ObjectiveTo evaluate the antitumor activity of Periplaneta americana extract（PAE） against human-derived lung adenocarcinoma organoids（LUAD-PDOs） and to elucidate its potential mechanism based on transcriptomics. MethodsFresh tumor and adjacent normal tissues from patients with LUAD were collected to construct LUAD-PDOs and normal lung organoid（Nor-PDOs） models using 3D organoid culture technology. The effective intervention concentration of PAE was determined using the cell counting kit-8（CCK-8） assay. Experimental groups included the model group（LUAD-PDOs）， normal group， model administration group（LUAD-PDOs+PAE）， and normal administration group（Nor-PDOs+PAE）. Hematoxylin-eosin（HE） staining was used to observe the pathological structures of PDOs， immunohistochemistry（IHC） was performed to detect the expressions of the proliferation marker Ki-67 and lung adenocarcinoma differentiation markers cytokeratin-7（CK-7） and Napsin A， TUNEL staining was applied to detect cell apoptosis. RNA sequencing（RNA-Seq） was conducted to identify differentially expressed genes（DEGs）， followed by Gene Ontology（GO）， Kyoto Encyclopedia of Genes and Genomes（KEGG）， and Gene Set Enrichment Analysis（GSEA）， alongside protein-protein interaction（PPI） network analysis to screen core mechanisms. Finally， key targets were validated by integrating external database analysis with immunofluorescence（IF）. ResultsNor-PDOs and LUAD-PDOs that highly recapitulated the pathological characteristics of the primary tissues were successfully established. The CCK-8 assay determined that the effective intervention concentration of PAE was 16 g·L^-1. Morphological observation showed that Nor-PDOs exhibited lumen-forming structures， whereas LUAD-PDOs displayed dense， solid structures. CCK-8 and TUNEL assays revealed that， compared with the model group， PAE intervention inhibited the proliferation of LUAD-PDOs and promoted apoptosis in LUAD cells， while showing no significant effect on the viability of Nor-PDOs. Transcriptomic analysis identified 719 DEGs that were significantly reversed after PAE intervention（347 up-regulated and 372 down-regulated）（P<0.05）. GO enrichment analysis indicated that DEGs in the model administration group were significantly enriched in biological processes related to cell cycle regulation compared to the model group. KEGG pathway analysis revealed that PAE affected pathways related to proliferation and metabolism， including pathways in cancer and the p53 signaling pathway. GSEA further confirmed that PAE significantly enhanced the activity of the p53 signaling pathway（P<0.05）. PPI network analysis indicated that breast cancer type 1 susceptibility protein（BRCA1） and checkpoint kinase 1（CHEK1） were the core down-regulated targets in the p53 pathway. IF verified the high expression of BRCA1 and CHEK1 in LUAD-PDOs and their significant downregulation after PAE intervention（P<0.05）. Furthermore， survival analysis based on The Cancer Genome Atlas（TCGA） database indicated that low expression of BRCA1 and CHEK1 was significantly associated with prolonged overall survival in patients with LUAD（P<0.05）. ConclusionPAE effectively inhibits proliferation of LUAD-PDOs and promotes their apoptosis， its anti-tumor mechanism is potentially associated with the activation of the p53 signaling pathway， with BRCA1 and CHEK1 genes likely serving as key downstream targets for the effects of PAE.

ObjectiveTo explore the incidence of major low anterior resection syndrome （LARS） within six months after sphincter-preserving surgery for rectal cancer and to analyze its associated factors. MethodsClinical records， postoperative rehabilitation data and LARS scores were collected from 889 patients at 3 months postoperatively and from 844 patients at 6 months postoperatively. Patients were divided into a major LARS group and a non-major LARS group. Multivariable Logistic regression was used to analyze factors associated with major LARS at 3 and 6 months postoperatively， and the predictive value of the models was assessed using the Hosmer-Lemeshow goodness-of-fit test and the receiver operating characteristic （ROC）. ResultsAmong patients undergoing sphincter-preserving surgery for rectal cancer， 247 patients （27.8%） had major LARS at 3 months postoperatively and 181 patients （21.4%） at 6 months postoperatively. Multivariable Logistic regression showed that Kegel exercises， preoperative radiotherapy， anastomotic leakage， a tumor distance from the anal verge of ≤5 cm， and an anastomotic distance from the anal verge of ≤5 cm were independent factors for major LARS at 3 months postoperatively （P<0.05）. At 6 months postoperatively， occasional Kegel exercises during 0~3 months， Kegel exercises during 4~6 months， hydrotherapy during 4~6 months， preoperative chemotherapy， a tumor distance from the anal verge of ≤5 cm， and an anastomotic distance from the anal verge of ≤5 cm were independent factors （P<0.05）. The models at 3 and 6 months postoperatively showed goodness-of-fit test P values of 0.986 and 0.517 and area under the curve （AUCs） of 0.843 and 0.870， indicating good predictive value. ConclusionThe incidence of major LARS within six months after sphincter-preserving surgery for rectal cancer is relatively high， and greater attention should be paid to patients who receive preoperative chemoradiotherapy， develop anastomotic leakage， or have tumor and anastomotic distances from the anal verge of ≤5 cm. Patients should also be advised that early postoperative Kegel exercises and hydrotherapy may reduce the incidence of major LARS.

