Objective:To investigate the influencing mechanisms and driving pathways of chronic disease management efficiency for older adults under community-and home-based integrated health and social care.Methods:Guided by the Framework for Countries to Achieve an Integrated Continuum of Long-term Care and the Integrated Care for Older People framework,35 cities/counties/districts from eastern,central,and western China were selected.Data envelopment analysis(DEA)was employed to evaluate comprehensive efficiency,complemented by fuzzy-set qualitative comparative analysis(fsQCA)to identify conditional configurations of high-and low-efficiency pathways.Results:DEA identified six of the 35 regions(17.1%)as DEA-efficient(θ=1,S-/S+=0).fsQCA identified three high-efficiency pathways and four low-efficiency pathways.Governance mechanisms emerged as the core condition across all high-efficiency pathways.Low-efficiency pathways exhibited systemic deficiencies,including governance gaps,fragmented financing,and inadequate health information systems.Conclusion:Under integrated long-term care,governance systems form the cornerstone for enhancing chronic disease management efficacy.Cross-sectoral collaboration is critical to institutional integration,while dynamic resource allocation can mitigate technical limitations.Sustainable financing and interoperable health information systems are pivotal to addressing regional disparities.

AIM To evaluate the quality of Croci Stigma from different producing areas.METHODS The analysis was performed on a 25 ℃ thermostatic Waters Acquity UPLC HSS T3 column(2.1 mm× 100 mm,1.8μm),with the mobile phase comprising of 0.1％phosphoric acid-acetonitrile flowing at 0.35 mL/min in a gradient elution manner,and the detection wavelengths were set at 254,440 nm.The UPLC fingerprints were established,after which orthogonal partial least squares discriminant analysis was performed,picrocrocin,crocin-Ⅰ,crocin-Ⅱ,crocin-Ⅲ,crocin-Ⅳ contents and chromaticity values(L*,a*,b*,E*ab)were determined,Pearson correlation analysis was adopted in the investigation of correlations between chromaticity values and internal constituent contents.RESULTS There were 14 common peaks in the fingerprints for 22 batches of medicinal materials with the similarities of more than 0.98.Various batches of medicinal materials were clustered into 2 types,7 quality difference components were screened.crocin-Ⅰ content in medicinal materials from different producing areas demonstrated significant differences(P＜0.05);the redder the color of medicinal material,the higher the contents of crocins.Picrocrocin,crocin-Ⅰ,crocin-Ⅱ,crocin-Ⅳ contents displayed highly significant correlations with colorimetric values(P＜0.01),while crocin-Ⅲ content exhibited no significant correlation with the latter(P＞0.05).CONCLUSION This accurate and reliable method can provide references for the quality control and color-quality relationship elucidation of Croci Stigma.

OBJECTIVE To explore the effect of Astragali Radix-Curcuma Zedoaria-Paridis Rhizoma(Qi-Zhu-Zao)combina-tion on inhibiting the growth and metastasis of colon cancer based on the PINK1/Parkin/EMT signaling pathway.METHODS Thirty male BALB/c mice were randomly assigned to five groups:sham operation group,model group,positive control group,high-dose Qi-Zhu-Zao group(5.85 g·kg-1),and low-dose Qi-Zhu-Zao group(2.925 g·kg-1),with six mice in each group.An orthotopic colon cancer model was established in the mice using CT26.WT cells.After 15 days of treatment,tumor and liver tissues were collected from each group.Hematoxylin and eosin(HE)staining was performed to assess tumor metastasis,and transmission electron microscopy was used to observe mitochondrial autophagy in tumor tissues.The expression of mitochondrial autophagy-related proteins PINK1,Parkin,p62,and LC3-Ⅱ/LC3-Ⅰ was analyzed using Western blot and immunohistochemistry(IHC).Additionally,the expression levels of epithelial-mesenchymal transition(EMT)-related proteins and mRNA,including E-cadherin,N-cadherin,Vimentin,and Snail,were detected using Western blot,qPCR,and IHC staining.RESULTS Compared to the model group,mice in the treatment groups exhibited significantly reduced tumor volumes and fewer metastatic foci.Additionally,liver tissues showed pathological changes,and the overall growth condition of the mice was markedly improved;the tumor tissues in the treatment groups displayed selective mitochon-drial autophagy,accompanied by the formation of autophagosomes.The treatment influenced the PINK1/Parkin pathway-mediated mi-tochondrial autophagy biological process,with PINK1,Parkin,p62,and LC3-Ⅱ/LC3-Ⅰ levels being significantly upregulated(P<0.05,P<0.01),the high-dose group exhibited a more significant impact than the low-dose group(P<0.05,P<0.01).Furthermore,the treatment groups also showed significant reductions in the protein and mRNA levels of N-cadherin,Vimentin,and Snail(P<0.05,P<0.01),along with significant increases in the protein and mRNA levels of E-cadherin(P<0.05,P<0.01),these effects were more pronounced in the high-dose group compared to the low-dose group(P<0.05,P<0.01).CONCLUSION The herbal combination of Qi-Zhu-Zao inhibits tumor growth and metastasis to a certain extent in a mouse model of orthotopic transplantation of colon cancer.The underlying mechanism may involve the restoration of mitochondrial function through the PINK1/Parkin signaling pathway and the inhibition of the epithelial-mesenchymal transition(EMT)process,thereby achieving a therapeutic effect on colon cancer.

