OBJECTIVE To provide a scientific basis for the quality evaluation and clinical application of Qingwen hufei granules. METHODS Fourteen batches of Qingwen hufei granules were used as samples to establish high-performance liquid chromatography （HPLC） fingerprints using the Similarity Evaluation System for Chromatographic Fingerprint of Traditional Chinese Medicine （2012 Edition）. The chromatographic peaks were identified and the similarity was evaluated. Cluster analysis （CA）， principal component analysis （PCA）， and orthogonal partial least squares-discriminant analysis （OPLS-DA） were used to conduct chemical pattern recognition analysis on the 14 batches of samples. Meanwhile， the contents of neochlorogenic acid （NGA）， chlorogenic acid （CHA）， cryptochlorogenic acid （CGA）， forsythoside A （FTA）， 3，5-O-dicaffeoylquinic acid （3，5-O- DA）， 4，5-O-dicaffeoylquinic acid （4，5-O-DA）， and angoroside C （AGC） in the samples were determined by HPLC. RESULTS The methodological investigation results of both the fingerprint and the content determination complied with the relevant requirements. Fourteen common peaks were indicated in the HPLC fingerprints of the 14 batches of samples， and 7 of them were identified [NGA （peak 2）， CHA （peak 3）， CGA （peak 5）， FTA （peak 11）， 3，5-O-DA （peak 12）， 4，5-O-DA （peak 13）， and AGC （peak 14）]； the similarity of each sample was greater than 0.94. The results of CA and PCA showed that the samples could be classified into 3 categories； the results of OPLS-DA indicated that peak 4 （unknown）， peak 11 （FTA）， peak 8 （unknown）， peak 9 （unknown）， and peak 1 （unknown） were the differential components. The content ranges of NGA， CHA， CGA， 3，5-O-DA， FTA， 4，5-O-DA and AGC in the 14 batches of samples were 0.210 4-0.458 7， 0.269 1-0.506 3， 0.228 1-0.461 1， 0.443 9-1.044 6， 0.066 7-0.155 7， 0.062 8-0.143 8， and 0.057 4-0.105 7 mg/g， respectively. CONCLUSIONS The HPLC fingerprint and multi-component content determination methods established in this study are efficient and reliable， and can be used for the quality evaluation of Qingwen hufei granules.

Objective To address the safety challenges arising from the rapid development of nuclear energy and technology, assess the current status of health emergency response capabilities in nuclear radiation emergencies, and promote capacity enhancement. Methods A preliminary evaluation system for health emergency response capability in nuclear radiation emergencies was developed based on a literature review. Two rounds of Delphi expert consultation (n = 20) were conducted, and the analytic hierarchy process was employed to establish judgment matrices for assigning indicator weights. Results The finalized system included six primary indicators (radiation protection capability, triage capability, decontamination and evacuation capability, medical treatment capability, radiation detection capability, and radiation dose estimation capability), along with 29 secondary indicators, such as capability for setting up emergency zones, capability for protecting personnel from internal and external contamination, on-site first aid capability, and personal dose monitoring capability. The expert response rate was 0.95, and the expert authority coefficient reached 0.80. The Kendall’s coefficient of concordance was W = 0.288 (P<0.01) for the first round of expert consultation and W = 0.308 (P<0.01) for the second round. Both rounds demonstrated high agreement among experts, and the consultation questionnaires passed reliability and validity tests. Conclusion By integrating qualitative analysis and quantitative calculation, this study developed a scientifically sound and operationally feasible evaluation system. This system will help identify gaps in health emergency response capabilities and provide scientific guidance and a decision-making basis for optimizing emergency plans and improving the level of health emergency response in nuclear radiation emergencies.

