Diabetic nephropathy （DN） is one of the most common and severe microvascular complications of diabetes， with a complex pathogenesis involving immune inflammatory responses， oxidative stress， apoptosis， glomerulosclerosis， renal interstitial fibrosis， and other pathological processes. In recent years， numerous animal or cell model experiments have revealed that the transforming growth factor-β （TGF-β）/mothers against decapentaplegic homolog （Smad）， phosphoinositide 3-kinase （PI3K）/ protein kinase B （Akt）/mammalian target of rapamycin （mTOR）， mitogen-activated protein kinase （MAPK）， AMP-activated protein kinase （AMPK）， nuclear factor-κB （NF-κB）， Janus kinase （JAK）/signal transducer and activator of transcription （STAT）， neurogenic locus notch homolog protein （Notch）， nuclear factor E₂-related factor 2 （Nrf2）， secretory glycoprotein （Wnt）/β-catenin， and other classical signaling pathways play important roles in the occurrence and development of DN. Traditional Chinese medicines， as natural drugs， possess characteristics such as multiple components， multiple targets， and few adverse reactions， demonstrating unique advantages in regulating the aforementioned signaling pathways and improving renal pathological changes. This review summarized recent research progress on the intervention of DN through the regulation of the aforementioned signaling pathways by single compounds and formulas of traditional Chinese medicine， focusing on their mechanisms of action in regulating immune inflammatory responses， inhibiting renal fibrosis， oxidative stress， improving metabolic disorders， and other aspects. The aim is to provide theoretical references for a deeper understanding of the modern pharmacological basis and clinical application of traditional Chinese medicine in the treatment of DN.

The welfare and ethics of laboratory animals are the ethical principles and behavioral norms that need to be followed in conducting animal-based scientific research, breeding and managing laboratory animals, and supervising and regulating such activities. The level of protection of laboratory animal welfare and ethics is closely related to the development of science and technology, which has become a widely recognized international consensus. At present, Guangdong Province is accelerating the construction of a high-level science and technology innovation province and the Guangdong-Hong Kong-Macao Greater Bay Area International Science and Technology Innovation Center. Guangdong Province should rely on its advanced governance capacity in the field of laboratory animal science and technology ethics to promote the high-quality development of its laboratory animal science and technology sector. Based on the management laws, regulations, and institutional mechanisms of laboratory animals in China, this paper explores the optimization of the laboratory animal science and technology ethics governance system, which includes the institutional guarantees, responsibility systems, ethical review and supervision mechanisms, and education and outreach. Through methods such as literature research, questionnaire surveys, and interview investigations, an empirical study of the laboratory animal science and technology ethics governance system in Guangdong Province has been conducted. Analysis of literature and research results shows that Guangdong Province has basically established a laboratory animal management system, collaboration mechanism, supervision mechanism, and education and training system that meet the current requirements of the laboratory animal science and technology ethics governance system in China. However, there are still problems such as an incomplete laboratory animal science and technology ethics supervision mechanism, an underdeveloped operation mechanism of review institutions, insufficient attention paid by laboratory animal units to the ethical review of animal experiments, inconsistent ethical review standards, and a lack of professional ethical education and training for ethics review personnel. Therefore, optimization measures such as improving the laboratory animal science and technology ethics review system, strengthening supervision and inspection, further strengthening the accountability of responsible entities, formulating review norms, and enhancing hierarchical and classified education and training are proposed, to provide a theoretical basis for promoting the normalized and long-term governance of laboratory animal science and technology ethics in Guangdong Province.

