OBJECTIVE To systematically evaluate the methodological quality of the postoperative chemotherapy guidelines/ consensuses for ovarian epithelial tumor. METHODS A search was conducted across databases including PubMed， Embase， Web of Science， CBM， VIP， Chinese Medical Journal Data， Wanfang Data， and CNKI， as well as the official websites of GIN， NICE， Medlive， AHRQ， CSCO， ASCO， and NCCN. The search period was from the establishment of the databases/websites to March 10， 2025. The quality of the included guidelines/consensus was evaluated by using the AGREE-Ⅱ tool. RESULTS A total of 16 guidelines/consensuses were included. The domain scores of AGREE-Ⅱ evaluation were as follows： scope and purpose of 85.07%， participants of 47.92%， rigor of development of 57.49%， clarity of presentation of 88.02%， applicability of 8.20%， and independence of 53.39%. Among them， 14 were recommended at grade B and 2 were recommended at grade C. The subgroup analysis by different countries/regions and different types of studies showed that the scores for participants， rigor of development， and independence of the guidelines/consensuses in China were significantly lower than foreign countries （P＜0.05）； the scores for participants and rigor of development of the guidelines were significantly higher than consensuses （P＜0.05）. The guideline/ consensus recommendation results indicated that grade B guidelines/consensus recommend platinum-based combination chemotherapy as the preferred adjuvant chemotherapy regimen for stage Ⅰ high-grade serous carcinoma patients；platinum-based combination chemotherapy±bevacizumab was recommended as the preferred adjuvant chemotherapy regimen for stage Ⅱ-Ⅳ high- grade serous carcinoma patients and for platinum-sensitive recurrent high-grade serous carcinoma patients； non-platinum single- agent chemotherapy±bevacizumab was recommended as the preferred chemotherapy regimen for platinum-resistant recurrent high- grade serous carcinoma patients. CONCLUSIONS The overall quality of postoperative chemotherapy guidelines/consensuses for ovarian epithelial tumor is not high. The methodological quality of guidelines/consensuses in China is still lagging behind that of foreign countries. The recommendations differ from those in foreign countries. It is recommended to improve the aspects of participants， rigor of development， and independence， to recommend treatment plans based on the different stages of ovarian cancer， and develop guidelines/consensuses that align with China’s national conditions.

This study aims to research the relationship between arterial stiffness and serum indirect bilirub in levels(IBIL)in patients with type 2 diabetes by measuring brachial-ankle pulse wave velocity (baPWV). The clinical data of 1 327 patients with T2DM admitted to Qingdao Huangdao District People′s Hospital from July 1st, 2018 to March 1st, 2024 were retrospectively and cross-sectionally analyzed (609 men and 718 women; age range, 45.3-79.5 years; median age, 60.3 years; mean age, 61.4 years). The subjects were stratified based on gender-specific quartiles of IBIL values(male, Q1:<6.7 μmol/L, Q2:6.7-8.9 μmol/L, Q3:8.9-12.3 μmol/L, Q4:≥12.3 μmol/L;female, Q1:<6.4 μmol/L, Q2:6.4-7.9 μmol/L, Q3:7.9-10.4 μmol/L, Q4:≥10.4 μmol/L), and a high baPWV was defined as greater than 18.37 m/s (75th percentile). The results showed that the serum IBIL concentration was negatively correlated with the duration of diabetes ( r=-0.142, P=0.010), the SBP ( r=-0.158, P=0.005) and the baPWV ( r=-0.194, P<0.001) in women and was positively correlated with TC (men: r=0.282, P<0.001; women: r=0.237, P<0.001), HDL-C (men: r=0.171, P=0.011; women: r=0.287, P<0.001) and LDL-C (men: r=0.196, P=0.009; women: r=0.233, P<0.001) levels in both genders. Dividing IBIL levels into quartiles, there were significant statistical differences in the incidence of high baPWV among different subgroups of female patients ( χ 2=36.468, P<0.001), and the incidence of high baPWV showed a decreasing trend with increasing IBIL levels. After adjusting for confounding factors, the IB levels were inversely associated with a greater risk of a high baPWV both as a continuous variable [a 1-SD difference; odds ratio ( OR):0.836; 95% confidence interval ( CI):0.774-0.942; P=0.009] and when categorized in quartiles (the highest vs. the lowest quartile; OR:0.381; 95% CI:0.162-0.897; P=0.025) in women but not in men. Low IBIL levels were significantly associated with arterial stiffness in middle-aged and elderly women with type 2 diabetes. In conclusion, the serum IBIL levels were independent protective factors for macrovascular disease in middle-aged and elderly diabetic women.

