Objective To identify factors affecting and key environmental factors of the Oncomelania hupensis snail density in the Yangtze River Delta region using machine learning methods. Methods Administrative village-level O. hupensis snail survey data in the Yangtze River Delta (including Shanghai Municipality, Jiangsu Province, Zhejiang Province and Anhui Province) from 2011 to 2021 were retrieved from the Information Management System for Parasitic Disease Control of Chinese Center for Disease Control and Prevention. Environmental factor data were captured from the Google Earth Engine platform, including elevation, slope, terrain, normalized difference vegetation index (NDVI), vegetation type, soil type, total petroleum hydrocarbon (TPH), ammonium nitrogen, inorganic nitrogen, dissolved oxygen, pH of water, chemical oxygen demand (COD) and inorganic phosphorus, and climatic factor data in the study region were retrieved from the Copernicus Climate Data Store, including annual precipitation, aridity index and annual mean temperature (AMT). O. hupensis snail survey data in the Yangtze River Delta region from 2011 to 2021 were randomly divided into a training set (70%) and a test set (30%), and five machine learning models were selected for machine learning model construction and comparative analysis of the O. hupensis snail density using the software R 4.3.0, including random forest (RF), eXtreme gradient boosting (XGBoost), support vector machine (SVM), gradient boosting machine (GBM) and neural network (NN). The XGBoost model was employed to construct a predictive model for the O. hupensis snail density, and the impact of each environmental factor on O. hupensis snail distribution was quantified. The SHapley Additive exPlanations (SHAPs) values were calculated to estimate the average contribution of each variable to the model prediction, and the core environmental factors affecting the O. hupensis snail population density were screened. Results Among the five machine learning models, the XGBoost model exhibited the optimal comprehensive performance, with the coefficient of determination (R²) of 0.855, mean squared error (MSE) of 0.188, root mean squared error (RMSE) of 0.434 and mean absolute error (MAE) of 0.155, respectively. Analysis of factors affecting the O. hupensis snail density with the XGBoost model showed that among the 16 environmental factors, the top four high-impact factors ranked by SHAPs values included annual precipitation, elevation, aridity index and NDVI, with cumulative SHAPs contributions of 75%, which was higher than that of other environmental factors. If NDVI was higher than 0.6, the O. hupensis snail density increased with NDVI and peaked if NDVI was 0.8 (1.60 snails/0.1 m²). The O. hupensis snail density increased with elevation if the elevation ranged from 14 to 40 m, and slowly rose if the annual precipitation ranged from 900 to 1 300 mm, and then increased rapidly to the peak (1.52 snails/0.1 m²) if the annual precipitation ranged from 1 300 to 1 500 mm. In addition, the O. hupensis snail density increased rapidly to the maximum (1.60 snails/0.1 m²) if the aridity index ranged from 0.8 to 1.1, and decreased gradually if the aridity index exceeded 1.1. Conclusions The XGBoost model shows excellent performance in prediction of the O. hupensis snail density and identification of key environmental factors in the Yangtze River Delta region. Annual precipitation, elevation, aridity index and NDVI are key environmental factors affecting the distribution and density of O. hupensis snails in the Yangtze River Delta region.

