This paper introduces a real-world cohort research model for community-acquired pneumonia （CAP） based on the Jiangsu Traditional Chinese Medicine （TCM） Dominant Diseases Diagnosis and Treatment Data Platform. Firstly， data cleaning is performed by standardizing diagnosis， symptoms， treatment and imaging， intelligently extracting unstructured information， and cleaning and constructing a standardized database. Secondly， for cohort establishment， CAP patients across the province are screened in accordance with CAP diagnostic criteria to build a high-quality disease-specific cohort. Lastly， in terms of protocol design， the characteristics of TCM research and the CAP disease profile are considered to determine appropriate inclusion and exclusion criteria， estimate sample size， define interventions， outcomes and economic evaluations， providing a reference for real-world TCM research on CAP.

This paper introduces a real-world cohort research model for community-acquired pneumonia （CAP） based on the Jiangsu Traditional Chinese Medicine （TCM） Dominant Diseases Diagnosis and Treatment Data Platform. Firstly， data cleaning is performed by standardizing diagnosis， symptoms， treatment and imaging， intelligently extracting unstructured information， and cleaning and constructing a standardized database. Secondly， for cohort establishment， CAP patients across the province are screened in accordance with CAP diagnostic criteria to build a high-quality disease-specific cohort. Lastly， in terms of protocol design， the characteristics of TCM research and the CAP disease profile are considered to determine appropriate inclusion and exclusion criteria， estimate sample size， define interventions， outcomes and economic evaluations， providing a reference for real-world TCM research on CAP.

Objective To explore serum periostein,interleukin (IL)-5,IL-8 and IL-13 expression levels in patients with allergic bronchopulmonary aspergillosis (ABPA) and their correlation with lung function. Methods 73 patients with ABPA admitted to Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2019 to December 2022 were selected as the case group,and 60 asthma patients during the same period were selected as the control group. ELISA was used to detect serum levels of Periodin,IL-5,IL-8 and IL-13. Pearson analysis was used to investigate the correlation between serum Periodin and lung function indicators. Multivariate Logistic regression analysis was used to investigate the effect of serum period on the occurrence of ABPA in patients with bronchial asthma,and the diagnostic value of serum Periodin for ABPA was evaluated by ROC curves. Results Compared with the control group,the serum levels of Periostin(97.64±28.05 ng/ml vs 57.39±22.78 ng/ml),IL-5(1.62±0.35 ng/L vs 0.59±0.31 ng/L),IL-8(79.22±10.26 ng/L vs 51.04±8.26 ng/L )and IL-13(1.59±0.43 ng/L vs 1.02±0.51 ng/L)in the case group increased(t=6.997～17.776),the total serum IgE,specific IgE positivity rate,eosinophil count and fractional exhaled nitric oxide (FeNO) levels in the case group increased(t=9.341～131.469),the percentage of forced expiratory volume in the first second to the expected value (FEV1％pred),and forced expiratory volume in the first second/forced vital capacity (FEV1/FVC) levels decreased(t=2.652,3.126),the differences were statistically significant(all P<0.05),respectively. Serum Periodin in ABPA patients was positively correlated with IL-5,IL-8,IL-13 and FeNO (r=0.539～0.695,all P<0.05),and negatively correlated with FEV1％ pred,FVC％ pred and FEV1/FVC (r=-0.657,-0.506,-0.582,all P<0.05). Compared with serum Periosin>68.35 ng/ml,bronchial asthma patients with serum Periodin 97.83～131.02 ng/ml and>131.02 ng/ml had a higher risk of ABPA,and the differences were statistically significant (all P<0.05),respectively .The area under the curve of combined diagnosis of ABPA with serum Periodin+IL-5+IL-8+IL-13+total IgE+specific IgE+eosinophils was better than that of single periodin and periodin combined with inflammatory factor diagnosis,the difference was statistically significant(Z=3.562,2.931,all P<0.05).Conclusion Serum Periostin is abnormally elevated in ABPA patients,which is closely related to lung function. Early detection can assist in clinical diagnosis of ABPA.

