The liver performs multiple life-sustaining functions. Hepatic diseases, including hepatitis, cirrhosis, and hepatoma, pose significant health and economic burdens globally. Along with the advances in nanotechnology, mesoporous silica nanoparticles (MSNs) exhibiting diversiform size and shape, distinct morphological properties, and favorable physico-chemical features have become an ideal choice for drug delivery systems and inspire alternative thinking for the management of hepatic diseases. Initially, we introduce the physiological structure of the liver and highlight its intrinsic cell types and correlative functions. Next, we detail the synthesis methods and physicochemical properties of MSNs and their capacity for controlled drug loading and release. Particularly, we discuss the interactions between liver and MSNs with respect to the passive targeting mechanisms of MSNs within the liver by adjusting their particle size, pore diameter, surface charge, hydrophobicity/hydrophilicity, and surface functionalization. Subsequently, we emphasize the role of MSNs in regulating liver pathophysiology, exploring their value in addressing liver pathological states, such as tumors and inflammation, combined with multi-functional designs and intelligent modes to enhance drug targeting and minimize side effects. Lastly, we put forward the problems, challenges, opportunities, as well as clinical translational issues faced by MSNs in the management of liver diseases.

Objective:To deeply understand the views of nurses on nursing robots, so as to provide reference for standardizing the application of nursing robots and promoting innovation in smart nursing service models.Methods:From March to June 2023, purposive sampling was used to select 15 registered nurses from two ClassⅢ general hospitals in Shanghai as research subjects for semi-structured interviews. Colaizzi 7-step analysis method was used to analyze interview data.Results:Three themes were extracted, including the perceived multiple benefits of nursing robots (obtaining work assistants, facilitating nursing safety, and promoting professional value recognition), the perceived multiple risks of nursing robots affecting patients (concerns about affecting patient safety, concerns about triggering negative emotions in patients, and concerns about functional limitations), and the perceived multiple dilemmas in the application of nursing robots (concerns about academic burden, concerns about changes in work patterns, concerns about unclear responsibilities, and concerns about affecting nursing positions) .Conclusions:Although nurses hold a positive attitude towards nursing robots and expect them to reduce their workload, nurses are also concerned that they may not be able to fully adapt to the clinical environment, pose potential risks to the physical and mental health of patients, and pose new challenges to nursing staff and work models. In the face of intelligent nursing, efforts should be made to strengthen professional training for nurses in information technology, improve nursing work models and processes, and perfect the rules and regulations for the application of intelligent products. Multiple parties should cooperate to create a smart nursing application ecosystem.

Background::The calcineurin inhibitor (CNI)-based immune maintenance regimen that is commonly used after renal transplantation has greatly improved early graft survival after transplantation; however, the long-term prognosis of grafts has not been significantly improved. The nephrotoxicity of CNI drugs is one of the main risk factors for the poor long-term prognosis of grafts. Sirolimus (SRL) has been employed as an immunosuppressant in clinical practice for over 20 years and has been found to have no nephrotoxic effects on grafts. Presently, the regimen and timing of SRL application after renal transplantation vary, and clinical data are scarce. Multicenter prospective randomized controlled studies are particularly rare. This study aims to investigate the effects of early conversion to a low-dose CNI combined with SRL on the long-term prognosis of renal transplantation.Methods::Patients who receive four weeks of a standard regimen with CNI + mycophenolic acid (MPA) + glucocorticoid after renal transplantation in multiple transplant centers across China will be included in this study. At week 5, after the operation, patients in the experimental group will receive an additional administration of SRL, a reduction in the CNI drug doses, withdrawal of MPA medication, and maintenance of glucocorticoids. In addition, patients in the control group will receive the maintained standard of care. The patients’ vital signs, routine blood tests, routine urine tests, blood biochemistry, serum creatinine, BK virus (BKV)/cytomegalovirus (CMV), and trough concentrations of CNI drugs and SRL at the baseline and weeks 12, 24, 36, 48, 72, and 104 after conversion will be recorded. Patient survival, graft survival, and estimated glomerular filtration rate will be calculated, and concomitant medications and adverse events will also be recorded.Conclusion::The study data will be utilized to evaluate the efficacy and safety of early conversion to low-dose CNIs combined with SRL in renal transplant patients.Trial registration::Chinese Clinical Trial Registry, ChiCTR1800017277.

