Promoting the international acceptance of clinical studies about traditional Chinese medicine (TCM) interventions is a key strategy for internationalization of TCM. However, the complexities of TCM interventions—in terms of the theories, practice patterns, and components—pose challenges to the design and implementation of clinical studies that are well accepted by the international community. This article summarized the current status of clinical studies about TCM interventions that were published in international journals, explored underlying barriers hindering the international acceptance, and discussed potential strategies for future development.

Promoting the international acceptance of clinical studies about traditional Chinese medicine (TCM) interventions is a key strategy for internationalization of TCM. However, the complexities of TCM interventions—in terms of the theories, practice patterns, and components—pose challenges to the design and implementation of clinical studies that are well accepted by the international community. This article summarized the current status of clinical studies about TCM interventions that were published in international journals, explored underlying barriers hindering the international acceptance, and discussed potential strategies for future development.

Promoting the international acceptance of clinical studies about traditional Chinese medicine (TCM) interventions is a key strategy for internationalization of TCM. However, the complexities of TCM interventions—in terms of the theories, practice patterns, and components—pose challenges to the design and implementation of clinical studies that are well accepted by the international community. This article summarized the current status of clinical studies about TCM interventions that were published in international journals, explored underlying barriers hindering the international acceptance, and discussed potential strategies for future development.

Neoadjuvant therapy for pancreatic cancer is undergoing a paradigm shift from conventional chemotherapy to precision medicine. This expert forum discussed cutting-edge issues in pancreatic cancer neoadjuvant therapy from an evidence-based perspective, incorporating the latest clinical research advances. We focused on innovative directions including immunotherapy combination strategies, liquid biopsy applications, artificial intelligence (AI)-assisted decision making, and individualized precision medicine. We proposed forward-looking concepts such as molecular subtyping-guided individualized treatment strategies, multi-omics integrated efficacy prediction models, and standardized multidisciplinary collaborative care systems. These innovative concepts will drive pancreatic cancer neoadjuvant therapy toward more precise and effective directions.

Objective To explore the effect of a multicomponent exercise and cognitive stimulation program in elderly patients with mental disorders and sarcopenia,so as to provide references for reducing the risk of falls,preventing and improving sarcopenia,and enhancing cognitive function in patients.Methods The multi-component exercise and cognitive stimulation program was formulated through literature review and expert meeting.In this quasi-experimental study,76 elderly patients with mental disorders and sarcopenia who were hospitalized in a tertiary mental health center in Shanghai from January 2023 to February 2024 were selected as research subjects.They were randomly divided into an experimental group and a control group according to their hospitalization building number(38 cases in each group).The experimental group was treated with multicomponent exercise combined with cognitive stimulation program based on routine nursing,and the control group was treated with routine nursing.The risk of falls,skeletal muscle mass,muscle strength,physical function,cognitive function,and incidence of adverse events were compared between 2 groups after 12 weeks of intervention.Results A total of 75 patients with 37 in the control group and 38 in the experimental group completed the study.The TUG time,6M walking speed and the score of Short Physical Performance Bettery of the experimental group were all lower than those of the control group(P＜0.05),and the scores of skeletal muscle mass,muscle strength,calf circumference,physical function and cognitive function of the experimental group were all higher than those of the control group(P＜0.05).Neither group experienced any adverse events.Conclusion The application of this multicomponent exercise combined cognitive stimulation program developed for elderly patients with mental disorders and sarcopenia can effectively reduce the risk of falls,enhance the skeletal muscle mass and muscle strength and improve the cognitive function in elderly patients with mental disorders and sarcopenia.

