ObjectiveTo evaluate the efficacy and safety of Xiaoji Hufei Formula in protecting children with close contact exposure to influenza， and to provide reference and evidence-based support for better clinical prevention and treatment of influenza in children. MethodsA multicenter， prospective， non-randomized， parallel， controlled trial was conducted from October 2021 to May 2022 in five hospitals， including Dongfang Hospital of Beijing University of Chinese Medicine. Confirmed influenza cases and influenza-like illness （ILI） cases were collected， and eligible children with close contact exposure to these cases were recruited in the outpatient clinics. According to whether the enrolled close contacts were willing to take Xiaoji Hufei formula for influenza prevention， they were assigned to the observation group （108 cases） or the control group （108 cases）. Follow-up visits were conducted on days 7 and 14 after enrollment. The primary outcomes were the incidence of ILI and the rate of laboratory-confirmed influenza. Secondary outcomes included traditional Chinese medicine （TCM） symptom score scale for influenza， influenza-related emergency （outpatient） visit rate， influenza hospitalization rate， and time to onset after exposure to influenza cases. ResultsA total of 216 participants were enrolled， with 108 in the observation group and 108 in the control group. Primary outcomes： （1） Incidence of ILI： The incidence was 12.0% （13/108） in the observation group and 23.1% （25/108） in the control group， with the observation group showing a significantly lower incidence （χ²=4.6， P<0.05）. （2） Influenza confirmation rate： 3.7% （4/108） in the observation group and 4.6% （5/108） in the control group， with no statistically significant difference. Secondary outcomes： （1） TCM symptom score scale： after onset， nasal congestion and runny nose scores differed significantly between the two groups （P<0.05）， while other symptoms such as fever， sore throat， and cough showed no significant differences. （2） Influenza-related emergency （outpatient） visit rate： 84.6% （11 cases） in the observation group and 96.0% （24 cases） in the control group， with no significant difference. （3） Time to onset after exposure： The median onset time after exposure to index patients was 7 days in the observation group and 4 days in the control group， with a statistically significant difference （P<0.05）. ConclusionIn previously healthy children exposed to infectious influenza cases under unprotected conditions， Xiaoji Hufei formula prophylaxis significantly reduced the incidence of ILI. Xiaoji Hufei Formula can be recommended as a specific preventive prescription for influenza in children.

ObjectiveTo evaluate the efficacy and safety of Xiaoji Hufei Formula in protecting children with close contact exposure to influenza， and to provide reference and evidence-based support for better clinical prevention and treatment of influenza in children. MethodsA multicenter， prospective， non-randomized， parallel， controlled trial was conducted from October 2021 to May 2022 in five hospitals， including Dongfang Hospital of Beijing University of Chinese Medicine. Confirmed influenza cases and influenza-like illness （ILI） cases were collected， and eligible children with close contact exposure to these cases were recruited in the outpatient clinics. According to whether the enrolled close contacts were willing to take Xiaoji Hufei formula for influenza prevention， they were assigned to the observation group （108 cases） or the control group （108 cases）. Follow-up visits were conducted on days 7 and 14 after enrollment. The primary outcomes were the incidence of ILI and the rate of laboratory-confirmed influenza. Secondary outcomes included traditional Chinese medicine （TCM） symptom score scale for influenza， influenza-related emergency （outpatient） visit rate， influenza hospitalization rate， and time to onset after exposure to influenza cases. ResultsA total of 216 participants were enrolled， with 108 in the observation group and 108 in the control group. Primary outcomes： （1） Incidence of ILI： The incidence was 12.0% （13/108） in the observation group and 23.1% （25/108） in the control group， with the observation group showing a significantly lower incidence （χ²=4.6， P<0.05）. （2） Influenza confirmation rate： 3.7% （4/108） in the observation group and 4.6% （5/108） in the control group， with no statistically significant difference. Secondary outcomes： （1） TCM symptom score scale： after onset， nasal congestion and runny nose scores differed significantly between the two groups （P<0.05）， while other symptoms such as fever， sore throat， and cough showed no significant differences. （2） Influenza-related emergency （outpatient） visit rate： 84.6% （11 cases） in the observation group and 96.0% （24 cases） in the control group， with no significant difference. （3） Time to onset after exposure： The median onset time after exposure to index patients was 7 days in the observation group and 4 days in the control group， with a statistically significant difference （P<0.05）. ConclusionIn previously healthy children exposed to infectious influenza cases under unprotected conditions， Xiaoji Hufei formula prophylaxis significantly reduced the incidence of ILI. Xiaoji Hufei Formula can be recommended as a specific preventive prescription for influenza in children.

