Approximately 30%-40% of epilepsy patients do not respond well to adequate anti-seizure medications (ASMs), a condition known as pharmacoresistant epilepsy. The management of pharmacoresistant epilepsy remains an intractable issue in the clinic. Its early prediction is important for prevention and diagnosis. However, it still lacks effective predictors and approaches. Here, a classical model of pharmacoresistant temporal lobe epilepsy (TLE) was established to screen pharmacoresistant and pharmaco-responsive individuals by applying phenytoin to amygdaloid-kindled rats. Ictal electroencephalograms (EEGs) recorded before phenytoin treatment were analyzed. Based on ictal EEGs from pharmacoresistant and pharmaco-responsive rats, a convolutional neural network predictive model was constructed to predict pharmacoresistance, and achieved 78% prediction accuracy. We further found the ictal EEGs from pharmacoresistant rats have a lower gamma-band power, which was verified in seizure EEGs from pharmacoresistant TLE patients. Prospectively, therapies targeting the subiculum in those predicted as "pharmacoresistant" individual rats significantly reduced the subsequent occurrence of pharmacoresistance. These results demonstrate a new methodology to predict whether TLE individuals become resistant to ASMs in a classic pharmacoresistant TLE model. This may be of translational importance for the precise management of pharmacoresistant TLE.
Epilepsy, Temporal Lobe/diagnosis* ; Animals ; Drug Resistant Epilepsy/drug therapy* ; Electroencephalography/methods* ; Rats ; Anticonvulsants/pharmacology* ; Neural Networks, Computer ; Male ; Humans ; Phenytoin/pharmacology* ; Adult ; Disease Models, Animal ; Female ; Rats, Sprague-Dawley ; Young Adult ; Convolutional Neural Networks

As a common clinical treatment technique, nasogastric tube insertion plays an important role in assisting in disease diagnosis and treatment, and promoting patient recovery. Nasogastric tubes currently used in clinical practice are packaged individually without accompanying sterile materials, hence additional materials need to be prepared before operation, which is complicated and prone to omission, consumes clinical manpower, and increases the proportion of departmental consumption. The operator needs to hold the nasogastric tube with one hand and place it with the other hand during operation, the lack of auxiliary tool for uniformly controlling the placement of gastric tubes may easily lead to tube failure due to patient intolerance, agitation, or uneven force exerted by the operator, and improper force may even result in violent tube placement, leading to adverse outcomes such as mucosal bleeding and aspiration into the airway. Medical staff of intensive care unit of department of infectious diseases of Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology have designed a nasogastric tube auxiliary pushing device and an intubation kit to overcome the above problems, and obtaining National Utility Model Patent of China (patent number: ZL 2024 2 0300856.X). The device consists of two parts: a nasogastric tube auxiliary pushing device and a nasogastric tube insertion kit. Nasogastric tube auxiliary pushing device mainly consists of a nasogastric tube with guide wire, a circular wire harness, and a booster base with a pushing element. The tube insertion kit includes sterile treatment trays, main placement slots, and other operational accessory slots. The new nasogastric tube auxiliary pushing device and tube insertion kit integrates packaging and portable design, providing stable and uniform assistance for safe insertion of nasogastric tubes by a single person, which is able to reduce the occurrence of complications, ensure patient safety, improve patient comfort, and reduce occupational exposure risks, making it suitable for clinical promotion.
Intubation, Gastrointestinal/methods* ; Equipment Design ; Humans

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective:To investigate the clinical characteristics and risk factors of airway mucus plugging in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods:This was a retrospective cross-sectional study. A total of 322 hospitalized AECOPD patients admitted to the First Affiliated Hospital of Anhui Medical University from February 2023 to February 2025 were enrolled. Based on chest high-resolution computed tomography (HRCT) findings of airway mucus plugging, patients were classified into mucus plugging and non-mucus plugging groups. General and clinical data were collected, including age, sex, disease duration, smoking and alcohol history, comorbidities, number of acute exacerbations in the past year, routine blood tests, biochemical indices, pulmonary function, and pathogen detection. The incidence of airway mucus plugging in AECOPD patients was calculated, and differences in baseline characteristics, laboratory parameters, and pulmonary function between the two groups were compared. Logistic regression was used to identify independent risk factors for mucus plugging, and receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of relevant indicators.Results:Of the 322 enrolled patients, 87(27.02%) were found to have airway mucus plugging. Univariate analysis revealed statistically significant differences between the mucus plug group and the non-plug group in the following parameters (all P<0.05): body mass index (BMI), disease duration, smoking status, Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, modified British Medical Research Council (mMRC) dyspnea scale, COPD Assessment Test (CAT) score, frequency of acute exacerbations, neutrophil percentage, absolute lymphocyte count, lymphocyte percentage, albumin, C-reactive protein (CRP), activated partial thromboplastin time, fibrinogen, fibrin(ogen) degradation products, D-dimer, Aspergillus infection rate, percentage of forced expiratory volume in 1 second to predicted value (FEV 1%pred), ratio of FEV 1 to forced vital capacity (FEV 1/FVC), and percentage of maximal mid-expiratory flow to predicted value (MMEF 75/25%pred). Multivariate logistic regression analysis identified the following as independent risk factors for airway mucus plugs (all P<0.05): elevated CRP ( OR=1.022, 95% CI: 1.013-1.036), decreased albumin ( OR=0.891, 95% CI: 0.825-0.959), Aspergillus infection ( OR=1.774, 95% CI: 1.366-2.317), and reduced MMEF 75/25%pred value ( OR=0.978, 95% CI: 0.964-0.990). ROC curve analysis showed that the combined predictive model incorporating CRP, albumin, Aspergillus infection, and MMEF 75/25%pred had an area under the ROC curve (AUC) of 0.776(95% CI: 0.714-0.838), which was superior to each individual indicator alone, with AUCs of 0.721 for CRP, 0.687 for albumin, 0.579 for Aspergillus infection, and 0.631 for MMEF 75/25%pred. Conclusions:AECOPD patients with airway mucus plugging exhibit higher inflammatory markers, poorer nutritional status, a higher likelihood of Aspergillus infection, worse pulmonary function, and poorer prognosis. Aspergillus infection, elevated CRP, decreased albumin, and reduced MMEF 75/25%pred are independent risk factors for mucus plugs in AECOPD.

