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.

ObjectiveTo systematically screen and validate key immunogenic cell death （ICD）-related genes that play important roles in primary sjögren’s syndrome （pSS） using multi-omics data. MethodsGene expression profiles of pSS patients and healthy controls （GSE66795， 131pSS patients/29 healthy controls） were obtained from the Gene Expression Omnibus （GEO） database. Candidate genes were selected by intersecting these profiles with known ICD core gene sets and pSS-related targets. The CIBERSORT algorithm was used to analyze immune cell infiltration characteristics. Validation of gene expression was performed using transcriptomic data from sorted CD8⁺ T cell subsets （GSE93683）. Finally， labial gland tissues and peripheral blood samples from 10 pSS patients and 4 healthy controls were collected， and key genes were experimentally validated by reverse transcription quantitative polymerase chain reaction （RT-qPCR）. ResultsSeven intersecting genes from the ICD-differentially expressed genes （DEGs）-pSS intersection were identified ［caspase 1 （CASP1）， forkhead box P3 （FOXP3）， interferon-gamma （IFNG）， myeloid differentiation primary response 88 （MYD88）， toll-like receptor 7 （TLR7）， DExD/H-box helicase 58 （DDX58）， and interferon induced helicase C domain 1 （IFIH1）］. Immune infiltration analysis showed that in pSS labial gland tissues， the proportions of naïve B cells and dendritic cells significantly increased， while the proportions of resting NK cells and M0 macrophages decreased （P<0.05）. Transcriptomic data of CD8⁺T cell subsets indicated that IFIH1 expression was significantly elevated in central memory CD8⁺T cells （P<0.05）. RT-qPCR experimental validation revealed that DDX58， IFIH1， and CASP1 were significantly upregulated in both peripheral blood leukocytes and labial gland tissues of pSS patients （all P<0.05）， whereas IFNG expression increased in peripheral blood but decreased in labial gland tissues （P<0.05）. ConclusionThis study identified and confirmed DDX58， IFIH1， CASP1， and IFNG as key ICD-related genes in pSS through a combination of bioinformatics and experimental validation， providing new candidate targets for further understanding the immunopathological mechanisms of pSS.

By systematically combing ancient and modern literature， this paper examined Tribuli Fructus and Astragali Complanati Semen（ACS） used in the famous classical formulas from the aspects of name， origin， production area， harvesting and processing， clinical efficacy， so as to provide a basis for the development of famous classical formulas containing such medicinal materials. The results showed that the names of Tribuli Fructus in the past dynasties were mostly derived from its morphology， and there were nicknames such as Baijili， Cijili and Dujili. The name of ACS in the past dynasties were mostly originated from its production areas， and there were nicknames such as Baijili， Shayuan Jili and Tongjili. Because both of them had the name of Baijili， confusion began to appear in the Song dynasty. In ancient and modern times， the main origin of Tribuli Fructus were Tribulus terrestris， and ancient literature recorded the genuine producing areas of Tribuli Fructus was Dali in Shaanxi and Tianshui in Gansu， but today it is mainly cultivated in Anhui and Shandong. The fruit is the medicinal part， harvested in autumn throughout history. There is no description of the quality of Tribuli Fructus in ancient times， and the plump， firm texture， grayish-white color is the best in modern times. Traditional processing methods for Tribuli Fructus included stir-frying and wine processing， while modern commonly used is purified， fried and salt-processed. The ancient records of Tribuli Fructus were spicy， bitter， and warm in nature， with modern research adding that it is slightly toxic. The main effects of ancient and modern times include treating wind disorders， improving vision， promoting muscle growth， and treating vitiligo. The mainstream base of ACS used throughout history is Astragalus complanatus. Ancient texts indicated ACS primarily originated from Shaanxi province. Today， the finest varieties come from Tongguan and Dali in Shaanxi. The medicinal part is the seed， traditionally harvested in autumn. Modern harvesting occurs in late autumn or early winter， followed by sun-drying. Ancient texts valued seeds with a fragrant aroma as superior， while modern standards prioritize plump， uniform and free of impurities. Traditional processing methods for ACS included frying until blackened and wine-frying， while modern practice commonly employs purification methods. In terms of medicinal properties， the ancient and modern records are sweet and warm in nature. Due to originally classified under Tribuli Fructus， its effects were thus regarded as equivalent to those of Tribuli Fructus， serving as the medicine for treating wind disorders， additional functions included tonifying the kidneys and treating vitiligo. The present record of its efficacy is to tonify the kidney and promote Yang， solidify sperm and reduce urine， nourish the liver and brighten the eye， etc. Based on the textual research results， it is suggested that when developing the famous classical formulas of Tribuli Fructus medicinal materials， we should pay attention to the specific reference object of Baijili， T. terrestris and A. complanatus should be identified and selected， and the processing method should be in accordance with the requirements of the formulas.