Background Sunshine duration is closely associated with population mental health and emotional states, although its relationship with mental and behavioral disorders (MBD) remains insufficiently studied. Objective To analyze the effect of sunshine duration on hospital admissions for MBD in Zigong City, Sichuan Province. Methods Hospital admission records for MBD from 10 medical institutions, meteorological data, and ambient air pollutant concentrations were collected in Zigong City from January 1, 2019 to December 31, 2024. A distributed lag non-linear model (DLNM) was employed to calculate single-day and cumulative lag effects of different sunshine duration exposures—0 h (P₀, P₅, P₂₅), 6 h (P₇₅), and 10.4 h (P₉₅)—on hospitalization risks for MBD, stratified by diagnostic category, sex, and age groups. Results This study analyzed 36597 hospital admissions for MBD in Zigong City. The exposure-response curve for sunshine duration at lag 0 d exhibited an inverted N-shaped pattern, with minimum relative risk (RR) of hospitalizations observed at 14 h sunshine duration. The immediate effects of different levels of sunshine duration on the hospitalization risk for MBD, schizophrenia, schizotypal and delusional disorders (SSDD), and neurotic, stress-related and somatoform disorders (NSSD) were significant, with the cumulative effect peaking at lags 12–13 days. For extremely short sunshine duration 0 h, the maximum relative risk (RR) values (with 95% confidence intervals, 95%CI) of hospitalization risk were 1.209 (1.001, 1.459) at lag 1 d for SSDD patients and 1.398 (1.133, 1.724) at lag 0 d for NSSD patients, respectively. The cumulative effect on hospitalization risk induced by short sunshine duration 6 h was higher than that induced by extremely short sunshine duration 0 h and long sunshine duration 10.4 h. Among populations stratified by gender and age, male patients and those aged over 70 years had higher hospitalization risks. For short sunshine duration 6 h, the cumulative RR (CRR) value (95%CI) of hospitalization risk for male MBD patients was 3.373 (1.362, 8.358) at cumulative lag 0–12 d, which was higher than that for female patients [2.943 (1.471, 5.889) at cumulative lag 0–13 d]. The population aged over 70 years was more sensitive to single-day and cumulative lag effects on hospitalization risk than other age groups. For short sunshine duration 6 h, the RR and CRR values (95%CI) of single-day and cumulative lag effects on hospitalization risk were 1.336 (1.002, 1.783) at lag 0 day and 5.085 (1.680, 15.392) at cumulative lag 0–12 d, respectively. At lag 13 d, long sunshine duration 10.4 h exposure was associated with depression hospitalizations in patients <20 years with RR=1.127 (95%CI: 1.002, 1.270). Conclusion When the daily sunshine duration is less than 14 h, it will increase the hospitalization risk of MBD in the population to varying degrees, with both single-day and cumulative lag effects. It is recommended that the public, especially vulnerable groups such as people with MBD aged 70 years and above and those with depression under 20 years, strengthen health protection to reduce the health risks caused by changes in sunshine.

Digestive system tumors are the leading cause of cancer incidence and mortality globally， and their occurrence and development generally follow the key pathological process of inflammation-cancer transformation. Therefore， intervening in the precancerous lesion stage is an important strategy to block malignant transformation of the disease and reduce the incidence rate of tumors. Banxia Xiexin Tang-related prescriptions （including Banxia Xiexin Tang， Shengjiang Xiexin Tang， and Gancao Xiexin Tang） originated from the Shanghan Zabinglun They follow the principle of pungent dispersing and bitter descending， combination of cold and warm medicinals， and tonifying deficiency and purging excess， which aligns with the core pathogenesis of digestive system precancerous lesions characterized by cold-heat intermingling and disorder of ascending and descending. These prescriptions are widely used in the clinical treatment of various digestive system inflammatory disorders such as atrophic gastritis， ulcerative colitis， and reflux esophagitis. This review systematically summarizes the theoretical basis， clinical evidence， and therapeutic mechanisms of such prescriptions in preventing and treating the inflammation-cancer transformation process in the digestive system. Clinical studies have shown that whether used alone or in combination with modern therapies， Banxia Xiexin Tang can effectively alleviate symptoms， repair histopathological changes， and improve patients' quality of life. Basic research further reveals that their efficacy stems from multi-target systemic regulatory effects： ameliorating the chronic inflammatory microenvironment， antagonizing oxidative stress， reshaping the gut microbiota， restoring the immune balance， regulating cell proliferation and apoptosis， etc. On the basis of the convergence of traditional Chinese and Western medicine understanding of inflammation-cancer transformation， this article constructs a research framework centered on regulating the inflammatory microenvironment homeostasis to systematically elucidate the mechanism of treating different diseases with the same method （Banxia Xiexin Tang）. In view of the limitations of current research in terms of evidence level， disease-syndrome combination models， and overall mechanism analysis of compound prescriptions， this article proposes future research directions of integrating high-quality clinical research， systems biology， and cutting-edge technologies， providing a new theoretical basis and translational ideas for the precise prevention and control of digestive system tumors with traditional Chinese medicine.

