ObjectiveTo investigate the effects of excessive activation of the Specific protein 1 （Sp1）-MicroRNA-582-3p （miR-582-3p）-cyclin-dependent kinase inhibitor （p27） axis on the cell cycle and proliferation of A549 lung adenocarcinoma cells at the cellular level， thereby investigating the possible mechanisms by which Astragali Radix and Hedyotis diffusa（A-H） regulate the axis to inhibit A549 cells proliferation. MethodsLentiviral plasmid transfection technology was used to obtain four stable A549 transgenic cell lines： shRNA-Sp1+LV-miR-582-3p mimic， shRNA-Sp1+LV-mNC， shRNA-NC+LV-miR-582-3p mimic， and shRNA-NC+LV-mNC. Real-time PCR was used to detect the effect of Sp1 on miR-582-3p expression in A549 lung adenocarcinoma cells. CCK-8 and colony formation assay were used to detect the effect of Sp1 on cell proliferation through miR-582-3p， while flow cytometry was used to detect the effect of Sp1 on cell cycle via miR-582-3p. Western blot was used to detect the effect of Sp1 on cyclin in A549 cells through miR-582-3p. CCK-8 was employed to detect the effects of different concentrations （5%， 10%， 20%， 40%， 80%） of A-H on A549 cell viability， and the optimal concentration was selected for subsequent mechanism exploration. Stable transgenic strains oe-Sp1 and control oe-Vector were constructed using the above-mentioned transfection techniques. Real-time PCR was then used to investigate the effect of A-H on miR-582-3p expression in A549 cells， while Western blot was employed to detect the effect of A-H on Sp1 and p27 expression in A549 lung adenocarcinoma cells. ResultsCompared with the shRNA-NC+LV-mNC group， the expression of miR-582-3p was significantly inhibited in the shRNA-Sp1+LV-mNC group （P<0.01）. Compared with the shRNA-Sp1+LV-mNC group， the shRNA-Sp1+LV-miR-582-3p mimic group significantly reversed miR-582-3p expression （P<0.01）， indicating that Sp1 has a significant regulatory effect on miR-582-3p. Compared with the shRNA-Sp1+LV-mNC group， the shRNA-Sp1+LV-miR-582-3p mimic group significantly reversed cell proliferation （P<0.01）， suggesting that miR-582-3p can partially reverse the proliferative effect of Sp1 on A549 lung adenocarcinoma. Compared with the shRNA-Sp1+LV-mNC group， the shRNA-Sp1+LV-miR-582-3p mimic group showed a significant decrease in G₀/G₁ proportions， while the G₂/M and S phase proportions increased significantly （P<0.01）， indicating that miR-582-3p can partially reverse the effect of Sp1 on the A549 cell cycle. Compared with the shRNA-Sp1+LV-mNC group， the shRNA-Sp1+LV-miR-582-3p mimic group significantly reversed the expression of various proteins with the decrease of p27 and the increase of Cyclin D₁， CDK4， Cyclin E， CDK2， p-Rb， and E2F3 （P<0.01）， indicating that miR-582-3p can partially reverse the effect of Sp1 on the cell cycle of A549 lung adenocarcinoma. Compared with the blank group， the serum containing A-H significantly inhibited A549 cell viability in a concentration-dependent manner. Therefore， 10% A-H was selected for intervention of subsequent mechanism experiments. Compared with A-H+oe-Vector， A-H+oe-Sp1 significantly reversed the downregulation of Sp1， miR-582-3p， and the upregulation of p27 （P<0.01）. This suggests that Sp1 can partially reverse the effects of A-H on miR-582-3p and p27 levels in A549 lung adenocarcinoma cells. ConclusionOveractivation of the Sp1-miR-582-3p-p27 axis significantly promotes the proliferation of A549 lung adenocarcinoma cells， and the potential mechanism of the inhibitory effect of A-H on the proliferation of A549 cells may be related to its inhibition on the overactivation of the Sp1-miR-582-3p-p27 axis.

