Triple-negative breast cancer (TNBC) represents a distinctive subtype, characterized by the absence of estrogen receptors, progesterone receptors, and human epidermal growth factor receptor 2 (HER2). Due to its high inter-tumor and intra-tumor heterogeneity, TNBC poses significant chanllenges for personalized diagnosis and treatment. The advant of clustered regular interspaced short palindromic repeats (CRISPR) technology has profoundly enhanced our understanding of the structure and function of the TNBC genome, providing a powerful tool for investigating the occurrence and development of diseases. This review focuses on the application of CRISPR/Cas technology in the personalized diagnosis and treatment of TNBC. We begin by discussing the unique attributes of TNBC and the limitations of current diagnostic and treatment approaches: conventional diagnostic methods provide limited insights into TNBC, while traditional chemotherapy drugs are often associated with low efficacy and severe side effects. The CRISPR/Cas system, which activates Cas enzymes through complementary guide RNAs (gRNAs) to selectively degrade specific nucleic acids, has emerged as a robust tool for TNBC research. This technology enables precise gene editing, allowing for a deeper understanding of TNBC heterogeneity by marking and tracking diverse cell clones. Additionally, CRISPR facilitates high-throughput screening to promptly identify genes involved in TNBC growth, metastasis, and drug resistance, thus revealing new therapeutic targets and strategies. In TNBC diagnostics, CRISPR/Cas was applied to develop molecular diagnostic systems based on Cas9, Cas12, and Cas13, each employing distinct detection principles. These systems can sensitively and specifically detect a variety of TNBC biomarkers, including cell-specific DNA/RNA and circulating tumor DNA (ctDNA). In the realm of precision therapy, CRISPR/Cas has been utilized to identify key genes implicated in TNBC progression and treatment resistance. CRISPR-based screening has uncovered potential therapeutic targets, while its gene-editing capabilities have facilitated the development of combination therapies with traditional chemotherapy drugs, enhancing their efficacy. Despite its promise, the clinical translation of CRISPR/Cas technology remains in its early stages. Several clinical trials are underway to assess its safety and efficacy in the treatment of various genetic diseases and cancers. Challenges such as off-target effects, editing efficiency, and delivery methods remain to be addressed. The integration of CRISPR/Cas with other technologies, such as 3D cell culture systems, human induced pluripotent stem cells (hiPSCs), and artificial intelligence (AI), is expected to further advance precision medicine for TNBC. These technological convergences can offer deeper insights into disease mechanisms and facilitate the development of personalized treatment strategies. In conclusion, the CRISPR/Cas system holds immense potential in the precise diagnosis and treatment of TNBC. As the technology progresses and becomes more costs-effective, its clinical relevance will grow, and the translation of CRISPR/Cas system data into clinical applications will pave the way for optimal diagnosis and treatment strategies for TNBC patients. However, technical hurdles and ethical considerations require ongoing research and regulation to ensure safety and efficacy.

OBJECTIVE To analyze and identify the chemical components of Weite’an tablet which is a hospital preparation by UHPLC-Q-TOF-MS, and to find the drug migration components in rat plasma. METHODS In 0.05% formic acid water acetonitrile mobile phase system, after chromatographic separation of the Acquire UPLC BEH C18 column, Q-TOF positive and negative ion scanning was performed, and data processing was performed in SWATH collection mode. At the same time, quantitative analysis of various components in plasma samples was conducted through MRMHR data processing function during qualitative identification. RESULTS A total of 52 chemical components were isolated and identified in the experiment, including 22 flavonoids, 6 phenolic acids, 5 terpenoids, 3 coumarins, 2 alkaloids, amino acids and other compounds. Eight components were introduced into the blood: 6-hydroxy-7-methoxycoumarin, hesperidin, tangerine, stachydrine, berberine, scutellarin and quercetin. CONCLUSION This method is accurate and stable, and is suitable for the analysis and identification of chemical components in Weite’an tablets. The experimental results lay a solid foundation for clinical rational drug use, follow-up drug tissue distribution and basic research of effectors.

