Objective To longitudinally investigate the characteristics of postoperative weight changes in patients with esophageal cancer and analyze its influencing factors, which can provide certain guidance for nutritional intervention in patients with esophageal cancer. Methods Patients with esophageal cancer who underwent surgical treatment at the Sichuan Cancer Hospital from December 2020 to February 2022 were prospectively included. The general information questionnaire and body composition analyzer were used to longitudinally investigate the patients’ weight and body composition before surgery (T0), 1 month after surgery (T1), 3 months after surgery (T2) and 6 months after surgery (T3), and the change characteristics were analyzed. The generalized estimating equation was used to analyze the influencing factors for postoperative weight changes in patients with esophageal cancer. Results A total of 130 patients were enrolled, including 110 males and 20 females, aged 42-79 (63.33±8.16) years. The weight and body composition of patients with esophageal cancer showed a continuous slow downward trend within 6 months after surgery. The weight loss rate of patients at 1, 3, and 6 months after surgery was 5.10%, 7.76%, and 9.86%, respectively. The analysis results of the influencing factors for postoperative weight showed that patients with the following characteristics had more weight loss: female (β=−7.703, P=0.001), ≥60 years (β=−3.657, P=0.010), smoking (β=4.622, P=0.010), low tumor differentiation degree (β=4.314, P=0.039), and high frequency of eating (β=−3.400, P=0.008). Conclusion Weight loss is an important health problem for patients with esophageal cancer after surgery, and patients have a continuous downward trend in weight within 6 months after surgery. Medical staff should pay special attention to the patients who are female, ≥60 years, having smoking history and low tumor differentiation degree.

Objective To analyze the mutation status of Kirsten rat sarcoma viral oncogene homolog(KRAS),phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha(PIK3CA),v-raf murine sarcoma viral oncogene homolog B1(BRAF)genes,and the expression of mismatch repair(MMR)and human epidermal growth factor receptor 2(HER-2)proteins in tumor tissues of patients with colorectal cancer(CRC)harboring neuroblastoma rat sarcoma viral oncogene homolog(NRAS)gene mutations,and explore their relationships with the clinicopathological characteristics of CRC patients.Methods The clinicopathological data of 546 patients with NRAS mutation CRC were retrospectively analyzed.The mutation status of NRAS,KRAS,PIK3CA,and BRAF genes was detected by AmoyDx amplification refractory mutation system(ARMS)-polymerase chain reaction(PCR)kit(fluorescent PCR method),the expression levels of MMR and HER-2 proteins were detected by immunohistochemical staining EnVision method,and the relationship between them and the clinicopathological characteristics of patients were analyzed.Results The mutation rate of single-point mutations in the NRAS gene was 98.35%(537/546),double-point mutations in the NRAS gene were 1.65%(9/546),and double mutations in the NRAS and KRAS genes were 1.47%(8/546).No patients were found to harbor mutations in the PIK3CA or BRAF genes.The types of NRAS mutations included Q61R(or Q61K,Q61L,Q61H)mutations(266/546,48.72%),G12D(or G12S)mutations(154/546,28.21%),G13R(or G12C,G12V,G12A,G13V)mutations(134/546,24.54%),and A146T mutation(1/546,0.18%).G13R(or G12C,G12V,G12A,G13V)mutations in the NRAS gene were more likely to occur in the rectum cancer patients(P=0.035);although the tumors had a larger diameter(P=0.029),the patients had a longer progression-free survival after surgery(P=0.028).Among patients with NRAS gene mutations,HER-2 positive expression was associated with perineural invasion(P=0.003),and the patients with deficient MMR were younger on average(P=0.041)and were associated with double-point mutations in the NRAS gene(P=0.018).Conclusion CRC harboring NRAS mutations may have unique clinicopathological characteristics and molecular phenotypes,providing possibilities for individualized treatment and prognosis evaluation of CRC.

