Chemotherapy-induced complications, particularly lethal cardiovascular diseases, pose significant challenges for cancer survivors. The intertwined adverse effects, brought by cancer and its complication, further complicate anticancer therapy and lead to diminished clinical outcomes. Simple supplementation of cardioprotective agents falls short in addressing these challenges. Developing bi-functional co-therapy agents provided another potential solution to consolidate the chemotherapy and reduce cardiac events simultaneously. Drug repurposing was naturally endowed with co-therapeutic potential of two indications, implying a unique chance in the development of bi-functional agents. Herein, we further proposed a novel "trilogy of drug repurposing" strategy that comprises function-based, target-focused, and scaffold-driven repurposing approaches, aiming to systematically elucidate the advantages of repurposed drugs in rationally developing bi-functional agent. Through function-based repurposing, a cardioprotective agent, carvedilol (CAR), was identified as a potential neddylation inhibitor to suppress lung cancer growth. Employing target-focused SAR studies and scaffold-driven drug design, we synthesized 44 CAR derivatives to achieve a balance between anticancer and cardioprotection. Remarkably, optimal derivative 43 displayed promising bi-functional effects, especially in various self-established heart failure mice models with and without tumor-bearing. Collectively, the present study validated the practicability of the "trilogy of drug repurposing" strategy in the development of bi-functional co-therapy agents.

This paper reviews the concepts, status, influencing factors and interventions of home self-management of diabetic foot ulcers patients, with a view to providing reference for establishing and improving the home self-management model of diabetic foot ulcers patients suitable for China.

Triangle chronic disease stratified management model, as an effective chronic disease management model, can divide patients into different levels according to the stratified disease assessment criteria, enhance intervention effectiveness, improve management efficiency, and reduce costs by implementing targeted and personalized nursing measures. This article summarizes the overview of the Triangle chronic disease stratified management model, research progress at home and abroad, and the current application status in transitional care for chronic disease patients in order to provide a reference for medical staff to carry out transitional care for chronic disease patients.

Objective:To construct the risk control operation and maintenance management system of TiRobot Recon navigation system of Tianji orthopedic robot(hereinafter referred to as the risk control operation and maintenance management system)and to analyze the application effect,so as to provide theoretical guidance and reference for improving the clinical service effect and quality of Tianji orthopedic robot.Methods:By reviewing the literature and summarizing clinical practice experience,the risk critical control points of the TiRobot Recon navigation system were clarified,and the risk control operation and maintenance management system was constructed based on this.The management effect of TiRobot Recon navigation system before the implementation of system(January 2022 to December 2022)and after the implementation(January 2023 to December 2023)was compared.Results:After the implementation of the risk control operation and maintenance system,the average daily use time,expected target compliance rate,system risk event reporting accuracy,risk early warning timeliness and risk event data standardization of TiRobot Recon navigation system were higher than before the implementation,and the system failure standby time and failure rate were lower than those before the implementation,and the difference was statistically significant(t=6.956,9.656,5.415,4.678,3.711,3.354,5.229,P<0.05).After the implementation of the risk control operation and maintenance system of sub-line control,the scores of daily maintenance,pre-use inspection,post-use cleaning,system operation,fault response,emergency treatment and other operation proficiency scores of the TiRobot Recon navigation system were higher than those before the implementation,and the difference was statistically significant(t=4.225,2.399,2.385,2.597,2.421,3.560,P<0.05).Conclusion:The use of risk control operation and maintenance platform can improve the use effect of TiRobot Recon navigation system,strengthen the operation proficiency of personnel,with obvious advantages in clinical application and promotion value.

Traumatic supraorbital fissure syndrome (TSOFS) is a symptom complex caused by nerve entrapment in the supraorbital fissure after skull base trauma. If the compressed cranial nerve in the supraorbital fissure is not decompressed surgically, ptosis, diplopia and eye movement disorder may exist for a long time and seriously affect the patients′ quality of life. Since its overall incidence is not high, it is not familiarized with the majority of neurosurgeons and some TSOFS may be complicated with skull base vascular injury. If the supraorbital fissure surgery is performed without treatment of vascular injury, it may cause massive hemorrhage, and disability and even life-threatening in severe cases. At present, there is no consensus or guideline on the diagnosis and treatment of TSOFS that can be referred to both domestically and internationally. To improve the understanding of TSOFS among clinical physicians and establish standardized diagnosis and treatment plans, the Skull Base Trauma Group of the Neurorepair Professional Committee of the Chinese Medical Doctor Association, Neurotrauma Group of the Neurosurgery Branch of the Chinese Medical Association, Neurotrauma Group of the Traumatology Branch of the Chinese Medical Association, and Editorial Committee of Chinese Journal of Trauma organized relevant experts to formulate Chinese expert consensus on the diagnosis and treatment of traumatic supraorbital fissure syndrome ( version 2024) based on evidence of evidence-based medicine and clinical experience of diagnosis and treatment. This consensus puts forward 12 recommendations on the diagnosis, classification, treatment, efficacy evaluation and follow-up of TSOFS, aiming to provide references for neurosurgeons from hospitals of all levels to standardize the diagnosis and treatment of TSOFS.

