The brain-gut interaction theory is a multidimensional integrative concept based on the brain-gut axis， involving neural， endocrine， and immune regulatory networks as well as the gut microbiota. Zang-fu organs （脏腑） theory in traditional Chinese medicine （TCM） shows a high degree of consistency with the brain-gut interaction theory， and the core functions such as the spleen and stomach governing the ascending of the clear and descending of the turbid， the liver governing the free flow of qi， and the heart governing mental and emotional activities are closely associated with the multi-level regulatory mechanisms of the brain-gut axis. TCM therapy can modulate brain-gut interactions through multiple pathways in the treatment of spleen and stomach diseases， including the regulation of gastrointestinal hormone secretion， neurotransmitter levels， the hypothalamic-pituitary-adrenal （HPA） axis， immune homeostasis and inflammatory responses， as well as the gut microecology. However， current basic research on the brain-gut interaction theory in TCM for spleen and stomach diseases still faces several challenges， such as difficulties in integrating TCM spleen-stomach theory with modern pathophysiology， lack of innovation in research concepts， and limitations in research methodologies. It is therefore proposed that multidisciplinary collaboration， multi-omics technologies， and targeted research approaches should be adopted to provide more comprehensive methods for basic research on TCM spleen and stomach diseases， thereby promoting the in-depth development of brain-gut interaction theory.

Objective:To strengthen the management of low-value consumables in public hospitals by introducing the Supply Processing Distribution(SPD)management model,and to explore refined operational management strategies and path optimization for low-value consumables.Methods:The SPD management model was introduced,and the entire process of hospital consumables was refinedly managed using third-party supply chain information management platforms,visualized tertiary department warehouses,Radio Frequency Identification(RFID)technology and intelligent cabinet systems,Unique Device Identification(UDI)coding,"four-code integration"and other supporting technologies.Results:Based on the analysis of the current situation in the target Hospital,specific measures related to the management of low-value consumables were introduced after the introduction of the SPD model.Conclusion:It provides a reference and guidance for the hospital's medical consumables management department to promote refined management of medical consumables under the SPD model.

