ObjectiveThis study aims to investigate the effect of Liuwei Dihuangwan on the autophagy function in the hippocampus of senescence-accelerated mouse prone 8 （SAMP8） by regulating the expression of glycoprotein non-metastatic melanoma protein B （GPNMB）. Furthermore， it is designed to explore the mechanism of the method of tonifying the kidneys and replenishing essence in the treatment of Alzheimer's disease （AD）. MethodsIn experiment 1， 24 5-month-old SAMP8 mice were randomly and equally divided into the model group， and the low-， middle- and high-dose（0.59，1.18，2.36 g·kg^-1） Liuwei Dihuangwan groups. At the same time， six 5-month-old senescence accelerated mouse resistant 1 （SAMR1） mice were used as the control group. The learning and memory ability was evaluated through novel object recognition experiment. Serum cortisol （Cort）， adrenocorticotropic hormone （ACTH） and urine 17-hydroxycorticosteroid （17-OHCS） levels were detected by enzyme-linked immunosorbent assay （ELISA）. The ultrastructure of hippocampal neurons was observed by transmission electron microscope （TEM）， and the expression levels of hippocampal GPNMB， a disintegrin and metalloproteinase 10 （ADAM10） and autophagy-related proteins were detected by Western blot. In experiment 2， 18 SAMP8 mice were randomly and equally divided into the model group， vector control group （Vector）， and GPNMB overexpression group （GPNMB^OE）. Lentiviral vectors were stereotactically injected into the brain （2 μL per side in the GPNMB^OE group）. Western blot was used to detect the expression of the above target proteins in the hippocampus； In Experiment 3， 24 SAMP8 mice were randomly and equally divided into the model group， Liuwei Dihuangwan group， Liuwei Dihuangwan+negative control （NC） group， and Liuwei Dihuangwan+GPNMB silencing group （shGPNMB）. Before drug treatment， the Liuwei Dihuangwan+NC group and the Liuwei Dihuangwan+shGPNMB group were injected with negative control and GPNMB silencing lentivirus， respectively. Western blot was used to detect the expression of the above target proteins in the hippocampus. ResultsThe novel object discrimination index of mice in the model group was significantly lower than that of mice in the control group （P<0.01）. The novel object discrimination index of mice in the medium- and high-dose Liuwei Dihuangwan groups was significantly higher than that of mice in the model group （P<0.01）. Aggregated autolysosomes were observed in the normal hippocampus tissue by TEM. In the model group， mitochondria were dominant， and no typical characteristic autophagosomes were observed. In the low- and medium-dose Liuwei Dihuangwan groups， a small number of autolysosomes and autophagosomes with double-membrane structures were observed. In the high-dose Liuwei Dihuangwan group， the number of autophagosomes and autolysosomes was greater than that in the low- and medium-dose groups. The results of ELISA and Western blot showed that compared with the control group， the levels of serum Cort， ACTH， and urine 17-OHCS in the model group were substantially increased， while the expression of hippocampal ADAM10， Beclin1， and microtubule associated-protein light chain 3-Ⅱ/Ⅰ （LC3 Ⅱ/Ⅰ） was significantly decreased. The expression of GPNMB and ubiquitin binding protein p62 was significantly increased （P<0.05， P<0.01）. Compared with the model group， the serum Cort and ACTH levels in the low-， medium-， and high-dose Liuwei Dihuangwan groups were significantly reduced， while only the urine 17-OHCS level in the high-dose group was significantly reduced. The hippocampal GPNMB， ADAM10， Beclin1， and LC3 Ⅱ/Ⅰ expression levels in the medium-， and high-dose groups of Liuwei Dihuangwan were significantly increased compared to the model group， whereas the expression of p62 was significantly reduced （P<0.01）. The above indicators showed a progressive trend among the three groups. Compared with the model group， the GPNMB^OE group showed a significant increase in GPNMB， ADAM10， Beclin1， LC3 Ⅱ/Ⅰ expression， and a significant decrease in p62 expression （P<0.01）. Compared with the model group， the expression of GPNMB， ADAM10， Beclin1， and LC3 Ⅱ/Ⅰ in the hippocampus of the Liuwei Dihuangwan group significantly increased， while the expression of p62 significantly decreased （P<0.01）. Compared with the Liuwei Dihuangwan group， the Liuwei Dihuangwan+shGPNMB group showed a significant decrease in GPNMB， ADAM10， Beclin1， LC3 Ⅱ/Ⅰ， and a significant increase in p62 expression （P<0.01）. ConclusionLiuwei Dihuangwan can enhance hippocampal autophagy function and improve AD by upregulating GPNMB expression.

