Objective: To characterize perioperative dynamic changes in immune-cell phenotypes and inflammatory cytokines in patients undergoing CPB (cardiopulmonary bypass) cardiac surgery, and to explore their associations with postoperative outcomes. Methods: In this prospective cohort study, 120 adult patients who underwent elective cardiac surgery under CPB at West China Hospital from May 2022 to March 2023 were enrolled. Perioperative immune-cell phenotypes and concentrations of 40 inflammation-related cytokines were measured. The primary outcomes were the sequential organ failure assessment (SOFA) score at 24 h after surgery and ΔSOFA (the peak SOFA score within 48 h after surgery minus the preoperative SOFA score). Secondary outcomes included major adverse cardiovascular events (MACE), acute kidney injury (AKI), respiratory failure, severe liver injury, and infection. Results: The mean age of enrolled patients was 57±10 years. Of these, 52% (62/120) were male and 90% (108/120) underwent valve surgery. During the rewarming to the end of CPB, neutrophil counts rapidly increased (7.39×10 /L vs preoperative 3.07×10 /L, P<0.001), with significant upregulation of CD11b (7.30×10 /L vs preoperative 3.05×10 /L, P<0.001) and CD54 (7.15×10 /L vs preoperative 2.99×10 /L, P<0.001). Lymphocyte counts increased at the end of CPB (1.75×10 /L vs preoperative 1.12×10 /L, P<0.001) but decreased significantly at 24 h after surgery (0.59×10 /L vs preoperative 1.12×10 /L, P<0.001). Plasma analysis showed that multiple pro-inflammatory cytokines increased during CPB and remained elevated up to 24 h after surgery; five chemokines and the anti-inflammatory cytokine IL-10 peaked at the end of CPB. The SOFA score increased from 1 (1, 2) preoperatively to 7 (5, 10) at 24 h after surgery, with a ΔSOFA of 6 (4, 8). Within 30 days after surgery, 48 patients (40.0%) developed AKI, 17 (14.2%) developed infection, 4 (3.3%) developed severe liver injury, 3 (2.5%) developed respiratory failure, and 3 (2.5%) experienced MACE. During the 2-year follow-up, 8 patients (6.7%) experienced MACE and 5 (4.2%) died. Conclusion: Multi-organ dysfunction is common after cardiac surgery under CPB (median ΔSOFA, 6), accompanied by perioperative activation of multiple immune-cell subsets and upregulation of pro-inflammatory, anti-inflammatory, and chemotactic mediators. This study provides data-driven evidence and research clues for further investigation of the associations between CPB-related immune perturbations and postoperative organ dysfunction and clinical outcomes.

