Pathogenesis, diagnosis, and treatment of epilepsy: electromagnetic stimulation-mediated neuromodulation therapy and new technologies

Epilepsy is a severe,relapsing,and multifactorial neurological disorder.Studies regarding the accurate diagnosis,prognosis,and in-depth pathogenesis are crucial for the precise and effective treatment of epilepsy.The pathogenesis of epilepsy is complex and involves alterations in variables such as gene expression,protein expression,ion channel activity,energy metabolites,and gut microbiota composition.Satisfactory results are lacking for conventional treatments for epilepsy.Surgical resection of lesions,drug therapy,and non-drug interventions are mainly used in clinical practice to treat pain associated with epilepsy.Non-pharmacological treatments,such as a ketogenic diet,gene therapy for nerve regeneration,and neural regulation,are currently areas of research focus.This review provides a comprehensive overview of the pathogenesis,diagnostic methods,and treatments of epilepsy.It also elaborates on the theoretical basis,treatment modes,and effects of invasive nerve stimulation in neurotherapy,including percutaneous vagus nerve stimulation,deep brain electrical stimulation,repetitive nerve electrical stimulation,in addition to non-invasive transcranial magnetic stimulation and transcranial direct current stimulation.Numerous studies have shown that electromagnetic stimulation-mediated neuromodulation therapy can markedly improve neurological function and reduce the frequency of epileptic seizures.Additionally,many new technologies for the diagnosis and treatment of epilepsy are being explored.However,current research is mainly focused on analyzing patients’clinical manifestations and exploring relevant diagnostic and treatment methods to study the pathogenesis at a molecular level,which has led to a lack of consensus regarding the mechanisms related to the disease.

Advancing treatment strategies:Insights from network meta-analysis of hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma

This study examines the pivotal findings of the network meta-analysis of Zhou et al,which evaluated the efficacy of hepatic arterial infusion chemotherapy and combination therapies for advanced hepatocellular carcinoma(HCC).This meta-analysis suggests that therapeutic combinations have greater efficacy than do standard treatments.The article highlights the key insights that have the potential to shift current clinical practice and enhance outcomes for patients with advanced HCC.Additionally,this article discusses further research that can be conducted to optimize these treatments and achieve personalized care for patients with HCC.

The emerging role of mesenchymal stem cell-derived extracellular vesicles to ameliorate hippocampal NLRP3 inflammation induced by binge-like ethanol treatment in adolescence

Our previous studies have reported that activation of the NLRP3(NOD-,LRR-and pyrin domain-containing protein 3)-inflammasome complex in ethanol-treated astrocytes and chronic alcohol-fed mice could be associated with neuroinflammation and brain damage.Mesenchymal stem cell-derived extracellular vesicles(MSC-EVs)have been shown to restore the neuroinflammatory response,along with myelin and synaptic structural alterations in the prefrontal cortex,and alleviate cognitive and memory dysfunctions induced by binge-like ethanol treatment in adolescent mice.Considering the therapeutic role of the molecules contained in mesenchymal stem cell-derived extracellular vesicles,the present study analyzed whether the administration of mesenchymal stem cell-derived extracellular vesicles isolated from adipose tissue,which inhibited the activation of the NLRP3 inflammasome,was capable of reducing hippocampal neuroinflammation in adolescent mice treated with binge drinking.We demonstrated that the administration of mesenchymal stem cell-derived extracellular vesicles ameliorated the activation of the hippocampal NLRP3 inflammasome complex and other NLRs inflammasomes(e.g.,pyrin domain-containing 1,caspase recruitment domain-containing 4,and absent in melanoma 2,as well as the alterations in inflammatory genes(interleukin-1β,interleukin-18,inducible nitric oxide synthase,nuclear factor-kappa B,monocyte chemoattractant protein-1,and C–X3–C motif chemokine ligand 1)and miRNAs(miR-21a-5p,miR-146a-5p,and miR-141-5p)induced by binge-like ethanol treatment in adolescent mice.Bioinformatic analysis further revealed the involvement of miR-21a-5p and miR-146a-5p with inflammatory target genes and NOD-like receptor signaling pathways.Taken together,these findings provide novel evidence of the therapeutic potential of MSC-derived EVs to ameliorate the hippocampal neuroinflammatory response associated with NLRP3 inflammasome activation induced by binge drinking in adolescence.

