Objective To analyze the epidemiological characteristics and disease burden of liver cancer in Guangdong Province in 2020, and to provide a scientific foundation for the development of regionalized prevention and control strategies for liver cancer. Methods According to the cancer registry data of Guangdong Province, the incidence, mortality and age-standardized rate by Chinese standard population in 2020 were calculated to analyze the epidemiological characteristics of liver cancer. The disability adjusted life years (DALYs), year of life loss (YLL), year of lived with disability (YLD), and cause-eliminated life expectancy were used to assess the disease burden of liver cancer. Results In 2020, the crude incidence rate and the age-standardized incidence rate of liver cancer in Guangdong Province were 27.79/100 000 and 20.84/100 000，respectively, and the crude mortality rate and the age-standardized mortality rate of liver cancer were 25.49/100,000 and 17.64/100 000, respectively. The total DALY and DALY rate of liver cancer in Guangdong Province were 515 311 person-years and 513.83/100 000, respectively. After eliminating the causes of death from liver cancer, the life expectancy in Guangdong Province increased from 84.60 years to 84.99 years. All indicators consistently demonstrated that the burden of liver cancer was higher in males than that in females, and the burden of liver cancer was higher in rural areas than that in urban areas. Conclusion Liver cancer in Guangdong Province exhibits a high incidence, mortality and disease burden level in 2020. There are obvious differences of gender, age and region in cancer burden. It is necessary to strengthen liver cancer screening and diagnosis and treatment in men, the elderly and those in rural areas to reduce the burden of liver cancer gradually in Guangdong Province.

Digital intelligence technology is a comprehensive technical system with data as the key element and artificial intelligence as the core driving force. It provides innovative methodological support for addressing core bottlenecks in rare disease etiology research, including sample scarcity, high-dimensional datacomplexity, intricate pathogenic mechanisms, and challenges in causal validation. This paper systematically reviews the application pathways and current implementation of digital intelligence across four major stages of rare disease research, including etiological clue mining, causal inference, mechanism analysis, and clinical translation. Furthermore, it summarizes the technical strengths, existing limitations, and developmental challenges, aiming to inform optimization of the research paradigm and promote the sustainable advancement of rare disease research.

Vacuum compression molding (VCM) is a novel technology supporting the research and development of pharmaceutical solid dispersions. It is widely applied due to its precision and convenience in sample preparation. This technology integrates the principles of heating, melting, cooling, and vacuum compression to transform solid powders into shaped solids directly. By selecting different molds, temperatures, and pressures, researchers can prepare samples with diverse characteristics. This paper presents an overview of the equipment composition and working principles of VCM technology, demonstrating its distinct advantages in the formulation screening process of amorphous solid dispersions through comparative analysis with hot melt extrusion using case studies, and introduces its applications in the development of drug delivery systems and rheological characterization analysis, with a perspective on the future development of its functions.

