Precancerous lesions of gastric cancer （PLGC） are a group of pathological changes caused by abnormalities in the structure， morphology， and differentiation of gastric mucosal epithelial cells. Since the early symptoms are hidden and non-specific， PLGC is not easy to be diagnosed and it has often developed into intermediate or advanced gastric cancer once being diagnosed and missed the best time for treatment. Accordingly， the incidence of this disease is increasing year by year， which lifts a heavy burden on the patients. The pathogenesis of PLGC is complex， involving inflammatory microenvironment， bile reflux， glycolysis， autophagy， and apoptosis. Currently， PLGC is mainly treated with anti-inflammatory and endoscopic therapies， which are difficult to curb the development of PLGC. Therefore， seeking a safe and effective therapy is an important topic of modern research. Traditional Chinese medicine （TCM）， characterized by treatment based on syndrome differentiation and a holistic view， exerts effects via multiple pathways， mechanisms， and targets. Recent studies have confirmed that TCM can regulate the phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin （PI3K/Akt/mTOR）， Wnt/β-catenin， Sonic Hedgehog， nuclear factor-κB （NF-κB）， Janus kinase/signal transducer and activator of transcription （JAK/STAT）， hypoxia-inducible factor-1α （HIF-1α）， neurogenic locus notch homolog protein （Notch）， nuclear factor E₂-related factor 2 （Nrf2） and other signaling pathways. By targeting these pathways， TCM can inhibit aerobic glycolysis， reduce oxidative stress， repair the inflammatory microenvironment， regulate cellular autophagy， and promote vascular normalization， thereby delaying or reversing PLGC. However， few researchers have systematically summarized the TCM regulation of PLGC-associated pathways. By reviewing the relevant articles at home and abroad， this paper summarized the roles of the above signaling pathways in the development of PLGC and the research progress in the regulation of signaling pathways by TCM in the treatment of PLGC， with a view to providing a new theoretical basis for the clinical research on PLGC and the drug development for this disease.

BACKGROUND:The biomechanical analysis of scoliosis cases is limited,with only independent analysis focusing on the spine or lower limbs,thus lacking a comprehensive evaluation of the multidimensional body.As a result,it becomes challenging to reflect the movement relationship between the trunk and lower limbs during daily activities,which hinders comprehensive clinical treatment guidance. OBJECTIVE:To explore the relationship between different segments of the spine and the kinematics/kinetics of the lower limbs during gait activities by measuring spinal kinematics in scoliosis patients,to provide a comprehensive and multi-level assessment of the biomechanical differences between scoliosis patients and the normal population,consequently offering evidence-based guidance for the prevention and treatment of scoliosis. METHODS:A cross-sectional study was conducted from July 2020 to June 2021 at the Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine in Fuzhou University City.A total of 28 scoliosis patients and 28 normal individuals in the same age group were included.Three-dimensional motion capture system was used to capture gait kinematic data at a sampling frequency of 100 Hz.Two force plates(AMTI 400600,sampling frequency 1 500 Hz)were embedded in a 10-meter-long 2.4-meter-wide level ground walkway(with an effective data collection length of 4 m)to collect kinetic data.The differences in spatial-temporal parameters,kinematics,and kinetics of gait between the two groups were compared.Immediately after inclusion,all subjects underwent full spinal X-ray measurements to compare the differences between the scoliosis and normal groups. RESULTS AND CONCLUSION:(1)Patients with scoliosis exhibited reduced relative rotational range of motion between the shoulder and trunk,as well as between the thorax and pelvis,compared to the normal group(P<0.05).However,the rotational range of motion in the pelvis was larger in patients with scoliosis compared to the normal group(P<0.05).(2)Patients with scoliosis showed decreased range of motion in the hip and knee joints,as well as reduced peak torque in hip joint flexion and extension,and lower peak values of ground reaction forces in the concave and convex directions,in comparison to the normal group(P<0.05).(3)Patients with scoliosis demonstrated greater asymmetry indices in knee joint range of motion,relative rotational range of motion between the shoulder and trunk,and between the thorax and pelvis,when compared to the normal group(P<0.05).(4)These findings illustrate a rigid movement pattern among the shoulder,thorax,and pelvis in patients with scoliosis during level walking.There is a reduction in range of motion in the hip and knee joints,as well as decreased peak torque values in hip joint flexion and extension,and ground reaction forces in the concave and convex directions.These characteristics can serve as foundational elements for assessing rehabilitation and developing treatment plans.

