As a major global public health concern,the incidence of depression disorder is increasing annually.The pathological mechanism of depression involves bidirectional dysregulation between the hypothalamic-pituitary-adrenal(HPA)and gut-brain axes.According to traditional Chinese medicine(TCM),the liver controls conveyance and dispersion,the spleen governs transportation and transformation,and both jointly maintain the balance between ascending and descending qi movement and zang fu viscera function in the body.Liver qi stagnation and spleen deficiency result in qi movement disorder and a lack of source qi and blood,leading to depression induced by malnutrition of heart spirit.As a classic prescription for soothing the liver,invigorating the spleen,and replenishing blood,Xiaoyao Powder is used to reinforce healthy qi and eliminate pathogenic factors.Xiaoyao Powder not only regulates the"yin in property of liver"but also strengthens the"ascending and descending"of the spleen.As commonly used by ancient and modern physicians,also indirectly inhibits HPA axis upregulation and improves depression-related gastrointestinal dysfunction.This paper systematically expounds the multi-dimensional mechanism of Xiaoyao Powder in treating depression through the two-way regulation of the HPA-gut-brain axis.It reveals the therapeutic characteristics of"multi-component and multi-target"in TCM to provide a novel theoretical basis for the modernization of TCM and the treatment of depression by combining TCM and Western medicine.

Depression is closely associated with a neuro-endocrine-immune(NEI)system imbalance.The"excessive vitality leading to restraint and counter-regulation(Kang Hai Cheng Zhi)"theory elucidates the self-regulating mechanism for maintaining dynamic equilibrium in the body,and serves as an importance principle guiding treatment formulation and medication selection.Based on the correlation between NEI system imbalance and the traditional Chinese medicine pathogenesis of depression,and integrating the"Kang Hai Cheng Zhi"theory,the author posits that the pathogenesis of depression lies in overactive liver invading spleen,earth dampness impeding wood′s ascendancy,and disharmony between body and mind,as well as imbalance in storage and discharge functions of liver and kidney,disharmony between Yin and Yang,and disrupted counter-regulation.This dosely aligns with two key pathological methanisms at the micro level:microglial-limbic system homeostatic imbalance and hypothalamic-pituitary-adrenal axis-inflammatory circuit dysregulation.Clinically,the treatment principle for depression adheres to supporting the counter-regulation to restrain excess,with herbal interventions using strategies such as restraining wood to support earth,dredging earth to unblock wood,and harmonizing pivotal functions,as well as nourishing water to nurture wood,warming kidney to tonify liver,and relieving depression to calm the spirit.These approaches aim to regulate the liver,spleen,and kidney,embodying the core therapeutic tenet of"striving for equilibrium,"thereby restoring the body′s self-regulating capability.

OBJECTIVE From the perspective of China’s health system， to evaluate the cost-effectiveness of maintenance therapy with clopidogrel or aspirin monotherapy in percutaneous coronary intervention （PCI） patients after dual antiplatelet therapy （DAPT）. METHODS A Markov model was adopted with a research period of 25 years and a cycle period of 1 year. Cohort simulations were conducted respectively for the clopidogrel group and aspirin group to predict and compare the long-term economic and health outcomes of PCI patients receiving either clopidogrel or aspirin monotherapy maintenance regimens after DAPT， and cost-effectiveness analysis was conducted. The willingness-to-pay （WTP） threshold was set at the level of 1 times China’s per capita gross domestic product （GDP） in 2024[95 749 yuan per quality-adjusted life year （QALY）]， and the incremental cost- effectiveness ratio （ICER） was calculated. The robustness of the basic analysis results was verified by using single-factor sensitivity analysis and probabilistic sensitivity analysis. RESULTS After PCI， patients received DAPT， clopidogrel monotherapy maintenance treatment reduced the occurrence of death events， and aspirin monotherapy maintenance treatment had a lower probability of stroke and myocardial infarction events. The ICER of the clopidogrel group regimen compared with the aspirin group regimen was 34 644.87 yuan/QALY， which was less than the WTP threshold set in this study. The results of univariate sensitivity analysis indicated that notable uncertainties affecting the basic analysis results were the probability of event-free progression to death in the aspirin group， the event-free cost in the clopidogrel group， and the event-free cost in the aspirin group. The results of probabilistic sensitivity analysis indicated that when the WTP threshold was 95 749 yuan /QALY， the economic probabilities of the clopidogrel group and the aspirin group were 83% and 17%， respectively. The economic probability of the clopidogrel group regimens showed an upward trend with the increase of the WTP threshold. CONCLUSIONS Compared to aspirin monotherapy for maintenance therapy， under the WTP threshold of 1 times China’s per capita GDP in 2024， receiving clopidogrel monotherapy for maintenance therapy after DAPT in PCI patients is more cost-effective.

