OBJECTIVE To explore the efficacy and safety of toludesvenlafaxine in the treatment of patients with major depressive disorder （MDD） with anhedonia. METHODS This retrospective study included 160 patients with MDD with anhedonia who were treated at Hebei Mental Health Center from May 2023 to August 2025. These patients were divided into a control group （ n ＝81） and an observation group （ n ＝79） according to treatment regimens. All patients received transcranial magnetic stimulation therapy. On this basis，the control group was treated with Sertraline Hydrochloride Tablets， while the observation group received Toludesvenlafaxine Hydrochloride Sustained-Release Tablets，with an 8-week continuous treatment course.To compare t he clinical total effective rate， anhedonia remission rate，the severity of depressive symptoms，degree of anhedonia，cognitive function，social function and quality of life between the two groups before and after treatment， the incidence of adverse reactions during treatment was recorded simultaneously. RESULTS After treatment，the total effective rate and anhedonia remission rate of the observation group were significantly higher than the control group （ P ＜0.05）. At the 4th and 8th weeks of treatment， the scores of Snaith-Hamilton Pleasure Scale， Hamilton Depression Rating Scale-17 Items， and Sheehan Disability Scale of both groups were significantly lower than those before treatment in the same group， and the observation group was significantly lower than the control group （ P ＜0.05）； the scores of Montreal Cognitive Assessment and Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form were significantly higher than those before treatment in the same group， and the observation group was significantly higher than the control group （ P ＜0.05）. There was no statistically significant difference in the overall incidence of adverse reactions between the two groups （ P ＞0.05）. CONCLUSIONS Toludesvenlafaxine can significantly improve depressive symptoms， cognitive function， and social function in MDD patients with anhedonia，with good safety.

Objective To investigate the etiology and treatment of dysuria shortly after holmium laser enucleation of the prostate (HoLEP) for benign prostatic hyperplasia (BPH), so as to improve the therapeutic efficacy. Methods A retrospective analysis was conducted on 1361 BPH patients who received HoLEP at our hospital during Mar. 2018 and Mar. 2025. All patients underwent ultrasound, computed tomography (CT), urethral probing or radiography, cystourethroscopy, and urodynamic testing. The causes, treatments and prognosis of dysuria after operation were summarized. Results ninety-eight patients (7.2%) experienced dysuria within 3 months after surgery, and all patients received initial urethral dilation. Among the 62 cases with urethral stricture, 28 were treated with urethral dilation (average of 8 sessions), 16 underwent external urethral incision, 8 underwent anterior urethroplasty, and 10 underwent transurethral plasma incision for urethral stricture. Of the 12 cases with residual prostate tissue, 5 underwent urethral plasma prostatectomy and 7 received medication. All of the 12 cases with bladder neck contracture underwent transurethral plasma incision of the bladder neck and local drug injection. Five cases with intravesical blood clots underwent urethral blood clot irrigation, 2 of which developed active bleeding and then underwent electrocoagulation. Four cases with detrusor dysfunction had catheters re-indwelled for one week followed by medication. Two cases with stone and one case with tissue fragment impacted in the urethra underwent urethral holmium lithotripsy and cystoscopic removal. All patients underwent reoperation successfully and experienced complete resolution or significant improvement of urinary difficulties. Conclusion A certain proportion of patients experience dysuria after HoLEP, with diverse etiologies. The combination of prevention and treatment can reduce the incidence of dysuria.

OBJECTIVE To compare the efficacy and safety of different classes of antibacterial agents in hospitalized adult patients with community-acquired pneumonia （CAP）.METHODS PubMed， Embase，the Cochrane Library，Web of Science，CNKI，and Wanfang data were searched from inception to January 1，2026，to identify randomized controlled trials that evaluated different classes of antibacterial agents in hospitalized adults with CAP.After screening the literature， extracting the data， and evaluating the quality of the literature， a network meta-analysis was performed using Stata 18.0.RESULTS A total of 25 studies were included，involving 7 863 patients. In terms of efficacy，compared with carbapenems，penicillins，cephalosporins，macrolides，and pleuromutilins were associated with significantly higher treatment failure rates （ P ＜0.05），carbapenems and traditional tetracyclines were ranked as the top two by the surface under the cumulative ranking curve area （SUCRA）. No statistically significant differences were observed in mortality among the interventions （ P ＞0.05），carbapenems and other quinolones were ranked as the top two by SUCRA. In terms of safety，no statistically significant differences were observed among the interventions in the incidence of adverse events or discontinuation rates （ P ＞0.05）；traditional tetracyclines and novel tetracyclines were ranked as the top two by SUCRA for the incidence of adverse events，while novel tetracyclines and pleuromutilins were ranked as the top two by SUCRA for discontinuation rates.CONCLUSIONS Carbapenems significantly reduced the treatment failure rate in hospitalized adults with CAP. The safety profiles of all antibacterial agents were comparable， with novel tetracyclines showing a more favorable safety profile.

