Chronic atrophic gastritis （CAG）， a premalignant gastric condition， represents a critical stage in inflammation-cancer transformation. In this pathological process， mitochondrial damage serves as a key mediator in the inflammation-driven transformation of normal gastric mucosal epithelial cells into gastric cancer cells， while the dysregulation of the reactive oxygen species （ROS）/NOD-like receptor protein 3 （NLRP3） axis plays a key role in perpetuating the vicious cycle of inflammation-mitochondrial damage. The classical theory of traditional Chinese medicine （TCM）， vigorous fire consuming Qi， aptly encapsulates this pathological feature. The essence of this theory lies in the struggle between pathogenic and vital factors， wherein vigorous fire shares similarities with chronic inflammation and may be regarded as a driving force behind inflammation-cancer transformation. Qi reflects the mitochondrial function， and consuming Qi signifies structural and functional impairment of mitochondria. Thus， this theory accurately summarizes the pathological characteristics of inflammation-mitochondrial damage during CAG progression. Building upon this theoretical framework， the theory of vigorous fire consuming Qi provides a holistic understanding of CAG pathogenesis. Reviewing the clinical expertise of TCM master YANG Chunbo in treating spleen-stomach disorders， this paper further elucidates its therapeutic implications： modulating systemic inflammatory responses to restore gastric mucosal homeostasis and targeting mitochondrial damage as a pivotal intervention to delay CAG progression. Clinically， achieving dynamic equilibrium between fire and Qi is essential， mitigating excessive inflammation without compromising vital Qi， while reinforcing Qi without exacerbating pathological fire. This approach offers novel insights for developing preventive and therapeutic strategies against CAG.

ObjectiveTo characterize the seasonal patterns of influenza in Kunming City, Yunnan Province before, during, and after the COVID-19 pandemic, and provide scientific evidence for optimizing influenza prevention and control strategies. MethodsInfluenza-like illness (ILI) and etiological surveillance data for influenza from the 14^th week of 2010 to the 13^th week of 2024 in Kunming City of Yunnan Province were collected. Harmonic regression models were constructed to analyze the epidemic characteristics and seasonal patterns of influenza before (2010/2011‒2019/2020 influenza seasons), during (2020/2021‒2022/2023 influenza seasons), and after (2023/2024 influenza season) the COVID-19 pandemic. ResultsBefore the COVID-19 pandemic, influenza in Kunming City mainly exhibited an annual cyclic pattern without a significant semi-annual periodicity, peaking from December to February of the next year, with an epidemic duration of 20‒30 weeks. During the pandemic, influenza seasonality shifted, with an increase in semi-annual periodicity and an approximate one month delay in annual peaks. However, after the pandemic, the annual amplitude of influenza increased compared with that before the pandemic, and the epidemic duration extended by about one month. Although the annual peak largely reverted to the pre-pandemic levels, the annual peaks for different influenza subtypes/lineages had not fully recovered. ConclusionInfluenza seasonality in Kunming City underwent substantial alterations following the COVID-19 pandemic and has not yet fully reverted to pre-pandemic levels. Continuous surveillance on different subtypes/lineages of influenza viruses remains essential, and prevention and control strategies should be adjusted and optimized in a timely manner based on current epidemic trends.

