Objective: To analyze the regulatory effect of Atractylodes macrocephala Koidz. extract on the immune function of mice, so as to provide a reference for the study of the mechanism of Atractylodes macrocephala Koidz. regulating immune function. Methods: Forty-eight SPF healthy male ICR mice were randomly divided into control group and low (0.5 g/kg), medium (2.0 g/kg), and high (4.0 g/kg) dose groups, with 12 mice in each group. The mice in control group were given the pure water by gavage once a day, while the mice in each dose group were given the corresponding dose of Atractylodes macrocephala Koidz. extract by gavage once a day. The delayed allergy test was performed for 28 consecutive days. Sixty SPF healthy male ICR mice were randomly divided into a control group, polyinosinic acid injection group (model group), and low, medium, and high dose groups, with 12 mice in each group. The mice in control group were given the pure water by gavage once a day, while the mice in each dose group were given the corresponding dose of Atractylodes macrocephala Koidz. extract by gavage once a day for 14 consecutive days. On days 13 and 14 of administration, the mice in the model group and each dose group were intraperitoneally injected with sterile polyinosinic acid solution to perform the immunosuppressive experiment induced by polyinosinic acid. The mouse ear pieces were weighed, and the thymus and spleen of the mice were weighed and stained with HE to calculate the pathological scores. Peripheral blood was collected for blood cell detection and T cell classification. Results: Mice in each group had normal feeding, activity, and growth status, and no abnormality was observed. In the delayed allergy test, compared with the control group, the degree and rate of ear swelling in the low, medium and high dose groups were higher, the white blood cell count in the medium dose group was higher, and the absolute values of lymphocytes in the low and medium dose groups were higher (all P<0.05). Compared with the control group, the pathological scores of the thymus and spleen in the model group were higher (both P<0.05). In the immunosuppressive experiments in mice induced by polyinosinic acid, compared with the model group, the pathological score of the thymus in the high dose group was lower (P<0.05), and the boundary between the thymus cortex and medulla was improved. Conclusions Atractylodes macrocephala Koidz. extract can increase the degree of ear swelling and peripheral blood white blood cell count in mice. High dose of Atractylodes macrocephala Koidz. extract can improve the thymus injury induced by polyinosinic acid, and has an immunomodulatory effect.

Objective:To analyze the immunization status of routine vaccines for children aged 0-7 years old with special health status in Tianhe District, Guangzhou City, from 2023 to 2024.Methods:From April 2023 to March 2024, 42 vaccination units in Tianhe District, Guangzhou, were organized to collect data on diseases and vaccination history of children with special health status. Vaccination rates were calculated, and multivariate logistic regression models were used to explore the impact of special health status on vaccination rates.Results:A total of 1 976 children aged 0-7 years old with special health status were included, with an average of (1.26±0.58) diseases per participant. The average number of vaccine doses administered for routine immunizations was (14.29±4.27), and the full vaccination coverage was 72.76%. The vaccination rate of 10 doses in the immunization program vaccine was less than 90.00%. The timely rate of the first dose of hepatitis B vaccine (HepB1) was 74.14%, and that of the first dose of measles vaccine (MCV1) was 63.93%. Compared with children with infectious diseases, those with neonatal diseases were more likely to miss the third dose of poliomyelitis vaccine (PV3), MCV1 and the second dose of Group A meningococcal polysaccharide vaccine (MPSV-A2). Those with neuromuscular system diseases were more likely to miss PV3, MPSV-A2 and the first dose of Japanese encephalitis vaccine, live (JE-L1). Those with congenital heart disease were more likely to miss PV3, the third dose of diphtheria tetanus-acellular pertussis vaccine (DTaP3), MCV1, MPSV-A2, and JE-L1. Those with hematological disorders were more likely to miss PV3, MCV1, MPSV-A2, and JE-L1. Those with genetic diseases were more likely to miss MPSV-A2. Those with comorbidities were more likely to miss MCV1 and MPSV-A2. Those with neonatal diseases, neuromuscular system diseases, congenital heart disease, hematopoietic system diseases, genetic diseases, or comorbidities had difficulties in completing the full vaccination process.Conclusion:Children with special health conditions have lower rates of routine immunization and timely vaccination. More measures are needed to improve vaccination rates.

