Asthma is a chronic inflammatory respiratory disease involving multiple cells and cellular components， characterized by recurrent episodes of wheezing， shortness of breath， chest tightness， and coughing， significantly impacting patients' quality of life. The phosphatidylinositol 3-kinase/protein kinase B（PI3K/Akt） signaling pathway， as a crucial hub in intracellular signaling， is widely involved in the regulation of cell growth， proliferation， survival， metabolism， and a series of pathophysiological processes. Its regulatory role in the pathological progression of asthma is particularly significant， specifically in promoting airway inflammation， mediating epithelial mesenchymal transition， accelerating airway remodeling， regulating cell autophagy， inducing mucus hypersecretion， and influencing immune response balance. This study analyzed potential molecular targets of the PI3K/Akt pathway， including activators such as cysteine proteinase inhibitor 1（CST1）， found in inflammatory zone 1（FIZZ1） and free fatty acid receptor 1（FFAR1）， and inhibitors such as human β-defensin-3（hBD-3）， disintegrins， metalloproteinase 33（ADAM33） and interleukin-27（IL-27）， and initially revealed the potential molecular mechanisms of traditional Chinese medicine（TCM） in asthma intervention. Based on this， the authors systematically summarized the efficacy and specific mechanisms of TCM monomers， compounds， and external treatments for asthma by regulating the PI3K/Akt signaling pathway through literature review and analysis， aiming at establishing a robust foundation for the wide application and advanced development of TCM in asthma treatment， offering innovative insights for clinical research and drug development of asthma.

Asthma is a chronic inflammatory respiratory disease involving multiple cells and cellular components， characterized by recurrent episodes of wheezing， shortness of breath， chest tightness， and coughing， significantly impacting patients' quality of life. The phosphatidylinositol 3-kinase/protein kinase B（PI3K/Akt） signaling pathway， as a crucial hub in intracellular signaling， is widely involved in the regulation of cell growth， proliferation， survival， metabolism， and a series of pathophysiological processes. Its regulatory role in the pathological progression of asthma is particularly significant， specifically in promoting airway inflammation， mediating epithelial mesenchymal transition， accelerating airway remodeling， regulating cell autophagy， inducing mucus hypersecretion， and influencing immune response balance. This study analyzed potential molecular targets of the PI3K/Akt pathway， including activators such as cysteine proteinase inhibitor 1（CST1）， found in inflammatory zone 1（FIZZ1） and free fatty acid receptor 1（FFAR1）， and inhibitors such as human β-defensin-3（hBD-3）， disintegrins， metalloproteinase 33（ADAM33） and interleukin-27（IL-27）， and initially revealed the potential molecular mechanisms of traditional Chinese medicine（TCM） in asthma intervention. Based on this， the authors systematically summarized the efficacy and specific mechanisms of TCM monomers， compounds， and external treatments for asthma by regulating the PI3K/Akt signaling pathway through literature review and analysis， aiming at establishing a robust foundation for the wide application and advanced development of TCM in asthma treatment， offering innovative insights for clinical research and drug development of asthma.

