epsis is a systemic inflammatory response syndrome triggered by infection， and its high mortality rate is closely associated with immune imbalance， particularly the imbalance in the differentiation of helper T cell （Th） cell subsets [Th1， Th2， Th17， regulatory T cell （Treg） ] . In recent years， traditional Chinese medicine （TCM）， with its characteristics of multi-component and multi-target actions， has demonstrated unique advantages in regulating Th cell differentiation and function， as well as correcting immune imbalances in sepsis， offering new perspectives for immunotherapy of sepsis. This review summarizes relevant studies on the regulation of Th cell differentiation for sepsis treatment by TCM monomers and active ingredients （such as Astragalus membranaceus ， Scutellaria baicalensis ， Coptis chinensis ， Rheum palmatum ， Ganoderma lucidum ， Ginkgo biloba ， and Cistanche deserticola ）， the alcohol extract of Dai Baijie， and TCM formulas and preparations categorized as blood-activating and stasis-removing， purgative and laxative， warming and tonifying yang， and tonifying qi and nourishing yin. The results indicate that these TCM monomers， active ingredients， extracts， formulas， and preparations can regulate the Th1/Th2 and Th17/Treg balance， target the differentiation balance of Th cell subsets， alleviate inflammatory responses， or improve immune suppression， thereby exerting therapeutic effects on sepsis.

Sensorineural hearing loss (SNHL), the most commonly-occurring form of hearing loss, is caused mainly by injury to or the loss of hair cells and spiral ganglion neurons in the cochlea. Numerous environmental and physiological factors have been shown to cause acquired SNHL, such as ototoxic drugs, noise exposure, aging, infections, and diseases. Several programmed cell death (PCD) pathways have been reported to be involved in SNHL, especially some novel PCD pathways that have only recently been reported, such as ferroptosis, necroptosis, and pyroptosis. Here we summarize these PCD pathways and their roles and mechanisms in SNHL, aiming to provide new insights and potential therapeutic strategies for SNHL by targeting these PCD pathways.
Humans ; Hearing Loss, Sensorineural/metabolism* ; Necroptosis/drug effects* ; Pyroptosis/drug effects* ; Ferroptosis/drug effects* ; Animals

The intestinal flora and its metabolites are closely bound up with the metabolism and immune function of human body and at the meantime affect the metabolisms of nutrients and drugs,which play an important role in maintaining the physiological function.As the largest reservoir of microorganisms within the human body,the intestinal flora play a vital role in maintaining the health.Numerous studies have shown that the alteration of intestinal flora may not only affect the emergence of gastrointestinal diseases but also has impact on the common diseases of multiple systems,it may mediate the emergence and development of relevant diseases through gut-kid-ney axis,gut-liver axis,and gut-brain axis,and interact with the diseases.As a traditional Chinese medicine ex-ternal therapy,the traditional Chinese medicine enema therapy has remarkable advantages in treatment of various clinical diseases and shows significant effect on improvement of intestinal flora imbalance during the disease pro-gression.The effect of the traditional Chinese medicine enema therapy on improving the intestinal flora imbalance of the patients during the process of emergence and development of the common diseases is reviewed in the article.

Objective:To construct a risk classification model based on logistic regression for medical equipment,so as to improve the application efficiency of medical equipment in the department of cardiovascular medicine. Methods:The logistic regression algorithm was used to construct the risk grade of adverse event of medical equipment of the department of cardiovascular medicine,and data collation and analysis were used to realize monitoring and management control for medical equipment. The 31 sets used medical equipment in the Department of Cardiovascular equipment of Xi'an No.3 Hospital from October 2021 to October 2022 were selected. Equipment management was conducted using conventional methods for risk management from October 2021 to October 2022,while equipment management from November 2022 to November 2023 adopted a risk classification model based on logistic regression was used to conduct risk management. A total of 204 logs of equipment application of the two kinds of management methods were selected,and each method selected 102 logs. The error rate of clinical operation,the occurrence of equipment failure,the timeliness score of risk management of equipment and the rate of hidden danger of safety risk of equipment were compared between the two kinds of management methods. Results:The number of error use of equipment,operational error and man-made mistake were respectively 3,2 and 2 in 102 logs that were managed by using risk classification model,and the incidence rates of them were respectively 2.94％,1.97％ and 1.97％,which were lower than those by using conventional management method,and the differences were statistically significant (x2=11.613,13.058,14.191,P<0.05). The average failure rate,self-maintenance rate of failure and average scrap rate of the medical equipment of the department of cardiovascular medicine of the management with risk classification model were respectively (0.56±0.22)％,(0.79±0.19)％ and (0.90±0.22)％,all of which were lower than those of conventional management method,and the differences were statistically significant (x2=16.971,15.531,15.809,P<0.05). The risk early warning,risk identification,and the average timeliness scores of risk prevention and control of using the management with risk classification model were respectively (90.29±8.69),(89.69±7.69),and (94.58±6.69),all of which were higher than those of using the management with conventional management method,and the differences were statistically significant (t=13.325,11.003,11.676,P<0.05). The number of mechanical injury,associated infection,and abnormal operation of equipment were respectively 1,1 and 2 in 31 medical equipment that were managed by risk classification model,and the incidence rates of them were respectively 3.23％,3.23％ and 6.45％,all of which were lower than those of conventional management methods,and the differences were statistical significances (x2=5.167,7.631,5.413,P<0.05),respectively. Conclusion:The application of a risk classification model based on logistic regression for medical equipment of the department of cardiovascular medicine can improve the utilization rate of equipment,and reduce the potential risk hidden danger of safety,and enhance the operation quality of equipment.