Objective:To develop a quality assessment index system for infection prevention and control in integrated medical and elderly care facilities, providing methods for assessing infection control quality and a theoretical basis for enhancing infection prevention and control capabilities.Methods:This study initially constructed a framework for the quality evaluation index system through literature reviews, work specifications and standards and expert interviews. The Delphi method was employed to conduct two rounds of consultations with 19 experts to evaluate the necessity, feasibility, stability, and sensitivity of the indicators. The expert′s active coefficient, authority coefficient, degree of consensus, and coordination were statistically analyzed. The indicators were revised based on expert opinions to finalize the evaluation index system. The weights of the evaluation dimensions were determined using the Analytic Hierarchy Process (AHP), while the weights of the indicators were determined using the proportional allocation method. Reliability was assessed via Cronbach′s α coefficient, and content validity was verified through the Content Validity Index ( CVI). Results:After two rounds of expert consultation, the expert positive coefficient, expert authority coefficient ( Cr) and expert coordination coefficient Kendall′s W was 100%, 0.992 and 0.634 ( P<0.001), indicating high expert authority, good concentration and coordination of opinions. The assessment index system for infection prevention and control quality in integrated medical and elderly care facilities was ultimately constructed, comprising three primary indicators, 18 secondary indicators and 68 tertiary indicators. Among the primary indicators, the process quality had the highest weight of 0.338. Within the process quality, the secondary indicators with the highest weights were infection control material allocation, hand hygiene quality and the management of cluster outbreaks. A total of 11 unique evaluation indicators for integrated medical and elderly care facilities were established, with the highest weighted indicator being the rate of standardized surveillance of infection-related risk factors. Reliability and validity analyses demonstrated that the overall Cronbach′s α coefficient of the system was 0.991, and the Scale-level Content Validity Index was 0.936, confirming good reliability and validity. Conclusion:The evaluation index system constructed in this study can serve as an effective assessment tool for the quantitative evaluation of infection control quality in integrated medical and elderly care facilities. Furthermore, it is recommended that the system undergo continuous optimization concerning its application.

Huopo Xialingtang is a famous classical formula for treating dampness and warmth， which is included in the Catalogue of Ancient Famous Classical Formulas（The First Batch）. In this paper， bibliometric methods was used to collect the literature related to Huopo Xialingtang， and 16 items of related literature were retrieved， involving five medical books， which were used to textual research on the origin， name， composition， drug dosage， preparation method， processing and main treatment symptoms of this formula. The results indicated that Huopo Xialingtang was originated from Yiyuan written by Shi Funan in the Qing dynasty， and and was later named and extended by He Lianchen. The composition of the proposed formula was consistent with the record of Yiyuan， and the origin of each Chinese materia medica was basically clear. Houpo was the dried bark and root bark of Magnolia officinalis， Zexie was the dried tubers of Alisma orientale， Kuxingren was the dried mature seeds of Prunus armeniaca， Doukou was the dried mature fruits of Amomum kravanh， the origin of Tuhuoxiang was consistent with the 2018 edition of Shanghai Standards of Processing Chinese Crud Drugs， and the origins of the remaining Chinese medicines were consistent with the 2020 edition of Chinese Pharmacopoeia. The converted dose of each Chinese medicine was 7.46 g for Agastache rugosa， 3.73 g for Magnoliae Officinalis Cortex， 8.39 g for Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine， 11.19 g for Poria， 11.19 g for Armeniacae Semen Amarum， 14.92 g for Coicis Semen， 2.61 g for Amomi Fructus Rotundus， 5.60 g for Polyporus， 5.60 g for Alismatis Rhizoma， 14.92 g for Tetrapanacis Medulla. Huopo Xialingtang was initially used for the treatment of dampness and warmth at the beginning of the disease， and was later expanded to treat dampness obstruction， dampness-warming dysentery and so on， but always with the dampness-heat in the lungs and spleen as the pathogenesis. In modern times， the clinical application is more extensive， used in digestive， respiratory， endocrine， nervous system and other types of diseases， especially for chronic gastritis， stomach pain and fever. By combing the ancient literature of Huopo Xialingtang， we verified the origin of the formula and determined the key information of the prescription， which can provide literature reference for the clinical application and drug development of this formula.

