Over the past two decades, genome-wide association study(GWAS) has identified numerous genetic variants and loci associated with heritable diseases. With the gradual maturation and saturation of GWAS methodologies, transcriptome-wide association study(TWAS) offers a novel perspective by linkinggenetic phenotypes to gene expression levels. By integrating TWAS with other multi-omics analyses, researchers can gain a deeper understanding of heritable diseases. This article provides an overview of recent groundbreaking and representative TWAS methods and tools, analyzes their strengths and limitations, and discusses future trends in TWAS development.

Primary aldosteronism(PA)is an important cause of secondary hypertension,and adrenal vein sampling(AVS),as the gold standard for identifying the dominant side in PA,plays a critical role in guiding subsequent therapeutic strategies.AVS is an invasive procedure that is not yet widely available in China.To promote the popularization and standardization of AVS,the Chinese Society of Hypertension(Chinese Research Hospital Association)and the Group of Interventional Diagnosis and Treatment of Hypertension(China International Exchange and Promotive Association for Medical and Health Care)have summarized domestic and foreign evidence and the operational experience of many experts.This consensus has summarized and updated the significance,indications,pre-procedural preparation,procedural steps and key points,prevention and management of complications,and result interpretation of AVS.This consensus provides comprehensive and clinically relevant guidance for the clinical practice and development of AVS,effectively promoting its popularization and standardization.

Objective:To construct an esophageal language rehabilitation program for patients after total laryngectomy (TL) based on the behavioral change wheel theory and exploring its application effects.Methods:The multidisciplinary team constructed the first draft of the esophageal language rehabilitation program for patients after TL based on the behavioral change wheel theory, combined with a literature review, and used an expert meeting to revise the rehabilitation program to form the final draft of the program. Adopting experimental research, 35 patients after TL who attended the nursing outpatient clinic of Beijing Tongren Hospital, Capital Medical University from February 2023 to May 2023 were selected as the control group by convenience sampling method, and 35 patients after TL who attended the nursing outpatient clinic from June 2023 to September 2023 were selected as the experimental group. The experimental group applied the TL postoperative patients′ esophageal language rehabilitation program based on the behavioral change wheel theory on the basis of conventional nursing measures, and the control group received conventional nursing care. The status of language rehabilitation training, quality of life, social behavioral status, and anxiety and depression status before intervention, 1, 3, 6 months after intervention were compared between the two groups.Results:Both groups of patients completed the study. There were 29 males and 6 females in the control group, with an age of (54.63 ± 10.44) years old. There were 34 males and 1 female in the experimental group, with an age of (55.17 ± 10.67) years old. There was no statistically significant difference in the language rehabilitation training status, quality of life, social behavior status, and anxiety and depression status between the two groups before intervention (all P>0.05). The total scores of speech rehabilitation training in the experimental group at 1, 3, and 6 months after intervention were (32.80 ± 2.49), (39.80 ± 2.75), (51.91 ± 4.20) points, respectively, which were higher than those in the control group (23.40 ± 3.42), (24.40 ± 3.42), (25.80 ± 3.42) points, and the differences were statistically significant ( t=14.53, 23.44, 32.70, all P<0.05). The total scores of quality of life in the experimental group at 1, 3, and 6 months after intervention were (98.91 ± 8.49), (134.66 ± 11.31), (157.97 ± 13.97) points, respectively, which were higher than those in the control group (67.06 ± 7.64), (72.16 ± 7.64), (99.46 ± 8.09) points, and the differences were statistically significant ( t=17.53, 30.16, 21.45, all P<0.05). The scores for social occasion diet and language comprehension in the experimental group at 1, 3, and 6 months after intervention were (40.41 ± 13.94), (40.43 ± 24.08), (40.60 ± 18.56), and (43.71 ± 12.26), (47.40 ± 17.09), (52.50 ± 13.82), respectively, which were higher than those in the control group (30.59 ± 15.98), (30.57 ± 18.28), (27.21 ± 15.27), and (27.29 ± 15.13), (23.60 ± 14.78), (19.50 ± 12.78), and the differences were statistically significant ( t values were -6.88-2.16, all P<0.05). The total scores of anxiety and depression in the experimental group at 1, 3, and 6 months after intervention were (23.74 ± 2.73), (14.89 ± 3.89), (12.11 ± 3.14) points, respectively, which were lower than those in the control group (32.63 ± 1.85), (30.63 ± 1.85), (24.80 ± 2.75) points, and the differences were statistically significant (t=-19.55, -27.10, -17.97, all P<0.05). Conclusions:The esophageal language rehabilitation program for patients after TL based on the behavioral change wheel theory in this study is scientific, feasible, and can improve the patients′ esophageal language expression, quality of life, anxiety and depression, and social behavioral status, which can provide a reference for clinical care.

