ObjectiveTo investigate the effects of Huangqi Jianzhongtang （HQJZ） on macrophage polarization and fat consumption in cancer cachexia （CC） mice. MethodsUltra-performance liquid chromatography-quadrupole/electrostatic field Orbitrap high-resolution mass spectrometry （UPLC-Q-Orbitrap HRMS） was used to control the quality of HQJZ. （1） In vitro experiment： HQJZ-containing serum was prepared， and the optimal concentration was determined by cytotoxicity assay. Mouse monocyte-derived macrophages （RAW264.7） were cultured and randomly divided into six groups， including a blank group， a classically activated macrophages （M1） group， an alternatively activated macrophages （M2） group， a HQJZ + blank group， a HQJZ+M1 group， and a HQJZ + M2 group. The relative expression of macrophage marker genes CD86， inducible nitric oxide synthase （iNOS）， CD206， and arginase-1 （Arg1） was detected by real-time quantitative polymerase chain reaction （Real-time PCR ）. （2） In vivo experiment： Thirty-two BALB/c mice were randomly divided into a control group， a model group， a medroxyprogesterone acetate （MPA） group， and a HQJZ group. Except for the control group， the other mice were injected with CT-26 colon cancer cells to establish a CC model. Mice in the MPA and HQJZ groups were given MPA （0.13 g·kg^-1·d^-1） or HQJZ （13.13 g·kg^-1·d^-1） by gavage， respectively， while mice in the control and model groups were given an equal volume of saline by gavage， with interventions continued for 10 d. Real-time PCR was used to detect the expression of macrophage markers （iNOS， Arg1， CD86， CD206） and fat browning-related genes uncoupling protein 1 （UCP1） and peroxisome proliferator-activated receptor γ （PPARγ） in epididymal adipose tissue. Western blot （WB） was used to detect protein expression levels of UCP1 and PPARγ. Micro-computed tomography （micro-CT） was used to measure residual fat volume， and hematoxylin-eosin （HE） staining was used to assess fat browning and calculate pathological scores. ResultsIn vitro， the dominant effective concentration of HQJZ-containing serum was 12.5%. Real-time PCR results showed that， compared with the blank group， Arg1 expression decreased in the HQJZ+blank group （P<0.05）， CD206 showed a downward trend without statistical significance， while iNOS and CD86 expression were significantly increased （P<0.05）. Compared with the M1 group， Arg1 and CD206 expression decreased in the HQJZ+M1 group （P<0.05）. Compared with the M2 group， CD206 expression decreased in the HQJZ+M2 group （P<0.05）， CD86 expression increased significantly （P<0.01）. In vivo， Real-time PCR results showed that， compared with the control group， CD86 and CD206 expression levels were significantly increased in the model group （P<0.01）. Compared with the model group， CD206 expression in the MPA group was significantly decreased （P<0.01）. In the HQJZ group， CD206 was significantly decreased （P<0.01）. WB results showed that， compared with the model group， protein expression of UCP1 and PPARγ was significantly reduced in the HQJZ group （P<0.05， P<0.01）. micro-CT results showed that the total white fat volume in the HQJZ group was greater than that in the model group （P<0.05）. HE staining results showed that pathological scores in the HQJZ group were lower than those in the model group （P<0.05）. ConclusionHQJZ may inhibit white adipose tissue browning by promoting macrophage M1 polarization and suppressing M2 polarization， thereby delaying fat consumption in CC mice.

Objective To analyze the epidemiological characteristics of hepatitis E (HE) in Huai'an City from 2015 to 2024, and construct and validate the prediction effect of the Seasonal Autoregressive Integrated Moving Average (SARIMA) model, and to provide a scientific basis for HE prevention and control. Methods Data of reported HE cases in Huai'an City from January 2015 to December 2024 were extracted from the National Disease Control and Prevention Information System. Descriptive epidemiological methods were used to analyze the temporal, regional and population distribution characteristics of HE incidence. After data preprocessing, stationarity test and randomness test, the SARIMA model was constructed. The optimal model was selected by minimizing the Akaike Information Criterion (AIC). The model performance was evaluated by adjusted R-squared (Adj R²) and root mean square error (RMSE). The monthly incidence rate of HE in Huai'an City in 2025 was predicted and compared with the actual incidence data to validate the model. Results A total of 1 713 HE cases were reported in Huai'an City from 2015 to 2024, showing a fluctuating upward trend. Huaiyin District (339 cases) and Lianshui County (334 cases) were high-incidence areas. The cases were mainly concentrated in people aged 45 and above (83.3%), males (gender ratio 2.37:1) and farmers (70.8%). The optimal model was SARIMA (1,1,1)×(2,0,1)₁₂, with residual as white noise sequence. There was no statistical difference between the actual incidence and predicted value from January to August 2025 (P>0.05). Conclusion HE incidence in Huai'an has obvious aggregation and temporal fluctuation characteristics. The SARIMA model has a good prediction effect, which can provide reference for formulating targeted prevention and control strategies.

