ObjectiveTo analyze the causes and trends of injury-related mortality among elderly residents in Yuyao City, and to provide a scientific basis for formulating prevention and control strategies for injury-related deaths among the elderly. MethodsData on injury-related deaths among elderly residents aged 60 years old and above in Yuyao City from 2013 to 2022 were collected. The epidemiological characteristics were analyzed, including the crude mortality rates, standardized mortality rates, age-specific mortality rates, annual percent change (APC), and average annual percent change (AAPC). ResultsThe crude mortality rate of injury among elderly people aged 60 years old and above in Yuyao City was 263.90/100 000, with a standardized mortality rate of 131.21/100 000. A statistically significant decreasing trend in standardized mortality was observed from 2013 to 2020 (APC=-3.17%, P=0.017). The standardized mortality rates of injury for elderly males and females were 154.74/100 000 and 134.46/100 000, respectively. Among elderly females, the standardized mortality rate of injury initially decreased and then increased (APC_2013—2020=-5.14%, APC_2021—2022=22.86%, both P<0.05). The top five causes for injury-related deaths among the elderly were accidental falls, traffic injuries from motor vehicles, drowning, accidental asphyxia, and suicide, accounting for 74.78% of all injury-related deaths among the elderly. Among these top five causes, mortality rates due to accidental falls, motor vehicle traffic injuries, and accidental asphyxia all increased significantly with age (χ_trend²=8 315.40, 25.12, and 37.26, respectively; all P<0.001). Analyses of the annual trends showed a significant increase in deaths caused by accidental falls (AAPC=4.97%, P=0.013) and a significant decrease in deaths caused by suicide (AAPC=-14.87%, P<0.001). ConclusionFrom 2013 to 2022, the injury-related mortality burden among adults aged 60 years old and above in Yuyao City remained considerable, primarily caused by accidental falls, motor vehicle traffic injuries, drowning, accidental asphyxia, and suicide. There is an urgent need to develop targeted injury prevention strategies and measures to reduce the risk of unintentional injury deaths among the elderly.

Objective:To investigate the age-specific distribution characteristics of plantar pressure parameters in healthy children aged 3-12 years.Methods:This cross-sectional study retrieved data from the hospital information system in January 2025 for 272 children aged 3-12 years who underwent physical examinations and voluntarily completed plantar pressure analysis at Beijing Children′s Hospital, Capital Medical University, from July 2022 to December 2024. Demographic and clinical data, including anthropometric measurements (height and weight), flatfoot diagnosis and plantar pressure parameters (maximum pressure, time to maximum force, and contact time percentage in bilateral forefoot, midfoot, and hindfoot) were recorded. Participants were categorized into 3 age groups (3-6 years, 7-9 years, and 10-12 years) and were grouped by gender as well. Intergroup comparisons used one-way ANOVA or least-significant difference test or χ2 tests. Spearman′s rank correlation assessed the relationship between flatfoot prevalence and age. Results:Among 272 children (143 boys, 129 girls), age groups comprised 3-6 years (118 children, 64 boys and 54 girls), 7-9 years (96 children, 49 boys and 47 girls), and 10-12 years (58 children, 30 boys and 28 girls). Flatfoot prevalence was higher in boys than in that of girls (41.3% (59/143) vs. 28.7% (37/129), χ2=4.70, P=0.030), and negatively correlated with age ( r=-0.21, P<0.001). There all had statistically differences in the maximum pressure values of the bilateral forefoot and hindfoot among the 3 age groups (all P<0.001), and after pairwise comparison, those of the group of aged 3-6 years were all the lowest, and those of the group of aged 10-12 years were all the highest (all P<0.05). The maximum pressure values of bilateral midfoot in the group of aged 10-12 years were all higher than those of the other two groups (all P<0.001). There had no statistically differences in the time maximum force value of the bilateral forefoot among the 3 age groups (all P>0.05). The time maximum force values of bilateral midfoot in the group of aged 3-6 years were all lower than those of the other two groups (all P<0.05). There all had statistically differences in the time maximum force value of the bilateral hindfoot among the 3 age groups (all P<0.001), and after pairwise comparison, those of the group of aged 3-6 years were all the lowest, and those of the group of aged 10-12 years were all the highest (all P<0.05). There all had statistically differences in the contact time percentage values of the bilateral forefoot among the 3 age groups (all P<0.001), and after pairwise comparison, those of the group of aged 3-6 years were all the lowest, and those of the group of aged 10-12 years were all the highest (all P<0.05). There had no statistically differences in the contact time percentage values of the bilateral midfoot among the 3 age groups (all P>0.05). There all had statistically differences in the contact time percentage values of the bilateral hindfoot among the 3 age groups (all P<0.001), and after pairwise comparison, those of the group of aged 3-6 years were all lower than those of the other two groups (all P<0.05). Conclusion:Plantar pressure parameters exhibit distinct age-related patterns, reflecting the development of gait patterns and foot arch formation, which will be useful for monitoring physical growth and sports rehabilitation.

