Traditional Chinese medicine and its bioactive components have garnered increasing attention as potential therapeutic options for allergic asthma. By targeting the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) signaling pathway, these natural compounds exhibit unique advantages in multilevel immunomodulation and inflammation suppression compared with single-target synthetic drugs. Accumulating pharmacological evidence supports their capacity to restore pathway homeostasis, positioning them as promising candidates for complementary strategies in asthma management. Allergic asthma, a heterogeneous respiratory disorder affecting approximately 150 million individuals worldwide, arises from a complex interplay of genetic predisposition, environmental exposures, and lifestyle factors. Its pathological progression is marked by aberrant activation of the PI3K/AKT signaling cascade, with the mechanistic target of rapamycin serving as a key downstream regulatory node. This evolutionarily conserved pathway orchestrates fundamental cellular processes that contribute to three hallmark pathological features of allergic asthma: chronic airway inflammation, structural remodeling of the bronchial architecture, and airway hyperresponsiveness. This review has 3 primary objectives: (1) to evaluate the role of the PI3K/AKT pathway in allergic asthma pathogenesis, (2) to analyze the molecular mechanisms of representative traditional Chinese medicine preparations and their active ingredients, and (3) to identify novel bioactive inhibitors derived from natural products. Collectively, these investigations provide a conceptual framework for the development of next-generation targeted therapies and for optimizing clinical management strategies for allergic asthma.

ObjectiveTo evaluate the diagnostic value of cone-beam computed tomography （CBCT） arthrography for temporomandibular joint disc perforation. MethodsA retrospective analysis was conducted on patients who were clinically diagnosed with temporomandibular joint osteoarthrosis （TMJOA） and underwent CBCT arthrography and open surgery between December 2013 and January 2023. The diagnostic results of CBCT arthrography were compared with the gold standard of open surgical exploration to determine the number of true and false positive and negative cases， thereby evaluating the overall accuracy of CBCT arthrography in diagnosing disc perforation. ResultsA total of 90 patients （106 joints） met the inclusion criteria of this study， including 10 males with an average age of 36.4 years and 80 females with an average age of 42.6 years. Among them， 74 joints exhibited unilateral lesions （82.22%）， and 16 joints exhibited bilateral lesions （17.78%）. Among these， 94 joints （88.68%） showed good contrast medium visualization， while 12 joints （11.32%） showed poor contrast medium visualization. CBCT arthrography clearly diagnosed disc perforation in 75 joints （70.75%）， and surgical exploration confirmed perforation in 75 joints. In 5 cases， poor contrast medium visualization was observed， and the imaging diagnosis suggested possible perforation， with surgical exploration confirming perforation in 5 cases； the true positive rate of imaging diagnosis was 100%. CBCT arthrography clearly diagnosed the absence of disc perforation in 19 joints （17.92%）， and surgical exploration confirmed the absence of perforation in 19 joints， with a true negative rate of 73.08%. In 7 cases， poor contrast medium visualization was observed， and the imaging results did not report disc perforation， but surgical exploration revealed perforation in 7 cases， with a false negative rate of 26.92%. ConclusionsCBCT arthrography demonstrates high diagnostic accuracy for temporomandibular joint disc perforation and may provide reliable imaging evidence for clinical decision-making.

ObjectiveTo evaluate the diagnostic value of cone-beam computed tomography （CBCT） arthrography for temporomandibular joint disc perforation. MethodsA retrospective analysis was conducted on patients who were clinically diagnosed with temporomandibular joint osteoarthrosis （TMJOA） and underwent CBCT arthrography and open surgery between December 2013 and January 2023. The diagnostic results of CBCT arthrography were compared with the gold standard of open surgical exploration to determine the number of true and false positive and negative cases， thereby evaluating the overall accuracy of CBCT arthrography in diagnosing disc perforation. ResultsA total of 90 patients （106 joints） met the inclusion criteria of this study， including 10 males with an average age of 36.4 years and 80 females with an average age of 42.6 years. Among them， 74 joints exhibited unilateral lesions （82.22%）， and 16 joints exhibited bilateral lesions （17.78%）. Among these， 94 joints （88.68%） showed good contrast medium visualization， while 12 joints （11.32%） showed poor contrast medium visualization. CBCT arthrography clearly diagnosed disc perforation in 75 joints （70.75%）， and surgical exploration confirmed perforation in 75 joints. In 5 cases， poor contrast medium visualization was observed， and the imaging diagnosis suggested possible perforation， with surgical exploration confirming perforation in 5 cases； the true positive rate of imaging diagnosis was 100%. CBCT arthrography clearly diagnosed the absence of disc perforation in 19 joints （17.92%）， and surgical exploration confirmed the absence of perforation in 19 joints， with a true negative rate of 73.08%. In 7 cases， poor contrast medium visualization was observed， and the imaging results did not report disc perforation， but surgical exploration revealed perforation in 7 cases， with a false negative rate of 26.92%. ConclusionsCBCT arthrography demonstrates high diagnostic accuracy for temporomandibular joint disc perforation and may provide reliable imaging evidence for clinical decision-making.

