Objective This study aimed to apply the integrated Promoting Action on Research Implementation in Health Services(i-PARIHS)framework to translate best evidence into clinical practice,with the goal of reducing unplanned discontinua-tion of continuous renal replacement therapy(CRRT)and providing guidance for clinical staff.Methods A systematic search was conducted for guidelines,systematic reviews,evidence summaries,and expert consensus documents related to unplanned CRRT discontinuation.Retrieved literature underwent quality appraisal,synthesis,and integration.Through evidence-based group discussions,baseline clinical audits,and FAME(Feasibility,Appropriateness,Meaningfulness,Effectiveness)-based evi-dence appraisal,implementation strategies were developed across three i-PARIHS dimensions:context,recipients,and facilita-tion.Outcomes including unplanned CRRT discontinuation rates,average length of hospital stay,mortality,and nurse competen-cy were compared before and after evidence implementation.Results After evidence extraction,synthesis,and contextual adap-tation,a site-specific evidence translation model was established,comprising 16 audit criteria with corresponding review methods.Following implementation,significant reductions were observed in unplanned CRRT discontinuation rates,average length of stay,and mortality(all P＜0.05).Nurses' nursing competency also improved significantly(P＜0.05),indicating a positive impact of the evidence translation initiative.Conclusion The i-PARIHS framework effectively reduces unplanned CRRT discontinuation and is applicable in clinical practice.The results offer evidence for improving nursing quality and offering a reference for future evidence translation initiatives in critical care.

Objective To investigate the clinical outcome differences between robotic-assisted intramedullary nailing and traditional manual surgery,and to analyze the advantages and feasibility of robotic-assisted intramedullary nail fixation in the treatment of intertrochanteric fractures in elderly patients.Methods From December 2023 to December 2024,elderly patients with intertrochanteric fractures who underwent surgery at Department of Trauma Orthopedics,Beijing Luhe Hospital,Capital Medical University were included.Patients were divided into two groups based on the surgical method.The robotic-assisted group underwent robotic-assisted intramedullary nail fixation,while the traditional group received manual intramedullary nail fixation.Baseline data and observation indicators were collected and compared between the two groups to assess any differences.Results There were no statistically significant differences in baseline data between the two groups(P>0.05).The intraoperative blood loss in the robotic-assisted group was(94.28±9.43)mL,compared to(143.00±11.11)mL in the traditional group(P<0.001).The operative time in the robotic-assisted group was(53.06±9.89)min,while in the traditional group,it was(66.74±10.18)min(P<0.001).The skin incision length for the main nail in the robotic-assisted group was(3.23±0.64)cm,whereas in the traditional group,it was(4.03±0.79)cm(P<0.01).Postoperative hemoglobin levels in the robotic-assisted group decreased by(12.63±4.27)g/L,compared to(17.29±4.32)g/L in the traditional group(P=0.018).At 6 months postoperatively,the Harris hip scores in the robotic-assisted group showed 30 cases of excellent,10 good,and 3 poor outcomes,while in the traditional group,there were 22 excellent,15 good,and 6 poor cases(P=0.198).Conclusion Robotic-assisted intramedullary nailing for intertrochanteric fractures offers advantages such as minimally invasive and precise procedures,shorter operative times,and reduced blood loss.Compared to traditional surgical methods,it demonstrates certain benefits in reducing postoperative complications in elderly patients.

Objective To investigate the clinical outcome differences between robotic-assisted intramedullary nailing and traditional manual surgery,and to analyze the advantages and feasibility of robotic-assisted intramedullary nail fixation in the treatment of intertrochanteric fractures in elderly patients.Methods From December 2023 to December 2024,elderly patients with intertrochanteric fractures who underwent surgery at Department of Trauma Orthopedics,Beijing Luhe Hospital,Capital Medical University were included.Patients were divided into two groups based on the surgical method.The robotic-assisted group underwent robotic-assisted intramedullary nail fixation,while the traditional group received manual intramedullary nail fixation.Baseline data and observation indicators were collected and compared between the two groups to assess any differences.Results There were no statistically significant differences in baseline data between the two groups(P>0.05).The intraoperative blood loss in the robotic-assisted group was(94.28±9.43)mL,compared to(143.00±11.11)mL in the traditional group(P<0.001).The operative time in the robotic-assisted group was(53.06±9.89)min,while in the traditional group,it was(66.74±10.18)min(P<0.001).The skin incision length for the main nail in the robotic-assisted group was(3.23±0.64)cm,whereas in the traditional group,it was(4.03±0.79)cm(P<0.01).Postoperative hemoglobin levels in the robotic-assisted group decreased by(12.63±4.27)g/L,compared to(17.29±4.32)g/L in the traditional group(P=0.018).At 6 months postoperatively,the Harris hip scores in the robotic-assisted group showed 30 cases of excellent,10 good,and 3 poor outcomes,while in the traditional group,there were 22 excellent,15 good,and 6 poor cases(P=0.198).Conclusion Robotic-assisted intramedullary nailing for intertrochanteric fractures offers advantages such as minimally invasive and precise procedures,shorter operative times,and reduced blood loss.Compared to traditional surgical methods,it demonstrates certain benefits in reducing postoperative complications in elderly patients.

