With the growing aging population, female stress urinary incontinence (SUI), due to its high incidence, has become a common disease that seriously affects patients' quality of life and brings heavy economic burden to families and society.Over the past century, the surgical treatments of SUI were continuously updated along with the in-depth research on the disease mechanism.However, in recent years, the concept of anti-incontinence surgery has shifted from treating the causes to reshaping the urinary control mechanism.As a result, the mid-urethral sling (MUS) procedure has gained global acceptance since its introduction, swiftly acknowledged both domestically and internationally as the gold standard due to its minimally invasive nature and proven effectiveness.MUS is also the most commonly used surgical method for SUI patients treated in our center.Based on our own surgical experience, we will analyze the main steps, technical points, and preventive strategies of surgical complications of MUS, so as to provide clinical reference.

Myocardial ischemia-reperfusion injury （MIRI） is a common cardiac pathological process， resulting from the combined effects of multiple mechanisms involving metabolic changes and mitochondrial dysfunction. Mitochondrial quality control （MQC）， as a key regulatory mechanism， may serve as an important target for the prevention and treatment of MIRI. In recent years， traditional Chinese medicine （TCM） has demonstrated unique advantages in the field of improving MIRI， with multiple targets， multiple pathways， and low toxic and side effects. It has gained widespread clinical recognition and application. Through systematically organizing and summarizing recent studies on the targeting of MQC by monomers， active fractions， herb pairs， compound formulas and related preparations of TCM to improve MIRI， this paper finds that monomers and active fractions of TCM （such as schisandrin B， isoliquiritigenin， calenduloside E， berberine， Lycium barbarum polysaccharides and so on） as well as TCM herb pairs， compound formulas， and related preparations （couplet medicinals of Fuzi-Ganjiang， Yixin formula， Shuangshen ningxin capsule， Baijin formula， Yiqi huoxue decoction and so on）， can alleviate MIRI by activating MQC to reduce oxidative stress-induced damage， promote mitochondrial biogenesis， maintain mitochondrial fission/fusion homeostasis， regulate mitochondrial autophagy， and restore mitochondrial calcium homeostasis.

Under the background of carbon peaking and carbon neutrality goals, the Ministry of Ecology and Environment, together with 15 national ministries and commissions, has formulated the Implementation Plan on Establishing a Carbon Footprint Management System, and it is urgent for traditional Chinese medicine(TCM) pharmaceutical enterprises to carry out research on carbon footprint accounting methods of related products. Based on the life cycle assessment(LCA) theory, taking mulberry leaf extract produced by a certain enterprise as an example, this study analyzed the carbon footprint of TCM extracts during the life cycle. The results show that for every 1 kg of product produced, the carbon emissions from the stages of raw material acquisition, transportation, and extract production are-20.569, 1.205, and 173.577 kgCO_2eq(CO_2 equivalent), respectively. The carbon footprint of the product is 154.213 kgCO_2eq·kg~(-1). In addition, the carbon emission is the highest in the production stage, in which the consumption of ethanol solvents makes the greatest contribution to the carbon footprint, accounting for 25.71%, more than one-fourth of the total carbon footprint. The second contribution was from the treatment process of TCM residues, accounting for 19.67%, closely followed by wastewater treatment(17.71%), the consumption of hot steam(17.43%), and drinking water(16.90%). The consumption of electric power and packaging materials has a smaller carbon emission of 2.58%. In particular, the carbon emission caused by the consumption of packaging materials is only 0.04%, which is negligible. The results of the study are expected to provide a reference for TCM enterprises to carry out research on the carbon footprint of products, offer ideas for collaborative innovation in reducing pollution and carbon emissions throughout the entire industry chain of TCM, and develop new quality productivity of modern TCM industry based on green and low-carbon manufacturing.
Morus/chemistry* ; Plant Leaves/chemistry* ; Carbon Footprint ; Drugs, Chinese Herbal/chemistry* ; Plant Extracts/analysis* ; Medicine, Chinese Traditional

