Airway mucus hypersecretion is one of the important pathophysiological and clinical manifestations of chronic obstructive pulmonary disease. It has been reported in the literature that COPD patients with chronic airway mucus hypersecretion have more frequent acute exacerbations, more severe lung function decline, and higher hospitalizations and mortality. Therefore, it is particularly critical to understand the pathogenesis of hypersecretion of mucus in chronic obstructive pulmonary disease and find out effective treatment. This article focuses on the structure, significance of airway mucus and the mechanism of hypersecretion of mucus in chronic obstructive pulmonary disease (COPD). In addition, we also summarized drug and non-drug therapy for chronic airway mucus hypersecretion in this article. Drug therapy includes traditional drug therapy, some new targeted drug therapy for pathogenesis and traditional Chinese medicine therapy, and non-drug therapy includes smoking cessation, physical therapy and bronchos-copy therapy. We hope that it will provide new ideas and directions for the treatment of mucus hypersecretion in COPD patients.

Currently, clinically used drugs for the treatment of gout inflammation, such as colchicine, nonsteroidal anti-inflammatory drugs, and glucocorticoids, can only relieve the pain of joint inflammation and have severe hepatorenal toxicity and multiple organ adverse reactions. The NOD-like receptor thermal protein domain associated protein 3 (NLRP3) inflammasome is a key complex that induces the onset of gout inflammation and has become a crucial target in the development of anti-gout drugs. This article reviews the research progress of anti-gout small molecules targeting the NLRP3 inflammasome and their bioactivity evaluation methods in the past five years, in order to provide information for the development of specific drugs for the treatment of gout inflammation.

ObjectiveTo provide technical support for the molecular surveillance of pathogenic bacteria strains carrying mobile colistin resistance-1 （mcr⁃1） gene isolate from inlet of wastewater treatment plants （WWTP）. MethodsThe Enterobacteriaceae strains carrying mcr⁃1 resistance gene isolate from inlet of WWTP during April 1 to June 30， 2023 in Shanghai were cultured on blood-rich and SS culture medium and were identified using a mass spectrometry analyzer. The mcr⁃1 gene and copy number were detected by real-time fluorescence quantitative PCR. Drug susceptibility test was performed by microbroth dilution method. The copy numbers of Escherichia coli carrying mcr⁃1 gene isolated from wastewater and human fecel were statistically analyzed by SPSS 25.0. ResultsA total of 14 strains carrying the mcr⁃1 gene were isolated from 49 WWTP samples， and the positive isolation rate was 28.6%， including 12 non-diarrheal E. coli strains and 2 Klebsiella pneumoniae strains. The drug susceptibility results showed that all 14 strains were multi-drug resistant bacteria. They were all sensitive to imipenem and tigecycline， but were ampicillin- and cefazolin-resistant. There was no significant difference in the copy number between human-sourced diarrheal E. coli and wastewater-sourced non-diarrheal E. coli （t=0.647， P>0.05）. ConclusionThe isolation and identification of strains carrying the mcr⁃1 gene from inlet of WWTP samples were firstly established in Shanghai. The multi-drug resistance among the isolated strains is severe. To effectively prevent and control the spread of colistin-resistant bacteria， more attention should be paid to the surveillance of mcr⁃1 gene.

