BACKGROUND: Quantitative flow ratio (QFR) holds significant value in guiding drug-coated balloon (DCB) treatment and enhancing outcomes. However, the predictive capability of post-angioplasty QFR for long-term clinical events in patients with de novo lesions who receive DCB treatment remains uncertain. The aim of this study was to explore the potential significance of post-angioplasty QFR measurements in predicting clinical outcomes in patients underwent DCB treatment for de novo lesions. METHODS: Patients who underwent DCB-only intervention for de novo lesions were enrolled. QFR was conducted after DCB treatment. The patients were then categorized based on post-angioplasty QFR. The primary endpoint was major adverse cardiac events (MACE), encompassing all-cause death, cardiovascular death, nonfatal myocardial infarction, stroke, and target vessel revascularization. RESULTS: A total of 553 patients with 561 lesions were included. The median follow-up period was 505 days, during which 66 (11.8%) MACEs occurred. Based on post-procedural QFR grouping, there were 259 cases in the high QFR group (QFR > 0.93) and 302 cases in the low QFR group (QFR ≤ 0.93). Kaplan-Meier analysis revealed a significantly higher cumulative incidence of MACE in the low QFR group (log-rank P = 0.004). The multivariate Cox proportional hazards model demonstrated a significant inverse correlation between QFR and the occurrence of MACEs (HR = 0.522, 95%CI: 0.289-0.942, P = 0.031). Landmark analysis indicated that high QFR had a significant reducing effect on the cumulative incidence of MACEs within 1 year (log-rank P = 0.016) and 1-5 years (log-rank P = 0.026). CONCLUSIONS In patients who underwent DCB-only treatment for de novo lesions, higher post-procedural QFR values (> 0.93) were identified as an independent protective factor against adverse prognosis.

OBJECTIVE: To evaluate the anti-hepatocellular carcinoma (HCC) activity of total alkaloids from Gelsemium elegans Benth. (TAG) in vivo and in vitro and to elucidate their potential mechanisms of action through transcriptomic analysis. METHODS: TAG extraction was conducted, and the primary components were quantified using high-performance liquid chromatography (HPLC). The effects of TAG (100, 150, and 200 µg/mL) on various tumor cells, including SMMC-7721, HepG2, H22, CAL27, MCF7, HT29, and HCT116, were assessed. Effects of TAG on HCC proliferation and apoptosis were detected by colony formation assays and cell stainings. Caspase-3, Bcl-2, and Bax protein levels were detected by Western blotting. In vivo, a tumor xenograft model was developed using H22 cells. Totally 40 Kunming mice were randomly assigned to model, cyclophosphamide (20 mg/kg), TAG low-dose (TAG-L, 0.5 mg/kg), and TAG high-dose (TAG-H, 1 mg/kg) groups, with 10 mice in each group. Tumor volume, body weight, and tumor weight were recorded and compared during 14-day treatment. Immune organ index were calculated. Tissue changes were oberseved by hematoxylin and eosin staining and immunohistochemistry. Additionally, transcriptomic and metabolomic analyses, as well as quatitative real-time polymerase chain reaction (RT-qPCR), were performed to detect mRNA and metabolite expressions. RESULTS: HPLC successfully identified the components of TAG extraction. Live cell imaging and analysis, along with cell viability assays, demonstrated that TAG inhibited the proliferation of SMMC-7721, HepG2, H22, CAL27, MCF7, HT29, and HCT116 cells. Colony formation assays, Hoechst 33258 staining, Rhodamine 123 staining, and Western blotting revealed that TAG not only inhibited HCC proliferation but also promoted apoptosis (P<0.05). In vivo experiments showed that TAG inhibited the growth of solid tumors in HCC in mice (P<0.05). Transcriptomic analysis and RT-qPCR indicated that the inhibition of HCC by TAG was associated with the regulation of the key gene CXCL13. CONCLUSION TAG inhibits HCC both in vivo and in vitro, with its inhibitory effect linked to the regulation of the key gene CXCL13.
Animals ; Apoptosis/drug effects* ; Liver Neoplasms/genetics* ; Carcinoma, Hepatocellular/genetics* ; Humans ; Alkaloids/therapeutic use* ; Gelsemium/chemistry* ; Cell Line, Tumor ; Cell Proliferation/drug effects* ; Mice ; Xenograft Model Antitumor Assays

