In recent years, research on stem cell therapy in the field of lung transplantation has gradually increased, demonstrating its potential in improving the outcomes of lung transplantation. As a treatment option for end-stage lung diseases, lung transplantation faces challenges such as scarcity of donor organs, postoperative complications and rejection. Stem cells, with their self-renewal and multi-directional differentiation capabilities, have emerged as strong candidates for alternative or adjunctive treatments. Current studies show that embryonic stem cells and umbilical cord mesenchymal stem cells play significant roles in lung tissue regeneration and immune regulation. However, stem cell therapy still needs to overcome issues such as the selection of cell sources, low survival rates after transplantation and unclear long-term efficacy in clinical applications. Future research should focus on exploring new stem cell sources, improving transplantation techniques and establishing efficacy evaluation systems.

Objective To establish quality evaluation method of Andrographis paniculata standard decoction by UPLC. Methods 21 batches of Andrographis paniculata standard decoctions were prepared according to the standardization method of TCM decoction pieces. The UPLC characteristic chromatograms analysis method was established. With andrographolide as a reference, quantitative analysis of multi-components by single marker （QAMS） was established for new neoandrographolide, 14 deoxyandrographolide and dehydrated andrographolide. The results were compared with the external standard method （ESM） to determine the accuracy of the method. Results Similarity Evaluation System for Chromatographic Fingerprint of TCM （2012 edition） was used to analyze and compare the characteristic chromatograms, and seven common peaks were determined and five were identified including luteolin-7-O-β-D-glucuronide, andrographolide, neoandrographolide, 14-deoxyandrographolide and dehydroandrographolide. The RSDs of content results of each component by QAMS and ESM were all within 3%. Conclusion The determination method was reliable and accurate, which could be used to reflect the intrinsic quality of Andrographis paniculata standard decoction comprehensively and provide the basis for the quality evaluation of Andrographis paniculata formula granules and other preparations.

Objective: To analyze the epidemiological characteristics and incidence trends of pulmonary tuberculosis (TB) in children aged 0-14 years in Shaanxi Province from 2010 to 2024, so as to provide a reference for optimizing child TB prevention and control strategies. Methods: Data on pulmonary TB cases in children aged 0-14 years and demographic information in Shaanxi Province from 2010 to 2024 were collected from Surveillance and Reporting Management System with Disease Prevention and Control Information Management System under the National Health Security Informatization Project Disease Prevention and Control Information System. A Joinpoint regression model was established to analyze the temporal, spatial, and population distribution trends of child pulmonary TB incidence. Results: A total of 2 954 cases of pulmonary TB in children aged 0-14 years were reported in Shaanxi Province from 2010 to 2024, accounting for 0.97% of all TB cases in the general population. The average annual reported incidence rate in children was 3.32 per 100 000. Among these cases, 804 were pathogenetically positive, showing a increasing trend ( χ 2 trend =420.94, P < 0.01 ). The overall reported incidence rate of pulmonary TB in children aged 0-14 years in Shaanxi Province showed a decreasing trend, dropping from 5.35 per 100 000 in 2010 to 2.41 per 100 000 in 2024. Joinpoint regression analysis identified three distinct phases for the reported incidence rate of TB:a rapid decline from 2010 to 2013 (APC=-20.02%, 95% CI = -33.64% to -10.42%), a slight increase from 2013 to 2017 (APC=11.18%, 95% CI =3.07%-24.17%) and a slight decline again from 2017 to 2024 (APC= -7.27 %, 95% CI =-12.73% to -4.30%) (all P <0.01). Among children aged 0-14 years, the age group with the highest average annual reported incidence rate was 10-14 years (8.02 per 100 000), followed by 5-9 years (1.44 per 100 000), and 0-4 years had the lowest rate (0.95 per 100 000). The difference in reported incidence rates among the three age groups was statistically significant ( χ 2= 51.91, P <0.01). The average annual reported incidence rate of TB was 3.25 per 100 000 in boys and 3.39 per 100 000 in girls, with no statistically significant difference ( χ 2=2.01, P >0.05). There was no obvious periodic variation in the annual case reporting. Among all cities in Shaanxi Province, Ankang City had the highest average annual reported incidence rate (5.16 per 100 000). Conclusions From 2010 to 2024, the reported incidence rate of pulmonary TB in children aged 0-14 years in Shaanxi Province showed an overall decreasing trend. However, it is still necessary to strengthen active surveillance, implement targeted measures in high incidence areas such as Ankang City, and maintain continuous attention to child TB prevention and control.

