Traditional Chinese medicine(TCM)has been used for the control and prevention of infectious diseases for thousands of years.Due to its characteristics of multiple components and multiple targets,it shows promising therapeutic prospects in the field of anti-infection.Here,we provide a detailed introduction to the current application of various omics technologies,such as metabolomics,proteomics,genomics,and transcriptomics in the study of TCM's anti-infective properties.The application of omics technologies can help explore the active components and their targets in TCM that contribute to its anti-infective effects;elucidate the biosynthetic pathways of active components,aiding in the discovery of new active ingredients;and investigate the mechanisms by which TCM affects pathogenic microorganisms,as well as interpret the mechanisms of TCM's synergy with antibiotics.As more research findings are produced and validated,the role of TCM in addressing the global challenge of antimicrobial resistance will become increasingly prominent through the integration of multi-omics and multidisciplinary research methods in the future.

Traditional Chinese medicine(TCM)has been used for the control and prevention of infectious diseases for thousands of years.Due to its characteristics of multiple components and multiple targets,it shows promising therapeutic prospects in the field of anti-infection.Here,we provide a detailed introduction to the current application of various omics technologies,such as metabolomics,proteomics,genomics,and transcriptomics in the study of TCM's anti-infective properties.The application of omics technologies can help explore the active components and their targets in TCM that contribute to its anti-infective effects;elucidate the biosynthetic pathways of active components,aiding in the discovery of new active ingredients;and investigate the mechanisms by which TCM affects pathogenic microorganisms,as well as interpret the mechanisms of TCM's synergy with antibiotics.As more research findings are produced and validated,the role of TCM in addressing the global challenge of antimicrobial resistance will become increasingly prominent through the integration of multi-omics and multidisciplinary research methods in the future.

Fungal infections are a growing public health threat, especially as the at-risk population for invasive fungal disease expanding and antifungal resistance emerging.In 2022, the World Health Organization released the first fungal priority pathogens list, aiming to encourage countries to strengthen the response to fungal infections.As one of the first countries to issue and implement the National Action Plan to Contain Antimicrobial Resistance in the world, China has attached great importance to the management of fungal infections.A series of actions and efforts have been made, including improving the legal and regulatory system related to the prevention and treatment of fungal infections, strengthening the management of clinical application of antifungal drugs, improving the diagnosis and treatment ability of fungal infections and the standardization of diagnosis and treatment, establishing a monitoring and evaluation system for fungal infections and drug resistance.Initial results have been achieved.In the future, under the guidance of the new national action plan to contain antimicrobial resistance, the level of diagnosis and treatment of fungal infections will be further improved to reduce the occurrence of fungal infections and the spread of antifungal resistance.

Objective:To explore the clinical application of preimplantation genetic testing for monogenic disorders (PGT-M) in an unique case with Spinal muscular atrophy (SMA) type 2+ 0.Methods:A special SMA family presented at the Third Affiliated Hospital of Guangzhou Medical University on October 19, 2020 was selected as the study subject. Multiple ligation-dependent probe amplification (MLPA) and molecular tagging linkage analysis were carried out to identify the SMN1 genotype of the couple and their fetus. Subsequently, next-generation sequencing (NGS), molecular tagging linkage analysis, and chromosomal microarray analysis were employed to determine the haplotypes and validate the result of PGT-M on the 11 embryos derived for the couple. Results:The female partner was identified as a carrier of the rare SMN1[2+ 0] variant, and prenatal diagnosis confirmed the fetus to be affected by SMA. Ultimately, PGT-M has successfully selected four embryos free from the pathogenic SMN1 variants and X chromosome deletion. Conclusion:PGT-M can effectively prevent the transmission of rare genetic variants such as the SMA 2+ 0 subtype in the families. Above finding has provided guidance for genetic counseling and family planning for the couple.

Objective:To explore the challenges in the implementation of drug centralized volume-based procurement policies in hospitals and propose corresponding optimization suggestions.Methods:From August to December 2023, a purposive sampling was conducted to select 11 pharmaceutical experts from tertiary hospitals in China for Delphi method. The survey content included " policy recommendations for promoting the acceleration and expansion of national drug centralized procurement and retaining surplus medical insurance funds for centralized procurement" .Results:Survey participants gave feedback on a set of existing problems found in the implementation of drug centralized procurement policies and proposed corresponding optimization methods. Kendall′s W coefficient of the specialist consultation was 0.332( P<0.05), demonstrating good consistency and concentration of the expert opinions. Among the problems, the score of drug supply guarantee was the highest(mean value of importance was 4.45). At the same time, the recommendation of strengthening monitoring and early warning, coordination and dispatch, and effectively ensuring the supply of centralized drug procurement had the highest score and concentration(mean value of importance was 4.91, coefficient of variation was 0.06). Conclusions:Through Delphi method, this study revealed issues and optimization methods in the implementation of drug centralized procurement policies in hospitals. The findings could provide valuable insights for improvements in the pharmaceutical sector and future policy adjustments.

