OBJECTIVE To establish the high-performance liquid chromatography （HPLC） fingerprint of Sagina japonica ， and to establish a quantitative analysis of multi-components by single-marker （QAMS） method for simultaneous determination of six componen ts in S. japonica ， aiming to provide references for the quality control of this medicinal herb. METHODS HPLC method was used to establish the fingerprints of 12 batches （No. S1-S12） of S . japonica according to Similarity Evaluation System of Chromatographic Fingerprint of Traditional Chinese Medicine . The similarity evaluation and identification of common peaks were conducted， followed by cluster analysis （CA） and principal component analysis （PCA） for 12 batches of samples. Using vicenin-2 as internal reference， the contents of p-hydroxy cinnamic acid， apigenin-6-C-arabinoside-8-C-glucoside， isoorientin， vitexin and 20-hydroxyecdysone were determined by QAMS method. The results were then compared with those obtained by the external standard method. RESULTS The similarities of HPLC fingerprints for 12 batches of S . japonica ranged from 0.828-0.998. A total of 17 common peaks were calibrated， and 6 common peaks were identified. Specifically， peak 5 was identified as vicenin-2， peak 7 as p-hydroxycinnamic acid， peak 10 as apigenin-6-C-arabinoside-8-C-glucoside， peak 11 as isoorientin， peak 13 as vitexin， and peak 15 as 20-hydroxyecdysone. The results of CA showed that S1-S5， S7 and S9-S11 were clustered into one category， S6 was clustered into one category， and S8 and S12 were clustered into one category. The results of PCA revealed that the accumulative contribution rate of the four main components was 89.430%. The content ranges measured by QAMS method for p-hydroxy cinnamic acid， apigenin-6-C-arabinoside-8-C-glucoside， isoorientin， vitexin and 20-hydroxyecdysone were 0.017 4-0.269 4， 0.568 8-4.240 3， 0.503 2-5.040 3， 0.024 0-0.132 0 and 2.551 3-4.881 1 mg/g， respectively. There was no significant difference in the contents of components measured between QAMS method and the external standard method （ P ＞0.05）. CONCLUSIONS The established HPLC fingerprint and QAMS method can be used for quality evaluation and quality control of S . japonica.

Objective To analyze the characteristics of viral hepatitis mortality and life loss among residents in Pudong New Area from 2003 to 2023, and to provide a basis for related prevention and control work. Methods Viral hepatitis mortality data were obtained from the Pudong New Area mortality monitoring system. The crude mortality rate (CMR), standardized mortality rate (SMR), potential years of life lost (PYLL), average years of life lost (AYLL), and standardized potential years of life lost (SPYLL) were calculated to analyze viral hepatitis deaths. The average annual change (AAPC) and annual percentage change (APC) of the mortality rate were calculated by Joinpoint regression analysis to analyze the trend of mortality. Results The CMR and SMR of viral hepatitis among residents in Pudong New Area from 2003 to 2023 were 3.89/100000 and 1.98/100000, respectively. Both CMR and SMR of viral hepatitis showed a decreasing trend over time (CMR:APC=-5.476, t=-13.581, P<0.001; SMR:APC=- 7.624, t= -21.253, P<0.001). The CMR for males was 4.75/100000 and the SMR for males was 2.65/100000; the CMR for females was 3.04/100000 and the SMR for females was 1.32/100000, with a higher mortality rate for males than for females（Z_CME=12.094，P<0.001; Z_SMR=-14.718，P<0.001). Deaths were concentrated in the age groups of 45-64 years old and 65 years old and above, accounting for 91.62% of the total deaths. The PYLL of deaths due to viral hepatitis among residents in Pudong New Area from 2003 to 2023 was 26912 person-years, with a PYLLR of 0.45% and an AYLL of 8.88 years per person. Conclusion The mortality rate of viral hepatitis among the residents of Pudong New Area in 2003-2023 shows a decreasing trend over time. The mortality rate of males is higher than that of females, and the deaths of middle-aged and elderly people account for a large proportion of the total deaths. Chronic hepatitis B is the main cause of death.

