Objective:To construct an intelligent evaluation model based on the grey whitening weight cluster algorithm for risk in supply chain of medical consumables,and explore its application value in the management for medical consumables.Methods:The risk source of supply chain of medical consumables under the supply-processing-distribution(SPD)mode was analyzed,and the problems in the management for supply chain were evaluated by using grey whitening weight cluster,and an intelligent evaluation model for risk in supply chain of medical consumables was constructed to conduct control and management for risk in supply chain of medical consumables.A total of 10.61 million pieces of 400 types of medical consumables that were purchased and used by the National Center for Children's Health,China,Beijing Children's Hospital,Capital Medical University from 2022 to 2023 were selected.In them,the 5.15 million pieces of 200 types of medical consumables that were purchased and used during January and December 2022 were controlled and managed for risk through the management mode of assessment and prediction with experts.The 5.46 million pieces of 200 types of medical consumables that were purchased and used during January and December 2023 were controlled and managed for risk through used the intelligent evaluation model based on the gray whitening weight cluster algorithm under the SPD mode in supply chain of medical consumables for risk(prediction management mode with evaluation model).The incidences of risk,and the accuracy of data in supply chain between the two management modes were compared.A self-made satisfaction questionnaire was used to investigate the satisfaction rates of medical staffs,medical technicians,managers of department,and keepers of warehouse regarding to the supply of medical consumables.Results:The incidence rates of risks in suppliers,inventory,finance,technical support and information security of supply chain were respectively 1.8%,2.2%,0.4%,1.5%and 3.1%by adopting prediction management mode with evaluation model in 100,000 randomly inspected cases of medical consumables,all of which were lower than those of the management mode of assessment and prediction with experts,and the differences were statistically significant(x2=9.239,23.013,11.706,21.141,42.331,P<0.05).The accuracy rates of supply data of spot check for the consumables of auxiliary examination,the nursing consumables in ward,the consumables of surgical treatment,the consumables of oral treatment and other disposable consumables of prediction management mode with evaluation model were all higher than those of the management mode of assessment and prediction with experts,and the differences were statistically significant(x2=11.628,15.842,7.790,7.289,7.448,P<0.05).The satisfaction rates of medical staffs,medical technicians,managers of department and keepers of warehouse for clinical supply of medical consumables in prediction management mode with evaluation model were all higher than those in the management mode of assessment and prediction with experts,and the differences were statistically significant(x2=4.824,5.703,5.529,5.143,P<0.05).Conclusion:The intelligent evaluation model based on the grey whitening weight cluster algorithm under the SPD mode for risk in supply chain of medical consumables can reduce the incidence rate of risk in the supply chain of medical consumables,and improve the accuracy of supply data of medical consumables,and enhance the satisfaction of staffs in hospital.

Objectives:To analyze the 100 most cited papers in the field of spino-pelvic sagittal balance since 2003,summarize and sort out the research hotspots and trends by using bibliometrics,in order to pro-vide references for related research and disease diagnosis and treatment in this field.Methods:The English literature in the field of spino-pelvic sagittal balance published from 2003 to 2023 was searched in the Web of Science Core Collection(WoSCC)database.According to the inclusion and exclusion criteria,the keywords,publication year,first author,publishing institution,country,publication journal,and total number of citations of the included literature were extracted for summary and visual analysis.VOSviewer,CiteSpace,RStudio and other bibliometric analysis tools were used to reveal the global trends and research hotspots in this field.Results:A total of 6804 articles were retrieved according to the search criteria set in this study.Based on the title,abstract and full text of the articles,the top 100 most cited articles were finally obtained,including 86 original articles and 14 reviews.58 articles were published between the year 2003 and 2019,and cited 200 times or more.The most cited article was"The impact of positive sagittal balance in adult spinal defor-mity",with a total of 1179 citations.The country with the largest number of publications was the United States.The journal published the most articles was Spine.The most published institution was the University of Washington.The most prolific first author was Lafage V.Balance was the most frequent keyword.After reading the full text,the topics of the literature were summarized into seven aspects:radiological parameters,surgery,complications,classification system,general overview,compensation mechanism and others.Conclu-sions:Radiological parameters,surgery,and complications are still the focus of current research.Minimally invasive surgical techniques and individualized treatment are the future research and development trends.The number of articles published by Chinese scholars is increasing,while the number of citations is relatively small.

