Objective To observe the expression of serum carcinoembryonic antigen(CEA)and interleu-kin-35(IL-35)in patients with differentiated thyroid cancer(DTC),and to analyze the correlation between them and lung metastasis.Methods A total of 150 patients with DTC treated in the hospital from January 2018 to December 2021 were selected as the case group,and another 150 healthy individuals who underwent the physical examination in the hospital in December 2021 were selected as the control group.The case group was divided into lung metastasis group and non lung metastasis group according to the occurrence of lung me-tastasis.The clinical data,serum CEA,IL-35 levels and other laboratory indexes in each group were counted,the correlation between the expression of serum CEA and IL-35 and lung metastasis of DTC patients was ana-lyzed,and the evaluation value of receiver operating characteristic(ROC)curve and area under curve(AUC)on lung metastasis of DTC patients was evaluated.Results The serum CEA level in the case group was higher than that in the control group,and the serum IL-35 level was lower than that in the control group,and the differences were statistically significant(P＜0.05).Among 150 patients with DTC,25 cases had lung metas-tasis,accounting for 16.67％.The levels of serum thyroid stimulating hormone,thyroglobulin and CEA in pa-tients with DTC in lung metastasis group were higher than those in non lung metastasis group,and the level of serum IL-35 was lower than that in non lung metastasis group,and the differences were statistically significant(P＜0.05).The correlation analysis showed that there was a positive correlation between the expression of serum CEA in DTC patients and lung metastasis(r=0.580,P＜0.001),and there was a negative correlation between serum IL-35 and lung metastasis(r=-0.283,P＜0.001).ROC curve analysis was drawn and showed that the area under the curve(AUC)of serum CEA and IL-35 alone and in combination for predicting lung metastasis in patients with DTC were 0.906,0.711 and 0.936 respectively,the sensitivity corresponding to the cut off value was 0.760,0.840 and 0.840 respectively,and the specificity was 0.984,0.544 and 0.968 respectively.Conclusion There is a certain correlation between the expression of serum CEA and lung metas-tasis in DTC patients.Although serum IL-35 is related to lung metastasis,the correlation is extremely weak.The combination of serum CEA and IL-35 has the potential to be used for the evaluation of clinical DTC lung metastasis.

Objective:To observe the clinical efficacy and safety of Jianpi Bushen Jiedu Prescription combined with 5-fluorouracil (5-FU)-based chemotherapy and targeted therapy for the treatment of advanced colorectal cancer patients with liver and kidney yin deficiency combined with spleen deficiency pattern.Methods:A randomized controlled trial was conducted. A total of 72 hospitalized patients with advanced colorectal cancer treated at the Department of Oncology, Nanjing Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from October 2022 to January 2024 were enrolled as study subjects. Using a random number table method, they were allocated into two groups, with 36 patients in each group. The control group received the mFOLFOX6/FOLFIRI combined with bevacizumab regimen, while the treatment group was administered additional oral Jianpi Bushen Jiedu Prescription on the basis of the control group. Two weeks was a cycle in both groups, with a total of 6 cycles of treatment. Serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199), and carbohydrate antigen 724 (CA724) were detected using electrochemiluminescence; the Karnofsky Performance Status (KPS) scale was utilized to evaluate patients' functional status; vital signs were continuously monitored, and adverse reactions were recorded. The short-term efficacy and TCM syndrome efficacy of patients were evaluated.Results:The treatment group demonstrated higher objective response rate (ORR) [31.25% (10/32) vs. 21.88% (7/32), χ2=0.72] and disease control rate (DCR) [84.38% (27/32) vs. 71.88% (23/32), χ2=1.46] compared to the control group, without statistical significance ( P>0.05). Post-treatment levels of CEA [4.09 (3.31,8.57) μg/L vs. 10.07 (4.55,22.35) μg/L, Z=-2.10] and CA72-4 [4.54 (2.04,10.99) mU/L vs. 9.48 (4.34,18.95) mU/L, Z=-2.52] in the treatment group were significantly lower than those in the control group ( P<0.05). The total effective rate of TCM syndrome was significantly higher in the treatment group [78.13% (25/32)] compared with the control group [50.00% (16/32)], with statistical significance ( χ2=5.50, P=0.019). Post-treatment KPS scores in the treatment group [80.0 (80.0, 80.0) vs. 70.0 (62.5, 80.0), Z=-2.76] were significantly higher compared with the control group ( P<0.01). During the treatment period, the treatment group showed statistical significance compared with the control group in the incidence of hemoglobin decrease ( χ2=4.66), leukopenia decrease ( χ2=4.27), and peripheral neuropathy ( χ2=3.93), with statistical significance ( P<0.05). Conclusion:The addition of Jianpi Bushen Jiedu Prescription to 5-FU-based chemotherapy combined with targeted therapy demonstrates significant clinical benefits in advanced colorectal cancer patients, including reducing tumor marker levels, alleviating clinical symptoms, improving quality of life, and mitigating treatment-related toxicities, with a good safety.

