Chronic obstructive pulmonary disease (COPD) is the most common chronic respiratory disease around the world, and pharmacotherapy is the foremost treatment method currently. In recent decades, with the rapid development of bronchoscopic interventional therapy, endoscopic physical ablation technology presents a therapeutic effect in treating COPD, with few treatment-related side effects, showing excellent application prospects in treating COPD. Since ablation techniques in this field are emerging technologies with low patient acceptance, they are not widely used in the clinical treatment of COPD. This article reviews the development process of physical ablation techniques. Moreover, their current application status and the prospects in the field of COPD treatment are also summarized and analyzed. We hope to promote the application of physical ablation in the clinical treatment of COPD and provide practical references and a theoretical basis for the clinical treatment of COPD.

Retinopathy of prematurity(ROP)is a leading cause of childhood blindness, with extremely preterm and very-low-birth-weight infants now constituting the main high-risk group. ROP progresses in two stages: early retinal microvascular degeneration and progressive vascular arrest, followed by abnormal neovascularization in the avascular area. Early oxidative and nitrosative stress—amplified by oxygen fluctuations and immature antioxidant defenses—drives the two-phase pathogenesis via hypoxia-inducible factor/vascular endothelial growth factor(HIF/VEGF), NOX/STAT3, and nuclear factor erythroid 2 related factor 2(Nrf2)-antioxidant response element(ARE)pathways, mediating apoptosis of endothelial cells, damage to barrier and pathological angiogenesis. This review systematically analyzes different oxygen-induced retinopathy(OIR)models, elucidates key signaling pathways including Notch, Wnt in physiological and pathological vascularization, with particular emphasis on the biphasic effects of Nrf2 and the differential roles of NOX signaling between phases. We also discuss the limitations of anti-VEGF therapy and oxygen management principles. Reactive oxygen species(ROS)play context-dependent roles across vaso-obliteration and neovascularization phases. Based on mechanistic insights, we propose future directions including combined/sequential interventions, ferroptosis and lipid peroxidation targeting, nano-delivery systems for enhanced bioavailability, and perinatal safety assessment strategies, aiming to provide translatable mechanistic basis for reducing pathological neovascularization while promoting physiological vascular development.

Objective: To investigate the association between childhood obesity and type 2 diabetes mellitus (T2DM) as well as coronary artery heart disease (CHD). Methods: Genome-wide association study (GWAS) data for childhood obesity were collected from the ECG consortium, encompassing information on children aged 2 to 18 years, including 18 613 cases and 12 696 controls. GWAS data for T2DM were collected from the DIAGRAM consortium, including 242 283 cases and 1 569 734 controls. GWAS data for CHD were collected from the CARDIoGRAMplusC4D consortium, including 10 801 cases and 137 371 controls. Pleiotropic genes associated with both T2DM and CHD were analyzed using the MAGMA, PLACO and conditional false discovery rate (cFDR) methods. Mendelian randomization (MR) analysis was performed using inverse variance weighted (IVW) method, exploring the causal relationships among childhood obesity, T2DM and CHD. Heterogeneity was evaluated using Cochran's Q test, horizontal pleiotropy and exclude outliers were tested using MR-Egger regression and MR-PRESSO test. The mediating variables among the three diseases were investigated by using a mediation analysis. Results: The results of MAGMA, PLACO and cFDR analyses identified 80 pleiotropic genes associated with both T2DM and CHD, primarily distributed on chromosomes 3, 17 and 19. The MR analysis revealed that childhood obesity increased the risk of T2DM (OR=1.151, 95%CI: 1.033-1.283) and CHD (OR=1.158, 95%CI: 1.068-1.255), T2DM increased the risk of CHD (OR=1.182, 95%CI: 1.139-1.227), and CHD increased the risk of T2DM (OR=1.124, 95%CI: 1.055-1.198). The MR-Egger regression analysis showed no horizontal pleiotropy, and the MR-PRESSO test did not identify any outliers (all P>0.05). Mediation analysis indicated that childhood obesity directly increased the risk of CHD (effect value=0.096, 95%CI: 0.012-0.180) and indirectly increased the risk of CHD through T2DM (effect value=0.023, 95%CI: 0.005-0.041), with the mediation effect accounting for 15.65% of the total effect. Conclusions There are potential causal associations between childhood obesity and T2DM as well as CHD, with a bidirectional causal relationship between T2DM and CHD. T2DM also plays a mediating role in the association between childhood obesity and CHD.

