Based on the thinking of programmatization and proceduralization， this study integrated traditional Chinese medicine （TCM） classic theories with modern knowledge expression technologies to construct a "formula-symptom" syndrome differentiation thinking model centered on "symptom clustering-main syndrome screening-formula adaptation"， and explored the standardization and intelligentization path of TCM syndrome differentiation and treatment. By establishing the mapping relationship model between formulas and syndromes including quantitative weight analysis of chief， deputy， assistant and envoy medicines， designing the logical hierarchical structure of formula-syndrome decision tree （application of three-level decision tree and fuzzy logic）， and formulating the procedural design of four diagnostic methods （structured collection， correlation model， and dynamic correction mechanism）， the standardization and visualization of the syndrome differentiation process are realized. This model can be transformed into the core data set for artificial intelligence training. Through ternary knowledge graph and machine learning algorithms， it can improve the repeatability of syndrome differentiation and the efficiency of diagnosis and treatment， and implement the strategy of "group model + individual modification" to balance the conflict between quantification and individualization. The core value of this model lies in promoting the objectification and precision development of TCM syndrome differentiation and treatment through the integration of traditional syndrome differentiation thinking and modern system science.

Objective: To analyze the nucleic acid load of human parvovirus B19 in major commercially available blood products in China, including human albumin, human intravenous immunoglobulin, human rabies immunoglobulin and various coagulation factor products, aiming to provide evidence for improving blood product manufacturing processes and quality control of source plasma. Methods: A total of 98 batches of coagulation factor products were tested for human parvovirus B19 nucleic acid using real-time fluorescent quantitative PCR, including 42 batches of human prothrombin complex, 35 batches of human coagulation factor Ⅷ, and 21 batches of human fibrinogen. Additionally, 6 batches of human albumin, 6 batches of human intravenous immunoglobulin, and 38 batches of human rabies immunoglobulin were tested for human parvovirus B19 nucleic acid. Results: Human parvovirus B19 nucleic acid were undetectable in human albumin, human intravenous immunoglobulin and human rabies immunoglobulin. Among the 98 batches of coagulation factor products tested for human parvovirus B19 nucleic acid, B19 nucleic acid reactivity rate was 69.0% (29/42) for human prothrombin complex batches, but nucleic acid concentration were all significantly lower than 10 IU/mL. The reactivity rate of B19 nucleic acid in 35 batches of human coagulation factor Ⅷ was 48.6% (17/35), with nucleic acid concentration all below 10 IU/mL. The reactivity rate of B19 nucleic acid in 21 batches of human fibrinogen was 61.9% (13/21), with nucleic acid concentration all below 10 IU/mL. Conclusion: No human parvovirus B19 has been detected in human albumin, human intravenous immunoglobulin, or human rabies immunoglobulin. Human parvovirus B19 nucleic acid may exist in commercially available coagulation factor products, highlighting the need for enhanced screening of human parvovirus B19 nucleic acid in these products. It is also recommended that B19 viral nucleic acid testing be conducted on source plasma, particularly for coagulation factor products.

Objective: To analyze the nucleic acid load of human parvovirus B19 in major commercially available blood products in China, including human albumin, human intravenous immunoglobulin, human rabies immunoglobulin and various coagulation factor products, aiming to provide evidence for improving blood product manufacturing processes and quality control of source plasma. Methods: A total of 98 batches of coagulation factor products were tested for human parvovirus B19 nucleic acid using real-time fluorescent quantitative PCR, including 42 batches of human prothrombin complex, 35 batches of human coagulation factor Ⅷ, and 21 batches of human fibrinogen. Additionally, 6 batches of human albumin, 6 batches of human intravenous immunoglobulin, and 38 batches of human rabies immunoglobulin were tested for human parvovirus B19 nucleic acid. Results: Human parvovirus B19 nucleic acid were undetectable in human albumin, human intravenous immunoglobulin and human rabies immunoglobulin. Among the 98 batches of coagulation factor products tested for human parvovirus B19 nucleic acid, B19 nucleic acid reactivity rate was 69.0% (29/42) for human prothrombin complex batches, but nucleic acid concentration were all significantly lower than 10 IU/mL. The reactivity rate of B19 nucleic acid in 35 batches of human coagulation factor Ⅷ was 48.6% (17/35), with nucleic acid concentration all below 10 IU/mL. The reactivity rate of B19 nucleic acid in 21 batches of human fibrinogen was 61.9% (13/21), with nucleic acid concentration all below 10 IU/mL. Conclusion: No human parvovirus B19 has been detected in human albumin, human intravenous immunoglobulin, or human rabies immunoglobulin. Human parvovirus B19 nucleic acid may exist in commercially available coagulation factor products, highlighting the need for enhanced screening of human parvovirus B19 nucleic acid in these products. It is also recommended that B19 viral nucleic acid testing be conducted on source plasma, particularly for coagulation factor products.

