Boai Hospital of Zhongshan

HER2-positive breast cancer is clinically aggressive and frequently disseminates to regional lymph nodes, yet the transcriptomic programs associated with nodal spread remain incompletely defined. Here, we profiled matched tumor-draining lymph nodes (TDLN) and metastatic tumor-involved lymph nodes (TMLN) from six patients with HER2-positive breast cancer using RNA sequencing (RNA-seq). Differential expression analysis was performed with DESeq2, applying Benjamini-Hochberg correction (FDR < 0.05) and an absolute log2 fold-change threshold (|log2FC| ≥ 1). We identified 237 differentially expressed genes (182 upregulated and 55 downregulated in TMLN vs. TDLN). Functional enrichment analyses highlighted extracellular matrix (ECM)-receptor interaction, PI3K-AKT signaling, focal adhesion, and cholesterol metabolism as prominent pathways associated with metastatic lymph nodes, suggesting coordinated ECM remodeling and signaling activation during nodal dissemination. Among the most upregulated genes, POSTN emerged as a key candidate and was further linked to adverse clinicopathologic characteristics. In an independent validation cohort (n = 120), higher POSTN expression was associated with inferior disease-free survival. Collectively, these results nominate POSTN as a potential prognostic biomarker and support ECM-centered and PI3K-AKT-related mechanisms as actionable biological features of lymph-node metastasis in HER2-positive breast cancer.

To evaluate whether baseline cheese and yogurt intake is associated with sleep duration at baseline, 3- and 6-month follow-ups among preschool-aged children. We conducted a prospective cohort study in Zhongshan City, Guangdong Province, China. Parents completed baseline questionnaires on cheese and yogurt intake frequency, sleep duration and potential confounders, with sleep time followed up at 3 and 6 months. Sleep duration of < 10 h per day was defined as insufficient. Multivariable logistic regression and mixed-effects models were used to evaluate the association between the baseline cheese and yogurt intake and sleep duration at baseline, 3- and 6-month follow-ups. A total of 221 preschool-aged children were included in the analysis. No significant association was found between yogurt consumption and sleep duration at any time point. For cheese intake, a significant trend was identified at 6 months (p = 0.007), and cheese intake ≥ 7 servings/week showed a reduced prevalence of insufficient sleep (adjusted OR = 0.001, 99.2% CI: 0.000-0.168). Mixed-effects models confirmed a significant interaction between high cheese intake and 6-month follow-up (OR = 0.217, 95% CI: 0.052-0.917). Our findings suggest that frequent cheese intake may reduce the risk of insufficient sleep in preschool-aged children, whereas yogurt shows no comparable association. These differential results underscore the need for product-specific analyses. Despite limitations in sample size and measurement, the study adds to evidence linking diet, microbiota, and sleep. Further research should clarify underlying mechanisms and guide actionable, child-appropriate dietary recommendations.

IntroductionThe International Classification of Functioning, Disability and Health—Rehabilitation Set (ICF-RS) is a standardized tool for multidimensional rehabilitation assessment, but its responsiveness in post-total knee arthroplasty (TKA) inpatient settings remains underexplored.MethodsA retrospective single-center cohort study was conducted on 47 patients who underwent primary unilateral TKA and received inpatient rehabilitation in Changsha, China (January 2023–December 2024). ICF-RS scores (30 categories) were assessed at admission and discharge. Responsiveness was evaluated using Wilcoxon signed-rank tests with Benjamini-Hochberg FDR correction. Response counts (improved/stable/worsened) were the primary outcome presentation.ResultsOf 30 ICF-RS categories, 27 showed 100% data completeness; 3 social/sexual items had substantial missingness. Following rehabilitation, 23 categories demonstrated statistically significant improvement after FDR correction. Consistent directional improvement was observed in mobility (d450 Walking: 24/47 improved), self-care (d510–d540), and pain (b280: 26/47 improved) domains. The total score decreased from 47.51 ± 13.59 to 35.81 ± 11.38 (Cohen's d = 1.51). Notably, b710 (joint mobility) showed no responsiveness (0/47 improved, 1/47 worsened), despite expected clinical range-of-motion gains.DiscussionICF-RS demonstrates responsiveness to post-TKA inpatient rehabilitation for most functional domains. The lack of change in b710 highlights a limitation of generic assessment tools for capturing localized physical impairments in single-joint conditions, suggesting the need for complementary condition-specific measures. The study context—where ICF-RS scores influence reimbursement—underscores the importance of assessment integrity considerations in function-based payment implementations.

