Objective:To evaluate the perceived level of home exercise behavior in elderly patients with ovarian cancer and analyze its influencing factors, so as to promote home exercise behavior of patients and improve the quality of life.Methods:A total of 227 elderly patients with ovarian cancer from January 1, 2021 to October 1, 2023 in the First Affiliated Hospital, School of Medicine, Zhejiang University were selected by convenience sampling method. A cross-sectional survey was conducted by General Information Questionnaire, Exercise Benefits/Barriers Scale (EBBS), Social Support Rating Scale (SSRS), General Self-efficacy Scale (GSES) and Brief Fatigue Inventory (BFI). The influencing factors on the perceived level of home exercise behavior in elderly patients with ovarian cancer were analyzed.Results:There were 227 elderly female patients with ovarian cancer, including 151 patients aged<70 years old and 76 patients aged ≥70 years old. The scores of EBBS, SSRS, GSES, BFI were (123.37±11.02), (37.68±7.44), (29.35±6.54), (5.82±2.01) points. The perception of exercise behavior was positively correlated with general self-efficacy and social support ( r=0.752, 0.901, both P<0.01), was negatively correlated with cancer-related fatigue ( r=-0.198, P<0.01). The results showed that general self-efficacy, social support, age≥70 years old, no spouse, not being informed of the benefits of exercise,fatigue due to moderate and severe cancer, duration of disease ≥12 months were the influencing factors ( t values were -4.56 - 4.46, all P<0.05). Conclusions:Elderly patients with ovarian cancer need to improve their perception level of home exercise behavior. In the formulation of home exercise behavior for elderly patients with ovarian cancer, education and cognition on the perceived benefits of home exercise behavior should be strengthened, and patients′ physical and mental status should be evaluated before exercise to actively reduce cancer-related fatigue. At the same time, the combination of family support can improve the perceived level of exercise behavior of elderly patients with ovarian cancer at home, so as to promote home exercise behavior of patients.

Objective:To evaluate the perceived level of home exercise behavior in elderly patients with ovarian cancer and analyze its influencing factors, so as to promote home exercise behavior of patients and improve the quality of life.Methods:A total of 227 elderly patients with ovarian cancer from January 1, 2021 to October 1, 2023 in the First Affiliated Hospital, School of Medicine, Zhejiang University were selected by convenience sampling method. A cross-sectional survey was conducted by General Information Questionnaire, Exercise Benefits/Barriers Scale (EBBS), Social Support Rating Scale (SSRS), General Self-efficacy Scale (GSES) and Brief Fatigue Inventory (BFI). The influencing factors on the perceived level of home exercise behavior in elderly patients with ovarian cancer were analyzed.Results:There were 227 elderly female patients with ovarian cancer, including 151 patients aged<70 years old and 76 patients aged ≥70 years old. The scores of EBBS, SSRS, GSES, BFI were (123.37±11.02), (37.68±7.44), (29.35±6.54), (5.82±2.01) points. The perception of exercise behavior was positively correlated with general self-efficacy and social support ( r=0.752, 0.901, both P<0.01), was negatively correlated with cancer-related fatigue ( r=-0.198, P<0.01). The results showed that general self-efficacy, social support, age≥70 years old, no spouse, not being informed of the benefits of exercise,fatigue due to moderate and severe cancer, duration of disease ≥12 months were the influencing factors ( t values were -4.56 - 4.46, all P<0.05). Conclusions:Elderly patients with ovarian cancer need to improve their perception level of home exercise behavior. In the formulation of home exercise behavior for elderly patients with ovarian cancer, education and cognition on the perceived benefits of home exercise behavior should be strengthened, and patients′ physical and mental status should be evaluated before exercise to actively reduce cancer-related fatigue. At the same time, the combination of family support can improve the perceived level of exercise behavior of elderly patients with ovarian cancer at home, so as to promote home exercise behavior of patients.

