Sepsis presents challenges in clinical treatment due to its high incidence,difficult treatment,and high fatality rate.The intestine has long been considered the"motor"of multiple organ dysfunction syndrome(MODS).Intestinal dysfunction is one of the common complications of sepsis,which is often neglected due to its hidden occurrence and poor clinical efficacy,leading to poor prognosis.Therefore,it is of great significance to explore the pathogenesis and treatment of intestinal dysfunction in sepsis.As an effective supplement for the clinical treatment of intestinal dysfunction in sepsis,Traditional Chinese medicine has been paid more and more attention by clinicians.This article summarizes the research progress on the pathogenesis of sepsis-induced intestinal dysfunction and the clinical application of traditional Chinese medicine(TCM),aiming to provide more ideas and references for the clinical treatment of sepsis.

Objective:To analyze the risk factors of multidrug-resistant organism（MDRO）infection among patients in neurosurgery intensive care unit（NSICU）and to construct a risk prediction nomogram.Methods:A total of 434 patients admitted in the NSICU of the First Affiliated Hospital of Kangda College of Nanjing Medical University from August 2021 to October 2022 were enrolled in the study. Patients were divided into modeling group（ n=217）and validation group（ n=217）. Multivariate Logistic regression was used to analyze the risk factors of MDRO infection in patients，and R software was used to construct a risk prediction nomogram.The prediction power of the nomogram was evaluated with receiver operating characteristic（ROC）curve，the calibration of the model was assessed with Hosmer-Lemeshow（H-L）goodness-of-fit method. Results:Multivariate Logistic regression analysis showed that the underlying disease≥3（ OR=2.580，95% CI 1.322-5.035），the combination of antimicrobial drugs >10 days（ OR=2.336，95% CI 1.182-4.615），hypoproteinemia（ OR=1.962，95% CI 1.031-3.735），invasive operation time（10-20 d： OR=2.358，95% CI 1.048-5.306；>20 d： OR=3.486，95% CI 1.643-7.395）and GCS≤8 points（ OR=2.961，95% CI 1.470-5.963）were independent risk factors of MDRO infection among patients in NSICU. The area under the curve（AUC）of the nomogram in predicting the risk of MDRO infection for patients in modeling group was 0.787（95% CI 0.725-0.849）with a sensitivity of 73.3% and a specificity of 72.5%，the H-L test results were χ2=7.482， P=0.486，the calibration curve was close to the ideal curve，and the mean absolute error was 0.022. The AUC of the nomogram in predicting MDRO infection for patients in verification group was 0.800（95% CI 0.739-0.861）with a sensitivity of 74.7% and a specificity of 73.9%，the H-L test results were χ2=9.824， P=0.278，the calibration curve was close to the ideal curve，and the average absolute error was 0.015. Conclusion:The nomogram constructed based on the risk factors can effectively predict the risk of MDRO infection for patients in neurosurgical ICU，which may be used in clinic pratcice.

Objective:To understand the epidemiological characteristics of public health emergency events (PHEE) of varicella in China from 2006 to 2021 and related response performances.Methods:The data of varicella PHEE in 31 provinces of China from 2006 to 2021 were collected through the Public Health Emergency Management Information System, Microsoft Excel 2019 software and SPSS 26.0 statistical software were used to conduct descriptive epidemiological, statistical analysis on the time, area, location distribution, scale and epidemic management.Results:A total of 11 443 PHEE involving 341 048 related cases were reported from 2006 to 2021, with an annual attack rate of 1.78%-3.80% and a total attack rate of 2.33% (341 048/14 624 042). The number of PHEE and related cases of varicella decreased from 1 107 (35 349) in 2007 to 262 (6 884) in 2012 ( Z=-2.40, P<0.001), then increased year by year to 1 318 (42 649) in 2019 ( Z=2.58, P<0.001), with a significant decline since 2020. The varicella PHEE in China presents the seasonal characteristics,the peak is from April to June and from October to December, respectively. The sub-peak of varicella PHEE in eastern China generally appears 1-2 months earlier than in central and western China. Varicella PHEE reports are mainly distributed in eastern China, the attack rate is relatively high in western China, school-reported varicella PHEE was 88.26% of the total reports (10 099/11 443). The epidemic scale of varrcella PHEE typically range from 10 to 29 cases per year among the given outbreaks. The M ( Q1, Q3) of average number of cases, average duration, and average reporting interval of PHEE were 23 (16,35), 20 (14, 26) days, and 9 (5,19) days, respectively, and the reporting interval was positively correlated with the duration ( r=0.854, P<0.001). Conclusions:The varicella PHEE in China from 2006 to 2021 has not been effectively controlled. Schools are the key places to prevent and control varicella PHEE. Improving the sensitivity of varicella PHEE monitoring, strengthening the timely disposal of varicella epidemic, and promoting varicella vaccination are effective measures to prevent and control varicella PHEE.