BACKGROUND: Generalized pustular psoriasis (GPP), a rare and recurrent autoinflammatory disease, imposes a substantial burden on patients and society. Awareness of GPP in China remains limited. METHODS: This cross-sectional survey, conducted between September 2021 and May 2023 across 14 hospitals in China, included GPP patients of all ages and disease phases. Data collected encompassed demographics, clinical characteristics, economic impact, disease severity, quality of life, and treatment-related complications. Risk factors for GPP recurrence were analyzed. RESULTS: Among 127 patients (female/male ratio = 1.35:1), the mean age of disease onset was 25 years (1st quartile [Q1]-3rd quartile [Q3]: 11-44 years); 29.2% had experienced GPP for more than 10 years. Recurrence occurred in 75.6% of patients, and nearly half reported no identifiable triggers. Younger age at disease onset ( P  = 0.021) and transitioning to plaque psoriasis ( P  = 0.022) were associated with higher recurrence rates. The median diagnostic delay was 8 months (Q1-Q3: 2-41 months), and 32.3% of patients reported misdiagnoses. Comorbidities were present in 53.5% of patients, whereas 51.1% experienced systemic complications during treatment. Depression and anxiety affected 84.5% and 95.6% of patients, respectively. During GPP flares, the median Dermatology Life Quality Index score was 19.0 (Q1-Q3: 13.0-23.5). This score showed significant differences between patients with and without systemic symptoms; it demonstrated correlations with both depression and anxiety scores. Treatment costs caused financial hardship in 55.9% of patients, underscoring the burden associated with GPP. CONCLUSIONS The substantial disease and economic burdens among Chinese GPP patients warrant increased attention. Patients with early onset disease and those transitioning to plaque psoriasis require targeted interventions to mitigate the high recurrence risk.
Humans ; Male ; Female ; Psoriasis/pathology* ; Adult ; Cross-Sectional Studies ; Adolescent ; Child ; Young Adult ; Quality of Life ; Middle Aged ; China/epidemiology* ; Recurrence ; Risk Factors ; Surveys and Questionnaires ; East Asian People

ObjectiveTo investigate the features and mechanism of action of intestinal flora in patients with nonalcoholic fatty liver disease （NAFLD） and Helicobacter pylori （HP） infection by comparing the changes in intestinal flora between the healthy population， the patients with HP infection， the patients with NAFLD， and the patients with NAFLD and HP infection. MethodsThis study was conducted among the 19 patients with NAFLD （NAFLD group）， 19 patients with HP infection （HP group）， and 19 patients with NAFLD and HP infection （NAFLD+HP group） who were admitted to The Second Affiliated Hospital of Henan University of Science and Technology from March 1， 2023 to April 30， 2024， and 20 individuals undergoing physical examination were enrolled as control group. Fecal samples were collected， total DNA was extracted for PCR amplification， and 16S rDNA sequencing was performed to compare the features of intestinal flora between the four groups. An analysis of variance was used for comparison of continuous data between multiple groups， and the chi-square test was used for comparison of categorical data between multiple groups. The Mann-Whitney U test or the Kruskal-Wallis H test was used for comparison of the species in intestinal flora. ResultsThe NAFLD+HP group showed a tendency of reduction in flora abundance compared with the other three groups. There was a significant difference in flora distribution between the NAFLD+HP group and the NAFLD group and between the NAFLD group and the control group （P<0.05）. At the phylum level， the top three species in the NAFLD+HP group were Firmicutes （59.94%）， Proteobacteria （17.00%）， and Actinobacteria （14.75%）， with an increase in the proportion of Proteobacteria and a reduction in the proportion of Actinobacteria compared with the other three groups. At the genus level， the top five dominant bacteria in the NAFLD+HP group were Bifidobacterium， Streptococcus， Escherichia-Shigella， Agathobacter， and Ruminococcus gnavus_group. Compared with the NAFLD group， the NAFLD+HP group had increases in the abundance of Streptococcus， Veillonella， and Rothia and reductions in the abundance of Dialister and Ruminococcus toraues_group. Compared with the HP group， the NAFLD+HP group had reductions in the abundance of Collinsella， Subdoligranulum， Catenibacterium， and Porphyromonas and increases in the abundance of Citrobacter and Olsenella （all P<0.05）. ConclusionPatients with NAFLD and HP infection have changed in intestinal flora. These flora may be the intestinal microecological factors for HP infection in promoting the development and progression of NAFLD.

