ObjectiveTo investigate the role of Krüppel-like factor 4 （KLF4） in type 1 diabetic nephropathy （DN） and to elucidate its underlying mechanisms. MethodsSixteen male Sprague-Dawley （SD） rats were selected and randomly divided into control group and model group， with 8 rats in each group. Rats in model group were intraperitoneally injected with a single dose of 55 mg/kg streptozotocin （STZ） to establish a diabetic nephropathy （DN） model， while those in control group were injected with an equal volume of sodium citrate buffer at the same time. After successful model establishment， the serum levels of blood urea nitrogen （BUN） and serum creatinine （SCR） were determined. Hematoxylin-eosin （HE） staining was performed on renal tissues to observe pathological changes， and immunofluorescence staining was conducted to detect the expression of KLF4 in renal tissues. Lipid peroxidation levels were evaluated by measuring malondialdehyde （MDA）， Fe²⁺， and lipid peroxidation products in rat kidneys. A high glucose （HG）-induced cell injury model was established in HK-2 cells， with mitochondrial membrane potential assessed using 5，5'，6，6'-tetrachloro-1，1'，3，3'- tetraethylbenzimidazolylcarbocyanine iodide （JC-1） staining. Lipid peroxidation levels （MDA， Fe²⁺， and lipid peroxides） were measured in HK-2 cells.KLF4-overexpressing HK-2 cells were then constructed， followed by repeated JC-1， MDA， Fe²⁺， and lipid peroxidation assays. Western blot was performed to evaluate the expression of ferroptosis-related proteins including glutathione peroxidase 4 （GPX4）， nuclear factor erythroid 2-related factor 2 （NRF2）， and Kelch-like ECH-associated protein 1 （Keap1）， in renal tissues， HK-2 cells， and KLF4-overexpressing HK-2 cells. ResultsCompared with the control group， DN rats exhibited elevated serum BUN and SCR levels， glomerular hypertrophy， renal interstitial fibrosis， and decreased KLF4 expression. Additionally， MDA， Fe²⁺， and lipid peroxidation levels increased， indicating enhanced ferroptosis in renal tissues， accompanied by reduced GPX4 and NRF2 expression and elevated Keap1 levels. Similarly， HG-treated HK-2 cells showed decreased KLF4 expression， increased MDA， Fe²⁺ and lipid peroxidation， elevated ferroptosis， and dysregulated GPX4/NRF2/Keap1 expression. However， KLF4 overexpression reversed these alterations induced by high glucose treatment. ConclusionIn the renal tissues of type 1 diabetic rats， the expression of KLF4 decreases the level of ferroptosis increases， and KLF4 overexpression could alleviate HG-induced HK-2 cell injury.

Under the multi-campus development model of public hospitals,cultural integration and innovation face nu-merous challenges due to spatial constraints,personnel structure differences,and functional positioning across campuses.System-atic cultural development is required to bridge these gaps and enhance the sense of belonging among both patients and staff in new campuses.This case study focuses on the Huangpu Campus of Sun Yat-sen University Cancer Center,launched in 2021,explo-ring a dual-dimensional approach to multi-campus cultural integration through"healing spaces."The practical strategies include:①Direct Space Construction:Establishing patient-centered healing environments through service hubs to optimize clinical experi-ences and humanistic care;(②Inidirect Environment Development:Leveraging staff service centers to foster the integration of the hospital's"collaborative,fulfilling,and striving culture,"thereby strengthening employee engagement.Post-implementation,significant improvements were observed in both patient and staff satisfaction metrics.The initiative has yielded a replicable cultur-al management framework for multi-campus public hospitals,offering valuable insights for cultural innovation in similar healthcare settings.

