Objective To establish a stable,reliable,and clinically relevant porcine model of endotoxin-induced acute respiratory distress syndrome(ARDS).Methods Ten 8-month-old male Bama minipigs were deeply sedated,followed by invasive mechanical ventilation and electrocardiographic monitoring.Lipopolysaccharide(LPS)was intravenously pumped at 600 μg/(kg·h)for 3 hours,then maintained at 15 μg/(kg·h)thereafter.Dynamic monitoring was performed at five time points after LPS injection(LPS 0,1,3,5,and 8 h),including arterial blood gas analysis and chest computed tomography(CT)scans.Pathological examination of lung tissues obtained via bronchoscopic biopsy(HE staining and transmission electron microscopy)was conducted.These indicators were comprehensively used to evaluate the success of the animal model.Results At 5 hours after LPS administration,8 minipigs developed symptoms such as skin cyanosis,elevated body temperature,and respiratory distress.The oxygenation index decreased to<300 mmHg.Chest CT scans showed diffuse pulmonary infiltrates.Histopathology revealed alveolar edema and hyaline membrane formation.Transmission electron microscopy demonstrated disruption of pulmonary blood-air barrier,depletion of lamellar bodies in type Ⅱ pneumocytes,inflammatory cell infiltration,and exudation of plasma proteins and fibrin.Compared with LPS 0 h,at LPS 8 h,the oxygenation index and arterial blood pH were significantly decreased(P<0.001),while blood lactic acid and serum potassium were significantly increased(P<0.05);serum calcium and base excess were significantly decreased(P<0.05),and the lung injury score based on HE-stained lung sections was significantly increased(P<0.01).Conclusion The porcine ARDS model established by continuous LPS injection can dynamically simulate the pathophysiological characteristics and typical pathological manifestations of clinical septic ARDS,making it an effective tool to study the pathogenesis,prevention,and treatment strategies of septic ARDS.

Targeted covalent inhibitors,primarily targeting cysteine residues,have attracted great attention as potential drug candidates due to good potency and prolonged duration of action.However,their dis-covery is challenging.In this research,a database-assisted liquid chromatography-tandem mass spec-trometry(LC-MS/MS)strategy was developed to quickly discover potential cysteine-targeting compounds.First,compounds with potential reactive groups were selected and incubated with N-acetyl-cysteine in microsomes.And the precursor ions of possible cysteine-adducts were predicted based on covalent binding mechanisms to establish in-house database.Second,substrate-independent product ions produced from N-acetyl-cysteine moiety were selected.Third,multiple reaction monitoring scan was conducted to achieve sensitive screening for cysteine-targeting compounds.This strategy showed broad applicability,and covalent compounds with diverse structures were screened out,offering structural resources for covalent inhibitors development.Moreover,the screened compounds,norket-amine and hydroxynorketamine,could modify synaptic transmission-related proteins in vivo,indicating their potential as covalent inhibitors.This experimental-based screening strategy provides a quick and reliable guidance for the design and discovery of covalent inhibitors.

A colorimetric detection method for xanthine oxidase activity and its inhibitors(XOI)based on nitrogen-doped carbon-supported ruthenium metal atom(Ru/NC)nanozyme was developed.Through a host-guest strategy,Ru/NC nanozyme with excellent peroxidase-like activity was prepared using zeolitic imidazolate framework-8(ZIF-8)as the host molecule and ruthenium acetylacetonate(Ru(acac)3)as the guest molecule.Based on its peroxidase-like catalytic activity,the visual method for detection of hydrogen peroxide(H 2O 2)and analysis of xanthine oxidase(XO)activity were developed.Under optimized experimental conditions,the linear detection range for H 2O 2 was 10-500 μmol/L,with a detection limit of 4.8 μmol/L(3σ);for XO activity analysis,the linear range was 1-7 mU/mL,with a detection limit of 0.69 mU/mL(3σ).Furthermore,an effective method for screening XOI was developed,which had the advantages of low cost,simplicity,and visualization.

Detection of poor-water-soluble substances typically requires an organic solvent containing solution,and therefore,the biosensors that can operate in such conditions are highly promising for practical applications.However,most existing biosensors have been developed in aqueous solution and it is hard to work effectively in organic solvent systems.In this work,we uncovered that the G-quadruplex(G4)/hemin DNAzyme(G4HD)could be strongly reactivated by NH4 in organic solvents at concentration up to 30％,and the activity was significantly higher than that in aqueous solutions containing K+.Based on this discovery,a biosensing system was developed for small molecule in 40％methanol by coupling G4HD with our previously identified RNA-cleaving DNAzyme(E3).This system comprised an ATP-activated aptazyme that was made of E3 and a G4HD that was activated by the cleavage product of the aptazyme.By using a manmade pipette tip filter to separate the reaction products,the subsequent colorimetric reaction of the G4HD could be triggered.This biosensing system enabled the visualization of target molecules in organic cosolvents without any other instruments.The activable DNAzyme-cascade sensing system had potential in point-of-care detection of poor-water-soluble pollutants,thereby enhancing the practical values of functional nucleic acid-based biosensors in real-world detection conditions.

