Chaihu Guizhi Ganjiangtang was first recorded in the Treatise on Cold Damage （Shang Han Lun）. This prescription is composed of Bupleuri Radix， Scutellariae Radix， Cinnamomi Ramulus， Zingiberis Rhizoma， Trichosanthis Radix， Ostreae Concha， and Glycyrrhizae Radix et Rhizoma. It has the effects of soothing Lesser Yang， warming the spleen， and stimulating the generation of body fluid. It is mainly used to treat digestive tract diseases such as chronic cholecystitis （CC）， irritable bowel syndrome， and non-alcoholic fatty liver disease. Dyspepsia caused by CC presents a variety of gastrointestinal symptoms such as abdominal pain， poor appetite， postprandial fullness， aversion to greasy food， soft stool， and bitter mouth， being a type of biliary dyspepsia. In modern medicine， dyspepsia caused by CC is mainly managed by medical treatment and surgical treatment. Internal medicine mainly focuses on reducing inflammation， promoting the function of gallbladder， resolving stones， alleviating spasms， and relieving the pain for CC， demonstrating definite short-term efficacy but suffering from single effects， high recurrence rate， and poor compliance. Although surgical treatment can cure cholecystitis， it is accompanied by the increased incidence of adverse events such as abdominal pain， diarrhea， and dyspepsia. Modern clinical studies have confirmed that Chaihu Guizhi Ganjiangtang can significantly alleviate the symptoms such as abdominal pain and dyspepsia of CC patients. Pharmacological studies have found that Chaihu Guizhi Ganjiangtang mainly contains active ingredients such as Bupleuri Radix saponins， baicalin， cinnamaldehyde， gingerol， Trichosanthis Radix polysaccharide， Ostreae Concha polysaccharide， and Glycyrrhizae Radix et Rhizoma total flavonoids. Chaihu Guizhi Ganjiangtang can ameliorate the symptoms of dyspepsia caused by CC by inhibiting inflammatory responses， improving gallbladder contraction and gastrointestinal motility， regulating the bile acid-intestinal flora axis and the brain-gut axis， and modulating blood lipids through multiple targets. By reviewing the previous literature， this article summarizes the research progress in the treatment of dyspepsia caused by CC with Chaihu Guizhi Ganjiangtang and its main active ingredients as well as the pathogenesis of this disease and puts forward the shortcomings and improvement strategies for the current research. The review aims to provide a reference for the further research on Chaihu Guizhi Ganjiangtang in the treatment of dyspepsia caused by CC.

Objective: To explore the effects of personality and sleep quality with psychological distress of junior and senior high school stduents, so as to provide a reference basis for precise interventions of junior and senior high school students mental health. Methods: In October 2023, a convenience sampling method was used to select 9 034 students aged 12-17 from Shiyan City as the study subjects. The Pittsburgh Sleep Quality Index (PSQI) and Kessler Psychological Distress Scale (K10) were used to collect information on sleep quality and psychological distress of junior and senior high school stduents. Between group comparison was conducted by using t-test and Chi-square test. Generalized linear models were employed to analyze the interaction and joint effects of personality and sleep quality on psychological distress. Results: The generalized linear model analysis showed that the interaction between personality and sleep quality on psychological distress was statistically significant of junior and senior high school students(effect size=0.80, P <0.01). The general linear model analysis indicated that, after adjusting for variables such as age, gender, screen time, and daily sitting time with the extroverted and good sleep quality group as the reference, the introverted and poor sleep quality group had the largest mean difference in psychological distress scores (difference=0.51, P <0.05). When stratified by sleep quality, psychological distress scores were higher in the introverted and neutral personality groups with both poor and good sleep quality compared to the extroverted group (poor sleep quality: introverted difference=3.71, neutral difference=1.14; good sleep quality: introverted difference=2.23, neutral difference=0.57, all P < 0.05). When stratified by personality, psychological distress scores were higher in the poor sleep quality groups for introverted, neutral, and extroverted individuals compared to their good sleep quality counterparts (differences=8.66, 7.83, 7.34, all P < 0.05 ). Conclusions Personality and sleep quality have interactive and joint effects on psychological distress of junior and senior high school stduents. Personalized psychological interventions should be developed based on personality and sleep quality.

