ObjectiveTo investigate the effects of Yishen Juanbi pills （YSJB）-containing bone marrow fluid on the migration and differentiation phenotypes of CD4⁺T lymphocytes based on the stromal cell-derived factor-1/chemokine receptor 4 （SDF-1/CXCR4） signaling pathway. MethodsPrimary CD4⁺T lymphocytes were isolated from mice using magnetic bead separation and identified for purity by flow cytometry. A CD4⁺T lymphocyte culture system was then established to observe the effects of SDF-1 on CD4⁺T-cell migration and differentiation. On this basis， the experimental groups included the Sham group， the ovariectomy （OVX） group， the Sham+collagen-induced arthritis （CIA） group， the OVX+CIA group， the Sham+CIA+YSJB group （2.16 g·kg^-1）， the OVX+CIA+YSJB group （2.16 g·kg^-1）， and the OVX+CIA+methotrexate （MTX） group （1.5 mg·kg^-1）. Bone marrow fluid from each group was prepared according to previous methods and added to the CD4⁺ T-cell culture system at 5% （v/v）. Transwell assays were used to examine CD4⁺T-cell migration in each group. Real-time PCR was used to measure the mRNA expression levels of interleukin （IL）-17， tumor necrosis factor-α （TNF-α）， retinoic-acid-related orphan receptor γt （RORγt）， IL-10， transforming growth factor-β （TGF-β）， forkhead box P3 （FoxP3）， CXCR4， phosphoinositide 3-kinase （PI3K）， and protein kinase B （Akt）. Western blot was used to detect the expression of helper T （Th）17/regulatory T （Treg） cell signature factors （RORγt， FoxP3）， CXCR4， PI3K， phosphorylated （p）-PI3K， Akt， and p-Akt. In a separate set of experiments， cells were divided into the Sham group， OVX+CIA group， OVX+CIA+CXCR4 antagonist AMD3100 group， and OVX+CIA+YSJB+AMD3100 group to observe changes in the above indicators following AMD3100 intervention. ResultsCompared with the Sham group， the number of migrated cells in the lower chamber was significantly increased in the Sham+CIA and OVX+CIA groups （P<0.05， P<0.01）. The mRNA expression of RORγt， IL-17， TNF-α， CXCR4， PI3K， and Akt was significantly upregulated， whereas FoxP3， IL-10， and TGF-β mRNA expression was significantly decreased （P<0.05， P<0.01）. Protein expression of RORγt， CXCR4， p-PI3K/PI3K， and p-Akt/Akt was significantly increased， while FoxP3 protein expression was markedly decreased （P<0.05， P<0.01）. Compared with the OVX+CIA group， the OVX+CIA+YSJB group and OVX+CIA+MTX group showed significantly reduced migration （P<0.05）， mRNA expression of RORγt， IL-17， TNF-α， CXCR4， PI3K， and Akt was also significantly decreased， while FoxP3， IL-10， and TGF-β mRNA expression was significantly increased （P<0.05， P<0.01）. RORγt protein expression was significantly downregulated， and FoxP3 protein expression markedly upregulated （P<0.05）. In the OVX+CIA+YSJB group， CXCR4， p-PI3K/PI3K， and p-Akt/Akt protein expression was significantly decreased （P<0.05）. Compared with the OVX+CIA group， RORγt， CXCR4， PI3K， and Akt mRNA expression in CD4⁺T cells was significantly decreased in the OVX+CIA+AMD3100 group and the OVX+CIA+YSJB+AMD3100 group， while FoxP3 mRNA and protein expression was significantly upregulated （P<0.05， P<0.01）. RORγt， CXCR4， p-PI3K/PI3K， and p-Akt/Akt protein expression was also markedly decreased （P<0.05， P<0.01）. Compared with the OVX+CIA+AMD3100 group， the OVX+CIA+YSJB+AMD3100 group showed significantly decreased RORγt and Akt mRNA expression （P<0.05） and significantly lower p-Akt/Akt protein expression （P<0.05）. ConclusionYSJB-containing bone marrow fluid suppresses CD4⁺T-cell migration and regulates Th17/Treg balance by downregulating Th17-associated signature factors and upregulating Treg-associated signature factors through inhibition of the SDF-1/CXCR4 signaling pathway and PI3K/Akt signaling pathway. The SDF-1/CXCR4 signaling pathway is one of the targets through which YSJB inhibits CD4⁺T-cell differentiation.

