ObjectiveTo investigate the protective effect of genistein （Gen） on etoposide-induced chondrocyte senescence and its underlying mechanism. MethodsThe C28/I2 cell line was treated with different concentrations of Gen and etoposide， and the cell viability was detected by the CCK-8 assay. The senescence model of C28/I2 chondrocytes was induced by etoposide， with Gen intervention. Senescence-associated β-galactosidase （SA-β-gal） staining was performed to detect the senescence-positive rate and staining characteristics of chondrocytes. The expressions of peroxiredoxin 6 （Prdx6）， cyclin-dependent kinaseto clarify the functional necessity of Prdx6. ResultsCompared with the etoposide group， the C28/I2 chondrocyte viability significantly increased （P<0.01）， the expression ofsenescence-associated proteins p21 and p16 decreased （P<0.01， P<0.05）， the expression of senescence-associated genes p21 and p16 reduced （both P<0.01）， the fluorescence intensity of senescence-associated proteins p21 and p16 was diminished （P<0.05， P<0.01）， and the proportion of SA-β-gal-positive cells decreased （P<0.01） in the Gen+etoposide group. Compared with the Control group， the expression of Prdx6 was downregulated in the etoposide group （P<0.05）. Compared with the etoposide group， the expression of Prdx6 was upregulated in the Gen+etoposide group （P<0.01）. Compared with the Control group， the GPx activity significantly decreased in the si-Prdx6 group （P<0.01）. Furthermore， compared with the si-Prdx6 group， the GPx activity increased in the si-Prdx6+Gen group （P<0.05）. Molecular docking results revealed that Gen formed hydrogen bond interactions with the active site of Prdx6. After Prdx6 knockdown， the expression of senescence-associated genes p21 and p16 and the fluorescence intensity of senescence-associated proteins p21 and p16 both increased in the Gen+etoposide+si-Prdx6 group （both P<0.01）. ConclusionGen can inhibit etoposide-induced senescence of C28/I2 chondrocytes by upregulating the expression of Prdx6. This study provides potential drug targets and experimental basis for the prevention and treatment of chondrocyte senescence-related diseases.

Objective:To explore the clinical efficacy value of the medical failure mode,and failure mode and effect analysis(FMEA)mode in equipment management of the department of optimizing blood purification equipment.Methods:Based on the management concept of medical FMEA,a FMEA management mode for equipment was constructed to manage the hemodialysis equipment in the blood purification department of the First Affiliated Hospital of Hebei North University.A total of 83 used hemodialysis equipment in the blood purification department of our hospital from October 2022 to September 2024 were selected,and they were managed respectively by using conventional management mode and FMEA management mode.The differences of operation quality of equipment,comprehensive efficiency of equipment and the management capabilities of managers who used the equipment between two kinds of management modes were compared.Results:The average values of failure rate of equipment,self-repair rate,maintenance rate,and standardized operation rate of using FMEA management mode were respectively(4.72±0.11)%,(90.62±3.44)%,(95.42±2.43)%and(96.22±1.48)%.The failure rate of FMEA management mode was lower than that of conventional management mode,while the self-repair rate,maintenance rate,and standardized operation rate were higher than those of conventional management mode,and the differences were statistically significant(t=108.568,13.658,9.318,10.354,P＜0.05).The average values of availability ratio of equipment,ratio of performance index,and ratio of quality index of adopting FMEA management mode were respectively(91.04±2.65)%,(96.94±2.31)%and(97.66±1.19)%,which were higher than those of conventional management mode,and the differences were statistically significant(t=19.330,13.085,14.889,P＜0.05).The scores of job responsibilities,basic knowledge for equipment,guarantee capabilities for operation and management performance of manager were respectively(94.12±2.76),(92.03±2.50),(91.35±2.62)and(93.65±3.28)in using the FMEA management mode,which were all higher than those of the conventional management mode,and the differences were statistically significant(t=7.630,11.027,17.311,11.645,P＜0.05).Conclusion:The application of medical FMEA management mode in the management for hemodialysis equipment in the blood purification department can improve the quality of equipment operation,and reduce the failure frequency of equipment,and enhance the overall utilization efficiency of equipment,and improve the quality of clinical services in the department.

