Tuberculosis (TB), a chronic infectious disease caused by Mycobacterium tuberculosis, is primarily airborne and remains a global health problem, especially in resource-limited countries and regions. The emergence of drug resistance in M. tuberculosis has rendered the existing means ineffective in the treatment of TB. Therefore, research in new therapeutic directions has become imperative. In this review, we outline functional peptides in terms of the mechanisms of action, anti-TB attempts, advantages and disadvantages, and latest advances, aiming to analyze the research progress in anti-TB peptides. Furthermore, we investigate the potential applications of bioactive compounds found in traditional Chinese Medicine within the context of peptides.

Objective To clarify the concept of caregiver fatigue in an aging society and to provide references in the elderly people nursing.Methods Literature on caregiver fatigue was systematically retrieved from databases of China National Knowledge Infrastructure(CNKI),Wanfang Data,Chinese Biomedical Literature Database,PubMed,EMbase,Scopus,and Web of Science from the inception to June 15th 2024.Walker and Avant's framework for concept analysis was performed to analyse the retrieved literature.Results Forty-one papers were included in the study.Caregiver fatigue was identified to comprise of five defining attributes:simultaneous physical and psychological burden,subjective perception,changing over time,negative impact arising from caregiving,and negative impact on both caregivers and care recipients.Antecedents included three perspectives:caregiver-related,care-recipient-related and environmental,The consequences included an impact on both the caregiver and the person being cared for.Empirical assessment indicators of fatigue include the checklist individual strength(CIS)and the fatigue assessment instrument(FAI)and fatigue scale-14(FS-14,FS-14).Conclusion Walker and Avant's conceptual analysis identifies five attributes of caregiver fatigue.Nurses should pay attention to and evaluate the degree of caregiver fatigue from multiple perspectives,thereby effectively identifying and intervening in the fatigue as early as possible.

Avian infectious bronchitis(IB),a rapidly spreading and acute disease in chickens,is caused by the infectious bronchitis virus(IBV).IB is characterized by its remarkable genetic varia-bility.IBV has a high degree of mutation,and the existing means of immunization often fail to a-chieve good results,seriously affecting the development of the domestic poultry industry.This ar-ticle offers a comprehensive review of the current understanding of the immune response to IBV,focusing on three key areas:non-specific immunity,mucosal immunity,and specific immunity.By dissecting these aspects,the aim is to provide a theoretical reference for the study of the immune mechanism of IBV.

Purpose To investigate the application value of MRI in distinguishing Association Research Circulation Osseous(ARCO)stage II and IIIA of osteonecrosis of the femoral head.Materials and Methods A total of 48 patients with ARCO stage II/IIIA non-traumatic osteonecrosis of the femoral head in the Fourth Medical Center of Chinese PLA General Hospital from October 2022 to September 2023 were retrospectively included,with a total of 75 hips.The hips were divided into ARCO stage II group(26 hips)and stage IIIA group(49 hips)based on CT.The MRI findings(including irregular articular surface of femoral head,similar closed-loop shape of necrotic-viable interface,fibrous granulation tissue and cystic change in necrotic area,perinecrotic bone marrow edema,articular effusion and synovitis)were compared between the two groups,and the diagnostic efficiencies were evaluated.Results Irregular articular surface of femoral head,cystic change and fibrous granulation tissue in necrotic area and synovitis were more common in stage IIIA group than in stage II group,the range of bone marrow edema was larger than that in stage II group,the grade of articular effusion was larger than that in stage II group,and similar closed-loop shape of the necrotic-viable interface was found in stage II group,but no such sign was found in stage IIIA group,with statistical difference of all the above(χ2/Z=-5.727-54.764,all P<0.001).The area under the curve of irregular articular surface of femoral head,bone marrow edema,synovitis,articular effusion,fibrous granulation tissue in necrotic area,cystic change in the necrotic area,and similar closed-loop shape of the necrotic-viable interface in distinguishing ARCO stage II and IIIA were 0.931,0.891,0.845,0.799,0.772,0.724 and 0.692,respectively.The diagnostic efficiency of irregular articular surface of femoral head was not statistically significant with bone marrow edema and synovitis(both P>0.05),and higher than articular effusion,fibrous granulation tissue in necrotic area,cystic change in necrotic area,and similar closed-loop shape of the necrotic-viable interface(Z=2.054,2.711,4.182,4.003,all P<0.05).Conclusion MRI is helpful to distinguish ARCO stage II from stage IIIA of osteonecrosis of the femoral head.The diagnostic efficiencies of irregular articular surface of femoral head,bone marrow edema and synovitis are higher.

Objective:To evaluate the association between postoperative delirium (POD) and preoperative frailty in elderly patients undergoing knee or hip arthroplasty.Methods:This nested case-control study utilized medical records from elderly patients who underwent knee or hip arthroplasty under combined spinal-epidural anesthesia at Qingdao Municipal Hospital between September 2021 and May 2023. Participants were divided into 2 groups based on clinically diagnosed POD: POD group ( n=53) and non-POD group ( n=256). Univariate analysis was conducted on suspected influencing factors, and logistic regression analysis was utilized to identify the risk factors for POD. Receiver operating characteristic and clinical decision curves were plotted to evaluate the predictive performance of these risk factors for POD. Mediation analysis was performed, and a clinically applicable nomogram was constructed to achieve visual prediction of outcomes. Results:There were statistically significant differences in age, preoperative frailty, body mass index, American Society of Anesthesiologists Physical Status classification, Memorial Delirium Assessment Scale scores, and concentrations of Aβ 42, Aβ 40, phosphorylated tau protein (p-tau protein) and tau protein, Aβ 42/tau ratio and Aβ 42/p-tau ratio in cerebrospinal fluid (CSF) between non-POD group and POD group ( P<0.05). Preoperative frailty was a risk factor for POD ( P<0.05). Mediation analysis revealed that the association between preoperative frailty and POD was mediated by CSF tau protein concentrations. The area under the receiver operating characteristic curve of preoperative frailty and CSF biomarker concentrations in predicting POD was 0.974 ( P<0.05). The clinical decision curve demonstrated that the model combining the preoperative frailty and CSF biomarker concentrations predicted a higher net benefit ( P<0.05). The clinical decision curve showed that the model combining preoperative frailty and CSF biomarker concentrations predicted a higher net benefit. Conclusions:Preoperative frailty is a risk factor for POD in elderly patients undergoing knee or hip arthroplasty, and its combination with CSF biomarker concentrations can effectively predict the occurrence of POD. CSF tau concentration mediates the association between preoperative frailty and development of POD.