Objective This study aimed to apply the integrated Promoting Action on Research Implementation in Health Services(i-PARIHS)framework to translate best evidence into clinical practice,with the goal of reducing unplanned discontinua-tion of continuous renal replacement therapy(CRRT)and providing guidance for clinical staff.Methods A systematic search was conducted for guidelines,systematic reviews,evidence summaries,and expert consensus documents related to unplanned CRRT discontinuation.Retrieved literature underwent quality appraisal,synthesis,and integration.Through evidence-based group discussions,baseline clinical audits,and FAME(Feasibility,Appropriateness,Meaningfulness,Effectiveness)-based evi-dence appraisal,implementation strategies were developed across three i-PARIHS dimensions:context,recipients,and facilita-tion.Outcomes including unplanned CRRT discontinuation rates,average length of hospital stay,mortality,and nurse competen-cy were compared before and after evidence implementation.Results After evidence extraction,synthesis,and contextual adap-tation,a site-specific evidence translation model was established,comprising 16 audit criteria with corresponding review methods.Following implementation,significant reductions were observed in unplanned CRRT discontinuation rates,average length of stay,and mortality(all P＜0.05).Nurses' nursing competency also improved significantly(P＜0.05),indicating a positive impact of the evidence translation initiative.Conclusion The i-PARIHS framework effectively reduces unplanned CRRT discontinuation and is applicable in clinical practice.The results offer evidence for improving nursing quality and offering a reference for future evidence translation initiatives in critical care.

Objective To investigate the inhibitory effect and mechanism of lentinan on colitis-associated colorectal cancer (CAC) induced by azomethane (AOM)/dextran sulfate sodium salt (DSS) through the IL-6/ STAT3 pathway. Methods C57BL/6 mice were randomly divided into a control group, a model group, a low-dose group (0.865 mg/kg lentinan), a medium-dose group (1.73 mg/kg lentinan), and a high-dose group (3.46 mg/kg lentinan). Except the control group, CAC was induced by AOM/DSS in the other groups, and corresponding drugs were injected intraperitoneally during the modeling process. Body mass, disease activity index (DAI) score, colon length, and tumor number were compared among all groups. Hematoxylin–eosin staining was used to observe the pathological morphology of colon. ELISA was utilized to detect the IL-6, IL-1β, and IL-18 contents in serum. Western blot analysis was conducted to detect the expression levels of IL-6, p-STAT3, and c-Myc in colon tissues. Results The tumor number, DAI score, serum IL-6, IL-1β, and IL-18 contents and the expression levels of IL-6, p-STAT3, and c-Myc in the colon tissue of the model group were higher than those of the control group, while the body mass and colon length were lower than those of the control group (P<0.05). The pathological morphology of colon tissues showed adenocarcinoma formation. After different doses of lentinan intervention, the tumor number, DAI score, serum IL-6, IL-1β, and IL-18 contents and the expression levels of IL-6, p-STAT3, and c-Myc in colon tissues were all lower than those in the model group, while body mass and colon length were higher than those in the model group (P<0.05). The pathological morphology of colon tissues showed adenomas of different grades but no adenocarcinoma was found. Conclusion Lentinan inhibits CAC formation, and its anticancer effect is related to the inhibition of the IL-6/STAT3 pathway.

Objective To investigate the effects of different extracorporeal membrane oxygenation(ECMO)bypass modes on the prognosis of patients with combined pulmonary fibrosis and emphysema(CPFE)during lung transplantation.Methods A retrospective analysis was conducted on 44 CPFE patients who underwent lung transplantation,and they were divided into the venous-venous ECMO(VV-ECMO)group(30 cases)and the venous-arterial ECMO(VA-ECMO)group(14 cases).The preoperative,intraoperative,postoperative and follow-up related indicators of two groups were compared.Results Compared with the VV-ECMO group,the patients in the VA-ECMO group were younger,had higher pulmonary artery pressure before surgery,fewer posterolateral incision types,longer operation times,and higher incidence of postoperative bronchopleural fistula(all P<0.05).The pulmonary artery pressure decreased after surgery in both groups,with a greater decrease in the VA-ECMO group(P<0.05).There was no statistically significant difference in postoperative survival rates between the two groups(P>0.05).Conclusions Both VA-ECMO and VV-ECMO are safe and effective in lung transplant patients with CPFE.The bypass mode has no significant impact on the short and medium-term prognosis of the patients.VA-ECMO is more suitable for patients with higher preoperative pulmonary artery pressure.