OBJECTIVE To explore the effect and mechanism of embryonic intervention with Zuogui pill on the glucose tolerance in offsprings of pregnant rats with gestational diabetes mellitus. METHODS Pregnant rats were randomly divided into blank group， model group， positive control group （insulin glargine）， Zuogui pill low-， medium- and high-dose groups （4.725， 9.45， 18.9 g/kg）. In addition to the blank group， streptozotocin was injected intraperitoneally to establish a gestational diabetes mellitus rat model. From day 6 to day 18 of pregnancy， each group was given relevant medicine and distilled water intragastrically， once a day. After 21 days of birth， the body weight and body length of offsprings were recorded， and the area under the curve （AUC） was calculated through a glucose tolerance test. After 22 days of birth， fasting blood glucose （FBG）， fasting insulin （FINS） levels in serum， insulin sensitivity index （ISI）， and homeostasis model assessment of insulin resistance （HOMA-IR） were measured， and the morphological structure of pancreatic tissue was observed. The protein spectrum of pancreatic tissue was analyzed by tandem mass tag-based proteomics， and protein and mRNA expression levels of apolipoprotein A1（ApoA1）， solute carrier family 27 member 1 （Slc27a1）， kininogen 1（Kng1） and sodium/potassium-transporting ATPase subunit alpha 2 （Atp1a2）， solute carrier family 7 member 5 （Slc7a5）， solute carrier family 3 member 2 （Slc3a2）， bile acid-coenzyme A： amino acid N- acyltransferase （Baat）， eukaryotic translation initiation factor 2 subunit gamma （Eif2s3） were detected. RESULTS Compared with the model group， the body weight， body length and ISI of offsprings in the positive control group and Zuogui pill medium-dose group were significantly increased （P＜0.05）， while the glucose tolerance and islet cell proliferation were significantly improved， and the AUC， FBG， FINS and HOMA-IR were significantly decreased （P＜0.05）. There were 88 potential target proteins for the embryonic intervention of Zuogui pill in offsprings of pregnant rats with gestational diabetes mellitus，involving multiple pathways such as peroxisome proliferator-activated receptor （PPAR）， cyclic guanosine monophosphate-protein kinase G （cGMP-PKG）， fat digestion and absorption， and bile secretion. The proteins closely related to glucose metabolism and insulin resistance mainly included ApoA1， Slc27a1， Kng1， Atp1a2， Slc7a5， Slc3a2， Baat， and Eif2s3. Among them， compared with the model group， protein and mRNA expressions of Slc7a5， Slc3a2， and Baat in the pancreatic tissues of pregnant rat offsprings in the Zuogui pill medium-dose group were significantly up-regulated （P＜0.05）； protein and mRNA expressions of ApoA1， Slc27a1， Kng1， Atp1a2 and Eif2s3 were all significantly down-regulated （P＜0.05）. CONCLUSIONS The intervention of Zuogui pill in the embryonic period on offsprings of pregnant rats with gestational diabetes mellitus can improve their blood glucose levels and pancreatic pathological morphology. The mechanism may be related to the upregulation of the expressions of Slc7a5， Slc3a2， and Baat and the down-regulation of ApoA1， Slc27a1， Kng1， Atp1a2 and Eif2s3 expressions in the PPAR， cGMP-PKG， fat digestion and absorption， and bile secretion pathways.

Objective To investigate the effectiveness and safety of drug-eluting beads bronchial arterial chemoembolization(DEB-BACE)versus BACE for the treatment of stage Ⅲ-Ⅳ lung squamous cell carcinoma.Methods A total of 104 patients with stage Ⅲ-Ⅳ lung squamous cell carcinoma,who were admitted to the Lishui Municipal Central Hospital of China between January 2013 and August 2021,were enrolled in this study.According to the therapeutic scheme,the patients were divided into DEB-BACE group(n=41)and BACE group(n=63).For patients of DEB-BACE group,Cisplatin at 75 mg/m2 dose and gemcitabine at 1 000 mg/m2 dose(400 mg was used as loaded-drug dose)were injected through a microcatheter,which was followed by embolization with CalliSpheres microspheres loaded with 400 mg of gemcitabine.For patients of BACE group,Cisplatin at 75 mg/m2 and gemcitabatin at 1 000 mg/m2 were injected through a microcatheter,which was followed by arterial embolization with blank microspheres.Three weeks after DEB-BACE or BACE,the patients of both groups were started on intravenous chemotherapy.The primary study endpoint was overall survival(OS).The secondary study endpoints included progression-free survival(PFS),objective response rate(ORR),disease control rate(DCR),adverse reactions,and the remission rate of dyspnea.Results Of the 104 patients,63 received BACE sequential intravenous chemotherapy and 41 received DEB-BACE sequential intravenous chemotherapy.The median OS in DEB-BACE group was 23.0 moths,which was obviously longer than 12.0 months in BACE group(P=0.009).Multivariate Cox regression analysis showed that DEB-BACE treatment was an independent risk factor for OS(HR=0.59,95％ CI:0.38-0.91,Log-rank test P=0.018).Meanwhile,the remission rate of dyspnea in DEB-BACE group was significantly higher than that in BACE group(57.1％ vs 30.6％,P＜0.043).Conclusion Compared with BACE sequential intravenous chemotherapy,DEB-BACE sequential intravenous chemotherapy can significantly prolong the survival time of patients with stage Ⅲ-Ⅳ lung squamous cell carcinoma and significantly improve the symptoms of dyspnea,which has important applications in the treatment of patients with advanced lung squamous cell carcinoma.

