It is believed that the head and facial orifices are connected with the brain's spirit and the spirits of the five organs. Their functions， including vision， hearing， smell， taste， and speech， are manifestations of the activity of the spirit. Furthermore， head and facial orifice disorders are interrelated with spirit disorders， forming a cause-and-effect relationship. Acupuncture has a regulatory effect on the spirit. Based on this， acupuncture for regulating the spirit in treating head and facial orifice disorders is proposed. This includes regulating the brain's spirit to treat functional disorders， regulating the heart's spirit to clarify the functions of governing substances， regulating the organ's spirit to benefit the orifices and enhance the communication of the spirit， and regulating the liver's spirit to promote the flow of Qi （气） and relieve stagnation， thereby providing a framework for acupuncture to treat head and facial orifice disorders.

To summarise the clinical experience of treating insomnia with the method of resolving depression， regulating the middle， and tranquilising mind. It is believed that the key to the pathogenesis of insomnia lies in qi depression， disharmony of qi pivot， and disharmony of qi and blood， and the core treatment is to resolve depression， regulating the middle， and tranquilising mind. The self-prescribed Jieyu Anmian Formula （解郁安眠方） could be used as the basic treatment， then modified according to the performance of the patient and syndromes. For syndrome of liver depression restricting spleen， the treatment should soothe liver and invigorate spleen， resolve depression and regulate the middle； for syndrome of liver depression and phlegm coagulation， the treatment should resolve depression and phlegm， support the earth and free the wood； for syndrome of liver depression transforming into fire， the treatment should soothe liver and clear fire， resolve depression and dysphoria； for syndrome of qi stagnation and blood stasis， the treatment should activate blood and regulate the middle， resolve depression and tranquilise mind.

Objective To investigate the changing antibiotic resistance profiles of E.coli isolated from patients in the 52 hospitals participating in the CHINET program from 2015 to 2021.Methods Antimicrobial susceptibility was tested for clinical isolates of E.coli according to the unified protocol of CHINET program.WHONET 5.6 and SPSS 20.0 software were used for data analysis.Results Atotal of 289 760 nonduplicate clinical strains ofE.coli were isolated from 2015 to 2021,mainly from urine samples(44.7±3.2)％.The proportion of E.coli strains isolated from urine samples was higher in females than in males(59.0％vs 29.5％).The proportion of E.coli strains isolated from respiratory tract and cerebrospinal fluid samples was significantly higher in children than in adults(16.7％vs 7.8％,0.8％vs 0.1％,both P＜0.05).The isolates from internal medicine department accounted for the largest proportion(28.9±2.8)％with an increasing trend over years.Overall,the prevalence of ESBLs-producing E.coli and carbapenem resistant E.coli(CREco)was 55.9％and 1.8％,respectively during the 7-year period.The prevalence of ESBLs-producing E.coli was the highest in tertiary hospitals each year from 2015 to 2021 compared to secondary hospitals.The prevalence of CREco was higher in children's hospitals compared to secondary and tertiary hospitals each year from 2015 to 2021.The prevalence of ESBLs-producing E.coli in tertiary hospitals and children's hospitals and the prevalence of CREco in children's hospitals showed a decreasing trend over the 7-year period.The prevalence of CREco in secondary and tertiary hospitals increased slowly.Antibiotic resistance rates changed slowly from 2015 to 2021.Carbapenem drugs(imipenem,meropenem)were the most active drugs amongβ-lactams against E.coli(resistance rate≤2.1％).The resistance rates of E.coli to β-lactam/β-lactam inhibitor combinations(piperacillin-tazobactam,cefoperazone-sulbactam),aminoglycosides(amikacin),nitrofurantoin and fosfomycin(for urinary isolates only)were all less than 10％.The resistance rate of E.coli strains to antibiotics varied with the level of hospitals and the departments where the strains were isolated,especially for cefazolin and ciprofloxacin,to which the resistance rate of E.coli strains from children in non-ICU departments was significantly lower than that of the strains isolated from other departments(P＜0.05).The E.coli isolates from ICU showed higher resistance rate to most antimicrobial agents tested(excluding tigecycline)than the strains isolated from other departments.The E.coli strains isolated from tertiary hospitals showed higher resistance rates to the antimicrobial agents tested(excluding tigecycline,polymyxin B,cefepime and carbapenems)than the strains from secondary hospitals and children's hospitals.Conclusions E.coli is an important pathogen causing clinical infection.More than half of the clinical isolates produced ESBL.The prevalence of CREco is increasing in secondary and tertiary hospitals over the 7-year period even though the overall prevalence is still low.This is an issue of concern.

