BACKGROUND:Macrophages play a key role in the occurrence and progression of lung diseases,and autophagy plays an important role in maintaining environmental homeostasis and functional stability in macrophages.It has been suggested that macrophage autophagic activity has two sides in lung inflammatory diseases.OBJECTIVE:To summarize the relationship between macrophage autophagy and lung diseases,thereby providing reference for exploring the prevention and treatment strategies of lung inflammatory diseases by targeting macrophage autophagy.METHODS:Literature retrieval was performed in CNKI and PubMed for relevant literature published from database inception to September 2024.The search terms were"macrophage autophagy,efferocytosis,macrophage polarization,acute lung injury,pneumonia,chronic obstructive pulmonary disease,pulmonary fibrosis,asthma"in Chinese and English,respectively.The search results were included or excluded based on the selection criteria,and 100 papers that met the criteria were finally included in the review.RESULTS AND CONCLUSION:(1)The obstruction of autophagy flow will induce the polarization imbalance of macrophages and impair their efferocytosis,resulting in the increase of M1 macrophages and aggravating inflammation.(2)The judgment of autophagic activity should be based on whether the autophagy flow is smooth or not,and it is essential to evaluate the degradation ability of autophagy.Some studies failed to comprehensively detect the degradation ability of autophagy lysosomes to assess whether the autophagy flow is unobtrusive.As a result,the so-called two-sided view of pulmonary macrophage autophagy in pulmonary inflammatory diseases in such studies is actually related to the one-sided judgment of autophagy activity.(3)The pathological manifestations vary across different pulmonary diseases and even at different stages of the same disease.Activation of macrophage autophagy plays a positive role in regulating pulmonary inflammatory homeostasis in conditions such as acute lung injury,infectious pneumonia,mild chronic obstructive pulmonary disease,early-stage pulmonary fibrosis,and secondary asthma.However,in the severe fibrotic stage of chronic obstructive pulmonary disease and the progressive stage of pulmonary fibrosis,the activation of pulmonary macrophage autophagy aggravates pulmonary fibrosis,reflecting the dual nature of macrophage autophagy.In allergic asthma,autophagy is activated in lung-resident macrophages but suppressed in infiltrating monocyte-derived macrophages from circulation.The former is closely related to airway stenosis,and the latter aggravates pneumonia disorders.Therefore,identifying the types and progression stages of lung diseases,along with accurately assessing autophagic activity,is crucial for future investigations into the relationship between macrophage autophagy and disease pathogenesis,thereby facilitating the development of therapeutic strategies in the future.

BACKGROUND:Macrophages play a key role in the occurrence and progression of lung diseases,and autophagy plays an important role in maintaining environmental homeostasis and functional stability in macrophages.It has been suggested that macrophage autophagic activity has two sides in lung inflammatory diseases.OBJECTIVE:To summarize the relationship between macrophage autophagy and lung diseases,thereby providing reference for exploring the prevention and treatment strategies of lung inflammatory diseases by targeting macrophage autophagy.METHODS:Literature retrieval was performed in CNKI and PubMed for relevant literature published from database inception to September 2024.The search terms were"macrophage autophagy,efferocytosis,macrophage polarization,acute lung injury,pneumonia,chronic obstructive pulmonary disease,pulmonary fibrosis,asthma"in Chinese and English,respectively.The search results were included or excluded based on the selection criteria,and 100 papers that met the criteria were finally included in the review.RESULTS AND CONCLUSION:(1)The obstruction of autophagy flow will induce the polarization imbalance of macrophages and impair their efferocytosis,resulting in the increase of M1 macrophages and aggravating inflammation.(2)The judgment of autophagic activity should be based on whether the autophagy flow is smooth or not,and it is essential to evaluate the degradation ability of autophagy.Some studies failed to comprehensively detect the degradation ability of autophagy lysosomes to assess whether the autophagy flow is unobtrusive.As a result,the so-called two-sided view of pulmonary macrophage autophagy in pulmonary inflammatory diseases in such studies is actually related to the one-sided judgment of autophagy activity.(3)The pathological manifestations vary across different pulmonary diseases and even at different stages of the same disease.Activation of macrophage autophagy plays a positive role in regulating pulmonary inflammatory homeostasis in conditions such as acute lung injury,infectious pneumonia,mild chronic obstructive pulmonary disease,early-stage pulmonary fibrosis,and secondary asthma.However,in the severe fibrotic stage of chronic obstructive pulmonary disease and the progressive stage of pulmonary fibrosis,the activation of pulmonary macrophage autophagy aggravates pulmonary fibrosis,reflecting the dual nature of macrophage autophagy.In allergic asthma,autophagy is activated in lung-resident macrophages but suppressed in infiltrating monocyte-derived macrophages from circulation.The former is closely related to airway stenosis,and the latter aggravates pneumonia disorders.Therefore,identifying the types and progression stages of lung diseases,along with accurately assessing autophagic activity,is crucial for future investigations into the relationship between macrophage autophagy and disease pathogenesis,thereby facilitating the development of therapeutic strategies in the future.

