ObjectiveTo explore the potential mechanism of Xianglian Huazhuo prescription （XLHZ） in treating chronic atrophic gastritis （CAG） by regulating cell cycle and inhibiting proliferation， using bioinformatics technology and animal experiments. MethodsDifferential expressed genes （DEGs） related to CAG were screened using GEO database and GEO2R tool. Weighted gene co-expression network analysis （WGCNA） was employed to search for hub genes of CAG. These hub genes were intersected with cell cycle proliferation based on GeneCards database. Eenrichment analysis of the intersecting genes was performed to obtain signaling pathways and biological processes related to CAG. Protein protein interaction （PPI） analysis of genes was conducted using the Protein Interaction Platform （STRING） database to search the super hub gene （hub 2.0）， and animal experiments were conducted for further validation. Fourteen of 70 male Wistar rats were randomly selected as the normal group， and the remaining 56 rats were prepared by the combined modeling method of "starvation disorder+N-methyl-N-nitro-N-nitrosoguanidine （MNNG） + sodium salicylate". The successfully modeled rats were randomly divided into the model group， XLHZ-H， XLHZ-M， and XLHZ-L groups （36， 18， 9 g·kg^-1， respectively）， and Morodan group （1.4 g·kg^-1）. Each group was given corresponding intervention for 60 days. Hematoxylin-eosin （HE） staining was used to observe the histopathological changes of gastric mucosa in rats. The ultrastructure of gastric mucosal tissue cells was observed by transmission electron microscopy. The relative expression levels of TGF-β₁， Smad2 and Smad3 proteins， S/G₂/M phase marker geminin and proliferation marker MCM2 were detected by Western blot in gastric mucosal tissue， and Spearman correlation analysis was performed. ResultsA total of 15 hub 2.0 genes were identified， including TGF-β₁， suggesting the involvement of the TGF-β₁ signaling pathway in the CAG pathogenesis. Compared with the normal group， the expressions of TGF-β₁， Smad2， geminin and MCM2 proteins in the gastric mucosa tissue of the model group were increased （P<0.05）， and the expression of Smad3 protein was decreased （P<0.05）. Compared with the model group， the expressions of TGF-β₁ and geminin in the gastric mucosa were decreased in the drug groups （P<0.05）. The XLHZ-M group， XLHZ-H group and Morodan group had significantly decreased protein expression of Smad2 and MCM2 （P<0.05）. The protein expression of Smad3 was significantly increased in XLHZ-M， XLHZ-H， and Morodan groups （P<0.05）. Spearman correlation analysis showed that Smad3 was negatively correlated with other indicators， and positively correlated with other indicators （P<0.01）. ConclusionXLHZ may inhibit TGF-β₁/Smads signaling pathway， regulate cell cycle， and inhibit proliferation in the treatment of CAG.

