【Objective】 To explore the correlation between body mass index (BMI) and lipid indexes with prostate volume in patients with benign prostatic hyperplasia (BPH) so as to provide reference for the clinical prevention of this disease. 【Methods】 Clinical data of 578 patients admitted to the Department of Urology of Chinese PLA General Hospital during Jan.2014 and Dec.2022 were collected.The patients underwent initial prostate puncture biopsy or prostatectomy and BPH was confirmed pathologically.The patients’ age, time of onset of the disease, BMI, past medical history and biochemical indexes were analyzed.According to the total prostate volume (TPV) grading, the patients were divided into TPV>75 mL and TPV≤75 mL groups.The general data of the two groups were compared, and predictors of TPV were determined with linear regression analysis.The samples were stratified with BMI to observe the differences in the effects of apolipoprotein B (ApoB) on TPV. 【Results】 There were 215 cases in the TPV>75 mL group and 363 cases in the TPV≤75 mL group.The levels of BMI, triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and apolipoprotein B (ApoB) were higher in the TPV>75 mL group (P<0.01).Multivariate linear regression analysis showed that age (β=0.604, P=0.003), BMI (β=2.000, P<0.001), ApoB (β=23.792, P<0.001) and TPV had a significant positive linear correlation; after adjusting for the confounders of age and BMI, ApoB was not linearly correlated with TPV in BPH population with BMI<24 (P>0.05), and ApoB predicted prostate volume growth in overweight and obese BPH population respectively (β=26.411, P=0.011; β=47.602, P=0.017). 【Conclusion】 Age, ApoB and BMI can be used as predictors of volume growth in BPH patients, which can help further research on the pathogenesis and progression of BPH.

The difference in the crystal form of the drug leads to different solubility and stability,affecting drug's the clinical efficacy and bioavailability.Therefore,in recent years,drug crystal forms have received more and more attention from researchers.By reviewing and sorting out relevant literature,this paper summarizes the research progress of drug crystallization theory in recent years from the aspects of influencing factors of drug crystal form,identification and control of drug crystal form,drug crystal form evaluation methods,and applications,aiming to provide a reference for drug crystal form control and process screening.

Traditional Chinese medicine monomer has certain curative effects in tumor treatment,but its low targeting and difficulty in gathering at the tumor site limit its application.As a new type of drug delivery method,environmentally responsive nano drug delivery system has the advantages of targeted drug delivery,reducing drug side effects,and environmentally responsive release,and has been widely used in tumor treatment.In this paper,by consulting and sorting out the relevant literature,the general situation of traditional Chinese medicine monomers in the treatment of tumors,the classification of environment-responsive traditional Chinese medicine monomer nano drug delivery system,and its application in tumor treatment are summarized in three aspects,to provide ideas for solving the limitations of traditional Chinese medicine monomer in the treatment of tumor.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective: To explore the association between incidence of injuries and health related behavior among middle school students in China, to provide evidence for injury prevention. Methods: A questionnaire survey was conducted among 1 067 students who were selected from Zhejiang, Guangdong, Jiangxi, Sichuan and Guizhou provinces by using stratified random cluster sampling method. Chi square test and multiple Logistic regression analyses were used to analyze incidence of injuries and health related behavior. Results: The prevalence of self injury among middle school students in five provinces was 11.0%, the prevalence of intentional injury was 13.2%. Multiple Logistic regression analyses showed that attempting smoking, not eating breakfast every day, having a low mood more than 2 weeks in the past 6 months were positively correlated with self injury ( OR=3.02, 2.04, 4.30, P ＜0.01) after adjusting for region, and the smoking attempt behavior was positively correlated with intentional injury ( OR=2.03, P ＜0.05) after adjusting for region, urban and rural, residence condition, weekly allowance condition. Conclusion Smoking attempt behavior could be viewed as a shared predictor for both self injury and intentional injury behavior among middle school students, smoking control intervention should be carried out actively among students.