Neurological disorders, including Alzheimer’s disease (AD), Parkinson’s disease (PD), cerebral ischemia, and multiple sclerosis (MS), impose an escalating global health burden and remain largely incurable. These disorders arise from multifactorial and interconnected pathological processes, such as chronic neuroinflammation, oxidative stress, protein misfolding and aggregation, demyelination, and neurovascular dysfunction. Despite substantial advances in elucidating disease-associated molecular mechanisms, current therapeutic strategies are predominantly symptomatic and fail to effectively halt or reverse disease progression. This limitation highlights the urgent need to identify endogenous regulatory molecules capable of coordinating neuronal survival, synaptic maintenance, inflammatory control, and tissue repair within the central nervous system (CNS). Pleiotrophin (PTN) is a heparin-binding, growth-associated cytokine that has emerged as a key regulator of neural development, plasticity, and regeneration. Structurally, PTN contains multiple high-affinity heparin-binding domains that facilitate interactions with extracellular matrix components and cell surface proteoglycans, enabling spatially restricted and context-dependent signaling. Through these molecular properties, PTN functions as a multifunctional organizer of neural growth, plasticity, and tissue remodeling across developmental and adult stages. Its diverse biological effects are executed through a multi-receptor signaling system that integrates extracellular cues with intracellular programs governing cellular survival, migration, and differentiation. Notably, PTN displays a highly dynamic and cell type-specific expression pattern in the central nervous system, being enriched in neural progenitor cells during development and later restricted to discrete neuronal populations, neural stem cells, and non-neuronal niche cells—including astrocytes, pericytes, and vascular endothelial cells—which serve as critical sources of PTN under physiological and pathological conditions. PTN expression is tightly regulated during development and exhibits pronounced plasticity in response to pathological stimuli. Under physiological conditions, PTN is transiently expressed during critical windows of neural growth and synaptogenesis, supporting neuron-glia interactions and myelin formation. In contrast, in pathological contexts such as amyloid β-protein (Aβ) accumulation in AD, dopaminergic neuron degeneration in PD, demyelination in MS, and ischemic brain injury, PTN expression is frequently dysregulated, suggesting an active role in disease-associated remodeling rather than a passive bystander effect. Importantly, accumulating evidence indicates that PTN exerts a dual and context-dependent influence on neurological disorders. On the one hand, aberrant PTN signaling may contribute to maladaptive responses, including sustained glial activation, dysregulated neuroinflammation, extracellular matrix remodeling, and enhanced Aβ deposition. On the other hand, PTN displays robust neuroprotective and reparative functions by promoting neuronal survival, enhancing oligodendrocyte maturation and remyelination, and stimulating post-injury angiogenesis, thereby facilitating tissue repair and functional recovery. At the mechanistic level, PTN signaling is characterized by extensive cross-talk among receptor-dependent pathways. Activation of anaplastic lymphoma kinase (ALK) triggers canonical PI3K-AKT-mTOR and MAPK cascades that support neuronal survival and axonal integrity. PTN binding to protein tyrosine phosphatase receptor type Z1 (PTPRZ1) induces conformational inhibition of its phosphatase activity, resulting in increased phosphorylation of downstream effectors such as β-catenin, Fyn, and Src, which regulate neuronal migration and synaptic stabilization. Syndecan-3 (SDC3) functions as both a co-receptor and an independent signaling mediator by capturing extracellular PTN, amplifying ALK- and PTPRZ1-dependent signaling, and directly modulating cytoskeletal dynamics through PKC and ERK pathways. In parallel, PTN interaction with αVβ3 integrin contributes to remodeling of the neurovascular niche, linking angiogenesis with neurogenesis and neural repair. From a translational perspective, therapeutic strategies targeting PTN can be broadly classified into 3 categories: direct enhancement of PTN signaling through exogenous protein supplementation or gene therapy-mediated upregulation, pharmacological modulation of PTN-associated receptor pathways and downstream signaling nodes, and exploitation of PTN as a dynamic biomarker to inform disease stratification and therapeutic responsiveness. These complementary approaches underscore the growing interest in PTN-centered interventions across a spectrum of neurological disorders. In summary, PTN functions not merely as a classical trophic factor but as a central signaling hub integrating inflammatory regulation, neural regeneration, and vascular remodeling within the CNS. This review aims to synthesize current insights into PTN’s molecular architecture, multi-receptor signaling mechanisms, and disease-specific functions, and to highlight emerging therapeutic strategies targeting PTN. By conceptualizing PTN as a dynamic modulator of neuronal resilience rather than a static biomarker, we propose that precise modulation of PTN signaling may offer promising avenues for therapeutic development in neurodegenerative and neuroinflammatory diseases.

This paper summarizes professor TU Jinwen's clinical experience in treating cancer-related insomnia （CRI） based on different qi and fire. It is believed that the pathogenesis of CRI can be divided into three stages. At the initial stage， qi movement is constrained， while the strong fire begins to stir， and the sovereign fire is unsettled， when qi is abundant， but the fire is not excessive. For this， Sanhua Jieyu Anshen Decoction （三花解郁安神汤） is suggested， which can move qi and vent constraint， clear and diffuse strong fire， calm the heart and spirit. At the progressive stage， strong fire becomes intense and burning， and qi transformation weakens， with toxin fire harassing the spirit. This is the stage where both qi and fire are excessive， for which Huanglian Jiedu Anshen Decoction （黄连解毒安神汤） can be used to clear and dissipate strong fire， drain fire and resolve toxin， clear heart and calm spirit. At the terminal stage， strong fire subsides， and consumption of qi damages healthy qi， with failure of nourishment of heart spirit， when both qi and fire deplete. Correspondingly， Erren Yangxin Anshen Decoction （二仁养心安神汤） is used to boost qi and nourish yin， restore interaction between the heart and the kidney， nourish the heart and calm spirit.

