The blood-brain barrier （BBB） is a physical and biochemical barrier that precisely regulates brain homeostasis and plays a central role in controlling the transport of endogenous and exogenous drugs and related metabolites across the blood-brain interface. These functions of the BBB are mediated by its major components， including brain microvascular endothelial cells （BMECs）， tight junction protein complexes， and influx and efflux transporter proteins. One of the pathological features of ischemic stroke （IS） is BBB disruption， which plays an important role in the development of post-stroke brain injury and subsequent neurological dysfunction. Therefore， given the increasing incidence of IS， there is an urgent need to develop new therapeutic strategies to prevent BBB dysfunction and thereby protect injured brain tissue after IS. This study describes the pathological mechanisms by which BMEC injury after IS leads to BBB dysfunction and elucidates the association between BMECs and IS， including the regulation of apoptosis， autophagy， inflammatory responses， oxidative stress， neurotoxic effects， and cerebral edema. In addition， this article summarizes Chinese herbal medicines that may prevent and treat IS by targeting BMECs. These include monomeric compounds and single herbs such as flavonoids， glycosides， phenols， phthalides， terpenoids， and Styrax. Traditional Chinese medicine （TCM） compound formulas and preparations include oral formulations such as Buyang Huanwu decoction， Sailuotong， Naoxintong capsules， Dandeng Tongnao capsules， and Shexiang Tongxin dropping pills， as well as injectable preparations such as Tongluo Jiunao injection， Xingnaojing injection， Danshen polyphenolic acid for injection， Yiqi Fumai injection， and Shuxuetong injection. This study aims to explore the protective effects of TCM against IS through targeted regulation of BMEC function， providing new insights into the mechanisms of IS and endovascular therapeutic strategies.

Objective To investigate the common diseases and the causes of diseases in Chinese Antarctic researchers,so as to provide reference for the medical support.Methods Medical records of 1 127 people with injuries and diseases who participated in four Antarctic scientific expeditions(the 31st,35th,36th,and 39th time)were retrospectively analyzed.The causes of the injuries and diseases as well as the implications for nursing were investigated.Results The top 10 diseases in the four Antarctic expeditions were acute soft tissue injury,dermatomycosis,pharyngitis,insomnia,periodontitis,gastroenteritis,motion sickness,acute upper respiratory infection,primary hypertension,and frostbite.The causes of the diseases in the four Antarctic expeditions were analyzed,and the nursing of different diseases was proposed.Conclusion It is necessary to take preventive measures based on the characteristics of injuries and diseases during Antarctic expeditions,so as to effectively prevent and treat these diseases and provide more comprehensive medical support for Antarctic scientific expeditions.

Objective To establish a homozygous zebrafish map3k15 knockout line using CRISPR/Cas9 gene editing technology so to provide an animal model for investigation of potential role of map3k15 in renal diseases.Methods 1)Analyzing the expression pattern of map3k15 in zebrafish;2)Establishing a homozygous map3k15 knockout zebrafish line using CRISPR/Cas9;3)Observing the phenotypic effects of map3k15 deficiency in ze-brafish.Results 1)map3k15 was expressed in the zebrafish pronephros,and map3k15/map3k15 protein was found highly conserved across species;2)map3k15-/-mutant zebrafish model was constructed with+2 bp mutation and+1 bp mutation;3)map3k15 mutant zebrafish exhibited edema in yolk sac,pericardium and head during embryonic development.Conclusions A homozygous zebrafish map3k15 knockout line is successfully developed which may provide an important model for future research on the role of map3k15 in renal development and disease.

