Irritable bowel syndrome （IBS） is a functional bowel disorder characterized primarily by abdominal pain and altered defecation habits. In recent years， traditional Chinese medicine （TCM） has made progress in multiple aspects of IBS research and treatment， including syndrome distribution， development of TCM formulas， clinical efficacy evaluation， external therapies， and psychosocial regulation. However， it still faces challenges such as over-reliance on symptomatic manifestations rather than biomarkers for diagnostic criteria， and the lack of high-quality evidence-based data supporting the efficacy of TCM formulas in treating IBS. This paper proposed that TCM diagnosis and treatment of IBS should adhere to the strategy of integrating the holistic concept with syndrome differentiation and treatment， combining TCM external therapies such as acupuncture， moxibustion and acupoint application）， and emphasizing individualized diagnosis and treatment for psychosomatic abnormalities. Future research should integrate multi-omics technologies， artificial intelligence and other methods to deepen the understanding of the pathogenesis of IBS and the mechanisms of TCM formulas， so as to promote the standardization and internationalization of TCM in the diagnosis and treatment of IBS.

Objective To evaluate the efficacy and safety of biomaterial sling in the treatment of female stress urinary incontinence (SUI), so as to explore the possibility of replacing traditional synthetic materials with biomaterials in SUI surgery. Methods Clinical data of 22 SUI patients undergoing retropubic mid-urethral sling surgery in our hospital during Jan.and Dec.2023 were retrospectively collected. Perioperative parameters were analyzed, and all patients were followed up for more than one year. The quality of life was assessed using the incontinence impact questionnaire-short form-7 (IIQSF-7), numerical rating scale (NRS), and urogenital distress inventory-short form-6 (UDI-6). Results All 22 operations were successfully completed. The follow-up was 13-25 (mean 15.2±4.6) months, operation time (47.0±11.1) minutes, hospital stay (0.8± 0.2) days, and pain duration (6.1±4.9) days. One year after surgery, all patients'NRS, IIQSF-7 and UDI-6 scores were significantly reduced (P<0.001). One week after surgery, all patients were improved. No sling exposure or urinary tract infection was found during the follow-up. Conclusion Biomaterial sling is an effective and relatively safe method for the treatment of female SUI, demonstrating satisfactory short-term outcomes. However, the long-term effects still need further research.

Objective:To design a multi-epitope antigen of norovirus(NoV)based on bioinformatics technology and to pre-pare and characterize it.Methods:Bioinformatics methods were used to construct and analyze the NoV multi-epitope antigen NoV-ZH.Recombinant proteins were prepared and characterized by prokaryotic expression system,and monoclonal antibodies were prepared by animal immunization and hybridoma technology,and initially applied in colloidal gold platform.Results:The designed multi-epitope antigen had a large proportion of random curls in the secondary structure,with theoretical molecular mass and isoelectric point(PI)of 13.1 ku and 7.16,which were stable and hydrophilic.It had good immunogenicity and could activate humoral and cellular immune re-sponses.The proteins prepared by ligating pET-28a(+)and pET-32a vectors with antigenic sequences were expressed as inclusion body proteins and soluble proteins,respectively.A pair of paired antibodies was obtained by animal immunization and hybridoma tech-nique,and applied to colloidal gold test strips with a sensitivity of 0.5 ng/ml,and the test strips could specifically bind two genotypes of NoV recombinant capsid proteins.Conclusion:The successful preparation and characterization of multi-epitope antigen of norovirus provides a reference for the subsequent exploration of NoV universal detection targets and the development of diagnostic raw materials.

