Objective:To investigate the cognitive characteristics and related influencing factors in Parkinson′s disease (PD) patients with or without olfactory anosognosia (OA).Methods:A total of 113 PD patients who were treated at the Affiliated Hospital of Yangzhou University between March 2023 and April 2024 were selected. The PD Olfactory Dysfunction Auxiliary Diagnostic Card was used to assess olfactory function. Based on the olfactory identification scores and subjective awareness of olfactory dysfunction, patients were divided into the normosmic group, olfactory dysfunction group, and the later was further divided into olfactory dysfunction without OA (OA-) group, and olfactory dysfunction with OA (OA+) group. The results of the Unified Parkinson′s Disease Rating Scale-Ⅲ (UPDRS-Ⅲ) and Hoehn-Yahr (H-Y) staging assessments of the patients were collected. Non-motor symptoms such as cognitive function, anxiety, depression, sleep disturbances, and constipation were evaluated using relevant scales. Logistic regression analysis was used to explore the related factors affecting OA in PD patients with olfactory decline.Results:The Montreal Cognitive Assessment (MoCA) scores of the olfactory dysfunction group were lower than those of the normosmic group (20.30±4.47 vs 22.64±2.50, t=2.907, P=0.007). The Self-Rating Anxiety Scale scores (39.00±8.60 vs 43.86±10.63, t=2.444, P=0.016), visuospatial and executive function scores (2.35±1.32 vs 2.98±1.42, t=2.263, P=0.026), and orientation scores (4.88±1.14 vs 5.34±1.07, t=2.046, P=0.043) of the OA+ group were lower than those of the OA- group. Logistic regression analysis revealed that lower MoCA scores were an independent risk factor for PD combined with OA ( OR=0.853, 95% CI 0.743-0.980, P=0.024). Conclusions:PD patients with olfactory dysfunction exhibit more severe cognitive impairment. Among them, patients with OA show more significant impairments in visuospatial, executive function and orientation. Cognitive impairment may be an independent risk factor for PD combined with OA.

ObjectiveBased on multi-index and multi-method detection， the quality of Rukuaixiao preparations was systematically evaluated from the perspective of characteristic components， and the existing problems were analyzed. MethodsLiquid chromatography-mass spectrometry（LC-MS） for the determination of 16 characteristic components was established to evaluate the quality of 129 batches of Rukuaixiao preparations. High performance liquid chromatography（HPLC） was established to determine the contents of salvianolic acids and tanshinones， investigate the rationality of quality control index of Salviae Miltiorrhizae Radix et Rhizoma in the standard for Rukuaixiao preparations in the 2020 edition of Pharmacopoeia of the People's Republic of China（hereinafter referred to as Chinese Pharmacopoeia） （volume Ⅰ）， and trace the causes of significant difference among different batches. The processing and different extraction methods of Vaccariae Semen were tested， analyzing the impact of formulation changes across different editions of Chinese Pharmacopoeia. The LC-MS was established for determining the changes in the ratio of toosendanin and isotoosendanin after water extraction of Toosendan Fructus. The contents of active components in different parts of Gleditsiae Spina were determined to identify the reason of the low contents of characteristic components in some enterprises. ResultsBased on the comprehensive analysis of the samples from different dosage forms， the contents of characteristic components of Vaccariae Semen and Gleditsiae Spina in tablets from manufacturer B and granules from manufacturer D were significantly higher than those in tablets from manufacturer A， and tablets and capsules from manufacturer C. The contents of tanshinones in some batches of products from manufacturer A were abnormally high， potentially linked to the use of 70% ethanol reflux during extraction of Salviae Miltiorrhizae Radix et Rhizoma. All samples from manufacturer C exhibited abnormally high proportions of salvianic acid A and 3，4-dihydroxybenzaldehyde（salvianolic acid degradation products） to the total seven phenolic acids， indicating a risk of blindly pursuing tanshinol content and neglecting more effective components. The extraction rate of the characteristic components from Vaccariae Semen by decocting with water was obviously higher than that by reflux extraction with 70% ethanol. However， using the stir-fried Vaccariae Semen could reduce the loss of ingredients. The content ratio of toosendanin and isotoosendanin decreased from the crude herb to the prepared medicine when Toosendan Fructus was prepared by water decoction. The reason for the low component content of Gleditsiae Spina may be attributed to manufacturers using excessive non-medicinal parts in their formulations. ConclusionIt is suggested that enterprises should ensure the quality of raw material inputs， especially those without quality-control items in the standard， reduce the use of non-medicinal parts， and prohibit arbitrary alterations to manufacturing methods or processes. It is also recommended that Vaccariae Semen in Rukuaixiao capsules and granules should be changed to the stir-fried processed products. Isotoosendanin should be taken into consideration in the drug supervision when Toosendan Fructus is prepared into medicine by water decoction. Salvianolic acid B should be set as a quality control index for Salviae Miltiorrhizae Radix et Rhizoma when revising the pharmacopoeia standard of Rukuaixiao preparations.

