by Jie Li, Jian Zhang, Jun Ke, Zhijian Ren, Cuncheng Feng
The treatment of colorectal cancer (CRC) remains challenging due to chemotherapy resistance and genetic heterogeneity. Indole-3-lactic acid (ILA), a tryptophan metabolite derived from gut microbiota, exhibits promising anti-inflammatory and anticancer properties; however, its specific molecular targets and regulatory mechanisms in CRC remain poorly understood. In this study, we combined network pharmacology and machine learning with molecular docking to identify candidate targets and pathways for ILA in CRC. We identified 39 ILA-CRC common targets, ultimately identifying four hub genes through the intersection of machine learning models. Validation in independent GEO datasets confirmed significant differential expression of these genes in CRC tissues. Functional enrichment analyses linked these genes to the PPAR, PI3K-AKT, and IL-17 signaling pathways, and gene set enrichment analysis further implicated ascorbate and aldarate metabolism, DNA replication, and fatty acid metabolism. Immune infiltration analysis indicated associations between hub gene expression and immune cell populations, including mast cells, neutrophils, and macrophages, suggesting potential involvement in the tumor immune microenvironment. Molecular docking supported favorable binding of ILA to all four hub proteins, and 100-ns molecular dynamics simulations specifically validated the dynamic stability of the ILA-HMOX1 complex. In conclusion, these results highlight EPHA2, HMOX1, MMP3, and PARP1 as candidate targets and suggest that ILA may influence CRC-related signaling, metabolic programs, and immune contexture, providing a theoretical foundation for developing gut microbiota-derived metabolites as novel anticancer strategies.This study investigated the efficacy and safety of a novel thermo-reversible antimicrobial wound gel (TRG, revyve Antimicrobial Wound Gel) designed to combat biofilm-related infections in wounds. The TRG was evaluated for its ability to disrupt biofilms, sustain antimicrobial activity and promote wound healing. The gel exhibited thermo-reversible properties, transitioning from a less viscous liquid ≤ 18°C to a highly viscous solid gel at wound temperature which would facilitate easy application and removal. Antimicrobial testing demonstrated that TRG effectively inactivated a broad range of wound-related pathogens, including Staphylococcus aureus and Pseudomonas aeruginosa, with a 99.99%–99.9999% reduction in bacterial counts within 30 min. The TRG also maintained its antimicrobial efficacy after multiple inoculations with high microbial load (107 CFU/mL) over 7 days. In vitro biofilm assays showed effectiveness against biofilm bacteria with a reduction of ≥ 99.99% bacterial counts with one application over the course of 7 days. Biocompatibility testing confirmed that TRG was safe, with no signs of tissue necrosis or signs of tissue damage and no impact on wound healing in a porcine wound model. TRG's ability to reduce both planktonic and biofilm-based bacteria without compromising wound healing makes it a promising candidate for treating both chronic and acute wounds.
by Xinrui Zhao, Jie Li, Nan Hu, Xiaoming Wu, Junbo Duan
Amino acid metabolism plays a critical role in tumor growth and immune regulation, yet its comprehensive function in breast cancer remains underexplored. We developed an amino acid metabolism–related gene signature (AAMRGS) to predict prognosis and therapeutic response in breast cancer. The AAMRGS was constructed using a machine-learning framework integrating ten algorithms and validated across multiple independent cohorts. It served as an independent prognostic factor and outperformed existing amino acid metabolism–related signatures and clinical variables. Moreover, the prognostic utility of AAMRGS was further validated across pan-cancer datasets, and an AAMRGS-based nomogram was constructed to facilitate clinical application. Functional enrichment and protein–protein interaction analyses revealed that AAMRGS genes were primarily involved in metabolic reprogramming and cell proliferation. Experimental validation confirmed the downregulation of key genes such as SAV1 and IGF2R in breast cancer cells. Integrative analyses revealed that the high-AAMRGS subgroup exhibited a greater copy number variation burden, higher tumor mutation burden (TMB), enrichment of immunosuppressive cell populations, and increased sensitivity to most chemotherapeutic drugs. In contrast, the low-AAMRGS subgroup displayed higher immune scores, stronger immune activation, enrichment of anti-tumor immune cells, and greater responsiveness to immunotherapy. Collectively, our findings establish AAMRGS as a reliable prognostic signature and a potential tool to guide individualized therapeutic strategies for breast cancer patients.Determine the positive psychological experience of patients with chronic heart failure through a systematic literature review and to provide a reliable basis for their psychological care.
