Objective To construct glucose oxidase（GOx）–loaded nanogels （GONGs）, optimize their formulation, and evaluate their capacity to inhibit the Warburg effect in glioma cells. Methods A responsive polymer （HAM） was synthesized and used to self-assemble GONGs, which were then characterized. Encapsulation efficiency and drug loading were determined using fluorescence spectrophotometry. Biocompatibility was tested by measuring cytotoxicity and hemolytic activity. Western blotting was used to evaluate the effects of GONGs on the expression of proteins associated with the Warburg phenotype and oxidative damage in glioma cells. Results GONGs prepared at a drug–to–polymer ratio of 1∶10 exhibited a particle size of 140.3 nm and a zeta potential of −27.2 mV. Compared with free GOx, GONGs markedly reduced cytotoxicity, increased the IC₅₀ in hUVEC cells from 2.150 nmol/L to 74.86 nmol/L, and significantly decreased hemolysis. At a GOx concentration of 2 nmol/L, GONGs effectively downregulated glycolysis-related proteins, such as HK2 and LDHA, and inhibited glutamine metabolism in glioma cells. Conclusion GONGs exhibited high GOx loading capacity, significantly reduced GOx-induced cytotoxicity, inhibited the Warburg effect in glioma cells and induced oxidative damage.

Objective To prepare a thermosensitive hydrogel scaffold loaded with bone marrow mesenchymal stem cells（BMSCs） and resveratrol liposomes （RSV-LIP） to form a therapeutic unit and evaluate its treatment efficacy for traumatic brain injury （TBI）. Methods BMSCs were extracted from rats, and RSV-LIP was prepared and characterized. Cell models were constructed to investigate the pharmacological effects of BMSCs combined with RSV-LIP. BMSCs and RSV-LIP were then loaded into the hydrogel, and a TBI mouse model was established to evaluate the therapeutic effects of the hydrogel. Results The RSV-LIP had a particle size of 127.8 nm, a Zeta potential of −4.9 mV, an encapsulation efficiency of 78.50%, and a drug loading content of 2.37%. Live-dead staining indicated good biocompatibility of the hydrogel. The combination of BMSCs and RSV-LIP significantly inhibited TNF-α and reduced ROS levels, promoting cell migration in scratch assays. Compared to the control group, the hydrogel group showed significantly lower mNSS scores （P<0.01）, higher hanging scores （P<0.001）, and reduced stepping errors （P<0.001）. Conclusion The combination of BMSCs and RSV-LIP exhibited antioxidative stress, anti-inflammatory, and neurogenic cell migration-promoting effects. When loaded into a hydrogel scaffold and locally implanted, it could improve the motor and sensory functions in TBI mice.

BACKGROUND: Concurrent chemo-radiotherapy (CCRT) is the standard treatment for locally advanced cervical cancer (LACC), but there are still many patients who suffer tumor recurrence. However, valuable predictors of treatment outcomes remain limited. This study aimed to assess the value of the serum immune biomarkers to predict the prognosis. METHODS: We reviewed cervical cancer patients treated with CCRT between January 2014 and May 2018 at Peking Union Medical College Hospital. The systemic immune inflammation index (SII), systemic inflammation response index (SIRI), and lactate dehydrogenase (LDH) were calculated using blood samples. The relationship between immune markers and the treatment outcome was analyzed. The area under the receiver operating characteristic (ROC) curve was used to evaluate the predictive efficiency. The Cox proportional hazards model and log-rank were used to predict overall survival (OS) and disease-free survival (DFS). RESULTS: This study included 667 patients. Among them, 195 (29.2%) patients were defined as treatment failure, including 127 (19.0%) patients with pelvic failure, 94 (14.1%) distant failure, and 25 (3.7%) concurrent pelvic and distant failure. It revealed that the tumor stage, size, metastatic lymph nodes (MLNs), and serum immune biomarkers, such as SII, SIRI, and LDH, were significantly related to treatment outcomes. We demonstrated that the optimal cut-off of the SII, SIRI, and LDH were 970.4 × 10 9 /L, 1.3 × 10 9 /L, and 207.52 U/L, respectively. Importantly, this study presented that LDH level had the highest OR (OR = 4.2; 95% CI [2.3-10.8]). Furthermore, the OS and DFS for patients with pre-SII ≥970.5 × 10 9 /L were significantly worse than those with pre-SII <970.5 × 10 9 /L. Similarly, pre-SIRI ≥1.25 × 10 9 /L and pre-LDH ≥207.5 U/L were related to poor survival outcomes. CONCLUSIONS This study demonstrated that the baseline SII, SIRI, and LDH levels can be used to accurately and effectively predict the treatment outcomes after CCRT and long-term prognosis. Our results may offer additional prognostic information in clinical, which helps to detect the potential recurrent metastasis in time.
Humans ; Female ; Uterine Cervical Neoplasms/drug therapy* ; Middle Aged ; Adult ; Aged ; Chemoradiotherapy/methods* ; L-Lactate Dehydrogenase/blood* ; Treatment Outcome ; Disease-Free Survival ; Prognosis ; ROC Curve ; Biomarkers, Tumor/blood* ; Proportional Hazards Models