To understand the progress of, summarize experiences from, and analyze problems in the national schistosomiasis elimination programme, this article presented the national schistosomiasis epidemiology and surveillance in the People’s Republic of China in 2025. By the end of 2025, Shanghai Municipality, Zhejiang Province, Fujian Province, Guangdong Province and Guangxi Zhuang Autonomous Region maintained the achievement of schistosomiasis elimination, and 7 provinces of Jiangsu, Sichuan, Yunnan, Hubei, Hunan, Anhui and Jiangxi remained at the criteria of schistosomiasis transmission interruption. In 2025, there were 450 counties (cities, districts), 3 203 townships and 26 029 villages endemic for schistosomiasis in China, with a total population of 73.598 million in endemic villages. Among the 450 endemic counties (cities, districts), 421 (93.56%) achieved the criteria of schistosomiasis elimination and 29 (6.44%) reached the criteria of transmission interruption. In 2025, a total of 3 630 874 residents received immunological tests for schistosomiasis across endemic areas in China, with 31 588 seropositives identified (seroprevalence, 0.87%), and a total of 154 293 individuals received parasitological examinations, with 5 egg-positives detected. A total of 26 688 advanced schistosomiasis cases were recorded in China by the end of 2025. Of 529 683 bovines raised in schistosomiasis-endemic villages in China in 2025, 101 637 bovines received immunological tests for schistosomiasis, with 183 seropositives detected (seroprevalence, 0.18%), and 165 654 bovines received parasitological examinations, with no egg-positives identified. In 2025, Oncomelania hupensis snail survey was performed covering an area of 667 524.82 hm² in China, and 176 378.64 hm² O. hupensis snail habitats were identified, including 123.77 hm² emerging O. hupensis snail habitats and 953.71 hm² re-emerging O. hupensis snail habitats. A total of 19 283 schistosomiasis cases received chemotherapy with praziquantel in China in 2025, and 477 450 person-times and 304 279 herd-times received expanded chemotherapy, respectively. In addition, O. hupensis snail control with chemical treatment covered 116 475.10 hm² snail habitats across China in 2025, with an actual area with chemical control covering 68 510.93 hm² and an area with environmental improvements covering 1 101.84 hm². The national schistosomiasis surveillance results indicated that the mean prevalence of Schistosoma japonicum infections was both 0 among humans and bovines in 2025, and no S. japonicum infection was detected in O. hupensis snails. These data showed that the prevalence of schistosomiasis remained low in China in 2025; however, the area of O. hupensis snail habitats stayed high, with an increase in emerging and reemerging O. hupensis snail habitats. It is recommended to improve the surveillance and forecast mechanism for schistosomiasis and precisely implement the O. hupensis snail control programme in high-risk areas.

The self-remodeling of scleral extracellular matrix(ECM)is a significant characteristic alterationin the development of myopia, and it also influences the progression of myopia. The mechanisms of scleral remodeling are intricate, with transforming growth factor-β(TGF-β)and its associated signaling pathways playing a pivotal role. This review systematically summarizes the major metabolic changes in scleral ECM, the molecular mechanisms of the TGF-β signaling pathway, and its regulatory effects on scleral remodeling during myopic development, aiming to provide new insights and potential strategies for the treatment and prevention of myopia.

Objective To explore the mechanism of Modified Xiaoxianxiong Decoction(MXD)in"treating different diseases with the same method"for type 2 diabetes mellitus(T2DM)and obstructive sleep apnea(OSA)using network pharmacology and molecular docking.Methods Active components and related targets of the seven herbs in MXD(composed of Coptidis Rhizoma,Pinelliae Rhizoma,Trichosanthis Fructus,Bupleuri Radix,Salviae Miltiorrhizae Radix et Rhizoma,Paeoniae Radix Rubra,Astragali Radix)were retrieved and screened from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP).Swiss Target Prediction was used for target prediction of active components,followed by gene standardization using the UniProt database.Disease-related targets of T2DM and OSA were obtained from DisGeNET,OMIM,and GeneCards databases.A Venn diagram was used to identify overlapping targets between disease-related targets and active component-related targets,yielding potential therapeutic targets of MXD for both T2DM and OSA.The STRING database and Cytoscape 3.10.2 were employed to construct a protein-protein interaction(PPI)network and a"drug-component-target"network,respectively.Core active components and core targets were identified through network topology analysis.GO functional and KEGG pathway enrichment analyses were performed on potential targets using Metascape.Molecular docking validation was conducted using AutoDock to assess binding affinity between core targets and compounds.Results A total of 157 active components of MXD acted on 1 043 protein targets.After comparison with 1 798 OSA-related targets and 3 466 T2DM-related targets,253 potential therapeutic targets were identified.GO enrichment analysis revealed that these targets were primarily involved in biological processes such as upregulation of phosphorus metabolism,regulation of cell migration,circulatory system processes,and hormone level regulation.KEGG pathway analysis identified key pathways including Rap1,AGE-RAGE,cAMP,and Alzheimer's disease.PPI and"drug-component-target"network topology analysis screened 39 core targets(e.g.,IL-6,TNF,Akt1,IL-1β,EGFR)and core active components(e.g.,salvianolic acid B,tanshinone IIA,baicalin,curcumin).Molecular docking confirmed stable binding between these components and their corresponding target proteins.Conclusion The common pharmacodynamic basis of MXD in"treating different diseases with the same method"for T2DM and OSA includes active components such as salvianolic acid B,baicalin,and curcumin.The shared mechanism may involve key targets(e.g.,IL-6,TNF,Akt1)and modulation of signaling pathways such as Rap1,AGE-RAGE,and cAMP.