OBJECTIVE To study the extraction process of Hongqijin granules with the standard decoction of Hongqijin formula as the reference. METHODS Fifteen batches of Hongqijin formula standard decoction were prepared. The reference characteristic chromatogram was established， and the chromatographic similarity was calculated. The average extraction yield and average transfer rates of calycosin-7-glucoside， salidroside， curcumin， and emodin of the 15 batches of standard decoction were determined. Taking soaking time， water addition amount， and decoction time as influencing factors， and extraction yield， transfer rates of marker components， as well as chromatographic similarity with the reference characteristic chromatogram as evaluation indexes， orthogonal test combined with principal component analysis was adopted to optimize the extraction process of Hongqijin granules， followed by process verification. RESULTS The average extraction yield of 15 batches of Hongqijin formula standard decoction was 32.55%. The average transfer rates of calycosin-7-glucoside， salidroside， curcumin， and emodin were 70.68%， 74.35%， 2.16%， and 4.62%， respectively. The optimal extraction process of Hongqijin granules was confirmed as follows： extraction was carried out twice； the first extraction used 8-fold water for 60 min， and the second extraction adopted 6.5-fold water for 45 min. In three validation tests， the average extraction yield was 33.01%. The average transfer rates of the four marker components were 79.51%， 75.54%， 1.84%， and 4.30%， with all RSD values less than 2%. The chromatographic similarities between the extracting solution and reference characteristic chromatogram were all higher than 0.990. CONCLUSIONS The optimized extraction process of Hongqijin granules exhibits good stability， and the material basis of the extracting solution is consistent with that of Hongqijin formula standard decoction.

Objective To explore the clinical effect of active risk prevention nursing on the prevention of skin injury in patients with esophageal cancer during radiotherapy.Methods A total of 102 patients who underwent radiotherapy for esophageal cancer in Jiangsu Cancer Hospital from December 2022 to November 2023 were enrolled.They were assigned to control group(n=51,routine nursing)and study group(n=51,routine nursing+active risk prevention)according to the random number table.The skin injury,quality of life,and nursing satisfaction were compared between the two groups.Results The skin injury in the study group at 20 Gy,40 Gy and at the end of radiotherapy was significantly slighter than that in the control group(P<0.05).After 4 weeks of intervention,the total score of SF-36 and scores in all dimensions in the study group were higher than those in the control group,and the degree of nursing satisfaction in the study group was significantly higher than that in the control group(72.55%vs 94.12%,χ2=8.541,P<0.05).Conclusion Active risk prevention can reduce skin injury,improve quality of life,and help to improve nursing satisfaction in patients with esophageal cancer during radiotherapy.

OBJECTIVE To investigate the distribution and drug resistance of multidrug-resistant bacteria in the neonatal intensive care unit of a three-A children's hospital in Henan Province,and to provide reference for ational drug use in clinical practice.METHODS Clinical specimens from hospitalized newborns in neonatal intensive care unit from a three-A children's hospital from Jan.1,2019 to Dec.31,2023 were subjected to etiological exam-ination and drug sensitivity test,and to analyze the distribution and drug resistance of multidrug-resistant bacteri-a in hospitalized newborns.RESULTS During the 5-year period,1139 strains of multidrug-resistant bacteria were i-solated,including 229 gram-positive bacteria(20.11％)and 910 gram-negative bacteria(79.89％).There were 92 strains of methicillin-resistant Staphylococcus aureus(MRSA)(accounting for 8.08％),57 strains(accounting for 5.00％)of methicillin-resistant coagulase-negative Staphylococcus epidermidis and 28 strains(accounting for 2.46％)of methicillin-resistant coagulase-negative human Staphylococcus.370 strains(accounting for 32.48)of carbapenem-resistant Klebsiella pneumoniae(CRKP),268 strains(accounting for 23.53％)of extenspectrum β-lactamase-producing Escherichia coli and 85 strains(accounting for 7.46％)of K.pneumoniae,there were 767 sputum specimens(67.34％),160 blood specimens from peripheral intravenous puncture and central venous cath-eterization(PICC)(14.05％),63 bronchoalveolar lavage fluid specimens(5.53％),29 secretion specimens(eye and wound secretions)(2.54％),and 120 other specimens(10.54％).K.pneumoniae and E.coli producing su-per-broad spectrum β-lactamase,CRKP and MRSA were the main drug-resistant bacteria.CONCLUSION The sit-uation of drug resistance in neonatal intensive care unit is serious,therefore monitoring bacterial resistance should be strengthened according to the clinical laboratory results,and antibiotics should be applied rationally.