Objective : To analyze the influencing factors associated with the coexistence of multidrug-resistantEscherichia coli(MDR-ECO) infection and active tuberculosis(ATB) in patients with lung infections. Methods: A total of 204 hospitalized patients with lung infections caused by MDR-ECO were enrolled. Among them, patients with coexisting ATB were identified and assigned to the observation group. Univariate and multivariate Logistic regression analysis were performed to identify the risk factors for the coexistence of MDR-ECO lung infection and ATB. Results : Factors such as patient age, neutrophil count, hemoglobin level, malignancy, rheumatoid arthritis, history of antibiotic exposure, and history of surgery within the past year were found to be influencing factors for the coexistence of MDR-ECO lung infection and ATB(allP<0.05). Specifically, advanced age(95%CI: 0.949-0.992,P=0.008), decreased neutrophils(95%CI: 0.750-0.922,P<0.001), and a history of antibiotic exposure(95%CI: 1.202-2.596,P=0.004) were identified as risk factors. Conclusion Some patients with MDR-ECO lung infections are prone to coexisting with ATB. Therefore, it is recommended to strengthen ATB screening among high-risk patients, including those at peak ages for susceptibility, with low neutrophil counts, and with a history of antibiotic exposure.

In recent years,significant breakthroughs have been achieved in the immunotherapy for Alzheimer's disease.In line with global advancements,two anti-amyloid-β monoclonal antibodies have been approved and successfully launched in China for clinical use.Lecanemab and Donanemab were officially used in June 2024 and April 2025 in China,respectively.In order to standardize the rational and safe application of anti-amyloid-β monoclonal antibodies for Alzheimer's disease in China,this article integrates recom-mendations from the clinical trials and real-world experience from the author's team and domestic peers to further update the recom-mendations for the clinical use of anti-amyloid-β monoclonal antibody based on the 2024 version.It includes indications for therapy,pre-treatment evaluation and preparation,administration protocols and safety measures during treatment,and post-treatment monitor-ing strategies.

This article outlines the formulation process of the local standard of Traditional Chinese Medicine Chronic Disease Management Guideline for Menopausal Women with Emotional Disorders(DB44/T 2547-2024;hereafter referred to as the"Guideline").By analyzing its structural framework and content,this study elucidates the TCM-specific chronic disease management strategies incorporated in the Guidelines,aiming to supply references to the development of similar standards and provide guidance for TCM chronic disease management practices.The development for the Guideline involved a multi-dimensional evidence collection process,including literature review,summary of expert experience,and expert consultations.By employing a multi-dimensional evidence-based approach,the Guideline has effectively integrated diverse evidence sources,and ensures the standard formulation being scientific and precise.The Guideline proposes the requirements for TCM-specific chronic disease management of menopausal women with emotional disorders firstly.By incorporating TCM lifestyle regulation,TCM emotional management,TCM dietary therapy,medication guidance,exercise therapies,and distinctive external treatments,the Guideline has developed into a comprehensive TCM chronic disease management system for prevention,treatment,rehabilitation and health preservation.The integrated approach effectively reduces the recurrence of emotional disorder and enhances quality of life of the patients.

