ObjectiveTo systematically retrieve， analyze， and summarize the basic information and clinical research evidence of Chinese patent medicines （CPMs） for endometriosis via a scoping review method. MethodsCPMs indicated for EM were identified from three major drug lists， CNKI， clinical guidelines， and textbooks. Relevant clinical studies were retrieved from eight Chinese and English databases from inception to April 1， 2025. Key data from included studies were extracted to analyze characteristics of CPMs and their clinical evidence. ResultsA total of 18 CPMs were included， among which those with blood-activating and stasis-resolving effects accounted for the highest proportion. Constituent herbs predominantly exhibited sweet， bitter， and pungent flavors， with tropism to the liver and spleen meridians. Daily treatment costs varied substantially across CPMs. The 438 included studies involved 13 CPMs， among which Guizhi Fuling capsules/pills， Sanjie Zhentong capsules， and Dan'e Fukang soft extract/granules were the most extensively studied. Randomized controlled trials （RCTs） were the predominant study design. The most common comparison was between CPMs combined with Western medicine and Western medicine alone. The largest number of studies reported a sample size of 51-100 cases. The high-frequency outcome indicators covered 10 domains， including clinical response rate， adverse reactions， female hormone levels， serum CA125 levels， and recurrence status. ConclusionMultiple oral CPMs demonstrate efficacy in EM management， yet inadequate safety profiles persist in drug labeling. The annual number of clinical studies on oral CPMs for endometriosis showed an overall increasing trend. However， clinical research has shortcomings including uneven distribution of CPMs， small sample sizes， and suboptimal methodological rigor. Future efforts should focus on updating drug indications and safety information in package inserts， conducting high-quality clinical research， and generating more robust evidence to support the clinical use of oral CPMs for EM.

ObjectiveTo systematically retrieve， analyze， and summarize the basic information and clinical research evidence of Chinese patent medicines （CPMs） for endometriosis via a scoping review method. MethodsCPMs indicated for EM were identified from three major drug lists， CNKI， clinical guidelines， and textbooks. Relevant clinical studies were retrieved from eight Chinese and English databases from inception to April 1， 2025. Key data from included studies were extracted to analyze characteristics of CPMs and their clinical evidence. ResultsA total of 18 CPMs were included， among which those with blood-activating and stasis-resolving effects accounted for the highest proportion. Constituent herbs predominantly exhibited sweet， bitter， and pungent flavors， with tropism to the liver and spleen meridians. Daily treatment costs varied substantially across CPMs. The 438 included studies involved 13 CPMs， among which Guizhi Fuling capsules/pills， Sanjie Zhentong capsules， and Dan'e Fukang soft extract/granules were the most extensively studied. Randomized controlled trials （RCTs） were the predominant study design. The most common comparison was between CPMs combined with Western medicine and Western medicine alone. The largest number of studies reported a sample size of 51-100 cases. The high-frequency outcome indicators covered 10 domains， including clinical response rate， adverse reactions， female hormone levels， serum CA125 levels， and recurrence status. ConclusionMultiple oral CPMs demonstrate efficacy in EM management， yet inadequate safety profiles persist in drug labeling. The annual number of clinical studies on oral CPMs for endometriosis showed an overall increasing trend. However， clinical research has shortcomings including uneven distribution of CPMs， small sample sizes， and suboptimal methodological rigor. Future efforts should focus on updating drug indications and safety information in package inserts， conducting high-quality clinical research， and generating more robust evidence to support the clinical use of oral CPMs for EM.

