ObjectiveTo investigate the migration and distribution characteristics of chemical constituents in blood and hippocampal tissues before and after vinegar processing of Citri Reticulatae Pericarpium Viride（CRPV）， and to explore the potential material basis and mechanisms underlying their regulatory effects on emotional disorders by comparing the effects of raw and vinegar-processed products of CRPV. MethodsUltra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry（UPLC-Q-TOF-MS/MS） was employed to characterize and identify the chemical constituents of raw and vinegar-processed products of CRPV extracts， as well as their migrating components in blood and hippocampal tissues after oral administration. Reference standards， databases， and relevant literature were utilized for compound annotation， with data processing performed using PeakView 1.2 software. Seventy male C57BL/6 mice were randomly divided into seven groups， including the blank group， model group， diazepam group（2.5 mg·kg^-1）， raw CRPV low/high dose groups（0.6， 1.2 g·kg^-1）， and vinegar-processed CRPV low/high dose groups（0.6， 1.2 g·kg^-1）， with 10 mice per group. Except for the blank group， all other groups underwent chronic restraint stress（2 h·d^-1） for 20 d. Each drug-treated group received oral administration at the predetermined dose starting 10 d after modeling， with a total treatment duration of 10 d. Following model-based drug administration， mice underwent open-field， forced swimming， and elevated plus maze tests. After anesthesia with isoflurane， whole brains were collected from each group of mice， and hippocampi were dissected. Reactive oxygen species（ROS） level in hippocampal tissues was quantified by enzyme-linked immunosorbent assay（ELISA）. Hematoxylin-eosin（HE） staining was used to observe hippocampal tissue morphology. Immunofluorescence was performed to detect neuronal nuclei（NeuN） and peroxisome proliferator-activated receptor alpha（PPARα） expressions in hippocampal tissue. Then， pharmacodynamic evaluations were conducted to assess the effects of raw and vinegar-processed CRPV on mood disorders， exploring the potential mechanisms. ResultsVinegar processing caused significant changes in the chemical composition of CRPV， with 18 components showing increased relative content and 35 components showing decreased relative content. The primary changes occurred in flavonoid compounds， including 20 flavonoids， 20 flavonoid glycosides， 3 triterpenes， 3 phenolic acids， 1 alkaloid， and 6 other compounds. Twenty-one components were detected in blood（15 methoxyflavones， 4 flavonoid glycosides， and 2 phenolic acids）， with 17 shared between raw and vinegar-processed CRPV. Seven components reached hippocampal tissues（all common to both forms）. In regulating emotional disorders， Vinegar-processed CRPV exhibited superior antidepressant-like effects compared to raw products. HE staining revealed that both treatments improved hippocampal neuronal morphology， particularly in the damaged CA1 and CA3 regions. Immunofluorescence and ELISA analyses demonstrated that both raw and vinegar-processed CRPV significantly modulated NeuN and PPARα expressions in hippocampal tissue while alleviating oxidative stress induced by excessive ROS（P<0.05）. ConclusionThe chemical composition of CRPV undergoes changes after vinegar processing， but the migrating components in blood and hippocampus are primarily methoxyflavonoids. These components may serve as the potential material basis for activating the PPARα pathway， thereby negatively regulating ROS generation in the hippocampus， reducing oxidative stress， and promoting the development of NeuN-positive neurons. These findings provide experimental evidence for enhancing quality standards， pharmacodynamic material research， and active drug development of raw and vinegar-processed CRPV.

