Objective To explore the imaging characteristics of lung cancers associated with cystic airspaces (LCCA) and the effects of different treatment regimens. Methods A retrospective analysis was conducted on the clinical and radiological data of LCCA patients who underwent surgical resection and pathological confirmation at the Department of Thoracic Surgery, the First Affiliated Hospital of Soochow University from 2016 to 2023. The relationship between various radiological classifications and clinical pathology was studied. Based on the postoperative adjuvant treatment follow-up results, the effects of different treatment regimens were analyzed. Results A total of 147 patients were included, including 90 males and 57 females, with a median age of 63 (55, 70) years. There were 21 patients of imaging typeⅠ, 50 patients of typeⅡ, 57 patients of type Ⅲ, and 19 patients of type Ⅳ. The lobulation sign or burr sign of typeⅠcyst walls (P=0.004), and intracystic septa (P=0.030) were more commonly seen in the high-aggressiveness group. The components of the cyst walls or nodules of types Ⅰ-Ⅳ in the high-aggressiveness group were mostly solid or sub-solid (P<0.05). Multivariate logistic regression analysis indicated that subsolid cyst wall (OR=4.734, P=0.023), solid cyst wall (OR=97.972, P<0.001), and the lobulation sign or burr sign of the cyst wall (OR=13.215, P=0.024) were independent risk factors for aggressiveness. Fifty-eight patients received adjuvant therapy after surgery, including 22 in the chemotherapy group, 15 in the targeted therapy group, and 21 in the combined therapy group. The progression-free survival of the combined therapy group was better than the other two groups (P=0.045). Conclusion There is a correlation between the imaging features of LCCA and pathological aggressiveness. Compared to postoperative targeted therapy or chemotherapy alone, postoperative chemotherapy combined with targeted therapy can improve the progression-free survival of LCCA patients.

Objective To establish an efficient purification and endotoxin [lipopolysaccharide(LPS)] removal process for group B Neisseria meningitidis V2.16 type factor H-binding protein(fHbp), obtain recombinant fHbp protein with high purity and low endotoxin, and provide technical support for the development of related vaccines.Methods The fHbp protein was expressed in E. coli BL21(DE3) mediated by major outer membrane lipoprotein(MLP) signal peptide. After bacterial cell disruption and inclusion body denaturation-renaturation, the LPS removal effects of different types of ceramic hydroxyapatite(CHT)(CHT TypeⅠ/Ⅱ/XT), cation exchange resin(Mab 60 SP) and anion exchange resin(Capto Q ImpRes) were compared under different chromatography modes(flow-through, bind-elution) and process parameters. Three batches of parallel verification experiments were carried out by combining the optimal chromatography methods to optimize the process conditions.Results The optimal chromatography combination process was determined as follows: CHT Type XT resin in flow-through mode, Capto Q ImpRes resin in bind-elution mode, Mab 60 SP resin in bind-elution mode. In three batches of parallel experiments, the average total LPS removal rate was 94. 45% with the highest of 95. 21%, and the protein purity reached over95%.Conclusion The three-step chromatography combination process can efficiently remove endotoxin from recombinant fHbp protein with good repeatability, providing a reliable technical basis for the industrial production of group B Neisseria meningitidis recombinant protein vaccines.

[Objective]To explore and analyze the thoughts of medical and Yiology of the book Waijing Weiyan written by CHEN Shiduo,a medical doctor from Zhejiang Province in the late Ming and early Qing dynasties.[Methods]By means of literature research method,this paper sorted out and screened the articles related to the thoughts of medicine and Yiology in the book and studied them,discussed and analysed CHEN Shiduo's thoughts of medical and Yiology on"the trigrams of the Zhouyi""The River Vehicle Theory""The Nine Palaces and Eight Winds""Heavenly Stems and Earthly Branches",etc.,discussing to explore the connotation of the thoughts of medicine and Yiology in Waijing Weiyan.[Results]The chapters of Waijing Weiyan,which mainly embody the ideas of medical thinking,include"The Mingmen is the Governor of Meridians""Inability of Water to Restrict Fire""Nomenclature of the Eight King of Wind""Relief of Yang Disease and Relief of Yin Disease",etc.The thoughts of medical and Yiology contained therein is mainly reflected in five aspects,namely,expending the imagery of"Kan"and"Li"to explain the doctrine of Mingmen;using the"Ji-Ji Hexagram"interpreting the water and fire of the human body;innovating the River Vehicle Theory in Taoism to explain the pathway lifting and lowering of Qi;inheriting the thoughts of Nine Palaces and Eight Winds,and rationally treating the eight winds occupancy;proposing the twelve"times of exuberance of Qi"to discuss the prognosis of diseases by day and night.[Conclusion]Waijing Weiyan shows the main contents of CHEN Shiduo's thoughts of medicine and Yiology,reflecting his academic characteristics such as emphasizing the coordination of water and fire and the elevation of Qi,advocating the compatibility of thoughts of medicine and Yiology with the actual medical practice,and being good at explaining the medical theories with the tools of medical and Yiology.The study of the theory of medicine and Yiology in Waijing Weiyan helps to understand and grasp the essence of CHEN Shiduo's medical thoughts,and provides ideas for the study and development of the academic thoughts of the Zhejiang school of traditional Chinese medicine.

