Objective To understand and evaluate the overall status of nucleic acid detection efficacy for influenza A virus in the na-tionwide clinical laboratories of China,and discover and identify the potential issues to further improve the detection quality.Methods During 2024,the National Center for Clinical Laboratories distributed five samples to nationwide 1 367 participating laboratories.The detection efficacy of each participating laboratory was evaluated by calculating the overall percent agreement(OPA)of the test results using different detection reagents.Results The results of OPA,positive percent agreement(PPA)and negative percent agreement(NPA)of the five samples were 99.87％(6 826/6 835),99.89％(5 462/5 468),and 99.78％(1 364/1 367),respectively.No statistical difference of PPAs was observed between the H3N2 samples with different concentrations,between H1N1(2009)and H3N2 samples with equivalent concentration(1.0×104 copies/mL),and between seasonal H1N1 and H3N2 samples with equivalent concen-tration(1.0×105 copies/mL)(P＞0.05).Conclusion The results indicated the clinical laboratories in China exhibited robust efficacy in the molecular detection for two prevalent influenza A virus subtypes,i.e.,H1N1(2009)and H3N2.However,false-negative and false-positive results were encountered in a few laboratories.

Objective:To explore the protective effect of knock-down the expression of B lymphocyte induced maturation protein 1(Blimp1)gene on early liver injury in carbon tetrachloride(CCl4)-induced mouse model of liver fibrosis.Methods:C57BL/6 mice were intraderitoneal injected with 5％CCl4 olive oil solution to create mouse model of hepatic fibrosis.The expression of Blimp1 gene in the mice was re-duced by intraderitoneal injection of short hairpin RNA(shRNA)adeno-associated virus(AAV).The mice were randomly divided into 3 groups:blank test group(n=10),CCl4+AAV-shRNA-NC group(n=10)and CCl4+AAV-shRNA-Blimp1 group(n=10).After 27 days of preparation of the CCl4 mouse model,animal materials were carried out.Western blot and real-time PCR were used to detect the levels of Blimp1,α-smooth muscle actin(α-SMA),collagen type Ⅰ alpha 1(COL1A1),collagen typeⅢ alpha 1(COL3A1),and their mRNA expression levels of liver tissue in each group.The serum of each group was separated to measure aspartate transaminase(AST)and alanine transaminase(ALT)by automatic biochemical analyzer.The pathological changes of liver tissue and the degree of liver fibrosis in the mice were detected by pathological staining including hematoxylin-eosin staining,Masson,and Sirius red.Results:The expression levels of Blimp1 protein in the liver of CCl4+AAV-shRNA-NC group(2.036±0.244,t=3.690,P=0.002)were significantly increased than that of the blank test group.In the CCl4+AAV-shRNA-Blimp1 group,the expression of Blimp1 protein decreased to the basal level(0.783±0.249,t=6.223,P=0.003).Compared with the serum levels of ALT[(1 957.8±633.6)U/L]and AST[(1 808.8±260.1)U/L]in the CCl4+AAV-shRNA-NC group,the serum levels of ALT[(894.0±360.1)U/L,t=3.998,P=0.003]and AST[(820.0±100.6)U/L,t=6.141,P=0.004]in the CCl4+AAV-shRNA-Blimp1 group were significantly decreased.The pathological re-sults of the CCl4+AAV-shRNA-Blimp1 group showed that compared with the CCl4+AAV-shRNA-NC group,the infiltration of inflammatory cells in the liver tissue was reduced and the degree of fibrosis was alleviated.The level of α-SMA(0.676±0.064,t=7.930,P=0.001),COL1A1(1.426±0.143,t=6.364,P=0.003)and COL3A1(1.124±0.198,t=3.440,P=0.026)of liver in the CCl4+AAV-shRNA-Blimp1 group were significantly decreased than that of CCl4+AAV-shRNA-NC group,and the mRNA expression levels were altered as well as their protein levels.Conclusion:Blimp1 plays an important role in CCl4-induced liver fibrosis in mice,and knock-down the expression of Blimp1 gene is beneficial to protect early liver injury in mice.

