ObjectiveTo analyze the adverse reactions associated with the clinical use of Banxia （Rhizoma Pinelliae）- Wutou （Aconitum） in the same formula， with the aim of providing a reference for the safety of their clinical application. MethodsLiterature on the clinical application of antagonistic herbs "Banxia-Wutou" used in the same formula， published from January 1st， 2014， to June 30th， 2023， was retrieved from databases including CNKI， VIP， Wanfang， SinoMed， PubMed， Cochrane Library， and Embase. A database was established， and information related to adverse reactions was extracted， including descriptions， classifications， specific manifestations， management and outcomes， patients' primary diseases （western medicine diseases and traditional Chinese medicine diagnoses and syndromes）， and medication information （dosage， ratio， administration routes， and dosage forms）. ResultsA total of 79 researches simultaneously used antagonistic herbs Banxia-Wutou in the same formula and reported associated advers reactions. Gastrointestinal adverse reactions were the most common， with 8 studies reporting management of adverse reactions and 3 studies reporting improvement with no intervention. Among the 11 researches， the adverse reaction relieved to extant， while other 69 researches didn't report the managment of adverse reaction and its prognosis. For the primary disease in western medicine system， chronic bronchitis and chronic obstructive pulmonary disease （COPD） were most common， while gastric pain was the most common symptom in traditional Chinese medicine with spleen and kidney deficiency and spleen stomach cold deficiency being the most frequent syndromes. The most common Banxia dosage was 10 g， while for the Wutou， Fuzi （Radix Aconiti Lateralis Praeparata） was predominant with the highest dose at 15 g. The most frequent herbal combination was Banxia-fuzi， with a 1∶1 ratio. The main administration route was oral， and the primary dosage form was decoction. ConclusionGastrointestinal adverse reactions are the most common in the clinical use of Banxia-Wutou antagonistic herb combinations. Research on the safety of "Banxia-Wutou" combinations should focus on respiratory system diseases and spleen-stomach related conditions.

This paper systematically reviews the phased development history of spacesuit technology across various nations,analyzes its core technologies and breakthroughs,points out the limitations of current spacesuit technology,and explores future directions for spacesuit development in response to deep-space exploration and commercialization demands.It clarifies that spacesuits are transitioning from passive protective gear to intelligent operational platforms,requiring interdisciplinary innovations to overcome key challenges such as lightweight design,adaptive systems,high reliability,and efficient human-machine interaction.

When conducting extravehicular activities under low-gravity conditions like on the moon,the weight of the spacesuit is one of the loads that human body has to bear.The centroid position of the spacesuit will affect the motion control of the human-spacesuit system.In order to reveal the influence of the centroid position of the lunar spacesuit on human motion under lunar-gravity,a suspended 1/6 gravity simulation system was used for the experiment.When subjects were under different load centroids which include front and back on sagittal plane,left and right on coronal plane,up and down on cross-section plane,near to coordinate origin,the postures and plantar pressures of subjects during three typical movements:standing,single-knee standing and walking were captured.Inverse dynamics solution is adopted to analyze the joint torques of human body in above conditions.Combined with the subjective evaluation,the appropriate load centroid area was analyzed by comparative.The experiment shows that,human is non-sensitive to the up and down change of load centroid,the after is back change,the front and right load centroid are the mostly avoided.The results obtained by this study will provide a reference for the layout design of the lunar spacesuit.

Cholesterol (CH) plays a crucial role in enhancing the membrane stability of drug delivery systems (DDS). However, its association with conditions such as hyperlipidemia often leads to criticism, overshadowing its influence on the biological effects of formulations. In this study, we reevaluated the delivery effect of CH using widely applied lipid microspheres (LM) as a model DDS. We conducted comprehensive investigations into the impact of CH on the distribution, cell uptake, and protein corona (PC) of LM at sites of cardiovascular inflammatory injury. The results demonstrated that moderate CH promoted the accumulation of LM at inflamed cardiac and vascular sites without exacerbating damage while partially mitigating pathological damage. Then, the slow cellular uptake rate observed for CH@LM contributed to a prolonged duration of drug efficacy. Network pharmacology and molecular docking analyses revealed that CH depended on LM and exerted its biological effects by modulating peroxisome proliferator-activated receptor gamma (PPAR-γ) expression in vascular endothelial cells and estrogen receptor alpha (ERα) protein levels in myocardial cells, thereby enhancing LM uptake at cardiovascular inflammation sites. Proteomics analysis unveiled a serum adsorption pattern for CH@LM under inflammatory conditions showing significant adsorption with CH metabolism-related apolipoprotein family members such as apolipoprotein A-V (Apoa5); this may be a major contributing factor to their prolonged circulation in vivo and explains why CH enhances the distribution of LM at cardiovascular inflammatory injury sites. It should be noted that changes in cell types and physiological environments can also influence the biological behavior of formulations. The findings enhance the conceptualization of CH and LM delivery, providing novel strategies for investigating prescription factors' bioactivity.

