Hypertrophic scar is a fibrous hyperplastic disorder that arises from skin injuries. The current therapeutic modalities are constrained by the dense and rigid scar tissue which impedes effective drug delivery. Additionally, insufficient autophagic activity in fibroblasts hinders their apoptosis, leading to excessive matrix deposition. Here, we developed an active microneedle (MN) system to overcome these challenges by integrating micromotor-driven drug delivery with autophagy regulation to remodel the scar microenvironment. Specifically, sodium bicarbonate and citric acid were introduced into the MNs as a built-in engine to generate CO₂ bubbles, thereby enabling enhanced lateral and vertical drug diffusion into dense scar tissue. The system concurrently encapsulated curcumin (Cur), an autophagy activator, and triamcinolone acetonide (TA), synergistically inducing fibroblast apoptosis by upregulating autophagic activity. In vitro studies demonstrated that active MNs achieved efficient drug penetration within isolated scar tissue. The rabbit hypertrophic scar model revealed that TA-Cur MNs significantly reduced the scar elevation index, suppressed collagen I and transforming growth factor-β1 (TGF-β1) expression, and elevated LC3 protein levels. These findings highlight the potential of the active MN system as an efficacious platform for autonomous augmented drug delivery and autophagy-targeted therapy in fibrotic disorder treatments.

Objective:To analyze the carriage status, subtype distribution and flanking gene sequence characteristics of oxacillinases (OXA enzyme) in 241 clinical strains of Pseudomonas aeruginosa, and assess their roles in the drug resistance of Pseudomonas aeruginosa and ability to horizontally transfer across species. Methods:Clinical P. aeruginosa isolates were collected from four hospitals in Sanya, Tangshan, Zhangjiakou, and Beijing. The prevalence of oxacillinases and their flanking gene sequences was analyzed by whole-genome sequencing (NGS) and bioinformatic approaches. Results:A total of 241 isolates of P. aeruginosa were gathered, and 35 blaOXA subtypes were identified through screening of 252 blaOXA genes. These genes were classified into three subfamilies: blaOXA-50-like (241, 95.6%), blaOXA-1-like (9, 3.6%) and blaOXA-10-like (2, 0.8%). Among these, 11 subtypes (11, 31.4%) were novel blaOXA subtypes. Nine of these belonged to the blaOXA-50-like subfamily and were designated as blaOXA-1244, blaOXA-1245, blaOXA-1246, blaOXA-1250, blaOXA-1252, blaOXA-1253, blaOXA-1254, blaOXA-1255, and blaOXA-1256. The remaining two belonged to the blaOXA-10-like subfamily and were named blaOXA-1247 and blaOXA-1248. Compared to the amino acid sequence of OXA-10, the newly identified subtype OXA-1247 exhibited a mutation at position 117, where a valine was replaced by a leucine. This change was thought to improve the enzyme′s ability to hydrolyze carbapenems. In the analysis of the flanking sequences of the blaOXA genes, Class I integrons were identified in four bacterial strains. The variable regions of these integrons carried three distinct patterns of resistance gene cassettes: aac( 6′) -Ib-blaOXA-1247-ant( 3′′) -Ia, aac( 6′) -Ib-blaOXA-1248 and aac( 6′) -Ib- blaIMP-45-blaOXA-1-catB3. Among these, the strain BJ2326 carried a class I integron that was connected to the downstream IS CR1 element to form a composite class I integron structure, additionally carrying the resistance gene blaPER-1. Out of the 223 non-wild-type P. aeruginosa strains, 127 strains exhibited non-wild-type profiles to the four beta-lactam antibiotics MEM, CAZ, FEP, and TZP, with the combination of MEM+CAZ+FEP being the most prevalent, representing 57.0% of the total. Conclusions:The blaOXA genes in 241 clinical P. aeruginosa strains showed diversity. Some blaOXA genes had a co-transfer risk with the metallo-β-lactamase resistance gene blaIMP-45. Among the 11 newly discovered blaOXA subtypes, the new subtype OXA-1247 may have carbapenemase activity and potential for horizontal transfer.

