Objective Analyzing the trends and driving factors of China's population structure changes from a global perspective, revealing its commonalities and specificities in reference to global levels, to provide a scientific basis for optimizing public health policies. Methods Integrating the latest authoritative data from sources such as the National Bureau of Statistics, GBD 2023, and the UN Population Division, this study utilizes Joinpoint regression to identify trend inflection points and conducts multidimensional analysis combined with methods such as ArcGIS spatial visualization. Results China's population is characterized by the triple overlapping trends of ^“negative growth, low birth rates, and aging^”. The total population has experienced continuous negative growth since 2022. Taking 2023 as an example, the population pyramid exhibited features of a ^“narrowing base and expanding top^”. The number of people in the 0-year age group was only 42.80% of the 1990 figure, while the population aged 60 and above was 2.89 times that of 1990. Significant interprovincial disparities exist, with some provinces showing a clustering phenomenon of ^“high mortality and low birth rates^”. According to the Seventh National Population Census, the male population was larger, with an overall sex ratio of 105. The sex ratio reached balance (i.e., 100) at age 58 and dropped to just 42 by age 100. The disease spectrum is undergoing rapid transformation: the proportion of deaths attributable to chronic non-communicable diseases increased from 74.26% in 1990 to 90.69% in 2023. Conclusion China's population structure is undergoing accelerated changes characterized by declining fertility and population aging, which have formed a self-reinforcing negative cycle, posing multiple challenges to public health and services. There is an urgent need to establish a targeted policy framework focused on enhancing childbearing support, improving health services and chronic disease management for the elderly, and optimizing long-term care systems to foster a virtuous cycle in the demographic structure and enhance the overall health of the population.

Objective To systematically analyze the trends in life expectancy and healthy life expectancy in China from 1990 to 2023, identify the factors influencing changes in life expectancy, and provide scientific evidence for the Healthy China Strategy. Methods Based on the most recent authoritative data from the Global Burden of Disease Study 2023 (GBD 2023), the United Nations Population Division, the World Bank, and Our World in Data, complete life tables and cause-deleted life tables were constructed. Analytical methods including Joinpoint regression and ARIMA forecasting were comprehensively applied to systematically evaluate life expectancy, survival probability, and the burden of diseases and risk factors. Results From 1990 to 2023, life expectancy at birth in China exhibited sustained and rapid growth (average annual percentage change, AAPC = 0.63%), with a growth rate significantly higher than those observed in the United States, Japan, and the global average (AAPC = 0.12%, 0.21%, and 0.45%, respectively). Survival probability improved across all age groups, with particularly notable gains in children and the oldest-old. Interprovincial and sex-based disparities persisted. Cause-deleted analysis revealed that cardiovascular disease (CVD) accounted for the greatest loss in life expectancy at birth. From 2004 to 2020, years of life lost due to CVD increased annually, reaching 8.70 years in 2020 for the zero-age group in China. Neoplasm ranked second in causing life expectancy loss, which remained relatively stable at approximately 3 years over the study period. Among risk factors, tobacco use, hypertension, air pollution, dietary risks, and high fasting plasma glucose were identified as prominent contributors to life expectancy loss. Strong positive correlations were observed between health resources, economic growth, and life expectancy. Conclusion China has made remarkable progress in extending lifespan and improving quality of life, but it still faces challenges such as chronic diseases limiting lifespan and life quality, diverse health risks, and disparities in health levels and life expectancy across regions and populations.

