Objective To investigate the post-discharge exercise behavior and factors influencing moderate to vigorous intensity physical activity (MVPA) in patients undergoing lung surgery. Methods A total of 2874 patients from the large prospective, observational perioperative lung symptom study cohort (CN-PRO-Lung 3) in the Department of Thoracic Surgery at Sichuan Cancer Hospital between April 7, 2021, and January 31, 2024, were selected as the survey subjects. A survey was conducted using the Investigation of Exercise Behavior after Lung Surgery questionnaire and the International Physical Activity Questionnaire-Short Form (IPAQ-SF) among patients who underwent lung surgery. Binary logistic regression was used to analyze the factors influencing patients’ engagement in MVPA. Results A total of 702 patients were surveyed, including 252 males and 450 females, with an average age of (52.4±10.2) years. Patients with lung cancer accounted for 85.9%. Only 36.0% of the patients had regular exercise habits, while 42.3% did not engage in any physical activity. The three main barriers for postoperative exercise were physical discomfort (pain, coughing, shortness of breath, etc, 54.7%), lack of professional guidance (41.7%), and concerns about the surgical wound (28.9%). The proportions of patients engaging in vigorous, moderate, and low-intensity physical activity were 5.7%, 28.2%, and 66.1%, respectively. Multivariate analysis showed that patients with a personal annual income ≥50000 yuan (OR=1.52, 95%CI 1.01-2.29, P=0.044), high school education or above (OR=1.92, 95%CI 1.33-2.76, P<0.001), and lobectomy (OR=1.44, 95%CI 1.02-2.03, P=0.037) engaged in more MVPA. Conclusion Patients undergoing lung surgery have inadequate physical activity after discharge, particularly lacking in MVPA. Patients with higher income, higher educational levels, and lobectomy are more frequently engaged in MVPA. Measures such as symptom control, providing exercise guidance, and enhancing education on wound care may potentially improve the inadequate physical activity in lung surgery patients after discharge.

Objective To establish and verify a set of methods based on bio-layer interferometry(BLI) technology for the detection of Fc receptor affinity of IgG_4 monoclonal antibodies,and to provide reliable detection methods for the quality research and supervision of this category of pharmaceuticals.Methods According to the characteristics of the interaction between each Fc receptor and IgG_4 monoclonal antibodies,Protein A(ProA),anti-penta-HIS(HIS1K) and streptavidin(SA)biosensors were selected respectively,and the corresponding immobilization strategy,sample concentration,binding and dissociation time,and buffer system were set for different receptors.Among them,Fc gamma receptorⅠ(FcγRⅠ) adopted ProA sensor to immobilize antibodies and then analyze receptors.FcγRⅡa,FcγRⅡb/c and FcγRⅢ were analyzed using HIS1K sensor to immobilize the receptor.FcRn was detected by binding His-tag antibody to SA sensor followed by immobili-zation of the receptor.The specificity and repeatability of the method were verified,and bevacizumab was used as a positive control to confirm the detection performance of the method.The Fc receptor affinity of six batches of IgG_4-type programmed death-1(PD-1)-targeted monoclonal antibody products and working reference substances was determined by the established method.Results In each receptor detection,all the interference light wavelength shift signals of the assay buffer were < 0.003 nm.The relative standard deviations(RSDs) of IgG_4 PD-1 targeting monoclonal antibody injection with FcγRⅠ/CD64 and FcRn KD were 1.9% and 5.8%,respectively,and were all < 25% with FcγRⅡa/CD32a(H/67),FcγRⅡb/c(CD32b/c),FcγRⅢa/CD16a(V176) and other weak affinity receptors.The KDs with FcγRⅢa/CD16a(F176) and FcγRⅢb/CD16b were all >1 × 10-5 mol/L,showing no affinity.The measured results of bevacizumab were consistent with the theoretical values.The KDs of six batches of IgG_4 monoclonal antibody injection samples with FcγRⅠ/CD64 were(3.029-3.193) × 10~(-9) mol/L,and the KDs with FcRn were(1.398-1.622) × 10~(-7) mol/L,which were consistent with preclinical research data.The KDs with FcγRⅡa/CD32a(H/67),FcγRⅡb/c(CD32b/c),and FcγRⅢa/CD16a(V176) were(0.920-1.402) × 10~(-5),(4.673-5.682) ×10~(-6),and(2.236-3.994) × 10~(-5) mol/L,respectively,all showing weak affinity.The KDs with FcγRⅢa/CD16a(F176) and FcγRⅢb/CD16b were both > 1 × 10~(-5) mol/L,showing no affinity.The Fc receptor affinity determination results of each batch of products were basically consistent with those of the working reference substances.Conclusion The established affinity detection method based on BLI technology has good specificity and precision,which can be used for the quality research and supervision of monoclonal antibody drugs,and also provides reference for the affinity detection of other antibody drugs.