Objective:To evaluate the role of ferroptosis in reduction of intestinal ischemia-reperfusion injury (IRI) by sodium butyrate pretreatment in mice.Methods:Thirty SPF healthy male C57BL/6 mice, aged 6-8 weeks, weighing 20-23 g, were divided into 5 groups ( n=6 each) using a random number table method: sham operation group (S group), intestinal IRI group (IR group), intestinal IRI + sodium butyrate pretreatment group (IN group), intestinal IRI + sodium butyrate pretreatment+ FER-1 group (INF group), and intestinal IRI + sodium butyrate pretreatment + Erastin group (INE group). The intestinal IRI model was established by occluding the superior mesenteric artery for 45 min followed by reperfusion for 30 min in S group. In IN, INF and INE groups, sodium butyrate was administered by gavage at a dose of 500 mg/kg daily at 1 week before developing the model, while the equal volume of normal saline was given by gavage in the other two groups. The ferroptosis inhibitor FER-1 5 mg/kg and ferroptosis agonist Erastin 30 mg/kg were intraperitoneally injected at 1 h prior to ischemia in INF and INE groups. Mice were sacrificed after anesthesia at the end of reperfusion to obtain small intestinal tissues for examination of the pathological changes (using light microscopy) which were scored according to Chiu and for determination of the contents of Fe 2+, malondialdehyde (MDA), glutathione (GSH) and glutathione disulfide(GSSG) (by enzyme-linked immunosorbent assay), expression of glutathione peroxidase 4 (GPX4), solute carrier family 7 member 11 (SLC7A11), and ferritin heavy chain 1 (FTH1) (by Western blot). The ratio of GSH to GSSG was calculated. Results:Compared to S group, Chiu′s scores and contents of MDA and Fe 2+ were significantly increased, the expression of GSH, GPX4, FTH1 and SLC7A11 was down-regulated, and the GSH/GSSG ratio was decreased in IR group ( P<0.001). Compared to IR group, Chiu′s scores and contents of MDA and Fe 2+ were significantly decreased, the expression of GSH, GPX4, FTH1 and SLC7A11 was up-regulated, and the GSH/GSSG ratio was increased in IN and INF groups ( P<0.001). Compared to IN group, Chiu′s scores and contents of MDA and Fe 2+ were significantly increased, the expression of GSH, GPX4, FTH1 and SLC7A11 was down-regulated, and the GSH/GSSG ratio was decreased in INE group ( P<0.001). Conclusions:Ferroptosis is involved in sodium butyrate pretreatment-induced reduction of intestinal I/RI in mice.

Background and Aims:Polycystic ovary syndrome(PCOS)is a common endocrine disorder among obese women,often accompanied by psychological issues such as anxiety and depression.Laparoscopic sleeve gastrectomy(LSG)is an effective treatment for obesity and its related metabolic conditions,and has shown clear benefits in improving weight and metabolic profiles in PCOS patients.However,the potential mechanisms by which psychological status may affect weight loss outcomes remain unclear.This study aimed to evaluate the psychological characteristics of obese patients with PCOS and explore their impact on postoperative weight loss outcomes,in order to provide evidence for individualized intervention strategies.Methods:Female obese patients scheduled for LSG between November 2020 and September 2022 were enrolled and divided into PCOS and non-PCOS groups.Standardized psychological scales were used to assess anxiety,depression,self-esteem,and eating behaviors.Weight loss outcomes were recorded at 6 and 12 months postoperatively.Propensity score matching was used to control for confounding factors such as age and body mass index(BMI),and correlation analysis was conducted to explore the relationship between psychological status and weight loss outcomes.Results:A total of 314 patients were included,with 130 cases(41.4％)in the PCOS group.Before matching,the PCOS group had significantly worse psychological indicators and lower weight loss outcomes compared to the non-PCOS group(all P＜0.05);after matching,these differences were no longer statistically significant(all P＞0.05).Emotional eating was positively correlated with 12-month weight loss outcomes in the PCOS group,while anxiety and internalized weight stigma were associated with weight loss outcomes in the non-PCOS group(P＜0.05).Additionally,among patients with moderate and extreme obesity,weight loss outcomes in the PCOS group were superior to those in the non-PCOS group(P＜0.05).BMI was negatively correlated with self-esteem,eating behaviors,and quality of life(all P＜0.05).Conclusion:Obese patients with PCOS exhibit notable psychological distress.However,after controlling for BMI and age,their psychological status and weight loss outcomes are comparable to those of non-PCOS patients.BMI may serve as an important confounding factor,and psychological factors may influence weight loss indirectly through eating behaviors.Preoperative psychological screening and intervention are recommended.

