Sepsis is a systemic inflammatory response caused by severe infection or trauma, and is one of the common causes of acute lung injury(ALI) and acute respiratory distress syndrome(ARDS). Sepsis-acute lung injury(SALI) is a critical clinical condition with high morbidity and mortality. Its pathogenesis is complex and not yet fully understood, and there is currently a lack of targeted and effective treatment options. Pyroptosis, a novel form of programmed cell death, plays a key role in the pathological process of SALI by activating inflammasomes and releasing inflammatory factors, making it a potential therapeutic target. In recent years, the role of traditional Chinese medicine(TCM) in regulating signaling pathways related to pyroptosis through multi-components and multi-targets has attracted increasing attention. TCM may intervene in pyroptosis by inhibiting the activation of NLRP3 inflammasomes and regulating the expression of Caspase family proteins, thus alleviating inflammatory damage in lung tissues. This paper systematically reviews the molecular regulatory network of pyroptosis in SALI and explores the potential mechanisms and research progress on TCM intervention in cellular pyroptosis. The aim is to provide new ideas and theoretical support for basic research and clinical treatment strategies of TCM in SALI.
Pyroptosis/drug effects* ; Humans ; Sepsis/genetics* ; Acute Lung Injury/physiopathology* ; Animals ; Drugs, Chinese Herbal/therapeutic use* ; Medicine, Chinese Traditional ; Inflammasomes/metabolism* ; NLR Family, Pyrin Domain-Containing 3 Protein/genetics*

Objective To examine the toxicity and sublethal effects of calcium cyanamide against susceptible isolates of Aedes albopictus, so as to provide insights into rational use of calcium cyanamide for integrated management of Ae. albopictus. Methods The sublethal concentrations [30% lethal concentration (LC₃₀) and median lethal concentration (LC₅₀)] of calcium cyana mide against susceptible strains of Ae. albopictus were determined using the larval immersion test. With 100 mL of dechlorinated water as the control group, after the larvae of susceptible strains of Ae. albopictus were immersed in calcium cyanamide for 24 hours, the pupation rate, pupation duration, emergence rate, number of eggs laid, percentage of eggs hatched, and lifespan of Ae. albopictus were calculated and compared post-treatment with calcium cyanamide at different sublethal concentrations. The midgut tissues of larvae of susceptible strains of Ae. albopictus treated with 100 mg/L calcium cyanamide were sampled for pathological sectioning to observe midgut tissue damages. To evaluate the residual activity, 100 larvae of susceptible strains of Ae. albopictus were treated with 200 mg/L and 500 mg/L calcium cyanamide, and the mortality of larvae was calculated every 24 hour, with dead larvae replaced until no larval death. Results The regression equation for the toxicity of calcium cyanamide against larvae of susceptible strains of Ae. albopictus was y = -9.441 + 4.657x, with an LC₅₀ of 106.42 mg/L [95% confidence interval (CI): (94.64, 118.36) mg/L] and an LC₃₀ of 82.17 mg/L [95% CI: (94.64, 118.36) mg/L], respectively. After larvae of susceptible strains of Ae. albopictus were treated with sublethal concentrations (LC₃₀ and LC₅₀) of calcium cyanamide for 24 hours, there were reduced pupation and emergence rates of larvae (all P values < 0.000 1), prolonged pupal stage (both P values < 0.000 1), reduced numbers of eggs laid by survival female Ae. albopictus (both P values < 0.000 1), reduced percentages of eggs hatched by Ae. albopictus eggs (both P values < 0.000 1), and reduced median survival period of survival female Ae. albopictus (χ² = 9.36 and 20.33, both P values < 0.01) in the LC₃₀ and LC₅₀ groups relative to the control group. There was a numerical decline in the median survival period of survival female Ae. albopictus in the LC₃₀ groups relative to the control group (χ² = 2.42, P > 0.05), and there was a significant decline in the median survival period of survival female Ae. albopictus in the LC₅₀ group relative to the control group (χ² = 11.42, P < 0.01). Histopathological examinations showed severe damages to the midgut tissues of larvae of susceptible strains of Ae. albopictus, and residual activity assay revealed that the mortality of larvae of susceptible strains of Ae. albopictus was both 0 on day 32 post-treatment with calcium cyanamide at a concentration of 200 mg/L and on day 70 post-treatment with calcium cyanamide at a concentration of 500 mg/L, showing complete loss of the larvicidal activity of calcium cyanamide. Conclusions Calcium cyanamide is highly toxic against susceptible strains of Ae. albopictus, and calcium cyanamide at sublethal concentrations (LC₃₀ and LC₅₀) may inhibit growth, development, and reproductive capability of susceptible strains of Ae. albopictus, and shorten the lifespan of adult mosquitoes.

