OBJECTIVE To build a new workflow of pharmacy intravenous admixture services （PIVAS）， effectively connect intelligent equipment， and promote the intelligent development of PIVAS. METHODS Based on intelligent auxiliary equipment， PIVAS workflow was optimized， and a process-oriented model was established. This model integrated intelligent prescription review （automatic prescription review+manual intervention mode）， intelligent labeling， intelligent allocation， intelligent sorting， and finished infusion quality inspection system. Furthermore， an assessment was conducted to examine unreasonable medical order rate of intelligent prescription review， the working efficiency and error rate of intelligent labeling machine and intelligent sorting machine， and the dispensing efficiency and accuracy of intelligent dispensing robot. RESULTS Under the intelligent prescription review mode， the rate of unreasonable medical orders decreased from 0.157% to 0.050% （P＜0.05）； automatic labeling efficiency reached 21.7 sheets/min， surpassing the manual labeling efficiency of 13.8 sheets/min （P＜0.05）， and the daily labeling error rate decreased from 6.1‰ to 2.5‰ （P＜0.05）. Simultaneously operating two dispensing robots significantly improved the efficiency of batch dispensing and reduced the residual amount of liquid medicine （P＜0.05）； additionally， a quality testing system for finished infusion was established， involving appearance， Tyndall effect， insoluble particles， turbidity， absorbance， pH and osmotic pressure， to ensure the quality of finished infusion and reduce the risk of infusion. CONCLUSIONS The new process of PIVAS connected with intelligent devices in our hospital can improve work efficiency， reduce dispensing errors， ensure the quality of finished infusion， and improve the level of pharmaceutical care.

OBJECTIVE: To investigate the clinical efficacy of lengthened proximal femoral nail antirotation (PFNA) and InterTan in the treatment of subtrochanteric femur fractures in the elderly. METHODS: A retrospective analysis was performed on the data of 65 elderly patients diagnosed with subtrochanteric femoral fractures who met the inclusion criteria between October 2016 and January 2022. The enrolled patients were categorized into two groups according to the type of internal fixation used: the lengthened proximal femoral nail antirotation(PFNA) group and the InterTan group. There were 32 patients in the PFNA group, comprising 20 males and 12 females, with ages ranging from 60 to 85 years old with an average of (69.3±6.7 ) years old. Among these patients, 15 patients resulted from traffic accidents and 17 patients were caused by falls. According to the Seinsheimer classification system, there were 11 patients as type Ⅱ, 14 patients as type Ⅲ, 6 patients as type Ⅳ, and 1 patient as type Ⅴ. The InterTan group comprised 33 patients, including 20 males and 13 females, aged from 60 to 85 years old with an average of (69.8±7.8 ) years old. Of these, 15 patients resulted from traffic accidents, while 18 patients were caused by falls. According to the Seinsheimer classification system, 10 patients as type Ⅱ, 15 patients as type Ⅲ, 7 patients as type Ⅳ, and 1 patient as type Ⅴ. The intraoperative blood loss, operative duration, and fracture healing time were recorded and compared between two groups. The quality of fracture reduction was assessed using Chang's criteria. Additionally, the Harris hip score was utilized to evaluate hip function in both groups at 3 months postoperatively and at the final follow-up. RESULTS: All patients were followed up for a period ranging from 10 to 20 months with an average of (14.6±4.5) months. No statistically significant differences were observed between two groups in terms of operation time, intraoperative blood loss, quality of fracture reduction, or reduction methods (P>0.05). Three months after the surgery, the Harris hip score in the InterTan group was 80.0(78.0, 83.5) points, which was significantly higher than that in the PFNA group, which recorded a score of 77.5(75.0, 81.8) points. This difference was statistically significant (P<0.05). At the final follow-up, the Harris hip score in the InterTan group was 80.0(76.5, 87.0), while that in the PFNA group was 78.0(74.3, 82.8). No statistically significant difference was observed between two groups (P>0.05). CONCLUSION The use of lengthened PFNA and InterTan in the treatment of elderly subtrochanteric femur fractures can both achieve good treatment results, with the advantages of simple operation, firm fixation, and low failure rate of internal fixation. The lengthened InterTan can achieve better hip function than PFNA.
Humans ; Male ; Female ; Aged ; Aged, 80 and over ; Bone Nails ; Retrospective Studies ; Hip Fractures/surgery* ; Middle Aged ; Fracture Fixation, Intramedullary/instrumentation* ; Fracture Fixation, Internal/methods* ; Femoral Fractures/surgery*