Objective To study whether there is a difference in the percentage consonants correct(PCC)of children with functional speech sound disorders(SSD)at different ages,and to explore the distribution in types of consonant errors at different ages.Methods A total of 172 children with ages from 4 to 7 years who were diagnosed with functional speech sound disorders and admitted to the Department of Rehabilitation of the Third Xiangya hospi-tal of Central South University participated in the study.The children were divided into three groups according to their ages:Groups 1 to 3.Groups 1,2,and 3 consisted of 97,45,and 30 children,respectively(Group 1:63 boys and 34 girls,aged 4 to＜5 years;Group 2:36 boys and 9 girls,aged 5 to＜6 years;and Group 3:36 boys and 9 girls,aged 6 to＜7 years).Picture-naming task was used to assess children's phonology.The types of consonant error were recorded and the percentage consonants correct(PCC)and the incidence of consonant errors in different places of articulation(stopping,affrication,frication,nasalization,and lateralization)was calculated.Results ①There was no significant difference in the PCC results among the three groups(P＞0.05).②There was a significant difference in omission errors(Z=6.531,P=0.038＜0.05),but not for substitution and distortion errors among the three groups(P＞0.05).③The omission of the lateral/l/was major among the three groups of children.④There were more stopping,affrication and frication in all three groups of children,yet no significant difference in the results of incidence of consonant errors in different places of articulation(stopping,nasalization,affrication,frica-tion and lateralization)among the three groups(P＞0.05).Conclusion There was no significant difference in the PCC among children with functional speech sound disorders at different ages.There were obvious differences in the distribution of omission errors in different age groups,suggesting idiosyncrasy.Children with SSD demonstrated similar characteristics of consonant phonetic errors at different age stages,included mainly the omission of the lateral/1/and more stopping,affrication and frication.

Biliary fibrosis (BF) is the result of pathological repair of bile tract injury, characterized by thickening and sclerosis of the bile duct wall and progressive stricture of the lumen, which may ultimately lead to serious adverse outcomes such as biliary obstruction, biliary cirrhosis, liver failure, and hepatobiliary malignancies. Current research describes BF as a pathological feature of certain bile tract diseases, lacking a systematic summary of its etiology, pathophysiology, molecular mechanisms, and treatment. BF is a common but easily neglected disease state in biliary system, which may promote the development and progression of hepatobiliary diseases through abnormal repair mechanism after pathological biliary tract injury. Based on the latest research progress from both domestic and international perspectives, the authors review the concept, clinical manifestation, etiology, pathogenesis, and therapeutic strategies of BF to provide a reference for clinical physicians.

Objective To analyze the effects and mechanisms of a disintegrin and metalloproteinase with thrombospondin motifs 14(ADAMTS14)gene in gastric cancer associated with Helicobacter pylori(Hp)infection and explore the potential of ADAMTS14 as a novel target for biological therapy of gastric cancer.Methods The Caner Genome Atlas(TCGA)and Gene Expression Omnibus(GEO)databases were utilized to analyze differentially expressed genes in gastric cancer tissues and Hp-positive gastric mucosa,and to screen potential targets.For the selected target ADAMTS14,its expression pattern in gastric cancer and Hp-positive gastric mucosa was analyzed.Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis was performed on the genes co-expressed with ADAMTS14 in gastric cancer.Kaplan-Meier Plotter database was used to analyze the correlation between high-and low-ADAMTS14 expression and prognosis of gastric cancer patients.The expression of ADAMTS14 and its relationship with clinicopathological features in 30 patients with gastric cancer were analyzed using real-time fluorescent quantitative PCR(RT-qPCR)and immunohistochemistry.The relationship between Hp infection and ADAMTS14 expression was analyzed using GEO database,and confirmed by cell line infection experiment.ADAMTS14 expression in gastric cancer cell line NCI-N87 was silenced by small interfering RNA to analyze its effect on the function of gastric cancer cells;The effect of ADAMTS14 knockdown on downstream target genes of Hippo signaling pathway was analyzed by RT-qPCR and Western blotting.Results A total of 16 genes closely related to Hp infection and gastric cancer were identified by analyzing the TCGA and GEO databases.According to TCGA database,the ADAMTS14 expression in gastric cancer tissues was higher than that in healthy gastric mucosa(P<0.0001).RT-qPCR and immunohistochemistry results also showed higher ADAMTS14 expression in gastric cancer tissues compared to adjacent tissues(P<0.01).Survival analysis demonstrated poor prognosis in patients with high ADAMTS14 expression(P<0.001).Data from GSE60427 showed that ADAMTS14 expression was upregulated in Hp-infected gastric mucosa and cell lines(P<0.001).After Hp P12 infection,the ADAMTS14 expression in NCI-N87 cells was higher than that in uninfected group.ADAMTS14 knockdown significantly inhibited the proliferation and migration of NCI-N87 cells(P<0.05),and it also significantly inhibited the expression of Hippo signaling pathway target genes,including BMP7,BMPR2,FZD4,PARD3 and SAV1(P<0.05).Conclusion ADAMTS14 is highly expressed in Hp-positive gastric mucosa and gastric cancer tissues,which may accelerate gastric cancer progression by regulating Hippo signaling pathway,and holds potential as a new marker and therapeutic target for Hp infective gastric cancer.