Objective:To develop a quality assessment index system for infection prevention and control in integrated medical and elderly care facilities, providing methods for assessing infection control quality and a theoretical basis for enhancing infection prevention and control capabilities.Methods:This study initially constructed a framework for the quality evaluation index system through literature reviews, work specifications and standards and expert interviews. The Delphi method was employed to conduct two rounds of consultations with 19 experts to evaluate the necessity, feasibility, stability, and sensitivity of the indicators. The expert′s active coefficient, authority coefficient, degree of consensus, and coordination were statistically analyzed. The indicators were revised based on expert opinions to finalize the evaluation index system. The weights of the evaluation dimensions were determined using the Analytic Hierarchy Process (AHP), while the weights of the indicators were determined using the proportional allocation method. Reliability was assessed via Cronbach′s α coefficient, and content validity was verified through the Content Validity Index ( CVI). Results:After two rounds of expert consultation, the expert positive coefficient, expert authority coefficient ( Cr) and expert coordination coefficient Kendall′s W was 100%, 0.992 and 0.634 ( P<0.001), indicating high expert authority, good concentration and coordination of opinions. The assessment index system for infection prevention and control quality in integrated medical and elderly care facilities was ultimately constructed, comprising three primary indicators, 18 secondary indicators and 68 tertiary indicators. Among the primary indicators, the process quality had the highest weight of 0.338. Within the process quality, the secondary indicators with the highest weights were infection control material allocation, hand hygiene quality and the management of cluster outbreaks. A total of 11 unique evaluation indicators for integrated medical and elderly care facilities were established, with the highest weighted indicator being the rate of standardized surveillance of infection-related risk factors. Reliability and validity analyses demonstrated that the overall Cronbach′s α coefficient of the system was 0.991, and the Scale-level Content Validity Index was 0.936, confirming good reliability and validity. Conclusion:The evaluation index system constructed in this study can serve as an effective assessment tool for the quantitative evaluation of infection control quality in integrated medical and elderly care facilities. Furthermore, it is recommended that the system undergo continuous optimization concerning its application.

Objective To explore serum periostein,interleukin (IL)-5,IL-8 and IL-13 expression levels in patients with allergic bronchopulmonary aspergillosis (ABPA) and their correlation with lung function. Methods 73 patients with ABPA admitted to Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2019 to December 2022 were selected as the case group,and 60 asthma patients during the same period were selected as the control group. ELISA was used to detect serum levels of Periodin,IL-5,IL-8 and IL-13. Pearson analysis was used to investigate the correlation between serum Periodin and lung function indicators. Multivariate Logistic regression analysis was used to investigate the effect of serum period on the occurrence of ABPA in patients with bronchial asthma,and the diagnostic value of serum Periodin for ABPA was evaluated by ROC curves. Results Compared with the control group,the serum levels of Periostin(97.64±28.05 ng/ml vs 57.39±22.78 ng/ml),IL-5(1.62±0.35 ng/L vs 0.59±0.31 ng/L),IL-8(79.22±10.26 ng/L vs 51.04±8.26 ng/L )and IL-13(1.59±0.43 ng/L vs 1.02±0.51 ng/L)in the case group increased(t=6.997～17.776),the total serum IgE,specific IgE positivity rate,eosinophil count and fractional exhaled nitric oxide (FeNO) levels in the case group increased(t=9.341～131.469),the percentage of forced expiratory volume in the first second to the expected value (FEV1％pred),and forced expiratory volume in the first second/forced vital capacity (FEV1/FVC) levels decreased(t=2.652,3.126),the differences were statistically significant(all P<0.05),respectively. Serum Periodin in ABPA patients was positively correlated with IL-5,IL-8,IL-13 and FeNO (r=0.539～0.695,all P<0.05),and negatively correlated with FEV1％ pred,FVC％ pred and FEV1/FVC (r=-0.657,-0.506,-0.582,all P<0.05). Compared with serum Periosin>68.35 ng/ml,bronchial asthma patients with serum Periodin 97.83～131.02 ng/ml and>131.02 ng/ml had a higher risk of ABPA,and the differences were statistically significant (all P<0.05),respectively .The area under the curve of combined diagnosis of ABPA with serum Periodin+IL-5+IL-8+IL-13+total IgE+specific IgE+eosinophils was better than that of single periodin and periodin combined with inflammatory factor diagnosis,the difference was statistically significant(Z=3.562,2.931,all P<0.05).Conclusion Serum Periostin is abnormally elevated in ABPA patients,which is closely related to lung function. Early detection can assist in clinical diagnosis of ABPA.

