Purpose/Significance To investigate the application of cutting-edge technologies in predicting the incidence of hemor-rhagic fever with renal syndrome(HFRS),to compile and integrate various time-series analysis methods,evaluate and select the opti-mal model.Method/Process By utilizing national HFRS incidence data from 2004 to 2020,the effectiveness of models is predicted based on statistical methods:SARIMA,STL-ARIMA and TBATS,neural network approaches:NNAR,LSTM and combined models of SARIMA-LSTM with 3 different weighting schemes.The performance of these models is comprehensively assessed using RMSE,MAE and MAPE.Result/Conclusion The SARIMA and LSTM models are identified as the superior individual models.The combined SARI-MA-LSTM model demonstrates enhanced performance compared to individual models.The SARIMA-LSTM model optimized using the reciprocal of error method is deemed the optimal model.The optimal model is expected to provide technical support and references for the early warning system model design of HFRS.

Objective:To explore the effects of online supportive disclosure therapy on the self-expression level, professional identity, dimission intention, and turnover rate of pre-dimission nurses, in order to provide a reference for nursing managers to stabilize the nursing team.Methods:A quasi experimental research method was used, and a convenient sampling method was used to select 192 pre resigned nurses from Shandong Provincial Third Hospital, the First Affiliated Hospital of Shandong First Medical University, and Shandong First Medical University Affiliated Provincial Hospital from October 2021 to December 2022 as the research subjects. They were divided into a control group and an experimental group by random number table method, with 96 nurses in each group. The control group received routine exit interviews, while the experimental group received online supportive disclosure therapy intervention based on this. The self-expression level, professional identity, dimission intention, and turnover rate of two groups of nurses before and 1, 2 months after the intervention were evaluated.Results:Finally, 94 nurses in the control group and 92 nurses in the experimental group completed the study. There were no significant differences in the self-expression level, professional identity, dimission intention before the intervention between the two groups ( P>0.05). After 1 and 2 months of the intervention, the scores of the Pain Self Disclosure Index, Nurse Professional Identity Rating Scale, and Resignation Intention Scale of the experimental group were 36.33 ± 5.13, 73.88 ± 8.72, 14.18 ± 1.12 and 34.22 ± 6.78, 98.26 ± 11.29, 6.16 ± 1.19, respectively,and the control group were 28.06 ± 8.23, 64.72 ± 10.39, 17.82 ± 1.37 and 44.26 ± 7.62, 79.82 ± 8.66, 9.18 ± 1.06, there were statistically significant differences between the two groups ( t values were -13.54 to -2.11, all P<0.05); there were statistically significant differences in the inter group effects, time effects, and interaction effects of the scores on the Pain Self Disclosure Index, Professional Identity Rating Scale, and Resignation Intention Scale between the two groups ( F values were 5.12 to 14.82, all P<0.05). The turnover rate of nurses in the experimental group was 1.09% (1/92), lower than 8.51% (8/94) in the control group, and the difference between the two groups was statistically significant ( χ2=1.59, P<0.05). Conclusions:Online supportive disclosure therapy can improve the self-expression level and professional identity of pre-dimission nurses, and reduce their willingness to resign and turnover rate.

Pulmonary blast injury has become the main type of trauma in modern warfare, characterized by externally mild injuries but internally severe injuries, rapid disease progression, and a high rate of early death. The injury is complicated in clinical practice, often with multiple and compound injuries. Currently, there is a lack of effective protective materials, accurate injury detection instrument and portable monitoring and transportation equipment, standardized clinical treatment guidelines in various medical centers, and evidence-based guidelines at home and abroad, resulting in a high mortality in clinlcal practice. Therefore, the Trauma Branch of Chinese Medical Association and the Editorial Committee of Chinese Journal of Trauma organized military and civilian experts in related fields such as thoracic surgery and traumatic surgery to jointly develop the Clinical treatment guideline for pulmonary blast injury ( version 2023) by combining evidence for effectiveness and clinical first-line treatment experience. This guideline provided 16 recommended opinions surrounding definition, characteristics, pre-hospital diagnosis and treatment, and in-hospital treatment of pulmonary blast injury, hoping to provide a basis for the clinical treatment in hospitals at different levels.

