OBJECTIVE To investigate the effects and potential mechanism of persimmon leaf （PL） extract against ferroptosis induced by H2O2 in IEC-6 cells. METHODS Using IEC-6 cells as object， the effects of ferroptosis inhibitor ferrostatin-1 on IEC-6 cell viability induced by H2O2 were investigated； IEC-6 cells were divided into control group， H2O2 group， H2O2+PL 25 μg/mL group and H2O2+PL 50 μg/mL group. The levels of oxidant stress indexes [content of malondialdehyde （MDA）， activity of superoxide dismutase （SOD）， and levels of reactive oxygen species （ROS）]， mitochondrial membrane potential （MMP） as well as mRNA and protein expressions of nuclear factor-erythroid-2 related factor 2 （Nrf2）， heme oxygenase-1 （HO-1）， NADPH/quinone oxidoreductase-1 （NQO-1）， cystine/glutamate anti-porter （xCT）， glutathione peroxidase 4 （GPX4） and ferritin heavy chain （FTH） were detected. RESULTS Ferroptosis inhibitor ferrostatin-1 could significantly increase the survival rate of H2O2-induced cells （P＜ 0.01）. Compared with the control group， MDA content， ROS level， mRNA expressions of Nrf2 and NQO-1 as well as protein expressions of Nrf2 and HO-1 were increased or up-regulated significantly， while SOD activity， MMP， mRNA expressions of xCT， GPX4 and FTH as well as protein expressions of GPX4 and FTH were decreased or down-regulated significantly （P＜0.01 or P＜0.05）. Compared with the H2O2 group， oxidative stress Δ indexes of H2O2+PL 25， 50 μg/mL groups were reversed to different extents， MMP level was increased significantly， as well as mRNA and protein expressions of Nrf2， HO-1， NQO-1，xCT， GPX4 and FTH were up-regulated to different extents；there were statistical significances in some indexes between groups （P＜0.01 or P＜0.05）. CONCLUSIONS PL extract can alleviate mitochondrial membrane damage and abnormal accumulation of ROS caused by H2O2， which may be related to the inhibition of ferroptosis by activating the Nrf2/HO-1 signaling pathway.

Objective To understand the surveillance situation of poliovirus in Guangzhou from 2011 to 2024, and to further strengthen polio surveillance and ensure the continued maintenance of a polio-free status. Methods An analysis was conducted on the discovery and investigation results of six cases of vaccine-derived poliovirus (VDPV) detected in Guangzhou. Results A total of 6 VDPV incidents were reported in Guangzhou from 2011 to June 2024, among which 5 incidents were from sewage sample testing in the Liede Sewage Treatment Plant in Guangzhou, all of which were confirmed as VDPV, with 1 for type I, 1 for type II, and 3 for type III. In addition, one confirmed HFMD case was identified as a type VDPV II carrier. No presence of any wild poliovirus (WPV), VDPV cases, or circulating VDPV (cVDPV) was reported. Conclusion Guangzhou City has maintained a high level of vigilance and effectiveness in the monitoring and prevention of polio. Continuously strengthening the construction of the polio monitoring network, optimizing vaccination strategies, and comprehensively improving public health awareness are still the focus of the prevention and control work in the future.

【Objective】 To investigate the predictive value of nutritional risk index (NRI), systemic immune inflammatory index (SⅡ) and triglyceride glucose (TyG) index on the condition and prognosis of patients with acute pancreatitis (AP). 【Methods】 A total of 173 AP patients were divided into mild acute pancreatitis (MAP) group (n=79), moderate acute pancreatitis (MSAP) group (n=44), and severe acute pancreatitis (SAP) group (n=50) according to their severity. All the 50 SAP patients were divided into death group (19 cases) and survival group (31 cases) according to the death situation. The NRI, SⅡ and TyG indexes of each group were recorded and compared. The values of NRI, SⅡ and TyG index in predicting the occurrence and death of SAP were analyzed with ROC curve. Pearson correlation analysis of the correlation between NRI, SⅡ, and TyG index in SAP patients was made. 【Results】 NRI was significantly lower in SAP group (89.25±4.50) than in MSAP group (93.40±6.25) and MAP group (97.62±8.60), while SⅡand TyG index in SAP group (2 706.30±1 052.74, 7.84±1.21) were significantly higher than those in MSAP group (1 937.24±983.48, 6.52±1.05) and MAP group (1 280.58±717.36, 4.65±0.58) (P<0.001). NRI in death group (86.40±3.70) was significantly lower than that in survival group (91.46±5.28), while SⅡ and TyG index in death group (3 085.73±1 192.48, 9.05±1.37) were significantly higher than those in survival group (2 270.26±994.53, 6.70±1.10) (P<0.001). The ROC curve showed that the AUC of NRI, SⅡ and TyG index jointly predicting SAP occurrence and death was 0.850 (95% CI: 0.792-0.908) and 0.905 (95% CI: 0.843-0.966), respectively. Correlation analysis showed that NRI was negatively correlated with SⅡ and TyG index in SAP patients (r=-0.761, P<0.001, r=-0.813, P<0.001), while SⅡ was positively correlated with TyG index (r=0.842, P<0.001). 【Conclusion】 NRI, SⅡ and TyG index are related to the severity and death of AP patients, and the combination of the three indexes has good value in predicting the occurrence and prognosis of SAP.

