Released in February 2025, American Society for Gastrointestinal Endoscopy（ASGE） guideline on the diagnosis and management of gastroesophageal reflux disease(GERD), is based on a large body of evidence-based medical evidence over the past decade. It has systematically updated the indications for endoscopic examination, standards for high-quality endoscopic examination, and multidimensional management strategies, while focusing on elucidating the new role of endoscopic intervention in the diagnosis and treatment of GERD. The guideline aimed to provide clinicians with an authoritative guiding tool that integrates both scientific and practical value.

Acute liver injury (ALI) serves as a critical precursor and major etiological factor in the progression and ultimate manifestation of various hepatic disorders. The prevention and treatment of ALI is still a serious global challenge. Given the limited therapeutic options for ALI, exploring novel targeted therapeutic agents becomes imperative. The potential therapeutic efficacy of inhibiting RIPK2 is highlighted, as it may provide significant benefits by attenuating the MAPK pathway and NF-κB signaling. Herein, we propose a CMD-OPT model, a two-stage molecular optimization tool for the rapid discovery of RIPK2 inhibitors with optimal properties. Compound RP20, which targets the ATP binding site, demonstrated excellent kinase specificity, ideal oral pharmacokinetics, and superior therapeutic effects in a model of APAP-induced ALI, positioning RP20 as a promising preclinical candidate. This marks the first application of RIPK2 inhibitors in ALI treatment, opening a novel therapeutic pathway for clinical applications. These results highlight the efficacy of the CMD-OPT model in producing lead compounds from known active molecules, showcasing its significant potential in drug discovery.

Alzheimer's disease(AD), a neurodegenerative disorder associated with aging, is the most prevalent form of dementia.As the aging population continues to expand, AD presents significant health and caregiving challenges for families and society, making it a pressing international public health concern.In recent years, numerous countries have implemented dementia prevention and treatment strategies that emphasize community-based comprehensive approaches.Currently, the community-based AD prevention and treatment model in China is still in the exploratory phase, with community efforts lacking organization.In alignment with China's action plan for advancing dementia prevention and treatment, and to achieve the strategic objective of "healthy aging, " this consensus is based on the principle of three-level prevention and is tailored to the characteristics of AD disease progression.It aims to develop a comprehensive prevention and treatment strategy for AD that is suitable for communities in China, providing technical guidance and support to establish a scientific basis for formulating community AD prevention and treatment models.

Objective To investigate the diagnostic potential of combining 3.0T magnetic resonance imag-ing(MRI)T2 mapping sequences with serum nesfatin-1 levels for detecting early osteoarthritis(OA)in elderly knees.Methods 97 elderly patients with knee osteoarthritis(OA group)and 52 elderly individuals undergoing physical examinations(control group)were recruited from a hospital between May 2023 and May 2024.Based on X-ray findings,the OA group was further divided into an early-stage subgroup and a non-early-stage subgroup.All participants underwent 3.0T MRI T2 mapping sequence scans to measure the T2 values in the knee cartilage region,and serum nesfatin-1 levels were assessed.Differences in these indicators were compared between groups.Additionally,a receiver operating characteristic(ROC)curve was constructed to evaluate the diagnostic value of these parameters for early-stage knee OA in elderly individuals.Results Among 97 elderly patients with knee OA,35 cases were classified into the early-stage group,and 62 cases were categorized into the non-early-stage group.The T2 values in five cartilage regions of the knee and serum nesfatin-1 levels were significantly higher in the OA group compared to the control group(P<0.05).Moreover,these values were significantly lower in the early-stage group than in the non-early-stage group(P<0.05).The areas under the curve(AUC)for diagnosing early-stage OA using T2 values in knee cartilage regions and serum nesfatin-1 levels ranged from 0.774 to 0.871.Notably,the AUC for combined diagnosis reached 0.939(P<0.05).Conclusion 3.0T MRI using the T2 mapping sequence in combination with serum nesfatin-1 level detection demonstrates high diagnostic value for early OA in elderly patients with knee involvement.

