To explore the role of the "Clinical Practice Guidelines" column and others in the Medical Joumnal of Peking Union Medical College Hospital (Med J PUMCH) in promoting diseiplinary development.

Objective: To analyze the trends in new diagnosis rates of HIV/AIDS cases in Huzhou City, Zhejiang Province from 2009 to 2023, so as to provide the basis for improving HIV/AIDS prevention and control strategies. Methods: Data of newly reported HIV/AIDS cases in Huzhou City from 2009 to 2023 were collected through the Chinese Disease Prevention and Control Information System. The new diagnosis rate was calculated as the ratio of newly reported HIV/AIDS cases within one year to the permanent resident population during the same period. The gender, age, and regional distribution characteristics of new diagnosis rates of HIV/AIDS cases were described. The trends were analyzed using average annual percent change (AAPC) and annual percent change (APC). Results: A total of 2 088 new HIV/AIDS cases were reported in Huzhou City from 2009 to 2023, with an average annual new diagnosis rate of 4.53/105. The new diagnosis rates showed an overall increasing trend from 2009 to 2023 (AAPC=12.745%, P<0.05), with rapid growth during 2009 to 2015 (APC=32.734%, P<0.05) but no significant trend during 2015 to 2023 (P>0.05). The average annual new diagnosis rate was significantly higher in males than in females (7.54/100 000 vs. 1.40/100 000, P<0.05). Male new diagnosis rate trend closely mirrored the overall population pattern, while females showed a continuous upward trend without clear inflection point (AAPC=12.575%, P<0.05). Age-specific analysis revealed average annual new diagnosis rates of 2.75/100 000, 6.16/100 000 and 3.83/100 000 for AIDS/HIV cases aged <25, 25-<50 and ≥50 years, respectively. The cases aged <25 years showed no significant trend (P>0.05), while the cases aged 25-<50 and ≥50 years followed patterns similar to the overall population. The average annual new diagnosis rates of HIV/AIDS cases in Wuxing District, Nanxun District, Deqing County, Changxing County and Anji County were 6.54/100 000, 3.43/100 000, 3.45/100 000, 3.56/100 000 and 4.94/100 000, respectively, showing overall upward trends (AAPC=9.672%, 27.599%, 11.800%, 18.896% and 10.254%, all P<0.05). Conclusions The new diagnosis rate of HIV/AIDS cases showed an overall upward trend in Huzhou City from 2009 to 2023. Cases are mainly concentrated among males, people aged 25-<50 years and Wuxing District, making them key targets for HIV/AIDS prevention and control.

Objective:To elucidate the etiological and epidemiological characteristics and epidemiological patterns of viral acute respiratory infections (ARI) in Shanghai during 2023, with the aim of providing robust laboratory evidence for effective prevention and control strategies against related respiratory diseases and facilitating risk assessment.Methods:Respiratory pathogens were detected in the clinical surveillance specimens submitted by sentinel hospitals through multiplex PCR, as part of the multi-pathogen surveillance of acute respiratory infections in Shanghai during 2023. The obtained detection result were statistically analyzed in conjunction with sample information.Results:The positive detection rate of viral pathogens in 2023 was 21.17% (984/4 648), with rates of 33.53% (504/1 503) observed in ILI cases and 15.62% (480/3 145) in SARI cases. Influenza A virus (FluA) was the predominant virus detected, accounting for 13.7% (637/4 648). Other viruses identified in the surveillance samples included influenza B virus (Flu B), human rhinovirus/enterovirus (HRV/HEV), respiratory syncytial virus (RSV), human metapneumovirus (HMPV), parainfluenza virus (PIV), adenovirus (ADV) and human bocavirus (HBoV). Regarding temporal distribution, HRV/HEV and RSV exhibited the highest detection rates during the second quarter at 2.27% each (28/1 236). PIV had its peak during the third quarter at a rate of 2.49% (35/1 405), and HMPV showed prevalence mainly during the third and fourth quarters, with detection rates of 2.63% (37/1 405) and 2.35% (32/1 360), respectively.Conclusions:In acute respiratory infection surveillance cases in Shanghai in 2023, Flu A emerged as the predominant respiratory pathogen. The detection rate of HMPV ranked second only to Flu A, while other respiratory viruses such as HRV/HEV, RSV, and PIV were detected during different seasons and co-circulated. The prevalence of various respiratory viruses varied among different infected populations and over times.

