Needle-free injection technology (NFIT) refers to the drug delivery systems in which drugs are propelled as high-speed jet streams using any of the pressure source to penetrate the skin to the required depth. NFIT is a promising drug delivery system as it enables the injection of liquids, powders, and depot/projectiles, and has the advantages of preventing needle stick accidents, improving drug bioavailability, eliminating needle-phobia, increasing vaccine immunity, simplifying operations and is convenient for patients to use. NFIT and its research background, the structure and classification of needle-free jet injectors (NFJI), drugs that can be delivered using NFJI and the factors affecting the injection effect are comprehensively reviewed in this paper. The limitations and potential development directions are summarized to provide a theoretical basis for the application and development of NFIT.

Objective To investigate the therapeutic effect and mechanism of Chaihu Guizhi Ganjiang Decoction on non-alcoholic fatty liver disease(NAFLD)rats.Methods The experiment was conducted in five groups:normal group,model group,low-and high-dose groups of Chinese medicine(Chaihu Guizhi Ganjiang Decoction)and GSK872[receptor interacting protein kinase(RIP)3 inhibitor]group.Except for the normal group,the NAFLD rat model was constructed using high-fat chow feeding method in the remaining groups,respectively.At the end of treatment,hepatocyte apoptosis was observed by terminal transferase uridyl nick end labeling(TUNEL)method,and serum levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),lipids[total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)],and the levels of inflammatory factors tumor necrosis factor α(TNF-α)and interleukin 1β(IL-1β)in liver tissues were measured by enzyme-linked immunosorbent assay(ELISA);and the levels of phosphorylation of RIP1,RIP3,and mixed lineage kinase structural domain-like protein(MLKL)were detected in liver tissues by Western Blot.Results Compared with the normal group,the apoptotic index of rat hepatocytes in the model group was elevated,ALT and AST in serum were significantly elevated,TC,TG and LDL-C levels were significantly elevated,and HDL-C level was significantly reduced,and the contents of TNF-α and IL-1β as well as the phosphorylated expression levels of RIP1,RIP3 and MLKL were significantly elevated in the liver tissues(P＜0.05);compared with the model group,the apoptotic index of hepatocytes in rats in the low-and high-dose groups of Chinese medicine and GSK872 group was reduced,the serum levels of ALT and AST were significantly reduced,the levels of TC,TG and LDL-C were significantly reduced,the level of HDL-C was significantly increased,and the contents of TNF-α and IL-1β and the phosphorylated expressions of RIP1,RIP3 and MLKL in the liver tissues were significantly reduced(P＜0.05);there was no significant difference in the above-mentioned indexes between the low-dose and high-dose groups of Chinese medicine and the GSK872 group(P＞0.05).Conclusion Chaihu Guizhi Ganjiang Decoction can effectively improve NAFLD in rats,and its mechanism may be related to the inhibition of RIP1/RIP3/MLKL signaling pathway activation,which in turn inhibits necrotic apoptosis.

Objective To construct a 3D printed PLLA/β-tricalcium(PLLA/β-TCP)bone tissue engineering scaffold surface porous structure through simple treatment with NaOH solution,increase the roughness and hydrophilicity of the scaffold,and promote cell adhesion on the scaffold surface.Methods The PLLA/β-TCP mesh scaffold was prepared by 3D printing melt deposition molding technology,and the scaffold was roughed by NaOH etching.The effects of NaOH concentration and time on the scaffold were observed according to the microstructure,energy spectrum,contact angle,mechanics,and cell adhesion of the scaffold.Results The PLLA/β-TCP composite scaffold constructed by melt deposition technology had a pre-set porous structure,and the pores were interconnected.After NaOH etching,a porous structure with both macroscopic and microscopic pores was formed.The increase in any of the NaOH concentration and time parameters would lead to the increase of pore diameter and surface roughness.When the NaOH treatment parameter was 0.1 mol/L(9 h),it could significantly reduce the water contact angle on the surface of the scaffold,and had no significant effect on the compressive strength of the scaffold.In vitro cell testing showed that the surface porous composite scaffold etched with NaOH had more advantages in the adhesion and proliferation of BMSCs.Conclusion Using NaOH to process 3D printing of PLLA/β-TCP bone tissue engineering scaffolds can effectively improve the surface morphology of the scaffold,and optimize its hydrophilicity and cell adhesion.