Objective:To investigate the active ingredients and targets of Compound Gastritis Mixture(CGM)in the treatment of chronic atrophic gastritis(CAG)by network pharmacology method,and to validate the potential mechanism combined with molecular docking technology and cellular experiments.Methods:The Traditional Chinese Medicine System Analysis Platform(TCMSP)and Swiss Target Prediction databases were used to select the herbal ingredients of CGM and the corresponding targets;the GeneCards and Online Mendelian Inheritance in Man(OMIM)database were used to screen the targets of CAG;the common targets of CGM and CAG were analyzed from the Venny2.1.0 platform;STRING online platform was used to construct protein-protein interaction(PPI)networks for common drug-disease targets and screen the core targets.Cytoscape 3.9.1 software was used to construct the drug-disease-target network and screen the drug core components;Gene Ontology(GO)fuctional,Kyoto Encyclopedia of Genes and Genomes(KEGG)signaling pathway enrichment analysis were used to analyze the common targets of CGM and CAG;and AutoDock analysis software was used to perform molecular docking analysis of predicted main components of the drugs and core targets.The gastric mucosal epithelial cells GES-1 were induced by lipopolysaccharide(LPS)to construct CAG cell model.The GES-1 cells were divided into blank group(10%serum complete medium),model group(10 mg·L-1 LPS),and different concentrations of CGM groups(50,100,200,400,800 and 1 600 g·L-1 CGM+10 mg·L-1 LPS),and cells were incubated for 12,24,and 48 h.The cell counting kit-8(CCK-8)assay was used to detect the proliferation activities of GES-1 cells.The GES-1 cells were divided into blank group(10%serum complete medium),model group(10 mg·L-1 LPS)and CGM group(1 600 g·L-1 CGM+10 mg·L-1 LPS).Real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the expression levels of interleukin(IL)-6,tumor necrosis factor(TNF),serine/threonine protein kinase 1(AKT1),IL-1β,and epidermal growth factor receptor(EGFR)mRNA in the cells in various groups.Results:A total of 198 ingredients of CGM were screened,and 128 common targets with CAG were identified.The main herbal ingredients of CGM in treatment of CAG were quercetin,kaempferol,and lluteolin,which mainly acted on the core targets of IL-6,TNF,AKT1,IL-1β,and EGFR.The GO function enrichment analysis results showed that the top 15 targets mainly focused on biological processes(BP)such as apoptosis,inflammatory response and cell proliferation,mainly included cellular components(CC)such as cytoplasm,cell surface and macromolecular complexes,and mainly exerted molecular functions(MF)such as proteins,enzymes and ubiquitin-protein ligases.A total of 158 pathways were obtained from KEGG signaling pathway enrichment analysis,mainly involved cancer-related pathways,TNF signaling pathways,viral infection,programmed cell death-ligand 1(PD-L1)/programmed cell death protein-1(PD-1)pathways,apoptosis,NOD-like receptor signaling pathways,Toll-like receptor signaling pathways,EGFR,and IL-17 signaling pathways.The binding energies of the core targets IL-6,TNF,IL-1β,AKT1,and EGFR with main herbal ingredients quercetin,kaempferol,and luteolin were<-5 kcal·mol-1.The CCK-8 assay results showed that compared with blank group,after 24 and 48 h of cell culture,the proliferation activities of the cells in model group were significantly decreased(P<0.01),and the inhibition of the proliferation activity was more obvious after 48 h;therefore,48 h was selected for the modeling time;compared with model group,the proliferation activities of cells in 800 and 1 600g·L-1 GCM groups were significantly decreased(P<0.01),and the promotion of cell proliferation activity was more obvious in 1 600g·L-1 GCM group,so the intervening concentration of this drug was selected for the subsequent experiments.The RT-qPCR method results showed that compared with blank group,the expression levels of IL-6,TNF,IL-1β,AKT1,and EGFR mRNA in the cells in model group were significantly increased(P<0.01);compared with model group,the expression levels of IL-6,IL-1β,AKT1 and EGFR mRNA in the cells in CGM group were significantly decreased(P<0.01).Conclusion:CGM may play a role in the prevention and treatment of CAG through multiple ingredients such as quercetin,kaempferol and lignocerol,acting on the multiple target proteins such as IL-6,TNF,AKT1,IL-1β,and EGFR,as well as involving a variety of"inflammatory-cancer-related"pathways.

