Objective To investigate the combined effect of berberine （BBR） and fluconazole （FLC） on FLC-tolerant Candida albicans in vitro. Methods The sensitivity of 8 strains of Candida albicans to FLC was assessed by determining their minimal inhibitory concentration （MIC） using broth microdilution method. FLC-tolerant strains were screened from FLC-sensitive strains by disk diffusion assay. The effect of BBR combined with FLC on FLC-tolerant Candida albicans was investigated by disk diffusion assay. Results All eight strains of Candida albicans exhibited sensitivity to FLC, with minimal inhibitory concentration （MIC₅₀） values below 0.5 μg/ml. Strains Y0109, 9821, 7879, 7654, and 9296 displayed colony growth in the inhibition zone after 48 h of constant temperature incubation, indicating FLC tolerance. When strains Y0109 and 9821 were subjected to a combination of BBR and FLC, the number of colonies within the inhibition zone decreased progressively with the increase of BBR concentration following a 48 h constant temperature culture. The inhibition zone became clear with the increasing of BBR concentration and increased with the increase of FLC loading, which showed a dose-dependent relationship. Conclusion The BBR combined with FLC demonstrated efficacy against FLC-tolerant strains.

Objective To evaluate retinal vascular and neural changes in patients with coronary artery disease with depression(CADD)and to investigate their association with depression severity.Methods A total of 40 patients with CADD,56 patients with CAD without depressive disorder(CADND),and 31 healthy controls were included in this study.The vessel density of superficial capillary plexus(SCP)and deep capillary plexus(DCP),and the thickness of the retinal nerve fiber layer(RNFL)and ganglion cell complex(GCC),were quanti-fied using optical coherence tomography angiography(OCTA)to analyze the differences between the groups and their correlation with PHQ-9 scores.Results Compared with the healthy control group,SCP and DCP were signifi-cantly decreased in both CADD and CADND groups(P<0.05).Both superior hemi in RNFL thickness and GCC thickness(including mean,superior hemi,and inferior hemi)were significantly increased in patients with CADD compared with patients with CADND(P<0.05).PHQ-9 scores were negatively correlated with the mean and infe-rior RNFL thickness(P<0.05).Conclusion Both retinal vascular neural structures were altered in patients with CADD,and the neural alterations were strongly correlated with the severity of the patient's depression symptom.

Objective:To investigate the effect of COX6C on the proliferation of multiple myeloma(MM)cells and its mechanism of action.Methods:The expression of COX6C in MM cell lines were detected by RT-PCR.siRNA technology was used to knockdown COX6C expression in OPM2 cells.MTT assay and flow cytometry were employed to assess the effect of COX6C knockdown by siRNA on cell proliferation,mitochondrial membrane potential(Δ Ψm),and intracellular adenosine triphosphate(ATP)levels.The mitochondrial morphological changes in OPM2 cells pre-and post-siRNA-mediated COX6C knockdown were observed by transmission electron microscopy(TEM).Results:The relative expression level of COX6C was significantly increased in MM cell lines(P＜0.01).Following siRNA-mediated COX6C knockdown,OPM2 cell proliferation was inhibited,with viable cells accounting for 62.32％±3.43％and 47.01％±5.12％after 48 and 72 hours of culture,respectively.siRNA-mediated COX6C knockdown also caused significant reductions in mitochondrial membrane potential and intracellular ATP levels(P＜0.05),accompanied by mitochondrial shortening,swelling,and incomplete cristae structures.Conclusion:COX6C may promote the proliferation of MM cells by altering the mitochondrial structure and elevating intracellular ATP levels.