ObjectiveBased on multi-index and multi-method detection， the quality of Rukuaixiao preparations was systematically evaluated from the perspective of characteristic components， and the existing problems were analyzed. MethodsLiquid chromatography-mass spectrometry（LC-MS） for the determination of 16 characteristic components was established to evaluate the quality of 129 batches of Rukuaixiao preparations. High performance liquid chromatography（HPLC） was established to determine the contents of salvianolic acids and tanshinones， investigate the rationality of quality control index of Salviae Miltiorrhizae Radix et Rhizoma in the standard for Rukuaixiao preparations in the 2020 edition of Pharmacopoeia of the People's Republic of China（hereinafter referred to as Chinese Pharmacopoeia） （volume Ⅰ）， and trace the causes of significant difference among different batches. The processing and different extraction methods of Vaccariae Semen were tested， analyzing the impact of formulation changes across different editions of Chinese Pharmacopoeia. The LC-MS was established for determining the changes in the ratio of toosendanin and isotoosendanin after water extraction of Toosendan Fructus. The contents of active components in different parts of Gleditsiae Spina were determined to identify the reason of the low contents of characteristic components in some enterprises. ResultsBased on the comprehensive analysis of the samples from different dosage forms， the contents of characteristic components of Vaccariae Semen and Gleditsiae Spina in tablets from manufacturer B and granules from manufacturer D were significantly higher than those in tablets from manufacturer A， and tablets and capsules from manufacturer C. The contents of tanshinones in some batches of products from manufacturer A were abnormally high， potentially linked to the use of 70% ethanol reflux during extraction of Salviae Miltiorrhizae Radix et Rhizoma. All samples from manufacturer C exhibited abnormally high proportions of salvianic acid A and 3，4-dihydroxybenzaldehyde（salvianolic acid degradation products） to the total seven phenolic acids， indicating a risk of blindly pursuing tanshinol content and neglecting more effective components. The extraction rate of the characteristic components from Vaccariae Semen by decocting with water was obviously higher than that by reflux extraction with 70% ethanol. However， using the stir-fried Vaccariae Semen could reduce the loss of ingredients. The content ratio of toosendanin and isotoosendanin decreased from the crude herb to the prepared medicine when Toosendan Fructus was prepared by water decoction. The reason for the low component content of Gleditsiae Spina may be attributed to manufacturers using excessive non-medicinal parts in their formulations. ConclusionIt is suggested that enterprises should ensure the quality of raw material inputs， especially those without quality-control items in the standard， reduce the use of non-medicinal parts， and prohibit arbitrary alterations to manufacturing methods or processes. It is also recommended that Vaccariae Semen in Rukuaixiao capsules and granules should be changed to the stir-fried processed products. Isotoosendanin should be taken into consideration in the drug supervision when Toosendan Fructus is prepared into medicine by water decoction. Salvianolic acid B should be set as a quality control index for Salviae Miltiorrhizae Radix et Rhizoma when revising the pharmacopoeia standard of Rukuaixiao preparations.