The Pharmacovigilance Guideline for Clinical Application of Chinese Patent Medicine for External Use （T/CACM 1563.5—2024）， the first guideline in China specializing for the clinical safety of Chinese patent medicines for external use， was led by the Institute of Basic Research in Clinical Medicine，China Academy of Chinese Medical Sciences，and jointly developed by more than 30 research institutions of medical sciences across the country. Aiming to standardize the pharmacovigilance activities in the clinical application of Chinese patent medicines for external use，the guideline systematically categorizes potential risks and proposes prevention and control measures that cover 11 core sections of risk monitoring and reporting， signal identification，as well as assessment and control， addressing the gap in domestic and international standardization of this field. The compilation of this guideline strictly adhered to international norms and domestic regulations， involving multiple rounds of expert consultations，hybrid interviews， and evidence integration （covering literature，medical insurance，essential medicine，pharmacopoeia data， and regulatory information）. With the scope of application defined to include medical institutions， pharmaceutical manufacturers and distribution enterprises，as well as regulatory authorities， the guideline focuses on key issues such as inherent medicine risks，quality risks，off-label use，risks of combination therapy，and the safety in special populations. During the compilation，core discrepancies such as the definition of application scope and quality risk control were addressed to ensure alignment with regulations such as the Drug Administration Law of the People's Republic of China and the Good Pharmacovigilance Practice. The guideline is registered internationally （PREPARE—2022CN463）. In the future，the implementation of the guideline will be promoted through hierarchical dissemination，dynamic revision，and post-effectiveness evaluation， contributing to rational clinical use and improved patient safety.

The Pharmacovigilance Guideline for Clinical Application of Chinese Patent Medicine for External Use （T/CACM 1563.5—2024）， the first guideline in China specializing for the clinical safety of Chinese patent medicines for external use， was led by the Institute of Basic Research in Clinical Medicine，China Academy of Chinese Medical Sciences，and jointly developed by more than 30 research institutions of medical sciences across the country. Aiming to standardize the pharmacovigilance activities in the clinical application of Chinese patent medicines for external use，the guideline systematically categorizes potential risks and proposes prevention and control measures that cover 11 core sections of risk monitoring and reporting， signal identification，as well as assessment and control， addressing the gap in domestic and international standardization of this field. The compilation of this guideline strictly adhered to international norms and domestic regulations， involving multiple rounds of expert consultations，hybrid interviews， and evidence integration （covering literature，medical insurance，essential medicine，pharmacopoeia data， and regulatory information）. With the scope of application defined to include medical institutions， pharmaceutical manufacturers and distribution enterprises，as well as regulatory authorities， the guideline focuses on key issues such as inherent medicine risks，quality risks，off-label use，risks of combination therapy，and the safety in special populations. During the compilation，core discrepancies such as the definition of application scope and quality risk control were addressed to ensure alignment with regulations such as the Drug Administration Law of the People's Republic of China and the Good Pharmacovigilance Practice. The guideline is registered internationally （PREPARE—2022CN463）. In the future，the implementation of the guideline will be promoted through hierarchical dissemination，dynamic revision，and post-effectiveness evaluation， contributing to rational clinical use and improved patient safety.