Objective To explore the value of nomogram model based on MR T1WI enhanced radiomics features and clinical fac-tors in predicting the prognosis of gliomas.Methods A retrospective selection was conducted on 135 patients with postoperative pathologically confirmed gliomas,who were categorized into poor prognosis group(n=59)and good prognosis group(n=76)according to survival condition at 20 months postoperatively.All patients were randomly divided into training group(n=94)and validation group(n=41)in a 7︰3 ratio.Radiomics features were extracted by 3D Slicer software,and the extracted radiomics features were downscaled by intraclass correlation coefficient(ICC),t-test,least absolute shrinkage and selection operator(LASSO)regression,and a total of 1 058 features were extracted for each patient,and 10 optimal radiomics features were obtained,to finally get the Radiomics score(Radscore).After combining clinical features and Radscore,a nomogram model was constructed.Results In the training group,Radscore was significantly higher in the poor prognosis group than that in the good prognosis group(t=8.773,P<0.05).The area under the curve(AUC)of receiver operating characteristic(ROC)curve of the training and validation groups of the radiomics model were 0.751[95%confidence interval(CI)0.654-0.849]and 0.606(95%CI 0.426-0.787),respectively.The AUC of the nomogram model were 0.899(95%CI 0.839-0.960)and 0.908(95%CI 0.823-0.994)in the training and validation groups,respectively,with much better predictive efficacy of the nomogram model.Conclusion A nomogram model based on MR T1WI enhanced radiomics features and clinical factors has good predictive efficacy in the prognosis of gliomas after surgery.

Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T _NANC), time to symptom improvement (T _SI), and time of hospital stay (T _HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T _NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.

Objective To explore the value of nomogram model based on MR T1WI enhanced radiomics features and clinical fac-tors in predicting the prognosis of gliomas.Methods A retrospective selection was conducted on 135 patients with postoperative pathologically confirmed gliomas,who were categorized into poor prognosis group(n=59)and good prognosis group(n=76)according to survival condition at 20 months postoperatively.All patients were randomly divided into training group(n=94)and validation group(n=41)in a 7︰3 ratio.Radiomics features were extracted by 3D Slicer software,and the extracted radiomics features were downscaled by intraclass correlation coefficient(ICC),t-test,least absolute shrinkage and selection operator(LASSO)regression,and a total of 1 058 features were extracted for each patient,and 10 optimal radiomics features were obtained,to finally get the Radiomics score(Radscore).After combining clinical features and Radscore,a nomogram model was constructed.Results In the training group,Radscore was significantly higher in the poor prognosis group than that in the good prognosis group(t=8.773,P<0.05).The area under the curve(AUC)of receiver operating characteristic(ROC)curve of the training and validation groups of the radiomics model were 0.751[95%confidence interval(CI)0.654-0.849]and 0.606(95%CI 0.426-0.787),respectively.The AUC of the nomogram model were 0.899(95%CI 0.839-0.960)and 0.908(95%CI 0.823-0.994)in the training and validation groups,respectively,with much better predictive efficacy of the nomogram model.Conclusion A nomogram model based on MR T1WI enhanced radiomics features and clinical factors has good predictive efficacy in the prognosis of gliomas after surgery.

