Background: Murraya, a genus of shrubs and trees in the Rutaceae family, consists of approximately 9 species in China with significant medicinal and horticultural value. However, the phylogeny and taxonomy of Murraya species remain controversial, particularly with respect to Murraya exotica and M. paniculata. Objective: This study aimed to provide insights into the taxonomy, phylogeny, and identification of Murraya. Methods: In this study, the chloroplast (CP) genomes of 7 Murraya species were sequenced, assembled, and subjected to comparative and phylogenetic analyses. Results: The CP genomes of Murraya ranged from 158,573 to 160,817 bp in length and encoded 112 unique genes, including 78 protein-coding genes, 30 tRNA genes, and 4 rRNA genes. Similar to other angiosperms, the inverted repeat regions of the CP genomes exhibited lower sequence divergence than the single-copy regions, and coding regions were more conserved than noncoding regions. Comparative analysis identified several highly variable regions (eg, matK, ycf1, ndhI-ndhA, trnH-GUG-psbA, rpl32-trnL) that could serve as molecular markers for species identification in Murraya. Among these, the ycf1 gene was validated as a useful marker for distinguishing M. exotica from M. paniculata. Positive selection was detected in 10 genes, including rbcL, psaJ, ndhD, ndhF, rpl2, rpl20, ycf1, accD, ccsA, and rpl32. Phylogenetic analysis based on CP genomes supported the recognition of M. exotica and M. paniculata as independent species. Moreover, the phylogenetic trees indicated that Murraya is not monophyletic, with sect. Bergera showing a closer relationship to Clausena. Molecular dating results suggested that the diversification of M. paniculata, M. alata, and M. exotica occurred approximately 9.11 Mya (95% highest posterior density: 4.90-13.87 Mya). Conclusion: These findings provide valuable CP genome data for clarifying the phylogenetic relationships between M. exotica and M. paniculata, and for advancing the study of DNA markers and the evolutionary history of Murraya.

Objective: To assess the current status of bacterial detection capabilities in various blood collection and supply and related laboratories across China, and to identify key factors affecting the consistency of test results. Methods: A pooled analysis was conducted on data from 21 external quality assessment (EQA) rounds for blood bacterial detection carried out by the China International Transfusion Infection Prevention and Control (CITIC) project from 2019 to 2025. The study covered three types of laboratories-blood centers, central blood stations, and commercial laboratories—across 23 provincial-level administrative regions in China. Statistics were compiled on the number of participating laboratories, and the concordance rates were calculated for different institution types, different automated blood culture systems, different bacterial concentrations, and different strains. Non-standard reporting issues were also reviewed, and statistical methods were applied for analysis. Results: Over the seven-year period, the number of participating laboratories increased from 161 to 236, with an average annual growth rate of 6.58%, and the annual concordance rates ranged from 82.61% to 94.92%. The overall laboratory concordance rates for the three types of participating laboratories were all>89.0% (P>0.05), while commercial laboratories showed a significant year-by-year increase (70.97%-100%, P<0.05). The concordance rates of automated blood culture systems from eight manufacturers showed no significant differences (97.98%-100%, P>0.05), indicating stable performance across all devices. The overall sample concordance rate was 98.88%, with negative samples showing a lower rate than positive samples (97.97% vs 99.14%); positive sample rates increased with higher concentrations; and low-concentration Gram-negative bacterial samples had a lower concordance rate than Gram-positive ones (93.15% vs 100%). A total of 50 instances of non-standard result reporting were identified, with incorrect time units accounting for the highest proportion (52.0%). Conclusion The participation scale and overall testing proficiency of blood collection and supply and related laboratories nationwide have improved year by year, and all types of automated blood culture devices can meet the requirements for blood bacterial screening. Detection of negative and low-concentration positive samples remains a weak link in current bacterial EQA, and the standardization of laboratory data reporting requires further strengthening. Continuous: external quality assessment, targeted training, and standardized reporting procedures can effectively enhance the homogenization level of blood bacterial testing across the country and ensure the safety of clinical transfusion.

