BACKGROUND:Macrophages play a key role in the occurrence and progression of lung diseases,and autophagy plays an important role in maintaining environmental homeostasis and functional stability in macrophages.It has been suggested that macrophage autophagic activity has two sides in lung inflammatory diseases.OBJECTIVE:To summarize the relationship between macrophage autophagy and lung diseases,thereby providing reference for exploring the prevention and treatment strategies of lung inflammatory diseases by targeting macrophage autophagy.METHODS:Literature retrieval was performed in CNKI and PubMed for relevant literature published from database inception to September 2024.The search terms were"macrophage autophagy,efferocytosis,macrophage polarization,acute lung injury,pneumonia,chronic obstructive pulmonary disease,pulmonary fibrosis,asthma"in Chinese and English,respectively.The search results were included or excluded based on the selection criteria,and 100 papers that met the criteria were finally included in the review.RESULTS AND CONCLUSION:(1)The obstruction of autophagy flow will induce the polarization imbalance of macrophages and impair their efferocytosis,resulting in the increase of M1 macrophages and aggravating inflammation.(2)The judgment of autophagic activity should be based on whether the autophagy flow is smooth or not,and it is essential to evaluate the degradation ability of autophagy.Some studies failed to comprehensively detect the degradation ability of autophagy lysosomes to assess whether the autophagy flow is unobtrusive.As a result,the so-called two-sided view of pulmonary macrophage autophagy in pulmonary inflammatory diseases in such studies is actually related to the one-sided judgment of autophagy activity.(3)The pathological manifestations vary across different pulmonary diseases and even at different stages of the same disease.Activation of macrophage autophagy plays a positive role in regulating pulmonary inflammatory homeostasis in conditions such as acute lung injury,infectious pneumonia,mild chronic obstructive pulmonary disease,early-stage pulmonary fibrosis,and secondary asthma.However,in the severe fibrotic stage of chronic obstructive pulmonary disease and the progressive stage of pulmonary fibrosis,the activation of pulmonary macrophage autophagy aggravates pulmonary fibrosis,reflecting the dual nature of macrophage autophagy.In allergic asthma,autophagy is activated in lung-resident macrophages but suppressed in infiltrating monocyte-derived macrophages from circulation.The former is closely related to airway stenosis,and the latter aggravates pneumonia disorders.Therefore,identifying the types and progression stages of lung diseases,along with accurately assessing autophagic activity,is crucial for future investigations into the relationship between macrophage autophagy and disease pathogenesis,thereby facilitating the development of therapeutic strategies in the future.

BACKGROUND:Macrophages play a key role in the occurrence and progression of lung diseases,and autophagy plays an important role in maintaining environmental homeostasis and functional stability in macrophages.It has been suggested that macrophage autophagic activity has two sides in lung inflammatory diseases.OBJECTIVE:To summarize the relationship between macrophage autophagy and lung diseases,thereby providing reference for exploring the prevention and treatment strategies of lung inflammatory diseases by targeting macrophage autophagy.METHODS:Literature retrieval was performed in CNKI and PubMed for relevant literature published from database inception to September 2024.The search terms were"macrophage autophagy,efferocytosis,macrophage polarization,acute lung injury,pneumonia,chronic obstructive pulmonary disease,pulmonary fibrosis,asthma"in Chinese and English,respectively.The search results were included or excluded based on the selection criteria,and 100 papers that met the criteria were finally included in the review.RESULTS AND CONCLUSION:(1)The obstruction of autophagy flow will induce the polarization imbalance of macrophages and impair their efferocytosis,resulting in the increase of M1 macrophages and aggravating inflammation.(2)The judgment of autophagic activity should be based on whether the autophagy flow is smooth or not,and it is essential to evaluate the degradation ability of autophagy.Some studies failed to comprehensively detect the degradation ability of autophagy lysosomes to assess whether the autophagy flow is unobtrusive.As a result,the so-called two-sided view of pulmonary macrophage autophagy in pulmonary inflammatory diseases in such studies is actually related to the one-sided judgment of autophagy activity.(3)The pathological manifestations vary across different pulmonary diseases and even at different stages of the same disease.Activation of macrophage autophagy plays a positive role in regulating pulmonary inflammatory homeostasis in conditions such as acute lung injury,infectious pneumonia,mild chronic obstructive pulmonary disease,early-stage pulmonary fibrosis,and secondary asthma.However,in the severe fibrotic stage of chronic obstructive pulmonary disease and the progressive stage of pulmonary fibrosis,the activation of pulmonary macrophage autophagy aggravates pulmonary fibrosis,reflecting the dual nature of macrophage autophagy.In allergic asthma,autophagy is activated in lung-resident macrophages but suppressed in infiltrating monocyte-derived macrophages from circulation.The former is closely related to airway stenosis,and the latter aggravates pneumonia disorders.Therefore,identifying the types and progression stages of lung diseases,along with accurately assessing autophagic activity,is crucial for future investigations into the relationship between macrophage autophagy and disease pathogenesis,thereby facilitating the development of therapeutic strategies in the future.