Objective:To analyze mortality risk factors in patients with severe pneumonia and investigate their varying influences across different time periods.Methods:A total of 134 patients with severe pneumonia admitted to the Emergency Department of Xiang’an Hospital, Xiamen University, between June 2019 and February 2020 were enrolled. All patients were treated in the EICU and followed up for four years. Based on outcomes, they were categorized into a death group ( n=77) and a survival group ( n=57). COX regression analysis was employed to identify mortality risk factors at different time points, while logistic regression analysis was used to assess risk factors influencing mortality during hospitalization, ICU stay, 1-month, and 1-year follow-up periods. Results:Mortality rates were 11.9% ( n=16) during ICU admission, 20.8% ( n=28) during hospitalization, 16.4% ( n=22) within 1 month, and 31.3% ( n=42) within 1 year. By the end of the follow-up, 57.4% ( n=77) of patients had died. Ten mortality risk factors were identified, with the number increasing over time. During ICU admission and hospitalization, significant risk factors included total bilirubin levels, APACHE-II score, invasive ventilation, ARDS, and vasopressor use in the ICU. One-month mortality risk additionally involved bacterial infection. One-year mortality risk further incorporated advanced age and chronic heart failure. By the end of follow-up, acute kidney injury (AKI) during ICU admission also emerged as a contributing factor, while higher body weight was identified as a protective factor. Conclusions:The number of mortality risk factors in severe pneumonia patients increases progressively over time. Early-stage factors during hospitalization and ICU admission exert a stronger impact on short-term mortality, whereas bacterial infection, advanced age, and chronic heart failure become increasingly significant in later stages. These findings highlight the dynamic nature of risk factors and underscore the importance of tailored monitoring and intervention strategies at different disease phases.

Objective:To construct and validate a risk-scoring model for predicting delayed onset of lactogenesis stage Ⅱ (DOL Ⅱ) in mothers separated from their premature infants.Methods:This was a retrospective study. (1) Modeling group: This group enrolled 310 mothers who were separated from their premature infants after delivery at Wuxi Maternal and Child Health Hospital from December 2021 to November 2022. They were further divided into the DOL Ⅱ group (144 cases) and the non-DOL Ⅱgroup (166 cases) according to whether they had DOL Ⅱ or not. Based on the results of multivariate logistic regression analysis, each risk factor was assigned a score, and a risk prediction scoring model was established. (2) Validation group: This group included 130 mothers of premature infants who experienced mother-infant separation after delivery at Wuxi Maternal and Child Health Hospital from December 2022 to March 2023. The area under the receiver operating characteristic (ROC) curve was used to evaluate the discrimination, and the Hosmer-Lemeshow test was used to assess the goodness of fit. The Chi-square test (or Fisher's exact probability test) or Wilcoxon rank sum test were used for inter-group data comparison. Results:This risk prediction scoring model included 10 risk factors [maternal age≥35 years old, hypertensive disorders of pregnancy, anemia, gestational diabetes mellitus, preterm rupture of membrane, start breastfeeding >6 hours, postpartum admission of maternal intensive care unit, cesarean section, score of Edinburgh Postpartum Depression Scale >9.5, postpartum neutrophil-to-lymphocyte ratio ≥4.369, Fatigue Scale-14 ≥7.5, body mass index in the first trimester ≥23.719 kg/m 2, postpartum BMI≥27.661 kg/m 2,and increase of BMI during pregnancy ≥5.393 kg/m 2], with an area under the ROC curve of 0.838 (95% CI: 0.795-0.882, P<0.001), a maximum Yoden index of 0.526, a specificity of 0.825, a sensitivity of 0.701, and an optimal threshold of 4.5. After rounding the score off to the nearest whole number, those with a score≥5 were defined as at high risk of DOL Ⅱ, while those with a score<5 were at low risk. Hosmer-Lemeshow test showed χ2=3.43 and P=0.634. The positive predictive value, the negative predictive value, and the accuracy were 77.7%, 76.1%, and 76.8%, respectively. In the modeling group, 130 out of the 310 cases (41.9%) were predicted to be at high risk by the model with 101 (32.6%) experiencing DOL Ⅱ, while 180 cases (58.1%) were predicted to be at low risk with 43 (13.9%) experiencing DOL Ⅱ. Among the 130 cases in the validation group, 59 (45.4%) were predicted to be at high risk with 39 (30.0%) experiencing DOL Ⅱ, while 71 (54.6%) were predicted to be at low risk with 19 (14.6%) experiencing DOL Ⅱ. The model validation results showed that the area under the ROC curve was 0.774 (95% CI: 0.693-0.855, P<0.001) and the Hosmer-Lemeshow test showed χ2=3.09 and P=0.687, with the positive predictive value of 66.1%, the negative predictive value of 73.2%, and the accuracy of 70.0%. Conclusions:This study preliminarily establishes a risk scoring model for predicting DOL Ⅱ in mothers separated from their premature infants which is of certain predictive value and can provide a reference for developing predictive lactation support measures.

