Objective:To conduct a scoping review to analyse the types, performance, advantages and disadvantages of cognitive function assessment tools for ICU patients, to provide a reference for the evaluation of cognitive function in ICU patients in future.Methods:A scoping review study was conducted, literature on cognitive function assessment tools for ICU patients in 9 domestic and foreign databases including China National Knowledge Infrastructure, Wanfang Database, VIP Database, China Biology Medicine disc, PubMed, Web of Science, Cochrane Library, Embase and CINAHL were systematically searched. The search period was from the establishment of the database to May 20, 2024. Literature was independently screened by 2 researchers and relevant information was extracted and summarized.Results:Totally 17 studies were included, with 9 tools for assessing cognitive function in ICU patients, including 6 questionnaires, 1 test battery, 1 assessment software, and 1 telephone interview questionnaire. All of above were generalizable tools, except for the Chinese and English versions of the John-Hopkins Adapted Cognitive Exam as ICU-specific tools. The Mini-Mental State Examination was the most widely used assessment scale.Conclusions:Appropriate assessment tools should be selected according to the specific clinical setting, but there is still a lack of specialized and standardized assessment tools for cognitive dysfunction in ICU patients. In the future, standardized tools which fit our cultural context for evaluating cognitive function in ICU patients should be developed.

Integrase inhibitors (INSTIs) are the newest class of antiretroviral drug which are available to people living with the human immunodeficiency virus (HIV). Since 2007, five types of INSTIs have been marketed: Raltegravir, Elvitegravir, Dolutegravir, Bictegravir and Cabotegravir, all of which were approved by the US Food and Drug Administration (FDA) for use in the initiation of antiretroviral therapy (ART) in treatment-na?ve individuals. Compared with other types of antiretroviral drugs, INSTIs have better efficacy and tolerability, so many countries around the world have listed INSTIs-containing regimens as the preferred regimen for HIV ART. In recent years, with the widespread use of INSTIs, some research data suggest that INSTIs may have some adverse effects (AEs), such as central nervous system symptoms, abnormal lipid metabolism, weight gain, abnormal liver and kidney function, etc. This review summarizes the current use of INSTIs in people living with the HIV, and highlights the clinical efficacy and their AEs among the five types of INSTIs in China.

Objective To analyze the disease burden and change trend of breast cancer mortality among Chinese women from 2013 to 2021.Methods The indicators of breast cancer-related mortality (MR),age-standardized mortality rate (ASMR),deaths,and urban-rural deaths in the Chinese Cause of Death Surveil-lance Dataset from 2013 to 2021 were collected and collated,and the trend changes of MR,ASMR,and years lost in life of premature death (YLL) were analyzed,annual percentage change (APC) was used for trend a-nalysis,and Fisher substitution test was used to compare APC in different regions.Results From 2013 to 2021,a total of 88112 cases of breast cancer died,with an average annual MR of 7.56/100000 and an ASMR of 6.34/100000.From 2013 to 2021,the MR rate of breast cancer (APC=2.12%,t=5.414,P<0.001),MR in rural areas (APC=2.84%,t=7.581,P<0.001),and YLL in rural areas (APC=1.61%,t=3.588,P=0.009) showed an upward trend in China.MR at 40-<45 years old showed a downward trend (APC=-2.76%,t=-4.689,P=0.002),and at 70-<75 years old (APC=1.41%,t=2.494,P=0.041),75-<80 years old (APC=3.05%,t=3.690,P=0.008),and 80-<85 years old (APC=1.82%,t=2.909,P=0.023).There was a statistically significant difference in APC between MR and ASMR in urban and rural areas (P<0.001).There was no significant difference in the trend of other indicators (P>0.05).Conclusion From 2013 to 2021,the disease burden of breast cancer mortality in Chinese women showed an upward trend,and the comprehensive prevention and treatment of breast cancer should be strengthened to reduce the risk of breast cancer death.

