ObjectiveTo investigate the mechanism by which Wumeiwan suppresses the development and progression of colorectal cancer（CRC） through the regulation of fatty acid metabolic reprogramming， thereby providing new experimental evidence for the prevention and treatment of CRC. MethodsA total of 120 C57BL/6 mice were randomly divided into the blank group， model group， Wumeiwan high-， medium-， and low-dose groups（54， 27， 13.5 g·kg^-1）， and the mesalazine group（0.01 g·kg^-1）， with 20 mice in each group. Except for the blank group， all mice were subjected to azoxymethane（AOM）/dextran sulfate sodium（DSS） treatment to establish an inflammation-associated CRC model. One week after AOM injection， mice in the treatment groups received intragastric administration of the designated drugs， while the blank and model groups received an equal volume of purified water， continuing until 20 d after the intervention endpoint. Hematoxylin-eosin（HE） staining was used to observe colonic histopathological alterations， and immunohistochemistry for vascular endothelial growth factor（VEGF） was performed to evaluate neovascularization and tumor invasion. Metabolomics combined with Kyoto Encyclopedia of Genes and Genomes（KEGG） and metabolite set enrichment analysis（MSEA） was applied to identify key CRC-related metabolic pathways， which were further validated by transcriptomic Gene Ontology（GO） enrichment and gene heatmap analysis. Subsequently， Western blot was performed to determine the expression levels of core proteins in these pathways， and immunofluorescence was used to analyze their localization and co-expression patterns in tissues， thereby elucidating the mechanism of Wumeiwan from multiple biological dimensions. ResultsCompared with the blank group， mice in the model group exhibited a significant decrease in body weight and a significant increase in the disease activity index（DAI） score（P<0.05）， with pronounced colonic mucosal damage accompanied by aggravated tumor invasion. Compared with the model group， Wumeiwan intervention markedly improved body weight loss and reduced DAI score， attenuated mucosal injury， and significantly decreased VEGF expression level（P<0.05）. Multi-omics analysis revealed that differential metabolites and genes across groups were commonly enriched in fatty acid metabolism， fatty acid biosynthesis， and other lipid-related pathways. Relative to the blank group， the model group showed significant upregulation levels of fatty acid synthesis-related genes， including sterol regulatory element-binding protein 1（SREBP1）， fatty acid synthase（FASN）， stearoyl-CoA desaturase 1（SCD1）， as well as saturated fatty acids（P<0.05）. Compared with the model group， treatment with Wumeiwan significantly reduced the expression of key genes involved in fatty acid metabolic pathways， including SREBP1， FASN， and SCD1（P<0.05）. Western blot results further confirmed that proteins in this pathway were significantly elevated in the model group， whereas they were markedly downregulated following Wumeiwan treatment（P<0.05）. Immunofluorescence analysis demonstrated enhanced co-localization of SREBP1 with the cancer-associated fibroblast（CAF） marker α-smooth muscle actin（SMA） in the model group， whereas this co-localization signal was attenuated after Wumeiwan intervention（P<0.05）. ConclusionWumeiwan can improve survival outcomes and alleviate colonic pathological damage in CRC mice， its therapeutic mechanism may be closely associated with the regulation of fatty acid metabolic reprogramming mediated by the SREBP1/FASN/SCD1 signaling pathway.

This article presents a comprehensive review of new methods for target identification of complex components in tradi-tional Chinese medicine(TCM)and research progress in their applications.It systematically summarizes classical approaches and cutting-edge technical systems for target identification,cov-ering multiple strategies such as proteomic analysis,fluorescence resonance energy transfer(FRET)technology,network pharma-cology prediction models,high-throughput biochip screening,tar-get capture strategies based on molecular affinity fishing,gene site-directed mutagenesis verification,and co-crystallization structure analysis of target proteins.The review emphasizes the critical role of target identification in elucidating the action mechanisms of TCM and facilitating new drug development,lay-ing a foundation for promoting the modernization of TCM.