Mitochondrial autophagy is a unique mechanism that selectively clears dysfunctional or excess mitochondria,closely related to Alzheimer's disease(AD),which is characterized by aggregated neurotoxic proteins and dysfunctional mitochondria.Numerous recent studies have confirmed that traditional Chinese medicine can have significant therapeutic effects against AD,and its advantages including multi-target,multi-pathway,and multi-action mechanisms have become an important component of AD research.Chinese medicine formulas and monomeric active ingredients,such as Jiannaoyizhi Fang,Danggui Shaoyao Tang,alkaloids,and flavonoids,can regulate mitochondrial autophagy-related signaling pathways and targets,inhibit neuronal mitochondrial autophagy defects,and play a neuroprotective role.This review elaborates on the basic process of mitochondrial autophagy and its related signaling pathways and molecular mechanisms in the pathogenesis of AD,and considers the latest research progress on the use of traditional Chinese medicine to improve AD by regulating mitochondrial autophagy,to provide ideas and references for future basic research and clinical treatment.

Mitochondrial autophagy is a unique mechanism that selectively clears dysfunctional or excess mitochondria,closely related to Alzheimer's disease(AD),which is characterized by aggregated neurotoxic proteins and dysfunctional mitochondria.Numerous recent studies have confirmed that traditional Chinese medicine can have significant therapeutic effects against AD,and its advantages including multi-target,multi-pathway,and multi-action mechanisms have become an important component of AD research.Chinese medicine formulas and monomeric active ingredients,such as Jiannaoyizhi Fang,Danggui Shaoyao Tang,alkaloids,and flavonoids,can regulate mitochondrial autophagy-related signaling pathways and targets,inhibit neuronal mitochondrial autophagy defects,and play a neuroprotective role.This review elaborates on the basic process of mitochondrial autophagy and its related signaling pathways and molecular mechanisms in the pathogenesis of AD,and considers the latest research progress on the use of traditional Chinese medicine to improve AD by regulating mitochondrial autophagy,to provide ideas and references for future basic research and clinical treatment.

BACKGROUND:Autophagy has become a rapidly developing research hotspot in the biomedical fields.Many researchers are actively exploring the molecular regulatory mechanism of autophagy in a variety of diseases.However,the role of autophagy in hair growth is still unknown. OBJECTIVE:To review the current research progress and application value of autophagy in hair growth and regeneration,to understand the role of autophagy in hair growth,to explore the pathogenesis of autophagy in pathological hair loss,and to provide new ideas for the study of drugs for hair loss. METHODS:Using"hair follicle growth,hair growth,hair regeneration,autophagy associated proteins,autophagy activity,autophagy associated genes,autophagy"as Chinese search terms and"hair growth,hair follicle,hair regeneration,autophagy"as English search terms,PubMed and CNKI databases were searched.The research progress on autophagy,hair growth and the role of autophagy in hair growth in and outside China in recent years was reviewed and summarized.Articles incompatible with the subject content of the paper were excluded.Finally,78 articles were included for the result analysis. RESULTS AND CONCLUSION:(1)Autophagy is a normal metabolic process in eukaryotes with complex molecular mechanisms and functional properties,which is beneficial to cell survival and cell death.(2)Alopecia-related diseases are associated with changes in autophagy activity,which can regulate hair growth cycle.Knockout or overexpression of autophagy-related genes can change the state of hair growth.Multiple autophagy related signaling pathways have been found to be related to hair follicle growth.Activators or inhibitors of autophagy can be used to treat or prevent hair loss.

