As one of the most delicate surgeries in the whole body, vitreoretinal surgery requires a high degree of refinement and stability of the surgeon's operation due to the limitation of the operating space, and the fact that any subtle surgical trauma can lead to serious visual function damage. Surgical robots can significantly improve the precision and safety of the vitreoretinal surgical procedures and have good application prospects. As an emerging technology, in recent years, scholars at home and abroad have carried out a lot of research on the surgical robot in the surgical treatment of vitreoretinal diseases, and have achieved certain research results. Starting from the development history of surgical robots, this review analyzes and summarizes the safety and stability of surgical robots assisted retinal endovascular surgery, subretinal injection, macular surgery and real-time manipulation of retinal laser photocoagulation, briefly generalized the challenges that surgical robots still faced, and aim to provide more research directions of surgical robots in the treatment of vitreoretinal diseases.

As one of the most delicate surgeries in the whole body, vitreoretinal surgery requires a high degree of refinement and stability of the surgeon's operation due to the limitation of the operating space, and the fact that any subtle surgical trauma can lead to serious visual function damage. Surgical robots can significantly improve the precision and safety of the vitreoretinal surgical procedures and have good application prospects. As an emerging technology, in recent years, scholars at home and abroad have carried out a lot of research on the surgical robot in the surgical treatment of vitreoretinal diseases, and have achieved certain research results. Starting from the development history of surgical robots, this review analyzes and summarizes the safety and stability of surgical robots assisted retinal endovascular surgery, subretinal injection, macular surgery and real-time manipulation of retinal laser photocoagulation, briefly generalized the challenges that surgical robots still faced, and aim to provide more research directions of surgical robots in the treatment of vitreoretinal diseases.

Aconitum (Ranunculaceae) has a long-standing history in traditional Chinese medicine (TCM), where it has been widely used to treat conditions such as rheumatoid arthritis (RA), myocardial infarction, and heart failure. However, the potency of Aconitum alkaloids, the primary active components of Aconitum, also confers substantial toxicity. Therefore, assessing the efficacy and toxicity of these Aconitum alkaloids is crucial for ensuring clinical effectiveness and safety. Metabolomics, a quantitative method for analyzing low-molecular-weight metabolites involved in metabolic pathways, provides a comprehensive view of the metabolic state across multiple systems in vivo. This approach has become a vital investigative tool for facilitating the evaluation of their efficacy and toxicity, identifying potential sensitive biomarkers, and offering a promising avenue for elucidating the pharmacological and toxicological mechanisms underlying TCM. This review focuses on the applications of metabolomics in pharmacological and toxicological studies of Aconitum alkaloids in recent years and highlights the significant role of metabolomics in exploring compatibility detoxification and the mechanisms of TCM processing, aiming to identify more viable methods for characterizing toxic medicinal plants.
Aconitum/metabolism* ; Metabolomics/methods* ; Alkaloids/metabolism* ; Humans ; Animals ; Drugs, Chinese Herbal/pharmacology* ; Medicine, Chinese Traditional

