ObjectiveTo evaluate the efficacy of immediate postoperative oral administration of 2 mg estradiol/estradiol dydrogesterone tablets in reducing secondary surgery for retainedproducts of conception（RPOC）， preventing intrauterine adhesions（IUA）， and promoting endometrial repair following induced abortion. MethodsA retrospective analysis was conducted on 494 patients who underwent induced abortion. The control group （n=214） received conventional postoperative treatment with antibiotics and Yimucao granules， while the observation group （n=280） received immediate administration of estradiol/dydrogesterone tablets （each tablet contains 2 mg of estradiol），combined with antibiotics and Yimucao granules. The two groups were compared for the secondary surgery rate for RPOC， incidence of IUA， endometrial thickness at 2 weeks postoperatively， duration of postoperative vaginal bleeding， time to menstrual resumption， incidence of reduced menstrual volume after resumption， and postoperative complications （pelvic infection， intrauterine fluid accumulation）. ResultsThe observation group showed a lower rate of secondary surgery for RPOC compared to the control group （0.4% vs 2.3%）， but the difference was not statistically significant （P=0.13， Fisher’s exact test）. The observation group also had a significantly lower incidence of IUA （P<0.05）， greater postoperative endometrial thickness at 2 weeks （P<0.05）， and significantly shorter duration of postoperative vaginal bleeding and time to menstrual resumption. The incidence of reduced menstrual volume postoperatively and complications （pelvic infection， intrauterine fluid accumulation） were also significantly lower in the observation group （all P<0.05）. ConclusionImmediate oral administration of estradiol/dydrogesterone tablets after induced abortion significantly prevents intrauterine adhesions， shortens postoperative vaginal bleeding duration， promotes endometrial repair， improves menstrual recovery， and potentially reduces the risk of secondary surgery for retained products of conception.

The aim of this updated guideline is to provide comprehensive recommendations for the management of gout in patients with common comorbidities, such as chronic kidney disease(CKD), cardiovascular disease(CVD), diabetes, osteoarthritis(OA), and gastrointestinal disorders. This guideline was developed by a multidisciplinary expert panel consisting of specialists in endocrinology, rheumatology, nephrology, cardiology, gastroenterology, and methodology. The development process adhered to standard methodologies, including PICO(population, intervention, comparator, and outcomes) question deconstruction, systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation(GRADE) for evidence and recommendation evaluation, Delphi voting, and expert consensus. The guideline presents 26 evidence-based recommendations addressing 7 clinical questions for patients with hyperuricemia and gout in the context of comorbidities. Key recommendations include the maintenance of strict serum urate targets, particularly for patients with CKD stage≥3, chronic gouty arthritis, and OA, in order to prevent disease progression. In patients with CVD or diabetes, intra-articular triamcinolone is preferred over systemic glucocorticoids. Prioritized anti-inflammatory treatments for patients with CKD, gastrointestinal diseases and OA are recommended. The guideline also introduces emerging therapies, such as interleukin-1 inhibitors and selective urate transport inhibitors, as potential treatment options for refractory cases. The update offers a comprehensive, patient-centered approach to managing gout, particularly in individuals with associated comorbidities. Multidisciplinary collaboration and emerging new treatments and evidence ensure the optimization of the recommendations.