Obesity, as a chronic recurrent disease, has become a major public health challenge in China. To implement the requirements of the Healthy China Initiative (2019—2030), under domestic guidelines or consensus statements on overweight and obesity, and in alignment with the latest scientific advances globally, the Quality control protocol for adult overweight and obesity screening in health management (examination) institutions (2025 edition) was developed. This protocol was drafted by the Health Management Center of Shanghai Changzheng Hospital and formulated through multiple rounds of deliberation by experts in China’s health examination quality control field. The protocol establishes unified standards for screening facilities, personnel qualifications, and measurement or testing procedures. It defines specific screening items, outlines a standardized screening pathway, and sets requirements for the final medical review, ensuring the scientific validity, effectiveness, and safety of the screening process. The implementation of this protocol will enhance the consistency of weight management practices for adults across health examination institutions and strengthen the quality control of overweight and obesity screening programs.

Objective : To construct triggering receptor expressed on myeloid cells 2(TREM2) gene knockout(TREM2-/-) mice using CRISPR/Cas9 technology, to breed TREM2-/- mice and to analyze the genotype of TREM2-/- mice. Methods : CRISPR/Cas9 technology was used to selectively knock out exon 2-3 regions of TREM2 gene to construct a TREM2-/- mouse model, and the genetic background of all mice was C57BL/6J. Polymerase chain reaction(PCR) was used to identify the genotype of mice. Quantitative real-time PCR(qPCR) and Western blot were used to detect the expression level of TREM2 in major tissues of mice, and the authenticity and scientific nature of PCR identification results were verified from mRNA level and protein level. According to the sgRNA sequence, the possible off-target sites were predicted on the CCTop website, and the tail DNA of mice was extracted and amplified by PCR and then Sanger sequencing was performed to detect whether there was off-target effect in TREM2-/- mice. Results : TREM2-/- mice were successfully constructed by CRISPR/Cas9 technology, and the mice were genotyped. The results of agarose gel electrophoresis showed that the mouse genotype with only 415 bp band amplified was wild type(WT), the mouse genotype of the 449 bp band amplified only was TREM2-/-, and the mouse genotypes amplified with 415 bp and 449 bp double bands were heterozygous. qPCR results showed that compared with WT mice, the mRNA expression of TREM2 in heart and brain tissues of TREM2-/- mice was down-regulated(P-/- mice was reduced(P-/- mice. Conclusion TREM2-/- mice are successfully constructed and bred, a reliable genotype identification method is established, the genetic stability of the mouse model is verified, which will provide an important genetic animal model for the study of TREM2 gene function.

Objective:To investigate the cognitive characteristics and related influencing factors in Parkinson′s disease (PD) patients with or without olfactory anosognosia (OA).Methods:A total of 113 PD patients who were treated at the Affiliated Hospital of Yangzhou University between March 2023 and April 2024 were selected. The PD Olfactory Dysfunction Auxiliary Diagnostic Card was used to assess olfactory function. Based on the olfactory identification scores and subjective awareness of olfactory dysfunction, patients were divided into the normosmic group, olfactory dysfunction group, and the later was further divided into olfactory dysfunction without OA (OA-) group, and olfactory dysfunction with OA (OA+) group. The results of the Unified Parkinson′s Disease Rating Scale-Ⅲ (UPDRS-Ⅲ) and Hoehn-Yahr (H-Y) staging assessments of the patients were collected. Non-motor symptoms such as cognitive function, anxiety, depression, sleep disturbances, and constipation were evaluated using relevant scales. Logistic regression analysis was used to explore the related factors affecting OA in PD patients with olfactory decline.Results:The Montreal Cognitive Assessment (MoCA) scores of the olfactory dysfunction group were lower than those of the normosmic group (20.30±4.47 vs 22.64±2.50, t=2.907, P=0.007). The Self-Rating Anxiety Scale scores (39.00±8.60 vs 43.86±10.63, t=2.444, P=0.016), visuospatial and executive function scores (2.35±1.32 vs 2.98±1.42, t=2.263, P=0.026), and orientation scores (4.88±1.14 vs 5.34±1.07, t=2.046, P=0.043) of the OA+ group were lower than those of the OA- group. Logistic regression analysis revealed that lower MoCA scores were an independent risk factor for PD combined with OA ( OR=0.853, 95% CI 0.743-0.980, P=0.024). Conclusions:PD patients with olfactory dysfunction exhibit more severe cognitive impairment. Among them, patients with OA show more significant impairments in visuospatial, executive function and orientation. Cognitive impairment may be an independent risk factor for PD combined with OA.

