Severe pneumonia is one of the most common and critical respiratory diseases in clinical practice. It is characterized by rapid progression， difficult treatment， high mortality， and many complications， posing a significant threat to the life and health of patients. The pathogenesis of severe pneumonia is highly complex， and studies have shown that its occurrence and development are closely related to multiple signaling pathways. Currently， the treatment of severe pneumonia mainly focuses on anti-infection， mechanical ventilation， and glucocorticoids， but clinical outcomes are often not ideal. Therefore， finding safe and effective alternative therapies is particularly important. In recent years， with the deepening of research into traditional Chinese medicine （TCM）， it has gained widespread attention in the treatment of severe pneumonia. This paper reviewed the relationship between severe pneumonia and relevant signaling pathways in recent years and how TCM regulated these pathways in the treatment of severe pneumonia. It was found that TCM could regulate the Toll-like receptor 4 （TLR4）/myeloid differentiation factor 88 （MyD88）/nuclear factor-κB （NF-κB）， Janus kinase （JAK）/signal transducer and activator of transcription （STAT）， phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）/mammalian target of rapamycin （mTOR）， NOD-like receptor protein 3 （NLRP3）， and nuclear factor E₂-related factor 2 （Nrf2） signaling pathways， playing a role in reducing the inflammatory response， inhibiting cell apoptosis and pyroptosis， improving oxidative stress， and other effects in the treatment of severe pneumonia. Among these pathways， it was found that all of them regulated inflammation to treat severe pneumonia. Therefore， reducing inflammation is the core mechanism by which Chinese medicine treats severe pneumonia. This review provides direction for the clinical treatment of severe pneumonia and offers a scientific basis for the research and development of new drugs.

Objective: To investigate the epidemiological characteristics of pertussis in Jiaxing City from 2004 to 2023 and spatio-temporal clustering characteristics from 2022 to 2023, so as to provide insights into formulation of pertussis control measures. Methods: Data of pertussis cases in Jiaxing City from 2004 to 2023 were collected through the Infectious Disease Report Information System of Chinese Disease Prevention and Control Information System. The epidemiological characteristics of pertussis cases in Jiaxing City from 2004 to 2023 were descriptively analyzed, and the spatio-temporal clustering characteristics from 2022 to 2023 were analyzed using spatio-temporal scanning. Results: A total of 478 pertussis cases were reported in Jiaxing City from 2004 to 2023, with an average annual reported incidence of 0.53/105. The reported incidence showed an upward trend from 2004 to 2023 (P<0.05), with the highest in 2022 (3.17/105). Higher incidence of pertussis was reported in June to August (149 cases, 31.17%) and November to December (112 cases, 23.43%). There was no statistically significant difference in the reported incidence between males and females (0.56/105 vs. 0.50/105, P>0.05). The cases aged under one year accounted for the highest proportion, with 199 cases (41.63%). Haining City (0.68/105), Jiashan County (0.64/105) and Tongxiang City (0.60/105) ranked the top three in the reported incidence of pertussis. Spatio-temporal scanning analysis showed that from 2022 to 2023, the primary clustering area of pertussis was centered in Daqiao Town of Nanhu District, covering 27 towns (streets) in Nanhu District, Jiashan County, Xiuzhou District and Pinghu City, and the clustering time was from November to December, 2023. Conclusions The reported incidence of pertussis was at a low level in Jiaxing City, but showed an upward trend from 2004 to 2023. The incidence of pertussis was higher among infants under one year of age, peaked in June to August and November to December, and was concentrated in Nanhu District and its surrounding areas.

