The Type III Secretion System (T3SS) serves as a pivotal virulence apparatus for numerous Gram-negative bacterial pathogens, enabling them to infect both animal and plant hosts. Functioning as a molecular syringe, the T3SS directly translocates bacterial effector proteins from the bacterial cytoplasm into the interior of eukaryotic host cells. These effectors are central weapons that precisely manipulate a wide spectrum of host cellular physiological processes, ranging from cytoskeletal dynamics to immune signaling, to establish a favorable niche for bacterial survival and proliferation. Among the diverse arsenal of T3SS effectors, the YopJ family constitutes a critical group of virulence factors. Members of this family are characterized by a conserved catalytic triad structure—a hallmark of the CE clan of cysteine proteases that has been evolutionarily repurposed to confer acetyltransferase activity. A defining and intriguing feature of these enzymes is their stringent dependence on a host-derived eukaryotic cofactor, inositol hexakisphosphate (IP₆), for allosteric activation. This requirement acts as a sophisticated molecular safeguard, ensuring enzymatic activity only within the appropriate host environment, thereby preventing detrimental effects on the bacterium itself. While seminal studies on individual members such as Yersinia’s YopJ and Salmonella’s AvrA have provided deep mechanistic insights, a systematic and integrative understanding of the structure-function relationships across the entire family remains fragmented. Key questions persist regarding how a conserved catalytic core has diverged to recognize distinct host substrates in different kingdoms of life. To address this gap, this article provides a systematic review of the YopJ family, focusing on three interconnected aspects: their structural features, their catalytic mechanism, and their divergent immunosuppressive strategies in animal versus plant hosts. By conducting a comparative analysis of the sequences and resolved three-dimensional structures of three representative members (e.g., HopZ1a, PopP2, AvrA), we elucidate regions of significant variation embedded within the conserved core catalytic architecture. These variable regions, often involving surface loops and substrate-binding interfaces, are crucial determinants of target specificity and functional specialization. The functional divergence of this effector family is most apparent when comparing their modes of action in different hosts. In animal hosts, YopJ-family effectors primarily sabotage innate immune signaling pathways. They achieve this by acetylating key serine and threonine residues within the activation loops of critical kinases in the MAPK and NF‑κB pathways. This post-translational modification blocks the phosphorylation and subsequent activation of these kinases, leading to potent suppression of inflammatory cytokine production. Conversely, in plant hosts, the strategy broadens to dismantle the two-tiered plant immune system. YopJ homologs target a more diverse set of substrates, including immune-associated receptor-like cytoplasmic kinases (RLCKs), microtubule networks via tubulin acetylation (which disrupts cellular trafficking and signaling), and transcription factors central to defense gene regulation. This multi-target approach effectively suppresses both Pattern-Triggered Immunity (PTI) and Effector-Triggered Immunity (ETI). In conclusion, this synthesis aims to deepen the mechanistic understanding of YopJ family-mediated pathogenesis by integrating structural biology with cellular function across host kingdoms. Elucidating the precise molecular basis for substrate selection—how conserved platforms achieve target diversity—is a major frontier. Furthermore, this knowledge provides a vital theoretical foundation for developing novel anti-virulence strategies. Targeting the conserved IP₆-binding pocket or the catalytic acetyltransferase activity itself represents a promising avenue for designing broad-spectrum inhibitors that could disarm this critical family of bacterial effectors, potentially offering new therapeutic approaches against a range of pathogenic bacteria.

Objective To explore the effectiveness of the generative large language model MedGo in nursing decision-making for elderly patients with multimorbidity. Methods A quasi-randomized controlled trial study was conducted involving 6 junior nurses, 6 senior nurses and the MedGo model from January 1, 2025 to March 31, 2025 at the Emergency Internal Medicine Ward of Shanghai East Hospital Affiliated to Tongji University. Clinical data of 120 elderly patients with multimorbidity were analyzed to compare the performance of the three groups in four tasks (nursing diagnosis assessment, nursing intervention formulation, complication identification, and complication prevention) from three evaluation dimensions: decision-making time consumption, decision accuracy, and decision-making quality. Results In terms of decision-making time, the senior nurse group completed all four tasks faster than the junior nurse group (P＜0.01), and the MedGo group completed all four tasks faster than the junior nurse group (P＜0.001) and the senior nurse group (P＜0.001). In terms of decision-making accuracy, senior nurse group scored higher than junior nurse group in all four tasks (P＜0.001), while the MedGo group outperformed the senior nurse group only in complication identification (P＜0.001). In terms of decision-making quality, the MedGo group scored higher than junior nurse group (P＜0.001) and senior nurse group (P＜0.001) in all four tasks. Conclusions The MedGo model demonstrates advantages of high efficiency, accuracy, and quality in nursing decision-making for elderly patients with multimorbidity; senior nurses outperform junior nurses in decision-making, providing diverse references for clinical nursing decision-making.