Objective: To explore the interaction between school bullying and insomnia in relation to depression-anxiety-stress emotions among primary and secondary school students,so as to provide a basis for preventing negative emotional states in adolescents. Methods: In October 2024, a stratified cluster sampling method was used to select 3 058 students in grade 5-6 of primary, junior and senior high school in Sheyang County of Jiangsu Province. The Delaware Bullying Victimization Scale, Insomnia Severity Index, Depression-Anxiety-Stress Scale-21, and Study Condition Questionnaire were employed to investigate school bullying, insomnia, depression-anxiety-stress emotions, and academic performance. The χ 2 test and Logistic regression were used to analyze the association between school bullying and insomnia interactions and depression-anxiety-stress emotions among primary and secondary school students, multiplicative interaction analysis was conducted, and additive interaction analysis was performed using R software. Results: The detection rates of depression-anxiety-stress emotions among primary and secondary school students were 21.6%, 28.4% and 10.8%, respectively. The detection rates of physical bullying, relationship bullying, verbal bullying and cyberbullying in school bullying were 10.6%, 14.0%, 22.3%, and 6.2%, respectively. The detection rate for insomnia was 23.1%. Results from Logistic regression analysis showed that, after adjusting for relevant factors, physical, relational, verbal, and cyberbullying and insomnia were positively correlated with the detection rates of depression ( OR = 5.72- 10.93), anxiety ( OR =6.35-12.17), and stress emotions ( OR =5.97-14.52) among primary and secondary school students (all P <0.01). The multiplicative interaction between physical, relational, verbal, and cyberbullying and insomnia was positively correlated with the detection rates of depression ( OR =8.00-18.01), anxiety ( OR =11.35-17.76), and stress emotions ( OR =7.64-9.12) in primary and secondary school students (all P <0.01). Additive interactions were observed between physical, relational, verbal, and cyberbullying and insomnia in relation to the detection rates of depression, anxiety, and stress emotions among primary and secondary school students (both RERI and AP >0 and the credible interval excluded 0, SI >1 and the credible interval excluded 1). Conclusion School bullying and insomnia are associated with depression, anxiety, and stress emotions among primary and secondary school students, and they exhibit both multiplicative and additive interactions.

Transfusion and Anemia Expertise Initiative-Control/Avoidance of Bleeding developed a strategy for platelet and plasma infusion management in critically ill children based on systematic reviews and consensus meetings of international multidisciplinary experts. One good practice statement and six expert consensus statements were proposed for plasma and platelet transfusions in critically ill children following severe trauma, traumatic brain injury, and/or intracranial hemorrhage. This article introduces the specific methods and basis for the formation of recommendations in this part of the guide.

Pulmonary fibrosis（PF） is a progressive and life-threatening disease with limited therapeutic options， highlighting the urgent need for innovative drug discovery strategies. To address this challenge， the authors propose the formula-originated rational intelligent screening&translation（FIRST）， a systematic framework for developing anti-fibrotic monomers derived from classical traditional Chinese medicine（TCM）. The strategy integrates three key dimensions， including tissue-oriented intelligent screening of active compounds， structural optimization based on drug-target spatial interactions and plant biosynthetic pathways， and cross-scale validation of drug. We further highlight its applications in discovering tissue-oriented novel drugs from clinically validated TCM， the development and mechanistic elucidation of anti-fibrotic therapeutics， as well as the clinical translation and secondary development of candidate drugs. This strategy paves the way for first-in-class， formula-derived monomeric drugs with defined structures， clarified mechanisms， and proven safety， offering a transformative avenue to meet the urgent therapeutic needs of PF and setting a new paradigm for TCM-based drug innovation.

Pulmonary fibrosis（PF） is a progressive and life-threatening disease with limited therapeutic options， highlighting the urgent need for innovative drug discovery strategies. To address this challenge， the authors propose the formula-originated rational intelligent screening&translation（FIRST）， a systematic framework for developing anti-fibrotic monomers derived from classical traditional Chinese medicine（TCM）. The strategy integrates three key dimensions， including tissue-oriented intelligent screening of active compounds， structural optimization based on drug-target spatial interactions and plant biosynthetic pathways， and cross-scale validation of drug. We further highlight its applications in discovering tissue-oriented novel drugs from clinically validated TCM， the development and mechanistic elucidation of anti-fibrotic therapeutics， as well as the clinical translation and secondary development of candidate drugs. This strategy paves the way for first-in-class， formula-derived monomeric drugs with defined structures， clarified mechanisms， and proven safety， offering a transformative avenue to meet the urgent therapeutic needs of PF and setting a new paradigm for TCM-based drug innovation.

