ObjectiveTo investigate the inhibitory effect of Biejiajian Pills （BJJW） on the growth of liver cancer， as well as its potential mechanism in mediating the AMP-activated protein kinase （AMPK）/mammalian target of rapamycin （mTOR） pathway through mitochondrial energy metabolism. MethodsHuman hepatoma Huh7 cells were used to establish a nude mouse model of subcutaneous xenograft tumor. A total of 18 tumor-bearing nude mice were randomly divided into model group， BJJW group （2.2 g/kg）， and metformin group （250 mg/kg）， and the corresponding drug was given by gavage for 14 consecutive days. Tumor volume and weight were monitored during the experiment； HE staining was used to observe histopathological changes； the levels of reactive oxygen species （ROS） and adenosine triphosphate （ATP） in tumor tissue were measured； immunohistochemistry and Western blotting were used to measure the expression levels of proteins associated with the AMPK/mTOR pathway. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups， and the Tukey’s test was used for further comparison between two groups； the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups， and the Dunn’s test was used for further comparison between two groups. ResultsCompared with the model group， the BJJW group had a tumor inhibition rate of 45.73%， with significant reductions in both tumor volume and weight （P<0.01）. Pathological examination showed that compared with the model group， the BJJW group had a significant reduction in the number of tumor cells and the presence of extensive necrosis. Mechanistic studies showed that compared with the model group， the BJJW group had a significant increase in ROS level （P<0.001） and a significant reduction in ATP level （P<0.001）， as well as significant increases in p-AMPK/AMPK ratio （0.81±0.20 vs 0.13±0.04， P<0.01） and p-ULK1/ULK1 ratio （0.69±0.17 vs 0.18±0.13， P<0.01） and a significant reduction in p-mTOR/mTOR ratio （1.34±0.16 vs 3.20±0.62， P<0.01）. ConclusionBJJW may inhibit the growth of liver cancer by inducing mitochondrial energy metabolism dysfunction， increasing the level of ROS， reducing the level of ATP， and activating the AMPK/mTOR signaling pathway.

Objective To investigate the relationship between the level of hand grip strength(HGS)-based cachexia index(H-CXI)and all-cause mortality in a population with abnormal liver function.Methods The study was based on the America National Health and Nutrition Examination Survey(NHANES)data from 2011～2014,which included 2 752 cases of people with abnormal liver function and followed up until December 31,2019,using Kaplan-Meier survival analysis and COX regression modeling to assess the relationship between H-CXI levels and all-cause mortality,and restricted cubic spline analysis to explore the nonlinear relationship.Results There were 244 all-cause deaths during a mean follow-up time of 82.70±3.86 months.H-CXI was ana-lyzed as a categorical variable(quartiles),and Cox regression analyses showed that in model 2,the risk of all-cause mortality was reduced in groups Q2,Q3 and Q4 compared with group Q1(HR=0.41,95%CI:0.21～0.82,P=0.012 1;HR=0.34,95%CI:0.16～0.69,P=0.003 1;HR=0.24,95%CI:0.09～0.67,P=0.006 3).Subgroup analyses revealed an interaction between stroke and all-cause mortality,and restricted cubic spline revealed a nonlinear relationship between H-CXI levels and all-cause mortality.Con-clusion H-CXI levels are negatively associated with the risk of all-cause mortality in people with abnormal liver function,and attention to H-CXI levels is needed in clinical practice to prevent adverse health outcomes.

