ObjectiveThis paper aims to investigate and evaluate the staged efficacy and safety of the representative empirical prescription of the “Zhu Ke Jiao” theory， Qijia Rougan prescription， combined with entecavir in the treatment of hepatic fibrosis in chronic hepatitis B. MethodsA multicenter randomized controlled clinical study was conducted， and 101 patients diagnosed with chronic hepatitis B-related hepatic fibrosis （CHB-HF） who met the diagnosis and inclusion criteria were randomly assigned to an observation group （Qijia Rougan prescription + entecavir） and a control group （entecavir）. The treatment duration was 24 weeks. Liver stiffness measurement （LSM）， fibrosis-4 index （FIB-4）， portal vein diameter， hepatitis B serology， biochemical indicators， hepatic fibrosis markers in serum ［hyaluronic acid （HA）， laminin （LN）， procollagen Ⅲ peptide （PⅢP）， and type Ⅳ collagen （Ⅳ-C）］， and traditional Chinese medicine syndrome scores were used as efficacy evaluation indicators. Efficacy assessments and explorations of different staged subgroups of Qijia Rougan prescription were conducted according to LSM values based on the Metavir pathological staging standard. ResultsA total of 98 cases were included for statistical analysis， with 49 cases in the observation group and 49 in the control group. The general data of the patients in both groups were comparable. Compared with the same group before treatment， the observation group showed a significant reduction in LSM and FIB-4 （P<0.01）， as well as notable improvements in LN， Ⅳ-C， and various TCM syndrome scores （P<0.05， P<0.01）. When compared to the control group after treatment， the observation group demonstrated significant improvements in LSM， FIB-4， and various TCM syndrome score indicators （P<0.05， P<0.01）， indicating that the observation group performed better than the control group. Subgroup analysis of the regression of hepatic fibrosis stages showed that compared to the same group before treatment， the observation group had better improvement in regression of stages F2 and F3 （P<0.05）. When compared to the control group after treatment， the observation group exhibited superior improvement in regression of stage F3 （P<0.05）. No adverse events occurred in either group during the treatment period. ConclusionCompared with entecavir alone， the combination of Qijia Rougan prescription and entecavir significantly improves the degree of hepatic fibrosis and clinical TCM symptoms in patients. The optimal intervention period is primarily during stage F3， which is a potential “interception” point of the “Zhu Ke Jiao” theory.

AIM: To explore the effect of Kappa angle on changes in visual quality and stereoscopic acuity after regional refractive multifocal intraocular lens(MIOL)implantation in patients with high myopia complicated by cataract.METHODS:A retrospective analysis was conducted on data from patients with normal Kappa angle and high myopia complicated by cataract treated at the hospital from January 2024 to January 2025. Patients were divided into two groups based on the median preoperative Kappa angle(0.182 mm): Group A(00.05). The actual residual astigmatism in Group A was lower than that in Group B at 7 d, 1 and 3 mo postoperatively(all P<0.001). The proportion of eyes with near stereoscopic acuity <60″ was higher in Group A than in Group B, while the proportion of eyes with near stereoscopic acuity between 400″ and 3000″ was lower in Group A than in Group B(both P<0.05). Meanwhile, the incidence of visual disturbances in Group B was higher than that in Group A(P<0.05).CONCLUSION: The Kappa angle has no significant effect on visual acuity or objective visual quality in patients with normal Kappa angle and high myopia complicated by cataract after regional refractive MIOL implantation. However, patients with a larger Kappa angle exhibit higher postoperative residual astigmatism, worse near stereoscopic acuity, and a higher incidence of vision-related adverse symptoms.

Objective: To explore the association of physical activity and sugar sweetened beverage consumption with psychological sub health among middle school students in Bao an District, Shenzhen, so as to provide a reference for adolescent mental health promotion. Methods: A questionnaire survey was conducted in November 2024 by a stratified cluster random sampling method to select 6 926 junior and senior middle school students from 5 middle schools in Shenzhen. The questionnaire from Youth Risk Behavior Surveillance System was used to assess the consumption of sugar sweetened beverages, and physical activity Rating Scale was used to assess the level of physical activity, and Brief Instrument on Psychological Health of Youths was used to evaluate the psychological sub health status. The Chi -square test was used to analyze the differences in the detection rates of psychological sub health among different groups of middle school students, and a multivariate Logistic regression model was established to analyze the effects of physical activity and sugar sweetened beverage consumption and their combined effects on the psychological sub health of middle school students. Results: The detection rate of psychological sub health among middle school students in Bao an District, Shenzhen was 18.93%. Multivariate Logistic regression analysis showed that, after controlling for confounding factors such as gender, school stage, family residence, family economic status, parental literacy, academic stress and number of friends, lack of physical activity or excessive sugar sweetened beverage consumption were associated with increased risks of psychological sub health among middle school students ( OR =1.36, 1.45); and the highest risk of psychological sub health was found in middle school students who were lack of physical activity and excessive sugar sweetened beverage consumption ( OR =2.59) ( P <0.01). Further analysis by school stages showed that junior high school students with sufficient physical activity and excessive intake of sugary drinks ( ROR =2.10), lack of physical activity and excessive intake of sugary drinks ( ROR =2.31) were at higher risks of psychological sub health than senior high school students( P <0.05). Conclusions Insufficient physical activity and excessive sugar sweetened beverage consumption are closely associated with an increased risk of psychological sub health among middle school students. Effective interventions should be targeted to reduce the risk of psychological sub health problems among middle school students.

