ObjectiveTo investigate the differences in clinicopathological features and prognosis between patients with drug-induced vanishing bile duct syndrome （VBDS） and those with VBDS induced by autoimmune liver disease， and to summarize the key points for clinical differentiation. MethodsA total of 67 patients who were diagnosed with VBDS by liver biopsy in The First Affiliated Hospital of Soochow University and Wuxi Fifth People’s Hospital from January 2018 to June 2024 were enrolled as subjects， among whom 18 had drug-induced VBDS （D-VBDS group） and 49 had VBDS induced by autoimmune liver disease （A-VBDS group）. Related data were collected， including general information， clinical symptoms and signs， laboratory markers， liver pathomorphological features， and prognosis. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. ResultsAmong the 67 VBDS patients， female patients accounted for a higher proportion （80.60%）， and the patients aged 40 — 59 years accounted for 55.22%； there were 18 patients （26.87%） with D-VBDS and 49 patients （73.13%） with A-VBDS. Yellow urine （83.58%） was the most common clinical symptom in VBDS patients， followed by fatigue （64.18%）， poor appetite （64.18%）， jaundice of the sclera （62.69%）， abdominal distension （23.88%）， pruritus （23.88%）， nausea and vomiting （20.90%）， and fever （13.43%）. Compared with the D-VBDS group， the A-VBDS group had a significantly higher degree of plasma cell infiltration and a significantly lower degree of canalicular bile plugs （χ²=14.186， 6.568， both P<0.05）. Compared with the A-VBDS group， the D-VBDS group had significantly higher peak levels of alanine aminotransferase， total bilirubin， direct bilirubin， and indirect bilirubin （Z=-2.546， -2.957， -2.628， -2.772， all P<0.05）. Compared with the D-VBDS group， the patients in the A-VBDS group were more likely to develop liver cirrhosis （χ²=4.682， P=0.030）. ConclusionThe levels of alanine aminotransferase and bilirubin and liver pathomorphological features are objective indicators for differentiating D-VBDS from A-VBDS， and they are of great importance for clarifying diagnosis and determining the degree of liver injury. Patients with A-VBDS are more likely to develop liver cirrhosis.

The red doctor spirit is a spiritual quality gradually molded during the process of the Communist Party of China （CPC） leading China’s healthcare undertakings. It has witnessed the century-long history of China’s healthcare undertakings and is an important part of the CPC’s red culture. The formation of the red doctor spirit not only stems from the scientific guidance of Marxism but is also deeply rooted in the civilizational nourishment of the excellent traditional Chinese culture， which was ultimately formed in the revolutionary practice of the CPC. Currently， the red doctor spirit still has important contemporary value in building good medical ethics and professionalism， practicing socialist core values， and accelerating the construction of a healthy China. In the context of the new era， accelerating the modernization translation of the red doctor spirit requires exploring its material expression forms， hastening the organic integration of the red doctor spirit and digital technology， and promoting the integration of the red doctor spirit into the ideological and political education in colleges and universities， thereby realizing the inheritance and development of the red doctor spirit in the context of the new era.

Objective To investigate the effects of sauchinone(Sch)on the growth and immune escape of liver cancer cells by regulating the Krüppel like factor 5(KLF5)-erythropoietin-producing hepatocellular receptor A2(EphA2)pathway.Methods Huh-7 cells were grouped into liver cancer group,Sch low,medium,and high-dose groups(Sch-L group,Sch-M group,Sch-H group),Sch-H+KLF5 activator negative control group(OE-NC),and Sch-H+KLF5 activator(OE-KLF5)group.5-bromo-2-deoxyuracil(EdU)staining,CCK-8,scratch assay,and Transwll were used to detect the proliferation,migration,and invasion of Huh-7 cells,respectively.Western blot was applied to detect proliferative cell nuclear antigen(PCNA),migration invasion enhancer(MIEN1),matrix metalloproteinase-2(MMP-2),programmed death receptor ligand 1(PD-L1),KLF5,and EphA2 proteins in Huh-7 cells.The Huh-7 cells in above 6 groups were co cultured with activated CD8+T cells in a 96 well plate and named as liver cancer co culture group,Sch-L co culture group,Sch-M co culture group,Sch-H co culture group,Sch-H+OE-NC co culture group,and Sch-H+OE-KLF5 co culture group.The killing rate of CD8+T cells in the co culture system and the levels of interferon-γ(IFN-γ),interleukin-4(IL-4),and tumor necrosis factor-α(TNF-α)in the supernatant were detected.Results Compared with the liver cancer group,the EdU positive rate,OD450 value,cell invasion number,and PCNA,MIEN1,MMP-2,PD-L1,KLF5,and EphA2 proteins in the Sch-L,Sch-M,and Sch-H groups reduced,the migration distance shorten(P<0.05).Compared with the Sch-H group and Sch-H+OE-NC group,the EdU positive rate,OD450 value,cell invasion number,and PCNA,MIEN1,MMP-2,PD-L1,KLF5,and EphA2 proteins in the Sch-H+OE-KLF5 group increased,the migration distance prolonged(P<0.05).Compared with the liver cancer co culture group,the killing rate of CD8+T cells on Huh-7 cells and the levels of IFN-γ,TNF-α,and IL-4 in the supernatant in the Sch-L co culture group,Sch-M co culture group,and Sch-H co culture group increased(P<0.05).Compared with the Sch-H co culture group and the Sch-H+OE-NC co culture group,the killing rate of CD8+T cells on Huh-7 cells and the levels of IFN-γ,TNF-α,and IL-4 in the supernatant in the Sch-H+OE-KLF5 co culture group decreased(P<0.05).Conclusion Sch may inhibit growth and immune escape of liver cancer cells by inhibiting the KLF5-EphA2 pathway.

