OBJECTIVE To confirm trigger items for adverse drug reaction （ADR） induced by bevacizumab， to identify and analyze the occurrence of related ADR， and to establish a predictive model for severe adverse reaction （SAR） caused by this drug. METHODS Based on the global trigger tool （GTT） theory， and referencing the GTT White Paper， drug package inserts and relevant literature， trigger items for bevacizumab-related ADR were confirmed using a single-round Delphi method. Utilizing these established items， electronic medical records of relevant patients at Guilin People’s Hospital from January 2020 to September 2024 were actively screened via the China Hospital Pharmacovigilance System. Pharmacists then identified and tallied the occurrence of bevacizumab-induced ADR. Data from patients with any positive trigger item served as the study subjects （divided into training and test sets at a ratio of 7∶3）， candidate feature variables were selected from 39 related variables using the Boruta algorithm， and the multivariable Logistic regression analysis was performed with the occurrence of SAR as the dependent variable. Based on these candidate features， Logistic Regression， Extreme Gradient Boosting， Light Gradient Boosting Machine， Random Forest， and Categorical Boosting models were constructed. Model performance was evaluated using metrics including the area under the curve （AUC） of receiver operating characteristic curve and recall rate. The Shapley Additive exPlanations （SHAP） method was applied to analyze and interpret the contribution of each variable. A nomogram was constructed based on the optimal model. RESULTS A total of 38 trigger items for active monitoring of bevacizumab-related ADR were determined， comprising 17 laboratory indicators， 13 clinical manifestations， and 8 intervention measures. In total， 483 patients with positive trigger items were included， and 318 patients with bevacizumab-induced ADR were identified， including 83 SARs. The positive predictive values for the trigger items and cases were 43.57% （708/1 625） and 63.84% （318/483）， respectively. Bevacizumab-induced ADR involved 7 systems/organs， with the hematological system being the most frequently involved （64.15%）. The Boruta algorithm selected 7 vari ables： serum potassium， hematocrit， albumin-to-globulin ratio， prealbumin， hypertension history， age and red blood cell count. Multivariable Logistic regression showed that elevated serum potassium levels were associated with a decreased risk of bevacizumab-induced SAR （OR＝0.234， P ＝0.002）， while a history of hypertension （OR＝2.642， P ＝0.006） and increased age （OR＝1.040， P ＝0.025） were associated with an increased risk. The Logistic Regression model demonstrated superior performance with higher AUC， F1 score and recall rate （0.761， 0.447， 0.607）， compared to other models. SHAP evaluation results indicated that variables such as serum potassium， hematocrit， and age ranked highest in importance. CONCLUSIONS Totally 38 trigger entries have been successfully identified for active screening of bevacizumab-related ADR. Elevated serum potassium levels are a protective factor against bevacizumab-induced SAR， whereas the hypertension history and increased age are risk factors. The Logistic Regression model is the optimal predictive model.

Objective: To analyze the developmental trajectories of clustered health risk behaviors and their association with self-esteem and lonelinesss among junior high school students, so as to provide a reference for formulating comprehensive prevention and control measures of health risk behaviors among adolescents. Methods: In October 2023, 1 165 first year junior high school students from two schools of Jishou City in Hunan Province were selected by convenient sampling method for three follow up surveys (T1:October 2023; T2:April 2024; T3:October 2024). The Adolescent Health Risk Behavior Questionnaire, Rosenberg Self esteem Scale and Loneliness Scale were used to assess health risk behaviors, self esteem and loneliness, respectively. Latent growth curve modeling and latent growth mixture modeling were applied to analyze the developmental trajectories of clustered health risk behaviors among junior high school students. Logistic regression was used to analyze the association of the developmental trajectories of clustered health risk behaviors with self esteem and loneliness among junior high school students. Results: The overall developmental trajectories among junior high school students showed a declining trend (intercept=0.15, slope=-1.65, both P <0.05), with three heterogeneous categories:low risk improvement group ( n =862, 74.0%), moderate risk stable group ( n =260, 22.3%), and high risk deterioration group ( n =43, 3.7%). After adjusting the status of the left behind individuals，using the low risk improvement group as the reference category in multinomial Logistic regression analysis, results indicated that higher loneliness scores among junior high school students increased the risks of belonging to the moderate risk stable group ( OR=1.02, 95%CI =1.00- 1.04 ) and the high risk deterioration group ( OR=1.04, 95%CI =1.00-1.08), while higher self esteem scores reduced the risks of belonging to the moderate risk stable group ( OR=0.93, 95%CI =0.91-0.96) and the high risk deterioration group ( OR=0.88, 95%CI =0.83-0.94) (all P <0.05). Conclusions The overall trend of clustered health risk behaviors among junior high school students gradually improves, and the self esteem and loneliness are significant correlative factors. Targeted intervention measures should be developed for the junior high school students, with a focus on enhancing their self esteem and alleviating loneliness.

