Objective To explore the effects of different serum potassium levels on the 28-day prognosis of elderly patients with sepsis. Methods A retrospective analysis was conducted on the clinical data and laboratory indicators within 24 hours after the diagnosis in 204 elderly patients with sepsis admitted to the Department of Critical Care Medicine, Zhongshan Hospital, Fudan University from January 2018 to January 2022. According to the potassium concentrations in the blood of the patients within 24 hours after admission to intensive care unit (ICU), the patients were divided into the hyperkalemia group (K^＋≥5.3 mmol/L), normokalemia group (K^＋ 3.5–＜5.3 mmol/L), and hypokalemia group (K^＋＜3.5 mmol/L). According to 28-day outcomes, the patients were divided into the death group and survival group. The acute physiological and chronic health evaluation (APACHE) Ⅱ score, sequential organ failure assessment (SOFA) score and laboratory indicators were analyzed. Multivariate logistic regression analysis was used to analyze the risk factors for 28-day mortality in elderly patients with sepsis. Results Compared with the normokalemia group (n＝99), patients in both the hyperkalemia (n＝61) and hypokalemia (n＝44) groups had significantly higher levels of C-reactive protein (CRP) and procalcitonin (PCT), longer duration of mechanical ventilation, longer length of hospital stay and ICU stay, and higher mortality (P ＜ 0.05). The death group (n＝49) had significantly higher APACHE Ⅱ score, SOFA score, white blood cell (WBC) counts, CRP level, and PCT level than the survival group (n＝155, P＜0.05). Multivariate logistic regression analysis showed that increased or decreased serum potassium level, higher SOFA score, and increased WBC counts were independent risk factors for 28-day mortality in elderly patients with sepsis (P＜0.05). Quadratic fitted curve showed a U-shaped association between serum potassium levels and 28-day mortality risk in elderly patients with sepsis, with the lowest mortality risk observed within the intermediate (normal) range, and both hypokalemia and hyperkalemia were associated with an increased mortality risk (P＝0.182). Conclusion Both increased and decreased serum potassium levels are independent risk factors for 28-day mortality in elderly patients with sepsis, which should be given particular attention in clinical management.

Veterinary Immunology is a science that studies organization structure and biological function of animal immune system.It is a subject with strong theory and application,which is a very important basic course in undergraduate education of veteri-nary medicine.With rapid development of modern science and technology,people have a deeper understanding of immunology,and traditional teaching content and teaching mode can no longer meet teaching needs of modern veterinary undergraduates.This paper briefly analyzes problems existing in current teaching process of Veterinary Immunology,and puts forward relevant suggestions for teaching reform,aiming at improving teaching quality of undergraduate Veterinary Immunology and shouldering important mission of cultivating innovative veterinary talents for socialist modernization of our country.

Hypertrophic scar is a fibrous hyperplastic disorder that arises from skin injuries. The current therapeutic modalities are constrained by the dense and rigid scar tissue which impedes effective drug delivery. Additionally, insufficient autophagic activity in fibroblasts hinders their apoptosis, leading to excessive matrix deposition. Here, we developed an active microneedle (MN) system to overcome these challenges by integrating micromotor-driven drug delivery with autophagy regulation to remodel the scar microenvironment. Specifically, sodium bicarbonate and citric acid were introduced into the MNs as a built-in engine to generate CO₂ bubbles, thereby enabling enhanced lateral and vertical drug diffusion into dense scar tissue. The system concurrently encapsulated curcumin (Cur), an autophagy activator, and triamcinolone acetonide (TA), synergistically inducing fibroblast apoptosis by upregulating autophagic activity. In vitro studies demonstrated that active MNs achieved efficient drug penetration within isolated scar tissue. The rabbit hypertrophic scar model revealed that TA-Cur MNs significantly reduced the scar elevation index, suppressed collagen I and transforming growth factor-β1 (TGF-β1) expression, and elevated LC3 protein levels. These findings highlight the potential of the active MN system as an efficacious platform for autonomous augmented drug delivery and autophagy-targeted therapy in fibrotic disorder treatments.