Objective To explore the differences in the use of hypoglycemic drugs and glycated hemoglobin(HbA1c)levels among elderly patients with type 2 diabetes mellitus(T2DM)of different age groups,and to provide some references for individualized blood glucose control in elderly T2DM patients.Methods A retrospective study was conducted.A total of 187 elderly(≥70 years old)T2DM patients admitted to Guangdong Provincial People's Hospital from October 2022 to August 2024 were selected as the research subjects.The patients were divided into three groups according to age:70-79(93 cases),80-89(52 cases),and≥90(42 cases)years old.The differences in glucose metabolism,lipid metabolism,renal function and the use of hypoglycemic drugs among the groups were compared.Results With increasing age,the hospital stays for the 70-79,80-89,and≥90 years old groups significantly increased(days:7.78±2.84,10.17±7.97,15.45±11.21,P<0.05),diastolic blood pressure gradually decreased[mmHg(1 mmHg≈ 0.133 kPa):75.60±9.15,73.77±10.79,67.45±9.50],estimated glomerular filtration rate(eGFR)and HbA1c both significantly decreased[eGFR(mL·min-1·1.73 m-2):65.55±23.01,49.68±20.19,46.39±16.41;HbA1c(9.02±1.99)%,(8.75±2.21)%,(7.80±1.43)%,all P<0.05].In terms of hypoglycemic treatment,the average number of hypoglycemic drugs used by the≥90 years old group was significantly less than that of the 80-89 years old group and the 70-79 years old group(types:1.86±0.78 vs.2.67±1.12,2.88±0.93,both P<0.01).With increasing age,the usage rates of sodium-glucose cotransporter 2 inhibitors(SGLT-2i)and metformin(MET)in the 70-79,80-89,and≥90 years old groups gradually decreased[SGLT-2i:50.54%(47/93),42.31%(22/52),26.19%(11/42),MET:46.24%(43/93),30.77%(16/52),7.14%(3/42),all P<0.05].Conclusions Medical workers have fully considered factors such as renal function,diabetic cardiovascular complications,health status,and life expectancy in the use of hypoglycemic drugs for elderly T2DM patients and have implemented individualized blood glucose management.However,in the≥90 years old group,the HbA1c level is too strict,and the risk of hypoglycemia should be carefully prevented.

Although percutaneous pulmonary artery denervation (PADN) has demonstrated long-term benefits in combined post- and pre-capillary pulmonary hypertension, its usefulness for isolated post-capillary pulmonary hypertension (IpcPH) remains unclear. This report presents 2 cases of IpcPH due to left heart failure who underwent PADN treatment following an insufficient response to optimized conventional therapy. This case study illustrates how PADN, when combined with heart failure guideline-directed medical therapy, may represent a promising treatment option for IpcPH.

Objective:To analyze the epidemiological and clinical characteristics of leptospirosis in Wenzhou City, and to provide a scientific basis for formulating prevention and control strategies of leptospirosis in Wenzhou City.Methods:Information on leptospirosis case from 2019 to 2023 was collected from the China Information System for Disease Control and Prevention. Descriptive epidemiological methods were used to analyze the three-dimensional distribution and clinical manifestations of leptospirosis.Results:From 2019 to 2023, the annual average incidence rate of leptospirosis in Wenzhou City was 0.43/100 000, and the annual average mortality was 0.01/100 000. The incidence rate was the highest in 2021 (0.74/100 000), and there was a statistically significant difference in the incidence rate over the five years ( χ2 = 35.48, P < 0.001). Cases were reported in all regions in Wenzhou City except for Dongtou District and Longgang City, with Yongjia County had the highest number of cases (114 cases). The impact rate of streets/townships was 35.14% (65/185), among them Yongjia County had the highest impact rate of steets/townships (86.36%, 19/22). The onset season was from August to October (88.83%, 159/179), with a male to female ratio of 4.97 ∶ 1.00 (149/30). The age group of 61 - 70 years old was the most affected (39.66%, 71/179), and farmers were the main occupation (70.95%, 127/179). Twenty-six point eighty-two per cent (48/179) of the cases had a clear history of animal contact within one month before onset, and 68.16% (122/179) had a history of contact with contaminated water. The main clinical type was influenza-typhoid type (23.46%, 42/179), with the main clinical manifestations being fever (84.92%, 152/179), chills (55.87%, 100/179), and fatigue (62.57%, 112/179). Twelve point twenty-nine per cent 12.29% (22/179), 8.38% (15/179), and 22.91% (41/179) of cases showed conjunctival congestion, lymph node enlargement, and gastrocnemius muscle tenderness, respectively. Clinical outcomes showed that 73.74% (132/179) of the cases recovered or improved, and 3 cases died. Conclusions:From 2019 to 2023, the overall prevalence of leptospirosis in Wenzhou City is at a low level, but there are deaths that need to be taken seriously. In order to control the disease, continuous monitoring should be carried out, health education for relevant populations should be strengthened, and the risk of leptospirosis should be reduced.

