OBJECTIVE To systematically evaluate the effects of supplementation with different doses of vitamin D on maternal and infant outcomes in vitamin D-deficient pregnant women. METHODS Related literature on the effects of supplementing different doses of vitamin D on maternal and infant outcomes was searched in databases including CNKI， Wanfang Data， VIP， PubMed， Medline， the Cochrane Library， Embase from their inception to June 30， 2025. The risk of bias assessment tool from the Cochrane Handbook 5.1 was used to evaluate the quality of included literature. Meta-analysis of outcome indicators was performed by using RevMan 5.4 software. RESULTS A total of 15 studies were included， involving 4 664 patients [2 129 in the experimental group （daily dose ＞2 000 IU）， 2 058 in control group 1 （daily dose ≤1 000 IU） and 477 in control group 2 （daily dose ＞1 000-≤2 000 IU） ] . Meta-analysis results showed that the incidence of preeclampsia （PE） [OR＝0.71， 95%CI （0.53， 0.96）， P ＝0.03 ] ， gestational diabetes mellitus （GDM） [OR＝0.60， 95%CI （0.43， 0.84）， P ＝0.003 ] ， low birth weight of newborn [OR＝0.72， 95%CI （0.53， 0.97）， P ＝0.03 ] and macrosomia [OR＝0.53， 95%CI （0.29， 0.98）， P ＝0.04 ] in the experimental group were significant lower than control group 1； but there was no significant difference in the incidence of premature delivery [OR＝0.86， 95%CI （0.65， 1.13）， P ＝0.28 ] ， cesarean delivery [OR＝0.92， 95%CI （0.74， 1.15）， P ＝0.48 ] or stillbirth rate [OR＝0.77， 95%CI （0.48， 1.24）， P ＝0.29 ] . The incidence of low birth weight of ne wborn [OR＝0.64， 95%CI （0.41， 0.98）， P ＝0.04 ] in the experimental group was significant lower than control group 2； but there was no significant difference in the incidence of PE [OR＝0.61， 95%CI （0.25， 1.49）， P ＝0.28 ] ， the incidence of GDM [OR＝0.73， 95%CI （0.42， 1.24）， P ＝0.24 ] ， premature delivery rate [OR＝0.90， 95%CI （0.59， 1.39）， P ＝0.63 ] ， cesarean delivery rate [OR＝0.92， 95%CI （0.64， 1.33）， P ＝0.66 ] ， or stillbirth rate [OR＝0.68， 95%CI （0.24， 1.94）， P ＝0.48 ] . CONCLUSIONS Different doses of vitamin D supplementation in early pregnancy have a significant impact on maternal and infant pregnancy outcomes in vitamin D-deficient pregnant women； daily doses ＞2 000 IU have significant advantages in reducing the incidence of PE and GDM and improving the outcome of premature delivery.