OBJECTIVE To analyze the traditional Chinese medicine （TCM） emergency management policy texts in China， reveal the characteristics， problems and improvement directions of Chinese medicine emergency management policies in China， and provide references and lessons for improving the level of Chinese medicine emergency management. METHODS Twenty-four TCM emergency management policy texts issued at the central level from 2016 to 2023 were coded and analyzed using Nvivo11 software to construct a three-dimensional analysis framework based on policy tools， stakeholders and policy strength. RESULTS In the policy tools dimension， the environmental type was the most （46.74%）， the supply type was the second （31.80%）， and the demand type was the least （21.46%）； in the stakeholder dimension， there were more healthcare institutions （40.63%） and government departments （31.25%）， and fewer healthcare workers （14.84%） and residents （13.28%）； in the policy strength dimension， the overall policy strength was poor， and the differences in effectiveness across policy instruments and stakeholders were more significant. The cross-cutting results showed that there was a certain degree of mismatch in policy instruments， stakeholders and policy strength. CONCLUSIONS The use of supply-oriented policy tools is slightly lacking， and the use of policy tools should be optimized in a coordinated manner； the distribution of stakeholders is relatively unbalanced， and synergies among stakeholders should be enhanced； the overall strength of policies is poor， and the top-level design of relevant policies should be improved.

Objective:To investigate the clinical features and prognosis of male with anti-melanoma differentiation-associated gene 5 (MDA5) autoantibody.Methods:The clinical data of 246 patients with DM and anti-MDA5 autoantibodies hospitalized by Jiangsu Myositis Cooperation Group from 2017 to 2020 were collected and retrospectively analyzed. Chi-square test was performed to compared between counting data groups; Quantitative data were expressed by M ( Q1, Q3), and rank sum test was used for comparison between groups; Single factor survival analysis was performed by Kaplan-Meier method and Log rank test; Cox regression analysis were used for multivariate survival analysis. Results:①The male group had a higher proportion of rash at the sun exposure area [67.1%(47/70) vs 52.8%(93/176), χ2=4.18, P=0.041] and V-sign [50.0%(35/70) vs 30.7%(54/176), χ2=8.09, P=0.004] than the female group. The male group had higher levels of creatine kinase [112(18, 981)U/L vs 57 (13.6, 1 433)U/L, Z=-3.50, P<0.001] and ferritin [1 500 (166, 32 716)ng/ml vs 569 (18, 14 839)ng/ml, Z=-5.85, P<0.001] than the female group. The proportion of ILD [40.0%(28/70) vs 59.7%(105/176), χ2=7.82, P=0.020] patients and the red blood cell sedimentation rate[31.0(4.0, 101.5)mm/1 h vs 43.4(5.0, 126.5)mm/1 h, Z=-2.22, P=0.026] in the male group was lower than that of the female group, but the proportion of rapidly progressive interstitial lung disease (PR-ILD) [47.1%(33/70) vs 31.3%(55/176), χ2=5.51, P=0.019] was higher than that of the female group. ②In male patients with positive anti-MDA5 antibodies,the death group had a shorter course of disease[1.0(1.0, 3.0) month vs 2.5(0.5,84) month, Z=-3.07, P=0.002], the incidence of arthritis [16.7%(4/24) vs 42.2%(19/45), χ2=4.60, P=0.032] were low than those in survival group,while aspartate aminotransferase (AST)[64(22.1, 565)U/L vs 51(14,601)U/L, Z=-2.42, P=0.016], lactate dehydrogenase (LDH) [485(24,1 464)U/L vs 352(170, 1 213)U/L, Z=-3.38, P=0.001], C-reactive protein (CRP) [11.6(2.9, 61.7) mg/L vs 4.95(0.6, 86.4) mg/L, Z=-1.96, P=0.050], and ferritin levels [2 000(681, 7 676) vs 1 125 (166, 32 716)ng/ml, Z=-3.18, P=0.001] were higher than those in the survival group, and RP-ILD [95.8%(23/24) vs 22.2%(10/45), χ2=33.99, P<0.001] occurred at a significantly higher rate. ③Cox regression analysis indicated that the course of disease LDH level, and RP-ILD were related factors for the prognosis of male anti-MDA5 antibodies [ HR (95% CI)=0.203(0.077, 0.534), P=0.001; HR (95% CI)=1.002(1.001, 1.004), P=0.003; HR (95% CI)=95.674 (10.872, 841.904), P<0.001]. Conclusion:The clinical manifestations of male anti-MDA5 antibody-positive patients are different from those of female. The incidence of ILD is low, but the proportion of PR-ILD is high. The course of disease, serum LDH level, and RP-ILD are prognostic factors of male anti-MDA5 antibody-positive patients.

