Objective To investigate the effect of perindopril on the nicotinamide adenine dinucleotide phosphate(NADPH)oxidase 4(NOX4)/NOD-like receptor protein 3(NLRP3)signaling pathway in rat liver fibrosis induced by thioacetamide(TAA).Methods Thirty-two SD rats were randomly divided into the blank group,the model group(TAA 200 mg/kg,twice a week for 6 weeks)and the low/high dose group(TAA+perindopril 2/8 mg/kg),with 8 rats in each group.Two weeks after modeling,the administration group was given the corresponding dose of perindopril by gavage(for 4 weeks).At the end of the 6th week,liver pathological sections were used to observe pathological changes of liver tissue and degrees of fibrosis and inflammation.The biochemical analyzer was used to detect alanine aminotransferase(ALT)and aspartate aminotransferase(AST).Enzyme-linked immunosorbent assay(ELISA)was used to detect NLRP3 and IL-1β.Immunohistochemistry was used to detect NOX4,NLRP3,Caspase-1,IL-1β protein and α-smooth muscle agonist protein(α-SMA).Results Compared with the blank group,liver collagen fibers were significantly proliferated in the model group,a large number of inflammatory cells infiltrated,and serum levels of ALT and AST,as well as NLRP3 and IL-1β in rats were significantly increased.The average optical density values of positive proteins such as NOX4,NLRP3,Caspase-1,IL-1β and α-SMA in rat liver tissue increased significantly(P<0.05).Compared with the model group,the proliferation of collagen fibers and inflammatory infiltration were significantly reduced in both the low-dose and high-dose groups,and serum levels of ALT and AST,NLRP3 and IL-1β in rats were significantly decreased.The average optical density values of positive proteins such as NOX4,NLRP3,Caspase-1,IL-1β and α-SMA in rat liver tissue decreased significantly(P<0.05).Moreover,the degree of liver fibrosis reduction in rats was better in the high-dose group than that in the low-dose group.Conclusion Perindopril may regulate the NLRP3 signaling pathway by inhibiting the expression of NOX4,thereby reducing oxidative stress damage and inflammatory responses and thus delaying the process of liver fibrosis.

Humanistic caring for patients in the operating room refers to providing the whole process of caring medical services for patients in the operating room. In order to standardize humanistic caring services for patients in the operating room of medical institutions, improve the comprehensive service level of the operating room, and enhance the surgical experience of patients, the Chinese Association for Life Care released the group standard " Humanistic Caring Management Standards for Patients in the Operating Room" in December 2023. This article interpreted the basic requirements for humanistic caring of patients in the operating room, the environment and facilities for humanistic caring, the procedures and measures for humanistic caring, and the quality management framework, aiming to assist administrators and clinical practitioners across various levels of medical institutions in accurately understanding and effectively implementing the standard, and to provide essential textual reference and practical guidance for promoting the application of the standard.

Objective To investigate the effect of perindopril on the nicotinamide adenine dinucleotide phosphate(NADPH)oxidase 4(NOX4)/NOD-like receptor protein 3(NLRP3)signaling pathway in rat liver fibrosis induced by thioacetamide(TAA).Methods Thirty-two SD rats were randomly divided into the blank group,the model group(TAA 200 mg/kg,twice a week for 6 weeks)and the low/high dose group(TAA+perindopril 2/8 mg/kg),with 8 rats in each group.Two weeks after modeling,the administration group was given the corresponding dose of perindopril by gavage(for 4 weeks).At the end of the 6th week,liver pathological sections were used to observe pathological changes of liver tissue and degrees of fibrosis and inflammation.The biochemical analyzer was used to detect alanine aminotransferase(ALT)and aspartate aminotransferase(AST).Enzyme-linked immunosorbent assay(ELISA)was used to detect NLRP3 and IL-1β.Immunohistochemistry was used to detect NOX4,NLRP3,Caspase-1,IL-1β protein and α-smooth muscle agonist protein(α-SMA).Results Compared with the blank group,liver collagen fibers were significantly proliferated in the model group,a large number of inflammatory cells infiltrated,and serum levels of ALT and AST,as well as NLRP3 and IL-1β in rats were significantly increased.The average optical density values of positive proteins such as NOX4,NLRP3,Caspase-1,IL-1β and α-SMA in rat liver tissue increased significantly(P<0.05).Compared with the model group,the proliferation of collagen fibers and inflammatory infiltration were significantly reduced in both the low-dose and high-dose groups,and serum levels of ALT and AST,NLRP3 and IL-1β in rats were significantly decreased.The average optical density values of positive proteins such as NOX4,NLRP3,Caspase-1,IL-1β and α-SMA in rat liver tissue decreased significantly(P<0.05).Moreover,the degree of liver fibrosis reduction in rats was better in the high-dose group than that in the low-dose group.Conclusion Perindopril may regulate the NLRP3 signaling pathway by inhibiting the expression of NOX4,thereby reducing oxidative stress damage and inflammatory responses and thus delaying the process of liver fibrosis.