Digestive system malignant tumors （DT） are one of the leading causes of death globally and carry a heavy economic burden. Gut microbiota plays a critical role in maintaining host health， including providing nutrition， defending against pathogens， and promoting immune development. In recent years， more and more studies have shown that dysbiosis of gut microbiota is closely associated with DT such as gastric cancer， liver cancer， and colon cancer. Therefore， targeted regulation of gut microbiota plays a potential role in inhibiting the growth and metastasis of DT， while its specific regulatory mechanism remains unclear. As the studies about the anti-tumor effects of traditional Chinese medicine （TCM）， especially the basic and clinical studies on the regulation of gut microbiota by TCM in tumor treatment， have been growing， the therapeutic effects of TCM on DT have attracted much attention. This paper provides a systematic review of the relationship between gut microbiota and DT， as well as the related studies on the modulation of gut microbiota by TCM against DT， with the aim of providing a foundation and direction for future basic and clinical studies on DT. The literature review shows that gut microbiota influence the occurrence and development of DT through multiple pathways. These pathways include triggering chronic inflammation， producing oncogenic metabolites， inducing genomic instability， regulating the immune system， and altering the tumor microenvironment. TCM can exert anti-DT effects by regulating the composition of gut microbiota， modulating gut microbiota metabolites， repairing intestinal barrier function， and influencing immune functions. Therefore， understanding the relationship between gut microbiota and DT and the regulatory mechanisms of TCM may provide new strategies for future prevention and treatment of DT.

ObjectiveTo analyze the output and efficiency of chronic disease management services for hypertension and diabetes in community health service institutions in Shanghai, to evaluate the allocation and efficiency of chronic disease management resources, and to provide references for improving the efficiency of chronic disease management in Shanghai’s communities. MethodsA total of 73 community health institutions from 15 districts of Shanghai were selected. Based on the chronic disease management resource data of community health institutions in 2019, 2021, and 2023, descriptive methods and the BCC model in Data Envelopment Analysis (DEA) were used to analyze the resource allocation, service output, and the efficiency of chronic disease management services in community health institutions in Shanghai. ResultsFrom 2019 to 2023, the indicators of resource allocation and service output of community health service institutions in Shanghai all showed upward trends. In terms of service efficiency, the average number of chronic disease patients managed by each health technician decreased from 237 to 231, and the number of patients served per 1 000 working hours decreased from 54 to 44. DEA efficiency analyses showed that the average overall efficiency increased from 0.867 in 2019 to 0.886 in 2021 and then decreased to 0.811 in 2023. The average technical efficiency decreased from 0.901 to 0.847, which was the main reason for the decline in overall efficiency. The average scale efficiency showed an initial increase followed by a decrease, rising from 0.961 in 2019 to 0.977 in 2021 and dropping back to 0.955 in 2023. The number of strong effective districts (overall efficiency=1.000) decreased from 6 in 2019 to 3 in 2023, and the efficiency differences between districts expanded. The range of overall efficiency widened from 0.622‒1.000 to 0.513‒1.000, indicating a decline in overall efficiency and an increase in inter-district heterogeneity. ConclusionFrom 2019 to 2023, the total volume of resource allocation and service output for chronic disease management in community health service institutions in Shanghai increased continuously. However, both the service output efficiency and the overall resource allocation efficiency declined, driven primarily by a decrease in technical efficiency, and accompanied by widening inter‑district disparities.

