ObjectiveTo explore the effects of Kaixuan Jiedu core prescription （KXJD） on sphingolipid metabolism in the mouse model of imiquimod-induced psoriasis-like skin lesions. MethodsThirty-seven male C57BL/6J mice were randomly assigned into five groups： healthy control （n=11）， model （n=11）， methotrexate （MTX， n=5）， low-dose （15.21 g·kg^-1） KXJD （n=5）， and high-dose （30.42 g·kg^-1） KXJD （n=5）. Psoriasis-like skin lesions were induced in mice with 62.5 mg 5% imiquimod cream applied on the back. The KXJD groups and MTX group were treated with 0.2 mL corresponding decoction and MTX， respectively， by gavage daily， while the other groups were given an equal volume of normal saline by the same way. After 5 days of treatment， back skin lesions were collected. Firstly， healthy control and model mice were selected for tandem mass tag （TMT） quantitative proteomics （control vs model=3 vs 3） and targeted lipid metabolomics （control vs model=11 vs 11）. Then， the binding degree between core components and target proteins was predicted via network pharmacology and molecular docking. Finally， an animal experiment was performed to decipher the specific regulation mechanism of KXJD on sphingolipid metabolism. Immunohistochemistry was employed to determine the expression level of sphingosine-1-phosphate （S1P）， and Western blot was employed to determine the expression levels of sphingosine kinase 2 （SPHK2） and monocyte chemotactic protein-1 （MCP-1）. ResultsTMT proteomics and targeted lipid metabolomics suggested that sphingolipid metabolism was active in the psoriatic skin， and key proteases ［serine palmitoyltransferase， long chain base subunit 2 （SPTLC2）， SPHK2， delta（4）-desaturase sphingolipid 1 （Degs1）， and ceramide synthase 4 （CerS4）］ and 8 sphingolipid metabolites （including ceramides， sphingol， sphingomyelin， and glycosphingolipid） expressed abnormally （P<0.05） compared with those in the healthy skin. The molecular docking results indicated that the binding energy between the active components （quercetin， kaempferol， and luteolin） in KXJD and key proteins involved in sphingolipid metabolism was less than-8 kal·mol^-1. Further experimental verification showed elevated expression levels of SPHK2， S1P， and MCP-1 in psoriatic skin compared with healthy skin （P<0.05）， and KXJD down-regulated the expression levels of SPHK2， S1P， and MCP-1 compared with the model group （P<0.05）. ConclusionThis study indicates that there is an imbalance in sphingolipid metabolism in psoriatic skin lesions. KXJD may reduce psoriasis-like lesions in mice by regulating sphingolipid metabolism via the SPHK2/S1P/MCP-1 pathway.

