OBJECTIVE To investigate the effects and mechanisms of Buyang huanwu decoction （BYHWD） and its active fractions in ameliorating non-alcoholic fatty liver disease. METHODS BYHWD and its effective fractions obtained through ethanol precipitation， as well as 30% ethanol， 50% ethanol， and 75% ethanol fractions （namely， the CC effective fraction， 30YC effective fraction， 50YC effective fraction， and 75YC effective fraction）， were prepared. These preparations were administered to rats via intragastric administration to prepare corresponding drug-containing serum （blank serum and simvastatin-containing serum were prepared using the same protocol）. Human L02 hepatocytes were divided into control group， model group， simvastatin-containing serum group， BYHWD-containing serum group， CC-containing serum group， 30YC-containing serum group， 50YC-containing serum group， and 75YC-containing serum group. Except for the control group， other groups were given 0.2 mol/L oleic acid for 24 h to induce a lipid accumulation model， and then intervened with 20% drug-containing serum/blank serum for 24 h. The lipid deposition in cells was observed， and the proportion of lipid droplet area was calculated； the levels of triglycerides （TG） and indicators of oxidative stress [malondialdehyde （MDA）， superoxide dismutase （SOD）] as well as liver function [alanine amino- transferase （ALT）， aspartate amino-transferase （AST）] in cells were detected； protein and mRNA expressions of AMP-activated protein kinase （AMPK）/sterol regulatory element-binding protein-1 （SREBP-1）/glycerol-3-phosphate acyltransferase （GPAT） signaling pathway were also measured. RESULTS Compared with the control group， cells in the model group exhibited severe cellular steatosis， with a significantly increased proportion of lipid droplet area， as well as the elevated levels of TG， ALT， AST， and MDA in cells， along with significantly up-regulated mRNA and protein expression levels of SREBP-1 and GPAT （P＜0.05）. The level of SOD， mRNA expression of AMPK， as well as the protein phosphorylation level of AMPK were decreased significantly （P＜0.05）. Compared with the model group， cellular steatosis was alleviated in all drug-containing serum groups， and the levels of most of the aforementioned quantitative indicators were significantly reversed （P＜0.05）. CONCLUSIONS BYHWD and its active fractions can exert a therapeutic effect on improving non-alcoholic fatty liver disease by regulating the AMPK/SREBP-1/GPAT signaling pathway， inhibiting oxidative stress responses， and reducing lipid deposition.

Objective: To investigate the prevalence and influencing factors of the co-occurrence of elevated blood pressure and depressive symptoms among junior and senior high school students in Anhui Province, so as to provide evidence for comprehensive interventions on physical and mental health among adolescents. Methods: From September to December 2024, a multi stage random cluster sampling method was used to select 103 225 junior and senior high school students from 16 prefecture level cities in Anhui Province. Data were collected through questionnaire surveys and physical measurements. Elevated blood pressure was determined according to the Reference of Screening for Elevated Blood Pressure among Children and Adolescents Aged 7-18 Years. Depressive symptoms among middle school students were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Chi-square test, Chi-square test for trend, and multivariate Logistic regression model were used to analyze the risk factors for the co-occurrence of elevated blood pressure and depressive symptoms. Results: The detection rate of elevated blood pressure was 15.22%, the detection rate of depressive symptoms was 18.56%, and the co-occurrence rate of the two conditions was 2.67% among junior and senior high school students. Multivariate Logistic regression analysis showed that after controlling for gender, school stage, household registration, and overweight and obesity status,compared with those who don t drink sugary drink and eat fried food, and get enough sleep, sugar sweetened beverage intake <1 and ≥1 time/d( OR =1.28,1.61), fried food consumption ≥1 time/d( OR =1.37), and insufficient sleep ( OR =1.54) were all associated with an increased risk of the co-occurrence of elevated blood pressure and depressive symptoms(all P <0.05). Daily fresh vegetable intake ≥1 time/d( OR =0.78) and fresh fruit intake ≥1 time/d( OR =0.85) were both associated with a decreased risk of the co-occurrence(both P <0.05). Compared with students who did not eat breakfast, students who ate breakfast sometimes and every day ( OR =0.62,0.36) had a lower co-occurrence risk(both P < 0.05). Junior and senior high school students with daily outdoor activity duration≥1 h ( OR =0.81) had a lower risk of the co-occurrence of elevated blood pressure and depressive symptoms ( P <0.05). Conclusions Sugar sweetened beverage drink and fried food consumption, inadequate consumption of fresh vegetables, fruits and breakfast, lack of outdoor activity, and insufficient sleep are risk factors for the co-occurrence of elevated blood pressure and depressive symptoms among junior and senior high school students in Anhui Province. It is necessary to establish school health promotion strategies integrating nutrition, exercise and sleep management as intervention targets to reduce the co-occurrence risk of elevated blood pressure and depressive symptoms among junior and senior high school students.

