BACKGROUND: The beneficial effects of sodium-glucose co-transporter-2 inhibitors (SGLT2i) on adverse cardiac outcomes in diabetic patients are well-established. However, the effects of SGLT2i against cancer therapy-related cardiotoxicity remain understudied. We investigated the association between SGLT2i and cardiac outcomes in cancer patients. METHODS: PubMed, Embase, and the Cochrane Library were searched from their inception until September 30, 2024 for studies evaluating the effects of SGLT2i in patients with cancer. The primary outcomes included incident heart failure (HF), HF exacerbation, HF hospitalization, atrial fibrillation/atrial flutter (AF/AFL), myocardial infarction, and all-cause mortality. The secondary outcomes included acute kidney injury and sepsis. Odds ratio (OR) with 95% CI was pooled. RESULTS: Thirteen studies with 85,596 patients were included. Compared to non-SGLT2i use, SGLT2i treatment was associated with lower risks of incident HF (OR = 0.51, 95% CI: 0.32-0.79, P = 0.003), HF exacerbation (OR = 0.74, 95% CI: 0.63-0.87, P < 0.001), AF/AFL (OR = 0.67, 95% CI: 0.55-0.82, P < 0.001), myocardial infarction (OR = 0.61, 95% CI: 0.41-0.90, P = 0.01), and all-cause mortality (OR = 0.44, 95% CI: 0.28-0.69, P < 0.001), but not for HF hospitalization (OR = 0.58, 95% CI: 0.22-1.55, P = 0.28). As for safety outcomes, SGLT2i use was associated with lower risks of acute kidney injury (OR = 0.68, 95% CI: 0.57-0.81, P < 0.001) and sepsis (OR = 0.32, 95% CI: 0.23-0.44, P < 0.001). CONCLUSIONS SGLT2i were associated with lower risks of incident HF, HF exacerbation, AF/AFL, myocardial infarction, all-cause mortality, acute kidney injury, and sepsis in cancer patients.

[Purpose]To investigate the acceptance and willingness-to-pay(WTP)of combined can-cer screening among rural residents in Shandong Province,and to analyze its influencing factors.[Methods]A face-to-face questionnaire survey was conducted among rural residents aged 40～70 in villages setected by cluster sampling from three counties(county level city or district)in Shan-dong Province.The questionnaire was developed using the method of double-bound dichotomous choice combined with open-ended questions in contingent valuation.The factors influencing inten-sity of WTP was analyzed with using single-factor and ordinary least squares regression models.[Results]A total of 962 subjects were surveyed.89.19％of the respondents were willing to accept cancer combined screening,and 62.00％were willing to pay part of the costs.The average of WTP was 963.67 CNY,which accounted for 32.12％of the total cost.The proportion of respon-dents who were willing to pay between 0～1 500 CNY was the highest(76.49％).In the multivariate analysis,age,sex and income had significant effects on the maximum payment of multi-cancer screening.[Conclusion]The acceptance of multi-cancer screening among rural residents in the study sites is high,but the willingness-to-pay is limited.The out-of-pocket payment for multi-can-cer screening should be controlled,and a co-payment mechanism among government,enterprises,social organizations and individuals should be explored.

Objective To evaluate the baseline characteristics and short-term safety of lecanemab in treatment of Alzheimer's disease(AD)in Chinese patients in a real-world study.Methods A mul-ticenter,retrospective,observational study was conducted on 646 AD patients who were continu-ously recruited and receved of lecanemab therapy in 84 medical centers from June 26,2024 to March 1,2025.Their clinical data,including baseline Mini-mental state examination(MMSE)score and clinical dementia rating(CDR)score before and after treatment,were collected,and the CDR-global score(CDR-GS)and CDR-sum of box score were calculated.The incidences of infu-sion-related reactions(IRR)and amyloid-related imaging abnormalities(ARIA),including ARIA with edema and effusion(ARIA-E)and ARIA with hemosiderin deposit(ARIA-H)within 3 months of treatment were observed and recorded.Apolipoprotein E(ApoE)genetic test was per-formed on 454 patients.Baseline characteristics and short-term safety of the patients were ana-lyzed.Results There were 301 patients(46.59％)having a baseline CDR-GS score of 0.5 and 345(53.41％)patients had a CDR score of 1.In the 454 patients receiving genetic test,the ApoEε4 carriers accounted for 31.27％(202 cases),including 17 cases of ApoEε4 homozygous carriers(8.42％).The incidence of IRR was 4.95％(32/646),which mainly occurred during the first infu-sion(90.63％,29/32),and there were 96.88％(31/32)of mild and 3.13％(1/32)of moderate IRR,with main manifestations of fever,dizziness,vomiting,etc.Sixteen patients(2.48％)experienced ARIA,including 5(31.25％)ARIA-E,10(62.50％)ARIA-H,and 1(6.25％)ARIA-E and ARIA-H.For the 5 patients with ARIA-E,2 were symptomatic,and in terms of radiographic severity,3 cases were mild and 2 cases were moderate ARIA-E.In the 10 patients with ARIA-H,all of them had no clinical symptoms,and in terms of radiographic severity,6 had mild and 4 had moderate ARIA-H.Among the 17 ApoEε4 homozygous patients,only one patient(5.88％)experi-enced ARIA-H with a moderate radiographic severity.Multivariate analysis showed that age in-creased the trend of ARIA risk,but no statistical difference was observed(P=0.056).Conclusion In this real-world study in China,AD patients receiving lecanemab treatment have the characteris-tics of being younger in age but higher disease severity.Short-term follow-up data suggest that lecanemab has good safety.

