Acute lung injury （ALI） is a life-threatening condition characterized by uncontrolled pulmonary inflammatory responses， presenting high morbidity and mortality rates that pose serious threats to patient health. The pathogenesis of ALI involves complex interactions among pathological mechanisms including immune-inflammatory responses， disruption of the alveolar-capillary barrier， mesenchymal stem cell dysfunction， metabolic disorders， ferroptosis， and alterations in the gut microbiota. The dysregulation of programmed cell death （PCD） has increasingly emerged as a research focus. PCD represents a genetically regulated autonomous process of cell death， crucial for maintaining the internal stability of organisms. Recent studies indicate that multiple PCD modes， including apoptosis， pyroptosis， necroptosis， autophagy， and ferroptosis， participate in the development and progression of ALI by mediating pathological processes such as alveolar epithelial cell injury and vascular endothelial barrier disruption. Current therapeutic approaches for ALI encompass lung-protective ventilation， body fluid management， mesenchymal stem cell therapy， and pharmacological interventions. While these measures may alleviate clinical symptoms， they remain unable to reverse the pathological progression of lung injury. Traditional Chinese medicine （TCM） possesses the unique advantages of a holistic perspective and syndrome differentiation-based treatment， achieving breakthrough progress in targeted PCD intervention for ALI. It can mitigate pulmonary tissue injury by suppressing inflammatory responses， regulating immune function， and improving coagulation disorders， thereby delaying the onset and progression of ALI. This paper delves into the molecular mechanisms of PCD in ALI， systematically reviewing the effects of TCM extracts， active constituents （terpenoids， saponins， flavonoids， and phenols）， and compound formulas （e.g.， Qingjie Huagong prescription， Maxing Kugan Tang， and Yifei Jianpi prescription） in improving pulmonary epithelial cell function and mitigating lung injury by modulating PCD pathways. This review aims to provide theoretical underpinnings and novel directions for drug development in the clinical prevention and treatment of ALI.

Acute lung injury （ALI） is a life-threatening condition characterized by uncontrolled pulmonary inflammatory responses， presenting high morbidity and mortality rates that pose serious threats to patient health. The pathogenesis of ALI involves complex interactions among pathological mechanisms including immune-inflammatory responses， disruption of the alveolar-capillary barrier， mesenchymal stem cell dysfunction， metabolic disorders， ferroptosis， and alterations in the gut microbiota. The dysregulation of programmed cell death （PCD） has increasingly emerged as a research focus. PCD represents a genetically regulated autonomous process of cell death， crucial for maintaining the internal stability of organisms. Recent studies indicate that multiple PCD modes， including apoptosis， pyroptosis， necroptosis， autophagy， and ferroptosis， participate in the development and progression of ALI by mediating pathological processes such as alveolar epithelial cell injury and vascular endothelial barrier disruption. Current therapeutic approaches for ALI encompass lung-protective ventilation， body fluid management， mesenchymal stem cell therapy， and pharmacological interventions. While these measures may alleviate clinical symptoms， they remain unable to reverse the pathological progression of lung injury. Traditional Chinese medicine （TCM） possesses the unique advantages of a holistic perspective and syndrome differentiation-based treatment， achieving breakthrough progress in targeted PCD intervention for ALI. It can mitigate pulmonary tissue injury by suppressing inflammatory responses， regulating immune function， and improving coagulation disorders， thereby delaying the onset and progression of ALI. This paper delves into the molecular mechanisms of PCD in ALI， systematically reviewing the effects of TCM extracts， active constituents （terpenoids， saponins， flavonoids， and phenols）， and compound formulas （e.g.， Qingjie Huagong prescription， Maxing Kugan Tang， and Yifei Jianpi prescription） in improving pulmonary epithelial cell function and mitigating lung injury by modulating PCD pathways. This review aims to provide theoretical underpinnings and novel directions for drug development in the clinical prevention and treatment of ALI.

Objective To investigate the effects of different use methods of tourniquet on hidden blood loss and knee joint swelling in total knee arthroplasty(TKA),and to explore its potential benefits for postoperative rehabilitation.Methods A prospective study was conducted from March 2018 to March 2023 in Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University,involving 131 patients who underwent TKA.The patients were divided into three groups based on the method of tourniquet use:44 patients routinely used a tourniquet in group A,48 patients only used a tourniquet during the application of bone cement in group B,and 39 patients did not use tourniquet in group C.Operation time,dressing changes,intraoperative blood loss,total blood loss,explicit blood loss,hidden blood loss,percentage of hidden blood loss,postoperative blood transfusion,hemoglobin(Hb),hematocrit(HCT),C-reactive protein(CRP),and creatine kinase(CK)were compared among groups.The pain and functional recovery were evaluated by visual analogue scale(VAS)and knee society clinical rating system(KSS)before surgery,and 3 days,1 month,and 3 months after surgery.The degree of limb swelling and the range of motion of the knee were also compared among groups.Results Group A had shorter operation time and less frequency of postoperative dressing changes than the other two groups(P<0.05).The hidden blood loss and total blood loss in group A were significantly less than those in group C(P<0.05),and the hidden blood loss and total blood loss volume in the three groups from low to high was group A

