With the widespread use of antibiotics, drug-resistant bacterial infections have become a significant threat to human health. Finding new antibacterial strategies that can effectively control drug-resistant bacterial infections has become an urgent task. Unlike small molecule drugs that target bacterial proteins, antisense oligonucleotide (ASO) can target genes related to bacterial resistance, pathogenesis, growth, reproduction and biofilm formation. By regulating the expression of these genes, ASO can inhibit or kill bacteria, providing a novel approach for the development of antibacterial drugs. To overcome the challenge of delivering antisense oligonucleotide into bacterial cells, various drug delivery systems have been applied in this field, including cell-penetrating peptides, lipid nanoparticles and inorganic nanoparticles, which have injected new momentum into the development of antisense oligonucleotide in the antibacterial realm. This review summarizes the current development of small nucleic acid drugs, the antibacterial mechanisms, targets, sequences and delivery vectors of antisense oligonucleotide, providing a reference for the research and development of antisense oligonucleotide in the treatment of bacterial infections.

Objective:This study aimed to validated the diagnostic accuracy of Global Leadership Initiative on Malnutrition(GLIM)criteria for malnutrition in pancreatic cancer patients undergoing pancreaticoduodenectomy and to evaluated its prognostic value for postoperative outcome.Methods:A retrospective analysis was conducted on 230 consecutive pancreatic cancer patients who underwent pancreaticoduodenectomy at the Department of Pancreatobiliary Surgery,Sun Yat-sen University Cancer Center,between January 2018 to January 2024.Patients were stratified into malnutrition group and non-malnutrition group using Nutritional Risk Screening 2002(NRS 2002)and GLIM criteria.Multivariable logistic regression identified independent risk factors for postoperative morbidity.Results:GLIM criteria identified malnutrition in 96 patients(41.7％).Compared with the non-malnourished group,the number of preoperative nutritional support(t=20.038,P<0.001),the number of preoperative enteral nutrition support(t=8.377,P=0.004),the number of preoperative parenteral nutrition support(t=22.302,P<0.001),the number of anemia(t=8.037,P=0.005)and preoperative parenteral nutrition use days(t=-2.898,P=0.009),the difference was statistically significant.There were statistically significant differences in C-reactive protein(t=10.944,P=0.008),NLR(t=-2.523,P=0.012)and PNI(t=-2.397,P=0.017)between the two groups before surgery.Preoperative BMI(t=-4.410,P<0.001)was significantly lower in the malnourished group.The number of postoperative parenteral nutrition days(Z=-2.283,P=0.022)and amino acid supplementation during postoperative hospitalization were significantly higher in the malnourished group(Z=-2.309,P=0.021).The incidence of malnutrition was higher in patients with Clavien-Dindo grade≥Ⅲ(P=0.030)and intra-abdominal infections(P=0.049).Multivariable analysis identified preoperative weight loss(OR=2.154,95％CI:1.158～4.005;P=0.015)and BMI reduction(OR=0.175,95％CI:0.040～0.775;P=0.022)as independent predictors of postoperative complications.Conclusions:The GLIM standard effectively characterize malnutrition status in pancreatic cancer patients after pancreaticoduodenectomy patients and demonstrate superior predictive performance for postoperative morbidity.It has good predictive performance and clinical application value.

Objective To observe the clinical effect of Zuogui Pill combined with western medi-cine in treatment of gestational diabetes mellitus(GDM)with qi and yin deficiency syndrome.Meth-ods A total of 92 GDM patients with qi and yin deficiency syndrome from the Second Affiliated Hos-pital of Guizhou University of Traditional Chinese Medicine between January 2022 and October 2023 were enrolled and randomly divided into study group and control group,with 46 patients in each group.The control group received western medicine treatment,while the study group received Zuogui Pill combined with western medicine treatment.Both groups were treated for 4 weeks.The treatment effects,as well as the levels of glycolipid indicators[total cholesterol(TC),triglyceride(TG),fast-ing plasma glucose(FPG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),and glycated hemoglobin(HbA1c)],insulin resistance indicators[fasting in-sulin(FINS),homeostasis model assessment of β-cell function(HOMA-β),and homeostasis model assessment of insulin resistance(HOMA-IR)],inflammatory and stress factors[serum amyloid A(SAA),interleukin-6(IL-6),malondialdehyde(MDA),and reactive oxygen species(ROS)],serum microRNA(miR)-21 and miR-149 levels,and occurrence of adverse pregnancy outcomes were compared be-tween the two groups before and after treatment.Results After 4 weeks of treatment,the total ef-fective rate was higher in the study group than that in the control group(P＜0.05).After treat-ment,the levels of FPG,HbA1c,TC,LDL-C,and TG were lower,and the levels of HDL-C were higher in both groups than before treatment,and the levels of FPG,HbA1c,TC,LDL-C in the study group were lower than those in the control group,and the level of HDL-C was higher in the study group than that in the control group(P＜0.05).After treatment,the levels of FINS and HOMA-IR were lower in both groups than before treatment,and their levels in the study group were lower than those in the control group;the levels of HOMA-β were higher in both groups than before treatment,and its level in the study group was higher than that in the control group(P＜0.05).After treat-ment,the levels of SAA,IL-6,MDA,and ROS were lower in both groups than before treatment,and their levels in the study group were lower than those in the control group(P＜0.05).Before treatment,there were no statistically significant differences in the levels of serum miR-21 and miR-149 between the two groups(P＞0.05);after treatment,the levels of serum miR-21 and miR-149 were lower in both groups than before treatment,and their levels in the study group were lower than those in the control group(P＜0.05).Before treatment,the traditional Chinese medicine syndrome score was(8.12±1.31)in the study group and(7.86±1.28)in the control group,with no statisti-cally significant difference between the two groups(P＞0.05);after treatment,the traditional Chi-nese medicine syndrome score was(3.31±0.46)in the study group,which was lower than(4.57±0.59)in the control group(t=11.423,P＜0.05).Compared with the control group,the incidence of adverse pregnancy outcomes was lower in the study group(P＜0.05).Conclusion Zuogui Pill combined with western medicine can effectively improve glycolipid metabolism and insulin resistance in GDM patients and reduce the incidence of adverse pregnancy outcomes.

