Objective: To investigate the correlation between color parameters (L^*, a^*, b^*, Eab^*) and the contents of reducing sugars, total polysaccharides, total oligosaccharides, as well as four saccharides (fructose, glucose, sucrose, and kestose) during the nine cycles of steaming and sun-drying processing of Polygonatum kingianum, and to preliminarily explore the optimal processing duration.
Methods: The color changes were objectively evaluated using a colorimeter. The anthrone-sulfuric acid method was employed to determine total polysaccharides and oligosaccharides. The 3,5-dinitrosalicylic acid (DNS) colorimetric method was used to measure total reducing sugar content. High-performance liquid chromatography coupled with charged aerosol detection (HPLC-CAD) was applied for quantitative analysis of fructose, glucose, sucrose, and kestose. Multivariate statistical analysis was conducted to assess samples from different processing stages.
Results: Significant variations in color and component contents were observed across processing stages. The herbal pieces progressively darkened with increased processing cycles: brightness (L^*) and total color difference (Eab^*) initially decreased then stabilized, while a^* (red-green) and b^* (yellow-blue) values first increased then declined. Total polysaccharides and oligosaccharides showed overall decreasing trends, whereas reducing sugars initially increased before stabilizing. Fructose and glucose levels rose continuously, while sucrose and kestose decreased progressively, becoming undetectable after five cycles.
Conclusion: The chromatic alteration and saccharide composition of P. kingianum showed significant correlation with processing duration. Both total color difference (Eab^*) and reducing sugar content stabilized after four processing cycles (12 hours), suggesting that four cycles of steaming and sun-drying may represent the optimal processing duration.

Objective To identify determinants of subtherapeutic voriconazole(VRCZ)concentrations in allogeneic hematopoietic stem cell transplantation(allo-HSCT)recipients and to develop/validate a nomogram-based risk prediction model.Methods This study retrospectively analyzed 310 VRCZ therapeutic drug monitoring(TDM)measurements from allo-HSCT recipients at 310 patients who under went allo-HSCT surgery at Hebei Yanda Ludaopei Hospital from October 2022 to October 2024 and received VRCZ for the prevention and treatment of invasive fungal infections before transplantion were selected as the study subjects.Cases were stratified into target-concentration group(0.5～5.0μg/ml)and subtherapeutic group(<0.5μg/ml).Through single factor and multiple factor Logistic regression analysis,indeipendent predictive factors forvecz plasma concentration non-compliance were screened,and a column chart prediction model(NPM)was constructed.The performance of the model was evaluateding area under the receiver operating characteristic curve(AUC),Hosmer-Lemeshow(H-L)goodness-of-fit test,and decision curve analysis(DCA).Results Among 310 VRCZ-TDM measurements,71.61%(222/310)achieved target concentrations.Multivariate analysis showed that CYP2C19 intermediate metabolite,daily dose of cyclosporine A(CSA),daily dose of VRCZ,creatinine(Cr)>97 μmol/L,albumin(Alb)and C-reactive protein(CRP)were independent influencing factors for VRCZ blood drug concentration non-compliance(Wald χ2=4.046～13.221,all P＜0.05).The nomogram demonstrated excellent discrimination,calibration(H-L goodness of fit test χ2=2.663,P=0.954),and clinical utility with net benefit across 0.05～0.96 risk thresholds.Conclusion The nomogram incorporating CYP2C19 gene phenotype,daily CSA dosing,daily VRCZ dosing,Cr levels,Alb and CRP provides a validated tool for optimizing VRCZ therapy in allo-HSCT recipients,enabling precision dosing strategies.

Based on the Political Economic Social Technological(PEST)-Strengths Weakness Opportunity Threats(SWOT)model,by sorting out the macro-environmental factors such as politics,economy,society and technology,and combining the internal strengths and weaknesses of the hospital as well as the external opportunities and threats,it puts forward the strategies to optimize the comprehensive budget management.It is found that hospitals face problems in total budget management such as disconnection between budgeting and strategy,and low level of informatization,but they also have advantages such as resource optimization and support for decision-making.The external environment provides opportunities such as health insurance reform and financing channel expansion,while there are threats such as industry competition and data security.It is suggested to improve the budget management level and promote the high-quality development of hospitals by expanding funding sources,strengthening cost control,and promoting the integration of industry and finance.