As a major global public health concern,the incidence of depression disorder is increasing annually.The pathological mechanism of depression involves bidirectional dysregulation between the hypothalamic-pituitary-adrenal(HPA)and gut-brain axes.According to traditional Chinese medicine(TCM),the liver controls conveyance and dispersion,the spleen governs transportation and transformation,and both jointly maintain the balance between ascending and descending qi movement and zang fu viscera function in the body.Liver qi stagnation and spleen deficiency result in qi movement disorder and a lack of source qi and blood,leading to depression induced by malnutrition of heart spirit.As a classic prescription for soothing the liver,invigorating the spleen,and replenishing blood,Xiaoyao Powder is used to reinforce healthy qi and eliminate pathogenic factors.Xiaoyao Powder not only regulates the"yin in property of liver"but also strengthens the"ascending and descending"of the spleen.As commonly used by ancient and modern physicians,also indirectly inhibits HPA axis upregulation and improves depression-related gastrointestinal dysfunction.This paper systematically expounds the multi-dimensional mechanism of Xiaoyao Powder in treating depression through the two-way regulation of the HPA-gut-brain axis.It reveals the therapeutic characteristics of"multi-component and multi-target"in TCM to provide a novel theoretical basis for the modernization of TCM and the treatment of depression by combining TCM and Western medicine.

Depression is closely associated with a neuro-endocrine-immune(NEI)system imbalance.The"excessive vitality leading to restraint and counter-regulation(Kang Hai Cheng Zhi)"theory elucidates the self-regulating mechanism for maintaining dynamic equilibrium in the body,and serves as an importance principle guiding treatment formulation and medication selection.Based on the correlation between NEI system imbalance and the traditional Chinese medicine pathogenesis of depression,and integrating the"Kang Hai Cheng Zhi"theory,the author posits that the pathogenesis of depression lies in overactive liver invading spleen,earth dampness impeding wood′s ascendancy,and disharmony between body and mind,as well as imbalance in storage and discharge functions of liver and kidney,disharmony between Yin and Yang,and disrupted counter-regulation.This dosely aligns with two key pathological methanisms at the micro level:microglial-limbic system homeostatic imbalance and hypothalamic-pituitary-adrenal axis-inflammatory circuit dysregulation.Clinically,the treatment principle for depression adheres to supporting the counter-regulation to restrain excess,with herbal interventions using strategies such as restraining wood to support earth,dredging earth to unblock wood,and harmonizing pivotal functions,as well as nourishing water to nurture wood,warming kidney to tonify liver,and relieving depression to calm the spirit.These approaches aim to regulate the liver,spleen,and kidney,embodying the core therapeutic tenet of"striving for equilibrium,"thereby restoring the body′s self-regulating capability.