Lung adenocarcinoma (LUAD) is a global malignancy with significant chemoresistance impacting patient prognosis. The pro-tumorigenic role of hyaluronan-mediated motility receptor (HMMR) in LUAD is recognized. This study was designed to investigate the underlying mechanisms by which HMMR affects chemoresistance in LUAD. Bioinformatics presented the expression patterns of HMMR in LUAD patients and the association between HMMR levels and patient survival, followed by qRT-PCR to verify HMMR expression in LUAD tissues and cells. Further, bioinformatics was leveraged to identify the signaling pathways enriched by HMMR and its relevance to glycolytic genes, we also analyzed changes in the glycolytic activity of LUAD cells by manipulating HMMR expression. Stemness was evaluated through cell aggregation assays and Western blot, and drug responsiveness was gauged using CCK-8 assays, alongside flow cytometry for apoptosis analysis. HMMR was highly expressed in LUAD tissues and cells, and this overexpression correlated with poorer prognoses in patients. GSEA showed that HMMR was notably enriched in the glycolysis and gluconeogenesis pathways, correlating positively with the expression of key glycolytic genes. Cellular experiments confirmed that HMMR knockdown notably suppressed aerobic glycolysis in LUAD cells. Moreover, overexpression of HMMR could further enhance the stemness and cisplatin resistance of LUAD cells by stimulating glycolysis. In brief, this study has validated that high levels of HMMR in LUAD are predictive of poor patient prognosis, and that overexpression of HMMR can catalyze aerobic glycolysis, thus promoting stemness and chemoresistance in LUAD cells. Thus, HMMR could be a target for improving chemosensitivity in LUAD.

Objective To explore the optimal warning threshold of motor evoked potentials(MEP)in decompression surgery for ossification of the posterior longitudinal ligament(OPLL)at cervical and thoracic segments,and the predictive role of different MEP parameters on postoperative lower extremity motor function.Methods A retrospective analysis was conducted on the clinical data of 227 patients diagnosed with cervical or thoracic OPLL and underwent decompression surgery from January 2022 to January 2024 in the hospital.There were 131 males and 96 females,with an average age of(60±10)years.All patients underwent continuous neuro-physiological monitoring during the operation,and the minimum ratio of MEP amplitude change to the baseline at the beginning of the operation(Dmax)and the ratio of MEP terminal amplitude change to the baseline at the end of the operation(Dend)were recorded.The correlations between these two ratios and the lower extremity motor func-tion immediately after the operation and at 1 year were compared.According to the Medical Research Council muscle strength score(MRC)standard,a postoperative score increase of≥1 point compared to preoperative was defined as postoperative motor dysfunction.Pearson correlation coefficients were used to evaluate the correlations between Dmax and Dend and the lower extremity motor function immediately after the operation and at 1 year.Receiver operating characteristic(ROC)curves were drawn to predict postoperative lower extremity motor dysfunc-tion using Dmax and Dend.Results Among the 227 patients,186 had cervical OPLL and 41 had thoracic OPLL.The incidence of lower extremity motor dysfunction immediately after the operation and at 1 year was 7 cases(3.76%)and 2 cases(1.08%)in the cervical group,and 9 cases(21.95%)and 3 cases(7.32%)in the thoracic group,respectively.The incidence of lower extremity motor dysfunction in the thoracic group was higher than that in the cervical group(P<0.001).The baseline induction rate of bilateral lower extremity MEPs was 98.92%(368/372)in the cervical group and 96.34%(79/82)in the thoracic group.The Pearson correlation coefficients of Dend with the bilateral lower extremity motor function immediately after the operation in the cervical and thoracic groups were both greater than those of Dmax,and the differences were statistically significant(cervical group:r=0.669,0.517,P=0.001 2;thoracic group:r=0.882,0.727,P=0.003 6),while the differences in the Pearson corre-lation coefficients of Dend and Dmax with the bilateral lower extremity motor function at 1 year were not statistically significant(cervical group:r=0.457,0.352,P=0.088;thoracic group:r=0.760,0.625,P=0.098).The cut-off values of Dend for the cervical group were 0.853 immediately after the operation and at 1 year,and the cut-off values of Dmax were 0.881 and 0.978,respectively.For the thoracic group,the cut-off values of Dend were 0.532 immediately after the operation and 0.639 at 1 year,and the cut-off values of Dmax were 0.532 and 0.640,respec-tively.Conclusions In OPLL surgery,the MEP monitoring strategy should be adjusted according to the surgical segment.For the cervical segment,Dmax should be emphasized to balance high sensitivity and specificity,while for the thoracic segment,Dmax or Dend can be flexibly selected.Higher MEP warning thresholds are required for cervical OPLL surgery(Dmax:0.881 immediately after the operation and 0.978 at 1 year;Dend:0.853),while significantly lower thresholds are needed for thoracic OPLL(Dmax/Dend:0.532 immediately after the operation and 0.640 at 1 year).

