ObjectiveTo investigate the incidence of postherpetic neuralgia （PHN） and its associated risk factors in patients aged ≥50 years with herpes zoster （HZ） who received standard antiviral therapy at the dermatology outpatient clinic of our center. MethodsHZ patients were identified by searching the medical record system using "herpes zoster" as the keyword， and those diagnosed between July 2020 and July 2021. Patients meeting the inclusion criteria were followed up via telephone to retrospectively assess the occurrence of PHN. Patients were divided into a PHN group and a non-PHN group based on the presence of PHN. General patient information （gender， age， and underlying diseases）， prodromal pain intensity， and lesion characteristics （area， location， and acute-phase pain intensity） as well as treatment modalities （pharmacotherapy， physical therapy， and combined analgesic therapy） were compared between the two groups. Intergroup comparisons and multifactorial analyses were performed to identify factors associated with the development of PHN in HZ patients. Pain intensity was assessed using the Numerical Rating Scale （NRS） for PHN pain， acute-phase HZ pain， and prodromal pain. Intergroup comparisons were conducted using the chi-square test， Mann-Whitney U test， and t-test. Binary logistic regression was used for multivariate analysis to identify independent risk factors. ResultsA total of 238 HZ patients aged ≥50 years who received standard antiviral therapy were ultimately included， of whom 76 （31.9%） developed PHN. Unifactorial analysis showed that age， lesion area， acute-phase pain intensity， and the use of gabapentin or combined analgesic therapy significantly influenced the occurrence of PHN after HZ （P<0.05）. Statistically significant indicators （P<0.05） from the unifactorial analysis and the different analgesic regimens adopted by patients were included in the multifactorial analysis. Multifactorial analysis revealed that lesion area ≥1% （OR=2.501； 95%CI=1.408-4.443； P=0.002<0.05） and acute-phase pain score （OR=1.160； 95%CI=1.028-1.309； P=0.016<0.05） were independent risk factors for PHN. Age and the use of gabapentin or combined analgesic therapy showed no statistically significant association with the occurrence of PHN （P>0.05）. ConclusionsIn HZ patients aged ≥50 years receiving standard antiviral therapy， the incidence of PHN is 31.9%. A lesion area ≥1% and higher acute-phase pain NRS scores are identified as independent risk factors for the development of PHN in these patients.

ObjectiveTo investigate the incidence of postherpetic neuralgia （PHN） and its associated risk factors in patients aged ≥50 years with herpes zoster （HZ） who received standard antiviral therapy at the dermatology outpatient clinic of our center. MethodsHZ patients were identified by searching the medical record system using "herpes zoster" as the keyword， and those diagnosed between July 2020 and July 2021. Patients meeting the inclusion criteria were followed up via telephone to retrospectively assess the occurrence of PHN. Patients were divided into a PHN group and a non-PHN group based on the presence of PHN. General patient information （gender， age， and underlying diseases）， prodromal pain intensity， and lesion characteristics （area， location， and acute-phase pain intensity） as well as treatment modalities （pharmacotherapy， physical therapy， and combined analgesic therapy） were compared between the two groups. Intergroup comparisons and multifactorial analyses were performed to identify factors associated with the development of PHN in HZ patients. Pain intensity was assessed using the Numerical Rating Scale （NRS） for PHN pain， acute-phase HZ pain， and prodromal pain. Intergroup comparisons were conducted using the chi-square test， Mann-Whitney U test， and t-test. Binary logistic regression was used for multivariate analysis to identify independent risk factors. ResultsA total of 238 HZ patients aged ≥50 years who received standard antiviral therapy were ultimately included， of whom 76 （31.9%） developed PHN. Unifactorial analysis showed that age， lesion area， acute-phase pain intensity， and the use of gabapentin or combined analgesic therapy significantly influenced the occurrence of PHN after HZ （P<0.05）. Statistically significant indicators （P<0.05） from the unifactorial analysis and the different analgesic regimens adopted by patients were included in the multifactorial analysis. Multifactorial analysis revealed that lesion area ≥1% （OR=2.501； 95%CI=1.408-4.443； P=0.002<0.05） and acute-phase pain score （OR=1.160； 95%CI=1.028-1.309； P=0.016<0.05） were independent risk factors for PHN. Age and the use of gabapentin or combined analgesic therapy showed no statistically significant association with the occurrence of PHN （P>0.05）. ConclusionsIn HZ patients aged ≥50 years receiving standard antiviral therapy， the incidence of PHN is 31.9%. A lesion area ≥1% and higher acute-phase pain NRS scores are identified as independent risk factors for the development of PHN in these patients.