OBJECTIVE: To investigate the biomechanical characteristics of retrograde tibial nailing (RTN) and distal tibial L-shaped plating in the internal fixation of distal tibial fractures. METHODS: Fourteen fresh adult tibia specimens were selected, comprising 7 males and 7 females aged from 34 to 55 years old. The specimens were randomly divided into experimental group and control group by numerical table method with 7 specimens in each group. RTN was used for internal fixation of distal tibial fractures in the experimental group, and L-shaped plate was used for internal fixation of distal tibial fractures in the control group. The axial compression properties of the two groups of specimens were tested under the pressure of 100, 200, 300, 400, and 500 N after operation, and torsional resistance at torque levels of 1.0, 2.0, 3.0, 4.0, 5.0 N·m. The anti-fatigue performance of the specimens was tested at 500 N pressure for 3 000 and 10 000 cycles. X-ray fluoroscopy was performed to observe whether the the internal fixator was deformed and whether the screw was loosened or broken. RESULTS: When the pressure was 400 N and 500 N, the axial compression displacement of the experimental group was (1.11±0.06) mm and (1.24±0.05) mm, which were smaller than those of the control group (1.21±0.08) mm and (1.37±0.11) mm, and the differences were statistically signific (P<0.05). Under the pressure of 500 N, the axial compression stiffness of the experimental group was (389.24±17.79) N·mm^-1, which was significantly higher than that of the control group (362.37±14.44) N·mm^-1(P<0.05). When the torque was 4 and 5 N·m, the torsion angles of the experimental group were (2.97±0.23) ° and (3.41±0.17) °, which were smaller than those of the control group (3.31±0.28) ° and (3.76±0.20) °, and the differences were statistically significant (P<0.05). When the torque was 5 N·m, the torsional stiffness of the experimental group was (1.48±0.07) N·m per degree, which was higher than that of the control group (1.36±0.06) N·m per degree, and the difference was statistically significant (P<0.05). For the intragroup comparison of fatigue resistance, the differences in axial compression displacement between the two groups were not statistically significant at 3 000 and 10 000 cycles (all P>0.05). When 3 000 times and 10 000 times of compression, the axial compression displacement of the experimental group was (1.38±0.08), (1.43±0.07) mm, which was smaller than that of the control group (1.51±0.10), (1.54±0.08) mm, the differences were statistically significant (P<0.05). In the experimental group, no screw loosening, fracture or internal fixation deformation was found, while in the control group, locking screw loosening occurred in 2 models after 10 000 pressures. CONCLUSION The biomechanical performance of RTN is obviously better than that of the distal tibial L-shaped plate, which provides biomechanical data support for the clinical application of RTN.
Humans ; Female ; Male ; Adult ; Tibial Fractures/physiopathology* ; Middle Aged ; Biomechanical Phenomena ; Bone Plates ; Fracture Fixation, Internal/instrumentation* ; Bone Nails ; Tibia/surgery*

