ObjectiveThis paper aims to observe the syndrome improvement and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome）. MethodsThrough a multi-center randomized controlled methodology design，confirmed influenza cases were collected from October 2022 to April 2023 in the pediatrics department of eight hospitals，such as Dongfang Hospital of Beijing University of Chinese Medicine. A total of 180 children with influenza and heat accumulation in the lung and stomach syndrome conforming to the standard were recruited through the clinic. The sick children meeting the inclusion criteria were randomly divided into groups by a block-randomized method. The children in the experimental group were treated with Qingxuan Daozhi formula for five days，and those in the control group were treated with Oseltamivir Phosphate Granules for five days. The primary efficacy indicator was the negative conversion rate of influenza antigen detection. Secondary efficacy indicators were the Canadian acute respiratory illness and flu scale （CARIFS） and the incidence of complications，severe cases， and critical cases. Follow-up observation was conducted on the day of enrollment，48 hours after medication，72 hours after medication， and （6+1） d after medication. ResultsOne hundred and eighty participants were randomly assigned to the experimental group （90 cases） or the control group （90 cases）. All participants were followed up during the study. Comparison of influenza antigen detection results in the primary efficacy indicators showed that the average time of negative influenza antigen conversion in the experimental group was （5.29±1.25） d，and that in the control group was （5.40±1.68） d，without a statistically significant difference. After five days of intervention，52 cases in the experimental group and 51 cases in the control group converted to negative，without a statistically significant difference. CARIFS score results in the secondary efficacy indicators showed that during 72 hours after intervention，there were statistically significant differences between the experimental group and the control group in three dimensions， including headache，muscle soreness， and the need for extra care （P<0.05）. On the （6+1） days after the intervention，the differences in both the experimental group and the control group were statistically significant in 10 dimensions， including sore throat，bad sleep，uncomfortable feeling，poor spirit and fatigue，crying more than usual，the need for extra care，symptom，function，influence on parents，and total score （P<0.05）. The comparison results within the group in the dimensional scores of symptom， function， and influence on parents，as well as the CARIFS total score showed that with the delay of follow-up time，scores of both groups decreased significantly，with a statistically significant difference （P<0.01）. Inter-group comparison results showed that the mean score of the experimental group was higher than that of the control group at the time of enrollment. With the progress of intervention，the score of the experimental group was significantly decreased compared with that of the control group. At the end of follow-up，the mean score of the experimental group was lower than that of the control group，with no statistically significant difference. In terms of the incidence of complications，severe cases， and critical cases， there were no complications，severe cases， and critical cases in the two groups，without a statistically significant difference. ConclusionThe symptom improvement effect and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome） are not inferior to Oseltamivir Phosphate granules， and children's acceptance is better. It can be more widely used in clinical treatment of influenza in children （heat accumulation in the lung and stomach syndrome）.

Objective: To confirm the reactive anti-TP ELISA screening results in blood donor samples, and analyze implementaion of re-examination among reactive donors, so as to provide data support for effectively formulating re-examination strategies. Methods: Confirmation tests were performed on 331 samples (including 224 cases with dual-reagent reactivity and 107 cases with single-reagent reactivity) using treponema pallidum particle agglutination assays (TPPA). A total of 136 blood samples were collected from blood donors who have previously tested for anti-TP ELISA with single-reagent reactivity and voluntarily applied for re-examination from 2020 to 2024. Infectious disease indicators were detected in accordance with the "Technical Operating Procedures of Blood Stations (2019 Edition)". Among them, anti-TP screening was performed using ELISA reagents from two different manufacturers, and HBV/HCV/HIV nucleic acid testing was conducted using an individual donation nucleic acid testing (ID-NAT) mode. Supplementary tests (WB or TPPA) were conducted on samples with anti-TP ELISA single-reagent reactivity. A two-sided Pearson's chi-squared test or Fisher's exact test was used to evaluate the differences of the positive rates of anti-TP among different groups or reagents. Results: Among the 331 samples, the confirmed positive rate was 93.75% (210/224) for dual-reagent reactive samples, and 2.8% (3/107) for single-reagent reactive samples. The confirmed positive rates of double reagent reactive samples with different reagent combinations were 91.7% (95% CI: 85.6%-95.5%), 95.6% (95% CI: 85.2%-98.8%), 96.6% (95% CI: 86.2%-97.3%) respectively, with no statistically significant difference (χ =1.597, P=0.463). From 2020 to 2024, 994 donors showed anti-TP ELISA single-reagent reactive results. Among them, 136 (136/994, 13.68%) donors voluntarily applied for re-examination. After the first round of re-examination, 88 (88/136, 64.71%) donors passed the re-examination, and 18 donors were permanently deffered (18/136, 13.24%). Among the permanently quarantined donors, 12 donors remained anti-TP ELISA single-reagent reactive, including 8 confirmed positive for TP-specific antobodies and 4 with indeterminate results. The remaining 6 donors converted to dual-reagent reactive. Conclusion: The dual-reagent reactive results in anti-TP ELISA has a high true positive rate, and the corresponding blood donors can be directly deffered. The majority of single-reagent reactive anti TP-ELISA results are false positives. Timely confirmation or supplementary testing allows prompt notification of evaluation results to blood donors, and reduces unnecessary follow-up examinations. This helps improve the quality of blood donor services and management efficiency, as well as prevent blood donor attrition.

