ObjectiveTo investigate the mechanism by which Gegen Qinliantang（GQT） improves skeletal muscle insulin resistance. MethodsThe db/m mice were used as the normal group， while db/db mice were assigned to a model group， low-dose （3.12 g·kg^-1）， medium-dose （6.24 g·kg^-1）， and high-dose （12.48 g·kg^-1） GQT groups， and a Western medicine group （semaglutide， 0.045 mg·kg^-1），n=6 in each group. All groups received corresponding interventions. Intraperitoneal glucose tolerance test （IPGTT）， intraperitoneal insulin tolerance test （IPITT）， and hematoxylin-eosin （HE） staining were used to evaluate insulin resistance and therapeutic efficacy. Serum lipid levels were measured using an automatic biochemical analyzer， and apoptosis in skeletal muscle was assessed via TUNEL assay. Transcriptome sequencing combined with gene ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） analyses was performed to identify differentially expressed genes （DEGs）. Real-time quantitative polymerase chain reaction （Real-time PCR） was used to validate gene expression. Molecular docking was applied to evaluate the binding patterns between active components of GQT and key regulatory genes to elucidate pharmacological mechanisms. ResultsCompared with the model group， the medium-dose and high-dose GQT groups showed significantly reduced fasting blood glucose （FBG） levels （P<0.01）. Triglycerides （TG）， total cholesterol （TC）， and low-density lipoprotein cholesterol （LDL-C） were markedly decreased （P<0.01）， while high-density lipoprotein cholesterol （HDL-C） was significantly increased （P<0.01）. IPGTT， IPITT， and HE staining demonstrated that GQT enhanced insulin sensitivity and restored skeletal muscle morphology. GQT also alleviated apoptosis in skeletal muscle tissue. Transcriptome analysis revealed that GQT primarily affected biological processes such as oxidative phosphorylation， metabolic pathways， cellular processes， and protein binding. Real-time PCR results showed that CBR2， CDK6， F830016B08Rik， IL-1β， Rab27b， and COLEC12 were key regulatory genes. Molecular docking demonstrated that CBR2， IL-1β， Rab27b， and COLEC12 formed stable binding with the main active components of GQT. The therapeutic effects of high- and medium-dose GQT were comparable to those of the semaglutide group. ConclusionGQT improves skeletal muscle insulin resistance， potentially by regulating apoptosis as part of its underlying biological mechanism.

Objective: To characterize perioperative dynamic changes in immune-cell phenotypes and inflammatory cytokines in patients undergoing CPB (cardiopulmonary bypass) cardiac surgery, and to explore their associations with postoperative outcomes. Methods: In this prospective cohort study, 120 adult patients who underwent elective cardiac surgery under CPB at West China Hospital from May 2022 to March 2023 were enrolled. Perioperative immune-cell phenotypes and concentrations of 40 inflammation-related cytokines were measured. The primary outcomes were the sequential organ failure assessment (SOFA) score at 24 h after surgery and ΔSOFA (the peak SOFA score within 48 h after surgery minus the preoperative SOFA score). Secondary outcomes included major adverse cardiovascular events (MACE), acute kidney injury (AKI), respiratory failure, severe liver injury, and infection. Results: The mean age of enrolled patients was 57±10 years. Of these, 52% (62/120) were male and 90% (108/120) underwent valve surgery. During the rewarming to the end of CPB, neutrophil counts rapidly increased (7.39×10 /L vs preoperative 3.07×10 /L, P<0.001), with significant upregulation of CD11b (7.30×10 /L vs preoperative 3.05×10 /L, P<0.001) and CD54 (7.15×10 /L vs preoperative 2.99×10 /L, P<0.001). Lymphocyte counts increased at the end of CPB (1.75×10 /L vs preoperative 1.12×10 /L, P<0.001) but decreased significantly at 24 h after surgery (0.59×10 /L vs preoperative 1.12×10 /L, P<0.001). Plasma analysis showed that multiple pro-inflammatory cytokines increased during CPB and remained elevated up to 24 h after surgery; five chemokines and the anti-inflammatory cytokine IL-10 peaked at the end of CPB. The SOFA score increased from 1 (1, 2) preoperatively to 7 (5, 10) at 24 h after surgery, with a ΔSOFA of 6 (4, 8). Within 30 days after surgery, 48 patients (40.0%) developed AKI, 17 (14.2%) developed infection, 4 (3.3%) developed severe liver injury, 3 (2.5%) developed respiratory failure, and 3 (2.5%) experienced MACE. During the 2-year follow-up, 8 patients (6.7%) experienced MACE and 5 (4.2%) died. Conclusion: Multi-organ dysfunction is common after cardiac surgery under CPB (median ΔSOFA, 6), accompanied by perioperative activation of multiple immune-cell subsets and upregulation of pro-inflammatory, anti-inflammatory, and chemotactic mediators. This study provides data-driven evidence and research clues for further investigation of the associations between CPB-related immune perturbations and postoperative organ dysfunction and clinical outcomes.

