Rheumatoid arthritis belongs to arthralgia syndrome in the theory of traditional Chinese medicine， and cold-dampness obstruction syndrome and dampness-heat obstruction syndrome are core syndromes and main syndrome differentiation types of this disease. Fine therapeutic effects have been obtained in the long-term clinical practice of many famous traditional Chinese medicine practitioners following the syndrome differentiation and treatment based on the guiding principles of cold and heat. To adapt to the clinical diagnosis practice of combining disease differentiation and syndrome differentiation， and to better carry out basic research on integrated Chinese and Western medicine and preclinical study on new traditional Chinese medicines， Guidelines for Establishing Animal Models of Rheumatoid Arthritis with Cold-Dampness Obstruction Syndrome and Dampness-Heat Obstruction Syndrome （hereinafter referred to as the Guidelines） were compiled by our research group， in cooperation with the renowned experts in research fields including traditional Chinese medicine， clinical medicine， zoology and evidence-based medicine， which provide a meaningful reference for scientific research， teaching and clinical applications. The compilation process of the Guidelines was guided by the theory of disease and syndrome integration and the principles of "evidence takes the main place， consensus plays an auxiliary role， and experience serves as the reference". Based on the comprehensive evaluation of pathogenesis homology， behavioral phenotypic consistency， and drug treatment predictability compared between animal models and human diseases， by the nominal group method， "recommendations" were formed for recommendations supported by evidence， and "consensus recommendations" were formed for recommendations not supported by evidence. Guidelines were formed involving content such as animal types， arthritis modeling methods， external stimulation conditions， and modeling assessment indicators during the establishment of the animal models of rheumatoid arthritis with cold-dampness obstruction syndrome and dampness-heat obstruction syndrome. The Guidelines are applicable for the disease and syndrome research on rheumatoid arthritis， investigation of therapeutic mechanisms， and development of new traditional Chinese medicine. The Guidelines also provide a reference for the establishment of guidelines on other types of diseases and syndromes combined with animal models to further promote the modernization of traditional Chinese medicine research and its integration with international academic development.

The Guidelines for Establishing Animal Models of Rheumatoid Arthritis with Cold-dampness Obstruction Syndrome and Dampness-heat Obstruction Syndrome （hereinafter referred to as the Guidelines） （No. T/CACM1567-2024） was published by Chinese Association of Chinese Medicine on January 11， 2024. To assist researchers and medical workers in understanding and applying the Guidelines more accurately， and also to provide reference and assistance for the establishment of guidelines on other types of diseases and syndromes combined with animal models， this paper made a declaration of the workflow， technological links， development references， promotion of its application and after-effect evaluation of the Guidelines that has been made according to the requirements of "Draft Group Standard of the Standardization Office of the Chinese Association of Traditional Chinese Medicine".

Healthcare-associated infection(HAI)is a global public health problem that poses a significant socio-economic burden.Hand hygiene is still considered as one of the most effective measures to prevent the spread of pathogens and reduce the incidence of HAI.This paper systematically reviews the latest progress in hand hygiene-related new products,intelligent monitoring technology,and compliance promotion strategies,aiming to provide scientific basis for the management and optimized scheme of hand hygiene in clinical practice in medical institutions in China,ultimately enhance the hand hygiene compliance of healthcare workers,ensure patient safety,and reduce the burden of HAI.

Objective To analyze the causal relationship between brain resting state functional magnetic resonance imaging(rsfMRI)network and myocardial infarction using the Mendelian randomization(MR)research method.Methods Four analytical methods of MR[inverse-variance weighted(IVW),weighted median method(WME),weighted mode method,and MR-Egger method]were used to conduct a two-way two-sample analysis between 191 types of rsfMRI phenotypes of the brain(34 691 types)and myocardial infarction.And based on the aggregated analysis of genome-wide association studies(GWAS)data,MR was used to explain the causal relationship between the two.Then,the IVW method was used for analysis and research as the main result,and other analytical methods were used as supplementary analyses.Finally,the credibility of the results was verified by using sensitivity analysis.Results The neural connection activities located at the edge of the fusiform gyrus of the temporal lobe and the default mode network[odds ratio(OR)=1.260,95%confidence interval(95%CI)1.120-1.420,P<0.001]may increase the risk of myocardial infarction.In addition,the motor and subcortical cerebellar networks located in the posterior central gyrus,anterior central gyrus,and cerebellum(OR=0.770,95%CI was 0.680-0.880,P<0.001),and the subcortical cerebellar and motor networks located in the cerebellum and paracentric lobules(OR=0.810,95%CI was 0.720-0.900,P<0.001)and the neural connection activities of the motor and subcortical cerebellar networks located in the posterior central gyrus,anterior central gyrus and subcortex(OR=0.730,95%CI was 0.630-0.840,P<0.001)were associated with a reduced risk of myocardial infarction.Sensitivity analysis showed that the research results were reliable,and after the reverse MR study,it was confirmed that there was no reverse causal association between the two.Conclusion The network signals located at the edge of the fusiform gyrus of the temporal lobe and in the default mode may be potential risk factors for myocardial infarction;the motor and subcortical cerebellar networks located in the posterior central gyrus,anterior central gyrus and cerebellum,as well as the subcortical cerebellar and motor networks located in the cerebellum and paracentric lobules,and the neural connection activities of the motor and subcortical cerebellar networks located in the posterior central gyrus,anterior central gyrus and subcortex may be potential protective factors,providing new ideas for the prevention and treatment of myocardial infarction.

