OBJECTIVE To quantitatively assess the compatibility risk of commonly used intravenous drugs in intensive care unit （ICU） patients with severe pneumonia， and provide a reference for reducing the incidence of adverse events caused by incompatibility. METHODS The PASS clinical pharmacy management system was used to retrospectively collect the data of patients diagnosed with “severe pneumonia” in the ICU of Hebei General Hospital from January 2023 to June 2025， and the commonly used intravenous drugs and medication frequency were extracted. Based on authoritative databases such as Micromedex and Stabilis as well as relevant literature， the compatibility data of commonly used intravenous drugs with 0.9% Sodium chloride injection and 5% Glucose injection were summarized. The theoretical and actual compatibility risk values were calculated using formulas， and high-risk drugs were screened and the compatibility query table was drawn. RESULTS A total of 158 ICU patients with severe pneumonia were treated with 89 intravenous drugs， and 24 drugs with high compatibility risk were identified. The drug with the highest theoretical compatibility risk value was Amphotericin B for injection （risk value 146）， and the drug with the highest actual compatibility risk value was Propofol medium and long chain fat emulsion injection （risk value 8 740）. Among the 24 high-risk drugs， six drugs， namely Esomeprazole sodium for injection， Ambroxol hydrochloride injection， Midazolam injection， Methylprednisolone sodium succinate for injection， Furosemide injection， and Cefoperazone sodium and sulbactam sodium for injection， simultaneously ranked among the top 15 in both theoretical and actual compatibility risk rankings. Among 650 pairwise compatibility combinations of the 24 drugs， 24.62% were compatible， 11.23% were incompatible， 6.77% had conflicting evidence， and 57.38% had missing evidence. CONCLUSIONS This study quantitatively analyzed the medication safety of commonly used intravenous drugs in ICU patients with severe pneumonia， identified 24 drugs with high compatibility risk， and established a compatibility query table for high-risk drugs， which helps reduce the risk of ICU compatibility adverse events.

Objective:To investigate the expression characteristics of the SLFN11 gene in pancreatic cancer and its relationship with cis-diamminedichloroplatinum(DDP)resistance.Methods:This study analyzed multiple publicly available datasets, including GSE207611, GSE186205, GSE73978, GSE217845, and GSE238163 from the gene expression omnibus(GEO)datasets.These datasets comprise gene expression data and single-cell sequencing data from pancreatic cancer cell lines and patients, which were utilized to examine the expression characteristics of the SLFN11 gene and its association with cisplatin resistance.Receiver operating characteristic (ROC) curves were generated, and the area under the curve (AUC) value along with the confidence interval ( CI) were calculated.Additionally, Kaplan-Meier survival analysis and single-cell RNA sequencing(scRNA-seq)data analysis were conducted. Results:The differential expression of the SLFN11 gene between tumor and adjacent normal tissues was statistically significant( P<0.05). The AUC value for SLFN11 in diagnosing pancreatic cancer was 0.761.SLFN11, along with its associated genes PTN and SLC15A3, collectively influenced the survival of pancreatic cancer patients.Results from single-cell sequencing demonstrated high expression of SLFN11 in mesenchymal stem cells. Conclusions:The SLFN11 gene demonstrates significant diagnostic and prognostic value in pancreatic cancer and may play a role in the mechanism of cisplatin resistance.

Objective:To investigate the expression characteristics of the SLFN11 gene in pancreatic cancer and its relationship with cis-diamminedichloroplatinum(DDP)resistance.Methods:This study analyzed multiple publicly available datasets, including GSE207611, GSE186205, GSE73978, GSE217845, and GSE238163 from the gene expression omnibus(GEO)datasets.These datasets comprise gene expression data and single-cell sequencing data from pancreatic cancer cell lines and patients, which were utilized to examine the expression characteristics of the SLFN11 gene and its association with cisplatin resistance.Receiver operating characteristic (ROC) curves were generated, and the area under the curve (AUC) value along with the confidence interval ( CI) were calculated.Additionally, Kaplan-Meier survival analysis and single-cell RNA sequencing(scRNA-seq)data analysis were conducted. Results:The differential expression of the SLFN11 gene between tumor and adjacent normal tissues was statistically significant( P<0.05). The AUC value for SLFN11 in diagnosing pancreatic cancer was 0.761.SLFN11, along with its associated genes PTN and SLC15A3, collectively influenced the survival of pancreatic cancer patients.Results from single-cell sequencing demonstrated high expression of SLFN11 in mesenchymal stem cells. Conclusions:The SLFN11 gene demonstrates significant diagnostic and prognostic value in pancreatic cancer and may play a role in the mechanism of cisplatin resistance.

