ObjectiveThis paper aims to observe the protective effect of Huamoyan granules on knee osteoarthritis （KOA） and explore whether its protective effect is oriented toward an anti-inflammatory direction by regulation of macrophage polarization， which can effectively inhibit the progression of pathological inflammatory response， reduce the release of inflammatory pain mediators， and downregulate the protein expression level of transient receptor potential vanilloid 1 （TRPV1）， so as to provide experimental evidence for its clinical application and investigate its action mechanism. MethodsAfter adaptive feeding， Sprague-Dawley （SD） rats were randomly divided into six groups： sham group， model group， celecoxib group， and high， medium， and low-dose synovitis granule groups （9.6， 4.8， 2.4 g·kg^-1）. The administration dose of celecoxib capsules was 20 mg·kg^-1. There were 10 rats in the sham group and 12 rats in the model group and each administration group. A KOA animal model was established by means of intra-articular injection of sodium iodoacetate into the knee joint. From the 10^th day of the experiment， each administration group was given intragastric administration at a dose of 10 mL·kg^-1 for 4 weeks. General conditions of rats in each group were assessed daily. The pressure pain threshold （PPT） to mechanical stimulation and joint diameter were recorded. X-ray examination was performed on the right knee joints of rats for imaging analysis. Enzyme linked immunosorbent assay （ELISA） was performed to detect the tumor necrosis factor-α （TNF-α）， serum interleukin-1β （IL-1β）， and other pro-inflammatory cytokines in rat serum samples， as well as the expression levels of neurogenic inflammatory mediators such as nerve growth factor （NGF） and calcitonin gene-related peptide （CGRP）. Histopathological changes in the knee joint synovial tissues were examined by hematoxylineosin （HE） staining. Safranin O-fast green staining was performed to observe and evaluate the degree of knee cartilage lesions. Western blot was employed to quantitatively analyze TRPV1， p38 mitogen-activated protein kinase （p38 MAPK）， and phosphorylated （p）-p38 MAPK in rat knee synovial tissues. Immunofluorescence （IF） was used to measure and assess M1/M2 macrophage polarization. ResultsCompared with those in the sham group， the circumference and joint diameter of the right knee were markedly enlarged in the model group （P<0.01）， while PPTs of rats showed a significant reduction （P<0.01）. The contents of IL-1β， TNF-α， CGRP， and NGF in rats' serum were significantly elevated （P<0.01）， and the synovial Krenn score was increased （P<0.01）. The Mankin score of cartilage tissue was increased （P<0.01）， and the protein expressions of TRPV1 and p-p38 MAPK/p38 MAPK were significantly upregulated （P<0.01）. The experimental intervention significantly reduced the proportion of pro-inflammatory M1 macrophages in the total macrophage population （P<0.01）， and the percentage of M2 macrophages was decreased （P<0.01）. The M1/M2 macrophage ratio was significantly elevated （P<0.01）. Knee joint diameters of all dose groups of Huamoyan granules and the celecoxib group were reduced （P<0.01） compared with those of the model group， and the PPT recovery speeds in the high and medium-dose groups of Huamoyan granules were more obvious （P<0.05）. The contents of IL-1β， CGRP， and NGF in the rats' serum in all administration groups were significantly reduced （P<0.05， P<0.01）， and the content of TNF-α in rats' serum was significantly reduced （P<0.01）. All dose groups of Huamoyan granules demonstrated significant reductions in both synovial Krenn score （P<0.05， P<0.01） and protein expression of TRPV1 and p-p38 MAPK/p38 MAPK in rats' synovial tissues （P<0.01）. The percentage of M1 macrophages in the synovial tissues of the celecoxib group and all dose groups of Huamoyan granules was decreased （P<0.01）. The percentage of M2 macrophages was increased （P<0.05）， and the M1/M2 ratio was decreased （P<0.01）. ConclusionHuamoyan granules can alleviate the inflammatory response of KOA， reduce the release of inflammatory pain mediators， and downregulate TRPV1 protein expression by regulating macrophage polarization. Its mechanism may be related to the TRPV1/p38 MAPK signaling pathway， thereby achieving the effect of improving peripheral pain hypersensitivity in KOA.