Intravitreal anti-vascular endothelial growth factor(anti-VEGF)therapy has been widely used, but the variability in its therapeutic efficacy limits individualized treatment. In recent years, the application of artificial intelligence(AI)has opened up new avenues for personalized treatment response prediction, and its core branches include machine learning(ML)and deep learning(DL). This review systematically retrieved and analyzed 41 relevant studies published up to April 2025. Comprehensive analysis reveals that AI predictive models are evolving from forecasting single endpoints(such as visual acuity or central retinal thickness)to integrating multi-dimensional endpoints(encompassing anatomical, functional, and treatment demand parameters)and generating predictive imaging outputs. In terms of technical approaches, DL models(28 studies, accounting for 68.3%)dominate this field due to their robust image interpretation capabilities, while ML models(10 studies, 24.4%)retain significant value in the analysis of structured clinical data. Cross-disease comparisons indicate that research efforts are most concentrated on age-related macular degeneration(ARMD)and diabetic macular edema(DME), with shared conceptual frameworks for model construction, yet distinct anatomical and functional indicators are prioritized for each disease. Currently, the field confronts several key challenges, including insufficient prospective clinical validation, limited model interpretability(the “black box problem”), and a scarcity of high-quality multi-center datasets. Moving forward, it is imperative to advance real-world validation and develop explainable AI techniques to expedite the clinical translation of these predictive models.