Background:To compare the efficacy and safety of monthly administrations of gonadotropin releasing hormone (GnRH) agonists LY01005 and Zoladex ? in Chinese patients with premenopausal breast cancer. Methods:From October 2020 to November 2021, 188 premenopausal breast cancer patients were enrolled in 34 hospitals and randomized 1:1 to receive either LY01005 or Zoladex ? every 28 days for a total of three injections. All patients concomitantly received oral tamoxifen (TAM). The primary efficacy endpoint was cumulative probability of maintaining menopausal level [oestradiol (E2) ≤30 pg/ml] from day 29 to day 85. The second efficacy endpoint included changes in E2, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) compared with the baseline. Pharmacokinetics (PK), pharmacodynamics (PD), and safety were analyzed. The study also evaluated the pharmacokinetic and pharmacodynamic characteristics of LY01005. Results:A total of 188 patients were randomised and 187 patients received either LY01005 or Zoladex ?. Cumulative probabilities of maintaining menopausal level (E2≤30 pg/ml) from day 29 to day 85 were 93.1% for LY01005 and 86.3% for Zoladex ?. The between-group difference was 6.8% (95% CI: -2.3%, 15.9%) and primary efficacy in the LY01005 group was not inferior to that in the Zoladex ? group. Changes in E2, LH, and FSH levels compared with the baseline were equivalent between the two groups (E2: 89.34% to 90.23% vs. 82.11% to 85.02%; LH: 88.89% to 95.52% vs. 89.70% to 97.02%; FSH: 75.36% to 80.85% vs.73.07% to 80.24%, respectively). After three consecutive doses of LY01005, the LH and FSH levels of the subjects showed a transient increase after the first dose, reached a peak on the second day and then started to decrease. The LH and FSH reached a lower level and remained at or below that level until the 85th day. Both treatments were well-tolerated. Conclusion:LY01005 is as effective as Zoladex ? in suppressing E2 to menopausal levels in Chinese patients with premenopausal breast cancer, with a similar safety profile.

Pasteurella is a genus of zoonotic pathogens that are widely distributed in both healthy and diseased ani-mals.Reports of human infections caused by wild animal bites are rare.This paper reports the first case of Pasteu-rella multocida infection caused by a snow leopard bite in China.The strains were identified using the DL-96 Ⅱ bac-terial identification system,BRUKER automatic microbial mass spectrometer,and Autof ms 1000 mass spectrome-ter.Antimicrobial susceptibility testing was performed using the DL-96 Ⅱ bacterial assay system.After wound de-bridement,surgical incision and drainage,and combined antimicrobial treatment,the patient recovered and was dis-charged from the hospital.This paper aims to improve clinical health care workers'understanding on this bacterium.

This study explored the effects and underlying mechanism of Raf kinase inhibitory protein(RKIP)on apoptosis in mast cells sensitized by Echinococcus granulosus cyst fluid.Bone marrow-derived mast cells(BMMCs)were isolated and cultured from RKIP knockout(KO)and wild-type(WT)C57BL/6 mice.Cells were divided into control and sensitized groups.The sensitized group was incubated for 24 h in RPMI1640 medium containing 10%serum from mice infected with E.granulosus,then activated for 3 h or 6 h with E.granulosus cyst fluid.The control group was incubated for 24 h in RPMI1640 medium,and then received an equal vol-ume of PBS.Cells and supernatants were collected for analysis.Flow cytometry was used to detect the expression of CD117 and FcεRⅠα on BMMCs.The levels of β-hexosaminidase,IL-4,and TNF-α in the supernatant were quantified with ELISA.Western blot analy-sis was used to assess expression changes in RKIP,apoptosis-related proteins,and pathway proteins in BMMC before and after sensi-tization.Flow cytometry analysis revealed that after 4 weeks of induction,the CD117 and FcεRⅠα double-positivity rates on both WT and KO BMMC exceeded 90%.ELISA indicated that the E.granulosus cyst fluid resulted in significantly greater β-hexosaminidase re-lease(F=16.88,P<0.05),and levels of IL-4(F=16.51,P<0.05)and TNF-α(F=9.78,P<0.05)in the KO sensitized group than the WT sensitized group.With respect to the WT control group,the WT sensitized group showed significantly down-regulated pro-tein expression levels of RKIP(F=8.20,P<0.05)and Bcl-2(F=101.40,P<0.01)after 3 h,but significantly up-regulated levels of p-PI3K(F=8.04,P<0.05),p-Akt(F=32.52,P<0.01),p-P65(F=13.29,P<0.05),and cleaved-caspase-3(F=46.34,P<0.01).With respect to the WT sensitized group,the KO sensitized group showed significantly up-regulated protein expression of p-PI3K(F=8.45,P<0.05),p-Akt(F=8.58,P<0.05),p-P65(F=11.02,P<0.05),and Bcl-2(F=84.50,P<0.001)after 3 h,but significantly down-regulated expression of cleaved-caspase-3(F=15.66,P<0.05).In conclusion,RKIP may inhibit the PI3K/Akt/NF-κB pathway,thereby inducing apoptosis in mast cells sensitized by E.granulosus cyst fluid.This process may help ease aller-gic reactions caused by mast cells in echinococcosis,thus offering a promising new approach for preventing and treating such reactions.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

