OBJECTIVE To establish standardized operating procedures,result interpretation guidelines,and clinical application protocols for dust mite-nasal allergen challenge(NAC),and to systematically evaluate its operational reliability and safety.METHODS Patients with positive serum-specific IgE(sIgE)against mites and healthy controls were enrolled between January 2023 and December 2024.Demographic and clinical information was systematically collected.A standardized mite allergen extract was utilized to prepare the challenge solution for all participants.Bilateral synchronous nasal spray challenges were conducted using progressively increasing concentrations(1 000,3 000,10 000,and 30 000 BU/ml).During the challenge,total nasal symptom scores,visual analogue scale,acoustic rhinometry,active anterior rhinomanometry,and four-phase rhinomanometry were assessed,and all evaluation data and diagnostic outcomes were documented accordingly.RESULTS Compared to the baseline measurements,both subjective symptom scores and objective evaluation indicators in patients demonstrated statistically significant changes following NAC(P≤0.001).Among these patients,40 individuals(81.6%)exhibited a positive response to the dust mite-NAC.All healthy control subjects showed negative results in the test.CONCLUSION This study established standardized operating procedures and clinical application guidelines for the dust mite-NAC.These encompass indications,contraindications,preparation of stimulation solutions,procedural steps,operational standards,criteria for positive results,and pre-/post-examination precautions,thereby providing a clinically actionable framework for dust mite-NAC implementation.

Objective Based on the national drug sampling inspection program,this study aims to comprehensively and systematically evaluate the quality of Xuanmai Ganjie preparations,analyze existing quality issues,and provide references and suggestions for quality control of this variety.Methods A total of 237 batches of Xuanmai Ganjie preparations were tested using legal standards,and methods were established for detecting adulteration of Ophiopogon japonicus with counterfeit varieties,paclobutrazol residue levels,and determining the content of platycodin D in Xuanmai Ganjie preparations.These methods were applied to the quality control and evaluation of Xuanmai Ganjie preparations.Results Through statutory inspection,one batch of Xuanmai Ganjie granules was found non-compliant.Specific batches were identified to contain the following irregularities:adulteration of Ophiopogon japonicus with counterfeit varieties,paclobutrazol residue levels exceeding proposed limits,and platycodin D content below the established threshold.Conclusion The overall quality of Xuanmai Ganjie granules was average,while the overall quality of Xuanmai Ganjie capsules and lozenges was relatively good.Manufacturing enterprises should strengthen their sense of primary responsibility and enhance control over the entire drug production process.

Objective:To explore the potential profile characteristics and influencing factors of rehabilitation motivation in elderly patients with first stroke, so as to provide reference for promoting precise rehabilitation mode.Methods:A convenience sampling method was employed to conduct a cross-sectional survey of elderly patients with first stroke admitted to the Huanhu Hospital Affiliated to Tianjin Medical University from October 2024 to March 2025. The survey utilized a general information questionnaire, the Motivation in Stroke Patients for Rehabilitation Scale, the Perceived Social Support Scale (PSSS), the Exercise Adherence Questionnaire (EAQ), and the Stroke Stigma Scale (SSS). Potential categories of rehabilitation motivation among elderly patients with first stroke were identified using latent profile analysis, and the influencing factors of these potential categories were explored using the ordered multinomial Logistic regression.Results:A total of 290 survey questionnaires were distributed, and 281 valid questionnaires were collected, with an effective response rate of 96.9%(281/290). Among 281 elderly patients with first stroke, there were 152 males and 129 females, with an age of (68.68 ± 6.89) years. The score of the Motivation in Stroke Patients for Rehabilitation Scale was 56.00 (36.00, 68.00) points. Rehabilitation motivation among elderly patients with first stroke could be categorized into three groups: low motivation-lack of family support and unclear goals group (44.1%, 124/281), moderate motivation-social reintegration driven but insufficient behavior group (41.3%, 116/281), and high motivation autonomous planning adaptation and value internalization group (14.6%, 41/281). The ordered multinomial Logistic regression analysis showed that compared to patients aged ≥80 years, patients aged 60-69 years were less likely to belong to the high motivation autonomous planning adaptation and value internalization group ( OR=0.231, P<0.05). Compared to patients with a per capita monthly income of ≥5 001 yuan, patients with a per capita monthly income of 3 001-5 000 yuan were more likely to belong to the high motivation autonomous planning adaptation and value internalization group ( OR=2.340, P<0.05). Compared to heavily dependent patients, patients who were completely independent ( OR=0.160, P<0.05), mildly dependent ( OR=0.155, P<0.01), and moderately dependent ( OR=0.211, P<0.05) were less likely to belong to the high motivation autonomous planning adaptation and value internalization group. The higher the EAQ score, the more likely patients were to belong to the high motivation autonomous planning adaptation and value internalization group ( OR=1.139, P<0.01). The higher the PSSS score, the more likely patients were to belong to the high motivation autonomous planning adaptation and value internalization group ( OR=1.108, P<0.01). The higher the SSS score, the less likely patients were to belong to the high motivation autonomous planning adaptation and value internalization group ( OR=0.787, P<0.01). Conclusions:Healthcare professionals can develop targeted intervention strategies based on the characteristics and influencing factors of patients' different rehabilitation motivations, thereby enhancing their rehabilitation motivation and promoting patient recovery.