Objective:To investigate the influencing mechanisms and driving pathways of chronic disease management efficiency for older adults under community-and home-based integrated health and social care.Methods:Guided by the Framework for Countries to Achieve an Integrated Continuum of Long-term Care and the Integrated Care for Older People framework,35 cities/counties/districts from eastern,central,and western China were selected.Data envelopment analysis(DEA)was employed to evaluate comprehensive efficiency,complemented by fuzzy-set qualitative comparative analysis(fsQCA)to identify conditional configurations of high-and low-efficiency pathways.Results:DEA identified six of the 35 regions(17.1%)as DEA-efficient(θ=1,S-/S+=0).fsQCA identified three high-efficiency pathways and four low-efficiency pathways.Governance mechanisms emerged as the core condition across all high-efficiency pathways.Low-efficiency pathways exhibited systemic deficiencies,including governance gaps,fragmented financing,and inadequate health information systems.Conclusion:Under integrated long-term care,governance systems form the cornerstone for enhancing chronic disease management efficacy.Cross-sectoral collaboration is critical to institutional integration,while dynamic resource allocation can mitigate technical limitations.Sustainable financing and interoperable health information systems are pivotal to addressing regional disparities.

Objective To explore the relationship between dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)and clinical pathological features of invasive breast cancer and lymphovascular invasion(LVI).Methods Imaging and clinical pathological data were retrospectively collected from 508 patients with invasive breast cancer who underwent breast DCE-MRI at the First Medical Center of Chinese PLA General Hospital from January 2019 to August 2021.Patients were divided into the LVI-positive(LVI+)group(n=79)and LVI-negative(LVI-)group(n=429)based on postoperative pathological results.Univariate and multivariate logistic regression analyses were used to identify risk factors for LVI.Results Compared with LVI-group,LVI+group had a higher proportion of patients aged<45 years(44.3%vs.27.0%,P=0.002),non-mass-like enhancement(NME)(31.7%vs.17.7%,P=0.004),Ki-67 expression rate(40.0%vs.30.0%,P<0.001),high Ki-67 expression(94.9%vs.78.1%,P=0.001),Luminal B subtype(76.0%vs.60.1%,P=0.008),and positive axillary lymph nodes rate(72.2%vs.31.5%,P<0.001),while the proportion of Luminal A subtype was lower(2.5%vs.21.5%,P<0.001).Univariate and multivariate logistic regression analyses showed that age≥45 years(OR=0.468,95%CI 0.280-0.783,P=0.004)was an independent protective factor for LVI,while NME(OR=1.987,95%CI 1.126-3.444,P=0.016)was an independent risk factor.Compared with Luminal A subtype,patients with Luminal B subtype(OR=10.482,95%CI 3.164-64.923,P=0.001),HER-2 overexpression subtype(OR=11.571,95%CI 2.755-79.341,P=0.003)and triple-negative subtypes(OR=8.433,95%CI 1.985-57.908,P=0.009)had a higher risk of LVI.Conclusions Age≥45 years is an independent protective factor for LVI,while NME is an independent risk factor.Among molecular subtypes,patients with Luminal B,HER-2 overexpression and triple-negative subtypes have a higher risk of LVI compared with the Luminal A subtype.

