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.

By combing the mechanism of retrograde transmission of damp-heat epidemic to the pericardium,it is believed that the retrograde transmission of damp-heat epidemic to the pericardium is the transmission trend of damp-heat turbid epidemic evil from the lung wei or lung to the pericardium,and the turbid evil harming the clear is an important pathological mechanism leading to the retro-grade transmission of epidemic evil.Clinical treatment should be based on the theory of turbid evil harming the clear,and the lung qi should be disseminated to promote yang first to cut off the retrograde transmission of epidemic evil;if retrograde transmission occurs,phlegm and turbidity should be removed to promote yang,and be careful to prevent the separation of yin and yang.

Objective:To analyze the effect of alprostadil on renal hemodynamic parameters in patients with severe lupus nephritis (LN) complicated with acute kidney injury (AKI).Methods:The clinical data of 130 patients with severe LN complicated with AKI from August 2020 to August 2023 in Affiliated Hospital of Jining Medical University were retrospectively analyzed. Among them, 66 patients were treated with continuous renal replacement therapy (CRRT) (CRRT group), and 64 patients were treated with CRRT combined with alprostadil (combination group). All patients of both groups were treated 10 d. The efficacy, renal function (serum creatinine, blood urea nitrogen and 24 h urinary protein quantitation), renal hemodynamic parameters and serum inflammatory factors were compared between two groups. The renal hemodynamic parameters included peak systolic velocity (PSV), resistance index (RI) and end diastolic velocity (EDV)), serum inflammatory factors (procalcitonin (PCT); and the inflammatory factor included procalcitonin (PCT), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6).Results:The total effective rate in combination group was significantly higher than that in CRRT group: 96.88% (62/64) vs. 81.82% (54/66), and there was statistical difference ( χ2 = 7.67, P<0.01). There were no statistical difference in the indexes before treatment between two groups ( P>0.05). The serum creatinine, blood urea nitrogen, 24 h urinary protein quantitation, RI, PCT, TNF-α and IL-6 after treatment in combination group were significantly lower than those in CRRT group: (82.16 ± 16.66) μmol/L vs. (128.55 ± 21.06) μmol/L, (6.15 ± 1.66) nmol/L vs. (10.28 ± 2.45) nmol/L, (1.21 ± 0.42) g vs. (2.06 ± 0.52) g, (0.51 ± 0.12) cm/s vs. (0.61 ± 0.24) cm/s, (0.65 ± 0.12) μg/L vs. (0.89 ± 0.18) μg/L, (3.26 ± 0.34) μg/L vs. (6.82 ± 1.14) μg/L and (26.62 ± 3.62) μg/L vs. (40.55 ± 8.14) μg/L, the PSV and EDV were significantly higher than those in CRRT group: (25.66 ± 3.62) cm/s vs. (22.05 ± 1.84) cm/s and (10.92 ± 1.85) cm/s vs. (8.34 ± 1.26) cm/s, and there were statistical differences ( P<0.01). Conclusions:Alprostadil combined with CRRT can effectively improve renal function and renal hemodynamic in patients with severe LN complicated with AKI, enhance therapeutic efficacy, and inhibit the release of proinflammatory cytokines such as PCT.