Objective To explore an artificial intelligence (AI)-based method for automated hand hygiene monitoring and to compare the effectiveness of three algorithms (UniFormerV2, TDN, C3D) in recognizing hand hygiene steps in surgical settings, thereby aiding hospital infection control. Methods From April to October 2024, we non-invasively collected 641 video recordings of healthcare staff performing hand hygiene at four-bay scrub sinks in two tertiary hospitals using overhead HD cameras. The dataset was annotated by five trained experts for model training and validation. Results Following training on 385 samples, internal validation (n=119) showed the C3D model achieved 81% accuracy, 87% recall, and an 83% F1-score. The TDN model achieved 93%, 91%, and 92% for the same metrics. The UniFormerV2 model outperformed both, with an accuracy, recall, and F1-score of 93%—an improvement of over 10 percentage points compared to traditional CNNs (TDN, C3D). It also achieved an 84% accuracy in external validation, demonstrating strong generalization. Conclusion The UniFormerV2 model is more accurate than CNN-based models for hand hygiene step recognition and shows robust performance in external validation. It presents a viable tool for healthcare facilities to enhance hand hygiene management, ultimately improving medical quality and patient safety.

By consulting ancient and modern literature， this article systematically reviews and verifies the historical evolution of the herbal medicine known as Baijiang across various dimensions， including name， origin， scientific name verification， medicinal parts， production area， quality， harvesting and processing， as well as its nature， taste， and therapeutic effects， in order to provide a reference for the development and utilization of famous classical formulas containing Patriniae Herba. Patriniae Herba has a long history of use. It derives its name from the distinctive musty odor of its roots， which resembles spoiled soy sauce. However， due to its alias Kucai， there has been much confusion with other plants. Since the Ming dynasty， various plants have been used interchangeably as Baijiang. Herbal textual research showed that Patriniae Herba was first recorded in Shennong Bencaojing， and throughout history， Baijiang has been recognized as its standard name， though it has also been known by alternative names such as Luchang， Lujiang， and Suanyi. The main sources used throughout the ages were Patrinia scabiosaefolia or P. villosa， which is consistent with the 1977 edition of the Pharmacopoeia of the People's Republic of China. However， while the roots were traditionally used medicinally， the whole plant is now more commonly used in modern practice. In addition， the whole plants of Thlaspi arvense from the Cruciferae family and Sonchus brachyotus from the Compositae family are commonly used as regional substitutes for Baijiang. According to ancient records， Patriniae Herba was primarily found in Jiangxia（present-day eastern Hubei province） and Jiangdong（the region south of the lower reaches of the Yangtze River）， but modern literature shows that it is distributed throughout the country without a distinct geographical origin. In ancient times， the roots were harvested in August and sun-dried， today， the whole plant is typically dug up in summer or autumn and sun-dried. In recent times， the quality has been summarized as being best when the roots are long， the leaves are abundant and green， and the aroma is strong. Regarding the processing， ancient methods often involved baking（drying over fire）， while modern methods typically involve removing impurities， washing， and then cutting and drying the segments. The effects of Patriniae Herba are to clear heat and detoxify， eliminate blood stasis and drain pus. During the Han and Northern and Southern dynasties， it was used to treat skin diseases caused by heat， abscesses， postpartum diseases， and rheumatism， during the Five dynasties period， its therapeutic applications expanded to include diseases of the five senses， and by the modern era， conditions such as neurasthenia and insomnia were added. Regarding its properties and taste， it was recorded as bitter and neutral during the Han dynasty. By the Tang dynasty， it was slightly cold， with a taste of acrid and bitter. During the Yuan and Ming dynasties， it was mostly slightly cold and neutral， with a bitter and salty taste. In the Qing dynasty and modern times， it was mostly bitter and neutral， and in contemporary times， it has evolved to a taste of acrid， bitter， and cool. Based on the results of this study， it is recommended that when developing and utilizing famous classical formulas containing Patriniae Herba， one should select the entire herb of the historically mainstream sources， P. scabiosaefolia or P. villosa from the Valerianaceae family， and choose the processing method according to the prescription requirements. It is recommended to use raw products without specific requirements.

