ObjectiveTo evaluate the efficacy and safety of Janus kinase （JAK） inhibitors combined with Chinese herbal medicine （CHM） in treating rheumatoid arthritis （RA）. MethodsClinical data from 169 RA patients were retrospectively collected. Among them， 71 cases received JAK inhibitors as the control group， while 98 cases received JAK inhibitors plus CHM as the observation group， both treated for 24 weeks. The rheumatoid factor （RF）， cyclic citic peptide antibody （anti-CCP）， erythrocyte sedimentation rate （ESR）， C-reactive protein （CRP）， and white blood cell count （WBC） were recorded before and after treatment. Databases including CNKI， Wanfang， VIP， PubMed and Web of Science were searched from inception till August 31st， 2025 for randomized controlled trials （RCTs） on the combined use of JAK inhibitors and CHM for RA. The methodological quality of the included studies was evaluated using the risk of bias assessment tool. Meta-analyses were performed for RF， anti-CCP， ESR， CRP， 28-joint disease activity score （DAS28）， overall clinical effective rate， and incidence of adverse events. Sensitivity analysis were also performed. ResultsThe retrospective study demonstrated that after treatment， ESR， CRP， and anti-CCP levels decreased in the observation group， while ESR and CRP levels decreased in the control group （P＜0.05）. Moreover， ESR and RF levels in the observation group were lower than those in the control group （P＜0.05）. A total of 9 RCTs involving 770 patients were included in the meta-analysis. The results indicated that the JAK inhibitors plus CHM group was superior to the JAK inhibitors group in reducing RF （MD=-8.97， 95%CI -15.01 to -2.94， P=0.004）， CRP （MD=-3.34， 95%CI -3.82 to -2.86， P＜0.001）， ESR （MD=-5.33， 95%CI -7.98 to -2.69， P＜0.001）， and DAS28 score （MD=-0.54， 95%CI -0.74 to -0.34， P＜0.001）， as well as in improving the overall clinical effective rate （OR=4.53， 95%CI 2.55 to 8.03， P＜0.001）. No statistically significant differences were observed between groups in anti-CCP levels （SMD=-2.08， 95%CI -4.41 to 0.24， P=0.080） or incidence of adverse events （OR=0.93， 95%CI 0.55 to 1.57， P=0.790）. ConclusionThe combination of JAK inhibitors and CHM demonstrates remarkable efficacy in treating RA， contributing to improved disease activity and reduced inflammatory markers with a favorable safety profile.

Objective: To investigate the treatment outcomes and influencing factors among elderly patients with pulmonary tuberculosis in Lishui City, Zhejiang Province, so as to provide a basis for optimizing the prevention and control strategies of pulmonary tuberculosis and reducing the risk of adverse treatment outcomes among elderly patients. Methods: Data on patients aged ≥60 years with pulmonary tuberculosis in Lishui City from 2016 to 2022 were collected from the Tuberculosis Information Management System of the China Disease Prevention and Control Information System, including basic information, diagnosis and treatment details, and laboratory test results. The successful treatment rate and the incidence of adverse treatment outcomes were calculated. Factors affecting adverse treatment outcomes among elderly patients with pulmonary tuberculosis were analyzed using multivariable logistic regression model. Results: A total of 3 094 elderly patients with pulmonary tuberculosis were registered in Lishui City from 2016 to 2022, with a median age of 70 (interquartile range, 13) years. There were 2 396 male patients (77.44%) and 698 female patients (22.56%). A total of 2 676 patients achieved successful treatment, with a successful treatment rate of 86.49%. The successful treatment rate demonstrated a significant upward trend from 2016 to 2022 (P<0.05). There were 418 patients with adverse treatment outcomes, accounting for an incidence of 13.51%. The main types of adverse outcomes were death and loss to follow-up, with 199 and 100 patients, accounting for 47.61% and 23.92%, respectively. Multivariable logistic regression analysis showed that elderly patients with pulmonary tuberculosis who were male (OR=1.333, 95%CI: 1.018-1.745), aged ≥70 years (70-<80 years, OR=1.909, 95%CI: 1.469-2.481; ≥80 years, OR=3.878, 95%CI: 2.967-5.068), living in rural areas (OR=1.332, 95%CI: 1.068-1.661), with positive etiological results (OR=1.470, 95%CI: 1.143-1.889), and undergoing retreatment (OR=1.923, 95%CI: 1.419-2.607) had a higher risk of adverse treatment outcomes. Conclusions The successful treatment rate showed an upward trend among elderly patients with pulmonary tuberculosis in Lishui City from 2016 to 2022. Gender, age, place of residence, etiological results, and treatment type were influencing factors for adverse treatment outcomes among elderly patients with pulmonary tuberculosis.

