This paper introduces a real-world cohort research model for community-acquired pneumonia （CAP） based on the Jiangsu Traditional Chinese Medicine （TCM） Dominant Diseases Diagnosis and Treatment Data Platform. Firstly， data cleaning is performed by standardizing diagnosis， symptoms， treatment and imaging， intelligently extracting unstructured information， and cleaning and constructing a standardized database. Secondly， for cohort establishment， CAP patients across the province are screened in accordance with CAP diagnostic criteria to build a high-quality disease-specific cohort. Lastly， in terms of protocol design， the characteristics of TCM research and the CAP disease profile are considered to determine appropriate inclusion and exclusion criteria， estimate sample size， define interventions， outcomes and economic evaluations， providing a reference for real-world TCM research on CAP.

This paper introduces a real-world cohort research model for community-acquired pneumonia （CAP） based on the Jiangsu Traditional Chinese Medicine （TCM） Dominant Diseases Diagnosis and Treatment Data Platform. Firstly， data cleaning is performed by standardizing diagnosis， symptoms， treatment and imaging， intelligently extracting unstructured information， and cleaning and constructing a standardized database. Secondly， for cohort establishment， CAP patients across the province are screened in accordance with CAP diagnostic criteria to build a high-quality disease-specific cohort. Lastly， in terms of protocol design， the characteristics of TCM research and the CAP disease profile are considered to determine appropriate inclusion and exclusion criteria， estimate sample size， define interventions， outcomes and economic evaluations， providing a reference for real-world TCM research on CAP.

Oral squamous cell carcinoma (OSCC) is a common head and neck malignancy. Approximately 50% to 60% of patients with OSCC are diagnosed at a locally advanced stage (clinical staging III-IVa). Even with comprehensive and sequential treatment primarily based on surgery, the 5-year overall survival rate remains below 50%, and patients often suffer from postoperative functional impairments such as difficulties with speaking and swallowing. Programmed death receptor-1 (PD-1) inhibitors are increasingly used in the neoadjuvant treatment of locally advanced OSCC and have shown encouraging efficacy. However, clinical practice still faces key challenges, including the definition of indications, optimization of combination regimens, and standards for efficacy evaluation. Based on the latest research advances worldwide and the clinical experience of the expert group, this expert consensus systematically evaluates the application of PD-1 inhibitors in the neoadjuvant treatment of locally advanced OSCC, covering combination strategies, treatment cycles and surgical timing, efficacy assessment, use of biomarkers, management of special populations and immune related adverse events, principles for immunotherapy rechallenge, and function preservation strategies. After multiple rounds of panel discussion and through anonymous voting using the Delphi method, the following consensus statements have been formulated: 1) Neoadjuvant therapy with PD-1 inhibitors can be used preoperatively in patients with locally advanced OSCC. The preferred regimen is a PD-1 inhibitor combined with platinum based chemotherapy, administered for 2-3 cycles. 2) During the efficacy evaluation of neoadjuvant therapy, radiographic assessment should follow the dual criteria of Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 and immune RECIST (iRECIST). After surgery, systematic pathological evaluation of both the primary lesion and regional lymph nodes is required. For combination chemotherapy regimens, PD-L1 expression and combined positive score need not be used as mandatory inclusion or exclusion criteria. 3) For special populations such as the elderly (≥ 70 years), individuals with stable HIV viral load, and carriers of chronic HBV/HCV, PD-1 inhibitors may be used cautiously under the guidance of a multidisciplinary team (MDT), with close monitoring for adverse events. 4) For patients with a poor response to neoadjuvant therapy, continuation of the original treatment regimen is not recommended; the subsequent treatment plan should be adjusted promptly after MDT assessment. Organ transplant recipients and patients with active autoimmune diseases are not recommended to receive neoadjuvant PD-1 inhibitor therapy due to the high risk of immune related activation. Rechallenge is generally not advised for patients who have experienced high risk immune related adverse events such as immune mediated myocarditis, neurotoxicity, or pneumonitis. 5) For patients with a good pathological response, individualized de escalation surgery and function preservation strategies can be explored. This consensus aims to promote the standardized, safe, and precise application of neoadjuvant PD-1 inhibitor strategies in the management of locally advanced OSCC patients.

