To investigate the impact of mild-to-moderate frailty on the long-term prognosis of hospitalized elderly patients with type 2 diabetes mellitus(T2DM).

ObjectiveTo improve the quality and service performance of community visual health services in Shanghai, and to establish a set of reasonable and effective evaluation index system for community visual health services. MethodsCentered on the national and Shanghai-based visual health policies and based on the current status and development trends of community visual health service program in Shanghai, the candidate indicators were formed through literature review and expert interviews, firstly. The framework of an evaluation index system was formulated through qualitative research successively, which was further revised and perfected using the Delphi method. Coefficient weights were calculated using the analytic hierarchy process (AHP), culminating in the establishment of the community visual health evaluation index system, lastly. ResultsA total of 22 visual health experts from district-level center for disease control, hospital ophthalmology and leaders in charging of visual health service in community health centers participated in the Delphi questionnaire survey, with a questionnaire recovery rate of 100% and an expert authority coefficient of 0.86, indicating high credibility. After a round of correspondence to experts’ importance ratings and discussions, a comprehensive evaluation index system comprising 3 primary indicators, 12 secondary indicators, and 47 tertiary indicators, along with 5 additional indicators, was finalized. ConclusionAn index system tailored to effective evaluation for community visual health initiatives was drawn up in this study, which can promote the capacity building in community eye health services, facilitating the high-quality development of visual health courses, and enhancing residents’ eye health.

Objective To understand the clinical applicability and implementation of expert consensus on the implementation and removal of protective restraints in psychiatry,and to provide references for promoting the standardized practice of psychiatric protective restraints and updating the consensus.Methods By the convenience sampling method,a questionnaire survey was conducted among nurses from 480 hospitals in 30 provinces from June 15 to July 15,2024.The survey was conducted using the instrument for evaluating clinical applicability of guide-lines(version 2.0)and a self-compiled questionnaire on the clinical implementation of the restraint consensus.Results A total of 7,844 valid questionnaires were collected,with a valid questionnaire recovery rate of 93.78％.The results of clinical applicability scoring showed that the consensus had the lowest availability score(64.72％)and the highest acceptability score(76.74％).The results showed that nurses' receiving training and the level of their hospitals were the main influencing factors for scores in various dimensions(P＜0.05).4,774 participants(87.42％)believed that the application of consensus could enhance the standardization of nurses' restraint operations.The safety rate of the restraint consensus was 79.51％,and the economic ratio was 76.87％.Among the evaluators,1,739(22.17％)believed that there were implementation obstacles in the consensus.Conclusion The clinical applicability of the consensus is relatively good,and the application of the consensus helps to improve the standardization of clinical operations.In the future,efforts should be made to strengthen the promotion and training of the consensus,develop hierarchical promotion strategies according to the characteristics of medical institutions,and improve the quality of evidence for the consensus,so as to further enhance the clinical application effect of the consensus.

Objective To investigate the clinical features,etiological features and prognosis of patients with hematologic diseases complicated with candidemia for improving clinical diagnosis and treatment.Methods A retrospective analysis was conducted for 107 hematological patients complicated with candidemia who were treated in the First Affiliated Hospital of Zhengzhou University,Henan Cancer Hospital,Henan Provincial People's Hospital,or Zhengzhou People's Hospital from June 2022 to May 2024.The clinical data and pathogenic bacteria were analyzed by univariate and multivariate analyses.Results The Candida pathogen of the 107 cases of candidemia were mostly Candida tropicalis(73.8％),followed by Candida parapsilosis,Candida glabrata,and Candida albicans.Antifungal susceptibility testing showed that 43.9％,47.7％,and 48.6％of the Candida strains were resistant voriconazole,fluconazole and itraconazole,respectively.Logistic regression analysis found that disease not in remission(OR=7.795,95％CI:2.274-26.723),septic shock(OR=10.376,95％CI:1.129-95.388),multiple organ dysfunction syndrome(MODS)(OR=9.107,95％CI:1.789-46.361),and inappropriate antifungal treatment(OR=3.422,95％CI:1.153-10.153)were risk factors for 30-day mortality in hematological patients with candidemia.Conclusions Candidemia in patients with hematological diseases is associated with high mortality rate,the major pathogen of which is Candida tropicalis.The Candida isolates showed high resistance rates to azoles.Disease not in remission,septic shock,MODS,and inappropriate antifungal treatment are the risk factors for mortality.

The neonatal Fc receptor(FcRn)prolongs the half-life of immunoglobulin G(IgG)and promotes its recycling by binding to and making it an important receptor for maintaining serum IgG homeostasis.However,the abnormal accumulation of pathogenic IgG is closely related to the occurrence of various neuroimmune diseases.FcRn antagonists can significantly reduce the level of pathogenic IgG by blocking the binding of FcRn to IgG,thereby effectively alleviating the clinical symptoms of related diseases.As an emerging targeted therapeutic drug,FcRn antagonists have shown their potential in treating IgG-mediated neuroimmune diseases.This article summarizes the mechanism of action,types and clinical research progress of FcRn antagonists with the aim of providing new ideas for the precise treatment of IgG-mediated neuroimmune diseases.Future research should focus on the long-term safety of drugs,expansion of indications and individualized treatment strategies to further enhance their clinical application value.

