ObjectiveTo explore the potential mechanism of Xiezhuo Jiedu prescription in regulating autophagy in the treatment of ulcerative colitis （UC） by bioinformatics and animal experiments. MethodsThe differentially expressed genes （DEGs） in the colonic mucosal tissue of UC patients was obtained from the Gene Expression Omnibus （GEO）， and those overlapped with autophagy genes were obtained as the differentially expressed autophagy-related genes （DEARGs）. DEARGs were imported into Metascape and STRING， respectively， for gene ontology/Kyoto Encyclopedia of Genes and Genomics （GO/KEGG） enrichment analysis and protein-protein interaction （PPI） analysis. Finally， 15 key DEARGs were obtained. The core DEARGs were obtained by least absolute shrinkage and selection operator （LASSO） regression and receiver operating characteristic curve （ROC） analysis. The CIBERSORT deconvolution algorithm was used to analyze the immunoinfiltration of UC patients and the correlations between core DEARGs and immune cells. C57BL/6J mice were assigned into a normal group and a modeling group. The mouse model of UC was established by free drinking of 2.5% dextran sulfate sodium. The modeled mice were assigned into low-， medium-， and high-dose Xiezhuo Jiedu prescription and mesalazine groups according to the random number table method and administrated with corresponding agents by gavage for 7 days. The colonic mucosal morphology was observed by hematoxylin-eosin staining. The protein and mRNA levels of cysteinyl aspartate-specific proteinase 1 （Caspase-1）， cathepsin B （CTSB）， C-C motif chemokine-2 （CCL2）， CXC motif receptor 4 （CXCR4）， and hypoxia-inducing factor-1α （HIF-1α） in the colon tissue were determined by Western blot and real-time fluorescence quantitative polymerase chain reaction， respectively. ResultsThe dataset GSE87466 was screened from GEO and interlaced with autophagy genes. After PPI analysis， LASSO regression， and ROC analysis， the core DEARGs （Caspase-1， CCL2， CTSB， and CXCR4） were obtained. The results of immunoinfiltration analysis showed that the counts of NK cells， M0 macrophages， M1 macrophages， and dendritic cells in the colonic mucosal tissue of UC patients had significant differences， and core DEARGs had significant correlations with these immune cells. This result， combined with the prediction results of network pharmacology， suggested that the HIF-1α signaling pathway may play a key role in the regulation of UC by Xiezhuo Jiedu prescription. The animal experiments showed that Xiezhuo Jiedu prescription significantly alleviated colonic mucosal inflammation in UC mice. Compared with the normal group， the model group showed up-regulated protein and mRNA levels of caspase-1， CCL2， CTSB， CXCR4， and HIF-1α， which were down-regulated after treatment with Xiezhuo Jiedu prescription or mesalazine. ConclusionCaspase-1， CCL2， CTSB， and CXCR4 are autophagy genes that are closely related to the onset of UC. Xiezhuo Jiedu prescription can down-regulate the expression of core autophagy genes to alleviate the inflammation in the colonic mucosa of mice.

Critically ill patients are at high risk for hospital acquired infections, which can significantly increase the mortality rate and treatment costs for these patients. Therefore, in the process of treating the primary disease, strict prevention and control of new hospital infections is an essential component of the treatment for critically ill patients. The treatment of critically ill patients involves multiple steps and requires a concerted effort from various aspects such as theory, management, education, standards, and supervision to achieve effective prevention and control of hospital infections. However, there is currently a lack of unified understanding and standards for hospital infection prevention and control. To address this, in March 2024, a group of experts in critical care medicine, infectious diseases, and hospital infection from China discussed the current situation and issues of hospital infection control in the intensive care unit together. Based on a review of the latest evidence-based medical evidence from both domestic and international sources, 2024 Expert Consensus on Hospital Acquired Infection Control Principles in the Department of Critical Care Medicine was formed, aiming to provide a basis for the development of hospital infection prevention and control strategies in the field of critical care medicine.