BACKGROUND: While emotional distress, encompassing anxiety and depression, has been associated with negative clinical outcomes, its impact across various clinical departments and general hospitals has been less explored. Previous studies with limited sample sizes have examined the effectiveness of specific treatments (e.g., antidepressants) rather than a systemic management strategy for outcome improvement in non-psychiatric inpatients. To enhance the understanding of the importance of addressing mental health care needs among non-psychiatric patients in general hospitals, this study retrospectively investigated the impacts of emotional distress and the effects of early detection and management of depression and anxiety on hospital length of stay (LOS) and rate of long LOS (LLOS, i.e., LOS >30 days) in a large sample of non-psychiatric inpatients. METHODS: This retrospective cohort study included 487,871 inpatients from 20 non-psychiatric departments of a general hospital. They were divided, according to whether they underwent a novel strategy to manage emotional distress which deployed the Huaxi Emotional Distress Index (HEI) for brief screening with grading psychological services (BS-GPS), into BS-GPS ( n = 178,883) and non-BS-GPS ( n = 308,988) cohorts. The LOS and rate of LLOS between the BS-GPS and non-BS-GPS cohorts and between subcohorts with and without clinically significant anxiety and/or depression (CSAD, i.e., HEI score ≥11 on admission to the hospital) in the BS-GPS cohort were compared using univariable analyses, multilevel analyses, and/or propensity score-matched analyses, respectively. RESULTS: The detection rate of CSAD in the BS-GPS cohort varied from 2.64% (95% confidence interval [CI]: 2.49%-2.81%) to 20.50% (95% CI: 19.43%-21.62%) across the 20 departments, with a average rate of 5.36%. Significant differences were observed in both the LOS and LLOS rates between the subcohorts with CSAD (12.7 days, 535/9590) and without CSAD (9.5 days, 3800/169,293) and between the BS-GPS (9.6 days, 4335/178,883) and non-BS-GPS (10.8 days, 11,483/308,988) cohorts. These differences remained significant after controlling for confounders using propensity score-matched comparisons. A multilevel analysis indicated that BS-GPS was negatively associated with both LOS and LLOS after controlling for sociodemographics and the departments of patient discharge and remained negatively associated with LLOS after controlling additionally for the year of patient discharge. CONCLUSION Emotional distress significantly prolonged the LOS and increased the LLOS of non-psychiatric inpatients across most departments and general hospitals. These impacts were moderated by the implementation of BS-GPS. Thus, BS-GPS has the potential as an effective, resource-saving strategy for enhancing mental health care and optimizing medical resources in general hospitals.
Humans ; Retrospective Studies ; Male ; Length of Stay/statistics & numerical data* ; Female ; Middle Aged ; Adult ; Psychological Distress ; Inpatients/psychology* ; Aged ; Anxiety/diagnosis* ; Depression/diagnosis*

