ObjectiveTo investigate the effects of Huangqi Jianzhongtang （HQJZ） on macrophage polarization and fat consumption in cancer cachexia （CC） mice. MethodsUltra-performance liquid chromatography-quadrupole/electrostatic field Orbitrap high-resolution mass spectrometry （UPLC-Q-Orbitrap HRMS） was used to control the quality of HQJZ. （1） In vitro experiment： HQJZ-containing serum was prepared， and the optimal concentration was determined by cytotoxicity assay. Mouse monocyte-derived macrophages （RAW264.7） were cultured and randomly divided into six groups， including a blank group， a classically activated macrophages （M1） group， an alternatively activated macrophages （M2） group， a HQJZ + blank group， a HQJZ+M1 group， and a HQJZ + M2 group. The relative expression of macrophage marker genes CD86， inducible nitric oxide synthase （iNOS）， CD206， and arginase-1 （Arg1） was detected by real-time quantitative polymerase chain reaction （Real-time PCR ）. （2） In vivo experiment： Thirty-two BALB/c mice were randomly divided into a control group， a model group， a medroxyprogesterone acetate （MPA） group， and a HQJZ group. Except for the control group， the other mice were injected with CT-26 colon cancer cells to establish a CC model. Mice in the MPA and HQJZ groups were given MPA （0.13 g·kg^-1·d^-1） or HQJZ （13.13 g·kg^-1·d^-1） by gavage， respectively， while mice in the control and model groups were given an equal volume of saline by gavage， with interventions continued for 10 d. Real-time PCR was used to detect the expression of macrophage markers （iNOS， Arg1， CD86， CD206） and fat browning-related genes uncoupling protein 1 （UCP1） and peroxisome proliferator-activated receptor γ （PPARγ） in epididymal adipose tissue. Western blot （WB） was used to detect protein expression levels of UCP1 and PPARγ. Micro-computed tomography （micro-CT） was used to measure residual fat volume， and hematoxylin-eosin （HE） staining was used to assess fat browning and calculate pathological scores. ResultsIn vitro， the dominant effective concentration of HQJZ-containing serum was 12.5%. Real-time PCR results showed that， compared with the blank group， Arg1 expression decreased in the HQJZ+blank group （P<0.05）， CD206 showed a downward trend without statistical significance， while iNOS and CD86 expression were significantly increased （P<0.05）. Compared with the M1 group， Arg1 and CD206 expression decreased in the HQJZ+M1 group （P<0.05）. Compared with the M2 group， CD206 expression decreased in the HQJZ+M2 group （P<0.05）， CD86 expression increased significantly （P<0.01）. In vivo， Real-time PCR results showed that， compared with the control group， CD86 and CD206 expression levels were significantly increased in the model group （P<0.01）. Compared with the model group， CD206 expression in the MPA group was significantly decreased （P<0.01）. In the HQJZ group， CD206 was significantly decreased （P<0.01）. WB results showed that， compared with the model group， protein expression of UCP1 and PPARγ was significantly reduced in the HQJZ group （P<0.05， P<0.01）. micro-CT results showed that the total white fat volume in the HQJZ group was greater than that in the model group （P<0.05）. HE staining results showed that pathological scores in the HQJZ group were lower than those in the model group （P<0.05）. ConclusionHQJZ may inhibit white adipose tissue browning by promoting macrophage M1 polarization and suppressing M2 polarization， thereby delaying fat consumption in CC mice.

Objective:To investigate the association between urinary arsenic, selenium, and chromium levels and the risk and predisposing factors of diabetes mellitus in people with previous endemic arsenic exposure.Methods:From September to December 2024, 240 residents in the drinking-water-borne endemic arsenic disease area in Hohhot were taken as the study subjects. They were divided into an exposed group ( n = 91) and a non-exposed group ( n = 149) based on whether they had suffered from arsenism in the past. The exposed group was further divided into diabetes and non diabetes subgroups ( n = 54, 37) based on the prevalence of diabetes, and the diabetes subgroup was further divided into type 1 and type 2 diabetes subgroups ( n = 23, 31) based on the type of diabetes. Questionnaire survey was conducted to investigate the basic situation, measure fasting blood glucose, and determine the levels of arsenic, selenium, and chromium in urine by inductively coupled plasma mass spectrometry. Multivariate logistic regression analysis was used to assess the risk factors of diabetes mellitus. Results:The difference of prevalence of diabetes mellitus was statistically significant between the exposed group and non-exposed group [59.3% (54/91) vs. 41.6% (62/149), χ2 = 7.11, P = 0.008]. The levels of urinary arsenic, selenium, and chromium in the exposed group were higher than those in the non-exposed group ( t = - 2.00, - 2.14, - 2.18, P < 0.05). There were statistically significant differences in urinary arsenic level, body mass index (BMI), the distribution of age, smoking status, and gender between the diabetes patients and non-diabetes patients in the exposed group ( t = 2.20, 3.57, χ2 = 10.76, 5.23, 4.01, P < 0.05). The difference of urinary arsenic levels were statistically significant between patients with type 1 diabetes and type 2 diabetes in the exposed group ( t = - 2.06, P = 0.048). Multivariate logistic regression analysis showed that BMI, age, sex, smoking, and urinary arsenic levels were risk factors for diabetes ( P < 0.05). For every 1-unit increase in urinary arsenic, fasting blood glucose levels increased by 0.057 times (95% CI: 0.018 - 0.103, P = 0.029). Conclusions:There is a significant correlation between the urine arsenic level of people with previous endemic arsenic exposure and diabetes, especially type 2 diabetes. Men, smoking, overweight, age ≥65 years, and high urinary arsenic level are risk factors for diabetes.

