Traditional development of small protein scaffolds has relied on display technologies and mutation-based engineering, which limit sequence and functional diversity, thereby constraining their therapeutic and application potential. Protein design tools have significantly advanced the creation of novel protein sequences, structures, and functions. However, further improvements in design strategies are still needed to more efficiently optimize the functional performance of protein-based drugs and enhance their druggability. Here, we extended an evolution-based design protocol to create a novel minibinder, BindHer, against the human epidermal growth factor receptor 2 (HER2). It not only exhibits super stability and binding selectivity but also demonstrates remarkable properties in tissue specificity. Radiolabeling experiments with ^99mTc, ⁶⁸Ga, and ¹⁸F revealed that BindHer efficiently targets tumors in HER2-positive breast cancer mouse models, with minimal nonspecific liver absorption, outperforming scaffolds designed through traditional engineering. These findings highlight a new rational approach to automated protein design, offering significant potential for large-scale applications in therapeutic mini-protein development.

Nuclear radiation exposure events and tumor radiotherapy are highly susceptible to a range of psychological, physiological and other health problems, which can seriously affect patients' quality of life. It has been shown that 87.5 % of tumor patients are exposed to varying degrees of radiation injury during radiotherapy. The treatment of radiation injury (RI) in modern medicine is limited to drug therapy, cell therapy, etc. Among them, the most chemical drugs cause many adverse reactions including fatigue, nausea, vomiting, etc., and there are very few drugs dedicated to the treatment of RI. Traditional Chinese medicine (TCM) is a rich natural medicinal resource, which has a wide range of pharmacological activities, multiple targets of action and minimal toxic side effects. Many studies have demonstrated that TCM and its compound preparations have enormous potential in the treatment of radiation induced comprehensive diseases. However, TCM is limited in clinical application due to its slow onset of action, complex active ingredients, and low bioavailability. Therefore, the article reviews the application, molecular mechanisms, and new dosage forms of TCM in the prevention and treatment of RI. On this basis, we will focus on discussing the development advantages and application prospects of the combination of traditional Chinese and Western medicine to achieve highly efficient treatment of RI. This review aims to provide scientific and effective drug delivery strategies and basic theoretical support for the clinical effective treatment of RI with TCM, and further promote the innovative development of TCM.

Objective:To compare the clinical efficacy between robot-assisted and free-hand percutaneous cannulated screwing (PCS) in the treatment of femoral neck fractures in the middle-aged and young patients.Methods:A retrospective study was conducted to analyze the clinical data of 53 patients with femoral neck fracture who had been treated with PCS from May 2020 to May 2022 at Department of Traumatic Surgery, Maoming Hospital Affiliated to Southern Medical University. In the robot group of 25 patients subjected to robot-assisted PCS, there were 11 males and 14 females with an age of (48.2 ± 11.9) years; in the free-hand group of 28 patients subjected to free-hand PCS, there were 13 males and 15 females with an age of (48.5 ± 9.8) years. The 2 groups were compared in terms of operation time, intraoperative bleeding, intraoperative guide drills, intraoperative fluoroscopy frequency, fracture union time, Harris hip score at the last follow-up and postoperative complications. Postoperative imaging examination was performed to evaluate distribution accuracy of the cannulated screws in the femoral neck (deviation between the screws and the femoral neck axis, parallelism between the screws and distance between the screws and the neck cortex).Results:There was no statistically significant difference between the robot and free-hand groups in the general clinical data before operation, showing comparability ( P>0.05). The robot group showed significantly shorter operation time [(32.7 ± 4.8) min], significantly less intraoperative bleeding [(14.6 ± 4.8) mL], significantly less intraoperative guide drillings [(3.5 ± 0.7) times] and significantly less intraoperative fluoroscopy frequency [(7.9 ± 1.4) times] than the free-hand group [(56.9 ± 11.3) min, (27.0 ± 7.3) mL, (9.1 ± 1.8) times and (16.3 ± 6.0) times)] (all P<0.05). Postoperative imaging showed that the deviation between the screws and the femoral neck axis was 4.4° ± 1.1° on the anteroposterior X-ray film and 3.2° ± 0.8° on the lateral X-ray film, the parallelism between the screws 4.9° ± 0.8° on the anteroposterior X-ray film and 3.0° ± 0.7° on the lateral X-ray film, and the distance between the screws and the femoral neck cortex (10.4 ± 2.7) mm in the robot group, all significantly smaller than those in the free-hand group [10.5° ± 2.8°, 4.9° ± 1.1°, 12.1° ± 4.0°, 5.1° ± 1.3°, and (15.4 ± 3.2) mm] (all P<0.05). All the 53 patients were followed up for (22.2 ± 8.5) months. All fractures got united. The fracture union time in the robot group [(20.6 ± 4.6) weeks] was insignificantly shorter than that in the free-hand group [(23.7 ± 7.7) weeks] ( P>0.05). At the last follow-up, the Harris hip score in the robot group [(88.6 ± 5.6) points] was significantly higher than that in the free-hand group [(84.8 ± 6.3) points] ( P<0.05). Follow-ups revealed 2 cases of internal fixation loosening, 1 case of screw head cutting and 1 case of femoral head necrosis in the free-hand group but none of such complications in the robot group. Conclusion:In the treatment of femoral neck fractures in the middle-aged and young patients, compared with free-hand PCS, robot-assisted PCS shows advantages of shorter intraoperative time, less bleeding, less fluoroscopic radiation, higher accuracy of screw placement, a lower incidence of postoperative complications and better functional recovery of the hip joint.

