Objective:To discuss the effect of sericin on the phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt)/nuclear factor-κB(NF-κB)signaling pathway and apoptosis in the streptozotocin(STZ)-damaged INS-1 cells,and to clarify its mechanism.Methods:The INS-1 cells were cultured with complete medium containing 0,0.1,0.3,1.0,3.0,and 10.0 μmol·L-1 Akt1 inhibitor A-674563,10 mmol·L-1 STZ,and 600 mg·L-1 sericin,and divided into 0,0.1,0.3,1.0,3.0,and 10.0 μmol·L-1 A-674563 groups,and the control group(complete medium without drugs)was set up.Cell counting kit-8(CCK-8)method was used to detect the survival rates of the INS-1 cells,and the half-maximal inhibitory concentration(IC50)value was calculated to determine the optimal inhibitory concentration of A-674563,which was further verified by Western blotting method.The INS-1 cells were divided into normal control group(complete medium),model group(10 mmol·L-1 STZ+complete medium),and low,medium,and high doses of sericin groups(10 mmol·L-1 STZ+150 mg·L-1 sericin+complete medium,10 mmol·L-1 STZ+300 mg·L-1 sericin+complete medium,and 10 mmol·L-1 STZ+600 mg·L-1 sericin+complete medium).CCK-8 method was used to detect the survival rates of the INS-1 cells in various groups to determine the optimal concentration of sericin.Additionally,the INS-1 cells were divided into normal control group(complete medium),model group(10 mmol·L-1 STZ+complete medium),sericin group(10 mmol·L-1 STZ+600 mg·L-1 sericin+complete medium),and A-674563 group(10 mmol·L-1 STZ+600 mg·L-1 sericin+0.3 μmol·L-1 A-674563+complete medium).Flow cytometry was used to detect the apoptotic rates of the INS-1 cells in various groups;real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the expression levels of Akt1,NF-κB,tumor necrosis factor-α(TNF-α),and interleukin-6(IL-6)mRNA in the INS-1 cells in various groups;Western blotting method was used to detect the expression levels of phosphorylated Akt1(p-Akt1)and NF-κB proteins in the INS-1 cells in various groups;enzyme linked immunosorbent assay(ELISA)method was used to detect the levels of TNF-α and IL-6 in the INS-1 cells in various groups.Results:The survival rates of the INS-1 cells in control group was 100.00%±0.00%;in 0,0.1,0.3,1.0,3.0,and 10.0 μmol·L-1 A-674563+10 mmol·L-1 STZ+600 mg·L-1 sericin+complete medium groups,which were 82.50%±2.28%,69.47%±1.94%,51.51%±1.74%,38.94%±1.57%,24.79%±1.14%,and 19.85%±1.03%,respectively.The IC?? value of A-674563 for INS-1 cells was 0.3 μmol·L-1,and 0.3 μmol·L-1 A-674563 was selected for subsequent experiments.Compared with 0 μmol·L-1 A-674563,the expression level of p-Akt1 protein in the INS-1 cells after treated with 0.3 μmol·L-1 A-674563+10 mmol·L-1 STZ+600 mg·L-1 sericin+complete medium was significantly decreased(P<0.05).The CCK-8 results showed that compared with normal control group,the survival rate of the INS-1 cells in model group was significantly decreased(P<0.05);compared with model group,the survival rates of the INS-1 cells in low,medium,and high doses of sericin groups were significantly increased(P<0.05);compared with low and medium doses of sericin groups,the survival rate of the INS-1 cells in high dose of sericin group was significantly increased(P<0.05).Thus,600 mg·L-1 sericin was selected for subsequent experiments.The CCK-8 results showed that compared with normal control group,the survival rate of the INS-1 cells in model group was significantly decreased(P<0.05);compared with model group,the survival rate of the INS-1 cells in sericin group was significantly increased(P<0.05);compared with sericin group,the survival rate of the INS-1 cells in A-674563 group was significantly decreased(P<0.05).The flow cytometry results showed that compared with normal control group,the apoptotic rate of the INS-1 cells in model group was significantly increased(P<0.05);compared with model group,the apoptotic rate of the INS-1 cells in sericin group was significantly decreased(P<0.05);compared with sericin group,the apoptotic rate of the INS-1 cells in A-674563 group was significantly increased(P<0.05).The RT-qPCR results showed that compared with normal control group,the expression level of Akt1 mRNA in the INS-1 cells in model group was significantly decreased(P<0.05);compared with model group,the expression levels of Akt1 mRNA in the INS-1 cells in low,medium,and high doses of sericin groups were significantly increased(P<0.05);compared with low and medium doses of sericin groups,the expression level of Akt1 mRNA in the INS-1 cells in high dose of sericin group was significantly increased(P<0.05).Compared with normal control group,the expression levels of NF-κB,TNF-α,and IL-6 mRNA in the INS-1 cells in model group were significantly increased(P<0.05);compared with model group,the expression levels of NF-κB,TNF-α,and IL-6 mRNA in the INS-1 cells in sericin group were significantly decreased(P<0.05);compared with sericin group,the expression level of NF-κB mRNA in the INS-1 cells in A-674563 group was significantly increased(P<0.05).The Western blotting results showed that compared with normal control group,the expression level of p-Akt1 protein in the INS-1 cells in model group was significantly decreased(P<0.05);compared with model group,the expression levels of p-Akt1 protein in the INS-1 cells in low,medium,and high doses of sericin groups were significantly increased(P<0.05);compared with low and medium doses of sericin groups,the expression level of p-Akt1 protein in the INS-1 cells in high dose of sericin group was significantly increased(P<0.05).Compared with normal control group,the expression level of NF-κB protein in the INS-1 cells in model group was significantly increased(P<0.05);compared with model group,the expression level of NF-κB protein in the INS-1 cells in sericin group was significantly decreased(P<0.05);compared with sericin group,the expression level of NF-κB protein in the INS-1 cells in A-674563 group was significantly increased(P<0.05).The ELISA results showed that compared with normal control group,the levels of TNF-α and IL-6 in the INS-1 cells in model group were significantly increased(P<0.05);compared with model group,the levels of TNF-α and IL-6 in the INS-1 cells in sericin group were significantly decreased(P<0.05);compared with sericin group,the levels of TNF-α and IL-6 in the INS-1 cells in A-674563 group were significantly increased(P<0.05).Conclusion:Sericin alleviates the PI3K/Akt/NF-κB signaling pathway-mediated inflammatory response and apoptosis by targeting Akt1,exerting a protective effect against STZ-induced damage in INS-1 cells.