Objective:This study focused on the importance of mutual recognition of medical ethics review and the necessity of collaborative governance, combining with the current situation of mutual recognition of medical ethics review in China, and analyzing the difficulties in promoting mutual recognition of review and exploring improvement strategies.Methods:A literature research method was used to sort, summarize, refine and conclude the findings of the literature related to mutual recognition of medical ethics review.Results:Challenges persisted in the mutual recognition of medical ethics review in China, including inadequate impetus for mutual recognition among medical institutions, insufficient system and organizational support, limited acknowledgment of the audit unit's review capacity, and a lack of coordination and cooperation mechanisms.Conclusions:Implementing effective measures in benefit coordination, system and organization coordination, ability coordination, and platform coordination will facilitate the mutual recognition of medical ethics review.

Zearalenone(ZEN)is a mycotoxin that extensively contaminates food and feed,posing a significant threat to public health.However,the mechanisms behind ZEN-induced intestinal immunotoxicity remain unclear.In this study,Sprague-Dawley(SD)rats were exposed to ZEN at a dosage of 5 mg/kg/day b.w.for a duration of 14 days.The results demonstrated that ZEN exposure led to notable pathological alterations and immunosup-pression within the intestine.Furthermore,ZEN exposure caused a significant reduction in the levels of apolipoprotein E(ApoE)and liver X receptor(LXR)(P＜0.05).Conversely,it upregulated the levels of myeloid-derived suppressor cells(MDSCs)markers(P＜0.05)and decreased the presence of 27-hydroxycholesterol(27-HC)in the intestine(P＜0.05).It was observed that ApoE or LXR agonists were able to mitigate the immunosuppressive effects induced by ZEN.Additionally,a bioinformatics analysis highlighted that the downregulation of ApoE might elevate the susceptibility to colorectal,breast,and lung cancers.These find-ings underscore the crucial role of the 27-HC/LXR/ApoE axis disruption in ZEN-induced MDSCs proliferation and subsequent inhibition of T lymphocyte activation within the rat intestine.Notably,ApoE may emerge as a pivotal target linking ZEN exposure to cancer development.

OBJECTIVE To explore the effects of multi-disciplinary comprehensive management team of tertiary hospital collaborated with the pharmacists from community health service center （hereinafter referred to as “community pharmacists”） on elderly patients with hypertension in the community. METHODS Elderly patients with hypertension from May 2020 to May 2021 in Yuhua Community Health Service Center of Nanjing were divided into control group （76 cases） and observation group （76 cases） according to the management style. The control group was treated with regular community medical services and the observation group received regular community medical services plus pharmaceutical care provided by the comprehensive management team collaborated with community pharmacists. The compliance， blood pressure control status and hypertension-related complications were compared between 2 groups before management and after 24 months of management. RESULTS After 24 months of management， the compliance and blood pressure compliance rates in both groups were higher than before management； meanwhile， the observation group was significantly higher than control group at the corresponding period （P＜0.05 or P＜ 0.01）. The blood pressure levels of both groups were significantly lower than before management， and the systolic blood pressure as well as the incidences of the whole complications and cerebrovascular injury in the observation group were significantly lower than control group at the 583867635@qq.com corresponding period （P＜0.05）. There was statistical significance in the effects of the rate of reaching the standard of blood pressure on the complications （P＜0.01）. CONCLUSIONS The hypertension management mode of comprehensive management team collaborated with community pharmacists can significantly improve the compliance and blood pressure compliance rate of elderly patients with hypertension， and reduce the incidence of hypertension-related complications.