Objective Combined with domestic and foreign guidelines,to explore the individualized treatment strategy of urosepsis,and to provide reference for standardized diagnosis and treatment of urosepsis patient.Methods To analyze the diagnosis and treatment process of a patient with urogenic sepsis who was admitted to the department of critical care medicine of the First Affiliated Hospital of Xi'an Jiaotong University in April 15,2021.During the diagnosis and treatment process,we performed puncture drainage fluid and urine culture as soon as possible to confirm the diagnosis from the perspective of etiology.Considering the possible pathogenic bacteria at the infection site,the drug resistance of pathogenic bacteria in medical units,and drug safety,imipenem and cilastatin was chosen for anti-infective therapy.A two-step approach was used for drug administration based on drug pharmacokinetics/pharmacodynamic(PK/PD)characteristics,and drug concentration monitoring.The patients were followed up after discharge.Results The patient was critically ill on admission and was diagnosed with urosepsis.We optimize the empirical use of antimicrobials based on their PK/PD characteristics.Ultrasound-guided percutaneous nephrostomy of the left renal pelvis was performed to adequately drain the infection.Urine culture returned as extended-spectrum β-lactamase(ESBL)-producing Escherichia coli,confirming the etiological diagnosis.After 7 days of treatment,the patient's condition improved,the antibacterial drugs were downgraded to piperacillin-tazobactam,and the total course of anti-infection was 14 days.The patient was in good condition 2 months after discharge,and underwent left ureteral calculus and lithotripsy in the local hospital,and the left nephrostomy tube was removed.After discharge,the patient's condition was stable,no recurrence was found after 7 months of follow-up,and daily life was not affected.Conclusions Management of infection foci in urosepsis patient is critical.Diagnosis and treatment should refer to domestic and foreign guidelines,and formulate treatment strategies based on the distribution of local pathogens,drug resistance,and the actual clinical conditions of patients.Optimize the use of antibiotics based on drug PK/PD characteristics,monitor the concentration of therapeutic drugs,and realize individualized treatment.

ObjectiveTo explore the mechanism of Gancao Fuzitang （GCFZ）in inhibiting the bone destruction of collagen-induced arthritis （CIA） model in mice. MethodThirty male DBa/1J mice were randomly divided into normal group， CIA group， low-dose GCFZ group （GCFZ-L， 2.4 g·kg^-1）， high-dose GCFZ group （GCFZ-H， 4.8 g·kg^-1）， and methotrexate group （MTX， 1 mg·kg^-1）， with six mice in each group. The CIA model was induced by secondary immunization method. The arthritis index of mice in each group was observed and recorded， and the histopathological changes in ankle joint were observed by hematoxylin-eosin （HE） staining. The damage to ankle cartilage was detected by safranin O-fast green staining. Micro-CT scanning was used to detect the bone destruction of ankle joint， and the expression of nuclear factor-κB p65 （NF-κB p65）， p-NF-κB p65， inhibitory-κB kinase α/β （IKKα/β）， and p-IKKα/β was observed by immunohistochemical staining. ResultCompared with the normal group， the CIA group showed manifest joint swelling and increased arthritis index score （P<0.01）. Compared with the CIA group， the groups with drug intervention could inhibit joint swelling and reduce arthritis index score （P<0.05， P<0.01）. As revealed by HE staining and safranine O-green staining， compared with the CIA group， the groups with drug intervention could inhibit synovial invasion and reduce the destruction of articular cartilage. Micro-CT scanning analysis showed that compared with the CIA group， the GCFZ-H group and the MTX group showed reduced bone destruction scores （P<0.01）. The immunohistochemical results showed that compared with the normal group， the CIA group showed increased optical density values of NF-κB p65， p-NF-κB p65， IKKα/β， and p-IKKα/β（P<0.01）. Compared with the CIA group， the GCFZ-H group and the MTX group showed reduced optical density values of NF-κB p65， p-NF-κB p65， IKKα/β， and p-IKKα/β（P<0.05，P<0.01）. In the GCFZ-L group， only the NF-κB p65 optical density value decreased（P<0.01）. ConclusionGCFZ may inhibit bone destruction in CIA mice by regulating the NF-κB signaling pathway.

