Triple-negative breast cancer (TNBC) remains a refractory subtype of breast cancer due to its resistance to various therapeutic strategies. In this study, we introduce a "brake-release and accelerator-pressing" approach to engineer a microneedle patch embedded with copper-doped Prussian blue nanoparticles (Cu-PB) and the ferroptosis inducer sorafenib (SRF) for raised chemodynamic (CDT)/photothermal (PTT) combination therapy against TNBC. Upon transdermal insertion, the dissolving microneedles swiftly disintegrate and facilitate the release of SRF. Under gentle external light exposure, copper ions (Cu²⁺) and iron ions (Fe³⁺) were liberated from Cu-PB. The direct chelation of Cu²⁺ and the indirect suppression by SRF, collectively attenuate glutathione peroxidase 4 (GPX4) enzymatic function, destabilizing the cellular redox equilibrium (referred to as the "brake-release" strategy). The release of Cu²⁺ and Fe³⁺ ions instigates a Fenton/Fenton-like reaction within tumor cells, further yielding hydroxyl radicals and elevating reactive oxygen species (ROS) concentrations (referred to as the "accelerator-pressing" strategy). This overwhelming ROS accumulation, coupled with the impaired clearance of resultant lipid peroxides (LPO), ultimately triggers a robust ferroptosis cell death response. In summary, this study presents an innovative combinatorial therapeutic strategy based on dual-ferroptosis induction for TNBC, implying a promising therapeutic platform for developing ferroptosis-centered treatments for this aggressive breast cancer subtype.

Objective:To compare the efficacy between vonoprazan fumarate and rabeprazole for the treatment of artificial ulcers after endoscopic submucosal dissection (ESD).Methods:In this prospective randomized controlled study, patients who underwent ESD between December 2021 and August 2023 at Jiangsu Province Hospital were enrolled and randomly divided into two groups. Vonoprazan fumarate combined with rebamipide (vonoprazan group) or rabeprazole combined with rebamipide (rabeprazole group) were given respectively from the 4th day after ESD. After 8 weeks, the healing of the ulcers was compared.Results:Ninety-one patients were enrolled in the study, including 51 in the vonoprazan group and 40 in the rabeprazole group. The ulcer area reduction rate of the vonoprazan group was significantly higher than that of the rabeprazole group (92.86%±3.80% VS 90.04%±4.28%, t=3.281, P=0.001), but there was no significant difference in the healing rate [15.69% (8/51) VS 7.50% (3/40), χ2=1.414, P=0.234] or the adverse event occurrence ( P>0.05) between the two groups. Conclusion:Vonoprazan fumarate can achieve better ulcer treatment without increasing the risk of adverse events.

Burn induced coagulopathy (BIC) is one of the common complications after burn injury. The types and clinical manifestations of BIC vary dramatically, which frequently leads serious consequences. However, at present BIC does not attract enough attention in clinic. In order to prevent and treat BIC more effectively, the authors suggest that it is necessary to strengthen coagulation surveillance, operation management, infection control, rational application of drugs, prevention and treatment of deep vein thrombosis, relative clinical and basic research, and others.

Objective : To explore the application of ZnxNi1－xS@ DOX nanostructures in combined photothermal- chemotherapy treatment of tumors，and to provide new ideas for the study of tumor treatment methods． Methods: The morphology and elementary composition of ZnxNi1－xS nanostructures were characterized by scanning emission e- lectron microscopy and other methods．The photothermal properties of ZnxNi1－xS nanostructures were explored by infrared thermal camera．The release of DOX under different temperature and pH was investigated by fluorescence spectrophotometer．The biosafety of ZnxNi1－xS nanostructures and the in vitro antitumor properties of ZnxNi1－xS@ DOX nanostructures were investigated by MTT assay. Results : The as-prepared ZnxNi1－xS nanostructure had good dispersion and uniform size．The ZnxNi1－xS nanostructures had good photothermal effect．The drug release behavior showed temperature and pH responsiveness．The MTT assay showed that ZnxNi1－xS nanostructures were nontoxic to normal cells．ZnxNi1－xS@ DOX nanostructures could significantly inhibit the growth of tumor cells under near-infra- red illumination． Conclusion The as-prepared ZnxNi1－xS nanostructure has good biocompatibility，on the basis of which the ZnxNi1－xS@ DOX nanostructures achieve good antitumor performance，which can be used for combined photothermal-chemotherapy treatment of tumors.