[Purpose]To analyze the trends of cervical cancer incidence in Qidong City of Jiangsu Province from 1977 to 2021.[Methods]Based on the cervical cancer registration database in Qi-dong City from 1977 to 2021,the crude incidence rate,the age-standardized rate by the standard Chinese standard population and the world standard population(ASRC and ASRW),the truncated rate of 35～64 years old,the cumulative rate of 0～74 years old,and the cumulative risk were cal-culated;the incidence rates of birth cohorts were analyzed.Joinpoint regression analysis was per-formed with Joinpoint 4.9.0.0 software to calculate the annual percentage change(APC)and the average annual percentage change(AAPC)of cervical cancer incidence.[Results]A total of 2 253 new cases of cervical cancer registered in Qidong City from 1977 to 2021,accounting for 1.62％of the total case numbers of cancer in the whole population,and for 4.03％of the total number of cancers in women.The crude incidence rate was 8.75/105,the ASRC was 4.54/105,the ASRW was 6.01/105,the truncated rate(35～64 years old)was 15.09/105,the cumulative rate(0～74 years old)was 0.63％,and the cumulative risk was 0.63％.The incidence of cervical cancer increased with age from 1977 to 2021.The average incident age was 55.36 years old,with the lowest age of 47.51 years old in 2010.Secular trend analysis showed that the AAPC of the crude incidence of cervical cancer was 6.010％(95％CI:4.951％～7.081％)(P＜0.001),among which the trend decreased from 1977 to 1999,with an APC of-2.507％;and then the trend increased from 1999 to 2017,with an APC of 14.436％(P＜0.001).The rising and falling trend curves of the AS-RC and ASRW were similar to that of the crude incidence.The age group and time period analysis showed that the peak incidence was in the older age groups before 2006,while the peak inci-dence appeared in the age groups of 45～54 years old from 2007 to 2021.The AAPCs in age groups of 25～64 years old demonstrated upward trends(all P＜0.05).The birth cohort analysis showed that the cervical cancer incidence in the 1937-1941 birth cohort was the lowest,and the birth cohort-specific rates in all age groups showed"V-shape"trends.[Conclusion]Long-term monitoring of cervical cancer incidence in Qidong has shown a trend of initially slow decline fol-lowed by a rapid increase,with the peak incident shifting towards younger ages.The rising trends of cervical cancer incidence in last two decades may be associated with the increased HPV infection,suggesting that measures to reduce HPV infection and enhance vaccination should be strengthened.

[Purpose]To analyze the incidence trend and age,period,cohort effects of brain and other central nervous system tumors(brain tumor)in Qidong City of Jiangsu Province from 1972 to 2021.[Methods]The incidence data of brain tumor from 1972 to 2021 were collected from the Qidong cancer registry database.The crude incidence rate(CR),age-standardized rate by Chi-nese standard population(ASRC),age-standardized rate by world standard population(ASRW)and average annual percentage change(AAPC)were calculated.The age-period-cohort(APC)model was used to analyze the age,period,and cohort effects of brain tumor incidence in Qidong City from 1972 to 2021.[Results]A total of 2 801 cases of brain tumor occurred in Qidong City from 1972 to 2021,including 1 475 male cases and 1 326 female cases.From 1972-1976 to 2017-2021,the CR increased from 1.81/10 5 to 9.28/10 5,the ASRC increased from 2.07/10 5 to 4.96/10 5,and ASRW increased from 2.00/105 to 4.98/105.From 1972 to 2021 the AAPC of CR,ASRC and ASRW were 3.97％(3.53％for male and 4.37％for female),2.02％(1.66％for male and 2.24％for female)and 2.06％(1.63％for male and 2.24％for female)(all P＜0.001).The Wald's Chi-square test of the APC model showed that there were significant differences in the trends of age,period and birth cohort effect of brain tumor risk(all P＜0.05).The age effect showed that the incidence of brain tumor increased with age,starting from the age group of 45～49 years old and reaching a peak of 25.84/10 5 in age group of 75～79 years old(95％CI:21.17/10 5～31.53/10 5).The period ef-fect showed that the risk of recent period was higher than that in the early period using 1992-1996 period as the reference,reaching the highest in 2012-2016(RR=1.64,95％CI:1.38～1.95).The birth cohort effect showed that the highest risk was in 2017-2021 births cohort(RR=11.17,95％CI:4.26～29.26)using 1952-1956 birth cohort as the reference.[Conclusion]The incidence of brain tumor in Qidong City has been rising;and age,period and cohort are the main influencing factors,suggesting that the middle-aged and elderly population should be the focus of brain tumor prevention and control.