Objective:To investigate the correlation between metabolic syndrome (MS), its different components and the risk of cholecystolithiasis and gallbladder polyp in Uygur population in rural areas of southern Xinjiang.Methods:This study was a prospective cohort study. A baseline survey was conducted in August 2016. A typical sampling method was used to select 10 476 Uygur people in rural areas of southern Xinjiang as the research objects. Baseline clinical data were collected, including demographic data such as age, gender, and education level, and laboratory examination indicators such as blood glucose and triglyceride levels. According to the MS diagnostic criteria of the relevant guidelines, 10 476 subjects were divided into the MS group (3 475 cases) and the non-MS group (7 001 cases). The incidence of cholecystolithiasis and gallbladder polyp was followed up in 2019, 2021 and 2023, respectively. Cox regression was used to analyze the correlation between MS, its different components and the risk of cholecystolithiasis and gallbladder polyp. Chi-square test and independent sample t test were used for statistical analysis. Results:The median follow-up time was 6.43 years in 10 476 subjects, and the overall cumulative incidence of cholecystolithiasis and gallbladder polyp was 5.43% (569/10 476). The cumulative incidence of cholecystolithiasis and gallbladder polyp in the MS group was 10.73% (373/ 3 475), which was significantly higher than that in the non-MS group (2.80% (196/7 001)); χ2= 284.62, P<0.001). The results of multivariate Cox regression analysis showed that, 41 to 59 years old ( HR=1.26, 95% confidence interval (95% CI): 1.03 to 1.54, P=0.025), ≥60 years old ( HR=1.88, 95% CI: 1.45 to 2.45, P<0.001), female ( HR=1.34, 95% CI: 1.13 to 1.60, P=0.001), MS ( HR=2.19, 95% CI: 1.59 to 3.01, P<0.001), hypertriglyceridemia ( HR=1.47, 95% CI: 1.18 to 1.83, P=0.001), hypertension ( HR=1.30, 95% CI: 1.04 to 1.62, P=0.023), and hyperglycemia ( HR=1.24, 95% CI: 1.01 to 1.52, P=0.041) were independent risk factors for cholecystolithiasis and gallbladder polyp. After the adjustment of age and gender, MS ( HR=3.39, 95% CI: 2.82 to 4.07, P<0.001), hypertriglyceridemia ( HR=2.37, 95% CI: 2.00 to 2.81, P<0.001), hypertension ( HR=2.00, 95% CI: 1.66 to 2.41, P<0.001), and hyperglycemia ( HR=1.86, 95% CI: 1.55 to 2.23, P<0.001) were still correlated with cholecystolithiasis and gallbladder polyp, and there was the srtongest correlation between MS and cholecystolithiasis and gallbladder polyp. The results of univariate Cox regression analysis showed that along with the increase of accumulated of MS components, the risk of cholecystolithiasis and gallbladder polyp significantly increased (1 to 5 components corresponding HR (95% CI) were 1.92 (1.13 to 3.24), 2.21 (1.32 to 3.69), 6.91 (4.22 to 11.30), 8.56 (5.15 to 14.22), and 10.73 (5.66 to 20.33); P=0.015, =0.002, <0.001, <0.001, and <0.001); after age and gender were adjusted, this trend still existed (1 to 5 components corresponding HR (95% CI) were 1.81(1.07 to 3.06), 1.95(1.16 to 3.27), 5.64(3.42 to 9.32), 6.69(3.97 to 11.25), and 7.76(4.04 to 14.91); P=0.028, =0.012, <0.001, <0.001, and <0.001). Conclusion:MS and its components can increase the risk of cholecystolithiasis and gallbladder polyp, and the risk of cholecystolithiasis and gallbladder polyp significantly increases along with the increase of accumulated of MS components.

