AIM:To establish a physiological-based pharmacokinetic(PBPK)model of ertapen-em in elderly patients with chronic kidney disease,and to analyze the pharmacokinetic/pharmacody-namic index f％ T＞MIC at different doses.METH-ODS:The physicochemical properties and pharma-cokinetic characteristics of ertapenem were collect-ed by reviewing the literature and databases,and a healthy adult model was established in PKSim? software,and then extrapolated to the PBPK model of the elderly.The clinical pharmacokinetic re-search data were used to optimize and validate the model,and the mean folding error(MFE)was used as the index to evaluate the prediction perfor-mance of the model.The final model was used to simulate the in vivo exposure of elderly patients with chronic kidney disease after administration,and the pharmacokinetic/pharmacodynamic index of commonly used clinical dosing regimens was an-alyzed,and the recommended dosing regimens were given.RESULTS:The MFE of the area under the curve(AUC0-t),peak concentration(Cmax)and peak time(Tmmax)predicted by the established PBPK model of ertapenem in adults were 0.92,0.79 and 1.02,respectively,and the predicted value of the optimized PBPK model of ertapenem in the elderly was also consistent with the observed value of 0.5＜MFE＜2 standards,all of which have good predictive performance.With f％ T＞MIC greater than 40％as the drug efficacy target,the minimum inhibitory concentration(MIC)is 0.5-1 μg/mL for sensitive bacteria,and elderly patients with chronic kidney disease can consider reducing the drug dose as ap-propriate.CONCLUSION:The PBPK model of ertap-enem in elderly patients with renal insufficiency has been successfully established,and the model has good prediction performance and provides a reference for clinical personalized medication in el-derly patients with renal insufficiency.

Objective:To analyze the epidemiological characteristics and trends of preterm births in China using medical institution survey data, thereby providing epidemiological data support for perinatal care.Methods:Based on a nationwide sampling survey on healthcare quality data from 2017 to 2022, this study included 3 547, 4 436, 4 513, 4 535, 5 068, and 5 790 medical institutions, with 7 039 107, 8 926 441, 9 006 420, 7 051 984, 7 311 862, and 7 354 062 parturient women, respectively. The overall rates of preterm birth (live births at 28 to 36 +6 weeks of gestation/overall live births) and early preterm birth (live births at 28 to <34 weeks of gestation/overall live births) were calculated at the national level, across diverse provinces, autonomous regions, municipalities and Xinjiang Production and Construction Corps, and for various levels of medical institutions. Generalized estimating equations were used to analyze the influence of maternal characteristics and medical institution characteristics on the rates of preterm birth and early preterm birth. Results:From 2017 to 2022, both the preterm birth rate and the early preterm birth rate in China showed a continuous increase. The preterm birth rate rose from 5.13% (363 036/7 079 454) in 2017 to 6.56% (487 150/7 424 734) in 2022, and the early preterm birth rate increased from 1.32% (118 021/8 971 870) in 2018 to 1.43% (106 157/7 424 734) in 2022. These rates showed an overall increasing trend in private, secondary public specialty, and general hospitals. In tertiary public specialty hospitals, these rates fluctuated around 8.0% and 2.0% from the year 2018, respectively, while in tertiary public general hospitals, these rates peaked in 2020 at 8.63% (205 570/2 381 523) and 2.19% (52 197/2 381 523), respectively. Compared with 2017, by 2022, the preterm birth rate had increased to varying degrees in all provinces, autonomous regions, municipalities and Xinjiang Production and Construction Corps, except for Henan Province [preterm birth rate in 2017 was 6.22% (27 173/437 187); preterm birth rate in 2022 was 5.83% (37 604/645 104)]. As for the early preterm birth rate, it showed a decline in Fujian, Guangdong, Guangxi, Hainan, Henan, Jiangsu, Shanghai, Xinjiang, Yunnan, and Zhejiang, but had increased to varying degrees in all other provinces , autonomous regions, municipalities and Xinjiang Production and Construction Corps across the country. The grade and location of medical institutions both had a significant impact on the preterm birth rate and early preterm birth rate (both P<0.05). For every 1% increase in the proportions of multiparous women, women of advanced maternal age, or twin pregnancies, the preterm birth rate increased by 0.014%, 0.042%, and 0.763%, and the early preterm birth rate increased by 0.004%, 0.013%, and 0.239%, respectively (all P<0.05). Conclusion:From 2017 to 2022, the preterm birth rate and early preterm birth rate in China have continued to rise, reflecting the dual challenges of changing characteristics in the childbearing population and the uneven distribution of medical and health resources faced by maternal and child healthcare in China.

