, 2024 to August, 2025, 200 elderly ischemic stroke patients with frailty from Affiliated Hospital, North China University of Science and Technology were randomized into control group and observation groups 1, 2 and 3, with 50 cases in each group. All the groups received 30% 1RM resistance training. In addition, the observation groups received BFRT of 40%, 50% and 60% arterial occlusion pressure (AOP), respectively. Before training, and four and eight weeks after training, their motor function was evaluated with Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and Fugl-Meyer Assessment-Lower Extremities (FMA-LE), grip strength, 10-Metre Walk Test (10MWT) and Berg Balance Scale (BBS); Fried Frailty Phenotype (FFP) was used to assess frailty status; and the score of modified Ashworth Scale (MAS), blood pressure and resting heart rate were recorded. ResultsOne case dropped out in each group. For the scores of FMA-UE and FMA-LE, the grip strength of both hands, the time of 10MWT and the score of BBS, the main effects of group and time, and interaction effect were all significant (F > 2.745, P < 0.05); four weeks after training, the above indexes were better in the observation groups than in the control group (P < 0.05); eight weeks after training, the scores of FMA-UE and FMA-LE, the grip strength of both hand and the score of BBS were better in the observation group 3 than in the observation groups 1 and 2 (P < 0.05), and the time of 10MWT was better in the observation group 3 than in the observation group 1 (P < 0.05). For the score of FFP, the main effect of group was significant (F = 688.360, P < 0.001), however, the effects of time and interaction were not significant (P > 0.05). For the score of MAS, the main effect of group was significant (F = 7.171, P = 0.008), however, the effects of time and interaction were not significant (P > 0.05). For the blood pressure and resting heart rate, the main effects of group and time, and interaction effect were not significant (P > 0.05). ConclusionBFRT under different intensities combined with LIRT can safely improve the motor function, grip strength, walking ability in elderly stroke patients, and 60% AOP may be more effective.

Alzheimer's disease （AD） is a chronic neurodegenerative disorder with an unclear pathogenesis and currently no cure. It is characterized by a long disease course， diverse symptoms， and a persistent， difficult-to-treat nature， which greatly affects the quality of life of elderly patients. Traditional Chinese medicine （TCM） offers significant advantages in the treatment of AD， featuring multi-component， multi-target， and multi-pathway characteristics， with few adverse reactions and good safety. Angelica sinensis is a commonly used medicinal herb. As a frequently used clinical medicine for nourishing and activating blood， it shows significant efficacy in treating blood deficiency syndrome. In recent years， studies have revealed that A. sinensis exhibits significant activity in the prevention and treatment of AD. It contains various active components such as organic acids， volatile oils， and polysaccharides， and possesses pharmacological effects including anti-inflammatory， antioxidant， hepatoprotective， and neuroprotective properties. This article summarizes and outlines the mechanisms of A. sinensis and its compound formulas in the prevention and treatment of AD， providing a reference for its clinical application and the treatment of AD.

[Objective] To explore the influencing factors of quality monitoring index on the nucleic acid pooling detection mode and continuously improve the detection quality of nucleic acid laboratory. [Methods] The quality monitoring indicators (NAT reactive rate, NAT resolution reactive rate, NAT invalid batch rate, NAT invalid result rate, equipment failure rate) and causes of invalidity in our laboratory from January 1, 2020 to December 31, 2022 were retrospectively analyzed. The quality monitoring indicators of the laboratory during 2020 to 2022 were compared longitudinally. The quality monitoring indicators of the laboratory in 2022 were compared horizontally with the overall level in Shandong for the same period to find the differences. [Results] From 2020 to 2022, a total of 218 686 samples were detected, the NAT reactive rate was 0.15‰ (32 samples in total), the resolution reactive rate was 39.02%, the invalid batch rate was 1.06%, the invalid result rate was 1.18%, and the equipment failure rate was 3.58%. There were no differences in the NAT reactive rate, NAT resolution reactive rate and NAT invalid batch rate among different years (P>0.05), but there were differences in the invalid result rate (P<0.05). Equipment failure was the main cause of invalid results (56.53%). Compared with other laboratories in Shandong, there were differences in the NAT reactive rate and invalid result rate (P<0.05). There were differences in the reaction rate, resolution rate and invalid result rate among different reagents (P<0.05). Compared with other two laboratories using the same manufacturer's reagent, there were differences in the reactive rate and invalid result rate (P<0.05), but no difference in the resolution rate and invalid batch rate (P>0.05). [Conclusion] Establishing quality indexes for process control and regular analysis can timely detect potential risks in laboratory operation. The use of quality indicators to implement self-comparison and inter-laboratory comparison can help the laboratory systematically and scientifically evaluate its own operating status and formulate corresponding quality management strategies, thereby improving the laboratory's testing capacity and ensure the safety of blood use.

