Depression,a common mood disorder,has a complex pathogenesis.In recent years,the accelerated pace of life has been accompanied by an increase in the prevalence rate of depression,leading to extensive attention being given to this condition.External stress and inflammation synergize to damage blood vessel and brain functions,induce immune disorders,cause microglia activation,and increase the expression of pro-inflammatory cytokines and their receptors.Inflammatory reactions continue to escalate,which affects the normal metabolism and metabolism of the neurotransmitter system.The abnormal functioning of molecular pathways leads to mutations in brain cell and nerve genes,and further formation of the immune-inflammation-neuron cycle pathway becomes an important mechanism in the occurrence and development of depression.A large number of studies have shown that traditional Chinese medicines can improve depression symptoms by restoring neuroimmune inflammation homeostasis.This article explains neuroimmune inflammation's close connection with depression and its pathogenesis and reviews the role of various traditional Chinese medical therapies in improving and treating depression by participating in the regulation of neuroimmune inflammation.This review provides new perspectives on the precise treatment of depression and the development of immune-targeted drugs.

Objective:To explore the association between cognitive function and the level of gamma-amino-butyric acid(GABA)in anterior cingulate cortex(ACC)before and after treatment in patients with major depres-sion disorder.Methods:Totally 31 medication-naive patients with major depression disorder meeting the criteria of the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)and 33 normal controls were col-lected.Each eligible patient received treatment with selective serotonin reuptake inhibitor agents for 8 weeks.The MATRICS Consensus Cognitive Battery(MCCB)was used to evaluate the cognitive function.By means of 1H magnetic resonance spectroscopy,anterior cingulate cortex GABA concentrations were measured.Results:At base-line,the concentration of ACC GABA relative to water(GABA+/W)was lower in the patient group than in the control group(P＜0.05)and increased after treatment(P＜0.05).ACC GABA+/W was negatively associated with verbal learning and visual memory score in patient group at baseline(correlation coefficient and P value were r=-0.40,P＜0.05;r=-0.42,P＜0.05,respectively).The ACC GABA+/W difference resulted of treatment in patient group was positively associated with the difference of working memory score and the difference of reasoning and problem-solving score(correlation coefficient and P value were r=0.58,P＜0.05;r=0.66,P＜0.05,respec-tively).Conclusion:The cognitive dysfunction of patients with major depression disorder may not be related to the degree of depression and anxiety.And improvement of cognitive function may be associated with increase of ACC GABA concentrations.

Objective:To analyze the genetic evolution and molecular characteristics of H7N9 avian influenza virus (AIV) isolated in a live poultry market.Methods:Samples such as poultry feces, sewage, and hair removal machine and chopping board swabs were collected. Real-time fluorescent quantitative PCR was used to detect influenza A virus and H7N9 AIV in the samples. The whole genome of H7N9 AIV was amplified with influenza A virus universal primers and sequenced. BLAST and MEGA X were used for sequence alignment, phylogenetic analysis and molecular characterization.Results:Seven poultry-related environment samples were collected in the live poultry market in Xuchang city in February 2023, and four were positive for H7N9 AIV. The whole genome sequences of three H7N9 AIV isolates were successfully obtained, and the isolates shared high nucleotide identity in different genes (98.37%-100.00%). BLAST analysis showed they were highly identical to H7N9 strains isolated from domestic poultry in China from 2020 to 2021. Genetic evolution analysis showed that the three isolates clustered in the same branch and were closer to the recent environmental isolates than to the recent strains isolated from human or avian. Through comparison with the sequences of the representative strains in different periods, it was found that the isolated strains in this study showed high avian pathogenicity with four amino acids KRAA inserted at the cleavage site; the hemagglutinin receptor-binding site was QSG, which was an avian binding receptor; there was a G186I mutation in hemagglutinin. Mammalian-adaptive mutation E627K was not detected in polymerase basic protein 2. Mutations (R292K and I38T) associated with drug resistance to neuraminidase inhibitor (oseltamivir) and polymerase acidic protein inhibitor (baloshavir) were not detected, suggesting that these isolates remained susceptible to these drugs. A S31N mutation was found in M2 protein, indicating they were resistant to alkamines.Conclusions:The three H7N9 AIV strains isolated in the live poultry market have high avian pathogenicity, but there are no significant increase in mutations related to the binding ability to human receptors, mammalian pathogenicity, viral transmissibility, or drug resistance as compared with previous representative strains causing human or avian infection.

The immune related adverse events(irAE)caused by tumor immune checkpoint inhibitors(ICI)have attracted increasing attention of clinical experts.Immune-mediated liver injury caused by ICIs(ILICI)is not uncommon in clinical practice,but specific diagnostic method of ILICI is lacking.Biopsy of liver tissue can help improve the diagnosis and management of ILICI.In the treatment of ILICI,the immediate use of corticosteroid therapy is not necessarily.A balance between efficacy,toxicity,and specific treatment need to be achieved,and further refined through multidisciplinary team(MDT)cooperation.Appropriate dosaging and identification of novel predictive targets should be considered in order to reduce the incidence and severity of ILICI in the future.Meanwhile,further basic research is required to elucidate the potential pathophysiological mechanisms and risk factors of ILICI.With the refinement of evidence in clinical evidence-based medicine and deepening of basic research,the diagnosis and treatment level of ILICI will also be further improved.