Ferroptosis, an iron-dependent form of programmed cell death characterized by lipid peroxidation, oxidative stress, and dysregulated iron metabolism, plays a significant role in the pathogenesis of glaucoma. This review systematically summarizes the fundamental mechanisms of ferroptosis, the involvement of oxidative stress and ferroptosis in glaucoma, the relationship between ferroptosis and glaucomatous neurodegeneration, and the potential therapeutic strategies targeting ferroptosis in glaucoma. Studies have shown that ferroptosis-regulating factors play a crucial role in mitigating oxidative damage and preserving cellular function. However, the complexity of their regulatory mechanisms not only hinders a comprehensive understanding of their roles but also impedes clinical translation. Although ferroptosis inhibitors have demonstrated promising neuroprotective effects in animal models, their clinical application remains challenged by issues such as drug safety and target specificity. Therefore, the development of more targeted and low-toxicity therapeutic strategies is essential to advance personalized and precise treatment for glaucoma.

Objective To analyze the clinical characteristics of recipients with interstitial lung disease (ILD) who underwent second lung transplantation and summarize the diagnostic and therapeutic experience. Methods A retrospective analysis was conducted on the clinical data of 14 patients who underwent first and second lung transplants for ILD at the First Affiliated Hospital of Guangzhou Medical University from January 2015 to December 2024. The preoperative conditions, intraoperative events, postoperative treatments and prognoses of the first and second lung transplantation were compared, and the postoperative survival of ILD patients after the second lung transplantation was analyzed. Results Among the 14 recipients of the second lung transplant, 13 underwent the procedure due to chronic lung allograft dysfunction, and 1 due to airway complications. The median interval time from the first to the second lung transplant was 32 (2, 80) months. Before the second transplantation, 2 recipients required endotracheal intubation and mechanical ventilation, and 2 required endotracheal intubation, mechanical ventilation, and extracorporeal membrane oxygenation (ECMO) support. The surgical time for the second lung transplantation was longer than that for the first, with increased intraoperative red blood cell and plasma transfusion volumes, the proportion of ECMO support during the second lung transplantation was higher than that during the first (all P<0.05). However, the cold ischemia time for one-sided lung transplant completion in the first lung transplant was similar to that in the second lung transplantation (P>0.05). The median follow-up time after the second lung transplantation was 32 (1, 63) months. The 1-month, 6-month and 1-year survival rates after the second lung transplantation were 79%, 57% and 50%, respectively, with causes of death being infection, multiple organ failure and gastrointestinal bleeding. Conclusions For ILD patients undergoing second lung transplantation after the first lung transplantation, the second lung transplantation is more challenging, with longer surgical time and higher intraoperative blood loss. It requires higher surgical skills and perioperative management. Non-emergency second transplantation may still achieve good results.

Ischemic stroke (IS) is a prevalent neurological disorder often resulting in significant disability or mortality. Resveratrol, extracted from Polygonum cuspidatum Sieb. et Zucc. (commonly known as Japanese knotweed), has been recognized for its potent neuroprotective properties. However, the neuroprotective efficacy of its derivative, (E)-4-(3,5-dimethoxystyryl) quinoline (RV02), against ischemic stroke remains inadequately explored. This study aimed to evaluate the protective effects of RV02 on neuronal ischemia-reperfusion injury both in vitro and in vivo. The research utilized an animal model of middle cerebral artery occlusion/reperfusion and SH-SY5Y cells subjected to oxygen-glucose deprivation and reperfusion to simulate ischemic conditions. The findings demonstrate that RV02 attenuates neuronal mitochondrial damage and scavenges reactive oxygen species (ROS) through mitophagy activation. Furthermore, Parkin knockdown was found to abolish RV02's ability to activate mitophagy and neuroprotection in vitro. These results suggest that RV02 shows promise as a neuroprotective agent, with the activation of Parkin-mediated mitophagy potentially serving as the primary mechanism underlying its neuroprotective effects.
Animals ; Ubiquitin-Protein Ligases/genetics* ; Mitophagy/drug effects* ; Resveratrol/analogs & derivatives* ; Neuroprotective Agents/pharmacology* ; Humans ; Neurons/metabolism* ; Reactive Oxygen Species/metabolism* ; Ischemic Stroke/genetics* ; Male ; Quinolines/pharmacology* ; Mice ; Fallopia japonica/chemistry* ; Mitochondria/metabolism* ; Reperfusion Injury/metabolism* ; Rats ; Mice, Inbred C57BL ; Disease Models, Animal