BACKGROUND:A large number of articles have reported the effect and mechanism of platelet-rich plasma and hydrogel in the treatment of spinal cord injury,but few articles have summarized their treatment strategies for spinal cord injury. OBJECTIVE:To summarize the pathological process of spinal cord injury and the strategies of repairing spinal cord injury with platelet-rich plasma and hydrogel alone and in combination. METHODS:PubMed and CNKI databases were searched for articles published from inception to March 2024 by computer.The Chinese search terms were"spinal cord injury,platelet-rich plasma,hydrogel."The English search terms were"spinal cord injury,spinal cord,platelet-rich plasma,hydrogel,angiogenesis,neuralgia,combination therapy."Articles were screened according to inclusion and exclusion criteria,and 128 articles were finally included for review and analysis. RESULTS AND CONCLUSION:(1)The classification of platelet-rich plasma is complex and diverse,and the effects of platelet-rich plasma in the repair treatment of spinal cord injury are various,but they all show certain positive effects,that is,they can promote axon regeneration,stimulate angiogenesis,and treat neuropathic pain and so on.(2)The effect of platelet-rich plasma is mainly due to the growth factors contained in platelet-rich plasma.(3)There are many types of hydrogels,which mainly play the role of filling,simulating extracellular matrix,carrying drugs and biological products,and carrying cells as scaffolds in the repair treatment of spinal cord injury.(4)Compared with single therapy,combination therapy of platelet-rich plasma and hydrogel can promote nerve regeneration and spinal cord function recovery more effectively.

Objective To detect the expression level of serum LncRNA P53RRA in patients with primary hepatocellular carcinoma(HCC)and explore its clinical application value in the diagnosis of HCC.Methods Ninety-three patients with primary HCC visited Zhongshan Hospital Affiliated to Fudan University from November 2019 to December 2020 were selected as the HCC group and 88 healthy individuals undergone physical examination as the control group.Their serum samples were collected and the expression levels of serum LncRNA P53RRA were detected by real-time fluorescence quantitative PCR(qRT-PCR).The correlations of serum P53RRA levels with clinicopathological parameters and clinical biochemical indicators such as alanine aminotransferase(ALT),glutamate amin-otransferase(AST),gamma-glutamyl transpeptidase(GGT),and alkaline phosphatase(ALP)in HCC patients were analyzed.The diagnostic value of serum P53RRA for HCC was evaluated by the receiver operating characteristic(ROC)curve.Results The expres-sion levels of serum P53RRA in HCC patients(2.15±0.22)were significantly lower than that in healthy controls(3.54±0.33),and the difference was statistically significant(t=3.489,P＜0.05).The analysis of clinicopathological parameters showed that the expres-sion levels of serum P53RRA in HCC patients were correlated with tumor staging(χ2=9.590,P＜0.05),α-fetoprotein(AFP,χ2=5.732,P＜0.05),and GGT(χ2=5.732,P＜0.05).ROC curve analysis showed that the area under the ROC curve(AUCROC)of ser-um P53RRA in the diagnosis of HCC was 0.750(95%CI:0.679-0.821),with a sensitivity of 65.6%and specificity of 64.8%.The AUCROC,sensitivity and specificity of P53RRA combined with AFP and GGT in the diagnosis of HCC were 0.911(95%CI:0.867-0.953),88.2%and 70.5%,respectively,which were higher than those of single indicator.Conclusion LncRNA P53RRA is expec-ted to serve as a novel non-invasive biomarker,effectively assisting in the clinical diagnosis of HCC.

Intrahepatic cholangiocarcinoma(ICC)is a malignant tumor originating from the epithelial cells of the intrahepatic bile ducts,with adenocarcinoma being its predominant pathological type.Due to its insidious onset and the difficulty of early diagnosis,ICC has a high mortality rate.Currently,complete resection of the tumor through surgery remains the only potential curative treatment for ICC,but only a small proportion of patients are eligible for surgery.In this context,a multidisciplinary comprehensive treatment model,centered around surgery and combined with systemic chemotherapy,targeted therapy,immunotherapy,supplemented by local interventional therapies and radiotherapy,has emerged as an effective strategy for improving the prognosis of ICC patients.This paper systematically reviews the latest research advances in chemotherapy,targeted therapy,immunotherapy,and local treatment for ICC,and summarizes the current clinical treatment strategies,aiming to provide a robust reference for the precise treatment of patients with advanced ICC.