Aromatic immunity in traditional Chinese medicine(TCM) is the medical knowledge accumulated in the process of people's struggling with diseases. It plays an important role in plague prevention, disease treatment, health preservation, and rehabilitation, and has profound TCM basic theoretical support and abundant modern scientific evidence. With the in-depth promotion of the Healthy China initiative and the succession of health needs in the post-COVID-19 era, how to practice the health concept of aromatic immunity in TCM and develop its health service resources with high quality has become an important proposition to be discussed urgently. This paper summarizes the cognitive process, puts forward the basic concept, discusses the scientific connotation and clinical application value, and looks forward to the future development trend of aromatic immunity in TCM, aiming to provide guidance for the development of great health products and promote the application of aromatic immunity in TCM in serving people's health.
Medicine, Chinese Traditional/methods* ; Humans ; COVID-19/immunology* ; China ; Drugs, Chinese Herbal/therapeutic use* ; SARS-CoV-2

Acute high-altitude (HA) illnesses (AHAIs), including acute mountain sickness (AMS), HA cerebral edema (HACE), and HA pulmonary edema (HAPE), represent significant health challenges for individuals rapidly ascending to high altitudes. Cytokines (interleukins (ILs)) and chemokines, which are involved in inflammatory and immunological responses, regulate the response of the body to hypoxic stress. Their dysregulation can contribute to the clinical symptoms of AMS, HACE, and HAPE by increasing vascular permeability, causing edema and damaging tissue. AHAIs elevate the levels of pro-inflammatory cytokines and chemokines, such as IL-17, tumor necrosis factor α (TNF-α), IL-1, IL-6, C-X-C motif chemokine ligand (CXCL) 10, CXCL8, C-C motif ligand 2 (CCL2 (CCL2), and CCL3, exacerbating symptoms. Thus, this review focuses on the cytokines and chemokines involved in AHAIs and the molecular mechanisms that extend beyond these cytokines and chemokines in clinical and preclinical contexts. Identifying these mediators and pathways helps researchers design drugs that reduce symptoms, slow disease progression, and enhance outcomes. Cytokines and chemokines have complex functions in these disorders and may serve as prospective therapeutic targets. Finally, we discuss treatment possibilities for AHAIs (drugs, exercise, and other inhibitors). This knowledge will help us to protect and improve the health of individuals at high altitudes.

Objective To analyze the influencing factors of death in the elderly with coronavirus disease 2019(COVID-19).Methods The case data of death caused by COVID-19 in West China Fourth Hospital from January 1 to July 8,2023 were collected,and surviving cases from the West China Elderly Health Cohort infected with COVID-19 during the same period were selected as the control.LASSO-Logistic regression was adopted to analyze the data after propensity score matching and the validity of the model was verified by drawing the receiver operating characteristic curve.Results A total of 3 239 COVID-19 survivors and 142 deaths with COVID-19 were included.The results of LASSO-Logistic regression showed that smoking(OR=3.33,95%CI=1.46-7.59,P=0.004),stroke(OR=3.55,95%CI=1.15-10.30,P=0.022),malignant tumors(OR=19.93, 95%CI=8.52-49.23, P<0.001),coronary heart disease(OR=7.68, 95%CI=3.52-17.07, P<0.001),fever(OR=0.51, 95%CI=0.26-0.96, P=0.042),difficulty breathing or asthma symptoms(OR=21.48, 95%CI=9.44-51.95, P<0.001),and vomiting(OR=8.19,95%CI=2.87-23.58, P<0.001)increased the risk of death with COVID-19.The prediction model constructed based on the influencing factors achieved an area under the curve of 0.889 in the test set.Conclusions Smoking,stroke,malignant tumors,coronary heart disease,fever,breathing difficulty or asthma symptoms,and vomiting were identified as key factors influencing the death risk in COVID-19.
Humans ; COVID-19/mortality* ; Aged ; Propensity Score ; China/epidemiology* ; Risk Factors ; Logistic Models ; Smoking ; SARS-CoV-2 ; Male ; Female ; Stroke ; Neoplasms