Objective:To analyze the clinical characteristics and outcomes of patients with invasive fungal sinusitis (invasive fungal rhinosinusitis, IFR) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and explored the risk factors for IFR after allo-HSCT.Methods:Nineteen patients with IFR after allo-HSCT at Peking University People’s Hospital from January 2012 to December 2021 were selected as the study group, and 95 patients without IFR after allo-HSCT during this period were randomly selected as the control group (1:5 ratio) .Results:Nineteen patients, including 10 males and 9 females, had IFR after allo-HSCT. The median age was 36 (10–59) years. The median IFR onset time was 68 (9–880) days after allo-HSCT. There were seven patients with acute myeloid leukemia, five with acute lymphoblastic leukemia, two with myelodysplastic syndrome, two with chronic myeloid leukemia, one with acute mixed-cell leukemia, one with multiple myeloma, and one with T-lymphoblastic lymph node tumor. There were 13 confirmed cases and 6 clinically diagnosed cases. The responsible fungus was Mucor in two cases, Rhizopus in four, Aspergillus in four, and Candida in three. Five patients received combined treatment comprising amphotericin B and posaconazole, one patient received combined treatment comprising voriconazole and posaconazole, nine patients received voriconazole, and four patients received amphotericin B. In addition to antifungal treatment, 10 patients underwent surgery. After antifungal treatment and surgery, 15 patients achieved a response, including 13 patients with a complete response and 2 patients with a partial response. Multivariate analysis revealed that neutropenia before transplantation ( P=0.021) , hemorrhagic cystitis after transplantation ( P=0.012) , delayed platelet engraftment ( P=0.008) , and lower transplant mononuclear cell count ( P=0.012) were independent risk factors for IFR after allo-HSCT. The 5-year overall survival rates in the IFR and control groups after transplantation were 29.00%±0.12% and 91.00%±0.03%, respectively ( P<0.01) . Conclusion:Although IFR is rare, it is associated with poor outcomes in patients undergoing allo-HSCT. The combination of antifungal treatment and surgery might be effective.

Objective:To systematically retrieve the assessment tools for patient care complexity at home and abroad, and compare their release institutions, formation process, applicable population, assessment methods and main contents.Methods:Articles on patient care complexity assessment tools was retrieved through computers in PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, WanFang Data, China Biomedical Database, and VIP Database. The retrieval time limit was from the establishment of the database to July 2, 2022. Excel 2019 was used to extract the name, release institution, evaluation method, main content and other information of the assessment tools and compare the content characteristics of the assessment tools.Results:A total of 26 assessment tools for patient care complexity were included in this study, involving 37 articles, mainly observational studies. The 26 tools were mainly issued by institutions of higher learning, and most of them were applicable to ordinary inpatients. The assessment contents included the general situation of the patient, severity of the disease, treatment items, mental cognitive function, mental health, socio-economic support and compliance.Conclusions:At home and abroad, the patient care complexity evaluation tools are mainly used to evaluate ordinary adult inpatients. There are few tools to evaluate children, the elderly, Intensive Care Unit (ICU) and other special types of patients, and there is a lack of relevant intervention research. In China, there are few tools for evaluating patient care complexity involving indicators related to mental cognitive function, which suggests that nurses can consider the mental cognitive function of patients when building relevant assessment tools in the future. In addition, the application effect of such tools in patient risk identification and safety management, nursing human resource allocation and other fields should be verified.

