Osteoarthritis （OA） is characterized by articular cartilage degeneration， synovial hyperplasia， hyperosteogeny， and narrowing of joint space， which can be caused by trauma， inflammation， and other factors. With the increasing global population aging， the incidence of OA is rising year by year， making it a major public health problem that urgently needs to be addressed. Exploring effective treatment schemes is particularly important. The pathogenesis of OA is complex， including oxidative stress， autophagy， and apoptosis. Recent studies have found that ferroptosis， a new type of cell death， is also an important pathogenic factor in OA， characterized by a series of complex changes such as iron ion accumulation， glutathione （GSH） depletion， and mitochondrial dysfunction. Research shows that inhibiting ferroptosis in chondrocytes can promote chondrocyte proliferation， delay extracellular matrix （ECM） degradation， and reduce synovial hyperplasia and inflammation. Targeting ferroptosis is a new direction in the treatment of OA. OA treatment includes intra-articular injections of steroids or hyaluronic acid and artificial joint replacement， but there are limitations. Traditional Chinese medicine （TCM） has been widely used in the treatment of various diseases because of its low cost， low drug resistance， and few side effects. Cell and animal experiments have further confirmed that TCM can intervene in the treatment of OA with ferroptosis from multiple targets， multiple levels， and aspects， but the mechanism of its treatment of OA based on ferroptosis has not been clarified. This paper discussed iron metabolism， lipid peroxidation， cysteine/glutamate transporter system Xc^- （system Xc^-）/GSH/glutathione peroxidase 4 （GPX4） pathway， nicotinamide adenine dinucleotide phosphate（NADPH）/ferroptosis suppressor protein 1 （FSP1）/coenzyme Q₁₀ （CoQ₁₀） pathway， tumor protein p53 in OA， and related molecular targets of Chinese medicine monomers and compounds on ferroptosis inhibition. Their potential therapeutic mechanisms were further analyzed to provide theoretical guidance for the treatment of OA by TCM and useful reference for the research and development of related drugs.

Trace elements and vitamins are essential micronutrients for metabolism.Micronutrients deficiency results in adverse effects on human body,and brings huge challenge to clinical nutrition therapy.To normalize micronutrients application in clinical practice,European Society for Clinical Nutrition and Metabolism(ESPEN)published ESPENpractical short micronutrient guideline on January 2024.Based on previous version published in 2022,current guideline shortens the interpretation of biochemical and physical mechanisms,focuses on micronutrients deficiency and inflammation,recommends the methods of micronutrients assessment and supplementation in different statuses during clinical practices.This paper summarizes specific recommendations and comments for domestic peers to communicate,and provides reference for the management of micronutrient therapy in China.

The concentration of end-tidal carbon dioxide is one of the important indicators for evaluating whether the human respiratory system is normal.Accurately detecting of end-tidal carbon dioxide is of great significance in clinical practice.With the continuous promotion of the localization of end-tidal carbon dioxide monitoring technology,its application in clinical practice in China has become increasingly widespread in recent years.The study is based on the non-dispersive infrared method and comprehensively elaborates on the detection principle,gas sampling methods,key technologies,and technological progress of end-tidal carbon dioxide detection technology.It comprehensively introduces the current development status of this technology and provides reference for application promotion and further improvement.

Objective To generate and identify the Itgbl1(integrin beta-like)promoter-driven Cre knock-in mouse line.Methods Itgbll-Cre knock-in mice were generated using clustered regularly interspaced short palindromic repeats(CRISPR)/CRISPR-associated protein 9(Cas9)gene editing.The Itgbl1-Cre mice were crossed with the Cre reporter ROSALSL-tdTomato)mice to detect the expression profile of Cre activity.The tdTomato expression pattern across tissues and cell-specific markers were used to identify the cell types of Itgbl1-expressing cells and their progeny.Results and Conclusion tdTomato was specifically expressed in mucous acinar cells of the sublingual gland,pancreatic islet cells,and gastric endocrine cells.In addition,tdTomato expression was also found in some of the neurons of the retina and brain,as well as in a few cells in the serosal layer of the intestine,articular cartilage,periosteum,and bone marrow.The first Itgbl1-Cre recombinase transgenic mouse line was established,which can specifically label the mucous acinar cells of the sublingual gland.