OBJECTIVE: To observe the efficacy and safety of Tiaowei Jiannao acupuncture (acupuncture for regulating defensive qi and nourishing brain) for post-ischemic stroke insomnia (PISI). METHODS: A total of 96 patients with PISI were randomized into an acupuncture group (32 cases, 1 case was excluded), a medication group (32 cases, 1 case dropped out, 1 case was excluded) and a sham-acupuncture group (32 cases, 1 case dropped out, 1 case was excluded). In the acupuncture group, Tiaowei Jiannao acupuncture was applied at bilateral Shenmai (BL62), Zhaohai (KI6), Hegu (LI4), Taichong (LR3), and Baihui (GV20), Sishencong (EX-HN1), Yintang (GV24⁺), Shenting (GV24), once a day, 1-day interval was taken after 6-day treatment, for 3 weeks totally. In the medication group, eszopiclone tablet was given orally, 1-3 mg a time, once a day for 3 weeks. In the sham-acupuncture group, non-invasive sham acupuncture was applied, the acupoint selection, frequency and course of treatment were the same as the acupuncture group. Before treatment, after 2,3 weeks of treatment, the scores of Pittsburgh sleep quality index (PSQI), self-rating sleep scale (SRSS), National Institutes of Health Stroke scale (NIHSS), Hamilton depression scale-17 (HAMD-17) were observed; before and after treatment, the sleep parameters were recorded using polysomnography (PSG); and the efficacy and safety were evaluated after treatment in the 3 groups. RESULTS: After 2,3 weeks of treatment, the scores of PSQI, HAMD-17 and SRSS in the acupuncture group and the medication group, as well as the SRSS scores in the sham-acupuncture group were decreased compared with those before treatment (P<0.05); after 2 weeks of treatment, the NIHSS score in the acupuncture group was decreased compared with that before treatment (P<0.05); after 3 weeks of treatment, the NIHSS scores in the acupuncture group, the medication group and the sham-acupuncture group were decreased compared with those before treatment (P<0.05). After 3 weeks of treatment, the scores of PSQI, SRSS, HAMD-17 and NIHSS in the acupuncture group and the medication group, as well as the NIHSS score in the sham-acupuncture group were decreased compared with those after 2 weeks of treatment (P<0.05). After 2,3 weeks of treatment, the scores of PSQI, SRSS and HAMD-17 in the acupuncture group and the medication group were lower than those in the sham-acupuncture group (P<0.05), the NIHSS scores in the acupuncture group were lower than those in the medication group and the sham-acupuncture group (P<0.05); after 3 weeks of treatment, HAMD-17 score in the acupuncture group was lower than that in the medication group (P<0.05), the NIHSS score in the medication group was lower than that in the sham-acupuncture group (P<0.05). Compared before treatment, after treatment, the total sleep time was prolonged (P<0.05), the wake after sleep onset, sleep latency, and non-rapid eye movement (NREM) sleep latency were shortened (P<0.05), the sleep efficiency was improved (P<0.05), the number of awakenings was reduced (P<0.05), the percentage of rapid eye movement (REM%) and the percentage of NREM stage 1 (N1%) were decreased (P<0.05), the percentage of NREM stage 2 (N2%) and the percentage of NREM stage 3 (N3%) were increased (P<0.05) in the acupuncture group and the medication group; the sleep latency was shortened in the sham-acupuncture group (P<0.05). After treatment, the PSG indexes in the acupuncture group and the medication group were superior to those in the sham-acupuncture group (P<0.05); in the acupuncture group, the number of awakenings was less than that in the medication group (P<0.05), the REM% and N1% were lower than those in the medication group (P<0.05), the N2% and N3% were higher than those in the medication group (P<0.05). The total effective rate were 93.5% (29/31) and 90.0% (27/30) in the acupuncture group and the medication group respectively, which were higher than 10.0% (3/30) in the sham-acupuncture group (P<0.05). There was no serious adverse events in any of the 3 groups. CONCLUSION Tiaowei Jiannao acupuncture improves the insomnia symptoms in patients with ischemic stroke, improves the quality of sleep, increases the deep sleep, promotes the recovery of neurological function, and relieves the depression. It is effective and safe for the treatment of PISI.
Humans ; Acupuncture Therapy ; Male ; Sleep Initiation and Maintenance Disorders/physiopathology* ; Female ; Middle Aged ; Aged ; Acupuncture Points ; Treatment Outcome ; Adult ; Ischemic Stroke/complications* ; Stroke/complications* ; Sleep