Objective To analyze the diversity and composition of gut microbiota in individuals with circadian rhythm disruption and their correlation with cognition.Methods Night shift workers and regular shift workers were subjected from our hospital during August 2022 and October 2024.The participants with circadian rhythm disorders were assigned into an experimental group(n=24),and those with normal circadian rhythms were into a control group(n=24).Their height,weight,age,gender,body mass index(BMI)and fresh fecal samples were collected,and Montreal Cognitive Assessment(MoCA)and Mini-Mental State Examination(MMSE)were used to evaluate their mental status.Metagenomics,Alpha and Beta diversity analyses,Linear Discriminant Analysis Effect Size(LEfSe),and Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis were employed to investigate the diversity and function characteristics of gut microbiota in the participants.Results There were no statistical differences between the 2 groups in baseline data,such as height,weight,gender,age,and BMI(P>0.05).Alpha diversity analysis indicated that no statistical differences were observed in the ACE,Chao1,Shannon,or Simpson indices between the 2 groups,while beta diversity analysis revealed significant differences(P<0.01),suggesting different structure of gut microbiota between them.In the experimental group,the abundance of Faecalibacterium prausnitzii and Agathobacter rectalis was decreased,while that of Escherichia coli and Phocaeicola vulgaratus was increased,with significant differences when compared with the control group(P<0.05).Additionally,KEGG functional analysis showed that the experimental group had obviously higher expression levels in Th17 cell differentiation and the IL-17 signaling pathway than the control group(P<0.05).Agathobacter rectalis and Faecalibacterium prausnitzii were positively correlated with MoCA score and MMSE score(P<0.05,P<0.01).Agathobacter rectalis was negatively correlated with the IL-17 signaling pathway and Th17 cell differentiation.Conclusion Individuals with circadian rhythm disorders have significant changes in the structure and function of gut microbiota when compared to those with normal circadian rhythms.Agathobacter rectalis may be involved in the regulation of the IL-17 signaling pathway and differentiation of Th17 cells,thereby possibly impacting the increases of cognitive score related to circadian rhythm disorders.

Ankylosing spondylitis (AS) combined with lower cervical fracture is often categorized into unstable fracture, with a high incidence of neurological injury and a high rate of disability and morbidity. As factors such as shoulder occlusion may affect the accuracy of X-ray imaging diagnosis, it is often easily misdiagnosed at the primary diagnosis. Non-operative treatment has complications such as bone nonunion and the possibility of secondary neurological damage, while the timing, access and choice of surgical treatment are still controversial. Currently, there are no clinical practice guidelines for the treatment of AS combined with lower cervical fracture with or without dislocation. To this end, the Spinal Trauma Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate Clinical guidelines for the treatment of ankylosing spondylitis combined with lower cervical fracture in adults ( version 2024) in accordance with the principles of evidence-based medicine, scientificity and practicality, in which 11 recommendations were put forward in terms of the diagnosis, imaging evaluation, typing and treatment, etc, to provide guidance for the diagnosis and treatment of AS combined with lower cervical fracture.

The Major Principles of the Five Elements is a collection of Yin-Yang and Five Elements theories in the middle ancient period of China.The Xiangshu model of Yin-Yang and Five Elements is the basic paradigm to clarify the world and its existence."Constitution"and"Function"are a pair of important categories used in ancient philosophy to describe the relationship be-tween the nature and function of ontology.Based on the two temporal and spatial rhythms of the Heluo Heaven and Earth Five Elements view and the Jiugong Bafeng spatiotemporal view constructed by the Xiangshu model,The Major Principles of the Five Elements explains the connotation and characteristics of traditional medical constitution and function,aiming to elucidate the evolution process of the path-ogenesis of constitution and function,guide the dialectical thinking of constitution and function,and flexibly select and combine drug properties and flavors to harmonize the human constitution and function.This paper provides a unique perspective and method for ex-plaining the concept and connotation of constitution and function in traditional Chinese medicine by glimpsing the gradual changing way of thinking in traditional medicine from the Pre-Qin period to the Tang Dynasty.

