ObjectiveTo investigate the effects of zinc finger E-box binding homeobox 1 （ZEB1） on the proliferation， migration， and invasion of lung adenocarcinoma H322 cells， as well as its underlying molecular mechanisms. MethodsThe gene expression characteristics of the transcription factor ZEB1 in lung adenocarcinoma were analyzed using data from the GEO and TCGA public databases. RT-qPCR and Western blot were employed to measure mRNA and protein expression levels of ZEB1 in lung adenocarcinoma cell lines （H322， A549， 95-D） and normal human bronchial epithelial cells （BEAS-2B）. Lentiviral transduction was utilized to establish stable ZEB1-overexpressing （Oe-ZEB1） and vector control （Oe-NC） H322 cell lines. Cell proliferation was assessed using CCK-8， colony formation， and EdU assays， while apoptosis was evaluated by Hoechst33258/PI double staining. Wound healing and Transwell assays were performed to examine cell migration and invasion capabilities. Cell cycle distribution was determined by flow cytometry， and Western blot was used to analyze protein expression changes in relevant signaling pathways. ResultsThe findings from GEO and TCGA indicated that ZEB1 expression in lung adenocarcinoma varied with tumor malignancy grade. RT-qPCR and Western blot analyses revealed significantly higher ZEB1 expression in lung adenocarcinoma cell lines compared to BEAS-2B cells （P0.05）. Results from the CCK-8， colony formation， EdU， wound healing， and Transwell assays demonstrated that， compared with the un-transfected control （Control） group， Oe-ZEB1 H322 cells exhibited enhanced proliferation， migration， and invasion capabilities （P0.05）. Hoechst33258/PI double staining and flow cytometry analyses showed that， relative to the Control group， apoptosis was reduced in Oe-ZEB1 H322 cells （P0.05）. Additionally， a decreased proportion of cells in the G₁ phase and an increased proportion in the S phase were observed in Oe-ZEB1 cells， indicating accelerated cell cycle progression. Western blot analysis further revealed that， compared with the Control group， Oe-ZEB1 H322 cells exhibited upregulated expression of N-cadherin， mutant p53 （mutp53）， and Cyclin D1 （P0.05）， while expression levels of E-cadherin， murine double minute 2 （MDM2）， and p21 were downregulated （P0.05）. ConclusionOverexpression of ZEB1 promotes the proliferation， migration， and invasion of lung adenocarcinoma H322 cells and may facilitate cell cycle progression by modulating the MDM2/mutp53/p21 signaling pathway， thereby promoting the transition of cells from the G₀/G₁ phase to the S phase.

The recombinant human thyroid-stimulating hormone (rhTSH) can be used for differentiated thyroid cancer (DTC) preparation before ¹³¹I therapy, and follow-up. Since its approval by the American Food and Drug Administration (FDA) in 1998, rhTSH has been clinically used in European countries, the United States, and other countries for nearly 30 years. In April 2024, China’s first independently developed rhTSH agent was approved. Based on clinical experience and evidence from domestic and international studies, an expert consensus on the application of rhTSH has been developed following thorough consultations among experts. The consensus offers evidence-based recommendations to guide the appropriate use of rhTSH in clinical practice.