This paper reviews the current situation of massive open online course (MOOC) construction both domestically and internationally, highlighting the similarities, differences, and limitations of MOOC construction across nations. Based on the full-cycle MOOC construction of the "clinical epidemiology" course at Southern Medical University, including course design, resource integration, online deployment, and teaching evaluation, this study explored the significance, implementation path, and challenges of MOOC construction. This paper also reflects on the activation of teaching content, teacher-student interaction, and teaching mode, aiming to provide a reference for the construction and continuous enhancement of MOOC in China.

Objective:To dry fresh Ginseng Radix et Rhizoma using different drying conditions; To investigate the effects of different drying conditions on the drying characteristics and medicinal quality of Ginseng Radix et Rhizoma.Methods:With moisture, powder color, extract, total polysaccharide and ginsenoside contents of Rg 1, Re, Rf, Rb 1, Rc, Rb 2 and Rd as indexes, the drying characteristics of Ginseng Radix et Rhizoma were studied based on Weibull function model, and the quality of Ginseng Radix et Rhizoma after drying was evaluated by entropy weight-TOPSIS model. Results:The drying method for Ginseng Radix et Rhizoma from its origin can be achieved by controlling the relative humidity of the drying medium to 50%, drying at 70 ℃ for 24 h, and then reducing the drying temperature to 60 ℃ until the moisture content was below 12.0%. This method could achieve high drying efficiency and produce high-quality Ginseng Radix et Rhizoma.Conclusions:The drying process of Ginseng Radix et Rhizoma is a falling rate process controlled by internal moisture diffusion. The drying rate of fresh Ginseng Radix et Rhizoma is affected by temperature and humidity. There is a certain correlation between the color of powder and the content of moisture, alcohol-soluble extractives and ginsenosides.

The aim of this updated guideline is to provide comprehensive recommendations for the management of gout in patients with common comorbidities, such as chronic kidney disease(CKD), cardiovascular disease(CVD), diabetes, osteoarthritis(OA), and gastrointestinal disorders. This guideline was developed by a multidisciplinary expert panel consisting of specialists in endocrinology, rheumatology, nephrology, cardiology, gastroenterology, and methodology. The development process adhered to standard methodologies, including PICO(population, intervention, comparator, and outcomes) question deconstruction, systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation(GRADE) for evidence and recommendation evaluation, Delphi voting, and expert consensus. The guideline presents 26 evidence-based recommendations addressing 7 clinical questions for patients with hyperuricemia and gout in the context of comorbidities. Key recommendations include the maintenance of strict serum urate targets, particularly for patients with CKD stage≥3, chronic gouty arthritis, and OA, in order to prevent disease progression. In patients with CVD or diabetes, intra-articular triamcinolone is preferred over systemic glucocorticoids. Prioritized anti-inflammatory treatments for patients with CKD, gastrointestinal diseases and OA are recommended. The guideline also introduces emerging therapies, such as interleukin-1 inhibitors and selective urate transport inhibitors, as potential treatment options for refractory cases. The update offers a comprehensive, patient-centered approach to managing gout, particularly in individuals with associated comorbidities. Multidisciplinary collaboration and emerging new treatments and evidence ensure the optimization of the recommendations.

