Mitochondrial quality control （MQC） homeostasis serves as a fundamental mechanism in maintaining the mitochondrial structure and function. Dysregulation of MQC contributes to the progression of acute ischemic stroke （AIS） through multiple pathways including disturbances in energy metabolism， increased oxidative stress， and imbalances in mitochondrial fusion and fission. Drawing upon the traditional Chinese medicine （TCM） theory of the kidney governing Yin and Yang， this study innovatively proposes an integrative model of "Yin-Yang dynamic balance-MQC homeostasis" to elucidate the underlying pathophysiological mechanisms. Specifically， kidney Yang deficiency and decline result in reduced driving force， thereby inhibiting mitochondrial fusion. This leads to decreased efficiency of oxidative phosphorylation and impaired adenosine triphosphate （ATP） production. Conversely， when kidney Yin is dysfunctional and excessive phlegm-blood stasis accumulates， mitochondrial fission becomes hyperactive， causing rapid accumulation of reactive oxygen species （ROS） and intensified oxidative stress. The interplay between these two pathological states culminates in the central TCM pathogenesis—Yin-Yang imbalance and disordered Qi and blood-of AIS. To address this pathogenesis， a therapeutic strategy is proposed： tonifying the kidney as the primary intervention to restore MQC homeostasis， supplemented by resolving phlegm and removing blood stasis to interrupt the deleterious cycle of cerebral vascular damage. This work integrates the holistic perspective of TCM with contemporary molecular insights， offering precise intervention targets along the "kidney-mitochondria axis" for the prevention and treatment of AIS， while establishing a novel integrative paradigm for stroke management that bridges traditional and modern medicine. Future research should focus on elucidating the molecular mechanisms through which TCM regulates MQC in AIS and integrating classical TCM theories with evidence-based medicine to facilitate the translation of theoretical insights into clinical applications.

Objective Aimed at investigating the effect and molecular mechanism of artemisinin on hemo-dynamics and vascular remodeling in monocrotaline(MCT)-induced pulmonary arterial hypertension(PAH)rats.Methods 30 male SD rats were randomly divided into 3 groups(n=10):control group,MCT-induced PAH group(MCT group,60 mg/kg)and artemisinin intervention group(50 mg/kg).At 28 days after modeling,the right ventricular systolic pressure(RVSP),mean pulmonary artery pressure(mPAP),heart rate and right ventricular hypertrophy index(RVHI)were measured to evaluate the development of PAH.HE staining and α-SMA immuno-histochemistry were used to observe the morphology and assess muscularization of pulmonary arterioles,and the percentage of medial wall thickness(WT%),the percentage of vascular wall area(WA%)and the proportion of muscular vessels were calculated to evaluate the degree of pulmonary vascular remodeling.The mRNA and protein levels of HIF-1α and LDHA were detected by real-time PCR and Western blot,respectively.Pyruvate and lactate concentration in lung tissue was measured using pyruvate and lactateassay kit.Results Compared with the control group,the RVSP,mPAP,heart rate and RVHI were significantly increased in MCT-induced PAH rats(all P<0.05).Histological analysis showed that the increasedmedial wall thickness of small pulmonary arteries and vascular muscularization were observed in MCT-treated rats compared with control rats.WT%,WA%and muscularization degrees of pulmonary arterioles were higher in MCT-treated rats than those in the control group(all P<0.05),suggesting successful construction of PAH model.Compared with the MCT group,the RVSP,mPAP,heart rate and RVHI decreased in the rats treated with artemisinin(all P<0.05),accompanied with lower WT%and WA%(P<0.05),and muscularization of pulmonary arterioles was improved(P<0.05).Further study showed the mRNA and protein levels ofHIF-1α and LDHA in lung tissue of MCT-induced PAH rats were higher than those in the control group,the content of lactate and pyruvate and the ratio of lactate to pyruvate were higher than that in the control group(all P<0.05).However,the mRNA and protein levels of HIF-1α and LDHA in lung tissue of rats treated with artemisinin were lower than those in the MCT group,the content of lactate and pyruvate and the ratio of lactate to pyruvate were lower than that in the MCT group(all P<0.05).Conclusion Artemisinin improves hemodynamic and pulmonary vascular remodeling in PAH rats through inhibiting HIF-1α/LDHA signaling pathway-mediated glycolysis.