Objective To analyze the literature about Xiaoxianxiong Decoction based on the bibliometric method;To explore the research status and hotspots and trend of Xiaoxianxiong Decoction.Methods Relevant literature about Xiaoxianxiong Decoction was retrieved from CNKI,VIP,Wanfang Data and CBM from the establishment of the databases to January 26,2024.NoteExpress 3.5.0 and CiteSpace 6.1.R6 software were used to sort out the data related to authors,institutions and keywords,and draw maps for analysis.Results After screening,a total of 1 023 articles were included,and the number of publications is on the rise.The journal with the most articles was Journal of Sichuan Traditional Chinese Medicine(35 articles),Journal of New Chinese Medicine(32 articles),and Henan Traditional Chinese Medicine(30 articles).The literature type was the most with the number of clinical applications,accounting for 40.08%(410 articles).Totally 884 authors were included,and the authors with the most articles were Sun Qinguo(10 articles),Liu Yujie(10 articles)and Geng Yun(8 articles).A total of 782 institutions were included,and the institution with the most articles was Hubei University of Chinese Medicine(35 articles),Hunan University of Chinese Medicine(18 articles),Shandong University of Traditional Chinese Medicine(15 articles),etc.A total of 871 keywords were included,forming 10 clusters.The keywords with high frequency and betweeness centrality were"classic formulas","coronary heart disease","experience of famous doctors","angina"and"medical records".Conclusion The research on Xiaoxianxiong Decoction continues to gain popularity.Research hotspots include clinical applications,the experience of famous doctors,and basic research.It has a wide range of disease types,mainly focusing on syndrome differentiation and treatment of phlegm heat syndrome of coronary heart disease and angina pectoris.In recent years,it has gradually expanded to diabetes,gastric cancer and other diseases.

Objective To systemly retrieve and integrate relevant evidence on non-pharmacological treatment of urinary retention after pelvic floor reconstruction to provide a scientific basis for clinical practice.Methods According to the"6S"pyramid model,a top-down search was conducted Chinese and English databases to collect guidelines,systematic reviews,and best practice documents published up to July 1,2024,two researchers independently completed literature screening,quality evaluation,and evidence extraction,and evaluated the quality,extracted evidence,and graded for the literature that met the criteria.Results A total of 8 articles were screened out,including 1 guideline,4 best practices,and 3 systematic reviews.A total of 28 best pieces of evidence were summarized,covering 6 themes:Assessment and management of urinary retention after pelvic floor reconstruction,catheterization,vaginal dilators,physical therapy,external treatment methods of traditional Chinese medicine,and surgical treatment.Conclusion This study integrate the best evidence on non-pharmacological treatment of urinary retention after pelvic floor reconstruction,which can provide evidence-based support for clinical medical staff to formulate individualized perioperative management plans.