Chronic atrophic gastritis （CAG）， a common digestive system disease， has an unclear pathogenesis. Currently， it is mostly believed to be related to Helicobacter pylori （Hp） infection， immune factors， dietary factors， bile reflux， long-term use of antibiotics and anti-inflammatory drugs， and other factors. Ferroptosis is a regulated cell death mechanism that is iron-dependent and characterized by disruption of iron metabolism and accumulation of lipid peroxides. More and more studies have found that ferroptosis is closely related to the onset of CAG. Professor LI Diangui， a master of traditional Chinese medicine， first proposed the turbid toxin theory， which holds that spleen deficiency and turbid toxin is the main pathogenic mechanism of CAG. Abnormal iron metabolism regulation is a prerequisite for the accumulation of turbid toxin in CAG， and ferroptosis is in accordance with the pathogenic mechanism （spleen deficiency and turbid toxin） of CAG. This article explores the pathological mechanism of spleen deficiency and turbid toxin in CAG from the perspectives of iron metabolism， oxidative stress， and lipid peroxidation， providing theoretical support of traditional Chinese medicine for the modern research on CAG. It enriches the modern scientific connotation of the turbid toxicity theory and provides new ideas and breakthrough points for the clinical treatment of CAG.

Chronic atrophic gastritis （CAG）， a common digestive system disease， has an unclear pathogenesis. Currently， it is mostly believed to be related to Helicobacter pylori （Hp） infection， immune factors， dietary factors， bile reflux， long-term use of antibiotics and anti-inflammatory drugs， and other factors. Ferroptosis is a regulated cell death mechanism that is iron-dependent and characterized by disruption of iron metabolism and accumulation of lipid peroxides. More and more studies have found that ferroptosis is closely related to the onset of CAG. Professor LI Diangui， a master of traditional Chinese medicine， first proposed the turbid toxin theory， which holds that spleen deficiency and turbid toxin is the main pathogenic mechanism of CAG. Abnormal iron metabolism regulation is a prerequisite for the accumulation of turbid toxin in CAG， and ferroptosis is in accordance with the pathogenic mechanism （spleen deficiency and turbid toxin） of CAG. This article explores the pathological mechanism of spleen deficiency and turbid toxin in CAG from the perspectives of iron metabolism， oxidative stress， and lipid peroxidation， providing theoretical support of traditional Chinese medicine for the modern research on CAG. It enriches the modern scientific connotation of the turbid toxicity theory and provides new ideas and breakthrough points for the clinical treatment of CAG.

Objective:To explore the application effect of interventional teaching in undergraduate nursing internship in operating rooms.Methods:A total of 98 undergraduate nursing students who worked as interns in the operating room during the two school years from June 2022 to February 2024 were selected as research subjects. Students who entered the program from June 2022 to February 2023 were enrolled into control group (50 students), and those who entered from June 2023 to February 2024 were enrolled into experimental group (48 students). The students conducted their internships in batches (with 4 to 5 students per subgroup) following a departmental rotation mechanism. The control group received routine teaching, while the experimental group received interventional teaching. At the end of the internship, the two groups were compared for their performance, including basic and specialized knowledge, skills, theory, and operation; patient reception, tripartite verification, and intraoperative cooperation for planned video-assisted thoracoscopic bullectomy; and their degrees of satisfaction with the teaching. The t-test was performed using SPSS 26.0. Results:The experimental group achieved significantly higher theoretical scores than the control group [(91.69±4.51) vs. (74.52±6.06)]. Meanwhile, the experimental group was significantly superior to the control group in operational performance, including surgical hand disinfection [(96.08±1.93) vs. (92.14±3.07)] and wearing and removing sterile surgical gowns and sterile gloves [(97.00±1.75) vs. (94.10±3.48)). In terms of specialized knowledge and skills, specifically, patient reception and third-party verification in simulated surgical nursing, the experimental group achieved higher scores than the control group [(98.77±0.69) vs. (94.04±2.56); (98.54±0.65) vs. (94.64±2.65)]. In terms of intraoperative cooperation, the experimental group showed a slight advantage over the control group. The experimental group had higher degrees of satisfaction with teaching than the control group, including course design, implementation methods, course arrangement, teaching attitude, teaching methods, degree of participation, gains, and assistance.Conclusions:After adopting interventional teaching, the teaching effect for nursing internship in operating rooms is better. It improves the various assessment scores of nursing students, enhances their comprehensive abilities and degrees of satisfaction with teaching, and reinforces the teaching abilities in operating rooms.

