ObjectiveTo investigate the possible mechanism of Pibai Yucuo Formula （枇柏愈痤方， PYF） in treating acne from the perspective of skin barrier damage. MethodsThirty-two mice were randomly divided into blank group， model group， minocycline group， and PYF group， with 8 mice in each group. Except for the blank group， mice were induced by intradermal injection of Cutibacterium acnes （C.acnes） combined with topical application of artificial sebum to establish acne model. The blank group and model group received intragastric administration of 0.2 ml of distilled water， while the PYF group received intragastric administration of 22.75 g/（kg·d）of PYF， and the minocycline group received 0.013 g/（kg·d）of minocycline suspension， all once daily for 5 consecutive days. On day 0 and day 6 of the experiment， the body weight of mice in each group was recorded， and the absolute value of the body weight difference during the experiment was calculated. Skin conditions were assessed with multifunctional skin imaging system on the 2nd， 4th and 6th day of the experiment. Skin barrier function indicators including transepidermal water loss （TEWL）， and the water content of the stratum corneum and epidermis on day 0， 2， 4 and 6 of the experiment. Optical coherence tomography （OCT） was used to observe stratum corneum and skin thickness on the 1st， 3rd and 5th day of the experiment. Hematoxylin-eosin （HE） staining was performed to observe histopathological changes， while ELISA was used to detect interleukin-17A （IL-17A） levels， and immunofluorescence staining was used to assess skin barrier-related proteins filaggrin （FLG） and loricrin （LOR） levels of skin lesions on day 6 of the experiment. ResultsCompared to the blank group， the model group showed a decrease in body weight on day 6， and an increase in the absolute value of the difference in body weight before and after the experiment （P＜0.05）. On day 4 and 6， TEWL values increased， while water content in the skin stratum corneum and epidermis decreased （P＜0.05）， accompanied by elevated IL-17A level and reduced immunofluorescence intensity of FLG and LOR proteins （P＜0.05）. The model group mice showed papules or pustules at the skin modeling site with progressively worsening desquamation under multifunctional skin imaging system. OCT revealed focal epidermal protrusions， blurred epidermal-dermal boundaries， and disorganized structural layers. HE staining showed significant epidermal hyperkeratosis and incomplete keratinization in the skin， with keratin plug formation in hair follicles and glandular lumens， thickened stratum corneum， hyperplasia of the stratum spinosum， as well as dense dermal inflammatory cell infiltration， and capillary dilation. Compared to the model group， both the minocycline group and the PYF group showed a reduced difference in body weight before and after experiment （P＜0.05）. On day 4 and 6， the TEWL value decreased， and water content of the skin stratum corneum increased （P＜0.05）； on day 6， the IL-17A level in the skin lesions decreased and immunofluorescence intensity of FLG and LOR proteins increased （P＜0.05）. On day 4 and 6， the severity of the skin lesions and range of redness and swelling were lighter than those in the model group， with reverted epidermal thickness， smoother surface and clearer epidermis-dermis boundary. HE staining showed that the degree of skin keratinization was reduced， and the inflammatory infiltration and vascular dilation in the dermis were improved compared to the model group. The PYF group showed better results than the minocycline group in reducing TEWL value on day 4 （P＜0.05）. ConclusionPYF may improve inflammation and skin barrier damage by downregulating IL-17A levels in lesion tissue and increasing skin barrier-related proteins， which could be one of the potential mechanism of action on acne.

