The active components in traditional Chinese medicine （TCM） generally have problems such as poor solubility and low bioavailability， which seriously restrict their clinical efficacy. In recent years， TCM nano-self-assembly based on the non-covalent interactions between molecules has become the research frontier in this field because it can spontaneously form an orderly structure and improve the insoluble components in the body. Moreover， TCM nano-self-assembly has shown unique advantages in the treatment of fibrosis， inflammatory and immune diseases， infectious diseases， and cancer. This article summarizes the research context， structural system， and potential as a pharmacological substance basis of TCM nano-self-assembly by reviewing recent published studies， with focuses on the application of TCM nano-self-assembly in the treatment of diseases from single components to complex systems. In addition， this article summarizes its advantages， mechanism characteristics， and main challenges faced. At present， this field still faces issues such as insufficient mechanism research， a lack of in-depth understanding of the competitive assembly rules of multiple components， difficulty in quality control， unclear in vivo processes and safety， and obstacles to clinical translation. To address these issues， this article proposes a series of solutions， including introducing molecular dynamics simulation and artificial intelligence to predict assembly behavior， using experimental techniques to analyze non-covalent interactions， establishing a comprehensive evaluation system with multiple indicators， using isotope labeling and in vivo imaging techniques to dynamically track in vivo processes， conducting standardized safety evaluation， promoting the filing of hospital preparations and new drug applications， and strengthening early communication between research and regulation. Finally， this article points out the future development directions， aiming to provide reference for subsequent research and clinical translation.

The active components in traditional Chinese medicine （TCM） generally have problems such as poor solubility and low bioavailability， which seriously restrict their clinical efficacy. In recent years， TCM nano-self-assembly based on the non-covalent interactions between molecules has become the research frontier in this field because it can spontaneously form an orderly structure and improve the insoluble components in the body. Moreover， TCM nano-self-assembly has shown unique advantages in the treatment of fibrosis， inflammatory and immune diseases， infectious diseases， and cancer. This article summarizes the research context， structural system， and potential as a pharmacological substance basis of TCM nano-self-assembly by reviewing recent published studies， with focuses on the application of TCM nano-self-assembly in the treatment of diseases from single components to complex systems. In addition， this article summarizes its advantages， mechanism characteristics， and main challenges faced. At present， this field still faces issues such as insufficient mechanism research， a lack of in-depth understanding of the competitive assembly rules of multiple components， difficulty in quality control， unclear in vivo processes and safety， and obstacles to clinical translation. To address these issues， this article proposes a series of solutions， including introducing molecular dynamics simulation and artificial intelligence to predict assembly behavior， using experimental techniques to analyze non-covalent interactions， establishing a comprehensive evaluation system with multiple indicators， using isotope labeling and in vivo imaging techniques to dynamically track in vivo processes， conducting standardized safety evaluation， promoting the filing of hospital preparations and new drug applications， and strengthening early communication between research and regulation. Finally， this article points out the future development directions， aiming to provide reference for subsequent research and clinical translation.

