BACKGROUND: Both medication and non-medication therapies are effective approaches to control blood pressure (BP) in hypertension patients. However, the association of joint changes in antihypertensive medication use and healthy lifestyle index (HLI) with BP control among hypertension patients is seldom reported, which needs to provide more evidence by prospective intervention studies. We examined the association of antihypertensive medication use and HLI with BP control among employees with hypertension in China based on a workplace-based multicomponent intervention program. METHODS: Between January 2013 and December 2014, a cluster randomized clinical trial of a workplace-based multicomponent intervention program was conducted in 60 workplaces across 20 urban areas in China. Workplaces were randomly divided into intervention (n = 40) and control (n = 20) groups. Basic information on employees at each workplace was collected by trained professionals, including sociodemographic characteristics, medical history, family history, lifestyle behaviors, medication status and physical measurements. After baseline, the intervention group received a 2-year intervention to achieve BP control, which included: (1) a workplace wellness program for all employees; (2) a guidelines-oriented hypertension management protocol. HLI including nonsmoking, nondrinking, adequate physical activity, weight within reference range and balanced diet, were coded on a 5-point scale (range: 0-5, with higher score indicating a healthier lifestyle). Antihypertensive medication use was defined as taking drug within the last 2 weeks. Changes in HLI, antihypertensive medication use and BP control from baseline to 24 months were measured after the intervention. RESULTS: Overall, 4655 employees were included (age: 46.3 ± 7.6 years, men: 3547 (82.3%)). After 24 months of the intervention, there was a significant improvement in lifestyle [smoking (OR = 0.65, 95% CI: 0.43-0.99; P = 0.045), drinking (OR = 0.52, 95% CI: 0.40-0.68; P < 0.001), regular exercise (OR = 3.10, 95% CI: 2.53-3.78; P < 0.001), excessive intake of fatty food (OR = 0.17, 95% CI: 0.06-0.52; P = 0.002), restrictive use of salt (OR = 0.26, 95% CI: 0.12-0.56; P = 0.001)]. Compare to employees with a deteriorating lifestyle after the intervention, those with an improved lifestyle had a higher BP control. In the intervention group, compared with employees not using antihypertensive medication, those who consistent used (OR = 2.34; 95% CI: 1.16-4.72; P = 0.017) or changed from not using to using antihypertensive medication (OR = 2.24; 95% CI: 1.08-4.62; P = 0.030) had higher BP control. Compared with those having lower HLI, participants with a same (OR = 1.38; 95% CI: 0.99-1.93; P = 0.056) or high (OR = 1.79; 95% CI: 1.27~2.53; P < 0.001) HLI had higher BP control. Those who used antihypertensive medication and had a high HLI had the highest BP control (OR = 1.88; 95% CI: 1.32-2.67, P < 0.001). Subgroup analysis also showed the consistent effect as the above. CONCLUSION These findings suggest that adherence to antihypertensive medication treatment and healthy lifestyle were associated with a significant improvement in BP control among employees with hypertension.

Objective This study aimed to investigate the potential relationship between urinary metals copper (Cu), arsenic (As), strontium (Sr), barium (Ba), iron (Fe), lead (Pb) and manganese (Mn) and grip strength. Methods We used linear regression models, quantile g-computation and Bayesian kernel machine regression (BKMR) to assess the relationship between metals and grip strength.Results In the multimetal linear regression, Cu (β=-2.119), As (β=-1.318), Sr (β=-2.480), Ba (β=0.781), Fe (β= 1.130) and Mn (β=-0.404) were significantly correlated with grip strength (P < 0.05). The results of the quantile g-computation showed that the risk of occurrence of grip strength reduction was -1.007 (95％ confidence interval:-1.362, -0.652; P < 0.001) when each quartile of the mixture of the seven metals was increased. Bayesian kernel function regression model analysis showed that mixtures of the seven metals had a negative overall effect on grip strength, with Cu, As and Sr being negatively associated with grip strength levels. In the total population, potential interactions were observed between As and Mn and between Cu and Mn (Pinteractions of 0.003 and 0.018, respectively).Conclusion In summary, this study suggests that combined exposure to metal mixtures is negatively associated with grip strength. Cu, Sr and As were negatively correlated with grip strength levels, and there were potential interactions between As and Mn and between Cu and Mn.