BACKGROUND: The available evidence regarding the benefits of percutaneous coronary intervention (PCI) on patients receiving dialysis with coronary artery disease (CAD) is limited and inconsistent. This study aimed to evaluate the association between PCI and clinical outcomes as compared with medical therapy alone in patients undergoing dialysis with CAD in China. METHODS: This multicenter, retrospective study was conducted in 30 tertiary medical centers across 12 provinces in China from January 2015 to June 2021 to include patients on dialysis with CAD. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. Secondary outcomes included all-cause death, the individual components of MACE, and Bleeding Academic Research Consortium criteria types 2, 3, or 5 bleeding. Multivariable Cox proportional hazard models were used to assess the association between PCI and outcomes. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were performed to account for potential between-group differences. RESULTS: Of the 1146 patients on dialysis with significant CAD, 821 (71.6%) underwent PCI. After a median follow-up of 23.0 months, PCI was associated with a 43.0% significantly lower risk for MACE (33.9% [ n  = 278] vs . 43.7% [ n  = 142]; adjusted hazards ratio 0.57, 95% confidence interval 0.45-0.71), along with a slightly increased risk for bleeding outcomes that did not reach statistical significance (11.1% vs . 8.3%; adjusted hazards ratio 1.31, 95% confidence interval, 0.82-2.11). Furthermore, PCI was associated with a significant reduction in all-cause and cardiovascular mortalities. Subgroup analysis did not modify the association of PCI with patient outcomes. These primary findings were consistent across IPTW, PSM, and competing risk analyses. CONCLUSION This study indicated that PCI in patients on dialysis with CAD was significantly associated with lower MACE and mortality when comparing with those with medical therapy alone, albeit with a slightly increased risk for bleeding events that did not reach statistical significance.
Humans ; Percutaneous Coronary Intervention/methods* ; Male ; Female ; Coronary Artery Disease/drug therapy* ; Retrospective Studies ; Renal Dialysis/methods* ; Middle Aged ; Aged ; China ; Proportional Hazards Models ; Treatment Outcome

This study aims to research the relationship between arterial stiffness and serum indirect bilirub in levels(IBIL)in patients with type 2 diabetes by measuring brachial-ankle pulse wave velocity (baPWV). The clinical data of 1 327 patients with T2DM admitted to Qingdao Huangdao District People′s Hospital from July 1st, 2018 to March 1st, 2024 were retrospectively and cross-sectionally analyzed (609 men and 718 women; age range, 45.3-79.5 years; median age, 60.3 years; mean age, 61.4 years). The subjects were stratified based on gender-specific quartiles of IBIL values(male, Q1:<6.7 μmol/L, Q2:6.7-8.9 μmol/L, Q3:8.9-12.3 μmol/L, Q4:≥12.3 μmol/L;female, Q1:<6.4 μmol/L, Q2:6.4-7.9 μmol/L, Q3:7.9-10.4 μmol/L, Q4:≥10.4 μmol/L), and a high baPWV was defined as greater than 18.37 m/s (75th percentile). The results showed that the serum IBIL concentration was negatively correlated with the duration of diabetes ( r=-0.142, P=0.010), the SBP ( r=-0.158, P=0.005) and the baPWV ( r=-0.194, P<0.001) in women and was positively correlated with TC (men: r=0.282, P<0.001; women: r=0.237, P<0.001), HDL-C (men: r=0.171, P=0.011; women: r=0.287, P<0.001) and LDL-C (men: r=0.196, P=0.009; women: r=0.233, P<0.001) levels in both genders. Dividing IBIL levels into quartiles, there were significant statistical differences in the incidence of high baPWV among different subgroups of female patients ( χ 2=36.468, P<0.001), and the incidence of high baPWV showed a decreasing trend with increasing IBIL levels. After adjusting for confounding factors, the IB levels were inversely associated with a greater risk of a high baPWV both as a continuous variable [a 1-SD difference; odds ratio ( OR):0.836; 95% confidence interval ( CI):0.774-0.942; P=0.009] and when categorized in quartiles (the highest vs. the lowest quartile; OR:0.381; 95% CI:0.162-0.897; P=0.025) in women but not in men. Low IBIL levels were significantly associated with arterial stiffness in middle-aged and elderly women with type 2 diabetes. In conclusion, the serum IBIL levels were independent protective factors for macrovascular disease in middle-aged and elderly diabetic women.

