ObjectiveTo evaluate the efficacy and safety of Janus kinase （JAK） inhibitors combined with Chinese herbal medicine （CHM） in treating rheumatoid arthritis （RA）. MethodsClinical data from 169 RA patients were retrospectively collected. Among them， 71 cases received JAK inhibitors as the control group， while 98 cases received JAK inhibitors plus CHM as the observation group， both treated for 24 weeks. The rheumatoid factor （RF）， cyclic citic peptide antibody （anti-CCP）， erythrocyte sedimentation rate （ESR）， C-reactive protein （CRP）， and white blood cell count （WBC） were recorded before and after treatment. Databases including CNKI， Wanfang， VIP， PubMed and Web of Science were searched from inception till August 31st， 2025 for randomized controlled trials （RCTs） on the combined use of JAK inhibitors and CHM for RA. The methodological quality of the included studies was evaluated using the risk of bias assessment tool. Meta-analyses were performed for RF， anti-CCP， ESR， CRP， 28-joint disease activity score （DAS28）， overall clinical effective rate， and incidence of adverse events. Sensitivity analysis were also performed. ResultsThe retrospective study demonstrated that after treatment， ESR， CRP， and anti-CCP levels decreased in the observation group， while ESR and CRP levels decreased in the control group （P＜0.05）. Moreover， ESR and RF levels in the observation group were lower than those in the control group （P＜0.05）. A total of 9 RCTs involving 770 patients were included in the meta-analysis. The results indicated that the JAK inhibitors plus CHM group was superior to the JAK inhibitors group in reducing RF （MD=-8.97， 95%CI -15.01 to -2.94， P=0.004）， CRP （MD=-3.34， 95%CI -3.82 to -2.86， P＜0.001）， ESR （MD=-5.33， 95%CI -7.98 to -2.69， P＜0.001）， and DAS28 score （MD=-0.54， 95%CI -0.74 to -0.34， P＜0.001）， as well as in improving the overall clinical effective rate （OR=4.53， 95%CI 2.55 to 8.03， P＜0.001）. No statistically significant differences were observed between groups in anti-CCP levels （SMD=-2.08， 95%CI -4.41 to 0.24， P=0.080） or incidence of adverse events （OR=0.93， 95%CI 0.55 to 1.57， P=0.790）. ConclusionThe combination of JAK inhibitors and CHM demonstrates remarkable efficacy in treating RA， contributing to improved disease activity and reduced inflammatory markers with a favorable safety profile.

Objective:To qualitatively and quantitatively compare and evaluate the application of the Fast BLADE sequence and the conventional BLADE sequence in 3T magnetic resonance (MR) liver T2-weighted imaging (T2WI).Methods:A total of 72 patients who underwent liver MR examination at the Chongqing People′s Hospital from December 2023 to July 2024 were selected. All patients underwent liver magnetic resonance imaging (MRI) scanning using a 3T MR scanner, including both the Fast BLADE sequence and the conventional BLADE sequence. The total imaging time of the two sequences was recorded. Two observers used a " 5-point scale" to evaluate the overall image quality, motion artifacts, and radial artifacts of the Fast BLADE and conventional BLADE sequences respectively, and measured the image signal-to-noise ratio (SNR) at the same spatial position in the two groups of images. Statistical analysis was used to evaluate the differences in imaging time and image quality between the Fast BLADE sequence and the conventional BLADE sequence in liver T2WI imaging.Results:The imaging time of the Fast BLADE sequence in liver T2WI imaging was significantly shorter than that of the conventional BLADE sequence ( P<0.01), and the image SNR was significantly higher than that of the conventional BLADE sequence ( P<0.01). The overall image quality, motion artifact reduction, and radial artifact reduction of the Fast BLADE sequence were all superior to those of the conventional BLADE sequence (all P<0.05). The Kappa coefficients for the consistency of the two observers′ evaluations on overall image quality, motion artifacts, and radial artifacts were 0.78, 0.66, and 0.71 respectively. Conclusions:The Fast BLADE sequence can shorten the imaging time and provide images with higher SNR, and thus can replace the conventional BLADE sequence for liver T2WI imaging.

Objective:To qualitatively and quantitatively compare and evaluate the application of the Fast BLADE sequence and the conventional BLADE sequence in 3T magnetic resonance (MR) liver T2-weighted imaging (T2WI).Methods:A total of 72 patients who underwent liver MR examination at the Chongqing People′s Hospital from December 2023 to July 2024 were selected. All patients underwent liver magnetic resonance imaging (MRI) scanning using a 3T MR scanner, including both the Fast BLADE sequence and the conventional BLADE sequence. The total imaging time of the two sequences was recorded. Two observers used a " 5-point scale" to evaluate the overall image quality, motion artifacts, and radial artifacts of the Fast BLADE and conventional BLADE sequences respectively, and measured the image signal-to-noise ratio (SNR) at the same spatial position in the two groups of images. Statistical analysis was used to evaluate the differences in imaging time and image quality between the Fast BLADE sequence and the conventional BLADE sequence in liver T2WI imaging.Results:The imaging time of the Fast BLADE sequence in liver T2WI imaging was significantly shorter than that of the conventional BLADE sequence ( P<0.01), and the image SNR was significantly higher than that of the conventional BLADE sequence ( P<0.01). The overall image quality, motion artifact reduction, and radial artifact reduction of the Fast BLADE sequence were all superior to those of the conventional BLADE sequence (all P<0.05). The Kappa coefficients for the consistency of the two observers′ evaluations on overall image quality, motion artifacts, and radial artifacts were 0.78, 0.66, and 0.71 respectively. Conclusions:The Fast BLADE sequence can shorten the imaging time and provide images with higher SNR, and thus can replace the conventional BLADE sequence for liver T2WI imaging.