Qualitative meta-synthesis.
A qualitative meta-synthesis was conducted to extract and analyse qualitative research from PubMed, Web of Science, Embase, Cochrane, CINAHL, PsycINFO and Chinese Database, including China National Knowledge Internet, Wanfang Database, China Biology Medicine Disc and VIP database from the inception of the database to 24 March 2024.
Two researchers screened, extracted and cross-checked data. Disputes resolved via discussion or 3rd researcher. Irrelevant titles/abstracts were excluded; full-texts were reviewed for final inclusion.
A total of 17 qualitative studies yielded 58 results, categorised into 10 groups and synthesised into three themes: positive attitudes and emotional responses, positive changes after the disease diagnosis and supportive factors for positive psychology.
Heart failure patients can experience positive psychology post-illness. Care providers should prioritise psychological assessment and support factors to meet needs, foster rehabilitation and improved quality of life.
CHF patients crucially contributed to this qualitative meta-synthesis by sharing insights into their positive psychological experiences, resilience and coping strategies.
To synthesise evidence on the self-perceived consequences of workplace violence (WPV) among male nurses in hospital care settings.
Mixed-methods systematic review (PROSPERO: CRD420251041864).
Systematic searches were performed in PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, and China Biomedical Database. Quantitative, qualitative, and mixed-methods studies on registered male nurses were included. Methodological quality was assessed using the Mixed Methods Assessment Tool 2018. Data synthesis followed the Joanna Briggs Institute convergent integrated approach.
Six databases were searched from their inception to April 30, 2025.
Twenty six studies (18 quantitative, 6 qualitative, and 2 mixed-methods) from 12 countries (n = 2354 male nurses; 7 in psychiatric departments, 4 in emergency departments, 2 in psychiatric hospitals, 1 in an ICU, 1 in an operating room, and 11 unspecified department studies in hospital nursing settings) were included. Six themes emerged: (1) Physical health damage; (2) Mental health trauma; (3) Impediments to Career Advancement; (4) Deterioration of working environment and social relations; (5) Impaired Quality of Patient Care; and (6) Deficiencies in Violence Coping Mechanisms and Potential Risks.
WPV inflicts multidimensional harm on male nurses, spanning their health, career, social well-being, and care quality, compounded by systemic underreporting.
Urgent interventions are needed, including gender-sensitive training, improved reporting systems, mental health support, and safe workplaces. Addressing WPV is vital for nurse retention and patient safety.
This review highlights under-studied WPV toward male nurses, revealing profound personal and professional impacts. It informs healthcare policymakers, administrators, and clinicians, urging gender-inclusive prevention strategies to protect nurses and enhance global care quality.
This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.
No patient or public contribution was involved in this systematic review.
To explore the possible barriers and facilitators to implementing the Upright Positions in the Second Stage of Labour (UPSSL) programme in Chinese healthcare settings.
A mixed-method convergent design with the guidance of Consolidated Framework for Implementation Research (CFIR).
An online survey study and semi-structured interviews were conducted between March and May 2023. Healthcare professionals were recruited from four hospitals in Shijiazhuang, China. One hundred and thirty-one participants completed the survey study, and 23 of them were interviewed individually. Descriptive statistics evaluated the possible barriers and facilitators of implementing the UPSSL programme within the CFIR framework quantitatively. Guided by the CFIR framework, qualitative data were analysed using directed content analysis to summarize healthcare professionals' perspectives on barriers and facilitators of the UPSSL programme.
