ObjectiveTo multidimensionally analyze the clinical effects of Qianyang Yuyin granules on elderly hypertensive patients through an "energy-inflammation-aging" network. MethodsRelevant datasets were retrieved from the GEO database. Gene set enrichment analysis （GSEA） was performed on the gene expression profiles of peripheral blood cells from patients with essential hypertension in dataset GSE24752. The GSEA referenced "GO gene sets" and "KEGG gene sets" to identify significantly enriched gene sets. A clinical trial was conducted using a randomized controlled study design. A total of 40 patients meeting the inclusion criteria were enrolled. The control group received standard antihypertensive treatment with angiotensin receptor blockers （ARBs） or combined calcium channel blockers （CCBs）. In contrast，the treatment group received Qianyang Yuyin Granules in addition to the standard treatment for 12 weeks. Blood pressure levels and clinical efficacy were observed，and changes in energy metabolism indicators，DNA damage markers，and senescence-associated secretory phenotype （SASP） in blood were measured using ELISA before and after treatment. ResultsGSEA results indicated significant energy metabolism dysregulation in hypertensive patients. Clinical findings showed that both groups achieved blood pressure control without significant intergroup differences. In terms of clinical efficacy，the treatment group had a significantly higher effective rate compared to the control group （95% vs 65%，P0.05）. After treatment，the treatment group showed a significant increase in NAD⁺ levels （P0.01），with higher levels compared to the control group （P0.05）. The treatment group also exhibited a greater reduction in DNA damage marker 8-OHdG （P0.01） and cell adhesion factors ICAM-1 and VCAM-1 （P0.01） compared to the control group. Pro-inflammatory cytokines IL-1β and IL-6 were significantly reduced in the treatment group （P0.01），with greater reductions compared to the control group （P0.05，P0.01）. Anti-inflammatory cytokines IFN-α，IL-4，and IL-10 were significantly elevated in the treatment group （P0.01），with higher levels compared to the control group （P0.01）. No significant adverse reactions were reported in either group. ConclusionThe "energy- inflammation- aging" network plays an important role in the pathological mechanism of hypertension patients. Qianyang Yuyin granules may delay the aging process by increasing patients' energy metabolism levels，reducing DNA oxidative damage，and maintaining the balance of inflammatory factors.

Objective To explore the correlation between hospitalization for severe asthma and climate change among adult residents in Dalian. Methods Clinical data of asthma inpatients in Dalian First Affiliated Hospital from January to December 2022 were collected, and assigned into severe asthma group and non-severe asthma group according to the diagnostic criteria of severe asthma. Spirometer was used for the measurement of (forced expiratory volume in the first second , FEV1) and (forced vital capacity , FVC), and the serum white blood cell count and C-reactive protein level were measured by biochemical analyzer. Meantime, meteorological parameters including monthly average temperature, relative humidity, wind speed and duration of sunshine hours were also collected. Then Spearman correlation analysis was conducted to discuss the correlation between the number of hospitalizations for severe asthma and meteorological parameters. Of the 260 asthma patients, 153 had severe asthma and 107 had non-severe asthma. There were 85 male and 68 female patients with severe asthma. The onset age distribution of severe asthma was concentrated at 60-79 years old, with 94 cases, followed by 50-59 years old (n=26). The peak time of onset in each year was from March to May, with 14, 19 and 16 cases, respectively. The secondary peak was from November to January, with 15, 18 and 13 cases, and there were fewer hospital admissions from June to October. FEV1 and FEV1/FVC values were smaller in severe asthma group than in non-severe asthma group, while the white blood cell count and C-reactive protein levels were higher than those in non severe asthma group (P<0.05). The average monthly temperature in Dalian began to rise in January, reached a peak in August, and then gradually dropped, with the lowest temperature in December. The monthly average humidity reached the peak from July to September. The monthly mean wind speed reached its peak from November to December. The monthly average sunshine reached its peak from June to September. Spearman correlation analysis denoted that the number of hospitalization for severe asthma was not correlated with average sunshine hours and wind speed (P>0.05), but was negatively correlated with average temperature and humidity (P<0.05). Conclusion The number of hospital admissions for severe asthma in Dalian varies with the seasons, therefore, early and active interventions are of great value in preventing severe asthma in months with high variations in temperature and humidity.

