ObjectiveTo evaluate the antitumor activity of Periplaneta americana extract（PAE） against human-derived lung adenocarcinoma organoids（LUAD-PDOs） and to elucidate its potential mechanism based on transcriptomics. MethodsFresh tumor and adjacent normal tissues from patients with LUAD were collected to construct LUAD-PDOs and normal lung organoid（Nor-PDOs） models using 3D organoid culture technology. The effective intervention concentration of PAE was determined using the cell counting kit-8（CCK-8） assay. Experimental groups included the model group（LUAD-PDOs）， normal group， model administration group（LUAD-PDOs+PAE）， and normal administration group（Nor-PDOs+PAE）. Hematoxylin-eosin（HE） staining was used to observe the pathological structures of PDOs， immunohistochemistry（IHC） was performed to detect the expressions of the proliferation marker Ki-67 and lung adenocarcinoma differentiation markers cytokeratin-7（CK-7） and Napsin A， TUNEL staining was applied to detect cell apoptosis. RNA sequencing（RNA-Seq） was conducted to identify differentially expressed genes（DEGs）， followed by Gene Ontology（GO）， Kyoto Encyclopedia of Genes and Genomes（KEGG）， and Gene Set Enrichment Analysis（GSEA）， alongside protein-protein interaction（PPI） network analysis to screen core mechanisms. Finally， key targets were validated by integrating external database analysis with immunofluorescence（IF）. ResultsNor-PDOs and LUAD-PDOs that highly recapitulated the pathological characteristics of the primary tissues were successfully established. The CCK-8 assay determined that the effective intervention concentration of PAE was 16 g·L^-1. Morphological observation showed that Nor-PDOs exhibited lumen-forming structures， whereas LUAD-PDOs displayed dense， solid structures. CCK-8 and TUNEL assays revealed that， compared with the model group， PAE intervention inhibited the proliferation of LUAD-PDOs and promoted apoptosis in LUAD cells， while showing no significant effect on the viability of Nor-PDOs. Transcriptomic analysis identified 719 DEGs that were significantly reversed after PAE intervention（347 up-regulated and 372 down-regulated）（P<0.05）. GO enrichment analysis indicated that DEGs in the model administration group were significantly enriched in biological processes related to cell cycle regulation compared to the model group. KEGG pathway analysis revealed that PAE affected pathways related to proliferation and metabolism， including pathways in cancer and the p53 signaling pathway. GSEA further confirmed that PAE significantly enhanced the activity of the p53 signaling pathway（P<0.05）. PPI network analysis indicated that breast cancer type 1 susceptibility protein（BRCA1） and checkpoint kinase 1（CHEK1） were the core down-regulated targets in the p53 pathway. IF verified the high expression of BRCA1 and CHEK1 in LUAD-PDOs and their significant downregulation after PAE intervention（P<0.05）. Furthermore， survival analysis based on The Cancer Genome Atlas（TCGA） database indicated that low expression of BRCA1 and CHEK1 was significantly associated with prolonged overall survival in patients with LUAD（P<0.05）. ConclusionPAE effectively inhibits proliferation of LUAD-PDOs and promotes their apoptosis， its anti-tumor mechanism is potentially associated with the activation of the p53 signaling pathway， with BRCA1 and CHEK1 genes likely serving as key downstream targets for the effects of PAE.

