OBJECTIVE To investigate the mechanism of pachymic acid on renal injury in pregnancy induced hypertension （PIH） rats by regulating the silent information regulator transcript 1/peroxisome proliferator-activated receptor γ coactivator-1α （Sirt1/PGC-1α） pathway. METHODS Pregnant SD rats were prepared by co-caging and PIH model was induced using N-nitro-L- arginine methyl ester （L-NAME） method. PIH rats were randomly divided into model group， L-pachymic acid （low-dose pachymic acid， 10 mg/kg） group， H-pachymic acid （high-dose pachymic acid， 20 mg/kg） group， and H-pachymic acid+EX527 （20 mg/kg pachymic acid+10 mg/kg EX527） group， with 6 rats in each group. Another 6 normal pregnant rats were selected as blank group. Each group was given relevant medicine or solvent intragastrically or intraperitoneally daily， once a day， for 28 consecutive days. After the last administration， 24 h urinary protein and tail artery systolic blood pressure （SBP） were measured in pregnant rats from each group， along with the levels of serum creatinine （Scr）， blood urea nitrogen （BUN），uric acid （UA）， and cystatin C （Cys-C）. The contents of superoxide dismutase （SOD）， malondialdehyde （MDA）， glutathione peroxidase （GSH-Px）， and 8-hydroxy-2′-deoxyguanosine （8-OHdG） in renal tissue， as well as the mRNA and protein expression levels of Sirt1 and PGC-1α， were also determined. Meanwhile， renal histopathological changes in rats from each group were evaluated using hematoxylin-eosin （HE） staining and periodic acid-Schiff （PAS） staining. RESULTS Compared with model group， L-pachymic acid group and H-pachymic acid group exhibited significant decreases in 24 h urine protein quantification， tail artery SBP， Scr， BUN， UA， Cys-C levels， glomerulosclerosis index score of renal tissue， renal tubular injury score， the percentage of PAS positive area， MDA and 8-OHdG （P＜0.05）. Conversely， the contents of SOD and GSH-Px， along with the mRNA and protein expression levels of Sirt1 and PGC-1α， were significantly increased （P＜0.05）. Moreover， these improvements were more pronounced in H-pachymic acid group （P＜0.05）. Compared with H-pachymic acid group， the aforementioned indicators in pregnant rats from the H-pachymic acid+EX527 group showed significant reversal （P＜0.05）. CONCLUSIONS Pachymic acid significantly ameliorates renal injury induced by PIH in rats， potentially through activation of the Sirt1/PGC-1α pathway.

Biohybrid robots are hybrid systems that deeply integrate living biological components （such as cells, tissues, organs, or microorganisms） with artificial synthetic components （including sensors, actuators, control systems, and structural materials）. Focusing on key advancements in cellular/microbial-level and tissue-level biohybrid robots, the applications in two major scenarios: targeted drug delivery in vivo and drug evaluation in vitro were reviewed. International research progress demonstrated that biohybrid robots offered novel solutions for overcoming deep tissue delivery barriers, enhancing biocompatibility, and enabling real-time monitoring. However, their clinical translation still faced critical challenges, including reproducibility, in vivo/in vitro nutrient supply, encapsulation technologies, and safety regulatory frameworks.

Sepsis is a systemic inflammatory response triggered by infection and often leads to acute kidney injury(AKI).The pathogenesis of sepsis-associated AKI is complex,involving multiple factors such as renal ischemia,inflammation and oxidative stress.In recent years,pyroptosis,a pro-inflammatory form of programmed cell death,has gradually attracted the attention of researchers.Pyroptosis is activated by inflammasomes(e.g.,the NOD-like receptor pyrin domain-related protein 3 inflammasome,NLRP3 inflammasome),accompanied by Gas-dermin D(GSDMD)-mediated formation of cell membrane pores and release of cellular contents,which leads to exacerbation of local and systemic inflammatory responses.The mechanism of pyroptosis in sepsis-associated AKI has not been fully elucidated,but AKI is directly involved in the process of renal functional impairment by indu-cing the death of renal tubular epithelial cells and exacerbating the local inflammatory response.Blockade of key molecules in the pyroptosis pathway,such as GSDMD or NLRP3 inflammasome,can significantly alleviate renal injury,suggesting that the pyroptosis pathway may be a potential therapeutic target for sepsis-associated AKI.This review summarizes the recent research progress on pyroptosis in sepsis-associated AKI,and discuss its cen-tral role in the pathogenesis,particularly focusing on the inflammasome and GSDMD pathways.Additionally,this paper analyzes the potential of focal death inhibition as a therapeutic strategy and proposes future research direc-tions with the expectation of providing references for the treatment of sepsis-related AKI.