Endothelial dysfunction induced by inflammation and oxidative stress represents a critical pathological mechanism in cardiovascular and cerebrovascular diseases, including sepsis and atherosclerosis. Although crebanine has been reported to possess antiinflammatory and analgesic properties, its effects on inflammation and oxidative stress in endothelial cells remain unknown. In this study, we assessed cell viability, apoptosis, and migration using the Cell Counting Kit-8 (CCK-8), flow cytometry, and a wound healing assay, respectively. The levels of reactive oxygen species (ROS) and the expression of inflammatory and oxidative stress markers were determined by qRT-PCR, enzyme-linked immunosorbent assay (ELISA), and Western blotting analysis. Our results demonstrated that crebanine alleviated lipopolysaccharide (LPS)-induced apoptosis and dysfunction in human umbilical vein endothelial cells (HUVECs). Crebanine treatment inhibited the production of pro-inflammatory cytokines (TNF-α, IL-6, IL-1β), ROS, and malondialdehyde (MDA), while it enhanced the activity of the antioxidant enzyme superoxide dismutase (SOD). Mechanistically, crebanine suppressed LPS-induced activation of the NF-κB signaling pathway in HUVECs. Furthermore, the improvement effect of crebanine on the inflammation and dysfunction in LPS-treated HUVECs was reversed by diprovocim, an NF-κB activator.These findings suggest that crebanine ameliorates LPS-induced inflammation and oxidative stress in HUVECs by inhibiting the NF-κB signaling pathway, indicating its potential therapeutic value for treating vascular endothelial dysfunction-related diseases.

OBJECTIVE To study the quality standard of the ethnic medicine Diplazium lanceum， and to provide reference for its quality control.METHODS The medicinal material of D. lanceum was identified by properties， microscopy， and thin-layer chromatography（TLC）， and its moisture， ash， and extract contents were determined. The contents of chlorogenic acid and rutin in 10 batches of D. lanceum were determined by high-performance liquid chromatography . RESULTS The rhizome of D. lanceum is slender and creeping， the leaf is leathery and shriveled， and yellow sporangia are borne on the abaxial surface of the leaf. The transverse section of the leaf shows inclusions， sclerenchyma， phloem cells， etc.； the transverse section of the petiole shows ground tissue， sclerenchyma， endodermis， etc.； the transverse section of the rhizome shows ground tissue， tracheids， vascular bundles， etc.； and the powder shows spiral vessels and brown inclusions. The TLC identification results showed that the chromatogram of the test sample exhibited spots of the same color at the corresponding positions as the chromatogram of the chlorogenic acid reference substance. The content ranges of moisture， total ash， acid-insoluble ash， extract， chlorogenic acid， and rutin in the 10 batches of samples were 10.18%-12.43%， 7.08%-19.12%， 0.95%-10.62%， 14.13%-26.05%， 0.113 1-1.015 9 mg/g， and 0.009 9-0.208 9 mg/g， respectively. CONCLUSIONS In the quality standard of D. lanceum， the moisture content should be ≤12.5%， total ash content should be ≤20.0%， acid-insoluble ash content should be ≤11.0%， extract content should be ≥14.0%， and chlorogenic acid content should be ≥0.11 mg/g. The established method is simple， specific， and reproducible， and can provide a scientific basis for the quality control of D. lanceum.

