Objective To investigate the factors affecting the occurrence of new postoperative cardiac complications in patients undergoing esophageal cancer surgery with concomitant coronary heart disease. Methods Clinical data of patients who underwent esophageal cancer surgery with coronary heart disease at the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University from December 2019 to June 2023 were collected. Patients were divided into two groups based on whether they experienced postoperative cardiac complications. Using the occurrence of cardiac complications as the dependent variable, a multivariate logistic regression model was established to identify related influencing factors. Results A total of 223 patients were included, comprising 148 males and 75 females, with an average age of (71.78±6.31) years (range 53-88 years). Seventy-one (31.84%) patients experienced at least one new cardiac complication postoperatively, including 2 acute coronary syndrome, 13 heart failure, and 59 new-onset postoperative arrhythmias. Univariate analysis showed that age, systemic immune-inflammation index, pulmonary infection, need for invasive mechanical ventilation due to respiratory failure, acute respiratory distress syndrome (ARDS), acute delirium, pleural effusion requiring drainage, and acute renal failure were risk factors for postoperative new-onset cardiac complications (all P<0.05). Multivariate logistic regression analysis identified age, postoperative length of hospital stay, ARDS, and systemic immune-inflammation index as independent risk factors for new cardiac complications in esophageal cancer patients with coronary heart disease. Conclusion Strengthening perioperative management of esophageal cancer patients, ranging from preoperative evaluation to postoperative complication treatment, is crucial. Particular attention should be paid to age, ARDS, and other indicators to improve postoperative prognoses in patients with coronary heart disease complicated by esophageal cancer.

Objective: To evaluate the effects of a multidisciplinary weight management intervention, so as to provide a reference for the formulation of overweight and obesity intervention measures. Methods: From April to September 2025, overweight and obese residents aged 18-60 years who participated in a weight loss competition at the Health Management Center of Beilun People's Hospital in Ningbo City were selected as study subjects. They were divided into a control group and an intervention group. The control group received conventional weight management, while the intervention group received the multidisciplinary integrated weight management in addition to the conventional weight management, for a total intervention period of 8 weeks. Weight, body mass index (BMI), waist circumference, hip circumference, waist-to-hip ratio, fasting blood glucose (FBG), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and blood pressure were collected before and after the intervention through physical examinations and laboratory tests. The generalized estimating equations (GEE) method was employed to analyze the differences in indicators between the two groups before and after the intervention. Results: The control group comprised 241 participants, including 161 females (66.80%), with a mean age of (35.66±7.80) years. The intervention group consisted of 127 participants, including 86 females (67.72%), with a mean age of (36.80±7.05) years. No statistically significant differences were observed between the two groups at baseline in terms of age, gender, weight, BMI, or waist-to-hip ratio (all P>0.05). Results from the GEE analysis indicated significant interactions between group and time for weight, BMI, waist circumference, and hip circumference (all P<0.05) with greater reductions in these parameters observed in the intervention group compared to the control group before and after the intervention. Similarly, significant interactions between group and time were observed for FBG, TG, TC, and LDL-C (all P<0.05), with the intervention group demonstrating larger decreases in these markers compared to the control group. However, no statistically significant interactions between group and time were observed for waist-to-hip ratio, HDL-C, systolic blood pressure, and diastolic blood pressure (all P>0.05). Following the intervention, a weight loss exceeding 10% was achieved by 13 participants (5.39%) in the control group and 62 participants (48.82%) in the intervention group. The proportion of individuals with a weight loss exceeding 10% was significantly higher in the intervention group compared to the control group (P<0.05). Conclusion Compared to conventional weight management, multidisciplinary integrated weight management demonstrated greater efficacy in improving weight-related indicators and blood glucose, blood lipids, and enhancing weight loss outcomes among overweight and obese residents.