Objective:To investigate the effect of abdominal circumference on intestinal radiation dose volume and acute intestinal toxicity in pelvic intensity modulated radiation therapy for rectal cancer.Methods:A total of 150 patients with locally advanced rectal cancer (LARC) who received adjuvant and neoadjuvant concurrent chemoradiotherapy at the Affiliated Cancer Hospital of Guizhou Medical University from March 2023 to January 2025 were enrolled, including 82 cases of adjuvant radiotherapy and 68 cases of neoadjuvant radiotherapy. All patients underwent radiotherapy CT simulation positioning in the standard mode of prone position with abdominal board padding and bladder filling. Intestinal toxicity was categorized as a binary variable based on the occurrence of ≥2 grade acute intestinal toxicity. Linear and logistic regression models were used to analyze the factors influencing intestinal radiation dose volumes (V 10, V 20, V 30, V 40) and acute intestinal toxicity in LARC patients. Generalized additive models and piecewise linear and logistic regression analyses were employed to examine the threshold effects of abdominal circumference on intestinal radiation dose volumes and acute intestinal toxicity. The threshold value for abdominal circumference was determined based on the upper limit of the 95% CI for the threshold. A difference test was used to validate the differences in intestinal radiation dose volume and acute intestinal toxicity between small and medium-to-large abdominal circumferences. Results:Univariate analysis showed that, gender, body mass, abdominal circumference, planning target volume (PTV), intestinal volume were all influencing factors for the radiation dose volumes (V 10, V 20, V 30, V 40) of each intestinal segment of patients with LARC undergoing adjuvant radiotherapy (all P<0.05). Body mass, abdominal circumference, intestinal volume were all influencing factors for the radiation dose volumes (V 10, V 20, V 30, V 40) of each intestinal segment of patients with LARC undergoing neoadjuvant radiotherapy (all P<0.05). Body mass index (BMI), abdominal circumference, intestinal volume and individual intestinal radiation volumes (V 10, V 20, V 30, V 40) were all influencing factors for the acute intestinal toxicity of patients with LARC undergoing adjuvant radiotherapy (all P<0.05). Body mass, BMI, abdominal circumference, multiple intestinal radiation dose volumes (V 20, V 30, V 40) were all influencing factors for the acute intestinal toxicity of patients with LARC undergoing neoadjuvant radiotherapy (all P<0.05). Multivariate analysis showed that, abdominal circumference (V 10: β=-1.01, 95% CI: -1.68--0.33, P=0.004; V 20: β=-0.94, 95% CI: -1.28--0.60, P<0.001; V 30: β=-0.58, 95% CI: -0.82--0.34, P<0.001; V 40: β=-0.41, 95% CI: -0.60--0.23, P<0.001) was an independent influencing factor for the radiation dose volume of each intestinal segment of patients with LARC undergoing adjuvant radiotherapy. Abdominal circumference (V 10: β=-0.92, 95% CI: -1.62--0.22, P=0.010; V 20: β=-0.84, 95% CI: -1.11--0.57, P<0.001; V 30: β=-0.42, 95% CI: -0.57--0.28, P<0.001; V 40: β=-0.30, 95% CI: -0.41--0.19, P<0.001) was an independent influencing factor for the radiation dose volume of each intestinal segment of patients with LARC undergoing neoadjuvant radiotherapy. Abdominal circumference ( OR=0.86, 95% CI: 0.78-0.95, P=0.002) was an independent influencing factor for the acute intestinal toxicity of patients with LARC undergoing adjuvant radiotherapy. Abdominal circumference ( OR=0.87, 95% CI: 0.79-0.96, P=0.004) was an independent influencing factor for the acute intestinal toxicity of patients with LARC undergoing neoadjuvant radiotherapy. The generalized additive model revealed a nonlinear relationship between abdominal circumference and intestinal radiation dose volume and acute intestinal toxicity of adjuvant radiotherapy patients. Further segmented regression analysis results showed that there was a threshold effect between abdominal circumference and intestinal radiation dose volume (V 10, V 20, V 30, V 40) and acute intestinal toxicity. The inflection point values between abdominal circumference and intestinal radiation dose volume V 10, V 20, V 30, V 40 in LARC patients undergoing adjuvant radiotherapy were all 71.9 cm; the inflection point values between abdominal circumference and the intestinal radiation dose volume V 10, V 20, V 30, V 40 in LARC patients undergoing neoadjuvant radiotherapy were 69.0, 69.0, 69.0, 68.6 cm, respectively; The inflection point values between abdominal circumference and acute intestinal toxicity in LARC patients undergoing adjuvant radiotherapy and neoadjuvant radiotherapy were 71.9, 69.0 cm, respectively. Based on the upper limit of the 95% CI threshold, the cutoff values for small and medium-to-large abdominal circumferences for patients undergoing adjuvant and neoadjuvant radiotherapy were set at 76.1, 71.9 cm, respectively. In patients undergoing adjuvant radiotherapy, the levels of intestinal radiation dose volume V 10 [ (7.65±2.29) cm 3vs. (5.88±2.68) cm 3, t=2.76, P=0.007], V 20 [ (4.28±1.27) cm 3vs. (2.72±1.31) cm 3, t=4.81, P<0.001], V 30 [ (2.42±1.07) cm 3vs. (1.37±0.76) cm 3, t=4.95, P<0.001], V 40 [ (1.69±0.74) cm 3vs. (0.92±0.58) cm 3, t=4.93, P<0.001] in the small abdominal circumference group ( n=22) were significantly higher than those in patients with medium-to-large abdominal circumferences ( n=60) ; In patients undergoing neoadjuvant radiotherapy, patients with small abdominal circumferences ( n=11) had significantly higher V 20 [ (3.09±0.84) cm 3vs. (2.28±1.17) cm 3, t=2.17, P=0.033], V 30 [1.44 (1.22, 1.53) cm 3vs. 0.91 (0.56, 1.22) cm 3, Z=-3.04, P=0.002], V 40 [0.93 (0.84, 1.09) cm 3vs. 0.44 (0.30, 0.81) cm 3, Z=-3.19, P=0.001] than patients with medium-to-large abdominal circumferences ( n=57). In patients receiving adjuvant radiotherapy and neoadjuvant radiotherapy, there were statistically significant differences in acute intestinal toxicity between patients with small abdominal circumferences and with medium-to-large abdominal circumferences ( χ2=10.46, P=0.001; χ2=8.13, P=0.004) . Conclusions:In the standard mode (prone position with abdominal board padding and bladder filling), abdominal circumference is an independent factor influencing the intestinal radiation dose volume and acute intestinal toxicity in rectal cancer radiotherapy patients. There is a significant non-linear threshold effect between abdominal circumference and different levels of intestinal radiation dose volume and acute intestinal toxicity. The impact of abdominal circumference on intestinal radiation dose volume and toxicity differs significantly before and after the inflection point value. Patients with smaller abdominal circumferences not only fail to achieve the expected benefits under the current standard radiotherapy regimen but also face higher risks of intestinal radiation dose volume and toxicity.

