Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

Objective:To evaluate the feasibility of transjugular transcatheter tricuspid valve replacement (TTVR) using the LuX-Valve Plus system (Ningbo Jenscare Scientific, China) for the treatment of severe tricuspid regurgitation in real-world clinical settings.Methods:This prospective study enrolled 81 patients with severe ricuspid regurgitation (≥3+) who underwent TTVR with the LuX-Valve Plus system at the Department of Cardiology, West China Hospital of Sichuan University between May 2022 and March 2024. Among them, 44 patients were from a compassionate-use study, and 37 were from two premarket clinical trials. Baseline clinical data, preprocedural imaging, procedural outcomes, and postprocedural follow-up data were collected. The primary endpoint events included device success, procedural success, and 30 d composite adverse events.Results:The age of the cohort was (74.5±7.8) years, with 54 females (67%). Device success and procedural success rates were both 90% (73/81). Post-procedural tricuspid regurgitation improved, with a 6% (5/81) incidence of moderate-to-severe paravalvular leakage. The rate of permanent pacemaker implantation was 12% (10/81), of which 5% (4/81) had pre-existing indications for pacemaker implantation. Major bleeding events occurred in 10% (8/81) of patients, and the 30 d composite endpoint rate was 25% (20/81).Conclusion:TTVR using the LuX-Valve Plus system demonstrates promising feasibility for high-risk surgical patients with severe tricuspid regurgitation, effectively reducing or eliminating regurgitation with acceptable safety. However, challenges remain in reducing risks of major adverse events, including permanent pacemaker implantation and severe bleeding.

Objective:We aimed to explore the effect of exercise on cardiac function and APJ system in old mice.Meth-ods:Male C57/BL6 mice were divided into young group(n=30),old control group(n=30),old continuous moderate-intensity training(CMIT)group(n=30),and old high-intensity interval training(HIIT)group(n=30).Mice in the CMIT group and HIIT group underwent 8-week exercise intervention,respectively.Mice in the young group and old con-trol group were placed on stationary treadmill simultaneously.The heart function parameters were measured,and the ex-pression of APJ/Apelin in myocardium and circulating Apelin/Elabela were compared among above-mentioned groups.Results:Compared yo mice in old control group,those in the CMIT group and HIIT group had significant higher left ven-tricular ejection fraction[(67.74±6.18)％,(70.69±7.43)％vs.(61.17±4.78)％]and left ventricular fractional short-ening[(33.07±4.29)％,(33.37±5.57)％vs.(28.05±3.61)％](P＜0.05 or＜0.01);and significant lower Tei index[(0.78±0.09),(0.78±0.12)vs.(0.88±0.08)]and left ventricular posterior wall thickness at diastole[(1.01±0.09)mm,(1.02±0.10)mm vs.(1.19±0.14)mm](P＜0.05all).Compared to mice in old control group,those in the HIIT group had significant higher mitral valve E/A ratio[(1.63±0.11)vs.(1.42±0.18),P=0.043].Compared to mice in old control group,those in the HIIT group had significant higher expressions of APJ and Apelin in myocardium,as well as the levels of Apelin[(1186.23±393.74)pg/ml vs.(413.17±80.81)pg/ml]and Elabela[(5.38±2.76)ng/ml vs.(1.57±0.60)ng/ml]in the serum(P＜0.05 or＜0.01).Conclusion:Long-term exercise initiated late in life could im-prove heart function of mice.The APJ-Apelin/Elabela system may be involved in the exercise-mediated improvement of cardiac aging.

Objective To determine the application effect of esketamine pretreatment in laparoscopic high ligation of hernia sac in children.Methods A total of 70 children who received laparoscopic high ligation of hernia sac under general anesthesia were selected and divided into the control group and the observation group according to the random number table method,with 35 cases in each group.The control group received conventional general anesthesia,while the observation group was intravenously injected with 0.5 mg/kg of esketamine 15 minutes before the induction of general anesthesia.The preoperative anxiety score,respiratory mechanics indexes,lung injury status,anesthesia recovery,and adverse reactions during the awakening period were compared between the two groups.Results The anxiety scores of the observation group 10 minutes before anesthesia and immediately before anesthesia were significantly lower than those of the control group(P<0.05).The peak airway pressure and mean airway pressure of the observation group 30 minutes after establishing pneumoperitoneum and at the end of the operation were significantly lower than those of the control group(P<0.05).The levels of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)at the end of the operation in the observation group were significantly lower than those in the control group(P<0.05).There was no statistically significant difference in the time of spontaneous breathing recovery,time to regain consciousness,tracheal extubation time,or post-anesthesia care unit(PACU)stay time between the two groups(P>0.05).The incidence of adverse reactions during the anesthetic awakening period in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Esketamine pretreatment can significantly alleviate preoperative separation anxiety for children undergoing laparoscopic high ligation of hernia sac,reduce lung injury,and decrease airway pressure,which is beneficial to lung protection and postoperative anesthetic recovery,and has few adverse reactions.

