ObjectiveTo investigate the mechanism of action of modified Chaihu Shugan Powder in the treatment of abnormal gallbladder relaxation in gallbladder cholesterol stone （CS） with liver depression syndrome， and to provide a basis for clinical medication. MethodsMice were given a high-fat lithogenic diet combined with chronic unpredictable mild stress （CUMS） to establish a model of CS. A total of 45 male C57BL/6 mice were randomly divided into blank group （6 mice fed a normal diet） and CS group （39 mice fed a high-fat lithogenic diet）. After CS modeling， the CS group was further randomly divided into four subgroups of CS group， CS liver depression group， traditional Chinese medicine group （treated with modified Chaihu Shugan Powder）， and Western medicine group （treated with ursodeoxycholic acid）， with 9 mice in each group. All subgroups were fed with the high-fat lithogenic diet， and all mice except those in the CS group were given 21 days of CUMS for modeling. Samples were collected after intervention. The serum levels of cholecystokinin （CCK）， liver function parameters， and blood lipid profiles were measured； HE staining was performed for liver and gallbladder tissue； qPCR and Western blot were used to measure the mRNA and protein expression levels of G protein-coupled bile acid receptor 1 （TGR5） and glucagon-likepeptide-1/2 （GLP-1/2） in the intestine and TGR5 and glucagon-like peptide-2 receptor （GLP-2R） in gallbladder； metabolomics methods were used to determine bile acid composition in intestinal contents. The independent-samples t-test was used for comparison of continuous data between two groups； a one-way analysis of variance was used for comparison between multiple groups， and the least significant difference t-test or the Games-Howell method was used for further comparison between two groups. ResultsCompared with the blank group， the CS group showed significant gallstone formation， bile turbidity， hepatic steatosis， abnormal gallbladder wall structure， and significant increases in anxiety- and depression-like behaviors based on behavioral tests； significant increases in the level of total cholesterol in bile and the serum levels of alanine aminotransferase， aspartate aminotransferase， and low-density lipoprotein and significant reductions in the level of total bile acid （TBA） in bile and the serum levels of CCK and high-density lipoprotein （HDL） （all P<0.05）； significant increases in the mRNA expression levels of GLP-1/2 and TGR5 in the intestine and the protein expression levels of GLP-2R and TGR5 in the gallbladder and significant reductions in the mRNA expression levels of GLP-2R and TGR5 in the gallbladder （all P<0.05）； significant changes in multiple bile acid components in intestinal contents （all P<0.05）. Compared with the CS group， the CS liver depression group had further aggravation of pathological and behavioral manifestations， changes in bile acid composition， significant increases in the protein and mRNA expression levels of TGR5 and GLP-1/2 in the intestine， and significant increases in the protein and mRNA expression levels of TGR5 and GLP-2R in the gallbladder （all P<0.01）. Compared with the CS liver depression group， both treatment groups had an improvement in gallbladder morphology， alleviation of stones and liver injury， and recovery of liver function and blood lipid levels， as well as significant reductions in the protein and mRNA expression levels of TGR5 and GLP-1/2 in the intestine and TGR5 and GLP-2R in the gallbladder （all P<0.05）； the traditional Chinese medicine group showed significant increases in glycodeoxycholic acid （GDCA）， tauro-α-muricholic acid （T-α-MCA）， and taurochenodeoxycholic acid （TCDCA） （all P<0.05）， while the Western medicine group showed significant increases in taurohyodeoxycholic acid， T-α-MCA， TCDCA， GDCA， and glycoursodeoxycholic acid （all P<0.05）. Compared with the Western medicine group， the traditional Chinese medicine group had significantly greater behavioral improvements， significantly higher levels of TBA in bile and serum HDL （both P<0.01）， significant reductions in the protein expression levels of TGR5 and GLP-1/2 in the intestine and TGR5 and GLP-2R in the gallbladder， and a significant reduction in the mRNA expression level of TGR5 in the intestine （all P<0.01）， as well as a significant increase in tauroursodeoxycholic acid and significant reductions in glycoursodeoxycholic acid， taurohyodeoxycholic acid， TCDCA， and taurolithocholic acid （all P<0.05）. ConclusionModified Chaihu Shugan Powder can improve liver function and abnormal gallbladder relaxation in CS with liver depression syndrome by regulating the bile acid-TGR5 axis， thereby exerting the therapeutic effect of soothing the liver， resolving depression， moving Qi， and promoting bile flow.