ObjectiveBased on the theory of "spleen governing transportation and transformation"， this study investigates the efficacy of Atractylodis Macrocephalae Rhizoma processed with Aurantii Fructus Immaturus juice（AMR-AFI） in improving slow-transit constipation（STC）， as well as the synergistic regulatory mechanism involving the microbiota-metabolism axis， thereby elucidating the scientific basis of its processing theory. MethodsAnimals were randomly divided into the control group， model group， positive drug（mosapride） group（3 mg·kg^-1）， and low-， medium-， and high-dose groups of AMR-AFI（3.9， 7.8， 15.6 g·kg^-1）. Except for the control group， the remaining five groups were induced with STC using loperamide hydrochloride. Following modeling， interventions were administered. All groups received continuous administration for 15 d， during which fecal samples， colon tissue， and serum were collected. Constipation improvement was assessed by measuring fecal moisture content and small intestinal propulsion rate， histological morphology of colonic tissue was observed via hematoxylin-eosin（HE） staining， and the levels of interleukin（IL）-6， tumor necrosis factor（TNF）-α， and IL-2 in serum were detected using enzyme-linked immunosorbent assay（ELISA）. Furthermore， the microbial community structure in mouse feces was analyzed by 16S rRNA sequencing， while transcriptomic sequencing was employed to screen differentially expressed genes in colonic tissue， followed by gene ontology（GO） and Kyoto Encyclopedia of Genes and Genomes（KEGG） enrichment analyses. Finally， Spearman correlation analysis was conducted to explore the association between differential microbiota and differential genes. ResultsCompared with the control group， the intestinal propulsion rate and fecal moisture content in the model group were significantly decreased（P<0.01）， while serum levels of IL-6， TNF-α， and IL-2 were significantly elevated（P<0.01）. HE staining showed damage and shedding of colonic mucosal epithelial cells， along with a reduction in goblet cells in the model group. In comparison with the model group， all treatment groups improved the pathological state of the colonic mucosa to varying degrees and reduced serum levels of IL-6， TNF-α， and IL-2（P<0.01）. Among these， the high-dose group of AMR-AFI significantly increased the intestinal propulsion rate and fecal moisture content of rats（P<0.05， P<0.01）. Further transcriptomic analysis revealed that a total of 104 differentially expressed genes were identified from comparisons between the model group and the control group， as well as between the model group and the high-dose group of AMR-AFI. These genes were mainly enriched in pathways closely related to STC pathogenesis， such as arachidonic acid metabolism and aldosterone-regulated sodium reabsorption. 16S rRNA sequencing results indicated that AMR-AFI reversed the structural imbalance of the gut microbiota in model mice， increased species richness， downregulated the relative abundance of pro-inflammatory bacteria such as Parasutterella， and enriched beneficial and butyrate-producing bacteria， including Lachnospiraceae_NK4A136_group， Ruminococcaceae， and Lachnospiraceae. Spearman correlation analysis further showed that the beneficial bacteria enriched in the AMR-AFI group were negatively correlated with genes involved in the arachidonic acid metabolic pathway and positively correlated with genes in the aldosterone-regulated sodium reabsorption pathway. In contrast， pro-inflammatory bacteria in the model group exhibited the opposite correlation trends. ConclusionAMR-AFI can effectively exert synergistic therapeutic effects on STC by regulating intestinal microbiota， arachidonic acid-mediated inflammatory metabolism， and aldosterone-regulated water-salt balance pathways.

ObjectiveBased on the theory of "spleen governing transportation and transformation"， this study investigates the efficacy of Atractylodis Macrocephalae Rhizoma processed with Aurantii Fructus Immaturus juice（AMR-AFI） in improving slow-transit constipation（STC）， as well as the synergistic regulatory mechanism involving the microbiota-metabolism axis， thereby elucidating the scientific basis of its processing theory. MethodsAnimals were randomly divided into the control group， model group， positive drug（mosapride） group（3 mg·kg^-1）， and low-， medium-， and high-dose groups of AMR-AFI（3.9， 7.8， 15.6 g·kg^-1）. Except for the control group， the remaining five groups were induced with STC using loperamide hydrochloride. Following modeling， interventions were administered. All groups received continuous administration for 15 d， during which fecal samples， colon tissue， and serum were collected. Constipation improvement was assessed by measuring fecal moisture content and small intestinal propulsion rate， histological morphology of colonic tissue was observed via hematoxylin-eosin（HE） staining， and the levels of interleukin（IL）-6， tumor necrosis factor（TNF）-α， and IL-2 in serum were detected using enzyme-linked immunosorbent assay（ELISA）. Furthermore， the microbial community structure in mouse feces was analyzed by 16S rRNA sequencing， while transcriptomic sequencing was employed to screen differentially expressed genes in colonic tissue， followed by gene ontology（GO） and Kyoto Encyclopedia of Genes and Genomes（KEGG） enrichment analyses. Finally， Spearman correlation analysis was conducted to explore the association between differential microbiota and differential genes. ResultsCompared with the control group， the intestinal propulsion rate and fecal moisture content in the model