Objective:To explore the risk factors of adverse events during the perioperative period of transurethral resection of bladder tumor(TURBT)in bladder cancer patients with coronary atherosclerotic heart disease(CAD).Methods:We retrospectively analyzed the clinical data of bladder cancer patients who underwent TURBT in Beijing Anzhen Hospital from June 2022 to September 2024.All patients with bladder cancer and CAD underwent coronary computed tomography angiography(CCTA)for diagnosis and assessment of CAD before surgery.Based on the CCTA results,the patients with bladder cancer and CAD were divided into two groups:those with mild to moderate coronary stenosis and those with severe coronary stenosis.The severe coronary stenosis group was further divided into two subgroups based on whether they received low-molecular-weight heparin(LMWH)bridging therapy or continued their anti-platelet treatment before surgery.Perioperative anticoagulation and antiplatelet strategies were adjusted according to the opinions of the specialists.The incidence of adverse events within 30 days postoperative-ly was followed up and analyzed.Results:A total of 80 bladder cancer patients with CAD who underwent TURBT were included in the study.Among the 80 patients with CAD,55(68.8％)had mild to moder-ate coronary stenosis,and 25(31.2％)had severe coronary stenosis.Compared with those had mild to moderate coronary stenosis,the patients who had severe coronary stenosis had a higher incidence of post-operative bleeding and pulmonary embolism,although the differences were not statistically significant(P＞0.05).However,the incidence of postoperative myocardial infarction was significantly higher in the patients who had severe coronary stenosis(P=0.034).Among the patients with severe coronary stenosis,8(32.0％)received LMWH bridging therapy before TURBT,and 17(68.0％)continued their previous antiplatelet treatment.Compared with those who continued antiplatelet treatment,the patients who re-ceived LMWH bridging therapy had a higher incidence of postoperative bleeding and pulmonary embo-lism,although the differences were not statistically significant(P＞0.05).However,the incidence of postoperative myocardial infarction was significantly higher in the LMWH bridging group(P=0.032).Conclusion:Patients with mild-to-moderate coronary stenosis demonstrate relatively low perioperative risk during TURBT procedures and may safely undergo TURBT following antiplatelet therapy discontinuation.Conversely,those with severe coronary stenosis exhibit significantly higher perioperative risk and require intensive monitoring.In bladder cancer patients with concomitant severe coronary stenosis,perioperative LMWH bridging therapy is associated with increased myocardial infarction risk,whereas continued anti-platelet therapy does not elevate postoperative bleeding risk.Current evidence therefore supports maintai-ning antiplatelet therapy in these patients,with appropriate bleeding risk assessment.

Objective:To explore the relationship between insomnia, depression, sense of meaning in life and suicidal behavior among college students.Methods:A cross-sectional survey was conducted among 7 260 college students at a university in Hebei Province from September to November 2024. The insomnia severity index (ISI), patient health questionnaire(PHQ-9), meaning in life questionnaire(MLQ), and suicide behavior questionnaire-revised (SBQ-R) were used for assessment. Structural equation modeling test was conducted by Mplus 8.0 to test the mediating effect of depression and the moderating effect of sense of meaning in life.Results:(1) The scores of insomnia (6.00 (4.00, 8.00)), depression (2.50 (0, 2.00)), and suicidal behavior (4.00 (3.00, 4.00)) were significantly and positively correlated with each other ( r=0.51-0.66, all P<0.01). The sense of meaning in life (47.80 (39.00, 58.00)) was negatively correlated with insomnia, depression, and suicidal behavior ( r=-0.04--0.22, all P<0.01). (2) Insomnia could positively predict suicidal behavior among college students ( β= 0.15, P<0.01). (3) Depression played a partial mediating role between insomnia and suicidal behavior, with a mediating effect value of 0.40 (95% CI= 0.37-0.43), accounting for 72.73%(0.40/0.55) of the total effect. Conclusion:Depression plays a partial mediating role between insomnia and suicidal behavior among college students. The sense of meaning in life can moderate the impact of insomnia on depression and suicidal behavior.