Objective:To investigate improvement effect of astragalus polysaccharides(APS)on recurrent spontaneous abor-tion(RSA)in rats and its mechanism.Methods:Pregnant rats were randomly grouped into control group,RSA group,dexamethasone group,APS low,medium,high doses groups and LY294002 group.A RSA rat model was constructed,uterine organ index and embryo loss rate were calculated.HE staining was applied to observe histopathology changes of decidua.ELISA was applied to detect serum levels of estradiol(E2),progesterone(P),prolactin(PRL),cytokines such as IFN-γ,TNF-α,IL-4 and IL-10.Immunohisto-chemistry was applied to detect expression of decidua progesterone receptor(PR).Western blot was applied to detect expression of PI3K/AKT signaling pathway proteins of decidua.Results:Compared with control group,desquamated cells of rats in RSA group exhibit edema,disordered arrangement,nuclear pyknosis and disappearance,and decidua reduced interstitial blood vessels,uterine organ index,serum IL-4,IL-10,E2,P,PRL levels,decidua PR,p-PI3K,p-AKT expressions were obviously reduced,embryo loss rate,IFN-γ and TNF-α levels were obviously increased(P<0.05);compared with RSA group,morphology of decidual cells and interstitial blood vessels in dexamethasone group and APS low,medium and high doses groups were improved,uterine organ index,serum IL-4,IL-10,E2,P,PRL levels,decidua PR,p-PI3K,p-AKT expressions were obviously increased,embryo loss rate,serum IFN-γ and TNF-α levels were obviously reduced(P<0.05);LY294002 reversed improvement effect of high-dose APS on adverse pregnancy out-comes in RSA rats(P<0.05).Conclusion:APS can reduce miscarriage rate of RSA rats,regulate Th1/Th2 balance,whose mecha-nism may be related to activation of PI3K/AKT.

Objective To investigate the effects of gut microbiota regulation combined with exercise rehabilitation on non-motor symptoms and neurological function in Parkinson's disease patients.Methods A total of 154 Parkinson's disease patients admitted to our hospital from January 2022 to January 2024 were selected as the subjects of the study.Using a random number table,these 154 patients were evenly divided into a control group and a treatment group,with 77 patients in each group.Both groups received standard treatments,but the control group also underwent exercise rehabilitation therapy,while the treatment group received probiotic supplementation and exercise rehabilitation therapy.The effectiveness of the two groups was then compared.Results Following the 12 weeks,24 weeks therapeutic regimen,The treatment group showed significantly better outcomes(P<0.05).Clinically meaningful reductions were observed in Hoehn-Yahr staging,alongside decreased scores on standardized instruments assessing psychiatric symptoms HAMA,HAMD,SCOPA-AUT,UPDRS Ⅰ-IV and PDSS(P<0.05).Concurrently,the study group exhibited enhanced MMSE(P<0.05).Fecal microbiome analyses revealed a favorable ecological shift characterized by increased colonization of beneficial genera Bifidobacterium and Lactobacillus,with concomitant suppression of pathobionts Enterococcus and Enterobacteriaceae.Gait analysis revealed increased step length,speed,and frequency in the treatment group(P<0.05).Conclusion Patients with Parkinson's disease who received probiotics combined with exercise rehabilitation treatment could effectively improve non-motor symptoms and neurological function,while promoting the balance of intestinal flora,and reduce clinical symptoms.

Objective To comprehensively evaluate the prevalence of and influencing factors for low-level viraemia(LLV)in Chinese patients receiving antiviral therapy for human immunodeficiency virus(HIV)infection through systematic review and Meta-analysis.Methods Cochrane Library,Web of Science,Embase,PubMed,China Bio-medicine(CBM),VIP,China National Knowledge Infrastructure(CNKI),and Wanfang Data were systematically retrieved.Retrieval time was from the establishment of the database to February 2024.Literatures related to the prevalence of LLV in patients receiving antiviral therapy for HIV infection were retrieved using combination of key-words and free words.Stata 16.0 software was used for Meta-analysis.Random effects model was adopted to calcu-late the combined prevalence and its 95％confidence interval.Results A total of 15 papers were included in analy-sis,involving 191 212 specimens.Meta-analysis random effects model showed that the prevalence of LLV in Chinese patients receiving antiviral therapy for HIV infection was 13.00％(95％CI:7.82％-19.24％).Subgroup analysis showed that cross-sectional studies,northern regions,males,age ≥50 years,heterosexual transmission routes,baseline CD4+T lymphocyte count＜200 cells/μL,and patients who had ever changed therapy regimens had higher LLV prevalence.Conclusion The prevalence of LLV in patients receiving antiviral therapy for HIV infection is re-latively higher.Attention should be paid to such high-risk population,and appropriate antiviral therapy schemes should be selected as early as possible.Timely intervention is necessary when LLV occurs.