OBJECTIVE To explore the mechanism of Chaiqi yigan granules （CQYG） against liver cancer through the ferroptosis pathway. METHODS Network pharmacology combined with ferroptosis-related database was used to screen key targets and main effective components of CQYG against liver cancer via regulating ferroptosis； molecular docking technology was employed to analyze the binding ability of main active components to key targets. Human liver Huh-7 cells were divided into blank serum control （CON） group， CQYG drug-containing serum （CQYGKL） group， ferroptosis inducer （RSL3） group， mammalian target of rapamycin complex 1 （mTORC1） inhibitor （RMC-5552） group， mTORC1 agonist （CCT007093） group， and CCT007093+CQYGKL group. The levels of Fe 2+ ， malondialdehyde （MDA）， and glutathione （GSH） in the cells were detected in the former three groups； mRNA expressions of mammalian target of rapamycin （mTOR）， sterol regulatory element-binding protein 1 （SREBP1）， and stearoyl-CoA desaturase 1 （SCD1）， protein expressions of SREBP1 and SCD1 as well as phosphorylation levels of mTOR and ribosomal S6 kinase （S6K） proteins were detected in all groups. RESULTS Key targets of CQYG for anti-liver cancer through the ferroptosis pathway were mTOR， SREBP1， SCD1，etc. The main active components included quercetin， tanshinone Ⅱ A ， baicalein， etc. The binding energies of main active components to key targets were all less than －5 kJ/mol. Compared with CON group， the levels of Fe 2+ and MDA in the cells in CQYGKL group and RSL3 group were significantly increased， while the levels of GSH were significantly decreased （ P ＜0.05）. mRNA expressions of mTOR， SREBP1 and SCD1， protein expressions of SREBP1 and SCD1， as well as the phosphorylation levels of mTOR and S6K proteins were significantly decreased in the CQYGKL group， RSL3 group， and RMC-5552 group， whereas all the above indicators were significantly increased in the CCT007093 group （ P ＜0.05）. Compared with CCT007093 group， the changes in all the above indicators were significantly suppressed in the CCT007093+CQYGKL group （ P ＜0.05）. CONCLUSIONS CQYG may induce ferroptosis by inhibiting mTORC1/SREBP1/SCD1 axis， thereby exerting anti-liver cancer effects.

Since the founding of the People’s Republic of China, remarkable achievements have been gained in infectious disease prevention and control, and rich practical experiences have been accumulated. If these experiences are shared with developing countries, it will greatly contribute to global infectious disease control and global health security. Under the framework of Forum on China-Africa Cooperation, a series of China-Africa public health capacity training programs have been recently held in China, in order to help improve the capability of infectious disease control in African countries. This article summarized and refined good design concepts and practices from these programs, so as to provide insights into sustainable optimization of China-Africa public health capacity training and improvements of the training effectiveness.

Objective To establish a highly efficient and sensitive technical system for the identification and analysis of platycodin-type saponins, systematically compare the differences in platycodin-type saponins among Platycodon grandiflorum from different producing areas, and provide scientific references for the screening of high-quality Platycodon grandiflorum resources, authenticity evaluation, and construction of standardized quality control systems. Methods A total of 45 batches of P. grandiflorum medicinal materials from 3 producing areas （Anhui, Henan, and Jilin, with 15 batches per area） were selected as research objects. Qualitative identification and semi-quantitative analysis of saponin components were performed based on ultra-high performance liquid chromatography-quadrupole-time-of-flight tandem mass spectrometry （UHPLC-Q-TOF/MS） technology. Meanwhile, two multivariate statistical methods, principal component analysis （PCA） and partial least squares-discriminant analysis （PLS-DA）, were combined to analyze the differences in platycodin-type saponins of Platycodon grandiflorus from different producing areas. Results A total of 28 saponin components were identified from Platycodon grandiflorus of the three producing areas. PCA results showed that there were minor differences in platycodin-type saponins between Henan Platycodon grandiflorus and Jilin Platycodon grandiflorus, while Anhui P. grandiflorum exhibited significant differences from both. PLS-DA further screened 15 major differential compounds. Among them, the contents of 6 components including 3''-O-acetylpolygalacin D2 and platycodin H in Anhui Platycodon grandiflorus were higher than those in Henan and Jilin Platycodon grandiflorus; platycodigenic acid A had the highest content in Jilin Platycodon grandiflorus; the contents of platycodin D3, polygalacin J, and polygalacin D were relatively higher in Henan Platycodon grandiflorus. Conclusion This study clarified the characteristic differences in core components of Platycodon grandiflorus from the three major producing areas, which provided an important theoretical basis for the screening of high-quality Platycodon grandiflorus resources, elucidation of the mechanism underlying its authenticity, and construction of a standardized quality control system.

