Objective To explore the role of neogambogic acid in the characteristics of colorectal cancer stem cells (CRC-CSCs) through the Wnt/β-catenin signaling pathway. Methods The colorectal cells SW480 and HCT166 were divided into control group and neogambogic acid groups (1.5, 3, 6, and 12 μmol/L). The viability of CRC-CSCs was determined by MTT method, and spheroid and clone formation assays were used to assess the capacity of spheroid formation and self-renewal ability of the cells. The effects of neogambogic acid on the apoptosis and cell cycle of CRC-CSCs were evaluated by flow cytometry assays. Real-time quantitative PCR was used to detect the mRNA expression levels of relative markers (CD133, CD44, ALDH1, Oct4, and Nanog) of CRC-CSCs, and the protein expression levels of the self-renewal marker (PCNA), apoptosis markers (cleaved caspase-3 and cleaved caspase-9), and Wnt/β-catenin signaling pathway markers (p-GSK3β, GSK3β, β-catenin, and Wnt) were analyzed using Western blot. Results Compared with the control group, after neogambogic acid treatment, the viability of SW480 and HCT116 cells decreased (P<0.05), the spheroid forming ability and the clone numbers of CRC-CSCs decreased (P<0.001, P<0.01) but the cell apoptosis rate increased (P<0.01), and cell cycle was arrested in G₀/G₁ phase. Moreover, neogambogic acid downregulated the mRNA and protein expression of relative markers of CRC-CSCs (CD133, CD44, ALDH1, Oct4, and Nanog), PCNA, p-GSK3β, β-catenin, and Wnt (P<0.05) and upregulated the expression of cleaved caspase-3, cleaved caspase-9, and GSK3β (P<0.01). Conclusion Neogambogic can inhibit the stem cell properties of colorectal cells via inhibition of Wnt/β-catenin signaling pathway. As a result, neogambogic acid may be an attractive agent against colorectal cancer.

Objective To externally validate a prediction model based on clinical and CT imaging features for the preoperative identification of high-grade patterns (HGP), such as micropapillary and solid subtypes, in early-stage lung adenocarcinoma, in order to guide clinical treatment decisions. Methods This study conducted an external validation of a previously developed prediction model using a cohort of patients with clinical stage ⅠA lung adenocarcinoma from the Fourth Hospital of Hebei Medical University. The model, which incorporated factors including tumor size, density, and lobulation, was assessed for its discrimination, calibration performance, and clinical impact. Results A total of 650 patients (293 males, 357 females; age range: 30-82 years) were included. The validation showed that the model demonstrated good performance in discriminating HGP (area under the curve>0.7). After recalibration, the model's calibration performance was improved. Decision curve analysis (DCA) indicated that at a threshold probability>0.6, the number of HGP patients predicted by the model closely approximated the actual number of cases. Conclusion This study confirms the effectiveness of a clinical and imaging feature-based prediction model for identifying HGP in stage ⅠA lung adenocarcinoma in a clinical setting. Successful application of this model may be significant for determining surgical strategies and improving patients' prognosis. Despite certain limitations, these findings provide new directions for future research.

Objective To investigate the effect of early stability rehabilitation exercises in elderly patients after the surgery for degenerative lumbar disease and to provide effective guidance for the postoperative rehabilitation.Methods From February 2023 to May 2024,a convenience sampling method was used to select 121 patients who received surgery for degenerative lumbar disease in our hospital as the study subjects.The patients were randomly divided into two groups with a random number table:a control group(n=61)and an intervention group(n=60).Patients in the control group received routine nursing care and rehabilitation exercises,while the patients in the intervention group received 2 weeks of early stability rehabilitation exercises on top of the control group.Lumbar spine function,daily living self-care ability and score of pain were recorded and compared between the two groups on day 1 or day 3 before surgery and at 2 weeks and 4 weeks after surgery.Results JOA scores of the intervention group were found higher than those of the control group at 2 and 4 weeks after surgery,all with significant differences between the groups(P<0.05).VAS scores of the intervention group were lower than those of the control group at 3 days,2 weeks,and 4 weeks after surgery,all with significant differences(P<0.05).Scores for daily living self-care ability of the intervention group were higher than those of the control group at 2 weeks and 4 weeks after surgery,all with significant differences(P<0.05).The repeated measures analysis of variance showed that the time main effect and inter group main effect of JOA score,VAS score and self-care ability score in daily life of different time all showed statistical significance between the groups(all P<0.001).Conclusion An early stability rehabilitation exercise can improve the postoperative lumbar function,pains,and self-care ability in daily life in elderly patients after the surgery for degenerative lumbar diseases,as well as accelerate the postoperative recovery,while ensuring the safety of patients.

