Objective:To investigate the impact of bedside ultrasound-guided hyperthermic intraperitoneal chemotherapy (HIPEC) after laparoscopic gastric cancer surgery on the prognosis of patients with only positive peritoneal lavage cytology (CY+) and no other distant metastases.Methods:The clinicopathological data of 49 patients with only positive peritoneal lavage cytology who underwent laparoscopic gastrectomy and D2 lymph node dissection from December 2017 to December 2022 were retrospectively analyzed. The patients were divided into the HIPEC group (27 cases) and the non-HIPEC group (22 cases) based on whether they received postoperative bedside ultrasound-guided HIPEC. The patterns of postoperative recurrence and metastasis and the 3-year survival rates were compared between the two groups. Univariate and multivariate analyses using the Cox proportional hazards model were conducted to determine the prognostic factors.Results:There was no statistically significant difference in all baseline clinicopathological data between the two groups ( P>0.05); the median follow-up time for all patients was 31 months (ranging from 13 to 73 months), and the overall recurrence rate for all patients was 55.1% (27/49). Among them, 12 cases (24.5%) had peritoneal metastasis, 7 cases (14.3%) had hematogenous recurrence, 5 cases (10.2%) had distant lymph node metastasis, and 3 cases (6.1%) had local recurrence. The overall recurrence rates of patients in the HIPEC group and the non-HIPEC group were 51.8% (14/27) and 59.1% (13/22), respectively. There was no statistically significant difference (χ 2=0.26, P=0.612). The peritoneal metastasis rate of patients in the HIPEC group was 18.5% (5/27), which was lower than that of the non-HIPEC group at 31.8% (7/22). However, there was no statistically significant difference (χ 2=1.16, P=0.282). The proportions of local recurrence, hematogenous metastasis, and distant lymph node metastasis were comparable between the two groups (all P>0.05). The cumulative 3-year recurrence rates of the two groups were similar (70.7% vs. 71.3%, P=0.266). In the HIPEC group, the 3-year overall survival rate was 61.1%, which was significantly higher than that of the non-HIPEC group (31.5%). The difference was statistically significant ( P=0.014). The disease-free progression survival rates of the two groups were 29.3% and 28.7% respectively, and there was no statistically significant difference between them ( P=0.266). Cox multivariate analysis showed that no postoperative HIPEC (HR=5.21, 95%CI:1.90-14.31, P=0.001), poor tumor differentiation (HR=3.78, 95%CI:1.07-13.26, P=0.038), and later N stage (HR=6.18, 95%CI:1.39-7.59, P=0.017) were independent risk factors for the overall survival rate after surgery ( P<0.05). Later N stage (HR=3.67, 95%CI:1.07-12.55, P=0.038) was an independent risk factor for the disease-free progression survival rate after surgery ( P<0.05). Conclusion:Bedside ultrasound-guided HIPEC after laparoscopic gastrectomy and D2 lymph node dissection can improve the overall survival of CY+ gastric cancer patients.

Objective:To investigate the status quo of occult hepatitis B virus infection (OBI) among blood donors in certain region and to explore the characteristics of amino acid variation between antibody to hepatitis B core antigen (HBcAb) and S region.Methods:The qualified blood samples from January 2019 to December 2022 were collected, and the OBI samples were screened by ELISA and HBV DNA. The OBI samples were quantitatively detected by HBcAb and HBV DNA and analyzed by HBV S region sequencing.Results:A total of 126 OBI positive samples were detected out of 188933 samples, the detection rate was 0.07%, and there was no significant difference in the detection rate of OBI between gender and blood donation times ( P>0.05). The highest OBI detection rate was found in 46-55 years old group (0.15%), other education group (0.35%) and occupational workers group (0.13%). The total detection rate of HBcAb (+ ) in 126 OBI samples was 90.48%. As the S/CO value of HBcAb (+ ) increased, the positive detection rate of HBV DNA also increased, and the correlation coefficient between HBcAb (+ ) and the quantitative value of HBV DNA was 0.782. The proportion of HBV B genotype in OBI blood donors was the highest (73.08%). A total of 15 OBI-related mutation sites were found, and there was no statistically significant difference among the mutation sites. Conclusions:OBI exists in blood donors in certain region, and HBcAb (+ ) is moderately positively correlated with the quantitative value of HBV DNA. HBV infection in OBI blood donors is mainly type B.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective:To construct a framework for evaluating the quality of health economic evaluation methodology based on the pragmatic clinical trial.Methods:An evaluation framework was constructed based on existing quality evaluation tools for health economic evaluation other quality evaluation tools.The weights of each item in the framework were determined by the Delphi method,and the weighted average was calculated using the expert authority coefficient.Results:A total of 23 experts were consulted,and the expert authority coefficients were 0.88 and 0.90,respectively.The results of the Wilcoxon signed-rank test showed no statistically signifi-cant differences among the expert opinions in two rounds(P＞0.05).Finally,a framework with 3 dimensions and 8 items was estab-lished.Conclusion:The evaluation framework has high scientificity and reliability.