[Objective] To investigate the seroprevalence characteristics of hepatitis E virus (HEV) among blood donors with hepatitis B virus (HBV) infection, so as to provide data support for the monitoring, prevention and treatment of HEV. [Methods] From January to December 2022, 219 samples positive for hepatitis B surface antigen (HBsAg), 142 occult hepatitis B virus infection (OBI) samples (HBV group) and 873 samples tested negative (control group) were collected. 361 samples were further tested with viral load assay and serological testing for five serological markers (HBsAg, HBsAb, HBeAg, HBeAb and HBcAb), and the DNA load was measured using real time fluorescence quantitative PCR. Commercially available enzyme-linked immunosorbent assays (ELISA) were used for the detection of anti-HEV IgG, anti-HEV IgM and HEV antigen (Ag). The Chi-square test or Fisher's exact test was used to assess the differences in the reactivity rates of anti-HEV IgG and anti-HEV IgM among different blood donor populations and different variables. Multivariable logistic regression was used to examine potential risk factors associated with anti-HEV IgG seroprevalence. [Results] In the HBV group, HBsAg positive donors exhibited low expression of antigen. The HBV DNA load of OBI infected donors ranged from 1 to 131.43 IU/mL (median 11.24 IU/mL). The prevalence of anti-HEV IgG and IgM antibody in the HBV group were 34.63% and 1.11%, respectively. Among them, the prevalence of anti-HEV IgG and anti-HEV IgM in the HBV group was 34.63% and 0, respectively (P<0.05), while in the OBI donors, they were 41.55% and 2.82%, respectively. In the normal donors, the reactivity rates for anti-HEV IgG and anti-HEV IgM were 18.67% and 1.49%, respectively. Statistical analysis showed that there was a difference in the reactivity rate of anti-HEV IgG between the HBV-infected donors and the normal donors (34.63% vs 18.67%, P<0.05), but no difference in the reactivity rate of anti-HEV IgM (1.11% vs 1.49%, P>0.05). No HEV Ag was detected in either group of blood donors. Multivariate logistic regression analysis indicated that age was an independent risk factor for anti-HEV IgG reactivity in both groups of blood donors. [Conclusion] The reactivity rate of anti-HEV IgG among HBV-infected blood donors was significantly higher than that in the normal donors in Wuhan, with age being an independent risk factor. Therefore, for HBV-infected donors, it is essential to strengthen and prioritize the prevention and treatment of HEV to reduce the spread of HEV.

Malnutrition significantly impacts patient outcomes and prognosis.Enteral nutrition(EN)serves as a critical nutritional support strategy for hospitalized patients,particularly those who are critically ill,by effectively addressing malnutrition.However,nutritional requirements vary substantially based on disease state and individual characteristics.Artificial intelligence(AI)enables precision EN management through its advanced data processing and predictive analytics capabilities.This review examines current applications of AI in precision EN delivery,identifies existing challenges,and proposes solutions.We aim to inform future research directions and facilitate AI integration into clinical EN practice,ultimately optimizing patient-centered nutritional care.

