Objective To explore the molecular mechanisms by which cucurbitacin B(CuB)regulates the mitochondrial ap-optosis pathway through the nicotinamide phosphoribosyltransferase(NAMPT)/forkhead transcription factor O subfamily member 3a(FoxO3a)axis to affect the biological function of non-small cell lung cancer(NSCLC)cells.Methods Gefitinib(GEF)and CuB were used to intervene in A549 cells.Network pharmacology was employed to analyze the targets and downstream pathways,and different vector-transfected cell groups were set up.Cell viability was detected by CCK-8 assay,cell invasion by Transwell assay,and cell apoptosis by flow cytometry.The mitochondrial membrane potential(MMP)level was measured using a JC-1 kit,and intracellular reactive oxygen species(ROS)levels were detected using a kit.Western blot was used to detect the expression of mitochondrial dynamics-related proteins(DRP1,Mfn1),as well as the protein levels of NAMPT and FoxO3a in A549 cells.The mRNA expression of NAMPT was detected by qRT-PCR.Additionally,a xenograft model in nude mice was es-tablished to verify the therapeutic effects of CuB in vivo.Results Compared with the control group,GEF and CuB intervention significantly inhibited the viability and invasion of A549 cells and induced cell apoptosis.Moreover,CuB intervention significant-ly decreased the MMP level,increased ROS concentration,and upregulated the expression of DRP1 while downregulating Mfn1 in A549 cells(P＜0.05).NAMPT,a therapeutic target,was highly expressed in A549 cells and was inhibited by CuB.Compared with the vector group,overexpression of NAMPT significantly promoted the growth of A549 cells and inhibited mitochondrial apoptosis.Compared with the vector+CuB(100 nmol/L)group,overexpression of NAMPT reversed the effects of CuB on A549 cells(P＜0.05).Compared with the si-NAMPT-NC group,silencing NAMPT significantly inhibited the growth of A549 cells and promoted mitochondrial apoptosis,while knockdown of FoxO3a enhanced the viability and invasion of A549 cells and re-versed the damaging effects of si-NAMPT on cancer cells(P＜0.05).In vivo experimental results showed that CuB inhibited tumor weight and volume in a dose-dependent manner.Conclusion CuB regulates the NAMPT-FoxO3a axis through the mito-chondrial apoptosis pathway to inhibit the progression of NSCLC both in vitro and in vivo.

Objective To explore the molecular mechanisms by which cucurbitacin B(CuB)regulates the mitochondrial ap-optosis pathway through the nicotinamide phosphoribosyltransferase(NAMPT)/forkhead transcription factor O subfamily member 3a(FoxO3a)axis to affect the biological function of non-small cell lung cancer(NSCLC)cells.Methods Gefitinib(GEF)and CuB were used to intervene in A549 cells.Network pharmacology was employed to analyze the targets and downstream pathways,and different vector-transfected cell groups were set up.Cell viability was detected by CCK-8 assay,cell invasion by Transwell assay,and cell apoptosis by flow cytometry.The mitochondrial membrane potential(MMP)level was measured using a JC-1 kit,and intracellular reactive oxygen species(ROS)levels were detected using a kit.Western blot was used to detect the expression of mitochondrial dynamics-related proteins(DRP1,Mfn1),as well as the protein levels of NAMPT and FoxO3a in A549 cells.The mRNA expression of NAMPT was detected by qRT-PCR.Additionally,a xenograft model in nude mice was es-tablished to verify the therapeutic effects of CuB in vivo.Results Compared with the control group,GEF and CuB intervention significantly inhibited the viability and invasion of A549 cells and induced cell apoptosis.Moreover,CuB intervention significant-ly decreased the MMP level,increased ROS concentration,and upregulated the expression of DRP1 while downregulating Mfn1 in A549 cells(P＜0.05).NAMPT,a therapeutic target,was highly expressed in A549 cells and was inhibited by CuB.Compared with the vector group,overexpression of NAMPT significantly promoted the growth of A549 cells and inhibited mitochondrial apoptosis.Compared with the vector+CuB(100 nmol/L)group,overexpression of NAMPT reversed the effects of CuB on A549 cells(P＜0.05).Compared with the si-NAMPT-NC group,silencing NAMPT significantly inhibited the growth of A549 cells and promoted mitochondrial apoptosis,while knockdown of FoxO3a enhanced the viability and invasion of A549 cells and re-versed the damaging effects of si-NAMPT on cancer cells(P＜0.05).In vivo experimental results showed that CuB inhibited tumor weight and volume in a dose-dependent manner.Conclusion CuB regulates the NAMPT-FoxO3a axis through the mito-chondrial apoptosis pathway to inhibit the progression of NSCLC both in vitro and in vivo.