Influence of heat treatment on microstructure,mechanical and corrosion behavior of WE43 alloy fabricated by laser-beam powder bed fusion

Magnesium(Mg)alloys are considered to be a new generation of revolutionary medical metals.Laser-beam powder bed fusion(PBF-LB)is suitable for fabricating metal implants withpersonalized and complicated structures.However,the as-built part usually exhibits undesirable microstructure and unsatisfactory performance.In this work,WE43 parts were firstly fabricated by PBF-LB and then subjected to heat treatment.Although a high densification rate of 99.91%was achieved using suitable processes,the as-built parts exhibited anisotropic and layeredmicrostructure with heterogeneously precipitated Nd-rich intermetallic.After heat treatment,fine and nano-scaled Mg24Y5particles were precipitated.Meanwhile,theα-Mg grainsunderwent recrystallization and turned coarsened slightly,which effectively weakened thetexture intensity and reduced the anisotropy.As a consequence,the yield strength and ultimate tensile strength were significantly improved to(250.2±3.5)MPa and(312±3.7)MPa,respectively,while the elongation was still maintained at a high level of 15.2%.Furthermore,the homogenized microstructure reduced the tendency of localized corrosion and favoredthe development of uniform passivation film.Thus,the degradation rate of WE43 parts was decreased by an order of magnitude.Besides,in-vitro cell experiments proved their favorable biocompatibility.

Epidemiological and clinical features,treatment status,and economic burden of traumatic spinal cord injury in China:a hospital-based retrospective study

Traumatic spinal cord injury is potentially catastrophic and can lead to permanent disability or even death.China has the largest population of patients with traumatic spinal cord injury.Previous studies of traumatic spinal cord injury in China have mostly been regional in scope;national-level studies have been rare.To the best of our knowledge,no national-level study of treatment status and economic burden has been performed.This retrospective study aimed to examine the epidemiological and clinical features,treatment status,and economic burden of traumatic spinal cord injury in China at the national level.We included 13,465 traumatic spinal cord injury patients who were injured between January 2013 and December 2018 and treated in 30 hospitals in 11 provinces/municipalities representing all geographical divisions of China.Patient epidemiological and clinical features,treatment status,and total and daily costs were recorded.Trends in the percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department and cost of care were assessed by annual percentage change using the Joinpoint Regression Program.The percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department did not significantly change overall(annual percentage change,-0.5%and 2.1%,respectively).A total of 10,053(74.7%)patients underwent surgery.Only 2.8%of patients who underwent surgery did so within 24 hours of injury.A total of 2005(14.9%)patients were treated with high-dose(≥500 mg)methylprednisolone sodium succinate/methylprednisolone(MPSS/MP);615(4.6%)received it within 8 hours.The total cost for acute traumatic spinal cord injury decreased over the study period(-4.7%),while daily cost did not significantly change(1.0%increase).Our findings indicate that public health initiatives should aim at improving hospitals’ability to complete early surgery within 24 hours,which is associated with improved sensorimotor recovery,increasing the awareness rate of clinical guidelines related to high-dose MPSS/MP to reduce the use of the treatment with insufficient evidence.

