ObjectiveTo explore the possible mechanisms of Wenyang Huazhuo Formula （温阳化浊方， WHF） in improving reproductive aging from the perspective of the ovarian mechanical microenvironment. MethodsThe experiment included five groups， 3-month group （20 female mice at 3 months of age）， 6-month group （20 female mice at 6 months of age）， 6-month + WHF group （20 female mice at 5 months of age treated with WHF）， 9-month group （20 female mice at 9 months of age）， and 9-month + WHF group （20 female mice at 8 months of age treated with WHF）. The 6-month + WHF group and 9-month + WHF group were orally administered WHF 41.2 g/（kg·d） once daily for 4 consecutive weeks. The other three groups received no intervention. Reproductive hormone levels were measured by ELISA. HE staining was used to count the numbers of various stages of follicles. Ovarian hyaluronic acid （HA） content and collagen fiber content were measured to evaluate the ovarian mechanical microenvironment. Superovulation was performed to observe the number of eggs obtained， as well as the number of offspring and birth weight to assess fertility. The in vitro fertilization and blastocyst culture of oocytes from female offspring in each group were observed to evaluate the effect of WHF on offspring reproductive potential. ResultsCompared with the 3-month group， the 6-month group and 9-month group showed significantly decreased serum levels of gonadotropin-releasing hormone （GnRH）， follicle-stimulating hormone （FSH）， and luteinizing hormone （LH）， decreased ovarian collagen content， and reduced numbers of primordial and secondary follicles. In contrast， the numbers of primary follicles， antral follicles， and atretic follicles increased. The levels of anti-Müllerian hormone （AMH）， ovarian HA content， and the fertilization rate， cleavage rate， and blastocyst formation rate of oocytes from offspring were significantly lower （P＜0.05）. Compared with the 6-month group， the 6-month + WHF group showed significantly reduced serum levels of GnRH， FSH， and LH， with a significant decrease in primary follicles， antral follicles， and atretic follicles as well as increase of AMH levels， ovarian HA content， number of primordial and secondary follicle， egg count， and offspring birth weight （P＜0.05）. Compared with the 9-month group， the 9-month + WHF group exhibited reduced GnRH， FSH， and collagen fiber content， as well as reduced number of primary follicles， antral follicles， and atretic follicles. However， AMH levels， ovarian HA content， number of primordial and secondary follicle， egg count， offspring numbers， birth weight， fertilization rate， cleavage rate， and blastocyst formation rate of oocytes from offspring all significantly increased （P＜0.05）. ConclusionWHF can significantly improve the ovarian reserve， fertility， and reproductive potential in offspring during reproductive mid-life and late-life stages. Its effect may be related to the remodeling of the mechanical microenvironment of aging ovaries. Moreover， the effect on the mechanical microenvironment remodeling of late-stage ovaries and the improvement of the offspring reproductive potential is more significant.

ObjectiveTo understand the epidemic characteristics of influenza in Beijing from 2023 to 2024, and to provide a scientific basis for the prevention and control of influenza. MethodsData on influenza-like illness (ILI) from secondary level and above hospitals, etiology surveillance data, and influenza clusters outbreaks data from 2023‒2024 were used to analyze the epidemic trend and pathogenic characteristics of influenza. Furthermore, an influenza comprehensive index was used to categorize the epidemic intensity at the severity level. ResultsA total of 2 065 857 ILI cases were reported in 2023‒2024 epidemic season, and the percentage of ILI was 3.67%. The age group of 5‒14 years accounted for the highest proportion of ILI (30.48%). A total of 41 766 throat swabs from ILI were detected, with a positive rate of 17.28%.A (H3N2) (51.86%) and B Victoria (41.93%) were the most prevalent subtypes of influenza virus. Clustered influenza outbreaks occurred mainly in primary schools (57.78%) and middle schools (35.55%), mainly caused by the influenza A (H3N2) subtype (85.93%). According to the influenza comprehensive index (I), the period of influenza activity and above (I>0.5) lasted for a total of 37 weeks, accounting for 71.15% of the entire influenza season. ConclusionCompared with previous years, the epidemic level of influenza in Beijing was increased in 2023‒2024, and the peak time became earlier. The comprehensive index method can objectively evaluate the level of influenza epidemic and provide suggestions for the future prevention and control of influenza in Beijing.

