OBJECTIVE: To construct a longitudinal trajectory model of arterial oxygen tension (PaO₂) within 24 hours after cardiac arrest (CA). METHODS: A retrospective cohort study was conducted. CA patients admitted to the ICU from 2014 to 2015 were selected from the eICU Collaborative Research Database (eICU-CRD). Data about patients' demographic characteristics, history of comorbidities, laboratory test indicators within 24 hours of intensive care unit (ICU) admission [including all PaO₂ data and arterial carbon dioxide tension (PaCO₂)], vasopressor use, and clinical outcomes were extracted from the database. The primary outcome variable was all-cause in-hospital mortality. Group-based trajectory model (GBTM) were built based on the changes in PaO₂ within 24 hours of ICU admission, and patients were grouped according to their initial static PaO₂ values upon ICU admission. Multivariable adjusted Poisson regression analysis was used to compare the in-hospital mortality risk among patients in different PaO₂ dynamic trajectory groups. Sensitivity analyses were performed using multivariable logistic regression and multivariable adjusted Poisson regression without imputation of missing values. RESULTS: A total of 3 866 CA patients were included. Three GBTM trajectory groups were identified based on PaO₂ changes within 24 hours of ICU admission: Group-1 (low level first increased then decreased, 148 cases), Group-2 (sustained low level, 3 040 cases), and Group-3 (first high level then decreased, 678 cases). Significant differences were found among the three groups in age, body weight, maximum serum potassium, maximum PaCO₂, minimum hemoglobin (Hb), vasopressor use, total hospitalization time, ICU stay, and hospital mortality. After incorporating variables with significant differences into the multivariable adjusted Poisson regression model, results showed that compared to Group-2 patients, patients in Group-1 and Group-3 had an increased risk of all-cause in-hospital mortality [Group-1 adjusted relative risk (aRR) = 1.20, 95% confidence interval (95%CI) was 1.02-1.41; Group-3 aRR = 1.11, 95%CI was 1.01-1.24]. Based on initial static PaO₂ values at ICU admission, patients were divided into four groups: PaO₂ < 100 mmHg (1 mmHg = 0.133 kPa; 1 217 cases), PaO₂ 100-200 mmHg (569 cases), PaO₂ 201-300 mmHg (547 cases), and PaO₂ > 300 mmHg (1 082 cases). Multivariable adjusted Poisson regression analysis indicated a significant upward trend in aRR for the latter three groups compared to the PaO₂ < 100 mmHg group. Sensitivity analyses revealed that compared to Group-2, patients in Group-1 and Group-3 had a significantly increased risk of all-cause in-hospital mortality (both P < 0.05). CONCLUSIONS Within 24 hours after return of spontaneous circulation in CA patients, PaO₂ exhibits different dynamic trajectories, and patients with hyperoxia have an increased risk of in-hospital mortality.
Humans ; Retrospective Studies ; Hospital Mortality ; Heart Arrest/blood* ; Prognosis ; Oxygen/blood* ; Intensive Care Units ; Cardiopulmonary Resuscitation ; Male ; Female ; Middle Aged

OBJECTIVE: Huachansu injection (HCSI), a promising anti-cancer Chinese medicine injection, has been reported to have the potential for reducing the toxicity of chemotherapy and improving the quality of life for colorectal cancer (CRC) patients. The objective of this study is to explore the synergistic and detoxifying effects of HCSI when used in combination with irinotecan (CPT-11). METHODS: To investigate the effect of HCSI on anti-CRC efficacy and intestinal toxicity of CPT-11, we measured changes in the biological behavior of LoVo cells in vitro, and anti-tumor effects in LoVo cell xenograft nude mice models in vivo. Meanwhile, the effect of HCSI on intestinal toxicity and the uridine diphosphate-glucuronosyltransferase 1A1 (UGT1A1) expression was investigated in the CPT-11-induced colitis mouse model. Subsequently, we measured the effect of HCSI and its 13 constituent bufadienolides on the expression of UGT1A1 and organic anion transporting polypeptides 1B3 (OATP1B3) in HepG2 cells. RESULTS: The combination index (CI) results showed that the combination of HCSI and CPT-11 exhibited a synergistic effect (CI < 1), which significantly suppressing the LoVo cell migration, enhancing G2/M and S phase arrest, and inhibiting tumor growth in vivo. Additionally, the damage to intestinal tissues was attenuated by HCSI in CPT-11-induced colitis model, while the increased expression of UGT1A1 in HepG2 cells and in mouse was observed. CONCLUSION The co-therapy with HCSI alleviated the intestinal toxicity induced by CPT-11 and exerted an enhanced anti-CRC effect. The detoxifying mechanism may be related to the increased expression of UGT1A1 and OATP1B3 by HCSI and its bufadienolides components. The findings of this study may serve as a theoretical insights and strategies to improve CRC patient outcomes. Please cite this article as: Jiang B, Meng ZY, Hu YJ, Chen JJ, Zong L, Xu LY, Zhang XQ, Zhang JX, Han YL. Huachansu injection enhances anti-colorectal cancer efficacy of irinotecan and alleviates its induced intestinal toxicity through upregulating UGT1A1-OATP1B3 expression in vitro and in vivo. J Integr Med. 2025; 23(5):576-590.
Irinotecan/therapeutic use* ; Animals ; Glucuronosyltransferase/genetics* ; Humans ; Colorectal Neoplasms/metabolism* ; Drugs, Chinese Herbal/therapeutic use* ; Mice, Nude ; Mice ; Up-Regulation/drug effects* ; Male ; Xenograft Model Antitumor Assays ; Mice, Inbred BALB C ; Hep G2 Cells ; Cell Line, Tumor ; Intestines/drug effects* ; Amphibian Venoms

