OBJECTIVE: Paridis Rhizoma (Chonglou in Chinese), a traditional Chinese herbal medicine, has been shown have strong anti-tumor effects. Paris saponin VII (PSVII), an active constituent isolated from Paridis Rhizoma, was demonstrated to significantly suppress the proliferation of BxPC-3 cells in our previous study. Here, we aimed to elucidate the anti-pancreatic ductal adenocarcinoma (PDAC) effect of PSVII and the underlying mechanism. METHODS: Cell viability was determined by CCK-8, colony formation, and cell migration assays. Cell apoptosis and reactive oxygen species (ROS) production were measured by flow cytometry with annexin V/propidine iodide (Annexin V/PI) and 2',7'-dichlorodihydrofluorescein diacetate (DCFH-DA), respectively. Pyroptosis was evaluated by morphological features, Hoechst 33342/PI staining assay, and release of lactate dehydrogenase (LDH). JC-1 fluorescent dye was employed to measure mitochondrial membrane potential. Western blotting and reverse transcription-quantitative polymerase chain reaction (RT-qPCR) were used to determine the levels of proteins or mRNAs. The effect in vivo was assessed by a xenograft tumor model. RESULTS: PSVII inhibited the viability of PDAC cells (BxPC-3, PANC-1, and Capan-2 cells) and induced gasdermin E (GSDME) cleavage, as well as the simultaneous cleavage of Caspase-3 and poly (ADP-ribose) polymerase 1 (PARP). Knockdown of GSDME shifted PSVII-induced pyroptosis to apoptosis. Additionally, the effect of PSVII was significantly attenuated by Z-Asp(OMe)-Glu(OMe)-Val-Asp(OMe)-fluoromethylketone (Z-DEVD-FMK), on the induction of GSDME-dependent pyroptosis. PSVII also elevated intracellular ROS accumulation and stimulated Bax and Caspase-3/GSDME to conduct pyroptosis in PDAC cells. The ROS scavenger N-acetyl cysteine (NAC) suppressed the release of LDH and inhibited Caspase-9, Caspase-3, and GSDME cleavage in PDAC cells, ultimately reversing PSVII-induced pyroptosis. Furthermore, in a xenograft tumor model, PSVII markedly suppressed the growth of PDAC tumors and induced pyroptosis. CONCLUSION These results demonstrated that PSVII exerts therapeutic effects through Caspase-3/GSDME-dependent pyroptosis and may constitute a novel strategy for preventing chemotherapeutic resistance in patients with PDAC in the future.

OBJECTIVE To investigate the clinical efficacy of integrating pharmacists into family health teams （FHTs） for long-term medication therapeutical management （MTM） in stroke patients， and empirically evaluate the service model. METHODS A pharmacist team， jointly established by clinical and community pharmacists from the Affiliated Suzhou Hospital of Nanjing Medical University （hereinafter referred to as “our hospital”）， developed a pharmacist-supported MTM model integrated into FHTs. Using a prospective randomized controlled design， 170 stroke patients discharged from our hospital （July 2022-December 2023） and enrolled in FHTs at Suzhou Runda Community Hospital were randomly divided into trial group （88 cases） and control group （82 cases） according to random number table. The control group received routine FHTs care （without pharmacist involvement in the team collaboration）， while the trial group xhz8405@126.com received 12-month MTM services supported by pharmacists via an information platform. These services specifically included innovative interventions such as personalized medication regimen optimization based on the MTM framework， dynamic medication adherence management， medication safety monitoring， a home medication assessment system， and distinctive service offerings. Outcomes of the 2 grousp were compared before and after intervention， involving medication adherence （adherence rate， adherence score）， compliance rates for stroke recurrence risk factors [blood pressure， low-density lipoprotein cholesterol （LDL-C）]， and incidence of adverse drug reactions （ADR）. RESULTS After 12 months， the trial group exhibited significantly higher medication adherence rates， improved adherence scores， higher compliance rates for blood pressure and LDL-C targets compared to the control group （P＜0.05）. The incidence of ADR in the trial group （4.55%） was significantly lower than that in the control group （8.11%）， though the difference was not statistically significant （P＞ 0.05）. CONCLUSIONS Pharmacist involvement in FHTs to deliver MTM services significantly enhances medication adherence and optimizes risk factor for stroke recurrence， offering practical evidence for advancing pharmaceutical care in chronic disease management under the family doctor system.

