This study aimed to elucidate the protective effect and underlying mechanism of epigallocatechin gallate (EGCG) against high glucose-induced pancreatic β-cell developmental anomalies in zebrafish. Zebrafish embryos were exposed to 2 % glucose to induce abnormal pancreatic β-cell development and were pretreated with 10 μmol/L or 50 μmol/L EGCG. Mortality and body length were recorded; and the expression of key genes related to pancreatic β-cell development and function of pancreatic β-cells was detected by RT-PCR. The morphology of pancreatic β-cells in Tg(ins:mCherry) zebrafish was examined under a fluorescent microscope; and glucose levels, as well as the activities of superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase (CAT), and the levels of malondialdehyde (MDA) and reactive oxygen species (ROS), were measured using commercial kits. The results showed that high-glucose treatment led to an increased mortality rate and body length in zebrafish larvae, along with sustained downregulation in the expression of transcription factors regulating β-cell development. The expression of the insulin a gene (insa) initially increased and then decreased. High-glucose treatment also induced an increase in pancreatic fragmentation and hollow malformations, enlarged islet area, and elevated glucose levels in the body. Furthermore, it caused abnormal activities of SOD, GPx, and CAT enzymes, along with a significant rise in MDA and ROS content in zebrafish larvae. However, intervention with 50 μmol/L EGCG significantly reversed these abnormalities, restored normal β-cell morphology and function, and notably improved the oxidative stress status. In conclusion, EGCG significantly ameliorates high glucose-induced abnormal development of pancreatic β-cells in zebrafish, and its mechanism may be related to the improvement of oxidative stress and glucose levels in zebrafish.

Neuraxial labor analgesia effectively alleviates maternal pain and enhances pain control dur-ing delivery.However,breakthrough pain(BTP)following labor analgesia may occur in some parturients after neuraxial anesthesia,potentially prolonging labor progression,compromising maternal-fetal safety,and in-creasing the risk of cesarean delivery.Therefore,understanding and managing breakthrough pain are crucial in clinical practice.This review synthesizes current evidence on risk factors,neuraxial anesthesia modalities,ma-intenance techniques,and rational use of analgesic drugs to reduce BTP.

A 17-year-old female patient developed fever after novel coronavirus infection and took ibuprofen sustained-release capsules 0.3 g 4 times within 3 days by herself. During the medication, the patient developed the symptoms such as chest tightness, shortness of breath, limbs fatigue, sweating, muscle soreness, and dark urine successively. Laboratory tests showed creatine kinase (CK) 583 800 U/L, CK-MB 45 μg/L, lactate dehydrogenase 4 772 U/L, serum creatinine (Scr) 392 μmol/L, myoglobin 87 μg/L, and urea nitrogen 32.8 mmol/L. It was considered that rhabdomyolysis with acute kidney injury might be related to ibuprofen. The patient was given symptomatic treatments such as renal replacement therapy, hemodialysis, blood transfusion, rehydration, diuresis, etc. Thirty-three days later, the patient′s muscle soreness and other symptoms disappeared, the urine color returned to normal, laboratory tests showed CK 168 U/L, myoglobin 24 μg/L, and Scr 52 μmol/L.

A 17-year-old female patient developed fever after novel coronavirus infection and took ibuprofen sustained-release capsules 0.3 g 4 times within 3 days by herself. During the medication, the patient developed the symptoms such as chest tightness, shortness of breath, limbs fatigue, sweating, muscle soreness, and dark urine successively. Laboratory tests showed creatine kinase (CK) 583 800 U/L, CK-MB 45 μg/L, lactate dehydrogenase 4 772 U/L, serum creatinine (Scr) 392 μmol/L, myoglobin 87 μg/L, and urea nitrogen 32.8 mmol/L. It was considered that rhabdomyolysis with acute kidney injury might be related to ibuprofen. The patient was given symptomatic treatments such as renal replacement therapy, hemodialysis, blood transfusion, rehydration, diuresis, etc. Thirty-three days later, the patient′s muscle soreness and other symptoms disappeared, the urine color returned to normal, laboratory tests showed CK 168 U/L, myoglobin 24 μg/L, and Scr 52 μmol/L.

Multidrug resistance （MDR） has been a main culprit behind the failure of chemotherapy in patients with malignant tumors and a major obstacle to improving the life quality and prolonging the survival of patients. Hepatocellular carcinoma cells， the innate drug-resistant cells， are generally insensitive to radiotherapy and chemotherapy. Moreover， as the early symptoms of hepatocellular carcinoma are atypical， most patients are diagnosed at the advanced stage， with short survival period and high recurrence rate. Thus， the sensitivity to chemotherapy drugs is decreased. This explains how MDR becomes one of the important reasons for the failure of primary hepatocellular carcinoma （PHC） treatment. Therefore， it is an urgent task to search for safe and effective chemosensitizers with little adverse effect in the research on the drug resistance of hepatocellular carcinoma. As Chinese medicine has been widely applied in the treatment of tumors， the mechanisms of compound Chinese medicine prescriptions， Chinese medicine injections， and single Chinese medicinal in reversing chemotherapy resistance in liver cancer have attracted the interest of scholars. According to previous reports， the mechanisms can be summarized as increasing intracellular drug concentration， influencing changes in enzyme activity， inducing apoptosis， reversing abnormalities in cellular signaling pathways， and regulating the tumor microenvironment. Traditional Chinese medicine reduces the chemotherapy resistance of hepatocellular carcinoma cells through multiple targets and multiple pathways， thereby improving the chemotherapy sensitivity of the cancer cells and enhancing the toxicity of chemotherapeutic drugs to hepatocellular carcinoma cells. Therefore， exploring the mechanism of MDR of hepatocellular carcinoma from the perspective of traditional Chinese medicine is important for reversing the MDR and is of great reference value for clinical treatment of hepatocellular carcinoma. However， there are few experimental types and adverse effects available. Thus， the multi-mechanism and multi-target experiments and clinical research should be carried out in the future.

