Using big data and artificial intelligence to establish a multi-point monitoring, early warning, and disposal system to achieve early warning and intervention of infectious disease outbreaks is an important means of controlling the spread of the epidemic. Taking Xiaoshan district as an example, this study analyzes the monitoring contents, warning methods, and application effectiveness of the infectious disease monitoring, early warning and disposal system. Based on Xiaoshan′s health big data resources, the system starts with syndrome, disease diagnosis and etiology. Through advanced technologies such as artificial intelligence and block chain, it realizes early identification of infectious disease outbreaks, data fusion, multi-cross collaboration, and closed-loop management. It has improved the sensitivity of clustered outbreaks monitoring and the effectiveness of epidemic disposal and provided a reference for grassroots disease prevention and control departments to establish an infectious disease monitoring and early warning system.

Using big data and artificial intelligence to establish a multi-point monitoring, early warning, and disposal system to achieve early warning and intervention of infectious disease outbreaks is an important means of controlling the spread of the epidemic. Taking Xiaoshan district as an example, this study analyzes the monitoring contents, warning methods, and application effectiveness of the infectious disease monitoring, early warning and disposal system. Based on Xiaoshan′s health big data resources, the system starts with syndrome, disease diagnosis and etiology. Through advanced technologies such as artificial intelligence and block chain, it realizes early identification of infectious disease outbreaks, data fusion, multi-cross collaboration, and closed-loop management. It has improved the sensitivity of clustered outbreaks monitoring and the effectiveness of epidemic disposal and provided a reference for grassroots disease prevention and control departments to establish an infectious disease monitoring and early warning system.

Entinostat plus exemestane in hormone receptor-positive (HR+) advanced breast cancer (ABC) previously showed encouraging outcomes. This multicenter phase 3 trial evaluated the efficacy and safety of entinostat plus exemestane in Chinese patients with HR + ABC that relapsed/progressed after ≥1 endocrine therapy. Patients were randomized (2:1) to oral exemestane 25 mg/day plus entinostat (n = 235) or placebo (n = 119) 5 mg/week in 28-day cycles. The primary endpoint was the independent radiographic committee (IRC)-assessed progression-free survival (PFS). The median age was 52 (range, 28-75) years and 222 (62.7%) patients were postmenopausal. CDK4/6 inhibitors and fulvestrant were previously used in 23 (6.5%) and 92 (26.0%) patients, respectively. The baseline characteristics were comparable between the entinostat and placebo groups. The median PFS was 6.32 (95% CI, 5.30-9.11) and 3.72 (95% CI, 1.91-5.49) months in the entinostat and placebo groups (HR, 0.76; 95% CI, 0.58-0.98; P = 0.046), respectively. Grade ≥3 adverse events (AEs) occurred in 154 (65.5%) patients in the entinostat group versus 23 (19.3%) in the placebo group, and the most common grade ≥3 treatment-related AEs were neutropenia [103 (43.8%)], thrombocytopenia [20 (8.5%)], and leucopenia [15 (6.4%)]. Entinostat plus exemestane significantly improved PFS compared with exemestane, with generally manageable toxicities in HR + ABC (ClinicalTrials.gov #NCT03538171).

Thanks to the support of relevant national policies since 2018, Internet hospitals in China had developed rapidly. The authors sorted out the current situation of Internet hospital management and construction in China through policy document search and literature search, and found such loopholes as lack of unified supervision and process supervision, barriers between online and offline one-stop services, obsolete information interoperability and network security technology, and poor doctor-patient satisfaction and treatment efficiency. It is recommended to establish a provincial-level standardized supervision and evaluation system, explore an integrated online and offline medical service system, improve the hospital informationized operation guarantee system, promote the improvement of doctor-patient communication satisfaction system, and further promote the development of Internet hospitals in China.

Introduces the regulatory requirements of the Natural and Over-the-Counter Health Products Administration on the quality of natural health products, and adopts the literature research method to translate and interpret Health Canada's "Guidelines for the Quality of Natural Health Products" on the quality management and quality control of natural health products. Policy documents, from the perspective of stakeholders, provide requirements for the detection methods and standards of natural health products, such as characterization, identification experiments, component content, pollutants and impurity content detection, etc. To achieve natural health Quality management and quality control in the whole process of product production. Familiar with and understand the requirements for the quality management of natural health products in Canada will help to promote the legal and compliant management of product quality in the production process of Traditional Chinese Medicine (TCM) products after registration in Canada, and promote the production and sustainable development of TCM products. At the same time, it provides a reference for further improving my country's drug quality management system normative system documents, and assists the effective connection between the registration-related standards of Chinese patent medicines and international standards.