Objective:To evaluate the feasibility of a six-step suspension technique for endoscopic lateral neck dissection (LND) through the chest-breast approach in patients with papillary thyroid carcinoma (PTC).Methods:This is a retrospective case series study.Clinical data of 81 PTC patients who underwent endoscopic LND via the chest-breast approach using the six-step suspension method at the Department of Thyroid Surgery, Shenzhen People′s Hospital were collected from January 2022 to October 2024. The cohort consisted of 15 male and 66 female patients, with age of (35.2±10.2)years (range:8.5 to 65.0 years). Key variables, including LND duration, total operative time, postoperative hospital stay, details of lymph node metastasis, postoperative complications, and follow-up data were recorded and analyzed.Results:The duration of LND was (131.8±42.2)minutes (range: 65 to 275 minutes), and the total operative time was (195.5±49.6)minutes (range: 110 to 390 minutes). The postoperative hospital stay was (4.8±1.5)days(range:3 to 15 days). The number of dissected lateral cervical lymph nodes was 32.7±10.1 (range: 11 to 54). The maximum tumor diameter was (16.1±10.1)mm(range:2 to 30 mm), while the maximum size of metastatic lymph nodes was (16.7±6.2)mm(range:7 to 30 mm). The positivity rate was 24.7% (841/3 410) in the lateral cervical+central lymph node and 16.1% (427/2 646) in the lateral cervical lymph node. Postoperative lymphatic leakage occurred in 2 patients, both of whom were successfully treated conservatively. No other significant complications were reported. During the postoperative follow-up period, which lasted for (18.3±7.4) months (range: 1.1 to 34.4 months), the mean postoperative serum thyroglobulin (Tg) level ( M(IQR)) was 0.05 (0.50) μg/L (range: 0.01 to 7.90 μg/L), with 86.4% of patients showing a Tg ≤1.00 μg/L. Through imaging evaluations, no evidence of residual disease or recurrence was detected. Conclusion:Endoscopic LND via the chest-breast approach, utilizing the six-step suspension method, maybe a feasible and effective technique with promising clinical outcomes.

Objective To explore the mechanism of Lacticaseibacillus paracasei E6 for improving vinorelbine-induced immunosuppression in zebrafish.Methods The intestinal colonization of L.paracasei E6 labeled by fluorescein isothiocyanate(FITC)in zebrafish was observed under fluorescence microscope.In a zebrafish model of vinorelbine-induced immunosuppression,the immunomodulatory activity of L.paracasei E6 was assessed by analyzing macrophage and neutrophil counts in the caudal hematopoietic tissue(CHT),the number of T-lymphocyte,and the expressions of interleukin-12(IL-12)and interferon-γ(IFN-γ).The contents of short-chain fatty acids(SCFAs)in L.paracasei E6 fermentation supernatant and the metabolites of L.paracasei E6 in zebrafish were detected by LC-MS/MS-based targeted metabolomics.The immunomodulatory effects of the SCFAs including sodium acetate,sodium propionate and sodium butyrate were evaluated in the zebrafish model of immunosuppression.Results After inoculation,green fluorescence of FITC-labeled L.paracasei E6 was clearly observed in the intestinal ball,midgut and posterior gut regions of zebrafish.In the immunocompromised zebrafish model,L.paracasei E6 significantly alleviated the reduction of macrophage and neutrophil counts in the CHT,increased the fluorescence intensity of T-lymphocytes,and promoted the expressions of IL-12 and IFN-γ.Compared with MRS medium,L.paracasei E6 fermentation supernatant showed significantly higher levels of acetic acid,propionic acid and butyric acid,which were also detected in immunocompromised zebrafish following treatment with L.paracasei E6.Treatment of the zebrafish model with sodium acetate and sodium propionate significantly increased macrophage and neutrophil counts in the CHT and effectively inhibited vinorelbine-induced reduction of thymus T cells.Conclusion L.paracasei E6 can improve vinorelbine-induced immunosuppression in zebrafish through its SCFA metabolites acetic acid and propionic acid.