Objective To explore the relationship of the systemic immune-inflammation index (SII) with heart failure incidence in elderly people with hypertension and its nursing implications. Methods According to the data of the National Health and Nutrition Examination Survey (NHANES) database from 1999 to 2010, a total of 5 607 hypertension patients aged 60 and above were screened out and divided into heart failure group with 437 cases and non-heart failure group with 5 170 cases. All the participants were divided into Q₁ to Q₄ groups based on their SII levels by using the quartile method, with Q₁ as the reference group. After gradually adjusting for potential confounding factors, the differences in prevalence rate of heart failure among four groups were explored by Logistic regression analysis, and subgroup analyses were conducted as well. Results There were significant differences in race, age, education level, income level, smoking history, drinking history, body mass index (BMI), C-reactive protein, estimated glomerular filtration rate (eGFR), hemoglobin, diabetes history and coronary heart disease history between the two groups (P < 0.05). Compared with the non-heart failure group, the heart failure group had significant lower lymphocyte and platelet counts, while the neutrophil count and SII were significantly higher (P < 0.05). The result of multiple Logistic regression analysis showed a positive correlation between the increase of SII and the prevalence rate of heart failure (P < 0.05). After adjusting for related confounding factors, the values of odds ratio (OR) and 95% confidence interval (95%CI) for prevalence rate of heart failure in patients with SII from the second to the fourth quartiles were 0.80 (0.57 to 1.11), 1.14 (0.84 to 1.56) and 1.38 (1.02 to 1.87) respectively (P_trend=0.006). Subgroup analyses were carried out according to gender, diabetes, coronary heart disease, hyperlipidemia and eGFR, and the results showed that among women without coronary heart disease, with eGFR≤90 mL/(min·1.73 m²) and with or without hyperlipidemia, participants with the highest quartile of SII (Q₄) had a significant higher risk of heart failure than those with Q₁ (P_trend < 0.05). Conclusion SII may be independently associated with the prevalence rate of heart failure in elderly people with hypertension, and has guiding significance for clinical and nursing work.

OBJECTIVE: To explore the clinical characteristics and genetic etiology of a consanguineous Chinese pedigree affected with Congenital coagulation factor XII (XII) deficiency. METHODS: Members of the pedigree who had visited Ruian People's Hospital on July 12, 2021 were selected as the study subjects. Clinical data of the pedigree were reviewed. Peripheral venous blood samples were taken from the subjects. Blood coagulation index and genetic testing were carried out. Candidate variant was verified by Sanger sequencing and bioinformatic analysis. RESULTS: This pedigree has comprised 6 individuals from 3 generations, including the proband, his father, mother, wife, sister and son. The proband was a 51-year-old male with kidney stones. Blood coagulation test showed that his activated partial thromboplastin time (APTT) was significantly prolonged, whilst the FXII activity (FXII:C) and FXII antigen (FXII:Ag) were extremely reduced. The FXII:C and FXII:Ag of proband's father, mother, sister and son have all reduced to about half of the lower limit of reference range. Genetic testing revealed that the proband has harbored homozygous missense variant of c.1A>G (p.Arg2Tyr) of the start codon in exon 1 of the F12 gene. Sanger sequencing confirmed that his father, mother, sister and son were all heterozygous for the variant, whilst his wife was of the wild type. By bioinformatic analysis, the variant has not been included in the HGMD database. Prediction with SIFT online software suggested the variant is harmful. Simulation with Swiss-Pbd Viewer v4.0.1 software suggested that the variant has a great impact on the structure of FXII protein. Based on the Standards and Guidelines for the Interpretation of Sequence Variants: A Joint Consensus Recommendation of the American College of Medical Genetics and Genomics (ACMG), the variant was rated as likely pathogenic. CONCLUSION The c.1A>G (p.Arg2Tyr) variant of the F12 gene probably underlay the Congenital FXII deficiency in this pedigree. Above finding has further expanded the spectrum of F12 gene variants and provided a reference for clinical diagnosis and genetic counseling for this pedigree.
Male ; Female ; Humans ; Middle Aged ; Factor XII/genetics* ; Pedigree ; Codon, Initiator ; East Asian People ; Mothers ; Factor XII Deficiency/genetics* ; Mutation

