ObjectiveThis study aimed to elucidate the mechanistic role of Staphylococcus aureus in the pathogenesis of atopic dermatitis (AD), a chronic inflammatory skin disorder characterized by pruritus and barrier dysfunction. A key focus was screening traditional Chinese medicine (TCM) active components with dual antibacterial and antipruritic efficacy, followed by systematic evaluation of their in vitro antibacterial activity. Additionally, a novel drug delivery system was constructed to enable localized efficient drug delivery, inhibiting S. aureus proliferation and alleviating its induced pruritus, thereby providing new strategies for targeted AD therapy. MethodsMale C57BL/6J mice aged 6-8 weeks (body weight 18-22 g) were used to establish an AD model via repeated oxazolone sensitization. On day 14, microbial samples were collected from the lesional area (1 cm²) using sterile cotton swabs, followed by vortex mixing, serial dilution, and plating on 5% sheep blood agar plates (incubated at 37°C for 24 h). Single colonies with complete transparent β-hemolytic zones were isolated and identified as vancomycin-intermediate S. aureus (VISA) via 16S rRNA sequencing. An S. aureus mono-infection animal model was then established by applying gauze saturated with bacterial suspension (McFarland turbidity 0.1) to the nape and back skin of mice. The pruritic phenotype and inflammatory cell infiltration induced by S. aureus were evaluated using comprehensive approaches including behavioral assays (e.g., scratching frequency recording), hematoxylin-eosin (HE) staining, and toluidine blue staining. The in vitro antibacterial efficacy of the TCM monomer pseudolaric acid B (PAB) and double network hydrogel (DN) was separately assessed by disk diffusion assay, while the minimum inhibitory concentration (MIC) of PAB was determined via broth dilution method. Further validation of the pharmacodynamic characteristics of the composite system (PAB@DN, composed of PAB and DN) was conducted through behavioral assays, HE staining, and dermatitis scoring, with its drug release profile evaluated by mass spectrometry analysis. Based on scratching behavioral analysis and dermatitis scoring, the optimal ratio and concentration of PAB@DN were optimized. ResultsThe S. aureus load in AD lesional tissues was significantly higher than in normal skin ((5.3±0.33)×10⁶ CFU vs. (3.6±0.26)×10⁷ CFU, P<0.001). In the S. aureus mono-infection group, mice exhibited a 6.7-fold increase in scratching frequency compared to the control group. HE staining revealed marked epidermal thickening ((10.4±2.39) μm vs. (85.6±1.95) μm, P<0.000 1), and toluidine blue staining showed a 23-fold increase in mast cell degranulation. Pseudolaric acid B exhibited a significant concentration-dependent inhibitory effect onS. aureus growth, with its in vitro antibacterial effect being 57% that of the antibiotic cefepime (inhibition zone diameter: PAB (1.885±0.036) cm vs. cefepime (3.636±0.005) cm, P<0.000 1) and a minimum inhibitory concentration (MIC) of 1 g/L. The carrier double network hydrogel (DN) itself lacked direct antibacterial activity (no significant difference in inhibition zone diameter compared to the control) but effectively ameliorated the dry symptoms of AD-like lesions. The PAB@DN composite system demonstrated a synergistic effect compared to individual components, resulting in a 50% reduction in scratching behavior, an 86% decrease in dermatitis score, and a 60% reduction in epidermal thickening. It also reduced the S. aureus load in mouse skin by approximately 34%, with the optimal effective formulation being PAB at 1 g/L loaded onto DN. ConclusionS. aureus colonization plays a critical driving role in the onset and progression of AD. Using an S. aureus infection model, this study confirmed that the pseudolaric acidB-hydrogel composite delivery system (PAB@DN) can effectively alleviate S. aureus-induced pruritus and skin damage, providing experimental evidence for microbiota-targeted therapy of AD.