Objective:To investigate the predictive value of changes in body mass index (BMI) and blood glucose indicators in early pregnancy for gestational diabetes mellitus (GDM).Methods:A total of 126 pregnant women with GDM who were admitted to the Department of Obstetrics at Jiaxing Maternity and Child Health Care Hospital from January 2022 to December 2023 were retrospectively analyzed and included in the GDM group. Additionally, 140 healthy pregnant women were included in the non-GDM group. Changes in BMI and levels of blood glucose indicators [fasting blood glucose (FBG), 1-hour postprandial blood glucose, 2-hour postprandial blood glucose (2hPG), and glycated hemoglobin during early pregnancy were compared between the two groups. Influential factors for GDM were analyzed using a multivariate logistic regression model. The predictive value of changes in BMI and blood glucose indicators during early pregnancy for GDM was assessed using receiver operating characteristic curves.Results:The BMI at 10 [(24.60 ± 0.82) kg/m2] and 14 weeks of pregnancy [(23.50 ± 0.85) kg/m2] in the GDM group was significantly higher compared with the non-GDM group (both P < 0.05). The levels of FBG [(5.98 ± 0.36) mmol/L], 1-hour postprandial blood glucose [(10.95 ± 0.83) mmol/L], and 2hPG [(8.60 ± 0.82) mmol/L] in the GDM group were also significantly higher than those in the non-GDM group ( t = 12.25, 23.90, 5.98, all P < 0.001). The levels of total cholesterol [(6.35 ± 1.10) mmol/L] and triglycerides [(3.23 ± 0.60) mmol/L] in the GDM group were significantly higher compared with the non-GDM group ( t = 6.45, 7.45, both P < 0.001). The number of cesarean sections ( n = 69 cases) and the incidence of adverse delivery outcomes [26.98% (34/126)] in the GDM group were significantly higher than those in the non-GDM group ( χ2 = 16.72, 12.71, both P < 0.001). Multivariate logistic regression analysis indicated that BMI at 10 weeks of pregnancy, BMI at 14 weeks of pregnancy, FBG, and 2hPG were independent risk factors for GDM ( OR = 1.292, 6.514, 2.601, 1.784, all P < 0.05). According to Receiver Operating Characteristic curve analysis, the area under the curve (AUC) (95% CI) for BMI at 10 and 14 weeks of pregnancy were 0.717 (0.630-0.795) and 0.719 (0.631-0.796), respectively. The AUC (95% CI) for FBG and 2hPG levels were 0.731 (0.635-0.813) and 0.802 (0.712-0.873), respectively. The AUC (95% CI) for the combined evaluation of these indicators was 0.911 (0.839-0.958), indicating that the combined evaluation had a higher predictive value for GDM than the use of a single indicator ( P < 0.05). Conclusions:The changes in BMI and blood glucose indicators during early pregnancy are closely related to the occurrence of GDM. The combination of these measurements has a high predictive value for GDM and is of significant importance for its prevention.

American ginseng (Panax quinquefolius L.), a widely used herbal medicine and dietary supplement, has attracted increasing attention from both academia and industry in recent years. To better understand the research frontiers and hotspots, we conducted a bibliometric analysis of American ginseng studies indexed in the Web of Science Core Collection from 1985 to 2024, using CiteSpace and VOSviewer. A total of 1169 publications were identified, with a marked increase in output since 2011. Hotspot analysis revealed growing interest in pharmacological effects, ginsenoside analysis, polysaccharide studies, and quality control. Furthermore, we assessed future research trends, suggesting that quality control and the modulation of gut microbiota will remain central topics. This study provides a clearer understanding of the evolving research landscape on American ginseng and offers guidance for future investigations.