Objective:To analyze the epidemic characteristics and clinical key indicators of the patients infected with SARS-CoV-2 of the local Omicron variant epidemic, to understand the clinical characteristics of mild and severe patients, and to provide a scientific basis for the effective treatment and prevention of severe disease.Methods:From January 2020 to March 2022, the clinical and laboratory data of COVID-19 patients admitted to the Fifth People's Hospital of Wuxi were retrospective analyzed, including virus gene subtypes, demographic information, clinical classification, main clinical symptoms, and key indicators of clinical testing, and the changes of clinical characteristics of the patients infected with SARS-CoV-2.Results:A total of 150 patients with SARS-CoV-2 infection were admitted, 78, 52 and 20 in 2020, 2021 and 2022, including 10, 1 and 1 severe patient, and the main infected virus strains were L, Delta, and Omicron variants. The relapse rate of patients infected with the Omicron variant was as high as 15.0% (3/20), the incidence of diarrhea decreased to 10.0% (2/20), the incidence of severe disease decreased to 5.0% (1/20), and the number of hospitalization days of mild patients increased compared with 2020 (days: 20.43±1.78 vs. 15.84±1.12); respiratory symptoms were reduced, and the proportion of pulmonary lesions decreased to 10.5%; the virus titer of severely ill patients with SARS-CoV-2 Omicron variant infection (day 3) was higher than that of L-type strain (Ct value: 23.92±1.16 vs. 28.19±1.54). The acute plasma cytokines interleukin (IL-6, IL-10) and tumor necrosis factor-α (TNF-α) were significantly lower in patients with severe Omicron variant new coronavirus infection than those with mild disease [IL-6 (ng/L): 3.92±0.24 vs. 6.02±0.41, IL-10 (ng/L): 0.58±0.01 vs. 4.43±0.32, TNF-α (ng/L): 1.73±0.02 vs. 6.91±1.25, all P < 0.05], while γ-interferon (IFN-γ) and IL-17A were significantly higher than patients with mild disease [IFN-γ (ng/L): 23.07±0.17 vs. 13.52±2.34, IL-17A (ng/L): 35.58±0.08 vs. 26.39±1.37, both P < 0.05]. Compared with previous epidemics (2020 and 2021), the proportion of CD4/CD8 ratio, lymphocyte count, eosinophil and serum creatinine decreased in patients with mild Omicron infection in 2022 (36.8% vs. 22.1%, 9.8%; 36.8% vs. 23.5%, 7.8%; 42.1% vs. 41.2%, 15.7%; 42.1% vs. 19.1%, 9.8%), the proportion of patients with elevated monocyte count and procalcitonin was large (42.1% vs. 50.0%, 23.5%; 21.1% vs. 5.9%, 0). Conclusion:The incidences of severe disease in patients with SARS-CoV-2 Omicron variant infection was significantly lower than that of previous epidemics, and the occurrence of severe diseases was still related to the underlying diseases.

Objective:To explore the status of psychological safety behavior in inpatients and its correlation with perceived participation.Methods:From June 2021 to January 2022, 900 inpatients admitted to 2 secondary hospitals and 2 tertiary hospitals in Yantai, Shandong Province were selected as the research objects using the convenience sampling method. General information questionnaires, Psychological Safety Questionnaire and Patient Perceived Participation Scales were used to investigate inpatients. Hierarchical regression analysis was used to explore the relationship between psychological safety behavior and perceived participation in inpatients. A total of 900 questionnaires were distributed in this study, and 886 valid questionnaires were recovered, with an effective recovery rate of 98.44%.Results:The total score of the Psychological and Behavioral Safety Questionnaire of 886 inpatients was (98.97±16.52), and the item average score was (2.91±0.38) ; the total score of the Patient Perception Participation Scale was (36.59±4.91), and the item average score was (2.81±0.35). The results of Pearson correlation analysis showed that the total score of Psychological Behavioral Safety Questionnaire was negatively correlated with the total score of the Patient Perception Participation Scale ( r=-0.358, P<0.01). Hierarchical regression analysis showed that patient perception was the influencing factor of psychological safety behavior, which could independently explain 25.6% of the variance in psychological safety behavior. Conclusions:The psychological safety behavior of inpatients is at a moderate level, and the perceived participation of inpatients is the influencing factor of psychological safety behavior. Medical staff should improve the level of perceived participation so as to reduce the risk of psychological safety behavior.

Objective:To explore the application rules and effects of "Four Elements, One Peptide, and Two Transplantations" in the bundle treatment of the patients with coronavirus disease 2019 (COVID-19), so as to provide a scientific evidence for effective treatment and prevention of severe type.Methods:A retrospective comparative study method was used to analyze the clinical data of COVID-19 patients admitted to Wuxi Fifth People's Hospital from January 2020 to March 2022, including demographic information, underlying diseases, clinical classification, length of hospital stay, treatment cost, clinical symptoms, laboratory tests and other key indicators, and evaluate the application rules and effect of "Four Elements, One Peptide, and Two Transplantations" in the bundle treatment of the patients with COVID-19.Results:The L-type new coronavirus strain was predominant in 2020, the Delta variant in 2021, and the Omicron variant in 2022. The proportion of mild cases was highest in 2022, with the highest proportion of > 65 years old patients developing severe and critical. Among the 150 patients, the proportion of interferon use (100.0%) was the highest in the bundle treatment regimen of "Four Elements, One Peptide, and Two Transplantation". The combined use of vitamin C, interferon and thymopeptide was highest in 2022. More than 75.0% of the age > 65 years old group had underlying diseases, which was also the age group with the highest proportion of "Four Elements, One Peptide, and Two transplantations". Compared with mild cases, the age, length of hospital stay, and hospitalization cost of patients with COVID-19 increased significantly with severity. Mild, ordinary, severe, and critically ill patients all had low lymphocyte counts, with 40.0% of severe patients having the lowest lymphocyte counts within 3 days of admission. The lymphocyte count of critically ill patients was reduced or continuously reduced after admission, and the use of the "Four Elements, One Peptide, and Two transplantations" method to regulate immunity can effectively save the lives of critically ill patients. Of all cases of COVID-19 infection, 51.3% were asymptomatic, followed by respiratory symptoms (48.7%) and lung lesions (38.0%). Patients with renal dysfunction received this bundle therapy was highest, followed abnormal coagulation and abnormal liver function. This bundle therapy promoted a significant increase in CD4 + T lymphocytes and B lymphocytes in various cases. After treatment, as the virus turns negative, the proportion of M1 type macrophages increased, and the proportion of regulatory T cell (Treg cells) that suppress immunity and the infection related C-C chemokine receptor type (CCR10 +) Treg cells decreased. Mild adult cases showed a great change and declined rapidly. Conclusions:Advanced age with underlying diseases is a risk factor for severe disease of COVID-19, the "Four Elements, One Peptide, and Two transplantations" bundle fine treatment of COVID-19 can improve the proportion of lymphocyte composition and organ function, which can control the occurrence and development of severe diseases. In addition to the proportion of CD4 + T cells, the changes of the M1 macrophage, total Treg cell, and CCR10 + Treg cell proportions can be used to determine disease changes of adult patients.