Objective:To analyze effect of miR-532-3p on macrophage polarization in rats with chronic kidney disease(CKD)through targeted inhibition of Notch1 signal pathway.Methods:A total of 75 SD rats were divided into control group,CKD group,ago-NC group,ago-miR-532-3p group and FLI-06 group,except for control group,CKD models were constructed and corresponding plas-mids and inhibitors were injected,control group and CKD group were replaced with same amount of normal saline.Serum creatinine(Scr),blood urea nitrogen(BUN),TNF-α,IL-1β and IL-10 were measured by ELISA,HE staining and Masson staining were used to observe renal tissue pathology and renal fibrosis in rats,flow cytometry was used to detect CD11c+and CD206+of macrophages,miR-532-3p expression in rat kidney tissue was detected by qRT-PCR,Notch1 protein was detected by Western blot;target binding of miR-532-3p to Notch1 was determined by double luciferase reporter gene.Results:Structure of glomerulus,renal tubules and epithelial cells was complete,cell boundaries were clear,and cells were arranged neatly in control group;glomerular epithelial cell necrosis,mesangial matrix,glomerulosclerosis,inflammatory cell infiltration and renal fibrosis were increased in CKD group;compared with CKD group,damage degree of glomerulus and tubules,inflammatory infiltration cells and renal fibrosis degree in ago-miR-532-3p group and FLI-06 group were reduced;compared with control group,serum Scr,BUN,TNF-α,IL-1β,proportion of CD11c+,CD11c+/CD206+and Notch1 protein expression in macrophages of renal tissue were increased,serum IL-10 level,CD206+and miR-532-3p in renal tissue were decreased(P<0.05);compared with CKD group,serum Scr,BUN,TNF-α,IL-1β,proportion of CD11c+,CD11c+/CD206+and Notch1 protein expression in macrophages of renal tissue in ago-miR-532-3p group and FLI-06 group were decreased,serum IL-10 level,CD206+and miR-532-3p in renal tissue were increased(P<0.05);miR-532-3p targeted Notch1,and overexpression of miR-532-3p inhibited Notch1 protein expression.Conclusion:Promoting expression of miR-532-3p protects kidney tissue of CKD rats by inhibiting Notch1 pathway,which may be due to regulating polarization of macrophages.

Objective:To analyze the trend of ovarian cancer incidence in Qidong City from 1972 to 2021 and evaluate the age, period, and cohort effect.Methods:The ovarian cancer incidence data from 1972 to 2021 were extracted from the Qidong Cancer Registry Database, the crude incidence rate (CR), age standardized rate by Chinese population (ASR-C), age standardized rate by world population (ASR-W), and average annual percent change (AAPC) were calculated. The age-period-cohort model was used to analyze the age, period, and birth cohort effects of the ovarian cancer incidence in Qidong from 1972 to 2021.Results:From 1972 to 2021, a total of 1 007 cases of ovarian cancer occurred in Qidong. The AAPC values of CR, ASR-C, and ASR-W were 7.02% , 5.17%, and 5.12% , respectively (all P＜0.001). The time trends showed that, the AAPC values of the age groups of 0-34, 35-44, 45-54, 55-64, 65-74, and over 75 years old were 4.10%, 4.74%, 6.02%, 4.86%, 4.23%, and 5.18%, respectively (all P＜0.05). The age effect showed that the incidence rate of ovarian cancer increased obviously from the 45-49 year-old group, reaching a peak of 20.67/100 000 in the 75-79 year-old group. Compared with the 1992-1996 group, the period of 2002-2021 had significant effects on the incidence rise of ovarian cancer (all P＜0.05), and the incidence rate ratio ( RR) increased with the period: in 2017-2021 the RR was 3.86 (95% CI: 2.72-5.47). Using births from 1952 to 1956 as the reference group, the RR increased slowly from 0.12 (95% CI: 0.02-0.91) in 1892-1896, and peaked in 2007-2011 with an RR of 18.05 (95% CI: 3.51-92.87). The birth cohorts in 1967-2011 had significant effects on the incidence rise of ovarian cancer (all P＜0.05). The Waldχ 2 test of the age-period-cohort model showed that there were significant differences in the age, period, and birth cohort effects (all P＜0.001). Conclusions:The incidence of ovarian cancer in Qidong was on the rise. Age, period, and cohort were the main factors affecting the incidence of ovarian cancer. The middle-aged and elderly women were the focus of ovarian cancer prevention and control.