Objective:To investigate the clinical effects of Erchen decoction acupoint application on the prevention of chemotherapy-induced nausea and vomiting. Methods:A prospective study was conducted involving 120 patients with solid tumors who visited Wenzhou Central Hospital between January 2022 and July 2023. The patients were randomly divided into an observation group and a control group using a random number table method. Ultimately, 55 patients in the observation group and 51 patients in the control group completed the study (due to dropouts or rescue treatment, 5 patients were excluded from the treatment group and 9 patients were excluded from the control group). The observation group received Erchen decoction acupoint application in addition to the antiemetic regimen of tropisetron and dexamethasone, while the control group received an acupoint application of pigment powder alongside the same antiemetic regimen as the observation group. The clinical efficacy, pre- and post-treatment grading of nausea and vomiting, adverse reactions, and quality of life scores were compared between the two groups. Results:There was no statistically significant difference in the effective rate of treating vomiting between the two groups ( P > 0.05). However, the total effective rate for delayed vomiting in the observation group was significantly higher at 98.18% (54/55) compared with 84.31% (43/51) in the control group ( χ2 = 4.75, P < 0.05). The proportion of patients in the observation group with a nausea grade of 0 was 76.36% (42/55), which was significantly higher than the 37.25% (19/51) in the control group ( Z = 4.12, P < 0.001). Furthermore, the observation group had higher scores in social functioning [(72.83 ± 6.67)], cognitive functioning [(78.91 ± 5.83)], emotional functioning [(70.65 ± 6.64)], role functioning [(71.70 ± 6.68)], physical functioning [(76.23 ± 7.28)], and overall health [(73.56 ± 6.21)]compared with the control group [(64.57 ± 7.28), (70.87 ± 6.67), (63.24 ± 5.57), (65.36 ± 5.73), (68.82 ± 6.71), and (66.56 ± 5.74), t = 6.10, 6.62, 6.20, 5.23, 5.44, 6.01, all P < 0.05]. There was no statistically significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusions:Erchen decoction acupoint application can effectively alleviate chemotherapy-induced delayed nausea and vomiting and improve the quality of life of patients.

Objective The purpose of writing the"expert consensus on humanistic care for patients in hospice care"(hereinafter referred to as the"consensus")aims to standardize the practice of humanistic care in the field of hospice care,ensuring that humanistic care is integrated throughout the entire service process for hospice care patients and their families.Methods A systematic search was conducted in domestic and foreign databases for literature related to hospice care and humanistic care,including guidelines,expert consensuses,systematic reviews or Meta-analyses,and evidence summaries.High-quality evidence was evaluated,extracted,and summarized to form the initial draft of the"consensus".From June to October 2024,20 experts from the fields of hospice care,nursing humanities,and evidence-based nursing were invited to participate in 1 round of expert consultation.Among them,13 experts were selected for 2 rounds of expert demonstration meetings.After collating and analyzing the experts' opinions,the initial draft was revised and refined,ultimately resulting in the final version of the"consensus".Results The effective response rate of the consultation questionnaire was 100％,with expert authority coefficient of 0.880,judgment coefficient of 0.935,and familiarity level of 0.825.The Kendall harmony coefficient of the expert consultation was 0.134(P＜0.05).The"consensus"consisted of 13 aspects,including the targets and objectives,principles,institutional guarantees,environmental requirements,etc.Conclusion This"consensus"possesses strong scientific rigor and practicality,which can provide guidance and references for the practice of humanistic care in the field of hospice care,promoting the standardization and humanization of hospice care services.