Objective:To analyze the carriage status, subtype distribution and flanking gene sequence characteristics of oxacillinases (OXA enzyme) in 241 clinical strains of Pseudomonas aeruginosa, and assess their roles in the drug resistance of Pseudomonas aeruginosa and ability to horizontally transfer across species. Methods:Clinical P. aeruginosa isolates were collected from four hospitals in Sanya, Tangshan, Zhangjiakou, and Beijing. The prevalence of oxacillinases and their flanking gene sequences was analyzed by whole-genome sequencing (NGS) and bioinformatic approaches. Results:A total of 241 isolates of P. aeruginosa were gathered, and 35 blaOXA subtypes were identified through screening of 252 blaOXA genes. These genes were classified into three subfamilies: blaOXA-50-like (241, 95.6%), blaOXA-1-like (9, 3.6%) and blaOXA-10-like (2, 0.8%). Among these, 11 subtypes (11, 31.4%) were novel blaOXA subtypes. Nine of these belonged to the blaOXA-50-like subfamily and were designated as blaOXA-1244, blaOXA-1245, blaOXA-1246, blaOXA-1250, blaOXA-1252, blaOXA-1253, blaOXA-1254, blaOXA-1255, and blaOXA-1256. The remaining two belonged to the blaOXA-10-like subfamily and were named blaOXA-1247 and blaOXA-1248. Compared to the amino acid sequence of OXA-10, the newly identified subtype OXA-1247 exhibited a mutation at position 117, where a valine was replaced by a leucine. This change was thought to improve the enzyme′s ability to hydrolyze carbapenems. In the analysis of the flanking sequences of the blaOXA genes, Class I integrons were identified in four bacterial strains. The variable regions of these integrons carried three distinct patterns of resistance gene cassettes: aac( 6′) -Ib-blaOXA-1247-ant( 3′′) -Ia, aac( 6′) -Ib-blaOXA-1248 and aac( 6′) -Ib- blaIMP-45-blaOXA-1-catB3. Among these, the strain BJ2326 carried a class I integron that was connected to the downstream IS CR1 element to form a composite class I integron structure, additionally carrying the resistance gene blaPER-1. Out of the 223 non-wild-type P. aeruginosa strains, 127 strains exhibited non-wild-type profiles to the four beta-lactam antibiotics MEM, CAZ, FEP, and TZP, with the combination of MEM+CAZ+FEP being the most prevalent, representing 57.0% of the total. Conclusions:The blaOXA genes in 241 clinical P. aeruginosa strains showed diversity. Some blaOXA genes had a co-transfer risk with the metallo-β-lactamase resistance gene blaIMP-45. Among the 11 newly discovered blaOXA subtypes, the new subtype OXA-1247 may have carbapenemase activity and potential for horizontal transfer.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Programmed cell death protein ligand-1(PD-L1)is an important immune checkpoint molecule that plays an important role in regulating the body's immune response.Several clinical studies have shown that the expression level of PD-L1 in tumors is closely related to the efficacy of immune checkpoint inhibitors.Due to the spatial and temporal heterogeneity of tumors,immunohistochemical methods commonly used in clinical practice cannot accurately and comprehensively reflect the ex-pression level of PD-L1 in patients.Given that nuclear-medicine molecular imaging technology can noninvasively,real-time,dy-namically and visually monitor the expression level of PD-L1 in vivo at the molecular level,this article mainly focuses on the re-search of peptide-based radiolabeled molecular probes targeting PD-L1,with the aim of providing guidance for the search of no-vel peptide molecular probes for immunoimaging as well as for the screening of immunotherapy-suitable patients and evaluation of therapeutic efficacy,and other clinical applications.

Objective To analyze the important abnormal results of physical examination of the staff in our hospital in recent 2 years,and to provide evidence for the health management of the staff in our hospital.Methods The physical examina-tion data of hospital staff in recent 2 years were retrospectively analyzed,and the important abnormal results were statistically ana-lyzed.Results A total of 3 584 employees participated in physical examination,including753 males and 2831 females.There were 92 cases with significant abnormal results,and the total detection rate was 2.57%.The detection rate of significant abnor-mal results was slightly lower in males(17cases,2.26%)than in females(75cases,2.65%),and the age of females[(48.89±19.53)years]was lower than that of males[(55.68±17.43)years].The age group with the most significant detec-tion rate of important abnormal results was 50-59 years old(3.07%),and the diseases detected by important abnormal results were as follows:There were 26 thyroid tumors,19 lung tumors,13 breast tumors,12 space occupying cases(3 liver,4 kidney,2 adrenal glands,1 adnexa,1 pancreas,1 mediastinum),9 vascular lesions,6 abnormal tumor markers,5 cervical lesions,1 tuberculosis,and 1 subdural hematoma.Among them,thyroid tumors,breast tumors,lung tumors and cervical lesions were the main cases in women,and vascular diseases,lung tumors,space-occupying lesions(liver and kidney)and thyroid tumors were the main cases in men.Conclusion Physical examination is of great significance in detecting important abnormal diseases.We should attach great importance to physical examination,detect serious diseases as early as possible,and strengthen health man-agement accordingly.

