To investigate the prevalence and associated factors of fall risk among Chinese older adults, and to examine the roles of urban-rural differences, regional disparities, physical health status, and psychosocial factors in falls among this population, thereby providing evidence for tailored fall prevention strategies.

Objective:To systematically evaluate the efficacy and safety of iGlarLixi in the treatment of type 2 diabetes, providing evidence-based support for rational clinical medication.Methods:A systematic review was conducted by retrieving articles from PubMed, Embase, Cochrane Library, Web of Science, Sinomed, CNKI, Wanfang, and VIP databases to collect randomized controlled trials comparing the efficacy and safety of iGlarLixi(intervention group) with placebo or other anti-hyperglycemic drugs(control group) in the treatment of type 2 diabetes. The search was conducted from the inception of the databases up to August 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias in the included studies. Meta-analysis was performed using RevMan 5.4 software. Results:A total of 11 studies with 6 392 patients were included in the meta-analysis. The results of the meta-analysis showed that in terms of efficacy, compared to insulin and GLP-1RAs, iGlarLixi demonstrated better reduction in patients′ HbA 1C levels(Insulin group WMD=-0.40, 95% CI -0.54--0.27, P<0.001; GLP-1RAs group WMD=-0.86, 95% CI -1.05--0.68, P<0.001), increased HbA 1C target rate(Insulin group OR=2.83, 95% CI 2.00-3.99, P<0.001; GLP-1RAs group OR=6.45, 95% CI 4.81-8.64, P<0.001), increased HbA 1C control rate without weight gain(Insulin group OR=3.00, 95% CI 2.43-3.71, P<0.001; GLP-1RAs group OR=2.67, 95% CI 1.76-4.06, P<0.001). Furthermore, iGlarLixi showed an advantage in weight reduction compared to the insulin group and demonstrated superior reduction in fasting plasma glucose compared to the GLP-1RAs group. In terms of safety, the incidence of hypoglycemic events in the iGlarLixi group was similar to that in the insulin group, but the incidence of gastrointestinal adverse events was higher than that in the insulin group. There was no difference in the incidence of gastrointestinal adverse events compared with GLP-1RAs, but the incidence of hypoglycemic events was higher in the iGlarLixi group. The incidence of serious adverse events was similar to that in the insulin and GLP-1RAs groups(Insulin group OR=0.94, 95% CI 0.71-1.23, P=0.640; GLP-1RAs group OR=0.97, 95% CI 0.61-1.52, P=0.880). Conclusion:iGlarLixi is superior to insulin but inferior to GLP-1RAs in reducing body weight, and the overall incidence of adverse events is not significantly different from that of insulin and GLP-1RAs, indicating that iGlarLixi is well tolerated and safe, and has a good clinical application prospect.

Ulcerative colitis(UC)is characterized by chronic relapsing intestinal inflammation.Currently,there is no effective treatment for the disease.According to our preliminary data,1,8-cineole,which is the main active compound of Amomum compactum Sol.ex Maton volatile oil and an effective drug for the treat-ment of pneumonia,showed remarkable anti-inflammatory effects on colitis pathogenesis.However,its mechanism of action and direct targets remain unclear.This study investigated the direct targets and mechanism through which 1,8-cineole exerts its anti-inflammatory effects using a dextran sulfate so-dium salt-induced colitis mouse model.The effects of 1,8-cineole on macrophage polarization were investigated using activated bone marrow-derived macrophages and RAW264.7 cells.In addition,1,8-cineole targets were revealed by drug affinity responsive target stability,thermal shift assay,cellular thermal shift assay,and heat shock protein 90(HSP90)adenosine triphosphatases(ATPase)activity assays.The results showed that 1,8-cineole exhibited powerful anti-inflammatory properties in vitro and in vivo by inhibiting the macrophage M1 polarization and protecting intestinal barrier function.Mech-anistically,1,8-cineole directly interacted with HSP90 and decreased its ATPase activity,also inhibited nucleotide-binding and oligomerization domain-,leucine rich repeat-,and pyrin domain-containing 3(NLRP3)binding to HSP90 and suppressor of G-two allele of SKP1(SGT1)and suppressed NLRP3 inflammasome activation in macrophages.These results demonstrated that 1,8-cineole is a potential drug candidate for UC treatment.

Objective:To construct the evaluation index system of lumbar puncture teaching for medical students, aiming to create a scientific assessment and evaluation method covering theoretical knowledge, skill practice, and professional accomplishment, so as to comprehensively evaluate the teaching effect of lumbar puncture for medical students, and improve the practical ability of clinical skills of medical students more effectively.Methods:The evaluation index scheme of lumbar puncture teaching for medical students was initially formulated through literature review and group discussion, and 20 experts related to clinical front-line work and medicine were invited to revise the scheme by applying Delphi expert consultation and applying analytic hierarchy process to quantify the entries and establish the final index weights at all levels.Results:The valid recovery rate of both rounds of expert consultation questionnaires in this study was 100%. The second round of expert consultation was conducted without changing experts, with an authority factor of 0.88. Kendall's coefficient of harmony was 0.136 and 0.184, respectively. After two rounds of expert consultation, the evaluation index system of lumbar puncture teaching for medical students, including 3 primary indicators (theoretical knowledge, comprehensive clinical ability and professionalism), 7 secondary indicators and 22 tertiary indicators, was initially constructed.Conclusion:The evaluation index system of lumbar puncture teaching for medical students constructed in this study is scientific and credible, which can provide quantitative basis for the training and assessment of medical students, and is of great theoretical and practical significance.

