Objective To investigate the expression of CPEB2 in triple-negative breast cancer (TNBC) and its impact on the malignant progression of tumors. Methods The expression level of CPEB2 in breast cancer was analyzed through a database, and the differential expression in clinical pathological specimens was verified by immunohistochemical experiments. Stable CPEB2 overexpressing TNBC cell lines were constructed, and CCK-8 and Transwell assays were used to detect the changes in cell phenotypes. Western blot was used to explore the expression of key molecules in the MEK/ERK signaling pathway. Results The expression of CPEB2 in TNBC tissues was significantly lower than that in adjacent tissues (χ²=16.57, P<0.001). Patients with high expression of CPEB2 had a significantly longer overall survival than those with low expression. Overexpression of CPEB2 inhibited the proliferation, migration, and invasion abilities of TNBC cells and the activation of the MEK/ERK signaling pathway. Conclusion The expression of CPEB2 is downregulated in TNBC. Upregulation of CPEB2 inhibits the proliferation, migration, and invasion of TNBC cells, accompanied by decreased activation of the MEK/ERK pathway (reduced p-MEK and p-ERK levels), suggesting that CPEB2 may participate in the malignant progression of TNBC by regulating the MEK/ERK pathway.

Objective: To identify the core symptoms and bridge symptoms in the network structure among adolescents bullying victimization, anxiety and depressive symptoms, and to explore the interrelationships among these three variables, so as to provide a basis for the precise prevention of bullying behaviors and the improvement of adolescents psychological health conditions. Methods: From October to November 2023, a stratified cluster random sampling method was employed to select 4 759 middle and high school students from four cities in Guangxi: Beihai, Guigang, Hechi, and Laibin. The Chinese version of the Olweus Bully/Victim Questionnaire (OBVQ) was used to assess bullying victimization among adolescents, while the Generalized Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9) were utilized to assess anxiety and depressive symptoms, respectively. The Bootnet package (version 1.6) in R software (version 4.4.1) was used to construct a network structure and analyze the associations between bullying victimization, anxiety symptoms and depressive symptoms among adolescents. Results: The reporting rates of depressive symptoms, anxiety symptoms, and bullying victimization among adolescents in Guangxi were 24.67%, 16.33%, and 16.58%, respectively. Network analysis revealed that the node with the highest expected influence was "property being taken or damaged", with a standardized expected influence (EI) index of 2.09. The top two nodes in terms of bridge expected influence were "thoughts of self harm or suicide" and "irritability", with standardized bridge expected influence (BEI) indices of 2.15 and 1.27, respectively. The stronger associations were observed between the node "property being taken or damaged" and the nodes "physical attacks such as hitting, kicking, pushing, or shoving" and "ridiculed due to accent", with edge weights of 0.43 and 0.35, respectively. Conclusion Targeting preventive measures against the symptoms with the highest expected influence and bridge expected influence in the network of bullying victimization, anxiety and depressive symptoms among adolescents may be an effective approach to reduce the negative impact of bullying victimization, anxiety and depressive symptoms on adolescents.

Objective:To analyze the drug resistance status of Mycobacterium tuberculosis（MTB）at a hospital in Xiamen over the past decade. Methods:Sputum culture-positive specimens of tuberculosis patients from Xiamen Xinglin Hospital from 2015 to 2024 were collected retrospectively. Isolates were identified as MTB complex and subjected to drug susceptibility testing. Drug resistance patterns and trends over the study period were analyzed using descriptive statistics and Chi-square trend tests in SPSS 27.0 and GraphPad Prism 8.0.Results:Among 3 883 MTB isolates analyzed，1 132（29.15%）exhibited resistance to at least one drug. The highest rates of resistance to individual first-line drugs were observed for isoniazid（INH，16.04%），streptomycin（SM，15.43%），and rifampicin（RFP，12.28%）. Multidrug-resistant tuberculosis（MDR-TB）was identified in 380 isolates（9.79%）. The predominant MDR resistance patterns were INH+RFP+SM（2.34%），INH+RFP（1.65%），and INH+RFP+SM+ethambutol（EMB）（1.03%）. Polyresistance was found in 188 isolates（4.84%），the predominant patterns were INH+SM（1.49%），INH+fluoroquinolone（FQs）（0.31%），and INH+para-aminosalicylic acid（PAS）（0.31%）. Extensively drug-resistant tuberculosis（XDR-TB）was detected in 49 isolates（1.26%）. From 2015 to 2024，significant decreasing trends were observed for overall drug resistance（ χ2=8.858， P=0.003），MDR（ χ2=15.692， P<0.001），and RFP resistance（ χ2=21.627， P<0.001）. In contrast，fluoroquinolone（FQs）resistance showed no significant trend（ χ2=0.149， P=0.699）. Among RFP resistant and MDR isolates，FQs resistance rates were notably high at 33.12%（158/477）and 36.84%（140/380），respectively. Conclusions:The MTB resistance situation in the hospital has gradually declined in the past 10 years，but the resistance situation remains severe，and clinical attention needs to be strengthened on the use of FQs.

