Objective:To analyze the epidemiological characteristics and changing trends of elderly patients with drug-resistant pulmonary tuberculosis(DR-PTB)at Beijing Chest Hospital, Capital Medical University, in order to provide references for clinical prevention and treatment.Methods:Data were retrospectively collected from all DR-PTB cases hospitalized in the electronic medical record system of Beijing Chest Hospital from 2019 to 2023.The epidemiological characteristics including classification, gender, age, occupation and their changing trends among elderly DR-PTB patients were analyzed.Results:Among 1 981 hospitalized DR-PTB patients, 400(20.19%)were elderly[aged 60-92 years, mean(68.67±7.01)years], showing an overall increasing trend from 2019 to 2023.Mono-resistant PTB was the most common(198 cases, 49.50%), followed by multidrug-resistant PTB(170 cases, 42.50%), extensively drug-resistant PTB(21 cases, 5.25%), and polyresistant PTB(11 cases, 2.75%).Among the elderly DR-PTB patients, 287 cases(71.75%)were male, 200 cases(50.00%)were initial treatment cases, 377 cases(94.25%)were Han nationality, 165 cases(41.25%)were Beijing residents, 185 cases(46.25%)were employees of enterprises and institutions, 109 cases(27.25%)were farmers, 68 cases(17.00%)were unemployed individuals, 202 cases(50.50%)were pathogen-positive cases(smear and culture positive), and 228 cases(57.00%), 331 cases(82.75%), 196 cases(49.00%)were patients with comorbidities, complications, and extrapulmonary tuberculosis, respectively.There were no significant differences between elderly and non-elderly groups in ethnicity, treatment classification, or comorbidities(all P>0.05).However, significantly differences were found in gender ( χ2=12.718, P<0.001), occupation ( χ2=97.500, P<0.001), patient origin ( χ2=119.771, P<0.001), pathogen detection results ( χ2=10.101, P=0.001), and drug resistance patterns ( χ2=15.990, P=0.001).The proportion of elderly DR-PTB patients showed an overall increasing trend, with rises in females(25.64%-28.70%), unemployed individuals(7.69%-20.37%), other occupations(5.13%-19.40%), Han ethnicity(91.03%-99.07%), initial treatment(33.33%-57.41%), smear-negative but culture-positive cases(46.15%-53.70%), polyresistant PTB(1.28%-9.26%), and extensively drug-resistant PTB(1.28%-3.70%). Conclusions:Among elderly DR-PTB patients, the proportions of female, unemployed individuals and other occupations, initial treatment cases, smear-negative but culture-positive cases, polyresistant PTB, and extensively drug-resistant PTB are increasing annually.Future efforts should focus on targeted prevention and treatment for key populations to further reduce the rate of elderly DR-PTB.

With the completion of the "Human Genome Project" and the smooth progress of the "Herbal Genome Project", the research wave of RNAomics is gradually advancing, opening the research gateway for the modernization of traditional Chinese medicine (TCM) and initiating the post-genome era of medicinal plant RNA research. Therefore, this article proposes for the first time the concept of HerbRNomes, which involves constructing databases of medicinal plant, medicinal fungus, and medicinal animal RNA at different stages, from different origins, and in different organs. This research aims to explore the role of HerbRNA in self-genetic information transmission, functional regulation, as well as cross-species regulation functional mechanisms and key technologies. It also investigates application scenarios, providing a theoretical basis and research ideas for the resistance of TCM or medicinal plants to adversity and stress, molecular assistant breeding, and the development of small nucleic acid drugs. This article reviews recent research progress in elucidating the molecular mechanisms of the transmission and expression of genetic information, self-regulation and cross-species regulation of herbs at the RNA level, along with key technologies. It proposes a development strategy for small nucleic acid drugs based on HerbRNomes, providing theoretical support and guidance for the modernization of TCM based on HerbRNomes research.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective:To investigate the longitudinal stability of the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and the Activity of Daily Living Scale (ADL).Methods:The longitudinal cognitive assessment results of 68 dementia patients admitted to the Dementia and Leukoencephalopathy Outpatient Clinic, Department of Neurology, Peking Union Medical College Hospital, from January 2021 to January 2024, were retrospectively analyzed, including the total and sub-items scores of the MMSE, MoCA, and ADL. Two different rules were applied to analyze the abnormality rates: rule 1, where the current test result being better than the previous one was considered an abnormality; rule 2, where the current test result being better than the previous average score was considered an abnormality (If a patient had only 2 cognitive assessments, rule 2 was considered the same as rule 1). Two rules were used to analyze the abnormality rates of the scales. The statistical analyses were repeated after excluding patients with possible anxiety and depression status.Results:In assessing the total score stability, MMSE showed the lowest abnormality rates [27.2% (31/114) under rule 1 and 29.8% (34/114) under rule 2], while MoCA had the highest abnormality rates [41.3% (26/63) and 46.0% (29/63), respectively]. The ADL abnormality rates were 27.7% (23/83) and 33.7% (28/83), respectively. Among MoCA sub-items, category cue, multiple choice cue, second memory trial, orientation, and clock showed higher abnormality rates [31.7%(20/63), 30.2%(19/63), 23.8%(15/63), 22.2%(14/63), 22.2%(14/63), respectively]. After excluding population with possible anxiety and depression status, the relative abnormality rates of MMSE and ADL sub-items did not significantly change, while the abnormality rate of orientation in MoCA sub-items decreased relatively.Conclusion:The MMSE and ADL exhibit good stability in long-term monitoring of dementia patients, serving as essential tools for assessing and following up cognitive changes.