Objective:To evaluate the validity and reliability of Positive Beliefs About Rumination Scale(PBRS)in Chinese college students.Methods:A total of 968 college students were selected.Exploratory factor a-nalysis,criterion validity and internal consistency reliability test were performed on sample 1(n=496).The Rumi-native Responses Scale(RRS),Metacognitions Questionnaire(MCQ)and Beck Depression Inventory-Ⅱ(BDI-Ⅱ)were used as criteria for criterion validity test.Confirmatory factor analysis and Measurement invariance across gen-der were performed on sample 2(n=472).The 87 college studentsin sample 1 were retested 6 weeks later.Results:The exploratory factor analysis found 1 factor,which explained 54.39％of the total variance.The confirmatory factor analysis showed that the 1-factor model fitted well(x2/df=3.38,CFI=0.962,TLI=0.940,SRMR=0.043,RMSEA=0.071).The scores of the Positive Beliefs About Rumination Scale were positively cor-related with the scores of RRS,MCQ and BDI-Ⅱ(ICC=0.37,0.41,0.12,Ps＜0.01).The Cronbach α coefficient of the Positive Beliefs About Rumination Scale was 0.89.The retest reliability(ICC)of the Positive Beliefs About Rumination Scale was 0.72.The configural,weak,strong and strict invariance of the PBRS across gender were all acceptable(△CFI,△TLI＜0.01).Conclusion:The Positive Beliefs About Rumination Scale has good validity and reliability in Chinese college students.

Objective:To explore the changes of iron metabolism in patients with hepatitis B cirrhosis and esophageal and gastric varices complicated with portal vein thrombosis.Methods:This study was a cross-sectional study. 253 patients with hepatitis B cirrhosis with esophageal and gastric varices who were hospitalized in the Zhongshan Hospital, Fudan University from January 1, 2020 to December 31, 2021 were included in this study. They were divided into portal vein thrombosis group ( n=57) and non portal vein thrombosis group ( n=196) according to the presence or absence of portal vein thrombosis. The iron metabolism characteristics of the two groups were compared, and subgroups were analyzed according to the presence or absence of ascites, platelet count level, D-dimer level, and Child grade. The factors related to portal vein thrombosis were screened through multivariate logistic regression analysis. Results:The ratio of Child pugh B/C, ascites, D-dimer and platelet count in patients with hepatitis B cirrhosis and esophageal and gastric varices complicated with portal vein thrombosis was higher (all P<0.05). Patients with portal vein thrombosis had higher levels of soluble transferrin receptor [2.4(1.8, 3.6)mg/L vs 1.8(1.3, 2.7)mg/L, P=0.006], and lower levels of ferritin [33.1(18.9, 63.3)ng/ml vs 57.7(19.4, 142.5)ng/ml, P=0.038]. Layered analysis showed that ascites, platelet count levels, D-dimer levels, and Child-pugh grade did not affect the negative correlation trend between ferritin and portal vein thrombosis, and the positive correlation trend between soluble transferrin receptors and portal vein thrombosis. Moreover, soluble transferrin receptors showed a statistically significant positive correlation with portal vein thrombosis in the absence of ascites, low D-dimer levels, and Child-pugh grade A. Multivariate analysis suggested that after weighing Child-pugh grading, platelet count, and D-dimer levels, ferritin ( OR=0.943, 95% CI: 0.904-0.983, P=0.006) and soluble transferrin receptor ( OR=1.034, 95% CI: 0.001-1.067, P=0.044) were independently associated with portal vein thrombosis. Conclusions:In patients with hepatitis B cirrhosis with esophageal and gastric varices, the characteristics of iron metabolism in patients with portal vein thrombosis are different from those in patients without thrombosis, with higher levels of soluble transferrin receptor and lower levels of ferritin.