RNA editing, an essential post-transcriptional reaction occurring in double-stranded RNA (dsRNA), generates informational diversity in the transcriptome and proteome. In mammals, the main type of RNA editing is the conversion of adenosine to inosine (A-to-I), processed by adenosine deaminases acting on the RNAs (ADARs) family, and interpreted as guanosine during nucleotide base-pairing. It has been reported that millions of nucleotide sites in human transcriptome undergo A-to-I editing events, catalyzed by the primarily responsible enzyme, ADAR1. In hematological malignancies including myeloid/lymphocytic leukemia and multiple myeloma, dysregulation of ADAR1 directly impacts the A-to-I editing states occurring in coding regions, non-coding regions, and immature miRNA precursors. Subsequently, aberrant A-to-I editing states result in altered molecular events, such as protein-coding sequence changes, intron retention, alternative splicing, and miRNA biogenesis inhibition. As a vital factor of the generation and stemness maintenance in leukemia stem cells (LSCs), disordered RNA editing drives the chaos of molecular regulatory network and ultimately promotes the cell proliferation, apoptosis inhibition and drug resistance. At present, novel drugs designed to target RNA editing(e.g., rebecsinib) are under development and have achieved outstanding results in animal experiments. Compared with traditional antitumor drugs, epigenetic antitumor drugs are expected to overcome the shackle of drug resistance and recurrence in hematological malignancies, and provide new treatment options for patients. This review summarized the recent advances in the regulation mechanism of ADAR1-mediated RNA editing events in hematologic malignancies, and further discussed the medical potential and clinical application of ADAR1.

Four furan α-butenolactones were isolated from 50% acetone extract of tuber of Alisma orientale by silica gel column, chromatography gel column and high performance liquid chromatography techniques. Their structures were identified by modern wave spectroscopy techniques and electronic circular dichroism (ECD) and assigned as (5R)-5-hydroxy-3,4-dimethylfuran-2(5H)-one (1), 5-hydroxy-3,5-dimethylfuran-2(5H)-one (2), 5-hydroxy-4-(1-methylethyl)-2(5H)-furanone (3) and alismanoid A (4). Compound 1 was new compound and compounds 2–4 were first isolated from Alisma orientale. Compound 1-4 had potential antifibrotic activities.

Umbilical cord mesenchymal stem cells (UC-MSCs) have been widely used in regenerative medicine, but there is limited research on the stability of UC-MSCs formulation during production. This study aims to assess the stability of the cell stock solution and intermediate product throughout the production process, as well as the final product following reconstitution, in order to offer guidance for the manufacturing process and serve as a reference for formulation reconstitution methods. Three batches of cell formulation were produced and stored under low temperature (2-8 ℃) and room temperature (20-26 ℃) during cell stock solution and intermediate product stages. The storage time intervals for cell stock solution were 0, 2, 4, and 6 h, while for intermediate products, the intervals were 0, 1, 2, and 3 h. The evaluation items included visual inspection, viable cell concentration, cell viability, cell surface markers, lymphocyte proliferation inhibition rate, and sterility. Additionally, dilution and culture stability studies were performed after reconstitution of the cell product. The reconstitution diluents included 0.9% sodium chloride injection, 0.9% sodium chloride injection + 1% human serum albumin, and 0.9% sodium chloride injection + 2% human serum albumin, with dilution ratios of 10-fold and 40-fold. The storage time intervals after dilution were 0, 1, 2, 3, and 4 h. The reconstitution culture media included DMEM medium, DMEM + 2% platelet lysate, 0.9% sodium chloride injection, and 0.9% sodium chloride injection + 1% human serum albumin, and the culture duration was 24 h. The evaluation items were viable cell concentration and cell viability. The results showed that the cell stock solution remained stable for up to 6 h under both low temperature (2-8 ℃) and room temperature (20-26 ℃) conditions, while the intermediate product remained stable for up to 3 h under the same conditions. After formulation reconstitution, using sodium chloride injection diluted with 1% or 2% human serum albumin maintained a viability of over 80% within 4 h. It was observed that different dilution factors had an impact on cell viability. After formulation reconstitution, cultivation in medium with 2% platelet lysate resulted in a cell viability of over 80% after 24 h. In conclusion, the stability of cell stock solution within 6 h and intermediate product within 3 h meets the requirements. The addition of 1% or 2% human serum albumin in the reconstitution diluent can better protect the post-reconstitution cell viability.

