ObjectiveTo investigate the clinical effect of Ershen Zhenwu Decoction on chronic heart failure （CHF） due to heart-kidney Yang deficiency and blood stasis and its regulatory effects on miR-423-5p/Smad7/transforming growth factor-β₁ （TGF-β₁）/Smads axis and myocardial fibrosis indicators. MethodsOne hundred and fourteen patients with heart failure with reduced ejection fraction （HFrEF） and heart failure with mildly reduced ejection fraction （HFmrEF） were randomly allocated into a control group and an observation group. The control group was treated with dapagliflozin tablets， sacubitril-valsartan sodium tablets， metoprolol succinate， and spironolactone， and the observation group was treated with Ershen Zhenwu Decoction on the basis of the therapy in the control group. The course of treatment was 8 weeks in both groups. The 6-min walking distance， New York Heart Association （NYHA） heart function grade， Minnesota Living with Heart Failure Questionnaire （MLHFQ） score， N-terminal pro-B-type natriuretic peptide （NT-proBNP）， angiotensin Ⅱ （Ang Ⅱ）， left ventricular ejection fraction （LVEF）， left ventricular end-diastolic diameter （LVIDd）， left ventricular end-systolic diameter （LVIDs）， interventricular septum thickness at diastole （IVSd）， left ventricular end-diastolic posterior wall thickness （LVPWd）， left ventricular shortening fraction （FS）， miR-423-5p， Smad7， Smad2， Smad3， Smad4， TGF-β₁， Ang Ⅱ， type Ⅰ collagen （Col Ⅰ）， type Ⅲ collagen （Col Ⅲ）， mRNA levels of fibronectin （Fn） and α-smooth muscle actin （α-SMA） in the myocardial tissue were observed before and after treatment in both groups to evaluate the efficacy of cardiac function and drug safety. ResultsAfter treatment， both groups showed declined levels of NT-proBNP， Ang Ⅱ， miR-423-5p， Smad2， Smad3， Smad4， TGF-β₁， Col Ⅰ， Col Ⅲ， and mRNA levels of Fn and α-SMA （P0.05）， and the levels of the indicators above were lower in the observation group than in the control group （P0.05）. After treatment， the Smad7 level increased obviously in both groups （P0.05） and was higher in the observation group than in the control group （P0.05）. After treatment， both groups showed decreased MLHFQ scores and increased 6-min walking distance （P0.05）， and the observation group had lower MLHFQ score and longer 6-min walking distance than the control group （P0.05）. After treatment， the control group showed increased LVEF and FS （P0.05） and the observation group showcased decreased LVIDd and LVIDs and increased LVEF and FS （P0.05）. Moreover， the observation group had lower LVIDd and LVIDs （P0.05） and higher LVEF and FS （P0.05） than the control group. The total response rate of cardiac function in the observation group was 90.38% （47/52）， which was higher than that （70.59%， 36/51） in the control group （P0.05）. No adverse reactions associated with Ershen Zhenwu Decoction were observed during the study period. ConclusionErshen Zhenwu Decoction can improve the cardiac function， exercise tolerance， and quality of life， regulate neuroendocrine factors， and slow down/reverse myocardial remodeling in the patients with HFrEF and HFmrEF （syndrome of heart-kidney Yang deficiency and blood stasis by regulating the miR-423-5p/Smad7/TGF-β₁/Smads axis， inhibiting α-SMA and Fn expression， and alleviating myocardial fibrosis. It is worthy of further study.