Objective:To explore the effect of triple pre-rehabilitation strategy on improving nutritional status, negative emotions and quality of life in breast cancer patients undergoing neoadjuvant chemotherapy, so as to provide reference for clinical practice.Methods:A quasi experimental research was adopted. A total of 133 patients who underwent neoadjuvant chemotherapy for breast cancer at Gansu Provincial Cancer Hospital between December 2023 and December 2024 were recruited as research participants. Patients were stratified into the experimental group ( n = 66) and control group ( n = 67) according to their admission sequence. The control group received routine health guidance, while the experimental group was provided with a triple pre-rehabilitation strategy based on the control group. The serum albumin, body mass index, anxiety, depression scores and quality of life scores were compared between the two groups before intervention, 3 weeks after intervention and 2 weeks post-surgery. Results:Totally 64 patients in each group completed the study. The age of the experimental group was (49.50 ± 10.46) years, and that of the control group was (50.42 ± 12.50) years. All of them were females. After a 3-week intervention, the serum albumin levels in the experimental group were (42.62 ± 1.56) g/L, compared to (40.50 ± 1.31) g/L 2 weeks post-surgery. In the control group, these values were (40.98 ± 1.35) g/L and (40.00 ± 1.67) g/L, respectively. The differences between groups were statistically significant ( t = -6.38, -1.89, both P<0.05). Additionally, body mass index of the experimental group was (24.02 ± 1.35) kg/m 2 after the 3-week intervention and (23.48 ± 1.72) kg/m 2 2 weeks post-surgery, which were significantly higher than those of the control group (22.98 ± 1.72) kg/m 2 and (22.50 ± 1.31) kg/m 2, respectively ( t = - 3.81, - 3.61, both P<0.05). The anxiety scores in the experimental group were (6.00 ± 2.09) of 3 weeks after intervention and (7.00 ± 2.62) 2 weeks post-surgery, both of which were significantly lower than those in the control group (7.00 ± 2.26) and (8.00 ± 2.76), with statistically significant differences ( t = 2.60, 2.10, both P<0.05). Additionally, the depression scores in the experimental group were (5.00 ± 2.20) of 3 weeks after intervention and (6.00 ± 2.40) 2 weeks post-surgery, which were also significantly lower than those in the control group (6.00 ± 2.02) and (7.00 ± 2.09), with statistically significant differences ( t = 2.68, 2.52, both P<0.05). Furthermore, the quality of life scores in the experimental group were (94.84 ± 18.00) of 3 weeks after intervention and (84.02 ± 17.13) 2 weeks post-surgery, which were significantly higher than those in the control group (82.00 ± 18.75) and (72.03 ± 17.10), with statistically significant differences ( t = - 3.95, - 3.96, both P<0.05). Conclusions:The triple pre-rehabilitation strategy plays a crucial role in mitigating the nutritional risk for breast cancer patients undergoing neoadjuvant chemotherapy, alleviating their negative emotions, and enhancing their quality of life. This approach is anticipated to serve as a valuable reference for preoperative health guidance tailored to breast cancer patients undergoing neoadjuvant chemotherapy.

The malignancy of pancreatic cancer is high. Radical resection is the main treatment method for non-metastatic pancreatic ductal adenocarcinoma. Neoadjuvant therapy can improve the surgical resection rate of borderline resectable pancreatic ductal adenocarcinoma (BR-PDAC) and prolong the survival of patients. In recent years, a large number of studies have been conducted on neoadjuvant therapy for pancreatic cancer at home and abroad, including radiotherapy, chemotherapy, immunotherapy and combination therapy. This article mainly reviews the current research status of neoadjuvant therapy for BR-PDAC.