Objective To investigate the inhibitory effect of MKK6(E)fusion protein on the growth of o-varian cancer graft tumors in nude mice and its possible mechanism.Methods A subcutaneous transplantation tumor model in nude mice was constructed using subcutaneous injection of human ovarian cancer HO8910PM cells,which were divided into model group,paclitaxel(positive control,3 mg/mL)group,MKK6(E)fusion protein(1.2 mmol/L)group and MKK6(E)fusion protein+SB202190(p38 agonist,10 μmol/L)group by numerical randomization table,each with 6 animals.The drug was administered continuously in the tail vein for 21 d,once every 3 d.At the end of the administration,the tumor was exfoliated and the tumor volume,mass and tumor inhibition rate were calculated.Serum carbohydrate antigen(CA)125 level was detected by enzyme linked immunosorbent assay(ELISA),histopathology of the tumor was detected by HE staining,and apoptosis of the tumor cells was detected by TUNEL staining.In addition,expression of Fibronectin,matrix metallo-peptidase(MMP)2,and MMP9 were detected by immunohistochemistry,apoptosis and the p38/ATF-2 pathway-related proteins were detected by Western blot.Results Compared with the model group,the tumor volume,mass and serum CA125 level of nude mice in the paclitaxel group and the MKK6(E)fusion protein group were reduced,the tumor suppression rate and the apoptosis rate of cancer cells were increased,the volume of cancer cells in the transplanted tumor tissue was reduced,the nucleus was lightly stained,the di-viding heterogeneity was reduced compared with that of the model group,and the large area of lamellar nec-rotic zone and apoptotic cells were seen,and the expression of Fibronectin,MMP2 and MMP9 was reduced.Bax and Cleaved caspase 3 expression was up-regulated,and Bcl-2 expression and phosphorylated p38(p-p38)/p38 and p-ATF-2/ATF-2 were down-regulated(P＜0.05).Compared with the MKK6(E)fusion pro-tein group,nude mice in the MKK6(E)fusion protein+SB202190 group showed increased tumor volume,mass and serum CA125 levels,decreased tumor suppression and cancer cell apoptosis,better cancer cell status,decreased necrotic areas,increased expression of Fibronectin,MMP2 and MMP9,and down-regulated Bax and Cleaved caspase 3 expression was down-regulated,and Bcl-2 expression and p-p38/p38 and p-ATF-2/ATF-2 were up-regulated(P＜0.05).While p-ERK/ERK and p-JNK/JNK were compared among the 4 groups,the difference was not statistically significant(P＞0.05).Conclusion MKK6(E)fusion protein inhibits the growth of ovarian cancer subcutaneous graft tumors,and its mechanism may be related to the inhibition of p38/ATF-2 signa-ling pathway activation.