BACKGROUND: Molecular subtyping is an essential complementarity after pathological analyses for targeted therapy. This study aimed to investigate the consistency of next-generation sequencing (NGS) results between circulating tumor DNA (ctDNA)-based and tissue-based in non-small cell lung cancer (NSCLC) and identify the patient characteristics that favor ctDNA testing. METHODS: Patients who diagnosed with NSCLC and received both ctDNA- and cancer tissue-based NGS before surgery or systemic treatment in Lung Cancer Center, Sichuan University West China Hospital between December 2017 and August 2022 were enrolled. A 425-cancer panel with a HiSeq 4000 NGS platform was used for NGS. The unweighted Cohen's kappa coefficient was employed to discriminate the high-concordance group from the low-concordance group with a cutoff value of 0.6. Six machine learning models were used to identify patient characteristics that relate to high concordance between ctDNA-based and tissue-based NGS. RESULTS: A total of 85 patients were enrolled, of which 22.4% (19/85) had stage III disease and 56.5% (48/85) had stage IV disease. Forty-four patients (51.8%) showed consistent gene mutation types between ctDNA-based and tissue-based NGS, while one patient (1.2%) tested negative in both approaches. Patients with advanced diseases and metastases to other organs would be suitable for the ctDNA-based NGS, and the generalized linear model showed that T stage, M stage, and tumor mutation burden were the critical discriminators to predict the consistency of results between ctDNA-based and tissue-based NGS. CONCLUSION ctDNA-based NGS showed comparable detection performance in the targeted gene mutations compared with tissue-based NGS, and it could be considered in advanced or metastatic NSCLC.
Humans ; Carcinoma, Non-Small-Cell Lung/pathology* ; Circulating Tumor DNA/blood* ; High-Throughput Nucleotide Sequencing/methods* ; Female ; Male ; Lung Neoplasms/pathology* ; Middle Aged ; Mutation/genetics* ; Aged ; Adult ; Aged, 80 and over

Objective To investigate the correlations of serum Aβ1-42,P-Tau181,and Hcy levels with sleep disorders in patients with Parkinson's disease(PD).Methods A total of 80 PD patients were divided into a normal sleep group(＜7 points)and a sleep disorder group(≥7 points)based on the evaluations with Pittsburgh Sleep Quality Index(PSQI).Univariate and multivariate logistic regression analyses were performed to investigate the correlations between the levels of serum A β1-42,P-Tau181,and Hcy levels and sleep disorders.Receiver operating characteristic(ROC)curves were used to analyze the efficacy parameters of different indicators in pre-dicting sleep disorders in those patients.Results Univariate and multivariate logistic regression analyses showed that serum Aβ1-42 and Hcy were protective and independent risk factors for sleep disorders in the PD patients,respectively(P＜0.05).The predictive AUCs of serum Aβ1-42 and Hcy levels for sleep disorders in the PD patients were 0.757(95%CI:0.652～0.861)and 0.796(95%CI:0.688～0.905),respectively.Conclusion The levels of serum Aβ1-42 and Hcy in PD patients are closely related to sleep disorders.Therefore,they can be used as predic-tive factors for clinical diagnosis of PD with sleep disorders.

OBJECTIVE To investigate the effect of Guanxinning tablets(GXN) on early heart failure model rats, and to explore the protective mechanism of GXN on heart failure rats from the perspective of intestinal flora. METHODS Six rats who underwent sham operation were set as sham operation group. Took 80 SD rats to undergo aortic arch stenosis and established a heart failure rat model. The surviving rats were divided into 4 groups, namely the model control group, the positive control group(captopril tablets 12.5 mg·kg–1), high-dose and low-dose of GXN group(600, 1 200 mg·kg–1). The 4 groups were administered continuously for 8 weeks. Cardiac ultrasonography was performed every 4 week. Serum NT-proBNP, hs-CRP, IL-6, TNF-α, SOD and MDA levels were measured. The effects of GXN on the structure and function of intestinal flora were observed based on the high-throughput sequencing technology and bioinformatics analysis of 16S gut microbiome. RESULTS Compared to the model control group, after giving different doses of GXN, the survival rate of rats increased, and the thickness of the ventricular wall decreased to varying degrees. The weight of the heart and coefficient of the heart were all reduced. GXN could also reduce the level of inflammatory factors, inhibit the level increase of NT-proBNP in rats, and increase the activity of serum SOD. In addition, GXN intervention could significantly improve the intestinal flora diversity of rats with heart failure, the possible target genera of GXN were Akkermansia genera, Phascolarctobacterium genera and Oxalobacter genera. The effect of GXN on intestinal function in rats with heart failure might be concentrated in non-homologous end-joining, influenza A, carotenoid synthesis, indole alkaloids biosynthesis, betalain biosynthesis, renin-angiotensin system and other biological pathways. CONCLUSION The protective effect of GXN on early heart failure rats may be related to the regulation of intestinal flora pathway.