Objective: To evaluate the efficacy and safety of ruxolitinib combined with low-dose hormone for patients with acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods: Thirty patients with aGVHD after allo-HSCT admitted to the Department of Hematology of the General Hospital of Western Theater Command from November 2021 to November 2024 were retrospectively analyzed. All patients were treated with low-dose hormone (methylprednisolone 0.3-1 mg kg -d ) combined with ruxolitinib 5-10 mg d . The efficacy and adverse reactions were observed during the follow-up period to analyze the survival outcomes of the patients. Results: A total of 30 patients with aGVHD after allo-HSCT were included in this study, consisting of 15 (50%) males and 15 (50%) females with a median age of 34 year-old (ranging from 14 to 62). Classification by disease type: there were 18 cases of acute myeloid leukemia, 4 cases of acute lymphoblastic leukemia, 4 cases of aplastic anemia, and 4 cases of myelodysplastic syndrome. Classification by aGVHD severity: there were 27 cases (90%) of Ⅱ-Ⅳ degree aGVHD and 11 cases (36.7%) of Ⅲ-Ⅳ degree aGVHD. Ruxolitinib in combination with low-dose glucocorticoid treatment yield responses in 28 (93.3%) patients, of which 27 (90%) achieved complete remission (CR), while 1 (3.3%) showed partial remission (PR). One patient (3.3%) had no response (NR), and 1 patient (3.3%) exhibited progressed disease (PD). Overall survival (OS) at 1 year of transplantation was 73.9% (95%CI 49.5% to 87.7%), progression-free survival (PFS) was 93.3% (95%CI 75.9% to 98.3%), non-relapse mortality (NRM) was 20.6% (95%CI 7.9% to 47.4%), and median survival time was 27.6 months. Conclusion: Ruxolitinib combined with low-dose hormones is safe and effective in the treatment of aGVHD after allo-HSCT.

Objectives: . The prognostic value of the pretreatment albumin-to-alkaline phosphatase ratio (AAPR) in head and neck cancer (HNC) remains uncertain. This meta-analysis aimed to evaluate the predictive role of AAPR for survival outcomes in patients with HNC. Methods: . A comprehensive search of the Cochrane Library, PubMed, and Embase databases was conducted to identify relevant studies published up to July 30, 2024. We included studies on AAPR and survival outcomes in HNC patients. Results: . Eight studies comprising 1,737 HNC patients were analyzed using random-effects models. Lower AAPR values were significantly correlated with worse overall survival (hazard ratio [HR], 2.08), progression-free survival (HR, 2.00), and disease-free survival (HR, 2.18). Sensitivity analyses confirmed the robustness of these results, with no significant publication bias detected. Conclusion . Our findings suggest that pretreatment AAPR could serve as a valuable and cost-effective prognostic indicator in HNC, potentially aiding clinicians in risk stratification and treatment decision-making. However, additional validation studies are warranted to confirm its clinical applicability.

Objective To evaluate the effect of bundle intervention on reducing catheter-associated urinary tract in-fection(CAUTI).Methods Hospitalized patients with urinary catheterization in a tertiary first-class hospital were subjected to targeted monitoring of a baseline survey from January to December 2022(pre-intervention).The main causes were found out,and bundle intervention measures were developed and implemented through plan-do-check-act(PDCA)tools from January to March 2023(intervention period).The data from April to December 2023(post-intervention)were collected,difference in catheter use rate and incidence of CAUTI before and after intervention were compared.Results The implementation rate of correctly hanging urine collection bags after intervention was 97.00％,the implementation rate of timely emptying urine collection bags was 91.72％,awareness rate of hand hy-giene among patient's family members was 79.13％,implementation rate of urinary catheter clamping during trans-portation was 74.79％,and daily evaluation implementation rate was 87.68％,which were higher than the pre-in-tervention rates of 85.63％,80.47％,62.75％,60.00％,and 79.93％,respectively.The incidence of CAUTI de-creased from 1.23‰ before intervention to 0.57‰ after intervention,the use rate of urinary catheter decreased from 5.53％before intervention to 5.37％after intervention.Differences of the above indicators were all statistically sig-nificant(all P＜0.05).Conclusion Through targeted monitoring on CAUTI and PDCA quality tools,the weak links in healthcare-associated infection control are identified,more targeted prevention and control measures are for-mulated,the implementation of bundle intervention measures can reduce the incidence of CAUTI.