ObjectiveTo investigate the clinical effect of Ershen Zhenwu Decoction on chronic heart failure （CHF） due to heart-kidney Yang deficiency and blood stasis and its regulatory effects on miR-423-5p/Smad7/transforming growth factor-β₁ （TGF-β₁）/Smads axis and myocardial fibrosis indicators. MethodsOne hundred and fourteen patients with heart failure with reduced ejection fraction （HFrEF） and heart failure with mildly reduced ejection fraction （HFmrEF） were randomly allocated into a control group and an observation group. The control group was treated with dapagliflozin tablets， sacubitril-valsartan sodium tablets， metoprolol succinate， and spironolactone， and the observation group was treated with Ershen Zhenwu Decoction on the basis of the therapy in the control group. The course of treatment was 8 weeks in both groups. The 6-min walking distance， New York Heart Association （NYHA） heart function grade， Minnesota Living with Heart Failure Questionnaire （MLHFQ） score， N-terminal pro-B-type natriuretic peptide （NT-proBNP）， angiotensin Ⅱ （Ang Ⅱ）， left ventricular ejection fraction （LVEF）， left ventricular end-diastolic diameter （LVIDd）， left ventricular end-systolic diameter （LVIDs）， interventricular septum thickness at diastole （IVSd）， left ventricular end-diastolic posterior wall thickness （LVPWd）， left ventricular shortening fraction （FS）， miR-423-5p， Smad7， Smad2， Smad3， Smad4， TGF-β₁， Ang Ⅱ， type Ⅰ collagen （Col Ⅰ）， type Ⅲ collagen （Col Ⅲ）， mRNA levels of fibronectin （Fn） and α-smooth muscle actin （α-SMA） in the myocardial tissue were observed before and after treatment in both groups to evaluate the efficacy of cardiac function and drug safety. ResultsAfter treatment， both groups showed declined levels of NT-proBNP， Ang Ⅱ， miR-423-5p， Smad2， Smad3， Smad4， TGF-β₁， Col Ⅰ， Col Ⅲ， and mRNA levels of Fn and α-SMA （P0.05）， and the levels of the indicators above were lower in the observation group than in the control group （P0.05）. After treatment， the Smad7 level increased obviously in both groups （P0.05） and was higher in the observation group than in the control group （P0.05）. After treatment， both groups showed decreased MLHFQ scores and increased 6-min walking distance （P0.05）， and the observation group had lower MLHFQ score and longer 6-min walking distance than the control group （P0.05）. After treatment， the control group showed increased LVEF and FS （P0.05） and the observation group showcased decreased LVIDd and LVIDs and increased LVEF and FS （P0.05）. Moreover， the observation group had lower LVIDd and LVIDs （P0.05） and higher LVEF and FS （P0.05） than the control group. The total response rate of cardiac function in the observation group was 90.38% （47/52）， which was higher than that （70.59%， 36/51） in the control group （P0.05）. No adverse reactions associated with Ershen Zhenwu Decoction were observed during the study period. ConclusionErshen Zhenwu Decoction can improve the cardiac function， exercise tolerance， and quality of life， regulate neuroendocrine factors， and slow down/reverse myocardial remodeling in the patients with HFrEF and HFmrEF （syndrome of heart-kidney Yang deficiency and blood stasis by regulating the miR-423-5p/Smad7/TGF-β₁/Smads axis， inhibiting α-SMA and Fn expression， and alleviating myocardial fibrosis. It is worthy of further study.

