ObjectiveTo evaluate the efficacy and safety of Xiaoji Hufei Formula in protecting children with close contact exposure to influenza， and to provide reference and evidence-based support for better clinical prevention and treatment of influenza in children. MethodsA multicenter， prospective， non-randomized， parallel， controlled trial was conducted from October 2021 to May 2022 in five hospitals， including Dongfang Hospital of Beijing University of Chinese Medicine. Confirmed influenza cases and influenza-like illness （ILI） cases were collected， and eligible children with close contact exposure to these cases were recruited in the outpatient clinics. According to whether the enrolled close contacts were willing to take Xiaoji Hufei formula for influenza prevention， they were assigned to the observation group （108 cases） or the control group （108 cases）. Follow-up visits were conducted on days 7 and 14 after enrollment. The primary outcomes were the incidence of ILI and the rate of laboratory-confirmed influenza. Secondary outcomes included traditional Chinese medicine （TCM） symptom score scale for influenza， influenza-related emergency （outpatient） visit rate， influenza hospitalization rate， and time to onset after exposure to influenza cases. ResultsA total of 216 participants were enrolled， with 108 in the observation group and 108 in the control group. Primary outcomes： （1） Incidence of ILI： The incidence was 12.0% （13/108） in the observation group and 23.1% （25/108） in the control group， with the observation group showing a significantly lower incidence （χ²=4.6， P<0.05）. （2） Influenza confirmation rate： 3.7% （4/108） in the observation group and 4.6% （5/108） in the control group， with no statistically significant difference. Secondary outcomes： （1） TCM symptom score scale： after onset， nasal congestion and runny nose scores differed significantly between the two groups （P<0.05）， while other symptoms such as fever， sore throat， and cough showed no significant differences. （2） Influenza-related emergency （outpatient） visit rate： 84.6% （11 cases） in the observation group and 96.0% （24 cases） in the control group， with no significant difference. （3） Time to onset after exposure： The median onset time after exposure to index patients was 7 days in the observation group and 4 days in the control group， with a statistically significant difference （P<0.05）. ConclusionIn previously healthy children exposed to infectious influenza cases under unprotected conditions， Xiaoji Hufei formula prophylaxis significantly reduced the incidence of ILI. Xiaoji Hufei Formula can be recommended as a specific preventive prescription for influenza in children.

ObjectiveTo evaluate the efficacy and safety of Xiaoji Hufei Formula in protecting children with close contact exposure to influenza， and to provide reference and evidence-based support for better clinical prevention and treatment of influenza in children. MethodsA multicenter， prospective， non-randomized， parallel， controlled trial was conducted from October 2021 to May 2022 in five hospitals， including Dongfang Hospital of Beijing University of Chinese Medicine. Confirmed influenza cases and influenza-like illness （ILI） cases were collected， and eligible children with close contact exposure to these cases were recruited in the outpatient clinics. According to whether the enrolled close contacts were willing to take Xiaoji Hufei formula for influenza prevention， they were assigned to the observation group （108 cases） or the control group （108 cases）. Follow-up visits were conducted on days 7 and 14 after enrollment. The primary outcomes were the incidence of ILI and the rate of laboratory-confirmed influenza. Secondary outcomes included traditional Chinese medicine （TCM） symptom score scale for influenza， influenza-related emergency （outpatient） visit rate， influenza hospitalization rate， and time to onset after exposure to influenza cases. ResultsA total of 216 participants were enrolled， with 108 in the observation group and 108 in the control group. Primary outcomes： （1） Incidence of ILI： The incidence was 12.0% （13/108） in the observation group and 23.1% （25/108） in the control group， with the observation group showing a significantly lower incidence （χ²=4.6， P<0.05）. （2） Influenza confirmation rate： 3.7% （4/108） in the observation group and 4.6% （5/108） in the control group， with no statistically significant difference. Secondary outcomes： （1） TCM symptom score scale： after onset， nasal congestion and runny nose scores differed significantly between the two groups （P<0.05）， while other symptoms such as fever， sore throat， and cough showed no significant differences. （2） Influenza-related emergency （outpatient） visit rate： 84.6% （11 cases） in the observation group and 96.0% （24 cases） in the control group， with no significant difference. （3） Time to onset after exposure： The median onset time after exposure to index patients was 7 days in the observation group and 4 days in the control group， with a statistically significant difference （P<0.05）. ConclusionIn previously healthy children exposed to infectious influenza cases under unprotected conditions， Xiaoji Hufei formula prophylaxis significantly reduced the incidence of ILI. Xiaoji Hufei Formula can be recommended as a specific preventive prescription for influenza in children.

