To investigate the risk factors for acute kidney injury (AKI) following the use of amphotericin B deoxycholate and to develop a predictive model to guide clinical monitoring and intervention.

Objective:To study the correlation between iodine level in drinking water and conventional water quality indicators.Methods:From June 2017 to July 2018, a simple random sampling method was used to select administrative villages (communities) from 88 counties (cities, districts) in Guizhou Province with a sampling size greater than 5%. One drinking water sample was collected from each administrative village (community), and conventional water quality indicators (including fluorine, aluminum, mercury, selenium, sulfate, total dissolved solids and total hardness) were tested in accordance with the methods outlined in the "Standards for Drinking Water Quality" (GB 5749-2006). The cerium sulfate catalytic spectrophotometric method was employed to test drinking water iodine level. Spearman method was utilized to analyze the correlation between iodine level in drinking water and conventional water quality indicators.Results:A total of 904 drinking water samples were tested, with a median iodine level of 1.90 μg/L and a range of 0.10 - 36.70 μg/L. There were 899 administrative villages (communities) with a water iodine level of less than 10 μg/L, accounting for 99.45%. There were only 5 administrative villages (communities) with a water iodine level of greater than 10 μg/L, accounting for 0.55%. Correlation analysis revealed that in Guizhou Province, the iodine level in drinking water was positively correlated with the levels of fluorine, aluminum, sulfate, total dissolved solids, and total hardness [correlation coefficients ( r) = 0.11, 0.07, 0.07, 0.08, 0.07, P < 0.05], and was a negatively correlated with mercury and selenium levels ( r = - 0.12, - 0.12, P < 0.001). Conclusions:External environment in Guizhou Province is generally deficient in iodine. The iodine level in drinking water is positively correlated with the levels of fluorine, aluminum, sulfate, total dissolved solids, and total hardness, and negatively correlated with the levels of mercury and selenium.

Objective:To evaluate the feasibility and outcomes of transnasal endoscopic clipping of the paraclival internal carotid artery (ICA) in skull base surgery.Methods:The paraclival ICA was anatomically dissected in cadaveric head specimens. The clinical data of 15 patients with skull base lesions involving the ICA who admitted to the Department of Otorhinolaryngology Head and Neck Surgery at Tianjin Huanhu Hospital from January 2021 to December 2023 were retrospectively analyzed. Among them, 4 patients underwent transnasal endoscopic clipping of the paraclival ICA and concurrent lesion resection. The surgical methods were summarized, and the key points and indications of this technique were analyzed.Results:Intraoperative clipping of the ICA was successful and hemostatic in all 4 patients. Postoperatively, 3 patients had no complications, while 1 patient developed delayed ischemic cerebral infarction. Two patients were cured, 1 patient was maintained on immunotherapy, and 1 patient died. During follow-up, the clip was in situ in 1 patient, had detached in another, and was obscured by temporal muscle coverage in the remaining 2 patients.Conclusions:Transnasal endoscopic clipping of the paraclival ICA represents a potential option for managing the ICA in skull base surgery. However, it carries significant risks and limitations, mandating careful patient selection based on specific circumstances.

Objective:It explored the effects of local financial input on the efficiency of health resource allocation in China,and analyzed its nonlinear relationship,so as to provide a basis for health policy formulation.Methods:Based on the data of 31 provinces,municipalities and autonomous regions from 2010 to 2022,the super-efficiency SBM model was used to measure the allocation efficiency of health resources,and its distribution dynamics were analyzed in combination with kernel density estimation.The threshold regression model was used to evaluate the impact of different financial input levels on the efficiency.Results:Local financial input has significant threshold effect on health resource allocation efficiency.Kernel density estimation shows that with the increase of input,the efficiency distribution tends to be concentrated,the high efficiency region increases,and the low efficiency region decreases.Threshold regression results show that when the financial input exceeds the key threshold of 7.1%,the positive impact is significantly enhanced.Conclusion:Raising the key threshold of financial input can significantly improve the efficiency of health resource allocation.Policymakers should take regional differences into account,formulate differentiated strategies,strengthen implementation and supervision,ensure the effective use of funds,so as optimize health resource allocation.