Objective:To construct the gemcitabine resistant cell lines of human pancreatic cancer cell line (PANC1) and mouse pancreatic cancer cell line (PANC02), and to investigate their biological behavior changes.Methods:Gemcitabine-resistant cell lines PANC1-GR of human pancreatic cancer and PANC02-GR of mouse pancreatic cancer were induced by concentration gradient increment method. Cell count assay (CCK-8), flow cytometry, cell scratch assay and Transwell assay were used to detect the drug resistance, proliferation, cell cycle, migration and invasion of the four groups of cell lines. The drug-resistant cells were also compared with the parent cells.Results:The resistance indices of PANC1-GR and PANC02-GR were 153.3 and 185.4, respectively. The results of CCK-8 showed that with the increase of gemcitabine concentration, the proliferation of resistant cells changed significantly compared with parental cells, the population doubling time of PANC1-GR was significantly shorter than that of PANC1 (1.5±0.1) d vs (2.4±0.2) d ( t=8.00, P<0.001). The proportion of cells in S and G2/M phase increased, and the proportion of cells in G0/G1 phase decreased. The cell scratch and Transwell experiments indicated that the 24h mobility of PANC1-GR and PANC02-GR was higher than that of parent cells (47.6±2.4)% vs (28.7±6.3)% and (53.6±3.2)% vs (30.1±1.4)%, the number of individual field (200 times magnification) penetrating membrane cells was also higher than that of parent cells (269.7±30.9) vs (62.7±10.1) and (172.0±30.8) vs (36.3±4.9), with statistical significance (all P<0.05). Conclusion:Concentration gradient increment method can successfully establish gemcitabine-resistant pancreatic cancer cell lines, which have stronger proliferation, migration and invasiveness, and can be used to study the mechanism of drug resistance in pancreatic cancer.

Objective To explore the mechanism of NLRP3 gene knockout in relation to the abnormal mucosal barrier and inflammatory factors in ulcerative colitis(UC)mice.Methods Thirty-two NLRP3-knockout(NLRP3-/-)mice and 30 C57BL/6 wild-type(WT)mice were divided randomly into six groups:NLRP3-/-blank,NLRP3-/-model,NLRP3-/-mesalazine,WT blank,WT model,and WT mesalazine groups.Except for mice in the two blank groups,mice in the other groups were given 3％dextran sodium sulfate to drink freely for 5 days to establish an UC mouse model.After successful establishment of the model,mice in each group underwent intragastric administration of the respective solution for 7 consecutive days.The general condition,body weight,disease activity index(DAI)score,and colon length were observed and evaluated in each group.Histopathological changes in the colon were observed by hematoxylin and eosin staining.ZO-1,claudin-1,occludin,tumor necrosis factor(TNF)-αand interleukin(IL)-6 expression in colon tissue were detected by immunohistochemistry.Results(1)The DAI score was significantly higher in the NLRP3-/-model group compared with the WT model group on day 12,while colon length was significantly shorter and pathological injury of the intestinal mucosa was more serious.Expression levels of ZO-1,claudin-1,and occludin in colon tissue were lower whereas expression levels of TNF-α and IL-6 were significantly higher in the NLRP3-/-model group compared with the WT model group.(2)Regarding the two mesalazine groups,the DAI score was significantly higher and expression levels of ZO-1,claudin-1,and occludin in colon tissue were lower in the NLRP3-/-mesalazine compared with the WT mesalazine group on day 12.Conclusions Specific knockout of the NLRP3 gene makes mice more sensitive to UC.Compared with WT mice,NLRP3-/-UC mice have more severe mucosal barrier injury and release more inflammatory factors.Mesalazine could repair the mucosal barrier and reduce inflammation in NLRP3-/-and WT UC mice.Under the same experimental conditions,mesalazine repaired the mucosal barrier more effectively in WT compared with NLRP3-/-UC mice.