ObjectiveTo analyze the epidemiological status, serotypes, and drug resistance characteristics of Vibrio parahaemolyticus in foodborne disease surveillance in Wenzhou from 2016 to 2024, and to provide scientific evidence and data support for the prevention and control of Vibrio parahaemolyticus infections. MethodsA total of 45 980 stool or anal swab samples were collected from patients with vomiting and diarrhea as the main symptoms and a history of consuming suspicious food at medical institutions at all levels in Wenzhou from 2016 to 2024. Isolation, identification, and drug susceptibility testing were performed. Case information was collected through the National Foodborne Disease Surveillance Reporting System. The Cochran-Mantel-Haenszel (CMH) chi-square test was used to analyze the detection rates among groups. ResultsAmong the 45 980 suspected samples, 2 821 were positive for Vibrio parahaemolyticus, with an overall detection rate of 6.14%. A comparison of detection rates across different population groups revealed that the highest rates were found among adults aged 20‒39 (8.57%,1 603/18 697) and among farmers and workers (7.93%, 994/12 537). A comparison of detection rates across different seasons revealed that the detection rates were higher from June to October (5.12%, 9.04%, 15.04%, 14.68%, and 7.80%, respectively), peaking in August. Analyses of the sampling results for suspect foodstuffs revealed that aquatic products and their derivatives accounted for the highest proportion (42.86%). Regarding the setting of food consumption, the household accounted for 44.53% (1 257/2 821). From 2016 to 2020, the predominant serotype was O3:K6 (28.82%, 813/2 821), followed by O10:K4 (28.25%, 797/2 821) and O4:KUT (23.61%, 666/2 821). In terms of drug resistance, the resistance rate to cefazolin was the highest at 84.15% (393/467), and the multi-drug resistance rate was 6.21% (29/467). ConclusionFrom 2016 to 2024, patients with suspected foodborne illnesses in Wenzhou City experienced a peak in Vibrio parahaemolyticus infections during the summer and autumn months (June to October). Young adults aged 20‒39, as well as farmers and manual workers, were the key target groups for the prevention and control of Vibrio parahaemolyticus infections. The predominant serotype of Vibrio parahaemolyticus shifted from O3:K6 to O10:K4. Vibrio parahaemolyticus exhibited a high level of resistance to cefazolin. It is essential to strengthen surveillance of the epidemiological trends of the predominant serotype, monitor changes in the antibiotic resistance of Vibrio parahaemolyticus, enhance health education for key populations, and intensify regulatory inspections of high-risk foods such as aquatic products and their derivatives.

OBJECTIVE To comprehensively evaluate the quality of adverse drug reaction （ADR） reports in clinical departments or ward （hereinafter referred to as “department”） based on game theory combinatorial weighting-technique for order preference by similarity to ideal solution （TOPSIS）-rank-sum ratio （RSR） method， providing a reference for the further standardization of ADR reporting. METHODS Based on relevant documents and scoring criteria， the ADR report quality evaluation standards previously developed by our team were modified. Using game theory principles， the fusion of subjective and objective weights for each indicator was determined. A game theory combinatorial weighting-TOPSIS-RSR model was developed to evaluate and categorize the quality of raw ADR reports submitted by departments to the pharmacy department at Bozhou Hospital of Anhui Medical University. RESULTS A total of 222 ADR reports from 23 departments were included. The game theory combinatorial weighting method identifies weak points in management， such as ADR symptoms and signs， the description of underlying diseases， timing of ADR， by optimizing the weightings of the indicators. The TOPSIS-RSR method calculates that the mean relative closeness of the departments was 0.401 7， indicating that the overall report quality ranged from moderate to substandard. 20095） Three departments， including neurosurgery， demonstrated medium reporting quality [estinate closeness （Ĉ）i ≥0.506]， while two departments， such as the respiratory department，were rated as unqualified （Ĉi＜0.278）. The remaining departments were all deemed qualified （0.278≤ Ĉi＜0.506）. CONCLUSIONS The developed game theory combinatorial weighting-TOPSIS-RSR method provides an effective approach for the quality evaluation of ADR reports， which not only balances subjective and objective weights but also facilitates comparisons among different departments. There is still room for improvement in the ADR report quality at the hospital.

BackgroundPatients with depressive disorder often exhibit impaired decision-making functions. However， the relationship between decision-making abilities and depressive and anxiety symptoms in these patients remains unclear. ObjectiveTo explore the characteristics of decision-making behavior in patients with depressive disorder， and to analyze its relationship with clinical symptoms. MethodsA total of 48 patients diagnosed with depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders， fourth edition （DSM-IV） were recruited from the Department of Psychosomatic Medicine of the Affiliated Hospital of Southwest Medical University from October 2020 to May 2023. Concurrently， 52 healthy individuals matched for age and gender were recruited from Luzhou as the control group. Beck Depression Inventory （BDI） and Beck Anxiety Inventory （BAI） were used for assessment， and decision-making behavior was evaluated using Probabilistic Reversal Learning （PRL） task. Indicators assessed included the number of trials to criterion， perseverative errors， win-stay rate and lose-shift rate. Spearman correlation analysis was used to assess the correlation between BDI and BAI scores and PRL task indicators. ResultsThe depression group showed a significantly higher lose-shift rate compared with the control group （t=3.684， P<0.01）. There were no statistically significant differences between two groups in trials to criterion， perseverative errors and win-stay rate （t=0.329， 0.132， 0.609， P>0.05）. In depression group， BDI and BAI scores were positively correlated with the win-stay rate（r=0.450， 0.398， P<0.01）. ConclusionPatients with depressive disorder are more likely to change their decision-making strategies following negative outcomes. Furthermore， the severity of depressive and anxiety symptoms is associated with a greater propensity to maintain existing decisions after receiving positive feedback. ［Funded by 2019 Joint Project of Luzhou Science and Technology Bureau-Southwest Medical University （number， 2019LZXNYDJ39］

