"Dietary inquiry" is a core component of the diagnostic system in traditional Chinese medicine （TCM）， which can be divided into three aspects including appetite， eating capacity， and food preference. Abnormalities in appetite are mainly attributed to dysfunction of the mind and impaired regulatory mechanisms. Clinical inquiry should focus on hunger sensation and the willingness to eat voluntarily. Treatment should aim to soothe the liver， regulate the spleen， nourish and calm the mind. Abnormalities in eating capacity are related to disorders of qi movement and structural dysfunction， for which inquiry should focus on whether food descends smoothly and on postprandial reactions， and the corresponding treatment is descending qi， relieving fullness， and promoting bowel movement and digestion. Abnormalities in food preference arise from damage caused by the five flavors and imbalance of visceral qi， for which inquiry should focus on dietary preferences and whether eating brings comfort. It is important to distinguish between "stomach preference" and "oral preference"， and treatment should carefully differentiate flavor tendencies and correct imbalances through appropriate dietary flavors. By refining the content of dietary inquiry， this study explores how different dimensions of eating status reflect the holistic concept and syndrome differentiation-based treatment in TCM， providing a reference for the clinical diagnosis and treatment of spleen and stomach diseases and related disorders.

"Dietary inquiry" is a core component of the diagnostic system in traditional Chinese medicine （TCM）， which can be divided into three aspects including appetite， eating capacity， and food preference. Abnormalities in appetite are mainly attributed to dysfunction of the mind and impaired regulatory mechanisms. Clinical inquiry should focus on hunger sensation and the willingness to eat voluntarily. Treatment should aim to soothe the liver， regulate the spleen， nourish and calm the mind. Abnormalities in eating capacity are related to disorders of qi movement and structural dysfunction， for which inquiry should focus on whether food descends smoothly and on postprandial reactions， and the corresponding treatment is descending qi， relieving fullness， and promoting bowel movement and digestion. Abnormalities in food preference arise from damage caused by the five flavors and imbalance of visceral qi， for which inquiry should focus on dietary preferences and whether eating brings comfort. It is important to distinguish between "stomach preference" and "oral preference"， and treatment should carefully differentiate flavor tendencies and correct imbalances through appropriate dietary flavors. By refining the content of dietary inquiry， this study explores how different dimensions of eating status reflect the holistic concept and syndrome differentiation-based treatment in TCM， providing a reference for the clinical diagnosis and treatment of spleen and stomach diseases and related disorders.

OBJECTIVE To explore an intelligent shelf management scheme aimed at enhancing the effective utilization rate of shelves and reducing the risk of dispensing errors for easily confused medicine， thereby facilitating the upgrade of intelligent shelf management in inpatient pharmacies. METHODS An intelligent positioning software based on the “five-level positioning” concept was designed using informational technology. Human-machine collaboration mode was adopted to optimize the shelf management process by integrating priority information， including pharmacological action， drug dosage， packaging color， injection drug type， and label style. Then， the effectiveness of the intelligent positioning software was evaluated comprehensively from multiple aspects such as shelf location arrangement effect， internal dispensing error rate and work experience. RESULTS Compared with the application of intelligent shelf management scheme （April-May， 2025）， the proportion of injectable drugs on the middle layer increased from 59.9% to 78.2% after the application of scheme （June-July， 2025）； the average internal dispensing error rate dropped from 0.098% to 0.049%. Intelligent positioning software ensured precise warehousing positioning， simplified management， reduced dispensing errors and achieved a good experience for pharmacists. In addition， the “intelligent positioning software for pharmaceutical shelf management”， developed based on the “five-level positioning” concept， had been granted one national computer software copyright. CONCLUSIONS In summary， the intelligent positioning software fully considers the actual work needs such as shelf capacity， drug dosage and distance between similar drugs. It can provide accurate prediction of pharmaceutical shelf and optimization scheme， basically achieving dual optimization of low error rate and high dispensing efficiency.

Objective: To retrospectively investigate the clinical efficacy, safety, and management experience of a patient diagnosed with polycythemia vera (PV) at the age of 3 who underwent regular erythrocytapheresis for 7 years starting at the age of 10. Methods: Treatment was initiated when the patient's hematocrit was≥50%. The goal was to reduce the hematocrit to below 40%; the removal volume was calculated as 10%-15% of the total red blood cell mass, and an equal volume of normal saline was supplemented during the procedure. Pre-treatment precautions included avoiding fasting and high-fat diets. Post-treatment measures included lying flat for 30 minutes, reducing strenuous exercise for 2–3 days, and rechecking complete blood count 2–5 days after the procedure. During the procedure, adverse reactions such as palpitations, dyspnea, hypotension, and convulsions were monitored. Follow-up was conducted after 3 days to assess any delayed adverse effects. Results: As of August 2025, the patient had undergone a total of 16 erythrocytapheresis sessions. The average volume ranged from 212 to 500 mL. The frequency was 1 to 4 times annually. Post-procedure, hemoglobin (Hb) and hematocrit (Hct) were effectively controlled. Conclusion: Continuous erythrocytapheresis can effectively control Hb and Hct levels in PV patients, preventing adverse effects from the primary disease. Erythrocytapheresis demonstrates efficacy with minimal adverse reactions and can be used as a routine therapeutic technique for PV patients.

