Lower-extremity vascular disease has a high morbidity rate and often leads to disability and death in its advanced stages. Although angiography-guided endovascular intervention is the primary treatment for peripheral vascular disease, it frequently fails to detect subtle lumen features and falls short of meeting the increasing clinical need for precise management. Intravascular ultrasound (IVUS) merges noninvasive ultrasound imaging with invasive catheterization techniques, providing 360° imaging of the vascular cross-section and delivering accurate information about lesion morphology. IVUS has been crucial in supporting decisionmaking for preoperative assessment, intraoperative monitoring, and postoperative optimization during vascular interventions. This review aims to summarize the latest applications of IVUS in lower-extremity vascular disease, discuss its strengths and limitations, and explore future directions for its use.

Radiochemotherapy-induced oral mucositis (OM) is a common oral complication in patients with tumors following head and neck radiotherapy or chemotherapy. Erosion and ulcers are the main features of OM that seriously affect the quality of life of patients and even the progress of tumor treatment. To date, differences in clinical prevention and treatment plans for OM have been noted among doctors of various specialties, which has increased the uncertainty of treatment effects. On the basis of current research evidence, this expert consensus outlines risk factors, clinical manifestations, clinical grading, ancillary examinations, diagnostic basis, prevention and treatment strategies and efficacy indicators for OM. In addition to strategies such as basic oral care, anti-inflammatory and analgesic agents, anti-infective agents, pro-healing agents, and photobiotherapy recommended in previous guidelines, we also emphasize the role of traditional Chinese medicine in OM prevention and treatment. This expert consensus aims to provide references and guidance for dental physicians and oncologists in formulating strategies for OM prevention, diagnosis, and treatment, standardizing clinical practice, reducing OM occurrence, promoting healing, and improving the quality of life of patients.
Humans ; Chemoradiotherapy/adverse effects* ; Consensus ; Risk Factors ; Stomatitis/etiology*

Lower-extremity vascular disease has a high morbidity rate and often leads to disability and death in its advanced stages. Although angiography-guided endovascular intervention is the primary treatment for peripheral vascular disease, it frequently fails to detect subtle lumen features and falls short of meeting the increasing clinical need for precise management. Intravascular ultrasound (IVUS) merges noninvasive ultrasound imaging with invasive catheterization techniques, providing 360° imaging of the vascular cross-section and delivering accurate information about lesion morphology. IVUS has been crucial in supporting decisionmaking for preoperative assessment, intraoperative monitoring, and postoperative optimization during vascular interventions. This review aims to summarize the latest applications of IVUS in lower-extremity vascular disease, discuss its strengths and limitations, and explore future directions for its use.

Chemotherapy-induced peripheral neuropathy(CIPN)refers to some symptoms and signs of peripheral nerve dysfunc-tion caused by using anti-tumor drugs,which is related to the dose of chemotherapy drugs.The pathogenesis of CIPN has not been fully defined,and the efficacy of existing therapeutic drugs and methods is limited.Therefore,it is of great scientific value and social significance to explore the pathogenesis of CIPN,de-velop new therapeutic drugs and methods,and solve the unmet clinical needs.This paper will elaborate on the pathogenesis of CIPN from the molecular and cellular levels,and review the treatment progress of CIPN,so as to provide reference for clinical treatment and direction for future research.

Ubiquitination represents a critical post-translational modification of proteins,capable of indu-cing alterations in the stability,cellular localisation and activity of substrate proteins.Consequently,it plays a pivotal role in a multitude of essential cellular processes.The intracellular parasite Legionella pneumophila releases in excess of 300 effector proteins into its host cell via its distinctive type IVB secre-tion system.These effector proteins regulate the physiological activity of host cells,thereby facilitating the growth and reproduction of Legionella and ultimately resulting in Legionella infection in humans.In the context of host infection,a number of effector proteins have been identified as regulators of the host cell ubiquitination system.Together with SidJ,SdjA,DupA/DupB,LnaB,and MavL,SidEs precisely and dynamically modulate the ubiquitination pathway of host cells,thereby providing a suitable environment for L.pneumophila to survive.The clarification of the biological functions of LnaB and MavL has led to the elucidation of this complex non-canonical ubiquitination regulatory cycle in L.pneumophila.This re-view presents a summary of the structural and enzymatic basis of non-classical ubiquitination mediated by SidEs,along with an examination of its biological significance in regulating endoplasmic reticulum rear-rangement and promoting Legionella-containing vacuole formation in host cells;the mechanism by which SidJ/SdjA regulates the phosphoribosylation activity of SidEs;and DupA/DupB,LnaB and MavL reverse the ubiquitination of host substrate proteins by SidEs through a multi-step catalytic reaction.In conclu-sion,this study will provide a reference for further understanding the detailed mechanism and biological significance of this type of non-classical ubiquitination modification,as well as offering insights into the pathogenic mechanism of L.pneumophila.