Objective:To investigate changes of choroid plexus volume in patients with essential hypertension using deep learning-based segmentation technique.Methods:According to the inclusion criteria,19 patients with essential hypertension who visited The 900th Hospital of People's Liberation Army Joint Service Support Force from December 2022 to May 2024 were divided into hypertension group.Additionally,19 healthy individuals,matched with the hypertension group in terms of gender,age,and years of education,were recruited as the healthy control group during the same period.All participants underwent data acquisition of three-dimensional T1(T1-3D)brain structural images using a Siemens 3.0T Trio magnetic resonance(MR)scanner.A pre-trained deep learning model,which based on the 3D U-Net architecture and generated by fully convolutional neural network,was employed for choroid plexus segmentation,and the total brain volume and lateral ventricle volume were calculated using the United Imaging Artificial Intelligence(AI)platform.Statistical analysis of the choroid plexus volume and other data for both groups were performed using SPSS27.0.Results:Compared with the healthy control group(1 866 mm3),the hypertensive group(2 047 mm3)showed an abnormal increase in choroid plexus volume(x2=3.900,P<0.05).Moreover,the choroid plexus volume was positively correlated with lateral ventricle volume and systolic blood pressure(r=0.849,P<0.05),and was negatively correlated with digit span(forward)in the hypertensive group(r=-0.374,P<0.05).Conclusion:The choroid plexus volume in patients with essential hypertension abnormally increased,which might be a factor promoting to changes in brain structure,it can affect further the cognitive function of patients with hypertension.

Objective:To investigate the clinical efficacy of programmed Retzius-sparing robot-assisted radical prostatectomy and " Sandwich" technique of total urethral reconstruction.Methods:The clinical data of 120 consecutive patients who underwent programmed Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) by the same operator at the Cancer Hospital of the Chinese Academy of Medical Sciences from January 2023 to August 2024 were retrospectively analyzed to explore the efficacy and summarize the experience. Baseline characteristics included: mean age (67.2±7.5) years, BMI (25.3±3.1)kg/m 2, prostate volume (32.3±15.8) ml, and PSA (16.6±19.7) ng/ml (57 cases 4-10 ng/ml; 41 >10-20 ng/ml; 22 >20 ng/ml). 28 patients underwent radical prostatectomy without prostate biopsy, while 92 had biopsy-proven cancer (Gleason: 6/7/8/9/10: 18/35/17/17/5). Clinical stages were cT 1(8), cT 2(73), cT 3(39). The surgical method was programmed Retzius-sparing robot-assisted radical prostatectomy and " Sandwich" technique of total urethral reconstruction. The peritoneum was incised slightly above the Douglas pouch and denonvilliers' fascia was dissected closely along the dorsal aspect of prostate, extending to the prostatic apex. Both vas deferens were transected, and the seminal vesicles were isolated. A combination of blunt and sharp dissection was employed to expose the prostatic fascia. The bladder neck was precisely visualized and transected. The urethra was precisely dissected, exposed and divided. Complete urethral reconstruction was performed using the "Sandwich" technique of total urethral reconstruction. The operation time, intraoperative bleeding, catheter preservation time, pathological staging and positive margin rate, and recovery of urinary control immediately after postoperative catheter removal were recorded. Results:In this study, all 120 surgeries were successfully completed, with no cases converted to anterior approach radical surgery or open surgery, and no serious intraoperative complications such as post-shamus hemorrhage or ureteric/rectal injury. The median postoperative follow-up was 16.0(10.0, 20.0)months, and there were no cases of readmission for surgical complications. The average duration of surgery was (93.6±35.9) min, and the average bleeding volume was (85.3±32.1) ml. The mean duration of catheter after surgery was (7.3±1.2)d. Immediate urinary control was achieved in 98 cases when the catheter was removed, and the rate of immediate urinary control was 81.7%. Postoperative urinary control rate was 88.3% at 1 month after surgery, 94.2% at 3 month after surgery, 98.3% at 6 month after surgery. There were 70 cases with pT 2 and 50 cases with pT 3 after postoperative pathological stage. There were 18 cases (15.0%) with positive margins, including 6 cases (8.6%) with positive margins in T 2 and 12 cases (24.0%) with positive margins in T 3 stage. There were no serious complications after surgery, and urinary retention occurred in 3 cases after urinary catheter removal, and the urinary catheter was removed after 1 week. 93.3% (112/120), 90.8% (109/120), and 89.2% (107/120) of patients with PSA < 0.2 ng/ml at 1, 3, and 6 months after surgery, respectively. For postoperative erectile function, we selected patients younger than 60 years of age, who had surgery to preserve unilateral or bilateral vascular nerve bundles, and who were followed for more than 6 months. A total of 18 patients met the above conditions and were followed up for erectile function, among which 4 of the 11 patients (36.4%) who retained unilateral vascular nerve bundles regained erectile function. Among the 7 patients with bilateral vascular nerve bundle preservation, 3 patients (42.9%) regained erectile function. Conclusions:The programmed RS-RARP combined with the " Sandwich" urethral reconstruction technique is technically feasible for patients with localized prostate cancer. Recent follow-up data indicate satisfactory postoperative urinary continence and oncological control outcomes.