Objective Utilizing patient journey mapping to decipher disease management behaviors,barriers,and needs in young and middle-aged liver transplant recipients,providing implications for self-management optimization and quality of life improvement.Methods Using purposive sampling,12 young and middle-aged liver transplant patients who attended outpatient clinics or were hospitalized in liver transplant center of a tertiary hospital in Qingdao were selected for semi-structured interviews from September to November 2024.Thematic extraction and analysis were performed using Colaizzi's 7-step analysis,ultimately resulting in the development of a patient journey map.Results The journey stages were divided into transplantation decision-making period,transplantation waiting period,perioperative period,and post-discharge management period,and the journey key elements were designed as behaviors,barriers,and needs.A total of 25 themes were extracted,including behaviors(such as referrals to higher-level hospitals,verification of treatment options),barriers(such as lack of decision-making autonomy,health information-seeking barriers),and needs(such as shared decision-making,financial assistance).Ultimately,resulting in a map of the disease management journey for young and middle-aged liver transplant recipients.Conclusion The behaviors,barriers,and needs in disease management among young and middle-aged liver transplant recipients demonstrate distinct phase-specific patterns.Healthcare providers should deliver precise and dynamic interventions tailored to each clinical phase,aiming to foster optimal self-management behaviors,address phase-specific banriers,and meet evolving patient needs throughout the transplant continuum.

To investigate the expression level of costimulatory molecule B7-H3 in the tumor tissues and the level of soluble costimulatory molecule B7-H3 (sB7-H3) in the serum of patients with colorectal cancer (CRC), so as to evaluate the clinical value of sB7-H3 in auxiliary diagnosis of CRC. A cross-sectional study design was adopted. A total of 232 CRC patients, 87 patients with benign colorectal diseases, and 59 healthy subjects who were treated in Shanghai Eighth People′s Hospital from January 2020 to December 2022 were selected. The levels of sB7-H3, CEA, CA199, CA724 and CA50 in the serum were detected. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of sB7-H3 and the above-mentioned tumor markers for colorectal cancer (CRC). The expression levels of B7-H3 in CRC tissues and benign colorectal disease tissues were detected by immunohistochemistry. The relationship between the levels of sB7-H3 and clinicopathological features was analyzed statistically. The results showed that compared with the benign disease group or the healthy control respectively, the serum levels of sB7-H3, CEA, CA199, CA724 and CA50 in the CRC group were significantly increased, and the differences were statistically significant ( P<0.05). In the CRC group, the serum levels of sB7-H3 showed a weak positive correlation with CA50, CEA and CA724 (the r values were 0.220, 0.217 and 0.182 respectively; the P values were 0.005,<0.001 and 0.024 respectively), and there was no significant correlation with CA199 (the r value was 0.162; the P value were 0.051). The areas under the curve (AUC) of sB7-H3, CEA, CA199, CA724 and CA50 for diagnosing CRC were 0.862, 0.774, 0.646, 0.677 and 0.644 respectively, and the cut-off values were 20.67 ng/ml, 10.74 U/ml, 3.17 ng/ml, 3.16 U/ml, and 22.55 U/ml, respectively. Taking 20.67 ng/ml as the cut-off value, the positive rate of sB7-H3 in CRC was 62.9%, which was significantly higher than that in patients with benign colorectal diseases (35.6%) and the healthy control group (10%) ( χ2=81.995, P<0.001; χ2=103.56, P<0.001). The positive rates of sB7-H3 and CEA in patients with pathological stages Ⅲ and Ⅳ were significantly higher than those in patients with stages Ⅰ and Ⅱ ( χ2=82.876, P<0.001; χ2=22.617, P<0.001). The positive rate of sB7-H3 in patients with pathological stages Ⅰ and Ⅱ was 56.2%, which was significantly higher than that of CEA (38%) ( χ2=50.378, P<0.001). Immunohistochemistry showed that B7-H3 positive staining was mainly distributed in the cytoplasm. The positive expression rate of B7-H3 in CRC (75.8%) was significantly higher than that in benign colorectal diseases (15.4%) ( χ2=16.133, P<0.001). The serum level of sB7-H3 in CRC patients was positively correlated with the expression level of B7-H3 in tumor tissues ( r=0.766, P<0.001). The serum level of sB7-H3 was significantly correlated with distant metastasis and pathological stage of CRC ( W=899, P=0.002; H=10.465, P=0.015). In conclusion, serum level of sB7-H3 may have certain clinical value in the auxiliary diagnosis of CRC.