Objective:To investigate the therapeutic efficacy of spleen-invigorating, dampness-removing and stasis-dissolving formula (SDSF) combined with endocrinotherapy for metastatic hormone-sensitive prostate cancer (mHSPC).Methods:A retrospective case control study was conducted. The clinical data of 193 mHSPC patients treated at First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, the Second Hospital of Tianjin Medical University, and Tianjin First Central Hospital from January 2018 to March 2021 were retrospectively analyzed. All patients were treated with continuous endocrinotherapy and they were divided into the combination therapy group (82 cases) and the monotherapy group (94 cases) based on whether they received SDSF treatment or not. Prostate specific antigen (PSA), serum testosterone, blood lipids (triglyceride, total cholesterol), fasting blood glucose, and international prostate symptoms score (I-PSS) and Karnofsky score were compared between the 2 groups. Kaplan-Meier method was used to analyze the progression-free survival (PFS), and log-rank test was performed. The Cox proportional risk model was used to make univariate analysis and multivariate analysis on the influencing factors of PFS.Results:A total of 176 mHSPC patients were finally enrolled and the age was 67±11 years. There were no statistically significant differences in terms of PSA, serum testosterone, triglyceride, total cholesterol and fasting blood glucose, I-PSS score and Karnofsky score between the two groups (all P > 0.05). A total of 91 mHSPC patients developed metastatic castration resistant prostate cancer (mCRPC), including the combination therapy group (40 cases) and the monotherapy group (51 cases), and 9 patients died because of the progression to mCRPC. The median PFS time of all patients was 19 months, that was 17.9 months in the monotherapy group and 20.4 months in the combination therapy group; and the difference was statistically significant between the 2 groups ( P = 0.001). Multivariate Cox regression analysis results showed that combination therapy with SDSF and the lowest testosterone level were independent influencing factors of PFS ( P = 0.001). The total cholesterol at 6-, 9-, 12-month in the combination therapy group was lower than that in the monotherapy group (all P < 0.05), triglyceride at 3-, 6-, 9-, 12-month in the combination therapy group was lower than that in the monotherapy group (all P < 0.05); and the differences in fasting blood glucose after treatment at different time points were not statistically significant between the 2 groups (all P > 0.05); I-PSS score at 9-, 12-month in the monotherapy group was lower than that in the monotherapy group (both P < 0.05). Conclusions:The combination of SDSF with endocrinotherapy can delay the progression of mHSPC, improve treatment-related complications, and enhance patients' quality of life.

Abstract OBJECTIVE To explore the material basis and mechanism of Crataegi Fructus in improving metabolic hypertension(MH) by using network pharmacology and molecular docking technique.METHODS The components of Crataegi Fructus were collected by HERB, ETCM database and literature survey; screening all ingredients of Crataegi Fructus to improve MH targets through databases such as SwissTargetPrediction and GeneCards; build "active ingredient-target-disease" network of Crataegi Fructus with Cytoscape software; DAVID was used to analyze GO enrichment and KEGG pathway. The core components and core targets were verified by molecular docking with Autodock software. RESULTS The total of 89 active components were screened from Crataegi Fructus and acted on 84 targets. Among them, the core active components of Crataegi Fructus to improve MH were maslinic acid, fomefficinic acid B, linolenic acid, linoleic acid, methyl-n-nonylketone, apigenin, ursolic acid, etc. The core targets were CYP19A1, PPARA, ESR1, PTGS2, PPARG, NR3C1, MMP9, TNF, etc. The mechanism of action mainly involved multiple signaling pathways such as inflammation, glycolipid metabolism, and vascular endothelial function. Molecular docking showed that the core active ingredients of Crataegi Fructus had high affinity with core targets. CONCLUSION Crataegi Fructus may regulate multiple signaling pathways such as TNF, IL-17, AGE-RAGE, HIF-1, cGMP-PKG through multi-component regulation, thereby inhibiting inflammatory response, improving glucose and lipid metabolism abnormalities, and improving vascular endothelial function, so as to comprehensively exert the role of improving MH in various aspects.