Shegan Mahuangtang was a famous classical formula for treating asthma and is included in the the Catalogue of Ancient Famous Classical Formulas（The Second Batch）. By means of bibliometrics， this study conducts a textual research and analysis on the key information of its formula origin， composition， drug origins， processing， dosage， decocting methods， efficacy， and clinical application. According to research， Shegan Mahuangtang was first recorded in Synopsis of the Golden Chamber and is the ancestral formula for treating cold asthma， which has been used to this day. Suggestions for the drug origins in Shegan Mahuangtang is as follows：Shegan is selected from the dried rhizomes of Belamcanda chinensis（Iridaceae）， Mahuang is selected from the dried herbaceous stems of Ephedra sinica（Ephedraceae）， Shengjiang is selected from the fresh rhizomes of Zingiber officinale（Zingiberaceae）， Xixin is selected from the dried roots and rhizomes of Asarum heterotropoides var. mandshuricum， A. sieboldii var. seoulense or A. sieboldii（Aristolochiaceae）， Ziwan is selected from the dried roots and rhizomes of Aster tataricus（Compositae）， Kuandonghua is selected from the dried flower buds of Tussilago farfara（Compositae）， Nanwuweizi is selected from the dried mature fruits of Schisandra sphenanthera（Magnoliaceae）， Dazao is selected from the dried mature fruit of Ziziphus jujuba（Rhamnaceae）， and Banxia， a plant of the Araceae family， is selected as the processed products of dried tubers from Pinellia ternata. The recommended dosage is 41.4 g of Shegan， Xixin， Ziwan and Kuandonghua， 55.2 g of Mahuang and Shengjiang， 37.5 g of Nanwuweizi， 21 g of Dazao， 34.5 g of Banxia. The decoction method is to boil Mahuang first in 2.4 L of water， remove the froth on the top， and add the rest of the herbs and decoct them together， and then boil them to 600 mL， and then take it at warm temperature， 200 mL each time， 3 times a day. In terms of clinical application， Shegan Mahuangtang is most commonly used for respiratory system diseases， especially in the treatment of adult or pediatric bronchial asthma and cough variant asthma. Phlegm sound in the throat is the core symptom of Shegan Mahuangtang in clinical practice， and the core pathogenesis is "cold fluid stagnated in the lungs". By excavating and sorting out the ancient and modern literature of Shegan Mahuangtang， key information is confirmed， which can provide literature reference for the modern clinical application and new drug development of this famous classical formula.

Objective: To investigate the epidemiological and spatio-temporal characteristics of influenza in Jiaxing City, Zhejiang Province, so as to provide insights into perfecting the prevention and control strategies of influenza. Methods: Data of influenza in Jiaxing City from 2019 to 2023 were collected from the Chinese Disease Prevention and Control Information System. Population data of the same period were collected from the Zhejiang Health Information Network Reporting System. The epidemiological characteristics of influenza were analyzed using descriptive analysis. Vector map information was collected from the Open Street Map, and the spatio-temporal clustering characteristics of influenza were analyzed using spatial autocorrelation and spatio-temporal scanning. Results: A total of 181 501 cases of influenza were reported in Jiaxing City from 2019 to 2023, with an average annual reported incidence of 653.93/105. The majority of cases were aged 5 to <15 years (59 785 cases, 32.94%). The majority of the occupations were students (78 239 cases, 43.11%) and pre-school children (33 715 cases, 18.58%). The county (city, district) with the highest reported incidence was Haining City (1 451.70/105), and the town (street) with the highest reported incidence was Chang'an Town (1 932.78/105). Spatial autocorrelation analysis showed that the incidence of influenza in Jiaxing City from 2019 to 2023 had positive spatial correlations (all Moran's I>0, all P<0.05), with a high-high clustering in the southern region. Spatio-temporal scanning analysis showed that there was a spatio-temporal clustering of influenza in Jiaxing City from 2019 to 2023, with the southern region being the primary-type clustering area and the period between November and January of the following year being the clustering time. Conclusion There was a significant spatio-temporal clustering of influenza in Jiaxing City from 2019 to 2023, with winter being the peak season and the southern region being the primary area.