ObjectiveTo observe the clinical effectiveness of horticultural therapy involving the planting of Chinese medicinal herbs （mint and lily potted plants） combined with intradermal needling therapy for generalized anxiety disorder （GAD） of liver depression transforming into fire syndrome under transcranial magnetic stimulation and basic psychological therapy， and to explore the possible mechanisms of action. MethodsA total of 180 patients with GAD of liver depression transforming into fire syndrome were randomly divided into three groups， horticultural therapy group， intradermal needling group， and horticultural therapy+intradermal needling group， with 60 patients in each. All groups received basic treatment including basic psychological therapy and transcranial magnetic stimulation. The horticultural therapy group received horticultural therapy in addition to the basic treatment； the intradermal needling group received intradermal needling therapy once a week for 8 weeks in addition to the basic treatment； the horticultural therapy+intradermal needling group received both horticultural therapy and intradermal needling therapy， following the same procedures and duration. Hamilton Anxiety Rating Scale （HAMA）， Self-Rating Anxiety Scale （SAS）， and Pittsburgh Sleep Quality Index （PSQI） scores were assessed at baseline and after 2， 4， 6， and 8 weeks of treatment. Serum levels of adrenocorticotropic hormone （ACTH） and corticosterone （CORT） were measured before treatment and after 8 weeks of treatment. Motor-evoked potential （MEP） baseline levels were recorded before treatment， and MEP amplitude ratios were compared after 1 week and 8 weeks of treatment. Clinical effectiveness and safety were evaluated after 8 weeks of treatment. Pearson correlation analysis was used to examine the relationships between serum ACTH and CORT levels， MEP amplitude， and anxiety. ResultsIn the horticultural therapy group and intradermal needling group， HAMA， SAS and PSQI scores after 4， 6， and 8 weeks treatment were lower than baseline scores （P＜0.05）. In the horticultural therapy+intradermal needling group， these scores showed a significant decline starting after 2 weeks treatment and continuing through 8 weeks after treatment （P＜0.05）. The HAMA， SAS， and PSQI scores in the horticultural therapy+intradermal needling group were significantly lower than those in the other two groups after 2， 4， 6， and 8 weeks treatment （P＜0.05）. After 8 weeks of treatment， serum CORT and ACTH levels in the horticultural therapy+intradermal needling group were significantly lower than baseline levels （P＜0.05） and were also lower than those in the horticultural therapy group and intradermal needling group at the same time point （P＜0.01）. When comparing the level after 8 weeks treatment to that after 1 week treatment， under PAS10 stimulation， the MEP amplitude ratio in the intradermal needling group decreased at 30 minutes， while in the horticultural therapy+intradermal needling group， the MEP amplitude ratio decreased at all time points （P＜0.05 or P＜0.001）； under PAS25 stimulation， the MEP amplitude ratio in the horticultural therapy group increased at 20 minutes， and in the intradermal needle group at 10 minutes （P＜0.05）. In the horticultural therapy+intradermal needling group， the MEP amplitude ratio increased significantly at all time points after treatment （P＜0.001）. The cure rate in the horticultural therapy+intradermal needling group （74.14%， 43/58） was significantly higher than that in the horticultural therapy group （30.00%， 18/60） and the intradermal needling group （48.28%， 28/58， P＜0.05）. Correlation analysis revealed that serum ACTH and CORT levels were positively correlated with HAMA scores （r = 0.488， P＜0.01； r = 0.428， P＜0.01）. Following PAS10 intervention， the MEP amplitude ratio was positively correlated with HAMA scores （r = 0.458， P＜0.01）， whereas after PAS25 intervention， the MEP amplitude ratio was negatively correlated with HAMA scores （r = -0.562， P＜0.01）. ConclusionHorticultural therapy combined with intradermal needling treatment， under transcranial magnetic stimulation and basic psychological therapy， demonstrates significant clinical effectiveness in patients with GAD of liver depression transforming into fire syndrome. Its mechanism of action may be related to the regulation of hyperactivation of the hypothalamic-pituitary-adrenal （HPA） axis and the reduction of cortical excitability.

BACKGROUND:Precision therapy based on multifunctional nanomaterials is a novel therapeutic model for malignancies that can integrate multiple imaging and therapeutic models into one nanoscale platform to achieve visual combination treatment. OBJECTIVE:To prepare novel nanoparticles loaded with Cu2(OH)PO4 nanoparticles(CuNPs)and nuciferine(NF)(h-PCuNF),and to explore their ability to mediate combined photothermal therapy/photodynamic therapy/chemodynamic therapy/chemotherapy for malignancy. METHODS:The h-PCuNF nanoparticles were synthesized through a double-emulsion procedure,through which the CuNPs and NF were loaded into the shell of hollow poly(lactic-co-glycolic)acid nanocarriers.The morphology,structure,particle size,and zeta potential of the h-PCuNF nanoparticles were characterized.In deionized water,the magnetic resonance imaging and photothermal conversion performances of the h-PCuNF nanoparticles,as well as their capability to implement reactive oxygen species production by mediating photocatalysis and Fenton-like reactions,were evaluated.In liver malignant tumor cell line HepG2 cells,the effectiveness of the photothermal therapy/photodynamic therapy/chemodynamic therapy/chemotherapy combination therapy mediated by the nanoparticles was detected by employing fluorescence imaging and MTT assay. RESULTS AND CONCLUSION:(1)The h-PCuNF nanoparticles possessed a hollow spherical structure in which the CuNPs(drug loading rate and encapsulation rate were 26.3%and 63.2%,respectively)and NF(drug loading rate and encapsulation rate were 11.0%and 52.6%,respectively)were loaded into the shell.The average particle size of the h-PCuNF nanoparticles was(309.2±10.0)nm,while the zeta potential was determined to be(-12.5±0.9)mV.In physiological environments,the nanoparticles possess favorable suspension stability.(2)In deionized water,the h-PCuNF nanoparticles could markedly enhance T1-weighted magnetic resonance imaging images.The h-PCuNF nanoparticles showed remarkable photothermal conversion and photocatalytic reactive oxygen species generation capabilities under near infrared laser irradiation.In addition,the h-PCuNF nanoparticles could consume glutathione and mediate Fenton-like reactions to produce·OH.(3)The h-PCuNF nanoparticles could be taken up by HepG2 tumor cells and were mainly distributed in the cytoplasm.The synergistic therapeutic effect was demonstrated after the nanoparticles were activated by near infrared laser irradiation,because CuNPs mediated photothermal therapy/photodynamic therapy/chemodynamic therapy and NF mediated chemotherapy could synergistically eliminate the tumor cells.