Objective To analyze the interactions between different structural types of volatile oil compo-nents(VOCs)and skin lipid molecules,and investigate the mechanism of volatile oil in Chi-nese materia medica(VOCMM)as penetration enhancers. Methods In this study,210 different structural types of VOCs were selected from the VOCMM penetration enhancer database,and the molecular docking experiments were conducted with three main lipid molecules of skin:ceramide 2(CER2),cholesterol(CHL),and free fatty acid(FFA).Each VOC was docked individually with each lipid molecule.Cluster analysis was used to explore the relationship between the binding energy of VOCs and their molecular struc-tures.Nine specific pathogen-free(SPF)Sprague Dawley(SD)rats were randomly divided in-to Control,Nootkatone,and 3-Butylidenephthalide groups for in vitro percutaneous experi-ments,with three rats in each group.The donor pool solutions were 3%gastrodin,3%gas-trodin+3%nootkatone,and 3%gastrodin+3%3-butylidenephthalide,respectively.The pen-etration enhancing effects of VOCs with higher binding energy were evaluated by comparing the 12-hour cumulative percutaneous absorption of gastrodin(Q12,μg/cm2). Results(i)Most of the VOCs were non-hydrogen bonded to the hydrophobic parts of CHL and FFA,and hydrogen bonded to the head group of CER2.Among them,sesquiterpene ox-ides showed the most pronounced binding affinity to CER2.The VOCs with 2-4 rings(in-cluding carbon rings,benzene rings,and heterocycles)demonstrated stronger binding affini-ty for three skin lipid molecules compared with the VOCs without intramolecular rings(P<0.01).(ii)According to the cluster analysis,most of the VOCs that bond well to CER2 had 2-3 intramolecular rings.The non-oxygenated VOCs were bonded to CER2 in a hydrophobic manner.The oxygenated VOCs were mostly bonded to CER2 by hydrogen bonding.(iii)The results of Franz diffusion cell experiment showed that the Q12 of Control group was 260.60±25.09 μg/cm2,and the transdermal absorption of gastrodin was significantly increased in Nootkatone group(Q12=5 503.00±1 080.00 μg/cm2,P<0.01).The transdermal absorption of gastrodin was also increased in 3-Butylidenephthalide group(Q12=495.40±56.98 μg/cm2,P>0.05).(iv)The type of oxygen-containing functional groups in VOCs was also an influencing factor of binding affinity to CER2. Conclusion The interactions between different types of VOCs with different structures in the VOCMM and three skin lipid molecules in the stratum corneum were investigated at the molecular level in this paper.This research provided theoretical guidance and data support for the screening of volatile oil-based penetration enhancers,and a simple and rapid method for studying the penetration-enhancing mechanism of volatile oils.

Objective To systematically evaluate the prognostic prediction model for chronic heart failure patients in China, and provide reference for the construction, application, and promotion of related prognostic prediction models. Methods A comprehensive search was conducted on the studies related to prognostic prediction model for Chinese patients with chronic heart failure published in The Cochrane Library, PubMed, EMbase, Web of Science, CNKI, VIP, Wanfang, and the China Biological Medicine databases from inception to March 31, 2023. Two researchers strictly followed the inclusion and exclusion criteria to independently screen literature and extract data, and used the prediction model risk of bias assessment tool (PROBAST) to evaluate the quality of the models. Results A total of 25 studies were enrolled, including 123 prognostic prediction models for chronic heart failure patients. The area under the receiver operating characteristic curve (AUC) of the models ranged from 0.690 to 0.959. Twenty-two studies mostly used random splitting and Bootstrap for internal model validation, with an AUC range of 0.620-0.932. Seven studies conducted external validation of the model, with an AUC range of 0.720-0.874. The overall bias risk of all models was high, and the overall applicability was low. The main predictive factors included in the models were the N-terminal pro-brain natriuretic peptide, age, left ventricular ejection fraction, New York Heart Association heart function grading, and body mass index. Conclusion The quality of modeling methodology for predicting the prognosis of chronic heart failure patients in China is poor, and the predictive performance of different models varies greatly. For developed models, external validation and clinical application research should be vigorously carried out. For model development research, it is necessary to comprehensively consider various predictive factors related to disease prognosis before modeling. During modeling, large sample and prospective studies should be conducted strictly in accordance with the PROBAST standard, and the research results should be comprehensively reported using multivariate prediction model reporting guidelines to develop high-quality predictive models with strong scalability.