AIM: To observe the effect ofacacia honey (AH) on serum uric acid level and renal function in potassium oxonate modelrats after drinking AH aqueous solution. METHODS: Sixty male SD rats were selected and randomly divided into control group (CON group), potassium oxonate model group (OA model group), 10% fructose group (10% F group) and different concentration honey groups (25%, 12.5% and 6.25% AH groups). All rats were fed with normal diet.The rats in CON group were subcutaneously injected with 5% sodium carboxymethyl cellulose (CMC-Na) solution and drunk sterile water every day, while rats in other groups were injected with 100 mg / kg OA solution suspended with 5% CMC-Na subcutaneouslyand drunksterile water orfructose solution or AH solution of different concentrations every day. Before and during the 4-week test, rats were weighed and blood was taken once a week. At the end of test, urine and feces specimens or kidney tissues were collected and blood was taken from the abdominal aorta. The uric acid content in blood, urine, and feces and the levels of serum creatinine (Cre) and blood urea nitrogen (BUN) or inflammatory factors in kidney tissues were measured. Renal function and histology were evaluated. RESULTS: Compared with CON group, AH could significantly reduce the body weight of rats (P<0.05), increase the kidney organ coefficient, the levels of serum uric acid, and uric acid in urine or feces, and reduce the level of fecal uric acid (FUA) in rats. AH can down regulate the level of tumor necrosis factor alpha (TNF-a) (P< 0.05) and up regulate the expression of monocyte chemoattractant protein 1 (MCP-1) and transforming growth factor β - 1 (TGF - β1) in rats kidneys; AH can cause slight to mild dilatation of renal tubules and mild to moderate basophilic lesions of renal rubules in rat kidney in a dose dependent manner. CONCLUSION: In the doses rang of present study, AH can cause hyperuricemia, renal tubular dilatation and basophilic lesions, and lead to renal function damage in rats.

ObjectiveTo analyze the quality changes of Platycladi Semen before and after the deterioration of moth-eaten and rancidity during storage. MethodFour types samples of Platycladi Semen， including normal， moth-eaten， oxidative rancidity and hydrolytic rancidity， were determined for volatile components， odor， and taste based on headspace solid phase microextraction/gas chromatography-mass spectrometry （HS-SPME/GC-MS） and electronic sensory techniques such as electronic nose and electronic tongue. Volatile components were identified by searching the database and manual comparison， the odor and taste were determined by the response values of the electronic nose and electronic tongue sensors， and the difference between samples before and after deterioration was studied by multivariate statistical analysis. ResultA total of 85 compounds were identified in Platycladi Semen samples. Compared with the normal samples， the number of volatile compounds in samples after hydrolytic rancidity decreased by 5， the number of volatile compounds in samples after moth-eaten and oxidative rancidity increased by 1 and 21， respectively. Aldehydes and acids accounted for majority of types. Among them， the contents of N-hexanoic acid， hexanal and propionic acid in the samples of oxidative rancidity reached 11.49%， 10.21% and 7.52%， which became the key indicators of rancidity. There was significant variance among the odor components corresponding to W1W， W2W and W1S sensors by electronic nose analysis. It was indicated that the value of sourness in deteriorated samples generally increased by mean of electronic tongue analysis. Compared with normal samples， the moth-eaten samples had changed slightly and rancidity samples had changed significantly especially oxidative rancidity samples of volatile components， odor and taste by multivariate statistical analysis. ConclusionIn terms of Platycladi Semen， the oxidative rancidity caused by nature storage for 12 months has the greatest impact on the quality. Therefore， it should be mainly to prevent oxidative rancidity to ensure the quality of Platycladi Semen.