Objective:To explore the effect of emergency "zero channel" process on improving the efficiency of intravenous thrombolysis in stroke.Methods:Fifty-eight acute ischemic stroke patients admitted to our hospital from January 2020 to December 2020 were enrolled into experimental group; another 58 acute ischemic stroke patients admitted to our hospital from January 2019 to December 2019 and matched with age and gender were selected as control group. "Green channel" process was adopted for patients in the control group, and optimized "zero channel" process (moving the working passageway forward to the ambulance) was implemented for patients in the experimental group. Door to rescue room time (DRRT), door to consultation time (DCT), door to laboratory examination completion time (DLECT), door to CT report time (DCRT), and door to needle time (DNT) were used to evaluate the times of emergency treatment. The thrombolytic effect of the two groups was compared by evaluating the recanalization rate of occluded vessels and thrombolytic efficiency. Modified Rankin scale (mRS) was used to evaluate the prognoses 6 months after treatment in both groups, and mRS scores≤2 was defined as good prognosis.Results:The DCRT, DCT and DNT in the experimental group were significantly shorter than those in the control group ( P<0.05); the compliance rate of DNT≤60 min in the experimental group was significantly higher as compared with that in the control group ( P<0.05). The immediate recanalization rate of occluded vessels in the experimental group and control group was 60.3% and 27.6%, and the thrombolytic efficiency was94.83% and 82.76%; significant differences were noted between the two groups ( χ2=12.633, P<0.001; χ2=4.245, P=0.039). The good prognosis rate of the experimental group and control group was 36.2% and 15.5%, respectively, after 6 months of follow-up ( χ2=4.016, P=0.041). Conclusion:Emergency "zero channel" can further shorten DCT, DCRT, and DNT, and improve the efficiency of thrombolysis and prognoses of acute ischemic stroke patients.

Objective:To explore the application effect of standardized intraoperative temperature management in patients with laparoscopic partial nephrectomy (LPN) .Methods:Using the convenient sampling method, a total of 100 patients who underwent LPN in Wuxi Second People's Hospital from July 2019 to June 2021 were selected as research objects. They were randomly divided into the control group and the observation group, with 50 cases in each group. The control group was given conventional thermal insulation measures, while the observation group was given standardized intraoperative temperature management on the basis of the control group. The differences in postoperative recovery indexes and body temperature at each time point were compared between the two groups.Results:The recovery time of anesthesia, recovery time of spontaneous respiration and stay time of anesthesia recovery room in the observation group were less than those in the control group, and the differences were statistically significant ( P<0.01). The complication rate of observation group was 2% (1/50), lower than 16% (8/50) of control group, and the difference was statistically significant ( P<0.05). The body temperature of observation group was higher than that of control group at 30 min after operation, 60 min after operation, immediately after operation and at the time of recovery, and the differences were statistically significant ( P<0.01) . Conclusions:The application of standardized body temperature management in LPN surgery can shorten the recovery time of anesthesia and help to maintain the stability of intraoperative temperature.

Objective:To investigate the expression level and clinical value of serum miR-148a-3p and miR-551b-5p in patients with acute pancreatitis (AP).Methods:The clinical data of 152 patients with AP admitted to Danzhou people's Hospital from January 2017 to September 2020 were selected. According to the severity of their illness, they were divided into MAP group ( n=70), MSAP group ( n=40), and SAP group ( n=42). The SAP group was divided into survival group ( n=25) and death group ( n=17) according to the prognosis of the patients. Another 50 healthy people were selected as the control group. Fastening venous blood was collected on the day of onset, and the expression levels of serum miR-148a-3p and miR-551b-5p in each group were detected by real-time quantitative PCR. The receiver operating characteristic curve (ROC) was drawn and the area under the curve (AUC) was calculated. The expression levels of serum miR-148a-3p and miR-551b-5p were analyzed to evaluate the prognosis of SAP. The correlation between serum miR-148a-3p and miR-551b-5p expression levels in SAP patients was analyzed by Pearson method. Results:The expression levels of serum miR-148a-3p (3.18±1.27 vs 0.96±0.28) and miR-551b-5p (1.94±0.85 vs 0.51±0.12) in AP group were significantly higher than those in control group ( P<0.001). The expression levels of serum miR-148a-3p (4.36±1.70 vs 2.84±1.10, 2.50±0.92) and miR-551b-5p (2.80±1.04 vs 1.68±0.53, 1.42±0.45) in SAP group were significantly higher than those in MSAP group and MAP group ( P<0.001). The expression levels of serum miR-148a-3p (5.30±1.95 vs 3.47±1.40) and miR-551b-5p (3.62±1.37 vs 2.08±0.91) in death group were significantly higher than those in survival group ( P<0.001). ROC curve analysis showed that the AUC of the combination of miR-148a-3p and miR-551b-5 in judging the prognosis of SAP was significantly higher than that of the single index of miR-148a-3p and miR-551b-5[0.943(95% CI0.886-0.997) vs 0.860(95% CI0.797-0.924), 0.822(95% CI0.795-0.880)], with a sensitivity of 98.3% and specificity of 84.6%. Correlation analysis showed that there were positive correlation between the expression level of serum miR-148a-3p and miR-551b-5p in SAP patients ( r=0.835, P<0.001). Conclusions:The expression levels of miR-148a-3p and miR-551b-5p in serum of AP patients were significantly increased, and the combined detection of miR-148a-3p and miR-551b-5p had a good value in judging the prognosis of SAP.