Objective:To analyze the clinical data of patients with severe fever with thrombocytopenia syndrome（SFTS）in Linyi city of Shandong province from 2023 to 2024，analyze the related factors affecting the prognosis，improve the understanding of the disease and reduce its mortality..Methods:The data of 36 SFTS patients diagnosed and admitted to Linyi People's Hospital from May 2023 to August 2024 were retrospectively analyzed. According to the clinical outcomes of the patients，they were divided into a survival group（n=30）and a death group（n=6）. The clinical data and laboratory test results of the two groups were analyzed to evaluate the risk factors related to prognosis.Results:The median age in the death group was 68.33 years old，and that in the survival group was 63.96 years old，with no statistically significant difference. All patients had fever，22 had fatigue and poor appetite，and 21 had muscle aches and other systemic symptoms. some were prone to general symptoms such as fatigue，poor appetite，and muscle soreness. All patients in the death group had neurological symptoms such as headache and consciousness disorders. The levels of serum potassium，CRP，PCT，IL-6，ALT，AST，CK，CK-MB，LDH，α-HBDH，APTT，D-D，and viral load in the death group were higher than those in the survival group，with statistically significant differences（ t=-3.344， P=0.002； Z=-2.195， P=0.028； Z=-3.648， P=0.000； Z=-3.641， P=0.000； Z=-2.241， P=0.025； Z=-2.288， P=0.022； Z=-2.427， P=0.015； Z=-2.007， P=0.045； Z=-3.127， P=0.002； Z=-2.404， P=0.016； Z=-2.755， P=0.006； Z=-3.081， P=0.002； P<0.05）. The platelet count in the death group was lower than that in the survival group，and the difference was statistically significant（ Z=-3.292， P=0.001， P<0.05）. Multivariate Logistic regression analysis showed that patients with increased AST，CK，IL-6，APTT，D-dimer and decreased platelet count had an increased risk of death. Fungal infections occurred in 15 cases，including 5 cases of Candida albicans，3 cases of Candida parapsilosis，and 7 cases of Aspergillus. All patients in the death group had fungal infections，all of whom had Aspergillus infections. Conclusion:SFTS patients often have fever，fatigue，and muscle soreness，and critically ill patients are prone to neurological symptoms. Patients with elevated AST，CK，IL-6，APTT，D-D，viral load，and decreased platelet count in the course of the disease often indicate poor prognosis and should be closely monitored. In addition，critically ill patients are prone to fungal infection.