ObjectiveTo clarify the expression of TRIM28 in non-M3 acute myeloid leukemia （AML） and its correlation with clinical indicators and prognosis， and to further explore the effect of TRIM28 expression levels on the proliferation and apoptosis of AML cells using small interfering RNA. MethodsThe GSE34577 dataset was analyzed using R software to compare TRIM28 expression between healthy controls and non-M3 acute myeloid leukemia （AML） patients. Clinical samples from non-M3 AML patients were collected， with TRIM28 expression levels measured using real-time quantitative PCR （qPCR）. The analysis focused on correlations between TRIM28 expression and various clinical indicators， treatment efficacy， and patient prognosis. Furthermore， small interfering RNA （siRNA） technology was employed to downregulate TRIM28 expression in human primary AML cells （HL60 cell line）. The effects on cell proliferation and apoptosis were then assessed through CCK-8 assays and flow cytometry， respectively. ResultsThe results showed that TRIM28 was up-regulated in non-M3 AML of both online database GSE34577 and clinical samples （P<0.000 1）， TRIM28 expression of new diagnosis group and relapsed refractory group was higher than iron deficiency anemia group （P<0.01）， and there was no significance between different French-American-British classification systems subtype. TRIM28 expression was higher in non-M3 AML patients with a poor genetic prognosis stratified as moderate than in the good prognosis group， and TRIM28 expression was associated with NPM1 combined with the FLT3-ITD mutation， positively correlated with age， bone marrow blast， peripheral blood blast and white blood cell， negatively correlated with hemoglobin. In addition， interference TRIM28 greatly inhibited cell proliferation and promoted cell apoptosis. ConclusionThis study reveals that TRIM28 is highly expressed in non-M3 AML and associated with prognosis， and plays a key role in the proliferation and apoptosis of AML cells， suggesting that TRIM28 may serve as a novel therapeutic target for non-M3 AML.

ObjectiveTo investigate the mechanism of action of Jiedu Huayu granules in improving liver injury in mice with acute liver failure （ALF） by observing its effect on a mouse model of ALF after prophylactic administration， and to provide a basis for clinical medication. MethodsA total of 60 specific pathogen-free male C57BL/6J mice were divided into normal group， model group， Jiedu Huayu granules group （JDHY group）， and farnesoid X receptor （FXR） agonist （GW4064） group using a random number table， with 15 mice in each group. The model of ALF was induced by a single intraperitoneal injection of D-galactosamine combined with lipopolysaccharide. The mice in the JDHY group were given prophylactic administration of 0.3 g/mL drug solution of Jiedu Huayu granules by gavage for 3 days before modeling， those in the normal group and the model group were given 0.9% NaCl solution by gavage， and those in the GW4064 group were given intraperitoneal injection of GW4064 for 3 consecutive days before modeling. The mice were sacrificed after modeling， and serum and liver tissue samples were collected. A veterinary automatic biochemical analyzer was used to measure the serum levels of total bilirubin （TBil）， total bile acids （TBA）， gamma-glutamyl transferase （GGT）， alanine aminotransferase （ALT）， and aspartate aminotransferase （AST） in mice from each group； HE staining was used to observe liver pathological changes； RT-PCR was used to measure the mRNA expression levels of FXR， fibroblast growth factor 15 （FGF15）， fibroblast growth factor receptor 4 （FGFR4）， small heterodimer partner （SHP）， and bile salt export pump （BSEP） in mice， and Western blot was used to measure the protein expression levels of FXR， FGF15， FGFR4， SHP， and BSEP. A one-way analysis of variance was used for comparison between groups， and the Dunett method was used for further comparison between two groups. ResultsCompared with the normal group， the model group had significant increases in the serum levels of TBil， ALT， AST， TBA， and GGT （all P<0.01）， and compared with the model group， the JDHY group and the GW4064 group had significant reductions in the serum levels of TBil， ALT， AST， TBA， and GGT （all P <0.01）. HE staining showed that compared with the model group， the JDHY group and the GW4064 group had milder pathological injury， a reduction in the area of hepatocyte necrosis， and alleviation of cellular swelling and edema. Compared with the normal group， the model group had significant reductions in the mRNA and protein expression levels of FXR， FGF15， FGFR4， SHP， and BSEP in liver tissue （all P <0.01）， and compared with the model group， the JDHY group and the GW4064 group had significant increases in the mRNA and protein expression levels of FXR， FGF15， FGFR4， SHP， and BSEP in liver tissue （all P <0.05）. ConclusionJiedu Huayu granules may alleviate liver injury in mice with ALF through the FXR/SHP axis.

