This paper discusses the pathogenesis and treatment strategies of skin cancer based on the theory of "spleen deficiency-sweat pore obstruction-toxin accumulation". It is believed that although the disease is located in the skin and body hair， it is not only the localized disorder but closely related to the imbalance of qi and blood of zang-fu （脏腑） organs. The core of the disease is the synergistic disorder of spleen， sweat pore， and skin and body hair. The disease progression follows a dynamic evolution from spleen deficiency with loss of nourishment， initial closure of sweat pore to binding of dampness and stasis with obstruction of sweat pore， and then to cancer toxin consolidation with damage to sweat pore. Based on this， three principles of building earth， opening sweat pore and attacking toxin are established. The method of fortifying spleen and raising the clear aims to consolidate the root and restore validity， with commonly used prescriptions including modifications of Buzhong Yiqi Decoction （补中益气汤）， Liujunzi Decoction （六君子汤） and Guipi Decoction （归脾汤）. The method of opening sweat pores with acrid-moistening medicinals is suggested when dredging and unblocking the sweat pore， commonly using acrid and warm dispersing medicinals， supplemented with herbs that nourish fluids and moisten dryness. The method of clearing heat and removing toxin is to break cancer toxin directly， and modifications of prescriptions such as Wuwei Xiaodu Beverage （五味消毒饮）， Xiaolei Pills （消瘰丸） and Xihuang Pills （犀黄丸） are commonly used. These approaches provide valuable ideas for the prevention and treatment of skin cancer with traditional Chinese medicine.

Despite significant advances in the field of critical care medicine over the past three decades, veno-arterial extracorporeal membrane oxygenation (V-A ECMO) remains the primary temporary mechanical circulatory support modality for patients with acute severe circulatory failure. With the accumulation of clinical experience and the increasing maturity of operational techniques in V-A ECMO, its technical management—particularly hemodynamic management—has become a key factor influencing patient outcomes. To further improve patient survival, the Chinese Critical Care Ultrasound Study Group, in collaboration with the Hemodynamic Therapy of Critical Care Collaborative Group and the Critical Care Medicine Branch of the China International Exchange and Promotive Association for Medical and Health Care, organized experts in critical care medicine to develop the Consensus on Hemodynamic Management in Adult Veno-Arterial Extracorporeal Membrane Oxygenation (2026 Edition). Based on years of clinical experience and the latest evidence-based medical evidence, this consensus formulates 15 systematic recommendations covering the entire process of V-A ECMO, including initiation, management during support, and weaning, aiming to promote standardized application of hemodynamic management in V-A ECMO.

ObjectiveTo investigate the efficacy and safety of simplified diagnosis and treatment strategies and regimens in the treatment of patients with human immunodeficiency virus （HIV）/hepatitis C virus （HCV） co-infection. MethodsThis multicenter prospective real-world study was conducted among 198 patients with HIV/HCV co-infection who received hepatitis C treatment in 10 designated primary hospitals for hepatitis C in Yuxi， China from July 2023 to June 2024， and according to whether genotype detection was performed， they were divided into genotype detection group with 122 patients and non-genotype detection group with 76 patients. The patients were observed in terms of sustained virologic response at 12 weeks （SVR12）， safety， and liver biochemical parameters. Propensity score matching was used to match the two cohorts， using caliper matching （caliper value = 0.02） at a ratio of 1∶1. The independent-samples t test or the Wilcoxon signed-rank test was used for comparison of continuous data between two groups， and the chi-square test was used for comparison of categorical data between groups. ResultsAmong the 122 patients in the genotype detection group， 63.11% （77/122） had genotype 3， while the non-genotype detection group had 76 patients； both groups achieved an SVR12 rate of 100%. From baseline to 12 weeks after treatment， both groups had a significant increase in the serum level of albumin， significant reductions in the serum levels of total bilirubin， alanine aminotransferase， aspartate aminotransferase， and alpha-fetoprotein， and a significant reduction in FibroScan value （all P<0.05）. A total of 54 patients （27.27%） experienced at least one adverse reaction， and anemia was the most common adverse reaction （38 patients， 19.19%）， with an incidence rate of 50.00% （33/66） in patients with liver cirrhosis. HIV viral load remained <50 IU/mL before and after treatment， and there was no significant change in CD4⁺ T lymphocyte count after treatment （Z=-0.969， P=0.202）. Compared with the genotype detection group， the non-genotype detection group had a significantly shorter time from positive HCV RNA testing to treatment initiation （4±2 days vs 19±4 days， t=5.321， P<0.05） and significantly lower testing costs （618±97 yuan vs 789±129 yuan， t=3.661， P<0.05）. ConclusionFor patients with HIV/HCV co-infection， the simplified diagnosis and treatment strategies can achieve a relatively high SVR12 rate， improve biochemical indicators， and effectively reduce time cost and economic burden， with a favorable safety profile.