Objective:To investigate the age-specific distribution characteristics of plantar pressure parameters in healthy children aged 3-12 years.Methods:This cross-sectional study retrieved data from the hospital information system in January 2025 for 272 children aged 3-12 years who underwent physical examinations and voluntarily completed plantar pressure analysis at Beijing Children′s Hospital, Capital Medical University, from July 2022 to December 2024. Demographic and clinical data, including anthropometric measurements (height and weight), flatfoot diagnosis and plantar pressure parameters (maximum pressure, time to maximum force, and contact time percentage in bilateral forefoot, midfoot, and hindfoot) were recorded. Participants were categorized into 3 age groups (3-6 years, 7-9 years, and 10-12 years) and were grouped by gender as well. Intergroup comparisons used one-way ANOVA or least-significant difference test or χ2 tests. Spearman′s rank correlation assessed the relationship between flatfoot prevalence and age. Results:Among 272 children (143 boys, 129 girls), age groups comprised 3-6 years (118 children, 64 boys and 54 girls), 7-9 years (96 children, 49 boys and 47 girls), and 10-12 years (58 children, 30 boys and 28 girls). Flatfoot prevalence was higher in boys than in that of girls (41.3% (59/143) vs. 28.7% (37/129), χ2=4.70, P=0.030), and negatively correlated with age ( r=-0.21, P<0.001). There all had statistically differences in the maximum pressure values of the bilateral forefoot and hindfoot among the 3 age groups (all P<0.001), and after pairwise comparison, those of the group of aged 3-6 years were all the lowest, and those of the group of aged 10-12 years were all the highest (all P<0.05). The maximum pressure values of bilateral midfoot in the group of aged 10-12 years were all higher than those of the other two groups (all P<0.001). There had no statistically differences in the time maximum force value of the bilateral forefoot among the 3 age groups (all P>0.05). The time maximum force values of bilateral midfoot in the group of aged 3-6 years were all lower than those of the other two groups (all P<0.05). There all had statistically differences in the time maximum force value of the bilateral hindfoot among the 3 age groups (all P<0.001), and after pairwise comparison, those of the group of aged 3-6 years were all the lowest, and those of the group of aged 10-12 years were all the highest (all P<0.05). There all had statistically differences in the contact time percentage values of the bilateral forefoot among the 3 age groups (all P<0.001), and after pairwise comparison, those of the group of aged 3-6 years were all the lowest, and those of the group of aged 10-12 years were all the highest (all P<0.05). There had no statistically differences in the contact time percentage values of the bilateral midfoot among the 3 age groups (all P>0.05). There all had statistically differences in the contact time percentage values of the bilateral hindfoot among the 3 age groups (all P<0.001), and after pairwise comparison, those of the group of aged 3-6 years were all lower than those of the other two groups (all P<0.05). Conclusion:Plantar pressure parameters exhibit distinct age-related patterns, reflecting the development of gait patterns and foot arch formation, which will be useful for monitoring physical growth and sports rehabilitation.