Objective To analyze the differences in the epidemiological characteristics,susceptible popula-tions,and laboratory index of patients with common acute upper respiratory tract infections(novel coronavir-us infection,influenza A and influenza B)between plateau and plain areas.Methods Clinical data of 408 008 patients with symptoms of fever or upper respiratory tract infection in the fever clinic of the Second Affiliated Hospital of Zhejiang University and General Hospital of Xizang Military Command from January 2023 to Au-gust 2024 were collected.The epidemic characteristics,susceptible populations,and peripheral blood test data were compared and analyzed.Results The total positive rate of novel coronavirus infection,influenza A virus and influenza B virus infection in plain group(17.86％)was higher than that in plateau group(14.49％),and the difference was statistically significant(P＜0.05).The positive rates(17.98％and 17.76％)of male and female upper respiratory tract infection pathogens(novel coronavirus,influenza A virus and influenza B virus)in plain group were higher than those in plateau group(13.94％and 16.00％),and the differences were statis-tically significant(P＜0.05).The total positive rates of three kinds of upper respiratory tract infection patho-gens were 16.21％,18.27％and 14.63％in the plain group,and 14.62％,14.06％and 21.26％in the plateau group,respectively.According to the results of pathogen analysis of susceptible populations,whether it was plateau or plain,the positive rate of influenza A virus was higher in the minor group,the positive rate of influ-enza B virus was highest in the adult group,and the positive rate of novel coronavirus was highest in the elder-ly group.In terms of epidemic season,plateau and plain areas were different,and the epidemic occurred earlier in the plain area.In terms of peripheral blood test indicators,there were statistically significant differences in lymphocyte count,monocyte count,neutrophil to lymphocyte ratio and other indicators between plateau group and plain group(P＜0.05),while there were no statistically significant differences in white blood cell count between plateau group and plain group(P＞0.05).Conclusion The epidemiological characteristics of acute upper respiratory tract infection in plateau area are obviously different from those in plain area,which may be related to the natural environment and human geography environment.

Bone and joint infections(BJI)are serious postoperative complications,and traditional bacterial culture techniques serve as the gold standard for diagnosis,but there are problems with untimely or undiag-nosed diagnosis.Metagenomics next-generation sequencing(mNGS),as an emerging technology,can detect various pathogens such as bacteria,viruses,parasites,and fungi in samples without bias,providing a new ap-proach for the diagnosis of BJI.This article reviews the application progress of mNGS in BJI,including techni-cal principles,advantages,limitations,and clinical application status.mNGS exhibits high sensitivity and speci-ficity in the diagnosis of prosthetic joint infections(PJI),and its advantages are obvious especially in cultiva-ting negative cases.In addition,mNGS can optimize traditional culture methods,improve the sensitivity of in-traoperative culture,and be used to guide antibiotic selection.However,mNGS has limitations such as slow database updates,sample contamination,and high costs.Further research is needed in the future to elucidate its complete clinical benefits and promote its widespread application in the field of orthopedics.