Objective:To construct a risk classification model for adverse events of medical consumables,so as to achieve automatic evaluation for risk level of such events,and enhance the capability for risk management of adverse events of medical consumables,and ensure the safety of medical apparatuses.Methods:The data of adverse events of medical consumables of 370 cases of 148 types that were reported by Shandong Provincial Third Hospital from 2020 to 2023 were selected,and they were divided into high-risk and low-risk types.Eight key factors of them,which included the number of cases,injury level,type of registration certificate,with source and without source,high-value and low-value,domestic and imports,product classification,and risk levels,were counted to form a dataset.K-nearest neighbor(KNN),support vector machine(SVM)and decision tree algorithms in machine learning were used to construct a risk classification model for adverse events of medical consumables.The data of 12 adverse events of medical consumables of 5 types of our hospital,which were newly reported in 2024,were integrated for their parameters.Then,the accuracy rate and prediction performance of the model were further analyzed.Results:By comparing the KNN,SVM and decision tree algorithm models,the effect of SVM algorithm model was better,and its accuracy rate was 90.54%,and its area under curve(AUC)value of the receiver operating characteristic(ROC)curve was 0.944,and its Kolmogorov-Smirnov(KS)test value was 0.808.The model had favorable predictive performance.The results,that invoked SVM algorithm model to conduct verification of actual prediction for 12 adverse events of medical consumables of 5 types,indicated it was same between predictive outcomes and risk levels of manual evaluation.Conclusion:The risk classification model of adverse events of medical consumables has established an operational model for assessing the risk level of such events,which can assist monitoring personnel for adverse event of medical apparatuses to quickly and accurately find risk signals of adverse events of medical consumables,and improve the monitoring capability of them for these adverse events.

Objective:To construct a risk classification model for adverse events of medical consumables,so as to achieve automatic evaluation for risk level of such events,and enhance the capability for risk management of adverse events of medical consumables,and ensure the safety of medical apparatuses.Methods:The data of adverse events of medical consumables of 370 cases of 148 types that were reported by Shandong Provincial Third Hospital from 2020 to 2023 were selected,and they were divided into high-risk and low-risk types.Eight key factors of them,which included the number of cases,injury level,type of registration certificate,with source and without source,high-value and low-value,domestic and imports,product classification,and risk levels,were counted to form a dataset.K-nearest neighbor(KNN),support vector machine(SVM)and decision tree algorithms in machine learning were used to construct a risk classification model for adverse events of medical consumables.The data of 12 adverse events of medical consumables of 5 types of our hospital,which were newly reported in 2024,were integrated for their parameters.Then,the accuracy rate and prediction performance of the model were further analyzed.Results:By comparing the KNN,SVM and decision tree algorithm models,the effect of SVM algorithm model was better,and its accuracy rate was 90.54%,and its area under curve(AUC)value of the receiver operating characteristic(ROC)curve was 0.944,and its Kolmogorov-Smirnov(KS)test value was 0.808.The model had favorable predictive performance.The results,that invoked SVM algorithm model to conduct verification of actual prediction for 12 adverse events of medical consumables of 5 types,indicated it was same between predictive outcomes and risk levels of manual evaluation.Conclusion:The risk classification model of adverse events of medical consumables has established an operational model for assessing the risk level of such events,which can assist monitoring personnel for adverse event of medical apparatuses to quickly and accurately find risk signals of adverse events of medical consumables,and improve the monitoring capability of them for these adverse events.

AIM: To evaluate the refractive status through computer refractometer and OPD-Scan III auto refractometer in cataract patients after extended depth of focus(EDOF)intraocular lens implantation.METHODS: Retrospective observational study. A total of 61 cases(76 eyes)that received phacomulsification and implanted with TECNIS® Symfony ZXR00 intraocular lens in Shanghai Eye Diseases Prevention & Treatment Center from May 2022 to May 2023 were collected. Measurements from the computer refractometer, OPD-Scan III auto refractometer, and subjective refraction, were taken from all patients on the same day postoperatively.RESULTS: There were statistical significant difference in sphere(S)and spherical equivalent(SE)readings from the computer refractometer and subjective refraction(all P<0.01), with mean differences of -0.67±0.37 D and -0.75±0.35 D, respectively, and the S and SE obtained from computer refractometer more incline to myopia than those from subjective refraction; there were statistical significant difference in computer refractometer and subjective refraction(P<0.01), with a relative small absolute difference(0.21±0.24 D). The S, cylinder(C)and SE of computer refractometer(S, C, SE)were positively correlated with subjective refraction(r=0.7994, 0.7929, and 0.8118, respectively, all P<0.01). Additionally, there were statistical significant differences in S, C and SE of OPD-Scan Ⅲ and subjective refraction(P<0.01), and the absolute differences of S(0.63±0.36 D), C(0.35±0.26 D)and SE(0.53±0.36 D)were small. Furthermore, the S, C and SE of OPD-Scan Ⅲ were positively correlated with subjective refraction(r=0.4410, 0.4982, 0.5224, all P<0.01).CONCLUSION: In patients who received implantation of EDOF lenses, the consistency of computer refractometer, OPD-Scan III auto refractometer and subjective refraction was good. The average difference of the S and SE obtained via computer refractometer was large, but both exhibited a myopic shift relative to those derived from subjective refraction, and the C values demonstrated minimal discrepancy. Furthermore, the differences between OPD-Scan III auto refractometer and subjective refraction were small, but the direction of the difference is unstable, sometimes it is myopic deviation, while sometimes it is hyperopic deviation.