Objective:To analyze the effect of alprostadil on renal hemodynamic parameters in patients with severe lupus nephritis (LN) complicated with acute kidney injury (AKI).Methods:The clinical data of 130 patients with severe LN complicated with AKI from August 2020 to August 2023 in Affiliated Hospital of Jining Medical University were retrospectively analyzed. Among them, 66 patients were treated with continuous renal replacement therapy (CRRT) (CRRT group), and 64 patients were treated with CRRT combined with alprostadil (combination group). All patients of both groups were treated 10 d. The efficacy, renal function (serum creatinine, blood urea nitrogen and 24 h urinary protein quantitation), renal hemodynamic parameters and serum inflammatory factors were compared between two groups. The renal hemodynamic parameters included peak systolic velocity (PSV), resistance index (RI) and end diastolic velocity (EDV)), serum inflammatory factors (procalcitonin (PCT); and the inflammatory factor included procalcitonin (PCT), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6).Results:The total effective rate in combination group was significantly higher than that in CRRT group: 96.88% (62/64) vs. 81.82% (54/66), and there was statistical difference ( χ2 = 7.67, P<0.01). There were no statistical difference in the indexes before treatment between two groups ( P>0.05). The serum creatinine, blood urea nitrogen, 24 h urinary protein quantitation, RI, PCT, TNF-α and IL-6 after treatment in combination group were significantly lower than those in CRRT group: (82.16 ± 16.66) μmol/L vs. (128.55 ± 21.06) μmol/L, (6.15 ± 1.66) nmol/L vs. (10.28 ± 2.45) nmol/L, (1.21 ± 0.42) g vs. (2.06 ± 0.52) g, (0.51 ± 0.12) cm/s vs. (0.61 ± 0.24) cm/s, (0.65 ± 0.12) μg/L vs. (0.89 ± 0.18) μg/L, (3.26 ± 0.34) μg/L vs. (6.82 ± 1.14) μg/L and (26.62 ± 3.62) μg/L vs. (40.55 ± 8.14) μg/L, the PSV and EDV were significantly higher than those in CRRT group: (25.66 ± 3.62) cm/s vs. (22.05 ± 1.84) cm/s and (10.92 ± 1.85) cm/s vs. (8.34 ± 1.26) cm/s, and there were statistical differences ( P<0.01). Conclusions:Alprostadil combined with CRRT can effectively improve renal function and renal hemodynamic in patients with severe LN complicated with AKI, enhance therapeutic efficacy, and inhibit the release of proinflammatory cytokines such as PCT.

BACKGROUND:Apoptosis plays an important role in secondary brain injury.Therefore,to explore the pathophysiological mechanism of promoting nerve cell survival after traumatic brain injury provides a new direction and theoretical basis for the prevention and treatment of traumatic brain injury. OBJECTIVE:To explore the expression changes of Lnx1 molecule in mammalian cortical neurons after brain injury and the possible mechanism involved in secondary brain injury. METHODS:Eighty adult SD rats were divided into 20 male and 20 female mice in sham operation group and 20 male and 20 female mice in traumatic brain injury group.The traumatic brain injury rat model was established by heavy falling method.At 6,12,24,48,and 72 hours after brain injury,the expression of related molecules in damaged cortical neurons was analyzed by RT-qPCR,western blot assay,and immunofluorescence staining. RESULTS AND CONCLUSION:(1)The brain tissue of traumatic brain injury group was bleeding and obvious tissue injury could be observed.Water content of brain tissue increased after traumatic brain injury.(2)Compared with the sham operation group,the expression of Lnx1 in cortical neurons after traumatic brain injury increased significantly at 24 hours after injury.(3)After traumatic brain injury,the expression of PBK and BCR protein decreased,and the pro-survival factor ctgf increased.(4)These findings suggest that after traumatic brain injury,the expression of Lnx1 is up-regulated in neurons,which may be due to the decrease of the expression of its target molecules PBK and BCR,and further promote the expression of living factor ctgf,which has a protective effect on the damaged neurons.

Objective:To explore the experience of clinical nurses in implementing nutritional management for patients with cirrhosis based on the nutrition care process and model, so as to provide references for nutritional management of patients with cirrhosis.Methods:From March to May 2024, 14 nurses from the Taihe County People's Hospital were selected for face-to-face semi-structured interviews using purposive sampling method. The Colaizzi's 7-step analysis was used to analyze the interview data.Results:A total of four themes were ultimately summarized, namely, multidimensional factors affecting patients' acceptance of nutritional management, nurses' professional competence affecting the implementation of nutritional management, deficiencies in practice affecting the implementation of nutritional management, and collaborative relationships between nurses and patients affecting the successful implementation of nutritional management.Conclusions:From the nurses' perspective, this study identifies strengths and weaknesses in the management and implementation of nutrition for patients with cirrhosis, which can provide a basis for further improvement and development of targeted nutritional management programs for patients with cirrhosis.

