Autoimmune hepatitis （AIH） is an immune-mediated chronic liver inflammatory disease with unknown pathogenesis， and intestinal barrier dysfunction is considered an important factor. Meanwhile， there are sex and age differences in the incidence rate of AIH， suggesting that hormone may be involved in regulation. On this basis， this article focuses on the association between estrogen， intestinal barrier， and immune homeostasis， systematically reviews the evidence that estrogen deficiency disrupts intestinal barrier homeostasis， and further summarizes the potential mechanism of estrogen in regulating the development and progression of AIH via intestinal barrier.

Autoimmune hepatitis （AIH） is an inflammatory disease caused by immune dysfunction， and its pathogenic mechanism remains unclear. In recent years， a large number of studies have shown that iron homeostasis imbalance and ferroptosis are closely associated with the pathogenesis and progression of AIH. This article reviews the pathological mechanism and impact of iron overload and ferroptosis in AIH， in order to provide new insights and theoretical bases for research on the mechanism and clinical treatment of AIH.

Cardiac arrest (CA) is a critical condition in the field of cardiovascular medicine. Despite successful resuscitation, patients continue to have a high mortality rate, largely due to post CA syndrome (PCAS). However, the injury and pathophysiological mechanisms underlying PCAS remain unclear. Experimental animal models are valuable tools for exploring the etiology, pathogenesis, and potential interventions for CA and PCAS. Current CA animal models include electrical induction of ventricular fibrillation (VF), myocardial infarction, high potassium, asphyxia, and hemorrhagic shock. Although these models do not fully replicate the complexity of clinical CA, the mechanistic insights they provide remain highly relevant, including post-CA brain injury (PCABI), post-CA myocardial dysfunction (PAMD), systemic ischaemia/reperfusion injury (IRI), and the persistent precipitating pathology. Summarizing the methods of establishing CA models, the challenges encountered in the modeling process, and the mechanisms of PCAS can provide a foundation for developing standardized CA modeling protocols.
Animals ; Disease Models, Animal ; Post-Cardiac Arrest Syndrome/physiopathology* ; Heart Arrest/physiopathology* ; Humans ; Ventricular Fibrillation/complications*

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.

Objective:To investigate the therapeutic effects of fluticasone propionate combined with loratadine syrup and montelukast sodium on asthma and allergic rhinitis in children.Methods:A total of 119 children with asthma and allergic rhinitis, admitted to Department of Pediatrics, Dongyang Maternal and Child Health Hospital from March 2021 to March 2024, were selected for this retrospective study. Based on the different treatment methods recorded in the medical record system, the children were divided into two groups: the control group ( n = 70), which received loratadine syrup combined with montelukast sodium, and the observation group ( n = 49), which received fluticasone propionate combined with loratadine syrup and montelukast sodium. Clinical symptoms (rhinitis and asthma), serum markers (immunoglobulin E, interleukin-4, and interleukin-6), lung function (maximum peak expiratory flow rate, forced expiratory volume in the first second, forced expiratory flow at 25% of vital capacity, forced expiratory flow at 50% of vital capacity, forced expiratory flow at 75% of vital capacity), as well as adverse reactions and clinical efficacy, were observed and compared between the two groups. Results:After treatment, the symptom scores for both rhinitis and asthma in the observation group were significantly lower than those in the control group [(3.65 ± 0.88) vs. (4.55 ± 1.06), t = 4.88, P < 0.001; (2.15 ± 0.56) vs. (3.28 ± 0.89), t = 7.86, P < 0.001]. The levels of immunoglobulin E, interleukin-4, and interleukin-6 in the observation group were significantly lower than those in the control group [(0.31 ± 0.18) g/L vs. (0.42 ± 0.19) g/L, t = 3.18, P = 0.002; (56.83 ± 8.25) ng/L vs. (62.16 ± 9.94) ng/L, t = 3.08, P = 0.003; (32.48 ± 3.11) ng/L vs. (39.61 ± 4.72) ng/L, t = 9.26, P < 0.001]. The values for forced expiratory volume in the first second and forced expiratory flow at 25%, 50%, and 75% of vital capacity in the observation group were significantly higher than those in the control group [(87.18 ± 5.15)% vs. (84.36 ± 4.68)%, t = 3.10, P = 0.002; (89.35 ± 3.88)% vs. (83.25 ± 3.56)%, t = 8.86, P < 0.001; (74.36 ± 6.65)% vs. (65.25 ± 5.36)%, t = 8.26, P < 0.001; (71.68 ± 8.76)% vs. (65.35 ± 7.86)%, t = 4.12, P < 0.001; (69.24 ± 4.38)% vs. (65.35 ± 2.43)%, t = 6.20, P < 0.001]. The incidence of adverse reactions was significantly higher in the observation group than in the control group [8.16% (4/49) vs. 4.29% (3/70), χ2 = 0.60, P = 0.439]. The overall response rate was significantly higher in the observation group than in the control group [95.92% (47/49) vs. 82.86% (58/70), χ2 = 5.26, P = 0.022]. Conclusions:Fluticasone propionate combined with loratadine syrup and montelukast sodium can effectively alleviate symptoms in children with asthma and allergic rhinitis, improve serum indicators, enhance lung function, and increase clinical efficacy without substantially increasing adverse reactions, demonstrating high safety.