Objective:To compare the efficacy of oliceridine and sufentanil when combined with propofol for painless gastroscopy.Methods:In this randomized controlled trial, 66 patients of either sex, aged 18-64 yr, with a body mass index of 18-26 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰor Ⅱ, scheduled for elective painless gastroscopy from September 2024 to November 2024, were divided into 2 groups ( n=33 each) using a table of computer-generated random numbers: sufentanil combined with propofol group (SP group) and oliceridine combined with propofol group (OP group). Sufentanil 0.1 μg/kg was intravenously injected in group SP, oliceridine 0.02 mg/kg was intravenously injected in group OP, and 1 min later propofol 2 mg/kg was intravenously injected in both groups. When the modified Observer′s Assessment of Alertness and Sedation score ≤ 1, the painless gastroscopy was performed. Heart rate, mean arterial pressure and peripheral oxygen saturation were recorded on admission to the operating room, immediately after insertion of the gastroscope, and at the end of procedure. The success of sedation, time of gastroscopy, emergence time, consumption of propofol and use of vasoactive drugs were recorded. The occurrence of adverse events such as respiratory depression, hypotension, dizziness and nausea was also recorded. Results:Compared with group SP, the incidence of respiratory depression was significantly decreased in group OP ( P<0.05). There was no statistically significant difference in the incidence of hypotension, dizziness and nausea and heart rate, mean arterial pressure and peripheral oxygen saturation at different time points between the two groups ( P>0.05). Conclusions:Oliceridine provides better efficacy than sufentanil when combined with propofol in painless gastroscopy.

Antimicrobial resistance(AMR)has been a difficult problem of globally public health that can threaten human health.If its spread could not be effectively curbed,it will lead to increasing limitation in the options of clinical treatment.In the increasingly complex environment of diagnosis and treatment of infectious diseases,it is particularly urgent to build a rapid,accurate and widely popularized diagnosis system for pathogen,which is the key prerequisite of realizing accurate assessment for susceptibility of antimicrobial drug.This article comprehensively reviewed the main rapid diagnostic techniques currently used in AMR monitoring and detecting for antimicrobial susceptibility on the basis of the above conditions.It not only provided a detailed analysis of molecular typing methods represented by gene sequencing and phenotype identification methods based on conventional culture,but also focused on a new joint diagnostic strategy that combined genomic information with functional verification.Through comparative study for various technical principles,operating procedures and clinical applicability,the purpose of this paper was to provide scientific basis for optimizing the rapid detection scheme of drug susceptibility in clinical microbiology laboratories,and promote a comprehensive improvement of the level of diagnosis and treatment for infectious diseases,and ultimately improve the multi-layered network system of prevention and control for nosocomial infection.

