Objective To explore the visiting behavior and health management strategy of patients with cardiovascular disease (CVD) and the industry management strategies under the family doctor contract service model. Methods A total of 351 patients with CVD from January 2022 to January 2025 were included in the case investigation by random sampling. Taking the number of visits in community health service institutions/total number of visits ≥90% as high compliance, the influencing factors of the visiting behavior of CVD patients were analyzed. Results Finally, 344 valid questionnaires were collected, with an effective recovery rate of 98.01%. The study subjects were categorized into high compliance group (271 cases) and low compliance group (73 cases). The scores of policy cognition understanding, institutional trust and medical service understanding in the high compliance group were higher compared with those in the low compliance group (P<0.05). There was no significant difference in the understanding of medical expenses between the two groups (P>0.05). Multivariate logistic regression model analysis revealed that CVD duration [OR (95% CI): 1.72 (1.21-2.44)], policy cognition understanding [OR (95% CI): 2.16 (1.20-3.89)] and institutional trust [OR (95% CI): 1.88 (1.08-3.25)] were independently associated with medical treatment behavior in CVD patients (P<0.05). Conclusion Enhancing the policy cognition understanding and institutional trust of CVD patients on family doctor contract service can promote patients to seek medical treatment and promote the high-quality development of family doctor contract service.

To improve the consistency of outcome documentation and address the potential for outcome reporting bias in clinical trials involving integrative Chinese and Western medicine (ICWM) for ulcerative colitis (UC), we aim to develop a customized core outcome set (COS) that incorporates input from various stakeholders. The study design of this COS has been informed by the Core Outcome Measures in Effectiveness Trials Initiative Handbook, with adherence to the guidelines from the Core Outcome Set-STAndards for Reporting statement and Core Outcome Set-STAndardised Protocol Items recommendations. Five groups of stakeholders will be invited to participate in the development of COS for clinical trials with ICWM for UC, including healthcare professionals, patients, COS developers, COS users, and methodologists. The process will involve five stages: (1) conducting a systematic review of outcomes reported in clinical trials and protocols to develop a list of potential outcome domains; (2) conducting semi-structured interviews to obtain important outcomes; (3) choosing the most important outcomes by conducting three-round Delphi surveys; (4) achieving a consensus in a face-to-face meeting to discuss the final COS; and (5) publication, dissemination and implementation of COS. Consequently, this specialized COS will be applicable to clinical trials involving both traditional Chinese medicine (TCM) and ICWM interventions. Please cite this article as: Zhang X, Zhang L, Wang J, Lau CT, Wang N, Zhang X, Wang P, Li J, Han F, Bian Z. A protocol for developing, disseminating and implementing a core outcome set for clinical trials of integrative Chinese and Western medicine for ulcerative colitis. J Integr Med. 2025; 23(6):654-659.
Colitis, Ulcerative/therapy* ; Humans ; Medicine, Chinese Traditional ; Clinical Trials as Topic ; Integrative Medicine ; Research Design ; Outcome Assessment, Health Care ; Delphi Technique

Objective To analyze the phenotypic characteristics of albinism and their correlations. Methods Literatures related to albinism in PubMed database before June 10, 2023 were obtained, and phenotypic entities were extracted from their abstract texts to construct a phenotypic co-occurrence network. GePhi and VOSviewer software were used to analyze the overall characteristics and phenotypic clustering of the network. The Apriori algorithm was used to mine the association rules between phenotypes. The AA index was used for link prediction, predicting possible combinations of albino phenotypes. Results The phenotypic co-occurrence network of albinism had a small-world characteristic, and nystagmus, hypopigmentation of skin and foveal dysplasia of retina were the main phenotypes. Phenotypic abnormalities of albinism were mainly divided into five categories, including visual system abnormalities, immune system abnormalities, skin and hair system abnormalities, nervous system abnormalities, and respiratory as well as digestive system abnormalities. A variety of ocular abnormalities were associated with nystagmus. The combination of abnormal phenotypes that may occur in albinism included pneumonia with hypopigmentation of the skin, foveal dysplasia of the retina and atrophy of the optic nerve. Conclusion Predicting and analyzing the phenotypic characteristics of albinism and the associative patterns among phenotypes, as well as the potential co-occurrence of phenotypes in albinism patients can provide valuable references for identifying research directions for albinism and for the recognition, diagnosis, and prediction of albinism development.

