Acute respiratory distress syndrome (ARDS) is the leading cause of respiratory failure with high morbidity and mortality. Pulmonary surfactant (PS)-based complementary therapies have exhibited potential for ARDS healing and applied as an adjunctive therapy strategy. Coacervate (Coac) has the characteristics of softness, deformability and excellent molecular enrichment properties, and has attracted extensive attention in the biomedical field. Here PS and coacervate were combined for the potential ARDS treatment. The Coac, fabricated from polyallylamine hydrochloride (PAH) and adenosine triphosphate (ATP) by simple mixing, exhibited soft droplet property and high enrichment for dexamethasone sodium phosphate (DSP). To avoid the fusion effect of membraneless coacervate and endow it with biological functions of PS, liposomes with PS-biomimetic lipid components (PS-lipo) were further introduced to construct PS-biomimetic membranized coacervate (DSP@PS-Coac). The DSP@PS-Coac demonstrated high lung targeting effect and significant penetration efficiency after intravenous injection. Furthermore, PS-lipo replenished the endogenous PS pool and facilitated the distribution of DSP in inflammatory cells in the lung. In the ARDS mouse model, PS-Coac and DSP exerted synergetic anti-inflammatory functions, via reducing the recruitment of inflammatory neutrophils and modulating macrophages into anti-inflammatory phenotype. The overall results confirmed that DSP@PS-Coac may provide a promising delivery option for the treatment of ARDS.

Objective:To explore the efficacy and safety of vagus nerve stimulation (VNS) combined with rehabilitation training in recovery of upper limb function in patients with ischemic stroke (IS) through Meta-analysis.Methods:Randomized controlled trials on upper limb motor dysfunction in IS patients accepted VNS published in PubMed, Web of Science, Embase, CNKI, Wanfang and VIP databases, and Chinese Biomedical Literature Database were retrieved. The retrieval period was from establishment of the databases to April 2025. Quality of the trials was assessed according to Cochrane handbook for systematic reviews of interventions (version 5.1). Two researchers independently screened the literature, extracted the data and evaluated the risk of bias of the included articles; and then, Meta-analysis was conducted by RevMan 5.4 software.Results:Eleven articles of randomized controlled trails were chosen, including 495 patients. Three articles were rated as A-level in terms of quality, and 8 were rated as B-level. Overall bias risk of the included studies was low. Results of Meta-analysis showed that compared with the control group (rehabilitation training alone), the intervention group (VNS combined with rehabilitation training) had significantly improved upper limb motor function (Fugl-Meyer assessment of upper limb motor function: standardized mean difference [ SMD]=0.77, 95% CI: 0.24-1.30, P<0.001) and activities of daily living (modified Barthel index: SMD=0.86, 95% CI: 0.56-1.16, P<0.001). Meanwhile, compared with those in the control group, incidence of adverse events ( RR=1.12, 95% CI: 0.95-1.33, P=0.170) and incidence of severe adverse events ( RR=1.67, 95% CI: 0.51-5.50, P=0.400) in the intervention group did not significantly increase. Results of subgroup analysis showed that compared with that in the control group, more significantly improved upper limb motor function was noted in patients from the non-invasive VNS intervention sub-group ( SMD=1.09, 95% CI: 0.46-1.72, P<0.001), intervention sub-group with a frequency of 5 times per week ( SMD=1.73, 95% CI: 0.58-2.87, P<0.001), and intervention sub-group with a duration of 4 weeks ( SMD=1.09, 95%CI: 0.72-1.47, P<0.001). Conclusion:VNS combined with rehabilitation training has good safety and efficacy in upper limb motor dysfunction after IS.

A wealth of prior studies has confirmed that intratumoral microbiota can survive within tumor tissue, thereby promoting or inhibiting tumor growth. With the development of high-throughput sequencing and metabolomics, increasing attention has been paid to the correlation between intratumoral microbiota and host metabolism, and their effect on tumorigenesis and progression. This review focuses on the interaction between intratumoral microbiota and tumor metabolism. It emphasizes the effects of intratumoral microbiota on tumor sugar, lipid, and amino acid metabolism and explores emerging therapeutic strategies for guiding tumor prevention and treatment by modulating tumor metabolism. Although the specific role of intratumoral microbiota in tumor metabolism remains to be further studied, a deepened understanding of the interaction between tumor-specific microbiota and tumor metabolism may provide new directions and application prospects for tumor prevention and treatment.

