ObjectiveTo investigate the migration and distribution characteristics of chemical constituents in blood and hippocampal tissues before and after vinegar processing of Citri Reticulatae Pericarpium Viride（CRPV）， and to explore the potential material basis and mechanisms underlying their regulatory effects on emotional disorders by comparing the effects of raw and vinegar-processed products of CRPV. MethodsUltra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry（UPLC-Q-TOF-MS/MS） was employed to characterize and identify the chemical constituents of raw and vinegar-processed products of CRPV extracts， as well as their migrating components in blood and hippocampal tissues after oral administration. Reference standards， databases， and relevant literature were utilized for compound annotation， with data processing performed using PeakView 1.2 software. Seventy male C57BL/6 mice were randomly divided into seven groups， including the blank group， model group， diazepam group（2.5 mg·kg^-1）， raw CRPV low/high dose groups（0.6， 1.2 g·kg^-1）， and vinegar-processed CRPV low/high dose groups（0.6， 1.2 g·kg^-1）， with 10 mice per group. Except for the blank group， all other groups underwent chronic restraint stress（2 h·d^-1） for 20 d. Each drug-treated group received oral administration at the predetermined dose starting 10 d after modeling， with a total treatment duration of 10 d. Following model-based drug administration， mice underwent open-field， forced swimming， and elevated plus maze tests. After anesthesia with isoflurane， whole brains were collected from each group of mice， and hippocampi were dissected. Reactive oxygen species（ROS） level in hippocampal tissues was quantified by enzyme-linked immunosorbent assay（ELISA）. Hematoxylin-eosin（HE） staining was used to observe hippocampal tissue morphology. Immunofluorescence was performed to detect neuronal nuclei（NeuN） and peroxisome proliferator-activated receptor alpha（PPARα） expressions in hippocampal tissue. Then， pharmacodynamic evaluations were conducted to assess the effects of raw and vinegar-processed CRPV on mood disorders， exploring the potential mechanisms. ResultsVinegar processing caused significant changes in the chemical composition of CRPV， with 18 components showing increased relative content and 35 components showing decreased relative content. The primary changes occurred in flavonoid compounds， including 20 flavonoids， 20 flavonoid glycosides， 3 triterpenes， 3 phenolic acids， 1 alkaloid， and 6 other compounds. Twenty-one components were detected in blood（15 methoxyflavones， 4 flavonoid glycosides， and 2 phenolic acids）， with 17 shared between raw and vinegar-processed CRPV. Seven components reached hippocampal tissues（all common to both forms）. In regulating emotional disorders， Vinegar-processed CRPV exhibited superior antidepressant-like effects compared to raw products. HE staining revealed that both treatments improved hippocampal neuronal morphology， particularly in the damaged CA1 and CA3 regions. Immunofluorescence and ELISA analyses demonstrated that both raw and vinegar-processed CRPV significantly modulated NeuN and PPARα expressions in hippocampal tissue while alleviating oxidative stress induced by excessive ROS（P<0.05）. ConclusionThe chemical composition of CRPV undergoes changes after vinegar processing， but the migrating components in blood and hippocampus are primarily methoxyflavonoids. These components may serve as the potential material basis for activating the PPARα pathway， thereby negatively regulating ROS generation in the hippocampus， reducing oxidative stress， and promoting the development of NeuN-positive neurons. These findings provide experimental evidence for enhancing quality standards， pharmacodynamic material research， and active drug development of raw and vinegar-processed CRPV.

