Chronic heart failure （CHF） is a complex clinical syndrome caused by ventricular dysfunction， with mitochondrial energy metabolism disorder being a critical factor in disease progression. Heart-Yang deficiency syndrome， as the core pathogenesis of CHF， persists throughout the disease course. Insufficiency of heart-Yang leads to weakened warming and propelling functions， resulting in the accumulation of phlegm-fluid， blood stasis， and dampness. This eventually causes Qi stagnation with phlegm obstruction and blood stasis with water retention， forming a vicious cycle that exacerbates disease progression. According to the theory of reinforcing Yang， the clinical experience of the traditional Chinese medicine （TCM） master Tang Zuxuan in treating CHF with heart-Yang deficiency syndrome， and achievements from molecular biological studies， this study innovatively proposes an integrated research framework of "TCM syndrome differentiation and staging-mitochondrial metabolism mechanisms-intervention with Yang-reinforcing prescriptions" which is characterized by the integration of traditional Chinese and Western medicine. Heart-Yang deficiency syndrome is classified into mild （Stage Ⅰ-Ⅱ）， severe （Stage Ⅲ）， and critical （Stage Ⅳ） stages. The study elucidates the precise correlations between the pathogenesis of each stage and mitochondrial metabolism disorders from theoretical， pathophysiological， and therapeutic perspectives. The mild stage is characterized by impaired biogenesis and substrate-utilization imbalance， corresponding to heart-Yang deficiency and phlegm-fluid aggregation. Linggui Zhugantang and similar prescriptions can significantly improve the expression of peroxisome proliferator-activated receptor gamma co-activator-1α（PGC-1α）/silent information regulator 2 homolog 1 （SIRT1） and ATPase activity. The severe stage centers on oxidative stress and structural damage， reflecting Yang deficiency with water overflow and phlegm-blood stasis intermingling. At this stage， Zhenwu Tang and Qiangxin Tang can effectively mitigate oxidative stress damage， increase adenosine triphosphate （ATP） content， and repair mitochondrial structure. The critical stage arises from calcium overload and mitochondrial disintegration， leading to the collapse of Yin-Yang equilibrium. At this stage， Yang-restoring and crisis-resolving prescriptions such as Fuling Sini Tang and Qili Qiangxin capsules can inhibit abnormal opening of the mitochondrial permeability transition pore （MPTP）， reduce cardiomyocyte apoptosis rate， and protect mitochondrial function. By summarizing the characteristics of mitochondrial energy metabolism disorders at different stages of CHF， this study explores the application of the theory of reinforcing Yang in treating heart-Yang deficiency syndrome and provides new insights for the clinical diagnosis and treatment of CHF.