Purpose/Significance To address the challenge of low willingness to share scientific data among stakeholders in the tradi-tional Chinese medicine(TCM)industry,and to promote standardization,aggregation,sharing,and application of scientific data in the field of TCM.Method/Process By adhering to national standards for scientific data submission and management,integrating technologies such as blockchain and digital watermarking,the study aims to establish atrusted process for the exchange of scientific data in the field of TCM and build a TCM scientific data management platform.Result/Conclusion This platform will provide information technology support for regional TCM scientific data exchange,and effectively improve the efficiency and willingness of scientific data exchange within the region.

Pulmonary blast injury has become the main type of trauma in modern warfare, characterized by externally mild injuries but internally severe injuries, rapid disease progression, and a high rate of early death. The injury is complicated in clinical practice, often with multiple and compound injuries. Currently, there is a lack of effective protective materials, accurate injury detection instrument and portable monitoring and transportation equipment, standardized clinical treatment guidelines in various medical centers, and evidence-based guidelines at home and abroad, resulting in a high mortality in clinlcal practice. Therefore, the Trauma Branch of Chinese Medical Association and the Editorial Committee of Chinese Journal of Trauma organized military and civilian experts in related fields such as thoracic surgery and traumatic surgery to jointly develop the Clinical treatment guideline for pulmonary blast injury ( version 2023) by combining evidence for effectiveness and clinical first-line treatment experience. This guideline provided 16 recommended opinions surrounding definition, characteristics, pre-hospital diagnosis and treatment, and in-hospital treatment of pulmonary blast injury, hoping to provide a basis for the clinical treatment in hospitals at different levels.

Lung cancer is one of the malignant tumors with the highest morbidity and mortality. Epidermal growth factor receptor is expressed in the majority of non-small cell lung cancer tumor cells, making it possible to give these patients more precise and targeted therapies. The mechanisms of abnormal EGFR regulation are closely related to the efficacy of targeted therapy and the occurrence of drug resistance. Therefore, this review will review the expression mechanism of EGFR in NSCLC and the acquired drug resistance of epidermal growth factor receptor tyrosine kinase inhibitor after treatment of NSCLC.

OBJECTIVE To investigate the surgical efficacy and prognostic factors of patients with advanced nasal and sinuses malignancies,in order to provide more reference for surgical plan selection and prognosis evaluation.METHODS A total of 117 patients with advanced nasal and sinuses malignancies were retrospectively chosen in the period from January 2010 to January 2019 in our hospital.The clinical characteristics and follow-up survival data were analyzed,and the independent prognostic factors of advanced nasal and paranasal malignant tumors were evaluated by univariate and multivariate methods.RESULTS The progression free survival rate and overall survival rate were 48.71％and 62.39％,respectively.The median progression free survival time and overall survival time were 32.48 months and 39.80 months,respectively.Univariate and multivariate analysis showed that age,histopathological type,marginal status and whether adjuvant therapy was accepted were independent factors influencing progression free survival time and overall survival time after surgery for advanced nasal and sinus malignancies(P＜0.05).CONCLUSION The surgical efficacy of advanced nasal and sinusoidal malignancies is satisfactory and the clinical prognosis is related to age,marginal status and adjuvant therapy.

Objective:To retrieve the evidence of scraping operation in patients with neck, shoulder and low back pain, and evaluate and summarize the evidence.Methods:Identified evidence-based problems based on the population, intervention, professional, outcome, setting and type of evidence (PIPOST) model, and searched UpToDate, British Medical Journal (BMJ) Clinical Evidence, Guidelines International Network, Registered Nurses' Association of Ontario, Scottish Intercollegiate Guidelines Network, New Zealand Guidelines Group, World Health Organization, American College of Physicians Club, BMJ Best Practice, Agency for Healthcare Research and Quality, Joanna Briggs Institute Evidence-Based Health Care Center Database, Nursing Consult, China Guideline Clearinghouse, Cochrane Library, Embase, PubMed, CINAHL, Web of Science, Medlive, China National Knowledge Infrastructure and SinoMed. The retrieval time limit was from March 1, 2012 to April 30, 2022. Four researchers independently evaluated the quality of the article, and two researchers summarized the evidence of the included article.Results:A total of 9 articles were included, including 1 guideline, 2 systematic reviews, and 6 randomized controlled trials. A total of 20 pieces of scraping application evidence were extracted from patients with neck, shoulder and low back pain, including 6 aspects, involving preparation before scraping, scraping intervention methods, scraping degree, precautions, contraindications, and handling of abnormal conditions.Conclusions:The best evidence of scraping therapy to improve patients' neck, shoulder and low back pain summarized in this study can provide a reference for improving the operation practice of medical and nursing staffs and nursing outcomes.

Under the current situation of the rapid development of brain-like artificial intelligence and the increasingly complex electromagnetic environment, the most bionic and anti-interference spiking neural network has shown great potential in computing speed, real-time information processing, and spatiotemporal data processing. Spiking neural network is the core part of brain-like artificial intelligence, which realizes brain-like computing by simulating the structure of biological neural network and the way of information transmission. This article first summarizes the advantages and disadvantages of the five models, and analyzes the characteristics of several network topologies. Then, it summarizes the spiking neural network algorithms. The unsupervised learning based on spike timing dependent plasticity (STDP) rules and four types of supervised learning algorithms are analyzed. Finally, the research on brain-like neuromorphic chips at home and abroad are reviewed. This paper aims to provide learning ideas and research directions for new colleagues in the field of spiking neural network.
Algorithms ; Artificial Intelligence ; Brain ; Neural Networks, Computer