Objective:To observe the curative effect of He Style fire acupuncture on functional dyspepsia of deficiency cold of spleen and stomach syndrome.Methods:Sixty patients who met the inclusion criteria from March 2017 to March 2019 in Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University were divided into 2 groups according to the random number table method, with 30 in each group. The control group was given mosapride tablets, one tablet (5 mg) each time half an hour before meals. On the basis of the control group, the treatment group was given fire acupuncture on Zusanli(ST36), Zhongwan(CV12), Pishu(BL20), Weishu(BL21), Guanyuan(CV4) and Qihai (CV6) twice a week. The course of treatment for both groups of patients was 4 weeks. A follow-up was visited at 1 month after the treatment. The total Symptom Scores and Health-Related Quality of Life Scale (SF-36) scores were performed before and after treatment, and the total scores of syndromes of patients with Deficiency cold of spleen and stomach before and after treatment were used for clinical efficacy evaluation, and adverse events during treatment were recorded.Results:The total efficiency of the treatment group was 93.3% (28/30), and 76.7% (23/30) in the control group, and the 2 groups were statistically significant ( χ2=4.78, P<0.05). After treatment, the upper abdominal pain, upper abdominal burning, postprandial fullness and discomfort, early satiety, and total scores in the treatment group were significantly lower than those in the control group ( t values were 4.27, 5.16, 3.93, 4.69, 4.28, respectively, all Ps<0.05); during follow-up, the upper abdominal pain, upper abdominal burning, postprandial fullness and discomfort and the total scores in the treatment group were significantly lower than those in the control group ( t values were 3.63, 3.22, 4.03, 3.04, respectively, all Ps<0.05). In terms of SF-36, after treatment, the treatment group showed significantly higher scores in the control group of physical function, physiology, mental health, and health changes compared with the control group ( t values were 2.97, 4.05, 4.22, 3.05, respectively, all Ps<0.05). During follow-up, the treatment group with physiological function, physical function, physical pain, overall health, life vitality, mental health, health changes scores were significantly higher than those in the control group ( t values were 3.27, 4.23 3.85, 3.15, 3.25, 6.15, 3.85, respectively, all Ps<0.05). Conclusion:He Style fire acupuncture combined with western medicine treatment can improve the symptoms of upper abdominal pain and upper abdominal burning, and the quality of lifein the patients with functional dyspepsia.

Objective:To detect the inflammatory reaction of macrophages induced by lipoglycans of different genotypes of Mycobacterium tuberculosis ( Mtb) in vitro and to analyze the differences in lipoglycan virulence. Methods:Lipoglycans were extracted from Mtb of Beijing, T1 and MANU2 genotypes and H37Rv by Triton X-114 liquid phase method and the crude extracts of lipoglycans was used to stimulate RAW264.7 macrophages. Changes in cytokine and receptor expression and cell apoptosis were detected 24 h after stimulation. The virulence of lipoglycans from different genotypes of Mtb was analyzed and compared. One-way analysis of variance and Tukey′s multiple comparisons test were used to compare the differences in various indexes between groups. Results:The expression of IL-10 at mRNA level induced by lipoglycans from Mtb of Beijing, T1 and MANU2 genotypes and H37Rv was (0.94±0.24), (1.86±0.24), (1.90±0.24) and (2.55±0.75) times that of the control group. Moreover, IL-10 mRNA expression induced by lipoglycans from Mtb of Beijing genotype was significantly lower than that of H37Rv group ( P<0.05). After stimulating RAW264.7 cells with the crude extracts of lipoglycans, the proportions of living cells in H37Rv, Beijing genotype, T1 genotype and MANU2 genotype groups were (72.75±2.25)%, (60.99±0.13)%, (80.66±0.40)% and (79.06±1.19)%, and the total cell apoptosis ratios was (10.42±0.23)%, (8.30±0.03)%, (9.24±0.79)% and (8.04±0.48)%, respectively. The proportion of living cells in Beijing genotype group was the lowest ( P<0.05), and the proportions of living cells in T1 and MANU2 genotype groups were higher than that in H37Rv group ( P<0.05). There was no significant difference in cell apoptosis ratio among the groups ( P>0.05). Lipoglycan-induced cell death was increased in Beijing genotype group, and the lipoglycan from Beijing genotype Mtb was more virulent than those from Mtb of T1 and MANU2 genotypes. Conclusions:Lipoglycan from Mtb of Beijing genotype could induce a higher level of cell death in vitro. It was an antigen component with stronger virulence than those from Mtb of T1 and MANU2 genotypes.

