Elemene is widely recognized as an effective anti-cancer compound and is routinely administered in Chinese clinical settings for the management of several solid tumors, including non-small cell lung cancer (NSCLC). However, its detailed molecular mechanism has not been adequately demonstrated. In this research, it was demonstrated that elemene effectively curtailed NSCLC growth in the patient-derived xenograft (PDX) model. Mechanistically, employing high-throughput screening techniques and subsequent biochemical validations such as microscale thermophoresis (MST), microRNA-145-5p (miR-145-5p) was pinpointed as a critical target through which elemene exerts its anti-tumor effects. Interestingly, elemene serves as a binding stabilizer for miR-145-5p, demonstrating a strong binding affinity (dissociation constant (K _D) = 0.39 ± 0.17 μg/mL) and preventing its degradation both in vitro and in vivo, while not interfering with the synthesis of the primary microRNA transcripts (pri-miRNAs) and precursor miRNAs (pre-miRNAs). The stabilization of miR-145-5p by elemene resulted in an increased level of this miRNA, subsequently suppressing NSCLC progression through the miR-145-5p/mitogen-activated protein kinase kinase kinase 3 (MAP3K3)/nuclear factor kappaB (NF-κB) pathway. Our findings provide a new perspective on revealing the interaction patterns between clinical anti-tumor drugs and miRNAs.

BACKGROUND:U937 cells can be used as a cell model for studying the biological characteristics,signaling pathways,and therapeutic targets of acute myeloid leukemia.Although it has been reported that long non-coding RNA KIAA0125 is highly expressed in acute myeloid leukemia,its biological function in U937 cells remains unclear,and its mechanism of action in the occurrence and development of acute myeloid leukemia needs to be further clarified. OBJECTIVE:To investigate the expression level of long non-coding RNA KIAA0125 in peripheral blood of patients with acute myeloid leukemia and its effect on the proliferation and apoptosis of U937 cells. METHODS:RNA-sequencing was used to analyze the bone marrow monocyte samples from acute myeloid leukemia patients,and the differentially expressed gene long non-coding RNA KIAA0125 was screened.The expression of long non-coding RNA KIAA0125 in peripheral blood of patients with acute myeloid leukemia was detected by qRT-PCR.The relationship between long non-coding RNA KIAA0125 mRNA expression and prognosis in bone marrow cells of 173 acute myeloid leukemia patients and 70 healthy people was statistically analyzed by GEPIA database.Subsequently,recombinant lentivirus technology and CRISPR/Cas9-SAM technology were used to construct U937 cell lines with knockdown/overexpression of long non-coding RNA KIAA0125.qRT-PCR was used to detect the knockdown/overexpression efficiency of long non-coding RNA KIAA0125.Next,CCK-8 assay,flow cytometry,and western blot assay were used to detect the effects of knockdown/overexpression of long non-coding RNA KIAA0125 on the proliferation and apoptosis of U937 cells.Finally,western blot assay was used to detect the effect of knockdown/overexpressed long non-coding RNA KIAA0125 on Wnt/β-catenin signaling pathway-related proteins. RESULTS AND CONCLUSION:(1)The results of qRT-PCR showed that long non-coding RNA KIAA0125 was highly expressed in peripheral blood of acute myeloid leukemia patients.The results of GEPIA database showed that long non-coding RNA KIAA0125 was highly expressed in bone marrow cells of acute myeloid leukemia patients,and the high expression group had worse overall survival.(2)The knockdown efficiency of long non-coding RNA KIAA0125 in knockdown group was 70%,and the U937 cells that stably down-regulated long non-coding RNA KIAA0125 expression were successfully constructed.The expression of long non-coding RNA KIAA0125 in overexpression group was four times that of vector group,and stable U937 cells were successfully constructed.(3)Knockdown of long non-coding RNA KIAA0125 inhibited the proliferation of U937 cells and promoted their apoptosis.Overexpression of long non-coding RNA KIAA0125 promoted the proliferation of U937 cells but had no significant effect on the apoptosis of U937 cells.(4)Knockdown of long non-coding RNA KIAA0125 inhibited the activity of Wnt/β-catenin signaling pathway,while overexpression of long non-coding RNA KIAA0125 activated Wnt/β-catenin signaling pathway.These results confirm that long non-coding RNA KIAA0125 is highly expressed in acute myeloid leukemia peripheral blood.Long non-coding RNA KIAA0125 may affect the proliferation and apoptosis of U937 cells by regulating the Wnt/β-catenin signaling pathway,and may be a potential prognostic marker for acute myeloid leukemia.