Chemical constituents of n-butanol fraction of ethanol extract from the leaves of Cyclocarya paliurus (Batalin) Iljinskaja were studied. Ten compounds were purified by silica gel, MCI, ODS, Sephadex LH-20 column chromatography and semi-preparative high-performance liquid chromatography. Based on the physicochemical properties and spectroscopic data, these compounds were identified as (4S)-4,8-dihydroxy-α-tetralone-5-[6′-(3′′,5′′-dimethoxy-(E)-p-coumaroyl)]-β-D-glucopyranoside (1), (4S)-4,8-dihydroxy-α-tetralone-5-[6′-(E)-feruloyl]-β-D-glucopyranoside (2), (1S,3R,4S,5R)-4,5-di-O-caffeoyl quinic acid methyl ester (3), (1R,3R,4S,5R)-3,4-di-O-caffeoyl quinic acid methyl ester (4), (3R,5R)-3,4,5-tri-O-caffeoylquinic acid methyl ester (5), (1R,3R,4S,5R)-3-O-caffeoyl-5-O-p-coumaroyl quinic acid methyl ester (6), (1R,3R,4S,5R)-3-O-p-coumaroy-4-O-caffeoyl quinic acid methyl ester (7), (1R,3R,4S,5R)-3-O-caffeoyl-4-O-p-coumaroy quinic acid methyl ester (8), (3R,5R)-3,5-di-O-caffeoyl quinic acid methyl ester (9) and (1S,3R,4R,5R)-4-O-caffeoyl-5-O-feruloyl quinic acid methyl ester (10). Among them, compound 1 was a new compound, and compounds 3–10 were isolated from the genus Cyclocarya for the first time.

Objective To gain insights into the biological characteristics of different populations of Culex tritaeniorhynchus within and around the Yellow Sea wetland from the perspective of the occurrence of resistance, we investigated the levels of resistance to deltamethrin and kdr gene mutation in the wetland and its peripheral areas. Methods Specimens were collected from Cx. tritaeniorhynchus populations at two monitoring sites in the Rare Bird National Nature Reserve and Tiaozi Ni Wetland Scenic Area, and also from two populations in Yancheng City and the Liuhe District of Nanjing, and the resistance of these mosquitoes to deltamethrin was determined using the CDC biotest bottle method. For each concentration of deltamethrin assessed, a random subset of exposed specimens was selected for amplification of the kdr gene fragment, followed by Sanger sequencing to identify and analyze resistance-associated mutations. Results The LC50 levels of deltamethrin among mosquitoes from the four populations in Luhe, Yancheng, the Rare Bird National Nature Reserve and the Tiaozi Ni Wetland Scenic Area were 2.048 5, 7.798 2, 3.473 3, and 17.695 5 mg/mL, respectively, with corresponding concentrations of deltamethrin ranging from 0.005 to 5.000,0.050 to 50.000,0.050 to 25.000 and 0.050 to 50.000 mg/mL, respectively. Furthermore, the ranges of the KT50 values were 11.76-107.43, 67.05-216.30,29.77-107.43 and 28.40-329.51 min; the 1-h knockdown rates were 34.58%-99.15%, 9.52%-43.80%, 55.09%-73.01%, and 10.09%-68.07%; and the 24-h mortality rates were 12.15%-67.52%,9.52%-79.56%,13.17%-82.21%, and 11.01%-78.99%, respectively. With respect to kdr gene mutation, we assayed a total of 63,70,59, and 57 mosquitoes for the four populations, for which we detected L1014F mutation frequencies of 14.29%, 35.00%, 20.34%, and 31.58%, respectively, with a majority of these mutations being heterozygous for resistance. In addition, five adult mosquitoes were identified has having synonymous mutations at site 1011[i. e. , AAT(asparagine)mutation to AAC(asparagine)]. Conclusions Our findings revealed the clear resistance of Cx. tritaeniorhynchus to deltamethrin in the Yancheng region of the Yellow Sea wetland, and the resistance phenotype and kdr frequency of Cx. tritaeniorhynchus in the wetland environment were comparable to those of Cx. tritaeniorhynchus in the wetland environment, thereby indicating that the resistance of different populations of Cx. tritaeniorhynchus was homogeneous under the pressure of different insecticide selection within and around the wetland. However, the underlying mechanisms need to be further studied.