Objective To analyze the development of nuclear medicine services in Hunan Province and to assess internal radiation doses among the nuclear medicine workers (NMWs) involved in iodine-131 radionuclide therapy. Methods Based on a survey of nuclear medicine institutions in Hunan Province, a total of 61 NMWs from seven hospitals providing iodine-131 therapy for thyroid cancer were selected as the study subjects by convenience sampling method. Thyroidal iodine-131 activity was measured using a portable gamma spectrometer to estimate internal dose and total annual effective dose. Results A total of 47 nuclear medicine institutions were reported in Hunan Province by 2023, most of which were public and tertiary hospitals, accounting for 38. Iodine-131 therapy was performed in 30 institutions, including nine for thyroid cancer. A total of nine participants had detectable thyroidal iodine-131 activity among 61 workers involved in iodine-131 thyroid cancer treatment, with the detection rate of 14.8%. Their internal radiation annual committed effective doses ranged from 0.100 to 1.584 mSv, with a mean of 0.499 mSv and median of 0.426 mSv. Except for one cleaner, the remaining eight physicians and nurses had the total annual effective doses ranging from 0.311 to 3.007 mSv, with a mean of 1.305 mSv, all below the annual dose limit of 20.000 mSv among radiation workers specified in national standard. Conclusion Internal exposure to iodine-131 among the NMWs should not be neglected. Standardized procedures and strengthened internal dose monitoring are recommended.

Complex liver resection (CLR) is a collective term for surgical procedures addre-ssing complex invasion of intrahepatic vasculobiliary structures that cannot be radically resected through conventional methods. The ex vivo liver resection and autotransplantation (ELRA) and its modified techniques have significantly enhanced the technical feasibility of CLR implementation. In recent years, advancements in modified ELRA techniques and derivative procedures, including conversion resection, in-situ hypothermic perfusion, and auxiliary liver transplantation, have further diversified CLR methodologies, offering more personalized treatment options for CLR candidates. Given the complexity of such cases and substantial variations in surgical approach selection, improving procedural safety and scalability remains a critical challenge in CLR practice. The authors review the current application of modified techniques based on ELRA in CLR, evaluate the clinical significance based on institutional experiences, and propose future directions and individual selection for advancing the safe implementation of CLR.

Complex liver resection (CLR) is a collective term for surgical procedures addre-ssing complex invasion of intrahepatic vasculobiliary structures that cannot be radically resected through conventional methods. The ex vivo liver resection and autotransplantation (ELRA) and its modified techniques have significantly enhanced the technical feasibility of CLR implementation. In recent years, advancements in modified ELRA techniques and derivative procedures, including conversion resection, in-situ hypothermic perfusion, and auxiliary liver transplantation, have further diversified CLR methodologies, offering more personalized treatment options for CLR candidates. Given the complexity of such cases and substantial variations in surgical approach selection, improving procedural safety and scalability remains a critical challenge in CLR practice. The authors review the current application of modified techniques based on ELRA in CLR, evaluate the clinical significance based on institutional experiences, and propose future directions and individual selection for advancing the safe implementation of CLR.