Objective:To discuss the effect of Compound Rehmannia Granules on intestinal flora of the pneumonia model rats induced by Streptococcus pneumoniae(Spn)through 16s rRNA sequencing technology,and to clarify its potential mechanism.Methods:A total of 30 rats were randomly divided into control group(normal rats),model group(Spn-induced pneumonia rat models),low dose of Compound Rehmannia Granules group(pneumonia rat models administered 1.75 g·kg-1 Compound Rehmannia Granules by gavage),medium dose of Compound Rehmannia Granules group(pneumonia rat models administered 3.50 g·kg-1 Compound Rehmannia Granules by gavage),and high dose of Compound Rehmannia Granules group(pneumonia rat model administered 7.00 g·kg-1 Compound Rehmannia Granules by gavage),with 6 rats in each group.The wet/dry weight(W/D)ratio of lung tissue and blood gas indexes were measured;HE staining was used to observe the pathomorphology and the degree of lung injury in lung tissue of the rats in various groups were assessed;kit assay was used to detect the bacterial load level and the levels of interleukin(IL)-6,IL-8,and IL-10 in bronchoalveolar lavage fluid(BALF)of the rats in various groups;16s rRNA intestinal flora sequencing analysis was performed.Results:Compared with control group,the arterial partial pressure of carbon dioxide(PaCO2)of the rats in model group was significantly increased(P<0.05),and the arterial partial pressure of oxygen(PaO2)and oxygen saturation(SaO2)were significantly decreased(P<0.05);compared with model group,the PaCO2 of the rats in low,medium,and high doses of Compound Rehmannia Granules groups was significantly decreased(P<0.05),and the PaO? and SaO?were significantly increased(P<0.05),showing a dose-dependent manner.The HE staining results showed no significant injury in lung tissue of the rats in control group;the cells in lung tissue of the rats in model group were arranged disorderly with massive inflammatory cell infiltration,and the alveolar wall capillaries were significantly dilated;compared with model group,the morphological damage of lung tissue of the rats in low,medium,and high doses of Compound Rehmannia Granules groups was improved.Compared with control group,the W/D value and pathological score of lung tissue of the rats in model group were significantly increased(P<0.05);compared with model group,the W/D value and pathological scores of lung tissue of the rats in low,medium,and high doses of Compound Rehmannia Granules groups were significantly decreased(P<0.05),showing a dose-dependent manner.Compared with control group,the bacterial load level in BALF of the rats in model group was significantly increased(P<0.05);compared with model group,the bacterial load level in BALF of the rats in low,medium,and high doses of Compound Rehmannia Granules groups was significantly decreased(P<0.05),showing a dose-dependent manner.Compared with control group,the levels of IL-6 and IL-8 in BALF of the rats in model group were significantly increased(P<0.05),and the IL-10 level was significantly decreased(P<0.05);compared with model group,the levels of IL-6 and IL-8 in BALF of the rats in low,medium,and high doses of Compound Rehmannia Granules groups were significantly decreased(P<0.05),and the IL-10 level was significantly increased(P<0.05),showing a dose-dependent manner.Compared with control group,the microbial abundance indicator(Chao1),microbial diversity and evenness indicator(Shannon),microbial dominance indicator(Simpson),and observed species indicator(observed_species)of the rats in model group were significantly decreased(P<0.05);compared with model group,the Chao1,Shannon,Simpson,and(observed_species)indices of the rats in low,medium,and high doses of Compound Rehmannia Granules groups were significantly increased(P<0.05),showing a dose-dependent manner.Compared with control group,the relative abundance of Bacteroidetes in model group was decreased,the relative abundance of Firmicutes was increased,and the Firmicutes/Bacteroidetes ratio was significantly increased(P<0.05);compared with model group,the relative abundances of Bacteroidetes in low,medium,and high doses of Compound Rehmannia Granules groups were increased,the relative abundance of Firmicutes was decreased,and the Firmicutes/Bacteroidetes ratio was significantly decreased(P<0.05),showing a dose-dependent manner.At the family level,compared with control group,the relative abundances of Corynebacteriaceae,Staphylococcaceae,and Moraxellaceae in model group were significantly increased,while the relative abundances of Lactobacillaceae,Lachnospiraceae,and Akkermansiaceae were significantly decreased;compared with model group,the relative abundances of Corynebacteriaceae,Staphylococcaceae,and Moraxellaceae in low,medium,and high doses of Compound Rehmannia Granules groups were significantly decreased,and the relative abundances of Lactobacillaceae,Lachnospiraceae,and Akkermansiaceae were significantly increased.At the genus level,compared with control group,the relative abundances of Desulfovibrio and Facklamia in model group were significantly increased,and the relative abundances of Bifidobacterium and Ruminococcaceae were significantly decreased;compared with model group,the relative abundances of Desulfovibrio and Facklamia in low,medium,and high doses of Compound Rehmannia Granules groups were significantly decreased,and the relative abundances of Bifidobacterium and Ruminococcaceae were significantly increased.Conclusion:Compound Rehmannia Granules can alleviate inflammation and lung injury in Spn-induced pneumonia rats,which may be related to the increase in the abundance and diversity of intestinal flora.