Objective:To explore the protective effect of knock-down the expression of B lymphocyte induced maturation protein 1(Blimp1)gene on early liver injury in carbon tetrachloride(CCl4)-induced mouse model of liver fibrosis.Methods:C57BL/6 mice were intraderitoneal injected with 5％CCl4 olive oil solution to create mouse model of hepatic fibrosis.The expression of Blimp1 gene in the mice was re-duced by intraderitoneal injection of short hairpin RNA(shRNA)adeno-associated virus(AAV).The mice were randomly divided into 3 groups:blank test group(n=10),CCl4+AAV-shRNA-NC group(n=10)and CCl4+AAV-shRNA-Blimp1 group(n=10).After 27 days of preparation of the CCl4 mouse model,animal materials were carried out.Western blot and real-time PCR were used to detect the levels of Blimp1,α-smooth muscle actin(α-SMA),collagen type Ⅰ alpha 1(COL1A1),collagen typeⅢ alpha 1(COL3A1),and their mRNA expression levels of liver tissue in each group.The serum of each group was separated to measure aspartate transaminase(AST)and alanine transaminase(ALT)by automatic biochemical analyzer.The pathological changes of liver tissue and the degree of liver fibrosis in the mice were detected by pathological staining including hematoxylin-eosin staining,Masson,and Sirius red.Results:The expression levels of Blimp1 protein in the liver of CCl4+AAV-shRNA-NC group(2.036±0.244,t=3.690,P=0.002)were significantly increased than that of the blank test group.In the CCl4+AAV-shRNA-Blimp1 group,the expression of Blimp1 protein decreased to the basal level(0.783±0.249,t=6.223,P=0.003).Compared with the serum levels of ALT[(1 957.8±633.6)U/L]and AST[(1 808.8±260.1)U/L]in the CCl4+AAV-shRNA-NC group,the serum levels of ALT[(894.0±360.1)U/L,t=3.998,P=0.003]and AST[(820.0±100.6)U/L,t=6.141,P=0.004]in the CCl4+AAV-shRNA-Blimp1 group were significantly decreased.The pathological re-sults of the CCl4+AAV-shRNA-Blimp1 group showed that compared with the CCl4+AAV-shRNA-NC group,the infiltration of inflammatory cells in the liver tissue was reduced and the degree of fibrosis was alleviated.The level of α-SMA(0.676±0.064,t=7.930,P=0.001),COL1A1(1.426±0.143,t=6.364,P=0.003)and COL3A1(1.124±0.198,t=3.440,P=0.026)of liver in the CCl4+AAV-shRNA-Blimp1 group were significantly decreased than that of CCl4+AAV-shRNA-NC group,and the mRNA expression levels were altered as well as their protein levels.Conclusion:Blimp1 plays an important role in CCl4-induced liver fibrosis in mice,and knock-down the expression of Blimp1 gene is beneficial to protect early liver injury in mice.

Objective:To construct a symptom network for type 2 diabetes mellitus (T2DM) patients, identify bridging symptoms and core symptoms, and explore influencing factors, providing references for precise and efficient symptom management.Methods:A convenience sampling method was used to select 340 T2DM patients hospitalized in the Endocrinology Department of Affiliated Hospital of North Sichuan Medical College from December 2023 to February 2024. A general information survey and the Chinese version of Diabetes Symptom Checklist-Revised were used to collect data. Multiple linear regression analysis was performed to explore the influencing factors of T2DM patients' lack of vitality. Network analysis was used to identify core symptoms and bridging symptoms among symptom clusters. A total of 340 questionnaires were distributed, and 336 valid questionnaires were returned, resulting in a valid response rate of 98.8% (336/340) .Results:The most common symptoms in T2DM patients included thirst and dry mouth, foamy urine, and overall fatigue. The most troublesome symptoms were overall fatigue, lack of vitality, and thirst and dry mouth. In the symptom network, lack of vitality had the highest intensity ( rs=7.980) and closeness centrality ( rc=0.014), followed by overall fatigue ( rs=7.940) and feeling down ( rs=7.200). Overall fatigue ( rbs=7.190, rbc=0.380) was identified as the strongest bridging symptom in the network. Univariate analysis showed that age, education level, diabetes duration, diabetes complications, and regular blood glucose monitoring were significant factors affecting lack of vitality in T2DM patients ( P<0.05). Multiple linear regression analysis indicated that education level, regular blood glucose monitoring, and diabetes complications were significant factors affecting lack of vitality ( P<0.05) . Conclusions:Lack of vitality is the core symptom in T2DM patients, and overall fatigue is the bridging symptom connecting different symptom clusters. The lack of vitality is influenced by factors such as education level, regular blood glucose monitoring, and diabetes complications. Healthcare providers should use symptom network analysis to timely identify core symptoms, bridging symptoms, and their influencing factors, and develop precise and efficient interventions to improve symptom management and reduce the symptom burden in T2DM patients.

