Sepsis remains a challenge in critical care worldwide，with intestinal microbiome dysbiosis implicated in its onset，progression，and organ dysfunction. Germ-free （GF） and human microbiota-colonized animals，by eliminating confounding from resident microbiota and combining induction methods such as CLP/LPS/live-bacterial challenge with fecal microbiota transplantation （FMT） and mono- or combined colonization，enable causal tests and dissection of microbiota-host interactions and drug mechanisms. This review summarizes the application of GF and related models in sepsis research. At the immune level，TLR-related signaling and pathogen community-induced suppression of IRF3-dependent defense affect innate immunity and pathogen clearance. At the barrier level，reprogramming of tight junction proteins and increased permeability drive gut-derived amplification. At the metabolic level，short-chain fatty acids and bile acids function as metabolic valves influencing GPR/HDAC signaling. At the epigenetic level，EZH2 and histone deacetylation emerge as druggable targets. We further synthesize anti-sepsis evidence for traditional Chinese medicine （TCM），mainly from conventional animals and clinical studies，discussing how formulae （e.g.，Xuebijing，Shenfu，and Huanglian Jiedu Tang） and active constituents （e.g.，berberine，luteolin，ginsenosides，and resveratrol） may act through microbiota-related and direct host pathways，with FMT/metabolite replenishment enabling further causal testing. Finally，we propose a closed-loop GF-humanized-clinical stratification paradigm for integrated evaluation of microecology，epigenetics，immunity，and organ outcomes，providing a translational path for precision prevention and treatment based on TCM and the microbiome.

Radix Bupleuri(RB)is commonly used to treat depression,but it can also lead to hepatotoxicity after long-term use.In many anti-depression prescriptions,RB is often used in combination with Radix Paeoniae Alba(RPA)as an herb pair.However,whether RPA can alleviate RB-induced hepatotoxicity remain unclear.In this work,the results confirmed that RB had a dose-dependent antidepressant effect,but the optimal antidepressant dose caused hepatotoxicity.Notably,RPA effectively reversed RB-induced hepatotoxicity.Afterward,the mechanism of RB-induced hepatotoxicity was confirmed.The results showed that saiko-saponin A and saikosaponin D could inhibit GSH synthase(GSS)activity in the liver,and further cause liver injury through oxidative stress and nuclear factor kappa B(NF-KB)/NOD-like receptor thermal protein domain associated protein 3(NLRP3)pathway.Furthermore,the mechanisms by which RPA attenuates RB-induced hepatotoxicity were investigated.The results demonstrated that RPA increased the abundance of intestinal bacteria with glycosidase activity,thereby promoting the conversion of saikosaponins to sai-kogenins in vivo.Different from saikosaponin A and saikosaponin D,which are directly combined with GSS as an inhibitor,their deglycosylation conversion products saikogenin F and saikogenin G exhibited no GSS binding activity.Based on this,RPA can alleviate the inhibitory effect of saikosaponins on GSS activity to reshape the liver redox balance and further reverse the RB-induced liver inflammatory response by the NF-κB/NLRP3 pathway.In conclusion,the present study suggests that promoting the conversion of saikosa-ponins by modulating gut microbiota to attenuate the inhibition of GSS is the potential mechanism by which RPA prevents RB-induced hepatotoxicity.

Objective:To establish a nomograph prediction model of early critical changes in children with febrile convulsion, and to provide guidance for the prevention and nursing of children with febrile convulsion.Methods:Convenient sampling method was adopted to select 384 children with febrile convulsion in Anhui Children ′s Hospital from January 2018 to April 2021 as the research objects. Based on pews, the children with febrile convulsion were divided into 334 cases of non risk group and 50 cases of risk group. Binary Logistic regression analysis were used to determine the independent risk factors affecting the early critical changes of children with febrile convulsion. A nomogram was drawn based on the independent risk factors. The discrimination and consistency of the model were verified by model ROC curve and Hosmer Lemeshow goodness of fit.The external validation of model prediction efficiency were verified by validation data. Results:Binary Logistic regression analysis showed that age, respiratory rhythm disorder, unconsciousness, breath rate, heart rate, neutrophil-to-lymphocyte ratio (NLR), red blood cell distribution width (RDW), duration of first convulsion and mean body temperature after first convulsion were influence factors for early critical changes in children with febrile convulsion ( P<0.05). The C-index of the model was 0.974 (95% CI 0.954-0.993), and the C-index of the external validation of the model was 0.922 (95% CI 0.880-0.966). The results of H-L fitting test showed that the difference was not statistically significant( χ2=0.29, P>0.05). Conclusions:The early critical changes of children with febrile convulsion may be affected by respiratory rhythm disorder, confusion of consciousness, breath rate, heart rate, NLR, RDW, duration of the first convulsion, mean temperature after the first convulsion and other factors. Pediatric emergency department should collect corresponding intervention measures for children with febrile convulsion according to the establishment of prediction model to prevent their early deterioration.

