OBJECTIVE To systematically sort out the drugs causing drug-induced liver injury （DILI） and their relevant information， and to develop the Expert consensus on the medication catalog for drug-induced liver injury and rational drug use （hereinafter referred to as the Consensus）， so as to provide a reference for rational clinical use. METHODS Systematic searches were conducted across various literature databases， guideline retrieval websites and professional liver injury websites. Drugs identified as causing DILI from the included literature and online resources were extracted and assigned scores based on source credibility： three points for LiverTox A-class drugs and two points for B-class drugs； two points for drugs from Hepatox and guidelines； and one point for drugs from consensus and related literature sources. Drugs classified as LiverTox category A/B or with total scores ≥4 were included in the preliminary list of DILI-causing drugs. Opinions were collected and integrated from a multidisciplinary expert panel comprising 45 medical and pharmaceutical experts from 27 provinces across China through three rounds of the Delphi method （including questionnaires and discussion sessions）， and after revision， the final version of Consensus was formed. RESULTS & CONCLUSIONS This Consensus included 12 traditional Chinese medicines （TCMs） such as Polygoni Multiflori Radix and Ephedrae Herba， 151 Western medicines including amiodarone and atorvastatin， along with rational use information. For TCM， eight rational use information were included： evidence-based score， liver injury classification based on pathogenesis， liver injury classification based on biochemical abnormality pattern， clinical phenotype， laboratory examination manifestations， latency period， recovery time， and management strategies. For Western medicines， six additional items were included based on the TCM， namely liver function monitoring， discontinuation， contraindications， cautions， dose adjustments， and risk factors， totaling 14 items. This Consensus systematically compiles DILI drugs and their rational use information， which will support clinicians in enhancing the prevention， identification， and management of DILI， reducing the incidence of liver injury， and ensuring patient medication safety and efficacy.

Objective:To analyze the trend of colorectal cancer incidence and age changes in cancer registration areas of Jiangsu Province from 2009 to 2019.Methods:Based on the continuous and complete data of 16 cancer registries with qualified quality control in Jiangsu Province from 2009 to 2019, the crude incidence rate, age-standardized incidence rate by Segi World Standard Population (ASIRW), age-specific incidence rate, mean age at onset, standardized mean age at onset, standardized age-specific incidence proportion, and incidence proportion of the population over 60 years old of colorectal cancer were calculated. Joinpoint software was used to calculate the average annual percentage change (AAPC) of crude incidence rate, ASIRW, age-specific incidence rate, and incidence proportion of the population over 60 years, respectively. Birth cohort models were constructed to analyze the incidence of colorectal cancer and its trends in the population born from 1929 to 2019. Linear regression models were used to analyze the correlation between mean age at onset, standardized mean age at onset and the year of onset.Results:From 2009 to 2019, a total of 48 036 new cases of colorectal cancer were collected from 16 cancer registries in Jiangsu Province, including 27 508 males and 20 528 females. The crude incidence rate and ASIRW of colorectal cancer in Jiangsu Province increased from 19.00/100 000 and 12.32/100 000 in 2009 to 33.49/100 000 and 16.75/100 000 in 2019, respectively, showing a significant upward trend (CR: AAPC=5.99%, ASIRW: AAPC=3.54%, P<0.001). The increase of ASIRW was greater in males than that observed in females (males: AAPC=4.31%, females: AAPC=2.34%, P<0.001), and greater in rural areas than in urban areas (rural areas: AAPC=4.03%, urban areas: AAPC=3.13%, P<0.001). The incidence of people over 50 years old increased significantly by year, with the 60~69 age group exhibiting a more rapid increase ( AAPC=4.97%, P<0.05). In the birth cohort, the incidence increased rapidly in the population over 50 years with the passage of birth year, with AAPCs ranging from 1.76% to 7.05% ( P<0.05). From 2009 to 2019, the standardized mean age at onset of colorectal cancer increased by 0.10 years annually. The proportion of standardized age-specific incidence exhibited a trend of increase in older age groups, and the incidence proportion of the population over 60 years old showed a significant yearly increase ( AAPC=0.86%, P<0.001). Conclusion:From 2009 to 2019, the incidence, mean age at onset and the incidence proportion of the population over 60 years old of colorectal cancer in Jiangsu Province could exhibit a rapid upward trend. The increase is particularly pronounced in males and rural areas. Additionally, the age-specific incidence distribution reveals a trend of increase in older age groups. Therefore, targeted adjustments and comprehensive prevention measures should be strengthened.

