In the context of burgeoning economic trade, there has been a remarkable increase in the number of ships travelling between domestic and international ports. Inbound and outbound cargo ships, cruise liners, ferries, and other types of vessels have emerged as critical vehicles for the dispersal of vector organisms and the spread of infectious disease agents. Public health concerns associated with these vessels represent a significant threat to human welfare. In this paper, we comprehensively review the hazards posed by vector organisms on ships, the latest advances in prevention and control strategies, and proposes appropriate countermeasures. The aim is to provide effective guidance for the prevention and control of public health security issues caused by ship-borne vector organisms.

OBJECTIVE: To evaluate the dynamic changes of glucocorticoid (GC) dose and the feasibility of GC discontinuation in rheumatoid arthritis (RA) patients under the background of Chinese medicine (CM). METHODS: This multicenter retrospective cohort study included 1,196 RA patients enrolled in the China Rheumatoid Arthritis Registry of Patients with Chinese Medicine (CERTAIN) from September 1, 2019 to December 4, 2023, who initiated GC therapy. Participants were divided into the Western medicine (WM) and integrative medicine (IM, combination of CM and WM) groups based on medication regimen. Follow-up was performed at least every 3 months to assess dynamic changes in GC dose. Changes in GC dose were analyzed by generalized estimator equation, the probability of GC discontinuation was assessed using Kaplan-Meier curve, and predictors of GC discontinuation were analyzed by Cox regression. Patients with <12 months of follow-up were excluded for the sensitivity analysis. RESULTS: Among 1,196 patients (85.4% female; median age 56.4 years), 880 (73.6%) received IM. Over a median 12-month follow-up, 34.3% (410 cases) discontinued GC, with significantly higher rates in the IM group (40.8% vs. 16.1% in WM; P<0.05). GC dose declined progressively, with IM patients demonstrating faster reductions (median 3.75 mg vs. 5.00 mg in WM at 12 months; P<0.05). Multivariate Cox analysis identified age <60 years [P<0.001, hazard ratios (HR)=2.142, 95% confidence interval (CI): 1.523-3.012], IM therapy (P=0.001, HR=2.175, 95% CI: 1.369-3.456), baseline GC dose ⩽7.5 mg (P=0.003, HR=1.637, 95% CI: 1.177-2.275), and absence of non-steroidal anti-inflammatory drugs use (P=0.001, HR=2.546, 95% CI: 1.432-4.527) as significant predictors of GC discontinuation. Sensitivity analysis (545 cases) confirmed these findings. CONCLUSIONS RA patients receiving CM face difficulties in following guideline-recommended GC discontinuation protocols. IM can promote GC discontinuation and is a promising strategy to reduce GC dependency in RA management. (Trial registration: ClinicalTrials.gov, No. NCT05219214).
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Arthritis, Rheumatoid/drug therapy* ; Glucocorticoids/therapeutic use* ; Medicine, Chinese Traditional ; Retrospective Studies

Sacubitril valsartan sodium tablets are a novel supramolecular co-crystal drug that combines the dual effects of angiotensin receptor blockade and neprilysin inhibitor.It has shown broad application prospects in heart failure,hypertension,maintaining water sodium balance in the body,and protecting target organs,etc.It is a major breakthrough in cardiovascular treatment drugs in recent years.It is clinically used in China for chronic heart failure in adult patients with reduced ejection fraction and primary hypertension.In recent years,pharmaceutical co-crystals has become a hot topic in the research of crystalline drugs,and sacubitril valsartan sodium tablets,as a marketed co-crystal drug,have attracted industry attention.This article summarizes the characteristics of sacubitril valsartan sodium co-crystal drug,the application and approval cases through relevant literature investigation,and discussses pharmaceutical research of the formulation,in order to provide some references for the research and development of generic drugs.

Sacubitril valsartan sodium tablets are a novel supramolecular co-crystal drug that combines the dual effects of angiotensin receptor blockade and neprilysin inhibitor.It has shown broad application prospects in heart failure,hypertension,maintaining water sodium balance in the body,and protecting target organs,etc.It is a major breakthrough in cardiovascular treatment drugs in recent years.It is clinically used in China for chronic heart failure in adult patients with reduced ejection fraction and primary hypertension.In recent years,pharmaceutical co-crystals has become a hot topic in the research of crystalline drugs,and sacubitril valsartan sodium tablets,as a marketed co-crystal drug,have attracted industry attention.This article summarizes the characteristics of sacubitril valsartan sodium co-crystal drug,the application and approval cases through relevant literature investigation,and discussses pharmaceutical research of the formulation,in order to provide some references for the research and development of generic drugs.