AIM To optimize the extraction process for total polyphenols from Conioselinum vaginatu(Spreng.)Thell.,make component analysis,and evaluate their anti-oxidant,hypoglycemic activities.METHODS The effects of ultrasound,enzymatic hydrolysis,acid hydrolysis,alcohol extraction and hydrolysis processes on the extraction quantity of total polyphenols were investigated,respectively.With extraction temperature,extraction time,ethanol concetration and liquid-solid ratio as influencing factors,extraction quantity of total polyphenols as an evaluation index,the extraction process was optimized by response surface method.HPLC was adopted in the identification of polyphenolic composition and determination of their contents.Subsequently,total polyphenols' scavenging capacities on DPPH,ABTS,OH free radicals,total reducing power and inhibitory capacity on α-glucosidase were determined.RESULTS The highest extraction quantity of total polyphenols was observable when extraction process was employed.The optimal conditions were determined to be 62 ℃ for extraction temperature,54 min for extraction time,69％for ethanol concentration,and 50∶1 for liquid-solid ratio,the extraction quantity of total polyphenols was(9.51±0.2)mg GAE/g.Seven constituents existed in C.vaginatu,among which ferulic acid demonstrated the highest content,followed by that of myricetin,while D-tryptophan content was the lowest.At the concentration of 7.61 mg/L,total polyphenols displayed the scavenging rates on DPPH,ABTS,OH free radicals of 80.70％,85.97％,28.60％,total reducing power of 0.22,and inhibition rate on α-glucosidase of 77.23％,respectively.CONCLUSION This stable and reliable method can be used for the extraction of total polyphenols from C.vaginatum with strong anti-oxidant,hypoglycemic activities.

Objective:To explore and compare the effect and prognosis of small bone window surgery at different timings in the treatment of hypertensive intracerebral hemorrhage (HICH).Methods:Using a retrospective analysis, HICH patients admitted to department of neurosurgery of Guihang Guiyang Hospital were selected from May 2021 to May 2023. According to the different surgical timings, the patients were divided into ultra-early group (time from onset to surgery <6 h) and early group (onset to surgery time ≥6~<24 h). Propensity score was used to match 51 cases in each group. The perioperative indicators (surgical time, intraoperative blood loss, hospital stay, hematoma clearance rate), incidence rates of complications, neurological function (National Institute of Health Stroke Scale (NIHSS), Barthel index), endothelin and arginine vasopressin (AVP) before surgery and after 7 days of surgery, clinical efficacy (Glasgow Outcome Scale (GOS)) at 1 month after surgery, rebleeding rate and mortality rate within 1 year after surgery were compared between both groups. Chi-square test was used for between-group comparison of enumeration data, t test was adopted for between-group comparison of measurement data with normal distribution, and non-parametric rank sum test was adopted for comparison of ranked data between groups.Results:The intraoperative blood loss and hospital stay in ultra-early group with (186.54±20.15) mL and (14.45±2.04) d were significantly less or shorter than (220.10±24.61) mL and (16.79±2.52) d in early group, the difference was statistically significant ( t values were 7.54 and 5.15; both P<0.001). At 7 days after surgery, the NIHSS ((14.55±1.57) and (16.14±2.13) points), endothelin ((69.14±6.37) and (73.48±6.83) mg/L) and AVP ((12.81±2.02) and (14.35±2.23) μg/L) in ultra-early group and early group were significantly lower than before ((32.67±3.81) and (32.38±3.53) points, (89.67±7.25) and (88.24±6.38) mg/L, (18.47±2.41) and (18.04±2.37) μg/L) while the Barthel index ((72.35±10.14) and (67.45±9.78) points) was significantly higher than before ((49.45±7.41) and (47.87±7.37) points),and the difference was statistically significant ( t values were 31.40, 28.13, 15.19, 11.28, 12.85, 8.10, 13.02, and 11.42, respectively; all P<0.001) and the NIHSS, endothelin and AVP in ultra-early group were significantly lower than in early group, while the Barthel index was significantly higher than early group, the difference was statistically significant ( t values were 4.29, 3.32, 3.66, and 2.48 respectively; P values were <0.001, 0.001, <0.001, and 0.015, respectively ). GOS grading (grade I-grade V: 1, 3, 9, 22, 16 cases) in ultra-early group at 1 month after surgery was significantly better than that in early group (grade I-V: 3, 5, 10, 26, 7 cases) ( Z=1.97, P=0.049). Conclusion:Both ultra-early and early small bone window surgery have good results in the treatment of HICH, but ultra-early surgery is more beneficial to the recovery of patients' neurological function and has better prognosis, which can be used as a reference.