group were significantly decreased（P<0.01）， while serum levels of IL-6， TNF-α， and IL-2 were significantly elevated（P<0.01）. HE staining showed damage and shedding of colonic mucosal epithelial cells， along with a reduction in goblet cells in the model group. In comparison with the model group， all treatment groups improved the pathological state of the colonic mucosa to varying degrees and reduced serum levels of IL-6， TNF-α， and IL-2（P<0.01）. Among these， the high-dose group of AMR-AFI significantly increased the intestinal propulsion rate and fecal moisture content of rats（P<0.05， P<0.01）. Further transcriptomic analysis revealed that a total of 104 differentially expressed genes were identified from comparisons between the model group and the control group， as well as between the model group and the high-dose group of AMR-AFI. These genes were mainly enriched in pathways closely related to STC pathogenesis， such as arachidonic acid metabolism and aldosterone-regulated sodium reabsorption. 16S rRNA sequencing results indicated that AMR-AFI reversed the structural imbalance of the gut microbiota in model mice， increased species richness， downregulated the relative abundance of pro-inflammatory bacteria such as Parasutterella， and enriched beneficial and butyrate-producing bacteria， including Lachnospiraceae_NK4A136_group， Ruminococcaceae， and Lachnospiraceae. Spearman correlation analysis further showed that the beneficial bacteria enriched in the AMR-AFI group were negatively correlated with genes involved in the arachidonic acid metabolic pathway and positively correlated with genes in the aldosterone-regulated sodium reabsorption pathway. In contrast， pro-inflammatory bacteria in the model group exhibited the opposite correlation trends. ConclusionAMR-AFI can effectively exert synergistic therapeutic effects on STC by regulating intestinal microbiota， arachidonic acid-mediated inflammatory metabolism， and aldosterone-regulated water-salt balance pathways.

ObjectiveTaking Aurantii Fructus Immaturus juice（AFI）-processed Atractylodis Macrocephalae Rhizoma（AMR） as an example， this study aims to systematically compare the volatile and non-volatile components of AMR and its processed products， investigate the key differential components， evaluate their anti-inflammatory activities， and elucidate the synergistic mechanism of processing. MethodsThe chemical compositions of volatile and non-volatile components in AMR and AFI-processed AMR were systematically characterized using gas chromatography-mass spectrometry（GC-MS） and ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry（UPLC-Q-TOF-MS）， with relative mass fractions and response values determined separately. Volatile components were identified through searches in the National Institute of Standards and Technology（NIST）17 database， comparison with retention index（RI） and fragmentation pattern matching. Non-volatile components were identified by searching Waters Traditional Chinese Medicine （TCM） spectral library， in conjunction with PubChem and MassBank， characteristic fragmentation patterns and response values were also used to support identification. Differential components were screened using principal component analysis（PCA）， orthogonal partial least squares-discriminant analysis（OPLS-DA）， with variable importance in the projection（VIP） value >1. Components with high log₂fold change（FC） among major differential groups were selected as those exhibiting significant changes before and after processing. The anti-inflammatory activity of the differential compounds was evaluated by assessing their effects on nitric oxide（NO） production in a lipopolysaccharide（LPS）-induced RAW264.7 macrophage model. Enzyme-linked immunosorbent assay（ELISA） was used to detect the effects of the differential components on tumor necrosis factor（TNF）-α， interleukin（IL）-1β， IL-6， and monocyte chemotactic protein（MCP）-1 levels， and immunofluorescence（IF） was employed to assess their effects on nuclear transcription factor（NF）-κB p65 translocation， thereby elucidating the underlying molecular mechanisms. ResultsA total of 36 compounds were identified in the volatile components of AMR and AFI-processed AMR， among which， sesquiterpenes and monoterpenes were significantly increased after processing. In the non-volatile components， 36 compounds were identified， and the main differential components were flavonoids， sesquiterpenoids， and triterpenoids. Flavonoids were the primary differential components distinguishing AMR from its processed products， representing compounds directly introduced during processing. Five compounds， including atractylenolide Ⅲ， tangeritin， nobiletin， hesperidin and narirutin， were selected as representatives of three classes based on their most prominent differential expression among different compound types for subsequent anti-inflammatory activity studies. The results showed that 100 μmol·L^-1 tangerine and narirutin could significantly inhibit LPS-induced NO production（P<0.01） in a concentration-dependent manner. Tangeritin was able to significantly inhibit the levels of TNF-α and MCP-1 secreted by RAW264.7（P<0.05）， while narirutin significantly inhibited the levels of TNF-α， IL-1β， MCP-1 and IL-6（P<0.01）. IF revealed that both tangeritin and narirutin significantly blocked the translocation of NF-κB p65 from the cytoplasm to the nucleus. ConclusionAFI-processed AMR significantly alters the chemical composition profile of AMR， and the newly introduced flavonoid components during processing may be key to its enhanced anti-inflammatory effects.