OBJECTIVE To study how resveratrol(Res)mitigates acute lung injury(ALI)in mice induced by sulfur mustard(SM)and potential mechanism.METHODS Male C57BL/6N mice were randomly divided into the control group(50 μL physiological saline via nebulization),SM group(SM 5 mg·kg-1 via nebulization),SM+Res 10 or 20 mg·kg-1 groups(1 h after administration of SM 5 mg·kg-1,Res 10 or 20 mg·kg-1 was administered via nebulization).Mice in each group were weighed 0,24,48 and 72 h after SM administration.Mice were sacrificed 72 h after SM administration,and lung tissues were collected,weighed for wet and dry weights,and the wet/dry ratio was calculated.HE staining was employed to detect the pathological changes of lung tissues while real-time quantitative PCR(RT-qPCR)was used to detect the mRNA expression levels of interleukin 6(IL-6)and IL-1β.Transcriptomic changes of the SM group and the SM+Res 20 mg·kg-1 group were detected with the next-generation sequencing technology.RT-qPCR was used to detect the mRNA expression changes of adenosine 5'-monophos-phate-activated protein kinase(AMPK)and silence information regulator 1(SIRT1)in lung tissues.RESULTS 72 h after SM administration,the body mass of mice in the SM group was significantly decreased compared with normal control group,while the wet/dry ratio of the lung was significantly increased,so were the mRNA expression levels of IL-6 and IL-1β in lung tissues were also significantly increased.Pathological changes of lung tissues included alveolar cavity atrophy,marked parenchymal tissues,and diffuse infiltration of local inflammatory cells.Compared with the SM group,the body mass of mice in the SM+Res 10 and 20 mg·kg-1 groups significantly increased,the wet/dry ratio of lung tissues was significantly reduced,and expressions of IL-6 and IL-1β mRNA were significantly decreased in SM+Res 10 and 20 mg·kg-1 groups.Compared with the normal control group,the mRNA expression levels of AMPK and SIRT1 in lung tissues of the SM group were significantly decreased.Compared with the SM group,the mRNA expression levels of AMPK in lung tissues of the SM+Res 10 and 20 mg·kg-1 groups were significantly increased while the mRNA expression level of SIRT1 was significantly decreased.CONCLUSION Res can mitigate ALI in mice induced by SM,and the mechanism may be related to the inhibition of cell apoptosis by regulating the AMPK/SIRT1 signaling pathway.

Objective:To explore the role of PTPN11 gene polymorphisms in Noonan syndrome (NS) and other related diseases and to evaluate the association between PTPN11 gene variants and various disease phenotypes.Methods:This study first described a case of 7-year-old girl diagnosed with Nonan symdrome who visited our department in Februay 2024 presented to our department six months ago and was diagnosed with Noonan syndrome. Whole-exome sequencing revealed a heterozygous variant in her PTPN11 gene, with the single nucleotide polymorphism (SNP) locus identified as rs121918457. Due to limited phenotypic data associated with rs121918457 in available databases, the cis-expression quantitative trait locus (cis-eQTL) rs12425405, located near the PTPN11 gene, was used as a proxy to further investigate the impact of PTPN11 gene expression regulation on various disease phenotypes. A PheWAS analysis was conducted to assess the statistical association between PTPN11 polymorphism and diverse phenotypic traits. All data were analyzed using the PheWeb online tool, and statistical significance was tested using the P-value. Bonferroni correction was applied for multiple comparisons to ensure the reliability of the results. The significance level was set at P<0.05, and the Bonferroni-corrected significance threshold was P=3.52×10 -5. Results:This case demonstrated that, in addition to the typical clinical features of Noonan syndrome, the child also presented with significant hypertension and autoimmune symptoms (such as joint pain, peripheral nerve damage, and positive antinuclear antibodies). The PheWAS analysis revealed significant statistical associations between the rs12425405 polymorphism and the following disease phenotypes: myocardial infarction ( P=1.90×10 -5), coronary atherosclerosis ( P=7.40×10 -5), ischemic heart disease ( P=2.30×10 -5), and hypertension ( P=8.8×10 -5). Additionally, rs12425405 showed statistical associations with some autoimmune symptoms (such as rheumatoid arthritis) ( P=0.027), but did not reach the corrected significance threshold ( P>3.52×10 -5). Conclusion:PTPN11 gene mutations are not only pathogenic factors in Noonan syndrome but may also play a critical role in the development of cardiovascular diseases and are associated with autoimmune symptoms. However, further research is needed to elucidate the functional mechanisms of the PTPN11 gene across multiple diseases and determine whether common genetic drivers are present.

Grounded in organizational change-complex systems theory,it investigates the pathways and mechanisms for deep integration of Artificial Intelligence(AI)into clinical management.Addressing structural challenges in current clinical management systems,it propose a dynamic three-phase model"unfreezing-changing-refreezing"driven by AI technologies.By deconstructing systemic contradictions arising from technological penetration e.g.,multi-agent coordination,ethical risks,and responsibility ambiguity,a layered governance framework and dynamic regulatory mechanisms are established.Through synergistic evolution of technology,organization,and institution,an adaptive transition in clinical management paradigms can be achieved,ultimately fostering an AI-augmented healthcare ecosystem that balances efficiency with safety.