Objective:This study evaluated the efficacy of the PST technique: Preservation of the left colic artery (P), suture reinforcement (S), and transanal tube (T) combined with selective fecal diversion via end ileostomy, in preventing anastomotic leakage following laparoscopic anterior resection (LAR) for mid-to-low rectal cancer.Methods:We retrospectively collected data for this descriptive case series from patients who underwent laparoscopic LAR with complete or partial application of the PST technique, some of whom received prophylactic ileostomy, at the Department of Colorectal Surgery, Zhongshan Hospital Affiliated to Fudan University, and its Xiamen Branch between July, 2022 and December, 2024. "Partial PST" was defined as the implementation of PS (Preservation of the left colic artery + suture reinforcement), PT (Preservation of the left colic artery + transanal tube), ST (suture reinforcement + transanal tube), or a single T procedure (Transanal tube). The primary outcome measures were the proportion of patients who received the PST technique and terminal ileostomy, as well as the incidence of anastomotic leaks.Results:Among 198 patients, 145 received complete PST. Fifty-three patients underwent partial PST (PT) because anastomotic reinforcement was not feasible due to an excessively low anastomosis or obesity. All patients achieved R0 resection. Postoperative pathology showed that 108 patients (54.5%) were at T3-T4 stage, and 81 patients (40.9%) had poorly differentiated adenocarcinoma or mucinous adenocarcinoma. A total of 19.7% (39/198) of patients developed grade II or higher postoperative complications, including 11 cases (5.6%) of surgical site infection and 7 cases (3.5%) of urinary retention. Five patients were rehospitalized within 30 days after surgery, among whom 2 had intestinal obstruction, and 3 developed grade C anastomotic leaks that required reoperation for salvage enterostomy. The overall incidence of anastomotic leakage was 3.0% (6/198). Fifty-three patients (26.8%) received protective ileostomy, with an anastomotic leak incidence of 1.9% (1/53). Methylene blue leakage occurred in 20 patients (10.1%), all of whom received prophylactic ileostomy and had no anastomotic leakage postoperatively. Among 61 patients who received neoadjuvant chemoradiotherapy before surgery, 28 underwent prophylactic ileostomy, and none developed anastomotic leaks after surgery.Conclusions:Routine application of the PST technique during laparoscopic low anterior resection, along with prophylactic enterostomy for ultra-high-risk populations, can effectively control the incidence of anastomotic leakage.

OBJECTIVE To study the improvement effects and potential mechanisms of water extract from Chrysanthemum morifolium on skeletal muscle atrophy in rats after ischemic stroke.METHODS Sprague-Dawley rats were randomly divided into sham operation group,model group,ATP group(10 mg/kg),C morifolium water extract high-dose and low-dose groups(1.08,0.54 g/kg).Except for sham operation group,ischemic stroke models were induced in rats from the other groups using middle cerebral artery occlusion.Starting from the first day after surgery,rats in each group were given corresponding drug/normal saline intragastrically,once a day,for consecutive 7 days.On the 7th day post-surgery,the rats'body weights were measured,and their motor functions were evaluated,including Longa scores,exercise distance,grip strength;the electrophysiological signals of the skeletal muscles in rats were measured;the pathological morphology of the soleus muscle in rats was observed;the levels of tumor necrosis factor-α(TNF-α)in serum and soleus muscle were measured;the expressions of proteins related to TNF-α/c-Jun N-terminal kinase(JNK)/mitogen-activated protein kinase(MAPK)signaling pathway in the soleus muscle were determined.RESULTS Compared with sham operation group,the body weight,grip strength and exercise distance of rats were decreased/shortened significantly(P＜0.01);additionally,there was a notable reduction in the interpeak value of skeletal muscle electrophysiology(P＜0.05 or P＜0.01).Longa score,as well as the levels of TNF-α in serum and soleus muscle,and the expression levels of TNF-α,phosphorylated JNK,phosphorylated MAPK,muscle ring-finger protein-1,and muscle atrophy Fbox-1 protein in the soleus muscle,were all significantly elevated(P＜0.01).The skeletal muscle cells of the soleus muscle in the model group showed significant atrophy,with a markedly decreased cross-sectional area(P＜0.01).Compared with the model group,the levels of the aforementioned indicators were significantly reversed in C.morifolium water extract groups(P＜0.05 or P＜0.01),and the skeletal muscle cells of the soleus muscle were markedly enlarged.CONCLUSIONS C morifolium water extract can improve skeletal muscle atrophy in rats after ischemic stroke,the mechanism of which may be associated with suppressing the activation of the TNF-α/JNK/MAPK signaling pathway.