Objective:To analyze the medication law of Professor Li Fazhi in the prescriptions for the treatment of cough; To explore his academic thoughts.Methods:Medical cases of Professor Li about the treatment for cough from January 1, 2015 to October 31, 2022 were collected. Excel2016 and R language 4.2.1 were used to conduct multidimensional analysis on property and taste, and meridians of drugs. High-frequency efficacy classification was explored through factor analysis, clustering analysis was conducted to distinguish drug groups, and time-lapse analysis on proportion and meridian was conducted on high-frequency drugs.Results:4 746 prescriptions involved 270 kinds of Chinese materia medica, with a total frequency of 57 700 times. The most common property and taste was warm, followed by cold. Warm medicines were mainly pungent warm and cold warm, and cold medicines were mainly pungent cold, sweet cold and bitter cold, and the main meridians were lung, spleen, stomach, and liver meridians. The top 35 kinds of Chinese materia medica with frequency could be clustered into 9 groups. Group 1: Perillae Fructus, Armeniacae Semen Amarum and Ephedrae Herba; group 2: Magnoliae Flosmagnoliae Flos, Cicadae Periostracum and Glycyrrhizae Radix et Rhizoma; group 3: Peucedani Radix, Platycodonis Radix, Mori Cortex, Schizonepetae Herba, Saposhnikoviae Radix and Farfarae Flos; group 4: Angelicae Dahuricae Radix, Notopterygii Rhizoma et Radix, Citri Reticulatae Pericarpium, Astragali Radix, Cimicifugae Rhizoma and Coptidis Rhizoma; group 5: Coicis Semen, Phragmitis Rhizoma, Persicae Semen and Benincasae Semen; group 6: Perillae Folium; group 7: Bupleuri Radix, Mume Fructus, Aurantii Fructus Immaturus, Scutellariae Radix and Paeoniae Radix Alba; group 8: Asari Radix et Rhizoma, Cinnamomi Ramulus, Zingiberis Rhizoma, Schisandrae Chinensis Fructus and Pinelliae Rhizoma Praeparatum cum Alumine; group 9: Poria and Glycyrrhizae Radix et Rhizoma Praeparata cum Melle. The time-lapse analysis showed that the proportion of drugs used in the past three years such as Glycyrrhizae Radix et Rhizoma Praeparata cum Melle, Poria and Aurantii Fructus was gradually increasing.Conclusions:Professor Li's treatment of cough focuses on the lungs, spleen, and stomach. Clinical medication emphasizes the combination of ascending and descending factors, as well as the use of cold and warm. In recent years, there has been a greater emphasis on treating cough from the middle energizer.