ObjectiveTo explore the material basis of the "interaction of blood stasis and toxin" mechanism in cerebral ischemia-reperfusion injury， as well as the protective role of Huoxue Huayu Jiedu prescription （HXHYJDF） against ferroptosis. MethodsSixty SPF-grade male SD rats were randomly divided into six groups： sham group， model group， deferoxamine （DFO） group （100 mg·kg^-1）， low-dose HXHYJDF group （4.52 g·kg^-1）， medium-dose HXHYJDF group （9.04 g·kg^-1）， and high-dose HXHYJDF group （18.07 g·kg^-1）， with ten rats in each group. Except for the sham group， the other groups were used to replicate the model of focal cerebral ischemia-reperfusion in the middle cerebral artery of rats by the reforming Longa method. Neurological function was assessed at 1^st， 3^rd， 5^th， and 7^th days post-reperfusion using the modified neurological severity scores （m-NSS）. Brain tissue pathology and the morphology of mitochondria were observed using hematoxylin-eosin （HE） staining and transmission electron microscopy. The contents of malondialdehyde （MDA）， glutathione （GSH）， divalent iron ions （Fe²⁺）， and reactive oxygen species （ROS） in the ischemic cerebral tissue were detected using enzyme-linked immunosorbent assay （ELISA）. Immunohistochemistry and Western blot （WB） were used to detect the expression of iron death marker proteins glutathione peroxidase 4 （GPX4）， ferroportin-1 （FPN1）， transferrin receptor protein 1 （TfR1）， and ferritin mitochondrial （FtMt） in brain tissue. ResultsCompared with the sham group， the mNSS score of the model group was significantly increased （P<0.01）. HE staining showed that the number of neurons in the cortex of brain tissue was seriously reduced， and the intercellular space was widened. The nucleus was fragmented， and the cytoplasm was vacuolated. The results of transmission electron microscopy showed that the mitochondria in the cytoplasm contracted and rounded， and the mitochondrial cristae decreased. The matrix was lost and vacuolated， and the density of the mitochondrial bilayer membrane increased. The results of ELISA showed that the content of GSH decreased significantly （P<0.01）， and the contents of MDA， Fe²⁺， and ROS increased significantly （P<0.01）. The results of immunohistochemistry and WB showed that the expression of GPX4 and FPN1 proteins was significantly decreased （P<0.01）， and the expression of FtMt and TfR1 proteins was significantly increased （P<0.01）. Compared with those of the model group， the m-NSS scores of the high-dose and medium-dose HXHYJDF groups began to decrease on the 3^rd and 5^th days， respectively （P<0.05， P<0.01）. The results of HE and transmission electron microscopy showed that the intervention of HXHYJDF improved the pathological changes of neurons and mitochondria. The results of ELISA showed that the content of GSH in the medium-dose and high-dose HXHYJDF groups increased significantly （P<0.01）， and the contents of MDA， Fe²⁺， and ROS decreased significantly （P<0.05， P<0.01）. The content of GSH in the low-dose HXHYJDF group increased significantly （P<0.01）， and the contents of MDA and ROS decreased significantly （P<0.01）. The results of immunohistochemistry showed that the expression of GPX4 and FPN1 in the high-dose HXHYJDF group increased significantly （P<0.01）， and the expression of FtMt and TfR1 decreased significantly （P<0.01）. The expression of GPX4 and FPN1 in the medium-dose HXHYJDF group increased significantly （P<0.05）， and the expression of TfR1 decreased significantly （P<0.01）. WB results showed that the expression levels of FPN1 and GPX4 proteins in the high-dose， medium-dose， and low-dose HXHYJDF groups were significantly up-regulated （P<0.01）， and the expression levels of FtMt and TfR1 proteins were significantly down-regulated （P<0.01）. ConclusionHXHYJDF can significantly improve neurological dysfunction symptoms in rats with cerebral ischemia-reperfusion injury， improve the pathological morphology of the infarcted brain tissue， and protect the brain tissue of rats with cerebral ischemia-reperfusion injury to a certain extent. Neuronal ferroptosis is involved in cerebral ischemia-reperfusion injury， with increased levels of MDA， Fe²⁺， ROS， and TfR1 and decreased levels of FtMt， FPN1， GPX4， and GSH potentially constituting the material basis of the interaction of blood stasis and toxin mechanism in cerebral ischemia-reperfusion injury. HXHYJDF may exert brain-protective effects by regulating iron metabolism-related proteins， promoting the discharge of free iron， reducing brain iron deposition， alleviating oxidative stress， and inhibiting ferroptosis.

Helicobacter pylori(H.pylori)infection triggers gastric mucosal inflammatory responses and spasmolytic polypeptide-expressing metaplasia(SPEM).These pathological conditions can escalate the severity of chronic gas-tritis,gastric ulcers and even cause gastric cancer.SPEM is frequently viewed as an early sign of gastric mucosal injury and the onset of carcinogenesis.A comprehensive analysis of the genesis and molecular regulation of SPEM cells in the context of H.pylori infection further has enlightened the pathogenesis of gastric mucosal diseases and provide new ideas and targets for diagnosing and treatment of H.pylori-related gastric mucosal diseases.This paper reviews a variety of molecular biomarkers associated with SPEM,encompassing TFF2,CD44v9,and AQP5,and delineates their pivotal regulatory functions in H.pylori infection and SPEM.This paper also reviews the origination of SPEM cells and pertinent molecular regulatory mechanisms.