Objective To analyze the epidemiological characteristics of newly reported occupational diseases in Huangpu District, Guangzhou City, from 2010 to 2024. Methods Data on newly reported occupational diseases in Huangpu District, Guangzhou City, from 2010 to 2024 were collected from the Occupational Diseases and Health Hazard Factors Monitoring Information System, a subsystem of the China Disease Prevention and Control Information System. The spectrum composition and distribution characteristics of diseases were analyzed by year, enterprise and industry. Results A total of 501 newly diagnosed occupational disease cases involving seven categories and 21 specific disease types were reported in Huangpu District from 2010 to 2024. The overall trend showed a pattern of rapid increase, decline after peaking, and low-level fluctuation. The top four occupational disease categories by case count were occupational pneumoconiosis and other respiratory diseases (32.53%), occupational ear, nose, and throat diseases (30.14%), occupational diseases caused by physical factors (21.96%), and occupational chemical poisoning (12.18%). The predominant specific diseases type within these four categories were occupational pneumoconiosis, occupational noise-induced deafness, occupational hand-arm vibration disease, and occupational benzene poisoning. Cases were mainly distributed in enterprises invested by Hong Kong-, Macao-, and Taiwan, in private enterprises, and in foreign-invested enterprises, accounting for 82.44% of all cases. Medium- and small-sized enterprises were predominant in terms of enterprise scale, accounting for 46.71% and 34.33%, respectively. Cases were predominantly distributed across four industries: manufacturing of railway, ship, aerospace, and other transport equipment; manufacture of articles for culture, education, arts and crafts, sport, and entertainment; manufacturing of general-purpose machinery; and manufacture of chemicals and chemical products. Collectively, these sectors accounted for 56.09% of all cases. Conclusion Future occupational health work in Huangpu District should focus on key diseases including occupational pneumoconiosis, occupational noise-induced deafness, and occupational benzene poisoning. Prevention and control measures should target small- and medium-sized enterprises in high-risk industries such as shipbuilding and automobile manufacturing.

To systematically evaluate the impact of the "group-based " medical assistance program for Xizang, conducted by Peking Union Medical College Hospital, on the implementation outcomes of standardized residency training (SRT) at the Xizang Autonomous Region People′s Hospital, and to provide evidence-based decision-making references and policy optimization recommendations for medical education support models in border ethnic minority regions.

ObjectiveTo evaluate the safety and clinical utilization of traditional Chinese medicine （TCM） formula granules based on real-world data， and to provide evidence for their rational clinical use. MethodsA multicenter， prospective， open-label， observational centralized monitoring study was conducted. Participants who received TCM formula granules in 293 medical institutions throughout China from February 5th， 2020 to May 20th， 2025 were consecutively enrolled. The year of data collection was used as the stratification factor. Demographic characteristics （including sex， age， and concomitant medication use）， information on TCM formula granule use （including mean prescribed dosage and inappropriate use）， and adverse event（AE）/adverse drug reaction（ADR） occurrence and related factors were collected and statistically analyzed. ResultsA total of 42 011 participants were included in the safety set （SS）， with a mean age of （38.34±22.30） years， including 18 693 males and 23 318 females. Among them， 3519 participants （8.38%） had a history of or concomitant diseases. The three most common comorbidities were hypertension （1189 cases， 33.79%）， diabetes mellitus （850 cases， 24.15%）， and coronary heart disease （471 cases， 13.38%）. The top three diagnostic categories were respiratory， thoracic， and mediastinal diseases （7008 cases， 16.68%）， infectious and parasitic diseases （6591 cases， 15.69%）， and gastrointestinal diseases （4580 cases， 10.90%）.Among 41 961 participants with available concomitant medication data， 3332（7.94%） received concomitant medications， and western medicines were the most commonly used concomitant medications （2819 cases， 6.72%）. The mean prescribed dosage of TCM formula granules （expressed as the equivalent dosage of crude herbal pieces） was （158.23±104.86） g in 2020， （131.70±65.84） g in 2021， （130.62±59.96） g in 2022， （86.74±50.61） g in 2023， （118.59±52.01） g in 2024， and （134.38±49.43） g in 2025. The five most frequently prescribed toxic herbs were Kuxingren （Semen Armeniacae Amarum， 2746 cases， 6.54%）， Xixin （Radix et Rhizoma Asari， 2193 cases， 5.22%）， processed Kuxingren （862 cases， 2.05%）， Baiqucai （Herba Chelidonii， 747 cases， 1.78%）， and Wuzhuyu （Fructus Evodiae， 645 cases， 1.54%）. Prescriptions involving incompatible combinations of the "eighteen antagonisms" and the "nineteen mutual inhibitions" were most frequently observed in 2020 （54 cases， 0.503%）， and then decreased markedly， remaining at zero or an extremely low level thereafter. The overall incidence of adverse drug reactions （ADRs） associated with TCM formula granules was 0.057% （24 cases）， indicating a rare occurrence. The annual incidence was 0.028% （3 cases） in 2020， 0 in both 2021 and 2022， 0.065% （5 cases） in 2023， 0.158% （15 cases） in 2024， and 0.226% （1 case） in 2025. Among the 24 patients who experienced ADRs， 15 had inappropriate medication use.Five of the 24 patients used toxic herbs， and all five had inappropriate medication. Multivariate logistic regression analysis showed that no history of drug-related adverse reactions ［OR=0.053， 95%CI（0.006， 0.465）］ and no concomitant medication ［OR=0.315， 95%CI（0.109， 0.911）］ were associated with a lower risk of ADRs. ConclusionTCM formula granules are widely used in clinical practice and exhibit a favorable overall safety. Greater attention should be paid to people with a history of drug-related adverse reactions and those receiving concomitant medications to further improve medication safety.