Objective:To construct a risk classification model based on logistic regression for medical equipment,so as to improve the application efficiency of medical equipment in the department of cardiovascular medicine. Methods:The logistic regression algorithm was used to construct the risk grade of adverse event of medical equipment of the department of cardiovascular medicine,and data collation and analysis were used to realize monitoring and management control for medical equipment. The 31 sets used medical equipment in the Department of Cardiovascular equipment of Xi'an No.3 Hospital from October 2021 to October 2022 were selected. Equipment management was conducted using conventional methods for risk management from October 2021 to October 2022,while equipment management from November 2022 to November 2023 adopted a risk classification model based on logistic regression was used to conduct risk management. A total of 204 logs of equipment application of the two kinds of management methods were selected,and each method selected 102 logs. The error rate of clinical operation,the occurrence of equipment failure,the timeliness score of risk management of equipment and the rate of hidden danger of safety risk of equipment were compared between the two kinds of management methods. Results:The number of error use of equipment,operational error and man-made mistake were respectively 3,2 and 2 in 102 logs that were managed by using risk classification model,and the incidence rates of them were respectively 2.94％,1.97％ and 1.97％,which were lower than those by using conventional management method,and the differences were statistically significant (x2=11.613,13.058,14.191,P<0.05). The average failure rate,self-maintenance rate of failure and average scrap rate of the medical equipment of the department of cardiovascular medicine of the management with risk classification model were respectively (0.56±0.22)％,(0.79±0.19)％ and (0.90±0.22)％,all of which were lower than those of conventional management method,and the differences were statistically significant (x2=16.971,15.531,15.809,P<0.05). The risk early warning,risk identification,and the average timeliness scores of risk prevention and control of using the management with risk classification model were respectively (90.29±8.69),(89.69±7.69),and (94.58±6.69),all of which were higher than those of using the management with conventional management method,and the differences were statistically significant (t=13.325,11.003,11.676,P<0.05). The number of mechanical injury,associated infection,and abnormal operation of equipment were respectively 1,1 and 2 in 31 medical equipment that were managed by risk classification model,and the incidence rates of them were respectively 3.23％,3.23％ and 6.45％,all of which were lower than those of conventional management methods,and the differences were statistical significances (x2=5.167,7.631,5.413,P<0.05),respectively. Conclusion:The application of a risk classification model based on logistic regression for medical equipment of the department of cardiovascular medicine can improve the utilization rate of equipment,and reduce the potential risk hidden danger of safety,and enhance the operation quality of equipment.

The intestinal flora and its metabolites are closely bound up with the metabolism and immune function of human body and at the meantime affect the metabolisms of nutrients and drugs,which play an important role in maintaining the physiological function.As the largest reservoir of microorganisms within the human body,the intestinal flora play a vital role in maintaining the health.Numerous studies have shown that the alteration of intestinal flora may not only affect the emergence of gastrointestinal diseases but also has impact on the common diseases of multiple systems,it may mediate the emergence and development of relevant diseases through gut-kid-ney axis,gut-liver axis,and gut-brain axis,and interact with the diseases.As a traditional Chinese medicine ex-ternal therapy,the traditional Chinese medicine enema therapy has remarkable advantages in treatment of various clinical diseases and shows significant effect on improvement of intestinal flora imbalance during the disease pro-gression.The effect of the traditional Chinese medicine enema therapy on improving the intestinal flora imbalance of the patients during the process of emergence and development of the common diseases is reviewed in the article.