OBJECTIVES: To compare the anti-inflammatory, antibacterial and analgesic effects of Yinqiao Powder (YQS) formulated granules and decoction. METHODS: We first evaluated the anti-inflammatory effects of the two dosage forms of YQS in a LPS-induced RAW 264.7 cell model using RT-qPCR and Western blotting. We further constructed zebrafish models of inflammation by copper sulfate exposure, caudal fin transection, or LPS and Poly (I:C) microinjection, and evaluated anti-inflammatory effects of YQS granules and decoction by examining neutrophil aggregation and HE staining findings. In a mouse model of acute lung injury (ALI) induced by intratracheal LPS instillation, the effects of YQS gavage at 10, 15, and 20 g/kg on lung pathologies were evaluated by calculating lung wet-dry weight ratio and using HE staining, ELISA and Western blotting. The microbroth dilution method was used to evaluate the antibacterial effect of YQS. Mouse pain models established by hot plate and intraperitoneal injection of glacial acetic acid were used to evaluate the analgesic effects of YQS at 10, 15, and 20 g/kg. RESULTS: Both YQS granules and decoction significantly reduced TNF-α, IL-6, and IL-1β expressions and p-STAT3 (Tyr 705) phosphorylation level in LPS-induced RAW 264.7 cells, and obviously inhibited neutrophil aggregation in the zebrafish models. In ALI mice, YQS granules and decoction effectively ameliorated lung injury, lowered lung wet-dry weight ratio, and reduced p-STAT3 (Tyr 705) expression and TNF-α and IL-6 levels. YQS produced obvious antibacterial effect at the doses of 15.63 and 31.25 mg/mL, and significantly reduced body torsion and increased pain threshold in the mouse pain models. CONCLUSIONS The two dosage forms of TQS have similar anti-inflammatory, antibacterial and analgesic effects with only differences in their inhibitory effect on TNF-α, IL-6 and IL-1β mRNA expressions in LPS-induced RAW 264.7 cells.
Animals ; Mice ; Drugs, Chinese Herbal/pharmacology* ; Anti-Inflammatory Agents/pharmacology* ; Analgesics/pharmacology* ; RAW 264.7 Cells ; Zebrafish ; Anti-Bacterial Agents/pharmacology* ; Powders ; Tumor Necrosis Factor-alpha/metabolism* ; Acute Lung Injury/drug therapy* ; Interleukin-6/metabolism* ; Lipopolysaccharides

Objective To construct a discharge preparation program for patients after total laryn-gectomy led by specialist nurses and explore its application effects.Methods A multidisciplinary team was established to construct a discharge preparation program for patients after total laryngectomy led by specialist nurses based on Meleis's transition theory.A total of 120 patients who underwent to-tal laryngectomy from April 2023 to October 2024 were selected as the study subjects.A total of 60 patients admitted from April to December 2023 were set as control group,and 60 patients admitted from January to October 2024 were set as intervention group.The intervention group implemented the discharge preparation program for patients after total laryngectomy led by specialist nurses,while the control group received conventional perioperative management after total laryngectomy.The discharge readiness,quality of discharge instruction,and incidence of complications during hospitalization on the day of discharge were compared between the two groups.Additionally,the scores of home health care experience at 1 and 3 months after discharge were compared between the two groups.Results On the day of discharge,the scores of each dimension and the total score of the discharge readinessscale in the intervention group were higher than those in the control group.The scores of the dimensions("Actually received content"and"Discharge instruction skills and effects")and the total score of the Quality of Discharge Instruction Scale in the intervention group were higher than those in the control group,with statistically significant differences(P＜0.05).The total incidence of complications during hospitalization in the intervention group was lower than that in the control group,with a sta-tistically significant difference(P＜0.05).At 1 and 3 months after discharge,the scores of the home health care experience scale in the intervention group were higher than those in the control group,with statistically significant differences(P＜0.05).Conclusion The construction of a dis-charge preparation service program for patients after total laryngectomy led by specialist nurses based on Meleis's transition theory can effectively improve the discharge readiness and quality of discharge instruction of patients undergoing total laryngectomy,reduce the incidence of complications,and im-prove the prognosis and early home health care level.