Currently,the ethical review model for organ donation and transplantation in domestic hospitals is generally characterized by suddenness,unpredictability,tight time,difficulty in convening meetings and training committee members,as well as generally low quality and efficiency of ethical review,which cannot meet clinical needs and cause the waste of some scarce resources.The team of the Clinical Application Center of Human Organ Transplantation and the Ethics Committee of the First People's Hospital of Kunming combine more than 10 years of review practice experience,as well as continuously explore and optimize the ethical review process and operating procedures for organ donation and transplantation.The special application has been approved and jointly developed with Soochow University and the Medical Ethics Committee of Fujian Province to build a full-process information software system management platform for organ ethical review of donation and transplantation,giving the full play the advantages of the review information system in improving work efficiency and review quality,facilitating full-process information management,and conducting online training and learning for committee members,with a view to providing a specialized practical model for addressing the difficulties and challenges related to ethical review of human organ donation and transplantation.

Objective To establish a UHPLC method for the determination of zolpidem tartrate tablets after radiation, and to investigate the effect of different radiation doses on the content of zolpidem tartrate tablets. Methods Ultra high performance liquid chromatography was used. The content of zolpidem tartrate tablets irradiated by γ-ray was determined. Using C₁₈ column, acetonitrile methanol-0.05 mol/L phosphoric acid solution (the pH value as 5.5 with triethylamine) (18∶26∶56) was used as the mobile phase. The flow rate was 0.7 ml/min, and the detection wavelength was 254 nm. Results The method validation showed good linearity in the concentration range of 5-80 μg/ml (r=0.999 6); The average recovery was 98.2%, RSD was 1.72%, and the repeatability was 0.87%. The contents of zolpidem tartrate were 105.1%, 106.4%, 102.7% and 105.4% under 0, 8, 25 and 80 kGy radiation. Conclusion UHPLC has accurate results with short analysis cycle in this study. It is suitable for the determination of zolpidem tartrate tablets after radiation. The content of zolpidem tartrate tablets remained basically unchanged after radiation.

Objective:To evaluate the effect of tropisetron on pyroptosis in cardiomyocytes subjected to hypoxia-reoxygenation (H/R) and the relationship with α7 nicotinic acetylcholine receptor (α7nAChR).Methods:Routinely cultured H9C2 cardiomyocytes were divided into 4 groups ( n=6 each) using a random number table method: control group (C group), H/R group, tropisetron plus H/R group (Tro+ H/R group), and α7nAchR antagonist MLA plus tropisetron plus H/R group (MLA+ Tro+ H/R group). H/R was produced by 12 h exposure of cells to hypoxia followed by 6 h reoxygenation in the other three groups except group C. Tropisetron at the final concentration of 10 nmol/L was added at 1 h before hypoxia in group Tro+ H/R.In group MLA+ Tro+ H/R, MLA was added at 2 h before hypoxia, and then 1 h later tropisetron at the final concentration of 10 nmol/L was given.At 6 h of reoxygenation, the pyroptosis rate of cardiomyocytes was determined by fluorescence immunostaining of caspase-1-AlexaFluor 488/DAPI, the concentrations of interleukin-1beta (IL-1β) and IL-18 in the supernatant were determined by enzyme-linked immunosorbent assay, the activity of LDH in the supernatant was measured by 2, 4 dinitrophenylhydra-zine colorimetric method, and the expression of α7nAchR, NLRP3 and caspase-1 in cardiomyocytes was detected by Western blot. Results:Compared with group C, the pyroptosis rate, activity of LDH and concentrations of IL-1β and IL-18 in the supernatant were significantly increased, the expression of NLRP3 and caspase-1 was up-regulated, and the expression of α7nAchR was down-regulated in group H/R ( P<0.05). Compared with group H/R, the pyroptosis rate, activity of LDH and concentrations of IL-1β and IL-18 in the supernatant were significantly decreased, the expression of NLRP3 and caspase-1 was down-regulated, and the expression of α7nAchR was up-regulated in group Tro+ H/R ( P<0.05). Compared with group Tro+ H/R, the pyroptosis rate, activity of LDH and concentrations of IL-1β and IL-18 in the supernatant were significantly increased, the expression of NLRP3 and caspase-1 was up-regulated, and the expression of α7nAchR was down-regulated in group MLA+ Tro+ H/R ( P<0.05). Conclusion:α7nAchR is involved in the process of tropisetron inhibiting pyroptosis in cardiomyocytes subjected to H/R.