BACKGROUND:Autophagy has become a rapidly developing research hotspot in the biomedical fields.Many researchers are actively exploring the molecular regulatory mechanism of autophagy in a variety of diseases.However,the role of autophagy in hair growth is still unknown. OBJECTIVE:To review the current research progress and application value of autophagy in hair growth and regeneration,to understand the role of autophagy in hair growth,to explore the pathogenesis of autophagy in pathological hair loss,and to provide new ideas for the study of drugs for hair loss. METHODS:Using"hair follicle growth,hair growth,hair regeneration,autophagy associated proteins,autophagy activity,autophagy associated genes,autophagy"as Chinese search terms and"hair growth,hair follicle,hair regeneration,autophagy"as English search terms,PubMed and CNKI databases were searched.The research progress on autophagy,hair growth and the role of autophagy in hair growth in and outside China in recent years was reviewed and summarized.Articles incompatible with the subject content of the paper were excluded.Finally,78 articles were included for the result analysis. RESULTS AND CONCLUSION:(1)Autophagy is a normal metabolic process in eukaryotes with complex molecular mechanisms and functional properties,which is beneficial to cell survival and cell death.(2)Alopecia-related diseases are associated with changes in autophagy activity,which can regulate hair growth cycle.Knockout or overexpression of autophagy-related genes can change the state of hair growth.Multiple autophagy related signaling pathways have been found to be related to hair follicle growth.Activators or inhibitors of autophagy can be used to treat or prevent hair loss.

Objective To improve the efficiency of hospital antimicrobial management and ensure rational clinical use of antimicrobial agents with the aid of antimicrobial stewardship(AMS)empowered by digital intelligence tech-nology in hospital.Methods Information systems such as early warning of antimicrobial indexes,closed-loop ma-nagement of microbial detection information,and decision-making system of antimicrobial resistance monitoring data were applied to the traditional AMS system.Through hospital information systems(HIS)to collect data about thera-peutic antimicrobial use and healthcare-associated infection(HAI)quality control indexes of hospitalized patients in a tertiary first-class public hospital in Shenzhen City before and after digital technology improvement,indexes of 2021 and 2022 were as control group(before improvement)and observation group(after improvement)respective-ly,improvement trend of antimicrobial management was compared.Results After upgrading and renovating the hospital information system,hospital antimicrobial management indexes improved significantly compared to before the renovation.The use rate of antimicrobial agents and the preventive use rate of antimicrobial agents in class Ⅰincision surgery in patients in the observation group were both lower than those in the control group(27.0％vs 38.8％,20.9％vs 23.8％,respectively,both P＜0.05).Antimicrobial use density in hospitalized patients in the observa-tion group was lower than that in the control group([33.27±3.03]DDDs vs[42.06±4.42]DDDs),difference was statistically significant(t=13.11,P＜0.001).The observation group had a higher qualified rate for evaluating antimicrobial medical orders compared to the control group(98.5％vs 96.8％).The pathogenic detection rate of hospitalized patients before therapeutic antimicrobial use and pathogen detection rate related to HAI diagnosis were both higher than those in the control group(87.1％vs 84.5％,99.0％vs 95.4％,respectively),differences were both statistically significant(both P＜0.05).Conclusion Empowering the hospital's AMS system with digital technology can promote more scientific,standardized,efficient,and rational antimicrobial management in hospitals.

BackgroundSuicidal behavior in adolescence and early adulthood is a major public health concern， and suicide attempts are found to be associated with reasons for living and self-control， whereas there remains a striking lack of empirical research exploring the association among the three in college students. ObjectiveTo explore the relationship among suicide attempts， reasons for living and self-control， and to inform targeted efforts to prevent the development of suicidal behavior. MethodsFrom April to May 2023， a sample of 775 college students from 10 colleges and universities in Shaanxi province， Sichuan province and Chongqing municipality were selected using random sampling method. All students were subjected to complete Self-Control Scale （SCS）， the Reasons for Living Inventory for Adolescents （RFL-A）， and the self-administered Suicide Attempt Questionnaire. Spearman correlation analysis was utilized to examine the correlation among the above scales in students， and mediation analysis was performed using Mplus 8.3. ResultsA total of 738 college students （95.32%） completed the effective questionnaire survey.Suicide attempts were detected in 99 college students （13.41%）. SCS score was positively correlated with RFL-A score （r=0.329， P<0.01）， and SCS score and RFL-A score were both negatively correlated with the risk of suicide attempts （r=-0.194， -0.285， P<0.01）. The indirect mediation effect value of self-control on the relationship between reasons for living and suicide attempts was -0.059 （95% CI： -0.105~-0.018）， accounting for 11.07% of the total effect. There was a gender difference in the mediating effect of self-control， among which the effect was significant in male group， with an indirect effect value of -0.089 （95% CI： -0.163~-0.030） and accounting for 15.72% of the total effect， whereas the mediating effect was not significant in female group （95% CI： -0.407~0.115）. ConclusionReasons for living can negatively predict suicide attempts among college students， and self-control may play a mediating role in the relationship between reasons for living and suicide attempts among college students， and the mediating effect of self-control appears to be statistically significant only in male but not in female students.