A new definition of metabolic dysfunction-associated fatty liver disease (MAFLD) has recently been proposed. We aim to examine the associations of MAFLD, particularly its discordance from non-alcoholic fatty liver disease (NAFLD), with the progression of elevated brachial-ankle pulse wave velocity (baPWV) and albuminuria in a community-based study sample in Shanghai, China. After 4.3 years of follow-up, 778 participants developed elevated baPWV and 499 developed albuminuria. In comparison with the non-MAFLD group, the multivariable adjusted odds ratio (OR) of MAFLD group for new-onset elevated baPWV was 1.25 (95% confidence interval (CI) 1.01-1.55) and 1.35 (95% CI 1.07-1.70) for albuminuria. Participants without NAFLD but diagnosed according to MAFLD definition were associated with higher risk of incident albuminuria (OR 1.77; 95% CI 1.07-2.94). Patients with MAFLD with high value of hepamet fibrosis score or poor-controlled diabetes had higher risk of elevated baPWV or albuminuria. In conclusion, MAFLD was associated with new-onset elevated baPWV and albuminuria independently of body mass index, waist circumference, and hip circumference. Individuals without NAFLD but diagnosed as MAFLD had high risk of albuminuria, supporting that MAFLD criteria would be practical for the evaluation of long-term risk of subclinical atherosclerosis among fatty liver patients.
Humans ; Pulse Wave Analysis ; Albuminuria ; Ankle Brachial Index ; Non-alcoholic Fatty Liver Disease/diagnosis* ; Vascular Stiffness ; Prospective Studies ; Risk Factors ; China/epidemiology*

OBJECTIVE：To know about the research status of health utility value obtained by mapping method in pharmacoeconomic evaluation ，and to provide reference for bibliometric study in pharmacoeconomic evaluation . METHODS ： Using“Mapping method ”“Health utility value ”“Cost-utility”“Utility point system ”as Chinese and English keywords ，retrieved from CNKI ，Wanfang database ，PubMed，Medline，Ebsco，Ovid and Wiley database ，empirical journal documents published from the inception to Dec. 31st，2018 about using mapping method to obtain health utility value were collected. The bibliometrics was used to statistically analyze basic information of included literature ，the construction and test of the model ，the type of the best model and so on. RESULTS ：The 124 included documents were all published in English journal. In the construction and testing of the mapping model ，the most frequently used econometric methods ，performance evaluation indicators and model testing methods were ordinary least squares （OLS），mean absolute error （MAE）and residual normality test ，application frequency of which were 97 times（31.60％），89 times（24.93％）and 62 times（21.09％）. There are 117 articles that define the best mapping model ，of which 101 articles（86.32％）have the best direct mapping effect. Most of the non-utility measurement scales adopted specific scales （92 articles，77.97％），and a few literatures adopted the universal scale （26 articles，22.03％）. The most utility measurement scales were 3-level European 5-dimensional health scale （79 articles，66.95％）. CONCLUSIONS ：The domestic empirical researches that use the mapping method to obtain health utility values need to be developed yet. A series of mapping models successfully developed by foreign scholars not only provide the feasibility of using non-utility measurement scales for cost-utility analysis ，but also provide more ideas for China to choose the corresponding econometric methods ，evaluation indicators and mapping methods in the empirical research of the mapping method in the future.

