The biological activity of chitinase in degrading chitin has garnered extensive attention,particularly for its potential applications in biological control.This study utilized four spore-form-ing Bacillus strains isolated from Dermacentor nuttalli ticks collected in the Hulunbuir region.Traditional bacterial culture methods were employed for isolation and identification,followed by 16S rRNA sequencing and phylogenetic analysis of the purified cultures.chitin-hydrolyzing strains were screened using colloidal chitin plates,and specific chitinase genes were detected via PCR.Fer-mentation was conducted at 37.0 ℃ for 4 d,and the supernatants were subjected to enzyme activity analysis using the DNS method.Four Gram-positive Bacillus strains were successfully isolated from tick tissue samples,they were identified as B.proteolyticus,B.paramycoides,B.thuringien-sis,and B.cereus,and renamed IMH/B-1,IMH/P-1,IMH/T-1,and IMH/C-1,respectively.PCR a-nalysis detected chitinase genes in B.proteolyticus and B.thuringiensis,while B.cereus and B.pa-ramycoides lacked these genes.However,three strains B.proteolyticus,B.thuringiensis,and B.ce-reus demonstrated significant(P＜0.01)chitin degradation activity on colloidal chitin.Enzyme ac-tivity assays revealed that chitinase activity ranged from 1.292 to 2.032 U/mL,with B.proteolytic-us exhibiting the highest activity 2.032 U/mL,followed by B.cereus 1.496 U/mL and B.thuring-iensis 1.324 U/mL.This study provides a foundation for further research and application of chiti-nase-producing Bacillus strains.

To achieve the national objectives of improving medical quality and safety,the Shanghai Shenkang Hospital Development Center has formulated a list of major targets,tasks,and key results based onthe Objective and Key Results (OKR) method.The primary approaches adopted include establishing an organizational structure to advance medical quality and safety supervision,setting up a series of quantitative indicators for medical quality and safety targets,formulating standardized management systems,building an information platform,and strengthening supervision.It argues that the adoption of OKR can effectively promote the implementation of national target management for improving medical quality and safety,establish a cross-institutional management network for medical quality and safety,strengthen process management,and effectively drive continuous improvement in medical quality and safety.

The applications of nuclear technology in industries, medicine, and other fields have increased the risk of radiation injury. Although some small-molecule drugs for radiation injury treatment have been applied clinically or are in preclinical research, their therapeutic efficacy is significantly limited by short circulation time and rapid metabolism. Nanomaterials have attracted growing attention with their outstanding bioactivity, chemical stability, tissue compatibility, and targeted delivery capabilities, therefore having the promise of offering the potential solutions to the limitations of current small-molecule drugs. However, their biosafety and clinical efficacy require further investigation. This review summarizes the design strategies and classifications of nanomaterials for radiation injury treatment, analyzes current research progress in their therapeutic applications, and introduces nanomaterial-based approaches for enhancing the elimination of internal radionuclide contamination. Finally, the challenges and future prospects of nanomaterials in radiation injury treatment are discussed. This review aims to provide researchers with a comprehensive understanding of recent advances in nanomaterial-based radiation injury therapeutics, thereby promoting further development in this field.