OBJECTIVE To explore the current status,etiological characteristics and risk factors for nosocomial in-fections in the patients who are treated with extracorporeal membrane oxygenation(ECMO)so as to provide bases for treatment and prevention of nosocomial infections in the ICU patients treated with ECMO.METHODS The clinical data were retrospectively collected from the patients who were treated with ECMO in the ICU of Xinyang Central Hospital from Jan.2021 to Dec.2023.The patients were divided into the infection group and the non-infec-tion group according the status of nosocomial infection during the ECMO treatment period.The constituent ratios of pathogens isolated from the patients with infections were recorded,and multivariate logistic regression analysis was performed for independent risk factors for the ECMO-related nosocomial infections.RESULTS Of 86 patients who were finally enrolled in the study,33(38.37％)had nosocomial infections.Totally 54 strains of pathogens were isolated from the patients with the infections,43(79.63％)of which were gram-negative bacteria,7(12.97％)were gram-positive bacteria,and 4(7.41％)were fungi.There were 36(66.67％)strains of multi-drug-resistant organisms(MDROs)among the 54 strains of pathogens,and 27(81.82％)patients were detected with MDROs.Among the ECMO patients with postoperative nosocomial infections,21(63.64％)cases had pul-monary infections,8(24.24％)cases had bloodstream infection,and 4(12.12％)had urinary system infections.Multivariate logistic analysis showed that the high blood glucose level at the beginning of treatment with ECMO,long duration of ECMO treatment and long time of central venous catheter indwelling were the independent risk factors for the nosocomial infections in the patients treated with ECMO(P＜0.05).CONCLUSION The isolation rate of gram-negative bacteria is relatively high among the pathogens isolated from the ECMO patients with post-operative nosocomial infections,and the drug resistance rates are high.The high blood glucose level,long duration of ECMO supporting treatment and long time of central venous catheter indwelling are the independent risk factors for the nosocomial infections in the patients treated with ECMO.

Colorectal cancer(CRC)is the most common malignant tumor of the digestive tract,with its incidence rate increasing annually and showing a younger-age trend,imposing heavy health and economic burdens on society and families.Regular moderate-to-vigorous physical exercise has been demonstrated to significantly reduce the risk of developing CRC,alleviate complications and adverse reactions related to anti-tumor treatment,improve patients'quality of life,and prolong survival.As a simple and economical non-pharmacological intervention,exercise plays a crucial role throughout CRC development and treatment by regulating inflammatory signals and promoting anabolic metabolism through multi-omics regulatory networks.This article reviewed the latest evidence from clinical and experimental studies,emphasizing the indispensability of exercise in the comprehensive management of CRC patients,and provided a summary analysis of relevant mechanisms.Future research should further investigate the specific impacts of various exercise types,intensities,and frequencies on CRC,combine them with clinical treatment methods such as radiotherapy and chemotherapy,and explore precision approaches under multimodal interventions to maximize clinical benefits.

Colorectal cancer(CRC)is the most common malignant tumor of the digestive tract,with its incidence rate increasing annually and showing a younger-age trend,imposing heavy health and economic burdens on society and families.Regular moderate-to-vigorous physical exercise has been demonstrated to significantly reduce the risk of developing CRC,alleviate complications and adverse reactions related to anti-tumor treatment,improve patients'quality of life,and prolong survival.As a simple and economical non-pharmacological intervention,exercise plays a crucial role throughout CRC development and treatment by regulating inflammatory signals and promoting anabolic metabolism through multi-omics regulatory networks.This article reviewed the latest evidence from clinical and experimental studies,emphasizing the indispensability of exercise in the comprehensive management of CRC patients,and provided a summary analysis of relevant mechanisms.Future research should further investigate the specific impacts of various exercise types,intensities,and frequencies on CRC,combine them with clinical treatment methods such as radiotherapy and chemotherapy,and explore precision approaches under multimodal interventions to maximize clinical benefits.

