Objective To analyze the clinical characteristics,laboratory test,imaging examination,and treatment outcome of invasive Klebsiella pneumoniae liver abscess syndrome(IKPLAS)in the elderly,and improve clinicians' understanding on this disease.Methods Clinical data of 7 elderly patients who were diagnosed with IKPLAS in a hospital from January 2020 to February 2024 were analyzed retrospectively.Results Among the 7 elderly patients with IKPLAS,there were 3 males and 4 females,ranging in age from 60 to 78 years old.All 7 patients were with community-acquired infection.The main clinical symptoms were fever(n=7),chills(n=6),upper abdominal pain(n=4),fatigue and poor appetite(n=3),cough and expectoration(n=5),vomiting(n=3),vision decrease(n=2),and disturbance of consciousness(n=1).All 7 patients had pathogenic evidence of Klebsiella pneumoniae(KP),including 4 cases with KP isolated from liver puncture pus,3 from blood culture,and 1 from both liver puncture pus and intraocular pus.Among the 7 patients,there were 5,2,1,3,1,1 cases combined with pulmonary abscess,endophthalmitis,brain abscess,bloodstream infection,urinary system infection,and pelvic infection,re-spectively.Conclusion Elderly patients with IKPLAS have a variety of underlying diseases and diverse clinical symptoms,showing no specificity.Once IKPLAS was suspected,timely testing for pathogen and screening for other metastatic infection sites outside the liver should be performed.Timely drainage of liver abscess and selection of ap-propriate antimicrobial agents for treatment based on antimicrobial susceptibility testing result can improve patients' survival rate.

Objective:To explore the application value of part-cut jejunal transection in digestive tract reconstruction of totally laparoscopic total gastrectomy.Methods:The propensity score matching and retrospective cohort study was conducted. The clinicopathological data of 112 patients with gastric cancer who underwent totally laparoscopic total gastrectomy in The Second Affiliated Hospital of Anhui Medical University from June 2018 to September 2022 were collected. There were 81 males and 31 females, aged (70±8)years. Among the 112 patients, 60 patients undergoing diges-tive tract reconstruction by Roux-en-Y anastomosis with part-cut jejunum were set as the part-cut group, and 52 patients undergoing digestive tract reconstruction by traditional Roux-en-Y anasto-mosis were set as the traditional group. Observation indicators: (1) propensity score matching status and comparison of clinical data of patients between the two groups after matching; (2) intraopera-tive and postoperative conditions; (3) follow-up. Comparison of measurement data with normal dis-tribution between groups was conducted using the independent sample t test. Comparison of count data between groups was conducted using the chi-square test or Fisher exact probability. Com-parison of ordinal data was conducted using the nonparametic rank sum test. Propensity score matching was performed using the 1∶1 nearest neighbor matching method, with the caliper value of 0.02. Results:(1) Propensity score matching status and comparison of clinical data of patients between the two groups after matching. Of the 112 patients, 90 patients were successfully matched, with 45 cases in each of the part-cut group and the traditional group. After propensity score matching, the elimination of body mass index, clinical TNM staging confounding bias ensured comparability. (2) Intraoperative and postoperative conditions. After propensity score matching, the total operation time and digestive tract reconstruction time of patients in the part-cut group were (217.0±15.1)minutes and (34.7±1.8)minutes, versus (252.6±21.9)minutes and (52.6±7.4)minutes in the traditional group, respectively, showing significant differences in the above indicators between the two groups ( t=?8.97, ?15.66, P<0.05). (3) Follow-up. After propensity score matching, 90 patients were followed up postoperatively for (47±15)months. During the follow-up, no patient in either group received secondary surgery, and there was no death. There were 3 cases and 10 cases of Roux stasis syndrome in the part-cut group and the traditional group, respectively, showing a significant difference between the two groups ( χ2=4.41, P<0.05). Conclusion:Compared with traditional Roux-en-Y anastomosis, the Roux-en-Y anastomosis with part-cut jejunum in totally laparoscopic total gastrectomy can signifi-cantly shorten the time for digestive tract reconstruction and reduce the incidence of postoperative Roux stasis syndrome.