Objective:To explore the current dietary patterns and influencing factors of patients with coronary heart disease (CHD) in severe cold regions, aiming to provide scientific evidence for developing targeted dietary interventions.Methods:A total of 340 patients with CHD who visited the Department of Cardiology at the Second Affiliated Hospital of Harbin Medical University between September and December 2023 were selected using convenience sampling. Patients were assessed using a general information questionnaire, Semi-Quantitative Food Frequency Questionnaire, Food Choice Questionnaire, Nutritional Knowledge Questionnaire, 7-Item Generalized Anxiety Disorder Scale, and Patient Health Questionnaire-9.Results:A total of 340 questionnaires were distributed, and 333 valid questionnaires were collected, with an effective response rate of 97.94% (333/340). Two dietary patterns were identified among patients with CHD in severe cold regions: a "fruit-nut-dairy" dietary pattern and a "meat-seafood-grain" dietary pattern. Factors influencing the "fruit-nut-dairy" dietary pattern included gender, nutritional knowledge, and food choice motivations such as accessibility, sensory appeal, brand and packaging, and emotional dimensions ( P<0.05). Factors influencing the "meat-seafood-grain" dietary pattern included body mass index (BMI), living alone or not, monthly income, and food choice motivations such as convenience, health attributes, sensory appeal, and price ( P<0.05) . Conclusions:When providing dietary interventions for CHD patients, targeted control of factors such as gender, BMI, living alone or not, monthly income, nutritional knowledge, and key elements of food choice motivations may optimize patients' irrational dietary structures and reduce adverse disease outcomes.

Objective To investigate the effects of sauchinone(Sch)on the growth and immune escape of liver cancer cells by regulating the Krüppel like factor 5(KLF5)-erythropoietin-producing hepatocellular receptor A2(EphA2)pathway.Methods Huh-7 cells were grouped into liver cancer group,Sch low,medium,and high-dose groups(Sch-L group,Sch-M group,Sch-H group),Sch-H+KLF5 activator negative control group(OE-NC),and Sch-H+KLF5 activator(OE-KLF5)group.5-bromo-2-deoxyuracil(EdU)staining,CCK-8,scratch assay,and Transwll were used to detect the proliferation,migration,and invasion of Huh-7 cells,respectively.Western blot was applied to detect proliferative cell nuclear antigen(PCNA),migration invasion enhancer(MIEN1),matrix metalloproteinase-2(MMP-2),programmed death receptor ligand 1(PD-L1),KLF5,and EphA2 proteins in Huh-7 cells.The Huh-7 cells in above 6 groups were co cultured with activated CD8+T cells in a 96 well plate and named as liver cancer co culture group,Sch-L co culture group,Sch-M co culture group,Sch-H co culture group,Sch-H+OE-NC co culture group,and Sch-H+OE-KLF5 co culture group.The killing rate of CD8+T cells in the co culture system and the levels of interferon-γ(IFN-γ),interleukin-4(IL-4),and tumor necrosis factor-α(TNF-α)in the supernatant were detected.Results Compared with the liver cancer group,the EdU positive rate,OD450 value,cell invasion number,and PCNA,MIEN1,MMP-2,PD-L1,KLF5,and EphA2 proteins in the Sch-L,Sch-M,and Sch-H groups reduced,the migration distance shorten(P<0.05).Compared with the Sch-H group and Sch-H+OE-NC group,the EdU positive rate,OD450 value,cell invasion number,and PCNA,MIEN1,MMP-2,PD-L1,KLF5,and EphA2 proteins in the Sch-H+OE-KLF5 group increased,the migration distance prolonged(P<0.05).Compared with the liver cancer co culture group,the killing rate of CD8+T cells on Huh-7 cells and the levels of IFN-γ,TNF-α,and IL-4 in the supernatant in the Sch-L co culture group,Sch-M co culture group,and Sch-H co culture group increased(P<0.05).Compared with the Sch-H co culture group and the Sch-H+OE-NC co culture group,the killing rate of CD8+T cells on Huh-7 cells and the levels of IFN-γ,TNF-α,and IL-4 in the supernatant in the Sch-H+OE-KLF5 co culture group decreased(P<0.05).Conclusion Sch may inhibit growth and immune escape of liver cancer cells by inhibiting the KLF5-EphA2 pathway.