This paper discusses the pathogenesis and treatment strategies of skin cancer based on the theory of "spleen deficiency-sweat pore obstruction-toxin accumulation". It is believed that although the disease is located in the skin and body hair， it is not only the localized disorder but closely related to the imbalance of qi and blood of zang-fu （脏腑） organs. The core of the disease is the synergistic disorder of spleen， sweat pore， and skin and body hair. The disease progression follows a dynamic evolution from spleen deficiency with loss of nourishment， initial closure of sweat pore to binding of dampness and stasis with obstruction of sweat pore， and then to cancer toxin consolidation with damage to sweat pore. Based on this， three principles of building earth， opening sweat pore and attacking toxin are established. The method of fortifying spleen and raising the clear aims to consolidate the root and restore validity， with commonly used prescriptions including modifications of Buzhong Yiqi Decoction （补中益气汤）， Liujunzi Decoction （六君子汤） and Guipi Decoction （归脾汤）. The method of opening sweat pores with acrid-moistening medicinals is suggested when dredging and unblocking the sweat pore， commonly using acrid and warm dispersing medicinals， supplemented with herbs that nourish fluids and moisten dryness. The method of clearing heat and removing toxin is to break cancer toxin directly， and modifications of prescriptions such as Wuwei Xiaodu Beverage （五味消毒饮）， Xiaolei Pills （消瘰丸） and Xihuang Pills （犀黄丸） are commonly used. These approaches provide valuable ideas for the prevention and treatment of skin cancer with traditional Chinese medicine.

OBJECTIVE To assess the correlation between the steady-state minimal concentration （cmin） and 24 h area under the drug concentration-time curve （AUC24）/minimal inhibitory concentration （MIC） ratio （AUC24/MIC） of vancomycin in pediatric patients， and analyze independent risk factors for treatment failure. METHODS Data of hospitalized children treated with vancomycin and receiving therapeutic drug monitoring in our hospital from January 2021 to July 2024 were retrospectively collected and divided into success group and failure group according to whether the treatment was successful or not. Spearman correlation analysis was used to analyze the correlation between cmin and AUC24/MIC of vancomycin， and one-way and multifactorial Logistic regression analyses were used to screen the independent risk factors for vancomycin treatment failure. RESULTS A total of 59 children were included， with 41 in the success group and 18 in the failure group. Compared with the failure group， AUC24/MIC of vancomycin was significantly higher in the success group （P＝0.038）， but there was no statistically significant difference in the cmin of the two groups （P＞0.05）； cmin of vancomycin was significantly positively correlated with AUC24/MIC （r＝0.499， P＜0.001）， but it has a certain efficacy in predicting the achievement of the AUC24/MIC standard （≥400） （area under the receiver operator characteristic curve＝0.696）， with an optimal cutoff value of 6.05 mg/L determined by the Youden index. The efficacy of AUC24/ MIC in predicting treatment failure was superior to cmin （areas under the receiver operator characteristic curve were 0.671 vs. 0.523， P were 0.038 vs. 0.684）， with higher sensitivity （83.3% vs. 66.7%）. Hypoproteinemia and AUC24/MIC≤369.1 were independent risk factors for vancomycin treatment failure （P＜0.05）. The incidence of nephrotoxicity was 3.4%. CONCLUSIONS There is a significant positive correlation between cmin and AUC24/MIC of vancomycin in pediatric patients； hypoproteinemia and AUC24/MIC≤369.1 are independent risk factors for vancomycin treatment failure in children.