Maxing Shigan Decoction is first mentioned in Shang Han Za Bing Lun. The original formula consists of Ephedrae Herba, Armeniacae Semen Amarum, Glycyrrhizae Radix et Rhizoma, and Gypsum Fibrosum, and is a clinical prescription for treating cough and asthma. This article analyzed and verified the prescription source, composition, indications, dosage, processing method, decoction and administration method of Maxing Shigan Decoction. This study collected a total of 171 ancient books related to Maxing Shigan Decoction, among which 41 books recorded its key information in detail, covering 57 valid entries. In terms of medicinal ingredients, it is recommended to use Ephedra sinica Stapf, a plant in the Ephedrae Herba family, to dry the herbaceous stem of Ephedra sinica without the need for node removal; Glycyrrhiza uralensis Fisch. et Rhizoma is processed using dried roots and rhizomes of the legume plant Glycyrrhiza uralensis, and processed by honey roasting; Armeniacae Semen Amarum is made from dried and mature seeds of Prunus armeniaca L., a plant in the Rosaceae family, which are crushed when used; Gypsum Fibrosum is selected from sulfate mineral gypsum group gypsum. Suggested dosage: 55.2 g Ephedrae Herba, 111 g Gypsum Fibrosum, 27.6 g Glycyrrhizae Radix et Rhizoma, and 20 g Armeniacae Semen Amarum. The decoction method is to use 1 400 ml of water; first, fry the ephedra to 1 000 ml, remove the foam, add the remaining medicine, decoct 400 ml, remove the sediment, and warm orally taken 200 ml twice a day. Maxing Shigan Decoction has the functions of resolving superficies syndrome with pungent and cool natured drugs, clearing lung-heat and relieving asthma. Its main indications are diverse, involving multiple disciplines such as typhoid fever, warm diseases, pediatrics, and ophthalmology. However, its pathogenesis is generally attributed to the presence of "external wind pathogen and pathogenic heat congesting lung". By analyzing the ancient and modern literature on Maxing Shigan Decoction, the key information of its composition and dosage, drug origin and processing, decoction and administration methods, and functional indications is confirmed, in order to provide a basis for the clinical application and new drug development of Maxing Shigan Decoction.

Objective:To prepare novel dental composite resins using zinc(Zn)-and nitrogen(N)-modified titanium dioxide(TiO?)nanoparticles(NPs)and mesoporous alumina(Al?O?,r type,20 mm)NPs as reinforcing fillers,systematically evaluating their antibacterial activity,mechanical strength,basic performance,and biosafety to obtain the dental composite resins with excellent antibacterial activity and mechanical strength.Methods:Zn-N-TiO? NPs and mesoporous Al?O? NPs were added into a resin matrix at varying mass ratios to prepare five composite resins:control group(no filler),group 0(Zn-N-TiO?∶Al?O?=1∶0),group 1(Zn-N-TiO?∶Al?O?=1∶1),group 2(Zn-N-TiO?∶Al?O?=1∶2),and group 3(Zn-N-TiO?∶Al?O?=1∶3).Plate colony counting method was used to detect the number of adhered bacteria on composite resin surfaces in various groups and calculate the antibacterial rate;scanning electron microscope(SEM)was used to observe the morphology of adhered bacteria in various groups;universal testing machine was used to measure flexural strength(FS)and elastic modulus(EM)of composite resins in various groups;SEM was used to observe fracture surface morphology of composite resins in various groups;microhardness tester was used to determine Vickers microhardness of the composite resins in various groups;Fourier transform infrared spectroscope was used to detect double bond conversion rate(DC)after 20 s photocuring and calculate curing depth;water contact angle meter was used to measure water contact angle(WCA),water sorption property(WSP),and water solubility level(WSL)of composite resins in various groups;cell counting kit-8(CCK-8)method was used to evaluate relative growth rate(RGR)of the mouse fibroblast L-929 cells cultured in composite resin extracts on days 1,3,and 5 and determine in vitro cytotoxicity grade.Results:The plate colony counting results showed that compared with control group,the colony counts on agar plates in the other groups were significantly reduced,with group 1 showing the lowest count.The SEM