Objective To investigate the expression change of cytokines in peripheral blood and intestinal mucosa in the patients with diarrhea post-infectious irritable bowel syndrome(PI-IBS) and its relation with clinical symptoms scores.Methods Thirty outpatients and inpatients with diarrhea PI-IBS(observation group) and contemporaneous 30 individuals undergoing physical examination(control group) in the Hainan Provincial People's Hospital from January to December 2013 were selected.The peripheral blood mononuclear cells(PBMC) were separated and cultured.Then the levels of IFN-y and IL-10 in peripheral blood and cell culture supernatant fluid were detected by ELISA.The colonic mucosal tissue was taken by coloscopy.Then colonic mucosal IFN-γ and IL-10 protein expression was detected by immunohistochemistry staining.Furthermore,the correlationship between the level change of IFN-γ and IL-10 with clinical symptom score was analyzed by using the Spearman correlation method.Results Peripheral blod IL-10 and IFN-γ levels had no statistical difference between the two groups(P＞0.05).Compared with the control group,in PBMC seperation and cuture,the IFN-γ level in the observation group was increased and IL-10 level was decreased,the difference was statistically signifieant(P＜0.01).The intestinal main symptom score in the observation group had the positive correlation with IFN-γ expression level of PBMC culture supernatant fluid and colonic mucosal IFN-γ expression level(r=0.45,0.94,P＜0.01),and had the negative correlation with IL-10 expression level(r=-0.52,-0.79,P＜0.01).Conclusion The unbalance of IFN-γ and IL-10 level could be involved in the pathogenesis of diarrhea PI-IBS,which can serve as the observation indicators of disease activity.

Colorectal cancer (CRC) is one of the leading causes of death worldwide. Thus, the development of new therapeutic targets for CRC treatment is urgently needed. SGK1 is involved in various cellular activities, and its dysregulation can result in multiple cancers. However, little is known about its roles and associated molecular mechanisms in CRC. In present study, we found that SGK1 was highly expressed in tumor tissues compared with peri-tumor samples from CRC patients. In vitro experiments revealed that SGK1 overexpression promoted colonic tumor cell proliferation and migration and inhibited cell apoptosis induced by 5-fluorouracil (5-FU), while SGK1 shRNA and inhibitors showed the inverse effects. Using CRC xenograft mice models, we demonstrated that knockdown or therapeutic inhibition of SGK1 repressed tumor cell proliferation and tumor growth. Moreover, SGK1 inhibitors increased p27 expression and promoted p27 nuclear accumulation in colorectal cancer cells, and p27 siRNAs could attenuate the repression of CRC cell proliferation induced by SGK1 inhibitors. Collectively, SGK1 promotes colorectal cancer development via regulation of CRC cell proliferation, migration and survival. Inhibition of SGK1 represents a novel strategy for the treatment of CRC.
Animals ; Apoptosis ; Cause of Death ; Cell Proliferation ; Colon ; Colorectal Neoplasms* ; Fluorouracil ; Heterografts ; Humans ; In Vitro Techniques ; Mice ; Repression, Psychology ; RNA, Small Interfering

[Objective]To study the clinical features and expressions of IL-17A,IFN-γ,and IL-10 in serum and intestinal mucosa of patients with post-infectious irritable bowel syndrome and non post-infectious irritable bowel syndrome.[Methods]44 diar?rhea-predominate IBS patients(21 with PI-IBS,23 with NPI-IBS)and 10 healthy controls were recruited in this study. Investigation questionnaires of GSRS,SAS,SDS were carried out to evaluate the gastrointestinal function,anxiety status and depression status of IBS patients. The expressions of IL-17A,IFN-γ,and IL-10 in intestinal mucosa and serum were measured by immunohistochemis?try(IHC)and enzyme-linked immunosorbent assay(ELISA).[Results]The SDS scores of NPI-IBS patients were higher than those of controls(P<0.05),and the SAS and SDS scores of PI-IBS patients were higher than those of controls(P<0.05). The GSRS, SAS and SDS scores of PI-IBS group were higher than those of NPI-IBS group(P<0.05). Compared with healthy controls,PI-IBS and NPI-IBS group showed significant rise of IL-17A,IFN-γlevels and decrease of IL-10 level in intestinal mucosa(P<0.05);In serum,the IL-17A levels were up-regulated and the IL-10 levels were decreased in PI-IBS group but not in NPI-IBS group when compared with controls(P<0.05). In intestinal mucosa and serum,IL-17A and IFN-γlevels in PI-IBS group were slightly higher than those in NPI-IBS group(P > 0.05).[Conclusion]PI-IBS and NPI-IBS patients existed various anxiety and depression. The levels of IL-17A and IFN-γ increased and level of IL-10 decreased in PI-IBS and NPI-IBS group. But the clinical symptoms and changes of cytokines of PI-IBS patients were more significant. There may exist other pathogenesis in PI-IBS but not in NPI-IBS.