Objective:To analyze the differences between trans-radial access (TRA) and trans-femoral access (TFA) in hepatic arterial perfusion chemotherapy (HAIC) in terms of patient experience, postoperative complications, and patient preferences; explore whether TRA in HAIC is associated with better patient experience and compliance; and determine whether it is safer than TFA.Methods:The study was a retrospective cohort study of patients with advanced hepatocellular carcinoma and liver metastases from colorectal cancer treated with HAIC. We enrolled a total of 91 patients with advanced liver malignancies treated with HAIC from November 2022 to May 2023 in the Department of Interventional Therapy and Hepatobiliary Medicine at Tianjin Medical University Cancer Hospital. The patients were divided into three groups: group TRA ( n=20, receiving TRA HAIC only), group TFA ( n=33, receiving TFA HAIC only), and crossover group [ n=19, receiving TFA HAIC (Cross-TFA group) first, followed by TRA HAIC (Cross-TRA group)]. Meanwhile, to facilitate the expression of partial results, all patients receiving TRA HAIC were defined as the TRA-HAIC group ( n=39, TRA+Cross-TRA group), and all patients receiving TFA HAIC were defined as the TFA-HAIC group ( n=52, TFA+Cross-TFA group). The primary research index was the Quality of Life (QOL) visualization scale score. The secondary research index included approach-related and catheter-related adverse events, duration of surgery, and mean length of patient stay. We used various statistical methods such as Mann-Whitney U test, t-test, Chi-square test, Fisher′s exact test, univariate logistic regression analysis, and multi-factor analysis. Results:TRA patients had significantly lower QOL scores than TFA patients (all P<0.001). The QOL scores of the Cross-TRA group were significantly lower than those of the Cross-TFA group (pain at the puncture site Z=-3.24, P=0.001, others P<0.001). The QOL scores of the Cross-TRA group were compared with those of the TRA group, which showed that the scores of the Cross-TRA group in overall discomfort ( Z=-3.07, P=0.002), postoperative toilet difficulty ( Z=-2.12, P=0.034), and walking difficulty ( Z=-2.58, P=0.010) were significantly lower than those of the TRA group. Satisfaction scores were significantly higher in the Cross-TRA group than in the Cross-TFA group ( Z=-3.78, P<0.001), and patients were more likely to receive TRA HAIC as the next procedure ( χ2=30.42, P<0.001). In terms of mean length of stay, patients receiving TRA HAIC had a significantly lower mean length of stay than those receiving TFA HAIC (50.1±3.2 h vs. 58.4±6.4 h, t=7.98, P<0.001). The incidence of radial artery occlusion (RAO) as an approach-related adverse event was 15.4% (6/39) in the TRA-HAIC group, which was significantly higher than that in the TFA-HAIC group (15.4% vs. 0, χ2=8.56, P=0.005). Notably, multifactorial analysis of RAO-related factors showed that intraoperative enoxaparin use and patency of radial artery flow during pressure were significantly associated with a reduced risk of postoperative RAO ( P=0.037 for enoxaparin use and P=0.049 for pressure). Conclusions:With respect to procedure approach, TRA was significantly better than TFA in terms of patient satisfaction and mean length of stay. Through further process optimization and prevention of adverse reactions, the incidence of adverse reactions can be maintained at a relatively low level, so that patients can benefit from TRA in future operations in terms of cost-effectiveness and medical efficiency.

Objective:This investigation sought to delineate the associations among colorectal adenomatous polyps, diabetes, and biomolecules involved in glucose metabolism.Method:Data were collected from 40 patients who underwent endoscopic polypectomy at the Endoscopy Department of Shandong Cancer Hospital between June 2019 and September 2021. This cohort included 27 patients with inflammatory polyps and 13 with adenomatous polyps. We assessed fasting insulin (Fins), fasting blood glucose (FBG), and the mRNA expressions of fibroblast growth factor 19 (FGF-19) and insulin-like growth factor 1 (IGF-1) in the polyp tissues. Both univariate and multivariate logistic regression analyses were employed to ascertain the determinants influencing the emergence of adenomatous polyps. From these analyses, a predictive nomogram was constructed to forecast the occurrence of adenomatous polyps, and evaluations on the discriminative capacity, calibration, and clinical utility of the model were conducted.Results:The adenomatous polyp group exhibited markedly elevated levels of glucose, insulin, FGF-19, and IGF-1, with respective concentrations of (8.67±2.70) mmol/L, (12.72±7.69) μU/L, 2.20±1.88, and 1.36±0.69. These figures were significantly higher compared to the inflammatory polyp group, which showed levels of (5.51±0.72) mmol/L, (5.49±2.68) μU/L, 0.53±0.97, and 0.41±0.46, respectively, P=0.001. Multivariate logistic regression revealed that the relative expression of IGF-1 served as an independent risk factor for the development of colorectal adenomatous polyps ( OR=5.622, 95% CI:1.085-29.126). The nomogram displayed a C-index of 0.849, indicating substantial discriminative capability. The calibration curve affirmed the model's accuracy in aligning predicted probabilities with actual outcomes, and the clinical decision curve demonstrated thepractical clinical applicability of the model. Conclusions:There was a significant correlation between the occurrence of colorectal adenomatous polyps and glucose metabolic pathways. Individuals with diabetes showed a higher propensity to develop such polyps.