Objective To solve the problem of insufficient hydrophilicity on the surface of polycaprolactone(PCL)/β-TCP bone tissue engineering scaffolds,NaOH etching method was used to improve the surface microstructure of 3D printed PCL/β-TCP scaffolds,further affecting their hydrophilicity and cell response.Methods PCL/β-TCP mesh scaffolds were prepared using 3D printing melt deposition molding technology,and the surface roughness of the scaffolds was modified by NaOH etching.The effects of two reaction parameters,NaOH concentration and time,on the microstructure,spectral elements,contact angle,compressive strength,and cell adhesion of the scaffolds before and after modification were observed.Results After NaOH etching,the surface microporous structure of the mesh scaffold was successfully prepared.With the increase of either NaOH concentration or time,the surface micropores of the scaffold increased while the contact angle of the material surface decreased.However,the compression strength of the etched scaffold treated with NaOH for 1 mol/L(24 h)or 10 mol/L(6 h)was not statistically significant compared to the untreated group(P＞0.05).The number of cells on the etched scaffold increased,with a larger spreading area of individual cells,making it more advantageous in the adhesion and proliferation of BMSCs.Conclusion The use of NaOH etching to improve the hydrophilicity of 3D printed PCL/β-TCP bone tissue engineering scaffolds is a low-cost and effective strategy which can effectively improve the wettability and cell adhesion of the scaffolds.

Objective To investigate the relationship between two-lung ventilation (TLV) with single-lumen endotracheal tube (SLT), one-lung ventilation (OLV) with double-lumen endotracheal tube (DLT) and postoperative pulmonary complications (PPCs) after total thoracoscopic cardiac surgery. Methods The clinical data of patients who underwent totally thoracoscopic cardiac surgeries in the Guangdong Provincial People’s Hospital from October 2019 to October 2021 were retrospectively analyzed. The patients were divided into 2 group according to the type of endotracheal tube, including a SLT group and a DLT group. Baseline data, surgical variables and PPCs were compared. The influencing factors of PPCs in the two groups were analyzed by binary logistic regression analysis. Results Finally 349 patients were enrolled, including 180 males and 169 females with an average age of (50.0±14.8) years. There were 219 patients in the SLT group and 130 patients in the DLT group. There was no statistical difference in baseline data, surgical variables or PPCs between the two groups (P＞0.05). Binary logistic regression analysis showed that PPCs were related to body mass index in the SLT group (OR=0.778, 95%CI 0.637 to 0.951, P=0.014) and preoperative smoking history in the DLT group (OR=0.058, 95%CI 0.004 to 0.903, P=0.042). Conclusion For the patients who undergo totally thoracoscopic cardiac surgery, TLV with SLT and OLV with DLT show no significant association with PPCs. At the same time, PPCs are associated with body mass index in the SLT group, while associated with preoperative smoking history in the DLT group.

This paper mainly discusses the practical significance of the internal quality assurance system of graduate students in a military medical university based on training process management. The integrated internal quality assurance system follows the direction of three core steps—course learning, scientific research practice training, and dissertation writing, and highlights nine key points—learning foundation in admission education and training, knowledge acquisition in course learning, application ability in teaching and scientific research practice, innovation ability in academic activities and innovation competitions, topic selection quality in thesis proposal, training quality in mid-term assessment, paper quality in dissertation writing, output quality in thesis defense, and comprehensive quality in diploma awarding. Our exploration and practical experience is shared in this article.