Purpose To investigate the correlation between intervertebral disc degeneration and paraspinal muscle fatty infiltration in chronic low back pain(CLBP)using quantitative MRI techniques.Materials and Methods A total of 63 CLBP patients and 42 volunteers in Zigong Fourth People's Hospital from September 2023 to March 2024 were retrospectively collected.Magnetic resonance scans were performed using multi-echo water-fat separation technique and T2 mapping technique.Intervertebral disc degeneration was assessed using the Pfirrmann grading,while paraspinal muscle fatty infiltration was evaluated using the Goutallier grading.Proton density fat fraction(PDFF)of the multifidus and erector spinae muscles,and T2 values of the nucleus pulposus were quantitatively measured.The relationships between these parameters and their associations with age and gender were analyzed.Results Compared with healthy volunteers,CLBP patients showed significantly reduced T2 values of the nucleus pulposusand significantly increased PDFF of the paraspinal muscles(Z=-5.54-4.65,all P<0.001).The Pfirrmann grading of intervertebral discs and the Goutallier grading of paraspinal muscles were significantly correlated with the T2 value of the nucleus pulposus and the PDFF of the paraspinal muscles(|r|>0.4,P<0.05).Age and Pfirrmann grading were independent predictors of paraspinal muscle fat infiltration(β=0.228-5.682,all P<0.001),and gender was also an independent predictor at the L4/5 intervertebral disc level(β=-2.834,-3.352,both P<0.05).Conclusion Intervertebral disc degeneration and paraspinal muscle fat infiltration are closely related in CLBP,age and gender also have an impact.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

AIM To establish the preparation process and quality standard for Zhenggu Pills.METHODS With decoction time,decoction frequency and water addition as influencing factors,comprehensive score for extract yield and transfer rates of epicatechin and naringin as an evaluation index,the decoction process was optimized by orthogonal test.With sugarless paste relative density,medicinal powder fineness,sugarless paste-corn starch ratio,drying temperature and drying time as influencing factors,soft material traits,pill formability,moisture and disintegration time limit as evaluation indices,the formability process was optimized by single factor test.TLC was adopted in the qualitative identification of Dipsaci Radix,salt-processed Psoraleae Fructus,cooked Rhei Radix et Rhizoma and Notoginseng Radix et Rhizoma.HPLC was used for the content determination of paeoniflorin and naringin.RESULTS The optimal decoction process was determined to be 0.5 h for decoction time,two times for decoction frequency,and 10 times for water addition,the comprehensive score was 0.93.The optimal formability process was determined to be 1.21-1.22 for sugarless paste relative density,80 mesh for medicinal powder fineness,1∶0.17-1∶0.18 for sugarless paste-corn starch ratio,70 ℃ for drying temperature,and 24 h for drying time,good soft material traits and pill formability were observable,and moisture and disintegration time limit accored with 2020 edition of Chinese Pharmacopoeia requirements.The TLC spots were clear without negative interference.Two constituents showed good linear relationships within 61.30-490.41 μg/mL(r=0.999 8)and 3.27-26.18 μg/mL(r=0.999 8),whose average recoveries were 100.15％and 98.15％with the RSDs of 0.55％and 2.30％,respectively.CONCLUSION This stable,reliable and specific method can be used for the production and quality evaluation of Zhenggu Pills.