Objective:This investigation sought to delineate the associations among colorectal adenomatous polyps, diabetes, and biomolecules involved in glucose metabolism.Method:Data were collected from 40 patients who underwent endoscopic polypectomy at the Endoscopy Department of Shandong Cancer Hospital between June 2019 and September 2021. This cohort included 27 patients with inflammatory polyps and 13 with adenomatous polyps. We assessed fasting insulin (Fins), fasting blood glucose (FBG), and the mRNA expressions of fibroblast growth factor 19 (FGF-19) and insulin-like growth factor 1 (IGF-1) in the polyp tissues. Both univariate and multivariate logistic regression analyses were employed to ascertain the determinants influencing the emergence of adenomatous polyps. From these analyses, a predictive nomogram was constructed to forecast the occurrence of adenomatous polyps, and evaluations on the discriminative capacity, calibration, and clinical utility of the model were conducted.Results:The adenomatous polyp group exhibited markedly elevated levels of glucose, insulin, FGF-19, and IGF-1, with respective concentrations of (8.67±2.70) mmol/L, (12.72±7.69) μU/L, 2.20±1.88, and 1.36±0.69. These figures were significantly higher compared to the inflammatory polyp group, which showed levels of (5.51±0.72) mmol/L, (5.49±2.68) μU/L, 0.53±0.97, and 0.41±0.46, respectively, P=0.001. Multivariate logistic regression revealed that the relative expression of IGF-1 served as an independent risk factor for the development of colorectal adenomatous polyps ( OR=5.622, 95% CI:1.085-29.126). The nomogram displayed a C-index of 0.849, indicating substantial discriminative capability. The calibration curve affirmed the model's accuracy in aligning predicted probabilities with actual outcomes, and the clinical decision curve demonstrated thepractical clinical applicability of the model. Conclusions:There was a significant correlation between the occurrence of colorectal adenomatous polyps and glucose metabolic pathways. Individuals with diabetes showed a higher propensity to develop such polyps.

Objective:To assess the predictive value of a combined multiclassification model for computed tomography(CT)in the patholo-gical analysis of ground-glass nodules(GGN).Methods:Pulmonary GGN lesions that were pathologically confirmed as invasive adenocar-cinoma(IAC),minimally invasive adenocarcinoma(MIA),adenocarcinoma in situ(AIS),and preinvasive lesions(PILs),were collected from pa-tients who were treated at The First Affiliated Hospital of Xinxiang Medical University between February 2019 and March 2023.A total of 324 nodules were retrospectively collected from 285 patients,and divided into three groups:infiltrating IAC,MIA,and PILs.Radiomics and clinical-CT features were selected through recursive feature elimination and univariate Logistic regression.Seven models were constructed using Logistic regression(LR),support vector machine(SVM),random forest(RF),and integrative learning(stacking).Results:The hybrid model combining clinical-CT-radiomics features and an integrative strategy showed superior predictive performance,with an accuracy of 0.791,precision of 0.788,specificity of 0.857,recall of 0.790,and F1-Score of 0.789.Conclusions:The multiclassification joint model based on CT-radiomics is effective in predicting pathological classification of pulmonary GGNs.This model aids in accurate imaging diagnosis and can provide a basis for optimizing treatment plans.