Objective:To explore the clinical efficacy value of the medical failure mode,and failure mode and effect analysis(FMEA)mode in equipment management of the department of optimizing blood purification equipment.Methods:Based on the management concept of medical FMEA,a FMEA management mode for equipment was constructed to manage the hemodialysis equipment in the blood purification department of the First Affiliated Hospital of Hebei North University.A total of 83 used hemodialysis equipment in the blood purification department of our hospital from October 2022 to September 2024 were selected,and they were managed respectively by using conventional management mode and FMEA management mode.The differences of operation quality of equipment,comprehensive efficiency of equipment and the management capabilities of managers who used the equipment between two kinds of management modes were compared.Results:The average values of failure rate of equipment,self-repair rate,maintenance rate,and standardized operation rate of using FMEA management mode were respectively(4.72±0.11)%,(90.62±3.44)%,(95.42±2.43)%and(96.22±1.48)%.The failure rate of FMEA management mode was lower than that of conventional management mode,while the self-repair rate,maintenance rate,and standardized operation rate were higher than those of conventional management mode,and the differences were statistically significant(t=108.568,13.658,9.318,10.354,P＜0.05).The average values of availability ratio of equipment,ratio of performance index,and ratio of quality index of adopting FMEA management mode were respectively(91.04±2.65)%,(96.94±2.31)%and(97.66±1.19)%,which were higher than those of conventional management mode,and the differences were statistically significant(t=19.330,13.085,14.889,P＜0.05).The scores of job responsibilities,basic knowledge for equipment,guarantee capabilities for operation and management performance of manager were respectively(94.12±2.76),(92.03±2.50),(91.35±2.62)and(93.65±3.28)in using the FMEA management mode,which were all higher than those of the conventional management mode,and the differences were statistically significant(t=7.630,11.027,17.311,11.645,P＜0.05).Conclusion:The application of medical FMEA management mode in the management for hemodialysis equipment in the blood purification department can improve the quality of equipment operation,and reduce the failure frequency of equipment,and enhance the overall utilization efficiency of equipment,and improve the quality of clinical services in the department.

Objective:To investigate the protective effect of moxibustion on joints and its influence on the expression levels of S100 calcium binding protein A8(S100A8),S100 calcium binding protein A9(S100A9),serum amyloid A1(SAA1),and related inflammatory factors in rats with adjuvant arthritis(AA).Methods:Forty Wistar rats were randomly divided into a normal group,a model group,a moxibustion group,and a medication group,with 10 rats in each group.Except for the normal group,AA models were established in the other three groups by exposing rats to wind-cold-dampness environmental conditions combined with complete Freund's adjuvant.After successful modeling,the moxibustion group received moxibustion intervention,while the medication group was administered tripterygium glycosides tablets via oral gavage.The normal and model groups underwent similar handling and fixation without additional interventions.After 15 d of intervention,hematoxylin-eosin staining was used to assess pathological changes in the knee joint synovial membrane.Western blotting was performed to detect the protein expression of S100A8,S100A9,and SAA1 in the synovial tissue.Enzyme-linked immunosorbent assay was used to measure the serum levels of interferon(IFN)-γ,interleukin(IL)-6,and IL-23.Results:Compared to the normal group,the model group exhibited significantly increased protein expression of S100A8,S100A9,and SAA1 in the knee joint synovial tissue,as well as elevated serum levels of IFN-γ,IL-6,and IL-23(P<0.01).Histopathological analysis revealed marked synovial hyperplasia and extensive infiltration of inflammatory cells in the model group.Compared to the model group,both the moxibustion and medication groups showed significant reductions in the protein expression of S100A8,S100A9,and SAA1 in the synovial tissue,as well as decreased serum levels of IFN-γ,IL-6,and IL-23(P<0.01).Additionally,synovial tissue in these two groups displayed minimal hyperplasia and only mild inflammatory cell infiltration.Notably,compared to the moxibustion group,the medication group exhibited significantly higher protein expression of S100A9 in the synovial tissue(P<0.05),while no significant differences were observed in the expression of S100A8,SAA1,or serum levels of IFN-γ,IL-6,and IL-23(P>0.05).Both intervention groups showed comparable degrees of synovial inflammation,clear tissue structure,and no obvious hyperplasia.Conclusion:Moxibustion can alleviate joint swelling and reduce inflammatory responses in AA rats.Its mechanism may involve regulating the protein expression of S100A8,S100A9,and SAA1 in the knee joint synovial tissue.