Radiotherapy, as an important means of tumor treatment, plays a significant role in the treatment of cervical cancer. However, the ovaries are highly sensitive to radiation, which is prone to appear radiation-related injuries, leading to ovarian dysfunction and loss of fertility in young female patients, seriously affecting their physical and mental health. The degree of ovarian injury is influenced by various factors such as the dose, volume, and duration of radiation exposure to the ovaries, as well as the patient's age. Ovarian displacement and advancements in radiotherapy techniques can significantly relieve radiation-related ovarian injury. Currently, drug protection techniques are still immature, and new fertility preservation methods are receiving increasing attention but require further improvement. This article reviewed the research progress in the molecular mechanisms, prevention strategies, and new fertility preservation techniques for ovarian injury related to cervical cancer radiotherapy, aiming to provide a reference for ovarian function protection during radiotherapy for young cervical cancer patients.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

The incidence of osteoporotic thoracolumbar vertebral fracture (OTLVF) in the elderly is gradually increasing. The kyphotic deformity caused by various factors has become an important characteristic of OTLVF and has received increasing attention. Its clinical manifestations include pain, delayed nerve damage, sagittal imbalance, etc. Currently, the definition and diagnosis of OTLVF with kyphotic deformity in the elderly are still unclear. Although there are many treatment options, they are controversial. Existing guidelines or consensuses pay little attention to this type of fracture with kyphotic deformity. To this end, the Lumbar Education Working Group of the Spine Branch of the Chinese Medicine Education Association and Editorial Committee of Chinese Journal of Trauma organized the experts in the relevant fields to jointly develop Clinical guidelines for the diagnosis and treatment of osteoporotic thoracolumbar vertebral fractures with kyphotic deformity in the elderly ( version 2024), based on evidence-based medical advancements and the principles of scientificity, practicality, and advanced nature, which provided 18 recommendations to standardize the clinical diagnosis and treatment.

From October 2021 to February 2023, we retrospectively analyzed the clinical and laboratory data of six patients (three male and three female, median age: 54 years, age range: 29-73 years) with mast cell leukemia (MCL) diagnosed in the First Affiliated Hospital of Soochow University (The Mastocytosis Collaborative Network of China). All patients had acute MCL, with at least one C-finding present. The main clinical presentations were hypoalbuminemia ( n=4), fatigue ( n=3), fever ( n=2), abdominal discomfort ( n=2), osteolytic lesions ( n=2), dizziness ( n=1), skin flushing ( n=1), and weight loss ( n=1). Splenomegaly and lymphadenopathy were noted in six and three patients, respectively. Six patients were strongly positive for CD117, five were positive for CD30 and CD25, and four were positive for CD2. Four patients had a normal karyotype and two patients had an abnormal karyotype. Gene mutations were detected in 4/6 cases. The median serum tryptase level was 24.9 (range: 20.1-171.9) μg/L. Two patients were treated with venetoclax and azacitidine for induction (one patient achieved partial remission by combination with afatinib, while there was no remission after combination with dasatinib in the other patient). Two patients did not achieve complete remission despite treatment with cladribine and imatinib, respectively. One patient treated with interferon combined with glucocorticoids was lost to follow-up, and one patient abandoned treatment. The follow-up time ranged from 1.1 to 21.7 months. Three patients died and two survived. Overall, MCL is a rare subtype of systemic mastocytosis with heterogeneous clinical course, and these patients have poor outcome. A better understanding of the clinical characteristics, treatment, and prognosis of MCL is urgently needed.