Although small in size, the eyeballs are extremely important in function, and are delicate and complex in structure. With the wide application of acupuncture for eye diseases and the high frequency of use of intra-orbital points, the incidence of acupuncture accidents increases accordingly in treatment. We reported two recent accident cases, retinal tear and ciliochoroidal detachment that occurred during the regular operation of acupuncture and acupoint injection at intra-orbital points, in order to strengthen people's awareness of acupuncture accidents caused by acupuncture at the points in the orbital region, and enhance the sound development and comprehensive promotion of acupuncture in treatment of eye diseases.
Humans ; Acupuncture Therapy/adverse effects* ; Acupuncture Points ; Male ; Adult ; Female ; Middle Aged ; Orbit ; Retinal Perforations/therapy*

Objective:To analyze the epidemiological characteristics of drug resistance genes of carbapenemase-producing Escherichia coli (CPECO) in Henan Province Hospital of Traditional Chinese Medicine from 2021 to 2023, providing data support and theoretical basis for controlling nosocomial infections of CPECO.Methods:Using a cross-sectional study, 30 carbapenem-resistant Escherichia coli (CRECO) strains confirmed by VITEK-2 Compact identification and drug sensitivity test in the Clinical Microbiology Laboratory of Henan Province Hospital of Traditional Chinese Medicine from 2021 to 2023 were tested, using carbapenemase inhibitor enhancement test to conduct preliminary screening of carbapenemases, and colloidal gold immunochromatography and polymerase chain reaction (PCR) were used to determine the phenotypes and genotypes of common carbapenemases ( blaKPC, blaNDM, blaVIM, blaIMP, blaOXA) respectively, and the genotypes ( blaSHV, blaTEM, blaCTX) of common extended Spectrum beta-lactamases (ESBL) were confirmed using PCR. The PCR amplification products of carbapenemase and ESBL positive strains were Sanger-sequenced, and the sequencing products were compared on the Blast website to determine the exact carbapenemase and ESBL genotypes. Sequence typing (ST) was performed on CPECO using the Achtman multi-locus sequence typing scheme to determine the cloning relationship between different strains. Results:A total of 21 CPECO strains were screened. Drug sensitivity test results showed that CPECO strains showed widespread drug resistance, with the resistance rate to monocyclic (aztreonam) and trimethoprim/sulfamethoxazole being over 60%(16/21, 14/21), and the resistance rate to other antibacterial drugs being 100%. Only the sensitivity to aminoglycosides and fosfomycin remained relatively high, and no strains resistant to tigecycline and colistin were found. Colloidal gold immunochromatography detected 18 blaNDM types, 2 blaKPC types, and 1 blaIMP type. Sequencing of drug resistance gene PCR products classified 17 blaNDM-5 strains, 1 blaNDM-4 strain, 2 blaKPC-2 strain, and 1 blaIMP-4 strain, which were completely consistent with the results of screening test and colloidal gold immunochromatography. ESBL resistance gene testing showed that the detection rate of blaTEM was 42.9%(9/21), blaCTX-M was 33.3%(7/21), and blaSHV was 4.8%(1/21). The rate of blaNDM producing CPECO carrying both ESBL resistance genes was 27.8%(5/18). The MLST typing results revealed 11 sequence types (STs), including one ST155 clonal complex and nine singleton STs. Among these, there were seven strains of ST167, five strains of ST410, and one strain each of ST58, ST68, ST69, ST93, ST131, ST155, ST648, ST1114, and ST3268. Conclusion:The main resistance mechanism identified in this study for CPECO was the production of blaNDM-5 carbapenemase, with a high proportion of strains also carrying blaTEM-1D and/or blaCTX-M-15 ESBLs. MLST typing found that the epidemic strain of CPECO showed certain polymorphism, but there were clonal transmission of multiple clonal complexes between ST167 and ST410.