This study was performed to explore the therapeutic effect of Xiezhuo Jiedu Formula on ulcerative colitis rats and its effects on β-catenin/FOSL2/ARID5A signaling pathway and macrophage polarization.Rats of ulcerative colitis was induced and divide into control group,model group,positive group(intervention with sulfasalazine),and low,medium and high-dose groups(intervention with Xiezhuo Jiedu Fang).After 14 days of intervention,the disease activity index(DAI)and colon mucosa damage index(CDMI)were calculated and used to evaluate the state of rats.HE staining was used to observe lesion tissue;ELISA was used to detect of serum levels of TNF-α and IL-6;flow cytometry was used to detect peripheral blood M1 and M2 macrophage content;RT-PCR was used to detect the mRNA expression of iNOS,CD206,and β-Catenin/FOSL2/ARID5A;immunohistochemistry was used to detect β-Catenin/FOSL2/ARID5A signaling pathway protein expression in colon tissue.Data showed that DAI score,CMDI score,and serum TNF-α and IL-6 in the low,medium,and high dose groups were significantly lower than the model group(P＜0.05).HE staining showed that the colon tissue damage and inflammatory infiltration in the low,medium,and high dose groups were slighter than those in the model group(P＜0.05).The rate of M1 type macrophages and iNOS mRNA in the low,medium,and high dose groups were significantly lower than those in the model group,while the rate of M2 type macrophages and CD206 mRNA were significantly higher than those in the model group(P＜0.05).The mRNA and protein expressions of β-catenin and FOSL2 in colon tissue of low,medium,and high dose groups were significantly higher than those of the model group,while the mRNA level and protein expression of ARID5A were significantly lower than that of the model group(P＜0.05).Taken together,Xiezhuo Jiedu formula can effectively alleviate the clinical symptoms,reduce inflammatory response,downregulate β-catenin/FOSL2/ARID5A expression,regulate macrophage polarization and promote disease recovery of ulcerative colitis in rats.

OBJECTIVE To set up normal ranges for indexes in embryo-fetal development toxicity studies in Sprague-Dawley(SD)rats and to establish a background database to provide reference for the embryo-fetal development toxicity evaluation of drugs.METHODS The data on embryonic develop-ment and fetal growth from embryo-fetal development toxicity studies(11 items)conducted by our center between 2013 and 2022 was statistically analyzed,involving 205 pregnant rats and 3037 fetuses in total,with the mean and standard deviation,coefficient of variation and 95%confidence interval calculated.The indexes included body mass,body mass gain and food consumption during pregnancy,pregnancy outcomes(pregnancy rate,average corpora lutea,average Implant sites,average live conceptuses,live conceptuse rate,resorption rate and dead conceptuse rate),fetal growth and development(fetal mass,placental mass and sex ratio),appearance abnormality rate,visceral abnormality rate,and skeletal abnormality rate.RESULTS The mass of pregnant rats trended up during gestation,with significant increases in the late period.Food consumption increased along with gestation.Caesarean section was conducted on gestation day 20,and the pregnancy rate was 93.2%.The average corpora lutea,Implant sites and live conceptuses were 18.0±3.2,15.9±2.8 and 14.8±3.0,respectively.The live conceptuse rate was 93.4%while the total dead embryo rate was 6.6%.The average mass of fetuses and placenta were respectively 3.6±0.3 and(0.6±0.3)g,and the fetal sex ratio(male/female)was 0.94.The incidence of fetal appearance abnormalities was about 0.2%,and that of soft tissue abnormalities was approximately 0.8%.The rate of skeletal abnormalities was about 1.2%,with higher incidence of non-ossification and incomplete ossification mostly identified on sternum and hyoid bone.The numbers of ossifications of metacarpal bones,metatarsal bones and sacrococcygeal vertebrae were 7.0±0.7,8.0±0.1 and 7.4±0.5,respectively.The rate of ossification of sternumⅠtoⅣwas higher,with an average of about 98.6%-99.9%.The ossification rates of sternum Ⅴ and Ⅵ were(68.0±28.4)%and(82.8±23.9)%.CONCLUSION The background database of indexes in the embryo-fetal development toxicity study on SD rats is established for our GLP laboratory,which provides reference for reproductive toxicity studies.

Objective To explore the effect of FBXW7 on ferroptosis in head and neck squamous cell carcinoma.Methods Head and neck squamous cell lines HN4 and HN6 were cultured in vitro.FBXW7 and SOX2 overexpression plasmids were constructed,and the plasmids were stably transfected into cell lines.The overexpression transfection efficiency was verified at the transcription level and protein level by qRT-PCR and Western blot experiments,respectively.The lipid peroxidation levels of head and neck squamous cell carcinoma cells with overexpressing FBXW7 were verified by measuring malondialdehyde(MDA),glutathione(GSH),and reactive ox-ygen species(ROS)levels.After treating cells with ferroptosis inhibitor Fer-1,the changes in cell viability were further detected to ver-ify the effect of FBXW7 on ferroptosis.The effect of transfection of the overexpressed plasmid on cellular pathways was detected by Western blot.Results HN4 and HN6 cell lines showed increased levels of lipid peroxidation after overexpression of FBXW7,and the ferroptosis inhibitor Fer-1 was able to effectively reverse the ferroptosis induced by overexpression of FBXW7.Western blot assay results showed that overexpression of FBXW7 reduced the expression of c-Myc,SOX2 and SLC7A11.Conclusion FBXW7 regulates the ex-pression of SOX2-SLC7A11 by degrading c-Myc,thereby effectively regulating ferroptosis in HNSCC.