Objective:To investigate the magnetic resonance imaging (MRI) features of pediatric and adolescent mediastinal T-lymphoblastic lymphoma (T-LBL) and to evaluate their predictive value for early treatment response.Methods:A retrospective, multicenter case series study was conducted on 49 pediatric and adolescent patients diagnosed with mediastinal T-LBL between September 2020 and May 2024 at the Fifth Affiliated Hospital of Zhengzhou University, Beijing Gaobo Boren Hospital, and Henan Cancer Hospital.All patients underwent chest MRI, including conventional MRI sequences and diffusion-weighted imaging.Tumor imaging characteristics were analyzed, and quantitative parameters such as minimum apparent diffusion coefficient (ADCmin), maximum ADC (ADCmax), and mean ADC (ADCmean) were measured.Treatment response was evaluated 15 days post-treatment.The patients were divided into a response group (complete or partial response, 26 cases) and a non-response group (progressive disease or minor response, 23 cases).The relationship between MRI features and treatment response was analyzed.The intraclass correlation coefficient was used to assess inter-reader agreement, and independent sample t-tests and chi-square tests were employed to compare differences between groups.Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the predictive performance of imaging parameters. Results:Significant differences were observed between the response and non-response groups in ADC values [ADCmin (0.80±0.41)×10 -3 mm 2/s vs.(1.23±0.70)×10 -3 mm 2/s, ADCmax (1.14±0.48)×10 -3 mm 2/s vs.(1.92±0.77)×10 -3 mm 2/s, ADCmean (0.98±0.42)×10 -3 mm 2/s vs.(1.56±0.74)×10 -3 mm 2/s] and the maximum tumor diameter was [(11.92±3.61) cm vs.(8.17±2.46) cm] (all P<0.05).ROC curve analysis showed that ADCmax had the highest predictive efficiency for treatment response, with an area under the curve (AUC) of 0.853 (95% CI: 0.790-0.910), sensitivity of 92.3%, and specificity of 65.2%.The AUC for the maximum tumor diameter was 0.814, demonstrating its excellent predictive performance. Conclusions:MRI features, particularly ADC values and the maximum tumor diameter, can effectively predict treatment response in pediatric and adolescent mediastinal T-LBL.

Objective:To explore the effect of prognosis appearance of the combination of microneedle array radiofrequency and CO2 array laser on psychological stress response of patients with facial acne scar.Methods:A total of 100 patients with facial acne scar,who admitted to Chengdu Second People's Hospital from August 2020 to August 2020,were selected,and they were divided into study group and control group,with 50 cases in each group.Study group adopted combined treatment with microneedle array radiofrequency and CO2 array laser,and control group adopted microneedle array radiofrequency to conduct treatment.The curative effect after treatment was compared between two groups.The Vancouver scar scale(VSS)was adopted to score the scar condition of patients,and Hamilton anxiety(HAMA)rating scale,Hamilton depression(HAMD)of rating scale and self-esteem scale(SES)were adopted to evaluate the psychological stress response of patients,and the score of the comprehensive evaluation questionnaire of quality of life(GQOLI-74 score)was adopted to evaluate the difference of quality of life of patients between before and after treatment.Results:After treatment,the overall curative effect of study group was 92.00%,which was better than 72.00%of control group,and the difference was significant(x2=6.775,P<0.05).The VSS scores of study group after received treatment of 2,4 times were significantly lower than those before treatment,and were lower than those of control group,and the differences of those between two groups were significant(t=5.850,9.040,P<0.05),respectively.After treatment,the SES scores of two groups all rose,and the HAMD and HAMA scores of two groups all reduced,and the three scores of study group were all better than those of control group,and the differences of them between two groups were significant(t=3.456,3.909,6.063,P<0.05).Pearson correlation showed that the VSS score was negatively correlated with the SES score(r=-0.249,P<0.05),and was positively correlated with the HAMD score and the HAMA score(r=0.653,0.695,P<0.05),respectively.After treatment,the GQOLI-74 scores of each indicator(material and life,physical function,psychological function,and social function)of two groups rose all,and the GQOLI-74 scores of study group were all better than those of control group,and the differences of them between two groups were significant(t=4.324,7.497,3.870,4.534,P<0.05),respectively.Conclusion:The combination of microneedle array radiofrequency and CO2 array laser has better curative effect in treating facial acne scar,which can effectively promote prognosis appearance,and relieve psychological stress response,and improve the quality of life.