We collected the positive serum of Echinococcus granulosus infection in sheep,an inter-mediate host with strong immune response,and used healthy serum as negative control,purified the serum and target protein to capture and enrich the corresponding antigen by immunoprecipita-tion,and obtained target protein-antibody-target protein complex.Mass spectrometry strategies were combined to screen and identify specific antigens associated with Echinococcus granulosus,and the proteins with the highest peptide coverage were analyzed bioinformatically using online prediction software.The results showed that 133 Echinococcus granulosus related proteins were i-dentified by IP-MS.Among them,one protein with peptide coverage≥70％was actin Ⅱ,and three proteins with peptide coverage between 30％to 40％were Ton B box domain containing protein,NADH dehydrogenase(ubiquinone)1 α-subcomplex 2(NADH dehydrogenase[ubiquinone])and lactic dehydrogenase.There were six proteins with 20％to 30％peptide coverage,namely,spli-cing factor 3B subunit 5,tumor protein D52,expressed conserved protein,NADH dehydrogenase(ubiquinone)1 alpha subcomplex 7,inosine-5'-monophosphate dehydrogenase,and aldo keto re-ductase family 1 member B4.Bioinformatics analysis revealed that actin protein has no signal pep-tide,it is probably a non-secretory protein and is subcellularly localized to the cytoskeleton,six op-timal potential antigenic epitopes are present,and the secondary and tertiary structures are consist-ently dominated by α-helices and irregular convolutions.The results indicate that immunoprecipita-tion-mass spectrometry is a high-throughput,simple,rapid and effective method for screening and identifying fine-grained Echinococcus granulosus antigens,which can provide a basis for screening specific molecules for serodiagnostic markers in intermediate host sheep and for the development of novel diagnostic techniques for hydatid diseases.

With the continuous development of medical technology,the clinical demand for medical consumables is steadily increasing.The management of medical consumables directly impacts both patient safety and institutional operational effi-ciency.By conducting in-depth analysis of the current status and existing problems in medical consumables warehouse manage-ment,this research proposes measures to improve the management system.These measures include optimizing the layout of ware-houses,improving the informatization of warehouse management,strengthening the inventory management of medical consuma-bles,enhancing the management of secondary warehouses,and offering professional skills training for warehouse staff.Manage-ment methods such as PDCA(Plan-Do-Check-Act)are used to continuously optimize warehouse management,enhance the man-agement efficiency of medical consumables management,and ultimately achieve refined management of medical consumables warehouses.

This study aims to construct and identify the cDNA expression library of 3rd day larva of Echinococcus granulosus.Echinococcus granulosus protoscolex was isolated and collected from the liver of a fresh infected sheep with cysts,and the experimental dogs were infected manually by mouth.On the 3rd day,approximately 1.5 meters of the duodenal jejunum was taken during the au-topsy,and the worm body was dislodged by swinging it in 38-40 ℃ physiological saline,and then the 3-day larvae of Echinococcus granulosus were collected.Total RNA was extracted by TRIzol reagent,mRNA was isolated and purified using PolyATtract? mRNA Isolation Systems.The cD-NA was synthesized by reverse transcription,ligated with pBluescript sk-vector after addition of a 5'junction and introduced into E.coli by electrotransformation to construct a cDNA expression li-brary for 3-day-old larvae of Echinococcus granulosus.The average length of insert cDNA frag-ments was 1.0-1.2 kb.The initial capacity of constructed library was 1.15×107 CFU/mL,titer of amplified library was 1× 1010 CFU/mL,recombination rate was 100％.The constructed cDNA ex-pression library and the inserted fragment size were suitable.This library is expected to be used for screening candidate genes and diagnostic antigen molecules of definitive hosts canine vaccines of Echinococcus granulosus.

