Cuproptosis, recently defined as a unique form of cell death distinct from programmed cell death, is triggered by copper overload within mitochondria. Genes associated with cuproptosis have been found to correlate with tumorigenesis and tumor progression, making the targeting of cuproptosis pathways a promising direction for anti-tumor therapies. Copper ion carriers can transport copper ions into cells, inducing cuproptosis and laying the foundation for its application in cancer treatment. This article elaborates on the homeostasis of copper and the mechanisms related to cuproptosis, further clarifying the relationship between cuproptosis and lung cancer treatment targets. This review aims to summarize current progress in research related to cuproptosis and lung cancer, providing new theories and bases for the clinical treatment of lung cancer.

ObjectiveTo compare the differences between wild Alpiniae Oxyphyllae Fructus（WAOF） and cultivated Alpiniae Oxyphyllae Fructus（CAOF） through a traditional quality evaluation system for medicinal materials. MethodsA total of 10 batches of WAOF and 12 batches of CAOF samples were collected from various regions of Hainan province. Relevant analytical methods from the 2020 edition of the Pharmacopoeia of the People's Republic of China were employed to observe the characteristics of WAOF and CAOF， followed by microscopic identification， thin-layer chromatography（TLC） identification， moisture content（toluene method）， total ash， acid-insoluble ash， water-soluble and alcohol-soluble extracts（hot dipping method）， water-soluble protein， total polysaccharides and total flavonoids（ultraviolet spectrophotometry）， and volatile oil content（method A under general rule 2204）. The contents of five active components（protocatechuic acid， chrysin， kaempferol， tectochrysin and nootkatone） were quantified using ultra-performance liquid chromatography（UPLC）， and the antioxidant activity was evaluated. Building upon traditional quality evaluation of AOF， quantitative measurements were conducted on its appearance traits including diameter， length， plumpness（diameter/length ratio）， and color. Canonical correlation analysis was performed using SPSS 26.0 to explore relationships between appearance traits and intrinsic quality. ResultsNo significant differences were observed between WAOF and CAOF in microscopic observation， TLC identification， moisture content， protocatechuic acid content， kaempferol content， odor， or antioxidant activity measured by 2，2ʹ-azino-bis（3-ethylbenzothiazoline-6-sulfonic acid）（ABTS） method. WAOF exhibited significantly higher levels in water-soluble extracts， alcohol-soluble extracts， total polysaccharide content， water-soluble protein content， 100-grain weight， length， and total color difference（ΔE^*ab） compared to CAOF（P<0.01）. In contrast， CAOF showed significantly higher levels of total ash， acid-insoluble ash， content of total flavonoids， volatile oil content， chrysin content， tectochrysin content， nootkatone content， diameter， plumpness， lightness（L^*）， red-green chromaticity（a^*）， yellow-blue chromaticity（b^*）， and antioxidant activity measured by 1，1-diphenyl-2-picrylhydrazyl（DPPH） method compared to WAOF（P<0.01）. Correlation analysis between 7 phenotypic traits and 8 quality traits revealed that among the phenotypic traits， plumpness， L^*， a^*， and b^* exerted significant influence on intrinsic quality. Among the quality traits， total flavonoids， volatile oils， nootkatone， chrysin， and tectochrysin contributed substantially to intrinsic quality. ConclusionPlumpness， L^*， a^*， and b^* of AOF significantly influence its intrinsic quality， and higher values of these parameters indicate relatively superior intrinsic quality. The comprehensive quality evaluation reveals that CAOF samples collected in this study are superior to their wild counterparts.

