OBJECTIVES: To explore the efficacy of DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy for management of cancer pain and provide reference for its standardized clinical application. Methods and. RESULTS: Recommendations were formulated based on literature review and expert group discussion, and consensus was reached following expert consultation. The consensus recommendations are comprehensive, covering the entire treatment procedures from preoperative assessment and preparation, surgical operation process, postoperative management and traditional Chinese medicine treatment to individualized treatment planning. The study results showed that the treatment plans combining traditional Chinese with Western medicine effectively alleviated cancer pain, reduced the use of opioid drugs, and significantly improved the quality of life and enhanced immune function of the patients. Postoperative follow-up suggested good treatment tolerance among the patients without serious complications. CONCLUSIONS The formulated consensus is comprehensive and can provide reference for clinicians to use DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy. The combined treatment has a high clinical value with a good safety profile for management of cancer pain.
Humans ; Medicine, Chinese Traditional ; Cancer Pain/therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Drug Delivery Systems ; Pain Management/methods* ; China

Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis,pri-marily transmitted through respiratory droplets,and poses a significant global public health challenge.Despite the availability of vaccines and chemotherapy regimens,the emergence of drug resistance and high incidence rates continue to render the prevention and control situation severe.The intestinal mi-crobiota modulates host immunity through metabolites such as short-chain fatty acids,influencing macrophage function,T-cell differentiation,and inflammatory responses,thereby regulating tubercu-losis susceptibility,disease progression,and treatment responses.This review systematically summa-rized the role of intestinal microecology in immune regulation of tuberculosis and its potential applica-tion strategies,delved into the possible immune regulatory mechanisms,proposed that the interaction between intestinal microbiota and immune checkpoint inhibitors may serve as a warning for the clinical risk of tuberculosis reactivation,and analyzed the potential of intestinal microecology as a therapeutic target for tuberculosis.

Objective To explore the efficacy of DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy for management of cancer pain and provide reference for its standardized clinical application.Methods and Results Recommendations were formulated based on literature review and expert group discussion,and consensus was reached following expert consultation.The consensus recommendations are comprehensive,covering the entire treatment procedures from preoperative assessment and preparation,surgical operation process,postoperative management and traditional Chinese medicine treatment to individualized treatment planning.The study results showed that the treatment plans combining traditional Chinese with Western medicine effectively alleviated cancer pain,reduced the use of opioid drugs,and significantly improved the quality of life and enhanced immune function of the patients.Postoperative follow-up suggested good treatment tolerance among the patients without serious complications.Conclusion The formulated consensus is comprehensive and can provide reference for clinicians to use DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy.The combined treatment has a high clinical value with a good safety profile for management of cancer pain.

Objective:To evaluate the role of cancerous inhibitor of protein phosphatase 2A (CIP2A) in preoperative sleep deprivation (PSD)-induced aggravation of postoperative cognitive dysfunction (POCD) in aged mice.Methods:One hundred and ten healthy C57BL/6J mice of either sex, aged 18-20 months, weighing 29-35 g, were divided into 5 groups ( n=22 each) using a random number table method: sham operation group (S group), abdominal surgery group (O group), PSD + abdominal surgery group (D+ O group), CIP2A shRNA + abdominal surgery group (CS+ O group), and CIP2A shRNA+ PSD+ abdominal surgery group (CS+ D+ O group). At 14 days before surgery, control shRNA lentivirus was injected into the hippocampus in S, O and CS+ O groups, and CIP2A shRNA was injected into the hippocampus in D+ O and CS+ D+ O groups. PSD was carried out for 3 consecutive days prior to surgery. Cognitive function was assessed using the Morris water maze test at days 7-11 after surgery. The mice were sacrificed under deep anesthesia at day 3 after surgery, and hippocampal tissues were obtained to determine the expression of CIP2A, high mobility group box 1 (HMGB1), ionized calcium-binding adapter molecule 1 (Iba-1), alpha subunit of protein phosphatase 2A (PP2Aa), catalytic subunit of protein phosphatase 2A (PP2Ac), phosphorylated tau protein (p-tau) (S396), and p-tau (S404) (by Western blot), levels of reactive oxygen species (ROS), malondialdehyde (MDA), and superoxide dismutase (SOD), and count of Iba-1 positive cells in the hippocampal CA1 region (using immunofluorescence staining). Results:Compared with S group, the escape latency was significantly prolonged, the frequency of crossing the platform was reduced, duration of stay in the target quadrant was shortened, the expression of CIP2A, Iba-1 and HMGB1 was up-regulated, PP2Ac expression was down-regulated, levels of ROS and MDA and count of Iba-1 positive cells were increased, and the activity of SOD was decreased in O group ( P<0.05). Compared with O group, the escape latency was significantly prolonged, the frequency of crossing the platform was reduced, duration of stay in the target quadrant was shortened, the expression of CIP2A, Iba-1 and HMGB1 was up-regulated, PP2Ac expression was down-regulated, levels of ROS and MDA and count of Iba-1 positive cells were increased, and the activity of SOD was decreased in D+ O group, and the escape latency was significantly shortened, the frequency of crossing the platform was increased, duration of stay in the target quadrant was prolonged, the expression of CIP2A, Iba-1 and HMGB1 was down-regulated, PP2Ac expression was up-regulated, levels of ROS and MDA and count of Iba-1 positive cells were decreased, and the activity of SOD was increased in CS+ O group ( P<0.05). Compared with D+ O group, the escape latency was significantly shortened, the frequency of crossing the platform was increased, duration of stay in the target quadrant was prolonged, the expression of CIP2A, Iba-1 and HMGB1 was down-regulated, PP2Ac expression was up-regulated, levels of ROS and MDA and count of Iba-1 positive cells were decreased, and the activity of SOD was increased in CS+ D+ O group ( P<0.05). There was no significant difference in PP2Aa expression among the five groups ( P>0.05). Conclusions:The mechanism by which PSD aggravates POCD is related to up-regulating the expression of CIP2A and promoting oxidative stress responses, neuroinflammatory responses and phosphorylation of tau protein in aged mice.