OBJECTIVE To systematically review medication-related risk factors for falls in older adults， to provide references for ensuring medication safety among older adults. METHODS A systematic search was conducted in PubMed， Embase， Web of Science， and CNKI for relevant literature published from database inception to November 1， 2025. Relevant studies on medication-related falls in older adults， both domestic and international， were included. Drug factors influencing falls in older adults were summarized and analyzed. RESULTS A total of 22 studies were included. Four major classes of fall-risk-increasing drugs were identified： psychotropic medications [12 studies， odds ratio （OR） range 1.500-5.790]， cardiovascular system drugs （5 studies， OR range 1.236-4.784）， analgesics （3 studies， OR range 1.500-4.490）， and hypoglycemic agents （3 studies， OR range 2.070-2.751）. Additionally， anticholinergic burden （1 study， OR was 2.610） and polypharmacy （7 studies， OR range 2.902-25.897 for the use of ≥4 medications） were identified as significant risk factors for falls. CONCLUSIONS Falls in older adults are significantly associated with psychotropic medications， cardiovascular system drugs， analgesics， and hypoglycemic agents， among which psychotropic medications pose the highest risk. Anticholinergic burden and polypharmacy are also important risk factors. In clinical practice， interventions should be implemented through deprescribing and risk monitoring to effectively reduce the risk of falls in older adults.

Objective: To investigate the damaging effects of red blood cell supernatant (RBC-S) stored for different durations (7 d, 14 d, and 28 d) on vascular endothelial cells, and to explore the underlying mechanisms using bioinformatics analysis, so as to provide references for optimizing red blood cell transfusion strategies. Methods: Human umbilical vein endothelial cells (HUVECs) were co-cultured with RBC-S stored for 7, 14 and 28 days, designated as the 7 d group, 14 d group and 28 d group respectively, which were collectively defined as the experimental groups. Cell damage was evaluated by cell proliferation assay (Cell Counting Kit8, CCK8), lactate dehydrogenase (LDH) release assay, 4′, 6diamidino2phenylindole (DAPI) staining, and flow cytometry for apoptosis and reactive oxygen species (ROS) levels. The damage degree of RBC-S on vascular endothelial cells was assessed by statistical analysis of damage data among different groups. Since the damage effect reached a plateau at all time points, the 28 d storage group was selected as the representative for further mechanistic studies. Transcriptomic analysis was performed to explore the role of frizzled class receptor 1 (FZD1) and Wnt signaling pathway in red blood cell storagerelated endothelial dysfunction. Results: Compared with the control group, the storage groups treated with 7 d, 14 d, and 28 d RBC-S showed significantly decreased cell proliferation rates [control group 100%, 7 d group (69.51±2.30)%, 14 d group (74.54±2.89)%, 28 d group (73.59±2.36)%, P<0.05], significantly reduced numbers of DAPI-stained cell nuclei [control group (213±12.5) per field, 7 d group (140.33±17.04) per field, 14 d group (152.00±23.72) per field, 28 d group (144.33±19.09) per field, P<0.05] and significantly increased LDH release [control group (1), 7 d group (8.33±1.41), 14 d group (9.23±0.83), 28 d group (9.16±0.60), P<0.05]. There was no significant difference in the degree of damage caused by RBC-S among different storage groups (P>0.05). With the prolongation of storage time, free hemoglobin (FHb) gradually increased [control group (not detected), 7 d (16.57±6.38) mg/L, 14 d (76.80±22.83) mg/L, 28 d (286.97±29.02) mg/L, P<0.05]. The apoptotic rate (20.53±2.94)% and ROS relative intensity (5.13±0.91) in the 28 d storage group were significantly higher than those in the control group (P<0.05). Transcriptomic analysis showed that FZD1 played a key role in vascular endothelial dysfunction induced by red blood cell storage and was closely related to the Wnt signaling regulatory network. Conclusion: RBC-S stored for 7 d, 14 d, or 28 d can all significantly damage vascular endothelial cells, and the damaging effect reaches a plateau at 7 d of storage. Mechanistic investigation of the 28 d group indicated that the downregulation of the FZD1/Wnt signaling pathway may play a critical role in vascular endothelial dysfunction induced by red blood cell storage, providing a theoretical basis for further optimizing red blood cell storage and transfusion strategies.