Objective:To explore the current dietary patterns and influencing factors of patients with coronary heart disease (CHD) in severe cold regions, aiming to provide scientific evidence for developing targeted dietary interventions.Methods:A total of 340 patients with CHD who visited the Department of Cardiology at the Second Affiliated Hospital of Harbin Medical University between September and December 2023 were selected using convenience sampling. Patients were assessed using a general information questionnaire, Semi-Quantitative Food Frequency Questionnaire, Food Choice Questionnaire, Nutritional Knowledge Questionnaire, 7-Item Generalized Anxiety Disorder Scale, and Patient Health Questionnaire-9.Results:A total of 340 questionnaires were distributed, and 333 valid questionnaires were collected, with an effective response rate of 97.94% (333/340). Two dietary patterns were identified among patients with CHD in severe cold regions: a "fruit-nut-dairy" dietary pattern and a "meat-seafood-grain" dietary pattern. Factors influencing the "fruit-nut-dairy" dietary pattern included gender, nutritional knowledge, and food choice motivations such as accessibility, sensory appeal, brand and packaging, and emotional dimensions ( P<0.05). Factors influencing the "meat-seafood-grain" dietary pattern included body mass index (BMI), living alone or not, monthly income, and food choice motivations such as convenience, health attributes, sensory appeal, and price ( P<0.05) . Conclusions:When providing dietary interventions for CHD patients, targeted control of factors such as gender, BMI, living alone or not, monthly income, nutritional knowledge, and key elements of food choice motivations may optimize patients' irrational dietary structures and reduce adverse disease outcomes.

OBJECTIVE: To compare the impact of different peroneus longus tendon (PLT) stump management techniques on ankle function following arthroscopic anterior cruciate ligament (ACL) reconstruction with autologous PLT grafts. METHODS: A retrospective analysis was conducted on 60 patients with ACL rupture who met the inclusion criteria between August 2020 and July 2024. All patients underwent arthroscopic ACL reconstruction using the autologous PLT grafts. Patients were assigned to group A [PLT stump sutured to peroneus brevis tendon (PBT), n=30] or group B (no stump intervention, n=30). The two groups showed no significant difference ( P>0.05) in baseline data, including gender, age, body mass index, injury mechanism, affected side, preoperative American Orthopaedic Foot and Ankle Society (AOFAS) score, ankle muscle strength, ankle range of motion, and arch-related angles. Postoperative outcomes were assessed using the AOFAS score, ankle muscle strength (eversion and first-ray plantar flexion), arch-related angles (medial/lateral longitudinal and anterior/posterior arch), ankle range of motion (eversion, inversion, dorsiflexion, plantarflexion), and limb symmetry index (LSI). Change values in muscle strength, arch-related angles, and range of motion from preoperative to 12 months postoperatively were calculated for intergroup comparison. RESULTS: Groups A and B had comparable PLT graft lengths and diameters ( P>0.05). All patients were followed up 13-16 months (mean, 14.5 months). Postoperative complications included 1 case of incision infection, 1 case of deep vein thrombosis, and 1 case of knee stiffness in group A, 1 case of knee stiffness in group B. There was no significant difference in the overall complication incidences between groups ( P>0.05). No significant difference was found in the AOFAS scores between different time points and between groups ( P>0.05). At 12 months after operation, neither group showed significant changes from preoperative baseline in ankle strength, range of motion, or arch-related angles, and there was no significant difference in these change values between groups ( P>0.05). There was no significant difference in LSI between the two groups at 6 or 12 months postoperatively ( P>0.05). CONCLUSION Both suturing and leaving the PLT stump untreated during arthroscopic ACL reconstruction provided comparable ankle outcomes and well-preserved foot and ankle function.
Humans ; Anterior Cruciate Ligament Reconstruction/methods* ; Male ; Retrospective Studies ; Female ; Adult ; Anterior Cruciate Ligament Injuries/surgery* ; Tendons/transplantation* ; Range of Motion, Articular ; Arthroscopy/methods* ; Young Adult ; Treatment Outcome ; Muscle Strength ; Transplantation, Autologous ; Ankle Joint/surgery* ; Middle Aged ; Adolescent