Objective To investigate the acquisition of the"standard for intubation and maintenance of nasointestinal tube in adult patients"of Chinese Nursing Association,and its influencing factors,so as to provide a basis for targeted training programs.Methods A multi-centered,cross-sectional study was performed in 31 provinces from September to November 2023,and nurses from different departments which use nasointestinal tubes like intensive care units,gastroenterology,neurology,geriatrics were included by a convenient sampling method.The tool was a self-designed questionnaire based on the group standard and the survey was conducted.Multiple linear regression analysis was used to explore the influencing factors of nurses'knowledge of nasointestinal tubes intubation and maintenance.Results 1 350 valid questionnaires were collected.Only 61.63％of the respondents knew about the publishing of the standard.The score of knowledge of tube intubation and maintenance was(61.09±13.56).The results of multiple linear regression analysis showed the influencing factors of the score of knowledge of intubation and maintenance were as follows:education level,professional title,job position,intubation experience within half a year,and corresponding achievements(P＜0.05).Conclusion The acqui-sition level of nurses for the standard calls for continuous promotion.Nursing managers should establish targeted training programs based on the related influencing factors,so as to advance the implementation of the group standard.

OBJECTIVE To explore the clinical characteristics of Mycoplasma pneumoniae pneumonia(MPP)after COVID-19 epidemic so as to offer help for early clinical diagnosis and treatment.METHODS The clinical data that were collected from the MPP patients who were treated in the fever clinic of the First Medical Center of Chinese PLA General Hospital from Jul.2023 to Aug.2024 were retrospectively analyzed.The results of laboratory tests for the different age groups of patients complicated with other pathogens were statistically analyzed.RESULTS Of totally 161 MPP patients who were enrolled in the study,78(48.85％)were male,and 83(51.55％)were fe-male;the average age was(32.98±14.35)years old,and the patients aged between 20 and 40 years old accoun-ted for 43.48％(70 cases).The enrolled patients were divided into the simple MPP group with 92(57.14％)ca-ses and the MPP+mixed group with 69(42.86％)cases according to the result of etiological test of sputum;the patients of MPP+mixed group were divided into the MPP+bacteria group with 42(60.87％)cases,the MPP+fungi group with 10(14.49％)cases,and the MPP+viruses group with 17(24.64％)cases.There was significant difference in the age among the groups(P＜0.05);there were no significant differences in the sex,white blood cell counts and percentage of mononuclear cells among the groups,the percentage of lymphocytes was highest in the simple MPP group,the levels of C-reactive protein(CRP)and interleukin-6(IL-6)were highest in the MPP+bacteria group,and there were significant differences(P＜0.05).All of the patients were divided into three groups:the ≤20-year-old group the＞20-40-year old group and the＞40-year-old group.There were no sig-nificant differences in the white blood cell counts,percentage of lymphocytes,percentage of mononuclear cells and IL-6 level among the three groups,and the CRP level was highest in the＞20-40-year old group(P=0.025).Ran-dom forest model analysis showed that the weight of CRP was highest(22.65％)among the clinical characteristics of the MPP patients,which played a key role in construction of model.As for other factors,the weight of age was 17.02％,the percentage of lymphocytes 15.34％,the white blood cells counts 14.86％,the percentage of mono-nuclear cells 14.39％,the IL-6 13.61％,the gender 2.13％.CONCLUSION MPP maintains common among the patients aged less than 40 years old after the COVID-19 epidemic,nearly half of the patients are complicated with the infections of other pathogens,and CRP is more helpful for the clinical diagnosis and treatment of the MPP in early stage.