Conventional cancer therapies, such as radiotherapy and chemotherapy, often damage normal cells and may induce new tumors. Oncolytic viruses (OVs) selectively target tumor cells while sparing normal cells. Most OVs used in clinical trials have been genetically engineered to enhance their ability to target tumor cells and activate immune responses. To develop a specific OV-based approach for treating cervical cancer, this study constructed an oncolytic adenovirus that delivered a base editor targeting oncogenes to achieve efficient killing of tumor cells through inhibiting tumor growth and directly lysing tumor cells. We utilized the human telomerase reverse transcriptase (TERT) promoter to drive the expression of adenovirus early region 1A (E1A) and successfully constructed the P-hTERT-E1A-GFP vector, which was validated for its activity in cervical cancer cells. Given the critical role of the MYC oncogene in the research of oncology, identifying efficient editing sites for the MYC oncogene is a key step in this study.Three MYC-targeting gRNAs were engineered and co-delivered with ABE8e base editor plasmids into HEK293T cells. Following puromycin selection, Sanger sequencing demonstrated differential editing efficiencies: MYC-1 (43%), MYC-2 (25%), and MYC-3 (35%), identifying MYC-1 as the most efficient editing locus. By constructing the P-ABEs-hTERT-E1A-GFP and P-MYC gRNA-hTERT-E1A-GFP vectors, we successfully packaged the virus and confirmed its specificity and efficacy. The experimental results demonstrate that this novel oncolytic adenovirus effectively inhibits the growth of HeLa cells in vitro, providing new experimental evidence and potential strategies for treating cervical cancer based on the HeLa cell model.
Humans ; Uterine Cervical Neoplasms/pathology* ; Oncolytic Viruses/genetics* ; Female ; HEK293 Cells ; Oncolytic Virotherapy/methods* ; Adenoviridae/genetics* ; Gene Editing/methods* ; Telomerase/genetics* ; Adenovirus E1A Proteins/genetics* ; Genetic Vectors/genetics* ; HeLa Cells

Objective To explore the perioperative safety and prognostic factors of sequential hepatectomy after conversion therapy using vascular interventional therapy(including transarterial chemoembolization and hepatic arterial infusion chemotherapy)combined with tyrosine kinase inhibitors(TKI)and programmed death-1(PD-1)inhibitors in patients with initially unresectable hepatocellular carcinoma.Methods The clinical data of 106 eligible HCC patients treated in Tumor Hospital Affiliated to Guangxi Medical University from Nov.2019 to Apr.2024 were retrospectively analyzed.The perioperative parameters and postoperative pathological outcomes were described in detail,and factors influencing prognosis were analyzed.Results The median operative time for hepatectomy after conversion therapy was 240 min,with a median blood loss of 200 mL.Intraoperative blood transfusion was required in 24(22.6％)patients.Postoperative adverse reactions occurred in 49.1％(52/106)of patients,with liver failure being the most common adverse reactions(23 patients,21.7％).One(0.9％)patient died during the perioperative period,while the remaining 105 patients were followed up for a median duration of 14.7 months,during which 49(46.2％)patients experienced recurrence.Among them,39(36.8％)cases experienced early recurrence(within 1 year),and 33(31.1％)cases had intrahepatic recurrence.Thirteen(12.3％)patients died during follow-up.The median recurrence-free survival(RFS)was 15.7 months,with 1-year and 2-year RFS rates being 56.9％and 40.3％,respectively.The median overall survival(OS)was not reached,with 1-year and 2-year OS rates being 94.2％and 85.3％,respectively.Multivariate Cox regression analysis demonstrated that achieving complete pathological response(hazard ratio[HR]=0.410,95％confidence interval[CI]0.172-0.980,P=0.045),presence of microvascular invasion(HR=2.423,95％CI 1.269-4.625,P=0.007),satellite nodules(HR=1.916,95％CI 1.014-3.620,P=0.045),and multiple tumors(HR=1.818,95％CI 1.012-3.241,P=0.046)were independent factors associated with postoperative recurrence.Conclusion For patients with initially unresectable hepatocellular carcinoma,vascular interventional therapy combined with TKI and PD-1 inhibitors followed by sequential hepatectomy may be a feasible treatment strategy,with manageable adverse reactions and promising efficacy.

