Objective To evaluate the efficacy of combining the replenishing qi and nourishing yin empirical formula with anti-vascular endothelial growth factor (VEGF) in diabetic macular edema (DME). Methods A retrospective analysis was conducted on 59 patients diagnosed with DME at Tongji Hospital of Tongji University or Shanghai Nanxiang Hospital, Jiading District from June 2019 to December 2022. Among them, 29 cases received intravitreal injection of ranibizumab (anti-VEGF group), while 30 cases received both intravitreal injection of ranibizumab and oral administration of the replenishing qi and nourishing yin empirical formula (combined treatment group). The best corrected visual acuity (BCVA), central macular thickness (CMT), and the traditional Chinese medicine (TCM) syndrome score were compared between the two groups before treatment and at 4, 8, 12, 16, 20, and 24 weeks after treatment. Results Compared with before treatment, BCVA significantly improved (P＜0.05) and CMT significantly decreased (P＜0.05) at different time points after treatment in both groups. At 16, 20, and 24 weeks after treatment, BCVA in the combined treatment group was superior to that in the anti-VEGF group (P＜0.01). At 12, 16, 20, and 24 weeks after treatment, CMT in the combined treatment group was lower than that in the anti-VEGF group (P＜0.01). Starting from week 8 after treatment, the TCM syndrome scores in the combined treatment group were lower than those in the anti-VEGF group (P＜0.01). Conclusions The replenishing qi and nourishing yin empirical formula could improve the efficacy of anti-VEGF therapy in DME patients, indicating that integrating traditional Chinese and Western medicine has certain clinical application value in treating DME.

Objective:To observe the effects of 12.5% carbohydrate (CHO) solution and medium chain triglycerides (MCT) solutions at various concentrations on gastric emptying, in order to determine the optimal MCT-CHO combination for enhanced recovery after surgery.Methods:This study was a prospective study. Ten healthy volunteers were selected to ingest 400 ml of the following 5 solutions every day: water, 12.5% CHO, 1% MCT, 2% MCT and 4% MCT. According to the above results, the optimal concentration of MCT solution was 2% MCT, showing comparable gastric emptying rate compared with 12.5% CHO solution. On this basis, combinations of MCT and CHO solutions were determined to be 30 energy % (EN%) MCT+70 EN% CHO and 20 EN% MCT+80 EN% CHO according to the energy distribution ratio. Then the volunteers were given 400 ml of the following 4 solutions every day: 12.5% CHO, 2% MCT, 30 EN% MCT+70 EN% CHO (equivalent to 2% MCT+8% CHO), and 20 EN% MCT+80 EN% CHO (equivalent to 4.4% MCT+10% CHO). Gastric emptying during fasting (T m) and immediately (T 1), 30 min (T 2), 60 min (T 3), 90 min (T 4) and 120 min after ingestion (T 5) were observed by antral ultrasonography. The degree of thirst, hunger, and anxiety was assessed by Visual Analogue Scale, and the taste was rated. Results:The gastric emptying rate in descending order was 20%EN MCT+80%EN CHO group>30%EN MCT+70%EN CHO group≈2％MCT group≈12.5%CHO group. There was no significant difference in gastric emptying rate between 30 EN% MCT+70 EN% CHO group and 12.5% CHO group ( P>0.05). The scores of thirst, hunger and anxiety in 30 EN% MCT+70 EN% CHO group at T 1 to T 5 were significantly lower than those at T m ( P<0.05). 30 EN% MCT+70 EN% CHO group showed the highest taste score. Conclusion:30 EN% MCT+70 EN% CHO solution has similar gastric emptying rate compared with 12.5% CHO solution. It can relieve thirst, hunger, anxiety and other subjective feelings caused by fasting, with tastes better than 12.5% CHO solution.

Preoperative localization of pulmonary small nodules can effectively improve the safety and success rate of video-assisted thoracoscopic surgery(VATS),but there are still controversies regarding the selection of relevant techniques.Interventional Oncology Committee of the Chinese Anti-Cancer Association organized domestic interventional radiology experts engaged in treatment of pulmonary malignancies,based on clinical experience and evidence-based medical evidence to formulate this Chinese expert consensus on preoperative auxiliary localization techniques for VATS of pulmonary small nodules.

