Objective:To investigate the relationship of multi-slice CT (MSCT) findings and epidermal growth factor receptor (EGFR), kirsten rat sarcoma viral oncogene (KRAS) and survival outcome in patients with isolated lung adenocarcinoma.Methods:The clinical data of 120 patients with solitary lung adenocarcinoma treated in the First Hospital of Qinhuangdao from January 2019 to September 2021 were collected retrospectively, the MSCT findings were analyzed, the correlationship of MSCT findings and EGFR, KRAS were analyzed by Spearman correlation, the MSCT findings of patients with different prognosis were compared, the prognostic risk factors were analyzed by Cox proportional risk model. A decision curve was drawn to analyze the net return of MSCT findings and biological factors combined to predict the prognosis of patients with isolated lung adenocarcinoma.Results:The MSCT findings results of 120 patients of isolated lung adenocarcinoma showed that the tumor diameter was (16.22 ± 3.31) mm, 88 patients with lobed signs, 74 patients with burr signs, 16 patients with vascular cluster signs, 76 patients with pleural indentation signs, 12 patients with cystic cavity changes, 75 patients with pure ground glass density shadows, 45 patients with mixed ground glass density shadows, 67 patients with round or almost round, and 53 patients with irregular shapes. There were positive correlation between MSCT findings (lobed signs, burr signs, pleural indentation signs, and cystic cavity changes) and EGFR and KRAS status in patients with isolated lung adenocarcinoma ( P<0.05). After 12 months of follow-up, 4 patients were lost, 96 patients survived and 20 patients died. The results of Cox proportional risk model analysis showed that lobed signs, pleural indentation signs, EGFR and KRAS mutants were high risk factors for death in patients with isolated lung adenocarcinoma ( P<0.05). The results of decision curve analysis showed that when the threshold value was 0.1 - 0.5, the model combined with lobed signs, pleural indentation signs, EGFR and KRAS status predicted the net death rate was better than the prediction value of simple indicators. Conclusions:MSCT findings in patients with isolated lung adenocarcinoma is closely related to EGFR and KRAS status, and the combination of these three factors has a higher net return in predicting prognosis, which is conductive to guiding clinical treatment and prognosis evaluation.

AIM:To investigate the effects of cannabinoid receptor agonist WIN55212-2(WIN)on acute lung injury(ALI)in septic mice,and to explore its potential mechanisms through glycolysis.METHODS:A mouse model of septic ALI was established by intraperitoneal injections of lipopolysaccharide(LPS).Male C57BL/6J mice were randomly divided into 4 groups(n=6):(1)control group;(2)LPS group,receiving intraperitoneal injections of LPS at 10 mg/kg;(3)LPS+WIN group,receiving 1 mg/kg WIN intraperitoneally 30 min prior to LPS injection;(4)LPS+WIN+MHY1485[mammalian target of rapamycin(mTOR)activator]group,receiving 10 mg/kg MHY1485 intraperitoneally 1 d before LPS injection and 1 mg/kg WIN plus 10 mg/kg MHY1485 30 min before LPS injection.Tissues were collected 24 h after modeling for analysis.Lung indexes were calculated,and histopathological changes of lung tissues were observed via he-matoxylin-eosin(HE)staining.Inflammatory cytokines interleukin-1β(IL-1β)and IL-10 in lung tissues,and lactic acid and lactate dehydrogenase A(LDHA)in serum were quantified using ELISA.The levels of mTOR/hypoxia-inducible fac-tor-1α(HIF-1α)/6-phosphofructo-2-kinase/fructose-2,6-biphosphatase 3(PFKFB3)signaling pathway-related proteins were assessed by Western blot.RESULTS:Compared with control group,the LPS group exhibited an increased lung in-dex,significant lung tissue damage,an increase in IL-1β levels(P＜0.05),a decrease in IL-10 levels(P＜0.05),and el-evated expressions of lactate and LDHA(P＜0.05),along with increased levels of phosphorylated mTOR(p-mTOR),HIF-1α and PFKFB3 proteins(P＜0.05).The LPS+WIN group showed improvements with a reduced lung index(P＜0.05),lessened lung injury,decreased IL-1β levels(P＜0.05),increased IL-10 levels(P＜0.05),and lower levels of lactic acid,LDHA,p-mTOR,HIF-1α,and PFKFB3(P＜0.05).Conversely,the LPS+WIN+MHY1485 group displayed increased lung indexes and lung tissue damage,elevated IL-1β levels(P＜0.05),reduced IL-10 levels(P＜0.05),and higher expressions of lactic acid,LDHA,p-mTOR,HIF-1α and PFKFB3(P＜0.05)compared to the LPS+WIN group.CONCLUSION:WIN55212-2 mitigates sepsis-induced ALI,potentially by modulating the mTOR/HIF-1α/PFKFB3 sig-naling pathway,thereby inhibiting glycolysis and alleviating inflammatory responses.