To address the challenge of cultural integration in multi-campus public hospitals,the Cancer Center of Sun Yat-Sen University has embarked on a practical exploration using cultural and creative work as a vehicle,guided by cultural confi-dence.The center has created a cultural and creative matrix for its 60th anniversary,systematically innovating the cultural and creative work mechanism,vertically activating historical and cultural resources,and linking both inside and outside the hospital campuses.Additionally,a"full-cycle"cultural and creative system has been designed for the Huangpu campus,covering multi-ple scenarios and horizontally strengthening cross-campus identity.Following the principle of"appreciating the beauty of diversity while cherishing our own,"the Cancer Center of Sun Yat-Sen University aims to transform cultural soft power into a driving force for high-quality development and enhance cultural confidence through party building leadership.The"Cancer Center of Sun Yat-Sen University approach"of promoting cultural integration in multi-campus hospitals through cultural and creative work provides an empirical example for transforming cultural soft power into a driving force for high-quality development and enhancing cultural confidence in multi-campus public hospitals.The key lessons lie in deeply tapping into historical and cultural resources,emphasi-zing identity,building a collaborative innovation mechanism,and realizing the organic integration of cultural integration and high-quality hospital development.

Under the multi-campus development model of public hospitals,cultural integration and innovation face nu-merous challenges due to spatial constraints,personnel structure differences,and functional positioning across campuses.System-atic cultural development is required to bridge these gaps and enhance the sense of belonging among both patients and staff in new campuses.This case study focuses on the Huangpu Campus of Sun Yat-sen University Cancer Center,launched in 2021,explo-ring a dual-dimensional approach to multi-campus cultural integration through"healing spaces."The practical strategies include:①Direct Space Construction:Establishing patient-centered healing environments through service hubs to optimize clinical experi-ences and humanistic care;(②Inidirect Environment Development:Leveraging staff service centers to foster the integration of the hospital's"collaborative,fulfilling,and striving culture,"thereby strengthening employee engagement.Post-implementation,significant improvements were observed in both patient and staff satisfaction metrics.The initiative has yielded a replicable cultur-al management framework for multi-campus public hospitals,offering valuable insights for cultural innovation in similar healthcare settings.

Objective:To investigate a surgical method and clinical outcomes of a fascia pedicled island flap with dorsal branch of proper palmar digital nerve in reconstruction of defects of digital pulp.Methods:Seventy-five patients who had digital pulp defects and treated at Department of Orthopaedics, Xinjiang Production and Construction Corps Alar Hospital, Shaw Hospital Affiliated Zhejiang University School of Medicine, from December 2019 to December 2022, were retrospectively analysed. The patients were 40 males and 35 females aged 25-61 years with an average age of 42 years. The defects of digital pulp involved in 23 thumbs, 15 per group of index fingers, middle fingers and ring fingers, and 7 little fingers. The digital pulp defects were 0.8 cm×0.9 cm to 1.5 cm×2.1 cm in size, and the sizes of flap were 1.0 cm×1.2 cm to 1.8 cm×2.4 cm. Donor sites were covered by medium-thickness skin grafts and pressurised bandage was applied. Clinical outcomes of the surgery were monitored through the postoperative follow-ups at outpatient clinic, WeChat and telephone reviews.Results:Postoperative follow-up ranged 9 to 15 months, with an average of 12 months. The donor sites and skin grafts all achieved stage-I healing. Seventy-three flaps completely survived after surgery. However, 2 flaps had partial necrosis, which healed after dressing changes, 4 flaps encountered flap bruising and swelling, which were rectified by removal of high-tension sutures, and 7 flaps had tension blisters, which had disappeared in 2 weeks. At the final follow-up, the appearance and texture of the flaps were graded as excellent for 54 flaps and good for 21 flaps, all without pale, cyanotic or dark in colour. Forty-nine flaps showed normal elasticity or with slight atrophy, 24 with mild atrophy, 2 with moderate atrophy and none with obvious or severe atrophy. Mobility of the affected digits was rated as excellent for 57 digits (average 42.3°), good for 12 (average 26.7°) and fair in 6 digits (average 16.3°). TPD of flap surfaces ranged 6 to 11 mm, with an average of 8.1 mm. Digital function were evaluated according to the Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, with 48 digits in excellent (average 11.2 points), 22 in good (average 8.1 points) and 5 in fair (average 5.4 points) and with a combined excellence and good rates of 93.33%. All flap donor sites were in normal function. For patient satisfaction: 53 patients were well satisfied, 21 were fairly satisfied and 1 was dissatisfied.Conclusion:Application of the island flap with dorsal branch of proper palmar digital nerve with fascio-pedicled in reconstruction of the defect of digital pulp has a high survival rate, simple surgical operation, good satisfactory outcome, with the digital artery being remained intact.