Objective:To explore the latent categories and influencing factors of health activation among community-dwelling older adults with chronic diseases.Methods:Older patients with chronic diseases attending three community health centers in Hefei City from August to December 2023 were selected for the study using the convenience sampling method. The survey utilized the General Information Questionnaire, Consumer Health Activation Index, Chinese version of the Life-Space Assessment, Social Support Rating Scale, and Simplified Coping Style Questionnaire. Mplus 8.3 software was applied for latent profile analysis to examine patients' health activation, and unordered multicategory Logistic regression was used to explore the factors influencing different categories of health activation.Results:A total of 382 questionnaires were distributed, and 368 valid questionnaires were recovered, with a valid recovery rate of 96.34%. Three latent categories of health activation existed in community-dwelling older adults with chronic diseases, which were named as low health activation-high efficiency-coping inability group (16.85%, 62/368) , medium health activation group (27.99%, 103/368) , and high activation perception-action group (55.16%, 203/368) . Multicategory logistic regression analysis indicated that place of residence, age, self-rated health status, life space, social support, and active coping strategies were significant factors influencing the health activation of different latent categories of community-dwelling older adults with chronic diseases (all P<0.05) . Conclusions:The health activation of community-dwelling older adults with chronic diseases can be classified into three latent categories. Primary healthcare providers should identify the characteristics of patients in different categories and implement targeted nursing interventions to enhance their health activation levels.

Objective To investigate the correlation between cognitive function and medication compliance in patients with type 2 diabetes mellitus(T2DM).Methods Patients with T2DM who were admitted to the Department of Endocrinology,Drum Tower Hospital,Nanjing University School of Medicine from July 2023 to December 2023 were selected.The clinical data and laboratory results of the patients were collected.The medication compliance of the patients was evaluated by Adherence to Refills and Medications Scales(ARMS).And the overall cognitive function and independent cognitive domain tests were performed.According to the diagnostic criteria of mild cognitive impairment(MCI),patients were divided into normal cognitive group and MCI group.Linear regression analysis was used to evaluate the correlation between cognitive function and medication compliance in T2DM patients.Multivariate logistic regression analysis was used to explore the relationship between cognitive dysfunction and poor medication compliance in T2DM patients.Results A total of 216 patients with T2DM were enrolled,including 113 patients with normal cognitive function and 103 patients with MCI.The ARMS score(16.4±4.1 vs.15.1±2.8)and the rate of poor medication compliance(54.4%vs.31.0%)in the MCI group were higher than those in the normal cognitive group(all P<0.05).After adjusting for gender,age,years of education and glycosylated hemoglobin,ARMS scores were significantly negatively correlated with immediate memory,attention and delayed memory scores(all P<0.05).Multivariate logistic regression analysis showed that patients with MCI had a higher risk of poor medication adherence[OR=2.645,95%CI=(1.414,4.946),P<0.001].Conclusions Poor cognitive function,especially memory and concentration,is associated with reduced medication compliance in patients with T2DM.Patients with memory and attention problems should be given appropriate medication advice to improve their compliance in clinical practice.