Humans ; Norepinephrine ; Bacterial Infections/drug therapy* ; Immunity, Innate

Objective To explore application of feedforward control nursing intervention in anesthesia recovery management of patients undergoing robot-assisted thoracoscopic radical resection for lung cancer.Methods Sixty-four patients underwent robot-assisted thoracoscopic radical resection for lung cancer at People's Hospital of Liaocheng City in Shandong Province from December 2021 to May 2022 were selected as research objects.They were randomly divided into control group and experimental group,with 32 cases in each group.Control group received routine nursing measures,while experimental group received nursing intervention under guidance of feedforward control on basis of control group.Pass rate of nurses relevant theoretical knowledge,incidence of perioperative complications,nursing satisfaction,nursing quality score,recovery room stay time,self-rating anxiety scale(SAS)and self-rating depression scale(SDS)scores before operation and when leaving recovery room were compared between two groups.Results Pass rate of nurses relevant theoretical knowledge in experimental group was significantly higher than that in control group(P<0.05).Total incidence rate of pressure injury,incidence rate of fluid circuit problems,agitation and hypothermia in experimental group were significantly lower than those in control group(P<0.05).Nursing effect,nursing professionalism,nursing operation and nursing attitude scores of experimental group were significantly higher than those of control group,and recovery room stay time of experimental group was significantly shorter than that of control group(P<0.05).When leaving recovery room,SAS and SDS scores of experimental group were significantly lower than those of preoperative in this group and control group(P<0.05).Conclusion Application of feedforward control nursing intervention in robot-assisted thoracoscopic lung cancer patient anesthesia recovery management can effectively reduce incidence of perioperative complications,shorten recovery time,improve nursing satisfaction and nursing quality scores,and improve patients'early postoperative anxiety and depression status,which is worthy of clinical application and promotion.

In recent years, the incidence and prevalence of Crohn′s disease in China have been increasing, and the interaction between psychological factors and Crohn′s disease has attracted increasing attention. Studies have shown that the incidence of anxiety and depression in patients with Crohn′s disease is significantly higher than that in healthy people. In addition, with the development of medical diagnosis and treatment technology, functional brain imaging technology is increasingly playing an indispensable role in the diagnosis and treatment of Crohn′s disease, which provides some new ideas for the study of the interaction between psychological factors and Crohn′s disease.This article reviews the situation of anxiety and depression in patients with Crohn′s disease and the research progress of functional brain imaging characteristics in Crohn′s disease, so as to provide new ideas for the diagnosis and treatment of Crohn′s disease.

The miR-34 family plays an important role in gastric cancer, and the inactivation or reduced expression of the miR-34 family is detected in gastric cancer cell lines and gastric cancer tissues compared with normal gastric mucosa tissues, indicating it is associated with the occurrence and development of gastric cancer. Studies have shown that miR-34 plays a key role in inhibiting gastric cancer progression by regulating IGF2BP3, survivin, Bcl-2 and epithelial-mesenchymal transition-related pathway, indicating that miR-34 is an important target for gastric cancer treatment. In terms of clinical treatment, miR-34 has not only been proved to have radiochemotherapy sensitization, but also achieved good curative effect in tumor clinical trials. With the emergence of miR-34 vectors targeting gastric cancer, it is possible to use it for gastric cancer treatment. Deep understanding of the molecular basis and clinical efficacy of miR-34 for gastric cancer treatment can help to evaluate the potential of the miR-34 family as a new therapeutic target for gastric cancer.

Objective:To investigate the effect of Mediterranean diet on blood glucose control and cardiovascular risk factors in patients with type 2 diabetes.Methods:As to December 2021, the PubMed, Cochrance Central Register of Controlled Trials and Cochrance Database, Cochranc Library, Embase, China National Knowledge Infrastructure and Wanfang Medical Network system were searched for clinical randomized controlled trials(RCTs) of Mediterranean diet in patients with type 2 diabetes to conduct Meta-analysis The main observation index were cardiovascular risk factors, and the mean difference and its 95% confidence interval were used to estimate the effect size.Results:There were six RCTs, and 1181 patients met the inclusion criteria and entered the Meta-analysis. Compared with the control group, the intervention group can significantly reduce the level of systolic blood pressure ( MD=-1.20, 95% CI-2.21 to -0.19) and diastolic blood pressure ( MD=-4.17, 95% CI-7.12 to -1.22) in patients with type 2 diabetes mellitus, but there were no significant difference in the level of TC ( MD=2.92, 95% CI-0.84 to-6.67), HDL ( MD=2.33, 95% CI-0.27 to -4.92) and LDL ( MD=-2.34, 95% CI-5.67 to -0.99) between the two groups (all P>0.05). Conclusions:The meta-analysis provided evidence the Mediterranean diet showed the beneficial improvements in blood pressure glycemic control, but the effect of Mediterranean diet on lipid profile was not significant, which needed further verification.