Objective To examine the changing prevalence and antimicrobial resistance profiles of Burkholderia cepacia in 52 hospitals across China from 2015 to 2021.Methods A total of 9 261 strains of B.cepacia were collected from 52 hospitals between January 1,2015 and December 31,2021.Antimicrobial susceptibility of the strains was tested using Kirby-Bauer method or automated antimicrobial susceptibility testing systems according to a unified protocol.The results were interpreted according to the breakpoints released in the Clinical & Laboratory Standards Institute(CLSI)guidelines(2023 edition).Results A total of 9 261 strains of B.cepacia were isolated from all age groups,especially elderly patients.The proportion was 11.1％(1 032 strains)in children,significantly lower than the proportion in adults.About half(46.5％,4 310/9 261)of the strains were isolated from patients at least 60 years old and 42.3％(3 919/9 261)of the strains were isolated from young adults.Most isolates(71.1％)were isolated from sputum and respiratory secretions,followed by urine(10.7％)and blood samples(8.1％).B.cepacia isolates were highly susceptible to the five antimicrobial agents recommended in the CLSI M100 document(33rd edition,2023).B.cepacia isolates showed relatively higher resistance rates to meropenem and levofloxacin.However,the resistance rates to ceftazidime,trimethoprim-sulfamethoxazole,and minocycline remained below 8.1％.The percentage of B.cepacia strains resistant to levofloxacin was the highest compared to other antibiotics in any of the three age groups(from 12.4％in the patients＜18 years old to 20.6％in the patients aged 60 years or older).Conclusions B.cepacia is one of the clinically important non-fermenting gram-negative bacteria.Accurate and timely reporting of antimicrobial susceptibility test results and ongoing antimicrobial resistance surveillance are helpful for rational prescription of antimicrobial agents and proper prevention and control of nosocomial infections.

Objective To summarize the changing prevalence of carbapenem resistance in Enterobacterales based on the data of CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021 for improving antimicrobial treatment in clinical practice.Methods Antimicrobial susceptibility testing was performed using a commercial automated susceptibility testing system according to the unified CHINET protocol.The results were interpreted according to the breakpoints of the Clinical & Laboratory Standards Institute(CLSI)M100 31st ed in 2021.Results Over the seven-year period(2015-2021),the overall prevalence of carbapenem-resistant Enterobacterales(CRE)was 9.43％(62 342/661 235).The prevalence of CRE strains in Klebsiella pneumoniae,Citrobacter freundii,and Enterobacter cloacae was 22.38％,9.73％,and 8.47％,respectively.The prevalence of CRE strains in Escherichia coli was 1.99％.A few CRE strains were also identified in Salmonella and Shigella.The CRE strains were mainly isolated from respiratory specimens(44.23±2.80)％,followed by blood(20.88±3.40)％and urine(18.40±3.45)％.Intensive care units(ICUs)were the major source of the CRE strains(27.43±5.20)％.CRE strains were resistant to all the β-lactam antibiotics tested and most non-β-lactam antimicrobial agents.The CRE strains were relatively susceptible to tigecycline and polymyxins with low resistance rates.Conclusions The prevalence of CRE strains was increasing from 2015 to 2021.CRE strains were highly resistant to most of the antibacterial drugs used in clinical practice.Clinicians should prescribe antimicrobial agents rationally.Hospitals should strengthen antibiotic stewardship in key clinical settings such as ICUs,and take effective infection control measures to curb CRE outbreak and epidemic in hospitals.