Objective To explore the efficacy and safety of pegylated doxorubicin liposome(PLD)in neoadjuvant chemotherapy(NAC)for breast cancer.Methods A total of 126 breast cancer patients treated with the NAC regimen containing PLD in the Third Xiangya Hospital of Central South University from Janu-ary 2018 to December 2022 were selected as the research subjects.The clinical efficacy,pathological efficacy and occurrence of adverse reactions of the patients were observed,and total pathological complete response(tpCR)rates of different molecular subtypes were analyzed.The changes in left ventricular ejection fraction(LVEF)were compared between before and after treatment.Results Among 126 patients,the clinical efficacy of NAC in 119 cases was evaluated,and the objective response rate(ORR)was 67.2％(80/119).A total of 123 patients were evaluated for the pathological efficacy,breast cancer pathological complete response(bpCR)rate was 13.8％(17/123);tpCR rate was 12.2％(15/123),in which the the human epidermal growth factor receptor 2(HER2)positive[hormone receptor(HR)negative]type had the highest rate(33.3％),followed by triple-negative(21.7％).There was no hand-foot syndrome occurred,and only one case developed the grade 2 oral mucositis.LVEF showed no statistically significant difference between before and after treatment[69.9％(51.0％,87.0％)vs.69.0％(57.0％,85.0％)](P＞0.05).Conclusion The NAC regimen containing PLD has a better effect on HER2—positive and triple-negative breast cancer.

Objective:To investigate the potential characteristic manifestations and application value of the Dynamic Visual Acuity Test（DVAT） in vestibular migraine（VM）. Methods:A total of 50 VM patients（case group） and 50 healthy subjects（control group） diagnosed at the Department of Otorhinolaryngology Head and Neck Surgery, First Hospital of Shanxi Medical University between November 1, 2023, and December 31, 2024, were enrolled. The case group underwent DVAT, video head impulse test（vHIT）, caloric test, and Dizziness Handicap Inventory（DHI） assessment, whereas the control group only received DVAT. Group-based analyses were conducted to examine the effect of age on Dynamic Visual Acuity Loss（DVALoss）, as well as the correlations of DVALoss with vestibular function tests and DHI scores. Results:DVALoss in the case group was significantly higher than that in the control group（P<0.001）. In both groups, age was significantly and positively correlated with DVALoss（P<0.001）. Within the case group, DVALoss was strongly and positively correlated with DHI scores（r=0.807, P<0.001）; it was negatively correlated with the vestibulo-ocular reflex（VOR） gain in vHIT, though without clinical significance, and showed no significant association with the caloric test. Age and DVALoss collectively accounted for 71.3% of the variance in DHI scores（R²=0.713）, with age exerting a relatively minor actual impact. Conclusion:DVAT can sensitively identify the core functional impairments of VM. DVALoss, as a direct functional reflection of the pathological mechanism of VM, is strongly correlated with DHI scores. Incorporating DVALoss into standardized assessments may provide an objective basis for the diagnosis and management of VM.
Humans ; Migraine Disorders/diagnosis* ; Visual Acuity ; Case-Control Studies ; Head Impulse Test ; Vestibular Function Tests ; Female ; Male ; Adult ; Vestibular Diseases/physiopathology* ; Middle Aged ; Caloric Tests