Objective:To analyze the role of learning engagement and learning burnout in the relationship between supervisors' guidance and the personal ability of postgraduates in the Professional Master's Program in Clinical Medicine.Methods:A total of 4 016 postgraduates in the Professional Master's Program in Clinical Medicine from 61 colleges were surveyed in 2020. Common method bias was assessed using the Harman's single factor test and total score was determined by the entropy weight method. Causality and mediation effect were analyzed by linear regression, and mediation effect was tested by Bootstrapping.Results:The average scores of supervisors' guidance, learning burnout, learning engagement and personal ability were (4.13±0.87), (2.49±1.11), (3.88±0.83), and (3.71±0.78), respectively. Supervisors' guidance significantly and positively impacted learning engagement ( β=0.689, P<0.001) and personal ability ( β=0.504, P<0.001). Learning engagement played a partial mediating role (89.30% of mediation effect) between supervisors' guidance and personal ability. Learning burnout (interaction term β=0.078, P<0.001) positively regulated the relationship between supervisors' guidance and learning engagement. Conclusions:Learning engagement can mediate the effect of supervisors' guidance on the personal ability of postgraduates in the Professional Master's Program in Clinical Medicine, and learning burnout positively regulates the effect of supervisors' guidance on learning engagement. Strengthened supervisors' guidance, increased attention to students' learning burnout, and enhanced learning engagement can further improve the personal abilities of postgraduates in the Professional Master's Program in Clinical Medicine.

Objective:To investigate the "burnout-engagement continuum" status of postgraduate supervisors of the Professional Master's Program in Clinical Medicine and to identify key populations.Methods:From October to November 2023, an anonymous online questionnaire survey was conducted to determine the "burnout-engagement continuum" status of postgraduate supervisors of the Professional Master's Program in Clinical Medicine. The scores of different dimensions of job burnout are expressed as mean±standard deviation, and the distribution of supervisors of different status is presented in frequency and percentage. All data analyses were performed in R 4.3.1. Distribution of the five profiles among supervisors of different status was compared using the chi-square test and compared pairwise using the Bonferroni method.Results:A total of 2 664 valid questionnaires were collected. The scores of emotional exhaustion, cynicism and personal accomplishment were（2.46±0.95),（1.74±0.89), and（4.23±0.90), respectively. The prevalence of job engagement, inefficacy, overexertion, disengagement, and burnout among the supervisors were 42.76%（1 139/2 664), 43.54%（1 160/2 664), 33.03%（880/2 664), 14.71%（392/2 664), and 13.66%（364/2 664), respectively. In terms of demographics, the distribution of the "burnout-engagement continuum" was significantly different by age, sex, marital status, and highest education level（ P<0.05). In terms of work-related characteristics, the distribution of the "burnout-engagement continuum" was significantly different by income, professional title, administrative position, and working hours on weekdays and holidays（ P<0.05). The distribution of engagement, inefficacy, and overexertion was significantly different between the eastern and western regions（ P<0.05). Conclusions:There is a high percentage of individuals with burnout among postgraduate supervisors of the Professional Master's Program in Clinical Medicine, and inefficacy is a common negative state. Supervisors who work in the western regions, are under 45 years of age, are male, are married, have a doctorate degree, hold associate senior professional title, have lower relative income, are not holding administrative duties, and work more than 10 hours on workdays and more than 4 hours on holidays are key populations that require increased attention. The psychological state of supervisors can be improved by providing them with more resources, work benefits, and incentives.