Objective To analyze the epidemiological characteristics of poisonous mushroom-related foodborne disease incidents in Chongqing from 2010 to 2024, and to provide a scientific basis for effective prevention and control of mushroom-related foodborne diseases. Methods Data of poisonous mushroom related foodborne disease incidents reported by the CDCs of 39 districts and counties in Chongqing from 2010 to 2024 were collected, and their epidemic characteristics were analyzed. Results A total of 264 poisonous mushroom poisoning outbreaks were reported in Chongqing from 2010 to 2024, resulting in 1 046 cases of illness, 543 hospitalizations, and 15 deaths, with a mortality rate of 1.43%. The peak of poisoning incidents was from June to October, accounting for 89.02% of the total number of incidents. The top three high-incidence areas were Pengshui Miao Tujia Autonomous County, Dianjiang County, and Nanchuan District. Poisonous mushroom poisoning incidents occurring in household settings, accidental picking and ingestion, and cases involving unidentified mushroom species accounted for 89.02%, 83.33%, and 90.15% of all foodborne disease outbreak incidents, respectively. Conclusion Foodborne disease incidents related to poisonous mushrooms in Chongqing City show an upward trend, and the effectiveness of prevention and control needs to be improved. Based on their seasonal, regional and household clustering characteristics, efforts should be made before the peak season of mushroom poisoning in high-risk areas, targeting key populations with health education, monitoring and early warning, food safety supervision, and medical treatment.

This article provides a systematic review of the research progress in the mechanisms related to lung cancer and ferroptosis， ferroptosis-related lung cancer biomarkers and gene mutation targets， and ferroptosis-targeted regulation of Chinese medicine in treating lung cancer in the past five years， providing a feasible and effective basis for the prevention and treatment of lung cancer with Chinese medicine and the development of new drugs. According to the available studies， ferroptosis is widely suppressed in lung cancer， while the specific regulatory mechanisms have not been fully elucidated. The suppression is related to lipid metabolism， iron metabolism， cystine/glutamate antiporter system Xc^- （System Xc^-）/glutathione （GSH）/glutathione peroxidase 4 （GPX4）， ferroptosis suppressor protein 1 （FSP1）/coenzyme Q10 （CoQ10）/nicotinamide adenine dinucleotide phosphate ［NAD（P）H］， long non-coding RNA （lncRNA）， nuclear factor E₂-related factor 2 （Nrf2）， and p53. In modern times， traditional Chinese medicine is widely used in the comprehensive treatment of lung cancer， and it has gradually become a hot research topic due to its obvious advantages of anti-tumor activity， high efficacy， and low toxicity. Traditional Chinese medicine plays an important role in the treatment of lung cancer. Studies have shown that the active components， extracts， and prescriptions of Chinese medicine can induce ferroptosis in lung cancer cells through targeted regulation of iron metabolism， lipid metabolism， and p53， Nrf2， LncRNA， and GPX4 pathways to inhibit the growth and proliferation of lung cancer， thus exerting anti-tumor effects. Therefore， regulating ferroptosis is expected to become a new direction for preventing lung cancer. Basic research has shown that Chinese medicine can regulate ferroptosis via multiple targets and pathways in the treatment of lung cancer. At present， Chinese medicine demonstrates great research prospects in regulating ferroptosis to treat lung cancer， which， howeve， still faces challenges to achieve clinical transformation.

Staphylococcus aureus is a Gram-positive bacterium with strong pathogenicity. With the widespread use of antibiotics， its multi-drug resistance has gradually increased. Among them， methicillin-resistant S. aureus （MRSA） is one of the main pathogens of hospital and community infections. Antimicrobial peptides are short-chain peptides with good antibacterial effects and low drug resistance， which have been widely studied in recent years. This study summarizes the mechanism of action of antimicrobial peptides and related study on antimicrobial peptides against MRSA from different sources. It is found that the mechanisms of action of antimicrobial peptides include targeting bacterial cell membranes， bacterial cells， and bacterial cell walls， etc. Besides isolating antimicrobial peptides with anti-MRSA activity from animals， plants， and microorganisms， antimicrobial peptides can also be obtained through synthetic methods. Among them， GHa-derived peptides from animal sources， Ib-AMP4 from plant sources， Ph-SA from microbial sources， the synthetic peptide LLKLLLKLL-NH2， and so on， due to their effective antibacterial activity， rapid bactericidal speed， and low toxicity， are promising candidates for anti-MRSA drugs.

