Acute Gelsemium poisoning is a systemic disease primarily affecting the central nervous system and respiratory symptoms caused by the ingestion of a substantial amount of Gelsemium within a short period. It manifests as sudden onset and rapid progression, primarily caused by accidental ingestion due to misidentification, and posing significant health risks. The compilation of the Technical Plan for Emergency Health Response to Acute Gelsemium Poisoning describes in detail the specialized practice and technical requirements in the process of handling acute Gelsemium poisoning, including accident investigation and management, laboratory testing and identification, in-hospital treatment, and health monitoring. The guidelines clarify key procedures and requirements such as personal protection, investigation elements, etiology determination, medical rescue, and health education. The key to acute Gelsemium poisoning investigation lies in promptly identifying the toxin through exposure history, clinical manifestations, and sample testing. Because there is no specific antidote for Gelsemium poisoning, immediate removal from exposure, rapid elimination of the toxin, and respiratory monitoring are critical on-site rescue measures. Visual identification of food or herbal materials, followed by laboratory testing to determine Gelsemium alkaloids in samples is a rapid effective screening method. These guidelines offer a scientific, objective, and practical framework to support effective emergency responses to acute Gelsemium poisoning incidences.

Objective:To analyze the values of platelet transforming growth factor-β (TGF-β) and SMAD family member 2 (Smad2) in patients′ peripheral platelets for CRC diagnosis and staging.Methods:Retrospective case-control study. Tumor tissues, paratumor tissues and peripheral blood samples were collected from 248 CRC patients (147 males, 101 females; age 21-93 years) diagnosed in the First Hospital of Jilin University from October 10th, 2020, to March 10th, 2025. Peripheral blood samples were also collected from 40 colorectal adenomatous polyp patients (21 males, 19 females; age 22-74 years) and 75 healthy individuals (43 males, 32 females; age 18-81 years) during the same period. Tissue homogenates and platelets were isolated using tissue disruption and gradient centrifugation, respectively. Total RNA was respectively extracted from tissues and platelets, and the expression levels of TGF-β and Smad2 were quantified by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) expressed as relative quantity 2 -ΔΔCt. Differences of TGF-β and Smad2 expression were compared between CRC tissues and adjacent tissues, as well as among CRC patients, polyp patients, and healthy controls. The relationship of platelet TGF-β and Smad2 expression with pathological features includingtumor stage, pathological type, and metastasis were analyzed. The efficiency of platelet TGF-β, Smad2, and their combination in diagnosing CRC was evaluated using receiver operating characteristic (ROC) curves. Results:The expression levels of TGF-β and Smad2 in CRC tumor tissues[1.09 (0.45, 2.00), 2.93 (0.78, 6.73)] were significantly higher than those in adjacent tissues[0.81 (0.27, 1.50), 1.29 (0.40, 2.63)] ( Z TGF-β=4.54, Z Smad2=6.67, both P<0.001). The expression levels of TGF-β and Smad2 in platelets of CRC patients[2.73(1.53, 4.38), 3.16 (1.58, 4.38)] were significantly higher than those in the colorectal polyp group[1.23(0.70, 2.54), 1.16(0.78, 2.27)] and the healthy control group[0.96(0.51, 1.88), 0.92 (0.55, 1.88)] ( H TGF-β=59.71, H Smad2=78.74, both P<0.001). Platelet TGF-β expression increased progressively with tumor stage (stage 1-4) ( P<0.05), while platelet Smad2 levels were higher in metastatic CRC compared with non-metastatic cases ( P<0.05). ROC curve analysis showed that the area under the curve (AUC) for diagnosing CRC when combining platelet TGF-β and Smad2 was 0.81[95%Confidence interval( CI) 0.77—0.86], which was 0.90 (95% CI 0.86—0.93) if adding serum carcinoembryonic antigen (CEA). Conclusion:Platelet TGF-β and Smad2 expression correlates with the diagnosis and staging of CRC, demonstrating potential as liquid biopsy biomarkers for colorectal malignancies.