Background/Aims: Dysregulated cholesterol metabolism is a hallmark of hepatocellular carcinoma (HCC) that drives tumor initiation and progression. However, clinical targeting of cholesterol metabolism has yielded limited benefits due to stringent feedback in tumor cells. Identifying a central mediator capable of restoring cholesterol homeostasis within the cell’s intrinsically fine-tuned regulatory framework is urgently needed. Methods: We integrated a proteomic dataset from patients with cholesterol-dysregulated HCC into a global cholesterol metabolic regulatory network to identify potential therapeutic targets for disrupted cholesterol homeostasis. The prognostic significance of the candidate targets was further validated in an independent cohort through immunohistochemistry. Functional and mechanistic studies were conducted in vitro using HCC cell lines and in vivo using mouse models. The pharmacological efficacy of the candidate agent was evaluated in both subcutaneous and orthotopic HCC mouse models. Results: ER lipid raft-associated 1 (ERLIN1), a pivotal regulator of cholesterol metabolism reprogramming, was identified as an independent favorable prognostic indicator in HCC. ERLIN1 constrains HCC progression both in vitro and in vivo by stabilizing the INSIG1–SCAP–SREBP2 axis and maintaining the metabolic balance of intracellular cholesterol. Under hypoxia, impaired factor-inhibiting hypoxia-1-dependent hydroxylation of ASB11 at asparagine residues 90 and 92 enhances ASB11-mediated ERLIN1 degradation. Pharmacological targeting of this axis using zoledronic acid (ZoA) attenuated HCC progression by weakening the ASB11–ERLIN1 interaction and restoring cholesterol homeostasis. Conclusions ERLIN1 represents a druggable metabolic vulnerability in cholesterol-dysregulated HCC. Targeting the ASB11–ERLIN1 axis with the clinically approved ZoA reestablishes cholesterol homeostasis and offers a promising therapeutic strategy to overcome the current limitations of cholesterol-targeted HCC therapies.

Objective:To establish a framework of entrustable professional activity indicators for non-anesthesiology residents during rotation in the Department of Anesthesiology, standardize the training process, and provide an effective evaluation method.Methods:Based on literature review and discussions, a preliminary expert consultation questionnaire was developed. From July to November 2024, a modified Delphi method was adopted and relevant experts were invited to assess the importance, validity, and feasibility of each indicator using a 5-point Likert scale. The results were used to screen and refine the entrustable professional activity indicators for non-anesthesiology residents during rotation in the Department of Anesthesiology.Results:In the two rounds of expert consultation, the valid questionnaire return rate reached 100.00%, with an expert judgment basis coefficient of 0.73 and a familiarity coefficient of 0.90. Based on expert feedback, the final framework retained 3 first-level indicators and 12 second-level indicators. Modifications included renaming "Anesthesia Management" to "Anesthetic Drug Management", swapping the order of "Intraoperative Emergency Management" and "Airway Management", and removing the indicator "Resuscitation Assessment".Conclusions:This study preliminarily developed a framework of entrustable professional activity indicators for non-anesthesiology residents during rotation in the Department of Anesthesiology. The framework provides a simple and practical competency evaluation method for standardized training, which can enhance training quality and effectiveness.

Objective:To learn about the epidemic characteristics and temporal-spatial trends of human anthrax in Shaanxi Province, and to provide a theoretical basis for prevention and control of anthrax.Methods:The epidemic data of human anthrax in Shaanxi Province from 1955 to 2024 were collected for descriptive epidemiological analysis. Joinpoint regression model was used to analyze the trend of anthrax incidence rate. The trend at all times and different intervals were estimated by average annual percent change (AAPC) and annual percent change (APC), respectively. Based on the number of human anthrax cases in each county (district) of Shaanxi Province from 1980 to 2024, datasets were constructed in segments every five years for global and local spatial autocorrelation analysis.Results:From 1955 to 2024, a total of 3 900 cases of human anthrax were reported in Shaanxi Province, with 124 deaths. The average annual incidence rate was 0.18/100 000 and the fatality rate was 3.18%. The incidence rate of human anthrax generally showed a downward trend (AAPC = - 3.21, t = - 1.99, P = 0.044), with the fastest decline rate from 1977 to 1993 (APC = - 15.24, t = - 4.08, P < 0.001). A temporal and regional distribution analysis was conducted on 484 human anthrax cases in Shaanxi Province from 1980 to 2024. The peak period of incidence was from July to September, accounting for 52.27% (253/484). The cities with a relatively high number of reported cases were Weinan City (201 cases), Xianyang City (161 cases), and Xi'an City (77 cases), accounting for a total of 90.70% (439/484). A population distribution analysis was conducted on 93 human anthrax cases in Shaanxi Province from 2005 to 2024, with 73 males (78.49%) and 20 females (21.51%), resulting in a male to female ratio of 3.65 ∶ 1.00. The age range was 13 to 79 years old, with a median of 44 years old. The age group of 35 to 59 years old had a higher case of the disease, accounting for 65.59% (61/93). Farmers were the main occupation, accounting for 87.10% (81/93). The shortest time interval between onset and diagnosis of 93 human anthrax cases was 0 days, the longest was 47 days, and the median was 5 days. The results of global spatial autocorrelation analysis showed that there was spatial positive correlation in human anthrax cases from 1980 to 1984, 1985 to 1989, 2000 to 2004, and 2020 to 2024 (global Moran's I > 0, Z > 1.96, P < 0.05). The results of local spatial autocorrelation analysis showed that the high-high aggregation area of human anthrax cases was concentrated in the Guanzhong region. Conclusions:From 1955 to 2024, the incidence rate of human anthrax in Shaanxi Province generally shows a downward trend. The peak period of incidence is from July to September, and the affected populations are mainly middle-aged male farmers. Human anthrax cases from 1980 to 1984, 1985 to 1989, 2000 to 2004 and 2020 to 2024 show spatial clustering, with high-high clustering areas concentrated in the Guanzhong region.