Objective:To assess the predictors of outcomes for different subtypes of liver failure, and the effectiveness of artificial liver support systems in the treatment of liver failure.Methods:The clinical data of 112 patients with hepatitis B virus (HBV)- and non-HBV-related liver failure admitted to the intensive care unit (ICU) of the Fifth People's Hospital of Wuxi were collected from January to December 2020. The relevant etiologies of acute, subacute, acute-on-chronic, subacute-on-chronic, chronic subtype liver failure were analyzed. The efficacies of artificial liver support systems in the treatment of various subtypes of liver failure were also compared. The correlation of various indicators was analyzed by Spearman correlation analysis, the risk factors affecting the prognosis of patients with liver failure were analyzed by multivariate Logistic regression equation, and receiver operator characteristic curve (ROC curve) of subjects was plotted to evaluate the predictive value of each risk factor for the prognosis of patients with liver failure.Results:Among the 112 liver failure patients, 63 were caused by hepatitis B and 49 were caused by non-hepatitis B. The liver failure caused by hepatitis B was 6 times higher than for men than for women, which was higher than that of non-HBV liver failure group (1.33 times). Antithrombin Ⅲ (AT Ⅲ) and total bilirubin (TBil) levels of subacute liver failure were higher than those of pre-liver failure in the HBV liver failure group [AT Ⅲ: (59.33±14.57)% vs. (35.66±20.72)%, TBil (μmol/L): 399.21±112.94 vs. 206.08±126.96, both P < 0.05]. The levels of AT Ⅲ in patients with pre-liver failure and chronic liver failure in the non-HBV liver failure group were significantly higher than those with acute liver failure [(58.33±15.28%), (44.00±19.10)% vs. (31.33±7.57)%, both P < 0.05], patients with acute liver failure had significantly lower level of TBil than pre-liver failure (μmol/L: 107.83±49.73 vs. 286.20±128.92, P < 0.05), the TBil levels in patients with subacute and acute-on-chronic liver failure were also significantly higher than that in pre-liver failure group (μmol/L: 417.27±118.60, 373.00±187.00 vs. 286.20±128.92, both P < 0.05). Patients with subacute liver failure, subacute-on-chronic liver failure and chronic liver failure in the non-HBV failure group were significantly longer than those in acute liver failure (days: 36.00±8.31, 27.52±11.71, 27.72±22.71 vs. 11.00±1.41, all P < 0.05). There was no statistically significant difference in the case fatality rate of using the artificial liver support system between the HBV failure group and the non-HBV failure group (55.6% vs. 50.0%, P < 0.05), the levels of AT Ⅲ in the two groups of surviving patients were significantly higher than that of the dead [HBV liver failure group: (36.20±6.26)% vs. (27.33±8.87)%, non-HBV liver failure group: (41.06±4.16)% vs. (28.71±12.35)%, both P < 0.01]. Correlation analysis showed that there was a clear positive correlation between AT Ⅲ and TBil in the dead patients of HBV liver failure group and the survival and death patients of non-HBV liver failure group ( r values were 0.069, 0.341, 0.064, and P values were 0.723, 1.196 and 0.761, respectively); there was a significant inverse correlation between AT Ⅲ and TBil in the HBV liver failure group ( r = -0.105, P = 0.745). Multivariate Logistic regression analysis showed that AT Ⅲ was an independent risk factor affecting the prognosis of patients with non-HBV liver failure [odd ratio ( OR) = 1.023, 95% confidence interval (95% CI) was -0.001 to 0.001, P = 0.007]. TBil was an independent risk factor affecting prognosis of patients with HBV liver failure ( OR = 1.005, 95% CI was -0.002 to -7.543, P = 0.033). The analysis of ROC curve showed that AT Ⅲ had a predictive value for the prognosis of patients with non-HBV liver failure, the area under the ROC curve (AUC) = 0.747, the 95% CI was 0.592-0.902, P = 0.009. When the optimal truncation value was 39.5%, its sensitivity and specificity were 83.33% and 56.25%, respectively. Conclusions:Artificial liver support system treatment of liver failure was difficult to effectively reduce the mortality of patients with end-stage liver failure. In addition to AT Ⅲ, TBil also could be used as an indicator to assess liver compensatency and predict prognosis in liver failure patients.