OBJECTIVE To investigate the effects of different sterilization methods on 3D-printed polylactic acid(PLA)guide plates for orthopedic surgery,and to analyze their physical properties,microbial contamination,structural performance and bio compatibility after sterilization.METHODS PLA guide plates for orthopedic surgery were prepared with 3D printing technology and divided into a blank group,a hydrogen peroxide plasma steriliza-tion group,an ethylene oxide sterilization group and a pressure steam sterilization group.Before and after sterili-zation,the changes in volume and weight of the surgical guide plates were measured,microbial detection was con-ducted,structural changes were observed with a laser scanning confocal microscope,and cell co-culture was con-ducted to evaluate biocompatibility,thereby the effects of different sterilization methods were assessed.RESULTS The three sterilization methods had no significant effect on the volume and weight of PLA surgical guide plates.Microbial detection showed that all three sterilization methods were effective in killing bacteria,and bacte-rial cultures were negative.Laser confocal scanning microscopy revealed that sterilization treatment caused certain changes to the microstructure of the surgical guide plates,but high-temperature sterilization had a more pro-nounced effect on the deformation of the guide plate edges.Cell co-culture results indicated that the surgical guide plates treated with the three sterilization methods exhibited acceptable cytotoxicity and had little effect on cell pro-liferation.CONCLUSIONS All three sterilization methods cause microstructural changes to the surgical guide plate.Among them,pressure steam sterilization significantly deforms the structure of the guide plate,directly af-fecting its precise positioning of mutual spatial distances,angular relationships and orientation during surgery.Al-though hydrogen peroxide plasma sterilization does not cause significant deformation,ethylene oxide sterilization has the least impact on material properties and structural stability while ensuring the sterilization effect of PLA surgical guide plates.

Objective:To investigate protective mechanism of resveratrol(RES)on brain injury after ischemic stroke(IS)and its regulatory mechanism on nico-tinamide adenine dinucleotide phosphate oxidase 2(NOX2)mediated polarization of microglia.Methods:Low and high doses of RES were used for intervention.Tetrabromocinnamic acid(TBCA),a specific agonist of NOX2,was used to save function.PC12 and LMAI Bio cell models with oxygen-glucose deprivation/reoxygenation(OGD/R)were constructed.TUNEL was used to detect apoptosis of PC12 cells.Immunofluorescence was used to detect polarization of LMAI Bio cells.Western blot was used to detect expressions of NOX2,NF-κB,TNF-α,IL-1β,IL-10 and TGF-β in PC12 and LMAI Bio cells.Results:RES could significantly inhibit apoptosis of PC12 cells induced by OGD/R,and regulate LMAI Bio cells polarization to M2 type.Western blot showed that RES could significantly down-regulate NOX2,NF-κB,TNF-α and IL-1β expressions in OGD/R cells,up-regulate IL-10 and TGF-β expressions,while TBCA could partially reverse protective effect of RES on neurons.Conclusion:RES can inhibit neuronal apoptosis after IS,which may be related to its regulation of NOX2-mediated polarization of microglia.

This article presents a comprehensive review of new methods for target identification of complex components in tradi-tional Chinese medicine(TCM)and research progress in their applications.It systematically summarizes classical approaches and cutting-edge technical systems for target identification,cov-ering multiple strategies such as proteomic analysis,fluorescence resonance energy transfer(FRET)technology,network pharma-cology prediction models,high-throughput biochip screening,tar-get capture strategies based on molecular affinity fishing,gene site-directed mutagenesis verification,and co-crystallization structure analysis of target proteins.The review emphasizes the critical role of target identification in elucidating the action mechanisms of TCM and facilitating new drug development,lay-ing a foundation for promoting the modernization of TCM.