Objective:To compare the real-world efficacy and safety profile of tenofovir amibufenamid (TMF) and tenofovir alafenamide (TAF) tablets in the treatment of patients with chronic hepatitis B (CHB).Methods:This retrospective study included patients with chronic hepatitis B who received TMF and TAF antiviral treatment at the Infectious Disease Outpatient Department of the First Affiliated Hospital of Zhengzhou University from January 2021 to December 2023. The primary and secondary outcome was to study the patient HBV DNA conversion rate (<20 IU/ml), alanine aminotransferase (ALT) normalization rate, renal function, and lipid levels of patients at 48 weeks of treatment. The comparison of data between measurement data groups was differentiated using a t-test and Mann-Whitney U test. The inter-group comparison rate in count data was performed using the χ2 test or Fisher's exact probability. Results:A total of 440 cases were enrolled, including 220 in the TMF group (63 treatment-na?ve and 157 treatment-experienced) and 220 cases in the TAF group (61 treatment-na?ve and 159 treatment-experienced). In terms of efficacy, the HBV DNA seroconversion rates in the TMF group and TAF group were 90.5% and 85.2% ( P=0.372), respectively, while the ALT normalization rates were 92.1% and 88.5% ( P=0.505), respectively, at 48 weeks of treatment. The HBV DNA-negative conversion rate for the newly treated patients was 99.4% and 98.7%, respectively ( P=1.000), while the rates of ALT normalization were 94.9% and 92.3%, respectively ( P=0.863). In terms of safety profile, the serum creatinine level was lower in the TMF group than that in the TAF group at 48 weeks of treatment [TMF group 66.5 (56.3, 78.3) μmol/L, TAF group 70.6 (60.7, 77.8) μmol/L, Z=-2.282, P=0.022]. However, there was no statistically significant difference in other renal function and tubular function related indicators between the two groups of patients ( P>0.05). The serum high-density lipoprotein levels were higher in the TMF group than those in the TAF group [TMF 1.4 (1.1, 1.6) mmol/L vs. TAF group 1.3 (1.1, 1.6) mmol/L, Z=-2.204, P=0.027] at 48 weeks of treatment. However, there was no statistically significant difference in other blood lipid indicators between the two groups of patients ( P>0.05). Conclusion:There is no statistically significant difference in efficacy and safety profiles between TMF and TAF at 48 weeks in the treatment of patients with chronic hepatitis B, and the overall safety profile is favorable.

Six novel compounds,comprising three quinolones(1a,1b,and 2)and three flavanones(3-5),along with seven known analogs(6-13),were isolated from the 95％EtOH extract of the stems and leaves of Glycosmis craibii var.glabra.The structures of the new compounds were elucidated using HR-ESI-MS,UV,and 1D and 2D nuclear magnetic resonance(NMR)data analysis.The ab-solute configurations were determined through Mosher ester and electronic circular dichroism(ECD)spectral analysis.Compounds 2,6,9,and 10 demonstrated inhibition of nitric oxide(NO)production stimulated by lipopolysaccharide in BV-2 microglial cells,with IC50 values ranging from 13.5 to 20.1 μmol·L-1,comparable to the positive control,dexamethasone.

Hepatocellular carcinoma (HCC) is characterized by high postoperative recurrence and mortality rates. In recent years, researchers have identified a significant correlation between microvascular invasion (MVI) and early postoperative recurrence and metastasis of HCC, making it a focal point of HCC research. Accurate preoperative prediction of MVI occurrence and the implementation of relevant interventions (such as expanded resection) could provide substantial benefits to patients. This study analyzes global research over the past decade on MVI predictive indicators based on tumor biological characteristics, genetic measurements, imaging examinations, and tumor markers. The aim is to use these predictive indicators to objectively forecast the occurrence of MVI, thereby aiding in preoperative individual assessments and enhancing treatment plans.

This paper analyzes the current situation of constructing postgraduate education quality assurance systems worldwide, and explores the specific path of constructing a "seven-in-one" medical postgraduate education quality assurance system. The system should be constructed according to the education practice in military medical universities and consider the following aspects: first-class students, first-class teaching, first-class tutors, first-class disciplines, first-class management, first-class culture, and first-class achievements. The system should be constructed by enrollment reform and innovation, teaching method reform, tutor team construction, discipline construction, cultural atmosphere creation, and emphasis on cultivating achievements.