Objective To investigate the epidemiological characteristics of lymphoma mortality and potential years of life lost among Wuhan residents, and to provide a scientific basis for the prevention and control of lymphoma. Methods Data on lymphoma deaths among residents in Wuhan from 2010 to 2019 were collected from the population-based Wuhan Mortality Surveillance System. Joinpoint regression model was used to evaluate the trends in age-standardized mortality rates and potential years of life lost due to lymphoma among the residents of different ages and genders. Potential years of life lost rate was used to assess the disease burden. Results There were 4 055 deaths (2481in male and 1 574 in female) from major kidney diseases in Wuhan residents between 2010 to 2019, with an age-standardized mortality rate of 5.11/100 000. The mortality rate of major kidney diseases showed an upward trend with increasing age. Between 2010 and 2019, the age-standardized mortality rates of the multiple myeloma and non-Hodgkin lymphoma were significantly increased (APC=6.924%, APC=1.407%, P＜0.05), and the potential years of life lost rate of non-Hodgkin lymphoma in female were significantly increased (APC=7.935%，P＜0.05). Conclusion From 2010 to 2019, the mortality rate of lymphoma among residents of Wuhan City shows an upward trend, especially for multiple myeloma and non-Hodgkin lymphoma. The disease burden of multiple myeloma shows an increasing trend in the female population, suggesting the need to take corresponding preventive and control measures.

OBJECTIVE Based on comment texts from the Weibo platform， this study adopts the text mining method to systematically analyze the public’s emotional attitudes and core concerns of “medical insurance reimbursement”， and explore the public’s real experiences and feedback in the implementation of the current system. METHODS With “medical insurance reimbursement” as the keyword， Python web crawler technology was used to collect Weibo comment texts from December 2023 to April 2025. Word frequency analysis， sentiment analysis， semantic network analysis and Latent Dirichlet Allocation （LDA） topic models were adopted to mine the in-depth features of comment texts and investigate the public’s concerns and emotional attitudes toward “medical insurance reimbursement”. RESULTS A total of 3 645 valid comment texts were obtained. The overall emotional of the public toward “medical insurance reimbursement” was weakly positive： 66.4% of the comments contained positive emotions， and 32.4% contained negative emotions. Semantic network analysis indicated that positive public emotions mainly centered on the achievements of medical insurance reform and the improvement of security level， while negative emotions mainly focused on reimbursement rules， economic burden and the implementation of medical insurance policies. The LDA model identified eight core themes， mainly including access of new drugs to medical insurance catalogs， medical insurance support for traditional Chinese medicine and biomedicine， disputes over medical insurance coverage of specific medical items， cross-regional medical treatment and medical insurance settlement， medical insurance reimbursement and medical burden， as well as the approval of innovative drugs and medical insurance payment. CONCLUSIONS The public generally holds a positive attitude toward “medical insurance reimbursement”， yet still has many expectations in terms of policy implementation. On the premise of guaranteeing the sustainability of medical insurance funds， it is suggested to further improve the transparency and fairness of the reimbursement process， and promote the scientific， standardized and efficient development of the medical insurance system. Meanwhile， attention should be paid to public opinion feedback on social media， and the policy communication mechanism should be strengthened， so as to enhance the public’s sense of gain and trust in the medical insurance system.