Objective To detect levels of plasma long non coding RNA(lncRNA)CCAAT enhancer binding protein alpha antisense 1(CEBPA-AS1)and microRNA-139-5p(miR-139-5p)in patients with acute cerebral infarction(ACI),and to explore their relationship with cognitive dysfunction in ACI patients.Methods A total of 132 ACI patients treated in our hospital were included for the study.The Montreal Cognitive Assessment Scale(MoCA)was used to evaluate the cognitive function of ACI patients,and they were diveded into the cognitive dysfunction group(n=63)and the normal cognitive function group(n=69).The general data of the two groups were compared.The qRT-PCR method was applied to measure plasma levels of lncRNA CEBPA-AS1 and miR-139-5p in ACI patients.Pearson method was applied to analyze the correlation between plasma lncRNA CEBPA-AS1 and miR-139-5p in ACI patients.Multivariate Logistic regression was applied to analyze factors influencing cognitive dysfunction in ACI patients.Receiver operating characteristic(ROC)curve was applied to evaluate the diagnostic value of plasma lncRNA CEBPA-AS1 and miR-139-5p for cognitive dysfunction in ACI patients.Results Compared with the normal cognitive function group,the plasma lncRNA CEBPA-AS1 was higher and the miR-139-5p was lower in the cognitive dysfunction group(P＜0.05).Correlation analysis showed that there was a negative correlation between lncRNA CEBPA-AS1 and miR-139-5p(r=-0.462,P＜0.01).Multivariate analysis showed that high school education or below,decreased plasma miR-139-5p,and increased lncRNA CEBPA-AS1 were risk factors for cognitive dysfunction in ACI patients(P＜0.05).The area under the curve(AUC)of lncRNA CEBPA-AS1 and miR-139-5p in the diagnosis of cognitive dysfunction in ACI patients was 0.865 and 0.798,respectively.The combined diagnostic efficacy of the two(AUC=0.912)was better than single index.Conclusion The plasma lncRNA CEBPA-AS1 is increased and the plasma miR-139-5p is decreased in patients with ACI combined with cognitive dysfunction,and both are influencing factors for cognitive dysfunction in ACI patients,and the combined diagnostic efficacy is high.

Objective:A GC method was established for the determination of three potential genotoxic impuri-ties methyl ethanesulfonate,ethyl ethanesulfonate and isopropyl ethanesulfonate in baritinib raw materials.Methods:The chromatography was performed on Agilent J&W DB-1701(30 m×0.25 mm,1.0 μm)col-umn.The heating procedure was the initial temperature of 100℃,maintained for 3 min,at the rate of 5℃per minute to 180℃,maintained for 2 min,and then at the rate of 30℃per minute to 240℃,maintained for 5 min.The temperature of the injector was 240℃.The shunt ratio was 1∶10.The carrier gas was helium with a flow rate of 2.0 mL per minute.The temperature of the detector was 260℃and the injection volume was 2 μL.Results:The specificity,linearity and range,limit of quantification and detection,accuracy,pre-cision,repeatability and stability of the method meet the requirements.Conclusion:The analytical method is simple,accurate,sensitive and reproducible,and can be used for quality control of three potential genotoxic impurities in baritinib.

Pancreatic cancers (PCs) is a common malignant tumor with poor prognosis in the digestive system. Its main treatment methods include surgery, radiotherapy, chemotherapy, and targeted therapy. The early diagnosis rate of hidden onset of PCs is low, and most patients have already lost the opportunity to undergo surgery when diagnosed with PCs. Chemotherapy is still the main treatment for advanced PCs, but the use of chemotherapy drugs in PCs can easily lead to drug resistance. The most significant feature that distinguishes PCs from other tumors is its rich and dense matrix, which not only hinders drug penetration but also impedes the infiltration of immune cells. The above reasons have led to a very low survival rate of PCs patients. Therefore, drug delivery systems are very important in the diagnosis and treatment of PCs. They can improve drug delivery, enhance biological barrier penetration, reduce side effects, and combine multiple treatment methods. Therefore, the treatment prospects of PCs are very broad. Currently, drug delivery systems widely applied in PCs primarily include nanodrug delivery systems, tumor microenvironment-targeted drug delivery system, immunotherapy drug delivery system, gene therapy drug delivery system, and combination therapy drug delivery system that synergize multiple therapeutic modalities. Emerging drug delivery systems (DDSs) have revolutionized PCs treatment by addressing these challenges through multiple mechanisms. Nanoformulations improve drug solubility, prolong circulation time, and reduce systemic toxicity via passive/active targeting. Smart DDSs responsive to PCs-specific stimuli enable extracellular matrix degradation, tumor-associated fibroblasts reprogramming, and vascular normalization to enhance drug accessibility. Last but not least, carrier systems loaded with myeloid-derived suppressor cell inhibitors or T cell activators can reverse immunosuppression and potentiate immunotherapy efficacy. Advanced platforms co-deliver chemotherapeutics with immunomodulators, gene-editing tools, or sonodynamic agents to achieve synergistic antitumor effects. These platforms aim to address critical challenges in PCs treatment, such as enhancing drug bioavailability, overcoming stromal barriers, reprogramming immunosuppressive niches, and achieving multi-mechanistic antitumor effects. This article provides a systematic summary and prospective analysis of the current development status, latest cutting-edge advances, opportunities, and challenges of the above-mentioned drug delivery systems in the field of PCs therapy.