Aim To analyze the correlation between N6-methyladenosine(m6 A)and ferroptosis in acute myo-cardial infarction(AMI).Methods Two microarray datasets GSE34198 and GSE59867 was explored from GEO data-base.Both AMI and control samples were analyzed for differentially expressed genes.GO,KEGG,and GSVA analysis of the screened differential genes was performed using R.Machine learning was used to screen ferroptosis associated genes for DRA,GBM,LASSO and randomForest characteristic genes.The expression data of the core ferroptosis gene and m6A-related genes were analyzed by Pearson correlation analysis,and the m6A modified genes and ferroptosis associated genes with strong correlation were screened.Finally,10 cases of AMI and 10 control whole blood samples from the Fifth Affiliated Hospital of Xinjiang Medical University were collected,and the expression of related genes was verified by RT-qPCR and Western blot.Results 431 common differentially expressed genes were extracted from two datasets,GO and KEGG analysis showed that these genes were mainly enriched in TNF signaling pathway,FoxO signaling pathway and B cell receptor signaling pathway.The enrichment pathways of differentially expressed genes by GSVA were cuproptosis,netotic cell death,entotic cell death,alkaliptosis and ferroptosis.The characteristic genes of ferroptosis associated genes were screened by machine learning,and 19 core ferroptosis associated genes were screened from them.The expression data of ferroptosis associated genes and m6A-related genes were analyzed by Pearson correlation analysis.LRPPRC-IREB2,LRPPRC-ATG5,YTHDC2-IREB2,HNRNPA2B1-IREB2 and YTHDC2-ATG5 were the most correlated top five genes.The results of RT-qPCR and Western blot showed that the gene expression levels of LRPPRC,YTHDC2,HNRN-PA2B1,IREB2 and ATG5 were significantly lower than those of the control group(P＜0.001),which was consistent with the gene expression in the database.Conclusion m6A methylation is associated with ferroptosis in AMI.By regula-ting m6A methylation-related genes,ferroptosis in AMI can be regulated.It provides a new idea for the further study of the pathogenesis of the disease.

AIM:To evaluate the effects of liposo-mal bupivacaine for interscalene brachial plexus block on postoperative analgesia and diaphragmat-ic function in patients undergoing arthroscopic ro-tator cuff repair surgery based on a randomized controlled trial.METHODS:Forty patients who scheduled to undergo arthroscopic rotator cuff re-pair surgery,regardless of gender,aged 18 to 65 years,ASA grade Ⅰ or Ⅱ were selected from October 2023 to February 2024.The patients were random-ly divided into bupivacaine liposome group(group LB)and the levobupivacaine group(group BV),with 20 cases in each group.Patients in both groups re-ceived an ultrasound-guided interscalene brachial plexus block,15 mL mixed liquids(bupivacaine lipo-some 10 mL+0.5％levobupivacaine 10 mL)were in-jected into the level of C5-C6 nerve roots and 5 mL onto the surface of prevertebral fascia in the LB group,and same volume of 0.375％levobupiva-caine were injected at the same sites in the BV group respectively.Standardized general anesthe-sia and standardized postoperative analgesia were followed.The primary outcome measures included 48 h rest/motor numerical rating scale(NRS)scores after surgery and the incidence of hemidiaphrag-matic paralysis(HDP)after block.The secondary outcome measures included rest/motor NRS scores at other time points after surgery,pulse oxygen sat-uration(SpO2)30 min after block,duration of sen-sory and motor block,number of analgesic pump presses,time of first postoperative used of opioid drugs and opioid consumption,use of additional analgesics in the wards,satisfaction with analgesia,and the occurrence of perioperative adverse ef-fects and neurological complications.RESULTS:Compared with group BV,patients in LB group showed lower rest NRS scores at 48 h postopera-tion(P＜0.05)and higher incidence of HDP at 24 h after block(45％vs.5.3％,P＜0.05).However,there was no significant difference in motor NRS scores at 48 h,HDP incidence at 30 min and 6 h after block between the two groups(P＞0.05).Both groups showed a decrease in SpO2 after block com-pared to before block(P＜0.05).Compared with BV group,patients in LB group had a significantly lon-ger duration of sensory and motor block(P＜0.01),fewer effective presses with the analgesic pump(P＜0.01),delay in first opioid use and less opioid con-sumption(P＜0.05),higher level of satisfaction with analgesia(P＜0.01),and a lower rate of use of addi-tional analgesics in the ward(P＜0.05).There was no statistically significant difference in the total in-traoperative remifentanil consumption,incidence of perioperative adverse reactions and neurological complication between the two groups(P＞0.05).CONCLUSION:Compared with using levobupiva-caine alone,the addition of liposomal bupivacaine for interscalene brachial plexus block in arthroscop-ic rotator cuff repair can reduce postoperative NRS scores,decrease postoperative opioid dosage and significantly prolong blockduration,but can easily lead to longer duration of HDP in patients.

