This article systematically reviews the current research status as well as diagnosis and treatment strategies of traditional Chinese medicine （TCM） for gastroesophageal reflux disease （GERD）. Studies demonstrate that TCM， based on the "disease-syndrome combination" approach， exhibits multi-target advantages in alleviating symptoms of various GERD subtypes， promoting mucosal repair， regulating emotions， and facilitating the reduction of western medication. To address clinical challenges such as symptom overlap and limited therapeutic efficacy， strategies have been proposed including "treating different diseases with the same method" and integrated regulation based on viscera correlation. Future efforts should focus on elucidating the mechanisms of compound prescriptions， promoting TCM drug development under the "three-combination" evaluation framework that integrates TCM theory， human experience and clinical trial evidence， and optimizing integrated traditional and western medicine models to enhance GERD management.

ObjectiveTo investigate a suspected outbreak of healthcare-associated infection with carbapenem-resistant Klebsiella pneumoniae (CRKP) in a geriatric emergency ward, and to provide references for the prevention and control of multidrug-resistant bacteria in a hospital in Shanghai. MethodsOn-site epidemiological investigation, combined with environmental hygiene monitoring and pulsed field gel electrophoresis (PFGE) molecular typing method, were adopted to investigate a suspected outbreak of CRKP infection in the geriatric emergency ward of a hospital from October to November 2022, aiming at finding out factors caused the outbreak before taking corresponding control measures. ResultsA total of 3 cases of healthcare-associated CRKP infection were identified, of which 2 cases were homologous to a previous case of community-associated CRKP infection. What’s more, the 2 cases lived in the same ward with the latter and with adjacent beds, but the third case was non-homologous to the community-associated infection case. A total of 46 samples were collected from the environmental surfaces and the hands of healthcare workers, of which 7 samples tested positive for CRKP and were identical to the strains from the 2 healthcare-associated infection cases and the 1 community-associated infection case, originating from the bedrails, bedside tables, surface of non-invasive ventilator, bed curtains and panels of monitoring equipment, with a detection rate of 15.22%. But none of the 11 samples from the hands of healthcare workers tested positive for CRKP. The outbreak was effectively controlled after taking specific prevention and control measures such as strengthening personnel management, intensifying environmental cleaning and disinfection and strictly enforcing hand hygiene among healthcare workers. Subsequently, no similar new cases were reported during the 14-day follow-up period. ConclusionIncomplete environmental cleaning and disinfection, as well as inadequate enforcement of hand hygiene among heatheare workers may have contributed to the suspected outbreak of CRKP in the geriatric emergency ward. Early warning and timely investigation of suspected outbreaks of multidrug-resistant bacteria are crucial for preventing and controlling such outbreaks in hospitals.

Acute kidney injury (AKI) is a critical clinical condition characterized by rapid renal function decline, with high morbidity, mortality, and healthcare costs. Traditional Chinese medicine (TCM) has shown potential effects on mitigating oxidative stress and programmed cell death in AKI models. Scutellaria barbata D. Don (SB) and Scleromitrion diffusum (Willd.) R. J. Wang (SD), a classic TCM herbal pair exhibited anti-inflammatory and antioxidant activities. Using advanced chromatographic separation technology, we enriched the effective fractions of water extracts from SB-SD, obtaining self-assembled herbal nanoparticles (SB and SD nanoparticles, SSNPs) rich in flavonoids and terpenoids. These SSNPs demonstrated robust antioxidant properties in vitro and mitigated AKI progression in vivo by activating the nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway. Oral administration of SSNPs in mice resulted in absorption into the bloodstream, formation of a protein corona, reduced macrophage phagocytosis, and enhanced bioavailability and renal targeting. Furthermore, we investigated the self-assembly principle of SSNPs using representative flavonoids and terpenoids. Kinetic studies and in situ transmission electron microscopy (in situ TEM) revealed that these compounds self-assemble via supramolecular forces like hydrogen bonding and π-π interactions, forming stable nanostructures. This study elucidates the renoprotective effects and mechanisms of SB and SD, and provides a novel approach for the development of TCM-based nanomedicines, highlighting the potential of nano-TCM in AKI treatment.

In the global public health field,healthcare-associated infection(HAI)has become one of the important factors affecting patient safety,decreasing medical quality,and increasing medical expense.This paper comprehen-sively analyzes relevant research in recent years,deeply explores the relationship between the use of different types of drugs and HAI,including antimicrobial agents,immunosuppressants,and proton pump inhibitors,aiming to systematically review the risk factors and pathogenicity of drug-related HAI in hospitalized patients both domestica-lly and internationally,so as to provide theoretical basis for the prevention and control of HAI.

Meat food is an important part of people's dietary supplements,but in recent years,meat adulteration cases are hidden and frequent,which seriously affects people's health and destroys the fairness of the market.Based on this,this paper analyses the development trend of meat adulteration and the current meat adulteration detection technology is summarized,combed in detail the use of the most widely used real-time fluorescence quantitative PCR technology application of the status quo and challenges to help real-time fluorescence quantitative PCR technology testing in meat adulteration evidence testing to the direction of more high detection efficiency and higher accuracy development.