OBJECTIVE To explore the risk factors for hospital-associated infections(HAI)in dead patients so as to provide bases for development of prevention strategies for the hospital-associated infections.METHODS Totally 560 patients who died due to non-SARS-CoV-2 infections and hospitalized in Gansu Provincial People's Hospital for more than 48 hours in 2019 and 2023 were retrospectively analyzed,70 of whom had HAI and were assigned as the HAI group,and the rest of 490 patients were assigned as the non-HAI group.The incidence of HAI,major causes of death,risk factors and economic burden were observed.RESULTS The incidence of HAI was 12.50％a-mong the dead patients,the lower respiratory tract infection was the predominant type of infection,and the re-spiratory failure was the primary and direct cause of death in the HAI group;the total treatment cost of the HAI group was higher than that of the non-HAI group(P＜0.05).Univariate analysis showed that there were signifi-cant differences in the length of hospital stay,multidrug-resistant organisms infections,combined use of antibiot-ics,surgery,hemodialysis/peritoneal dialysis,invasive procedures(drainage,puncture,intubation,tracheoto-my),use of equipment like ventilator or urinary catheter,central venous catheter indwelling,blood transfusion,and use of immunosuppressors/glucocorticoids between the HAI group and the non-HAI group(P＜0.05),while there were no significant differences in the sex,age,underlying diseases,modified early warning score(MEWS)and major diagnosis and chemoradiotherapy between the two groups.Multivariate analysis indicated that the length of hospital stay more than 14 days,history of surgery and combined use of antibiotics were the risk factors for HAI in the dead patients(P＜0.05).CONCLUSION It is necessary for the hospital to identify the high-risk pa-tients as early as possible,pay close attention to the lower respiratory tract infection,reduce the risk of HAI by shortening the length of hospital stay,standardizing the invasive procedures and reasonably using antibiotics so as to improve the prognosis of the patients.

Acute myocardial infarction is caused by continuous ischemia and hypoxia of myocardial cells,leading to myocardial cell necrosis.Reperfusion therapy is the standard strategy for reducing infarct size and improving the prognosis of myocardial infarction.However,myocardial injury caused by reperfusion therapy is accompanied by various pathophys-iological processes,such as oxidative stress,inflammatory response,myocardial fibrosis,extracellular matrix remodeling,etc.Transcription factor EB(TFEB)is a central regulatory factor in the autophagy-lysosome signaling pathway,involved in signaling pathways such as stress response,myocardial energy metabolism,autophagy,and lysosomal biogenesis.It is closely related to the repair of myocardial injury after myocardial infarction.This review aims to elucidate the mechanism of TFEB in myocardial ischemic injury.

AIM:To establish a stable and efficient rat model of alcoholic liver disease(ALD),we investigat-ed the effects of different alcoholic beverage concentrations and alcohol dosing regimens.METHODS:(1)SPF-grade male SD rats were randomized into 5 groups(n=10):blank,ALD1,ALD2,ALD3,and ALD4.Except for the blank group,rats received intragastric administration of 56%alcohol(6 mL/kg twice daily with an 8-hour interval)for 4 weeks,along with free access to 0%,5%,10%,or 15%alcoholic beverage to evaluate concentration-dependent effects.(2)An-other cohort was divided into three groups(n=10):blank,ALD5,and ALD6.Rats(except blank)were gavaged with 56%alcohol twice daily for 9 weeks(8 mL/kg for ALD5;6 mL/kg in week 1,increasing by 0.5 mL/kg weekly for ALD6),with 10%alcoholic beverage available ad libitum to assess dose-dependent effects.Serum biochemical markers[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total cholesterol(TC),triglycerides(TG),high-density li-poprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)]and inflammatory cytokines[interleu-kin-6(IL-6),IL-1β and tumor necrosis factor-α(TNF-α)]were analyzed after modeling,complemented by imaging(B-ultrasound,CT,and MRI).Success and survival rates were calculated.RESULTS:(1)ALD1～4 groups exhibited sig-nificantly elevated ALT,AST,TC,TG,LDL-C,IL-1β,IL-6 and TNF-α(P<0.05 or P<0.01)and reduced HDL-C and liver-to-spleen CT density ratio vs blank.ALD3(10%alcoholic beverage)showed the highest modeling success rate with low mortality.(2)ALD5 and ALD6 groups also had siginificant differin terms(P<0.01),with ALD6(gradually increas-ing dose)displaying more severe liver injury,higher success rate,and better survival.CONCLUSION:The optimal ALD model was induced by intragastric administration of 56%alcohol(6 mL/kg twice daily in week 1,increasing by 0.5 mL/kg weekly for 9 weeks)combined with 10%alcoholic beverage.This protocol offers a reliable approach for ALD re-search and drug development.

Acute myocardial infarction is caused by continuous ischemia and hypoxia of myocardial cells,leading to myocardial cell necrosis.Reperfusion therapy is the standard strategy for reducing infarct size and improving the prognosis of myocardial infarction.However,myocardial injury caused by reperfusion therapy is accompanied by various pathophys-iological processes,such as oxidative stress,inflammatory response,myocardial fibrosis,extracellular matrix remodeling,etc.Transcription factor EB(TFEB)is a central regulatory factor in the autophagy-lysosome signaling pathway,involved in signaling pathways such as stress response,myocardial energy metabolism,autophagy,and lysosomal biogenesis.It is closely related to the repair of myocardial injury after myocardial infarction.This review aims to elucidate the mechanism of TFEB in myocardial ischemic injury.

