ObjectiveTo investigate the effects of jatrorrhizine on endogenous metabolites and metabolic pathways in the mouse model of ulcerative colitis. MethodsThirty male C57BL/6J mice were randomly divided into the normal group， the model group， the low-dose and high-dose jatrorrhizine groups （0.04， 0.16 g·kg^-1）， and the mesalazine group （0.52 g·kg^-1）The mouse model of ulcerative colitis was established with 3% dextran sulfate sodium （DSS） and treated with different doses of jatrorrhizine by gavage. The changes in body weight， colon length， disease activity index （DAI）， and colonic histopathology were analyzed to evaluate the therapeutic effects of jatrorrhizine. UPLC-Q-TOF/MS was employed to determine the serum and fecal levels of metabolites in mice. Metabolomics methods were used to screen the differential metabolites， on the basis of which the potential therapeutic mechanism of jatrorrhizine on DSS-induced ulcerative colitis in mice was investigated. ResultsAfter intervention with jatrorrhizine， the model mice showed significantly decreased DAI（P<0.05，P<0.01）， recovered colon length，（P<0.05，P<0.01） and alleviated histopathology of the colon. The metabolomics study screened out 13 differential metabolites in the serum and 8 differential metabolites in the feces. The pathway enrichment analysis predicted three potential metabolic pathways： Biosynthesis of unsaturated fatty acids， phenylalanine， tyrosine and tryptophan biosynthesis， and phenylalanine metabolism. ConclusionJatrorrhizine may treat ulcerative colitis by regulating the biosynthesis and metabolism of amino acids and the synthesis of unsaturated fatty acids.

In the era of evidence-based medicine， the progress of medical science and technology has enriched medical diagnostic tools and treatment methods， but it has also led to the loss of medical warmth and the alienation of the doctor-patient relationships. William Osler emphasized that while medical technology advances， attention should also be paid to the practice of narrative medicine and the development of physician’s narrative literacy. The view of the physician he advocated reminds us that the core of medicine still lies in the narrative connection between doctors and patients， as well as a deep understanding of human nature. By exploring the relationship between Osler’s view of the physician and narrative medicine as well as physician’s narrative literacy， this paper analyzed the methods of cultivating physician’s narrative literacy， providing references for modern medical education and practice， and assisting in the harmony and unity of science and technology and humanity.

AIM:To investigating the predictive value of serum delta-like ligand 4(DLL4), complement C1q/tumor necrosis factor-related protein 5(CTRP5)levels for the severity of diabetic retinopathy(DR)and visual disability.METHODS:Patients with DR admitted to Tangshan Central Hospital between January 2022 and January 2024 were enrolled. Based on disease severity, patients were divided into a proliferative DR group and a non-proliferative DR group. After one year of follow-up, patients were further categorized into a vision disability group and a non-visual disability group based on visual impairment status. Enzyme-linked immunosorbent assay(ELISA)was used to detect serum levels of DLL4 and CTRP5. The data and serum levels of DLL4 and CTRP5 were compared among patients with different medical conditions and visual disabilities. Pearson method was used to explore the correlation between serum levels of DLL4, CTRP5 and glucose and lipid metabolism indicators. Multivariate Logistic regression was performed to explore the influencing factors of visual disability in DR Receiver operating characteristic(ROC)curve was performed to explore the value of serum levels of DLL4 and CTRP5 in predicting visual disability in DR.RESULTS: This study included 245 DR patients.Ninety-five patients were in the proliferative DR group(mean age 51.61±3.44 y, 51 men and 44 women), and 150 patients were in the non-proliferative DR group(mean age 51.22±3.11 y, 86 men and 64 women). The visually disability group consisted of 39 participants(mean age 51.64±3.87 y; 21 men and 18 women), while the non-visually disability group consisted of 206 participants(mean age 51.32±3.12 y; 116 men and 90 women). Patients in the proliferative DR group exhibited longer DR duration, higher levels of FPG, TG, TC, LDL-C, and serum DLL4 and CTRP5, and lower HDL-C levels compared to the non-proliferative DR group(all P<0.05). The serum levels of DLL4 were positively correlated with FPG(P<0.001), while the serum levels of CTRP5 were prominently positively correlated with FPG, TG, TC, LDL-C, and prominently negatively correlated with HDL-C(all P<0.001). The visual disability group had longer duration of DR and higher serum levels of DLL4 and CTRP5 than the non-visual disability group(all P<0.001). The duration of DR and serum levels of DLL4 and CTRP5 were influencing factors for visual disability in DR patients(all P<0.001). The joint detection of serum levels of DLL4 and CTRP5 had a higher value in predicting visual disability in DR patients than the single indicator prediction(ZDLL4-joint=3.018, PDLL4-joint=0.003; ZCTRP5-joint=2.784, PCTRP5-joint=0.005). CONCLUSION: Serum levels of DLL4 and CTRP5 are elevated in DR patients, and are closely related to the disease condition. The joint detection of serum levels of DLL4 and CTRP5 has high value in predicting visual disability in DR patients.

