With the rapid roll out of vaccination programs and extraordinary non-pharmaceutical interventions (NPIs) by the government, China has maintained a "dynamic zero-COVID-19" policy over the last two years. However, the global pandemic and immune evasion of Omicron variant poses a huge challenge to China. Currently, about 87.69% of the Chinese population has been vaccinated, most with inactivated vaccines. Although seroepidemiological data on the vaccinated are lacking, published data suggested that even a homologous booster of an inactivated vaccine displayed very limited neutralizing activity against the Omicron variant and that neutralizing activity was significantly lower than that of a heterologous booster or mRNA vaccine alone. A great concern is whether the neutralizing antibodies induced by inactivated vaccines can provide sufficient protection against the Omicron variant since local transmission of the Omicron variant is now occurring in China. The era of extraordinary NPIs by governments and countries to control the transmission of SARS-CoV-2 is going to change. Omicron's immune evasion of neutralizing antibodies induced by current vaccines and the majority of existing therapeutic SARS-CoV-2 monoclonal antibodies (mAbs) suggest an urgent need for more effective vaccines and highly effective oral antivirals, which will be the keys for the battle against Omicron in the future.

As the number of people with COVID-19 increases daily around the world, point-of-care testing (POCT) is gaining attention as a tool that can provide immediate test results and greatly help to deter infection and determine what to do next. POCT has several drawbacks such as a low sensitivity and specificity, but according to studies POCT has increased sensitivity on par with that of polymerase chain reaction testing. The advantage of POCT is that the results can be obtained quickly, regardless of the location. To further enhance its benefits, POCT is being developed and researched in conjunction with the Internet of medical things (IoMT), which allows POCT results to be collected, recorded, and managed over a network. IoMT will be beneficial not only for the use of POCT simply as a testing tool but also for its integration into diagnostic and health management systems. IoMT will enable people to regularly receive their test results in their daily lives and to provide personalized diagnosis and treatment of individual conditions, which will be beneficial in terms of disease prevention and maintenance of health.

Oral care is defined in a narrow sense as cleaning of the teeth, oral cavity, and dentures, and in a broad sense as the maintenance of oral functions (feeding, swallowing, chewing, speech, aesthetics, etc.), dental treatment, feeding and swallowing training, and articulation training. In the past, it was recognized as simply cleaning the mouth, but the concept of oral care has gradually expanded, and many studies and surveys have been conducted in cooperation with various other professions. As a result, oral health care is involved not only in the prevention of pneumonia, but also in the onset and suppression for severity of diabetes, cardiovascular diseases, some malignant tumors, cerebrovascular diseases, rheumatoid arthritis, dementia, etc. It is also a powerful supportive therapy in cancer treatment. In the terminal stages of life, oral health care can help people to maintain their dignity by continuing to consume food orally until the end of their lives, and in times of disaster, oral health care has been found to be as important as attention to deep vein thrombosis. It has also been found to be effective in preventing severe diseases such as COVID-19. And, although it has not been discussed much, it has been found to have medical and economic benefits such as reducing the duration of hospitalization and treatment costs. This article reviews the results of research to date.

Hepatocellular carcinoma (HCC) is the fifth most common malignancy and the second leading cause of cancer-related mortality worldwide. This review is an updated version that summarizes comprehensive guidelines published from January 2001 to January 2022 worldwide with a focus on the clinical management of HCC. The electronic databases MEDLINE, the Chinese SinoMed, and the Japanese CiNii were systematically searched. A total of 22 characteristic guidelines for HCC management were ultimately included, including 1 international guideline, 11 guidelines from Asia, 5 from Europe, 4 from the America, and 1 from Australia. If guidelines were published in multiple versions, the most recent update was included, and surveillance, diagnosis, and treatment were compared. The composition of and recommendations in current guidelines on HCC varied, so these guidelines were regrouped and diagnostic and treatment algorithms were summarized graphically to provide the latest information to clinicians. The diagnostic criteria were grouped into 2 categories: a "Size-based pathway" and a "Non-size-based pathway". The treatment criteria were summarized according to different treatment algorithms, and mainstream treatment options were reviewed. Findings from comparison of current guidelines might help target and concentrate efforts to improve the clinical management of HCC. However, further studies are needed to improve the management and outcomes of HCC. More straightforward or refined guidelines would help guide doctors to make better decisions in the treatment of HCC in the future.