BACKGROUND:The use of assistive devices and technologies for blindness is a common intervention for people with visual impairment today,improving participation in activities of daily living and work-learning abilities,and facilitating return to family and society.The forms,technologies and functions of assistive devices for blindness in the age of digital information and intelligence vary,and their classification has not yet been effectively discussed and evaluated in a uniform manner.OBJECTIVE:To classify and evaluate the compensation function of intelligent guide devices for the people with visual impairment in China based on the International Classification of Functioning,Disability and Health(ICF).METHODS:CNKI,CQVIP and WanFang databases were searched for relevant literature.The time frame for the search was from January 1,2013 to December 31,2023.Based on the ICF theoretical model and framework structure,the terminology structure and coding procedure were applied to summarize the relevant visual impairment assessment categories,collate and analyze the research and classification of the compensation function of intelligent assistive devices for the people with visual impairment in China.RESULTS AND CONCLUSION:(1)A total of 197 articles were finally included.There was 1 article on body function,containing b2(b210);1 article on body structure,containing s2(s220);119 articles addressing activity and participation,containing d1(10 articles involving d110,d115,d120,d140,and d166,)d3(4 articles involving d315,d325,d345,and d360),d4(102 articles involving d465,d470),and d8(3 articles involving d820,d825);76 articles addressing environmental factors,including e1(72 articles involving e115,e120,e125,e130,e140,e150,e155,e160)and e2(4 articles involving e210 and e240).(2)The ICF-based research classification of the compensation function of intelligent guide devices for the people with visual impairment contains 4 parts,8 classifications and 25 categories,with areas related to physical compensation,daily necessities,education and learning,traveling and blindness guidance,and layout planning.

Immunotherapy has been widely used in cancer treatment in recent years and functions by stimulating the immune system to kill tumor cells. Radiation therapy (RT) uses radiation to induce DNA damage and kill tumor cells. However, this activates the body's immune system, promoting the release of tumor-related antigens from inactive dendritic cells, which stimulates the recurrence and metastasis of tumors in immune system tissues. The combination of RT and immunotherapy has been increasingly evaluated in recent years, with studies confirming the synergistic effect of the two antitumor therapies. Particularly, the combination of RT by dose adjustment with different immunotherapies has positive implications on antitumor immunity as well as disease prognosis compared with respective monotherapies. This review summarizes the current research status, progress, and prospects of RT combined with immunotherapy in cancer treatment. It additionally discusses the prevalent concerns regarding the dose, time window, and toxicity of this combination therapy.
Humans ; Neoplasms/radiotherapy* ; Immunotherapy/methods* ; Combined Modality Therapy ; Radiotherapy/methods*

Objective To investigate the effects of cucurbitacin B (CucB) on alleviating skin lesions and inflammation in psoriasis mice via the cGAS-STING signaling pathway. Methods The expression of genes associated with the cGAS-STING signaling pathway in psoriatic lesions and non-lesional skin was analyzed, and hallmark gene set enrichment analysis was performed. The cytotoxicity of CucB on BMDMs was evaluated using the CCK-8 assay. The expression levels of genes and proteins related to the cGAS-STING signaling pathway, along with the secretion of inflammatory cytokines, were measured at different concentrations of CucB using quantitative PCR, Western blotting, and ELISA. Imiquimod-induced psoriasis BALB/c mice were divided into four groups: normal group, model group, low-dose CucB group [0.1 mg/ (kg.d)], and high-dose CucB group [0.4 mg/ (kg.d)], with five mice per group. PASI scoring was performed to assess the severity of psoriasis after 6 days of treatment, and HE staining was conducted to observe pathological damage. Meanwhile, the mRNA levels of inflammatory cytokines and their secretion were detected by qPCR and ELISA. Results Most cGAS-STING signaling-related genes were upregulated in lesional skin of psoriasis patients, and the hallmark gene set enrichment analysis revealed that the most significantly upregulated genes were primarily associated with immune response signaling pathways. CucB inhibited dsDNA-induced phosphorylation of interferon regulatory factor 3 (IRF3) and STING proteins in both bone-marrow derived macrophages(BMDMs) and THP-1 cells. CucB also suppressed dsDNA-induced mRNA expression of IFNB1, TNF, IFIT1, CXCL10, ISG15, and reduced the secretion of cytokines such as IFN-β, IL-1β, and TNF-α in THP-1 cells. In the imiquimod-induced psoriasis mouse model, CucB treatment reduced psoriatic symptoms, alleviated skin lesions, and attenuated inflammation. ELISA and qPCR results showed that CucB significantly reduced serum secretion levels of IL-6, TNF-α, and IL-1β, as well as the mRNA levels of IL23A, IL1B, IL6, TNF, and IFNB1. Conclusion CucB inhibits cytoplasmic DNA-induced activationc of the GAS-STING pathway. CucB significantly attenuates skin lesions and inflammation in IMQ-induced psoriatic mice, and the potential molecular mechanism may be related to the down-regulation of the cGAS-STING pathway.
Animals ; Psoriasis/pathology* ; Signal Transduction/drug effects* ; Membrane Proteins/genetics* ; Mice ; Nucleotidyltransferases/genetics* ; Disease Models, Animal ; Mice, Inbred BALB C ; Skin/metabolism* ; Triterpenes/therapeutic use* ; Humans ; Cytokines/metabolism* ; Inflammation/drug therapy* ; Male