The dental operative microscope has been widely employed in the field of dentistry, particularly in endodontics and operative dentistry, resulting in significant advancements in the effectiveness of root canal therapy, endodontic surgery, and dental restoration. However, the improper use of this microscope continues to be common in clinical settings, primarily due to operators' insufficient understanding and proficiency in both the features and established operating procedures of this equipment. In October 2019, Professor Jingping Liang, Vice Chairman of the Society of Cariology and Endodontology, Chinese Stomatological Association, organized a consensus meeting with Chinese experts in endodontics and operative dentistry. The objective of this meeting was to establish a standard operation procedure for the dental operative microscope. Subsequently, a consensus was reached and officially issued. Over the span of about four years, the content of this consensus has been further developed and improved through practical experience.
Humans ; Dentistry, Operative ; Consensus ; Endodontics ; Root Canal Therapy ; Dental Care

Objective:To understand the medical cost ratio and its influencing factors of breast cancer chemotherapy and molecular targeted therapy in a hospital, for reference for reasonable control of medical cost.Methods:The first page data of all breast cancer chemotherapy and molecular targeted therapy cases in a tertiary hospital from January to June 2021 were selected to extract the data of age, hospitalization expenses, hospitalization time, complications or complications. The influence of each index on the distribution of medical expense ratio was analyzed by single factor analysis and chi-square test was used for comparison between groups.Results:A total of 3 109 cases of chemotherapy and molecular targeted therapy for breast malignant tumors were included, of which very low-rate, low-rate, high-rate and very high-rate accounted for 7.04%(219 cases), 58.32%(1 813 cases), 30.81%(958 cases) and 3.83%(119 cases) respectively. In addition to the way of admission, there were significant differences in the distribution of medical cost rates under different ages, time consumption index, complications or concomitants, admission departments, treatment methods and medical insurance types( P<0.01). Conclusions:There were many factors affecting the medical cost rate of breast malignant tumors. Relevant departments should expand the pilot scope of DRG payment, promote the multi-disciplinary diagnosis and treatment mode of tumors, refine the DRG grouping scheme, to provide standardized and homogeneous diagnosis and treatment services for tumor patients, and reasonably control the excessive growth of medical costs.

Background:Primary health care system is a critical component of diabetes care and management.This article aimed to analyze the availability of glucose-lowering drugs in primary health institutions (PHIs) in China,and to explore the relationship between availability of glucose-lowering drugs and medication adherence among type 2 diabetes mellitus (T2DM) patients.Methods:This cross-sectional study conducted in Shandong Province,eastern China (hereafter referred to as Shandong),between August and December 2017.In total,2520 community-managed T2DM patients were se-lected from 68 PHIs in Shandong,including 62 village-level and 6 township-level PHIs.The self-developed ques-tionnaire was used to survey the availability of glucose-lowering drugs in PHIs.Patients' medication adherence was assessed by four self-reported questions,and was classified as either adherent or non-adherent.Descriptive statistics was used to analyze the availability of glucose-lowering drugs in PHIs and the medication adherence among the T2DM patients.Multilevel logistic regression models were used to explore the relationship between the availability of glucose-lowering drugs in PHIs and patients' medication adherence.Results:A total of 1866 T2DM patients prescribed with at least one glucose-lowering drug were included in analysis.Among them,58.5％ patients followed their antidiabetic treatment well.In village-level PHIs,the pa-tient's adherence rate was lower than in township-level PHIs (55.9％ vs.61.1％,P ＜ 0.05).Among the 68 PHIs,average (2.53±0.97) glucose-lowering products (generic names) were available,which in village-level PHIs were less than in township-level PHIs (2.47 vs.3.17,P ＜ 0.05).And the number of available glucose-lowering products in PHIs was associated with the adherence of T2DM patients.Conclusion:Poor availability of glucose-lowering products was found in PHIs in Shandong.The availability of glucose-lowering products in PHIs was positively associated with patients' medication adherence,and could be enhanced to improve the control of diabetes in primary care settings.