OBJECTIVE Based on comment texts from the Weibo platform， this study adopts the text mining method to systematically analyze the public’s emotional attitudes and core concerns of “medical insurance reimbursement”， and explore the public’s real experiences and feedback in the implementation of the current system. METHODS With “medical insurance reimbursement” as the keyword， Python web crawler technology was used to collect Weibo comment texts from December 2023 to April 2025. Word frequency analysis， sentiment analysis， semantic network analysis and Latent Dirichlet Allocation （LDA） topic models were adopted to mine the in-depth features of comment texts and investigate the public’s concerns and emotional attitudes toward “medical insurance reimbursement”. RESULTS A total of 3 645 valid comment texts were obtained. The overall emotional of the public toward “medical insurance reimbursement” was weakly positive： 66.4% of the comments contained positive emotions， and 32.4% contained negative emotions. Semantic network analysis indicated that positive public emotions mainly centered on the achievements of medical insurance reform and the improvement of security level， while negative emotions mainly focused on reimbursement rules， economic burden and the implementation of medical insurance policies. The LDA model identified eight core themes， mainly including access of new drugs to medical insurance catalogs， medical insurance support for traditional Chinese medicine and biomedicine， disputes over medical insurance coverage of specific medical items， cross-regional medical treatment and medical insurance settlement， medical insurance reimbursement and medical burden， as well as the approval of innovative drugs and medical insurance payment. CONCLUSIONS The public generally holds a positive attitude toward “medical insurance reimbursement”， yet still has many expectations in terms of policy implementation. On the premise of guaranteeing the sustainability of medical insurance funds， it is suggested to further improve the transparency and fairness of the reimbursement process， and promote the scientific， standardized and efficient development of the medical insurance system. Meanwhile， attention should be paid to public opinion feedback on social media， and the policy communication mechanism should be strengthened， so as to enhance the public’s sense of gain and trust in the medical insurance system.

ObjectiveTo explore the efficacy and potential neural mechanisms of individualized precision rehabilitation combining multimodal neuromodulation technologies under the guidance of multidisciplinary team (MDT)-based whole process dynamic assessment in a patient with large-area cerebral infarction who responded poorly to conventional rehabilitation. MethodsA 38-year-old male patient presented with hemiplegia and complete aphasia following large-area cerebral infarction in the left fronto-temporo-parietal lobe and basal ganglia due to arterial dissection. Under the MDT framework, the patient underwent six months of inpatient rehabilitation and one month of outpatient follow-up. Multimodal assessments were performed at multiple time points using diffusion tensor imaging (DTI), functional magnetic resonance imaging (fMRI), three-dimensional gait analysis and 128-channel electroencephalogram (EEG) monitoring, combined with standardized scales, such as Chinese Rehabilitation Research Center Standard Aphasia Examination (CRRCAE), Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), simplified Fugl-Meyer Assessment (FMA) and modified Barthel Index (MBI). The rehabilitation protocol integrated conventional therapies with multimodal interventions, including multi-target transcranial magnetic stimulation, brain-computer interface (BCI)-driven robotic hand training and task-oriented virtual reality upper limb training. ResultsAfter intervention, the patient showed significant improvements: LOTCA score increased by 16 points, CRRCAE subscale scores improved by 60% to 90%, total FMA score increased from 20 to 54, FMA-Balance reached 12, and MBI improved from 40 to 91. DTI revealed an increase in global fiber tract count, elevated fractional anisotropy in the corpus callosum and right corticospinal tract, and significantly increased amplitude of low-frequency fluctuations and regional homogeneity in specific brain regions on fMRI. Event-related desynchronization dynamically decreased during BCI training, and three-dimensional gait parameters showed overall improvement. ConclusionFor patients with large-area stroke who respond inadequately to conventional rehabilitation, an individualized precision rehabilitation system based on MDT whole-process dynamic assessment and integrating multimodal neuromodulation with conventional therapy can effectively enhance cognitive, language, motor functions and activities of daily living. Neuroimaging and electrophysiological findings suggest that the mechanism may involve promoting neural fiber remodeling and modulating regional brain activity.