Objective To analyze the clinical characteristics of children with moyamoya disease and the influence of Chinese medicine identification and acupuncture treatment plan on their prognosis.Methods A retrospective analysis was conducted on the diagnosis and treatment of children diagnosed with moyamoya disease who underwent surgery and were treated with acupuncture at Tianjin Children's Hospital on July 10,2023.The main acupuncture points were as follows:Points on head and face:shangxing,yintang,touwei,middle line of vertex,anterior oblique line of vertex-temporal(the upper 1/5 section),lateral line 1 of vertex,anterior temporal line,renzhong,shanglianquan,sibai,yingxiang,quanliao,xiaguan,and dicang;Points on upper extremities:jiquan,chize,neiguan(quick stabbing without leaving needles),jianyu,jianliao,quchi,waiguan,yangxi,houxi,hegu;Points on lower extremities:weizhong,weiyang(quick stabbing without leaving needles),biguan,xuehai,liangqiu,zusanli,qiuxu,sanyinjiao,and taichong),the needles were performed once a day,and continuous treatment for 5 days each week,and the general conditions of the children were observed after 2 weeks of treatment,and the Fugl-Meyer assessment(FMA),the Barthel index(BI),and the simple test for evaluating hand function(STEF)were used,to assess left upper limb motor function;neurophysiologic techniques were used to examine motor nerve conduction in the left limb.Results The child was an 8-year-old male admitted to the hospital on July 10,2023.①Complaint:unfavorable movement of the left limb for more than 1 month.②History:the child had an abnormal seizure during waking hours 2 years before admission,which lasted for about 1 minute and then resolved on its own,and he could recall the course of the seizure afterward.Attended at the department of neurology of our hospital and diagnosed with moyamoya disease after being discharged from the hospital,the child was found at home to have weakness of the left limbs,unable to lift the upper limbs and unable to walk on the lower limbs.Attended at the department of neurosurgery of a certain hospital and was diagnosed with acute cerebral infarction and underwent cranio-cerebral vascular anastomosis.After the operation,the child's left limb activity is unfavorable,the right limb has no motor disorder and sensory abnormality,speech expression is unclear,to further improve the motor function of the child's limbs,the patient was referred to the rehabilitation department of our hospital,the initial diagnosis of moyamoya disease disease recovery(left hemiplegia),according to the specific conditions of the adjustment of the acupuncture program,2 weeks after the treatment,the patient's facial lines were basically symmetrical,crying and laughing,the corner of the mouth does not droop.After 4 weeks of treatment,the child was able to walk on the ground independently,but hemiplegic gait,left lower limb muscle tone basically relieved,proximal muscle strength grade Ⅲ-Ⅳ,distal muscle strength grade Ⅱ-Ⅲ.After 6 weeks of treatment,the child's hemiplegic gait was improved,proximal muscle strength was grade Ⅳ,distal muscle strength was grade Ⅲ-Ⅳ,the left hand could hold objects for a few minutes,left thumb flexor strength was grade Ⅲ,dorsal extensor strength was grade Ⅱ,and the rest of the four fingers flexor and dorsal extensor strength was grade Ⅳ.The proximal muscle strength was grade Ⅴ and distal muscle strength was grade Ⅳ.The left wrist could move freely,the left interphalangeal joint could extend and hold objects,and the motor function of the left upper limb was basically established,and the condition was stabilized.FMA,BI and STEF scores all increased with the prolongation of the treatment time,and the latency and nerve conduction velocity of the median nerve,peroneal nerve and tibial nerve tended to normal after treatment.Conclusion The efficacy of traditional acupuncture in treating pediatric moyamoya disease after cerebral infarction surgery rehabilitation is remarkable,which can significantly improve the clinical symptoms of children recovering from moyamoya disease.

Objective:To analyze the immunization status of routine vaccines for children aged 0-7 years old with special health status in Tianhe District, Guangzhou City, from 2023 to 2024.Methods:From April 2023 to March 2024, 42 vaccination units in Tianhe District, Guangzhou, were organized to collect data on diseases and vaccination history of children with special health status. Vaccination rates were calculated, and multivariate logistic regression models were used to explore the impact of special health status on vaccination rates.Results:A total of 1 976 children aged 0-7 years old with special health status were included, with an average of (1.26±0.58) diseases per participant. The average number of vaccine doses administered for routine immunizations was (14.29±4.27), and the full vaccination coverage was 72.76%. The vaccination rate of 10 doses in the immunization program vaccine was less than 90.00%. The timely rate of the first dose of hepatitis B vaccine (HepB1) was 74.14%, and that of the first dose of measles vaccine (MCV1) was 63.93%. Compared with children with infectious diseases, those with neonatal diseases were more likely to miss the third dose of poliomyelitis vaccine (PV3), MCV1 and the second dose of Group A meningococcal polysaccharide vaccine (MPSV-A2). Those with neuromuscular system diseases were more likely to miss PV3, MPSV-A2 and the first dose of Japanese encephalitis vaccine, live (JE-L1). Those with congenital heart disease were more likely to miss PV3, the third dose of diphtheria tetanus-acellular pertussis vaccine (DTaP3), MCV1, MPSV-A2, and JE-L1. Those with hematological disorders were more likely to miss PV3, MCV1, MPSV-A2, and JE-L1. Those with genetic diseases were more likely to miss MPSV-A2. Those with comorbidities were more likely to miss MCV1 and MPSV-A2. Those with neonatal diseases, neuromuscular system diseases, congenital heart disease, hematopoietic system diseases, genetic diseases, or comorbidities had difficulties in completing the full vaccination process.Conclusion:Children with special health conditions have lower rates of routine immunization and timely vaccination. More measures are needed to improve vaccination rates.