Objective:To investigate the predictive value of preoperative lymphocyte-to-monocyte ratio (LMR) combined with platelet-to-lymphocyte ratio (PLR) (LMR-PLR) scoring model for prognosis of pancreatic ductal adenocarcinoma (PDAC) after radical resection.Methods:The retrospective cohort study was conducted. The clinicopathological data of 116 patients with PDAC who were admitted to the Second Hospital of Lanzhou University from January 2015 to December 2019 were collected. There were 73 males and 43 females, aged 61.5(range, 29.0-75.0)years. All patients underwent radical resection for PDAC. Observation indicators: (1) optimal cut-off value of LMR and PLR; (2) clinicopathological features of patients with different scores of preoperative LMR-PLR scoring model; (3) follow-up and survival; (4) influencing factors for prognosis of PDAC patients; (5) construction and verification of nomogram prediction model. Measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data was conducted using the Mann-Whitney U test. The Graphpad prism 8 was used to draw survival curve, the Kaplan-Meier method was used to calculate survival rate, and the Log-Rank test was used for survival analysis. The COX proportional hazard regression model was used for univariate and multivariate analyses. The X-tile software was used to determine the optimal cut-off values of LMR and PLR. The nomogram prediction model was conducted based on the results of multivariate analysis, and the receiver operating characteristic (ROC) curve was drawn. The area under curve (AUC) was used to evaluate the discrimination of nomogram prediction model. The calibration curve was used to evaluate the consistency of nomogram prediction model and the decision curve was used to evaluate the clinical benefits. Results:(1) Optimal cut-off value of LMR and PLR. The optimal cut-off values of LMR and PLR were 1.9 and 156.3. (2) Clinicopathological features of patients with different scores of preoperative LMR-PLR scoring model. Cases with LMR-PLR scoring as 0, 1, 2 were 11, 42, 63. Cases with CA125 <12.4 U/mL, cases postoperative with vascular invasion, cases with postoperative chemotherapy in patients with 0, 1, 2 of LMR-PLR scoring were 1, 8, 24, 9, 27, 27, 3, 26, 43, showing significant differences among them ( χ2=6.73, 8.37, 6.68, P<0.05). (3) Follow-up and survival. All 116 patients were followed up for 39(range, 2-86)months. The 1-, 2-, 3-year survival rate of 116 PDAC patients was 50.9%, 37.9%, 19.3%, respectively, with a survival time of 13(range, 1-85)months. The survival time of patients with LMR-PLR scoring as 0, 1, 2 was 3(range, 1-9)months, 7(range, 2-56)months, 26(range, 2-85)months, respectively, showing a significant difference among them ( χ2=48.78, P<0.05). (4) Influencing factors for prognosis of PDAC patients. Results of multivariate analysis showed that carcinoembryonic antigen (CEA), CA19-9, LMR-PLR score, tumor diameter were independent factors affecting prognosis of patients ( hazard ratio=1.61, 1.88, 0.27, 1.87, 95% confidence interval as 1.02-2.54, 1.18-3.00, 0.19-0.39, 1.13-3.09, P<0.05). (5) Construction and verification of nomogram prediction model. The nomogram prediction model was constructed based on CEA, CA19-9, LMR-PLR score and tumor diameter. The AUC of ROC curve in predicting 1-, 2-, 3-year survival rate of patients was 0.86 (95% confidence interval as 0.79-0.93, P<0.05), 0.86 (95% confidence interval as 0.79-0.92, P<0.05), 0.87 (95% confidence interval as 0.78-0.95, P<0.05), respectively. Results of calibration curve showed that the predicted survival rate of nomogram prediction model was consistent with the actual survival rate, with the consistency index as 0.74. Results of decision curve showed that the predictive performance of nomogram prediction model was superior to that of a single factor at a risk threshold of 0.12-0.85. Conclusions:CEA, CA19-9, LMR-PLR score, tumor diameter are independent factors affecting prognosis of patients undergoing radical resection for PDAC, and the nomogram prediction model can predict postoperative survival rate. The predicted survival rate of nomogram prediction model is consistent with the actual survival rate, and the predictive performance of nomogram prediction model is superior to that of a single factor at a risk threshold of 0.12-0.85.

