AIM:To evaluate the optimal timing of preoperative intravitreal anti vascular endothelial growth factor(VEGF)therapy in proliferative diabetic retinopathy(PDR)using intraoperative fluorescein angiography(IOFA).METHODS:A retrospective case series study was conducted on patients who underwent vitrectomy for PDR with vitreous hemorrhage(VH)at Sichuan Provincial People's Hospital from January 2023 to February 2025. Patients were divided into three groups according to the interval between intravitreal conbercept injection and surgery: Group A(3 d before surgery), Group B(7 d before surgery), and Group C(14 d before surgery). IOFA was used to assess the number and size of retinal neovascularization(NV). Additional data were collected including preoperative best corrected visual acuity(BCVA), vitreous hemorrhage grading, operative time, frequency of intraoperative endodiathermy, duration of high perfusion pressure, vitreoretinal adhesion grade, postoperative BCVA, and central macular thickness(CMT). Multidimensional analyses were performed.RESULTS:This study enrolled a total of 91 patients(94 eyes)with PDR accompanied by vitreous hemorrhage. Among them, Group A consisted of 31 patients(31 eyes; 18 males, 13 females; mean age 53.26±12.38 y), Group B consisted of 34 patients(37 eyes; 21 males, 13 females; mean age 51.61±14.16 y), and Group C consisted of 26 patients(26 eyes; 18 males, 8 females; mean age 51.00±12.02 y), with baseline characteristics comparable among the three groups(all P>0.05). Comparative analysis of NV visualized via IOFA revealed that both the number and size of NVs were significantly lower in Groups B and C than in Group A(all P<0.0167), while no statistically significant differences were observed between Groups B and C(both P>0.05). No significant differences were found among the three groups regarding other intraoperative parameters, including operation time, frequency of electrocoagulation application, duration of high perfusion pressure, or grading of vitreoretinal adhesion(all P>0.05).CONCLUSION:IOFA confirms that preoperative anti-VEGF therapy administered 7 or 14 d before surgery is more effective than a 3 d interval in suppressing retinal NV activity in PDR patients.

BACKGROUND:The long-term patency rate of synthetic blood vessels remains a significant challenge that requires urgent attention.Enhancing the anticoagulant performance of small-caliber artificial blood vessels is crucial in ensuring their long-term efficacy.OBJECTIVE:To investigate the anticoagulation activity of polycaprolactone/low molecular weight fucoidan nanofibers with shell core structure and determine the effect on the activity of human umbilical vein endothelial cells.METHODS:Polycaprolactone nanofiber membranes and polycaprolactone/low molecular weight fucoidan nanofiber membranes with polycaprolactone as shell layer and low molecular weight fucoidan as core layer were prepared by emulsion electrospinning method(the mass ratio of low molecular weight fucoidan to polycaprolactone was 10％,25％,40％,and 55％,respectively).The morphology and structure of the fibers were characterized by scanning electron microscopy,fluorescence microscopy,and infrared spectroscopy.The mechanical strength of the fiber membranes was detected by tensile test.The loading rate and sustained release rate of low molecular weight fucoidan in the nanofibers were detected by 1,9-dimethylmethylene blue dye.The anticoagulant properties of the fiber membranes were verified by hemolysis test,dynamic coagulation test,plasma recalcification test,and platelet adhesion test.The five fiber membranes were co-cultured with human umbilical vein endothelial cells.The cell proliferation was detected by CCK-8 assay and the cell morphology was observed by fluorescence microscopy.RESULTS AND CONCLUSION:(1)Scanning electron microscope showed that the surface of polycaprolactone/low molecular weight brown algae polysaccharide nanofiber membrane was smooth,the fiber diameter was uniform,and there was no obvious beaded structure.With the increase of low molecular weight brown algae polysaccharide content in the fiber membrane,the diameter of the fiber membrane increased and the maximum tensile stress decreased,but it still met the mechanical properties requirements of small-caliber artificial blood vessels.Fluorescence images and infrared spectra confirmed that low molecular weight brown algae polysaccharide was successfully loaded into polycaprolactone nanofiber membrane,and the low molecular weight brown algae polysaccharide loaded in each group of fiber membranes was released suddenly within 12 hours and released at a relatively low rate after 48 hours.(2)Compared with polycaprolactone nanofiber membrane,polycaprolactone/low molecular weight brown algae polysaccharide nanofiber membrane had better anticoagulant activity,among which the group with a mass ratio of low molecular weight brown algae polysaccharide to polycaprolactone of 25％had the best anticoagulant effect.All five fiber membranes supported the growth and proliferation of human umbilical vein endothelial cells without affecting cell morphology and had no obvious cytotoxicity.(3)The results show that the polycaprolactone/low molecular weight brown algae polysaccharide nanofiber membrane has good anticoagulant function,blood compatibility,and cell compatibility.