This study was aimed at analyzing the clinical and laboratory characteristics of patients with Listeria monocyto-genes bacteremia,to provide evidence for its diagnosis and treatment.A retrospective analysis was conducted on the clinical data for patients with L.monocytogenes bacteremia at Tangdu Hospital between September 2012 and April 2022.The data included age,sex,underlying diseases,treatments,and prognosis.Changes in indicators such as white blood cell(WBC)count,mono-cyte percentage,neutrophil percentage,monocyte/neutrophil ratio(M/N),C-reactive protein(CRP),and procalcitonin before and after treatment were statistically analyzed.Among the 32 patients with L.monocytogenes bacteremia,the average age was 31.9 years,and three patients were older than 65 years.The incidence rate was highest in summer(11 patients,34.4％),fol-lowed by spring(9 patients,28.1％).A total of 24 patients(75.0％)had underlying diseases.After accurate diagnosis,the treatment plans of 29 patients were adjusted to target antibacterial therapy consisting primarily of penicillins(17 patients,53.1％)and carbapenems(12 patients,37.5％).After treatment,the levels of neutrophils,lymphocytes,and CRP were signifi-cantly lower than those before treatment(P＜0.05).A total of 29 patients(90.6％)improved and were discharged,one patient died,and two patients had poor prognosis.The primary risk factors for L.monocytogenes infection were autoimmune diseases,tumors,and pregnancy.Penicillin was the first choice effective empirical treatment for listeriosis.A clear diagnosis of the pathogen and appropriate choice of antibiotics were particularly important for the treatment of L.monocytogenes infection.

Humans ; Consensus ; Hypersensitivity ; Desensitization, Immunologic/adverse effects* ; Immunotherapy/adverse effects* ; Injections, Subcutaneous ; Allergens

ObjectiveTo analyze the online public Q&A texts on HPV vaccine， focus on the important issues related to HPV vaccination and cervical cancer prevention in China， and propose strategies and suggestions. MethodsThe latent Dirichlet allocation （LDA） topic model was employed to extract key topics of 15 565 Q&A texts related to HPV vaccines from the social Q&A platform "Zhihu". The Baidu AI sentiment analysis tool was used to analyze the emotional tendencies of the texts corresponding to each topic， and the topics were classified based on the strategic coordinate method. ResultsOnline users focused on eight topics about HPV vaccine information. Among them， vaccination knowledge， HPV vaccination hesitation， and HPV vaccine development and marketing belonged to the low positivity-high negativity emotional topics， HPV infection and high-risk factors belonged to the low positivity-low negativity emotional topics， and HPV vaccine appointment channels， comparison between domestic and imported vaccines， HPV vaccines and cervical cancer prevention， and HPV vaccine types and selection were grouped under high positivity-low negativity emotional topics. ConclusionPublic concerns regarding HPV vaccines can be classified into three major dimensions： health knowledge， health beliefs， and health behaviors. Overall， the public's views and attitudes towards vaccine-related issues are not optimistic. Strengthening science publicity and education， enhancing vaccine supervision， and encouraging enterprises’ innovative research and development capability are effective strategies to improve public awareness of cervical cancer prevention and accelerate the full HPV vaccination coverage.

Objective Dexmedetomidine is a highly selective alpha-2 adrenergic receptor agonist with sedative and analgesic properties but without respiratory depression effect and has been widely used in perioperative anesthesia. Here we performed a systematic review and meta-analysis to evaluate the effect of dexmedetomidine on maintaining perioperative hemodynamic stability in elderly patients.Methods PubMed, Web of Science, the Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang Data were searched for randomized-controlled trials (RCTs) on the application of dexmedetomidine in maintaining perioperative hemodynamic stability in elderly patients from their inception to September, 2021. The standardized mean differences (SMD) with 95% confidence interval (CI) were employed to analyze the data. The random-effect model was used for the potential clinical inconsistency.Results A total of 12 RCTs with 833 elderly patients (dexmedetomidine group, 546 patients; control group, 287 patients) were included. There was no significant increase in perioperative heart rate (HR), mean arterial pressure (MAP), and diastolic blood pressure (DBP) in the dexmedetomidine group before and during the operation. In addition, the variations of hemodynamic indexes including HR, MAP, SBP (systolic blood pressure), and DBP were significantly lower in the dexmedetomidine group compared with the control group (HR: SMD = -0.87, 95% CI: -1.13 to -0.62; MAP: SMD = -1.12, 95% CI: -1.60 to -0.63; SBP: SMD = -1.27, 95% CI: -2.26 to -0.27; DBP: SMD = -0.96, 95% CI: -1.33 to -0.59). Subgroup analysis found that with the prolongation of 1.0 μg/kg dexmedetomidine infusion, the patient's heart rate declined in a time-dependent way.Conclusion Dexmedetomidine provides more stable hemodynamics during perioperative period in elderly patients. However, further well-conducted trials are required to assess the effective and safer doses of dexmedetomidine in elderly patients.
Humans ; Aged ; Dexmedetomidine/adverse effects* ; Hemodynamics ; Hypnotics and Sedatives/pharmacology* ; Blood Pressure ; Heart Rate