Objective To explore the feasibility and safety of robot-assisted partial right nephrectomy using a combined retroperitoneal and transperitoneal approach in the treatment of horseshoe kidney with renal tumor.Methods Clinical and follow-up data of a patient with horseshoe kidney with renal tumor were retrospectively analyzed.Before operation,the diagnosis was confirmed with renal CT scanning and enhancement with angiography to show the blood supply.After that,the patient underwent robot-assisted partial right nephrectomy for horseshoe kidney by robot-assisted partial right nephrectomy using a combined retroperitoneal and transperitoneal approach.After operation,the patient was followed up.Results The operation went smooth with an operation time of 270 min.The intraoperative warm ischemia time was 30 min,intraoperative bleeding was approximately 300 mL,and no intraoperative or postoperative complications occurred.After 2 months of follow-up,the patient recovered well,and no chest and abdominal lymph node enlargement and lung metastasis were observed.Conclusion Robot-assisted partial nephrectomy of horseshoe kidney using a combined retroperitoneal and transperitoneal approach is a safe and feasible minimally invasive treatment option.

Over-expression of glutathione S-transferase(GST)can promote Cisplatin resistance in hepatocellular carcinoma(HCC)treatment.Hence,inhibiting GST is an attractive strategy to improve Cisplatin sensi-tivity in HCC therapy.Although several synthesized GST inhibitors have been developed,the side effects and narrow spectrum for anticancer seriously limit their clinical application.Considering the abundance of natural compounds with anticancer activity,this study developed a rapid fluorescence technique to screen"green"natural GST inhibitors with high specificity.The fluorescence assay demonstrated that schisanlactone B(hereafter abbreviated as C1)isolated from Xue tong significantly down-regulated GST levels in Cisplatin-resistant HCC cells in vitro and in vivo.Importantly,C1 can selectively kill HCC cells from normal liver cells,effectively improving the therapeutic effect of Cisplatin on HCC mice by down-regulating GST expression.Considering the high GST levels in HCC patients,this compound demon-strated the high potential for sensitizing HCC therapy in clinical practice by down-regulating GST levels.

Due to the non-targeted release and low solubility of anti-gastric cancer agent,apatinib(Apa),a first-line drug with long-term usage in a high dosage often induces multi-drug resistance and causes serious side effects.In order to avoid these drawbacks,lipid-film-coated Prussian blue nanoparticles(PB NPs)with hyaluronan(HA)modification was used for Apa loading to improve its solubility and targeting ability.Furthermore,anti-tumor compound of gamabufotalin(CS-6)was selected as a partner of Apa with reducing dosage for combinational gastric therapy.Thus,HA-Apa-Lip@PB-CS-6 NPs were constructed to synchro-nously transport the two drugs into tumor tissue.In vitro assay indicated that HA-Apa-Lip@PB-CS-6 NPs can synergistically inhibit proliferation and invasion/metastasis of BGC-823 cells via downregulating vascular endothelial growth factor receptor(VEGFR)and matrix metalloproteinase-9(MMP-9).In vivo assay demonstrated strongest anti-tumor growth and liver metastasis of HA-Apa-Lip@PB-CS-6 NPs adminis-tration in BGC-823 cells-bearing mice compared with other groups due to the excellent penetration in tumor tissues and outstanding synergistic effects.In summary,we have successfully developed a new nanocomplexes for synchronous Apa/CS-6 delivery and synergistic gastric cancer(GC)therapy.

Objective:To establish a three-dimensional quantitative structure-activity relationship (3D-QSAR) model for thiazide 11β-hydroxy steroid dehydrogenase ( HSD) inhibitors in order to perform structure modification and find thiazide 11β-HSD inhibitors with more activity. Methods: The 3D-QSAR model of thiazine derivatives was constructed by the method of comparative molecular force field analysis, and the model was validated by using a molecular docking method. Results:An accurate 3D-QSAR model of 11β-HSD inhibitors was obtained (CoMFA:q2 =0. 346, r2 =0. 850, where q2 was the cross-validation coefficient and r2 was the non-cross validation coefficient) . Conclusion:The results provide important theoretical basis for the rational design of novel thiazide 11β-HSD inhibitors.