To investigate the current situation and demand for specialized development of allergy nursing in 88 hospitals in Guangdong Province, as well as to provide evidence for the management of allergy nursing. From August to December 2023, a cross-sectional study was conducted to analyze the core managers of allergy nursing-related work in eighty-eight hospitals in Guangdong Province supported by the Allergy Nursing Branch of the Guangdong Nurses Association and the Nursing Group of the Allergy Branch of the Guangdong Medical Association. An online survey was conducted using the Delphi method to compile a questionnaire on the current status and demand for specialized development of allergy nursing in Guangdong Province. Chi-square tests and Fisher′s exact probability method were used to analyze the differences in the current status of specialty technology applications and the development and demand of specialized nursing between hospitals with or without allergy specialty departments. The results showed that among the eighty-eight hospitals in the nineteen prefecture-level cities surveyed in Guangdong Province, 17 hospitals (19%) had established allergy specialty departments, all of which were top-tier tertiary hospitals. The establishment duration [ M ( Q1, Q3)] was 3 (1, 10) years. The implementation rates of skin prick test (94%, 16/17), in-vitro examination (82%, 14/17), nasal endoscopy (82%, 14/17), subcutaneous specific immunotherapy (82%, 14/17), multidisciplinary consultation (65%, 11/17), fractional exhaled nitric oxide detection (47%, 8/17), skin patch test (41%, 7/17), and autologous serum skin test (35%, 6/17) in hospitals with allergy department were higher than those in hospitals without allergy department [59%, 42/71 ( χ 2= 7.462, P=0.006)], [54%, 38/71 ( χ 2= 4.717, P=0.030)], [51%, 36/71 ( χ 2= 5.599, P=0.018)], [34%, 24/71 ( χ 2= 13.177, P<0.001)], [24%, 17/71 ( χ 2= 10.505, P=0.001)], [24%, 17/71 ( χ 2= 5.540, P=0.019)], [11%, 8/71 (Fisher′s exact test, P=0.008)], [11%, 8/71 (Fisher′s exact test, P=0.025)]. In the development plan of allergy nursing in the next two years, hospitals that had set up allergy departments had a higher proportion in adding nurses (82%, 14/17, χ 2= 13.177, P<0.001), formulating specialized nurse training plans (71%, 12/17, χ 2= 3.980, P=0.046), formulating group standards or clinical guidelines (41%, 7/17, Fisher′s exact test, P=0.046), and formulating assessment standards (53%, 9/17, Fisher′s exact test, P=0.002). The demand for all aspects of allergy specialty nursing knowledge and skills accounted for more than 50%, and it was not related to whether the hospital set up an allergy department. In conclusion, the specialized development of allergy nursing in Guangdong province is still in its early stages, and there is a great demand for improving knowledge and skills in allergy. Further standardization of specialty construction is needed, along with the training of allergic nurses, to promote the comprehensive development of allergic reaction nursing specialties from point to area.

To investigate the current situation and demand for specialized development of allergy nursing in 88 hospitals in Guangdong Province, as well as to provide evidence for the management of allergy nursing. From August to December 2023, a cross-sectional study was conducted to analyze the core managers of allergy nursing-related work in eighty-eight hospitals in Guangdong Province supported by the Allergy Nursing Branch of the Guangdong Nurses Association and the Nursing Group of the Allergy Branch of the Guangdong Medical Association. An online survey was conducted using the Delphi method to compile a questionnaire on the current status and demand for specialized development of allergy nursing in Guangdong Province. Chi-square tests and Fisher′s exact probability method were used to analyze the differences in the current status of specialty technology applications and the development and demand of specialized nursing between hospitals with or without allergy specialty departments. The results showed that among the eighty-eight hospitals in the nineteen prefecture-level cities surveyed in Guangdong Province, 17 hospitals (19%) had established allergy specialty departments, all of which were top-tier tertiary hospitals. The establishment duration [ M ( Q1, Q3)] was 3 (1, 10) years. The implementation rates of skin prick test (94%, 16/17), in-vitro examination (82%, 14/17), nasal endoscopy (82%, 14/17), subcutaneous specific immunotherapy (82%, 14/17), multidisciplinary consultation (65%, 11/17), fractional exhaled nitric oxide detection (47%, 8/17), skin patch test (41%, 7/17), and autologous serum skin test (35%, 6/17) in hospitals with allergy department were higher than those in hospitals without allergy department [59%, 42/71 ( χ 2= 7.462, P=0.006)], [54%, 38/71 ( χ 2= 4.717, P=0.030)], [51%, 36/71 ( χ 2= 5.599, P=0.018)], [34%, 24/71 ( χ 2= 13.177, P<0.001)], [24%, 17/71 ( χ 2= 10.505, P=0.001)], [24%, 17/71 ( χ 2= 5.540, P=0.019)], [11%, 8/71 (Fisher′s exact test, P=0.008)], [11%, 8/71 (Fisher′s exact test, P=0.025)]. In the development plan of allergy nursing in the next two years, hospitals that had set up allergy departments had a higher proportion in adding nurses (82%, 14/17, χ 2= 13.177, P<0.001), formulating specialized nurse training plans (71%, 12/17, χ 2= 3.980, P=0.046), formulating group standards or clinical guidelines (41%, 7/17, Fisher′s exact test, P=0.046), and formulating assessment standards (53%, 9/17, Fisher′s exact test, P=0.002). The demand for all aspects of allergy specialty nursing knowledge and skills accounted for more than 50%, and it was not related to whether the hospital set up an allergy department. In conclusion, the specialized development of allergy nursing in Guangdong province is still in its early stages, and there is a great demand for improving knowledge and skills in allergy. Further standardization of specialty construction is needed, along with the training of allergic nurses, to promote the comprehensive development of allergic reaction nursing specialties from point to area.