Objective:To investigate the completion rate of tumor evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients in the national multicenter real-world database.Methods:The prospective real-world study was conducted. The clinicopathological data of 1 074 patients who underwent surgical treatment for mid and low rectal cancer in 47 national medical institutions, including Peking Union Medical College Hospital et al, from May 12,2023 to May 11,2024 were collected. Observation indicators: (1) clinical characteristics of patients with mid and low rectal cancer; (2) initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer; (3) initial imaging evaluation of patients with mid and low rectal cancer; (4) imaging evaluation after neoadjuvant therapy for patients with mid and low rectal cancer. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M( Q1, Q3). Count data were described as absoluter numbers and/or percentages. Results:(1) Clinical characteristics of patients with mid and low rectal cancer. Of the 1 074 patients, there were 713 males and 361 females, aged 63(56,70)years. The body mass index of 1 074 patients was 24(21,26)kg/m 2.For American Society of Anesthesiologists classification, there were 147 cases of stage Ⅰ, 641 cases of stage Ⅱ, 157 cases of stage Ⅲ, 2 cases of stage Ⅳ, and there were 127 cases missing data. (2) Initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer. Of the 1 074 patients, there were 787 cases (73.28%) undergoing complete colonoscopy, and there were only 197 cases (18.34%) undergoing immunohistochemical evaluation of all four mismatch repair proteins. (3) Initial imaging evaluation of patients with mid and low rectal cancer. Of the 1 074 patients, there were 842(78.40%) patients completing magnetic resonance imaging (MRI) or ultrasound evaluation, and there were 914(85.10%) patients completing chest, abdomen, and pelvis enhanced computed tomography (CT) evaluation. In the 149 patients completing rectal ultrasound evaluation, there were 122 cases (81.88%) comple-ting T staging evaluation, and there were 81 cases (54.36%) completing N staging evaluation. In the 808 patients completing rectal MRI evaluation, there were 708 cases (87.62%) completing T staging evaluation, and there were 590 cases (73.02%) completing N staging evaluation. (4) Imaging evalua-tion after neoadjuvant therapy for patients with mid and low rectal cancer. Of the 388 patients with neoadjuvant therapy, there were 332 patients (85.57%) completing MRI or ultrasound evaluation, and there were 327 patients (84.28%) completing chest, abdomen, and pelvis enhanced CT evalua-tion. In the 70 patients completing rectal ultrasound evaluation, there were 65 cases (92.86%) com-pleting T staging evaluation, and there were 49 cases (70.00%) completing N staging evaluation. In the 327 patients completing rectal MRI evaluation, there were 246 cases (75.23%) completing T staging, and there were 228 cases (69.72%) completing N staging evaluation. Conclusion:The com-pletion rate of tumor imaging evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients on a national scale is relatively good.