Lean six sigma (LSS) emphasizes patient demand-oriented, and continuously optimizing prolesses to achieve efficiency and standardization in medical services. Starting in 2021, a specialized children′s hospital (comprising one main campus and three branch campuses) introduced the LSS management method. Through define, measure, analyze, improve, and control, the hospital utilized tools such as questionnaire surveys, SIPOC models, and fishbone diagrams to identify pain points in the building of multi-campus child-friendly hospital and develop improvement measures.To address the main issues of insufficient cross-campus collaboration, significant disparities in service quality among different campuses, unclear functional positioning of each campus, and inadequate integration with social security mechanisms, the hospital implemented a " homogeneity-differentiation-coordination" management mode. The hospital implemented unified diagnosis and treatment standards and clinical pathways, carried out remote consultations and expert rotations, completed mutual recognition of examination and testing results, optimized child friendly labeling and child friendly environment, and built a " hospital-to-hospitals, hospital to medical schools, and hospital to community health centers" linkage platform, etc., to promote the standardization of diagnosis and treatment processes, clear functional positioning of the hospital area, and efficient resource allocation. Through practice, the outpatient appointment rate and patient satisfaction rate in the main hospital had increased from 86.72% and 98.64% in January December 2021 to 91.87% and 99.72% in January December 2024, respectively; The patient waiting time had been shortened from 26.54 minutes to 21.94 minutes, and the efficiency of medical treatment and service experience had been significantly improved. As of 2024, mutual recognition of 214 inspection and testing items had been achieved cross hospital campuses, forming a collaborative pattern of " main hospital leading, campuses support, and resource complementarity", and significantly improving the level of collaboration and child friendly connotation among multi-campus. This practice explored the integration path of multi-campus collaborative governance and child-friendly services, which could provide reference and inspiration for the similar hospitals.