ObjectiveTo investigate the mechanism by which 2，3，5，4'-tetrahydroxyldiphenylethylene-2-O-glucoside （THSG） mitigates cerebral ischemia/reperfusion （CI/R） injury by regulating mitochondrial calcium overload and promoting mitophagy. MethodsSixty male SD rats were randomized into sham， model， SAS （40 mg·kg^-1）， and low-， medium- and high-dose （10， 20， 40 mg·kg^-1， respectively） THSG groups， with 10 rats in each group. The middle cerebral artery occlusion/reperfusion （MCAO/R） model was established by the modified Longa suture method. An oxygen-glucose deprivation/reoxygenation （OGD/R） model was constructed in PC12 cells. Neurological deficits were assessed via Zea Longa scoring， and cerebral infarct volume was measured by 2，3，5-triphenyltetrazolium chloride （TTC） staining. Structural and functional changes of cortical neurons in MCAO/R rats were assessed by hematoxylin-eosin and Nissl staining. PC12 cell viability was detected by cell counting kit-8 （CCK-8） assay， and mitochondrial calcium levels were quantified by Rhod-2 AM. Immunofluorescence was used to detect co-localization of PTEN-induced kinase 1 （PINK1） and leucine zipper/EF-hand-containing transmembrane protein 1 （LETM1） in neurons. Transmission electron microscopy （TEM） was employed to observe mitochondrial morphology in neurons. Western blot was employed to analyze the expression of translocase of outer mitochondrial membrane 20 （TOMM20）， autophagy-associated protein p62， microtubule-associated protein light chain 3 （LC3）， cysteinyl aspartate-specific proteinase-9 （Caspase-9）， B-cell lymphoma 2-associated protein X （Bax）， and cytochrome C （Cyt C）. ResultsCompared with the sham group， the model group exhibited increased infarct volume （P<0.01） and neurological deficit scores （P<0.01）， neuronal structure was disrupted with reduced Nissl bodies. （P<0.01）， mitochondrial swelling/fragmentation， decreased PINK1/LETM1 co-localization （P<0.01）， upregulated protein levels of LC3Ⅱ/LC3Ⅰ， TOMM20， Caspase-9， Bax， and Cyt C （P<0.01）， downregulated protein level of p62 （P<0.05）， weakened PC12 viability （P<0.01）， and elevated mitochondrial calcium level （P<0.01）. Compared with the model group， THSG and SAS groups showed reduced infarct volumes （P<0.05，P<0.01） and neurological deficit scores （P<0.05，P<0.01）， mitigated mitochondrial damage， and increased PINK1/LETM1 co-localization （P<0.01）. Medium/high-dose THSG and SAS alleviated the neurological damage， increased Nissl bodies （P<0.05，P<0.01）， downregulated the protein levels of p62， TOMM20， Caspase-9， Bax， and Cyt C （P<0.05，P<0.01）， and elevated the LC3Ⅱ/LC3Ⅰ level （P<0.05，P<0.01）. High-dose THSG enhanced PC12 cell viability （P<0.01）， increased PINK1/LETM1 co-localization （P<0.01）， and reduced mitochondrial calcium （P<0.01）. ConclusionTHSG may exert the neuroprotective effect on CI/R injury by activating the PINK1-LETM1 signaling pathway， reducing the mitochondrial calcium overload， and promoting mitophagy.

