Objective:To establish a rapid and precise dose measurement method with EBT4 film and ensure its measurement accuracy to be within the required range through strict operational procedures for the purpose of addressing the two essential issues of poor measurement accuracy and timeliness of EBT film under FLASH conditions.Methods:After storing under different humidity conditions for a certain period of time, the film was exposed to radiation for analyzing the influence of air humidity on the intrinsic performance of EBT film. By means of repeated scanning operations and the film angle rotation, the influences of repeated scanning and film placement angle were analuzed. Parabolic correction method was used to reduce the spatial position influence during the scanning process. By analying the relationship between net optical density (netOD) and absorbed dose through the comparison of three fitting method, the optimal fitting curve was selected. After irradiation of the same batch of films for 5 min and 24 h, the film doses were calibrated and then compared with ionization chamber-measured result. The rapid and precise film dosimetry method was used to measure both the percentage depth dose from X-rays at ultra-high dose rate and the dose distribution at a depth of 2 cm in water.Results:Air humidity had the greatest influence on the intrinsic performance of EBT film (approximately 20%). The average deviation of repeated scans is within 0.5%. The angle at which the film is placed significantly affected the readouts of the film with the maximum influence approximately 70%. The net optical density combined with polynomial fitting can control the fitting residuals of 1-16 Gy within 3%. The change rate of light channels at 5 min already mostly met the requirements of the rapid mode (< 0.5%). Compared with the measurement result obtained using the reference ionization chamber, the deviations of the 5 min or 24 h dose calibration curves were all within 2%.Conclusions:The EBT4 film can be employed as a precise dosimeter to quickly measure the FLASH radiation dose. Rapid and precise FLASH dose measurements can meet the stringent requirements of both preclinical and clinical FLASH research.

Objective:To investigate the pathogenetic characteristics and risk factors of nosocomial infection with multidrug-resistant organisms (MDRO) in trauma patients.Methods:A retrospective case-control study was conducted to analyze the clinical data of 103 trauma patients with nosocomial infection admitted to the 926th Hospital of the Joint Logistics Support Force of the PLA from January 2021 to December 2023, including 84 males and 19 females aged 12-80 years [50(39, 59)years]. The patients were divided into MDRO infection group ( n=36) and non-MDRO infection group ( n=67) according to whether nosocomial MDRO infection occurred. The pathogenetic characteristics of MDRO infection were observed. Univariate analysis was used to compare the two groups in terms of their demographic characteristics (gender, age), comorbidities (hypertension, diabetes mellitus), injuries [multiple injuries, open injuries, injury severity score (ISS)], laboratory indicators (hemoglobin, leukocytes) on admission, and other treatment data (emergency admission to the healthcare facility, transferal, length of hospital stay before diagnosis of infection, number of surgeries before diagnosis of infection, blood transfusion before diagnosis of infection, tracheotomy/tracheal intubation before diagnosis of infection). Logistic regression analysis was used to screen the independent risk factors for nosocomial MDRO infection in trauma patients. Results:A total of 52 MDRO strains were detected, including 17 Gram-positive (33%) and 35 Gram-negative (67%) ones, with the top 5 strains being Escherichia coli, Staphylococcus aureus, Acinetobacter baumannii, Klebsiella pneumoniae, and Staphylococcus epidermidis, respectively. The specimen source with the most detected MDRO strains was wound/incision secretion, followed by sputum. The results of the univariate analysis showed statistically significant differences in ISS and hemoglobin on admission between two groups ( P<0.05); however, no statistically significant differences were observed in gender, age, hypertension, diabetes mellitus, multiple injuries, open injuries, leukocytes on admission, emergency admission to the healthcare facility, transferal, length of hospital stay before diagnosis of infection, number of surgeries before diagnosis of infection, blood transfusion before diagnosis of infection, or tracheotomy/tracheal intubation before diagnosis of infection ( P>0.05). The results of the multivariate Logistic regression analysis showed that male gender ( OR=5.01, 95% CI 1.09, 23.08, P<0.05), age ( OR=1.03, 95% CI 1.00, 1.07, P<0.05), multiple injuries ( OR=5.28, 95% CI 1.04, 26.87, P<0.05), hemoglobin on admission ( OR=0.97, 95% CI 0.95, 0.99, P<0.05), and length of hospital stay before diagnosis of infection ( OR=1.06, 95% CI 1.01, 1.11, P<0.05) were significantly associated with the occurrence of nosocomial MDRO infection in trauma patients. Conclusions:In trauma patients, nosocomial MDRO infection pathogens were predominantly Gram-negative and the top five strains are Escherichia coli, Staphylococcus aureus, Acinetobacter baumannii, Klebsiella pneumoniae and Staphylococcus epidermidis, respectively. Male gender, age, multiple injuries, hemoglobin on admission and length of hospital stay before diagnosis of infection are independent risk factors for the occurrence of nosocomial MDRO infection in trauma patients.