Objective To design and evaluate the clinical application efficacy of a novel bilateral-separation endotracheal tube fixation device and provide references for clinical practice.Methods Using convenient sampling,60 patients from the Neurological Intensive Care Unit of a tertiary-level hospital in Zhengzhou were selected from May to December 2024.Patients were randomly divided into an experimental group(n=30)and a control group(n=30).The experimental group utilized the novel bilateral-separation endotracheal tube fixation device,while the control group employed traditional bandage fixation methods.Differences in fixation time,tube displacement,and intubation duration were compared between the 2 groups.Results The experimental group demonstrated significantly shorter tube fixation times compared to the control group(P＜0.05).However,no statistically significant differences were observed between the groups regarding intubation duration and tube displacement(P＞0.05).Conclusion The novel bilateral-separation endotracheal tube fixation device can reduce tube fixation time for patients in neurological intensive care and enhance nurse satisfaction.Despite not showing advantages in preventing tube displacement,the device still presents promising potential for broad clinical application.

Objective:To investigate the clinical efficacy of spinal subtle adjustment manipulation combined with acupuncture in the treatment of lumbar disc herniation(LDH).Methods:A total of 94 patients with LDH were enrolled and randomly divided into a control group and an observation group using a random number table method,with 47 cases in each group.The control group received acupuncture treatment;the observation group was treated with spinal subtle adjustment manipulation in addition to the intervention of the control group.The treatment lasted for 4 consecutive weeks.The Oswestry disability index(ODI)and visual analog scale(VAS)scores were compared before and after treatment;isokinetic testing was used to evaluate the biomechanical properties of lower back extensor muscle groups before and after treatment,measuring the peak torque(PT),average power(AP),and lower back flexion/extension ratio(F/E)at 60(°)/s isokinetic movements;after treatment,the comprehensive efficacy was assessed using the MacNab criteria,and the incidence of adverse reactions was compared between the two groups.Results:After treatment,the ODI and VAS scores in the observation group were significantly lower than those in the control group(P<0.05),while the AP and PT were significantly higher than those in the control group(P<0.05),and the F/E was significantly lower than that in the control group(P<0.05).The effective rate in the observation group was significantly higher than that in the control group(P<0.05).During the treatment period,the incidence of adverse reactions in both groups was 4.3％,and there was no statistically significant difference between the groups(P>0.05).Conclusion:Spinal subtle adjustment manipulation combined with acupuncture in the treatment of LDH can reduce the patients'pain and dysfunction,improve the biomechanical properties of lower back muscles,enhance the effectiveness of conservative treatment,and has a relatively high safety.

