To evaluate the efficacy and safety of dye-free submucosal injection solution for gastric endoscopic submucosal dissection (ESD), a retrospective cohort study was performed on data of inpatients with early gastric cancer and precancerous lesions who underwent ESD at the Digestive Endoscopy Center of Jiangsu Province Hospital of Traditional Chinese Medicine from January to December 2020. Cases were divided into dye-free submucosal injection solution group (the observation group) and dye-containing solution group (the control group). A total of 108 cases met the eligibility criteria for analysis (39 VS 69). Baseline characteristics were comparable between the two groups ( P>0.05). Compared with the control group, the observation group showed similar median procedure time (30.5 min VS 35.0 min), median dissection speed (0.3 cm2/min VS 0.4 cm2/min), mean volume of injection solution used (39.2 mL VS 38.8 mL), en bloc resection rate [100.0% (39/39) VS 98.6% (68/69)], and curative resection rate [97.4% (38/39) VS 97.1% (67/69)] (all P>0.05). Postoperative stay was 3.0±0.8 days in the observation group and 3.2±0.8 days in the control group ( t=-0.908, P=0.378). Delayed bleeding occurred in 3 (7.7%) patients VS 2 (2.9%) patients ( P=0.349), and postoperative infection occurred in 3 (7.7%) patients VS 8 (11.6%) patients ( P=0.743), respectively. In gastric ESD, dye-free submucosal injection solution demonstrates efficacy comparable with dye-containing solution and does not appreciably increase the incidence of intraoperative or postoperative complications.

To evaluate the efficacy and safety of dye-free submucosal injection solution for gastric endoscopic submucosal dissection (ESD), a retrospective cohort study was performed on data of inpatients with early gastric cancer and precancerous lesions who underwent ESD at the Digestive Endoscopy Center of Jiangsu Province Hospital of Traditional Chinese Medicine from January to December 2020. Cases were divided into dye-free submucosal injection solution group (the observation group) and dye-containing solution group (the control group). A total of 108 cases met the eligibility criteria for analysis (39 VS 69). Baseline characteristics were comparable between the two groups ( P>0.05). Compared with the control group, the observation group showed similar median procedure time (30.5 min VS 35.0 min), median dissection speed (0.3 cm2/min VS 0.4 cm2/min), mean volume of injection solution used (39.2 mL VS 38.8 mL), en bloc resection rate [100.0% (39/39) VS 98.6% (68/69)], and curative resection rate [97.4% (38/39) VS 97.1% (67/69)] (all P>0.05). Postoperative stay was 3.0±0.8 days in the observation group and 3.2±0.8 days in the control group ( t=-0.908, P=0.378). Delayed bleeding occurred in 3 (7.7%) patients VS 2 (2.9%) patients ( P=0.349), and postoperative infection occurred in 3 (7.7%) patients VS 8 (11.6%) patients ( P=0.743), respectively. In gastric ESD, dye-free submucosal injection solution demonstrates efficacy comparable with dye-containing solution and does not appreciably increase the incidence of intraoperative or postoperative complications.

Objective:To investigate the effect of toxifolin(TAX)on the malignant biological behaviors of human bladder cancer T24 cells through the Rac1/NF-κB/AKT signaling pathway.Methods:Bladder cancer T24 cells were routinely cultured and divided into:Ctrl group(untreated),TAX-L group(5 μmol/L TAX),TAX-M group(10 μmol/L TAX),TAX-H group(20 μmol/L TAX),and TAX-H+Rac1 activator group(20 μmol/L TAX+50 nmol/L ML-097).CCK-8 method,clone formation assay,scratch healing assay,Transwell chamber assay,and flow cytometry were used to evaluate the effects of different concentrations of TAX on the proliferation,migration,invasion,and apoptosis of T24 cells.WB method was used to examine the expression of apoptosis-related proteins,epithelial-mesenchymal transition(EMT)-related proteins,and Rac1/NF-κB/AKT axis related proteins in T24 cells;A nude mice xenograft model was used to assess the effect of TAX on tumor growth.Results:TAX dose-dependently inhibited the proliferation,migration,and invasion of T24 cells and promoted apoptosis(all P<0.05).TAX also increased the expression of apoptosis proteins BAX and E-cadherin,while decreasing the expression of Bcl-2,N-cadherin,and Rac1/NF-κB/AKT signaling pathway-related proteins(all P<0.05).Furthermore,TAX inhibited tumor growth in the xenograft model(P<0.05).ML-097 partially reversed these effects(all P<0.05).Conclusion:TAX inhibits the malignant biological behaviors of bladder cancer T24 cells and promotes their apoptosis by inhibiting Rac1/NF-κB/AKT signaling pathway.