Objective:To establish a high performance liquid chromatography-evaporative light scattering detector(HPLC-ELSD)technique for simultaneous determining the content of excipients sucrose and mannitol in meningo-coccal polysaccharide vaccine.Methods:Using NanoChrom Sugar-10Ca analytical column(300 mm × 7.8 mm)and HPLC system(Agilent 1260).With purified water as the mobile phase,a flow rate of 0.5 mL·min-1,column temperature was 80 ℃,and the injection volume was 50 μL.The evaporative light detector was based on nitrogen.The carrier gas flow rate is 3.2 L·min-1,the temperature of drift tube was 1 10 ℃,the gain value was 1,and the impactor was"mode 1".This assay was subsequently validated for its system suitability,specificity,repeatability,intermediate precision and linearity,and accuracy.The established method was used to assay the contents of the sucrose and mannitol in four batches of meningococcal polysaccharide vaccine.Results:The estab-lished HPLC-ELSD method showed good systemic suitability.Specificity validation showed that there was no inter-ference peak in the blank solvent;the separation of the target peaks between sucrose and mannitol was＞2.0.The relative standard deviations(RSD)value of peak area of sucrose and mannitol in six tests were 0.44％and 0.38％,respectively.RSD of intermediate precision of both sucrose and mannitol were lower than 2.00％,indica-ting that the precision of high performance liquid chromatography instrument was well.The linear range of two excipients were 12.5-150.0 μg·mL-1(R2＞0.99,respectively).The recovery rate of sucrose and mannitol were 95.74％-99.33％,94.37％-98.85％,respectively.There was no significant difference in the contents of sucrose and mannitol in 4 batches of meningococcal polysaccharide vaccine.Conclusion:The HPLC-ELSD method showed good specificity,precision,linearity and accuracy,and the test results were stable and reliable,so that it is suitable for simultaneous determination of sucrose and mannitol contents of meningococcal polysaccharide injections.

Objective To elucidate the molecular mechanism of reserpine-induced depression using network toxicology,molecular docking techniques,behavioral assessments of animal models,and histopathological analyses.Methods Core targets were screened using multi-database network toxicology,followed by the construction of a protein-protein interaction network and validation of core targets through molecular docking.Sprague Dawley rats were divided randomly into control and reserpine(0.5 mg/kg)groups,and administered the corresponding treatments once daily for 4 consecutive days.Behavioral changes were assessed using the forced-swim and open-field tests.Serum neurotransmitters were quantified by enzyme-linked immunosorbent assay and neuropathological damage was observed via tissue staining.Target gene expression regulation was verified by Western blot.Results Network toxicology screening and molecular docking simulation demonstrated that reserpine exhibited significant binding affinity with the dopamine D2 receptor,cyclic-AMP response element binding protein,and serine/threonine-protein kinase 1(AKT1).Animal experiments demonstrated that reserpine-treated rats displayed depression-like behaviors,including motor inhibition(P＜0.01),with decreased serum levels of norepinephrine and 5-hydroxytryptamine(P＜0.01),respectively.Pathological observations revealed microglial proliferation in the cerebral cortex,increased apoptosis,and reduced Nissl bodies in the hippocampal CA1 region.Down-regulation of brain-derived neurotrophic factor(BDNF)in brain tissue and decreased expression of hippocampal AKT1 and phosphorylated AKT1 were also observed.Conclusions Reserpine influences monoamine transmitter metabolism and neuronal structural integrity via the inhibition of BDNF and AKT1 protein expression,resulting in depressive-like behavior and cerebral nerve damage in rats.

Gastrointestinal dysfunction is a common and significant complication in colorectal surgical practice, which is associated with gut microbiota dysbiosis caused by various perioperative interventions. Currently, enhanced recovery after surgery (ERAS) protocols have been increasingly adopted in clinical practice, greatly accelerating the recovery of postoperative intestinal function. However, there are still no effective interventions in the ERAS protocols to target surgery-induced gut microbiota dysbiosis. Probiotics, as a key treatment method targeting the gut microbiota, can stimulate intestinal motility, inhibit the colonization of pathogenic bacteria, enhance intestinal barrier function, among other effects. Based on these effects of probiotics, they are expected to resolve the neglected gut microbiota dysbiosis, further accelerating the postoperative recovery of intestinal function after colorectal surgery. This article reviews the mechanisms and clinical progress in postoperative bowel functional recovery after colorectal surgery.