Colorectal cancer ranks third in global incidence and is the second leading cause of cancer-related mortality. Doxorubicin, an anthracycline chemotherapeutic drug, is integral to current cancer treatment protocols. However, toxicity and resistance to doxorubicin poses a significant challenge to effective therapy. Panobinostat has emerged as a critical agent in colorectal cancer treatment due to its potential to overcome doxorubicin resistance and enhance the efficacy of existing therapeutic protocols. This study aimed to evaluate the capability of panobinostat to surmount doxorubicin toxicity and resistance in colorectal cancer. Specifically, we assessed the efficacy of panobinostat in enhancing the therapeutic response to doxorubicin in colorectal cancer cells and explored the potential synergistic effects of their combined treatment. Our results demonstrate that the combination treatment significantly reduces cell viability and colony-forming ability in colorectal cancer cells compared to individual treatments. The combination induces significant apoptosis, as evidenced by increased levels of cleaved PARP and cleaved caspase-9, while also resulting in a greater reduction in p-Akt/p-GSK-3β/mTOR expression, along with substantial decreases in c-Myc and SREBP-1 levels, compared to monotherapies. Consistent with the in vitro experimental results, the combination treatment significantly inhibited tumor formation in colorectal cancer xenograft nude mice compared to the groups treated with either agent alone. In conclusion, our research suggests that the panobinostat effectively enhances the effect of doxorubicin and combination of two drugs significantly reduced colorectal cancer tumor growth by targeting the Akt/ GSK-3β/mTOR signaling pathway, indicating a synergistic therapeutic potential of these two drugs in colorectal cancer treatment.

Colorectal cancer ranks third in global incidence and is the second leading cause of cancer-related mortality. Doxorubicin, an anthracycline chemotherapeutic drug, is integral to current cancer treatment protocols. However, toxicity and resistance to doxorubicin poses a significant challenge to effective therapy. Panobinostat has emerged as a critical agent in colorectal cancer treatment due to its potential to overcome doxorubicin resistance and enhance the efficacy of existing therapeutic protocols. This study aimed to evaluate the capability of panobinostat to surmount doxorubicin toxicity and resistance in colorectal cancer. Specifically, we assessed the efficacy of panobinostat in enhancing the therapeutic response to doxorubicin in colorectal cancer cells and explored the potential synergistic effects of their combined treatment. Our results demonstrate that the combination treatment significantly reduces cell viability and colony-forming ability in colorectal cancer cells compared to individual treatments. The combination induces significant apoptosis, as evidenced by increased levels of cleaved PARP and cleaved caspase-9, while also resulting in a greater reduction in p-Akt/p-GSK-3β/mTOR expression, along with substantial decreases in c-Myc and SREBP-1 levels, compared to monotherapies. Consistent with the in vitro experimental results, the combination treatment significantly inhibited tumor formation in colorectal cancer xenograft nude mice compared to the groups treated with either agent alone. In conclusion, our research suggests that the panobinostat effectively enhances the effect of doxorubicin and combination of two drugs significantly reduced colorectal cancer tumor growth by targeting the Akt/ GSK-3β/mTOR signaling pathway, indicating a synergistic therapeutic potential of these two drugs in colorectal cancer treatment.