BACKGROUND:The long-term patency rate of synthetic blood vessels remains a significant challenge that requires urgent attention.Enhancing the anticoagulant performance of small-caliber artificial blood vessels is crucial in ensuring their long-term efficacy.OBJECTIVE:To investigate the anticoagulation activity of polycaprolactone/low molecular weight fucoidan nanofibers with shell core structure and determine the effect on the activity of human umbilical vein endothelial cells.METHODS:Polycaprolactone nanofiber membranes and polycaprolactone/low molecular weight fucoidan nanofiber membranes with polycaprolactone as shell layer and low molecular weight fucoidan as core layer were prepared by emulsion electrospinning method(the mass ratio of low molecular weight fucoidan to polycaprolactone was 10％,25％,40％,and 55％,respectively).The morphology and structure of the fibers were characterized by scanning electron microscopy,fluorescence microscopy,and infrared spectroscopy.The mechanical strength of the fiber membranes was detected by tensile test.The loading rate and sustained release rate of low molecular weight fucoidan in the nanofibers were detected by 1,9-dimethylmethylene blue dye.The anticoagulant properties of the fiber membranes were verified by hemolysis test,dynamic coagulation test,plasma recalcification test,and platelet adhesion test.The five fiber membranes were co-cultured with human umbilical vein endothelial cells.The cell proliferation was detected by CCK-8 assay and the cell morphology was observed by fluorescence microscopy.RESULTS AND CONCLUSION:(1)Scanning electron microscope showed that the surface of polycaprolactone/low molecular weight brown algae polysaccharide nanofiber membrane was smooth,the fiber diameter was uniform,and there was no obvious beaded structure.With the increase of low molecular weight brown algae polysaccharide content in the fiber membrane,the diameter of the fiber membrane increased and the maximum tensile stress decreased,but it still met the mechanical properties requirements of small-caliber artificial blood vessels.Fluorescence images and infrared spectra confirmed that low molecular weight brown algae polysaccharide was successfully loaded into polycaprolactone nanofiber membrane,and the low molecular weight brown algae polysaccharide loaded in each group of fiber membranes was released suddenly within 12 hours and released at a relatively low rate after 48 hours.(2)Compared with polycaprolactone nanofiber membrane,polycaprolactone/low molecular weight brown algae polysaccharide nanofiber membrane had better anticoagulant activity,among which the group with a mass ratio of low molecular weight brown algae polysaccharide to polycaprolactone of 25％had the best anticoagulant effect.All five fiber membranes supported the growth and proliferation of human umbilical vein endothelial cells without affecting cell morphology and had no obvious cytotoxicity.(3)The results show that the polycaprolactone/low molecular weight brown algae polysaccharide nanofiber membrane has good anticoagulant function,blood compatibility,and cell compatibility.