The aim of the experiment was to study the effects of Echinacea purpurea extract on the digestive ability,immune function and intestinal barrier of the Bamei ternary pigs.Forty-eight healthy pigs of 50 days old were randomly divided into four groups,each with three replicates and four pigs in each replicate.The control group(CON)was fed a basal diet,and the experimental group was divided into 5 g/kg(T1),10 g/kg(T2)and 15 g/kg(T3)of Echinacea extract in the basal diet.The pre-test period was 5 days and the main test period was 35 days with free feeding and drinking during the test period.The results showed that:There was no significant effect on the apparent digestibility of nutrients and jejunum morphology in the test group compared to the CON group(P＞0.05).Amylase and trypsin activities were significantly higher in the experimental group and lipase activities were significantly higher in T2 and T3 groups compared to CON group(P＜0.05).GSH,CAT and T-AOC activities were significantly higher in the experimental group compared to CON group(P＜0.05).In comparison with CON group,the levels of IL-1 and IL-6 were significantly lower in the experimental group(P＜0.05),and the levels of TNF-α were significantly lower in the T2 and T3 groups(P＜0.05);and the levels of IL-10 were signifi-cantly higher in the T3 group(P＜0.05).The mRNA and protein expression levels of TLR4,MyD88,TRAF6,and NF-κB were significantly lower in the experimental group(P＜0.05).The mRNA and protein expression levels of CLDN-1,OCLN and ZO-1 were significantly increased in the test group(P＜0.05).The results between the test groups showed that the protein expression levels of CLDN-1 and OCLN were significantly increased in the T3 group compared with the T1 group(P＜0.05).In conclusion,the addition of Echinacea extract to the ration can,to a certain ex-tent,improve the digestive ability,balance the immune ability,and improve the intestinal barrier function of the Bamei ternary pigs,thus promoting the intestinal health of pigs.

Objective:This study investigated the expression level of phosphatidylserine-specific phospholipase A1(PLA1A)in colorectal can-cer(CRC)and analyzed its correlations with clinicopathological features,prognosis,and immune infiltration.Methods:The expression level of PLA1A in CRC was screened,and the influence of this expression level on patient prognosis was analyzed using bioinformatics methods.A cohort of 192 patients diagnosed with CRC at Shanxi Province Cancer Hospital from January to December 2020 were selected.The PLA1A ex-pression level in those with CRC was determined using immunohistochemistry(IHC)and real-time quantitative reverse transcription PCR(RT-qPCR).The relationship between PLA1A level and the clinicopathological features of the patients with CRC was analyzed using the chi-square test.The expression levels of immune cell markers CD4 and CD8 as well as immunosuppressive checkpoints PD-1,TIM-3,and CTLA-4 in CRC were detected via IHC,and their correlations with PLA1A level were analyzed using the chi-square test.Results:The results of bioinformatics analysis showed that the expression level of PLA1A in CRC tissue was higher than paracancerous tissue,which correlated with overall surviv-al(OS)(P<0.05).The IHC and RT-qPCR results showed that PLA1A expression level was significantly upregulated in CRC tissiue(P<0.05).High PLA1A level was closely associated with the TNM stage,degree of differentiation,and lymph node metastasis(P<0.05).The IHC results demonstrated that PLA1A positively correlated with the infiltrating CD8+T cell level(P<0.05).In addition,the elevated PLA1A levels upregu-lated the expressions of immunosuppressive checkpoints PD-1,TIM-3,and CTLA-4(P<0.05).Conclusions:PLA1A is highly expressed in CRC,which is closely related to immune infiltrating cells and immunosuppressive checkpoints,suggesting that PLA1A plays an important role in immune infiltration in CRC,a finding that provides guidance in the treatment of CRC.