Objective:To develop a comprehensive training curriculum to enhance the effective implementation of the national initiative promoting dementia care and prevention.Methods:The Delphi method was utilized in an expert consultation that included 44 participants.The initial draft of the training curriculum was developed based on the current state of dementia care and prevention.This draft was subsequently evaluated for its importance, feasibility, and ease of dissemination.Experts offered targeted modifications and additional recommendations.Results:The recovery rate of the expert consultation questionnaire was 95.5%, with a recovery validity rate of 90.9%.The expert authority coefficient was 0.91, and the Kendall's coordination coefficient( W)for expert scoring was 0.316, with a significance level of P<0.001.Four course modules were ultimately identified: the foundation of memory clinic work, the complete management practice skills, group counseling techniques for caregivers, and practical skills for caregivers.The importance of these modules was rated with a mean of 4.92 to 4.95, and the coefficient of variation ranged from 0.044 to 0.063.Each module had a mean value of 4.92 to 4.95, with a coefficient of variation of 0.044 to 0.063; the mean value for practicality was between 4.78 and 4.92, with a coefficient of variation of 0.055 to 0.098; and the mean value for ease of generalization ranged from 4.28 to 4.65, with a coefficient of variation from 0.140 to 0.203.The four modules comprised a total of 55 specific course content items, with the mean value for each item ranging from 4.76 to 5.00 and a coefficient of variation from 0.000 to 0.121.The mean value of usefulness assigned to each entry ranged from 4.55 to 4.98, with a coefficient of variation from 0.031 to 0.150.Additionally, the mean value for ease of propagation assigned to each entry ranged from 4.00 to 4.83, with a coefficient of variation from 0.091 to 0.245. Conclusions:The developed training curriculum, which comprises four course modules and 55 items, demonstrated consistently high levels of importance, practicality, and ease of dissemination.These findings indicate that the curriculum is well-aligned with national initiatives aimed at enhancing dementia care and prevention.

Objective:To explore the application effect of a childlike cognition-empowered collaborative nursing model in pediatric burn patients aged 3 years and younger and their elderly caregivers, so as to provide reference for improving the cooperative nursing ability of elderly caregivers and improving the treatment and rehabilitation effect of burn children.Methods:This quasi-experimental study enrolled 80 pediatric burn patients aged 3 years and younger admitted to Children′s Hospital of Nanjing Medical University from January 2022 to December 2023 via convenience sampling, each paired with one elderly caregiver. Based on admission time, they were divided into the control group (40 patients and caregivers admitted from January to December in 2022) and the intervention group (40 patients and caregivers admitted from January to December in 2023). The control group received routine nursing, while the intervention group received a childlike cognition-empowered collaborative nursing model. Self-rating Anxiety Scale (SAS) and Chinese version of Positive Aspects of Caregiving (PAC) were used to evaluate the degree of anxiety and positive feelings of the elderly caregivers in the 2 groups. FLACC (F: face; L: legs; A: activity; C: cry; C: consol ability) Pain Assessment Scale, Child Medical Fear Scale (CMFS) and Vancouver Scar Scale (VSS) were used to evaluate dressing change pain, medical fear and scar status of the patients in the 2 groups.Results:A total of 80 pediatric burn patients and 80 elderly caregivers were included. The patients were (2.5 ± 0.2) years old in the control group, with 23 males and 17 females, and were (2.6 ± 0.1) years old in the intervention group, with 24 males and 16 females. The elderly caregivers were (62.0 ± 1.5) years old in the control group, with 9 males and 31 females, and were (61.0 ± 1.2) years old in the intervention group, with 8 males and 32 females. There were no significant differences in SAS and PAC scores between the 2 groups of elderly caregivers before intervention (both P>0.05). There were no significant differences in FLACC Pain Assessment Scale, CMFS before intervention and VSS scores within 1 week after wound healing between the 2 groups of patients (all P>0.05). After the intervention, the SAS score of the elderly caregivers in the intervention group was (45.80 ± 2.81) points, lower than (57.78 ± 4.63) points in the control group, the difference was statistically significant ( t=13.99, P<0.05), and the PAC score in the intervention group was (38.85 ± 3.03) points, higher than (30.15 ± 3.03) points in the control group, the difference was statistically significant ( t=-15.24, P<0.05). The FLACC Pain Assessment Scale, CMFS after intervention, VSS scores at 6 months of rehabilitation treatment of the patients in the intervention group were (3.35 ± 0.45), (22.20 ± 1.07), (6.50 ± 0.68) points, lower than (7.00 ± 0.45), (51.43 ± 2.26), (8.68 ± 0.76) points in the control group, the differences were statistically significant ( t=34.86, 73.87, 13.45, all P<0.05). Conclusions:The childlike cognition-empowered collaborative nursing model can enhance the caregiving enthusiasm of elderly caregivers, alleviate negative emotions among both elderly caregivers and pediatric burn patients aged 3 and younger, improve the collaborative nursing abilities of elderly caregivers, and enhance the treatment and rehabilitation outcomes of pediatric burn patients.

