Chronic obstructive pulmonary disease (COPD) poses a significant public health challenge in China due to its high prevalence and substantial disease burden. Primary healthcare institutions (PHIs) serve as the cornerstone for COPD prevention and management. However, they currently face critical challenges, including inadequate diagnostic capacity, suboptimal treatment standardization, and limited patient awareness. In recent years, national efforts have initiated the development of a primary-level COPD prevention and management network. Key strategies include incorporating COPD into the Fundamental Public Health Service Program (FPHSP), strengthening lung function screening, promoting tiered diagnosis and treatment systems, establishing central-local coordination mechanisms, and implementing National Major Public Health Service Programs. Future directions necessitate focused efforts on: constructing integrated prevention and treatment models; optimizing the two-way referral system; enhancing screening for high-risk populations; leveraging digital health empowerment; and establishing a multi-dimensional quality evaluation system. These concerted actions are essential to build a comprehensive, high-quality COPD healthcare management system within primary care settings, ultimately contributing to the goals of the Healthy China Initiative (2019-2030).

Under stress,the cold-inducible RNA-binding protein(CIRP)is translocated from the nucleus to the cytoplasm and subsequently released outside the cell.Extracellular CIRP(eCIRP),acting as a damage-associated mo-lecular pattern,amplifies inflammation through various mechanisms and leads to an uncontrolled inflammatory response,thereby contributing to the occurrence and progression of sepsis and other critical pathological processes.Certain CIRP-tar-geting drugs have demonstrated promising anti-sepsis effects through the reduction of CIRP expression,the decrease of eCIRP release,the neutralization of eCIRP,or the intervention in receptor binding.This review examines the release mechanism of CIRP and the role of eCIRP in the development of sepsis,with the aim of providing new insights for the pre-vention and treatment of sepsis by targeting eCIRP.

Following hemorrhagic shock,locally released chemotactic molecules attract neutrophils to rapidly migrate to the damaged tissues,while effectively bind,engulf and kill microorganisms,along with chromatin releasing and forming a substance deco-rated with a meshwork of microbicidal proteins and enzymes,a DNA-protein structure named neutrophil extracellular traps(NETs).The formation and degradation of NETs are regulated by multiple factors,and an imbalance in the formation and degradation of NETs plays a role in cellular damage and the aggregation of inflammatory factors,which is one of the main mechanisms of uncontrolled in-flammatory response and further aggravates organ damage.Studies have shown that NETs are involved in the process of hemorrhagic shock-induced organ damage,but the relevant mechanisms have not been fully elucidated.In this paper,we review the role of NETs in organ damage after hemorrhagic shock and the related mechanisms,and in order to understand the role of NETs and provide a refer-ence for new targets for the prevention and treatment of hemorrhagic shock.

Following hemorrhagic shock,locally released chemotactic molecules attract neutrophils to rapidly migrate to the damaged tissues,while effectively bind,engulf and kill microorganisms,along with chromatin releasing and forming a substance deco-rated with a meshwork of microbicidal proteins and enzymes,a DNA-protein structure named neutrophil extracellular traps(NETs).The formation and degradation of NETs are regulated by multiple factors,and an imbalance in the formation and degradation of NETs plays a role in cellular damage and the aggregation of inflammatory factors,which is one of the main mechanisms of uncontrolled in-flammatory response and further aggravates organ damage.Studies have shown that NETs are involved in the process of hemorrhagic shock-induced organ damage,but the relevant mechanisms have not been fully elucidated.In this paper,we review the role of NETs in organ damage after hemorrhagic shock and the related mechanisms,and in order to understand the role of NETs and provide a refer-ence for new targets for the prevention and treatment of hemorrhagic shock.

Chronic obstructive pulmonary disease (COPD) poses a significant public health challenge in China due to its high prevalence and substantial disease burden. Primary healthcare institutions (PHIs) serve as the cornerstone for COPD prevention and management. However, they currently face critical challenges, including inadequate diagnostic capacity, suboptimal treatment standardization, and limited patient awareness. In recent years, national efforts have initiated the development of a primary-level COPD prevention and management network. Key strategies include incorporating COPD into the Fundamental Public Health Service Program (FPHSP), strengthening lung function screening, promoting tiered diagnosis and treatment systems, establishing central-local coordination mechanisms, and implementing National Major Public Health Service Programs. Future directions necessitate focused efforts on: constructing integrated prevention and treatment models; optimizing the two-way referral system; enhancing screening for high-risk populations; leveraging digital health empowerment; and establishing a multi-dimensional quality evaluation system. These concerted actions are essential to build a comprehensive, high-quality COPD healthcare management system within primary care settings, ultimately contributing to the goals of the Healthy China Initiative (2019-2030).

