Over the past three decades， China has made significant progress in the prevention and control of viral hepatitis， and the incidence rates of new-onset pediatric hepatitis B virus infections and acute viral hepatitis in the population have reduced to a relatively low level； however， there is still a heavy disease burden of chronic viral hepatitis in China， which severely affects the health status of the population. This study systematically summarizes the achievements of viral hepatitis prevention and control in China， analyzes existing problems and challenges， and proposes comprehensive prevention and control strategies and measures to eliminate viral hepatitis as a public health threat based on the national conditions of China， in order to provide a reference for related departments in China on how to achieve the action targets for eliminating viral hepatitis as a public health threat by 2030.

Background::Evaluating the impact of digestive system diseases is vital for devising effective prevention strategies. However, comprehensive reports on the burden of digestive system diseases in China are lacking. Our study aimed to provide an overview of the burden and trends of digestive system diseases from 1990 to 2019 in China and its provinces.Methods::This cross-sectional study utilized the Global Disease Burden Study 2019 to estimate the incidence, mortality rate, disability-adjusted life years (DALYs), years of life disability, years of life lost, and changes in the burden of digestive diseases across Chinese provinces from 1990 to 2019. The analysis of disease burden primarily examines the characteristics of sub-disease distribution, time trends, age distribution, and sex distribution. Additionally, we compared provincial age-standardized DALYs for digestive diseases with the expected rates based on the socio-demographic index (SDI).Results::In 2019, there were 499.2 million cases of digestive system diseases in China, resulting in 1,557,310 deaths. Stomach cancer, colon and rectal cancer, and esophageal cancer are the top three diseases associated with mortality and DALY related to digestive system diseases. Meanwhile, cirrhosis and other chronic liver diseases, gastroesophageal reflux disease, and gallbladder and biliary diseases are the top three kinds of diseases with the highest prevalence among digestive system diseases. The risk of gastric cancer sharply increases among men after the age of 40 years, leading to a significant disparity in burden between men and women. As the SDI increased, the DALYs associated with digestive system diseases in China and its provinces showed a downward trend.Conclusion::Our study highlights the inverse correlation between DALYs associated with digestive system diseases and the SDI.

Objective:To investigate the association between diet, physical activity and cognitive impairment among elderly patients with diabetes mellitus.Methods:This study investigated patients aged 60 years and above with type 2 diabetes in the Department of Endocrinology at Penglai People's Hospital from October 2021 to May 2022.Information on patients' demographics, lifestyle, disease history, daily diet, physical activities, and social network was collected using questionnaires.The Montreal Cognitive Assessment(MoCA)was utilized to evaluate the cognitive status of the participants.A logistic regression model was conducted to identify the associations between diet, physical activity, and cognitive impairment.Results:A total of 1 355 patients aged 60 years and above with type 2 diabetes were included in this study.During the assessment, 565(41.7%)patients were identified as having cognitive impairment.After adjusting for other factors, it was found that alcohol consumption was associated with a higher risk of cognitive impairment( OR: 1.45, 95% CI: 1.04-2.04, P=0.03).Furthermore, patients with diabetes who consumed fruits more than once a day had a higher risk of cognitive impairment( OR: 1.52, 95% CI: 1.20-1.93, P<0.001).On the other hand, the consumption of vegetables was found to be negatively associated with the risk of cognitive impairment( OR: 0.41, 95% CI: 0.24-0.68, P=0.001).Additionally, engaging in physical activities and having a strong social network were found to significantly reduce the risk of cognitive impairment( OR: 0.49, 95% CI: 0.39-0.64, P<0.001; OR: 0.56, 95% CI: 0.43-0.71, P<0.001)respectively. Conclusions:Our findings indicate a significant association between diet, physical activity, and cognitive function in elderly individuals with type 2 diabetes.It is crucial to identify and intervene on risk factors to delay and prevent cognitive impairment.Furthermore, these interventions may also aid diabetes patients in effectively managing their cognition.

