Recently, there has been an increasing risk of importation of tropical diseases into China and the resultant re-transmission in the country with the in-depth implementation of the “Belt and Road” Initiative, which poses a serious threat to the national public health security. To effectively respond to the cross-border transmission risk of tropical diseases and facilitate the process towards tropical disease control and elimination in China and the countries along the “Belt and Road” Initiative, this article analyzes the current status and governance risks of major imported tropical diseases, cross-border joint prevention and control polices implemented for tropical diseases and challenges in the establishment of the joint prevention and control system for tropical diseases in China, and discusses the establishment and implementation path of the joint prevention and control system for tropical diseases in countries along the “Belt and Road” Initiative. This path covers the establishment of cross-border cooperation mechanisms, research and development and pilot production of Chinese public health products, and implementation of key cross-border tropical disease prevention and control projects. The establishment of this system will further improve Chinese prevention and control capabilities for key cross-border tropical diseases, build a demonstrative prevention and control model for tropical diseases, and promote international technical exchanges and cooperation of tropical diseases.

OBJECTIVE To systematically evaluate medication risk prediction models for hospitalized adult patients and provide references for their development and clinical application. METHODS Databases including PubMed， Embase， Web of Science， CNKI， Wanfang data， VIP and CBM were searched for studies on medication risk prediction models from their inception to May 2024. After screening the literature， extracting data， and evaluating the quality of the literature， descriptive analysis was performed on the results of the included studies. RESULTS A total of 13 studies were included， involving 12 models. Nine studies used Logistic regression algorithm for modeling， and the number of included predictive factors ranged from 3 to 11； the area under the receiver operating characteristic curve ranged from 0.65 to 0.865. The literature quality evaluation results showed that 10 studies had high risk of bias； 10 studies had high applicability risk. A total of 31 predictive factors were extracted， including 15 items of basic patient information， 3 test indicators， and 5 items of medication information， and 8 others. CONCLUSIONS The existing medication risk prediction models for hospitalized adult inpatients are mainly Logistic regression algorithm， with predictive factors mainly focusing on basic indicators such as demographics. The overall prediction performance of the models needs to be improved， and the overall risk of bias is relatively high.

ObjectiveTo investigate the effect of 1，25（OH）₂D₃ on the level of peroxisome proliferator-activated receptor-γ （PPAR-γ） in the liver， the phenotype of hepatic macrophages， and liver inflammation in a rat model of nonalcoholic steatohepatitis （NASH）， as well as the mechanism of 1，25（OH）₂D₃ improving liver inflammation. MethodsAfter 1 week of adaptive feeding， 24 specific pathogen-free Wistar rats were randomly divided into normal group ［choline-supplemented L-amino acid-defined （CSAA） diet］， normal+1，25（OH）₂D₃ group ［CSAA diet+1，25（OH）₂D₃］， model group ［choline-deficient L-amino acid-defined diet （CDAA） diet］， and model+1，25（OH）₂D₃ group ［CDAA diet+1，25（OH）₂D₃］， with 6 rats in each group. The dose of 1，25（OH）₂D₃ was 5 μg/kg for intraperitoneal injection twice a week for 12 weeks. The serum levels of aspartate aminotransferase （AST） and alanine aminotransferase （ALT） were measured， liver histopathology was observed， and SAF score was assessed. M1 hepatic macrophages and M2 hepatic macrophages were measured to analyze in the change in the phenotype of hepatic macrophages， and ELISA was used to measure the levels of tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， interleukin-4 （IL-4）， and interleukin-10 （IL-10） in liver tissue， and qPCR was used to measure the mRNA level of PPAR-γ. The two-factor analysis of variance was use for comparison between groups， and the least significant difference t-test was used for further comparison； the Pearson method was used for correlation analysis. ResultsCompared with the normal group， the model rats with CDAA diet-induced NASH had significant increases in the serum levels of AST and ALT （P=0.019 and P<0.001）， the SAF score of liver histopathology （P<0.001）， the level of M1 hepatic macrophages （P<0.001）， and the ratio of M1 and M2 hepatic macrophages （P<0.001）， as well as a significant increase in the level of TNF-α （P<0.001） and a significant reduction in the level of IL-4 in liver tissue （P=0.025）. The 1，25（OH）₂D₃ group had significant reductions in the serum levels of ALT （P<0.001）， the SAF score of liver histopathology （P<0.001）， the level of M1 hepatic macrophages （P<0.001）， and the ratio of M1 and M2 hepatic macrophages （P=0.001）， the level of IL-1β （P<0.001） and a significant increase in the level of M2 hepatic macrophages （P=0.017）， the level of IL-10 （P=0.039）， the level of IL-4 （P<0.001）， the level of PPAR-γ （P=0.016）. There were significant interactions between CDAA diet-induced NASH model and 1，25（OH）₂D₃ in serum the levels of AST and ALT （P=0.007 and P=0.008）， the SAF scores of liver histopathology （P<0.001）， the level of M1 hepatic macrophages （P<0.001）， the level of M2 hepatic macrophages （P=0.008）， the ratio of M1 and M2 of hepatic macrophages （P=0.005）， the level of TNF-α （P<0.001）， the level of IL-10 （P=0.038）， the level of IL-4 （P<0.001） and the level of PPAR-γ （P=0.009）. The correlation analysis showed that PPAR-γ was negatively correlated with the ratio of M1 and M2 hepatic macrophages （r=-0.415， P=0.044） and was positively correlated with M2 hepatic macrophages （r=0.435， P=0.033）， IL-10 （r=0.433， P=0.035）， and IL-4 （r=0.532， P=0.007）. ConclusionThis study shows that 1，25（OH）₂D₃ improves liver inflammation in NASH by activating PPAR-γ to regulate the phenotypic transformation of hepatic macrophages.