Objective:To investigate the characteristics of metabolic indicators in patients with allergic rhinitis (AR) and the potential relationship between AR and metabolic syndrome (MetS).Methods:A total of 179 patients with MetS admitted to the Dahua Hospital in Xuhui District, Shanghai, from June 2021 to May 2024 were retrospectively included. They were divided into an AR group (69 cases) and a non-AR group (110 cases) based on the presence of AR. Clinical data including demographic information, metabolic indicators, and immunological test results were collected. Multivariate logistic regression analysis was used to identify clinical risk factors associated with MetS complicated with AR, and a nomogram prediction model was constructed. The model′s discriminative ability, calibration, and clinical predictive performance were evaluated using receiver operating characteristic (ROC) curves, consistency index (C-index), and decision curve analysis.Results:The AR group had a significantly higher proportion of males, fasting C-peptide levels, total cholesterol, low-density lipoprotein cholesterol, CD4/CD8 ratio, immunoglobulin M, immunoglobulin E, CD3 cell count, CD4 cell count, and interleukin-6 levels compared to the non-AR group, while hip circumference was significantly lower (all P<0.05). Logistic regression analysis showed that male sex ( OR=2.156, P=0.042), total cholesterol ( OR=1.504, P=0.003), fasting C-peptide ( OR=3.342, P=0.016), CD4 cell count ( OR=1.002, P=0.011), and interleukin-6 ( OR=1.124, P=0.002) were risk factors for AR in MetS patients, while hip circumference ( OR=0.956, P=0.026) was a protective factor. The area under the ROC curve of the nomogram model was 0.771(95% CI: 0.698-0.841), and the C-index was 0.769(95% CI: 0.732-0.806), indicating good predictive ability and consistency of the model. Conclusions:The occurrence of AR is closely associated with multiple metabolic indicators, suggesting that AR may not only be a local inflammatory condition but also involve systemic metabolic abnormalities. The nomogram model based on these risk factors can be used for individualized risk assessment and early intervention.

Objective:To evaluate the diagnostic value of image enhancement endoscopy (IEE) for sinonasal malignant tumors.Methods:Patients with nasal neoplasms at the Department of Otorhinolaryngology Head and Neck Surgery at Beijing Tongren Hospital from January 2019 to December 2021 were examined using white light endoscopy (WLE) and IEE. Targeted biopsy was performed after image collection, and the images were analyzed by two blinded observers. Pathological diagnosis was compared with endoscopic findings. Diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated, and P<0.05 was statistically significant. Kappa(k) was employed to assess consistency between endoscopic and histopathological diagnoses. The vascular patterns of sinonasal malignancy were compared with Ni endoscopic classification.Results:This study ultimately included 193 patients with nasal tumors, and 41 cases (21.24%, 41/193) were comfirmed histopathologically with sinonasal malignancies. WLE correctly diagnosed 18 cases (43.90%, 18/41), while IEE diagnosed 28 cases (68.29%, 28/41). Among the 41 malignancies, 28 cases (68.29%, 28/41) showed patchy/punctate patterns and tortuous vessels (Ni type Ⅴ). All 14 squamous epithelium-derived malignancies (34.15%, 14/41) had Ni type Ⅴ vessels. Of 27 non-squamous malignancies, 14 cases (34.15%, 14/41) were Ni type Ⅴ, 7 cases (17.07%, 7/41) were false negatives, 6 cases (14.63%, 6/41) that their vessels were obscured by necrotic tissue. Compared to WLE, IEE had higher sensitivity (80.00% vs 51.42%), specificity (98.68% vs 96.69%), PPV (93.33% vs 78.26%), NPV (95.51% vs 89.57%), diagnostic consistency (95.16% vs 88.17%), and κ value (0.832 vs 0.554). Conclusions:IEE improves the endoscopic diagnosis of sinonasal malignancies. Ni type Ⅴ is suitable for the diagnosis of malignant tumors of squamous epithelial malignant tumors.