Objective:To explore the potential categories of internal ability of elderly patients with ischemic stroke, identify the influencing factors and propose corresponding nursing interventions.Methods:This was a cross-sectional study. From January 2025 to May 2025, the elderly patients with ischemic stroke in Tianjin Huanhu Hospital were selected by convenient sampling method. The general information questionnaire, the Internal Capacity Assessment Scale for the Older People, the Health Literacy Scale for stroke patients and the Perceived Social Support Scale were used to investigate. To determine latent categories of patients' intrinsic capacity, potential profile analysis was employed. Subsequently, multivariable Logistic regression examined factors associated with these categories.Results:A total of 260 survey questionnaires were distributed, and 256 valid questionnaires were finally collected, with an effective response rate of 98.46% (256/260). Among of them, there were 166 males and 90 females, aged 68.00 (63.00, 74.00) years.The intrinsic ability of elderly patients with ischemic stroke could be divided into three potential categories: low sensation-low exercise group (27.0%, 69/256), relatively stable intrinsic ability group (37.5%, 96/256) and low cognition-low psychology group (35.5%, 91/256). Multivariable Logistic regression showed that advanced age (compared to the low sensation-low exercise group, OR=0.902; compared to the relatively stable intrinsic ability group, OR=0.813), smoking (compared to the low sensation-low exercise group, OR=0.459; compared to the relatively stable intrinsic ability group, OR=0.442), the lower the Barthel index (compared to the low sensation-low exercise group, ≤40 points with OR=0.157; 41-60 points with OR=0.285) were more likely to enter the low cognition-low psychology group (all P<0.05); other chronic disease types ≤1 (compared to the low cognition-low psychology group, OR=2.630), higher health literacy scores (compared to the low cognition-low psychology group, OR=1.033) were more likely to enter the relatively stable intrinsic ability group (both P<0.05); and stroke frequency was the first occurrence (compared to the low cognition-low psychology group, OR=2.725) was more likely to enter the low sensation-low exercise group ( P<0.05). Conclusions:In older adults with ischemic stroke, the characteristics of intrinsic ability are clearly categorized. To enhance patient outcomes, healthcare professionals are advised to tailor nursing interventions based on the unique features and specific influencing factors associated with each potential category.

Objective This research aims to establish a scientific research performance evaluation indicator system for public hospital staff,providing evaluation standards and assessment criteria for their research performances.Methods An indica-tor pool was developed through literature review.The indicators were determined through two rounds of Delphi expert consultations.Analytic Hierarchy Process(AHP)was used to calculate their weights and thus establish an indicator system.Results The indica-tor system consists of 8 primary indicators-research projects(0.193 3),talent cultivation(0.264 3),patents(0.046 2),publica-tions(0.118 5),monographs(0.068 1),awards(0.147 2),standards(0.094 3),and research errors(0.068 1)-encompassing 29 secondary indicators.The response rate of the second-round expert consultation was 0.85;the authority coefficient was 0.94;the importance rating of indicators was 4.44,and Kendall's coefficient was 0.260(P＜0.05).The consistency index(CI)and consistency ratio(CR)values were＜0.1,indicating good results.Conclusion The indicator system demonstrates scientifically good validity and feasibility.Thus it can be used to evaluate the research performances of public hospital staff,providing decision support for resource allocation and the optimization of incentive mechanisms.