OBJECTIVE: Diabetes-induced gastrointestinal (GI) motility disorders are increasingly prevalent. Damage to the enteric nervous system (ENS), composed primarily of enteric neurons and glial cells, is an essential mechanism involved in these disorders. Although electroacupuncture (EA) has shown the potential to mitigate enteric neuronal loss, its mechanism is not fully understood. Additionally, the effects of EA on enteric glial cells have not been investigated. Enteric neural precursor cells (ENPCs) contribute to the structural and functional integrity of the ENS, yet whether EA enhances their differentiation into enteric neurons and glial cells remains unexplored. This study investigates whether EA promotes ENS repair through enhancing ENPC-derived neurogenesis and gliogenesis and elucidates the potential molecular mechanisms involved. METHODS: Transgenic mice were used to trace Nestin⁺/nerve growth factor receptor (Ngfr)⁺ ENPCs labeled with green fluorescent protein (GFP) in vivo. Mice were randomly divided into four groups: control, diabetes mellitus (DM), DM + sham EA, and DM + EA. The effects of EA on diabetic mice were evaluated by GI motility, ENS structure, and ENPC differentiation. Glial cell line-derived neurotrophic factor (GDNF)/Ret signaling was detected to clarify the underlying molecular mechanisms. RESULTS: EA alleviated diabetes-induced GI motility disorders, as indicated by reduced whole gut transit time, shortened colonic bead expulsion time, and enhanced smooth muscle contractility. Furthermore, EA attenuated diabetes-induced losses of enteric neurons and glial cells, thereby restoring ENS integrity. Notably, EA reversed the diabetes-induced decrease in ENPCs and significantly increased the absolute number and the proportion of ENPC-derived enteric neurons. However, immunofluorescence analyses revealed no colocalization between EA-induced glial fibrillary acidic protein⁺ glial cells and GFP-labeled ENPCs. Mechanistically, GDNF/Ret signaling was elevated in intestinal tissues and upregulated in ENPCs in EA-treated diabetic mice. CONCLUSION EA facilitates ENS repair by promoting Nestin⁺/Ngfr⁺ ENPC differentiation into enteric neurons via upregulation of GDNF/Ret signaling, and driving enteric gliogenesis from non-Nestin⁺/Ngfr⁺ ENPCs. These findings highlight EA's role in ameliorating diabetes-induced GI dysmotility through ENPC-derived ENS restoration. Please cite this article as: Guo JL, Liu S, Ding SJ, Yang X, Du F. Electroacupuncture at ST36 improves gastrointestinal motility disorders by promoting enteric nervous system regeneration through GDNF/Ret signaling in diabetic mice. J Integr Med. 2025; 23(5):548-559.
Animals ; Electroacupuncture ; Enteric Nervous System/physiology* ; Gastrointestinal Motility/physiology* ; Glial Cell Line-Derived Neurotrophic Factor/metabolism* ; Diabetes Mellitus, Experimental/therapy* ; Signal Transduction ; Mice ; Gastrointestinal Diseases/physiopathology* ; Proto-Oncogene Proteins c-ret/metabolism* ; Mice, Transgenic ; Male ; Nerve Regeneration ; Neural Stem Cells ; Mice, Inbred C57BL ; Acupuncture Points

AIM:The aim of this study is to investigate the clinical utility of neutrophil gelatinase-associated lipocalin(NGAL)and other biomarkers in serum for patients with acute and chronic kidney injury.METHODS:A total of 171 patients with acute kidney injury(AKI)and 209 patients with chronic kidney disease(CKD)who sought medical care at the Third Affiliated Hospital of Sun Yat-sen University in Guangzhou between January 2022 and July 2023 were in-cluded in this study.Data on potassium(K),sodium(Na),chloride(Cl),carbon dioxide(CO2),urea(Urea),and glu-cose(GLU)were collected from each group of participants.A total of 94 individuals who were deemed healthy and had un-dergone physical examinations within the same time frame were chosen as the control group.The serum NGAL levels of all three groups were measured using latex immunoturbidimetry.The diagnostic effectiveness of serum NGAL and other bio-markers in identifying acute and chronic kidney injury was analyzed.Multiple logistic regression equations were employed to examine the factors influencing the occurrence of AKI and CKD in patients.Additionally,receiver operating characteris-tic(ROC)curves were constructed to evaluate the clinical significance of these biomarkers in patients with kidney injury.RESULTS:Through bioinformatic analysis,it was suggested that NGAL may be a detection marker of kidney injury.Ac-cording to general data,in the AKI and the CKD groups,K,Na,CO2,Urea,GLU and NGAL levels were higher than those in the healthy control group(P＜0.05).Multivariate logistic regression equation analysis showed that Na,Urea,GLU and NGAL levels were all independent risk factors for AKI or CKD disease occurrence(P＜0.05).The ROC curve analysis showed that in the AKI group,the area under the curve(AUC)for Na,Urea,GLU and NGAL were 0.711,0.960,0.793 and 0.841,respectively(P＜0.01).In the CKD group,the AUC for Na,Urea,GLU and NGAL were 0.681,0.990,0.703 and 0.930,respectively(P＜0.01).The sensitivity and specificity of NGAL and Urea combined diagnosis for AKI were 81.9%and 61.1%,respectively,and those for CKD were 62.7%and 80.0%,respectively.CONCLUSION:Serum NGAL can serve as an indicator of acute and chronic kidney injury,and its combination with other biomarkers also has certain clinical application value in acute and chronic kidney injury.