Objective:To investigate the efficacy of radiotherapy in patients with advanced esophageal cancer receiving first-line chemoimmunotherapy.Methods:A retrospective analysis was conducted on the data of 137 patients with Stage Ⅳ esophageal squamous cell carcinoma (ESCC) treated at our hospital from January 2018 to May 2023. These patients were divided into two groups: a group treated with first-line chemoimmunotherapy combined with radiotherapy (chemoimmunotherapy + radiotherapy group, n = 43) and a group treated with only chemoimmunotherapy ( n = 94). Inverse probability of treatment weighting (IPTW) was applied to balance baseline characteristics between the groups. With overall survival (OS) and progression-free survival (PFS) as study endpoints, the survival data were analyzed using the Kaplan-Meier method, the log-rank test, and the Cox regression method. Results:Before calibration, the chemoimmunotherapy + radiotherapy group significantly outperformed the sole chemoimmunotherapy group in median PFS (13.6 months vs. 7.0 months; HR: 0.501, 95% CI: 0.309-0.811, P = 0.005). After calibration using the COX proportional-hazards model for age, gender, Eastern Cooperative Oncology Group (ECOG) performance status, smoking history, T/N/M stage, and tumor location, the chemoimmunotherapy + radiotherapy group still had significant advantages in PFS (14.7 months vs. 7.0 months; HR: 0.441, 95% CI: 0.261-0.745, P = 0.002). IPTW analysis further confirmed this trend (13.9 months vs. 7.0 months; HR: 0.492, 95% CI: 0.304-0.795, P < 0.001). Specifically, the median OS of the chemoimmunotherapy + radiotherapy group demonstrated significant improvement in all analyses: pre-calibration (29.5 months vs. 18.0 months; HR: 0.507, 95% CI: 0.297-0.867, P = 0.013), after calibration using the Cox model (27.5 months vs. 16.7 months; HR: 0.470, 95% CI: 0.266-0.830, P = 0.009), and after calibration using IPTW (29.5 months vs. 16.9 months; HR: 0.448, 95% CI: 0.262-0.764, P < 0.001). Conclusions:The combination of radiotherapy and first-line chemoimmunotherapy can significantly improve survival outcomes of patients with advanced ESCC, suggesting its potential as a standard treatment strategy.

The biological activity of chitinase in degrading chitin has garnered extensive attention,particularly for its potential applications in biological control.This study utilized four spore-form-ing Bacillus strains isolated from Dermacentor nuttalli ticks collected in the Hulunbuir region.Traditional bacterial culture methods were employed for isolation and identification,followed by 16S rRNA sequencing and phylogenetic analysis of the purified cultures.chitin-hydrolyzing strains were screened using colloidal chitin plates,and specific chitinase genes were detected via PCR.Fer-mentation was conducted at 37.0 ℃ for 4 d,and the supernatants were subjected to enzyme activity analysis using the DNS method.Four Gram-positive Bacillus strains were successfully isolated from tick tissue samples,they were identified as B.proteolyticus,B.paramycoides,B.thuringien-sis,and B.cereus,and renamed IMH/B-1,IMH/P-1,IMH/T-1,and IMH/C-1,respectively.PCR a-nalysis detected chitinase genes in B.proteolyticus and B.thuringiensis,while B.cereus and B.pa-ramycoides lacked these genes.However,three strains B.proteolyticus,B.thuringiensis,and B.ce-reus demonstrated significant(P＜0.01)chitin degradation activity on colloidal chitin.Enzyme ac-tivity assays revealed that chitinase activity ranged from 1.292 to 2.032 U/mL,with B.proteolytic-us exhibiting the highest activity 2.032 U/mL,followed by B.cereus 1.496 U/mL and B.thuring-iensis 1.324 U/mL.This study provides a foundation for further research and application of chiti-nase-producing Bacillus strains.

