Recent clinical trials have demonstrated a protective effect in using traditional Chinese medicine Tongxinluo (TXL) capsule to treat atherosclerosis. However, clinical evidence of the effects of TXL treatment on coronary plaque vulnerability is unavailable. In response, we developed this study to investigate the hypothesis that on the basis of statin therapy, treatment with TXL capsule may stabilize coronary lesions in patients with acute coronary syndrome (ACS). The TXL-CAP study was an investigator-initiated, randomized, double-blind clinical trial conducted across 18 medical centers in China. Patients with ACS aging from 18 to 80 years old who had a non-intervened coronary target lesion with a fibrous cap thickness (FCT) < 100 μm and lipid arc > 90° as defined by optical coherence tomography (OCT) were recruited. A total of 220 patients who met the selection criteria but did not meet the exclusion criteria will be finally recruited and randomized to receive treatment with TXL (n = 110) or placebo (n = 110) for a duration of 12 months. The primary endpoint was the difference in the minimum FCT of the coronary target lesion between TXL and placebo groups at the end of the 12-month follow-up. Secondary endpoints included: (1) changes of the maximum lipid arc and length of the target plaque, and the percentage of lipid, fibrous, and calcified plaques at the end of the 12-month period; (2) the incidence of composite cardiovascular events and coronary revascularization within the 12 months; (3) changes in the grade and scores of the angina pectoris as assessed using the Canadian Cardiovascular Society (CCS) grading system and Seattle angina questionnaire (SAQ) score, respectively; and (4) changes in hs-CRP serum levels. The results of the TXL-CAP trial will provide additional clinical data for revealing whether TXL capsules stabilizes coronary vulnerable plaques in Chinese ACS patients.

Objective:To analyze the clinical efficacy of vascular resection and reconstruction during radical resection in patients with hilar cholangiocarcinoma.Methods:A retrospective analysis was conducted on the clinical data of 151 patients with hilar cholangiocarcinoma who underwent radical resection in the Department of Hepatobiliary and Pancreatic Surgery at the First Affiliated Hospital of Anhui Medical University from April 2018 to April 2025. Among them, there were 91 males and 60 females, with an age of (65.4±10.5) years. According to whether radical resection of hilar cholangiocarcinoma was combined with vascular resection, the patients were divided into the vascular resection group ( n=19) and the control group ( n=132). Postoperative complications such as bleeding, biliary fistula, and thrombosis were recorded, along with intraoperative blood loss, R 0 resection rate, perioperative mortality, and recurrence rate at six months postoperatively. Results:The preoperative bilirubin reduction and intraoperative blood loss in the vascular resection group were 6 (31.6) and 200 (200, 200) ml, respectively, while those in the control group were 45 (34.1) and 200 (100, 200) ml, respectively. There were no statistically significant differences between the two groups (all P>0.05). The combined liver resection, Billroth operation type Ⅰ-Ⅱ, and operation time in the vascular resection group were 18 (94.7), 1 (5.3), and 420 (377.5, 512.5) min, respectively, while those in the control group were 79 (59.8), 38 (28.8), and 322.5 (260, 410) min, respectively. There were statistically significant differences between the two groups (all P<0.05). The R 0 resection, perioperative mortality rate, postoperative bleeding, postoperative biliary fistula, postoperative thrombosis, postoperative pathology (adenocarcinoma), and recurrence rate at 6 months after surgery in the vascular resection group were 16 (84.2), 2 (10.5), 2 (10.5), 3 (15.8), 1 (5.3), 18 (94.7), and 1 (5.9), respectively, while those in the control group were 103 (78.0), 5 (3.8), 5 (3.8), 25 (18.9), 2 (1.5), 121 (91.7), and 6 (4.7), respectively. There were no statistically significant differences between the two groups (all P>0.05). The postoperative hospital stay, alanine aminotransferase on the 1st and 3rd day after surgery, and postoperative liver failure in the vascular resection group were 18 (13.5, 21.5) days, 619 (305.4, 1 634.0) U/L, and 1 (5.3), respectively, while those in the control group were 14 (11, 18), 254.5 (139.3, 468.3) U/L, and 3 (2.3), respectively. There were statistically significant differences between the two groups (all P<0.05). Conclusion:Vascular resection and reconstruction during radical resection of hilar cholangiocarcinoma in patients has certain safety and efficacy.

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.