This study aims to investigate the biological function of the Clumping factor B(clfB)gene in Staphylococcus aureus.The recombinant plasmid pBT2-△clfB was constructed and elec-troporated into Staphylococcus aureus J57 to delete clfB by homologous recombination.The ex-pression plasmid pLI50-clfB was constructed,modified,and electroporated into clfB gene deletion strain △clfB and constructed a complementation strain(C△clfB).J57,△clfB,and C△clfB were cultured at 37℃ for 12 h,and the growth curves of each strain were plotted.The hemolytic properties of each strain were analyzed by contact method,the motility of each strain on TSA plates was determined,and the autolysis rate of each strain under the action of TritonX-100 was determined.Crystal violet staining was used to detect each strain's biofilm formation ability,and biofilm components formed by each strain were quantitatively analyzed.The K-B method was used to determine the sensitivity of each strain to commonly used antibiotics.ClfB gene deletion strain△clfB and the complemented strain C△clfB were successfully constructed.The growth curves of the deletion strain were almost consistent with those of the wild and complemented strains,and there was no significant difference.Compared with J57 and C△clfB,the hemoly ability and the athletic of △clfB decreased.In the condition of TritonX-100,the autolysis rate of △clfB was significantly lower than that of J57 and C△clfB(P＜0.01).Compared with J57 and C△clfB,the ability of △clfB to form biofilm was significantly lower than that of J57 and C△clfB(P＜0.05),and the content of extracellular DNA and protein in the biofilm was significantly decreased.In con-trast,the content of soluble polysaccharides was significantly increased(P＜0.05).Compared with J57 and C△clfB,△clfB was more sensitive to chloramphenicol,gentamicin,and kanamycin while more resistant to linezolid.ClfB gene is closely related to the autolysis,hemolytic activity,athlet-ic,and biofilm formation ability of Staphylococcus aureus,affecting the sensitivity of bacteria to certain antibiotics.

This study aims to investigate the biological function of the Clumping factor B(clfB)gene in Staphylococcus aureus.The recombinant plasmid pBT2-△clfB was constructed and elec-troporated into Staphylococcus aureus J57 to delete clfB by homologous recombination.The ex-pression plasmid pLI50-clfB was constructed,modified,and electroporated into clfB gene deletion strain △clfB and constructed a complementation strain(C△clfB).J57,△clfB,and C△clfB were cultured at 37℃ for 12 h,and the growth curves of each strain were plotted.The hemolytic properties of each strain were analyzed by contact method,the motility of each strain on TSA plates was determined,and the autolysis rate of each strain under the action of TritonX-100 was determined.Crystal violet staining was used to detect each strain's biofilm formation ability,and biofilm components formed by each strain were quantitatively analyzed.The K-B method was used to determine the sensitivity of each strain to commonly used antibiotics.ClfB gene deletion strain△clfB and the complemented strain C△clfB were successfully constructed.The growth curves of the deletion strain were almost consistent with those of the wild and complemented strains,and there was no significant difference.Compared with J57 and C△clfB,the hemoly ability and the athletic of △clfB decreased.In the condition of TritonX-100,the autolysis rate of △clfB was significantly lower than that of J57 and C△clfB(P＜0.01).Compared with J57 and C△clfB,the ability of △clfB to form biofilm was significantly lower than that of J57 and C△clfB(P＜0.05),and the content of extracellular DNA and protein in the biofilm was significantly decreased.In con-trast,the content of soluble polysaccharides was significantly increased(P＜0.05).Compared with J57 and C△clfB,△clfB was more sensitive to chloramphenicol,gentamicin,and kanamycin while more resistant to linezolid.ClfB gene is closely related to the autolysis,hemolytic activity,athlet-ic,and biofilm formation ability of Staphylococcus aureus,affecting the sensitivity of bacteria to certain antibiotics.