Objective:To investigate the impact of virtual navigation bronchoscopy on perioperative information in patients undergoing thoracoscopic pulmonary resection.Methods:Employed three distinct propensity score matching models to effectively address the baseline data disparities among patients undergoing thoracoscopic pulmonary resection. Categorized the patients into two groups: pulmonary wedge resection and pulmonary segmentectomy. Compared the disparities in clinical characteristics, intraoperative lesion resection, and postoperative recovery between patients who underwent virtual navigation bronchoscopy assisted localization prior to surgery and those who did not employ any specific localization methods.Results:This reserch included a total of 127 patients who underwent localization assisted by virtual navigation bronchoscopy, and 122 patients who did not undergo specialized localization. After propensity score matching, the navigation group demonstrated a statistically significant reduction in intraoperative blood loss[model 3, 40(20, 50) ml vs. 50(20, 100) ml, P=0.027], drainage volume on the first day post-surgery[model 3, 100(50, 175) ml vs. 150(100, 220) ml, P=0.023], and incidence of residual pleural effusion(model 3, 31 cases vs. 38 cases, P=0.046) compared to the non-positioning group among patients undergoing pulmonary wedge resection. In the pulmonary segmentectomy group, we observed a reduction in intraoperative blood loss[model 3, 50(30, 100) ml vs. 100(50, 100) ml, P=0.003] and incidence of residual pneumothorax(model 3, 18 cases vs. 28 cases, P=0.012) in patients who underwent navigation-assisted procedures compared to those without specialized positioning. Conclusion:The utilization of virtual navigation bronchoscopy for preoperative localization assistance in thoracoscopic sublobectomy(including wedge resection and segmental resection) may represent a viable approach to mitigate intraoperative injury and facilitate postoperative recovery.

Objective:To develop a scale on hospice care perception and attitude in family members of critically ill patients, so as to provide a valid tool for measuring the cognition and attitude level of hospice care among family members of critically ill patients.Methods:During May 2022 to 2023, an initial pool of scale entries was formed through the literature analysis method and group discussion. The scale′s first draft was formed by applying the Delphi correspondence method and a small sample pre-survey. The developed scale was administered to 98 family members of critically ill patients in Shandong Provincial Hospital Affiliated to Shandong First Medical University to test the reliability and validity of scale.Results:The results of exploratory factor analysis extracted 5 explanatory factors with a cumulative contribution rate of 77.65%. The developed Hospice Care Perceptions and Attitudes of Families of Critically Ill Patients Scale had 19 items. The content validity of 0.922 and a Cronbach alpha coefficient of 0.816 showed good validity and reliability.Conclusions:The scale has sufficient reliability and can be used to assess cognitive and attitudinal levels of hospice care in family members of critically ill patients.

Ulcerative colitis (UC) is a chronic and non-specific inflammatory bowel disease (IBD). Huanglian Ganjiang decoction (HGD), derived from ancient book Beiji Qianjin Yao Fang, has demonstrated efficacy in treating UC patients traditionally. Previous research established that the compatibility of cold herb Coptidis Rhizoma + Phellodendri Chinensis Cortex (CP) and hot herb Angelicae Sinensis Radix + Zingiberis Rhizoma (AZ) in HGD synergistically improved colitis mice. This study investigated the compatibility mechanisms through which CP and AZ regulated inflammatory balance in colitis mice. The experimental colitis model was established by administering 3% dextran sulphate sodium (DSS) to mice for 7 days, followed by CP, AZ and CPAZ treatment for an additional 7 days. M1/M2 macrophage polarization levels, glucose metabolites levels and pyruvate dehydrogenase kinase 4 (PDK4) expression were analyzed using flow cytometry, Western blot, immunofluorescence and targeted glucose metabolomics. The findings indicated that CP inhibited M1 macrophage polarization, decreased inflammatory metabolites associated with tricarboxylic acid (TCA) cycle, and suppressed PDK4 expression and pyruvate dehydrogenase (PDH) (Ser-293) phosphorylation level. AZ enhanced M2 macrophage polarization, increased lactate axis metabolite lactate levels, and upregulated PDK4 expression and PDH (Ser-293) phosphorylation level. TCA cycle blocker AG-221 and adeno-associated virus (AAV)-PDK4 partially negated CP's inhibition of M1 macrophage polarization. Lactate axis antagonist oxamate and PDK4 inhibitor dichloroacetate (DCA) partially reduced AZ's activation of M2 macrophage polarization. In conclusion, the compatibility of CP and AZ synergistically alleviated colitis in mice through M1/M2 macrophage polarization balance via PDK4-mediated glucose metabolism reprogramming. Specifically, CP reduced M1 macrophage polarization by restoration of TCA cycle via PDK4 inhibition, while AZ increased M2 macrophage polarization through activation of PDK4/lactate axis.
Animals ; Drugs, Chinese Herbal/chemistry* ; Mice ; Macrophages/immunology* ; Glucose/metabolism* ; Pyruvate Dehydrogenase Acetyl-Transferring Kinase/genetics* ; Male ; Mice, Inbred C57BL ; Humans ; Colitis/drug therapy* ; Disease Models, Animal ; Colitis, Ulcerative/drug therapy* ; Metabolic Reprogramming