Objective:To develop and validate a risk prediction model for cognitive frailty in elderly patients with type 2 diabetes.Methods:A total of 483 elderly patients with type 2 diabetes who visited Tianjin First Central Hospital from June to December 2022 were selected using convenience sampling. They were randomly divided into a modeling group ( n=338) and a validation group ( n=145). Data were collected using a self-designed general information questionnaire, the Short-Form Mini Nutritional Assessment (MNA-SF), the Geriatric Depression Scale-15 (GDS-15), the Frailty Phenotype (FP), the Montreal Cognitive Assessment (MoCA), and the Clinical Dementia Rating (CDR). Logistic regression analysis was performed to identify the influencing factors. A cognitive frailty risk prediction nomogram model was constructed based on the results. The model was validated in the validation group, and its predictive performance and clinical applicability were evaluated using the area under the receiver operating characteristic curve ( AUC), calibration curve, and clinical decision curve analysis. A total of 483 questionnaires were distributed and all were returned as valid, resulting in a 100.0% response rate. Results:The prevalence of cognitive frailty in the 483 elderly patients with type 2 diabetes was 20.3% (98/483). Age, regular exercise, duration of diabetes, HbA1c levels, depression and nutritional status were identified as predictive factors in the model. The AUC of the model was 0.886, and the Hosmer-Lemeshow test showed a χ 2 value of 8.004 ( P=0.433). The optimal cutoff value was 0.335, and the accuracy was 89.0%. Conclusions:The prediction model demonstrates good fit and strong predictive performance, and can intuitively and easily identify elderly patients with type 2 diabetes who are at high risk of cognitive frailty, providing a reference for early screening and intervention.

Objective To survey the nutritional status of elderly hospitalized patients with hyper-tension and frailty,and explore the correlation between nutrition and frailty.Methods A total of 801 elderly hypertensive patients admitted to our hospital from October 2022 to December 2023 were cosecutively enrolled,and according to Fried frailty phenotype criteria,they were divided into frailty group(score:≥3,276 cases),pre-frailty group(score:1-3,362 cases)and non-frailty group(score:0,163 cases).At the same time,MNA was used to evaluate the nutritional risk of the patients,and the scores of ADL and the score of ACCI were recorded.Logistic regression mod-el was used to analyze the influencing factors of frailty in elderly hypertensive patients,Spearman correlation analysis was employed to analyze the relationship between frailty and nutrition-related indicators,and ROC curve was plotted to analyze the predictive performance of these nutritional indicators in the occurrence of frailty.Results There were statistically differences among the three groups in terms of age,mean SBP,complication of other chronic diseases,polypharmacy,mean handgrip strength,calf circumference,MNA score and classification,ADL and ACCI scores,and levels of hemoglobin,HDL-C,LDL-C,TC,albumin,25-hydroxyvitamin D[25(OH)D],bone alkaline phosphatase,VitB12 and Hcy(P＜0.05,P＜0.01).Multivariate logistic regression analysis revealed that polypharmacy(OR=2.361,95％CI:1.332-4.183),MNA score ≥24(OR=0.298,95％CI:0.110-0.808),ADL score(OR=1.094,95％CI:1.028-1.166),albumin(OR=0.963,95％CI:0.934-0.994),and 25(OH)D(OR=0.989,95％CI:0.980-0.998)were independent risk factors for frailty in elderly hypertensive patients(P＜0.05,P＜0.01).Frailty was positively cor-related with age,polypharmacy,other chronic diseases,and ACCI score(P＜0.01),and negatively with MNA score,MNA classification,hemoglobin,albumin,25(OH)D,HDL-C,LDL-C,Hcy,average grip strength,and calf circumference(P＜0.01).ROC curve analysis showed that the AUC values of 25(OH)D,albumin,and MNA score were 0.607,0.588,and 0.700,separately.Con-clusion Elderly patients with hypertension and frailty have poor nutritional status,and identify-ing early frailty relies on nutritional risk assessment.Frail patients have a high risk of malnutri-tion and are influenced by various factors.Among them,albumin,MNA score,and 25(OH)D can effectively predict the occurrence of frailty in elderly hospitalized hypertensive patients,with MNA score having stronger predictive performance.