The advantages of 3D printed applicators in brachytherapy of gynecological malignant tumors were introduced,and the current application progress of 3D printing applicator in brachytherapy of cervical cancer,endometrial cancer,vaginal cancer and vaginal recurrent tumors was reviewed.The shortcomings of 3D printed applicators in brachytherapy of gynecological malignant tumors were analyzed,and the direction of its future development was pointed out.[Chinese Medical Equipment Journal,2025,46(2):102-107]

The advantages of 3D printed applicators in brachytherapy of gynecological malignant tumors were introduced,and the current application progress of 3D printing applicator in brachytherapy of cervical cancer,endometrial cancer,vaginal cancer and vaginal recurrent tumors was reviewed.The shortcomings of 3D printed applicators in brachytherapy of gynecological malignant tumors were analyzed,and the direction of its future development was pointed out.[Chinese Medical Equipment Journal,2025,46(2):102-107]

Objective To compare the early predictive value of different scoring systems for the severity,organ failure and complications of acute pancreatitis(AP)in elderly patients under the newly revised Atlanta criteria.Methods Patients with acute pancreatitis treated was collected.After admission,complete the computed tomography severity index(CTSI),the bedside index of severity in acute pancreatitis(BISAP),the pancreatis 3(PANC-3)and the harmlessness acute pancreatitis score(HAPS).The area under receiver operating characteristic(ROC)curve(AUC),sensitivity,specificity and Yordan's index of four scores for predicting SAP,local pancreatic complications and multiple organ failure were compared.Results The areas under the ROC curve predicted by the CTSI,BISAP,PANC-3 and HAPS scoring systems for SAP were 0.76,0.91,0.48 and 0.55;sensitivities of 75.87％,89.61％,61.18％and 78.38％;specificity of 80.29％,74.72％,67.48％and 69.69％;Yordan's index of 0.56,0.64,0.29 and 0.48,respectively.The AUC of CTSI,BISAP,PANC-3 and HAPS scoring systems for predicting local pancreatic complications were 0.94,0.82,0.59 and 0.64;sensitivity of 74.59％,68.23％,71.11％and 69.28％;specificity of 93.88％,83.01％,78.59％and 76.46％;Yordan's index were 0.68,0.51,0.50 and 0.46,respectively.The AUC of CTSI,BISAP,PANC-3 and HAPS scoring systems for predicting multiple organ failure were 0.60,0.84,0.64 and 0.80,sensitivities were 54.18％,74.82％,58.59％and 65.67％,specificity were 76.11％,77.20％,72.68％and 89.36％,Jordan's indices were 0.30,0.52,0.31 and 0.55,respectively.Conclusion BISAP score is higher than CTSI,HAPS and PANC-3 scoring system in predicting the accuracy of sap and the risk of multiple organ failure.

Aim To investigate the protective effect of total flavonoids of Dracocephalum moldavica(TFDM)on atherosclerosis in rats and the inflammation of mouse macrophage RAW264.7 aggravated by trimeth-ylamine N-oxide(TMAO)and its possible mecha-nism.Methods The AS model of SD rats was estab-lished by high-fat diet feeding combined with intraper-itoneal injection of vitamin D3.The rats were divided into control group,model group,simvastatin group(15 mg·kg-1)and TFDM group(60,30,15 mg·kg-1).Biochemical method was used to detect the levels of se-rum total cholesterol(TC),triglyceride(TG)and low density lipoprotein cholesterol(LDL-C).HE staining was used to detect the pathological changes of aortic tissue.ELISA kit was used to detect the expression of TMAO,IL-1β,IL-6 in serum and TNF-α in liver tis-sue.Western blot was used to detect the expression of JAK,STAT and TNF-α protein in aorta.In addition,RAW264.7 macrophages were cultured in vitro,and LPS+TMAO was used to establish a macrophage in-flammation model,which was intervened by TFDM(100,50,25 mg·L-1).CCK-8 was used to determine cell viability and proliferation,and RT-qPCR was used to detect the expression of TNF-α,IL-6,JAK and STAT mRNA in cells.Results TFDM could significantly down-regulate the levels of serum TC,TG,LDL-C,ser-um TMAO,IL-1β,IL-6 and liver TNF-α,reduce aortic plaque deposition,and down-regulate the protein ex-pression of TNF-α,JAK and STAT in aorta.In addi-tion,TFDM intervention can significantly down-regulate the expression of TNF-α,IL-6,JAK,STAT mRNA and the expression of JAK,STAT protein.Conclusion TFDM can reduce the content of TMAO in serum,in-hibit JAK/STAT inflammatory signaling pathway and slow down the occurrence of inflammation,playing an anti-AS role.

