Objective: To assess the clinical application value of a prediction model for red blood cell (RBC) demand in surgical procedures. Methods: Demographic data, laboratory parameters, anesthesia and transfusion records, and model prediction data were retrospectively collected from surgical patients at the First Medical Center of Chinese PLA General Hospital between 2018 and 2024. Statistical analysis was performed using the Chi-square test, t-test, and Mann-Kendall trend test. Results: From 2018 to 2024, the predictive model for RBC demand in surgical procedures was used to evaluate a total of 112 293 surgeries. During this period, the model call rate (77.49%-98.91%, P<0.05), compliance rate (56.81%-84.92%, P<0.05), and prediction accuracy rate (66.82%-94.17%, P<0.05) all showed significant upward trends. The total blood usage across the hospital (13645.4-7723.5 units, P<0.05) and the average blood usage per surgery (0.21-0.1 units, P<0.05) exhibited overall downward trends. Postoperative average hemoglobin levels in the non-compliance group (112.1-105.3 g/L in the non-compliance group vs 106.9-92.7 g/L in the compliance group, P<0.05) and the intraoperative excessive transfusion rate (5.06%-6.05% in the non-compliance group vs 0.09%-0.04% in the compliance group, P<0.05) were significantly higher in the non-compliance group compared to the compliance group. Conclusion: The predictive model for RBC demand in surgical procedures has played a positive role in conserving blood resources, optimizing blood resource allocation, and reducing intraoperative risks.

Obesity and its related metabolic diseases have become a major global public health threat, and its rising incidence significantly increases the risk of cardiovascular and cerebrovascular diseases, diabetes and other complications. Pancreatic lipase is a key enzyme that converts food-borne lipids into triglycerides and fatty acids, and the effective inhibition of its activity has become an important strategy for the treatment of obesity. This paper discusses the screening methods of pancreatic lipase inhibitors, and summarizes and reviews the basic principles, advantages and disadvantages and application status of traditional screening methods, modern new screening methods and virtual screening methods. In view of the problems faced by the screening methods of pancreatic lipase inhibitors, future research urgently needs to move towards a collaborative innovation path of multi-technology integration, intelligent screening and complex systematization of traditional Chinese medicine, so as to open up new research paradigms.

Objective:To explore the application of serum microRNA (miR)-30b-5p and miR-141-3p levels in the diagnosis of early neonatal ventilator-associated pneumonia (VAP).Methods:From January 2020 to January 2023, 90 hospitalized newborns who received invasive mechanical ventilation in the Qingdao Eighth People′s Hospital were retrospectively selected as the study subjects. Among them, 49 cases with VAP were as the VAP group, and 41 cases without VAP were as the non VAP group. The serum levels of miR-30b-5p and miR-141-3p were measured before and 48 h after mechanical ventilation in the two groups, and the pulmonary infection scoring system (CPIS) was applied to evaluate the pulmonary infection status. Spearman test was applied to analyze the correlation between serum miR-30b-5p, miR-141-3p levels and CPIS scores; Logistic regression was applied to analyze the influencing factors of VAP; the efficacy of serum miR-30b-5p and miR-141-3p levels alone and in combination for the diagnosis of VAP were analyzed by the receiver operating characteristic (ROC) curve.Results:After 48 h of mechanical ventilation, compared with the non VAP group, the serum levels of miR-30b-5p and miR-141-3p in the VAP group were obviously reduced, while the CPIS scores in the VAP group was obviously increased: (0.47 ± 0.15) μg/L vs. (1.02 ± 0.24) μg/L, (0.36 ± 0.11) μg/L vs. (1.02 ± 0.28) μg/L, (5.19 ± 1.24) scores vs. (3.74 ± 1.08) scores, there were statistical differences ( P<0.05). The results of Spearman test showed that serum levels of miR-30b-5p and miR-141-3p were negatively correlated with CPIS scores ( r = - 0.572, - 0.580, P<0.05). Logistic regression analysis showed that serum miR-30b-5p, miR-141-3pand CPIS scores were risk factors that affected VAP in newborns. The results of ROC curve analysis showed that the area under the curve (AUC) of serum miR-30b-5p and miR-141-3p levels combined diagnosis was 0.891(95% CI 0.808 - 0.947), which was higher than the AUC of diagnosed separately ( Z = 1.96, 2.44, P<0.05). Conclusions:Abnormal expression of miR-30b-5p and miR-141-3p in serum has certain diagnostic value for neonatal VAP, and can provide certain reference for clinical diagnosis.