images results showed densely distributed and morphologically intact Streptococcus mutans in control group;small clusters of bacteria with depressed cell membranes in group 0 and group 3;sparsely distributed bacteria with obvious membrane shrinkage and cytoplasmic leakage in group 1 and group 2.No statistically significant difference in colony counts was found between group 1 and group 2(P>0.05),but both were lower than the other groups(P<0.05).All the composite resins in experimental groups exhibited>85%antibacterial rates,with group 1 and group 2 exceeding 99%.The composite resins in group 0 showed the lowest FS.With addition of mesoporous Al?O?,the FS of the composite resin in group 1 and group 2 were significantly increased,with the composite resin in group 2 showing the highest FS among all groups.Although the FS of the composite resin in group 3 was lower than that in group 2,but it remained higher than other groups(P<0.05).The SEM images results showed that in control group,the smooth-surfaced sillicon dioxide(SiO?)particles exhibited clear fracture interfaces with resin matrix,with>50%particle exposure;the composite resin in group 0 showed similar morphology and large Zn-N-TiO? agglomerates with tight filler-matrix bonding;the composite resin in group 1,2,and 3 showed resin adhesion to SiO? surfaces(<50%particle exposure)and uneven fracture surfaces.Fractured SiO? spheres were observed in group 2.Filler distribution was uniform in group 1 and group 2,while the minor NP agglomeration occurred in group 3.The composite resin in control group showed the lowest EM.The EM was significantly improved in experimental groups,with group 3 having the highest value.Group 0 exhibited the lowest Vickers microhardness,showing statistically significant differences among other groups(P<0.05).The Vickers microhardness of the composite resion was gradually increased with the rising of Al?O? content.The resins in group 2 and group 3 achieved>45 HV hardness,representing increases of 29.73%and 33.82%compared with control group,and 51.34%and 56.28%compared with group 0.No significant differences in DC of the composite resin were found among groups(P>0.05).The depth of cure for all composite resin groups exceeded 4 mm,with no significance differences observed between various groups(P>0.05).The composite resin in group 0 showed the smallest WCA.The hydrophobicity of the composite resion was increased with the rising of Al?O? content,but all the WCA values remained<80°.The composite resin in group 3 had the largest WCA without statistical significance compared with group 2(P>0.05).Filler incorporation reduced the water sorption/solubility.The composite resin in the CCK-8 assay results showed the composite resins in all groups had RGR>75%,meeting in vitro safety standards.Conclusion:Reinforcing fillers impart superior antibacterial activity and mechanical properties to composite resins.Under experimental conditions,group 2 composite resin achieves optimal comprehensive performance in antibacterial efficacy and mechanical strength,demonstrating promising clinical application potential.

Objective:To investigate the clinical characteristics and risk factors of airway mucus plugging in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods:This was a retrospective cross-sectional study. A total of 322 hospitalized AECOPD patients admitted to the First Affiliated Hospital of Anhui Medical University from February 2023 to February 2025 were enrolled. Based on chest high-resolution computed tomography (HRCT) findings of airway mucus plugging, patients were classified into mucus plugging and non-mucus plugging groups. General and clinical data were collected, including age, sex, disease duration, smoking and alcohol history, comorbidities, number of acute exacerbations in the past year, routine blood tests, biochemical indices, pulmonary function, and pathogen detection. The incidence of airway mucus plugging in AECOPD patients was calculated, and differences in baseline characteristics, laboratory parameters, and pulmonary function between the two groups were compared. Logistic regression was used to identify independent risk factors for mucus plugging, and receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of relevant indicators.Results:Of the 