Objective To analyze the distribution of pathogenic bacteria,changes in serum levels of long non-coding ribonucleic acid(lncRNA)nuclear enriched abundant transcript 1(NEAT1),Ga-lectin-3,and monocyte chemotactic protein-1(MCP-1),and their relationship with cardiac func-tion in patients with chronic heart failure(CHF)complicated with pulmonary infection(PI).Methods A total of 278 CHF patients treated in the Second Cardiovascular Ward of the Third Affiliated Hospital of Henan University of Chinese Medicine from January 2020 to February 2022 were recruited,and according to the occurrence of PI or not,they were divided into a PI group(98 cases)and a non-PI group(180 cases).The distribution of pathogenic bacteria in the PI group was analyzed.ROC curves were plotted to evaluate the predictive value of serum indicators for PI in CHF patients.Results Among the 98 CHF patients with PI,161 strains of pathogenic bacteria were detected,with Gram-negative(G-)bacteria most prevalent,accounting for 114 strains(70.8％).Serum levels of lncRNA NEAT1,Galectin-3,and MCP-1 were significantly higher in the PI group than the non-PI group(P＜0.01).Pearson correlation analysis showed that serum levels of lncRNA NEAT1,Galectin-3,and MCP-1 were positively correlated with cardiac function(r=0.794,r=0.523,r=0.709,P＜0.01).ROC curve analysis revealed that the combined detec-tion of serum lncRNA NEAT1,Galectin-3,and MCP-1 had the highest predictive value for PI in CHF patients than each indicator alone,and the AUC value,sensitivity,and specificity of the com-bined detection was 0.926,84.54％,and 92.78％,respectively(P＜0.01).Conclusion Gram-negative bacteria are predominant type of pathogenic bacteria in CHF patients with PI.Serum levels of lncRNA NEAT1,Galectin-3,and MCP-1 are increasing with the occurrence of infection and worsening of cardiac function.Combined detection of these indicators provides higher predic-tive value for PI in CHF patients.

Objective To analyze the distribution of pathogenic bacteria,changes in serum levels of long non-coding ribonucleic acid(lncRNA)nuclear enriched abundant transcript 1(NEAT1),Ga-lectin-3,and monocyte chemotactic protein-1(MCP-1),and their relationship with cardiac func-tion in patients with chronic heart failure(CHF)complicated with pulmonary infection(PI).Methods A total of 278 CHF patients treated in the Second Cardiovascular Ward of the Third Affiliated Hospital of Henan University of Chinese Medicine from January 2020 to February 2022 were recruited,and according to the occurrence of PI or not,they were divided into a PI group(98 cases)and a non-PI group(180 cases).The distribution of pathogenic bacteria in the PI group was analyzed.ROC curves were plotted to evaluate the predictive value of serum indicators for PI in CHF patients.Results Among the 98 CHF patients with PI,161 strains of pathogenic bacteria were detected,with Gram-negative(G-)bacteria most prevalent,accounting for 114 strains(70.8％).Serum levels of lncRNA NEAT1,Galectin-3,and MCP-1 were significantly higher in the PI group than the non-PI group(P＜0.01).Pearson correlation analysis showed that serum levels of lncRNA NEAT1,Galectin-3,and MCP-1 were positively correlated with cardiac function(r=0.794,r=0.523,r=0.709,P＜0.01).ROC curve analysis revealed that the combined detec-tion of serum lncRNA NEAT1,Galectin-3,and MCP-1 had the highest predictive value for PI in CHF patients than each indicator alone,and the AUC value,sensitivity,and specificity of the com-bined detection was 0.926,84.54％,and 92.78％,respectively(P＜0.01).Conclusion Gram-negative bacteria are predominant type of pathogenic bacteria in CHF patients with PI.Serum levels of lncRNA NEAT1,Galectin-3,and MCP-1 are increasing with the occurrence of infection and worsening of cardiac function.Combined detection of these indicators provides higher predic-tive value for PI in CHF patients.

Objective:To systematically evaluate and synthesize qualitative studies on the journey experiences and needs of patients with cancer-associated venous thromboembolism (CAT) , providing reference for developing full-course intervention strategies oriented to CAT prevention and management needs.Methods:Literature was retrieved from PubMed, Web of Science, Embase, Cochrane Library, CINAHL, China National Knowledge Infrastructure, Wanfang Data, and VIP regarding qualitative studies on CAT patients' prevention and management journey experiences and needs, from database inception to June 30, 2024. The quality of included literature was assessed using the 2024 version of the Joanna Briggs Institute (JBI) Qualitative Research Quality Appraisal Criteria. Findings were synthesized using a Meta-synthesis approach.Results:A total of 13 studies were included, from which 104 themes were extracted and categorized into 12 new categories, ultimately integrated into three synthesized findings: tasks change as the journey progresses; emotions gradually shift from negative to positive; pain points are key areas to improve the journey experience.Conclusions:CAT patients experience varying journey-related experiences and needs. Healthcare providers should identify key management content at each stage to meet patients' multidimensional and diverse prevention and management needs, constructing individualized management plans oriented to CAT journey requirements.