Objective To analyze the literature on drug treatment pathways to sort out the development process,and to present the research status,hotspots,and trends.Methods Researches on drug treatment pathways were retrieved from the WoSCC,CNKI,Wanfang Database,and VIP Chinese Journal Database from the time of database establishment to October 312024.The CiteSpace 6.3.R1 and VOSviewer 1.6.20 were used to generate visual maps,including publications,countries,journals,institutions,authors,and keywords.Results A total of 150 papers were included,45 in Chinese and 105 in English.The number of Chinese and English research publications has increased significantly in the past five years.The United States has the largest number of publications in this field.There is relatively little cooperation among domestic research groups,but international cooperation is closer.In Chinese journals,research topics in this field mainly focus on the whole process from formulation to implementation of drug treatment pathways.Perioperative drug use,chronic drug use,and adjuvant drug use are research hotspots.In recent years,attention to clinical pharmacists and evidence-based pharmacy has increased.English journals mainly focus on cancer treatment-related research,with current research focusing on patient experience and social benefits.Conclusion Research in the field of drug treatment pathways in English journals is developing rapidly,but no core journal area has been formed specifically in this area.At present,the research on drug treatment pathways in Chinese journals is in its initial stage and is advancing rapidly,but the overall number is still relatively small,the research content and diseases involved are limited,and the research system is not perfect.Chinese researchers should pay attention to the research hotspot,broaden the research topic and further improve the quantity and quality of the research in this field.

Objective To investigate the factors affecting the exposure of polymyxin B and the correlation between pharmacokinetic/pharmacodynamic(PK/PD)indexes and efficacy in patients with multidrug-resistant Gram-negative bacterial(MDR-GNB)infections.Methods This prospective study was conducted in patients who received polymyxin B to treat MDR-GNB infections in the intensive care unit of Nanjing Drum Tower Hospital,Medical College,Nanjing University from January 2021 to December 2023.Plasma concentrations of polymyxin B were analyzed using a high-performance liquid chromatography-tandem mass spectrometry,and the influencing factors of exposure were investigated.The predictive value of area under the concentration-time curve(AUC24h)and AUC24hto minimum inhibitory concentration ratio for efficacy was determined by the receiver operating characteristic curve.Results The median of AUC24h was 76.11(56.06,96.94)μg·mL-1·h in 96 patients with MDR-GNB infections.Patients in the high-dose group(≥ 150 mg·d-1)were more likely to have higher exposure of polymyxin B than those in the low-dose group(＜150 mg·d-1)(P＜0.05).The exposure in patients with renal replacement therapy was significantly de-creased(P＜0.01).However,increasing the dose in patients receiving renal replacement therapy had no significant difference on exposure.The ROC curve showed AUC24h/MIC was closely correlated with clinical efficacy in patients with MDR-GNB infections(AUCROC=0.724,P＜0.01)and the optimal cut-off value of AUC24h/MIC was 62.1.Subgroup analysis showed that the optimal cut-off values of AUC24h/MIC in patients with and without pulmonary infection were 70.8 and 61.5,respectively.The clinical effi-cacy rate was significantly higher in AUC24 h/MIC≥62.1 group,compared with those in AUC24 h/MIC＜62.1 group(72.88％vs.32.43％,P＜0.01).After treatment,the decreasing trend of inflammation indicators in AUC24 h/MIC≥ 62.1 group was superior to those in AUC24h/MIC＜62.1 group.Conclusion The dose and renal replacement therapy are the significant factors influencing the exposure of polymyxin B.AUC24 h/MIC with the target of 62.1 was the optimal exposure index to predict the efficacy in the treatment of MDR-GNB infections and the optimal threshold of AUC24h/MIC was higher in patients with pulmonary infections than in non-pulmonary patients,so therapeutic drug monitoring is recommended to adjust the AUC24h/MIC index to achieve individual-ized medication.