ObjectiveBased on the theory of "spleen governing transportation and transformation"， this study investigates the efficacy of Atractylodis Macrocephalae Rhizoma processed with Aurantii Fructus Immaturus juice（AMR-AFI） in improving slow-transit constipation（STC）， as well as the synergistic regulatory mechanism involving the microbiota-metabolism axis， thereby elucidating the scientific basis of its processing theory. MethodsAnimals were randomly divided into the control group， model group， positive drug（mosapride） group（3 mg·kg^-1）， and low-， medium-， and high-dose groups of AMR-AFI（3.9， 7.8， 15.6 g·kg^-1）. Except for the control group， the remaining five groups were induced with STC using loperamide hydrochloride. Following modeling， interventions were administered. All groups received continuous administration for 15 d， during which fecal samples， colon tissue， and serum were collected. Constipation improvement was assessed by measuring fecal moisture content and small intestinal propulsion rate， histological morphology of colonic tissue was observed via hematoxylin-eosin（HE） staining， and the levels of interleukin（IL）-6， tumor necrosis factor（TNF）-α， and IL-2 in serum were detected using enzyme-linked immunosorbent assay（ELISA）. Furthermore， the microbial community structure in mouse feces was analyzed by 16S rRNA sequencing， while transcriptomic sequencing was employed to screen differentially expressed genes in colonic tissue， followed by gene ontology（GO） and Kyoto Encyclopedia of Genes and Genomes（KEGG） enrichment analyses. Finally， Spearman correlation analysis was conducted to explore the association between differential microbiota and differential genes. ResultsCompared with the control group， the intestinal propulsion rate and fecal moisture content in the model group were significantly decreased（P<0.01）， while serum levels of IL-6， TNF-α， and IL-2 were significantly elevated（P<0.01）. HE staining showed damage and shedding of colonic mucosal epithelial cells， along with a reduction in goblet cells in the model group. In comparison with the model group， all treatment groups improved the pathological state of the colonic mucosa to varying degrees and reduced serum levels of IL-6， TNF-α， and IL-2（P<0.01）. Among these， the high-dose group of AMR-AFI significantly increased the intestinal propulsion rate and fecal moisture content of rats（P<0.05， P<0.01）. Further transcriptomic analysis revealed that a total of 104 differentially expressed genes were identified from comparisons between the model group and the control group， as well as between the model group and the high-dose group of AMR-AFI. These genes were mainly enriched in pathways closely related to STC pathogenesis， such as arachidonic acid metabolism and aldosterone-regulated sodium reabsorption. 16S rRNA sequencing results indicated that AMR-AFI reversed the structural imbalance of the gut microbiota in model mice， increased species richness， downregulated the relative abundance of pro-inflammatory bacteria such as Parasutterella， and enriched beneficial and butyrate-producing bacteria， including Lachnospiraceae_NK4A136_group， Ruminococcaceae， and Lachnospiraceae. Spearman correlation analysis further showed that the beneficial bacteria enriched in the AMR-AFI group were negatively correlated with genes involved in the arachidonic acid metabolic pathway and positively correlated with genes in the aldosterone-regulated sodium reabsorption pathway. In contrast， pro-inflammatory bacteria in the model group exhibited the opposite correlation trends. ConclusionAMR-AFI can effectively exert synergistic therapeutic effects on STC by regulating intestinal microbiota， arachidonic acid-mediated inflammatory metabolism， and aldosterone-regulated water-salt balance pathways.

ObjectiveBased on the theory of "spleen governing transportation and transformation"， this study investigates the efficacy of Atractylodis Macrocephalae Rhizoma processed with Aurantii Fructus Immaturus juice（AMR-AFI） in improving slow-transit constipation（STC）， as well as the synergistic regulatory mechanism involving the microbiota-metabolism axis， thereby elucidating the scientific basis of its processing theory. MethodsAnimals were randomly divided into the control group， model group， positive drug（mosapride） group（3 mg·kg^-1）， and low-， medium-， and high-dose groups of AMR-AFI（3.9， 7.8， 15.6 g·kg^-1）. Except for the control group， the remaining five groups were induced with STC using loperamide hydrochloride. Following modeling， interventions were administered. All groups received continuous administration for 15 d， during which fecal samples， colon tissue， and