Objective To compare the performance of 3 risk prediction models based on machine learning in predicting the risk of compassion fatigue among obstetrics and gynaecology nurses.Methods Using the convenience sampling method,1 323 obstetrics and gynaecology nurses from 11 tertiary hospitals in 9 cities were selected from December 2022 to March 2023,and were randomly divided into a training set and a test set according to 7∶3 ratio.Compassion Fatigue Scale,Five Facet Mindfulness Questionnaire and Emotional Intelligence Scale were used for the survey.A total of 3 types of risk prediction models were constructed for the factors affecting the compassion fatigue of obstetrics and gynaecology nurses,namely,Logistic Regression,Decision Tree,and Random Forest.The accuracy,precision,specificity,sensitivity,Fl score and AUC were used to compare the predictive performance of the 3 models.Results Finally 1 276 maternity nurses completed the survey.All 3 models showed that nature of employment,years of experience,mindfulness and emotional intelligence were independent risk factors for compassion fatigue in obstetrics and gynaecology nurses(P＜0.05).The results of model comparison showed that the accuracy of Logistic regression,decision tree and random forest were 0.804,0.806,0.796;the precision was 0.821,0.827,0.823;the sensitivity was 0.956,0.949,0.939;the Fl score was 0.883,0.884,0.877;the AUC was 0.704(95％CI:0.701～0.713),0.760(95％CI:0.751～0.771),0.742(95％CI:0.723～0.762)respectively.Conclusion The risk prediction model of factors affecting compassion fatigue among obstetrics and gynaecology nurses constructed by decision tree performed the best,and the predictive performance was better than that of the random forest and logistic regression models.The multi-model effectively predicts the risk of compassion fatigue in obstetrics and gynecology nurses,explores the interaction of influencing factors in multiple dimensions,and it can inform the early identification and prevention of compassion fatigue and the development of related interventions.

Objective To establish a performance evaluation index system for fixed asset management in public hospitals provides a scientific basis for the performance evaluation of fixed asset management in public hospitals in Hainan Province.Methods Utilizing the literature review method,an initial framework of evaluation index was established.This framework was then adjusted and optimized through expert consultation.The Analytic Hierarchy Process was employed to quantify the weights of each evaluation index,leading to the construction of the final evaluation index system.Results The results indicated that the active coefficient of expert consultation was 100％,the authority coefficient was 0.83,and the variation coefficient range for the second round of expert consultation was 0.06 to 0.20.The Kendall's W coefficient of concordance for the comprehensive indicators evalation indexs 0.486,with P<0.001.The established performance evaluation index system for fixed asset management in public hospitals in Hainan Province encompasses three primary indicators,seven secondary indicators,and 33 tertiary indicators.The weights allocated to these three primary indicators are 0.4705,0.3051 and 0.2244,respectively.Conclusion The performance evaluation index system for fixed asset management in public hospitals in Hainan Province is scientifically and reasonably designed,providing a theoretical basis and reference for the performance evaluation of fixed asset management in public hospitals in Hainan Province.

Objective To explore the clinical efficacy of swallowing training combined with Vitalstim neuromuscular electrical stimulation in patients with dysphagia after stroke for providing a scientific basis for improving the swallowing function.Methods A total of 100 patients with post-stroke dysphagia were enrolled and randomly divided into control group(n=50,conventional swallowing training)and observation group(n=50,conventional swallowing training+Vitalstim neuromuscular electrical stimulation),with a total treatment course of 3 weeks.The swallowing functions before and after treatment was compared between two groups.Results After treatment,observation group scored lower on the water swallow test and the Rosenbek Penetration-Aspiration Scale(P<0.05),while higher on the Functional Oral Intake Scale and the Functional Independence Measure as compared with control group(P<0.05).In addition,the score of Nutritional Risk Screening 2002(NRS2002)was higher in observation group than in control group(P<0.05).Conclusion The combination of swallowing training and Vitalstim neuromuscular electrical stimulator can effectively improve the swallowing function of stroke patients and has high clinical application value,worthy of further promotion and research.