Objective:To investigate the clinical efficacy of Jinghua Weikang capsule combined with Bifidobacterium for curing patients featured by spleen-stomach damp-heat syndrome and Helicobacter pylori (Hp) infection with low DOB values.Methods:To enroll 130 cases who were admitted to the Digestion Center of Beijing Hospital of Traditional Chinese Medicine, Capital Medical University from March 2019 to March 2020. According to the treaatment protocols, the quadruple therapy group and dual therapy group, each had 65 patients. The quadruple therapy group had two different treatment protocols, 34 cases with Rabeprazole sodium enteric-coated tablet, Bismuth potassium citrate capsule, Amoxicillin capsule, and Clarithromycin, the other one had 31 cases with Rabeprazole sodium enteric-coated tablet, Bismuth potassium citrate capsule, Amoxicillin capsule, and Levofloxacin tablets. The Dual therapy group was treated with Jinghua Weikang capsule combined with Bifidobacterium. As for quadruple therapy group, 14 days was a course of treatment, while28 days was a course of treatment for dual therapy group. The two groups were treated for one course, respectively. The TCM syndromes were scored before and after treatment. After 4-weeks long drug withdrawal, all cases were reexamined via 13C-UBT. The Hp eradication rate, efficacy evaluation and adverse reactions were compared between both groups.Results:The eradication rate was 90.8% (59/65) in quadruple therapy group and 78.5% (51/65) in dual therapy group. There was no statistical difference between two groups ( χ２=3.78, P=0.052). As for quadruple therapy group, the eradication rate was 91.2% (31/34) in Protocol One and 90.3% (28/31) in Protocol Two. There was no statistical difference between two protocols ( χ２=0.01, P=0.906). After treatment, the TCM syndrome score of quadruple therapy group [(7.02±0.89) vs. (6.51±0.85), Z=-3.01], was significantly higher than that of dual therapy group ( P<0.01). The total effective rate was 93.9% (61/65) in dual therapy group and 78.5% (51/65) in quadruple therapy group. There was statistically significantly difference between two groups ( χ２=6.45, P=0.011). The adverse reactions was 24.6% (16/65) in quadruple therapy group and 6.2% (4/65) in dual therapy group. There was statistically significantly difference in two groups ( χ２=8.51, P=0.004). Conclusions:The Jinghua Weikang capsule combined with Bifidobacterium had curative effects on Hp infected patients with low DOB values. It could improve TCM Syndromes with little adverse reactions.