OBJECTIVE To explore the current status,etiological characteristics and risk factors for nosocomial in-fections in the patients who are treated with extracorporeal membrane oxygenation(ECMO)so as to provide bases for treatment and prevention of nosocomial infections in the ICU patients treated with ECMO.METHODS The clinical data were retrospectively collected from the patients who were treated with ECMO in the ICU of Xinyang Central Hospital from Jan.2021 to Dec.2023.The patients were divided into the infection group and the non-infec-tion group according the status of nosocomial infection during the ECMO treatment period.The constituent ratios of pathogens isolated from the patients with infections were recorded,and multivariate logistic regression analysis was performed for independent risk factors for the ECMO-related nosocomial infections.RESULTS Of 86 patients who were finally enrolled in the study,33(38.37％)had nosocomial infections.Totally 54 strains of pathogens were isolated from the patients with the infections,43(79.63％)of which were gram-negative bacteria,7(12.97％)were gram-positive bacteria,and 4(7.41％)were fungi.There were 36(66.67％)strains of multi-drug-resistant organisms(MDROs)among the 54 strains of pathogens,and 27(81.82％)patients were detected with MDROs.Among the ECMO patients with postoperative nosocomial infections,21(63.64％)cases had pul-monary infections,8(24.24％)cases had bloodstream infection,and 4(12.12％)had urinary system infections.Multivariate logistic analysis showed that the high blood glucose level at the beginning of treatment with ECMO,long duration of ECMO treatment and long time of central venous catheter indwelling were the independent risk factors for the nosocomial infections in the patients treated with ECMO(P＜0.05).CONCLUSION The isolation rate of gram-negative bacteria is relatively high among the pathogens isolated from the ECMO patients with post-operative nosocomial infections,and the drug resistance rates are high.The high blood glucose level,long duration of ECMO supporting treatment and long time of central venous catheter indwelling are the independent risk factors for the nosocomial infections in the patients treated with ECMO.

AIM To establish the quantitative models for gallic acid,mononucleoside,loganin,resveratrol,and rhein in Yishen Xiezhuo Mixture.METHODS HPLC was adopted in the content determination of various effective components,after which the near-infrared spectroscopy(NIRS)data were collected in 128 batches of samples and pretreatment was conducted,competitive adaptive reweighting sampling(CARS)algorithm was used for screening wavelength,partial least square method(PLS)regression analysis was performed.RESULTS There were no significant differences between the predicted values obtained by PLS models and measured values obtained by HPLC for various effective components(P＞0.05).CONCLUSION The quantitative models established by NIRS combined with chemometrics display good predictive performance,which can be used for the rapid determination of effective components in Yishen Xiezhuo Mixture,and provide a reference for the rapid monitoring of other traditional Chinese medicine preparations in production processes.

This study aims to explore the effects and mechanisms of the traditional Chinese medicine Cordyceps sinensis(CS) in ameliorating heart aging and injury in mice based on animal experiments and network pharmacology. A mouse model of heart aging was established by continuously subcutaneous injection of D-galactose(D-gal). Thirty mice were randomly assigned into a normal group, a model group, a low-dose CS(CS-L) group, a high-dose CS(CS-H) group, and a vitamin E(VE) group. Mice in these groups were administrated with normal saline, different doses of CS suspension, or VE suspension via gavage daily. After 60 days of treatment with D-gal and various drugs, all mice were euthanized, and blood and heart tissue samples were collected for determination of the indicators related to heart aging and injury in mice. Experimental results showed that both high and low doses of CS and VE ameliorated the aging phenotype, improved the heart index and myocardial enzyme spectrum, restored the expression levels of proteins associated with cell cycle arrest and senescence-associated secretory phenotypes(SASP), and alleviated the fibrosis and histopathological changes of the heart tissue in model mice. From the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP),259 active ingredients of CS were retrieved. From Gene Cards and OMIM, 2 568 targets related to heart aging were identified, and 133common targets shared by CS and heart aging were obtained. The Gene Ontology(GO) functional annotation and Kyoto Encyclopedia of Genes and Genomes( KEGG) pathway enrichment revealed that the pathways related to heart aging involved oxidative stress,apoptosis, inflammation-related signaling pathways, etc. The animal experiment results showed that both high and low doses of CS and VE ameliorated oxidative stress and apoptosis in the heart tissue to varying degrees in model mice. Additionally, CS-H and VE activated the nuclear factor E2-related factor 2(Nrf2)/heme oxygenase-1(HO-1) pathway and inhibited the expression of key proteins in the nuclear factor-κB(NF-κB) pathway in the heart tissue of model mice. In conclusion, this study demonstrated based on network pharmacology and animal experiments that CS may alleviate heart aging and injury in aging mice by reducing oxidative stress,apoptosis, and inflammation in the heart via the Nrf2/HO-1/NF-κB pathway.
Animals ; Cordyceps/chemistry* ; Mice ; NF-E2-Related Factor 2/genetics* ; NF-kappa B/genetics* ; Aging/genetics* ; Male ; Signal Transduction/drug effects* ; Network Pharmacology ; Drugs, Chinese Herbal/pharmacology* ; Heme Oxygenase-1/genetics* ; Heart/drug effects* ; Humans ; Myocardium/metabolism* ; Membrane Proteins/genetics*