Objective:To investigate the phenotype and function of the intestinal γδT lymphocytes in post-infectious irritable bowel syndrome mouse model. Methods:The mouse model for post-infectious irritable bowel syndrome was established by the infection with trichinella spiralis. The intestinal inflammation,abdominal withdrawal reflex( AWR) and colon transportation test were observed. 2 and 8 weeks later,the animals were sacrificed and the lymphocytes in the intestinal lymph nodes and spleen were collected,from which the γδT lymphocytes were isolated and purified by monoclonal antibody-immuno-microbeads method. The functions of the purified γδT lymphocytes were evaluated,including proliferation by 3 HTdR;CD69,CD62L molecule staining by flow cytometry. Furthermore,the con-centration of cytokine IL-17 and IFN-γ in the supernatant of the cultured γδT lymphocytes were detected by ELISA. Results: At 2nd weeks after infection,significant intestinal inflammation was observed,with increasingγδT lymphocytes,proliferating and activating with increasing production of IL-17. At 8th weeks after infection, the intestinal inflammation disappeared, whereas the number of γδT lymphocytes remained increasing,also with proliferating and activating with increasing production of IL-17. Meanwhile,the mice show higher AWR score and Bristol score. Conclusion: γδT lymphocytes could participate in the pathogenesis of PI-IBS via their proliferation,activation and production of IL-17.

Objective To analyze and evaluate the joint teaching of subspeciahy teachers in the application of diagnostics probation.Methods 293 clinical medical undergraduates of Grade 2009 were randomly divided into experimental group(the joint subspeciahies teaching group,n=153) and control group(traditional teaching group,n=140).The two groups of students were divided into the 14-16 study group.The diagnostics probation teaching content(all general physical examination and ECG examination)was decomposed in the experiment group and students were taught by different subspecialties teachers while the students of the control group were taught by a teacher of internal medicine.The final examination grades and operative performance of the two groups were compared,evaluated and U tested.At the same time the questionnaire smvey was conducted to the students in the experimental group.Results The experimental group's theory examination score was (75.2 ± 8.9) and the operative assessment score was (88.5 ± 6.2),higher than that in the control group(70.9 ± 10.7 and 84.6 ± 5.5),the difference was statistically significant(P=0.001).The questionnaire results showed 92.8％(142/153)medical students improved their clinical skill,86.9％(133/153) medical students were satisfied with the joint teaching of subspecialty teachers.Conclusions The subspecialty teachers' joint teaching can improve students' clinical practice ability.It is a valuable teaching method in diagnostics teaching.

ObjectiveTo evaluate the result of problem-based learning combined with Casebased learning teaching model in the clinical probation of digestive medicine.MethodsPBL combined CBL teaching method and traditional teaching method were used respectively among 120 medical students who were divided into two groups randomly. Educational effects were evaluated through examination and ques-tionnaire.Results The PBL combined CBL group test scores are significantly higher than traditional teaching group ( P＜0.05 ).96.4％ students thought it was necessary to have PBL combined CBL teaching.ConclusionsPBL combined CBL teaching method is an effective teaching method for medical students.

Objective To investigate the effect of curcumin on chronic pancreatitis in rat.Methods Eighteen one-month old male SD rats were randomly divided into control group,ANP group and curcumin group with 6 rats in each group.After fed by 25％ alcohol for twelve weeks,the rats in ANP group were intraperitoneally injected with lipopolysaccharides ( LPS,2 mg/kg body weight) once a week for 4 weeks.The rats in curcumin group were fed with curcumin when they were intraperitoneally injected with lipopolysaccharides.Seventeen weeks later,the rats were sacrificed.Serum glucose was measured,pancreatic morphology was routinely examined,collagen deposition was determined by Masson stain,and the amylase and lipase in pancreatic tissue were evaluated,TGF-β1 mRNA was determined by using RT-PCR.Results The pathological score of control group,ANP group and curcumin group was 1.17 ±0.41,7.33 ±2.58 and 3.50 ± 1.05,and the score in curcumin group was lower than that of ANP group (P ＜ 0.01 ),but which was higher than that in control group (P ＜ 0.05 ).There was no difference in the serum glucose among the groups.The levels of amylase and lipase in pancreatic tissue were (7348 ± 102 ),( 14135 ± 1272) U/g,which were significantly higher than those in ANP group[( 5428 ± 547 ) and (9123 ± 1250 ) U/g,P ＜ 0.05].The expressions of TGF β1 mRNA in control group,ANP group and curcumin group were 0.618 ± 0.019,0.818 ±0.012,0.745 ±0.088,and the values in ANP group were significantly higher than those in control group and curcumin group (P ＜ 0.01 ).Conclusions On the basis of long term ethanol intake,repeatedly intraperitoneal injection of LPS can induce chronic pancreatitis,and curcumin has anti-fibrosis effect possibly by its inhibitory effect on the expression of TGF-β1.