OBJECTIVE To compare the efficacy and safety of infliximab（IFX）， ustekinumab（UST） and vedolizumab（VDZ） in the treatment of active Crohn’s disease （CD）. METHODS The patients with active CD who were diagnosed and initially received any of the aforementioned biologics at the First Affiliated Hospital of the USTC （Anhui Provincial Hospital） from January 2020 to December 2023 were selected as the study subjects. They were divided into the IFX group （34 cases）， the UST group （37 cases）， and the VDZ group （15 cases） based on their treatment regimens. Patients in all three groups received induction and maintenance therapy with IFX， UST or VDZ for at least 12 months. The CD Activity Index （CDAI） scores and their changes from baseline （ΔCDAI）， clinical remission rates， clinical response rates， nutritional indicators [body mass index （BMI）， albumin （ALB）， hemoglobin （HGB）]， and inflammatory markers [C-reactive protein （CRP）， erythrocyte sedimentation rate （ESR）] of three groups after the induction phase （9th week of treatment） and during the maintenance phase （12th month of treatment） were compared. Additionally， the cumulative clinical remission rates at 1 year of treatment and the incidence of adverse events （AEs） were compared. RESULTS There were no statistically significant differences in the aforementioned baseline indicators among the three groups （ P ＞0.05）. In all three groups， the CDAI scores were significantly lower after the induction phase and during the maintenance phase， compared to the baseline （ P ＜0.05）. In the IFX group， CDAI scores at the above time points were significantly lower than those in the UST and VDZ groups during the same periods （ P ＜0.05）， and the absolute value of ΔCDAI during the maintenance phase was significantly higher than that in the VDZ group （ P ＜0.05）. The clinical remission rate in the IFX group during the maintenance phase was significantly higher than that in the UST and VDZ groups during the same period， and the clinical response rate was significantly higher than that in the VDZ group during the same period （ P ＜0.05）. The levels of ALB， HGB， CRP and ESR in the IFX group after the induction phase and during the maintenance phase， as well as the levels of CRP and ESR in the UST group after the induction phase， all improved significantly compared to the baseline. Furthermore， the levels of ALB and HGB in the IFX group were significantly higher than those in the UST and VDZ groups during the same period （ P ＜0.05）. The cumulative clinical remission rates among the three groups were significantly different （ P ＜0.05）， with patients in the IFX group achieving remission more rapidly and at a higher proportion. There was no statistically significant difference in the incidence of AEs among IFX， UST and VDZ groups （14.71%， 8.11% and 20.00%， respectively； P ＞0.05）； infusion reactions were the most common AEs in the IFX group （8.82%）. CONCLUSIONS Compared with UST and VDZ， IFX demonstrates a higher clinical remission rate during the maintenance phase， more effectively improves active CD patients’ nutritional status， and continuously reduces systemic inflammatory responses. However， clinicians should be mindful of the risk of adverse events， such as infusion reactions， associated with this drug.

Objective To establish a full-chain follow-up system for tumor patients during chemotherapy and to evaluate its application effect.Methods A full-chain follow-up system was built according to the actual needs of cancer patients during chemotherapy,including 5 modules:patient health records,follow-up plan,risk identification and abnormal reminder,online consultation,interaction between doctors and patients and data visualization analysis and intelligent statistical management.Convenience sampling method was used to select 96 patients with tumor at chemotherapy stage who were treated in a tertiary A hospital in Deyang City,Sichuan Province from February to June 2023 as a test group,and the full chain follow-up system for tumor patients at chemotherapy stage was applied for follow-up;93 patients with tumor at chemotherapy stage were treated from February to June 2022 as a control group for routine follow-up care.Indicators of self-management ability,quality of life and satisfaction with follow-up services were compared between the 2 groups before and after the application of the system.Results 94 cases in the test group and 92 cases in the control group completed the study.After the application of the system,the test group scored(169.44±11.96)on the Cancer Patients Self-Management Scale,higher than(150.76±13.44)in the control group.The score on the Cancer Patients Quality of Life Core Scale was(65.50±7.90),higher than(59.81±7.27)in the control group.The score on the Questionnaire of Satisfaction with the Follow-Up Service was(52.00±3.30),higher than(48.89±3.54)in the control group,and the difference between the 2 groups was statistically significant(P＜0.001).Conclusion The application of the full-chain follow-up system can meet the diversified and multi-level follow-up needs of tumor patients during chemotherapy,achieve accurate,professional and intelligent nursing follow-up services,effectively improve patients'symptom self-management ability and quality of life,and improve patients'satisfaction with nursing services.