serum were collected. Constipation improvement was assessed by measuring fecal moisture content and small intestinal propulsion rate， histological morphology of colonic tissue was observed via hematoxylin-eosin（HE） staining， and the levels of interleukin（IL）-6， tumor necrosis factor（TNF）-α， and IL-2 in serum were detected using enzyme-linked immunosorbent assay（ELISA）. Furthermore， the microbial community structure in mouse feces was analyzed by 16S rRNA sequencing， while transcriptomic sequencing was employed to screen differentially expressed genes in colonic tissue， followed by gene ontology（GO） and Kyoto Encyclopedia of Genes and Genomes（KEGG） enrichment analyses. Finally， Spearman correlation analysis was conducted to explore the association between differential microbiota and differential genes. ResultsCompared with the control group， the intestinal propulsion rate and fecal moisture content in the model group were significantly decreased（P<0.01）， while serum levels of IL-6， TNF-α， and IL-2 were significantly elevated（P<0.01）. HE staining showed damage and shedding of colonic mucosal epithelial cells， along with a reduction in goblet cells in the model group. In comparison with the model group， all treatment groups improved the pathological state of the colonic mucosa to varying degrees and reduced serum levels of IL-6， TNF-α， and IL-2（P<0.01）. Among these， the high-dose group of AMR-AFI significantly increased the intestinal propulsion rate and fecal moisture content of rats（P<0.05， P<0.01）. Further transcriptomic analysis revealed that a total of 104 differentially expressed genes were identified from comparisons between the model group and the control group， as well as between the model group and the high-dose group of AMR-AFI. These genes were mainly enriched in pathways closely related to STC pathogenesis， such as arachidonic acid metabolism and aldosterone-regulated sodium reabsorption. 16S rRNA sequencing results indicated that AMR-AFI reversed the structural imbalance of the gut microbiota in model mice， increased species richness， downregulated the relative abundance of pro-inflammatory bacteria such as Parasutterella， and enriched beneficial and butyrate-producing bacteria， including Lachnospiraceae_NK4A136_group， Ruminococcaceae， and Lachnospiraceae. Spearman correlation analysis further showed that the beneficial bacteria enriched in the AMR-AFI group were negatively correlated with genes involved in the arachidonic acid metabolic pathway and positively correlated with genes in the aldosterone-regulated sodium reabsorption pathway. In contrast， pro-inflammatory bacteria in the model group exhibited the opposite correlation trends. ConclusionAMR-AFI can effectively exert synergistic therapeutic effects on STC by regulating intestinal microbiota， arachidonic acid-mediated inflammatory metabolism， and aldosterone-regulated water-salt balance pathways.

Objective To explore the impact of lung cancer screening on the changes of health risk behaviors in 420 high-risk populations. Methods Among the 420 high-risk subjects who underwent lung cancer screening in the hospital from January 2022 to February 2024 were included and underwent low-dose computed tomography (LDCT) screening and were followed up for 1 year. Multivariate logistic regression analysis was used to analyze the association between lung cancer screening and changes in health risk behaviors. Results Compared with the baseline situation, the smoking rate, alcohol drinking rate and long-term exposure to asbestos and other carcinogens were lower during 1-year follow-up, and the regular physical examination rate was increased (P<0.05). In this study, health-risk behaviors of 176 subjects changed during 1-year follow-up, and women, subjects who consulted physicians about physical condition, subjects having positive nodules and subjects having previous history of lung disease accounted for higher proportions (P<0.05). Logistic regression analysis suggested that women, consulting physicians about their physical condition, having positive nodules and having previous history of lung disease were more likely to change health risk behaviors (P<0.05). Conclusion Lung cancer screening prompts high-risk individuals (smokers, drinkers, those with long-term exposure to asbestos and other carcinogens, and those without regular physical examination) to change their health risk behaviors. Women, those who actively consult physicians about their physical condition, those with positive nodules and those with previous history of lung disease are more likely to change their unhealthy habits through screening than other individuals.

