OBJECTIVE To investigate the prevalence and influencing factors of potentially inappropriate medication （PIM） among the elderly in nursing homes in Urumqi based on three PIM screening tools， and to compare the applicability of different tools. METHODS A cross-sectional study design was adopted. Elderly individuals from six nursing homes in Urumqi were selected as the research subjects from May 2021 to September 2023. Demographic characteristics， disease burden and medication records of the elderly were collected. PIM screening was performed using the Chinese PIM criteria （2024 edition）， the American Geriatrics Society （AGS） Beers criteria （2023 edition）， and the Screening Tool of Older Person’S Prescriptions（STOPP）/Screening Tool to Alert to Right Treatment（START） （2023 edition）. Fleiss’s Kappa test was used to assess the consistency among the three screening tools， and multivariate Logistic regression was used to analyze the influencing factors of PIM. RESULTS The prevalence of PIM screened by the Chinese PIM criteria was 47.4% （323/682）， by the AGS Beers criteria was 43.4% （296/682）， and by the STOPP criteria was 50.9% （347/682）. The consistency among the three screening tools was low （Fleiss’s Kappa＝0.12， P ＜0.001）. Multivariate Logistic regression analysis showed that all three screening tools indicated that polypharmacy， aspirin use and psychotropic drug use were independent risk factors for PIM among elderly in nursing houses （all OR＞1， P ＜0.05）. CONCLUSIONS The prevalence of PIM among the elderly in nursing homes in Urumqi is relatively high. Polypharmacy， aspirin use and psychotropic drug use are common independent risk factors for PIM. There are differences in screening results among the three tools with low consistency. The Chinese PIM criteria can serve as a first-line tool for PIM screening in nursing homes.

ObjectiveTo develop an early - warning approach for influenza in Anhui province using the moving epidemic method （MEM）， offering a scientific basis for influenza prevention and control in the province. MethodsBased on the surveillance data reported weekly by influenza sentinel hospitals and network laboratories in the “China Influenza Surveillance Information System”， the weekly influenza virus detection positive rate （positive rate， PR） across the province was analyzed. The MEM was used to estimate the epidemic threshold and classification intensity threshold of influenza in Anhui province before and after the COVID-19 pandemic， respectively. The early warning effect of the MEM was evaluated using cross-validation. ResultsEpidemic and graded intensity thresholds of influenza were derived using PR and MEM. Prior to the COVID-19 pandemic， the starting， medium-intensity， high-intensity， extremely-high-intensity， and ending thresholds of influenza epidemics were 17.08%， 38.47%， 53.20%， 59.71%， and 12.34% respectively. At this point， the model exhibited sensitivity of 0.98， specificity of 0.86， Matthews correlation coefficient of 0.84， and Youden index of 0.84. After the COVID-19 pandemic， these thresholds were 25.61%， 43.81%， 63.29%， 74.46%， and 17.82% respectively. At this point， the model demonstrates sensitivity of 0.86， specificity of 0.92， Matthews correlation coefficient of 0.78， and Youden index of 0.77. ConclusionMEM shows good applicability in estimating the epidemic and graded intensity thresholds of influenza during the winter and spring in Anhui province. Both the influenza epidemic threshold and graded intensity thresholds after the COVID-19 pandemic are higher than those before the pandemic.

ObjectiveTo explore the impact of meteorological factors on influenza-like illness （ILI） cases in Anhui Province. MethodsILI surveillance data of Anhui Province from 2016 to 2023 were collected from the “China Influenza Surveillance Information System”， and meteorological data were obtained from Anhui Meteorological Center. R 4.2.1 was used to conduct Spearman rank correlation analysis between ILI cases and meteorological factors. A generalized additive model （GAM） was established to analyze the impact of meteorological factors on ILI cases. ResultsCorrelation analysis and GAM analysis showed that the average temperature and average relative humidity with a one-week lag had significant non-linear effects on ILI （P<0.05）. When the weekly average temperature was below 14 ℃， the number of ILI cases gradually increased as the temperature decreased. When the weekly average relative humidity was below 65%， the number of ILI cases gradually increased as the weekly average relative humidity decreased. The changes in ILI among the age groups 5-14， 15-24 and 25-59 years were influenced by meteorological factors， exhibiting a nonlinear relationship with weekly average temperature or weekly average relative humidity. ConclusionWeekly average temperature and weekly average relative humidity are the main factors affecting ILI in Anhui Province， and there is a lag effect， which can provide a reference for influenza surveillance and early warning.