Against the backdrop of digital transformation in higher education， the traditional teaching model has become inadequate to meet the demands for cultivating new-quality nursing talents. Nursing ethics teaching confronts several dilemmas， such as unbalanced regional development， disconnection between theory and practice， scattered teaching resources， and fragmented knowledge points. With the iterative update of modern digital technologies， the knowledge graph， due to its structured， semantic， scalable， and multi-source integrative characteristics， offers a technological pathway to address these issues. Based on the construction foundation of the Ministry of Education’s first batch of virtual teaching and research platforms for humanistic nursing courses， the nursing ethics artificial intelligence（Al）course was developed around the“thinking-research-teaching-learning”framework. By strengthening ideological and political guidance， constructing a curriculum knowledge graph， and promoting the deep integration of humanistic care and professional knowledge，the course realized intelligent support for research，learning，and teaching. This innovative education model provides a replicable paradigm for cultivating outstanding nursing talents equipped with humanistic literacy， digital competence， and advanced ethical thinking， while also offering references for the digital transformation of higher nursing education.

Objective: To investigate the associations of anxiety, depressive symptoms and their comorbidity with neck-shoulder pain (NSP) and low back pain (LBP) among junior and senior high school students, thereby providing evidence for the promotion of physical and mental health. Methods: Stratified cluster random sampling method was used to select 638 junior and senior high school students in Taiyuan, Shanxi Province. The baseline survey (T1) was conducted in May 2025, and the follow up survey (T2) was conducted in October 2025. The Generalized Anxiety Disorder Scale-7, Patient Health Questionnaire-9, and Assessment of Spinal Health of Youths were used to assess anxiety/depressive symptoms and symptoms of NSP and LBP among junior and senior high school students. Multivariable modified Poisson regression models were applied to investigate the associations between anxiety, depressive symptoms and their comorbidity with NSP and LBP among junior and senior high school students. Results: The baseline survey showed that the detection rates of anxiety symptoms, depressive symptom, and their comorbidity symptoms among junior and senior high school students were 7.5%, 9.9% and 5.5%, respectively.The follow up results showed that the detection rates of NSP and LBP among junior and senior high school students were 10.7% and 10.8%. After adjusting for variables such as gender, school stage and boarding status, multivariable modified Poisson regression analyses indicated that depressive symptom at T1 was positively associated with NSP and LBP at T2 ( RR =2.41, 2.50; 95% CI =1.15-5.09,1.15-5.47,both P <0.05). The comorbidity of anxiety and depressive symptoms at T1 was positively associated with LBP at T2 ( RR =3.08, 95% CI =1.67-5.68, P <0.05). Conclusion Anxiety and depressive symptoms are positively associated with the occurrence of NSP and LBP among junior and senior high school students; among these, depressive symptoms and the comorbidity of anxiety and depressive symptoms show greater impacts.

After continuous development and improvement, lung transplantation has become the preferred means to treat a variety of benign end-stage lung diseases. However, the field of lung transplantation still faces many challenges, including shortage of donor resources, preservation and maintenance of donor lungs, and postoperative complications. Lung tissue samples removed after lung transplantation are excellent clinical resources for the study of benign end-stage lung disease and perioperative complications of lung transplantation. However, at present, the collection, storage and utilization of tissue samples after lung transplantation are limited to a single study, and unified technical specifications have not been formed. Based on the construction plan of the biobank for lung transplantation in the First Affiliated Hospital of Xi'an Jiaotong University, this study reviewed the practical experience in the collection, storage and utilization of lung transplant tissue samples in the aspects of ethical review, staffing, collection process, storage method, quality control and efficient utilization, in order to provide references for lung transplant related research.