【Objective】 To elucidate the possible role of arginine and histidine in the pathogenesis of schizophrenia by exploring the serum levels of semi-essential amino acids (arginine and histidine) in patients with schizophrenia and their correlation with psychiatric symptoms. 【Methods】 We selected 72 inpatients with schizophrenia admitted to The First Affiliated Hospital of Xi’an Jiaotong University from March 2021 to October 2022 and 72 healthy volunteers enrolled in Yanta Community during the same period as the research subjects. Serum arginine and histidine levels were measured in patients with schizophrenia and healthy controls using serum liquid chromatography-mass spectrometry (LC-MS). We used the Positive and Negative Symptom Scale (PANSS) to evaluate the mental symptoms of patients with schizophrenia and analyzed the correlation of serum arginine and histidine levels with disease course, frequency of onset, and PANSS score. 【Results】 The levels of serum arginine (P<0.001) and histidine (P=0.011) in the schizophrenia group were significantly lower than those in the control group. The levels of serum arginine and histidine were significantly negatively correlated with the frequency of onset (rs=-0.410, rs=-0.262), total score of PANSS (rs=-0.298, rs=-0.256), positive factors (rs=-0.299, rs=-0.234) and cognitive impairment factors (rs=-0.251, rs=-0.296). In addition, serum arginine levels had significantly negative correlation with anxiety and depression factors (rs=-0.269, P<0.05). 【Conclusion】 The serum levels of arginine and histidine in patients with schizophrenia are significantly lower than those in healthy individuals, and are negatively correlated with overall mental symptoms, severity of positive symptoms and cognitive impairment. The severity of anxiety and depression symptoms is negatively correlated with arginine levels. The detection of serum arginine and histidine can provide reference for the diagnosis and assessment of the severity of schizophrenia in the future.

With the deepening of the reform of the medical and health system and the continuous optimization of the medical order,it is especially important to organize the development of admission and discharge standards and improve the service of preparing patients for discharge.In recent years,the research and application of machine learning technology in the medical field has been intensifying,and it has unique advantages in processing data and risk prediction research.Therefore,this paper reviews the development process,types of machine leaming,the content and effects of its application in patient discharge preparation services,and the current problems,in order to provide references for healthcare professionals to implement the best clinical decisions and further improve the patient discharge preparation service model.

Data analysis models may assist the transmission of traditional Chinese medicine （TCM） experience and clinical diagnosis and treatment， and the possibility of constructing a “data-knowledge” dual-drive model was explored by taking gastric precancerous state as an example. Data-driven is to make clinical decisions around data analysis， and its syndrome-differentiation decision-making research relies on hidden structural models and partially observable Markov decision-making processes to identify the etiology of diseases， syndrome elements， evolution of pathogenesis， and syndrome differentiation protocols； knowledge-driven is to make use of data and information to promote decision-making and action processes， and its syndrome-differentiation decision-making research relies on convolutional neural networks to improve the accuracy of local disease identification and syndrome differentiation. The “data-knowledge” dual-driven model can make up for the shortcomings of single-drive numerical simulation accuracy， and achieve a balance between local disease identification and macroscopic syndrome differentiation. On the basis of previous research， we explored the construction method of diagnostic assisted decision-making platform for gastric precancerous state， and believed that the diagnostic and decision-making ability of doctors can be extended through the assistance of machines and algorithms. Meanwhile， the related research methods were integrated and the core features of gastric precancerous state based on TCM syndrome differentiation and endoscopic pathology diagnosis and prediction were obtained， and the elements of endoscopic pathology recognition based on TCM syndrome differentiation were explored， so as to provide ideas for the in-depth research and innovative application of cutting-edge data analysis technology in the field of intelligent TCM syndrome differentiation.