ObjectiveBased on the hemodynamic indicators of transcranial Doppler （TCD），this study aimed to analyze the correlations of visual analogue scale（VAS） and Hamilton depression rating scale 24-item（HAMD-24） scores with mean blood velocity （Vm） of the anterior cerebral artery （ACA），the middle cerebral artery （MCA）， and the posterior cerebral artery （PCA），and the correlation between VAS score of headache and HAMD-24 score，and explore the clinical efficacy of Xiaoyaosan combined with paroxetine tablets in the treatment of migraine with liver depression and blood deficiency syndrome and depression. MethodSixty-two outpatients treated in the encephalopathy department， the First Afffiliated Hospital of Anhui University of Chinese Medicine between January 2019 to June 2020 who were in line with the diagnostic criteria were enrolled and divided into a treatment group （32 cases） and a control group （30 cases）. All patients were treated with paroxetine tablets，while those in the treatment group received additional Xiaoyaosan. The changes in relevant indicators in the two groups before and after treatment were observed. The effects of Xiaoyaosan on the TCD indicators （Vm_ACA， Vm_MCA， and Vm_PCA）， scores of migraine and depression ［including VAS score， Headache Impact Test-6 （HIT-6） score，and HAMD-24 score］， and the traditional Chinese medicine （TCM） syndrome score were analyzed. ResultVAS and HAMD-24 scores were positively correlated with Vm_ACA， Vm_MCA， and Vm_PCA （P<0.01）. VAS scores were positively correlated with HAMD-24 scores. Compared with the conditions before treatment， the levels of TCD indicators （Vm_ACA， Vm_MCA， and Vm_PCA） in the two groups decreased after treatment （P<0.01）， and the scores of HIT-6， VAS， and HAMD-24 in the two groups were significantly improved （P<0.01）. Compared with the control group after treatment， the treatment group showed decreased levels of TCD indicators （Vm_ACA， Vm_MCA， and Vm_PCA） （P<0.01） and superior improvement of HIT-6， VAS， and HAMD-24 scores （P<0.01）. The effective rate in the treatment group was 90.6% （29/32）， higher than 63.3% （19/30） in the control group （χ²=5.13，P<0.05）. There was no significant difference in adverse reactions between the two groups. ConclusionTCD indicators can effectively reflect the cerebral blood flow of patients with migraine and depression co-morbidity，and migraine is correlated with the onset and severity of depression. The comprehensive analysis showed that the efficacy of Xiaoyaosan combine paroxetine tablets was better than that of paroxetine tablets alone in the treatment of migraine with liver depression and blood deficiency syndrome and depression. This therapeutic protocol can significantly improve cerebral blood flow and the symptoms and degree of migraine and depression and can provide references for clinical treatment.

The performance appraisal of tertiary public hospitals is key to their high-quality development. Since 2019, Children′s Hospital of Zhejiang University School of Medicine has taken the following measures to leverage performance appraisal. Namely promoting medical technology innovation to enhance the diagnosis and treatment capabilities of difficult and critical diseases; Reasonably setting a target system, improving the performance appraisal mechanism of the hospital; Improving operational efficiency, enhancing the sense of gain by children patients; Building a high-quality talent pool, promoting sustainable development, and effectively promoting high-quality development of hospitals. These measures can provide reference for promoting the high-quality development of hospitals.