Objective To evaluate the pharmacokinetics(PK)of tenofovir alafenamide Fumarate tablets(25 mg)in healthy Chinese subjects after single oral administration to provide a basis for bioequivalence evaluation.Methods Using a single-dose,randomized,open-lable,two-period,two-way crossover design under fasting condition,while three-way crossover design under fed condition,42 healthy subjects respectively for fasting and fed study were enrolled,and randomized into two groups to receive a single dose of test product(T)or reference product(R)25 mg.Plasma concentration of tenofovir alafenamide and tenofovir were determined by liquid chromatography-tandem mass spectrometry(LC-MS/MS)method.The pharmacokinetic parameters were calculated by WinNonlin software(8.1 version)using non-compartmental model,and bioequivalence evaluation was performed for the two preparations.Relevant safety evaluations were performed during the trial.Results The test product and the reference product under fasting study,the main PK parameters of tenofovir alafenamide were as follows:Cmax were(215.17±94.24)and(199.30±71.11)ng·mL-1;AUC0-t were(135.44±71.60)and(123.91±53.82)h·ng·mL-1;the main PK parameters of tenofovir were as follows:Cmax were(7.30±2.27)and(7.12±1.74)ng·mL-1,AUC0-t of tenofovir were(237.16±47.09)and(230.06±43.41)h·ng·mL-1,respectively.The test product and the reference product under fed study,the main PK parameters of tenofovir were as follows:Cmax were(197.69±82.19)and(197.10±110.54)ng·mL-1;AUC0-t were(197.69±82.19)and(197.10±110.54)h·ng·mL-1;the main PK parameters of tenofovir were as follows:CMax were(2.57±1.37)and(2.58±1.31)ng·mL-1;AUC0-t were(227.08±74.33)and(238.51±128.30)h·ng·mL-1,respectively.The 90％confidence interval for geometric mean ratio of Cmax,AUC0-tof T and R under fed condition were between 80.00％-125.00％,respectively.The incidence of adverse events in fasting and fed tests was 21.43％and 30.95％,respectively,and no serious adverse event was reported.Conclusion The test formulation and reference formulation of tenofovir alafenamide fumarate tablets were equivalent and was safe.

Objective:To explore the impact of rehabilitation exercise intervention mode based on cardiac function classification on clinical effect and quality of life(QOL)in patients with chronic heart failure(CHF).Methods:A total of 160 CHF patients who visited our hospital from Dec 2021 to Jan 2023 were selected,and 154 cases were fi-nally enrolled.According to the random number table method,patients were divided into study group and control group with 77 cases in each group.Control group received routine nursing program,while the study group received rehabilitation exercise intervention based on cardiac function classification on the basis of control group,both groups were intervened for three months.Clinical total effective rate,and cardiopulmonary function,serum oxidative stress indicators and MLHFQ score before and after intervention were compared between two groups.Results:Total effective rates of study subgroups of class Ⅱ and Ⅲ were significantly higher than those of control group(class Ⅱ:100.00％vs.83.78％;class Ⅲ:97.37％vs.80.00％)(P＜0.05 both).Compared with control subgroup of classⅢ after intervention,there were significant rise in peak VO2[(16.98±2.03)ml·min-1·kg-1 vs.(18.61±2.41)ml·min-1·kg-1],LVEF[(41.73±4.53)％vs.(48.03±5.22)％]and 6MWD[(351.34±61.00)m vs.(391.53±64.42)m](P＜0.01 all);and significant reductions in LVEDd[(57.55±3.91)mm vs.(53.18±3.07)mm],LVESd[(35.90±2.91)mm vs.(30.50±2.67)mm],levels of LPO[(6.00±0.99)mg/L vs.(3.95±0.61)mg/L],MPO[(3.83±0.58)mg/L vs.(2.03±0.28)mg/L],and MLHFQ total score[(57.05±4.57)points vs.(45.29±3.94)points]in study subgroup of class Ⅲ(P=0.001 all).Compared with control subgroup of class Ⅱ after intervention,there were significant rise in peak VO2,LVEF and 6MWD,and significant reductions in LVEDd,LVESd,levels of LPO,MPO and MLHFQ score in study subgroup of class Ⅱ,P＜0.05 or＜0.01.There was no significant difference in the incidence rate of adverse events during follow-up between two groups(3.90％vs.6.49％,P=0.717).Conclusion:Rehabilitation exercise intervention based on cardiac function classifi-cation can significantly improve cardiopulmonary function,inhibit oxidative stress response in vivo and improve quality of life in CHF patients,which is worthy of promotion and application in clinical practice.