Objective:To investigate the correlation between metabolic syndrome (MS), its different components and the risk of cholecystolithiasis and gallbladder polyp in Uygur population in rural areas of southern Xinjiang.Methods:This study was a prospective cohort study. A baseline survey was conducted in August 2016. A typical sampling method was used to select 10 476 Uygur people in rural areas of southern Xinjiang as the research objects. Baseline clinical data were collected, including demographic data such as age, gender, and education level, and laboratory examination indicators such as blood glucose and triglyceride levels. According to the MS diagnostic criteria of the relevant guidelines, 10 476 subjects were divided into the MS group (3 475 cases) and the non-MS group (7 001 cases). The incidence of cholecystolithiasis and gallbladder polyp was followed up in 2019, 2021 and 2023, respectively. Cox regression was used to analyze the correlation between MS, its different components and the risk of cholecystolithiasis and gallbladder polyp. Chi-square test and independent sample t test were used for statistical analysis. Results:The median follow-up time was 6.43 years in 10 476 subjects, and the overall cumulative incidence of cholecystolithiasis and gallbladder polyp was 5.43% (569/10 476). The cumulative incidence of cholecystolithiasis and gallbladder polyp in the MS group was 10.73% (373/ 3 475), which was significantly higher than that in the non-MS group (2.80% (196/7 001)); χ2= 284.62, P<0.001). The results of multivariate Cox regression analysis showed that, 41 to 59 years old ( HR=1.26, 95% confidence interval (95% CI): 1.03 to 1.54, P=0.025), ≥60 years old ( HR=1.88, 95% CI: 1.45 to 2.45, P<0.001), female ( HR=1.34, 95% CI: 1.13 to 1.60, P=0.001), MS ( HR=2.19, 95% CI: 1.59 to 3.01, P<0.001), hypertriglyceridemia ( HR=1.47, 95% CI: 1.18 to 1.83, P=0.001), hypertension ( HR=1.30, 95% CI: 1.04 to 1.62, P=0.023), and hyperglycemia ( HR=1.24, 95% CI: 1.01 to 1.52, P=0.041) were independent risk factors for cholecystolithiasis and gallbladder polyp. After the adjustment of age and gender, MS ( HR=3.39, 95% CI: 2.82 to 4.07, P<0.001), hypertriglyceridemia ( HR=2.37, 95% CI: 2.00 to 2.81, P<0.001), hypertension ( HR=2.00, 95% CI: 1.66 to 2.41, P<0.001), and hyperglycemia ( HR=1.86, 95% CI: 1.55 to 2.23, P<0.001) were still correlated with cholecystolithiasis and gallbladder polyp, and there was the srtongest correlation between MS and cholecystolithiasis and gallbladder polyp. The results of univariate Cox regression analysis showed that along with the increase of accumulated of MS components, the risk of cholecystolithiasis and gallbladder polyp significantly increased (1 to 5 components corresponding HR (95% CI) were 1.92 (1.13 to 3.24), 2.21 (1.32 to 3.69), 6.91 (4.22 to 11.30), 8.56 (5.15 to 14.22), and 10.73 (5.66 to 20.33); P=0.015, =0.002, <0.001, <0.001, and <0.001); after age and gender were adjusted, this trend still existed (1 to 5 components corresponding HR (95% CI) were 1.81(1.07 to 3.06), 1.95(1.16 to 3.27), 5.64(3.42 to 9.32), 6.69(3.97 to 11.25), and 7.76(4.04 to 14.91); P=0.028, =0.012, <0.001, <0.001, and <0.001). Conclusion:MS and its components can increase the risk of cholecystolithiasis and gallbladder polyp, and the risk of cholecystolithiasis and gallbladder polyp significantly increases along with the increase of accumulated of MS components.

Colorectal cancer (CRC) is one of the most common malignant tumors recorded worldwide. This condition has high morbidity and mortality and seriously endangers people's health. Traditional diagnostic models fail to meet people's current needs for real-time monitoring of tumors. Compared with traditional detection methods, ctDNA detection is not only noninvasive but can also attain real-time detection of comprehensive genomic information of tumors. The advancement of detection technology has gradually highlighted the potential of ctDNA detection in the clinical treatment of CRC. This article reviews the advancements on the clinical application of ctDNA in early screening, minimal residual disease detection, and guidance on individualized treatment of CRC patients.

