Objective To study the mini-character and microscopic features of Plantago asiatica from different populations and summarize the exclusive features to provide a reference for the effective identification of Plantago asiatica. Methods Stereomicroscope and optical microscope were used to identify 30 batches of Plantago asiatica from different populations.The similarities and differences in mini-character and microscopic features of Plantago asiatica among different populations were identified. Results The differences in mini character between the Plantago asiatica from different populations were mainly reflected in whether there was fluff on the surface of leaves, inflorescence peduncles, and persistent sepals, as well as whether the epidermis of fibrous roots was flaky. The differences in microscopic characteristics between the Plantago asiatica from different populations were mainly reflected in the number of non-glandular hairs on the leaf surface, the shape of the petiole endothelial layer cells, and the number of large vascular bundles, and the number of layers of mesophyll palisade tissue cells, etc. Conclusion Plantago asiatica from different populations can be identified through mini-character and microscopic; by comparing the relevant identification features, which can provide a basis for revising and improving the standards of Plantago asiatica.

Objective: To explore the effects of personality and sleep quality with psychological distress of junior and senior high school stduents, so as to provide a reference basis for precise interventions of junior and senior high school students mental health. Methods: In October 2023, a convenience sampling method was used to select 9 034 students aged 12-17 from Shiyan City as the study subjects. The Pittsburgh Sleep Quality Index (PSQI) and Kessler Psychological Distress Scale (K10) were used to collect information on sleep quality and psychological distress of junior and senior high school stduents. Between group comparison was conducted by using t-test and Chi-square test. Generalized linear models were employed to analyze the interaction and joint effects of personality and sleep quality on psychological distress. Results: The generalized linear model analysis showed that the interaction between personality and sleep quality on psychological distress was statistically significant of junior and senior high school students(effect size=0.80, P <0.01). The general linear model analysis indicated that, after adjusting for variables such as age, gender, screen time, and daily sitting time with the extroverted and good sleep quality group as the reference, the introverted and poor sleep quality group had the largest mean difference in psychological distress scores (difference=0.51, P <0.05). When stratified by sleep quality, psychological distress scores were higher in the introverted and neutral personality groups with both poor and good sleep quality compared to the extroverted group (poor sleep quality: introverted difference=3.71, neutral difference=1.14; good sleep quality: introverted difference=2.23, neutral difference=0.57, all P < 0.05). When stratified by personality, psychological distress scores were higher in the poor sleep quality groups for introverted, neutral, and extroverted individuals compared to their good sleep quality counterparts (differences=8.66, 7.83, 7.34, all P < 0.05 ). Conclusions Personality and sleep quality have interactive and joint effects on psychological distress of junior and senior high school stduents. Personalized psychological interventions should be developed based on personality and sleep quality.

End-stage liver disease (ESLD) covers the end-stage of acute and chronic liver diseases, mainly involving decompensated cirrhosis, various types of liver failure, and advanced liver cancer. Hepatocyte transplantation has shown promise in treating ESLD, but its clinical application is hampered by the shortage of donor hepatocytes. Cell therapy, an emerging effective treatment for ESLD, faces the same limitation due to scarce hepatocyte availability. Hepatocyte-like cells (HLCs), which are terminally differentiated cells, can be induced from both stem cells and somatic cells. As HLCs exhibit the morphology and function of primary hepatocytes, they offer a promising supplementary source of hepatocytes for cell therapy. First, we provide a background for the differentiation and maturation of primary hepatocytes. Subsequently, based on the current insights into the molecular pathways that regulate hepatocyte differentiation in vivo, we describe a strategy for establishing HLC derived from either stem cells or somatic cells. The key characteristics of these HLCs are also detailed. Furthermore, HLC offers therapeutic potential for liver failure, and HLC-based liver organoids and bioartificial liver systems have demonstrated the ability to provide liver functions, offering an innovative approach to treating various types of ESLD. Despite their promise, challenges such as efficiency in differentiation and functional maturation need to be addressed to improve the clinical application of HLCs. This review discusses these advancements and outlines the therapeutic potential and current challenges of HLC therapy for ESLD.

Objective To introduce the calculation of the DISO index in multi-dimensional data ranking for disease surveillance, and evaluate its applicability. Methods Using the data from the quality supervision and inspection of infectious disease reporting in Jingzhou City in a certain year as an example, the DISO index was used to rank 16 investigated medical institutions and compared with the TOPSIS method. The consistency between the two evaluation results was analyzed using Spearman correlation. Then, The DISO index from different medical institutions was used to evaluate the ranking of 8 counties (cities, districts). The evaluation indicators for the supervision and inspection included six items: report rate, timely report rate, completeness of report card filling, accuracy of report card filling, consistency rate with network information report, and completeness of valid ID number filling. Results Among the 16 medical institutions, 8 institutions had all six evaluation indicators at 100%. Using the two methods to rank the 16 medical institutions, the two methods showed that the 8 medical institutions with all six evaluation indicators at 100% were ranked first. There was a strong correlation between the rankings of the 16 medical institutions using the two methods (r_s=0.992, P=0.000). The three counties (cities, districts) with all six evaluation indicators at 100% were all ranked first, while country G was ranked seventh and country E was ranked eighth. Conclusion The results of the DISO index and the TOPSIS method were similar in one-dimensional ranking. DISO can be used for multi-dimensional ranking of disease surveillance data and deserves to be promoted and applied.