With the progress of society and the continuous improvement of people′s living standards in China, the public′s demand for medical services is becoming increasingly diversified. How to move hospital services forward and improve medical services centered on patients has become a key consideration for hospitals to enhance patients′ sense of medical satisfaction. A certain hospital has established a one-stop patient service hotline, integrating functions such as number inquiry, medical consultation, appointment registration, appointment examination, praise and suggestions, complaint follow-up, etc., injecting a complaint handling management mode, and responding to and solving patient feedback problems in a timely manner. Since the launch of the patient service hotline, it has effectively solved the problems that patients encountered during their visits, effectively reduced the hospital′s complaint rate, and initially formed a service closed-loop management. From March to October 2023, the demand ratio of the 12345 hotline in the hospital has continuously decreased, and was significantly lower than the average level of 22 municipal hospitals in Beijing. In the future, we should further improve the communication skills between doctors and patients, focus on managing appeals and services, and continue to strengthen proactive governance.

Objective:To investigate the role of p-AKT-mTOR-P70S6K signaling pathway in radiation therapy for polyploid cervical cancer cells.Methods:Human cervical cancer HeLa cell lines were selected and HeLa cells were radiated under 7 Gy of 6 MV X-ray. The morphological changes of the cells were observed with an inverted microscope on day 5 after radiation induction. All cells were divided into the 7 Gy group (7 Gy X-ray radiation but not transfected polyploidy HeLa cells) and the control group (the non-radiation-induced and not transfected HeLa cells). In addition, the plasmid carrying pcDNA3 negative control sequence and the plasmid carrying pcDNA3-TT-AKT sequence were transfected into HeLa cells, respectively, which were induced by 7 Gy X-ray radiation after 48 h of transfection, and then they were recorded as the pcDNA3 + 7 Gy group and the pcDNA3-TT-AKT + 7 Gy group. Cell proliferation ability was detected by using CCK-8 assay, cell cycle was detected by using flow cytometry, cell apoptosis was detected by using mitochondrial membrane potential assay, the relative expression levels of cell proliferation, cell cycle, apoptosis and autophagy related proteins were tested by using Western blot.Results:Most of the normal HeLa cells in the 7 Gy group died on day 5 after radiation induction, and only a few surviving cells increased in size with multiple nuclei. The results of Western blot showed that the relative expression levels of p-AKT, p-mTOR and p-P70S6K in HeLa cells of the 7 Gy group were lower than those of the control group (all P < 0.05). CCK-8 assay showed that the absorbance ( A) values were 0.45±0.06, 0.65±0.06 after 48 h of culture and 0.75±0.05, 1.05±0.02 after 72 h of culture, respectively in the pcDNA3 + 7 Gy group and the pcDNA3-TT-AKT + 7 Gy group, and the differences were statistically significant (all P < 0.05), and the A values in the pcDNA3-TT-AKT + 7 Gy group were all higher than those in the pcDNA3 +7 Gy group. Flow cytometry results showed that the proportion of cells was (29.2±3.6)%, (26.7±1.7)% in G 0/G 1 phase and (29.6±1.6)%, (30.3±0.6)% in G 2/M phase, respectively in the pcDNA3 + 7 Gy group and the pcDNA3-TT-AKT + 7 Gy group, and the differences were not statistically significant (all P > 0.05); the proportion of cells in S phase was (10.2±0.9)% and (14.6±1.5)%, respectively in the pcDNA3 + 7 Gy group and the pcDNA3-TT-AKT + 7 Gy group, and the differences were statistically significant ( t = 2.86, P = 0.043). Mitochondrial membrane potential assay showed that the green fluorescence proportion was (23.1±2.5)% and (14.3±1.9)%, respectively in the pcDNA3 + 7 Gy group and the pcDNA3-TT-AKT + 7 Gy group, and the different was statistically significant ( t = 4.82, P = 0.009). Western blot results showed that the relative expression level of p-cdc25c (Ser216) in the pcDNA3-TT-AKT+7 Gy group was higher than that in the pcDNA3+7 Gy group ( P < 0.001); and the relative expression levels of Bak and LC3-Ⅱ/Ⅰ in the pcDNA3-TT-AKT+7Gy group were lower than those in the pcDNA3 +7 Gy group, respectively (all P < 0.05). Conclusions:The p-AKT-mTOR-P70S6K signaling pathway may be involved in the regulation of radiation-induced polyploidy HeLa cell proliferation, cell cycle and cell apoptosis.