Objective:To investigate the differential expression of Nuclear Factor Kappa B(NF-κB)and Tumor Necrosis Factor-Alpha(TNF-α)in endometrial polyp tissues,polyp-adjacent endometrium,and normal endometrium,and to analyze their correlation with local inflammatory responses,thereby elucidating the pathogenesis of endometrial polyps.Methods:Thirty-six patients with hysteroscopically confirmed endometrial polyps at Qingdao University Affiliated Hospital(September 2023-December 2024)were enrolled.Polyp tissues and adjacent endometrial tissues(0.5 cm-1 cm from polyps)were collected during surgery.Twenty-six patients undergoing hysterectomy for uterine fibroids,with pathologically confirmed normal endometrium,served as controls.The expression of NF-κB and TNF-α proteins was assessed using immunohistochemistry(IHC).Real-time quantitative PCR(RT-qPCR)was employed to detect the mRNA expression levels of NF-κB and TNF-α,and Western blot analysis was used to measure their protein expression.Differences among the three groups were compared.Results:Immunohistochemical analysis demonstrated:NF-κB p65 was predominantly localized to the cytoplasm and/or nucleus;TNF-α-positive expression was principally observed in the cytoplasmic compartment and/or cell membrane,manifesting as brown-yellow to brownish granules.The positive expression rate of NF-κB protein was significantly elevated in endometrial polyp tissues compared to both adjacent endometrial tissues and normal endometrial tissues(P＜0.05),whereas no statistically significant difference was observed between adjacent and normal endometrial tissues(P＞0.05).TNF-α protein expression exhibited a gradient pattern:Endometrial polyp tissues＞Adjacent endometrial tissues＞Normal endometrial tissues(with all inter-group comparisons demonstrating statistically significant differences,P＜0.05).Real-time quantitative PCR analysis revealed a significant gradient trend in the mRNA expression of NF-κB and TNF-α in endometrial polyp tissues:NF-κB mRNA:Polyp group(7.15±3.15)＞parapolyp group(4.38±2.01)＞normal group(1.03±0.30),with significant intergroup differences(all P＜0.05).TNF-α mRNA:Polyp tissue(17.66±9.25)＞parapolyp tissue(9.35±5.75)＞normal endometrium(1.16±0.58),with statistically significant differences among all groups(all P＜0.05).Western blot quantification further confirmed this trend:NF-κB protein:Expression in the polyp group(0.87±0.11)was 2.23-fold higher than in the normal group(0.39±0.02)(P=0.0007),while the parapolyp group(0.59±0.07)showed a 51％increase compared to the normal group(P=0.0435).TNF-α protein:Expression in the polyp group(1.13±0.21)was elevated by 94.8％versus the parapolyp group(0.58±0.03,P=0.0036)and by 494.7％versus the normal group(0.19±0.03,P=0.0002).One-way ANOVA indicated significant intergroup differences(F=43.56,P＜0.05).Conclusion:The TNF-α-mediated NF-κB signaling pathway is abnormally activated in endometrial polyps,exhibiting its highest expression at the polyp site.This suggests that the localized chronic inflammatory microenvironment may promote polyp formation through persistent stimulation of the NF-κB pathway.Targeted regulation of this pathway offers a novel strategy for preventing polyp recurrence.

Objective To investigate the effect of different decompression methods on the efficacy of the unilateral biportal endoscopy(UBE)in the treatment of severe lumbar spinal stenosis(LSS).Methods A total of 203 elderly patients with LSS who underwent UBE treatment in our hospital from September 2021 to June 2024 were selected and divided into the unilateral group(102 cases)and the bilateral group(101 cases)according to different decompression methods.The unilateral group underwent unilateral decompression during operation,while the bilateral group underwent bilateral decompression(with bilateral decompression through the same incision and unilateral approach)during operation.The perioperative conditions,anatomical image parameters,visual analogue scale(VAS)scores,Oswestry disability index(ODI),and complications were compared between the two groups.The rehabilitation progress and complications of patients with different Charlson comorbidity index(CCI)values were compared.Results The operation time of patients in the bilateral group was longer than that in the unilateral group(P<0.05).The dural sac area and lumbar spinal canal area of patients in the bilateral group were larger than those in the unilateral group immediately after operation and 3 months after operation(P<0.05).The VAS scores and ODI 7 days and 3 months after operation of patients in the bilateral group were lower than those in the unilateral group(P<0.05).There was no statistically significant difference in the total incidence of complications between the two groups of patients(P>0.05).The first time of getting out of bed after operation and hospital stay in patients with CCI value>2 scores were longer than those in patients with CCI value≤2 scores(P<0.05).Conclusion Compared with unilateral decompression,bilateral decompression for elderly patients with severe LSS takes a longer surgical time,but it can better restore lumbar shape,alleviate pain,improve lumbar function,and has higher safety,and the milder the patient's condition,the faster the postoperative recovery.