Objective:Investigation of the relationship between variant angina pectoris syncope and coronary artery spastic targeted location, arrhythmias, and coronary artery stenostic lesion.Methods:This study combined retrospective and prospective registry approaches. Data were sourced from the case database of Henan province "Multicenter Clinical Observation Study of Variant Angina Pectoris". A total of 507 patients with variant angina pectoris who had complete records from June 1980 to December 2022 were consecutively enrolled. Select patients among them who experienced syncope, and analyze the target vessel sites of coronary artery spasm, arrhythmias during variant angina pectoris attacks, and the degree of stenosis in coronary artery lesions.Results:Among 507 variant angina pectoris patients, 88 experienced syncope. Age was (53.9±9.7) years and 66 patients (75.0%) were male. Forty patients (45.5%, 40/88) were aged 50-59 years. The incidence of syncope in variant angina pectoris caused by left anterior descending artery (LAD) spasm, right coronary artery (RCA) spasm, and multivessel coronary artery spasm was 7.4% (15/202), 22.7% (42/185), and 23.6% (25/106), respectively. The latter two were significantly higher than those in the LAD group ( P all<0.05). Among 77 patients with variant angina pectoris syncope, definitive electrocardiogram recordings were available during syncope episodes. All patients exhibited arrhythmias during syncope: 34 cases involved tachyarrhythmias and 43 cases involved bradyarrhythmias. The incidence of rapid arrhythmias in patients with LAD, RCA, and multi-vessel spasm syncope was 72.7% (8/11), 24.3% (9/37), and 54.2% (13/24), respectively, with P<0.05 for the first two. Bradyarrhythmias occurred in 27.3% (3/11) of LAD, 75.7% (28/37) of RCA, and 45.8% (11/24) of multivessel coronary artery spasm syncope cases, with the first two showing P<0.05. Coronary angiography analysis of 56 syncope patients revealed target vessel locations and stenosis severity: 12 patients had LAD lesions and 41 had RCA lesions, stenosis ≥50% occurred in 66.7% (8/12) and 43.9% (18/41) of these lesions, respectively ( P>0.05). Conclusions:Variant angina pectoris syncope predominantly affects middle-aged males. Bradyarrhythmias triggered by RCA spasm are a common cause, while the incidence of syncope shows no significant correlation with the degree of coronary artery stenostic lesion, whether in the LAD or the RCA.