Objective To retrospectively analyze the efficacy and safety of abatacept(ABA)in anti citrullinated peptide antibody(ACPA)positive rheumatoid arthritis(RA).Methods Clinical data from ACPA positive RA patients who visited the Department of Rheumatology and Immunology at the Second Hospital of Hebei Medical University from May 2020 to January 2023 and were treated with ABA were retrospectively collected and analyzed,to evaluate the efficacy and safety of ABA at 12 weeks and 24 weeks of treatment.Efficacy evaluation measures included RA disease activity score-28(DAS-28),clinical disease activity index(CDAI),and remission criteria of RA of American College of Rheumatology(ACR).Results A total of 35 ACPA-positive RA patients were included in the final analysis.The DAS-28,CDAI,ACR20,ACR50,and ACR70 remission rates at 12 weeks after treatment were 34.29%,31.43%,60.00%,28.57%,and 14.29%,respectively;the DAS-28,CDAI,ACR20,ACR50,and ACR70 remission rates at 24 weeks after treatment were 74.29%,82.86%,85.71%,54.29%,and 31.43%,respectively;in addition,the remission rate at 24 weeks was significantly higher than that at 12 weeks(P﹤0.05).Among the 35 patients included in the analysis,4 patients experienced respiratory tract infections,3 patients experienced transient creatinine elevation,and 4 patients experienced elevated blood uric acid.Conclusion In the real world,ABA's clinical remission rate is consistent with expectations,and clinical combination drug regimens are flexible and diverse,with high drug safety.

Objective The objective of this study was to analyze the longitudinal trend of multidimensional treatment quality of breast cancer based on the latent growth mixture model(LGMM),identify potential change patterns and influencing factors,and pro-vide scientific basis for improving treatment quality and patient prognosis.Methods The quality monitoring data of breast cancer from four consecutive years were obtained in the National"Quality Monitoring System for Specific(single)Disease";Based on the item response theory(IRT),the treatment quality of breast cancer in the three dimensions of preoperative examination,treatment,and out-come was calculated;LGMM was constructed to analyze the independent and joint change trend of breast cancer treatment quality in all dimensions,and the optimal model was determined based on practical significance and statistical indicators.Results In the inde-pendent trend analysis,2 potential categories were identified for preoperative examination,treatment,and outcome dimensions.Among them,9%showed a rapid upward trend in the preoperative examination dimension,and 91%showed a relatively stable trend;The sta-ble growth accounted for 23%and slow decline accounted for 77%in the treatment dimension;13%of the outcome dimensions showed an upward trend,while 87%showed a downward trend.In the joint trend analysis of changes,2 potential categories were identified:the first category accounted for about 8%,and the preoperative examination dimension of this category had a good treatment quality,with mean intercepts and slopes of 3.326 and 3.367,respectively.The treatment quality in the treatment and outcome dimensions had steadily improved;The second category accounted for about 92%,and the treatment quality in this dimension was relatively good.Its mean intercept and slope were 0.548 and 0.018,respectively.There is still room for improvement in the treatment quality of the pre-operative examination and outcome dimensions;BMI and M stage in patient characteristics are important influencing factors on the trend of combined changes in treatment quality.Conclusion The treatment quality of breast cancer during this study period has im-proved to varying degrees in all dimensions of preoperative examination,treatment and outcome;In the joint trend analysis of the three dimensions,the improvement of treatment quality in the preoperative examination dimension can provide feasible references for subse-quent treatment and achieve the goal of reducing complications.