This study aimed to explore key quality control factors that affected the prognosis of intensive care unit (ICU) patients in Chinese mainland over six years (2015-2020). The data for this study were from 31 provincial and municipal hospitals (3425 hospital ICUs) and included 2 110 685 ICU patients, for a total of 27 607 376 ICU hospitalization days. We found that 15 initially established quality control indicators were good predictors of patient prognosis, including percentage of ICU patients out of all inpatients (%), percentage of ICU bed occupancy of total inpatient bed occupancy (%), percentage of all ICU inpatients with an APACHE II score ⩾15 (%), three-hour (surviving sepsis campaign) SSC bundle compliance (%), six-hour SSC bundle compliance (%), rate of microbe detection before antibiotics (%), percentage of drug deep venous thrombosis (DVT) prophylaxis (%), percentage of unplanned endotracheal extubations (%), percentage of patients reintubated within 48 hours (%), unplanned transfers to the ICU (%), 48-h ICU readmission rate (%), ventilator associated pneumonia (VAP) (per 1000 ventilator days), catheter related blood stream infection (CRBSI) (per 1000 catheter days), catheter-associated urinary tract infections (CAUTI) (per 1000 catheter days), in-hospital mortality (%). When exploratory factor analysis was applied, the 15 indicators were divided into 6 core elements that varied in weight regarding quality evaluation: nosocomial infection management (21.35%), compliance with the Surviving Sepsis Campaign guidelines (17.97%), ICU resources (17.46%), airway management (15.53%), prevention of deep-vein thrombosis (14.07%), and severity of patient condition (13.61%). Based on the different weights of the core elements associated with the 15 indicators, we developed an integrated quality scoring system defined as F score=21.35%xnosocomial infection management + 17.97%xcompliance with SSC guidelines + 17.46%×ICU resources + 15.53%×airway management + 14.07%×DVT prevention + 13.61%×severity of patient condition. This evidence-based quality scoring system will help in assessing the key elements of quality management and establish a foundation for further optimization of the quality control indicator system.
Humans ; China/epidemiology* ; Cross Infection/epidemiology* ; Intensive Care Units/statistics & numerical data* ; Quality Control ; Quality Indicators, Health Care/statistics & numerical data* ; Sepsis/therapy* ; East Asian People/statistics & numerical data*

【Objective】 To investigate the role of microRNA-218 (miR-218) in regulating prostate cancer (PCa) cell stemness and epithelial-mesenchymal transition (EMT). 【Methods】 PCa cell line stably overexpressing miR-218 was constructed with lentivirus transfection. The expression of miR-218 was detected with real-time fluorescence quantitative polymerase chain reaction (q-PCR). The migration ability was detected with Transwell assay. The expression of EMT related proteins were detected with Western blot. The properties of cells were determined with colony formation and tumor sphere formation assays. 【Results】 The results of q-PCR showed that the mRNA level of miR-218 was significantly lower in PCa cell lines LNCaP and C4-2 than in BPH-1. Transwell assay showed that miR-218 inhibited the migration of PCa cells. Western blot showed that the expression of EMT related proteins were inhibited by miR-218. Colony formation and tumor sphere formation assays showed that overexpression of miR-218 significantly inhibited the properties of cells. 【Conclusion】 The expression of miR-218 is downregulated in PCa cell lines. miR-28 can inhibit cell migration, EMT and cancer stem cell properties.

Objective To investigate the predictive value of preoperative fibrinogen/albumin ratio (FAR) and systemic immune inflammation index (SII) on the postoperative prognosis of patients with pancreatic ductal adenocarcinoma. Methods An ROC curve was used in determining the best cutoff values of FAR and SII and then grouped. The Cox proportional hazards model was used in analyzing the prognostic factors of radical pancreatic cancer surgery, and then a Nomogram prognostic model was established. C-index, AUC, and calibration curve were used in evaluating the discrimination and calibration ability of the Nomogram. DCA curves were used in assessing the clinical validity of the Nomograms. Results The optimal cutoff values for preoperative FAR and SII were 0.095 and 532.945, respectively. FAR≥ 0.095, SII≥ 532.945, CA199≥ 450.9 U/ml, maximum tumor diameter≥ 4 cm, and the absence of postoperative chemotherapy were independent risk factors for the poor prognosis of pancreatic cancer (P<0.05). The discrimination ability, calibration ability, and clinical effectiveness of Nomogram prognostic model were better than those of the TNM staging system. Conclusion The constructed Nomogram prognostic model has higher accuracy and level of discrimination and more clinical benefits than the TNM staging prognostic model.