Objective:To assess the risk of hearing impairment caused by Gentamicin in Chinese children.Methods:A retrospective analysis.Related literature was retrieved and selected according to inclusion and exclusion criteria, and relevant data was extracted.An evidence-based analysis was conducted on the relationship between hearing impairment and the application of Gentamicin in children.Results:A total of 150 literature reports in Chinese and 483 in English were retrieved.After screening according to inclusion and exclusion criteria, 33 studies in Chinese and 20 in English were included for analysis.There were 13 clinical case reports, 17 retrospective studies and 4 prospective studies on hearing impairment after the application of the Gentamicin in Chinese children.There were 19 international clinical studies.In the 13 clinical case reports including 21 cases who had a history of Gentamicin, no relationship between hearing impairment and Gentamicin was described.A total of 13 419 patients with hearing impairment were included in 17 retrospective studies, and 3 063 (22.8%) of them had Gentamicin exposure in childhood.Among 19 international studies on the application of Gentamicin in children, 13 reported cases with hearing impairment.The incidence of hearing impairment in Gentamicin-treated patients ranged from 0.9% to 30.9%, and the reasons were family history of hearing impairment, otitis media, and sequelae of nervous system injuries.No children with hearing impairment were proved related to Gentamicin.Five studies with a control group (not the Gentamicin-treated group) showed no difference in the incidence of hearing impairment between the Gentamicin-treated group(0-30.9%) and the control group (0-31.4%).Conclusions:All the retrospective reports of hearing impairment caused by Gentamicin in Chinese children do not describe the causal relationship between hearing impairment and Gentamicin.In international studies, the incidence of hearing impairment is not higher in Gentamicin-treated children.Cohort and randomized controlled studies are needed to further assess the risk of hearing impairment in Chinese children.

AIM:To investigate the effects of Xiaoyao-Kang'ai-Jieyu formula(XYKAJY)-containing serum on the co-culture of BV2 and HT22 cells from mice with breast cancer-related depression(BCRD).METHODS:The op-timal concentration of XYKAJY-containing serum was determined using mouse HT22 cells.In vitro co-culture model of mouse HT22 and BV2 cells was established through incubation with 4T1 cell supernatant and 200 μmol/L corticosterone.The cells were then divided into control group,model group,blank serum group,positive drug serum group,5%XY-KAJY-containing serum group,10%XYKAJY-containing serum group,15%XYKAJY-containing serum group and 20%XYKAJY-containing serum group.Alterations in HT22 cell viability was detected by CCK8 assay.The concentration level of interleukin-1β(IL-1β),IL-6 and IL-18 in the cell supernatant was quantified using enzyme-linked immunosorbent as-say(ELISA).Flow cytometry was conducted to assess the apoptosis rate of HT22 cells and quantify the expression levels of adhesion molecule CD11b on the surface of BV2 cells.Immunofluorescence was performed to determine the expression of neuron-specific enolase(NSE),synapsin 1(Syn1)and postsynaptic density protein 95(PSD95)in HT22 cells,and that of inducible nitric oxide synthase(iNOS)in BV2 cells.RESULTS:Treatment with XYKAJY-containing serum down-regulated CD11b expression level in BV2 cells(P<0.01),and reduced the release of IL-1β,IL-6 and IL-18(P<0.01).Moreover,it significantly improved the viability of HT22 cells(P<0.01),enhanced cell morphology integrity,and reduced the apoptosis rate(P<0.01).CONCLUSION:These findings indicated that XYKAJY-containing serum im-proved the function of mouse HT22 neurons by regulating the polarization phenotype of mouse BV2 cells and alleviating neuroinflammatory-induced toxicity.

Objective:To explore the experience of clinical nurses in implementing nutritional management for patients with cirrhosis based on the nutrition care process and model, so as to provide references for nutritional management of patients with cirrhosis.Methods:From March to May 2024, 14 nurses from the Taihe County People's Hospital were selected for face-to-face semi-structured interviews using purposive sampling method. The Colaizzi's 7-step analysis was used to analyze the interview data.Results:A total of four themes were ultimately summarized, namely, multidimensional factors affecting patients' acceptance of nutritional management, nurses' professional competence affecting the implementation of nutritional management, deficiencies in practice affecting the implementation of nutritional management, and collaborative relationships between nurses and patients affecting the successful implementation of nutritional management.Conclusions:From the nurses' perspective, this study identifies strengths and weaknesses in the management and implementation of nutrition for patients with cirrhosis, which can provide a basis for further improvement and development of targeted nutritional management programs for patients with cirrhosis.

Objective To investigate the current situation of medical record writing and management in lnternet hospitals in Chongqing.Methods The medical record writing,medical record management and medical record risk of 45 lnternet hospitals in Chongqing were investigated by questionnaire and expert consultation.Results ln terms of lnternet medical record management,80.95%of them are structured medical records.61.90%had the quality control standard for medical records of lnternet hospitals.76.19%took the current quality control standard of medical records of general outpatient service as the quality control standard of medical records of lnternet hospitals.59.52%of them had a special person responsible for the quality control of medical records on the lnternet.ln terms of lnternet writing,47.62%of the current lnternet electronic medical records are simpler in format and content than the outpatient medical records of physical medical institutions,and 45.24%are consistent.Only 28.57%of people believe that the identity information of guardians of young children or patients with mental disorders needs to be recorded in medical records.ln terms of the risks of lnternet medical records,78.57%believed that there were risks in the management and writing of lnternet medical records.After medical disputes occurred,85.72%of the lnternet medical records as a legal support were at risk,of which 33.33%thought the risk was high,and 7.14%thought the risk was particularly high.Conclusion Chongqing's lnternet medical record writing and management ability needs to be further improved.lt is of practical significance to establish national or local or online medical record writing and management standards.