A retrospective analysis was conducted on data from five patients comprehensively diagnosed with emphysematous osteomyelitis (EO) based on clinical, imaging, microbiological culture, and surgical findings at Hebei Medical University Third Hospital from December 2020 to May 2024. Among these five cases, there were three males and two females, aged between 11 and 69 years. Three patients had infection risk factors (two with diabetes and one with anemia), while two had no documented risk factors in their medical history. All patients presented with fever, localized pain at the infection site, and elevated inflammatory markers. Site of incidence: EO affected the lumbar spine in three cases, the ilium in one case, and the femur in one case. Pathogenic microorganisms: The causative agents included Klebsiella pneumoniae (two cases), Escherichia coli (one case), Burkholderia cepacia (one case), and a mixed infection of Staphylococcus aureus and Acinetobacter baumannii (one case). Imaging findings: Among the three patients who underwent X-ray examinations, one showed normal results, while two exhibited bone destruction. CT scans of all five cases revealed the characteristic "pumice sign" without periosteal reaction or osteosclerosis. MRI, performed on four patients, demonstrated bone destruction, swelling of surrounding soft tissues, and soft tissue abscess formation. Treatment and outcomes: Four patients underwent surgical debridement combined with perioperative antibiotic therapy. Of these, three recovered well, while one achieved good infection control but suffered severe joint destruction. One patient died after treatment was discontinued. The clinical and laboratory findings of EO resemble those of common acute osteomyelitis; however, EO has distinct imaging characteristics. Timely diagnosis, aggressive surgical debridement, and strong, targeted antibiotic therapy can result in favorable outcomes. Conversely, delayed diagnosis and treatment may lead to severe complications or death.

Objective:To investigate the clinical efficacy of programmed Retzius-sparing robot-assisted radical prostatectomy and " Sandwich" technique of total urethral reconstruction.Methods:The clinical data of 120 consecutive patients who underwent programmed Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) by the same operator at the Cancer Hospital of the Chinese Academy of Medical Sciences from January 2023 to August 2024 were retrospectively analyzed to explore the efficacy and summarize the experience. Baseline characteristics included: mean age (67.2±7.5) years, BMI (25.3±3.1)kg/m 2, prostate volume (32.3±15.8) ml, and PSA (16.6±19.7) ng/ml (57 cases 4-10 ng/ml; 41 >10-20 ng/ml; 22 >20 ng/ml). 28 patients underwent radical prostatectomy without prostate biopsy, while 92 had biopsy-proven cancer (Gleason: 6/7/8/9/10: 18/35/17/17/5). Clinical stages were cT 1(8), cT 2(73), cT 3(39). The surgical method was programmed Retzius-sparing robot-assisted radical prostatectomy and " Sandwich" technique of total urethral reconstruction. The peritoneum was incised slightly above the Douglas pouch and denonvilliers' fascia was dissected closely along the dorsal aspect of prostate, extending to the prostatic apex. Both vas deferens were transected, and the seminal vesicles were isolated. A combination of blunt and sharp dissection was employed to expose the prostatic fascia. The bladder neck was precisely visualized and transected. The urethra was precisely dissected, exposed and divided. Complete urethral reconstruction was performed using the "Sandwich" technique of total urethral reconstruction. The operation time, intraoperative bleeding, catheter preservation time, pathological staging and positive margin rate, and recovery of urinary control immediately after postoperative catheter removal were recorded. Results:In this study, all 120 surgeries were successfully completed, with no cases converted to anterior approach radical surgery or open surgery, and no serious intraoperative complications such as post-shamus hemorrhage or ureteric/rectal injury. The median postoperative follow-up was 16.0(10.0, 20.0)months, and there were no cases of readmission for surgical complications. The average duration of surgery was (93.6±35.9) min, and the average bleeding volume was (85.3±32.1) ml. The mean duration of catheter after surgery was (7.3±1.2)d. Immediate urinary control was achieved in 98 cases when the catheter was removed, and the rate of immediate urinary control was 81.7%. Postoperative urinary control rate was 88.3% at 1 month after surgery, 94.2% at 3 month after surgery, 98.3% at 6 month after surgery. There were 70 cases with pT 2 and 50 cases with pT 3 after postoperative pathological stage. There were 18 cases (15.0%) with positive margins, including 6 cases (8.6%) with positive margins in T 2 and 12 cases (24.0%) with positive margins in T 3 stage. There were no serious complications after surgery, and urinary retention occurred in 3 cases after urinary catheter removal, and the urinary catheter was removed after 1 week. 93.3% (112/120), 90.8% (109/120), and 89.2% (107/120) of patients with PSA < 0.2 ng/ml at 1, 3, and 6 months after surgery, respectively. For postoperative erectile function, we selected patients younger than 60 years of age, who had surgery to preserve unilateral or bilateral vascular nerve bundles, and who were followed for more than 6 months. A total of 18 patients met the above conditions and were followed up for erectile function, among which 4 of the 11 patients (36.4%) who retained unilateral vascular nerve bundles regained erectile function. Among the 7 patients with bilateral vascular nerve bundle preservation, 3 patients (42.9%) regained erectile function. Conclusions:The programmed RS-RARP combined with the " Sandwich" urethral reconstruction technique is technically feasible for patients with localized prostate cancer. Recent follow-up data indicate satisfactory postoperative urinary continence and oncological control outcomes.