Objective To explore the mechanism of action of mitochondrial DNA(mtDNA)of alveolar epithelial type Ⅱ cells(AECⅡ)in silicotic fibrosis.Methods This study was divided into the animal experiment and cell experiment.Animal experiment:twenty-eight C57BL/6 mice were randomly divided into the saline group(n=14)and the silicosis model group(n=14),which were given 50 μL of sterile saline and 50 μL of 50 mg/mL of SiO2 suspension by tracheal perfusion respectively.HE staining and Masson staining were performed to observe the histopathological changes of mouse lung tissues after sampling with the exposure of 28 days and 56 days,and Western blot was used to detect the expression levels of functional proteins of pulmonary surfactant protein-D(SP-D),and Krebs von den Lungen-6(KL-6),and fibrotic protein of transforming growth factor-β1(TGF-β1)in mouse lung tissues.Cell experiment:AECⅡ cell line of A549 was exposed to different concentrations of SiO2 suspension.CCK-8 was used to detect cell viability,DAPI staining was used to observe cell apoptosis,Western blot was used to detect related protein expression,JC-1 was used to detect the changes of mitochondrial membrane potential,and RT-qPCR was used to detect mtDNA levels in whole cells,mitochondria,cytoplasm and supernatant.The expression levels of related proteins in AECⅡ were detected by Western blot after cleared mtDNA by DnaseⅠ.Results Histopathological examination of lung tissues showed that SiO2 exposure led to damage in mice lung tissues,with infiltration of inflammatory cell,silica nodules,and a significant increase of collagen fibers.After SiO2 exposure,the protein expressions of SP-D,KL-6 and TGF-β1 in lung tissues were up-regulated(P<0.05).DAPI staining and CCK-8 results showed a reduced activity and impaired apoptosis of AECⅡ after treated with 400 and 800 μg/mL SiO2.JC-1 assay results demonstrated that exposure to 800 μg/mL SiO2 caused a decrease of mitochondrial membrane potential in AECⅡ(P<0.05).RT-qPCR results showed that 800 μg/mL SiO2 exposure led to increased mtDNA levels in the cytoplasm and supernatant of AECⅡ(P<0.05).Western blot results showed that 800 μg/mL SiO2 exposure caused an increase in the levels of SP-D,KL-6,and TGF-β1 proteins,while which were ameliorated by Dnase Ⅰ treatment.Conclusion SiO2 exposure results in the escape and release of AECⅡ mtDNA and dysfunction of AECⅡ,thereby leading to the development of pulmonary fibrosis.