Chronic fatigue syndrome(CFS)is a chronic comprehensive disease with a slow course and often accompanied by a variety of physical and psychiatric symptoms.At present,the incidence rate is on the rise.Based on the theory of"qi-pulse smooth and unobstructed",the pathogenesis of CFS is considered to be the loss of spleen and kidney and the deficiency of qi-pulse as the root;liver and lung disorders,qi-pulse stagnation as the pivot;wind fire invasion,phlegm blood stasis as the superficiality.Treatment should focus on tonifying the spleen and tonifying the kidneys to treat its root cause.According to the degree of deficiency of spleen and kidney and the emphasis of deficiency of qi-blood yin-yang,Buzhong Yiqi Decoction,Guipi Decoction,Shengyang Yiwei Decoction,Linggui Zhugan Decoction and Shenqi Pills should be selected flexibly.The methods of soothing the liver and regulating the lungs to regulate their pivot,harmonizing the liver and lungs,and using both ascending and descending functions should be used.Chaihu Shugan Powder,Xiaoyao Powder,Sini Powder,Guizhi Decoction,Shengmai Powder,etc.could be selected flexibly according to the disease location and disease focus.Clearing wind and clearing heat,eliminating phlegm and promoting blood circulation should be used to treat its superficiality,emphasizing tonifying deficiency and resolving depression.According to the different pathogenesis of patients,the corresponding treatment method should be flexibly chosen to supplement with medication.One medical case was attached in this article as the evidence,in order to provide reference for the TCM treatment of CFS.

ObjectiveTo analyze the literature related to traditional Chinese medicine （TCM） pharmacology of Institute of Chinese Materia and Medica， China Academy of Chinese Medical Sciences （hereinafter referred to as "Institute of Chinese Materia and Medica"）， and evaluate the research status， development trend， influence of discipline members， and patent technology of this field. MethodThe papers from 2002 to 2024 in the databases of CNKI and Web of Science （WOS） were searched， whose first authors or corresponding authors are from the Institute of Chinese Materia and Medica， and CiteSpace 6.3.R6 was adopted for visual analysis of the annual number of publications and keywords. Additionally， the total number of published papers， citation times， and other measurement parameters of discipline members of TCM pharmacology in the institute were counted. After obtaining the h index， the academic track was calculated， and the academic influence of discipline members was quantitatively evaluated from the aspects of the academic track T and highly cited papers. Meanwhile， patent data from 2005 to 2024 of TCM pharmacology in the studied institute were retrieved from the HimmPat patent database， and Excel 2022 and Origin 2021 were utilized to conduct visual analysis on the overall patent application trend and technology composition. ResultIn the past 20 years or more， the annual publication of academic papers has been on the rise generally， and the key words include "animal model"， "mechanism of action"， "network pharmacology" and so on. The studies focus on the innovative methods of TCM pharmacological mechanisms， basic research on TCM prevention and treatment of major non-infectious diseases， and the prevention and treatment of respiratory viral diseases. The academic track T of the discipline members of TCM pharmacology in the Institute of Chinese Materia and Medica is positive， with sound personal influence. In recent years， the patent application trend has increased significantly， mainly concentrating on A61K patents and G01N subcategories， and IPC large-group analysis shows that the main technical applications are mainly in A61K36， A61K31， and other fields. ConclusionTCM pharmacology in the institute develops steadily and the academic influence of the discipline members is still sound， with fruitful patent achievements. In the future， research on pharmacological discipline innovation and new drug research and development can be enhanced， and multidisciplinary integration studies should be carried out to promote TCM modernization.