Objective This study aims to evaluate the effectiveness of intelligent bed management model in integrating bed resources in a large comprehensive hospital.Methods Inpatient data from a tertiary hospital between January 2021 and De-cember 2024 were collected.An intelligent hospital-wide bed management platform was constructed to implement bed resource sharing mechanisms and establish a standardized bed reservation grading system.The implementation effect of the system was e-valuated from the perspective of bed occupancy rate,average length of stay,and patient satisfaction.Results After implementa-tion,bed occupancy rates in key monitored departments moved into a reasonable range:Rehabilitation Medicine Department fell from 113.18％to 101.48％(t=4.26,P＜0.01),while Neurology Department increased from 88.18％to 96.20％(t=3.85,P＜0.01).Annual inpatient admissions increased from 83,931 to 103,852(x2=156.82,P＜0.001),and average length of stay shortened from 7.15 days to 6.21 days(t=4.73,P＜0.01).The admission waiting time was cut by 72.7 hours(-43.1％),and satisfaction with bed allocation rationality improved by 11.2 points(t=5.94,P＜0.001).Staff time spent on bed-assignment fell by 42 minutes per shift(t=8.92,P＜0.001),and cross-department transfers increased by 378 episodes per month(x2=145.26,P＜0.001).Conclusion The intelligent bed management model can effectively improve hospital bed utili-zation efficiency,enhance healthcare service quality,reduce staff workload,and merits wider application in similar hospitals.

Aim To investigate the effects of edaravone(EDA)on depression-like behaviors in a rat model of post-stroke depression(PSD)and to explore the un-derlying mechanisms.Methods SD rats were ran-domly divided into:sham operation group(Sham),cerebral ischemia group(CI),post-stroke depression(PSD),fluoxetine(10 mg·kg-1)group,and EDA(5,15 mg·kg-1)group.A PSD rat model was estab-lished using the suture method combined with 56 d of chronic unpredictable mild stimulation.Drug treatment was given once daily for 28 d after stimulation.Body weight and sucrose water preference were measured during the stimulation period,and serum TNF-α,IL-1 β,IL-6,MDA,SOD levels,and hippocampal tissue HO-1 and GPX4 protein expression were detected at the end of stimulation.Results Compared with the sham group,the rat neurological function scores of the remaining groups increased(P＜0.01).Compared with the PSD group,EDA increased the body weight and sucrose water preference of the rats(P＜0.01),significantly decreased the serum TNF-α,IL-1β and IL-6 levels,decreased the MDA level,increased the SOD level(P＜0.01),and up-regulated hippocampal HO-1 and GPX4 protein expression(P＜0.01).Con-clusions EDA improves depression-like behaviors and inhibits peripheral inflammation and oxidative stress in-jury in PSD rats,and its mechanism may be related to the activation of HO-1/GPX4 pathway to inhibit oxida-tive stress.

Objective To investigate the value of ultrasound for differentiating pancreatoblastoma(PB)and solid pseudopapillary tumor of pancreas(SPT)in children.Methods Data of 7 children with PB(PB group)and 22 with SPT(SPT group)were retrospectively analyzed.The clinical data and lesion's ultrasonic manifestations were compared between groups.Receiver operating characteristic(ROC)curves of clinical and ultrasound related parameters being significantly different between groups showed by univariate analysis were draw,and the area under the curve(AUC)were calculated to evaluate their efficacy for differentiating PB and SPT.Ultrasound parameters with P＜0.05 in univariate analysis were incorporated into binary logistic analysis,and a ultrasound regression model was constructed to distinguish PB and SPT,and its diagnostic efficacy was evaluated.Results Significant differences of children'age,gender,serum alpha fetoprotein level,and the shape,maximum diameter,texture,calcification and local invasion of lesions were found between groups(all P＜0.05).AUC of single serum alpha fetoprotein level,the shape,maximum diameter,texture,calcification and local invasion of lesion for differentiating PB and SPT was 1.000,0.766,0.854,0.776,0.789 and 0.714,respectively(all P＜0.05).The shape(OR=8.704,P=0.075)and maximum diameter of lesions(OR=1.695,P=0.042)showed with ultrasound were both important differentiating factors for PB and SPT,and AUC of the ultrasound regression model constructed based on them was 0.886.Conclusion Ultrasound could effectively differentiate PB and SPT in children.