Since 1973,the World Symposium on Pulmonary Hypertension(WSPH)has served as a pivotal platform for the advancing research in pulmonary hypertension(PH).At the 6th WSPH in 2018,the WSPH expert group refined the definitions related to cardiopulmonary physiology and right ventricular(RV)failure,thereby underscoring the critical role of RV dysfunction in the progression of PH.With ongoing advances in the field,RV failure associated with PH has received increasing attention and is now recognized as an important determinant of the prognosis of PH.The 7th WSPH,held in Barcelona,Spain,in 2024,presented the latest perspectives on the RV pathophysiology and its interaction with the pulmonary vasculature.The symposium emphasized new insights into the pathology of RV failure,RV phenotypes across different PH subgroups,and progress in therapeutic approaches targeting RV dysfunction.Additionally,the WSPH expert group delineated prospective research directions and identified unresolved issues.This article will review the RV function-related updates from the 7th WSPH and summarize recent findings,providing a systematic review of the evolution and breakthroughs in RV function research within the context of PH.

Objective To explore the clinical efficacy of applying exoskeleton robots in lower limb functional rehabilitation for patients after minimally invasive surgery for cervical spondylotic myelopathy(CSM).Methods A retrospective analysis was conducted on the clinical data of 56 patients who underwent spinal endoscopic minimally invasive surgery between April 2021 and October 2022.Based on the rehabilitation methods,patients were divided into the observation group(robot-assisted rehabilitation group)and the control group(conventional rehabilitation group).The Japanese Orthopaedic Association(JOA)scores for cervical spinal cord function,lower limb somatosensory evoked potential amplitudes,and gait analysis indicators(step frequency,walking speed,and stance phase ratio)were assessed preoperatively,4 weeks postoperatively,and 8 weeks postoperatively.Results In 4 and 8 weeks after surgery,both groups showed significant improvements in JOA scores,lower-limb somatosensory evoked potential amplitudes,and gait parameters(step frequency,walking speed,and stance phase ratio)com-pared with preoperative data(P<0.05).Furthermore,the improvements in JOA scores,somatosensory evoked potential amplitudes,and gait parameters in the observation group were significantly greater than those in the control group at both 4 and 8 weeks postoperatively(P<0.05).However,at the 2-year follow-up,there were no statistically significant differences(P>0.05)between the two groups in any of these measures.Conclusions Rehabilitation using lower limb exoskeleton robots can accelerate spinal cord function recovery and improve lower limb walking ability in patients after minimally invasive surgery for CSM,demonstrating superior short-term clinical efficacy com-pared to conventional rehabilitation.However,no significant differences were observed between the two methods during long-term follow-up.

Objective To analyze the expression levels of RNA demethylase alkB homolog 5(ALKBH5)and p21 activated kinase 5(PAK5)in high-risk human papillomavirus(HR-HPV)positive cervical cancer tissue,and explore their clinical significance.Methods A total of 96 patients with HR-HPV positive cervical cancer were selected as the research object.The expressions of ALKBH5 and PAK5 mRNA and protein in cancer tissue and adjacent tissue were analyzed by real-time fluorescent quantitative PCR,immunohistochemistry and Western blot assay.The expression levels of ALKBH5 and PAK5 proteins in patients with HR-HPV positive cervical cancer with different clinicopathological characteristics were compared.Multivariate Cox regression analysis was used to analyze influencing factors of death in patients with HR-HPV positive cervical cancer.Kaplan-Meier curve was used to analyze the effects of ALKBH5 and PAK5 protein expression on the 5-year survival rate of patients.Results The results of real-time fluorescent quantitative PCR,immunohistochemistry and Western blot assay showed that expression levels of ALKBH5 and PAK5 mRNA and protein in HR-HPV positive cervical cancer tissue were higher than those in adjacent tissue(P<0.05).The positive rates of ALKBH5 and PAK5 in cancer tissue of HR-HPV positive cervical cancer patients with FIGO stage ⅡA and lymph node metastasis were increased(P<0.05).ALKBH5 positive(HR=1.467,95％CI:1.104-1.949),PAK5 positive(HR=1.435,95％CI:1.093-1.884),FIGO stage ⅡA(HR=1.435,95％CI=1.065-1.933)and lymph node metastasis(HR=1.652,95％CI:1.053-2.593)were risk factors affecting the prognosis of HR-HPV positive cervical cancer patients(P<0.05).The 5-year cumulative survival rate was lower in the ALKBH5 positive group[72.58％(45/62)vs.91.18％(31/34)]than that of the ALKBH5 negative group(log rank χ2=4.481,P=0.034).The 5-year overall survival rate of the PAK5 positive group[71.67％(43/60)vs.91.67％(33/36)]was lower than that of the PAK5 negative group(log rank χ2=4.153,P=0.043).Conclusion The expression levels of ALKBH5 and PAK5 are significantly up-regulated in HR-HPV positive cervical cancer,both of which are related to the poor clinicopathological features of patients,and are helpful to evaluate the prognosis.