Objective:To observe the analgesic effect and therapeutic mechanism of the dragon-tiger fight needling method in treating lumbar disc herniation(LDH).Methods:A total of 100 patients with LDH were selected and randomly divided into an observation group and a control group,with 50 patients in each group.Both groups received the same basic treatment of Western medicine.The observation group received additional acupuncture treatment using the dragon-tiger fight needling method,administered once every other day for a consecutive month.Before and after treatment,the serum levels of bradykinin(BK),soluble tumor necrosis factor type 1 receptor(sTNF-R1),α1-acid glycoprotein(α1-AGP),phospholipase A2(PLA2),methionine enkephalin(M-ENK),β-endorphin(β-EP),and 6-keto prostaglandin E1α(6-keto-PGE1α)were measured in both groups.Additionally,the sensory conduction velocities(SCV)of the sural nerve and superficial peroneal nerve,as well as the biomechanical indicators of lumbar muscles(including the lumbar flexion-extension ratio and peak torque and average power in the lumbar extension position)were assessed.The Oswestry disability index(ODI)was evaluated,and traditional Chinese medicine(TCM)symptoms were scored for patients in both groups.After treatment,the clinical efficacy of the two groups was compared.Results:After treatment,the serum levels of α1-AGP and PLA2 in both groups decreased compared to their respective pre-treatment levels(P<0.05),and the levels in the observation group were lower than those in the control group(P<0.05).The serum levels of sTNF-R1 in both groups increased compared to their respective pre-treatment levels(P<0.05),and the levels in the observation group were higher than those in the control group(P<0.05).The serum levels of 6-keto-PGE1α and BK in both groups decreased significantly compared to their respective pre-treatment levels(P<0.05),and the levels in the observation group were lower than those in the control group(P<0.05).The serum levels of M-ENK and β-EP in both groups increased compared to their respective pre-treatment levels(P<0.05),and the levels in the observation group were higher than those in the control group(P<0.05).The lumbar flexion-extension ratio in both groups decreased compared to their respective pre-treatment level(P<0.05),and the ratio in the observation group was lower than that in the control group(P<0.05).The peak torque and average power in the lumbar extension position increased in both groups compared to their respective pre-treatment levels(P<0.05),and both values in the observation group were higher than those in the control group(P<0.05).The SCV of the superficial peroneal nerve and sural nerve in both groups increased compared to their respective pre-treatment levels(P<0.05),and the values in the observation group were higher than those in the control group(P<0.05).The ODI and TCM symptom scores in both groups decreased(P<0.05),and the scores in the observation group were lower than those in the control group(P<0.05).Conclusion:Based on Western medicine treatment,acupuncture treatment using the dragon-tiger fight needling method for LDH patients can inhibit inflammatory markers,regulate pain mediator levels,alleviate pain,improve the biomechanical and electromyographic indicators of lumbar extensor muscles,and thus enhance lumbar function and clinical efficacy.

Sepsis is a systemic inflammatory response triggered by infection and often leads to acute kidney injury(AKI).The pathogenesis of sepsis-associated AKI is complex,involving multiple factors such as renal ischemia,inflammation and oxidative stress.In recent years,pyroptosis,a pro-inflammatory form of programmed cell death,has gradually attracted the attention of researchers.Pyroptosis is activated by inflammasomes(e.g.,the NOD-like receptor pyrin domain-related protein 3 inflammasome,NLRP3 inflammasome),accompanied by Gas-dermin D(GSDMD)-mediated formation of cell membrane pores and release of cellular contents,which leads to exacerbation of local and systemic inflammatory responses.The mechanism of pyroptosis in sepsis-associated AKI has not been fully elucidated,but AKI is directly involved in the process of renal functional impairment by indu-cing the death of renal tubular epithelial cells and exacerbating the local inflammatory response.Blockade of key molecules in the pyroptosis pathway,such as GSDMD or NLRP3 inflammasome,can significantly alleviate renal injury,suggesting that the pyroptosis pathway may be a potential therapeutic target for sepsis-associated AKI.This review summarizes the recent research progress on pyroptosis in sepsis-associated AKI,and discuss its cen-tral role in the pathogenesis,particularly focusing on the inflammasome and GSDMD pathways.Additionally,this paper analyzes the potential of focal death inhibition as a therapeutic strategy and proposes future research direc-tions with the expectation of providing references for the treatment of sepsis-related AKI.