BACKGROUND: Spatiotemporal disparities exist in the disease burden of non-communicable diseases (NCDs) attributable to kidney dysfunction, which has been poorly assessed. The present study aimed to evaluate the spatiotemporal trends of the global burden of NCDs attributable to kidney dysfunction and to predict future trends. METHODS: Data on NCDs attributable to kidney dysfunction, quantified using deaths and disability-adjusted life-years (DALYs), were extracted from the Global Burden of Diseases Injuries, and Risk Factors (GBD) Study in 2019. Estimated annual percentage change (EAPC) of age-standardized rate (ASR) was calculated with linear regression to assess the changing trend. Pearson's correlation analysis was used to determine the association between ASR and sociodemographic index (SDI) for 21 GBD regions. A Bayesian age-period-cohort (BAPC) model was used to predict future trends up to 2040. RESULTS: Between 1990 and 2019, the absolute number of deaths and DALYs from NCDs attributable to kidney dysfunction increased globally. The death cases increased from 1,571,720 (95% uncertainty interval [UI]: 1,344,420-1,805,598) in 1990 to 3,161,552 (95% UI: 2,723,363-3,623,814) in 2019 for both sexes combined. Both the ASR of death and DALYs increased in Andean Latin America, the Caribbean, Central Latin America, Southeast Asia, Oceania, and Southern Sub-Saharan Africa. In contrast, the age-standardized metrics decreased in the high-income Asia Pacific region. The relationship between SDI and ASR of death and DALYs was negatively correlated. The BAPC model indicated that there would be approximately 5,806,780 death cases and 119,013,659 DALY cases in 2040 that could be attributed to kidney dysfunction. Age-standardized death of cardiovascular diseases (CVDs) and CKD attributable to kidney dysfunction were predicted to decrease and increase from 2020 to 2040, respectively. CONCLUSION NCDs attributable to kidney dysfunction remain a major public health concern worldwide. Efforts are required to attenuate the death and disability burden, particularly in low and low-to-middle SDI regions.
Humans ; Noncommunicable Diseases/epidemiology* ; Global Burden of Disease ; Disability-Adjusted Life Years ; Male ; Female ; Risk Factors ; Middle Aged ; Kidney Diseases/epidemiology* ; Bayes Theorem ; Adult ; Aged ; Global Health ; Quality-Adjusted Life Years

Lean six sigma (LSS) emphasizes patient demand-oriented, and continuously optimizing prolesses to achieve efficiency and standardization in medical services. Starting in 2021, a specialized children′s hospital (comprising one main campus and three branch campuses) introduced the LSS management method. Through define, measure, analyze, improve, and control, the hospital utilized tools such as questionnaire surveys, SIPOC models, and fishbone diagrams to identify pain points in the building of multi-campus child-friendly hospital and develop improvement measures.To address the main issues of insufficient cross-campus collaboration, significant disparities in service quality among different campuses, unclear functional positioning of each campus, and inadequate integration with social security mechanisms, the hospital implemented a " homogeneity-differentiation-coordination" management mode. The hospital implemented unified diagnosis and treatment standards and clinical pathways, carried out remote consultations and expert rotations, completed mutual recognition of examination and testing results, optimized child friendly labeling and child friendly environment, and built a " hospital-to-hospitals, hospital to medical schools, and hospital to community health centers" linkage platform, etc., to promote the standardization of diagnosis and treatment processes, clear functional positioning of the hospital area, and efficient resource allocation. Through practice, the outpatient appointment rate and patient satisfaction rate in the main hospital had increased from 86.72% and 98.64% in January December 2021 to 91.87% and 99.72% in January December 2024, respectively; The patient waiting time had been shortened from 26.54 minutes to 21.94 minutes, and the efficiency of medical treatment and service experience had been significantly improved. As of 2024, mutual recognition of 214 inspection and testing items had been achieved cross hospital campuses, forming a collaborative pattern of " main hospital leading, campuses support, and resource complementarity", and significantly improving the level of collaboration and child friendly connotation among multi-campus. This practice explored the integration path of multi-campus collaborative governance and child-friendly services, which could provide reference and inspiration for the similar hospitals.

Objective To analyze the serum metabolomic changes of preterm infants with bronchopulmonary dysplasia(BPD)at postmenstrual age(PMA)36 weeks,screen potential biomarkers and associated metabolic pathways,and assess their relationship with short-term respiratory outcomes.Methods A retrospective case-control study was conducted.Infants with gestational age 28-32 weeks admitted to the Children's Hospital Affiliated to Zhengzhou University from January to December 2024 were included.Twenty infants with BPD and 20 gestational age-,birth weight-,and sex-matched non-BPD preterm infants were included.Serum collected at PMA 36 weeks was subjected to untargeted metabolomics analysis,and associations with short-term respiratory outcomes were analyzed.Results Thirteen potential biomarkers distinguishing BPD were identified(area under the curve>0.75,P<0.05).Eight biomarkers—including terephthalic acid,phosphatidylinositol,fumarate,and lysophosphatidic acid—were significantly upregulated(FC≥1.5),while five biomarkers,such as 7α-hydroxy-3-oxo-4-cholestenoate ester and phosphatidylcholine,were significantly downregulated(FC≤1/1.5).Pathway analysis indicated five pathways associated with BPD,including glycerophospholipid metabolism and phenylalanine metabolism.Dysregulation of glycerophospholipid and bile acid metabolism may affect adverse short-term respiratory outcomes in infants with BPD.Conclusions The 13 significantly different metabolites may serve as biomarkers for the diagnosis of BPD.Glycerophospholipid metabolism is associated with the occurrence of BPD and with adverse short-term respiratory outcomes.