Insulin is an important protein hormone that participates in multiple metabolic pathways.Biosynthetic insulin has been widely used in the treatment of type 1 and type 2 diabetes.Currently,the number of reported cases of insulin overdose both at home and abroad is gradually increasing,and insulin homicide is no longer a means of"committing murder without leaving a trace".At present,there are no systematic protocols for the identification of insulin overdose in the field of forensic medi-cine in China.This article introduces the causes,toxicological characteristics,forensic examination,labo-ratory testing methods and indicator reference of insulin overdose.Based on the identification practice and research results and referring to relevant studies on insulin overdose at home and abroad,this pa-per aims to provide recommendations and references for the formulation of forensic identification guide-lines for insulin overdose cases.

Thoracolumbar spine fracture often leads to severe pain, functional impairments, and neurological deficits, for which open reduction and internal fixation can effectively restore the spinal structural stability. Open decompression and reduction with internal fixation can help relieve spinal cord compression and improve spinal function in cases of concomitant cord injury. Although spinal stability can be restored through surgery, patients often face chronic pain and functional impairments postoperatively. A postoperative rehabilitation program is critical in optimizing therapeutic outcomes, reducing complications, and minimizing the risk of secondary injuries. However, current rehabilitation methods, such as physical therapy, functional training, and pain management, are confronted with problems in clinical practice, including significant variation in efficacy, poor patient adherence, and prolonged rehabilitation period. There is an urgent need for a unified rehabilitation strategy to address these problems. To this end, the Spinal Trauma Group of the Orthopedic Physicians Branch of the Chinese Medical Association and the Spine Health Professional Committee of the Chinese Human Health Technology Promotion Association organized experts from relevant fields to formulate Evidence-based guidelines for rehabilitation treatment after internal fixation of thoracolumbar spine fracture in adults ( version 2025) by integrating evidences from clinical researches and advanced rehabilitation concepts at home and abroad. A total number of 14 recommendations concerning the rehabilitation treatment with multimodal analgesia, psychological intervention, deep vein thrombosis prevention, core muscle and extremity exercise, appropriate use of braces, early weight-bearing, device-aided rehabilitation exercise, neuroregulatory therapy, rehabilitation team were put forward, aiming to standardize the post-operative rehabilitation process following internal fixation, promote the functional recovery, and enhance patients′ quality of life.

Acute symptomatic osteoporotic thoracolumbar compression fracture (ASOTLF) can lead to chronic low back pain, kyphosis deformity, pulmonary dysfunction, loss of mobility, and even life-threatening complications. Vertebral augmentation is currently the mainstream treatment method for this condition. In 2019, the Editorial Board of Chinese Journal of Trauma and the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association collaboratively led the development of Clinical guideline for vertebral augmentation for acute symptomatic osteoporotic thoracolumbar compression fractures. Six years later, with advances in clinical diagnosis and treatment techniques as well as accumulating evidence in related fields, the 2019 guideline requires updating. To this end, the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association, the Spinal Health Professional Committee of China Human Health Science and Technology Promotion Association, and the Minimally Invasive Orthopedics Professional Committee of Shaanxi Medical Doctor Association have organized experts in the field to develop the Clinical guideline for vertebral augmentation of acute symptomatic osteoporotic thoracolumbar compression fractures ( version 2025) , based on the latest evidence-based medical researches. This guideline incorporates 3 recommendations retained from the 2019 version with updated strength of evidence, along with 12 new recommendations. It provides recommendations from six aspects of diagnosis, pain management, treatment option selection, prevention of postoperative complications, anti-osteoporosis therapy, and postoperative rehabilitation, aiming to provide a reference for standard treatment of vertebral augmentation for ASOTLF in hospitals at all levels.