Objective This study aims to investigate the work fatigue risks of clinical nursing staff in a tertiary hospital in Xingguo County and analyze the influencing factors,providing a reference for formulating scientific work processes and systems and improving nursing quality.Methods A convenience sampling was conducted to select 179 clinical nurses from a tertiary hos-pital in Xingguo County from March to April 2025.A self-designed general information questionnaire,a clinical nursing staff work fatigue risk assessment questionnaire,and the nurse work stressor scale were used for the investigation.Univariate and multiple linear regression analyses were conducted to identify the influencing factors of work fatigue risks.Results A total of 186 ques-tionnaires were distributed,with 7 excluded as invalid and 179 valid responses(96.24％).The work fatigue risk assessment score of the 179 clinical nurses was(84.39±10.26),indicating a relatively high level of fatigue.There were significant differ-ences in work fatigue risk scores across genders,weekly working hours,years of work experience,contract types,and work stress levels(P＜0.05).Multiple linear regression analysis showed that gender(B=0.624,95％CI=0.194～1.054),weekly work-ing hours(B=0.037,95％CI=0.067～0.007),years of work experience(B=0.028,95％CI=0.010～0.046),contract type(B=-0.517,95％CI=-0.997～-0.037),and work stress(B=0.127,95％CI=0.050～0.204)were the influen-cing factors of work fatigue risks(P＜0.05).Conclusion The work fatigue risks of clinical nursing staff in a tertiary hospital in Xingguo County are at a relatively high level.Gender,weekly working hours,years of work experience,contract type,and work stress are the main influencing factors.Nursing managers should pay attention to these factors and take targeted measures to inter-vene and reduce the work fatigue risks of nursing staff.

Objective:To analyze the incidence trends of malignant tumors in the elderly population aged over 60 years in Qidong City from 1972 to 2021, as well as to predict the incidence rate for the next decade.Methods:Data were obtained from the Qidong Cancer Registry and Reporting System.The crude incidence rate(CR), age-standardized incidence rate using the Chinese standard population(ASRC), and age-standardized incidence rate based on Segi's world standard population(ASRW)were calculated.Joinpoint regression analysis was conducted using Joinpoint 4.9.1.0 software to determine the average annual percentage change(AAPC)in incidence.Additionally, the ARIMA model implemented in SAS 9.2 software was utilized for time series analysis to forecast incidence trends over the forthcoming 10 years.Results:In Qidong City, a total of 87, 401 malignant tumors were reported in the elderly population.The ASRW increased from 736.85 per 100, 000 in the years 1972-1976 to 1 056.33 per 100, 000 in 2017-2021.Specifically, the ASRW for males rose from 968.56 per 100, 000 to 1 332.75 per 100, 000, while the ASRW for females increased from 550.62 per 100, 000 to 825.44 per 100, 000, with AAPC values of 1.16%, 0.94%, and 1.44% over 50 years(all P<0.001).The incidence trend exhibited an upward trajectory with age, peaking in the 75-79 age group.The AAPC values for the incidence rates in the age groups of 60-64, 65-69, 70-74, 75-79, and those aged over 80 were 0.64%, 0.93%, 0.92%, 2.02%, and 2.44%, respectively(all P<0.001).Among the various cancers, lung cancer, which ranked first, saw an increase in ASRW from 100.87 per 100, 000 in 1972-1981 to 248.84 per 100, 000 in 2012-2021.In contrast, gastric cancer, ranked second, decreased from 216.23 per 100, 000 in 1972-1981 to 103.54 per 100, 000 in 2012-2021.Liver cancer, ranked third, fluctuated from 113.47 per 100, 000 in 1972-1981 to 125.13 per 100, 000 in 2012-2021.Colorectal cancer, ranked fourth, increased from 40.06 per 100, 000 in 1972-1981 to 123.47 per 100, 000 in 2012-2021, while esophageal cancer, ranked fifth, decreased from 63.42 per 100, 000 in 1972-1981 to 28.65 per 100, 000 in 2012-2021.The AAPC values over 50 years for these cancers were 2.25%, -1.89%, 0.36%, 3.13%, and -1.86%, respectively(all P<0.05).Projections indicate that by 2031, the incidence of malignant tumors among the elderly population in Qidong will reach 1 253.84 per 100, 000, with estimates of 1 566.67 per 100, 000 for males and 983.14 per 100, 000 for females. Conclusions:The incidence of malignant tumors among the elderly population in Qidong City is increasing.Common types of cancer in this demographic include lung cancer, gastric cancer, liver cancer, colorectal cancer, and esophageal cancer.Notably, lung cancer, liver cancer, and colorectal cancer are on the rise and should be prioritized in cancer prevention and control efforts.