Objective:To strengthen the management of low-value consumables in public hospitals by introducing the Supply Processing Distribution(SPD)management model,and to explore refined operational management strategies and path optimization for low-value consumables.Methods:The SPD management model was introduced,and the entire process of hospital consumables was refinedly managed using third-party supply chain information management platforms,visualized tertiary department warehouses,Radio Frequency Identification(RFID)technology and intelligent cabinet systems,Unique Device Identification(UDI)coding,"four-code integration"and other supporting technologies.Results:Based on the analysis of the current situation in the target Hospital,specific measures related to the management of low-value consumables were introduced after the introduction of the SPD model.Conclusion:It provides a reference and guidance for the hospital's medical consumables management department to promote refined management of medical consumables under the SPD model.

With the incidence rate of female tumors rising year by year and its younger trend,the demand for fertility preservation is increasing.The application of fertility preservation technology in young female tumor patients,as well as its ethical,legal,and psychological aspects,posed certain challenges.The effectiveness and safety of the technology,as well as the ethical and legal issues faced in the implementation process,such as the health of offspring after preserving the patient's fertility,patient reproductive autonomy,and the handling of frozen reproductive materials,were all open to discussion.Fertility preservation was not only related to technology and healthcare,but also involved the psychological and emotional needs of patients and their families.In addition,the laws and regulations on fertility preservation need to be further improved,to better protect the reproductive rights of young tumor patients and provide safe legal protection.

Objective:To compare the cumulative live birth rate (CLBR) per oocyte retrieval cycle between gonadotropin-releasing hormone (GnRH) antagonist protocol and progestin-primed ovarian stimulation (PPOS) protocol in patients aged 20-50 years.Methods:A retrospective cohort study was conducted to analyze 3 752 infertile patients aged 20-50 years who received in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET). They used either GnRH antagonist protocol or PPOS protocol at the Center of Assisted Reproduction in Shanghai First Maternity and Infant Hospital from January 2017 to April 2021. One to one propensity score matching (PSM) was used to match the population characteristics. Baseline, clinical and laboratory characteristics, as well as pregnancy outcomes were compared between the two groups. The differences of CLBR was analyzed by multivariate logistic regression and subgroup analysis. Results:After matching, 1 466 patients (733 in each group) were included in the analysis. No significant differences were detected in age, body mass index, infertility type, cause and duration of infertility, number of stimulation cycles, basal follicle-stimulating hormone, number of antral follicles and composition ratio of insemination methods between the two groups ( P>0.05). Serum estradiol level [1 700.30 (1 011.76, 2 580.50) ng/L] and luteinizing hormone (LH) level [1.95 (1.07, 5.27) U/L] on trigger day were significantly lower in GnRH antagonist group than in PPOS group [2 056.50 (884.08, 3 601.59) ng/L, P=0.010; 3.00 (1.51, 5.00) U/L, P<0.001]. The cycle cancellation rate of PPOS group [30.56% (224/733)] was significantly higher than that of GnRH antagonist group [18.83% (138/733), P<0.001]. The numbers of oocytes obtained, available embryos and good-quality embryos were similar to those in GnRH antagonist group (all P>0.05). For each embryo transfer cycle, the implantation rate [16.97% (207/1 220) vs. 21.42% (266/1 242)], the clinical pregnancy rate [21.78% (188/863) vs. 27.38% (233/851)], the onging pregnancy rate [16.11% (139/863) vs. 21.62% (184/851)] and the live birth rate [15.06% (130/863) vs. 20.80% (177/851)] were significantly lower in PPOS group than in GnRH antagonist group ( P=0.010, P=0.012, P=0.004 and P=0.002, respectively). The CLBR of PPOS group was significantly lower than that of GnRH antagonist group [17.74% (130/733) vs. 24.15% (177/733), P=0.003]. Multivariate logistic regression analysis showed that ovarian stimulation protocol was an independent risk factor for CLBR [ OR=1.42, 95% CI: 1.03-1.95, P=0.032]. The results of subgroup analysis showed that the CLBR of PPOS group was significantly lower than that of GnRH antagonist group in the population aged ≤35 years and underwent non-first IVF/ICSI cycle [21.35% (111/520) vs. 28.93% (151/522), P=0.005; 7.85% (41/522) vs. 12.23% (62/507), P=0.019]. Conclusion:Compared with PPOS regimen, antagonist regimen can improve the CLBR per oocyte cycle in infertile patients aged 20-50 years, and is more significant in women aged ≤35 years and non-first oocyte collection patients.