Objective:To evaluate clinical efficacy of Xuanbai Chengqi Decoction in the treatment of severe pneumonia with gastrointestinal dysfunction of syndrome of lung heat and fu-organ excess; To discuss its effects on short chain fatty acid (SCFA)/G protein coupled receptor 43 (GPR43) axis.Methods:It was a randomized controlled trial. From January 2020 to January 2022, 60 hospitalized patients with severe pneumonia complicated with gastrointestinal dysfunction (syndrome of lung heat and fu-organ excess) in the Intensive Care Department and Emergency Intensive Care Unit of Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine were selected as the observation subjects. They were divided into experimental group and control group according to random number table method, with 30 cases in each group. Patients in the control group were treated with conventional Western medicine, while patients in the experimental group received Xuanbai Chengqi Decoction combined with conventional Western medicine. Both groups were treated continuously for 7 days and followed up for 28 days. TCM syndrome scores were evaluated before and after treatment. Clinical Pulmonary Infection Score (CPIS) was used to assess pulmonary infection, Gastrointestinal Dysfunction Score (GIDS) was used to assess the degree of gastrointestinal dysfunction, and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score was used to assess the prognosis. ELISA was used to detect levels of procalcitonin (PCT), IL-6, CRP, D-lactate (D-LA), short chain fatty acids (SCFA), and G protein coupled receptor 43 (GPR43). The fully automated blood analyzer (flow cytometry) was used to detect white blood cells (WBC) and the proportion of neutrophils (N%). Indirect bladder pressure measurement method was used to measure the intra-abdominal pressure of patients. During treatment, the adverse reactions or events were recorded. Patients were followed up for 28 days and the 28-day mortality rate was recorded.Results:The total effective rate was 73.33% (22/30) in the experimental group and 40.00% (12/30) in the control group, with statistical significance ( χ2=6.79, P<0.05). After treatment, TCM syndrome scores, CPIS, GIDS, and APACHEⅡ score in the experimental group were lower than those in the control group ( t values were 2.84，3.34，2.75，3.05，respectively， P<0.01), serum PCT [(0.35 ± 0.11) μg/L vs. (0.64 ± 0.10) μg/L, t=2.45], IL-6 [(19.33 ± 3.54) ng/L vs. (60.13 ± 15.01) ng/L, t=2.98], N% [(78.84 ± 2.09)% vs. (83.30±2.31)%, t=3.43], and CRP [(28.43 ± 6.38) mg/L vs. (54.48 ± 9.03) mg/L, t=4.02], intra-abdominal pressure [(9.11 ± 2.55) mmHg vs.(11.70 ± 3.02) mmHg, t=7.78] and D-LA [(0.11±0.05) mmol/L vs. (0.18±0.12) mmol/L, t=6.45] in the experimental group were lower than those in the control group ( P<0.05 or P<0.01). After treatment, serum SCFA [(48.18 ± 36.31) μmol/L vs. (35.10 ± 19.32)μmol/L, t=1.95] and GPR43 [(1 254.61 ± 437.40) ng/L vs. (990.15 ± 403.03) ng/L, t=2.13] in the experimental group were higher than those in the control group ( P<0.05). The 28-day mortality rates of the experimental group and the control group were 20.00% (6/30) and 46.67% (14/30) respectively, with statistical significance ( χ2=4.80, P<0.05). During the trial, there were no serious adverse reactions or adverse events in either group. Conclusion:Xuanbai Chengqi Decoction can effectively treat severe pneumonia complicated with gastrointestinal dysfunction. The mechanism may involve the up-regulation of SCFA/GPR43 axis.

Immune checkpoint inhibitors(ICIs)represent the most widely used immunotherapeutic approach for antitumor treatment,yet the understanding of their associated hepatotoxicity remains incomplete.This article delves into and analyzes the similarities and differences among the management guidelines on ICI-related hepatotoxicity issued by the Chinese Society of Clinical Oncology(CSCO),the National Comprehensive Cancer Network(NCCN)of the United States,and the American Society of Clinical Oncology(ASCO),aiming to provide a more comprehensive management strategy for clinical practice.By reviewing and analyzing the latest guidelines,this study compares the differences and similarities in the diagnosis,assessment,grading criteria,and treatment strategies for ICI-related liver toxicity among these guidelines.The definitions and diagnostic criteria for ICI-related liver toxicity are generally consistent across different guidelines,primarily relying on the elevated levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),bilirubin,and alkaline phosphatase(ALP)for grading.Notably,the ASCO guidelines place a stronger emphasis on the assessment of symptoms of hepatic dysfunction.In terms of treatment strategies,all guidelines recommend using corticosteroids or immunosuppressants based on the toxicity grade.However,there are discrepancies in management strategies among the guidelines.Clinicians should tailor management strategies by considering the specific conditions of patients and integrating the recommendations from various guidelines.Additionally,given the current inadequate understanding of ICI-induced hepatotoxicity primarily manifested as cirrhosis in the existing guidelines,it is imperative to continuously update and refine these management guidelines as research progresses and clinical experience accumulates.