Objective:To identify risk factors affecting survival outcomes in elderly patients (≥75 years) with early gastric cancer (EGC) and establish a predictive scoring system to aid in treatment decision-making.Methods:A retrospective analysis was conducted on EGC patients who underwent gastroscopy, endoscopic submucosal dissection (ESD), surgical resection, or conservative treatment at the Endoscopy Center of the First Affiliated Hospital of Dalian Medical University between January 2016 and January 2023. Clinical data were analyzed to identify prognostic risk factors and develop a predictive scoring system. The low-risk group and high-risk group were divided according to the scores, and the overall survival of patients who received different treatments were compared between two groups.Results:A total of 180 patients were included, of whom 50 underwent ESD, 97 surgery, and 33 conservative treatment. Cox proportional risk model multivariate analysis identified three independent risk factors for survival: Charlson comorbidity index (CCI) >2 ( P=0.014, HR=2.411, 95% CI: 1.196-4.864), prognostic nutritional index (PNI) ≤43.275 ( P=0.011, HR=2.294, 95% CI: 1.205-4.365), and presence of multiple primary cancers ( P=0.004, HR=2.797, 95% CI: 1.401-5.585). A weighted scoring system assigned 1 point each for CCI>2, PNI≤43.275, and multiple primary cancers. Receiver operating characteristic curve analysis determined an optimal cutoff score of 1.5 ( P<0.001, area under curve=0.726). Patients were stratified into low-risk (score≤1) and high-risk (score≥2) groups. In the low-risk group, both ESD and surgical resection demonstrated superior overall survival compared with conservative treatment (95.1%, 87.5%, and 61.5%, respectively, P=0.003), with no significant difference between ESD and surgery ( P=0.466). In the high-risk group, no statistically significant overall survival difference was observed among ESD, surgery, and conservative treatment (55.6%, 64.7%, and 30.0%, respectively, P=0.152). Conclusion:CCI, PNI, and multiple primary cancers are critical prognostic factors for elderly EGC patients. The proposed scoring system (total 3 points) guides treatment decisions: ESD or surgery is recommended for low-risk patients (score≤1), while conservative management may benefit high-risk patients (score≥2).

Objective:To identify risk factors affecting survival outcomes in elderly patients (≥75 years) with early gastric cancer (EGC) and establish a predictive scoring system to aid in treatment decision-making.Methods:A retrospective analysis was conducted on EGC patients who underwent gastroscopy, endoscopic submucosal dissection (ESD), surgical resection, or conservative treatment at the Endoscopy Center of the First Affiliated Hospital of Dalian Medical University between January 2016 and January 2023. Clinical data were analyzed to identify prognostic risk factors and develop a predictive scoring system. The low-risk group and high-risk group were divided according to the scores, and the overall survival of patients who received different treatments were compared between two groups.Results:A total of 180 patients were included, of whom 50 underwent ESD, 97 surgery, and 33 conservative treatment. Cox proportional risk model multivariate analysis identified three independent risk factors for survival: Charlson comorbidity index (CCI) >2 ( P=0.014, HR=2.411, 95% CI: 1.196-4.864), prognostic nutritional index (PNI) ≤43.275 ( P=0.011, HR=2.294, 95% CI: 1.205-4.365), and presence of multiple primary cancers ( P=0.004, HR=2.797, 95% CI: 1.401-5.585). A weighted scoring system assigned 1 point each for CCI>2, PNI≤43.275, and multiple primary cancers. Receiver operating characteristic curve analysis determined an optimal cutoff score of 1.5 ( P<0.001, area under curve=0.726). Patients were stratified into low-risk (score≤1) and high-risk (score≥2) groups. In the low-risk group, both ESD and surgical resection demonstrated superior overall survival compared with conservative treatment (95.1%, 87.5%, and 61.5%, respectively, P=0.003), with no significant difference between ESD and surgery ( P=0.466). In the high-risk group, no statistically significant overall survival difference was observed among ESD, surgery, and conservative treatment (55.6%, 64.7%, and 30.0%, respectively, P=0.152). Conclusion:CCI, PNI, and multiple primary cancers are critical prognostic factors for elderly EGC patients. The proposed scoring system (total 3 points) guides treatment decisions: ESD or surgery is recommended for low-risk patients (score≤1), while conservative management may benefit high-risk patients (score≥2).

