ObjectiveTo investigate the preventive effect and mechanism of Dendrobium officinale （DO） on non-alcoholic fatty liver disease （NAFLD） by network pharmacology and animal experiments. MethodsDO components in blood after administration were identified and analyzed using ultra-performance liquid chromatography-quadrupole-electrostatic field orbitrap high-resolution mass spectrometry （UPLC-QE-HF-MS/MS）. Network pharmacology and molecular docking methods were employed to obtain active ingredients and potential targets of DO for NAFLD control. High-fat feeds were used to replicate the NAFLD rat model. Biochemical kits were used for detecting the expression levels of blood lipids， hepatic lipids， and liver functions of rats. Hematoxylin-eosin （HE） staining and oil red O staining were employed to observe pathological changes in rat liver， and real-time fluorescence quantitative PCR （Real-time PCR） assay was performed to validate potential targets obtained from the network pharmacology analysis. ResultsA total of 13 DO components were identified in blood， including berberine， dihydrosanguinarine， and oxypeucedanin. A total of 14 potential targets were screened through network pharmacology， including Forkhead box protein O1 （FoxO1）， epidermal growth factor receptor （EGFR）， and insulin-like growth factor 1 （IGF-1R）， involving pathways such as the advanced glycation end product （AGE）/receptor for AGE （RAGE） signaling pathway， blood lipids and atherosclerosis， insulin resistance， and FoxO signaling. The results of animal experiments showed that the NAFLD rat model was successfully replicated. After the preventive treatment with DO for NAFLD rats， the indexes of blood lipids， hepatic lipids， and liver function were normalized； lipid deposition and lesions in the liver were significantly improved； the expression level of FoxO1 mRNA in the liver was significantly reduced （P<0.05）， and the mRNA expression levels of phosphatidylinositide 3-kinases （PI3K）， protein kinase B （Akt）， EGFR， and IGF-1R were significantly increased （P<0.05）. ConclusionDO has a preventive effect on NAFLD rats， and the mechanism of action may be related to the modulation of IGF1R and EGFR targets and activation of the PI3K/Akt/FoxO1 signaling pathway.

Integrase inhibitors (INSTIs) are the newest class of antiretroviral drug which are available to people living with the human immunodeficiency virus (HIV). Since 2007, five types of INSTIs have been marketed: Raltegravir, Elvitegravir, Dolutegravir, Bictegravir and Cabotegravir, all of which were approved by the US Food and Drug Administration (FDA) for use in the initiation of antiretroviral therapy (ART) in treatment-na?ve individuals. Compared with other types of antiretroviral drugs, INSTIs have better efficacy and tolerability, so many countries around the world have listed INSTIs-containing regimens as the preferred regimen for HIV ART. In recent years, with the widespread use of INSTIs, some research data suggest that INSTIs may have some adverse effects (AEs), such as central nervous system symptoms, abnormal lipid metabolism, weight gain, abnormal liver and kidney function, etc. This review summarizes the current use of INSTIs in people living with the HIV, and highlights the clinical efficacy and their AEs among the five types of INSTIs in China.

Objective:To analyze and evaluate the current situation of falls in the frail elderly population, and to provide a reliable basis for formulating measures for fall prevention.Methods:CNKI, VIP Database, Wanfang Database, China Biomedical Database, PubMed, Embase, Web of Science, CINAHL, Cochrane Library, Sinomed were searched, and cross-sectional studies on falls in the frail elderly population were searched, and the search time limit was established until June 30, 2023. Two review authors independently screened studies, extracted data, assessed the risk of bias of included studies, and Meta-analyses were performed using Stata 16.0 software and RevMan5.4.Results:A total of 12 cross-sectional studies with a total sample size of 4 597 cases were included. Meta-analysis showed that the incidence of falls in the frail elderly population was 39.9% (1 834/4 597). The results of subgroup analysis showed that there was significant difference in the female, age, chronic pain, body mass index, live alone ( P<0.05). The incidence of falls in male and female was 25.9%(640/2 471) and 40.7%(1 005/2 471), respectively. The incidence of falls in the aged 60-69, 70-79 and over 80 years old was 25.7%(470/1 831), 30.6% (560/1 831) and 46.8%(857/1 831), respectively. The incidence of falls in body mass index < 18.5, 18.5-24.0, >24.0 kg/m 2 was 12.29%(63/512), 9.58%(49/512) and 19.89%(101/512), respectively. The incidence of falls in with or without chronic pain was 33.55%(181/541) and 16.03%(87/541), respectively. The incidence of falls in living alone and not living alone was 32.3%(524/1 624) and 16.9%(274/1 624), respectively. Conclusions:The incidence of falls in the frail elderly population is at a relatively high level. Women, older adults, overweight, have chronic pain and live alone have a higher incidence of falls.

ObjectiveTo investigate effect of conducting training of autism spectrum disorder （ASD） early screening skill on improving the ability to early identify ASD of medical staffs in primary care hospitals. MethodsIn September 2021， the training of ASD early screening skills was carried out for medical staffs from 20 primary care hospitals in Chengdu. After training， the training effect was evaluated. The numbers of referrals from primary care hospitals to superior hospitals， confirmed ASD as well as their average diagnostic age of children with ASD before and after training were used as evaluation indicators. ResultsAfter training， the number of children with suspected ASD referred by primary care hospitals was more than that before training ［（16.65±11.60） vs. （3.40±2.23）， t=5.431， P<0.01］， the number of children diagnosed with ASD was more than that before training［（6.85±4.93） vs. （2.45±1.67）， t=4.171， P<0.01］， and the differences were statistically significant. As for the diagnosed age of ASD children， after training， the average age was lower than that before training ［（34.95±11.67） vs. （42.2±14.64）， t=-2.553， P=0.019］. ConclusionTraining of ASD early screening skills for medical staffs in primary care hospitals may help to improve their ability to early screening ASD children.