Objective:To systematically analyze the revisions content and technological development trends of microbiological standards in the Chinese Pharmacopoeia(ChP)2025 Edition,and explore its novel requirements in risk-based pharmaceutical product lifecycle management.Methods:A comprehensive review was conducted on 26 microbiological-related standards to summarize the revision directions and scientific implications from perspectives including the revision overview,international harmonization of microbiological standards,risk-based quality man-agement system,and novel tools and methods with Chinese characteristics.Results:The ChP 2025 edition demon-strates three prominent features in microbiological-related standards:enhanced international harmonization,intro-duced emerging molecular biological technologies,and established a risk-based microbiological quality control sys-tem.Conclusion:The new edition of the Pharmacopoeia has systematically constructed a microbiological standard system,which significantly improves the scientificity,standardization and applicability of the standards,providing a crucial support for advancing the microbiological quality control in pharmaceutical industries of China.

Objective: To systematically analyze the revisions content and technological development trends of microbiological standards in the Chinese Pharmacopoeia (ChP) 2025 Edition, and explore its novel requirements in risk-based pharmaceutical product lifecycle management.
Methods: A comprehensive review was conducted on 26 microbiological-related standards to summarize the revision directions and scientific implications from perspectives including the revision overview, international harmonization of microbiological standards, risk-based quality management system, and novel tools and methods with Chinese characteristics.
Results: The ChP 2025 edition demonstrates three prominent features in microbiological-related standards: enhanced international harmonization, introduced emerging molecular biological technologies, and established a risk-based microbiological quality control system.
Conclusion: The new edition of the Pharmacopoeia has systematically constructed a microbiological standard system, which significantly improves the scientificity, standardization and applicability of the standards, providing a crucial support for advancing the microbiological quality control in pharmaceutical industries of China.

Objective:To explore the efficacy and safety of intense pulsed light (IPL) for facial early linear scars.Methods:The patients who underwent facial plastic surgery and cosmetic suturing at the Department of Plastic and Aesthetic Surgery, the Second Affiliated Hospital of Soochow University from June to December 2023 were included. A randomized self-controlled study was conducted. Each post-operative wound was divided into the treatment and control sides by random number. The treatment side received 3 sessions of IPL treatment at 2-3 d after wound suturing, 6-7 d after suture removal and 6 weeks after surgery, respectively. The control side did not receive IPL treatment. After 3 months follow-up, the Vancouver scar scale (VSS), patient and observer scar assessment scale (POSAS) were used to evaluate the scars on both sides. Adverse reactions were recorded. VSS evaluated scar severity through four items: vascularity (0-3 points), pigmentation (0-3 points), thickness (0-4 points), and pliability (0-5 points), with a total score of 0-15 points. The higher the score, the more serious the scar was. POSAS consisted of observer scar assessment scale (OSAS) and patient scar assessment scale (PSAS), OSAS included vascularity, pigmentation, thickness, surface relief, pliability, surface area and overall opinion. While PSAS included pain, itching, color, thickness, stiffness, irregularity, and overall opinion. Each component was assessed on a scale ranging from 1 to 10, while maximum scores indicated the worst outcome. Statistical analysis was performed using the Graphpad Prism 8.0 software. Normal distributed measurement data were expressed as Mean±SD, and non-normally distributed measurement data were expressed as M( Q1, Q3). Comparisons of VSS, OSAS, PSAS scores between the treatment and control sides were performed using paired sample t-test or paired sample Wilcoxon rank sum test. P<0.05 was considered statistically significant. Results:A total of 23 facial trauma patients with 27 scars formed after debridement and aesthetic suture were enrolled in this study, including 17 males and 6 females, aged (28.2±6.1) years old. The length of the scars were (5.9±1.8) cm. After three sessions of treatment and 3 months follow-up, with regard to VSS, the treatment sides scored vascularity [0(0, 1) vs. 1(1, 1)], thickness [0(0, 0) vs. 0(0, 1)], and total scores [0.5(0, 1) vs. 1(1, 2.75)], which were statistically lower than the control sides (all P<0.05). With regard to OSAS, the treatment sides scored vascularity(2.1±0.9 vs. 3.0±1.0), pigmentation(2.2±0.8 vs. 2.3±0.8), thickness(1.4±0.7 vs. 1.9±0.9), surface relief(1.7±0.6 vs. 2.2±1.1), pliability(1.8±0.8 vs. 2.1±1.1), overall opinion(1.9±0.8 vs. 2.8±1.1) and total scores(12.6±4.4 vs. 16.2±6.2), which were statistically lower than the control sides(all P<0.05).With regard to PSAS, the treatment sides scored scar color(2.9±1.3 vs. 3.9±1.7), thickness(1.8±1.4 vs. 2.4±1.5), overall opinion(2.2±1.0 vs. 3.1±1.3) and total scores(14.3±6.7 vs. 17.7±7.7), which were statistically lower than the control sides(all P<0.05). No adverse reactions such as wound infection, delayed wound healing and blister formation were observed in all patients. Conclusion:IPL is effective in the treatment of early facial scars, which can significantly improve the vascularity, thickness, pigmentation, surface relief and pliability of scars, and improve the scars appearance. This treatment method is safe with few adverse reactions.