Objective To establish a full-chain follow-up system for tumor patients during chemotherapy and to evaluate its application effect.Methods A full-chain follow-up system was built according to the actual needs of cancer patients during chemotherapy,including 5 modules:patient health records,follow-up plan,risk identification and abnormal reminder,online consultation,interaction between doctors and patients and data visualization analysis and intelligent statistical management.Convenience sampling method was used to select 96 patients with tumor at chemotherapy stage who were treated in a tertiary A hospital in Deyang City,Sichuan Province from February to June 2023 as a test group,and the full chain follow-up system for tumor patients at chemotherapy stage was applied for follow-up;93 patients with tumor at chemotherapy stage were treated from February to June 2022 as a control group for routine follow-up care.Indicators of self-management ability,quality of life and satisfaction with follow-up services were compared between the 2 groups before and after the application of the system.Results 94 cases in the test group and 92 cases in the control group completed the study.After the application of the system,the test group scored(169.44±11.96)on the Cancer Patients Self-Management Scale,higher than(150.76±13.44)in the control group.The score on the Cancer Patients Quality of Life Core Scale was(65.50±7.90),higher than(59.81±7.27)in the control group.The score on the Questionnaire of Satisfaction with the Follow-Up Service was(52.00±3.30),higher than(48.89±3.54)in the control group,and the difference between the 2 groups was statistically significant(P＜0.001).Conclusion The application of the full-chain follow-up system can meet the diversified and multi-level follow-up needs of tumor patients during chemotherapy,achieve accurate,professional and intelligent nursing follow-up services,effectively improve patients'symptom self-management ability and quality of life,and improve patients'satisfaction with nursing services.

Objective To evaluate the predictive ability and influencing factors of individualized drug administration adjuvant decision-making system Java PK? for Desktop(JPKD)for tacrolimus blood concentration in kidney transplant recipients.Methods The monitoring data of tacrolimus blood concentration from 149 recipients early after kidney transplantation were collected.The trough blood concentration of tacrolimus was predicted by JPKD.The absolute weighted deviation and relative prediction deviation between the actual and predicted concentration were calculated.The influencing factors of the absolute weighted deviation were analyzed by univariate and multivariate logistic regression analyses,and the predictive values of these influencing factors on the accuracy of software prediction were assessed by delineating the receiver operating characteristic(ROC)curve.Results Two hundred and sixty-six samples of tacrolimus blood concentration data were collected from 149 patients.The measured blood concentration of tacrolimus was(6.5±3.0)ng/mL(1.1-16.6 ng/mL),and the predicted value calculated by JPKD was(5.6±2.5)ng/mL(1.4-14.4 ng/mL).The absolute weighted deviation of the calculated data was 28.38％,and the relative prediction deviation was-13.55％.Univariate analysis showed that gender,albumin,changes in hematocrit,cytochrome P450(CYP)3A5*3 genotype and C3435T genotype were associated with the inaccurate prediction results.Multivariate logistic regression analysis found that CYP3A5*3 genotype of AA and the changes in hematocrit were the independent risk factors affecting the accuracy of tacrolimus blood concentration predicted by JPKD.ROC curve analysis showed that when the changes in hematocrit exceeded 2.25％,the risk of inaccurate software prediction was increased.Conclusions JPKD possesses certain accuracy in predicting the blood concentration of tacrolimus in kidney transplant recipients,which may improve the qualified rate of tacrolimus blood concentration.Nevertheless,CYP3A5*3 genotype and the changes of hematocrit may affect the accuracy of predictions.

