Sepsis is a systemic inflammatory response syndrome triggered by infection. It progresses rapidly and tends to develop into multiple organ dysfunction. Tanshinone ⅡA， one of the core active ingredients of Salvia miltiorrhiza， exerts remarkable targeted protective effects against sepsis-induced multiple organ dysfunction. This paper reviews the mechanisms by which tanshinone ⅡA alleviates sepsis-induced multiple organ dysfunction. Tanshinone ⅡA can relieve sepsis-induced lung injury by inhibiting the activity of Toll-like receptor 4/myeloid differentiation primary response protein 88/nuclear factor- κB， phosphatidylinositol 3-kinase/protein kinase B signaling pathways and maintaining mitochondrial homeostasis. It ameliorates sepsis- induced myocardial injury via suppressing the activation of NOD-like receptor family pyrin domain-containing 3/caspase-1 signaling pathway， downregulating the expression of inflammatory factors and regulating autophagy. It mitigates sepsis-induced renal injury by regulating oxidative stress imbalance and reducing the expression of apoptosis-related proteins. It alleviates sepsis-caused liver injury through inhibiting the release of inflammatory factors and hepatocyte apoptosis. It improves sepsis-induced intestinal barrier dysfunction by upregulating the expression of tight junction proteins and restraining inflammatory responses. Furthermore， it relieves sepsis-associated encephalopathy by activating peroxisome proliferator-activated receptor gamma coactivator-1α/nuclear respiratory factor 1/mitochondrial transcription factor A signaling pathway. Tanshinone ⅡA is expected to be a vital candidate drug for comprehensive prevention and treatment of sepsis. However， interdisciplinary research is required to break through current bottlenecks and realize the transformation from basic experiments to clinical application.

Background The health effects of environmental exposures are often characterized by complex interactions. However, evidence on the joint health effects of ambient oxidizing pollutants and air temperature in the cold regions of Northern China remains limited. Objective To examine the independent and interactive effects of atmospheric oxidizing pollutants and air temperature on daily mortality among residents of Hohhot. Methods Daily data on air quality, meteorological factors, and cause-specific mortality in Hohhot from 2018 to2023 were collected. A quasi-Poisson generalized additive model (GAM) combined with a distributed lag non-linear model (DLNM) was used to examine the effects of ambient oxidant pollutants [ozone (O₃), nitrogen dioxide (NO₂), and total oxidant (Oₓ)] and air temperature on daily circulatory and respiratory mortality. Potential interactions between oxidizing pollutants and temperature were evaluated using bivariate exposure–response surface models and quantified through stratified analyses. Results For each 10 μg·m⁻³ increase in O₃, O_X, and NO₂ concentrations, the strongest associations with circulatory disease mortality occurred at lag1, with excess risks (ERs) of 1.10% (95%CI: 0.50%, 1.71%), 1.84% (95%CI: 0.94%, 2.75%), and 1.49% (95%CI: 0.36%, 2.62%), respectively. The strongest associations of O₃ and O_X with respiratory disease mortality were observed at lag2, with ERs of 1.61% (95%CI: 0.61%, 2.62%) and 2.61% (95%CI: 1.61%, 3.62%), respectively. NO₂ showed the strongest cumulative association with respiratory disease mortality at lag02, with an ER of 3.22% (95%CI: 1.24%, 5.25%). High temperature exhibited immediate or short-term effects, while low temperature showed lagged effects. The exposure–response relationships between temperature and mortality risks for respiratory circulatory diseases were U-shaped. Positive additive interactions were observed between high temperature and high concentrations of O₃ and O_X. For the joint exposure to high temperature and high O₃, the relative excess risks due to interaction (RERIs) for circulatory and respiratory disease mortality were 0.131 (95%CI: 0.086, 0.176) and 0.279 (95%CI: 0.198, 0.360), respectively. For the joint exposure to high temperature and high O_X, the corresponding RERI values were 0.080 (95%CI: 0.038, 0.123) and 0.154 (95%CI: 0.074, 0.234), respectively. In contrast, high temperature and high NO₂ concentration exhibited antagonistic or attenuating interactions. Conclusion Ambient oxidizing pollutants, high temperature, and low temperature are independently associated with increased circulatory and respiratory disease mortality. High temperature combined with high concentrations of O₃ or O_X exerts positive additive interactions, with the respiratory system showing particular vulnerability. The mortality risks associated with NO₂ are more pronounced under low temperature conditions, whereas its interaction with high temperature appear antagonistic, suggesting a temperature-dependent risk-modifying effect.