Objective:To analyze the clinical data of patients with severe fever with thrombocytopenia syndrome（SFTS）in Linyi city of Shandong province from 2023 to 2024，analyze the related factors affecting the prognosis，improve the understanding of the disease and reduce its mortality..Methods:The data of 36 SFTS patients diagnosed and admitted to Linyi People's Hospital from May 2023 to August 2024 were retrospectively analyzed. According to the clinical outcomes of the patients，they were divided into a survival group（n=30）and a death group（n=6）. The clinical data and laboratory test results of the two groups were analyzed to evaluate the risk factors related to prognosis.Results:The median age in the death group was 68.33 years old，and that in the survival group was 63.96 years old，with no statistically significant difference. All patients had fever，22 had fatigue and poor appetite，and 21 had muscle aches and other systemic symptoms. some were prone to general symptoms such as fatigue，poor appetite，and muscle soreness. All patients in the death group had neurological symptoms such as headache and consciousness disorders. The levels of serum potassium，CRP，PCT，IL-6，ALT，AST，CK，CK-MB，LDH，α-HBDH，APTT，D-D，and viral load in the death group were higher than those in the survival group，with statistically significant differences（ t=-3.344， P=0.002； Z=-2.195， P=0.028； Z=-3.648， P=0.000； Z=-3.641， P=0.000； Z=-2.241， P=0.025； Z=-2.288， P=0.022； Z=-2.427， P=0.015； Z=-2.007， P=0.045； Z=-3.127， P=0.002； Z=-2.404， P=0.016； Z=-2.755， P=0.006； Z=-3.081， P=0.002； P<0.05）. The platelet count in the death group was lower than that in the survival group，and the difference was statistically significant（ Z=-3.292， P=0.001， P<0.05）. Multivariate Logistic regression analysis showed that patients with increased AST，CK，IL-6，APTT，D-dimer and decreased platelet count had an increased risk of death. Fungal infections occurred in 15 cases，including 5 cases of Candida albicans，3 cases of Candida parapsilosis，and 7 cases of Aspergillus. All patients in the death group had fungal infections，all of whom had Aspergillus infections. Conclusion:SFTS patients often have fever，fatigue，and muscle soreness，and critically ill patients are prone to neurological symptoms. Patients with elevated AST，CK，IL-6，APTT，D-D，viral load，and decreased platelet count in the course of the disease often indicate poor prognosis and should be closely monitored. In addition，critically ill patients are prone to fungal infection.

Objective:To investigate the clinical efficacy of individualised microvascular decompression (MVD) for trigeminal neuralgia (TN), so as to provide individualised treatment strategies and new thoughts for treatment.Methods:Clinical data of 46 patients who had TN and treated in the Department of Neurosurgery at the First Affiliated Hospital of Anhui Medical University from January 2021 to September 2023 were retrospectively studied. The study consisted of 19 males and 27 females, with an average age of morbidity at (58.3 ± 9.0) years old. Preoperative pain ratings and surgical outcomes were evaluated using the Barrow Neurological Institute (BNI) pain rating scale, and of which 27 patients were rated at BNI grade IV and 19 at grade V before surgery. A posterior trans-sigmoid sinus approach was applied in surgery on all patients, which could be performed in various ways depending on the vascular conditions identified during surgery. Ten patients were treated with microsurgery, 12 with endoscopic surgery and 24 with combined endoscopic surgery and microsurgery. After having identified the responsible vessel(s), a vascular decompression for the affected trigeminal nerve was performed and the nerve decompression was achieved by a polyester pad. Long-term postoperative follow-ups were conducted via telephone interviews or outpatient visits.Results:A total of 46 patients received the microvascular decompression surgery. Among them, 43 cases (93.5%) achieved immediate and complete pain relief of BNI grade I after surgery, and 3 cases (6.5%) achieved partial pain relief of BNI grade Ⅱ. Four patients developed facial numbness and sensory reduction, 2 developed facial paralysis (of House-Brackmann grade Ⅱ of 1 patient and grade Ⅲ of the other), 8 developed pneumocephalus, 4 developed postoperative fever, and 2 developed subcutaneous effusion. After treatment, the pneumocephalus and fever were cured, subcutaneous effusion was disappeared in 1 patient, but remained in the other. The mean follow-up period for the 46 patients was 16.2 (1-33) months. During the follow-up, 2 of the 3 patients of BNI grade Ⅱ immediately after surgery had complete remission to BNI grade Ⅰ and the other had recurrence and aggravation at BNI grade Ⅳ.Conclusion:The complexity of the responsible vessels is one of the important factors to be considered in the microvascular decompression strategy for trigeminal neuralgia. An individualised surgical plan according to a specific vascular condition identified in the surgery, is a best possible or worthiness surgical strategy in the treatment for a TN.