Objective To analyze the composition and distribution characteristics of death causes among elderly inpa-tients in a municipal hospital based on Diagnosis-Related Groups(DRG).This analysis aims to provide data support for the treat-ment and management of diseases in elderly patients and for the development of related disciplines,ultimately aiming to reduce the mortality rate of elderly patients.Methods A total of 1 811 death cases of elderly inpatients(aged≥60 years)were extrac-ted from the medical record management system and DRG operation analysis system of a prefecture-level tertiary hospital between January 1,2022,and December 31,2024.Information from the inpatient medical records'front page and DRG grouping data were matched.A retrospective analysis was conducted on 1,587 cases with hospitalization durations of 60 days orless included in DRG groups using Excel 2021.Results Elderly inpatients accounted for more than 80% of the total deaths.The deaths were mainly caused by three major categories:respiratory diseases and dysfunctions(35.03%),circulatory system diseases and dys-functions(25.27%),and nervous system diseases and dysfunctions(14.43%).The internal medicine treatment group had the highest number of deaths,followed by the surgical operation group,and then the non-operating room operation group.Among eld-erly deceased patients,83.68% had complications or comorbidities,with 85.47% having severe complications or comorbidities,mainly in patients aged 70 and above.Conclusion Elderly patients are the primary population group at risk of death.Based on the disease characteristics of elderly deceased patients in different age groups,hospitals should focus on strengthening the devel-opment of geriatrics departments,advance disciplinary technologies,and enhance patient satisfaction to provide comprehensive and personalized diagnosis and treatment,thereby supporting healthy aging.

Sacroiliac complex injuries are commonly seen in high-energy pelvic fractures. The injuries make a big difference in treatment patterns due to the diverse injury types, posing considerable challenges in formulating optimal treatment strategies, and hence are persistent clinical difficulties in orthopedic trauma. The clinical management of sacroiliac complex injuries presents several key challenges such as a non-negligible rate of missed diagnoses in associated vascular and visceral injuries, absence of standardized protocols for surgical approaches and reduction-fixation strategies across different injury patterns, and ongoing controversies regarding surgical indications and optimal timing for patients combined with concomitant lumbosacral plexus injuries. Currently, no systematic clinical guidelines are available for the diagnosis and treatment of sacroiliac complex injuries both domestically and internationally. To this end, the Pelvic and Acetabular Surgery Group, Orthopedic Branch, China International Exchange and Promotive Association for Medical and Health Care and Orthopedic Physician Branch, Chinese Medical Doctor Association organized a panel of domestic experts in the field to develop the Clinical guideline for the diagnosis and treatment of sacroiliac complex injuries ( version 2025), based on evidence-based medicine and adhering to the principles of scientific rigor, clinical applicability, and innovation. These guidelines provided 11 recommendations covering diagnosis, therapeutic principles and techniques, management protocols for lumbosacral plexus injuries, outcome evaluation, and postoperative rehabilitation pathways, etc., aiming to standardize the clinical management of sacroiliac complex injuries.

AIM To investigate the effects of Yiqi Juanbi Formula on chondrocyte pyroptosis in rat models of collagen-induced arthritis(CIA).METHODS Fifty rats were subcutaneously injected at the tail base with an emulsion containing equal volumes of bovine type Ⅱ collagen and incomplete Freund's adjuvant(IFA)to establish the CIA models.These rats were then randomly assigned to the model group,the methotrexate group(0.35 mg/kg),and the low-dose,medium-dose,and high-dose Yiqi Juanbi Formula groups(9.4,18.7,37.4 g/kg),in contrast to the ten intact rats serving in the normal control group.Following four weeks of intragastric administration,the rats had their general conditions observed;their joint swelling and arthritis indices measured;their ankle joint pathology assessed by HE staining;their serum levels of IL-1β,IL-18 and TNF-ɑ detected by ELISA;their mRNA expressions of NLRP3,Caspase-1,GSDMD,IL-1β,IL-18 and TNF-ɑ in ankle cartilage quantified by RT-qPCR;their protein expressions of NF-κB,NLRP3 and Caspase-1 in ankle cartilage analyzed by Western blot;and their NLRP3 and GSDMD positive expressions in ankle cartilage examined by immunohistochemistry.RESULTS Compared to the control group,the model group showed significantly increased joint swelling and arthritis indices(P＜0.01);elevated serum levels of IL-1 β,IL-18 and TNF-ɑ(P＜0.01);pathological changes including cartilage surface defects,reduced cell count,altered cellular morphology,irregular cell arrangement,and significant inflammatory cell infiltration in synovial tissue;upregulated mRNA expressions of NF-κB,NLRP3,Caspase-1,GSDMD,IL-1β,IL-18 and TNF-ɑ(P＜0.01)and increased protein expressions of NF-κB,NLRP3 and Caspase-1(P＜0.01)in ankle cartilage;enhanced positive expressions of NLRP3 and GSDMD in ankle cartilage(P＜0.01).Compared to the model group,the groups intervened with methotrexate or medium-or high-dose Yiqi Juanbi Formula exhibited reduced joint swelling and arthritis indices(P＜0.01);alleviated pathological damage in ankle joints;decreased serum levels of IL-1β,IL-18 and TNF-ɑ(P＜0.01);downregulated mRNA expressions of NF-κB,NLRP3,Caspase-1,GSDMD,IL-1β,IL-18 and TNF-ɑ(P＜0.05,P＜0.01),and reduced protein expressions of NF-κB,NLRP3 and Caspase-1(P＜0.05,P＜0.01)in ankle cartilage;and diminished positive expressions of NLRP3 and GSDMD in ankle cartilage(P＜0.01).CONCLUSION Yiqi Juanbi Formula alleviates inflammation in CIA rats,potentially by inhibiting the activation of the NF-κB/NLRP3/Caspase-1 signaling pathway,thereby suppressing chondrocyte pyroptosis.