Objective To explore the health issues and influencing factors of workers in new forms of employment, represented by couriers and food delivery workers, based on the social-ecological model (SEM). Methods A total of 44 couriers and food delivery workers from Beijing City, Shanghai City, Guangzhou City, and Chongqing City were recruited as the study subjects using purposive sampling combined with snowball sampling method. An interview guide was developed based on the SEM to conduct semi-structured interviews. Thematic analysis was employed to code and analyze the interview data. Results The health influencing factors among the couriers and food delivery workers based on the SEM included three first-level themes at the micro-, meso-, and macro-levels, namely "individual factors," "occupational environmental factors," and "social environmental factors," each comprising three second-level themes. At the micro-level, individual factors such as insufficient health literacy, unhealthy lifestyles and behaviors, and sustained psychological burden jointly contributed to the health vulnerability among these couriers and food delivery workers. At the meso-level, occupational environmental factors including algorithmic management, high-load work environments, and inadequate interpersonal support, jointly construct a high-pressure and high-intensity work pattern. At the macro-level, social environmental factors such as insufficient social security caused by the de facto nature of labor relations, economic pressure resulting from unstable income in the market environment, and psychological depletion caused by occupational discrimination further exacerbate the health vulnerability among these workers. Conclusion The health issues of the couriers and food delivery workers result from the interplay of factors across micro-, meso-, and macro- levels. Therefore, a multi-level collaborative health protection system involving individuals, organizations, and society should be established to improve their health status.

Patients with craniopharyngioma are at a high risk of developing metabolic dysfunction-associated fatty liver disease and its severe complications， yet this association is often neglected in clinical practice， with a lack of systematic reviews. This article systematically reviews the clinical spectrum and epidemiological characteristics of liver diseases associated with craniopharyngioma， with a focus on their core pathogenic mechanisms， and it also summarizes current tumor treatment strategies aimed at preventing hypothalamic injury and highlights that establishing a multidisciplinary collaborative diagnosis and treatment model and implementing early intervention are key to improving prognosis. Future research should focus on elucidating the precise pathways through which hypothalamic injury leads to metabolic disturbances， thereby facilitating the development of targeted therapies， in order to provide new directions for fundamentally improving the clinical outcomes of these patients.

ObjectiveTo investigate the clinical characteristics， diagnostic challenges， and treatment strategies in pediatric patients with ureteropelvic junction obstruction （UPJO） complicated with ipsilateral ureterovesical junction obstruction （UVJO）. MethodsA retrospective analysis was conducted on clinical data of pediatric patients admitted to our hospital between January 2014 and December 2024 with a confirmed diagnosis of UPJO complicated with UVJO. The collected clinical parameters included gender， age at presentation， initial diagnosis， lesion laterality， imaging findings， surgical procedures， and follow-up outcomes. ResultsThe study cohort comprised 14 pediatric patients （male=10 and female=4） with a median age of 3.1 months at presentation. The initial diagnoses were UPJO in 9 cases and UVJO in 5 cases. Preoperatively， only 6 cased showed ureteral dilation on MRU. The definitive diagnosis was confirmed by intraoperative retrograde pyelography in 5 cases， postoperative antegrade pyelography via a nephrostomy tube in 7 patients， and combined application of the two modalities in 2 patients. For primary surgical intervention， 9 patients underwent pyelo-plasty， 2 underwent ureteral reimplantation， 2 received percutaneous nephrostomy， and 1 underwent ureteral orifice dilation. Intraoperative nephrostomy tube placement was performed in 10 patients. With a median follow-up duration of 5.5 years， 4 patients required revision surgery. Of these， only 1 patient ， who had an initial diagnosis of UPJO， required staged management for persistent obstruction， whereas UPJ obstruction resolved after ureteroneocystostomy in the remaining 3 patients with an initial diagnosis of UVJO. Among the 10 patients who did not undergo revision surgery， 8 showed delayed distal urinary drainage on APG， yet remained asymptomatic with continuous improvement of hydronephrosis after nephrostomy tube clamping. ConclusionsPreoperative diagnosis of concurrent UPJO and ipsilateral UVJO in pediatric patients is clinically challenging. Further intraoperative evaluation is mandatory when antegrade or retrograde ureteral stent placement fails during surgery. For patients with an initial diagnosis of UPJO， pyeloplasty is the first-line treatment. Routine retrograde pyelography is not recommended， whereas nephrostomy tube with subsequent postoperative APG evaluation can prevent unnecessary ureteroneocystostomy. For patients with an initial diagnosis of UVJO accompanied by severe ureteral dilation， primary ureteroneocystostomy is feasible initial management strategy.