Objective To explore the differences in the use of hypoglycemic drugs and glycated hemoglobin(HbA1c)levels among elderly patients with type 2 diabetes mellitus(T2DM)of different age groups,and to provide some references for individualized blood glucose control in elderly T2DM patients.Methods A retrospective study was conducted.A total of 187 elderly(≥70 years old)T2DM patients admitted to Guangdong Provincial People's Hospital from October 2022 to August 2024 were selected as the research subjects.The patients were divided into three groups according to age:70-79(93 cases),80-89(52 cases),and≥90(42 cases)years old.The differences in glucose metabolism,lipid metabolism,renal function and the use of hypoglycemic drugs among the groups were compared.Results With increasing age,the hospital stays for the 70-79,80-89,and≥90 years old groups significantly increased(days:7.78±2.84,10.17±7.97,15.45±11.21,P<0.05),diastolic blood pressure gradually decreased[mmHg(1 mmHg≈ 0.133 kPa):75.60±9.15,73.77±10.79,67.45±9.50],estimated glomerular filtration rate(eGFR)and HbA1c both significantly decreased[eGFR(mL·min-1·1.73 m-2):65.55±23.01,49.68±20.19,46.39±16.41;HbA1c(9.02±1.99)%,(8.75±2.21)%,(7.80±1.43)%,all P<0.05].In terms of hypoglycemic treatment,the average number of hypoglycemic drugs used by the≥90 years old group was significantly less than that of the 80-89 years old group and the 70-79 years old group(types:1.86±0.78 vs.2.67±1.12,2.88±0.93,both P<0.01).With increasing age,the usage rates of sodium-glucose cotransporter 2 inhibitors(SGLT-2i)and metformin(MET)in the 70-79,80-89,and≥90 years old groups gradually decreased[SGLT-2i:50.54%(47/93),42.31%(22/52),26.19%(11/42),MET:46.24%(43/93),30.77%(16/52),7.14%(3/42),all P<0.05].Conclusions Medical workers have fully considered factors such as renal function,diabetic cardiovascular complications,health status,and life expectancy in the use of hypoglycemic drugs for elderly T2DM patients and have implemented individualized blood glucose management.However,in the≥90 years old group,the HbA1c level is too strict,and the risk of hypoglycemia should be carefully prevented.

OBJECTIVES: To investigate the mechanisms of Modified Chaihu Guizhi Decoction (MCGD) for ameliorating anxiety- and depression-like behaviors in a mouse model of chronic unpredictable mild stress (CUMS). METHODS: The main chemical constituents of MCGD were identified through literature review, and network pharmacology analysis was performed to predict the potential pharmacological mechanisms of MCGD. For in vivo validation, male C57BL/6J mice were randomized into control group, CUMS model group, fluoxetine (FLX) treatment group, and low- and high-dose MCGD treatment groups (n=15), and in all but the control group, CUMS models were established by daily exposure to two randomized stressors for 28 consecutive days. Starting from 3 days prior to modeling, MCGD and fluoxetine treatments were administered daily via gavage and intraperitoneal injection, respectively. Depression- and anxiety-like behaviors of the mice were assessed using sucrose preference test, forced swim test, open field test and elevated plus maze test. The changes in mRNA expressions of the clock genes and inflammatory markers and expressions of the JAK2/STAT3 signaling proteins were detected using RT-qPCR and Western blotting, and immunofluorescence staining was used to detect microglia activation in the mice. RESULTS: The key active compounds in MCGD identified by network pharmacology analysis included quercetin, acacetin, formononetin, nobiletin, and baicalein. GO analysis identified 607 enriched pathways, and KEGG pathway enrichment revealed significant involvement of the JAK2/STAT3 and NF-κB signaling pathways. In the mouse models of CUMS, treatment with both fluoxetine and MCGD significantly alleviated anxiety- and depression-like behaviors. MCGD treatment significantly reduced Iba1 expression, improved the inflammatory markers, reversed the decrease in clock gene circadian rhythm amplitude, and obviously downregulated the expressions of JAK2, p-STAT3, p-NF-κB, IL-1β, and IL-6 proteins. CONCLUSIONS MCGD effectively alleviates anxiety- and depression-like behaviors in CUMS mice by modulating the inflammatory pathways and inhibiting the JAK2/STAT3 signaling pathway.
Animals ; Janus Kinase 2/metabolism* ; STAT3 Transcription Factor/metabolism* ; Signal Transduction/drug effects* ; Depression/metabolism* ; Drugs, Chinese Herbal/pharmacology* ; Mice ; Male ; Mice, Inbred C57BL ; Anxiety/drug therapy* ; Stress, Psychological ; Disease Models, Animal