Ropeginterferon α-2b(Ropeg),a novel,long-acting pegylated prolene alpha interferon,is the first interferon specifically approved for the treatment of patients with polycythemia vera(PV),and has been found in clinical trials and experience to induce hematologic remission,control disease-related symptoms,and reduce JAK2V617F allelic burden in patients with myeloproliferative neoplasms(MPNs).It has a lower incidence and severity of adverse drug reactions than pegylated interferon alpha and hydroxyurea and a longer dosing interval.Some patients with low-risk PV and myelofibrosis can benefit from it.This article reviews the latest progress of Ropeg in MPN.

Background: Trauma remains a leading cause of death and disability. With the rapidly growing aging population, geriatric patients face heightened trauma risks due to physiological decline and comorbidities. Despite the growing burden, data on the clinical characteristics, injury mechanisms, patterns, and healthcare utilization in this group remain limited. This study analyzed trauma outcomes and associated factors in geriatric patients. Methods: We conducted a retrospective cohort study using data from a Level I trauma center. Patients aged ≥65 years were compared with younger adults (<65 years). Variables included demographics, injury mechanism, Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), Abbreviated Injury Scale (AIS), Injury Severity Score, clinical outcomes, and medical costs. Multivariate logistic regression identified mortality predictors. Results: Among 10,358 trauma patients with mean age of 54.2 years, 61.9% of younger patients were male, compared to 37.7% in the geriatric group (p<0.001). Geriatric patients exhibited lower male predominance, higher costs, and greater mortality (p<0.001). Multivariable analysis revealed that, among geriatric groups, male sex, older age, lower GCS, lower RTS, burns injuries, and severe injuries (AIS ≥3) to head, thoracic, extremity, and appearance were significant mortality predictors. Undergoing orthopedic and thoracic surgeries was associated with lower mortality in geriatric patients. Conclusion Geriatric trauma patients experience higher mortality risks and demands. Timely interventions, critical care management, appropriate triage, and age-adapted assessment tools are essential for improving clinical outcomes. These findings underscore the importance of interdisciplinary care strategies to optimize geriatric trauma management and resource utilization.

Objective:To systematically integrate qualitative studies on the experience of self-advocacy in cancer patients, so as to provide basis for formulating targeted intervention strategies and improving the level of self-advocacy in cancer patients.Methods:Qualitative studies on the self-advocacy experience of cancer patients were systematically searched from PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, VIP database, and China Biomedical Literature Service System, and the search period was from the establishment of the database to December 31, 2023. The quality of literature was evaluated using the qualitative research quality evaluation criteria of JBI Evidence-Based Health Care Center in Australia, and the results were integrated by aggregative meta-integration method.Results:A total of 12 literatures were included, and 51 research results were extracted, which were summarized into 12 categories, and four integrated results were obtained: different voices of self-advocacy rights, positive power of self-advocacy rights, obstacles to self-advocacy rights, and multi-dimensional demand for advocacy rights.Conclusions:Medical staff should adhere to the concept of "patient-centered", guide cancer patients to enhance their awareness of self-advocacy rights, attach importance to positive power, stimulate internal drive, create a good atmosphere of advocacy rights, improve patients′advocacy ability in multiple ways, and meet multi-dimensional needs.