Objective Based on the intervention map to develop a comprehensive nutrition education program for pancreaticoduodenectomy patients and to explore the effect of its clinical application,aiming at providing references for clinical nursing practice.Methods A convenience sampling method was used to select 76 patients who were to undergo pancreaticoduodenectomy in the department of hepatobiliary and pancreatic surgery of a tertiary hospital in Anhui Province as the study subjects.The 38 patients admitted from October 2021 to September 2022 were in a control group,and the 38 patients admitted from October 2022 to July 2023 were in an experimental group.The experimental group received the comprehensive nutritional education programme constructed in this study,and the control group used conventional nutrition health education measures,and the length of intervention for both groups was from pre-hospitalization to discharge for 6 months.Nutrition-related indicators,postoperative complications,hospitalisation time,hospitalisation costs and satisfaction were compared between the 2 groups.Results A total of 64 patients completed this study,with 33 in the experimental group and 31 in the control group.Repeated measurement analysis of variance showed that the interaction effects of BMI,total serum protein and serum preprotein were statistically significant(P＜0.05).The incidence of complications,hospitalization days and hospitalization costs of the experimental group were lower than those of the control group(P＜0.05).The scores of nutrition education-related satisfaction in the experimental group were higher than those in the control group(P＜0.001).Conclusion A comprehensive nutritional education program based on intervention map can improve the nutritional status of pancreaticoduodenectomy patients to a certain extent,reduce the occurrence of complications,and promote patients'recovery.

Objective:To analyze the influence of embolic agent type selection on the clinical efficacy of transfemoral artery interventional therapy for hepatocellular carcinoma.Methods:The clinical data of 140 cases of hepatocellular carcinoma patients treated with femoral artery interventional therapy in the 960th Hospital of the Joint Logistic Support Force of the PLA from January 2020 to December 2022 were retrospectively analyzed. Among them, 35 patients treated with iodized oil was in group A, 35 patients treated with anhydrous ethanol was in group B, 35 patients treated with gelatin sponge granule embolization agent was in group C, 35 patients treated with drug-loaded microsphere embolization agents was in group D. The clinical efficacy and serum tumor markers before and after treatment of the four groups were compared, and the occurrence of adverse reactions in the four groups were analyzed.Results:There was statistical significance in the total effective rate of the four groups ( P<0.05), among which the total effective rate of group D was the highest [97.14% (34/35)], followed by group C [85.71% (30/35)], and the total effective rate of group A and B [54.29% (19/35), 62.86% (22/35)] was lower.After treatment, the levels of alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), alkaline phosphatase (ALP), γ-glutamyltransferase (GGT) and alpha-fetoprotein anisoplast L3 (AFP-L3) were all decreased compared with those before treatment ( P<0.05), and there were statistically significant differences in the above indexes among the four groups ( P<0.05). Among them, the levels of AFP, CEA, ALP, GGT and AFP-L3 in group D were the lowest, followed by group C, and higher in group A and B. There was no significant difference in the total incidence of adverse reactions among the four groups ( P>0.05). Conclusions:There is no significant difference in the safety of oil iodide, anhydrous ethanol, gelatin sponge particles embolic agent and drug-carrying microspheres embolic agent applied in transfemoral interventional therapy of hepatocellular carcinoma, and in the comparison of the efficacy, it is found that the drug-carrying microspheres embolic agent have the best efficacy, followed by gelatin sponge particles embolic agent, and oil iodide embolic agent and anhydrous ethanol are poor.