Objective To investigate the effects of remimazolam(Rem)on postoperative cognitive function in aging model rats and elu-cidate the mechanisms underlying its regulation of the brain-derived neurotrophic factor/tyrosine kinase receptor-B(BDNF/TrkB)pathway.Methods SD rats were randomly assigned to control,model,Rem-L,Rem-M,Rem-H,and Rem-H+7,8-DHF groups,and a Morris water maze test was used to evaluate the learning and memory abilities of rats,whereas pathological changes in the hippocampal neurons of rats were assessed histologically using hematoxylin and eosin staining.In addition,we also examined the levels of inflammatory factors,including interleukin-18(IL-18),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)in rat serum,and those of oxidative stress indi-cators[superoxide dismutase(SOD),glutathione peroxidase(GSH-PX),and malondialdehyde(MDA)]in brain tissue,whereas Western blotting analysis was performed to determine the expression of BDNF/TrkB signaling axis-related proteins and their downstream signaling molecules.Results Hippocampal neurons of the control group rats were observed to be characterized by a tight and regular arrangement,with clear cell boundaries,cytoplasm,and nuclei.Contrastingly,the hippocampal neurons of model group rats were found to be disorderly arranged,with irregular cell morphologies and condensed nuclei being detected in some cells.In water maze tests,compared with the con-trol group rats,those in the model group were found to have a longer escape latency(P＜0.05),and in these rats,we detected significant increases in the levels of IL-1β,IL-18,TNF-α in serum,and levels of MDA,BDNF,TrkB,p-AKT/AKT,and ERK1 in brain tissues(P＜0.05),whereas there were significant reductions in the levels of SOD and GSH(P＜0.05).Furthermore,compared with rats in the model group,the hippocampal neuronal cells of rats in the Rem-L,Rem-M,and Rem-H groups tended to become gradually more orderly,along with a progressive reduction in the number of damaged cells(P＜0.05).In addition,there was a gradual shortening of the escape latency of these rats(P＜0.05),along with gradual reductions in the levels of IL-1β,IL-18,TNF-α in serum,and the levels of MDA,BDNF,and TrkB in brain tissues(P＜0.05),whereas the levels of SOD and GSH gradually increased(P＜0.05).Moreover,we established that the addition of the BDNF/TrkB activator 7,8-DHF reversed the regulatory effect of Rem on the postoperative cognitive function in aging rats(P＜0.05).Conclusion Rem can regulate the postoperative cognitive function in aging rats,the underlying mechanisms of action of which may be associated with an inhibition of the BDNF/TrkB pathway.

As the application of immune checkpoint inhibitors(ICIs)in the perioperative treatment of melanoma is increasingly introduced at earlier stages,it presents a critical opportunity for the development and clinical translation of neoadjuvant therapy.The results of phaseⅠ/Ⅱ clinical trials on neoadjuvant ICI therapy for melanoma demonstrate that neoadjuvant ICIs effectively improve the pathologic re-sponse rate in melanoma patients.Recent studies have shown that combining ICIs with other treatment modalities,including radiotherapy,chemotherapy,and targeted therapies,can enhance antitumor efficacy of neoadjuvant treatment for patients with melanoma.Optimizing treatment regimens,managing adverse events,identifying and addressing pseudoprogression,and handling cases of oligoprogression have become key areas of research in incorporating ICI regimens into neoadjuvant treatment for patients with melanoma.The search for bio-markers to monitor immunotherapy efficacy is expected to become a major focus of future research.This article provides a review of the re-search progress,controversies,and challenges in the application of ICIs in the neoadjuvant treatment of melanoma,and discusses future re-search directions,aiming to offer insights into the clinical application and development of ICIs in melanoma neoadjuvant therapy.

Objective:To explore the application of serum microRNA (miR)-30b-5p and miR-141-3p levels in the diagnosis of early neonatal ventilator-associated pneumonia (VAP).Methods:From January 2020 to January 2023, 90 hospitalized newborns who received invasive mechanical ventilation in the Qingdao Eighth People′s Hospital were retrospectively selected as the study subjects. Among them, 49 cases with VAP were as the VAP group, and 41 cases without VAP were as the non VAP group. The serum levels of miR-30b-5p and miR-141-3p were measured before and 48 h after mechanical ventilation in the two groups, and the pulmonary infection scoring system (CPIS) was applied to evaluate the pulmonary infection status. Spearman test was applied to analyze the correlation between serum miR-30b-5p, miR-141-3p levels and CPIS scores; Logistic regression was applied to analyze the influencing factors of VAP; the efficacy of serum miR-30b-5p and miR-141-3p levels alone and in combination for the diagnosis of VAP were analyzed by the receiver operating characteristic (ROC) curve.Results:After 48 h of mechanical ventilation, compared with the non VAP group, the serum levels of miR-30b-5p and miR-141-3p in the VAP group were obviously reduced, while the CPIS scores in the VAP group was obviously increased: (0.47 ± 0.15) μg/L vs. (1.02 ± 0.24) μg/L, (0.36 ± 0.11) μg/L vs. (1.02 ± 0.28) μg/L, (5.19 ± 1.24) scores vs. (3.74 ± 1.08) scores, there were statistical differences ( P<0.05). The results of Spearman test showed that serum levels of miR-30b-5p and miR-141-3p were negatively correlated with CPIS scores ( r = - 0.572, - 0.580, P<0.05). Logistic regression analysis showed that serum miR-30b-5p, miR-141-3pand CPIS scores were risk factors that affected VAP in newborns. The results of ROC curve analysis showed that the area under the curve (AUC) of serum miR-30b-5p and miR-141-3p levels combined diagnosis was 0.891(95% CI 0.808 - 0.947), which was higher than the AUC of diagnosed separately ( Z = 1.96, 2.44, P<0.05). Conclusions:Abnormal expression of miR-30b-5p and miR-141-3p in serum has certain diagnostic value for neonatal VAP, and can provide certain reference for clinical diagnosis.