Objective:To analyze the characteristics of sleep disordered breathing (SDB) in children with allergic rhinitis (AR), and improve the diagnosis and treatment at AR combined with obstructive sleep apnea (OSA).Methods:The clinical data of 120 patients with AR and OSA (AR and OSA group) admitted to the respiratory department at Shenzhen Children′s Hospital from May 2019 to December 2020 were retrospectively analyzed.A total of 120 children diagnosed with OSA and excluded AR during the same period were selected as control group.The SDB day and night symptoms, sleep structure characteristics and sleep breathing events were compared between two groups.Results:The average course of disease in children with AR and OSA was significantly longer than that in control group ( P=0.030). The main manifestations of children in AR and OSA group were mouth breathing (100.0%), snoring (99.2%), nasal obstruction (88.5%), and restless sleep (68.0%). There was no significant difference in sleep structure between two groups ( P>0.05), but the sleep efficiency of AR and OSA group was significantly lower than that of control group ( P=0.028). The respiratory events apnea hypopnea index, obstructive apnea index, obstructive apnea hypopnea index, hypopnea index and oxygen desaturation index of each sleep period in AR and OSA group were significantly higher than those in control group ( P<0.05). Among the children in AR and OSA group, moderate and severe OSA were the main manifestations, and the difference between two groups was statistically significant ( P<0.001). Conclusion:The combination of AR delayed the course of OSA in children.The main characteristics of sleep disordered breathing in children with AR are mouth opening, restless sleep, snoring and nasal obstruction.The sleep efficiency is decreased.Obstructive hypopnea and apnea are the most common respiratory events, and oxygen deficiency often occurs in rapid eye movement phase.Children with AR are more likely to have moderate or severe obstructive sleep apnea.

The flowers of Buddleja officinalis has a long history of being used as a medicine and is widely used in clinical practice，mainly for the treatment of swelling and pain of eye ，afraid of seeing strong light ，easy to shed tears ，pannus. Since its development，there are many aliases and variant names ，and the origins and place of origin are confused and complicated . Based on this，the author researches the name ，origin，place of origin ，processing，taste and meridian tropism ，efficacy，functions and indications of B. officinalis flower by consulting ancient and modern literature . The results show that the name of B. officinalis floweris first recorded in the book KaibaoBencao of the Song Dynasty ，including many variant names such as “mimenghua” “yang’erduo”“dongbudiao”，etc.；the origins of it shall be the dried flowers or buds of B. officinalis Maxim.，which belongs to the family of Loganiaeeae ，stated in the Chinese Pharmacopoeia （2020 edition）.In ancient times ，B. officinalis flower is mainly produced in Sichuan ，Chongqing，Yunnan，Guizhou and other places ；the processing methods mainly include cleansing ，stir-frying， wine-frying，honey-frying，honey wine -frying，licorice-frying and so on . Nowadays，B. officinalis flower is mainly produced in Shanxi，Shaanxi，Gansu，Sichuan and other places ；the processing methods mainly include cleansing and honey -frying. About its taste andmeridian tropism ，the ancient herbal understanding is more consistent ，i.e. taste sweet ，flat or slightly cold ，non-toxic， passing through liver meridian channel ；the flower of B. officinalis is good at wind -expelling and blood -cooling therapy ，clearing liver and improving vision ，eliminating eye screens ；it can be used to treat eye diseases caused by heat evil of liver meridian .

