To promote the development of extracellular vesicles of herbal medicine especially the establishment of standardization, led by the National Expert Committee on Research and Application of Chinese Herbal Vesicles, research experts in the field of herbal medicine and extracellular vesicles were invited nationwide with the support of the Expert Committee on Research and Application of Chinese Herbal Vesicles, Professional Committee on Extracellular Vesicle Research and Application, Chinese Society of Research Hospitals and the Guangdong Engineering Research Center of Chinese Herbal Vesicles. Based on the collation of relevant literature, we have adopted the Delphi method, the consensus meeting method combined with the nominal group method to form a discussion draft of "Consensus statement on research and application of Chinese herbal medicine derived extracellular vesicles-like particles (2023)". The first draft was discussed in online and offline meetings on October 12, 14, November 2, 2022 and April and May 2023 on the current status of research, nomenclature, isolation methods, quality standards and research applications of extracellular vesicles of Chinese herbal medicines, and 13 consensus opinions were finally formed. At the Third Academic Conference on Research and Application of Chinese Herbal Vesicles, held on May 26, 2023, Kewei Zhao, convenor of the consensus, presented and read the consensus to the experts of the Expert Committee on Research and Application of Chinese Herbal Vesicles. The consensus highlights the characteristics and advantages of Chinese medicine, inherits the essence, and keeps the righteousness and innovation, aiming to provide a reference for colleagues engaged in research and application of Chinese herbal vesicles at home and abroad, decode the mystery behind Chinese herbal vesicles together, establish a safe, effective and controllable accurate Chinese herbal vesicle prevention and treatment system, and build a bridge for Chinese medicine to the world.

Small interfering RNA (siRNA) has a promising future in the treatment of ocular diseases due to its high efficiency, specificity, and low toxicity in inhibiting the expression of target genes and proteins. However, due to the unique anatomical structure of the eye and various barriers, delivering nucleic acids to the retina remains a significant challenge. In this study, we rationally design PACD, an A-B-C type non-viral vector copolymer composed of a hydrophilic PEG block (A), a siRNA binding block (B) and a pH-responsive block (C). PACDs can self-assemble into nanosized polymeric micelles that compact siRNAs into polyplexes through simple mixing. By evaluating its pH-responsive activity, gene silencing efficiency in retinal cells, intraocular distribution, and anti-angiogenesis therapy in a mouse model of hypoxia-induced angiogenesis, we demonstrate the efficiency and safety of PACD in delivering siRNA in the retina. We are surprised to discover that, the PACD/siRNA polyplexes exhibit remarkable intracellular endosomal escape efficiency, excellent gene silencing, and inhibit retinal angiogenesis. Our study provides design guidance for developing efficient nonviral ocular nucleic acid delivery systems.

Iron is an indispensable nutritional element for human growth and development. It has a protective effect on cardiovascular. The changes and metabolism of iron can affect the physiological and pathological state of the body. Current research has confirmed that iron overload will promote the synthesis of cholesterol and increase lipid metabolism disorders. Lipid metabolic disorders in the body easily induce the occurrence and development of related metabolic diseases, and increase the hidden dangers of the outbreak of relevant risk factors. This article reviews iron and lipid metabolic and other metabolic diseases and natural products to prevent diseases through iron metabolic pathway, which aims to provide more powerful references for in-depth research on the mechanism of metabolic diseases and related diseases and target drug research and development.