Objective: To investigate the association between plant-based diet and different types of obesity, so as to provide references for obesity prevention. Methods: Residents aged 35-75 years from 33 counties (cities, districts) in Zhejiang Province were selected as study subjects using a multistage stratified random sampling method between April and December 2024. Demographic information and living behaviors were collected using questionnaire surveys. Height, weight and waist circumference were measured, and body mass index (BMI) was calculated. BMI ≥28.0 kg/m2 was defined as obesity, waist circumference ≥90 cm in males or ≥85 cm in females was defined as central obesity, and individual with obesity who also had central obesity was defined as having compound obesity. Food intake over a 3-day period was collected using the consecutive 3-day 24-hour dietary recall method. The plant diet index (PDI), healthful plant diet index (HPDI), and unhealthful plant diet index (UPDI) were calculated, and categorized into quintiles (Q1-Q5) based on their distribution. Association between the PDI, PDI, UPDI and different types of obesity were analyzed using multivariable logistic regression models. Results: A total of 4 882 individuals were surveyed, including 2 233 males (45.74%) and 2 649 females (54.26%). The average age was (55.42±12.14) years. There were 537 individuals of obesity, 1 718 individuals of central obesity, and 500 individuals of compound obesity, with detection rates of 11.00%, 35.19%, and 10.24%, respectively. Multivariable logistic regression analysis showed that, after adjusting for demographic information and living behaviors, compared with Q1 group, HPDI Q5 group showed a 29.6% lower risk of obesity (OR=0.704, 95%CI: 0.525-0.943) and a 32.1% lower risk of compound obesity (OR=0.679, 95%CI: 0.502-0.918). Conversely, the UPDI Q5 group exhibited a 39.5% higher risk of obesity (OR=1.395, 95%CI: 1.032-1.886) and a 39.8% higher risk of compound obesity (OR=1.398, 95%CI: 1.025-1.907). No statistically significant association was found between PDI and obesity, central obesity, and compound obesity (all P>0.05). As HPDI increased, the risks of obesity and compound obesity showed decreasing trends; as UPDI increased, the risks of obesity and compound obesity showed increasing trends (all Ptrend<0.05). Conclusion A healthful plant-based diet is associated with reduced risks of obesity and compound obesity, while an unhealthful plant-based diet is associated with increased risks of obesity and compound obesity.

Objective To investigate the levels of gross α and gross β activities in different water types within a 40-kilometer radius around the Zhangzhou Nuclear Power Plant prior to its operation. Methods In 2018, drinking water samples were collected from the area surrounding the nuclear power plant during both the wet and dry seasons, including source water, treated water, tap water, and well water. The gross α and gross β activity concentrations were measured using a low-background α/β counter, followed by statistical analysis. Results A total of 80 water samples from different sources around the Zhangzhou Nuclear Power Plant were collected. The average gross α and gross β activity concentrations during the wet season were (0.110 ± 0.036) Bq/L and (0.643 ± 0.028) Bq/L, respectively, while those during the dry season were (0.124 ± 0.032) Bq/L and (0.624 ± 0.026) Bq/L, respectively. There were no significant differences in the gross α and gross β activity concentrations between the wet and dry seasons for the overall sample set (P > 0.05). However, there were statistically significant differences in the gross α and gross β activity concentrations between the wet and dry seasons for source water and well water (Z_wet = −2.005, −2.123; Z_dry = −1.943, −3.090; P < 0.05). Conclusion The radioactivity levels in different water types within various ranges around the Zhangzhou Nuclear Power Plant before its operation were determined. The measured activity concentrations were at the same level as those from previous investigations in other regions of Fujian Province.