Colorectal cancer ranks third in global incidence and is the second leading cause of cancer-related mortality. Doxorubicin, an anthracycline chemotherapeutic drug, is integral to current cancer treatment protocols. However, toxicity and resistance to doxorubicin poses a significant challenge to effective therapy. Panobinostat has emerged as a critical agent in colorectal cancer treatment due to its potential to overcome doxorubicin resistance and enhance the efficacy of existing therapeutic protocols. This study aimed to evaluate the capability of panobinostat to surmount doxorubicin toxicity and resistance in colorectal cancer. Specifically, we assessed the efficacy of panobinostat in enhancing the therapeutic response to doxorubicin in colorectal cancer cells and explored the potential synergistic effects of their combined treatment. Our results demonstrate that the combination treatment significantly reduces cell viability and colony-forming ability in colorectal cancer cells compared to individual treatments. The combination induces significant apoptosis, as evidenced by increased levels of cleaved PARP and cleaved caspase-9, while also resulting in a greater reduction in p-Akt/p-GSK-3β/mTOR expression, along with substantial decreases in c-Myc and SREBP-1 levels, compared to monotherapies. Consistent with the in vitro experimental results, the combination treatment significantly inhibited tumor formation in colorectal cancer xenograft nude mice compared to the groups treated with either agent alone. In conclusion, our research suggests that the panobinostat effectively enhances the effect of doxorubicin and combination of two drugs significantly reduced colorectal cancer tumor growth by targeting the Akt/ GSK-3β/mTOR signaling pathway, indicating a synergistic therapeutic potential of these two drugs in colorectal cancer treatment.

Colorectal cancer ranks third in global incidence and is the second leading cause of cancer-related mortality. Doxorubicin, an anthracycline chemotherapeutic drug, is integral to current cancer treatment protocols. However, toxicity and resistance to doxorubicin poses a significant challenge to effective therapy. Panobinostat has emerged as a critical agent in colorectal cancer treatment due to its potential to overcome doxorubicin resistance and enhance the efficacy of existing therapeutic protocols. This study aimed to evaluate the capability of panobinostat to surmount doxorubicin toxicity and resistance in colorectal cancer. Specifically, we assessed the efficacy of panobinostat in enhancing the therapeutic response to doxorubicin in colorectal cancer cells and explored the potential synergistic effects of their combined treatment. Our results demonstrate that the combination treatment significantly reduces cell viability and colony-forming ability in colorectal cancer cells compared to individual treatments. The combination induces significant apoptosis, as evidenced by increased levels of cleaved PARP and cleaved caspase-9, while also resulting in a greater reduction in p-Akt/p-GSK-3β/mTOR expression, along with substantial decreases in c-Myc and SREBP-1 levels, compared to monotherapies. Consistent with the in vitro experimental results, the combination treatment significantly inhibited tumor formation in colorectal cancer xenograft nude mice compared to the groups treated with either agent alone. In conclusion, our research suggests that the panobinostat effectively enhances the effect of doxorubicin and combination of two drugs significantly reduced colorectal cancer tumor growth by targeting the Akt/ GSK-3β/mTOR signaling pathway, indicating a synergistic therapeutic potential of these two drugs in colorectal cancer treatment.

Colorectal cancer ranks third in global incidence and is the second leading cause of cancer-related mortality. Doxorubicin, an anthracycline chemotherapeutic drug, is integral to current cancer treatment protocols. However, toxicity and resistance to doxorubicin poses a significant challenge to effective therapy. Panobinostat has emerged as a critical agent in colorectal cancer treatment due to its potential to overcome doxorubicin resistance and enhance the efficacy of existing therapeutic protocols. This study aimed to evaluate the capability of panobinostat to surmount doxorubicin toxicity and resistance in colorectal cancer. Specifically, we assessed the efficacy of panobinostat in enhancing the therapeutic response to doxorubicin in colorectal cancer cells and explored the potential synergistic effects of their combined treatment. Our results demonstrate that the combination treatment significantly reduces cell viability and colony-forming ability in colorectal cancer cells compared to individual treatments. The combination induces significant apoptosis, as evidenced by increased levels of cleaved PARP and cleaved caspase-9, while also resulting in a greater reduction in p-Akt/p-GSK-3β/mTOR expression, along with substantial decreases in c-Myc and SREBP-1 levels, compared to monotherapies. Consistent with the in vitro experimental results, the combination treatment significantly inhibited tumor formation in colorectal cancer xenograft nude mice compared to the groups treated with either agent alone. In conclusion, our research suggests that the panobinostat effectively enhances the effect of doxorubicin and combination of two drugs significantly reduced colorectal cancer tumor growth by targeting the Akt/ GSK-3β/mTOR signaling pathway, indicating a synergistic therapeutic potential of these two drugs in colorectal cancer treatment.

