Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Septic shock is the primary cause of mortality in sepsis, with its core pathophysiological mechanism being severe ischemia and hypoxia in critical units—composed of microcirculation and the mitochondria of functional cells—resulting from disruptions in blood flow and oxygen flow following a dysregulated host response. Due to the systemically convergent yet clinically heterogeneous nature of the host response, current understanding and management strategies for hemodynamics remain inconsistent, often leading to inadequate resuscitation or overtreatment. To improve the quality of care, based on a systematic review of the "blood flow-oxygen flow" theory, an expert panel emphasizes reevaluating septic shock from an integrated perspective of blood flow and oxygen flow, and has formulated the Expert Consensus on Blood Flow and Oxygen Delivery Phenotyping and Clinical Management of Septic Shock (2025). The consensus proposes that clinical typing of blood flow-oxygen flow should comprehensively consider cardiac function, vascular tone, oxygen flow utilization status in critical units, and disease trajectory, while optimizing subtype identification by integrating host response phenotypes and artificial intelligence technologies. It advocates establishing a continuous assessment system through multi-site oxygen flow monitoring for organ perfusion, peripheral perfusion monitoring, and critical care ultrasound. Under the framework of the "critical care triangle", the consensus promotes the implementation of individualized, bundled management strategies, providing guidance for multiple management points to restore blood flow-oxygen flow matching, reduce the risk of organ failure, and decrease patient mortality.

Objective: To analyze the text structure, temporal evolution, and mechanism related shortcomings of policies related to family-school-society collaboration in promoting students physical and mental health in China, thereby providing a reference for improving collaborative mechanisms in the context of health promoting school development. Methods: The PKULAW Laws and Regulations Database was used as the data source. A total of 115 relevant policy documents issued by relevant departments from the founding of the People s Republic of China to May 7, 2026, were included. Drawing on the adolescent health policy analysis framework and adapting it to the Chinese contexts of family-school-society collaborative education, health promoting school development, and interdepartmental collaborative governance, policy text analysis was conducted. Multi label coding was applied to 629 semantic units, and fractional counting was used to calculate the weights of 6 main dimensions and 31 subdimensions and to describe the dimensional composition of the policies and its changes over time. Results: Policies related to family-school-society collaboration in promoting students physical and mental health gradually evolved from early principle based collaboration centered on the ideological and moral development of minors into institutional arrangements supported by the Healthy China initiative, the legal institutionalization of family education, collaborative education mechanisms, and health promoting school development. Among the 6 main dimensions, policy features and costs accounted for 54.8% of the total weight, followed by implementation considerations (22.9%), monitoring and evaluation (9.5%), policy appropriateness (5.6%), inclusion and coverage (4.8%), and participatory approach (2.5%). At the subdimension level, proposed interventions, target population characteristics, intersectoral linkages, consideration of adolescents social ecology, and goal setting accounted for 18.7%, 16.0%, 12.0%, 9.6%, and 9.4% of the total weight, respectively, whereas adolescent participation and the incorporation of young people s voices accounted for only 0.3% and 0.1% , respectively. These findings indicated that the policy texts focused primarily on problem identification, target population specification, and implementation arrangements, while provisions concerning students active participation, identification of differentiated needs, and support from disaggregated data remained relatively limited. Conclusions China has established a policy framework for family-school-society collaboration in promoting students physical and mental health that emphasizes goal setting, responsibility division, and organizational implementation, while gradually extending to specific health promotion tasks. Nevertheless, policy provisions concerning students active participation, the identification of differentiated needs, stratified and category specific monitoring, and the use of evaluation feedback require further specification.

Diabetic macular edema(DME), a serious complication of diabetic retinopathy(DR), is a chronic condition caused by multiple factors. Throughout its progression, inflammatory factors and vascular endothelial growth factor(VEGF)play a critical role. Anti-VEGF drugs have shown significant effectiveness in the treatment of DME; however, some patients may experience persistent DME after injection or require frequent injections. Dexamethasone intravitreal implants(DEX implants)serve as a sustained-release implant characterized by a reasonable release profile and high bioavailability. They offer safe, effective, and prolonged anti-inflammatory effects, aiding in the repair of retinal barrier and reduction of exudation. To further enhance patients' visual quality, exploring the efficacy of DEX implants in combination with existing treatment regimens has great clinical significance. This review primarily discusses the research advancements in DEX implants, focusing on their pharmacological properties, indications for use, and their combination with existing drugs and treatment methods. It also evaluates the advantages and disadvantages of combination therapy or switching to DEX implants compared to current standard treatments, aiming to provide guidance for personalized treatment options for patients with DME.