Objective:To investigate the application of time series models in forecasting pre-hospital emergency ambulance trips in Handan City and develop the LPro ensemble model for improved prediction accuracy to support emergency resource allocation.Methods:Pre-hospital emergency data from Handan Emergency Medical Command Center (2019-2023) were retrospectively analyzed. From 324 799 original records, 289 949 valid records were included after cleaning. The training set (2019-2022: 215 918 records) included 35 527 records in 2019, 52 015 in 2020, 61 836 in 2021, and 66 540 in 2022. The validation set (2023) contained 74 031 records. ARIMA, linear trend seasonal, exponential smoothing, and Prophet models were fitted to the training set. The LPro ensemble model was constructed using MAPE-based weighting (linear trend seasonal model: 0.38, Prophet: 0.62). Performance metrics included MAPE, RMSE, MAE, and R 2. Results:Data showed annual growth (compound annual growth rate 23.27%) and seasonal patterns (October peaks, February troughs). Ambulance dispatches increased annually with monthly cyclical patterns. For 2023 validation predictions: ARIMA (MAPE 8.76%, RMSE 619, MAE 491, R 2 0.4563), linear trend seasonal (MAPE 9.83%, RMSE 671, MAE 545, R 2 0.3608), Prophet (MAPE 8.43%, RMSE 562, MAE 503, R 2 0.5513), exponential smoothing (MAPE 8.08%, RMSE 643, MAE 410, R 2 0.4124). LPro model showed superior performance (MAPE 7.05%, RMSE 491, MAE 393, R 2 0.6570), with 16.37% lower MAPE, 12.63% lower RMSE, 21.87% lower MAE, and 19.17% higher R 2 versus Prophet. Conclusion:The LPro ensemble model substantially enhances prediction accuracy and reliability, offering scientific support for emergency resource optimization and dispatch scheduling in Handan City.

Objective To observe the clinical efficacy of traditional Chinese medicine(TCM)sequential therapy in treating patients with psoriasis vulgaris in Shenzhen,and to explore the syndrome differentiation and treatment for the patients with psoriasis vulgaris in Shenzhen region.Methods From January 2019 to February 2024,70 cases of psoriasis vulgaris admitted to Shenzhen Bao'an Traditional Chinese Medicine Hospital Affiliated to Guangzhou University of Chinese Medicine(Shenzhen Bao'an Traditional Chinese Medicine Hospital Group)were retrospectively analyzed.The patients were divided into the observation group(39 cases)and the control group(31 cases)according to the treatment plans.In the control group,only topical application of Calcipotriol Ointment was given throughout the treatment,while in the observation group the patients were treated with TCM sequential therapy according to the illness stage on the basis of treatment for the control group,i.e.,internal administration of modified Shuiniujiao Huanglian Decoction was given in the acute stage and modified Sijunzi Shuiniujiao Decoction was given in the remission stage.Both groups were treated for 3 months.Before and after the treatment,the changes of Psoriasis Area and Severity Index(PASI)scores,Dermatology Life Quality Index(DLQI)scores and TCM syndrome scores in the two groups were observed.After treatment,the clinical efficacy and drug safety of the two groups were evaluated.Results(1)After 3 months of treatment,the total effective rate of the observation group was 89.74%(35/39),and that of the control group was 74.19%(23/31).The intergroup comparison(tested by chi-square test)showed that the efficacy of the observation group was significantly superior to that of the control group(P＜0.05).(2)After treatment,the PASI scores for evaluating the severity of skin lesions in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the decrease in the observation group was significantly superior to that in the control group(P＜0.05).(3)After treatment,the DLQI scores for evaluating the quality of life in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the decrease in the observation group was significantly superior to that in the control group(P＜0.05).(4)After treatment,the scores of TCM syndromes such as erythema,itching,vexation and dry mouth in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the decrease in the observation group was significantly superior to that in the control group(P＜0.05).(5)During the treatment period,no obvious adverse reactions occurred in the two groups of patients,with high safety.Conclusion On the basis of conventional western medicine treatment,application of TCM sequential therapy exerts certain clinical efficacy in treating patients with psoriasis vulgaris in Shenzhen region,and the combined therapy is effective on controlling the patients'illness conditions,significantly alleviating the symptoms and improving the quality of life of the patients.