ObjectiveTo explore the potential mechanism of Xianglian Huazhuo prescription （XLHZ） in treating chronic atrophic gastritis （CAG） by regulating cell cycle and inhibiting proliferation， using bioinformatics technology and animal experiments. MethodsDifferential expressed genes （DEGs） related to CAG were screened using GEO database and GEO2R tool. Weighted gene co-expression network analysis （WGCNA） was employed to search for hub genes of CAG. These hub genes were intersected with cell cycle proliferation based on GeneCards database. Eenrichment analysis of the intersecting genes was performed to obtain signaling pathways and biological processes related to CAG. Protein protein interaction （PPI） analysis of genes was conducted using the Protein Interaction Platform （STRING） database to search the super hub gene （hub 2.0）， and animal experiments were conducted for further validation. Fourteen of 70 male Wistar rats were randomly selected as the normal group， and the remaining 56 rats were prepared by the combined modeling method of "starvation disorder+N-methyl-N-nitro-N-nitrosoguanidine （MNNG） + sodium salicylate". The successfully modeled rats were randomly divided into the model group， XLHZ-H， XLHZ-M， and XLHZ-L groups （36， 18， 9 g·kg^-1， respectively）， and Morodan group （1.4 g·kg^-1）. Each group was given corresponding intervention for 60 days. Hematoxylin-eosin （HE） staining was used to observe the histopathological changes of gastric mucosa in rats. The ultrastructure of gastric mucosal tissue cells was observed by transmission electron microscopy. The relative expression levels of TGF-β₁， Smad2 and Smad3 proteins， S/G₂/M phase marker geminin and proliferation marker MCM2 were detected by Western blot in gastric mucosal tissue， and Spearman correlation analysis was performed. ResultsA total of 15 hub 2.0 genes were identified， including TGF-β₁， suggesting the involvement of the TGF-β₁ signaling pathway in the CAG pathogenesis. Compared with the normal group， the expressions of TGF-β₁， Smad2， geminin and MCM2 proteins in the gastric mucosa tissue of the model group were increased （P<0.05）， and the expression of Smad3 protein was decreased （P<0.05）. Compared with the model group， the expressions of TGF-β₁ and geminin in the gastric mucosa were decreased in the drug groups （P<0.05）. The XLHZ-M group， XLHZ-H group and Morodan group had significantly decreased protein expression of Smad2 and MCM2 （P<0.05）. The protein expression of Smad3 was significantly increased in XLHZ-M， XLHZ-H， and Morodan groups （P<0.05）. Spearman correlation analysis showed that Smad3 was negatively correlated with other indicators， and positively correlated with other indicators （P<0.01）. ConclusionXLHZ may inhibit TGF-β₁/Smads signaling pathway， regulate cell cycle， and inhibit proliferation in the treatment of CAG.

Objective: To investigate the treatment outcomes and influencing factors among elderly patients with pulmonary tuberculosis in Lishui City, Zhejiang Province, so as to provide a basis for optimizing the prevention and control strategies of pulmonary tuberculosis and reducing the risk of adverse treatment outcomes among elderly patients. Methods: Data on patients aged ≥60 years with pulmonary tuberculosis in Lishui City from 2016 to 2022 were collected from the Tuberculosis Information Management System of the China Disease Prevention and Control Information System, including basic information, diagnosis and treatment details, and laboratory test results. The successful treatment rate and the incidence of adverse treatment outcomes were calculated. Factors affecting adverse treatment outcomes among elderly patients with pulmonary tuberculosis were analyzed using multivariable logistic regression model. Results: A total of 3 094 elderly patients with pulmonary tuberculosis were registered in Lishui City from 2016 to 2022, with a median age of 70 (interquartile range, 13) years. There were 2 396 male patients (77.44%) and 698 female patients (22.56%). A total of 2 676 patients achieved successful treatment, with a successful treatment rate of 86.49%. The successful treatment rate demonstrated a significant upward trend from 2016 to 2022 (P<0.05). There were 418 patients with adverse treatment outcomes, accounting for an incidence of 13.51%. The main types of adverse outcomes were death and loss to follow-up, with 199 and 100 patients, accounting for 47.61% and 23.92%, respectively. Multivariable logistic regression analysis showed that elderly patients with pulmonary tuberculosis who were male (OR=1.333, 95%CI: 1.018-1.745), aged ≥70 years (70-<80 years, OR=1.909, 95%CI: 1.469-2.481; ≥80 years, OR=3.878, 95%CI: 2.967-5.068), living in rural areas (OR=1.332, 95%CI: 1.068-1.661), with positive etiological results (OR=1.470, 95%CI: 1.143-1.889), and undergoing retreatment (OR=1.923, 95%CI: 1.419-2.607) had a higher risk of adverse treatment outcomes. Conclusions The successful treatment rate showed an upward trend among elderly patients with pulmonary tuberculosis in Lishui City from 2016 to 2022. Gender, age, place of residence, etiological results, and treatment type were influencing factors for adverse treatment outcomes among elderly patients with pulmonary tuberculosis.