Objective:To study the comparative genomic characteristics of Marmota himalayana-derived (referred to as marmota-derived) Brucella abortus (B.ab). Methods:The species and types of one strain of marmota-derived Brucella and one strain of human-derived Brucella isolated from the brucellosis epidemic area in Qinghai Province in the same year were identified. Meanwhile, DNA was extracted for whole genome sequencing and comparative genomics analysis (including phylogenetic tree construction, gene family clustering analysis, common/specific gene analysis, and genomic structural variation analysis, etc.). Results:Two Brucella strains from different hosts were identified as B.ab. By constructing a phylogenetic tree, the marmota-derived B.ab strain was grouped with strains from Heilongjiang Province and showed genetic correlation with strains from Russia. Human-derived B.ab strain was classified as a strain in Inner Mongolia Autonomous Region, Hebei Province, Beijing City, and Gansu Province. The multilocus sequence typing (MLST) of the two strains belonged to the ST2 type. Multiple locus variable-number tandem repeat analysis (MLVA) belonged to two new MLVA-8 and MLVA-11 genotypes, which were clustered in two subclusters of the same cluster and clustered with the strains from Inner Mongolia Autonomous Region, Xinjiang Uygur Autonomous Region, and Hebei Province. The pan-genome numbers of the marmota-derived B.ab and human-derived B.ab were 283 and 8, respectively; the number of core genes (common genes) was 68 and 2, respectively; and the number of unique genes was 3 and 4, respectively. The unique gene encoded proteins were inconsistent. In marmota-derived B.ab, the main ones were the ABC transporter ATP-binding protein, N-terminal acetyltransferase, and glucose/galactose transporter. The number of homologous genes of the marmota-derived B.ab and human-derived B.ab was 16 and 20, respectively; the number of translocation and inversion genes was 13 and 8, respectively; the number of deletion mutation genes was 11 and 14, respectively. Pathogenicity analysis showed that both strains had the mprF resistance gene, and the marmota-derived B.ab strain also carried bacitracin and macrolide resistance genes. Conclusions:Brucella exhibits cross-species genetic diversity. The proteins encoded by the unique genes of the marmota-derived B.ab mainly play a role in metabolic and epigenetic regulation. The strains cluster with B.ab strains from northern China, providing a reference for molecular epidemiology and pathogen tracing of B.ab infection.

ObjectiveTo characterize the evidence distribution and methodological quality of randomized controlled trials （RCTs） on oral Chinese herbal medicine （CHM） for atopic dermatitis （AD） based on evidence mapping. MethodsSeven databases （CNKI， Wanfang Data， VIP， CBM， Cochrane Library， PubMed， and Embase） and the Chinese Clinical Trial Registry were searched for the RCTs in Chinese and English. Evidence distribution was presented graphically and textually， and methodological quality was assessed via the Cochrane Risk of Bias tool （ROB 1.0）. ResultsA total of 168 RCTs were included. The number of annual publications showing an increasing trend， and 72.6% RCTs had sample sizes of 51-100 participants. The studies evaluated 108 distinct CHM interventions categorized as decoctions， granules， Chinese patent medicines， and extracts. Compound Glycyrrhizin was the most frequently used， followed by Xiaofengsan and Chushi Weiling decoction. Among the RCTs， 57.1% had the treatment courses of 4-8 weeks. Outcome measures predominantly focused on clinical response rate， skin lesion severity scores， and adverse events， with less attention to TCM symptom scores， skin barrier function， and relapse rates. The overall risk of bias was generally high. ConclusionWhile CHM for AD is a research hotspot and demonstrates clinical advantages， the related studies have problems such as unclear clinical positioning， poor research standardization and methodological quality， and insufficient prominence of TCM clinical advantages. Large-sample， methodologically rigorous， and high-quality studies are needed to enhance the evidence base for CHM in treating AD.

ObjectiveTo characterize the evidence distribution and methodological quality of randomized controlled trials （RCTs） on oral Chinese herbal medicine （CHM） for atopic dermatitis （AD） based on evidence mapping. MethodsSeven databases （CNKI， Wanfang Data， VIP， CBM， Cochrane Library， PubMed， and Embase） and the Chinese Clinical Trial Registry were searched for the RCTs in Chinese and English. Evidence distribution was presented graphically and textually， and methodological quality was assessed via the Cochrane Risk of Bias tool （ROB 1.0）. ResultsA total of 168 RCTs were included. The number of annual publications showing an increasing trend， and 72.6% RCTs had sample sizes of 51-100 participants. The studies evaluated 108 distinct CHM interventions categorized as decoctions， granules， Chinese patent medicines， and extracts. Compound Glycyrrhizin was the most frequently used， followed by Xiaofengsan and Chushi Weiling decoction. Among the RCTs， 57.1% had the treatment courses of 4-8 weeks. Outcome measures predominantly focused on clinical response rate， skin lesion severity scores， and adverse events， with less attention to TCM symptom scores， skin barrier function， and relapse rates. The overall risk of bias was generally high. ConclusionWhile CHM for AD is a research hotspot and demonstrates clinical advantages， the related studies have problems such as unclear clinical positioning， poor research standardization and methodological quality， and insufficient prominence of TCM clinical advantages. Large-sample， methodologically rigorous， and high-quality studies are needed to enhance the evidence base for CHM in treating AD.