Objective To characterize the changing species distribution and antibiotic resistance profiles of respiratory isolates in hospitals participating in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Methods Commercial automated antimicrobial susceptibility testing systems and disk diffusion method were used to test the susceptibility of respiratory bacterial isolates to antimicrobial agents following the standardized technical protocol established by the CHINET program.Results A total of 589 746 respiratory isolates were collected from 2015 to 2021.Overall,82.6％of the isolates were Gram-negative bacteria and 17.4％were Gram-positive bacteria.The bacterial isolates from outpatients and inpatients accounted for(6.0±0.9)％and(94.0±0.1)％,respectively.The top microorganisms were Klebsiella spp.,Acinetobacter spp.,Pseudomonas aeruginosa,Staphylococcus aureus,Haemophilus spp.,Stenotrophomonas maltophilia,Escherichia coli,and Streptococcus pneumoniae.Each microorganism was isolated from significantly more males than from females(P＜0.05).The overall prevalence of methicillin-resistant S.aureus(MRSA)was 39.9％.The prevalence of penicillin-resistant S.pneumoniae was 1.4％.The prevalence of extended-spectrum β-lactamase(ESBL)-producing E.coli and K.pneumoniae was 67.8％and 41.3％,respectively.The overall prevalence of carbapenem-resistant E.coli,K.pneumoniae,Enterobacter cloacae,Pseudomonas aeruginosa,and Acinetobacter baumannii was 3.7％,20.8％,9.4％,29.8％,and 73.3％,respectively.The prevalence of β-lactamase was 96.1％in Moraxella catarrhalis and 60.0％in Haemophilus influenzae.The H.influenzae isolates from children(＜18 years)showed significantly higher resistance rates to β-lactam antibiotics than the isolates from adults(P＜0.05).Conclusions Gram-negative bacteria are still predominant in respiratory isolates associated with serious antibiotic resistance.Antimicrobial resistance surveillance should be strengthened in clinical practice to support accurate etiological diagnosis and appropriate antimicrobial therapy based on antimicrobial susceptibility testing results.

Objective:To investigate the optimal timing for stage II vitreous surgery for open ocular trauma and its effects on complications, intraocular pressure, and visual acuity.Methods:A total of 98 patients with open ocular trauma were selected as subjects from the Third Department of Ophthalmology at Baoji People's Hospital who received treatment between May 2021 and March 2024. This study used a retrospective design. Based on the different intervals between stage I emergency debridement and suturing and stage II vitreous surgery, the patients were divided into two groups: the control group (with an interval of > 14 days) and the observation group (with an interval of ≤ 14 days), with 49 cases in each group. The postoperative complications, intraocular pressure recovery, and visual acuity improvement were compared between the two groups.Results:At 1 month after surgery, the total cure rate in the observation group was significantly higher than that in the control group [95.92% (47/49) vs. 81.63% (40/49), χ2 = 5.02, P = 0.025]. In the observation group, the visual acuity levels were as follows: level I [2.05% (1/49)], level II [4.08% (2/49)], level III [6.12% (3/49)], level IV [77.55% (38/49)], and level V [10.20% (5/49)]. These results were significantly better than those in the control group, which had the following levels: 18.37% (9/49), 20.41% (10/49), 24.49% (12/49), 34.69% (17/49), and 2.05% (1/49) for levels I-V respectively ( Z = 5.12, P < 0.001). At 1 week after surgery, there were no statistically significant differences in the rates of normal intraocular pressure, high intraocular pressure, or low intraocular pressure between the observation and control groups (all P > 0.05). At 1 week after surgery, the levels of interleukin-4 (IL-4), IL-6, IL-12, IL-17, and interferon-γ in the observation group were (14.85 ± 2.82) ng/L, (7.52 ± 0.54) ng/L, (10.05 ± 2.63) ng/L, (9.17 ± 1.83) ng/L, and (8.95 ± 2.30) ng/L, respectively. These levels in the observation group were significantly lower than those in the control group [(16.48 ± 2.46) ng/L, (7.83 ± 0.64) ng/L, (11.30 ± 2.60) ng/L, (10.22 ± 1.46) ng/L, (10.03 ± 2.24) ng/L, t = -2.79, -2.37, -2.16, -2.87, -2.15, all P < 0.05]. The incidences of silicone oil-dependent eyes, secondary glaucoma, re-vitreal hemorrhage, and ocular atrophy in the observation group were not statistically different from those in the control group (all P > 0.05). The incidence of traumatic proliferative vitreo-retinopathy in the observation group was significantly lower than that in the control group [0 vs. 10.20% (5/49), χ2 = 5.27, P = 0.022]. Conclusions:In patients with open ocular trauma, performing stage II vitreous surgery within 2 weeks after stage I emergency debridement and suturing yields better therapeutic outcomes. This approach can significantly increase the retinal reattachment rate, improve postoperative visual acuity, and effectively prevent and reduce the incidence of traumatic proliferative vitreoretinopathy.