Objective:To understand the trends of the disease burden of Alzheimer's disease(AD)attributable to high body mass index(BMI)and high fasting plasma glucose(FPG)in the past 30 years and future trends in China, and to provide suggestions for the prevention and treatment of AD.Methods:Based on the Global Burden of Disease Research Database(GBD), data on AD deaths and disability adjusted life years(DALYs)attributable to high BMI and high FPG were collected from 1990 to 2021 in Chinese and global populations.The Joinpoint log-linear regression model was used to explore and compare the changing trends of AD burden in China and globally from 1990 to 2021, and a Bayesian age-period-cohort model was constructed for predictive analysis.Results:In 2021, the age-standardized mortality and DALYs rates of AD attributed to high BMI in the Chinese population were 1.256/100, 000 and 24.751/100, 000, respectively, and those attributed to high FPG were 3.636/100, 000 and 66.721/100, 000, respectively.The age-standardized rates of mortality and DALYs of females were both higher than those of males.From 1990 to 2021, the age-standardized rates of mortality and DALYs of AD attributed to high BMI increased slowly at first and then rapidly in China, the corresponding average annual percent change(AAPC)and 95% confidence interval(95% CI)were 9.87%(9.63%-10.12%), and 9.81%(9.54%-10.09%), respectively( P<0.001). The age-standardized rates of mortality and DALYs of AD caused by high FPG showed a fluctuating upward trend, with AAPC of 0.29%(95% CI: 0.17%-0.41%)and 0.53%(95% CI: 0.45%-0.61%), respectively( P<0.001). It is predicted that by 2030, the age-standardized rates of mortality and DALYs of AD attributed to high BMI and high FPG in the whole population of China will increase to 4.87/100 000 and 97.20/100 000, both lower than the global level(5.45/100 000 and 100.24/100 000). In addition to a slight decline in the age-standardized mortality rate in Chinese men, the age-standardized rates of mortality and DALYs attributed to high BMI and high FPG in Chinese women and the global population will both show an upward trend. Conclusions:The burden of AD attributed to high BMI and high FPG is relatively severe, with gender differences, and is expected to increase slightly by 2030.It is recommended that early identification of key high-risk populations of AD should be strengthened, especially for the elderly and female groups.Interventions targeting modifiable risk factors should be carried out, and effective measures should be adopted to reduce the burden of AD.

Objective:To investigate the value of coronary CTA (CCTA)-based traditional features and radiomics of plaque in the identification of culprit lesions that caused acute myocardial infarction (AMI).Methods:This was a retrospective multicenter study. From July 2016 to November 2023, a total of 344 patients from the Affiliated Hospital of Qingdao University (training cohort, n=184), Shandong Provincial Hospital Affiliated to Shandong First Medical University (validation cohort, n=88) and Qilu Hospital of Shandong University (test cohort, n=72) who received percutaneous coronary intervention (PCI) due to AMI and underwent CCTA within 48 hours of AMI were enrolled. The culprit plaques and non-culprit plaques were identified using a combination of electrocardiogram, CCTA, and angiographic findings. The vessel, plaque location, plaque type, Coronary Artery Disease-Reporting and Data System (CAD-RADS) score, high-risk plaque characteristics, plaque length, plaque volume, and burden were analyzed, and 1 904 radiomics features were extracted for each plaque. The traditional imaging model, the radiomics model, and the combined model were established by using multivariate Logistic regression analysis. The area under the receiver operating characteristic curve (AUC) was used to evaluate the performance of each model in identifying culprit lesions. The DeLong test was used for the comparison of AUC between every two models. The net reclassification index (NRI) was used to evaluate the incremental value of the combined model to the traditional imaging model and the radiomics model. The decision curve analysis (DCA) was used to assess the clinical net benefit of these models. A correlation heatmap was used to evaluate the correlation between the radiomics score and traditional CCTA factors. The interpretable analysis of the decision process of the combined model was performed by the Shapley Additive exPlanations (SHAP). Results:In the validation cohort and the test cohort, the AUC of the traditional imaging model developed by the vessel, plaque type, positive remodeling and CAD-RADS score was 0.898 (95% CI 0.869-0.922) and 0.881 (95% CI 0.848-0.910), respectively. The radiomics model developed by six radiomics features was 0.863 (95% CI 0.831-0.891) and 0.863 (95% CI 0.827-0.864), respectively. The AUC of the combined model was 0.930 (95% CI 0.905-0.950)and 0.919 (95% CI 0.889-0.942), respectively. In the validation cohort and the test cohort, the AUC of the combined model was higher than that of the traditional imaging model ( Z=4.013, 4.272, P<0.001) and that of the radiomics model ( Z=4.819, 3.784, P<0.001), respectively. In the validation cohort, the combined model yielded an NRI of 20.43% (95% CI 10.43%-30.44%, P<0.001) and 20.21% (95% CI 9.62%-30.80%, P<0.001) for identifying culprit lesions compared with the traditional imaging model and the radiomics model, respectively. In the test cohort, the combined model yielded an NRI of 28.05% (95% CI 16.72%-39.38%, P<0.001) and 23.57% (95% CI 13.58%-33.56%, P<0.001) for identifying culprit lesions compared with the traditional imaging model and the radiomics model, respectively. DCA showed the combined model had the highest clinical net benefit. The correlation heatmap showed the radiomics score was not correlated or only weakly correlated with traditional CCTA factors. SHAP indicated the radiomics and CAD-RADS score contributed significantly to the model. Conclusion:The CCTA-based traditional features and radiomics of plaque have favorable performance for the identification of culprit plaques in patients with AMI.