ObjectiveTo analyze the effect of O₃ pollution on outpatient visits for respiratory diseases in a district of Shanghai. MethodsWe collected the respiratory disease outpatient data， and atmospheric and meteorological data of from a suburban general hospital in Shanghai from 2015 to 2017. A time-series analysis by generalized additive model was conducted to examine the relationship between O₃ pollution and daily outpatient visits. ResultsThe daily outpatient volume for respiratory diseases was 831. The daily 8 h median concentration of O₃ was 101.04 μg·m^-3. The excess relative risk was 0.461% （95%CI： 0.240%‒0.682%） at lag3. Stratified by gender and age， females， child and the aged had higher risk of respiratory diseases. In the double-pollutant model， PM_2.5 and PM₁₀ increased health effects， while CO reduced health effects. ConclusionThe increase of O₃ concentration can increase the daily outpatient volume of respiratory diseases.

Objectives:To investigate the effect of resistance exercise(RE)on the dissolution of catheter-associated thrombus(CRT)and its possible mechanism.Methods:A total of 36 male SD rats were randomly divided into control group,CRT group,CRT+ RE group(n=12 in each group).Rats in the CRT group did not receive any intervention,while rats in the CRT+RE group received RE intervention 10 days after modeling for 28 days.The thrombolysis rate was evaluated by Hematoxylin-Eosin staining.The contents of irisin,interleukin(IL)-6 and IL-10 in serum were detected by ELISA.The relative mRNA expression levels of peroxisome proliferator-activated receptor γ coactivator α(PGC-1α)and fibronectin type Ⅲ domain-containing 5(FNDC5)in gastrocnemius were detected by real-time quantitative PCR(qPCR).Results:There was no thrombosis in control group.Compared with control group,the contents of irisin and IL-10 in CRT group were significantly decreased,while the content of IL-6 in CRT rats was significantly increased(all P<0.01).Thrombolysis rate was significantly higher,and the mRNA expressions of PGC-1α and FNDC5 in gastrocnemius were significantly upregulated in CRT+RE group than in CRT group(all P<0.01).Serum irisin,IL-10 contents were significantly increased,IL-6 content was significantly lower in CRT+RE group than in CRT group(all P<0.01).Conclusions:Resistance exercise for 28 days could promote the dissolution of CRT,which may be related to the up-regulation of irisin expression and the inhibition of inflammation.

Objective To evaluate the impact of overall burden of cerebral small vessel disease(CSVD)combined with intracranial large artery atherosclerosis(ICAS)on cognitive function in very old patients.Methods A total of 178 advanced elderly patients admitted to Department of General Medicine of Wuhan Central Hospital between January 2013 and December 2022 were re-cruited in this retrospective study.According to the results of Montreal Cognitive Assessment Scale,they were divided into dementia group(n=83)and non-dementia group(n=95).All pa-tients underwent brain MRI imaging,MRI susceptibility weighted imaging and cerebral angiogra-phy.Based on these imaging findings of MRI,the effect of total burden score of CSVD and athero-sclerosis on cognition were evaluated.The volumes of 14 different gyri in the left and right brain were measured in the patients with CSVD burden score ≤2 and those ≥3.Results There were significantly more patients with numbers of microbleeding foci＞10 and lacunar foci ≥5 in the dementia group than the non-dementia group(P＜0.01).But,no statistical difference was seen in intracranial and extracranial arterial stenosis between the two groups(P＞0.05).The volumes of left and right anterior cingulate gyrus,left and right paracingulate cortex,right hippocampus,left parahippocampal gyrus,right transverse temporal gyrus and left inferior temporal gyrus were no-tably smaller in the CSVD score ≥3 group than the CSVD ≤2 group(1723.444 vs 1867.167,1590.167 vs 1595.670,1481.466 vs 1509.540,1543.831 vs 1585.505,1038.345 vs 1305.831,1220.525 vs 1392.352,P＜0.05).Conclusion Cognitive function in the advanced elderly is mainly affected by the burden of CSVD,and atherosclerotic stenosis of large arteries is not the main fac-tor affecting cognitive function.The total burden of CSVD is correlated with atrophy of some gyri.