Objective:To explore the efficacy and safety of Ganhai Weikang capsule (GWC) in the treatment of functional dyspepsia (FD).Methods:A randomized, double-blind, placebo-controlled parallel, multi-center, superiority clinical trial was conducted. From March 2018 to April 2020, totally 324 patients with dyspepsia symptoms, who were diagnosed as chronic non-atrophic gastritis by endoscopy and pathology and met the Rome Ⅳ diagnostic criteria for FD from 7 top hospitals were enrolled, including the First Affiliated Hospital of Naval Medical University (Shanghai Changhai Hospital), Heilongjiang Hospital of Traditional Chinese Medicine, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Qilu Hospital of Shandong University, the First Affiliated Hospital of Zhejiang University, Beijing Hospital of Traditional Chinese Medicine of Capital Medical University and the Third Xiangya Hospital of Central South University. The patients were randomly divided into the GWC group and the placebo group according to the ratio of 1∶1. The patients of GWC group were given GWC and the patients of placebo group were given GWC capsule simulant. The patients of both groups orally took capsules before meals, 2.4 g each time and 3 times per day, and the course of treatment was 4 weeks. The main efficacy index was the total clinical effective rate after 4 weeks, and the secondary efficacy index was the changes of clinical symptom scores of upper abdominal pain, upper abdominal burning, postprandial fullness and early satiety. The safety index included laboratory tests and adverse events. Chi-square test and Wilcoxon rank sum test were used for statistical analysis.Results:A total of 320 FD patients were enrolled in the full analysis set (FAS), which included 161 cases in GWC group and 159 cases in placebo group. A total of 298 cases were in the per-protocol set (PPS), 149 cases each in GWC group and placebo group. The results of FAS and PPS both showed that the total clinical effective rates of the GWC group were higher than those of the placebo group (84.5%, 136/161 vs. 44.0%, 70/159 and 83.9%, 125/149 vs. 46.3%, 69/149), and the differences were statistically significant ( χ2=57.07 and 46.32, both P<0.001). In addition, the differences of the total score of main symptoms and each symptom (upper abdominal pain, upper abdominal burning, postprandial fullness and early satiety) before and after treatment of GWC group were all higher than those of the placebo group (FAS: 10 (7, 14) vs. 5 (3, 11); 3 (2, 4) vs. 2 (0, 3); 2 (0, 4) vs. 1 (0, 3); 3 (1, 4) vs. 2 (1, 3); 2 (0, 4) vs. 1 (0, 3). PPS: 10 (7, 13) vs. 5 (3, 11); 3 (2, 4) vs. 2 (0, 3); 2 (0, 4) vs. 1 (0, 2); 3 (1, 4) vs. 2 (1, 3); 2 (0, 4) vs.1 (0, 3)), and the differences were statistically significant (FAS: Z=5.80, 5.91, 3.19, 3.72 and 3.30; PPS: Z=5.14, 5.11, 2.86, 3.21 and 2.84; all P<0.01). The results of FAS and PPS indicated that the improvement rates of main symptoms and each symptom (upper abdominal pain, upper abdominal burning, postprandial fullness and early satiety) of GWC group were all higher than those of the placebo group (FAS: 77.8% (54.6%, 91.3%) vs. 42.9% (28.6%, 61.5%); 100.0% (60.0%, 100.0%) vs. 50.0% (25.0%, 60.0%); 100.0% (50.0%, 100.0%) vs. 50.0% (25.0%, 100.0%); 71.4% (33.3%, 100.0%) vs. 41.4% (25.0%, 66.7%); 100.0% (50.0%, 100.0%) vs. 50.0% (20.0%, 100.0%). PPS: 77.8% (54.2%, 89.5%) vs. 44.0% (28.6%, 65.0%); 100.0% (60.0%, 100.0%) vs. 50.0% (25.0%, 100.0%); 100.0% (50.0%, 100.0%) vs. 50.0% (25.0%, 100.0%); 71.4% (33.3%, 100.0%) vs. 46.4% (25.0%, 66.7%); 100.0% (50.0%, 100.0%) vs. 50.0% (20.0%, 100.0%)), and the differences were statistically significant (FAS: Z=8.60, 7.72, 4.98, 4.24 and 5.61; PPS: Z=7.90, 7.03, 4.49, 3.88 and 4.83; all P<0.001). After 2 weeks of treatment, the differences of the total score of main symptoms and score of each symptom (upper abdominal pain, upper abdominal burning and early satiety) before and after treatment of GWC group were all higher than those of the placebo group (5.0 (3.0, 8.0) vs. 4.0 (2.0, 6.0); 2.0 (1.0, 2.0) vs. 2.0 (0.0, 2.0); 1.5 (0.0, 2.0) vs. 1.0 (0.0, 2.0); 1.5 (0.0, 2.0) vs. 1.0 (0.0, 2.0)), and the differences were statistically significant ( Z=2.95, 3.44, 2.43 and 2.79, all P<0.05). There was no significant difference in the incidence of adverse events between the GWC group and the placebo group (0.6%, 1/163 vs. 0, 0/159). Conclusion:The clinical total effective rate of GWC in the treatment of FD is superior to that of placebo and it has good safety.