Mastitis is one of the most widespread infectious diseases that adversely affects the profitability of the dairy industry worldwide. Accurate diagnosis and identification of pathogens early to cull infected animals and minimize the spread of infection in herds is critical for improving treatment effects and dairy farm welfare. The major pathogens causing mastitis and pathogenesis are assessed first. The most recent and advanced strategies for detecting mastitis, including genomics and proteomics approaches, are then evaluated .Finally, the advantages and disadvantages of each technique, potential research directions, and future perspectives are reported. This review provides a theoretical basis to help veterinarians select the most sensitive, specific, and cost-effective approach for detecting bovine mastitis early.

Objective:To systematically evaluate the efficacy and safety of carfilzomib in treating relapsed and/or refractory multiple myeloma (RRMM) in the real world.Methods:Relevant databases at home and abroad were searched (up to April 2023), and the literature on real-world studies of carfilzomib in the treatment of RRMM was collected. The quality of the literature was evaluated with the methodological index for non-randomized studies (MINORS) scale. Research data on the effectiveness and safety in RRMM patients treated with carfilzomib were extracted. The effectiveness indicators included the overall response rate (ORR), median progression-free survival (PFS), and overall survival (OS). The safety indicators included the incidence of adverse events (AEs) and the rate of treatment termination due to AEs, etc. Stata 13.0 software was used for meta-analysis of single proportions, and the occurrence of major adverse events was analyzed by descriptive statistics.Results:A total of 12 studies were entered, including 2 615 patients. The quality evaluation results showed that all of the 12 studies were with high quality. The meta-analysis of single proportions showed that ORR of carfilzomib in the treatment of RRMM was 75%[95% confidence interval ( CI): 68%-82%], the incidence of ≥ grade 3 AEs was 46% (95 %CI: 44%-49%), and the incidence of treatment termination due to AEs was 14% (95 %CI: 10%-19%). AEs with an incidence of >5% included thrombocytopenia, anemia, neutropenia, infection, hypertension, liver injury, and kidney injury. Conclusions:In the real world, the efficacy of carfilzomib in the treatment of RRMM is lower than that in clinical trials. The occurrence of infection during carfilzomib treatment and drug toxicity to the hematological system, cardiovascular system, liver, and kidney need to be paid attention to.

Objective:To systematically evaluate the efficacy and safety of carfilzomib in treating relapsed and/or refractory multiple myeloma (RRMM) in the real world.Methods:Relevant databases at home and abroad were searched (up to April 2023), and the literature on real-world studies of carfilzomib in the treatment of RRMM was collected. The quality of the literature was evaluated with the methodological index for non-randomized studies (MINORS) scale. Research data on the effectiveness and safety in RRMM patients treated with carfilzomib were extracted. The effectiveness indicators included the overall response rate (ORR), median progression-free survival (PFS), and overall survival (OS). The safety indicators included the incidence of adverse events (AEs) and the rate of treatment termination due to AEs, etc. Stata 13.0 software was used for meta-analysis of single proportions, and the occurrence of major adverse events was analyzed by descriptive statistics.Results:A total of 12 studies were entered, including 2 615 patients. The quality evaluation results showed that all of the 12 studies were with high quality. The meta-analysis of single proportions showed that ORR of carfilzomib in the treatment of RRMM was 75%[95% confidence interval ( CI): 68%-82%], the incidence of ≥ grade 3 AEs was 46% (95 %CI: 44%-49%), and the incidence of treatment termination due to AEs was 14% (95 %CI: 10%-19%). AEs with an incidence of >5% included thrombocytopenia, anemia, neutropenia, infection, hypertension, liver injury, and kidney injury. Conclusions:In the real world, the efficacy of carfilzomib in the treatment of RRMM is lower than that in clinical trials. The occurrence of infection during carfilzomib treatment and drug toxicity to the hematological system, cardiovascular system, liver, and kidney need to be paid attention to.