Objective: To analyze the whole genome characteristics of Salmonella in diarrhea cases in Hohhot City, so as to provide the evidence for the prevention and control of Salmonella infection and rational clinical use of antibiotics. Methods: Salmonella strains were isolated and identified from fecal specimens of acute diarrhea cases at sentinel hospitals for national foodborne disease surveillance in Hohhot City from 2021 to 2023. DNA was extracted for whole genome sequencing. Bioinformatics analysis based on the Microobench Pathogen Genome Analysis System was conducted to determine serotypes, multi-locus sequence typing (MLST), drug resistance genes, and virulence genes. Additionally, 60 Salmonella genomic sequences from different regions across China were downloaded from the NCBI Genome database. A phylogenetic tree was constructed based on core-genome MLST (cgMLST) to analyze the phylogenetic relationship between strains from Hohhot City and those from other regions of China. Results: From 2021 to 2023, a total of 42 Salmonella strains isolated in Hohhot City were classified into 12 serotypes. Salmonella Enteritidis ST11, Salmonella I 4,[5],12:i:- ST34, and Salmonella Typhimurium ST19 were identified as the dominant strains, represented by 13, 10, and 6 isolates, which accounted for 30.95%, 23.81%, and 14.29%, respectively. Seventy-seven drug resistance genes belonging to 12 classes were detected. Among them, 17 Salmonella strains carried amino acid substitutions in the fluoroquinolone resistance-determining region caused by mutations at the gyrA and parC loci. Virulence genes covered all stages of Salmonella pathogenesis, with a predominance of genes associated with adhesion. Phylogenetic tree analysis results revealed that the 42 Salmonella strains from Hohhot City were distributed across evolutionary branches A, B, C, D, and F. They clustered with 60 strains from other regions of China, suggesting potential cross-regional transmission. Conclusions Salmonella strains isolated in Hohhot City exhibited diverse serotypes, carried multiple drug resistance genes and virulence genes, and displayed high genetic diversity. These findings indicate a potential risk of cross-regional transmission, highlighting the need for enhanced surveillance and prevention measures.

Background Exposure to ozone (O₃) is closely associated with an increased risk of mortality in the population, but this association exhibits regional heterogeneity, and relevant research in northern and central-western China is limited. Hohhot, as a typical city in the northern and western region, has seen a significant upward trend in O₃ concentrations (an increase of 17.9 μg·m⁻³ in 2020 compared to 2016). Studies targeting this region can fill the regional research gap. Objective To evaluate the health effects of ground-level O₃ exposure on resident mortality in Hohhot from 2018 to 2023. Methods Air quality, meteorological, and mortality data in Hohhot from 2018 to 2023 were collected. A time-series analysis based on Quasi-Poisson generalized additive model (GAM) was employed, controlling for meteorological factors, day-of-week effects, and holiday effects, to assess the impact of O₃ on non-accidental mortality, mortality from circulatory system diseases (CSD), and mortality from respiratory system diseases (RSD). Results From 2018 to 2023, the non-accidental, CSD, and RSD mortalities in Hohhot amounted to 89721, 47394, and 11378 cases, respectively. The daily maximum 8-hour average O₃ concentration (O₃-8 h) was 90.00 μg·m⁻³. According to the Class I limit (100 μg·m⁻³) of GB 3095—2012 Ambient Air Quality Standard, the annual average number of days exceeding the standard was 144 d. For single-day lag effects, O₃ had the strongest health impact on non-accidental mortality and CSD mortality on the current day (lag0), with effect sizes of 0.78% (95%CI: 0.33%, 1.24%) and 1.10% (95%CI: 0.50%, 1.71%), respectively. The strongest impact on RSD mortality occurred on the second day (lag2), with an effect size of 1.61% (95%CI: 0.61%, 2.62%). The subgroup analyses showed that for every 10 μg·m⁻³ increase in O₃-8 h concentration, the risk of non-accidental mortality in females increased by 0.70% (95%CI: 0.01%, 1.41%); for CSD mortality, the risk in males and individuals aged ≥65 years increased by 0.73% (95%CI: 0.01%, 1.47%) and 0.76% (95%CI: 0.13%, 1.39%), respectively. During the warm season, statistically significant risks were observed for non-accidental, CSD, and RSD mortalities, with increases of 1.07% (95%CI: 0.54%, 1.60%), 1.31% (95%CI: 0.59%, 2.04%), and 2.27% (95%CI: 1.07%, 3.49%), respectively. In the two-pollutant models incorporating sulfur dioxide (SO₂), nitrogen dioxide (NO₂), carbon monoxide (CO), particulate matter with an aerodynamic diameter of 10 micrometers or less (PM₁₀), and fine particulate matter (PM_2.5), the effect estimates (excess risk) of O₃ remained stable and statistically significant (P<0.05), indicating model robustness. Conclusion Ground-level O₃ exposure in Hohhot increases mortalities due to non-accidental causes, CSD, and RSD, with more pronounced effects during the warm season. Females and individuals aged ≥65 years may be susceptible populations. Therefore, relevant authorities should prioritize the potential health risks of O₃ exposure, particularly to vulnerable groups, and promote targeted prevention and control strategies.