The aim of this study is to investigate the inhibitory effects and mechanism of three or-ganic acids,including formic acid(FA),butyric acid(BA)and lactic acid(LA),on the pathogenic-ity of Salmonella enteritidis(SE),Escherichia coli(EC)and Staphylococcus aureus(SA).The growth of pathogens was detected by Minimum Inhibitory Concentration(MIC)and Oxford Cup antimicrobial zone assays.The motility of pathogens was detected by soft agar plate method,and the biofilm of pathogens was detected by crystal violet staining.Quantitative real-time polymerase chain reaction(qRT-PCR)was used to measure the expression levels of genes related to the patho-genicity of SE.The results showed that FA and BA significantly inhibited the growth of SE,EC and SA,and FA had a superior inhibitory effect on EC(MIC:0.25 g/L;inhibition zone:20.0 mm)and SA(MIC:0.5 g/L;inhibition zone:25.0 mm).In addition,the three organic acids significantly inhibited the motility of SE,EC and SA as accessed by swimming and swarming assays,and FA showed the best inhibition effect.Besides,the three organic acids,especially FA,markedly inhibited the biofilm formation of SE,EC and SA.Finally,our results showed that the three organic acids in-hibited the expression of the main virulence genes encoded by SPI-1(InvA,InvF,SopE,SopB,SipB,HilA and SipA),SPI-2(SopD2),pili-related genes(FliF,LpfA,SefA and FimF)and flagellum-related genes(FlhD,FliC and FliD)of SE.This study demonstrates that FA,BA,and LA significantly inhibited the growth and pathogenicity of the four pathogens,among which FA showed the most obvious effect on inhibiting the growth,motility,biofilm formation and virulence gene expression.Our study provided a theoretical basis for the application of organic acids in the field of animal husbandry.

Objective:To analyze the clinicopathological characteristics and prognostic factors in gastric cancer patients with bone metastasis,and to evaluate the impact of different treatment regimens on survival in patients with synchronous and metachronous bone metastasis.Methods:A total of 120 gastric cancer patients with bone metastasis treated at Nanjing Drum Tower Hospital between 2015 and 2023 were enrolled,including 36 with synchronous bone metastasis and 84 with metachronous bone metastasis.Clinicopathological features were compared between the two groups using the χ2 test.Cox proportional hazards regression model was employed to identify risk factors for overall survival after bone metastasis(OS-BM).The Kaplan-Meier method was used to analyze the effects of different treatments on OS-BM in both synchronous and metachronous groups.Results:Among the 120 patients,104(86.6%)had metastases to other organs.Comparative analysis revealed that synchronous bone metastasis patients exhibited elevated serum C-reactive protein and decreased serum albumin,whereas metachronous bone metastasis patients had reduced peripheral white blood cell and neutrophil counts(all P<0.05).Metachronous bone metastasis(HR=2.35,95%CI[1.47,3.74],P<0.01),serum CA125≥30.2 U/mL(HR=1.6,95%CI[1.03,2.48],P=0.036),white blood cell count≥9.5×10?/L(HR=2.15,95%CI[1.17,3.92],P=0.013),and absence of immunotherapy(HR=2.26,95%CI[1.5,3.39],P<0.01)were independent risk factors affecting patient prognosis.Combined immunotherapy significantly prolonged OS-BM in gastric cancer patients with bone metastasis compared to non-immunotherapy regimens(9.63 vs 4.53 months,P=0.002).Patients with metachronous bone metastasis demonstrated better response to immunotherapy compared to those with synchronous metastases(median OS-BM:10.8 vs 7.3 months,P=0.004).Conclusion:Immunotherapy is an independent protective factor for survival in gastric cancer patients with bone metastasis.Early combination therapy centered on immunotherapy alongside chemotherapy is recommended to prolong survival in such patients.