ObjectiveTo explore the listed varieties and prescription characteristics of Chinese patent medicines for stroke in China， explore the medication rules of Chinese medicine for stroke， and provide guidance for further clinical research and development of Chinese patent medicines. MethodsExcel 2021 and the Ancient and Modern Medical Record Cloud Platform （V2.3.5） were used to systematically mine and analyze the varieties and prescriptions of Chinese patent medicines for stroke in China. ResultsA total of 244 Chinese patent medicines （two for different dosage forms of the same prescription）， 1 736 approval documents for Chinese patent medicines， 792 manufacturers， and 83 varieties of protected Chinese patent medicines were finally included in the database. The top three dosage forms were capsules （75）， pills （53）， and tablets （42）. There were 28 Chinese patent medicines for stroke in the National Essential Drug Catalogue （2018）， 129 in the National Essential Medical Insurance， Industrial Injury Insurance and Maternity Insurance Drug Catalogue （2023）， and 4 in the National Non-prescription Drug Catalogue. Among the 138 prescriptions screened out， Chinese patent medicines mainly treated stroke patients with the syndrome of Qi deficiency and blood stasis. The top three most frequent medicinal herbs were Chuanxiong Rhizoma （63）， Pheretima （47）， and Salviae Miltiorrhizae Radix et Rhizoma （47）. The medicinal herbs used were mainly warm， pungent， with the meridian tropism to the liver meridian. The correlation analysis showed that the herb pair with the highest support was Astragali Radix-Chuanxiong Rhizoma， and that with the highest confidence was Carthami Flos-Chuanxiong Rhizoma. Five herb combinations were identified based on the cluster analysis. ConclusionThe Chinese patent medicines for stroke mainly treat patients with the syndrome of Qi deficiency and blood stasis. The medicinal herbs used in the prescriptions mainly have the functions of activating blood and resolving stasis， extinguishing wind and stopping convulsions. Drug compatibility usually focuses on activating blood and resolving stasis， as well as expelling phlegm and opening orifices. This review of the varieties and prescription characteristics of Chinese patent medicines for stroke helps optimize clinical decision-making， guide drug research and development， promote medical research and scientific progress， and provide more effective support and guarantee for the treatment of stroke patients.

Objective To establish a classification tree model for non-alcoholic fatty liver disease(NAFLD)among aircrews,screen for influencing factors of NAFLD,so as to provide scientific basis for prevention and intervention decisions for NAFLD.Methods Aircrews who underwent recuperation at a sanatorium from January 2019 to December 2023 were selected as the research objects.Their annual physical examination data were collected and the NAFLD detection rate was calculated.Age,body mass index(BMI),blood pressure,waist circumference,blood routine,biochemistry indexes,and thyroid function were incorporated,and a NAFLD risk model was constructed using classification regression tree method.The predictive performance of the NAFLD classification tree model was evaluated through model misclassification matrix,risk statistics,and receiver operating characteristic curve.Results A total of 4088 aircrews were included in the study,and NAFLD was detected in 380 persons(380/4088,9.30%).The NAFLD model consisted of three layers,and five explanatory variables affecting the onset of NAFLD were extracted,including BMI,triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),alanine aminotransferase(ALT),and total bilirubin(TBIL).BMI was located at the top of the classification tree and was the most important risk factor for NAFLD in aircrews.The area under the curve(AUC)of the model was 0.853.The predictive accuracy of NAFLD was 90.9%,indicating that the model has good accuracy and fitting effect.Conclusion In this study,the detection rate of NAFLD in aircrews was 9.30%.BMI,TG,HDL-C,ALT,and TBIL are risk factors for the onset of NAFLD.NAFLD is mainly related to weight gain and lipid metabolism disorders caused by unhealthy lifestyles.