Intra-aortic balloon pump(IABP),as the most commonly used percutaneous mechanical circulatory assist device,is routinely implanted through the femoral artery pathway.However,when implantation through the femoral artery pathway is difficult or contraindicated,other pathways including the brachial artery pathway,axillary artery pathway,etc.can be considered.IABP assisted interventional treatment for complex high-risk and indicated patients(CHIP)can reduce the risk of intraoperative complications,stabilize hemodynamics,increase the complete revascularization rate of CHIP,and improve long-term prognosis.The reverse guidewire technique can improve the success rate of percutaneous coronary intervention(PCI)for chronic total occlusion(CTO)of coronary arteries.In clinical practice,the reverse pathway is often chosen in addition to the forward pathway,such as the contralateral radial and brachial artery pathway,femoral artery pathway,etc.This article reports a case of bilateral femoral artery occlusion,in which IABP was implanted through the left brachial artery pathway,and then with the assistance of IABP,the right coronary artery CTO lesion was successfully opened through the right radial artery in the forward direction and the right brachial artery in the reverse direction,with the aim of providing reference for clinical PCI treatment for such special cases.

Aim To utilize molecular docking and in vitro experiments to investigate the regulatory mecha-nism of stigmasterol on the TLR4/MyD88/NF-κB sig-naling pathway in hepatocellular carcinoma.Methods Molecular docking was performed using AutoDock to study the binding affinity of stigmasterol with TLR4,MyD88,and NF-κB.The effects on cell proliferation and migration were assessed through CCK-8,wound healing assays,and Transwell experiments,while colony formation ability was measured using a colony formation assay.Flow cytometry was employed to examine apop-tosis and cell cycle.Western blot analysis was used to evaluate the expression levels of TLR4,MyD88,and NF-κB proteins after stigmasterol treatment.Results Molecular docking indicated that stigmasterol exhibited favorable binding conformations with TLR4,MyD88,and NF-κB.In vitro,stigmasterol demonstrated inhibi-tory effects on proliferation,migration,invasion,and colony formation in hepatocellular carcinoma cells.Ad-ditionally,it promoted apoptosis,inhibited cell cycle progression,and reduced protein expression of the TLR4/MyD88/NF-κB signaling pathway(P＜0.05).Conclusion Stigmasterol suppresses the activity of hepatocellular carcinoma cells by modulating the TLR4/MyD88/NF-κB signaling pathway.

Objective:The greater tuberosity angle(GTA)and critical shoulder angle(CSA)are commonly referred to as radiographic markers which were used to described morphology of the greater tu-berosity and acromion respectively.At present,most international studies focus on the correlation be-tween the above two parameters and rotator cuff tears(RCTs),and their diagnostic value and risk assess-ment.This study attempts to find out the trend of GTA and CSA changes and risk threshold of RCTs,as well as the protective factors and risk factors.Methods:In this study,130 individuals from May 2019 to December 2020 were recruited.According to Southern California Orthopedic Institute(SCOI)classifica-tion,the individuals were divided into four groups retrospectively:Group A,negative control group;Group B,partial tears(articular side);Group C,partial tears(bursal side);Group D,full-thickness tears.GTA and CSA were measured respectively on true anteroposterior position X-ray of shoulder with arm in neutral rotation and performed by the same trained technician team in single-blind.The correla-tions between RCTs and relevant factors were analyzed.Results:According to the area under the receiver operating characteristic curve(AUC),GTA and CSA of RCTs(Groups B,C and D)were 0.736 and 0.673 with 95％confidence interval(CI),the cut-off value of GTA and CSA of RCTs were 70.5° and 39.5° respectively.Comparing with the control group,RCTs groups had significant statistical differences in age and body mass index(BMI)(P＜0.05),especially the full-thickness RCTs(Group D),which was older than Groups A,B and C(P＜0.05,cut-off value:56.5 years old)and shorter than Groups A and B(P＜0.05,cut-off value:1.58 m).Analyzed from scatter plot and regression analysis,there was no linear correlation between GTA and CSA.There were no significant differences in gender,dominant shoulders and smoking between the RCTs groups and the control group(P＞0.05).Conclusion:Larger GTA(＞70.5°)and CSA(＞39.5°)would be highly predictive in diagnosing RCTs without linear cor-relation,and GTA has a higher diagnostic value in contrast.Subacromial impingement and shoulder de-generation occurred before RCTs.Patients with age＞56.5 years and height＜1.58 m were more likely to develop disease of full-thickness RCTs and no statistic differences in weight and BMI.Gender,domi-nant shoulder and smoking were neither risk factors nor protective factors.

