Objective To analyze the effect and molecular mechanism of phellodendron amurense in the treatment of liver injury based on network pharmacology,and to verify the relevant prediction targets and the protective effect of phellodendron amurense extract-Phellodendron amurense polysaccharide on immune liver injury through mice.Methods TCMSP and Swiss target prediction databases were used to retrieve and screen phellodendron amurenses active components and action targets,and then obtain disease-related targets on GeneCards and OMIM websites,and take compounds and disease intersection targets for protein interaction.Analysis,GO biological function and KEGG signaling pathway enrichment analysis,followed by molecular docking of compounds and key target proteins,and finally established a mouse liver injury model induced by Daodou protein A(Con A)to explore the mechanism of phellodendron amurense extract in the treatment of liver injury.Results 37 active ingredients were screened.The key targets for their treatment were tumor necrosis factor α(TNF-α),serine/threonine protein kinase 1(AKT1),signal transduction and transcription activation factor 3(STAT3),epidermal growth factor receptor(EGFR)anditin.Enzyme 3(CASP3)and other enrichment analysis showed that phellodendron amurense might play a protective role in protecting the liver through molecular mechanisms such as positive regulation of MAPK cas-cade reaction,oxidative stress response and regulatory PI3K-Akt signaling pathway,lipid and atherosclerosis.Ani-mal experiments had found that the gastric treatment of phellodendron amurense polysaccharide could improve the activity of superoxide dismutase(SOD)and catalase(CAT)in liver tissue,reduce the levels of serum alkaline phosphatase(ALP),aspartate aminotransferase(AST)and malonaldehyde(MDA)in liver tissue,and regulate serum inflammatory factor while the expression of intercitin(IL)-6,IL-1 β,tumor necrosis factor α(TNF-α),ac-tivated the expression of transforming growth factor β1(TGF-β1),and reduced TNF-α mRNA expression in liver tissue.Conclusion Phellodendron amurense can intervene in lipid and atherosclerosis pathways by acting on tar-gets such as TNF-α,AKT1,STAT3,EGFR and CASP3 to reduce oxidative stress and inflammatory reactions and achieve liver protection.

BACKGROUND:Careful regulation of bone immune response during repair of bone scaffold is important for bone regeneration. OBJECTIVE:To review the influence of bone immune response on bone repair and the design of bone tissue engineering scaffold with regulating bone immune function and its application in bone repair. METHODS:Relevant articles published from 1973 to 2023 were retrieved from Science Direct,PubMed,Web of Science,and CNKI databases.English search terms were"osteoimmunology,macrophages,bone repair materials,bone scaffold,bone defects,bone regeneration".Chinese search terms were"bone immunity,macrophages,bone repair material,bone stent,bone defect,bone regeneration".Totally 80 articles of the latest research progress in this field were summarized and analyzed. RESULTS AND CONCLUSION:(1)A detailed review was conducted on the important time points in the origin and development process of bone immunity,and it was explained that macrophages,as important members of the bone immune regulatory system,can be divided into two phenotypes:M1(pro-inflammatory)and M2(anti-inflammatory),and play a key role in different stages of bone regeneration.During the inflammatory phase,M1 type macrophages can activate osteoclasts,initiate tissue repair processes,and participate in the reconstruction of bone microvascular networks.On the other hand,during the bone tissue regeneration process in the later stages of inflammation,sustained high expression of M1 type macrophages can hinder the formation of new bones.During the repair phase,M2 macrophages can secrete osteogenic cytokines,stimulate osteogenic differentiation and mineralization of bone marrow mesenchymal stem cells,and promote bone formation.On the other hand,long-term activation of M2 macrophages can increase the secretion of fibrogenic molecules,leading to excessive formation of scar tissue and delaying the healing process.Therefore,regulating macrophages to undergo phenotype transformation at appropriate stages and constructing an immune microenvironment beneficial for osteogenesis has great significance for bone regeneration.(2)In the process of designing bone scaffolds with bone immune regulation characteristics,the physical and chemical properties such as scaffold roughness,pore structure,stiffness,hydrophilicity,surface charge,and surface functional groups can be changed to affect non-specific protein and cell adhesion,thereby affecting the interaction between bone scaffolds and the immune system.By designing surface functional coatings of bioactive substances such as hydroxyapatite,bioactive glass,metal ions,extracellular matrix,drugs,cytokines,and exosomes,the immune microenvironment can be actively regulated by releasing bioactive substances after implantation into the body,affecting macrophage polarization and crosstalk between macrophages and bone cells,and promoting more M2 polarization of macrophages,so as to build a bone immune microenvironment that is conducive to bone regeneration.(3)Based on the research and development of bone tissue engineering scaffolds,in addition to focusing on the direct regulatory factors of stem cell osteogenic differentiation,this article also proposes that attention should be paid to the management of the immune microenvironment of stem cell differentiation.By regulating the appropriate bone immune microenvironment,more stem cell osteogenic differentiation can be induced;the osteogenic efficiency of the scaffold can be enhanced,and the concept of"bone immune regulatory characteristics"can be condensed;deeply elucidated the multi-directional regulatory role of the bone immune microenvironment and introduced the existing strategies for changing the physicochemical properties and surface functional coating of scaffolds to endow them with bone immune regulatory potential,providing new ideas for guiding the development of a new generation of bone tissue engineering scaffolds with bone immune regulatory characteristics.However,the bone immune microenvironment is a dynamic equilibrium state,and most of the existing regulatory strategies do not consider the dynamic matching of regulation.Therefore,the research and development of intelligent bone immune regulatory scaffolds with efficient and targeted regulation of the immune microenvironment will be a key focus of attention for scholars in future.