Objective To analyze the clinical characteristics of children with moyamoya disease and the influence of Chinese medicine identification and acupuncture treatment plan on their prognosis.Methods A retrospective analysis was conducted on the diagnosis and treatment of children diagnosed with moyamoya disease who underwent surgery and were treated with acupuncture at Tianjin Children's Hospital on July 10,2023.The main acupuncture points were as follows:Points on head and face:shangxing,yintang,touwei,middle line of vertex,anterior oblique line of vertex-temporal(the upper 1/5 section),lateral line 1 of vertex,anterior temporal line,renzhong,shanglianquan,sibai,yingxiang,quanliao,xiaguan,and dicang;Points on upper extremities:jiquan,chize,neiguan(quick stabbing without leaving needles),jianyu,jianliao,quchi,waiguan,yangxi,houxi,hegu;Points on lower extremities:weizhong,weiyang(quick stabbing without leaving needles),biguan,xuehai,liangqiu,zusanli,qiuxu,sanyinjiao,and taichong),the needles were performed once a day,and continuous treatment for 5 days each week,and the general conditions of the children were observed after 2 weeks of treatment,and the Fugl-Meyer assessment(FMA),the Barthel index(BI),and the simple test for evaluating hand function(STEF)were used,to assess left upper limb motor function;neurophysiologic techniques were used to examine motor nerve conduction in the left limb.Results The child was an 8-year-old male admitted to the hospital on July 10,2023.①Complaint:unfavorable movement of the left limb for more than 1 month.②History:the child had an abnormal seizure during waking hours 2 years before admission,which lasted for about 1 minute and then resolved on its own,and he could recall the course of the seizure afterward.Attended at the department of neurology of our hospital and diagnosed with moyamoya disease after being discharged from the hospital,the child was found at home to have weakness of the left limbs,unable to lift the upper limbs and unable to walk on the lower limbs.Attended at the department of neurosurgery of a certain hospital and was diagnosed with acute cerebral infarction and underwent cranio-cerebral vascular anastomosis.After the operation,the child's left limb activity is unfavorable,the right limb has no motor disorder and sensory abnormality,speech expression is unclear,to further improve the motor function of the child's limbs,the patient was referred to the rehabilitation department of our hospital,the initial diagnosis of moyamoya disease disease recovery(left hemiplegia),according to the specific conditions of the adjustment of the acupuncture program,2 weeks after the treatment,the patient's facial lines were basically symmetrical,crying and laughing,the corner of the mouth does not droop.After 4 weeks of treatment,the child was able to walk on the ground independently,but hemiplegic gait,left lower limb muscle tone basically relieved,proximal muscle strength grade Ⅲ-Ⅳ,distal muscle strength grade Ⅱ-Ⅲ.After 6 weeks of treatment,the child's hemiplegic gait was improved,proximal muscle strength was grade Ⅳ,distal muscle strength was grade Ⅲ-Ⅳ,the left hand could hold objects for a few minutes,left thumb flexor strength was grade Ⅲ,dorsal extensor strength was grade Ⅱ,and the rest of the four fingers flexor and dorsal extensor strength was grade Ⅳ.The proximal muscle strength was grade Ⅴ and distal muscle strength was grade Ⅳ.The left wrist could move freely,the left interphalangeal joint could extend and hold objects,and the motor function of the left upper limb was basically established,and the condition was stabilized.FMA,BI and STEF scores all increased with the prolongation of the treatment time,and the latency and nerve conduction velocity of the median nerve,peroneal nerve and tibial nerve tended to normal after treatment.Conclusion The efficacy of traditional acupuncture in treating pediatric moyamoya disease after cerebral infarction surgery rehabilitation is remarkable,which can significantly improve the clinical symptoms of children recovering from moyamoya disease.