This paper introduces the "eight-dimensional materia medica framework" theory proposed by Professor TONG Xiaolin and， in light of his academic perspectives and clinical experience， explores its inheritance and innovation of the concept of "four pillars of medicinals" by ZHANG Jiebin of Ming-dynasty from multiple angles. Building upon the four foundational medicinals， Renshen （Panax ginseng）， Shudihuang （Rehmannia glutinosa Praeparata）， Fuzi （Aconitum carmichaelii Praeparata）， and Dahuang （Rheum palmatum）， as the "four pillars of medicinals"， and using eight-principle pattern differentiation framework， this theory expands the representative medicinals to eight. It establishes the "eight-dimensional materia medica framework"， i.e. exterior-Mahuang （Ephedra sinica）， interior-Rougui （Cinnamomum cassia）， cold-Huanglian （Coptis chinensis）， heat-Ganjiang （Zingiber officinale）， deficiency-Renshen （Panax ginseng）， excess-Dahuang （Rheum palmatum）， yin-Shudihuang （Rehmannia glutinosa Praeparata）， and yang-Fuzi （Aconitum carmichaelii Praeparata）. This framework highlights the pivotal roles of these eight medicinals in the treatment of exterior and interior patterns， cold and heat syndromes， deficiency and excess conditions， as well as yin deficiency and yang deficiency. Integrated with the state-target differentiation and treatment theory， this approach enriches the traditional actions of the eight representative medicinals by incorporating findings from modern pharmacological research， achieving a transition from macroscopic regulation of pathological states to microscopic target-oriented intervention. Furthermore， through investigations into dose-effect relationships and the expansion of principles for herbal compatibility， the clinical practicality of the "eight-dimensional materia medica framework" is further demonstrated， promoting the integrative development of Chinese and western medicine at the level of clinical application of Chinese materia medica.

Background With China's socioeconomic development, significant lifestyle changes have occurred among occupational groups, leading to alterations in cardiovascular metabolic risk factors. However, few studies have examined the secular trends of these risk factors in China's working population. Objective To analyze the trends in cardiovascular metabolic risk factors among the occupational population in nine provinces of China from 2009 to 2018, and to explore the associations between different occupational types and these risk factors, along with their clustering patterns, thereby providing evidence for targeted interventions. Methods This study utilized data from the China Health and Nutrition Survey (CHNS) in 2009, 2015, and 2018. The dataset covered 13274 employed individuals aged 18-59 years. Only participants with complete blood test results and physical measurement data were included in the final analysis. The average annual percentage change (AAPC) in the positive rates of risk factors was calculated using Joinpoint regression to analyze temporal trends. Multinomial logistic regression and binary logistic regression models were employed to examine the cross-sectional associations between occupational types (categorized as white-collar workers, agricultural workers, blue-collar workers, service workers, and others) and nine cardiovascular metabolic risk factors and their clustering (defined as having ≥2 risk factors) in 2018. Results A total of 8451 participants were included. From 2009 to 2018, significant increasing trends (AAPC>0, P<0.05) were observed for overweight, obesity, central obesity, borderline elevated triglycerides (TG), borderline elevated to elevated total cholesterol (TC), borderline elevated low-density lipoprotein cholesterol (LDL-C), elevated blood pressure and hypertension, diabetes. The most rapid increases were found for obesity (AAPC=6.07%, 95%CI: 3.42%, 8.88%), hypertension (AAPC=4.10%, 95%CI: 0.62%, 7.77%), and central obesity (AAPC=3.27%, 95%CI: 1.24%, 5.36%). The clustering rate of risk factors increased from 62.3% in 2009 to 73.2% in 2018 (AAPC=1.87%, 95%CI: 1.02%, 2.73%). The cross-sectional analysis in 2018, after adjusting for confounders, showed that compared with white-collar workers, blue-collar workers had a significantly lower risk of overweight (OR=0.67, 95%CI: 0.48, 0.95), central obesity (OR=0.65, 95%CI: 0.45, 0.92), and borderline high TG (OR=0.54, 95%CI: 0.35, 0.82). In contrast, agricultural workers had a higher risk of hypertension (OR=1.76, 95%CI: 1.14, 2.72). Conclusion Between 2009 and 2015, the burden of most cardiometabolic risk factors increases significantly among the Chinese occupational population, with the rate of increase slowing by 2018. Risks vary across occupational types, among which blue- collar workers report lower target outcomes. Targeted interventions focusing on the rapidly increasing risk factors and high-risk occupational groups are recommended.