OBJECTIVE: To review the research progress and challenges of poly (L-lactic acid) (PLLA) membrane in preventing tendon adhesion. METHODS: The relevant literature at home and abroad in recent years was extensively searched, covering the mechanism of tendon adhesion formation, the adaptation challenge and balancing strategy of PLLA, the physicochemical modification of PLLA anti-adhesion membrane and its application in tendon anti-adhesion. In this paper, the research progress and modification strategies of PLLA membranes were systematically reviewed from the three dimensions of tissue adaptation, mechanical adaptation, and degradation adaptation. RESULTS: The three-dimensional adaptation of PLLA membrane is optimized by combining materials (such as hydroxyapatite, polycaprolactone), structural design (multilayer/gradient membrane), and drug loading (anti-inflammatory drug). The balance between anti-adhesion and pro-healing is achieved, the mechanical adaptation significantly improve, and degradation is achieved (targeting the degradation cycle to 2-4 weeks to cover the tendon repair period). CONCLUSION In the future, it is necessary to identify the optimal balance point of three-dimensional fitness, unify the evaluation criteria and solve the degradation side effects through the co-design of physicochemical modification and drug loading system to break through the bottleneck of clinical translation.
Tissue Adhesions/prevention & control* ; Polyesters/chemistry* ; Humans ; Biocompatible Materials/chemistry* ; Tendons/surgery* ; Membranes, Artificial ; Tendon Injuries/surgery* ; Wound Healing ; Animals ; Durapatite/chemistry*

Iron is indispensable for the viablility of nearly all living organisms, and it is imperative for cells, tissues, and organisms to acquire this essential metal sufficiently and maintain its metabolic stability for survival. Disruption of iron homeostasis can lead to the development of various diseases. There is a robust connection between iron metabolism and infection, immunity, inflammation, and aging, suggesting that disorders in iron metabolism may contribute to the pathogenesis of arthritis. Numerous studies have focused on the significant role of iron metabolism in the development of arthritis and its potential for targeted drug therapy. Targeting iron metabolism offers a promising approach for individualized treatment of arthritis. Therefore, this review aimed to investigate the mechanisms by which the body maintains iron metabolism and the impacts of iron and iron metabolism disorders on arthritis. Furthermore, this review aimed to identify potential therapeutic targets and active substances related to iron metabolism, which could provide promising research directions in this field.

Objective To study the correlation between single nucleotide polymorphisms at loci rs4535211,rs75885714,and rs7653834 of phosphatidylinositol-specific phospholipase 2 (PLCL2) gene and large artery atherosclerotic (LAA) ischemic stroke.Methods A total of 105 patients with newly diagnosed LAA ischemic stroke admitted to the Second Affiliated Hospital of Xinjiang Medical University from July 2021 to July 2022 were selected as the observation group,and 103 patients with gender and age matching phys-ical examination in this hospital during the same period were selected as the control group. The clinical data and serum inflammatory markers were collected and compared between the two groups.Genotypes of PLCL2 gene rs4535211,rs75885714 and rs7653834 loci in the two groups were detected,and genotype and allele fre-quencies were calculated.Results The levels of C-reactive protein (CRP),interleukin-6 (IL-6),neutrophil to lymphocyte ratio (NLR),monocyte to high-density lipoprotein-cholesterol ratio (MHR),platelet to lympho-cyte ratio (PLR) and D-dimer in the observation group were higher than those in the control group.The level of high density lipoprotein-cholesterol (HDL-C) was lower than that of the control group (P<0.05). rs7653834 locus was C/C,C/T,T/T genotypes,and the difference between the two groups was statistically significant (P<0.05).The levels of C/C,T/C and T/T genotypes NLR and PLR at rs7653834 locus were sta-tistically significant between the two groups (P<0.05).The analysis results of co-dominant model,dominant model and overdominant model showed that there was statistical significance in rs7653834 locus genotype be-tween the two groups (P<0.05).Conclusion There may be a potential association between rs7653834 locus polymorphism of PLCL2 gene and LAA type ischemic stroke.