Clinical manifestation,lifestyle,and treatment patterns of chronic erosive gastritis:A multicenter real-world study in China

BACKGROUND Although chronic erosive gastritis(CEG)is common,its clinical characteristics have not been fully elucidated.The lack of consensus regarding its treatment has resulted in varied treatment regimens.AIM To explore the clinical characteristics,treatment patterns,and short-term outcomes in CEG patients in China.METHODS We recruited patients with chronic non-atrophic or mild-to-moderate atrophic gastritis with erosion based on endoscopy and pathology.Patients and treating physicians completed a questionnaire regarding history,endoscopic findings,and treatment plans as well as a follow-up questionnaire to investigate changes in symptoms after 4 wk of treatment.RESULTS Three thousand five hundred sixty-three patients from 42 centers across 24 cities in China were included.Epigastric pain(68.0%),abdominal distension(62.6%),and postprandial fullness(47.5%)were the most common presenting symptoms.Gastritis was classified as chronic non-atrophic in 69.9%of patients.Among those with erosive lesions,72.1%of patients had lesions in the antrum,51.0%had multiple lesions,and 67.3%had superficial flat lesions.In patients with epigastric pain,the combination of a mucosal protective agent(MPA)and proton pump inhibitor was more effective.For those with postprandial fullness,acid regurgitation,early satiety,or nausea,a MPA appeared more promising.CONCLUSION CEG is a multifactorial disease which is common in Asian patients and has non-specific symptoms.Gastroscopy may play a major role in its detection and diagnosis.Treatment should be individualized based on symptom profile.

Five commonly used traditional Chinese medicine formulas in the treatment of ulcerative colitis:A network meta-analysis

BACKGROUND Currently,traditional Chinese medicine(TCM)formulas are commonly being used as adjunctive therapy for ulcerative colitis in China.Network meta-analysis,a quantitative and comprehensive analytical method,can systematically compare the effects of different adjunctive treatment options for ulcerative colitis,providing scientific evidence for clinical decision-making.AIM To evaluate the clinical efficacy and safety of commonly used TCM for the treatment of ulcerative colitis(UC)in clinical practice through a network metaanalysis.METHODS Clinical randomized controlled trials of these TCM formulas used for the adjuvant treatment of UC were searched from the establishment of the databases to July 1,2022.Studies that met the inclusion criteria were screened and evaluated for literature quality and risk of bias according to the Cochrane 5.1 standard.The methodological quality of the studies was assessed using ReviewManager(RevMan)5.4,and a funnel plot was constructed to test for publication bias.ADDIS 1.16 statistical software was used to perform statistical analysis of the treatment measures and derive the network relationship and ranking diagrams of the various intervention measures.RESULTS A total of 64 randomized controlled trials involving 5456 patients with UC were included in this study.The adjuvant treatment of UC using five TCM formulations was able to improve the clinical outcome of the patients.Adjuvant treatment with Baitouweng decoction(BTWT)showed a significant effect[mean difference=36.22,95%confidence interval(CI):7.63 to 65.76].For the reduction of tumor necrosis factor in patients with UC,adjunctive therapy with BTWT(mean difference=−9.55,95%CI:−17.89 to−1.41),Shenlingbaizhu powder[SLBZS;odds ratio(OR)=0.19,95%CI:0.08 to 0.39],and Shaoyao decoction(OR=−23.02,95%CI:−33.64 to−13.14)was effective.Shaoyao decoction was more effective than BTWT(OR=0.12,95%CI:0.03 to 0.39),SLBZS(OR=0.19,95%CI:0.08 to 0.39),and Xi Lei powder(OR=0.34,95%CI:0.13 to 0.81)in reducing tumor necrosis factor and the recurrence rate of UC.CONCLUSION TCM combined with mesalazine is more effective than mesalazine alone in the treatment of UC.

