OBJECTIVE To comprehensively evaluate the 16 commonly used kinds of enteral nutrition preparations in Hebei province， aiming to provide a reference for the selection of drugs in medical institutions and clinical drug decision-making. METHODS Based on the Quick Guide for Drug Evaluation and Selection in Chinese Medical Institutions （the Second Edition）， evaluation evidence was collected， and the included drugs were scored and evaluated from four dimensions of pharmaceutical characteristics， clinical characteristics， economy and other attributes. RESULTS & CONCLUSIONS The scores for Enteral nutritional emulsion （TPF-T）， Enteral nutritional emulsion （TPF-D）， Enteral nutritional emulsion （TPF）， Enteral nutritional emulsion （TPF-HE）， Enteral nutritional emulsion （TP）， Enteral nutritional emulsion （SP）， Enteral nutritional suspension （TPF） （1.5 kcal/mL， 1 kcal＝4.184 kJ）， Enteral nutritional suspension （TPF） （1.0 kcal/mL）， Intact protein enteral nutrition （powder）， Enteral nutritional suspension （TPF-DM）， Enteral nutritional suspension （TPF-MCT）， Enteral nutritional suspension （SP）， Short- peptide enteral nutrition， Enteral nutritional powder （TP）， Enteral nutritional suspension （TPF-D） and Enteral nutritional suspension （TPF-FOS） were 82.9， 84.1， 84.1， 86.1， 78.4， 79.1， 82.6， 82.3， 82.4， 80.2， 83.0， 82.4， 82.1， 85.7， 76.0， 82.4 points， respectively. All medications scored above 70 points. In practice， appropriate drugs can be selected according to clinical requirements and patient needs.

OBJECTIVE To improve the inventory turnover rate of traditional Chinese medicine （TCM） decoction pieces in hospitals and achieve refined inventory management for cost reduction and efficiency improvement. METHODS Inventory data of TCM decoction pieces in our hospital from 2022 to 2023 were collected. Based on the sale amount and demand coefficient of variation respectively， the ABC classification method and XYZ analysis method were adopted for classification. The two classification results were combined through a cross matrix to divide them into three-level management priorities： level Ⅰ （AX， AY， BX）， level Ⅱ （AZ， BY， CX）， and level Ⅲ （BZ， CY， CZ）. Differentiated inventory strategies were formulated for each level， and core indicators such as turnover rate and inventory cost before and after inventory management optimization were compared. RESULTS There were 58 types （14.22%） in level Ⅰ， 85 types （20.83%） in level Ⅱ， and 265 types （64.95%） in level Ⅲ. After inventory management optimization， the average inventory value of TCM decoction pieces decreased by 341 800 yuan， the average turnover rate increased by 73.03%， and the average turnover days decreased by 4.98 days. The differences in all indicators before and after optimization were statistically significant （ P ＜0.01）. CONCLUSIONS The ABC-XYZ analysis method can break through the single-dimensional limitation of the traditional ABC classification method， adapt to characteristics such as the strong seasonality of TCM decoction pieces， significantly optimize the inventory structure， improve turnover efficiency， and reduce operating costs. It provides a feasible plan for the refined and scientific management of hospital TCM warehouses.

This paper summarizes professor XUAN Guowei's clinical experience in treating melasma from the perspective of kidney deficiency with vigorous fire， and scorching the collaterals to form stasis. It is proposed that the core pathogenesis of melasma is kidney deficiency with vigorous fire， along with the scorching of collaterals to form stasis， for which the the core therapeutic principle is enriching the kidney and subduing fire， combined with invigorating blood and dissolving stasis. In clinical practice， the self-formulated Xiaoban Decoction （消斑汤） is utilized as the foundational formula， complemented by external therapies such as acupuncture and moxibustion， acupoint injection， and the external application of Chinese herbal medicine. Furthermore， emphasis is placed on daily care and regulation， including strict sun protection， maintaining a joyful mood， ensuring adequate sleep， and following a healthy diet. This paper aims to provide a clinical reference for the treatment of melasma with traditional Chinese medicine.