OBJECTIVE To construct a closed-loop management model for externally dispensed intravenous prescriptions， and to provide reference for standardized management of externally dispensed intravenous prescriptions. METHODS Based on the Expert Consensus on Closed-loop Management of Externally Dispensed Intravenous Prescriptions in Guangxi Zhuang Autonomous Region previously formulated by our hospital， risk points during the entire process were systematically identified through multidisciplinary team brainstorming and a fishbone diagram. A series of strategies were subsequently formulated and implemented， including qualifying designated external dispensing pharmacies and the drug catalogs， operating and maintaining the hospital information system and the Pharmacy Intravenous Admixture Service （PIVAS） intelligent management platform， and strengthening differentiated training for staff in the whole workflow. A whole-process closed-loop management system was constructed with PIVAS as the co re hub and the daytime chemotherapy center as the safety terminal. RESULTS A total of 3 cooperating pharmacies and an initial drug list comprising 35 product specifications were selected. A closed‑loop management process encompassing hospital outpatient prescribing， patient drug purchase in designated pharmacies， PIVAS drug dispensing， and medication use in daytime chemotherapy center was successfully established. This system enabled the mandatory grouping and association of externally dispensed intravenous prescriptions with in-hospital diluents， full-process verification based on drug traceability codes， intelligent monitoring of infusion parameters， and whole-process data traceability. CONCLUSIONS The constructed model effectively resolves the coordination and safety oversight during the use of externally dispensed intravenous drugs from out-of-hospital circulation to in-hospital use， and has preliminarily enabled procedural standardization， whole-process information traceability， and proactive control of medication risks.

With the widespread application of low-dose computed tomography (CT), the detection rate of multiple lung cancers (MLCs) is gradually increasing. The diagnosis and treatment of MLCs have become a major challenge in clinical practice in thoracic surgery and oncology. In April 2025, the Lung Cancer Professional Committee of the China Anti-Cancer Association (CACA) organized multidisciplinary experts from both domestic and international fields to release the first edition of the CACA Expert Consensus on the Diagnosis and Treatment of Multiple Lung Cancers, providing systematic recommendations for the diagnostic system, molecularassessment strategies, and surgical and non-surgical management of MLCs. This article provides a detailed interpretation of the core content of this consensus and, by incorporating the latest research progress in the field, delves into the pathogenesis, precise diagnostic strategies, and individualized treatment pathways for multiple lung cancers, aiming to offer a more comprehensive reference for clinical practice.