Objective To construct a model combining with traditional Chinese medicine(TCM)syndrome for predicting the risk of disease progression in patients with idiopathic membranous nephropathy(IMN)by machine learning methods,thus to quantitatively evaluating the value of TCM syndrome in the prediction of the risk of disease progression in IMN.Methods Monofactor analysis,recursive feature elimination(RFE)and multivariate binary Logistic regression analysis were used to screen the independent related factors affecting the risk of disease progression of IMN,and then a risk prediction model was constructed.A total of 102 patients with IMN were randomly assigned to the training set and the test set in a ratio of 65∶35,and then the comparison was conducted in the performance indicators of accuracy,sensitivity,specificity,F1 value,and area under the receiver operating characteristic(ROC)area under the curve(AUC)of the risk prediction model with or without the inclusion of the TCM syndrome information.Results Before the inclusion of TCM syndrome information,12 clinical characteristic variables for patients with MN were obtained after monofactor analysis combined with RFE screening,and they were age,hemoglobin quantification,urinary occult blood,24-hour urine protein quantification,urine protein-creatinine ratio,estimated glomerular filtration rate(eGFR),creatinine,uric acid,alanine transaminase,anti-phospholipase A2 receptor antibody(PLA2R-Ab),total cholesterol,and low-density lipoprotein cholesterd.A risk cholesterol prediction model containing the above variables was constructed.The multivariate binary Logistic regression analysis showed that the differences of the clinical variables mentioned above between the training-set group and test-set group were statistically significant,and the risk prediction model presented good sensitivity and predictability.Monofactor analysis combined with RFE screening was performed again after the inclusion of TCM syndrome information,and then 14 variables were obtained,which included blood stasis syndrome and dampness obstruction syndrome.The sensitivity and specificity of the model with the inclusion of the TCM syndrome information were significantly improved when compared with those without the inclusion of TCM syndrome information.Conclusion The results of the study initially indicate that TCM syndrome can be used as an important supplementary variable for predicting the risk of disease progression in IMN,and will provide a reference for intelligent diagnosis through the integration of traditional Chinese and western medicine information,and will supply the guidance for the treatment of IMN with TCM.

Objective To explore the relationships of ultrasound vascular index quantification and elastic modulus with biological characteristics of breast cancer and its clinical significance. Methods A total of 103 patients with breast cancer who received neoadjuvant chemotherapy (NAC) were selected as study subjects. The relationships of the quantification of vascular index (VI) and maximum elastic modulus (E_max) of shear wave elastography (SWE) with the biological characteristics of breast cancer before NAC were analyzed. According to the pathological response of NAC, the patients were divided into significant response group and non-significant response group. The change rates of VI and E_max at the end of different cycles of NAC were compared between the two groups. Receiver operating characteristic (ROC) curve was used to analyze the change rates of VI and E_max at the end of different cycles to predict the pathological response of NAC in breast cancer. Results Before NAC, VI and E_max were related to the degree of differentiation, pathological stage and HER-2 expression in breast cancer tissues (P < 0.05). The significant response group had higher change rates of VI and E_max at the end of 1, 2, and 4 week of NAC compared to the non-significant response group (P < 0.01). At the end of the second cycle, AUC of change rates of VI combined with E_max predicted the pathological response of NAC in breast cancer was 0.918, with the sensitivity of 0.874, and specificity of 0.905, which were higher than 0.832 of AUC, 0.78 of sensitivity, and 0.827 of specificity at the end of 1 week of NAC, and were higher than 0.853 of AUC, 0.827 of sensitivity, and 0.849 of specificity at the end of the fourth week. Conclusion VI and E_max are correlated with the degree of differentiation, pathological stage and HER-2 expression in breast cancer. At the end of the second cycle of chemotherapy, the change rates of the VI combined with E_max have the best efficacy in predicting the pathological reaction of NAC in breast cancer.