Objective To investigate the effects of the rhein on the mitochondria fission and epithelial-mesenchymal transition(EMT)of breast cancer cells MDA-MB-231.Methods Human breast cancer cells were intervened with rhein,and the cells were divided into control group(0 μmol·L-1),low dose rhein group(100 μmol·L-1),and high dose rhein group(200 μmol·L-1).The proliferation activity of the cells was detected by CCK-8,and migrations was detected by Scratch-healing migration assay.The morphology and distribution of mitochondria were detected by transmission electron microscope,and the expression levels of Dynamin-related protein 1(Drp1),mitofusin2(Mfn2),E-cadherin,Vimentin proteins were detected by Western blot.Results Compared with control group,Rhein significantly reduced the protein expression of Drp1、Vimentin(P<0.05),and increased E-cadherin and Mfn2,thus down-regulating mitochondria fission,inhibiting cell proliferation and migration.High dose Rhein was better than low dose.Conclusion Rhein can inhibit the proliferation and migration of breast cancer cells by reducing the expression of Drp1,Vimentin and up-regulating Mfn2,E-cadherin proteins.

Objective:To compare the cumulative live birth rate (CLBR) per oocyte retrieval cycle between gonadotropin-releasing hormone (GnRH) antagonist protocol and progestin-primed ovarian stimulation (PPOS) protocol in patients aged 20-50 years.Methods:A retrospective cohort study was conducted to analyze 3 752 infertile patients aged 20-50 years who received in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET). They used either GnRH antagonist protocol or PPOS protocol at the Center of Assisted Reproduction in Shanghai First Maternity and Infant Hospital from January 2017 to April 2021. One to one propensity score matching (PSM) was used to match the population characteristics. Baseline, clinical and laboratory characteristics, as well as pregnancy outcomes were compared between the two groups. The differences of CLBR was analyzed by multivariate logistic regression and subgroup analysis. Results:After matching, 1 466 patients (733 in each group) were included in the analysis. No significant differences were detected in age, body mass index, infertility type, cause and duration of infertility, number of stimulation cycles, basal follicle-stimulating hormone, number of antral follicles and composition ratio of insemination methods between the two groups ( P>0.05). Serum estradiol level [1 700.30 (1 011.76, 2 580.50) ng/L] and luteinizing hormone (LH) level [1.95 (1.07, 5.27) U/L] on trigger day were significantly lower in GnRH antagonist group than in PPOS group [2 056.50 (884.08, 3 601.59) ng/L, P=0.010; 3.00 (1.51, 5.00) U/L, P<0.001]. The cycle cancellation rate of PPOS group [30.56% (224/733)] was significantly higher than that of GnRH antagonist group [18.83% (138/733), P<0.001]. The numbers of oocytes obtained, available embryos and good-quality embryos were similar to those in GnRH antagonist group (all P>0.05). For each embryo transfer cycle, the implantation rate [16.97% (207/1 220) vs. 21.42% (266/1 242)], the clinical pregnancy rate [21.78% (188/863) vs. 27.38% (233/851)], the onging pregnancy rate [16.11% (139/863) vs. 21.62% (184/851)] and the live birth rate [15.06% (130/863) vs. 20.80% (177/851)] were significantly lower in PPOS group than in GnRH antagonist group ( P=0.010, P=0.012, P=0.004 and P=0.002, respectively). The CLBR of PPOS group was significantly lower than that of GnRH antagonist group [17.74% (130/733) vs. 24.15% (177/733), P=0.003]. Multivariate logistic regression analysis showed that ovarian stimulation protocol was an independent risk factor for CLBR [ OR=1.42, 95% CI: 1.03-1.95, P=0.032]. The results of subgroup analysis showed that the CLBR of PPOS group was significantly lower than that of GnRH antagonist group in the population aged ≤35 years and underwent non-first IVF/ICSI cycle [21.35% (111/520) vs. 28.93% (151/522), P=0.005; 7.85% (41/522) vs. 12.23% (62/507), P=0.019]. Conclusion:Compared with PPOS regimen, antagonist regimen can improve the CLBR per oocyte cycle in infertile patients aged 20-50 years, and is more significant in women aged ≤35 years and non-first oocyte collection patients.