Objective:To investigate the safety and efficacy of Tubridge flow diverter for the treatment of recurrent internal carotid blood blister-like aneurysms after stent-assisted embolization.Methods:From June 2018 to April 2021, patients with recurrent internal carotid blood blister-like aneurysms treated with Tubridge flow diverter in the Department of Neurosurgery, Changhai Hospital, Naval Medical University were enrolled retrospectively. The perioperative safety, immediate postoperative and follow-up results were analyzed.Results:A total of 6 patients with recurrent internal carotid blood blister-like aneurysm after stent-assisted embolization were enrolled. The time interval from the first stent-assisted embolization to Tubridge placement was 14 to 90 d. Tubridge implantation alone was used in 4 patients, and Tubridge was implanted in the other 2 patients after the coils were packed. There were no complications during the perioperative period, and no rebleeding was observed after clinical follow-up for 5 to 36 months. Five patients were followed up by angiography for 1-3 months, and the aneurysms disappeared completely.Conclusion:Tubridge flow diverter for the treatment of recurrent internal carotid blood blister-like aneurysms is safe and effective.

In addition to causing high disability and high fatality rates, ruptured intracranial aneurysms can also cause cognitive impairment. Although preventive surgical treatment can avoid intracranial aneurysm rupture and bleeding, patients may still have a certain degree of cognitive impairment, even in patients with good clinical recovery after surgery. There is no systematic review on the effect of different surgical methods on cognitive function, and the best surgical method is still inconclusive. This article reviews the cognitive impairment in patients with intracranial aneurysm, hoping to provide a basis for clinical treatment decisions.

Minimizing the burden on study subjects and assessing the general dietary nutritional status as accurately as possible are the basis of a nutritional epidemiological cohort study in the general population. While introducing the main dietary nutrition assessment methods, this paper manly describes the basic contents and principles for the development of food frequency questionnaire, and briefly illustrates the problems and solutions for the development of area specific food frequency questionnaires by taking the example of Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) cohort study. Finally, discusses preliminarily the necessity and possibility of developing a national food frequency questionnaire.