Epigenomic imbalance drives abnormal transcriptional processes,promoting the onset and progression of cancer.Although defective gene regulation generally affects carcinogenesis and tumor suppression networks,tumor immunogenicity and immune cells involved in antitumor responses may also be affected by epigenomic changes,which may have significant implications for the development and application of epigenetic therapy,cancer immunotherapy,and their combinations.Herein,we focus on the impact of epigenetic regulation on tumor immune cell function and the role of key abnormal epigenetic processes,DNA methylation,histone post-translational modification,and chromatin structure in tumor immunogenicity,and introduce these epigenetic research methods.We emphasize the value of small-molecule inhibitors of epigenetic modulators in enhancing antitumor immune responses and discuss the challenges of developing treatment plans that combine epigenetic therapy and immuno-therapy through the complex interaction between cancer epigenetics and cancer immunology.

Objective:To explore the trajectory of postpartum post-traumatic stress disorder (PP-PTSD) in women of advanced maternal age and its influencing factors.Methods:From September 2021 to March 2023, convenience sampling was used to select women of advanced maternal age in the Department of Gynecology and Obstetrics at Taizhou Hospital of Zhejiang Province as participants. Parturients were surveyed at one week, one month, six months, and 12 months after delivering using General Information Questionnaire, Post-traumatic Stress Disorder Check-list-civilian Version, Social Capital Scale, and 10-item Connor-Davidson Resilience Scale. The latent growth mixture model was used to analyze the trajectory of PP-PTSD.Results:A total of 467 questionnaires were distributed, and 456 valid questionnaires were collected, with a valid rate of 97.64%. There were four types of PP-PTSD trajectories in women of advanced maternal age, namely non PP-PTSD type (71.27%, 325/456), early onset-gradual recovery type (12.06%, 55/456), early onset-prolonged type (9.21%, 42/456), and late onset-risk type (7.46%, 34/456). Univariate analysis showed that delivery mode, pregnancy complications, social capital, and psychological resilience were potential categories of influencing factors for the trajectory of PP-PTSD in women of advanced maternal age ( P<0.05) . Conclusions:There is population heterogeneity in the trajectory of PP-PTSD among women of advanced maternal age. It is recommended that medical and nursing staff dynamically monitor the PP-PTSD of women of advanced maternal age, identify their trajectory types early, and develop precise intervention measures based on classification.

Objective:To study the iodine nutrition status of key populations in Sichuan Province, so as to provide a basis for scientific supplementation of iodine and adjustment of prevention and control measures.Methods:From 2018 to 2022, the stratified cluster sampling method was used in 21 counties (district) in Sichuan Province. Each county (district) was divided into 5 areas based on east, west, south, north, and center. One township (street) was selected as a monitoring site from each area. Forty children aged 8 - 10 years old and 20 pregnant women, women of childbearing age, lactating women, and their infants and young children (0 - 2 years old) were randomly selected from each monitoring site. Household edible salt and urine samples were collected for salt and urine iodine testing. B-ultrasound method was used for thyroid examination in children.Results:A total of 52 019 samples of edible salt were collected, including 50 084 qualified iodized salt samples. The qualified iodized salt consumption rate was 96.3%, and the median salt iodine was 27.1 mg/kg. A total of 21 021 urine samples from children were tested, with a median urine iodine level of 199.5 μg/L. A total of 10 293 urine samples were taken from pregnant women, and the median urine iodine level was 172.6 μg/L. A total of 10 502 urine samples were taken from women of childbearing age, with a median urine iodine level of 174.4 μg/L. A total of 10 444 urine samples were taken from lactating women, and the median urine iodine level was 164.9 μg/L. There were 10 442 urine samples from infants and young children, and the median urine iodine level was 191.9 μg/L. A total of 21 028 children underwent thyroid examination, with a goiter rate of 1.8% (370/21 028).Conclusion:From 2018 to 2022, the iodine nutrition of key populations in Sichuan Province is at an appropriate level, and the elimination of iodine deficiency disorders continues to be maintained.