Background: and Purpose Vertebrobasilar fusiform aneurysms (VBFAs) carry substantial morbidity and mortality, but optimal management for unruptured VBFAs remains unclear. We compared the safety and efficacy of conservative management (CM), stent-assisted coiling (SAC), and flow diverters (FDs) in patients with unruptured VBFAs, focusing on long-term prognosis. Methods: This study included data from a nationwide Chinese cohort of patients with vertebrobasilar dissecting aneurysms. Inverse probability of treatment weighting (IPTW) balanced confounders across groups. The primary outcome was poor prognosis (modified Rankin Scale score >2). Secondary outcomes included aneurysm rupture, ischemic stroke, compression symptoms, and VBFA-related deaths. Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup and sensitivity analyses were performed. Results: Among 1,115 patients with unruptured VBFAs, 838 (median age, 54 years; 655 men) were included. After IPTW, baseline characteristics were balanced. Median follow-up was 54 months. FD was associated with a lower risk of poor prognosis than CM (OR, 0.48 [95% CI, 0.30 to 0.77]; p=0.002), with no difference between CM and SAC. FD also reduced aneurysm rupture (OR, 0.20 [95% CI, 0.07 to 0.60]; p=0.004) and compression symptoms (OR, 0.30 [95% CI, 0.13 to 0.68]; p=0.004) versus CM. Time-to-event analyses further revealed significant differences in vertebral artery lesions and Type I–II VBFAs, whereas no significant differences were observed in basilar or vertebrobasilar junction lesions or in Type III–IV VBFAs. Conclusions Compared with CM, FD was associated with improved long-term outcomes in unruptured VBFAs, particularly in vertebral artery lesions and Type I–II VBFAs, although residual confounding cannot be excluded.

On June 27， 2026， the Asian Pacific Association for the Study of the Liver （APASL） released updated management guidelines for chronic HBV infection， which systematically elaborates on screening， vaccination， antiviral treatment， and hepatocellular carcinoma surveillance and other aspects in 13 key areas， and provides comprehensive recommendations. This article summarizes and makes an excerpt of the key recommendations from the updated guidelines.

Objective To construct a patient decision aid(PtDA)for exercise training in pa-tients with chronic obstructive pulmonary disease(COPD)and explore its impacts on decision-making quality of patients' exercise regimens.Methods The development of the PtDA for exercise training in COPD patients was accomplished through literature analysis,the Delphi method,and user surveys,followed by an intervention study.A total of 59 inpatients with COPD were included as study sub-jects.The control group received routine care along with general exercise training guidance,while the intervention group received routine care combined with shared decision-making for exercise training based on the PtDA.The decision conflict and decision preparedness levels of patients in both groups were compared before the intervention and on the day of discharge.The exercise self-efficacy of pa-tients was measured before intervention,on the day of discharge,and 1 month and 3 months after dis-charge.Results The intervention group had significantly lower scores for decision conflict and signif-icantly higher scores for decision preparedness and exercise self-efficacy compared with the control group(P＜0.05).Conclusion The PtDA for exercise training can improve decision conflict and de-cision preparedness in COPD patients,enhance their exercise self-efficacy levels,and provide references for healthcare professionals in improving exercise adherence.

Objective To analyze the differences in oral hygiene and oral microbiota between the patients with schizophrenia and healthy individuals in Baoshan City.Methods 26 patients with schizophrenia from Baoshan Third People's Hospital were selected as the SCZ group and 26 healthy individuals matched by age and BMI as the HC(Healthy control)group.Demographic data,physical indicators,and oral conditions were collected.Saliva samples from 52 subjects were collected and 16S rDNA gene sequencing was used to compare the differences in oral hygiene and oral microbiota between the patients with schizophrenia and the healthy individuals.Results The difference in oral microbial community richness between the SCZ group and the HC group was statistically significant(P<0.05),with the SCZ group containing higher species than the HC group;at the genus level,except for Fusobacterium in the SCZ group and Actinomyces in the HC group,the top 5 dominant bacterial species in both groups were consistent;the results of species difference analysis showed that Fusobacterium and Campylobacter in the SCZ group were higher than those in the HC group(P<0.05).Conclusion The partial dominant bacterial species in the oral cavity of the patients with schizophrenia have changed to sulfate-reducing bacteria that produce hydrogen sulfide.Excessive production of hydrogen sulfide or polysulfide may damage the energy metabolism of mitochondria.