Objective:To explore the application effect of nursing intervention based on the mindfulness-attention-acceptance theory in children with bronchopneumonia.Methods:Totally 127 children with bronchopneumonia admitted to the First Affiliated Hospital of Xinjiang Medical University from January to July 2023 were selected by convenience sampling. They were randomly divided into a control group and an observation group according to a random number table. The control group (63 cases) received routine nursing intervention, while the observation group (64 cases) received nursing intervention based on the mindfulness-attention-acceptance theory in addition to the routine nursing intervention. The improvement in psychological resilience, coping styles, and emotional behaviors of the two groups were compared before and after the intervention.Results:After the intervention, the scores of all dimensions of the Psychological Resilience Scale in both groups were higher than that before the intervention, with the observation group scoring higher than the control group ( P<0.05). The observation group scored higher on all dimensions of positive coping and lower on all dimensions of negative coping compared to the control group ( P<0.05). The prosocial behavior dimension score of the observation group was higher than that of the control group, while the scores of emotional symptoms, conduct problems, and hyperactivity-inattention dimensions were lower than those of the control group ( P<0.05) . Conclusions:The application of nursing intervention based on the mindfulness-attention-acceptance theory in children with bronchopneumonia can effectively improve their psychological resilience, coping styles, and emotional behaviors.

Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is the main pathogen that causes COVID-19,which is fast-mutating and highly transmissible.The infection has led to a global epidemic.As the main preventive and control measure,vaccination plays a critical role in fighting a-gainst COVID-19.Although a large number of epitope-based and mucosal vaccines have been stud-ied,few peptide epitope vaccines targeting the mucosa and their functional evaluation have been re-ported.In this study,we used SARS-CoV-2 structural protein M peptide epitope predicted by the IEDB database as an antigenic target to design the MS-3S gene containing 3 050 and 1 229 signal peptides and DCpep optimized for insertion into MS2 phage coat proteins.The expression plasmid pSIP:MS-3S was constructed by cloning the PCR fragments seamlessly and was transformed into Lactiplantibacillus plantarum 18 to obtain the recombinant bacterium LP18:MS-3S.Expression conditions such as induction time,inducer concentration,rotational speed and initial pH were opti-mized.The intranasal immunization experiments were performed to examine the vaccine efficacy.The results showed that the 916 bp-long target gene MS-3S modified and optimized was amplified and used to successfully construct the recombinant bacterial strain LP18:MS-3S.The optimal con-ditions for recombinant protein expression were obtained and verified by Western blot,flow cy-tometry,immunofluorescence and other detection methods.The optimal expression conditions were determined as follows:induction time was 4 h with 100 pg/L of SppIP as the optimal induction concentration.Antibody-specific for the epitope was verified by ELISA experiments in serum,alve-olar lavage fluid and fecal dilutions of mice.In summary,a recombinant bacterial strain expressing the epitope antigen of the SARS-CoV-2 M protein peptide was constructed.The obtained protein can induce the body to produce humoral and mucosal immunity,which lays the foundation for the development of a vaccine candidate for the mucosal immunity of COVID-19.

Beta-amyloid (Aβ) is considered to be a central event in Alzheimer's disease (AD). However, it has been found that some population have Aβ deposition in the brain and even AD related pathology without obvious cognitive impairment, which indicates that there are factors in the body to avoid or cope with Aβ damage, and this phenomenon is called Aβ tolerance. Starting from the concepts of resilience and reserve, this paper intends to sort out the epidemiology and quantitative methods, brain characteristics and influencing factors of Aβ tolerance, in order to further deepen clinicians' understanding of Aβ tolerance in AD diagnosis and treatment, so as to provide new ideas for prevention and treatment of the disease.