The engineering application of microbially induced carbonate precipitation(MICP)is limited by pH-dependent conformational dynamics of urease.Focusing on the α-subunit urease from Sporosarcina pasteurii,this study integrated conductivity experiments and constant-pH molecular dynamics simulations to analyze active site conformational dynamics and catalytic function across pH 3-11.Results showed that under neutral conditions(pH 7-8),key histidine residues(HIS139/HIS249)exhibited minimal dis-placement(＜0.5 ?),the longest hydrogen bond lifetime(＞8 ps),highest conformational stability(root mean square deviation,RMSD:0.15-0.18 nm),and optimal catalytic activity(conductivity change rate:0.03 mS/cm·min-1,CaCO3 precipitation:3.84 g).Extreme pH(pH 3/11)induced structural collapse(displacement up to 1.8 ?)and complete activity loss.Simulations revealed that neutral pH sta-bilizes a protonation-dependent cooperative allosteric network by maintaining active site cavity volume(～120 ?3)and moderate conformational coherence(correlation coefficient～0.8).This work deciphers the molecular mechanism of pH-regulated urease dynamics through protonation states,providing theoreti-cal support for MICP applications in acidic mine tailing remediation and alkaline soil stabilization.

Objective To investigate the role of long non-coding RNA 01004 (LncRNA01004) in accelerating the malignant progression of breast cancer cells and its potential regulatory mechanism. Methods Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the expression level of LncRNA01004 in breast cancer tissues and cells. The Starbase online database predicted the binding of LncRNA01004 to CPSF1 and verified it through RNA binding protein immunoprecipitation(RIP) analysis. MCF-7 cells were transfected with LncRNA01004 interference sequence (sh-LncRNA01004) or overexpressed vector (LncRNA01004),or co-transfected with Cleavage and Polyadenylation Specific Factor 1 (CPSF1) interference sequence (sh-CPSF1). Cell viability,invasion and apoptosis were detected with CCK-8,Transwell and flow cytometry (FCM). The overexpression and silencing efficiency of LINC01004 and CPSF1 were detected by qPCR. Western blot (WB) analysis of CPSF1 protein,apoptosis-related protein[B cell lymphoma/leukemia-2(Bcl-2),Bcl-2 Associated X(Bax)]and Epithelial-Mesenchymal transition (EMT) related protein[Epitheia-cadherin(E-cadherin),Nerve-cadherin(N-cadherin),Vimentin,zinc-finger transcription factor(Snail)],and the activity of Cysteinyl aspartate-specific proteinase-3 (Caspase-3) was determined by enzyme-linked immunosorbent assay. Results LncRNA01004 was significantly up-regulated in breast cancer tissues (5.14±0.33) compared with paracancer tissues (1.02±0.03),with the statistically significant difference (t=-78.637,P<0.001);LncRNA01004 expression in breast cancer cells was significantly higher than that in normal breast epithelial cells,the difference between groups is statistically significant (F=142.248,P<0.001). Compared with the Control group,LncRNA01004 significantly inhibited the proliferation (42.15±2.11 vs 100.02±0.65) and invasion (18.65％±1.44％ vs 41.36％±1.57％) of MCF-7 cells,induced apoptosis (16.58％±1.52％ vs 5.24％±1.12％),increased the activity of Caspase-3 (2.93±0.711. vs 51±0.43) and the expression of Bax (2.74±0.39 vs 1.01±0.02) protein,and inhibited the expression of BcL-2 (0.32±0.07 vs 1.02±0.03) protein,with the statistically significant difference (t=3.075～19.332,all P<0.05). Significantly increased compared with Control group,the silent LncRNA01004 E-cadherin (3.06±0.37 vs 1.01±0.02) protein levels,lower N-cadherin (0.44±0.11 vs 1.00±0.01),Vimentin (0.39±0.13 vs 1.02±0.03) and Snail(0.30±0.08 vs 1.01±0.03) protein levels,with the statistically significant difference (t=9.989～17.164,all P<0.05).LncRNA01004 binds to CPSF1 and promotes CPSF1 protein expression.Silencing CPSF1 inhibited the proliferation and invasion of MCF-7 cells,induced cell apoptosis,and counteracted the effect of LncRNA01004 overexpression on MCF-7 cells. Conclusion LncRNA01004 may promote EMT through up-regulation of CPSF1,and then promote proliferation and invasion of breast cancer cells,inhibit cell apoptosis,and participate in the malignant progression of breast cancer.