BACKGROUND:The abnormal gait of stroke patients seriously affects their propulsive force during walking,which subsequently reduces their walking speed,walking distance,and stability,increases their risk of falls,and seriously affects their quality of life. OBJECTIVE:To review the relevant research on propulsive force deficits in stroke patients with hemiplegia,to summarize the understanding of existing researchers on propulsive force deficits,to analyze the relationship between propulsive force and gait,and finally to explain and compare the latest rehabilitation technologies used to improve propulsive force deficits,providing reference for clinical treatment. METHODS:Relevant literature was retrieved from WanFang,CNKI,PubMed,and Web of Science Core Collection through computer search.The Chinese and English search terms were"propulsive force OR propulsive,stroke OR cerebral infarction OR hemiplegia,walk* OR gait."The search time limit was from 2003 to 2023,and 71 articles were finally included for review and analysis. RESULTS AND CONCLUSION:Training targeting the hip and ankle joints may be more effective for patients'walking function,especially training with the application of flexible exoskeleton robots,but more sufficient evidence is still needed to use propulsion as a prognostic indicator of walking function in stroke patients.Biomechanical variables related to propulsive force include:the hip joint extension angle at terminal stance,ankle joint dorsiflexion torque,and knee joint extension.Damage to the corticospinal tract,cerebellar-cortical pathways,and the reticulospinal tract in hemiplegic patients are associated with reduced propulsive force and gait asymmetry.Propulsive force is crucial for the stability of healthy gait,and a decrease in propulsive force is unfavorable for gait stability.Gait symmetry is correlated with propulsive force,stride length symmetry,trunk displacement,and lower limb swing ability,with propulsive force being a key factor.Propulsive force can serve as a quantitative indicator for assessing the gait of hemiplegic patients,and evaluation of gait using propulsive force is beneficial for the long-term development of walking ability.Main rehabilitation techniques for improving propulsive force include:lower limb exoskeleton robot walking training,treadmill training combined with functional electrical stimulation,adaptive speed treadmill training,biofeedback technology,and whole-body vibration training.Among them,whole-body vibration training and biofeedback technology are more effective.The specific contributions and mechanisms of the hip,knee,and ankle joints in improving propulsive force are still controversial,but it is expected that the contributions of the hip and ankle joints are greater.Focusing on the improvement of propulsive force as a rehabilitation goal may yield more sustainable advancements in walking function.However,several current challenges persist in this field:understanding the neurobiological basis of propulsive force deficits in stroke patients,assessing the long-term efficacy of current rehabilitation techniques for enhancing propulsive force,and determining the most suitable patient populations for the application of major rehabilitation techniques aiming at improving propulsive force.These areas require further exploration by subsequent researchers.

OBJECTIVE To investigate the effect of eukaryotic translation elongation factor 1A1(eEF1A1)on the replication of vesicular stomatitis virus(VSV)and Herpes simplex virus 1(HSV-1)to identify a potential target for broad-spectrum regulation of viruses.METHODS Small interfering RNA(si-eEF1A)was transfected into human skin fibroblasts(BJ-5ta)to inhibit the expression of eEF1A1,and the negative control group was set up.The transfection efficiency was detected by real-time fluo-rescence quantitative PCR(RT-qPCR)and Western blotting,the cell model of eEF1A1 gene silencing was constructed.The cell model was infected with VSV,the gene copy number and protein expression of VSV in the cells were detected.The cell model was infected with HSV-1,the mRNA and protein expres-sion of HSV-1 in the cells were detected.The cell models were transfected with polyinosinic acid[Poly(I:C)]or sodium deoxyribonucleic acid(HT-DNA),respectively.The mRNA expression of interferon-β(IFN-β),C-X-C Motif Chemokine 10(CXCL10)and interferon-stimulated gene 56(ISG56)were detected by RT-qPCR.The phosphorylation expression of interferon regulatory factor 3(IRF3)and TANK binding kinase 1(TBK1)were detected by Western blotting.RESULT Compared with the negative control group,the mRNA and protein expression of eEF1A1 in the eEF1A1 gene silencing group were signifi-cantly decreased(P<0.01),the cell model of eEF1A1 gene silencing was successfully constructed.Compared with the negative control group,the VSV gene copy number of the eEF1A1 gene silencing group decreased by 70%-80%.The VSV protein expression decreased significantly(P<0.01).The mRNA expression of HSV-1 was decreased by 50%-60%,and the protein expression of HSV-1 was significantly decreased(P<0.01).After stimulation with Poly(I:C)or HT-DNA,compared with the negative control group.there was no significant difference in the mRNA expressions of IFN-β,ISG56 and CXCL10 and the protein phosphorylation expression of IRF3 and TBK1 in the eEF1A1 gene silencing group.CONCLUSION eEF1A1 silencing can inhibit VSV and HSV-1 virus replication,suggesting that eEF1A1 has a potential broad-spectrum regulatory effect on RNA viruses and DNA viruses,and may not recog-nize activated immune pathways through intracellular nucleic acid recognition.