Objective To investigate whether an association existed between elevated serum β2-microglobulin levels and post stroke cognitive impairment(PSCI).Methods A total of 140 patients with ischemic stroke in Wenzhou People's Hospital during December 2022 to December 2023 were prospectively were enrolled including 73 patients in the PSCI group and 67 patients in the non-post stroke cognitive impairment(PSNCI)group.Serum β2-microglobulin and other biochemical indicators were measured within 24 hours after admission.PSCI was assessed using the mini-mental state examination(MMSE)score with a threshold of≥27 points serving as the diagnostic criterion.Results The age,National Institutes of Health Stroke Scale(NIHSS)score at admission,proportion of low education level,proportion of multiple or large area infarction and serum β2-microglobulin level in the PSCI group were higher than those in the PSNCI group.Multivariate Logistic regression analysis showed that age,NIHSS score at admission,multiple or large area infarction and serum β2-microglobulin level were risk factors for PSCI,and education level was a protective factor for PSCI.Conclusion The increase of β2-microglobulin level is a risk factor for cognitive impairment after ischemic stroke.The detection of β2-microglobulin level in stroke patients may realize the early detection of PSCI.

Objective:To compare the real-world efficacy and safety profile of tenofovir amibufenamid (TMF) and tenofovir alafenamide (TAF) tablets in the treatment of patients with chronic hepatitis B (CHB).Methods:This retrospective study included patients with chronic hepatitis B who received TMF and TAF antiviral treatment at the Infectious Disease Outpatient Department of the First Affiliated Hospital of Zhengzhou University from January 2021 to December 2023. The primary and secondary outcome was to study the patient HBV DNA conversion rate (<20 IU/ml), alanine aminotransferase (ALT) normalization rate, renal function, and lipid levels of patients at 48 weeks of treatment. The comparison of data between measurement data groups was differentiated using a t-test and Mann-Whitney U test. The inter-group comparison rate in count data was performed using the χ2 test or Fisher's exact probability. Results:A total of 440 cases were enrolled, including 220 in the TMF group (63 treatment-na?ve and 157 treatment-experienced) and 220 cases in the TAF group (61 treatment-na?ve and 159 treatment-experienced). In terms of efficacy, the HBV DNA seroconversion rates in the TMF group and TAF group were 90.5% and 85.2% ( P=0.372), respectively, while the ALT normalization rates were 92.1% and 88.5% ( P=0.505), respectively, at 48 weeks of treatment. The HBV DNA-negative conversion rate for the newly treated patients was 99.4% and 98.7%, respectively ( P=1.000), while the rates of ALT normalization were 94.9% and 92.3%, respectively ( P=0.863). In terms of safety profile, the serum creatinine level was lower in the TMF group than that in the TAF group at 48 weeks of treatment [TMF group 66.5 (56.3, 78.3) μmol/L, TAF group 70.6 (60.7, 77.8) μmol/L, Z=-2.282, P=0.022]. However, there was no statistically significant difference in other renal function and tubular function related indicators between the two groups of patients ( P>0.05). The serum high-density lipoprotein levels were higher in the TMF group than those in the TAF group [TMF 1.4 (1.1, 1.6) mmol/L vs. TAF group 1.3 (1.1, 1.6) mmol/L, Z=-2.204, P=0.027] at 48 weeks of treatment. However, there was no statistically significant difference in other blood lipid indicators between the two groups of patients ( P>0.05). Conclusion:There is no statistically significant difference in efficacy and safety profiles between TMF and TAF at 48 weeks in the treatment of patients with chronic hepatitis B, and the overall safety profile is favorable.