Objective To investigate the mechanism by which 4-week high-intensity interval training(HIIT)regulates the mitochondrial unfolded protein response(UPRmt)in skeletal muscle and improves mitochondrial function in a rat model of chronic unpredictable mild stress(CUMS).Methods Male SPF-grade SD rats(6～8 weeks old)were divided randomly into control(C),model(M),HIIT+control(HC),and HIIT+model(HM)groups.Rats in the M and HM groups were subjected to CUMS for 8 weeks to establish a depression model,while rats in the HC and HM groups received HIIT for 5 d a week for 4 weeks.The exercise regimen consisted of 3 min high-speed(85％～90％Smax)combined with 1 min low-speed(50％～55％Smax)uninterrupted repetitive training(Smax is maximum training speed).Behavioral changes were evaluated at weeks 4 and 8.Tissue samples were taken 24 h after the last behavioral test and skeletal muscle mitochondria were examined by transmission electron microscopy.The ATP and reactive oxygen species(ROS)contents were measured by enzyme-linked immunosorbent assays and protein expression levels of activating transcription factor(ATF)4,ATF5,C/EBP homologous protein(CHOP),and heat shock protein 60(HSP60)were detected by Western blot.Results(1)The body mass,number of crossing grids,number of upright positions,sugar-water preference rate,and ATP content were significantly decreased in group M compared with group C(P＜0.01),while the number of damaged mitochondria,ROS content,ATF4,ATF5,CHOP,and HSP60 protein expression were significantly increased(P＜0.01).(2)After 4-weeks of HIIT intervention,the ATP content and ATF4 and ATF5 protein expression levels were significantly increased in the HC group compared with C group(P＜0.05,P＜0.01).The number of crossing grids,number of upright positions,sugar-water preference rate,ATP content,and ATF4 protein expression were significantly increased in the HM group compared with M group(P＜0.01),while the number of damaged mitochondria,ROS content,and ATF5,CHOP,and HSP60 protein expression levels were significantly decreased(P＜0.01).(3)After 4 weeks of HIIT intervention,the number of crossing grids in CUMS rats was significantly positively correlated with ATF4 protein expression,and ROS content was correlated with CHOP protein expression,number of damaged mitochondria,and ATF5 protein expression(|r|＞0.75,P＜0.01;|r|＞0.75,P＜0.05).Upright frequency was significantly negatively correlated with ATF5 and HSP60 protein expression,the number of crossing grids,the sugar-water preference rate,and the expression of CHOP and HSP60 proteins(|r|＜0.75,P＜0.05).Conclusions 4-week HIIT intervention can improve mitochondrial dysfunction and alleviate depressive-like behavior in CUMS rats by regulating skeletal muscle UPRmt.

Objective:To investigate the clinical features, pathologic characteristics, treatment and prognosis of primary mediastinal large B-cell lymphoma (PMBCL) in children.Methods:Clinical data including clinical manifestations, treatment, clinical efficacy of 8 cases of childhood PMBCL treated in Beijing Children′s Hospital, Capital Medical University from March 2017 to February 2024 were collected retrospectively, the clinical characteristics and prognosis of them were summarized.Results:Among the 8 children, there were 5 males and 3 females. The age at the time of initial diagnosis was 11.0 (10.3, 13.5) years. The first clinical symptoms were cough (8 cases) and stridor (6 cases). The lesions most often involved the mediastinum (8 cases), lungs (5 cases, hilum more often), pericardium (5 cases), and pleura (4 cases). Extra thoracic invasion was present in 4 cases, 7 cases had huge tumor lesions and 7 cases were phase Ⅲ clinical stage. Except for 1 case who underwent surgical resection of the tumor, the remaining 7 cases were treated with DA-EPOCH+R (dose adjusted-etoposide+prednisone+vincristine+cyclo-phosphamide+doxorubicin+rituximab) chemotherapy. The follow-up time was 25.0 (10.5, 43.3) months, with 7 cases in complete and partial metabolism response, 1 case had disease progression. All 8 cases survived.Conclusions:PMBCL is most common in school-age boys and most of them present with huge mediastinal tumor focus. PMBCL expresses B-cell spectrum antigens and weakly expresses CD30.The application of DA-EPOCH+R is effective in the treatment of PMBCL in children.