The principle of "supplementing or draining by the preference and aversions of the the five zang organs" emphasizes that prescriptions should align the five flavors of medicinals with the needs of the five organs， achieving supplementation through harmonizing flavors and drainage through opposing flavors. This paper analyzed the formulas for regulating the spleen found in Wings of the Thousand Gold Pieces Formulary （《千金翼方》） from the perspective of "supplementing or draining by the preference and aversions"， to summarize SUN Simiao's prescription characteristics for treating spleen-related disorders. In terms of the combination rule of medicinal properties and flavors， formulas like Bupi Decoction （补脾汤） for supplementing the spleen use sweet and warm medicinals paired with bitter and drying medicinals； those for draining the spleen use acrid and warm medicinals paired with bitter and cold medicinals； those for warming the spleen employs acrid and hot medicinals with sweet and warm medicinals； those like Jianpi Decoction （建脾汤） for strengthening spleen combines sweet and warm with sour and bitter medicinals； Zhuanpi Pill （转脾丸） pairs acrid and warm medicinals with sweet and warm medicinals； and Roupi Decoction （柔脾汤） uses sweet and warm medicinals with sweet and bitter medicinals. Regarding the medicinal flavors， warm dominates the four qi （the four properties）， while sweet， bitter， and acrid are the main among the five flavors. Clinical practice involves applying comprehensive therapy methods such as the combination of sweet and bitter to harmonize， acrid and sweet to transform yang， pungent to disperse and bitter to descend， balancing cold and warm， and combining supplementation and drainage. The foundational principle is to tonify spleen qi and protect the middle jiao， and treatment is tailored based on the disease condition， location， nature， and the characteristics of the medicinals， with careful selection of suitable dosage forms and administration methods.

OBJECTIVE To assess the current status of hospital-acquired infections and their economic burden in or-thopedic patients based on diagnosis-related groups(DRG).METHOD Based on the National Health Insurance dis-ease diagnosis-related groups,32 413 orthopedic patients from a tertiary care hospital in Beijing in 2021 were grouped,hospital-acquired infections were retrospectively analyzed,and the direct and indirect economic burdens of different DRG groups were assess using indictors such as hospitalization time and cost,bed turnover loss,and labor time loss.RESULTS A total of 32 413 patients were included,the incidence of hospital-acquired infection was 0.47％(153/32 413),the site of infection was predominantly the surgical site(57.99％),and hospital-acquired infections in the hematologic system had a greater impact on cost-consumption indices and time-consumption indi-ces.The infection cases were concentrated in 19.58％of the DRGs groups.The IF23 group(lower limb bone sur-gery with complications and comorbidities)had the highest direct economic burden(24 010 yuan/case)due to hos-pital-acquired infections,and the increase in the cost of consumables and medication was the main factor causing the direct economic burden.At both the hospital level and family-society level,the top three DRG groups in terms of indirect economic burden due to hospital-acquired infections were IB15,IB13 and IF23.CONCLUSION Hospital-acquired infections in orthopedic patients have a tendency to be concentrated,quantitatively assessment of their e-conomic burden based on DRGs not only illustrates the importance of hospital-acquired infection prevention and control,but also accurately identifies the disease groups that require focused management,providing an evidence-based basis for precise prevention and control of hospital-acquired infections.

OBJECTIVE To assess the current status of hospital-acquired infections and their economic burden in or-thopedic patients based on diagnosis-related groups(DRG).METHOD Based on the National Health Insurance dis-ease diagnosis-related groups,32 413 orthopedic patients from a tertiary care hospital in Beijing in 2021 were grouped,hospital-acquired infections were retrospectively analyzed,and the direct and indirect economic burdens of different DRG groups were assess using indictors such as hospitalization time and cost,bed turnover loss,and labor time loss.RESULTS A total of 32 413 patients were included,the incidence of hospital-acquired infection was 0.47％(153/32 413),the site of infection was predominantly the surgical site(57.99％),and hospital-acquired infections in the hematologic system had a greater impact on cost-consumption indices and time-consumption indi-ces.The infection cases were concentrated in 19.58％of the DRGs groups.The IF23 group(lower limb bone sur-gery with complications and comorbidities)had the highest direct economic burden(24 010 yuan/case)due to hos-pital-acquired infections,and the increase in the cost of consumables and medication was the main factor causing the direct economic burden.At both the hospital level and family-society level,the top three DRG groups in terms of indirect economic burden due to hospital-acquired infections were IB15,IB13 and IF23.CONCLUSION Hospital-acquired infections in orthopedic patients have a tendency to be concentrated,quantitatively assessment of their e-conomic burden based on DRGs not only illustrates the importance of hospital-acquired infection prevention and control,but also accurately identifies the disease groups that require focused management,providing an evidence-based basis for precise prevention and control of hospital-acquired infections.