Objective To investigate the relationship between the level of hand grip strength(HGS)-based cachexia index(H-CXI)and all-cause mortality in a population with abnormal liver function.Methods The study was based on the America National Health and Nutrition Examination Survey(NHANES)data from 2011～2014,which included 2 752 cases of people with abnormal liver function and followed up until December 31,2019,using Kaplan-Meier survival analysis and COX regression modeling to assess the relationship between H-CXI levels and all-cause mortality,and restricted cubic spline analysis to explore the nonlinear relationship.Results There were 244 all-cause deaths during a mean follow-up time of 82.70±3.86 months.H-CXI was ana-lyzed as a categorical variable(quartiles),and Cox regression analyses showed that in model 2,the risk of all-cause mortality was reduced in groups Q2,Q3 and Q4 compared with group Q1(HR=0.41,95%CI:0.21～0.82,P=0.012 1;HR=0.34,95%CI:0.16～0.69,P=0.003 1;HR=0.24,95%CI:0.09～0.67,P=0.006 3).Subgroup analyses revealed an interaction between stroke and all-cause mortality,and restricted cubic spline revealed a nonlinear relationship between H-CXI levels and all-cause mortality.Con-clusion H-CXI levels are negatively associated with the risk of all-cause mortality in people with abnormal liver function,and attention to H-CXI levels is needed in clinical practice to prevent adverse health outcomes.

OBJECTIVE To retrospectively analyze the drug resistance characteristics of the patients with multidrug-resistant organisms(MDROs)infections who were hospitalized from 2022 to 2023 and observe the effect of multi-disciplinary teamwork(MDT)mode so as to provide scientific bases for prevention and control of MDROs infec-tions and hospital-associated infections.METHODS A total of 639 patients with MDROs infection who were hospi-talized in Jianyang People's Hospital from Jan.2022 to Dec.2023 were recruited as the research subjects.The clinical data were collected from the patients,the drug resistance characteristics of bacteria were analyzed.The effects of MDT and pharmacological supervision on treatment of the patients with MDROs infection were observed and compared.RESULTS The methicillin-resistant Staphylococcus aureus(MRSA)(359 strains,56.18％)was dominant among the pathogens isolated from the 639 patients with MDROs infections,followed by the carbapen-em-resistant Klebsiella pneumoniae(CRKP)(96 strains,15.02％)and carbapenem-resistant Acinetobacter bau-mannii(82 strains,12.83％).Of the patients with MDROs infection,150(23.47％)were from critical care medicine department,94(14.71％)from pediatrics department,and 82(12.83％)from general surgery de-partment.The result of drug susceptibility test showed that the S.aureus strains were susceptible to linezolid,daptomycin,vancomycin and tigecycline;most of the gram-negative bacteria were susceptible to carbapenems,while the A.baumannii strains were highly resistant to the commonly used antibiotics.The total isolation rate of MDROs and the case-time infection rate of MDROs infections were 14.32％and 0.05％,respectively,after MDT and pharmacological supervision were carried out,lower than those before carried out;the effective treatment rate of the patients with MDROs was 76.47％after MDT and pharmacological supervision were carried out,higher than that before they were carried out,and there were significant differences(all P＜0.05).CONCLUSION MDT and pharmacological supervision may improve the curative effect of the patients with MDROs infection and reduce the isolation rate of MDROs as well as the incidence of hospital-associated infections.

OBJECTIVE To retrospectively analyze the drug resistance characteristics of the patients with multidrug-resistant organisms(MDROs)infections who were hospitalized from 2022 to 2023 and observe the effect of multi-disciplinary teamwork(MDT)mode so as to provide scientific bases for prevention and control of MDROs infec-tions and hospital-associated infections.METHODS A total of 639 patients with MDROs infection who were hospi-talized in Jianyang People's Hospital from Jan.2022 to Dec.2023 were recruited as the research subjects.The clinical data were collected from the patients,the drug resistance characteristics of bacteria were analyzed.The effects of MDT and pharmacological supervision on treatment of the patients with MDROs infection were observed and compared.RESULTS The methicillin-resistant Staphylococcus aureus(MRSA)(359 strains,56.18％)was dominant among the pathogens isolated from the 639 patients with MDROs infections,followed by the carbapen-em-resistant Klebsiella pneumoniae(CRKP)(96 strains,15.02％)and carbapenem-resistant Acinetobacter bau-mannii(82 strains,12.83％).Of the patients with MDROs infection,150(23.47％)were from critical care medicine department,94(14.71％)from pediatrics department,and 82(12.83％)from general surgery de-partment.The result of drug susceptibility test showed that the S.aureus strains were susceptible to linezolid,daptomycin,vancomycin and tigecycline;most of the gram-negative bacteria were susceptible to carbapenems,while the A.baumannii strains were highly resistant to the commonly used antibiotics.The total isolation rate of MDROs and the case-time infection rate of MDROs infections were 14.32％and 0.05％,respectively,after MDT and pharmacological supervision were carried out,lower than those before carried out;the effective treatment rate of the patients with MDROs was 76.47％after MDT and pharmacological supervision were carried out,higher than that before they were carried out,and there were significant differences(all P＜0.05).CONCLUSION MDT and pharmacological supervision may improve the curative effect of the patients with MDROs infection and reduce the isolation rate of MDROs as well as the incidence of hospital-associated infections.