Objective To investigate alteration of blood routine parameters,blood gas analysis profile,coagulation function,and inflammatory factors during exposure to high-altitude hypoxic environments.Methods Rats were raised in a hypobaric oxygen chamber to simulate the altitude of 5 500 meters.The animals were divided into groups with exposure duration of 0(control),1,3,5,7,14,and 28 days.Arterial blood gas was measured using a blood gas analyzer.The routine blood test was performed by an automatic five-differential animal hematology analyzer.The coagulation function was measured by a fully automatic coagulation analyzer.The level of plasma D-dimer(DD),erythropoietin(EPO),interleukin-10(IL-10),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and C-reactive protein(CRP)was detected by ELISA method.The protein expression of IL-10,IL-6,and TNF-α in lung tissues of the animals was detected by Western blot.Results As compare to control group,the arterial partial pressure of ox-ygen(PaO2)decreased at different durations of hypoxia exposure.The PaO2 in the group exposed to hypoxia for 7 d was the lowest(P＜0.05).The red blood cell count(RBC),hemoglobin(HGB),hematocrit(HCT),mean cor-puscular volume(MCV),mean corpuscular hemoglobin concentration(MCHC)and mean platelet volume(MPV)were all higher than control group(P＜0.05).Erythropoietin(EPO),prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB)and D-dimer(DD)all gradually increased(P＜0.05).The white blood cell count(WBC)and platelet count(PLT),as well as the plasma inflammatory fac-tors including interleukin-10(IL-10),interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α),C-reactive protein(CRP),and the expression of inflammatory factors in the lung tissue including IL-10,IL-6 and TNF-α pro-teins all showed a curve of increasing at beginning and then followed by a slow decrease with the prolongation of the hypoxia time(P＜0.05).Conclusions In high-altitude hypoxic environment,the blood circulation undergoes dy-namic evolution of functional remodeling with higher risk of inflammatory response.As the hypoxia time prolongs,the animals adapt the environment and the level of inflammatory cytokines gradually decline but remains at a level which is still higher than that of control animals.