Thoracic paravertebral nerve block(TPVB)is a regional anesthesia technique that pro-vides ipsilateral somatosensory,motor and sympathetic nerves block segmentally by injecting local anesthetics in the paravertebral space.In recent years,there has been an increasing number of studies on the use of TPVB technique for anesthesia and analgesia in pediatric thoracic and upper abdominal surgery,showing good perioperative analgesic efficacy.This article intends to provide a review of the current applica-tion and progress of TPVB technique for pediatric perioperative analgesia in terms of medication regimens,drug diffusion routes,block methods,clinical application,and complications.

[Objective]To present a case of complete androgen insensitivity syndrome (CAIS) coexisting with Müllerian duct remnants (MDR) and to review previous reports in the literature to enhance the understanding of the clinical manifestations and pathophysiology of CAIS.[Methods]The study aimed to diagnose complete androgen insensitivity syndrome (CAIS) by conducting physical examinations,chromosomal analysis,whole exome sequencing,laboratory tests including follicle-stimulating hormone (FSH),luteinizing hormone (LH),total testosterone,estradiol,anti-Müllerian hormone (AMH),inhibin B,dehydroepiandrosterone sulfate (DHEAS),androstenedione,17-hydroxyprogesterone,and imaging studies such as pelvic ultrasound and pelvic magnetic resonance imaging (MRI). Laparoscopy revealed the presence of Müllerian duct structures. Additionally,the study reviewed similar cases of CAIS combined with Müllerian duct remnants reported in the literature.[Results]The child presented with female phenotype,elevated levels of FSH,LH,and testosterone. Pelvic MRI showed bilateral cryptorchidism without visible uterus or fallopian tubes. The chromosomal karyotype was 46,XY,and whole exome sequencing identified a pathogenic variant in the androgen receptor (AR) gene,c.2359C>T (p.Arg787*). No abnormalities were found in the AMH and AMHR2 gene tests. Laparoscopic exploration revealed underdeveloped testes and an underdeveloped uterus. Pathology showed the presence of fallopian tube-like structures next to the testicles. A total of 11 cases with genetically confirmed diagnosis of CAIS coexisting with MDR were retrieved from the database. The findings suggest that the initial clinical presentation,biochemical data,and gonadal pathology of CAIS with MDR are similar to those without MDR.[Conclusion]The study reports a patient with CAIS coexisting with MDR,which broadens the clinical spectrum of CAIS and provides a perspective for basic research on Müllerian duct regression that is independent of the AMH-AMHR2 signaling pathway.

Forsythiae fructus,a traditional Chinese medicine for heat clearing and detoxifying,is commonly used in clinic.It mainly contains phenylethanol glycosides,lignans,terpenoids,volatile oils,flavonoids and other chemical components.Numerous studies have confirmed that forsythiae fructus has anti-inflammatory,antibacterial,antiviral,anti-cancer and other pharmacological effects.Moreover,it has high safety.In this paper,the chemical composition,pharmacological action and safety of forsythiae fructus were reviewed.The aim of this study is to collect the relevant research achievements of forsythiae fructus,and to provide ideas and references for its further research and clinical application.

Structural and functional explorations on bio-soft matter such as micelles,vesicles,nanoparticles,ag-gregates or polymers derived from traditional Chinese medicine(TCM)has emerged as a new topic in the field of TCM.The discovery of such cross-scaled bio-soft matter may provide a unique perspective for unraveling the new effective material basis of TCM as well as developing innovative medicine and biomaterials.Despite the rapid rise of TCM-derived bio-soft matter,their hierarchical structure and as-sembly mechanism must be unambiguously probed for a further in-depth understanding of their pharmacological activity.In this review,the current emerged TCM-derived bio-soft matter assembled from either small molecules or macromolecules is introduced,and particularly the unambiguous elucidation of their hierarchical structure and assembly mechanism with combined electron microscopic and spectroscopic techniques is depicted.The pros and cons of each technique are also discussed.The future challenges and perspective of TCM-derived bio-soft matter are outlined,particularly the requirement for their precise in situ structural determination is highlighted.