Objective:To investigate the enrollment scale and distribution of Master's Degree in Pediatrics programs in China, and to provide a reference for promoting pediatric education and disciplinary development.Methods:Data on colleges and universities authorized to award Master's Degree in Pediatrics in 2023 were collected, sorted, and analyzed for the number, structure, distribution, and enrollment scale and direction of these institutions using descriptive statistics.Results:Among the 117 clinical medicine academic master's degree programs in China, 72 enroll pediatric academic master's degree candidates, with an enrollment of 260 students. Among the 120 master's degree programs in clinical medicine, 104 enroll professional master's degree candidates, enrolling 1 195 students. Enrollment is mainly concentrated in East China, "non-double first-class" colleges and universities, medical colleges and universities with subject level B, and enrollment is carried out in the direction of secondary disciplines.Conclusions:The number of colleges and universities authorized to award Master's Degree in Pediatrics was small, and the distribution of these colleges and universities was unbalanced. The enrollment scale was small and the orientation of Professional Master's Degree was not reasonable. Some colleges and universities were authorized to award Master's Degree in Pediatrics, but did not enroll any students. It is suggested to increase the number of colleges and universities authorized to award Master's Degree in Pediatrics and strengthen the staffing of pediatric departments. The aim is to expand the enrollment scale of candidates for Master's Degree in Pediatrics, improving the differential training of candidates for Academic Master's Degree and Professional Master's Degree, and attach importance to the construction of pediatrics.

Objective:To summarize emergency rescue capacity evaluation tools for community nurses.Methods:China National Knowledge Infrastructure, Wanfang Data, VIP, China Biology Medicine disc, PubMed, Embase, CINAHL, Web of Science core collection, and other databases were searched by computer, and the search period was from the establishment of the databases to April 23, 2023. The relevant contents of emergency rescue capacity evaluation tools for community nurses were extracted and analyzed.Results:A total of 16 articles were included, involving seven kinds of emergency rescue capacity assessment tools for community nurses. The evaluation methods of the tools were all self-evaluation. The evaluation mainly involved the ability of nurses in four stages of emergency rescue prevention, preparation, response, and recovery.Conclusions:There are limitations in the evaluation content, method, and application effect of the emergency rescue capacity evaluation tools for community nurses. In the future, it is still necessary to develop or introduce foreign emergency rescue capacity evaluation tools with comprehensive evaluation content and good reliability and validity.

Objective To establish the energy expenditure(EE)prediction models of health Qigong Wuqinxi based on heart rate combined with accelerometer counts in different body parts,so to provide a reference for monitoring EE of Wuqinxi.Methods Seventy-four healthy college students aged 18-30 were selected as the research objects.They were divided into a skilled group of 39(21 males and 18 females)and a primary group of 35(17 males and 18 females)according to their level of practice,with 55 in the model group and 19 in the validation group.When performing a set of Wuqinxi,all subjects were recorded heart rate(HR),accelerometer counts[the average counts of X-axis,Y-axis,Z-axis and vector magnitude(VM)],and EE-related indicators by wearing the Polar heart rate moni-tor,ActiGraph-GT3X+accelerometers(9 parts:waist,both arms,both wrists,both thighs,and both ankles)and CORTEX Meta Max3B-R2 portable indirect calorimeter.Based on the accurate EE mea-sured by the gas metabolism meter,linear regression models of only HR,only accelerometer counts,or HR combined accelerometer counts were established,and their accuracy was analyzed and com-pared.Results The EE of Wuqinxi was significantly correlated with gender,height,weight,muscle mass,HR-related indicators,and accelerometer counts in different parts(X-axis counts of the waist,VM values of the left thigh and counts of the X-axis and Y-axis,VM values of the right thigh and the Y-axis,Z-axis count value,left ankle VM value and Y-axis count value,right ankle VM value and Y-axis,Z-axis count value)(P<0.05).Moreover,the adjusted R2 of the prediction model of only HR,only accelerometer counts,and the both were 0.582,0.508 and 0.678,respectively(P<0.05).The correlation between the predicted and measured values ranged between 0.706 and 0.817.Accord-ing to the Bland-Altman analysis,for each model,all except one error value fell outside the 95%confidence interval.That is,all models had an excellent fitting effect and high accuracy.Among them,the combined model was of the best prediction effect:EE(kcal)=-20.089+0.279×body weight(kg)+0.243×ΔHR(exercise HR-quiet HR,bpm)+0.001×Right thigh Y-axis count value+0.181×exer-cise HR(bpm)-4.202×gender(male=0,female=1).Conclusion The EE prediction model of Wuqinxi es-tablished on HR combined with accelerometer counts has the best effect and can calculate the EE more accurately.