Objective:To build an investigator-initiated clinical research process management indicator system based on the theory of Hazard Analysis and Critical Control Point(HACCP).Methods:A plan was developed according to HACCP principles, and 23 experts were invited to form an expert advisory group. Literature research, panel discussion, and Delphi method were used to collect clinical research process management indicators, and the weight of each indicator was calculated via Analytic Hierarchy Process(AHP).Results:Two rounds of expert consultation were carried out with a high positive coefficient and a high expert authority level, and finally formed 3 primary indicators and 14 secondary indicators. The primary indicators were project establishment, project process management, and project implementation assessment, with weights of 0.142 8, 0.714 4, and 0.142 8, respectively.Conclusions:This study established a clinical research process management system based on HACCP theory from 3 dimensions: project establishment, project process management, and project implementation assessment, carried out precise management of clinical research according to the weights of secondary indicators, focusing on the content of indicators with great weight, and provided an important reference for the management of investigator-initiated clinical research.

Objective:Through the establishment of a tertiary hospital ethics review information system, the information management of ethics review is carried out, thereby improving the quality and efficiency of ethics review.Methods:Four steps that including status quo analysis and problem identifying, corrective action plan making, outcome monitoring, as well as experience analysis were conducted, according to which a full-chain ethical review information system was developed. This system has certain characteristics such as well-featured functions, reasonable structure and user friendly, which fulfilled the expectation of the information management of review work.Results:The updated ethics review information system provides much stronger support for ethics review management and also improves its efficiency.Conclusions:The information system makes the management of ethics review more efficient, standardized and well-organised.

Objective To observe the regulation of Panx1 on ATP/IP3 signaling pathway and its mechanism during cisplatin-induced apoptosis of lung adenocarcinoma cells. Methods Human lung adenocarcinoma cell line A549 was used as the research object and carbenoxolone (CBX) was used as a drug interference tool. A549 cells were divided into normal control group, the CBX group, the cisplatin (DDP) group and the CBX+DDP group. MTT assay and Annexin V/PI assay were used to detect the survival and apoptosis rates of A549 cells. The relative concentrations of extracellular adenosine triphosphate (ATP) and intracellular inositol triphosphate (IP3) were measured by Chemiluminescence and ELISA. Results Compared with DDP group, the cell survival rate of CBX+DDP group increased, while the early and late apoptotic rates and the release concentration of extracellular ATP and intracellular IP3 decreased (all P < 0.01). Conclusion Panx1 can increase the sensitivity of lung adenocarcinoma cells to cisplatin by regulating the ATP/IP3 signaling pathway.

Objective To explore value of incision with no compression bandage combined with early function rehabilitation for patients with? breast cancer? after operation.Methods A total of 150 breast cancer patients underwent unilateral modified radical mastectomy were randomly divided into experimental group and the control group,with 75 cases per group.The control group used conventional nursing,and the experimental group adopted postoperative fast-track surgery nursing,and the patients were followed up for one year after surgery.Drainage tube removal time,wound healing,hospitalization days,cost of treatment,limb shoulder joint activity and limb lymphedema incidence were compared between groups.Results The incidences of skin flap necrosis,subcutaneous effusion,and upper limb lymphedema of experimental group were not higher than the control group.The function recovery of upper limb exercise was obviously better than the control group,the difference was statistically significant (P ＜ 0.05).No significant difference was seen in extubation time,hospitalization days and cost of treatment in two groups (P ＞ 0.05).Conclusion The incision with no compression bandage combined with functional exercise can promote the recovery for postoperative patients with breast cancer,and it has important clinical value.

Objective To explore value of incision with no compression bandage combined with early function rehabilitation for patients with? breast cancer? after operation.Methods A total of 150 breast cancer patients underwent unilateral modified radical mastectomy were randomly divided into experimental group and the control group,with 75 cases per group.The control group used conventional nursing,and the experimental group adopted postoperative fast-track surgery nursing,and the patients were followed up for one year after surgery.Drainage tube removal time,wound healing,hospitalization days,cost of treatment,limb shoulder joint activity and limb lymphedema incidence were compared between groups.Results The incidences of skin flap necrosis,subcutaneous effusion,and upper limb lymphedema of experimental group were not higher than the control group.The function recovery of upper limb exercise was obviously better than the control group,the difference was statistically significant (P ＜ 0.05).No significant difference was seen in extubation time,hospitalization days and cost of treatment in two groups (P ＞ 0.05).Conclusion The incision with no compression bandage combined with functional exercise can promote the recovery for postoperative patients with breast cancer,and it has important clinical value.