Objective To investigate the current situation of emergency rescue patient retention in Jianyang People's Hospital and explore its causes.Methods A retrospective analysis was conducted on the data of 4 834 patients rescued in the emergency room of Jianyang People's Hospital in 2022.They were divided into retention group and non retention group based on whether the emergency detention time exceeded 6 hours.With detention as the dependent variable and factors that may lead to emergency detention as the independent variable,binary logistic regression method was applied to screen for factors related to emergency detention.Results The median retention time for emergency rescue patients was 4.84 hours,with 3 721 cases(76.98%)having a retention time≤6 hours and 1 113 cases(23.02%)having a retention time＞6 hours;the main influencing factors for emergency detention included age,visit time,visit season,admission method,involving two or more departments,diversion direction,and treatment compliance(P＜0.05).Conclusion Emergency patients aged≥41 years old,treated from 17:00 to＜08:00 the next day,visited in winter,admitted on their own,involving two or more departments,diverted to hospitalization,and with average or poor treatment compliance are prone to emergency detention.Therefore,the emergency department of the hospital should develop appropriate management measures based on the above factors to reduce emergency detention time.

Objective To investigate the current situation of emergency rescue patient retention in Jianyang People's Hospital and explore its causes.Methods A retrospective analysis was conducted on the data of 4 834 patients rescued in the emergency room of Jianyang People's Hospital in 2022.They were divided into retention group and non retention group based on whether the emergency detention time exceeded 6 hours.With detention as the dependent variable and factors that may lead to emergency detention as the independent variable,binary logistic regression method was applied to screen for factors related to emergency detention.Results The median retention time for emergency rescue patients was 4.84 hours,with 3 721 cases(76.98%)having a retention time≤6 hours and 1 113 cases(23.02%)having a retention time＞6 hours;the main influencing factors for emergency detention included age,visit time,visit season,admission method,involving two or more departments,diversion direction,and treatment compliance(P＜0.05).Conclusion Emergency patients aged≥41 years old,treated from 17:00 to＜08:00 the next day,visited in winter,admitted on their own,involving two or more departments,diverted to hospitalization,and with average or poor treatment compliance are prone to emergency detention.Therefore,the emergency department of the hospital should develop appropriate management measures based on the above factors to reduce emergency detention time.

Objective To investigate the current situation of emergency rescue patient retention in Jianyang People's Hospital and explore its causes.Methods A retrospective analysis was conducted on the data of 4 834 patients rescued in the emergency room of Jianyang People's Hospital in 2022.They were divided into retention group and non retention group based on whether the emergency detention time exceeded 6 hours.With detention as the dependent variable and factors that may lead to emergency detention as the independent variable,binary logistic regression method was applied to screen for factors related to emergency detention.Results The median retention time for emergency rescue patients was 4.84 hours,with 3 721 cases(76.98%)having a retention time≤6 hours and 1 113 cases(23.02%)having a retention time＞6 hours;the main influencing factors for emergency detention included age,visit time,visit season,admission method,involving two or more departments,diversion direction,and treatment compliance(P＜0.05).Conclusion Emergency patients aged≥41 years old,treated from 17:00 to＜08:00 the next day,visited in winter,admitted on their own,involving two or more departments,diverted to hospitalization,and with average or poor treatment compliance are prone to emergency detention.Therefore,the emergency department of the hospital should develop appropriate management measures based on the above factors to reduce emergency detention time.