Objective:To investigate the impact of virtual navigation bronchoscopy on perioperative information in patients undergoing thoracoscopic pulmonary resection.Methods:Employed three distinct propensity score matching models to effectively address the baseline data disparities among patients undergoing thoracoscopic pulmonary resection. Categorized the patients into two groups: pulmonary wedge resection and pulmonary segmentectomy. Compared the disparities in clinical characteristics, intraoperative lesion resection, and postoperative recovery between patients who underwent virtual navigation bronchoscopy assisted localization prior to surgery and those who did not employ any specific localization methods.Results:This reserch included a total of 127 patients who underwent localization assisted by virtual navigation bronchoscopy, and 122 patients who did not undergo specialized localization. After propensity score matching, the navigation group demonstrated a statistically significant reduction in intraoperative blood loss[model 3, 40(20, 50) ml vs. 50(20, 100) ml, P=0.027], drainage volume on the first day post-surgery[model 3, 100(50, 175) ml vs. 150(100, 220) ml, P=0.023], and incidence of residual pleural effusion(model 3, 31 cases vs. 38 cases, P=0.046) compared to the non-positioning group among patients undergoing pulmonary wedge resection. In the pulmonary segmentectomy group, we observed a reduction in intraoperative blood loss[model 3, 50(30, 100) ml vs. 100(50, 100) ml, P=0.003] and incidence of residual pneumothorax(model 3, 18 cases vs. 28 cases, P=0.012) in patients who underwent navigation-assisted procedures compared to those without specialized positioning. Conclusion:The utilization of virtual navigation bronchoscopy for preoperative localization assistance in thoracoscopic sublobectomy(including wedge resection and segmental resection) may represent a viable approach to mitigate intraoperative injury and facilitate postoperative recovery.

Objective:To establish a model based on the characteristics of breast cancer ultrasound images through deep learning methods to predict the risk of axillary lymph node metastasis（ALNM）in patients with breast cancer（maximum diameter ≤2.5 cm）before surgery.Methods:A total of 419 patients（3 433 breast tumor ultrasound images）with breast cancer（maximum diameter ≤2.5 cm）who underwent axillary lymph node dissection at Beijing Tiantan Hospital，Capital Medical University from January 2019 to December 2024 were retrospectively included. According to the pathological results of axillary lymph nodes，they were divided into 220 cases in the ALNM occurrence group（positive group）and 199 cases in the non-ALNM occurrence group（negative group）. The breast cancer ultrasound images of the two groups of cases were randomly classified into the training set（2 404 images），the validation set（687 images）and the test set（342 images）according to a ratio of 7∶2∶1. YOLOv8 was used as the basic model of You Only Look Once（YOLO）and optimized. The optimized model was applied to locate and capture the potential ultrasound features of breast cancer cases in the training set. A prediction model was constructed based on the captured ultrasound features. The model was adjusted and optimized through the validation set，and then matched with the case images in the test set. The confusion classification matrix graph and the curve graph for measuring the model performance were used to evaluate the model prediction performance and interpret the model，and the efficacy of this model in identifying breast cancer patients at risk of ALNM was analyzed.Results:There were statistically significant differences between the positive and negative groups in terms of the pathological maximum diameter of breast tumors，pathological T staging，the differentiation degree，the presence of distant metastasis，the maximum diameter measured by ultrasound，the quadrant of breast tumor occurrence，the Breast Imaging - Reporting and Data System（BI-RADS）classification of breast tumors，and the presence of abnormal ultrasound features of lymph node（all P<0.05）. The established deep learning model could automatically perform bounding box localization for the breast cancer of patients.The breast tumors in the positive group had potential ultrasound features that could be captured by the model compared with those in the negative group. The mean average precision（mAP）50 was 0.883，mAP 50-95 was 0.636，PR-AUC was 0.884 5，strict PR-AUC was 0.636 4，the sensitivity was 90.5%，and the specificity was 91.2%，and it had a good predictive efficacy. Conclusions:This prediction model based on the ultrasound characteristics of breast cancer through deep learning can effectively predict breast cancer（maximum diameter ≤ 2.5 cm）with the risk of ALNM，providing an effective basis for the clinical management of axillary lymph nodes in breast cancer patients.