Chronic obstructive pulmonary disease （COPD） is a common clinical chronic airway disease with high morbidity， high mortality， a heavy disease burden， and complex mechanisms that have not been fully elucidated. Clinical problems promote the continuous progress of basic research. The establishment and evaluation of animal models is an important way to delve into the pathogenesis and treatment strategies of COPD. On the basis of the etiology， pathogenesis， diagnostic criteria， and syndrome differentiation of COPD in traditional Chinese medicine （TCM） and Western medicine， this paper summarizes the establishment methods and characteristics of existing animal models of COPD and analyzes the fitting degree of the models with the disease characteristics in Western medicine and syndrome characteristics in TCM. The results showed that the animal models of COPD in Western medicine were mainly induced by single factors and compound factors， and the model with the highest fitting degree was established by cigarette smoke combined with lipopolysaccharide and hormone. The model showed a fitting degree of 84% with the disease characteristics in Western medicine and 70% with the syndrome characteristics in TCM， being consistent with the clinical characteristics of COPD induced by multiple factors. Most of the animal models of COPD in TCM were established on the basis of disease models and combined with TCM etiology and pathogenesis characteristics， and prepared by syndrome differentiation. Among them， the model of accumulation of cold and water retention in lung had the highest fitting degree of 92% with the TCM diagnostic criteria. The models of phlegm-heat obstructing lung and phlegm-stasis obstructing lung had the fitting degree of 94% with clinical manifestations in Western medicine and the highest fitting degree with the diagnostic criteria in Western medicine. Different animal models of COPD have their own advantages and disadvantages， and most of them simply replicate the manifestations of COPD at a certain stage， failing to reflect the multiple causes and the dynamic changes of TCM etiology and pathogenesis. Moreover， the syndromes of these models fail to match the clinical syndromes in TCM. Therefore， establishing the animal models reflecting clinical characteristics of COPD in TCM and Western medicine and improving the model evaluation criteria are important contents to promote the overall development of integrated traditional Chinese and western medicine for COPD.

Objective:To evaluate the clinical efficacy and the mid- and long-term follow-up outcomes of transanal anaplasty for treating rectovestibular fistula.Methods:The clinical data of 68 female infants diagnosed with rectovestibular fistula undergoing transanal anoplasty at the Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University from Oct 2014 to Dec 2023 was collected. Postoperative complications, perineal and anal appearances, and defecation function of postoperative children aged 3 years or older were recorded.Results:After surgery 68 children followed-up for 6 months of recent with short-term complications in 6 cases, including 3 cases of incision infection, 2 cases of rectal mucosal prolapse, and 1 case of anal stenosis. Rintala score was (18.65±1.99). Twenty-five children underwent anorectal manometry, no significant differences were observed in the maximal systolic pressure of the anal canal( t=-0.596, P=0.563) and the maximum systolic time( t=-0.183, P=0.854). The resting pressure( t=-3.050, P=0.005), functional length( t=2.696, P=0.012), and positive rate of rectal anal inhibitory reflex( χ2=6.382, P=0.012) of the anal canal were significantly lower than those of the normal group( P<0.05). Conclusions:Transanal anaplasty for the treatment of rectovestibular fistula in girls has a low incidence of complications. It results in a normal perineal body appearance, good anal bowel control, and high quality of life.