Background/Aims: Liver transplantation (LT) following total hepatectomy is a life-saving treatment for hepatocellular carcinoma (HCC). The HCC recurrence after LT hinders the effectiveness of the procedure. The objective of this study is to develop a pre-operative risk stratification model based on a liquid biopsy. Methods: We conducted a comprehensive multi-omics study of 260 HCC patients from three centers, including clinical data, low-coverage whole-genome sequencing of cell-free DNA (cfDNA) from plasma, as well as whole-exome, single-nucleus RNA, and spatial transcriptomics from matched tumor and non-tumor tissues. Results: We identified cfDNA-derived copy number alteration (CNA) signatures associated with post-transplant recurrence. By integrating cfDNA-derived CNA profiles with single-cell transcriptomic data, we traced recurrence-associated cfDNA to a distinct subpopulation of malignant cells within the primary tumor. These cells were embedded in a pro-metastatic microenvironment of specialized endothelial subtypes and cancer-associated fibroblasts. Notably, most recurrence-associated lesions were detectable in cfDNA prior to liver transplantation (LT). Building on these insights, we developed the ZJU Criteria based on CNA fragments and tumor markers, a pre-LT risk prediction tool that integrates conventional clinical factors with cfDNA-derived CNA signatures, and validated it using internal and independent external cohorts. Conclusion Our findings suggest that post-transplant recurrence commonly originates from advanced subclones that emerge late during tumor evolution. The ZJU Criteria provides an accurate, non-invasive strategy that significantly improves pre-LT risk stratification and clinical decision-making for patients with HCC.

Objective To explore the efficacy and underlying mechanism of Astragalus in the treatment of viral pancreatitis using network pharmacology,with confirmation of its efficacy and mechanism in cell experiments.Methods Astragalus and viral pancreatitis targets obtained from the Traditional Chinese Medicine Systems Pharmacology(TCMSP)and GeneCards databases were combined to obtain intersection targets.GO functional enrichment and KEGG signaling pathway enrichment analyses of therapeutic targets were conducted using the Database for Annotation,Visualization,and Integrated Discovery(DAVID)database.The interactions between therapeutic targets were analyzed using the STRING database and Cytoscape 3.10.2,and the core therapeutic targets were screened.Molecular docking between the most effective therapeutic components and the core targets was performed using PyMOL 3.0 and AutoDock Tools 1.5.7.CVB3 was used to construct a viral pancreatitis cell model for verification of the core targets.Results Seventy-eight therapeutic targets were identified.Enrichment analyses revealed the possible involvement of pathways related to cancer,lipids and atherosclerosis,and PI3K-AKT signaling.AKT1,TP53,HIF1A,CASP3,IL-6,and MMP9 were identified as possible core targets.The result of cell experiments showed that the expression level of AMY was significantly increased in the model group(P＜0.05).The Astragalus injection group exhibited significantly decreased expression levels of AMY,AKT1,TP53,HIF1A,CASP3,IL-6,and MMP9 compared with the model group(P＜0.05).Conclusions Astragalus injection effectively treated viral pancreatitis,and its therapeutic mechanism may involve reduced expression levels of AKT1,TP53,HIF1A,CASP3,IL-6,and MMP9.

