Objective To explore the clinical efficacy of Xingqi Tongjiang tablets in treating postprandial distress syndrome(PDS)of liver-stomach disharmony syndrome and its impact on electrogastrogram indicators.Methods A total of 300 patients with PDS were prospectively selected and randomly divided into the control group(treated with mosapride citrate+placebo of Xingqi Tongjiang tablets,n=151)and the observation group(treated with mosapride citrate+Xingqi Tongjiang tablets,n=149)according to the random number table method.The levels of traditional Chinese medicine(TCM)syndrome scores,clinical efficacy,electrogastrography indicators,negative emotion scores,quality of life scores and adverse reactions were compared between the two groups.Results After treatment,the TCM syndrome scores of both groups decreased,and the scores of the observation group were lower than those of the control group(P＜0.05).The total effective rate of the observation group was higher than that of the control group(P＜0.05).After treatment,the percentages of normal gastric slow waves(NGSW)in the overall stomach and gastric antrum before and after meals of both groups increased,and the proportion of slow waves(SR)decreased.Moreover,the increased NGSW and the decreased SR in the observation group were more significant(P＜0.05).The scores of the Hamilton Anxiety Scale(HAMA)and the Hamilton Depression Scale(HAMD)decreased after treatment in both groups,and the scores of the observation group were lower(P＜0.05).The scores of the Nepean Dyspepsia Quality of Life Index(NDLQI)increased after treatment in both groups,and the scores of the observation group were higher(P＜0.05).There were no significant differences in adverse reactions between the two groups.Conclusion Xingqi Tongjiang tablets can effectively improve the electrogastrogram indicators of patients with postprandial distress syndrome of liver-stomach disharmony syndrome,and enhance clinical efficacy.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

Objective To explore the clinical efficacy of Xingqi Tongjiang tablets in treating postprandial distress syndrome(PDS)of liver-stomach disharmony syndrome and its impact on electrogastrogram indicators.Methods A total of 300 patients with PDS were prospectively selected and randomly divided into the control group(treated with mosapride citrate+placebo of Xingqi Tongjiang tablets,n=151)and the observation group(treated with mosapride citrate+Xingqi Tongjiang tablets,n=149)according to the random number table method.The levels of traditional Chinese medicine(TCM)syndrome scores,clinical efficacy,electrogastrography indicators,negative emotion scores,quality of life scores and adverse reactions were compared between the two groups.Results After treatment,the TCM syndrome scores of both groups decreased,and the scores of the observation group were lower than those of the control group(P＜0.05).The total effective rate of the observation group was higher than that of the control group(P＜0.05).After treatment,the percentages of normal gastric slow waves(NGSW)in the overall stomach and gastric antrum before and after meals of both groups increased,and the proportion of slow waves(SR)decreased.Moreover,the increased NGSW and the decreased SR in the observation group were more significant(P＜0.05).The scores of the Hamilton Anxiety Scale(HAMA)and the Hamilton Depression Scale(HAMD)decreased after treatment in both groups,and the scores of the observation group were lower(P＜0.05).The scores of the Nepean Dyspepsia Quality of Life Index(NDLQI)increased after treatment in both groups,and the scores of the observation group were higher(P＜0.05).There were no significant differences in adverse reactions between the two groups.Conclusion Xingqi Tongjiang tablets can effectively improve the electrogastrogram indicators of patients with postprandial distress syndrome of liver-stomach disharmony syndrome,and enhance clinical efficacy.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

Objective:To determine the incidence of adrenal incidentalomas(AIs) in patients with diabetes mellitus and the metabolism profiles.Methods:A total of 615 hospitalized patients with diabetes mellitus in the Department of Endocrinology and Metabolism of Peking University People′s Hospital from March 2020 to May 2021 were retrospectively included in this study. AIs were screened by unenhanced chest computed tomography(CT) retrospectively and subsequently confirmed by multiplanar reconstruction. Participants′ physical indicators, metabolic profiles, and adrenal function parameters were collected. Unpaired t test, Mann-Whitney U test, and Chi-Square test were adopted to compare the metabolism profiles between diabetes mellitus patients with or without AIs. Regression models were used to estimate the correlations between AIs and the metabolism profiles such as blood glucose, blood lipids, blood pressure, and the adrenal function parameters.Results:Twenty-seven out of 615 participants were detected with AIs(4.4%). Patients with AIs had higher body mass index, waist circumference, and hip circumference than patients without AIs [(29.4±5.1)kg/m 2vs(26.8±3.8)kg/m 2,P=0.018; (102.3±11.7)cm vs(95.8±10.3)cm, P=0.002; (107.3±10.1)cm vs(101.4±7.6)cm, P=0.008]. The levels of serum uric acid and urinary albumin/creatinine ratio were also significantly increased in patients with AIs [(409.6±118.1)μmol/L vs(357.4±100.6)μmol/L, P=0.009; 21.25(7.49, 180.24)mg/g vs 8.60(4.71, 34.56)mg/g, P=0.010]. Besides, individuals with AIs were also associated with a higher risk of co-existing hypertension( P=0.045). Conclusion:The incidence of AIs in patients with diabetes is 4.4%. The presence of AIs in patients with diabetes may associated with increased risk of obesity and hypertension.