There are many kinds o f Taraxacum plants，which are widely distributed . The dried whole plants of many kinds of plants can be used as medicinal materials ，and the origin is confused . This study finds that Taraxaci Herba first appears as “Pugoncao”in the Liu Juanzi Guiyifang of Jin Dynasty after consulting ancient herbal books ，medical books ，prescription books and modern literature . According to characteristics ，morphology，color and sound of the plant ，it has “Huanghualang”， “Gounoucao”，“Fugongying”，“Pugongying”，“Huanghuadiding”and other aliases . Taraxaci Herba originates from the dried whole plant of Compositae family Taraxacum mongolicum Hand.-Mazz.，T. borealisinense Kitam. or several plants of the same genus . Similar to it ，Sonchus oleraceus Linn.（also known as “Kujucai”）cannot replace Taraxaci Herba as medicine . Because of its characteristics of rapid reproduction and vigorous growth ，Taraxaci Herba is widely distributed in most areas of China .“Absolutely no in Lingnan ”stated in Bencao Gangmu is inconsistent with the actual situation after consulting the relevant works . Ancient physicians take growth height of Taraxaci Herba as their quality standard . Now，those with many leaves ，gray green color and long roots are preferred . Ancient doctors pointed out that Taraxaci Herba were mostly harvested in April and May of the lunar calendar ， and modern research believes that it should be harvested in the near flowering period . In ancient times ，Taraxaci Herba is processed by many methods ，such as purification ，charcoal-frying，honey-frying and wine -frying. In modern times ，purification is the main method. This paper provides theoretical support for the value development and rational utilization of Taraxaci Herba by systematically researching its name ，origin，place of production ，harvesting and processing .

Cell pyroptosis is a programmed death of inflammatory cells. Many members of the gasdermin family （the effector protein family that forms pores） participate in the pathological process of a variety of diseases， such as cancer， myocardial ischemia， renal injury， and osteoarthritis， mainly by activating cysteine aspartate-specific protease （Caspase） for polymerization and shear. Cell pyroptosis has bidirectional regulation. Induction of pyroptosis can promote cell clearance under pathological conditions （such as cancer and tumor cells）， but long-term induction of pyroptosis can lead to abnormal lipid and related vitamin metabolism in vivo. Regulating the balance between cell pyroptosis and proliferation is an important target for traditional Chinese medicine （TCM） treatment of diseases. The Yin-Yang theory runs through the whole process of TCM diagnosis and treatment， which is used to explain the physiological and pathological changes of human body and guide the theory， diagnosis and treatment of diseases and health care. The balance between cell proliferation and pyroptosis is essentially the embodiment of Yin-Yang balance at the cellular level， and the theory of Yin-Yang spontaneous harmonization dominates the balance. TCM intervention on cell pyroptosis is mainly reflected in promoting and inhibiting cell pyroptosis， which has the same significance as Yin-Yang regulation. Based on this theory， this paper revealed the relationship between TCM inhibiting and promoting cell pyroptosis through the Yin-Yang theory， to provide theoretical support for the modernization of the Yin-Yang theory and new goals for the diagnosis and treatment of diseases.

Objective:To evaluate the compatibility laws of effective-component compatibility of Bufei Yishen formula Ⅲ (ECC-BYFⅢ) in regulating mucus hypersecretion of chronic obstructive pulmonary disease (COPD).Methods:According to the efficacy of the original Chinese medicine, the components of ECC-BYFⅢ were divided into four categories: Buqi (Ginsenoside Rh1+Astragaloside), Bushen (Icariin), Huatan (Nobiletin), and Huoxue (Paeonol). The four categories were divided into 14 groups based on the method of mathematical permutation. ① The rats were divided into control group, model group, ECC-BYFⅢ, and different components compatibility groups according to the random number table, totaling 17 groups. COPD rat model in stable phase was established by cigarette smoke exposure combined with repeated bacterial infections. The corresponding drugs were given by gavage at the 9th week of modeling, and the samples were collected at the end of the 16th week. The levels of matrix metalloproteinase-9 (MMP-9) and tissue inhibitors of metalloproteinase 1 (TIMP-1) in serum and bronchoalveolar lavage fluid (BALF), and the levels of mucin (MUC) 5AC in lung tissue and BALF were detected by enzyme linked immunosorbent assay (ELISA). ② Human lung epithelial cells BEAS-2B were divided into blank group, model group, and different components compatibility groups. Hypoxia-induced mucus hypersecretion model of human lung epithelial cells BEAS-2B was established 4 hours after corresponding drug pretreatment. The mRNA expressions of MUC5AC, MUC5B, and MUC1 were detected by quantitative polymerase chain reaction (PCR). The mucus secretion indexes of rats and BEAS-2B cells were evaluated by Region (R) value comprehensive evaluation method.Results:① Compared with the control group, MMP-9 in serum and BALF from the model group were significantly increased, the level of TIMP-1 was significantly decreased, and MUC5AC in lung tissue and BALF were significantly increased. The results of R value comprehensive evaluation showed that except for the Buqi and Bushen groups, ECC-BYFⅢ and other components compatibility groups significantly corrected mucus hypersecretion in COPD rats, ECC-BYFⅢ, Bushen Quxie, Fuzheng Huatan, and Quxie groups were much better (R values were 2.15±0.42, 2.11±0.23, 2.16±0.23 and 2.16±0.55, respectively), compared with the model group (R value: 3.00±0.00), the differences were statistically significant (all P < 0.05). ② Compared with the blank group, the mRNA expressions of MUC5AC, MUC5B, and MUC1 increased in the model group. But different components compatibility groups had no significant effects on the mucus secretion of BEAS-2B cells. ③ The comprehensive evaluation results of R value about each in vivo and in vitro index showed that ECC-BYFⅢ, Huoxue, Quxie, Bushen Huoxue, Fuzheng Huatan, Buqi Quxie groups significantly corrected the mucus hypersecretion (R values were 2.30±0.43, 2.33±0.44, 2.12±0.68, 2.27±0.64, 2.24±0.27 and 2.29±0.47, respectively), compared with the model group (R value: 3.00±0.00), the difference was statistically significant (all P < 0.01). The order was: Quxie > Fuzheng Huatan > Bushen Huoxue > Buqi Quxie > ECC-BYFⅢ > Huoxue. Conclusions:Different components compatibility of ECC-BYFⅢ had different effects on COPD mucus secretion. The components containing Huatan (Nobiletin) or Huoxue (Paeonol) showed a better inhibitory effect on mucus secretion.