Objective:To analyze the values of platelet transforming growth factor-β (TGF-β) and SMAD family member 2 (Smad2) in patients′ peripheral platelets for CRC diagnosis and staging.Methods:Retrospective case-control study. Tumor tissues, paratumor tissues and peripheral blood samples were collected from 248 CRC patients (147 males, 101 females; age 21-93 years) diagnosed in the First Hospital of Jilin University from October 10th, 2020, to March 10th, 2025. Peripheral blood samples were also collected from 40 colorectal adenomatous polyp patients (21 males, 19 females; age 22-74 years) and 75 healthy individuals (43 males, 32 females; age 18-81 years) during the same period. Tissue homogenates and platelets were isolated using tissue disruption and gradient centrifugation, respectively. Total RNA was respectively extracted from tissues and platelets, and the expression levels of TGF-β and Smad2 were quantified by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) expressed as relative quantity 2 -ΔΔCt. Differences of TGF-β and Smad2 expression were compared between CRC tissues and adjacent tissues, as well as among CRC patients, polyp patients, and healthy controls. The relationship of platelet TGF-β and Smad2 expression with pathological features includingtumor stage, pathological type, and metastasis were analyzed. The efficiency of platelet TGF-β, Smad2, and their combination in diagnosing CRC was evaluated using receiver operating characteristic (ROC) curves. Results:The expression levels of TGF-β and Smad2 in CRC tumor tissues[1.09 (0.45, 2.00), 2.93 (0.78, 6.73)] were significantly higher than those in adjacent tissues[0.81 (0.27, 1.50), 1.29 (0.40, 2.63)] ( Z TGF-β=4.54, Z Smad2=6.67, both P<0.001). The expression levels of TGF-β and Smad2 in platelets of CRC patients[2.73(1.53, 4.38), 3.16 (1.58, 4.38)] were significantly higher than those in the colorectal polyp group[1.23(0.70, 2.54), 1.16(0.78, 2.27)] and the healthy control group[0.96(0.51, 1.88), 0.92 (0.55, 1.88)] ( H TGF-β=59.71, H Smad2=78.74, both P<0.001). Platelet TGF-β expression increased progressively with tumor stage (stage 1-4) ( P<0.05), while platelet Smad2 levels were higher in metastatic CRC compared with non-metastatic cases ( P<0.05). ROC curve analysis showed that the area under the curve (AUC) for diagnosing CRC when combining platelet TGF-β and Smad2 was 0.81[95%Confidence interval( CI) 0.77—0.86], which was 0.90 (95% CI 0.86—0.93) if adding serum carcinoembryonic antigen (CEA). Conclusion:Platelet TGF-β and Smad2 expression correlates with the diagnosis and staging of CRC, demonstrating potential as liquid biopsy biomarkers for colorectal malignancies.