Breast cancer is the number one killer threatening women's health, and the side effects caused by its treatment seriously affect patients' quality of life. Research has confirmed that good patient activation can effectively improve the quality of life of breast cancer patients, and it is of great significance to improve the quality of care and the recovery process of breast cancer patients.The purpose of this study is to review the current situation, assessment tools, influencing factors, and interventions of breast cancer patients' activation, in order to provide reference for researchers to conduct patient activation-related studies in the future.

Respiratory viruses,characterized by high mutation rates and strong immune evasion,remain a significant global public health challenge.Natural products have gained increasing attention due to their multi-target modulation and high safety profiles,dem-onstrating unique advantages in antiviral,anti-inflammatory,and immunoregulatory applications.Forsythia,a deciduous shrub of the Oleaceae family,possesses medicinal value in nearly all its parts,with flavonoids being among its most prominent bioactive compo-nents.This review provides a comprehensive summary of the botanical characteristics and traditional medicinal uses of Forsythia,the composition and structural classification of flavonoids from different parts of the plant,and its clinical applications.Building on the"holistic view"of traditional Chinese medicine,this review primarily discusses the antiviral mechanisms of Forsythia-derived flavo-noids in four key aspects:viral targeting,immune regulation,inflammation suppression,and post-viral syndrome.Additionally,it ana-lyzes its clinical application advantages and translational strategies,providing a basis for further development of new natural products and therapeutic drugs in clinical practice.

Objectives:To explore whether short-course radiotherapy (SCRT)-based total neoadjuvant therapy (TNT) combined with PD-1 inhibitors could further promote tumor regression and improve the prognosis.Methods:This is a prospective, multicenter, two-arm randomized controlled, seamless phase Ⅱ/Ⅲ trial for proficient mismatch repair or microsatellite stable (pMMR/MSS) locally advanced rectal cancer (LARC). Eligible patients were randomly assigned to the iTNT (TNT+PD-1) group or the TNT group. Patients in the TNT group received SCRT (5 Gy×5) followed by 4 cycles of CAPOX or 6 cycles of mFOLFOX chemotherapy, with the iTNT group receiving SCRT followed by the same regime in combination with 4 cycles of Sintilimab. Total mesorectal excision (TME) surgery or watch and wait (W&W) was performed after neoadjuvant therapy and then 2 cycles of same regimen as before were recommended. The primary endpoints are the complete response (CR) rate for phase Ⅱ trial and 3-year disease-free survival (DFS) for phase Ⅲ trial. A total of 588 patients will be enrolled for the phase Ⅱ/Ⅲ trial. Short-term efficacy and safety data from the initial 100 treated patients were analyzed as planned.Results:From 2022-8-31 to 2023-5-24 the initial 100 patients were enrolled from 10 hospitals in China, 76.0%(76/100) patients were male, and the median age was 61 years (21-74 years). More patients had tumors located in the lower rectum (78.0%, 78/100), staged T3-4 (97.0%, 97/100) and N1-2 (93.0%, 93/100), and about half of the tumors invaded the mesorectal fascia (52.0%, 52/100) and with extramural vascular invasion (51.0%, 51/100). Analyses were performed according to the per-protocal (PP) set. All patients in the iTNT group ( n=52) and the TNT group ( n=48) completed SCRT; The 4-cycle chemotherapy±Sintilimab completion rates were 86.5% and 100.0% in the iTNT and TNT groups, respectively. In the iTNT group, 82.7% (43/52), 11.5% (6/52), and 5.8% (3/52) of the patients received 4, 3, and 2 cycles of PD-1 inhibitor. After TNT, 68 patients underwent radical surgery and 15 patients achieved cCR and adopted W&W. The pathological complete response (pCR) rates were 48.5% (16/33) and 17.1% (6/35) in the iTNT and TNT groups, with CR rates of 50.0% (25/50) and 26.1% (12/46), respectively. The incidence of treatment-related grade 3-4 adverse events was 26.9% (14/52, iTNT group) and 18.8% (9/48, TNT group), with thrombocytopenia and leukopenia being the most common. Among patients receiving immunotherapy, grade 3 immunotherapy-related adverse events occurred in 2 (3.8%, 2/52) patients: one case was pancreatitis, another case was hepatitis combined with myositis and myocarditis. Conclusion:The preliminary results show that SCRT-based TNT combined with PD-1 inhibitors could further improve the CR rate for LARC without unexpected serious adverse events.