Objective To investigate the consistency between mismatch repair proyeins expressions detected by immunohistochemistry(IHC)and microsatellite instability(MSI)identified by next-generation sequencing(NGS),and evaluate the correlation of these results with the clinical characteristics of Chinese colorectal cancer(CRC).Methods Using IHC and NGS to identify mismatch repair(MMR)and MSI status in CRC,and assessing the consistency between these different detection methods.Results The concordance rate of MSI status detected by IHC and NGS was 98.36%,indicating good agreement(Kappa=0.856).Certain pathogenic or likely pathogenic germline variants were present in the pMMR/MSI-H subtype.The co-deficiency of MLH1 and PMS2 was most common in the dMMR/MSS subtype.Patients with inconsistent typing were more likely to have early-onset right-sided colon cancer(P<0.01)and the tumor with relatively poor differentiation.Conclusions The consistency of MSI status detected by IHC and NGS is very high,98%or more.To avoid the misdiagnosis of MSI status affecting clinical decision-making for treatment plans,it is imperative to ensure the accuracy of MSI analysis,particularly in poorly differentiated early-stage right-sided colon cancers.

By carrying out hazard vulnerability analysis,the main emergencies that hospitals need to deal with are identi-fied,and various emergency plans are formulated and improved in a targeted manner,so as to improve the emergency response capacity of hospitals.In this paper,Kaiser model risk matrix was used to evaluate and rank the relative risk of risk events in a tertiary hospital in Tianjin.It was found that the relative risk degree of risk events faced by the sample hospital was lower than that of similar studies,but it was still necessary to pay attention to five key risk events,including violent medical disputes,haze,wind,snow and ice,and earthquake.The purpose is to provide theoretical basis for the continuous improvement of hospital emer-gency system,and is the preliminary basis for hospitals to do a good job in emergency management and improve emergency han-dling ability.

By carrying out hazard vulnerability analysis,the main emergencies that hospitals need to deal with are identi-fied,and various emergency plans are formulated and improved in a targeted manner,so as to improve the emergency response capacity of hospitals.In this paper,Kaiser model risk matrix was used to evaluate and rank the relative risk of risk events in a tertiary hospital in Tianjin.It was found that the relative risk degree of risk events faced by the sample hospital was lower than that of similar studies,but it was still necessary to pay attention to five key risk events,including violent medical disputes,haze,wind,snow and ice,and earthquake.The purpose is to provide theoretical basis for the continuous improvement of hospital emer-gency system,and is the preliminary basis for hospitals to do a good job in emergency management and improve emergency han-dling ability.

ObjectiveTo investigate rehabilitation competence among trainers and trainees whom participated in the training program entitled National Training Program of Shortage Rehabilitation Physicians (NTPSRP) using World Health Organization rehabilitation competency framework (RCF). MethodsBased on RCF, a questionnaire was developed and administrated through network using Questionnaire Star. All the trainers and trainees who participated in NTPSRP were investigated in September, 2023. ResultsA total of 911 subjects were collected from 27 provinces, including 426 trainers (teachers) and 485 trainees (students). The average age of the teachers was older, with more years of work experience and professional experience in rehabilitation medicine. The degree and professional title of the teachers was also higher. The overall internal consistency reliability of the questionnaire was good (Cronbach's α = 0.988), and all the internal consistency reliability in five fields was good (Cronbach's α > 0.9). The five dimensional structure of RCF in the results was consistent with the prior model established by RCF theory. The self-ratings of all physicians in the five fields were higher than the median level, and was higher in the teachers than in the students [(3.42±0.68) vs. (2.73±0.80), P < 0.001]. Gender and years of experience in rehabilitation medicine were independent factors for the total score of the questionnaire. The total self-rating of female students was 9.65 points lower than that of the male (95%CI 4.386 to 14.914); and one more year in rehabilitation medicine would increase 1.78 points in self-rating (95%CI 1.140 to 2.419). ConclusionThe structure and content of RCF can be used to evaluate the competence of rehabilitation physicians. The teachers and students of NTPSRP are eligible to RCF. RCF-based evaluation can be used to guide the development of continuing education courses for rehabilitation professionals.