Objective:To analyze and predict the epidemiological characteristics of hepatitis B mortality status among Chinese residents from 2006 to 2021 and 2022 to 2027, so as to provide a reference for hepatitis B prevention and control.Methods:The dataset of hepatitis B death cases from 2006 to 2021 published by the Chinese Center for Disease Control and Prevention was collected. The age was standardized using the population structure in 2000 as the standard population. The crude mortality rate (CMR) and age-standardized mortality rate (ASMR) were calculated for hepatitis B. The epidemiological distribution characteristics of hepatitis B deaths in terms of region, gender, age, and time were analyzed. The Joinpoint regression analysis model was used to analyze the changing trend. The gray model was used to predict the CMR and ASMR of hepatitis B from 2022 to 2027.Results:A total of 77 722 cases died of hepatitis B from 2006 to 2021, with an average CMR and ASMR of 2.69/100 000 and 2.00/100 000, respectively. The ASMR of male and female showed an overall downward trend, with an average annual percentage change (AAPC) of -5.4 (95% CI: -8.1 to -2.7, P<0.001) and -5.7 (95% CI: -8.4 to -3.0, P<0.001), respectively. The ASMR of urban and rural areas showed an overall downward trend, with an AAPC of -5.0 (95% CI: -7.7 to -2.2, P=0.001) and -5.7 (95% CI: -9.0 to -2.4, P=0.001), respectively. The average ASMR of hepatitis B from 2006 to 2021 in western, central, and eastern China was 2.86/100,000, 2.05/100,000 and 1.42/100,000, respectively, and the overall trend was downward. The gray model prediction results showed that the CMR of hepatitis B from 2022 to 2027 among Chinese residents was 2.36/100 000, 2.29/100 000, 2.22/100 000, 2.16/100 000, 2.10/100 000 and 2.03/100 000, respectively, while the ASMR was 1.37/100 000, 1.30/100 000, 1.23/100 000, 1.16/100 000, 1.10/100 000 and 1.04/100 000, respectively. Conclusions:The CMR and ASMR of hepatitis B have a declining trend year by year among Chinese residents, and further progress has been made in the prevention and treatment. The key focus and emphasis of future work should be to strengthen the screening and prevention of hepatitis B in rural areas, western regions, male demographics, targeted preventive and control measure formulations, and the lowering of mortality rates.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Bone grafting is a primary method for treating bone defects. Among various graft materials, xenogeneic bone substitutes are widely used in clinical practice due to their abundant sources, convenient processing and storage, and avoidance of secondary surgeries. With the advancement of domestic production and the limitations of imported products, an increasing number of bone filling or grafting substitute materials isentering clinical trials. Relevant experts have drafted this consensus to enhance the management of medical device clinical trials, protect the rights of participants, and ensure the scientific and effective execution of trials. It summarizes clinical experience in aspects, such as design principles, participant inclusion/exclusion criteria, observation periods, efficacy evaluation metrics, safety assessment indicators, and quality control, to provide guidance for professionals in the field.
Humans ; Bone Substitutes/therapeutic use* ; Randomized Controlled Trials as Topic/methods* ; Consensus ; Bone Transplantation ; Research Design

Extended reality(XR)technology includes virtual reality(VR),augmented reality(AR)and mixed reality(MR)Combining virtual environments with physical world,the extended reality(XR)technology has great potential in rehabilitation of patients with stroke.This article reviews the intervention effects of XR technology on the functions of limb,swallowing,speech and cognition and psychological outcomes in patients with stroke.Based on this review,issues in application of XR are identified and targeted solutions are proposed,thereby offering a guidance for application of XR technology in stroke rehabilitation in China.

Objective:To explore the direct effect of perceived social support on self-advocacy and the mediating effect of active coping strategies in breast cancer patients.Methods:A convenience sampling method was used to select 240 breast cancer patients hospitalized at Qilu Hospital of Shandong University from April 2023 to April 2024. General information questionnaire, the Female Self-Advocacy Scale in Cancer Survivorship (FSACS), the Simplified Ways of Coping Questionnaire (SWCQ), and the Perceived Social Support Scale (PSSS) were used to collect the data.Results:The effective response rate for the questionnaires was 93.75% (225/240). The total score for FSACS in 225 breast cancer patients was (75.36±9.88), the active coping score for SWCQ was (21.68±6.07), and the total score for PSSS was (55.63±8.04). The mediating effect analysis revealed that perceived social support had a direct positive predictive effect on self-advocacy ( β=0.420, P<0.01). Active coping played a mediating role in the relationship between perceived social support and self-advocacy, with a mediating effect value of 0.210, a 95% confidence interval of 0.112 to 0.318, and the mediating effect accounting for 33.33% of the total effect. Conclusions:Perceived social support not only positively affects the self-advocacy level of breast cancer patients but also indirectly influences it through the mediating role of active coping. Medical staff should emphasize improving perceived social support levels and encourage patients to adopt active coping strategies to enhance their self-advocacy.