Objective:To investigate the current situation and influence factors of prehospital thrombolysis treatment for ST segment elevation myocardial infarction (STEMI) in China, to analyze the main factors affecting prehospital thrombolysis implementation, and optimize the pre-hospital thrombolysis strategy for STEMI to reduce mortality.Methods:A multicenter cross-sectional survey was conducted. 21 cities from six major geographical regions in China were selected by using convenient sampling method. An anonymous online electronic questionnaire was used to investigate the current situation and influence factors of prehospital emergency physicians and grassroots physicians implementing prehospital thrombolysis treatment for STEMI patients. Chi-square test was used to analyze the differences in count data between groups, and multivariate logistic regression was used to analyze the factors affecting prehospital thrombolysis in STEMI.Results:A total of 5 163 prehospital emergency physicians and physicians from grassroots township health centers/community health service centers or village clinics participated in this survey. Among them, 3208 (62.13%) have never implemtent thrombolysis, and 1 955 (37.87%) have did it before. The results of the multivariate logistic regression analysis indicated that physicians with 5-10 years of experience ( OR=1.41, 95% CI: 1.18-1.69, P<0.01), 11-20 years of experience ( OR=1.25, 95% CI: 1.03-1.52, P=0.02), those working in village clinics ( OR=1.30, 95% CI: 1.05-1.61, P=0.02), those in pre-hospital emergency medical institutions/departments ( OR=3.19, 95% CI: 2.80-3.64, P<0.01), those whose units are equipped with remote ECG transmission capabilities ( OR=1.72, 95% CI: 1.50-1.96, P<0.01), or ECG AI-assisted diagnostic tools ( OR=1.31, 95% CI: 1.15-1.49, P<0.01), and those who believe that thrombolysis is highly effective and should be widely adopted ( OR=2.55, 95% CI: 2.09-3.12, P<0.01) or consider it somewhat effective but warranting caution ( OR=2.11, 95% CI: 1.73-2.59, P<0.001), were more likely to make pre-hospital thrombolysis decisions for STEMI patients. To improve the current situation of pre-hospital thrombolysis for STEMI, the top four measures prioritized by pre-hospital emergency and grassroots physicians were enhancing the rescue capabilities of primary care doctors (92.22%), strengthening guidance from higherlevel hospitals (84.99%), increasing support for information technology (83.37%), and improving public health education (74.75%). Conclusions:The implementation rate of prehospital thrombolysis for STEMI in China still needs to be improved. Optimizing the prehospital thrombolysis strategy for STEMI, strengthening the allocation of basic medical resources and information technology support, and improving the referral mechanism are conducive to the implementation of prehospital thrombolysis for STEMI.

The paper reported a patient under maintained hemodialysis for 11 years, with a large mass appeared in the right thigh after local injury. The mass was clinically considered as tumoral calcinosis combined with clinical, imaging and pathological findings. Several treatments such as enhancing dialysis adequacy, low calcium dialysate, calcimimetic agent, non-calcium- phosphorus binding agents, parathyroidectomy and intravenous infusion of sodium thiosulfate could not vanish the mass. Finally, the lump was surgically removed. The treatment of tumoral calcinosis in the hemodialysis patient can provide a instruction for similar situations in clinical practice.

Metabolic-associated fatty liver disease (MAFLD), which is previously known as non-alcoholic fatty liver disease (NAFLD), represents a major health concern worldwide with limited therapy. Here, we provide evidence that ferroptosis, a novel form of regulated cell death characterized by iron-driven lipid peroxidation, was comprehensively activated in liver tissues from MAFLD patients. The canonical-GPX4 (cGPX4), which is the most important negative controller of ferroptosis, is downregulated at protein but not mRNA level. Interestingly, a non-canonical GPX4 transcript-variant is induced (inducible-GPX4, iGPX4) in MAFLD condition. The high fat-fructose/sucrose diet (HFFD) and methionine/choline-deficient diet (MCD)-induced MAFLD pathologies, including hepatocellular ballooning, steatohepatitis and fibrosis, were attenuated and aggravated, respectively, in cGPX4-and iGPX4-knockin mice. cGPX4 and iGPX4 isoforms also displayed opposing effects on oxidative stress and ferroptosis in hepatocytes. Knockdown of iGPX4 by siRNA alleviated lipid stress, ferroptosis and cell injury. Mechanistically, the triggered iGPX4 interacts with cGPX4 to facilitate the transformation of cGPX4 from enzymatic-active monomer to enzymatic-inactive oligomers upon lipid stress, and thus promotes ferroptosis. Co-immunoprecipitation and nano LC-MS/MS analyses confirmed the interaction between iGPX4 and cGPX4. Our results reveal a detrimental role of non-canonical GPX4 isoform in ferroptosis, and indicate selectively targeting iGPX4 may be a promising therapeutic strategy for MAFLD.

Objective: To investigate the association of D-dimer (DD) level on admission with the hospital length of stay (LOS) for the children with community-acquired pneumonia (CAP). Methods: The children diagnosed as CAP hospitalized in the Second Hospital of Tianjin Medical University from December 2016 to December 2017 were studied. The clinical and biological variables were retrieved via electronic medical record system. Binary logistic regression model and Cox proportional risk model were constructed to estimate the assosiation of DD level with hospital length of stay(LOS). Results: A total of 413 children met the inclusion criteria. Their median of LOS was 7 days (range from 3 to 21 days). The median of DD level on admission was 510.87 ng/mL and tertiles were 400 ng/mL and 712.23 ng/mL. In logistic regression model, both the high (＞712.23 ng/mL) and middle (400-712.23 ng/mL) DD level groups were in more risk for hospital stay of more than 7 days in comparison with the low DD level group (＜400). The OR values were 3.335 (95%CI:1.973-5.637, P＜0.001) and 2.015 (95%CI:1.195-3.398, P=0.009) respectively. Consistently, in Cox model high level of DD was associated with low probability of discharge (HR=0.652, 95%CI: 0.486-0.874, P=0.004 ), suggesting more risk of prolonged LOS in contrast to the low DD level group. Conclusion The DD level on admission should be independently associated with the hospital length of stay, suggesting the consideration of DD levels may be helpful for clinical management of the hospitalized children with CAP.