Objective To study the inhibitory effect of secondary metabolites of Pseudomonas aeruginosa(PA)on Candida albicans(CA)and to explore some of the mechanisms.Methods PA and CA strains were i-solated from clinical specimens from the hospital.Then,PA strains with inhibitory effects on CA were screened through cross-line test and co-incubation test,and crude extracts of PA secondary metabolites were prepared,and were tested together with pyocyanin,phenazine-1-carboxylic acid,1-hydroxyphenazine,and 3-ox-ododecyl-l-homoserine lactone(3-oxo-HSL).The inhibitory effects of various PA secondary metabolites on CA were determined through minimum inhibitory concentration test,minimum bactericidal concentration test,time-sterilization curve measurement,and XTT method activity measurement test,and some mechanisms by which PA secondary metabolites inhibited CA were explored.Results The strongest inhibitory effect on CA was 1-hydroxyphenazine,and at a concentration of 6.250 μg/mL,the relative activity of CA decreased to 0.00%.Next were pyocyanin and PA crude extract,and the relative fungal activity of CA decreased to 0.00%at concentrations of 200 and 100 μg/mL.1-hydroxyphenazine,pyocyanin,3-oxo-HSL and PA crude extract all had inhibitory effects on the formation of CA hyphae.Reactive oxygen species(ROS)were generated in CA cells treated with 1-hydroxyphenazine,phenazine 1-carboxylic acid,pyocyanin,and PA crude extract,and the highest levels of ROS were induced by pyocyanin and 1-hydroxyphenazine.Conclusion Phenazine secondary metabolites 1-hydroxyphenazine and pyocyanin have significant inhibitory effects on the growth and activity of CA,and both induce the highest amount of ROS.The quorum-sensing signal molecule 3-oxo-HSL have no in-hibitory effect on CA growth,but have a significant inhibitory effect on the formation of fungal hyphae.

Objective To analyze the literature on drug treatment pathways to sort out the development process,and to present the research status,hotspots,and trends.Methods Researches on drug treatment pathways were retrieved from the WoSCC,CNKI,Wanfang Database,and VIP Chinese Journal Database from the time of database establishment to October 312024.The CiteSpace 6.3.R1 and VOSviewer 1.6.20 were used to generate visual maps,including publications,countries,journals,institutions,authors,and keywords.Results A total of 150 papers were included,45 in Chinese and 105 in English.The number of Chinese and English research publications has increased significantly in the past five years.The United States has the largest number of publications in this field.There is relatively little cooperation among domestic research groups,but international cooperation is closer.In Chinese journals,research topics in this field mainly focus on the whole process from formulation to implementation of drug treatment pathways.Perioperative drug use,chronic drug use,and adjuvant drug use are research hotspots.In recent years,attention to clinical pharmacists and evidence-based pharmacy has increased.English journals mainly focus on cancer treatment-related research,with current research focusing on patient experience and social benefits.Conclusion Research in the field of drug treatment pathways in English journals is developing rapidly,but no core journal area has been formed specifically in this area.At present,the research on drug treatment pathways in Chinese journals is in its initial stage and is advancing rapidly,but the overall number is still relatively small,the research content and diseases involved are limited,and the research system is not perfect.Chinese researchers should pay attention to the research hotspot,broaden the research topic and further improve the quantity and quality of the research in this field.

Objective To investigate the factors affecting the exposure of polymyxin B and the correlation between pharmacokinetic/pharmacodynamic(PK/PD)indexes and efficacy in patients with multidrug-resistant Gram-negative bacterial(MDR-GNB)infections.Methods This prospective study was conducted in patients who received polymyxin B to treat MDR-GNB infections in the intensive care unit of Nanjing Drum Tower Hospital,Medical College,Nanjing University from January 2021 to December 2023.Plasma concentrations of polymyxin B were analyzed using a high-performance liquid chromatography-tandem mass spectrometry,and the influencing factors of exposure were investigated.The predictive value of area under the concentration-time curve(AUC24h)and AUC24hto minimum inhibitory concentration ratio for efficacy was determined by the receiver operating characteristic curve.Results The median of AUC24h was 76.11(56.06,96.94)μg·mL-1·h in 96 patients with MDR-GNB infections.Patients in the high-dose group(≥ 150 mg·d-1)were more likely to have higher exposure of polymyxin B than those in the low-dose group(＜150 mg·d-1)(P＜0.05).The exposure in patients with renal replacement therapy was significantly de-creased(P＜0.01).However,increasing the dose in patients receiving renal replacement therapy had no significant difference on exposure.The ROC curve showed AUC24h/MIC was closely correlated with clinical efficacy in patients with MDR-GNB infections(AUCROC=0.724,P＜0.01)and the optimal cut-off value of AUC24h/MIC was 62.1.Subgroup analysis showed that the optimal cut-off values of AUC24h/MIC in patients with and without pulmonary infection were 70.8 and 61.5,respectively.The clinical effi-cacy rate was significantly higher in AUC24 h/MIC≥62.1 group,compared with those in AUC24 h/MIC＜62.1 group(72.88％vs.32.43％,P＜0.01).After treatment,the decreasing trend of inflammation indicators in AUC24 h/MIC≥ 62.1 group was superior to those in AUC24h/MIC＜62.1 group.Conclusion The dose and renal replacement therapy are the significant factors influencing the exposure of polymyxin B.AUC24 h/MIC with the target of 62.1 was the optimal exposure index to predict the efficacy in the treatment of MDR-GNB infections and the optimal threshold of AUC24h/MIC was higher in patients with pulmonary infections than in non-pulmonary patients,so therapeutic drug monitoring is recommended to adjust the AUC24h/MIC index to achieve individual-ized medication.