Objective:To investigate the clinical efficacy of compound sabal berry tablets on overactive bladder symptoms in patients with benign prostatic hyperplasia after transurethral laser enucleation of the prostate.Methods:This study was a prospective study. Eighty patients with benign prostatic hyperplasia who underwent laser enucleation at Tongliao People's Hospital from January 2024 to December 2024 were included in this study. The patients were randomly divided into a study group and a control group using the random number table method, with 40 patients per group. The control group received 0.2 mg of tolterodine tartrate tablets twice a day after surgery. The study group was given compound sabal berry tablets (0.5 g orally three times a day) in addition to the treatment provided to the control group. Both groups of patients were treated for 4 weeks after surgery. The clinical efficacy of the two groups was compared, including the International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS), Maximum Postoperative Urinary Flow Rate (Qmax), Post-Void Residual (PVR), and the incidence of postoperative bladder irritative symptoms.Results:The differences in the preoperative indicators, including IPSS, OABSS, Qmax, and PVR, between the two groups were not statistically significant (all P > 0.05). Preoperatively, in the control group, Qmax was (8.64 ± 2.83) mL/s, IPSS was (25.10 ± 4.37), OABSS was (10.52 ± 1.87), and PVR was (80.70 ± 6.34) mL; in the study group, the respective values were (9.12 ± 2.95) mL/s, (24.60 ± 4.53), (10.83 ± 1.73), and (80.10 ± 5.61) mL. Postoperatively, in the control group, Qmax was (20.30 ± 3.65) mL/s, IPSS was (8.50 ± 1.58), OABSS was (4.09 ± 0.52), and PVR was (9.70 ± 2.48) mL, while in the study group, the respective values were (21.40 ± 4.38) mL/s, (7.40 ± 1.76), (1.71 ± 0.36), and (9.00 ± 1.75) mL. Postoperatively, both groups showed a significant increase in Qmax, while IPSS, OABSS, and PVR all significantly decreased (all P < 0.05). Postoperatively, the IPSS and OABSS in the study group were significantly lower than those in the control group ( t = -3.28, -25.89, both P < 0.05). However, there were no statistically significant differences in Qmax and PVR between the two groups (both P > 0.05). The incidence of bladder irritative symptoms in the study group [12.50% (5/40)] was significantly lower than that in the control group [35.00% (14/40), χ2 = 8.64, P < 0.05]. Conclusions:Compound sabal berry tablets can reduce postoperative prostate symptoms and overactive bladder symptoms in patients undergoing transurethral laser enucleation of the prostate for benign prostatic hyperplasia, demonstrating a certain clinical efficacy.

Objective To evaluate the preliminary effects of a Traditronal Chinese Medicine(TCM)incentive policy aimed at the number of discharge patients on the synergistic improvement of performance assessment indicators in the Traditional Chinese Hospital.Methods It selected detailed data from the first page of medical records at the grade A teritary hospital from October,2018 to October,2021.Using the Interrupted Time Series analysis method,two breakpoints were taken as the start time of COVID-19(December 2019)and the official implementation time of dis-charge performance program(September 2020).The utilization rate of TCM decoction pieces among discharged pa-tients,the utilization rate of TCM non-drug therapy among discharged patients,the proportion of discharged pa-tients mainly treated with TCM,and the proportion of inpatient medical service income before and after the break-point were analyzed.Results Despite the impact of COVID-19,after the policy was implemented,four key indicators showed a positive growth trend:the proportion of discharged patients treated primarily with TCM,the rate of TCM decoction use among discharged patients,the rate of TCM non-pharmaceutical therapy use among discharged pa-tients,and the proportion of medical service income,respectively.Conclusion The introduction of a TCM reward module in the discharge performance bonus plan of the sample hospital effectively stimulated the enthusiasm of medical staff in applying TCM.The utilization rate of TCM decoction slices,the utilization rate of TCM non-drug therapy,the proportion of discharged patients treated mainly by TCM and the proportion of medical service income all showed an upward trend,indicating that the incentive policy of TCM has a positive impact on the national examination index of TCM hospitals.