Objective Based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses(PRISMA)guidelines,to obtain precise and reliable comprehensive effect conclusions by quantitatively combining pharmacodynamic results from animal experiments investigating Astragali Radix(single-entity Astragali Radix preparation)or its ingredients for treatment of acute pancreatitis(AP)in literature reports through meta-analysis.Methods Databases including China National Knowledge Infrastructure(CNKI),VIP Database for Chinese Technical Periodicals(VIP),Wanfang Data Knowledge Service Platform,China Biomedical Literature Database(CBMdisc),PubMed,and Web of Science(WOS)were searched from inception to March 2025 for animal studies related to Astragali Radix(single-entity Astragali Radix preparation)or its ingredients for AP treatment.Risk of bias for included studies was assessed with SYRCLE tool.Heterogeneity among studies was evaluated according to Cochrane Handbook using Cochrane's Qtest and/2statistic.Sensitivity analysis was performed using the leave-one-out method,and publication bias risk was detected using Egger's test.Results A total of 297 articles were retrieved,and after screening and evaluation,19 animal studies were finally included for meta-analysis.These 19 publications cover SD rats,as well as three breeds of mice:C57BL/6 mice,BALB/c mice,and Kunming mice.SYRCLE scores ranged from 3 to 4.The results of the sensitivity analysis showed that no study significantly affected the heterogeneity index.The results of Egger's test showed a significant publication bias with P＜0.05.Cochrane's Qtest and I2statistic indicated substantial heterogeneity among studies.Meta-analysis results of 19 animal studies showed that single-entity Astragali Radix preparation(Astragali Radix injection)could reduce serum amylase(AMY)levels,an AP-specific indicator.The Astragali Radix ingredients could decrease both AMY and lipase(LPS)levels.Astragali Radix injection or its ingredients could reduce serum levels of tumor necrosis factor-α(TNF-α),interleukin(IL)-6,and IL-1 β,while increasing IL-10 levels;could increase serum levels of superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px),and decrease malondialdehyde(MDA)levels.High-dose groups of Astragali Radix injection or Astragali Radix ingredients were more effective than low-dose groups in reducing AMY,TNF-α,and IL-6 levels and increasing SOD levels,but dosage effect on MDA levels was not demonstrated.Conclusion Evidence-based analysis of animal experiment results shows that in various animal models including SD rats,C57BL/6 mice,BALB/c mice,and Kunming mice,Astragali Radix injection or its ingredients can effectively reduce expression or secretion levels of AP-specific indicators(AMY and LPS).The mechanisms may be related to some inflammatory mediators,including reducing TNF-α,IL-6,and IL-1 β levels and increasing IL-10 levels;They may also intervene in oxidative/antioxidative equilibrium,such as increasing SOD and GSH-Px levels and reducing MDA levels.Except for MDA,dose-response relationships are shown for reducing AMY,TNF-α,and IL-6 levels and increasing SOD levels with Astragali Radix injection or its ingredients.However,due to high heterogeneity,potential publication bias risk,and species differences between animal models and human diseases in existing studies,further high-quality clinical trials or animal experiments are still needed in the future.

Objective Based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses(PRISMA)guidelines,to obtain precise and reliable comprehensive effect conclusions by quantitatively combining pharmacodynamic results from animal experiments investigating Astragali Radix(single-entity Astragali Radix preparation)or its ingredients for treatment of acute pancreatitis(AP)in literature reports through meta-analysis.Methods Databases including China National Knowledge Infrastructure(CNKI),VIP Database for Chinese Technical Periodicals(VIP),Wanfang Data Knowledge Service Platform,China Biomedical Literature Database(CBMdisc),PubMed,and Web of Science(WOS)were searched from inception to March 2025 for animal studies related to Astragali Radix(single-entity Astragali Radix preparation)or its ingredients for AP treatment.Risk of bias for included studies was assessed with SYRCLE tool.Heterogeneity among studies was evaluated according to Cochrane Handbook using Cochrane's Qtest and/2statistic.Sensitivity analysis was performed using the leave-one-out method,and publication bias risk was detected using Egger's test.Results A total of 297 articles were retrieved,and after screening and evaluation,19 animal studies were finally included for meta-analysis.These 19 publications cover SD rats,as well as three breeds of mice:C57BL/6 mice,BALB/c mice,and Kunming mice.SYRCLE scores ranged from 3 to 4.The results of the sensitivity analysis showed that no study significantly affected the heterogeneity index.The results of Egger's test showed a significant publication bias with P＜0.05.Cochrane's Qtest and I2statistic indicated substantial heterogeneity among studies.Meta-analysis results of 19 animal studies showed that single-entity Astragali Radix preparation(Astragali Radix injection)could reduce serum amylase(AMY)levels,an AP-specific indicator.The Astragali Radix ingredients could decrease both AMY and lipase(LPS)levels.Astragali Radix injection or its ingredients could reduce serum levels of tumor necrosis factor-α(TNF-α),interleukin(IL)-6,and IL-1 β,while increasing IL-10 levels;could increase serum levels of superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px),and decrease malondialdehyde(MDA)levels.High-dose groups of Astragali Radix injection or Astragali Radix ingredients were more effective than low-dose groups in reducing AMY,TNF-α,and IL-6 levels and increasing SOD levels,but dosage effect on MDA levels was not demonstrated.Conclusion Evidence-based analysis of animal experiment results shows that in various animal models including SD rats,C57BL/6 mice,BALB/c mice,and Kunming mice,Astragali Radix injection or its ingredients can effectively reduce expression or secretion levels of AP-specific indicators(AMY and LPS).The mechanisms may be related to some inflammatory mediators,including reducing TNF-α,IL-6,and IL-1 β levels and increasing IL-10 levels;They may also intervene in oxidative/antioxidative equilibrium,such as increasing SOD and GSH-Px levels and reducing MDA levels.Except for MDA,dose-response relationships are shown for reducing AMY,TNF-α,and IL-6 levels and increasing SOD levels with Astragali Radix injection or its ingredients.However,due to high heterogeneity,potential publication bias risk,and species differences between animal models and human diseases in existing studies,further high-quality clinical trials or animal experiments are still needed in the future.