Objective:To discuss whether safranal affects the proliferation,migration,and phenotypic transformation of the vascular smooth muscle cells(VSMCs)in a high-glucose environment and to clarify the function of safranal in the prevention and treatment of diabetic(DM)vascular complications.Methods:The SD rats were selected as experimental subjects;primary VSMCs were cultured from rat thoracic aortas and divided into control group,25 mmol·L-1 high glucose(HG)group,HG+20 μmol·L-1 safranal group,HG+40 μmol·L-1 safranal group,and HG+80 μmol·L-1 safranal group.The cells in control group received no treatment;the cells in 25 mmol·L-1 HG group were pretreated with 25 mmol·L-1 HG;the cells in HG+20,40,and 80 μmol·L-1 safranal groups were further treated with 20,40,and 80 μmol·L-1 safranal respectively for 48 h on the basis of 25 mmol·L-1 HG group.Cell counting kit-8(CCK-8)method was used to determine the appropriate concentration of safranal and detect the viabilities of the VSMCs in various groups;cell scratch healing assay was used to detect the scratch healing rates of the VSMCs in various groups;Transwell chamber assay was used to detect the numbers of the migration VSMCs in various groups;immunofluorescence method was used to detect the fluorescence intensities of alpha-smooth muscle actin(α-SMA)and rabbit anti-osteopontin(OPN)in the VSMCs in various groups;Western blotting method was used to detect the expression levels of OPN,α-SMA,and proliferating cell nuclear antigen(PCNA)in the VSMCs in various groups.Results:Under microscope,on the 4th day of in vitro culture,the spindle-shaped or triangular cells crawled out from the edge of the thoracic aorta tissue blocks,with long spindle being the most common morphology.On the 14th,the cells gradually covered the bottom of the dish;when cell density reached 80%-90%,the characteristic"hills and valleys"growth pattern appeared.Third-generation cells were taken for immunofluorescence identification;immunofluorescence staining with VSMC-specific marker α-SMA showed positive expression of α-SMA protein in the primarily cultured VSMCs.The CCK-8 assay results showed that compared with control group,the cell viability of the cells in 160 μmol·L-1 safranal group was significantly decreased(P<0.01),indicating toxic damage to the cells.Under the conditions of safranal concentrations at 20,40,and 80 μmol·L-1 respectively,after 48 h intervention on VSMCs,no significant adverse effect on cell viability was observed;considering both the effect and toxicity of safranal,these three concentrations were used in subsequent cell experiments.After 48 h intervention,compared with control group,the activity of the VSMCs in 25 mmol·L-1 HG group was increased(P<0.001);compared with 25 mmol·L-1 HG group,the activities of the VSMCs in HG+20,40,and 80 μmol·L-1 safranal groups were gradually decreased(P<0.05).The cell scratch healing assay and Transwell assay results showed that after 48 h intervention,the scratch healing rate of the VSMCs in 25 mmol·L-1 HG group was significantly higher than that in control group(P<0.01),and the number of transmembrane cells through the Transwell chamber was significantly increased(P<0.05);compared with 25 mmol·L-1 HG group,the scratch healing rates of the VSMCs in HG+20,40,and 80 μmol·L-1 safranal groups were gradually decreased(P<0.05),and the number of transmembrane cells was decreased(P<0.05).The immunofluorescence staining results showed that compared with control group,the fluorescence intensity of α-SMA protein in the VSMCs in 25 mmol·L-1 HG group was significantly weakened(P<0.001),while the fluorescence intensity of OPN protein was significantly enhanced(P<0.001);compared with 25 mmol·L-1 HG group,the fluorescence intensities of α-SMA protein in the VSMCs in HG+20,40,and 80 μmol·L-1 safranal groups were gradually increased(P<0.05),and the fluorescence intensities of OPN were gradually weakened(P<0.05).The Western blotting method results showed that compared with control group,the expression level of α-SMA protein in the VSMCs in 25 mmol·L-1 HG group was decreased(P<0.05),and the expression levels of PCNA and OPN proteins were increased(P<0.01);compared with 25 mmol·L-1 HG group,the expression level of α-SMA protein in the VSMCs in HG+20,40,and 80 μmol·L-1 safranal groups were increased(P<0.05),and the expression levels of PCNA and OPN proteins were decreased(P<0.05).Conclusion:Safranal can inhibit the proliferation,migration,and phenotypic transformation of the VSMCs induced by high glucose.

Knee osteoarthritis (KOA) is a common chronic degenerative disease that not only causes pain and reduces the quality of life for patients but also imposes a significant societal burden. Clinical pathways can be developed by referencing recommendations from clinical practice guidelines to localize guidelines within the context of integrated traditional Chinese and western medical systems. However, existing clinical pathways suffer from shortcomings such as deficiencies in integrated traditional Chinese and western medical diagnosis and treatment, inadequate shared decision-making between healthcare providers and patients, and suboptimal visualization of clinical pathways. This study aimed to address and optimize the clinical pathway of KOA by comprehensively organizing and localizing the recommended guidelines. The concept of integrated traditional Chinese and western medicine was reflected through the construction of a path of joint decision-making between doctors and patients, emphasizing the coexistence of diagnosis and screening, the combination of clinical and imaging staging, joint decision-making between doctors and patients, and treatment stages. This pathway emphasizes patient-centered approach, with pain relief and functional rehabilitation running parallel, achieving the implementation of evidence-based concepts in practical medical practice. It provides a concrete basis for joint decision-making between doctors and patients in the integrated treatment of KOA with traditional Chinese and western medicine, which helps to improve diagnosis and treatment efficiency and patient quality of life.