OBJECTIVE To observe the short-term efficacy and safety of venetoclax combined with homoharringtonine and cytarabine in the treatment of acute myeloid leukemia （AML）. METHODS The data of 40 newly diagnosed AML patients admitted to our hospital from October 2022 to November 2023 were retrospectively collected and divided into observation group and control group according to treatment plan， with 20 cases in each group. The patients in the control group were given Daunorubicin hydrochloride for injection+Cytarabine for injection， and the patients in the observation group were given Venetoclax tablets+ Homoharringtonine injection+Cytarabine for injection. The patients in both groups were given relevant medicine， with 28 days as one cycle. The short-term efficacy， negative rate of minimal residual disease （MRD）， duration of granulocyte deficiency， duration of platelet （PLT） ＜20×109 L－1， transfusion volume of suspended red blood cells and platelet， and the occurrence of adverse drug reactions were evaluated in both groups after 1 cycle of induction chemotherapy. RESULTS The complete remission or complete remission with incomplete hematologic recovery （CR/CRi） rate in the observation group was significantly higher than control group （P＜0.05）， and the negative rate of MRD in the observation group was also significantly higher than control group （P＜0.05）. However， in low-， medium- and high-risk patients， there was no statistical significance in CR/CRi rates between the two groups （P＞0.05）. There were no significant differences in the duration of agranulocytosis， the duration of PLT ＜20×109 L－1， the amount of suspended red blood cell transfusion， the amount of platelet transfusion， the incidence of hematologic toxicity and the incidence of non-hematologic toxicity between 2 groups （P＞0.05）. CONCLUSIONS Venetoclax combined with homoharringtonine and cytarabine show good short-term efficacy and safety in the treatment of AML.

Objective To explore the learning curve of robotic-assisted kidney transplantation(RAKT).Methods The clinical data of 96 consecutive RAKT patients performed by the same surgical team were retrospectively analyzed.The arterial anastomosis time,venous anastomosis time,ureteral anastomosis time,hospital stay,and blood loss were selected as evaluation indicators.The learning curve of RAKT was analyzed using the cumulative sum(CUSUM),and the curve was divided into the learning improvement stage and the proficient mastery stage according to the learning curve.The learning curve was verified by comparing the general data and surgical data of patients in different learning stages,and the clinical efficacy of each stage was analyzed.Results The optimal fitting equation of the learning curve reached its peak at the 33rd case,which was the minimum number of surgeries required to master RAKT.There was no statistically significant difference in age,gender,dialysis type,previous abdominal surgery history,number of donor renal arteries,and preoperative serum creatinine between the learning improvement group and the proficient mastery group(all P>0.05).Compared with the learning improvement stage,the body mass index(BMI)was higher,and the number of right donor kidney was increased compared to the left donor kidney in the proficient mastery stage(both P<0.05).There were no significant differences in arterial anastomosis time,ureteral anastomosis time,postoperative serum creatinine,and complications between the two groups(all P>0.05).The iliac vessel dissection time,warm ischemia time,venous anastomosis time,blood loss,and hospital stay in the proficient mastery stage were superior to those in the learning improvement stage,with statistically significant differences(all P<0.05).Conclusions RAKT requires at least 33 cases to cross the learning curve.There is no difference in complications and recovery of transplant renal function between the learning improvement stage and the proficient mastery stage.