Objective To analyze the epidemiological characteristics and risk factors of chronic kidney disease in patients with 10 years of hypertension. Methods A total of 350 patients with 10 years or longer course of hypertension who underwent physical examination in the Second Affiliated Hospital of Air Force Medical University from June 2021 to June 2024 were selected. General information of the patients was collected through questionnaires. Renal function related indicators and imaging results were obtained through relevant laboratory tests and imaging examinations. Based on the results of renal function related indicators, the epidemiological characteristics of chronic kidney disease in hypertensive patients with 10 years of hypertension, as well as risk factors for chronic kidney disease in the hypertensive patients were identified. Results Among the 350 patients enrolled in this study, there were 71 (20.29%) with proteinuria, 32 (9.14%) with hematuria, and 40 (11.43%) with decreased renal function. A total of 80 (22.86%) cases with structural variations such as kidney stones and cysts were detected by renal B-mode ultrasound. There were 121 (34.57%) patients with hypertension and chronic kidney disease. There were statistically significant differences in gender, age, diabetes, hyperlipidemia and hyperuricemia between patients with chronic kidney disease and those without (P<0.05). Multivariate logistic regression analysis results showed that gender, age, diabetes, hyperlipidemia, and hyperuricemia were the risk factors for chronic kidney disease in patients with hypertension (P<0.05). Conclusion Patients with 10 years of hypertension have a high risk of chronic kidney disease, and the risk factors include gender, age, diabetes, hyperuricemia, and hyperlipidemia.

Objective To develop an enteral nutrition management system for critically ill patients and assess its application outcomes to standardize enteral nutrition management.Methods Based on relevant guidelines and indicator systems,a management system for enteral nutrition in critically ill patients was constructed,consisting of 4 modules:nutritional screening and assessment,nutritional implementation,nutritional monitoring,and statistical analysis.A convenience sampling method was used to select enteral nutrition patients and healthcare staff from the ICU of a tertiary hospital in Ningbo.Data from January to February 2024 served as an experimental group,while data from January to February 2023 constituted a control group.The 2 groups were compared regarding nutritional risk screening rate,feeding interruption rate,completion rate of the enteral nutrition plan,and incidence of complications.At the same time,the system's effectiveness was assessed by healthcare professionals using the clinical nursing information system effectiveness evaluation form.Results The study included 111 patients in the experimental group and 101 patients in the control group.The experimental group exhibited a significantly higher nutritional risk screening rate and enteral nutrition plan completion rate,as well as significantly lower feeding interruption rate and incidence of mechanical complications compared to the control group(P＜0.05).The system received a high effectiveness rating,with an average score of 104.73±9.34.Conclusion The application of the enteral nutrition management system effectively improves the nutritional risk screening rate and completion rate of enteral nutrition plans,while reducing both the feeding interruption rate and the incidence of mechanical complications.Healthcare staff highly rated the system.

OBJECTIVE To understand the drug resistance,serotypes,virulence-associated genes and epidemiologi-cal characteristics of group B Streptococcus(GBS)isolated from puerpera in this area so as to provide bases for prevention of mother-to-infant infections.METHODS Totally 67 strains of GBS were isolated from obstetrics out-patient department of The First Affiliated Hospital of Nanchang University from Jan.2023 to Dec.2023.The spe-cies of the strains were identified by VITEK MS,the drug susceptibility testing was carried out by disc diffu-sion method.Multilocus sequencing types,capsular types,virulence genes and drug resistance genes were analyzed by means of whole genome sequencing technique.RESULTS The 67 strains of GBS were sensitive to penicillin,vancomycin,ceftriaxone and linezolid;the drug resistance rates to erythromycin and clindamycin were 76.12％and 55.22％,respectively.All strains fell into 7 serotypes,with serotype V predominant;21 sequence types were in-volved,with ST529 most prevalent;8 clonal complexes(CCs)were involved,with CC12 most common.Totally 17 types of drug resistance genes were identified,and the carrying rate of macrolide resistance gene ErmB was highest.Among all the virulence genes except for the adhesion genes fbsA and fbsB,the carrying rates of 18 genes involving in invasion,adhesion,and immune evasion-associated virulence genes were more than 86.57％;67.16％of the strains co-expressed both PI-1 and PI-2a pilus islands.CONCLUSIONS The drug resistance rate of the GBS strains isolated from the puerpera is high,and the strains carry multiple drug resistance genes and viru-lence genes and present with molecular clonal diversity.The serotype V/ST529 is the predominant clone,for which the prevention and control should be strengthened.