Objective The potential mechanism of hepatotoxicity induced by rhubarb was preliminarily explored by network pharmacology and verified by cell experiments.Methods Based on network pharmacology,component collection and target prediction are carried out through multiple databases.PPI network construction,GO enrichment analysis and KEGG pathway analysis were combined with software to systematically predict the mechanism of hepatotoxicity induced by rhubarb.The pathway information predicted by network pharmacology was verified by primary hepatocyte experiments and Western blot experiments.Results The results of network pharmacology showed that RH was the main component of hepatotoxicity induced by rhubarb.Seventeen core targets of hepatotoxicity induced by rhubarb were obtained.KEGG results suggested that DNA damage and apoptosis were one of the key mechanisms of hepatotoxicity induced by rhubarb.The results of primary hepatocytes and Western blot showed that RH could inhibit the viability of primary hepatocytes in a time-dose dependent manner.ABT and SFP can significantly reduce the toxicity of RH on primary liver cells in mice,and RFP can increase the toxicity of RH to mouse primary liver cells.Upregulation of γ-H2AX and PARP-1 protein in primary liver cells of mice after treatment with different concentrations of RH.Conclusion RH in rhubarb can significantly inhibit the viability of mouse primary hepatocytes,and its toxicity to mouse primary hepatocytes is mainly caused by the metabolic activation of RH by CYP 2C9.RH can activate PARP-1 protein,phosphorylate H2AX,induce DNA damage and apoptosis in mouse primary hepatocytes.

This study explored the comorbidity mechanisms of coronary heart disease and depression from the perspectives of "constraint causing disease" and "disease causing constraint"， for which "constraint" is the link， and the key lies in the stagnation of qi. The heart storing manifestations in traditional Chinese medicine （TCM） encompasses most physiological processes of the circulatory system， the mental nervous system， and some functions of the endocrine system， and cardiovascular diseases and psychological disorders are closely related to it. In TCM， it is proposed that the stagnation of heart yang leading to "yang deficiency" is the pathogenesis of chest tightness， and emotional disturbance leading to the stagnation of yang qi aggravates the chest tightness， reflecting the process of "disease causing constraint". As the disease progresses， the appearance of phlegm and stasis further worsens the condition， reflecting the process of "constraint causing disease". Based on modern medical understanding， the abnormal accumulation of lipids， platelets， oxidative products， cytokines， and other substances constitute a form of "constraint"， which is also the material basis for the comorbidity of coronary heart disease and depression. These substances promote neuronal damage or apoptosis in the emotional and cognitive regions， inducing the onset of depression， reflecting the process of "disease causing constraint". Meanwhile， adverse emotions lead to sympathetic nerve excitement， resulting in the production of catecholamines， promoting platelet aggregation， elevating levels of inflammatory markers， and increasing the risk of coronary heart disease， reflecting the process of "disease causing constraint".

The long-acting cabotegravir and rilpivirine injection regimen（CAB+RPV regimen）is the first approved long-acting antiretroviral therapy（ART）for HIV in China，administered once every two months. This regimen provides an innovative alternative to daily oral ART，benefiting virologically suppressed patients. Several large clinical-studies have shown that the CAB+RPV regimen achieves comparable virologic suppression and safety to daily oral regimens，while significantly enhancing patient satisfaction. Based on international and domestic HIV/AIDs guidelines and clinical evidence，this consensus offers expert recommendations on patient selection，clinical management，and key communication strategies for healthcare providers to support the effective use of this regimen，aiming to improve quality of life for people living with HIV and accumulate domestic clinical experience with this advanced treatment approach.