A retrospective analysis was conducted on data from five patients comprehensively diagnosed with emphysematous osteomyelitis (EO) based on clinical, imaging, microbiological culture, and surgical findings at Hebei Medical University Third Hospital from December 2020 to May 2024. Among these five cases, there were three males and two females, aged between 11 and 69 years. Three patients had infection risk factors (two with diabetes and one with anemia), while two had no documented risk factors in their medical history. All patients presented with fever, localized pain at the infection site, and elevated inflammatory markers. Site of incidence: EO affected the lumbar spine in three cases, the ilium in one case, and the femur in one case. Pathogenic microorganisms: The causative agents included Klebsiella pneumoniae (two cases), Escherichia coli (one case), Burkholderia cepacia (one case), and a mixed infection of Staphylococcus aureus and Acinetobacter baumannii (one case). Imaging findings: Among the three patients who underwent X-ray examinations, one showed normal results, while two exhibited bone destruction. CT scans of all five cases revealed the characteristic "pumice sign" without periosteal reaction or osteosclerosis. MRI, performed on four patients, demonstrated bone destruction, swelling of surrounding soft tissues, and soft tissue abscess formation. Treatment and outcomes: Four patients underwent surgical debridement combined with perioperative antibiotic therapy. Of these, three recovered well, while one achieved good infection control but suffered severe joint destruction. One patient died after treatment was discontinued. The clinical and laboratory findings of EO resemble those of common acute osteomyelitis; however, EO has distinct imaging characteristics. Timely diagnosis, aggressive surgical debridement, and strong, targeted antibiotic therapy can result in favorable outcomes. Conversely, delayed diagnosis and treatment may lead to severe complications or death.

Objective To explore the application effect of constructing a data sharing-based multidrug-resistant or-ganism(MDRO)information reminder system combined with multidisciplinary standardized measures on the whole-process closed-loop management of MDRO.Methods Hospitalized patients from whom MDRO were detected from January 1 to July 31,2024 were taken as the control group,those from August 1,2024,to May 31,2025 were as the intervention group.The control group adopted the traditional manual reporting mode for MDRO,while the in-tervention group adopted the combination of MDRO reminder system and multidisciplinary management mode.Differences in isolation order issuing rate for MDRO and process-and outcome-indicators for multidisciplinary spe-cialty before and after system implementation were compared.Results After implementing information reminder system combined with multidisciplinary measures,issuing rates of ≤24 hour and＜4 hour MDRO isolation orders in the intervention group were both higher than in the control group([90.20％vs 65.23％,P＜0.05],[80.64％vs 55.08％,P＜0.001],respectively).Antimicrobial use rate in the intervention group was lower than in the con-trol group(36.27％vs 43.41％),with a statistically significant difference(P＜0.05).The implementation rates of MDRO prevention and control measures,pathogen detection rates,and fluorescence labeling clearance rates in the intervention group were all higher than those in the control group,all with statistically significant differences(all P＜0.05).The detection rate of MDRO decreased compared with the control group(10.83％vs 16.49％),and the in-cidence of MDRO healthcare-associated infection in the intervention group was lower than that in the control group(0.09％vs 0.19％),both with statistically significant differences(both P＜0.001).The treatment expense in the intervention group reduced by 27 422 Yuan compared with the control group.Conclusion This study constructed an MDRO reminder system,realized full-chain monitoring system for the multidisciplinary MDRO information interac-tion platform,strengthened multidisciplinary in-depth integration,and improved the prevention and control effect for MDRO.