Objective: To evaluate the health economic value of the free screening policy for congenital heart disease (CHD) among newborns in Lishui City, Zhejiang Province, so as to provide the evidence for optimizing health resource allocation and improving basic public health services. Methods: Data on free CHD screening in Lishui City from 2022 to 2024 were collected through the Newborn CHD Screening Registration System of Lishui Maternity and Child Health Care Hospital. With no screening as the control, costs, benefits and utilities were calculated and discounted to the year 2022 at a discount rate of 3%. Benefit-cost ratio (BCR) and incremental cost-utility ratio (ICUR) were used for economic evaluation. One-way sensitivity analysis and Monte Carlo probabilistic sensitivity analysis were conducte. Results: A total of 44 343 newborns were screened for free CHD in Lishui City from 2022 to 2024. Among them, 4 202 tested positive on initial screening, 367 were confirmed as CHD cases, and 3 835 were false-positive. After discounting, the total screening cost was 2.141 0 million yuan, with total benefits of 13.148 2 million yuan and the net health utility gain was 245.32 quality-adjusted life year (QALY). The BCR was 6.14, and the ICUR was 8 727 yuan/QALY, which was lower than the willingness-to-pay threshold of per capita gross domestic product in Lishui City (78 978 yuan/QALY). Sensitivity analysis showed that the BCR remained above 1 and the ICUR remained below the willingness-to-pay threshold across all key parameters, indicating robust results. Conclusions The free newborn CHD screening policy in Lishui City presents favorable economic efficiency and scalability. It is recommended to further optimize costs and benefits through centralized procurement of consumables and closed-loop information management.

Polycystic ovary syndrome （PCOS）， a common reproductive endocrine disorder in women， is one of the leading causes of ovulatory infertility in women of reproductive age. Due to its heterogeneous etiology， complex symptoms， and challenging treatment， PCOS has become a focal point of research in gynecological and reproductive medicine globally. The pathogenesis of PCOS is complex and may involve regulatory mechanisms such as inflammatory responses， oxidative stress， and cellular autophagy. Crown-like structures （CLSs） refer to pro-inflammatory microenvironments formed by macrophages engulfing adipocytes. The inflammatory disorders induced by CLSs are one of the key factors contributing to the development of PCOS and its complications. Current studies have indicated that the obese status in PCOS accelerates the formation of CLSs， and the density of CLSs can predict the progression of metabolic disorders and influence the outcomes of various metabolic diseases. Traditional Chinese Medicine （TCM） offers the unique advantages of a holistic view， four diagnostic methods， and syndrome differentiation and treatment to ameliorate the symptoms and signs of PCOS through multiple levels， pathways， and targets. Although studies on the mechanisms of metabolic diseases and CLS formation have been reported in China and abroad， there is still a lack of literature on the correlation between CLSs and PCOS， as well as reviews on TCM interventions targeting CLSs for treating this disease. Therefore， this paper summarized the correlation between obese PCOS and CLSs and reviewed recent studies on TCM interventions based on CLS formation （adipose tissue-macrophage inflammatory crosstalk） in the treatment of obese PCOS， aiming to provide new research perspectives for the prevention and treatment of PCOS using TCM.