ObjectiveTo observe the effects of five Huoxue Huayu prescriptions on blood lipid metabolism， liver tissue and adenosine triphosphate binding cassette transporter A1 （ABCA1） and peroxisome proliferator-activated receptor γ（PPARγ） expression in New Zealand rabbits with blood stasis syndrome， and to compare their differences in order to provide laboratory evidence for clinical selection of prescriptions and drugs. MethodSeventy New Zealand rabbits were randomly divided into normal group （n=10） and model group （n=60）. The blood stasis syndrome was modeled by the method of starvation+high-fat feed+adrenaline. After the models were successfully established， they were randomly divided into Xuefu Zhuyutang（3.55 g·kg^-1·d^-1） group， Danshenyin（1.962 g·kg^-1·d^-1） group， Shixiaosan（0.56 g·kg^-1·d^-1） group， Huoluo Xiaolingdan（2.80 g·kg^-1·d^-1） group， and Taohong Siwutang（2.66 g·kg^-1·d^-1） group， and were given corresponding compound prescriptions by gavage. The normal group and model group were given the same dose of distilled water. After the treatment of 30 consecutive days， blood was taken from the abdominal aorta to detect the content of total cholesterol （TC）， triglycerides （TG）， high-density lipoprotein cholesterol （HDL-C）， low-density lipoprotein cholesterol（LDL-C） and apolipoprotein A1 （ApoA1）. Hematoxylin-eosin（HE） staining was used to observe the changes in liver tissue. Real-time polymerase chain reaction （Real-time PCR） and Western blot were used to detect the mRNA and protein expression of ABCA1 and PPARγ in liver tissue， respectively. ResultCompared with the conditions in the normal group， increased mRNA and protein levels of HDL-C， LDL-C， TG， TC， and PPARγ （P<0.01）， decreased ApoA1 level （P<0.05） and decreased mRNA and protein levels of ABCA1 （P<0.01） were found in the model group. Compared with the conditions in the model group， the HDL-C level in the five Huoxue Huayu prescriptions was lowered （P<0.05）， and lowered TG level in Xuefu Zhuyutang group and Shixiaosan group （P<0.05）， decreased LDL-C and TC levels in Shixiaosan group （P<0.05）， and increased ApoA1 level in the Huoluo Xiaolingdan group （P<0.01） and Taohong Siwutang group （P<0.05） were observed. Furthermore， the mRNA and protein levels of ABCA1 in Xuefu Zhuyutang group， Shixiaosan group， Huoluo Xiaolingdan group and Taohong Siwutang group were elevated （P<0.05， P<0.01）， and the elevated levels were higher than that of Danshenyin group （P<0.05）. The mRNA level of PPARγ in the five Huoxue Huayu prescriptions was reduced （P<0.01）， and its protein level was also decreased in Xuefu Zhuyutang group， Shixiaosan group， Huoluo Xiaolingdan group and Taohong Siwutang group （P<0.01）. ConclusionThe five Huoxue Huayu prescriptions had a certain therapeutic effect on dyslipidemia，which might be achieved by up-regulating the expression of ApoA1 and ABCA1 to promote the production of HDL-C and strengthen the excretion of dysfunctional HDL-C. And Xuefu Zhuyutang had the optimal effect in lowering lipid.