ObjectiveTo explore the changes in volatile components， total polysaccharides， enzyme activity， and chromaticity value of Myristicae Semen Koji（MSK） during the fermentation process， and conduct correlation analysis. MethodsBased on gas chromatography-mass spectrometry（GC-MS）， the changes of volatile components in MSK at different fermentation times were identified. The phenol sulfuric acid method， dinitrosalicylic acid method（DNS）， and carboxymethyl cellulose sodium salt method（CMC-Na） were used to investigate the total polysaccharide content， amylase activity， and cellulase activity during the fermentation process. Visual analysis technology was used to explore the changes in chromaticity values， revealing the fermentation process of MSK and the dynamic changes of various measurement indicators， partial least squares-discriminant analysis（PLS-DA） was used to explore the differential compounds of MSK at different fermentation degrees， and Pearson correlation analysis was used to explore the correlation between volatile components of MSK and total polysaccharides， enzyme activity， and chromaticity values. ResultsA total of 60 volatile compounds were identified from MSK， the relative contents of components such as （+）-α-pinene， β-phellandrene， β-pinene， （+）-limonene， and p-cymene obviously increased， while the relative contents of components such as safrole， methyl isoeugenol， methyleugenol， myristicin， and elemicin significantly decreased. During the fermentation process， the total polysaccharide content showed an upward trend， while the activities of amylase and cellulase showed an initial increase followed by a decrease， and reached their maximum value at 40 h. the overall brightness（L^*） and total color difference（ΔE^*） gradually increased， while the changes in red-green value（a^*） and yellow-blue value（b^*） were not obvious. PLS-DA results showed that MSK could be clearly distinguished at different fermentation times， and 13 differential biomarkers were screened out. Pearson correlation analysis results showed that the contents of α-terpinene， β-phellandrene， methyleugenol， β-cubebene and myristic acid had an obvious correlation with chromaticity values. ConclusionAfter fermentation， the volatile components， total polysaccharides， amylase activity， and cellulase activity of MSK undergo significant changes， and there is a clear correlation between them and chromaticity values， which reveals the dynamic changes in the fermentation process and related indicators of MSK， laying a foundation for the quality control.

Objective To explore the efficacy and underlying mechanism of Astragalus in the treatment of viral pancreatitis using network pharmacology,with confirmation of its efficacy and mechanism in cell experiments.Methods Astragalus and viral pancreatitis targets obtained from the Traditional Chinese Medicine Systems Pharmacology(TCMSP)and GeneCards databases were combined to obtain intersection targets.GO functional enrichment and KEGG signaling pathway enrichment analyses of therapeutic targets were conducted using the Database for Annotation,Visualization,and Integrated Discovery(DAVID)database.The interactions between therapeutic targets were analyzed using the STRING database and Cytoscape 3.10.2,and the core therapeutic targets were screened.Molecular docking between the most effective therapeutic components and the core targets was performed using PyMOL 3.0 and AutoDock Tools 1.5.7.CVB3 was used to construct a viral pancreatitis cell model for verification of the core targets.Results Seventy-eight therapeutic targets were identified.Enrichment analyses revealed the possible involvement of pathways related to cancer,lipids and atherosclerosis,and PI3K-AKT signaling.AKT1,TP53,HIF1A,CASP3,IL-6,and MMP9 were identified as possible core targets.The result of cell experiments showed that the expression level of AMY was significantly increased in the model group(P＜0.05).The Astragalus injection group exhibited significantly decreased expression levels of AMY,AKT1,TP53,HIF1A,CASP3,IL-6,and MMP9 compared with the model group(P＜0.05).Conclusions Astragalus injection effectively treated viral pancreatitis,and its therapeutic mechanism may involve reduced expression levels of AKT1,TP53,HIF1A,CASP3,IL-6,and MMP9.