OBJECTIVE To analyze trends in the burden of disease associated with falls from 1990 to 2023， identify risk factors for falls， and provide a reference for the development of measures to reduce the burden of disease associated with falls and the formulation of public health policies. METHODS Based on the data of 2023 from the Global Burden of Disease （GBD） database， the changes in fall-related prevalence， mortality， disability-adjusted life years （DALYs） and incidence in China and globally from 1990 to 2023 were analyzed， and the stratified analyses by gender， age and socio-demographic index （SDI） were conducted. The risk factors related to falls in 2023 were systematically analyzed， and the impact of multimorbidity and polypharmacy on the occurrence of falls by combining relevant literature evidence was explored. RESULTS & CONCLUSIONS Globally， the percentage changes in age-standardized rates of fall-related prevalence， mortality， DALYs and incidence from 1990 to 2023 were －2.4% （95%UI： －4.8% to －0.3%）， －7.8% （95%UI： －20.5% to 10.9%）， －10.6% （95%UI： －16.5% to －4.3%）， and －4.6% （95%UI： －8.1% to －0.8%）， respectively. However， in some regions， the percentage changes in age-standardized rates for these indicators were greater than 0 （e.g.， prevalence， mortality and DALYs in Australasia， and incidence in Andean Latin America）. In China， the percentage changes in age-standardized rates of fall-related mortality and DALYs from 1990 to 2023 were －18.3% （95%UI： －56.7% to 32.3%） and 1.9% （95%UI： －10.1% to 12.4%）， while the percentage changes in age-standardized rates of prevalence and incidence were 25.9% （95%UI： 20.2% to 32.0%） and 35.7% （95%UI： 28.5% to 44.1%）， respectively. Globally， in regions with high and medium-to-high SDI levels， the percentage changes in age-standardized rates of fall-related prevalence and incidence showed an upward trend， while DALYs showed a downward trend； however， the trend in mortality was unclear. In regions with a middle SDI level， the percentage changes in age-standardized rates of fall-related prevalence and incidence both showed an upward trend， while the trends in mortality and DALYs were unclear. In regions with low-to-medium SDI level， the percentage changes in age-standardized rate of fall-related prevalence， DALYs and incidence all showed a downward trend， while the trend in mortality was unclear； in regions with low SDI level， the trends for all above indicators were unclear. Correlation analyses of the burden of fall-related diseases in China and globally indicated that the risk of fall-related diseases was higher among younger and middle-to-older adult male populations， while women were concentrated in older age groups. Meanwhile， as the SDI levels increase， the percentage change in age-standardized rate of DALYs for fall-related diseases showed a clear upward trend， and this trend was more pronounced in high-SDI regions. Tobacco use， alcohol consumption， low bone density， and occupational risks were risk factors for falls， with low bone density and occupational risks contributing significantly （exceeding 20% in some regions）； multimorbidity and polypharmacy could also significantly increase the risk of falls. It is recommended that clinical settings establish a list of fall-risk increasing drugs and a warning system， improve medication reviews， strengthen medication education and adherence management， foster multidisciplinary collaboration， and develop medication strategies for specific patient populations to reduce the incidence of falls and alleviate the burden of disease.