Pancreatic cancer is a highly malignant tumor,and its incidence rate has been slowly increasing since 2000.Although the improvement of diagnosis and treatment has led to an increase in the five-year survival rate of pancreatic cancer compared to 50 years ago,it remains one of the discouraging tumor diseases regarding its prognosis.In 2024,many achievements were made in the research of early screening,disease mechanism,clinical diagnosis and treatment of pancreatic cancer,showing a good prospect for clinical application.In early screening,artificial intelligence(AI)technology has empowered early diagnosis and screening of pancreatic cancer,pushing clinical diagnosis and treatment to a new level.Additionally,improvements in the accuracy of technologies such as liquid biopsy have provided new directions for early screening of pancreatic cancer.In terms of research on disease pathogenesis,3D genome mapping technology has revealed the polyclonal origin and genetic heterogeneity of pancreatic intraepithelial neoplasm(PanIN).In basic research,a branched organ simulation system that mimics the unique structural characteristics of pancreatic cancer provides a new model for in vitro studies of pancreatic cancer.Lactate,an important tumor metabolite,links the metabolic microenvironment of pancreatic cancer with epigenetic changes,revealing potential therapeutic targets.Defects in the histone H3K36 trimethyltransferase SETD2 contribute to endogenous epigenetic dysregulation in pancreatic cancer and promote mitochondrial oxidative phosphorylation(OXPHOS)and tumor progression.The platelet-derived growth factor receptor(PDGFR)axis,which facilitates communication between stromal cells and cancer cells,forms a bidirectional secretory circuit and may become a new therapeutic target.Chimeric antigen receptor macrophage(CAR-M)therapy targeting the tyrosine kinase receptor c-MET demonstrates potential for synergistic enhancement with chemotherapy drugs.Macrophages in the pancreatic cancer microenvironment promote the development of pancreatic cancer cachexia through the CCL5/TRAF6/nuclear factor-κB(NF-κB)pathway,suggesting that macrophages could be an effective target for predicting and intervening in the development of pancreatic cancer cachexia.In terms of advancements in diagnosis and treatment,surgery following neoadjuvant chemotherapy can improve overall survival(OS)in resectable and borderline resectable patients,but further optimization of neoadjuvant chemotherapy protocols is needed.The first clinically effective KRASG12D-targeted drug has been reported,and research on inhibitors of a wide range of KRAS mutants is continually emerging.Patient stratification based on glycolysis-related scores(GRS)can further guide the selection of treatment protocols."Intelligent exosomes"(ExoSmart)enhance cellular uptake capacity to assist in improving chemotherapy efficacy.The implementation of clinical trials combining immunotherapy with chemotherapy is expected to synergistically improve the efficacy of pancreatic cancer treatment.Pembrolizumab and anlotinib combined with albumin-bound paclitaxel/gemcitabine(PAAG)have shown great efficacy and safety in first-line treatment of metastatic pancreatic cancer(mPC)patients.The cancer vaccine ELI-002 2P,which targets KRAS mutation-encoded neoantigens,can induce an antitumor immune response.Oncolytic adenovirus therapy can synergistically improve the efficacy of treatment in advanced pancreatic ductal adenocarcinoma patients when combined with chemotherapy.This article reviewed the latest major progress in the field of basic research and diagnosis and treatment of pancreatic cancer in 2024.

Objectives:To preliminarily investigate the safety and efficacy of same-day discharge(SDD)following radiofrequency catheter ablation for arrhythmia.Methods:A total of 50 consecutive patients who underwent radiofrequency catheter ablation for arrhythmia in the SDD strategy at Fuwai Hospital from 8 July 2024 to 18 September 2024 were included in this analysis.The study evaluated the immediate success rate of the ablation,the rate of all-cause and arrhythmia-related readmission,outpatient or emergency visits and incidence of complications within 30 days post ablation,and recurrence rate of arrhythmias over a 3-month follow-up period.Results:The average age of the 50 patients was(47.2±16.1)years old,32 patients(64.0%)were male.Radiofrequency catheter ablation was performed in 47 patients(94.0%),including 18(36.0%)atrial fibrillation(AF)ablation.Three patients(6.0%)underwent electrophysiological study only.The immediate success rate for ablation patients was 100%(47/47).None of the patients developed vascular puncture-related or ablation-related complications.The average hospital stay and postoperative observation time were(6.84±1.13)hours and(3.40±1.12)hours,respectively.The all-cause and arrhythmia-related readmission,outpatient or emergency visits rates within 30 days were 12.0%(6/50)and 2.0%(1/50),respectively.Two patients(4.0%)post ablation experienced AF recurrence during the 3-months follow-up period.Conclusions:Radiofrequency catheter ablation for arrhythmias in SDD strategy is safe,effective,and feasible.

OBJECTIVE To explore the application of digital twin technology in modeling and simulating the hospi-tal-associated transmission pathways of multidrug-resistant organisms(MDROs)and propose MDRO transmis-sion prevention and control strategies based on digital twins.METHODS Real-time hospital data and person-nel mobility information from Jun.2023 to Jun.2024 were collected and analyzed.A dynamic model of the hospi-tal's internal environment and MDROs transmission was established by digital modeling and 3D simulation tech-nology of the hospital environment.A simulation platform was utilized to analyze the impact of different preven-tion and control measures on MDROs transmission risks.Digital twin technology was employed for predicting and real-time monitoring of organism transmission pathways.RESULTS Simulation data showed that under initial pre-vention and control conditions,Ward A had 8 infected individuals and a transmission duration of 12 days.Af-ter implementing comprehensive measures of"increased cleaning frequency+enhanced personnel protection",the number of infected individuals reduced to 4,the transmission duration shortened to 6 days and the transmis-sion risk reduction rate reached 45.00％.The digital twin model can effectively reflect the transmission patterns of MDROs within the hospital and provide quantitative risk assessments under different prevention and control strat-egies.CONCLUSIONS Digital twin technology can predict and simulate organism transmission pathways in real-time,providing scientific decision-making support for hospitals.It has the potential to become a new paradigm for MDROs prevention and control.