Objective To investigate the intervention effect of Xiao'er Zhixiao Pingchuan Granules(XEZXPCG)on ovalbumin(OVA)-induced airway remodeling in asthmatic mice and its potential mechanism by regulating macrophage migration inhibitory factor(MIF)and inhibiting the phosphoinositide 3-kinase(PI3K)/protein kinase B(Akt)signaling pathway.Methods A total of 96 SPF-grade male BALB/c mice were randomly divided into blank,model,XEZXPCG low/medium/high-dose groups(2.05,4.10,and 8.20 g/kg),adeno-associated virus(AAV)NC shRNA,AAV MIF shRNA(MIF gene silencing),and LY294002(PI3K/Akt inhibitor,1 mg/kg)groups(12 mice in each group).Asthma models were established through OVA sensitization and challenge.Airway resistance and the proportions of inflammatory cells(eosinophils and macrophages)in bronchoalveolar lavage fluid(BALF)were detected.Serum inflammatory factor(OVA-IgE,interleukin[IL]-1β,IL-6,tumor necrosis factor-alpha,and interferon-gamma)levels and BALF were quantified.Hematoxylin and eosin,Masson,and periodic acid-Schiff staining were used to evaluate airway wall thickness(Wat/Phm),smooth muscle area(Wam/Phm),collagen deposition,and goblet cell metaplasia.Western blotting,immunofluorescence,and real-time fluorescence-qPCR were used to detect MIF protein and mRNA expressions,as well as activation markers of the PI3K/Akt pathway and cell cycle-related proteins(including cyclin-dependant kinase 6[CDK6],Cyclin D1,Cyclin D3,and p21),in lung tissues.Results Compared to the model group,a XEZXPCG medium or high-dose significantly reduced airway resistance(P<0.05),improved the imbalance of eosinophil and macrophage proportions in BALF,and decreased inflammatory factor levels in serum and BALF(P<0.05).XEZXPCG medium or high-dose alleviated airway epithelial damage,goblet cell hyperplasia,and collagen fiber deposition,and reduced the Wat/Phm and Wam/Phm(P<0.05),with effects comparable to those of the AAV MIF shRNA and LY294002 groups.XEZXPCG medium and high-inhibited MIF protein/mRNA expression(P<0.05),downregulated Akt phosphorylation(P<0.05),upregulated p21 protein expression,and downregulated Cyclin D1,Cyclin D3,and CDK6 expressions(P<0.05).Conclusion XEZXPCG alleviates airway inflammation and improves airway remodeling in OVA-induced asthmatic mice by inhibiting MIF expression,downregulating the PI3K/Akt signaling pathway,and regulating cell cycle progression.XEZXPCG enhances airway remodeling through MIF-mediated PI3K/Akt pathway regulation.

Objective To summarize the changing prevalence of carbapenem resistance in Enterobacterales based on the data of CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021 for improving antimicrobial treatment in clinical practice.Methods Antimicrobial susceptibility testing was performed using a commercial automated susceptibility testing system according to the unified CHINET protocol.The results were interpreted according to the breakpoints of the Clinical & Laboratory Standards Institute(CLSI)M100 31st ed in 2021.Results Over the seven-year period(2015-2021),the overall prevalence of carbapenem-resistant Enterobacterales(CRE)was 9.43％(62 342/661 235).The prevalence of CRE strains in Klebsiella pneumoniae,Citrobacter freundii,and Enterobacter cloacae was 22.38％,9.73％,and 8.47％,respectively.The prevalence of CRE strains in Escherichia coli was 1.99％.A few CRE strains were also identified in Salmonella and Shigella.The CRE strains were mainly isolated from respiratory specimens(44.23±2.80)％,followed by blood(20.88±3.40)％and urine(18.40±3.45)％.Intensive care units(ICUs)were the major source of the CRE strains(27.43±5.20)％.CRE strains were resistant to all the β-lactam antibiotics tested and most non-β-lactam antimicrobial agents.The CRE strains were relatively susceptible to tigecycline and polymyxins with low resistance rates.Conclusions The prevalence of CRE strains was increasing from 2015 to 2021.CRE strains were highly resistant to most of the antibacterial drugs used in clinical practice.Clinicians should prescribe antimicrobial agents rationally.Hospitals should strengthen antibiotic stewardship in key clinical settings such as ICUs,and take effective infection control measures to curb CRE outbreak and epidemic in hospitals.