Objective:To analyze the epidemiological characteristics of drug resistance genes of carbapenemase-producing Escherichia coli (CPECO) in Henan Province Hospital of Traditional Chinese Medicine from 2021 to 2023, providing data support and theoretical basis for controlling nosocomial infections of CPECO.Methods:Using a cross-sectional study, 30 carbapenem-resistant Escherichia coli (CRECO) strains confirmed by VITEK-2 Compact identification and drug sensitivity test in the Clinical Microbiology Laboratory of Henan Province Hospital of Traditional Chinese Medicine from 2021 to 2023 were tested, using carbapenemase inhibitor enhancement test to conduct preliminary screening of carbapenemases, and colloidal gold immunochromatography and polymerase chain reaction (PCR) were used to determine the phenotypes and genotypes of common carbapenemases ( blaKPC, blaNDM, blaVIM, blaIMP, blaOXA) respectively, and the genotypes ( blaSHV, blaTEM, blaCTX) of common extended Spectrum beta-lactamases (ESBL) were confirmed using PCR. The PCR amplification products of carbapenemase and ESBL positive strains were Sanger-sequenced, and the sequencing products were compared on the Blast website to determine the exact carbapenemase and ESBL genotypes. Sequence typing (ST) was performed on CPECO using the Achtman multi-locus sequence typing scheme to determine the cloning relationship between different strains. Results:A total of 21 CPECO strains were screened. Drug sensitivity test results showed that CPECO strains showed widespread drug resistance, with the resistance rate to monocyclic (aztreonam) and trimethoprim/sulfamethoxazole being over 60%(16/21, 14/21), and the resistance rate to other antibacterial drugs being 100%. Only the sensitivity to aminoglycosides and fosfomycin remained relatively high, and no strains resistant to tigecycline and colistin were found. Colloidal gold immunochromatography detected 18 blaNDM types, 2 blaKPC types, and 1 blaIMP type. Sequencing of drug resistance gene PCR products classified 17 blaNDM-5 strains, 1 blaNDM-4 strain, 2 blaKPC-2 strain, and 1 blaIMP-4 strain, which were completely consistent with the results of screening test and colloidal gold immunochromatography. ESBL resistance gene testing showed that the detection rate of blaTEM was 42.9%(9/21), blaCTX-M was 33.3%(7/21), and blaSHV was 4.8%(1/21). The rate of blaNDM producing CPECO carrying both ESBL resistance genes was 27.8%(5/18). The MLST typing results revealed 11 sequence types (STs), including one ST155 clonal complex and nine singleton STs. Among these, there were seven strains of ST167, five strains of ST410, and one strain each of ST58, ST68, ST69, ST93, ST131, ST155, ST648, ST1114, and ST3268. Conclusion:The main resistance mechanism identified in this study for CPECO was the production of blaNDM-5 carbapenemase, with a high proportion of strains also carrying blaTEM-1D and/or blaCTX-M-15 ESBLs. MLST typing found that the epidemic strain of CPECO showed certain polymorphism, but there were clonal transmission of multiple clonal complexes between ST167 and ST410.

Objective:To analyze the influence of embolic agent type selection on the clinical efficacy of transfemoral artery interventional therapy for hepatocellular carcinoma.Methods:The clinical data of 140 cases of hepatocellular carcinoma patients treated with femoral artery interventional therapy in the 960th Hospital of the Joint Logistic Support Force of the PLA from January 2020 to December 2022 were retrospectively analyzed. Among them, 35 patients treated with iodized oil was in group A, 35 patients treated with anhydrous ethanol was in group B, 35 patients treated with gelatin sponge granule embolization agent was in group C, 35 patients treated with drug-loaded microsphere embolization agents was in group D. The clinical efficacy and serum tumor markers before and after treatment of the four groups were compared, and the occurrence of adverse reactions in the four groups were analyzed.Results:There was statistical significance in the total effective rate of the four groups ( P<0.05), among which the total effective rate of group D was the highest [97.14% (34/35)], followed by group C [85.71% (30/35)], and the total effective rate of group A and B [54.29% (19/35), 62.86% (22/35)] was lower.After treatment, the levels of alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), alkaline phosphatase (ALP), γ-glutamyltransferase (GGT) and alpha-fetoprotein anisoplast L3 (AFP-L3) were all decreased compared with those before treatment ( P<0.05), and there were statistically significant differences in the above indexes among the four groups ( P<0.05). Among them, the levels of AFP, CEA, ALP, GGT and AFP-L3 in group D were the lowest, followed by group C, and higher in group A and B. There was no significant difference in the total incidence of adverse reactions among the four groups ( P>0.05). Conclusions:There is no significant difference in the safety of oil iodide, anhydrous ethanol, gelatin sponge particles embolic agent and drug-carrying microspheres embolic agent applied in transfemoral interventional therapy of hepatocellular carcinoma, and in the comparison of the efficacy, it is found that the drug-carrying microspheres embolic agent have the best efficacy, followed by gelatin sponge particles embolic agent, and oil iodide embolic agent and anhydrous ethanol are poor.