Objective:To establish a rapid and precise dose measurement method with EBT4 film and ensure its measurement accuracy to be within the required range through strict operational procedures for the purpose of addressing the two essential issues of poor measurement accuracy and timeliness of EBT film under FLASH conditions.Methods:After storing under different humidity conditions for a certain period of time, the film was exposed to radiation for analyzing the influence of air humidity on the intrinsic performance of EBT film. By means of repeated scanning operations and the film angle rotation, the influences of repeated scanning and film placement angle were analuzed. Parabolic correction method was used to reduce the spatial position influence during the scanning process. By analying the relationship between net optical density (netOD) and absorbed dose through the comparison of three fitting method, the optimal fitting curve was selected. After irradiation of the same batch of films for 5 min and 24 h, the film doses were calibrated and then compared with ionization chamber-measured result. The rapid and precise film dosimetry method was used to measure both the percentage depth dose from X-rays at ultra-high dose rate and the dose distribution at a depth of 2 cm in water.Results:Air humidity had the greatest influence on the intrinsic performance of EBT film (approximately 20%). The average deviation of repeated scans is within 0.5%. The angle at which the film is placed significantly affected the readouts of the film with the maximum influence approximately 70%. The net optical density combined with polynomial fitting can control the fitting residuals of 1-16 Gy within 3%. The change rate of light channels at 5 min already mostly met the requirements of the rapid mode (< 0.5%). Compared with the measurement result obtained using the reference ionization chamber, the deviations of the 5 min or 24 h dose calibration curves were all within 2%.Conclusions:The EBT4 film can be employed as a precise dosimeter to quickly measure the FLASH radiation dose. Rapid and precise FLASH dose measurements can meet the stringent requirements of both preclinical and clinical FLASH research.

Objective:To investigate the pathogenetic characteristics and risk factors of nosocomial infection with multidrug-resistant organisms (MDRO) in trauma patients.Methods:A retrospective case-control study was conducted to analyze the clinical data of 103 trauma patients with nosocomial infection admitted to the 926th Hospital of the Joint Logistics Support Force of the PLA from January 2021 to December 2023, including 84 males and 19 females aged 12-80 years [50(39, 59)years]. The patients were divided into MDRO infection group ( n=36) and non-MDRO infection group ( n=67) according to whether nosocomial MDRO infection occurred. The pathogenetic characteristics of MDRO infection were observed. Univariate analysis was used to compare the two groups in terms of their demographic characteristics (gender, age), comorbidities (hypertension, diabetes mellitus), injuries [multiple injuries, open injuries, injury severity score (ISS)], laboratory indicators (hemoglobin, leukocytes) on admission, and other treatment data (emergency admission to the healthcare facility, transferal, length of hospital stay before diagnosis of infection, number of surgeries before diagnosis of infection, blood transfusion before diagnosis of infection, tracheotomy/tracheal intubation before diagnosis of infection). Logistic regression analysis was used to screen the independent risk factors for nosocomial MDRO infection in trauma patients. Results:A total of 52 MDRO strains were detected, including 17 Gram-positive (33%) and 35 Gram-negative (67%) ones, with the top 5 strains being Escherichia coli, Staphylococcus aureus, Acinetobacter baumannii, Klebsiella pneumoniae, and Staphylococcus epidermidis, respectively. The specimen source with the most detected MDRO strains was wound/incision secretion, followed by sputum. The results of the univariate analysis showed statistically significant differences in ISS and hemoglobin on admission between two groups ( P<0.05); however, no statistically significant differences were observed in gender, age, hypertension, diabetes mellitus, multiple injuries, open injuries, leukocytes on admission, emergency admission to the healthcare facility, transferal, length of hospital stay before diagnosis of infection, number of surgeries before diagnosis of infection, blood transfusion before diagnosis of infection, or tracheotomy/tracheal intubation before diagnosis of infection ( P>0.05). The results of the multivariate Logistic regression analysis showed that male gender ( OR=5.01, 95% CI 1.09, 23.08, P<0.05), age ( OR=1.03, 95% CI 1.00, 1.07, P<0.05), multiple injuries ( OR=5.28, 95% CI 1.04, 26.87, P<0.05), hemoglobin on admission ( OR=0.97, 95% CI 0.95, 0.99, P<0.05), and length of hospital stay before diagnosis of infection ( OR=1.06, 95% CI 1.01, 1.11, P<0.05) were significantly associated with the occurrence of nosocomial MDRO infection in trauma patients. Conclusions:In trauma patients, nosocomial MDRO infection pathogens were predominantly Gram-negative and the top five strains are Escherichia coli, Staphylococcus aureus, Acinetobacter baumannii, Klebsiella pneumoniae and Staphylococcus epidermidis, respectively. Male gender, age, multiple injuries, hemoglobin on admission and length of hospital stay before diagnosis of infection are independent risk factors for the occurrence of nosocomial MDRO infection in trauma patients.