Aim To detect the non-coding RNA(ncRNA)expression profile of neuroglioma cells via whole transcriptome sequencing,establish the ceRNA network and reveal the molecular mechanism of ncRNA participating in the inhibition of neuroglioma cell prolif-eration by melatonin.Methods Neuroglioma cells were intervened with by 0,2,4,6 and 8 mmol·L-1 melatonin for 24,48 and 72 h,and the inhibitory effect of melatonin on cell proliferation was detected via CCK-8;after the intervention of 0 and 4 mmol·L-1 melatonin to U251 cells for 24 h,differentially ex-pressed miRNA(DEmiRNA),lncRNA(DElncRNA)and mRNA(DEmRNA)were detected through whole transcriptome sequencing,along with GO and KEGG enrichment analysis of DEmRNA;the ceRNA network was constructed,and the key gene expression of ceR-NA was verified through qRT-PCR.Results Melato-nin exerts a time-dose-dependent inhibitory effect on the proliferation of neuroglioma cells;a total of 5049 DEmRNA,635 DElncRNA and 146 DEmiRNA in 0 and 4 mmol·L-1 melatonin groups were screened out via whole transcriptome sequencing;DEmRNAs were mainly enriched in cancer-related signaling pathways,such as ferroptosis,mTOR signaling pathway,FoxO signaling pathway and cell cycle;the ceRNA network included 4 lncRNAs,3 miRNAs and 48 mRNAs.As verified through real-time PCR,the expressions of hsa-miR-129-5p,hsa-miR-362-5p,LINC00707 and SLC16A1-AS1 of U251 cells were consistent with the sequencing results,and the gene expression of U87 cells was basically consistent with the sequencing re-sults.Conclusions Melatonin affects cancer-related signaling pathways through the differential expression of ncRNA so as to inhibit the proliferation of U251 cells;the ceRNA network composed of LINC00707,SLC16A1-AS1,hsa-miR-129-5p and hsa-miR-362-5p may take a part in the molecular mechanism of melato-nin in inhibiting neuroglioma cell proliferation.

Objective To evaluate the baseline characteristics and short-term safety of lecanemab in treatment of Alzheimer's disease(AD)in Chinese patients in a real-world study.Methods A mul-ticenter,retrospective,observational study was conducted on 646 AD patients who were continu-ously recruited and receved of lecanemab therapy in 84 medical centers from June 26,2024 to March 1,2025.Their clinical data,including baseline Mini-mental state examination(MMSE)score and clinical dementia rating(CDR)score before and after treatment,were collected,and the CDR-global score(CDR-GS)and CDR-sum of box score were calculated.The incidences of infu-sion-related reactions(IRR)and amyloid-related imaging abnormalities(ARIA),including ARIA with edema and effusion(ARIA-E)and ARIA with hemosiderin deposit(ARIA-H)within 3 months of treatment were observed and recorded.Apolipoprotein E(ApoE)genetic test was per-formed on 454 patients.Baseline characteristics and short-term safety of the patients were ana-lyzed.Results There were 301 patients(46.59％)having a baseline CDR-GS score of 0.5 and 345(53.41％)patients had a CDR score of 1.In the 454 patients receiving genetic test,the ApoEε4 carriers accounted for 31.27％(202 cases),including 17 cases of ApoEε4 homozygous carriers(8.42％).The incidence of IRR was 4.95％(32/646),which mainly occurred during the first infu-sion(90.63％,29/32),and there were 96.88％(31/32)of mild and 3.13％(1/32)of moderate IRR,with main manifestations of fever,dizziness,vomiting,etc.Sixteen patients(2.48％)experienced ARIA,including 5(31.25％)ARIA-E,10(62.50％)ARIA-H,and 1(6.25％)ARIA-E and ARIA-H.For the 5 patients with ARIA-E,2 were symptomatic,and in terms of radiographic severity,3 cases were mild and 2 cases were moderate ARIA-E.In the 10 patients with ARIA-H,all of them had no clinical symptoms,and in terms of radiographic severity,6 had mild and 4 had moderate ARIA-H.Among the 17 ApoEε4 homozygous patients,only one patient(5.88％)experi-enced ARIA-H with a moderate radiographic severity.Multivariate analysis showed that age in-creased the trend of ARIA risk,but no statistical difference was observed(P=0.056).Conclusion In this real-world study in China,AD patients receiving lecanemab treatment have the characteris-tics of being younger in age but higher disease severity.Short-term follow-up data suggest that lecanemab has good safety.