Objective:This study intends to analyze the differences of indexes between the death group and the survival group of CSA-AKI patients undergoing CRRT before, during, and after heart surgery, and at the beginning and the end of CRRT, and to study the risk factors affecting the death of patients, so as to provide guidance for improving the prognosis.Methods:From January 2020 to October 2022, a total of 101 patients (59 in the mortality group and 42 in the survival group) were admitted to the Department of Cardiac Surgery at the First Affiliated Hospital of Zhengzhou University for cardiac surgery complicated by acute kidney injury necessitating postoperative continuous renal replacement therapy (CRRT). A retrospective analysis of clinical data was conducted to ascertain the risk factors influencing the 30-day mortality rate.Results:The postoperative complications of the two groups showed that the mortality group had a large proportion of MODS and LCOS ( P<0.05). Multivariate regression analysis showed that intraoperative mean arterial depression, high SOFA score at the beginning of CRRT, high APACHE Ⅱ score at the beginning of CRRT, and low platelet at the end of CRRT were independent risk factors for death( P<0.05). ROC curve analysis shows that SOFA score and APACHE Ⅱ score at the beginning of CRRT have predictive value for the 30-day death risk of CSA-AKI patients receiving CRRT. Conclusion:Low intraoperative MAP, high SOFA and APACHE Ⅱ scores at the beginning of CRRT, and low platelets at the end of CRRT were independent risk factors for 30-day mortality risk in patients with CSA-AKI undergoing CRRT.

Objective:To investigate the pathogen distribution, temporal trends in the rates of antimicrobial resistance, and susceptibility of bloodstream isolates and comparatively explore the epidemiological characteristics of bloodstream infections in hematology departments across 56 healthcare facilities in Guangdong Province from 2020 to 2024.Methods:A multicenter analysis was conducted to evaluate the constituent ratio of different pathogens isolated from clinical isolate data from bloodstream specimens in hematology, respiratory, and intensive care unit (ICU) departments across 56 healthcare facilities in Guangdong Province (2020-2024), and antimicrobial resistance trends in pathogens with high-detection rate over 5 years were assessed. Carbapenem-resistant Gram-negative organisms (CRO) were randomly sampled for carbapenemase gene detection and in vitro antimicrobial susceptibility tests with novel antimicrobial agents.Results:From 2020 to 2024, a total of 8 968, 6 440, and 25 511 bloodstream isolates were identified in the hematology, respiratory, and ICU departments, respectively, across 56 participating facilities in Guangdong Province, with significant differences in the pathogen constituent ratio among departments ( P<0.001). Notably, the hematology department demonstrated a predominance of Escherichia coli (24.1%), Klebsiella pneumoniae (17.5%), Pseudomonas aeruginosa (11.7%), coagulase-negative Staphylococci (15.2%), and Staphylococcus aureus (5.1%). In the resistance analysis, the rates of meropenem resistance of Escherichia coli and Klebsiella pneumonia increased from 6.7% and 5.8% (2020) to 14.0% and 15.8% (2024), respectively. Conversely, Pseudomonas aeruginosa exhibited a declining trend in the rate of meropenem resistance (6.2% to 1.9%) and imipenem (10.2% to 6.1%) during the same period. Acinetobacter baumannii demonstrated a biphasic resistance pattern to common antimicrobial agents, characterized by an initial decline, followed by a rebound. In this study, the susceptibility rates to conventional antimicrobial agents were significantly higher in Staphylococcus aureus versus coagulase-negative Staphylococci, with no glycopeptide- or linezolid-resistant strains detected. Notably, the prevalence of vancomycin-resistant Enterococcus faecium increased from 0 in 2020 to 23.1% in 2024. CRO carbapenemase phenotypes through active surveillance revealed that 80% Escherichia coli isolates were carrying blaNDM, 90% Klebsiella pneumoniae isolates were carrying blaKPC, 10% Pseudomonas aeruginosa isolates were carrying blaVIM, and 100% Acinetobacter baumannii were carrying blaOXA-23. The results of the antimicrobial susceptibility test in CRO revealed that carbapenem-resistant Escherichia coli (CRECO) demonstrated a 0 resistance rate to tigecycline, polymyxin B, and aztreonam/avibactam, whereas carbapenem-resistant Klebsiella pneumoniae exhibited a 0 resistance rate to aztreonam/avibactam, ceftazidime/avibactam, and imipenem/relebactam. Carbapenem-resistant Pseudomonas aeruginosa exhibited a 95.0% susceptibility rate to amikacin and polymyxin B, with a 45.0% resistance rate to ceftazidime/avibactam. In contrast, carbapenem-resistant Acinetobacter baumannii demonstrated complete susceptibility (100.0%) to sulbactam/durlobactam (MIC90=2 μg/ml), whereas eravacycline showed MIC50 and MIC90 values of 1 and 2 μg/ml, respectively. Conclusion:The pathogen constituent ratio of bloodstream isolates differed significantly among hematology, respiratory, and ICU departments. Notably, although CRO exhibited an escalating prevalence, it sustained high susceptibility to novel antimicrobial agents.