With the continuous evolution of minimally invasive surgical concepts,operative techniques are progressively advancing from"minimal injury"toward"scarless"approaches.Super-minimally laparoscopic surgery(SMLS)is a novel surgical modality developed on the basis of conventional laparoscopic techniques through the innovation and recombination of operative elements,aiming to achieve smaller trauma and improved cosmetic outcomes.Utilizing the umbilical skin fold as a natural scar-concealing site,SMLS establishes no more than two primary operating channels(maximum diameter≤15 mm),supplemented by auxiliary ports≤2 mm in diameter on the abdominal wall.Combined with innovative separable surgical instruments and high-definition visualization systems,this approach provides a systematic solution to key issues such as residual access-site scarring.This review summarizes the development,technical innovations,current clinical applications,and potential aesthetic value of SMLS in the evolution of minimally invasive surgery,aiming to offer theoretical insights and research reference for its future promotion and technical refinement.

With the continuous evolution of minimally invasive surgical concepts,operative techniques are progressively advancing from"minimal injury"toward"scarless"approaches.Super-minimally laparoscopic surgery(SMLS)is a novel surgical modality developed on the basis of conventional laparoscopic techniques through the innovation and recombination of operative elements,aiming to achieve smaller trauma and improved cosmetic outcomes.Utilizing the umbilical skin fold as a natural scar-concealing site,SMLS establishes no more than two primary operating channels(maximum diameter≤15 mm),supplemented by auxiliary ports≤2 mm in diameter on the abdominal wall.Combined with innovative separable surgical instruments and high-definition visualization systems,this approach provides a systematic solution to key issues such as residual access-site scarring.This review summarizes the development,technical innovations,current clinical applications,and potential aesthetic value of SMLS in the evolution of minimally invasive surgery,aiming to offer theoretical insights and research reference for its future promotion and technical refinement.

Objective:To investigate the protective effect of moxibustion on joints and its influence on the expression levels of S100 calcium binding protein A8(S100A8),S100 calcium binding protein A9(S100A9),serum amyloid A1(SAA1),and related inflammatory factors in rats with adjuvant arthritis(AA).Methods:Forty Wistar rats were randomly divided into a normal group,a model group,a moxibustion group,and a medication group,with 10 rats in each group.Except for the normal group,AA models were established in the other three groups by exposing rats to wind-cold-dampness environmental conditions combined with complete Freund's adjuvant.After successful modeling,the moxibustion group received moxibustion intervention,while the medication group was administered tripterygium glycosides tablets via oral gavage.The normal and model groups underwent similar handling and fixation without additional interventions.After 15 d of intervention,hematoxylin-eosin staining was used to assess pathological changes in the knee joint synovial membrane.Western blotting was performed to detect the protein expression of S100A8,S100A9,and SAA1 in the synovial tissue.Enzyme-linked immunosorbent assay was used to measure the serum levels of interferon(IFN)-γ,interleukin(IL)-6,and IL-23.Results:Compared to the normal group,the model group exhibited significantly increased protein expression of S100A8,S100A9,and SAA1 in the knee joint synovial tissue,as well as elevated serum levels of IFN-γ,IL-6,and IL-23(P<0.01).Histopathological analysis revealed marked synovial hyperplasia and extensive infiltration of inflammatory cells in the model group.Compared to the model group,both the moxibustion and medication groups showed significant reductions in the protein expression of S100A8,S100A9,and SAA1 in the synovial tissue,as well as decreased serum levels of IFN-γ,IL-6,and IL-23(P<0.01).Additionally,synovial tissue in these two groups displayed minimal hyperplasia and only mild inflammatory cell infiltration.Notably,compared to the moxibustion group,the medication group exhibited significantly higher protein expression of S100A9 in the synovial tissue(P<0.05),while no significant differences were observed in the expression of S100A8,SAA1,or serum levels of IFN-γ,IL-6,and IL-23(P>0.05).Both intervention groups showed comparable degrees of synovial inflammation,clear tissue structure,and no obvious hyperplasia.Conclusion:Moxibustion can alleviate joint swelling and reduce inflammatory responses in AA rats.Its mechanism may involve regulating the protein expression of S100A8,S100A9,and SAA1 in the knee joint synovial tissue.