Objective:To establish auto verification rules for the routine coagulation assays,and to provide reference for clinical laboratories to improve the quality and efficiency of results verification.Methods:A total of 24,510 specimens of sodium citrate anticoagulation routine coagulation test from the laboratory departments of eight hospitals including the First Medical Center,Chinese PLA General Hospital during January to March 2020 were collected and randomly divided into a rule establishment group and a rule verification group,with 6,670 specimens in the rule establishment group,including 2,056 Delta checks,and 17,840 specimens in the rule validation group,including 3,210 Delta checks.The activities of prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(Fib),thrombin time(TT),D-dimer(DD)and/or antithrombin(AT)were detected by Stago STA R Max automatic coagulation analyzer and supporting reagents.Taking the manual verification results as the standard,the auto verification and manual false negative rate(invalid verification),false positive rate(invalid interception),pass rate,positive coincidence rate,negative coincidence rate,verification consistency rate and specimen turnaround time(TAT)of the two groups were calculated.Results:The auto verification rules and the application process were preliminarily established,including internal quality control,alarm information,auto verification scope,critical value and deviation value inspection.In the rule establishment group,the single item pass rate was 82.6%-92.4%,and the overall pass rate was 73.8%.The consistency rate between auto verification and manual verification was 98.2%,and the positive coincidence rate and negative coincidence rate were 24.4%and 73.8%,respectively.In the rule verification group,the single item pass rate was 86.4%-91.5%,and the overall review pass rate was 71.5%.By simulating the application of auto verification rules,the average TAT of two hospitals among the eight hospitals was shortened by 1.5 hours and 2.1 hours,respectively.Conclusion:The application of auto verification rules can reduce workload of manual verification,and significantly shorten the TAT,and improve the report efficiency of the laboratory.

ObjectiveTo analyze the characteristics of HIV-1 molecular network and pretreatment drug resistance genes in the middle-aged and elderly people aged ≥50 years in Huzhou City, Zhejiang Province, and to provide an evidence for the prevention and control of AIDS epidemic. MethodsA total of 332 samples from the newly reported and untreated AIDS patients aged ≥50 years in Huzhou City from January 2020 to December 2023 were collected, pol genes were amplified by reverse transcription polymerase chain reaction (RT-PCR) and nested polymerase chain reaction (nest⁃PCR). Phylogenetic trees analyzing the subtypes were constructed, and a molecular network with a gene distance threshold of 1.0% were constructed at the same time. Mutation sites of drug resistance-related genes were identified through the Data Analysis and Detection System of HIV-1 Resistance Gene Detection of Stanford University, USA. ResultsSequence samples of 308 patients were obtained, and9 genotypes were identified, including CRF07_BC in 172 cases (55.8%), CRF01_AE in 61 cases (19.8%), CRF08_BC in 43 cases (14.0%), CRF85_BC in 9 cases (2.9%), and CRF55_01B in 8 cases (2.6%), subtype B in 5 cases (1.6%), subtype C in 4 cases (1.3%), CRF67_01B in3 cases (1.0%), and unique recombination URF01_AE/07_BC in 3 cases (1.0%). When the gene distance threshold was 1.0%, 28 molecular clusters were formed, and 139 cases were connected to the network, with an access rate of 45.0%. The largest transmission cluster C1 contained 44 cases infected with CRF07_BC subtype, all of whom were heterosexually transmitted, and predominantly by males. A total of 30 patients were found to have low-grade or higher drug resistance mutations, and the pretreatment drug resistance rate was 9.7% (30/308). Among them, there were 5 cases (16.7%) of protease inhibitor (PI) related drug resistance mutations, and 26 cases (86.7%) of non-nucleoside reverse transcriptase inhibitors (NNRTI) related drug resistance mutations. ConclusionCRF07_BC is the subtype with the most clusters among the middle-aged and elderly infected patients aged ≥50 years in Huzhou City. Middle-aged and elderly transmission clusters are formed within the three counties of WX, NX and CX through related activities. Molecular network monitoring on newly reported cases aged ≥50 years in Huzhou City should be strengthened so that the new characteristics of epidemic changes can be detected in time, providing a scientific basis for adjusting AIDS prevention and control measures for the elderly.