Objective To analyze the CT manifestations of high altitude pulmonary edema(HAPE)to provide radiological evidence for its early and accurate diagnosis.Methods Totally 200 HAPE patients clinically confirmed at some hospital from April 2021 to April 2024 were enrolled into a study group,and 56 individuals undergoing health examinations at the hospital's physical examination center between January and June 2023 were included into a control group.Examinations were carried out with a United Imaging uCT528 40-slice spiral CT scanner.The patients in the study group were observed in terms of HAPE staging,the extent of pulmonary involvement,CT manifestations of different stages including location,distribution,density and morphology of pulmonary lesion.The diameters of the main pulmonary arteries and ascending aortas of the subjects in the two groups were measured,and the ratios of the two diameters were calculated.SPSS 25.0 software was used for statistical analysis.Results In the study group,there were 26 cases(13.0%)at early stage,105 ones at progression stage(52.5%),32 ones at critical outbreak stage(16.0%)and 37 ones at resolution and absorption stage(18.5%),and there were 35.5%with unilateral lung involvement and 64.5%with bilateral involvement.At early stage,HAPE chest CT manifestations included increased and thickened bilateral bronchovascular bundles,widened main pulmonary artery lumen and faint ground-glass opacity in lungs;at progression stage,HAPE chest CT manifestations revealed multiple cloud-like or patchy areas of increased density within lungs;at critical outbreak stage,CT scanning indicated diffuse patchy opacities and consolidation in lungs,white lung-like changes could be found in some severe cases,and bronchial air signs were shown within affected segments in some ones with severer signs in the right lung than in the left lung;at resolution and absorption stage the CT manifestations were similar to those at early stage,with lesions completely resolving after treatment.The study group had the diameters of the main pulmonary arteries greater while the diameters of the ascending aortas less than those of the control group,and the ratios of the diameters of the two diameters in the study group were higher than those in the control group,with the differences being statistically significant(all P<0.05).Conclusion Chest CT is an important examination method for the early diagnosis of HAPE and clarification of its clinical staging,which directly reflects the pulmonary pathological changes in HAPE patients and helps doctors fully understand the disease progression.

A series of treatment and nursing measures were given to a patient with very early-onset inflammatory bowel disease with anal fistula who underwent umbilical cord blood stem cell transplantation complicated with perianal infection, including being alert to the postoperative infection after stem cell transplantation; timely assessment of nutritional status and nutritional support; and multi-modal whole process psychological care. After 32d of careful treatment and care, the patient safely passed the "zero phase" of leukocytes, and the umbilical cord blood stem cell transplantation was successful, and the patient was successfully transferred to the general ward. For patients with combined anal fistula undergoing umbilical cord blood stem cell transplantation, accurate assessment and observation of the patient's condition can effectively control the occurrence and development of infection during the leukocyte-deficient phase and ensure the smooth progress of umbilical cord blood stem cell transplantation.