Objective:To investigate the clinical efficacy of fixation with a modified double-pulley anchor suture in the treatment of Rockwood type Ⅱ patella fractures.Methods:A retrospective study was conducted to analyze the 60 patients with Rockwood type Ⅱ patellar fracture who had been admitted to Department of Joint Surgery, The Hospital Affiliated to Qingdao University between November 2021 and November 2023. The cohort included 31 males and 29 females, with an age of (53.5±10.4) years. According to the treatment methods, the patients were divided into a study group (28 cases) which was treated by traction reinforcement of the terminal anchor suture in addition to fixation with a double-pulley anchor suture, and a control group (32 cases) which was treated by the traditional Kirschner wire tension band technique. The operation time, intraoperative blood loss, incision length, reoperation rate, complication rate, fracture healing, and visual analog scale (VAS) pain scores and Bostman scores at postoperative 1 month, 3 months, and 6 months and at the last follow-up were compared between the 2 groups.Results:No statistically significant differences were observed in the preoperative general data between the 2 groups, indicating that the 2 groups were comparable ( P>0.05). All patients were followed up for (12.8±1.4) months postoperatively. The study group demonstrated significantly lower intraoperative blood loss [(25.9±6.8) mL] than the control group [(40.5±11.6) mL], and a significantly lower reoperation rate (0) than the control group [53.1% (17/32)] ( P<0.05). There was no statistically significant difference between the 2 groups in operation time, incision length, incidence of complications, as well as in VAS pain scores or Bostman scores at postoperative 1 month, 3 months, or 6 months or at the last follow-up (all P>0.05). Fractures healed in both groups at 6 months postoperatively. Conclusions:For patients with Rockwood type Ⅱ patellar fracture, fixation with modified double-pulley suture anchor can achieve good clinical efficacy. Compared to the traditional Kirschner wire tension band technique, the modified mothed significantly reduces intraoperative blood loss and avoids secondary trauma caused by a second surgery for implant removal.

PURPOSE: Traumatic brain injury (TBI) is a significant public health issue that impacts individuals all over the world and is one of the main causes of mortality and morbidity. Decompressive craniectomy is the usual course of treatment. Basal cisternostomy has been shown to be highly effective as an alternative procedure to decompressive craniectomy. METHODS: We conducted a retrospective cohort of patients who received surgery for severe TBI between January 2019 and March 2023. Inclusion criterias were patients between the ages of 18 and 70 years who met the diagnostic criteria for severe TBI at first presentation and who underwent surgical intervention. The exclusion criteria were patients who have severe multiple injuries at the time of admission; preoperative intracranial pressure > 60 mmHg; cognitive impairment before the onset of the disease; hematologic disorders; or impaired functioning of the heart, liver, kidneys, or other visceral organs. Depending on the surgical approach, the patients were categorized into decompressive craniectomy group as well as basal cisternostomy group. General data and postoperative indicators, including Glasgow coma scale, intracranial pressure, etc., were recorded for both groups of patients. Among them, the Glasgow outcome scale extended assessment at 6 months served as the primary outcome. After that, the data were statistically analyzed using SPSS software. RESULTS: The trial enrolled 41 patients (32 men and 9 women) who met the inclusion criteria. Among them, 25 patients received decompressive decompressive craniectomy, and 16 patients received basal cisternostomy. Three days postoperative intracranial pressure levels were 10.07 ± 2.94 mmHg and 17.15 ± 14.65 mmHg (p = 0.013), respectively. The 6 months following discharge Glasgow outcome scale extended of patients was 4.73 ± 2.28 and 3.14 ± 2.15 (p = 0.027), respectively. CONCLUSION Our study reveals that basal cisternostomy in patients with surgically treated severe TBI has demonstrated significant efficacy in reducing intracranial pressure as well as patient prognosis follow-up and avoids removal of the bone flap. The efficacy of cisternostomy has to be studied in larger, multi-clinical center randomized trials.
Humans ; Brain Injuries, Traumatic/surgery* ; Retrospective Studies ; Male ; Female ; Adult ; Middle Aged ; Decompressive Craniectomy/methods* ; Aged ; Young Adult ; Adolescent ; Glasgow Coma Scale ; Treatment Outcome