Objective:To analyze and predict the epidemiological characteristics of hepatitis B mortality status among Chinese residents from 2006 to 2021 and 2022 to 2027, so as to provide a reference for hepatitis B prevention and control.Methods:The dataset of hepatitis B death cases from 2006 to 2021 published by the Chinese Center for Disease Control and Prevention was collected. The age was standardized using the population structure in 2000 as the standard population. The crude mortality rate (CMR) and age-standardized mortality rate (ASMR) were calculated for hepatitis B. The epidemiological distribution characteristics of hepatitis B deaths in terms of region, gender, age, and time were analyzed. The Joinpoint regression analysis model was used to analyze the changing trend. The gray model was used to predict the CMR and ASMR of hepatitis B from 2022 to 2027.Results:A total of 77 722 cases died of hepatitis B from 2006 to 2021, with an average CMR and ASMR of 2.69/100 000 and 2.00/100 000, respectively. The ASMR of male and female showed an overall downward trend, with an average annual percentage change (AAPC) of -5.4 (95% CI: -8.1 to -2.7, P<0.001) and -5.7 (95% CI: -8.4 to -3.0, P<0.001), respectively. The ASMR of urban and rural areas showed an overall downward trend, with an AAPC of -5.0 (95% CI: -7.7 to -2.2, P=0.001) and -5.7 (95% CI: -9.0 to -2.4, P=0.001), respectively. The average ASMR of hepatitis B from 2006 to 2021 in western, central, and eastern China was 2.86/100,000, 2.05/100,000 and 1.42/100,000, respectively, and the overall trend was downward. The gray model prediction results showed that the CMR of hepatitis B from 2022 to 2027 among Chinese residents was 2.36/100 000, 2.29/100 000, 2.22/100 000, 2.16/100 000, 2.10/100 000 and 2.03/100 000, respectively, while the ASMR was 1.37/100 000, 1.30/100 000, 1.23/100 000, 1.16/100 000, 1.10/100 000 and 1.04/100 000, respectively. Conclusions:The CMR and ASMR of hepatitis B have a declining trend year by year among Chinese residents, and further progress has been made in the prevention and treatment. The key focus and emphasis of future work should be to strengthen the screening and prevention of hepatitis B in rural areas, western regions, male demographics, targeted preventive and control measure formulations, and the lowering of mortality rates.

[Purpose]To analyze the trends in pancreatic cancer mortality and disease burden among residents in Shanghai Pudong New Area from 2002 to 2022,and to investigate the effects of age,period,and birth cohort on mortality risk.[Methods]Data on pancreatic cancer deaths among residents of Pudong New Area from 2002 to 2022 were collected through the Shanghai Population Cause of Death Registration System.The crude mortality rate,age-standardized mortality rate by Chinese standard population(ASMRC),potential years of life lost(PYLL),potential years of life lost rate(PYLLR),and average years of life lost(AYLL)were calculated.Joinpoint regression was applied to calculate the average annual percentage change(AAPC)for analyzing the changing trend of the mortality rate of pancreatic cancer.The age-period-cohort model was applied with R 4.4.1 to analyze the age,period,and cohort effects on the mortality risk of pancreatic cancer.[Results]The crude mortality rate of pancreatic cancer among residents in Pudong New Area increased from 10.42/105 in 2002 to 18.73/105 in 2022,showing a significant upward trend(AAPC=2.90％,P＜0.001);the ASMRC was generally stable(AAPC=-0.05％,P=0.775).The crude mortality rate of males(17.09/105)was higher than that of females(13.75/105),and both showed an upward trend(AAPC=3.05％and 2.75％respectively,both P＜0.001).After the age of 40,the mortality rate of pancreatic cancer increased significantly with the growth of age in both sexes.The PYLL was 31 347 person-years,showing an upward trend(AAPC=1.83％,P＜0.001),and the AYLL was 3.59 years,showing a downward trend(AAPC=-2.45％,P＜0.001).The age effect showed that the mortality risk of pan-creatic cancer was increased with age;the period effect showed that the mortality risk decreased from 2002 to 2016 and then increased;the cohort effect showed that the mortality risk increased with the advancement of the birth cohort.[Conclusion]From 2002 to 2022,the crude mortality rate of pancreatic cancer in Pudong New Area showed an upward trend,and the mortality rate of males was higher than that of females.The mortality risk of pancreatic cancer increases with age,and the later the birth year of the residents,the higher the mortality risk.Early screening should be strengthened for men and the elderly,environmental and lifestyle risk factors should be paid attention to in combination with the characteristics of cohort effect,and the prevention and control strategy for the whole population should be optimized.

Objective:To analyze the risk factors for human cytomegalovirus (HCMV) infection in pediatric recipients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:Clinical data of children who underwent first allo-HSCT were retrospectively analyzed from March 2017 to November 2024. A total of 259 pediatric allo-HSCT recipients were analyzed through comparing HCMV infection group (n=115) and Non-HCMV infection group (n=144). Clinical characteristics were compared, and risk factors for HCMV infection were analyzed using univariate and multivariate logistic regression.Results:The result of univariate analysis showed that adrenoleukodystrophy (ALD), length of hospitalization, duration of antiviral therapy, and bacterial infection were significantly associated with HCMV infection in pediatric allo-HSCT recipients ( P<0.05). The result of multivariate analysis showed that ALD was an independent protective factor against HCMV infection of allo-HSCT recipients ( P<0.05) [OR=0.22, 95% CI: 0.06-0.86], while umbilical cord blood transplantation (UCBT) was an independent risk factor for HCMV infection in allo-HSCT recipients ( P<0.05) [OR=6.13, 95% CI: 1.34-28.04]. When the area under the ROC curve (AUC) for predicting post-transplant relapse based on HCMV viral load was 0.75 (95% CI: 0.55-0.94, P=0.014) and at the cutoff value of 3×10 3 copies/ml, the sensitivity and specificity for predicting relapse were 81.13% and 66.67%, respectively. Conclusions:HCMV infection in pediatric allo-HSCT recipients may lead to longer hospitalization and increased risk of relapse.