Objective:The incidence of occupational burnout among emergency department healthcare workers is high,and their occupational health deserves attention.Establishing a comprehensive occupational health system in medical institutions is crucial.This study aims to understand the current status of occupational burnout among emergency department healthcare workers,analyze its influencing factors,and provide references for preventing burnout in this population. Methods:A cross-sectional survey was conducted using convenience sampling through the Questionnaire Star platform from December 2022 to January 2023 among emergency department healthcare workers.The Maslach Burnout Inventory-General Survey(MBI-GS)scale was used to assess the level of occupational burnout,and univariate analysis and binary Logistic regression analysis were employed to explore the influencing factors of burnout. Results:A total of 1 173 valid questionnaires were collected,with 946(80.65％)respondents experiencing occupational burnout.The proportions of mild-to-moderate and severe burnout were 73.57％and 7.08％,respectively.The scores for the three dimensions of burnout among emergency department healthcare workers were as follows:emotional exhaustion(EE)2.33±0.31;depersonalization(DP)1.88±0.28;low personal accomplishment(LPA)3.20±0.39.The overall score was 2.46±0.22.Factors associated with occupational burnout included being an only child(OR=1.362,95％CI-0.707 to-0.058),the average number of night shifts per month(OR=1.167,95％CI 0.091 to 0.272),and personal experience of workplace violence(OR=1.094,95％CI 0.027 to 0.195)(all P＜0.05). Conclusion:The incidence of occupational burnout is high among emergency department healthcare workers.Effective measures should be taken by management to promptly intervene,reduce burnout,and ensure the smooth functioning of emergency medical services.

Objective To analyze and verify the factors influencing the prediction model of suicidal ideation of burn patients in hospital based on international scale.Methods The clinical data of 194 burn patients treated in hospi-tal were retrospectively analyzed.General data questionnaire,ISI,HAMD,HAMA,ASDS and BSHS-B were used to evaluate the influencing factors of suicidal ideation.According to the presence or absence of suicidal ideation,the patients were divided into the suicidal ideation group and the non-suicidal ideation group.The baseline data be-tween the groups were compared,univariate screening of meaningful variables was conducted,and multivariate Lo-gistic regression modeling was further conducted.ROC analysis evaluated model differentiation,and internal verifi-cation was conducted.Results According to the baseline data analysis results,there were no statistically signifi-cant differences in age,BMI,years of education,smoking history,estimated percentage of burned area,head and neck burns,hip and perineal burns,and pain scores in the suicidal ideation group(21/194)compared with the non-suicidal ideation group(173/194).Gender(P=0.047),presence or absence of trunk burn(P=0.022),severity of burn(moderate burn:P=0.002;severe burn:P=0.458;extremely severe burn:P=0.169),ISI score(P=0.001),HAMD score(P=0.001),HAMA score(P＜0.001),ASDS score(P=0.003),BSHS-B score(P=0.011)had statistical significance.Multivariate Logistic regression analysis showed that the severity of burn(moderate burn:OR=0.103,P=0.009;severe burn:OR=0.351,P=0.223;extremely severe burn:OR=0.103,P=0.095)and HAMA score(OR=1.136,P=0.007)were independent influencing factors for burn patients with suicidal ideation.The Logistic regression prediction model was established by two independent influ-encing factors.ROC analysis results showed that the model had good differentiation(AUC=0.880,95％CI:0.808-0.952,P＜0.001)and the internal verification accuracy was 79.38％.Conclusion The prediction model built on the basis of two independent influencing factors,burn severity and HAMA score,has a good predic-tion accuracy,which is helpful for clinicians to intervene as soon as possible for burn patients with suicidal ideation in hospital,in order to reduce the incidence and enrich clinical psychological research.