Aim To study the effects of whole herb of Prunella and its active components on the malignant progression of breast cancer and its mechanism.Meth-ods Breast cancer transplantation tumor model was constructed and randomly divided into the model group,low,medium and high dose group of whole herb of Prunella(0.1,0.2,0.4 g·mL-1 by gavage)and paclitaxel(10 mg·kg-1 by intraperitoneal injection),which was administered by gavage every day,and the tumor tissues were collected after 28 days of interven-tion.The weight,tumor volume and mass of nude mice in each group were detected,HE staining was used to observe the morphology of breast cancer tumor tissues,and immunohistochemical staining was used to observe the proliferation of cell-cycle regulatory protein-67(Ki-67)and cytokeratin 17(CK17)in breast cancer tumor tissues.The cellular experiments were performed by u-sing different concentrations of the ethyl acetate extract of the whole herb of Prunella in breast cancer MDA-MB-231 cells for 24 h.The proliferation of MDA-MB-231 cells and the effects on the cell cycle and apoptosis of MDA-MB-231 cells were detected by using the CCK-8 assay,the cell cycle flow and the apoptotic cell flow.Western blot was used to detect the effect of ethyl ace-tate extract of whole herb of Prunella on the expression of apoptosis-related proteins in breast cancer MDA-MB-231 cells.UPLCQ-TOF MS/MS was used to detect the chemical compositions of the ethyl acetate extract of Prunella whole herb.Results The whole herb of Pru-nella had no significant effect on the growth of nude mice(P＞0.05);it could significantly inhibit the growth of transplanted tumors in nude mice with human breast cancer(P＜0.05);the results of HE staining showed that the cells in the tissues appeared to be rela-tively sparse with the increase of the dose of Prunella and had different degrees of nuclear consolidation and deep staining of nuclei and the apoptosis of the tumor cells increased;the metastasis of tumor cells to the liv-er and lungs was inhibited,when compared with that in the model group.Compared with the model group,the low,medium and high groups of Prunella had no signif-icant effect on the liver index,while the spleen index was significantly reduced(P＜0.05);the expression of Ki-67 and CK17 was reduced.The ethyl acetate ex-tract of the whole herb of Prunella could inhibit the proliferation of MDA-MB-231 cells in breast cancer(P＜0.01);the results of flow cytometry showed that,with the increase of the concentration of the ethyl ace-tate extract of the whole herb of Prunella,the proportion of S-phase cells in the MDA-MB-231 cells significantly increased,and the proportion of G0/G1-phase cells sig-nificantly decreased,while the proportion of G2-phase cells did not change significantly(P＜0.01);Western blotting was not affected in the low,medium and high groups,and the spleen index significantly decreased(P＜0.05);the expression of Ki-67 and CK17 was re-duced;the results of Western blot showed that the eth-yl acetate extract of the whole herb of Prunella promo-ted the expression of Bax,cleaved caspase-3,cleaved caspase-9 proteins,and inhibited the expression of Bcl-2,caspase-3,caspase-9,cyclinA2,and CDK2 proteins(P＜0.05,P＜0.01).The acetic acid of the whole herb of Prunella ethyl ester extract identified a total of 51 compounds.Conclusions The whole herb of Pru-nella can inhibit the growth of breast cancer in nude mice transplanted with tumors,promote the apoptosis of tumor cells,inhibit the proliferation of breast cancer MDA-MB-231 cells,inhibit the metastasis of tumor cells to the liver and lungs,protect the liver and spleen,and reduce the expression of the value-added markers Ki-67 and CK17 in tumor tissues,and the ef-fective ingredient of the whole herb,the ethyl acetate extract,can induce apoptosis.The mechanism may be related to the down-regulation of cyclinsA2,CDK2,Bcl-2,caspase-3,caspase-9 and up-regulation of Bax,cleaved caspase-3,cleaved caspase-9 protein expres-sion.

