ObjectiveTo investigate the protective effect of Rehmanniae Radix iridoid glycosides （RIG） on the kidney tissue of streptozotocin （STZ）-induced diabetic mice and explore the underlying mechanism. MethodsTwelve of 72 male C57BL/6J mice were randomly selected as the normal group， and the remaining 60 mice were fed with a high-fat diet for six weeks combined with injection of 60 mg·kg^-1 STZ for 4 days to model type 2 diabetes mellitus. The successfully modeled mice were randomized into model， metformin （250 mg·kg^-1）， catalpol （100 mg·kg^-1）， low-dose RIG （RIG-L， 200 mg·kg^-1） and high-dose RIG （RIG-H， 400 mg·kg^-1） groups （n=11）. Mice in each group were administrated with corresponding drugs， while those in the normal group and model group were administrated with the same dose of distilled water by gavage once a day. After 8 weeks of intervention， an oral glucose tolerance test （OGTT） was performed， and the area under the curve （AUC） was calculated. After mice were sacrificed， both kidneys were collected. The body weight， kidney weight， and fasting blood glucose （FBG） were measured. Biochemical assays were performed to measure the serum levels of triglycerides （TG）， total cholesterol （TC）， serum creatinine （SCr）， and blood urea nitrogen （BUN）. Enzyme-linked immunosorbent assay （ELISA） was employed to determine the serum level of fasting insulin （FINS）， and the insulin sensitivity index （ISI） and homeostatic model assessment for insulin resistance （HOMA-IR） were calculated. The pathological changes in kidneys of mice were observed by hematoxylin-eosin staining and Masson staining. The immunohistochemical method （IHC） was employed to assess the expression of interleukin-1 （IL-1）， interleukin-6 （IL-6）， tumor necrosis factor-α（TNF-α）， transforming growth factor-β₁ （TGF-β₁）， and collagen-3 （ColⅢ） in the kidney tissue. The protein levels of TGF-β₁， cell signal transduction molecule 3 （Smad3）， matrix metalloproteinase-9 （MMP-9）， and ColⅢ in kidneys of mice were determined by Western blot. ResultsCompared with the normal group， the model group showcased decreased body weight and ISI （P<0.01）， increased kidney weight， FBG， AUC， FINS， HOMA-IR， TC， TG， SCr， and BUN （P<0.01）， glomerular hypertrophy， capsular space narrowing， and collagen deposition in the kidney， up-regulated protein levels of IL-1， IL-6， TNF-α， TGF-β₁， ColⅢ， and Smad3 （P<0.01）， and down-regulated protein level of MMP-9 （P<0.01） in the kidney tissue. Compared with the model group， the treatment groups had no significant difference in the body weight and decreased kidney weight （P<0.05， P<0.01）. The FBG level declined in the RIG-H group after treatment for 4-8 weeks and in the metformin， catalpol， and RIG-L groups after treatment for 6-8 weeks （P<0.01）. The AUC in the RIG-L， RIG-H， and metformin groups decreased （P<0.05， P<0.01）. The levels of TC， SCr， and BUN in the serum of mice in each treatment group became lowered （P<0.05， P<0.01）. The level of TG declined in the RIG-L， RIG-H， and metformin groups （P<0.05， P<0.01）. The serum level of FINS declined in the catalpol， RIG-L， and metformin groups （P<0.01）. Compared with the model group， the treatment groups showed decreased HOMA-IR （P<0.01）， increased ISI （P<0.01）， alleviated pathological changes in the kidney tissue， and down-regulated expression of IL-1 and TGF-β₁. In addition， the protein levels of IL-6， TNF-α， and ColⅢ in the RIG-H and metformin groups and IL-6 and TNF-α in the RIG-L group were down-regulated （P<0.05， P<0.01）， and the protein levels of IL-6， TNF-α， and ColⅢ in the catalpol group and ColⅢ in the RIG-L group showed a decreasing trend without statistical difference. The protein levels of TGF-β₁， Smad3， and ColⅢ in the RIG-H and metformin groups were down-regulated （P<0.01）. Compared with that in the model group， the protein level of MMP-9 was up-regulated in each treatment group （P<0.01）. ConclusionRIG can improve the renal structure and function of diabetic mice by regulating the TGF-β₁/Smads signaling pathway.