Objective To propose a ventilator failure probability prediction method based on kernel ridge regression(KRR).Methods Firstly,the failure interval data of ventilators was collected and preprocessed to remove outliers.Secondly,the median rank method was used to estimate the failure probability.Finally,using the time data as the feature variable and the failure probability value as the target variable,a KRR model was established and trained by selecting the optimal kernel function and hyperparameter combination from radial basis kernel function,linear kernel function,polynomial kernel function,and S-type kernel function through grid search and cross-validation methods to predict ventilator failures.To verify the performance of the KRR model in predicting ventilator failure probability,it was compared with Weibull and its extended models.Results KRR achieved a coefficient of determination of 0.993 5,a mean squared error of 5.399 5×10-4,a root mean squared error of 0.023 2 and a mean absolute error of 0.018 3,outperforming Weibull and its extended models in prediction accuracy and error control.Conclusion The failure probability prediction method for ventilators based on KRR demonstrates exceptional performance in prediction accuracy and error control,and thus holds great potential for application.[Chinese Medical Equipment Journal,2025,46(5):73-77]

OBJECTIVE To explore the effect of Astragali Radix-Curcuma Zedoaria-Paridis Rhizoma(Qi-Zhu-Zao)combina-tion on inhibiting the growth and metastasis of colon cancer based on the PINK1/Parkin/EMT signaling pathway.METHODS Thirty male BALB/c mice were randomly assigned to five groups:sham operation group,model group,positive control group,high-dose Qi-Zhu-Zao group(5.85 g·kg-1),and low-dose Qi-Zhu-Zao group(2.925 g·kg-1),with six mice in each group.An orthotopic colon cancer model was established in the mice using CT26.WT cells.After 15 days of treatment,tumor and liver tissues were collected from each group.Hematoxylin and eosin(HE)staining was performed to assess tumor metastasis,and transmission electron microscopy was used to observe mitochondrial autophagy in tumor tissues.The expression of mitochondrial autophagy-related proteins PINK1,Parkin,p62,and LC3-Ⅱ/LC3-Ⅰ was analyzed using Western blot and immunohistochemistry(IHC).Additionally,the expression levels of epithelial-mesenchymal transition(EMT)-related proteins and mRNA,including E-cadherin,N-cadherin,Vimentin,and Snail,were detected using Western blot,qPCR,and IHC staining.RESULTS Compared to the model group,mice in the treatment groups exhibited significantly reduced tumor volumes and fewer metastatic foci.Additionally,liver tissues showed pathological changes,and the overall growth condition of the mice was markedly improved;the tumor tissues in the treatment groups displayed selective mitochon-drial autophagy,accompanied by the formation of autophagosomes.The treatment influenced the PINK1/Parkin pathway-mediated mi-tochondrial autophagy biological process,with PINK1,Parkin,p62,and LC3-Ⅱ/LC3-Ⅰ levels being significantly upregulated(P<0.05,P<0.01),the high-dose group exhibited a more significant impact than the low-dose group(P<0.05,P<0.01).Furthermore,the treatment groups also showed significant reductions in the protein and mRNA levels of N-cadherin,Vimentin,and Snail(P<0.05,P<0.01),along with significant increases in the protein and mRNA levels of E-cadherin(P<0.05,P<0.01),these effects were more pronounced in the high-dose group compared to the low-dose group(P<0.05,P<0.01).CONCLUSION The herbal combination of Qi-Zhu-Zao inhibits tumor growth and metastasis to a certain extent in a mouse model of orthotopic transplantation of colon cancer.The underlying mechanism may involve the restoration of mitochondrial function through the PINK1/Parkin signaling pathway and the inhibition of the epithelial-mesenchymal transition(EMT)process,thereby achieving a therapeutic effect on colon cancer.

This study was aimed at identifying the pathogenic bacteria responsible for the death of a young tiger at the Fujian Meihua Mountain South China Tiger Breeding Research Institute.Tissue samples from the lungs,liver,and intestines of the deceased tiger were collected,and the bacteria were cultured inasterile environment.The bacterial strains were characterized according to their morphological and molecular biological properties,including assessment of virulence genes and antibiotic resistance genes,mouse lethality tests,and antibiotic susceptibility evaluations.A predominant bacterial strain isolated from the liver of the deceased tiger was identified as enterotoxigenic Escherichia coli(ETEC)strain Tiger22513F.Phylogenetic analysis of the 16S rRNA gene revealed that the Tiger22513F strain exhibited close genetic similarity to the reference strain ETEC(MF919609.1),with 99.9%nucleotide similarity,and resided on the same evolutionary branch.The Tiger22513F strain contained 11 antibiotic resistance genes(tetA,sul1,sul3,cmlA,floR,blaTEM,blaSHV,blaCMY-2,qnrA,qnrS,and qnrD)along with five virulence genes(VT1,fyuA,tsh,iucD,and ST).Mouse lethality tests indicated significant pathogenicity toward mice,affecting primarily the lungs,liver,and intestines.Antibiotic susceptibility testing demonstrated that this strain exhibited resistance to various classes of beta-lactam antibiotics,as well as quinolones and aminoglycosides.This investigation successfully isolated a multi-drug resistant enterotoxigenic Escherichia coli strain with pronounced pathogenicity from the liver of a deceased tiger;thus providing valuable scientific insights for clinical diagnosis,as well as prevention and control measures,against ETEC infections in South China tigers.