Aim To investigate the role and mecha-nism of allopurinol(ALLO)in restoring the abnormal metabolism of kynurenine(Kyn)mediated by trypto-phan-2,3-dioxygenase 2(TDO2)to ameliorate ulcera-tive colitis(UC)in mice,and to provide experimental basis for the treatment of UC by ALLO.Methods A dextran sodium sulfate(DSS)-induced mouse UC mod-el was established,and the mice were randomly divided into the control group,the model group,the ALLO low,medium and high-dose groups(10,20,and 40 mg·kg-1),and the positive-significant salazosulfapyridine(SASP)(200 mg·kg-1)group.The body mass and disease activity index(DAI)scores of mice were re-corded;HE staining was performed to observe the de-gree of pathological damage in colon tissue;Western blot was performed to detect TDO2 protein expression in colon tissue;flow cytometry was performed to detect changes in the proportion of macrophages in spleen and mesenteric lymph nodes;ELISA was employed to de-tect the levels of TNF-α,IL-1β and IL-6 pro-inflamma-tory cytokines in the supernatant of colon tissue homog-enate;high performance liquid chromatography(HPLC)was used to detect the levels of tryptophan(Trp)and Kyn in the supernatant of colon tissue ho-mogenate.Results Compared with the model group,ALLO administration significantly ameliorated colonic histopathological injury in UC mice,decreased the pro-portion of macrophages in spleen and mesenteric lymph nodes,down-regulated the levels of TNF-α,IL-1 β,and IL-6 pro-inflammatory factors in serum of homogenate of colonic tissues,and inhibited the activity(Kyn/Trp ratio)and expression of TDO2 in colonic tissues.Con-clusion ALLO improves disease manifestations in mice with ulcerative colitis,which may be related to its restoration of abnormal Kyn metabolism.

Aim To investigate the role and mecha-nism of allopurinol(ALLO)in restoring the abnormal metabolism of kynurenine(Kyn)mediated by trypto-phan-2,3-dioxygenase 2(TDO2)to ameliorate ulcera-tive colitis(UC)in mice,and to provide experimental basis for the treatment of UC by ALLO.Methods A dextran sodium sulfate(DSS)-induced mouse UC mod-el was established,and the mice were randomly divided into the control group,the model group,the ALLO low,medium and high-dose groups(10,20,and 40 mg·kg-1),and the positive-significant salazosulfapyridine(SASP)(200 mg·kg-1)group.The body mass and disease activity index(DAI)scores of mice were re-corded;HE staining was performed to observe the de-gree of pathological damage in colon tissue;Western blot was performed to detect TDO2 protein expression in colon tissue;flow cytometry was performed to detect changes in the proportion of macrophages in spleen and mesenteric lymph nodes;ELISA was employed to de-tect the levels of TNF-α,IL-1β and IL-6 pro-inflamma-tory cytokines in the supernatant of colon tissue homog-enate;high performance liquid chromatography(HPLC)was used to detect the levels of tryptophan(Trp)and Kyn in the supernatant of colon tissue ho-mogenate.Results Compared with the model group,ALLO administration significantly ameliorated colonic histopathological injury in UC mice,decreased the pro-portion of macrophages in spleen and mesenteric lymph nodes,down-regulated the levels of TNF-α,IL-1 β,and IL-6 pro-inflammatory factors in serum of homogenate of colonic tissues,and inhibited the activity(Kyn/Trp ratio)and expression of TDO2 in colonic tissues.Con-clusion ALLO improves disease manifestations in mice with ulcerative colitis,which may be related to its restoration of abnormal Kyn metabolism.