Bile acids(BAs)are synthesized by the liver from cholesterol through several complementary pathways and aberrant cholesterol metabolism plays pivotal roles in the pathogeneses of cholesterol gallbladder polyps(CGP)and cholesterol gallstones(CGS).To date,there is neither systematic study on BAs profile of CGP or CGS,nor the relationship between them.To explore the metabolomics profile of plasma BAs in healthy volunteers,CGP and CGS patients,an ultra-performance liquid chromatography-tandem mass spectrometry(UPLC-MS/MS)method was developed and validated for simultaneous determination of 42 free and conjugated BAs in human plasma.The developed method was sensitive and reproducible to be applied for the quantification of BAs in the investigation of plasma samples.The results show that,compared to healthy volunteers,CGP and CGS were both characterized by the significant decrease in plasma BAs pool size,furthermore CGP and CGS shared aberrant BAs metabolic characteristics.Cheno-deoxycholic acid,glycochenodeoxycholic acid,λ-muricholic acid,deoxycholic acid,and 7-ketolithocholic acid were shared potential markers of these two cholesterol gallbladder diseases.Subsequent analysis showed that clinical characteristics including cysteine,ornithine and body mass index might be closely related to metabolisms of certain BA modules.This work provides metabolomic information for the study of gallbladder diseases and analytical methodologies for clinical target analysis and efficacy evaluation related to BAs in medical institutions.

Objective:To investigate influencing factors of polyspermy during conventional in vitro fertilization (IVF) in super-long protocol. Methods:This study was a retrospective case-control analysis. From October 2018 to August 2021, 316 patients who underwent conventional IVF using super-long protocol in the Department of Reproductive Medicine, Yuncheng Central Hospital of Shanxi Province were selected and divided into normal fertilization group and polyspermy fertilization group according to polyspermy fertilization incidence in this cycle. The general data and clinical assisted pregnancy data in the two groups were analyzed. The correlation factors of P<0.15 in the single factor analysis were included in logistic regression model for multivariate analysis. Results:There were 227 polyspermy fertilization cycles out of 316 IVF cycles, and the incidence of polyspermy fertilization was 71.84%. There were no significant differences in female age, infertility duration, primary infertility ratio, infertility factors, body mass index (BMI), basal follicle-stimulating hormone (FSH) level and basal anti-Müllerian hormone (AMH) level between normal fertilization group and polyspermy fertilization group (all P>0.05). There were no significant differences in gonadotropin (Gn) initiation dosage, total dosage and duration of Gn used, and progesterone (P) on human chorionic gonadotropin (hCG) injection day between normal fertilization group and polyspermy fertilization group (all P>0.05). The number of follicles with a diameter of ≥14 mm, estradiol (E 2) on hCG injection day and the number of retrieved oocytes in polyspermy fertilization group were significantly higher than those in normal fertilization group [13.66±4.51 vs. 11.78±3.54, P<0.001; (17 247.49±9 450.74) pmol/L vs. (14 135.29±7 369.84) pmol/L, P=0.002; 17.48±7.37 vs. 13.01±6.17, P<0.001]. Luteinizing hormone (LH) level on hCG injection day in polyspermy fertilization group was significantly lower than that in normal fertilization group [(0.79±0.51) U/L vs. (1.02±0.78) U/L, P=0.014]. Logistic regression results showed that the number of follicles with a diameter of ≥14 mm, E 2 and P level on hCG injection day could not enter the regression equation ( OR=1.063, OR=1.676 and OR=1.078, respectively, all P>0.05); LH level on hCG injection day and the number of retrieved oocytes were correlated with polyspermy ( OR=1.900, P=0.028; OR=2.539, P=0.003). Conclusion:The incidence of polyspermy fertilization cycle during conventional IVF in super-long protocol was high. The number of follicles with a diameter of ≥14 mm, E 2 and LH levels on hCG injection day and the number of retrieved oocytes were significantly correlated with the occurrence of polyspermy. Lower LH level on hCG injection day and larger number of retrieved oocytes were independent risk factors of conventional IVF polyspermy fertilization in super-long protocol, and the number of retrieved oocytes had the greater influence on polyspermy fertilization.