Aim To detect the non-coding RNA(ncRNA)expression profile of neuroglioma cells via whole transcriptome sequencing,establish the ceRNA network and reveal the molecular mechanism of ncRNA participating in the inhibition of neuroglioma cell prolif-eration by melatonin.Methods Neuroglioma cells were intervened with by 0,2,4,6 and 8 mmol·L-1 melatonin for 24,48 and 72 h,and the inhibitory effect of melatonin on cell proliferation was detected via CCK-8;after the intervention of 0 and 4 mmol·L-1 melatonin to U251 cells for 24 h,differentially ex-pressed miRNA(DEmiRNA),lncRNA(DElncRNA)and mRNA(DEmRNA)were detected through whole transcriptome sequencing,along with GO and KEGG enrichment analysis of DEmRNA;the ceRNA network was constructed,and the key gene expression of ceR-NA was verified through qRT-PCR.Results Melato-nin exerts a time-dose-dependent inhibitory effect on the proliferation of neuroglioma cells;a total of 5049 DEmRNA,635 DElncRNA and 146 DEmiRNA in 0 and 4 mmol·L-1 melatonin groups were screened out via whole transcriptome sequencing;DEmRNAs were mainly enriched in cancer-related signaling pathways,such as ferroptosis,mTOR signaling pathway,FoxO signaling pathway and cell cycle;the ceRNA network included 4 lncRNAs,3 miRNAs and 48 mRNAs.As verified through real-time PCR,the expressions of hsa-miR-129-5p,hsa-miR-362-5p,LINC00707 and SLC16A1-AS1 of U251 cells were consistent with the sequencing results,and the gene expression of U87 cells was basically consistent with the sequencing re-sults.Conclusions Melatonin affects cancer-related signaling pathways through the differential expression of ncRNA so as to inhibit the proliferation of U251 cells;the ceRNA network composed of LINC00707,SLC16A1-AS1,hsa-miR-129-5p and hsa-miR-362-5p may take a part in the molecular mechanism of melato-nin in inhibiting neuroglioma cell proliferation.

[Purpose]To investigate the acceptance and willingness-to-pay(WTP)of combined can-cer screening among rural residents in Shandong Province,and to analyze its influencing factors.[Methods]A face-to-face questionnaire survey was conducted among rural residents aged 40～70 in villages setected by cluster sampling from three counties(county level city or district)in Shan-dong Province.The questionnaire was developed using the method of double-bound dichotomous choice combined with open-ended questions in contingent valuation.The factors influencing inten-sity of WTP was analyzed with using single-factor and ordinary least squares regression models.[Results]A total of 962 subjects were surveyed.89.19％of the respondents were willing to accept cancer combined screening,and 62.00％were willing to pay part of the costs.The average of WTP was 963.67 CNY,which accounted for 32.12％of the total cost.The proportion of respon-dents who were willing to pay between 0～1 500 CNY was the highest(76.49％).In the multivariate analysis,age,sex and income had significant effects on the maximum payment of multi-cancer screening.[Conclusion]The acceptance of multi-cancer screening among rural residents in the study sites is high,but the willingness-to-pay is limited.The out-of-pocket payment for multi-can-cer screening should be controlled,and a co-payment mechanism among government,enterprises,social organizations and individuals should be explored.