Objective To analyze the clinical characteristics and explore the potential mechanisms under-lying acute wheezing associated with respiratory syncytial virus(RSV)and human rhinovirus(HRV)infections in infants.Methods A retrospective analysis was conducted on 560 infants who consecutively presented to the emer-gency department of Qingdao University Affiliated Women and Children's Hospital between January 2022 and December 2024 with acute exacerbation of wheezing caused by RSV and/or HRV infection;these infants constituted the infection group.A control group of 120 healthy infants who underwent routine physical examinations at the same hospital during the same period was also included.Multiplex PCR amplification sequencing technology was employed to detect respiratory pathogens via nucleic acid analysis.The infection group was further classified into the RSV-only group(n=248),the HRV-only group(n=186),and the co-infection group(HRV+RSV,n=126).One-way analysis of variance(ANOVA)was used to compare body mass index(BMI),peripheral blood white blood cell(WBC)count,neutrophil count,lymphocyte count,C-reactive protein(CRP)levels,and concentrations of interleukin(IL)-1β,IL-6,Toll-like receptor 4(TLR4),NOD-like receptor protein 3(NLRP3)inflamma-some,and matrix metalloproteinase-9(MMP-9)across the groups.Additionally,comparisons were made regarding gender distribution,severity of wheezing,history of wheezing,history of eczema,parental allergic history,oxygen supplementation requirements,and presence of concurrent pulmonary infection among the infected infants.Based on wheezing severity,the infection group was further divided into a severe wheezing group and a mild wheezing group.Clinical characteristics and biological indicators were analyzed and compared between these two groups to identify potential independent risk factors.Pearson correlation analysis was performed to evaluate the association between peripheral blood levels of IL-6,NLRP3,and MMP-9 and the severity of acute wheezing exacerbation in children.Results A one-way ANOVA indicated statistically significant differences in WBC count,neutrophil count,CRP,IL-1β,IL-6,TLR4,NLRP3,and MMP-9 levels across the study groups(all P<0.001).Both the RSV and co-infection groups demonstrated significantly higher rates of severe wheezing,oxygen requirement,and prolonged wheezing duration compared to the HRV group(all P<0.05).Among these,the co-infection group exhibited the highest oxygen requirement rate,although the duration of wheezing was shorter than that observed in the RSV group(P<0.05).The incidence of concurrent pulmonary infection was significantly greater in the RSV group compared to the HRV group(P<0.05).Additionally,the proportion of infants with a prior history of wheez-ing was significantly higher in the RSV group than in both the HRV and co-infection groups(P<0.05).Both the RSV and co-infection groups showed a significantly higher prevalence of eczema history among infants compared to the HRV group(P<0.05).Moreover,the co-infection group had a significantly higher proportion of parental allergic history compared with both the RSV and HRV groups(P<0.05).Clinical data analysis stratified by wheezing severity revealed that RSV was the most commonly detected virus among the enrolled infants,particularly in those presenting with severe wheezing(χ2=3.940,P=0.002).The severe wheezing group exhibited significantly higher rates of prior wheezing,history of eczema,parental allergy,need for oxygen supplementation,and concurrent pulmonary infections compared to the mild wheezing group(P<0.001).Furthermore,the duration of wheezing was significantly prolonged in the severe group relative to the mild group(t=2.058,P=0.040).Levels of IL-6,NLRP3,and MMP-9 were also significantly elevated in the severe wheezing group(P<0.05).Multivariate logistic regression analysis revealed that RSV infection,along with elevated levels of IL-6,NLRP3,and MMP-9,were independent risk factors associated with severe wheezing(OR=3.217,1.023,1.022,and 1.056,respectively;all P<0.05).In children with RSV/HRV infection,the severity of acute wheezing demonstrated a positive correlation with NLRP3 and MMP-9 levels(P<0.05).The Pearson correlation coefficient between NLRP3 and MMP-9 was r=0.238(P<0.001),indicating a weak yet statistically significant positive relationship.Conclusions RSV may provoke more severe respiratory inflammatory responses and clinical manifestations compared to HRV.Individuals with a genetic predisposition to allergies or a pre-existing history of respiratory conditions may experience height-ened severity of wheezing following viral infection.The NLRP3 inflammasome may further intensify airway inflam-mation and remodeling through the promotion of MMP-9 release.These mechanisms may collectively contribute to the pathogenesis of acute wheezing episodes and subsequently influence the progression of respiratory diseases.