Objective To design a novel bromodomain-containing protein 4(BRD4)and histone deacetylase(HDAC)dual-target inhibitor(11b),and to elucidate its therapeutic efficacy and mechanisms in suppressing prostate cancer through epigenetic regulation.Methods BRD4 and HDAC expression levels were assessed via immunohistochemistry(IHC)using prostate cancer tissue microarrays.The inhibitory activity of 11b was screened across three prostate cancer cell lines,with the half-maximal inhibitory concentration(IC50)determined by CCK-8 assay.Western blot was employed to analyze changes in the expression of target proteins,including BRD4,c-Myc proto-oncogene protein(c-Myc),and Ac-H3K27,with parallel comparisons to single-target agents,including suberoylanilide hydroxamic acid(SAHA),a HDAC inhibitor,and JQ-1,a BRD4 inhibitor.Cell invasion and proliferation were evaluated using Transwell and colony formation assays,and the autophagy mechanism was validated using 3-methyladenine(3-MA),an autophagy inhibitor.A PC-3 xenograft model was established in nude mice.Then,11b(7.5 mg/kg or 15 mg/kg),normal saline,SAHA,and JQ-1 were administered via intraperitoneal injection,and their tumor growth inhibition effects were observed.The percentage of target protein-positive cells and the expression levels of target genes were quantified via IHC and RT-PCR,respectively.Results BRD4 and HDAC expression levels were both higher in tumor tissues than those in normal tissues(P<0.01).11b exhibited the strongest inhibitory activity against PC-3 cells(IC50=8.28 μmol/L),outperforming SAHA(22.61 μmol/L)and JQ-1(22.09 μmol/L).Treatment with 11b reduced BRD4 and c-Myc expression by(41.58±3.28)%and(63.21±6.91)%,respectively(P<0.01),and increased the Ac-H3K27 level to 6.52-fold that of the negative control(NC)group(P<0.01),demonstrating greater modulation than either SAHA or JQ-1 did.The in vitro experiment showed that 8 μmol/L 11b treatment reduced PC-3 colony formation and migration by 97.5%and 96.3%,respectively(P<0.001),and co-treatment with 3-MA reversed its cytotoxic effects.The in vivo experiment showed that 11b at both 7.5 mg/kg and 15 mg/kg significantly reduced tumor volume and weight compared with the control,SAHA,and JQ-1 groups(all P<0.01),with the proportion of percentage of target protein-positive cells and the expression of target genes showing trends consistent with in vitro findings.Conclusion The dual-target inhibitor 11b exerts potent antitumor effects in prostate cancer by synergistically modulating the BRD4/HDAC pathways.11b demonstrates therapeutic efficacy superior to that of the single-target agents SAHA and JQ-1 in suppressing prostate cancer progression,highlighting its potential for clinical translation.

Objective:To compare the test methods for aluminum content determination in vaccines by inductively coupled plasma-mass spectrometry(ICP-MS),inductively coupled plasma optical emission spectrometry(ICP-OES)and titration of the Chinese Pharmacopoeia 2020.Methods:The pre-treatment procedures,linearity,repeatability,accuracy,quantification limit,detection limit and sample determination results of the three methods were compared and analyzed by methodological verification and sample testing.Results:There was a good linear relationship of ICP-OES in the concentration range of 1-20μg·mL-1 aluminum content,r=0.9999.Aluminum content in 6 types of vaccines was in the range of 99％-104.6％,and RSDs were lower than 3％(n=9).There was a good linear relationship of ICP-MS in the concentration range of 2.5-80ng·mL-1(r=0.999).Aluminum content in 6 types of vaccines were in the range of 99.4％-108.9％,and RSDs were lower than 8％(n=9).There was no significant difference between the three methods in the determination of aluminum content in vaccines,and RSDs were lower than 10％.Conclusion:Both ICP-MS and ICP-OES methods can be used for the determination of alu-minum content in aluminum adjuvant vaccine.Both detection methods are simple,fast and accurate.ICP-OES has lower instrument costs and is easier to promote in the laboratory.

Objective To explore the effect and mechanism of bone marrow-derived mesenchymal stem cell-conditioned medium(MSC-CM)on diabetic foot ulcer(DFU)in rats.Methods The model of diabetes mellitus type 2(T2DM)were induced by high fat diet and intraperitoneal injection of STZ in SD rats.DFU models were made by operation on hind limbs in diabetic rats.The rats were di-vided into four groups:normal control(NC)group,diabetes mellitus control(DM-C)group,MSC-CM group and mesenchymal stem cell(MSC)group,6 rats in each gruop.The MSC-CM group was injected with bone marrow-derived MSC-CM around ulcers.MSC group was injected with bone marrow-derived MSC.The other two groups were treated with injection of PBS.After the treatment,wound clousure,re-epithelialization(thickness of the stratum granulosums of the skin was detected by HE staining),cell proliferation(ki-67 was detected by immunohistochemistry),angiogenesis(CD31 was detected by immunofluorescence),autophagy(LC3B was detected by immunofluorescence and Western blot,autolysosome was observed by electron microscopy)and pyroptosis(IL-1 β,NLRP3,caspase-1,GSDMD and GSDMD-N were detected by Western blot)in ulers were evaluated.Results After the treatment,the wound area,IL-1β,caspase-1,GSDMD and GSDMD-N in MSC-CM group were lower than those in DM-C group.Thickness of the stratum gran-ulosums of the skin,ki-67,CD31 and LC3B in MSC-CM group were higher than those in DM-C group.The injection of MSC-CM to rats with DFU enhanced the wound healing process by accelerating wound closure,promoting cell proliferation and angiogenesis,enhan-cing cell autophagy and reducing cell pyroptosis in ulcers.Conclusion MSC-CM could be a novel cell-free therapeutic approach to treat rats with DFU accelerating the wound healing process.