BackgroundNon-suicidal self-injury （NSSI） behavior has become a global public health concern affecting the physical and mental health of adolescents. The experiential avoidance model posits that childhood trauma contributes to NSSI behavior through the mediating pathway of emotional dysregulation. However， existing research has predominantly focused on isolated psychological or social factors， with limited attention to their interactive effects of emotional dysregulation and social anxiety， both of which fall within the psychosocial domain. ObjectiveTo examine the relationship between childhood trauma and NSSI among adolescents， and to analyze the mediating role of emotional dysregulation and the moderating role of social anxiety， so as to provide evidence for targeted interventions for NSSI behavior of adolescents. MethodsA total of 282 adolescent inpatients who consecutively admitted to the Department of Psychiatry of Guangdong Provincial People's Hospital from March to December 2025 and met the Diagnostic and Statistical Manual of Mental Disorders，fifth edition（DSM-5）criteria for NSSI were enrolled as study participants. Participants were assessed using the general information questionnaire， the Adolescent Self-Harm Questionnaire， the Childhood Trauma Questionnaire （CTQ）， the Difficulties in Emotion Regulation Scale （DERS）， and the Social Anxiety Scale for Adolescents （SAS-A）. Pearson correlation analysis was used to examine correlations among scale scores. model 4 and model 58 of the Process 4.1 were used to test the mediating effect of emotional dysregulation and the moderating effect of social anxiety， respectively. ResultsCTQ score was positively associated with score of the Adolescent Self-Injury Questionnaire （r=0.279， P<0.01）. Emotional dysregulation significantly partially mediated the relationship between childhood trauma and NSSI behavior， with a mediating effect of 0.112 （95% CI： 0.043–0.208）， accounting for 40.14% of the total effect. Social anxiety moderated the association between childhood trauma and emotional dysregulation，the effect value was 0.102 （95% CI： 0.008–0.196）， as well as the relationship between emotional dysregulation and NSSI behavior， the effect value was 0.130 （95% CI： 0.033–0.226）. ConclusionEmotional dysregulation may mediate the relationship between childhood trauma and NSSI behavior among hospitalized adolescents， while social anxiety moderates both the first and second paths of this mediating process. ［Funded by Guangdong Medical Science and Technology Research Fund Project （number， A2022538）］

Objective: To analyze the distribution characteristics of school bullying related contents on the Douyin platform, and to provide a scientific basis for the prevention and intervention of school bullying in the online environment. Methods: Web crawler technology was employed to collect data related to school bullying from Douyin in May 2025, using 21 keywords including "school violence" and "child being beaten". A dataset comprising video titles, publisher types, and interaction metrics was constructed. After manual screening and classification, the content themes, engagement characteristics, and sentiment tendencies of titles were analyzed. Results: A total of 2 388 valid videos released between January 2019 and May 2025 were included. Physical bullying (767 cases, 32.12%) and verbal bullying (534 cases, 22.36%) were the most common types. Content themes differed significantly across account types ( χ 2=782.85, P <0.01). Official media accounts predominantly focused on case reports ( AR = 14.52 ) and legal updates ( AR =5.49), and social media influencer accounts preferred scenario reenactments ( AR =4.07) and film clips ( AR =3.83), while ordinary users focused on coping strategies ( AR =8.76). Account types had a stronger effect on engagement metrics than content themes (all P <0.01). Sentiment analysis of titles revealed that official media accounts tended toward negative sentiment ( AR = 6.41), social media influencer accounts toward neutral sentiment ( AR =2.47), and ordinary users toward positive sentiment ( AR =4.44). Keyword analysis showed high frequency terms related to responsible parties such as "children" "parents", and "classmates" , while demand oriented words like "how" were prominent. Conclusions School bullying related contents on Douyin demonstrate significant dissemination stratification by account type, and the dissemination effect is significantly influenced by the type of content publisher. There is a clear public demand for practical guidance on bullying prevention and intervention strategies.