Objective:To explore the effects of ropivacaine ultrasound-guided serratus anterior plane block anesthesia on analgesia, oxygen metabolism and postoperative cognitive function in patients undergoing radical mastectomy.Methods:The study subjects were 110 patients with breast cancer treated in hospital from Sep. 2020 to Dec. 2023. They were divided into the control group ( n=55, general anesthesia) and the study group ( n=55, general anesthesia + ultrasound-guided serratus anterior plane block anesthesia) by random odd-even criteria. The analgesic effect, the level of oxygen metabolism index before and after operation, postoperative cognitive function and the occurrence of adverse reactions were compared. Results:The intraoperative dosage of sufentanil, remifentanil and propofol, and the number of analgesic pump compression within 48h in the study group were lower [ (241.82±19.82) μg, (581.42±52.77) mg, (107.22±9.81) μg, (3.47±1.02) times vs. (271.22±24.87) μg, (638.91±63.79) mg, (121.48±10.84) μg, (5.81±1.35) ], and the first time of postoperative analgesia pump was higher [ (7.59±1.44) h vs. (5.05±1.24) h], with statistically significant differences ( t=6.86, 5.15, 7.23, 10.26, 9.80; P<0.05). The visual analog scores in the study group were lower at 1h, 4h and 8h after surgery [ (1.11±0.25) points, (1.89±0.54) points, (1.65±0.45) points vs. (2.17±0.49) points, (2.68±0.64) points, (2.33±0.64) points], with statistically significant differences ( t=14.29, 7.00, 6.45, P<0.05). The difference of arterial-carotid vein oxygen content between the time of the beginning of operation and 1h after surgery in the study group was lower [ (37.22±2.22) ng/L, (34.89±1.86) ng/L vs. (42.77±2.05) ng/L, (42.77±2.05) ng/L], while carotid venous blood oxygen content and cerebral oxygen uptake rate were higher [ (94.32±2.78) ng/L, (97.39±2.64) ng/L, (37.26±2.31) %, (44.76±2.54) % vs. (81.82±1.35) ng/L, (89.53±2.04) ng/L, (42.86±2.06) %, (47.58±2.15) %], with statistically significant differences ( timmediately after the surgery =6.81, 8.12, 10.26, t1h after the surgery =12.54, 7.34, 10.54; P<0.05) ; The cognitive function scores in the study group at 1 and 7 days after surgery were higher [ (24.78±2.59) points, (26.35±1.84) points vs. (20.36±2.14) points, (24.66±1.57) points], with statistically significant differences ( t=9.76, 5.18, P<0.05). The incidence of adverse reactions was 5.46% in the study group and 18.18% in the control group, and the difference was statistically significant ( χ2 value=4.27, P<0.05) . Conclusion:Ropivacaine ultrasound-guided serratus anterior plane block anesthesia can improve the analgesic effect of breast cancer patients, ensure the balance of oxygen metabolism in brain tissue, and reduce the cognitive function damage of patients, and has excellent clinical application value.

Objective:To summarize the evidence related to the guidance and management of breastfeeding in pregnant women with gestational diabetes mellitus.Methods:UpToDate, BMJ Best Practice, CINAHL, PubMed, Cochrane Library, Embase, Wanfang database, China National Knowledge Infrastructure, and other databases and professional websites were searched by computer for evidence on breastfeeding guidance and management for pregnant women with gestational diabetes mellitus, including clinical decisions, guidelines, evidence summaries, systematic reviews, expert consensus and randomized controlled trials. The search period was from database establishment to April 1, 2023. Two researchers independently conducted literature quality evaluation, evidence extraction, and integration.Results:A total of 23 articles were included, including 4 clinical decision-making articles, 4 guidelines, 4 evidence summaries, 6 systematic reviews, 1 expert consensus and 4 randomized controlled trials. A total of 21 best pieces of evidence were summarized from six aspects of support and education, knowledge and skills, safety issues, feeding issues, dietary care, and blood glucose monitoring.Conclusions:This study summarizes the best evidence on breastfeeding guidance and management for pregnant women with gestational diabetes and suggests that the medical staff should apply the proof according to the clinical situation and the patient's wish.

Objective:To systematically evaluate and Meta-synthesize qualitative studies on the home management needs of patients with spinal cord injury (SCI) to understand their actual self-management needs and improve the quality of home management for patients with SCI in China.Methods:A comprehensive search was conducted in databases including CNKI, Wanfang, CBM, PubMed, Embase, Web of Science, CINAHL, and Cochrane Library for qualitative research on the home management needs of patients with SCI, with a search timeframe up to November 30, 2023. The methodological quality of the included studies was evaluated using the Joanna Briggs Institute (JBI) Qualitative Assessment and Review Instrument (2016). Results were integrated and analyzed using Meta-synthesize methods.Results:A total of 15 studies were included, from which 58 distinct research findings were extracted. These were categorized into 10 new categories, which were further integrated into four main results: the need for positive emotional support, daily living-related needs, healthcare service needs, and social support needs.Conclusions:Healthcare providers should deeply understand the home management needs of patients with SCI. Utilizing artificial intelligence technology, an integrated support model encompassing hospital, home, and society can be constructed. Establishing a comprehensive home rehabilitation platform for patients with SCI can focus on psychological issues and enhance social support levels, thereby improving patients' quality of life.