Objective:This study applies an integrated SWOT-CLPV framework combined with stakeholder analysis to systematically assess the strengths,weaknesses,opportunities,and threats of China's disease control inspector system,while identifying its control factors,leverage points,key problems,and vulnerabilities.Methods:Drawing on literature review,policy document analysis,and expert interviews with seven public health professionals,we extracted and categorized SWOT elements.A CLPV interaction analysis was conducted alongside stakeholder mapping to evaluate internal dynamics and systemic risks.Results:The inspector system demonstrates strengths in policy innovation and medical-public health integration,with external opportunities stemming from rising public health awareness and digital health advancements.However,the system faces weak endogenous momentum,limited leverage,and prominent control constraints and problem-prone areas,especially among grassroots institutions and inspectors themselves.Cross-sectoral coordination barriers and uneven local implementation contribute to significant institutional vulnerabilities.Conclusion:To enhance implementation and resilience,the system requires capacity building for key actors,improved governance structures,incentive and evaluation reforms,and strengthened coordination mechanisms to support the sustained and adaptive development of public health supervision.

Objective:To explore the changes of serum histone deacetylase 2 (HDAC2), lonely G protein-coupled receptor ligand (Apelin) and B-type brain natriuretic peptide (BNP) in patients with chronic obstructive pulmonary disease (COPD) and the predictive value for prognosis.Methods:A retrospective selection was made of 100 COPD patients (COPD group) admitted to the Fourth People's Hospital of Langfang from May 2022 to May 2023 and 50 healthy individuals who underwent physical examinations during the same period (healthy control group) as the research subjects. The levels of serum HDAC2, Apelin and BNP in the two groups were compared. The levels of HDAC2, Apelin and BNP in COPD patients with different clinical characteristics were compared. The correlation among serum HDAC2, Apelin and BNP in COPD patients were analyzed by Spearman test. The predictive value of serum HDAC2, Apelin and BNP for the prognosis of patients with COPD was analyzed by the receiver operating characteristic (ROC) curve.Results:The level of HDAC2 in the COPD group was lower than that in the healthy control group, the levels of Apelin and BNP were higher than those in the healthy control group: (2.38 ± 0.56) U/L vs. (7.51 ± 1.33) U/L, (491.62 ± 53.82) ng/L vs. (337.19 ± 46.52) ng/L, (211.05 ± 23.46) ng/L vs. (37.52 ± 4.32) ng/L, there were statistical differences ( P<0.05). COPD patients with different clinical characteristics, including those in acute exacerbation and stable stages, mild, moderate and severe cases, COPD patients with pulmonary function grades Ⅱ, Ⅲ and Ⅳ, COPD patients with and without pulmonary hypertension, and patients with poor prognosis and good prognosis, there were statistically significant differences in the levels of HDAC2, Apelin and BNP ( P<0.05). The Spearman test results indicated that in COPD patients, serum HDAC2 was negatively correlated with Apelin ( r = - 0.469, P = 0.001), HDAC2 was negatively correlated with BNP ( r = - 0.435, P = 0.001), and Apelin was positively correlated with BNP ( r = 0.418, P = 0.001). The results of ROC curve analysis indicated that the combined detection of HDAC2, Apelin and BNP had the highest area under the curve for predicting the prognosis of COPD patients (0.954), with a sensitivity of 81.66%. Conclusions:COPD patients have lower HDAC2 and higher Apelin and BNP levels. The three indicators are correlated to a certain extent, and their levels are closely related to the clinical characteristics of patients. The combined detection of the three indicators can be used as important predictive indicators for the prognosis of COPD patients.

Alzheimer disease(AD)is a progressive neurodegenerative disorder characterized by cognitive dysfunction and declining learning and memory abilities,significantly impacting daily lives and behavioral capacities of the patients.The mitogen-activated protein kinase(MAPK)signaling pathway,primarily composed of extracellular signal-regulated kinase,p38 MAPK,and c-Jun N-terminal kinase.Mounting evidence suggests that the MAPK signaling path-way is intimately linked to the pathogenesis of AD,providing crucial insights into the disease's progression.In recent years,traditional Chinese medicine(TCM)has demonstrated promising potential in treating AD,with its advantages of personalized therapy and multi-target regulation garnering increasing research attention.This study aims to review the ex-perimental research landscape of TCM interventions targeting the MAPK signaling pathway for the prevention and treat-ment of AD over the past five years.The findings reveal that effective compounds and herbal formulas in TCM,such as isorhamnetin,nobiletin,parthenolide,Glehnia littoralis,Ishige okamurae,shikonin,artemisinin,kaempferol,myrice-tin,and Tripterygium glycosides,can alleviate AD symptoms by modulating the MAPK signaling pathway.These interven-tions mitigate Aβ-induced neuronal damage,reduce Tau protein hyperphosphorylation,and suppress neuroinflammatory responses.The objective of this review is to provide a scientific and theoretical reference for the clinical prevention and treatment of AD and to inform the development of novel therapeutic agents.