By consulting ancient and modern literature， this article systematically reviews and verifies the historical evolution of the herbal medicine known as Baijiang across various dimensions， including name， origin， scientific name verification， medicinal parts， production area， quality， harvesting and processing， as well as its nature， taste， and therapeutic effects， in order to provide a reference for the development and utilization of famous classical formulas containing Patriniae Herba. Patriniae Herba has a long history of use. It derives its name from the distinctive musty odor of its roots， which resembles spoiled soy sauce. However， due to its alias Kucai， there has been much confusion with other plants. Since the Ming dynasty， various plants have been used interchangeably as Baijiang. Herbal textual research showed that Patriniae Herba was first recorded in Shennong Bencaojing， and throughout history， Baijiang has been recognized as its standard name， though it has also been known by alternative names such as Luchang， Lujiang， and Suanyi. The main sources used throughout the ages were Patrinia scabiosaefolia or P. villosa， which is consistent with the 1977 edition of the Pharmacopoeia of the People's Republic of China. However， while the roots were traditionally used medicinally， the whole plant is now more commonly used in modern practice. In addition， the whole plants of Thlaspi arvense from the Cruciferae family and Sonchus brachyotus from the Compositae family are commonly used as regional substitutes for Baijiang. According to ancient records， Patriniae Herba was primarily found in Jiangxia（present-day eastern Hubei province） and Jiangdong（the region south of the lower reaches of the Yangtze River）， but modern literature shows that it is distributed throughout the country without a distinct geographical origin. In ancient times， the roots were harvested in August and sun-dried， today， the whole plant is typically dug up in summer or autumn and sun-dried. In recent times， the quality has been summarized as being best when the roots are long， the leaves are abundant and green， and the aroma is strong. Regarding the processing， ancient methods often involved baking（drying over fire）， while modern methods typically involve removing impurities， washing， and then cutting and drying the segments. The effects of Patriniae Herba are to clear heat and detoxify， eliminate blood stasis and drain pus. During the Han and Northern and Southern dynasties， it was used to treat skin diseases caused by heat， abscesses， postpartum diseases， and rheumatism， during the Five dynasties period， its therapeutic applications expanded to include diseases of the five senses， and by the modern era， conditions such as neurasthenia and insomnia were added. Regarding its properties and taste， it was recorded as bitter and neutral during the Han dynasty. By the Tang dynasty， it was slightly cold， with a taste of acrid and bitter. During the Yuan and Ming dynasties， it was mostly slightly cold and neutral， with a bitter and salty taste. In the Qing dynasty and modern times， it was mostly bitter and neutral， and in contemporary times， it has evolved to a taste of acrid， bitter， and cool. Based on the results of this study， it is recommended that when developing and utilizing famous classical formulas containing Patriniae Herba， one should select the entire herb of the historically mainstream sources， P. scabiosaefolia or P. villosa from the Valerianaceae family， and choose the processing method according to the prescription requirements. It is recommended to use raw products without specific requirements.