Objective: To understand the nutritional literacy level and associated factors of primary and secondary school students in Beijing, so as to provide a scientific basis for improving student nutrition. Methods: From October 2022 to May 2023, a multi stage cluster random sampling method was employed to select a total of 14 568 primary, junior and senior high school students from 16 districts (ecluding the Economic Technological Development area) in Beijing. Through a survey questionnaire on nutritional literacy and dietary hehavior of school age children, basic information as well as data on nutritional literacy levels across four dimensions:nutrition related knowledge concepts, food selection, food preparation, and food intake dimensions were obtained. The Wilcoxon rank sum test, Kruskal-Wallis test, Spearman correlation analysis, Chi square test and binary Logistic regression were used for the analysis. Results: The median total score of nutritional literacy among primary and secondary school students in Beijing was 68.8. Approximately 26.0% of primary and secondary school students achieved nutritional literacy standards. The median scores and rates of meeting the standards for nutrition related knowledge concepts, food selection, food preparation and food intake dimensions were 23.0, 42.1%; 17.0, 27.4%; 6.5, 33.5%; 23.0, 33.3%, respectively. There were positive correlations between all pairs of the four dimensions ( r=0.33-0.49, P <0.05). The results of multiple Logistic regression analysis showed that primary school students, junior high school students, female students, suburban students, caregivers with a college education level and a bachelor s degree or above were the positive arrelation factors that promoted the achievement of nutritional literacy standards ( OR =2.21, 1.39, 1.18, 1.27, 1.42, 1.66, P <0.05). Conclusion The literacy level of primary and secondary school students in Beijing needs to be significantly improved. School stage, gender, region and caregiver s education level are associated factors.

Objective:To analyze the distribution of different SF3B1 genotypes in patients with myelodysplastic syndromes (MDS) and its prognostic value.Methods:Totally, 377MDS patients who were initially diagnosed in the First Affiliated Hospital of Nanjing Medical University from January 2014 to January 2022 were included in the retrospective analysis.The patients were divided into three different groups according to mutation stcote of SF3B1, including 317 patients with SF3B1 wild type (SF3B1 WT) (214 males and 103 females, 63(49, 71) years old),39 patients with SF3B1 K700E mutation(SF3B1 K700E(17 males and 22 females, 65(52, 73)years old)) and 21 patients with SF3B1 non-K700E mutation(SF3B1 non-K700E)(13 males and 8 females, 67(63, 73) years old). MDS-related 20 gene mutations were detected using targeted sequencing technology; Survival curves were constructed by the Kaplan-Meier method; Cox proportional hazards model was established to evaluate different factors at diagnosis on survival by univariate and multivariate analyses.. Results:Compared with SF3B1 non-K700E patients, SF3B1 K700E patients had a higher median absolute neutrophil count ( P=0.002) and were likely to be in the low/int-1 International Prognostic Scoring System (IPSS) categories ( P=0.023). A 20-gene targeted sequencing analysis showed that, compared with SF3B1 WT patients, SF3B1 K700E patients were associated with lower frequency of ASXL1 and U2AF1 mutations ( P=0.018 and P=0.003); while compared with SF3B1 non-K700E patients, the frequency of ASXL1 mutation was significantly lower in SF3B1 K700E cases ( P=0.029). Patients with SF3B1 K700E had better overall survival (OS) in comparison with SF3B1 WT and SF3B1 non-K700E in MDS patients ( P<0.001 and P=0.045, respectively). In comparison with SF3B1 WT patients, SF3B1 MUT patients had more favorable OS and progression-free survival (PFS) in MDS without excess blasts ( P<0.001 and P<0.001, respectively), but no significant difference was found in MDS with excess blasts ( P>0.05). Compared with SF3B1 WT patients, SF3B1 K700E patients had superior OS and PFS in the int-1 IPSS category ( P=0.010 and P=0.013, respectively). By multivariable analysis, the presence of SF3B1 K700Ewas an independent predictor of superior OS ( HR=0.461,95% CI 0.262-0.811, P=0.007). Conclusion:SF3B1 K700E and SF3B1 non-K700E patients had significantly improved OS in comparison with SF3B1 WT MDS patients. Furthermore, SF3B1 K700E patients were associated with a better OS compared with SF3B1 non-K700E MDS patients. SF3B1 mutation could not overcome the poor prognostic effect of excess blasts, which highlights the importance of the SF3B1 mutation subtype in risk assessment of MDS without excess blasts.