Objective:To explore the correlation between renal function and abdominal aortic hemodynamic parameters based on four-dimensional flow(4D Flow) MRI in patients with chronic kidney disease (CKD).Methods:A cross-section prospective study was conducted on 73 patients diagnosed with CKD at First People′s Hospital of Changzhou between March 2021 and May 2023, as well as 13 volunteers without kidney injury. According to the estimated glomerular filtration rate (eGFR), the subjects were divided into CKD 1-3 stage group ( n=34), CKD 4-5 stage group ( n=39), and control group ( n=13). All subjects underwent 4D Flow MRI examination of the abdominal aorta, measuring pulse wave velocity (PWV), peak velocity, and maximum wall shear stress (WSS) at the proximal plane (Plane_1) and the higher renal artery opening plane (Plane_2) of the abdominal aorta. The differences in 4D Flow MRI hemodynamic parameters among the three groups were compared using a one-way analysis of variance or the Kruskal-Wallis test. The correlation between 4D Flow MRI hemodynamic parameters and eGFR was analyzed by using the Spearman correlation coefficient. The independent influencing factors that affect eGFR were analyzed by using multivariate linear regression analysis. Results:There were significant differences in abdominal aortic PWV and maximal WSS of Plane_1 and Plane_2 among the three groups ( H=10.38, P=0.006; F=11.16, P<0.001; F=4.75, P=0.011). There were no significant differences in the peak velocity of Plane_1 and Plane_2 among the three groups (both P>0.05). Abdominal aortic PWV was negatively correlated with eGFR ( r s=-0.30, P=0.005). There was a positive correlation between the maximal WSS of Plane_1 and Plane_2 with eGFR ( r s=0.39, P<0.001; r s=0.29, P=0.006). Abdominal aortic PWV and maximal WSS of Plane_1 were independent influencing factors of eGFR (b=-4.32, P=0.018; b=132.23, P=0.004). Conclusions:There is an independent correlation between renal function and abdominal aortic hemodynamic parameters based on 4D Flow MRI in patients with CKD, and abdominal aortic PWV and maximal WSS of Plane_1 were independent influencing factors of eGFR.

Objective To investigate the status of population dynamics and distribution changes of Aedes aegypti in Guangdong Province.Methods Continuous monitoring was conducted from May 2018 to July 2024 in Wushi Town and Qishui Town,Leizhou City,Zhanjiang City,Guangdong Province.Additionally,a survey of the distribution of Ae.aegypti along the Leizhou Peninsula coast was carried out.Results The density of Ae.aegypti in Zhanjiang showed a gradual decline from 2018 to 2024.The last detection of adult Ae.aegypti in Wushi Town was in September 2021,and the last larva was found in October 2023.No Ae.aegypti was detected in Qishui Town during surveys from 2021 to 2024.A survey of 18 coastal villages in the Leizhou Peninsula revealed no detections of Ae.aegypti.Conclusions This study provides a basis for understanding the distribution and population density fluctuations of Ae.aegypti,assessing its invasion risk,and scientifically conducting relevant prevention and control efforts.