Objective:To analyze the association between sleep status and ambulatory blood pressure monitoring indicators in community-dwelling hypertensive patients.Methods:It was a cross sentional study. Hypertensive patients who underwent 24-hour ambulatory blood pressure monitoring from May 2021 to April 2023 in Shanghai Xinzhuang Town were enrolled. The demographic information and sleep status of patients were obtained from the questionnaire. A TM-2430 blood pressure monitor was used to measure 24-hour ambulatory blood pressure, and the relevant indicators, including blood pressure level and blood pressure coefficient of variation were documented. The association between sleep status and blood pressure indicators was analyzed with multivariate linear regression model.Results:A total 1 135 patients aged (65.07±12.61) years were enrolled, and 473 (41.67%) of whom were males. The sleep time was<7 hours in 76 cases, 7- 8 hours in 219 cases and >8 hours in 840 cases; the bedtime was earlier than 22∶00 in 415 cases, between 22∶00 and 23∶00 in 474 cases and later than 23∶00 in 246 cases; the wake-up time was before 6∶00 in 230 cases, between 6∶00 and 7∶00 in 521 cases and after 7∶00 in 384 cases. Multivariate linear regression analysis showed that after controlling for gender and age, the sleep time was negatively associated with diurnal, noctumal and 24-hour diastolic blood pressure levels (all P<0.05), and positively associated with diurnal and noctumal systolic blood pressure coefficient of variation, noctumal diastolic blood pressure coefficient of variation, and 24-hour systolic blood pressure coefficient of variation (all P<0.05).The bedtime was positively associated with diurnal, noctumal and 24-hour diastolic blood pressure (all P<0.05), diastolic blood pressure (all P<0.05); and negatively associated with diurnal systolic blood pressure coefficient of variation, diurnal diastolic blood pressure coefficient of variation, noctumal systolic blood pressure coefficient of variation, 24-hour systolic blood pressure coefficient of variation, and 24-hour diastolic blood pressure coefficient of variation (all P<0.05). The wake-up time was positively associated with diurnal systolic blood pressure, diurnal, noctumal and 24-hour diastolic blood pressure (all P<0.05), and positively associated with diurmal systolic blood pressure and diastolic blood pressure (both P<0.05). Conclusion:Sleep status is closely associated with ambulatory blood pressure monitoring indicators in community-dwelling hypertensive patients.