Objective To investigate the mechanisms by which miR-23 regulates the PI3K/AKT/mTOR signaling pathway to influence myocardial remodeling,fibrosis,and angiogenesis in hypertensive heart failure(HF)rats.Methods Forty rats were randomly divided into four groups(n=10 per group):a control group,a model group,an antagomir-NC group,and an antagomir-23 group.The HF model was established using a high-salt diet,and intervention was performed via tail vein injection of antagomir-23.Cardiac function parameters,the degree of myocardial fibrosis,cell apoptosis levels,and the expression of angiogenesis-related proteins including CD31,VEGF,and bFGF were measured in each group.Concurrently,the activity of the PI3K/AKT/mTOR signaling pathway was assessed.A dual-luciferase reporter assay was conducted to confirm that miR-23 targets PI3K.Results Inhibition of miR-23 significantly improved cardiac function in hypertensive HF rats,reduced myocardial fibrosis and apoptosis,and enhanced the expression of CD31,VEGF,bFGF,and activated the PI3K/AKT/mTOR signaling pathway in hypertensive HF rats(all P<0.05).The dual-luciferase assay confirmed that miR-23 negatively regulates PI3K expression.Conclusion Inhibition of miR-23 can activate the PI3K/AKT/mTOR signaling pathway,promote angiogenesis,reduce myocardial damage,thereby delaying the progression of hypertensive heart failure.

Insomnia is a prevalent disorder characterized by difficulties in falling asleep or maintaining sleep.Chronic insomnia can severely impair physical and mental health,as well as quality of life.The traditional Chinese medicine(TCM)theory,"all the eleven zang organs depend on the gallbladder,"is derived from the chapter of Discussion on Six-Plus-Six System and the Manifestations of Organs of Plain Questions.It highlights the pivotal role of the gallbladder in maintaining visceral function.The gallbladder governs decision-making and plays a central role in sleep regulation by modulating spleen-stomach transportation and transformation,dispersing qi movement throughout the body,harmonizing yin and yang,and modulating ying and wei systems.Research has demonstrated that bile acids correspond closely with the gallbladder's TCM functions of"governing the earth zang"and"regulating the eleven zang organs,"serving as a crucial material basis for gallbladder physiology.Dysregulation of bile acid metabolism may contribute to insomnia through multiple pathways,including gastrointestinal dysfunction,disruption of gut microbiota balance,induction of neuroinflammation,and circadian rhythm disturbances.This study proposes that bile acid metabolism disorder may constitute a key pathological mechanism linking gallbladder dysfunction—according to TCM theory—to insomnia.Based on clinical experience,novel therapeutic strategies are proposed under the framework of"regulating the gallbladder to tranquilize mind",including the use of gallbladder-related materials,prioritized application of liver-regulating herbs,and implementation of a sleep rhythm reconstruction protocol.

Objective To explore the value of ultrasound intelligent diagnostic system combined with mammography for differentiating benign and malignant non-mass breast lesions(NMBL).Methods Totally 107 patients with NMBL were retrospectively enrolled,including 64 cases of malignant(malignant group)and 43 cases of benign lesions(benign group).Clinical,routine ultrasound,ultrasound intelligent diagnostic system(artificial intelligence[AI]system)and mammography data were compared between groups.Logistic regression analysis was performed,receiver operating characteristic(ROC)curves were drawn,the areas under the curves(AUC)were calculated,and the efficacy of AI system combined with mammography for differentiating benign and malignant NMBL was analyzed.Results Significant differences of the maximum diameter of lesion,ratio of axillary lymph node enlargement and suspected malignant calcification on mammography,as well as of AI system malignancy risk and AI system breast imaging reporting and data system(BI-RADS)classification were found between groups(all P＜0.05).AI system binary classification was obtained based on AI system malignancy risk.The AUC of suspected malignant calcification on mammography,AI system BI-RADS classification and AI system binary classification for differential diagnosis of benign and malignant NMBL was 0.840,0.810 and 0.817,respectively,while of suspected malignant calcification on mammography combined with AI system BI-RADS classification or AI system binary classification were both 0.856,higher than that of AI system BI-RADS classification/AI system binary classification alone(both P＜0.05)but not significantly different with that of suspected malignant calcification on mammography alone(both P＞0.05).Logistic regression analysis of age,the maximum diameter of lesion,axillary lymph node enlargement and suspected malignant calcification on mammography combined with AI system malignancy risk(model 1),AI system BI-RADS classification(model 2)or AI system binary classification(model 3)showed that suspected malignant calcification on mammography,AI system malignancy risk,AI system BI-RADS classification and AI system binary classification were all independent risk factors of malignant NMBL(all P＜0.05),and AUC of model 1,2 and 3 for differentiating benign and malignant NMBL was 0.966,0.964 and 0.957,respectively.Conclusion Ultrasound intelligent diagnostic system combined with mammography was helpful for differentiating benign and malignant NMBL.Combining with clinical indicators might improve diagnostic efficacy.