OBJECTIVES: In recent years, the incidence and detection rate of pancreatic cystic lesions (PCLs) have increased significantly. Endoscopic ultrasound (EUS) plays an indispensable role in the diagnosis and differential diagnosis of PCLs. However, evidence comparing the diagnostic performance of EUS-guided fine-needle aspiration (EUS-FNA) and fine-needle biopsy (FNB) remains limited. This study aims to compare the diagnostic yield, adequacy of tissue acquisition, and safety between EUS-FNA and EUS-FNB in evaluating PCLs to inform clinical practice. METHODS: A retrospective review was conducted on patients with PCLs who underwent either EUS-FNA or EUS-FNB between January 2014 and August 2021. The diagnostic yield, tissue acquisition adequacy, and incidence of adverse events were compared between the 2 groups. RESULTS: A total of 90 patients with PCLs were included (52 in the FNA group and 38 in the FNB group). The diagnostic yield was similar between the FNA and FNB groups (94.2% vs 94.7%, P>0.05). The adequacy of tissue acquisition was 71.2% in the FNA group and 81.6% in the FNB group (P>0.05). No statistically significant difference was observed in the incidence of adverse events between the 2 groups (P>0.05). CONCLUSIONS Both EUS-FNA and EUS-FNB demonstrate equally high diagnostic yields and tissue adequacy in PCLs, with excellent safety profiles. Both methods are safe and effective diagnostic tools for evaluating PCLs.
Humans ; Endoscopic Ultrasound-Guided Fine Needle Aspiration/adverse effects* ; Retrospective Studies ; Female ; Male ; Pancreatic Cyst/diagnostic imaging* ; Middle Aged ; Biopsy, Fine-Needle/adverse effects* ; Aged ; Pancreatic Neoplasms/diagnosis* ; Adult ; Endosonography/methods* ; Pancreas/pathology* ; Diagnosis, Differential

Traditional development of small protein scaffolds has relied on display technologies and mutation-based engineering, which limit sequence and functional diversity, thereby constraining their therapeutic and application potential. Protein design tools have significantly advanced the creation of novel protein sequences, structures, and functions. However, further improvements in design strategies are still needed to more efficiently optimize the functional performance of protein-based drugs and enhance their druggability. Here, we extended an evolution-based design protocol to create a novel minibinder, BindHer, against the human epidermal growth factor receptor 2 (HER2). It not only exhibits super stability and binding selectivity but also demonstrates remarkable properties in tissue specificity. Radiolabeling experiments with ^99mTc, ⁶⁸Ga, and ¹⁸F revealed that BindHer efficiently targets tumors in HER2-positive breast cancer mouse models, with minimal nonspecific liver absorption, outperforming scaffolds designed through traditional engineering. These findings highlight a new rational approach to automated protein design, offering significant potential for large-scale applications in therapeutic mini-protein development.

OBJECTIVE: Therapeutic angiogenesis has become a promising approach for treating ischemic heart disease (IHD). The present study aims to investigate the effects of Qishen Granule (QSG) on angiogenesis in myocardial ischemia (MI) and the potential mechanism. METHODS: In vivo study was conducted on rat model of myocardial infarction. QSG was performed daily at a dose of 2.352 g/kg for four weeks. Cardiac function was assessed by echocardiogram and pro-angiogenic effects were evaluated by Laser Doppler and CD31 expression. Oxygen-glucose deprivation (OGD) was applied in cultured human umbilical vein endothelial cells (HUVECs). Cell viability, wound healing and tube formation assay were used to test functions of HUVECs. ELISA and Western blots were used to assess protein expressions of bone morphogenetic protein 2-delta-like 4-notch homolog 1 (BMP2-Dll4-Notch1) signaling pathway. RESULTS: The results showed that QSG improved heart function, cardiac blood flow and microvessel density in myocardial ischemic rats. In vitro, QSG protected HUVECs by promoting the cell viability and tube formation. QSG upregulated bone morphogenetic protein-2 (BMP2) and downregulated delta-like 4 (Dll4) and notch homolog 1 (Notch1) expressions both in rats and HUVECs. CONCLUSION QSG protected against MI by promoting angiogenesis through BMP2-Dll4-Notch1 pathway. BMP2 might be a promising therapeutic target for IHD.