At the maternal-fetal interface, insulin-like growth factor 1 (IGF-1) promotes fetal growth by regulating transport and absorption of amino acid, glucose, and fatty acid in trophoblast cells. Additionally, IGF-1 facilitates proliferation and differentiation of decidual cells, angiogenesis, and decidualization via regulating metabolism, immune responses, and anti- or pro-inflammatory responses of decidual cells. However, more studies are needed to verify the underlying mechanisms of IGF-1 in maternal decidual cells. IGF-1 is regulated by upstream hormones, cytokines, small molecule nutrients, oxygen, and environmental pollutants. Drugs, such as growth hormone, mifepristone, prednisolone and melatonin, can regulate the expression of IGF-1 and further improve pregnancy outcomes. Verifying the upstream and downstream mechanisms of IGF-1 at the maternal-fetal interface helps to find out more potential targets for the diagnosis and treatment of pregnancy-related diseases, and provide new ideas for the field.

At the maternal-fetal interface, insulin-like growth factor 1 (IGF-1) promotes fetal growth by regulating transport and absorption of amino acid, glucose, and fatty acid in trophoblast cells. Additionally, IGF-1 facilitates proliferation and differentiation of decidual cells, angiogenesis, and decidualization via regulating metabolism, immune responses, and anti- or pro-inflammatory responses of decidual cells. However, more studies are needed to verify the underlying mechanisms of IGF-1 in maternal decidual cells. IGF-1 is regulated by upstream hormones, cytokines, small molecule nutrients, oxygen, and environmental pollutants. Drugs, such as growth hormone, mifepristone, prednisolone and melatonin, can regulate the expression of IGF-1 and further improve pregnancy outcomes. Verifying the upstream and downstream mechanisms of IGF-1 at the maternal-fetal interface helps to find out more potential targets for the diagnosis and treatment of pregnancy-related diseases, and provide new ideas for the field.

Objective:To explore the effect of Wechat knowledge-attitude-practice(KAP) intervention on medication adherence and treatment outcome of college students with depression.Methods:A total of 184 college students with depression who received medical treatment in psychiatric outpatient department of Tsinghua university from January 2019 to September 2021 were divided into control group and intervention group( n=92 in each group). All students in both groups received routine health education, and students in intervention group received additional Wechat KAP intervention.Before and after the intervention, the changes of disease knowledge and medication attitude were investigated by self-made questionnaires. Medication adherence rating scale (MARS) was used to investigate medication adherence three times in half a year. Before and half a year after the intervention, self-rating anxiety scale(SAS) and self-rating depression scale(SDS) were measured and the treatment outcome was evaluated by △SAS and △SDS combined with GI. SPSS 11.5 was used for statistical analysis of data, including t-test and chi square test. Results:At the end of the 4th, 12th and 24th week, the shedding rates of the intervention group (13.04%, 18.48%, 31.52%) were lower than those of the control group (33.70%, 46.74%, 59.78%) ( χ2=10.96, 16.72, 14.81, all P<0.001). At the end of the 4th week and the 12th week, the MARS scores of the intervention group (6.57±1.67, 7.55±1.79) were higher than those of the control group (5.06±1.62, 6.53±1.76)( t=5.41, 3.13, both P<0.01), and the proportion of people who wanted to stop the medicine by themselves in the intervention group (5/80, 14/75) was lower than that of the control group (22/61、20/49)( χ2=19.87, 7.31, both P<0.01). After half a year, the △SAS and △SDS of the intervention group (12.01±2.01, 11.65±2.03) were higher than those of the control group (8.11±1.91, 7.83±1.82) ( t=13.38, 13.33, both P<0.001). GI in the intervention group showed significant improvement in 31 cases, slight improvement in 28 cases, no change in 24 cases, and deterioration in 8 cases, which were better than those in the control group (20 cases, 21 cases, 31 cases and 18 cases)( χ2=8.10, P=0.044). Conclusion:Wechat KAP intervention is beneficial to improve the medication adherence and treatment outcome of patients with depression.