Objective To investigate the efficacy of Lactobacillus plantarum ZG03(L.plantarum ZG03)for ameliorating oxidative stress in zebrafish.Methods We evaluated the growth pattern of L.plantarum ZG03,observed its morphology using field emission scanning electron microscopy,and assessed its safety and potential efficacy with whole-genome sequencing for genetic analysis.FITC-labeled ZG03 was used to observe its intestinal colonization in zebrafish.In a zebrafish model of 2%glucose-induced oxidative stress,the effect of ZG03 was evaluated by assessing the changes in neutrophils in the caudal hematopoietic tissue(CHT),superoxide dismutase(SOD)activity,reactive oxygen species(ROS)levels,and malondialdehyde(MDA)content.Liquid chromatography-mass spectrometry-based targeted metabolomics was used for analyzing short-chain fatty acids(SCFAs)in the zebrafish,and the antioxidant effects of the key metabolites(acetate,propionate,and caproate)were tested.Results On MRS agar,L.plantarum ZG03 formed circular,smooth,moist,and milky-white colonies with a rod-shaped cell morphology.Genomic analysis revealed abundant sugar metabolism gene clusters.After inoculation of FITC-labeled L.plantarum ZG03 in zebrafish,green fluorescence was clearly observed in the intestinal bulb,mid-intestine,and hind intestine.In zebrafish with glucose-induced oxidative stress,L.plantarum ZG03 significantly reduced ROS levels and the number of neutrophils in the CHT with increased SOD activity.L.plantarum ZG03 significantly increased the content of SCFAs including acetic acid,propionic acid,and caproic acid in zebrafish metabolites.In addition,sodium acetate,sodium propionate,and sodium caproate in the SCFAs significantly increased SOD activity in the zebrafish models.Conclusion L.plantarum ZG03 ameliorates oxidative stress in a glucose-induced zebrafish model through its metabolites,particularly the SCFAs including acetic acid,propionic acid and caproic acid.

OBJECTIVE To explore the effect and mechanism of Zexie tang （ZXT） on reducing lipid accumulation through network pharmacology， and compare the difference of traditional decoction versus formula granules. METHODS The active components and targets of ZXT were identified using TCMSP and SwissTargetPrediction databases. GeneCards， OMIM， DisGeNET and TTD databases were used to analyze the related targets of non-alcoholic fatty liver disease （NAFLD）； protein-protein interaction network model was constructed by String database；“ ZXT-NAFLD target-pathway” network diagram was constructed by using CytoScape software； target enrichment analysis was performed by using Metascape platform. Fat accumulation model of human hepatocellular carcinoma HepG2 cells was established to observe the effects of traditional decoction and formula granules of ZXT on lipid accumulation of cells. RESULTS Alisol B， alisol C， 1-monolinolein and alisol B monoacetate were the key active components of ZXT in the treatment of NAFLD. The core targets included MDM2， MAPK1， PIK3CB， PRKCQ and MAPK14， etc. The core signaling pathways included endocrine resistance， insulin resistance and Th17 cell differentiation. Compared with model group， except for the Zexie formula granules group and Baizhu formula granules group， the absorbance values in all other administration groups were significantly decreased （P＜0.01）； the absorbance value of Baizhu traditional decoction group was significantly higher than that of ZXT traditional decoction group （P＜0.01）； the absorbance values of Zexie formula granule group and Baizhu formula granule group were significantly higher than that of ZXT formula granule group （P＜0.01）； the absorbance value of Zexie formula granule group was significantly higher than that of Zexie traditional decoction group （P＜0.01）； the absorbance value of Baizhu formula granule group was significantly higher than that of Baizhu traditional decoction group （P＜0.01）. CONCLUSIONS ZXT reduces lipid accumulation of human hepatocellular carcinoma cells through multiple components， multiple target and multiple pathways， and its traditional decoction and formula granules exhibit slightly different lipid-lowering effects.

Probiotics play a crucial role in colon cancer treatment by metabolizing prebiotics to generate short-chain fatty acids (SCFAs). Colon cancer patients are frequently propositioned to supplement with probiotics to enhance the conversion and utilization of prebiotics. Nevertheless, the delivery and colonization of probiotics is hindered by the harsh conditions of gastrointestinal tract (GIT). Here, we devised a straightforward yet potent modified prebiotic-based "shield" (Gelatin-Inulin, GI), employing dietary inulin and natural polymer gelatin crosslinked via hydrogen bonding for enveloping Lactobacillus reuteri (Lr) to formulate synbiotic hydrogel capsules (Lr@Gl). The GI "shield" serves as a dynamic barrier, augmenting the resistance of Lr to gastric acid and facilitating its bioactivity and adherence in the GIT, synergizing with Lr to elicit an anti-tumor effect. Simultaneously, Lr@GI demonstrates anti-tumor effects by depleting glutathione to release reactive oxygen species, accompanied by the activation of NLRP3 (NOD-like receptor family pyrin domain containing 3), and the induction M1 macrophage polarization. Furthermore, Lr@GI can not only promote the recovery of intestinal barrier but also regulate intestinal flora, promoting the production of SCFAs and further exerting anti-tumor effect. Crucially, Lr@GI also potentiates the anti-tumor effect of 5-Fluorouracil. The construction and synergistic anti-tumor mechanism of synbiotic hydrogel capsules system provide valuable insights for gut microbial tumor therapy.