Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective:To correlate the expression of interleukin-6 (IL-6), CD40 ligand (CD40L), and soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) with regulatory T lymphocyte (Treg)/helper T lymphocyte 17 (Th17) in children with immune thrombocytopenic purpura (ITP) and to assess their combined diagnostic value.Methods:A retrospective study was conducted involving 80 children with ITP (ITP group) and 80 healthy children undergoing routine health screenings (control group) at Jinhua Central Hospital from February 2023 to February 2024. The levels of IL-6, CD40L, and sTREM-1, along with the Treg/Th17 ratio, were compared between the two groups and among children with different degrees of ITP severity. The correlations between IL-6, CD40L, and sTREM-1 and the severity of ITP, as well as the Treg/Th17 ratio were analyzed. Additionally, the diagnostic value of the combined tests was evaluated.Results:The levels of IL-6, CD40L, and sTREM-1 in the ITP group were (46.53 ± 8.69) ng/L, (6.51 ± 1.51), and (18.76 ± 3.72) ng/L, respectively. These values in the ITP group were significantly higher than those in the control group [(11.72 ± 1.58) ng/L, (4.31 ± 1.25), (8.07 ± 1.34) ng/L, t = 35.25, 10.04, 24.18, all P < 0.001]. The Treg/Th17 ratio in the ITP group was (1.34 ± 0.41), which was significantly lower than that in the control group [(13.56 ± 2.87), t = 37.70, P < 0.001]. In children with severe ITP, the levels of IL-6, CD40L, and sTREM-1 were (56.39 ± 11.70) ng/L, (9.62 ± 1.78), and (24.72 ± 4.81) ng/L, respectively. For those with moderate ITP, the levels were (45.41 ± 8.27) ng/L, (6.38 ± 1.40), and (17.69 ± 3.56) ng/L, respectively. In children with mild ITP, the levels were (37.04 ± 6.32) ng/L, (5.11 ± 1.32), and (14.50 ± 3.04) ng/L. The Treg/Th17 ratio in children with mild ITP was (0.95 ± 0.26), which was significantly lower than that in the moderate (1.37 ± 0.40) and severe (2.88 ± 0.56) groups. All differences were statistically significant among the three groups ( F = 23.98, 42.57, 37.15, 122.23, all P < 0.001). The levels of IL-6, CD40L, and sTREM-1 were positively correlated with the severity of ITP ( r = 0.565, 0.542, 0.538) and negatively correlated with the Treg/Th17 ratio ( r = -0.572, -0.536, -0.532), with all correlations being statistically significant (all P < 0.001). The receiver operating characteristic curve analysis indicated that the area under the curve values for the individual diagnoses of IL-6, CD40L, and sTREM-1 were 0.779, 0.750, and 0.763, respectively. In contrast, the area under the curve value for the combined diagnosis was 0.951, which was greater than that for each individual marker ( Z = 1.924, 2.137, 2.015, P = 0.037, 0.026, 0.031). Conclusions:The levels of IL-6, CD40L, and sTREM-1 in children with ITP are substantially correlated with the severity of ITP and the Treg/Th17 ratio, demonstrating notable diagnostic efficacy for ITP. Notably, the combination of IL-6, CD40L, and sTREM-1 greatly enhances diagnostic value.

ADC189 is a novel drug of cap-dependent endonuclease inhibitor. In our study, its antiviral efficacy was evaluated in vitro and in vivo, and compared with baloxavir marboxil and oseltamivir. A first-in-human phase I study in healthy volunteers included single ascending dose (SAD) and food effect (FE) parts. In the preclinical study, ADC189 showed potent antiviral activity against various types of influenza viruses, including H1N1, H3N2, influenza B virus, and highly pathogenic avian influenza, comparable to baloxavir marboxil. Additionally, ADC189 exhibited much better antiviral efficacy than oseltamivir in H1N1 infected mice. In the phase I study, ADC189 was rapidly metabolized to ADC189-I07, and its exposure increased proportionally with the dose. The terminal elimination half-life (T_1/2) ranged from 76.69 to 98.28 hours. Of note, food had no effect on the concentration, clearance, and exposure of ADC189. It was well tolerated, with few treatment-emergent adverse events (TEAEs) reported and no serious adverse events (SAEs). ADC189 demonstrated excellent antiviral efficacy both in vitro and in vivo. It was safe, well-tolerated, and had favorable pharmacokinetic characteristics in healthy volunteers, supporting its potential for single oral dosing in clinical practice.