Alzheimer's disease (AD) is a leading cause of dementia in the elderly. Mitogen-activated protein kinase phosphatase 1 (MKP-1) plays a neuroprotective role in AD. However, the molecular mechanisms underlying the effects of MKP-1 on AD have not been extensively studied. MicroRNAs (miRNAs) regulate gene expression at the post-transcriptional level, thereby repressing mRNA translation. Here, we reported that the microRNA-429-3p (miR-429-3p) was significantly increased in the brain of APP23/PS45 AD model mice and N2A^APP AD model cells. We further found that miR-429-3p could downregulate MKP-1 expression by directly binding to its 3'-untranslated region (3' UTR). Inhibition of miR-429-3p by its antagomir (A-miR-429) restored the expression of MKP-1 to a control level and consequently reduced the amyloidogenic processing of APP and Aβ accumulation. More importantly, intranasal administration of A-miR-429 successfully ameliorated the deficits of hippocampal CA1 long-term potentiation and spatial learning and memory in AD model mice by suppressing extracellular signal-regulated kinase (ERK1/2)-mediated GluA1 hyperphosphorylation at Ser831 site, thereby increasing the surface expression of GluA1-containing α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors (AMPARs). Together, these results demonstrate that inhibiting miR-429-3p to upregulate MKP-1 effectively improves cognitive and synaptic functions in AD model mice, suggesting that miR-429/MKP-1 pathway may be a novel therapeutic target for AD treatment.

Objective To investigate the health status of workers exposed to noise in a brewery in Beijing and to analyze the relationship between hearing loss and blood pressure. Methods A total of 949 noise-exposed workers in a brewery who participated in occupational health examination were selected as the investigation subjects. A survey was conducted to investigate the pure tone hearing threshold and abnormal blood pressure of the workers with different characteristics, and to analyze the relationship between the two. Results Among the noise-exposed workers, the detection rates of hearing abnormality, hypertension, and increased systolic and diastolic blood pressure were 73.55%, 52.37%, 43.84% and 46.47%, respectively. The detection rates of hearing abnormality, indicators of hypertension, high frequency hearing threshold abnormality and increased binaural high frequency hearing threshold on average in males were higher than those in females (P < 0.05). Except that there was no statistically significant difference in weighted values of the better ear’s hearing thresholds among different working age groups (P> 0.05), the detection rates of other hearing abnormality, indicators of hypertension, speech frequency hearing threshold abnormality, high frequency hearing threshold abnormality，increased binaural high frequency hearing threshold on average and the weighted value of the better ear's hearing threshold all increased or had an increasing trend with the increase of age or working years (P< 0.05). The detection rates of hypertension in the groups with high frequency hearing threshold abnormality and increased binaural high frequency hearing threshold on average were higher than those in the normal group (P＜0.05). Conclusion The noise-exposed workers in the brewery have hearing impairment, which is related to the occurrence of hypertension. It is recommended to strengthen the publicity and education on noise protection and take protective measures to reduce the occurrence of occupational noise injury.