Objective To investigate the clinical outcome differences between robotic-assisted intramedullary nailing and traditional manual surgery,and to analyze the advantages and feasibility of robotic-assisted intramedullary nail fixation in the treatment of intertrochanteric fractures in elderly patients.Methods From December 2023 to December 2024,elderly patients with intertrochanteric fractures who underwent surgery at Department of Trauma Orthopedics,Beijing Luhe Hospital,Capital Medical University were included.Patients were divided into two groups based on the surgical method.The robotic-assisted group underwent robotic-assisted intramedullary nail fixation,while the traditional group received manual intramedullary nail fixation.Baseline data and observation indicators were collected and compared between the two groups to assess any differences.Results There were no statistically significant differences in baseline data between the two groups(P>0.05).The intraoperative blood loss in the robotic-assisted group was(94.28±9.43)mL,compared to(143.00±11.11)mL in the traditional group(P<0.001).The operative time in the robotic-assisted group was(53.06±9.89)min,while in the traditional group,it was(66.74±10.18)min(P<0.001).The skin incision length for the main nail in the robotic-assisted group was(3.23±0.64)cm,whereas in the traditional group,it was(4.03±0.79)cm(P<0.01).Postoperative hemoglobin levels in the robotic-assisted group decreased by(12.63±4.27)g/L,compared to(17.29±4.32)g/L in the traditional group(P=0.018).At 6 months postoperatively,the Harris hip scores in the robotic-assisted group showed 30 cases of excellent,10 good,and 3 poor outcomes,while in the traditional group,there were 22 excellent,15 good,and 6 poor cases(P=0.198).Conclusion Robotic-assisted intramedullary nailing for intertrochanteric fractures offers advantages such as minimally invasive and precise procedures,shorter operative times,and reduced blood loss.Compared to traditional surgical methods,it demonstrates certain benefits in reducing postoperative complications in elderly patients.

Ferroptosis is closely related to iron metabolism,lipid metabolism,and amino acid metabolism,which contribute to the production of reactive oxygen species,mitochondrial damage,and cell death.Ferroptosis has recently been recognized as a key regulatory mechanism during tumor development,including in acute leukemia.This review considers the inhibitory effects of drugs on the occurrence and development of acute leukemia,by regulating key proteins or factors involved in the above three metabolic pathways of ferroptosis and by interfering with the production of lipid peroxides.We also point out the deficiencies in current research and describe the role of ferroptosis in acute leukemia.The application of these findings in clinical trials will provide new ideas for future research and the treatment of leukemia.

BACKGROUND:Sinomenine hydrochloride has anti-tumor effects,but it is rarely reported in T-cell acute lymphoblastic leukemia.OBJECTIVE:To investigate the inhibitory effect of sinomenine hydrochloride on CEM cells in acute T lymphoblastic leukemia.METHODS:Different concentrations(0.5,1,2 and 4 mmol/L)of sinomenine hydrochloride were used to act on CEM cells.CCK-8 assay was used to detect the inhibition rate of cell proliferation and calculate the IC50.Inverted microscope and Giemsa staining were used to observe the changes of CEM cells.The RNA sequencing was performed to analyze the differential gene expression and biological information.Combined with transcriptome sequencing analysis results,flow cytometry was used to detect the apoptosis rate of CEM cells after treatment with of different concentrations(1,2,and 4 mmol/L)of sinomenine hydrochloride.Western blot assay was used to detect the expression of Bcl-2,Bax,and Caspase-9 proteins in CEM cells after treatment with of different concentrations(1,2,and 4 mmol/L)of sinomenine hydrochloride.RESULTS AND CONCLUSION:(1)Sinomenine hydrochloride inhibited the growth of CEM cells in dose and time-dependent manner.(2)After dosing,the number of CEM cells decreased and pyknosis appeared.(3)RNA sequencing revealed 53 differential expressed genes.Gene Ontology was significantly enriched in cellular process,cellular anatomical entities,and binding.Signaling pathway analysis related to tumor was apoptosis.(4)Sinomenine hydrochloride induced the apoptosis of CEM cell in a concentration-dependent manner.(5)Sinomenine hydrochloride could promote the expressions of Bax and Caspase-9,but restrain the expression of Bcl-2 in CEM cells.Therefore,sinomenine hydrochloride can induce apoptosis in CEM cells and suppress cell proliferation,maybe via up-regulation of the protein levels of Bax and caspase-9 and down-regulation of the protein level of Bcl-2.