Objective:To analyze the clinical features and diagnostic process of ring chromosome syndrome.Methods:Clinical data of 9 children with ring chromosome syndrome who were treated at the Children′s Medical Center of Peking University First Hospital from September 2009 to May 2025, were summarized and analyzed in a case series study. The data included clinical manifestations, types of epileptic seizures, genetic testing, treatment outcomes, and follow-up results, et al.Results:Among the 9 children with ring chromosome syndrome, there were 6 girls and 3 boys, including 4 children with ring chromosome 20 syndrome, 3 children with ring chromosome 14 syndrome, and 1 child each with ring chromosome 13 and 17 syndrome. All 9 children had de novo chromosomal variations. Among them, 3 children of ring chromosome 20 syndrome were mosaic, and the remaining 6 children were non-mosaic. All 9 children exhibited diverse clinical features, especially those with ring chromosome 20 syndrome, which presented with specific manifestations. The 4 children with ring chromosome 20 syndrome all had acute epileptic seizures as the initial symptom, with onset ages of 67, 39, 17, and 96 months, and all had focal seizures. One child with ring chromosome 20 syndrome had non-convulsive status epilepticus. Development of all 4 children with ring chromosome 20 syndrome was normal before seizure onset, but 3 children showed regression after onset. No physical deformities were observed in 4 children with ring chromosome 20 syndrome, and 2 children were misdiagnosed, 3 children underwent whole exome sequencing and copy number variation analysis in their families, with no abnormalities detected. All 4 children with ring chromosome 20 syndrome were diagnosed through chromosomal karyotype analysis, the intervals between onset and diagnosis were 2, 81, 19 and 13 months, respectively. Follow-up showed that epileptic seizures were not controlled in all 4 children with ring chromosome 20 syndrome. The other 5 children were characterized by developmental delay as the initial symptom, followed by epileptic seizures between 3 and 24 months of age. Developmental regression of the other 5 children did not occur after onset, 2 of them had microcephaly, and 3 had wide-set eyes. No misdiagnoses were reported in these 5 children, and the intervals between onset and diagnosis were 7, 3, 55, 3, and 106 months, respectively. Follow-up showed that epileptic seizures were controlled in these 5 children. Conclusions:Ring chromosome 20 syndrome typically manifest with epilepsy as the initial symptom and are refractory to drug treatment, their early development is entirely normal. Ring chromosome 13, 14, and 17 syndrome are characterized by developmental delay from an early age, followed by the onset of epileptic seizures, which are easily controlled. Conventional whole exome sequencing and copy number variation analysis in families rarely detect ring chromosome abnormalities. Early chromosomal karyotype analysis is essential for the diagnosis of ring chromosome syndrome.

This study examines the progress and application of Artificial Intelligence (AI) in the prevention and control of infectious diseases within Chinese healthcare institutions. It analyzes the difficulties and challenges encountered during implementation to promote the intelligent transformation and upgrading of infectious disease prevention and control. The results indicate that AI technology has made progress in areas such as infectious disease surveillance and early warning, risk assessment and emergency response, screening and detection, image-based diagnosis and analysis, and health management. Nevertheless, significant challenges remain, including limited application depth and breadth, issues with data quality and privacy protection, insufficient technological maturity and interpretability, potential legal risks, and a shortage of interdisciplinary professionals. To advance the application of AI technology in infectious disease prevention and control and support the modernization of China′s relevant systems, recommendations include strengthening policy support, establishing data standards and robust privacy protection mechanisms, increasing R&D investment, refining laws and regulations, and enhancing the training of interdisciplinary talent.

Objective lt aims to identify key issues in the current informatization development of internal control over revenue and expenditure in public hospitals.The findings are intended to serve as a reference for deepening this informatization effort.Methods Following the steps and requirements of content analysis method,it involved a semi-quantitative analysis of policies and expert interviews to establish an analytical framework.Two researchers uti-lized NVivo 15 software to analyze the policy and articles.The analysis results were quantified statistically,and key is-sues were summarized.Results lt developed a content analysis framework comprising 5 primary categories and 17 secondary categories.Based on this framework,326 analytical units extracted from 81 articles were categorized and statistically analyzed.Key problems corresponding to each secondary category were summarized.Conclusion To ad-dress five key issues,it proposes a five-dimensional solution including:building a digital foundation to integrate busi-ness systems;establishing a Master Data Management platform to dismantle data silos;developing flexible ap-proval mechanismsfor medical emergencies;deploying an Al risk control hub for precise payment interception,and implementing zero-trust architecture to enhance e-bill anti-counterfeiting-ultimately forming a business-finance-in-tegrated,data-and-Al-driven,proactively secured internal control system covering budget formulation to fund su-pervision.

The advent of bruton tyrosine kinase inhibitors (BTKi) has offered more therapeutic choices for patients with B-cell malignancies. However, with its widespread application in recent years, the use of BTKi increases the risk of severe infections in patients. Here, we report three cases of B-cell malignancies, including one case of chronic lymphocytic leukemia and two cases of diffuse large B-cell lymphoma. During treatment with BTKi zanubrutinib, different degrees of invasive fungal disease (IFD) of the central nervous system occurred in these patients. All patients fully recovered following antifungal therapy. With a median follow-up of 35 months, all patients remained in a continuous remission state, and none of them had a recurrence of IFD.