Forty adult male C57BL/6 mice were randomly divided into four groups:the control group,Salmonella typhimurium(S.typhimurium)(ST)group,phlorizin(PHZ)+S.typhimuri-um(ST)group,and PHZ(80 mg/kg)group,with 10 mice in each group.Morphological observa-tion,HE staining,ELISA,immunofluorescence and Western blot were performed,the results showed that PHZ significantly increased the cecal index,decreased the spleen index of S.typhi-murium-induced mice(P＜0.05),and reduce the pathological damage of cecum in mice.Mean-while,PHZ treatment also significantly reduced colonization of S.typhimurium in the cecum,spleen,mesenteric lymph nodes and liver(P＜0.05).The results of ELISA showed that PHZ treatment also significantly inhibited the S.ty phimurium-induced increase in the expression of IL-1β,INF-γ,TNF-a and IL-6 in the cecum of mice(P＜0.05).Immunofluorescence and Western blot results showed that PHZ significantly increased the protein expression levels of Occludin,Claudin-3,and ZO-1 in the cecal barrier of mice induced by S.typhimurium(P＜0.05).These results con-firmed that phlorizin could improve cecal inflammation and intestinal barrier damage induced by S.typhimurium in mice.

Objective To investigate the intervention effect of Xiao'er Zhixiao Pingchuan Granules(XEZXPCG)on ovalbumin(OVA)-induced airway remodeling in asthmatic mice and its potential mechanism by regulating macrophage migration inhibitory factor(MIF)and inhibiting the phosphoinositide 3-kinase(PI3K)/protein kinase B(Akt)signaling pathway.Methods A total of 96 SPF-grade male BALB/c mice were randomly divided into blank,model,XEZXPCG low/medium/high-dose groups(2.05,4.10,and 8.20 g/kg),adeno-associated virus(AAV)NC shRNA,AAV MIF shRNA(MIF gene silencing),and LY294002(PI3K/Akt inhibitor,1 mg/kg)groups(12 mice in each group).Asthma models were established through OVA sensitization and challenge.Airway resistance and the proportions of inflammatory cells(eosinophils and macrophages)in bronchoalveolar lavage fluid(BALF)were detected.Serum inflammatory factor(OVA-IgE,interleukin[IL]-1β,IL-6,tumor necrosis factor-alpha,and interferon-gamma)levels and BALF were quantified.Hematoxylin and eosin,Masson,and periodic acid-Schiff staining were used to evaluate airway wall thickness(Wat/Phm),smooth muscle area(Wam/Phm),collagen deposition,and goblet cell metaplasia.Western blotting,immunofluorescence,and real-time fluorescence-qPCR were used to detect MIF protein and mRNA expressions,as well as activation markers of the PI3K/Akt pathway and cell cycle-related proteins(including cyclin-dependant kinase 6[CDK6],Cyclin D1,Cyclin D3,and p21),in lung tissues.Results Compared to the model group,a XEZXPCG medium or high-dose significantly reduced airway resistance(P<0.05),improved the imbalance of eosinophil and macrophage proportions in BALF,and decreased inflammatory factor levels in serum and BALF(P<0.05).XEZXPCG medium or high-dose alleviated airway epithelial damage,goblet cell hyperplasia,and collagen fiber deposition,and reduced the Wat/Phm and Wam/Phm(P<0.05),with effects comparable to those of the AAV MIF shRNA and LY294002 groups.XEZXPCG medium and high-inhibited MIF protein/mRNA expression(P<0.05),downregulated Akt phosphorylation(P<0.05),upregulated p21 protein expression,and downregulated Cyclin D1,Cyclin D3,and CDK6 expressions(P<0.05).Conclusion XEZXPCG alleviates airway inflammation and improves airway remodeling in OVA-induced asthmatic mice by inhibiting MIF expression,downregulating the PI3K/Akt signaling pathway,and regulating cell cycle progression.XEZXPCG enhances airway remodeling through MIF-mediated PI3K/Akt pathway regulation.