OBJECTIVE To summarize and analyze the profile of the implementation of pharmaceutical service by community pharmacists for patients with chronic diseases in China. METHODS Literature was searched from CNKI， Wanfang database， PubMed （Medline）， Embase， and Scopus to collect studies about community pharmacists providing pharmaceutical services for patients with chronic diseases. The ways and contents of the implementation of pharmaceutical services for chronic diseases by community pharmacists were summarized descriptively. RESULTS A total of 75 studies were included， involving 49 trial studies and 26 cross-sectional studies. The study sites were mainly located in the developed regions of China， and the types of disease involved in the studies were mainly diabetes mellitus （n＝30） and hypertension （n＝28）； most studies used the following indexes to evaluate pharmaceutical services， such as changes in disease symptoms and related indicators（n＝35）， improvement of patient compliance（n＝34）， and the occurrence of adverse drug reactions （irrational drug use） （n＝25）. The pharmaceutical service provided by community pharmacists included medication education （84.0%）， monitoring and follow-up （64.0%）， and identifying and solving medication-related problems （58.7%）. Thirty-eight studies mentioned that pharmaceutical services were achieved through teamwork， 16 of which mentioned healthcare alliances. A few studies investigated stratified healthcare systems （n＝15） and internet-based pharmaceutical services （n＝10）. CONCLUSIONS In China， pharmaceutical services provided by community pharmacies for patients with chronic diseases are still mainly confined to economically developed areas， and the scope of services is limited to a few diseases and basic pharmaceutical practices. In the future， the implementation of precise pharmaceutical services for different diseases and patients’ disease status， the establishment of medical alliances， and the development of internet-based pharmaceutical services should become the focus of pharmaceutical services.

Objective:To compare the motivated forgetting ability between adolescents with depression and normal adolescents and to explore the relationship of this ability with childhood trauma and symptoms of depression.Methods:Totally 141 adolescents diagnosed with depression according to the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5),and 42 normal controls participated in the study.The directed forgetting(DF)task was employed,using emotional images as memory stimuli,to compare the recognition per-formance between the two groups.The presence of the DF effect was identified when the recognition score under the"to-be-remembered"condition was significantly higher than the"to-be-forgotten"condition.The Childhood Trauma Questionnaire Short Form(CTQ-SF)and Beck Depression Inventory-Ⅱ(BDI-Ⅱ)were utilized to assess the severi-ty of participants'childhood trauma and depression symptoms.Results:Unlike the control group,the adolescents with depression only exhibited the DF effect with positive stimuli(P＜0.001).In the depression group,the DF effect value for negative stimuli partially mediated the relationship between CTQ-SF scores and BDI-Ⅱ scores(effect size=0.10,95％confidence interval 0.05-0.17,accounting for 21.3％of the total effect).Conclusion:The motivated forgetting ability is partially impaired in adolescents with depression.The ability,especially regarding negative memories,plays a partial mediating role between childhood trauma and depressive symptoms in adolescents with depression.

Objective To explore training programs for pharmacists in retail pharmacies to implement medication therapy management services for patients with chronic diseases.Methods Combined with national conditions in China,the expert consultation method was used to establish a training program for pharmacists in retail pharmacies on chronic disease medication therapy management in terms of curriculum setting,teaching mode,and teaching assessment,and to implement the training.Qualitative interviews were conducted to gain an in-depth understanding of pharmacists'evaluations and suggestions on the training program.Results The training curriculum covered practice skills of pharmaceutical care and pharmacotherapeutics.The teaching modes included online learning and Q&A,case writing,role-playing and standardized patient case practices,and teaching assessment was conducted through knowledge quizzes,objective structured clinical exams,practice tests and questionnaires.181 pharmacists attended and completed the training,and the score of their overall satisfaction with the training program was 4.7(out of a maximum score of 5.0).Through the training,pharmacists'knowledge and skill levels in medication therapy management as well as attitudes,confidence and perceptions of practice were significantly improved and demonstrated better pharmacy practice abilities.Most pharmacists expressed their learning needs for disease-based pharmacy service model and communication skills training with patients in qualitative interviews.Conclusion A training program suitable for retail pharmacists to improve the comprehensive ability of chronic disease medication therapy management has initially formed,and disease-based doctor-patient communication ability and pharmaceutical care process training should become the focus of learning in medication therapy management service ability of retail pharmacists.