Objective:To investigate the drug resistance of newly diagnosed HIV-1 infected patients in Shanghai and to provide reference value for clinical antiretroviral therapy (ART).Methods:The peripheral venous blood plasma of 196 newly diagnosed HIV-1 infected patients screened according to the inclusion and exclusion criteria at the Shanghai Public Health Clinical Center from April to June 2023 was collected, HIV-1 RNA was extracted, the pol region was amplified by reverse transcription-polymerase chain reaction (RT-PCR) for sequencing, the mutation sites and ART drug resistance were analyzed.Results:The plasma of 196 newly diagnosed HIV-1 infected patients was amplified successfully in 162 cases (amplification success rate was 82.65%). The subtypes consisted of CRF07_BC(51.23%), CRF01_AE (27.78%), and others (6.79%), CRF55_01B (5.56%), B (3.70%), CRF01_AE/B (3.70%) and CRF08_BC (1.23%). The overall transmitted drug resistance rate was 7.41%, the protease inhibitors (PIs), non-nucleoside/nucleotide reverse transcriptase inhibitors (NNRTIs), nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs), integrase inhibitors (INSTIs) resistance rates were 3.09%, 3.70%, 0.00% and 0.62%, respectively. The proportion of NNRTIs-related mutation sites in B (66.67%) and CRF55_01B (88.89%) was higher than that in CRF07_BC (13.25%); the proportion of NNRTIs-related mutation sites in CRF55_01B (88.89%) was higher than that in CRF01_AE (22.22%) and other subtypes (18.18%), the difference was statistically significant (all P<0.05). Multivariate logistic regression analysis showed that the probability of PIs-related mutation sites in CRF01_AE/B was 21.71 times that of CRF07_BC[odds ratio ( OR)=21.71, 95% confidence interval ( CI): 3.36-140.27, P=0.001]. Conclusions:The transmitted drug resistance among newly diagnosed HIV-1 infected patients in Shanghai is at the moderate epidemic level, mainly NNRTIs and PIs-related drug resistance, and the INSTIs resistance rate is low, the use of INSTIs in ART regimens should be considered.

Objective To quantitatively analyze the effect of long-term ultrahigh-altitude and mid-high-altitude expo-sure on fundus microcirculation.Methods In the cross-sectional study,healthy residents from ultrahigh-altitude areas(＞3 500-5 500 m)and those from mid-high-altitude areas(＞1 500-3 500 m)were included as subjects.Meanwhile,healthy residents from plain areas were included as the control group.All subjects underwent optical coherence tomography angiography(OCTA)and spectral domain optical coherence tomography(SD-OCT)scans.Fundus images were quantified using ImageJ,and fundus microcirculation metrics were calculated and compared among these groups.Retinal microcircu-lation metrics included retinal vessel density(RVD),retinal skeleton density(RSD),fractal dimension(FD),foveal avas-cular zone(FAZ)area,and ganglion cell complex(GCC)thickness.Choroidal microcirculation metrics included subfoveal choroidal thickness(SFCT),luminal area(LA),total choroidal area(TCA),and choroidal vascularity index(CVI).Results In the ultra-high altitude group,the RVD was(32.52±3.57)％,the RSD was(15.05±4.24)％,and the FD was 1.68±0.08,all of which were significantly lower compared with the control group(all P＜0.001).The average thick-ness of GCC in the ultrahigh-altitude group was(98.76±10.26)μm,which was significantly thinner than the average thickness of GCC in the control group(P＜0.001).The TCA in the ultrahigh-altitude group was(2.15±0.49)mm2,the LA was(1.17±0.36)mm2,and the SFCT was(318.12±76.50)μm,all of which were significantly higher compared with the control group(all P＜0.001).However,the CVI was significantly decreased in the ultrahigh-altitude group compared with the control group(P＜0.001).There were no significant differences in fundus microcirculation metrics between the mid-high-altitude group and the control group(all P＞0.05).Conclusion Long-term ultrahigh-altitude exposure may induce ischemia and hypoxia in the fundus,primarily characterized by a decrease in the retinal and choroidal blood flow density,whereas long-term mid-high-altitude exposure cannot cause changes in the fundus microcirculation.