Objective: To analyze the changes in serum ghrelin and leptin levels in girls with central precocious puberty (CPP) after 24 weeks of aerobic training combined with gonadotropin releasing hormone agonist (GnRH-a) therapy, so as to provide reference for preventing girls from precocious puberty. Methods: A total of 96 girls with CPP who were treated at the Affiliated Huai an Hospital of Xuzhou Medical University between April 2022 and January 2024 were selected as study subjects. They were divided into a pharmacotherapy group and a combined pharmacotherapy and aerobic exercise group by random number table method, with 48 patients in each group. The pharmacotherapy group received subcutaneous injections of leuprorelin acetate microspheres at a dose of 100 μg/kg in the morning (8:00-10:00), administered once every 4 weeks for a total of 6 injections. The combined pharmacotherapy and aerobic exercise group participated in aerobic exercise in addition to the subcutaneous injections of leuprorelin acetate microspheres; the training was conducted for 24 weeks, 3 times per week, and was conducted after school for girls, for 20- 75 min per session. The t test was utilized to comparatively analyze the serum leptin and ghrelin levels of the patients in both groups before and after the intervention. Binary Logistic regression analysis was applied to explore the correlative factors influencing serum ghrelin and leptin levels in girls with CPP post intervention. Results: Following the intervention, the serum leptin [(7.85± 1.43)ng/mL ] and ghrelin [(8.46±1.06)ng/mL] levels in the girls of the pharmacotherapy group demonstrated no statistically significant changes compared to their pre intervention levels [(7.94±1.45) (8.35±1.22)ng/mL, respectively] ( t =0.41, -0.58, both P > 0.05 ). Conversely, in the combined pharmacotherapy and aerobic exercise group, the post intervention serum leptin levels [(6.35±1.62) ng/mL] significantly decreased compared to pre intervention [(7.87±1.59) ng/mL], and the serum ghrelin levels [(9.12±1.37) ng/mL] significantly increased compared to pre intervention [(8.22±1.47) ng/mL] ( t =6.20, 4.39, both P <0.05). Conclusion Aerobic training increases serum ghrelin levels and decreases serum leptin levels in girls with CPP.

OBJECTIVE: High-altitude hypoxia exposure often damages hippocampus-dependent learning and memory. Nogo-A is an important axonal growth inhibitory factor. However, its function in high-altitude hypoxia and its mechanism of action remain unclear. METHODS: In an in vivo study, a low-pressure oxygen chamber was used to simulate high-altitude hypoxia, and genetic or pharmacological intervention was used to block the Nogo-A/NgR1 signaling pathway. Contextual fear conditioning and Morris water maze behavioral tests were used to assess learning and memory in rats, and synaptic damage in the hippocampus and changes in oxidative stress levels were observed. In vitro, SH-SY5Y cells were used to assess oxidative stress and mitochondrial function with or without Nogo-A knockdown in Oxygen Glucose-Deprivation/Reperfusion (OGD/R) models. RESULTS: Exposure to acute high-altitude hypoxia for 3 or 7 days impaired learning and memory in rats, triggered oxidative stress in the hippocampal tissue, and reduced the dendritic spine density of hippocampal neurons. Blocking the Nogo-A/NgR1 pathway ameliorated oxidative stress, synaptic damage, and the learning and memory impairment induced by high-altitude exposure. CONCLUSION: Our results demonstrate the detrimental role of Nogo-A protein in mediating learning and memory impairment under high-altitude hypoxia and suggest the potential of the Nogo-A/NgR1 signaling pathway as a crucial therapeutic target for alleviating learning and memory dysfunction induced by high-altitude exposure. GRAPHICAL ABSTRACT available in www.besjournal.com.
Animals ; Oxidative Stress ; Hippocampus/metabolism* ; Rats ; Nogo Proteins/genetics* ; Male ; Rats, Sprague-Dawley ; Hypoxia/metabolism* ; Altitude ; Synapses ; Humans ; Altitude Sickness/metabolism*