OBJECTIVE To investigate the current status of monitoring indicators related to the"Perioperative In-fection Control"in medical institutions above the secondary level in Guizhou Province,and to delve into the imple-mentation of key measures for infection prevention and control during the perioperative period for patients under-going surgical operations.METHODS Based on the"Implementation Plan for the'Perioperative Infection Control'Initiative in Guizhou Province",a"Case Investigation Form on Key Measures for Infection Prevention and Control During the Perioperative Period for Patients Undergoing Surgical Operation"was developed.A total of 138 medi-cal institutions participated in the case investigation,and a total of 2 128 cases were investigated.RESULTS The overall monitoring indicators for the"Perioperative Infection Control"initiative in the 138 medical institutions a-bove the secondary level in Guizhou Province were at a relatively low level.The skin cleansing compliance rate was 80.32％,the hair removal compliance rate was 16.43％,the prophylactic antibacterial drug administration rate within 0.5-1 hour before surgery was 55.94％and the antibacterial drug discontinuation rate within 24 hours after prophylactic medication for type Ⅰ incision surgeries was 56.48％.The hair removal compliance rate was higher in tertiary medical institutions(19.21％)than in secondary medical institutions(14.34％)(P=0.039).The distri-bution of the four monitoring indicators varied in clinical departments and surgery types,with statistically signifi-cant differences(P＜0.05).The preferred method for surgical site skin cleansing in medical institutions across the province was local wiping,primarily with clean water(57.21％).The primary method for hair removal was razors(68.82％),and hair removal on the day of surgery was most common(61.75％).CONCLUSIONS Conduc-ting a survey on the current status of"Perioperative Infection Control"initiative monitoring indicators in medi-cal institutions in Guizhou Province helps to understand the implementation of key measures for perioperative in-fection prevention and control and set intervention targets,thus providing references for establishing a dynam-ic monitoring indicator change mechanism.

AIM To establish the quantitative models for gallic acid,mononucleoside,loganin,resveratrol,and rhein in Yishen Xiezhuo Mixture.METHODS HPLC was adopted in the content determination of various effective components,after which the near-infrared spectroscopy(NIRS)data were collected in 128 batches of samples and pretreatment was conducted,competitive adaptive reweighting sampling(CARS)algorithm was used for screening wavelength,partial least square method(PLS)regression analysis was performed.RESULTS There were no significant differences between the predicted values obtained by PLS models and measured values obtained by HPLC for various effective components(P＞0.05).CONCLUSION The quantitative models established by NIRS combined with chemometrics display good predictive performance,which can be used for the rapid determination of effective components in Yishen Xiezhuo Mixture,and provide a reference for the rapid monitoring of other traditional Chinese medicine preparations in production processes.

[Purpose]To analyze the prevalence and disease burden of malignant tumors in cancer registration areas of Hubei Province in 2020.[Methods]The incidence and mortality data of ma-lignant tumors in cancer registration areas in Hubei Province in 2020 were collected,and the data were quality controlled according to the quality evaluation standards and methods formulated by the National Cancer Center.The data from 24 registries met the inclusion criteria.Using descrip-tive epidemiological methods to calculate incidence/mortality rate,age-specific incidence/mortality rate,standardized incidence/mortality rate by Chinese standard population(ASRC),standardized incidence/mortality rate by world standard population(ASRW).Disability-adjusted life years(DALY)and DALY rates were calculated using formulas provided by the World Health Organization to as-sess the disease burden of malignant tumors.[Results]In 2020,the crude incidence of malignant tumors in cancer registration areas of Hubei Province was 311.36/105,the ASRC was 184.14/105,the ASRW was 197.37/105,and the cumulative rate of 0～74 years old was 20.52％.The age-spe-cific incidence of malignant tumors in the province and rural areas reached its peak in the age group of 75～79 years old,while in urban areas it reached its peak in the age group of 80～84 years old.In 2020,the crude mortality rate of malignant tumors in cancer registration areas of Hubei Province was 184.58/105,the ASRC was 96.91/105,the ASRW was 110.92/105,and the cumulative rate of 0～74 years old was 11.01％.The age-specific mortality rate of malignant tumors in the province and urban areas reached its peak in the age group of above 85 years old,while in rural areas it reached its peak in the age group of 80～84 years old.Lung cancer ranked first in the incidence and mortality of malignant tumors in the province.In the cancer registration area of Hubei Province,the DALY of malignant tumors in 2020 was 641 497 person-years,and the DALY rate was 28.6‰.[Conclusion]Common cancers such as lung cancer,female breast cancer and upper digestive tract cancer have a great impact on the incidence,mortality and disease burden of malignant tumors in Hubei Province.Targeted cancer screening and early diagnosis and treatment are the most effective means to improve social and economic benefits.