OBJECTIVE To know about the perception and current status of drug risk management among pharmacists in Chinese medical institutions， providing insights and recommendations for enhancing the drug risk management system in medical institutions. METHODS A questionnaire survey was conducted across 28 provinces， cities， and autonomous regions； stratified radom sampling was employed to study the population of medical workers and pharmaceutical professionals in medical institutions nationwide. The survey included information on the survey population， the current status of drug risk management implementation in medical institutions， the cognition， definition and process of drug risk management related concepts， and the content and mode of drug risk management work in medical institutions. Finally， suggestions were collected from various medical institutions on the system construction of drug risk management. Descriptive statistical analysis was adopted to summarize the obtained data. RESULTS A total of 446 questionnaires were collected in this survey， including 420 valid questionnaires and 26 invalid questionnaires. The questionnaire collection rate was 100%，and the effective rate was 94.17%. 51.19% of the respondents No.2020YFC2009001）。 based their understanding of drug risk management on Management Measures for Adverse Drug Reaction Reports and Monitoring， while 87.38% recognized the need for drug risk management throughout the drug use process. 63.33% of the participants stated that their medical institutions had dedicated positions related to drug risk management， with the highest proportion （72.17%） was in third-grade class A medical institutions. 66.43% reported implementing risk management across all drug use stages. Suggestions for the development of drug risk management systems in medical institutions by the research participants focused on enhancing guiding documents， clarifying concepts， establishing information-sharing mechanisms. CONCLUSIONS The overall awareness of drug risk management in China’s medical institutions is high， with practices in place across various stages in multiple forms. However， there remains a need to strengthen institutional documents， management regulations， system development， and information-sharing mechanisms to improve collaborative governance， improve drug management levels， and ensure patient safety.

Organ transplantation has become an effective treatment for multiple end-stage diseases. However, the recipients of organ transplantation need to take immunosuppressive drugs for a long time after operation, which leads to low immune function and relatively high incidence of bacterial, viral and fungal infections. Traditional microbial detection methods, such as pathogen culture, immunological detection and polymerase chain reaction, have been widely applied in infection detection, whereas these methods may cause problems, such as long detection time and presumed pathogens. Metagenomic next-generation sequencing has been widely adopted in infection prevention and control in organ transplantation in recent years due to high detection rate and comprehensive detection of pathogen spectrum. In this article, the application of metagenomic next-generation sequencing in the prevention and control of infection in solid organ transplantation was reviewed, aiming to provide reference for the diagnosis and treatment of transplantation-related infection.

Parkinson's disease(PD)is a prevalent condition among the elderly, with its incidence increasing with age and significantly affecting the quality of life in this demographic.Given the unique characteristics of older adults, such as comorbidities, polypharmacy, and reduced sensitivity to treatment regimens, it is essential to not only focus on the efficacy of medications used in PD treatment but also to carefully evaluate the associated drug risks.This article examines a drug risk management approach for treating elderly patients with PD, emphasizing the importance of gathering comprehensive drug information, identifying potential risks associated with drug selection, procurement, storage, prescription, and dispensing, and addressing specific considerations pertinent to the elderly population.Furthermore, the article proposes management strategies aimed at standardizing risk management in the treatment of elderly patients with PD, enhancing clinical pharmacy services in this area, and promoting rational drug use among this vulnerable group.

Objective:To explore the effects of lower concentrations of ropivacaine on ultrasound-guided nerve block in pediatric orthopedic surgery.Methods:Using a retrospective study method, 75 children who underwent orthopedic surgery at Wu Jiang District Children′s Hospital from May 2023 to February 2024 were selected and divided into Group A (25 cases, 0.15% ropivacaine nerve block), Group B (25 cases, 0.20% ropivacaine nerve block) and Group C (25 cases, 0.25% ropivacaine nerve block). The heart rate; mean arterial pressure; onset time of anesthesia; analgesic maintenance time; recovery time of movement and sensation; child face, legs, activity, cry, consolability behavioral tool (FLACC) score at 2 h after surgery; adverse reactions incidence of postoperative local anesthetic drugs were compared.Results:There was no statistically significant difference in the physical indicators of heart rate and mean arterial pressure among the three groups ( P>0.05). As the concentration of ropivacaine increased, the onset time of anesthesia in the three groups of children was shortened: (11.04 ± 1.02) vs. (10.44 ± 1.04) and (7.16 ± 0.85) min, and the differences between the three groups were statistically significant ( P<0.05); There was no statistically significant difference in the analgesic maintenance time among the three groups ( P>0.05). As the concentration of ropivacaine increased, the recovery time of movement and sensation was increased: (194.64 ± 20.43) min vs. (207.72 ± 22.34) and (250.32 ± 30.18) min, (176.44 ± 16.18) min vs. (189.24 ± 20.66) and (224.08±29.56) min, and the differences among the three groups were statistically significant ( P<0.05). There was no statistically significant difference in FLACC scores among the three groups of patients at 2 h after surgery ( P>0.05). The total incidence of adverse reactions in Group A was lower than that in Groups B and C: 4% (1/25) vs. 24% (6/25) and 52% (13/25), and the differences among the three groups were statistically significant ( P<0.05). Conclusions:The 0.15% ropivacaine used for ultrasound-guided nerve block in pediatric orthopedic surgery can achieve good anesthesia effects with low incidence of adverse reactions, and is worthy of clinical promotion.