Objective:To report our experience of treating open comminuted limb fractures caused by gunshots using the Masquelet technique.Methods:Between January 2016 and July 2018, 3 patients were admitted to Institute of Orthopedics, 920 Hospital of Joint Logistic Service of People's Liberation Army for open comminuted limb fractures caused by gunshots.They were all male, aged from 18 to 41 years (average, 30.7 years).Their fractures were complicated with perforating wounds and belonged to Gustilo type ⅢB for open fractures.The bone defects were 5 to 9 cm in length (average, 6.7 cm), located at the proximal femur in 2 cases and at the upper middle humerus in one.They were treated by standard Masquelet technique at 2 stages.The postoperative functions of the hip, knee and shoulder were evaluated according to the Harris hip score, Lowa knee score and Constant-Murley shoulder function score.Results:The 3 patients obtained an average follow-up of 17.3 months.The bone defects were all repaired in the 3 patients without any signs of infection.The 2 patients with femoral defects were rated as both excellent by the Harris hip score, as excellent in one and as good in the other by the Lowa knee score; the patient with humeral defects was rated as excellent by the Constant-Murley shoulder function score.Conclusion:Masquelet technique is a desirable treat-ment of segmental long bone defects caused by gunshots.

BACKGROUND:Many experiments and clinical studies have reported that venous blood, absorbable colagen sponge and rich fibrin clot, without the use of bone graft material, can al promote new bone formation; therefore, whether only transplanting concentrated growth factor in the maxilary sinus lift could effectively promote bone regeneration? OBJECTIVE: To conduct the maxilary sinus lift with concentrated growth factor as the graft material, and to observe the peri-implant bone level change. METHODS: Totaly 26 patients were involved, including 14 males and 12 females, aged 35-73 years. Maxilary sinus lift was conducted and autologous concentrated growth factor was taken as the graft material. Astra Tech implants were implanted simultaneously. Patients were divided into 6-12 months, 13-18 months and > 18 months groups according to the folow-up time. Patients were divided into≤ 5 mm, 5-7 mm, and≥ 7 mm groups according to the preoperative alveolar bone height. Patients were divided into≤ 2 mm, 2.0-3.0 mm, and≥3 mm groups according to the postoperative maxilary sinus lift height. The survival rate of implants and marginal bone level changes were observed during the folow-up. RESULTS AND CONCLUSION: Totaly 44 implants were implanted, of which 43 implants were considered as successful repair during the 6-18 months of postoperative folow-up. The survival rate of implants was 98%. There were no significant differences in the changes of mesial, distal and middle marginal bone levels between different folow-up time groups. The maxilary sinus lift with transplantation of concentrated growth factor resulted in a good osseointegration within 6-18 months post-operation. In addition, no significant differences were found in the changes of mesial, distal and middle marginal bone levels between different residual alveolar bone height groups, as wel as between different maxilary sinus lift height groups. It showed that the residual alveolar bone height and maxilary sinus lifting height had no significant effect on the peri-implant bone formation. Briefly, these findings demonstrate that the maxilary sinus lift with concentrated growth factor transplantation can result in a high survival rate of implants that are simultaneous implanted, and the alveolar bone around the implant is stable. But the long-term effect needs further observation.