Objective To explore the effectiveness of the tele-intelligent rehabilitation system based on a wearable device in early rehabilitation of patients after arthroscopic anterior cruciate ligament re-construction(ACLR).Methods A total of 70 patients(48 male,22 female,18～29 years old)undergo-ing arthroscopic ACLR were randomly divided into a tele-rehabilitation group(n=36)and a convention-al rehabilitation group(n=34).The tele-rehabilitation group underwent rehabilitation training using the tele-intelligent rehabilitation system based on a wearable device,while the conventional rehabilitation group conducted a home-based self-rehabilitation exercise according to the conventional education con-tent after surgery.Before surgery and 12 weeks postoperatively,both groups were assessed using the International Knee Documentation Committee(IKDC),lower extremity functional scale(LEFS),knee active range of motion(AROM),numeric pain rating scale(NPRS)and 12-item short-form health survey(SF-12).Results Before surgery,there was no significant difference between the two groups in the IKDC score,LEFS,knee mobility,walking NPRS,as well as physical component summary(PCS)and mental component summary(MCS)scores in the SF-12 scale(P>0.05).However,12 weeks postoperatively,the IKDC score,LEFS score,and knee mobility in the tele-rehabilitation group were 73.4±9.8,70.2±5.1,and 127.9°±5.8°,respectively,significantly better than those of the conventional rehabilitation group(64.3±13.7,63.6±9.6,and 122.7°±10.6°,respectively)(P<0.05 for all).Moreover,the walking NPRS scores in the tele-rehabilitation group were significantly low-er than the conventional rehabilitation group(P=0.01),while the PCS and the MCS scores of the for-mer were significantly superior to the latter(P<0.01).In addition,the minimum clinically important difference compliance rate of IKDC and LEFS score and the patient acceptable symptom state compli-ance rate of NPRS score in tele-rehabilitation group were significantly better than the latter group(P<0.05).Conclusion The remote intelligent rehabilitation system based on a wearable device is superior to the conventional rehabilitation in promoting early knee function recovery,joint mobility,relieving pain,and bettering the life quality of patients after ACLR.

Objective To explore the effectiveness of the tele-intelligent rehabilitation system based on a wearable device in early rehabilitation of patients after arthroscopic anterior cruciate ligament re-construction(ACLR).Methods A total of 70 patients(48 male,22 female,18～29 years old)undergo-ing arthroscopic ACLR were randomly divided into a tele-rehabilitation group(n=36)and a convention-al rehabilitation group(n=34).The tele-rehabilitation group underwent rehabilitation training using the tele-intelligent rehabilitation system based on a wearable device,while the conventional rehabilitation group conducted a home-based self-rehabilitation exercise according to the conventional education con-tent after surgery.Before surgery and 12 weeks postoperatively,both groups were assessed using the International Knee Documentation Committee(IKDC),lower extremity functional scale(LEFS),knee active range of motion(AROM),numeric pain rating scale(NPRS)and 12-item short-form health survey(SF-12).Results Before surgery,there was no significant difference between the two groups in the IKDC score,LEFS,knee mobility,walking NPRS,as well as physical component summary(PCS)and mental component summary(MCS)scores in the SF-12 scale(P>0.05).However,12 weeks postoperatively,the IKDC score,LEFS score,and knee mobility in the tele-rehabilitation group were 73.4±9.8,70.2±5.1,and 127.9°±5.8°,respectively,significantly better than those of the conventional rehabilitation group(64.3±13.7,63.6±9.6,and 122.7°±10.6°,respectively)(P<0.05 for all).Moreover,the walking NPRS scores in the tele-rehabilitation group were significantly low-er than the conventional rehabilitation group(P=0.01),while the PCS and the MCS scores of the for-mer were significantly superior to the latter(P<0.01).In addition,the minimum clinically important difference compliance rate of IKDC and LEFS score and the patient acceptable symptom state compli-ance rate of NPRS score in tele-rehabilitation group were significantly better than the latter group(P<0.05).Conclusion The remote intelligent rehabilitation system based on a wearable device is superior to the conventional rehabilitation in promoting early knee function recovery,joint mobility,relieving pain,and bettering the life quality of patients after ACLR.