OBJECTIVE: To evaluate the safety and efficacy of catheter-directed thrombolysis (CDT) versus systemic thrombolysis (ST) in the treatment of pulmonary embolism (PE). METHODS: The Cochrane Library, PubMed, and Embase databases were searched to collect the literature on the comparison of the results of CDT and ST in the treatment of PE from the beginning of their records to May 2020, and meta-analysis was performed by STATA software (version 15.1). Using standardized data-collection forms, the authors screened the studies and independently extracted data, and assessed the quality of the studies using the Newcastle-Ottawa Scale for cohort studies. Cohort studies that examined the following results were included in the current study: in-hospital mortality, all-cause bleeding rate, gastrointestinal bleeding rate, intracranial hemorrhage rate, the incidence of shock, and hospital length of stay. RESULTS: A total of eight articles, with 13,242 participants, involving 3962 participants in the CDT group and 9280 participants in the ST group were included. CDT compared with ST in the treatment of PE can significantly affect in-hospital mortality rate [odds ratio (OR) = 0.41, 95% CI: 0.30-0.56, P < 0.05], all-cause bleeding rate (OR = 1.20, 95% CI: 1.04-1.39, P = 0.012), gastrointestinal bleeding rate (OR = 1.43, 95% CI: 1.13-1.81, P = 0.003), the incidence of shock (OR = 0.46, 95% CI: 0.37-0.57, P < 0.05), and hospital length of stay [standard mean difference (SMD) = 0.16, 95% CI: 0.07-0.25, P < 0.05]. However, there was no significant effect on intracranial hemorrhage rate in patients with PE (OR = 0.70, 95% CI: 0.47-1.03, P = 0.070). CONCLUSIONS CDT is a viable alternative to ST in the treatment of PE, as it can significantly reduce in-hospital mortality rate, all-cause bleeding rate, gastrointestinal bleeding rate, and incidence of shock. However, CDT may prolong hospital length of stay to a certain extent. Further research is needed to evaluate the safety and efficacy of CDT and ST in the treatment of acute PE and other clinical outcomes.

Background: The stem of Syringa pinnatifolia is used as traditional Mongolian medicine for the treatment of cardiopulmonary diseases, in which sesquiterpenes are regarded as the primary medicinal compounds. However, only S. pinnatifolia from natural stands is able to produce medicinal-grade stems when compared with that from cultivated stands. Despite the need to develop an effective technique to promote sesquiterpene accumulation in cultivated stands to ensure sustainable resource production, studies on the potential use of fungal endophytes as fungal elicitors were limited. Objective: This study explored the potential of selected endophytic fungi isolated from the stems of wild and cultivated S. pinnatifolia and further examined their efficacy in promoting sesquiterpene production in S. pinnatifolia calli. Results: Among the 11 fungal groups, Valsa sp, isolated from wild S. pinnatifolia, emerged as a promising fungal elicitor for promoting sesquiterpene accumulation in S. pinnatifolia. This conclusion is drawn from the production of a humulane-type sesquiterpene, known to be one of the most prevalent subtypes of sesquiterpenes in S. pinnatifolia. In addition, it was demonstrated that methyl jasmonate and salicylic acid displayed little effect on sesquiterpene accumulation in S. pinnatifolia. Conclusions: The findings of this study lay a foundation for using fungal endophytes to promote sesquiterpene production in S. pinnatifolia. This contribution could subsequently advance the development of the local traditional medicine industry and aid in the protection of wild S. pinnatifolia.

Blood loss and blood transfusion requirement are important quality control indicators of cardiovascular surgery and cardiovascular anesthesia. Patient blood management (PBM) is an evidence-based, multidisciplinary approach to optimizing the care of patients who may need transfusion, which encompasses anemia management, hemodilution, cell salvage, hemostatic treatment, and other approaches to reducing bleeding and minimizing blood transfusion. PBM in cardiovascular surgery is a "team sport" that involves cardiac and vascular surgeons, anesthesiologists, perfusionist, intensivists, and other health care providers. The current work provides an overview of evidence and practice of PBM at Fuwai Hospital. Implementation of PBM should also take local resource availability and cost-effectiveness of different devices, drugs, technologies, and techniques into consideration.
Humans ; Blood Transfusion/methods* ; Anemia/therapy* ; Hemorrhage ; Hospitals ; Blood Loss, Surgical