Accurate prediction of drug responses in cancer cell lines(CCLs)and transferable prediction of clinical drug responses using CCLs are two major tasks in personalized medicine.Despite the rapid advancements in existing computational methods for preclinical and clinical cancer drug response(CDR)prediction,chal-lenges remain regarding the generalization of new drugs that are unseen in the training set.Herein,we propose a multimodal fusion deep learning(DL)model called drug-target and single-cell language based CDR(DTLCDR)to predict preclinical and clinical CDRs.The model integrates chemical descriptors,mo-lecular graph representations,predicted protein target profiles of drugs,and cell line expression profiles with general knowledge from single cells.Among these features,a well-trained drug-target interaction(DTI)prediction model is used to generate target profiles of drugs,and a pretrained single-cell language model is integrated to provide general genomic knowledge.Comparison experiments on the cell line drug sensitivity dataset demonstrated that DTLCDR exhibited improved generalizability and robustness in predicting unseen drugs compared with previous state-of-the-art baseline methods.Further ablation studies verified the effectiveness of each component of our model,highlighting the significant contribution of target information to generalizability.Subsequently,the ability of DTLCDR to predict novel molecules was validated through in vitro cell experiments,demonstrating its potential for real-world applications.Moreover,DTLCDR was transferred to the clinical datasets,demonstrating satisfactory performance in the clinical data,regardless of whether the drugs were included in the cell line dataset.Overall,our results suggest that the DTLCDR is a promising tool for personalized drug discovery.

Amino acid metabolism plays a critical role in the progression and development of breast cancer. Cancer cells, including those in breast cancer, reprogram amino acid metabolism to meet the demands of rapid proliferation, survival, and immune evasion. This includes alterations in the uptake and utilization of amino acids, such as glutamine, serine, glycine, and arginine, which provide essential building blocks for biosynthesis, energy production, and redox homeostasis. Notably, the metabolic phenotypes of breast cancer cells vary across molecular subtypes and disease stages, emphasizing the need for patient stratification and personalized therapeutic strategies. Advances in multi-level diagnostics, including phenotyping and predictive tools, such as AI-based analysis and body fluid profiling, have highlighted the potential for tailoring treatments to individual metabolic profiles. Enzymes, such as glutaminase and serine hydroxymethyltransferase, often upregulated in breast cancer, represent promising therapeutic targets. Understanding the interplay between amino acid metabolism and breast cancer biology, alongside the integration of personalized medicine approaches, can uncover novel insights into tumor progression and guide the development of precision therapies. This review explores the metabolic pathways of amino acids in breast cancer, with a focus on their implications for personalized treatment strategies.
Humans ; Breast Neoplasms/therapy* ; Female ; Amino Acids/metabolism*

Accurate prediction of drug responses in cancer cell lines (CCLs) and transferable prediction of clinical drug responses using CCLs are two major tasks in personalized medicine. Despite the rapid advancements in existing computational methods for preclinical and clinical cancer drug response (CDR) prediction, challenges remain regarding the generalization of new drugs that are unseen in the training set. Herein, we propose a multimodal fusion deep learning (DL) model called drug-target and single-cell language based CDR (DTLCDR) to predict preclinical and clinical CDRs. The model integrates chemical descriptors, molecular graph representations, predicted protein target profiles of drugs, and cell line expression profiles with general knowledge from single cells. Among these features, a well-trained drug-target interaction (DTI) prediction model is used to generate target profiles of drugs, and a pretrained single-cell language model is integrated to provide general genomic knowledge. Comparison experiments on the cell line drug sensitivity dataset demonstrated that DTLCDR exhibited improved generalizability and robustness in predicting unseen drugs compared with previous state-of-the-art baseline methods. Further ablation studies verified the effectiveness of each component of our model, highlighting the significant contribution of target information to generalizability. Subsequently, the ability of DTLCDR to predict novel molecules was validated through in vitro cell experiments, demonstrating its potential for real-world applications. Moreover, DTLCDR was transferred to the clinical datasets, demonstrating satisfactory performance in the clinical data, regardless of whether the drugs were included in the cell line dataset. Overall, our results suggest that the DTLCDR is a promising tool for personalized drug discovery.