Objective:To explore the level of triglyceride-glucose (TyG) index and its effect and clinical value in predicting breast cancer.Methods:A retrospective case-control study was conducted. A total of 700 patients with breast tumors who underwent surgical treatment in the Inner Mongolia Autonomous Region People's Hospital from July 2021 to June 2024 were selected, and finally 625 patients were included, including 388 patients with benign breast tumors and 237 patients with breast cancer, and all lesions were determined to be benign or malignant by pathology after surgery. Triglyceride and blood glucose data were collected to calculate the TyG index. The correlation between TyG index and occurrence of breast cancer was analyzed by univariate and multivariate binary logistic regression models. With postoperative pathological diagnosis as the gold standard, the receiver operating characteristic (ROC) curve was used to evaluate the efficacy of TyG index in distinguishing breast cancer from benign breast tumors.Results:The age of patients in the breast cancer group and the benign breast tumor group was (57±12) years old and (42±12) years old, respectively. There were statistically significant differences in the distributions of patients between the two groups in terms of nationality, marital status, height, body mass, body mass index (BMI), cholesterol, low-density lipoprotein cholesterol, triglyceride, blood glucose levels, and color ultrasound Breast Imaging Report and Data System (BI-RADS) classification (all P < 0.05), and there was no statistically significant difference in the level of high-density lipoprotein cholesterol between the two groups ( P > 0.05); the TyG index in the breast cancer group was higher than that in the benign breast tumor group (8.6±0.6 vs. 8.4±0.6), and the difference was statistically significant ( P <0.001). Logistic regression analysis showed that in the model with only the TyG index as a variable, the risk of breast cancer increased with the increase of TyG index [ OR = 1.97, 95% CI: 1.48-2.63, P < 0.001, Hosmer-Lemeshow (HL) test P = 0.077]; in the model with 6 variables including TyG index, nationality, marriage, height, body mass and BMI, the risk of breast cancer increased with the increase of TyG index ( OR = 1.47, 95% CI: 1.08-2.00, P = 0.015, HL test P = 0.832); however, after adding age and BI-RADS classification variables, although the TyG index was still an independent influencing factor for the occurrence of breast cancer ( OR = 0.58, 95% CI: 0.35-0.96, P = 0.033, HL test P = 0.165), the rise of TyG index was an independent protective factor for the occurrence of breast cancer; in the two variable models including TyG index and BI-RADS classification, the TyG index was not an independent influencing factor for the occurrence of breast cancer ( OR = 1.10, 95% CI: 0.72-1.70, P = 0.659), suggesting that the TyG index may not be able to assist in the diagnosis of breast cancer by ultrasound. ROC curve analysis showed that the area under the curve to distinguish breast cancer and benign breast tumor according to the TyG index was 0.623, the optimal critical value of the TyG index was 8.51, the corresponding sensitivity was 59.5%, and the specificity was 62.4%. Conclusions:The TyG index of breast cancer patients is higher than that of benign breast tumor patients. Breast tumor patients with elevated TyG index have an increased risk of breast cancer, which may be a potential non-invasive biomarker of breast cancer.

Breast cancer is the most common type of cancer among women. Although chemotherapy has extended the survival time of patients with breast cancer, the cardiovascular complications caused by chemotherapy drugs are on the rise, which limits the clinical use of anthracycline drugs. At present, it is believed that the mechanisms of cardiac adverse reactions induced by anthracycline drugs may be related with oxidative stress, topoisomerase inhibitor 2, abnormal expression of non-coded RNA in cells, induction of autophagy and apoptosis in myocardial cells, and other various cell death pathways. This article reviews the relationship between insulin-like growth factor receptor 2 and cardiac adverse reactions induced by anthracycline drugs.

The incidence of breast cancer remains high worldwide, which seriously threatens women's health. Many patients has benefited from the traditional way of surgery combined with drug therapy, but the drug resistance and side effects have made the treatment outcome unexpected, so new therapeutic targets for breast cancer need to be continuously discovered. In recent years, SLC7A5, as an amino acid transporter, plays a key role in metabolic reprogramming and immune microenvironment remodeling in breast cancer by regulating the uptake of glutamine and leucine. Although, the role of SLC7A5 in endocrine therapy resistance is still unclear, small molecule inhibitors targeting its function such as JPH203 have shown significant efficacies in preclinical models. This article reviews the structure and function of SLC7A5, its expression characteristics in breast cancer, and its molecular mechanism driving tumor progression, and discusses the therapeutic strategies targeting SLC7A5 and its potential for clinical translation.