Objective:To observe the effects of Alpiniae Oxyphyllae Fructus-Linderae Radix on miR-155-5p/SOCS1/inflammatory factor axis and cell apoptosis in hippocampus of depressed rats.Methods:A total of 60 SPF male Wistar rats were divided into six groups: control group, model group, fluoxetine group and Alpiniae Oxyphyllae Fructus-Linderae Radix low-, middle- and high-dosage groups, with 10 rats in each group. Except for the control group, all other groups used chronic mild unpredictable stimuli combined with solitary confinement to construct a depression rat model. Following an 8-week modeling period, the fluoxetine group received oral administration of 2 mg/kg Fluoxetine liquid daily and the Alpiniae Oxyphyllae Fructus-Linderae Radix groups received oral administration of 1 g/kg, 2 g/kg and 4 g/kg Alpiniae Oxyphyllae Fructus-Linderae Radix liquid daily, whereas the control group and model group were given an equivalent volume of distilled water for continuous drug intervention over a span of 3 weeks. The rats' behavioral variations were assessed through an open field test; miR-155-5p expression in the hippocampus was determined via RT-PCR; SOCS1 protein expression in the hippocampus was evaluated by Western Blot; TNF-α, IL-6 and IL-1β levels in the serum were quantified using ELISA; hippocampal cell apoptosis was examined through HE staining.Results:Compared with the model group, the fluoxetine group and Alpiniae Oxyphyllae Fructus-Linderae Radix middle- and high-dosage groups showed an increase in open field test scores ( P<0.05), a decrease in miR-155-5p expression in the hippocampus ( P<0.05), an increase in SOCS1 protein expression in the hippocampus ( P<0.05), a decrease in serum TNF-α, IL-1β, IL-6 levels ( P<0.05), and a reduction in apoptosis of hippocampal CA3 cells ( P<0.05). Conclusion:Alpiniae Oxyphyllae Fructus-Linderae Radix probably amplifies the indirect negative regulation of SOCS1 protein on inflammatory factors by suppressing miR-155-p expression in the hippocampus of depressed rats, thereby ameliorating cell apoptosis in the hippocampal area and manifesting antidepressant properties.

BACKGROUND: At present, biopsy is essential for the diagnosis of prostate cancer (PCa) before radical prostatectomy (RP). However, with the development of prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) and multiparametric magnetic resonance imaging (mpMRI), it might be feasible to avoid biopsy before RP. Herein, we aimed to explore the feasibility of avoiding biopsy before RP in patients highly suspected of having PCa after assessment of PSMA PET/CT and mpMRI. METHODS: Between December 2017 and April 2022, 56 patients with maximum standardized uptake value (SUVmax) of ≥4 and Prostate Imaging Reporting and Data System (PI-RADS) ≥4 lesions who received RP without preoperative biopsy were enrolled from two tertiary hospitals. The consistency between clinical and pathological diagnoses was evaluated. Preoperative characteristics were compared among patients with different pathological types, T stages, International Society of Urological Pathology (ISUP) grades, and European Association of Urology (EAU) risk groups. RESULTS: Fifty-five (98%) patients were confirmed with PCa by pathology, including 49 (89%) with clinically significant prostate cancer (csPCa, defined as ISUP grade ≥2 malignancy). One patient was diagnosed with high-grade prostatic intraepithelial neoplasia (HGPIN). CsPCa patients, compared with clinically insignificant prostate cancer (cisPCa) and HGPIN patients, were associated with a higher level of prostate-specific antigen (22.9 ng/mL vs . 10.0 ng/mL, P = 0.032), a lower median prostate volume (32.2 mL vs . 65.0 mL, P = 0.001), and a higher median SUVmax (13.3 vs . 5.6, P <0.001). CONCLUSIONS It might be feasible to avoid biopsy before RP for patients with a high probability of PCa based on PSMA PET/CT and mpMRI. However, the diagnostic efficacy of csPCa with PI-RADS ≥4 and SUVmax of ≥4 is inadequate for performing a procedure such as RP. Further prospective multicenter studies with larger sample sizes are necessary to confirm our perspectives and establish predictive models with PSMA PET/CT and mpMRI.
Humans ; Male ; Prostatectomy/methods* ; Prostatic Neoplasms/diagnosis* ; Middle Aged ; Aged ; Positron Emission Tomography Computed Tomography/methods* ; Biopsy ; Multiparametric Magnetic Resonance Imaging ; Prostate-Specific Antigen/metabolism*