Objective:To explore the evaluation and influence factors of computed tomography(CT)and magnetic resonance imaging(MRI)on thoracolumbar burst fracture combined with injury of posterior ligament complex(PLC).Methods:A total of 68 patients with thoracolumbar burst fractures who were diagnosed and treated in Handan First Hospital from January 2020 to June 2023 were selected as the research object,and the surgical result was used as gold standard.The 32 cases,who were diagnosed as thoracolumbar burst fractures combined with PLC injury according to the gold standard,were divided into PLC group.The 32 cases without PLC injury were divided into non-PLC group.Before operation,all patients underwent CT and MRI examinations,and the positively and negatively predictive values of CT and MRI in diagnosing thoracolumbar burst fracture combined with PLC injury were calculated by four-grid method.The area under curve(AUC)value,sensitivity and specificity of CT and MRI in diagnosing thoracolumbar burst fracture combined with PLC injury were analyzed by receiver operating characteristic(ROC)curve.Logistic regression model was used to analyze the risk factors of patients with thoracolumbar burst fracture who occurred PLC injury.The differences of the scores of ligamentous complex stability(LCS)score,intraspinal space occupancy rate and thoracolumbar injury classification and severity(TLICS)score,and the scoliosis angle(Cobb),superior iliac crest angle(SIEA),local kyphosis(LK)angle and intervertebral disc space depth(IISD)between two groups were compared.Results:For 68 with thoracolumbar burst fractures,the 34 cases were confirmed as PLC injury and 34 cases were confirmed as non-PLC injury by using CT examination.The positively and negatively predictive values of CT examination were respectively 70.59%(24/34)and 76.47%(26/34)for PLC injury,and the consistency between CT and gold standard was general(Kappa=0.471,P<0.001).The 33 cases were confirmed as PLC injury and 35 cases were confirmed as non-PLC injury by using MRI examination.The positively and negatively predictive values of MRI examination were respectively 90.91%(30/33)and 94.29%(33/35)for PLC injury,and the consistency between MRI examination and gold standard was general(Kappa=0.853,P<0.001).The diagnostic accuracy of MRI was 92.65%(63/68),which was significantly higher than that(73.53%,50/68)of CT(x2=8.843,P<0.05).ROC curve analysis showed that the AUC values of CT and MRI were respectively 0.730 and 0.919 in diagnosing thoracolumbar burst fracture combined with PLC injury.The sensitivities of them were respectively 70.60%and 75.40,and the specificities of them were respectively 88.20%and 95.70%.There were no significant differences between PLC group and non-PLC group in gender,age,body mass index(BMI),cause of injury,LCS score and intraspinal space occupancy rate(P>0.05).There were significant differences in TLICS score,Cobb angle,SIEA,LK and IISD between the two groups(x2=19.443,4.181,4.973,5.198,5.056,P<0.05),respectively.Logistic regression analysis showed that TLICS score>5 points,Cobb angle,SIEA,LK and IISD were risk factors that affected the occurrence of PLC injury in patients with thoracolumbar burst fracture(OR=13.973,1.155,1.365,1.385,5.262,P<0.001),respectively.Conclusion:The efficiency of MRI is higher than that of CT in diagnosing PLC injury in patients with thoracolumbar burst fracture,and TLICS score,Cobb angle,SIEA,LK and IISD have influences on the occurrence of PLC injury in patients with thoracolumbar burst fracture.

Objective To explore the pharmacologically active components in areca nut that induce oral submucosal fibrosis(OSF)and the possible mechanism.Methods The chemical components in areca nut were analyzed using Thermo QE plus liquid chromatography tandem high-resolution mass spectrometer and Compound discover 3.2 data processing software.The chemical activity of the top 20 compounds was analyzed based on Chinese Pharmacopoeia(2015),PubChem,Chemical book,and SciFinder databases.The potential active components,core targets,biological functions and signaling pathways affecting OSF were analyzed by network pharmacology.The targets of OSF were obtained by integrating Genecards and KEGG databases.The compounds acting on the targets were selected from the Systematic Pharmacology Technology Platform of Traditional Chinese Medicine(TCMSP),and the target-compound,compound-TCM,target-compound-TCM network was constructed.Molecular docking was used to analyze the component-target binding.Immunohistochemistry was used to examine the expressions of key proteins in the PI3K-Akt and MAPK pathways in clinical samples of OSF.Results The core intersection target genes between the top 10 active ingredients in areca nut extract and OSF involved mainly the PI3K-Akt and MAPK pathways.In the clinical samples,the expressions of PI3K protein decreased and the expressions p-PI3K,AKT1 and P-Akt all increased significantly in OSF tissue,where increased JNK protein expression and enhanced activity of c-Jun and c-Fos transcriptional factors were also detected.The OSF patients had significantly elevated plasma levels of IL-6 and IL-8 compared with healthy individuals.Conclusion The main active ingredients including arecoline,arecaine,and guvacine are capable of activating the PI3K-Akt and MAPK pathways to promote the expressions of inflammatory mediators IL-6 and IL-8 and induce collagen hyperplasia,thus leading to the occurrence of oral submucosal fibrosis.