Objective : To investigate the molecular mechanism of Toll⁃like receptor 4 ( TLR4)/Ras homologue A (RhoA) signaling pathway involved in regulating the effect of septic serum on vascular endothelial cell permeability before and after continuous hemofiltration. Methods : The serum of 5 patients with sepsis before and after continuous hemofiltration treatment was collected , and the levels of inflammatory cytokines in serum before and after hemofiltration were detected. Human umbilical vein endothelial cells (HUVEC) were treated with serum before and after continuous hemofiltration for 24 hours. The expression of VE⁃cadherin , F ⁃actin , TLR4 and RhoA in vascular endothelial cells were detected by Western blot. A TLR4 low expression cell line was constructed to detect the effect of TLR4 low expression on the expression of VE⁃cadherin , F ⁃actin and RhoA and the permeability of endothelial cells. Results : After continuous blood treatment , the serum levels of TLR4 , RhoA , interleukin⁃1 (IL⁃1) , interleukin⁃6 (IL⁃6) and tumor necrosis factor⁃α (TNF⁃α ) significantly decreased. The expression levels of VE⁃cadherin , F ⁃actin , TLR4 and RhoA in the serum intervention group after continuous hemofiltration treatment significantly decreased , and the cell permeability significantly decreased. Low expression of TLR4 significantly promoted the expression of VE⁃cadherin and F ⁃actin , and inhibited the expression of RhoA protein. Conclusion TLR4/RhoA signaling pathway is involved in the regulation of changes in vascular endothelial cell permeability induced by septic serum after continuous hemofiltration treatment.

Objective:To explore the feasibility of using multivariate statistical analysis to evaluate the quality of Astmgali radix from different habitats. Methods:The contents of Astragaloside saponinⅠ, Astragalus saponin Ⅱ, Astragaloside Ⅲ and Astragaloside A were determined by UPLC-ELSD. The components of astragalus saponins from different habitats were analyzed by TOPSIS and cluster thermogram.Results:TOPSIS analysis showed that the comprehensive quality of Astmgali radix samples from Shanxi, Gansu and Inner Mongolia was related(were 0.297 3, 0.346 0, 0.322 5), and the whole quality of S13 and S14 from Shanxi and N5 from Inner Mongolia were higher than others. Cluster thermogram showed that Astmgali radix was grouped into three groups according to region, and the quality difference of Astmgali radix was mainly reflected on Astragaloside saponinⅠand Astragalus saponin Ⅱ. Conclusions:The theory of multivariate statistical analysis is perfect, objective and reliable. It can be used as a reference for comprehensive quality evaluation of Traditional Chinese Medicine (TCM), selection of excellent germplasm resources and traceability of origin of TCM.