Objective The purpose of writing the"expert consensus on humanistic care for patients in hospice care"(hereinafter referred to as the"consensus")aims to standardize the practice of humanistic care in the field of hospice care,ensuring that humanistic care is integrated throughout the entire service process for hospice care patients and their families.Methods A systematic search was conducted in domestic and foreign databases for literature related to hospice care and humanistic care,including guidelines,expert consensuses,systematic reviews or Meta-analyses,and evidence summaries.High-quality evidence was evaluated,extracted,and summarized to form the initial draft of the"consensus".From June to October 2024,20 experts from the fields of hospice care,nursing humanities,and evidence-based nursing were invited to participate in 1 round of expert consultation.Among them,13 experts were selected for 2 rounds of expert demonstration meetings.After collating and analyzing the experts' opinions,the initial draft was revised and refined,ultimately resulting in the final version of the"consensus".Results The effective response rate of the consultation questionnaire was 100％,with expert authority coefficient of 0.880,judgment coefficient of 0.935,and familiarity level of 0.825.The Kendall harmony coefficient of the expert consultation was 0.134(P＜0.05).The"consensus"consisted of 13 aspects,including the targets and objectives,principles,institutional guarantees,environmental requirements,etc.Conclusion This"consensus"possesses strong scientific rigor and practicality,which can provide guidance and references for the practice of humanistic care in the field of hospice care,promoting the standardization and humanization of hospice care services.

Objective:To study the comparative genomic characteristics of Marmota himalayana-derived (referred to as marmota-derived) Brucella abortus (B.ab). Methods:The species and types of one strain of marmota-derived Brucella and one strain of human-derived Brucella isolated from the brucellosis epidemic area in Qinghai Province in the same year were identified. Meanwhile, DNA was extracted for whole genome sequencing and comparative genomics analysis (including phylogenetic tree construction, gene family clustering analysis, common/specific gene analysis, and genomic structural variation analysis, etc.). Results:Two Brucella strains from different hosts were identified as B.ab. By constructing a phylogenetic tree, the marmota-derived B.ab strain was grouped with strains from Heilongjiang Province and showed genetic correlation with strains from Russia. Human-derived B.ab strain was classified as a strain in Inner Mongolia Autonomous Region, Hebei Province, Beijing City, and Gansu Province. The multilocus sequence typing (MLST) of the two strains belonged to the ST2 type. Multiple locus variable-number tandem repeat analysis (MLVA) belonged to two new MLVA-8 and MLVA-11 genotypes, which were clustered in two subclusters of the same cluster and clustered with the strains from Inner Mongolia Autonomous Region, Xinjiang Uygur Autonomous Region, and Hebei Province. The pan-genome numbers of the marmota-derived B.ab and human-derived B.ab were 283 and 8, respectively; the number of core genes (common genes) was 68 and 2, respectively; and the number of unique genes was 3 and 4, respectively. The unique gene encoded proteins were inconsistent. In marmota-derived B.ab, the main ones were the ABC transporter ATP-binding protein, N-terminal acetyltransferase, and glucose/galactose transporter. The number of homologous genes of the marmota-derived B.ab and human-derived B.ab was 16 and 20, respectively; the number of translocation and inversion genes was 13 and 8, respectively; the number of deletion mutation genes was 11 and 14, respectively. Pathogenicity analysis showed that both strains had the mprF resistance gene, and the marmota-derived B.ab strain also carried bacitracin and macrolide resistance genes. Conclusions:Brucella exhibits cross-species genetic diversity. The proteins encoded by the unique genes of the marmota-derived B.ab mainly play a role in metabolic and epigenetic regulation. The strains cluster with B.ab strains from northern China, providing a reference for molecular epidemiology and pathogen tracing of B.ab infection.