Objective:To summarize the domestic and international research progress on adverse reactions to contrast-enhanced CT examinations, and forecast research themes, future hotspots, and trends.Methods:Using CiteSpace bibliometric methodology, retrieve Chinese and English literature on adverse reactions in patients undergoing contrast-enhanced CT examinations from China National Knowledge Infrastructure(CNKI), Wanfang Data Knowledge Service Platform, VIP Chinese Science and Technology Periodical Database, and Web of Science. The search period covers database inception to December 31, 2023. After deduplication, CiteSpace and other software are employed to conduct statistics and analyses on publication volume, publishing countries, institutions, and keywords for both Chinese and English literature separately.Results:A total of 3 749 articles were included, comprising 3 044 Chinese-language articles and 705 English-language publications. Visual analysis revealed that the annual number of publications on CT contrast-enhanced examination-related adverse reactions exhibited fluctuating growth from 1994 to 2023. The United States emerged as the leading contributor in this research domain, while China demonstrated rapid growth in recent years. Network analysis of research institutions revealed insufficient collaboration and communication among domestic institutions. Thematic clustering identified 22 clusters and 25 emerging keywords in Chinese literature, compared to 20 clusters and 7 burst keywords in English publications. Domestic research priorities focused predominantly on adverse reactions to contrast agents, nursing interventions, and nursing prevention strategies. International research trends emphasized safety, risk factor identification for adverse reactions, contrast-induced acute kidney injury (CI-AKI) prevention, and the prevention of adverse reactions using contrast-agent nanomaterials.Conclusions:Both domestic and international research in this field exhibits distinct emphases but universally underscores the importance of nursing. It is imperative to strengthen multidisciplinary collaboration among domestic institutions in the future. By focusing on research hotspots and cutting-edge frontiers, expanding the depth and breadth of China's research in this domain, and continuously optimizing nursing strategies, we can effectively enhance nursing quality for CT contrast-enhanced examination patients, optimize patient experience, and contribute to the high-quality development of nursing practice in this field.

BACKGROUND:During tissue repair and regeneration,macrophages exhibit multiple activities such as promoting inflammation,anti-inflammation,fibrosis,and wound healing at various stages of tissue damage.The heterogeneity and balanced polarization of macrophages are decisive in organ repair. OBJECTIVE:To explore the research hotspots and development trends in the field of macrophage polarization in tissue repair through visualization analysis methods,as well as the research level of global scientific and clinical workers in this field. METHODS:Using bibliometric analysis methods,this study employed Citespace literature visualization analysis software and VOSviewer tools,retrieving related literature from 2013 to 2023 in the Web of Science Core Collection's Science Citation Index Expanded(SCI-Expanded)and Social Sciences Citation Index Expanded(SSCI-Expanded)databases.The analysis results were presented in a dynamic map format,revealing the main trends and focuses of the research. RESULTS AND CONCLUSION:The number of publications in this field had dramatically increased from 2013 to 2023,with a significant rise starting in 2017.Chinese researchers had the highest number of publications,with 642 papers,while American researchers began focusing on this field early on.Professor Elisseeff Hennifer H had made a substantial contribution to the research in this area.Shanghai Jiao Tong University had produced the most publications.In recent years,keywords such as"hyaluronic acid"and"regulation"had been prevalent.Macrophage polarization research in tissue repair primarily concentrates on its multifunctional regulatory mechanisms,interactions with other cell types,and its behavior under specific pathological conditions.The main research areas include the role of macrophages in wound healing,cardiovascular diseases,chronic inflammation,tumor microenvironments,and regenerative medicine.A deeper understanding of the multifunctionality and polarization mechanisms of macrophages can lead to the development of new therapeutic strategies to enhance tissue repair and regeneration,thereby improving patient treatment outcomes.