Objective:To analyze the short- and medium-term efficacy, factors influencing the efficacy, and safety of dupilumab alone or in combination for the treatment of bullous pemphigoid (BP) .Methods:A single-center retrospective cohort study was conducted. Clinical data were collected from adult BP patients, who were regularly followed up and treated with dupilumab at the Department of Dermatology, Peking University First Hospital between March 2021 and June 2022. Dupilumab was administered subcutaneously every 2 weeks at a dose of 300 mg (except for the initial dose being 600 mg). Previous medications included glucocorticoids, minocycline, immunosuppressants, etc., and their dose remained unchanged or decreased according to patient condition. The short- and medium-term response rates were evaluated at weeks 2 and 16 after the first injection of dupilumab, respectively. Multivariate logistic regression analysis was conducted to identify factors influencing the disease control rate at week 2, and odds ratios ( ORs) were calculated; a multivariate Cox regression model was employed to analyze factors influencing the disease control rate within 16 weeks of follow-up, and hazard ratios ( HRs) were calculated; multiple linear regression analysis was performed to determine factors associated with the time to pruritus relief. Results:A total of 104 BP patients were eligible, including 60 males and 44 females; they were aged 75.6 ± 12.8 years, and the disease duration ( M [ Q1, Q3]) was 4.0 (2.0, 17.0) months. According to the percentage of the lesion area to the total body surface area, the disease severity was graded, and there were 17 mild cases, 30 moderate cases, 31 severe cases, and 26 extremely severe cases; 56 patients (53.9%) were treated with dupilumab combined with oral glucocorticoids at doses of 20.0 (15.0, 30.0) mg/d. At week 2 after the start of treatment, 63 patients (60.6%) achieved disease control, and 37 (35.6%) achieved marked disease control, resulting in a short-term response rate of 96.2%. Fifty-five patients were followed up for 16 weeks, 54 (98.2%) achieved improvement, and the systemic glucocorticoid dose was reduced to 10.0 (10.0, 17.5) mg/d. Disease control was achieved in 92 of 104 patients (88.5%) within 16 weeks, with the time to disease control being 14.0 (13.0, 26.0) days and the time to pruritus relief being 12.0 (3.0, 14.0) days. Multivariate logistic regression analysis showed that the higher the baseline disease severity, the lower the disease control rate at week 2 (compared with extremely severe cases, mild cases: OR = 37.655, 95% CI: 3.664, 386.981; moderate cases: OR = 12.143, 95% CI: 2.609, 56.528; severe cases: OR = 4.014, 95% CI: 1.121, 14.369, all P < 0.05). Multivariate Cox regression analysis showed that compared with severe BP patients, mild ( HR = 2.478, 95% CI: 1.200, 5.114, P = 0.014) and moderate BP patients ( HR = 2.076, 95% CI: 1.067, 4.038, P = 0.031) were more likely to achieve disease control during the 16-week treatment and follow-up. Multiple linear regression analysis revealed that the disease duration significantly influenced the time to pruritus relief ( P = 0.006), and the longer the disease duration, the longer the time to pruritus relief. During the follow-up, 13 adverse events occurred in 11 patients (10.6%), including 6 with pulmonary infections, 2 with heart failures, 1 with scabies, 1 with viral conjunctivitis, 1 with pericardial effusion (with a high likelihood of idiopathic pericarditis), 1 with organ failure, and 1 with intracerebral hemorrhage, but none of them were clearly related to dupilumab and most of them did not affect the treatment continuation; 3 deaths were reported, including 2 due to organ failures and 1 due to lung infection, which were all unrelated to dupilumab as determined by specialists. Conclusion:Dupilumab combination therapy for BP could result in rapid disease control, relieve pruritus, and reduce systemic glucocorticoid dosage, with a good safety profile.