Objective To establish a HS-GC test method for the determination of enflurane,isoflurane,diflurane,sevoflurane and its metabolite hexafluoroisopropanol(HFIP)in blood,and to establish a LC-MS/MS method for the determination of trifluoroacetic acid(TFA),the co-metabolite of enflurane,isoflurane,and deflurane in blood.Methods Place 0.5 mL blood sample in a 10 mL headspace bottle,add 1.0 mL ultrapure water to mix,then add 0.5 mL n-butanol internal standard solution,sealed and heated at 70℃for 20 min,take the upper layer of gas for HS-GC analysis,qualitatived by dual-column retention time and quantified by the internal standard curve;Blood sample was acetonitrile precipitated protein,separated by liquid chromatography,scanned with electrospray ionization(ESI),negative ion mode,and examined in multiple reaction monitoring mode(MRM),qualitatived by retention time and characteristic ions,quantified by standard curve.Results The detection limits(LOD)of enflurane,isoflurane,desflurane,heptaflurane,HFIP and TFA are 0.05,0.2,0.5,0.05,0.5 μg/mL and 0.5 ng/mL,and linear range as 1～100 μg/mL(TFA:1～100 ng/mL),with correlation coefficients greater than 0.999.The extraction recovery rate is between 30%and 80%,and the intra-day and inter-day precision are less than 5%.The accuracy is between 85%and 115%.Conclusion This method is quick and simple,and can be used for qualitative and quantitative analysis of enflurane,isoflurane,desflurane,sevoflurane and their metabolites in blood.

Objective To explore the optimal phases of reconstructed CT images under different heart rates based on dynamic phantom system simulating the motion of left ventricle and coronary arteries.Methods A dynamic phantom system which could simulate the periodic movements of the heart at 50-120 beats per minute(bpm)and the output of electrocardiogram signals was constructed.CT scanning were performed in the simulated R-R interval,and images were reconstructed with every 10％interval between 0 to 90％phases.Then subjective image quality scoring was performed,and inter-observer consistency of image quality scores was assessed.Finally the qualities of reconstructed images were compared among different phases under different heart rates.Results The inter-observer consistency of subjective imaging quality scores was high(Kendall W=0.83,P＜0.05).Under 50-60 bpm simulated heart rates,good reconstructed image qualities were obtained at most phases,especially at 30％,70％and 80％(all P＜0.05).When simulated heart rates were set as 65-75 bpm,the best reconstructing phases included 40％,70％and 80％(all P＜0.05),and images obtained in diastolic phase were better.Under 80-95 bpm,the best reconstructing phase was 30％(all P＜0.05).When the simulated heart rate reached 100 bpm and above,the reconstructed image qualities were poor at all phases.Conclusion The optimal reconstructed phases were different under different heart rates based on dynamic phantom system simulating the motion of left ventricle and coronary arteries.When the simulated heart rate reached 100 bpm and above,the qualities of reconstructed images were poor under all phases.

Recent progress in targeted metabolic therapy of cancer has been limited by the considerable toxicity associated with such drugs. To address this challenge, we developed a smart theranostic prodrug system that combines a fluorophore and an anticancer drug, specifically 6-diazo-5-oxo-l-norleucine (DON), using a thioketal linkage (TK). This system enables imaging, chemotherapy, photodynamic therapy, and on-demand drug release upon radiation exposure. The optimized prodrug, DON-TK-BM3, incorporating cyanine dyes as the fluorophore, displayed potent reactive oxygen species release and efficient tumor cell killing. Unlike the parent drug DON, DON-TK-BM3 exhibited no toxicity toward normal cells. Moreover, DON-TK-BM3 demonstrated high tumor accumulation and reduced side effects, including gastrointestinal toxicity, in mice. This study provides a practical strategy for designing prodrugs of metabolic inhibitors with significant toxicity stemming from their lack of tissue selectivity.