Objective:To investigate the clinical effects of Erchen decoction acupoint application on the prevention of chemotherapy-induced nausea and vomiting. Methods:A prospective study was conducted involving 120 patients with solid tumors who visited Wenzhou Central Hospital between January 2022 and July 2023. The patients were randomly divided into an observation group and a control group using a random number table method. Ultimately, 55 patients in the observation group and 51 patients in the control group completed the study (due to dropouts or rescue treatment, 5 patients were excluded from the treatment group and 9 patients were excluded from the control group). The observation group received Erchen decoction acupoint application in addition to the antiemetic regimen of tropisetron and dexamethasone, while the control group received an acupoint application of pigment powder alongside the same antiemetic regimen as the observation group. The clinical efficacy, pre- and post-treatment grading of nausea and vomiting, adverse reactions, and quality of life scores were compared between the two groups. Results:There was no statistically significant difference in the effective rate of treating vomiting between the two groups ( P > 0.05). However, the total effective rate for delayed vomiting in the observation group was significantly higher at 98.18% (54/55) compared with 84.31% (43/51) in the control group ( χ2 = 4.75, P < 0.05). The proportion of patients in the observation group with a nausea grade of 0 was 76.36% (42/55), which was significantly higher than the 37.25% (19/51) in the control group ( Z = 4.12, P < 0.001). Furthermore, the observation group had higher scores in social functioning [(72.83 ± 6.67)], cognitive functioning [(78.91 ± 5.83)], emotional functioning [(70.65 ± 6.64)], role functioning [(71.70 ± 6.68)], physical functioning [(76.23 ± 7.28)], and overall health [(73.56 ± 6.21)]compared with the control group [(64.57 ± 7.28), (70.87 ± 6.67), (63.24 ± 5.57), (65.36 ± 5.73), (68.82 ± 6.71), and (66.56 ± 5.74), t = 6.10, 6.62, 6.20, 5.23, 5.44, 6.01, all P < 0.05]. There was no statistically significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusions:Erchen decoction acupoint application can effectively alleviate chemotherapy-induced delayed nausea and vomiting and improve the quality of life of patients.

Objective:To analyze the surveillance results of human brucellosis in Qinghai Province, to study the epidemic characteristics of brucellosis, and to provide scientific basis for formulating brucellosis prevention and control strategies and measures.Methods:By using descriptive epidemiological method, surveillance data from 4 national and 26 provincial brucellosis surveillance sites in Qinghai Province in 2022 and brucellosis related information from the "Disease Surveillance Information Reporting and Management System" in 2022 were collected and summarized. The population, time, regional distribution and epidemic characteristics of brucellosis in Qinghai Province were analyzed.Results:In 2022, a total of 12 483 people were monitored at 4 national and 26 provincial brucellosis surveillance sites. In Rose Bengal plate agglutination test (RBPT), 714 patients were positive, and the positive rate was 5.72% (714/12 483). In tube agglutination test (SAT), 508 individuals tested positive, and the positive rate was 4.07% (508/12 483). There were 1 156 reported cases in 2022, including 910 males and 246 females, with a gender ratio of 3.70 ∶ 1.00. The age range was mainly between 30 and 59 years old, accounting for 77.68% (898/1 156). Most of them were farmers engaged in breeding and transportation, accounting for 81.40% (941/1 156). The onset time was concentrated from June to August, accounting for 50.26% (581/1 156). The distribution area was mainly in the northeast of Qinghai Province (Haibei Tibetan Autonomous Prefecture, Xining City, Haidong City), accounting for 86.33% (998/1 156).Conclusions:The epidemic of human brucellosis in Qinghai Province is still relatively serious, especially in the northeastern agricultural area. Comprehensive measures should be taken to further curb the outbreak of human brucellosis.