Objective:To study the effects of the alternate rapid maxillary expansion and constriction(Alt-RAMEC)with maxillary protraction on different parts of upper airway by CBCT.Methods:20 Angle Class Ⅲ patients aged 9-12 years were included,and CBCT images were taken before treatment and after Alt-RAMEC with maxillary protraction,the total volume of the upper airway,the volume of each part of the nasopharynx,palatopharynx,linguopharynx and laryngopharynx,the cross-sectional area of the division in-terface,and the minimum cross-sectional area were measured after 3D reconstruction using Dolphin software,the data were analyzed using SPSS 26.0 software.Results:The total upper airway volume,nasopharyngeal volume,and palatopharyngeal volume were in-creased by the average of 1 385.39 mm3(P=0.013),546.74 mm3(P=0.011)and 768.03 mm3(P=0.035)respectively after Alt-RAMEC with maxillary protraction treatment;the area of the nasopharyngeal and palatopharyngeal division interface increased by 73.79 mm2(P=0.002),the cross-sectional diameter by 1.41 mm(P=0.037),and sagittal diameter by 1.52 mm(P=0.022)respectively;however,there was no statistically significant change in the volume,minimum cross-sectional area,partition area,and partition transverse and sagittal diameters of the linguopharynx and laryngopharynx(P＞0.05).Conclusion:Alt-RAMEC with maxil-lary protraction can significantly increase nasopharyngeal and palatopharyngeal volumes,with no significant effect on the linguopharyn-geal and laryngopharyngeal segments of the airway.

Objective:Overweight and obesity prevalence has increased in low-income countries.This study systematically reviewed the obesity trend,disparities,and prevention and control efforts in Nepal. Methods:We searched PubMed and Google Scholar for articles and reports published between January 1,2004 and December 31,2022.Additional information on National policies and programs related to obesity prevention was retrieved from governmental websites and consultation with relevant experts.Overweight and obesity were defined using the World Health Organization body mass index cut points.Thirty-two studies and reports were included. Results:Overall,overweight and obesity rates increased in all groups in Nepal although nationally representative data remained limited.The combined overweight and obesity(OW/OB)and obesity rates in women aged 15-49 years increased from 8.5％to 22.2％and from 0.9％to 5.1％between 2006 and 2016,respectively.OW/OB and obesity rates in men were 17.1％and 2.5％based on data from the 2016 Demographic and Health Survey.OW/OB rate in under-five children increased from 0.6％to 2.8％between 2006 and 2016.Obesity rates for school-age(5-9 years)boys and girls in 2016 were 2.4％and 2.8％,respectively,and were 1.1％and 1.4％for male and female adolescents aged 10-19 years,respectively.OW/OB prevalence was much higher among women,residents in urban areas and central provinces,and in higher socioeconomic status groups.Projected prevalence of OW/OB and obesity for 2030 in adults aged 15-49 was 44.7％and 8.3％,respectively,while it was 2.2％for OW/OB in preschool children.Policies and direct interventions that specifically focused on obesity prevention and control are limited. Conclusions:OW/OB prevalence in Nepal has increased during the past 1.8 decades,disproportionately affecting population groups.Existing interventions mostly focused on undernutrition with some indirect implications for obesity prevention.In the future,Nepal needs to develop population-based programs for obesity prevention.