Objective To systematically review the sex differences in efficacy of immune checkpoint inhibitors (ICIs) for non-small cell lung cancer (NSCLC) patients. Methods We conducted a computer search of Medline, The Cochrane Library, and EMbase from inception to November 2022 to identify randomized controlled trials (RCTs) assessing the efficacy of ICIs in patients with NSCLC. A meta-analysis was performed using RevMan 5.4 software. Results Finally 16 RCTs with a total of 9 653 patients were included, and the modified Jadad scale score was≥4 points. Meta-analysis results showed that in female NSCLC patients receiving immune therapy, the median overall survival (OS) [HR=0.72, 95%CI (0.61, 0.85), P<0.001] was longer than that in males [HR=0.73, 95%CI (0.69, 0.78), P<0.001]. Males [HR=0.64, 95%CI (0.58, 0.71), P<0.001] had an advantage over females [HR=0.76, 95%CI (0.57, 1.03), P=0.760] in median progression-free survival (PFS). Conclusion Females receiving ICIs have an advantage over males in terms of median OS. However, males tend to derive greater benefit from ICIs in terms of median PFS.

Shegan Mahuangtang was a famous classical formula for treating asthma and is included in the the Catalogue of Ancient Famous Classical Formulas（The Second Batch）. By means of bibliometrics， this study conducts a textual research and analysis on the key information of its formula origin， composition， drug origins， processing， dosage， decocting methods， efficacy， and clinical application. According to research， Shegan Mahuangtang was first recorded in Synopsis of the Golden Chamber and is the ancestral formula for treating cold asthma， which has been used to this day. Suggestions for the drug origins in Shegan Mahuangtang is as follows：Shegan is selected from the dried rhizomes of Belamcanda chinensis（Iridaceae）， Mahuang is selected from the dried herbaceous stems of Ephedra sinica（Ephedraceae）， Shengjiang is selected from the fresh rhizomes of Zingiber officinale（Zingiberaceae）， Xixin is selected from the dried roots and rhizomes of Asarum heterotropoides var. mandshuricum， A. sieboldii var. seoulense or A. sieboldii（Aristolochiaceae）， Ziwan is selected from the dried roots and rhizomes of Aster tataricus（Compositae）， Kuandonghua is selected from the dried flower buds of Tussilago farfara（Compositae）， Nanwuweizi is selected from the dried mature fruits of Schisandra sphenanthera（Magnoliaceae）， Dazao is selected from the dried mature fruit of Ziziphus jujuba（Rhamnaceae）， and Banxia， a plant of the Araceae family， is selected as the processed products of dried tubers from Pinellia ternata. The recommended dosage is 41.4 g of Shegan， Xixin， Ziwan and Kuandonghua， 55.2 g of Mahuang and Shengjiang， 37.5 g of Nanwuweizi， 21 g of Dazao， 34.5 g of Banxia. The decoction method is to boil Mahuang first in 2.4 L of water， remove the froth on the top， and add the rest of the herbs and decoct them together， and then boil them to 600 mL， and then take it at warm temperature， 200 mL each time， 3 times a day. In terms of clinical application， Shegan Mahuangtang is most commonly used for respiratory system diseases， especially in the treatment of adult or pediatric bronchial asthma and cough variant asthma. Phlegm sound in the throat is the core symptom of Shegan Mahuangtang in clinical practice， and the core pathogenesis is "cold fluid stagnated in the lungs". By excavating and sorting out the ancient and modern literature of Shegan Mahuangtang， key information is confirmed， which can provide literature reference for the modern clinical application and new drug development of this famous classical formula.