ObjectiveHuman Ku70 protein mainly involves the non-homologous end joining (NHEJ) repair of double-stranded DNA breaks (DSB) through its DNA-binding properties, and it is recently reported having an RNA-binding ability. This paper is to explore whether Ku70 has RNA helicase activity and affects miRNA maturation. MethodsRNAs bound to Ku protein were analyzed by RNA immunoprecipitation sequencing (RIP-seq) and bioinfomatic anaylsis. The expression relationship between Ku protein and miRNAs was verified by Western blot (WB) and quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) assays. Binding ability of Ku protein to the RNAs was tested by biolayer interferometry (BLI) assay. RNA helicase activity of Ku protein was identified with EMSA assay. The effect of Ku70 regulated miR-124 on neuronal differentiation was performed by morphology analysis, WB and immunofluorescence assays with or without Zika virus (ZIKV) infection. ResultsWe revealed that the Ku70 protein had RNA helicase activity and affected miRNA maturation. Deficiency of Ku70 led to the up-regulation of a large number of mature miRNAs, especially neuronal specific miRNAs like miR-124. The knockdown of Ku70 promoted neuronal differentiation in human neural progenitor cells (hNPCs) and SH-SY5Y cells by boosting miR-124 maturation. Importantly, ZIKV infection reduced the expression of Ku70 whereas increased expression of miR-124 in hNPCs, and led to morphologically neuronal differentiation. ConclusionOur study revealed a novel function of Ku70 as an RNA helicase and regulating miRNA maturation. The reduced expression of Ku70 with ZIKV infection increased the expression of miR-124 and led to the premature differentiation of embryonic neural progenitor cells, which might be one of the causes of microcephaly.

Hepatohilar cholangiocarcinoma is a common malignant tumor of the biliary system,and radical surgery is one of the important treatment methods.Due to the narrow space at the hi-lum and the high rate of anatomical variation,radical surgery is challenging.By using medical imag-ing technology and 3D reconstruction,surgeons can accurately determine the stage and classifica-tion of hilar cholangiocarcinoma preoperatively.They can assess the tumor's resectability by Ac-cording to the bile duct separation limit points(U point,P point)and anticipate the impact of portal vein,bile duct,and arterial variations on the surgical plan,thereby improving the rate of radical re-section and reducing complication rates.