Objective To investigate the expression of human platelet antibodies(HPA)in children with immune thrombocytopenia(ITP)at different ages and their clinical significance in the treatment of ITP.Methods Two hundred eighty-eight cases of children who were newly diagnosed as primary ITP and detected with HPA from January 2013 to December 2015 in the First Affiliated Hospital of Zhengzhou University were selected.According to the HPA values,they were divided into <1:10 group,1:10 group and >1:10 group.According to their age,they were di-vided into <3-year-old group and ≥3-year-old group.Data were organized and the relationship among platelet antibody,age,gender and short-term efficiency of treatment was analyzed by using SPSS 21.0 statistical analysis soft-ware.Results In this study,there were 288 cases of children,with male to female ratio of about 1.3:1.0.As to the<3-year-old group and ≥ 3-year-old group,this difference of male to female ratio was statistically significant (respectively 1.93:1.00 and 1.02:1.00,χ2=6.629,P<0.05),and the difference of the HPA positive rate was statistically significant(respectively 72.5% and 59.5%,χ2=5.716,P<0.05);the HPA positive rate of boys and girls respectively was 65.9% and 63.7%,so their diffe-rence of the HPA positive rate was not statistically significant (χ2=0.143,P>0.05).Regarding the short-term efficiency,HPA in <1: 10 group,1: 10 group and >1:10 group was respectively 89.1%,89.1%,100.0%.Statistical analysis suggests:the short-term efficiency of <1:10 group and 1:10 group was basically the same(χ2=0.000,P>0.05);In comparison of <1:10 group with >1:10 group(χ2=4.268,P<0.05),and in comparison of 1:10 group with >1:10 group(χ2=4.411,P<0.05),their differences were statistically significant.Conclusions This study suggests that boys are more susceptible to ITP,espe-cially in the <3 age group.The total positive rate of HPA is higher in <3 years old group.The HPA has a certain guiding significance for the diagnosis of ITP.Compared with the other 2 groups,HPA>1:10 group may have higher short-term efficiency in clinical practice.

Objective To explore neural plasticity around an injured region of the spinal cord and the effects of step training on functional recovery after incomplete spinal cord injury (SCI). Methods Adult female Sprague-Dawley rats ( n = 24) were induced with spinal cord contusion at T10 and divided into a step training group and a control group ( 12 rats in each). Training started from the 7th day post-injury and lasted for (20 ± 10)min per day, 5 days per week, for 9 weeks. Treadmill speeds were 3 m/min at the beginning, and adjusted daily according to each rat's tolerance up to 11 m/min or more. The functional recovery was measured weekly with the open-field locomotor rating scale of Basso, Beattie and Bresnahan (BBB score). The expression of glial fibrillary acidic protein (GFAP), neurofilament protein (NF) and growth-associated protein-43 (GAP-43) in the spinal cord around the injured region were detected. Results After 70 days of step training, the average BBB score of the step training group reached ( 12.86 ± 0.94 ), significantly higher than that of the control group ( 10.71 ± 0.95 ). The expression of NF and GAP-43 around the injured region increased significantly more in the step training group than among the controls. Conclusions Step training can promote functional recovery and neural plasticity in rats after incomplete SCI.