Objective To explore the clinical efficacy of second-line treatment with Zebutinib for mantle cell lymphoma.Methods Totally 80 patients with mantle cell lymphoma admitted to Ganzhou Cancer Hospital from October 2020 to December 2021 were divided into observation group and control group by lottery method,40 cases in each group.The control group received first-line treatment combined Bendamustine for mantle cell lymphoma,while the observation group received second-line treatment combined with Zebutinib on the basis of first-line treatment.The patients were followed up for 2 years.The clinical efficacy,tumor marker levels,immune function,survival cycle and treatment safety of two groups were evaluated and compared.Results The objective remission rate and disease control rate of observation group were higher than those of control group(P＜0.05).After treatment,the levels of lactate dehydrogenase,β2-microglobulin and carcinoembryonic antigen of observation group were lower than those of control group(P＜0.05).After treatment,the immune function indicators of observation group was better than that of control group(P＜0.05).The progression free survival and overall survival of observation group were higher than those of control group(P＜0.05).Conclusion Zebutinib second-line treatment for mantle cell lymphoma has a good effect,can reduce tumor marker levels,improve patients immune function,prolong patients survival cycle,and has good treatment safety.

Objective To explore the current status of H.pylori infection in the natural population of Sanya City,analyze its influencing factors,and provide a reference basis for the prevention and control of H.pylori infection.Methods A total of 677 residents from four districts of Sanya City were selected by overall stratified random sampling method,and were subjected to urea 14C breath test and questionnaire survey to calculate the positive rate of H.pylori in the natural population and analyze the influencing factors of H.pylori infection.Results A total of 606 residents were included,and the number of H.pylori positive detections was 261,with a positive detection rate of 38.5％.Among them,different ethnicity,marital status,smoking,eating vegetables and fruits,and literacy level were associated with H.pylori infection(P＜0.05);gender,age,BMI,alcohol consumption,drinking water source,betel quid chewing,and the number of cohabitants were not significantly associated with H.pylori infection(P＞0.05).Family infection was an independent risk factor for H.pylori infection in the natural population of Sanya City,and Li ethnicity,frequent consumption of fruits and vegetables,and college and higher education level were independent protective factors for H.pylori infection in the natural population of Sanya City.Conclusion The rate of H.pylori infection in the natural population of Sanya City is lower than the national average.Consuming more fruits and vegetables and improving the awareness of hygiene protection are conducive to the prevention of H.pylori infection;and the promotion of the family and related members with the same examination and treatment is important to avoid aggregation of infection within the family.

Objective To investigate the satisfaction of clinical trial service quality of hospitals in Shanghai for clinical research associate(CRA),so as to provide reference for improving the quality of clinical trial service.Methods From Oct to Nov 2023,CRAs were surveyed using the revised SERVQUAL(service quality)scale.The questionnaire included 29 items in 5 dimensions of assurance,reliability,tangibility,responsiveness and empathy.Based on the modified importance-performance analysis(IPA)analysis,it was figured out which item was in the improvement area.Results A total of 163 CRAs from 10 companies were surveyed,and 160 valid questionnaires were collected.According to the revised IPA,6,2,1,2 and 2 items of the dimensions of assurance,reliability,tangibility,responsiveness and empathy fell into the improvement area,respectively.Conclusion CRAs surveyed may not be satisfied with the clinical trial service of Shanghai hospitals.We need to propose optimization strategies to improve the quality of clinical trial service from the aspects of standardization awareness,review mode,process acquisition,response and management system flexibility.

As artificial intelligence technology rapidly advances, its deployment within the medical sector presents substantial ethical challenges. Consequently, it becomes crucial to create a standardized, transparent, and secure framework for processing medical data. This includes setting the ethical boundaries for medical artificial intelligence and safeguarding both patient rights and data integrity. This consensus governs every facet of medical data handling through artificial intelligence, encompassing data gathering, processing, storage, transmission, utilization, and sharing. Its purpose is to ensure the management of medical data adheres to ethical standards and legal requirements, while safeguarding patient privacy and data security. Concurrently, the principles of compliance with the law, patient privacy respect, patient interest protection, and safety and reliability are underscored. Key issues such as informed consent, data usage, intellectual property protection, conflict of interest, and benefit sharing are examined in depth. The enactment of this expert consensus is intended to foster the profound integration and sustainable advancement of artificial intelligence within the medical domain, while simultaneously ensuring that artificial intelligence adheres strictly to the relevant ethical norms and legal frameworks during the processing of medical data.
Artificial Intelligence/legislation & jurisprudence* ; Humans ; Consensus ; Computer Security/standards* ; Confidentiality/ethics* ; Informed Consent/ethics*