Objective To design a post-structured technology-based clinical disease database system to solve the problems of the traditional disease database system in dependence on manual judgment,lack of auxiliary annotation and poor availability of electronic medical record data.Methods An entity recognition model was constructed with I2B2 standard and bi-directional long short-term memory(BiLSTM)model to form a medical record template library,and some relational templates were generated and complex medical entities were extracted to realize post-structuring of electronic medical records.Then a clinical disease database system was established based on the post-structured electronic medical record technology,which was composed of the modules for medical record structuring,structured assessment,data annotation,routine functions and system management.Results The system developed transformed the text of electronic medical records into structured language,contributed to data element extraction and intelligent structured service and enhanced the efficiency of clinical treatment and scientific research.Conclusion The system developed improves the data availability of clinical diseases,reduces the workload of user data processing,ensures the quality of data application and lays a foundation for assisted decision making during clinical treatment and scientific research.[Chinese Medical Equipment Journal,2024,45(4):20-26]

Objective This study aimed to explore the diagnostic concordance of fractional flow reserve(FFR)and quantitative flow ratio(QFR)and the characteristics affecting this concordance.Methods Patients with non-acute myocardial infarction admitted to the Department of Cardiology,Peking University Third Hospital between January 2019 and December 2021 were enrolled.The patients were divided into four groups:FFR+/QFR+and FFR-/QFR-,FFR+/QFR-and FFR-/QFR+with FFR or QFR≤0.80 as positive and＞0.80 as negative.Using FFR as the gold standard,the diagnostic value of QFR was analyzed,and differences in clinical features and pathological characteristics among the groups were compared.Results A total of 236 patients were included.The mean age was(64.48±9.63)years,and 67.8％were male.All patients had 30％-70％coronary stenosis.The consistency rate of QFR and FFR was 78.0％(n=184),and the Person correlation coefficient was 0.557(P＜0.001).Among FFR+patients,the minimum lumen diameter was larger[(1.56±0.34)mm vs.(1.39±0.31)mm,P=0.019],lesion length was shorter[(21.37±11.73)mm vs.(36.86±18.09)mm,P＜0.001],and coronary angiography-based index of microcirculartory resistance(AMR)was higher[(277.50±28.87)mmHg·s/m vs.(178.02±49.13)mmHg·s/m,P＜0.001]in the disconcordance group.Multivariate regression analysis suggested that AMR[OR 0.93,95％CI 0.88-0.99,P=0.030]and lesion length[OR 1.27,95％CI 1.01-1.60,P=0.045]were independent predictors of disconcordance.In the FFR-group,the lesion length was longer[(33.08±16.05)mm vs.(21.40±13.36)mm,P=0.020],and AMR[(169.66±24.01)mmHg·s/m vs.(265.95±44.78)mmHg·s/m,P＜0.001]and low-density lipoprotein-C[1.57(1.10,1.97)mmol/L vs.2.15(1.79,2.74)mmol/L,P=0.031]were lower in the disconcordance group.No statistically significant variables were identified by multivariate regression.Conclusions QFR had high diagnostic value compared with FFR.In the FFR+group,AMR and lesion length may have affected the diagnostic consistency of QFR and FFR.The study provided more evidence for the clinical application of QFR.

Objective:To evaluate the impact of self-crosslinked hyaluronic acid (SCH) gel on endometrium recovery after artificial abortion.Methods:A multicenter, prospective randomized controlled trial was conducted across 18 hospitals from December 2021 to February 2023, involving 382 women who underwent artificial abortion. Participants were randomly allocated to receive either treatment with SCH gel (SCH group) or no treatment (control group) in a 1∶1 ratio. The primary outcome was endometrium thickness in 14 to 18 days after the first postoperative menstruation. Secondary outcomes included changes in menstrual volume during the first postoperative menstruation, menstruation resumption within 6 postoperative weeks, time to menstruation resumption, duration of the first postoperative menstruation, and incidence of dysmenorrhea.Results:Baseline characteristics of participants were comparable between the two groups (all P>0.05), with 95.3% (182/191) in SCH group and 92.7% (177/191) in the control group completed the study. The postoperative endometrial thickness in SCH group was significantly greater than that in the control group [(9.78±3.15) vs (8.95±2.32) mm; P=0.005]. SCH group also had significantly fewer participants with reduced menstrual volume [23 cases (12.6%, 23/182) vs 31 cases (17.5%, 31/177); P=0.038]. Although SCH group experienced less dysmenorrhea during the first postoperative menstrual period, this difference was not statistically significant [28.5% (51/179) vs 37.1% (65/175); P=0.083]. Outcomes were similar between SCH group and the control group regarding the proportion of participants who resumed menstruation within 6 weeks postoperatively, time to menstruation resumption, and duration of the first postoperative menstruation ( P=0.792, 0.485, and 0.254, respectively). No serious adverse events were observed during the study period, and no adverse events were attributed to SCH gel treatment. Conclusion:The application of SCH gel after artificial abortion is safe and might aid in the recovery of the endometrium.