A retrospective analysis was conducted on data from five patients comprehensively diagnosed with emphysematous osteomyelitis (EO) based on clinical, imaging, microbiological culture, and surgical findings at Hebei Medical University Third Hospital from December 2020 to May 2024. Among these five cases, there were three males and two females, aged between 11 and 69 years. Three patients had infection risk factors (two with diabetes and one with anemia), while two had no documented risk factors in their medical history. All patients presented with fever, localized pain at the infection site, and elevated inflammatory markers. Site of incidence: EO affected the lumbar spine in three cases, the ilium in one case, and the femur in one case. Pathogenic microorganisms: The causative agents included Klebsiella pneumoniae (two cases), Escherichia coli (one case), Burkholderia cepacia (one case), and a mixed infection of Staphylococcus aureus and Acinetobacter baumannii (one case). Imaging findings: Among the three patients who underwent X-ray examinations, one showed normal results, while two exhibited bone destruction. CT scans of all five cases revealed the characteristic "pumice sign" without periosteal reaction or osteosclerosis. MRI, performed on four patients, demonstrated bone destruction, swelling of surrounding soft tissues, and soft tissue abscess formation. Treatment and outcomes: Four patients underwent surgical debridement combined with perioperative antibiotic therapy. Of these, three recovered well, while one achieved good infection control but suffered severe joint destruction. One patient died after treatment was discontinued. The clinical and laboratory findings of EO resemble those of common acute osteomyelitis; however, EO has distinct imaging characteristics. Timely diagnosis, aggressive surgical debridement, and strong, targeted antibiotic therapy can result in favorable outcomes. Conversely, delayed diagnosis and treatment may lead to severe complications or death.

Objective To explore the application effect of constructing a data sharing-based multidrug-resistant or-ganism(MDRO)information reminder system combined with multidisciplinary standardized measures on the whole-process closed-loop management of MDRO.Methods Hospitalized patients from whom MDRO were detected from January 1 to July 31,2024 were taken as the control group,those from August 1,2024,to May 31,2025 were as the intervention group.The control group adopted the traditional manual reporting mode for MDRO,while the in-tervention group adopted the combination of MDRO reminder system and multidisciplinary management mode.Differences in isolation order issuing rate for MDRO and process-and outcome-indicators for multidisciplinary spe-cialty before and after system implementation were compared.Results After implementing information reminder system combined with multidisciplinary measures,issuing rates of ≤24 hour and＜4 hour MDRO isolation orders in the intervention group were both higher than in the control group([90.20％vs 65.23％,P＜0.05],[80.64％vs 55.08％,P＜0.001],respectively).Antimicrobial use rate in the intervention group was lower than in the con-trol group(36.27％vs 43.41％),with a statistically significant difference(P＜0.05).The implementation rates of MDRO prevention and control measures,pathogen detection rates,and fluorescence labeling clearance rates in the intervention group were all higher than those in the control group,all with statistically significant differences(all P＜0.05).The detection rate of MDRO decreased compared with the control group(10.83％vs 16.49％),and the in-cidence of MDRO healthcare-associated infection in the intervention group was lower than that in the control group(0.09％vs 0.19％),both with statistically significant differences(both P＜0.001).The treatment expense in the intervention group reduced by 27 422 Yuan compared with the control group.Conclusion This study constructed an MDRO reminder system,realized full-chain monitoring system for the multidisciplinary MDRO information interac-tion platform,strengthened multidisciplinary in-depth integration,and improved the prevention and control effect for MDRO.