PURPOSE: Traumatic brain injury (TBI) is a significant public health issue that impacts individuals all over the world and is one of the main causes of mortality and morbidity. Decompressive craniectomy is the usual course of treatment. Basal cisternostomy has been shown to be highly effective as an alternative procedure to decompressive craniectomy. METHODS: We conducted a retrospective cohort of patients who received surgery for severe TBI between January 2019 and March 2023. Inclusion criterias were patients between the ages of 18 and 70 years who met the diagnostic criteria for severe TBI at first presentation and who underwent surgical intervention. The exclusion criteria were patients who have severe multiple injuries at the time of admission; preoperative intracranial pressure > 60 mmHg; cognitive impairment before the onset of the disease; hematologic disorders; or impaired functioning of the heart, liver, kidneys, or other visceral organs. Depending on the surgical approach, the patients were categorized into decompressive craniectomy group as well as basal cisternostomy group. General data and postoperative indicators, including Glasgow coma scale, intracranial pressure, etc., were recorded for both groups of patients. Among them, the Glasgow outcome scale extended assessment at 6 months served as the primary outcome. After that, the data were statistically analyzed using SPSS software. RESULTS: The trial enrolled 41 patients (32 men and 9 women) who met the inclusion criteria. Among them, 25 patients received decompressive decompressive craniectomy, and 16 patients received basal cisternostomy. Three days postoperative intracranial pressure levels were 10.07 ± 2.94 mmHg and 17.15 ± 14.65 mmHg (p = 0.013), respectively. The 6 months following discharge Glasgow outcome scale extended of patients was 4.73 ± 2.28 and 3.14 ± 2.15 (p = 0.027), respectively. CONCLUSION Our study reveals that basal cisternostomy in patients with surgically treated severe TBI has demonstrated significant efficacy in reducing intracranial pressure as well as patient prognosis follow-up and avoids removal of the bone flap. The efficacy of cisternostomy has to be studied in larger, multi-clinical center randomized trials.
Humans ; Brain Injuries, Traumatic/surgery* ; Retrospective Studies ; Male ; Female ; Adult ; Middle Aged ; Decompressive Craniectomy/methods* ; Aged ; Young Adult ; Adolescent ; Glasgow Coma Scale ; Treatment Outcome

Lysosomes represent a promising target for cancer therapy and reducing drug resistance. However, the short treatment time and low efficiency of lysosomal targeting have limited the application in lysosome-targeting anticancer drugs. In this study, we proposed an adhesive-bandage approach and synthesized a new lysosomal targeting drug, namely long-term lysosome-targeting anticancer drug (LLAD). It contains a SLC38A9-targeting covalently bound moiety and an alkaline component both to prolong the inhibition of SLC38A9 in lysosomes and alkalinize lysosomes. Upon short term and low-dose treatment of HeLa cells, at passage 0, with LLAD, it rapidly alkalinized lysosomes and also can be detected in lysosomes even at passage 15. LLAD induced apoptosis in HeLa cells through long-term lysosomal damage, and showed better long-term anticancer effect than cisplatin in vivo. Overall, our study paves the way for developing long-term lysosomal targeting drugs to treat cancer and overcome the drug resistance of cancer cells, and also provides a candidate drug, LLAD, for treating cancer.