Objective:To observe the effects of 12.5% carbohydrate (CHO) solution and medium chain triglycerides (MCT) solutions at various concentrations on gastric emptying, in order to determine the optimal MCT-CHO combination for enhanced recovery after surgery.Methods:This study was a prospective study. Ten healthy volunteers were selected to ingest 400 ml of the following 5 solutions every day: water, 12.5% CHO, 1% MCT, 2% MCT and 4% MCT. According to the above results, the optimal concentration of MCT solution was 2% MCT, showing comparable gastric emptying rate compared with 12.5% CHO solution. On this basis, combinations of MCT and CHO solutions were determined to be 30 energy % (EN%) MCT+70 EN% CHO and 20 EN% MCT+80 EN% CHO according to the energy distribution ratio. Then the volunteers were given 400 ml of the following 4 solutions every day: 12.5% CHO, 2% MCT, 30 EN% MCT+70 EN% CHO (equivalent to 2% MCT+8% CHO), and 20 EN% MCT+80 EN% CHO (equivalent to 4.4% MCT+10% CHO). Gastric emptying during fasting (T m) and immediately (T 1), 30 min (T 2), 60 min (T 3), 90 min (T 4) and 120 min after ingestion (T 5) were observed by antral ultrasonography. The degree of thirst, hunger, and anxiety was assessed by Visual Analogue Scale, and the taste was rated. Results:The gastric emptying rate in descending order was 20%EN MCT+80%EN CHO group>30%EN MCT+70%EN CHO group≈2％MCT group≈12.5%CHO group. There was no significant difference in gastric emptying rate between 30 EN% MCT+70 EN% CHO group and 12.5% CHO group ( P>0.05). The scores of thirst, hunger and anxiety in 30 EN% MCT+70 EN% CHO group at T 1 to T 5 were significantly lower than those at T m ( P<0.05). 30 EN% MCT+70 EN% CHO group showed the highest taste score. Conclusion:30 EN% MCT+70 EN% CHO solution has similar gastric emptying rate compared with 12.5% CHO solution. It can relieve thirst, hunger, anxiety and other subjective feelings caused by fasting, with tastes better than 12.5% CHO solution.

Preoperative localization of pulmonary small nodules can effectively improve the safety and success rate of video-assisted thoracoscopic surgery(VATS),but there are still controversies regarding the selection of relevant techniques.Interventional Oncology Committee of the Chinese Anti-Cancer Association organized domestic interventional radiology experts engaged in treatment of pulmonary malignancies,based on clinical experience and evidence-based medical evidence to formulate this Chinese expert consensus on preoperative auxiliary localization techniques for VATS of pulmonary small nodules.

Objective To investigate the regulatory effect of suppressor of cytokine signaling 1 (SOCS1) on the proliferation and apoptosis of myelodysplastic syndrome (MDS) cells SKM-1 and its potential mechanisms. Methods SOCS1 was overexpressed in SKM-1 cells by transfection with exogenous SOCS1-overexpressing plasmid. Cell viability, cell cycle and apoptosis were analyzed with CCK-8 and flow cytometry assays, respectively. Western blot was used to evaluate the expression of proteins related to the Janus kinase 2/signal transducer and activator of transcription (JAK2/STAT) signaling pathway. Additionally, a NOD/SCID mouse model of MDS was established to record mouse body weight and survival time, assessing the impact of the SOCS1 gene on the growth of SKM-1 cells in vivo. Results Transfection of the SOCS1-overexpressing plasmid significantly increased the mRNA and protein expression levels of SOCS1 in the MDS cell line SKM-1. Overexpression of SOCS1 remarkably reduced cell viability, inhibited cell proliferation, and promoted apoptosis of SKM-1 cells, which also decreased the expression of phosphorylated-JAK2 (p-JAK2), phosphorylated-STAT3 (p-STAT3), and p-STAT5 proteins. Furthermore, in vivo experiment results showed that the body weight and survival time of mice in the SOCS1 overexpression group were significantly better than those in the MDS model group, and the number of CD45⁺ SKM-1 cells in the peripheral blood was significantly lower than that in the MDS model group, indicating that SOCS1 overexpression could inhibit the activity of SKM-1 cells in mice. Western blot results verified the protein expression level of SOCS1 in the bone marrow of mice in the SOCS1 overexpression group was significantly higher than that in the MDS model group, while the protein expression levels of p-JAK2, p-STAT3, and p-STAT5 were significantly lower than those in the MDS model group. Conclusion SOCS1 inhibits the proliferation of MDS cell line SKM-1 and promotes its apoptosis by negatively regulating the JAK2/STAT signaling pathway, making it a potential therapeutic target for myelodysplastic syndromes.
Animals ; Humans ; Mice ; Apoptosis ; Body Weight ; Bone Marrow/metabolism* ; Janus Kinase 2/metabolism* ; Mice, Inbred NOD ; Mice, SCID ; Myelodysplastic Syndromes/metabolism* ; Phosphorylation ; STAT3 Transcription Factor/metabolism* ; STAT5 Transcription Factor/metabolism* ; Suppressor of Cytokine Signaling 1 Protein/metabolism* ; Cell Proliferation