Objective To investigate the current situation of emergency rescue patient retention in Jianyang People's Hospital and explore its causes.Methods A retrospective analysis was conducted on the data of 4 834 patients rescued in the emergency room of Jianyang People's Hospital in 2022.They were divided into retention group and non retention group based on whether the emergency detention time exceeded 6 hours.With detention as the dependent variable and factors that may lead to emergency detention as the independent variable,binary logistic regression method was applied to screen for factors related to emergency detention.Results The median retention time for emergency rescue patients was 4.84 hours,with 3 721 cases(76.98%)having a retention time≤6 hours and 1 113 cases(23.02%)having a retention time＞6 hours;the main influencing factors for emergency detention included age,visit time,visit season,admission method,involving two or more departments,diversion direction,and treatment compliance(P＜0.05).Conclusion Emergency patients aged≥41 years old,treated from 17:00 to＜08:00 the next day,visited in winter,admitted on their own,involving two or more departments,diverted to hospitalization,and with average or poor treatment compliance are prone to emergency detention.Therefore,the emergency department of the hospital should develop appropriate management measures based on the above factors to reduce emergency detention time.

Objective To investigate the current situation of emergency rescue patient retention in Jianyang People's Hospital and explore its causes.Methods A retrospective analysis was conducted on the data of 4 834 patients rescued in the emergency room of Jianyang People's Hospital in 2022.They were divided into retention group and non retention group based on whether the emergency detention time exceeded 6 hours.With detention as the dependent variable and factors that may lead to emergency detention as the independent variable,binary logistic regression method was applied to screen for factors related to emergency detention.Results The median retention time for emergency rescue patients was 4.84 hours,with 3 721 cases(76.98%)having a retention time≤6 hours and 1 113 cases(23.02%)having a retention time＞6 hours;the main influencing factors for emergency detention included age,visit time,visit season,admission method,involving two or more departments,diversion direction,and treatment compliance(P＜0.05).Conclusion Emergency patients aged≥41 years old,treated from 17:00 to＜08:00 the next day,visited in winter,admitted on their own,involving two or more departments,diverted to hospitalization,and with average or poor treatment compliance are prone to emergency detention.Therefore,the emergency department of the hospital should develop appropriate management measures based on the above factors to reduce emergency detention time.

Objective To investigate the effect and mechanism of Yiguan Decoction(YGJD)on the efficacy of M1 bone marrow-derived macrophages(M1-BMDMs)in the treatment of rats with liver cirrhosis induced by 2-AAF/CCl4.Methods BMDMs were isolated and induced into M1-BMDMs by lipopolysaccharide.A total of 50 male Wistar rats were randomly divided into normal group with 5 rats and model group with 45 rats.The rats for modeling were given subcutaneous injection of 50%CCl4 twice a week.Since week 7,the rats for modeling were randomly divided into model group(M group),YGJD group,M1-BMDM group,M1-BMDM+YGJD group,and sorafenib(SORA)group,and they were given subcutaneous injection of 30%CCl4 to maintain the progression of liver cirrhosis and intragastric administration of 2-AAF.CCR2 inhibitors were added to the drinking water,and each group was given the corresponding intervention.Related samples were collected at week 9.The rats were observed in terms of serum liver function parameters,liver pathology,hydroxyproline(Hyp)content in liver tissue,hepatic stellate cell activation,hepatic fibrosis and inflammation factors,and the expression levels of molecules associated with the Wnt signaling pathway.A one-way analysis of variance was used for comparison of continuous data between multiple groups,and the least significant difference t-test was used for further comparison between two groups.Results Compared with the M group,the M1-BMDM+YGJD group had significant reductions in the serum levels of alanine aminotransferase,aspartate aminotransferase,and total bilirubin(TBil)(all P<0.05)and a significant increase in the content of albumin(Alb)(P<0.05),and compared with the M1-BMDM group,the M1-BMDM+YGJD group had a significant reduction in the serum level of TBil(P<0.05)and a significant increase in the serum level of Alb(P<0.05).Compared with the M1-BMDM group,the M1-BMDM+YGJD group had significant reductions in the expression levels of CD68 and TNF-α(P<0.05).Compared with the M1-BMDM group,the M1-BMDM+YGJD group had significant reductions in Hyp content and Sirius red positive area(P<0.05).As for the non-canonical Wnt signaling pathway molecules,compared with the M1-BMDM group,the M1-BMDM+YGJD group had significantly lower mRNA and protein expression levels of Wnt5a(P<0.05)and mRNA expression level of Fzd2(P<0.05),as well as significant reductions in the mRNA expression levels of Wnt4,Wnt5b,and Fzd3(P<0.05),while there were no significant changes in the mRNA expression levels of the canonical Wnt signaling pathway molecules β-catenin,LRP5,LRP6,Fzd5,and TCF.Conclusion YGJD can enhance the therapeutic effect of M1-BMDMs on rats with liver cirrhosis induced by 2-AAF/CCl4,possibly by inhibiting the non-canonical Wnt5a/Fzd2 signaling pathway,which provides new ideas for the synergistic effect of traditional Chinese medicine on M1-BMDMs in the treatment of liver cirrhosis.