Objective:To investigate the effectiveness of combined teaching method integrating case-based teaching method(CBL),problem-based teaching method(PBL),and team-based teaching method(TBL)in clinical nursing teaching in pediatric intensive care unit(PICU).Methods:A total of 60 nursing students who trained in our PICU from Jan 2021 to Jun 2022 were selected as the control group,and 60 nursing students who trained in our PICU from Jul 2022 to Jun 2024 were selected as the research group.The control group received conventional nursing teaching mode,while the research group received combined teaching mode of CBL,PBL,and TBL.The scores of academic performance,logical thinking ability,self-learning ability,and clinical nursing comprehensive ability between the two groups were compared.Result:The scores of theoretical knowledge,operational skills,post-teaching Critical Thinking Disposition Inventory-Chinese Version(CTDI-CV)scale,self-directed learning readiness scale for nursing,and Mini-clinical evaluation exercise scale(Mini-CEX)in the research group were higher than those in the control group(P＜0.05).Conclusion:The combined teaching method of CBL,PBL,and TBL can effectively improve clinical nursing teaching results and comprehensive abilities of nursing students.

Objective:To investigate the effect of glucagon like peptide-2(GLP-2)on 2,4,6-trinitrobenzenesulfonic acid(TNBS)induced intestinal mucosal tissue damage and the effects of helper T cell 1/helper T cell 2(Th1/Th2)balance in rats with Crohn's disease(CD).Methods:Forty rats were randomly divided into control group,CD group,treatment(CD+GLP-2)group and positive control[CD+sulfasalazine(SASP)]group,with 10 rats in each group.TNBS induced CD model was established and the rats in the other 3 groups were given corresponding treatment.After completion,colon macroscopic damage index(CMDI)was evaluated,HE staining was used to observe the histopathological changes of intestinal mucosa,TUNEL staining was used to detect apoptosis of co-lonic tissue cells,ELISA was used to determine serum IFN-γ,TNF-α,IL-12,IL-4 and IL-10,immunohistochemical staining was used to detect the expressions of IFN-γ and IL-4 in colon tissues,flow cytometry was used to determine the proportion of Th1/Th2 in spleen.Results:Compared with CD group,CMDI in CD+GLP-2 group and CD+SASP group were significantly decreased(P all<0.001),intes-tinal mucosal damage was improved,the positive rate of TUNEL in colon tissue was significantly decreased(P all<0.001),the con-tents of IFN-γ,TNF-α and IL-12 in serum were significantly decreased(P all<0.001),the contents of IL-4 and IL-10 in serum were significantly increased(P all<0.001),the expression of IFN-γ in colon tissue was significantly decreased and the expression of IL-4 was significantly increased(P all<0.001),the proportion of Th1 cells was significantly decreased while the proportion of Th2 cells was significantly increased(P all<0.001),Th1/Th2 also decreased significantly(P all<0.001).Conclusion:GLP-2 can effectively im-prove the intestinal mucosal injury of CD rats induced by TNBS,and the mechanism may be related to regulating the immune balance of Th1/Th2 cells,inhibiting inflammatory response and reducing cell apoptosis.

Objective:To investigate the effectiveness of combined teaching method integrating case-based teaching method(CBL),problem-based teaching method(PBL),and team-based teaching method(TBL)in clinical nursing teaching in pediatric intensive care unit(PICU).Methods:A total of 60 nursing students who trained in our PICU from Jan 2021 to Jun 2022 were selected as the control group,and 60 nursing students who trained in our PICU from Jul 2022 to Jun 2024 were selected as the research group.The control group received conventional nursing teaching mode,while the research group received combined teaching mode of CBL,PBL,and TBL.The scores of academic performance,logical thinking ability,self-learning ability,and clinical nursing comprehensive ability between the two groups were compared.Result:The scores of theoretical knowledge,operational skills,post-teaching Critical Thinking Disposition Inventory-Chinese Version(CTDI-CV)scale,self-directed learning readiness scale for nursing,and Mini-clinical evaluation exercise scale(Mini-CEX)in the research group were higher than those in the control group(P＜0.05).Conclusion:The combined teaching method of CBL,PBL,and TBL can effectively improve clinical nursing teaching results and comprehensive abilities of nursing students.