OBJECTIVE To analyze the bacterial spectrum characteristics and drug resistance of midstream urine culture-positive cases in patients with urinary tract infection(UTI),and to provide reference for rational use of antibiotics.METHODS A retrospective analysis was conducted on 6 029 patients with urinary tract infections who had positive midstream urine cultures at the First Affiliated Hospital of Guangzhou Medical University from 2013 to 2023,with a total of 8 495 infectious bacterial detected,and the characteristics of the pathogens,antimicrobial susceptibility tests and the epidemiological features were analyzed.RESULTS There were 2 086 males and 3 943 fe-males.A total of 8 495 pathogens were isolated,of which 1 492 stains of gram-positive bacteria accounted for 17.56％,5 850 strains of gram-negative bacteria accounted for 68.86％,1 150 strains of fungi accounted for 13.54％,with Escherichia coli(42.30％),Klebsiella pneumoniae(7.59％),and Enterococcus faecalis(6.19％)being predominated.The major gram-negative bacteria had low resistance rates to meropenem,imipen-em and ertapenem(＜20％),and high resistance rates to ampicillin and cefazolin(＞34％).The major gram-posi-tive bacteria had low resistance rates to teicoplanin and quinupristin/dalfopristin(＜12％),very low resistance to linezolid(＜1％),and high resistance rates to erythromycin(＞40％).The main fungi had low resistance rates to flucytosine and amphotericin B(＜3％),while Candida tropicalis had high resistance rates to itraconazole,flu-conazole,and voriconazole(37.93％-42.18％).CONCLUSION The three most frequently isolated pathogens in the midstream urine cultures of patients with UTI are Escherichia coli,Klebsiella pneumoniae,and Group D En-terococcus faecalis,which show low resistance to tigecycline and high resistance to ciprofloxacin,ampicillin and levofloxacin,and these findings provide important references for clinical treatment of urinary tract infections.

Organizational well-being refers to individuals' perceptions of various cultural and organizational characteristics within an organization. It not only impacts the physical and mental health of nurses but also influences the quality of care and the development of the nursing workforce. However, this concept has yet to receive sufficient attention from healthcare institutions and nursing professionals. This review systematically examines the concept, theoretical models, measurement tools, influencing factors, and strategies for enhancement of organizational well-being among nurses. It aims to offer a reference for future research and practical implementation of organizational well-being in the nursing field.

The aim of the experiment was to study the effects of Echinacea purpurea extract on the digestive ability,immune function and intestinal barrier of the Bamei ternary pigs.Forty-eight healthy pigs of 50 days old were randomly divided into four groups,each with three replicates and four pigs in each replicate.The control group(CON)was fed a basal diet,and the experimental group was divided into 5 g/kg(T1),10 g/kg(T2)and 15 g/kg(T3)of Echinacea extract in the basal diet.The pre-test period was 5 days and the main test period was 35 days with free feeding and drinking during the test period.The results showed that:There was no significant effect on the apparent digestibility of nutrients and jejunum morphology in the test group compared to the CON group(P＞0.05).Amylase and trypsin activities were significantly higher in the experimental group and lipase activities were significantly higher in T2 and T3 groups compared to CON group(P＜0.05).GSH,CAT and T-AOC activities were significantly higher in the experimental group compared to CON group(P＜0.05).In comparison with CON group,the levels of IL-1 and IL-6 were significantly lower in the experimental group(P＜0.05),and the levels of TNF-α were significantly lower in the T2 and T3 groups(P＜0.05);and the levels of IL-10 were signifi-cantly higher in the T3 group(P＜0.05).The mRNA and protein expression levels of TLR4,MyD88,TRAF6,and NF-κB were significantly lower in the experimental group(P＜0.05).The mRNA and protein expression levels of CLDN-1,OCLN and ZO-1 were significantly increased in the test group(P＜0.05).The results between the test groups showed that the protein expression levels of CLDN-1 and OCLN were significantly increased in the T3 group compared with the T1 group(P＜0.05).In conclusion,the addition of Echinacea extract to the ration can,to a certain ex-tent,improve the digestive ability,balance the immune ability,and improve the intestinal barrier function of the Bamei ternary pigs,thus promoting the intestinal health of pigs.