ObjectiveTo determine the death level and change trend of malignant tumors among residents in Yuyao， and to provide support for accurate prevention and control of malignant tumors. MethodsWe collected the death monitoring data of Yuyao registered residents from 2014 to 2021， and calculated the indicators， including crude mortality rate （CMR）， standardized mortality rate （SMR）， potential years of life lost （PYLL）， average years of life lost （AYLL）， and PYLL rate （PYLLR）. We also calculated the average annual change percentage （AAPC） using Joinpoint regression model. ResultsThere were 13 754 deaths from malignant tumors in Yuyao from 2014 to 2021， accounting for 26.54% of the total deaths in the same period. The average annual mortality rate was 205.63/10⁵， and the standardized mortality rate was 115.62/10⁵. The SMR showed a downward trend in 8 years （AAPC=-4.76%， t=-2.296， P=0.061）. The average annual mortality of malignant tumors was 274.15/10⁵， and the standardized mortality was 149.83/10⁵. The average annual mortality of female malignant tumors was 139.03/10⁵， the standardized mortality was 81.01/10⁵. Male mortality was higher than the female mortality （χ²=1 487.389， P<0.001）.The mortality rate of malignant tumors increased with age （AAPC=54.94%，t=27.678，P<0.001）. The mortality rate of malignant tumors in different age groups showed a downward trend in 8 years （AAPC=-5.74% for 0- years old group， -8.49% for 15- years old group， -6.02% for 45- years old group， and -3.49% for ≥65 years old group）. The top five causes of death from malignant tumors in residents were lung cancer， gastric cancer， liver cancer， esophageal cancer and colorectal cancer， accounting for 68.15% of all deaths from malignant tumors. Lung cancer ranked first among the causes of death from male and female malignant tumors. PYLL caused by malignant tumor death was 96 585.50 person years， AYLL was 7.02 years per person ， and PYLLR was 16.42‰. ConclusionThe mortality rate of malignant tumors among registered residents in Yuyao is on the decline， but it is still the primary death cause threatening the residents. Lung cancer is the malignant tumor that causes the greatest loss of life. It is urgent to build a comprehensive intervention system for malignant tumors that focuses on men， middle-aged and elderly people， advocate a healthy lifestyle， and combine early screening and reasonable treatment to block disease progress.

Objective:To study the effects of short-term (30 d) exposure to different levels of PM 2.5 on oocyte quality, embryo quality and pregnancy outcomes in patients with early-follicular phase downregulation scheme. Methods:From December 2018 to February 2019, and from July to September 2019, 348 patients with early-follicular phase downregulation scheme who underwent assisted reproduction and assisted pregnancy in the Reproductive Medicine Center, Renmin Hospital, Hubei University of Medicine were selected as the research objects in this retrospective cohort study. According to PM 2.5 new air quality standard, with 115 μg/m 3 as the cut-off value, the patients were divided into high exposure group ( n=94) and low exposure group ( n=254). During the period from the start of ovulation induction to the pregnancy test day, the activity areas of the patients are in the urban area of Shiyan City. The PM 2.5 of atmospheric fine particles during this period was calculated, including total amount and daily average amount. The effects of fine particulate matter PM 2.5 on ovum abnormality rate, embryo quality (number of available embryos, number of high-quality embryos, high-quality embryo rate, and blastocyst formation rate) and pregnancy outcome (pregnancy rate, abortion rate, live birth rate and proportion of low birth weight infants) were compared between the two groups. Results:Compared with the low exposure group, the number of available embryos (3.9±1.1 vs. 4.3±1.2, P=0.005), the number of high-quality embryos (2.9±1.5 vs. 3.4±1.7, P=0.001), high-quality embryo rate [35.5% (352/992) vs. 40.4% (792/1 959), P=0.009] and proportion of low birth weight infants [21.4% (12/56) vs. 5.13% (8/156), P<0.001] in the high exposure group were significantly decreased, and there was no significant difference in other data. Conclusion:Short-term exposure to high levels of PM 2.5 had significant negative effects on the number of available embryos, the number of high-quality embryos, the rate of high-quality embryos and proportion of low birth weight infants in the early-follicular phase down-regulation scheme.