Wound repair and infection have long posed significant challenges in clinical medicine.Am-phibians,adapting to complex environments through long-term natural selection,have evolved skin sys-tems with remarkable abilities to resist external damage and promote rapid wound healing,making them an important source for discovering candidate molecules for wound healing.In this study,a novel peptide composed of 22 amino acids,with the sequence"VGKAGLETAACKATNSCFNIDW"and a molecular weight of 2299.6 D,was screened from the cDNA library of Odorrana tormota and named PN-VW22.The peptide was synthesized by solid-phase synthesis,and its effects on cell proliferation were evaluated using the CCK-8 assay and scratch wound healing assay in human keratinocytes(HaCaT)and mouse em-bryonic fibroblasts(NIH3T3).Antibacterial activity was assessed by determining the minimum inhibitory concentration(MIC).Results showed that PN-VW22 at various concentrations had no significant effect on the cell viability in NIH3T3 cells(P＞0.05),but significantly enhanced HaCaT cell viability at 0.5μmol/L(P＜0.001).Meanwhile,PN-VW22 induced cell proliferation and promoted wound healing in HaCaT cells,with a healing rate of 64.44％after 24 h incubation at 0.5 μmol/L.Furthermore,PN-VW22 exhibited antibacterial activity against Staphylococcus aureus with an MIC value of 13.92 μmol/L.In sum,this study identified PN-VW22 as a novel bifunctional peptide with both wound repair and anti-infective properties,providing a new toxin peptide template for the development of wound healing drugs.

The parallel chart records the diagnosis and treatment experience of a young patient with AIDS-complicated Burkitt lymphoma. This case not only reflects the immense psychological burden shouldered by the AIDS patient and his family，but also highlights the limitations of medical interventions in the context of complex real-world challenges. The study aims to reveal the psychosocial dilemmas faced by critically ill patients and their families，thereby prompting clinicians to deeply reflect on the significance of doctor-patient communication and emotional empathy in medical practice.

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.

Based on whole-genome identification of the TPS gene family in Perilla frutescens and screening, cloning, bioinformatics, and expression analysis of the synthetic enzyme for the insect-resistant component germacrene D, this study lays the foundation for understanding the biological function of the TPS gene family and the insect resistance mechanism in P. frutescens. This study used bioinformatics tools to identify the TPS gene family of P. frutescens based on its whole genome and predicted the physicochemical properties, systematic classification, and promoter cis-elements of the proteins. The relative content of germacrene D was detected in both normal and insect-infested leaves of P. frutescens, and the germacrene D synthase was screened and isolated. Gene cloning, bioinformatics analysis, and expression profiling were then performed. The results showed that a total of 99 TPS genes were identified in the genome, which were classified into the TPS-a, TPS-b, TPS-c, TPS-e/f, and TPS-g subfamilies. Conserved motif analysis showed that the TPS in P. frutescens has conserved structural characteristics within the same subfamily. Promoter cis-element analysis predicted the presence of light-responsive elements, multiple hormone-responsive elements, and stress-responsive elements in the TPS family of P. frutescens. Transcriptome data revealed that most of the TPS genes in P. frutescens were highly expressed in the leaves. GC-MS analysis showed that the relative content of germacrene D significantly increased in insect-damaged leaves, suggesting that it may act as an insect-resistant component. The germacrene D synthase gene was screened through homologous protein binding gene expression and was found to belong to the TPS-a subfamily, encoding a 64.89 kDa protein. This protein was hydrophilic, lacked a transmembrane structure and signal peptide, and was predominantly expressed in leaves, with significantly higher expression in insect-damaged leaves compared to normal leaves. In vitro expression results showed that germacrene D synthase tended to form inclusion bodies. Molecular docking showed that farnesyl pyrophosphate(FPP) fell into the active pocket of the protein and interacted strongly with six active sites. This study provides a foundation for further research on the biological functions of the TPS gene family in P. frutescens and the molecular mechanisms underlying its insect resistance.
Perilla frutescens/chemistry* ; Plant Proteins/chemistry* ; Multigene Family ; Sesquiterpenes, Germacrane/metabolism* ; Alkyl and Aryl Transferases/chemistry* ; Phylogeny ; Gene Expression Regulation, Plant