Human immunodeficiency virus (HIV) is an important challenge to human health. The patients with chronic infection have a gradually decrease of CD4⁺ T cells and eventually develop into acquired immunodeficiency syndrome (AIDS). Most HIV infected patients have received full virological suppression and immunological restoration due to antiretroviral therapy (ART), which improved their survival rate. After the initiation of ART, some patients get rapidly deteriorating clinical symptoms or even death, even though HIV replication is suppressed and CD4⁺ T lymphocytes raise, which called immune reconstruction inflammatory syndrome (IRIS). Clinical observations suggest that IRIS may be associated with a serious opportunistic infection and a very late onset of HIV/AIDS, but there are many unknowns from diagnosis to treatment and pathogenesis. This article reviews the incidence, the development of clinical features, related mechanisms and treatment strategies and other aspects of the disease.

Objective: To investigate the influence of condylar fractures on the growth of condylars after conservative treatments by three-dimensional measurement. Methods: Twenty three children with unilateral condylar fracture followed-up for at least 1 year in Shanghai Ninth People's Hospital were included from June 2016 to March 2017. CT scans were performed for each patient. Three-dimensional virtual skulls were reconstructed and measuring points were defined with Simplant 11.04 software. The depth of glenoid fossa, height of articular eminence, width, height and depth of condylar, deviation of pogonion were measured. Statistical analyses were conducted to assess difference between the bifid group and the normal group. Results: No difference was observed in the vertical position of crest of the articular eminence between two groups (P=0.110). The vertical position of roof of the glenoid fossa in bifid side was significantly superior than the one in normal side (P=0.010). Bifid side had a shorter (P=0.002) and wider(P=0.002) condylar than normal side did. No difference was observed in the depth of condylar between two groups (P=0.071). The average deviation of pogonion was (0.69±1.75) mm (P=0.072) from sagittal plan. Conclusions This short-termed study indicates that children's growth potential of condylar is under average after conservative treatments. Because the bone hyperosteogeny of glenoid fossa compensates the hypotrophy of condylar, no deviation of pogonion is detected.

Human height, a complex trait with over 80% heritability, is determined by genetic and environment factors. Currently, a certain amount of specific variants about human height have been found, especially with the widely used of genome-wide association studies (GWAS) in genetics research, making it a great progress for the discovering of height associated genes. However, single nucleotide polymorphisms (SNPs) found by GWAS can only explain a minority of the heritable. This article reviews the progress of GWAS about height associated genes and missing heritability domestic and overseas.

Objective To establishthe sensitivity indexes system for estimating nursing quality which conforms to China's national conditions and have the certain representative among the whole country. Methods After usingStructure-process-outcome as the theoretical framework and surveying the literatures domestic and abroad,a total of 42 nursing management experts from 30 provinces were consulted by the Delphi method,including symposium and two rounds of questionnaire consultation. Results The authority coefficient of the two rounds consultation were 0.89 and 0.91,familiarity coefficient were 0.86 and 0.88 respectively,and the coordination coefficient of expert opinion were 0.20 and 0.25. The sensitivity indexes system for estimating nursing qualityconsists of two level index systems,which were divided into three first level indexes and seven second level indexes. The first level index in-cluded nursing manpower allocation,nursing safety and nursing events,while the second level index includes nurse-inpatient ratio,accuracy rate of identification,the number of medication error events,the number of blood transfusion error events,the number of specimen error events,the number of drug extravasation events and high-risk patient falls (falling bed) incidence. Conclusion The results of this study are reliable. There is a clear definition and interpreta-tion of sensitivity indexes for estimating nursing quality and index monitoring is operable.

Primary biliary cholangitis (PBC) is an autoimmune liver disease mainly involving intrahepatic interlobular bile ducts and can progress to liver fibrosis, liver cirrhosis, and even liver failure. Ursodeoxycholic acid (UDCA) is the first-line therapeutic drug for PBC and can delay disease progression, but as high as 40% of patients have suboptimal response to UDCA. Obeticholic acid, a farnesoid X receptor agonist, has been approved by FDA in May 2016 for patients who have no response to UDCA treatment or cannot tolerate such treatment. Other drugs such as fibrates, glucocorticoids, immunosuppressants, biological agents, and mesenchymal stem cells are gradually used in clinical practice and bring new hope to patients with refractory PBC.

Primary biliary cholangitis (PBC) is an autoimmune liver disease mainly involving intrahepatic interlobular bile ducts and can progress to liver fibrosis, cirrhosis, and even liver failure. At present, the only drug approved for the treatment of PBC is ursodeoxycholic acid (UDCA), but up to 40% of PBC patients have suboptimal response to UDCA, and the risk of related complications is increased. Nowadays, other drugs and treatment methods, such as fibrates, glucocorticoids, immunosuppressants, obeticholic acid, biological agents, and mesenchymal stem cells, have been gradually applied in clinical practice and have brought the hope for the treatment of these patients.