Although cancer immunotherapy has made great strides in the clinic, it is still hindered by the tumor immunosuppressive microenvironment (TIME). The stimulator of interferon genes (STING) pathway which can modulate TIME effectively has emerged as a promising therapeutic recently. However, the delivery of most STING agonists, specifically cyclic dinucleotides (CDNs), is performed intratumorally due to their insufficient pharmacological properties, such as weak permeability across cell membranes and vulnerability to nuclease degradation. To expand the clinical applicability of CDNs, a novel pH-sensitive polycationic polymer-modified lipid nanoparticle (LNP-B) system was developed for intravenous delivery of CDNs. LNP-B significantly extended the circulation of CDNs and enhanced the accumulation of CDNs within the tumor, spleen, and tumor-draining lymph nodes compared with free CDNs thereby triggering the STING pathway of dendritic cells and repolarizing pro-tumor macrophages. These events subsequently gave rise to potent anti-tumor immune reactions and substantial inhibition of tumors in CT26 colon cancer-bearing mouse models. In addition, due to the acid-sensitive property of the polycationic polymer, the delivery system of LNP-B was more biocompatible and safer compared with lipid nanoparticles formulated with an indissociable cationic DOTAP (LNP-D). These findings suggest that LNP-B has great potential in the intravenous delivery of CDNs for tumor immunotherapy.

Objective To establish a quantifiable quality control index system for infection management in neonatal specialty hospitals for the comprehensive evaluation of neonatal healthcare-associated infection(HAI)management quality,and to promote the continuous enhancement and improvement of neonatal HAI management quality.Methods The framework of the index system was preliminarily established through literature research and focus group discussion,the indexes were repeatedly screened using Delphi expert consultation approach,and the weights of each index were determined using the analytic hierarchy process.The empirical study of the established index sys-tem was conducted using TOPSIS method and rank sum ratio method.Results Three rounds of expert consultation were conducted,and the effective response rate of the questionnaire was 100％.The authoritative coefficient of the third round of expert consultation was 0.89,and the Kendall's coefficient of concordance for expert opinion was 0.322.The established index system included 3 first-level indexes,6 second-level indexes,and 16 third-level inde-xes.Thirteen of third-level indexes could be directly obtained from the hospital information system.Conclusion The quality control index system for neonatal HAI management established in this study is relatively scientific,with rational weights and all quantifiable indexes.It can be used for vertical and horizontal evaluations of neonatal HAI management quality,providing a reference for the continuous improvement of neonatal HAI management work.

Objective To investigate the predictive value of the combination of cell cycle protein-dependent kinase inhibitor 3(CDKN3)and serum chitosanase 3-like protein 1(CHI3L1),and microRNA-106b(miR-106b)assays in hepatocellular carcinoma metastasis.Methods One hundred patients with hepatocellular carcinoma admitted to the hospital between September 2019 and December 2023 were selected as study subjects and included in the hepatocellular carcinoma group,87 patients with cirrhosis were included as the cirrhosis group during the same period,96 patients with chronic hepatitis B as the chronic hepatitis B group,and 98 healthy persons under-going routine physical examination were included in the healthy control group,and the groups were compared with respect to the serum CHI3L1,the cell-cycle molecule CDKN3,and the miR-106b levels.The hepatocellular carci-noma group was divided into 26 metastatic cases,63 non-metastatic cases,and 11 cases lost to follow-up according to whether they metastasized during the 1-year follow-up period,and baseline data,cell cycle molecules CDKN3,miR-106b,and serum CHI3L1 levels were compared between the two groups.Risk factors for hepatocellular carci-noma metastasis were analyzed using multifactorial logistic,and the predictive value of the combined detection of miR-106b,the cell cycle molecule CDKN3,and serum CHI3L1 for hepatocellular carcinoma metastasis was analyzed using ROC curves.Results Compared with the healthy control group,the levels of CHI3L1,cell cycle molecule CDKN3,and serum miR-106b were elevated in the hepatocellular carcinoma group,chronic type B group,and cirrhosis group,and the chronic type B group3 cm,CHI3L1,cytokinin A2(CCNA2),percentage of tumors with stage>Ⅲ,the cell cycle molecule CDKN3,abnormal plasminogen,glutamyltransferase(GGT),miR-106b,total bile acids(TBA),alpha-fetoprotein(AFP),number of tumors percentage of multiple occurrences,and glutamyltransferase(AST)levels were elevated,and the difference was statistically significant(P<0.05).The results of multifactorial logistics analysis showed that the risk factors for hepatocellular carcinoma metastasis included ALT,CCNA2,tumor>3 cm,AST,GGT,tumor stage>Ⅲ,AFP,CHI3L1,multiple tumors,abnormally high blood plasminogen,miR-106b,cell cycle molecule CDKN3,TBA.the results of the ROC curve analysis showed that miR-106b,serum CHI3L1,cell cycle molecule CDKN3 combined detection sensitivity was 93.65％,accuracy was 84.27％,and AUC value was 0.776 higher than the sensitivity,accuracy,and AUC value of single detection,and the difference was statistically significant(P<0.05).Conclusions Elevated levels of cell cycle molecule CDKN3,serum CHI3L1,and miR-106b are risk factors for liver cancer metastasis.It can be used to predict the occurrence of liver cancer metastasis,and the combined detection has significant predictive efficacy.