322 enrolled patients, 87(27.02%) were found to have airway mucus plugging. Univariate analysis revealed statistically significant differences between the mucus plug group and the non-plug group in the following parameters (all P<0.05): body mass index (BMI), disease duration, smoking status, Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, modified British Medical Research Council (mMRC) dyspnea scale, COPD Assessment Test (CAT) score, frequency of acute exacerbations, neutrophil percentage, absolute lymphocyte count, lymphocyte percentage, albumin, C-reactive protein (CRP), activated partial thromboplastin time, fibrinogen, fibrin(ogen) degradation products, D-dimer, Aspergillus infection rate, percentage of forced expiratory volume in 1 second to predicted value (FEV 1%pred), ratio of FEV 1 to forced vital capacity (FEV 1/FVC), and percentage of maximal mid-expiratory flow to predicted value (MMEF 75/25%pred). Multivariate logistic regression analysis identified the following as independent risk factors for airway mucus plugs (all P<0.05): elevated CRP ( OR=1.022, 95% CI: 1.013-1.036), decreased albumin ( OR=0.891, 95% CI: 0.825-0.959), Aspergillus infection ( OR=1.774, 95% CI: 1.366-2.317), and reduced MMEF 75/25%pred value ( OR=0.978, 95% CI: 0.964-0.990). ROC curve analysis showed that the combined predictive model incorporating CRP, albumin, Aspergillus infection, and MMEF 75/25%pred had an area under the ROC curve (AUC) of 0.776(95% CI: 0.714-0.838), which was superior to each individual indicator alone, with AUCs of 0.721 for CRP, 0.687 for albumin, 0.579 for Aspergillus infection, and 0.631 for MMEF 75/25%pred. Conclusions:AECOPD patients with airway mucus plugging exhibit higher inflammatory markers, poorer nutritional status, a higher likelihood of Aspergillus infection, worse pulmonary function, and poorer prognosis. Aspergillus infection, elevated CRP, decreased albumin, and reduced MMEF 75/25%pred are independent risk factors for mucus plugs in AECOPD.

Objective To investigate the effects of Xiaoyukang capsule on neuroinflammation and neuronal apoptosis after Intracerebral hemorrhage(ICH)in rats by regulating JNK/c-JUN signaling pathway.Methods Adult male SD rats were intrastriatally injected with bacterial collagenase Ⅶ to induce an ICH model and they were randomly divided into blank control group,model control group,Xiaoyukang capsule small dose group,medium dose group,and large dose group.Neurobehavioral tests,body mass measurements,hematoma volume statistics,hematoxylin-eosin(HE)staining,immunofluorescence,deoxynucleotidyl transferase dUTP nick end labeling(TUNEL)staining,enzyme-linked immunosorbent assay(ELISA)and Western Blotting were performed after 3 and 5 days,respectively.Results Compared with the blank control group,the rats in the model control group had severe neurobehavioral defects and weight loss(P＜0.05).The arrangement of neurons in brain tissue was disordered,and there was microglia/macrophages activation,neutrophil infiltration,neuronal apoptosis(P＜0.05).The levels of pro-inflammatory factors TNF-α,IL-1β and the expression of p-JNK,p-c-JUN,Bax,Caspase-3 and Cleaved Caspase-3 protein around hematoma were significantly increased(P＜0.05),while the anti-inflammatory factor IL-10 and anti-apoptotic protein Bcl-2 were decreased(P＜0.05).Compared with the model control group,Xiaoyukang capsule large dose group significantly improved the neurobehavioral function of rats,promoted weight recovery and hematoma absorption(P＜0.05).Reduce the pathological injury of brain tissue,inhibition of microglia/macrophages activation,neutrophil infiltration and neuronal apoptosis(P＜0.05).In addition,the levels of pro-inflammatory factors TNF-α,IL-1β and the expression of p-JNK,p-c-JUN,Bax,Caspase-3,Cleaved Caspase-3 protein around hematoma were significantly decreased(P＜0.05),and the anti-inflammatory factor IL-10 and anti-apoptotic protein Bcl-2 were increased(P＜0.05).Conclusion Xiaoyukang capsule can improve neurobehavioral defects in ICH rats,promote body mass recovery and hematoma absorption,reduce pathological damage of brain tissue,inhibit microglia/macrophage activation and neutrophil infiltration,its mechanism may be achieved by inhibiting JNK/c-JUN-mediated neuroinflammation and neuronal apoptosis.