Objective    To systematically evaluate the risk factors for postoperative pulmonary infection in patients with esophageal cancer. Methods    CNKI, Wangfang Data, VIP, CBM, PubMed, EMbase, The Cochrane Library were searched from inception to January 2021 to collect case-control studies, cohort studies and cross-sectional studies about risk factors for postoperative pulmonary infection in patients with esophageal cancer. Two researchers independently conducted literature screening, data extraction and quality assessment. RevMan 5.3 software and Stata 15.0 software were used for meta-analysis. Results    A total of 20 articles were included, covering 5 409 patients of esophageal cancer. The quality score of included studies was 6-8 points. Meta-analysis results showed that age (MD=1.99, 95%CI 0.10 to 3.88, P=0.04), age≥60 years (OR=2.68, 95%CI 1.46 to 4.91, P=0.001), smoking history (OR=2.41, 95%CI 1.77 to 3.28, P<0.001), diabetes (OR=2.30, 95%CI 1.90 to 2.77, P<0.001), chronic obstructive pulmonary disease (OR=3.69, 95%CI 2.09 to 6.52, P<0.001), pulmonary disease (OR=2.22, 95%CI 1.16 to 4.26, P=0.02), thoracotomy (OR=1.77, 95%CI 1.32 to 2.37, P<0.001), operation time (MD=14.08, 95%CI 9.64 to 18.52, P<0.001), operation time>4 h (OR=3.09, 95%CI 1.46 to 6.55, P=0.003), single lung ventilation (OR=3.46, 95%CI 1.61 to 7.44, P=0.001), recurrent laryngeal nerve injury (OR=5.66, 95%CI 1.63 to 19.71, P=0.006), and no use of patient-controlled epidural analgesia (PCEA) (OR=2.81, 95%CI 1.71 to 4.61, P<0.001) were risk factors for postoperative pulmonary infection in patients with esophageal cancer. Conclusion    The existing evidence shows that age, age≥60 years, smoking history, diabetes, chronic obstructive pulmonary disease, pulmonary disease, thoracotomy, operation time, operation time>4 h, single lung ventilation, recurrent laryngeal nerve injury, and no use of PCEA are risk factors for postoperative pulmonary infection in patients with esophageal cancer. Due to the limitation of the quantity and quality of included literature, the conclusion of this study still needs to be confirmed by more high-quality studies.

BACKGROUND: The formation of an inhibitory inflammatory microenvironment after spinal cord injury (SCI) remains a great challenge for nerve regeneration. The poor local microenvironment exacerbates nerve cell death; therefore, the reconstruction of a favorable microenvironment through small-molecule drugs is a promising strategy for promoting nerve regeneration. METHODS: In the present study, we synthesized curcumin-loaded micelle nanoparticles (Cur-NPs) to increase curcumin bioavailability and analyzed the physical and chemical properties of Cur-NPs by characterization experiments. We established an in vivo SCI model in rats and examined the ability of hind limb motor recovery using Basso–Beattie– Bresnahan scoring and hind limb trajectory assays. We also analyzed neural regeneration after SCI using immunofluorescence staining. RESULTS: The nanoparticles achieved the intelligent responsive release of curcumin while improving curcumin bioavailability. Most importantly, the released curcumin attenuated local inflammation by modulating the polarization of macrophages from an M1 pro-inflammatory phenotype to an M2 anti-inflammatory phenotype. M2-type macrophages can promote cell differentiation, proliferation, matrix secretion, and reorganization by secreting or expressing pro-repair cytokines to reduce the inflammatory response. The enhanced inflammatory microenvironment supported neuronal regeneration, nerve remyelination, and reduced scar formation. These effects facilitated functional repair in rats, mainly in the form of improved hindlimb movements. CONCLUSION Here, we synthesized pH/temperature dual-sensitive Cur-NPs. While improving the bioavailability of the drug, they were also able to achieve a smart responsive release in the inflammatory microenvironment that develops after SCI. The Cur-NPs promoted the regeneration and functional recovery of nerves after SCI through anti-inflammatory effects, providing a promising strategy for the repair of SCIs.

OBJECTIVE To establish the methods to identify the chemical components of Ixeris chinensis， and determine the contents of 7 components （chlorogenic acid， luteolin， quercetin， rutin， protocatechuic acid， isochlorogenic acid A， luteoloside）. METHODS HPLC-Q-Exactive-MS was used to identify the chemical components of I. chinensis. The contents of 7 components in I. chinensis， including chlorogenic acid， were determined by HPLC-MS/MS. RESULTS A total of 45 components were identified in I. chinensis， including 20 organic acids， 13 flavonoids， 4 fatty acids， 4 amino acids， 3 nucleosides， and 1 coumarin. The linear range of chlorogenic acid， luteolin， quercetin， rutin， protocatechuic acid， isochlorogenic acid A and luteoloside were 503.00- 25 150.00， 42.00-2 100.00， 5.05-252.50， 20.05-1 002.50， 25.10-1 255.00， 750.00-37 500.00， 196.00-9 800.00 ng/mL （r≥0.999 2）， respectively. RSDs of precision， stability and reproducibility tests were all less than 3.00% （n＝6）， and average recovery ranged from 96.72% to 105.84% （all RSD＜4.00%， n＝6）. The contents of 7 components in 3 batches of I. chinensis were 1 145.77- 3 261.25， 23.75-97.90， 0.92-2.12， 1.06-23.18， 9.35-21.85， 833.25-1 045.58， 199.56-1 869.78 μg/g， respectively. CONCLUSIONS The established methods for identification and content determination are rapid and simple， and can be used for the identification of chemical components and the content determination of 7 components in I. chinensis.