BackgroundWith the rapid development of the networking technologies， internet addiction has increasingly become a serious mental health issue. Previous studies have revealed the link between childhood trauma and internet addiction， while the mediating role of perceived stress in this link is not yet clear. ObjectiveTo investigate the role of medical students' perceived stress in the relationship between childhood trauma and internet addiction， so as to provide references for the intervention of internet addiction. MethodsFrom February to March 2023， a random sampling technique was used to select 1 232 undergraduate students from the School of Clinical Medical Sciences of Southwest Medical University as research subjects. The Childhood Trauma Questionnaire-Short Form （CTQ-SF）， Perceived Stress Scale （PSS）， Internet Gaming Disorder Scale （IGDS）， and Bergen Social Media Addiction Scale （BSMAS） were used for assessment. Pearson's correlation coefficients were calculated. The mediation effect of perceived stress in the relationship between childhood trauma and internet addiction was tested using Model 4 in the SPSS Process 4.1， and Bootstrapping procedure involving 5 000 replicates was employed to confirm the statistical significance. ResultsA total of 1 016 （82.47%） valid completed questionnaires were gathered. The CTQ-SF scores of medical students were positively correlated with PSS scores， IGD scores， and BSMAS scores （r=0.583， 0.474， 0.465， P<0.01）. PSS scores were positively correlated with IGD scores and BSMAS scores （r=0.369， 0.479， P<0.01）. Childhood trauma in medical students was found to positively predict perceived stress （β=0.191， P<0.01）， social media addiction （β=0.160， P<0.01）， and internet gaming disorder （β=0.106， P<0.01）. Perceived stress played a significant mediating role in the relationship between childhood trauma and internet gaming disorder， indirect effect value was 0.018 （95% CI： 0.009~0.027）， accounting for 16.98%. Perceived stress also exhibited a significant mediating role in the relationship between childhood trauma and social media addiction， indirect effect value was 0.063 （95% CI： 0.048~0.079）， accounting for 39.38%. ConclusionChildhood trauma in medical students may affect internet gaming disorder and social media addiction through perceived stress. ［Funded by 2022 Annual Research Project of Sichuan Applied Psychology Research Center，（number，CSXL-22102）］

Objective:To analyze the drug resistance status of Mycobacterium tuberculosis（MTB）at a hospital in Xiamen over the past decade. Methods:Sputum culture-positive specimens of tuberculosis patients from Xiamen Xinglin Hospital from 2015 to 2024 were collected retrospectively. Isolates were identified as MTB complex and subjected to drug susceptibility testing. Drug resistance patterns and trends over the study period were analyzed using descriptive statistics and Chi-square trend tests in SPSS 27.0 and GraphPad Prism 8.0.Results:Among 3 883 MTB isolates analyzed，1 132（29.15%）exhibited resistance to at least one drug. The highest rates of resistance to individual first-line drugs were observed for isoniazid（INH，16.04%），streptomycin（SM，15.43%），and rifampicin（RFP，12.28%）. Multidrug-resistant tuberculosis（MDR-TB）was identified in 380 isolates（9.79%）. The predominant MDR resistance patterns were INH+RFP+SM（2.34%），INH+RFP（1.65%），and INH+RFP+SM+ethambutol（EMB）（1.03%）. Polyresistance was found in 188 isolates（4.84%），the predominant patterns were INH+SM（1.49%），INH+fluoroquinolone（FQs）（0.31%），and INH+para-aminosalicylic acid（PAS）（0.31%）. Extensively drug-resistant tuberculosis（XDR-TB）was detected in 49 isolates（1.26%）. From 2015 to 2024，significant decreasing trends were observed for overall drug resistance（ χ2=8.858， P=0.003），MDR（ χ2=15.692， P<0.001），and RFP resistance（ χ2=21.627， P<0.001）. In contrast，fluoroquinolone（FQs）resistance showed no significant trend（ χ2=0.149， P=0.699）. Among RFP resistant and MDR isolates，FQs resistance rates were notably high at 33.12%（158/477）and 36.84%（140/380），respectively. Conclusions:The MTB resistance situation in the hospital has gradually declined in the past 10 years，but the resistance situation remains severe，and clinical attention needs to be strengthened on the use of FQs.