Aim To explore the possible regulatory effect of leptin on acyl-CoA synthetase long chain fami-ly member ACSL5 and their effect on migration and in-vasion of breast cancer cell,and to explore the underly-ing mechanism.Methods The expression of leptin receptor was detected by immunofluorescence assay.The migration and invasion ability of MCF-7 cells were detected by wound healing assay and Transwell assay respectively.The downstream target gene of leptin was analyzed by PCR microarray data.The expression of ACSL5 in breast cancer and its correlation with the staging and prognosis of breast cancer patients were as-sessed uing bioinformatics methods.The expression of ACSL5 in MCF-7 cells treated with different concentra-tions of leptin was detected using real time fluorescence quantitative polymerase chain reaction(RT-qPCR).Overexpressing ACSL5 was constructed by lentiviral transfection;the expressions of EMT related proteins,AMPK-α and p-AMPK-α were detected by Western blot.Results Leptin promoted breast cancer cell mi-gration and invasion and EMT.ACSL5 was significant-ly low expressed in breast cancer and related to progno-sis.Leptin downregulated the expression of ACSL5 through OBR.Leptin activated AMPK pathway to downregulate ACSL5 and promote migration,invasion and EMT of breast cancer cells.Conclusions Leptin may promote the migration,invasion and EMT of breast cancer by downregulating ACSL5 through activating AMPK pathway.

Aim To investigate the effects of edaravone(EDA)on depression-like behaviors in a rat model of post-stroke depression(PSD)and to explore the un-derlying mechanisms.Methods SD rats were ran-domly divided into:sham operation group(Sham),cerebral ischemia group(CI),post-stroke depression(PSD),fluoxetine(10 mg·kg-1)group,and EDA(5,15 mg·kg-1)group.A PSD rat model was estab-lished using the suture method combined with 56 d of chronic unpredictable mild stimulation.Drug treatment was given once daily for 28 d after stimulation.Body weight and sucrose water preference were measured during the stimulation period,and serum TNF-α,IL-1 β,IL-6,MDA,SOD levels,and hippocampal tissue HO-1 and GPX4 protein expression were detected at the end of stimulation.Results Compared with the sham group,the rat neurological function scores of the remaining groups increased(P＜0.01).Compared with the PSD group,EDA increased the body weight and sucrose water preference of the rats(P＜0.01),significantly decreased the serum TNF-α,IL-1β and IL-6 levels,decreased the MDA level,increased the SOD level(P＜0.01),and up-regulated hippocampal HO-1 and GPX4 protein expression(P＜0.01).Con-clusions EDA improves depression-like behaviors and inhibits peripheral inflammation and oxidative stress in-jury in PSD rats,and its mechanism may be related to the activation of HO-1/GPX4 pathway to inhibit oxida-tive stress.

Objective To understand the current status of work-related musculoskeletal disorders (WMSDs) among operating room doctors,thereby analyzing its effect on mental health. Methods A total of 1013 doctors in the operating rooms of 30 hospitals in 24 provinces from September to December 2022 were selected by cross-sectional survey method. The domestic musculoskeletal disease questionnaire was used to investigate the occurrence of WMSDs in operating room doctors,the symptom check list-90 (SCL-90) was used to evaluate the psychological status of operating room doctors,the relationship between WMSDs related items and SCL-90 scores was analyzed,the correla-tion between the rest time of each shift and SCL-90 factors was analyzed by Pearson method,and the influencing factors of mental health of operating room doctors were analyzed by multivariate Logistic regression.Results A total of 1100 questionnaires were distributed and 1013 valid questionnaires were recovered,with an effective rate of 92.10％. The incidence of WMSDs among operating room doctors in the past 1 year was 95.06％. The body parts with incidences of WMSDs from high to low were as follows:waist (36.92％),neck (35.54％),shoulder (33.56％),and upper back (32.77％). In the past 1 year,the SCL-90 scores and total scores of patients with musculoskeletal pain in various body parts,keeping the same back posture for a long time while work,bending the back at the same time of turning frequently while working,bowing the head for a long time while working,and bending the knee for a long time while working were significantly higher than those who were without the above conditions (P<0.05). Shorter rest time of each shift and longer periods of keeping the same back posture were the risk factors for the development of mental illness in operating room doctors. Conclusion The incidence of WMSDs in operating room doctors is high,which can influence the mental health of operating room doctors. Therefore,operating room doctors should avoid keeping the same back posture for a long time,bending the back at the same time of turning frequently,bowing the head for a long time,and bending the knee for a long time while working,and increase the rest time of each shift,in order to improve the mental condition of the operating room doctors.