Objective:To systematically analyze the incidence and influencing factors of frailty in elderly patients with hematologic malignancies.Methods:Research on frailty in elderly patients with hematologic malignancies was retrieved from Chinese and English databases such as China National Knowledge Infrastructure, Wanfang Data, PubMed, and Web of Science. The search period was from database establishment to August 23, 2024. Two researchers screened the included studies, conducted quality assessment, and extracted data. Meta-analysis was conducted using Stata 18 and RevMan 5.4.Results:A total of seven studies were included, encompassing 19 076 elderly hematologic malignancy patients, with a frailty incidence of 59% [95% CI (0.48, 0.69) ]. Meta-analysis revealed that age [ MD=4.31, 95% CI (3.67, 4.96) ], gender [ OR=0.88, 95% CI (0.83, 0.93) ], alcohol consumption [ OR=1.67, 95% CI (1.15, 2.44) ], self-care ability [ MD=-1.79, 95% CI (-3.17, -0.41) ], anemia [ OR=6.67, 95% CI (2.94, 15.14) ], infection [ OR=1.81, 95% CI (1.16, 2.84) ], and neuropathy [ OR=2.52, 95% CI (1.38, 4.61) ] were the influencing factors of frailty in elderly patients with hematologic malignancies. Conclusions:The incidence of frailty is high in elderly patients with hematologic malignancies. Elderly patients with hematologic malignancies who are older, female, consume alcohol, have low self-care ability, anemia, infections, and neuropathy are prone to frailty. Healthcare providers can conduct early screening and intervention for high-risk populations of frailty based on risk factors to improve the quality of life for elderly hematologic malignancy patients.

Objective To summarize the changing prevalence of carbapenem resistance in Enterobacterales based on the data of CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021 for improving antimicrobial treatment in clinical practice.Methods Antimicrobial susceptibility testing was performed using a commercial automated susceptibility testing system according to the unified CHINET protocol.The results were interpreted according to the breakpoints of the Clinical & Laboratory Standards Institute(CLSI)M100 31st ed in 2021.Results Over the seven-year period(2015-2021),the overall prevalence of carbapenem-resistant Enterobacterales(CRE)was 9.43％(62 342/661 235).The prevalence of CRE strains in Klebsiella pneumoniae,Citrobacter freundii,and Enterobacter cloacae was 22.38％,9.73％,and 8.47％,respectively.The prevalence of CRE strains in Escherichia coli was 1.99％.A few CRE strains were also identified in Salmonella and Shigella.The CRE strains were mainly isolated from respiratory specimens(44.23±2.80)％,followed by blood(20.88±3.40)％and urine(18.40±3.45)％.Intensive care units(ICUs)were the major source of the CRE strains(27.43±5.20)％.CRE strains were resistant to all the β-lactam antibiotics tested and most non-β-lactam antimicrobial agents.The CRE strains were relatively susceptible to tigecycline and polymyxins with low resistance rates.Conclusions The prevalence of CRE strains was increasing from 2015 to 2021.CRE strains were highly resistant to most of the antibacterial drugs used in clinical practice.Clinicians should prescribe antimicrobial agents rationally.Hospitals should strengthen antibiotic stewardship in key clinical settings such as ICUs,and take effective infection control measures to curb CRE outbreak and epidemic in hospitals.

Objective To characterize the changing species distribution and antibiotic resistance profiles of respiratory isolates in hospitals participating in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Methods Commercial automated antimicrobial susceptibility testing systems and disk diffusion method were used to test the susceptibility of respiratory bacterial isolates to antimicrobial agents following the standardized technical protocol established by the CHINET program.Results A total of 589 746 respiratory isolates were collected from 2015 to 2021.Overall,82.6％of the isolates were Gram-negative bacteria and 17.4％were Gram-positive bacteria.The bacterial isolates from outpatients and inpatients accounted for(6.0±0.9)％and(94.0±0.1)％,respectively.The top microorganisms were Klebsiella spp.,Acinetobacter spp.,Pseudomonas aeruginosa,Staphylococcus aureus,Haemophilus spp.,Stenotrophomonas maltophilia,Escherichia coli,and Streptococcus pneumoniae.Each microorganism was isolated from significantly more males than from females(P＜0.05).The overall prevalence of methicillin-resistant S.aureus(MRSA)was 39.9％.The prevalence of penicillin-resistant S.pneumoniae was 1.4％.The prevalence of extended-spectrum β-lactamase(ESBL)-producing E.coli and K.pneumoniae was 67.8％and 41.3％,respectively.The overall prevalence of carbapenem-resistant E.coli,K.pneumoniae,Enterobacter cloacae,Pseudomonas aeruginosa,and Acinetobacter baumannii was 3.7％,20.8％,9.4％,29.8％,and 73.3％,respectively.The prevalence of β-lactamase was 96.1％in Moraxella catarrhalis and 60.0％in Haemophilus influenzae.The H.influenzae isolates from children(＜18 years)showed significantly higher resistance rates to β-lactam antibiotics than the isolates from adults(P＜0.05).Conclusions Gram-negative bacteria are still predominant in respiratory isolates associated with serious antibiotic resistance.Antimicrobial resistance surveillance should be strengthened in clinical practice to support accurate etiological diagnosis and appropriate antimicrobial therapy based on antimicrobial susceptibility testing results.