Rapid turnover of the intestinal epithelium is a critical strategy to balance the uptake of nutrients and defend against environmental insults, whereas inappropriate death promotes the spread of inflammation. PPARα is highly expressed in the small intestine and regulates the absorption of dietary lipids. However, as a key mediator of inflammation, the impact of intestinal PPARα signaling on cell death pathways is unknown. Here, we show that Pparα deficiency of intestinal epithelium up-regulates necroptosis signals, disrupts the gut vascular barrier, and promotes LPS translocation into the liver. Intestinal Pparα deficiency drives age-related hepatic steatosis and aggravates hepatic fibrosis induced by a high-fat plus high-sucrose diet (HFHS). PPARα levels correlate with TRIM38 and MLKL in the human ileum. Inhibition of PPARα up-regulates necroptosis signals in the intestinal organoids triggered by TNF-α and LPS stimuli via TRIM38/TRIF and CREB3L3/MLKL pathways. Butyric acid ameliorates hepatic steatosis induced by intestinal Pparα deficiency through the inhibition of necroptosis. Our data suggest that intestinal PPARα is essential for the maintenance of microenvironmental homeostasis and the spread of inflammation via the gut-liver axis.

【Objective】 To explore the current status of positive psychological qualities among college students who had participated in voluntary blood donation in Changsha area, so as to demonstrate that scientific blood donation can promote mental health. 【Methods】 From May to June 2022, 1 440 college students in Changsha was selected as the research subjects by stratified random sampling method. They were divided into groups based on their experience of blood donation. A questionnaire survey was conducted using the General Information Questionnaire, the Chinese College Student Positive Psychological Product Quality Scale, and the Repeated Blood Donation Behavior Survey Scale. 【Results】 There were differences in the six dimensions of positive psychological quality among different family and friends in terms of their support for blood donation, blood donation status among different family members, understanding of voluntary blood donation knowledge (P<0.05). There were differences in positive psychological qualities among different levels of blood reimbursement experiences (cognitive dimension, moderation dimension, transcendence dimension), different blood donation times (moderation dimension, interpersonal dimension), different blood donation volumes (moderation dimension, fairness dimension), different comprehensive blood donation experiences (moderation dimension, transcendence dimension, interpersonal dimension, emotional dimension) and reasons for blood donation (cognitive dimension, moderation dimension, interpresonal dimension, emotional dimension, fairness dimension)(P<0.05). The positive psychological quality of college students was positively correlated with their intention to repeat blood donation behavior (P<0.01), and the difference was statistically significant. 【Conclusion】 The positive psychological quality of college students with blood donation experience in Changsha surpassed those without blood donation experience, and their positive psychological quality was positively correlated to their intention to repeated blood donation. Therefore, it is recommended to encourage voluntary blood donation among college students.

Chinese materia medica is the material basis of the development of traditional Chinese medicine， but the rapid growth of the demand for Chinese materia medica resources and environmental deterioration make a large number of wild medicine resources endangered. At present， artificial cultivation of Chinese medicinal materials is the main way to alleviate the contradiction between supply and demand in the market， but the production and quality of medicinal materials are seriously affected by the lack of process control， specialization and fine management in medicinal plant cultivation. Early prediction and evaluation of the growth， yield， diseases and insect pests of medicinal plants is an important technical means to guarantee the yield and quality of Chinese medicinal materials， and effective and non-destructive process monitoring technology is the prerequisite for realizing the modernization of Chinese medicine agriculture. With the advantages of rapid， non-destructive and accurate detection， hyperspectral remote sensing has been widely used in recent years for plant growth information extraction and yield assessment， as well as monitoring crop growth and response to adversity stress， becoming an important technical tool for precision agricultural production such as quality monitoring and pest and disease prevention. Therefore， combined with hyperspectral data processing and analysis methods， the application of hyperspectral remote sensing technology in monitoring plant physiological characteristics， environmental stress， resource investigation and quality inspection of medicinal materials is systematically reviewed， and combined with the characteristics of medicinal plants， the application prospect of hyperspectral remote sensing technology in improving the monitoring ability of production process of Chinese medicinal materials， realizing real-time dynamic monitoring of medicinal materials cultivation， developing early diagnosis technology of pests and diseases for nondestructive detection， and establishing quality traceability of high-quality Chinese medicinal materials is discussed， in order to solve the related problems in precision cultivation of Chinese medicine agriculture by hyperspectral remote sensing technology， and provide new ideas and solutions for the sustainable utilization of Chinese medicine resources and the development of intelligent Chinese medicine agriculture.