Objective:To explore the risk factors and etiological characteristics of urinary tract infection caused by urinary calculi in eastern Fujian region,in order to attract clinical attention and improve the prevention and treatment of urinary tract infection caused by urinary calculi.Methods:A total of 154 patients with urinary calculi admitted to Ningde People's Hospital(n=80)and Ningde Mindong Hospital(n=74)from November 2022 to October 2023 were selected as the main research objects.According to whether the patients had urinary tract infection,they were divided into infection group and non-infection group.The baseline data of the two groups were analyzed in detail,and the risk factors and pathogen distribution of urinary tract infection in patients with urinary calculi were analyzed.Results:There were 33 cases of urinary tract infection in 154 patients with urinary calculi,accounting for 21.43％.Univariate analysis showed that the urinary white blood cell count in the infection group was higher than that in the non-infection group,and the proportion of patients with effusion,urinary tract obstruction,calculi in the upper urinary tract,staghorn calculi,smoking history,diabetes,and urinary nitrite positive was higher than that in the uninfected group(P＜0.05).The results of binary logistic regression analysis showed that effusion,urinary tract obstruction,staghorn calculi,smoking history,diabetes,high urine white blood cell count and positive urine nitrite were independent risk factors for urinary tract infection in patients with urinary calculi(OR＞1,P＜0.05).A total of 33 strains of pathogenic bacteria were isolated from 33 patients in the infection group.Among them,23 strains(69.70％)were gram-negative bacteria,8 strains(24.24％)were gram-positive bacteria,and 2 strains(6.06％)were fungi.Among gram-negative bacteria,escherichia coli accounted for the highest proportion(48.48％),followed by klebsiella pneumoniae(9.09％).Among gram-positive bacteria,enterococcus faecalis accounted for the highest proportion(12.12％),followed by enterococcus faecium(6.06％).Candida and candida tropicalis in fungi was the same,accounted for 3.03％.Conclusion:The risk of urinary tract infection in patients with urinary calculi in eastern Fujian region is high.Effusion,urinary tract obstruction,staghorn calculi,smoking history,diabetes,high urine white blood cell count and positive urine nitrite are independent risk factors for urinary tract infection in patients with urinary calculi.The main urinary tract pathogens are gram-negative bacteria.

Objective:To explore the risk factors and etiological characteristics of urinary tract infection caused by urinary calculi in eastern Fujian region,in order to attract clinical attention and improve the prevention and treatment of urinary tract infection caused by urinary calculi.Methods:A total of 154 patients with urinary calculi admitted to Ningde People's Hospital(n=80)and Ningde Mindong Hospital(n=74)from November 2022 to October 2023 were selected as the main research objects.According to whether the patients had urinary tract infection,they were divided into infection group and non-infection group.The baseline data of the two groups were analyzed in detail,and the risk factors and pathogen distribution of urinary tract infection in patients with urinary calculi were analyzed.Results:There were 33 cases of urinary tract infection in 154 patients with urinary calculi,accounting for 21.43％.Univariate analysis showed that the urinary white blood cell count in the infection group was higher than that in the non-infection group,and the proportion of patients with effusion,urinary tract obstruction,calculi in the upper urinary tract,staghorn calculi,smoking history,diabetes,and urinary nitrite positive was higher than that in the uninfected group(P＜0.05).The results of binary logistic regression analysis showed that effusion,urinary tract obstruction,staghorn calculi,smoking history,diabetes,high urine white blood cell count and positive urine nitrite were independent risk factors for urinary tract infection in patients with urinary calculi(OR＞1,P＜0.05).A total of 33 strains of pathogenic bacteria were isolated from 33 patients in the infection group.Among them,23 strains(69.70％)were gram-negative bacteria,8 strains(24.24％)were gram-positive bacteria,and 2 strains(6.06％)were fungi.Among gram-negative bacteria,escherichia coli accounted for the highest proportion(48.48％),followed by klebsiella pneumoniae(9.09％).Among gram-positive bacteria,enterococcus faecalis accounted for the highest proportion(12.12％),followed by enterococcus faecium(6.06％).Candida and candida tropicalis in fungi was the same,accounted for 3.03％.Conclusion:The risk of urinary tract infection in patients with urinary calculi in eastern Fujian region is high.Effusion,urinary tract obstruction,staghorn calculi,smoking history,diabetes,high urine white blood cell count and positive urine nitrite are independent risk factors for urinary tract infection in patients with urinary calculi.The main urinary tract pathogens are gram-negative bacteria.