Objective:To construct and evaluate a training program for cardiovascular nurse specialists based on a core competency framework.Methods:Among 61 trainees participating in the first training class for cardiovascular nurse specialists organized by a provincial nursing society, a training program focusing on the nine core competencies for cardiovascular nurse specialists was implemented, which consisted of 4-week theoretical and 4-week practical training. The effectiveness of the training program was evaluated using the Kirkpatrick model. Data analyses were performed by using SPSS 26.0. Categorical data were presented as the number of cases; continuous variables in normal distribution were expressed as mean±standard deviation; and continuous variables in non-normal distribution were presented as median (interquartile range) and compared using non-parametric tests.Results:At the reaction level, the satisfaction rates of trainees with the theoretical and practical sections of the training program were 98.36% (60/61) and 95.08% (58/61), respectively. At the learning level, the comprehensive assessment score of the trainees was (83.01±3.39) points, and all of them successfully obtained their completion certificates, with a pass rate of 100.00% (61/61). At the behavior level, the core competencies for cardiovascular nurse specialists were significantly improved after training [the total score increased from 291.00 (254.00, 334.25) to 410.50 (354.50, 433.00), P<0.001]. At the results level, at six months after training, there were significant increases in the number of participants engaging in cardiovascular care practices, clinical nursing education and guidance, leadership roles, and research projects within their units as well as the number of individuals achieving career advancement (all P<0.05). Conclusions:The trainees are highly satisfied with the core competency-focused cardiovascular nurse training program, which can improve core competencies and cardiovascular nursing capabilities, expand the scope of cardiovascular nursing services, and foster the sustained advancement of the participants.

This article reports a successful case of preimplantation genetic testing (PGT) in a patient with autosomal dominant polycystic kidney disease type 2 (PKD2) combined with Robertsonian translocation. The patient carried a heterozygous frameshift mutation ( PKD2 c.428del, p.Gly143Alafs*90) and a Robertsonian translocation between chromosomes 14 and 15. Through combined PGT for monogenic disorders, structural rearrangements and aneuploidy screening, one euploid blastocyst free of the PKD2 mutation was selected from six embryos for transfer, resulting in the successful delivery of a healthy female infant. Follow-up until June 2025 confirmed normal developmental milestones. This case demonstrates that PGT can effectively mitigate dual genetic risks (monogenic disease and chromosomal abnormality), providing critical clinical insights for optimizing reproductive outcomes in patients with complex genetic backgrounds.

Objective:To investigate the predictive value of changes in body mass index (BMI) and blood glucose indicators in early pregnancy for gestational diabetes mellitus (GDM).Methods:A total of 126 pregnant women with GDM who were admitted to the Department of Obstetrics at Jiaxing Maternity and Child Health Care Hospital from January 2022 to December 2023 were retrospectively analyzed and included in the GDM group. Additionally, 140 healthy pregnant women were included in the non-GDM group. Changes in BMI and levels of blood glucose indicators [fasting blood glucose (FBG), 1-hour postprandial blood glucose, 2-hour postprandial blood glucose (2hPG), and glycated hemoglobin during early pregnancy were compared between the two groups. Influential factors for GDM were analyzed using a multivariate logistic regression model. The predictive value of changes in BMI and blood glucose indicators during early pregnancy for GDM was assessed using receiver operating characteristic curves.Results:The BMI at 10 [(24.60 ± 0.82) kg/m2] and 14 weeks of pregnancy [(23.50 ± 0.85) kg/m2] in the GDM group was significantly higher compared with the non-GDM group (both P < 0.05). The levels of FBG [(5.98 ± 0.36) mmol/L], 1-hour postprandial blood glucose [(10.95 ± 0.83) mmol/L], and 2hPG [(8.60 ± 0.82) mmol/L] in the GDM group were also significantly higher than those in the non-GDM group ( t = 12.25, 23.90, 5.98, all P < 0.001). The levels of total cholesterol [(6.35 ± 1.10) mmol/L] and triglycerides [(3.23 ± 0.60) mmol/L] in the GDM group were significantly higher compared with the non-GDM group ( t = 6.45, 7.45, both P < 0.001). The number of cesarean sections ( n = 69 cases) and the incidence of adverse delivery outcomes [26.98% (34/126)] in the GDM group were significantly higher than those in the non-GDM group ( χ2 = 16.72, 12.71, both P < 0.001). Multivariate logistic regression analysis indicated that BMI at 10 weeks of pregnancy, BMI at 14 weeks of pregnancy, FBG, and 2hPG were independent risk factors for GDM ( OR = 1.292, 6.514, 2.601, 1.784, all P < 0.05). According to Receiver Operating Characteristic curve analysis, the area under the curve (AUC) (95% CI) for BMI at 10 and 14 weeks of pregnancy were 0.717 (0.630-0.795) and 0.719 (0.631-0.796), respectively. The AUC (95% CI) for FBG and 2hPG levels were 0.731 (0.635-0.813) and 0.802 (0.712-0.873), respectively. The AUC (95% CI) for the combined evaluation of these indicators was 0.911 (0.839-0.958), indicating that the combined evaluation had a higher predictive value for GDM than the use of a single indicator ( P < 0.05). Conclusions:The changes in BMI and blood glucose indicators during early pregnancy are closely related to the occurrence of GDM. The combination of these measurements has a high predictive value for GDM and is of significant importance for its prevention.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.