Coagulase-negative Staphylococci(CoNS)are a group of gram-positive cocci incapable of producing co-agulase,which distinguishes them from Staphylococcus aureus.CoNS are widely distributed in natural environ-ment and are commonly found on skin,mucous membranes and other host-associated tissues.In recent years,CoNS have become one of the significant pathogenic factors for hospital-associated infections and have been partic-ularly prevalent among the patients with impaired immune function.Although the pathogenicity of CoNS is gener-ally considered lower than that of coagulase-positive Staphylococci,the widespread use of implanted medical de-vices and extensive use of antibiotics has led to increasingly serious problems of drug resistance,which has atta-ched great importance to the hospital.The databases such as PubMed,Embase and CNKI were retrieved to reveal the drug resistance mechanisms of CoNS,aiming to push forward the research and development of new drugs against drug-resistant bacteria and emerging diagnosis and treatment measures and provide scientific bases for sol-ving the problems of antibiotics resistance around the globe.

BACKGROUND: The use of potentially inappropriate medications (PIMs) is a major concern for medication safety as it may entail more harm than potential benefits for older adults. This study aimed to explore the prescribing rate, healthcare utilization, and expenditure of older adults using PIMs in China. METHODS: A cross-sectional analysis was conducted using a national representative database of all medical insurance beneficiaries across China, extracting ambulatory visit records of adults aged 65 years and above between 2015 and 2017. Descriptive analysis was conducted to measure the rate of patients exposed to PIM, prescribing rate of each PIM, average annual outpatient visits per patient, average total medication costs for each visit, average annual cost of PIMs for each patient, and average annual medication costs for each patient. Generalized linear model with logit link function and binomial distribution was used to examine the adjusted associations between PIMs and independent variables. RESULTS: In total, 845,278 (33.2%) participants were identified to be exposed to at least one PIM. Patients aged 75-84 years (38.1%, 969,809/2,545,430) and ≥85 years (37.9%, 964,718/2,545,430) were more likely to be prescribed with PIMs. Beneficiaries of the Urban Employee Basic Medical Insurance (UEBMI) and living in eastern and southern regions were more frequently prescribed with PIMs. Compared with patients without PIM exposure (7.5 visits, drug cost of RMB 1545.0 Yuan), patients with PIM exposure showed higher adjusted average annual number of outpatient visits (10.7 visits, β = 3.228, 95% confidence interval [CI] = 3.196-3.261) and higher annual drug costs (RMB 2461.8 Yuan, Coef. = 916.864, 95% CI = RMB 906.292-927.436 Yuan). CONCLUSIONS The results showed that the use of PIM among older adults was common in China. This study suggests that the use of PIM could be considered as a clear target, pending multidimensional efforts, to promote rational prescribing for older adults.
Humans ; Aged ; Cross-Sectional Studies ; Aged, 80 and over ; Male ; Female ; China ; Inappropriate Prescribing/economics* ; Patient Acceptance of Health Care/statistics & numerical data* ; Potentially Inappropriate Medication List/statistics & numerical data* ; Health Expenditures/statistics & numerical data*