Background: Clinical chemistry tests are most widely used in clinical laboratories, and diverse measurement systems for these analyses are available in China. We evaluated the imprecision of clinical chemistry measurement systems based on internal QC (IQC) data. Methods: IQC data for 27 general chemistry analytes were collected in February each year from 2013 to 2022. Four performance specifications were used to calculate pass rates for CVs of IQC data in 2022. Boxplots were drawn to analyze trends of CVs, and differences in CVs among different groups were assessed using the Mann–Whitney U-test or Kruskal– Wallis test. Results: The number of participating laboratories increased significantly from 1,777 in 2013 to 5,425 in 2022. CVs significantly decreased for all 27 analytes, except creatine kinase and lipase. Triglycerides, total bilirubin, direct bilirubin, iron, and γ-glutamyl transferase achieved pass rates > 80% for all goals. Nine analytes with pass rates < 80% based on 1/3 allowable total error were further analyzed; the results indicated that closed systems exhibited lower CVs than open systems for all analytes, except total protein. For all nine analytes, differences were significant between tertiary hospitals and non-tertiary hospitals and between accredited and non-accredited laboratories. Conclusions The CVs of IQC data for clinical chemistry have seen a continuous overall improvement in China. However, there is ample room for imprecision improvement for several analytes, with stricter performance specifications.

Ulcerative colitis is a chronic,non-specific inflammatory disease.The persistent damage to its intestinal epithelium is key to the development of the disease.In recent years,a new form of cell death has been identified by researchers-iron death-which is thought to be an important contributor to intestinal epithelial cell death.The occurrence of iron death is often associated with abnormal intracellular iron metabolism,reduced cystine/glutamate reverse transporter activity,abnormal lipid metabolism,voltage-dependent anion channel activation and overexpression of the Nrf2 gene.Iron death can lead to smaller mitochondria,increased membrane density and reduced number of cristae,unlike conventional cell death,which does not exhibit specific phenomena.Studies have found that TCM can alleviate iron death in intestinal epithelial cells by reducing intracellular iron content,inhibiting lipid reactive oxygen species production and regulating Nrf2 gene expression,thus acting as a treatment for ulcerative colitis.Therefore,Chinese medicine may become an important tool for the treatment of ulcerative colitis.This paper reviews the relationship between cellular iron death and ulcerative colitis and the research progress of Chinese medicine in treating ulcerative colitis through the iron death pathway.