Objective To investigate the population characteristics,distribution of traditional Chinese medicine(TCM)syndromes and influencing factors of long-term prognosis of diarrhea-predominant irritable bowel syndrome(IBS-D),and to provide evidence for the formulation of intervention program for IBS-D patients.Methods A total of 124 patients with IBS-D admitted to the medical institutions of the project team members from July 2020 to August 2022 were selected.According to the scoring results of IBS Quality of Life Measure(IBS-QOL),the patients were divided into the good prognosis group(81 cases)and the poor prognosis group(43 cases).The distribution of TCM syndromes in patients with IBS-D was explored,and the difference of IBS-QOL scores of the patients between good prognosis group and poor prognosis group was compared.Univariate logistic regression analysis and multivariate logistic regression analysis were used to determine the main risk factors for poor prognosis in patients with IBS-D.Results(1)The analysis of population characteristics showed that there was no significant difference in the proportion of male and female patients with IBS-D.The patients with IBS-D were usually middle-aged,and had a large interval span of the course of disease.The severity of their symptoms was mostly moderate.All of the patients with IBS-D had various degrees of anxiety and depression,and had nutritional imbalance.(2)The distribution of TCM syndromes in the patients with IBS-D were shown as the following:78 cases were identified as liver depression and spleen deficiency type,accounting for 62.90％;26 cases were identified as spleen-qi deficiency type,accounting for 20.97％;20 cases were identified as spleen and kidney yang deficiency type,accounting for 16.13％.(3)Analysis of IBS-QOL score showed that compared with the good prognosis group,the items scores of negative emotion,physical function,behavioral disorder,health status,being fastidious about food,social function,sexual behavior and interpersonal relationship of IBS-QOL in the poor prognosis group were significantly lowered(P＜0.01).(4)The univariate analysis showed that the risk of poor prognosis in patients with IBS-D would be increased by the factors of age,education level,course of disease,severity of symptoms,anxiety state,depression state,TCM syndrome types,Acute Physiology and Chronic Health Evaluation scoring system Ⅱ(APACHE 11)score,complication of neurological diseases,hemoglobin level,albumin level and total protein level(P＜0.01).(5)The multivariate Logistic regression analysis showed that the risk factors for poor prognosis of IBS-D patients involved age,education level below junior high school,the severity of symptoms being severe,Self-Rating Anxiety Scale(SAS)score,Self-Rating Depression Scale(SDS)score,TCM syndrome being liver depression and spleen deficiency type,hemoglobin level,albumin level and total protein level(P＜0.01).Conclusion Most of IBS-D patients exert long-term poor prognosis,and their long-term prognosis is affected by the factors of age,education level,severity of symptoms,anxiety and depression state,nutritional imbalance and TCM syndrome being liver depression and spleen deficiency type.The identification of the risk factors of poor prognosis will provide evidence for the formulation and adjustment of clinical intervention programs.

The Republic of China period （1912—1949） was an important stage of transition from traditional herbalism to clinical Chinese materia medica. The clinical application of Chinese materia medica became the focus of academic attention. During the Republic of China period， the research objectives， methods， and content of clinical Chinese materia medica were clarified， and the basic framework of Chinese materia medica was established through efficacy classification and item description. Based on the historical background at that time， striving for survival in adversity were the internal factors driving the construction of clinical Chinese materia medica， and the rise of academic education and the popularity of traditional Chinese medicine journals provided favorable conditions for the development of clinical Chinese materia medica. The clinical Chinese materia medica during the Republic of China period gradually formed a theoretical structure and core content that was distinctly different from that of traditional herbal medicine， which was integrated with the scientific research of Chinese materia medica and promoted the continuous development of Chinese materia medica together with other subdisciplines， presenting distinctive characteristics of the times and important academic significance.

Objective To investigate the protective effect of apigenin on renal tubular epithelial cells(HK-2)induced by hyperglycemia and its potential mechanism.Methods HK-2 cells were incubated with d-glucose to establish an in vitro diabetic nephropathy model.Cell viability,apoptosis and oxidative stress were assessed.The mRNA levels of nuclear factor erythroid-2 related factor 2(Nrf2),heme oxygenase-1(HO-1)and epoxy chloropropane Kelch sample related protein-1(Keap1)were measured by quantitative real-time-PCR(q-PCR).Western blot analysis was performed to measure the protein expression of Nrf2.Results In HK-2 cells,high glucose decreased cell viability in a concentration-and time-dependent manner.Apigenin improved the viability of HK-2 cells under high glucose stress,reduced apoptosis and proinflammatory cytokine production,and inhibited the oxidative stress.Apigenin increased mRNA expression of Nrf2 and HO-1,increased expression of Nrf2 protein and reduced the mRNA level of Keap1.Inhibition of Nrf2 using small interfering RNA(siRNA)abolished the protective effects of apigenin on HK-2 cells under high glucose stress.Conclusion Apigenin treatment can alleviate the damage of HK-2 cells under high glucose stress,and exert the anti-oxidation and anti-inflammation effects through Keap1-Nrf2-ARE pathway.