Objective To understand and evaluate the overall status of nucleic acid detection efficacy for influenza A virus in the na-tionwide clinical laboratories of China,and discover and identify the potential issues to further improve the detection quality.Methods During 2024,the National Center for Clinical Laboratories distributed five samples to nationwide 1 367 participating laboratories.The detection efficacy of each participating laboratory was evaluated by calculating the overall percent agreement(OPA)of the test results using different detection reagents.Results The results of OPA,positive percent agreement(PPA)and negative percent agreement(NPA)of the five samples were 99.87％(6 826/6 835),99.89％(5 462/5 468),and 99.78％(1 364/1 367),respectively.No statistical difference of PPAs was observed between the H3N2 samples with different concentrations,between H1N1(2009)and H3N2 samples with equivalent concentration(1.0×104 copies/mL),and between seasonal H1N1 and H3N2 samples with equivalent concen-tration(1.0×105 copies/mL)(P＞0.05).Conclusion The results indicated the clinical laboratories in China exhibited robust efficacy in the molecular detection for two prevalent influenza A virus subtypes,i.e.,H1N1(2009)and H3N2.However,false-negative and false-positive results were encountered in a few laboratories.

Objective:To construct a symptom network for type 2 diabetes mellitus (T2DM) patients, identify bridging symptoms and core symptoms, and explore influencing factors, providing references for precise and efficient symptom management.Methods:A convenience sampling method was used to select 340 T2DM patients hospitalized in the Endocrinology Department of Affiliated Hospital of North Sichuan Medical College from December 2023 to February 2024. A general information survey and the Chinese version of Diabetes Symptom Checklist-Revised were used to collect data. Multiple linear regression analysis was performed to explore the influencing factors of T2DM patients' lack of vitality. Network analysis was used to identify core symptoms and bridging symptoms among symptom clusters. A total of 340 questionnaires were distributed, and 336 valid questionnaires were returned, resulting in a valid response rate of 98.8% (336/340) .Results:The most common symptoms in T2DM patients included thirst and dry mouth, foamy urine, and overall fatigue. The most troublesome symptoms were overall fatigue, lack of vitality, and thirst and dry mouth. In the symptom network, lack of vitality had the highest intensity ( rs=7.980) and closeness centrality ( rc=0.014), followed by overall fatigue ( rs=7.940) and feeling down ( rs=7.200). Overall fatigue ( rbs=7.190, rbc=0.380) was identified as the strongest bridging symptom in the network. Univariate analysis showed that age, education level, diabetes duration, diabetes complications, and regular blood glucose monitoring were significant factors affecting lack of vitality in T2DM patients ( P<0.05). Multiple linear regression analysis indicated that education level, regular blood glucose monitoring, and diabetes complications were significant factors affecting lack of vitality ( P<0.05) . Conclusions:Lack of vitality is the core symptom in T2DM patients, and overall fatigue is the bridging symptom connecting different symptom clusters. The lack of vitality is influenced by factors such as education level, regular blood glucose monitoring, and diabetes complications. Healthcare providers should use symptom network analysis to timely identify core symptoms, bridging symptoms, and their influencing factors, and develop precise and efficient interventions to improve symptom management and reduce the symptom burden in T2DM patients.

Active herbal ingredients are gaining recognition for their potent anti-tumor efficacy, attributable to various mechanisms including tumor cell inhibition, immune system activation, and tumor angiogenesis inhibition. Recent studies have revealed that numerous anti-tumor herbal ingredients, such as ginsenosides, ursolic acid, oleanolic acid, and Angelica sinensis polysaccharides, can be utilized to develop smart drug carriers like liposomes, micelles, and nanoparticles. These carriers can deliver active herbal ingredients and co-deliver anti-tumor drugs to enhance drug accumulation at tumor sites, thereby improving anti-tumor efficacy. This study provides a comprehensive analysis of the mechanisms by which these active herbal ingredients-derived carriers enhance therapeutic outcomes. Additionally, it highlights the structural properties of these active herbal ingredients, demonstrating how their unique features can be strategically employed to design smart drug carriers with improved anti-tumor efficacy. The insights presented aim to serve as a reference and guide future innovations in the design and application of smart drug carriers for cancer therapy that leverage active herbal ingredients.
Humans ; Neoplasms/drug therapy* ; Drug Delivery Systems ; Drug Carriers/chemistry* ; Animals ; Drugs, Chinese Herbal/therapeutic use* ; Antineoplastic Agents, Phytogenic/administration & dosage* ; Nanoparticles/chemistry* ; Antineoplastic Agents/administration & dosage*