Objective To observe the effect of Zha's manipulation combined with muscle energy technique(MET)on neck and shoulder pain and Neck Disability Index(NDI)of patients with second and third cervical facet joint disorders,and then to find out a precise,safe and effective therapies for the its treatment.Methods A randomized controlled trial was conducted for 60 patients with second and third cervical facet joint disorders who met the inclusion criteria.The patients who admitted to the outpatient clinic of the Rehabilitation Department of Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine from June 2023 to July 2024 were randomly divided into a treatment group and a control group,with 30 patients in each group.The treatment group was given the treatment of Zha's manipulation combined with MET,and the control group was given conventional tuina therapy.The treatment was performed once a day and the course of treatment covered five consecutive treatments.The changes of Visual Analogue Scale(VAS)scores of pain and NDI scores in the two groups before and after treatment were observed.After treatment,the clinical efficacy of the two groups was evaluated.Results(1)During the treatment,there were no fell-off cases in the two groups,and all patients completed the whole course of treatment.(2)After five days of treatment,the total effective rate of the treatment group was 96.7％(29/30),and that of the control group was 86.7％(26/30);the intergroup comparison(tested by rank sum test)showed that the therapeutic efficacy of the treatment group was significantly superior to that of the control group(P＜0.05).(3)After treatment,the VAS scores of neck pain in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the decrease of the VAS scores of neck pain in the treatment group was significantly superior to that in the control group(P＜0.05).(4)After treatment,the NDI scores for evaluating the cervical vertebra function in the two groups were significantly improved compared with those before treatment(P＜0.05),and the improvement of NDI scores in the treatment group on was significantly superior to that in the control group(P＜0.05).Conclusion Zha's manipulation combined with MET therapy can effectively alleviate pain and improve the cervical vertebra function of patients with second and third cervical facet joint disorders,and its therapeutic efficacy is superior to that of conventional tuina therapy.

Environmentally-induced reproductive toxicity is one of the important causes of fertility declines and has become a significant global public health challenge.Elucidating the causal links between exposure to environmental hazards and reproductive damage,unraveling the underlying molecular mechanisms,and establishing precise reproductive injury assessment systems are crucial for development of targeted interventions and safeguarding human reproductive health.In this article,we systematically review the research progress on reproductive toxicity caused by emerging environmental chemical pollutants,common physical factors,and biological factors in the recent 3 years.We summarize the new technologies in the field of toxicology,including novel experimental models,exposomics,and artificial intelligence.We also discuss the potential research directions in risk assessment,prevention and intervention of environmental factors-induced reproductive damage.