Objective: To develop a prediction model for mild cognitive impairment (MCI) risk among the elderly, so as to provide a tool for MCI early screening. Methods : From July 2022 to September 2024, a multi-stage stratified random cluster sampling method was used to recruit permanent residents aged ≥65 years from the Xinjiang Uygur Autonomous Region as study participants. Data on sociodemographic characteristics, nutritional status, body composition indices, bone mineral density, and handgrip strength were collected through questionnaires and physical examinations. Sarcopenia was defined based on appendicular skeletal muscle index and handgrip strength. MCI was assessed using the Mini-Mental State Examination, with adjustments for educational level. Participants were randomly divided into a training set and a validation set in a 7∶3 ratio. LASSO regression and multivariable logistic regression models were employed to screen for predictors and construct an MCI risk prediction model. The predictive performance of the model was evaluated using receiver operating characteristic (ROC) curve and decision curve analysis (DCA). Results: A total of 1 641 participants were surveyed, including 755 males (46.01%) and 886 females (53.99%). The majority of participants were aged 65-<75 years, comprising 1 154 individuals (70.32%). MCI was detected in 517 participants, corresponding to a detection rate of 31.51%. Resultsfrom LASSO regression and multivariate logistic regression analysis showed that residence (rural, OR = 2.323, 95% CI: 1.682-3.210), age (75-<85 years, OR = 1.405, 95% CI: 1.019-1.937; ≥85 years, OR = 3.655, 95% CI: 1.696-7.875), educational level (primary school, OR = 0.341, 95% CI: 0.247-0.472; junior high school, OR = 0.255, 95% CI: 0.160-0.408; high school, OR = 0.286, 95% CI: 0.154-0.531; bachelor's degree or above, OR = 0.120, 95% CI: 0.041-0.351), history of alcohol consumption (yes, OR = 3.216, 95% CI: 2.164-4.779), risk of malnutrition (yes, OR = 1.464, 95% CI: 1.064-2.014), sarcopenia (yes, OR = 3.197, 95% CI: 2.332-4.385), and waist-to-hip ratio (abnormal, OR = 1.540, 95% CI: 1.159-2.048) were identified as predictive factors for MCI among the elderly. In the training set, the area under the ROC curve, sensitivity, and specificity were 0.788, 0.719, and 0.712, respectively. In the validation set, the corresponding values were 0.784, 0.913, and 0.542, respectively. DCA demonstrated that the model provided a higher clinical net benefit for predicting MCI risk when the risk threshold probability ranged from 0.124 to 0.764. Conclusion The prediction model developed in this study demonstrates good discriminative ability and clinical utility, indicating its substantial value for predicting the MCI risk among the elderly.

Objective Watch the proprioceptive neuromuscular facilitation(PNF)in the treatment of patients with shoulder-hand syndrome,and to explore its relevant therapeutic mechanisms.Methods Sixty patients with shoulder-hand syndrome were split into two groups at random:thirty cases each for observation and control.The control group received both standard medication and training in rehabilitation.Intradermal needles were inserted at the Jianjing,Jianyu,Binao,Qing Lengyuan,Shouwuli,and Quchi points and left in place for 48 hours for the treatment group.The PNF treatment was administered for thirty minutes every day,five times a week,whereas the control group underwent four weeks of traditional drug treatment and rehabilitation training.Before and after therapy,the following measures were used:the Disability of the Arm,Shoulder and Hand(DASH),the Activity of Daily Living Scale(ADL),the Simplified Fugl-Meyer Scale(FMA),and the Visual Analog Scale(VAS).In order to measure changes in endothelin-1(ET-1),nitric oxide(NO),and bradykinin(BK),serum was collected.Result Scale score:①Within-group comparison,compared with before treatment,VAS and DASH scores were significantly lower,FMA,a significant rise in ADL scores,differences were statistically significant(P<0.01).②Comparison between groups,compared with the control group,observation group of DASH score significantly lower after treatment(P<0.05),a significant rise in FMA and ADL scores(P<0.05),VAS score has no obvious difference(P>0.05).Laboratory index test:①Intra-group comparison:compared with before treatment,BK and ET-1 expression levels increased,NO and CGRP expression levels decreased,the differences were statistically significant(P<0.01).②Comparison between groups:Following treatment,the observation group showed increases in BK and ET-1 expression degrees as well as decreased NO and CGRP expression degrees.This difference was statistically significant(P<0.01).Conclusions Intradermal needle combined with PNF can promote shoulder pain symptoms,increase upper limb mobility,also improve quality of life in patients with shoulder-hand syndrome.One of the mechanisms may be to upregulate the expression level of BK and ET-1,and downregulate the expression level of NO and CGRP,so as to improve the microcirculation function and reduce the neurogenic inflammatory response.

High-quality development of public hospitals requires cultural construction as an endogenous driving force,ai-ming to build a cultural system that integrates systematic,innovative,and humanistic characteristics.Leveraging its century-old historical legacy,Qilu Hospital of Shandong University has established a cultural construction pathway characterized by"strategic planning,heritage preservation,brand building,exemplary leadership,and communication innovation"through five major sys-tems:improving top-level design,inheriting historical heritage,building distinctive brands,cultivating exemplary models,and expanding communication channels.This approach provides cultural and spiritual impetus for the hospital's high-quality develop-ment.Empirical evidence demonstrates that cultural construction in public hospitals must emphasize systematic top-level design,distinctive cultural identity,synergy between tradition and innovation,and long-term sustainability,ultimately transforming cul-tural"soft power"into"hard support"for development.This practice offers a replicable"Qilu Model"for nationwide public hos-pital cultural development,while injecting new connotations into the implementation of the Healthy China strategy.