Humans ; Antiviral Agents/therapeutic use* ; Animals ; Male ; Adult ; Mice ; Female ; Endonucleases/antagonists & inhibitors* ; Influenza, Human/drug therapy* ; Young Adult ; Dibenzothiepins/pharmacology* ; Oseltamivir/pharmacology* ; Middle Aged ; Triazines/pharmacology* ; Thiepins/pharmacology* ; Influenza B virus/drug effects* ; Influenza A Virus, H1N1 Subtype/drug effects* ; Pyridines/pharmacology* ; Morpholines ; Pyridones

As a common clinical treatment technique, nasogastric tube insertion plays an important role in assisting in disease diagnosis and treatment, and promoting patient recovery. Nasogastric tubes currently used in clinical practice are packaged individually without accompanying sterile materials, hence additional materials need to be prepared before operation, which is complicated and prone to omission, consumes clinical manpower, and increases the proportion of departmental consumption. The operator needs to hold the nasogastric tube with one hand and place it with the other hand during operation, the lack of auxiliary tool for uniformly controlling the placement of gastric tubes may easily lead to tube failure due to patient intolerance, agitation, or uneven force exerted by the operator, and improper force may even result in violent tube placement, leading to adverse outcomes such as mucosal bleeding and aspiration into the airway. Medical staff of intensive care unit of department of infectious diseases of Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology have designed a nasogastric tube auxiliary pushing device and an intubation kit to overcome the above problems, and obtaining National Utility Model Patent of China (patent number: ZL 2024 2 0300856.X). The device consists of two parts: a nasogastric tube auxiliary pushing device and a nasogastric tube insertion kit. Nasogastric tube auxiliary pushing device mainly consists of a nasogastric tube with guide wire, a circular wire harness, and a booster base with a pushing element. The tube insertion kit includes sterile treatment trays, main placement slots, and other operational accessory slots. The new nasogastric tube auxiliary pushing device and tube insertion kit integrates packaging and portable design, providing stable and uniform assistance for safe insertion of nasogastric tubes by a single person, which is able to reduce the occurrence of complications, ensure patient safety, improve patient comfort, and reduce occupational exposure risks, making it suitable for clinical promotion.
Intubation, Gastrointestinal/methods* ; Equipment Design ; Humans

Lung cancer remains one of the most prevalent and lethal malignancies worldwide. The advancement of its precise diagnosis and therapeutic development urgently requires in vitro models that can highly recapitulate the pathophysiological characteristics of human tissues. Organ-on-a-chip has emerged as a novel technological platform that integrates microfluidic engineering, biomaterials, and other engineering strategies with organoid culture. This platform enables precise control over the cellular microenvironment, thereby closely mimicking the three-dimensional structure and physiological functions of human organs in vitro. Organ-on-a-chip systems demonstrate significant advantages in cancer research, developmental biology, and disease modeling, as they not only preserve the heterogeneity and pathological features of patient samples but also support co-culture of various cell types to reconstruct the tumor microenvironment (TME). However, standardized construction methods and integrated analytical strategies for this technology in lung cancer research remain to be further refined. This review systematically elaborates on the key technical principles of organ-on-a-chip and its recent advances in lung cancer modeling, drug screening, and immunotherapy research. It aims to provide a theoretical foundation and technical perspective for promoting the deeper application of organ-on-a-chip in precision medicine and translational research for lung cancer.