Aim To study the role and mechanism of ML210 in glioma.Methods The cell viability was detected by CCK8 assay.The percentage of dead cells was detected by SYTOXstaining.The role of ferroptosis-signaling pathway in gliomas was detected bygenomics.Cell proliferation was observed by EdU staining and clone formation assay.Cell migration ability was detec-ted by scratch healing assay.The apoptosis was detec-ted by flow cytometry.Cell mitochondrial function was assesses by JC-1 staining.The mechanism of action of ML210 was detected by molecular docking coupled with immunoblotting assay(Western blot).The levels of ROS,MDA were observed by ELISA.Results Compared with the control group,ML210 treatment dose-dependently decreased glioma cell viability,in-hibited cell proliferation,migration,and increased cell apoptosis and mitochondrial dysfunction,which were reversed by ferroptosis antagonists.Gene microarray screening showed that 688 genes of the ferroptosissig-naling pathway were aberrant and 10 signaling path-ways were altered in gliomas.Molecular docking re-sults showed that ML210 binding to GPX4 significantly inhibited the protein expression level of GPX4 and pro-moted the elevation of ROS and MDA levels.Conclu-sions ML210 produces anti-glioma cells via GPX4-mediated ferroptosis pathway.

Objective To investigate the changing antibiotic resistance profiles of E.coli isolated from patients in the 52 hospitals participating in the CHINET program from 2015 to 2021.Methods Antimicrobial susceptibility was tested for clinical isolates of E.coli according to the unified protocol of CHINET program.WHONET 5.6 and SPSS 20.0 software were used for data analysis.Results Atotal of 289 760 nonduplicate clinical strains ofE.coli were isolated from 2015 to 2021,mainly from urine samples(44.7±3.2)％.The proportion of E.coli strains isolated from urine samples was higher in females than in males(59.0％vs 29.5％).The proportion of E.coli strains isolated from respiratory tract and cerebrospinal fluid samples was significantly higher in children than in adults(16.7％vs 7.8％,0.8％vs 0.1％,both P＜0.05).The isolates from internal medicine department accounted for the largest proportion(28.9±2.8)％with an increasing trend over years.Overall,the prevalence of ESBLs-producing E.coli and carbapenem resistant E.coli(CREco)was 55.9％and 1.8％,respectively during the 7-year period.The prevalence of ESBLs-producing E.coli was the highest in tertiary hospitals each year from 2015 to 2021 compared to secondary hospitals.The prevalence of CREco was higher in children's hospitals compared to secondary and tertiary hospitals each year from 2015 to 2021.The prevalence of ESBLs-producing E.coli in tertiary hospitals and children's hospitals and the prevalence of CREco in children's hospitals showed a decreasing trend over the 7-year period.The prevalence of CREco in secondary and tertiary hospitals increased slowly.Antibiotic resistance rates changed slowly from 2015 to 2021.Carbapenem drugs(imipenem,meropenem)were the most active drugs amongβ-lactams against E.coli(resistance rate≤2.1％).The resistance rates of E.coli to β-lactam/β-lactam inhibitor combinations(piperacillin-tazobactam,cefoperazone-sulbactam),aminoglycosides(amikacin),nitrofurantoin and fosfomycin(for urinary isolates only)were all less than 10％.The resistance rate of E.coli strains to antibiotics varied with the level of hospitals and the departments where the strains were isolated,especially for cefazolin and ciprofloxacin,to which the resistance rate of E.coli strains from children in non-ICU departments was significantly lower than that of the strains isolated from other departments(P＜0.05).The E.coli isolates from ICU showed higher resistance rate to most antimicrobial agents tested(excluding tigecycline)than the strains isolated from other departments.The E.coli strains isolated from tertiary hospitals showed higher resistance rates to the antimicrobial agents tested(excluding tigecycline,polymyxin B,cefepime and carbapenems)than the strains from secondary hospitals and children's hospitals.Conclusions E.coli is an important pathogen causing clinical infection.More than half of the clinical isolates produced ESBL.The prevalence of CREco is increasing in secondary and tertiary hospitals over the 7-year period even though the overall prevalence is still low.This is an issue of concern.