Objective To explore the impact of knocking down Sec31A on the malignant phenotype of head and neck squamous cell carcinoma(HNSCC)and its possible mechanisms.Methods Transcriptome sequencing data of HNSCC tissues and adjacent tissues were obtained from the TCGA database,and the expression levels of Sec31A were compared.Immunohistochemical staining was used to analyze the expression of Sec31A in HNSCC tissues.Kaplan-Meier survival analysis was used to compare the relationship between Sec31A and the prognosis of HNSCC patients.Small interfering plasmids si-Sec31A and si-NC were transfected into HNSCC cell lines HN6 and HN4,and the impact of knocking down Sec31A on the biological behavior of HNSCC cells was detected through CCK-8 exper-iments,plate cloning experiments,scratch healing experiments,and Transwell experiments.Changes in the expression levels of PI3K/AKT/mTOR pathway related proteins in cells were detected after knocking down Sec31A with HN6 and HN4 through Western Blot(WB)experiments.Stable transfected cell lines of HN6 siSec31A and HN6 siNC were constructed and inoculated subcutaneously in nude mice to further verify the tumorigenic effect of Sec31A in vivo.Results TCGA data showed that Sec31A was higher in HNSCC tissues than in adjacent normal tissues(P＜0.01),and high expression of Sec31A was significantly correlated with poor prognosis in pa-tients(P＜0.05).Immunohistochemical staining showed that Sec31A was expressed stronger in HNSCC tissues than in normal tissues.In HN6 and HN4 cells,knocking down Sec31A resulted in significantly weaker proliferation,migration,and invasion abilities compared to the control group.Through WB experiments,it was found that transfection of si-Sec31A with HN6 and HN4 significantly reduced the expression levels of p-PI3K,p-AKT,and p-mTOR proteins.After knocking down Sec31A with HN6,the transplanted tumor volume in nude mice was significantly smaller than that in the control group.Conclusion Knocking down Sec31A can inhibit the proliferation,migration and invasion of HNSCC cells,possibly through the PI3K/AKT/mTOR pathway.

Objective To investigate the value of radiomics nomogram model based on enhanced CT for predicting postoperative pancreatic fistula(POPF)in patients undergoing pancreaticoduodenectomy(PD).Methods The clinical and abdominal imaging data of 82 patients who underwent PD were analyzed retrospectively.They were divided into training set and validation set at a ratio of 3∶2.In the venous phase of CT,the maximum slice of the pancreatic duct was selected to delineate the region of interest(ROI),and the features were extracted and screened to construct the radiomics model.The independent risk factors associated with POPF were screened by univariate and multivariable logistic regression analyses to construct the clinical model.A nomogram model was created by combining Radiomics score(Radscore)and clinical risk factors.The diagnostic performance of the model was verified by the vali-dation set.Results The nomogram model demonstrated significant predictive power,with an area under the curve(AUC)of 0.862 and 0.806 in the training set and validation set,respectively.Conclusion The nomogram model exhibits excellent predictive performance and outperforms the clinical model and radiomics model in predicting POPF,which can provide important guidance for clinical deci-sion-making.

Objective To explore the value of a clinical-radiomics-deep learning(CRDL)fusion model based on biparametric mag-netic resonance imaging(bpMRI)in predicting biochemical recurrence(BCR)after radical prostatectomy(RP).Methods A retrospective analysis was conducted on 363 patients with prostate cancer(PCa)confirmed by RP pathology who underwent preoperative MRI,inclu-ding 84 cases experienced BCR(23.1％)and 279 cases did not experience BCR(76.9％).The patients were randomly divided into a training set(n=254)and a test set(n=109)in a ratio of 7∶3.Univariate Cox regression analysis was employed to select clinical variables related to BCR and the clinical model was constructed using backward stepwise multivariate Cox regression analysis.The radiomics features and deep learning(DL)features based on the DenseNet network were extracted.Radiomics and DL signatures were separately developed using least absolute shrinkage and selection operator(LASSO)-Cox regression algorithm.A CRDL fusion model was constructed by combining significant clinical features,DL signature and radiomics signature.The models'predictive performance for BCR was evaluated and compared using the concordance index(C-index).K-M survival curve and Log-rank test were used to assess the performance of CRDL fusion model in risk stratifica-tion of biochemical recurrence free survival(bRFS).Results In the test set,there was no statistically significant difference among C-index of radiomics signature,DL signature and clinical model(P＞0.05).The CRDL fusion model achieved a C-index of 0.83,higher than the clinical model,radiomics signature,and DL signature(P=0.03,0.01,and 0.03).K-M survival curve showed a significant difference in bRFS between low-risk and high-risk patients stratified by the CRDL fusion model[P＜0.000 1,hazard ratio(HR)=30.56,95％confidence interval(CI)10.64-87.75].Conclusion Radiomics signature and DL signature have comparable predictive per-formance for BCR after RP.The CRDL fusion model exhibits the best predictive efficacy for BCR,which is valuable for guiding postoperative treatment strategies in clinical practice.