BACKGROUND: The use of potentially inappropriate medications (PIMs) is a major concern for medication safety as it may entail more harm than potential benefits for older adults. This study aimed to explore the prescribing rate, healthcare utilization, and expenditure of older adults using PIMs in China. METHODS: A cross-sectional analysis was conducted using a national representative database of all medical insurance beneficiaries across China, extracting ambulatory visit records of adults aged 65 years and above between 2015 and 2017. Descriptive analysis was conducted to measure the rate of patients exposed to PIM, prescribing rate of each PIM, average annual outpatient visits per patient, average total medication costs for each visit, average annual cost of PIMs for each patient, and average annual medication costs for each patient. Generalized linear model with logit link function and binomial distribution was used to examine the adjusted associations between PIMs and independent variables. RESULTS: In total, 845,278 (33.2%) participants were identified to be exposed to at least one PIM. Patients aged 75-84 years (38.1%, 969,809/2,545,430) and ≥85 years (37.9%, 964,718/2,545,430) were more likely to be prescribed with PIMs. Beneficiaries of the Urban Employee Basic Medical Insurance (UEBMI) and living in eastern and southern regions were more frequently prescribed with PIMs. Compared with patients without PIM exposure (7.5 visits, drug cost of RMB 1545.0 Yuan), patients with PIM exposure showed higher adjusted average annual number of outpatient visits (10.7 visits, β = 3.228, 95% confidence interval [CI] = 3.196-3.261) and higher annual drug costs (RMB 2461.8 Yuan, Coef. = 916.864, 95% CI = RMB 906.292-927.436 Yuan). CONCLUSIONS The results showed that the use of PIM among older adults was common in China. This study suggests that the use of PIM could be considered as a clear target, pending multidimensional efforts, to promote rational prescribing for older adults.
Humans ; Aged ; Cross-Sectional Studies ; Aged, 80 and over ; Male ; Female ; China ; Inappropriate Prescribing/economics* ; Patient Acceptance of Health Care/statistics & numerical data* ; Potentially Inappropriate Medication List/statistics & numerical data* ; Health Expenditures/statistics & numerical data*

Lower-extremity vascular disease has a high morbidity rate and often leads to disability and death in its advanced stages. Although angiography-guided endovascular intervention is the primary treatment for peripheral vascular disease, it frequently fails to detect subtle lumen features and falls short of meeting the increasing clinical need for precise management. Intravascular ultrasound (IVUS) merges noninvasive ultrasound imaging with invasive catheterization techniques, providing 360° imaging of the vascular cross-section and delivering accurate information about lesion morphology. IVUS has been crucial in supporting decisionmaking for preoperative assessment, intraoperative monitoring, and postoperative optimization during vascular interventions. This review aims to summarize the latest applications of IVUS in lower-extremity vascular disease, discuss its strengths and limitations, and explore future directions for its use.

Objective To analyze the prevalence status of cardiometabolic risk factor (CMRF) and its aggregation among workers engaged in new forms of employment. Methods A total of 5 429 new employment workers (including couriers, online food delivery workers, and ride hailing drivers) who underwent health medical examinations at a tertiary hospital in Beijing City were selected as the research subjects using the judgment sampling method. Data on waist circumference, blood pressure, blood glucose, and blood lipid levels were collected to analyze their CMRF [central obesity, elevated blood pressure, elevated blood glucose, elevated triglycerides, and reduced high-density lipoprotein cholesterol (HDL-C)] and their aggregation (with ≥ 2 of the above 5 risk factors) status. Results The detection rates of central obesity, elevated blood pressure, elevated blood glucose, elevated triglycerides, and reduced HDL-C were 61.2%, 38.2%, 29.5%, 40.9% and 22.6%, respectively. The detection rates of CMRF aggregation was 57.8%. The result of multivariable logistic regression analysis showed that male, age ≥45 years, smoking, overweight, and obesity were risk factors for CMRF aggregation (all P<0.05). Conclusion The detection rate of CMRF and its aggregation among workers with new forms of employment in Beijing City is relatively high. Targeted prevention and control efforts should be strengthened for high-risk populations, especially males, workers aged ≥45 years, smokers, and those who are overweight or obese.

Central venous pressure(CVP)is a commonly used hemodynamic index in clinical practice,and the accuracy of its measurement results is influenced by the measurement technical specifications.Based on research evidence and clinical practice,this article interprets the main content of the group standard of CVP measurement technology,and proposes suggestions for its use.It aims to guide clinical nursing staff to correctly understand the principles and methods of CVP measurement,and promote the standardization of nursing practice and the accuracy of measurement results.

Lower-extremity vascular disease has a high morbidity rate and often leads to disability and death in its advanced stages. Although angiography-guided endovascular intervention is the primary treatment for peripheral vascular disease, it frequently fails to detect subtle lumen features and falls short of meeting the increasing clinical need for precise management. Intravascular ultrasound (IVUS) merges noninvasive ultrasound imaging with invasive catheterization techniques, providing 360° imaging of the vascular cross-section and delivering accurate information about lesion morphology. IVUS has been crucial in supporting decisionmaking for preoperative assessment, intraoperative monitoring, and postoperative optimization during vascular interventions. This review aims to summarize the latest applications of IVUS in lower-extremity vascular disease, discuss its strengths and limitations, and explore future directions for its use.