The increased aging population leads to a growing burden of mental disorders among older adults. High-quality clinical research plays a crucial role in advancing disease diagnosis and treatment. The article primarily comments on precision medicine in late-life depression. Based on a brief overview of the current research advances, the article explores the challenges Chinese geriatric psychiatrists face in the era of precision medicine. Additionally, the article proposes strengthening clinical research by establishing high-quality clinical cohorts and ultimately driving advancements in precision medicine for late-life depression.

Objective:This study aims to explore the optimization needs of the cognitive training tool "Fun Brain" from a professional perspective, providing insights for its enhancement and application.Methods:In April 2024, a qualitative research approach was employed, involving group interviews with 61 elderly health professionals organized into 9 groups. The interviews primarily focused on the user experience and optimization suggestions related to the "Fun Brain" app. Thematic analysis was conducted, with NVivo 14 software utilized for data management and processing. Data analysis followed Braun and Clarke′s six-phase procedure to ensure the scientific and systematic extraction of themes. Furthermore, high-frequency word analysis was performed, offering crucial clues for subsequent thematic analysis.Results:The study identified 12 initial themes and 6 optimization themes, with a primary focus on age-appropriate interfaces, personalized modules, and feedback mechanisms. These themes were refined into three core themes, including adaptation of training content, optimization of interaction design, and enhancement of participant motivation.Conclusion:Optimizing cognitive training tools for elderly users requires careful consideration of their specific needs, particularly regarding functional adaptation, interface design, and interactive experience. Implementing these optimizations can improve user engagement and training effectiveness, offering both scientific and practical guidance for the design and promotion of cognitive training tools.

Objective:To summarize domestic and foreign transitional readiness assessment tools for adolescents with chronic diseases and analyze the current status of their application in the clinic, so as to provide references for healthcare professionals to select appropriate tools.Methods:China National Knowledge Infrastructure, Wanfang Data, VIP and China Biomedical Literature Database, PubMed, Web of Science, Embase, Medline, CINAHL, Cochrane Library and scholar.google.com were searched for literature related to the assessment tools of transition readiness in adolescents with chronic illnesses from inception to March 29, 2024. Two researchers independently screened the literature and extracted the data.Results:A total of 491 articles were initially retrieved and 24 were included, involving a total of 8 transitional readiness assessment tools for adolescents with chronic diseases, including the Transition Readiness Assessment questionnaire, the University of North Carolina TRxANSITION Scale, Am I ON TRAC for adult care? Questionnaire, Transition Questionnaire, Self-Management and Transition to Adulthood with Rx=Treatment Questionnaire, Good 2 Go Questionnaire, State Assessment Questionnaire for Transition, and Self-assessment Scale of Transition Readiness for Adolescents. The Transition Readiness Assessment questionnaire and Self-Management and Transition to Adulthood with Rx=Treatment Questionnaire have good reliability and validity, comprehensive evaluation, wide applicability, simple use, and are suitable for clinical use.Conclusions:The quality of existing tools for assessing transitional readiness of adolescents with chronic diseases is mixed. The Transition Readiness Assessment questionnaire and Self-Management and Transition to Adulthood with Rx=Treatment Questionnaire are more appropriate options in the clinic, but they still need to be improved. Future studies need to continue to introduce tools to assess transitional readiness for chronic diseases in adolescents and develop localized assessment tools.