Objective To observe the application effects of scenario simulation combined with guided feedback teaching method in the teaching of endocrinology nursing interns.Methods A total of 180 nursing students who interned in the endocri-nology department of Southern Medical University Shenzhen Hospital from January 2020 to January 2023 were selected as the re-search subjects.Using a digital randomization method,the students were divided into a control group(90 cases)and an observa-tion group(90 cases).The control group received conventional teaching,while the observation group received scenario-based teaching combined with guided feedback teaching method.The intern performance,satisfaction of teaching instructors toward students,and students'satisfaction with teaching instructors were compared between the two groups.Results The intern per-formance of the observation group was higher and showed a greater improvement after training,with statistically significant differ-ences(P＜0.05).Both the students'satisfaction with teaching instructors and the teaching instructors'satisfaction with students in the observation group were higher than those in the control group,with statistically significant differences(P＜0.05).Conclusion The application of scenario simulation combined with guided feedback teaching method in the teaching of endocri-nology nursing interns can significantly improve students'intern performance,providing a more scientific basis for nursing intern-ship teaching.

Objective:To analyze the epidemiological trends and major risk attribution of pancreatic cancer in China, Japan and South Korea from 1990 to 2019.Methods:The descriptive epidemiological method was conducted. The overall incidence rate, mortality rate, age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of pancreatic cancer in China, Japan and South Korea from 1990 to 2019 were collected from the Global Burden of Disease (GBD) Database. Age-standardized rates were calculated based on the worldwide standardized population structure provided by GBD Database 2019. Observation indicators: (1) incidence and motality of pancreatic cancer in China, Japan and South Korea in 2019; (2) age-period-cohort model analysis of incidence and mortality rates of pancreatic cancer in China, Japan and South Korea from 1990 to 2019; (3) trends of ASIR and ASMR of pancreatic cancer in China, Japan and South Korea from 1990 to 2019; (4) trends of major risk attribution of pancreatic cancer related death in China, Japan and South Korea from 1990 to 2019. Count data were represented as absolute numbers, percentages and ratios. Joinpoint V.4.7.0.0 software was used to calculate the annual percentage change (APC), the average annual percentage change (AAPC) of incidence and mortality rates of pancreatic cancer in different time periods and 95% confidence interval (95% CI). The age-period-cohort model in STATA V.15.0 software was used to analyze the influence of different ages, periods and birth cohorts on the risk of onset and death of pancreatic cancer after controlling the other two variables, with the risk effect size described as relative risk (95% CI). Results:(1) Incidence and motality of pancreatic cancer in China, Japan and South Korea in 2019. In 2019, the incidence rate of pancreatic cancer in China increased from 0.07/100,000 among 15-19 years old to 64.01/100,000 among 85-89 years old, with increasing from 0.09/100,000 to 94.71/100,000 in males and from 0.04/100,000 to 47.47/100,000 in females. The mortality rate of pancreatic cancer in China increased from 0.04/100,000 among 15-19 years old to 79.58/100,000 among 85-89 years old, with increasing from 0.05/100,000 to 116.50/100,000 in males and from 0.03/100,000 to 59.69/100,000 in females. The incidence rate of pancreatic cancer in Japan increased from 0.03/100,000 among 15-19 years old to 162.26/100,000 among 85-89 years old, with increasing from 0.03/100,000 to 177.67/100,000 in males and from 0.04/100,000 to 153.67/100,000 in females. The mortality rate of pancreatic cancer in Japan increased from 0.02/100,000 among 15-19 years old to 154.88/100,000 among 85-89 years old, with increasing from 0.02/100,000 to 170.93/100,000 in males and from 0.02/100,000 to 145.94/100,000 in females. The incidence rate of pancreatic cancer in South Korea increased from 0.04/100,000 among 15-19 years old to 136.78/100,000 among 85-89 years old, with increasing from 0.03/100,000 to 153.78/100,000 in males and from 0.04/100,000 to 129.73/100,000 in females. The mortality rate of pancreatic cancer in South Korea increased from 0.02/100,000 among 15-19 years old to 135.98/100,000 among 85-89 years old, with increasing from 0.02/100,000 to 156.21/100,000 in males and from 0.02/100,000 to 127.59/100,000 in females. The peak incidence and mortality of pancreatic cancer in China were found in males aged 65-69 years, and the overall incidence and mortality of males in different age groups were higher than those of females in the same age group. In Japan, the peak incidence of pancreatic cancer occurred in females aged 80-84 years and the peak mortality occurred in males aged 75-79 