Humanistic caring for patients in the operating room refers to providing the whole process of caring medical services for patients in the operating room. In order to standardize humanistic caring services for patients in the operating room of medical institutions, improve the comprehensive service level of the operating room, and enhance the surgical experience of patients, the Chinese Association for Life Care released the group standard " Humanistic Caring Management Standards for Patients in the Operating Room" in December 2023. This article interpreted the basic requirements for humanistic caring of patients in the operating room, the environment and facilities for humanistic caring, the procedures and measures for humanistic caring, and the quality management framework, aiming to assist administrators and clinical practitioners across various levels of medical institutions in accurately understanding and effectively implementing the standard, and to provide essential textual reference and practical guidance for promoting the application of the standard.

Since the 1970s, the laboratory animal industry in Suzhou has gone through five stages: its inception, emergence, growth, transformation, and scaling up. It began with the manufacturing of caging equipment for laboratory animals, initially by imitation and later through independent innovation. The industry evolved from sporadic factories to clustered enterprises, gradually growing and opening up the export market for caging equipment. In the 21st century, with industrial upgrading and transformation, purification systems and related products began to develop, and industry organizations emerged. As China has modernized, the rise of automation and intelligent production has led to technological innovation in enterprises and the emergence of various outsourcing services in the laboratory animal industry, driving the large-scale development of the industrial chain. After nearly half a century of growth, the laboratory animal industry in Suzhou has formed a complete industrial chain, including the production of laboratory animals, caging equipment, feed and bedding materials, design and construction of laboratory animal facilities, quality testing of laboratory animals and environments, and animal experimentation services. Laboratory animal breeding equipment, the core of the industry, has reached the level of developed countries, and the industry's scale and influence are unmatched in China. Since the 21st century, biopharmaceuticals have become the "No.1 industry" in the development of Suzhou. With government support, the guidance of the local economy, and the assistance from universities and research institutes, the animal experiment outsourcing industry has begun to cluster in Suzhou. The continuous influx of CROs has driven the construction of large-scale laboratory animal facilities, and key research projects have been initiated, significantly enhancing the industry's R&D capabilities. The Suzhou laboratory animal industry has quickly expanded alongside the "No. 1 industry," creating a unique "Suzhou Path" for laboratory animals. Over nearly fifty years, the laboratory animal industry in Suzhou has been essential to the rapid development of the biopharmaceutical industry in Suzhou and China.

Objective:To analyze the relationship between killer cell immunoglobulin-like receptor ( KIR) genes and immune reconstitution failure in human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS) patients after anti-retroviral therapy (ART). Methods:HIV/AIDS patients receiving ART for ≥1 year who attended the AIDS outpatient clinics of Wuming Hospital of Guangxi Medical University and People′s Hospital of Mashan from May 2007 to December 2019 were included. Patients were divided into immune reconstitution failure group and full immune reconstitution group. Polymerase chain reaction with sequence specific primers (PCR-SSP) was used to detect KIR genotypes in all subjects, and the genotype frequency (PF) of 16 KIR genotypes was calculated. Statistical analysis was conducted using chi-square test. Multivariate logistic regression was used to analyze the relationship between KIR genotypes and immune reconstitution failure.Results:There were 102 patients with HIV/AIDS, including 44 immunological non-responders and 58 immunological responders. The PF of KIR2 DL5 in immune reconstitution failure group was 59.09%(26/44), which was higher than 36.21%(21/58) in full immune reconstitution group, and the difference was statistically significant ( χ2=5.27, P=0.022). Multivariate logistics regression analysis showed that KIR2 DL5 was associated with immune reconstitution failure when adjusted for age and baseline CD4 + T cell count. Positive expression of KIR2 DL5 may be a risk factor for immune reconstitution failure (adjusted odds ratio (a OR)=2.431, 95% confidence interval 1.012 to 5.844, P=0.047). Conclusions:Positive expression of KIR2 DL5 may be related to immune reconstitution failure in HIV/AIDS patients after ART.

Under the background of performance evaluation in nationwide tertiary public hospitals and the DRGs reform, how to improve the efficiency of daytime surgery management is becoming a hotspot for hospital managers. Since July 2020, a tertiary general hospital applied the theory of incentive compatibility to guide the medical workers to consciously strive to achieve such management goals as improving the quantity and quality of daytime surgeries by constructing an organizational management system, increasing performance rewards for daytime surgical teams, rewarding advanced collectives and individuals, convening work coordination and promotion meetings, formulating penalty terms, and strengthening supervision of surgical quality and safety indicators. The implementation rate of daytime surgery in hospitals, the number of departments conducting daytime surgery, the number of covered diseases, and the satisfaction rate of inpatients had increased from 6.94%, 6 departments, 64 diseases, and 90.5% in 2019 to 24.08%, 21 departments, 125 diseases, and 95.0% in 2022, respectively. The incidence of daytime surgical bleeding, and readmissions within 15 days decreased from 0.6% and 0.5% in 2019 to 0.5% and 0.2% in 2022, respectively. The theory of incentive compatibility was in line with the development goals of daytime surgery in China, providing an optimal strategy for improving the management efficiency of daytime surgery according to local conditions.