Objective To explore the expression of Nudix hydrolase 5(NUDT5)protein in breast cancer tissues and its correlation with ultrasound signs and clinicopathological characteristics.Methods A total of 108 patients with breast cancer admitted to our hospital from October 2019 to April 2022 were selected as the research objects.Ultrasound examination was performed before operation to observe the ultrasound signs of patients.Immunohistochemical method was used to detect the expressions of estrogen receptor(ER),progesterone receptor(PR)and human epidermal growth factor receptor 2(HER-2)in breast cancer tissues,and the expression levels of NUDT5 protein in breast cancer tissues and adjacent tissues,and the relationships of NUDT5 protein expression with ultrasound signs and clinicopathological characteristics of patients were analyzed.Results Among 108 patients,there were 62 cases with ER positive,60 cases with PR positive,and 28 cases with HER-2 positive.The positive expression rate of NUDT5 protein in breast cancer tissues was higher than that in adjacent tissues(P<0.05).The positive expression rate of NUDT5 protein was higher in breast cancer tissues with microcalcification,blood flow imaging grade(grade 2 to 3)and lymph node metastasis(P<0.05).The positive expression of NUDT5 protein was correlated with histological grade,ER and HER-2(P<0.05).The expression of NUDT5 protein in breast cancer tissue was positively correlated with ER negative and HER-2 positive(rs=0.463,0.398,P<0.05).Conclusion The positive expression rate of NUDT5 protein in breast cancer tissues is higher than that in adjacent tissues,and its expression has a certain correlation with microcalcification,blood flow imaging grade(grade 2 to 3),lymph node metastasis in ultrasound signs and histological grade,ER,and HER-2 in clinicopathological characteristics.

OBJECTIVE To evaluate the quality of Mongolian medicine Sendeng-4 based on qualitative and quantitative analysis combined with chemical pattern recognition， in order to provide the reference for its quality control. METHODS The chemical components in Sendeng-4 were analyzed qualitatively by HPLC-Q-Exactive-MS. The contents of 16 components （methyl gallate， ethyl gallate， epicatechin， dihydromyricetin， genipin-1-O-β-D-gentiobioside， caffeic acid， catechin， corilagin， deacetylasperulosidic acid methyl ester， rutin， geniposide， luteolin， myricetin， quercetin， ferulic acid， and toosendanin） in 15 batches of Sendeng-4 （sample S1-S15） were quantitatively analyzed by HPLC-MS/MS. Cluster analysis （CA）， principal component analysis （PCA）， and orthogonal partial least squares discriminant analysis were conducted and variable importance projection （VIP） value greater than 1 was used as the index to screen the differential components. RESULTS A total of 73 chemical components were identified in Sendeng-4， including 20 flavonoids， 16 tannins， 14 organic acids， etc. According to the quantitative analysis， the results exhibited that the average contentsthe of above 16 components in 15 batches of Sendeng-4 were 3.683-7.730， 2.391-6.952， 2 275.538-4 377.491， 2 699.188-3 537.924， 858.266-1 377.393， 3.366-11.003， 140.624-315.683，414.629-978.334， 285.501-1 510.457， 27.799-48.325， 3 625.415-6 309.563， 0.506-0.656， 442.337-649.283， 47.093-59.736， 12.942-15.822， 127.738-326.649 μg/g， respectively. According to the results of CA and PCA， 15 batches of samples could be clustered into two categories: S1-S3， S5-S6， S9-S10 and S13 were clustered into one category； S4， S7-S8， S11-S12， S14-S15 were clustered into one category. VIP values of geniposide， epicatechin， deacetylasperulosidic acid methyl ester and genipin-1-O- β-D-gentiobioside were all greater than 1. CONCLUSIONS HPLC-Q-Exactive-MS and HPLC-MS/MS techniques are employed for the qualitative and quantitative analysis of Sendeng-4. Through chemical pattern recognition analysis， four differential components are identified: geniposide， epicatechin， deacetylasperulosidic acid methyl ester， and genipin-1-O-β-D-gentiobioside.