Objective: To compare and analyze the antibacterial effects of platelets against five common clinical pathogenic bacteria including MRSA, SE, SA, E. coli, and CRKP, and to preliminarily explore the role of DCD sensitivity in the observed variations of antibacterial effects. Methods: The same number of platelets were used to establish co-culture systems of platelets and platelet lysates with the five pathogenic bacteria. The antibacterial effects of platelets and platelet lysates on the five pathogenic bacteria were evaluated by observing the turbidity of the bacterial solution, measuring the OD value of the bacterial solution and counting the colonies. The supernatant protein of platelets co-cultured with MRSA was collected for quantitative proteomics analysis to explore the important antibacterial proteins of platelets. The content of DCD in the supernatant after co-culture of platelets and platelet lysates with the five pathogenic bacteria was detected by ELISA to preliminarily analyze the reasons for the different antibacterial effects of platelets on the five pathogenic bacteria. Results: Compared with the control group of MRSA, SA, and SE, the turbidity of the bacterial solution decreased after co-culture of platelets and platelet lysates with MRSA, SA, and SE for 12 h, and the OD value and colony count were significantly reduced (P<0.05). The turbidity of the bacterial solution did not change significantly after co-culture of platelets and platelet lysates with E. coli for 24 h, but the OD value decreased (P<0.05), and the colony count decreased to 10 CFU/mL but the difference was not statistically significant (P>0.05). Compared with the control group of CRKP, the turbidity, OD value, and colony count of the bacterial solution did not change significantly after co-culture of platelets and platelet lysates with CRKP (P>0.05). Proteomics results showed that after co-culture with MRSA, important proteins related to platelet activation, including collagen, fibrinogen, von Willebrand factor, integrin αIIbβ3, platelet glycoprotein V and IV were significantly up-regulated. ELISA results showed that after co-culture with the five pathogenic bacteria, platelets could secrete a large amount of DCD, with the content around 3 μg/mL. Conclusion: The antibacterial effect of platelets on Gram-positive bacteria MRSA, SA, and SE is better than that on Gram-negative bacteria E. coli and CRKP, and platelets have the best antibacterial effect on MRSA. The differences in antibacterial effects of platelets on the five pathogenic bacteria may be related to the sensitivity of DCD antibacterial peptides to the five pathogenic bacteria.

The choice of biopsy method is critical in diagnosing prostate cancer (PCa). This retrospective cohort study compared systematic biopsy (SB) or cognitive fusion-targeted biopsy combined with SB (CB) in detecting PCa and clinically significant prostate cancer (csPCa). Data from 2572 men who underwent either SB or CB in Fudan University Shanghai Cancer Center (Shanghai, China) between January 2019 and December 2023 were analyzed. Propensity score matching (PSM) was used to balance baseline characteristics, and detection rates were compared before and after PSM. Subgroup analyses based on prostate-specific antigen (PSA) levels and Prostate Imaging-Reporting and Data System (PI-RADS) scores were performed. Primary and secondary outcomes were the detection rates of PCa and csPCa, respectively. Of 2572 men, 1778 were included in the PSM analysis. Before PSM, CB had higher detection rates for both PCa (62.9% vs 52.4%, odds ratio [OR]: 1.54, P < 0.001) and csPCa (54.9% vs 43.3%, OR: 1.60, P < 0.001) compared to SB. After PSM, CB remained superior in detecting PCa (63.1% vs 47.9%, OR: 1.86, P < 0.001) and csPCa (55.0% vs 38.2%, OR: 1.98, P < 0.001). In patients with PSA 4-12 ng ml -1 (>4 ng ml -1 and ≤12 ng ml -1 , which is also applicable to the following text), CB detected more PCa (59.8% vs 40.7%, OR: 2.17, P < 0.001) and csPCa (48.1% vs 27.7%, OR: 2.42, P < 0.001). CB also showed superior csPCa detection in those with PI-RADS 3 lesions (32.1% vs 18.0%, OR: 2.15, P = 0.038). Overall, CB significantly improves PCa and csPCa detection, especially in patients with PSA 4-12 ng ml -1 or PI-RADS 3 lesions.
Humans ; Male ; Prostatic Neoplasms/diagnosis* ; Propensity Score ; Retrospective Studies ; Middle Aged ; Aged ; Image-Guided Biopsy/methods* ; Prostate-Specific Antigen/blood* ; Prostate/diagnostic imaging*