Objective To observe and analyze the disease,health status,and related factors of college students in Lhasa at a specific time point,so as to reveal the distribution characteristics of acute mountain sickness(AMS)and the correlation between TCM constitution and other variables in the target population.Methods A cross-sectional observational study design was adopted.Univariate analysis was conducted on the differences between groups in demographic and sociological indicators,physiological indicators,risk factors,TCM constitution,sleep quality,and psychological state,with the presence or absence of AMS as the grouping variable.Binary Logistic regression analysis was performed with variables with P<0.05 in univariate analysis as independent variables and the presence or absence of AMS as the dependent variable to explore the correlation between AMS and various influencing factors.Results A total of 415 valid questionnaires were recovered.The prevalence of AMS peaked at 43.55%within 24 hours after entering Tibet,showing an overall trend of first increasing and then decreasing.AMS was significantly correlated with pre-entry mood,time adaptation,anxiety state,and constitution.College students in a state of tension and fear were 4.84 times more likely to develop AMS than those with no change in mood(OR=4.84,95%CI:1.07～21.95,P=0.041).College students with anxiety were 2.21 times more likely to develop AMS than those without anxiety(OR=2.21,95%CI:1.23～3.99,P=0.008).In terms of constitution,when the Pinghe Constitution was used as the reference group,the combined constitution was significantly associated with the occurrence of AMS(OR=2.44,95%CI:1.16～5.16,P=0.019).Among the eight biased constitutions,the prevalence of AMS in qi-deficiency constitution was 2.06 times that in non-qi-deficiency constitution(95%CI:1.05～4.06,P=0.036).In terms of time adaptation,the stages of 72～96 hours and 96～120 hours after arriving in Lhasa had P<0.05,with OR values of 0.38(95%CI:0.15～0.99)and 0.30(95%CI:0.13～0.66),respectively.Conclusion The main risk factors for AMS in college students in Lhasa are related to anxiety,pre-entry mood,and constitution,and the adaptation time of 72 hours is a protective factor for AMS.

The rapid development of generative large language models(GLLM)has attracted considerable attention in research of imaging medicine,which showed promise in terms of potential applications in ultrasound medicine.At present,GLLM possessed the theoretical level of a medical practitioner and had the capacity to enhance productivity through generating reliable,structured ultrasound reports and assisted diagnoses,hence being significant valuable for reducing time costs and improving effectiveness of physician-patient communication.The research status of GLLM in ultrasound medical knowledge quizzes,structured ultrasound report generation,as well as diagnosis and management of disease were reviewed in this article.

Objective To establish an ultra-high-performance liquid chromatography-triple quadrupole tandem mass spectrometry method for the determination of N-(1,3-dimethylbutyl)-N′-phenyl-p-phenylenediamine quinone (6PPDQ) in human plasma and urine. Methods Plasma and urine samples (0.3 mL each) were mixed with 0.9 mL acetonitrile and dichloromethane, vortexed, and subjected to ultrasonic treatment to facilitate extraction. After centrifugation, the extract was collected, evaporated to dry powder under nitrogen, and reconstituted. Separation was performed on a C18 column, and detection was carried out using ultra-high-performance liquid chromatography-triple quadrupole tandem mass spectrometry with external standard quantification. Results 6PPDQ showed good linearity in the range of 0.01-25.00 μg/L in both human plasma and urine, with correlation coefficients of 0.999 5 and 0.999 7, respectively. The detection limits for plasma and urine were 8 and 6 ng/L, and the lower limits of quantification were 27 and 19 ng/L, respectively. The average recovery rates were 97.00%-100.00% for plasma and 90.00%-96.50% for urine. The within-run relative standard deviations (RSDs) were 4.35%-10.00% for plasma and 2.34%-11.11% for urine, while the between-run RSDs were 6.80%-8.46% and 2.60%-10.00%, respectively. Samples can be stored for seven days at 4 ℃ or -20 ℃. respectively. Samples can be stored for seven days at 4 ℃ or -20 ℃. Matrix effects ranged from 87.12%-99.27% for plasma and 91.00%-97.56% for urine. Conclusion The proposed method is simple, highly sensitive, and reproducible, and is suitable for the determination of 6PPDQ in human plasma and urine samples.