Objective:To describe the trends of loss of muscle fiber thickness of the arm and calf.Methods:From April 2019 to July 2019, 58 patients admitted to ICU of Qinghai Provincial People's Hospital were enrolled. During ICU stay, the muscle fiber thickness in bilateral upper arm (biceps brachii) and bilateral calf (gastrocephus muscle) were measured by bedside color ultrasound every day.Results:The muscle fiber thickness of biceps and gastrocnemius on the left and right were (1.52 ± 0.37), (1.50 ± 0.34), (1.53±0.39), (1.51 ± 0.37) mm, respectively. The thickness of muscle fibers were (1.45 ± 0.35), (1.46 ± 0.37), (1.44±0.33), (1.41 ± 0.32) mm, which were significantly decreased in 48 h admitted to ICU ( t values were 2.106-4.711, P<0.05 or 0.01); and (1.43 ± 0.36), (1.44 ± 0.36), (1.44±0.32), (1.39 ± 0.32) mm in 72 h, which were significantly decreased than 24 h admitted to ICU ( t values were2.029-4.504, P<0.05 or 0.01). During 1 week admission to ICU , the muscle fiber thickness showed a continuous trend of decline, and the muscle fiber thickness of the left biceps, right biceps, left gastrocnemius and right gastrocnemius decreased by 8.38% (0.13/1.55), 10.19% (0.16/1.57), 9.87% (0.15/1.52), 11.11% (0.17/1.53), respectively compared with the ICU admission. The muscle fiber thickness of the left biceps, right biceps, left gastrocnemius and right gastrocnemius decreased by 9.87% (0.15/1.52), 9.33% (0.14/1.50), 9.15% (0.14/1.53), 11.26% (0.17/1.51), respectively. Conclusion:Muscle attenuation can be observed within 48h after ICU entry, and it tends to decrease with the extension of the length of hospital stay.

Objective:To observe the efficacy and safety of oral administration of low-molecular-weight collagen peptide on facial skin rejuvenation.Methods:A total of 66 female volunteers in Department of Dermatology, Beijing Friendship Hospital, Capital Medical University aged from 35 to 50 years old (average 42.89±4.44) from November 2018 to February 2019 were enrolled and randomly divided into two groups, 33 cases each. The testing group was given 5 g Su Yan Xin Ji collagen peptide for 12 weeks; the control group was given 5 g Tai Duo Jian collagen protein powder for 12 weeks. The effects were evaluated and analyzed using VISIA and CK complexion analysis system before and after 1, 2, 4 , 12 weeks of oral administration collagen; meanwhile, the volunteers' overall satisfaction and adverse reactions were also recorded.Results:In total, 61 volunteers completed the study. After 12 weeks of oral administration, the skin hydration of testing group and control group were all increased (65.41±10.60 vs 59.82±9.26), the transepidermal water loss, wrinkles, textures, pores, red areas and porphyrin were all decreased (19.19±4.24 vs.21.50±5.10; 7.38±3.67 vs. 8.98±6.67; 5.55±3.07 vs.6.60±4.84; 16.94±9.30 vs. 17.95±8.85; 21.92±4.60 vs. 22.11±5.34; 10.31±7.03 vs. 11.62±8.58). There were statistically significant differences between the 7 parameters before and after oral administration ( P<0.05). The difference of skin hydration between the testing and control group was statistically significant ( t=2.317, P=0.024). Although there was no statistical difference among the other six parameters, the improvement degree of the testing group was better than that of the control group. Surface spots, UV spots and brown spots of two groups showed no significant difference before and after treatment. Overall satisfaction of the testing group and the control group were 86.67% vs. 61.29% with significant difference 12 weeks after treatment ( χ2=5.074, P=0.024), while there were no significant differences in incidence of adverse reactions between two groups ( P>0.05). Conclusions:Oral administration of low-molecular-weight-collagen peptide can improve skin textures, moisturize skin with high overall satisfaction. It is an effective method of facial rejuvenation and better than that of collagen protein powder.