Purpose To explore the clinical and pathological characteristics of gastric amphicrine carcinoma(AC).Methods Clinical data of 12 patients with gastric AC were collected,and their clinical pathological character-istics and histological morphology were observed.Immunohistochemical staining,special staining,and electron micros-copy techniques were used to analyze their immune phenotype and ultrastructure.Molecular pathology was used to de-tect microsatellite status.Relevant literature was reviewed.Results Ten cases of gastric AC were located at the junc-tion of the esophagus and stomach/cardia,1 case at the gastric angle,and 1 case in the gastric antrum.The average maximum diameter of tumors was 4.25 cm.There were different proportions of tumor cells with signet-ring like charac-teristics in all cases.Four cases had neuroendocrine carcinoma components,and another 4 had adenocarcinoma.Elev-en cases had nerve invasion and vascular cancer thrombus.Eleven cases invaded the serosal layer/submucosal layer,and 1 case invaded the submucosal layer.Ten cases had lymph node metastasis.All 12 cases showed diffuse expression of CKpan and Syn,with 3 cases showed diffuse expression of CgA and 7 cases showed diffuse expression of CD56.The average proliferation index of Ki67 was 78.9％.Special staining showed clear intracellular mucus.Electron microscopy examination revealed electron dense particles and mucus particles within the tumor cells.A total of 10 patients were fol-lowed up,of which 7 survived,and 3 patients died from multiple systemic metastases at 0,24,and 30 months postop-eratively.Conclusion Gastric AC was more common in the junction of the esophagus and stomach/cardia,and histol-ogy shows a higher invasiveness.Their clear diagnosis depends on histological morphology,immunohistochemistry,and special staining.

Objective:To examine the current diagnostic and treatment practices, as well as surgical outcomes, for individuals over the age of 60 diagnosed with acute aortic arch dissection(ATAAD)at Tianjin University Chest Hospital.This analysis evaluates the safety and feasibility of performing open surgical procedures on elderly patients affected by aortic dissection.Methods:A retrospective analysis was conducted on 509 patients diagnosed with ATAAD who were registered in the Chest Pain Center data reporting platform(https: //datacs.chinacpc.org/)at Tianjin Chest Hospital, covering the period from June 2015 to December 2021.The patients were divided into two groups: the elderly group, consisting of individuals aged 60 years or older, and the non-elderly group, comprising those under 60 years of age.Their surgical conditions and short-term outcomes were subsequently examined and compared.Results:A total of 509 patients were included, 311 cases(61.1%)were identified within the non-elderly group, with a mean age of 45.78 ± 8.96 years(range: 21-59 years).In contrast, 198 cases(38.9%)belonged to the elderly group, with a mean age of 65.61 ± 4.13 years(range: 60-81 years).A total of 416 patients(81.7%)received surgical intervention.Among those who underwent surgery, the elderly group exhibited a significantly higher proportion of females(38.1% vs.20.6%, P<0.001), and these patients had smaller body surface areas and lower body mass index values.Furthermore, a greater number of elderly patients presented with comorbid conditions such as hypertension, coronary artery disease, chronic obstructive pulmonary disease, and stroke(all P<0.05).The 30-day all-cause mortality rate, incidence of cerebral infarction, and rate of continuous renal replacement therapy(CRRT)utilization were similar in both groups(20.9% vs.18.8%、15.1% vs.10.5%、19.4% vs.18.1%, all P>0.05).However, elderly patients experienced longer postoperative recovery durations, extended periods of ventilator dependency, and a higher incidence of new-onset atrial fibrillation following surgery(all P<0.05). Conclusions:The surgical rate for elderly patients with ATAAD is low, suggesting that there is significant potential for improvement in clinical diagnosis and treatment.Advanced age should not be viewed as a contraindication for surgery; rather, appropriate case selection and personalized treatment plans can enhance the success rate of surgical interventions.