Objective To investigate the efficacy of Qizhu Bishi Granules combined with methotrexate in the treatment of patients with rheumatoid arthritis (RA). Methods A total of 140 RA patients in the Shijiazhuang City Third Hospital from January to May 2023 were selected as research objects and randomly divided into a treatment group and a control group, with 70 cases in eachgroup. The control group was treated with methotrexate, while the treatment group was treated with Qizhu Bishi Granules combined with methotrexate, and the treatment duration was 3 months for both groups. The total effective rate, score of traditional Chinese medicine (TCM) syndromes, the number of swollen joints, the number of tender joints, the Visual Analogue Scale (VAS) score for pain, the Disease Activity Score in 28 Joints (DAS28), interleukin-1 (IL-1), tumor necrosis factor-α (TNF-α), erythrocyte sedimentation rate (ESR), high-sensitivity C reactive protein (hs-CRP), rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (anti-CCP antibody) levels before treatment and at 1 month and 3 months after treatment as well as therapeutic safety were compared between the two groups. Results The total effective rate in the treatment group was 97.14%, which was significantly higher than 87.14% in the control group (P < 0.05). After 1 month and 3 months of treatment, the scores of TCM syndromes, the number of swollen joints, the number of tender joints, the VAS score, DAS28, IL-1, TNF-α, ESR, hs-CRP, RF and anti-CCP antibody levels in the treatment group were significantly lower than those in the control group (P < 0.05). No adverse reactions occurred in both group. Conclusion Qizhu Bishi Granules combined with methotrexate in treating RA can effectively alleviate clinical symptoms, improve TCM syndromes, reduce inflammatory responses, decrease disease activity, and the therapeutic efficacy is reliable and safe.

BACKGROUND:Hydrogel microparticles,due to their porous and injectable properties,have demonstrated unique advantages in biomedical fields,such as the delivery of cells and bioactive factors/drugs,the construction of tissue repair scaffolds.They have broad application prospects. OBJECTIVE:To review the latest research progress and discuss the key problems and challenges in the research of bone tissue engineering based on hydrogel microparticles. METHODS:The relevant articles in PubMed and CNKI were searched by computer.The English key words were"hydrogels,microparticles,microspheres,microcarriers,bone,bone defect,bone repair,bone healing,bone tissue engineering"while the Chinese key words were"hydrogels,microparticles,microspheres,bone tissue engineering,bone defect,bone repair,bone regeneration".The retrieval period was from 2002 to 2022,and 127 articles were finally included for review. RESULTS AND CONCLUSION:(1)At present,various hydrogel microparticles have been developed for use in bone tissue engineering strategies,for example,hydrogel microparticles carrying cells or bioactive factors/drugs,hydrogel microparticles as biological scaffolds,stimulus-responsive hydrogel microparticles,biomineralized hydrogel microparticles,hydrogel microparticles combined with other biological materials.(2)Bone tissue engineering repair strategies based on hydrogel microparticles mainly regulate bone repair by promoting stem cell recruitment and osteogenic differentiation,regulating the local inflammatory microenvironment and promoting angiogenesis at the site of injury.However,the present studies did not deeply explore the effect of bone tissue engineering based on hydrogel microparticles on the recruitment and differentiation of endogenous stem cells and the regulation of the inflammatory microenvironment by the physical and chemical properties of hydrogel microparticles.The long-term in vivo adverse reactions of hydrogel microparticles have not been explored yet,and it is difficult to mass-produce them,thus future research needs to strengthen the mechanism exploration and technical route,so as to provide a reasonable reference for the development of hydrogel microparticles that can be used for clinical transformation.