Delirium has a high incidence and is associated with a poor patient prognosis.The pathogenesis of delirium is still unclear.Although antipsychotic drugs are the main intervention in clinical practice,there are currently no drugs that can definitively improve the long-term health-related quality of life in patients with delirium.In this study,we review research on the associations between epigenetic modifications such as non-coding RNAs,DNA methylation,and histone acetylation and the development of delirium,with the aim of providing information to support clinical decisions on the early identification and diagnosis of delirium,as well as its treatment and prognosis and the development of relevant targeted drugs.

Objective:To investigate the magnetic resonance imaging (MRI) features of pediatric and adolescent mediastinal T-lymphoblastic lymphoma (T-LBL) and to evaluate their predictive value for early treatment response.Methods:A retrospective, multicenter case series study was conducted on 49 pediatric and adolescent patients diagnosed with mediastinal T-LBL between September 2020 and May 2024 at the Fifth Affiliated Hospital of Zhengzhou University, Beijing Gaobo Boren Hospital, and Henan Cancer Hospital.All patients underwent chest MRI, including conventional MRI sequences and diffusion-weighted imaging.Tumor imaging characteristics were analyzed, and quantitative parameters such as minimum apparent diffusion coefficient (ADCmin), maximum ADC (ADCmax), and mean ADC (ADCmean) were measured.Treatment response was evaluated 15 days post-treatment.The patients were divided into a response group (complete or partial response, 26 cases) and a non-response group (progressive disease or minor response, 23 cases).The relationship between MRI features and treatment response was analyzed.The intraclass correlation coefficient was used to assess inter-reader agreement, and independent sample t-tests and chi-square tests were employed to compare differences between groups.Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the predictive performance of imaging parameters. Results:Significant differences were observed between the response and non-response groups in ADC values [ADCmin (0.80±0.41)×10 -3 mm 2/s vs.(1.23±0.70)×10 -3 mm 2/s, ADCmax (1.14±0.48)×10 -3 mm 2/s vs.(1.92±0.77)×10 -3 mm 2/s, ADCmean (0.98±0.42)×10 -3 mm 2/s vs.(1.56±0.74)×10 -3 mm 2/s] and the maximum tumor diameter was [(11.92±3.61) cm vs.(8.17±2.46) cm] (all P<0.05).ROC curve analysis showed that ADCmax had the highest predictive efficiency for treatment response, with an area under the curve (AUC) of 0.853 (95% CI: 0.790-0.910), sensitivity of 92.3%, and specificity of 65.2%.The AUC for the maximum tumor diameter was 0.814, demonstrating its excellent predictive performance. Conclusions:MRI features, particularly ADC values and the maximum tumor diameter, can effectively predict treatment response in pediatric and adolescent mediastinal T-LBL.