Objective:To investigate the correlations of KCNJ5 gene mutations and pathological subtypes based on 11β-hydroxylase (CYP11B1)/aldosterone synthase (CYP11B2) immunohistochemistry with clinical characteristics and postoperative outcomes in patients with unilateral primary aldosteronism undergoing adrenalectomy.Methods:This retrospective study enrolled 155 patients with primary aldosteronism who underwent unilateral adrenalectomy at the Department of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, between May 2023 and May 2024. KCNJ5 mutations were detected by Sanger sequencing, and patients were stratified into KCNJ5-mutant and wild-type groups based on genetic results. The KCNJ5-mutant cohort was further subclassified into complete remission and partial remission groups according to surgical outcomes. For KCNJ5-mutant cases, postoperative tissues underwent immunohistochemical subtyping for CYP11B1/CYP11B2 expression, and were divided into the CYP11B2 mono-positive group (CYP11B1 -/CYP11B2 +) and the CYP11B1/CYP11B2 co-expression group (CYP11B1 +/CYP11B2 +). Correlations of KCNJ5 mutations and pathological subtypes with baseline characteristics, biochemical profiles, and postoperative outcomes in unilateral primary aldosteronism patients were analyzed. Results:A total of 100 patients were included in the final analysis, aged (51.1±11.0) years, including 35 females (35%). The somatic KCNJ5 mutation rate was 69% (69/100), with 69 KCNJ5-mutant and 31 wild-type cases. Compared to wild-type patients, KCNJ5-mutant patients were younger ((48.4±10.8) years vs. (56.9±9.3) years, P=0.000 2), had a higher female proportion (45% vs. 13%, P=0.004 0), exhibited lower preoperative renin levels (3.4 (1.1, 39.5) ng/L vs. 9.7 (2.7, 19.6) ng/L, P=0.009 1) and had a higher rate of complete clinical remission (55% vs. 16%, P=0.000 3). Among KCNJ5-mutant patients, 38 achieved complete remission and 31 achieved partial remission. The complete remission group demonstrated younger age ((45.6±10.2) years vs. (52.0±10.5) years, P=0.012 6), shorter hypertension duration ((6.2±6.1) years vs. (10.7±10.1) years, P=0.020 4), higher preoperative plasma (951.5 (652.2, 1 690.8) pmol/L vs. 749.8 (518.5, 955.4) pmol/L, P=0.027 7) and urinary ((86 271.4±51 873.8) pmol/24 h vs. (61 860.2±24 411.2) pmol/24 h, P=0.019 2) aldosterone levels, greater lateralization index (22.6 (10.1, 42.5) vs. 11.1 (5.1, 19.8), P=0.022 7), fewer baseline antihypertensive defined daily dose (2.6±1.3 vs. 4.0±1.3, P<0.000 1), and larger tumor diameter (1.5 (1.2, 1.8) cm vs. 1.1 (1.0, 1.5) cm, P=0.000 7). Immunohistochemical subtyping revealed CYP11B2 mono-positivity in 24 mutant cases and CYP11B1/CYP11B2 co-expression in 45. The CYP11B2 mono-positive group showed more pronounced postoperative reduction in antihypertensive defined daily dose (2.9±1.3 vs. 2.2±1.2, P=0.018 3), though no significant difference in complete remission rates (46% vs. 60%, P=0.259 8) was observed. Conclusion:In patients with unilateral primary aldosteronism, those carrying KCNJ5 somatic mutations exhibit characteristics such as younger age and a higher proportion of females compared to wild-type patients, along with significantly better surgical outcomes. Moreover, among patients with KCNJ5 mutations, those whose pathological subtype shows pure CYP11B2 expression demonstrate a more pronounced reduction in postoperative antihypertensive defined daily dose than those with co-expression of CYP11B1/CYP11B2.

Objective To comparatively evaluate the diagnostic value of metagenomic next-generation sequencing(mNGS)versus conventional microbial culture in spinal infections.Methods A cross-section design was conducted on 82 consecutive patients with suspected spinal infections treated between February 2022 and January 2024 at Jiangbei Branch of First Affiliated Hospital of Army Medical University(Third Military Medical University).Microbiological culture,histopathological examination,and mNGS results from infected specimens were analyzed.Clinical diagnosis,primarily based on clinical manifestations,laboratory tests and radiologic features combined with medical history,was defined as the gold standard,and then the diagnostic performance,including sensitivity and specificity,were compared between mNGS and microbial culture.Results Among the 82 patients,definitive microbiological evidence was identified in 70 cases,and mNGS demonstrated a significantly higher detection rate than microbial culture(64 vs 36 cases,78.05％vs 43.9％,P<0.05).mNGS also obtained obviously higher sensitivity,accuracy,and negative predictive value(NPV),and notably lower positive predictive value(PPV)when compared to conventional microbial culture(all P<0.05).When stratified by infection type,mNGS obtained significantly higher sensitivity and accuracy compared to microbial culture in tuberculous spinal infections(P<0.05).For non-tuberculous spinal infections,mNGS also showed superior sensitivity to microbial culture(P<0.05).Conclusion In patients with spinal infections,mNGS demonstrates a significantly higher pathogen detection rate than conventional microbial culture.This technique can provide early and broad-spectrum pathogenic microbiological evidence for spinal infection.