Lean six sigma (LSS) emphasizes patient demand-oriented, and continuously optimizing prolesses to achieve efficiency and standardization in medical services. Starting in 2021, a specialized children′s hospital (comprising one main campus and three branch campuses) introduced the LSS management method. Through define, measure, analyze, improve, and control, the hospital utilized tools such as questionnaire surveys, SIPOC models, and fishbone diagrams to identify pain points in the building of multi-campus child-friendly hospital and develop improvement measures.To address the main issues of insufficient cross-campus collaboration, significant disparities in service quality among different campuses, unclear functional positioning of each campus, and inadequate integration with social security mechanisms, the hospital implemented a " homogeneity-differentiation-coordination" management mode. The hospital implemented unified diagnosis and treatment standards and clinical pathways, carried out remote consultations and expert rotations, completed mutual recognition of examination and testing results, optimized child friendly labeling and child friendly environment, and built a " hospital-to-hospitals, hospital to medical schools, and hospital to community health centers" linkage platform, etc., to promote the standardization of diagnosis and treatment processes, clear functional positioning of the hospital area, and efficient resource allocation. Through practice, the outpatient appointment rate and patient satisfaction rate in the main hospital had increased from 86.72% and 98.64% in January December 2021 to 91.87% and 99.72% in January December 2024, respectively; The patient waiting time had been shortened from 26.54 minutes to 21.94 minutes, and the efficiency of medical treatment and service experience had been significantly improved. As of 2024, mutual recognition of 214 inspection and testing items had been achieved cross hospital campuses, forming a collaborative pattern of " main hospital leading, campuses support, and resource complementarity", and significantly improving the level of collaboration and child friendly connotation among multi-campus. This practice explored the integration path of multi-campus collaborative governance and child-friendly services, which could provide reference and inspiration for the similar hospitals.

Objective:To investigate the light exposure in neonatal intensive care unit (NICU), and to explore the effect of light management on the growth and development of premature infants.Methods:This study adopted a quasi-experimental research method. Sixty-three premature infants hospitalized in NICU of Obstetrics and Gynecology Hospital Affiliated to Jiangnan University from January to December 2021 were selected by convenience sampling as the control group, and conventional premature infant care measures were implemented, while 60 hospitalized premature infants from January to December 2022 were selected as the observation group, and NICU light management strategies were implemented. The light intensity, bad light exposure, the growth of body mass, body length, hospitalization days of premature infants during hospitalization, and the feeding of premature infants during hospitalization were compared between the two groups.Results:Sixty-three patients were enrolled in the control group, including 28 males and 35 females with a gestational age of (32. 13 ± 1.94) weeks, while 60 patients were enrolled in the observation group, including 32 males and 28 females with a gestational age of (31. 79 ± 1.83) weeks. The daytime and nighttime illuminations in the observation group were (413.79 ± 181.95) and (18.95 ± 12.43) lux, which were better than those in the control group (145.12 ± 99.56) and (53.25 ± 38.34) lux, respectively. The rate of bad light exposure in the observation group was 18.2% (183/1 008). The difference was statistically significant ( t=-29.08, 11.55, χ2=126.99, all P<0.05). In the observation group, the body mass, weekly length gain, hospitalization days, milk intake and age at full feeding on the 7th and 14th day of birth were (1.74 ± 0.32) kg, (1.88 ± 0.32) kg, (1.63 ± 0.60) cm, (26.92 ± 12.32) d, (125.60 ± 69.43) ml/d, (239.33 ± 92.83) ml/d, (15.07 ± 10.01) d, and (1.58 ± 0.31) kg, (1.73 ± 0.31) kg, (1.39 ± 0.48) cm, (32.00 ± 14.00) d, (100.83 ± 68.54) ml/d, (195.05 ± 111.22) ml/d, (18.95 ± 10.76) d in the control group. There were significant differences between the two groups ( t values were -2.89 to 2.13, all P<0.05). Conclusions:The implementation of light management strategy in NICU can effectively reduce the bad light exposure of premature infants, promote their growth and development and shorten the length of hospital stay, which is worthy of clinical application.