Test Methods for Disinfection Products(WS/T 10009-2023),a health industry standard,was officially released by the National Disease Control and Prevention Administration on December 15,2023.The standard came into effect on May 1,2024.This standard systematically specifies the testing and evaluation methods for disinfection products,covering three core components—disinfection effect testing and evaluation,physical and chemical testing techniques,and toxicological testing methods.The standard provides an important technical basis for the testing of disinfection products in China.To promote an accurate understanding and effective implementation of the standard,this article focuses on the in-depth interpretation of the section concerning the testing and evaluation methods of disinfection effects.It provides a detailed explanation of the major updates,technical highlights,and scientific rationale behind the standard.The article incorporates discussions on optimizing the validation test methods for the disinfection and sterilization effects of disinfectants,simulated field testing of disinfectants,evaluation of air disinfection effects,and the supplementation and improvement of testing methods for disinfection devices(including sterilization devices).This article aims to provide clear technical guidance for disinfection product inspection personnel,researchers,and other professionals involved,promote the standardized application of the standard,improve the quality of disinfection products,and ensure scientific,effective,and safe disinfection practices.

In September 2024,the updated version of Chinese Clinical Practice Guidelines for Hypertension was published.This version of guidelines comprises 44 pivotal clinical inquiries and 99 recommendations pertaining to the diagnosis,assessment,and management of hypertension.The new version of the guidelines emphasizes moving the line of defense of antihypertensive treatment forward,strengthening antihypertensive treatment,reflecting the concept of strengthening initial prevention and primary prevention,and stressing the importance of lifestyle interven-tion and blood pressure monitoring,which is of great guiding value and practical significance to clinical work.This paper interprets the management strategy of hypertension patients from the perspective of nursing practice,in order to provide evidence-based guidance for clinical nursing work.

Objective:To explore the current situation and influencing factors of quality of life of septic patients in intensive care unit (ICU) after discharge, and to provide theoretical basis for clinical early psychological intervention and continuity of care.Methods:A prospective observational study was conducted. The septic patients who were hospitalized in the department of critical care medicine of the Affiliated Hospital of Jining Medical University and discharged with improvement from January 1 to December 31, 2022 were selected as the research objects. The demographic information, basic diseases, infection site, vital signs at ICU admission, severity scores of the condition within 24 hours after ICU admission, various biochemical indexes, treatment process, and prognostic indexes of all the patients were recorded. All patients were assessed by questionnaire at 3 months of discharge using the 36-item short-form health survey scale (SF-36 scale), the activities of daily living scale (ADL scale), and the Montreal cognitive assessment scale (MoCA scale). Multiple linear regression was used to analyze the factors influencing the quality of life of septic patients after discharge from the hospital.Results:A total of 200 septic patients were discharged with improvement and followed up at 3 months of discharge, of which 150 completed the questionnaire. Of the 150 patients, 57 had sepsis and 93 had septic shock. The total SF-36 scale score of septic patients at 3 months of discharge was 81.4±23.0, and the scores of dimensions were, in descending order, role-emotional (83.4±23.0), mental health (82.9±23.6), bodily pain (82.8±23.3), vitality (81.6±23.2), physical function (81.4±23.5), general health (81.1±23.3), role-physical (79.5±27.0), and social function (78.8±25.2). There was no statistically significant difference in the total SF-36 scale score between the patients with sepsis and septic shock (82.6±22.0 vs. 80.7±23.6, P > 0.05). Incorporating the statistically significant indicators from linear univariate analysis into multiple linear regression analysis, and the results showed that the factors influencing the quality of life of septic patients at 3 months after discharge included ADL scale score at 3 months after discharge [ β= 0.741, 95% confidence interval (95% CI) was 0.606 to 0.791, P < 0.001], length of ICU stay ( β= -0.209, 95% CI was -0.733 to -0.208, P = 0.001), duration of mechanical ventilation ( β= 0.147, 95% CI was 0.122 to 0.978, P = 0.012), total dosage of norepinephrine ( β= -0.111, 95% CI was -0.044 to -0.002, P = 0.028), mean arterial pressure (MAP) at ICU admission ( β= -0.102, 95% CI was -0.203 to -0.007, P = 0.036) and body weight ( β= 0.097, 95% CI was 0.005 to 0.345, P = 0.044). Conclusions:The quality of life of patients with sepsis at 3 months after discharge is at a moderately high level. The influencing factors of the quality of life of patients with sepsis at 3 months after discharge include the ADL scale score at 3 months after discharge, the length of ICU stay, the duration of mechanical ventilation, the total dosage of norepinephrine, MAP at ICU admission and body weight, and healthcare professionals should enhance the treatment and care of the patients during their hospitalization based on the above influencing factors, and pay attention to early psychological intervention and continued care for such patients.