Objective This study aims to evaluate the effectiveness of intelligent bed management model in integrating bed resources in a large comprehensive hospital.Methods Inpatient data from a tertiary hospital between January 2021 and De-cember 2024 were collected.An intelligent hospital-wide bed management platform was constructed to implement bed resource sharing mechanisms and establish a standardized bed reservation grading system.The implementation effect of the system was e-valuated from the perspective of bed occupancy rate,average length of stay,and patient satisfaction.Results After implementa-tion,bed occupancy rates in key monitored departments moved into a reasonable range:Rehabilitation Medicine Department fell from 113.18％to 101.48％(t=4.26,P＜0.01),while Neurology Department increased from 88.18％to 96.20％(t=3.85,P＜0.01).Annual inpatient admissions increased from 83,931 to 103,852(x2=156.82,P＜0.001),and average length of stay shortened from 7.15 days to 6.21 days(t=4.73,P＜0.01).The admission waiting time was cut by 72.7 hours(-43.1％),and satisfaction with bed allocation rationality improved by 11.2 points(t=5.94,P＜0.001).Staff time spent on bed-assignment fell by 42 minutes per shift(t=8.92,P＜0.001),and cross-department transfers increased by 378 episodes per month(x2=145.26,P＜0.001).Conclusion The intelligent bed management model can effectively improve hospital bed utili-zation efficiency,enhance healthcare service quality,reduce staff workload,and merits wider application in similar hospitals.

Objective To systematically retrieve,evaluate and summarise the best available evidence on prevention and management of diagnostic blood loss in critically ill adult patients and to provide guidance for standardising diagnostic blood sampling in clinical practice.Methods A structured evidence question was created using the PIPOST framework(Population,Intervention,Professional,Outcome,Setting and Type of evidence).Guided by the"5S"levels-of-evidence pyramid,a top-down systematic search was conducted on databases of BMJ Best Practice,UpToDate,the Joanna Briggs Institute(JBI)EBP Database,GIN,SIGN,RNAO,NICE,Medlive Guideline,WHO,National Blood Authority(Australia),National Health Commission of China,Cochrane Library,PubMed,EMbase,CINAHL,Web of Science,Wanfang Data,CNKI,VIP,and SinoMed.Searched literature included clinical decision aids,guidelines,evidence summaries,systematic reviews Meta analysis,RCTs,quasi-experimental,cross-sectional,cohort studies and expert consensus/opinions.Search period covered between 1st January 2015 and 10th February 2025.Quality appraisal,evidence extraction,synthesis and grading were performed according to JBI and GRADE approaches.Results Nineteen articles were retrieved including five guidelines,five systematic reviews,one RCT,two quasi-experimental studies,two cross-sectional studies,one professional standard and three expert consensuses.A total of 26 recommendations were extracted and they were organised into five domains:education and training,blood-sampling assessment,frequency of sampling,strategies to minimise blood volume drawn,and quality control.Conclusion This evidence summary provides the best current guidance for preventing and managing iatrogenic blood loss caused by diagnostic testing in critically ill adults,providing evidence-based basis for standardizing blood tests by medical staff.

Aim To explore the possible regulatory effect of leptin on acyl-CoA synthetase long chain fami-ly member ACSL5 and their effect on migration and in-vasion of breast cancer cell,and to explore the underly-ing mechanism.Methods The expression of leptin receptor was detected by immunofluorescence assay.The migration and invasion ability of MCF-7 cells were detected by wound healing assay and Transwell assay respectively.The downstream target gene of leptin was analyzed by PCR microarray data.The expression of ACSL5 in breast cancer and its correlation with the staging and prognosis of breast cancer patients were as-sessed uing bioinformatics methods.The expression of ACSL5 in MCF-7 cells treated with different concentra-tions of leptin was detected using real time fluorescence quantitative polymerase chain reaction(RT-qPCR).Overexpressing ACSL5 was constructed by lentiviral transfection;the expressions of EMT related proteins,AMPK-α and p-AMPK-α were detected by Western blot.Results Leptin promoted breast cancer cell mi-gration and invasion and EMT.ACSL5 was significant-ly low expressed in breast cancer and related to progno-sis.Leptin downregulated the expression of ACSL5 through OBR.Leptin activated AMPK pathway to downregulate ACSL5 and promote migration,invasion and EMT of breast cancer cells.Conclusions Leptin may promote the migration,invasion and EMT of breast cancer by downregulating ACSL5 through activating AMPK pathway.