ObjectiveTo explore the effects of Kaixuan Jiedu core prescription （KXJD） on sphingolipid metabolism in the mouse model of imiquimod-induced psoriasis-like skin lesions. MethodsThirty-seven male C57BL/6J mice were randomly assigned into five groups： healthy control （n=11）， model （n=11）， methotrexate （MTX， n=5）， low-dose （15.21 g·kg^-1） KXJD （n=5）， and high-dose （30.42 g·kg^-1） KXJD （n=5）. Psoriasis-like skin lesions were induced in mice with 62.5 mg 5% imiquimod cream applied on the back. The KXJD groups and MTX group were treated with 0.2 mL corresponding decoction and MTX， respectively， by gavage daily， while the other groups were given an equal volume of normal saline by the same way. After 5 days of treatment， back skin lesions were collected. Firstly， healthy control and model mice were selected for tandem mass tag （TMT） quantitative proteomics （control vs model=3 vs 3） and targeted lipid metabolomics （control vs model=11 vs 11）. Then， the binding degree between core components and target proteins was predicted via network pharmacology and molecular docking. Finally， an animal experiment was performed to decipher the specific regulation mechanism of KXJD on sphingolipid metabolism. Immunohistochemistry was employed to determine the expression level of sphingosine-1-phosphate （S1P）， and Western blot was employed to determine the expression levels of sphingosine kinase 2 （SPHK2） and monocyte chemotactic protein-1 （MCP-1）. ResultsTMT proteomics and targeted lipid metabolomics suggested that sphingolipid metabolism was active in the psoriatic skin， and key proteases ［serine palmitoyltransferase， long chain base subunit 2 （SPTLC2）， SPHK2， delta（4）-desaturase sphingolipid 1 （Degs1）， and ceramide synthase 4 （CerS4）］ and 8 sphingolipid metabolites （including ceramides， sphingol， sphingomyelin， and glycosphingolipid） expressed abnormally （P<0.05） compared with those in the healthy skin. The molecular docking results indicated that the binding energy between the active components （quercetin， kaempferol， and luteolin） in KXJD and key proteins involved in sphingolipid metabolism was less than-8 kal·mol^-1. Further experimental verification showed elevated expression levels of SPHK2， S1P， and MCP-1 in psoriatic skin compared with healthy skin （P<0.05）， and KXJD down-regulated the expression levels of SPHK2， S1P， and MCP-1 compared with the model group （P<0.05）. ConclusionThis study indicates that there is an imbalance in sphingolipid metabolism in psoriatic skin lesions. KXJD may reduce psoriasis-like lesions in mice by regulating sphingolipid metabolism via the SPHK2/S1P/MCP-1 pathway.

With the vigorous development of computers and internet, the construction of the information management system for Occupational Health Technical Service (OHTS) institutions in China has achieved impressive progress. But for the management of OHTS institutions, there are relatively few systems that can fully explore and utilize OHTS information. Base on this background, in light of the actual situation of the OHTS institution in Henan Province, an OHTS Information Management System was developed under the Java Spring Boot framework, with a MySQL database and a B/S multi-tier architecture. The platform integrates a vertical three-level network of ″provincial-municipal-county/district″ and a horizontal network involving health commissions, disease prevention and control bureaus, Centers for Disease Control and Prevention (occupational disease prevention and treatment institutes), and OHTS institutions. The system includes five core modules: dynamic management of institutional and personnel qualifications, full-process project supervision (including five categories of technical services such as pre-evaluation and control-effectiveness evaluation), multidimensional decision analysis (including eight statistical indicators of institutional distribution, equipment allocation, and occupational hazard factors), rapid generation and automated submission of various reports, and early warning and intelligent supervision. The system has been implemented in 61 OHTS institutions in Henan Province, improving the ″off-site supervision rate″ of supervision department and promoting the standardization and digital transformation of occupational health services.

As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.

Objective To analyze the application of outcome indicators and measurement tools in randomized controlled trials(RCTs)of TCM treatment for coronary heart disease(CHD)complicated with anxiety and depression in recent years;To facilitate the construction of core outcome set in this field.Methods The RCTs of TCM treatment for CHD complicated with anxiety and depression were retrieved from CNKI,Wanfang Data,VIP,CBM,PubMed,Web of Science,Embase,Cochrane Library,and the included RCTs were evaluated for bias risk,data extracted and analyzed.Results A total of 163 articles were included,with 157 outcome indicators categorized into 6 indicator domains according to their functional attributes.The application rates in descending order were symptoms and signs(98.16%),physiological and chemical tests(58.90%),TCM syndromes(48.47%),safety events(44.17%),quality of life(39.88%),and long-term prognosis(9.20%).By analyzing the frequency and distribution of outcome indicators,indicator combinations,measurement time points and tools found that the experimental design and the registration of study protocols were ignored,and the diagnosis and evaluation criteria of anxiety and depression and TCM diagnosis/syndrome differentiation were not standardized.The selection of outcome indicators was characterized by lack of comorbidity between CHD and anxiety and depression,no separation of primary and secondary,excessive number of indicators,irregular composite indicators,inconsistent application of TCM-specific indicators,lack of long-term prognosis,safety indicators and health economics evaluation.Conclusion There are some limitations in the RCT design and outcome indicators in the TCM treatment of CHD complicated with anxiety and depression.It is imperative to establish a core outcome set and standardize trial designs to enhance research quality.