Osteoarthritis(OA)is a common joint disease in clinical practice,and cartilage damage is a typical pathological change.The pathogenesis of OA is complex,and various adverse factors can lead to the occurrence of OA.Mitochondria are im-portant organelles within cells and play important roles in cellular physiological and pathological activ-ities.Mitochondrial quality control is an important regulatory mechanism in the body to maintain nor-mal mitochondrial structure and function,mainly including mitochondrial biogenesis,mitochondrial dynamics,mitochondrial autophagy,mitochondrial oxidative stress,and other forms.The imbalance of mitochondrial quality control in chondrocytes is closely related to the occurrence and development of osteoarthritis,and regulating the balance of mi-tochondrial quality control is a potential therapeu-tic point for osteoarthritis.The author reviewed rel-evant research literature in recent years to provide a review of the relationship between mitochondrial quality control and the occurrence and develop-ment of osteoarthritis,in order to provide new ideas and directions for the research and diagnosis and treatment strategies of osteoarthritis.

Objective To evaluate the effect of bundle intervention on reducing catheter-associated urinary tract in-fection(CAUTI).Methods Hospitalized patients with urinary catheterization in a tertiary first-class hospital were subjected to targeted monitoring of a baseline survey from January to December 2022(pre-intervention).The main causes were found out,and bundle intervention measures were developed and implemented through plan-do-check-act(PDCA)tools from January to March 2023(intervention period).The data from April to December 2023(post-intervention)were collected,difference in catheter use rate and incidence of CAUTI before and after intervention were compared.Results The implementation rate of correctly hanging urine collection bags after intervention was 97.00％,the implementation rate of timely emptying urine collection bags was 91.72％,awareness rate of hand hy-giene among patient's family members was 79.13％,implementation rate of urinary catheter clamping during trans-portation was 74.79％,and daily evaluation implementation rate was 87.68％,which were higher than the pre-in-tervention rates of 85.63％,80.47％,62.75％,60.00％,and 79.93％,respectively.The incidence of CAUTI de-creased from 1.23‰ before intervention to 0.57‰ after intervention,the use rate of urinary catheter decreased from 5.53％before intervention to 5.37％after intervention.Differences of the above indicators were all statistically sig-nificant(all P＜0.05).Conclusion Through targeted monitoring on CAUTI and PDCA quality tools,the weak links in healthcare-associated infection control are identified,more targeted prevention and control measures are for-mulated,the implementation of bundle intervention measures can reduce the incidence of CAUTI.

Objective To develop and evaluate a standardised nursing protocol for multidisciplinary team surgery assisted by a da Vinci surgical system based on systems management theory.Methods With the systems management theory,a nursing protocol was developed for multidisciplinary team surgery assisted by a da Vinci surgical system.Convenience sampling was employed to select 100 patients who received surgery assisted by a da Vinci surgical system between October 2022 and September 2023 at a Tire-ⅢA hospital in Longyan.The patients received the surgery between October 2022 and April 2023(n=50)were assigned to the control group,and those between May 2023 and September 2023(n=50)were assigned to the trial group.The patients in the control group received routine nursing care,while those in the trial group received a standardised nursing protocol for multidisciplinary team surgery assisted by a da Vinci surgical system based on systems management theory.Preoperative preparation time,setup time for surgery,surgical time,time of hospital stay,ICU admission rate,rate of surgical complication,and scores of satisfaction from medical staff and patients were compared between the two groups.Results Patients in trial group had a shorter time in preoperative preparation and setup than those in the control group(both P<0.001),However,there was no significant difference in surgical time(P>0.05).Patients in the trial group had shorter time of hospital stay,fewer ICU admission and a lower surgical complication rate(all P<0.05),and with higher satisfaction scores from patients,nurses and surgeons(all P<0.001).Conclusion The developed nursing protocol for the multidisciplinary team surgery assisted by a da Vinci surgical system is scientific.It improves surgical efficiency,patient safety and satisfaction among patients,surgeons and nurses.