Objective:To investigate the current status of application of stereotactic body radiation therapy (SBRT) in China, aiming to provide reference for promoting the development of this technology.Methods:From January to March 2024, a questionnaire was designed and distributed online, targeting member units of the Professional Committee of Stereotactic Radiosurgery Treatment, which covers 175 radiotherapy units in 30 provinces and regions nationwide. The survey focused on the current application of SBRT technology and its utilization in the treatment of early-stage non-small cell lung cancer (NSCLC). A statistical description of the survey results was presented.Results:Of 175 questionnaires distributed, a total of 130 valid responses were collected, with an effective response rate of 74.3%. A total of 81.5% (106/130) of the units had implemented SBRT technology, and 99.1% of the respondents believed it was necessary to further promote SBRT technology, yet the actual training rate was only 67.0%. SBRT equipment configuration: there were a total of 267 SBRT equipment, featuring a diverse range of types, with traditional linear accelerators as the mainstays, accounting for 76.0% ( n=203), followed by 12.0% ( n=32) for TOMO, 6.4% ( n=17) for Cyber knife, 3.7% ( n=10) for Gamma knife, and proton/heavy ion equipment at 1.5% ( n=4), respectively. The percentage of units with multi-leaf collimator leaf widths ≤0.5 cm was 93.4% (99/106). The application of SBRT: the first radiotherapy unit commenced SBRT in 2000, and this technology entered a period of rapid growth after 2015, sustaining a steady increase over the past decade; SBRT technology was mainly applied in the brain, lung, liver, bone, adrenal gland, and kidney, with application rates of 97.2%, 94.3%, 86.8%, 71.7%, 56.6%, and 27.4%, respectively, while the application rates for the pancreas, metastatic lymph nodes, and other parts were less than 5%. Current status of SBRT technology application in early-stage NSCLC: 90.6% (96/106) of units had implemented SBRT; pre-treatment multi-disciplinary diagnosis and treatment accounted for 77% (74/96); the proportion of application units for peripheral and central type lung cancer lesions both exceeded 57.3%, whereas the application rate for ultra-central type and lesions > 5 cm lung cancer was less than 30%; there was significant variability in the selection of reference guidelines, dose fractionation patterns, and the concept of central type among units. Conclusions:The development of SBRT technology in China is in a period of steady growth, but several issues such as low training rate and lack of standardization still exist. The survey results provide important reference for clinical training and promotion of SBRT technology in China.