Objective To explore the current situation of medication safety behavior of elderly cancer patients and the path relationship of various influencing factors for improving medication safety behavior.Methods A total of 340 elderly cancer patients were investigated by a demographic questionnaire,the Medication Safety Behavior Scale,the Medication Literacy Scale,the Family Care Index Questionnaire,and the Chinese version of the Empowerment Scale for Cancer Patients from August to December 2024.The multiple linear regression analysis was applied to analyze influencing factors,and data were analyzed using SmartPLS 4.0 to construct a partial least squares structural equation model with path analysis.Results A total of 307 valid questionnaires were collected.The mean medication safety behavior score was 31.89±5.38.Residential area,drug literacy,family care,and health empowerment are factors that affect medication safety in elderly cancer patients,accounting for 37.3％of the total variation.The path analysis results indicated that health empowerment(β=0.480),medication literacy(β=0.154),and family care(β=0.227)positively correlate with medication safety behavior.Health empowerment played a partial mediating role between family care and medication safety behavior,as well as between medication literacy and medication safety behavior.The mediating effects are 0.125 and 0.332(P＜0.001),accounting for 35.51％and 68.31％of the total effect,respectively.Conclusion Medication safety behaviors among elderly cancer patients are at a median level and influenced by multiple factors.By improving their levels of health empowerment,healthcare professionals can motivate patients to take an active role in medication safety management.Further,promoting education on medication knowledge and teaching relevant medical skills,and together with guiding patients to perceive family care and support,can collectively improve their overall medication safety behaviors.

Objective Through studying the chemical composition changes before and after the compatibility of Hedysari Radix Paeparata Cum Melle(HRPCM)-vinegar processed Curcumae Rhizoma(VPCR);To discuss the significance of the compatibility of HRPCM and VPCR;To establish the fingerprints before and after their compatibility.Methods ZORBAX Eclipse Plus C18 column was used;acetonitrile-0.01%phosphoric acid water was set as mobile phase,with gradient elution;column temperature was 30℃;detection wavelength was 214 nm;sample injection was 10 μL,which was used to investigate the content difference of major chemical components such as vanillic acid,calycosin-O-β-D-glucopyranoside,ononin,calycosin,onocerin,curdione,cincumol and germacrone,and establish the fingerprint of HRPCM,VPCR and HRPCM-VPCR.Results HPLC chromatographic conditions were established for the determination of 8 components in HRPCM-VPCR.Meanwhile,fingerprints were established before and after the compatibility of HRPCM-VPCR.26 common peaks were identified,among which 11 components such as vanillic acid were derived from HRPCM,14 components such as curcuma zedoariae were derived from VPCR,and 1 component was shared by both.Conclusion The material basis of the compatibility of HRPCM-VPCR differs from that of HRPCM and VPCR.The content of most chemical components decreases while the content of some components increases.The established HPLC method for content determination and fingerprint is simple,stable and reproducible,which can be used to evaluate and control the quality of HRPCM and VPCR.