Background and objective Tumor microenvironment(TME)is one of the important factors in tu-morigenesis and progression,in which tumor-associated macrophages(TAMs)play an important role in non-small cell lung cancer(NSCLC)progression.However,the mechanism of TAMs in NSCLC progression remains unclear,so this study aimed to investigate the role of TAMs in NSCLC progression and to find potential therapeutic targets.Methods Gene Expression Profiling Interactive Analysis(GEPIA)database was used to analyze the expression of prostaglandin E2 receptor 4(EP4)mRNA in NSCLC and normal lung tissues;the protein expression levels of cyclooxygenase-2(COX-2),EP4,cluster of differentiation 86(CD86),CD163 and CD31 were detected by immunohistochemistry(IHC)in 120 NSCLC tissues and 24 paracancerous tissues specimens.The nude mouse lung adenocarcinoma cell A549 and macrophage RAW264.7 co-transplanted tumor model was established.And the samples were collected by gavage with EP4 inhibitor E7046,and then stained with hematoxylin-eosin(HE),IHC,and immunofluorescence(IF),and then detected by Western blot for the epithelial mesenchymal transformation(EMT)of the tumor tissues of the nude mice in each group.Western blot was used to detect the expressions of EMT related protiens in each group of nude mice;full-length transcriptome sequencing was used to screen the key genes causing liver me-tastasis and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis was performed.Results EP4 mRNA expression level in NSCLC tissues was generally lower than that in normal lung tissues(P<0.05);COX-2,EP4,CD163,CD31 proteins were differentially expressed in NSCLC tissues and adjacent tissues,and differences were observed in many clinico-pathological parameters of NSCLC patients;RAW264.7 shortened the latency period of tumorigenesis of A549 and promoted the proliferation of tumors and liver metastasis of tumors,and E7046 could reduce tumor cell proliferation activity,tumor tissue vascular density and M2-type macrophage infiltration in nude mice;IF staining showed that macrophages were mainly distributed around the metastatic foci of tumors;Western blot results showed that compared with A549 alone transplantation group,the relative expression of E-cadherin protein in tumor tissues of mice in A549 and RAW264.7 co-transplantation group was significantly decreased,and the difference was statistically significant(P<0.05),while the relative expression of N-cadherin protein was up-regulated,but the difference was not statistically significant(P>0.05);the main pathways enriched in the differ-ential genes of the full-length transcriptome were the PI3K-AKT and MAPK signaling pathways.Conclusion During NSCLC development,the COX-2/PGE2/EP4 axis may promote tumor progression by inducing macrophage functional activation,and EP4 may be a potential new target for tumor immunotherapy.This study provides new perspectives and ideas for in-depth exploration of the mechanisms of NSCLC development,as well as a theoretical basis for the development of new therapeutic strategies for NSCLC.

Objective To assess inter-observer variations(IOV)in the delineation of target volumes and organs-at-risk(OAR)for intensity-modulated radiotherapy(IMRT)of nasopharyngeal carcinoma(NPC)among physicians from different levels of cancer centers,thereby providing a reference for quality control in multi-center clinical trials.Methods Twelve patients with NPC of different TMN stages were randomly selected.Three physicians from the same municipal cancer center manually delineated the target volume(GTVnx)and OAR for each patient.The manually modified and confirmed target volume(GTVnx)and OAR delineation structures by radiotherapy experts from the regional cancer center were used as the standard delineation.The absolute volume difference ratio(△V_diff),maximum/minimum volume ratio(MMR),coefficient of variation(CV),and Dice similarity coefficient(DSC)were used to compare the differences in organ delineation among physicians from different levels of cancer centers and among the 3 physicians from the same municipal cancer center.Furthermore,the IOV of GTVnx and OAR among physicians from different levels cancer centers were compared across different TMN stages.Results Significant differences in the delineation of GTVnx were observed among physicians from different levels of cancer centers.Among the 3 physicians,the maximum values of △V_diff,MMR,and CV were 97.23%±83.45%,2.19±0.75,and 0.31±0.14,respectively,with an average DSC of less than 0.7.Additionally,there were considerable differences in the delineation of small-volume OAR such as the left and right optic nerves,chiasm,and pituitary,with average MMR>2.8,CV>0.37,and DSC<0.51.However,relatively smaller differences were observed in the delineation of large-volume OAR such as the brainstem,spinal cord,left and right eyeballs,and left and right mandible,with average△V_diff<42%,MMR<1.55,and DSC>0.7.Compared with the differences among physicians from different levels cancer centers,the differences among the 3 physicians from the municipal cancer center were slightly reduced.Furthermore,there were also differences in the delineation of target volumes for NPC among physicians from different levels cancer centers,depending on the staging of the disease.Compared with the delineation of target volumes for earlier stage patients(stages I or II),the differences among physicians in the delineation of target volumes for advanced stage patients(stages III or IV)were smaller,with average △V_diff and DSC of 98.31%±67.36%vs 69.38%±72.61%(P<0.05)and 0.55±0.08 vs 0.72±0.12(P<0.05),respectively.Conclusion There are differences in the delineation of GTVnx and OAR in radiation therapy for NPC among physicians from different levels of cancer centers,especially in the delineation of target volume(GTVnx)and small-volume OAR for early-stage patients.To ensure the accuracy of multicenter clinical trials,it is recommended to provide unified training to physicians from different levels of cancer centers and review their delineation results to reduce the effect of differences on treatment outcomes.