BACKGROUND:Previous studies have successfully constructed erythropoietin-overexpressed umbilical cord mesenchymal stem cells.It was found that the apoptosis of ischemic and hypoxic human neuroblastoma cell line(SH-SY5Y)was significantly reduced by erythropoietin-overexpressed umbilical cord mesenchymal stem cells. OBJECTIVE:To explore the possible neuroprotective mechanisms of erythropoietin-overexpressed umbilical cord mesenchymal stem cells against ischemic-hypoxic SH-SY5Y and their associated epigenetic mechanisms. METHODS:Oxygen-glucose deprivation was applied to ischemia-hypoxia-induced SH-SY5Y cell injury,and multifactorial assays were applied to detect the expression levels of inflammatory factors in the cells before and after hypoxia and co-culture,respectively,with mesenchymal stem cells,as well as lentiviral-transfected null-loaded plasmids of the negative control mesenchymal stem cells and erythropoietin-overexpressed umbilical cord mesenchymal stem cells.The expression levels of supernatant inflammatory factors were detected by multifactor assay after co-culture.Proteomics was used to detect the differentially expressed proteins of negative control mesenchymal stem cells and erythropoietin-overexpressed umbilical cord mesenchymal stem cells.Cleavage under targets and tagmentation sequencing was applied to detect genomic H3K4me2 modification,and joint analysis was conducted with RNA-sequencing.Lentiviral vector infection was applied to construct the stable knockdown of REST in SH-SY5Y cells.qRT-PCR and western blot assay were performed to detect the expression level of REST.The apoptosis was detected by flow cytometry after co-culture of oxygen-glucose deprivation treatment with erythropoietin-overexpressed umbilical cord mesenchymal stem cells.The expression difference of H3K36me3 group proteins was detected by western blot assay,and transcriptome sequencing was performed to analyze the differentially expressed genes. RESULTS AND CONCLUSION:(1)Compared with the control group,monocyte chemotactic protein 1,interleukin-6,interleukin-18,and interleukin-1 beta,interferon α2,and interleukin-23 levels significantly increased in the cerebrospinal fluid supernatant of patients with ischemic-hypoxic encephalopathy(P<0.01).(2)After co-culturing SH-SY5Y cells with erythropoietin-overexpressed umbilical cord mesenchymal stem cells under ischemia and hypoxia,the expression levels of monocyte chemotactic protein 1 and interleukin-6 were significantly reduced.(3)Analysis of protein network interactions revealed significant downregulation of monocyte chemotactic protein 1,interleukin-6 related regulatory proteins CXCL1 and BGN.(4)Transcriptome sequencing analysis found that pro-inflammatory genes were down-regulated,and functional enrichment of histone modifications,and the expression of transcription factors REST and TET3 significantly up-regulated in the erythropoietin-overexpressed umbilical cord mesenchymal stem cell group compared with the negative control mesenchymal stem cell group.(5)Combined analysis of transcriptome sequencing and cleavage under targets and tagmentation revealed changes in epigenetic levels as well as significant activation of the promoter regions of transcription factors REST and TET3.(6)Stable knockdown REST in SH-SY5Y cells was successfully constructed;the transcript levels of REST mRNA and protein expression were both decreased.(7)After the REST knockdown SH-SY5Y cells were co-cultured with erythropoietin-overexpressed umbilical cord mesenchymal stem cells,apoptosis was significantly increased and H3K36me3 expression was significantly decreased.Transcriptome sequencing results showed that the expression of inflammation-related genes Aldh1l2 and Cth,as well as apoptosis-suppressor genes Mapk8ip1 and Sod2 was reduced at mRNA transcription level(P<0.01).(8)It is concluded that erythropoietin-overexpressed umbilical cord mesenchymal stem cells activated the expression of REST and TET3 by altering the kurtosis of H3K4me2 and upregulated the modification level of H3K36me3,which in turn regulated the expression of inflammation-related genes Aldh1l2 and Cth,as well as apoptosis-suppressor genes Mapk8ip1 and Sod2,and facilitated neuronal survival.