OBJECTIVE: To explore and quantify the association of hot night exposure during the sperm development period (0-90 lag days) with semen quality. METHODS: A total of 6,640 male sperm donors from 6 human sperm banks in China during 2014-2020 were recruited in this multicenter study. Two indices (i.e., hot night excess [HNE] and hot night duration [HND]) were used to estimate the heat intensity and duration during nighttime. Linear mixed models were used to examine the association between hot nights and semen quality parameters. RESULTS: The exposure-response relationship revealed that HNE and HND during 0-90 days before semen collection had a significantly inverse association with sperm motility. Specifically, a 1 °C increase in HNE was associated with decreased sperm progressive motility of 0.0090 (95% confidence interval [ CI]: -0.0147, -0.0033) and decreased total motility of 0.0094 (95% CI: -0.0160, -0.0029). HND was significantly associated with reduced sperm progressive motility and total motility of 0.0021 (95% CI: -0.0040, -0.0003) and 0.0023 (95% CI: -0.0043, -0.0002), respectively. Consistent results were observed at different temperature thresholds on hot nights. CONCLUSION Our findings highlight the need to mitigate nocturnal heat exposure during spermatogenesis to maintain optimal semen quality.
Humans ; Male ; Semen Analysis ; Adult ; Sperm Motility ; Hot Temperature/adverse effects* ; China ; Middle Aged ; Spermatozoa/physiology* ; Young Adult

Objective: To investigate the current status of sexual function and its influencing factors among pregnant women, so as to provide the reference for improving sexual health among pregnant women. Methods: From January to July 2025, pregnant women attending regular prenatal check-ups at Shanxi Children's Hospital (Shanxi Maternal and Child Health Hospital), were selected as study participants using a convenience sampling method. Information on sociodemographic, pregnancy-related conditions, and sexual activity during pregnancy was collected through questionnaire surveys. Sexual function status over the past four weeks was assessed using the Chinese version of the Female Sexual Function Index. A multiple linear regression model was employed to analyze the influencing factors for sexual function among pregnant women. Results: A total of 424 pregnant women were surveyed, with the majority aged 30-<35 years (211 cases, 49.76%). Among them, 72 were in the first trimester (16.98%), 200 in the second trimester (47.17%), and 152 in the third trimester (35.85%). The overall sexual function score among pregnant women was (17.85±6.46) points. Scores for the six domains, desire, arousal, lubrication, orgasm, satisfaction, and pain were (3.23±0.78) (2.21±1.20) (2.76±1.63) (2.95±1.68) (4.14±1.08) (2.56±1.96) points, respectively. Multiple linear regression analysis revealed that cohabitation with a companion (β'=0.124), stage of pregnancy (third trimester, β'=-0.360), and changes in sexual practices or positions during pregnancy (β'=0.164) were statistically associated with sexual function scores among pregnant women (all P<0.05). Conclusions Sexual function declines among pregnant women, with mean scores across all domains falling below the critical threshold. Cohabitation with a companion and appropriate adjustments in sexual practices or positions according to the stage of pregnancy may improve sexual function among pregnant women.

