Background::Homoharringtonine (HHT) is an effective anti-inflammatory, anti-viral, and anti-tumor protein synthesis inhibitor that has been applied clinically. Here, we explored the therapeutic effects of HHT in a mouse heart transplant model.Methods::Healthy C57BL/6 mice were used to observe the toxicity of HHT in the liver, kidney, and hematology. A mouse heart transplantation model was constructed, and the potential mechanism of HHT prolonging allograft survival was evaluated using Kaplan–Meier analysis, immunostaining, and bulk RNA sequencing analysis. The HHT-T cell crosstalk was modeled ex vivo to further verify the molecular mechanism of HHT-induced regulatory T cells (Tregs) differentiation. Results::HHT inhibited the activation and proliferation of T cells and promoted their apoptosis ex vivo. Treatment of 0.5 mg/kg HHT for 10 days significantly prolonged the mean graft survival time of the allografts from 7 days to 48 days ( P <0.001) without non-immune toxicity. The allografts had long-term survival after continuous HHT treatment for 28 days. HHT significantly reduced lymphocyte infiltration in the graft, and interferon-γ-secreting CD4 + and CD8 + T cells in the spleen ( P <0.01). HHT significantly increased the number of peripheral Tregs (about 20%, P <0.001) and serum interleukin (IL)-10 levels. HHT downregulated the expression of T cell receptor (TCR) signaling pathway-related genes ( CD4, H2-Eb1, TRAT1, and CD74) and upregulated the expression of IL-10 and transforming growth factor (TGF) -β pathway-related genes and Treg signature genes ( CTLA4, Foxp3, CD74, and ICOS). HHT increased CD4 + Foxp3 + cells and Foxp3 expression ex vivo, and it enhanced the inhibitory function of inducible Tregs. Conclusions::HHT promotes Treg cell differentiation and enhances Treg suppressive function by attenuating the TCR signaling pathway and upregulating the expression of Treg signature genes and IL-10 levels, thereby promoting mouse heart allograft acceptance. These findings may have therapeutic implications for organ transplant recipients, particularly those with viral infections and malignancies, which require a more suitable anti-rejection medication.

Objective:To investigate the effects of different deoxyepinephrine administration methods on hypotension in patients undergoing thoracoscopic general anesthesia.Methods:A total of 120 patients undergoing thoracoscopic general anesthesia in Jinhua Municipal Central Hospital from January 2020 to January 2023 were included in this study. They were randomly divided into a control group and an observation group ( n = 60 patients per group). Patients in the control group were given deoxyepinephrine once, and patients in the observation group were continuously pumped with deoxyepinephrine. Other anesthesia methods in the two groups were the same. Hemodynamic indexes (systolic blood pressure, diastolic blood pressure, and heart rate), incidence of hypotension (during anesthesia induction and operation), anesthesia time, operation time, urine volume, blood loss, infusion volume, and dosage of deoxyepinephrine were recorded. Results:At the time at which the first systolic blood pressure decreased by > 20% of the baseline (T1) and 5 minutes after T1 (T2), the systolic blood pressures in the observation group were significantly higher than those in the control group [T1: (99.77 ± 11.42) mmHg vs. (95.34 ± 15.37) mmHg, t = 1.79, P = 0.038; T2: (120.49 ± 12.48) mmHg vs. (113.45 ± 16.03) mmHg, t = 2.68, P = 0.004; 1 mmHg = 0.133 kPa]. At T1 and T2, diastolic blood pressures in the observation group were significantly higher than those in the control group [T1: (62.60 ± 5.81) mmHg vs. (59.43 ± 6.35) mmHg, t = 2.85, P = 0.003; T2: (73.61 ± 7.01) mmHg vs. (70.20 ± 8.15) mmHg, t = 2.46, P = 0.008]. The incidences of hypotension during anesthesia induction and surgery in the observation group were 8.33% (5/60) and 15.00% (9/60), respectively, which were significantly lower than 26.67% (16/60) and 33.33% (20/60) in the control group ( χ2 = 6.98, P = 0.008; χ2 = 5.50, P = 0.019). There were no significant differences in anesthesia time ( t = 0.19, P = 0.425) and operative time ( t = 0.27, P = 0.396) between the two groups. There were no significant differences in urine volume ( t = 0.92, P = 0.179), blood loss ( t = 1.02, P = 0.155), and infusion volume ( t = 0.91, P = 0.182) between the two groups. There was no significant difference in the dosage of deoxyepinephrine between the two groups ( t = 1.11, P = 0.134). Conclusion:Continuous infusion of deoxyepinephrine in patients undergoing thoracoscopic general anesthesia yields superior efficacy than a single administration of deoxyepinephrine. The former can stabilize the hemodynamic indicators of patients during surgery and reduce the incidence of hypotension.