Human physiological indicators have become an important standard for assessing health in modern society.Traditional detection methods often require a separate laboratory,complex operation process and long detection time,so it is urgent to develop portable,fast and accurate on-site detection technologies for bioanalysis.Point-of-care testing(POCT),which differs from traditional laboratory testing,can realize the rapid in situ detection of biomarkers without the complicated analytical process of the laboratory.Smartphones,which are an essential tool in our daily life,not only have independent operating systems and built-in storage functions,but also have high-definition cameras,which have great application potential in POCT visualization.The combination of various biosensing technologies and smartphones has developed into a new direction in the field of POCT.This review mainly introduced the research progress of smartphone-based visual biosensors in POCT in recent years,including colorimetric sensors,fluorescence sensors,chemiluminescence sensors and electrochemiluminescence sensors.Finally,the problems faced by smart-phone-based visual biosensors in the application of POCT were summarized,and their future development was prospected.

Objective:To explore the adverse outcomes of pregnant women with overt diabetes mellitus(ODM).Methods:A retrospective analysis was performed on 1321 pregnant women delivered in Peking Universi-ty International Hospital.Pregnant women were divided into normal blood glucose group(NGDM),gestational di-abetes mellitus group(GDM)and overt diabetes mellitus group(ODM).Maternal and neonatal adverse out-comes were compared.Results:The age,early pregnancy glycosylated hemoglobin,uric acid,triglycerides and late pregnancy glycosylated hemoglobin levels of women in ODM group were significantly higher than those in NGDM group,and the differences were statistically significant(P＜0.01).The risk of developing gestation hyper-tension(OR 6.32,P＜0.01)and cesarean section(OR 1.87,P＜0.05)in the ODM group was significantly high-er than that in the NGDM group.The rate of preterm birth(OR 2.73,P＜0.05)and macrosomia(OR 3.45,P＜0.01)in the ODM group was significantly higher than that in the NGDM group.Compared with the GDM group,the ODM group did not significantly increase the risk of hypertension,eclampsia or preeclampsia,shoulder dysto-cia,premature rupture of placenta,cesarean section,preterm birth,macrosomia,and low body mass infants(P＞0.05).Conclusion:Pregnant women with ODM increase the risk of gestational hypertension,cesarean section,preterm birth and macrosomia.Active management is needed in pregnant women with ODM.

Critically ill patients are at high risk for hospital acquired infections, which can significantly increase the mortality rate and treatment costs for these patients. Therefore, in the process of treating the primary disease, strict prevention and control of new hospital infections is an essential component of the treatment for critically ill patients. The treatment of critically ill patients involves multiple steps and requires a concerted effort from various aspects such as theory, management, education, standards, and supervision to achieve effective prevention and control of hospital infections. However, there is currently a lack of unified understanding and standards for hospital infection prevention and control. To address this, in March 2024, a group of experts in critical care medicine, infectious diseases, and hospital infection from China discussed the current situation and issues of hospital infection control in the intensive care unit together. Based on a review of the latest evidence-based medical evidence from both domestic and international sources, 2024 Expert Consensus on Hospital Acquired Infection Control Principles in the Department of Critical Care Medicine was formed, aiming to provide a basis for the development of hospital infection prevention and control strategies in the field of critical care medicine.