Objective:To evaluate the long-term outcomes and predictors of coronary atherosclerotic lesions deemed functionally non-ischemic (quantitative flow ratio(QFR)>0.80) and deferred from intervention.Methods:This study is a post-hoc analysis of the FAVOR Ⅲ China trial, which enrolled 3 825 patients with stable or unstable angina pectoris or with myocardial infarction occurring at least 72 hours prior to screening, between December 5, 2018 and January 9, 2020 from 26 research centers in China. Coronary vessels with QFR>0.80 and without interventional treatment were analyzed in this study. The primary endpoint was 3-year target vessel revascularization. Vessels with revascularization (revascularized group) during follow-up were matched 1∶1 using propensity score matching to comparable vessels without revascularization (non-revascularized group). Multivariate Cox regression analysis was used to identify the risk factors for target vessel revascularization (TVR).Results:A total of 6 212 functionally negative vessels with deferred intervention were included in the final analysis, among which 153 vessels (2.5%) underwent TVR during a 3-year follow-up. Prior to propensity score matching, 6 059 vessels comprised the non-revascularized group. At the vessel level, compared to the non-revascularized group, the revascularized group exhibited a significantly higher proportion of males (79.1% (121/153) vs. 70.2% (4 253/6 059), P=0.018), higher body mass index ((25.6±4.0) kg/m2 vs. (24.3±5.2) kg/m2, P=0.003), and a higher prevalence of hypertension (73.9% (113/153) vs. 65.1% (3 944/6 059), P=0.025). And 152 pairs of vessels were successfully matched. Multivariate Cox regression analysis identified in-stent restenosis lesions ( HR=2.59, 95% CI 1.28-5.23, P=0.008) as an independent risk factor for target vessel revascularization. Conclusions:Coronary lesions classified as functionally non-ischemic at baseline are not entirely stable and may progress to lesions that requiring revascularization over time. In-stent restenosis emerges as a critical independent predictor of revascularization.

Objective:Investigate the impact of calcification on the long-term outcomes of patients with coronary chronic total occlusion (CTO) after percutaneous coronary intervention (PCI).Methods:A retrospective cohort study was conducted. Patients who underwent PCI and had at least one CTO lesion at Fuwai Hospital between January 2010 and December 2013 were consecutively enrolled. Calcification was evaluated by coronary angiography, and patients were divided into two groups: moderate/severe calcification group and non/mild calcification group. Clinical follow-up was completed up to 5 years. Incidence of PCI-related complications and immediate procedural outcomes were compared between two groups, and the primary endpoint was the target lesion failure (TLF) at 5 years after PCI. Clinical follow-up endpoint events were analyzed using Kaplan-Meier survival analysis with log-rank test, and Cox multivariate regression model was used to evaluate the relationship between calcification and TLF.Results:The study included 2 659 CTO patients with an age of (57.2±10.5) years, of whom 442 (16.6%) were female, and among whom 13.5% (360/2 659) had moderate/severe calcification. Compared with the non/mild calcification group, the moderate/severe calcification group had a higher incidence of PCI-related complications (43.2% (156/361) vs. 32.5% (772/2 374), P<0.001) and procedural failure (34.3% (124/361) vs. 24.3% (577/2 374), P<0.001). Additionally, the moderate/severe calcification group showed a higher risk of the primary endpoint event (TLF) during the 5-year follow-up (19.8% vs. 15.3%, log-rank P=0.028). Higher incidence of cardiac death was observed in moderate/severe calcification group (5.7% vs. 2.7%, log-rank P=0.003). Cox multivariate regression analysis revealed that moderate/severe calcified plaques remained an independent risk factor for 5-year TLF after CTO-PCI ( HR=1.34, 95% CI: 1.01-1.79, P=0.043). Conclusion:Compared with CTO patients with non/mild calcification, those with moderate/severe calcification have higher procedural failure and complication rates, as well as poorer long-term prognosis, mainly due to an increase in cardiac death.

We report the clinical course from birth to adolescence of a patient carrying a compound heterozygous variation in the ectonucleotide pyrophosphatase/phosphodiesterase family member 1(ENPP1) gene. The patient was diagnosed with generalized arterial calcification of infancy shortly after birth, and subsequently with autosomal recessive hypophosphatemic rickets type 2 at the age of 11 years. Following effective blood pressure control, treatment with neutral phosphate, calcitriol, and vitamin D was initiated. During follow-up, no progression of vascular calcification was observed. Through this case report and a review of relevant literature, we aim to enhance clinicians′ understanding of this rare condition.