Five previously undescribed diterpenoids, named succipenoids D‒H (1‒5), along with four undescribed lignans, named succignans A‒D (6‒9), were isolated from the dichloromethane extract of Chinese medicinal succinum. Compounds 1‒5 were characterized as nor-abietane diterpenoids, while compounds 6‒9 were identified as lignans polymerized from two groups of phenylpropanoid units. The structures of these novel compounds, including their absolute configurations, were determined through spectroscopic and computational methods. Biological assessments of renal fibrosis demonstrated that compounds 6 and 7 effectively reduce the expression of proteins associated with renal fibrosis, including α-smooth muscle actin (α-SMA), collagen I, and fibronectin in transforming growth factor-β1 (TGF-β1) induced normal rat kidney proximal tubular epithelial cells (NRK-52e).
Animals ; Rats ; Lignans/isolation & purification* ; Diterpenes/isolation & purification* ; Fibrosis/drug therapy* ; Drugs, Chinese Herbal/pharmacology* ; Molecular Structure ; Cell Line ; Kidney Diseases/pathology* ; Transforming Growth Factor beta1/genetics* ; Kidney/metabolism* ; Actins/genetics* ; Fibronectins/genetics* ; Collagen Type I/genetics* ; Epithelial Cells/metabolism*

Acute respiratory distress syndrome (ARDS) is the leading cause of respiratory failure with high morbidity and mortality. Pulmonary surfactant (PS)-based complementary therapies have exhibited potential for ARDS healing and applied as an adjunctive therapy strategy. Coacervate (Coac) has the characteristics of softness, deformability and excellent molecular enrichment properties, and has attracted extensive attention in the biomedical field. Here PS and coacervate were combined for the potential ARDS treatment. The Coac, fabricated from polyallylamine hydrochloride (PAH) and adenosine triphosphate (ATP) by simple mixing, exhibited soft droplet property and high enrichment for dexamethasone sodium phosphate (DSP). To avoid the fusion effect of membraneless coacervate and endow it with biological functions of PS, liposomes with PS-biomimetic lipid components (PS-lipo) were further introduced to construct PS-biomimetic membranized coacervate (DSP@PS-Coac). The DSP@PS-Coac demonstrated high lung targeting effect and significant penetration efficiency after intravenous injection. Furthermore, PS-lipo replenished the endogenous PS pool and facilitated the distribution of DSP in inflammatory cells in the lung. In the ARDS mouse model, PS-Coac and DSP exerted synergetic anti-inflammatory functions, via reducing the recruitment of inflammatory neutrophils and modulating macrophages into anti-inflammatory phenotype. The overall results confirmed that DSP@PS-Coac may provide a promising delivery option for the treatment of ARDS.

OBJECTIVES: To explore the value of ferroptose-related genes in the diagnosis and prediction of ulcerative colitis (UC). METHODS: We used UC dataset from the GEO database to screen for differentially expressed genes (DEGs) in UC. The DEGs related to ferroptositis were screened from the FerrDb database and their functions were analyzed. The hub genes were identified by constructing the protein-protein interaction network (PPI), the differences in immune infiltration levels between UC and the control group were evaluated using CIBERSORT, and the diagnostic values of the hub genes for UC were verified by using the training set. In a mouse model of UC, we examined the expression levels of the hub genes in the colon tissues of the mice using real-time fluorescence quantitative PCR (qPCR). RESULTS: We identified a total of 76 DEGs related to ferroptosis. Functional enrichment analysis showed that these genes were significantly enriched in ferroptosis and hypoxia pathways. The PPI network identified 10 hub genes, and 9 of them were highly expressed in UC. Analysis of immune cell infiltration showed that 27 cell types were significantly increased in UC (P<0.05), and the immune checkpoints-related genes had the strongest correlation with the hub gene PPARG (P<0.05). Verification analysis using the training set showed that P4HB, PPARG and STAT3 had the best predictive value for UC (P<0.05). In the UC mouse model, the expression of PPARG was significantly decreased and the expressions of P4HB and STAT3 were significantly increased in the colon tissues of the mice as compared with the normal mice. CONCLUSIONS Ferroptose-related genes have significant value for diagnosis and prediction of UC.
Colitis, Ulcerative/genetics* ; Animals ; Mice ; Ferroptosis/genetics* ; Humans ; Protein Interaction Maps ; Disease Models, Animal ; Gene Expression Profiling ; STAT3 Transcription Factor/genetics*