Objective:To investigate the effect of titanium wire-absorbable suture dual line combined firm stitching technique in costal cartilage framework shaping for auricular reconstruction in congenital microtia patients.Methods:A retrospective study was conducted on 120 patients with congenital microtia who underwent auricular reconstruction surgery at the Plastic Surgery Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College from January 2020 to December 2021. Among these, 86 were male and 34 were female, with an age range of 6-15 (8.5±2.1) years. All patients underwent auricular reconstruction using the expanded skin flap method, and the titanium wire-absorbable suture dual line combined firm stitching technique was used to construct a multi-layer three-dimensional autologous costal cartilage framework. Postoperative follow-up was conducted for 1 to 3 years to evaluate the morphology, stability, patient satisfaction, and occurrence of adverse reactions.Results:Of the 120 patients, 119 (99.2%) achieved primary healing. The reconstructed auricles were lifelike with clear substructures, and the long-term shape of the auricles remained stable without significant deformation. One patient developed a local skin infection and ulceration, leading to exposure of the cartilage framework, which was successfully repaired using a temporal fascia flap and free skin graft. A total of 85.8% (103/120) of the patients were satisfied with the postoperative results, 13.3% (16/120) rated the outcome as average, and 0.8% (1/120) were dissatisfied. No cases of hematoma or flap necrosis were observed in any of the patients.Conclusion:The costal cartilage framework, constructed using the titanium wire-absorbable suture dual line combined firm stitching technique, demonstrates good clinical effects for auricular reconstruction with no severe adverse reactions.

Objective:By sequencing and analyzing the biliary flora by 16S rDNA high-throughput sequencing technology,to identify the main flora associated with gallbladder stone formation and the main flora regulated by the Dahuang lingxian(DHLX),pre-liminary investigation the effect of DHLX on the biliary flora.Methods:The 50 male guinea pigs were randomly divided into Normal group,Model group,DHLX group.There were 15 guinea pigs in the normal group and 20 guinea pigs in the DHLX group,and 20 guin-ea pigs in the model group:the guinea pig model of gallstone was replicated with high-fat lithogenic diet,which was simultaneously ad-ministrated by gavage.After continuous intervention for 8 weeks,bile and gallbladder tissue samples were collected,and the gallstone formation rate of guinea pigs in each group was calculated,the pathological morphological changes of gallbladder tissue were detected by HE,T-CHO,TBA,LPS,IL-6,TNF-α were detected by ELISA,and the changes of biliary flora were detected by 16S rDNA;the correlation between biliary flora and bile index was detected by Pearson statistical method.Results:The stone formation rate of guinea pigs in the normal group was 8.3%,the rate of model stone composition was 90.8%,and the stone composition rate of DHLX group was 36.4%,and the HE staining results showed that compared with the normal group,the mucous membrane of the guinea pig in the model group was thickened,the columnar epithelial cells were arranged in a large number of inflammatory cells,and the columnar epi-thelial cells of the gallbladder mucosa in the chinese medicine group were arranged neatly compared with the model group,the thick-ness of the mucosa was reduced compared with the model group,and some inflammatory cells were infiltrated;ELISA results showed that compared with the normal group,the expressions of T-CHO,LPS,IL-6 and TNF-α in the bile of guinea pigs in the model group were significantly increased(P<0.01),while the content of TBA was significantly reduced(P<0.01);compared with the model group,the expression of LPS and IL-6 in the bile of the DHLX group were significantly reduced(P<0.01).The results of 16S rDNA showed that compared with the normal group the Ace index and Chao1 index of the model group were significantly reduced(P<0.01),and the Chao1 index of the DHLX group was significantly higher than that of the model group(P<0.05);biliary flora at the genera level was mainly composed of Burkholderia,Sphingomycetes,Breghamus,Delfortella,Pseudomonas;correlation analysis showed that total cholesterol was negatively correlated with the abundance of Methyloversatilis(P<0.05),and total bile acids were positively corre-lated with the abundance of Burkholderia(P<0.05),and Pseudomonas erythrocytes,Rhizobia,the abundance of Phreatobacter was negatively correlated(P<0.01)and LPS was positively correlated with the abundance of Pseudomonas erythrocytes(P<0.01).Conclu-sion:Biliary microflora disorder exists in the formation of biliary stones,and biliary microflora may participate in the formation of stones by regulating cholesterol,bile acids and LPS.DHLX can regulate the changes in the abundance of the microflora,make the structure of the microflora become normal,reduce the inflammation of the gallbladder,and prevent the formation of gallstones.