OBJECTIVE: To explore the correlation between mechanical power normalized to dynamic lung compliance (Cdyn-MP) and weaning outcomes and prognosis in mechanically ventilated patients. METHODS: A prospective, observational cohort study was conducted. Patients who underwent invasive mechanical ventilation (IMV) for more than 24 hours and used a T-tube ventilation strategy for extubation in the intensive care unit (ICU) of Lianyungang First People's Hospital and Lianyungang Second People's Hospital between January 2022 and December 2023 were enrolled. The collected data encompassed patients' baseline characteristics, primary causes of ICU admission, vital signs and laboratory indicators during the initial spontaneous breathing trial (SBT), respiratory mechanics parameters within the 4-hour period prior to the SBT, weaning outcomes and prognostic indicators. Mechanical power (MP) and Cdyn-MP were calculated using a simplified MP equation. Univariate and multivariate Logistic regression analyses were utilized to determine the independent risk factors associated with weaning failure in patients undergoing mechanical ventilation. Restricted cubic spline (RCS) analysis and Spearman rank-sum test were employed to investigate the correlation between Cdyn-MP and weaning outcomes as well as prognosis. Receiver operator characteristic curve (ROC curve) was constructed, and the area under the ROC curve (AUC) was computed to evaluate the predictive accuracy of Cdyn-MP for weaning outcomes in mechanically ventilated patients. RESULTS: A total of 366 patients undergoing IMV were enrolled in this study, with 243 cases classified as successful weaning and 123 cases classified as failed weaning. Among them, 23 patients underwent re-intubation within 48 hours after the successful withdrawal of the first SBT, non-invasive ventilation, or died. Compared with the successful weaning group, the patients in the failed weaning group had significantly increased levels of sequential organ failure assessment (SOFA) score, body temperature and respiratory rate (RR) during SBT, and respiratory mechanical parameters within the 4-hour period prior to the SBT [ventilation frequency, positive end-expiratory pressure (PEEP), platform pressure (Pplat), peak inspiratory pressure (Ppeak), dynamic driving pressure (ΔPaw), fraction of inspired oxygen (FiO₂), MP, and Cdyn-MP], dynamic lung compliance (Cdyn) was significantly reduced, and duration of IMV, ICU length of stay, and total length of hospital stay were significantly prolonged. However, there were no statistically significant differences in age, gender, body mass index (BMI), smoking history, main causes of ICU admission, other vital signs [heart rate (HR), mean arterial pressure (MAP), saturation of peripheral oxygen (SpO₂)] and laboratory indicators [white blood cell count (WBC), albumin (Alb), serum creatinine (SCr)] during SBT of patients between the two groups. Univariate Logistic regression analysis was conducted, and variables with P < 0.05 and no multicollinearity with Cdyn-MP were selected for inclusion in the multivariate Logistic regression model. The results demonstrated that SOFA score [odds ratio (OR) = 1.081, 95% confidence interval (95%CI) was 1.008-1.160, P = 0.030], and PEEP (OR = 1.191, 95%CI was 1.075-1.329, P = 0.001), FiO₂ (OR = 1.035, 95%CI was 1.006-1.068, P = 0.021) and Cdyn-MP (OR = 1.190, 95%CI was 1.086-1.309, P < 0.001) within the 4-hour period prior to the SBT were independent risk factors for weaning failure in patients undergoing IMV. The RCS analysis after adjusting for confounding factors showed that as Cdyn-MP within the 4-hour period prior to the SBT increased, the risk of weaning failure in patients undergoing IMV significantly increased (P < 0.001). The Spearman rank correlation test showed that Cdyn-MP within the 4-hour period prior to the SBT was positively correlated with respiratory mechanical parameters including ΔPaw and MP (r values were 0.773 and 0.865, both P < 0.01), and negatively correlated with Cdyn (r = -0.587, P < 0.01). Cdyn-MP within the 4-hour period prior to the SBT was positively correlated with prognostic indicators such as duration of IMV, length of ICU stay, and total length of hospital stay (r values were 0.295, 0.196, and 0.120, all P < 0.05). ROC curve analysis demonstrated that, within the 4-hour period preceding the SBT, Cdyn-MP, MP, Cdyn, and ΔPaw possessed predictive value for weaning failure in patients undergoing IMV. Notably, Cdyn-MP exhibited superior predictive capability, evidenced by an AUC of 0.761, with a 95%CI ranging from 0.712 to 0.810 (P < 0.001). At the optimal cut-off value of 408.5 J/min×cmH₂O/mL×10^-3, the sensitivity was 68.29%, and the specificity was 71.19%. CONCLUSION Cdyn-MP is related to weaning outcomes and prognosis in mechanically ventilated patients, and has good predictive ability in assessing the risk of weaning failure.
Humans ; Prospective Studies ; Ventilator Weaning ; Prognosis ; Respiration, Artificial ; Intensive Care Units ; Lung Compliance ; Female ; Male ; Middle Aged ; Aged

A 34-year-old male patient was admitted to the hospital on October 6, 2023 due to fall from a high place. Physical examination showed blood pressure 96/53 mmHg (1 mmHg=0.133 kPa), heart rate of 105 beats/min, slight bulge in the right kidney area, and positive percussion pain in the right kidney area. CT examination showed complete rupture of the lower pole of the right kidney, thrombosis of the right renal vein, and contusion and laceration of the right posterior lobe of the liver. According to the American Association for the Surgery of Trauma renal injury classification, he was diagnosed as grade Ⅳ renal rupture. After blood transfusion and fluid infusion, vital signs were stable. Laparoscopic nephrectomy plus renal vein thrombectomy plus liver rupture repair were performed. The operation took 90 minutes, and about 300 ml of blood clots and fresh blood were aspirated during the operation. The patient's vital signs were stable after the operation, and he could get out of bed 3 days after the operation. CT reexamination 1 month after the operation showed right kidney resected and the liver healed well. This operation is feasible if the patient's vital signs are stable, with the advantages of small surgical incision, short operation time, less bleeding, fast postoperative recovery and good surgical effect.