Objective To study thO application valuO of ultrasound guidOd-corO nOOdlO biopsy(US-CNB) in thO diagnosis of brOast lOsions.Methods From January 2016 to April 2018,51 patiOnts with brOast massOs who undOrwOnt US-CNB in thO POoplO′s Hospital of TongchOng wOrO sOlOctOd. ThO pathological rOsults aftOr surgOry wOrO usOd as thO gold standard, and thO puncturO succOss ratO, sOnsitivity, spOcificity and accuracy of US -CNB wOrO analyzOd.Results Forty-ninO lOsions wOrO diagnosOd by qualitativO diagnosis, of which 42 lOsions wOrO malignant and 7 lOsions wOrO bOnign. Two lOsions wOrO diagnosOd by qualitativO diagnosis, and thO succOss ratO of puncturO was 96.1% (49/51).ThO postopOrativO pathology confirmOd that 44 casOs wOrO malignant and 6 casOs wOrO bOnign. ThO sOnsitivity, spOcificity and accuracy of US-CNB wOrO 97.7% (42/43),100.0% (42/42),98.0% (48/49),rOspOc-tivOly.Conclusion ThO succOss ratO and accuracy of US-CNB puncturO in thO diagnosis of bOnign and malignant lOsions arO high, consistOnt with thO gold standard. It has clinical significancO for thO basic hospital lOvOl.

Objective: To explore the clinical features of patients with synchronous lymphoma and carcinoma. Methods: The clinical data of 17 patients with Synchronous lymphoma and carcinoma from February 2012 to October 2017 were analyzed retrospectively. Results: Among 17 patients of lymphoma, 1 case HL, 2 cases B-NHL, 6 cases MZBL, 3 cases DLBCL, 1 case mantle cell lymphoma (MCL) , 3 cases NK/T- cell lymphoma, 1 case anaplastic large cell lymphoma(ALCL). In terms of 17 patients with carcinoma, 3 cases esophageal carcinoma, 3 cases gastric carcinoma, 2 cases colorectal carcinoma, 7 cases thyroid carcinoma, 1 case hepatocellular carcinoma and lung cancer. Up to 15 patients received operation, and some of them combined with chemotherapy, radiotherapy and autologous transplant. Follow-up analysis showed that 3 cases was undergoing treatment, 2 cases lost follow-up, 4 cases died, 3 cases achieved CR, 3 cases remained to be at SD, and 2 cases assessed for progression or recurrence. Conclusion The relationship between lymphoma and carcinoma was under discussion, patients with synchronous lymphoma and carcinoma were not unusual. We herein should raise awareness to avoid misdiagnosis.

Objective To construct expression vectors of calmodulin(CaM)mutants N2 and C2,and to express,purify,and identify the mutant proteins,in order to study the interactions between CaM and calcium channels. Methods The cDNA of N?lobe and C?lobe of CaM were used to prepare the cDNA of N2 and C2. Next,the recombinant cDNAs were cloned into a pGEX?6p?3 plasmid,and the recombinant plasmids were trans?ferred into E.coli BL21 cells. The transfected BL21 cells were stimulated with IPTG. The fusion proteins were extracted by ultrasonication and puri?fied by using GS?4B beads. Finally,protein activity was identified by the pull?down assay. Results Both the restriction digestion map and the DNA sequence identification results confirmed that the recombinant plasmids were successfully constructed. SDS?PAGE results showed high purity and concentration of N2 and C2 proteins. Their activities and binding abilities with the calcium channel fragment were confirmed by the pull?down assay.Conclusion In this study,expression vectors of N2 and C2 are successfully constructed,and physiologically active N2 and C2 CaM mutant proteins are obtained.