Protrusive facial deformities, characterized by the forward displacement of the teeth and/or jaws beyond the normal range, affect a considerable portion of the population. The manifestations and morphological mechanisms of protrusive facial deformities are complex and diverse, requiring orthodontists to possess a high level of theoretical knowledge and practical experience in the relevant orthodontic field. To further optimize the correction of protrusive facial deformities, this consensus proposes that the morphological mechanisms and diagnosis of protrusive facial deformities should be analyzed and judged from multiple dimensions and factors to accurately formulate treatment plans. It emphasizes the use of orthodontic strategies, including jaw growth modification, tooth extraction or non-extraction for anterior teeth retraction, and maxillofacial vertical control. These strategies aim to reduce anterior teeth and lip protrusion, increase chin prominence, harmonize nasolabial and chin-lip relationships, and improve the facial profile of patients with protrusive facial deformities. For severe skeletal protrusive facial deformities, orthodontic-orthognathic combined treatment may be suggested. This consensus summarizes the theoretical knowledge and clinical experience of numerous renowned oral experts nationwide, offering reference strategies for the correction of protrusive facial deformities.
Humans ; Orthodontics, Corrective/methods* ; Consensus ; Malocclusion/therapy* ; Patient Care Planning ; Cephalometry

OBJECTIVE: Humans are exposed to complex mixtures of environmental chemicals and other factors that can affect their health. Analysis of these mixture exposures presents several key challenges for environmental epidemiology and risk assessment, including high dimensionality, correlated exposure, and subtle individual effects. METHODS: We proposed a novel statistical approach, the generalized functional linear model (GFLM), to analyze the health effects of exposure mixtures. GFLM treats the effect of mixture exposures as a smooth function by reordering exposures based on specific mechanisms and capturing internal correlations to provide a meaningful estimation and interpretation. The robustness and efficiency was evaluated under various scenarios through extensive simulation studies. RESULTS: We applied the GFLM to two datasets from the National Health and Nutrition Examination Survey (NHANES). In the first application, we examined the effects of 37 nutrients on BMI (2011-2016 cycles). The GFLM identified a significant mixture effect, with fiber and fat emerging as the nutrients with the greatest negative and positive effects on BMI, respectively. For the second application, we investigated the association between four pre- and perfluoroalkyl substances (PFAS) and gout risk (2007-2018 cycles). Unlike traditional methods, the GFLM indicated no significant association, demonstrating its robustness to multicollinearity. CONCLUSION GFLM framework is a powerful tool for mixture exposure analysis, offering improved handling of correlated exposures and interpretable results. It demonstrates robust performance across various scenarios and real-world applications, advancing our understanding of complex environmental exposures and their health impacts on environmental epidemiology and toxicology.
Humans ; Environmental Exposure/analysis* ; Linear Models ; Nutrition Surveys ; Environmental Pollutants ; Body Mass Index

Objective To explore the risk factors for oral mucosal pressure injuries(OMPI)in patients with endotracheal intubation in the emergency intensive care unit(EICU)and to construct a nomogram prediction model based on these factors.Methods A case-control study design was adopt-ed to retrospectively collect clinical data from 209 adult patients with endotracheal intubation admitted to EICU.The patients were divided into OMPI group(53 patients)and non-OMPI group(156 pa-tients)based on whether OMPI occurred during the observation period.The clinical data of the two groups were analyzed,and multivariate Logistic regression analysis was used to screen risk factors for OMPI in patients with endotracheal intubation in the EICU.R software was used to draw a nomogram prediction model,and the predictive performance of the model was evaluated through the receiver oper-ating characteristic(ROC)curve,calibration curve,and decision curve analysis.Results Statistical-ly significant differences were observed between the two groups in prone position ventilation,vasocon-strictor use,consciousness at the time of intubation,Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score at the time of intubation,and duration of endotracheal intubation(P＜0.05).The results of multivariate Logistic regression analysis showed that prone position ventilation(OR=2.545,95％CI,1.261 to 5.135),vasoconstrictor use(OR=1.984,95％CI,1.162 to 3.387),inability to express complaints at time of intubation(OR=3.618,95％CI,1.891 to 6.924),high APACHE 11 score(OR=2.394,95％CI,1.322 to 4.336),and long duration of endotracheal in-tubation(OR=3.995,95％CI,1.857 to 8.593)were all risk factors for OMPI in patients with en-dotracheal intubation in the EICU(P＜0.05).ROC curve analysis showed that the area under the curve of the nomogram prediction model was 0.881;calibration curve analysis showed that the mean absolute error between the predicted probability and the actual probability of the model was 0.016;and decision curve analysis showed that the prediction model had practical value in clinical practice.Conclusion Prone position ventilation,vasoconstrictor use,inability to express complaints at the time of intubation,high APACHE Ⅱ score,and long duration of endotracheal intubation are all risk factors for OMPI in patients with endotracheal intubation in the EICU.The nomogram model con-structed based on these factors has good predictive performance for OMPI risk.