Diabetes mellitus (DM) is a chronic metabolic condition characterized by persistently high blood glucose levels. The emergence of drug resistance in DM therapy presents significant clinical challenges, highlighting the need for the development of new and effective therapeutic agents. The primary objective of this study is to investigate the potential anti-diabetic activity of a newly designed Schiff base molecule, 2-[(2,4-dichloro-benzylidene)-amino]-4-methyl-phenol [compound (I)]. Compound (I) was synthesized, and its structure was confirmed using spectroscopic methods such as UV-Vis, FT-IR, and NMR spectroscopy. Single-crystal X-ray diffraction (SC-XRD) revealed that compound (I) crystallizes in the orthorhombic P2₁2₁2₁ space group and is stabilized by a combination of intra- and intermolecular hydrogen bonds (O-H···N, O-H···O, C-H···O, and C-H···Cl), forming a robust 3D supramolecular framework. The compound (I) was evaluated for its anti-diabetic potential using In-silico α-amylase inhibition assays. The compound's cytocompatibility was assessed using the MTT assay. The interaction pattern and binding orientation of compound (I) within the catalytic site of human pancreatic α-amylase (HPA) was explored through molecular docking studies, supporting the biological results. Furthermore, the stability of the docked complex was evaluated through 100 ns molecular dynamics (MD) simulations. In addition, the quantum computational analysis was investigated using Density Functional Theory (DFT) at the B3LYP/6-31++G(d,p) level were conducted to explore the electronic properties of compound (I), including electrophilicity, nucleophilicity, hardness, and softness. Moreover, the binding thermodynamics of compound (I) with α-amylase were examined by Isothermal Titration Calorimetry (ITC), which elucidated the thermodynamic parameters and interaction mechanisms.

Based on a strategy integrating topological feature identification and path priority assessment, this study systematically explored the efficacy targets and differentiated mechanisms of Colquhounia Root Tablets(CRT) in the "homotherapy for heteropathy" of rheumatoid arthritis(RA) and diabetic kidney disease(DKD). Firstly, candidate targets of CRT and disease-specific genes were retrieved by integrating multi-source databases and transcriptomic data. Protein-protein interaction(PPI) networks were constructed to identify key targets shared by or specific to RA and DKD via topological feature identification. Subsequently, a path priority assessment was introduced to calculate the average shortest path(ASP) values from drug targets to various pathological segments, thereby quantifying intervention efficacy to lock onto "dominant pharmacodynamic links". The predicted key functional axes were validated through animal experiments. The results indicated that the core targets of CRT for both diseases involved shared pathways such as phosphatidylinositol 3-kinase(PI3K)-protein kinase B(Akt), tumor necrosis factor(TNF), and glycolysis/gluconeogenesis. Notably, path priority assessment revealed distinct dominant intervention links: for RA, CRT preferentially targeted "fibroblast-like synoviocyte(FLS) activation and invasion"(ASP=2.361), which mapped to the TNF-p38 mitogen-activated protein kinase(p38)-LIM domain kinase 1(LIMK1)-Cofilin1 axis to regulate cytoskeleton remodeling; for DKD, the dominant link was "filtration barrier injury and interstitial fibrosis"(ASP=2.295), converging on the TNF-poly(ADP-ribose) polymerase 1(PARP1)-signal transducer and activator of transcription 1(STAT1)-matrix metallopeptidase 9(MMP9) axis to mediate cellular senescence and senescence-associated secretory phenotype(SASP) secretion. Animal experiments confirmed that CRT significantly alleviated RA synovial invasion and DKD renal fibrosis by inhibiting these two differentiated signaling axes, respectively. By employing topological feature identification and path priority assessment, this study elucidates the scientific connotation of "homotherapy for heteropathy" of RA and DKD with CRT through both shared network regulation and intervention in disease-specific differential signaling axes associated with pharmacodynamic links.

This study aims to examine the relationship between symptom clusters (depressive symptoms, sleep disturbances, and pain) and frailty in older adults, with a specific focus on mediation and moderation effects. Data from two cross-sectional studies in Changsha and Hong Kong were analyzed, including nursing home residents without cancer and older adults with cancer. Study-stratified analyses were conducted in SPSS 26.0 and PROCESS, with adjustment for available covariates. Mediation tested whether sleep disturbances were indirectly associated with depressive symptoms and frailty, and moderated mediation examined whether pain severity or interference conditioned the association between depressive symptoms and sleep disturbances. In both groups, frailty, depressive symptoms, sleep disturbances, and pain were significantly associated. Sleep disturbances showed a significant indirect association between depressive symptoms and frailty in both groups. Pain interference, but not pain severity, moderated the association between depressive symptoms and sleep disturbances only among older adults without cancer. The findings highlight the importance of assessing and managing depressive symptoms, sleep disturbances, and pain-related interference when addressing frailty in older adults, particularly among those without cancer.