OBJECTIVE To evaluate the impact of bundle intervention measures on incidence of catheter-related in-fections in patients of neurosurgery intensive care unit(NICU).METHODS The related data regarding to incidence rates of hospital-associated infections and utilization rates of catheters were collected from the NICU patients of Renji Hospital,Shanghai Jiaotong University from 2007 to 2022.The effect of the bundle intervention measures on reducing the incidence of catheter-related infections was analyzed by means of interrupted tune series(ITS)method.RESULTS There was significant difference in the decline trend of incidence of the infections during the study(the trend x2=91.978,P＜0.001).ITS analysis showed that the utilization rate of catheters only presented the decline trend after the intervention(β2=-0.667,P=0.042),the utilization rate of ventilator tubes only de-clined after the intervention(β3=-26.375,P＜0.001).Th utilization rate of central venous catheters showed a downward trend before the intervention(β1=-2.525,P＜0.001)but did not change significantly after the inter-vention.The incidence of central line-associated bloodstream infection(CLABSI)was decreased(RR=0.268,95％CI:0.124 to 0.581),however,there was significant difference in the change of slope(RR=0.912,95％CI:0.730 to 1.140).The incidence of catheter-associated urinary tract infection(CAUTI)showed a downward trend(RR=0.796,95％CI:0.647 to 0.975),however,there was no significant difference in the change of the level(RR=1.543,95％CI:0.816 to 3.005).The incidence of ventilator-associated pneumonia(VAP)showed a downward trend(RR=0.829,95％CI:0.767 to 0.895),however,there was no significant difference in the change of the level(RR=0.817,95％CI:0.595 to 1.114).CONCLUSIONS The bundle intervention measures may effectively reduce the incidence of catheter-related infections.The incidence rates of the catheter-related infections vary in the chan-ging trends after the interventions are taken,indicating that it is necessary to comprehensively take the character-istics of catheter-related infections into account when carrying out the bundle intervention measures and continu-ously optimize the control strategies.

OBJECTIVE To evaluate the impact of bundle intervention measures on incidence of catheter-related in-fections in patients of neurosurgery intensive care unit(NICU).METHODS The related data regarding to incidence rates of hospital-associated infections and utilization rates of catheters were collected from the NICU patients of Renji Hospital,Shanghai Jiaotong University from 2007 to 2022.The effect of the bundle intervention measures on reducing the incidence of catheter-related infections was analyzed by means of interrupted tune series(ITS)method.RESULTS There was significant difference in the decline trend of incidence of the infections during the study(the trend x2=91.978,P＜0.001).ITS analysis showed that the utilization rate of catheters only presented the decline trend after the intervention(β2=-0.667,P=0.042),the utilization rate of ventilator tubes only de-clined after the intervention(β3=-26.375,P＜0.001).Th utilization rate of central venous catheters showed a downward trend before the intervention(β1=-2.525,P＜0.001)but did not change significantly after the inter-vention.The incidence of central line-associated bloodstream infection(CLABSI)was decreased(RR=0.268,95％CI:0.124 to 0.581),however,there was significant difference in the change of slope(RR=0.912,95％CI:0.730 to 1.140).The incidence of catheter-associated urinary tract infection(CAUTI)showed a downward trend(RR=0.796,95％CI:0.647 to 0.975),however,there was no significant difference in the change of the level(RR=1.543,95％CI:0.816 to 3.005).The incidence of ventilator-associated pneumonia(VAP)showed a downward trend(RR=0.829,95％CI:0.767 to 0.895),however,there was no significant difference in the change of the level(RR=0.817,95％CI:0.595 to 1.114).CONCLUSIONS The bundle intervention measures may effectively reduce the incidence of catheter-related infections.The incidence rates of the catheter-related infections vary in the chan-ging trends after the interventions are taken,indicating that it is necessary to comprehensively take the character-istics of catheter-related infections into account when carrying out the bundle intervention measures and continu-ously optimize the control strategies.

Referring to ZHANG Xichun's experience in treating dysentery from cold-fire accumulation， the treatment of ulcerative colitis （UC） in this paper can be divided into three stages including cold-fire accumulation stage， excessive heat and putrid intestine stage， and healthy qi deficiency and pathogen lingering stage. For people with slippery and excess pulse in the cold-fire accumulation stage， Xiaochengqi Decoction （小承气汤） added with Baishao （Radix Paeoniae Alba） and Gancao （Radix et Rhizoma Glycyrrhizae） can be used for purgation， while those with deficient pulse， Huazhi Decoction （化滞汤） or Xieli Decoction （燮理汤） can be used. In the excessive heat and putrid intestine stage， Tongbian Baitouweng Decoction （通变白头翁汤） and Jiedu Shenghua Elixir （解毒生化丹） are suggested. In the healthy qi deficiency and pathogen lingering stage， it is advised to use Jiedu Shenghua Elixir added with Shanyao （Rhizoma Dioscoreae）， and Sanbao Porridge （三宝粥）. Additionally， the medication rules， dosage and administration characteristics of Huanglian （Rhizoma Coptidis）-Rougui （Cortex Cinnamomi）， Yadanzi （Fructus Bruceae）， Diyu （Radix Sanguisorbae）， Shanyao and Liuhuang （Sulphur） by ZHANG Xichun have been summarized with the help of modern pharmacological research， so as to provide new ideas for the treatment of UC by TCM.