Objective To use the Internet of things based early warning model of lung cancer to perform early lung cancer screening among chronic obstructive pulmonary disease(COPD)patients in Lishui City.Methods Patients with COPD diagnosed in our hospital from July 2021 to June 2022 underwent plain chest CT,and the 300 patients who had lung nodules detected and agreed to participate in the study were completed with lung nodule target scan + two-and three-dimensional reconstruction to detect gene polymorphisms of CYP1A1,GST and XRCC1 and mirna130a and mir204-5p in peripheral blood.Asked to wear smart hand ring for 10 hours every day while awake from July 2022 to September 2022 to detect vital signs and exercise volume.Review lung nodule target scan + two three dimensional reconstruction in October 2022.If the nodules were larger than before,the patient was truthfully informed of the results.The patient and the specialist of our hospital discussed whether to carry out lung puncture for pathology.Patients with pathologically confirmed lung cancer were progression group and the rest were stable group.Results Totally 240 patients were in the stable group,48 patients were in the progression group,12 patients continued to follow-up after consultation by physicians.There were significant differences in adiposity,mean oximetry,nadir oximetry,forced vital capacity(FVC)predicted,exercise capacity,and lung nodule diameter between the two groups.The expression levels of peripheral mirna-130a,mirna-204-5p were significantly different between the two groups(P<0.001).There were significant differences in CYP1A1,GST,and XRCC1 genotypes in peripheral blood between stable and progressive patients.The areas under the receiver operating characteristic(ROC)curves were mean oxygen saturation(0.681),lowest oxygen saturation(0.735),FVC predicted(0.781),exercise(0.835),lung nodule length diameter(0.825),peripheral blood mirna-130a(0.796),mirna-204-5p(0.893).Conclusion The Internet of things based early warning model for lung cancer can be used for lung cancer screening among COPD patients.

Objective To analyze the efficacy of Astragalus membranaceus and Draba nemorosa in the treatment of chronic heart failure(CHF),the change of cardiac color ultrasound parameters and its predictive value for adverse end events.Methods A total of 92 patients with Qi-deficiency and blood-stasis combined with Shuiyin CHF treated in Wenzhou Hospital of Traditional Chinese Medicine from September 2019 to September 2021 were randomly selected and divided into two groups by random number table method,with 46 cases in each group.Patients in control group were received conventional Western medicine treatment,and patients in observation group were received the addition and subtraction treatment of Yiqi Huoxue Lishui prescription based on Astragalus membranaceus and Draba nemorosa.The clinical efficacy,TCM syndrome score,heart color ultrasound parameters and the incidence of adverse endpoint events within 6 months were compared between the two groups.Cardiac color doppler ultrasound parameters were compared between the occurrence group and the non-occurrence group,and receiver operating characteristic curve was drawn to analyze the predictive value of cardiac color Doppler ultrasound parameters for adverse end events.Results The total clinical effective rate of the observation group(95.65%)was higher than that of the control group(71.74%)(P<0.05).After treatment,palpitation,weakness,shortness of breath,lethargy and lip purple score in observation group were lower than those in control group(P<0.05).The left ventricular end-diastolic diameter(LVEDD)and left arial diameters(LAD)of the observation group were lower than those of the control group after treatment(P<0.05).After treatment,the left ventricular ejection fraction(LVEF)of the observation group was higher than that of the control group(P<0.05);The incidence of adverse endpoint events within 6 months in the observation group(2.17%)was lower than that in the control group(19.57%)(P<0.05).The LVEDD and LAD in the adverse end point event group were higher than those in the without adverse end point event group(P<0.05),and the LVEF was lower than that in the without adverse end point event group(P<0.05).The area under the curve(AUC)of LVEDD,LAD and LVEF combined to predict the occurrence of adverse endpoint events was 0.812,and the 95%CI confidence interval was 0.734-0.968;The sensitivity of combined detection(93.42%)was higher than that of single detection(71.52%,75.11%,79.62%)(P<0.05).The specificity of combined detection(82.27%)compared with that of single detection(70.19%,73.07%,77.28%)(P>0.05).Conclusion Supplementing qi and promoting blood circulation and rehydrating water based on Astragalus membranaceus and Draba nemorosa can effectively improve the cardiac function of CHF patients,alleviate symptoms such as palpitations and fatigue,and reduce the incidence of adverse endpoint events.In addition,the combined detection of cardiac ultrasound parameters can improve the prediction efficiency of adverse endpoint events,which has certain clinical value.