OBJECTIVE： To analyze the characteristics of adverse drug reactions/events （ADR/ADE） caused by TCM injections in 18 third grade class A hospitals from Xi’an， and to provide reference for rational drug use in clinic. METHODS： Totally 304 ADR/ADE cases of TCM injection reported by 18 third grade class A hospitals of Xi’an were analyzed statistically during 2013-2018 in respect of gender and ages， time distribution of ADR/ADE， distribution of ADR/ADE-inducing drugs， organs/systems involved in ADR/ADE and clinical manifestations， grading of ADR/ADE， outcome and relationship evaluation， drug combination. RESULTS： Totally 6 683 cases of ADR/ADE cases were reported in same period， 304 cases were caused by TCM injection （4.55％）. Among 304 cases of ADR/ADE， the number of women （162 cases， 53.29％） was slightly higher than that of men （142 cases， 46.71％）. The age of patients was mainly over 40 years old （223 cases， 73.35％）. Among them， 118 cases （38.82％） were over 60 years old. ADR/ADE occurred within 1 min to 10 days after administration， especially within 30 min after administration （123 cases， 40.46％）. ADR/ADE involved 36 varieties， mainly including agent for promoting blood circulation and dredging， agent for reinforcing and tonifying and agent for clearing away heat and detoxification， and Danhong injection accounted for the highest proportion （43 cases， 14.14％）. A total of 352 ADR/ADE case times occurred in 304 patients， mainly lesion of skin and appendents （164 case times， 46.59％）， followed by cardiovascular system lesions （54 case times， 15.34％） and systemic lesions （51 case times， 14.49％）. The main clinical manifestations were mainly pruritus （117 case times）， followed by rash （68 case times） and palpitation （34 case times）. Among 304 ADR/ADE reports， 26 cases （8.55％） were severe， 8 cases （2.63％） were new ADR/ADE， 302 cases （99.34％） were cured or improved， 2 cases （0.66％） were unknown， but none of them died. 266 cases （87.50％） were evaluated as likely to be related. 46 patients （15.13％） had combined use of drugs， including 9 cases of combined use of TCM injection and 37 cases of combined use of chemical medicine injection. CONCLUSIONS： TCM injections had a high incidence of ADR/ADE due to the complexity of their components， individual differences and clinical use. Most of them were rapid-onset ADR/ADE within 30 min and mild ADR/ADE commonly seen in lesion of skin and its appendents. The incidence could be reduced by rational clinical use and drug monitoring. For cardiovascular diseases and other basic diseases， attention should be paid to distinguishing their primary diseases from ADR/ADE caused by TCM injections， and more attention should be paid to their individualized drug use.

Vacuum sealing drainage (VSD) is frequently used in abdominal surgeries. However, relevant guidelines are rare. Chinese Trauma Surgeon Association organized a committee composed of 28 experts across China in July 2017, aiming to provide an evidence-based recommendation for the application of VSD in abdominal surgeries. Eleven questions regarding the use of VSD in abdominal surgeries were addressed: (1) which type of materials should be respectively chosen for the intraperitoneal cavity, retroperitoneal cavity and superficial incisions? (2) Can VSD be preventively used for a high-risk abdominal incision with primary suture? (3) Can VSD be used in severely contaminated/infected abdominal surgical sites? (4) Can VSD be used for temporary abdominal cavity closure under some special conditions such as severe abdominal trauma, infection, liver transplantation and intra-abdominal volume increment in abdominal compartment syndrome? (5) Can VSD be used in abdominal organ inflammation, injury, or postoperative drainage? (6) Can VSD be used in the treatment of intestinal fistula and pancreatic fistula? (7) Can VSD be used in the treatment of intra-abdominal and extra-peritoneal abscess? (8) Can VSD be used in the treatment of abdominal wall wounds, wound cavity, and defects? (9) Does VSD increase the risk of bleeding? (10) Does VSD increase the risk of intestinal wall injury? (11) Does VSD increase the risk of peritoneal adhesion? Focusing on these questions, evidence-based recommendations were given accordingly. VSD was strongly recommended regarding the questions 2-4. Weak recommendations were made regarding questions 1 and 5-11. Proper use of VSD in abdominal surgeries can lower the risk of infection in abdominal incisions with primary suture, treat severely contaminated/infected surgical sites and facilitate temporary abdominal cavity closure.
Abdomen ; surgery ; China ; Drainage ; methods ; Evidence-Based Medicine ; Humans ; Practice Guidelines as Topic ; Societies, Medical ; organization & administration ; Surgical Wound Infection ; prevention & control ; Traumatology ; organization & administration ; Vacuum