Objective To analyze the serum metabolomic changes of preterm infants with bronchopulmonary dysplasia(BPD)at postmenstrual age(PMA)36 weeks,screen potential biomarkers and associated metabolic pathways,and assess their relationship with short-term respiratory outcomes.Methods A retrospective case-control study was conducted.Infants with gestational age 28-32 weeks admitted to the Children's Hospital Affiliated to Zhengzhou University from January to December 2024 were included.Twenty infants with BPD and 20 gestational age-,birth weight-,and sex-matched non-BPD preterm infants were included.Serum collected at PMA 36 weeks was subjected to untargeted metabolomics analysis,and associations with short-term respiratory outcomes were analyzed.Results Thirteen potential biomarkers distinguishing BPD were identified(area under the curve>0.75,P<0.05).Eight biomarkers—including terephthalic acid,phosphatidylinositol,fumarate,and lysophosphatidic acid—were significantly upregulated(FC≥1.5),while five biomarkers,such as 7α-hydroxy-3-oxo-4-cholestenoate ester and phosphatidylcholine,were significantly downregulated(FC≤1/1.5).Pathway analysis indicated five pathways associated with BPD,including glycerophospholipid metabolism and phenylalanine metabolism.Dysregulation of glycerophospholipid and bile acid metabolism may affect adverse short-term respiratory outcomes in infants with BPD.Conclusions The 13 significantly different metabolites may serve as biomarkers for the diagnosis of BPD.Glycerophospholipid metabolism is associated with the occurrence of BPD and with adverse short-term respiratory outcomes.

Objective:To construct a framework for evaluating the quality of health economic evaluation methodology based on the pragmatic clinical trial.Methods:An evaluation framework was constructed based on existing quality evaluation tools for health economic evaluation other quality evaluation tools.The weights of each item in the framework were determined by the Delphi method,and the weighted average was calculated using the expert authority coefficient.Results:A total of 23 experts were consulted,and the expert authority coefficients were 0.88 and 0.90,respectively.The results of the Wilcoxon signed-rank test showed no statistically signifi-cant differences among the expert opinions in two rounds(P＞0.05).Finally,a framework with 3 dimensions and 8 items was estab-lished.Conclusion:The evaluation framework has high scientificity and reliability.

AIM: To investigate the decentration of the treatment zone(TZ)and the early impact on corneal higher-order aberrations(HOAs)induced by orthokeratology(OK)lenses fitted with digital corneal topography.METHODS: A retrospective longitudinal clinical study was conducted on 28 patients(28 right eyes)who were digitally fitted with OK lenses at the Laser Vision Center of Xi'an No.1 Hospital since 2023. Longitudinal measurements were taken at baseline, 1 wk, 1 and 3 mo post-treatment to assess changes in TZ diameter, decentration magnitude and direction. Furthermore, changes in corneal HOAs were observed, and correlations of decentration with each HOAs were also analyzed.RESULTS: The mean age of patients was 10.29±2.00 years, with 15 males and 13 females, and the average baseline spherical equivalent was -2.92±0.94 D. The average TZ diameters at 1 wk, 1, and 3 mo were 3.64±0.58, 3.83±0.57, and 3.69±0.55 mm, respectively, with no statistically significant differences between 1 wk and 3 mo. Horizontal decentration values were -0.43±0.28, -0.38±0.33, and -0.31±0.37 mm after wearing lenses for 1 wk, 1 and 3 mo, respectively, while vertical decentration values were -0.33±0.20, -0.33±0.23, and -0.36±0.23 mm across the same time points. The TZ consistently decentered inferotemporally, and changes in both horizontal and vertical decentration over time were not statistically significant(Fhorizontal=1.416, Phorizontal=0.252; Fvertical=0.126, Pvertical=0.882). Significant increases in total corneal HOAs, coma, and spherical aberration were observed at 5 mm optical zone post-wear(F=45.695, 33.401, and 45.091, all P<0.001). Vertical decentration at 1 wk and 1 mo was negatively correlated with total HOAs and coma(all P<0.05), while horizontal decentration at 3 mo showed a weak negative correlation with spherical aberration(P=0.037).CONCLUSION: Digitally-fitted OK lenses achieved stable TZ diameter by 1 wk post-wear, with minor inferotemporal decentration. Early post-wear corneal total HOAs, coma and sphercal aberration increased significantly, and vertical downward decentration was associated with elevated total HOAs and coma. However, correlations between decentration and HOAs weakened by 3 mo.