Objective:To examine the funding landscape of the National Natural Science Foundation of China(NSFC)concerning research focused on the elderly as a specific demographic group.It seeks to analyze prevailing research hotspots and to offer insightful research ideas for scholars in this field.Methods:The study employed a retrospective research design.It involved retrieving data on approved projects related to the elderly from the NSFC's official database, covering the period from 2000 to 2020.The data set included variables such as funding year, project title, project category, supporting institution, and funding amount(application codes: H1901, H1902, H1903).Statistical analysis was conducted using Excel software, while visual analysis was performed using CiteSpace software.Results:Between 2000 and 2020, a total of 710 projects focused on geriatrics received funding, amounting to RMB 361, 032, 300, 000.This period exhibited a fluctuating upward trend in both the number of projects and the total funding amount.The primary funding categories were face-to-face projects and youth science fund projects, which together accounted for 44.4%(315/710), 34.4%(244/710)respectively.The distribution of project-relying units demonstrated significant regional imbalance, with Beijing, Zhejiang, Jiangsu, and Shanghai being the predominant areas.Notably, Nanjing Medical University, Peking University, and Shanghai Jiao Tong University ranked as the top three institutions, with funding percentages of 5.9%(42/710), 5.4%(38/710), and 4.5%(32/710), respectively.The research themes encompassed nucleoplasmic interactions, brain networks, and bioinformatics, among others.Conclusions:The NSFC has consistently provided funding for in-depth research in the critical field of geriatrics.The primary research directions focus on aspects such as the mechanisms of aging and the pathogenesis of neurological diseases associated with aging.With the application of innovative technologies and methodologies, significant breakthroughs and achievements are anticipated in geriatrics, contributing to the improvement of health outcomes and the enhancement of the quality of life for the elderly.

Objective:To assess the levels and abnormal rates of trace elements and vitamins among older patients in Beijing Hospital, and to analyze the correlations between these measured indicators.Methods:This study selected 49 older individuals who underwent physical examinations at Beijing Hospital between May 2021 and March 2024.The participants were divided into two age groups: 60-79 years old(23 cases)and 80-100 years old(26 cases). Levels' differences of trace elements and vitamins between the two age groups were analyzed.Pearson correlation analysis was used to investigate the correlations among the tested indicators, and multivariate analysis was conducted using a generalized linear regression model.Results:Among the 49 older individuals, the overall abnormal rate for trace element test results was 8.16%(4 cases), with 2 cases of iron(Fe)deficiency(4.08%)and 2 cases of calcium(Ca)deficiency(4.08%). The overall abnormal rate for vitamin test results was 24.49%(12 cases), which included 5 cases of vitamin B2 deficiency(10.20%), 1 case of vitamin C deficiency(2.04%), and 6 cases of vitamin D deficiency(12.24%). Statistically significant differences were observed between the two age groups in zinc(Zn)and vitamin C levels( t=2.84, 2.83; P=0.007, 0.007). Pearson correlation analysis revealed correlations among 19 pairs of indicators.The top five correlations were between plumbum(Pb)and cadmium(Cd)( r=0.769, P<0.001), Fe and manganese(Mn)( r=0.685, P<0.001), Ca and magnesium(Mg)( r=0.677, P<0.001), vitamin B12 and vitamin C( r=0.455, P=0.001), and vitamin B9 and vitamin D( r=0.422, P=0.003), respectively.The results of the multivariate analysis indicated that, after adjusting for the effects of age group and gender, statistical differences in correlations remained among the remaining trace elements and vitamins, except for those between vitamin B1 and vitamin B12, vitamin B1 and vitamin C, and vitamin A and vitamin D (all P<0.05). Conclusions:The deficiency rates of trace elements and vitamins remain notably high among older patients in our hospital, underscoring the necessity for enhanced nutritional supplementation and regular monitoring of trace element and vitamin levels within this population.Furthermore, a correlation exists between trace elements and vitamins, which offers valuable insights for the diagnosis and treatment of related diseases.