Objective To evaluate an ultrasound-based deep learning radiomics nomogram(DLR_Nomo-gram)for non-invasively differentiating between type Ⅰ and type Ⅱ epithelial ovarian cancer(EOC)before surgery.Methods In this study,a cohort of 195 patients diagnosed with EOC was analyzed.Participants were randomly divided into a training set and a testing set at an 8∶2 ratio.Following data preprocessing,region of interest(ROI)delineation,feature extraction and selection,as well as the clipping and extraction of the maximum section sonogram for each sample,three initial models were developed:the radiomics signature(Rad_Sig),the deep transfer learning signature(DTL_Sig),and the clinical signature(Clinic_Sig).Subsequently,an integrated model—referred to as the DLR_Nomogram—was constructed by combining Rad_Sig,DTL_Sig,and Clinic_Sig,and was presented in the form of a nomogram.The performance of the model was evaluated using the receiver operating characteristic(ROC)curve and the corresponding area under the curve(AUC).Results In the testing set,the DLR_Nomogram demonstrated superior predictive performance(AUC:0.951,95%CI:0.876～1.000)compared to Rad_Sig(AUC:0.709,95%CI:0.539～0.880),DTL_Sig(AUC:0.842,95%CI:0.712～0.972),and Clinic_Sig(AUC:0.916,95%CI:0.827～1.000).The Hosmer-Lemeshow goodness-of-fit test for the DLR_Nomogram resulted in a p-value exceeding 0.05,indicating adequate model calibration.Moreover,decision curve analysis revealed that the DLR_No-mogram offers a higher net clinical benefit across a defined range of threshold probabilities.Conclusions The ultrasound-based DLR_Nomogram exhibits a robust ability to differentiate between Type Ⅰ and Type Ⅱ EOC,and may serve as a valuable clinical tool for guiding individualized preoperative diagnostic and therapeutic decision-making.

To assess the cross-contamination risk and genetic evolution ofStaphylococcus aureus(S.aureus)at various stages in a swine slaughterhouse,and to provide a reference for risk evalua-tion and control measures of S.aureus contamination during swine slaughtering,we conducted whole-genome sequencing on 31 isolates of S.aureus collected and preserved from the slaughter-house.Bioinformatics analyses were performed to investigate the genomic characteristics and genet-ic relationships of these isolates.Results revealed cross-contamination across different slaughter-house stages,predominantly with ST398-t1451 strains.Additionally,highly virulent ST9-t899 strains and ST398-t11 strains with numerous resistance genes were detected at various stages.The strains predominantly carried virulence genes such as hlgA,hlgB,and hlgC,with varying num-bers of resistance genes.Notably,two strains carried the optrA gene and three strains carried the cfr gene;the presence of the optrA gene is relatively rare among S.aureus.These genes confer re-sistance to novel synthetic antibiotics such as oxazolidinones and florfenicol and have the potential for horizontal gene transfer,increasing the risk of dissemination both within and beyond the slaughterhouse.Importantly,the study also detected a LA-MRSA-ST9 strain in water samples from the slaughterhouse,which could potentially infect humans.This strain exhibits zoonotic char-acteristics,highlighting the need for stricter protective measures for slaughterhouse workers to mitigate occupational exposure and infection risks.

Objective:To investigate the characteristics of fatty acid metabolism in the hepatic steatosis (HS) population and to explore the role of inflammation in the relationship between fatty acid metabolism and HS.Methods:A total of 3 112 subjects from the 2011–2014 National Health and Nutrition Examination Survey (NHANES) database were included in this retrospective study, among whom 1 552 were in the HS group (weighted percentage: 49.87%) and 1 560 in the control group (weighted percentage: 50.13%). The differences in dietary fatty acid and serum free fatty acid (FFA) levels and metabolic characteristics were compared. Logistic and weighted quantile sum (WQS) regression models were used to evaluate the impacts of various FFA indexes on HS. Mediation analysis was conducted to examine whether inflammation served as a mediator in the relationship between FFA and HS.Results:Dietary fatty acid intake did not differ significantly between the HS and control groups. However, serum FFA metabolism characteristics differed between these two groups, with the concentrations of 28 FFAs in the HS group significantly higher than those in the control group. The risk of HS was correlated negatively with serum unsaturated fatty acids/saturated fatty acids ( OR=0.69, 95% CI: 0.64–0.75, P<0.001), polyunsaturated fatty acids/saturated fatty acids ( OR=0.63, 95% CI: 0.99–0.69, P<0.001), and Health Promotion Index ( OR=0.78, 95% CI: 0.74–0.82, P<0.001) but positively with thrombosis index ( OR=2.20, 95% CI: 1.89–2.55, P<0.001). The WQS model showed that behenic acid had the greatest contribution weight to increase the risk of HS among the 30 FFAs. After adjusting for confounding factors, the risk of HS increased by 167% (95% CI: 2.14–3.34, P<0.001) for each unit increase in the WQS index. Further mediation analysis showed that albumin/globulin ratio, white blood cell count, and neutrophil to platelet ratio significantly mediated the relationship between serum FFA and HS ( P<0.05). Conclusion:People with similar dietary fatty acid structures may present different serum FFA metabolism characteristics. Serum FFA level correlates with the risk of HS, and inflammation plays an important role in mediating the relationship between fatty acid metabolism and HS.