Objective To evaluate the efficacy and safety of enteric-coated metformin hydrochloride capsules(Junlida?)in patients with T2DM and poor glycemic control under lifestyle interventions.Methods In this study,419 patients with T2DM were recruited from 15 research centers from July 2020 to March 2022,and randomly divided into observation(Obs)group(n=209)and control group(Con,n=210)using a multicenter,randomized,double-blind,non-inferiority trial design.Patients in the Obs group were treated with enteric-coated Metformin hydrochloride capsules(Junlida?),and patients in the Con group were treated with Metformin hydrochloride tablets(Glucophage?).The optimal effective dose of 2 g/d was achieved within 4 weeks,and the reasonable dose was maintained until the end of treatment.The treatment period was 24 weeks.HbA1c and its compliance rate,FPG,and body weight were compared between the two groups in full analysis set(FAS)and protocol set(PPS).Safety and adverse events(AE)were evaluated in safety set(SS).Results A total of 414 participants were randomized(207 cases in Obs group and 207 cases in Con group).414 cases in FAS population(207 cases in Obs group and 207 cases in Con group),and 328 cases in PPS population(164 cases in Obs group and 164 cases in Con group),and 414 cases in SS population(207 cases in Obs group and 207 cases in Con group).After treatment,HbA1c,FPG and body weight were lower in both groups(P<0.05)in FAS and PPS.HbA1c compliance rate was not significantly different between the two groups in FAS and PPS(P>0.05).The results of non-inferiority test showed that the lower limit was>-0.4%in both FAS(-0.154,95%CI-0.384～0.069)and PPS(-0.139,95%CI-0.390～0.112),and the Obs group reached non-inferiority end point.The achievement rate,compliance rate,safety index and incidence of AE were not significantly different between the two groups(P>0.05).Conclusions Junlida? demonstrated non-inferiority to Glucophage? in glycemic control and can be safely and effectively used in patients with diabetes.

This study was aimed at analyzing the biotypes and genetic diversity characteristics of five non-major Brucella species,to provide a scientific basis for understanding the species diversity of Brucella and strengthening pathogen monitoring and control.According to the biotypes(species,hosts,isolation locations,and time)and MLVA-16 genotypes(MLVA-16 lo-cus data,MLVA-11 genotypes)of five non-major pathogenic Brucella in the international MLVA database,we used Bionu-merics 8.0 software and PHYLOVIZ2.0 online software to analyze the geographical origin and genetic diversity characteristics of strains.A total of 227 strains were studied,including 121 Brucella ceti,47 B.pinnipedialis,37 Brucella ovis,11 B.mi-croti,and Brucella neotomae.The greatest host diversity was observed for B.ceti,followed by B.pinnipedialis and B.mi-croti.B.ceti was distributed in European and South American countries;B.pinnipedialiswas distributed in Europe;and B.microti.was distributed in the Czech Republic,Austria,and Hungary in Central Europe.B.ovis was widely distributed in Af-rica,Argentina,Australia,Brazil,Greece,the United States,Spain,and France.The MLVA-11 genotypes of different types of Brucella showed high polymorphism and large differences,thus suggesting that the strains have different geographical ori-gins.MST analysis indicated that the studied strains were divided into four branches(BCⅠ-Ⅳ),among which B.ceti was di-vided into two different branches(BC-Ⅰ and BC-Ⅱ),the strains of other types formed different branches(or sub-branches),and the strains of different types showed clear regional and dominant host characteristics.Genetic correlation analysis of strains of the Brucella genus revealed that non-major pathogenic Brucella had clear genetic,distribution,and host spectrum differ-ences with respect to four classical pathogenic Brucella species.Five non-major pathogenic Brucella strains presented unique genetic evolutionary patterns,geographical distributions,and host tropism characteristics,thereby providing new insight for understanding the biological and genetic diversity of those Brucella strains.

Objective To construct a quality evaluation index system for non-medical technical services in public hospitals,aiming to provide a more scientific and feasible basis for evaluating patient service quality.Methods Based on literature research,the SERVQUAL theory was used to preliminarily formulate a comprehensive and full-cycle evaluation index for patient service quality.The final evaluation index system was determined through expert consultation,and the Analytic Hierarchy Process was used to determine the weights of the evaluation indices.Results The questionnaire response rates for the two rounds of expert consultation were both 100％.The authority coefficients of the experts were 0.82 and 0.80,respectively,indicating a high level of expert authority.The Kendall's W coefficient increased from 0.088 to 0.107 between the two rounds,and the difference was statistically significant (P<0.001),indicating good consistency of expert opinions.The consistency results of each judgment matrix were less than 0.1,passing the consistency test.The final evaluation index system consisted of six primary indicators (tangibility,reliability,responsiveness,assurance,empathy,and continuity) and 33 secondary indicators.Conclusion The selection of evaluation indicators revolves around the core service processes of outpatient,inpatient,and other hospital services,focusing on key elements at various critical junctures that influence patient experience.The evaluation indicators aim to guide hospitals to improve not only essential needs but also desired improvements in service quality,thus promoting the continuous enhancement of hospital services.