Objective To investigate the diagnostic value of 4 novel inflammatory markers related to routine blood tests,namely neutrophil-to-lymphocyte ratio(NLR),red blood cell distribution width(RDW),hemoglobin-to-RDW ratio(HRR)and systemic immune-inflammation index(SII),in elderly patients with chronic cardiovascular disease(CVD)complicated with frailty.Methods Retrospectively analyze 110 patients with chronic stable CVD who were hospitalized in the cadre ward of cardiovascular medicine at the Air Force Characteristic Medical Center from January 2022 to June 2023.According to the assessment results of the Fried scale,they were divided into three groups:non-frailty group(Fried score=0,n=30),the pre-frailty group(Fried score 1 or 2,n=40)and frailty group(Fried score≥3,n=40).The differences in general information,the impairment rate of daily living activities,miniature nutritional assessment-short form(MNA-SF)scores,mini-mental state examination(MMSE)scores,and the indicators such as NLR,RDW,HRR,and SII among the three groups were compared.Spearman rank correlation was used to analyze the correlation between NLR,RDW,HRR,SII and frailty scores as well as each frailty indicator.Multivariate logistic regression analysis was performed to identify the independent risk factors for frailty in elderly patients with chronic CVD,and the receiver operating characteristic(ROC)curve was used to assess the clinical diagnostic value of NLR and HRR in elderly patients with chronic CVD complicated with frailty.Results Compared with non-frailty group and pre-frailty group,patients in frailty group were older,with higher impaired rates of daily living activities,NLR,RDW,and SII,and lower MNA-SF scores,MMSE scores,and HRR,and differences were statistically significant(P<0.05).Spearman rank correlation analysis showed that the frailty score was positively correlated with NLR(rs=0.354,P<0.001),and RDW(rs=0.448,P<0.001),negatively correlated with HRR(rs=-0.232,P=0.024),and had no significant correlation with SII(rs=0.144,P=0.167).Further analysis of the correlation between the above novel inflammatory markers and the 5 components of frailty showed that NLR was positively correlated with fatigue(rs=0.228,P=0.017),slowed walking speed(rs=0.299,P<0.001),and low physical function(rs=0.319,P<0.001);RDW was positively correlated with decreased grip strength(rs=0.321,P<0.001),slowed walking speed(rs=0.422,P<0.001),and low physical function(rs=0.246,P=0.001);and HRR was negatively correlated with slowed walking speed(rs=-0.230,P=0.025),and low physical function(rs=-0.299,P=0.003).Multivariate logistic regression analysis showed that MNA-SF score(OR=0.577,95%CI 0.342-0.973)was an independent protective factor for pre-frailty in elderly patients with chronic CVD(P<0.05);NLR(OR=7.866,95%CI 1.101-56.185)was an independent risk factor for frailty,while HRR(OR=0.344,95%CI 0.120-0.983)and MNA-SF score(OR=0.292,95%CI 0.146-0.580)were independent protective factors for frailty in elderly CVD patients(P<0.05).The area under the ROC curve of NLR and HRR for diagnosing frailty in elderly patients with chronic CVD were 0.778 and 0.749,respectively.Conclusion NLR and HRR have high clinical diagnostic value for frailty in elderly patients with chronic CVD,and are expected to become effective inflammatory markers for screening elderly patients with chronic CVD complicated with frailty.

Objective To evaluate the effect of bundle intervention on reducing catheter-associated urinary tract in-fection(CAUTI).Methods Hospitalized patients with urinary catheterization in a tertiary first-class hospital were subjected to targeted monitoring of a baseline survey from January to December 2022(pre-intervention).The main causes were found out,and bundle intervention measures were developed and implemented through plan-do-check-act(PDCA)tools from January to March 2023(intervention period).The data from April to December 2023(post-intervention)were collected,difference in catheter use rate and incidence of CAUTI before and after intervention were compared.Results The implementation rate of correctly hanging urine collection bags after intervention was 97.00％,the implementation rate of timely emptying urine collection bags was 91.72％,awareness rate of hand hy-giene among patient's family members was 79.13％,implementation rate of urinary catheter clamping during trans-portation was 74.79％,and daily evaluation implementation rate was 87.68％,which were higher than the pre-in-tervention rates of 85.63％,80.47％,62.75％,60.00％,and 79.93％,respectively.The incidence of CAUTI de-creased from 1.23‰ before intervention to 0.57‰ after intervention,the use rate of urinary catheter decreased from 5.53％before intervention to 5.37％after intervention.Differences of the above indicators were all statistically sig-nificant(all P＜0.05).Conclusion Through targeted monitoring on CAUTI and PDCA quality tools,the weak links in healthcare-associated infection control are identified,more targeted prevention and control measures are for-mulated,the implementation of bundle intervention measures can reduce the incidence of CAUTI.

Objective To examine the expression and validate the localization of the neurotrophin neuritin(NRN1)in human tissues using bioinformatics and experimental methods.Methods The tissue-specific expression of NRN1 was analyzed using the Human Pro-tein Atlas(HPA)database.NRN1 mRNA and protein expression were experimentally validated using real-time quantitative PCR and immunohistochemistry,respectively.A pEGFP-C1-NRN1 green fluorescent protein fusion vector was transfected into 293 cells,and NRN1 localization was assessed using immunofluorescence.Endogenous NRN1 localization was also examined in hippocampal HT22 cells.Results According to the HPA database,NRN1 expression was enriched in the cerebral cortex,parathyroid gland,adipose tissue,and placenta.Experimental validation confirmed NRN 1 expression in all the aforementioned tissues,with highest levels observed in the brain and spleen.Immunofluorescence analysis revealed that NRN 1 was predominantly localized to the membrane in HT22 cells and to the cyto-plasm in 293 cells.Conclusion NRN 1 is expressed in various human tissues,with notably high expression in the brain.It is primarily localized to the cell membrane and cytoplasm.