Objective:To systematically analyze the incidence and influencing factors of frailty in elderly patients with hematologic malignancies.Methods:Research on frailty in elderly patients with hematologic malignancies was retrieved from Chinese and English databases such as China National Knowledge Infrastructure, Wanfang Data, PubMed, and Web of Science. The search period was from database establishment to August 23, 2024. Two researchers screened the included studies, conducted quality assessment, and extracted data. Meta-analysis was conducted using Stata 18 and RevMan 5.4.Results:A total of seven studies were included, encompassing 19 076 elderly hematologic malignancy patients, with a frailty incidence of 59% [95% CI (0.48, 0.69) ]. Meta-analysis revealed that age [ MD=4.31, 95% CI (3.67, 4.96) ], gender [ OR=0.88, 95% CI (0.83, 0.93) ], alcohol consumption [ OR=1.67, 95% CI (1.15, 2.44) ], self-care ability [ MD=-1.79, 95% CI (-3.17, -0.41) ], anemia [ OR=6.67, 95% CI (2.94, 15.14) ], infection [ OR=1.81, 95% CI (1.16, 2.84) ], and neuropathy [ OR=2.52, 95% CI (1.38, 4.61) ] were the influencing factors of frailty in elderly patients with hematologic malignancies. Conclusions:The incidence of frailty is high in elderly patients with hematologic malignancies. Elderly patients with hematologic malignancies who are older, female, consume alcohol, have low self-care ability, anemia, infections, and neuropathy are prone to frailty. Healthcare providers can conduct early screening and intervention for high-risk populations of frailty based on risk factors to improve the quality of life for elderly hematologic malignancy patients.

Objective To investigate the distribution and antimicrobial resistance profiles of clinically isolated Haemophilus influenzae and Moraxella catarrhalis in hospitals across China from 2015 to 2021,and provide evidence for rational use of antimicrobial agents.Methods Data of H.influenzae and M.catarrhalis strains isolated from 2015 to 2021 in CHINET program were collected for analysis,and antimicrobial susceptibility testing was performed by disc diffusion method or automated systems according to the uniform protocol of CHINET.The results were interpreted according to the CLSI breakpoints in 2022.Beta-lactamases was detected by using nitrocefin disk.Results From 2015 to 2021,a total of 43 642 strains of Haemophilus species were isolated,accounting for 2.91％of the total clinical isolates and 4.07％of Gram-negative bacteria in CHINET program.Among the 40 437 strains of H.influenzae,66.89％were isolated from children and 33.11％were isolated from adults.More than 90％of the H.influenzae strains were isolated from respiratory tract specimens.The prevalence of β-lactamase was 53.79％in H.influenzae strains.The H.influenzae strains isolated from children showed higher resistance rate than the strains isolated from adults.Overall,779 strains of H.influenzae did not produce β-lactamase but were resistant to ampicillin(BLNAR).Beta-lactamase-producing strains showed significantly higher resistance rates to these antimicrobial agents than the β-lactamase-nonproducing strains.Of the 16 191 M.catarrhalis strains,80.06％were isolated from children and 19.94％isolated from adults.M.catarrhalis strains were mostly susceptible to both amoxicillin-clavulanic acid and cefuroxime,evidenced by resistance rate lower than 2.0％.Conclusions The emergence of antibiotic-resistant H.influenzae due to β-lactamase production poses a challenge for clinical anti-infective treatment.Therefore,it is very important to implement antibiotic resistance surveillance for H.influenzae and guide rational antibiotic use.All local clinical microbiology laboratories should actively improve antibiotic susceptibility testing and strengthen antibiotic resistance surveillance for H.influenzae.