Objective To investigate the protective effect of paravertebral nerve block combined with general anesthesia on liver injury after laparoscopic hepatectomy(LH).Methods A randomized controlled trial was conducted on 51 patients undergoing LH in our hospital between April and August 2024.They were randomly divided into control group(n=25,general anesthesia)and paravertebral block group(n=26,paravertebral nerve block before general anesthesia induction).Beside anesthesia,they received same other medical treatment.The following indicators were compared between the 2 groups,that is,serum levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL)and albumin(ALB),and systemic-immune inflammation(SII)index within 7 d before and on the 1st and 2nd days after surgery;heart rate and mean arterial pressure(MAP)before anesthesia induction(T1),before pneumoperitoneum establishment(T2),pneumoperitoneum establishment(T3),and at the first hilar occlusion(T4);usages of intraoperative norepinephrine,sevoflurane,and analgesic drugs 24 h postoperatively;as well as operation time,extubation time,and lengths of postanesthesia care unit(PACU)stay and hospital stay.Results The paravertebral block group had significantly lower ALT on the 1st day after surgery[178.40(126.55,325.86)vs 292.20(197.20,468.95)U/L],SII on the 2nd day after surgery[704.13(486.61,1 078.59)vs 1 075.09(753.80,1 614.38)],and amount of analgesic drugs in 24 h after surgery[29.70(27.37,32.07)vs 31.99(28.92,40.81)mg],and decreased MAP level at T3 and T4,early extubation,and shorter lengths of PACU stay and hospital stay when compared with the control group(all P<0.05).Conclusion Paravertebral nerve block combined with general anesthesia can reduce inflammatory responses,relieve postoperative pain,stabilize hemodynamics for patients undergoing LH,and thereby alleviate postoperative liver injury in them.

Objective To explore the occurrence of acute kidney injury(AKI)in patients with Stanford type A aortic dissection(TAAD)after surgical treatment,analyze the risk factors,and construct a prediction model.Methods A retrospective case-control study was conducted on 138 TAAD patients undergoing surgical treatment in our hospital from January 2016 to June 2024.After Kidney Disease Improving Global Outcomes(KDIGO)criteria was performed within 1 week after surgery,they were divided into AKI(n=95)and non-AKI(n=43)groups.Univariate and multivariate logistic regression analyses were performed to identify the perioperative risk factors.Then a nomogram model were constructed,and receiver operating characteristic(ROC)curve was plotted to analyze its predictive efficacy.Results The incidence of postoperative AKI was 68.84%(95 cases)in the TAAD patients,including 51.58%(49 cases)of stage 3 AKI and 38.95%(37 cases)requiring continuous renal replacement therapy.The length of ICU stay,time to extubation,and abandonment of treatment were significantly higher in the AKI group than the non-AKI group(P<0.001).Multifactorial analysis showed that the monocyte count on postoperative day 1(OR=3.521)and preoperative creatinine level(OR=1.019)were independent risk factors for AKI,postoperative uric acid level(OR=1.005)was correlated with AKI,and intraoperative urine volume(OR=0.739)and globulin level at 1 d postoperatively(OR=0.781)were protective factors.The area under the ROC curve of the constructed model was 0.866,with a sensitivity of 0.811 and a specificity of 0.791.Conclusion Postoperative AKI occurrence can be reduced in TAAD patients by optimizing the intraoperative urine output,modulating the postoperative inflammatory response,and strengthening nutritional support.Our prediction model for AKI risk is of significance for early clinical identification of high-risk patients in TAAD patients after surgical treatment.