OBJECTIVE To investigate the relationship between kinesin superfamily(KIF)18B,20A and epithelial-mesenchymal transition(EMT)markers,clinicopathological features and prognosis in nasopharyngeal carcinoma.METHODS 116 cases of nasopharyngeal biopsy tumor tissues diagnosed as nasopharyngeal carcinoma in Department of Otolaryngology,Yulin Traditional Chinese Medicine Hospital from July 2017 to May 2019 were selected,nasal mucosa biopsy tissues of 116 chronic nasopharyngitis patients were used as control,the expression of KIF18B,KIF20A,and EMT markers epithelial calreticulin(E-cadherin),vimentin,twist in nasopharyngeal carcinoma tissues and nasopharyngeal chronic mucositis tissues were compared.The relationship between KIF18B,KIF20A expression and EMT marker expression and clinicopathological features in nasopharyngeal carcinoma tissues were analyzed.5 years after follow-up,the relationship between KIF18B,KIF20A expression and the prognosis of nasopharyngeal carcinoma patients were analyzed by the Kaplan-Meier method and multivariate Cox regression analysis.RESULTS The positive expression rates of KIF18B,KIF20A,Vimentin and Twist in nasopharyngeal carcinoma tissues were 55.17％,42.24％,20.69％,and 26.72％respectively,which were higher than 13.79％,9.48％,4.31％,and 5.17％in nasopharyngeal chronic mucosal inflammation tissues;The positive expression rate of E-cadherin in nasopharyngeal carcinoma tissues was 68.10％,which was lower than 91.38％in nasopharyngeal chronic mucosal inflammation tissues(P<0.05).KIF18B and KIF20A were negatively correlated with E-cadherin expression(rs=-0.439,-0.432,P<0.05),KIF18B,KIF20A were positively correlated with Vimentin(rs=0.418,0.456,P<0.05)and Twist(rs=0.427,0.427,P<0.05).The KIF18B and KIF20A positive expression rates in patients with low differentiation,lymph node metastasis,TNM stage Ⅲ-Ⅵa,clinical efficacy stable disease(SD)/progressive disease(PD)were higher than those in patients with high differentiation,no lymph node metastasis,stage Ⅰ-Ⅱ,and complete response(CR)/partial response(PR)(P<0.05).4 patients were lost to 5 years after follow-up,the success rate of follow-up was 96.55％(112/116),31 patients died,and the 5-year overall survival rate was 72.32％(81/112).The 5-year cumulative survival rate in KIF18B and KIF20A positive expression nasopharyngeal carcinoma patients were lower than those in KIF18B and KIF20A negative expression nasopharyngeal carcinoma patients(P<0.05).TNM stage Ⅲ-Ⅵa(HR=1.154,95％CI:1.018-1.308),clinical efficacy SD/PD(HR=1.287,95％CI:1.132-1.654),KIF18B(HR=1.823,95％CI:1.332-2.493)and positive expression of KIF20A(HR=2.110,95％CI:1.460-3.051)were independent risk factors affecting the prognosis of nasopharyngeal carcinoma patients(P<0.05).CONCLUSION KIF18B and KIF20A are abnormally highly expressed in nasopharyngeal carcinoma tissues,the positive expression of the two are closely related to EMT,tumor malignant progression and prognosis,and KIF18B,KIF20A positive expression patients have shorter survival time.

Objective This study aimed to adapt the data-driven Palliative Care Outcomes Collaboration(PCOC)model to the local context and evaluate its feasibility and preliminary effectiveness in a palliative care unit in China,with the goal of informing its broader integration into national palliative care practice.Methods Based on international experience,a localized implementation protocol for the PCOC model was developed through expert con-sultations and a pilot study.The protocol incorporated key elements including organizational and managerial sup-port,team training and capacity building,information system integration,supervision and feedback mechanisms,pro-cess optimization,and data-driven decision-making.From June to December 2023,the protocol was piloted in the palliative care unit of a tertiary cancer hospital in Changsha,China.Implementation outcomes were assessed by comparing patients' urgent care response rates,symptom stability rates,and symptom improvement rates between the first 1～3 months and 4～6 months after implementation.Results During the study period,a total of 355 inpatients were enrolled,with the PCOC assessment achieving full coverage(100％)and a completion rate of 97.78％.There was no statistically significant difference in the urgent needs response rate between the first 1～3 months and the 4～6 months after the implementation of the PCOC model(P=0.533).However,compared to the first 1～3 months af-ter implementation,patients in the 4～6 months period showed significantly higher symptom stability rates for pain,psychological/spiritual issues,and family/caregiver problems,as well as a higher improvement rate for pain(P＜0.05).Conclusion The localized PCOC implementation protocol facilitates standardized assessment and symptom manage-ment,and its application can enhance the quality of palliative care.

