Objective To analyze the circuit-qi patterns during early embryonic period and at conception in congenital heart disease(CHD)patients based on the five-circuit and six-qi theory,and to explore the pathogenesis and etiology of CHD from a circuit-qi perspective.Methods With 16 400 non-CHD individuals as the healthy control group,a statistical analysis was performed for the circuit-qi patterns during early embryogenesis and at conception in 4 100 CHD patients(CHD group).Results The following factors were identified as significant predisposing factors for CHD:yearly circuit being excessive fire circuit during early embryogenesis,yearly qi being taiyang cold water of celestial qi combined with taiyin damp earth of terrestrial qi during early embryogenesis,yearly circuit being concurrent excessive fire circuit and earth circuit deficiency at conception,and yearly qi being taiyin damp earth of terrestrial qi paired with jueyin wind wood of celestial qi at conception(all P＜0.05 or P＜0.01).Conclusion There is a certain correlation between circuit-qi endowment during embryonic development and the prevalence of CHD.The core pathogenesis of CHD is rooted in heart-spleen insufficiency,with hyperactive heart-fire and cold kidney-water as its manifestations,and spleen deficiency failing in transportation serves as an important contributing factor in the development and progression of CHD.

In recent years,significant breakthroughs have been achieved in the immunotherapy for Alzheimer's disease.In line with global advancements,two anti-amyloid-β monoclonal antibodies have been approved and successfully launched in China for clinical use.Lecanemab and Donanemab were officially used in June 2024 and April 2025 in China,respectively.In order to standardize the rational and safe application of anti-amyloid-β monoclonal antibodies for Alzheimer's disease in China,this article integrates recom-mendations from the clinical trials and real-world experience from the author's team and domestic peers to further update the recom-mendations for the clinical use of anti-amyloid-β monoclonal antibody based on the 2024 version.It includes indications for therapy,pre-treatment evaluation and preparation,administration protocols and safety measures during treatment,and post-treatment monitor-ing strategies.

Inflammation plays a crucial role in the occurrence and development of post-stroke depres-sion(PSD),yet the specific molecular mechanisms are still not fully understood.In the field of drug research,traditional Chinese medicine preparations have attracted increasing attention for improving PSD symptoms due to their advantages of multiple targets,many links,and few side effects.At the same time,they have great re-search value in the prevention and treatment of PSD.This article reviews the mechanism of inflammatory re-action,such as the balance regulation of pro-inflammatory/anti-inflammatory factors,inflammatory markers,gene polymorphism of inflammatory factors in PSD,and the related research progress of Chinese medicine preparations in regulating inflammatory reaction to prevent and treat PSD,with a view to providing reference for the selection of clinical Chinese medicine preparations and the prevention and treatment of PSD.

Apical microsurgery is accurate and minimally invasive, produces few complications, and has a success rate of more than 90%. However, due to the lack of awareness and understanding of apical microsurgery by dental general practitioners and even endodontists, many clinical problems remain to be overcome. The consensus has gathered well-known domestic experts to hold a series of special discussions and reached the consensus. This document specifies the indications, contraindications, preoperative preparations, operational procedures, complication prevention measures, and efficacy evaluation of apical microsurgery and is applicable to dentists who perform apical microsurgery after systematic training.
Microsurgery/standards* ; Humans ; Apicoectomy ; Contraindications, Procedure ; Tooth Apex/diagnostic imaging* ; Postoperative Complications/prevention & control* ; Consensus ; Treatment Outcome

Pulpotomy, which belongs to vital pulp therapy, has become a strategy for managing pulpitis in recent decades. This minimally invasive treatment reflects the recognition of preserving healthy dental pulp and optimizing long-term patient-centered outcomes. Pulpotomy is categorized into partial pulpotomy (PP), the removal of a partial segment of the coronal pulp tissue, and full pulpotomy (FP), the removal of whole coronal pulp, which is followed by applying the biomaterials onto the remaining pulp tissue and ultimately restoring the tooth. Procedural decisions for the amount of pulp tissue removal or retention depend on the diagnostic of pulp vitality, the overall treatment plan, the patient's general health status, and pulp inflammation reassessment during operation. This statement represents the consensus of an expert committee convened by the Society of Cariology and Endodontics, Chinese Stomatological Association. It addresses the current evidence to support the application of pulpotomy as a potential alternative to root canal treatment (RCT) on mature permanent teeth with pulpitis from a biological basis, the development of capping biomaterial, and the diagnostic considerations to evidence-based medicine. This expert statement intends to provide a clinical protocol of pulpotomy, which facilitates practitioners in choosing the optimal procedure and increasing their confidence in this rapidly evolving field.
Humans ; Calcium Compounds/therapeutic use* ; Consensus ; Dental Pulp ; Dentition, Permanent ; Oxides/therapeutic use* ; Pulpitis/therapy* ; Pulpotomy/standards*