With the development of information technology and the increasing demand for vaccination services among the people, it is a definite trend to enhance the quality of vaccination services through digitization. This article starts with a clear concept of digital services for vaccination, introduces the current development status in China and abroad, analyzes the advantages and disadvantages of existing models in leading regions, takes a glean from the summation, and proposes targeted solutions. This study suggests establishing a departmental coordination mechanism for data interconnection and sharing, formulating data standards and functional specifications, enhancing the functionalities of the immunization planning information system, strengthening data collection and analytical usage, and intensifying appointment management and science and health education to provide expert guidance for the construction of digital vaccination services across the country in the future.

With the development of information technology and the increasing demand for vaccination services among the people, it is a definite trend to enhance the quality of vaccination services through digitization. This article starts with a clear concept of digital services for vaccination, introduces the current development status in China and abroad, analyzes the advantages and disadvantages of existing models in leading regions, takes a glean from the summation, and proposes targeted solutions. This study suggests establishing a departmental coordination mechanism for data interconnection and sharing, formulating data standards and functional specifications, enhancing the functionalities of the immunization planning information system, strengthening data collection and analytical usage, and intensifying appointment management and science and health education to provide expert guidance for the construction of digital vaccination services across the country in the future.

Glaucoma is one of the most common optic neuropathies, featuring progressive retinal ganglion cell damage and visual field loss (Tham et al., 2014; Xu et al., 2020). Currently, the only effective treatment for this condition is the reduction of intraocular pressure (IOP) (Palmberg, 2001; Heijl et al., 2002). Canaloplasty is a proven bleb-independent surgery with good efficacy and safety profiles in primary open-angle glaucoma (POAG) (Gołaszewska et al., 2021). However, early transient postoperative IOP elevation has been reported in up to 30% of cases (Riva et al., 2019), similar to that commonly observed in other internal drainage glaucoma surgeries such as implantation using iStent (0%-21.0%), CyPass (10.8%), and Hydrus (4.8%-6.5%) (Lavia et al., 2017). This complication may be a predictor of poor reserve in the outflow system and is potentially associated with surgical failure. Nonetheless, the exact pathophysiology of glaucoma remains unknown, and studies clarifying the risk factors for postoperative IOP elevation have been scarce.
Humans ; Intraocular Pressure ; Glaucoma, Open-Angle/surgery* ; Incidence ; Treatment Outcome ; Risk Factors