Multiple intersectional barriers and facilitators were identified from the survey and semi-interviews. Healthcare professionals believed that the UPSSL programme has a scientific evidence base, systematic contents, and possible benefits for women. However, various barriers existed at individual, system, and organizational levels. Major barriers included healthcare professionals and women's safety concerns towards the use of upright positions during childbirth, the healthcare professionals' unfamiliarity with assisting an upright position birth, poor adaptability of the programme protocol, inadequate facilities and staffing, and a lack of readiness to change in the clinical setting.
To facilitate the implementation of the UPSSL programme in China, tailored antenatal education on upright positions, especially addressing safety-related issues, should be provided to pregnant women, their families, or peers to enhance their understanding of and familiarity with such positions. Healthcare professionals should also be offered adequate training opportunities and necessary facilities. Furthermore, national-level policy changes might be required to address midwifery workforce shortages. Additionally, further research is warranted to select, adapt, and test effective implementation strategies for programme adoption.
What problem did the study address? The adoption of upright positions during the second stage of labour could promote better maternal and neonatal outcomes and a positive childbirth experience. However, the adoption of upright positions during the second stage of labour is suboptimal in healthcare settings in China. Barriers and facilitators of implementing upright positions during childbirth are unclear. What were the main findings? A range of barriers and facilitators within the CFIR framework to promote upright positions during childbirth from healthcare professionals' perspectives were identified, and the major barriers included safety concerns towards and unfamiliarity with an upright position birth, inadequate facilities and staffing, and a lack of readiness to change in the clinical setting. Where and on whom will the research have an impact? This study will enable a better understanding of the barriers and facilitators to promoting upright positions in the second stage of labour in China. The smooth and effective implementation of the UPSSL programme could help to promote better maternal and neonatal outcomes and improve women's childbirth experiences.
The reporting of this study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) and Good Reporting of A Mixed Methods Study (GRAMMS) guidelines.
In this study, healthcare professionals were involved in refining the topic guides and survey questions. Additionally, findings from the interviews were returned to them for comments and corrections.
Chronic heart failure (CHF) is a progressive life-limiting condition that necessitates early implementation of advance care planning (ACP). However, patients and caregivers encounter emotional, informational, and cultural barriers to effective ACP engagement. This meta-synthesis consolidates qualitative evidence to deepen our understanding of ACP practices in CHF care.
This study aimed to explore experiences of CHF patients and their caregivers in ACP, which is defined as a proactive decision-making process to establish future treatment plans based on patients' values. The study also aimed to identify barriers and facilitators influencing ACP decisions and assess the impact of flexible, personalized ACP approaches on care quality.
Using qualitative meta-synthesis, we analyzed 10 qualitative studies on CHF patients' and caregivers' ACP experiences. Data were thematically synthesized to identify emotional, relational, and practical factors that influence engagement in ACP.
Three themes emerged: (1) heart failure patients and caregivers face difficulties in ACP (difficulties from patients, difficulties from the family, and difficulties from the society), (2) multidimensional drivers and impacts of ACP (advance care planning drivers, acceptance and implementation of ACP, emotions and effects of ACP), (3) flexible, personalized ACP delivers tangible benefits (timing and effectiveness of ACP discussions, patients and caregivers have personalized needs for ACP, and patients and caregivers affirm ACP benefits).
ACP plays a critical role in improving end-of-life care quality and reducing emotional and decision-making burdens on caregivers. Flexible and personalized ACP strategies supported by trained healthcare professionals more effectively meet the unique needs of patients and families. To overcome persistent barriers and promote broader ACP adoption, healthcare systems should prioritize provider communication training, ACP education, and support systems tailored to diverse cultural contexts.