Objective:To explore the clinical efficacy of Wenshen Chushi Decoction combined with low intensity pulsed ultra-sound(LIPUS)on erectile dysfunction(ED)caused by renal deficiency and phlegm-dampness syndrome.Methods:One hundred and twenty ED patients were included from the Department of Andrology in the First Hospital of Hunan University of Traditional Chinese Medicine.The patients in control group were treated with Wenshen Chushi Decoction.While the patients in observation group were trea-ted with Wenshen Chushi Decoction combined with LIPUS for 8 consecutive weeks.After the treatment,the efficacy was evaluated using the International Index of Erectile Function-5(IIEF-5)score,Penile Flow Index(PFI),Traditional Chinese Medicine Syndrome Score,Self-Rating Depression Scale(SDS)score,and Self-Rating Anxiety Scale(SAS)score.Safety was also observed.And the ef-ficacy was followed up 4 weeks after the end of treatment.Results:Fifty-seven cases were enrolled into control group finally with 55 cases in the treatment group.After the treatment,all the patients in both of groups showed an improvement in IIEF-5 scores(P＜0.01).Compared with the control group(19.09±2.22),the IIEF-5 score in observation group(20.42±2.39)increased signifi-cantly(P＜0.01).After the treatment,the scores of PFI,TCM syndrome and SDS in both groups decreased(P＜0.01,P＜0.05,P＜0.01).Compared with the control group([3.77±1.21],[9.91±1.71]and[39.88±2.63]points),the observation group([2.92±1.08],[4.78±1.45],and[34.51±2.09]points)showed a more significant decrease(P＜0.01).There was no significant difference in total effective rate between the two groups(P＞0.05).During follow-up,the IIEF-5 scores of both groups of patients were higher than those before(P＜0.05,P＜0.01),and the observation group score was higher than that in the control group([17.15±3.37]vs[13.63±1.96],P＜0.01).No adverse reaction and abnormality of indicators occurred in both of two groups.Conclusion:Wenshen Chushi Decoction has a significant therapeutic effect on ED caused by renal deficiency and phlegm-dampness syndrome.It can not only improve the quality of erection,but also improve the physical and mental symptoms associated with ED,which makes therapeutic effect lasting longer.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:We aimed to explore the effect of exercise on cardiac function and APJ system in old mice.Meth-ods:Male C57/BL6 mice were divided into young group(n=30),old control group(n=30),old continuous moderate-intensity training(CMIT)group(n=30),and old high-intensity interval training(HIIT)group(n=30).Mice in the CMIT group and HIIT group underwent 8-week exercise intervention,respectively.Mice in the young group and old con-trol group were placed on stationary treadmill simultaneously.The heart function parameters were measured,and the ex-pression of APJ/Apelin in myocardium and circulating Apelin/Elabela were compared among above-mentioned groups.Results:Compared yo mice in old control group,those in the CMIT group and HIIT group had significant higher left ven-tricular ejection fraction[(67.74±6.18)％,(70.69±7.43)％vs.(61.17±4.78)％]and left ventricular fractional short-ening[(33.07±4.29)％,(33.37±5.57)％vs.(28.05±3.61)％](P＜0.05 or＜0.01);and significant lower Tei index[(0.78±0.09),(0.78±0.12)vs.(0.88±0.08)]and left ventricular posterior wall thickness at diastole[(1.01±0.09)mm,(1.02±0.10)mm vs.(1.19±0.14)mm](P＜0.05all).Compared to mice in old control group,those in the HIIT group had significant higher mitral valve E/A ratio[(1.63±0.11)vs.(1.42±0.18),P=0.043].Compared to mice in old control group,those in the HIIT group had significant higher expressions of APJ and Apelin in myocardium,as well as the levels of Apelin[(1186.23±393.74)pg/ml vs.(413.17±80.81)pg/ml]and Elabela[(5.38±2.76)ng/ml vs.(1.57±0.60)ng/ml]in the serum(P＜0.05 or＜0.01).Conclusion:Long-term exercise initiated late in life could im-prove heart function of mice.The APJ-Apelin/Elabela system may be involved in the exercise-mediated improvement of cardiac aging.