OBJECTIVE To investigate the current status and existing issues of hospital-associated infection manage-ment in non-public medical institutions,so as to provide data for the formulation of hospital-associated infec-tion management policies and the construction of a quality evaluation system for hospital-associated infection man-agement in non-public medical institutions.METHODS A qualitative research method was employed.In Dec.2023,semi-structured interviews were conducted with 38 directors of hospital-associated infection management depart-ments in primary,secondary and tertiary non-public medical institutions.The interview data were coded and ana-lyzed by Nvivo 12.0 software to refine themes.RESULTS Three themes were refined:the organizational system for hospital-associated infection management in non-public medical institutions had been basically established,but the division of functions and responsibilities was not yet fully clear,hospital-associated infection management had achieved certain results,including collaborating with other departments to standardize and implement infection control measures,enhancing staff awareness of infection control,and promoting the establishment of organization-al systems.There were issues in infection control works such as insufficient funding,personnel allocation not meeting requirements,and difficulties in implementing infection control measures.The most urgent assis-tance needed was to address the training and professional title promotion for full-time and part-time infection con-trol personnel.CONCLUSION Non-public medical institutions should strengthen staffing and training,enhance the pro-fessional capabilities of infection control personnel,and establish hospital-associated infection management standards that are tailored to the characteristics of non-public medical institutions at all levels.

OBJECTIVE To investigate the current status and existing issues of hospital-associated infection manage-ment in non-public medical institutions,so as to provide data for the formulation of hospital-associated infec-tion management policies and the construction of a quality evaluation system for hospital-associated infection man-agement in non-public medical institutions.METHODS A qualitative research method was employed.In Dec.2023,semi-structured interviews were conducted with 38 directors of hospital-associated infection management depart-ments in primary,secondary and tertiary non-public medical institutions.The interview data were coded and ana-lyzed by Nvivo 12.0 software to refine themes.RESULTS Three themes were refined:the organizational system for hospital-associated infection management in non-public medical institutions had been basically established,but the division of functions and responsibilities was not yet fully clear,hospital-associated infection management had achieved certain results,including collaborating with other departments to standardize and implement infection control measures,enhancing staff awareness of infection control,and promoting the establishment of organization-al systems.There were issues in infection control works such as insufficient funding,personnel allocation not meeting requirements,and difficulties in implementing infection control measures.The most urgent assis-tance needed was to address the training and professional title promotion for full-time and part-time infection con-trol personnel.CONCLUSION Non-public medical institutions should strengthen staffing and training,enhance the pro-fessional capabilities of infection control personnel,and establish hospital-associated infection management standards that are tailored to the characteristics of non-public medical institutions at all levels.

Objective To investigate the diagnostic potential of combining 3.0T magnetic resonance imag-ing(MRI)T2 mapping sequences with serum nesfatin-1 levels for detecting early osteoarthritis(OA)in elderly knees.Methods 97 elderly patients with knee osteoarthritis(OA group)and 52 elderly individuals undergoing physical examinations(control group)were recruited from a hospital between May 2023 and May 2024.Based on X-ray findings,the OA group was further divided into an early-stage subgroup and a non-early-stage subgroup.All participants underwent 3.0T MRI T2 mapping sequence scans to measure the T2 values in the knee cartilage region,and serum nesfatin-1 levels were assessed.Differences in these indicators were compared between groups.Additionally,a receiver operating characteristic(ROC)curve was constructed to evaluate the diagnostic value of these parameters for early-stage knee OA in elderly individuals.Results Among 97 elderly patients with knee OA,35 cases were classified into the early-stage group,and 62 cases were categorized into the non-early-stage group.The T2 values in five cartilage regions of the knee and serum nesfatin-1 levels were significantly higher in the OA group compared to the control group(P<0.05).Moreover,these values were significantly lower in the early-stage group than in the non-early-stage group(P<0.05).The areas under the curve(AUC)for diagnosing early-stage OA using T2 values in knee cartilage regions and serum nesfatin-1 levels ranged from 0.774 to 0.871.Notably,the AUC for combined diagnosis reached 0.939(P<0.05).Conclusion 3.0T MRI using the T2 mapping sequence in combination with serum nesfatin-1 level detection demonstrates high diagnostic value for early OA in elderly patients with knee involvement.