Objective To identify high-risk factors for healthcare-associated infection(HAI)in patients in inten-sive care units(ICUs),and develop a quick response(QR)code-based APP prediction tool.Methods Information of inpatients in general ICUs of three hospitals in Guizhou Province from January to December 2024 were collected.Risk factors were analyzed with a logistic regression model.QR code-based APP was constructed and validated.Results A total of 1 782 patients in general ICUs of three hospitals in Guizhou Province in 2024 were included in the analysis,out of which 410 were HAI cases,and the incidence of HAI was 23.01％.Multivariate logistic regre-ssion analysis results of HAI in ICU inpatients showed that regional gross domestic product(GDP)≥58 685 Yuan,performing pathogen culture during this hospitalization,history of diabetes mellitus,history of cancer,length of hospital stay ≥7 days before infection,and duration of persistent fever＞5 days before infection were independent risk factors for HAI in ICU patients(all P＜0.05).The discrimination of the model(area under the receiver operating characteristic curve[AUC]of 0.841),calibration(Brier score of 0.129),and clinical effectiveness(net benefit of 11.4％when the risk threshold was 5％-74％)all performed well.Conclusion The QR code-based APP prediction tool is of great significance for scientific research transformation and precise HAI control.

Objective To investigate the perioperative management of antithrombotic drugs in patients undergoing non-cardiac surgery.Methods Patients on long-term antithrombotic drugs who underwent non-cardiac surgery in our hospital were included.Through interviews with patients and physicians,perioperative antithrombotic medication regimens were reviewed and compared with the"Multidisciplinary Expert Consensus on Perioperative Management of Antithrombotic Therapy"to evaluate compliance with consensus and analyze influencing factors.Results A total of 372 patients were included in the analysis.Among them,355 patients were on long-term antiplatelet therapy alone,and 17 were on long-term oral anticoagulantion.364(97.8％)discontinued antithrombotic medications prior to surgery.109 patients(29.3％)received low molecular weight heparin(LMWH)bridging therapy.Among the 355 patients on antiplatelet therapy,108(30.4％)had discontinuation durations consistent with the consensus recommendations,while 186(52.4％)discontinued medications for longer periods.Postoperatively,the average hospital stay for antiplatelet therapy patients was 6.64 days,with only 37(10.4％)resuming therapy during hospitalization.The average hospital stay for patients on anticoagulants was 9.94 days,with only 2(11.8％)resuming therapy during hospitalization.Regarding perioperative risk assessment,only 40(10.8％)of patients underwent additional internal medical evaluation for thromboembolic risk after medication discontinuation,with the remainder assessed soly by surgeons.Coronary heart disease was an independent risk factor associated with internal medical evaluation(OR 2.851,95％CI 1.160-7.011,P=0.022).For bleeding risk assessment,surgeons evaluations aligned with the consensus in 68.0％of cases,but surgeons tended to underestimate risk compared to the consensus.Conclusions In this single-center study,perioperative antithrombotic management showed low compliance with expert consensus,characterized by prolonged preoperative medication discontinuation,high rates of LMWH bridging,and low postoperative in-hospital resumption of therapy.A robust multidisciplinary collaboration system should be established to enhance comprehensive patient assessment.

Neonatal sepsis is a global health problem that seriously affects the body health and life safety of newborns. It has a higher incidence in preterm infants,especially for early-onset sepsis (EOS) within 72 hours of birth. The diagnosis of neonatal EOS requires a series of examinations,and early and accurate diagnosis can improve clinical outcomes and reduce antibiotic overuse in a timely manner. At present,the commonly used biomarkers and traditional blood culture methods for EOS diagnosis have certain shortcomings,so it is urgent to find new molecular diagnostic methods. This article summarizes and compares the early and novel diagnostic methods of neonatal EOS,in order to provide a reference for clinical practice.