法舒地尔缓解β-淀粉样蛋白1-42诱导的SH-SY5Y细胞凋亡

背景:法舒地尔对阿尔茨海默病小鼠脑内的线粒体动力学有调节作用,并且可以抑制神经炎症,但能否调节线粒体自噬和NLRP3炎症小体进而减轻β-淀粉样蛋白毒性尚不清楚。目的:探究法舒地尔对β-淀粉样蛋白1-42诱导的人源神经母细胞瘤细胞株SH-SY5Y凋亡和线粒体自噬以及NLRP3炎症小体的调节作用。方法:将SH-SY5Y细胞接种于孔板内,细胞贴壁后分3组干预:对照组不加入任何药物,模型组加入20μmol/L β-淀粉样蛋白1-42,法舒地尔组同时加入20μmol/L β-淀粉样蛋白1-42与15 mg/L法舒地尔,干预24 h后,采用MTT法检测细胞活性,TUNEL染色检测细胞凋亡,qRT-PCR和Western blot检测凋亡相关蛋白表达,免疫荧光染色和Western blot检测线粒体自噬相关蛋白表达,免疫荧光染色和Western blot检测NLRP3炎症小体相关蛋白表达。结果与结论:(1)与对照组比较,模型组细胞活性降低、凋亡率升高(P<0.05);与模型组比较,法舒地尔组细胞活性升高、凋亡率降低(P<0.05);(2)qRT-PCR和Western blot检测结果显示,与对照组比较,模型组细胞Bax mRNA与蛋白表达升高(P<0.05),Bcl-2 mRNA与蛋白表达降低(P<0.05);与模型组比较,法舒地尔组细胞Bax mRNA与蛋白表达降低(P<0.05),Bcl-2 mRNA与蛋白表达升高(P<0.05);(3)免疫荧光染色和Western blot检测结果显示,与对照组相比,模型组细胞PINK1、帕金森病蛋白和LC3蛋白表达降低(P<0.05),p62蛋白表达升高(P<0.05);与模型组相比,法舒地尔组细胞PINK1、帕金森病蛋白和LC3蛋白表达升高(P<0.05),p62蛋白表达降低(P<0.05);(4)免疫荧光染色和Western blot检测结果显示,与对照组相比,模型组细胞NLRP3、ASC、Caspase-1和白细胞介素1β蛋白表达升高(P<0.05);与模型组相比,法舒地尔组细胞NLRP3、ASC、Caspase-1和白细胞介素1β蛋白表达降低(P<0.05);(5)结果表明,法舒地尔可以减轻β-淀粉样蛋白1-42诱导的SH-SY5Y细胞凋亡,其机制可能与激活线粒体自噬且抑制NLRP3炎症小体激活有关。

Deterioration of equivalent thermal conductivity of granite subjected to heating-cooling treatment

Understanding the thermal conductivity of granite is critical for many geological and deep engineering applications.The heated granite was subjected to air-,water-,and liquid nitrogen(LN2-)coolings in this context.The transient hot-wire technique was used to determine the equivalent thermal conductivity(ETC)of the granite before and after treatment.The deterioration mechanism of ETC is analyzed from the meso-perspective.Finally,the numerical model is used to quantitatively study the impact of cooling rate on the microcrack propagation and heat conduction characteristics of granite.The results show that the ETC of granite is not only related to the heating temperature,but also affected by the cooling rate.The ETC of granite decreases nonlinearly with increasing heating temperature.A faster cooling rate causes a greater decrease in ETC at the same heating temperature.The higher the heating temperature,the stronger the influence of cooling rate on ETC.The main explanation for the decrease in ETC of granite is the increase in porosity and microcrack density produced by the formation and propagation of pore structure and microcracks during heating and cooling.Further analysis displays that the damage of granite at the heating stage is induced by the difference in thermal expansion and elastic properties of mineral particles.At the cooling stage,the faster cooling rate causes a higher temperature gradient,which in turn produces greater thermal stress.As a result,it not only causes new cracks in the granite,but also aggravates the damage at the heating stage,which induces a further decrease in the heat conduction performance of granite,and this scenario is more obvious at higher temperatures.