Objective To analyze the feasibility of serum exosome hsa_circ_0084443 as a biomarker for early diagnosis of diabetic foot ulcer.Methods GSE114236 chip data from the Gene Expression Omnibus(GEO)database was downloaded to screen the differentially expressed circular DNA(circRNA).From December 2019 to August 2021,44 T2DM patients with diabetic foot ulcer(DFU)who received treatment at Baoji Central Hospital were included as the study subjects,all patients had Wagner grades 1～2.In addition,185 newly diagnosed T2DM patients without comorbidities(DM group)were included as controls during the same period.Serum samples from all participants were collected for extracting purified serum exosomes.The expression of serum exosomal hsa_circ_0084443 was detected by real-time fluorescence quantitative polymerase chain reaction(qRT-PCR),and the differences among different groups was compared.Spearman rank correlation analysis was used to investigate the relationship between serum exosomal hsa_circ_0084443 and Ankle-Brachial Index(ABI).Receiver operating characteristic(ROC)curves was used to analyze the efficacy of serum exosomal hsa_circ_0084443 in diagnosing early DFU.Results By analyzing the GSE114236 dataset,it was found that hsa_circ_0084443 was the circRNA with the highest differential expression.In the whole cohort analysis,the expression of serum exosome hsa_circ_0084443 in DFU group was significantly higher than that in DM group[1.18(0.84,2.06)vs 0.73(0.51,1.16)],and the differences was statistically significant(Z=-4.219,P<0.001).The expression level of serum exosome hsa_circ_0084443 in DFU group was negatively correlated with ABI(r=-0.420,P=0.005).After adjusting for age,smoking history and creatinine,the increased expression level of serum exosome hsa_circ_0084443 was still an independent risk factor for DFU(P＜0.001).Finally,the area under ROC curve(AUC)of serum exosome hsa_circ_0084443 for the diagnosis of early DFU was 0.705.Conclusion Serum exosome hsa_circ_0084443 is highly expressed in DFU patients and can be used as an important marker for early diagnosis of DFU.

Objective To analyze the feasibility of serum exosome hsa_circ_0084443 as a biomarker for early diagnosis of diabetic foot ulcer.Methods GSE114236 chip data from the Gene Expression Omnibus(GEO)database was downloaded to screen the differentially expressed circular DNA(circRNA).From December 2019 to August 2021,44 T2DM patients with diabetic foot ulcer(DFU)who received treatment at Baoji Central Hospital were included as the study subjects,all patients had Wagner grades 1～2.In addition,185 newly diagnosed T2DM patients without comorbidities(DM group)were included as controls during the same period.Serum samples from all participants were collected for extracting purified serum exosomes.The expression of serum exosomal hsa_circ_0084443 was detected by real-time fluorescence quantitative polymerase chain reaction(qRT-PCR),and the differences among different groups was compared.Spearman rank correlation analysis was used to investigate the relationship between serum exosomal hsa_circ_0084443 and Ankle-Brachial Index(ABI).Receiver operating characteristic(ROC)curves was used to analyze the efficacy of serum exosomal hsa_circ_0084443 in diagnosing early DFU.Results By analyzing the GSE114236 dataset,it was found that hsa_circ_0084443 was the circRNA with the highest differential expression.In the whole cohort analysis,the expression of serum exosome hsa_circ_0084443 in DFU group was significantly higher than that in DM group[1.18(0.84,2.06)vs 0.73(0.51,1.16)],and the differences was statistically significant(Z=-4.219,P<0.001).The expression level of serum exosome hsa_circ_0084443 in DFU group was negatively correlated with ABI(r=-0.420,P=0.005).After adjusting for age,smoking history and creatinine,the increased expression level of serum exosome hsa_circ_0084443 was still an independent risk factor for DFU(P＜0.001).Finally,the area under ROC curve(AUC)of serum exosome hsa_circ_0084443 for the diagnosis of early DFU was 0.705.Conclusion Serum exosome hsa_circ_0084443 is highly expressed in DFU patients and can be used as an important marker for early diagnosis of DFU.