Helicobacter pylori(Hp)is a major pathogen that causes peptic ulcer,mucosa-associated tissue lymphoma and gastric cancer.Adhesion colonization is a prerequisite for the pathogenesis of Hp.After infec-tion,Hp first uses urease to neutralize gastric acid,and then it adapts to the environment through motility and chemotactic swimming of flagella.Finally,Hp adheres to gastric epithelial cells through outer membrane pro-teins.Some outer membrane proteins have the biological effect of transporting virulence factors,mediating in-flammation and assisting Hp to produce pathological changes on human body.This paper reviews the mecha-nism of main colonization factors of Hp.

[Purpose]To analyze the cost-effectiveness and cost-utility conducted on the lung can-cer screening project in urban areas of Anhui Province,and to provide suggestions for the formu-lation of lung cancer screening policies in Anhui Province.[Methods]A Markov decision model for low-dose computed tomography(LDCT)lung cancer screening intervention was established based on on-site survey data and literature data.The development of the population under different interventions was simulated,using saved life years(LYS)and quality-adjusted life years(QALY)as effectiveness indicators,to conduct cost-effectiveness and cost-utility analyses of different screening strategies.Cost data were discounted at a 3％discount rate.[Results]The screening schemes of once a year,once every two years,once every three years,and once every five years all meet the cost-effectiveness principle for saving one LYS or QALY.Among them,the best screening strategy in terms of cost-effectiveness and cost-utility was the LDCT lung cancer screening strategy once every two years,with costs of 72 441.54 CNY and 71 050.24 CNY,respectively.[Conclusion]The LDCT lung cancer screening program demonstrates good cost-effectiveness,with strategies of dif-ferent screening frequencies being viable options.The optimal screening strategy is screening once every two years.

Objective To observe the value of preoperative magnetization transfer imaging(MTI)for predicting postoperative pancreatic fistula(POPF)after distal pancreatectomy(DP).Methods A total of 65 patients with pancreatic tumor who underwent DP and preoperative MR scanning were retrospectively enrolled and divided into clinically relevant POPF(CR-POPF)group(n=14,with grade B or C fistula),biochemical fistula group(n=31,postoperative drain fluid amylase level exceeding 3 times the upper limit of normal)and non-fistula group(n=20,postoperative drain fluid amylase level not exceeding 3 times the upper limit of normal)based on postoperative records.Clinical data and magnetization transfer ratio(MTR)of pancreatic tissue at the surgical margin were compared among 3 groups.The predictive value of MTR for CR-POPF was evaluated according to the area under the curve(AUC)of receiver operating characteristic(ROC)curve.Results Patients' age,intraoperative blood loss and the proportion of pancreatic ductal adenocarcinoma in both CR-POPF group and biochemical fistula group were lower than those in non-fistula group(all adjusted P＜0.05),while no significant difference was found between the former two groups(all adjusted P＞0.05).MTR of pancreatic tissue at the surgical margin in CR-POPF group was lower than that in both biochemical fistula group and non-fistula group(both P＜0.05),whereas no statistical difference was detected between the latter two groups(P＞0.05).The AUC of MTR for predicting CR-POPF after DP was 0.727.Conclusion Preoperative MTI could be used to predict POPF after DP.

Gastric cancer with peritoneal metastasis (GCPM) is a common and lethal manifestation of advanced gastric cancer, with a median survival of only 5-11 months. This consensus was developed by 30 experts from Asia (China, Japan, Korea, and Singapore) using the Delphi method and the GRADE evidence grading system. A total of 29 statements were formulated, covering the diagnosis and assessment of GCPM, indications for laparoscopic exploration and NIPS (normothermic intraperitoneal and systemic treatment), treatment regimens, prevention and management of complications, criteria for conversion surgery, and postoperative intraperitoneal therapy. The consensus aims to standardize clinical practice and improve the prognosis of patients with GCPM.