Barriers to the Acceptance of Tuberculosis Preventive Treatment:A Multicenter Cross-sectional Study in China

Objective We aimed to understand the willingness and barriers to the acceptance of tuberculosis(TB)preventive treatment(TPT)among people with latent TB infection(LTBI)in China.Methods A multicenter cross-sectional study was conducted from May 18,2023 to December 31,2023 across 10 counties in China.According to a national technical guide,we included healthcare workers,students,teachers,and others occupations aged 15-65 years as our research participants.Results Overall,17.0%(183/1,077)of participants accepted TPT.There were statistically significant differences in the acceptance rate of TPT among different sexes,ages,educational levels,and occupations(P<0.05).The main barriers to TPT acceptance were misconceptions that it had uncertain effects on prevention(57.8%,517/894),and concerns about side effects(32.7%,292/894).Conclusion An enhanced and comprehensive understanding of LTBI and TPT among people with LTBI is vital to further expand TPT in China.Moreover,targeted policies need to be developed to address barriers faced by different groups of people.

ANGPTL4 TSP-1及CyPA与脑卒中后癫痫患者认知功能的关系

目的探讨血管生成素样蛋白4(ANGPTL4)、凝血酶敏感蛋白-1(TSP-1)、亲环素A(CyPA与脑卒中后癫痫患者认知功能的关系。方法选取2021-01—2022-12河南大学第一附属医院神经内科收治的100例脑卒中后癫痫病例进行观察,按简易精神状态量表(MMSE)划分认知障碍标准将患者分为认知障碍组(50例)和认知正常组(50例),应用酶联免疫吸附试验(ELISA)检测2组患者的血清ANGPTL4、TSP-1、CyPA水平,MMSE量表测评2组患者的认知功能。结果与认知正常组比较,认知障碍组患者MMSE评分降低,ANGPTL4、TSP-1、CyPA水平升高(P<0.05);与轻度认知障碍患者比较,中度认知障碍患者血清ANGPTL4、TSP-1、CyPA水平升高(P<0.05);与中度认知障碍患者比较,重度认知障碍患者血清ANGPTL4、TSP-1、CyPA水平升高(P<0.05)。在脑卒中后癫痫患者中,血清ANGPTL4、TSP-1、Cy PA与MMSE评分各维度均呈负相关(P<0.05)。结论脑卒中后癫痫会降低MMSE评分,提高患者血清ANGPTL4、TSP-1、CyPA水平。ANGPTL4、TSP-1、CyPA水平越高,患者认知功能障碍越严重。

Influence of nonalcoholic fatty liver disease on response to antiviral treatment in patients with chronic hepatitis B:A meta-analysis

BACKGROUND Although hepatitis B virus infection is the leading cause of chronic liver injury globally,nonalcoholic fatty liver disease(NAFLD)is gradually gaining attention as another major chronic liver disease.The number of patients having chronic hepatitis B(CHB)with concomitant hepatic steatosis has increased.AIM To analyze the effect of NAFLD on the response to antiviral treatment in patients with CHB.METHODS Relevant English studies were systematically searched across PubMed,EMBASE,Web of Science,and Cochrane Library until October 2023.Studies in which the treatment outcomes were compared between patients with CHB only and those with CHB and hepatic steatosis were included.RESULTS Of the 2502 retrieved studies,11 articles were finally included.Biochemical response until 48 wk(OR=0.87,95%CI:0.50–1.53,P=0.000)and 96 wk(OR=0.35,95%CI:0.24–0.53,P=0.24)and virological response until 96 wk(OR=0.80,95%CI:0.43–1.49,P=0.097)were lower in patients with hepatic steatosis than in patients with CHB alone.CONCLUSION Hepatic steatosis lowers the biochemical response to antiviral treatment in patients with CHB.