This study aimed to investigate the effect of Dahuang Zhechong Pills(DHZCP) in delaying heart aging(HA) and explore the potential mechanism. Network pharmacology and molecular docking were employed to explore the targets and potential mechanisms of DHZCP in delaying HA. Furthermore, in vitro experiments were conducted with the DHZCP-containing serum to verify key targets and pathways in D-galactose(D-gal)-induced aging of cardiomyocytes. Active components of DHZCP were searched against the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCSMP), and relevant targets were predicted. HA-related targets were screened from the GeneCards, Online Mendelian Inheritance in Man(OMIM), and DisGeNET. The common targets shared by the active components of DHZCP and HA were used to construct a protein-protein interaction network in STRING 12.0, and core targets were screened based on degree in Cytoscape 3.9.1. Metaspace was used for Gene Ontology(GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG) enrichment analyses of the core targets to predict the mechanisms. Molecular docking was performed in AutoDock Vina. The results indicated that a total of 774 targets of the active components of DHZCP and 4 520 targets related to HA were screened out, including 510 common targets. Core targets included B-cell lymphoma 2(BCL-2), serine/threonine kinase 1(AKT1), and hypoxia-inducible factor 1 subunit A(HIF1A). The GO and KEGG enrichment analyses suggested that DHZCP mainly exerted its effects via the phosphatidylinositol 3-kinase(PI3K)/AKT signaling pathway, HIF-1α signaling pathway, longevity signaling pathway, and apoptosis signaling pathway. Among the pathways predicted by GO and KEGG enrichment analyses, the PI3K/AKT/HIF-1α signaling pathway was selected for verification. The cell-counting kit 8(CCK-8) assay showed that D-gal significantly inhibited the proliferation of H9c2 cells, while DHZCP-containing serum increased the viability of H9c2 cells. SA-β-gal staining revealed a significant increase in the number of blue-green positive cells in the D-gal group, which was reduced by DHZCP-containing serum. TUNEL staining showed that DHZCP-containing serum decreased the number of apoptotic cells. After treatment with DHZCP-containing serum, the protein levels of Klotho, BCL-2, p-PI3K/PI3K, p-AKT1/AKT1, and HIF-1α were up-regulated, while those of P21, P16, BCL-2 associated X protein(Bax), and cleaved caspase-3 were down-regulated. The results indicated that DHZCP delayed HA via multiple components, targets, and pathways. Specifically, DHZCP may delay HA by reducing apoptosis via activating the PI3K/AKT/HIF-1α signaling pathway.
Proto-Oncogene Proteins c-akt/genetics* ; Drugs, Chinese Herbal/pharmacology* ; Signal Transduction/drug effects* ; Apoptosis/drug effects* ; Myocytes, Cardiac/cytology* ; Hypoxia-Inducible Factor 1, alpha Subunit/genetics* ; Phosphatidylinositol 3-Kinases/genetics* ; Animals ; Rats ; Humans ; Molecular Docking Simulation ; Aging/metabolism* ; Protein Interaction Maps/drug effects* ; Heart/drug effects* ; Network Pharmacology

Traditional Chinese medicine(TCM) decoction pieces are a core carrier for the inheritance and innovation of TCM, and their quality and safety are critical to public health and the sustainable development of the industry. Conventional quality control models, while having established a well-developed system through long-term practice, still face challenges such as relatively long inspection cycles, insufficient objectivity in characterizing complex traits, and urgent needs for improving the efficiency of integrating multidimensional quality information when confronted with the dual demands of large-scale production and precision quality control. With the rapid development of artificial intelligence, machine learning can deeply analyze multidimensional data of the morphology, spectroscopy, and chemical fingerprints of decoction pieces by constructing high-dimensional feature space analysis models, significantly improving the standardization level and decision-making efficiency of quality evaluation. This article reviews the research progress in the application of machine learning in the processing, production, and rapid quality evaluation of TCM decoction pieces. It further analyzes current challenges in technological implementation and proposes potential solutions, offering theoretical and technical references to advance the digital and intelligent transformation of the industry.
Machine Learning ; Drugs, Chinese Herbal/standards* ; Quality Control ; Medicine, Chinese Traditional/standards* ; Humans