Objective To explore the application effect of multimodal analgesia combined with goal-di-rected fluid therapy based on enhanced recovery after surgery(ERAS)in the anesthesia management of pa-tients undergoing orthopedic robot-assisted pedicle internal fixation.Methods Eighty patients with lumbar fractures who underwent robot-assisted surgery in Huai'an 82 Hospital from February 2024 to February 2025 were selected as the research objects and divided into the ERAS group and the control group according to the random number table method,with 40 cases in each group.The ERAS group received multimodal analgesia combined with goal-directed fluid therapy based on ERAS,while the control group adopted the traditional an-esthesia protocol.The hemodynamic indicators[heart rate,mean arterial pressure(MAP)]before the start of anesthesia(T0),immediately before the operation(T1),at the end of the operation(T2),and at the time of postoperative recovery(T3),as well as the IL-6 levels at T0,24 hours after the operation(T4),48 hours after the operation(T5),and 72 hours after the operation(T6)were compared between the two groups.Recorded the postoperative recovery time,visual analogue scale(VAS)score,incidence of complications and hospital stay,as well as perioperative infusion management parameters[total infusion volume,positive fluid balance volume,the compliance rate of stroke volume variation(SVV),etc.].Results Compared with the control group,the proportion of MAP fluctuations≤±10%(87.5%vs.62.5%),and the proportion of basal heart rate increase≤20%(95.0%vs.70.0%)in the ERAS group were higher than those in the control group(P<0.05).At T4,the IL-6 levels in both groups were the highest,while the IL-6 levels from T4 to T6 in the ERAS group were lower than those in the control group(P<0.05).Compared with control group,wake times[(18.5±3.2)min vs.(25.1±4.5)min],bed time for the first time[(8.2±2.1)h vs.(20.5±4.3)h],the length of time[(4.2±1.1)d vs.(6.5±1.3)d]in the ERAS group were shorter,24-hour resting VAS score(2.1±0.6 vs.3.8±0.9)and the incidence of complications(20.0%vs.57.5%)were lower,the total infusion volume[(1 850±220)mL vs.(2 550±310)mL],the amount of colloid solution[(620±95)mL vs.(850±120)mL],and the positive balance volume of liquid[(320±90)mL vs.(1 120±210)mL]were less,the intraoperative urine volume[(0.55±0.08)mL·kg-1·h-1 vs.(0.30±0.10)mL·kg-1·h-1]was more,the differences were statistically significant(P<0.05).The compliance rate of SVV in the ERAS group was 95.0%(38/40).Conclusion Multimodal analgesia combined with goal-directed fluid therapy based on ERAS can effectively stabilize the perioperative physiological state of patients undergoing robot-assisted spinal sur-gery,accelerate postoperative functional recovery and reduce complications.

ObjectiveTo delineate the species composition structure and seasonal density fluctuations of mosquito populations in Yangpu District, Shanghai, and to provide scientific insights for the prevention and control of vector-borne diseases. MethodsA total of 12 monitoring sites from different habitats were selected to conduct adult mosquito monitoring using the CO₂ trap light method during 2019‒2023, elucidating the temporal and spatial distribution and change patterns of mosquito populations and densities in Yangpu District. ResultsFrom 2019 to 2023, a total of 1 321 female mosquitoes was captured, with an overall density of 0.16 case·(lamp·h)^-1. The species identified were predominantly Culex pipiens pallens (87.28%), followed by Aedes albopictus (12.64%), and Culex tritaeniorhynchus (0.08%). Seasonal distribution showed a typical single-peak pattern, with June‒August being the peak period. In terms of habitat distribution, the highest mosquito population density was found in residential areas [0.18 case·(lamp·h)^-1], followed by hospitals [0.13 case·(lamp·h)^-1] and parks [0.11 case·(lamp·h)^-1]. Culex pipiens pallens was the dominant species in all habitats, with a density of [0.14 case·(lamp·h)^-1]. Notably, there was a statistically significant difference in the composition of Culex pipiens pallens and Aedes albopictus among the three habitats mentioned(χ²=38.396, P<0.001; χ²=36.790, P<0.001). The mosquito density of the 12 streets from high to low is Changhai Road, Pingliang, Yinhang, Xinjiangwan City, Yanji, Daqiao, Wujiaochang, Kongjiang, Changbai New Village, Jiangpu, Siping and Dinghai.The distribution of mosquito density was relatively balanced across different communities (H=1.559, P=1.000). ConclusionThe results of CO₂ trap light monitoring reveals a relatively low density of adult mosquitoes in Yangpu District, with Culex pipiens pallens as the predominant species, and summer being the peak season for mosquitoes. In light of the threat of mosquito-borne diseases such as dengue fever, more effective and evidence-based mosquito control strategies, aligning with the distribution and behavioral patterns of mosquitoes, should be developed.