Objective To determine the application effect of esketamine pretreatment in laparoscopic high ligation of hernia sac in children.Methods A total of 70 children who received laparoscopic high ligation of hernia sac under general anesthesia were selected and divided into the control group and the observation group according to the random number table method,with 35 cases in each group.The control group received conventional general anesthesia,while the observation group was intravenously injected with 0.5 mg/kg of esketamine 15 minutes before the induction of general anesthesia.The preoperative anxiety score,respiratory mechanics indexes,lung injury status,anesthesia recovery,and adverse reactions during the awakening period were compared between the two groups.Results The anxiety scores of the observation group 10 minutes before anesthesia and immediately before anesthesia were significantly lower than those of the control group(P<0.05).The peak airway pressure and mean airway pressure of the observation group 30 minutes after establishing pneumoperitoneum and at the end of the operation were significantly lower than those of the control group(P<0.05).The levels of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)at the end of the operation in the observation group were significantly lower than those in the control group(P<0.05).There was no statistically significant difference in the time of spontaneous breathing recovery,time to regain consciousness,tracheal extubation time,or post-anesthesia care unit(PACU)stay time between the two groups(P>0.05).The incidence of adverse reactions during the anesthetic awakening period in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Esketamine pretreatment can significantly alleviate preoperative separation anxiety for children undergoing laparoscopic high ligation of hernia sac,reduce lung injury,and decrease airway pressure,which is beneficial to lung protection and postoperative anesthetic recovery,and has few adverse reactions.

Objective To investigate the effects and mechanisms of combined prescriptions of essential oils from five traditional Chinese medicinal herbs,namely peppermint,turmeric,ginger,Tibetan fennel,and cumin,on symptoms related to functional abdominal pain syndrome(FAPS).Methods Gas chromatography-mass spectrometry(GC-MS)was employed to analyze the chemical constituents of five essential oils,while network pharmacology was utilized to predict the key targets and signaling pathways associated with these essential oils in alleviating functional abdominal pain syndrome.A formula design methodology centered on these core targets and signaling pathways was developed for creating new prescriptions.Molecular docking technology was conducted to predict its the underlying mechanisms.Subsequently,animal experiments were performed to assess pharmacological activity,including hot plate tests and acetic acid-induced writhing assays to validate the analgesic effects of the newly formulated prescription,as well as xylene-induced ear swelling tests to evaluate its anti-inflammatory properties.The impact of the essential oil formulation on intestinal peristaltic function was examined through intestinal propulsion experiments.Additionally,enzyme-linked immunosorbent assay(ELISA)methods were employed to measure levels of serotonin(5-HT),prostaglandin E2(PGE2),and gamma-aminobutyric acid(GABA)in brain tissue.Western blot analysis was conducted to determine protein expression levels of TPH1 and SERT in the intestine,along with TPH2 and SERT in the brain.Results The main chemical components in five essential oils were identified and screened(peppermint:12,turmeric:8,ginger:14,cumin:2,fennel:6).Based on the network pharmacology analysis,four new essential oil prescriptions were successfully designed according to the complementary relationship between the five essential oils in improving functional abdominal pain syndrome at the target level,including 4 new prescription named Prescription A,B,C and D,these four prescriptions were all based on ginger and turmeric essential oils,with other essential oils serving as supplements or enhancements.The results of animal experiments showed that Prescription D could significantly reduce the writhe frequency of mice(P<0.05),all the four groups could significantly prolong the pain threshold of mice(P<0.05),and Prescription C had a significant effect on reducing the degree of ear swelling(P<0.05).The prescription of essential oil did not significantly affect the function of peristalsis and the speed of propulsion.The levels of 5-HT and PGE2 in the brain tissue were significantly inhibited(P<0.05),and the level of GABA was significantly increased(P<0.05).Prescription C could reduce the expression of TPH1 in the intestinal tissue(P<0.05),Prescription A,C and D could reduce the expression of TPH2,and all groups had a tendency to increase the expression of SERT in the brain tissue.Conclusion In summary,the therapeutic effects of the four novel prescriptions composed of the five essential oils demonstrated potential in improving symptoms related to FAPS,the mechanism might be through modulating abnormalities in the brain-gut axis system.