Objective To analyze the incidence and risk factors of hypothermia in elderly patients with malnutrition during proximal femoral nail antirotation(PFNA)internal fixation under general anesthesia.Methods A total of 139 elderly patients underwent PFNA internal fixation under general anesthesia were selected,and the nutritional status scores 1 day before surgery ranged from 0 to 11 points.Univariate and multivariate Logistic binary regression analysis was performed to analyze the related factors that may lead to intraoperative hypothermia.Results Among 139 elderly patients with preoperative nutritional scores of 0 to 11 points,79 cases(56.83%)developed intraoperative hypothermia.The results of univariate and multivariate Logistic binary regression analysis suggested that age≥75 years old,mini nutritional assessment short form(MNA-SF)nutritional score 0 to 7 points,BMI<18.5 kg/m2,duration of general anesthesia≥2 hours,intraoperative flushing fluid volume≥1 000 mL and intraoperative fluid volume≥1 000 mL were the risk factors for the occurrence of intraoperative hypothermia in elderly patients(OR>1,P<0.05).The use of warm blanket insulation was the protective factor against the occurrence of intraoperative hypothermia(OR<1,P<0.05).Conclusion The incidence of intraoperative hypothermia during PFNA internal fixation under general anesthesia in elderly patients with mainutrition before operation is high,and patients with poor nutritional status are more likely to develop intraoperative hypothermia.Patients with older age,poor nutritional status,lower BMI,longer duration of general anesthesia,and more intraoperative flushing fluid volume and intraoperative fluid volume are likely to lead to intraoperative hypothermia.The use of warm blanket can reduce the incidence of intraoperative hypothermia.

Objective:To explore the reasonable timing of radiotherapy for epidermal growth factor receptor ( EGFR) mutation-positive non-small cell lung cancer patients with brain metastasis in the era of third-generation targeted drugs. Methods:Clinical data of EGFR mutation-positive non-small cell lung cancer patients with brain metastasis who received first-line treatment with third-generation targeted drugs and stereotactic radiotherapy at Shanghai Armed Police Corps Hospital from September 2019 to May 2022 were retrospectively analyzed. According to the timing of radiotherapy before / after targeted drug resistance, all patients were divided into the early and salvage radiotherapy groups. The proportion of brain metastasis, physical fitness, complete response rate, objective response rate, delaying the progression of brain metastasis and overall survival (OS) were compared between two groups. Kaplan-Meier method was used for survival analysis, log-rank test was used for univariate prognostic analysis, and factors with P <0.1 were included in Cox multivariate analysis. Results:A total of 85 patients were included, including 51 (60%) cases receiving early radiotherapy. Patients who participated in early radiotherapy had a higher proportion of symptomatic brain metastasis (82% vs. 56%, P=0.013) and poorer physical fitness (Kanofsky performance score <70: 61% vs. 26%, P=0.002) compared to patients who underwent salvage radiotherapy. Early radiotherapy significantly improved the complete response rate of intracranial lesions (35% vs. 12%, P=0.015) and objective response rate (88% vs. 71%, P=0.041), delayed the progression of brain metastasis (median intracranial progression free survival: 23.0 months vs. 16.0 months, P=0.005; median intracranial secondary progression free survival: 31.0 months vs. 22.0 months, P=0.021), and improved OS (median OS: 44.0 months vs. 35.0 months, P=0.046). In multivariate analysis, diagnosis-specific graded prognostic assessment score <2.5, mutation of EGFR exon 21, and salvage brain radiotherapy were adverse prognostic factors for OS. Conclusion:In the era of third-generation targeted drugs therapy, early involvement of stereotactic radiotherapy in non-small cell lung cancer patients with brain metastasis can bring greater clinical benefits.

Airway mucus hypersecretion is one of the important pathophysiological and clinical manifestations of chronic obstructive pulmonary disease.It has been reported in the literature that COPD patients with chronic airway mucus hyperse-cretion have more frequent acute exacerbations,more severe lung function decline,and higher hos-pitalizations and mortality.Therefore,it is particu-larly critical to understand the pathogenesis of hy-persecretion of mucus in chronic obstructive pul-monary disease and find out effective treatment.This article focuses on the structure,significance of airway mucus and the mechanism of hypersecre-tion of mucus in chronic obstructive pulmonary dis-ease(COPD).In addition,we also summarized drug and non-drug therapy for chronic airway mucus hy-persecretion in this article.Drug therapy includes traditional drug therapy,some new targeted drug therapy for pathogenesis and traditional Chinese medicine therapy,and non-drug therapy includes smoking cessation,physical therapy and bronchos-copy therapy.We hope that it will provide new ideas and directions for the treatment of mucus hy-persecretion in COPD patients.