Based on discussing the U.S.strategies for reducing potentially preventable hospitalizations(PPHs)among elderly residents in long-term care facilities,the experiences are explored to provides insights for policy development in China.The U.S.has effectively lowered PPH rates and healthcare costs through a comprehensive long-term care service system,clinical interventions,and incentives.Analyzing the effectiveness and challenges of these measures suggests that China should conduct the reform by clarifying the roles of care institutions,strengthening incentive mechanisms,improving caregiver training,establishing evaluation systems,and enhancing data-driven decision support.It aims to develop a long-term care system tailored to China,reduce PPH rates,and improve the quality and efficiency of nursing services.

Tuberculosis （TB） and human immunodeficiency virus infection / acquired immune deficiency syndrome （HIV/AIDS） are both serious global public health threats. Early detection of infected persons and/or patients through TB/HIV bi-directional screening is crucial for prevention and control strategy in China and globally. In recent years， with the promotion and application of new TB and HIV detection technologies worldwide， TB/HIV bi-directional screening technologies and strategies have made remarkable changes. This expert consensus introduces the significance and challenges of TB/HIV bi-directional screening， summarizes important progress of research and applications， and makes recommendations on screening measures and procedures to further strengthen TB/HIV bi-directional screening in China.

Objective:To explore the adverse outcomes of pregnant women with overt diabetes mellitus(ODM).Methods:A retrospective analysis was performed on 1321 pregnant women delivered in Peking Universi-ty International Hospital.Pregnant women were divided into normal blood glucose group(NGDM),gestational di-abetes mellitus group(GDM)and overt diabetes mellitus group(ODM).Maternal and neonatal adverse out-comes were compared.Results:The age,early pregnancy glycosylated hemoglobin,uric acid,triglycerides and late pregnancy glycosylated hemoglobin levels of women in ODM group were significantly higher than those in NGDM group,and the differences were statistically significant(P＜0.01).The risk of developing gestation hyper-tension(OR 6.32,P＜0.01)and cesarean section(OR 1.87,P＜0.05)in the ODM group was significantly high-er than that in the NGDM group.The rate of preterm birth(OR 2.73,P＜0.05)and macrosomia(OR 3.45,P＜0.01)in the ODM group was significantly higher than that in the NGDM group.Compared with the GDM group,the ODM group did not significantly increase the risk of hypertension,eclampsia or preeclampsia,shoulder dysto-cia,premature rupture of placenta,cesarean section,preterm birth,macrosomia,and low body mass infants(P＞0.05).Conclusion:Pregnant women with ODM increase the risk of gestational hypertension,cesarean section,preterm birth and macrosomia.Active management is needed in pregnant women with ODM.

Based on discussing the U.S.strategies for reducing potentially preventable hospitalizations(PPHs)among elderly residents in long-term care facilities,the experiences are explored to provides insights for policy development in China.The U.S.has effectively lowered PPH rates and healthcare costs through a comprehensive long-term care service system,clinical interventions,and incentives.Analyzing the effectiveness and challenges of these measures suggests that China should conduct the reform by clarifying the roles of care institutions,strengthening incentive mechanisms,improving caregiver training,establishing evaluation systems,and enhancing data-driven decision support.It aims to develop a long-term care system tailored to China,reduce PPH rates,and improve the quality and efficiency of nursing services.

Objective:To explore the adverse outcomes of pregnant women with overt diabetes mellitus(ODM).Methods:A retrospective analysis was performed on 1321 pregnant women delivered in Peking Universi-ty International Hospital.Pregnant women were divided into normal blood glucose group(NGDM),gestational di-abetes mellitus group(GDM)and overt diabetes mellitus group(ODM).Maternal and neonatal adverse out-comes were compared.Results:The age,early pregnancy glycosylated hemoglobin,uric acid,triglycerides and late pregnancy glycosylated hemoglobin levels of women in ODM group were significantly higher than those in NGDM group,and the differences were statistically significant(P＜0.01).The risk of developing gestation hyper-tension(OR 6.32,P＜0.01)and cesarean section(OR 1.87,P＜0.05)in the ODM group was significantly high-er than that in the NGDM group.The rate of preterm birth(OR 2.73,P＜0.05)and macrosomia(OR 3.45,P＜0.01)in the ODM group was significantly higher than that in the NGDM group.Compared with the GDM group,the ODM group did not significantly increase the risk of hypertension,eclampsia or preeclampsia,shoulder dysto-cia,premature rupture of placenta,cesarean section,preterm birth,macrosomia,and low body mass infants(P＞0.05).Conclusion:Pregnant women with ODM increase the risk of gestational hypertension,cesarean section,preterm birth and macrosomia.Active management is needed in pregnant women with ODM.