Objective:To evaluate the efficacy of high-flow nasal cannula oxygen therapy for lumbosacral plexus block combined with intravenous anesthesia for hip replacement in elderly patients.Methods:Twenty-two elderly patients of either sex, aged 65-89 yr, with a body mass index of 18-28 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ, scheduled for elective lateral approach to unilateral hip replacement, capable of cooperating to complete the Mini-Mental State Examination with a score of ≥25, were included. Preoperative lumbosacral plexus block was performed on the affected side under ultrasound guidance. Sufentanil 0.1 μg/kg was intravenously injected at 5 min before skin incision, and propofol was given by target-controlled infusion at a plasma target concentration of 1.0-2.0 μg/ml. During the operation, spontaneous breathing was preserved and high-flow nasal cannula oxygen therapy was performed. FiO 2 was set at 60%, gas flow rate at 60 L/min, temperature at 37 ℃, humidity at 100%. The values of Bispectral Index were 60 -75, and the Surgical Pleth Index value was 30-60. If the Surgical Pleth Index value > 60, an additional sufentanil 0.05 μg/kg was added. PaO 2, FiO 2 and PaCO 2 were recorded immediately before nerve block (T 1), immediately after the start of surgery (T 2), 30 min after the start of surgery (T 3), 90 min after the start of surgery (T 4), immediately after the end of surgery (T 5) and immediately after leaving postanesthesia care unit (T 6). Lung ultrasound scores were recorded at T 1 and T 6. The development of intraoperative hypotension, bradycardia and hypoxemia and occurrence of postoperative nausea and vomiting, new pulmonary infection, delirium and cognitive dysfunction were recorded. Results:Nerve block was completed within 15 min in all the patients, and all the patients underwent surgery successfully. PaO 2/FiO 2 increased at T 4 and T 5, while at T 6 it decreased to the level observed at T 1 ( P<0.05); PaCO 2 increased at T 2-T 6 and reached the peak value at T 2 ( P<0.05). There was no significant difference in lung ultrasound scores at all time points ( P>0.05). There were 8 patients (36%) with hypotension and 2 patients (9%) with bradycardia, and no hypoxemia was found during operation. Postoperative nausea and vomiting occurred in 2 cases (9%) and delirium in 2 cases (9%), and no new pulmonary infection or cognitive dysfunction was found after operation. Conclusions:High-flow nasal cannula oxygen therapy can be safely and effectively used in elderly patients undergoing hip replacement with lumbosacral plexus block combined with intravenous anesthesia.

Objective To investigate the mechanisms by which astaxanthin(AST)alleviates oxaliplatin(OXA)-induced neuropathic pain through antioxidant pathways so as to provide theoretical basis for clinical intervention.Methods Animal experiments:SD rats were divided into five groups(n=6):control group,OXA(4 mg/kg)group,OXA+Oil group,OXA+AST(5 mg/kg)group,and OXA+AST(10 mg/kg)group.Mechanical and cold pain thresholds were measured at day 0,7,14,and 21.Malondialdehyde(MDA)content and superoxide dismutase(SOD)activity in the dorsal root ganglia(DRG)were detected using the thiobarbituric acid(TBA)method and WST-1 assay,respectively.Western blotting was performed to analyze the expressions of Nrf2 and HO-1.Cell experiments:neuro-2a cells were divided into control group,OXA(50 μmol/L)group,AST(10 μmol/L)group,and OXA(50 μmol/L)+AST(10 μmol/L)group.Cells were treated with nerve growth factor(NGF,50 ng/mL)to induce growth,and morphological changes were observed under an inverted microscope.Intracellular reactive oxygen species(ROS)level and mitochondrial superoxide were measured using DCFH-DA fluorescent probe and MitoSOXTM red,respectively.Mitochondrial function was assessed by JC-1 assay.Western blotting was used to detect Nrf2 and HO-1 expressions.Results Animal experiments:① Mechanical and cold pain thresholds were reduced in OXA and OXA+Oil groups(P＜0.05),while AST significantly increased these thresholds in OXA-treated rats(P＜0.05).② SOD activity decreased while MDA content increased in the DRG of OXA-treated rats(P＜0.05).AST restored SOD activity and reduced MDA level(P＜0.05,P＜0.01).③ Western blotting showed elevated Nrf2 and HO-1 expressions in OXA group(P＞0.05),which were further upregulated by AST(P＜0.05,P＜0.01).Cell experiments:① OXA reduced the number of neurite-bearing cells and shortened the average neurite length(P＜0.05).Inverted microscopic observation revealed that AST intervention increased both parameters(P＜0.01,P＜0.001).② OXA increased intracellular and mitochondrial ROS fluorescence intensity(P＜0.05),which was attenuated by AST(P＜0.01).③ JC-1 assay revealed decreased mitochondrial membrane potential in OXA group(P＜0.01),which was partially reversed by AST(P＜0.05).④ Western blotting results showed that OXA upregulated Nrf2 and HO-1 expressions(P＜0.05,P＜0.01),and AST further enhanced their levels(P＜0.01).Conclusion AST alleviates OXA-induced neuropathic pain by promoting Nrf2/HO-1 expression,enhancing SOD activity,reducing lipid peroxidation and ROS production,and improving mitochondrial function.

This article briefly introduces the new concept of burnout and the new burnout assessment tool BAT. In the past, the most famous burnout definition was proposed by Maslach and Leiter. The Maslach Burnout Inventory (MBI) developed by Maslach has also been the gold standard for evaluating burnout. With the development of burnout research, the concept of burnout has a certain defect. MBI has also been criticized in conceptual, practical and psychological measurement. It may hinder new research, and urgently needs to improve the concept and evaluation of burnout. Therefore, Schaufeli redefined the concept of burnout, and developed a new burnout assessment tool for groups and individuals based on the new concept of burnout-Burnout Assessment Tool (BAT) . This paper systematically reviews the proposal of the new concept of burnout, the development of the BAT scale and its application at home and abroad, and analyzes the advantages and application prospects of the BAT scale.