Objective To characterize the epidemiological,radiographic and clinical features of transmigrated mandibular canines by cone-beam CT(CBCT),in order to provide assistance for treatment planning.Methods Patients treated at our institution diagnosed with mandibular canines transmigration were retrospectively screened using CBCT images from June 2012 to December 2018.Clinical and radiographic parameters including location,classification,neighbouring structures,and associated anomalies were evaluated.Re-sults Eighty-two patients with 85 transmigrated mandibular canines were enrolled,establishing a prevalence of 0.11％(82/75 021).Among these cases,79 patients had unilateral transmigration of mandibular canines;the other 3 had bilateral transmigrations.Thirty-nine cases were male and 43 were female,with age ranging from 10 to 58.According to the Mupparapu classification,type Ⅰ(42,49.41％)was the most prevalent followed by type Ⅱ(19,22.35％)and type Ⅲ(15,17.65％).Fifty-three(62.35％)crowns were located labially,and often associated with odontoma,cyst and supernumerary tooth.Seventy transmigrated canines were surgically re-moved while 2 cases were tried to orthodontically aligned,failed and finally extracted.Ten cases received routine monitoring.Conclu-sion The transmigration of mandibular canines is rarely occurring abnormality with certain clinical imaging features which can assist in clinical diagnosis and treatment planning.

Objective:To evaluate the relationship between transverse sinus stenosis (TSS) and cerebral blood flow in normal adults based on four-dimensional flow (4D Flow) MRI.Methods:The study was a cross-sectional study. Totally 81 normal volunteers who underwent magnetic resonance venography (MRV) and 4D Flow MRI were prospectively enrolled at Beijing Friendship Hospital, Capital Medical University from January 2020 to December 2022. Based on MRV evaluation of transverse sinus dysplasia, the volunteers were divided into a dysplasia group (26 cases) and a non-dysplasia group (55 cases); The area of the stenosis and the normal transverse sinus at the distal end were measured. The degree of TSS and the bilateral average transverse sinus stenosis (BA-TSS) were calculated. TSS was determined using TSS levels of 1/3, 1/2, and 2/3 as thresholds, and was divided into three groups: no TSS group, unilateral TSS group, and bilateral TSS group, with 28, 39, and 14 cases, 37, 37, and 7 cases, and 43, 36, and 2 cases, respectively. Based on 4D Flow MRI, the blood flow of the internal carotid artery, vertebral artery, superior sagittal sinus, straight sinus, and transverse sinus distal and proximal ends were measured. The cerebral blood flow (bilateral internal carotid artery blood flow+bilateral vertebral artery blood flow), venous sinus return blood flow 1 (superior sagittal sinus blood flow+straight sinus blood flow), return blood flow 2 (sum of bilateral transverse sinus distal end blood flow), return blood flow 3 (sum of bilateral transverse sinus proximal end blood flow), and the ratio of return blood flow to cerebral blood flow were calculated. Independent sample t-test was used to compare the differences between the group with and without transverse sinus dysplasia; Single factor analysis of variance was used to compare the differences between the TSS free group, unilateral TSS group, and bilateral TSS group. Based on single factor linear regression, the relationships between BA-TSS and blood flow parameters were analyzed.Results:There was no statistically significant difference in various blood flow parameters between the group with and without transverse sinus dysplasia (all P>0.05). When using 1/3, 1/2, and 2/3 as thresholds, there was no statistically significant difference in various blood flow parameters between the non TSS group, unilateral TSS group, and bilateral TSS group (all P>0.05). BA-TSS was linearly positively correlated with cerebral blood flow (β=0.986, 95% CI 0.108-1.865, P=0.028), but not linearly correlated with return blood flow 1, 2, and 3 (all P>0.05). The degree of BA-TSS was linearly negatively correlated with return blood flow 1/cerebral blood flow (β=-0.001, 95% CI -0.002-0, P=0.009) and return blood flow 2/cerebral blood flow (β=-0.001, 95% CI -0.002-0, P=0.018), but not with return blood flow 3/cerebral blood flow ( P=0.076). Conclusion:The BA-TSS degree in normal adults is positively correlated with cerebral blood inflow and negatively correlated with the proportion of venous sinus outflow.