Objective:To explore the application effects of whole-process nutritional management in patients undergoing thoracoabdominal laparoscopic radical esophagectomy.Methods:A total of 144 patients who underwent thoracoabdominal laparoscopic radical esophagectomy at the Jiangsu Cancer Hospital between February 2022 and February 2024 were selected using convenience sampling method. Patients were randomly assigned to a control group ( n=72) receiving routine care and an observation group ( n=72) receiving whole-process nutritional management in addition to routine care. Nutritional status, postoperative recovery, nursing satisfaction, and weight loss were compared between the two groups. Results:On the day before surgery, the Nutritional Risk Screening (NRS-2002) score of the observation group was significantly lower than that of the control group, the difference was statistically significant ( P<0.05). The observation group had earlier times to first ambulation, bowel movement, flatus, and fewer total complications compared to the control group, the differences were statistically significant ( P<0.05). Nursing satisfaction scores in the observation group were significantly higher than in the control group, the differences were statistically significant ( P<0.05). One month postoperatively, the observation group experienced less weight loss than the control group, the difference was statistically significant ( P<0.05) . Conclusions:Whole-process nutritional management improves preoperative nutritional status scores, reduces postoperative complications and weight loss, and enhances patient satisfaction with nursing care in esophageal cancer patients undergoing thoracoabdominal laparoscopic radical esophagectomy.

Micro-computed tomography(Micro-CT)is a non-invasive technology that is widely used in animal experiments to assist in the detection of bone,lung,oral,metabolic,middle and inner ear diseases,as well as tumors,and in other animal disease models.The technique can provide diverse scientific and reliable imaging data for animal experiments and has accordingly become an indispensable experimental method in animal experiments.In this review,we introduce the imaging principles of Micro-CT,review its application in the study of animal disease models,summarize the limitations of Micro-CT technology,and consider its future prospects.

The study was aimed to assess the impact of Brucea javanica oil emulsion(BJOE)on the responsiveness of programmed death receptor-1(PD-1)monoclonal antibody to lung adenocarcinoma in mice.The experimental approach involved subcutaneously inoculating Lewis's lung adenocarcinoma(LLC)cells into C57BL/6 mice,which were then divided into four groups:model group,25 ml·kg-1 BJOE group,10 mg·kg-1 PD-1 group,and combination group(25 ml·kg-1 BJOE and 10 mg·kg-1 PD-1).Tumor volume,mass,and inhibition rate were evaluated;the apoptosis within tumor tissue was detected by TUNEL staining;CD4+and CD8+T cell proportions within tumor tissues were analyzed by flow cytometry;the levels of tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ)and granzyme B in tumor tissue were measured by enzyme-linked immunosorbent assay(ELISA).Additionally,LLC cells were categorized into a control group and three BJOE treatment groups(10,30,50 μl·ml-1),and programmed death ligand 1(PD-L1)expression in tumor tissues and LLC cells were assessed by Western blotting.Data showed that as compared with the model group,PD-1 monoclonal antibody alone did not significantly alter tumor volume,tumor mass,CD4+and CD8+T cell proportions,cytokine levels(IFN-γ,TNF-α,Granzyme B),or apoptosis in lung cancer-bearing mice.However,BJOE treatment reduced tumor volume and mass,enhanced CD4+and CD8+T cell proportions,increased cytokine levels,and augmented apoptosis(all P<0.05).Furthermore,the combination therapy of BJOE and PD-1 monoclonal antibody yielded significantly greater reductions in tumor volume and mass,with heightened CD4+and CD8+T cell proportions,cytokine levels,and apoptosis compared to either treatment alone(all P<0.05).Both BJOE treatment and the combination therapy significantly upregulated PD-L1 protein expression in tumor tissues compared to the model or PD-1 monoclonal antibody groups(P<0.05).Similarly,BJOE treatment at all tested concentrations significantly increased PD-L1 protein expression in LLC cells as compared to the control group(P<0.05).In conclusion,BJOE could upregulate PD-L1 expression in LLC cells and enhance the sensitivity of lung adenocarcinoma-bearing mice to PD-1 monoclonal antibodies.