ObjectiveThe significance of adverse childhood experiences (ACEs) among men who have sex with men (MSM) should not be overlooked. This study aims to assess the reliability and validity of the Chinese version of the Adverse Childhood Experiences-International Questionnaire (ACE-IQ) among the MSM population in China to evaluate its applicability in this group. MethodsA cross-sectional survey was conducted in three Chinese cities(Shanghai, Shenyang and Kunming) using snowball sampling, with a total of 1 130 MSM participants included. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to assess the structural validity of the scale. Internal consistency reliability was evaluated using Cronbach’s α coefficient, and split-half reliability was assessed with the Spearman-Brown coefficient. ResultsAccording to the EFA results, after removing item ACE10 (“parental death”), the 23-item ACE-IQ demonstrated a six-factor structure, including victimization or witnessing emotional/physical abuse, sexual abuse, physical neglect, family dysfunction, emotional neglect, and peer violence. CFA results indicated a good model fit for the six-factor model, supporting the EFA findings. The scale demonstrated good reliability, with a Cronbach's α coefficient of 0.852 and a Spearman-Brown coefficient of 0.899, indicating high internal consistency and split-half reliability within the studied population. ConclusionThe Chinese version of the ACE-IQ demonstrates satisfactory reliability and validity among MSM population, supporting its suitability for assessing ACEs in this group. The findings provide an empirical basis for subsequent mental health interventions.

Forensic medicine has been designated as a first-level discipline,presenting new opportunities and challenges for the development of forensic medicine.Since the 1980s,the establishment of foren-sic medicine discipline and the cultivation of high-level forensic talents have become hot topics in the development of forensic medicine in China.Since the 13th Five-Year Plan,the forensic team of Shanxi Medical University has been aiming at the forefront,proposing the development goals of"Five First-class"and the discipline development path"Six Major Achievements".It has selected benchmark disci-plines,identified gaps in disciplinary development,unified thoughts,formulated completion timelines,concentrated superior resources,assigned tasks to individuals,and created an"Organized Fill-in-the-Blank Format"forensic medicine discipline construction model with the characteristics of the new era.The construction model of forensic medicine has achieved good results in the goals,discipline frame-work,scientific research,talent cultivation,discipline team and platform construction,forming a rela-tively complete discipline construction and management system,and accumulating valuable experience for the construction of first-level discipline and high-level talent cultivation of forensic medicine.

Objective To investigate the relationship between serum thioredoxin reductase 1(TXNRD1),p21-activated kinase 1(PAK1)levels and insulin resistance(IR)and adverse pregnancy outcomes(APO)in pa-tients with gestational diabetes mellitus(GDM).Methods Eighty patients with GDM admitted to Baoji Third Hospital from January 2019 to January 2024 were selected as the GDM group.They were divided into the APO group(25 cases)and the non-APO group(55 cases)based on whether APO occurred.Eighty healthy pregnant women who came to the hospital for prenatal examination recently in a 1∶1 ratio were selected as the control group.The levels of serum TXNRD1 and PAK1 were detected by enzyme-linked immunosorbent assay.The correlation between the levels of serum TXNRD1 and PAK1 in patients with GDM and the homeo-static model assessment of insulin resistance(HOMA-IR)was analyzed through Pearson correlation analysis.Multivariate unconditional Logistic regression was used to analyze the relationship between serum TXNRD1 and PAK1 levels and APO in patients with GDM,and the receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of serum TXNRD1 and PAK1 levels for them.Results Compared with the control group,HOMA-IR and the levels of serum TXNRD1 and PAK1 in the GDM group increased,and the difference was statistically significant(P<0.05).Pearson correlation analysis showed that the levels of serum TXNRD1 and PAK1 in patients with GDM were positively correlated with HOMA-IR(r=0.783,0.790,P<0.001).The results of multivariate unconditional Logistic regression analysis showed that high TXNRD1 and high PAK1 were independent risk factors for APO in patients with GDM(P<0.05).The re-sults of ROC curve analysis showed that the area under the curve(AUC)of serum TXNRD1 and PAK1 levels alone and in combination for predicting APO in GDM patients was 0.785,0.789,and 0.900,respectively.The combined AUC of serum TXNRD1 and PAK1 levels for predicting APO in GDM patients was the largest(Z=2.148,2.454,P=0.032,0.014).Conclusion The levels of serum TXNRD1 and PAK1 in patients with GDM are related to IR and APO.The combination of levels of serum TXNRD1 and PAK1 have a certain pre-dictive efficacy for APO in patients with GDM.