Objective To study anatomical structures of the maxillary second molars(MSM)roots and canals and the relationship between root apices and the maxillary sinus.Methods Cone beam computed tomography imaging data of 526 MSM from 263 patients were evaluated retrospectively.The patient age,number of roots and canals,number of fused roots,type of root canal curvature,and anatomical relationship to the sinus floor were all documented and analyzed.Results It was found that the majority of MSM had three roots(59.1%),and the incidence of three root canals with three roots was the highest(47.3%).Fused roots were found in 192(36.5%)of the teeth examined.Palatal root canals of two-root,two-canal,and three-root,three-canal teeth had more curvature in the buccolingual direction than in the mesiodistal direction.The mesial buccal roots of MSM with three roots tended to extend into the max-illary sinus and the palatine roots of the three-rooted MSM tended to separate from the maxillary sinus.The distance between MSM and the sinus floor increased with age(P＜0.05).Conclusion The root and canal shape of MSM varies widely among a sample of individu-als.

Objective To understand the distribution and changing resistance profiles of clinical isolates of Enterococcus in hospitals across China from 2015 to 2021.Methods Antimicrobial susceptibility testing was conducted for the clinical isolates of Enterococcus according to the unified protocol of CHINET program by automated systems,Kirby-Bauer method,or E-test strip.The results were interpreted according to the Clinical & Laboratory Standards Institute(CLSI)breakpoints in 2021.WHONET 5.6 software was used for statistical analysis.Results A total of 124 565 strains of Enterococcus were isolated during the 7-year period,mainly including Enterococcus faecalis(50.7％)and Enterococcus faecalis(41.5％).The strains were mainly isolated from urinary tract specimens(46.9％±2.6％),and primarily from the patients in the department of internal medicine,surgery and ICU.E.faecium and E.faecalis strains showed low level resistance rate to vancomycin,teicoplanin and linezolid(≤3.6％).The prevalence of vancomycin-resistant E.faecalis and E.faecium was 0.1％and 1.3％,respectively.The prevalence of linezolid-resistant E.faecalis increased from 0.7％in 2015 to 3.4％in 2021,while the prevalence of linezolid-resistant E.faecium was 0.3％.Conclusions The clinical isolates of Enterococcus were still highly susceptible to vancomycin,teicoplanin,and linezolid,evidenced by a low resistance rate.However,the prevalence of linezolid-resistant E.faecalis was increasing during the 7-year period.It is necessary to strengthen antimicrobial resistance surveillance to effectively identify the emergence of antibiotic-resistant bacteria and curb the spread of resistant pathogens.

Objective:To understand the residents' cognition of commercial long-term insurance in Tianjin so as to provide a reference for improving service effect and quality of long-term insurance.Methods:A total of 31 residents from six districts of Tianjin were selected for semi-structured interviews from December 2022 to February 2023 by the convenient sampling method, and the data were analyzed by Colaizzi 7-step analysis method.Results:Three themes were extracted, namely, inadequate interpretation and promotion of commercial long-term insurance, immature development of commercial long-term insurance, and the ability of commercial long-term insurance to help caregivers reduce their family burden.Conclusions:The residents of Tianjin have a low awareness of commercial long-term insurance, which cannot meet the needs of most residents. It is urgent to strengthen their publicity further and improve their system.