OBJECTIVE To investigate the effects of soybean isoflavones （SI） on the reproductive development of young mice. METHODS C57BL/6 young mice were randomly divided into control group， SI low-dose and high-dose groups （10， 100 mg/kg）， with 10 mice in each group （half male and half female）. The young mice in each group were given corresponding liquid intragastrically， once a day， for 2 consecutive weeks. After the last administration， the percentage of body weight increase was calculated； serum estradiol and testosterone levels， malondialdehyde （MDA） content， total antioxidant capacity （T-AOC）， superoxide dismutase （SOD） and glutathione peroxidase （GSH-Px） activities in the reproductive organs of the young mice were determined. The histopathological changes in the reproductive organs were observed. The cell apoptosis of reproductive organs was detected. RESULTS Compared with the control group， the percentage of body weight increase in female mice was increased significantly in the SI high-dose group， while that of male mice was decreased significantly （P＜0.05 or P＜0.01）. Cystic follicles could be seen in the ovarian tissue in SI groups， a loose arrangement of spermatocytes could be seen in the testicular tissue， and partial epithelial cell shedding could be seen in epididymal tissue. The serum level of testosterone in female young mice and the serum levels of testosterone and estradiol in male young mice in SI groups， GSH-Px activity in the ovarian tissue of female young mice in the SI low-dose group， T-AOC activities in the ovarian tissue of female young mice in SI groups as well as the apoptotic rates of cells in testicular and epididymal tissue of male young mice in SI groups were increased significantly （P＜0.05 or P＜ 0.01）； the serum level of estradiol in female young mice in SI groups， SOD activity in the ovarian tissue of female young mice in the SI high-dose group， and MDA contents in the ovarian tissue of female young mice in SI groups as well as the apoptotic rates of cells in ovarian tissue of female mice in SI groups were decreased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS SI can enhance the antioxidant stress capacity of ovarian tissue in female young mice and reduce their oxidative stress damage， but it has certain toxicity to reproductive organs in male mice.