Objective Emergency response to public health emergencies constitutes a vital component of the modernization of national governance systems and capacities, directly impacting national security, social stability, and public health. This study aims to analyze the key issues and research hotspots in the field of emergency response to public health emergencies, providing theoretical foundations and practical guidance for formulating scientific and effective emergency strategies and policies. Ultimately, it seeks to enhance the nation’s capability to respond to public health emergencies and safeguard public health. Methods Using core journals indexed in the China National Knowledge Infrastructure (CNKI) database as the data source, 1094 journal articles in the field of emergency response to public health emergencies in China from 2003 to September 2024 were selected as the research sample. Citespace visualization software was employed to organize and analyze the research process in the field of emergency response to public health emergencies. Results The current research in this field predominantly involves small-scale cooperation, and the research process can be divided into four stages. The research in the emerging stage mainly focuses on the themes of emergency mechanism and emergency management, the development stage mainly centers on the themes of emergency capacity improvement and system exploration, the outbreak stage emphasizes the themes of COVID-19 and epidemic prevention and control, and the sustainable development stage highlights collaborative governance and informatization. Conclusion The COVID-19 pandemic has accelerated the development of research in this field. Currently, the field shows a continuous growth, with an increasing volume of publications. The focus of current research has shifted towards collaborative governance and the study of assessment tools, aiming to enhance the efficiency and effectiveness in responding to public health emergencies. Moreover, the field is advancing toward more systematic and comprehensive research. However, there is still a need to strengthen scientific communication and collaboration.

In recent years, cancer treatment methods and means are becoming more and more diversified, and single treatment methods often have limited efficacy, while the synergistic effect of immunity combined with chemotherapy can inhibit tumor growth more effectively. Based on this, we constructed a sodium alginate hydrogel composite system loaded with chemotherapeutic agents and tumor vaccines (named SA-DOX-NA) with a view to the combined use of chemotherapeutic agents and tumor vaccines. Firstly, the tumor vaccine (named NA) degradable under acidic conditions was constructed by in situ polymerization using chicken ovalbumin (OVA), acrylamide (AAM) and 2-(dimethylamino) ethyl methacrylate (DMAEMA) monomer. Then a hydrogel composite system SA-DOX-NA co-loaded with chemotherapeutic drug doxorubicin (DOX) and NA was prepared using sodium alginate as a matrix. The results showed that SA-DOX-NA had good in situ gel-forming ability and formed a mesh structure that could realize the co-loading of DOX and NA as well as the slow drug release. The electron microscopy results showed that SA-DOX-NA had good in situ gel-forming ability with good internal connectivity, and the three-dimensional mesh structure could realize the co-loading of DOX and NA as well as the slow drug release. The antitumor and immunomodulatory results showed that SA-DOX-NA both effectively inhibited the growth of tumor cells and efficiently promoted the proliferation and activation of DC2.4 dendritic cells without additional adjuvant. In summary, SA-DOX-NA exerts the dual efficacy of chemotherapy and immunotherapy for tumor treatment, and has a good application prospect in local tumor treatment.

Objective To understand the situation of dental cone beam computed tomography (CBCT) quality control testing phantoms in radiation health technical service institutions in Guangdong province, analyze the differences among different phantoms, and provide a reference for dental CBCT quality control testing. Methods The testing phantoms of 49 radiation health technical service institutions were used as the research objects. The designated CBCT equipment was used for scanning and imaging. The Z-score method was used to evaluate the high-contrast resolution, low-contrast resolution, and distance measurement deviation of each phantom. Results The satisfaction rates of various items for the phantoms in 49 institutions ranged from 85.7% to 100%. The distance measurement deviations of four institutions were “suspicious”, and the high-contrast resolution of four institutions and the distance measurement deviation of one institution were “unsatisfactory”. Conclusion The overall performance of dental CBCT quality control testing phantoms in radiological health technical service institutions in Guangdong province is satisfactory. However, there are still some phantoms with poor results in items such as distance measurement deviation and high-contrast resolution. The structural design, material selection, and manufacturing process of the phantom may all affect the results of quality control testing. Therefore, appropriate phantoms, optimized exposure conditions, and suitable reconstruction algorithms should be used in CBCT quality control testing to ensure accurate and reliable measurements.

Recently, significant progress has been made in the field of endovascular repair of complex aortic disease involving the major branches (aortic arch disease and complex abdominal aortic aneurysms). Open surgery was considered the “gold standard” for the treatment of these complicated aortic diseases, but was challenged by the huge surgical trauma and high risk of post-operative complications. However, the rapid development of branched and fenestrated endografts has provided an alternative safe and effective minimally invasive treatment for patients who cannot tolerate open surgery. Preliminary evidence has also shown that branched and fenestrated endografts have achieved significant technical success rates and clinical outcomes and have gradually become an important direction of innovation and development for endovascular repair of complex aortic disease. Nevertheless, both branched and fenestrated endografts are currently in the early stages of experience and a series of high-quality research studies are needed in the future to further compare them with open surgery and within different endovascular techniques.