ObjectiveTo investigate molecular alterations in tumor cells of multiple myeloma （MM） before and after B-cell maturation antigen （BCMA）-directed chimeric antigen receptor T-cell （CAR-T） therapy， with a focus on changes in invariant chain （CD74） expression and its potential association with macrophage migration inhibitory factor （MIF）. MethodsPaired bone marrow samples collected before BCMA CAR-T infusion and at ≥3 months after infusion were analyzed. Differential gene expression， functional enrichment， and cell-cell communication analyses were performed in malignant plasma cell-related populations. In vitro coculture experiments and MIF stimulation assays were conducted using the U266 cell line， and cell proliferation was assessed by CCK-8 and EdU incorporation assays. ResultsCD74 expression was upregulated in MM cells at ≥3 months after BCMA CAR-T therapy， and CD74 expression was consistently higher in post-treatment samples than in paired pre-treatment samples across all four cases. Genes upregulated after treatment were mainly enriched in antigen processing and presentation， cell adhesion， and immune-related processes. Cell-cell communication analysis revealed prominent interaction signals involving MIF-related pathways. In vitro experiments showed that coculture conditions induced changes in membrane CD74 expression in tumor cells， and MIF stimulation promoted proliferation of U266 cells. ConclusionCD74 expression is upregulated in tumor-associated MM cells following BCMA CAR-T therapy and is accompanied by the activation of the MIF-CD74 axis， suggesting a potential role in post-treatment adaptive changes and warranting further investigation into its therapeutic relevance.

Objective To identify the multi-dimensional needs of symptom management for oral cancer patients based on the journey map,and provide references for optimizing the symptom management of oral cancer patients.Methods From September 2023 to March 2024,the purposive sampling was used to select 15 perioperative oral cancer patients from a tertiary A general hospital in Zhengzhou for semi-structured interviews.The content analysis method was used to analyze the data and create a patient journey map.Results According to the time axis of diagnosis and treatment,the symptom management of patients with oral cancer was subdivided into 22 themes including identifying abnormal symptoms,clarifying diagnosis,anxiety,fear and uncertainty,guilt,high-risk behavioral inertia solidification,diagnostic trust crisis and so on from 3 dimensions of task,emotion,and pain point,and a journey map was formed.Conclusion The journey of symptom management for patients with oral cancer is long and complex,and the needs of patients'physiological and psychological symptom management are dynamically changing.In the future,the digital intelligence of big data technology can be combined to achieve whole-process,personalized and precise symptom management to improve the quality of life of oral cancer patients.

OBJECTIVE To investigate the distribution and drug resistance of multidrug-resistant bacteria in the neonatal intensive care unit of a three-A children's hospital in Henan Province,and to provide reference for ational drug use in clinical practice.METHODS Clinical specimens from hospitalized newborns in neonatal intensive care unit from a three-A children's hospital from Jan.1,2019 to Dec.31,2023 were subjected to etiological exam-ination and drug sensitivity test,and to analyze the distribution and drug resistance of multidrug-resistant bacteri-a in hospitalized newborns.RESULTS During the 5-year period,1139 strains of multidrug-resistant bacteria were i-solated,including 229 gram-positive bacteria(20.11％)and 910 gram-negative bacteria(79.89％).There were 92 strains of methicillin-resistant Staphylococcus aureus(MRSA)(accounting for 8.08％),57 strains(accounting for 5.00％)of methicillin-resistant coagulase-negative Staphylococcus epidermidis and 28 strains(accounting for 2.46％)of methicillin-resistant coagulase-negative human Staphylococcus.370 strains(accounting for 32.48)of carbapenem-resistant Klebsiella pneumoniae(CRKP),268 strains(accounting for 23.53％)of extenspectrum β-lactamase-producing Escherichia coli and 85 strains(accounting for 7.46％)of K.pneumoniae,there were 767 sputum specimens(67.34％),160 blood specimens from peripheral intravenous puncture and central venous cath-eterization(PICC)(14.05％),63 bronchoalveolar lavage fluid specimens(5.53％),29 secretion specimens(eye and wound secretions)(2.54％),and 120 other specimens(10.54％).K.pneumoniae and E.coli producing su-per-broad spectrum β-lactamase,CRKP and MRSA were the main drug-resistant bacteria.CONCLUSION The sit-uation of drug resistance in neonatal intensive care unit is serious,therefore monitoring bacterial resistance should be strengthened according to the clinical laboratory results,and antibiotics should be applied rationally.