Irinotecan (CPT11) chemotherapy-induced diarrhea affects a substantial cancer population due to β-glucuronidase (Gus) converting 10-O-glucuronyl-7-ethyl-10-hydroxycamptothecin (SN38G) to toxic 7-ethyl-10-hydroxycamptothecin (SN38). Existing interventions primarily address inflammation and Gus enzyme inhibition, neglecting epithelial repair and Gus-expressing bacteria. Herein, we discovered that dehydrodiisoeugenol (DDIE), isolated from nutmeg, alleviates CPT11-induced intestinal mucositis alongside a synergistic antitumor effect with CPT11 by improving weight loss, colon shortening, epithelial barrier dysfunction, goblet cells and intestinal stem cells (ISCs) loss, and wound-healing. The anti-mucositis effect of DDIE is gut microbiota-dependent. Analysis of microbiome profiling data from clinical patients and CPT11-induced mucositis mice reveals a strong correlation between CPT11 chemotoxicity and Gus-expressing bacteria, particularly Enterococcus faecalis (E. faecalis). DDIE counters CPT11-induced augmentation of E. faecalis, leading to decreased intestinal Gus and SN38 levels. The Partial Least Squares Path Model (PLS-PM) algorithm initially links E. faecalis to dysregulated epithelial renovation. This is further validated in a 3D intestinal organoid model, in which both SN38 and E. faecalis hinder the formation and differentiation of organoids. Interestingly, colonization of E. faecalis exacerbates CPT11-induced mucositis and disturbs epithelial differentiation. Our study unveils a microbiota-driven, epithelial reconstruction-mediated action of DDIE against mucositis, proposing the 'Gus bacteria-host-irinotecan axis' as a promising target for mitigating CPT11 chemotoxicity.

Angiostrongylus cantonensis is a food-borne zoonotic parasite, and human infection may cause eosinophilic meningitis. Non-coding RNAs (ncRNAs) may regulate physiological and pathological processes at multiple biological levels; however, there are few studies pertaining to the regulatory role of ncRNAs in A. cantonensis infection. Based on publications retrieved from PubMed, Wanfang Data and CNKI, the regulatory role of ncRNAs in A. cantonensis infections mainly includes immune responses, cell apoptosis and signaling transduction, and ncRNAs may serve as biomarkers for diagnosis of angiostrongyliasis. This review summarizes the main roles of ncRNAs in A. cantonensis infections and the underlying mechanisms, so as to provide insights into diagnosis and treatment of angiostrongyliasis.

Objective:To explore the clinical value of semi-ex vivo intestinal autotrans-plantation (IATx) for patients with mesenteric root regional tumors accompanied by vascular invasion.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 6 patients who underwent semi-ex vivo IATx in the Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital from September 2021 to December 2022 were collected. There were 4 males and 2 females, aged (47±21)years. Observation indicators: (1) surgical conditions; (2) postoperative conditions; (3) follow-up. Measurement data with normal distribution were represented by Mean± SD. Count data were represented by absolute numbers. Results:(1) Surgical conditions. All 6 patients completed semi-ex vivo IATx successfully. The operation time, warm ischemia time, cold ischemia time, volume of intraoperative blood transfusion were (10.2±2.1)hours, (2.3±1.6)minutes, (49.2±15.6)minutes, (707±263)mL. Of the 6 patients, 3 patients were intraoperatively perfused with cold UW solution, while the other 3 were not. (2) Postoperative conditions. Results of postoperative pathological examination of the 6 patients showed 4 cases of pancreatic ductal adenocarcinoma, 1 case of cholangiocarcinoma, and 1 case of mesenteric fibromatosis. All 6 cases had nega-tive surgical margins and the duration of postoperative hospital stay was (19±4)days. None of the patient had gastrointestinal bleeding or anastomotic leakage postoperatively, and the autotransplanted intestine functioned well. There was no perioperative death, and intravenous rehydration was not required after discharge. (3) Follow-up. All 6 patients were followed up for (12±5)months. Only 1 patient with mesenteric fibromatosis had recurrence in the 7th month postoperatively, while the remaining 5 patients showed no sign of recurrence or metastasis. There were 4 of 6 patients with chronic diarrhea. They were improved after oral loperamide, bifidobacterium and pancreatin capsules. All 6 patients survived.Conclusion:Semi-ex vivo IATx for the treatment of patients with mesenteric root regional tumors accompanied by vascular invasion is safe and feasible, which can achieve good short-term efficacy.