ObjectiveTo establish the self-reported core outcome set （COS） for patients with an example of a community study on heat-sensitive moxibustion for primary hypertension （PH）， to provide a reference for the selection of effectiveness evaluation indicators in community study on heat-sensitive moxibustion. MethodsA systematic literature search was conducted to collect outcomes used in randomized controlled trials and systematic review of heat-sensitive moxibustion for PH （Jan 2021）， and additional outcomes were added through patient and expert questionnaires （Feb 2021） to create a pool of outcome entries. A multidisciplinary expert Delphi survey was conducted to screen outcomes applicable to patient self-reporting （Apr 2021）， and the importance of outcome indicators was rated on a 5-Point Likert Scale. Finally， patient self-reported COS was determined through a consensus conference （June 2021）. ResultsA pool of patient self-reported indicators in the community study of heat-sensitive moxibustion treatment for PH was generated by standardizing and combining the outcome indicators based on the results of the literature search and the questionnaire survey， which consisted of totally 100 measurement tools or contents， excluding 51 indicators or measurement tools required measurement by specialized physicians or hospital equipment， and 49 items were retained to enter the initial list of indicator entries. For the first round of Delphi survey， the mean score for expert familiarity was 0.819， the mean score for basis of judgment was 0.710， and the expert authority coefficient was 0.765， with a total of 21 indicator measurement tools or contents deleted （significance score ≤ 75 or coefficient of variation ＞ 0.25）， 28 retained， and 3 new expert-added indicator entries added. In the second round of Delphi survey， the average score for expert familiarity was 0.859， the average score for basis for judgment was 0.763， and the expert authority coefficient was 0.811， with a total of 11 indicator measurement tools or contents deleted and 20 retained involving 5 domains. Following an expert consensus meeting， 8 outcome indicators were finalized for inclusion in the patient self-reported COS， including 6 indicators of effectiveness evaluation such as quality-of-life scores， blood pressure， traditional Chinese medicine symptom scores， cost-benefit， cardiovascular and cerebrovascular events， and adverse reactions/events， and 2 indicators of factors influencing effectiveness such as sensation of heat-sensitive moxibustion， and adherence. ConclusionIn this study， we initially established a criteria for evaluating the effectiveness in the community study on heat-sensitive moxibustion by constructing patient self-reported COS in the community study on heat-sensitive moxibustion for PH， which can provide a scientific research paradigm for the subsequent development of the community study on heat-sensitive moxibustion.

Chemotherapy is currently the mainstay of systemic management for triple-negative breast cancer (TNBC), but chemoresistance significantly impacts patient outcomes. Our research indicates that Doxorubicin (Dox)-resistant TNBC cells exhibit increased glycolysis and ATP generation compared to their parental cells, with this metabolic shift contributing to chemoresistance. We discovered that ALKBH3, an m¹A demethylase enzyme, is crucial in regulating the enhanced glycolysis in Dox-resistant TNBC cells. Knocking down ALKBH3 reduced ATP generation, glucose consumption, and lactate production, implicating its involvement in mediating glycolysis. Further investigation revealed that aldolase A (ALDOA), a key enzyme in glycolysis, is a downstream target of ALKBH3. ALKBH3 regulates ALDOA mRNA stability through m¹A demethylation at the 3'-untranslated region (3'UTR). This methylation negatively affects ALDOA mRNA stability by recruiting the YTHDF2/PAN2-PAN3 complex, leading to mRNA degradation. The ALKBH3/ALDOA axis promotes Dox resistance both in vitro and in vivo. Clinical analysis demonstrated that ALKBH3 and ALDOA are upregulated in breast cancer tissues, and higher expression of these proteins is associated with reduced overall survival in TNBC patients. Our study highlights the role of the ALKBH3/ALDOA axis in contributing to Dox resistance in TNBC cells through regulation of ALDOA mRNA stability and glycolysis.

Based on the Delphi method, this study conducted an expert questionnaire survey on the diagnostic criteria of edema in TCM by integrating preliminary literature research, aiming to further standardize the revision of Edema diagnosis in Criteria of Diagnosis and Therapeutic Effect of Diseases and Syndromes in Traditional Chinese Medicine (ZY/T001.1－94). Relevant literature on TCM edema was comprehensively retrieved from CNKI, Wanfang Data, VIP and CBM from 1994 to July 1, 2021. The content extracted from the literature was integrated with the diagnostic criteria outlined in the 1994 Criteria of Diagnosis and Therapeutic Effect of Diseases and Syndromes in Traditional Chinese Medicine to establish the questionnaire item pool; two rounds of Delphi expert surveys were conducted to identify content requiring revisions. Subsequently, the degree of concentration and coordination of the expert opinions were analyzed to determine items for inclusion in the revised draft. Ultimately, the finalized revised diagnostic criteria for edema were developed through expert panel discussions. Results showed expert participation rates of 84.21% and 78.13% in respective survey rounds. The progressive increase in Kendall's coefficient of concordance (Kendall's W=0.169 in Round 1 to Kendall's W=0.368 in Round 2) quantitatively validated enhanced expert consensus (both the degree of concentration and coordination) and systematic alignment of revision proposals for diagnostic items. The study findings demonstrated an urgent need for improving the diagnostic criteria section of the the 1994 Criteria of Diagnosis and Therapeutic Effect of Diseases and Syndromes in Traditional Chinese Medicine, and the proposed revisions would be expected to enhance the applicability and specificity of edema diagnostic standards in clinical practice.