The aryl hydrocarbon receptor (AhR) plays a crucial role in regulating many physiological processes. Activating the AhR-CYP1A1 axis has emerged as a novel therapeutic strategy against various inflammatory diseases. Here, a practical in situ cell-based fluorometric assay was constructed to screen AhR-CYP1A1 axis modulators, via functional sensing of CYP1A1 activities in live cells. Firstly, a cell-permeable, isoform-specific enzyme-activable fluorogenic substrate for CYP1A1 was rationally constructed for in-situ visualizing the dynamic changes of CYP1A1 function in living systems, which was subsequently used for discovering the efficacious modulators of the AhR-CYP1A1 axis. Following screening of a compound library, LAC-7 was identified as an efficacious activator of the AhR-CYP1A1 axis, which dose-dependently up-regulated the expression levels of both CYP1A1 and AhR in multiple cell lines. LAC-7 also suppressed macrophage M1 polarization and reduced the levels of inflammatory factors in LPS-induced bone marrow-derived macrophages. Animal tests showed that LAC-7 could significantly mitigate DSS-induced ulcerative colitis and LPS-induced acute lung injury in mice, and markedly reduced the levels of multiple inflammatory factors. Collectively, an optimized fluorometric cell-based assay was devised for in situ functional imaging of CYP1A1 activities in living systems, which strongly facilitated the discovery of efficacious modulators of the AhR-CYP1A1 axis as novel anti-inflammatory agents.

Objective:To understand nurses' experiences providing discharge preparation services for elderly patients with multiple chronic diseases and offer references for developing intervention strategies for discharge preparation services for these patients.Methods:A purposive sampling method was used to select 24 nurses from the cardiovascular departments, geriatrics wards, and other internal medicine departments of three Grade A tertiary hospitals, four Grade B hospitals, and one community health service center in Guilin City between March and April 2024. An interview outline was developed based on the social-ecological system theory, and semi-structured interviews were conducted to collect data. A directed content analysis method was used to analyze the data.Results:A total of three themes were identified: micro-level (nurses have a positive attitude but face shortcomings in age-appropriate discharge preparation services), meso-level (team collaboration mechanisms are weak), and macro-level (there is a desire to link social resources) .Conclusions:Nurses' discharge preparation services for elderly patients with multiple chronic diseases are inadequate. It is recommended to enhance nurses' discharge preparation skills through core competency-based training, improve the development of innovative healthcare platforms, and promote establishing of a multi-dimensional social care support system to improve the quality of discharge preparation services for elderly patients with multiple chronic diseases.