Objective:To establish and validate the prediction model for bone marrow metastasis (BMM) in malignant tumors by screening out laboratory multiparameters.Methods:This case-control study collected 444 cases of malignant tumor patients who were hospitalized in the First Hospital of Jilin University from March 2018 to March 2024, including 243 cases for model establishment set and 201 cases for model validation set. The model establishment set was divided into BMM positive group (81 cases) and BMM negative group (162 cases), and the model validation set was divided into positive group (67 cases) and a negative group (134 cases). We collected patients′ clinical information such as gender, age, clinical diagnosis, and results of 47 laboratory tests including routine blood analysis, coagulation, liver function, tumor markers, potassium, sodium, chloride, and calcium ion tests, bone marrow morphology, and bone marrow biopsy. BMM was taken as the outcome event, differencial variables were analyzed using inter group comparisons, the correlation among parameters was analyzed using Pearson correlation analysis, the risk factors for BMM were analyzed using multivariate conditional logistic regression analysis, to establish logistic model, followed by efficiency evaluation on BMM predictive model using receiver operating characteristic (ROC) curves.Results:In the model establishment set, Pearson correlation analysis of 28 parameters that differed between the BMM positive and negative groups revealed that the correlation coefficients of 17 parameters, including mean platelet volume (MPV), hematocrit (HCT), hemoglobin (HGB), and prothrombin time (PT), were no more than 0.6 ( P<0.05). Further multivariate conditional logistic regression analysis demonstrated that MPV, HGB, HCT, PT, red cell distribution width (RDW), platelet count (PLT), alkaline phosphatase (ALP), chloride (Cl -), and mean erythrocyte hemoglobin concentration (MCHC) were the risk factors of BMM occurence in malignancy [MPV ( OR=9.929, 95% CI 2.688-71.335), HCT ( OR=8.232, 95% CI 6.223-9.841), HGB ( OR=4.300, 95% CI 1.947-16.577), PT ( OR=3.738, 95% CI 1.359-11.666), RDW ( OR=1.995, 95% CI 1.275-3.807), ALP ( OR=1.025, 95% CI 1.012-1.045), PLT ( OR=1.014, 95% CI 1.002-1.031), MCHC ( OR=0.724, 95% CI 0.523-0.880) and Cl -( OR=0.703, 95% CI 0.472-0.967)]. In the model establishment set, combiation of risk factors provided an AUC of 0.943 (95% CI 0.898-0.987, P<0.001), a sensitivity of 86.3%, and a specificity of 89.2% for BMM prediction. In the model validation set, the AUC was 0.924 (95% CI 0.854-0.960, P<0.001), with a sensitivity and specificity of 86.7% and 83.8%, respectively. Conclusion:This study built and validated a multiple-parameter model for BMM, which may facilitate the timely detection of BMM and provide reference for decision making of bone marrow aspiration.

DEFENCATH?(taurolidine/heparin)is the first hemodialysis central venous catheter lock solution approved by the FDA.Taurolidine has broad-spectrum antibacterial activity against Gram-negative and Gram-positive bacterium and fungal species and anti-endotoxin and anti-exotoxin activities.Moreover,microbial resistance has not been observed,and the safety is good.Low-dose heparin is effective in anticoagulation and has a low risk of bleeding,and the two complement each other,clinical studies have reported that the catheter lock solution(CLS)effectively reduces the incidence of catheter-related blood stream infection(CRBSI),with good safety and significant clinical value.It will bring benefits to renal failure patients undergoing maintenance hemodialysis.

OBJECTIVE To provide a reference for accurately identifying and treating adverse reactions of osteonecrosis induced by bevacizumab. METHODS Clinical pharmacists participated in the treatment process of an adult patient with glioma who developed femoral head necrosis after the use of bevacizumab. By searching the FDA Adverse Event Reporting System （FAERS） and consulting relevant literature and drug instructions， the association between femoral head necrosis and bevacizumab was assessed. Medication recommendations were provided to the physician， and medication educations were provided to the patient. RESULTS The association between the patient’s femoral head necrosis and bevacizumab was assessed as “possibly related”. The physicians accepted the clinical pharmacists’ advice to discontinue bevacizumab and switched to anlotinib to continue antitumor treatment. The patient also followed the clinical pharmacists’ advice to avoid prolonged standing. Upon re-examination， the patient’s pain symptoms were under control， and the femoral head necrosis had not progressed. CONCLUSIONS Patients who receive long-term bevacizumab should attach great importance to bone pain and osteonecrosis， undergo regular imaging examinations， and detect and treat symptoms early to prevent the occurrence of severe osteonecrosis.