Objective To clarify the concept of caregiver fatigue in an aging society and to provide references in the elderly people nursing.Methods Literature on caregiver fatigue was systematically retrieved from databases of China National Knowledge Infrastructure(CNKI),Wanfang Data,Chinese Biomedical Literature Database,PubMed,EMbase,Scopus,and Web of Science from the inception to June 15th 2024.Walker and Avant's framework for concept analysis was performed to analyse the retrieved literature.Results Forty-one papers were included in the study.Caregiver fatigue was identified to comprise of five defining attributes:simultaneous physical and psychological burden,subjective perception,changing over time,negative impact arising from caregiving,and negative impact on both caregivers and care recipients.Antecedents included three perspectives:caregiver-related,care-recipient-related and environmental,The consequences included an impact on both the caregiver and the person being cared for.Empirical assessment indicators of fatigue include the checklist individual strength(CIS)and the fatigue assessment instrument(FAI)and fatigue scale-14(FS-14,FS-14).Conclusion Walker and Avant's conceptual analysis identifies five attributes of caregiver fatigue.Nurses should pay attention to and evaluate the degree of caregiver fatigue from multiple perspectives,thereby effectively identifying and intervening in the fatigue as early as possible.

Purpose To investigate the application value of MRI in distinguishing Association Research Circulation Osseous(ARCO)stage II and IIIA of osteonecrosis of the femoral head.Materials and Methods A total of 48 patients with ARCO stage II/IIIA non-traumatic osteonecrosis of the femoral head in the Fourth Medical Center of Chinese PLA General Hospital from October 2022 to September 2023 were retrospectively included,with a total of 75 hips.The hips were divided into ARCO stage II group(26 hips)and stage IIIA group(49 hips)based on CT.The MRI findings(including irregular articular surface of femoral head,similar closed-loop shape of necrotic-viable interface,fibrous granulation tissue and cystic change in necrotic area,perinecrotic bone marrow edema,articular effusion and synovitis)were compared between the two groups,and the diagnostic efficiencies were evaluated.Results Irregular articular surface of femoral head,cystic change and fibrous granulation tissue in necrotic area and synovitis were more common in stage IIIA group than in stage II group,the range of bone marrow edema was larger than that in stage II group,the grade of articular effusion was larger than that in stage II group,and similar closed-loop shape of the necrotic-viable interface was found in stage II group,but no such sign was found in stage IIIA group,with statistical difference of all the above(χ2/Z=-5.727-54.764,all P<0.001).The area under the curve of irregular articular surface of femoral head,bone marrow edema,synovitis,articular effusion,fibrous granulation tissue in necrotic area,cystic change in the necrotic area,and similar closed-loop shape of the necrotic-viable interface in distinguishing ARCO stage II and IIIA were 0.931,0.891,0.845,0.799,0.772,0.724 and 0.692,respectively.The diagnostic efficiency of irregular articular surface of femoral head was not statistically significant with bone marrow edema and synovitis(both P>0.05),and higher than articular effusion,fibrous granulation tissue in necrotic area,cystic change in necrotic area,and similar closed-loop shape of the necrotic-viable interface(Z=2.054,2.711,4.182,4.003,all P<0.05).Conclusion MRI is helpful to distinguish ARCO stage II from stage IIIA of osteonecrosis of the femoral head.The diagnostic efficiencies of irregular articular surface of femoral head,bone marrow edema and synovitis are higher.

This paper starts with an analysis of the types of risks in the procurement of public hospitals,explores the weak links in internal control,identifies problems in risk management,and proposes improvement suggestions to promote stand-ardized and refined management of hospital procurement.

Pregnancy is a complex biological process of human body,involving the growth and development of the embryo and the formation of the placenta and other stages.Placental-derived exosome(PdE)is secreted by various placental cells and is rich in various RNA,DNA,protein and lipids.PdE,as active carriers of molecular biomarkers and mediators of cell-to-cell communication,regulate the physiological functions of the mother and maintain the normal development of the fetus,and participate in the pathological process of pregnancy.This review examines the roles of placental microRNAs,long-chain non-coding RNAs,circular RNAs in gestational diabetes mellitus,focusing on their molecular mechanisms and potential as biomarkers for early diagnosis and therapeutic targets.

Pregnancy is a complex biological process of human body,involving the growth and development of the embryo and the formation of the placenta and other stages.Placental-derived exosome(PdE)is secreted by various placental cells and is rich in various RNA,DNA,protein and lipids.PdE,as active carriers of molecular biomarkers and mediators of cell-to-cell communication,regulate the physiological functions of the mother and maintain the normal development of the fetus,and participate in the pathological process of pregnancy.This review examines the roles of placental microRNAs,long-chain non-coding RNAs,circular RNAs in gestational diabetes mellitus,focusing on their molecular mechanisms and potential as biomarkers for early diagnosis and therapeutic targets.