Objective:To explore the relationship between insulin resistance, glucose and lipid metabolism related molecules and colorectal polyps.Methods:A total of 262 healthy people who underwent colonoscopy in Shandong cancer hospital from June 2019 to September 2020 were selected. The levels of serum vascular cell adhesion molecule-1 (VCAM-1), fibroblast growth factor 19 (FGF19), insulin like growth factor (IGF-1), fasting blood glucose and fasting blood insulin were detected by enzyme-linked immunosorbent assay (ELISA). Insulin resistance index (HOMA-IR) was calculated, and the influencing factors of occurrence, pathological type, size and number of polyps were analyzed.Results:Among 262 cases, 116 cases were polyp free, 113 cases were adenomatous polyp and 33 cases were inflammatory polyp. HOMA-IR, VCAM-1 and FGF19 in polyp group were 2.904±1.754, (334.415±139.573) ng/ml and (135.865±98.470) pg/ml, respectively, which were higher than 2.369±1.306, (302.480±99.946) ng/ml and(110.694±76.044) ng/ml in non-polyp group, respectively ( P<0.05). Multivariate Logistic regression analysis showed that the gender ( OR=4.269, 95% CI: 1.963-9.405) and FGF19 (77.0-131.4 pg/ml: OR=2.385, 95% CI: 1.155-4.926) were independent factors of colorectal polyps. The gender ( OR=3.799, 95% CI: 1.650-8.748) and FGF19 (77.0-131.4 pg/ml: OR=2.290, 95% CI: 1.072-4.891) were independent factors of colorectal adenomatous polyps. The gender( OR=6.725, 95% CI: 1.853-24.410) and fasting plasma glucose (≥6.5 mmol/L: OR=0.047, 95% CI: 0.009-0.245) were independent factors of colorectal inflammatory polyps. The gender ( OR=3.539, 95% CI: 1.293-9.689) was an independent factor for the occurrence of single polyp. The gender ( OR=5.063, 95% CI: 2.048-12.515), FGF19 (77.0-131.4 pg/ml: OR=2.502, 95% CI: 1.102-5.681), fasting plasma glucose (≥6.5 mmol/L: OR=0.282, 95% CI: 0.095-0.839) were independent factors of multiple polyps. The gender ( OR=3.416, 95% CI: 1.134-10.289) and fasting insulin (≥9.4 μU/ml: OR=9.480, 95% CI: 1.485-60.521) were independent risk factors for colorectal polyps<0.5 cm. The gender ( OR=3.151, 95% CI: 1.244-7.984) and fasting plasma glucose (≥6.5 mmol/L: OR=0.310, 95% CI: 0.102-0.941) were independent risk factors for colorectal polyps with the size of 0.5-0.9 cm. The gender ( OR=22.649, 95% CI: 4.154-123.485), age (55 to 64 years old: OR=4.473, 95% CI: 1.070-18.704; ≥65 years old: OR=5.815, 95% CI: 1.300-26.009), BMI (≥28 kg/m 2: OR=5.310, 95% CI: 1.224-23.032) and FGF19 (77.0-131.4 pg/ml: OR=7.474, 95% CI: 1.903-29.351) were independent factors for colorectal polyps with size ≥ 1.0 cm. Gender stratification analysis showed that FGF19 was an independent factor for the occurrence of male polyps (77.0-131.4 pg/ml: OR=6.109, 95% CI: 1.688-22.104) and adenomas (77.0-131.4 pg/ml: OR=6.401, 95% CI: 1.717-23.864). The age (55 to 64 years old: OR=3.783, 95% CI: 1.052-13.611) and VCAM-1 (≥352.8 ng/ml: OR=4.341, 95% CI: 1.142-16.493) were independent risk factors of female polyps. The age (55 to 64 years old: OR=5.743, 95% CI: 1.205-27.362, ≥65 years old: OR=6.885, 95% CI: 1.143-41.467), VCAM-1 (≥352.8 ng/ml: OR=6.313, 95% CI: 1.415-28.159) and IGF-1 (≥7.6 ng/ml: OR=5.621, 95% CI: 1.069-29.543) were independent factors of female adenoma. Conclusions:The occurrences of colorectal polyps and adenomatous polyps are related to insulin resistance and glucose and lipid metabolism. Serum FGF19 is an independent influencing factor for the occurrence of colorectal polyps and adenomatous polyps, and is a potential serological diagnostic marker and therapeutic target for colorectal polyps and adenomatous polyps.