Objective:To analyze the epidemiological characteristics of imported malaria in Shaoxing City and provide scientific basis for formulating prevention and control measures against imported malaria.Methods:A retrospective analysis was conducted. Data on imported malaria cases reported in Shaoxing City from 2012 to 2024 were collected from the infectious disease reporting information system of China Center for Disease Control and Prevention, and the parasitic disease control information management system, including general information, epidemiological investigation reports and diagnosis/treatment status, to analyze their epidemiological characteristics.Results:From 2012 to 2024, there were 110 imported malaria cases in Shaoxing City, including 105 males and 5 females, with a sex ratio of 21 ∶ 1. The youngest patient was 21 years old and the oldest was 73 years old, with 72 cases (65.45%) in the 30-50 age group. The 110 malaria cases included 69 cases of falciparum malaria, 22 cases of vivax malaria, 15 cases of ovale malaria, 3 cases of quartan malaria, and 1 case of mixed infection. The infection sources were Africa (84.55%, 93/110) and Asia (15.45%, 17/110). Among all patients, there were 19 foreign nationals and 91 Chinese citizens. The main purposes of travel for Chinese citizens were labor work (67.03%, 61/91) and business (29.67%, 27/91). Areas with more reported cases were Zhuji City (32 cases), Keqiao District (27 cases), Xinchang County (19 cases) and Yuecheng District (19 cases). The peak months of onset were January, July and September, with 12, 12 and 18 cases respectively. The first medical visits were mainly at county-level hospitals, center for disease control and prevention at all levels and municipal hospitals, with diagnosis rates of 86.67% (52/60), 100% (21/21) and 12/15 respectively. Compared with cases without malaria history, cases with malaria history had shorter time from onset to diagnosis (median, 5.00 d vs. 2.00 d, Z =-2.40, P = 0.004). Conclusions:From 2012 to 2024, imported malaria in Shaoxing City was mainly falciparum malaria, with Africa being the main infection source. The peak incidence occurred in summer. Male young adult overseas workers were the high-risk population. The prevention and control of imported malaria in Shaoxing City should focus on preventing relapse after importation and cure.

Objective:To analyze the epidemiological characteristics of imported malaria in Shaoxing City and provide scientific basis for formulating prevention and control measures against imported malaria.Methods:A retrospective analysis was conducted. Data on imported malaria cases reported in Shaoxing City from 2012 to 2024 were collected from the infectious disease reporting information system of China Center for Disease Control and Prevention, and the parasitic disease control information management system, including general information, epidemiological investigation reports and diagnosis/treatment status, to analyze their epidemiological characteristics.Results:From 2012 to 2024, there were 110 imported malaria cases in Shaoxing City, including 105 males and 5 females, with a sex ratio of 21 ∶ 1. The youngest patient was 21 years old and the oldest was 73 years old, with 72 cases (65.45%) in the 30-50 age group. The 110 malaria cases included 69 cases of falciparum malaria, 22 cases of vivax malaria, 15 cases of ovale malaria, 3 cases of quartan malaria, and 1 case of mixed infection. The infection sources were Africa (84.55%, 93/110) and Asia (15.45%, 17/110). Among all patients, there were 19 foreign nationals and 91 Chinese citizens. The main purposes of travel for Chinese citizens were labor work (67.03%, 61/91) and business (29.67%, 27/91). Areas with more reported cases were Zhuji City (32 cases), Keqiao District (27 cases), Xinchang County (19 cases) and Yuecheng District (19 cases). The peak months of onset were January, July and September, with 12, 12 and 18 cases respectively. The first medical visits were mainly at county-level hospitals, center for disease control and prevention at all levels and municipal hospitals, with diagnosis rates of 86.67% (52/60), 100% (21/21) and 12/15 respectively. Compared with cases without malaria history, cases with malaria history had shorter time from onset to diagnosis (median, 5.00 d vs. 2.00 d, Z =-2.40, P = 0.004). Conclusions:From 2012 to 2024, imported malaria in Shaoxing City was mainly falciparum malaria, with Africa being the main infection source. The peak incidence occurred in summer. Male young adult overseas workers were the high-risk population. The prevention and control of imported malaria in Shaoxing City should focus on preventing relapse after importation and cure.

Objective:To construct a nursing quality evaluation indicator system for pulse indicator continuous cardiac output (PiCCO) monitoring and provide a basis for evaluating the nursing quality of PiCCO monitoring.Methods:Using Donabedian′s "structure-process-result" three-dimensional quality evaluation model as the theoretical framework, the nursing quality evaluation indicator system for PiCCO was established through literature search, Delphi expert correspondence, and hierarchical analysis during the period May to August 2023.Results:Of the 22 experts, 6 were male and 16 were female, aged (46.59 ± 4.34) years. The return rates of the questionnaires of the 2 rounds of expert correspondence were both 100%, the coefficients of expert authority were both 0.945, and the Kendall coordination coefficients were 0.045-0.186 ( χ2 values were 2.00-221.46, all P<0.05) and 0.045-0.132 ( χ2 values were 2.00-82.16, all P<0.05), respectively. The finalized nursing quality evaluation indicator system for PiCCO included 3 primary indicators, 7 secondary indicators, and 36 tertiary indicators. Conclusions:The nursing quality evaluation indicator system for PiCCO is practical and scientific, which can provide reference for PiCCO monitoring nursing quality evaluation.