OBJECTIVES: Hypertriglyceridemic acute pancreatitis (HTG-AP) has a rapid onset and is associated with a high risk of progression and recurrence. Early identification of patients at risk of severe disease can help reduce the likelihood of multiple organ failure and mortality. This study aims to investigate the changes in inflammatory composite markers and D-dimer (D-D) levels in young and middle-aged/elderly patients with HTG-AP and to evaluate their predictive value for disease progression. METHODS: A total of 230 patients with HTG-AP admitted to Chongqing University Jiangjin Hospital (Jiangjin Central Hospital) between 2017 and 2023 were retrospectively enrolled. Patients were first divided into a young group (≤45 years) and a middle-aged/elderly group (>45 years), and then stratified into mild and severe groups based on disease severity. Inflammatory composite markers, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), C-reactive protein-to-lymphocyte ratio (CLR), systemic inflammation response index (SIRI), systemic immune inflammation index (SII), as well as D-D levels, were compared among groups. Least absolute shrinkage and selection operator (LASSO) regression and Logistic regression were used to identify independent risk factors for disease progression in each age group. Receiver operating characteristic (ROC) curves and the DeLong test were used to assess and compare the predictive performance (area under the curve, AUC) of risk factors. Internal validation was performed using the bootstrap method (n=1 000). RESULTS: No significant differences in NLR, PLR, MLR, SIRI, SII, CLR, or D-D levels were observed between the young (n=127) and middle-aged/elderly (n=103) groups (all P>0.05). Among young patients, the severe group (n=59) had significantly higher NLR, SIRI, SII, CLR, and D-D levels compared to the mild group (n=68) (all P<0.05). Among middle-aged/elderly patients, CLR and D-D levels were significantly higher in the severe group (n=49) than in the mild group (n=54) (P<0.05). LASSO and Logistic regression analyses identified elevated D-D as an independent risk factor for disease progression in young patients (P=0.007, OR=1.458, 95% CI 1.107 to 1.920), while both D-D (P=0.001, OR=2.267, 95% CI 1.413 to 3.637) and CLR (P=0.003, OR=1.007, 95% CI 1.003 to 1.012) were independent risk factors in middle-aged/elderly patients. ROC analysis showed that D-D predicted disease progression in young and middle-aged/elderly patients with AUCs of 0.653 and 0.741, sensitivities of 67.8% and 57.1%, and specificities of 72.1% and 88.9%, respectively. CLR predicted progression in middle-aged/elderly patients with an AUC of 0.687, sensitivity of 63.3%, and specificity of 70.4%. DeLong test showed no significant difference in AUC between D-D and CLR for middle-aged/elderly patients (Z=0.993, P=0.321). Internal validation via bootstrap analysis yielded a D-D AUC of 0.732, with sensitivity and specificity of 68.1% and 91.0%, respectively. CONCLUSIONS Differences in inflammatory response and coagulation function exist across age groups and disease severities in HTG-AP patients. Elevated D-D is an independent predictor of disease progression in both young and middle-aged/elderly patients, while CLR also predicts progression in the latter group. D-D, in particular, demonstrates strong predictive value for severe disease in middle-aged/elderly patients with HTG-AP.
Humans ; Fibrin Fibrinogen Degradation Products/metabolism* ; Disease Progression ; Middle Aged ; Pancreatitis/etiology* ; Male ; Female ; Retrospective Studies ; Adult ; Biomarkers/blood* ; Hypertriglyceridemia/blood* ; Acute Disease ; Predictive Value of Tests ; Aged ; Inflammation ; C-Reactive Protein/analysis* ; Neutrophils ; Age Factors