Objective To analyze the clinical characteristics,laboratory test,imaging examination,and treatment outcome of invasive Klebsiella pneumoniae liver abscess syndrome(IKPLAS)in the elderly,and improve clinicians' understanding on this disease.Methods Clinical data of 7 elderly patients who were diagnosed with IKPLAS in a hospital from January 2020 to February 2024 were analyzed retrospectively.Results Among the 7 elderly patients with IKPLAS,there were 3 males and 4 females,ranging in age from 60 to 78 years old.All 7 patients were with community-acquired infection.The main clinical symptoms were fever(n=7),chills(n=6),upper abdominal pain(n=4),fatigue and poor appetite(n=3),cough and expectoration(n=5),vomiting(n=3),vision decrease(n=2),and disturbance of consciousness(n=1).All 7 patients had pathogenic evidence of Klebsiella pneumoniae(KP),including 4 cases with KP isolated from liver puncture pus,3 from blood culture,and 1 from both liver puncture pus and intraocular pus.Among the 7 patients,there were 5,2,1,3,1,1 cases combined with pulmonary abscess,endophthalmitis,brain abscess,bloodstream infection,urinary system infection,and pelvic infection,re-spectively.Conclusion Elderly patients with IKPLAS have a variety of underlying diseases and diverse clinical symptoms,showing no specificity.Once IKPLAS was suspected,timely testing for pathogen and screening for other metastatic infection sites outside the liver should be performed.Timely drainage of liver abscess and selection of ap-propriate antimicrobial agents for treatment based on antimicrobial susceptibility testing result can improve patients' survival rate.

Objective:To explore the role and possible mechanism of ACOT11 in renal fibrosis model mice.Methods:A mouse model of renal fibrosis was established by unilateral ureteral obstruction(UUO)(Sham group and UUO7 group),and the expression of ACOT11 in the kidneys of UUO induced fibrosis mouse models was detected by protein immunoblotting and real-time fluorescence quantitative PCR(qRT-PCR).Subsequently,immunohistochemistry,Masson staining,H&E staining,PAS staining,and other experimental methods were used to detect the expression levels of fibrosis biomarkers fibronectin,α-SMA,and COL-1 in the kidneys of control and experimental group mice.In addition,by constructing ACOT11 gene knockout model mice and using the gene knockout model mice to construct a renal fibrosis model,the expression levels of fibrosis biomarkers such as fibronectin,α-SMA,COL-1,as well as fibrosis mechanism pathway related indicators TGF-β and Smad2 in the kidneys of each group of mice were further detected.Results:The results of WB and qRT-PCR experiments showed that the expression of ACOT11 in the kidney tissue of UUO model mice was significantly reduced compared to the Sham group.After knocking out the ACOT11 gene,H&E staining,PAS staining,and Masson staining showed that pathological inflammatory reactions such as abnormal glomerular and tubular structures,inflammatory cell infiltration and interstitial fibrous tissue proliferation in mice were significantly aggravated compared to the control group,and the expression of fibrosis markers Fibronectin,α-SMA,and COL-1 was significantly higher than that of the control group.Conclusion:ACOT11 plays a protective role in mice with unilateral ureteral obstruction model.After ACOT11 gene knockout,the fibrosis biomarkers of the mouse kidney increases and the degree of fibrosis worsens.

OBJECTIVE To establish the precise management model for the centralized preparation of cytotoxic drugs in pharmacy intravenous admixture services(PIVAS),and evaluate the effects of its application.METHODS Pharmacists in PIVAS established the precise management model by soliciting clinical opinions and consulting literature on the centralized preparation of cytotoxic drugs and continuously refining every step of the preparation of cytotoxic drugs,based on data feedback from the information closed-loop management system and the limit of stability time of finished solutions.The indicators such as the preparation time,delivery time,the storage time of finished infusion solutions after preparation,and the completion rate of infusion within the stability time limit were analyzed before the implementation(January to December 2023)and after the implementation(January to December 2024)of this model,to evaluate its application effectiveness.RESULTS The overall framework for the precise management model included upgrading the functions of the prescription review system,improving the prescription review database,providing specialized training for PIVAS pharmacists,managing dynamic batch decision for drug preparation,managing special drugs,managing finished infusion distribution,and establishing a continuous improvement mechanism.Compared with before implementation,the average preparation time of the second and third batches of cytotoxic drugs with more concentrated morning preparation tasks in this model was significantly shorter than before implementation(P＜0.05);the delivery time of finished infusion after implementation[(11.49±2.92)min]was significantly shorter than the delivery time before implementation[(22.11±5.03)min](P＜0.001);the storage time of some drugs with shorter stable time limit and carboplatin in combination regimens(paclitaxel or docetaxel+carboplatin)was significantly shortened compared to before implementation(P＜0.05),and the completion rate of infusion within the stability time limit was significantly improved compared to before implementation(P＜0.05).CONCLUSIONS Our hospital has successfully established a precise management model for the centralized preparation of cytotoxic drugs in PIVAS.This mode can significantly shorten the preparation time of each batch of PIVAS in the morning,make batch decisions more reasonable and improve the infusion completion rate within the stable time limit of the finished product.