To further improve the post competency of application-oriented medical students, the university medical simulation center, clinical teaching base, and off-campus social practice base were linked to establish a platform. Four key points were used to explore a new training model of "one body and four bases" for application-oriented medical students. This includes problem-oriented theoretical teaching to improve the professional knowledge of medical students, hands-on practice-oriented experimental teaching to improve the clinical skills, "strengthening clinical thinking training"-oriented practice in the base to enhance clinical awareness and cultivate clinical habits, and "cultivating humanistic literacy"-oriented off-campus social practice base to improve the humanistic sentiment and professional spirit of medical students. This teaching mode lays a foundation for training high-quality application-oriented medical talents with solid knowledge and skills and comprehensive development of ability and literacy, and provides a reference for teaching and research in similar colleges and universities.

Objective:To summarized the clinical characteristics of intracranial germ cell tumors（iGCTs）in children, with the ultimate goal of facilitating early tumor identification and guiding the prompt selection of appropriate treatment strategies.Methods:A retrospective analysis was conducted on pediatric patients with primary iGCTs admitted to Beijing Tiantan Hospital Affiliated to Capital Medical University between March 2021 and June 2022. Patient age, gender, clinical manifestations, tumor marker levels in cerebrospinal fluid (CSF) and blood, imaging features, and histopathological examination results were meticulously collected and statistically analyzed.Results:A total of 126 pediatric patients with iGCTs were included in the study, of which 86 cases (68.3%) were male,and 40 cases (31.7%) were female.The average age was (10.0 ± 3.5) years old. The mean age of onset was found between 6~14 years old(80.1%), with a male-to-female ratio of 2.2:1.The tumors were predominantly located in the sellar region (30.2%), basal ganglia (23.8%), and pineal region (19.8%). Notably, there were distinct differences in tumor location across different age groups: pineal region tumors were most prevalent in preschool children (71.4%), basal ganglia tumors were more common in school-age children (41.9%), and sellar region involvement was highest among adolescent patients(44.8%). Based on molecular marker analysis and biopsy diagnosis, 79 cases were classified as germinoma, 3 as teratoma, 2 as yolk sac tumor, 1 as choriocarcinoma, and 41 as mixed germinoma.All children underwent head CT and MRI examinations. Among them, 99 cases showed high-density lesions on CT,while 27 cases showed mixed density,including 39 cases of calcification and 35 cases of hydrocephalus.MRI revealed atrophy of the cerebral peduncle, caudate nucleus head, or cerebral cortex in 38 cases, involvement of the basal ganglia in 33 cases, and midbrain involvement in 5 cases.Blood β-human chorionic gonadotropin (β-HCG) and alpha-fetoprotein (AFP) levels were examined in all patients, while CSF tumor marker levels were analyzed in 103 cases. There were 76 cases with elevated β-HCG in blood and/or cerebrospinal fluid, and 24 cases with elevated AFP in blood and/or CSF.Additionally, all 86 male patients underwent genital ultrasound, revealed testicular microlithiasis in 12 cases and testicular cysts in 6 cases.Conclusion:The clinical presentation of iGCTs in pediatric patients exhibits significant heterogeneity in terms of epidemiology, classification, tumor location, and molecular markers. Notably, CSF β-HCG and AFP levels are equally crucial diagnostic indicators alongside blood tumor markers.Histological examination should be performed as early as possible in clinically suspected cases with negative tumor markers. Clinicians should remain vigilant for early imaging negative potential cases. In addition, male children with testicular microlithiasis or cysts should be closely followed up.

BACKGROUND:Electrical stimulation is an effective treatment plan for peripheral nerve injuries,but different frequencies of electrical stimulation have different mechanisms and applications for promoting peripheral nerve recovery.OBJECTIVE:To systematically sort out and summarize the roles and applications of different frequencies of electrical stimulation in the treatment of peripheral nerve injuries,and to deeply analyze the advantages and disadvantages of various methods in order to find the most beneficial treatment strategy for patients'nerve recovery.METHODS:Computer-based searches were conducted in the China National Knowledge Infrastructure(CNKI)and PubMed databases from the inception of the databases to May 2024.The search terms included"peripheral nerve injury,electrical stimulation,low frequency electrical stimulation,medium frequency electrical stimulation,high frequency electrical stimulation,TENS,interfering electricity,short wave,ultrashort wave,frequency"in both English and Chinese.Ultimately,74 relevant documents were included for analysis.RESULTS AND CONCLUSION:Peripheral nerve injury,a common clinical disease,can cause sensory and motor dysfunction in patients.Low-frequency electrical stimulation can promote cell proliferation and accelerate the expression of nerve growth factor within the cell after electrical stimulation,promote macrophage recruitment and infiltration,accelerate the clearance of myelin debris,and promote myelin regeneration of damaged axons.Medium-frequency electrical stimulation can act on deeper tissues and is better for relieving neuropathic pain.High-frequency electrical stimulation can promote the proliferation of Schwann cells and macrophages,inhibit inflammatory factors,and rapidly recruit cells to the site of nerve injury,accelerating the speed of nerve repair.Different frequencies of electrical stimulation have their own advantages in promoting the recovery of peripheral nerve injuries,but there are still some issues,such as differences in the site of electrical stimulation and the treatment plans for various disease types.