Objective To compare the efficacies of allogeneic hematopoietic stem cell transplantation(allo-HSCT)in the treatment of post-chronic aplastic anemia(CAA)myelodysplastic syndrome(MDS)and primary MDS.Methods A retrospective analysis was conducted on 32 patients who received allo-HSCT treatment in Department of Hematology,North China University of Science and Technology Affiliated Hospital between Feb.2012 and Feb.2022,including 12 patients with post-CAA MDS and 20 patients with primary MDS.The overall survival rate,cumulative incidence of relapse(CIR)rate,non-relapse mortality(NRM)rate,and event-free survival rate were compared between the 2 groups.Results The median follow-up time for CAA to progress to MDS was 120(72-180)months.All the patients were followed up for 36(3-79)months after allo-HSCT.The 3-year overall survival rate of the post-CAA MDS group was significantly higher than that of the primary MDS group(83.8%vs 45.0%,P=0.035).The 3-year CIR of the post-CAA MDS group was significantly lower than that of the primary MDS group(16.7%vs 55.0%,P=0.021).There was no significant difference in the event-free survival rates or NRM rates between the 2 groups(both P＞0.05).Conclusion The post-CAA MDS patients have better survival after allo-HSCT than the primary MDS patients.Early allo-HSCT treatment may improve the prognosis.

Objective To explore the risk factors of hospitalization within 24 h after birth and respiratory support in late preterm and term neonates.Methods A case-control study was conducted on 1 468 neonates with gestational ages≥34 weeks and<42 completed weeks delivered at the University-Town Hospital of Chongqing Medical University from January 2023 to March 2024.Maternal health parameters and neonatal outcomes were systematically obtained through standardized case report forms during the study period.The neonates were stratified into the hospitalization group and the non-hospitalization group based on neonatal ward admission within 24 h.For those hospitalized with infectious diseases,subgroup analysis was conducted with further categorization into respiratory support and the non-respiratory support subgroups according to ventilatory assistance requirements.The perinatal risk factors were compared between groups and subgroups,and the independent risk factors for hospitalization and the need for respiratory support within 24 h in neonates were identified.The indicators with P<0.1 in the univariate analysis were included in the multivariate logistic regression analysis,and the stepwise regression analysis was used to fit the multivariate logistic regression model.Results There were 213 cases(14.5%)in the hospitalization group and 1 255 cases(85.5%)in the non-hospitalization group.A total of 150 neonates were hospitalized due to infectious diseases,including 48 cases(32.0%)in the respiratory support subgroup and 102 cases(68.0%)in the non-respiratory support subgroup.The multivariate logistic regression analysis showed that non-regular maternal prenatal examination(OR=2.687,95%CI:1.175～6.141,P=0.019),intrauterine growth retardation(OR=2.711,95%CI:1.106～6.646,P=0.029),premature rupture of membranes(OR=1.667,95%CI:1.139～2.438,P=0.008),chorioamnionitis(OR=4.852,95%CI:2.114～11.135,P<0.001),infectious diseases in the first week before delivery(OR=1.531,95%CI:1.015～2.310,P=0.042),turbidity of amniotic fluid(OR=3.170,95%CI:2.099～4.787,P<0.001),abnormal placenta(OR=2.335,95%CI:1.202～4.534,P=0.012),complications during pregnancy(OR=2.367,95%CI:1.360～4.118,P=0.002),and the use of glucocorticoids before delivery(OR=2.744,95%CI:1.219～5.528,P=0.009)were positively correlated with hospitalization within 24 h postnatally in late preterm and term neonates.Gestational age(OR=0.693,95%CI:0.602～0.797,P<0.001),5-minute Apgar score(OR=0.026,95%CI:0.003～0.212,P=0.001),umbilical cord blood pH(OR=0.044,95%CI:0.002～0.793,P=0.034),and umbilical cord blood BE(OR=0.885,95%CI:0.823～0.823,P=0.001)were negatively correlated with it.Premature rupture of membranes(OR=0.207,95%CI:0.070～0.618,P=0.005),infectious diseases in the first week before delivery(OR=0.245,95%CI:0.070～0.854,P=0.027),5-minute Apgar score(OR=0.063,95%CI:0.008～0.526,P=0.011),and abnormal C-reactive protein of newborns(OR=0.145,95%CI:0.046～0.460,P=0.001)were negatively correlated with the need for respiratory support in neonates hospitalized due to infectious diseases.Conclusion Risk factors for neonatal hospitalization within 24 h postnatal late preterm and term are identified as irregular antenatal care,fetal growth restriction and premature rupture of membranes in late preterm and term neonates.premature rupture of membranes,antenatal maternal infections within 1 week prior to delivery and 5-minute Apgar score≥7 emerge as significant protective factors against respiratory support requirement in neonates hospitalized with infectious diseases.