Objective The objective of this study was to provide methodological references for the inheritance of the experience of well-known Chinese medicine doctors in the treatment of kidney disease.Methods The study collected medical case data for IgA nephropathy,diagnosed and treated by Professor Yang Nizhi's outpatient department at Guangdong Provincial Hospital of Traditional Chinese Medicine from 2010 to 2020.The data was standardized and divided into three groups:urine and blood,urine turbidity,and renal failure groups.The study utilized the FangNet platform to apply the PageRank algorithm and calculate the THScore of different subgroups of core herbs for IgA nephropathy.The distribution pattern of syndrome differentiation and corresponding herb use regulations were visualized through Python(SciPy package,Clusterheatmap package),and the study explored and verified the drug prescription through exploratory and confirmatory factor analysis based on Pearson correlation coefficient.The weighted least squares estimation mean and variance adjusted(WLSMV)and the oblique rotated GEOMIN method were used with the Mplus software.Results The study included a total of 548 treatments for 145 patients with IgA nephropathy,with heamturia group(54 cases),urine turbidity group(51 cases),and renal failure group(40 cases).Results showed 9 basic syndromes such as Qi deficiency syndrome(91.79%),blood stasis syndrome(77.01%),damp-heat syndrome(66.06%),and Yin deficiency syndrome(38.69%).There are 24 core drugs in total,23 in the urine and blood group,21 in the urine turbidity group,and 16 in the renal failure group.These drugs mainly include qi-tonifying and yang-invigorating drugs,nourishing yin and blood drugs,promoting blood circulation and removing blood stasis drugs,and clearing heat and cooling blood drugs.The regulations for the differentiation and medication of IgA nephropathy(Z-Score>0.5 and P<0.05)were as follows:Huangqi,Shan Zhu Yu,and Tusizi were commonly used in Qi deficiency syndrome;Danshen,Ze Lan,and Shan Zhu Yu were commonly used in blood stasis syndrome;Pu Gong Ying,Shi Wei,Tao Ren,and Tu Fu Ling were commonly used in damp-heat syndrome;and Mo Han Lian,Tai Zi Shen,and Nv Zhen Zi were commonly used in Yin deficiency syndrome.Through exploratory and confirmatory factor analysis,the core drug combination factors for the treatment of IgA nephropathy by Professor Yang Nizhi were obtained as follows:F1(Tusizi,Shan Zhu Yu,Huangqi);F2(White Mao Gen,Xiao Ji,Qian Cao);F3(Nv Zhen Zi,Mo Han Lian,Tai Zi Shen);and F4(Ze Lan,Tao Ren).Conclusion This study analyzed the diagnosis and treatment experience of Professor Yang Nizhi in the treatment of IgA nephropathy by grouping,defining the core syndrome of"Qi deficiency and blood stasis,damp-heat and Yin deficiency",and the core treatment methods of"tonifying Qi,promoting blood circulation,clearing heat,and nourishing Yin"using the PageRank algorithm and Mplus factor analysis.The study provided methodological references for the inheritance of the experience of famous Chinese medicine doctors and promoted the development and utilization of traditional Chinese medicine.

The human gastrointestinal tract is the largest reservoir of bacteria in the body,inhabiting a very complex and active microbial community.Under normal circumstances,the interaction between the intestinal flora and the host maintains a dynamic balance.Spleen deficiency syndrome is a common classic syndrome type in TCM clinical practice.A large number of studies have shown that spleen deficiency syndrome is closely related to intestinal microorganisms,and the balance of intestinal flora is the basis for the normal functioning of the spleen's main transportation and transformation functions.Intestinal flora imbalance can lead to a series of manifestations of spleen deficiency.In addition,intestinal flora is an important medium for the metabolism of polysaccharide components and the effectiveness of traditional Chinese medicine for invigorating the spleen,and traditional Chinese medicine for invigorating the spleen can also play a therapeutic role by regulating the structure and quantity of intestinal flora.This article summarizes the relationship between intestinal flora and spleen deficiency syndrome in physiology,pathology,and the efficacy of traditional Chinese medicine for invigorating the spleen.Based on intestinal flora,the study of spleen deficiency syndrome aims to provide some thoughts and suggestions for revealing the connotation of spleen deficiency syndrome in traditional Chinese medicine.