Objective To construct a regional collaborative cloud-based treatment model treatment model for patients with severe road traffic injuries,and to preliminarily evaluate the differences in nursing timeliness indicators and outcomes.Methods The regional collaborative cloud-based treatment platform includes 4 ports,including public security traffic police,pre-hospital emergency center,regional trauma center triage,and regional trauma center resuscitation unit.This forms a standardized real-time interactive treatment process between regional medical services and police for patients with severe road traffic injuries.Using a concurrent control study design,241 patients with severe road traffic injuries admitted to the emergency department of a regional trauma center in Zhejiang Province from May 2022 to May 2024 were selected as the study subjects.Among them,120 patients treated with the regional real-time collaborative cloud-based treatment model were designated as an experimental group,while 121 patients treated with the original trauma care process were designated as a control group.The differences in timeliness indicators and outcomes between the 2 groups were compared.Results The study included 241 patients with severe trauma.After the application of the regional collaborative cloud-based treatment model,the time from the scene of the accident to the hospital,the proportion of information early waming,completion time of pre-examination and triage,waiting time of the trauma team,the time of the first CT,the length of multidisciplinary consultation,and the time for completing hospitalization procedures in the experimental group were shorter than those in the control group(P＜0.05),the proportion of information early waming in the experimental group was 100％(120/120),and the proportion of information early waming in the control group was 52.1％(63/121).The difference between the two groups was statistically significant(P＜0.001).The survival rate of the experimental group was 90.8％(109/120),and that of the control group was 86.0％(104/121).There was no significant difference between the two groups(x2=1.399,P=0.237).Conclusion The regional collaborative cloud-based treatment model improves the timeliness and standardization of the treatment of patients with severe road traffic injury,which has certain reference significance and promotion value.

OBJECTIVE To investigate the molecular epidemiological characteristics of clinical isolates of carbapen-em-resistant Klebsiella pneumoniae(CRKP)resistant to ceftazidime/avibactam(CZA).METHODS From Jan.2022 to Dec.2023,totally 63 strains of non-repetitive CZA-resistant CRKP that were isolated for the first time from hospitalized patients of the First Affiliated Hospital of Nanchang University were enrolled in the study,and 50 strains of CZA-sensitive CRKP were randomly chosen as the research subjects.The drug susceptibility rates of the strains were observed.The drug resistance genes,virulence genes and capsular serotypes of the strains were detected by means of polymerase chain reaction(PCR).The molecular epidemiological characteristics of the strains were observed by using molecular biological techniques such as pulse field gel electrophoresis(PFGE)and multilocus sequence typing(MLST).RESULTS Among the CZA-resistant CRKP strains,45(71.43％)were iso-lated from sputum.The result of drug susceptibility testing showed that the drug resistance rates of the CZA-re-sistant strains to amikacin,aztreonam and minocycline were lower than those of the CZA-sensitive strains(P＜0.05),and the drug resistance rates of the CZA-resistant strains to tigecycline was higher than that of the CAZ-sensitive strains(P＜0.05).The carrying rates of blaKPC,blaNDM,blaSHV-1,blaTEM-1,blaCTX-M,blaqnrS,blaacc(6')-Ib and blarmtB genes of the CZA-resistant strains were relatively high.Among the detected capsular serotypes,K64(n=18,28.57％)was dominant.ST11(n=25,39.68％)was predominant strain among the CZA-resistant CRKP strains.CONCLUSIONS ST11 is dominant among the CZA-resistant CRKP strains.The strains carry with multiple drug resistance genes and virulence genes.The drug resistance rate of the CZA-resistant strains to tigecycline is higher than that of the CZA-sensitive strains,and it is necessary to attach great importance during the clinical treatment.