Objective:To analyze functional changes in macrophages in mouse models of vulvovaginal candidiasis (VVC) by modulating indoleamine 2,3-dioxygenase 1 (IDO1) .Methods:Forty specific-pathogen-free female ICR mice were randomly divided into 4 groups using a complete randomization method: a blank group, a VVC model group, a VVC model + 1-methyltryptophan (1-MT) group (referred to as the 1-MT group), a VVC model + interferon-γ (IFN-γ) group (referred to as the IFN-γ group), with 10 mice in each group. Except for the blank group, all the mice were injected subcutaneously with estradiol benzoate oil solution in the abdomen every other day for 6 days prior to modeling to induce pseudoestrus; after successful induction of pseudoestrus, the mice were inoculated vaginally with Candida albicans suspensions at a concentration of 2 × 10 9 CFU/ml once a day for 5 days to establish VVC mouse models, and subcutaneous injections of estradiol benzoate oil solution were continued simultaneously to maintain the pseudoestrus state; 1 day before inoculation with fungal suspensions, mice in the 1-MT group and IFN-γ group were pretreated with 1-MT and IFN-γ respectively, followed by once-daily same intervention for 6 consecutive days; mice in the blank group and VVC model group were intraperitoneally injected with physiological saline solution once a day for 6 consecutive days. On the 5th day of modeling, vaginal conditions in mice were observed and vaginal symptoms were scored; the vaginal lavage fluid was collected for smear microscopy and fungal colony counting; then, the mice were sacrificed, the vaginal tissues were collected and subjected to hematoxylin-eosin (HE) staining and periodic acid-Schiff (PAS) staining, and the expression of IDO1 and the macrophage surface marker F4/80 was determined in the vaginal tissues by an immunofluorescence method; real-time fluorescence-based quantitative PCR (qPCR) was performed to determine mRNA expression levels of IDO1, inducible nitric oxide synthase (iNOS), and arginase 1 (Arg-1) in the vaginal tissues, and Western blot analysis to determine the IDO1 protein expression in the vaginal tissues. One-way analysis of variance was used to analyze the differences in indices among groups, and Tukey test was used for multiple comparisons. Results:Smear microscopic examination of the vaginal lavage fluid on the 5th day of modeling showed elongated hyphae with a few spores in the VVC model group, a large number of elongated hyphae aggregating in clusters with surrounding spores in the 1-MT group, and a few thin and short hyphae with a large number of spores in the IFN-γ group. Compared with the VVC model group (360.0 ± 15.9), the fungal colony counts in the vaginal lavage fluid significantly increased in the 1-MT group (523.7 ± 67.7, P = 0.002), but significantly decreased in the IFN-γ group (258.3 ± 27.57, P = 0.026). HE staining and PAS staining showed small abscess formation in the epidermis and predominant infiltration of neutrophils throughout the epidermal and dermal layers with a large number of spores and a few hyphae in the VVC model group; thickened epidermis and diffuse inflammatory infiltration predominated by neutrophils in the dermis were seen in the 1-MT group, with a large number of hyphae and spores aggregating into clusters, which were predominated by hyphae; in the IFN-γ group, spores aggregated in the epidermis without obvious hyphae, and a small amount of inflammatory cells predominated by neutrophils infiltrated the dermis. Immunofluorescence assay revealed that the relative fluorescence intensities of IDO1 and F4/80 were highest in the IFN-γ group and the 1-MT group, respectively. Western blot analysis revealed that the IDO1 protein expression in the VVC model group was significantly higher than that in the blank group ( P < 0.001) and the 1-MT group ( P < 0.05), but significantly lower than that in the IFN-γ group ( P < 0.05). qPCR showed that iNOS mRNA expression significantly increased in the VVC model group compared with the blank group ( P < 0.01), and increased in the IFN-γ group compared with the blank group, VVC model group and 1-MT group (all P < 0.001); Arg-1 mRNA expression significantly increased in the VVC model group compared with the blank group ( P < 0.001) and IFN-γ group ( P < 0.01), and increased in the 1-MT group compared with the blank group, VVC model group, and IFN-γ group (all P < 0.001) . Conclusion:In the VVC mouse models, upregulation of IDO1 may cause macrophage polarization toward the M1 phenotype, and inhibition of IDO1 may cause increased macrophage recruitment and exacerbate the inflammatory response.