Objective:To systematically evaluate and synthesize qualitative studies on the journey experiences and needs of patients with cancer-associated venous thromboembolism (CAT) , providing reference for developing full-course intervention strategies oriented to CAT prevention and management needs.Methods:Literature was retrieved from PubMed, Web of Science, Embase, Cochrane Library, CINAHL, China National Knowledge Infrastructure, Wanfang Data, and VIP regarding qualitative studies on CAT patients' prevention and management journey experiences and needs, from database inception to June 30, 2024. The quality of included literature was assessed using the 2024 version of the Joanna Briggs Institute (JBI) Qualitative Research Quality Appraisal Criteria. Findings were synthesized using a Meta-synthesis approach.Results:A total of 13 studies were included, from which 104 themes were extracted and categorized into 12 new categories, ultimately integrated into three synthesized findings: tasks change as the journey progresses; emotions gradually shift from negative to positive; pain points are key areas to improve the journey experience.Conclusions:CAT patients experience varying journey-related experiences and needs. Healthcare providers should identify key management content at each stage to meet patients' multidimensional and diverse prevention and management needs, constructing individualized management plans oriented to CAT journey requirements.

Objective:To explore the application value of echocardiography in the management of pediatric mitral valve replacement.Methods:Thirty-three children who underwent mitral valve replacement at Union Hospital Tongji Medical College Huazhong University of Science and Technology from January 2009 to June 2023 were retrospectively analyzed. Clinical data and preoperative and postoperative echocardiographic data were collected. The differences in ultrasound parameters among preoperative，1-week postoperative，1-month postoperative and 1-year postoperative were compared.Results:Of the 33 children，there were 4 cases（12.12%）of mitral stenosis，33 cases（100%）of mitral regurgitation and 4 cases（12.12%）of mitral stenosis combined with regurgitation. Mechanical valve replacement was performed in 30 cases（90.91%）and bioprosthetic valve replacement in 3 cases（9.09%）. Compared with the preoperative period，the left atrial internal diameter and left ventricular end-diastolic internal diameter were significantly reduced at 1-week postoperatively，1-month postoperatively，and 1-year postoperatively，respectively（all P <0.05）.The left ventricular mass was significantly reduced and the left ventricular end-diastolic sphericity index was significantly increased（both P < 0.05）at 1-month postoperatively compared with preoperatively. The left ventricular ejection fraction was significantly higher at 1-year postoperatively compared with 1-week postoperatively（ P <0.05）. Conclusions:After pediatric mitral valve replacement，the left ventricular dimensions decrease，and cardiac function progressively recovers. Echocardiography is an essential tool for accurate preoperative assessment and postoperative follow-up in pediatric mitral valve replacement.

Objective:To explore the application value of echocardiography in the management of pediatric mitral valve replacement.Methods:Thirty-three children who underwent mitral valve replacement at Union Hospital Tongji Medical College Huazhong University of Science and Technology from January 2009 to June 2023 were retrospectively analyzed. Clinical data and preoperative and postoperative echocardiographic data were collected. The differences in ultrasound parameters among preoperative，1-week postoperative，1-month postoperative and 1-year postoperative were compared.Results:Of the 33 children，there were 4 cases（12.12%）of mitral stenosis，33 cases（100%）of mitral regurgitation and 4 cases（12.12%）of mitral stenosis combined with regurgitation. Mechanical valve replacement was performed in 30 cases（90.91%）and bioprosthetic valve replacement in 3 cases（9.09%）. Compared with the preoperative period，the left atrial internal diameter and left ventricular end-diastolic internal diameter were significantly reduced at 1-week postoperatively，1-month postoperatively，and 1-year postoperatively，respectively（all P <0.05）.The left ventricular mass was significantly reduced and the left ventricular end-diastolic sphericity index was significantly increased（both P < 0.05）at 1-month postoperatively compared with preoperatively. The left ventricular ejection fraction was significantly higher at 1-year postoperatively compared with 1-week postoperatively（ P <0.05）. Conclusions:After pediatric mitral valve replacement，the left ventricular dimensions decrease，and cardiac function progressively recovers. Echocardiography is an essential tool for accurate preoperative assessment and postoperative follow-up in pediatric mitral valve replacement.