ObjectiveTo investigate the attenuating effect of Dioscoreae Bulbiferae Rhizoma（DBR） processed with Phaseoli Radiati Semen（PRS） juice， and explore the attenuating mechanism based on ferroptosis of the main toxic target organ. MethodSixty male ICR mice were randomly divided into blank group， DBR group， water roasted DBR group（hereinafter referred to as water group）， PRS juice-roasted DBR group 1（DBR-PRS 10∶1， stuffy moistening for 40 min， stir-fried at 130 ℃ for 18 min， hereinafter referred to as group 1）， PRS juice-roasted DBR group 2（DBR-PRS 10∶1， stuffy moistening for 80 min， stir-fried at 100 ℃ for 14 min， hereinafter referred to as group 2）， PRS juice-roasted DBR group 3（DBR-PRS=20∶3， stuffy moistening for 40 min， stir-fried at 160 ℃ for 14 min， hereinafter referred to as group 3）. The raw and processed groups of DBR were gavaged with their corresponding 95% ethanol extract at a dose of 3 g·kg^-1·d^-1， while the blank group was gavaged with an equal volume of 0.5% sodium carboxymethyl cellulose， once a day for 14 consecutive days. Hematoxylin-eosin（HE） staining was used to observe the histopathological changes of mouse liver. Alanine aminotransferase（ALT） and aspartate aminotransferase（AST） levels in serum， as well as malondialdehyde（MDA）， ferrous ions（Fe²⁺）， reduced glutathione（GSH） and superoxide dismutase（SOD） levels in liver tissue were detected by the biochemical detection. Western blot was used to detect the expression of iron key proteins such as ferritin heavy chain 1（FTH1） and glutathione peroxidase 4（GPX4）. ResultHE staining results showed that the liver tissue structure of the blank group was clear， the morphology of hepatocytes was normal， the cytoplasms of hepatocytes in the DBR group and water group were loose and vacuolar， with obvious pathological damages， and the pathologic damages of mice in the group 1-3 were significantly improved. Compared with the blank group， the levels of ALT， AST， MDA and Fe²⁺ in mice from the DBR group were significantly increased（P<0.01）， while GSH and SOD levels were significantly reduced（P<0.01）， and the protein expression levels of FTH1 and GPX4 were significantly decreased（P<0.01）. Compared with the DBR group， the ALT， AST，MDA and Fe²⁺ levels of mice in the group 1-3 were significantly reduced（P<0.05， P<0.01）， the GSH and SOD levels and the protein expression levels of FTH1 and GPX4 were significantly increased（P<0.01）. Compared with the water group， the AST and MDA levels of mice in the group 1-3 were significantly reduced（P<0.05， P<0.01）， the SOD level significantly increased（P<0.05， P<0.01）， the FTH1 protein expression significantly increased（P<0.01）， and the serum ALT level of mice in the group 2-3 significantly reduce（P<0.01）， Fe²⁺ level significantly reduced（P<0.01）， GSH level significantly increased（P<0.05， P<0.01）， and GPX4 protein expression significantly increased（P<0.05， P<0.01）. Among the group 1-3， the group 3 had the best detoxification effect. ConclutionProcessing with PRS juice can reduce the liver injury induced by DBR， and the mechanism may be related to the inhibition of ferroptosis in the liver.

ObjectiveTo investigate the entrance surface dose （ESD） of digital radiography （DR）adult examinees in a grade A tertiary hospital in Shanghai， to analyze the dose level of the DR adult examinees， and to provide data for the development of DR typical dose reference. MethodsA DR equipment in the hospital was selected and the irradiation parameters and dose were determined in two randomly selected age groups （15‒39 years and 40‒69 years） of DR adult examinees. The examinations included chest PA， chest LAT， abdominal AP， pelvic AP， lumbar AP， lumbar LAT， thoracic AP， and thoracic LAT. The number of examinees in each exposure position was 20. ESD and effective dose were calculated for each age group and each position. ResultsA total of 320 examinees were investigated. The 75th percentiles of ESD in different exposure positions were as follows： chest PA 0.19 mGy；chest LAT 0.96 mGy；abdominal AP 3.63 mGy；pelvic AP 3.16 mGy；lumbar AP 9.27 mGy；lumbar LAT 18.29 mGy；thoracic AP 6.85 mGy；and thoracic LAT 13.40 mGy. ConclusionsThe differences between the estimated ESD and effective dose were large in different exposure positions、in the same exposure positions、and in the same positions with different exposure types， and there were statistically significant differences in ESD of examinees with different exposure positions. The estimated typical values of different exposure positions were apparently lower than the diagnostic reference level.

Sepsis is a heterogeneous syndrome.It is caused by infections,attributing to immune dysfunction pathologically.The disease is characterized by macrophage-mediated inflammation and immune response throughout its development.During septic development,macrophages metabolize crucially with glycolysis remarkably enhanced.The glycolystic enhancement facilitates septic development by promoting the inflammatory response of macrophages and altering their phenotype.Therefore,direct or indirect inhibition of macrophagic glycolysis can alleviate sepsis and neutralize damages to organs functionally,promoting the polarization of anti-inflammatory phenotype.In this review,we aim to investigate the relationship between macrophagic glycolysis and sepsis,focusing on researching into relevant molecular mechanisms by which glycolysis is regulated for treating sepsis.It is concluded that interfer-ing with macrophagic glycolysis may serve as a novel therapeutic strategy for treating sepsis.