To investigate the current situation and demand for specialized development of allergy nursing in 88 hospitals in Guangdong Province, as well as to provide evidence for the management of allergy nursing. From August to December 2023, a cross-sectional study was conducted to analyze the core managers of allergy nursing-related work in eighty-eight hospitals in Guangdong Province supported by the Allergy Nursing Branch of the Guangdong Nurses Association and the Nursing Group of the Allergy Branch of the Guangdong Medical Association. An online survey was conducted using the Delphi method to compile a questionnaire on the current status and demand for specialized development of allergy nursing in Guangdong Province. Chi-square tests and Fisher′s exact probability method were used to analyze the differences in the current status of specialty technology applications and the development and demand of specialized nursing between hospitals with or without allergy specialty departments. The results showed that among the eighty-eight hospitals in the nineteen prefecture-level cities surveyed in Guangdong Province, 17 hospitals (19%) had established allergy specialty departments, all of which were top-tier tertiary hospitals. The establishment duration [ M ( Q1, Q3)] was 3 (1, 10) years. The implementation rates of skin prick test (94%, 16/17), in-vitro examination (82%, 14/17), nasal endoscopy (82%, 14/17), subcutaneous specific immunotherapy (82%, 14/17), multidisciplinary consultation (65%, 11/17), fractional exhaled nitric oxide detection (47%, 8/17), skin patch test (41%, 7/17), and autologous serum skin test (35%, 6/17) in hospitals with allergy department were higher than those in hospitals without allergy department [59%, 42/71 ( χ 2= 7.462, P=0.006)], [54%, 38/71 ( χ 2= 4.717, P=0.030)], [51%, 36/71 ( χ 2= 5.599, P=0.018)], [34%, 24/71 ( χ 2= 13.177, P<0.001)], [24%, 17/71 ( χ 2= 10.505, P=0.001)], [24%, 17/71 ( χ 2= 5.540, P=0.019)], [11%, 8/71 (Fisher′s exact test, P=0.008)], [11%, 8/71 (Fisher′s exact test, P=0.025)]. In the development plan of allergy nursing in the next two years, hospitals that had set up allergy departments had a higher proportion in adding nurses (82%, 14/17, χ 2= 13.177, P<0.001), formulating specialized nurse training plans (71%, 12/17, χ 2= 3.980, P=0.046), formulating group standards or clinical guidelines (41%, 7/17, Fisher′s exact test, P=0.046), and formulating assessment standards (53%, 9/17, Fisher′s exact test, P=0.002). The demand for all aspects of allergy specialty nursing knowledge and skills accounted for more than 50%, and it was not related to whether the hospital set up an allergy department. In conclusion, the specialized development of allergy nursing in Guangdong province is still in its early stages, and there is a great demand for improving knowledge and skills in allergy. Further standardization of specialty construction is needed, along with the training of allergic nurses, to promote the comprehensive development of allergic reaction nursing specialties from point to area.

To investigate the current situation and demand for specialized development of allergy nursing in 88 hospitals in Guangdong Province, as well as to provide evidence for the management of allergy nursing. From August to December 2023, a cross-sectional study was conducted to analyze the core managers of allergy nursing-related work in eighty-eight hospitals in Guangdong Province supported by the Allergy Nursing Branch of the Guangdong Nurses Association and the Nursing Group of the Allergy Branch of the Guangdong Medical Association. An online survey was conducted using the Delphi method to compile a questionnaire on the current status and demand for specialized development of allergy nursing in Guangdong Province. Chi-square tests and Fisher′s exact probability method were used to analyze the differences in the current status of specialty technology applications and the development and demand of specialized nursing between hospitals with or without allergy specialty departments. The results showed that among the eighty-eight hospitals in the nineteen prefecture-level cities surveyed in Guangdong Province, 17 hospitals (19%) had established allergy specialty departments, all of which were top-tier tertiary hospitals. The establishment duration [ M ( Q1, Q3)] was 3 (1, 10) years. The implementation rates of skin prick test (94%, 16/17), in-vitro examination (82%, 14/17), nasal endoscopy (82%, 14/17), subcutaneous specific immunotherapy (82%, 14/17), multidisciplinary consultation (65%, 11/17), fractional exhaled nitric oxide detection (47%, 8/17), skin patch test (41%, 7/17), and autologous serum skin test (35%, 6/17) in hospitals with allergy department were higher than those in hospitals without allergy department [59%, 42/71 ( χ 2= 7.462, P=0.006)], [54%, 38/71 ( χ 2= 4.717, P=0.030)], [51%, 36/71 ( χ 2= 5.599, P=0.018)], [34%, 24/71 ( χ 2= 13.177, P<0.001)], [24%, 17/71 ( χ 2= 10.505, P=0.001)], [24%, 17/71 ( χ 2= 5.540, P=0.019)], [11%, 8/71 (Fisher′s exact test, P=0.008)], [11%, 8/71 (Fisher′s exact test, P=0.025)]. In the development plan of allergy nursing in the next two years, hospitals that had set up allergy departments had a higher proportion in adding nurses (82%, 14/17, χ 2= 13.177, P<0.001), formulating specialized nurse training plans (71%, 12/17, χ 2= 3.980, P=0.046), formulating group standards or clinical guidelines (41%, 7/17, Fisher′s exact test, P=0.046), and formulating assessment standards (53%, 9/17, Fisher′s exact test, P=0.002). The demand for all aspects of allergy specialty nursing knowledge and skills accounted for more than 50%, and it was not related to whether the hospital set up an allergy department. In conclusion, the specialized development of allergy nursing in Guangdong province is still in its early stages, and there is a great demand for improving knowledge and skills in allergy. Further standardization of specialty construction is needed, along with the training of allergic nurses, to promote the comprehensive development of allergic reaction nursing specialties from point to area.