Under stress,the cold-inducible RNA-binding protein(CIRP)is translocated from the nucleus to the cytoplasm and subsequently released outside the cell.Extracellular CIRP(eCIRP),acting as a damage-associated mo-lecular pattern,amplifies inflammation through various mechanisms and leads to an uncontrolled inflammatory response,thereby contributing to the occurrence and progression of sepsis and other critical pathological processes.Certain CIRP-tar-geting drugs have demonstrated promising anti-sepsis effects through the reduction of CIRP expression,the decrease of eCIRP release,the neutralization of eCIRP,or the intervention in receptor binding.This review examines the release mechanism of CIRP and the role of eCIRP in the development of sepsis,with the aim of providing new insights for the pre-vention and treatment of sepsis by targeting eCIRP.

Objective:To construct machine learning-based delirium prediction models for ICU patients with multiple trauma and evaluate their prediction efficiency.Methods:A retrospective case-control study was conducted to analyze the clinical data of 417 ICU multiple trauma patients admitted to the First Affiliated Hospital of Zhengzhou University from July 2019 to June 2022, including 305 males and 112 females, aged 18-88 years [(47.8±15.7)years]. The score of acute physiology and chronic health status assessment II (APACHE II) was 0-50 points [(9.80±0.29)points]. The patients were randomly divided into training set ( n=291) and test set ( n=126) with a ratio of 7∶3. The demographic data, past history, treatment and laboratory results of the patients were collected. Lasso regression analysis was applied to screen variables that were significantly correlated to the incidence of delirium in the training set and the variables were then included into the machine learning models. Six machine learning methods including the random forest, gradient boosting tree, extreme gradient boosting, logistic regression, support vector machine and K nearest neighbor were used to construct the delirium prediction models for ICU multiple trauma patients. The accuracy, sensitivity, precision, F1 fraction and area under the curve (AUC) of the receiver′s operating characteristics (ROC) curve were calculated by using the data in the test set to evaluate the prediction efficiency of the models. Results:With regards to the six prediction models, namely random forests, gradient boosting tree, extreme gradient boosting, logistic regression, support vector machine and K nearest neighbor prediction models, the accuracy in the test set was 0.70, 0.68, 0.69, 0.73, 0.70 and 0.60 respectively; the sensitivity was 0.74, 0.80, 0.81, 0.86, 0.85 and 0.69 respectively; the precision was 0.72, 0.69, 0.70, 0.73, 0.71 and 0.65 respectively; the F1 fraction was 0.73, 0.74, 0.75, 0.79, 0.78 and 0.67 respectively; the AUC was 0.72, 0.73, 0.72, 0.80, 0.74 and 0.64 respectively. Among them, the logistic regression model had the best discriminability.Conclusion:Delirium prediction models for ICU patients with multiple trauma have been successfully constructed, among which the logistic regression model has the best prediction efficiency and can serve as an effective tool for early prediction and prevention of delirium in the clinical care of patients with multiple trauma.

The effect and mechanism of chronic stress on psychosomatic diseases are important topics in stress research.The establishment of animal models to simulate human chronic stress is of great significance to investigations of stress responses,the pathogenesis of related diseases,clinical treatment,and drug development.In this paper,animal models of chronic stress commonly used in China and abroad are reviewed;the classification of stressors,animal selection,model construction,pathological manifestations,and evaluation indexes are summarized;and the advantages and disadvantages and application of various models are discussed.The paper provides a reference for the study and selection of models of chronic stress response.

Ferroptosis is a non-apoptotic mode of cell death characterized by iron-dependent lipid-peroxide-accumulation-induced membrane lipid peroxidation and mitochondrial atrophy.It differs from other programmed cell deaths in its morphological and biochemical properties.Ferroptosis is regulated by a variety of metabolic pathways that are involved in the acute lung injury induced by hemorrhagic shock,ischemia-reperfusion,sepsis,and radiation.This article reviews the main regulatory mechanisms of ferroptosis and its role in the pathogenesis of acute lung injury in various animal models with the aim of providing new strategies for the prevention and treatment of acute lung injury.

The Nod-like receptor pyrin domain-associated protein 3(NLRP3)-mediated pyroptosis of pulmonary parenchymal and immune cells plays a key role in the pathogenesis of lung injury during sepsis.NF-κB,JAK2/STAT3 and MAPK signaling pathways are involved in NLRP3-mediated pyroptosis.Targeting NLRP3-pyroptosis and its related signaling pathways,pharmacological interventions with Physalin B,schisandrin,erythropoietin,and physical therapies such as acupuncture at Zusanli and Feishu points,as well as NLRP3-specific inhibitors like ergolide,have all shown effective anti-septic effects in treating lung injuries.This article reviewed the roles and mechanisms of NLRP3-pyroptosis in sepsis-induced lung injury,as well as the experimental progresses made in targeting NLRP3 pyroptosis as a therapy.We aim to highlight the importance of NLRP3-pyroptosis as a target,providing insights for the prevention and treatment of sepsis-induced lung injury.