Objective To explore the effect of Roy's adaptive model nursing on the rehabilitation in patients with multiple myeloma.Methods Eighty patients with multiple myeloma who were treated in Huaibei Miners General Hospital from October 2018 to October 2021 were selected by convenient sampling.They were divided into two groups by random number table method,with 40 patients in each group.Routine nursing was applied in the control group,and Roy's adaptive model nursing was given to the study group.The nutritional status,psychological resilience and lifestyle improvement were compared between the two groups.Results Before nursing,there was no significant difference in the nutritional indicators,Connor-Davidson Resilience Scale(CD-RISC)score,or Health-Promoting Lifestyle Scale(HPLP Ⅱ)score between the two groups(P>0.05).After nursing,body mass index(BMI),triceps skinfold thickness(TSF),albumin(ALB)and prealbumin(PA),the scores of toughness,strength and optimism in CD-RISC,and the scores of interpersonal relationship,nutrition management,health responsibility,exercise management,stress management and mental growth in HPLP Ⅱ were increased in both groups(P<0.05),and these indexes in the study group were significantly higher than those in the control group(P<0.05).Conclusion Roy's adaptive model nursing can improve nutritional status,enhance psychological resilience and promote healthy lifestyle of patients with multiple myeloma.

Objective To explore the current situation of medication safety behavior of elderly cancer patients and the path relationship of various influencing factors for improving medication safety behavior.Methods A total of 340 elderly cancer patients were investigated by a demographic questionnaire,the Medication Safety Behavior Scale,the Medication Literacy Scale,the Family Care Index Questionnaire,and the Chinese version of the Empowerment Scale for Cancer Patients from August to December 2024.The multiple linear regression analysis was applied to analyze influencing factors,and data were analyzed using SmartPLS 4.0 to construct a partial least squares structural equation model with path analysis.Results A total of 307 valid questionnaires were collected.The mean medication safety behavior score was 31.89±5.38.Residential area,drug literacy,family care,and health empowerment are factors that affect medication safety in elderly cancer patients,accounting for 37.3％of the total variation.The path analysis results indicated that health empowerment(β=0.480),medication literacy(β=0.154),and family care(β=0.227)positively correlate with medication safety behavior.Health empowerment played a partial mediating role between family care and medication safety behavior,as well as between medication literacy and medication safety behavior.The mediating effects are 0.125 and 0.332(P＜0.001),accounting for 35.51％and 68.31％of the total effect,respectively.Conclusion Medication safety behaviors among elderly cancer patients are at a median level and influenced by multiple factors.By improving their levels of health empowerment,healthcare professionals can motivate patients to take an active role in medication safety management.Further,promoting education on medication knowledge and teaching relevant medical skills,and together with guiding patients to perceive family care and support,can collectively improve their overall medication safety behaviors.

Objective Through studying the chemical composition changes before and after the compatibility of Hedysari Radix Paeparata Cum Melle(HRPCM)-vinegar processed Curcumae Rhizoma(VPCR);To discuss the significance of the compatibility of HRPCM and VPCR;To establish the fingerprints before and after their compatibility.Methods ZORBAX Eclipse Plus C18 column was used;acetonitrile-0.01%phosphoric acid water was set as mobile phase,with gradient elution;column temperature was 30℃;detection wavelength was 214 nm;sample injection was 10 μL,which was used to investigate the content difference of major chemical components such as vanillic acid,calycosin-O-β-D-glucopyranoside,ononin,calycosin,onocerin,curdione,cincumol and germacrone,and establish the fingerprint of HRPCM,VPCR and HRPCM-VPCR.Results HPLC chromatographic conditions were established for the determination of 8 components in HRPCM-VPCR.Meanwhile,fingerprints were established before and after the compatibility of HRPCM-VPCR.26 common peaks were identified,among which 11 components such as vanillic acid were derived from HRPCM,14 components such as curcuma zedoariae were derived from VPCR,and 1 component was shared by both.Conclusion The material basis of the compatibility of HRPCM-VPCR differs from that of HRPCM and VPCR.The content of most chemical components decreases while the content of some components increases.The established HPLC method for content determination and fingerprint is simple,stable and reproducible,which can be used to evaluate and control the quality of HRPCM and VPCR.