Background In the context of global climate change, heatwaves pose an increasing threat to human health. Emergency ambulance calls are an important outcome indicator of acute health response in populations during heatwave weather. However, studies on the association between emergency ambulance calls and heatwaves in China have primarily focused on the southern regions, and less attention is paid to the northern regions, which hinders a comprehensive assessment of acute health impact posed by extreme heat. Objective To quantify the association between heatwaves and emergency ambulance calls in Dezhou City, Shandong Province. Methods The data on daily records of emergency ambulance calls, meteorological factors, and air pollution from May to September of 2020 to 2022 in Dezhou City, Shandong Province were collected. Heatwaves were defined by combining thresholds at the 90th, 92.5th, 95th, and 97.5th percentiles (P₉₀, P_92.5, P₉₅, and P_97.5) of the year-round daily mean temperature and durations of ≥2, 3, or 4 consecutive days, respectively. A generalized additive model with a distributed lag nonlinear model was used to estimate the relative risk of emergency ambulance calls during heatwave days compared with non-heatwave days. Results During the study period, a total of 143393 emergency ambulance calls were analyzed, with 59.75% of individuals aged <65 years, 53.38% male, and 44.94% due to respiratory causes. Compared to non-heatwave periods, all 12 types of defined heatwaves were significantly associated with an increased risk of emergency ambulance calls. The heatwave effect intensified progressively with higher temperature thresholds and longer durations. The cumulative relative risk rose from 1.12 (95%CI: 1.07, 1.17) for the P₉₀_2d type to 1.26 (95%CI: 1.14, 1.40) for the P_97.5_4d type. No significant gender difference was observed in the association between heatwaves and emergency ambulance calls. Regarding age, older adults were more vulnerable, with a relative risk of 1.60 (95%CI: 1.42, 1.81) for the most severe heatwave type P_97.5_4d compared with non-heatwave periods. Among the different causes of calls, the association between respiratory diseases and heatwaves was the most pronounced, with the relative risk increasing from 1.22 (95%CI: 1.15, 1.29) for the mildest heatwave type P₉₀_2d to 1.72 (95%CI: 1.54, 1.93) for the most severe heatwave type P_97.5_4d. Conclusion In Dezhou City, Shandong Province, heatwaves are significantly associated with an increased risk of emergency ambulance calls. The effects of heatwaves on emergency ambulance calls vary by age and disease type, with the elderly and patients with respiratory diseases being more susceptible. These groups should take protective measures.

Objective To measure radiation filed distribution in the treatment room of the Varian Halcyon medical linear accelerator, and to provide a basis for shielding design and potential exposure analysis of treatment rooms for this type of accelerator. Methods Under the 6 MV X-ray (FFF) mode at a maximum dose rate of 800 MU/min and a maximum irradiation field of 28.00 cm × 28.00 cm, a total of 540 MU was delivered during gantry rotation. Radiation field distribution was measured using thermoluminescence dosimeters located at multiple points in the room. The measured data were then applied to shielding calculations, and the results were compared with those obtained using empirical formulas. Results The overall radiation levels in the treatment room were in the range of 12.2 µGy/540 MU to 5.520 Gy/540 MU, with the highest dose (5.520 Gy/540 MU) observed at the isocenter, and the lowest dose (12.2 µGy/540 MU) recorded at approximately 6.5 m from the gantry head. The radiation levels at most points were within the range of 100-1000 µGy/540 MU. At heights of 0.5, 1.1, and 1.7 m, the radiation field exhibited a rapid attenuation from the beam center outward, with a faster decay along the treatment couch direction (Y-axis) than along the perpendicular direction (X-axis). Shielding calculations based on the measured radiation field yielded required wall thicknesses of 1219 mm (east wall), 949 mm (south wall), 1235 mm (west wall), and 1252 mm (north wall), all of which were smaller than those calculated using empirical formulas. Conclusion Thermoluminescence dosimeter is suitable for multi-point in situ measurement of radiation field distribution in Halcyon accelerator treatment rooms. The measurement results can be used to optimize the shielding design of Halcyon accelerator treatment rooms.