To understand the positive mental health status of medical students, improve their mental health level, and cultivate medical talents with sound personality and all-round development. Starting from the positive psychological health concept of healthy personality orientation, the Mental Health Scale with a Healthy Personality Orientation for College Students was used to conduct a random sampling survey on 600 medical students in a medical college. The results showed that the mental health score of medical students was (90.13±15.01), which was lower than that of national college students, and their difference was statistically significant (P=0.001). Medical students scored significantly lower than national college students in the three dimensions of happiness experience (P<0.001), interpersonal harmony (P=0.003), and goal pursuit (P=0.008). Moreover, there were group differences in the level and structure of mental health among medical students of different genders, grades, majors, and family origins (P<0.05). Universities should adopt targeted educational measures for different groups of medical students to guide them to cultivate positive psychological qualities and promote their physical and mental health development.

Body donation is the main source of human specimens preparation in medical universities and colleges. The low donation rate in China restricts the improvement of basic medical research and clinical treatment seriously. In the investigation, deep-rooted traditional concepts, unsound legal system, and inadequate government propaganda have become the major factors influencing body donation. Combined with the practice of body donation in the localities, this study puts forward some measures to promote the body donation, such as giving targeted publicity, promoting the concept of civilized funeral and burial, strengthening legislation, and simplifying the body donation process, which would lay the foundation for the development of medical education and research.

Long-term spaceflight affects numerous organ systems in the body, including metabolic dysfunction. Recently, ample evidence has demonstrated that the liver is a vulnerable organ during spaceflight. However, the changes in hepatocyte proliferation and cell cycle control under microgravity remain largely unexplored. In the present study, we first confirmed that the serum levels of aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase, biochemical markers of liver function, were altered in rats under tail suspension (TS) conditions to simulate microgravity, as shown in previous reports. Next, we demonstrated that the cell proliferation activity, determined by Ki67, PCNA and PH3, was significantly decreased at the different TS time points (TS for 14, 28 and 42 days) compared with that in the control group. Consistently, the positive cell cycle regulators Ccna2, Ccnd1, Cdk1, Cdk2 and cyclin D3 were also significantly decreased in the TS groups as shown by quantitative real-time PCR and western blotting analysis. Subsequent analysis revealed that the aberrant hepatocyte proliferation inhibition under simulated microgravity was associated with the upregulation of miR-223 in the liver. We further found that miR-223 inhibited the proliferation of Hepa1-6 cells and identified CDK2 and CUL1 as its direct targets. In addition, the decreased expression of CDK2 and CUL1 was negatively correlated with the level of p27 in vitro and in vivo, which may have been responsible for retarding hepatocyte proliferation. Collectively, these data indicate that upregulation of miR-223 was associated with the inhibition of liver cell growth and reveal the role of miR-223 in rat hepatocyte proliferation disorders and the pathophysiological process under simulated microgravity.
Alanine Transaminase ; Alkaline Phosphatase ; Animals ; Aspartate Aminotransferases ; Biomarkers ; Blotting, Western ; Cell Cycle ; Cell Cycle Checkpoints ; Cell Proliferation ; Cyclin D3 ; Hepatocytes* ; Hindlimb Suspension ; In Vitro Techniques ; Liver* ; Proliferating Cell Nuclear Antigen ; Rats* ; Real-Time Polymerase Chain Reaction ; Space Flight ; Up-Regulation* ; Weightlessness*

An QuEChERS-UPLC-MS/MS method was developed for the simultaneous determination of eight hydroxylated polybrominated diphenyl ethers( OH-PBDEs) in soil samples. After being mixed with 10 mL of water, the sample was extracted with acidified acetonitrile, cleaned up by C18 and primary secondary amine ( PSA ) . The separation of eight OH-PBDEs was performed on a C18 column using gradient elution of acetonitrile and water as mobile phase within 9 min. The OH-PBDEs were analyzed under the multiple-reaction monitoring ( MRM ) mode with negative electrospay ionization. Under the optimal conditions, the calibration curves were linear well in the range of 2-200 μg/L with correlation coefficients ranging from 0. 9936 to 0. 9990, and the limits of detection of eight OH-PBDEs were in the range of 0. 23-1. 21 ng/g. At the spiked levels of 5. 0 and 50 ng/g, the average spiked recoveries for eight OH-PBDEs were between 73. 2% and 117. 7%, with the relative standard derivations ( RSDs) from 5. 6% to 19. 7%. The developed method is simple and sensitive, and suitable for the rapid analysis of large quantities of samples.