Objective: To analyze the prevalence and the risk factors of fungal sepsis in 25 neonatal intensive care units (NICU) among preterm infants in China, and to provide a basis for preventive strategies of fungal sepsis. Methods: This was a second-analysis of the data from the "reduction of infection in neonatal intensive care units using the evidence-based practice for improving quality" study. The current status of fungal sepsis of the 24 731 preterm infants with the gestational age of <34⁺⁰ weeks, who were admitted to 25 participating NICU within 7 days of birth between May 2015 and April 2018 were retrospectively analyzed. These preterm infants were divided into the fungal sepsis group and the without fungal sepsis group according to whether they developed fungal sepsis to analyze the incidences and the microbiology of fungal sepsis. Chi-square test was used to compare the incidences of fungal sepsis in preterm infants with different gestational ages and birth weights and in different NICU. Multivariate Logistic regression analysis was used to study the outcomes of preterm infants with fungal sepsis, which were further compared with those of preterm infants without fungal sepsis. The 144 preterm infants in the fungal sepsis group were matched with 288 preterm infants in the non-fungal sepsis group by propensity score-matched method. Univariate and multivariate Logistic regression analysis were used to analyze the risk factors of fungal sepsis. Results: In all, 166 (0.7%) of the 24 731 preterm infants developed fungal sepsis, with the gestational age of (29.7±2.0) weeks and the birth weight of (1 300±293) g. The incidence of fungal sepsis increased with decreasing gestational age and birth weight (both P<0.001). The preterm infants with gestational age of <32 weeks accounted for 87.3% (145/166). The incidence of fungal sepsis was 1.0% (117/11 438) in very preterm infants and 2.0% (28/1 401) in extremely preterm infants, and was 1.3% (103/8 060) in very low birth weight infants and 1.7% (21/1 211) in extremely low birth weight infants, respectively. There was no fungal sepsis in 3 NICU, and the incidences in the other 22 NICU ranged from 0.7% (10/1 397) to 2.9% (21/724), with significant statistical difference (P<0.001). The pathogens were mainly Candida (150/166, 90.4%), including 59 cases of Candida albicans and 91 cases of non-Candida albicans, of which Candida parapsilosis was the most common (41 cases). Fungal sepsis was independently associated with increased risk of moderate to severe bronchopulmonary dysplasia (BPD) (adjusted OR 1.52, 95%CI 1.04-2.22, P=0.030) and severe retinopathy of prematurity (ROP) (adjusted OR 2.55, 95%CI 1.12-5.80, P=0.025). Previous broad spectrum antibiotics exposure (adjusted OR=2.50, 95%CI 1.50-4.17, P<0.001), prolonged use of central line (adjusted OR=1.05, 95%CI 1.03-1.08, P<0.001) and previous total parenteral nutrition (TPN) duration (adjusted OR=1.04, 95%CI 1.02-1.06, P<0.001) were all independently associated with increasing risk of fungal sepsis. Conclusions: Candida albicans and Candida parapsilosis are the main pathogens of fungal sepsis among preterm infants in Chinese NICU. Preterm infants with fungal sepsis are at increased risk of moderate to severe BPD and severe ROP. Previous broad spectrum antibiotics exposure, prolonged use of central line and prolonged duration of TPN will increase the risk of fungal sepsis. Ongoing initiatives are needed to reduce fungal sepsis based on these risk factors.
Infant ; Infant, Newborn ; Humans ; Birth Weight ; Intensive Care Units, Neonatal ; Retrospective Studies ; Tertiary Care Centers ; Infant, Extremely Low Birth Weight ; Gestational Age ; Infant, Extremely Premature ; Sepsis/epidemiology* ; Retinopathy of Prematurity/epidemiology* ; Bronchopulmonary Dysplasia/epidemiology*

  Objective  To study the demographic and clinical characteristics, correlation of genotype and phenotype and treatment of Blau syndrome to facilitate early diagnosis and timely treatment of Blau syndrome.  Methods  Seventy-two patients with Blau syndrome from 11 centers from May 2006 to April 2022 were retrospectively analyzed, and their general information, clinical data, laboratory examination and treatment medication were collected.  Results  The distribution of patients with Blau syndrome was uniform in geographical north and south of China, and there was no obvious gender bias. The mean age of onset was (14.30±12.81) months, and the age of diagnosis was (55.18±36.22) months. 35% of patients with Blau syndrome happened before 1 year old, and all patients developed before 5 years old. 87.50% (63/72) had granulomatous arthritis, 65.28% (47/72) had rash, 36.11% (26/72) had ocular involvement, 27.78% (20/72) had fever, and 15.28% (11/72) had pulmonary involvement. Arthritic manifestations of Blau syndrome were most at risk, followed by rash, ocular involvement, and fever.The first 25 months of the disease, the risk of developing a rash was the greatest. The risk of developing arthritis was the greatest between 25 months and 84 months. The main mutations were p.R334Q and p.R334W, and patients with p.R334Q mutation had relatively high incidence of fever (35.71%[5/14] vs. 14.29%[1/7], P=0.43) and ocular involvement (42.86%[6/14]vs. 28.57%[2/7], P=0.51). There was a relatively high incidence of rash (85.71%[6/7] vs. 64.29%[9/14], P=0.59) in patients with the p.R334W mutation. Forty-five patients(62.50%)were treated with a combina-tion of glucocorticoid and methotrexate. Twenty-two patients were treated with tumor necrosis factor antagonist in addition to glucocorticoid and methotrexate.  Conclusions  The risk of different clinical manifestations of Blau syndrome from high to low was arthritis, followed by rash, ocular involvement and fever. The main treatment was glucocorticoid combined with methotrexate, to which biological agents could be added.