ObjectiveTo investigate the mechanism by which 2，3，5，4'-tetrahydroxyldiphenylethylene-2-O-glucoside （THSG） mitigates cerebral ischemia/reperfusion （CI/R） injury by regulating mitochondrial calcium overload and promoting mitophagy. MethodsSixty male SD rats were randomized into sham， model， SAS （40 mg·kg^-1）， and low-， medium- and high-dose （10， 20， 40 mg·kg^-1， respectively） THSG groups， with 10 rats in each group. The middle cerebral artery occlusion/reperfusion （MCAO/R） model was established by the modified Longa suture method. An oxygen-glucose deprivation/reoxygenation （OGD/R） model was constructed in PC12 cells. Neurological deficits were assessed via Zea Longa scoring， and cerebral infarct volume was measured by 2，3，5-triphenyltetrazolium chloride （TTC） staining. Structural and functional changes of cortical neurons in MCAO/R rats were assessed by hematoxylin-eosin and Nissl staining. PC12 cell viability was detected by cell counting kit-8 （CCK-8） assay， and mitochondrial calcium levels were quantified by Rhod-2 AM. Immunofluorescence was used to detect co-localization of PTEN-induced kinase 1 （PINK1） and leucine zipper/EF-hand-containing transmembrane protein 1 （LETM1） in neurons. Transmission electron microscopy （TEM） was employed to observe mitochondrial morphology in neurons. Western blot was employed to analyze the expression of translocase of outer mitochondrial membrane 20 （TOMM20）， autophagy-associated protein p62， microtubule-associated protein light chain 3 （LC3）， cysteinyl aspartate-specific proteinase-9 （Caspase-9）， B-cell lymphoma 2-associated protein X （Bax）， and cytochrome C （Cyt C）. ResultsCompared with the sham group， the model group exhibited increased infarct volume （P<0.01） and neurological deficit scores （P<0.01）， neuronal structure was disrupted with reduced Nissl bodies. （P<0.01）， mitochondrial swelling/fragmentation， decreased PINK1/LETM1 co-localization （P<0.01）， upregulated protein levels of LC3Ⅱ/LC3Ⅰ， TOMM20， Caspase-9， Bax， and Cyt C （P<0.01）， downregulated protein level of p62 （P<0.05）， weakened PC12 viability （P<0.01）， and elevated mitochondrial calcium level （P<0.01）. Compared with the model group， THSG and SAS groups showed reduced infarct volumes （P<0.05，P<0.01） and neurological deficit scores （P<0.05，P<0.01）， mitigated mitochondrial damage， and increased PINK1/LETM1 co-localization （P<0.01）. Medium/high-dose THSG and SAS alleviated the neurological damage， increased Nissl bodies （P<0.05，P<0.01）， downregulated the protein levels of p62， TOMM20， Caspase-9， Bax， and Cyt C （P<0.05，P<0.01）， and elevated the LC3Ⅱ/LC3Ⅰ level （P<0.05，P<0.01）. High-dose THSG enhanced PC12 cell viability （P<0.01）， increased PINK1/LETM1 co-localization （P<0.01）， and reduced mitochondrial calcium （P<0.01）. ConclusionTHSG may exert the neuroprotective effect on CI/R injury by activating the PINK1-LETM1 signaling pathway， reducing the mitochondrial calcium overload， and promoting mitophagy.

Objective:To compare the efficacy of oliceridine and sufentanil when combined with propofol for painless gastroscopy.Methods:In this randomized controlled trial, 66 patients of either sex, aged 18-64 yr, with a body mass index of 18-26 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰor Ⅱ, scheduled for elective painless gastroscopy from September 2024 to November 2024, were divided into 2 groups ( n=33 each) using a table of computer-generated random numbers: sufentanil combined with propofol group (SP group) and oliceridine combined with propofol group (OP group). Sufentanil 0.1 μg/kg was intravenously injected in group SP, oliceridine 0.02 mg/kg was intravenously injected in group OP, and 1 min later propofol 2 mg/kg was intravenously injected in both groups. When the modified Observer′s Assessment of Alertness and Sedation score ≤ 1, the painless gastroscopy was performed. Heart rate, mean arterial pressure and peripheral oxygen saturation were recorded on admission to the operating room, immediately after insertion of the gastroscope, and at the end of procedure. The success of sedation, time of gastroscopy, emergence time, consumption of propofol and use of vasoactive drugs were recorded. The occurrence of adverse events such as respiratory depression, hypotension, dizziness and nausea was also recorded. Results:Compared with group SP, the incidence of respiratory depression was significantly decreased in group OP ( P<0.05). There was no statistically significant difference in the incidence of hypotension, dizziness and nausea and heart rate, mean arterial pressure and peripheral oxygen saturation at different time points between the two groups ( P>0.05). Conclusions:Oliceridine provides better efficacy than sufentanil when combined with propofol in painless gastroscopy.