Objective:To investigate the risk factors associated with 90-day mortality in critically ill patients receiving continuous renal replacement therapy (CRRT), with a particular focus on the association between hypotension within the first hour of CRRT initiation and 90-day mortality after hospital admission.Methods:This study was a post hoc analysis of a prospective cohort study investigating the impact of colloid versus crystalloid priming solutions on early hemodynamics in critically ill patients undergoing CRRT. The study enrolled intensive care unit patients who received CRRT at West China Hospital of Sichuan University from January 2024 to May 2024. The data were collected including demographic characteristics, laboratory tests, CRRT-related parameters, blood pressure, heart rate, sequential organ failure assessment scores, and vasoactive-inotropic score, etc. The 90-day survival outcome after hospital admission of critically ill patients aged 18-80 years who received continuous veno-venous hemodiafiltration was used as the primary outcome indicator. A Cox proportional hazards model analysis was conducted, and the predictive ability of the model was evaluated along with the test of the proportional hazards assumption. The risk factors associated with the 90-day mortality after hospital admission of critically ill patients receiving CRRT were explored, with a particular focus on whether hypotension occurring within the first hour of CRRT initiation was one of these risk factors.Results:A total of 208 patients were included in this study. Within 90 days after hospital admission, 141 patients (67.8%) died, among whom 102 were male (72.3%) and the median age was 61.0 (50.0, 71.5) years; 67 patients (32.2%) survived, among whom 53 were males (79.1%) and the median age was 56.0 (47.0, 68.0) years. The incidence of hypotension within the first hour of CRRT initiation was significantly higher in the death group than in the survival group [29.8% (42/141) vs. 16.4% (11/67), χ2=4.275, P=0.039]. Moreover, The mortality rate of the group with hypotension within the first hour of CRRT initiation was higher than that of the group without hypotension [79.2% (42/53) vs. 63.9% (99/155), χ2=4.275, P=0.039]. The Kaplan-Meier survival analysis showed that the median survival time of patients without hypotension within the first hour of CRRT initiation [39.0 d (95% CI 23.2-54.8)] was longer than that of patients with hypotension [26.0 d (95% CI 18.9-33.1)], and the 90-day cumulative survival rate after hospital admission of patients without hypotension was significantly higher than that of patients with hypotension (Log-rank test, χ2=5.100, P=0.024). Univariate and multivariate Cox proportional hazards analyses demonstrated that serum albumin ( HR=0.964, 95% CI 0.933-0.997, P=0.030), sequential organ failure assessment score ( HR=1.064, 95% CI 1.012-1.118, P=0.015), and the use of mechanical ventilation ( HR=8.272, 95% CI 1.145-59.743, P=0.036) were significantly associated with 90-day mortality in critically ill patients undergoing CRRT. In contrast, the vasoactive-inotropic score ( HR=1.004, 95% CI 0.999-1.008, P=0.079) and the presence of hypotension within the first hour of CRRT initiation ( HR=1.236, 95% CI 0.833-1.835, P=0.293) were not significantly associated with 90-day mortality in critically ill patients undergoing CRRT. The consistency index of this model was 0.654 (95% CI 0.617-0.691), the area under the receiver operating characteristic curve was 0.724 (95% CI 0.658-0.800), and the calibration curve showed that the predicted values of the model were well fitted to the actual observations, suggesting that the predictive effect of this model was relatively ideal. Conclusions:In critically ill patients undergoing CRRT, the occurrence of hypotension within the first hour of CRRT initiation was not significantly associated with 90-day mortality after hospital admission. Lower serum albumin levels, higher sequential organ failure assessment scores, and the use of mechanical ventilation may be the risk factors for 90-day mortality in this population.

A 65-year-old female patient was admitted to the First Affiliated Hospital of Anhui Medical University on July 31, 2024, due to "recurrent rash all over the body for more than 12 years and aggravation with fever for more than 20 days". The patient was previously diagnosed with acute urticaria due to full body rash with pruritus 12 years ago and treated with glucocorticoids. One year ago, she discontinued glucocorticoids at another hospital and was admitted to our hospital recently because of frequent rash and high fever. Elevated immunoglobulin M (IgM) was found from laboratory valuation and was identified as IgM kappa (IgM κ) monoclonal immunoglobulin by immunofixation electrophoresis. Cryoglobulin testing confirmed the presence of type I cryoglobulin (IgM κ type) in the blood. The patient was treated with oral colchicine tablets of 0.75 mg qd during hospitalization, resulting in partial remission. After discharge, the patient was treated with oral colchicine tablets 0.5 mg bid for maintenance treatment, and underwent regular outpatient follow-up every other month. By January 2025, the patient′s outpatient medical record showed that the rash was mostly controlled. If IgM κ type monoclonal immunoglobulin is present in the blood of patients with unexplained skin lesions, cryoglobulinemia needs to be considered clinically.