Objective:To evaluate the health benefits and intervention efficiency of different strategies of initiating antihypertensive therapy for the primary prevention of cardiovascular diseases in a community-based Chinese population from the Chinese electronic health records research in Yinzhou(CHERRY)study.Methods:A decision-analytic Markov model was used to simulate and compare different antihy-pertensive initiation strategies,including:Strategy 1,initiation of antihypertensive therapy for Chinese adults with systolic blood pressure(SBP)≥140 mmHg(2020 Chinese guideline on the primary preven-tion of cardiovascular diseases);Strategy 2,initiation of antihypertensive therapy for Chinese adults with SBP≥130 mmHg;Strategy 3,initiation of antihypertensive therapy for Chinese adults with SBP ≥140 mmHg,or with SBP between 130 and 140 mmHg and at high risk of cardiovascular diseases(2017 American College of Cardiology/American Heart Association guideline for the prevention,detection,evaluation,and management of high blood pressure in adults);Strategy 4,initiation of antihypertensive therapy for Chinese adults with SBP≥ 160 mmHg,or with SBP between 140 and 160 mmHg and at high risk of car-diovascular diseases(2019 United Kingdom National Institute for Health and Care Excellence guideline for the hypertension in adults:Diagnosis and management).The high 10-year cardiovascular risk was de-fined as the predicted risk over 10％based on the 2019 World Health Organization cardiovascular disease risk charts.Different strategies were simulated by the Markov model for ten years(cycles),with parame-ters mainly from the CHERRY study or published literature.After ten cycles of simulation,the numbers of quality-adjusted life years(QALY),cardiovascular events and all-cause deaths were calculated to evaluate the health benefits of each strategy,and the numbers needed to treat(NNT)for each cardiovas-cular event or all-cause death could be prevented were calculated to assess the intervention efficiency.One-way sensitivity analysis on the uncertainty of incidence rates of cardiovascular disease and probabilis-tic sensitivity analysis on the uncertainty of hazard ratios of interventions were conducted.Results:A to-tal of 213 987 Chinese adults aged 35-79 years without cardiovascular diseases were included.Com-pared with strategy 1,the number of cardiovascular events that could be prevented in strategy 2 increased by 666(95％UI:334-975),while the NNT per cardiovascular event prevented increased by 10(95％UI:7-20).In contrast to strategy 1,the number of cardiovascular events that could be prevented in strategy 3 increased by 388(95％UI:194-569),and the NNT per cardiovascular event prevented decreased by 6(95％UI:4-12),suggesting that strategy 3 had better health benefits and intervention efficiency.Compared to strategy 1,although the number of cardiovascular events that could be prevented decreased by 193(95％UI:98-281)in strategy 4,the NNT per cardiovascular event prevented decreased by 18(95％UI:13-37)with better efficiency.The results were consistent in the sensitivity analyses.Conclusion:When initiating antihypertensive therapy in an economically developed area of China,the strategy combined with cardiovascular risk assessment is more efficient than those purely based on the SBP threshold.The cardiovascular risk assessment strategy with different SBP thresholds is suggested to balance health benefits and intervention efficiency in diverse populations.

Objective:To systematically evaluate the effect of cognitive behavioral therapy (CBT) in elderly patients with depression.Methods:The randomized controlled trials on the effect of CBT in elderly patients with depression, published until December 15, 2022, were searched in PubMed, CINHAL, Cochrane Library, China Biology Medicine, China National Knowledge Infrastructure, WanFang Data, and VIP. Two researchers independently screened the literature, extracted data, and used the revised Cochrane risk of bias tool for randomized trials (ROB 2.0) to evaluate the quality of the included studies. Statistical analysis was conducted using Stata 16.0, and the quality of evidence was rated using Appraisal of Guidelines for Research and Evaluation (GRADE) predictor software.Results:A total of 11 randomized controlled trials were included, with a total of 833 elderly patients with depression. Randomized effect models were used to analyze outcome indicators such as depression, anxiety, and quality of life by combining effect quantities. Meta-analysis and GRADE evidence quality showed that compared to the control group, medium quality evidence showed that CBT could relieve depression in elderly depression patients with a statistical difference [ SMD=-1.58, 95% CI (-2.16, -0.99), P<0.05]. Low quality evidence suggested that CBT could alleviate anxiety in elderly depression patients also with a statistical difference [ SMD=-2.25, 95% CI (-4.04, -0.47), P<0.05]. Very low quality evidence indicated that CBT did not significantly improve the quality of life in elderly depression patients compared to conventional or pharmacological treatment [ SMD=-0.09, 95% CI (-2.07, 1.88), P>0.05] . Conclusions:Existing evidence suggests that CBT can alleviate depression and anxiety in elderly depression patients, but its improvement in quality of life is not yet significant. Treatment feedback and forms of CBT may become a research focus in recent years on intervention for elderly depression patients.