Objective:To study the clinical characteristics and risk factors of nephrocalcinosis in preterm infants.Methods:From March 2021 to August 2021, all preterm infants admitted to NICU of our hospital were retrospectively analyzed. The infants were assigned into nephrocalcinosis group and non-nephrocalcinosis group according to urinary tract ultrasound. Clinical data including gestational age, birth weight(BW), nutritional support strategy and complications were reviewed.Results:A total of 40 preterm infants (<34 weeks) were enrolled. 9 cases were in the nephrocalcinosis group and 31 cases in the non-nephrocalcinosis group. The nephrocalcinosis group had lower BW[(1 167±214) g vs.(1 586±215) g], higher calcium [6.9 (5.1, 8.7) g vs.3.3 (2.1, 6.8) g] and vitamin D intake [3.2(2.5, 4.2)×10 4U vs.1.7(1.1, 3.2)×10 4U] during hospitalization. No significant differences existed between the two groups on the following items:blood calcium and phosphate, 25-hydroxyvitamin D, feeding strategy, time to reach full enteral feeding(TFF), furosemide dosage and respiratory support duration ( P>0.05). In the nephrocalcinosis group, the median age of diagnosing nephrocalcinosis was 40.0(30.0, 52.5)d after birth. 5 cases showed bilateral nephrocalcinosis. 5 cases in the nephrocalcinosis group received renal tubule function examination,4 cases had increased urine β2 microglobulin and 2 cases had increased urine α1 microglobulin. 7 cases had elevated urine calcium in the nephrocalcinosis group. Follow-up showed that nephrocalcinosis disappeared 3-9 months after birth. Conclusions:BW, total calcium and vitamin D intake are risk factors for nephrocalcinosis in preterm infants. Increased urine β2 microglobulin and calcium levels are common co-morbidities in preterm infants with nephrocalcinosis.

Background Air pollution is a major public health concern. Air Quality Health Index (AQHI) is a very important air quality risk communication tool. However, AQHI is usually constructed by single-pollutant model, which has obvious disadvantages. Objective To construct an AQHI based on the joint effects of multiple air pollutants (J-AQHI), and to provide a scientific tool for health risk warning and risk communication of air pollution. Methods Data on non-accidental deaths in Yunnan, Guangdong, Hunan, Zhejiang, and Jilin provinces from January 1, 2013 to December 31, 2018 were obtained from the corresponding provincial disease surveillance points systems (DSPS), including date of death, age, gender, and cause of death. Daily meteorological (temperature and relative humidity) and air pollution data (SO₂, NO₂, CO, PM_2.5, PM₁₀, and maximum 8 h O₃ concentrations) at the same period were respectively derived from China Meteorological Data Sharing Service System and National Urban Air Quality Real-time Publishing Platform. Lasso regression was first applied to select air pollutants, then a time-stratified case-crossover design was applied. Each case was matched to 3 or 4 control days which were selected on the same days of the week in the same calendar month. Then a distributed lag nonlinear model (DLNM) was used to estimate the exposure-response relationship between selected air pollutants and mortality, which was used to construct the AQHI. Finally, AQHI was classified into four levels according to the air pollutant guidance limit values from World Health Organization Global Air Quality Guidelines (AQG 2021), and the excess risks (ERs) were calculated to compare the AQHI based on single-pollutant model and the J-AQHI based on multi-pollutant model. Results PM_2.5, NO₂, SO₂, and O₃ were selected by Lasso regression to establish DLNM model. The ERs for an interquartile range (IQR) increase and 95% confidence intervals (CI) for PM_2.5, NO₂, SO₂ and O₃ were 0.71% (0.34%–1.09%), 2.46% (1.78%–3.15%), 1.25% (0.9%–1.6%), and 0.27% (−0.11%–0.65%) respectively. The distribution of J-AQHI was right-skewed, and it was divided into four levels, with ranges of 0-1 for low risk, 2-3 for moderate risk, 4-5 for high health risk, and ≥6 for severe risk, and the corresponding proportions were 11.25%, 64.61%, 19.33%, and 4.81%, respectively. The ER (95%CI) of mortality risk increased by 3.61% (2.93–4.29) for each IQR increase of the multi-pollutant based J-AQHI , while it was 3.39% (2.68–4.11) for the single-pollutant based AQHI . Conclusion The J-AQHI generated by multi-pollutant model demonstrates the actual exposure health risk of air pollution in the population and provides new ideas for further improvement of AQHI calculation methods.