Approximately 300 million tons of plastic are produced globally each year,which has a serious impact on human health,marine life and the livestock industry.Microplastics have also been detected in meat and milk samples.Research has shown that nanoplastics(NP)(＜1 μm)and mi-croplastics(MP)(1 μm-5 mm)can affect the digestive,immune and reproductive systems of ani-mals.This experiment aims to investigate whether NP and MP regulate autophagy and damage the nervous system and spatial memory of animals.This experiment was divided into control group,nanoplastic group(PS-NP group,0.1 μm)and microplastic group(PS-MP group,1 μm),with 20 mice in each group.The mice were given 0.5 mL of PS-NP and PS-MP every day for 35 consecutive days,followed by neck amputation and brain analysis.The results showed that NPs and MPs of dif-ferent diameters caused varying degrees of damage to the brains of mice.In the behavioral tests of new object recognition,barnes maze and Y-shaped maze spatial memory,compared with the control group,the PS-NP group and PS-MP group showed a significant decrease in spatial memory ability of mice.HE staining results showed that neuronal cells in the PS-NP and PS-MP groups of mice exhibited shrinkage,decreased cell volume and deepened staining.The number of Nissl bodies de-creased,leading to dissolution and disappearance.RT-PCR and Western blot results showed that compared with the control group,the expression of glutamate receptors NR1,NR2A and NR2B in-creased in mice administered NP and MP orally,while the expression of autophagy related proteins Parkin,LC3B and Beclin1 was inhibited.In summary,this study suggests that nanoplastics and mi-croplastics stimulate glutamate receptors in mice by inhibiting the autophagy pathway,leading to impaired spatial memory.

Objective:To investigate the characteristics of visual and auditory sustained attention and sex differences in pupils of different grades.Method:Totally 231 students from grades 1 to 6 participated in this stud-y.The development and sex differences of sustained attention were measured by average reaction times,coefficients of variation for reaction times,omission error rates and commission error rates in visual and auditory two-choice re-action time(CRT)tasks.Result:The students in grade 5 had significantly slower visual average reaction times and coefficients of variation for reaction times(P＜0.001 or P＜0.05)than those in grade 3.The students in grade 5 had significantly lower auditory average reaction times,coefficients of variation for reaction times,omission error rates and commission error rates(P＜0.001 or P＜0.01)than those in grade 1.There was no significant sex differ-ences in visual or auditory average reaction times,coefficients of variation for reaction times or omission error rates(Ps＞0.05).Conclusion:There would be age differences in characteristics of both visual and auditory sustained at-tention in pupils,and may be no sex difference in visual or auditory sustained attention.

Objective The clinical characteristics of 21 cases of nocardiosis were reviewed and antimicrobial resistance of Nocardia strains was analyzed in order to improve the accuracy of clinical diagnosis and treatment of nocardiosis.Methods Clinical data of patients diagnosed with nocardiosis in Zhoukou Central Hospital from 2019-2023 and the corresponding results of antimicrobial susceptibility testing were retrospectively analyzed to summarize the clinical characteristics and outcomes of patients.Results Overall,the 21 cases of nocardiosis included 9 males and 12 females,aged 2-91 years.Underlying disease was reported in 15 patients.Most common type of nocardiosis was pulmonary nocardiosis in 15 cases,followed by skin and soft tissue infection,pleurisy,lymphadenitis,and disseminated nocardiosis.Laboratory tests showed increased levels of WBC,neutrophils percentage,erythrocyte sedimentation rate,C-reactive protein,and procalcitonin.The 21 strains of Nocardia included 4 strains of Nocardia cyriacigeorgica,2 strains each of Nocardia brasiliensis,Nocardia abscessus,Nocardia asiatica,Nocardia otitidiscaviarum and Nocardia beijingensis,and 1 strain each of Nocardia puris,Nocardia asteroides,Nocardia farcinica,Nocardia pneumoniae,Nocardia amamiensis,and 2 strains of unclassified Nocardia.All of the Nocardia strains(100％)were susceptible to linezolid,amikacin,and trimethoprim-sulfamethoxazole,followed by various levels of susceptibility to cefotaxime,moxifloxacin,imipenem and ceftriaxone,and lower susceptibility rate to cefepime,minocycline,ciprofloxacin and clarithromycin.Antimicrobial susceptibility of Nocardia strains varied with different Nocardia species.Of the 21 patients,two were referred to other hospitals,another two died,two patients received unknown treatment,and the remaining 15 patients were improved after antibiotic treatment,including sulfonamides combined with other antibiotics in 11 cases,other antibiotics in 4 cases.Conclusions Immunocompromised patients or those with underlying diseases are more susceptible to nocardiosis.The clinical features are complex and diverse.Antimicrobial susceptibility of Nocardia strains varied with different Nocardia species.Accurate identification and antimicrobial susceptibility test are essential for prescribing effective antibiotic treatment.