AIM To investigate the effects of Wenyang Jiedu Tongluo Recipe(WYJDTLR)on macrophage recruitment and polarization function in a mouse model of diabetic kidney disease(DKD).METHODS 50 db/db mice were randomly divided into the model group,the valsartan group(10.29 mg/kg)and the high-dose,medium-dose and low-dose WYJDTLR groups(26.52,13.26 and 6.63 g/kg),with 10 mice in each group,in contrast to another 10 db/m mice of the blank group.After 8 weeks of administration,the mice had their levels of fasting blood glucose,24-hour urinary protein quantity(24h-UTP),serum creatinine(Scr)and blood urea nitrogen(BUN)observed;their morphological changes of renal tissues observed by HE staining;their degree of renal glycogen deposition observed by PAS staining;their degree of renal fibrosis observed by Masson staining;their levels of MCP-1 and MCF-1 in serum and TNF-α and IL-1 β in renal tissue detected by ELISA;their renal protein expressions of VCAM-1 and ICAM-1 detected by IHC and Western blot;and their renal expressions of CD86 and CD206 detected by IF.RESULTS Compared with the model group,the WYJDTLR groups displayed decreased levels of fasting blood glucose,24h-UTP,Scr and BUN(P＜0.05,P＜0.01);improved degree of glomerular hypertrophy,mild proliferation of mesangial cells,dilatation of renal tubular,vacuolar degeneration of renal tubular epithelial cells,deposition of glomerular glycogen,and fibrosis of renal tissues(P＜0.01);decreased levels of MCP-1 and MCF-1 in serum and TNF-α and IL-1β in renal tissue(P＜0.05,P＜0.01);decreased renal protein expressions of VCAM-1 and ICAM-1(P＜0.05,P＜0.01),thus reduced the recruitment of macrophages to the kidney;decreased renal CD86 protein expression(P＜0.01);and increased CD206 protein expression(P＜0.01),thus inhibited M1-type polarization of macrophages and promoted M2-type polarization of macrophages.CONCLUSION WYJDTLR can delay the DKD progression in mice by reducing the occurrence of inflammatory reactions through reducing the level of macrophage recruitment factor,inhibiting the M1-type polarization,and promoting the M2-type polarization.

Abstract Nutritional literacy is an important component of health literacy and closely related to adolescents dietary habits and health conditions. Improving nutrition literacy not only helps adolescents to make healthier dietary choices but also aids in disease prevention. The article systematically reviews the individual and environmental factors influencing adolescent nutrition literacy, with a focus on exploring innovative intervention strategies based on traditional school interventions, new media platforms and virtual reality technology, so as to provide a theoretical foundation and practical guidance for improving the nutrition literacy and overall health of Chinese adolescents.

Early correction of childhood malocclusion is timely managing morphological, structural, and functional abnormalities at different dentomaxillofacial developmental stages. The selection of appropriate imaging examination and comprehensive radiological diagnosis and analysis play an important role in early correction of childhood malocclusion. This expert consensus is a collaborative effort by multidisciplinary experts in dentistry across the nation based on the current clinical evidence, aiming to provide general guidance on appropriate imaging examination selection, comprehensive and accurate imaging assessment for early orthodontic treatment patients.
Humans ; Malocclusion/diagnostic imaging* ; Child ; Consensus