ABSTRACT This study investigated fertility-related quality of life among married women of reproductive age (20–45 years) with endometriosis-associated infertility, focusing on the mediating role of family resilience between infertility-related stress and fertility-related quality of life. A cross-sectional survey was conducted between January 2024 and April 2025 at a tertiary hospital gynecology and reproductive center in Guangdong Province, China. Data were collected via structured questionnaires and analyzed using IBM SPSS Statistics 25.0 and AMOS 26.0. Results indicated moderate levels of fertility-related stress (M = 70.92, SD = 13.98). Pearson correlation analysis revealed a significant negative association between fertility-related stress and fertility-related quality of life (r = -0.435, p < 0.01), while family resilience showed a positive correlation with fertility-related quality of life (r = 0.377, p < 0.01). Mediation analysis demonstrated that family resilience partially mitigated the negative impact of stress on fertility-related quality of life (standardized indirect effect = -0.11, 95% CI [−0.18, −0.06], p < 0.001). The findings suggest that while fertility-related stress directly impairs fertility-related quality of life in this population, family resilience serves as a protective buffer. Clinically, interventions aimed at strengthening family support and adaptive capacity may help reduce stress and improve well-being in women with endometriosis-associated infertility.

Acute lung injury (ALI) is the major cause of respiratory failure, often triggered by inflammatory responses resulting in disruption of the pulmonary gas-blood barrier. Existing treatments are limited by the poor bioavailability via systemic administration, whereas volatile oils are unsuitable for developing into inhalable formulations. In this study, we developed an inhalable cocrystal of Exocarpium Citri Grandis volatile oil (EVO) using crystallization technology with β-cyclodextrin (EVO-βCD), aiming to improve the drug's bioavailability and enhance its therapeutic efficacy for ALI. In vitro studies revealed that EVO-βCD exhibited no significant cytotoxicity at concentrations of 7.5-120.0µg/mL and did not cause hemolysis at concentrations between 3.75-60.0µg/mL, suggesting favorable safety profiles. Additionally, EVO and EVO-βCD significantly reduced the ROS production in LPS pretreated 16HBE cells, highlighting their antioxidant potential. In vivo experiments demonstrated that EVO-βCD cocrystals were more effective than free EVO in reducing inflammatory cytokines (TNF-α, IL-1β, IL-6) and improving pulmonary edema in LPS-induced acute lung injury in mice. The cocrystal formulation enhanced the release rate of the drug, addressing the challenges of conventional powder inhalants. These findings suggest that EVO-βCD cocrystals hold promise as a novel therapeutic approach for ALI treatment with enhanced safety and efficacy.

BackgroundRecent studies suggest a role of gut microbiota in the development of neonatal hyperbilirubinemia, with bifidobacteria showing promise in alleviating symptoms. However, uncertainties persist regarding gut bifidobacterial species composition and their effects on bilirubin metabolism. Therefore, the study investigated the association between the gut microbiota and neonatal hyperbilirubinemia, assessing the potential and underlying mechanisms of Bifidobacterium in managing the condition.ResultsCompared to the high-risk group (requiring clinical intervention), low-risk neonates (designated as controls without therapeutic needed) demonstrated a higher abundance of breastfeeding-associated Bifidobacterium species, including Bifidobacterium longum subsp. infantis, B. bifidum, and B. breve. In an experimental neonatal hyperbilirubinemia rat model, these Bifidobacterium species’ protective effects were demonstrated by reducing serum bilirubin levels, maintaining growth and development, and improving neurobehavioral reflexes. These benefits are associated with improved liver and intestinal barrier functions and reduced enterohepatic circulation of bilirubin. Among the various treatment groups, B. longum subsp. infantis exhibited the most potent effect, followed by B. bifidum and B. breve. Intestinal metabolism analysis revealed that the levels of arachidonic acid and docosahexaenoic acid were increased and negatively correlated with bilirubin levels. These findings were further confirmed in the neonatal cohort study. Direct supplementation of these metabolites into the colon of neonatal rats improved disease phenotypes. In addition, both in vitro and in vivo experiments demonstrated the specific inhibitory effect of arachidonic acid and docosahexaenoic acid on β-glucuronidase enzyme activity. Notably, both in vitro intestinal fermentation models and genomic analyses demonstrated that the three Bifidobacterium species cannot synthesize these unsaturated fatty acids due to the lack of related genes. However, data suggested that these species might promote the accumulation of arachidonic acid and docosahexaenoic acid by regulating the gut microbiota’s structure and function. Moreover, these species show species-specific genomic distribution patterns, which might influence the gut microbiota's α-linolenic and linoleic acid metabolism pathways, thereby affecting bilirubin levels.ConclusionsThe results indicate that Bifidobacterium species associated with breastfeeding can prevent neonatal hyperbilirubinemia by regulating the gut microbiota–α-linolenic and linoleic acid metabolism–enterohepatic circulation axis, increasing gut metabolites arachidonic acid and docosahexaenoic acid, and reducing the enterohepatic circulation of bilirubin.Video Supplementary InformationThe online version contains supplementary material available at 10.1186/s40168-025-02190-y.