Objective To discuss the medium-term follow-up of clinically insignificant residual fragments (CIRF) after minimally invasive percutaneous nephrolithotomy lithotripsy (MPCNL).Methods The clinical data of 72 patients with CIRF medium-term follow-up were analyzed retrospectively.Results Seventy-two patients with CIRF.The anatomical distribution of CIRF was 10 at upper pole,15 at middle,35 at lower,10 at renal ureteropelvie junction and 2 at upper and lower pole.Stone analysis showed that 41 cases of calcium oxalate calculi,16 of calcium oxalate calculi mixed with carbonate calculi,3 calcium oxalate calculi mixed with uric acid,4 calcium oxalate calculi mixed with struvite stone,3 struvite stone,2 uric acid stone and 3 carbonate apatite mixed with struvite stone.Fifteen cases had clinical symptoms,including 2 renal colic pain,8 hematuria,5 lower urinary tract symptoms,4 cases CIRF located in upper pole,1 case in middle pole,4 cases in lower pole,6 cases in ureteropelvic junction,the incidence of clinical symptoms in ureteropelvic junction was significantly higher than that in other locations (6/10 vs.4/12,1/15,4/37,P ＜0.05).Eight cases required surgical procedure,5 cases underwent extracorporeal shock wave lithotripsy,3 cases with ureteral CIRF were performed with ureteroscopic lithotripsy.CIRF were clear after surgery,7 patients with ureteral CIRF had renal colic pains.The stones were excluded after spasmolytic analgesic treatments.Conclusions CIRF can be located variously in the kidney and ureter.Most CIRF are calcium oxalate calculi and locate in the lower pole.Patients with the history of previous open surgery or extracorporeal shock wave lithotripsy are more likely to get CIRF.Medium-term follow-up of CIRF reveals that CIRF located in the renal ureteropelvis junction are more likely to have clinical symptoms.

Objective To evaluate the clinical effects and safety of percutaneous nephrolithotomy (PCNL) by middle renal calice used as the main target for the treatment of staghorn stones with the combination of pneumatic and ultrasonic lithotrite.Methods Clinical data of 73 patients underwent PCNL by middle renal calices as main access with 57 incomplete staghorn stones and 35 complete staghorn stones.To observe the situation calculus removal rate and complications.Results Seventy cases (88 sides) underwent one session PCNL by single access tract (middle caliees),3 cases (4 sides) underwent one session PCNL by double access tracts (2 cases by middle and low calices,1 case by up and middle caliees).After the first period of lithoclasty,17 patients (25 sides) residual stones and the stone removal rate 72.8％ (67/92),among these patients,1 case (1 side) had fragments of lateral renal calyeeal stones with no further treatment.Other 16 cases (24 sides)underwent second session PCNL,all were treated by single access tract (middle calices) and 2 cases (2 sides)had extracorporeal shock wave lithotripsy before the second PCNL.After the second period of lithoclasty,76 sides composed of 27 complete staghorn stones and 49 incomplete staghorn stones had no residual fragments with the stone removal rate 82.6％ (76/92).The operative time lasted 120-320 min.Hemoglobin dropped 1-4 g/L,11 cases in the operation procedure and 3 cases after operation needed blood transfusion respectively.One case of renal pelvic infection after operation and 1 case had split renal dysfunction with peri-parenchyma infection.The hospitalization time was 9-18 days.Conclusion It is effective and safe to perform PCNL for staghorn stone by middle calices as a main access.Combining pneumatic and ultrasonic lithotrite will be very useful with high stone clearance,short procedure time and less complications.

Objective To compare the outcomes of antegrade and retrograde approach ureteroscopy for impacted upper ureteric calculi and assess the safety and efficiency of the two types of minimally invasive technique. Methods A total of 106 patients with impacted upper ureteric calculi were treated with ureteroscopy. The procedure was performed via antegrade percutaneous nephrostomy tract in 50 patients (antegrade group) and via retrograde transurethral access in 56 patients (retrograde group). Results The success rate of retrograde group was 92.9% (52/56). Operating time was (45 ± 5 ) min, hospital stay was (6 ± 1) days. The stone free rate was 80.4%(45/56) at 1 month follow-up,7 patients with residual calculi required ESWL combination. Complication rate was 5.4% (3/56). The success rate of antegrade group was 100.0% (50/50). Operating time was (55 ± 8 ) min, hospital stay was (8 ± 2) days. The stone free rate was 100.0% (50/50) and no complication was noted. The stone free rate and the complication rate indicated significant difference between the two groups (P ＜ 0.05). Conclusions Antegrade and retrograde access ureteroscopy for impacted upper ureteric calculi are safe and effective. Success rate and stone free rate of antegrade approach are higher than those of retrograde approach.

Recently the maintenance therapy of non-small-cell lung cancer (NSCLC) patients who completed required treatment cycles has caused widespread interests in the medical field. Traditional Chinese medicine may be a useful complement in maintenance treatment of mid-to-late stage NSCLC.