Traumatic brain injury (TBI) is intricately linked to the most severe clinical manifestations of brain damage. It encompasses dynamic pathological mechanisms, including hemodynamic disorders, excitotoxic injury, oxidative stress, mitochondrial dysfunction, inflammation, and neuronal death. This review provides a comprehensive analysis and summary of biomaterial-based tissue engineering scaffolds and nano-drug delivery systems. As an example of functionalized biomaterials, nano-drug delivery systems alter the pharmacokinetic properties of drugs. They provide multiple targeting strategies relying on factors such as morphology and scale, magnetic fields, pH, photosensitivity, and enzymes to facilitate the transport of therapeutics across the blood-brain barrier and to promote selective accumulation at the injury site. Furthermore, therapeutic agents can be incorporated into bioscaffolds to interact with the biochemical and biophysical environment of the brain. Bioscaffolds can mimic the extracellular matrix environment, regulate cellular interactions, and increase the effectiveness of local treatments following surgical interventions. Additionally, stem cell-based and exosome-dominated extracellular vesicle carriers exhibit high bioreactivity and low immunogenicity and can be used to design therapeutic agents with high bioactivity. This review also examines the utilization of endogenous bioactive materials in the treatment of TBI.

The applications of nuclear technology in industries, medicine, and other fields have increased the risk of radiation injury. Although some small-molecule drugs for radiation injury treatment have been applied clinically or are in preclinical research, their therapeutic efficacy is significantly limited by short circulation time and rapid metabolism. Nanomaterials have attracted growing attention with their outstanding bioactivity, chemical stability, tissue compatibility, and targeted delivery capabilities, therefore having the promise of offering the potential solutions to the limitations of current small-molecule drugs. However, their biosafety and clinical efficacy require further investigation. This review summarizes the design strategies and classifications of nanomaterials for radiation injury treatment, analyzes current research progress in their therapeutic applications, and introduces nanomaterial-based approaches for enhancing the elimination of internal radionuclide contamination. Finally, the challenges and future prospects of nanomaterials in radiation injury treatment are discussed. This review aims to provide researchers with a comprehensive understanding of recent advances in nanomaterial-based radiation injury therapeutics, thereby promoting further development in this field.

Objective:To investigate the efficacy of radiotherapy in patients with advanced esophageal cancer receiving first-line chemoimmunotherapy.Methods:A retrospective analysis was conducted on the data of 137 patients with Stage Ⅳ esophageal squamous cell carcinoma (ESCC) treated at our hospital from January 2018 to May 2023. These patients were divided into two groups: a group treated with first-line chemoimmunotherapy combined with radiotherapy (chemoimmunotherapy + radiotherapy group, n = 43) and a group treated with only chemoimmunotherapy ( n = 94). Inverse probability of treatment weighting (IPTW) was applied to balance baseline characteristics between the groups. With overall survival (OS) and progression-free survival (PFS) as study endpoints, the survival data were analyzed using the Kaplan-Meier method, the log-rank test, and the Cox regression method. Results:Before calibration, the chemoimmunotherapy + radiotherapy group significantly outperformed the sole chemoimmunotherapy group in median PFS (13.6 months vs. 7.0 months; HR: 0.501, 95% CI: 0.309-0.811, P = 0.005). After calibration using the COX proportional-hazards model for age, gender, Eastern Cooperative Oncology Group (ECOG) performance status, smoking history, T/N/M stage, and tumor location, the chemoimmunotherapy + radiotherapy group still had significant advantages in PFS (14.7 months vs. 7.0 months; HR: 0.441, 95% CI: 0.261-0.745, P = 0.002). IPTW analysis further confirmed this trend (13.9 months vs. 7.0 months; HR: 0.492, 95% CI: 0.304-0.795, P < 0.001). Specifically, the median OS of the chemoimmunotherapy + radiotherapy group demonstrated significant improvement in all analyses: pre-calibration (29.5 months vs. 18.0 months; HR: 0.507, 95% CI: 0.297-0.867, P = 0.013), after calibration using the Cox model (27.5 months vs. 16.7 months; HR: 0.470, 95% CI: 0.266-0.830, P = 0.009), and after calibration using IPTW (29.5 months vs. 16.9 months; HR: 0.448, 95% CI: 0.262-0.764, P < 0.001). Conclusions:The combination of radiotherapy and first-line chemoimmunotherapy can significantly improve survival outcomes of patients with advanced ESCC, suggesting its potential as a standard treatment strategy.