The long-acting cabotegravir and rilpivirine injection regimen（CAB+RPV regimen）is the first approved long-acting antiretroviral therapy（ART）for HIV in China，administered once every two months. This regimen provides an innovative alternative to daily oral ART，benefiting virologically suppressed patients. Several large clinical-studies have shown that the CAB+RPV regimen achieves comparable virologic suppression and safety to daily oral regimens，while significantly enhancing patient satisfaction. Based on international and domestic HIV/AIDs guidelines and clinical evidence，this consensus offers expert recommendations on patient selection，clinical management，and key communication strategies for healthcare providers to support the effective use of this regimen，aiming to improve quality of life for people living with HIV and accumulate domestic clinical experience with this advanced treatment approach.

ObjectiveTo observe the effect of Qinggan Jianpi Huoxue prescription（QGJPHXP） on the polarization of M1/M2 macrophages in rats with hepatic fibrosis induced by carbon tetrachloride（CCl₄）. MethodA rat hepatic fibrosis model was established by intraperitoneal injection of 40% CCl₄-olive oil suspension twice a week at the dosage of 2.0 mL·kg^-1 for 8 weeks. After the model was successfully established， these rats were randomly divided into the model group， QGJPHXP group（32.084 g·kg^-1） and Biejiajian pills（BJJP） group（0.925 5 g·kg^-1）， with 12 rats in each group. The blank group was injected intraperitoneally with the same amount of olive oil. The rats in the administration groups were given the corresponding solution according to the dose， and the blank and model groups were given the same dose of purified water， once a day. After 4 weeks of continuous administration， the liver tissues of rats were taken and stained with hematoxylin-eosin（HE） and Masson to observe the pathological changes. The serums were collected to detect the alanine aminotransferase（ALT） and aspartate aminotransferase（AST） levels. Interleukin（IL）-6， IL-12， IL-10， IL-1β， transforming growth factor-β₁（TGF-β₁） and tumor necrosis factor-α（TNF-α） levels in liver tissues were measured by enzyme-linked immunosorbent assay（ELISA）. The expression levels of CD86 and CD206 were detected by immunohistochemistry（IHC）. Western blot and real-time fluorescence quantitative polymerase chain reaction（Real-time PCR） were used to detect the protein and mRNA expression levels of inducible nitric oxide synthase（iNOS）， arginase-1（Arg-1）， phosphorylated p38 mitogen-activated protein kinase（p-p38 MAPK）， nuclear transcription factor-κB p65（NF-κB p65） in liver tissues of rats. ResultCompared with the blank group， the hepatic cell plate was irregularly arranged, and local inflammatory cell infiltration and fibrous hyperplasia were observed， while the serum levels of ALT and AST were significantly increased in the model group（P<0.01）， and IL-1β， IL-6， IL-12， TGF-β₁， TNF-α， CD86， CD206， iNOS， p-p38 MAPK，p38 MAPK and NF-κB p65 levels in liver tissues were obviously increased（P<0.05， P<0.01）， while the levels of IL-10 and Arg-1 were obviously decreased（P<0.05， P<0.01）. Compared with the model group， QGJPHXP group reduced the degree of liver cell fibrosis，and serum levels of ALT and AST（P<0.01）， and IL-1β， IL-6， IL-12， TGF-β₁， TNF-α， CD86， iNOS， p-p38 MAPK， p38 MAPK， and NF-κB p65 levels in liver tissues were obviously decreased（P<0.05， P<0.01）， the levels of IL-10， CD206 and Arg-1 were obviously increased in the QGJPHXP group（P<0.05， P<0.01）. ConclusionQGJPHXP has ability to inhibit the activation of pro-inflammatory M1 macrophages， induce the secretion of anti-inflammatory cytokines by M2 macrophages， reduce the release of pro-fibrogenic cytokines， and promote the macrophage polarization of M1 to M2 in liver for tissue repair， thereby serving as an anti-inflammatory and anti-hepatic fibrosis drug.