OBJECTIVE To evaluate the cost-utility of ciclesonide(CIC)versus budesonide(BUD)for the maintenance treatment of mild to moderate bronchial asthma.METHODS From the perspective of Chinese health service system,a Markov model was established based on the data from a clinical trial in China and some literature.The cycle length was 1 week,the time horizon was 60 years.A discount rate of 5％per year was applied.Cost-utility analysis was performed on therapeutic scheme of CIC and BUD using three times of China's per capita gross domestic product(GDP)in 2023 as the threshold of willing-to-pay(WTP).One-way sensitivity analysis,probabilistic sensitivity analysis and scenario analysis were applied to test the uncertainty of basic analysis.RESULTS Compared with BUD scheme,the incremental cost of the CIC scheme was 9 401.67 yuan,and the incremental quality-adjusted life years(QALYs)were 0.001 3;incremental cost-effectiveness ratio(ICER)was 6 928 868.26 yuan/QALY,far beyond the threshold of WTP 268 074 yuan/QALY.One-way sensitivity analysis showed that the usage,dosage and unit price of CIC and BUD were parameters that had a significant impact on ICER;probabilistic sensitivity analysis showed that the basic analysis results were relatively robust;scenario analysis showed that,when the price of CIC reduced to 159.95 yuan/branch,the probability of CIC scheme having economics was similar to that of BUD scheme.CONCLUSIONS At the current price,CIC is not economical compared with BUD for the maintenance treatment of mild to moderate asthma,using three times of China's GDP in 2023 as the threshold of WTP.

General practice standardized residency training is a crucial part of postgraduate education for cultivating general practitioner. The factors influencing the quality of general practice residency training cover various aspects such as the residents themselves, teaching staff, management and decision-making levels, as well as teaching resources. Guided by the goal of "fostering virtue through education", and integrated the spirit of Norman Bethune and modern innovation theories and the educational philosophy, the China-Japan Union Hospital of Jilin University has carried out comprehensive reforms in this field. It has constructed a PDCA cycle management system based on the concept of total quality management to improve the quality of education from multiple links such as quality planning and process monitoring. In terms of faculty development, based on the dissipative structure theory, a mechanism of "selection, evaluation, incentive, and elimination" has been established. Teacher communities have been formed and a training college has been established to strengthen the teaching team. In terms of platform construction, the linkage between "teaching base-community" and "on campus-off campus" has been strengthened and resources have been integrated. The reform has achieved remarkable results, and our practice may provide a reference for general practice medical education.

Objective:This study intends to analyze the differences of indexes between the death group and the survival group of CSA-AKI patients undergoing CRRT before, during, and after heart surgery, and at the beginning and the end of CRRT, and to study the risk factors affecting the death of patients, so as to provide guidance for improving the prognosis.Methods:From January 2020 to October 2022, a total of 101 patients (59 in the mortality group and 42 in the survival group) were admitted to the Department of Cardiac Surgery at the First Affiliated Hospital of Zhengzhou University for cardiac surgery complicated by acute kidney injury necessitating postoperative continuous renal replacement therapy (CRRT). A retrospective analysis of clinical data was conducted to ascertain the risk factors influencing the 30-day mortality rate.Results:The postoperative complications of the two groups showed that the mortality group had a large proportion of MODS and LCOS ( P<0.05). Multivariate regression analysis showed that intraoperative mean arterial depression, high SOFA score at the beginning of CRRT, high APACHE Ⅱ score at the beginning of CRRT, and low platelet at the end of CRRT were independent risk factors for death( P<0.05). ROC curve analysis shows that SOFA score and APACHE Ⅱ score at the beginning of CRRT have predictive value for the 30-day death risk of CSA-AKI patients receiving CRRT. Conclusion:Low intraoperative MAP, high SOFA and APACHE Ⅱ scores at the beginning of CRRT, and low platelets at the end of CRRT were independent risk factors for 30-day mortality risk in patients with CSA-AKI undergoing CRRT.

Chemotherapy-induced nausea and vomiting (CINV) is one of the common adverse reactions in cancer patients undergoing chemotherapy, with a relatively high incidence. This article reviews the research progress on risk prediction models for CINV, introduces the basic information of related risk prediction models, and compares differences in research methods and risk factors, aiming to provide reference for the establishment of a prevention and assessment system for CINV in cancer patients.