Objective:To analyze the correlation between thymus dose-volume parameters and lymphopenia in patients with early-stage breast cancer (BC) receiving adjuvant radiotherapy (RT).Methods:Medical records of 54 patients with early-stage BC who received postoperative adjuvant RT in the Second Affiliated Hospital of Soochow University from January to December 2019 were retrospectively analyzed. Absolute lymphocyte counts (ALC) were collected at 1 month before (baseline) and weekly during RT. Lymphopenia was graded based according to the common terminology criteria for adverse events version 5.0 and nadir/baseline ALC was calculated. The thymus was delineated according to anatomical boundaries in the original RT planning system. Dosimetric parameters were obtained from the dose volume histograms. Stepwise multiple linear regression analysis was used to explore the factors associated with nadir/baseline ALC. The cutoff values of dosimetric parameters for predicting ≥grade 3 lymphopenia were obtained using the receiver operating characteristic (ROC) curve.Results:The proportion of 54 patients experiencing ≥ grade 3 lymphopenia was 38.9%. The median value of thymus volume, mean dose, V 5 Gy, V 10 Gy were 14.02 cm 3, 4.95 Gy, 36.18%, and 6.61%, respectively. Stepwise multiple linear regression analysis revealed that baseline ALC ( P=0.005), quadrant location ( P=0.005) and mean thymus dose ( P<0.001) were significantly associated with nadir/baseline ALC. ROC curve analysis indicated that the cutoff values of thymus mean dose, V 5 Gy and V 10 Gy for predicting ≥ grade 3 lymphopenia were 6.12 Gy, 35.2%, and 7.4%, respectively. Conclusions:Lymphopenia in early-stage BC patients is significantly correlated with high dosimetric parameters of the thymus during postoperative adjuvant RT. Thymus may be considered as an organ at risk during RT.

BACKGROUND:Exploring the effects of foot contact patterns based on footwork on the joint movement characteristics of human lower limbs in table tennis can provide a scientific basis for guiding lower limb training.OBJECTIVE:To analyze the differences in kinematic and kinetic characteristics of table tennis athletes under different ground contact patterns.METHODS:Motion capture system and three-dimensional force platform were used to synchronously collect kinematic and kinetic data of the dominant side lower limb of 17 professional table tennis athletes in normal foot contact pattern and full-foot contact pattern.Paired t-tests were used to analyze the statistical differences in discrete metrics such as joint angles,ground reaction forces,joint reaction forces,and joint moments.Statistical parametric mapping was employed to analyze the statistical differences in continuous time-series data,such as the movement trajectory of the center foot of pressure and the knee joint moments.RESULTS AND CONCLUSION:(1)In the normal foot contact pattern,knee internal rotation,lateral ground reaction force,knee vertical reaction force,and knee extension moment were significantly higher than those in the full-foot contact pattern.(2)In the 89%-91%movement phase of the distance traveled by the plantar center of pressure,the center of pressure in the normal foot contact pattern was significantly farther away from that in the full-foot contact pattern.(3)In the 23%-38%movement phase of the X-axis torque curve,the knee extension moment in the normal foot contact pattern was significantly higher than that in the full-foot contact pattern.(4)In the 8%-18%phase of the Y-axis torque curve,the knee extension moment in the full-foot contact pattern was significantly higher than that in the normal foot contact pattern.By comparing the difference in lower limb biomechanical characteristics between different ground contact patterns and statistical parametric mapping analysis results,the full-foot contact pattern may be an important factor affecting athletes'performance.It is necessary to adjust and practice the touch patterns to avoid the use of full-footed touch patterns to improve the lower limb athletic ability of table tennis athletes.