Hepatic malignancies remain a global challenge. Hepatocellular carcinoma (HCC) accounts for around 90% of patients with liver cancer and is the sixth most common neoplasm worldwide and the fourth leading cause of cancer-related death. However, the long-term prognosis for HCC remains far from satisfactory, with a late diagnosis and limited treatment. DOX has served as conventional chemotherapy with the longest history of use. Although conventional chemotherapy is being challenged by molecular therapy and immune therapy, there is renewed optimism and interest in both systematic and locoregional therapy. Combined chemotherapy is widely used in clinical practice. In specific terms, FOLFOX can serve as a first-line (category 2B) option as recommended by the 2021 NCCN guidelines, while the efficacy of LTLD plus RFA has been confirmed in the phase III HEAT study. These approaches have challenged the dominant status of molecular therapy in terms of health economics and they have potential benefits in Asia, where HBV-related hepatocellular carcinoma is prevalent. Moreover, locoregional chemotherapy can be achieved with TACE and HAIC (possibly involving FOLFOX, DOX, mitomycin C, cisplatin, epirubicin, etc.). TACE was officially recommended by the 2021 NCCN guidelines for patients with Child-Pugh class B liver disease. In addition, HAIC has demonstrated a potential advantage in preliminary clinical practice, although it hasn't been included in any guidelines. Hence, this review summarizes large-scale trials and studies examining the development and innovative use of chemotherapeutic agents. Mounting clinical evidence warrants an exploration of the efficacy of chemotherapy.

Hormone therapy (HT) has been used in postmenopausal women for decades in clinical practice. With further analysis and newer studies, the benefits and risks of HT have been repeatedly verified and discussed. HT is recommended for the treatment of vasomotor symptoms (VMS), genitourinary syndrome of menopause (GSM) and the prevention of osteoporosis. However, the precise association between HT and the risks of cardiovascular diseases, venous thromboembolism, neurodegenerative diseases, breast cancer, and endometrial cancer remains controversial. Therefore, determining how to take advantage of and control the risks of HT by adjusting the initiation time, regimen, and duration is crucial. Recent studies have indicated that HT is not related to the risk of all-cause, cardiovascular, or breast cancer mortality although it might increase the incidence of some chronic diseases. For symptomatic postmenopausal women under the age of 60 without contraindications, early initiation of HT is safe and probably has a mortality benefit over the long term. Initiating HT close to menopause at the lowest effective dose is more likely to have maximal benefits and the lowest risks. Transdermal and vaginal HT may have a lower risk, but recent evidence suggests additional clinical benefits of oral HT formulations in relieving VMS and preventing osteoporosis. The pooled cohort risk equation for atherosclerotic cardiovascular disease (ASCVD) and the free app named Menopro can be used to perform individual risk assessments. In addition, Chinese herbal medicines have benefits in alleviating hot flashes, depression, and menopausal symptoms, although further data are needed to strongly support their efficacy. Acupuncture and electroacupuncture have definite efficacy in the treatment of postmenopausal symptoms with few adverse effects, so they are a reasonable option as an alternative therapy for high-risk women. This review discusses the history of, guidelines on, and strategies for HT in order to make suggestions based on the most up-to-date evidence for the management of postmenopausal women.

Due to continuous bone remodeling, the bone tissue is dynamic and constantly being updated. Bone remodeling is precisely regulated by the balance between osteoblast-induced bone formation and osteoclast-induced bone resorption. As a giant multinucleated cell, formation and activities of osteoclasts are regulated by macrophage colony-stimulating factor (M-CSF), receptor activator of nuclear factor-kappaB ligand (RANKL), and by pathological destabilization of the extracellular microenvironment. Microenvironmental acidosis, as the prime candidate, is a driving force of multiple biological activities of osteoclast precursor and osteoclasts. The mechanisms involved in these processes, especially acid-sensitive receptors/channels, are of great precision and complicated. Recently, remarkable progress has been achieved in the field of acid-sensitive mechanisms of osteoclasts. It is important to elucidate the relationship between microenvironmental acidosis and excessive osteoclasts activity, which will help in understanding the pathophysiology of diseases that are associated with excess bone resorption. This review summarizes physiological consequences and in particular, potential mechanisms of osteoclast precursor or osteoclasts in the context of acidosis microenvironments.