Objective·To determine hyaluronan(HA)expression in the endocrine-resistant microenvironment of estrogen receptor-positive(ER+)breast cancer and elucidate its impact on the acquired resistance.Methods·Chemiluminescent immunoassay was used to quantify HA levels in the culture supernatants of fulvestrant-resistant breast cancer cells.An immunofluorescence(IF)assay was performed to visualize the colocalization of CD44 and HA in MCF7/FulR cells.Using an established adaptive endocrine-resistant breast cancer mouse model,HA expression in resistant breast cancer tissues was assessed by immunohistochemistry(IHC)assay.Single-cell RNA sequencing(scRNA-seq)and RNA sequencing(RNA-seq)were conducted to examine transcriptomic profiles and alterations in HA-related genes in resistant breast cancer cells.Flow cytometry(FCM)was utilized to measure the proportion of CD44+CD24-cells in MCF7/FulR.The correlation between HA synthesis genes and cell stemness was investigated in clinical ER+breast cancers from GEO data sets.Hyaluronidase(HAase)treatment was applied to remove the"HA coat",and RT-qPCR and Western blotting analysis were carried out to monitor changes in stemness-related molecules.CCK-8 assays,flow cytometry(FCM),and Hoechst 33258 staining were performed to determine changes in apoptosis and fulvestrant efficiency after HAase treatment.Results·IF results revealed that compared with MCF7 cells,the"HA coat"on the surface of MCF7/FulR cells was significantly thickened.IHC demonstrated markedly increased HA retention in fulvestrant-resistant mouse breast cancer tissues.ScRNA-seq and RNA-seq analyses indicated elevated expression of stemness-related genes and HA synthesis-associated genes in fulvestrant-resistant breast cancer cells.Correlation analysis revealed a positive association between HA synthesis and cancer stemness in ER+breast cancer.IF and RT-qPCR results demonstrated that removing the HA coating from the surface of MCF7/FulR cells led to a significant reduction in the expression of stemness-related molecules;concurrently,CCK-8 assays,FCM analysis,and Hoechst 33258 staining revealed that"HA coat"clearance reduced MCF7/FulR'tolerance to fulvestrant and increased apoptosis.Conclusion·Endocrine-resistant breast cancer cells develop an enriched"HA coat",which promotes stemness in fulvestrant-resistant tumors.Disruption of this HA coat through HAase treatment effectively reduces cell stemness,induces apoptosis,and re-sensitizes breast cancer cells to fulvestrant.

Objective To summarize the best evidence of early rehabilitation management of hand function in patients with hand burn,and provide basis for medical personnel to carry out early rehabilitation management of hand burn.Methods According to the 5S model,all evidence on early rehabilitation management of hand function in patients with hand burns was retrieved from databases and websites including UpToDate,BMJ Best Practice,NICE,RNAO,GIN,and so on.The retrieved evidence included clinical decisions,guidelines,evidence summaries,expert consensuses,systematic reviews,Meta analysis.The search period of the summary of best evidence,expert concensus and guidelines are from the establishment of the database to December 20,2024,and the search period of the systematic reviews is from January 1,2019 to December 20,2024.Quality evaluation of literature,evidence extraction and summary were conducted.The evidence was graded according to JBI evidence pre-grading system 2014.Results Totally 17 pieces of the literature were included,including 1 clinical decision,4 guidelines,6 evidence summaries,3 expert consensus articles,and 3 systematic reviews.Totally pieces of best evidence were summarized,including 7 aspects of assessment,hand positioning,treatment of edema,dressing,use of orthotics,joint mobility training,and health education.Conclusion This study summarized the best evidence of early rehabilitation management of hand function in patients with hand burn,and provided evidence-based evidence for clinical rehabilitation management plan.According to the clinical situation,the medical staff can apply the evidence to clinical practice,so as to improve the hand function and quality of life of patients.