[Purpose]To analyze the epidemiological characteristics of lung cancer in 2020 and the trend from 2012 to 2020 in Hubei Province.[Methods]Qualified lung cancer registry data reported by 24 cancer registries in Hubei Province was utilized to estimate the number of new lung cancer cases and deaths.Incidence/mortality rate,age-specific incidence/mortality rate,age-standardized incidence/mortality rate by Chinese standard population(ASIRC and ASMRC)and by world stan-dard population(ASIRW and ASMRW),cumulative rate of 0～74 years old and other indicators of lung cancer in urban and rural areas,different sex,age groups in 2020 were calculated.Annual percentage change(APC),average annual percentage change(AAPC)and 95％confidence interval(CI)were calculated to analyze the trends of incidence and mortality of lung cancer in cancer regi-stration areas of Hubei Province from 2012 to 2020.[Results]In 2020,the estimated number of new lung cancer cases in Hubei Province was 41 531,accounting for 23.17％of all new cancer cases.The incidence rate was 72.13/105,with the ASIRC of 38.19/105 and ASIRW of 42.75/105 respectively.The cumulative incidence rate of 0～74 years old was 4.82％.The estimated number of lung cancer deaths in Hubei Province in 2020 was 31 374,accounting for 29.52％of all cancer deaths.The mortality rate was 54.49/105,with the ASMRC of 27.66/105 and ASMRW of 31.95/105,respectively.The cumulative mortality(0～74 years old)was 3.36％.The incidence of lung cancer was higher in urban areas than that in rural areas,and higher in men than that in women.The in-cidence and mortality of lung cancer increased with age,and reaching the peak in the age groups of 75～79 and 80～85 years old respectively.From 2012 to 2020,the overall trend of crude inci-dence and mortality of lung cancer in Hubei Province was stable.The ASIRC and ASMRC showed a slow decline during 2012-2020,with the AAPCs of-0.51％(95％CI:-1.06％～-0.02％)and-1.84％(95％CI:-2.65％～-0.53％),respectively.The ASIRC showed a slow decline(APC=-1.76％,95％CI:-3.30％～-1.03％)during 2012-2018 and increase trend(APC=3.33％,95％CI:0.61％～5.02％)during 2018-2020,respectively,while ASMRC showed a significant decrease trend(APC=-3.00％,95％CI:-6.58％～-1.13％)during 2016-2020.[Conclusion]The incidence and mortality levels of lung cancer in Hubei Province were relatively high,resulted in a heavy disease burden and no significant downward trend.In the future,we should continue to strengthen the compre-hensive prevention and treatment of lung cancer,and promote lung cancer screening and early diagno-sis and treatment for target populations vigorously,especially in rural areas.

[Purpose]To analyze the opportunistic screening results of upper gastrointestinal can-cer in Hubei Province from 2022 to 2023.[Methods]The data of upper gastrointestinal cancer opportunistic screening program in Hubei Province from January 1,2022 to December 31,2023 were summarized.The biopsy rate,positive lesion detection rate and early diagnosis rate were ana-lyzed.The differences in rates between/among different sexes,age groups and regions were com-pared by x2 test,trend x2 test.[Results]A total of 372 507 people were included in the oppor-tunistic screening of upper gastrointestinal cancer from 2022 to 2023.Among them,100 379 in-dividuals underwent biopsy histopathological examination,with a biopsy rate of 26.95％.A total of 4 678 positive cases(high-grade intraepithelial neoplasia,early-stage cancer and advanced can-cer)were detected in the opportunistic screening,with a positive lesion detection rate of 1.26％.The detection rates of positive lesion in the esophagus,cardia and stomach were 0.61％,0.07％and 0.58％,respectively.There were 721 cases of early upper gastrointestinal cancer(high-grade intraepithelial neoplasia,early-stage cancer),representing an early diagnosis rate of 15.41％.The early diagnosis rates for the esophagus,cardia and stomach were 14.53％,11.96％and 16.89％,respectively.[Conclusions]The implementation of opportunistic screening for upper gastrointesti-nal cancer is conducive to expanding the coverage of screening.It is necessary to strengthen stan-dardized and homogeneous training and complete high-quality endoscopic examination to improve the detection rate and early diagnosis rate of opportunistic screening program for upper gastroin-testinal cancer.