Objective To explore the role of Schlafen4(SLFN4)in acute pneumonia induced by hypervirulent Klebsiella pneumoniae(hvKp)via intratracheal aerosolization.Methods Differential expression gene Slfn4 was identified after infection with hvKp based on RNA sequencing(RNA-seq)and single-cell RNA sequencing(scRNA-seq)data before Slfn4-/-mice were obtained via CRISPR/Cas gene editing technology.Slfn4-/-mice and wild mice were challenged via intratracheal aerosolization.Mortality and weight changes were recorded for 14 d,while pathological changes and expression levels of interleukin-6(IL-6),IL-17A,IL-1β,and tumor necrosis factor-α(TNF-α)were detected at 48 h post-infection.Results SLFN4 expression was significantly increased in wild mice after infection with hvKp.Survival was significantly increased,and weight loss was mitigated before gradual recovery in Slfn4-/-mice after infection.The knockout of SLFN4 attenuated alveolar wall thickening,diminished neutrophil infiltration,and suppressed pro-inflammatory cytokine production(IL-6,IL-17A,IL-1β,TNF-α)in the lung at 48 h post-infection.Conclusion The deletion of SLFN4 may suppress the expression of specific pro-inflammatory cytokines and attenuate neutrophil over-recruitment in the lung,thereby alleviating pneumonia in mice after hvKp infection.

As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.

As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.

Objective:To investigate the status of resilience,perceived educational environment,and learning burnout among vocational medical students and analyze the mediating role of resilience.Methods:A total of 312 vocational medical students were assessed using the Resilience Scale,Educational Environment Perception Scale,and Learning Burnout Scale.Pearson correlation analysis was conducted to explore the relationships between learning burnout,perceived educational environment,and resilience.Structural equation modeling(SEM)was employed to test the mediating effect.Results:Among 312 vocational medical students,the learning burnout score was(62.24±5.64),the perceived educational environment score was(135.67±14.38),and the resilience score was(48.68±6.63).Learning burnout score was negatively correlated with perceived educational environment score and resilience score(r=-0.896,-0.869,P＜0.05),while perceived educational environment score was positively correlated with resilience score(r=0.905,P＜0.05).Resilience mediated 28.65%of the effect between perceived educational environment and learning burnout.Conclusion:Resilience partially mediates the relationship between perceived educational environment and learning burnout,confirming that perceived educational environment can indirectly reduce learning burnout by enhancing resilience among vocational medical students.

Objective:To investigate the status of resilience,perceived educational environment,and learning burnout among vocational medical students and analyze the mediating role of resilience.Methods:A total of 312 vocational medical students were assessed using the Resilience Scale,Educational Environment Perception Scale,and Learning Burnout Scale.Pearson correlation analysis was conducted to explore the relationships between learning burnout,perceived educational environment,and resilience.Structural equation modeling(SEM)was employed to test the mediating effect.Results:Among 312 vocational medical students,the learning burnout score was(62.24±5.64),the perceived educational environment score was(135.67±14.38),and the resilience score was(48.68±6.63).Learning burnout score was negatively correlated with perceived educational environment score and resilience score(r=-0.896,-0.869,P＜0.05),while perceived educational environment score was positively correlated with resilience score(r=0.905,P＜0.05).Resilience mediated 28.65%of the effect between perceived educational environment and learning burnout.Conclusion:Resilience partially mediates the relationship between perceived educational environment and learning burnout,confirming that perceived educational environment can indirectly reduce learning burnout by enhancing resilience among vocational medical students.