Objective To investigate the status and predictive factors of future acute exacerbation of asthma in adults. Methods Adult patients with asthma who were admitted to the hospital from March 2023 to July 2025 were selected. Based on the acute exacerbation status after follow-up, the patients were categorized into acute exacerbation group (n=107) and control group (n=245). The clinical data, pulmonary function [peak expiratory flow (PEF) and forced expiratory volume in the 1st second/forced vital capacity (FEV₁/FVC)] and health status [asthma control questionnaire (ACQ), Morisky medication adherence scale (MMAS-8), short form 36-item health survey (SF-36)] of the study subjects were collected. The correlation between the indicators and acute exacerbation was explored by logistic regression analysis, and the predictive efficiency was evaluated by ROC curve. Results The age, smoking history, asthma course, allergen exposure and ACQ in the acute exacerbation group were higher than those in the control group, while the average monthly family income, glucocorticoid treatment, PEF, FEV₁/FVC, MMAS-8 and SF-36 were lower (P<0.05). Multivariate logistic regression suggested that ACQ score, glucocorticoid treatment, MMAS-8 score, FEV₁/FVC, PEF and smoking history were the influencing factors of acute asthma exacerbation (P<0.05). ROC analysis revealed that the diagnostic efficiency of combined prediction was the highest (AUC=0.965), with sensitivity of 0.944 and specificity of 0.857 (P<0.05). Conclusion It is necessary to pay more attention to the medication compliance and asthma control level of patients, and integrate multi-dimensional information such as smoking history, pulmonary function and treatment conditions to accurately identify patients with high-risk acute exacerbation and implement targeted intervention measures.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

Objective:To explore the application effect of different doses of dexmedetomidine combined with propofol in elderly patients undergoing radical thyroidectomy for thyroid cancer.Methods:This study was a prospective study,102 elderly patients undergoing radical thyroidectomy for thyroid cancer at Shayang County People's Hospital of Jingmen from April 2022 to April 2024 were selected,they were randomly divided into low-dose group and high-dose group used random number table method,with 51 patients in each group.Low-dose group received propofol(2.0 mg/kg)combined with dexmedetomidine(loading dose 0.3 μg/kg)for anesthesia induction,while high-dose group received propofol(1.0 mg/kg)combined with dexmedetomidine(loading dose 0.6 μg/kg)for anesthesia induction.The postoperative recovery indicators,pain level,cognitive function,hemodynamic indicators[mean arterial pressure(MAP)and heart rate(HR)],and adverse reactions between two groups were compared.Results:Compared with high-dose group,low-dose group had shorter awakening time,spontaneous breathing recovery time,tracheal extubation time,and lower incidence of adverse reactions(P＜0.05).Compared with high-dose group at 6 h,12 h,and 24 h after surgery,low-dose group had lower pain visual analog scale(VAS)scores and higher mini-mental state examination(MMSE)scores(P＜0.05).Compared with high-dose group at separation of thyroid gland(T2)to completion of surgery(T3),low-dose group had lower MAP and HR(P＜0.05).Conclusion:Loading dose 0.3 μg/kg dexmedetomidine combined with propofol has a good analgesic effect in elderly patients undergoing radical surgery for thyroid cancer,it can also maintain hemodynamic stability,reduce the impact on cognitive function,and lower the incidence of adverse reactions.

Objective To investigate the effects of modified Zhujing Pill(ZJP)-medicated serum on mitochondrial autophagy and related proteins in a pressure-induced retinal ganglion cell(RGC)injury model in rats.Methods The modified ZJP-medicated serum and blank serum were prepared by the intragastric administration of modified ZJP(10 mL·kg-1)to 10 male Sprague-Dawley(SD)rats and equivalent normal saline to another 10 male SD rats.The RGC injury models of rats were constructed under the in vitro pressure of 0 mmHg,20 mmHg,40 mmHg,60 mmHg,and 80 mmHg(1 kPa=7.5 mmHg),respectively.According to the pressurization experiment results,the RGC injury model established under the in vitro pressure of 80 mmHg was selected for subsequent experiments.The RGCs of rats were divided into the normal group(NG group,untreated RGCs),model group(MG group,injured RGCs without serum intervention),blank serum group(KB group,injured RGCs treated with blank serum),and modified ZJP-medicated serum group(LVP group,injured RGCs treated with modified ZJP-medicated serum).The apoptosis of RGCs was detected by flow cytometry;the mitochondrial ultrastructure was observed via transmission electron microscopy;the protein expression level of PINK1,Parkin,LC3 Ⅱ/Ⅰ,and p62 was measured by Western blotting.Results Transmission electron microscopy revealed the in-tact double-membrane structure of mitochondria and evenly distributed mitochondrial crista in the NG group,while the MG and KB groups exhibited disrupted mitochondrial membranes,accompanied by a large number of vacuoles in the mitochon-dria.The mitochondria of the LVP group had a double-membrane structure and the vacuoles in the mitochondria decreased compared with those of the MG and KB groups,and the mitochondrial morphology was basically the same as that of the NG group.The flow cytometry results demonstrated the apoptosis rate of RGCs was(4.25±0.55)％,(20.79±3.06)％,(30.07±3.23)％,and(11.42±0.16)％in the NG,MG,KB,and LVP groups,respectively.Compared with the NG group,the ap-optosis rate of RGCs in rats increased in the MG group,and the difference was statistically significant(P＜0.01).Com-pared with the MG and KB groups,the apoptosis rate of RGCs in rats decreased in the LVP group,and the difference was statistically significant(both P＜0.05).The Western blotting results indicated that the MG group had an increased relative protein expression level of PINK1,Parkin,and LC3 Ⅱ/Ⅰ but a decreased relative protein expression level of p62 compared with the NG group,and the difference was statistically significant(all P＜0.01).Compared with the MG and KB groups,the LVP group had a decreased relative protein expression level of PINK1,Parkin,and LC3 Ⅱ/Ⅰ but an increased relative protein expression level of p62,and the difference was statistically significant(all P＜0.05).Conclusion The modified ZJP-medicated serum may protect RGCs by suppressing pressure-induced mitochondrial autophagy in vitro of rat RGCs via modulating PINK1/Parkin-mediated mitochondrial autophagy.