OBJECTIVE To investigate the current status of monitoring indicators related to the"Perioperative In-fection Control"in medical institutions above the secondary level in Guizhou Province,and to delve into the imple-mentation of key measures for infection prevention and control during the perioperative period for patients under-going surgical operations.METHODS Based on the"Implementation Plan for the'Perioperative Infection Control'Initiative in Guizhou Province",a"Case Investigation Form on Key Measures for Infection Prevention and Control During the Perioperative Period for Patients Undergoing Surgical Operation"was developed.A total of 138 medi-cal institutions participated in the case investigation,and a total of 2 128 cases were investigated.RESULTS The overall monitoring indicators for the"Perioperative Infection Control"initiative in the 138 medical institutions a-bove the secondary level in Guizhou Province were at a relatively low level.The skin cleansing compliance rate was 80.32％,the hair removal compliance rate was 16.43％,the prophylactic antibacterial drug administration rate within 0.5-1 hour before surgery was 55.94％and the antibacterial drug discontinuation rate within 24 hours after prophylactic medication for type Ⅰ incision surgeries was 56.48％.The hair removal compliance rate was higher in tertiary medical institutions(19.21％)than in secondary medical institutions(14.34％)(P=0.039).The distri-bution of the four monitoring indicators varied in clinical departments and surgery types,with statistically signifi-cant differences(P＜0.05).The preferred method for surgical site skin cleansing in medical institutions across the province was local wiping,primarily with clean water(57.21％).The primary method for hair removal was razors(68.82％),and hair removal on the day of surgery was most common(61.75％).CONCLUSIONS Conduc-ting a survey on the current status of"Perioperative Infection Control"initiative monitoring indicators in medi-cal institutions in Guizhou Province helps to understand the implementation of key measures for perioperative in-fection prevention and control and set intervention targets,thus providing references for establishing a dynam-ic monitoring indicator change mechanism.

Background:To compare the efficacy and safety of monthly administrations of gonadotropin releasing hormone (GnRH) agonists LY01005 and Zoladex ? in Chinese patients with premenopausal breast cancer. Methods:From October 2020 to November 2021, 188 premenopausal breast cancer patients were enrolled in 34 hospitals and randomized 1:1 to receive either LY01005 or Zoladex ? every 28 days for a total of three injections. All patients concomitantly received oral tamoxifen (TAM). The primary efficacy endpoint was cumulative probability of maintaining menopausal level [oestradiol (E2) ≤30 pg/ml] from day 29 to day 85. The second efficacy endpoint included changes in E2, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) compared with the baseline. Pharmacokinetics (PK), pharmacodynamics (PD), and safety were analyzed. The study also evaluated the pharmacokinetic and pharmacodynamic characteristics of LY01005. Results:A total of 188 patients were randomised and 187 patients received either LY01005 or Zoladex ?. Cumulative probabilities of maintaining menopausal level (E2≤30 pg/ml) from day 29 to day 85 were 93.1% for LY01005 and 86.3% for Zoladex ?. The between-group difference was 6.8% (95% CI: -2.3%, 15.9%) and primary efficacy in the LY01005 group was not inferior to that in the Zoladex ? group. Changes in E2, LH, and FSH levels compared with the baseline were equivalent between the two groups (E2: 89.34% to 90.23% vs. 82.11% to 85.02%; LH: 88.89% to 95.52% vs. 89.70% to 97.02%; FSH: 75.36% to 80.85% vs.73.07% to 80.24%, respectively). After three consecutive doses of LY01005, the LH and FSH levels of the subjects showed a transient increase after the first dose, reached a peak on the second day and then started to decrease. The LH and FSH reached a lower level and remained at or below that level until the 85th day. Both treatments were well-tolerated. Conclusion:LY01005 is as effective as Zoladex ? in suppressing E2 to menopausal levels in Chinese patients with premenopausal breast cancer, with a similar safety profile.