OBJECTIVES: Chronic obstructive pulmonary disease (COPD) is a major chronic respiratory condition with high morbidity and mortality, imposing a serious economic and public health burden. The World Health Organization ranks COPD among the top 4 chronic diseases worldwide. Zangsiwei Qingfei Mixture (ZSWQF), a novel Tibetan herbal formulation independently developed by our research team, has shown therapeutic potential for chronic respiratory diseases. This study aims to evaluate the effects of aerosolized ZSWQF on cigarette smoke-induced COPD in mice and explore its underlying mechanisms. METHODS: Thirty C57 mice were randomly divided into a Control group, a COPD group, and a ZSWQF group. The Control group received saline aerosol inhalation without cigarette smoke exposure; both the COPD group and the ZSWQF group were exposed to cigarette smoke, with the former receiving saline inhalation and the latter treated with ZSWQF aerosol. White blood cell (WBC) count was performed using a fully automatic blood cell analyzer. Serum, alanine transaminase (ALT), and serum creatinine (SCr), as well as interleukin (IL)-6, IL-8, and tumor necrosis factor (TNF)-α levels in serum and bronchoalveolar lavage fluid (BALF) were measured by enzyme-linked immunosorbent assay (ELISA). BALF cell classification was determined using a hematology analyzer. Lung function was assessed with a small animal pulmonary function system, including airway resistance (RI) and cyclic dynamic compliance (CyDN). Lung tissues were stained with hematoxylin and eosin (HE), and mean linear intercept (MLI) and destruction index (DI) were calculated to evaluate morphological changes. Network pharmacology was applied to identify disease-related and ZSWQF-related targets, followed by intersection and protein-protein interaction (PPI) network analysis, and enrichment analysis of biological functions and pathways. Primary type II alveolar epithelial cell (AEC II) from SD rats were isolated and divided into a Control group, a lipopolysaccharide (LPS) group, a normal serum group, a water extract of ZSWQF (W-ZSWQF) group, a ZSWQF containing serum group, and a MLN-4760 [angiotensin-converting enzyme (ACE) 2 inhibitor]. Western blotting was performed to assess protein expression of ACE, p38 [a mitogen-activated protein kinase (MAPK)], phospho (p)-p38, extracellular signal-regulated kinases 1 and 2 (ERK1/2), p-ERK1/2, c-Jun N-terminal kinase (JNK), p-JNK, inhibitor of nuclear factor-kappa B alpha (IκBα), p-IκBα, and p-p65 subunit of nuclear factor-kappa B (NF-κBp65). RESULTS: WBC counts were significantly higher in the COPD group than in controls (P<0.01) and decreased following ZSWQF treatment (P<0.05). No significant intergroup differences were found in organ weights, ALT, or SCr (all P>0.05). Serum and BALF levels of IL-6, IL-8, and TNF-α, as well as total BALF cells, neutrophils, and macrophages, were elevated in the COPD group compared with controls and reduced by ZSWQF treatment (P<0.05). COPD mice exhibited increased RI, decreased CyDN, marked alveolar congestion, inflammatory infiltration, thickened septa, and higher MLI and DI values versus controls (P<0.05); ZSWQF treatment significantly reduced MLI and DI (P<0.05). Network pharmacology identified 151 potential therapeutic targets for ZSWQF against COPD, with key nodes including TNF, IL-6, protein kinase B (Akt) 1, albumin (ALB), tumor protein p53 (TP53), non-receptor tyrosine kinase (SRC), epidermal growth factor receptor (EGFR), signal transducer and activator of transcription 3 (STAT) 3, matrix metalloproteinase (MMP)-9, and beta-catenin (CTNNB1). Enrichment analysis indicates involvement of cancer-related, phosphatidylinositol 3-kinase (PI3K)/Akt, hypoxia-inducible factor (HIF)-1, calcium, and MAPK signaling pathways. Western blotting results showed that compared with the LPS group, AEC II treated with ZSWQF-containing serum exhibited decreased expression of ACE, p-p38/p38, p-ERK1/2/ERK1/2, p-JNK/JNK, p-IκBα/IκBα, and p-NF-κBp65, while ACE2 expression was upregulated, consistent with the MAPK/nuclear factor-kappa B (NF-κB) pathway regulation predicted by network pharmacology. CONCLUSIONS Aerosolized ZSWQF provides protective effects in COPD mice by reducing airway inflammation and remodeling.
Animals ; Pulmonary Disease, Chronic Obstructive/etiology* ; Drugs, Chinese Herbal/therapeutic use* ; Mice ; Mice, Inbred C57BL ; Male ; Network Pharmacology ; Smoke/adverse effects* ; Bronchoalveolar Lavage Fluid ; Administration, Inhalation ; Inflammation/drug therapy* ; Tumor Necrosis Factor-alpha ; Lung/drug effects* ; Interleukin-6/blood*

The cerebellum plays a critical role not only in motor control but also in reward processing, emotional regulation, and addictive behaviors.Addictive behaviors alter the cerebellum’s neurotransmitter systems and synaptic connections, leading to dysfunction and reinforcing the persistence of addiction.This review summarizes the anatomical and functional foundations of the cerebellum in the reward circuitry and explores how cerebellar synaptic plasticity influences brain function in both substance and behavioral addictions. Furthermore, the potential role of the cerebellum in the progress of addiction and its clinical application prospects in addiction treatment are also discussed.