Objective:To understand the trends of the disease burden of Alzheimer's disease(AD)attributable to high body mass index(BMI)and high fasting plasma glucose(FPG)in the past 30 years and future trends in China, and to provide suggestions for the prevention and treatment of AD.Methods:Based on the Global Burden of Disease Research Database(GBD), data on AD deaths and disability adjusted life years(DALYs)attributable to high BMI and high FPG were collected from 1990 to 2021 in Chinese and global populations.The Joinpoint log-linear regression model was used to explore and compare the changing trends of AD burden in China and globally from 1990 to 2021, and a Bayesian age-period-cohort model was constructed for predictive analysis.Results:In 2021, the age-standardized mortality and DALYs rates of AD attributed to high BMI in the Chinese population were 1.256/100, 000 and 24.751/100, 000, respectively, and those attributed to high FPG were 3.636/100, 000 and 66.721/100, 000, respectively.The age-standardized rates of mortality and DALYs of females were both higher than those of males.From 1990 to 2021, the age-standardized rates of mortality and DALYs of AD attributed to high BMI increased slowly at first and then rapidly in China, the corresponding average annual percent change(AAPC)and 95% confidence interval(95% CI)were 9.87%(9.63%-10.12%), and 9.81%(9.54%-10.09%), respectively( P<0.001). The age-standardized rates of mortality and DALYs of AD caused by high FPG showed a fluctuating upward trend, with AAPC of 0.29%(95% CI: 0.17%-0.41%)and 0.53%(95% CI: 0.45%-0.61%), respectively( P<0.001). It is predicted that by 2030, the age-standardized rates of mortality and DALYs of AD attributed to high BMI and high FPG in the whole population of China will increase to 4.87/100 000 and 97.20/100 000, both lower than the global level(5.45/100 000 and 100.24/100 000). In addition to a slight decline in the age-standardized mortality rate in Chinese men, the age-standardized rates of mortality and DALYs attributed to high BMI and high FPG in Chinese women and the global population will both show an upward trend. Conclusions:The burden of AD attributed to high BMI and high FPG is relatively severe, with gender differences, and is expected to increase slightly by 2030.It is recommended that early identification of key high-risk populations of AD should be strengthened, especially for the elderly and female groups.Interventions targeting modifiable risk factors should be carried out, and effective measures should be adopted to reduce the burden of AD.

In the global public health field,healthcare-associated infection(HAI)has become one of the important factors affecting patient safety,decreasing medical quality,and increasing medical expense.This paper comprehen-sively analyzes relevant research in recent years,deeply explores the relationship between the use of different types of drugs and HAI,including antimicrobial agents,immunosuppressants,and proton pump inhibitors,aiming to systematically review the risk factors and pathogenicity of drug-related HAI in hospitalized patients both domestica-lly and internationally,so as to provide theoretical basis for the prevention and control of HAI.

Objective:To explore the evaluation method for key performance indicators of autonomous ultrasound scanning robots,so as to establish a testing scheme and conduct experiments.Methods:Based on the working principle of autonomous ultrasound scanning robots,three key performance indicators,which included scanning speed,scanning contact force,and accuracy of online adjustment,were established.The speed of the robotic arm,which execute autonomous scanning,was tested through laser rangefinders and a design of process equipment for displacement.The contact force of autonomous scanning was monitored and evaluated using a combination of ultrasound phantom and sensor with six-dimensional force.The displacement differences of phantom and robotic arm were monitored to evaluate the accuracy of online adjustment through designed a synchronization detection device for the displacements of phantom and robotic arm.Results:This research designed and provided test method and test device,which realized successful measurements for the speed,contact force,and accuracy of online adjustment in autonomous scanning of the ultrasonic scanning robot.Conclusion:The speed,contact force,and accuracy of online adjustment in scanning can be used as evaluation indicators of systematic performance of autonomous ultrasound scanning robots.The feasibility of these indicators is demonstrated through designed evaluation methods and corresponding experiments.