Objective Based on the intervention map to develop a comprehensive nutrition education program for pancreaticoduodenectomy patients and to explore the effect of its clinical application,aiming at providing references for clinical nursing practice.Methods A convenience sampling method was used to select 76 patients who were to undergo pancreaticoduodenectomy in the department of hepatobiliary and pancreatic surgery of a tertiary hospital in Anhui Province as the study subjects.The 38 patients admitted from October 2021 to September 2022 were in a control group,and the 38 patients admitted from October 2022 to July 2023 were in an experimental group.The experimental group received the comprehensive nutritional education programme constructed in this study,and the control group used conventional nutrition health education measures,and the length of intervention for both groups was from pre-hospitalization to discharge for 6 months.Nutrition-related indicators,postoperative complications,hospitalisation time,hospitalisation costs and satisfaction were compared between the 2 groups.Results A total of 64 patients completed this study,with 33 in the experimental group and 31 in the control group.Repeated measurement analysis of variance showed that the interaction effects of BMI,total serum protein and serum preprotein were statistically significant(P＜0.05).The incidence of complications,hospitalization days and hospitalization costs of the experimental group were lower than those of the control group(P＜0.05).The scores of nutrition education-related satisfaction in the experimental group were higher than those in the control group(P＜0.001).Conclusion A comprehensive nutritional education program based on intervention map can improve the nutritional status of pancreaticoduodenectomy patients to a certain extent,reduce the occurrence of complications,and promote patients'recovery.

Objective:To investigate the protective effect of quercetin against LasB-induced apoptosis, inflammation, and oxidative stress in THP-1 macrophages, providing valuable insights into the use of quercetin as a virulence inhibitor for Pseudomonas aeruginosa infection treatment. Methods:This was an experimental study. The experimental strain was the standard strain. The LasB protein was obtained utilizing protein recombination technology, while the enzyme activity of LasB was assessed through both the Elastin Congo red assay and fluorescently labelled elastin assay. The LasB-induced THP-1 macrophage infection model was established, and quercetin was utilized for intervention. Cell viability was evaluated via CCK-8 assay, while cell morphology was observed under an inverted microscope. Apoptosis detection involved employing both TUNEL and Annexin V/PI staining. The mRNA expression and protein levels of inflammatory cytokines and COX-2 were determined by RT-qPCR and ELISA respectively. Intracellular ROS levels were quantified using the DCFH-DA fluorescent probe. One-way ANOVA was used for statistical analysis, and Tukey test was used for multiple comparisons. Results:The pLasB with a molecular weight of 33 000 and acceptable enzymatic activity (purity>90%), was successfully obtained. THP-1 macrophages treated with pLasB at a concentration of 100 μg/ml presented significantly decreased viability and integrity rate when compared with the normal control group. Additionally, pLasB promoted apoptosis, up-regulated the levels of inflammatory cytokines IL-1α, IL-1β, IL-6, IL-10, IL-12, and TNF-α, increased intracellular ROS fluorescence intensity, and elevated COX-2 mRNA expression level. Furthermore, the viability of THP-1 macrophages was significantly enhanced under quercetin intervention at concentrations of 2.5 μmol/L, 5 μmol/L and 10 μmol/L. The apoptosis rate exhibited a significant reduction from 18.32%±0.17% to 13.17%±0.20%, 11.43%±0.06% and 7.74%±0.04%, respectively ( F=1 679, P<0.05). There was a notable down-regulation of pro-inflammatory cytokines IL-1α, IL-1β, IL-6, IL-12 and TNF-α while the anti-inflammatory cytokine IL-10 showed a significant up-regulation. Both intracellular ROS fluorescence intensity ( F=86.92, P<0.05) and COX-2 level ( F=24.62, P<0.05) demonstrated a substantial decrease. Conclusion:Quercetin demonstrates significant efficacy in inhibiting LasB-induced apoptosis, inflammation, and oxidative stress in THP-1 macrophages, which highlights immense potential as a potent virulence inhibitor of Pseudomonas aeruginosa.