Practice teaching plays a crucial role in cultivating the innovative spirit and practical ability of undergraduates majoring in traditional Chinese medicine. Guided by the integration of profession and industry, this study starts from the integration of experimental teaching contents in the curriculum group of Chinese medicinal material resources based on the upstream of the "entire traditional Chinese medicine industry chain" and introduces the educational concept of "concept, design, implementation, operation" (CDIO) and the method of project-based critical learning (PBCL) to integrate the practical tasks of the curriculum group of Chinese medicinal material resources, decompose the project into training stages, and provide problem-based learning guidance for each key link. With a focus on critical discussion learning, discussions on project design are carried out to continuously identify problems in the project. The best solution is selected to promote the implementation and execution of practical projects, so that students can significantly improve their professional knowledge, professional skills, team spirit, innovative spirit, interpersonal coordination ability, comprehensive professional ability, and active learning ability while completing the project. The assessment method that emphasizes the process, multiple methods, and the participation of multiple types of personnel is adopted to assess the comprehensive abilities of students. Practice has shown that the PBCL-CDIO education model can effectively improve the comprehensive abilities of students and may help with the cultivation of professional talents in the cultivation and identification of Chinese herbal medicine.

Objective:To explore the effect of virtual reality (VR) technology in postoperative pain management for surgical patients.Methods:The literature on VR technology for relieving postoperative pain in surgical patients was electronically retrieved from eight databases, including PubMed, Web of Science and so on. The search period was from database establishment to November 19, 2023. Two researchers independently screened literature, extracted data, and conducted literature quality evaluation, using RevMan 5.4 for Meta-analysis.Results:A total of 18 articles were included. Meta-analysis results showed that VR technology could reduce postoperative resting pain scores [ MD=-1.13, 95% CI (-1.29, -0.96), P<0.001], postoperative 12 hour pain scores [ MD=-0.49, 95% CI (-0.73, -0.24), P<0.001], postoperative 24 hour pain scores [ MD=-0.73, 95% CI (-0.92, -0.54), P<0.001], postoperative 48 hour pain scores [ MD=-0.69, 95% CI (-0.84, -0.53), P<0.001], postoperative 72 hour pain scores [ MD=-0.37, 95% CI (-0.59, -0.16), P<0.001], and postoperative pain scores during dressing changes [ MD=-1.11, 95% CI (-2.06, -0.16), P=0.02], and could improve patient postoperative comfort [ MD=8.31, 95% CI (6.57, 10.06), P<0.001] . Conclusions:As a non-pharmacological intervention, VR technology can alleviate postoperative pain and improve patient comfort in surgical patients. In the future, large-scale and high-quality research is still needed to further verify the effectiveness of VR technology.

Objective By investigating the effects of miR-379-5p on the proliferation,invasion and metastasis of mouse breast cancer 4T1 cells,we aimed to provide new therapeutic targets for the clinical inhibition of breast cancer proliferation,invasion,and metastasis.Methods After plasmid transfection,4T1 cells were utilized to detect the expression of miR-379-5p using fluorescence quantitative PCR.While 5-ethynyl-2'doxyuridine(EdU)cell proliferation and Transwell assays were employed to detect changes in the proliferation and invasion ability of 4T1 cells in each group.The migration ability of 4T1 cells after overexpression and knockdown of miR-379-5p was examined by scratch healing assay.A transplanted tumor model of breast cancer was established in BABL/c mice,and the effects of overexpressing miR-379-5p on tumor growth and the number and size of lung metastases were observed.Results EdU result showed that knocking down miR-379-5p enhanced the proliferation ability of the cells compared with the control group cells,and miR-379-5p overexpression reduced the capacity of breast cancer cells to proliferate(P＜0.05).Transwell and wound healing assays showed that miR-379-5p knockdown enhanced,while miR-379-5p overexpression significantly inhibited,the invasion and migratory ability of breast cancer cells(P＜0.01).An in vivo tumorigenesis experiment with BABL/c mice showed that miR-379-5p overexpression significantly slowed the tumor growth rate(P＜0.05)and inhibited lung metastasis(P＜0.01).Conclusions MiR-379-5p plays a role in tumor gene suppression in breast cancer and inhibits the proliferation,invasion,and migration of mouse breast cancer 4T1 cells.

Pulmonary blast injury has become the main type of trauma in modern warfare, characterized by externally mild injuries but internally severe injuries, rapid disease progression, and a high rate of early death. The injury is complicated in clinical practice, often with multiple and compound injuries. Currently, there is a lack of effective protective materials, accurate injury detection instrument and portable monitoring and transportation equipment, standardized clinical treatment guidelines in various medical centers, and evidence-based guidelines at home and abroad, resulting in a high mortality in clinlcal practice. Therefore, the Trauma Branch of Chinese Medical Association and the Editorial Committee of Chinese Journal of Trauma organized military and civilian experts in related fields such as thoracic surgery and traumatic surgery to jointly develop the Clinical treatment guideline for pulmonary blast injury ( version 2023) by combining evidence for effectiveness and clinical first-line treatment experience. This guideline provided 16 recommended opinions surrounding definition, characteristics, pre-hospital diagnosis and treatment, and in-hospital treatment of pulmonary blast injury, hoping to provide a basis for the clinical treatment in hospitals at different levels.