Objective:To explore the latent profile types of capability-opportunity-motivation-behavior in stroke patients and analyze the influencing factors of different latent profiles.Methods:From January to October 2023, totally 596 stroke patients from the Neurology Department of five ClassⅢ Grade A hospitals in Henan Province were selected by stratified random sampling. The patients were surveyed using a general information questionnaire, the Stroke Prevention Knowledge Questionnaire (SPKQ), the Social Support Rating Scale (SSRS), the WHO's Quality of Life Questionnaire- Brief Version (WHOQOL-BREF), the Short Form Health Belief Model Scale (SF-HBMS), and the Health Promoting Lifestyle ProfileⅡ (HPLPⅡ). Latent profile analysis was used to classify the capability-opportunity-motivation-behavior characteristics of stroke patients, and multiple logistic regression was conducted to explore the influencing factors of different latent profiles.Results:Three latent profiles of capability-opportunity-motivation-behavior in stroke patients were identified, including low capability-opportunity-motivation-behavior with high health beliefs (32.4%, 193/596), moderate capability-opportunity-motivation-behavior with insufficient health beliefs (47.5%, 283/596), and high capability-opportunity-motivation-behavior with lack of social support (20.1%, 120/596). Multiple logistic regression analysis showed that educational level, smoking history, family history, body mass index, and Charlson Comorbidity Index score were influencing factors of different latent profiles ( P<0.05) . Conclusions:Stroke patients exhibit distinct classifications of capability-opportunity-motivation-behavior. Targeted interventions should be conducted based on the characteristics of each category to improve health behavior management outcomes in patients.

【Objective】 To investigate the effects of formononetin (FMN) on cardiomyocyte apoptosis and HSP90/AKT in rats with dilated cardiomyopathy-mediated heart failure. 【Methods】 Echocardiography, ELISA, histological staining, and TUNEL staining were used to observe the protective effect of different doses of FMN on dilated cardiomyopathy-mediated heart failure in rats and the apoptosis of cardiomyocytes. The potential targets of formononetin on dilated cardiomyopathy-mediated heart failure were obtained from TCMSP, DisGeNet, GeneCards, and other databases, the key targets were obtained according to the protein-protein interaction (PPI) network, and the key targets were verified by molecular docking. Western blotting was used to further verify the regulatory role of key targets in the treatment of dilated cardiomyopathy-mediated heart failure with formononetin. 【Results】 Formononetin could reduce the levels of LVIDS, LVIDD, NT-pro BNP, cTn-T, CK, CK-MB, and LDH in rats with dilated cardiomyopathy-mediated heart failure, increase the levels of EF and FS, and reduce the apoptosis of cardiomyocytes. FMN had a strong binding effect on 10 key targets (AKT1, HSP90AA1, CASP3, MAPK1, MMP9, SRC, ALB, HRAS, IGF1, and EGFR) screened by network pharmacology, with HSP90AA1 and AKT1 having the strongest binding effect. Formononetin decreased the expression of HSP90, AKT and downstream CASP3 protein, but increased the expression of p-AKT in myocardial tissue. 【Conclusion】 Formononetin may inhibit the expression of HSP90, promote phosphorylation of AKT to p-AKT, and inhibit the expression of CASP3, thereby reducing the apoptosis of cardiomyocytes and improving myocardial tissue damage, so as to achieve the purpose of treating dilated cardiomyopathy-mediated heart failure.

Gastrointestinal symptom clusters are a commonly observed and distressing set of symptoms in pediatric patients undergoing chemotherapy for cancer. Traditional Chinese Medicine therapies hold a unique advantage and prospective application in alleviating these symptom clusters caused by chemotherapy in pediatric cancer patients. This review seeks to offer insights into the understanding of gastrointestinal symptom clusters caused by chemotherapy from both Western and Chinese medical perspectives. Moreover, it summarizes the applications of Traditional Chinese Medicine therapies in managing these symptoms, discussing the shortcomings present in existing research and potential future directions.