Objective To analyze the relationship between the relevant imaging signs of the Bosniak classification system version 2019 and the benign or malignant of cystic renal masses(CRMs).Methods The CRMs were graded using the Bosniak classification system version 2019,and the overall inter-observer agreement,and the agreement between different subgroups were compared.In addition,the diagnostic value of benign and malignant lesions with weighted weakened imaging signs,redefined and quantified imaging signs in the Bosniak classification system after upgrading from version 2005 to version 2019 was analyzed.Results Fifty-six CRMs were enrolled,including 43 benign and 13 malignant lesions.Based on the Bosniak classification system version 2019,the overall inter-observer agreement was excellent(Kappa=0.881),while the agreement of ≤30 mm and MRI were moderate(Kappa=0.548,0.722).In the comparison of the differences between benign and malignant CRMs,there were significant differences between the groups in age,lesion maximum diameter,thick septa or cyst wall,number of septa ≥4,mural nodule,and enhancement(P＜0.05).In the logistic regression model,the mural nodule was the only imaging sign that was significantly correlated with the malignant CRMs[odds ratio(OR)=9.842,P=0.022].Conclusion The Bosniak classification system version 2019 has an excellent overall inter-observer agreement.When the lesions are small,MRI can provide more imaging details.The mural nodule is an independent risk factor for malignant CRMs.

Background and Aims:Accurate early pathogen diagnosis is a breakthrough for improving the prognosis of infectious pancreatic necrosis(IPN)patients.However,there is currently a lack of efficient methods for early identification of IPN in clinical settings.This study was performed to assess the application value of next-generation sequencing technology based on metagenomic capture(MetaCAP)in the pathogen diagnosis of IPN. Methods:A prospective study was conducted on 29 patients suspected of having acute necrotizing pancreatitis at Xiangya Hospital of Central South University between January and July 2024.Blood samples were tested using MetaCAP and conventional pathogen culture.The results of peritoneal fluid pathogen culture were used as the gold standard to compare the diagnostic efficacy of the two methods. Results:Due to three cases lacking peritoneal fluid culture results,a total of 26 cases were included in the final analysis.The overall mortality rate was 23.1％(6/26).During hospitalization,9 cases(34.6％)were diagnosed with IPN.The sensitivity and negative predictive value of MetaCAP for diagnosing IPN were significantly higher than those of conventional pathogen culture(77.8％vs.11.1％,P=0.031;86.7％vs.65.2％,P=0.032),while the differences in specificity(76.5％vs.88.2％,P=0.689)and positive predictive value(63.6％vs.33.3％,P=0.347)between the two methods were not statistically significant.The average detection time for MetaCAP was 33(20-49)h,while microbial culture took 125(45-142)h,with a significant difference(P＜0.001).The average cost for blood MetaCAP testing was 2 500 yuan per case,but it accounted for only 1.19％of the average hospitalization cost. Conclusion:MetaCAP has significant value in the early pathogen diagnosis of IPN,with a shorter detection time,good testing efficacy,and health-economic value,demonstrating a promising clinical application prospect.

Sepsis is a life-threatening organ dysfunction caused by the host's dysfunctional response to infection. Sepsis-induced cardiomyopathy (SICM), as a serious complication of sepsis, is an acute reversible cardiac dysfunction syndrome unrelated to myocardial ischemia, which affects the outcome and prognosis of sepsis. As a complex microbial system, gut microbiota has been confirmed to be involved in the development of coronary heart disease, hypertension, heart failure and other cardiovascular diseases, and is also related to the occurrence and development of sepsis. However, there are few studies on the relationship between gut microbiota and SICM. This paper reviews the current research progress on gut microbiota and SICM, aiming at provide a new idea for clinical treatment of SICM.