Objective:To investigate the gait characteristics of patients with early Parkinson′s disease (PD) under cognitive dual task, and to provide sensitive kinematic indicators for the early diagnosis, timely treatment and reasonable rehabilitation of PD.Methods:A total of 62 outpatients and inpatients with early non-tremor Parkinson′s disease in Shijingshan Branch of Beijing Chaoyang Hospital Affiliated to Capital Medical University from September 2021 to August 2023 were selected as experimental group (PD group), and 62 healthy controls with comparable age composition ratio were selected as control group. The baseline data, Montreal Cognitive Assessment Scale scores, and the gait assessment scores of the motor part of the Unified Parkinson′s Disease Rating Scale were compared between the 2 groups. The wearable gait analysis device was used to collect the gait parameters of the 2 groups of subjects under single task and dual task, and the foot kinematic characteristics of the patients with early PD were quantified. Independent sample t test and Mann-Whitney U test were used to analyze the gait parameters of the 2 groups. The statistically significant variables were included in Logistic regression analysis to explore the association between gait parameters and PD. Finally, the diagnostic value of the variables was estimated by receiver operating characteristic (ROC) curve analysis. Results:Gait spatio-temporal parameters (per gait cycle): (1) The gait speed of the PD group was slower than that of the control group [(1.01±0.12) m/s vs (1.22±0.18) m/s, t=-7.526] during single task walking. The bipedal support time in the PD group was significantly longer than that in the control group [(0.29±0.05) s vs (0.22±0.06) s, t=6.659]. The differences were both statistically significant (both P<0.001). (2) During dual-task walking, PD patients showed slower gait speed [(0.88±0.11) m/s vs (1.19±0.16) m/s, t=-12.158, P<0.001]. The bipedal support time in the PD group was longer than that in the control group [(0.36±0.05) s vs (0.22±0.05) s, t=12.828, P<0.001]. PD patients had shorter stride length [(109.20±6.21) cm vs (112.77±5.87) cm, t=-3.203, P=0.010]. Stride frequency in the PD group was higher than that in the control group [(114.45±7.10) steps/min vs (110.87±7.16) steps/min, t=2.724, P=0.020]. The single leg support time was longer than that of the control group [(0.49±0.12) s vs (0.45±0.06) s, t=2.643, P=0.020] , and the differences were statistically significant. Gait kinematics parameters: (1) During single task walking, the maximum angle of foot movement in the sagittal plane in the PD group was smaller than that in the control group (17.19°±2.37° vs 19.71°±2.92°, t=-4.691, P<0.001). The minimum angle of movement in the sagittal plane was smaller than that in the control group (-67.08°±4.63° vs -70.10°±3.94°, t=0.395, P=0.001). The minimum horizontal angle of the foot during exercise in the PD group was lower than that in the control group (9.08°±4.02° vs 11.80°±3.60°, t=-3.461, P<0.001). The minimum angle of the foot coronal plane in the PD group was smaller than that in the control group (-10.55°±2.87° vs -12.04°±2.31°, t=2.831, P=0.030; the negative sign only represents the movement direction). The touch angle of the foot in the PD group was significantly lower than that in the control group (11.14°±2.78° vs 12.78°±3.57°, t=-2.779, P=0.030). (2) During dual-task walking, the maximum sagittal angle (15.44°±2.54° vs 18.99°±2.71°, t=-6.673, P<0.05), the minimum angle of sagittal plane (-65.68°±4.73° vs -70.02°±4.04°, t=-4.747, P<0.001; the negative sign only represents the direction of movement), the minimum coronal movement angle (-11.15°± 2.99° vs -13.18°±2.50°, t=3.642, P=0.020), the touch angle (11.01°±3.10° vs 12.83°±4.01°, t=-2.438, P=0.010), the minimum horizontal angle (8.83°±4.04° vs 11.83°±3.63°, t=-3.776, P<0.001), and the change of the angle from the ground (-65.00°±3.54° vs -67.06°±3.61°, t=3.133, P<0.001) in the PD group were all smaller than that in the control group. The differences were all statistically significant. Logistic regression analysis showed that step frequency was positively correlated with PD ( OR=1.124,95% CI 1.040-1.201, P=0.001), minimum angle of coronal plane was positively correlated with PD ( OR=1.501, 95% CI 1.040-2.151, P=0.030). Stride length was negatively correlated with PD ( OR=0.902, 95% CI 0.830-0.978, P=0.010). ROC curve was used to evaluate the diagnostic value of step frequency, stride length and minimum angle of coronal plane. For step frequency, when the maximum Youden index was 0.880, the best cut-off value to distinguish the PD group from the control group was 115.000, the sensitivity was 0.577, the specificity was 0.710, and the area under the curve was 0.656. For the minimum coronal angle, when the maximum Youden index was 0.251, the best cut-off value was -12.575, the sensitivity was 0.728, the specificity was 0.531, and the area under the curve was 0.670. For stride length, when the maximum Youden index was 0, the best cut-off value was 100.91, the sensitivity was 0.950, the specificity was 0.050, and the area under the curve was 0.300. Conclusions:Some gait parameters such as step frequency and minimum angle of coronal plane can be used as kinematic markers to reflect the gait characteristics of early PD, which may be helpful in tracking and evaluating the gait disorder characteristics of early PD patients and predicting the risk of PD. Some gait parameters of PD patients are significantly different from those of healthy people during cognitive-motor dual-task walking.