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Humans ; Lung Neoplasms/drug therapy* ; Organoids/drug effects* ; Lab-On-A-Chip Devices ; Animals ; Tumor Microenvironment

In recent years,significant breakthroughs have been achieved in the immunotherapy for Alzheimer's disease.In line with global advancements,two anti-amyloid-β monoclonal antibodies have been approved and successfully launched in China for clinical use.Lecanemab and Donanemab were officially used in June 2024 and April 2025 in China,respectively.In order to standardize the rational and safe application of anti-amyloid-β monoclonal antibodies for Alzheimer's disease in China,this article integrates recom-mendations from the clinical trials and real-world experience from the author's team and domestic peers to further update the recom-mendations for the clinical use of anti-amyloid-β monoclonal antibody based on the 2024 version.It includes indications for therapy,pre-treatment evaluation and preparation,administration protocols and safety measures during treatment,and post-treatment monitor-ing strategies.

Objective:To correlate the expression of interleukin-6 (IL-6), CD40 ligand (CD40L), and soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) with regulatory T lymphocyte (Treg)/helper T lymphocyte 17 (Th17) in children with immune thrombocytopenic purpura (ITP) and to assess their combined diagnostic value.Methods:A retrospective study was conducted involving 80 children with ITP (ITP group) and 80 healthy children undergoing routine health screenings (control group) at Jinhua Central Hospital from February 2023 to February 2024. The levels of IL-6, CD40L, and sTREM-1, along with the Treg/Th17 ratio, were compared between the two groups and among children with different degrees of ITP severity. The correlations between IL-6, CD40L, and sTREM-1 and the severity of ITP, as well as the Treg/Th17 ratio were analyzed. Additionally, the diagnostic value of the combined tests was evaluated.Results:The levels of IL-6, CD40L, and sTREM-1 in the ITP group were (46.53 ± 8.69) ng/L, (6.51 ± 1.51), and (18.76 ± 3.72) ng/L, respectively. These values in the ITP group were significantly higher than those in the control group [(11.72 ± 1.58) ng/L, (4.31 ± 1.25), (8.07 ± 1.34) ng/L, t = 35.25, 10.04, 24.18, all P < 0.001]. The Treg/Th17 ratio in the ITP group was (1.34 ± 0.41), which was significantly lower than that in the control group [(13.56 ± 2.87), t = 37.70, P < 0.001]. In children with severe ITP, the levels of IL-6, CD40L, and sTREM-1 were (56.39 ± 11.70) ng/L, (9.62 ± 1.78), and (24.72 ± 4.81) ng/L, respectively. For those with moderate ITP, the levels were (45.41 ± 8.27) ng/L, (6.38 ± 1.40), and (17.69 ± 3.56) ng/L, respectively. In children with mild ITP, the levels were (37.04 ± 6.32) ng/L, (5.11 ± 1.32), and (14.50 ± 3.04) ng/L. The Treg/Th17 ratio in children with mild ITP was (0.95 ± 0.26), which was significantly lower than that in the moderate (1.37 ± 0.40) and severe (2.88 ± 0.56) groups. All differences were statistically significant among the three groups ( F = 23.98, 42.57, 37.15, 122.23, all P < 0.001). The levels of IL-6, CD40L, and sTREM-1 were positively correlated with the severity of ITP ( r = 0.565, 0.542, 0.538) and negatively correlated with the Treg/Th17 ratio ( r = -0.572, -0.536, -0.532), with all correlations being statistically significant (all P < 0.001). The receiver operating characteristic curve analysis indicated that the area under the curve values for the individual diagnoses of IL-6, CD40L, and sTREM-1 were 0.779, 0.750, and 0.763, respectively. In contrast, the area under the curve value for the combined diagnosis was 0.951, which was greater than that for each individual marker ( Z = 1.924, 2.137, 2.015, P = 0.037, 0.026, 0.031). Conclusions:The levels of IL-6, CD40L, and sTREM-1 in children with ITP are substantially correlated with the severity of ITP and the Treg/Th17 ratio, demonstrating notable diagnostic efficacy for ITP. Notably, the combination of IL-6, CD40L, and sTREM-1 greatly enhances diagnostic value.