This study systematically analyzed the package inserts of vaccines purchased centrally for the Chinese national immunization program in 2024. By comparing them with the Childhood Immunization Schedule for National Immunization Program Vaccines-China (Version 2021) and vaccination practice guidelines, this study identified and summarized the limitations and misconceptions in the vaccination descriptions for populations with special health status. Thirty-two vaccine inserts were collected for twelve different types of national immunization program vaccines. An analysis was conducted on the documents for indications, immunization schedules, contraindications, precautions, drug interactions, clinical trial outcomes, and the use of medications in pregnant and lactating women. The primary issues included: rough statements regarding contraindications and precautions for vaccination; special populations with vaccination indications classified as contraindicated or indicated with precautions; immunization schedule without specified procedures and dosage for special populations; unreasonable timeframe for deferring vaccinations after the administration of antibody-containing blood products; absent rational recommendations for concurrent administration with other vaccines and immunosuppressants. Some current vaccine inserts of the national immunization program had broad and unreasonable descriptions of contraindications and precautions, which could affect the vaccination of populations with special health status, causing concerns among healthcare providers and vaccine recipients regarding vaccine safety and leading to vaccine hesitancy. It is recommended to promote evidence-based revision of description on vaccination for populations with special health status in vaccine inserts. Additionally, the principle for vaccinating children with special health status in the Childhood Immunization Schedule for National Immunization Program Vaccines-China (Version 2021) should be further refined to enhance confidence and convenience in vaccination practices.

This study systematically analyzed the package inserts of vaccines purchased centrally for the Chinese national immunization program in 2024. By comparing them with the Childhood Immunization Schedule for National Immunization Program Vaccines-China (Version 2021) and vaccination practice guidelines, this study identified and summarized the limitations and misconceptions in the vaccination descriptions for populations with special health status. Thirty-two vaccine inserts were collected for twelve different types of national immunization program vaccines. An analysis was conducted on the documents for indications, immunization schedules, contraindications, precautions, drug interactions, clinical trial outcomes, and the use of medications in pregnant and lactating women. The primary issues included: rough statements regarding contraindications and precautions for vaccination; special populations with vaccination indications classified as contraindicated or indicated with precautions; immunization schedule without specified procedures and dosage for special populations; unreasonable timeframe for deferring vaccinations after the administration of antibody-containing blood products; absent rational recommendations for concurrent administration with other vaccines and immunosuppressants. Some current vaccine inserts of the national immunization program had broad and unreasonable descriptions of contraindications and precautions, which could affect the vaccination of populations with special health status, causing concerns among healthcare providers and vaccine recipients regarding vaccine safety and leading to vaccine hesitancy. It is recommended to promote evidence-based revision of description on vaccination for populations with special health status in vaccine inserts. Additionally, the principle for vaccinating children with special health status in the Childhood Immunization Schedule for National Immunization Program Vaccines-China (Version 2021) should be further refined to enhance confidence and convenience in vaccination practices.

Chronic heart failure(CHF)is a common end-stage manifestation of cardiovascular disease,and the"spleen-small intestine-heart"axis is its important mechanism.Current studies have shown that the"spleen"in TCM and mitochondria function are similar,and the physiological dysfunction of the"small intestine"is also closely related to intestinal bacterial dysbiosis,and the pathology of the spleen and the small intestine will be transmitted to the heart to accelerate the occurrence and development of CHF.Based on the relevant theory of spleen-small intestine-heart,this article described the correlation between abnormal mitochondrial energy metabolism and imbalance of intestinal flora and CHF from the aspects of the spleen,small intestine and heart,and believed that the essence of CHF is a pathological condition formed by mitochondrial energy metabolism crisis and intestinal microecological disorders,which could provide theoretical references for the TCM prevention and treatment of CHF.