This study was aimed at establishing a method of ultra-fast quantitative PCR for Brucella detection.We used an exogenous recombinant plasmid as the internal reference and targeted the T4SS secretion system,an important Brucella viru-lence factor,to design specific primers and probes.The sensitivity,specificity,and repeatability of this method were evaluated,and a standard curve was constructed.The coincidence rate of detection findings with this method versus quantitative PCR was determined.This method markedly decreased the detection time to only 10 minutes.The standard curve demonstrated a good linear relationship(Y=-3.410 7x+38.357,R2=0.998 5)with a low minimum detection limit of 10 copies/μL.The method exhibited good specificity and did not specifically amplify several common clinical bacteria other than Brucella.The de-tection of three concentrations of positive plasmids yielded coefficients of variation(CVs)of 0.20％to 0.91％,thus demonstra-ting the method's excellent repeatability.Furthermore,140 clinical samples were analyzed concurrently with the fluorescence PCR method,which yielded a 100％compliance rate and consistent results.Our findings indicated that the Brucella ultra-fast quantitative PCR was ultrafast;had high sensitivity,high specificity,and good specificity;and can be used for the clinical de-tection of Brucella and emergency investigation of epidemics.Therefore,this method is valuable for the early diagnosis of Bru-cella.

Objective To observe the clinical efficacy and safety of dexmedetomidine injection combined with esketamine injection in the treatment of patients with oral squamous cell carcinoma radical resection.Methods Patients with oral squamous cell carcinoma radical resection were randomly divided into treatment and control groups.The treatment group will receive intravenous administration of 0.6 μg·kg-1 dexmedetomidine 10 minutes before anesthesia induction.Subsequently,anesthesia induction will be performed with intravenous administration of 0.5 mg·kg-1 esketamine.Anesthesia maintenance will be achieved with intravenous infusion of 0.25 mg·kg-1·h-1 esketamine and 0.3 μg·kg-1·h-1 dexmedetomidine used an infusion pump.The control group will receive intravenous administration of an equivalent volume of 0.9％NaCl 10 minutes before anesthesia induction.Anesthesia induction will then be performed with intravenous administration of 2.5-5.0 μg·kg-1 fentanyl.Anesthesia maintenance will involve intravenous infusion of 0.10-0.25 μg·kg-1·min-1 remifentanil used an infusion pump.The anesthesia effectiveness,analgesic effectiveness,hemodynamics and safety were compared between the two groups.Results Treatment group were enrolled 62 cases,1 case dropped out,and 61 cases were finally included in the statistical analysis.Control group were enrolled 61 cases,1 case dropped out,and 60 cases were finally included in the statistical analysis.The recovery room stay time of treatment and control groups was(25.97±4.52)and(18.39±3.64)min,the extubation time was(16.75±4.84)and(10.16±3.18)min,and the differences were statistically significant(all P＜0.05).After operation 24 h,visual analogue scores of treatment and control groups were(0.85±0.17)and(1.39±0.25)points,adrenocorticotropin levels were(60.07±7.13)and(72.64±9.81)pg·mL-1,cortisol levels were(481.20±49.15)and(539.94±57.77)nmol·L-1,and the differences were statistically significant(all P＜0.05).The mean arterial pressure at 30 min after anesthesia induction(T1)and at the end of surgery(T2)in treatment group were(82.34±4.98)and(86.57±4.18)mmHg,while those in control group were(77.25±7.16)and(76.02±6.29)mmHg;the heart rates of T1 and T2 in treatment groups were(64.08±4.19)and(66.45±4.83)time·min-1,while those in control group were(68.44±6.02)and(72.08±7.27)time·min-1;and the differences were statistically significant(all P＜0.05).The adverse drug reactions in two groups were nausea,vomiting,bradycardia and dizziness.The total incidences of adverse drug reactions in treatment and control groups were 8.20％and 15.00％,without significant difference(P＞0.05).Conclusion Dexmedetomidine injection combined with esketamine injection has a definitive analgesia efficacy in the treatment of patients with oral squamous cell carcinoma radical resection,which can significantly reduce stress responses,maintain hemodynamic stability,without increasing the incidence of adverse drug reactions.