Objective To analyze the current research status and hotspot issues of performance assessment in tertia-ry public hospitals in China,providing reference for subsequent research and practice.Methods Using"performance assessment of tertiary public hospitals"as the main keyword,a total of 520 articles were retrieved from the CNKI ac-ademic journal database from January 30,2019,to January 30,2024.After further screening of literature based on the inclusion and exclusion criteria,a total of 364 eligible articles were obtained.Visual analysis was conducted using the VOSviewer tool.Results The number of publications increased annually from 2019 to 2021,with a decline ob-served in 2022-2023."Chinese Journal of Health"published the most articles on performance assessment in tertiary public hospitals.Research institutions mainly focused on universities,health administrative departments,and hospi-tals.The hotspot clusters of research included performance assessment,public hospitals,target management,high-quality development,tertiary hospitals,and operational efficiency.Conclusion Performance assessment in tertia-ry public hospitals has received widespread attention,with rich connotations and obvious guiding effects,but further research is needed to deepen and explore related topics.

The performance evaluation of tertiary public hospitals aims to strengthen functional positioning,and the weight of indicators such as the proportion of surgery is relatively high in the evaluation indicators.In this con-text,some tertiary comprehensive hospitals with a high proportion of internal medicine business are facing significant challenges in sustained development.It comprehensively reviews the impact of performance evaluation indicators on the direction of internal medicine specialties,and uses SWOT analysis tools to condense the sustainable develop-ment path of tertiary public hospitals.This includes growth strategies(improving the ability to treat difficult and criti-cal diseases,undertaking scientific and educational tasks),transformational strategies(technological innovation,price approval),multiple business strategies(adjusting outpatient and inpatient structures,building specialized disease centers,etc.),and defensive strategies(reasonable diagnosis and treatment,clinical pathways),inorder to provide reference for hospital managers.

Objective To analyze the problems existing in the homogenization management of multi-branch hospitals based on the annual performance assessment data,and provide reference for promoting the high-quality development of public hospital branch districts.Methods Based on the Performance Assessment Operation Manual of National Tertiary Public Hospitals(2022 edition),10 indicators including the proportion of discharged patients undergoing surgery and the proportion of fourth-level surgery were screened,and the functional positioning,quality and safety,revenue and expenditure structure,and cost control of 4 hospitals of a certain medical institution from 2022 to 2023 were descriptively analyzed.Results The CMI value and the proportion of discharged surgery in the main hospital were significantly better than those in the branch hospitals,and there was no significant difference in the medical quality indicators of the four hospitals,and the operation efficiency of the branch hospital with outstanding specialty characteristics was better than that of other hospitals.Conclusion Public hospitals pay more attention to the"big specialty,small comprehensive"mode in the layout of branch districts,pay more attention to the quality control management at the specialty level in medical quality management,and strengthen the benefit analysis of different hospitals in the same specialty in operation management.

Objective To analyze the current research status and hotspot issues of performance assessment in tertia-ry public hospitals in China,providing reference for subsequent research and practice.Methods Using"performance assessment of tertiary public hospitals"as the main keyword,a total of 520 articles were retrieved from the CNKI ac-ademic journal database from January 30,2019,to January 30,2024.After further screening of literature based on the inclusion and exclusion criteria,a total of 364 eligible articles were obtained.Visual analysis was conducted using the VOSviewer tool.Results The number of publications increased annually from 2019 to 2021,with a decline ob-served in 2022-2023."Chinese Journal of Health"published the most articles on performance assessment in tertiary public hospitals.Research institutions mainly focused on universities,health administrative departments,and hospi-tals.The hotspot clusters of research included performance assessment,public hospitals,target management,high-quality development,tertiary hospitals,and operational efficiency.Conclusion Performance assessment in tertia-ry public hospitals has received widespread attention,with rich connotations and obvious guiding effects,but further research is needed to deepen and explore related topics.