Objective:To evaluate the efficacy and safety of Luofuoshan-Baicao oil (LBO) and wind medicated oil for the treatment of Aedes albopictus bites. Methods:A paired self-controlled study was conducted. Thirty-six healthy volunteers were recruited from Guangdong Provincial Hospital of Traditional Chinese Medicine from February 2023 to March 2023. Each participant's forearms were subjected to Aedes albopictus bites, with 3 bites on each arm. For the first 18 participants, LBO was applied to the left arm, and wind medicated oil to the right arm; for the latter 18 participants, wind medicated oil was applied to the left arm, and LBO to the right arm. The observation period was 24 hours. Within the first 3 hours after the mosquito bites, the topical agents were applied once every other hour for a total of 3 sessions, with an applicator centered on the bite site at a dose of approximately 50 μl, covering a skin area of about 2 cm in diameter; after 3 hours, participants applied the topical agents themselves until symptoms subsided or the 24-hour observation period ended. All subjects were followed up at the occurrence of skin lesions after mosquito bites, 0 to 3 hours after the first treatment, as well as 24 hours after the first treatment. During the follow-up, the effects of both topical agents on pruritus, erythema, papules, or wheals were evaluated, differences in treatment frequency were analyzed, and treatment-related adverse events were recorded. The time to disappearance of pruritus after treatment was statistically analyzed using Kaplan-Meier survival analysis, and intergroup differences were analyzed using the log-rank (Mantel-Cox) test. Two independent samples t-test was used for comparisons of other measurement data, and Pearson's chi-square test or Fisher's exact test was used for comparisons of count data between groups. Results:Within 3 hours after the first treatment, the time to initial disappearance of pruritus was significantly shorter in the LBO group (20.71 ± 1.92 min) than in the wind medicated oil group (28.30 ± 2.20 min, P < 0.05). The cumulative pruritus rate (the proportion of participants with pruritus among all participants) over time showed an overall stable fluctuation, and the cumulative pruritus rates at all observation points were significantly lower in the LBO group than in the wind medicated oil group ( P<0.05). After 3 hours of treatment, the mean values of changes in erythema diameters were 25.83 mm in the LBO group and 26.24 mm in the wind medicated oil group, while the mean values of changes in papule or wheal diameters were 8.25 mm in the LBO group and 9.18 mm in the wind medicated oil group; within 24 hours after the first treatment, the average time to disappearance of papules or wheals was 71.85 minutes in the LBO group and 73.01 minutes in the wind medicated oil group, while the average time to disappearance of erythema was 82.27 minutes in the LBO group and 84.86 minutes in the wind medicated oil group; there were no significant differences in the above observational indices between the two groups (all P > 0.05). The number of pruritus episodes within 24 hours of treatment was 56 in both the LBO group and wind medicated oil group, and the treatment frequency was 107 in both two groups; there were also no significant differences in the frequencies of pruritus episodes or treatment (both P > 0.05). No adverse events or reactions occurred during the trial. Conclusion:LBO was more effective than wind medicated oil in reducing the time to disappearance of pruritus after Aedes albopictus bites, with a high safety profile.

Objective:To evaluate the efficacy and safety of Luofuoshan-Baicao oil (LBO) and wind medicated oil for the treatment of Aedes albopictus bites. Methods:A paired self-controlled study was conducted. Thirty-six healthy volunteers were recruited from Guangdong Provincial Hospital of Traditional Chinese Medicine from February 2023 to March 2023. Each participant's forearms were subjected to Aedes albopictus bites, with 3 bites on each arm. For the first 18 participants, LBO was applied to the left arm, and wind medicated oil to the right arm; for the latter 18 participants, wind medicated oil was applied to the left arm, and LBO to the right arm. The observation period was 24 hours. Within the first 3 hours after the mosquito bites, the topical agents were applied once every other hour for a total of 3 sessions, with an applicator centered on the bite site at a dose of approximately 50 μl, covering a skin area of about 2 cm in diameter; after 3 hours, participants applied the topical agents themselves until symptoms subsided or the 24-hour observation period ended. All subjects were followed up at the occurrence of skin lesions after mosquito bites, 0 to 3 hours after the first treatment, as well as 24 hours after the first treatment. During the follow-up, the effects of both topical agents on pruritus, erythema, papules, or wheals were evaluated, differences in treatment frequency were analyzed, and treatment-related adverse events were recorded. The time to disappearance of pruritus after treatment was statistically analyzed using Kaplan-Meier survival analysis, and intergroup differences were analyzed using the log-rank (Mantel-Cox) test. Two independent samples t-test was used for comparisons of other measurement data, and Pearson's chi-square test or Fisher's exact test was used for comparisons of count data between groups. Results:Within 3 hours after the first treatment, the time to initial disappearance of pruritus was significantly shorter in the LBO group (20.71 ± 1.92 min) than in the wind medicated oil group (28.30 ± 2.20 min, P < 0.05). The cumulative pruritus rate (the proportion of participants with pruritus among all participants) over time showed an overall stable fluctuation, and the cumulative pruritus rates at all observation points were significantly lower in the LBO group than in the wind medicated oil group ( P<0.05). After 3 hours of treatment, the mean values of changes in erythema diameters were 25.83 mm in the LBO group and 26.24 mm in the wind medicated oil group, while the mean values of changes in papule or wheal diameters were 8.25 mm in the LBO group and 9.18 mm in the wind medicated oil group; within 24 hours after the first treatment, the average time to disappearance of papules or wheals was 71.85 minutes in the LBO group and 73.01 minutes in the wind medicated oil group, while the average time to disappearance of erythema was 82.27 minutes in the LBO group and 84.86 minutes in the wind medicated oil group; there were no significant differences in the above observational indices between the two groups (all P > 0.05). The number of pruritus episodes within 24 hours of treatment was 56 in both the LBO group and wind medicated oil group, and the treatment frequency was 107 in both two groups; there were also no significant differences in the frequencies of pruritus episodes or treatment (both P > 0.05). No adverse events or reactions occurred during the trial. Conclusion:LBO was more effective than wind medicated oil in reducing the time to disappearance of pruritus after Aedes albopictus bites, with a high safety profile.