The brain-gut axis is an important channel to realize the functional integration of the central nervous system and the enteric nervous system between the brain and the intestine. It is the medium for the occurrence and development of depression and plays an important role in the pathogenesis of depression. From the perspective of modern medicine and TCM, based on the theory of "brain-gut axis", this article discussed the operation method and mechanism of acupuncture at abdominal ring acupoint in the treatment of depression in Zhuang medicine, in order to provide new ideas for acupuncture treatment of depression.

Objective To observe the clinical efficacy of acupuncture in treating chronic insomnia disorder based on Huang Yuanyu's theory of"central qi ascending and descending,harmony of the four dimensions"regarding visceral qi movement.Methods Sixty patients diagnosed with chronic insomnia disorder at the Preventive Treatment Department of Yangjiang Hospital of Traditional Chinese Medicine from March 2022 to February 2023.The patients were randomly divided into an observation group and a control group according to a random number table,with 30 cases in each group.The observation group received acupuncture therapy,while the control group received oral administration of Alprazolam Tablets.The treatment duration spanned 4 weeks with 1 course per week.Clinical efficacy was evaluated after 1 month,and the changes in the Pittsburgh Sleep Quality Index(PSQI)scores and Hamilton Anxiety Rating Scale(HAMA)scores were observed.The Hamilton Depression Rating Scale(HAMD)scores were compared between groups before and after treatment.Results(1)After treatment,the PSQI scores of the two groups of patients were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the PSQI scores,and the difference was statistically significant(P＜0.05).(2)After treatment,the HAMA scores and HAMD scores in the two groups of patients were significantly improved(P＜0.05),an the observation group in improvement of HAMA and HAMD was significantly superior to the control group,with statistically statistical significance(P＜0.05).(3)The total effective rate was 83.33%(25/30)in the observation group and 70.00%(21/30)in the control group.The efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P＜0.05).Conclusion Acupuncture based on the ascending and descending of visceral qi movement theory significantly alleviates anxiety and depressive states while improving sleep quality in patients with chronic insomnia disorder,demonstrating notable clinical efficacy.

OBJECTIVE: To observe the effects of point-moxibustion with Zhuang medicinal thread on differentially expressed genes (DEGs) in the dorsal root ganglion (DRG), tissue morphology, and the expression of Fc epsilon RI (FcεRI) pathway proteins spleen tyrosine kinase (Syk) and membrane spanning 4-domain A2 (MS4A2) in rat model of postherpetic neuralgia (PHN), and to explore the potential mechanism by which this therapy alleviates pain sensitization. METHODS: Thirty-nine male Sprague-Dawley (SD) rats were randomly divided into a control group, a model group, and a moxibustion group, with 13 rats in each group. The PHN model was established in the model and moxibustion groups by intraperitoneal injection of resiniferatoxin. In the moxibustion group, bilateral L₄-L₆ "Jiaji" (EX-B2) points were treated with point-moxibustion with Zhuang medicinal thread from day 7 post-modeling, with two cones per acupoint per session, every other day for a total of 10 sessions. Mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) were measured at 1 day before modeling and on days 1, 4, 7, 13, 19, and 25 after modeling. After intervention, HE staining was used to observe DRG morphology. RNA sequencing was performed to analyze DEGs in DRG and conduct bioinformatics analysis. The expression of Syk and MS4A2 mRNA and proteins in the FcεRI pathway in DRG was detected by quantitative PCR and Western blot. RESULTS: Compared with the control group, the model group exhibited decreased MWT (P<0.05) and increased TWL (P<0.05); histopathological analysis revealed neuronal atrophy, nuclear displacement, and intracellular vacuoles, with a slightly loose arrangement; the RNA-Seq identified 3,207 DEGs (1,997 upregulated and 1,210 downregulated); the mRNA and protein expression levels of Syk and MS4A2 were significantly increased (P<0.01). Compared with the model group, the moxibustion group showed increased MWT (P<0.05) and decreased TWL (P<0.05), with relatively normal neuronal morphology; the RNA-Seq identified 426 DEGs (250 upregulated and 176 downregulated); the mRNA and protein expression levels of Syk and MS4A2 were significantly decreased (P<0.05). Venn diagram analysis identified 156 DEGs that showed a reversal in expression trends after treatment, including Syk and MS4A2, which are associated with pain sensitization. KEGG pathway analysis indicated that these DEGs were primarily enriched in the FcεRI pathway. CONCLUSION Point-moxibustion with Zhuang medicinal thread could alleviate pain sensitization in PHN rats, possibly by inhibiting the FcεRI signaling pathway and downregulating the expression of Syk and MS4A2.
Animals ; Rats, Sprague-Dawley ; Male ; Rats ; Moxibustion ; Neuralgia, Postherpetic/physiopathology* ; Syk Kinase/metabolism* ; Acupuncture Points ; Humans ; Ganglia, Spinal/metabolism* ; Signal Transduction