A comprehensive analytical method based on ultra-fast liquid chromatography coupled with triple quadrupole/linear ion trap tandem mass spectrometry(UFLC-QTRAP-MS/MS) was established for simultaneous determination of the content of 45 bioactive constituents including flavonoids, alkaloids, amino acids, phenolic acids, and nucleosides in Epimedium brevicornum. The multiple bioactive constituents in leaves, petioles, stems and rhizomes of E. brevicornum were analyzed. The gradient elution was performed at 30 ℃ in an XBridge~® C_(18) column(4.6 mm×100 mm, 3.5 μm) with 0.4% formic acid aqueous solution-acetonitrile as the mobile phase at a flow rate of 0.8 mL·min~(-1). Single factor experiment and response surface methodology were employed to optimize the extraction conditions. Multivariate statistical analyses including systematic cluster analysis(SCA), principal component analysis(PCA), partial least squares discriminant analysis(PLS-DA), and one-way analysis of variance(One-way ANOVA) were carried out to classify the samples from different parts and identify different constituents. Grey relation analysis(GRA) and entropy weight-TOPSIS analysis were performed to build a multi-index comprehensive evaluation model for different parts of E. brevicornum. The results showed that there was a good relationship between the mass concentrations of 45 constituents and the corresponding peak areas, with the correlation coefficients(r) not less than 0.999 0. The precision, repeatability, and stability of the established method were good for all the target constituents in this study, with the relative standard deviations(RSDs) less than 5.0%(0.62%-4.9%) and the average recovery of 94.51%-105.7%. The above results indicated that the bioactive constituents varied in different parts of E. brevicornum, and the overall quality followed the trend of leaves > petioles > rhizomes > stems. This study verified the rationality of the Chinese Pharmacopoeia(2020 edition) stipulating that the medicinal part of E. brevicornum is the leaf. Moreover, our study indicated that the rhizome had the potential for medicinal development. The established method was accurate and reliable, which can be used to comprehensive evaluate and control the quality of E. brevicornum. This study provides data reference for clarifying the medicinal parts and rationally utilizing the resources of E. brevicornum.
Chromatography, High Pressure Liquid ; Epimedium ; Tandem Mass Spectrometry ; Chromatography, Liquid ; Multivariate Analysis

The twenty-first century has already recorded more than ten major epidemics or pandemics of viral disease, including the devastating COVID-19. Novel effective antivirals with broad-spectrum coverage are urgently needed. Herein, we reported a novel broad-spectrum antiviral compound PAC5. Oral administration of PAC5 eliminated HBV cccDNA and reduced the large antigen load in distinct mouse models of HBV infection. Strikingly, oral administration of PAC5 in a hamster model of SARS-CoV-2 omicron (BA.1) infection significantly decreases viral loads and attenuates lung inflammation. Mechanistically, PAC5 binds to a pocket near Asp49 in the RNA recognition motif of hnRNPA2B1. PAC5-bound hnRNPA2B1 is extensively activated and translocated to the cytoplasm where it initiates the TBK1-IRF3 pathway, leading to the production of type I IFNs with antiviral activity. Our results indicate that PAC5 is a novel small-molecule agonist of hnRNPA2B1, which may have a role in dealing with emerging infectious diseases now and in the future.
Animals ; Mice ; Antiviral Agents/pharmacology* ; COVID-19 ; Hepatitis B virus ; Interferon Type I/metabolism* ; SARS-CoV-2/drug effects* ; Heterogeneous-Nuclear Ribonucleoprotein Group A-B/antagonists & inhibitors*