Objective:To investigate the mediating effect of psychological flexibility between recurrence risk perception and health behavior in stroke patients.Methods:From July to December 2024, 233 stroke patients at the First Affiliated Hospital of Zhengzhou University were selected using convenience sampling. Electronic questionnaires were used to collect patients' general information, perception of stroke recurrence risk, health behavior, and psychological flexibility.Results:The scores for recurrence risk perception, psychological flexibility, and health behavior of 233 stroke patients were (39.75±4.39), (47.45±4.19), and (54.04±3.78), respectively. Health behavior were positively correlated with recurrence risk perception ( r=0.495, P<0.01), and negatively correlated with psychological flexibility ( r=-0.367, P<0.01). Psychological flexibility partially mediated the relationship between recurrence risk perception and health behavior, with an effect value of 0.080 and an effect proportion of 17.5% (0.080/0.458) . Conclusions:Recurrence risk perception not only directly predicts health behavior in stroke patients but also indirectly influences their health behavior through psychological flexibility. Healthcare providers should enhance recurrence risk perception among stroke patients and incorporate the improvement of psychological flexibility as part of intervention strategies to improve patients' health behavior.

Objective To analyze the distribution characteristics and influencing factors of ultra-long hospitalization in malignant tumor patients and to explore strategies to reduce the average length of stay and enhance the efficiency of medical re-source utilization.Methods Ultra-long hospitalization was defined as the 99th percentile of hospital stay duration(P99=31 days).Data from patients discharged with malignant tumors in a specialized cancer hospital in 2024 were collected.The distribu-tion characteristics and influencing factors were analyzed using chi-square tests and logistic stepwise regression.Results Among the 36 097 patients with malignant tumors,the average length of stay was 4.95 days,with 375 cases classified as ultra-long hospi-talizations,accounting for 1.04％.These patients were predominantly over 55 years old,with a higher proportion of males.Pa-tients with stage Ⅲ malignant tumors,primary tumors classified as T2～T3,and primary sites in the esophagus,pancreas,and maxillofacial regions had a higher incidence of ultra-long hospitalizations.Significant factors influencing ultra-long hospitalization included treatment modality,complications(OR=20.319),number of discharge diagnoses(OR=6.915),ICU transfers(OR=4.714),unplanned reoperations(OR=4.416),tumor type,extent,and stage.Conclusion Medical institutions are advised to address the influencing factors of ultra-long hospitalizations by optimizing diagnostic and treatment processes,enhan-cing quality control systems,establishing early warning mechanisms,and strengthening information systems.These measures aim to improve the standardization of malignant tumor diagnosis and treatment,ensuring patient safety.

Objective To analyze the distribution characteristics and influencing factors of ultra-long hospitalization in malignant tumor patients and to explore strategies to reduce the average length of stay and enhance the efficiency of medical re-source utilization.Methods Ultra-long hospitalization was defined as the 99th percentile of hospital stay duration(P99=31 days).Data from patients discharged with malignant tumors in a specialized cancer hospital in 2024 were collected.The distribu-tion characteristics and influencing factors were analyzed using chi-square tests and logistic stepwise regression.Results Among the 36 097 patients with malignant tumors,the average length of stay was 4.95 days,with 375 cases classified as ultra-long hospi-talizations,accounting for 1.04％.These patients were predominantly over 55 years old,with a higher proportion of males.Pa-tients with stage Ⅲ malignant tumors,primary tumors classified as T2～T3,and primary sites in the esophagus,pancreas,and maxillofacial regions had a higher incidence of ultra-long hospitalizations.Significant factors influencing ultra-long hospitalization included treatment modality,complications(OR=20.319),number of discharge diagnoses(OR=6.915),ICU transfers(OR=4.714),unplanned reoperations(OR=4.416),tumor type,extent,and stage.Conclusion Medical institutions are advised to address the influencing factors of ultra-long hospitalizations by optimizing diagnostic and treatment processes,enhan-cing quality control systems,establishing early warning mechanisms,and strengthening information systems.These measures aim to improve the standardization of malignant tumor diagnosis and treatment,ensuring patient safety.

This article reports a case of extensive ocular inflammation following zoledronic acid infusion for the treatment of osteoporosis. The patient developed pain, eyelid edema, conjunctival congestion, and decreased vision in the right eye one day after receiving intravenous zoledronic acid, and was diagnosed with uveitis, scleritis, and periorbital soft tissue inflammation. The patient′s symptoms were evaluated using the clinical activity score(CAS). After high-dose corticosteroid pulse therapy combined with other comprehensive treatments, the symptoms improved markedly. This article reviews the incidence, clinical features, potential mechanisms, management, and prognosis of ocular adverse reactions induced by zoledronic acid, and highlights the importance of early recognition and timely treatment of ocular inflammation after zoledronic acid therapy.