Objective To investigate the clinical outcome differences between robotic-assisted intramedullary nailing and traditional manual surgery,and to analyze the advantages and feasibility of robotic-assisted intramedullary nail fixation in the treatment of intertrochanteric fractures in elderly patients.Methods From December 2023 to December 2024,elderly patients with intertrochanteric fractures who underwent surgery at Department of Trauma Orthopedics,Beijing Luhe Hospital,Capital Medical University were included.Patients were divided into two groups based on the surgical method.The robotic-assisted group underwent robotic-assisted intramedullary nail fixation,while the traditional group received manual intramedullary nail fixation.Baseline data and observation indicators were collected and compared between the two groups to assess any differences.Results There were no statistically significant differences in baseline data between the two groups(P>0.05).The intraoperative blood loss in the robotic-assisted group was(94.28±9.43)mL,compared to(143.00±11.11)mL in the traditional group(P<0.001).The operative time in the robotic-assisted group was(53.06±9.89)min,while in the traditional group,it was(66.74±10.18)min(P<0.001).The skin incision length for the main nail in the robotic-assisted group was(3.23±0.64)cm,whereas in the traditional group,it was(4.03±0.79)cm(P<0.01).Postoperative hemoglobin levels in the robotic-assisted group decreased by(12.63±4.27)g/L,compared to(17.29±4.32)g/L in the traditional group(P=0.018).At 6 months postoperatively,the Harris hip scores in the robotic-assisted group showed 30 cases of excellent,10 good,and 3 poor outcomes,while in the traditional group,there were 22 excellent,15 good,and 6 poor cases(P=0.198).Conclusion Robotic-assisted intramedullary nailing for intertrochanteric fractures offers advantages such as minimally invasive and precise procedures,shorter operative times,and reduced blood loss.Compared to traditional surgical methods,it demonstrates certain benefits in reducing postoperative complications in elderly patients.

BACKGROUND:Sinomenine hydrochloride has anti-tumor effects,but it is rarely reported in T-cell acute lymphoblastic leukemia.OBJECTIVE:To investigate the inhibitory effect of sinomenine hydrochloride on CEM cells in acute T lymphoblastic leukemia.METHODS:Different concentrations(0.5,1,2 and 4 mmol/L)of sinomenine hydrochloride were used to act on CEM cells.CCK-8 assay was used to detect the inhibition rate of cell proliferation and calculate the IC50.Inverted microscope and Giemsa staining were used to observe the changes of CEM cells.The RNA sequencing was performed to analyze the differential gene expression and biological information.Combined with transcriptome sequencing analysis results,flow cytometry was used to detect the apoptosis rate of CEM cells after treatment with of different concentrations(1,2,and 4 mmol/L)of sinomenine hydrochloride.Western blot assay was used to detect the expression of Bcl-2,Bax,and Caspase-9 proteins in CEM cells after treatment with of different concentrations(1,2,and 4 mmol/L)of sinomenine hydrochloride.RESULTS AND CONCLUSION:(1)Sinomenine hydrochloride inhibited the growth of CEM cells in dose and time-dependent manner.(2)After dosing,the number of CEM cells decreased and pyknosis appeared.(3)RNA sequencing revealed 53 differential expressed genes.Gene Ontology was significantly enriched in cellular process,cellular anatomical entities,and binding.Signaling pathway analysis related to tumor was apoptosis.(4)Sinomenine hydrochloride induced the apoptosis of CEM cell in a concentration-dependent manner.(5)Sinomenine hydrochloride could promote the expressions of Bax and Caspase-9,but restrain the expression of Bcl-2 in CEM cells.Therefore,sinomenine hydrochloride can induce apoptosis in CEM cells and suppress cell proliferation,maybe via up-regulation of the protein levels of Bax and caspase-9 and down-regulation of the protein level of Bcl-2.

Ferroptosis is closely related to iron metabolism,lipid metabolism,and amino acid metabolism,which contribute to the production of reactive oxygen species,mitochondrial damage,and cell death.Ferroptosis has recently been recognized as a key regulatory mechanism during tumor development,including in acute leukemia.This review considers the inhibitory effects of drugs on the occurrence and development of acute leukemia,by regulating key proteins or factors involved in the above three metabolic pathways of ferroptosis and by interfering with the production of lipid peroxides.We also point out the deficiencies in current research and describe the role of ferroptosis in acute leukemia.The application of these findings in clinical trials will provide new ideas for future research and the treatment of leukemia.

With the progress of information technology and intelligent technology,the intelligent development of urine testing instruments is facing new opportunities.Using the disease cybernetics theory model to analyze the business process and current urine testing instruments of clinical urine analyzer,a generational theoretical model of urine testing instruments has been constructed,which is conducive to guiding the intelligent development direction of urine testing instruments.The study divides urine testing instruments into one to four generations of products,with the first-generation of products being operated by doctors.The second-generation products are currently available for laboratory technicians to use various urine analyzers.The third-generation products further optimize the testing process and intelligence,without the need for inspectors to operate.The fourth-generation products are unmanned and do not require sampling.It can be seen that with the development of technology,urine analysis has indeed become more convenient,but after all,various instruments have their limitations.Therefore,the establishment of a theoretical model for the generation of urine testing instruments should be applied in clinical urine testing,which can not only improve the efficiency of urine analysis but also improve its quality.