Objective:To develop and evaluate a medical experience assessment scale for debridement and dressing change in chronic wound patients in China, and to provide a reference for improving hospital service quality.Methods:Based on the framework of hospital consumer assessment of healthcare providers and systems survey (HCAHPS) in the United States, a preliminary draft of the scale was formed through a literature review and qualitative interviews with 12 chronic wound patients (7 males and 5 females aged 58.1±12.3 years). Five experts were invited for content validity testing, and 191 chronic wound patients (111 males and 80 females aged 53.5±19.1 years) were selected to evaluate the internal consistency reliability, half reliability, retest reliability, and structural validity of the scale.Results:The Chronic Wound Patient Debridement and Dressing Experience Scale covered 5 dimensions with 30 sub-items and 2 comprehensive evaluation items, including demand response, good and friendly communication, professional trust, optimization of the medical treatment process, and encouragement of patient participation. The scale Cronbach′s α coefficient was 0.967 and ranged from 0.890 to 0.962 for each dimension. The overall retest reliability of the scale was 0.940 and ranged from 0.895 to 0.940 for each dimension. The overall half reliability of the scale was 0.923 and ranged from 0.834 to 0.935 for each dimension. 5 factors were extracted, with a cumulative variance contribution rate of 82.061%.Conclusions:Based on the HCAHPS framework in the United States, the Chronic Wound Debridement and Dressing Experience Scale developed has high reliability and validity, and can be used to evaluate the dressing change experience of patients with chronic wounds. It has clinical practice significance for dressing change in chronic wounds.

Objective To construct the performance evaluation index system of public hospitals,and provide reference for promoting the high-quality development of public hospitals.Methods Delphi method and analytic hierarchy process were used to determine the performance evaluation index system of public hospitals based on performance prism model.Results It established a public hospital performance evaluation system including 5 first-level indicators,16 second-level indicators and 40 third-level indicators of government,staff,patients,suppliers and regulatory agencies.The weights of the five first-level indicators are 0.254 8,0.476 8,0.154 4,0.073 4 and 0.040 6,respectively.Among the 16 second-level indicators,salary,quality and safety,practice environment,medical quality and operation efficiency rank the top 5.The combined weights were 0.268 5,0.174 3,0.165 4,0.080 9 and 0.060 6,respectively.Among the 40 tertiary indicators,the satisfaction of medical staff,the quality control index of single disease,organizational support,the intensity of antibacterial drug use and the case mortality of the low-risk group were investigated.The combined weights were 0.212 0,0.110 0,0.107 0,0.064 3 and 0.0624,respectively.Conclusion The performance evaluation index system of public hospitals based on the performance prism model established is helpful to guide hospitals to think about hospital strategic reform,process optimization and capacity improvement from the multi-dimensional perspective of internal and external stakeholders,so as to improve development performance and promote social harmonious development,and to improve performance,promote high-quality development.