Objective To investigate the occurrence of postoperative healthcare-associated infection(HAI)and its risk factors in neurosurgical patients undergoing removal of intracranial tumor,so as to provide theoretical basis for formulating intervention measures.Methods Prospective survey was adopted to monitor the occurrence of postoperative HAI in patients who admitted to the department of neurosurgery of a hospital and underwent selective removal of intracranial tumor between April 2013 and December 2014 ,risk factors for HAI were analyzed with univariate and multivariate logistic regression analysis.Results A total of 1 218 patients were surveyed,163 patents developed 193 times of postoperative HAI,inci-dence of postoperative HAI was 13.38%,case incidence of HAI was 15.85%.The main HAI site was intracranial site(n=125,64.77%),the next was lower respiratory tract (n=55,28.49%).Multivariate logistic regression analysis showed that operation grade and subtentorial operation were independent risk factors for postoperative HAI in neurosurgical patients undergoing removal of intracranial tumor,OR and 95%CI were 4.352(1.878-10.080)and 1.812(1.280-2.564)respec-tively.Conclusion Risk of postoperative HAI in neurosurgical patients undergoing high grade operation and subtentorial removal of intracranial tumor is high,effective prevention and control measures should be taken to prevent the occurrence of HAI.

Objective To study the influence of cochlear implantation on residual hearing in children .Methods Behavioral audiometry were performed pre -implant and 3~21 months post -implant on thirty -four cochlear implant recipients with severe to profound hearing loss .According to follow -up time ,they were divided into 2 groups which were Group A(3~12 months ,21 cases) and Group B(≥13 months ,13 cases) .The thresholds at 250 Hz ,500 Hz ,1 000 Hz and 2 000 Hz were analyzed .Results There were 25 out of 34 patients (73 .53% ) had partial residual hearing after cochlear implantation .Comparing to the hearing loss pre -operation and post -operation , which were most obvious at 500 Hz ,followed by 250 Hz ,1 000 Hz ,2 000 Hz (P<0 .05) ,and there were significant different among different frequencies .There was significant difference at different frequencies at hearing loss thresh-olds only in Group A .But there was no significant difference in Group B .With the prolonged time after the cochlear implantation ,residual hearing at all frequencies showed a trend of recovery .Conclusion The residual hearing could be partial preserved after cochlear implant in pediatric patients with severe to profound hearing impaired ,the residu-al hearing at lower frequencies (250 Hz ,500 Hz) were less affected than those at higher frequencies .With the pro-longed time after the cochlear implantation ,the residual hearing showed a certain degree of recovery .

OBJECTIVETo study the efficacy and safety of Naoxintong capsule treatment of stroke recovery with Qi-deficiency and blood-stasis syndrome (cerebral infarction), and to compared the non-inferiority analysis with the positive drug Tongxinluo capsule.

METHODTaking Tongxinluo capsules as control, randomized, double-blind, controlled, multi-center clinical experiments were studied. The evaluating indexes included the decrease of integral value of stroke patients, changes in traditional Chinese medicine, the improvement of the patient viability status (disability level), Chinese stroke scale (CSS), activities of daily living (DAL) scale and barthel index (BI ) points.

RESULTThe total effect of the two groups, Chinese and other symptoms, showed no significant statistical significance.

CONCLUSIONNaoxintong capsule stroke recovery, with Qi-deficiency and blood-stasis syndrome (cerebral infarction) has a therapeutic effect, and more secure.

Activities of Daily Living ; Adult ; Aged ; Capsules ; Double-Blind Method ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Qi ; Stroke ; drug therapy ; Treatment Outcome

OBJECTIVE The research aimed to investigate the incidence,clinical characteristics and risk factors of nosocomial infection in patients with mechanical ventilation in ICU,and explore the corresponding prevention procedures.METHODS Active surveillance was carried out by professional fulltime staff.The patients with mechanical ventilation in ICU above 48 hours were selected for the hospital infection surveillance,and the patients after tracheal intubation within 48 hours were also included.RESULTS The incidence of nosocomial infection was 54.28%,and the nosocomial infection were found in 69(65.71%) of the 105 cases.The major complication was mechanical ventilator-associated pneumonia(VAP).The risk factors were more than four times invasive operation and,tracheotomy(P