Objective:To study the localization value of stereoelectroencephalography (SEEG) in refractory epilepsy associated with tuberous sclerosis complex (TSC), and to analyze the prognosis related factors.Methods:A case control study.Data of 66 patients with TSC-related refractory epilepsy who underwent SEEG placement at the Epilepsy Center of Tsinghua University Yu-Quan Hospital from January 2014 to March 2023 were retrospectively analyzed, including medical history, seizure semiology, scalp electroencephalogram (EEG), imaging, and SEEG findings.Patients were divided into a seizure-free group and a seizure group according to the seizures after surgery. t/ χ2 test was used to compare the relationship between age of onset, age of surgery, duration of epilepsy, genetic findings, seizure symptoms, scalp EEG characteristics, SEEG placement protocol and prognosis. Results:A total of 66 patients met the enrollment criteria, of whom 55 patients were seizure-free after surgery (seizure-free group), and 11 patients still had seizures (seizure group).Among the 66 patients, there were 46 males and 20 females; the age of onset was (21.72±30.01) months; the age of SEEG surgery was (6.79±5.12) years; the duration of epilepsy was (4.98±4.11) years.SEEG results showed that seizures started with a single tuber in 43 patients (64.4%), seizures started with 2 or more tubers in one hemisphere in 16 patients, and 7 patients had bilateral multi-tubers or the pathogenic tuber(s) could not be identified.The following factors were found to be associated with prognosis: early age of surgery ( t=-3.463, P<0.01), ictal scalp EEG with a definite lateralization ( χ2=7.876, P<0.05), and the concordance of interictal and ictal EEG ( χ2=6.821, P<0.05).The age of onset, duration of epilepsy, seizure type and symptom, genetic findings, and SEEG placement protocol were not significantly correlated with prognosis.The results of SEEG identified that onset with a single tuber revealed a better postoperative outcome. Conclusions:This study confirms the safety and efficacy of SEEG in TSC-related refractory epilepsy, and also finds that ictal EEG is uniquely valuable in guiding SEEG placement for TSC-related refractory epilepsy, which can help us better select patients with TSC-related refractory epilepsy who are suitable for SEEG placement.

Objective:To design a health state holographic perceptual intelligence operation and maintenance system,and to explore the application effect in medical equipment management of infectious disease department.Methods:The holographic perception intelligent operation and maintenance system of health status of medical equipment in the infectious disease department was built by the perception layer,transmission layer and application layer to realize the automatic alarm,active protection and real-time monitoring functions of equipment management.A total of 119 medical devices in clinical use in the Department of Infectious Diseases of The Second Affiliated Hospital of Air Force Medical University from 2021 to 2022 were selected,according to different management methods,during the equipment operation and maintenance period in 2021,the conventional medical equipment(referred to as the conventional management mode)management mode was adopted;during the equipment operation and maintenance period in 2022,the holographic perception intelligent operation and maintenance system of medical equipment health status(referred to as the intelligent operation and maintenance management mode)was adopted.The differences in the safety score,maintenance status,and ability score of equipment users between the two management modes were compared.Results:The average scores of electrical safety,biological safety,radiation safety,damage safety,diagnosis and treatment safety of medical equipment using the intelligent operation and maintenance management mode were(0.47±0.21),(0.63±0.15),(1.38±0.11),(0.83±0.34)and(0.94±0.27),respectively,which were lower than those of the conventional management mode,and the difference was statistically significant(Department of Infectious Diseases;Medical equipment;Health status;Holographic sensing;Intelligent operation and maintenance=20.609,24.003,27.127,25.135,30.762,P＜0.05).The equipment failure maintenance rate,maintenance processing time and arrival time of equipment accessories using the intelligent operation and maintenance management mode were(85.41±3.37)%,(0.77±0.14)h and(3.29±0.58)d,respectively,which were lower than those of the conventional management mode,while the average score of equipment maintenance service quality was(95.36±5.13)points,which was higher than that of the equipment score of the conventional management mode,and the differences were statistically significant(t=16.638,25.569,29.333,18.499,P＜0.05).The average scores of equipment users with respect to the sense of responsibility for using the equipment,the ability to correctly operate the equipment,the effect of responding to equipment,the ability to give an accurate and timely alarm and other operating abilities with the intelligent operation and maintenance management mode were(97.48±5.66),(91.53±4.28),(93.37±5.12)and(95.62±4.93),respectively,which were higher than the scores of conventional management mode,and the difference was statistically significant(t=10.948,17.171,6.058,7.276,P＜0.05).Conclusion:The holographic perception intelligent operation and maintenance system of medical equipment health status in the Department of Infectious Diseases can improve the quality of medical equipment management,prevent equipment failures,reduce equipment maintenance,and improve the quality of equipment services.