Objective To improve and refine the relevant regulations and guiding principles of warnings on drug instructions and labels in China.Methods This paper sorted out the drug instructions of small molecule anti-tumor drugs listed by the U.S.Food and Drug Administration(FDA)from 2005 to 2022,included the drugs mentioned in the QT interval prolongation risk,analyzed the clinical research and QT research results,and sorted out the identification and warning rules of the instructions.Results A total of 35 drugs were included,4 drugs wrote the risk of QT interval prolongation in the black box warning,21 drugs were wrote in the warning and precautions position,6 drugs were wrote in the adverse reaction section,and 2 drugs were only described under clinical pharmacology section.According to the severity of the QT interval prolongation caused by the drug and whether there were serious clinical consequences,they were displayed in the warnings(black box warnings),precautions(warnings and precautions)and adverse reactions in the instructions.Conclusion The aim of this article is to provide a reference for the writing of QT risk warning information of the instructions of domestic drug production enterprises and regulatory departments.It is recommended to clarify the severity of drug safety and the location of the instructions in clinical research,and continue to carry out safety monitoring and update the instructions in time after listing.

Primary aldosteronism(PA)is an important cause of secondary hypertension,and adrenal vein sampling(AVS),as the gold standard for identifying the dominant side in PA,plays a critical role in guiding subsequent therapeutic strategies.AVS is an invasive procedure that is not yet widely available in China.To promote the popularization and standardization of AVS,the Chinese Society of Hypertension(Chinese Research Hospital Association)and the Group of Interventional Diagnosis and Treatment of Hypertension(China International Exchange and Promotive Association for Medical and Health Care)have summarized domestic and foreign evidence and the operational experience of many experts.This consensus has summarized and updated the significance,indications,pre-procedural preparation,procedural steps and key points,prevention and management of complications,and result interpretation of AVS.This consensus provides comprehensive and clinically relevant guidance for the clinical practice and development of AVS,effectively promoting its popularization and standardization.

AIM To investigate effects of petroleum ether fraction from Derris eriocarpa How on glucose and lipid metabolism in a mouse model of metabolic syndrome(MS).METHODS KM mice were fed a high-fat diet and administered streptozotocin intraperitoneally to establish MS models.The MS mice were then randomly assigned to the model group,the metformin hydrochloride group,the lovastatin group,the ursolic acid group,and the high-,medium-and low-dose D.eriocarpa petroleum ether fraction groups,with 10 mice in each group.Ten additional mice maitained on a normal diet served as the normal control group.After 4 weeks of intragastric administration,glucose and lipid metabolism indicators were measured.Hepatic pathological changes were assessed using HE staining and oil red O staining.Liver tissue mRNA expressions of ATF3,PEPCK,FXR,CYP7A1,HNF4ɑ,CYP8B1 and SRB1 were quantified by RT-qPCR.Hepatic protein expressions of ATF3,HNF4ɑ,PEPCK,FXR and CYP7A1 was analyzed by Western blot in MS mice.RESULTS Compared to the model group,the high-dose D.eriocarpa petroleum ether fraction group exhibited significant glucose tolerance improvement(reduced OGTT-AUC,P＜0.01);favorable serum lipid modulation in terms of increased HDL-C levels(P＜0.01)and decreased TG,TC,LDL-C(P＜0.01);reduced renal biomarkers(BUN,SCR)and hepatotoxic indicators of TBA,AST and ALT activities(P＜0.01);alleviated hepatic lipid accumulation and histopathological damage;downregulated mRNA and protein expressions of ATF3,HNF4ɑ and PEPCK,as well as CYP8B1 mRNA expression(P＜0.01);and upregulated mRNA and protein expressions of FXR and CYP7A1,along with SRB1 mRNA expression(P＜0.01).CONCLUSION D.eriocarpa petroleum ether fraction ameliorates glucose and lipid metabolism dysregulation in MS mice by modulating the ATF3/HNF4ɑ/CYP7A1 signaling pathway,consequently eliciting hypoglycemic,hypolipidemic,hepatoprotective and nephroprotective effects.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.