Non-alcoholic fatty liver disease(NAFLD)is a chronic liver disease caused by excessive lipid accumulation in the liver.Its incidence rate is increasing year by year and has become an increasingly serious public healthy problem.The pathogenesis of NAFLD is complex and has not been fully clarified at present.It is mainly related to multiple factors such as genetics,metabolism,intestinal flora and immune response.In order to explore the medication rules and mechanism of action of traditional Chinese medicine(TCM)in the treatment of NAFLD,and to provide references for the treatment of NAFLD with TCM and the research and development of new drugs,this article summarizes the TCM pathogenesis of NAFLD(such as"phlegm and blood stasis interlacing","liver depression and spleen deficiency",etc.)and modern etiology and pathogenesis(such as insulin resistance,lipid disorder,mitochondrial dysfunction,oxidative stress,etc.).The clinical research and experimental data at home and abroad in recent years were integrated to analyze the pathological process of NAFLD intervention by TCM through multiple targets,including improving insulin resistance and lipid metabolism disorders,inhibiting oxidative stress and mitochondrial dysfunction,etc.TCM has shown unique advantages in the prevention and treatment of NAFLD.However,the depth of its mechanism analysis and the level of clinical research still need to be improved.In the future,it is necessary to deepen the mechanism research by combining multi-omics technology to accelerate the modernization development of TCM.

Objective:To study the effect of traditional Chinese medicine (TCM) formula in the treatment of brucellosis.Methods:Patients with brucellosis who were treated at the Beidahuang Industry Group General Hospital from March to November 2024 were selected and their clinical data were collected. A case-control study was conducted, thirty patients treated with conventional therapy plus TCM formula were selected as the TCM group, and 35 patients treated with conventional therapy were selected as the control group. Blood routine, C-reactive protein (CRP), lymphocyte subsets (CD45 +, CD3 +, CD4 +, CD8 +, CD19 +), and related cytokines [interleukin (IL)-6, IL-10] were determined before and after treatment to observe the clinical effect of TCM formula in the treatment of brucellosis. Survival curve was draw, and Log-Rank test was used to compare the differences in clinical symptom relief time between the two groups of patients. Results:Compared with pre-treatment, there were statistically significant differences in the numbers of CD45 +, CD3 +, CD4 +, CD8 +, CD19 + lymphocytes, neutrophil (NEUT), and the levels of CRP, IL-6, and IL-10 in the TCM group after treatment ( P < 0.05). After treatment, the comparison of each index between the two groups showed that there were statistically significant differences in the numbers of CD45 +, CD3 +, CD4 +, and CD8 + lymphocytes [control group vs TCM group: 2 470.00 (1 895.50, 3 207.00) vs 1 991.00 (1 720.75, 2 367.25), 1 920.00 (1 364.50, 2 428.00) vs 1 591.00 (1 343.00, 1 884.00), 1 021.00 (785.00, 1 205.50) vs 839.50 (704.25, 1 010.25), (686.42 ± 294.47) vs (596.97 ± 205.32) pieces/μl, P < 0.05]. There was no statistically significant difference in the number of CD19 + lymphocytes, NEUT, and the levels of CRP, IL-6 and IL-10 ( P > 0.05). The Log-Rank test results showed that there were statistically significant differences in the relief time of hyperhidrosis and night sweats ( P = 0.016), fatigue ( P = 0.016), and muscle soreness ( P = 0.004) between the two groups of patients. Conclusion:TCM formula has certain effects in the adjuvant therapy of brucellosis, which can improve the immune function of lymphocytes and relieve clinical symptoms, and has clinical application value.

At present,some new tongue manifestations with distinct characteristics and high clinical value have not yet gained widespread consensus,which is unfavorable to their research and promotion.This paper representatively explores four types of tongue texture manifestations(liver gall line,bulging vein tongue,concave tip tongue,convex surface tongue)and two types of tongue coating manifestations(cracked tongue coating,white saliva line)among them.It is found that the liver gall line manifests as dark stagnation of various forms on the tongue surface,indicating liver qi stagnation and blood stasis as well as heat-toxin accumulation;the bulging vein tongue is characterized by clearly raised blood vessels on the tongue surface,suggesting blood stasis due to yang deficiency or cold congelation;the concave tip tongue is characterized by a depressed tip,indicating an abnormal tongue frenulum or malnutrition of heart,lung,and kidney;the convex surface tongue features a broad and thick tongue body with an overall"convex"shape,which is observed in healthy individuals or suggests qi movement disorder and spleen and stomach stagnation;the cracked tongue coating is characterized by cracks only on the tongue coating,indicating qi deficiency with disordered fluid or yin consumption due to intense heat;the white saliva line presents as strip-like white foam bands on the tongue margin,suggesting liver qi stagnation and dampness stagnancy due to spleen deficiency.No consensus exists regarding issues such as naming and description,reflecting the necessity of expanding and standardizing the theory of tongue diagnosis.This paper aims to emphasize the value and standardization of such new tongue manifestations,enrich the theoretical system of tongue diagnosis in traditional Chinese medicine,and provide novel insights and reference basis for clinical syndrome differentiation.