Alzheimer's disease(AD), a neurodegenerative disorder associated with aging, is the most prevalent form of dementia.As the aging population continues to expand, AD presents significant health and caregiving challenges for families and society, making it a pressing international public health concern.In recent years, numerous countries have implemented dementia prevention and treatment strategies that emphasize community-based comprehensive approaches.Currently, the community-based AD prevention and treatment model in China is still in the exploratory phase, with community efforts lacking organization.In alignment with China's action plan for advancing dementia prevention and treatment, and to achieve the strategic objective of "healthy aging, " this consensus is based on the principle of three-level prevention and is tailored to the characteristics of AD disease progression.It aims to develop a comprehensive prevention and treatment strategy for AD that is suitable for communities in China, providing technical guidance and support to establish a scientific basis for formulating community AD prevention and treatment models.

Objective: To investigate the resistance to rifampicin and isoniazid and the changing trends among patients with pulmonary tuberculosis in Luohu District, Shenzhen City, Guangdong Province from 2012 to 2022, so as to provide insights into improving drug-resistant pulmonary tuberculosis control and prevention strategies. Methods: Basic information, treatment classification and drug resistance data of patients with pulmonary tuberculosis and positive pathogenic detection in Luohu District from 2012 to 2022 were collected through the Tuberculosis Surveillance System of Chinese Disease Prevention and Control Information System, and resistance rates of rifampicin and isoniazid and the changing trends were analyzed. Results: A total of 2 126 patients with pulmonary tuberculosis were collected and had a median age of 34 (interquartile range, 25) years, including 1 334 males (62.75%) and 792 females (37.25%). There were 302 patients with drug-resistance in Luohu District from 2012 to 2022, with a resistance rate of 14.21%. Among them, 60 patients were monoresistant to rifampicin (2.82%), 113 patients were monoresistant to isoniazid (5.32%), and 129 patients were multidrug resistant (6.07%). The rate of rifampicin monoresistance showed a downward trend from 2012 to 2022, while the rate of multidrug resistance showed an upward trend (both P<0.05). There was no significant tendency in the rate of isoniazid monoresistance (P>0.05). The rate of multidrug resistance among patients without Shenzhen residence was higher than that among patients with Shenzhen residence; the rates of rifampicin resistance and multidrug resistance among retreated patients were higher than those among treatment-naïve patients (all P<0.05). Conclusions The rate of rifampicin monoresistance appeared a downward trend and the rate of multidrug resistance appeared an upward trend among patients with pulmonary tuberculosis in Luohu District from 2012 to 2022. Attention should be given to non-Shenzhen residence and retreated patients.

AIM: To evaluate the efficacy of high-intensity focused ultrasound cyclo plasty(UCP)in the treatment of glaucoma and to investigate related influencing factors.METHODS: The study involved a total of 110 patients(134 eyes)who received UCP treatment between January 2019 and January 2022 at three medical centers: Tianjin Eye Aier Eye Hospital, Chongqing Aier Eye Hospital, and Chongqing Nanping Aier Eye Hospital. Patients were classified into three categories: primary angle-closure glaucoma, primary open-angle glaucoma, and secondary glaucoma. Best corrected visual acuity, intraocular pressure, and the usage of anti-glaucoma medications, etc., were recorded at 6 and 12 mo postoperatively.RESULTS: After 6 months of the UCP procedure, statistically significant differences in intraocular pressure were observed across all groups(all P<0.05). At 12 mo postoperatively, intraocular pressure of the primary angle-closure and primary open-angle glaucoma groups showed differences(all P<0.05). Notably, there were no significant changes in visual acuity at either the 6 or 12 mo compared to preoperative values across all patient groups(all P>0.05). Furthermore, the study identified a statistically significant correlation between the changes in intraocular pressure at 6 mo and factors such as age, history of previous glaucoma surgery, baseline white-to-white(corneal diameter), and the extent of UCP treatment(all P<0.05).CONCLUSION: The UCP procedure has been demonstrated to effectively lower intraocular pressure in patients with glaucoma. The efficacy appears to be influenced by variables including patient age, previous glaucoma surgery history, baseline white-to-white(corneal diameter), and the scope of UCP treatment. Importantly, UCP treatment did not adversely affect visual acuity, underscoring its favorable safety profile.