Periarticular fracture of the shoulder is a common type of fractures in the elderly. Postoperative adverse events such as internal fixation failure, humeral head ischemic necrosis and upper limb dysfunction occur frequently, which seriously endangers the exercise and health of the elderly. Compared with the fracture with normal bone mass, the osteoporotic periarticular fracture of the shoulder is complicated with slow healing and poor rehabilitation, so the clinical management becomes more difficult. At present, there is no targeted guideline or consensus for this type of fracture in China. In such context, experts from Youth Osteoporosis Group of Chinese Orthopedic Association, Orthopedic Expert Committee of Geriatrics Branch of Chinese Association of Gerontology and Geriatrics, Osteoporosis Group of Youth Committee of Chinese Association of Orthopedic Surgeons and Osteoporosis Committee of Shanghai Association of Chinese Integrative Medicine developed the Chinese expert consensus on the diagnosis and treatment of osteoporotic periarticular fracture of the shoulder in the elderly ( version 2023). Nine recommendations were put forward from the aspects of diagnosis, treatment strategies and rehabilitation of osteoporotic periarticular fracture of the shoulder, hoping to promote the standardized, systematic and personalized diagnosis and treatment concept and improve functional outcomes and quality of life in elderly patients with osteoporotic periarticular fracture of the shoulder.

Objective:To explore the current situation of hypoglycemia fear of elderly patients with type 2 diabetes mellitus (T2DM) in the community, identify different types of hypoglycemia fear among elderly T2DM patients in the community by latent profile analysis, and analyze its influencing factors, so as to provide reference for formulating intervention measures.Methods:From February to April 2023, convenience sampling was used to select 300 elderly T2DM patients from three community health service centers in Shunqing District, Nanchong City, Sichuan Province as the research subject. The self-designed General Information Questionnaire, the Chinese Version Hypoglycemia Fear Survey-Ⅱ (CHFS-Ⅱ), and the Summary Diabetes Self Care Activities (SDSCA) were used to investigate the patients, and the latent profile of hypoglycemia fear was analyzed. Binary Logistic regression was used to analyze the influencing factors of different latent categories of hypoglycemic fear in elderly T2DM patients in the community.Results:A total of 300 questionnaires were distributed, and 290 valid questionnaires were collected, with an effective response rate of 96.7% (290/300). Among 290 elderly T2DM patients in the community, the hypoglycemia fear could be divided into two latent categories, including the "moderate worry-normal coping" group ( n=134) and the "high fear-cautious behavior" group ( n=156). The binary Logistic regression showed that marital status, whether there were complications of diabetes, treatment plan and self-management were the factors influencing the latent categories of elderly T2DM patients in the community, and the difference was statistically significant ( P<0.05) . Conclusions:There are classification characteristics of hypoglycemic fear levels in elderly T2DM patients in the community. Community medical and nursing staff should early identify patients in the "high fear-cautious behavior" group, regularly carry out targeted hypoglycemic health education and psychological intervention, reduce their hypoglycemic fear, and improve their quality of life.

Objective:To explore the impacts of workload and expected income index on the salary satisfaction of medical staff at public hospitals.Methods:From October 15th to November 10th, 2020, the salary system reform monitoring questionnaire for medical staff in public hospitals formulated by development center for medical science & technology National Health Commission was adopted to evaluate the workload, actual income, expected income and salary satisfaction of 120 pilot public hospitals for salary reforms in 21 cities (prefectures) in Sichuan province. The questionnaire survey was conducted among 8 651 medical staff of these hospitals. Descriptive analysis was carried out on the results of the questionnaire; the ratio of expected income to actual income, namely the expected income index, was used to reflect the relative difference between expected income and actual income; χ2 test and binary logistic regression were used to analyze the influencing factors of salary satisfaction. Results:8 133 valid questionnaires were recovered. The average working time per week of the survey subjects was 48.17 hours, and the average longest continuous working time was 15.30 hours; 85.63% (6 964) of the medical staff had expected income index greater than 1. The average score of salary satisfaction was 58.22 points and 57.72% (4 694) of the medical staff were dissatisfied. The longer the continuous working time (16-72 h versus 8-9 h, OR=0.755), the greater the expected income index (>1 versus =1, OR=0.522), and the lower the salary satisfaction. Conclusions:The workload of medical staff was heavy, the salary failed to meet the expected level, the sense of satisfaction was low. It is suggested to monitor in real time and dynamically adjust the workload of medical staff in combination with the actual situation, formulate the salary level in line with the technical labor value of different medical staff, and establish a comprehensive performance appraisal mechanism.