Objective To investigate the changes of fibrinogen and D -dimer levels in patients with severe burn and their relationship with prognosis .Methods 90 patients with severe burn were selected as the subjects .The patients were divided into the dead group (30 cases) and the survival group (60 cases) according to the prognosis of the patients.The differences and changes of fibrinogen and D -dimer at the same time after admission were compared between the two groups .Results At each time point after admission , the fibrinogen levels of the death group were significantly higher than those of the survival group at the same time [(5.9 ±1.5)g/L vs.(5.1 ±1.3)g/L,(8.8 ± 2.2)g/L vs.(7.4 ±2.5)g/L,(7.6 ±2.8)g/L vs.(5.7 ±1.2)g/L,(7.1 ±2.5)g/L vs.(4.3 ±1.7)g/L],the differences were statistically significant(t =3.892,4.762,5.436,6.987,all P <0.05).At each time point after admission,the D-dimer levels of the death group were significantly higher than those of the survival group at the same time[(743.4 ±226.2)ng/mL vs.(704.1 ±214.6)ng/mL,(935.4 ±256.9)ng/mL vs.(834.6 ±256.2)ng/mL, (846.3 ±291.5)ng/mL vs.(712.1 ±251.3) ng/mL,(756.7 ±232.8) ng/mL vs.(601.5 ±168.7) ng/mL],the differences were statistically significant (t=3.895,5.477,4.743,5.746,all P<0.05).The level of D-dimer in the survival group showed a rise firstly ,then showed a decrease trend after admission ,while the levels of fibrinogen and D-dimer of the death group were altered in double -peak change .Conclusion There is an obvious impairment of coagulation function in severe burn patients , and the level of D -dimer and fibrinogen is higher , the prognosis of patients is worse .

Objective To analyze the influential factors of the prognosis of neonatal cholestasis. Methods The data on 106 newborns with neonatal cholestasis collected from January 1, 2009 to June 30, 2016 was collected and analyzed retrospectively. All cases were divided into cure group (99 patients) and improvement group (7 patients) according to the effect of oral ursodeoxycholic acid therapy and comprehensive medical treatment. There was no cure for invalid case. The clinical features, course of disease and curative effect were observed. The levels of total bilirubin (TB), direct bilirubin (DB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transpeptidase (γ-GT), total bile acid (TBA) were compared between two groups. The ratio of neonatal bacterial infection, cytomegalovirus (CMV) infection, sex, total intravenous nutrition (more than 7 d), perinatal hypoxia, premature birth, maternal complicated intrahepatic cholestasis of pregnancy (ICP) were compared between two groups. Multiple Logistic regression analysis was used to analyze the prognosis factors of neonatal cholestasis. Results The levels of serum ALT, AST, γ-GT, TB, DB and TBA in improvement group were significantly higher than those in cure group, the course of disease in improvement group was significantly longer than that in cure group, there were significant differences (P<0.05). A strong linear correlation was showed between course of disease and the levels of serum ALT, AST, TB, DB and TBA (tALT=13.050, tAST=14.696, tTB=12.771, tDB=13.776, tTBA=12.019, P < 0.05). Multiple Logistic regression analysis showed that the prognosis of neonatal cholestasis was associated with bacterial infection, CMV infection, total intravenous nutrition (more than 7 d) and premature ( OR=9.375, 7.909, 11.333, 11.333, P < 0.05). Conclusions The higher the level of serum TB, DB, TBA, ALT and AST, the longer the course of the disease. Bacterial infection, CMV infection, total venous nutrition( ≥ 7 d) and premature are the risk factors of the prognosis of neonatal cholestasis. Therefore, prevention of neonatal bacterial and CMV infection, reduction of the occurrence of preterm delivery and reduction of the total parenteral nutrition time are very important to improve the prognosis of neonatal cholestasis.

Anesthesia plays an essential role in clinical operations. Guiding anesthesia by EEG signals is one of the most promising methods at present and it has obtained good results. The analysis and process of the EEG signals in anesthesia can provide clean signal for further research. This paper used variance threshold method to remove the mutation fast and large interfering signals; and used notch filter to remove frequency interference, smoothing filter to remove baseline drift and Butterworth low-pass filter to remove high frequency noise at the same time. In addition to this, the translation invariant wavelet method to remove interference noise on the signals which was after the classical filter and retained non-stationary characteristics was used to evaluate parameter calculation. By comparing the calculated parameters from treated signal using this paper's methods and untreated signal and standard signal, the standard deviation and correlation has been improved, particularly the major parameters BetaR, which provides better signal for integration of multi-parameter to evaluate depth of anesthesia index for the latter.
Anesthesia ; methods ; Humans ; Signal Processing, Computer-Assisted