Purpose To investigate the clinicopathological characteristics of the gastric oxyntic gland adenoma(GOGA).Methods We collected 18 samples of GOGA,histopathological features and immunohistochemical staining were assessed.Main features of pathological diagnosis,treatment methods and follow-up were retrospectively analyzed.Results There were 18 patients,including 9 females and 9 males,aged from 36 to 86 years old.The endoscopic im-age showed a flat lesion with whitish in color or a polypoid protrusions.The size ranged from 0.3 cm to 0.8 cm.Hema-toxylin and eosin staining showed irregular glandular structures in the mucosal lamina propria,with branched and anas-tomosed patterns.The tumour demonstrating composed of chief cells hyperplasia with mild nuclear atypia.All lesions were confined to the mucous lamina propria.There was no atrophic within the peripheral gastic mucosa.Immunohisto-chemical examination showed positive for Pepsinogen-Ⅰ and MUC6.Gene mutation were analyzed in 2 cases using next generation sequence technology,and no KRAS and GNAS mutation had been detected.Endoscopic surgical treatment was performed in 11 cases,and biopsy forceps removal was carried out in 7 cases.No recurrence or metastasis was ob-served during the follow-up period of 1 to 58 months.Conclusion GOGA is a rare lesion,and appears to behave bio-logically benign.A full understanding of its histological morphology and biological behavior can improve the diagnostic ability of clinincans,and facilitate further research in the future.

Objective:To explore latent categories of decent work perception among nurses in tuberculosis wards and analyze their influencing factors.Methods:Convenience sampling was used to select tuberculosis ward nurses from 13 general or specialized hospitals in China in July 2024 for the study. General Information Questionnaire, Decent Work Perception Scale (DWPS), Work-Family Support Scale, and Connor-Davidson Resilience Scale were used to survey the tuberculosis ward nurses. Mplus 8.3 software was used for latent profile analysis of decent work perception of nurses in tuberculosis wards. Unordered multicategorical Logistic regression was used to explore the factors influencing the latent categories of decent work perception for nurses in tuberculosis wards.Results:A total of 920 questionnaires were distributed, and 833 valid questionnaires were recovered, with a valid recovery rate of 90.54%. The mean DWPS item score of 833 tuberculosis ward nurses was [3.44 (2.94, 3.88) ]. Decent work perceptions of tuberculosis ward nurses were classified into three latent categories, namely, low decent perception-low occupational recognition type (15.61%, 130/833), medium decent perception-moderate occupational recognition type (50.54%, 421/833), and high decent perception-high occupational recognition type (33.85%, 282/833). Unordered multicategorical Logistic regression analysis revealed that organizational support, psychological resilience, job title, monthly income, hospital class, and number of monthly night shifts were the influencing factors of latent categories of decent work perception among nurses in tuberculosis wards.Conclusions:The decent work perception of nurses in tuberculosis wards is at a medium level. Nursing managers should focus on nurses with low decent perception-low occupational recognition and manage and support nurses according to the characteristics and influencing factors of different categories.