Objective:This paper explores the predictive value of indicators of cardiopulmonary exercise test in the degree of coronary artery disease in patients with coronary heart disease.It provides an objective basis for predicting the degree of coronary artery disease by non-invasive detection methods in patients with coronary heart disease,and provides objective guidance for formulating exercise prescriptions for patients with coronary heart disease. Method:Fifty-three patients with coronary heart disease who were treated in the Affiliated Cardiovascular Hospi-tal of Kunming Medical University from March 2020 to May 2022 were selected to complete coronary angiogra-phy and cardiopulmonary exercise test.According to the coronary angiography results and the SYNTAX score,the patients were divided into low group(SYNTAX≤22 points)with 30 cases and medium-high group(SYN-TAX＞22 points)with 23 cases.The general information of the patients such as gender,age,BMI and comor-bidities were collected,and the indicators of cardiopulmonary exercise test were collected. Result:Compared with the medium-high group,maximum oxygen uptake(VO2max),maximum oxygen uptake as a percentage of the predicted value(VO2max％P),maximum metabolic equivalent(METSmax),maximum heart rate(HRmax)and maximum heart rate as a percentage of predicted value(HR％P)of the low group were high-er,and the difference between the two groups was statistically significant with p-value less than 0.05.Com-pared with the medium-high group,the heart rate reserve(HRR)in the low group was lower,and the differ-ence between the two groups was statistically significant with p-value less than 0.05.The SYNTAX score was negatively correlated with VO2max,VO2max％P,maximum oxygen uptake in kilograms(VO2max/kg),METSmax,HRmax and HR％P,and positively correlated with HRR with P-value less than 0.05.HRR has the highest sensitivity in predicting coronary heart disease. Conclusion:The low group with low SYNTAX scores and mild coronary lesions has higher VO2max,VO2max％P,VO2max/kg,METSmax,HRmax and HR％P values,suggesting that the patients in this group have better cardiopulmo-nary reserve function and better exercise capacity.The high group with severe coronary artery disease has high-er HRR,and the gap between the maximum heart rate and the target heart rate during exercise is larger,which means it is more difficult for patients in the high group to reach the target heart rate.

Objective:To evaluate the effect of prior statins use on the in-hospital mortality of adult sepsis patients with type 2 diabetes (T2DM).Methods:A total of 3 545 sepsis patients with T2DM were retrospectively collected from the Critical Care Medical Information Market (MIMIC Ⅳ) database, with in-hospital mortality rate as the outcome variable. According to whether they have taken statins in the past, they were divided into two groups and propensity score matching was used. Multivariate Cox regression analysis was performed to calculate the adjusted hazard ratio ( HR) and 95% CI, and the relationship between past statins use and in-hospital mortality in sepsis patients with T2DM was analyzed. Results:A total of 3 545 sepsis patients with T2DM were included between 2008 and 2016. 1 556 patients used statins before admission, and 1 989 patients did not use statins. After propensity score matching, the number of patients who had previously used statins and those who had not used statins were 1 230 and 1 298, respectively. After adjusting for potential confounding factors, it was found that previous use of statins was associated with a reduced in-hospital mortality rate ( HR=0.82, 95% CI: 0.61-0.99, P=0.038). Kaplan Meier curves showed that sepsis patients with T2DM who used statins before admission had a lower in-hospital mortality rate (Log rank test: P<0.001). Conclusions:Pre admission use of statins may be associated with a reduced mortality rate in sepsis patients with concomitant T2DM.