Objective:To study the variational trend in disease characteristics of patients with hepatitis B-related primary liver cancer (HBV-HCC) in the past five years.Method:A single-center retrospective cross-sectional analysis was performed to compare patients diagnosed with HBV-HCC from January 2012 to December 2016 (control group) and from January 2017 to December 2021 (observation group). The data of the study variables were extracted from the electronic medical record system of the hospital information system of the Second Hospital of Lanzhou University. The 1:2 propensity score matching was used to adjust potential confounding factors such as gender and age. Multivariate logistic regression analysis was used to study the factors affecting changes in disease characteristics of the HBV-HCC population in the observation group. GraphPad Prism 8.0 software was used to draw forest plots to intuitively display the effect size of the study variables in the logistic regression analysis.The t-test was used to compare normally distributed data between groups. The χ2 test was used for inter-group comparison. Results:A total of 1 717 eligible cases were collected, including 510 in the control group and 1 207 in the observation group. Compared with the control group, the number of newly diagnosed cases in the observation group increased by 2.36 times, and males were still the main onset population (83.3% vs. 82.7%). The median age of onset increased (51.9 vs. 53.5 years, P<0.001). 79.4% of HBV-HCC patients had not received antiviral therapy, and the proportion of HBeAg-negative patients increased (56.4%). The factors affecting HBV-HCC patients included family history of HBV ( OR=1.626, 95% CI: 1.181-2.238), family history of hepatocellular carcinoma ( OR=1.388, 95% CI: 1.013-1.901), hypoviremia ( OR=1.322, 95% CI: 1.046-1.671), abnormal alanine aminotransferase ( OR=1.545, 95% CI: 1.231-1.940), liver fibrosis ( OR=1.478, 95% CI: 1.153-1.894), liver cirrhosis ( OR=1.431, 95% CI: 1.128-1.815), and metabolic-related fatty liver disease ( OR=1.438, 95% CI: 1.116-1.815) after propensity score matching adjustment. The factors affecting HBeAg-positive patients were decreased ( OR=0.390, 95% CI: 0.389-0.617); however, the number of early HBV-HCC diagnoses was increased (12.7% vs. 19.3%, P=0.001). Conclusion:The characteristics of patient disease and occurrence of HBV-HCC are changing over the past five years. The risk of developing hepatocellular carcinoma in middle- to older male patients with chronic hepatitis B is increasing with familial history of HBV and hepatocellular carcinoma, HBeAg negativity, hypoviremia, abnormal alanine aminotransferase, liver fibrosis, cirrhosis, and metabolic-related fatty liver disease.

Intrahepatic cholangiocarcinoma (ICC) is characterized with low incidence, high malignancy and poor prognosis. In China, hepatitis B virus (HBV)-associated ICC is the most common subtype of ICC and its incidence rate is on the rise. The pathogenesis and clinical characteristics of HBV-associated ICC are different from other types of ICC. In recent years, the targeted therapy has brought significant survival benefits for patients. This article reviews the pathogenesis of HBV-associated ICC and the latest research progress of the clinical characteristics and treatments of patients.

Objective:To establish and effect evaluate of management process of Da Vinci robotic surgical instrument based on bar code, and evaluate its application effect.Methods:This study was a randomized controlled trial using convenient sampling method. A total of 172 Da Vinci robotic surgeries from Jiangsu Cancer Hospital from September to November 2020 were selected as the control group, and 118 Da Vinci robotic surgeries from September to November 2021 were selected as the observation group. The control group adopted the traditional Da Vinci surgical instrument management mode, while the observation group adopted the management mode of Da Vinci surgical instrument based on bar code. The incidence of management problems related to Da Vinci surgical instruments, the number of reported adverse events of instruments rate and the impact of staff work effect were compared between two groups.Results:The incidence rates of non-traceable information, counting error, usage charge and bar code irregularity were 9.3% (11/118), 0, 0.8% (1/118) and 2.5% (3/118), respectively, which were lower than 26.7% (46/172), 17.4% (30/172), 12.2% (21/172) and 16.9% (29/172) of the control group. The differences were statistically significant ( χ2 values were 12.89-24.68, all P<0.01). The reporting rate of device adverse events in the control group was 0, and the observation group was 4.2% (5/118), and the difference between the two groups was statistically significant ( χ2=7.42, P<0.05). The number of sterilization package turnover sets in the observation group was 2(2, 3), which was lower than 2(2, 4) of the control group, and the difference was statistically significant ( Z=-2.50, P<0.05). The average amount of pre-purchased surgical instruments per surgical instrument in the observation group was 7 858.0 (6 712.1, 14 119.9), which was lower than that of the control group of 7 858.0 (7 858.0, 2 0385.0), and the difference was statistically significant ( Z=-2.97, P<0.05). Conclusions:The management process of Da Vinci Xi robotic surgical instrument based on bar code can reduce the incidence of related management problems, increase the reporting rate of adverse events, improve the work efficiency of the management of mechanical arm to optimize hospital of reusable medical equipment management level, thus further ensure medical safety and improve medical quality.