Objective:To explore the relationship between insulin resistance, glucose and lipid metabolism related molecules and colorectal polyps.Methods:A total of 262 healthy people who underwent colonoscopy in Shandong cancer hospital from June 2019 to September 2020 were selected. The levels of serum vascular cell adhesion molecule-1 (VCAM-1), fibroblast growth factor 19 (FGF19), insulin like growth factor (IGF-1), fasting blood glucose and fasting blood insulin were detected by enzyme-linked immunosorbent assay (ELISA). Insulin resistance index (HOMA-IR) was calculated, and the influencing factors of occurrence, pathological type, size and number of polyps were analyzed.Results:Among 262 cases, 116 cases were polyp free, 113 cases were adenomatous polyp and 33 cases were inflammatory polyp. HOMA-IR, VCAM-1 and FGF19 in polyp group were 2.904±1.754, (334.415±139.573) ng/ml and (135.865±98.470) pg/ml, respectively, which were higher than 2.369±1.306, (302.480±99.946) ng/ml and(110.694±76.044) ng/ml in non-polyp group, respectively ( P<0.05). Multivariate Logistic regression analysis showed that the gender ( OR=4.269, 95% CI: 1.963-9.405) and FGF19 (77.0-131.4 pg/ml: OR=2.385, 95% CI: 1.155-4.926) were independent factors of colorectal polyps. The gender ( OR=3.799, 95% CI: 1.650-8.748) and FGF19 (77.0-131.4 pg/ml: OR=2.290, 95% CI: 1.072-4.891) were independent factors of colorectal adenomatous polyps. The gender( OR=6.725, 95% CI: 1.853-24.410) and fasting plasma glucose (≥6.5 mmol/L: OR=0.047, 95% CI: 0.009-0.245) were independent factors of colorectal inflammatory polyps. The gender ( OR=3.539, 95% CI: 1.293-9.689) was an independent factor for the occurrence of single polyp. The gender ( OR=5.063, 95% CI: 2.048-12.515), FGF19 (77.0-131.4 pg/ml: OR=2.502, 95% CI: 1.102-5.681), fasting plasma glucose (≥6.5 mmol/L: OR=0.282, 95% CI: 0.095-0.839) were independent factors of multiple polyps. The gender ( OR=3.416, 95% CI: 1.134-10.289) and fasting insulin (≥9.4 μU/ml: OR=9.480, 95% CI: 1.485-60.521) were independent risk factors for colorectal polyps<0.5 cm. The gender ( OR=3.151, 95% CI: 1.244-7.984) and fasting plasma glucose (≥6.5 mmol/L: OR=0.310, 95% CI: 0.102-0.941) were independent risk factors for colorectal polyps with the size of 0.5-0.9 cm. The gender ( OR=22.649, 95% CI: 4.154-123.485), age (55 to 64 years old: OR=4.473, 95% CI: 1.070-18.704; ≥65 years old: OR=5.815, 95% CI: 1.300-26.009), BMI (≥28 kg/m 2: OR=5.310, 95% CI: 1.224-23.032) and FGF19 (77.0-131.4 pg/ml: OR=7.474, 95% CI: 1.903-29.351) were independent factors for colorectal polyps with size ≥ 1.0 cm. Gender stratification analysis showed that FGF19 was an independent factor for the occurrence of male polyps (77.0-131.4 pg/ml: OR=6.109, 95% CI: 1.688-22.104) and adenomas (77.0-131.4 pg/ml: OR=6.401, 95% CI: 1.717-23.864). The age (55 to 64 years old: OR=3.783, 95% CI: 1.052-13.611) and VCAM-1 (≥352.8 ng/ml: OR=4.341, 95% CI: 1.142-16.493) were independent risk factors of female polyps. The age (55 to 64 years old: OR=5.743, 95% CI: 1.205-27.362, ≥65 years old: OR=6.885, 95% CI: 1.143-41.467), VCAM-1 (≥352.8 ng/ml: OR=6.313, 95% CI: 1.415-28.159) and IGF-1 (≥7.6 ng/ml: OR=5.621, 95% CI: 1.069-29.543) were independent factors of female adenoma. Conclusions:The occurrences of colorectal polyps and adenomatous polyps are related to insulin resistance and glucose and lipid metabolism. Serum FGF19 is an independent influencing factor for the occurrence of colorectal polyps and adenomatous polyps, and is a potential serological diagnostic marker and therapeutic target for colorectal polyps and adenomatous polyps.