Objective To develop a gas chromatography-tandem mass spectrometry(GC-MS/MS)method for the simultaneous determination of ephedrine and pseudoephedrine in urine.Methods Urine samples containing ephedrine and pseudoephedrine components were extracted with ethyl acetate,centrifuged to collect the supernatant and evaporated to dryness under a nitrogen stream and then derivatized with heptafluorobutyric anhydride 60 μL at 70 ℃ for 30 min,and re-evaporated under nitrogen,and then solubilized with 50 μL of methanol,and then analyzed by GC-MS/MS.Results The method demonstraed excellent linearity for ephedrine(0.05～10 μg/mL,r=0.999 8)and pseudoephedrine(0.02～5 μg/mL,r=0.999 5).Extraction recoveries ranged from 89.4％～95.8％(ephedrine)and 90.3％～93.8％(pseudoephedrine).Limits of detection and quantification of ephedrine and pseudoephedrine were 0.005 μg/mL and 0.01 μg/mL,the intra-day precision and accuracy were less than 5.87％and 9.56％,respectively,and the inter-day precision and accuracy were less than 7.54％and 9.27％,respectively.The stability of ephedrine and pseudoephedrine in urine in 15 d was good under the conditions of room temperature and-20 ℃.Conclusion The GC-MS/MS analytical method for the analysis of ephedrine and pseudoephedrine components in urine established in this study is accurate,stable and sensitive,which can provide data technical support for the forensic toxicological analysis of amphetamine-type drugs or new psychoactive substances in the cathinone group.

Taking Xiaochaihu Decoction as an example,the application differences of classical prescriptions in modern medical context and Chinese medicine practice are compared and analyzed from the aspects of clinical application scope,understanding of pre-scription connotation,dosage specification,dosage form and decoction method.Strategies to solve the differences in efficacy are pro-posed:integrating the wisdom of classical prescriptions and reshaping the framework of Chinese medicine diagnosis and treatment;transforming the results of modern pharmacology and exploring the principles of classical prescriptions;controlling drug quality stand-ards and exploring new uses and dosages of classical prescriptions;keeping pace with the times in Chinese medicine decoction and strengthening management and control to ensure efficacy.It is believed that combining the essence of Chinese medicine with modern technology can make the application of classical prescriptions maintain traditional characteristics while meeting modern clinical require-ments.This can not only improve the adaptability of classical prescriptions to modern complex diseases,but also provide a reference for the modernization of traditional medicine.

Objective To exple the mechanism of Qixiong Zuogui Granules(QXZG)for enhancing synaptic plasticity in aging rats.Method Forty SD rats were randomized into control group,aging model group,donepezil treatment group,and QXZG treatment group(n=10).Except for the control rats,all the rats were subjected to daily intraperitoneal injection of D-galactose for 8 consecutive weeks to induce brain aging,and donepezil hydrochloride and QXZG suspension were administered by gavage during modeling.After the interventions,the rats were evaluated for general conditions,behavioral changes,oxidative stress indicators,hippocampal pathologies,and expressions of the brain-derived neurotrophic factor(BDNF)/tyrosine kinase receptor B(TrkB)pathway,p16,and synaptic plasticity-associated proteins.Results The rats in the model group exhibited obvious aging phenotypes such as yellowing of the teeth and hair,body weight loss,and impaired learning and memory abilities,with decreased serum SOD and GSH-Px activities and increased serum MDA level.The rat models also showed obvious pathological changes,reduced Nissl bodies,and elevated p16 protein expression in the hippocampal CA1 region,with significantly decreased expression levels of BDNF,TrkB,CREB and synaptic plasticity proteins SYN,GAP43,and PSD95.Treatment with QXZG alleviated the aging phenotypes in the rat models,improved their learning and memory abilities and pathological changes in the hippocampal CA1 region,reduced oxidative stress and p16 protein expression,and promoted the expressions of the BDNF/TrkB pathway proteins and synaptic plasticity proteins.Conclusion QXZG enhances synaptic plasticity and reduces oxidative stress in aging rats possibly by upregulating the BDNF/TrkB signaling pathway proteins,thereby delaying brain aging and improving learning and memory abilities of the rats.