Objective:To evaluate the effect of lower limb neuromuscular electrical stimulation (NMES) on mechanical ventilation patients in intensive care unit (ICU).Methods:Databases including the Cochrane Library, PubMed, Web of Science, Embase, SinoMed, CNKI, VIP and Wanfang database were searched from inception to May 2021. Randomized controlled trails (RCT) about the influence of NMES of lower limbs in patients with mechanical ventilation in ICU were collected. Routine rehabilitation measures were implemented in the control group, while the combination of routine rehabilitation and NMES on the lower limbs was implemented in the observation group. The literature screening, data extracting, and bias risk assessment of included studies were conducted independently by two reviewers. RevMan 5.3 software was used to perform Meta-analysis. Funnel plot was used to test publication bias.Results:A total of 8 RCT were eventually enrolled. The literature quality evaluation results showed that 1 study was grade A and 7 studies were grade B, suggesting that the quality of the included literature was relatively high. The Meta-analysis results showed that NMES in the lower extremities could effectively shorten the duration of mechanical ventilation in ICU patients [standardized mean difference ( SMD) = -0.51, 95% confidence interval (95% CI) was -0.72 to -0.31, P < 0.000 01], increase the maximum inspiratory pressure [MIP; mean difference ( MD) = 14.19, 95% CI was 9.30 to 19.09, P < 0.000 01], and improve the functional status of critically ill patients [functional status score for ICU (FSS-ICU); MD = 10.44, 95% CI was 3.12 to 17.77, P = 0.005] with statistically significances. However, there were no significant advantages in increasing the Medical Research Council (MRC) score ( MD = 2.13, 95% CI was -1.38 to 5.63, P = 0.23), reducing ICU mortality [relative risk ( RR) = 0.80, 95% CI was 0.51 to 1.24, P = 0.31], shortening length of ICU stay ( MD = -0.54, 95% CI was -3.67 to 2.59, P = 0.74), and the combined effect was not statistically significant. Funnel plot based on the duration of mechanical ventilation showed that the distribution of included articles was basically symmetrical, and no publication bias was detected. Conclusions:NMES of the lower limbs can not only shorten the ventilation duration effectively, but also improve the MIP and functional status of mechanically ventilated patients in ICU. However, it has no significant effect on the MRC score, ICU mortality and length of ICU stay of patients with mechanical ventilation. In the future, high-quality, large sample size and multi-center RCT are needed to verify the effects of NMES.

Objective To explore the effects of empowerment education combined with family support in management of elderly patients with coronary artery disease combined with renal dysfunction.Methods A total of 100 patients with coronary artery disease combined with renal dysfunction from March 2013 to March 2014 were included and randomly divided into observation group (n =50)and control group (n =50).The same drug treatment was used in both groups,additionally,the routine health education was performed in control group and empowerment education combined with family support was adopted in observation group.The self-care ability, life quality,satisfaction and clinical related indicators were evaluated before interventions and 6 months after interventions.Results After 6 months,there were more patients with medication compliance (72.0%), regular exercise (70.0%),and returning visit on time (70.0%)in observation group than those in control group (P <0.05).The levels of serum creatinine,urea nitrogen and urine protein decreased in both groups, and they decreased more significantly in observation group.The scores of life quality (96.49 ±2.63)and satisfaction (9.09 ±0.88 ) were higher in observation group than those in control group (P <0.05 ). Conclusions The empowerment education combined with family support can improve self-care ability,life quality,satisfaction and clinical related indicators of elderly patients with coronary artery disease combined with renal dysfunction.

[ ABSTRACT] AIM:To investigate the protective effect of naringin ( Nar) on the injury of human umbilical vein endothelial cells ( HUVECs) induced by 33 mmol/L high glucose ( HG) and to explore its possible mechanisms.METH-ODS:The injury model was established by treating HUVECs with HG medium for the indicated time (6, 12, 24, 48 and 72 h) , and then the levels of NO, eNOS and p-eNOS were detected, respectively.The effects of Nar on high glucose-in-duced endothelial cell injury were observed.HUVECs were treated with Nar at concentrations of 5, 10, 25, 50 and 100 mg/L for 6 h, 12 h, 24 h, 36 h and 48 h.The levels of NO in the supernatants were measured.The effects of Nar on HG-injured HUVECs were explored by treating the cells with 10 μmol/L of LY294002, a PI3K inhibitor, or 0.5 μmol/L of AKT inhibitorⅣ, an AKT inhibitor, and then the levels of NO, PI3K, AKT, eNOS and their phosphorylated proteins were determined by Western blot.RESULTS:Nar at concentration of 50 mg/L significantly attenuated the injury of endothelial cells induced by high glucose ( P<0.01) , and the protective effects of Nar were abolished by pretreating with the inhibitor of PI3K or AKT (P<0.01).CONCLUSION: Nar protects endothelial cells against the injury induced by high glucose through PI3K/AKT/eNOS pathway.