Objective:To explore the impact of a comprehensive intervention program that integrates transitional care with personalized discharge preparation services on discharge preparedness on the growth, development, and motor development in premature infants, providing guidance and reference for clinical practice.Methods:The 90 pairs of premature infants and their main caregivers who were treated in the neonatal department, Children ′s Hospital, Quanzhou Maternal and Child Health Hospital were studied from February 2023 to February 2024 by randomized control method. Used the table of random numbers, they were divided into the control group and the observation group, with 45 pairs in each group. The control group routinely administered care, while the observation group was implemented a transitional care combined with personalized discharge preparation services. The discharge preparedness, growth and motor development, and the disease uncertainty of caregivers were observed between the 2 groups. Results:There were 27 males and 18 females of the 45 preterm infants,with gestational age of 30.86 (29.36, 31.50) weeks in the control group, 24 males and 21 females with gestational age of 30.29(29.00, 31.07) weeks in the observation group. The main caregiver identities 43 were mothers and 2 were other identities in the control group, 42 were mothers and 3 were other identities in the observation group, with them being 31.00(28.00, 35.00) years old. There were 97.78% (44 /45) caregivers who thought the child was ready to go home in the observation group, while the control group were 84.44% (38 /45), these differences were statistically significant ( χ2=4.88, P<0.05). The total score of discharge readiness in the observation group were 240.00(237.00, 242.50) points, higher than in the control group 226.00(219.00, 229.50) points, these differences were statistically significant ( Z=-6.23, P<0.05). The head circumference and body weight of the observation group were (34.82 ± 1.14) cm and (3.60 ± 0.55) kg, while the control group were (34.25 ± 1.22) cm and (3.35 ± 0.53) kg, there were statistically significant between the two groups ( t=-2.29, -2.22, all P<0.05). The Test of Infant Motor Performance score in the observation group was 50.00(46.00, 52.00) points, while the control group was 45.00(42.00, 48.00) points, there were statistically significant between the two groups ( Z=-3.65, P<0.05). The total score of disease uncertainty in the observation was 52.00(45.50, 60.00) points, while the control group was 61.00(58.50, 65.00) points, there was statistically significant between the two groups ( Z=-4.62, P<0.05). Conclusions:The discharge preparedness of the caregivers of preterm infants was improved because of the use of transitional care combined with personalized discharge preparation services, and the growth and motor development of preterm infants were promoted, and the uncertainty of the family caregivers of preterm infants about the disease was reduced.

Objective:To study the level of regulatory T cell(Treg)in peripheral blood of diffuse large B-cell lymphoma(DLBCL)patients at initial diagnosis,and its value in the evaluation of efficacy and prognosis.Methods:A total of 72 newly diagnosed DLBCL patients admitted to the Second Affiliated Hospital of Anhui Medical University from January 2018 to February 2022 were selected as research objects,and 17 healthy volunteers were taken as the control group.The level of CD4+CD25+CD127lowTreg in peripheral blood of patients was detected by flow cytometry,and a comparative analysis was conducted in conjunction with the clinical characteristics of patients.Results:The percentage of Treg in peripheral blood before treatment was correlated with Ann Arbor stage,IPI score,ECOG score and hemoglobin(HB).The levels of Treg in peripheral blood at initial diagnosis were significantly lower than that of healthy con-trols(3.85±0.22 vs 5.15±0.31,P=0.007).DLBCL patients were divided into high Treg group and low Treg group according to the me-dian percentage of CD4+CD25+CD127lowTreg in peripheral blood to CD4+T cells at initial diagnosis,the total effective rate of high Treg group was significantly higher than that of low Treg group(P=0.035).ECOG score(P=0.040)and low level of Treg before treatment(P=0.014)were independent risk factors for progression-free survival(PFS)in DLBCL patients.Having B symptom(P=0.028),ECOG score≥2(P=0.041)and low level of Treg before treatment(P=0.036)were independent risk factors for OS.PFS(P=0.020)and OS(P=0.036)in low Treg group were significantly lower than those in high Treg group.Conclusion:The low percentage of CD4+CD25+CD127lowTreg in peripheral blood of newly diagnosed DLBCL patients indicates a poor prognosis.