Objective The study explored the psychological help-seeking experiences of adolescents with mood disorder,so as to provide references for healthcare professionals to carry out relevant interventions to facilitate adolescents'early access to mental health services.Methods A qualitative research was adopted,and 14 adolescents with mood disorder admitted to a tertiary hospital in Lanzhou City from December 2023 to March 2024 were interviewed by semi-structured interviews.The data was analyzed by Colaizzi seven-step method.Results 3 themes were extracted,including long and tortuous help-seeking journey(maladaptive coping,continuous exploration of informal help-seeking behavior,formal help-seeking for crisis-triggered or needs-driven),the psychological experience intertwining struggles and expectations(disappointment at not being taken seriously,helplessness at not being understood,expectation of more understanding and support),barriers to help-seeking(lack of knowledge,difficulties with self-disclosure,lack of trust,negative attitudes encountered when seeking informal help,negative experiences during formal help-seeking).Conclusion Adolescents with mood disorder experienced a long and tortuous journey while seeking help,faced with numerous barriers along the process,and desired to be understood and supported.Healthcare professionals should collaborate with families,schools,and other resources,to improve adolescents'mental health literacy and establish a robust social support system,so as to provide reliable support for adolescents with mood disorder in accessing professional mental health services.

Objective To investigate the cIinicopathological features and immunohistochemical expression of gastric hyperplastic polyps(GHPs)with dysplasia/adenocarcinoma.Methods A retrospective analysis of 24 cases(44 polyps)that were diagnosed as GHPs with dysplasia/adenocarcinoma in our hospital from January 2020 to December 2024 was reviewed,and clinical,histomorphological,immunophenotypic and follow-up data were analyzed.Results There were 20 female and 4 male cases,with a mean age of(65.5±7.9)(range 56～76)years.Among 44 polyps,3 occurred in the antrum of the stomach,1 in the gastric horn,and 40 in the fundus/body.Among the polyps,32 cases were diagnosed as high-grade dysplasia,4 cases as low-grade dysplasia,4 cases as coexistence of low-grade+high-grade dysplasia,2 cases as mucinous adenocarcinoma,1 cases as poorly differentiated adenocarcinoma,and 1 cases as signet-ring cell carcinoma.The histological manifestations of 23 cases of background mucosa were autoimmune metaplastic atrophic gastritis(AMAG).the P53 of 8 polyps showed a mutant expression pattern.Through MUC5/MUC6/MUC2/CD10 joint examination,33 cases showed gastric type(25 cases of which were foveal epithelium type),4 cases were intestinal type,5 cases were mixed gastrointestinal type,and 2 cases were non-gastrointestinal type.Conclusion The neoplastic transformation of GHPs is closely related to AMAG.It is necessary for clinicians and pathologists to strengthen their evaluation of background mucosa,to achieve early detection,early diagnosis and early treatment.

Objective The aim of this study is to explore the medication experience of adolescents with mood disorders,providing references for promoting their medication adherence.Methods Descriptive qualitative research was utilized.A total of 16 teenager patients with mood disorders from a tertiary A hospital in Lanzhou City,were selected for semi-structured interviews by purposive sampling.The data was analyzed by the Colaizzi 7-step analysis method.Results A total of 4 themes were extracted.①Cognitive experiences(Confusion and rejection at the initial stage;acceptance and compromise with time;self-stigmatization of medication).②Emotional experiences(expectations of medication effects at the initial stage;concerns and fears about side effects;anxiety of long-term medication;disappointment of the effect;desire for medication reduction).③Behavioral experiences(helpless persistence;poor medication behavior;coping with medication stigma on campus;traumatic experience of suicide by taking an overdose).④Multiple obstacles to the medication(family prejudice and misconceptions about medication;lack of acceptance and understanding by peers;lack of care and communication from health professionals;shortage of mental healthcare resources;limited access to medication information).Conclusion In the process of medication,the cognitive and emotional experience of adolescent patients with mood disorders showed multiple and changing characteristics,and there were behavioral experiences of poor medication compliance and poor coping style.At the same time,adolescents expressed diverse needs for medication.In the future,we should actively explore patient-centered personalized nursing according to the dynamic experience and demand of adolescents for drug treatment.

Cervical spinal cord injury without fracture-dislocation (CSCIWFD) is referred to as a special type of cervical spinal cord injury characterized by traumatic spinal cord dysfunction and no significant bony structural abnormalities on imagines. Duo to the high risk of missed diagnosis during the initial consultation, CSCIWFD may lead to progressive neurological deterioration or even complete paralysis, severely impacting patients′ prognosis. Currently, there are no established consensuses over the diagnosis and treatment of CSCIWFD, such as the lack of evidence-based standards for indications of non-surgical treatment and risk of secondary neurological injury, as well as debates over the optimal timing for surgical intervention and indications for different surgical approaches. To address these issues, the Spine Trauma Group of the Orthopedic Branch of the Chinese Medical Doctor Association organized experts in the relevant fields to formulate Diagnosis and treatment guideline for acute cervical spinal cord injury without fracture- dislocation in adults ( version 2025) . Based on evidence-based medicine and the principles of scientific rigor and clinical applicability, the guidelines proposed 11 recommendations covering terminology, diagnosis, evaluation treatment, and rehabilitation, etc., aiming to standardize the management of CSCIWFD.