The interaction of gut microbiota and its metabolites with the host not only plays an important role in maintaining gut homeostasis and host health, but also is a key link in responding to pathogen infections. A thorough understanding of the changes in gut microbiota and its metabolites during infection, as well as their role and mechanism in host defense against infection, is helpful to guide anti-infection treatment. This review focuses on the role of gut microbiota and their metabolites in host defense against bacterial, fungal, and viral infections, and reveals that they can exert anti-infection effects through resistance mechanisms (inducing antimicrobial substances, training immunity, inhibiting pathogen respiration, directly neutralizing pathogens, immune regulation) and tolerance mechanisms (altering energy metabolism patterns of microbiota, cell proliferation and tissue damage repair, maintaining physiological signal transduction in extraintestinal organs, inflammation regulation, maintaining the integrity of the intestinal barrier), and also summarizes measures to regulate gut microbiota against pathogen infections, in order to provide more ideas for novel anti-infection prevention and treatment strategies targeting gut microbiota and its metabolites.

This article provides an interpretation of the newly added sections in the 2023 guidelines titled Cardiovascular Disease: Risk Assessment and Reduction, Including Lipid Modification published by the National Institute for Health and Care Excellence (NICE). The new sections cover various aspects such as risk assessment tools for the primary prevention of cardiovascular disease (CVD), cardiovascular protective diets, and the use of aspirin and statins for both primary and secondary prevention of CVD. This interpretation aims to provide scientific guidance for CVD risk assessment and reduction in China.

[摘 要] 目的：探讨布托啡诺（BPH）对骨肉瘤（OS）细胞增殖、迁移和侵袭的影响及其相关的作用机制。方法：将MG-63细胞分为对照组、YAP抑制剂组（维替泊芬组）和BPH低、中、高浓度组，MTT法、克隆形成实验、FCM术、划痕愈合实验、Transwell实验、qPCR法、WB法和移植瘤实验分别检测处理后各组细胞的增殖活性、克隆形成数、细胞凋亡率、划痕愈合率，以及上皮钙黏蛋白（E-cadherin）、神经钙黏蛋白（N-cadherin）、波形蛋白（vimentin）mRNA的表达和YAP、TAZ蛋白的表达，同时观察BPH和维替泊芬对移植瘤生长的影响。结果：与对照组相比，维替泊芬组和BPH低、中、高浓度组细胞增殖活性、克隆数、划痕愈合率、侵袭细胞数，以及N-cadherin和vimentin mRNA水平、YAP和TAZ蛋白表达及移植瘤体积均显著降低（均P<0.05），细胞凋亡率、E-cadherin mRNA水平及对移植瘤的抑瘤率均升高（均P<0.05），且BPH高浓度组与维替泊芬组之间各项指标均无明显差异（均P>0.05）。结论：BPH可能通过抑制Hippo/YAP信号通路来抑制OS细胞MG-63增殖、迁移和侵袭。

In 2022, the World Falls Guidelines Working Group released the World Guidelines for Falls Prevention and Management for Older Adults. This article interprets the important recommended content of the guidelines, aiming to provide clinical medical and nursing staff with the latest evidence-based evidence, promote the clinical conversion of evidence, and provide the best guidance for medical and nursing work in China.

ObjectiveBased on the inhibitory activity of phosphodiesterase （PDE）， a method for determining the anti-inflammatory activity of Qingjin Huatantang was established to supplement and improve the quality control system of this famous classical formula. MethodHigh performance liquid chromatography （HPLC） was used to determine the activity of PDE， and the dose-effect relationship of inhibiting PDE activity of Qingjin Huatantang was investigated. The mobile phase consisted of methanol-0.5% acetic acid aqueous solution （5∶95）， and the detection wavelength was 254 nm. By measuring the PDE inhibition rate of multiple batches of Qingjin Huatantang water extract lyophilized powder， biological activity was marked with the activity of the neutralizing enzyme in the international unit U. ResultWhen the concentration of reaction substrate （cyclic adenosine monophosphate） was 50 μmol·L^-1 and the reaction time was 60 min， the enzymatic reaction was stable with 4 U·mL^-1 of PDE. In this reaction system， when the concentration of Qingjin Huatantang water extract lyophilized powder was 0.11-3.0 g·L^-1， the inhibitory effect of PDE showed a concentration-dependent relationship. It was determined that the concentration of Qingjin Huatantang water extract lyophilized powder to be tested was 1 g·L^-1， which showed a significant and stable inhibitory effect on PDE， and the inhibitory rate was >45%， that is， 1 mg of Qingjin Huatantang water extract lyophilized powder could neutralize the activity of 1.8 U PDE at least. ConclusionThis study establishes a biological activity evaluation method of Qingjin Huatantang based on the inhibitory activity of PDE， and the anti-inflammatory activity of Qingjin Huatantang is characterized by international unit U of PDE activity， which can provide a new method for the determination of biological activity of traditional Chinese medicine compounds.

At present, traditional methods on statistics have limitations in controlling time- varying confounding. This paper introduces an analysis method, parametric g-formula, which would adjust time-varying confounding, and also exemplifies the steps of its implementation for purpose to provide a new reference for researchers to deal with long-term observational data.