Objective To analyze the current status of stroke treatment in the hierarchical medical service network and the impact of referral on prognosis,to optimize the stroke treatment models,and to improve stroke treatment efficiency.Methods Totally 573 patients with acute ischemic stroke who were referred by the hierarchical medical service network in Lishui,Zhejiang Province from January 2020 to December 2022 were selected for analysis of treatment and clinical data.Based on whether they received endovascular treatment at a high-level stroke center,they were divided into an effective referral group(261 cases)and an ineffective referral group(312 cases).Demographic data,influencing factors,clinical characteristics,and laboratory tests were compared between the two groups,and the differences were analyzed by using single-factor analysis,and prognosis of the two groups of patients was assessed.Results Among 573 patients,197 received intravenous thrombolytic therapy and 261 received intravascular therapy.The effective referral rate was 45.55％.The proportion of patients in the effective referral group coronary artery disease and atrial fibrillation proportion is higher(x2=5.34,8.67,P＜0.05),more likely to show dysarthria,gaze,and consciousness disorder(x2=130.1,22.12,22.96,P＜0.05),and the baseline NIHSS score was higher(F=3.25,P＜0.05).Comparing the baseline blood cells counts of the two groups of patients at admission,the effective referral group showed lower eosinophil count,basophil count and lymphocyte(Z=-8.86,-5.39,F=0.598,P＜0.05).As for the prognosis,the proportion of neurological function improvement at discharge in the effective referral group was higher than that in the ineffective referral group.Binary Logistic regression analysis showed that baseline NIHSS score(OR=1.122,95％CI:1.074-1.172),eosinophil(OR=0.085,95％CI:0.013-0.564),and neutrophil count(OR=1.088,95％CI:1.011-1.172)were independent influencing factors for effective referrals.Conclusions The efficiency of the current regional stroke classification and treatment network needs to be further improved.Developing predictive models that include demographic characteristics,risk factors,symptoms,signs,and laboratory tests may help medical staff in stroke prevention and treatment centers quickly identify large vessel occlusion and improve acute ischemic stroke treatment efficiency.

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 analyze the current status of stroke treatment in the hierarchical medical service network and the impact of referral on prognosis,to optimize the stroke treatment models,and to improve stroke treatment efficiency.Methods Totally 573 patients with acute ischemic stroke who were referred by the hierarchical medical service network in Lishui,Zhejiang Province from January 2020 to December 2022 were selected for analysis of treatment and clinical data.Based on whether they received endovascular treatment at a high-level stroke center,they were divided into an effective referral group(261 cases)and an ineffective referral group(312 cases).Demographic data,influencing factors,clinical characteristics,and laboratory tests were compared between the two groups,and the differences were analyzed by using single-factor analysis,and prognosis of the two groups of patients was assessed.Results Among 573 patients,197 received intravenous thrombolytic therapy and 261 received intravascular therapy.The effective referral rate was 45.55％.The proportion of patients in the effective referral group coronary artery disease and atrial fibrillation proportion is higher(x2=5.34,8.67,P＜0.05),more likely to show dysarthria,gaze,and consciousness disorder(x2=130.1,22.12,22.96,P＜0.05),and the baseline NIHSS score was higher(F=3.25,P＜0.05).Comparing the baseline blood cells counts of the two groups of patients at admission,the effective referral group showed lower eosinophil count,basophil count and lymphocyte(Z=-8.86,-5.39,F=0.598,P＜0.05).As for the prognosis,the proportion of neurological function improvement at discharge in the effective referral group was higher than that in the ineffective referral group.Binary Logistic regression analysis showed that baseline NIHSS score(OR=1.122,95％CI:1.074-1.172),eosinophil(OR=0.085,95％CI:0.013-0.564),and neutrophil count(OR=1.088,95％CI:1.011-1.172)were independent influencing factors for effective referrals.Conclusions The efficiency of the current regional stroke classification and treatment network needs to be further improved.Developing predictive models that include demographic characteristics,risk factors,symptoms,signs,and laboratory tests may help medical staff in stroke prevention and treatment centers quickly identify large vessel occlusion and improve acute ischemic stroke treatment efficiency.