Currently, the epidemic of 2019 coronavirus disease (COVID-19) is still ongoing. The characteristics including high contagiousness, herd susceptibility and clinical phenotype diversity, made a serious influence on people’s daily life and rountine therapy for other diseases. Breast dieases are clinical common diseases. In the central epidemic area of COVID-19, Hubei province, especially Wuhan, the clinical specialists of breast diseases should consider all of the following factors comprehensively: the prevention of COVID-19, the diagnosis and treatment of breast diseases and the accessibility of medical resources. Besides, we should select the appropriate therapy and optimize treatment process so as to prevent the propagation and cross infection of COVID-19 as well as manage the breast diseases without delay. Therefore, we carried out some management proposals of the patients with breast diseases in the central epidemic area during the epidemic of COVID-19 on the basis of conventional treatment guidelines and clinical experiences. The suggestions and corrections from colleagues will be welcomed.

OBJECTIVE: To investigate the effect of exosomes derived from Epstein-Barr virus (EBV)-positive nasopharyngeal carcinoma (NPC) cells on lymphangiogenesis and lymph node metastasis of NPC. METHODS: Exosomes from NP69 cells and EBV-positive HK1 (HK1-EBV) cells were obtained by ultracentrifugation and identified by Western blotting and nanoparticle tracking analysis. Dio dye phagocytosis test was performed to observe exosome uptake by lymphatic endothelial cells. Lymphatic endothelial cells were treated with exosomes from nasopharyngeal epithelium (NP69), HK1-EBV, and C666-1 cells or exosome-free supernatant of HK1-EBV and C666-1 cells, and tube formation and migration of the cells were observed. In a nude mouse model of popliteal lymph node metastasis of NPC, the effects of normal saline, NP69 cell-derived exosomes, HK1-EBV cell-derived exosomes, exosome-free supernatant of HK1-EBV cells, and HK1-EBV exosome-free supernatant protein on lymphangiogenesis and lymph node metastasis of the tumor were observed. RESULTS: The exosomes obtained by ultracentrifugation contained abundant exosome-specific proteins and showed a normal size range. The exosomes from NPC cells and NP69 cells could be taken up by lymphatic endothelial cells. Compared with the blank control and exosomes form NP69 cells, exosomes derived from HK1-EBV and C666-1 cells significantly promoted tube formation and migration of lymphatic endothelial cells ( CONCLUSIONS Exosomes from EBV-positive NPC cells can significantly promote lymphangiogenesis and lymph node metastasis of NPC.
Animals ; Cell Line, Tumor ; Endothelial Cells ; Epstein-Barr Virus Infections ; Exosomes ; Herpesvirus 4, Human ; Humans ; Lymphangiogenesis ; Lymphatic Metastasis ; Mice ; Mice, Nude ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms

Objective To explore the application effects of Mini-Clinical Evaluation Exercise (Mini-CEX) teaching model in the training of emergency nursing in higher vocational education. Methods A total of 112 nursing students from nursing major Grade 2014 of He'nan Medical College were selected by convenient sampling method and divided into the experimental group (n=57) and the control group (n=55). The control group adopted the traditional method of the individual skill operation, while the experimental group adopted the Mini-CEX teaching method. Practical training assessment, Mini-CEX scale and Chinese Version of Critical Thinking Disposition Inventory(CTDI-CV) were applied to evaluate the nursing students of the two group. Results After training, the result of practical training assessment of the experimental group was better than that of the control, and the difference was statistically significant (P<0.001); the score of each dimension of Mini-CEX scale of the experimental group was higher than that of the control group, and the difference was statistically significant (P< 0.001); the total score and scores of all dimensions of CTDI-CV of the experimental group were higher than those of the control group, and the differences were statistically significant (P<0.05). Conclusions The application of Mini-CEX not only enhances practical skills, but also improves the nursing students' critical thinking ability, which provides reference for the training of high quality nursing personnel.

Objective: To analyze the clinicopathological characteristics of papillary thyroid microcarcinoma (PTMC) and risk factors for central lymph node metastasis(CLNM) in PTMC. Methods: The data of 900 patients with PTMC initially treated in our hospital from January 2004 to December 2015 were retrospectively analyzed. Chi-square test and Logistic regression analysis were performed to determine the risk factors for CLNM. Results: CLNM affected 162 (22.9%) of 707 patients treated with central lymph node dissection. Age, maximum tumor size, multifocality, bilaterality, and extracapsular spread (ECS) were significantly correlated with CLNM (all P<0.01). Age<45 years, maximum tumor size>5 mm, multifocality, bilaterality, and extracapsular spread were independently correlated with CLNM. Conclusion A prophylactic central lymph node dissection should be considered in PTMC patients with age<45 years, maximum tumor size>5 mm, multifocality, bilaterality, and extracapsular spread.