Objective:To study the effects of short-term (30 d) exposure to different levels of PM 2.5 on oocyte quality, embryo quality and pregnancy outcomes in patients with early-follicular phase downregulation scheme. Methods:From December 2018 to February 2019, and from July to September 2019, 348 patients with early-follicular phase downregulation scheme who underwent assisted reproduction and assisted pregnancy in the Reproductive Medicine Center, Renmin Hospital, Hubei University of Medicine were selected as the research objects in this retrospective cohort study. According to PM 2.5 new air quality standard, with 115 μg/m 3 as the cut-off value, the patients were divided into high exposure group ( n=94) and low exposure group ( n=254). During the period from the start of ovulation induction to the pregnancy test day, the activity areas of the patients are in the urban area of Shiyan City. The PM 2.5 of atmospheric fine particles during this period was calculated, including total amount and daily average amount. The effects of fine particulate matter PM 2.5 on ovum abnormality rate, embryo quality (number of available embryos, number of high-quality embryos, high-quality embryo rate, and blastocyst formation rate) and pregnancy outcome (pregnancy rate, abortion rate, live birth rate and proportion of low birth weight infants) were compared between the two groups. Results:Compared with the low exposure group, the number of available embryos (3.9±1.1 vs. 4.3±1.2, P=0.005), the number of high-quality embryos (2.9±1.5 vs. 3.4±1.7, P=0.001), high-quality embryo rate [35.5% (352/992) vs. 40.4% (792/1 959), P=0.009] and proportion of low birth weight infants [21.4% (12/56) vs. 5.13% (8/156), P<0.001] in the high exposure group were significantly decreased, and there was no significant difference in other data. Conclusion:Short-term exposure to high levels of PM 2.5 had significant negative effects on the number of available embryos, the number of high-quality embryos, the rate of high-quality embryos and proportion of low birth weight infants in the early-follicular phase down-regulation scheme.

OBJECTIVE To prepare Neuritic acid oral emulsion ，to optimize its formulation and preparation technology ，and to investigate its stability. METHODS Neuritic acid oral emulsion was prepared by mechanical method. On the basis of single factor experiment ，the appearance ，centrifugal stability ，centrifugal stability constant （Ke）and particle size of the emulsion as indexes，the formulation was optimized by orthogonal design ，taking the dosage of oleic acid ，octylphenol polyoxyethylene ether-10 and propylene glycol as factors ，the preparation technology was optimized by taking emulsification temperature ，shear time，pressure of high-pressure homogenization and cycle times of high-pressure homogenization as factors. The content of neuritic acid was determined by high performance liquid chromatography. The stability of Neuritic acid oral emulsion was investigated by high temperature test ，accelerated test and long-term test. RESULTS The optimal formulation and preparation technology were as follows：neuritic acid of 1 g，oleic acid of 5％ ，octylphenol polyoxyethylene ether- 10 of 4％ ，propylene glycol of 2％ ， emulsification temperature of 60 ℃ ，shear time of 2 min，homogenization pressure of 40 MPa and cycle times of twice. After three experiments ，the average particle size of Neuritic acid oral emulsion was 158.05 nm（RSD＝1.58％，n＝3），the average Ke was 0.39（RSD＝1.49％，n＝3），and the appearance was uniform milky white ，there was no stratification. The results of high temperature test showed that Neuritic acid oral emulsion was prone to stratification in high temperature environment ，and the content of neuritic acid increased. The results of accelerated test and long-term test showed that there was no significant change in the appearance or the content of neuritic acid when Neuritic acid oral emulsion was placed at room temperature for 6 months. CONCLUSIONS The formulation and preparation technology are stable and feasible ，and can be used for the preparation of Neuritic acid oral emulsion. Neuritic acid oral emulsion should not be placed in high temperature environment. It has good stability at room temperature for 6 months.