Objective:To understand residents' health status and disease characteristics by analyzing the disease spectrum and disease patterns of the entire population and elderly hospitalized patients in Tianjin between 2018 and 2020, thus providing scientific evidence for disease prevention and treatment.Methods:Information on the first page of inpatient medical records from 77 secondary or higher-level hospitals was provided by the Tianjin Health and Medical Big Data Platform.The codes of the International Classification of Diseases 10th revision(ICD-10)were used by the system for standardized diagnoses at hospital discharge.The disease spectrum of inpatients was analyzed based on the systems implicated by diseases.Age stratification was performed in examining changes in the orders of diseases across the spectrum.Results:Between 2018 and 2020, a total of 3 568 034 patients were discharged, with 1 204 733 in 2018, 1 372 747 in 2019, and 990 554 in 2020.Male patients accounted for 49.2%(1 756 867/3 568 034), elderly patients(65 years or older)accounted for 33.5%(1 194 189/3 568 034), and patients from tertiary hospitals accounted for 86.5%(3 085 482/3 568 034).According to the ICD-10, there were 19 categories of diseases when diagnoses at discharge were considered.Over the three-years period, the top ten diseases made up 81.1%(2 893 430/3 568 034)of all cases at discharge, with high consistency in their rankings(harmonic index value Wa=0.986, χ2=70.989, P<0.001).The circulatory system and the nervous system always occupied the top two positions, while the respiratory system decreased from third to seventh place in 2020.The rankings of factors affecting health and healthcare access increased.The circulatory system, nervous system, respiratory system, digestive system, and tumors consistently ranked among the top six categories in the disease spectrum of the elderly and the rankings of diseases related to the eye, ear, endocrine system, musculoskeletal system, and connective tissue system were also up compared to those of the entire population. Conclusions:Hospitalized patients are concentrated in tertiary hospitals, with a relatively high proportion of elderly patients.In the disease spectrum, circulatory system diseases, neurological system diseases, digestive system diseases, tumors, and respiratory system diseases have always been at the top of the list for medical treatment, both for the entire population and for elderly patients, with a significant decrease in the ranking of respiratory system diseases in 2020.The rankings of eye, ear, endocrine, musculoskeletal, and connective tissue diseases in elderly patients have increased compared to the entire population, indicating a need to step up the development of geriatric medicine and related specialties and the importance to promote the healthy China initiative and healthy aging.

Rheumatoid arthritis (RA) is a prevalent autoimmune disease characterized by chronic inflammation and excessive proliferation of the synovium. Currently, treatment options focus on either reducing inflammation or inhibiting synovial hyperplasia. However, these modalities are unsatisfactory in achieving the desired therapeutic outcomes. Halofuginone hydrobromide (HF), an herbal active ingredient, has demonstrated pharmacological effects of both anti-inflammation and inhibition of synovial hyperplasia proliferation. However, HF's medical efficacy is limited due to its poor water solubility, short half-life (t _1/2), and non-target toxicity. In the current study, by using the advantages of nanotechnology, we presented a novel dual-targeted nanocomplex, termed HA-M@P@HF NPs, which consisted of a hyaluronic acid (HA)-modified hybrid membrane (M)-camouflaged poly lactic-co-glycolic acid (PLGA) nanosystem for HF delivery. These nanocomplexes not only overcame the limitations of HF but also achieved simultaneous targeting of inflammatory macrophages and human fibroblast-like synoviocytes-RA (HFLS-RA). In vivo experiments demonstrated that these nanocomplexes effectively suppressed immune-mediated inflammation and synovial hyperplasia, safeguarding against bone destruction in rats with adjuvant-induced arthritis (AIA). Remarkable anti-arthritic effects of these nanocomplexes were accomplished through promoting repolarization of M1-to-M2 macrophages and apoptosis of HFLS-RA, thereby offering a promising therapeutic strategy for RA.

Rheumatoid arthritis(RA)is a prevalent autoimmune disease characterized by chronic inflammation and excessive proliferation of the synovium.Currently,treatment options focus on either reducing inflam-mation or inhibiting synovial hyperplasia.However,these modalities are unsatisfactory in achieving the desired therapeutic outcomes.Halofuginone hydrobromide(HF),an herbal active ingredient,has demonstrated pharmacological effects of both anti-inflammation and inhibition of synovial hyperplasia proliferation.However,HF's medical efficacy is limited due to its poor water solubility,short half-life(ti/2),and non-target toxicity.In the current study,by using the advantages of nanotechnology,we presented a novel dual-targeted nanocomplex,termed HA-M@P@HF NPs,which consisted of a hyaluronic acid(HA)-modified hybrid membrane(M)-camouflaged poly lactic-co-glycolic acid(PLGA)nanosystem for HF delivery.These nanocomplexes not only overcame the limitations of HF but also achieved simultaneous targeting of inflammatory macrophages and human fibroblast-like synoviocytes-RA(HFLS-RA).In vivo experiments demonstrated that these nanocomplexes effectively suppressed immune-mediated inflam-mation and synovial hyperplasia,safeguarding against bone destruction in rats with adjuvant-induced arthritis(AIA).Remarkable anti-arthritic effects of these nanocomplexes were accomplished through promoting repolarization of M1-to-M2 macrophages and apoptosis of HFLS-RA,thereby offering a promising therapeutic strategy for RA.

The latest epidemiological data suggests that the situation of adult diabetes in China is severe, and metabolic diseases have become significant chronic illnesses that have a serious impact on public health and social development. After more than six years of practice, the National Metabolic Management Center(MMC) has developed distinctive approaches to manage metabolic patients and has achieved a series of positive outcomes, continuously advancing the standardized diagnosis and treatment model. In order to further improve the efficiency, based on the first edition, the second edition guideline was composed by incorporating experience of the past six years in conjunction with the latest international and domestic guidelines.