BACKGROUND: This study aimed to determine the reasons for conversion and elucidate the safety and efficacy of transition to tenofovir alafenamide/emtricitabine/bictegravir sodium (TAF/FTC/BIC) in highly active antiretroviral therapy (HAART)-experienced HIV-infected patients in real-world settings. METHODS: We conducted a retrospective cohort study. The treatment conversion rationales, safety, and effectiveness in 1684 HIV-infected patients with previous HAART experience who switched to TAF/FTC/BIC were evaluated at Beijing Ditan Hospital from September 2021 to Auguest 2022. RESULTS: Regimen simplification (990/1684, 58.79%) was the most common reason for switching, followed by osteoporosis or osteopenia (375/1684, 22.27%), liver dysfunction (231/1684, 13.72%), decline in tenofovir alafenamide/emtricitabine/elvitegravir/cobicistat (TAF/FTC/EVG/c) with food restriction (215/1684, 12.77%), virological failure (116/1684, 6.89%), and renal dysfunction (90/1684, 5.34%). In patients receiving non-nucleotide reverse transcriptase inhibitors (NNRTI)-containing regimens, lipid panel changes 1 year after switching indicated a difference of 3.27 ± 1.10 mmol/L vs . 3.40 ± 1.59 mmol/L in triglyceride ( P  = 0.014), 4.82 ± 0.74 mmol/L vs . 4.88 ± 0.72 mmol/L in total cholesterol ( P  = 0.038), 3.09 ± 0.70 mmol/L vs . 3.18 ± 0.66 mmol/L in low-density lipoprotein ( P  <0.001), and 0.99 ± 0.11 mmol/L vs . 0.95 ± 0.10 mmol/L in high-density lipoprotein ( P  <0.001). Conversely, among patients receiving booster-containing regimens, including TAF/FTC/EVG/c and lopinavir/ritonavir (LPV/r), lipid panel changes presented decreased trends. We also observed an improved trend in viral load suppression, and alanine transaminase (ALT), aspartate transaminase (AST), estimated glomerular filtration rate (eGFR), and serum creatinine levels after the transition ( P  <0.001). CONCLUSION The transition to TAF/FTC/BIC demonstrated good treatment potency. Furthermore, this study elucidates the motivations behind the adoption of TAF/FTC/BIC in real-world scenarios, providing clinical evidence supporting the stable conversion to TAF/FTC/BIC for HAART-experienced patients.
Humans ; Antiretroviral Therapy, Highly Active/adverse effects* ; Anti-HIV Agents/adverse effects* ; HIV Infections/drug therapy* ; Tenofovir/therapeutic use* ; Retrospective Studies ; Emtricitabine/pharmacology* ; Adenine/therapeutic use* ; Lipids

Objective To develop the Quality of Life Scale for Patients with Aplastic Anemia(QLS-AA)and to test its reliability and validity.Methods According to the concept category and the four-dimensional model of quality of life,the scale item pool was initially constructed through literature review and qualitative interview.The draft of the QLS-AA was formed through expert inquiry,cognitive interviews and expert consultation.A questionnaire survey was conducted on 429 patients with aplastic anemia from the hematology departments of a tertiary general hospital in Zhejiang Province and a tertiary hematology hospital in Tianjin with the convenient sampling method from December 2021 to November 2022,and the item analysis and reliability,validity test of the pre-test scale were carried out.Results 422 valid questionnaires were collected,and the effective questionnaire recovery rate was 98.37％.3 common factors were extracted by exploratory factor analysis,and the cumulative variance contribution rate was 66.113％.The scale level consensus content validity index was 0.821,the scale level average content validity index was 0.970,the item level content validity index was 0.833～1.000,and the correlation coefficient with SF-36 was 0.719.The Cronbach's α was 0.944,and the split half reliability was 0.882,and retest reliability was 0.931.The final QLS-AA includes 3 dimensions with 39 items.Conclusion The process of developing QLS-AA in this study is scientifically standardized,and the scale has good reliability and validity,which can effectively evaluate the quality of life for patients with aplastic anemia.