Objective To compare the clinical efficacies of extrapleural internal fixation and transthoracic internal fixation in the treat-ment of thoracic tuberculosis.Methods A total of 70 patients with thoracic tuberculosis(T4 to T10)who were admitted to our hospital from June 2018 to June 2023 were enrolled,and their clinical data were retrospectively analyzed.The 35 patients treated with extrapleural internal fixation were included in the extrapleural group,and the other 35 patients treated with transthoracic internal fixation were included in the transthoracic group.The operation time,intraoperative blood loss,bone graft fusion time,kyphotic angle before and after operation,visual analogue scale(VAS)and Oswestry disability index(ODI)scores after operation,postoperative complications and recurrence were compared between the two groups.Results Compared with the transthoracic group,the operation time and bone graft fusion time were significantly shortened,and the intraoperative blood loss was significantly reduced in the extrapleural group,with statistically significant differences(P<0.05).The postoperative kyphotic angles of the two groups were smaller than those before operation,the postoperative kyphotic angle of the extrapleural group was smaller than that of the transthoracic group,and the differences were statistically significant(P<0.05).The VAS score 7 days after operation of the extrapleural group was lower than that of the transthoracic group,and the difference was statistically significant(P<0.05).The ODI score 1 month after operation of the extrapleural group was lower than that of the transthoracic group,and the difference was statistically significant(P<0.05).The incidence of postoperative complications in the extrapleural group(0)was lower than that in the transthoracic group(34.28%),and the difference was statistically significant(P<0.05).Conclusion Extrapleural internal fixation has the advantages of short time,less bleeding and less trauma in the treatment of thoracic tuberculosis,but it is difficult to completely remove the lesions.Transthoracic internal fixation can completely remove the lesion,but the surgical trauma is large.The choice of clinical operation plan should be comprehensively considered according to the specific condition of the patients,the location of the lesion,and the condition of the lung,so as to achieve the best treatment effect.

Objective:To analyze the trends and research hotspots in English publications from China′s anesthesiology discipline in international journals from 2000 to 2023 using the bibliometric analysis.Methods:Based on the results retrieved from the Science Citation Index Expanded database covering English publications from China′s anesthesiology discipline in international journals from January 2000 to December 2023, CiteSpace 6.3.R1 and VOSviewer 1.6.20.0 were employed to analyze the annual publication counts, institutions, authors, co-cited references, and keywords, etc. with knowledge graph generated.Results:A total of 53, 039 articles published in English from January 2000 to December 2023 were included. The annual number of articles published in English showed an overall increasing trend year by year. Basic research articles exhibited a phase of slow growth during 2000-2007, entered a period of accelerated growth from 2008, and demonstrated a slightly decreased trend by 2023. The number of clinical research articles increased rapidly since 2008, was equivalent to the basic research articles by 2020, surpassed basic research articles by 2023 and became the mainstream research direction of anesthesiology discipline. Among clinical research publications, case series studies predominated from 2000 to 2022, and cohort studies exceeded case series for the first time in 2023, ranking second only to the randomized controlled trials. Research hotspots in anesthesiology discipline predominantly focused on the relationship of neuropsychiatry to anesthesia, pain management, cardiovascular surgery and organ injury, COVID-19 pandemic and patient safety. In terms of journals, Medicine was the journal with the largest number of publications, with 1, 345 publications in 2023 and an impact factor of 1.3. American journals dominated the top 15 highly productive journals, and Anesthesiology had the highest h-index (60) and g-index (98) with an impact factor of 9.1. In terms of domestic high-yield institutions, Shanghai Jiao Tong University topped the list, publishing about 1, 200 papers between 2000 and 2023, followed by Sichuan University (about 850) and Capital Medical University (about 720). Conclusions:China′s anesthesiology research has demonstrated a meteoric rise in both the number of papers published and cited frequency, reflecting ascending scientific academic levels and innovation capacity in the the international arena. While acknowledging this quantitative expansion, recognition is warranted that enhancing research quality and international impact remains imperative to narrow the gap with advanced nations and gradually achieve advancement.