In line with the rising global incidence of cancer,tumor metastasis has become the leading cause of mortality among cancer patients.Formation of the pre-metastatic niche(PMN)creates an optimal microenvironment for tumor cell colonization and metastasis,thus facilitating tumor dissemination.In this context,cancer-associated fibroblasts(CAFs)have garnered significant attention as a result of their multifaceted roles in tumor progression.CAFs enhance the formation of the PMN and promote the invasive behavior of tumor cells by remodeling the extracellular matrix,inducing epithelial-mesenchymal transition,stimulating angiogenesis and modulating the tumor immune microenvironment.These processes not only expedite metastasis but also enable tumor immune evasion.This paper reviews the fundamental mechanisms and functions of CAFs in tumor metastasis,examines their potential applications in cancer research and therapy,and offers new perspectives and directions for the development of anti-tumor metastasis strategies.

Objective To analyze the expression levels of RNA demethylase alkB homolog 5(ALKBH5)and p21 activated kinase 5(PAK5)in high-risk human papillomavirus(HR-HPV)positive cervical cancer tissue,and explore their clinical significance.Methods A total of 96 patients with HR-HPV positive cervical cancer were selected as the research object.The expressions of ALKBH5 and PAK5 mRNA and protein in cancer tissue and adjacent tissue were analyzed by real-time fluorescent quantitative PCR,immunohistochemistry and Western blot assay.The expression levels of ALKBH5 and PAK5 proteins in patients with HR-HPV positive cervical cancer with different clinicopathological characteristics were compared.Multivariate Cox regression analysis was used to analyze influencing factors of death in patients with HR-HPV positive cervical cancer.Kaplan-Meier curve was used to analyze the effects of ALKBH5 and PAK5 protein expression on the 5-year survival rate of patients.Results The results of real-time fluorescent quantitative PCR,immunohistochemistry and Western blot assay showed that expression levels of ALKBH5 and PAK5 mRNA and protein in HR-HPV positive cervical cancer tissue were higher than those in adjacent tissue(P<0.05).The positive rates of ALKBH5 and PAK5 in cancer tissue of HR-HPV positive cervical cancer patients with FIGO stage ⅡA and lymph node metastasis were increased(P<0.05).ALKBH5 positive(HR=1.467,95％CI:1.104-1.949),PAK5 positive(HR=1.435,95％CI:1.093-1.884),FIGO stage ⅡA(HR=1.435,95％CI=1.065-1.933)and lymph node metastasis(HR=1.652,95％CI:1.053-2.593)were risk factors affecting the prognosis of HR-HPV positive cervical cancer patients(P<0.05).The 5-year cumulative survival rate was lower in the ALKBH5 positive group[72.58％(45/62)vs.91.18％(31/34)]than that of the ALKBH5 negative group(log rank χ2=4.481,P=0.034).The 5-year overall survival rate of the PAK5 positive group[71.67％(43/60)vs.91.67％(33/36)]was lower than that of the PAK5 negative group(log rank χ2=4.153,P=0.043).Conclusion The expression levels of ALKBH5 and PAK5 are significantly up-regulated in HR-HPV positive cervical cancer,both of which are related to the poor clinicopathological features of patients,and are helpful to evaluate the prognosis.

Patient-Reported Outcomes(PRO)is a subjective outcome indicator based on the concept of"patient-centered",in which patients report their own information such as health status,functional status,and treatment feelings,which is an ef-fective supplement to traditional objective outcome indicators.Based on the development status of the Patient Reported Outcome Measure(PROM),it systematically analyzed the concepts related to PRO with the goal of clarifying the Patient Experience Data(PED)with research value,and proposed six core types of PROs in the medical field,including health-related quality of life,health preference,health behavior,symptom burden,functional status and patient-reported experience.For each type of PRO,the key characteristics of the study were analyzed,the evidence and application directions of related PED and the production based on PED were described,and the existing international mainstream PROMs were reviewed.It is hoped that the connotation of PRO-related concepts can be comprehensively expounded,and PEDs with research significance and value can be explored,so as to provide guidance for the focus of PRO-related research in China,so as to promote the application and development of PRO in China.

Patient-Reported Outcomes(PRO)refers to a subjective outcome measure based on the concept of"patient-cen-tered",in which patients report their own health status,functional status,treatment feelings and other information,which is an ef-fective supplement to traditional objective outcome indicators.With the continuous promotion of PRO research,its application in the world is also constantly enriched.It takes the different application scenarios of PRO as the starting point and the evidence-based evidence that PRO can generate as the evaluation object,reviews the application status of PRO in the US,the European Union,the UK,Canada and other countries,regions or organizations,and summarizes the main application methods of PRO in different medical decision-making scenarios,in order to provide international experiences for the application research of PRO in China.