To report a case of an immunocompetent young adult male patient diagnosed with intracranial Aspergillus flavus infection， and to investigate the clinical features of this disease and related experience in diagnosis and treatment.A retrospective analysis was performed for the clinical data of a patient who had the initial presentation of high fever and headache and then progressed to meningoencephalitis， and the results of cerebrospinal fluid （CSF） metagenomic next-generation sequencing （mNGS） and treatment outcomes were summarized.The patient had an acute onset， with no response to empirical anti-infective therapy in the incipient stage， and then he gradually developed disturbance of consciousness and meningeal irritation sign. CSF analysis showed inflammatory changes， while conventional pathogen tests yielded negative results， and mNGS detected 27 specific sequences of Aspergillus flavus. The symptoms of the patient was significantly improved after antifungal therapy with voriconazole， with no recurrence after follow-up for 3 months.For unexplained central nervous system infections， especially those with negative results from conventional tests， mNGS can improve the detection rate of rare pathogens（e.g.，Aspergillus flavus）. Early diagnosis and targeted antifungal therapy are crucial for improving prognosis. This case highlights that invasive fungal infections should be considered even in immunocompetent individuals.
Aspergillus flavus

Objective: To investigate the influencing factors for kinesiophobia among elderly patients with chronic obstructive pulmonary disease (COPD), so as to provide the reference for alleviating kinesiophobia among COPD patients. Methods: From December 2023 to July 2024, COPD patients aged 60 years and above who sought medical treatment at a tertiary grade-a hospital in Guiyang City were selected. Demographic information was collected through questionnaire surveys. Kinesiophobia, exercise self-efficacy, social support, type D personality and coping styles were assessed using the Chinese version of Tampa Scale for Kinesiophobia, the Chinese version of the Self-Efficacy for Exercise Scale, Social Support Rating Scale, Type D Personality Scale and Chinese version of the Medical Coping Modes Questionnaire, respectively. Factors affecting kinesiophobia among elderly patients with COPD were analyzed using a multiple linear regression model. Results: A total of 300 COPD patients were surveyed, including 238 males (79.33%) and 62 females (20.67%). The majority of patients had a disease duration of less than 5 years, with 130 cases (43.33%). The average kinesiophobia score was (48.01±7.74) points. The average exercise self-efficacy score was (3.39±1.01) points. The average social support score was (34.42±6.76) points. There were 280 patients (93.33%) with type D personality. The average scores of the confrontation, avoidance, and resignation dimensions of coping styles were (17.42±5.00), (13.76±1.91), and (11.81±2.95) points, respectively. Multiple linear regression analysis showed that age (70-<80 years, β'=0.124; ≥80 years, β'=0.205), educational level (primary school and below, β'=0.228; junior high school, β'=0.182), household monthly income per capita (<3 000 yuan, β'=0.234; 3 000~<5 000 yuan, β'=0.165), social support (β'=0.294), type D personality (β'= 0.170), and coping styles (confrontation dimension, β'=-0.140; avoidance dimension, β'=0.154; resignation dimension, β'=0.175) statistically associated with kinesiophobia among elderly patients with COPD. Conclusion Kinesiophobia among elderly patients with COPD is associated with age, educational level, household monthly income per capita, social support, type D personality and coping styles.

Objective To retrieve,evaluate,and integrate evidence related to the operational proce-dures of ambulatory blood pressure monitoring(ABPM)in adults,aiming to enhance the accuracy and effec-tiveness of ambulatory blood pressure monitoring.Methods A systematic search was conducted following the"6S"pyramid model of evidence-based resources to identify literature pertaining to ABPM operations in adults from relevant domestic and international databases and websites,with the search period spanning from the inception of each database to April 2024.After screening the literature,the methodological quality of the included studies was evaluated.Evidence was extracted and summarized according to thematic categories.Results Based on the inclusion and exclusion criteria,15 publications were ultimately included,comprising 1 clinical decision,10 guidelines,1 best practice summary,and 3 expert consensus documents.A total of 32 evidence items were synthesized.Conclusions This study consolidates evidence related to ABPM operational procedures,providing an evidence-based foundation for standardizing ABPM practices among healthcare pro-fessionals.

To retrieve, evaluate, and integrate evidence related to the operational procedures of ambulatory blood pressure monitoring (ABPM) in adults, aiming to enhance the accuracy and effectiveness of ambulatory blood pressure monitoring.