Objective:To improve the diagnosis and treatment of autoimmune hepatitis (AIH) in children by analyzing their clinical characteristics and outcomes.Methods:Case summary.The general data, clinical manifestations, laboratory parameters, liver pathology, treatment and outcomes of 6 AIH children diagnosed at Xi′an Children′s Hospital from January 2019 to March 2024 were retrospectively analyzed.Results:All the 6 patients were diagnosed with AIH-1, and 5 of them were female, accounting for 83.3%.The median age of onset was 6.2 years old.Three cases (50.0%) had insidious onset.Elevated hepatic aminotransferase levels were detected incidentally in 2 cases (33.3%).One case (16.7%) presented symptoms resembling those of viral hepatitis.Two cases (33.3%) were accompanied by extrahepatic autoimmune diseases.All the children tested positive for anti-nuclear antibodies with a titer ≥1∶80 or 1∶100.Four cases (66.7%), 3 cases (50.0%), and 1 case (16.7%) tested positive for anti-smooth muscle antibodies, anti-perinuclear neutrophil cytoplasm antibodies and anti-soluble liver antigen, respectively.Liver pathology showed infiltration of lymphocytes-plasma cells and moderate or severe interfacial inflammation in all the 6 cases.Two cases (33.3%) had rosettes.All the patients were given oral corticosteroids combined with Azathioprine or Mycophenolate mofetil.The patients were followed up for 24.8 (12.0-52.0) months, during which 3 cases (50.0%) had partial remission and 3 cases (50.0%) achieved complete remission.Four cases (66.7%) showed transaminase fluctuations during corticosteroid reduction or cessation.Conclusions:Autoantibodies and liver pathology are important evidence for diagnosing AIH in children.Immunosuppressants have a high remission rate in the treatment of this disease, but transaminase fluctuations are prone to occur during corticosteroid reduction or cessation.

This study was aimed at identifying the pathogenic bacteria responsible for the death of a young tiger at the Fujian Meihua Mountain South China Tiger Breeding Research Institute.Tissue samples from the lungs,liver,and intestines of the deceased tiger were collected,and the bacteria were cultured inasterile environment.The bacterial strains were characterized according to their morphological and molecular biological properties,including assessment of virulence genes and antibiotic resistance genes,mouse lethality tests,and antibiotic susceptibility evaluations.A predominant bacterial strain isolated from the liver of the deceased tiger was identified as enterotoxigenic Escherichia coli(ETEC)strain Tiger22513F.Phylogenetic analysis of the 16S rRNA gene revealed that the Tiger22513F strain exhibited close genetic similarity to the reference strain ETEC(MF919609.1),with 99.9%nucleotide similarity,and resided on the same evolutionary branch.The Tiger22513F strain contained 11 antibiotic resistance genes(tetA,sul1,sul3,cmlA,floR,blaTEM,blaSHV,blaCMY-2,qnrA,qnrS,and qnrD)along with five virulence genes(VT1,fyuA,tsh,iucD,and ST).Mouse lethality tests indicated significant pathogenicity toward mice,affecting primarily the lungs,liver,and intestines.Antibiotic susceptibility testing demonstrated that this strain exhibited resistance to various classes of beta-lactam antibiotics,as well as quinolones and aminoglycosides.This investigation successfully isolated a multi-drug resistant enterotoxigenic Escherichia coli strain with pronounced pathogenicity from the liver of a deceased tiger;thus providing valuable scientific insights for clinical diagnosis,as well as prevention and control measures,against ETEC infections in South China tigers.