Objective:Investigation of the relationship between variant angina pectoris syncope and coronary artery spastic targeted location, arrhythmias, and coronary artery stenostic lesion.Methods:This study combined retrospective and prospective registry approaches. Data were sourced from the case database of Henan province "Multicenter Clinical Observation Study of Variant Angina Pectoris". A total of 507 patients with variant angina pectoris who had complete records from June 1980 to December 2022 were consecutively enrolled. Select patients among them who experienced syncope, and analyze the target vessel sites of coronary artery spasm, arrhythmias during variant angina pectoris attacks, and the degree of stenosis in coronary artery lesions.Results:Among 507 variant angina pectoris patients, 88 experienced syncope. Age was (53.9±9.7) years and 66 patients (75.0%) were male. Forty patients (45.5%, 40/88) were aged 50-59 years. The incidence of syncope in variant angina pectoris caused by left anterior descending artery (LAD) spasm, right coronary artery (RCA) spasm, and multivessel coronary artery spasm was 7.4% (15/202), 22.7% (42/185), and 23.6% (25/106), respectively. The latter two were significantly higher than those in the LAD group ( P all<0.05). Among 77 patients with variant angina pectoris syncope, definitive electrocardiogram recordings were available during syncope episodes. All patients exhibited arrhythmias during syncope: 34 cases involved tachyarrhythmias and 43 cases involved bradyarrhythmias. The incidence of rapid arrhythmias in patients with LAD, RCA, and multi-vessel spasm syncope was 72.7% (8/11), 24.3% (9/37), and 54.2% (13/24), respectively, with P<0.05 for the first two. Bradyarrhythmias occurred in 27.3% (3/11) of LAD, 75.7% (28/37) of RCA, and 45.8% (11/24) of multivessel coronary artery spasm syncope cases, with the first two showing P<0.05. Coronary angiography analysis of 56 syncope patients revealed target vessel locations and stenosis severity: 12 patients had LAD lesions and 41 had RCA lesions, stenosis ≥50% occurred in 66.7% (8/12) and 43.9% (18/41) of these lesions, respectively ( P>0.05). Conclusions:Variant angina pectoris syncope predominantly affects middle-aged males. Bradyarrhythmias triggered by RCA spasm are a common cause, while the incidence of syncope shows no significant correlation with the degree of coronary artery stenostic lesion, whether in the LAD or the RCA.

BACKGROUND: In China, lung cancer remains the cancer with the highest incidence and mortality rate. Among early-stage lung adenocarcinomas (LUAD), the micropapillary (MPP) component is prevalent and typically exhibits high aggressiveness, significantly correlating with early metastasis, lymphatic infiltration, and reduced five-year survival rates. Therefore, the study is to explore the similarities and differences between MPP and non-micropapillary (non-MPP) components in malignant pulmonary nodules characterized by GGOs in early-stage LUAD, identify unique mutational features of the MPP component and analyze the relationship between the ZNF469 gene, a member of the zinc-finger protein family, and the prognosis of early-stage LUAD, as well as its correlation with immune infiltration. METHODS: A total of 31 malignant pulmonary nodules of LUAD were collected and dissected into paired MPP and non-MPP components using microdissection. Whole-exome sequencing (WES) was performed on the components of early-stage malignant pulmonary nodules. Mutational signatures analysis was conducted using R packages such as maftools, Nonnegative Matrix Factorization (NMF), and Sigminer to unveil the genomic mutational characteristics unique to MPP components in invasive LUAD compared to other tumor tissues. Furthermore, we explored the expression of the ZNF469 gene in LUAD using The Cancer Genome Atlas (TCGA) database to investigate its potential association with the prognosis. We also investigated gene interaction networks and signaling pathways related to ZNF469 in LUAD using the GeneMANIA database and conducted Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. Lastly, we analyzed the correlation between ZNF469 gene expression and levels of immune cell infiltration in LUAD using the TIMER and TISIDB databases. RESULTS: MPP components exhibited a higher number of genomic variations, particularly the 13th COSMIC (Catalogue of Somatic Mutations in Cancer) mutational signature characterized by the activity of the cytidine deaminase APOBEC family, which was unique to MPP components compared to non-MPP components in tumor tissues. This suggests the potential involvement of APOBEC in the progression of MPP components in early-stage LUAD. Additionally, MPP samples with high similarity to APOBEC signature displayed a higher tumor mutational burden (TMB), indicating that these patients may be more likely to benefit from immunotherapy. The expression of ZNF469 was significantly upregulated in LUAD compared to normal tissue, and was associated with poor prognosis in LUAD patients (P<0.05). Gene interaction network analysis and GO/KEGG enrichment analysis revealed that COL6A1, COL1A1, COL1A2, TGFB2, MMP2, COL8A2 and C2CD4C interacted with ZNF469 and were mainly involved in encoding collagen proteins and participating in the constitution of extracellular matrix. ZNF469 expression was positively correlated with immune cell infiltration in LUAD (P<0.05). CONCLUSIONS The study has unveiled distinctive mutational signatures in the MPP components of early-stage invasive LUAD in the Asian population. Furthermore, we have identified that the elevated expression of mutated ZNF469 impacts the prognosis and immune infiltration in LUAD, suggesting its potential as a diagnostic and prognostic biomarker in LUAD.
Humans ; Lung Neoplasms/genetics* ; Adenocarcinoma of Lung/genetics* ; China ; Prognosis ; Transcription Factors