Objective To explore the clinical efficacy of Shenggu Tablets(mainly composed of Pyritum,Sappan Lignum,Dalbergiae Odoriferae Lignum,Notoginseng Radix et Rhizoma,Anemarrhenae Rhizoma,Rehmanniae Radix,Pheretima,and Os Draconis)combined with extension osteotomy using Taylor spatial frame(TSF)in the treatment of open tibial fracture with bone defect.Methods The clinical data of 73 patients with open tibia fracture and bone defect more than four centimeters admitted to Foshan Hospital of Traditional Chinese Medicine from July 2018 to September 2022 were retrospectively analyzed.The patients were divided into the observation group(37 cases)and the control group(36 cases)according to the medication of Shenggu Tablets or not.The control group was treated with extension osteotomy using TSF,and the observation group was treated with Shenggu Tablets combined with extension osteotomy using TSF until the healing of fractures.Six months after the operation,the clinical effect,total effective rate assessed by imaging,fracture healing time,and the incidence of complications in the two groups were compared.Results(1)Six months after the operation,the distinguished rate of clinical efficacy and the total effective rate assessed by imaging in the observation group were all 100.00%(37/37),which were significantly higher than those in the control group[(83.33%(30/36),86.11%(31/36)respectively],and the intergroup comparison showed that the differences were statistically significant(P＜0.05).(2)The fracture healing time of the observation group was(11.47±0.77)months,which was significantly shorter than that of the control group[(14.42±1.40)months],and the difference was statistically significant(P＜0.01).(3)The total incidence of postoperative complications in the patients of the observation group was 13.51%(5/37),which was significantly lower than that in the control group[38.89%(14/36)],with a statistically significant difference(P＜0.05).Conclusion Shenggu Tablets combined with extension osteotomy using TSF exerts certain efficacy in the treatment of open tibial fracture with bone defect by significantly promoting fracture healing,improving bone transport and speeding up osteogenic mineralization,shortening the time of fracture healing,and reducing the time of wearing the TSF.

Clinicians need to focus on various points in the diagnosis and treatment of insomnia.This article prescribed the treatment protocol based on the unique features,such as insomnia in the elderly,women experiencing specific physiologi-cal periods,children insomnia,insomnia in sleep-breathing disorder patients,insomnia in patients with chronic liver and kidney dysfunction.It pro-vides some reference for clinicians while they make decision on diagnosis,differentiation and treat-ment methods.

Objective:To develop the Psychological Monitors'Interpersonal Trust Questionnaire in Colleges(PMITQC)and test its validity and reliability.Methods:A preliminary questionnaire was formulated by construc-ting a model of the psychological monitors'interpersonal trust.Totally 515 psychological monitors were selected for item analysis and exploratory factor analysis.In addition,556 psychological monitors were selected for confirmatory factor analysis and internal consistency reliability tests,of which 114 were retested after 4 weeks.The Trust Scale(TS)and Interpersonal Trust Scale(ITS)were used to test the criterion validity.Results:The PMITQC contained 22 items and was composed of four factors that accounted for 68.634％of the variance.The confirmatory factor a-nalysis showed that the four-factor structure model fitted nicely(x2/df=4.22,NFI=0.92,RFI=0.91,IFI=0.94,TLI=0.93,CFI=0.94,RMSEA=0.076).The criterion validity test showed that the total scores and scores of 4 factor of PMITQC were positively correlated with the total scores of TS and ITS(r=0.28-0.48,Ps＜0.01).The Cronbach's coefficients of the total questionnaire and the 4 factors ranged from 0.87 to 0.97 and the test-retest reli-abilities ranged from 0.73 to 0.89.Conclusion:The Psychological Monitors'Interpersonal Trust Questionnaire in Colleges has good validity and reliability.

G protein-coupled receptor (GPR) 40, as one of GPRs family, plays a potential role in regulating glucose and lipid metabolism. To study the effect of GPR40 novel agonist SZZ15-11 on hyperglycemia and hyperlipidemia and its potential mechanism, spontaneous type 2 diabetic KKA^y mice, human hepatocellular carcinoma HepG2 cells and murine mature adipocyte 3T3-L1 cells were used. KKA^y mice were divided into four groups, vehicle group, TAK group, SZZ (50 mg·kg^-1) group and SZZ (100 mg·kg^-1) group, with oral gavage of 0.5% sodium carboxymethylcellulose (CMC), 50 mg·kg^-1 TAK875, 50 and 100 mg·kg^-1 SZZ15-11 respectively for 45 days. Fasting blood glucose, blood triglyceride (TG) and total cholesterol (TC), non-fasting blood glucose were tested. Oral glucose tolerance test and insulin tolerance test were executed. Blood insulin and glucagon were measured via enzyme-linked immunosorbent assay (ELISA). After mice′s execution, liver tissue was harvested to test TG and TC content. Then pathological morphology of liver was observed through hematoxylin-eosin (HE) staining, and the lipid metabolism relative signal pathway was analyzed by Western blot and RT-PCR. The experiments were approved by the Institutional Animal Care and Use Committee of the Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College. At the same time, Akt phosphorylation level in HepG2 cells and adiponectin in 3T3-L1 cells treated with TNFα were measured with Western blot. The results show that SZZ15-11 not only decreased blood glucose and lipid, improved insulin sensitivity, but also increased fasting blood glucagon and promoted insulin secretion after glucose loading in KKA^y mice. Additionally, SZZ15-11 alleviated hepatic steatosis and liver dysfunction in KKA^y mice. In liver tissue, SZZ15-11 increased AMPKα phosphorylation level and cholesterol metabolism relative gene Abcg8 transcription. In HepG2 cells, SZZ15-11 increased Akt phosphorylation level. In adipocyte 3T3-L1, SZZ15-11 recovered the decreased adiponectin expression by TNFα. This study proved that GPR40 agonist SZZ15-11 could be a candidate compound for regulating glucolipid metabolic disorder.