Objective:To evaluate the diagnostic efficacy and practicality of the Jaundice color card (JCard) as a screening tool for neonatal jaundice.Methods:Following the standards for reporting of diagnostic accuracy studies (STARD) statement, a multicenter prospective study was conducted in 9 hospitals in China from October 2019 to September 2021. A total of 845 newborns who were admitted to the hospital or outpatient department for liver function testing due to their own diseases. The inclusion criteria were a gestational age of ≥35 weeks, a birth weight of ≥2 000 g, and an age of ≤28 days. The neonate′s parents used the JCard to measure jaundice at the neonate′s cheek. Within 2 hours of the JCard measurement, transcutaneous bilirubin (TcB) was measured with a JH20-1B device and total serum bilirubin (TSB) was detected. The Pearson′s correlation analysis, Bland-Altman plots and the receiver operating characteristic (ROC) curve were used for statistic analysis.Results:Out of the 854 newborns, 445 were male and 409 were female; 46 were born at 35-36 weeks of gestational age and 808 were born at ≥37 weeks of gestational age. Additionally, 432 cases were aged 0-3 days, 236 cases were aged 4-7 days, and 186 cases were aged 8-28 days. The TSB level was (227.4±89.6) μmol/L, with a range of 23.7-717.0 μmol/L. The JCard level was (221.4±77.0) μmol/L and the TcB level was (252.5±76.0) μmol/L. Both the JCard and TcB values showed good correlation ( r=0.77 and 0.80, respectively) and agreements (96.0% (820/854) and 95.2% (813/854) of samples fell within the 95% limits of agreement, respectively) with TSB. The JCard value of 12 had a sensitivity of 0.93 and specificity of 0.75 for identifying a TSB ≥205.2?μmol/L, and a sensitivity of 1.00 and specificity of 0.35 for identifying a TSB ≥342.0?μmol/L. The TcB value of 205.2?μmol/L had a sensitivity of 0.97 and specificity of 0.60 for identifying TSB levels of 205.2 μmol/L, and a sensitivity of 1.00 and specificity of 0.26 for identifying TSB levels of 342.0 μmol/L. The areas under the ROC curve (AUC) of JCard for identifying TSB levels of 153.9, 205.2, 256.5, and 342.0 μmol/L were 0.96, 0.92, 0.83, and 0.83, respectively. The AUC of TcB were 0.94, 0.91, 0.86, and 0.87, respectively. There were both no significant differences between the AUC of JCard and TcB in identifying TSB levels of 153.9 and 205.2 μmol/L (both P>0.05). However, the AUC of JCard were both lower than those of TcB in identifying TSB levels of 256.5 and 342.0 μmol/L (both P<0.05). Conclusions:JCard can be used to classify different levels of bilirubin, but its diagnostic efficacy decreases with increasing bilirubin levels. When TSB level are ≤205.2 μmol/L, its diagnostic efficacy is equivalent to that of the JH20-1B. To prevent the misdiagnosis of severe jaundice, it is recommended that parents use a low JCard score, such as 12, to identify severe hyperbilirubinemia (TSB ≥342.0 μmol/L).

Purpose: This study was aimed to investigate long-term survivals and toxicities of early-stage nasopharyngeal carcinoma (NPC) in endemic area, evaluating the role of chemotherapy in stage II patients. Materials and Methods: Totally 187 patients with newly diagnosed NPC and restaged American Joint Committee on Cancer/ International Union Against Cancer 8th T1-2N0-1M0 were retrospectively recruited. All received intensity-modulated radiotherapy (IMRT)±chemotherapy (CT) from 2001 to 2010. Results: With 15.7-year median follow-up, 10-year locoregional recurrence-free survival, distant metastasis-free survival (DMFS), disease-specific survival (DSS), and overall survival (OS) were 93.3%, 93.5%, 92.9% and 88.2%, respectively. Multivariable analyses showed cervical lymph nodes positive and pre-treatment prognostic nutritional index ≥ 52.0 could independently predict DMFS (p=0.036 and p=0.011), DSS (p=0.014 and p=0.026), and OS (p=0.002 and p < 0.001); Charlson comorbidity index < 3 points could predict DSS (p=0.011); age > 45 years (p=0.002) and pre-treatment lactate dehydrogenase ≥ 240 U/L (p < 0.001) predicted OS. No grade 4 late toxicity happened; grade 3 late toxicities included subcutaneous fibrosis (4.3%), deafness or otitis (4.8%), skin dystrophy (2.1%), and xerostomia (1.1%). No differences on survivals were shown between IMRT+CT vs. IMRT alone in stage II patients, even in T2N1M0 (p > 0.05). Unsurprising, patients in IMRT+CT had more acute gastrointestinal reaction, myelosuppression, mucositis, late ear toxicity, and cranial nerve injury (all p < 0.05) than IMRT alone group. Conclusion Superior tumor control and satisfying long-term outcomes could be achieved with IMRT in early-stage NPC with mild late toxicities. As CT would bring more toxicities, it should be carefully performed to stage II patients.