Objective:To evaluate the clinical safety of Fufang E'jiao syrup and provide reference for its rational and safe clinical use. Methods:The literature involving Fufang E'jiao syrup in domestic and international databases, as well as the relevant clinical trials on ClinicalTrials.gov and the Chinese Clinical Trial Registry website were searched up to June 1, 2024. Those literature and clinical trials reporting drug adverse events were included, and the basic information about literature/clinical trials (title, publication year, study design, etc.), patients (age, gender, primary diseases, and dosage of Fufang E'jiao syrup), and adverse events (time of occurrence, clinical manifestations, and outcomes) was extracted. The adverse events were standardized and classified using the Medical Dictionary for Regulatory Activities version 25.0, and were also analyzed based on traditional Chinese medicine theory. Results:A total of 19 literature were included in the analysis, including 16 observational/experimental clinical studies, and 3 case reports. The 19 literature reported a total of 430 adverse events involving 398 patients, and the patients were mainly with malignant tumors and anemia. The 430 adverse events involved 11 system organ classes, which mainly included gastrointestinal disorders (260 events, 60.47%, with the most common symptom being dry mouth), respiratory, thoracic, and mediastinal disorders (119 events, 27.67%, with the most common symptom being dry throat), and skin and subcutaneous tissue disorders (16 events, 3.72%, with the most common symptom being mucosal ulcers). Based on traditional Chinese medicine theory, the 430 adverse events were mainly manifested as symptoms of indigestion (nausea, epigastric discomfort, and decreased appetite) and symptoms of "heat" (dry mouth and dry throat).Conclusions:Fufang E'jiao syrup has a relatively good overall safety profile, with the most common adverse events being symptoms of "heat" and gastrointestinal reactions. Patients should not use it blindly, and it should be used with syndrome differentiation in clinical practice.

Objective To investigate the predictive value of the combination of cell cycle protein-dependent kinase inhibitor 3(CDKN3)and serum chitosanase 3-like protein 1(CHI3L1),and microRNA-106b(miR-106b)assays in hepatocellular carcinoma metastasis.Methods One hundred patients with hepatocellular carcinoma admitted to the hospital between September 2019 and December 2023 were selected as study subjects and included in the hepatocellular carcinoma group,87 patients with cirrhosis were included as the cirrhosis group during the same period,96 patients with chronic hepatitis B as the chronic hepatitis B group,and 98 healthy persons under-going routine physical examination were included in the healthy control group,and the groups were compared with respect to the serum CHI3L1,the cell-cycle molecule CDKN3,and the miR-106b levels.The hepatocellular carci-noma group was divided into 26 metastatic cases,63 non-metastatic cases,and 11 cases lost to follow-up according to whether they metastasized during the 1-year follow-up period,and baseline data,cell cycle molecules CDKN3,miR-106b,and serum CHI3L1 levels were compared between the two groups.Risk factors for hepatocellular carci-noma metastasis were analyzed using multifactorial logistic,and the predictive value of the combined detection of miR-106b,the cell cycle molecule CDKN3,and serum CHI3L1 for hepatocellular carcinoma metastasis was analyzed using ROC curves.Results Compared with the healthy control group,the levels of CHI3L1,cell cycle molecule CDKN3,and serum miR-106b were elevated in the hepatocellular carcinoma group,chronic type B group,and cirrhosis group,and the chronic type B group3 cm,CHI3L1,cytokinin A2(CCNA2),percentage of tumors with stage>Ⅲ,the cell cycle molecule CDKN3,abnormal plasminogen,glutamyltransferase(GGT),miR-106b,total bile acids(TBA),alpha-fetoprotein(AFP),number of tumors percentage of multiple occurrences,and glutamyltransferase(AST)levels were elevated,and the difference was statistically significant(P<0.05).The results of multifactorial logistics analysis showed that the risk factors for hepatocellular carcinoma metastasis included ALT,CCNA2,tumor>3 cm,AST,GGT,tumor stage>Ⅲ,AFP,CHI3L1,multiple tumors,abnormally high blood plasminogen,miR-106b,cell cycle molecule CDKN3,TBA.the results of the ROC curve analysis showed that miR-106b,serum CHI3L1,cell cycle molecule CDKN3 combined detection sensitivity was 93.65％,accuracy was 84.27％,and AUC value was 0.776 higher than the sensitivity,accuracy,and AUC value of single detection,and the difference was statistically significant(P<0.05).Conclusions Elevated levels of cell cycle molecule CDKN3,serum CHI3L1,and miR-106b are risk factors for liver cancer metastasis.It can be used to predict the occurrence of liver cancer metastasis,and the combined detection has significant predictive efficacy.