Objective To explore the inhibitory effect of Sidaxue, a traditional Miao herbal medicine formula, on articular bone and cartilage destruction and synovial neovascularization in rats with collagen-induced arthritis (CIA). Methods In a SD rat model of CIA, we tested the effects of daily gavage of Sidaxue at low, moderate and high doses (10, 20, and 40 g/kg, respectively) for 21 days, with Tripterygium glycosides (GTW) as the positive control, on swelling in the hind limb plantar regions by arthritis index scoring. Pathologies in joint synovial membrane of the rats were observed with HE staining, and serum TNF-α and IL-1β levels were detected with ELISA. The expressions of NF-κB p65, matrix metalloproteinase 1 (MMP1), MMP2 and MMP9 at the mRNA and protein levels in the synovial tissues were detected using real-time PCR and Western blotting. Network pharmacology analysis was conducted to identify the important target proteins in the pathways correlated with the therapeutic effects of topical Sidaxue treatment for RA, and the core target proteins were screened by topological analysis. Results Treatment with GTW and Sidaxue at the 3 doses all significantly alleviated plantar swelling, lowered arthritis index scores, improved cartilage and bone damage and reduced neovascularization in CIA rats (P<0.05), and the effects of Sidaxue showed a dose dependence. Both GTW and Sidaxue treatments significantly lowered TNF-α, IL-1β, NF-κB p65, MMP1, MMP2, and MMP9 mRNA and protein expressions in the synovial tissues of CIA rats (P<0.05). Network pharmacological analysis identified MMPs as the core proteins associated with topical Sidaxue treatment of RA. Conclusion Sidaxue alleviates articular bone and cartilage damages and reduces synovial neovascularization in CIA rats possibly by downregulating MMPs via the TNF-α/IL-1β/NF-κB-MMP1, 2, 9 signaling pathway, and MMPs probably plays a key role in mediating the effect of Sidaxue though the therapeutic pathways other than oral administration.

Objective To evaluate the performance of ChatGPT-4.0 and ERNIE Bot-4.0 in the field of laboratory medicine,and ex-plore their application potential and challenges in this professional domain.Methods Using the national clinical medical laboratory technology(intermediate)examination questions as a benchmark,we compared the performance of the two models in mastering labora-tory medicine knowledge and answering consistency.We also and assessed the models'ability in interpreting test results and assisting diagnosis through 30 laboratory medicine cases.Results In the clinical medical examination technology test,both models passed the 60％qualification threshold.ChatGPT-4.0 was superior to ERNIE Bot-4.0 in terms of answering speed and consistency,but its answer-ing accuracy was significantly lower than that of ERNIE Bot-4.0(73.25％vs 80.75％).ERNIE Bot-4.0's accuracy rate was higher than the average accuracy rate of clinical aboratory personnel in this examination(78.03％).In the accuracy analysis of different question types,both performed worst in experimental technology questions(ERNIE Bot-4.0:66.32％,ChatGPT-4.0:60.53％)and best in bas-ic medical knowledge questions(both scoring 86.00％).In the case analysis test,ERNIE Bot-4.0 outperformed ChatGPT-4.0 in all cat-egories.Both models performed well in routine case analysis but made errors in complex case analysis.Conclusion In the field of la-boratory medicine,both large language models have shown certain application potential,especially in a Chinese context,where ERNIE Bot-4.0 significantly outperforms ChatGPT-4.0 in terms of answering accuracy and case analysis ability,indicating its relative advantage in domestic applications.However,both models still need improvement in experimental technical knowledge,complex case analysis ca-pabilities,and the accuracy and consistency of result output.At the current stage,there are still certain risks in directly applying such general large language models to clinical test result interpretation and assisted diagnosis,which provides a new research direction for the interpretation of test reports.