Objective:To explore the differences on clinical characteristics, concomitant diseases and treatment status between psoriasis and psoriatic arthritis (PsA), and provide clues for the early diagnosis and treatment of PsA.Methods:Data were collected by in-person interview of 225 patients with psoriasis and 299 patients with PSA who visited the department of rheumatology and Immunology and Department of Dermatology in People′s Hospital of Peking University from November 2020 to May 2021. After informed consent, the questionnaire was completed on site. The differences of clinical characteristics, concomitant diseases, mental health evaluation and treatment status between patients with arthritis (PsA) and patients with psoriasiswere analyzed and compared. Enumeration data were described by frequency. Chi square test was used to compare categorical variables. Multivariate Logistic regression analysis was used to determine the independent risk factors. P value of less than 0.05 was considered statistically significant. Results:Dactylitis [ OR(95% CI)=8.439(4.677,15.226), P<0.001], hip pain [ OR(95% CI)=3.442(1.829,6.480), P<0.001], heel pain [ OR(95% CI)=2.621(1.652,4.157), P<0.001] and low back pain [ OR(95% CI)=1.924(1.156,3.203), P=0.012] may be closely related to the progression of PsA ( P<0.05). The three most common concomitant diseases of patients with PsA and psoriasis both were overweight [43.1%(129/299)、29.3%(66/225)], fatty liver [(28.4%(85/299)、23.1%(52/225)]and hypertension[24.1%(72/299、13.3%(30/225)]. The proportion of osteoporosis in PsA group at the age of 30-39 and 40-49 years old was significantly higher than those in psoriasis group (30-39 years old:12.5%(10/80) vs 1.5%(1/65), χ2=6.14, P=0.013; 40~49 years old: 19.2%(15/78) vs 2.0%(1/51), χ2=8.46, P=0.004]. The proportion of hypertension in PsA group was also higher than that in psoriasis group at the age of 40~49 years old[7.0% (21/78) vs 2.7%(6/51), χ2=4.99, P=0.026)]. And the proportion of fatty liver in PsA group was also higher than that in psoriasis group at the age ≥60 years old [(46.0%(23/50) vs 29.1(7/24), χ2=4.99, P=0.025)]. Among 299 PsA patients, 47.1%(141/299) had anxiety tendency, 45.2%(135/299) had sleep disorder and 41.8%(125/299) had depression tendency. Among 225 psoriasis patients, 44.4%(100/225) had anxiety tendency, 40%(90/225) had sleep disorder and 36.9%(83/225) had depression tendency, there was no significant difference in above-mentioned situations between the PsA and psoriasis patients ( P>0.05). Conclusion:More attention should be paid to the management of concomitant diseases and psychological intervention in patients with PsA. When psoriasis patients occur with heel pain, dactylitis, low back pain and hip pain, the risk of development into PsA should be considered.

As an important element of medical and health sector innovation, the translation of scientific and technological achievements plays a key role in promoting their clinical application and meeting the medical needs of the people. The authors sorted out the problems in such translation at these affiliated hospitals in terms of " people", " finance", " material", and " system". Starting from 2017, the Tenth People′s Hospital Affiliated to Tongji University has explored such practices as establishing hospital-led clinical medical science and technology innovation parks and technology service limited companies. These practices aimed to address the issues of insufficient hospital scientific and technological innovation capabilities and the gap between the hospital′s operation mechanism to translate its scientific and technological achievements and the enterprises and the market. The clinical medical science and technology innovation park integrating administration, industry, education, research, medicine and application, has taken multiple measures to attract excellent research talents and projects from within and beyond the hospital, promote the implementation of innovative scientific research projects. The hospital also established a health industry mode with engagement of social capital from large enterprises. The Technology Services Co., Ltd. was based on the incubation and translation of hospital achievements, combining market and clinical needs, promoting multi-party cooperation between hospitals and external enterprises, improving the chain operation mechanism of hospital scientific and technological achievements translation work, and alleviating the problem of insufficient research pilot funds and productibility funds by means of hospital-led fundraising. The number of patent authorizations of hospitals had increased from 23 cases in 2018 to 105 in 2022, and the amount of patent conversion had increased from 2 million yuan in 2020 to 11 million yuan in 2022. It is recommended that affiliated hospitals of universities further improve the organizational structure of achievement translation, strengthen their professional talent teams, improve their operation mechanism of achievement translation, build a platform for medical school-enterprise cooperation, and improve the evaluation mechanism of translation assessment, in order to promote a virtuous cycle of hospital′s scientific and technological achievement translation work.