Objective To investigate the physical compatibility of admixture of cisplatin injection with 6 proton pump inhibitors.Methods At room temperature,cisplatin solutions at low,medium and high prepared concentrations(0.06,0.09,0.12 mg·mL-1)were mixed with the same volume of injection solutions of pantoprazole sodium,esomeprazole sodium,omeprazole sodium,rabeprazole sodium,lansoprazole sodium and ilaprazole sodium infusion,respectively.The changes of appearance,Tyndall effect,pH value,turbidity,the number of insoluble particles and UV absorbance of the admixtures were investigated within 8 h.Results The admixtures of cisplatin with pantoprazole sodium,esomeprazole,omeprazole sodium and rabeprazole sodium were clear and transparent within 8 h,and the change of pH value,turbidity changes,insoluble particles,UV absorbance value changes met the requirements.The combination of low concentration cisplatin and lansoprazole sodium was physically compatible and stable within 8 h.The number of insoluble particles in medium did not meet the requirements when high concentration cisplatin combined with lansoprazole sodium.All the indexes did not meet the requirements when cisplatin were combined with ilaprazole sodium.Conclusions Low concentration cisplatin is compatible with Lansoprazole sodium within 4 h at room temperature.Low,medium and high concentrations of cisplatin were compatible with pantoprazole sodium,esomeprazole sodium,omeprazole sodium and rabeprazole sodium within 8 h.High concentrations of cisplatin is incompatible with lansoprazole sodium.Cisplatin with low,medium and high concentrations are incompatible with iprrazole sodium.

Public health is a public service that is related to the health of the general public in a country or region.This article traces back to 1911-2023 and summarizes the major public health events during multiple periods,inclu-ding the beginning of public health during the Yale period,the initial establishment of Xiangya,and the establish-ment of the Faculty of Health of Hunan Medical College.It is the first systematic compilation of the history of Xiangya public health discipline.The milestones in the history of Xiangya public health discipline are as follows:(1)Dr.Yan Fuqing was the founder of health and public health around the establishment of Xiangya,and is the first person to propose the term'public health'.(2)The course of Health and Public Health in Xiangya began in 1916 and was offered in the academic year of 1918-1919.(3)Until the establishment of the Faculty of Health in 1975,the course of Health and Public Health was compulsory for Xiangya students.(4)In 1988,the Faculty of Health was renamed as the Faculty of Preventive Medicine,and the Institute of Preventive Medicine was established;In 1995,it was renamed as the School of Public Health of Hunan Medical University.In April 2000,after the merger and es-tablishment of Central South University,it was renamed as the School of Public Health of Central South University;In 2015,it was renamed as Xiangya School of Public Health of Central South University.Xiangya Public Health has been involved in almost all major public health work in China since its beginning,adhering to the principle of preven-tion first,promoting and serving people's health.

Objective To optimize the batch dispensing parameters of dispensing robots to ensure the standardization and homogenization of finished infusion.Methods Five parameters for intelligent dispensing robots were optimized with orthogonal test including push and pull times,standing time,needle rotation speed,solvent volume and pulling angle,with the insoluble particles as the evaluation index.Four finished infusion solutions including pantoprazole sodium solution,esomeprazole sodium solution,omeprazole sodium solution and eplazole sodium solution prepared at room temperature for 0,2,4,6 and 8 h were compared in terms of appearance,pH,osmolality and number of insoluble particles;the amounts of drug residue in empty syringe bottles and the efficiency of batch dispensing of the four finished infusion solutions using dispensing robot and manual operation were observed.Results After optimization the batch dispensing parameters of the robot were set as 2 times(push and pull times),5 s(standing time),low speed(needle rotation speed),6 mL(solvent volume)and 90°(pulling angle).After 8 h of dispensing at room temperature,the eplazole sodium solution became light yellow and clarified,and the number of insoluble particles went beyond the prescribed value in Chinese Pharmacopoeia 2020;the remained three solutions were colorless and clarified at 0,2,4,6 and 8 h,and the number of insoluble particles complied with the requirements of Chinese Pharmacopoeia 2020;there were no significant changes in pH and osmolality at 0,2,4,6 and 8 h.The robot had less drug residue than manual operation,and the efficiency of two robots operated by one person was higher than that of one person manually or one robot by one person,and all the differences were statistically significant(P＜0.05).Conclusion The batch dispensing parameters optimized with orthogonal test contributes to the standardization and homogeneity of the finished solutions with decreased drug residue while increased batch dispensing efficiency.[Chinese Medical Equipment Journal,2024,45(2):35-40]