Objective To analyze the clinical characteristics and related to risk factors of late-life depression patients with venous thromboembolism in the elderly ward.Methods A retrospective analysis was conducted on 143 hospitalized depression patients(aged≥60 years)including 65 depression patients with VTE(VTE group)and 78 depression patients without VTE(control group)in the elderly ward of Beijing Anding Hospital from January 2023 to September 2023.The clinic and laboratory data was collected such as general demographic information,relevant clinical data,VTE history,personal history,thyroid function,hormone levels,blood lipid levels and D-dimer to analyze and compare the clinical characteristics of two group patients,and Logistic regression was used to analyze the related risk factors of VTE in patients with depression.Results Compared with control group,patients in the VTE group were older[(70.94±5.88)years vs.(68.04±4.92)years,P<0.05],had a higher total HAMD score(26.35±9.28 vs.23.19±5.94,P<0.05),a higher proportion of a history of VTE[13 cases(20.0%)vs.6 cases(7.7%),P<0.05],a higher proportion of bedridden for more than 72 hours[42 cases(64.6%)vs.31 cases(39.7%),P<0.05],lower HDL-C levels[(1.27±0.27)mmol/L vs.(1.39±0.28)mmol/L,P<0.05],and higher levels of D-dimer[1.91(0.82,3.51)mg/L FEU vs.0.48(0.25,0.80)mg/L FEU,P<0.05].Logistic regression analysis showed that total HAMD scores(OR=1.077,P=0.018),history of VTE(OR=4.339,P=0.023),bedridden for more than 72 hours(OR=2.449,P=0.044),and D-dimer level(OR=2.404,P<0.001)were risk factors for hospitalized late-life depression patients with VTE in the elderly ward.Conclusions Depression patients with VTE in the elderly ward have several clinical characteristics including older age,more severe depressive symptoms,lower HDL-C levels,higher D-dimer levels,and higher proportion of a history of VTE and bedridden for more than 72 hours.Depressive symptoms,a history of VTE,bedridden for more than 72 hours,and D-dimer levels may be risk factors for late-life depression patients with VTE in the elderly ward.

Objective:To analyze the health literacy level among medical staff and its influencing factors.Methods:Using the convenient sampling method, the in-service medical staff from four medical institutions (Shanghai Pudong New Area People′s Hospital, Shanghai Pudong New Area Zhoupu Hospital, Shanghai Tenth People′s Hospital Chongming Branch, and Shanghai Jing′an District Zhabei Central Hospital) were administered with a national residents′ health literacy questionnaire uniformly compiled by the China Health Education Center, and an electronic questionnaire independently compiled in combination with professional characteristics of the medical staff. The survey period was January 5-17, 2021. The contents of the questionnaire included basic information regarding gender, age, education, and professional title. Respondents were also asked whether they had chronic diseases, and three aspects of health literacy for basic knowledge and concepts, healthy lifestyle and behavior and health skills covering six other types of health problems including scientific outlook on health, infectious disease prevention and control literacy, chronic disease prevention and control. Safety and first aid literacy, basic medical literacy, health information literacy were also assessed. The total score for the questionnaire was 100 points. Respondents with a score of 80 or more were considered to have a competent health literacy. A total of 870 questionnaires were distributed, excluding incomplete ones, 826 valid questionnaires were used for analysis. Logistic regression was used to analyze factors influencing the health literacy among medical staff.Results:The overall health literacy level of medical staff was 64.0%, with 79.7% of respondents indicating that they had basic knowledge and concepts, 70.8% indicating that they practiced healthy lifestyles and behaviors, and 33.5% showed proficiencies in terms of health skills. From high to low, the health literacy levels for the six types of health problems were safety and first aid literacy (80.5%), scientific outlook on health (76.4%), infectious disease prevention and control literacy (60.2%), chronic disease prevention and control literacy (70.9%), basic medical literacy (52.7%), and health information literacy (50.2%). The results of a multivariate logistic regression analysis showed that physical condition, a lifestyle harmful to one′s health, highest educational background, and a professional title in the previous year were the independent influencing factors related to health literacy ( P<0.05). Conclusion:Levels of health skills, basic medical literacy, and health information literacy among medical staff are low, and physical condition in the previous year, lifestyle, professional title, and education are important factors influencing the level of health literacy among medical staff.