Objective To study the application of combined detection of serum eosinophil cationic protein (ECP) ,C reactive protein (CRP ) and fractional exhaled nitric oxide (FeNO ) in the bronchial asthma . Methods 50 patients of bronchial asthma who received therapy from October 2014 to October 2016 in Tangs-han city union hospital were selected as research objects ,and selected 50 healthy people who received physical examination at the same time in the hospital as control group .The expression of serum ECP and CRP was de-tected by enzyme-linked immunosorbent assay ,and the FeNO concentration was detected using FeNO detec-tor .The expressions of serum ECP ,CRP and FeNO between the bronchial asthma group and the control group were compared ,and the expressions of serum ECP ,CRP and FeNO in patients with different severity of bron-chial asthma were compared ;the bronchial asthma group received 3 months of symptomatic treatment ,The ex-pression of serum ECP ,CRP and FeNO in patients with different therapeutic effects were compared .Results The serum ECP ,CRP and FeNO in the bronchial asthma group [(15 .86 ± 1 .47)ng/L ,(4 .87 ± 0 .52)mg/L , (61 .23 ± 11 .52)ppb]were significantly higher than those in the control group [(6 .62 ± 0 .63)ng/L ,(1 .04 ± 0 .23)mg/L ,(23 .58 ± 3 .40)ppb] ,the difference was statistically significant (P＜0 .05) ;The serum ECP ,CRP and FeNO in the acute attack of bronchial asthma[(18 .56 ± 1 .85)ng/L ,(5 .74 ± 0 .70)mg/L ,(66 .93 ± 10 .62) ppb] were higher than those in the remission stage[(12 .34 ± 1 .47)ng/L ,(3 .69 ± 0 .37)mg/L ,(54 .54 ± 8 .02) ppb] ,the difference was statistically significant (P＜0 .05) ;The patients with bronchial asthma were treated 3 months later ,clinical control in 28 cases ,partial control in 18 cases ,uncontrolled in 4 cases ,the serum ECP , CRP and FeNO in the clinical control group were significantly lower than those in the partial control group and the uncontrolled group ,the difference was statistically significant (P＜0 .05) .Conclusion The combined detection of serum ECP ,CRP and FeNO expression in patients with bronchial asthma is helpful to understand the severity of the disease ,it′s of positive significance in the early diagnosis and treatment of diseases .

This study elaborates on the content of caregiving preparation, the related theory model, the relevant evaluation tools and the intervention effect of caregiving preparation for stroke caregivers, in order to provide reference for health education, discharge guidance and nursing intervention research of stroke caregivers.

Objective? To explore the change regulation of periodical needs of main caregivers during transition period from being admitted to hospital to home among patients with initial stroke in 9 hospitals in Shanghai Pudong New Area and to analyze the reasons. Methods? From May 2017 to January 2018, we selected 1 200 initial stroke patients and 1 200 main caregivers of them in 9 hospitals of Shanghai Pudong New Area as subjects by convenience sampling. The Family Needs Questionnaire (FNQ) was used to investigate the change of needs of them on admission, at discharge and two weeks after discharge. A total of 1 200 questionnaires were sent out and 1 089 valid questionnaires were collected. Results? Among 1 089 main caregivers of initial stroke patients, the scores of importance of total demand on admission, at discharge and two weeks after discharge were (3.44±0.77),(3.24±0.82) and (3.01±0.71) respectively with statistical differences (P＜ 0.05). At different stages, the need for health information and need for professional support were two dimensions with the high importance of care need of main caregivers among initial stroke patients; the stage with the highest satisfaction with the total demand was at discharge; the items with high rates of no satisfaction with needs included "to be shown that my opinions are used in planning the treatment" "to have enough resource for myself" and "to be shown what to do when the patient is upset" on admission, at discharge and two weeks after discharge. Conclusions? The importance of total demand of main caregivers of initial stroke patients decreases with the increasing of disease course on admission, at discharge and two weeks after discharge. The need satisfaction is high at the stage of discharge and is low after discharge. Medical staff should strengthen the family follow-up.