ObjectiveTo reveal the effect of Wenxin prescription on mitochondrial energy metabolism and silent information regulator 1 （SIRT1）/peroxisome proliferator-activated receptor-γ coactivator-1α （PGC-1α）/recombinant estrogen-related receptor α （ERRα） signaling pathway in rats with myocardial ischemia-reperfusion injury. MethodTotally 90 male Wistar rats of SPF grade were randomly assigned into a sham operation group， a model group， and low-， medium-， and high-dose Wenxin prescription groups， with 18 rats in each group. The rats in low-， medium-， and high-dose Wenxin prescription groups were administrated with 0.99， 1.98， and 3.96 g·kg^-1 granules by gavage， respectively， and those in the sham operation group and model group with the same amount of normal saline. Twenty-one days after pre-administration， the rat model of myocardial ischemia-reperfusion injury was established by ligation of the left anterior descending coronary artery for 30 min and reperfusion for 2 h， and the rats in the sham operation group were only threaded without ligation. Myocardial infarction area was observed through 2，3，5-triphenyl-2h-tetrazolium chloride （TTC） staining， and the myocardial histopathology through hematoxylin-eosin （HE） staining. The levels of creatine kinase-MB （CK-MB） and lactate dehydrogenase （LDH） in serum， cytochrome C oxidase （CCO） and succinate dehydrogenase （SDH） in mitochondrion， and ATP in myocardial tissue were detected according to kit instructions. The mRNA and protein levels of SIRT1， PGC-1α， ERRα， and mitochondrial transcription factor A （TFAM） in myocardial tissue were determined by Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot， respectively. ResultCompared with the sham operation group， the model group showed broken and disordered myocardial fibers， cytoplasmic edema， and pyknosis and deviation of nuclei. Moreover， the modeling increased the levels of CK-MB and LDH （P<0.05， P<0.01）， lowered the levels of ATP， CCO， and SDH （P<0.05， P<0.01）， and down-regulated the mRNA and protein levels of SIRT1， PGC-1α， ERRα， and TFAM in myocardial tissue （P<0.05， P<0.01）. Compared with the model group， Wenxin prescription reduced the myocardial infarction area （especially in the high-dose group， P<0.01）， restored the pathological changes， lowered the levels of CK-MB and LDH （P<0.05， P<0.01）， increased the levels of ATP， CCO， and SDH （especially in the high-dose group， P<0.01）， and up-regulated the mRNA and protein levels of SIRT1， PGC-1α， ERRα， and TFAM in myocardial tissue （P<0.05， P<0.01）. ConclusionWenxin prescription can protect rats from myocardial ischemia-reperfusion injury by regulating myocardial mitochondrial energy metabolism via the SIRT1/PGC-1α/ERRα signaling pathway.

Tai Chi and Qigong (TCQ) are regarded as major therapies of complementary and alternative medicine (CAM), and welcomed by increasing practitioners worldwide for their efficacy in various health issues. To better learn about the popularity of TCQ in the United States, the related data collected from 2007, 2012 and 2017 questionnaires of the National Health Interview Survey (NHIS) were examined and analyzed. The result showed that adult TCQ practitioners in the US increased substantially from 2007-2017, the percentage of Tai Chi practitioners in adult population was 1.0% in 2007, and Qigong practitioners 0.3%; Tai Chi practitioners was 1.1% in 2012, and Qigong practitioners 0.3%; in 2017, Tai Chi practitioners was 1.5%, and Qigong practitioners 0.5%. The top three reasons for using TCQ were: 82.4% for general wellness or disease prevention, 64.6% to improve or enhance energy, and 35.1% recommended by family, friends or co-workers. The health benefits of TCQ, the demand for complementary therapies and increasing research evidences were positive factors for the growth, while there are also challenges including insufficiencies in scientific researches and lacking of standardized teaching system. To promote the future development of TCQ in the US and oversea countries, we should optimize the research methods and standardize the teaching system, encourage the exchange and training of TCQ related professionals, and promote the integration of TCQ into conventional medical system and other related industries.