Background The global prevalence of obesity is on the rise and is closely associated with various chronic non-communicable diseases such as cardiovascular diseases and diabetes. There is a relative lack of long-term dynamic studies on compound obesity among occupational populations. Objective To explore the changing trends of compound obesity among different occupational groups aged 18–59 years in nine provinces (autonomous regions, municipalities) of China from 1993 to 2018, and to provide a scientific basis for formulating targeted weight management strategies for occupational populations. Methods A total of 34519 employed adults aged 18–59 years from nine waves of the China Health and Nutrition Survey in1993, 1997, 2000, 2004, 2006, 2009, 2011, 2015, and 2018 were included. Obesity types were determined according to the Chinese Adult Weight Management Guidelines. The Joinpoint regression model was used to calculate the average annual percentage change (AAPC) and annual percentage change (APC) of compound obesity rates. Results From 1993 to 2018, the age-standardized compound obesity rate among the occupational population aged 18–59 years showed an upward trend (AAPC=6.24%, 95%CI: 5.09%, 7.41%, P<0.05). The AAPCs (95%CI) for age-standardized compound obesity rates among agricultural workers, blue-collar workers, other occupational groups, service workers, and white-collar workers were 9.55% (7.51%, 11.64%), 6.18% (4.70%, 7.69%), 5.53% (2.27%, 8.90%), 4.07% (2.40%, 5.77%), and 3.89% (2.16%, 5.65%), respectively, with statistically significant differences (P<0.05). Among males, the AAPCs (95%CI) for age-standardized compound obesity rates among agricultural workers, blue-collar workers, other occupational groups, service workers, and white-collar workers were 11.52% (7.71%, 15.47%), 7.28% (6.18%, 8.40%), 5.92% (2.28%, 9.69%), 5.56% (2.11%, 9.12%), and 4.22% (2.33%, 6.15%), respectively, with statistically significant differences (P<0.05). Among females, the AAPCs (95%CI) for age-standardized compound obesity rates among agricultural workers, blue-collar workers, and white-collar workers were 7.45% (6.22%, 8.69%), 3.72% (0.84%, 6.67%), and 2.41% (0.17%, 4.70%), respectively, with statistically significant differences (P<0.05). A turning point was observed in the compound obesity rate among female white-collar workers in 2006, with an APC (95%CI) of 9.69% (5.24%, 14.33%) from 2006 to 2008, showing a statistically significant difference (P<0.05), while no significant trend was found from 1993 to 2006 (P>0.05). No significant trends were observed in the age-standardized compound obesity rates among females in other occupational groups and service workers (P>0.05). Conclusion The compound obesity rate among China's occupational population is increasing rapidly, with the growth rate among agricultural workers being particularly prominent. In 2018, male white-collar workers and female agricultural workers exhibit relatively high compound obesity rates, warranting focused attention. Although the overall growth rate among service workers is slower, the expanding workforce in this sector indicates that obesity remains a serious issue. Targeted occupational health and weight management interventions are needed in the future.

Background With rising obesity rates and earlier hypertension onset among occupational populations, there is an urgent need to elucidate the long-term cardiovascular impacts of dynamic body weight patterns. Current evidence lacks trajectory modeling studies examining occupation-specific prevention strategies. Objective To investigate the association between long-term body mass index (BMI) trajectories and incident hypertension risk in Chinese working adults, and to examine occupation-specific heterogeneity in this relationship. Methods A dynamic sub-cohort of 4 413 occupational participants was constructed from ten survey waves (1991–2018) of the China Health and Nutrition Survey (CHNS). Eligible individuals had valid key BMI records at three or more independent follow-ups before the outcome event; the individual baseline was set as the year of their first participation in the survey. Group-based trajectory modeling (GBTM) was used to identify BMI change patterns. Cox proportional hazards regression was used to calculate hazard ratios (HRs) and 95% confidence interval (CI) for hypertension incidence across trajectory groups, with stratified analysis by occupational categories. Results Among 4413 occupational participants, 1441 incident hypertension cases were reported during the follow-up window. Three long-term BMI trajectories were identified: low-stable, moderate-slowly rising, and high-rising. In Model 3 with all selected confounders adjusted, compared with the low-stable group, the moderate-slowly rising group showed a significantly higher risk of incident hypertension (HR=1.28, 95%CI: 1.12, 1.45; P < 0.001), as did the high-increasing group (HR=1.80, 95%CI: 1.45, 2.23; P < 0.001). The stratified analyses revealed occupational differences in the association. Among agricultural workers, the moderate-slowly rising group (HR=1.35, 95%CI: 1.15, 1.57) and the high-rising group (HR=2.00, 95%CI: 1.50, 2.66) both exhibited significantly increased risks of hypertension (P<0.001). Conversely, among white-collar workers, an increased risk of hypertension was observed only in the high-rising group (HR=1.97, 95%CI: 1.23, 3.17; P<0.05). Conclusion Rapid BMI escalation constitutes a significant risk factor for incident hypertension in occupational populations. Targeted long-term weight monitoring and tailored interventions are recommended for high-risk occupations.