Objective: To analyse the influence path of family economic status on adolescent depressive symptoms, and to explore the chained mediation role of peer relationship and self satisfaction, as well as the moderating effect of the parent-child relationship, so as to provide a theoretical basis for the prevention and control of adolescent depressive symptoms. Methods: Data were obtained from the Database of Youth Health （DYH） in the National Population Health Science Data Center, and a total of 11 277 samples were included. Questionnaires were used to obtain information on family economic status, peer relationship, self satisfaction, parent-child relationship and depressive symptoms. Spearman correlation analysis was used to examine correlations among variables. Hierarchical linear regression analysis was used to analyze effects of family economic status and parent-child relationship on depressive symptom scores. The Process macro program was adopted to test the chained mediating effects of peer relationship and self satisfaction and the moderating effect of parent-child relationship. Results: The prevalence rate of depressive symptoms among adolescents was 24.2%. The prevalence rates of depressive symptoms significantly differed among adolescents with different family economic status and places of residence( χ 2=210.12, 4.18, both P ＜0.05). Adolescents with depressive symptoms had significantly lower scores on peer relationship, self satisfaction, and parent-child relationship compared to those without depressive symptoms ( t = 27.76 , 42.43, 31.12, all P ＜0.05). Family economic status were negatively correlated with adolescent depressive symptom scores ( B =-0.12, P <0.05).Parent-child relationship was negatively correlated with depressive symptom scores ( B = -0.02 , P < 0.05 ). After introducing the parent-child relationship, the negative effect of family economic conditions was reduced ( B = -0.08, P ＜ 0.01). Family economic conditions affected depressive symptoms through the chained mediating pathway involving peer relationship ( B = 2.07 ) and self satisfaction ( B =3.88)(both P <0.05). The parent-child relationship moderated this pathway: under conditions of high quality parent child relationship, the effect of family economic status on peer relationships was weaker ( B = 0.15); under low quality parent-child relationship, the positive effect of family economic status on peer relationships was enhanced ( B = 1.15 ) (both P ＜0.01). Conclusions Family economic status exert both direct and chain mediating effects on adolescent depression, and high quality parent-child relationship can play a protective moderation role. For economically disadvantaged families, it is critical to synergistically enhance parent-child relationship and social support in order to reduce depression risk among adolescents.

Objective: To systematically review the development and changes in mental health policies within the National Outline for Children s Development in China from 1992 to 2030, providing a reference basis for future formulation of mental health policies among children and adolescent in China. Methods: Based on the four editions of the National Outline for Children s Development in China across different periods from 1992 to 2030, word frequency analysis was used to reveal shifts in policy priorities, and an internationally recognized framework for adolescent health policy analysis was applied to conduct a textual review. Results: Word frequency analysis revealed that the term "psychological" appeared 6 times in the National Outline for Children s Development in China (2001-2010) but increased to 20 times in the National Outline for Children s Development in China (2021-2030) (abbreviated as the National Outline of 2021), while the term "health" rose from 4 times in the National Outline for Children s Development Plan in China in the 1990s to 68 times in the National Outline of 2021. The scope of mental health policy interventions expanded to encompass five key areas:health, safety, education, welfare and legal protection. Textual analysis highlighted that the policies of the National Outline for Children s Development in China were demand driven, prioritized vulnerable groups and continuously broadened their coverage, emphasizing sustainability and appropriateness, and monitoring/evaluation mechanisms. By 2023, 42.3% of primary schools and 64.8% of secondary schools employed full time mental health education teachers. However, the National Outline for Children s Development in China lacked direct evidence of children and adolescents participation in policy formulation, and publicly available mental health data disaggregated by age and gender remained limited. Conclusion Mental health policies of children and adolescents in China have evolved from nonexistence to gradual refinement, yet institutionalized channels for youth involvement in policy development and evaluation remain insufficient, and transparency in age and gender specific mental health data needs improvement.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Circulating fetal cells have been proven to contain complete cellular structures and comprehensive fetal genome information, enabling non-invasive prenatal diagnosis of aneuploidy diseases, chromosomal microdeletions, and monogenic diseases. However, due to the low abundance of these rare fetal cells in maternal peripheral blood, their isolation and detection remains challenging. In recent years, novel isolation and enrichment techniques, such as microfluidic technologies and novel nanomaterials, for circulating fetal cells enrichment have been continuously advancing.This review provides a comprehensive summary of two novel methodologies for the isolation and enrichment of circulating fetal cells. Their separation principles, advantages, limitations, as well as the separation efficiencies will also be described.