Objective To explore the characteristics of opportunistic infections(OIs)in HIV-infected indi-viduals with suboptimal immune reconstitution after ART treatment so as to provide a reference for preventing and managing HIV infections.Methods The clinical data including opportunistic infections specifically were acquired from 112 HIV-infected individuals with suboptimal immune reconstitution from the outpatient department of Wuming Hospital,Guangxi Medical University.The impact of baseline CD4+T lymphocyte counts on the incidence,type,and mixed infection rates of the opportunistic infections were analyzed.Results The opportunistic infection rate among the 112 HIV-infected individuals with suboptimal immune reconstitution was 42.86%,among which fungal infections were the most commonly seen.The opportunistic infection rate of the patients with a baseline of CD4+T lymphocyte counts≤50/μL was significantly higher than that of the patients with a baseline of CD4+T lymphocyte counts>50/μL,and there was no significant difference in the type of opportunistic infections as well as the rate of mixed infections.Conclusion HIV-infected people with suboptimal immune reconstitution in Guangxi are susceptible to HIV OIs.Among them,the group with a baseline CD4+ T lymphocyte counts≤50/μL has a higher rate of OIs,mainly fungal infections.

Objective:To analyze the detection strategy and basic detection situation of markers of infectious diseases transmitted by transfusion in blood testing laboratories of blood stations in China.Methods:Based on the data of practice comparison working party of Blood Stations in Mainland of China from 2017 to 2021, the data on the testing strategies and the basic detection information of the markers for the transmission of infectious diseases through transfusion in the member laboratories of the practice comparison working party of Blood Stations in Mainland of China from 2017 to 2021 were collected, and the situation of the selection for testing markers, testing strategy and the testing method and other relevant aspects were sorted out and analyzed by charts.Results:The selection of the testing markers was consistent, but HTLV testing item was added in some member laboratories. The detection strategy of using two ELISA reagents and one nucleic acid testing (NAT) reagent simultaneously was adopted in 47 member blood stations; 3) NAT method was dominated by mini pool-NAT in member laboratories. The number of members adopting mini-pools of 8 (MP8)-NAT decreased from 17 in 2017 to 14 in 2021, while the number of members adopting mini-pools of 6 (MP6)-NAT increased from 13 in 2017 to 22 in 2021; Roche NAT system accounted for the largest proportion.Conclusions:In order to ensure blood safety and avoid missing detection, the blood stations still adopt the detection strategy of using two ELISA reagents and one nucleic acid testing (NAT) reagent simultaneously; Meanwhile, in order to increase the NAT positive rate, the proportion of mini pool-NAT mainly decreased year by year despite its dominating role, while the proportion of individual donation-NAT increased year by year; NAT method is transiting from mini-pools of 8 (MP8) to mini-pools of 6 (MP6); The proportion of imported NAT system used in NAT laboratory is relatively large.

Phosphodiesterase-4 (PDE4) functions as a catalyzing enzyme targeting hydrolyzation of intracellular cyclic adenosine monophosphate (cAMP) and inhibition of PDE4 has been proven to be a competitive strategy for dermatological and pulmonary inflammation. However, the pathological role of PDE4 and the therapeutic feasibility of PDE4 inhibitors in chronic ulcerative colitis (UC) are less clearly understood. This study introduced apremilast, a breakthrough in discovery of PDE4 inhibitors, to explore the therapeutic capacity in dextran sulfate sodium (DSS)-induced experimental murine chronic UC. In the inflamed tissues, overexpression of PDE4 isoforms and defective cAMP-mediating pathway were firstly identified in chronic UC patients. Therapeutically, inhibition of PDE4 by apremilast modulated cAMP-predominant protein kinase A (PKA)-cAMP-response element binding protein (CREB) signaling and ameliorated the clinical symptoms of chronic UC, as evidenced by improvements on mucosal ulcerations, tissue fibrosis, and inflammatory infiltrations. Consequently, apremilast maintained a normal intestinal physical and chemical barrier function and rebuilt the mucosal homeostasis by interfering with the cross-talk between human epithelial cells and immune cells. Furthermore, we found that apremilast could remap the landscape of gut microbiota and exert regulatory effects on antimicrobial responses and the function of mucus in the gut microenvironment. Taken together, the present study revealed that intervene of PDE4 provided an infusive therapeutic strategy for patients with chronic and relapsing UC.