Objective To construct the performance evaluation index system of public hospitals,and provide reference for promoting the high-quality development of public hospitals.Methods Delphi method and analytic hierarchy process were used to determine the performance evaluation index system of public hospitals based on performance prism model.Results It established a public hospital performance evaluation system including 5 first-level indicators,16 second-level indicators and 40 third-level indicators of government,staff,patients,suppliers and regulatory agencies.The weights of the five first-level indicators are 0.254 8,0.476 8,0.154 4,0.073 4 and 0.040 6,respectively.Among the 16 second-level indicators,salary,quality and safety,practice environment,medical quality and operation efficiency rank the top 5.The combined weights were 0.268 5,0.174 3,0.165 4,0.080 9 and 0.060 6,respectively.Among the 40 tertiary indicators,the satisfaction of medical staff,the quality control index of single disease,organizational support,the intensity of antibacterial drug use and the case mortality of the low-risk group were investigated.The combined weights were 0.212 0,0.110 0,0.107 0,0.064 3 and 0.0624,respectively.Conclusion The performance evaluation index system of public hospitals based on the performance prism model established is helpful to guide hospitals to think about hospital strategic reform,process optimization and capacity improvement from the multi-dimensional perspective of internal and external stakeholders,so as to improve development performance and promote social harmonious development,and to improve performance,promote high-quality development.

Objective To construct the performance evaluation index system of public hospitals,and provide reference for promoting the high-quality development of public hospitals.Methods Delphi method and analytic hierarchy process were used to determine the performance evaluation index system of public hospitals based on performance prism model.Results It established a public hospital performance evaluation system including 5 first-level indicators,16 second-level indicators and 40 third-level indicators of government,staff,patients,suppliers and regulatory agencies.The weights of the five first-level indicators are 0.254 8,0.476 8,0.154 4,0.073 4 and 0.040 6,respectively.Among the 16 second-level indicators,salary,quality and safety,practice environment,medical quality and operation efficiency rank the top 5.The combined weights were 0.268 5,0.174 3,0.165 4,0.080 9 and 0.060 6,respectively.Among the 40 tertiary indicators,the satisfaction of medical staff,the quality control index of single disease,organizational support,the intensity of antibacterial drug use and the case mortality of the low-risk group were investigated.The combined weights were 0.212 0,0.110 0,0.107 0,0.064 3 and 0.0624,respectively.Conclusion The performance evaluation index system of public hospitals based on the performance prism model established is helpful to guide hospitals to think about hospital strategic reform,process optimization and capacity improvement from the multi-dimensional perspective of internal and external stakeholders,so as to improve development performance and promote social harmonious development,and to improve performance,promote high-quality development.

Objective To construct the performance evaluation index system of public hospitals,and provide reference for promoting the high-quality development of public hospitals.Methods Delphi method and analytic hierarchy process were used to determine the performance evaluation index system of public hospitals based on performance prism model.Results It established a public hospital performance evaluation system including 5 first-level indicators,16 second-level indicators and 40 third-level indicators of government,staff,patients,suppliers and regulatory agencies.The weights of the five first-level indicators are 0.254 8,0.476 8,0.154 4,0.073 4 and 0.040 6,respectively.Among the 16 second-level indicators,salary,quality and safety,practice environment,medical quality and operation efficiency rank the top 5.The combined weights were 0.268 5,0.174 3,0.165 4,0.080 9 and 0.060 6,respectively.Among the 40 tertiary indicators,the satisfaction of medical staff,the quality control index of single disease,organizational support,the intensity of antibacterial drug use and the case mortality of the low-risk group were investigated.The combined weights were 0.212 0,0.110 0,0.107 0,0.064 3 and 0.0624,respectively.Conclusion The performance evaluation index system of public hospitals based on the performance prism model established is helpful to guide hospitals to think about hospital strategic reform,process optimization and capacity improvement from the multi-dimensional perspective of internal and external stakeholders,so as to improve development performance and promote social harmonious development,and to improve performance,promote high-quality development.