Objective:To explore the efficacy and safety of vagus nerve stimulation (VNS) combined with rehabilitation training in recovery of upper limb function in patients with ischemic stroke (IS) through Meta-analysis.Methods:Randomized controlled trials on upper limb motor dysfunction in IS patients accepted VNS published in PubMed, Web of Science, Embase, CNKI, Wanfang and VIP databases, and Chinese Biomedical Literature Database were retrieved. The retrieval period was from establishment of the databases to April 2025. Quality of the trials was assessed according to Cochrane handbook for systematic reviews of interventions (version 5.1). Two researchers independently screened the literature, extracted the data and evaluated the risk of bias of the included articles; and then, Meta-analysis was conducted by RevMan 5.4 software.Results:Eleven articles of randomized controlled trails were chosen, including 495 patients. Three articles were rated as A-level in terms of quality, and 8 were rated as B-level. Overall bias risk of the included studies was low. Results of Meta-analysis showed that compared with the control group (rehabilitation training alone), the intervention group (VNS combined with rehabilitation training) had significantly improved upper limb motor function (Fugl-Meyer assessment of upper limb motor function: standardized mean difference [ SMD]=0.77, 95% CI: 0.24-1.30, P<0.001) and activities of daily living (modified Barthel index: SMD=0.86, 95% CI: 0.56-1.16, P<0.001). Meanwhile, compared with those in the control group, incidence of adverse events ( RR=1.12, 95% CI: 0.95-1.33, P=0.170) and incidence of severe adverse events ( RR=1.67, 95% CI: 0.51-5.50, P=0.400) in the intervention group did not significantly increase. Results of subgroup analysis showed that compared with that in the control group, more significantly improved upper limb motor function was noted in patients from the non-invasive VNS intervention sub-group ( SMD=1.09, 95% CI: 0.46-1.72, P<0.001), intervention sub-group with a frequency of 5 times per week ( SMD=1.73, 95% CI: 0.58-2.87, P<0.001), and intervention sub-group with a duration of 4 weeks ( SMD=1.09, 95%CI: 0.72-1.47, P<0.001). Conclusion:VNS combined with rehabilitation training has good safety and efficacy in upper limb motor dysfunction after IS.

Objective To evaluate the efficacy,safety and economics of romiplostim for treating primary immune thrombocytopenia(ITP)by rapid health technology assessment,and to provide an evidence-based basis for policy makers and clinical practice.Methods PubMed,Cochrane Library,Embase,CNKI,WanFang Data and VIP databases and the official websites of health technology assessment agency were electronically searched to collect high-quality clinical evidence and pharmacoeconomics evaluation literature of romiplostim for the treatment of ITP from inception to January 18,2024.Two researchers independently screened the literature,extracted information,and accessed the quality of included the literature,the extracted results were categorized and evaluated.Results A total of 14 literature were included,in which 8 systematic reviews/Meta-analysis and 6 pharmacoeconomic studies.In terms of efficacy,treatment with romiplostim significantly elevated platelet response rate,sustained platelet response rate,and mean platelet count in patients with ITP compared with placebo(P＜0.05).Romiplostim did not show a significant advantage in elevating patients'platelet response rate and sustained platelet response rate compared with other agents used to treat ITP(P＞0.05).In terms of safety,the incidence of serious adverse events was statistically lower with romiplostim compared to placebo(P＜0.05),while no significant differences were seen in the incidence of adverse events,bleeding events and thrombotic events(P＞0.05).There were no significant differences in the incidence of adverse events,serious adverse events,bleeding events,or thrombotic events when comparing romiplostim to other drugs for the treatment of ITP(P＞0.05).From an economic standpoint,most studies considered eltrombopag to be more economic advantages than romiplostim.Conclusion Romiplostim has good efficacy and safety in the treatment of ITP,and no advantage was shown in terms of economy.

Sesquiterpenoids are natural compounds composed of 15 carbon atoms， which can be divided into sesquiterpene alcohols， ketones， lactones， aldehydes， and carboxylic acids according to oxygen groups. These compounds are widely distributed in nature， and their physiological activities are diverse. For example， many sesquiterpenes with potential anticancer effects have been found for anti-tumor effects， including cytotoxicity， antioxidant， immune regulation， cell proliferation， and so on. In addition， some sesquiterpenoids have good application prospects in antibacterial， anti-inflammatory， and anti-cardiovascular diseases. Malignant tumors， inflammation， bacterial diseases， and cardiovascular diseases are the main diseases that cause human death， and natural products have unique advantages in the treatment of these diseases. Therefore， the development of new drugs that are easy to promote has become a new research hotspot. In this paper， the sesquiterpenes extracted from the natural components of Chinese herbs and plants with anti-tumor， anti-inflammatory， antibacterial， and anti-cardiovascular activities， such as Xanthium， Atractylodes， Convolvulus， Acanthium， Ligularia， Artemisia， Ligularia， Ligularia， Labiaceae Mint， Acanthophyllum， Turmeria， Ginger， and other Chinese herbs and plants， were discussed. The biological activities and related mechanisms of this compound were reviewed， which provided a reference for further research and clinical application of sesquiterpenes.