Objective To analyze the application effect of acetaminophen preemptive analgesia combined with intercostal nerve block in thoracoscopic lobectomy.Methods A total of 120 patients with lung cancer who underwent thoracoscopic lobectomy admitted to Lu'an Traditional Chinese Medicine Hospital from January 2021 to September 2023 were selected as the study objects,and they were divided into the control group and the observation group according to random number table method,with 60 cases in each group.Patients in the control group were given acetaminophen preemptive analgesia before anesthesia induction,while patients in the observation group were given intercostal nerve block on the basis of the control group.The visual analogue scale(VAS)score,Ramsay sedation score,serum β-endorphin level and prostaglandin E2 level 3,12,24 and 48 hours after operation of patients in the two groups were compared.The stress response indexes such as norepinephrine(NE),epinephrine(E)and serum cortisol(Cor),as well as immune function indexes such as CD3+,CD4+and CD4+/CD8+before anesthesia induction and after extubation of patients in the two groups were compared.The incidence of adverse reactions after extubation of patients in the two groups were compared.Results The VAS scores of patients after surgery in the two groups gradually increased with time,and the Ramsay sedation scores gradually decreased with time.The VAS scores of patients in the observation group were lower than those in the control group at each postoperative time point,and the Ramsay sedation scores were higher than those in the control group,with statistically significant differences(P<0.05).The levels of serum β-endorphin and prostaglandin E2 of patients after surgery in the two groups gradually decreased with time.The levels of serum β-endorphin of patients at each postoperative time point in the observation group were higher than those in the control group,and the levels of prostaglandin E2 of patients at each postoperative time point in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).The levels of NE,E,and Cor after extubation of patients in the two groups were significantly decreased(P<0.05),and those in the observation group were lower than those in the control group(P<0.05).The levels of CD3+,CD4+,and CD4+/CD8+after extubation of patients in the two groups were significantly decreased(P<0.05),and those in the observation group were higher than those in the control group(P<0.05).The total incidence of adverse reactions in the observation group was lower than that in the control group,with statistically significant difference(P<0.05).Conclusion The application of acetaminophen preemptive analgesia combined with intercostal nerve block in thoracoscopic lobectomy has good analgesic and sedative effects on patients,which is helpful to improve patients'immune function and reduce postoperative adverse reactions.

BACKGROUND:miRNAs expression has been reported to be associated with hepatic and renal fibrosis,and dermal fibrogenesis. Moreover,a targeted regulatory relationship between miR-192-5p and epidermal regulators has been demonstrated in gouty arthritis.OBJECTIVE:To investigate the expression and regulatory role of miR-192-5p in hypertrophic scar and to verify whether there is a targeted regulatory relationship between miR-192-5p and epidermal regulators. METHODS:(1) Six cases of hypertrophic scar tissue and six cases of normal skin tissue were collected from the First Affiliated Hospital of Xinjiang Medical University. And miR-192-5p and epidermal regulator mRNA expression were detected by qRT-PCR. (2) The primary hypertrophic scar fibroblasts were obtained using tissue explant method and cultured to 3-6 generations for subsequent experiments. There were three groups in the experiment:negative control group,miR-192-5p mimic group and miR-192-5p inhibitor group. The latter two groups were transfected with the corresponding sequences. Cell proliferation viability was detected by the cell counting kit-8 assay and EdU kit;and the migration ability was detected by the cell scratch test. Cell apoptosis was detected by flow cytometry. The gene and protein expressions of epidermal regulator,type Ⅰ collagen,type Ⅲ collagen and α-smooth muscle actin were detected by qRT-PCR and western blot,respectively. miR-192-5p targets were predicted by a bioinformatics website,and target binding was validated by dual luciferase assay. RESULTS AND CONCLUSION:(1) Compared with normal skin tissues and their fibroblasts,miR-192-5p and epidermal regulator were highly expressed in hypertrophic scar and hypertrophic scar fibroblasts (P<0.05 or P<0.01). (2) After overexpression of miR-192-5p,cell proliferation was enhanced (P<0.05) and EdU positive cell rate increased (P<0.01) when compared with the negative control group;after inhibition of miR-192-5p,cell viability (P<0.05) and EdU positive rate decreased (P<0.05). (3) At 24 hours after overexpression of miR-192-5p,compared with the negative control group,the area between cell scratches and apoptosis rate decreased in the miR-192-5p mimic group (P<0.05) but increased in the miR-192-5p inhibitor group (P<0.01). (4) At 48 hours after transfection,the mRNA and protein levels of epidermal regulator were significantly decreased in the miR-192-5p mimic group,while the mRNA and protein levels of type Ⅰ collagen,type Ⅲ collagen and α-smooth muscle actin were significantly increased (P<0.05 or P<0.01). The miR-192-5p inhibitor group showed opposite changes in the above four indicators (P<0.05 or P<0.01). (5) The Targetscan website predicted that epidermal regulator had a potential binding site for miR-192-5p. (6) Dual luciferase assays showed that miR-192-5p could bind to epidermal regulator in a targeted manner. To conclude,overexpression of miR-192-5p can decrease the expression of epidermal regulator,and the two may be negatively regulated,suggesting that regulation of epidermal regulator may play a role in inhibiting the proliferation of hypertrophic scar fibroblasts.

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.