Objective:To investigate the spatial and temporal distribution characteristics of brucellosis in Heilongjiang Province, Jilin Province and Inner Mongolia Autonomous Region (hereafter referred to as the Hei-Ji-Meng province and region), and study the influencing factors of brucellosis incidence.Methods:Using a retrospective analysis method, the data of brucellosis incidence in 22 prefecture-level cities in the Hei-Ji-Meng province and region from 2014 to 2018, as well as the data of natural environmental factors (precipitation, temperature, relative humidity, solar radiation, wind speed, vegetation index) and social environmental factors (livestock breeding, livestock and poultry meat production, cultivated land area) were collected and integrated. The spatial autocorrelation model and spatial Dubin model were used to analyze the spatial and temporal distribution rule of brucellosis and the impact of environmental factors on the incidence of brucellosis in prefecture-level cities.Results:From 2014 to 2018, the incidence of brucellosis in the Hei-Ji-Meng province and region was 18.77/100 000, among which the incidence in Inner Mongolia Autonomous Region was 33.45/100 000, followed by Heilongjiang Province (13.67/100 000) and Jilin Province (6.57/100 000). Among all prefecture-level cities, the brucellosis incidence was relatively higher in Hinggan League of Inner Mongolia Autonomous Region (69.10/100 000). Except 2016, the brucellosis incidence in other years had a positive spatial correlation (global Moran's I > 0, P < 0.05). The high-high concentration aggregation pattern was mainly concentrated in Ulanqab City, Xilingol League, Chifeng City, Tongliao City, Hinggan League, Hohhot City, and Hulunbuir City of Inner Mongolia Autonomous Region. Among the environmental factors related to brucellosis, cultivated land area and sheep breeding density had a positive effect on brucellosis incidence in the local area, with the effect intensity of 0.39 and 0.32, respectively ( P < 0.001). The average humidity from April to July had a negative effect on the brucellosis incidence in the local area, with the effect intensity of - 0.22 ( P = 0.023). The indirect effect of the number of pigs slaughtered on the brucellosis incidence in adjacent areas was the most significant, and the effect intensity was 2.15 ( P < 0.001). Conclusions:Among the Hei-Ji-Meng province and region, the annual average incidence rate of brucellosis in Inner Mongolia Autonomous Region is relatively higher, and the high-high concentration areas are mainly concentrated in this region. Among the environmental factors, the cultivated land area, sheep breeding density, the average humidity from April to July and the number of pigs slaughtered have an impact on brucellosis incidence.

Objective To explore the related influencing factors of orthostatic hypotension in patients with multiple system atrophy(MSA).Methods A retrospective study was conducted on 40 elderly MSA patients with orthostatic hypotension(MSA group)admitted to our department from January 2024 to March 2025,and another 46 elderly healthy individuals without orthostatic hypotension who taking physical examination were subjected and served as control group.General clinical data and related clinical indicators were compared between the two groups,and the related serum biomarkers of orthostatic hypotension in MSA patients were analyzed.Results The levels of vitamin D,low-density lipoprotein cholesterol(LDL-C),and uric acid were significantly lower in the MSA group than the control group(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that vitamin D,LDL-C,and uric acid levels were risk factors for the occurrence of orthostatic hypotension in MSA patients(OR=0.677,95％CI:0.530-0.864,P＜0.01;OR=0.057,95％CI:0.007-0.434,P＜0.01;OR=0.972,95％CI:0.954-0.992,P＜0.01).ROC curve analysis indicated that the optimal cut-off value of vitamin D,LDL-C,and uric acid levels in predicting the occurrence of orthostatic hypotension in MSA patients was 21.850 μg/L,2.895 mmol/L,and 274.500 μmol/L,the sensitivity was 0.848,0.630 and 0.783,and the specificity was 0.792,0.750 and 0.667,and the AUC value was 0.862,0.683 and 0.748,respectively.Conclusion Monitoring serum biomarkers,such as vitamin D,LDL-C,and uric acid may be helpful for the risk assessment and management of orthostatic hypotension in MSA patients.

Objective:To construct a prior based on the inherent properties of PET to accurately segment the lesion areas.Methods:A network framework for PET tumor segmentation driven by geodesic priors was proposed (geodesic network for short). Specifically, partial differential equations were constructed to characterize the geodesic distances between different regions in PET images. Tumor marker points identified by CT labeling were used as the initial conditions for the equations. To enhance the contrast between areas of lung or breast tumors and normal tissues, a smooth Heaviside function was utilized to map the geodesic distances. The network framework adopted a dual-branch architecture, using geodesic priors to assist in PET image segmentation.Results:The proposed method achieved a Dice coefficient of 94.92% in lung cancer segmentation and 90.12% in breast cancer segmentation. With the addition of geodesic priors in the Unet, the Dice coefficient for breast cancer increased by 32.37% (from 42.50% to 74.87%).Conclusion:Geodesic priors can significantly improve segmentation outcomes and enhance the generalization capability of the network.