Chromosomal region maintenance 1 (CRM1) is associated with an adverse prognosis in glioma. We previously reported that CRM1 inhibition suppressed glioma cell proliferation both in vitro and in vivo. In this study, we investigated the role of CRM1 in the migration and invasion of glioma cells. S109, a novel reversible selective inhibitor of CRM1, was used to treat Human glioma U87 and U251 cells. Cell migration and invasion were evaluated by wound-healing and transwell invasion assays. The results showed that S109 significantly inhibited the migration and invasion of U87 and U251 cells. However, mutation of Cys528 in CRM1 abolished the inhibitory activity of S109 in glioma cells. Furthermore, we found that S109 treatment decreased the expression level and activity of MMP2 and reduced the level of phosphorylated STAT3 but not total STAT3. Therefore, the inhibition of migration and invasion induced by S109 may be associated with the downregulation of MMP2 activity and expression, and inactivation of the STAT3 signaling pathway. These results support our previous conclusion that inhibition of CRM1 is an attractive strategy for the treatment of glioma.

Chromosomal region maintenance 1 (CRM1) is associated with an adverse prognosis in glioma. We previously reported that CRM1 inhibition suppressed glioma cell proliferation both in vitro and in vivo. In this study, we investigated the role of CRM1 in the migration and invasion of glioma cells. S109, a novel reversible selective inhibitor of CRM1, was used to treat Human glioma U87 and U251 cells. Cell migration and invasion were evaluated by wound-healing and transwell invasion assays. The results showed that S109 significantly inhibited the migration and invasion of U87 and U251 cells. However, mutation of Cys528 in CRM1 abolished the inhibitory activity of S109 in glioma cells. Furthermore, we found that S109 treatment decreased the expression level and activity of MMP2 and reduced the level of phosphorylated STAT3 but not total STAT3. Therefore, the inhibition of migration and invasion induced by S109 may be associated with the downregulation of MMP2 activity and expression, and inactivation of the STAT3 signaling pathway. These results support our previous conclusion that inhibition of CRM1 is an attractive strategy for the treatment of glioma.

OBJECTIVE：To establish QAMS method for simultaneou s determination of 7 effective components in Yao medicine Yueli yaomi spray ，such as α-cyperone，α-pinene，β-pinene，limonene，β-elemene，caryophyllene oxide and ligustilide ， so as to provide method reference for the quality control of the preparation. METHODS ：GC method was adopted. The determination was performed on DB- 1701P capillary column ，using nitrogen as carrier gas. The temperature of the hydrogen flame ion detector was 240 ℃. The temperature was programmed ，the inlet temperature was 240 ℃，the injection volume was 1 μL and the split ratio was 20 ∶ 1. Using limonene as internal reference ，the relative correction factors of other 6 components were calculated，the contents of them were calculated with relative correction factors ，and then compared with the results of internal standard method （using naphthalene as internal standard ）. RESULTS ：The mass concentration linear range of α-cyperone， α-pinene，β-pinene，limonene，β-elemene，caryophyllene oxide and ligustilide were 0.008 9-1.110 0，0.028 3-3.540 0，0.020 5- 2.560 0，0.023 0-2.880 0，0.016 3-2.035 0，0.013 1-1.640 0，0.008 3-1.040 0 mg/mL（all r＞0.999 0）；the limits of quantification were 0.005 6，0.013 1，0.011 4，0.018 6，0.010 8，0.008 9，0.004 5 mg/mL；the detection limits were 0.001 9，0.004 1，0.003 7， 0.006 2，0.003 5，0.002 9，0.001 5 mg/mL；RSDs for precision ，stability（24 h），and repeatability tests were all less than 2％ （n＝5 or n＝6）； the average recoveries were 98.48％ ， 014） 101.37％，97.96％，99.80％，102.79％，97.77％，102.14％， and RSDs were all lower than 2％（n＝9），respectively. The average relative correction factors of α-cyperone，α-pinene， β-pinene，β-elemene，caryophyllene oxide and ligustilide were 1.045 8，0.621 0，0.488 5，0.382 9，0.708 9，0.956 9 respectively，and the RSDs were all lower than 2％（n＝6）. There wa s no statistical significance in contents of 7 components between QAMS method and internal standard method （P＞0.05）. CONCLUSIONS ：The established QAMS method is simple ， accurate，stable and reproducible ，and can be used for simultaneous determination for 7 components in Yueli yaomi spray.