Objective:To verify the reliability and validity of the short version of the Chinese version of the new Burnout Assessment Tool (12 items version of Burnout Assessment Tool, BAT-12) .Methods:From October to December 2023, the cluster sampling method was adopted, and the Chinese version of the Maslach Burnout Inventory-General Survey (MBI-GS) and the BAT-12 scale were used simultaneously. A questionnaire survey was conducted among enterprise employees (4329 people) in Shanghai and Guangdong Province. Exploratory factor analysis and confirmatory factor analysis and other methods were employed to analyze its reliability (internal consistency reliability and combination reliability) and validity (structural validity, convergent validity, discriminative validity and criterion validity) .Results:A total of 4329 questionnaires were retrieved, among which 4086 were valid, with an effective recovery rate of 94.39%. The Cronbach's α coefficient of the Chinese version of the BAT-12 total scale was 0.956, and the combination reliability coefficients of each dimension ranged from 0.914 to 0.952. The scale contained 12 items, and 4 common factors were extracted from exploratory factor analysis, including exhaustion, mental distance, cognitive impairment, and emotional impairment. The cumulative variance contribution rate reached 86.63%. Confirmatory factor analysis showed that both the four-factor correlation model and the second-order model were ideally fitted overall, with the four-factor correlation model having the best data fit (comparative fit index 0.972, Tuker-Lewis fit index 0.962, root mean square error of approximation 0.064, and standardized root mean square residual 0.033). The average variance extracted (AVE) of each dimension of the scale ranged from 0.780 to 0.868, and the square roots of AVE (0.883 to 0.932) were all greater than their Pearson correlation coefficients (0.630 to 0.850). The Pearson correlation coefficient between BAT-12 and MBI-GS was 0.787 ( P<0.001) . Conclusion:The Chinese version of the BAT-12 scale demonstrates strong internal consistency and combination reliability, with excellent reliability. Its four-dimensional structure validity has been validated, with good convergent validity, discriminative validity, and ideal criterion validity, demonstrating excellent validity. The Chinese version of the BAT-12 scale can be used to measure the level of occupational burnout among Chinese employees.

Objective:To evaluate the efficacy of high-flow nasal cannula oxygen therapy for lumbosacral plexus block combined with intravenous anesthesia for hip replacement in elderly patients.Methods:Twenty-two elderly patients of either sex, aged 65-89 yr, with a body mass index of 18-28 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ, scheduled for elective lateral approach to unilateral hip replacement, capable of cooperating to complete the Mini-Mental State Examination with a score of ≥25, were included. Preoperative lumbosacral plexus block was performed on the affected side under ultrasound guidance. Sufentanil 0.1 μg/kg was intravenously injected at 5 min before skin incision, and propofol was given by target-controlled infusion at a plasma target concentration of 1.0-2.0 μg/ml. During the operation, spontaneous breathing was preserved and high-flow nasal cannula oxygen therapy was performed. FiO 2 was set at 60%, gas flow rate at 60 L/min, temperature at 37 ℃, humidity at 100%. The values of Bispectral Index were 60 -75, and the Surgical Pleth Index value was 30-60. If the Surgical Pleth Index value > 60, an additional sufentanil 0.05 μg/kg was added. PaO 2, FiO 2 and PaCO 2 were recorded immediately before nerve block (T 1), immediately after the start of surgery (T 2), 30 min after the start of surgery (T 3), 90 min after the start of surgery (T 4), immediately after the end of surgery (T 5) and immediately after leaving postanesthesia care unit (T 6). Lung ultrasound scores were recorded at T 1 and T 6. The development of intraoperative hypotension, bradycardia and hypoxemia and occurrence of postoperative nausea and vomiting, new pulmonary infection, delirium and cognitive dysfunction were recorded. Results:Nerve block was completed within 15 min in all the patients, and all the patients underwent surgery successfully. PaO 2/FiO 2 increased at T 4 and T 5, while at T 6 it decreased to the level observed at T 1 ( P<0.05); PaCO 2 increased at T 2-T 6 and reached the peak value at T 2 ( P<0.05). There was no significant difference in lung ultrasound scores at all time points ( P>0.05). There were 8 patients (36%) with hypotension and 2 patients (9%) with bradycardia, and no hypoxemia was found during operation. Postoperative nausea and vomiting occurred in 2 cases (9%) and delirium in 2 cases (9%), and no new pulmonary infection or cognitive dysfunction was found after operation. Conclusions:High-flow nasal cannula oxygen therapy can be safely and effectively used in elderly patients undergoing hip replacement with lumbosacral plexus block combined with intravenous anesthesia.