Objective A data mining method was used to analyse and summarize Professor Zheng Wenlong's ideas and prescription and medication rules for the treatment of cirrhosis,taking the case of cirrhosis of the liver in Ren-yin year(2022)as an example.Methods A collection of traditional Chinese medicine prescriptions for liver cirrhosis patients who received treatment at the clinic of chief traditional Chinese medicine physician Zheng Wenlong at Hangzhou Traditional Chinese Medicine Hospital of Zhejiang Chinese Medical University from January 20,2022 to January 19,2023,and who met the inclusion and exclusion criteria.An excel database was created to standardize the data,followed by frequency statistical analyzes of prescriptions,medications and the characteristics of herbal remedies.Association rule analysis was carried out using SPSS Modeler 18,which facilitated the creation of complex network diagrams,subsequently enhanced through visualization in software Cytoscape.Clustering analysis was executed utilizing SPSS 25.0.Results A total of 176 prescriptions were selected,and the top 3 most frequently used prescriptions were Lingzhu decoction,Shengming decoction and Beihua decoction,with the frequency of 10.13%(23/227),10.13%(23/227)and 9.69%(22/227).A diverse array of 155 herbal medicines were employed,and the top 3 most frequently used drugs were Glycyrrhiza,Poria and Zingiberis Rhizoma Recens,with the frequency of 4.75%(127/2 676),4.26%(114/2 676)and 3.21%(86/2 676).The predominant medicinal properties of these herbs were classified as either cold or warm,while the primary tastes identified were bitter,sweet and spicy,with channel tropism were liver,lung,stomach and spleen.According to the descending order of improvement percentage,the results showed that the strongly correlated pairs of herbs were Chaenomelis Fructus-Aconiti Lateralis Radix Praeparata and Citri Reticulatae Pericarpium Viride-Pericarpium Citri Reticulatae,with improvement degrees of 2.74%and 2.55%respectively;the strongly correlated 3-herb combinations(Jiao Yao)included Aconiti Lateralis Radix Praeparata-Poria-Chaenomelis Fructus and Aconiti Lateralis Radix Praeparata-Rhizoma Atractylodis Macrocephalae-Chaenomelis Fructus,with improvement degrees of 3.24%and 3.23%respectively.The clustering analysis categorized the high-frequency herbs into 3 distinct groups:C1:Citri Reticulatae Pericarpium Viride,Pericarpium Citri Reticulatae,Jujubae Fructus,Pinelliae Rhizoma Praeparatumcum Zingibere Et Alumine,and Zingiberis Rhizoma Recens;C2:Rhizoma Atractylodis Macrocephalae,Aconiti Lateralis Radix Praeparata,Artemisiae Scopariae Herba,and Paeoniae Radix Alba;C3:Schisandra Chinensis,Rhizoma Alismatis,Radix Glycyrrhizae,Poria,Zingiberis Rhizoma and Ramulus Cinnamomi.These correspond to the formulas of Erchen decoction,Yinchenshufu decoction and Wuling powder.Conclusions The underlying pathogenesis of cirrhosis is linked to dysfunctions of the Jueyin and Yangming meridians,as well as disturbances in the Shaoyang axis.The primary therapeutic approach of Professor Zheng Wenlong involves a comprehensive evaluate all of the patient's clinical presentation to identify the shared pathogenesis underlying various symptoms,integrating the patient's personal constitution with the annual cycle of the Five Phases(Wuyun)and Six Qi(Liuqi)as described in traditional Chinese medicine,and formulate prescriptions based on the interactions of the Five Phases(Wuxing)and guided by the yin-yang theory of"Opening-Closing-Pivot"(Kai-He-Shu).The focus of prescriptions is rehabilitation and the final goal is reach the state of"Tian Ren He Yi".

Objective lt aims to identify key issues in the current informatization development of internal control over revenue and expenditure in public hospitals.The findings are intended to serve as a reference for deepening this informatization effort.Methods Following the steps and requirements of content analysis method,it involved a semi-quantitative analysis of policies and expert interviews to establish an analytical framework.Two researchers uti-lized NVivo 15 software to analyze the policy and articles.The analysis results were quantified statistically,and key is-sues were summarized.Results lt developed a content analysis framework comprising 5 primary categories and 17 secondary categories.Based on this framework,326 analytical units extracted from 81 articles were categorized and statistically analyzed.Key problems corresponding to each secondary category were summarized.Conclusion To ad-dress five key issues,it proposes a five-dimensional solution including:building a digital foundation to integrate busi-ness systems;establishing a Master Data Management platform to dismantle data silos;developing flexible ap-proval mechanismsfor medical emergencies;deploying an Al risk control hub for precise payment interception,and implementing zero-trust architecture to enhance e-bill anti-counterfeiting-ultimately forming a business-finance-in-tegrated,data-and-Al-driven,proactively secured internal control system covering budget formulation to fund su-pervision.