Objective To investigate the dosimetric differences of different types of multileaf collima-tors(MLCs)on the planning target volume(PTV)and organs at risk(OARs)in volumetric modulated arc therapy(VMAT)for cervical cancer.Methods Twenty postoperative patients with cervical cancer receiving radiotherapy in this hospital from May 2023 to January 2024 were selected as the study subjects.For each pa-tient,two kinds of VMAT plans(MLCi2-MLC and AgilityTM-MLC)after cervical cancer operation were de-signed.The dosimetric parameters of the planning target volume(PTV),exposure dose by organs at risk(OAR),y passing rate and monitor units(MU)were compared between the two plans.Results Compared with MLci2-MLC,prescription dose(V45),conformity index(CI)and homogeneity index(HI)in AgilityTM-MLC were better,and the differences were statistically significant(P＜0.05),Compared with MLCi2-MLC,bladder V30,V40,average dose(Dmean),rectal V10,V20,V30,left femoral head V10,Dmean and small intestine V10,V30,Dmean and Dmax were lower,bladder V45,rectal V45,right femoral head V20 were higher,and the differences were statistically significant(P＜0.05).Compared with MLCi2-MLC,the y passing rate in AgilityTM-MLC was lower[(98.31±0.64)％vs.(99.73±0.37)％],and the difference was statistically significant(P＜0.05);while MU had no statistical difference between AgilityTM-MLC and MLCi2-MLC(996.74±65.46 vs.996.80±49.77,P＞0.05).Conclusion AgilityTM-MLC demonstrates better PTV conformity and homogenei-ty,as well as good protection on OARs in both high and low dose regions.

ObjectiveTo investigate the clinical appropriateness and application value of the peroxidase （POD） method for the detection of unbound bilirubin （UB） in neonatal serum. MethodsHydrogen peroxide （0.33 mol/L） and three different final concentrations （0.019， 0.038， 0.075 μg/mL） of horseradish peroxidase （HRP） were added to standard bilirubin solution （1， 2， 3 μmol/L） to obtain a standardized HRP primary rate constant Kp. Then 25 μL of neonatal serum was diluted by 41.6 fold， and measured with 2.4 and 4.8 μg/mL HRP at 37 ℃ under the dark， to determine the UB concentration. The accuracy， precision， and stability of the methodology were validated. The clinical characteristics of 33 jaundiced neonates were collected， including total serum bilirubin （TSB）， indirect bilirubin （IDB）， albumin （ALB）， bilirubin to albumin molar ratio （BAMR）， etc. The experimental data were analyzed by Graphpad Prism 8.0. ResultsA standardized Kp of （7.20±1.08） mL·μg^-1·min^-1 was determined at pH 7.4±0.2， 37 ℃ in the dark. The HRP activity and UB concentrations remained stable at -20 ℃ for 3 weeks and a week， respectively. The mean intra-day and inter-day coefficients of variation of the serum samples with different UB concentrations were less than 10%. In this study， the UB concentrations in 33 jaundiced neonates （gestational age ≥35 weeks） were measured by the POD method in the range of （0.32～1.20） μg/dL， which was positively correlated with TSB， IDB and BAMR. Of the five infants whose UB concentrations measured more than 1 μg/dL， three received intensive phototherapy （60%）. ConclusionsThe POD method combined with a standard equipment spectrophotometer to detect serum UB concentrations in neonates is easy to operate， rapid to detect， and low cost. This method has good accuracy and precision， which is convenient for clinical implementation. Moreover， the measurement of serum UB may assist us in better management of neonatal jaundice in clinical practice.