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective:To investigate the clinical efficacy and safety of deep hyperthermia combined with sintilimab and nab-PC (albumin-bound paclitaxel + carboplatin) regimen in the treatment of advanced squamous non-small cell lung cancer (NSCLC) with driver gene negative and programmed death-1 receptor ligand 1 (PD-L1) expression positive.Methods:A prospective case-control study was performed. A total of 84 advanced squamous NSCLC patients with driver gene negative and PD-L1 expression positive in Hebei Seventh People's Hospital from January 2020 to December 2022 were collected, and all patients were divided into the observation group and the control group according to the random number table method, with 42 cases in each group. The control group was given the treatment of sintilimab combined with nab-PC regimen, and the observation group was given deep hyperthermia on the basis of the control group. After 4 consecutive cycles of treatment, the short-term efficacy of the two groups was compared. The levels of serum tumor markers [carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCCA), cytokeratin fragment 19 (CYFR21-1)], and the positive expression rates of immunohistochemistry markers [p40, p63, and cytokeratin 5/6 (CK5/6)] before and after treatment were compared between two groups. Functional Assessment of Cancer Therapy-Lung cancer module (FACT-L) scores, the adverse reactions and the long-term survival of the two groups were compared.Results:There were 26 males and 16 females in the observation group, and the age was (59±11) years; there were 22 males and 15 females in the control group, and the age was (58±11) years. The objective remission rate and the disease control rate were 71.43% (30/42), 90.48% (38/42), respectively in the observation group, and 50.00% (21/42), 80.95% (34/42), respectively in the control group; the objective remission rate in the observation group was higher than that in the control group, and the difference was statistically significant ( χ2 = 4.04, P = 0.044); and there was no statistically significant difference in the disease control rate of both groups ( χ2 = 1.56, P = 0.212). The levels of serum CEA, SCCA and CYFRA21-1, and the positive expression rates of p40, p63, and CK5/6 in the two groups after treatment were lower than those before treatment (all P < 0.05); and the scores of physiological status, functional status, additional concern in FACT-L scores and the total score of the scale after treatment were higher than those before treatment (all P < 0.05). There were no statistically significant differences in the incidence of adverse reactions including thrombocytopenia, neutropenia, leukopenia, anemia, fever of the two groups (all P > 0.05). The median progression-free survival (PFS) time was 6.5 months (95% CI: 3.82-12.75), 5.1 months (95% CI: 3.14-12.26),respectively in the observation group and the control group, and the difference in the median PFS time was statistically significantly of both groups ( χ2 = 4.21, P = 0.040). The median overall survival (OS) time was 12.9 months (95% CI: 6.25-15.46), 9.7 months (95% CI: 4.74-13.02), respectively in the observation group and the control group, and the difference in the median OS time was statistically significantly of both groups ( χ2 = 4.43, P = 0.035). Conclusions:Deep hyperthermia combined with sintilimab and nab-PC regimen in the treatment of advanced squamous NSCLC with driver gene negative and PD-L1 expression positive can effectively reduce the serum tumor markers levels and positive expression rate of immunohistochemical markers, improve the quality of life of patients, and increase the short-term and long-term efficacy.

The gastric fundus fornix and upper part of the gastric body pose challenges for endoscopic submucosal dissection (ESD), resulting in unsatisfactory resection outcomes for lesions in these areas,because of the difficulty in the endoscope reaching the lesion site. Drawing inspiration from the formation of α loop during flexible colonoscopy and double-channel multibending gastroscope, a single-channel treatment gastroscope was utilized to create a multibending state (referred to as single-channel endoscope multibending method, SCMB). This method was employed to treat 6 patients with lesions in the stomach at Digestive Endoscopy Center of Affiliated Hospital of Nanjing University of Chinese Medicine from June 2021 to December 2021. There were 3 cases in the gastric fundus fornix, 2 cases in the greater curvature on the upper part of the gastric body, and 1 case in the posterior wall of gastric fundus and subcardia. After 2-3 attempts during surgery, SCMB was successfully performed in all cases within 60-120 seconds. All 6 cases completed successful endoscopic resection within 20-80 minutes without significant complications, including 4 cases of ESD and 2 cases of endoscopic full-thickness resection (EFR). Preliminary results indicate that SCMB method during ESD and its derivative technologies are both safe and effective for lesions in challenging areas where gastric ESD is difficult to perform. During surgery, this approach facilitates the front end of endoscope access to the lesion, providing a clear visual field and a stable dissection plane.