Purpose: Neoadjuvant therapy modality can increase the operability rate and mitigate pathological risks in locally advanced cervical cancer, but treatment response varies widely. It remains unclear whether genetic alterations correlate with the response to neoadjuvant therapy and disease-free survival (DFS) in locally advanced cervical cancer. Materials and Methods: A total of 62 locally advanced cervical cancer (stage IB-IIA) patients who received neoadjuvant chemoradiation plus radical hysterectomy were retrospectively analyzed. Patients’ tumor biopsy samples were comprehensively profiled using targeted next generation sequencing. Pathologic response to neoadjuvant treatment and DFS were evaluated against the association with genomic traits. Results: Genetic alterations of PIK3CA were most frequent (37%), comparable to that of Caucasian populations from The Cancer Genome Atlas. The mutation frequency of genes including TERT, POLD1, NOS2, and FGFR3 was significantly higher in Chinese patients whereas RPTOR, EGFR, and TP53 were underrepresented in comparison to Caucasians. Germline mutations were identified in 21% (13/62) of the cohort and more than half (57%) had mutations in DNA damage repair genes, including BRCA1/2, TP53 and PALB2. Importantly, high tumor mutation burden, TP53 polymorphism (rs1042522), and KEAP1 mutations were found to be associated with poor pathologic response to neoadjuvant chemoradiation treatment. KEAP1 mutations, PIK3CA-SOX2 co-amplification, TERC copy number gain, and TYMS polymorphism correlated with an increased risk of disease relapse. Conclusion We report the genomic profile of locally advanced cervical cancer patients and the distinction between Asian and Caucasian cohorts. Our findings highlight genomic traits associated with unfavorable neoadjuvant chemoradiation response and a higher risk of early disease recurrence.

ObjectiveTo investigate the effect of Loki Zupa on airway remodeling in asthma based on ultra-performance liquid chromatography-tandem mass spectrometry（UPLC-MS）combined with network pharmacology and experimental verification. MethodThe chemical constituents in Loki Zupa were identified by UPLC-MS. The potential active constituents of Loki Zupa were screened out based on literature retrieval， oral availability （OB） and drug-likeness （DL） in the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform（TCMSP） and Lipinski's rule of five in SwissADEM. The constituent targets of Loki Zupa were obtained through the SwissTargetPrediction. The relevant targets of airway remodeling in asthma were screened out from Online Mendelian Inheritance in Man（OMIM）， GeneCards， DrugBank， and DisGeNET. The STRING was used to conduct protein-protein interaction （PPI） among the main targets. Gene Ontology （GO） and Kyoto Encyclopedia of Genes and Genomes（KEGG） pathway enrichment analyses were carried out through DAVID. Finally， an asthmatic airway remodeling model was induced by ovalbumin （OVA） in mice， followed by hematoxylin and eosin（HE）， periodic acid Schiff（PAS）， and Masson staining for the observation of the pathological conditions of lung tissues. The inflammatory cells in the bronchoalveolar lavage fluid（BALF） of mice were detected. The protein expression levels in mouse lung tissues were detected by Western blot and key signaling pathways were further determined. ResultEighty-two constituents were detected in the negative ion mode and 74 in the positive ion mode by UPLC-MS. Thirty-six candidate constituents and 578 predicted targets of Loki Zupa were screened out through network pharmacology， and 173 common targets with airway remodeling in asthma were obtained， including key compounds such as sebacic acid， pectolinarigenin， naringenin， apigenin， and potential targets such as protein kinase B1（Akt）1 and hypoxia-inducible factor 1α（HIF-1α）. As predicted by KEGG enrichment analysis， Loki Zupa mainly exerted the effect against airway remodeling in asthma through phosphatidylinositol 3-kinase （PI3K）/Akt， HIF-1α， mitogen-activated protein kinase （MAPK）， and other signaling pathways. Animal experiments showed that the compound formula of Loki Zupa could reduce the proliferation of airway goblet cells in asthmatic mice， improve the deposition of collagen under the airway epithelium， and decrease the up-regulated relative expression levels of phosphorylate（p）-Akt/Akt and HIF-1α by OVA sensitization in mice （P<0.05， P<0.01）， which was consistent with the results of network pharmacology. ConclusionUPLC-MS combined with network pharmacology was used to preliminarily clarify the chemical composition of Loki Zupa and its underlying mechanism in intervention in airway remodeling in asthma. Specifically， Loki Zupa presumably synergistically intervened in airway remodeling in asthma through key targets represented by Akt1 and HIF-1α， and multiple pathways represented by the PI3K/Akt and HIF-lα pathways， which is expected to provide ideas for further research on Loki Zupa.