Objective To explore the application value of popaverine combined with stage rehabilitation for patients after free flap grafting for hand trauma.Methods Data of postoperative patients who underwent hand trauma from January 2021 to January 2022 in The 903rd Hospital of the Joint Logistics Support Force of the People's Liberation Army of Chinawere retrospectively collected,and they were divided into the combined rehabilitation group(poppadine combined with stage rehabilitation care)and the stage rehabilitation group(only stage rehabilitation care was applied)according to the treatment methods.Visual analog scale(VAS)scores,rehabilitation exercise adherence scores,postoperative rates of excellent cutaneous sensory function of the hand,total active mobility(TAM)of the fingers,Jamar grip strength,upper extremity functional assessment(DASH)scale scores,and the incidence of vascular crises were compared between the two groups.Results A total of 120 cases were included in the study,with 57 cases in the combined rehabilitation group and 63 cases in the stage rehabilitation group.There was no statistically significant difference in VAS scores,Jamar grip strength and DASH scores between the two groups before surgery(P＞0.05);at 14 days and 3 months of intervention,VAS scores of the two groups decreased compared with the pre-intervention period(P＜0.05),and VAS scores of the patients in the combined rehabilitation group were significantly lower than those in the stage rehabilitation group(P＜0.05).After 3 months of intervention,the rehabilitation exercise adherence score,the rate of excellent hand skin sensory function,and finger TAM of the patients in the combined rehabilitation group were higher than those in the stage rehabilitation group(P＜0.05);Jamar grip strength were elevated in both groups compared with the pre-intervention period,but the combined rehabilitation group were higher than those in the stage rehabilitation group(P＜0.05);DSAH scores were lower in both groups compared to pre-intervention,and were lower in the combined rehabilitation group than in the stage rehabilitation group;and during the 3 months of intervention,the incidence of vascular crisis was significantly lower in patients in the combined rehabilitation group than in the stage rehabilitation group(P＜0.05).Conclusion Opium poppy alkaloids combined with stage rehabilitation can effectively reduce patients'postoperative pain,enhance patients'adherence to rehabilitation exercises,effectively improve postoperative hand function and upper limb motor function,and reduce the incidence of vascular crisis.

Abstract: KRAS protein, a small GTPase encoded by the Kirsten rat sarcoma viral oncogene homologue (KRAS) gene, is involved in cell proliferation, differentiation, migration and cell survival, and is known as a regulatory switch for the cell life cycle. However, KRAS gene is prone to mutation, leading to hyperactivation of its downstream signaling pathways, and has a vital role in driving tumorigenesis. KRAS mutations predominantly take place at residue G12, G13 or Q61, and different mutants have varying effects on protein physiological functions and tumor types. Due to its smooth surface and high affinity for nucleotides, KRAS had been considered to be “undruggable” until the launch of selective KRAS G12C inhibitors sotorasib and adagrasib, which broke the dogma. This review introduces the structure and functions of KRAS, as well as the status and progress of inhibitors directly targeting KRAS mutants (G12C, G12D, G12R, G12S) and pan-KRAS inhibitors, aiming to provide some insightful reference for the development of KRAS inhibitors.

Objective To analyze the correlation between the multiple evaluation indicators in the early stage and the cure time(needed time from treatment to cure)of the patients with facial neuritis treated by ac-upuncture combined with medication,and to optimize the subjective and objective indicators enable predicting the cure time of facial neuritis in early stage.Methods All patients were treated by acupuncture and medica-tion combination.The research subjects were 64 patients with facial neuritis from the outpatient of cupuncture and moxibustion department of this hospital.The correlation between the grade of facial nerve paralysis,sur-face electromyography related data,scores of self-made symptom scoring scale,Sunnybrook Facial Grading System(SFGS)score,Facial Disability Index-Physical(FDIP)score,Facial Disability Index-Social(FDIS)score on 7 d of onset with the cure time was analyzed.Results The cure time was positively correlated with the grade of facial nerve paralysis and FDIS score on 7 d of onset(P＜0.01),amd negatively correlated with the scores of self-made symptom scoring scale,FDIP score,SFGS score and the affected side to healthy ratio of CMAP amplitude of buccal temporal branch of facial nerve(P＜0.01 or P＜0.05);the cure time had no sig-nificant correlation with the ratio of affected side and healthy side of CMAP amplitude in zygomatic branch of facial nerve,the ratio of affected side and healthy side of CMAP latent period of temporal branch,buccal branch and zygomatic branch of facial nerve and F wave output rate(P＞0.05).Conclusion In the early stage subjective indicators of the acupuncture combined with medication for treating facial neuritis,grade of facial nerve paralysis,self-made symptom scoring scale,scores of self-made symptom scoring scale,FDIP and FDIS scores and the ratio of affected side to healthy side of CMAP amplitude of the buccal branch,temporal branch of the facial nerve in sEMG in the objective indicators could be used to predict the cure time,better guide the treatment and have more effective and accurate comunication with the patients.