Background: Peroral endoscopic myotomy (POEM) is safe and effective in the treatment of achalasia (AC). However, there are few reports on application of POEM in the elderly, and is limited by small sample size and short follow-up. Aims: To evaluate the efficacy and safety of POEM and its influential factors on AC in geriatric patients. Methods: A total of 215 AC patients received POEM from November 2012 to December 2018 at the First Affiliated Hospital of Nanjing Medical University were enrolled, and were divided into elderly group (≥60 years old) and non-elderly group (<60 years old). The clinical information, POEM procedure, efficacy and safety were compared, follow-up was performed, and influential factors were analyzed. Results: The disease course in elderly group was significantly longer than that in non-elderly group (P=0.002); the integrated relaxation pressure (IRP) of lower esophageal sphincter in elderly group was significantly decreased than that in non-elderly group (P=0.013). No significant differences in basic information, Chicago classification, POEM procedure, postoperative Eckardt score between the two groups were found (P>0.05). The median follow-up was 42 (29, 60) months. The rate of treatment failure or recurrence in elderly group was significantly increased than that in non-elderly group (17.5% vs. 7.4%, P=0.047). However, there was no statistical difference in incidence of clinical reflux between the two groups (P>0.05). The postoperative efficacy was correlated with preoperative IRP in elderly patients (P=0.033). The propensity score matching results showed that no significant difference in prognosis was found between the two groups. Conclusions: POEM is safe and effective for elderly patients with AC. However, the efficacy is lower in elderly patients than that in non-elderly patients due to the long course of disease and lower preoperative IRP.

Objective To understand the frequency distribution of CYP2C9 and VKORC1 gene single nucleotide polymor-phisms in Yunnan Han population.Methods CYP2C9(430C> T,1075A>C and 1080C> G)locus and VKORC1(-1639G> A and 1173C> T)locus gene polymorphisms in 202 samples were detected by adopting electrochemical gene sensor method,and the allele frequencies and genotype frequencies were performed the statistics and the gene polymorphism in relevant populations was an-alyzed.Results Among 202 samples,202 cases(100.0%)were genotype C/C at CYP2C9 * 2 locus,C allele frequency was 100.0%;185 cases(91.6%)were genotype A/A at CYP2C9*3 locus,15 cases(7.4%)were A/C genotype,2 cases(1.0%)were C/C genotype,A allele frequency was 95.3%,C allele frequency was 4.7%;CYP2C9*5 locus genotype C/C was in 202 cases (100.0%),C allele frequency was 100%;VKORC1 -1639G > A locus genotype A/A was in 145 cases(71.8%),57 cases (28.2%)were G/A genotype,A allele frequency was 85.9%,G was 14.1%;1173C> T locus genotype T/T was in 145 cases (71.8%),C/T gene type in 57 cases(28.2%),T allele frequency was 85.9%,and C was 14.1%.Conclusion The distribution of CYP2C9 gene in Yunnan Han population is similar to that in other regions of our country.The VKORC1 gene is different from the foreign population,Chinese Han nationality and partial minority nationalities.

Objective To investigate the feasibility of Multi-dimensional Visual Hand Function Rehabilitation Quantitative Assessment System in the assessment of hand function for stroke patients. Methods From November, 2017 to July, 2018, 17 stroke inpatients were assessed with Fugl-Meyer Assessment-upper extremities (FMA-UE) and the Multi-dimensional Assessment System. Results The results of Multi-dimensional Assessment System positively correlated with the score of FMA-UE (r = 0.609, P = 0.010). Conclusion The Multi-dimensional Visual Hand Function Rehabilitation Quantitative Assessment System can be used to assess the hand function for stroke patients quantitatively.

Objective To evaluate the comparability of the detection results of different blood cells analysis systems in same hos-pital.Methods Referring to the Guideline for Comparability Verification of Quantitative Test Results in Medical Institutions,the comparability validation protocol was established.The EDTA-K2 anticoagulation fresh whole blood samples with proper concentra-tion were detected for 5 parameters of HGB,RBC,HCT,PLT and WBC by 4 systems (Sysmex XT-1800i,Sysmex XT-2000,Sys-mex XT-4000i and Mindray BC-5800).The range was calculated and the detection results consistency analysis was performed.Re-sults The acceptable standard of critical differentials was intended to be HGB3.5%,RBC3%,HCT3%,PLT12.5% and WBC 7.5%.The replication detection was at least 2 times and up to 5 times.The ranges of 3 concentrations after replication detection and sample comparison were 2.87%-6.29%,1.57%-2.99%,1.95%-4.77%,12.81%-25.74% and 6.72%-11.13% respective-ly.The ranges of RBC detection results in 4 systems were smaller than the critical differentials,the validation was passed.The ran-ges of HGB,HCT,PLT and WBC detection results in 4 systems all had the condition of more than the critical differentials,the vali-dation did not passed.After removing the test system with obvious bias,the validation of the detection results by other test systems was passed.Conclusion The RBC detection results by 4 systems have the comparability;the HGB,HCT and PLT detection results by Sysmex XT-1800i,Sysmex XT-2000i and Sysmex XT-4000i have the comparability;the WBC detection results by Sysmex XT-1800i,Sysmex XT-2000i and Mindray BC-5800 have the comparability.