Background: s/Aims: Sarcomatoid hepatocellular carcinoma (HCC) is a rare histological subtype of HCC characterized by extremely poor prognosis; however, its molecular characterization has not been elucidated. Methods: In this study, we conducted an integrated multiomics study of whole-exome sequencing, RNA-seq, spatial transcriptome, and immunohistochemical analyses of 28 paired sarcomatoid tumor components and conventional HCC components from 10 patients with sarcomatoid HCC, in order to identify frequently altered genes, infer the tumor subclonal architectures, track the genomic evolution, and delineate the transcriptional characteristics of sarcomatoid HCCs. Results: Our results showed that the sarcomatoid HCCs had poor prognosis. The sarcomatoid tumor components and the conventional HCC components were derived from common ancestors, mostly accessing similar mutational processes. Clonal phylogenies demonstrated branched tumor evolution during sarcomatoid HCC development and progression. TP53 mutation commonly occurred at tumor initiation, whereas ARID2 mutation often occurred later. Transcriptome analyses revealed the epithelial–mesenchymal transition (EMT) and hypoxic phenotype in sarcomatoid tumor components, which were confirmed by immunohistochemical staining. Moreover, we identified ARID2 mutations in 70% (7/10) of patients with sarcomatoid HCC but only 1–5% of patients with non-sarcomatoid HCC. Biofunctional investigations revealed that inactivating mutation of ARID2 contributes to HCC growth and metastasis and induces EMT in a hypoxic microenvironment. Conclusions We offer a comprehensive description of the molecular basis for sarcomatoid HCC, and identify genomic alteration (ARID2 mutation) together with the tumor microenvironment (hypoxic microenvironment), that may contribute to the formation of the sarcomatoid tumor component through EMT, leading to sarcomatoid HCC development and progression.

The aim of this study was to investigate the contribution of lung zinc ions to pathogenesis of lung ischemia/reperfusion (I/R) injury in rats. Male Sprague Dawley (SD) rats were randomly divided into control group, lung I/R group (I/R group), lung I/R + low-dose zinc chloride group (LZnCl₂+I/R group), lung I/R + high-dose ZnCl₂ group (HZnCl₂+I/R group), lung I/R + medium-dose ZnCl₂ group (MZnCl₂+I/R group) and TPEN+MZnCl₂+I/R group (n = 8 in each group). Inductively coupled plasma mass spectrometry (ICP-MS) was used to measure the concentration of zinc ions in lung tissue. The degree of lung tissue injury was analyzed by observing HE staining, alveolar damage index, lung wet/dry weight ratio and lung tissue gross changes. TUNEL staining was used to detect cellular apoptosis in lung tissue. Western blot and RT-qPCR were used to determine the protein expression levels of caspase-3 and ZIP8, as well as the mRNA expression levels of zinc transporters (ZIP, ZNT) in lung tissue. The mitochondrial membrane potential (MMP) of lung tissue was detected by JC-1 MMP detection kit. The results showed that, compared with the control group, the lung tissue damage, lung wet/dry weight ratio and alveolar damage index were significantly increased in the I/R group. And in the lung tissue, the concentration of Zn²⁺ was markedly decreased, while the cleaved caspase-3/caspase-3 ratio and apoptotic levels were significantly increased. The expression levels of ZIP8 mRNA and protein were down-regulated significantly, while the mRNA expression of other zinc transporters remained unchanged. There was also a significant decrease in MMP. Compared with the I/R group, both MZnCl₂+I/R group and HZnCl₂+I/R group exhibited significantly reduced lung tissue injury, lung wet/dry weight ratio and alveolar damage index, increased Zn²⁺ concentration, decreased ratio of cleaved caspase-3/caspase-3 and apoptosis, and up-regulated expression levels of ZIP8 mRNA and protein. In addition, the MMP was significantly increased in the lung tissue. Zn²⁺ chelating agent TPEN reversed the above-mentioned protective effects of medium-dose ZnCl₂ on the lung tissue in the I/R group. The aforementioned results suggest that exogenous administration of ZnCl₂ can improve lung I/R injury in rats.
Animals ; Reperfusion Injury/pathology* ; Male ; Rats, Sprague-Dawley ; Rats ; Chlorides/administration & dosage* ; Lung/pathology* ; Zinc Compounds/administration & dosage* ; Apoptosis/drug effects* ; Caspase 3/metabolism* ; Cation Transport Proteins/metabolism*