Objective:To systematically evaluate and integrate the midwifery care needs of parturition, to provide reference for formulating effective measures to improve obstetric care.Methods:A computer search was conducted on Cochrane Library, PubMed, Web of Science, Embase, China National Knowledge Infrastructure, China Biomedical Literature Database and Wanfang Database for qualitative research on midwifery care needs of parturition. The search period was from the establishment of the database to April 2024. The quality of the included literature was evaluated using the qualitative research quality evaluation criteria of the Australian Joanna Briggs Institute Evidence based Health Care Center. A thematic synthesis was used for result integration.Results:A total of 16 articles were included, and 63 major research results were extracted and summarized into 9 new categories, forming 4 integrated results: physiological comfort needs, respect needs, professional nursing support needs and social network harmonious needs.Conclusions:The needs of midwifery care during childbirth are diverse and need help and support from various aspects. It is suggested that nursing staff should pay attention to the experience and needs of childbirth, improve the management plan of nursing during childbirth, improve the cognitive experience of childbirth and promote natural childbirth.

ObjectiveThe bioinformatics method was used to screen ferroptosis differential genes （FRGs） closely related to ulcerative colitis （UC）， and animal experiments were conducted to verify whether the mechanism of Xiezhuo Jiedu recipe in treating UC is related to the regulation of ferroptosis. MethodThe differentially expressed genes （DEGs） of colonic mucosa tissue of UC patients were obtained from the GEO database， and the intersection of the genes with ferroptosis genes was used to obtain FRGs. The core FRGs were obtained by cluster analysis， minimum absolute contraction and selection operator （LASSO） regression， and receiver operating characteristic curve （ROC） curve analysis. In animal experiments， the UC mouse model was prepared by making the mouse freely drink 2.5% dextran sodium sulfate （DSS）. Xiezhuo Jiedu recipe and mesalazine were given by gavage for seven days， and the inflammatory infiltration of colonic mucosa was observed by hematoxylin-eosin （HE） staining. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to detect the mRNA expression levels of E3 ubiquitin ligase （FBXW7）， zinc finger protein （ZFP36）， solute carrier family 7 member 11 （SLC7A11）， and Toll-like receptor 4 （TLR4） in colon tissue. The protein expression levels of FBXW7， ZFP36， SLC7A11， and TLR4 in colon tissue were detected by Western blot. ResultDataset GSE87466 was screened from the GEO database， and its intersections with the ferroptosis gene were analyzed to obtain 21 FRGs. After cluster analysis， LASSO regression， and ROC analysis， core FRGs （FBXW7， ZFP36， SLC7A11， and TLR4） were obtained. Immunoinfiltration analysis showed significant differences in the expression of initial B cells， M1 macrophages， plasma cells， and M2 macrophages in the colonic mucosa tissue of UC mice， and there was a significant correlation between core FRGs and these immune cells. Further animal experiments showed that the colonic mucosa tissue of mice in the model group was disorganized and infiltrated by a large number of inflammatory cells. The inflammation of the colonic mucosa tissue of mice in each group was relieved to varying degrees after treatment with Xiezhuo Jiedu recipe and mesalazine， while the colonic mucosa tissue of mice in the high-dose group of Xiezhuo Jiedu recipe showed almost no inflammatory changes. Compared with the normal group， the protein and mRNA expressions of FBXW7， ZFP36， SLC7A11， and TLR4 in the model group were significantly increased， and the expression of core FRGs in colonic mucosa tissue of mice in all groups was significantly down-regulated after treatment with Xiezhuo Jiedu recipe and mesalazine. ConclusionFBXW7， ZFP36， SLC7A11， and TLR4 are ferroptosis genes closely related to the pathogenesis of UC， and Xiezhuo Jiedu recipe can significantly alleviate colonic mucosa inflammation in mice by down-regulating core ferroptosis genes.