自旋-轨道耦合作用下极化激元凝聚中的调制不稳定性

利用线性稳定性分析方法,对存在自旋-轨道耦合(SOS)作用的二维极化激元玻色-爱因斯坦凝聚(BEC)系统中的调制不稳定性(MI)进行了研究.分析了组分内部,组分之间以及SOC相互作用对系统调制不稳定性的影响.结果显示,当系统内部不存在SOC作用,组分之间的相互作用为0,组分内部存在排斥作用时,不会出现调制不稳定性,组分内部存在吸引作用时,会出现调制不稳定性,并且调制不稳定性区间长度随吸引作用的增强而增加;组分之间相互作用不为0时,组分之间的相互作用以平方形式出现,其正负不会对调制不稳定性产生实质性影响.存在SOC相互作用时,SOC相互作用会引起增益谱曲线的不规则振荡,破坏原来的调制不稳定性区间.

双偶氮苯-二苯并[b,i]噻蒽-[2,3-b]苯-5,7,12,14-四酮衍生物分子的二阶非线性光学性质

使用密度泛函理论(DFT)M06-2X方法、采用6-311+g(d,p)基组,分别对26个双偶氮-二苯并[b,i]噻蒽-[2,3-b]苯-5,7,12,14-四酮衍生物分子进行结构优化与频率计算;使用含时密度泛函理论(TD-DFT)TD-M06-2X方法计算了a1~d6分子的前线分子轨道与电子吸收光谱,采用有效场FF方法研究了二阶非线性光学性质(NLO).研究结果表明,26个噻蒽四酮类衍生物分子的能隙在1.33—2.02 eV范围,归属于有机半导体;最低能量吸收峰波长在601.8~609.5nm范围;在增大分子的二阶非线性光学系数β_(μ)(或β_(0))值方面,含相同偶氮苯基团或含不同偶氮苯基团分别引入到二苯并[b,i]噻蒽-[2,3-b]苯-5,7,12,14-四酮分子两侧的2,10位优于2,9位,在2,10位分别端接含推、拉基团的偶氮苯优于含相同给电子基团的偶氮苯.在偶氮苯苯环对位分别端接强吸电子基(-NO_(2))与强供电子基(如-N(CH_(3))_(2)、-N(Ph)_(3)、-N-苯基咔唑等)可增强体系的二阶非线性光学性能,获得性能良好的非线性光学材料.

基于TLR4 NF-κB通路-神经相关因子探究依达拉奉对急性脑梗死患者炎症反应与神经损伤的保护机制

目的基于Toll样受体4(TLR4)核因子-κB(NF-κB)通路-神经相关因子探究依达拉奉对急性脑梗死(ACI)患者炎症反应与神经损伤的保护机制。方法选取2020-07—2023-07保定市第一中心医院收治的110例ACI患者,以随机数字表法分为观察组、对照组,各55例,对照组给予阿替普酶溶栓,观察组给予阿替普酶溶栓联合依达拉奉治疗。比较2组疗效、神经功能[美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin评分]、TLR4 NF-κB通路指标(TLR4、NF-κB)、神经损伤相关因子[神经元特异性烯醇化酶(NSE)、中枢神经特异性蛋白(S-100β)、脑源性神经营养因子(BDNF)]、TLR4 NF-κB通路相关炎症因子[白介素-1β(IL-1β)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子(TNF-α)、五聚素3(PTX3)、脂蛋白相关磷脂酶A2(Lp-PLA2)]。结果观察组总有效率96.36%,高于对照组的83.64%(P<0.05)。治疗1、2周观察组NIHSS评分、改良Rankin评分均低于对照组(P<0.05),观察组TLR4、NF-κB均低于对照组(P<0.05)。相较于治疗前,2组治疗1、2周后S-100β、NSE水平明显下降,BDNF水平明显升高,观察组S-100β、NSE水平均低于对照组,BDNF水平高于对照组(P<0.05)。相较于治疗前,2组治疗1、2周后IL-1β、hs-CRP、TNF-α、PTX3、Lp-PLA2水平均明显下降,观察组IL-1β、hs-CRP、TNF-α、PTX3、Lp-PLA2水平均低于对照组(P<0.05)。结论依达拉奉对ACI患者的疗效显著,有利于缓解炎症反应,改善神经损伤,其保护机制可能与TLR4 NF-κB通路调控神经损伤、炎症反应相关因子有关。