Although oral nutritional supplements (ONSs) are widely prescribed to combat cancer-related malnutrition and enhance treatment outcomes, patient adherence is often inadequate. This study aims to examine patient-reported barriers and facilitators to ONS use in cancer care, with the goal of supporting healthcare professionals in developing patients' nutritional strategies.

A qualitative study was conducted. Between November 2023 and August 2024, semistructured interviews were conducted with 20 purposively selected cancer patients until data saturation was achieved. The health belief model (HBM) guided data collection and interpretation. Adherence patterns were derived from participants' self-reports. Data were analyzed using a two-stage approach: inductive, experience-oriented thematic analysis followed by theory-informed mapping of finalized themes onto HBM constructs.

Sixteen themes were identified reflecting perceptions of ONS use. Participants perceived their adherence as suboptimal and described inconsistent consumption of prescribed supplements. While participants acknowledged that poor nutritional intake could compromise recovery, barriers were prominent. These included unpleasant taste and odor, gastrointestinal side effects, sensory fatigue from limited flavors, misconceptions such as "sugar feeds cancer," and inadequate professional guidance. Barriers were shaped by individual health beliefs, emotional responses, and contextual support systems. Facilitators included motivation for recovery, family support, and supportive interactions with healthcare professionals.

Adherence to ONS among cancer patients is influenced by multifaceted factors extending beyond medical prescription. Addressing misconceptions, improving palatability and product variety, and strengthening professional and psychosocial support may enhance adherence. Tailored interventions guided by patient beliefs and experiences are essential to optimize nutritional outcomes during cancer treatment.

Breast cancer is the most common cancer among women and represents 24.5% of all cancer cases worldwide. As there are few studies on the subject in Angola, it is particularly interesting to characterize the survival of women diagnosed with breast cancer in that country. The collected data set contains all diagnosed patients followed up at the Angolan Cancer Control Institute (IACC) between 2013 and 2022. However, due to the impact of COVID-19, the data set under analysis consists of the prepandemic period (2013 to 2019). The aim is to study the population diagnosed with cancer in the country, not only descriptively but also to check which factors influence the survival time of patients from diagnosis to death from breast cancer. To this end, various methods are applied to see which best describes the time until the event under study occurs. Namely, this study examines survival analysis models, beginning with the well-known Cox proportional hazards model. It then transitions to parametric models based on exponential and Weibull distributions and finally explores generalizations of these models that offer greater flexibility. To achieve this flexibility in the survival distribution, we adopt the proportional hazards framework proposed by Younes and Lachin but applying a new approach by Royston and Parmar. The results show that the median survival time from breast cancer in the observed women was 560 days. The variables that were revealed to be significant risk factors were age, stage of the disease, and body mass index. According to Akaike's criterion, the flexible proportional hazards model with one knot proved to be the most appropriate model for these data.

Bevacizumab is a humanized monoclonal antibody against vascular endothelial growth factor A. Its long half-life and low volume of distribution allow circulating drug to persist in the body for weeks, which becomes clinically relevant when urgent or emergent surgery is needed. Because bevacizumab is largely intravascular, therapeutic plasma exchange (TPE) is attractive, though published experience is limited. We describe four adults who underwent TPE to facilitate surgery or postoperative wound healing after bevacizumab exposure: two with glioblastoma multiforme (GBM) before craniotomy, one with GBM after bowel resection with primary anastomosis, and one with metastatic rectal adenocarcinoma before craniotomy for a hemorrhagic brain mass. Patients received one to three sessions with albumin replacement, with fresh frozen plasma added in one case. No postoperative hemorrhage or delayed wound healing occurred. These cases support a practical role for TPE when residual bevacizumab exposure remains relevant and awaiting spontaneous clearance is not feasible.

Intraventricular meningiomas are rare tumors accounting for a small fraction of intracranial meningiomas and are often associated with significant surgical challenges due to their deep location and rich vascular supply. Pre-operative endovascular embolization has been proposed as an adjunct to reduce intraoperative bleeding and facilitate safer resection; however, its role in intraventricular lesions remains poorly defined.

We present a case of a 9.5-year-old boy with a highly vascular intraventricular meningioma who underwent pre-operative endovascular embolization followed by surgical resection. Additionally, a systematic review was conducted in accordance with PRISMA guidelines, searching PubMed and Scopus for studies reporting embolization of intraventricular meningiomas.

In the presented case, selective embolization of the posterior choroidal artery using a glue-lipiodol mixture was successfully performed without complications, leading to reduced tumor vascularity and enabling gross total resection with minimal blood loss (< 300 mL). The systematic review identified seven cases from six studies. Embolization was successful in six cases, with varying degrees of devascularization. Gross total resection was achieved in all surgically treated patients. Reported intraoperative blood loss ranged from 150 to 1850 mL. Complications occurred in two of seven cases, including postoperative epidural hematoma.

Pre-operative endovascular embolization appears to be a technically feasible adjunct in selected cases of intraventricular meningiomas. However, current evidence is limited to case reports and small case series, precluding definitive conclusions regarding its safety or clinical benefit.