Background::Although overnight fasting is recommended prior to endoscopic retrograde cholangiopancreatography (ERCP), the benefits and safety of high-carbohydrate fluid diet (CFD) intake 2 h before ERCP remain unclear. This study aimed to analyze whether high-CFD intake 2 h before ERCP can be safe and accelerate patients’ recovery.Methods::This prospective, multicenter, randomized controlled trial involved 15 tertiary ERCP centers. A total of 1330 patients were randomized into CFD group ( n = 665) and fasting group ( n = 665). The CFD group received 400 mL of maltodextrin orally 2 h before ERCP, while the control group abstained from food/water overnight (>6 h) before ERCP. All ERCP procedures were performed using deep sedation with intravenous propofol. The investigators were blinded but not the patients. The primary outcomes included postoperative fatigue and abdominal pain score, and the secondary outcomes included complications and changes in metabolic indicators. The outcomes were analyzed according to a modified intention-to-treat principle. Results::The post-ERCP fatigue scores were significantly lower at 4 h (4.1 ± 2.6 vs. 4.8 ± 2.8, t = 4.23, P <0.001) and 20 h (2.4 ± 2.1 vs. 3.4 ± 2.4, t= 7.94, P <0.001) in the CFD group, with least-squares mean differences of 0.48 (95% confidence interval [CI]: 0.26–0.71, P <0.001) and 0.76 (95% CI: 0.57–0.95, P <0.001), respectively. The 4-h pain scores (2.1 ± 1.7 vs. 2.2 ± 1.7, t = 2.60, P = 0.009, with a least-squares mean difference of 0.21 [95% CI: 0.05–0.37]) and positive urine ketone levels (7.7% [39/509] vs. 15.4% [82/533], χ2 = 15.13, P <0.001) were lower in the CFD group. The CFD group had significantly less cholangitis (2.1% [13/634] vs. 4.0% [26/658], χ2 = 3.99, P = 0.046) but not pancreatitis (5.5% [35/634] vs. 6.5% [43/658], χ2 = 0.59, P = 0.444). Subgroup analysis revealed that CFD reduced the incidence of complications in patients with native papilla (odds ratio [OR]: 0.61, 95% CI: 0.39–0.95, P = 0.028) in the multivariable models. Conclusion::Ingesting 400 mL of CFD 2 h before ERCP is safe, with a reduction in post-ERCP fatigue, abdominal pain, and cholangitis during recovery.Trail Registration::ClinicalTrials.gov, No. NCT03075280.

Bluetongue virus is an arbovirus that seriously harms ruminants such as sheep,this study aims to investigate the molecular mechanism of bluetongue virus infection and host cell interferon antiviral immune response.The study was conducted to characterize the mRNA expression of inter-feron pathway genes by real-time fluorescence quantitative PCR,as well as Western blot analysis of MDA5,TRAF3,RIG-Ⅰ,and TBK1 protein expression in BHK-21 cells induced by BTV with a multiplicity of infections(MOI)of 1 for 18,24,and 36 h.The results showed that the most pro-nounced changes in the expression of interferon signaling pathway genes were observed at 24 h of induction,the gene mRNA expression levels of the IFN-α,IFN-β,RIG-Ⅰ,TBK1,MDA5,VISA,and TRAF3 genes were upregulated.However,the mRNA expression levels of IKKε and TRAF6 genes were downregulated.At the protein level,MDA5 and TBK1 proteins were upregulated while RIG-1 and TRAF3 proteins were downregulated,which showed that BTV infection induces a typeⅠ interferon immune response in BHK-21 cells.This study lays the foundation for further exploring the antiviral immunity mechanism of IFN-Ⅰ signaling pathway regulatory genes in host cells infected with BTV infection.

Objective To investigate the curative effect of interventional therapy on postoperative multiple metastases of breast cancer.Methods A total of 15 patients with multiple metastases after breast cancer surgery were treated with interventional therapy.After comprehensive evaluation,all patients were treated with chemoembolization.The therapeutic regimen was docetaxel loaded on drug-eluting bead(DEB)combined with carboplatin,once in 1 d for 21 d,2 times in total,and then the regimen was changed to docetaxel and carboplatin combined with ordinary embolization microspheres,once in 1 d for 21 d,4 times in total.CT/MRI was performed on every 2 cycles and 1,3,and 6 months after interventional therapy to evaluate its efficacy and record adverse reactions.Results The overall remission rate(ORR)at 3 months after treatment was 75％,and the disease control rate(DCR)was 91.7％.The ORR and DCR at 6 months after treatment were 50％and 83.3％,respectively.Most of the common adverse reactions were below grade Ⅲ.Conclusion Interventional therapy for multiple metastases of breast cancer after operation has a definite short-term effect,with little adverse reactions.It is worthy of further promotion in the comprehensive treatment of postoperative metastases of breast cancer.