Objective To explore the correlation between aging and idiopathic pulmonary fibrosis(IPF)and reveal the underlying molecular mechanisms.Methods IPF models were established using young(2-month-old)and aged(18-month-old)C57BL/6J mice by intratracheal instillation of bleomycin(BLM)hydrochloride(2.5 mg/kg)after fully exposing the trachea.The control groups received an equal volume of saline administered in the same manner.Mice were divided randomly into four groups:a young control(Ctrl-Y)group,young model(IPF-Y)group,aged control(Ctrl-A)group,and aged model(IPF-A)group.Histopathological changes were evaluated by hematoxylin-eosin and Masson staining.Collagen type Ⅰ alpha 1 chain(COL1A1),α-smooth muscle actin(SMA),and fibronectin(FN)expression were detected by immunohistochemistry.Cell senescence was detected by senescence-associated beta-galactosidase(SA-β-Gal)staining.Differentially expressed genes were detected by transcrip tome sequencing,followed by gene ontology functional annotation(GO)and kyoto encyclopedia of genes and genomes(KEGG)pathway enrichment analysis.Core gene expression was validated by quantitative reverse transcription-polymerase chain reaction.Results The fibrosis score was significantly higher in the IPF-A group compared with the IPF-Y group(P＜0.05).Expression levels of α-SMA,and FN were significantly upregulated in the IPF-A group versus the IPF-Y group by 36％,and 25％,respectively(P＜0.05).The SA-β-Gal-positive area indicating senescence was significantly larger in the IPF-A group than in the IPF-Y group.Fifty-five senescence-IPF interactive genes were identified,among which Cdkn1a,MMP3,and Pdcd1 were synergistically upregulated in the IPF-A group(P＜0.05).KEGG analysis revealed the activation of signaling pathways such as extracellular matrix(ECM)-receptor interaction,phagosome,cytokine-cytokine receptor interaction,efferocytosis,and PI3K-Akt(FDR＜0.05).Conclusions aging promotes IPF progression,which induces lung tissue senescence.The underlying mechanism may involve ECM remodeling driven by immunosenescence,inflammatory accumulation,and metabolic disorders.

Objective:To explore the factors influencing healthcare-seeking time in diabetic foot patients and to develop and validate a predictive model for healthcare-seeking time.Methods:A total of 299 diabetic foot patients hospitalized in the Department of Endocrinology and Metabolism at the First Affiliated Hospital of Zhengzhou University from March 2023 to January 2024 were recruited for model development and internal validation. Sixty additional patients from the Second Affiliated Hospital of Zhengzhou University from September 2023 to January 2024 were used for external validation. Kaplan-Meier survival curves were used to estimate healthcare-seeking times. Cox regression analysis identified influencing factors and constructed the model. Random Survival Forest (RSF) was employed for variable selection and model construction. Internal validation was conducted using 10-fold cross-validation, and model evaluation utilized the integrated Brier score, C-index, and prediction error curve. Results:Kaplan-Meier analysis revealed that education level, foot self-care ability, lower extremity vascular disease, and disease perception significantly influenced healthcare-seeking time ( P<0.05). Cox regression identified gender, income level, medical payment method, living situation, marital status, ulcer history, social support, disease perception, and healthcare behavior perception as significant influencing factors ( P<0.05). RSF variable selection indicated that social support, disease perception, e-health literacy, healthcare behavior perception, and age were the most valuable factors for model construction. In external validation, the Brier scores for the Cox regression and RSF models were 0.059 and 0.088, respectively, while the C-indices were 0.862 and 0.683. Prediction error curves showed that the Cox regression model had lower prediction errors and higher predictive performance. Conclusions:The Cox regression model demonstrated superior performance and can assist nurses in effectively identifying high-risk populations for delayed healthcare-seeking in diabetic foot patients. This allows for timely interventions to improve healthcare behavior and reduce delays.