Objective:To investigate the clinical efficacy of fixation with a modified double-pulley anchor suture in the treatment of Rockwood type Ⅱ patella fractures.Methods:A retrospective study was conducted to analyze the 60 patients with Rockwood type Ⅱ patellar fracture who had been admitted to Department of Joint Surgery, The Hospital Affiliated to Qingdao University between November 2021 and November 2023. The cohort included 31 males and 29 females, with an age of (53.5±10.4) years. According to the treatment methods, the patients were divided into a study group (28 cases) which was treated by traction reinforcement of the terminal anchor suture in addition to fixation with a double-pulley anchor suture, and a control group (32 cases) which was treated by the traditional Kirschner wire tension band technique. The operation time, intraoperative blood loss, incision length, reoperation rate, complication rate, fracture healing, and visual analog scale (VAS) pain scores and Bostman scores at postoperative 1 month, 3 months, and 6 months and at the last follow-up were compared between the 2 groups.Results:No statistically significant differences were observed in the preoperative general data between the 2 groups, indicating that the 2 groups were comparable ( P>0.05). All patients were followed up for (12.8±1.4) months postoperatively. The study group demonstrated significantly lower intraoperative blood loss [(25.9±6.8) mL] than the control group [(40.5±11.6) mL], and a significantly lower reoperation rate (0) than the control group [53.1% (17/32)] ( P<0.05). There was no statistically significant difference between the 2 groups in operation time, incision length, incidence of complications, as well as in VAS pain scores or Bostman scores at postoperative 1 month, 3 months, or 6 months or at the last follow-up (all P>0.05). Fractures healed in both groups at 6 months postoperatively. Conclusions:For patients with Rockwood type Ⅱ patellar fracture, fixation with modified double-pulley suture anchor can achieve good clinical efficacy. Compared to the traditional Kirschner wire tension band technique, the modified mothed significantly reduces intraoperative blood loss and avoids secondary trauma caused by a second surgery for implant removal.

Objective To establish a high-throughput screening system to obtain key Staphylococcus aureus (S.aureus)secretory proteins which required for S.aureus survival in macrophages.Methods Based on our validated eukaryotic expression vector library of S.aureus secretory proteins,DNA transfection was used to obtain an RAW264.7 macrophage array expressing S.aureus secretory proteins.After the RAW264.7 cells were infected with S.aureus,the extracellular bacteria were removed to observe the intracellular surviving situation of S.aureus.Finally,the screening results were validated by the overexpression and knockout S.aureus of corresponding secretory proteins.Results The optimal transfection dose (1.0 μg/well)of plasmids for RAW264.7,multiplicity of infection (MOI,1 .0 ),and infection time (4 h after removing extracellular bacteria of S.aureus ) were established respectively.To validate the screening results,the corresponding overexpression and knockout strains were constructed.And hypothetical protein and Serine protease E were found to promote the survival of intracellular S.aureus.Conclusion We successfully construct a screening system for key secreted secretory proteins which required for S.aureus surviving in macrophages,which may advance the study of the intracellular surviving mechanism of S.aureus.

Objective To explore the mechanism which drives nimbolide(NIM)in treating acute pneumonia caused by Staphylococcus aureus(S.auteus).Methods A mouse model of acute pneumonia caused by S.auteus was constructed through endotracheal intubation.After NIM treatment,the survival rate was observed,the amount of bacteria in the lung was tested by plate culture,and the expression of inflammatory cytokines in the lung tissues was detected with ELISA.After primary cultured peritoneal macrophages(PM)were infected with S.auteus,the effect of NIM on the expression of inflammatory cytokines and activation of inflammatory pathway were studied with ELISA and Western blotting,respectively.The effect of RNF114 knockdown by lentiviral shRNA infection on inflammation responses in PM was explored with ELISA and Western blotting.Results Acute infection of S.auteus in the lung could cause acute death in the mice,while NIM treatment significantly improved the survival rate and down-regulated the levels of inflammatory cytokines in the lung.However,it had no effect on the lung colonization of S.auteus in the short term.The results of in vitro experiments indicated that NIM may regulate RNF114 function to down-regulate the phosphorylation level of ERK,inhibit the activation of MAPK pathway,and thus suppress the expression of inflammatory cytokines.Conclusion NIM may inhibit the activation of MAPK pathway by regulating the function of RNF114,and thus suppress the expression of inflammatory cytokines in the lung,and finally inhibit the death of mice with acute pulmonary hyperinflammation caused by S.auteus.