Tumor diseases have emerged as a major threat to human health.In this case,cancer hospitals must optimize patient experience while developing their facilities and medical resources.This paper takes the Huangpu Campus of Sun Yat-Sen University Cancer Center as an example to explore the strategies and practical effects of optimizing patient experience on the cam-pus from the perspective of peak experience.This hospital has successfully created high-quality peak experiences across multiple dimensions such as visual perception,trust,emotion,operations,efficiency,and lifestyle.The results indicated that Huangpu Hospital significantly improved patient satisfaction,medical resource expansion,operational efficiency,and social recognition.These achievements have validated the effectiveness of peak experience theory in the field of medical services,providing valuable insights for other hospitals.

OBJECTIVE To investigate the distribution characteristics and drug resistance of multidrug-resistant Acinetobacter baumannii(MDRAB)detected clinically in the Army 73rd Group Military Hospital in Xiamen,and to study the carrying conditions of drug-resistant gene-related insertion sequence elements(IS)and transposons(Tn)in the isolated strains of MDRAB.METHODS A total of 300 strains of Acinetobacter baumannii detected from inpatients admitted to the Army 73rd Group Military Hospital from Jan.2016 to Feb.2024 were collected.Automatic bacterial identification instruments and drug susceptibility tests were used for bacterial identi-fication and drug resistance analysis.Polymerase chain reaction(PCR)was employed to detect 6 Tn genetic mark-ers(merA,TnpU,TnpM,TnpR,TnpA21,TnpA7)and 3 IS genes(ISEcp1,ISCR1,IS26)in MDRAB strains.The detected IS and Tn-positive genes were subjected to sequencing and alignment verification.RESULTS Among 300 Acinetobacter baumannii strains,49(16.33％)were MDRAB.Most MDRAB strains were found in patients aged 75 and above(44.90％),mainly isolated from the brain center ICU(34.69％),critical care medi-cine ICU(20.41％),and respiratory medicine department(16.33％),sputum specimens accounted for the ma-jority(77.55％).MDRAB strains exhibited high drug resistance rates(≥97％)to cefpodoxime,nitrofurantoin,and aztreonam.MDRAB strains showed drug resistance rates＞80％to most antimicrobial agents,but were sensi-tive to polymyxin(12.24％)and tigecycline(28.57％).Compared with non-MDRAB strains,there were statisti-cally significant differences in drug resistance to common antimicrobial agents(P＜0.05).Among MDRAB strains,ISCR1,IS26,TnpU and TnpM genes were detected in IS and Tn,with detection rates of 51.02％,48.98％,51.02％and 22.45％,respectively.merA,TnpR,TnpA21,TnpA7 and ISEcp1 were not detected.CONCLUSIONS The drug resistance of Acinetobacter baumannii is severe,especially in elderly and criti-cally ill patients.The transmission of MDRAB strains may be associated with the genes ISCR1,IS26,TnpM and TnpU.

Sudden sensorineural hearing loss(SSNHL)is an idiopathic sensorineural hearing loss of at least 30 dB over three consecutive frequencies in less than 3 days.However,its pathogenesis is still unknown.Recent re-searches suggest that inflammation plays a very important role in its development and prognosis.For this reason,we reviewed the relationship between inflammation and SSNHL from the perspective of development and prognosis,and further discussed the role of inflammation in the pathogenesis of SSNHL.