Purpose To investigate the predictive value of placental microflow combined with serum cystatin C(Cys C)for late-onset preeclampsia(LOP).Materials and Methods This was a prospective study including 188 singleton pregnant women who underwent prenatal ultrasound examination and delivered in the First Affiliated Hospital,School of Medicine,Shihezi University from October 2021 to October 2022.The placental microvascular indexes,including vascularization index,flow index and vascularization-flow index(VFI),were detected by three-dimensional power Doppler ultrasound in the second trimester,and the serum Cys C level was detected.The pregnancy outcome of the pregnant women was divided into LOP group and normal group(NLOP group),and the predictive value of placental microflow combined with serum Cys C for LOP was analyzed.Results Placental vascularization index and VFI of the LOP group were lower than those of the NLOP group(29.77±11.97 vs.44.44±9.86,9.23±3.51 vs.15.05±4.38).However,serum Cys C in the LOP group was higher than that in the NLOP group[(1.13±0.17)mg/L vs.(0.84±0.18)mg/L],and the differences were statistically significant(t=-3.616,-4.790,4.682,all P<0.05).The area under the curve of placental VFI combined with serum Cys C for predicting LOP was 0.899,which had the highest predictive value.Conclusion Placental VFI combined with serum Cys C detection can help to improve the prediction efficiency of LOP,and it is better than each single item.

OBJECTIVE To analyze the characteristics of peripheral blood leukocyte morphology,scatterplot and leukocyte cell population data(CPD)in patients with severe fever and thrombocytopenia syndrome(SFTS),infec-tious mononucleosis(IM)and hemorrhagic fever with renal syndrome(HFRS),and to explore their differences.METHODS Blood routine examination data were collected,including microscopic cell images,scatter-plots and leukocyte CPD study parameters from 44 patients diagnosed with SFTS,17 with IM and 11 with HFRS at the First Affiliated Hospital with Nanjing Medical University from Mar.2023 to May 2024.These data were compared with those of healthy controls to explore specific differences in the characteristics of peripheral blood leu-kocyte.RESULTS All 3 viral infections exhibited a left shift in the nucleus under the microscope,yet the blood routine scatterplot and microscopic leukocyte characteristics differed.SFTS commonly presented with a plasmacy-toid reactive lymphocyte with scattered points appearing in the upper reactive lymphocyte area of the scatterplot.IM showed a predominant irregular fried-egg-like reactive lymphocyte under the microscope,with the scatterplot typically presenting a rocket-like shape,in patients with HFRS,there was a significant increase in im-mature granulocytes in peripheral blood and plasmacytoid reactive lymphocyte scatter points with blue immature granulocyte scatter points visible.The fluorescence distribution width(MO-WY)of monocytes in the SFTS group was lower than those in the IM,HFRS and healthy control groups(P＜0.05).Compared to SFTS,IM and healthy control groups,the lateral scattered light distribution width(NE-WX)and fluorescence distribution width(NE-WY)of neutrophils in the HFRS group were both increased(P＜0.05).CONCLUSIONS There are signifi-cant differences in the characteristics of peripheral blood leukocyte morphology,scatterplot and CPD study param-eters among three viral infection diseases SFTS,IM and HFRS.These differences can provide early clinical advice and assist in clinical differentiation.

As a non-invasive physiological indicator,electroencephalography signal provides an objective assessment of psychological stress levels among nursing staff in major public health emergencies,offering a scientific basis for targeted psychological interventions while overcoming the limitations of subjective bias inherent in traditional questionnaire-based methods.A psychological stress classification model based on bidirectional long short-term memory and attention mechanism is proposed to classify the psychological stress of clinical nurses more effectively by analyzing their electroencephalography signals.Experimental results show that the proposed model exhibits better classification performance than the traditional long short-term memory model on the DREAMER dataset,the Feeling Emotions dataset and the self-built dataset.This study provides a novel approach for assessing psychological stress,which is helpful to improve the pertinence and effectiveness of clinical nursing work.