Antimicrobial resistance(AMR)has been a difficult problem of globally public health that can threaten human health.If its spread could not be effectively curbed,it will lead to increasing limitation in the options of clinical treatment.In the increasingly complex environment of diagnosis and treatment of infectious diseases,it is particularly urgent to build a rapid,accurate and widely popularized diagnosis system for pathogen,which is the key prerequisite of realizing accurate assessment for susceptibility of antimicrobial drug.This article comprehensively reviewed the main rapid diagnostic techniques currently used in AMR monitoring and detecting for antimicrobial susceptibility on the basis of the above conditions.It not only provided a detailed analysis of molecular typing methods represented by gene sequencing and phenotype identification methods based on conventional culture,but also focused on a new joint diagnostic strategy that combined genomic information with functional verification.Through comparative study for various technical principles,operating procedures and clinical applicability,the purpose of this paper was to provide scientific basis for optimizing the rapid detection scheme of drug susceptibility in clinical microbiology laboratories,and promote a comprehensive improvement of the level of diagnosis and treatment for infectious diseases,and ultimately improve the multi-layered network system of prevention and control for nosocomial infection.

Objective:To determine the median effective dose (ED 50) of oliceridine for analgesia during induced abortion when combined with propofol. Methods:In this prospective study, 24 American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ patients, aged 20-45 yr, with a body mass index of 18-26 kg/m 2, who underwent painless induced abortion surgery at Sir Run Run Hospital affiliated to Nanjing Medical University from September to October 2024, were selected. The modified Dixon sequential method was used for the study. The initial dose of oliceridine was 0.025 mg/kg, and 2 min later propofol 2 mg/kg was intravenously injected. The ratio between the two successive doses of oliceridine was 1.0∶1.1. If the patient experienced inadequate analgesia during cervical dilation (frowning, moaning, involuntary limb movements, increase in heart rate or mean arterial pressure greater than 20% of baseline), the next patient received a higher dose of oliceridine, or conversely, a lower dose was given. The study was terminated when 7 turning points from inadequate analgesia to adequate analgesia were achieved. Dixon sequential trial formula was used to calculate the ED 50 of oliceridine and the confidence interval. The occurrence of adverse reactions such as intraoperative hypoxemia, postoperative dizziness and nausea and vomiting was recorded. Results:Twenty-four patients were ultimately included in this study. When combined with propofol 2 mg/kg, the ED 50 of oliceridine for analgesia during painless induced abortion surgery was 0.019 mg/kg (95% confidence interval 0.018-0.021 mg/kg). One patient developed hypoxemia, and two patients experienced mild dizziness after surgery. All patients had no nausea or vomiting. Conclusions:When combined with 2 mg/kg of propofol, the ED 50 of oliceridine for analgesia during is 0.019 mg/kg induced abortion surgery.

AIM:To compare the recovery of psy-chomotor function after intravenous anesthesia with remazolam or propofol compound alfentanil in patients undergoing painless gastrointestinal en-doscopy.METHODS:78 patients undergoing pain-less gastrointestinal endoscopy were randomly di-vided into group RA and group PA.Remiazolam or propofol combined with alfentanil were given intra-venously in group RA or group PA.The blood pres-sure,heart rate,respiratory rate and saturation of puls oxygen were recorded before procdure(T1),during checking(T2),awaking from anaesthesia(T3)and at discharging from PACU(T4).Psychomo-tor function,as measured by the Trieger's dot test(TDT)and digit symbol substitution test(DSST),were evaluated before anesthesia(T1),at discharg-ing from PACU(T4),1 h(T5)and 2 h(T6)after checking.RESULTS:From assessment of the TDT,number of dots missed(NDM),maximum distance of dots missed(MDDM)and average distance of dots missed(ADDM)at T4,T5 were significantly lower than those at T1 in two groups.The comple-tion rates and accuracy rates of DSST at T4,T5 were significantly lower than those at T1.Results of TDT and DSST at T6 were not significantly differ-ent to those at T1.The results of NDT,MDDM and ADDM at T4,T5 in group RA were significantly low-er than those in group PA.The completion rates and accuracy rates of DSST at T4,T5 in group RA increased significantly compared with group PA.Compared to group PA,the incidence of hypoten-sion was significantly lower in group RA.There was no significant difference in the incidence of respira-tory depression between the two groups.CONCLU-SION:Psychomotor function was fully recovered 2 h after surgery when remazolam compound alfent-anil was used for painless gastrointestinal endosco-py.Compared with propofol,psychomotor function recovery in the remazolam group was faster and there were fewer adverse effects after surgery in group RA.