Objective:To explore the structural relationship between WMSDs in the upper limbs and various risk factors in the occupational population in China, based on a large sample epidemiological survey and structural equation analysis, and to establish a structural equation model, so as to lay a foundation for the prevention and control of such diseases.Methods:The Chinese version of the Musculoskeletal Disorders Electronic Questionnaire was used to conduct a nationwide survey on the prevalence of WMSDs in the upper extremity. Six factors related to WMSDs in the upper extremity were extracted by the classification standard of adverse ergonomic factors and their source and confirmatory factor analysis, including work organization, work type, upper extremity work posture, individual factors, upper extremity fatigue and upper extremity WMSDs. The structural equation analysis was carried out and the structural equation model was established.Results:The incidence of WMSDs and fatigue in the upper limbs was 24.44% and 43.76%, respectively. The adjusted structural equation model fitting indicators were generally up to the standard (GFI=1.000, AGFI=1.000, RMSEA=0.043, NFI=0.808, TLI=0.784) . The four exogenous latent variables of work organization, work type, upper limb work posture and individual factors were correlated. There was a strong positive correlation between job type and upper limb work posture ( r=0.865) , a moderate positive correlation between work organization and job type and upper limb work posture ( r=0.570, 0.490) , and a weak negative correlation between individual factors and the other three exogenous latent variables. Upper limb work posture and individual factors had direct effects on upper limb WMSDs, and the effect coefficients were 0.10 and 0.06, respectively. Upper limb fatigue played a mediating role between work organization, work type, upper limb work posture and upper limb WMSDs. The effect coefficient was 0.46, and the composition ratios of indirect effects were 100.0%, 100.0%, and 38.3%, respectively. The direct path effect of upper limb work posture, individual factors and upper limb WMSDs was weaker than the mediating path through upper limb fatigue. Conclusion:When carrying out the prevention and control of upper limbWMSDs, it is necessary to comprehensively consider the pathogenesis path of upper limb muscle fatigue and upper limb WMSDs caused by work organization, work type, and upper limb work posture, so as to provide theoretical reference for improving the prevention and control level of such diseases.

Objective: To analyze the fluctuations of patient-reported outcomes (PROs) and their relationships with cytokines in the peripheral blood of patients undergoing chemotherapy for ovarian cancer (OC). Methods: PROs burden was prospectively measured by the M.D. Anderson Symptom Inventory-Ovarian Cancer (MDASI-OC) at baseline before chemotherapy, on a daily basis during and post-chemotherapy days (PCD) 7, 14, and 20. Cytokines were collected at baseline, days prior to hospital discharge and PCD 20. Pearson correlation was used to explore the associations between PROs and cytokines levels in peripheral blood. Results: The top 8 rated symptoms were compared between the neoadjuvant chemotherapy (NACT) group (n=20) and the postoperative adjuvant chemotherapy (PAC) group (n=7).Before chemotherapy, the mean scores of fatigue and lack of appetite in the NACT group were higher than those in the PAC group. After chemotherapy, pain, nausea, vomiting, disturbed sleep, lack of appetite, and constipation increased to peak during PCD 2–6; while, fatigue and numbness or tingling remained at high levels over PCD 2–13. By PCD 20, disturbed sleep and fatigue showed a significant increase in mean scores, particularly in the NACT group;while, other symptom scores decreased and returned to baseline levels. Additionally, the longitudinal fluctuations in pain, fatigue, and lack of appetite were positively associated with circulating levels of interleukin-6 and interferon gamma (p<0.05). Conclusion MDASI-OC was feasible and adaptable for demonstrating the fluctuations of symptom burden throughout chemotherapy course. Moreover, symptoms changing along with cytokines levels could provide clues for exploring mechanism underlying biochemical etiology.