Objective:To investigate the current status of application of stereotactic body radiation therapy (SBRT) in China, aiming to provide reference for promoting the development of this technology.Methods:From January to March 2024, a questionnaire was designed and distributed online, targeting member units of the Professional Committee of Stereotactic Radiosurgery Treatment, which covers 175 radiotherapy units in 30 provinces and regions nationwide. The survey focused on the current application of SBRT technology and its utilization in the treatment of early-stage non-small cell lung cancer (NSCLC). A statistical description of the survey results was presented.Results:Of 175 questionnaires distributed, a total of 130 valid responses were collected, with an effective response rate of 74.3%. A total of 81.5% (106/130) of the units had implemented SBRT technology, and 99.1% of the respondents believed it was necessary to further promote SBRT technology, yet the actual training rate was only 67.0%. SBRT equipment configuration: there were a total of 267 SBRT equipment, featuring a diverse range of types, with traditional linear accelerators as the mainstays, accounting for 76.0% ( n=203), followed by 12.0% ( n=32) for TOMO, 6.4% ( n=17) for Cyber knife, 3.7% ( n=10) for Gamma knife, and proton/heavy ion equipment at 1.5% ( n=4), respectively. The percentage of units with multi-leaf collimator leaf widths ≤0.5 cm was 93.4% (99/106). The application of SBRT: the first radiotherapy unit commenced SBRT in 2000, and this technology entered a period of rapid growth after 2015, sustaining a steady increase over the past decade; SBRT technology was mainly applied in the brain, lung, liver, bone, adrenal gland, and kidney, with application rates of 97.2%, 94.3%, 86.8%, 71.7%, 56.6%, and 27.4%, respectively, while the application rates for the pancreas, metastatic lymph nodes, and other parts were less than 5%. Current status of SBRT technology application in early-stage NSCLC: 90.6% (96/106) of units had implemented SBRT; pre-treatment multi-disciplinary diagnosis and treatment accounted for 77% (74/96); the proportion of application units for peripheral and central type lung cancer lesions both exceeded 57.3%, whereas the application rate for ultra-central type and lesions > 5 cm lung cancer was less than 30%; there was significant variability in the selection of reference guidelines, dose fractionation patterns, and the concept of central type among units. Conclusions:The development of SBRT technology in China is in a period of steady growth, but several issues such as low training rate and lack of standardization still exist. The survey results provide important reference for clinical training and promotion of SBRT technology in China.

Objective:To analyze the efficacy and safety of nalbuphine for analgesia in patients with non-mechanical ventilation in intensive care unit (ICU).Methods:From December 2018 to August 2021, a multicenter randomized controlled clinical study was conducted to select non-mechanical ventilation patients with analgesic needs admitted to ICU of four hospitals in Henan Province and Guizhou Province. Patients were randomly assigned to nalbuphine group and fentanyl group. The nalbuphine group was given continuous infusion of nalbuphine [0.05~0.20 mg/(kg·h)], and the fentanyl group was given continuous infusion of fentanyl [0.5~2.0 μg/(kg·h)]. The analgesic target was critical-care pain observation tool (CPOT) score<2. The observation time was 48 hours. The primary endpoint was CPOT score, the secondary endpoints were Richmond agitation-sedation score (RASS), ICU length of stay, adverse events, and proportion of mechanical ventilation. The quantitative data of the two groups were compared by t test or Mann-Whitney U test. The enumeration data were compared by chi square test or Fisher exact probability method. The data at different time points between groups were compared by repeated measures analysis of variance. Results:A total of 210 patients were enrolled, including 105 patients in the nalbuphine group and 105 patients in the fentanyl group. There was no significant difference in baseline data between the two groups (all P>0.05). There was no significant difference in CPOT score between nalbuphine group and fentanyl group at each time point after medication ( P>0.05), the CPOT score of both groups at each time point after medication was significantly lower than that before medication, and the analgesic target could be achieved and maintained 2 hours after medication. There was no significant difference in RASS between the two groups at each time point after medication ( P>0.05), which was significantly lower than that before medication, and the target sedative effect was achieved 2 hours after medication. There was no significant difference in ICU length of stay between nalbuphine group and fentanyl group [5.0(4.0,7.5) d vs. 5.0(4.0,8.0) d, P=0.504]. The incidence of delirium, nausea and vomiting, abdominal distension, pruritus, vertigo and other adverse events in the nalbuphine group was lower than that in the fentanyl group (all P<0.05). There was no significant difference in the incidence of other adverse events such as deep sedation, hypotension and bradycardia between the two groups (all P>0.05). The incidence of respiratory depression in nalbuphine group was not significantly different from that in fentanyl group ( P>0.05), but the proportion of mechanical ventilation was significantly lower than that in the fentanyl group [1.9% (2/105) vs. 8.6%(9/105), P=0.030]. Conclusions:Nalbuphine could be used for analgesia in ICU patients with non-mechanical ventilation. The target analgesic effect could be achieved within 2 hours, and it had a certain sedative effect with a low incidence of adverse reactions.