Fresh Chinese herbal medicine,being distinct from the dried herbs,is one of the therapies of traditional Chinese medicine(TCM)widely used in dermatology.It is employed to treat various skin diseases,namely herpes simplex,herpes zoster,common warts,flat warts,boils,carbuncles,erysipelas,acne vulgaris,fungal skin diseases,psoriasis,contact dermatitis,insect bite dermatitis,and eczema.The commonly-used fresh herbs for skin diseases are fresh Portulacae Herba,fresh Houttuyniae Herba,fresh Rubiae Radix,fresh Lygodii Spora,fresh Patriniae Herba,fresh Aloe,fresh Plataginis Herba,fresh Pinelliae Rhizoma,and fresh Taraxaci Herba.These herbs usually have the actions of clearing heat,detoxifying,and cooling blood.For the treatment of skin diseases,fresh herbal medicine can be administered orally or applied topically,with a predominant use of topical application or a combination of oral and topical administration.Due to the rapid development of modern society,the supply and standardization of fresh herbs fail in meeting the demands of a large population of the patients,leading to their gradual decline in use.However,the efficacy of fresh herbs cannot be entirely replaced by that of the dried herbs.This article reviewed the advances in the modern application of fresh Chinese herbal medicine in dermatology,aiming to promote further research and expand its clinical application in treating skin diseases.

Objective:To compare the current situation of research on workplace violence (WPV) among nurses at home and abroad, providing directions for further research.Methods:Research on WPV among nurses published in PubMed, Web of Science, EBSCO, China national knowledge infrastructure, Wanfang, and VIP databases from January 1, 2003 to October 14, 2023 were searched and screened, using visualization software CiteSpace and VOSviewer to analyze the distribution and correlation of countries, authors, institutions and keywords of the included studies.Results:A total of 1 082 Chinese articles and 2 770 English articles were included. From 2003 to 2023, the annual publication volume of research on nurse WPV showed a continuous upward trend in both Chinese and English literature. Among domestic institutions, Harbin Medical University published the most articles ( n=25). Among international research institutions, North South University ( n=9) and University of Malaya ( n=9) led in publication output. A total of 67 core authors were identified in Chinese literature and 194 in the English literature. Analysis of high-frequency keywords showed that the research topics could be summarized as research types, occurrence mechanisms, negative effects, high-risk precursors, intervention strategies, negative effects and population differences. Chinese Nursing Research ( n=40) and Journal of Nursing Management ( n=186) published the most Chinese and English articles. Conclusions:The amount of research on workplace violence among nurses has generally increased in recent years. The mechanisms of occurrence, high-risk precursors, and intervention strategies are important research directions. It is still necessary to further deepen the research content in the future.

Objective:To compare the current situation of research on workplace violence (WPV) among nurses at home and abroad, providing directions for further research.Methods:Research on WPV among nurses published in PubMed, Web of Science, EBSCO, China national knowledge infrastructure, Wanfang, and VIP databases from January 1, 2003 to October 14, 2023 were searched and screened, using visualization software CiteSpace and VOSviewer to analyze the distribution and correlation of countries, authors, institutions and keywords of the included studies.Results:A total of 1 082 Chinese articles and 2 770 English articles were included. From 2003 to 2023, the annual publication volume of research on nurse WPV showed a continuous upward trend in both Chinese and English literature. Among domestic institutions, Harbin Medical University published the most articles ( n=25). Among international research institutions, North South University ( n=9) and University of Malaya ( n=9) led in publication output. A total of 67 core authors were identified in Chinese literature and 194 in the English literature. Analysis of high-frequency keywords showed that the research topics could be summarized as research types, occurrence mechanisms, negative effects, high-risk precursors, intervention strategies, negative effects and population differences. Chinese Nursing Research ( n=40) and Journal of Nursing Management ( n=186) published the most Chinese and English articles. Conclusions:The amount of research on workplace violence among nurses has generally increased in recent years. The mechanisms of occurrence, high-risk precursors, and intervention strategies are important research directions. It is still necessary to further deepen the research content in the future.

Scavenger receptor class B, member 2 (SCARB2) is linked to Gaucher disease and Parkinson's disease. Deficiency in the SCARB2 gene causes progressive myoclonus epilepsy (PME), a rare group of inherited neurodegenerative diseases characterized by myoclonus. We found that Scarb2 deficiency in mice leads to age-dependent dietary lipid malabsorption, accompanied with vitamin E deficiency. Our investigation revealed that Scarb2 deficiency is associated with gut dysbiosis and an altered bile acid pool, leading to hyperactivation of FXR in intestine. Hyperactivation of FXR impairs epithelium renewal and lipid absorption. Patients with SCARB2 mutations have a severe reduction in their vitamin E levels and cannot absorb dietary vitamin E. Finally, inhibiting FXR or supplementing vitamin E ameliorates the neuromotor impairment and neuropathy in Scarb2 knockout mice. These data indicate that gastrointestinal dysfunction is associated with SCARB2 deficiency-related neurodegeneration, and SCARB2-associated neurodegeneration can be improved by addressing the nutrition deficits and gastrointestinal issues.
Animals ; Mice ; Dysbiosis/metabolism* ; Mice, Knockout ; Humans ; Lysosomal Membrane Proteins/genetics* ; Receptors, Scavenger/genetics* ; Gastrointestinal Microbiome ; Myoclonic Epilepsies, Progressive/genetics* ; Vitamin E Deficiency/complications* ; Neurodegenerative Diseases/genetics* ; Bile Acids and Salts/metabolism* ; Male ; Lipid Metabolism ; Intestinal Mucosa/pathology*