Objective To investigate the effects of cannabinoid receptor agonist,WIN55212-2(WIN),on acute kidney injury(AKI)in mice with sepsis and its underlying mechanism.Methods Twenty-four healthy male mice were divided into(n=6):Control group,sepsis group(LPS group),sepsis+WIN55212-2 group(LPS+WIN group)and sepsis+WIN55212-2+mTOR activator MHY1485 group(LPS+WIN+MHY group).The sepsis model was constructed by intraperitoneal injection of LPS.After the tissue and blood samples were harvested in 24 h after modeling,ELISA was used to determine the contents of IL-1β,IL-18 and lactate dehydrogenase A(LDHA)in the renal tissues,as well as Scr,kidney injury molecule-1(KIM-1)and lactic acid(LA)in the serum.HE staining was employed to observe the pathological changes of kidney tissue and Paller score was calculated.The expression of p-AKT,p-Mtor and 6-phosphofructokinase-2/fructose-2,6-biphosphatase 3(PFKFB3)in the renal tissues was detected by Western blotting.Results Compared with the Control group,the LPS group had obvious kidney tissue damage,increased Paller score(P＜0.05),increased serum contents of lactic acid,Scr and KIM-1(P＜0.05),up-regulated contents of LDHA,IL-1β and IL-18 in the renal tissues(P＜0.05),and elevated expression levels of p-AKT,p-Mtor and PFKFB3 in the renal tissues(P＜0.05).Milder pathological injury in kidney tissue,decreased Paller score(P＜0.05),reduced contents of lactic acid,Scr and KIM-1(P＜0.05),decreased contents of LDHA,IL-1β and IL-18(P＜0.05),and lower expression of p-AKT,p-Mtor and PFKFB3 were observed in the LPS+WIN group than the LPS group(P＜0.05).The LPS+WIN+MHY group had notably higher Paller score(P＜0.05),raised contents of lactic acid,Scr and KIM-1(P＜0.05),increased contents of LDHA,IL-1β and IL-18(P＜0.05),and up-regulated expression of p-AKT,p-Mtor and PFKFB3(P＜0.05)when compared with the LPS+WIN group.Conclusion WIN can alleviate AKI in sepsis,and it may reduce the level of glycolysis in renal tissue,and alleviate inflammation through inhibiting AKT/Mtor/PFKFB3 signaling pathway.

Objective To introduce a traceability closed-loop management system for the entire process of drug dispensing in the inpatient department.Methods In line with the requirements for intelligent healthcare construction and six-level electronic medical records development,a paperless drug dispensing process for the inpatient department was designed.A traceability closed-loop management system was established by improving both hardware equipment and software function.The system's practical effectiveness was evaluated from multiple perspectives.Results With process transformation,the workflow efficiency of doctors,nurses,pharmacists and clinical support staff has been significantly improved.Costs in terms of human resources and materials have been reduced,and the safe and rational use of medication has been promoted.Conclusions The improved process,which is based on the construction of intelligent devices and information technology,achieves a closed-loop and traceable management system for the entire drug dispensing process in the inpatient department.This system offers the benefits of safety,standardization,efficiency,and closed-loop traceability.It reduces the risk of dispensing mistakes,improves the safety of medication and has strong scalability.