Acute kidney injury (AKI), a life-threatening clinical syndrome, lacks effective therapeutic interventions beyond supportive care such as hemodialysis and kidney transplantation. Pathologically, excessive reactive oxygen species -mediated oxidative stress is recognized as a pivotal contributor to AKI progression, positioning reactive oxygen species scavenging as a critical therapeutic target. Emerging nanozymes, nanomaterials with enzyme-mimetic activities, have shown promise in addressing AKI by targeting renal oxidative stress. The article mainly reviewed the content of classification of nanozymes, research findings on nanozymes in treating AKI along with discussions on their mechanisms of action, as well as the current challenges and existing issues in nanozymes-based AKI therapy, to provide enhanced research perspectives for advancing nanozyme applications in the prevention and treatment of AKI.

China emerges as a major country in nuclear energy development and the application of nuclear and radiologic technology. The diagnosis and treatment of acute radiation syndrom (ARS) caused by external irradiation represent a core function in the country′s medical rescue of nuclear and radiological emergencies. Clinically, ARS manifests hematopoietic, gastrointestinal, cutaneous, and central nervous system syndromes, with specific clinical manifestations, signs, severity, and prognosis strongly correlated with radiation dose. China has established a number of national and provincial centers for treating radiation-induced damage. Nevertheless, most medical staff have limited experience in ARS treatment. This consensus presents a summary of recent experience in treating ARS of China. In combination with recommendations from international organizations such as the World Health Organization (WHO), this consensus proposes key evidence of critical clinical issues of ARS, covering all links in the rescue of external irradiation-induced ARS. Initially, clinical diagnosis, syndromes, and severe degrees should be determined based on clinical symptoms and dose estimates. It is necessary to normalize clinical treatment measures for hematopoietic recovery, gastrointestinal injury treatment, infection control, symptomatic treatment, and multi-organ function preservation. To this end, this consensus offers cautions. This consensus provides principles of treatment with traditional Chinese medicine, psychological intervention, and follow-up. Additionally, it highlights multidisciplinary collaboration. It is recommended that this consensus be applied in relevant treatment centers.

Breast cancer(BC)is one of the most prevalent malignant tumors affecting women worldwide,with its incidence rate continuously increasing.As a result,treatment strategies for this disease have received considerable attention.Research has highlighted the crucial role of the Hedgehog(Hh)signaling pathway in the initiation and progression of BC,particularly in promoting tumor growth and metastasis.There-fore,molecular targets within this pathway represent promising opportunities for the development of novel BC therapies.This study aims to elucidate the therapeutic mechanisms by which natural com-pounds modulate the Hh signaling pathway in BC.By conducting a comprehensive review of various natural compounds,including polyphenols,terpenes,and alkaloids,we reveal both common and unique regulatory mechanisms that influence this pathway.This investigation represents the first comprehen-sive analysis of five distinct mechanisms through which natural compounds modulate key molecules within the Hh pathway and their impact on the aggressive behaviors of BC.Furthermore,by exploring the structure-activity relationships between these compounds and their molecular targets,we shed light on the specific structural features that enable natural compounds to interact with various components of the Hh pathway.These novel insights contribute to advancing the development and clinical application of natural compound-based therapeutics.Our thorough review not only lays the groundwork for exploring innovative BC treatments but also opens new avenues for leveraging natural compounds in cancer therapy.