BACKGROUND:Bacterial infections and impaired angiogenesis have been obstacles to diabetic wound healing,and the problem of multidrug resistance cannot be ignored,so there is an urgent need to find a new therapeutic strategy. OBJECTIVE:To prepare platelet-camouflaged silver nanoparticle hydrogel and observe its therapeutic effect on diabetic wounds. METHODS:(1)In vitro test:The ultra-small silver nanoparticles(usAgNPs)were obtained by reflux heating.usAgNPs-PL/CMC hydrogel was prepared by coupling it with platelets(PL)and adding it to the carboxymethyl cellulose(CMC)hydrogel.The microstructures,swelling properties,and mechanical properties of the hydrogel were characterized.The antibacterial activity of the hydrogel was tested by 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)5[(phenylamino)carbonyl]-2H-tetrazolium hydroxide method,reactive oxygen species method,bacterial biofilm method,and bacterial activity.(2)In vivo test:Forty SD rats were randomly divided into sham operation group,model group,CMC hydrogel group,usAgNPs/CMC hydrogel group,and usAgNPs-PL/CMC hydrogel group,with eight rats in each group.The type 1 diabetes model was established in the other four groups except the sham operation group.After successful model establishment,a skin wound(20 mm in diameter)deep to the fascia layer was made on the back of rats of the five groups.Rats in the sham operation group and model group were injected with normal saline.The rats in the CMC hydrogel group,usAgNPs/CMC hydrogel group,and usAgNPs-PL/CMC hydrogel group were implanted with the corresponding hydrogel,separately.The wound healing condition and healing quality were observed after 14 days of treatment. RESULTS AND CONCLUSION:(1)In vitro test:The usAgNPs-PL/CMC hydrogel had a uniform three-dimensional network structure,good mechanical properties,and strong water absorption ability,which could remarkably inhibit the growth of Escherichia coli and Staphylococcus aureus,and had a good inhibition and clearance effect on the formation of biofilms of the two bacteria,and had a good antibacterial ability.(2)In vivo test:After 14 days of treatment,the wounds of the usAgNPs-PL/CMC hydrogel group were basically closed.The wound healing rate was the highest,and the number of wound colonies was significantly lower than that of the model group.After 14 days of treatment,hematoxylin-eosin and Masson staining showed that the tissue structure of regenerated dermis appeared on the wounds of the usAgNPs-PL/CMC hydrogel group,usAgNPs/CMC hydrogel group,and CMC hydrogel group,and the epidermis of the new granulation tissue was complete and thick.Parallel mature collagen fibers were observed in the usAgNPs-PL/CMC hydrogel group.After 7 days of treatment,CD31 immunohistochemistry and Ki67 immunofluorescence staining showed that the usAgNPs-PL/CMC hydrogel group had the highest number of microvessels and fibroblasts.(3)The results showed that usAgNPs-PL/CMC hydrogel could accelerate wound healing in type 1 diabetic rats by rapidly inhibiting bacteria and promoting angiogenesis.