Objective:To analyze the epidemiological characteristics and changing trends of elderly patients with drug-resistant pulmonary tuberculosis(DR-PTB)at Beijing Chest Hospital, Capital Medical University, in order to provide references for clinical prevention and treatment.Methods:Data were retrospectively collected from all DR-PTB cases hospitalized in the electronic medical record system of Beijing Chest Hospital from 2019 to 2023.The epidemiological characteristics including classification, gender, age, occupation and their changing trends among elderly DR-PTB patients were analyzed.Results:Among 1 981 hospitalized DR-PTB patients, 400(20.19%)were elderly[aged 60-92 years, mean(68.67±7.01)years], showing an overall increasing trend from 2019 to 2023.Mono-resistant PTB was the most common(198 cases, 49.50%), followed by multidrug-resistant PTB(170 cases, 42.50%), extensively drug-resistant PTB(21 cases, 5.25%), and polyresistant PTB(11 cases, 2.75%).Among the elderly DR-PTB patients, 287 cases(71.75%)were male, 200 cases(50.00%)were initial treatment cases, 377 cases(94.25%)were Han nationality, 165 cases(41.25%)were Beijing residents, 185 cases(46.25%)were employees of enterprises and institutions, 109 cases(27.25%)were farmers, 68 cases(17.00%)were unemployed individuals, 202 cases(50.50%)were pathogen-positive cases(smear and culture positive), and 228 cases(57.00%), 331 cases(82.75%), 196 cases(49.00%)were patients with comorbidities, complications, and extrapulmonary tuberculosis, respectively.There were no significant differences between elderly and non-elderly groups in ethnicity, treatment classification, or comorbidities(all P>0.05).However, significantly differences were found in gender ( χ2=12.718, P<0.001), occupation ( χ2=97.500, P<0.001), patient origin ( χ2=119.771, P<0.001), pathogen detection results ( χ2=10.101, P=0.001), and drug resistance patterns ( χ2=15.990, P=0.001).The proportion of elderly DR-PTB patients showed an overall increasing trend, with rises in females(25.64%-28.70%), unemployed individuals(7.69%-20.37%), other occupations(5.13%-19.40%), Han ethnicity(91.03%-99.07%), initial treatment(33.33%-57.41%), smear-negative but culture-positive cases(46.15%-53.70%), polyresistant PTB(1.28%-9.26%), and extensively drug-resistant PTB(1.28%-3.70%). Conclusions:Among elderly DR-PTB patients, the proportions of female, unemployed individuals and other occupations, initial treatment cases, smear-negative but culture-positive cases, polyresistant PTB, and extensively drug-resistant PTB are increasing annually.Future efforts should focus on targeted prevention and treatment for key populations to further reduce the rate of elderly DR-PTB.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective:To investigate the longitudinal stability of the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and the Activity of Daily Living Scale (ADL).Methods:The longitudinal cognitive assessment results of 68 dementia patients admitted to the Dementia and Leukoencephalopathy Outpatient Clinic, Department of Neurology, Peking Union Medical College Hospital, from January 2021 to January 2024, were retrospectively analyzed, including the total and sub-items scores of the MMSE, MoCA, and ADL. Two different rules were applied to analyze the abnormality rates: rule 1, where the current test result being better than the previous one was considered an abnormality; rule 2, where the current test result being better than the previous average score was considered an abnormality (If a patient had only 2 cognitive assessments, rule 2 was considered the same as rule 1). Two rules were used to analyze the abnormality rates of the scales. The statistical analyses were repeated after excluding patients with possible anxiety and depression status.Results:In assessing the total score stability, MMSE showed the lowest abnormality rates [27.2% (31/114) under rule 1 and 29.8% (34/114) under rule 2], while MoCA had the highest abnormality rates [41.3% (26/63) and 46.0% (29/63), respectively]. The ADL abnormality rates were 27.7% (23/83) and 33.7% (28/83), respectively. Among MoCA sub-items, category cue, multiple choice cue, second memory trial, orientation, and clock showed higher abnormality rates [31.7%(20/63), 30.2%(19/63), 23.8%(15/63), 22.2%(14/63), 22.2%(14/63), respectively]. After excluding population with possible anxiety and depression status, the relative abnormality rates of MMSE and ADL sub-items did not significantly change, while the abnormality rate of orientation in MoCA sub-items decreased relatively.Conclusion:The MMSE and ADL exhibit good stability in long-term monitoring of dementia patients, serving as essential tools for assessing and following up cognitive changes.