OBJECTIVE In the process of drug dispensing, using computer vision technology to identify drugs is vulnerable to the influence of lighting, angle, packaging and other factors, which will produce large identification errors. Therefore, this paper proposes an object detection algorithm for drug appearance recognition(YOLOv4-GhostNet-CMB). METHODS Firstly, the algorithm redesigned the backbone feature extraction network in YOLOv4 by using GhostNet. Secondly, the CA attention model was brought into the Ghost module, aggregate features along horizontal and vertical directions to enhance the precise positioning of drugs. Finally, Bi-FPN feature pyramid structure was introduced to connect with the new backbone, and added a feature graph output which could enhance feature extraction and improved the detection accuracy of drugs. RESULTS The experimental results show that the average detection accuracy of YOLOv4-GhostNet-CMB algorithm reached 92.24%, which was a significant improvement of 4.49% compared with YOLOv4 algorithm in term of detection accuracy. CONCLUSION The model size is only 150 MB, nd this algorithm can effectively identify drugs.

Objective: To explore the causal relationship between adolescent school connectedness and the co-occurrence with health risk behaviors among junior high school students, so as to provide the reference for reducing the occurrence of adolescents health risk behaviors among junior high school students. Methods: A total of 924 students from two junior high schools in Jishou City were selected by the convenience sampling and cluster sampling methods, and two follow up surveys were conducted at 6 month intervals in April (T1) and October (T2) of 2023 using the Adolescent Health Risk Behavior Questionnaire and the School Connection Scale. The scores of the co-occurrence of school connectedness and health risk behaviors among junior high school students were compared by different survey periods and genders using the t-test, and cross lagged analyses were performed using Mplus 8.3 software. Results: School connectedness scores among junior high school students in T1 and T2 surveys were (38.86±7.46) (37.87± 7.71 ) and co-occurrence of health risk behaviors scores were (1.64±0.68) (1.83±0.53), respectively, and the differences between the scores of the 2 surveys were statistically significant ( t=4.24, -4.14, P <0.05). The correlation between school connectedness and co-occurrence of health risk behaviors were statistically significant in both surveys ( r =-0.46 to -0.33, P <0.05). Cross lagged analyses showed that school connectedness in T1 negatively predicted the co-occurrence of health risk behaviors in T2 ( β =-0.08), and the co-occurrence of health risk behaviors in T1 negatively predicted the school connectedness in T2 ( β =-0.15) ( P <0.05). Conclusions There is a longitudinal causal relationship between school connectedness and co-occurrence of health risk behaviors among junior high school students. School connectedness should be improved through various ways to reduce the co-occurrence of health risk behaviors.

OBJECTIVE To establish the quality standard of Triadica cochinchinensis and to perform the acute toxicity study. METHODS Appearance properties, powder microscopic identification, and thin-layer chromatography(TLC) identification were researched. The specific chromatogram was established by HPLC. The content of cadmium(Cd), lead(Pb), arsenic(As), copper(Cu), and mercury(Hg) was determined by inductively coupled plasma-mass spectrometry(ICP-MS). Acute toxicity was studied by maximum dose. RESULTS The outer skin of herbs was dark brown, and the inner surface was light yellow brown and fibrous. Besides, crystal sheath fiber was common, and calcium oxalate clusters arranges in rows. In the TLC diagram of the test product, the fluorescent spots of the same color were displayed at the corresponding position of the control product(scopoletin, isofraxidin). Five common peaks were calibrated in the characteristic map and the three characteristic peaks(scopoletin, isofraxidin, dimethylfraxetin) were recognized. The content of the measured heavy metal elements was lower than the national limit standard. The linear correlation coefficient was R2 > 0.999. The precision, stability, repetitive RSD were < 10%. The average recovery rate of the added sample was 80%−120%, and the RSD was < 10%. The maximum dose of the acute toxicity test was 184.09 g·kg−1. The 14 d internal body mass, food intake, organ-body ratios, the serum glutamic pyruvic transaminase, glutamic oxaloacetic transaminase, blood urea nitrogen, and creatinine were not significantly different by comparing with the normal controls. Therefore, no significant toxicity was observed. CONCLUSION The established standard can provide a reference for evaluating the quality of Triadica cochinchinensis. The heavy metal content of ten batches of medicinal materials is within the safe range. Acute toxicity test show that there is no obvious significant adverse teactions after oral administration, and the safe dose range is large, which can provide a reference for the subsequent development and utilization.