Objective:To investigate the association between serum 25-hydroxyvitamin D [25(OH)D] levels and 24-h urinary calcium excretion (24-h UCaE) and hypercalciuria in Chinese adults.Methods:This cross-sectional study was conducted from March 2022 to March 2023 in nine cities in China and included 1 239 residents. Demographic characteristics were collected through questionnaires and physical examinations, fasting blood samples were assessed for bone metabolism indicators, and 24-h urine samples were used to determine the 24-h UCaE. Multiple linear regression analysis was used to explore the relationship between serum 25(OH)D and 24-h UCaE and bone metabolism indexes. The relationship between serum 25(OH)D and hypercalciuria was analyzed using a multiple logistic regression model combined with restricted cubic spline modeling.Results:The mean participant age was (47.9±18.1) years, of which 453 (36.6%) were male. The percentages of vitamin D sufficiency, insufficiency, and deficiency were 7.6% (94/1 239), 29.0% (359/1 239), and 63.4% (786/1 239), respectively. The multiple linear regression model showed that after adjusting for the covariates the 24-h UCaE gradually increased with higher levels of 25(OH)D ( P overall <0.001, P nonlinear <0.001). The logistic regression analysis revealed that compared with the vitamin D deficient group, the OR for the prevalence of hypercalciuria in the vitamin D sufficient and vitamin D insufficient groups were 3.290 (95% CI 1.745 to 6.202) and 3.742 (95% CI 2.458 to 5.697), respectively. The results of the restricted cubic spline modeling showed a positive nonlinear relationship between 25(OH)D and the prevalence of hypercalciuria ( P overall <0.001, P nonlinear <0.001). The prevalence of hypercalciuria increased when 25(OH)D was >17.00 μg/L and peaked at 26.71 μg/L, after which there was a decreasing trend in the prevalence of hypercalciuria with increasing 25(OH)D. Conclusion:Associations between serum 25(OH)D levels and urinary calcium excretion and the prevalence of hypercalciuria were observed in the Chinese adult population.

A 51-year-old female patient was admitted to the hospital due to abdominal pain, vomiting, and fever lasting for one day. The clinical diagnosis was acute pelvic inflammatory disease and adenomyosis. Empirical treatment with cefoperazone/sulbactam sodium was given. Six days later, the blood culture reported Campylobacter jejuni ( C. jejuni), and nine days later, the patient was discharged with negative blood culture. The strain was identified as C. jejuni by morphology and matrix-assisted laser de-sorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS). Whole-genome sequencing predicted that the multi-locus sequence type was ST7268 (ST464 complex), which was a new invasive clone of foodborne C. jejuni with typical molecular characteristics of high vitality, high virulence and high resistance.

Objective To analyze the burden and epidemic trends of gastric cancer in China from 1990 to 2021, and to provide a scientific basis for the formulation of effective prevention and control strategies. Methods　Data from the 2021 Global Burden of Disease (GBD) database were used to extract the number of the incidence, prevalence, and death cases, as well as the disability-adjusted life years (DALY) for gastric cancer in China from 1990 to 2021. The corresponding crude rates and age-standardized rates were calculated. The Joinpoint regression model was employed to analyze the trends in the burden of gastric cancer, and a comprehensive examination was conducted from multiple dimensions including age, gender, and time. Results From 1990 to 2021, the age-standardized incidence rate (ASIR) of gastric cancer in China decreased from 48.03 per 100,000 to 29.05 per 100,000, the age-standardized prevalence rate (ASPR) decreased from 67.17 per 100,000 to 57.23 per 100,000, the age-standardized mortality rate (ASMR) decreased from 46.05 per 100,000 to 21.51 per 100,000, and the age-standardized DALY rate (ASDR) decreased from 1181.61 per 100,000 to 501.26 per 100,000. The AAPCs of ASIR, ASPR, ASMR, and ASDR were -1.61%, -0.50%, -2.44%, and -2.75%, respectively. The incidence, prevalence, mortality and DALY rates showed a trend of increasing first and then decreasing with age. Although females had higher incidence, prevalence, mortality, and DALY numbers in the older age groups, males exhibited higher crude rates across all age groups. Conclusion　The overall disease burden of gastric cancer in China showed a downward trend from 1990 to 2021, and men and middle-aged and elderly people are the key populations for prevention and control efforts.

Objective To explore the correlation of MET status in patients with advanced prostatic acinar adenocarcinoma with the clinical pathological parameters and prognosis. Methods The specimen from 135 patients with advanced prostatic acinar adenocarcinoma was included. The expression of c-MET protein was detected via immunohistochemistry, and MET gene amplification was assessed by fluorescence in situ hybridization. The relationships of c-MET expression and gene amplification with clinicopathological features and prognosis were analyzed. Results The positive expression rate of c-MET was 52.60% (71/135). Compared with the c-MET expression in adjacent tissues, that in tumor tissues showed lower heterogeneous expression. Among the cases, 1.71% (2/117) exhibited MET gene polyploidy, but no gene amplification was detected. Positive c-MET expression was significantly correlated with high Gleason scores and grade groups (P=0.0073). However, no significant relationship was found between c-MET expression and progression-free survival or post-treatment t-PSA levels. Conclusion c-MET protein is expressed at a relatively low level in advanced prostatic acinar adenocarcinoma, suggesting that c-MET may not be a viable target for ADC drug development in prostatic acinar adenocarcinoma.