Acupuncture has been used to treat various disease for more than 3,000 years in China and other Asian countries. As a complementary and alternative therapy, it has gained increasing popularity and acceptance among public and healthcare professionals in the West. Over the past few decades, basic and clinical research on acupuncture has made considerable progress. Internationally recognized evidence from clinical studies has been published, a preliminary system to clinically evaluate acupuncture has been created, and some clinical guidelines have been formulated. Moreover, scientists have strived to explore the physiological and biological mechanisms of acupuncture. Some basic studies have indicated that acupuncture has various actions, such as analgesic, muscle relaxing, anti-inflammatory, mild anxiolytic, and antidepressant actions, with possible biological mechanisms such as central sensitization, neurotransmitters, the intestinal flora, immune regulation, oxidative stress, and neuroinflammation. The current review describes the common indications for acupuncture recommended by the WHO and the use of acupuncture in China, the United States, Australia, and several other countries. This review then summarized the mechanisms by which acupuncture treats common conditions including lower back pain (LBP), ischemic stroke, depression, and irritable bowel syndrome (IBS) and it also cited specific acupuncture points for treating these conditions. The hope is that this review will provide useful information for both acupuncturists and researchers to better understand the mechanisms of acupuncture and reasons for its usage.

In the context of an aging global population, the aging of patients with HIV is an issue that society will have to face. Data indicate that between 2011 and 2019, the proportion of patients age 60 and over who were newly diagnosed with HIV in China increased from 12% to 25%. In contrast to younger groups, the special characteristics of older patients pose major challenges to the management of their disease. The current study examined the clinical outcomes and psychological status of patients age 50 and over who were diagnosed with HIV. Out of a total of 566 older patients from eastern China, viral suppression was achieved in 446 (78.8%), treatment was immunologically effective in 410 (72.4%), and treatment was effective in 324 (57.2%). Thirty-nine patients (6.9%) had significant anxiety and 143 (25.3%) exhibited depressive tendencies. Level of education and the time from diagnosis to treatment were associated with the effectiveness of treatment. Age, sleep quality, chronic illness, exercise, and travel time to medical appointments were associated with depressive symptoms. These findings suggest that the burden of HIV among the older population remains high in more economically developed areas. The urgent need for HIV education and screening programs, as well as follow-up visits and early initiation of treatment in older patients, is called for.

In 2017, the World Health Organization highlighted polypharmacy as one of the key focus areas of the Global Patient Safety Challenge on Medication Safety. According to the experience of developed countries, the provision of primary pharmaceutical care plays a very important role in the intervention of polypharmacy in the elderly. It is necessary to assess the associations between elderly polypharmacy status and primary care in developing countries. The findings of this paper provide the prevalence of polypharmacy in patients with comorbid hypertension, and the factors associated with it. A total of 19,332 elderly patients with hypertension were completed, among which the mean (SD) number of diseases was 4.83 (1.99), the mean (SD) daily maximum number of drugs was 5.13 (2.89), and the rate of polypharmacy was 50.5%. Age, living areas, total number of visits, preference for medical institutions and the number of diseases were associated with polypharmacy. Among them, advanced age, greater number of visits and diseases are the risk factors of polypharmacy for elderly patients with comorbid hypertension. The rate of polypharmacy in patients who intend to seek treatment in community healthcare centers is low. A total of 9,603 pharmaceutical workers worked in Shanghai public hospitals in 2020, among them 52.0% worked in the central city area, and more than 70% worked in secondary and tertiary hospitals. There was a large mismatch between patients' medical preference and the number of pharmaceutical personnel. As a consequence, it is necessary to strengthen the development of community pharmaceutical care in primary medical institutions for elderly polypharmacy management.