Dual-targeted treatment for inflammatory bowel disease:Whether fecal microbiota transplantation can be an important part of it

Inflammatory bowel disease(IBD)is a chronic gastrointestinal inflammatory disease.With the emergence of biologics and other therapeutic methods,two biologics or one biologic combined with a novel small-molecule drug has been proposed in recent years to treat IBD.Although treatment strategies for IBD are being optimized,their efficacy and risks still warrant further consideration.This editorial explores the current risks associated with dual-targeted treatment for IBD and the great potential that fecal microbiota transplantation(FMT)may have for use in combination therapy for IBD.We are focused on addressing refractory IBD or biologically resistant IBD based on currently available dual-targeted treatment by incorporating FMT as part of this dual-targeted treatment.In this new therapy regimen,FMT represents a promising combination therapy.

New strategy for distal limb perfusion in veno-arterial extracorporeal membrane oxygenation treatment: application of continuous renal replacement therapy tubing

Extracorporeal membrane oxygenation(ECMO)is a technology that can temporarily take over the functions of the heart and lungs.Acute kidney injury is a common issue in patients receiving ECMO treatment,with reported incidence rates ranging from 70%to 85%.[1]To maintain the balance of fluids and electrolytes in patients,continuous renal replacement therapy(CRRT)is frequently employed.

Deciding on life-saving treatment after a violent suicide attempt:an ethical case report

To the editor:In the USA alone,there were 1.7 million suicide attempts in 2021.1 Although the majority of suicide attempts are not fatal,immediate medical attention is often necessary,especially when violent methods are used.2 These methods include jumping from heights,using a firearm,crashing a motor vehicle,and lying down or jumping in front of a moving object.

Diagnosis and therapy of tacrolimus toxicity in a liver transplant recipient during COVID-19 treatment

To the Editor:SARS-CoV-2,the pathogen responsible for the pandemic of coronavirus disease 2019(COVID-19),has had profound impacts on human health,and its antagonist Paxlovid is a commonly used treatment option[1].However,treatment selection for immunosuppressed patients,such as liver recipients,remains uncertain due to potential drug interactions and the risk of immunosuppressant dosage adjustment,which can cause liver injury[2].

Community-based prevention and treatment of cardiovascular diseases

The Annual Report on Cardiovascular Health and Diseases in China(2022)intricate landscape of cardiovascular health in China.This is the third section of the report with a specific focus on community-based prevention and treatment of cardiovascular diseases(CVD).This section of the report underscores the importance of initiatives outlined in the"Healthy China 2030 Plan,"emphasizing the comprehensive prevention and control strategy for chronic diseases.A key aspect of this plan involves the establishment of national demonstration areas aimed at comprehensive prevention and control of chronic diseases.By 2020,488 such areas had been set up across China,surpassing the initial target and covering a significant proportion of counties and districts.The report highlights the successful implementation of these strategies in Lishan district,Anshan city,where demonstration areas for comprehensive prevention and control of chronic diseases were launched in 2013.Over the course of seven years,the number of healthy units increased substantially,leading to improvements in managing risk factors for CVD among residents.Significant reductions in prevalence rates of overweight,obesity,smoking,passive smoking,and drinking were observed,along with the development of healthier behaviors among residents.Similarly,Qiaokou district in Wuhan City,designated as a national demonstration area in 2014,implemented comprehensive public health promotion initiatives.Notably,special clinics for hypertension intervention were established,contributing to an increase in self-reported rates of hypertension,a slight decrease in prevalence,and a remarkable improvement in the control rate among treated patients.Overall,these efforts underscore the effectiveness of community-based approaches in driving positive health outcomes and advancing the comprehensive prevention and control of chronic diseases,particularly cardiovascular diseases,in China.