Despite remarkable advances in cancer drug treatment, including chemotherapy, targeted therapy, and immunotherapy, therapeutic resistance remains a formidable clinical barrier, limiting durable responses and long-term survival. Drug resistance can be broadly categorized as intrinsic, where tumors fail to respond to initial treatment, or acquired, which emerges during or after therapy due to adaptive or evolutionary processes. A comprehensive understanding of the multifactorial and dynamic nature of resistance is essential for improving treatment efficacy. In this review, we systematically examine the molecular and cellular determinants of drug response and resistance across 22 cancer types, highlighting key resistance mechanisms such as compensatory pathway activation, phenotypic plasticity, immune evasion, enhanced DNA damage repair, and the survival of drug-tolerant persister cells. These mechanisms are further contextualized across major therapeutic modalities, supported by clinical trials. We also present emerging strategies to overcome resistance, including rational drug combinations, novel agents, microbiome modulation, adaptive and intermittent therapies and advanced drug delivery systems, each illustrated with representative clinical studies. Moreover, we discuss cutting-edge tools that are revolutionizing resistance research, including single-cell and spatial multiomic profiling, patient-derived tumor organoid and xenograft (PDO/PDX) models, and artificial intelligence (AI)-powered predictive analytics. By integrating insights across molecular, cellular, and clinical dimensions, this review offers a strategic framework for understanding and tackling cancer drug resistance, with important translational implications for the future of precision oncology.

Xiaoyao Powder, originally documented in the Taiping Huimin Heji Jufang(Beneficial Formulas from the Taiping Imperial Pharmacy), possesses the therapeutic actions of soothing the liver and nourishing the blood, as well as fortifying the spleen and dispelling dampness. It is regarded as one of the representative formulas within the harmonizing and releasing category. Subsequent generations have continuously modified this formula to accommodate evolving clinical demands. In recent years, this formula has been extensively applied in the prevention and treatment of breast cancer. This article retrieves and collates relevant literature from the past two decades to summarize the application of modified Xiaoyao Powder in breast cancer across three domains: formula and syndrome analysis, clinical research, and mechanism investigation. Formula and syndrome analysis reveals that this formula is particularly adept at addressing disorders arising from emotional disturbances and dysregulation of Qi and blood, aligning closely with the pathogenesis of liver depression and Qi stagnation as well as Qi and blood deficiency observed in breast cancer patients. In terms of clinical research, this formula can ameliorate breast cancer-associated complications such as climacteric-like syndrome, anxiety, depression, insomnia, and fatigue. It serves as an adjunct to surgical intervention, radiotherapy, and chemotherapy to improve therapeutic efficacy, reduce recurrence and metastasis rate, and modulate immune function. Furthermore, it exerts a certain inhibitory effect on precancerous breast lesions. Mechanistically, this formula demonstrates capacities to inhibit breast cancer proliferation and metastasis, induce apoptosis, regulate the tumor microenvironment and macrophage function, bidirectionally modulate the endogenous antioxidant system, suppress the &quot;brain-mammary neural connection&quot;, and reverse cellular drug resistance. Through the aforementioned three aspects, this article provides a comprehensive exposition of the current research status of modified Xiaoyao Powder in the treatment of breast cancer, summarizes existing limitations in both clinical and mechanistic investigations, and proposes corresponding improvements, with the aim of providing a foundation and conceptual framework for subsequent in-depth studies.

The chemical constituents of the ethyl acetate extract from Achyrocline satureioides were rapidly analyzed using ultra performance liquid chromatography-quadrupole time-of-flight tandem mass spectrometry(UPLC-Q-TOF-MS/MS) combined with the Global Natural Products Social Molecular Networking(GNPS) molecular network. The mass spectrometric characteristics of the phloroglucinol compounds were clarified. Guided by these features, systematic isolation was performed using ODS-C_(18), Sephadex LH-20, and semi-preparative high performance liquid chromatography(HPLC). The structures were elucidated using modern spectroscopic techniques such as nuclear magnetic resonance(NMR) spectroscopy and high-resolution mass spectrometry(HR-MS). A total of 38 compounds were identified from the ethyl acetate fraction by mass spectrometry, including 23 flavonoids. Additionally, 18 compounds were isolated from this fraction. Among them, compound 1 was a new unsaturated fatty acid, and compounds 2, 3, and 7-10 were phloroglucinols. Compounds 2, 3, 7, and 8 were obtained from this plant for the first time. The in vitro anti-proliferative activities of compounds 2, 3, and 7-10 against the non-small cell lung cancer cell lines A549 and H1975 were evaluated using the CCK-8 assay. Compound 8 exhibited significant anti-lung cancer activity. This integrated approach using LC-MS/MS combined with GNPS enables efficient analysis of the chemical components in the ethyl acetate fraction of A. satureioides and facilitates the guided isolation of phloroglucinol compounds, thereby enriching the understanding of its material basis.