Objective To explore the application effect of ultrasound-guided long axis iliac fascia block through femoral nerve for pain management in elderly patients with hip fractures.Methods A total of 60 elderly patients with hip fractures admitted to the Second Affiliated Hospital of Jiaxing University from March to June 2023 were selected,and they were divided into S group and L group according to random number table method,with 30 cases in each group.Patients in S group underwent short axis iliac fascia block through femoral nerve by ultrasound,while patients in L group underwent long axis iliac fascia block through femoral nerve by ultrasound.The static numerical rating scale(NRS)scores,dynamic NRS scores of two groups were compared before nerve block(T0),and 10min(T1),2h(T2),6h(T3)and 12h(T4)after nerve block,effective cases of nerve branch block,and occurrence of adverse events related to nerve block were compared between two groups.Results The static and dynamic NRS scores of two groups decreased first and then increased slightly with the extension of time.At time points T2 and T3,the static and dynamic NRS scores of patients in L group were significantly lower than those in S group(P<0.05).The effective cases of lateral femoral cutaneous nerve block and obturator nerve block in L group were significantly higher than those in S group(P<0.05).No adverse events such as local anesthetic poisoning,peripheral nerve injury,and analgesia covering up the disease occurred in both groups.Conclusion Ultrasound-guided long axis iliac fascia block through femoral nerve can effectively reduce early pain in elderly patients with hip fracture,and it is safe.

Objective To explore the median effective dose of propofol or cyclopofol combined with alfentanil in inhibiting body movement response during induced abortion.Methods From October 2021 to April 2022,patients aged 18-35 years,body mass index(BMI)18-28 kg/m2,American Society of Anesthesologists(ASA)I or II,fetal age<10 weeks,first pregnancy or no history of vaginal delivery were selected for elective painless induced abortion in Gynecological Surgery Center of the Second Hospital of Jiaxing.Patients were divided into 2 groups using a random number table method:propofol group(group P)and cyclopofol group(group C).During anesthesia induction,intravenous injection of alfentanil was followed by administration of propofol or cyclopofol with a dose set by the modified sequential method.If the patient had involuntary limb movement during surgery and affected the operation of the operator and needed additional anesthetic drugs,it was judged as a positive reaction,and intravenous propofol or cyclopofol 0.5mg/kg or 0.1mg/kg was added,and the next patient's propofol or cyclopofol was increased by a dose gradient.Conversely,the next patient was given a dose gradient of 0.5mg/kg propofol or 0.1mg/kg cyclopofol,respectively.Probit regression analysis was used to calculate the median effective dose(ED50),95%effective dose(ED95)and corresponding confidence interval(CI)of propofol and cyclopofol.Results The ED50(95%CI)and ED95(95%CI)of propofol in group P were 1.815(1.315-2.319)mg/kg and 2.901(2.368-6.447)mg/kg,respectively.The ED50(95%CI)and ED95(95%CI)of cyclopofol in group C were 0.381(0.279-0.484)mg/kg and 0.613(0.501-1.344)mg/kg,respectively,and the equivalent ratio of the two was 4.76(4.71-4.79).Conclusion The potency of ciprofol in inhibiting movement response during induced abortion is greater than that of propofol.

Objective To explore the clinical effect of different doses of alfentanil combined with low-dose propofol in painless colonoscopy in elderly patients.Methods A total of 120 elderly patients undergoing elective painless colonoscopy from January to March 2022,aged 65 to 80 years,gender unlimited,body mass index(BMI)18-28kg/m2,American Society of Anesthesiologists(ASA)grade Ⅰ～Ⅱ.Patients were included in the three groups by random number tables:alfentanyl 5μg/kg(N1),alfentanyl 7.5μg/kg(N2),and alfentanyl 10μg/kg(N3),40 patients in each group.Record the heart rate,mean arterial pressure,and oxygen saturation were recorded before anesthesia(T1),after anesthesia induction(T2),colonoscopy(T3),colonoscopy reaching the ileocecum(T4),and at the end of examination(T5).The success rate of anesthesia sedation,dosage of propofol,sedative induction time,colonoscopy time,sedative recovery time,use of vasoactive drugs and physician satisfaction of the three groups were recorded.The incidence of intraoperative hypoxemia,hypotension,spontaneous ycardia,bradycardia,postoperative nausea and dizziness,and postoperative fatiguesyndrome(POFS)and the occurrence of adverse reactions.Results Compared with T1,the mean arterial pressure in T2-T5 patients decreased significantly(P＜0.05),and the heart rate at T3 increased significantly(P＜0.05)in N1,the total dosage,induction time,induction time,awakening time and vasoactive drug use were decreased in N2 and N3,and the success rate of anesthesia sedation was significantly increased(P＜0.05).Comparing the N2 group,physician satisfaction decreased in the N1 and N3 groups(P＜0.05).The incidence of intraoperative hypotension and postoperative POFS decreased in the N2 and N3 groups(P＜0.05)and in the N1 and N2 groups(P＜0.05).Conclusion Afunentanil 7.5pg/kg compound propofol can be used safely and effectively for painless colonoscopy in elderly patients,and the incidence of adverse reactions is low,which improves the quality of postoperative recovery of patients,and is worthy of clinical promotion and application.