Objective:To investigate the association between hyperuricemia and the risk for stroke occurrence, as well as the mediating effect of hypertension on this association.Methods:In this study, the China Chronic Diseases and Nutrition Surveillance system in 2015 was used as baseline data. We identified hospital admissions for stroke using the electronic homepage of inpatient medical records from 2013-2020, and death data were obtained from the 2015-2020 National Mortality Surveillance System. A retrospective cohort was established after matching and linking the database. The Cox proportional hazard regression model was used to analyze the relationship between hyperuricemia and the risk of stroke and its subtypes. Restricted cubic spline analysis was conducted to examine the dose-response relationship between serum uric acid levels and the risk for stroke. Mediation analysis was performed to investigate the mediating effect of hypertension on the association between hyperuricemia and the risk for stroke and its subtypes. Subgroup analyses were conducted based on gender and age groups.Results:A total of 124 352 study subjects were included, with an accumulative follow-up time of 612 911.36 person-years. During the follow-up period, 4 638 cases of stroke were found, including 3 919 cases of ischemic stroke and 689 cases of hemorrhagic stroke. The incidence density of stroke was 756.72 per 100 000 person-years, 641.37 per 100 000 person-years for ischemic stroke, and 114.60 per 100 000 person-years for hemorrhagic stroke. Multivariable Cox proportional hazards regression models showed that after adjusting for covariates, compared to those without hyperuricemia, individuals with hyperuricemia had a 16% higher risk for stroke [hazard ratio ( HR)=1.16, 95% CI: 1.06-1.27], a 12% higher risk of ischemic stroke ( HR=1.12, 95% CI: 1.01-1.24), and a 39% higher risk of hemorrhagic stroke ( HR=1.39, 95% CI: 1.11-1.75). Mediation analysis showed that hypertension partially mediated the associations between hyperuricemia and the risk for stroke, ischemic stroke, and hemorrhagic stroke, with mediation proportions of 36.07%, 39.98%, and 25.34%, respectively. The mediating effect is pronounced in the male population and individuals below 65. Conclusion:Hyperuricemia is a risk factor for stroke, and hypertension partially mediates the effect of hyperuricemia on stroke.

Qingyan Dropping Pills have the effects of relieving wind and heat, detoxifying, and promoting the pharynx. It is commonly used in traditional Chinese medicines to treat acute and chronic pharyngitis, as well as sore throats and dry throats caused by surgery. Recently, many studies have shown that Qingyan Dropping Pills have certain effects on bacteriostasis, anti-inflammatory, antioxidant, and antiviral activities. As the coronavirus disease 2019 (COVID-19) pandemic enters the post-epidemic era, the regular use of drugs for COVID-19 pandemic symptoms has become a new trend. Therefore, there is a good market prospect to explore and develop Chinese patent medicines with antiviral effects. A preliminary study on the herbal formula and material basis of Qingyan Dropping Pills revealed that they have potential for antiviral applications. In this paper, the research on the quality study and antiviral effect of Qingyan Dropping Pills was reviewed, and the research direction of its secondary development was discussed to provide ideas and references for the new use of old traditional Chinese medicines.

To explore the effect of doctor-patient relationship perception on work performance among medical staff in public hospitals and its mechanism. The convenient sampling method was used to select 380 medical staff working in four public tertiary hospitals in Sichuan Province, Zhejiang Province, and Fujian Province from August 2022 to October 2022 as the research objects, and the General Information Questionnaire, Doctor-Patient Relationship Scale, General Self-Efficacy Scale, Perceived Organizational Support Scale, Work Performance Questionnaire were used. This paper showed that the doctor-patient relationship perception of medical staff was negatively correlated with self-efficacy (r=-0.392, P<0.01) and work performance (r=-0.286, P<0.01), self-efficacy was positively correlated with perceived organizational support (r=0.538, P<0.01) and work performance (r=0.507, P<0.01), perceived organizational support was positively correlated with work performance (r=0.510, P<0.01). Self-efficacy played a partial mediating role between doctor-patient relationship perception and work performance, and its effect value was -0.241, accounting for 64.78% of the total effect. Perceived organizational support weakened the negative predictive effect of doctor-patient relationship perception on self-efficacy, which moderates the first half path of the mediating model that doctor-patient relationship perception affects work performance through self-efficacy. It indicated that the doctor-patient relationship perceived by medical staff in public hospitals is poor. Measures should be taken from the aspects of policy support, hospital and society levels to alleviate the doctor-patient relationship, play the mediating role of self-efficacy and the moderating role of organizational support, minimize the negative impact of doctor-patient relationship on the work performance among medical staff, and improve the work performance of medical staff, so as to improve the overall quality of medical services.