Humans ; Receptors, Chimeric Antigen/therapeutic use* ; DNA-Binding Proteins/genetics* ; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma ; Proto-Oncogene Proteins c-bcl-2/genetics* ; Cell- and Tissue-Based Therapy ; Oncogene Proteins, Fusion/genetics* ; Translocation, Genetic

Purpose: This study attempted to detect the changes of cervical cancer screening rate and willingness among female migrants, and the associated socio-demographic factors in Shenzhen city. Materials and Methods: Two citywide surveys were conducted using a multistage random cluster sampling method in 2011 and 2014, respectively. Data on demographic characteristics, screening participation, and willingness to screen were collected. Logistic regression models were applied to detect possible associated socio-demographic characteristics, and their variations with survey years. Results: In total, 12,017 female migrants were enrolled, with a mean age (standard deviation) of 36.73 (6.55) years. From 2011 to 2014, the screening rate increased (25.8% vs. 35.1%, p < 0.001), while the willingness to screen remained stable (82.2% vs. 82.8%, p=0.46). Overall, socio-demographic characteristics of female migrants, including age, marital status, education, monthly income, employment, and medical insurance, were found to be positively associated with screening participation. Similar impacts in relation to willingness were observed except for age. However, these associations varied with survey years, mainly in the contributions of education and monthly income to screening participation, as well as age, monthly income, and medical insurance to willingness of being screened. Conclusion Identifying changes of associated socio-demographic factors precisely is warranted of necessity, which provides novel clues to adjust targeted actions regularly in promoting cervical cancer screening participation among female migrants in Shenzhen.

Objective:To investigate the expression of SET-NUP214 fusion gene in hematological malignancies and to analyze its related clinical biological characteristics.Methods:The clinical data of 24 patients with SET-NUP214 fusion gene-positive hematological malignancies were retrospectively analyzed, and the Kaplan-Meier method was used for survival analysis.Results:Among the 24 patients with SET-NUP214 fusion gene, 15 cases of acute lymphoblastic leukemia (ALL) (13 cases of T-ALL and 2 cases of B-ALL) , 7 cases of acute myeloid leukemia (AML) , and 2 cases of T/myeloid mixed acute leukemia have been identified. The immunophenotype of 13 cases of T-ALL was mainly characterized by CD3 +CD2 -, 73.3% of ALL was characterized by myeloid marker expression, and 85.7% of AML was characterized by CD7 expression. Complete remission (CR) was achieved in 22 patients (91.7%) after induction chemotherapy. All 24 patients received allogeneic hematopoietic stem cell transplantation (HSCT) . With a median follow-up of 24 months, the 3-year relapse free survival (RFS) of AML and ALL was 85.7% and 33.3%, respectively ( P=0.128) . Comparing 13 cases of SET-NUP214-positive and 62 cases of SET-NUP214-negative T-ALL, the CR rates of induction chemotherapy were 92.3% and 93.5% ( P=0.445) , and the 4-week CR rates of induction chemotherapy were 69.2% and 72.6%, respectively ( P=0.187) ; the differences were not statistically significant. After HSCT, the 3-year RFS of SET-NUP214 +T-ALL and SET-NUP214 -T-ALL was 38.5% and 66.4%, respectively ( P=0.028) , and the difference was statistically significant. Conclusion:The SET-NUP214 fusion gene is mainly detected in T cell-derived hematological malignancies, and the prognosis of SET-NUP214 positive T-ALL is relatively poor.