years. The morbidity and mortality of males aged <80 years were higher than those of females in the same age group, while the morbidity and mortality of males aged ≥80 years were lower than those of females in the same age group. In South Korea, the peak incidence of pancreatic cancer occurred in females aged 80-84 years, and the peak mortality occurred in males aged 70-74 years. The morbidity and mortality of males aged <75 years were higher than those of females in the same age group, while the morbidity and mortality of males aged ≥75 years were lower than those of females in the same age group. (2) Age-period-cohort model analysis of incidence and mortality rates of pancreatic cancer in China, Japan and South Korea from 1990 to 2019. Age effect: after adjustment for the period and cohort effects, the risk of incidence and mortality rates of pancreatic cancer in both males and females of China, Japan and South Korea increased with age, which is more obvious in females than males, and more obvious in Japanese than Chinese and Korean populations. Period effect: after adjustment for age and cohort effects, the risk of incidence and mortality rates of pancreatic cancer in both males and females of China, Japan and South Korea increased from 1990 to 2019, with the period effect more significant in the Chinese population. Cohort effect: after adjustment for age and period effects, the risk of morbidity and mortality rates of pancreatic cancer decreased with the passage of birth cohort in China, Japan and South Korea. (3) Trends of ASIR and ASMR of pancreatic cancer in China, Japan and South Korea from 1990 to 2019. The ASIR and ASMR of pancreatic cancer in China increased yearly from 1990 to 2019, and the ASIR and ASMR in 2019 were 1.82 times and 1.79 times those in 1990, respectively. The ASIR and ASMR of pancreatic cancer in Japan showed a slowly increasing trend, and the ASIR and ASMR in 2019 were 1.09 times and 1.05 times those in 1990, respectively. The ASIR and ASMR of pancreatic cancer in South Korea increased firstly, then decreased, and slowly increased. From 1990 to 2019, the AAPC of ASIR of pancreatic cancer in China was 2.08% (95% CI as 1.91% to 2.24%, P<0.05) and AAPC of ASMR was 2.02% (95% CI as 1.86% to 2.19%, P<0.05). The AAPC of ASIR of pancreatic cancer in Japan was 0.28% (95% CI as 0.15% to 0.42%, P<0.05) and AAPC of ASMR was 0.13% (95% CI as 0.03% to 0.24%, P<0.05). The AAPC of ASIR of pancreatic cancer in South Korea was 0.50% (95% CI as 0.21% to 0.80%, P<0.05) and AAPC of ASMR was 0.15% (95% CI as -0.10% to 0.40%, P>0.05). (4) Trends of major risk attribution of pancreatic cancer related death in China, Japan and South Korea from 1990 to 2019. The main risk factors for pancreatic cancer related death in China, Japan and South Korea from 1990 to 2019 were smoking, high fasting glucose and high body mass index (BMI). The trend of pancreatic cancer related death, mainly attributed to smoking, showed that the proportion of Chinese males increased from 31.4% in 1990 to 34.1% in 2000, then decreased to 31.1% in 2015, and then showed a slow increase to 31.7% in 2019. The proportion of Chinese females increased from 6.7% in 1990 to 10.4% in 2005 and then dropped to 8.7% in 2019. The proportion of Japanese males decreased from 38.8% in 1990 to 26.9% in 2019 and the proportion of Japanese females decreased from 20.9% in 1990 to 14.8% in 2019. The proportion of South Korean males decreased from 37.5% in 1990 to 30.3% in 2019 and the proportion of South Korean females decreased from 12.6% in 1990 to 10.0% in 2019. The trend of pancreatic cancer related death proportion, mainly attributed to high fasting blood glucose, showed that the proportion of Chinese males increased from 5.9% in 1990 to 7.1% in 2019 and the propor-tion of Chinese females increased from 6.2% in 1990 to 6.8% in 2019. The proportion of Japanese males increased from 7.0% in 1990 to 7.7% in 2019 and the proportion of females increased from 5.0% in 1990 to 5.5% in 2019. The proportion of South Korean males increased from 6.8% in 1990 to 9.7% in 2019 and the proportion of females increased from 6.1% in 1990 to 8.2% in 2019. The trend of pancreatic cancer related deaths proportion, attributed mainly to high BMI, showed that the proportion of Chinese males increased from 1.3% in 1990 to 3.0% in 2019 and the proportion of females increased from 2.1% in 1990 to 4.3% in 2019. The proportion of Japanese males increased from 2.0% in 1990 to 2.4% in 2019 and the proportion of females increased from 3.1% in 1990 to 3.4% in 2019. The proportion of South Korean males increased from 1.9% in 1990 to 3.1% in 2019 and the proportion of females increased from 3.4% in 1990 to 4.3% in 2019. Conclusions:The incidence of pancreatic cancer in China may continue to rise but to be stable in Japan and South Korea. The incidence of pancreatic cancer in females, especially elderly women, needs more attention. Smoking remains the most critical risk factor for pancreatic cancer. More attention should also be paid to the increased risk of pancreatic cancer associated with high BMI and high fasting plasma glucose.