Objective To establish a quantifiable quality control index system for infection management in neonatal specialty hospitals for the comprehensive evaluation of neonatal healthcare-associated infection(HAI)management quality,and to promote the continuous enhancement and improvement of neonatal HAI management quality.Methods The framework of the index system was preliminarily established through literature research and focus group discussion,the indexes were repeatedly screened using Delphi expert consultation approach,and the weights of each index were determined using the analytic hierarchy process.The empirical study of the established index sys-tem was conducted using TOPSIS method and rank sum ratio method.Results Three rounds of expert consultation were conducted,and the effective response rate of the questionnaire was 100％.The authoritative coefficient of the third round of expert consultation was 0.89,and the Kendall's coefficient of concordance for expert opinion was 0.322.The established index system included 3 first-level indexes,6 second-level indexes,and 16 third-level inde-xes.Thirteen of third-level indexes could be directly obtained from the hospital information system.Conclusion The quality control index system for neonatal HAI management established in this study is relatively scientific,with rational weights and all quantifiable indexes.It can be used for vertical and horizontal evaluations of neonatal HAI management quality,providing a reference for the continuous improvement of neonatal HAI management work.

Objective:To evaluate the clinical safety of Fufang E'jiao syrup and provide reference for its rational and safe clinical use. Methods:The literature involving Fufang E'jiao syrup in domestic and international databases, as well as the relevant clinical trials on ClinicalTrials.gov and the Chinese Clinical Trial Registry website were searched up to June 1, 2024. Those literature and clinical trials reporting drug adverse events were included, and the basic information about literature/clinical trials (title, publication year, study design, etc.), patients (age, gender, primary diseases, and dosage of Fufang E'jiao syrup), and adverse events (time of occurrence, clinical manifestations, and outcomes) was extracted. The adverse events were standardized and classified using the Medical Dictionary for Regulatory Activities version 25.0, and were also analyzed based on traditional Chinese medicine theory. Results:A total of 19 literature were included in the analysis, including 16 observational/experimental clinical studies, and 3 case reports. The 19 literature reported a total of 430 adverse events involving 398 patients, and the patients were mainly with malignant tumors and anemia. The 430 adverse events involved 11 system organ classes, which mainly included gastrointestinal disorders (260 events, 60.47%, with the most common symptom being dry mouth), respiratory, thoracic, and mediastinal disorders (119 events, 27.67%, with the most common symptom being dry throat), and skin and subcutaneous tissue disorders (16 events, 3.72%, with the most common symptom being mucosal ulcers). Based on traditional Chinese medicine theory, the 430 adverse events were mainly manifested as symptoms of indigestion (nausea, epigastric discomfort, and decreased appetite) and symptoms of "heat" (dry mouth and dry throat).Conclusions:Fufang E'jiao syrup has a relatively good overall safety profile, with the most common adverse events being symptoms of "heat" and gastrointestinal reactions. Patients should not use it blindly, and it should be used with syndrome differentiation in clinical practice.

In the process of conducting implementation research on health service issues, stakeholders' preference for contents related to evidence-based practice (EBP) and implementation strategies is closely related to whether EBP can be effectively implemented.However, multiple preference assessment methods exist, each with their own strengths, weaknesses, and application scenarios, which makes it challenging for researchers to select appropriate and effective preference assessment methods. This paper aims to review the origins, characteristics, and application scenarios of commonly used preference assessment methods, with the hope of providing valuable reference and lessons for domestic scholars to select and apply appropriate preference assessment methods in implementation research.

In the process of conducting implementation research on health service issues, stakeholders' preference for contents related to evidence-based practice (EBP) and implementation strategies is closely related to whether EBP can be effectively implemented.However, multiple preference assessment methods exist, each with their own strengths, weaknesses, and application scenarios, which makes it challenging for researchers to select appropriate and effective preference assessment methods. This paper aims to review the origins, characteristics, and application scenarios of commonly used preference assessment methods, with the hope of providing valuable reference and lessons for domestic scholars to select and apply appropriate preference assessment methods in implementation research.

Objective To analyze the risk factors of nosocomial infection among the patients in neuro-surgical ICU,and to construct the risk prediction model to provide reference for the prediction of nosocomial infection in neurosurgical ICU patients.Methods The clinical data of 280 patients admitted and treated in the neurosurgery ICU of this hospital from January 2021 to December 2022 were retrospectively analyzed.The pa-tients were divided into the infection group and non-infection group based on whether or not nosocomial infec-tion occurring,140 cases in each group.A total of 196 patients were extracted as the training set by a ratio of 7︰3 for constructing the model,while the remaining 84 patients served as the validation set for conducting the internal verification.The logistic regression was used to analyze the risk factors of nosocomial infection in the neurosurgery ICU patients,and a predictive model was established.The receiver operating characteristic (ROC) curve was drawn to evaluate the predictive effect of the model.Results The multivariate logistic re-gression analysis indicated that old age,long surgery time,catheter use and glucocorticoids use were screened as the main risk factors of nosocomial infection occurrence in neurosurgery ICU patients.The nomogram mod-el was constructed based on the results of multivariate analysis,the area under the curve of training set and validation set were 0.796 and 0.875,respectively.The correcting model reflected good consistency between actual diagnosis and predictive diagnosis.Conclusion The model constructed in this study has the high predic-tive value for the nosocomial infection occurrence risk in the patients of the neurosurgery ICU.