OBJECTIVE To investigate the characteristics of multidrug-resistant organisms(MDROs)infections in the patients of intensive care units(ICUs)so as to provide supportive data for precise prevention and control of in-fections.METHODS From Jan.2016 to Dec.2023,the case-time incidence of hospital-associated MDROs infec-tions,constituent ratios,infection sites and characteristics of drug resistance were observed and compared among the patients from 5 different ICUs of the First Affiliated Hospital of Suzhou University by means of real-time sur-veillance system of hospital-associated infection.RESULTS Among the ICU patients,there were 1322 case-times of hospital-associated infections with MDROs,and the case-time incidence rate was 4.67％,which varied in the ICUs.The patients with lower respiratory tract infections accounted for 66.51％,the patients with bloodstream infections 14.53％,the patients with urinary tract infections 10.78％.The distribution of infection sites,distribu-tion of pathogens and etiological spectrum of infection sites varied according to the ICUs.In general,the percenta-ges of carbapenem-resistant Klebsiella pneumoniae(CRKP)and carbapenem-resistant Acinetobacter baumannii(CRAB)infections were highest,which were 35.63％(471/1322)and 38.28％(506/1322),respectively.The drug resistance rates of the CRKP strains to polymyxin B and ceftazidime-avibactam were low,and the drug re-sistance rate to tigecycline was 38.44％.The drug resistance rates of the CRAB strains to polymyxin B and tigecy-cline were 10.00％and 21.64％,respectively.The carbapenem-resistant Pseudomonas aeruginosa(CRPA)strains showed high sensitivity to most of the antibiotics.The drug resistance rates of the methicillin-resistant Staphylococcus aureus(MRSA)strains to tetracycline,levofloxacin,gentamicin,moxifloxacin and ciprofloxacin were high.CONCLUSION It is necessary for the hospital to reasonably use antibiotics based on the result of sur-veillance of MDROs in the ICUs and take targeted prevention measures for the infections.

OBJECTIVE To investigate the current status and risk factors of carbapenem-resistant gram-negative or-ganisms(CRO)infections in neurosurgical ICU patients,and to construct and validate their prediction models.METHODS Clinical data and active screening microbiological results of 113 patients admitted to the Neurosurgical Intensive Care Unit(ICU)of The First Affiliated Hospital of Soochow University between Jul.2023 and Jan.2024 were retrospectively collected,and the patients were divided into a CRO-infected group(n=28)and a non-CRO-infected group(n=85).Predictive variables were screened using LASSO regression and logistic regression.Risk prediction models were constructed using random forest(RF)and logistic regression,the performance of the mod-el was evaluated by analyzing the area under the receiver operating characteristic(ROC)curve(AUC),calibration curves,and decision curves,and internal validation was performed using the bootstrap resampling method.RESULTS Among 113 neurosurgical ICU patients,28 cases developed CRO infections,with an infection rate of 24.78％.The highest infection rate was observed in lower respiratory tract infection,with 17 cases(15.04％).The predominant CRO pathogens were carbapenem-resistant Klebsiella pneumoniae(CRKP)and carbapenem-re-sistant Acinetobacter baumannii(CRAB),accounting for 50.00％and 42.86％of cases respectively.The AUC values for the RF prediction model and nomogram prediction modeling groups were 0.881 and 0.787 respectively,with Brier scores of 0.114 and 0.146,and threshold probabilities of net benefit ranging from 10％to 97％and 12％to 62％respectively.The RF prediction model exhibited superior discrimination,calibration,and clinical u-tility.The RF prediction model demonstrated that days of combined use of meropenem and vancomycin,GCS score,intestinal colonization,and hospitalization history were important predictors for CRO infections.CONCLUSION The prediction model for CRO infections in neurosurgical ICU patients established based on random forest algorithm has good predictive performance,and can be intervened with preventive and control measures for important predictive factors.

Objective To explore the effect of a multicomponent exercise and cognitive stimulation program in elderly patients with mental disorders and sarcopenia,so as to provide references for reducing the risk of falls,preventing and improving sarcopenia,and enhancing cognitive function in patients.Methods The multi-component exercise and cognitive stimulation program was formulated through literature review and expert meeting.In this quasi-experimental study,76 elderly patients with mental disorders and sarcopenia who were hospitalized in a tertiary mental health center in Shanghai from January 2023 to February 2024 were selected as research subjects.They were randomly divided into an experimental group and a control group according to their hospitalization building number(38 cases in each group).The experimental group was treated with multicomponent exercise combined with cognitive stimulation program based on routine nursing,and the control group was treated with routine nursing.The risk of falls,skeletal muscle mass,muscle strength,physical function,cognitive function,and incidence of adverse events were compared between 2 groups after 12 weeks of intervention.Results A total of 75 patients with 37 in the control group and 38 in the experimental group completed the study.The TUG time,6M walking speed and the score of Short Physical Performance Bettery of the experimental group were all lower than those of the control group(P＜0.05),and the scores of skeletal muscle mass,muscle strength,calf circumference,physical function and cognitive function of the experimental group were all higher than those of the control group(P＜0.05).Neither group experienced any adverse events.Conclusion The application of this multicomponent exercise combined cognitive stimulation program developed for elderly patients with mental disorders and sarcopenia can effectively reduce the risk of falls,enhance the skeletal muscle mass and muscle strength and improve the cognitive function in elderly patients with mental disorders and sarcopenia.