Objective To evaluate the effect of bundle intervention on reducing catheter-associated urinary tract in-fection(CAUTI).Methods Hospitalized patients with urinary catheterization in a tertiary first-class hospital were subjected to targeted monitoring of a baseline survey from January to December 2022(pre-intervention).The main causes were found out,and bundle intervention measures were developed and implemented through plan-do-check-act(PDCA)tools from January to March 2023(intervention period).The data from April to December 2023(post-intervention)were collected,difference in catheter use rate and incidence of CAUTI before and after intervention were compared.Results The implementation rate of correctly hanging urine collection bags after intervention was 97.00％,the implementation rate of timely emptying urine collection bags was 91.72％,awareness rate of hand hy-giene among patient's family members was 79.13％,implementation rate of urinary catheter clamping during trans-portation was 74.79％,and daily evaluation implementation rate was 87.68％,which were higher than the pre-in-tervention rates of 85.63％,80.47％,62.75％,60.00％,and 79.93％,respectively.The incidence of CAUTI de-creased from 1.23‰ before intervention to 0.57‰ after intervention,the use rate of urinary catheter decreased from 5.53％before intervention to 5.37％after intervention.Differences of the above indicators were all statistically sig-nificant(all P＜0.05).Conclusion Through targeted monitoring on CAUTI and PDCA quality tools,the weak links in healthcare-associated infection control are identified,more targeted prevention and control measures are for-mulated,the implementation of bundle intervention measures can reduce the incidence of CAUTI.

Objective To examine the expression and validate the localization of the neurotrophin neuritin(NRN1)in human tissues using bioinformatics and experimental methods.Methods The tissue-specific expression of NRN1 was analyzed using the Human Pro-tein Atlas(HPA)database.NRN1 mRNA and protein expression were experimentally validated using real-time quantitative PCR and immunohistochemistry,respectively.A pEGFP-C1-NRN1 green fluorescent protein fusion vector was transfected into 293 cells,and NRN1 localization was assessed using immunofluorescence.Endogenous NRN1 localization was also examined in hippocampal HT22 cells.Results According to the HPA database,NRN1 expression was enriched in the cerebral cortex,parathyroid gland,adipose tissue,and placenta.Experimental validation confirmed NRN 1 expression in all the aforementioned tissues,with highest levels observed in the brain and spleen.Immunofluorescence analysis revealed that NRN 1 was predominantly localized to the membrane in HT22 cells and to the cyto-plasm in 293 cells.Conclusion NRN 1 is expressed in various human tissues,with notably high expression in the brain.It is primarily localized to the cell membrane and cytoplasm.

Objective:To construct a foreign-funded medical safety risk review evaluation index system for the regulatory needs in the context of expanding the opening up of China's medical service industry,in order to achieve a dynamic balance between opening up and safety and prevent systemic risks.Methods:Using a combination of the Delphi method and hierarchical analysis method,21 senior experts from the fields of management of healthcare institutions,health policy,health jurisprudence and public safety were invited to participate in the construction of the indexes.Statistical quantities such as expert authority coefficient,coordination coefficient and content validity were used to ensure the specificity of the indicators,and the hierarchical analysis method was used to quantify the weights of the indicators and derive the analysis results.Results:the positive coefficients of the two rounds of expert consultation were greater than 95%,and the expert authority coefficient was 0.897;the expert Kendall coordination coefficients were 0.178 and 0.182,respectively,with P＜0.001,and the differences were all statistically significant.Through two rounds of expert correspondence,the evaluation index system of foreign-funded medical hospital safety risk review constructed by 4 first-level indicators,12 second-level indicator systems and 38 third-level indicators of functional safety,medical safety,bio-safety and information security was finalized.Conclusions:Through a multi-dimensional risk assessment framework,the system provides quantitative tools for the review and dynamic supervision of foreign medical access,which can support the policy synergy of"high level of openness and high level of security"and help modernize the governance capacity of China's medical service industry.