Objective:To explore the application value of part-cut jejunal transection in digestive tract reconstruction of totally laparoscopic total gastrectomy.Methods:The propensity score matching and retrospective cohort study was conducted. The clinicopathological data of 112 patients with gastric cancer who underwent totally laparoscopic total gastrectomy in The Second Affiliated Hospital of Anhui Medical University from June 2018 to September 2022 were collected. There were 81 males and 31 females, aged (70±8)years. Among the 112 patients, 60 patients undergoing diges-tive tract reconstruction by Roux-en-Y anastomosis with part-cut jejunum were set as the part-cut group, and 52 patients undergoing digestive tract reconstruction by traditional Roux-en-Y anasto-mosis were set as the traditional group. Observation indicators: (1) propensity score matching status and comparison of clinical data of patients between the two groups after matching; (2) intraopera-tive and postoperative conditions; (3) follow-up. Comparison of measurement data with normal dis-tribution between groups was conducted using the independent sample t test. Comparison of count data between groups was conducted using the chi-square test or Fisher exact probability. Com-parison of ordinal data was conducted using the nonparametic rank sum test. Propensity score matching was performed using the 1∶1 nearest neighbor matching method, with the caliper value of 0.02. Results:(1) Propensity score matching status and comparison of clinical data of patients between the two groups after matching. Of the 112 patients, 90 patients were successfully matched, with 45 cases in each of the part-cut group and the traditional group. After propensity score matching, the elimination of body mass index, clinical TNM staging confounding bias ensured comparability. (2) Intraoperative and postoperative conditions. After propensity score matching, the total operation time and digestive tract reconstruction time of patients in the part-cut group were (217.0±15.1)minutes and (34.7±1.8)minutes, versus (252.6±21.9)minutes and (52.6±7.4)minutes in the traditional group, respectively, showing significant differences in the above indicators between the two groups ( t=?8.97, ?15.66, P<0.05). (3) Follow-up. After propensity score matching, 90 patients were followed up postoperatively for (47±15)months. During the follow-up, no patient in either group received secondary surgery, and there was no death. There were 3 cases and 10 cases of Roux stasis syndrome in the part-cut group and the traditional group, respectively, showing a significant difference between the two groups ( χ2=4.41, P<0.05). Conclusion:Compared with traditional Roux-en-Y anastomosis, the Roux-en-Y anastomosis with part-cut jejunum in totally laparoscopic total gastrectomy can signifi-cantly shorten the time for digestive tract reconstruction and reduce the incidence of postoperative Roux stasis syndrome.

Objective:To explore the role and possible mechanism of ACOT11 in renal fibrosis model mice.Methods:A mouse model of renal fibrosis was established by unilateral ureteral obstruction(UUO)(Sham group and UUO7 group),and the expression of ACOT11 in the kidneys of UUO induced fibrosis mouse models was detected by protein immunoblotting and real-time fluorescence quantitative PCR(qRT-PCR).Subsequently,immunohistochemistry,Masson staining,H&E staining,PAS staining,and other experimental methods were used to detect the expression levels of fibrosis biomarkers fibronectin,α-SMA,and COL-1 in the kidneys of control and experimental group mice.In addition,by constructing ACOT11 gene knockout model mice and using the gene knockout model mice to construct a renal fibrosis model,the expression levels of fibrosis biomarkers such as fibronectin,α-SMA,COL-1,as well as fibrosis mechanism pathway related indicators TGF-β and Smad2 in the kidneys of each group of mice were further detected.Results:The results of WB and qRT-PCR experiments showed that the expression of ACOT11 in the kidney tissue of UUO model mice was significantly reduced compared to the Sham group.After knocking out the ACOT11 gene,H&E staining,PAS staining,and Masson staining showed that pathological inflammatory reactions such as abnormal glomerular and tubular structures,inflammatory cell infiltration and interstitial fibrous tissue proliferation in mice were significantly aggravated compared to the control group,and the expression of fibrosis markers Fibronectin,α-SMA,and COL-1 was significantly higher than that of the control group.Conclusion:ACOT11 plays a protective role in mice with unilateral ureteral obstruction model.After ACOT11 gene knockout,the fibrosis biomarkers of the mouse kidney increases and the degree of fibrosis worsens.

The alternative pathway (AP) of the complement system is a key contributor to the pathogenesis of several diseases including paroxysmal nocturnal hemoglobinuria (PNH), atypical hemolytic uremic syndrome (aHUS), C3 glomerular disease (C3G) and age-related macular degeneration (AMD). Complement factor B (CFB) is a trypsin-like serine protein that circulates in the human bloodstream in a latent form. As a key node of the alternative pathway, it is an important target for the treatment of diseases mediated by the complement system. With the successful launch of iptacopan, the CFB small molecule inhibitors has become a current research hotspot, a number of domestic and foreign pharmaceutical companies are actively developing CFB small molecule inhibitors. In this paper, the research progress of CFB small molecule inhibitors in recent years is systematically summarized, the representative compounds and their activities are introduced according to structural types and design ideas, so as to provide reference and ideas for the subsequent research on CFB small molecule inhibitors.