OBJECTIVE To understand the current management status of the special campaign for enhancing the pathogen detection rate before antimicrobial therapy in hospitalized patients in China,analyze identified issues dur-ing implementation,and propose improvement suggestions.METHOD A questionnaire survey was conducted to collect data from medical institutions participating in the special campaign within the region from May to Jul.2024,covering aspects such as quality control management,coordination mechanisms,data sources,indicator connotations and existing issues.RESULTS Variations were observed among medical institutions in the manage-ment of pathogen detection rates,primarily reflected in inconsistent usage of detection rate indicators,varying im-plementation levels of quality control measures and differences in multi-departmental participation.Additionally,discrepancies in data sources,statistical methods and interpretations of indicator connotations limited the compara-bility of data.CONCLUSIONS To address these issues,improvement measures such as strengthening informatiza-tion construction,standardizing indicator statistical methods and enhancing multi-departmental coordination mech-anisms should be implemented.These efforts will provide a scientific basis for the implementation of special cam-paign and robust support for the rational use of antimicrobial agents.

ObjectiveTo analyse the efficacy and mechanism of Guizhi Fulingwan in regulating sex hormone disorders in rats with benign prostatic hyperplasia （BPH）. MethodsThirty male SD rats were randomly divided into a sham group， a model group， a finasteride group （0.45 mg·kg^-1·d^-1）， and low-dose and high-dose groups of Guizhi Fulingwan （0.135， 0.337 5 g∙kg^-1∙d^-1）， with six in each group. The BPH model was prepared by subcutaneous injection of 3.5 mg∙kg^-1∙d^-1 testosterone propionate after debridement surgery in all groups except the sham group. The rats in the sham group and the model group were administered with an equal volume of saline by gavage， and the rest of the groups were administered with the corresponding medicinal solution by gavage for 35 days. Histopathology in rats was evaluated by prostate wet weight， volume， index， and hematoxylin-eosin （HE） staining. The serum sex hormone levels of testosterone （T）， dihydrotestosterone （DHT）， and estradiol （E₂） were determined by enzyme-linked immunosorbent assay. The protein expression of the androgen receptor （AR） was detected by immunohistochemistry. The serum metabolism profiles of rats in the sham group， the model group， and the high-dose group of Guizhi Fulingwan were compared by ultra-high performance liquid chromatography tandem Fourier transform mass spectrometry （UHPLCQ Exactive） to screen for metabolic markers and to obtain relevant metabolic pathways. ResultsCompared with those in the sham group， the wet weight， volume， index， serum sex hormone level， and AR protein expression of the prostate in the model group were all elevated （P<0.05， P<0.01）， and the histomorphology showed pathological changes. Compared with those in the model group， the wet weight， volume， index， serum sex hormone level， and AR protein expression of the prostate in the intervention groups showed a decreasing trend （P<0.05， P<0.01）， and histopathology was improved. Serum metabolomics analysis obtained a total of 40 metabolic markers related to the intervention effect of Guizhi Fulingwan， such as dehydrosafynol， hyoscyamine， and lumichrome， which were involved in the pathways of autophagy， riboflavin metabolism， and retrograde endocannabinoid signaling. ConclusionGuizhi Fulingwan can effectively regulate sex hormone disorders in BPH rats， and its mechanism may be related to autophagy， riboflavin metabolism， and retrograde endocannabinoid signaling.

Antibody-drug conjugates (ADC) are one of the most popular types of anti-tumor drugs nowadays. Monomethyl auristatin E (MMAE), as a tubulin binder, is the most common applied payload in ADC and is also the main component that causes peripheral neuropathy (PN). By describing the clinical characteristics of 3 cases with MMAE ADC associated severe PN complications and analyzing reported references, this article summarizes that the occurrence of MMAE ADC associated PN is correlated with therapeutic cycles and duration of ADC, MMAE ADC associated PN is different from traditional chemotherapy-induced PN in the clinical presentation. Patients with MMAE ADC associated PN may present with a length-dependent involvement of peripheral motor and sensory nerves, and generally their weakness and deep sensory deficiency symptoms are more serious compared with traditional chemotherapy-induced PN. Two of the 3 patients achieved a relatively rapid recovery after treated with plasma exchange or immunoglobulin intravenous infusions.