Objective To investigate the mental resilience of disabled elderly with suicidal ideation in nursing homes and analyze its related factors.Methods By using convenience sampling and the Chinese version of the Beck scale for suicide ideation,a total of 119 disabled elderly with suicidal ideation were screened from 8 nursing homes in Chongqing from May to October 2022.Then they were investigated with the general information questionnaire,the Memorial University of Newfoundland scale of happiness,the 10-item connor-davidson resilience scale and the hospital depression scale.Results The average score of resilience of disabled elderly with suicidal ideation was(1.58±0.70)points,which was at a lower level.There were statistically significant differences in the mental resilience of disabled elderly with suicidal ideation in terms of the nature of the nursing homes,the degree of disability and education,the length of stay,the frequency of communication with relatives and participation in collective activities.The mental resilience of disabled elderly with suicidal ideation was negatively correlated with depressive symptoms(r1=-0.631,P＜0.001),and positively correlated with subjective well-being(r2=0.652,P＜0.001).Among disabled elderly with suicidal ideation,the degree of education and subjective well-being positively predicted mental resilience,while depressive symptoms negatively predicted mental resilience(adjusted R2=0.521,P＜O.001).Conclusion The mental resilience level of disabled elderly with suicidal ideation in nursing homes is lower.Nursing homes should focus on improving the mental resilience of disabled elderly with lower educational level,lower subjective well-being and higher depression symptoms,so as to improve their adaptability.

Background: SM-like (LSM) genes a family of RNA-binding proteins, are involved in mRNA regulation and can function as oncogenes by altering mRNA stability. However, their roles in B-cell progression and tumorigenesis remain poorly understood. Methods: We analyzed gene expression profiles and overall survival data of 123 patients with mantle cell lymphoma (MCL). The LSM index was developed to assess its potential as a prognostic marker of MCL survival. Results: Five of the eight LSM genes were identified as potential prognostic markers for survival in MCL, with particular emphasis on the LSM.index. The expression levels of these LSM genes demonstrated their potential utility as classifiers of MCL. The LSM.index-high group exhibited both poorer survival rates and lower RNA levels than did the overall transcript profile. Notably, LSM1 and LSM8 were overexpressed in the LSM.index-high group, with LSM1 showing 2.5-fold increase (p < 0.001) and LSM8 depicting 1.8-fold increase (p < 0.01) than those in the LSM.index-low group.Furthermore, elevated LSM gene expression was associated with increased cell division and RNA splicing pathway activity. Conclusions The LSM.index demonstrates potential as a prognostic marker for survival in patients with MCL. Elevated expression of LSM genes, particularly LSM1 and LSM8, may be linked to poor survival outcomes through their involvement in cell division and RNA splicing pathways. These findings suggest that LSM genes may contribute to the aggressive behavior of MCL and represent potential targets for therapeutic interventions.

Background: SM-like (LSM) genes a family of RNA-binding proteins, are involved in mRNA regulation and can function as oncogenes by altering mRNA stability. However, their roles in B-cell progression and tumorigenesis remain poorly understood. Methods: We analyzed gene expression profiles and overall survival data of 123 patients with mantle cell lymphoma (MCL). The LSM index was developed to assess its potential as a prognostic marker of MCL survival. Results: Five of the eight LSM genes were identified as potential prognostic markers for survival in MCL, with particular emphasis on the LSM.index. The expression levels of these LSM genes demonstrated their potential utility as classifiers of MCL. The LSM.index-high group exhibited both poorer survival rates and lower RNA levels than did the overall transcript profile. Notably, LSM1 and LSM8 were overexpressed in the LSM.index-high group, with LSM1 showing 2.5-fold increase (p < 0.001) and LSM8 depicting 1.8-fold increase (p < 0.01) than those in the LSM.index-low group.Furthermore, elevated LSM gene expression was associated with increased cell division and RNA splicing pathway activity. Conclusions The LSM.index demonstrates potential as a prognostic marker for survival in patients with MCL. Elevated expression of LSM genes, particularly LSM1 and LSM8, may be linked to poor survival outcomes through their involvement in cell division and RNA splicing pathways. These findings suggest that LSM genes may contribute to the aggressive behavior of MCL and represent potential targets for therapeutic interventions.