Improving the reproducibility of biomedical research results is a major challenge. Transparent and accurate reporting of the research process enables readers to evaluate the reliability of the research results and further explore the experiment by repeating it or building upon its findings. The ARRIVE 2.0 guidelines, released in 2019 by the UK National Centre for the Replacement, Refinement and Reduction of Animals in Research (NC3Rs), provide a checklist that is applicable to any in vivo animal research report. These guidelines aim to improve the standardization of experimental design, implementation, and reporting, as well as enhance the reliability, repeatability, and clinical translation of animal experimental results. The use of the ARRIVE 2.0 guidelines not only enriches the details of animal experimental research reports, ensuring that information on animal experimental results is fully evaluated and utilized, but also enables readers to understand the content expressed by the author accurately and clearly, promoting the transparency and completeness of the fundamental research review process. At present, the ARRIVE 2.0 guidelines have been widely adopted by international biomedical journals. This article is based on the best practices following the ARRIVE 2.0 guidelines in international journals, and it interprets, explains, and elaborates in Chinese the fifth part of the comprehensive version of the ARRIVE 2.0 guidelines published in PLoS Biology in 2020 (the original text can be found at https://arriveguidelines.org). This section includes the items 6-11 of Recommended 11 section, covering "Animal Care and Monitoring", "Interpretation/Scientific Implications", "Generalisability/Translation", "Protocol Registration", "Data Access" and "Declaration of Interests". Its aim is to promote a comprehensive understanding and use of the ARRIVE 2.0 guidelines among domestic researchers, to enhance the standardization of experimental animal research and reporting, and to promote high-quality development of experimental animal sciences and comparative medicine research in China.

Objective:To investigate associations of serum vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor 2 (VEGFR2) with carotid plaque stability in elderly patients with acute ischemic stroke (AIS).Methods:Elderly AIS patients with carotid plaque detected by carotid ultrasound in the First People's Hospital of Xianyang from April 2022 to April 2024 were selected, and they were further divided into stable plaque group and vulnerable plaque group. Multivariate logisitic regression analysis was used to determine the correlation between serum VEGF/VEGFR2 and carotid plaque stability. Receiver operating characteristic (ROC) curve was used to analyze the differential value of serum VEGF and VEGFR2 on plaque stability. Results:A total of 183 patients were enrolled, including 139 males (75.96%), aged 68.10±4.97 years. One hundred and one patients (55.19%) had vulnerable plaques, and 82 (44.81%) had stable plaques. There were significant differences in age, triglycerides, VEGF, VEGFR2, baseline National Institutes of Health Stroke Scale scores, and the proportion of patients with hypertension, diabetes, smoking, and statins between the vulnerable plaque group and the stable plaque group (all P<0.05). Multivariate logistic regression analysis showed that serum VEGF (odds ratio [ OR] 1.021, 95% confidence interval [ CI] 1.004-1.037; P=0.015] and VEGFR2 ( OR 1.009, 95% CI 1.005-1.012; P<0.001) were independently associated with vulnerable plaques. ROC curve analysis showed that serum VEGF and VEGFR2 alone were effective in distinguishing plaque stability, and the areas under the curve were 0.744 (95% CI 0.673-0.815) and 0.809 (95% CI 0.749-0.870), respectively. The area under the curve of the combination of the two was 0.874 (95% CI 0.825-0.924). Conclusion:Serum VEGF and VEGFR2 are independently associated with vulnerable carotid plaques in elderly patients with AIS, and both alone or in combination have good discriminatory value for the stability of carotid plaques.