Objective:To investigate the clinical manifestations of medically refractory hereditary movement disorders in children and the efficacy of deep brain stimulation (DBS).Methods:A case series study.The clinical and follow-up data of 20 children with medically refractory hereditary movement disorders who underwent DBS treatment at the Neurology and Functional Neurosurgery Departments of Beijing Children′s Hospital, Capital Medical University, from July 2018 to April 2024, were retrospectively analyzed.The severity of movement disorder symptoms and surgical effects were evaluated using the Burke-Fahn-Marsden Dystonia Rating Scale Movement(BFMDRS-M) or the Unified Parkinson′s Disease Rating Scale Ⅲ(UPDRS Ⅲ).Results:There were 12 males and 8 females among the 20 children, with an onset age ranging from 4 months to 12 years and 5 months.Fourteen patients had hereditary dystonia, which is related to KMT2B in 11 patients, TOR1A in 2 patients and SGCE in 1 patient.Two patients had choreoathetosis, which is related to ADCY5-related familial movement disorders.Two patients had early-onset Parkinson′s disease, which is related to ATP6AP2 in 1 patient and VPS13C in 1 patient.Two patients had neurodevelopmental disorders with involuntary movements, which is related to GNAO1 in 1 patient, and the other patient was idiopathic.All the children were given oral Levodopa, Benzhexol, Baclofen, Tiapride Hydrochloride, Clonazepam alone or in combination.Three children showed obvious dyskinesia after Levodopa treatment.The symptoms of movement disorders in all children exhibited little to no improvement.Levetiracetam and Zonisamide had unstable effects in the treatment of myoclonia.DBS surgery was performed on all the patients aged from 3 to 16 years.Electrodes were successfully inserted into bilateral globus pallidus internus in 14 cases and bilateral subthalamic nuclei in 4 cases.The target was unknown in 2 cases.No surgery-related complications were observed.The patients were followed up for 3 months to 6 years, and the last follow-up age of the patients ranged from 5 years and 7 months to 22 years and 1 month.The rate of improvement in BFMDRS-M score was 37%-100% in 16 patients and >70% in 7 patients with hereditary dystonia.The rate of improvement in UPDRS Ⅲ score was 23% in 1 patient with VPS13C-related early-onset Parkinson′s disease. Conclusions:Childhood medically refractory hereditary movement disorders are a case series that exhibits significant phenotypic and genotypic heterogeneity.DBS surgery demonstrates significant efficacy for KMT2B-, TOR1A-, and SGCE-related hereditary movement disorders.

Delirium has a high incidence and is associated with a poor patient prognosis.The pathogenesis of delirium is still unclear.Although antipsychotic drugs are the main intervention in clinical practice,there are currently no drugs that can definitively improve the long-term health-related quality of life in patients with delirium.In this study,we review research on the associations between epigenetic modifications such as non-coding RNAs,DNA methylation,and histone acetylation and the development of delirium,with the aim of providing information to support clinical decisions on the early identification and diagnosis of delirium,as well as its treatment and prognosis and the development of relevant targeted drugs.

Healthcare-associated infection(HAI)is a global public health problem that poses a significant socio-economic burden.Hand hygiene is still considered as one of the most effective measures to prevent the spread of pathogens and reduce the incidence of HAI.This paper systematically reviews the latest progress in hand hygiene-related new products,intelligent monitoring technology,and compliance promotion strategies,aiming to provide scientific basis for the management and optimized scheme of hand hygiene in clinical practice in medical institutions in China,ultimately enhance the hand hygiene compliance of healthcare workers,ensure patient safety,and reduce the burden of HAI.

Objective To analyze the causal relationship between brain resting state functional magnetic resonance imaging(rsfMRI)network and myocardial infarction using the Mendelian randomization(MR)research method.Methods Four analytical methods of MR[inverse-variance weighted(IVW),weighted median method(WME),weighted mode method,and MR-Egger method]were used to conduct a two-way two-sample analysis between 191 types of rsfMRI phenotypes of the brain(34 691 types)and myocardial infarction.And based on the aggregated analysis of genome-wide association studies(GWAS)data,MR was used to explain the causal relationship between the two.Then,the IVW method was used for analysis and research as the main result,and other analytical methods were used as supplementary analyses.Finally,the credibility of the results was verified by using sensitivity analysis.Results The neural connection activities located at the edge of the fusiform gyrus of the temporal lobe and the default mode network[odds ratio(OR)=1.260,95%confidence interval(95%CI)1.120-1.420,P<0.001]may increase the risk of myocardial infarction.In addition,the motor and subcortical cerebellar networks located in the posterior central gyrus,anterior central gyrus,and cerebellum(OR=0.770,95%CI was 0.680-0.880,P<0.001),and the subcortical cerebellar and motor networks located in the cerebellum and paracentric lobules(OR=0.810,95%CI was 0.720-0.900,P<0.001)and the neural connection activities of the motor and subcortical cerebellar networks located in the posterior central gyrus,anterior central gyrus and subcortex(OR=0.730,95%CI was 0.630-0.840,P<0.001)were associated with a reduced risk of myocardial infarction.Sensitivity analysis showed that the research results were reliable,and after the reverse MR study,it was confirmed that there was no reverse causal association between the two.Conclusion The network signals located at the edge of the fusiform gyrus of the temporal lobe and in the default mode may be potential risk factors for myocardial infarction;the motor and subcortical cerebellar networks located in the posterior central gyrus,anterior central gyrus and cerebellum,as well as the subcortical cerebellar and motor networks located in the cerebellum and paracentric lobules,and the neural connection activities of the motor and subcortical cerebellar networks located in the posterior central gyrus,anterior central gyrus and subcortex may be potential protective factors,providing new ideas for the prevention and treatment of myocardial infarction.