Objective To observe the effect of knee arthroscopic enlarged valve resection(AEVR)combined with cyst wall resection(CWR)on popliteal cyst.Methods A retrospective analysis was conducted on the clinical data of 80 patients with popliteal cyst from June 2022 to June 2023.They were divided into two groups based on different surgical methods.Group A received 39 cases of traditional open cystectomy(TOC),while group B received 41 cases of AEVR-CWR.The perioperative indicators,length of hospital stay,pain status,knee joint function,knee joint range of motion,popliteal cyst grading,postoperative complications,and cyst survival were compared between the two groups.Results The surgical bleeding volume,total incidence of postoperative complications,and residual cyst rate at 6 months after surgery in group B were lower than those in group A,the incision length,and hospital stay in group B were shorter than those in group A,surgery time in group B was longer than that in group A,the differences were statistically significant(P＜0.05).After surgery,the visual analogue scale(VAS)of both groups was lower than that before surgery,and group B was lower than group A,the difference was statistically significant(P＜0.05).After surgery,the Lysholm score of both groups were higher than that before surgery,and group B was higher than group A,the knee range of motion of both groups were greater than that before surgery,and group B was greater than group A,the differences were statistically significant(P＜0.05).After surgery,the Rauschning-Lindgren grading of both groups was better than that before surgery,and group B was better than group A,the difference was statistically significant(P＜0.05).Conclusion The combination of AEVR and CWR can reduce surgical bleeding,shorten incision length and hospital stay,alleviate pain,improve knee joint range of motion,knee joint function,and grading of popliteal cysts,reduce the total incidence of postoperative complications and the residual rate of cysts at 6 months after surgery,but the surgery time has been extended.

Aim To explore the action mechanism of isoquercitrin(IQ)in ameliorating anxiety based on network pharmacology,cellular transcriptomics,molecu-lar docking and animal experiments.Methods The common targets of anxiety disorders and IQ were ob-tained by using relevant databases.The protein-protein interaction network,the biological function and signa-ling pathway enrichment analysis were conducted by u-sing the common targets.Primary hippocampal neurons were cultured in vitro,and corticosterone was added to induce neurons to establish a corticosterone injury mod-el.IQ treatment was added to the culture system,and transcriptomics was used to screen for differentially ex-pressed genes and enrich for differentially expressed pathways.Subsequently,the results were validated by quantitative real-time polymerase chain reaction(qRT-PCR).Possible targets and signaling pathways for IQ treatment on anxiety were speculated and screened u-sing network pharmacology,transcriptomics and molec-ular docking.The anxiety rat model was constructed,and the anxiety state of rats was evaluated after IQ in-tervention,and the protein expression level of hippo-campus was detected to verify the relevant mechanism.Results Network pharmacology,cellular transcrip-tome,and molecular docking analyses revealed that the key mechanism of IQ for anxiety may be related to the BDKRB2/PI3K/Akt signaling pathway.Animal exper-iments showed that IQ was effective in improving anxie-ty behaviour and learning memory ability in rats.IQ increased the movement distance and residence time in the central area of the open field,the time and number percentage of entries into the open arm in the elevated plus maze,and the spontaneous alternations score in the Y maze in rats,and significantly elevated protein expression of BDKRB2,PI3K,Akt and decreased pro-tein expression of NF-κB in the hippocampus.Conclu-sions Isoquercitrin can effectively treat anxiety,and the mechanism of action may be related to the regula-tion of BDKRB2/PI3K/Akt signaling pathway in hip-pocampus.

Objective To investigate the discovery and disposal process and epidemiological characteristics of the first confirmed case of mpox (formerly named monkeypox) in Huai'an, Jiangsu Province, and to provide reference for the prevention and control of key infectious diseases in this region. Methods The on-site epidemiological investigation data of the first confirmed case of mpox on June 21, 2023, as well as the results of nucleic acid detection and gene sequencing of laboratory specimens were analyzed retrospectively. Possible sources of infection were explored. Results The first confirmed case of mpox was an AIDS patient, men who had sex with men (MSM), who had no history of travel abroad or outside the city within 21 days before the onset of the disease, but had interacted with some people outside the city, and the epidemiological trajectory was complex. The detection of mpox virus nucleic acid was positive (BioGerm reagent: Ct value 21.8, ZhuoCheng reagent: Ct value 21.2). According to genetic sequencing, the first confirmed case was classified as C.1.1 lineage of clade IIb. During the investigation on the source of infection of the first confirmed case, one new asymptomatic infected person was found. Based on the epidemiological investigation and laboratory results, the first confirmed case was believed to be caused by local infection, however, the source of infection was unclear. Although there was an epidemiological association with asymptomatic infected people, the direct evidence of mutual infection was insufficient, and it could not be ruled out that there was still a hidden transmission chain between regions. The source of infection of the asymptomatic infected person was presumed to be the first confirmed case or an unidentified person with whom he had high-risk sex and caused anal bleeding. Conclusion The first confirmed case is caused by local infection. Awareness of case diagnosis and reporting in medical institutions should be improved, and publicity and education should be provided to key exposed populations, especially those men who have sex with men, to prevent the occurrence of large-scale local epidemic.