Objective:To explore medical students'cognition,current status,and demands regarding practical skills training in a medical college under the background of new medical science.Methods:A cross-sectional survey was conducted among medical undergraduates from Year 1 to Year 5 in a medical college.A self-designed scale was used to investigate the cognition,current status,and demands related to new medical education concepts.Pearson correlation analysis was used to analyze the relationship between satisfaction with practical teaching facilities and variables including understanding of new medical education,curriculum design,and proportion of practical teaching.Multiple linear regression was conducted to investigate the factors influencing satisfaction.Results:Among 1 253 participants,70.71%acquired new medical science information through online media,while 52.99%learned about it via school courses.Over 80%endorsed"whole-cycle health management"(preventive care before disease onset 91.94%,disease treatment 81.72%,and post-illness rehabilitation 82.60%).Experimental courses(85.16%),clinical skills training(66.88%),and social practice(66.24%)were primary practical forms,but the participation rates of research practice(40.78%)and innovation/entrepreneurship practice(34.72%)was comparatively lower.The satisfaction with practical teaching was positively correlated with adequacy of faculty guidance(r=0.707)and curriculum rationality(r=0.522)(P＜0.01).The multiple linear regression analysis showed that faculty guidance(β=0.436)and the proportion of practical teaching(β=0.319)were the key predictors of satisfaction.Conclusion:Medical students'cognition of practical skills training,curriculum optimization,and adequacy of faculty guidance significantly influence satisfaction with practical teaching,with faculty guidance and rationality of practical process playing key roles.

Objective To investigate the effect of unilateral or bilateral transcranial direct current stimulation(tDCS)on post-stroke dysphagia.Methods From February,2023 to March,2025,27 stroke patients with dysphagia and nasal feeding in Beijing Bo'ai Hos-pital were randomly divided into healthy side stimulation group,bilateral stimulation group and sham stimulation group,with nine cases in each group.All the groups received conventional swallowing training and tDCS,while the healthy side stimulation group stimulated on the healthy side of oropharyngeal cortex;and the bilateral stimu-lation group alternatively stimulated bilateral oropharyngeal cortex,with one hour interval between bilateral stim-ulation;the sham stimulation group stimulated the healthy side of oropharyngeal cortex for 30 seconds and then stop.The course lasted two weeks.The scores of Standard Swallowing Function Assessment Scale(SSA),Modi-fied Mann Assessment of Swallowing Ability(MMASA)and Rosenbek Penetration-Aspiration Scale(PAS)were compared before and after treatment.Results The intra-group effect(F=16.185,P<0.01)was significant in the scores of SSA,the intra-group effect(F=28.650,P<0.01)and interaction effect(F=3.453,P<0.01)were significant in the scores of MMASA,and there was no significant difference in the inter-group effect,intra-group effect and interaction effect in the scores of PAS(P>0.05).Post hoc test showed that there was no significant difference in the scores of SSA,MMASA and PAS among three groups(P>0.05).There was significant difference in the score difference of MMASA be-fore and after treatment among three groups(F=4.698,P<0.05).Post hoc test showed that the score difference of MMAS was more in the healthy side stimulation group than in the bilateral stimulation group and the sham stimulation group(P<0.05),with no significant difference between the bilateral stimulation group and the sham stimulation group(P>0.05).Conclusion tDCS can partly improve post-stroke dysphagia.The healthy side anode stimulation is superior to the alter-nating bilateral hemisphere anode stimulation.