Objective:To investigate the Correlation between ADC combined with serum C-reactive protein (CRP) and delayed encephalopathy after carbon monoxide poisoning (DEACMP), It provides scientific basis for early prediction of DEACMP.Methods:According to the design principle of case-control study, the data of acute carbon monoxide poisoning (ACOP) patients admitted to Shandong Provincial Hospital from December 2017 to December 2021 were retrospectively selected. Among them, patients with DEACMP were selected as the case group, without DEACMP were used as the control group. Univariate and multivariate analyses were performed on the two groups. Receiver operating characteristic curve (ROC) was used to evaluate the diagnostic efficacy of ADC combined with CRP as a combined predictor for disease.Results:A total of 89 patients with ACOP were included, including 33 patients with DEACMP and 56 patients without DEACMP. There were no significant differences in gender, age, smoking, drinking, and underlying diseases (hypertension, coronary heart disease) between groups ( P>0.05). Logistic regression analysis showed that white blood cell count (WBC) ( OR=1.64, 95% CI: 1.19-2.26, P=0.003), CRP ( OR=1.22, 95% CI: 1.03-1.45, P=0.019) and ADC value of central semiovale white matter ( OR=0.99, 95% CI: 0.98-1.00, P=0.010) were associated with DEACMP in patients with ACOP. The ROC curve results showed that the area under the ROC of ADC combined with CRP in the center of semiovale was 0.765 (95% CI: 0.656-0.845), the specificity was 87.9%, the sensitivity was 23.2%, and the cut-off value was 3.5°. Conclusions:WBC, CRP and ADC value of central semiovale are independent factors for DEACMP. ADC value of central semiovale combined with CRP has more clinical value in the early diagnosis of DEACMP. For ACOP patients with DEACMP triggering factors, the diagnosis and treatment awareness of early screening of brain magnetic resonance imaging should be strengthened to avoid DEACMP.

ObjectiveTo explore the impact of COVID-19 epidemic on the lifestyles of patients with chronic diseases and to help better chronic disease prevention and control during the epidemic. MethodsThe patients with hypertension and type 2 diabetes who were still under management in Baoshan District， Shanghai at the end of September 2019 were selected for the investigation through telephone follow-up from March 1 to April 30 in 2020. 960 participants were selected using a stratified random sampling method. Those who did not complete the investigation for any reasons were excluded. A total of 613 people were effectively investigated. We compared and analyzed the lifestyles of patients with chronic diseases during 2020 （COVID-19） with those in 2019. ResultsDuring the epidemic， the proportion of people who had regular physical exercise （P<0.05）and transportation activities（P<0.05） was lower than that before the epidemic. The proportion of people with light， moderate and heavy activity intensity（P<0.05） was lower than before the epidemic， and the difference was statistically significant. The time spent on sitting or leaning was more than that before the epidemic （P<0.05）. As for the condition of complying with the doctor’s advice， no significant difference was found in different age and chronic disease groups. There was a statistically significant difference in total food intake （χ²=7.994，P<0.05） and staple foods （χ²=6.677，P<0.05） between patients with or without hypertension. There was a statistically significant difference in total food intake（χ²=10.694，P<0.05） and staple food intake （χ²=9.523，P<0.05） between those with or without diabetes mellitus（P<0.05）. Patients with chronic diseases during the epidemic could not know about latest values of measurement index and had emotional problems such as restlessness， nervousness and irritability. ConclusionPatients with chronic diseases changes their lifestyles during the epidemic， and their exercise and travel conditions decrease during the COVID-19 lockdown period. Most patients have different levels of emotional problems such as restlessness and nervousness. It is recommended to increase the intensity and frequency of physical activity and promote mental health to better prevent and control the occurrence of chronic diseases.

This cross-sectional study aimed to investigate the quality of care of diabetes in Shanghai, China. A total of 173 235 patients with type 2 diabetes in 2017 were included in the analysis. Profiles of risk factors and intermediate outcomes were determined. The patients had a mean age of 66.43 ± 8.12 (standard deviation (SD)) years and a mean diabetes duration of 7.95 ± 5.53 (SD) years. The percentage of patients who achieved the target level for HbA_1c (< 7.0%) was 48.6%. Patients who achieved the target levels for blood pressure (BP) < 130/80 mmHg and low-density lipoprotein-cholesterol (LDL-c) < 2.6 mmol/L reached 17.5% and 34.0%, respectively. A total of 3.8% achieved all three target levels, and the value increased to 6.8% with an adaptation of the BP target level (< 140/90 mmHg) for those over 65 years. Multivariable analysis identified the factors associated with a great likelihood of achieving all three target levels: male, young age, short diabetes duration, low body mass index, macrovascular complications, no microvascular complications, prescribed with lipid-lowering medication, and no prescription of antihypertensive medication. In conclusion, nearly 50% and one-third of the patients with diabetes met the target levels for HbA_1c and LDL-c, respectively, with a low percentage achieving the BP target level. The percentage of patients who achieved all three target levels needs significant improvement.
Aged ; Blood Pressure ; China/epidemiology* ; Cholesterol, LDL/therapeutic use* ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/drug therapy* ; Glycated Hemoglobin A/analysis* ; Humans ; Male ; Middle Aged