Objective To discuss the clinical efficacy of catheter-directed thrombolysis(CDT)in treating acute pulmonary embolism(APE).Methods A total of 215 patients with APE,who were admitted to the Second Affiliated Hospital of Shandong First Medical University of China,were enrolled in this study.Pulmonary angiography was performed in all the patients.After the location of the thrombus was identified,the pigtail catheter was rotated so as to break the thrombus into small pieces,which was followed by local infusion of thrombolytic agent urokinase to make recanalization of the occluded pulmonary artery.The postoperative clinical symptoms,blood oxygen saturation,mean pulmonary artery pressure,BNP,D-dimer,RV/LV diameter ratio were compared with their preoperative values.PESI scoring was used to evaluate the severity of the pulmonary embolism.Patients with PESI grade-Ⅲ and PESI grade-Ⅳ were classified into medium-risk group,and patients with PESI grade-V were classified into higher-risk group.Results Symptom relief immediately after surgery was observed in 210 patients,complete recanalization of pulmonary artery was achieved in 200 patients,and partial recanalization of pulmonary artery was seen in 15 patients.The preoperative mean pulmonary artery pressure,blood oxygen saturation,BNP,D-dimer,RV/LV diameter ratio were(46.24±5.32)mmHg,(90.36±3.23)％,(8 000.12±750.56)pg/mL,(7.5±2.3)mg/L and(1.63±0.22)respectively;at one week after surgery the above indicators were(26.12±3.36)mmHg,(98.74±2.12)％,(240.35±33.52)pg/mL,(1.75±0.36)mg/L and(1.11±0.13)respectively;the differences were statistically significant(all P＜0.05).In the patients who had symptoms of hemoptysis,shock and syncope before surgery,all these symptoms were completely disappeared in one week after CDT,and the symptoms of dyspnea,chest pain,and palpitations were significantly relieved after CDT,the differences were statistically significant(all P＜0.05).The difference in survival time between different PESI grade groups was statistically significant(P＜0.05).No serious postoperative complications such as severe arrhythmia,cerebral hemorrhage,or gastrointestinal bleeding occurred.Postoperative 3-month CT pulmonary angiography(CTPA)showed that the main pulmonary artery was well visualized and no thrombus-produced filling defect shadow was detected.Conclusion For the treatment of APE,CDT can promptly and rapidly open the obstructed pulmonary artery lumen,restore pulmonary artery hemodynamics,and correct hypoxemia.Therefore,CDT is a safe,effective and quick treatment for APE.

Objective This study aimed to adapt the data-driven Palliative Care Outcomes Collaboration(PCOC)model to the local context and evaluate its feasibility and preliminary effectiveness in a palliative care unit in China,with the goal of informing its broader integration into national palliative care practice.Methods Based on international experience,a localized implementation protocol for the PCOC model was developed through expert con-sultations and a pilot study.The protocol incorporated key elements including organizational and managerial sup-port,team training and capacity building,information system integration,supervision and feedback mechanisms,pro-cess optimization,and data-driven decision-making.From June to December 2023,the protocol was piloted in the palliative care unit of a tertiary cancer hospital in Changsha,China.Implementation outcomes were assessed by comparing patients' urgent care response rates,symptom stability rates,and symptom improvement rates between the first 1～3 months and 4～6 months after implementation.Results During the study period,a total of 355 inpatients were enrolled,with the PCOC assessment achieving full coverage(100％)and a completion rate of 97.78％.There was no statistically significant difference in the urgent needs response rate between the first 1～3 months and the 4～6 months after the implementation of the PCOC model(P=0.533).However,compared to the first 1～3 months af-ter implementation,patients in the 4～6 months period showed significantly higher symptom stability rates for pain,psychological/spiritual issues,and family/caregiver problems,as well as a higher improvement rate for pain(P＜0.05).Conclusion The localized PCOC implementation protocol facilitates standardized assessment and symptom manage-ment,and its application can enhance the quality of palliative care.