OBJECTIVE To investigate the characteristics of multidrug-resistant organisms(MDROs)infections in the patients of intensive care units(ICUs)so as to provide supportive data for precise prevention and control of in-fections.METHODS From Jan.2016 to Dec.2023,the case-time incidence of hospital-associated MDROs infec-tions,constituent ratios,infection sites and characteristics of drug resistance were observed and compared among the patients from 5 different ICUs of the First Affiliated Hospital of Suzhou University by means of real-time sur-veillance system of hospital-associated infection.RESULTS Among the ICU patients,there were 1322 case-times of hospital-associated infections with MDROs,and the case-time incidence rate was 4.67％,which varied in the ICUs.The patients with lower respiratory tract infections accounted for 66.51％,the patients with bloodstream infections 14.53％,the patients with urinary tract infections 10.78％.The distribution of infection sites,distribu-tion of pathogens and etiological spectrum of infection sites varied according to the ICUs.In general,the percenta-ges of carbapenem-resistant Klebsiella pneumoniae(CRKP)and carbapenem-resistant Acinetobacter baumannii(CRAB)infections were highest,which were 35.63％(471/1322)and 38.28％(506/1322),respectively.The drug resistance rates of the CRKP strains to polymyxin B and ceftazidime-avibactam were low,and the drug re-sistance rate to tigecycline was 38.44％.The drug resistance rates of the CRAB strains to polymyxin B and tigecy-cline were 10.00％and 21.64％,respectively.The carbapenem-resistant Pseudomonas aeruginosa(CRPA)strains showed high sensitivity to most of the antibiotics.The drug resistance rates of the methicillin-resistant Staphylococcus aureus(MRSA)strains to tetracycline,levofloxacin,gentamicin,moxifloxacin and ciprofloxacin were high.CONCLUSION It is necessary for the hospital to reasonably use antibiotics based on the result of sur-veillance of MDROs in the ICUs and take targeted prevention measures for the infections.

OBJECTIVE To investigate the current status and risk factors of carbapenem-resistant gram-negative or-ganisms(CRO)infections in neurosurgical ICU patients,and to construct and validate their prediction models.METHODS Clinical data and active screening microbiological results of 113 patients admitted to the Neurosurgical Intensive Care Unit(ICU)of The First Affiliated Hospital of Soochow University between Jul.2023 and Jan.2024 were retrospectively collected,and the patients were divided into a CRO-infected group(n=28)and a non-CRO-infected group(n=85).Predictive variables were screened using LASSO regression and logistic regression.Risk prediction models were constructed using random forest(RF)and logistic regression,the performance of the mod-el was evaluated by analyzing the area under the receiver operating characteristic(ROC)curve(AUC),calibration curves,and decision curves,and internal validation was performed using the bootstrap resampling method.RESULTS Among 113 neurosurgical ICU patients,28 cases developed CRO infections,with an infection rate of 24.78％.The highest infection rate was observed in lower respiratory tract infection,with 17 cases(15.04％).The predominant CRO pathogens were carbapenem-resistant Klebsiella pneumoniae(CRKP)and carbapenem-re-sistant Acinetobacter baumannii(CRAB),accounting for 50.00％and 42.86％of cases respectively.The AUC values for the RF prediction model and nomogram prediction modeling groups were 0.881 and 0.787 respectively,with Brier scores of 0.114 and 0.146,and threshold probabilities of net benefit ranging from 10％to 97％and 12％to 62％respectively.The RF prediction model exhibited superior discrimination,calibration,and clinical u-tility.The RF prediction model demonstrated that days of combined use of meropenem and vancomycin,GCS score,intestinal colonization,and hospitalization history were important predictors for CRO infections.CONCLUSION The prediction model for CRO infections in neurosurgical ICU patients established based on random forest algorithm has good predictive performance,and can be intervened with preventive and control measures for important predictive factors.