To explore the advantages of traditional Chinese medicine （TCM） and integrative TCM-Western medicine approaches in the treatment of diabetic microvascular complications （DMC）， refine key pathophysiological insights and treatment principles， and promote academic innovation and strategic research planning in the prevention and treatment of DMC. The 38th session of the Expert Salon on Diseases Responding Specifically to Traditional Chinese Medicine， hosted by the China Association of Chinese Medicine， was held in Beijing， 2024. Experts in TCM， Western medicine， and interdisciplinary fields convened to conduct a systematic discussion on the pathogenesis， diagnostic and treatment challenges， and mechanism research related to DMC， ultimately forming a consensus on key directions. Four major research recommendations were proposed. The first is addressing clinical bottlenecks in the prevention and control of DMC by optimizing TCM-based evidence evaluation systems. The second is refining TCM core pathogenesis across DMC stages and establishing corresponding "disease-pattern-time" framework. The third is innovating mechanism research strategies to facilitate a shift from holistic regulation to targeted intervention in TCM. The fourth is advancing interdisciplinary collaboration to enhance the role of TCM in new drug development， research prioritization， and guideline formulation. TCM and integrative approaches offer distinct advantages in managing DMC. With a focus on the diseases responding specifically to TCM， strengthening evidence-based support and mechanism interpretation and promoting the integration of clinical care and research innovation will provide strong momentum for the modernization of TCM and the advancement of national health strategies.

In February 2025, a local cluster outbreak caused by the D8 genotype Measles virus (MV) was first discovered in Henan Province. Epidemiological investigations and laboratory testing were conducted, including the collection of serum and throat swabs for MV IgM antibody and nucleic acid detection, virus isolation and genetic homology analysis. Measures such as close contact tracing, vaccination rate assessment and supplementary immunization activities were implemented, successfully preventing broader community transmission. A total of three cases were reported during the outbreak, including one imported-related adolescent and two secondary local adult cases. All cases presented with typical symptoms such as fever and rash. Both adult cases were complicated by pneumonia, with one case developing into severe pneumonia. MV genotyping showed that the two secondary cases were both the D8 genotype, with the viral sequences being completely homologous to the Kazakhstan strain. Among the close contacts, 98.2% were adults, and 142 individuals received emergency vaccination.

Objective Exploring the components of complex scenarios of healthcare surges triggered by major epidemics to provide a theorical basis for building resilience in healthcare organizations.Methods A hybrid analysis method is used to summarize macro-meso-micro multi-level and multi-source heterogeneous information,extract the elements of complex scenarios of medical surge and evaluate the rationality.Fault Tree Analysis method is used to clarify the logical relationship between various scenario elements and construct scenario reasoning paths.Results 10 scenario states,11 disaster-bearing,24 emergency management and 23 scenario results are summarized and extracted to form the key elements of complex surge scenarios.Among them,M4 expansion and coordinated scheduling of key positions,B2 conventional drug inventory emergency/insufficient core treatment drugs,B emergency medical material transportation breakage,S3 disease symptom spectrum shift to severe disease,R13 prevention and control awareness laxity,and M5 media information dissemination management are the key driving factors that promote a major turning point in the scenario.The most positive scenario result is the orderly operation of the medical service system,and the most negative scenario result is the paralysis of the medical service system.Conclusion Medical institutions need to improve emergency plans based on the complex evolution scenarios of medical surges and agile governance capabilities targeting key turning points,focus on dynamically expanding and scheduling personnel in key positions,strengthen material rotation and reserve mechanisms,maintain smooth emergency logistics channels,and improve efficient management of media and public opinion,so as to comprehensively improve overall resilience.