Objective To explore the pharmacologically active components in areca nut that induce oral submucosal fibrosis(OSF)and the possible mechanism.Methods The chemical components in areca nut were analyzed using Thermo QE plus liquid chromatography tandem high-resolution mass spectrometer and Compound discover 3.2 data processing software.The chemical activity of the top 20 compounds was analyzed based on Chinese Pharmacopoeia(2015),PubChem,Chemical book,and SciFinder databases.The potential active components,core targets,biological functions and signaling pathways affecting OSF were analyzed by network pharmacology.The targets of OSF were obtained by integrating Genecards and KEGG databases.The compounds acting on the targets were selected from the Systematic Pharmacology Technology Platform of Traditional Chinese Medicine(TCMSP),and the target-compound,compound-TCM,target-compound-TCM network was constructed.Molecular docking was used to analyze the component-target binding.Immunohistochemistry was used to examine the expressions of key proteins in the PI3K-Akt and MAPK pathways in clinical samples of OSF.Results The core intersection target genes between the top 10 active ingredients in areca nut extract and OSF involved mainly the PI3K-Akt and MAPK pathways.In the clinical samples,the expressions of PI3K protein decreased and the expressions p-PI3K,AKT1 and P-Akt all increased significantly in OSF tissue,where increased JNK protein expression and enhanced activity of c-Jun and c-Fos transcriptional factors were also detected.The OSF patients had significantly elevated plasma levels of IL-6 and IL-8 compared with healthy individuals.Conclusion The main active ingredients including arecoline,arecaine,and guvacine are capable of activating the PI3K-Akt and MAPK pathways to promote the expressions of inflammatory mediators IL-6 and IL-8 and induce collagen hyperplasia,thus leading to the occurrence of oral submucosal fibrosis.

Objective:To construct a bi-parameter radiomics model of magnetic resonance based on radiomics features of T2 fat suppression weighted images of magnetic resonance and diffusion-weighted apparent diffusion coefficient mapping,and to study the diagnostic value of the bi-parameter radiomics model for prostate cancer with clinical significance. Method:The imaging and pathological data of 93 patients with prostate cancer,who were confirmed at the First People's Hospital of Tianshui from January 2021 to February 2024,were retrospectively analyzed. They were divided into training set (65 cases) and testing set (28 cases) by using 7:3 principle of random number grouping method. The magnetic resonance T2 weighted fat suppression images and apparent diffusion coefficient mapping based on diffusion weighted imaging were preprocessed,and the regions of interest (ROI) were delineated. 1197 radiomics features were extracted. Machine learning support vector machine method was used to construct a bi-parameter omics model,which combined T2 weighted fat suppression images and apparent diffusion coefficient mapping based on diffusion weighted imaging. And then,the efficiency of this bi-parameter omics model of diagnosing prostate cancer with clinical significance was evaluated. Result:The area under curve (AUC) values of receiver operating characteristic (ROC) curve of training group and testing group based on the MRI bi-parameter model were respectively 0.928 and 0.894 in diagnosing prostate cancer with clinical significance. The sensitivity and specificity of that were respectively 84.2％ and 95.7％. Conclusion:The constructed bi-parameter radiomics model through training and testing has higher diagnostic value for prostate cancer with clinical significance,and it is relatively objective and accurate,which can provide reliable basis for clinical diagnosis and treatment of prostate cancer with clinical significance.