Objective:To quantitatively evaluate China's digital health policies since the new healthcare reform,and provide recommendations for future policy formulation and optimization.Methods:Employing ROSTCM6 software,we conducted text mining analysis on 130 national-level digital health policies.Based on the findings,we constructed a PMC Index Model evaluation system comprising 9 primary variables and 42 secondary variables.From these policies,20 representative texts were selected for in-depth quantitative analysis.Results:The average PMC score of the 20 policies analyzed was 5.47,indicating overall excellence.One policy achieved the perfect standard,12 were rated as excellent,and 7 fell within the acceptable range.Notably,no policies were classified as inadequate.Conclusion:While China's digital health policies demonstrate considerable success,there are opportunities for improvement.It is crucial to fortify the temporal effectiveness of policies and implement systems for continuously monitoring the dynamic shifts within the policy environment.Furthermore,clarifying the roles of various policy actors and establishing a diversified collaborative governance mechanism are essential to ensuring effective policy implementation.Increase economic incentives to promote digital technology innovation and focus on policy balance to promote the development of the digital health industry.

italic>Salvia miltiorrhiza, a commonly used traditional Chinese medicine, has been widely recognized for its blood-activating and stasis-removing properties in the clinical treatment of cardiovascular and cerebrovascular diseases. The synthesis and regulatory mechanism of tanshinones, the key active constituents of Salvia miltiorrhiza, have been a hot topic of research. The paper summarized the research findings on the regulation of tanshinone biosynthesis by transcription factors such as AP2/ERF, bHLH, MYB, bZIP, and WRKY in recent years. The review identifies the existing issues in the transcriptional regulation studies of Salvia miltiorrhiza and discusses the research direction of transcription factors in the regulation of tanshinone biosynthesis, providing a theoretical basis for the further discovery and utilization of functional genes involved in the regulation of tanshinone bioactive constituents.

Airway mucus hypersecretion is one of the important pathophysiological and clinical manifestations of chronic obstructive pulmonary disease.It has been reported in the literature that COPD patients with chronic airway mucus hyperse-cretion have more frequent acute exacerbations,more severe lung function decline,and higher hos-pitalizations and mortality.Therefore,it is particu-larly critical to understand the pathogenesis of hy-persecretion of mucus in chronic obstructive pul-monary disease and find out effective treatment.This article focuses on the structure,significance of airway mucus and the mechanism of hypersecre-tion of mucus in chronic obstructive pulmonary dis-ease(COPD).In addition,we also summarized drug and non-drug therapy for chronic airway mucus hy-persecretion in this article.Drug therapy includes traditional drug therapy,some new targeted drug therapy for pathogenesis and traditional Chinese medicine therapy,and non-drug therapy includes smoking cessation,physical therapy and bronchos-copy therapy.We hope that it will provide new ideas and directions for the treatment of mucus hy-persecretion in COPD patients.

Airway mucus hypersecretion is one of the important pathophysiological and clinical manifestations of chronic obstructive pulmonary disease.It has been reported in the literature that COPD patients with chronic airway mucus hyperse-cretion have more frequent acute exacerbations,more severe lung function decline,and higher hos-pitalizations and mortality.Therefore,it is particu-larly critical to understand the pathogenesis of hy-persecretion of mucus in chronic obstructive pul-monary disease and find out effective treatment.This article focuses on the structure,significance of airway mucus and the mechanism of hypersecre-tion of mucus in chronic obstructive pulmonary dis-ease(COPD).In addition,we also summarized drug and non-drug therapy for chronic airway mucus hy-persecretion in this article.Drug therapy includes traditional drug therapy,some new targeted drug therapy for pathogenesis and traditional Chinese medicine therapy,and non-drug therapy includes smoking cessation,physical therapy and bronchos-copy therapy.We hope that it will provide new ideas and directions for the treatment of mucus hy-persecretion in COPD patients.