BACKGROUND:Steroid-induced osteonecrosis of the femoral head is a key risk factor for non-traumatic femoral head necrosis,and the incidence of it has gradually increased in recent years,but its specific pathogenesis is still unclear,and finding a reasonable animal model is essential for disease research and treatment.OBJECTIVE:To review the commonly used animal models of steroid-induced osteonecrosis of the femoral head in recent years,and to analyze the advantages and disadvantages of different modeling methods and evaluation criteria,so as to provide a reference for follow-up research. METHODS:The articles published from 2013 to 2023 were searched in CNKI,WanFang Data,and PubMed with the keywords "femoral head necrosis,osteonecrosis of the femoral head,steroid-induced osteonecrosis of the femoral head,animal model." Finally,61 articles were involved for comprehensive analysis according to the inclusion criteria,including 38 English articles and 23 Chinese articles.RESULTS AND CONCLUSION:(1) Rabbits,rats,and chickens are the animals that are widely used in the study of steroid-induced osteonecrosis of the femoral head models. (2) Hormone combined with lipopolysaccharide or horse serum modeling has low mortality,high success rate,and strong stability. (3) Histopathology is the gold standard for the evaluation model,but the experiment needs to be terminated,which is not conducive to subsequent experimental research,so finding a non-invasive alternative method is still the direction of future efforts. (4) An ideal model of steroid-induced osteonecrosis of the femoral head has not yet been explored,and future researchers need to continue to strive to achieve breakthroughs in this field as soon as possible.

Objective To report the individualized rehabilitation protocol administered to a patient suffering from corpus callosum injury subsequent to cerebral infarction,manifesting clinically as alien hand syndrome,attention deficits,spatial neglect and gait apraxia;and to emphasize the application of functional near infrared spectroscopy(fNIRS)in the assessment of cerebral activation.Methods A 54-year-old male with corpus callosum damage following cerebral infarction was assessed by a comprehen-sive array of neuropsychological assessments,such as Mini-Mental State Examination,Montreal Cognitive As-sessment,Loewenstein Occupational Therapy Cognitive Assessment and Wisconsin Card Sorting Test,etc.Based on these assessments,a personalized rehabilitation program was devised,incorporating physical therapy,occupa-tional therapy,task-oriented training,mirror therapy,computer-assisted cognitive training,as well as Schulte's square attention training,bilateral limb coordination training and transcranial magnetic stimulation(TMS).fNIRS was used to evaluate changes in brain activation before and after rehabilitation.Results After more than a month of comprehensive rehabilitation,the patient experienced significant improvements in Alien hand syndrome,attention deficit and spatial neglect.Gait was normalized,and enhancements were ob-served in motor function,cognition and activity of daily living.fNIRS analysis revealed favorable alterations in cerebral activation patterns.Conclusion For the intricate symptoms associated with corpus callosum injury,a multidisciplinary rehabilitation ap-proach,particularly the incorporation of Schulte's square attention training,bilateral coordination exercises and TMS,alongside fNIRS for monitoring cerebral activation,showed significant rehabilitation effects.

Objective To investigate the effect of ventilation with different tidal volumes on respiratory mechanics and haemodynamics in children with severe pneumonia.Methods A total of 104 children with severe pneumonia were divided into the control group and the observation group using a random number table method,with 52 cases in each group.Both groups underwent mechanical ventilation treatment.The control group was treated with conventional tidal volume of 10-12 mL/kg,while the observation group was given a low tidal volume of 6-8 mL/kg.The respiratory mechanics indicators,hemodynamic indicators and inflammatory factor indicators before and after treatment were compared between the two groups.Results After treatment,the airway resistance(AR)and airway closing pressure(AOP)were lower in the observation group than those of the control group(P＜0.05),and pulmonary dynamic compliance(Cdyn)was higher in the observation group than that of the control group(P＜0.05).There were no significant differences in heart rate(HR),mean arterial pressure(MAP)and central venous pressure(CVP)after treatment between the two groups(P＜0.05).After treatment,the levels of interleukin(IL)-6,IL-8 and tumor necrosis factor-α(TNF-α)were all lower in the observation group than those in the control group(P＜0.05).Conclusion Small tidal volume mechanical ventilation is effective in improving the respiratory mechanics of children with severe pneumonia without causing large fluctuations in their hemodynamics.At the same time,it can reduce the level of inflammatory factors in the organism.