Objective To explore the strategy of percutaneous balloon compression under local anesthesia for the treatment of primary trigeminal neuralgia.Methods Sixty patients with primary trigeminal neuralgia who underwent percutaneous puncture balloon compres-sion surgery at the Third Affiliated Hospital of Jinzhou Medical University between August 2018 and August 2022 were randomly divided into three groups.Group A received 2％lidocaine(1 mL)before puncturing the foramen ovale and 0.5％lidocaine(0.5 mL)after punc-turing the skull,group B received 2％lidocaine(1 mL)before puncturing the foramen ovale and 0.25％lidocaine(0.5 mL)after entering the skull,and group C received 2％lidocaine(0.5 mL)externally and 0.25％lidocaine 0.5 mL upon intracranial injection.The pain and trigeminal-cardiac reflex as well as postoperative facial pain and numbness experienced by the patients were recorded.Results No statistically significant differences in the Visual Analogue Scale(VAS)scores among the groups were observed before surgical puncture.At the time before foramen ovale puncture,the VAS score and incidence of trigeminal-cardiac reflex in group C were significantly higher than those in groups A and B(P＜0.05).No statistically significant differences were observed among the three groups during balloon com-pression(P＞0.05).After 6 and 12 months of follow-up,no statistically significant differences were observed in the degree of facial pain and numbness among the three groups of patients(P＞0.05).Conclusion A sufficient volume(2％lidocaine,1 mL)of local anesthetic should be administered to ensure an analgesic effect and suppress adverse reflexes before puncturing the foramen ovale.During balloon compression,a low-concentration local anesthetic(0.25％lidocaine,0.5 mL)can also achieve analgesic effects and significantly suppress adverse reflexes.Notably,various local anesthesia methods have no long-term effects.

Objective To establish a mouse model of H1N1 influenza wind-heat syndrome by combining climate intervention with influenza virus nasal drops.Methods Seventy-two BALB/c mice were divided randomly into nine groups:a Control group,wind-heat(FR)groups(FR-3Day,FR-5Day),and Model groups(1LD-3Day,2LD-3Day,3LD-3Day,1LD-5Day,2LD-5Day,2LD-5Day,3LD-5Day)(n=8 mice per group).Mice in the Control group were housed in a normal environment,while mice in the FR and Model groups were kept in wind-heat conditions for 7 d.Mice in the Model groups received nasal PR8 influenza virus infection on the 8th day,and mice in the Control and FR heat groups received equal amounts of physiological saline nasal drops.After virus challenge,each group was housed in a normal environment and samples were taken on days 3 and 5.The appearance of the mice was observed and recorded and the lung index,routine blood parameters,lung tissue pathology,serum interleukin(IL)-6 levels,and virus titers were detected in each group based on their behavioral status,stools,and body temperature.Results After 7 d of wind-heat intervention,mice in the FR groups showed no significant abnormalities in terms of appearance,stools,body temperature,routine blood parameters,or lung tissue pathology compared with the Control group.The appearance,lung index,red blood cell count,hemoglobin,hematocrit,pathological result,and body temperature in the Model groups worsened progressively with increasing time and toxin dosage,while the neutrophil percentage,lymphocyte percentage,virus titer,and serum IL-6 levels peaked on day 3 after viral attack,for the same viral dose,and then decreased slightly on day 5.Conclusions PR8 nasal drops and 7 d of wind-heat climate intervention can be used to establish a mouse model of influenza wind-heat syndrome.

Head and neck squamous cell carcinoma(HNSCC)is the sixth most common malignant tumor in the world.Due to its high incidence,poor prognosis,relapse-prone characteristics,and the existence of treatment resist-ance,HNSCC has a serious impact on patients'daily lives.As a bridge between innate immunity and adaptive immu-nity,dendritic cell(DC)plays a crucial role in tumor progression.In recent years,numerous studies have found that DC has complex and diverse functions in the tumor microenvironment(TME),and has a significant impact on the oc-currence and development of HNSCC.In this article,we provide a review of the mechanism of DC in HNSCC TME.