A mounting body of research suggests that circRNAs significantly contribute to the develop-ment of myocardial fibrosis.The microarray results of human circular RNA expression profile indicated that circHERC4_041 expression increased in the myocardium of patients with heart failure,RT-qPCR a-nalysis confirmed that the myocardial expression level of circHERC4_041 in individuals with heart failure were considerably elevated compared to that in healthy organ donors.Fluorescence in situ hybridization(FISH)confirmed that circHERC4_041 was abundant in the cytoplasm of human cardiomyocyte AC16.Overexpression of circHERC4_041 in mouse myocardial fibroblasts(mCFs)mediated by adenovirus in-hibited the expression of fibrosis-related proteins in mCFs.Experiments involving cell proliferation,wound healing,and Transwell assays demonstrated that overexpression of circHERC4_041 suppressed the growth and mobility of mCFs(P＜0.001).Sequence analysis results suggested that circHERC4_041 con-tains potential ribosome entry sequence(IRES)and open reading frame(ORF).Western blot confirmed that circHERC4_041 could translate the 516 amino acid HERC4-516aa protein,which was mainly located in the cytoplasm of the cell.Cell functional experiments confirmed that circHERC4_041 inhibited the fi-brotic phenotype of mCFs by specifically translating HERC4-516aa(P＜0.05).The specific interaction between HERC4-516aa and transglutaminase 2(TGM2)was confirmed by IP-MS screening and Co-IP i-dentification.Further results found that the degradation of TGM2 was promoted through proteasome path-way.The overexpression of TGM2 in mCFs facilitated by adenoviral vectors could counteract the suppres-sive effects of HERC4-516aa on the fibrotic phenotype of mCFs.Therefore,this study confirmed that the HERC4-516aa protein translated by circHERC4_041 can specifically bind to TGM2 to inhibit the fibrotic phenotype of myocardial fibroblasts.

Objective To explore the time-varying characteristics and correlation degree of autonomous rehabili-tation behavior and related symptoms of middle-aged stroke patients,and to provide a basis for clinical transitional nursing and precise rehabilitation.Methods Ecological momentary assessment was used to select 57 middle-aged stroke patients who underwent rehabilitation treatment in the Rehabilitation Medicine Department of a tertiary com-prehensive hospital in Wuhan from March 15 to August 30,2024,using convenience sampling method.Their au-tonomous rehabilitation behavior and related symptoms(fatigue,pain,emotion,sensation)were continuously monitored for 2 weeks.A hierarchical linear model was used to analyze the correlation between behavior and symptoms.Results The autonomous rehabilitation behavior of middle-aged stroke patients showed a fluctuating increasing trend,and the symptom score showed a slow decreasing trend.The hierarchical linear model showed that compared with female patients,male patients have longer duration of autonomous rehabilitation behavior(P＜0.05).The number and duration of autonomous rehabilitation behaviors in patients without fatigue were higher(P＜0.05).The number of autonomous rehabilitation behaviors in patients without pain was higher than that in patients with pain(P＜0.05).The number of autonomous rehabilitation behavior items among patients who perceived more pleasure in rehabilitation was higher than that among patients with greater difficulty in rehabilitation challenges(P＜0.05).Patients with high rehabilitation confidence have higher numbers and duration of autonomous rehabilitation behaviors compared to pa-tients with low rehabilitation confidence(P＜0.05).Conclusion There are significant individual differences and dy-namic changes in the autonomous rehabilitation behavior and related symptoms of middle-aged stroke patients.Nurs-ing staff should accurately implement personalized rehabilitation services during the transition period,enhance pa-tients'autonomy and self-management ability in home-based rehabilitation,in order to improve the overall rehabilita-tion effect.