Objective: To investigate the status of regular HIV testing and post exposure prophylaxis (PEP) behaviors among men who have sex with men (MSM) in Lishui City, Zhejiang Province, so as to provide the reference for developing targeted intervention strategies. Methods: A total of 389 MSM were selected from Lishui City by convenient sampling method from April to August 2022, and demographic information, sexual behaviors, HIV testing and PEP behaviors were collected through questionnaire surveys. MSM were clustered using two step clustering analysis, and regular HIV testing and PEP behaviors among different groups of MSM were compared. Factors affecting regular HIV testing and PEP behaviors were evaluated using a multivariable logistic regression model. Results: The MSM surveyed had a median age of 31.00 (interquartile range, 16.00) years. There were 146 MSM undergoing regular HIV testing, accounting for 37.53%, and 47 MSM receiving PEP, accounting for 12.08%. MSM were divided into two groups. There were 28.05% of MSM with regular HIV testing in group 1, which was lower than the 44.44% in group 2; and 22.56% receiving PEP, which was higher than the 4.44% in group 2 (both P<0.05). Multivariable logistic regression analysis identified age (OR=1.030, 95%CI: 1.011-1.050), sexual roles (both receptive and insertive, OR=2.999, 95%CI: 1.732-5.194) and homosexual behaviors in the past 6 months (use condoms every time, OR=4.567, 95%CI: 2.593-8.044) as factors affecting regular HIV testing among MSM; age (OR=0.970, 95%CI: 0.942-0.999), sexual orientation (OR=0.292, 95%CI: 0.139-0.612) and homosexual behaviors in the past 6 months (not use condoms, OR=0.135, 95%CI: 0.040-0.460; use condoms every time, OR=0.076, 95%CI: 0.018-0.326) as factors affecting PEP behaviors among MSM. Conclusion MSM with different characteristics of sexual behaviors have different preferences for HIV regular testing and PEP, with homosexual behaviors in the past 6 months, sexual roles and sexual orientation being the main influencing factors.

ObjectiveTo explore the effectiveness and safety of vibration-kneading abdominal tuina as an adjunct treatment for insomnia of phlegm-heat harassing the interior syndrome with "stomach disharmony" symptom. MethodsSeventy-six insomnia patients of phlegm-heat harassing the interior syndrome with "stomach disharmony" symptom were recruited， and randomly divided into the treatment group and the control group with 38 cases in each group. The control group received eszopiclone 2mg once a night and sleep hygiene guidance， while the treatment group received vibration-kneading abdominal tuina additionally， 5 times a week， 30 min each time. Both groups were treated for 4 weeks. The Pittsburgh Sleep Quality Index （PSQI） （including sleep quality， time to fall asleep， sleep duration， sleep efficiency， sleep disorders， daytime functioning scores， and total scores） and traditional Chinese medicine （TCM） symptom scores of "stomach disharmony" was assessed before and after 4-week treatment and at follow-up （12 weeks after treatment）. Adverse events were also observed and recorded during the study. Pearson correlation analysis was used to assess the correlation between the pre-treatment PQSI total score and TCM symptom score of "stomach disharmony". ResultsThe PSQI scores of sleep quality， time to fall asleep， sleep duration， sleep efficiency， sleep disorders， daytime dysfunction scores， and total scores reduced in both groups decreased after treatment and at follow-up （P＜0.05 or P＜0.01）， as well as the TCM symptom score of "stomach disharmony" （P＜0.01）. After treatment， the PSQI scores of sleep quality， sleep duration， and TCM symptom score of "stomach disharmony" of the treatment group were lower than those of the control group （P＜0.05 or P＜0.01）. At follow-up， the PSQI scores of sleep quality， sleep duration， sleep efficiency， daytime dysfunction score， total score， and TCM symptom score of "stomach disharmony" of the treatment group were lower than those of the control group （P＜0.05 or P＜0.01）. No adverse reactions occurred in any participants during the study. There was a positive correlation between the patients' pre-treatment PQSI total scores and TCM symptom score of "stomach disharmony" （r=0.88， P＜0.01）. ConclusionVibration-kneading abdominal tuina as an adjunct treatment could significantly improve the symptoms of stomach and epigastric symptoms in insomnia patients of phlegm-heat harassing the interior syndrome with "stomach disharmony" symptom， and improve the quality of sleep， with good immediate and long-term therapeutic effects， and sound safety.