OBJECTIVE To explore the effect of tracking methodology on investigation of contamination incidents of bronchoalveolar lavage fluid(BALF)specimens from the children.METHODS The onsite tracking was carried out for the contamination incidents of BALF specimens of the children through the tracking methodology,the quality control processes of cleaning and disinfection of bronchofiberscopes and the tracking routes were determined.The quality control process of cleaning and disinfection of bronchofiberscopes were evaluated,the existing risks were found out,and the specific improvement measures were formulated.RESULTS The onsite tracking was carried out for the incident of carbapenem-resistant Klebsiella pneumoniae(CRKP)that was caused by the contamination of 12 BALF specimens from pediatrics department wards before and after Nov.1,2021.No.2180014C bronchofiber-scope without biological surveillance was determined as the high-risk point of contamination of BALF specimens,the monitoring procedure of cleaning and disinfection of the bronchofiberscopes was revised.The BALF specimens that were submitted from Dec.1,2021 to Dec.31,2021 were tracked,and no CRKP was detected among the 23 submitted specimens.Totally 12 bronchofiberscope specimens were collected for biological surveillance,and the qualified rate was 100.00％.The treatment rooms of pediatrics department,hand disinfection effect of health care workers of cleaning and disinfection rooms and disinfection effect of object surfaces were monitored,and the quali-fied rate was increased from 98.39％to 100.00％.CONCLUSIONS The tracking methodology is an effective tool for quality management and can be used for evaluation of quality process of cleaning and disinfection of bronchofi-berscopes,which may find out the causes for adverse events in a timely manner and raise the medical safety.

Objective:To analyze the clinical characteristics and treatment of patients with acute Q fever in Dali Bai Autonomous Prefecture, Yunnan Province.Methods:A total of 26 patients with acute Q fever admitted to People′s Hospital of Yunnan Dali Bai Autonomous Prefecture from October 2022 to December 2023 were enrolled. A retrospective cross-sectional study analysis was performed to analyze the demographic characteristics, epidemiology, clinical manifestations, laboratory tests and pathogen detection of these patients.Results:Of the 26 patients, 25 were male and one was female. The age ranged from 18 to 82 years with an average age of (45.6±17.2) years. All of them were sporadic cases. The neighbors of eight patients had sheep and cattle, 11 cases had a history of field work, and four cases had a history of field trip. Coxiella burnetii was detected in 26 patients by different molecular diagnostic techniques, including 21 cases by blood quantitative polymerase chain reaction (qPCR), three cases by sputum multi-pathogen targeted next-generation sequencing (tNGS), one case by alveolar lavage fluid tNGS, and one case by cerebrospinal fluid metagenomic next-generation sequencing (mNGS). Routine blood cultures of 19 cases were negative. All 26 patients presented with chills and fever, 21 cases (80.8%) with headache, 19 cases (73.1%) with fatigue, 14 cases (53.8%) with generalized aches and pains, 12 cases (46.2%) with poor appetite, and 14 cases (53.8%) with cough. Twenty-four cases had concurrent hepatitis, 12 cases had pneumonia, one had encephalitis, and 19 cases had myocardial damage. The laboratory tests showed that 23 cases (88.5%) had normal white blood cell count, eight cases (30.8%) had decreased platelet count, 25 cases (96.2%) had C-reactive protein elevated, 24 cases (92.3%) had procalcitonin elevated, 14 out of 17 cases had elevated erythrocyte sedimentation rate, and 19 cases had elevated D-dimer levels. Liver function tests showed that alanine aminotransferase increased in 24 cases (92.3%) (all less than 10 times of upper limit of normal (ULN)), aspartate aminotransferase increased in 23 cases (88.5%) (all less than 10 times of ULN), alkaline phosphatase increased in 10 cases (38.5%)(all less than two times of ULN), and γ-glutamyl transpeptidase increased in 19 cases (73.1%), which were all less than 10 times of ULN. Myocardial enzymes were detected in 21 cases, of which seven cases (33.3%) had elevated lactate dehydrogenase and 12 cases (57.1%) had elevated hydroxybutyrate dehydrogenase (all less than three times of ULN). In terms of treatment, 16 cases were treated with doxycycline alone, and nine cases were treated with doxycycline combined with azithromycin or quinolones or rifampicin, and one with tigecycline. After treatment, the conditions of patients improved. The overall length of hospital stay was (7.7±5.0) d, and that of eight patients treated with doxycycline combined with quinolones or azithromycin was 4.8 to 6.0 days. Conclusions:Acute Q fever often has no clear epidemiological history, and the clinical manifestations and laboratory tests are lack of specificity. qPCR, tNGS, mNGS can provide pathogenic diagnostic evidence for suspected cases. In terms of treatment, doxycycline is the first choice for treatment of acute Q fever, and combined treatment with azithromycin or quinolones could result in a shorter hospital stay.