Objective:To construct a foreign-funded medical safety risk review evaluation index system for the regulatory needs in the context of expanding the opening up of China's medical service industry,in order to achieve a dynamic balance between opening up and safety and prevent systemic risks.Methods:Using a combination of the Delphi method and hierarchical analysis method,21 senior experts from the fields of management of healthcare institutions,health policy,health jurisprudence and public safety were invited to participate in the construction of the indexes.Statistical quantities such as expert authority coefficient,coordination coefficient and content validity were used to ensure the specificity of the indicators,and the hierarchical analysis method was used to quantify the weights of the indicators and derive the analysis results.Results:the positive coefficients of the two rounds of expert consultation were greater than 95%,and the expert authority coefficient was 0.897;the expert Kendall coordination coefficients were 0.178 and 0.182,respectively,with P＜0.001,and the differences were all statistically significant.Through two rounds of expert correspondence,the evaluation index system of foreign-funded medical hospital safety risk review constructed by 4 first-level indicators,12 second-level indicator systems and 38 third-level indicators of functional safety,medical safety,bio-safety and information security was finalized.Conclusions:Through a multi-dimensional risk assessment framework,the system provides quantitative tools for the review and dynamic supervision of foreign medical access,which can support the policy synergy of"high level of openness and high level of security"and help modernize the governance capacity of China's medical service industry.

Foods can be contaminated with foodborne pathogens through a variety of pathways, including water, air and soil. Food safety events caused by foodborne pathogens show a serious impact on human health. However, due to the diversity of foodborne pathogens and the complexity of food matrices, the rapid detection of foodborne pathogens was difficult. The conventional microbial culture and physiological and biochemical identification can hardly meet the need of rapid detection of foodborne pathogens in the field. It is necessary to develop rapid detection technologies for foodborne pathogens. Clustered regularly interspaced short palindromic repeats (CRISPR) and associated protein (Cas) are an adaptive immune systems of prokaryotes with specific recognition and cleavage of nucleic acid sequences, which shows good potential for development of nucleic acid detection and biosensing in the field. According to different forms of application, paper-based analytical devices can be categorized into test paper, lateral flow assay and microfluidic paper-based chips, etc. As a good simplicity and low-cost analytical testing tools, they show good prospects in the field of rapid testing. Therefore, the rapid and sensitive detection of foodborne pathogens can be realized by combining the efficient recognition ability of CRISPR/Cas system and the simplicity of paper-based analytical devices. In this paper, we briefly introduce an overview of the CRISPR/Cas system for nucleic acid detection, and this section focuses on an overview of the features and principles of the class 2 system, including types II, V and VI, which uses a single effector. The application of CRISPR/Cas system based test paper analysis, lateral flow assay and microfluidic paper-based chips for the detection of foodborne pathogens are highlighted in the paper, and finally the advantages, current challenges and future prospects of CRISPR/Cas system in combination with paper-based analytical devices to establish detection methods are discussed.

This study investigated the risk factors for treatment failure in patients with a single infection of Mycobacterium avium.Patients with Mycobacterium avium infection meeting the guidelines for diagnosis and treatment of non-tuberculous mycobacteriosis between January 2016 and December 2020 at Shanghai Pulmonary Hospital were included.A logistic regression model was used to analyze the risk factors for treatment failure.A total of 26(49％)of 53 patients with Mycobacterium avium infection included in the study had treatment failure.A higher proportion of patients with fever,anemia,and lung cavitation in the treatment failure group had significantly higher neutrophils and direct bilirubin,and significantly lower prealbumin.Multi-factorial logistic regression demonstrated that cavitation was an independent risk factor for treatment failure in patients with Mycobacterium avium infection,and Kaplan-Meier analysis indicated significantly lower cumulative 12-month cure rates in pa-tients with cavitation.Patients with Mycobacterium avium infection had a higher rate of treatment failure,and cavitation was found to be a risk factor for treatment failure.Our findings suggest that clinicians should pay attention to the monitoring and treatment of patients with Mycobacterium avium pulmonary cavities to improve the cure rate among patients.