Objective:To investigate the epidemiological characteristics of allergic rhinitis (AR) among adults in Yinchuan, focusing on its prevalence and associated risk factors in recent years.Methods:A cross-sectional epidemiological survey was conducted among adult residents in Yinchuan from June to October 2022, including three districts, two counties, and one city, to identify and analyze factors influencing the incidence of AR in the population.Results:A total of 3 345 individuals were surveyed, including 1 891 males (56.5%) and 1 454 females (43.5%). The overall AR prevalence was 17.2% (576/3 345). The self-reported prevalence was 16.2% (306/1 891) in males and 18.6% (270/1 454) in females, with no statistically significant difference ( χ2=3.29, P=0.07). The prevalence was significantly lower among the elderly (aged over 60 years) at 11.8% (60/509) compared to the middle-aged (aged 40-59 years) at 17.1% (202/1 183) and young adults (aged 18-39 years) at 19.0% (314/1 653, χ2=10.36, P=0.023). Han nationality had the highest self-reported prevalence (18.8%, 446/2 372), followed by other ethnic minorities (17.6%, 13/74), and Hui nationality (13.0%, 117/899; χ2=11.21, P=0.004). Regionally, Xingqing District had the highest self-reported prevalence at (19.5%, 188/964), followed by Jinfeng District (18.7%, 151/808), Lingwu City (17.5%, 58/332), Xixia District (14.9%, 78/522), Yongning County (14.3%, 49/342), and Helan County (13.8%, 52/377; χ2=35.68, P=0.038). In terms of disease severity, mild cases made up 55.4% (319/576), while moderate to severe cases constituted 44.6% (257/576). In terms of symptom characteristics, perennial AR patients accounted for 18.8% (108/576), seasonal AR patients accounted for 81.2% (468/576), and 25.7% (148/576) of self-reported AR patients had other allergic diseases. Regarding diagnosis and treatment, 38.7% (223/576) of patients underwent allergen tests, 65.1% (375/576) received medication, but 62.3% (359/576) reported symptoms persisting for 2-year post-treatment, 32.6% (188/576) reported uncontrolled symptoms, and 5% (29/576) experienced symptoms worsening. Conclusions:The study provides a preliminary understanding of the epidemiological characteristics of AR in Yinchuan. These findings provide a reference for formulating relevant public health policies, clarifying prevention and treatment strategies, and improving the prevention and control system for AR.

Objective:To construct an infectious clone of a Chinese HIV-1 CRF01_AE epidemic strain with strong replication capacity，and comprehensively identify its viral phenotype and replication capacity.Methods:Using the CRF01_AE clinical isolate GX2005002，which was previously isolated from whole blood of an HIV-1-infected individual in China by our laboratory，as the parental strain，the full-length genome of the virus（9.7 kb）was divided into 5' half fragment（5.1 kb）and 3' half fragment（4.6 kb）for amplification. The proviral DNA was used as a template to amplify the virus genome，which was then ligated into the eukaryotic expression vector pEASY-T1. The consistency of its sequence with the parental strain sequence was identified through full-length genome sequencing and phylogenetic analysis. The replication capacity，syncytium inducibility，and cell tropism were experimentally identified to determine its phenotypic consistency with the parental strain.Results:An infectious clone of the CRF01_AE strain was successfully constructed，and its genome sequence exhibited high consistency with the sequence of the parental strain. By transfecting target cells，a derivative virus with infectious activity and replication capability was successfully rescued. The derived virus maintained phenotypic characteristics consistent with the parental strain，such as cell tropism and syncytium inducibility.Conclusion:This study successfully constructed an infectious clone of a Chinese HIV-1 CRF01_AE epidemic strain with clear background and distinct phenotype. The genomic sequence and viral phenotypic characteristics of the derived virus are basically consistent with the parental strain，providing strong representation of the original isolate and serving as a powerful tool for research on the correlation between the genetic characteristics，viral phenotype，and pathogenicity of HIV-1 CRF01_AE strains.