Objective This study focuses on a tertiary public hospital in Ningxia to explore the practical application of discipline-specific research performance evaluation.To establish a performance evaluation index system tailored to the characteris-tics of tertiary public hospitals in underdeveloped regions and propose strategies for improving research performance evaluation through empirical research,thereby promoting high-quality hospital development.Methods Guided by the performance evalua-tion indicators for tertiary public hospitals and the accreditation standards for tertiary hospitals,and aligned with the hospital's o-verall work plan,a multi-dimensional and multi-level evaluation method was adopted.Following the SMART principles(Specific,Measurable,Achievable,Relevant,Time-bound)and differentiated scoring principles,research performance evaluation indica-tors were summarized,screened,and weighted.An empirical analysis of the research status of 20 disciplines from 2021 to 2024 was conducted to establish and continuously optimize a research performance evaluation index system suited to the hospital's needs.Results A research performance evaluation index system for public hospital disciplines was finalized,comprising 5 first-level indicators,14 second-level indicators,and 40 third-level indicators(22 quantitative and 18 qualitative).This system standardized the management of discipline-specific research and effectively promoted steady growth,structural adjustment,and development in hospital research.Conclusion Constructing a scientific,standardized,and operable research performance eval-uation index system is of significant importance for enhancing the research level of disciplines in public hospitals and strengthening discipline construction.

Objective To explore the safety of establishing the veno-arterial extracorporeal membrane oxygenation(VA-ECMO)pipeline through percutaneous puncture and the effectiveness of high-risk percutaneous coronary intervention(HR-PCI)under VA-ECMO assistance.Methods In this single-center retrospective study,patients who underwent HR-PCI assisted by VA-ECMO at Wuhan Asian Heart Hospital from December 2022 to December 2023 were included.The primary endpoint was the safety of establishing the VA-ECMO pipeline through percutaneous puncture,mainly characterized by extracorporeal membrane oxygenation(ECMO)-related complications,including severe bleeding/hematoma at the wound,arteriovenous fistula,pseudoaneurysm,peripheral arterial dissection,etc.The secondary endpoint was the effectiveness of HR-PCI under VA-ECMO assistance,defined as major adverse cardiovascular and cerebrovascular events(MACCE)at 6-month follow-up,including the composite events of all-cause death,non-fatal myocardial infarction,repeat revascularization,and ischemic stroke.Results Among the 189 patients included in the study,15(7.9％)had severe bleeding/hematoma at the puncture wound caused by VA-ECMO,8(4.2％)had wound infection,1(0.5％)had arteriovenous fistula,4(2.1％)had pseudoaneurysm,3(1.6％)had peripheral arterial dissection,8(4.2％)had systemic embolism,8(4.2％)had acute kidney injury,3(1.6％)had acute neurological injury,and 1(0.5％)died.percutaneous coronary intervention(PCI)was successful in 182 cases(96.3％),and a total of 36 cases(19.0％)had PCI-related complications.164 patients completed 6-month follow-up,among which 4(2.4％)had all-cause death,11(6.7％)had non-fatal myocardial infarction,11(6.7％)had unplanned repeat revascularization,and 2(1.2％)had the composite event of ischemic stroke.Conclusions Ultrasound-guided percutaneous puncture for establishing the VA-ECMO pipeline has high safety,and HR-PCI patients assisted by VA-ECMO have good short-term effects.