AIM To investigate the effects of Changpu Yujin Decoction(CPYJD)on striatal mitophagy and PINK1/Parkin signaling pathway in a rat model of Tourette syndrome(TS).METHODS Thirty-six SPF male SD rats were randomly assigned to the control group(n=9)and the TS modeling group(n=27).Rats in the modeling group received daily intraperitoneal injections of 3,3'-iminodipropionitrile(IDPN)(300 mg/kg)for 7 consecutive days to establish the TS model.Post-modeling,successfully induced TS rats were re-randomized into model group(no treatment),tiapride group(47.91 mg/kg)and CPYJD group(77.28 g/kg).All groups received their respective interventions via intragastric administration daily for 28 days.Following drug administration,behavioral scores were assessed in each group.Pathological alterations in the striatum were examined using HE staining,while ultrastructural changes were evaluated by transmission electron microscopy(TEM).Neuronal apoptosis was quantified via TUNEL staining,and ROS levels in striatum were measured by ELISA.Co-localization of PINK1 and LC3B was assessed using immunofluorescence(IF).Finally,mRNA and protein expressions of PINK1,Parkin,Beclin-1,P62 and LC3B(LC3B-Ⅱ/Ⅰ ratio)were analyzed by RT-qPCR and Western blot.RESULTS Compared to the control group,the model group demonstrated significantly increased behavioral scores(P＜0.01),elevated neuronal apoptosis rate and higher ROS levels in the striatum(P＜0.01);severe neuronal and mitochondrial damage in the striatum;significantly reduced mRNA and protein expressions of PINK1,Parkin,Beclin-1 and LC3B(LC3B-Ⅱ/Ⅰ ratio)in the striatum(P＜0.01);markedly upregulated P62 mRNA and protein expressions(P＜0.01).Compared to the model group,both the tiapride and CPYJD intervention groups exhibited significantly reduced behavioral scores(P＜0.01);decreased neuronal apoptosis rate and lower ROS levels(P＜0.01);improved pathological alterations in the striatal neurons and mitochondria;increased mRNA and protein expressions of PINK1,Parkin and Beclin-1 in the striatum(P＜0.05,P＜0.01);and decreased P62 mRNA and protein expressions(P＜0.01).Furthermore,the rats in the CPYJD group specifically showed elevated LC3B mRNA level and LC3B-Ⅱ/Ⅰ protein ratio in striatum(P＜0.05,P＜0.01).CONCLUSION The effect of CPYJD intervention in TS rats may involve activation of mitophagy through regulation of the PINK1/Parkin signaling pathway,improving mitochondrial function,reducing ROS levels,and thereby protecting neurons.

Hemorrhagic shock is a common clinical emergency that can aggravate cell injury after resuscitation. Astrocytes are crucial for the survival of neurons because they regulate the surrounding ionic microenvironment of neurons. Although hemorrhagic shock and resuscitation (HSR) injury can impair cognition, it remains unclear how this insult directly affects astrocytes. In this study, we established an HSR model by bleeding and re-transfusion in mice. The social interaction test and new object recognition test were applied to evaluate post-operative cognitive changes, and the results suggest that mice experience cognitive impairment following exposure to HSR. In the HSR group, the power spectral density of β and γ oscillations decreased, and the coupling of the θ oscillation phase and γ oscillation amplitude was abnormal, which indicated abnormal neuronal oscillation and cognitive impairment after HSR exposure. In brief, cognitive impairment in mice is strongly correlated with Ca²⁺ signal strength in lateral septum astrocytes following HSR.
Animals ; Astrocytes/metabolism* ; Shock, Hemorrhagic/metabolism* ; Resuscitation/adverse effects* ; Male ; Mice ; Calcium Signaling/physiology* ; Mice, Inbred C57BL ; Septal Nuclei/metabolism* ; Cognitive Dysfunction/etiology* ; Disease Models, Animal ; Cognition Disorders/etiology*