By combining the origin and research progress of the combination of disease and syndrome, the core pathogenesis, this article explored the research ideas and methods of the core pathogenesis of TCM. It is found that modern TCM is mostly guided by the idea of classification-staging-syndrome differentiation, the main prescription of the main disease, the special prescription of the special disease, and the idea of "dynamic-fixed sequential". The tongue image syndrome differentiation method, clustering analysis method, drug test syndrome method, compound pathogenesis method, "evidence-based pathogenesis-syndrome treatment system" research model, and the integration of traditional Chinese and Western medicine theory were used to explore the core pathogenesis of TCM under the condition of disease. Combined with the advantages of modern medical disease differentiation and TCM syndrome differentiation, the individualized diagnosis and treatment methods of integrated traditional Chinese and Western medicine have been continuously improved, in order to solve the stage contradictions of different clinical stages, effectively delay the progression of the disease and improve the prognosis of the disease.

Objective To investigate the protective effect of Danggui Shaoyao powder on ovarian function in cyclophospha-mide induced premature ovarian failure rats by regulating the adenosine monophosphate-activated protein kinase(AMPK)/mam-malian target of rapamycin(mTOR)signaling pathway.Methods Seventy-two rats were randomly divided into control group,model group,low-dose Danggui Shaoyao powder(L-Danggui Shaoyao powder,6.11 g/kg)group,medium dose Danggui Shaoyao powder(M-Danggui Shaoyao powder,12.22 g/kg)group,high-dose Danggui Shaoyao powder(H-Danggui Shaoyao powder,24.44 g/kg)group,and H-Danggui Shaoyao San+AMPK agonist AICAR(H-Danggui Shaoyao powder+AICAR,24.44 g/kg Danggui Shaoyao powder+200 mg/kg AICAR)group,with 12 rats in each group.The number of follicles at different stages was observed.ELISA,HE staining,TUNEL kit,and Western blot were used to detect FSH,E2,AMH,LH levels,ovarian tissue pathological changes,cell apoptosis,and expression of AMPK/mTOR pathway related proteins.Results Compared with Con-trol group,the FSH,LH,number of blocked follicles,apoptosis rate,Bax,Caspase-3,and p-AMPK/AMPK protein expression were higher in model group,while E2,AMH,primordial,primary,secondary,and antral follicles,Bcl-2,and p-mTOR/mTOR protein expression were lower(all P＜0.05).Compared with model group,FSH,LH,number of blocked follicles,apoptosis rate,Bax,Caspase-3,and p-AMPK/AMPK protein expression were lower in L,M,and H-Danggui Shaoyao powder groups,while E2,AMH,primordial,primary,secondary,and antral follicles,Bcl-2,and p-mTOR/mTOR protein expression were higher(all P＜0.05).Compared with the H-Danggui Shaoyao powder group,FSH,LH,number of blocked follicles,apoptosis rate,Bax,Caspase-3,and p-AMPK/AMPK protein expression were higher in H-Danggui Shaoyao powder+AICAR group,while E2,AM H,primordial,primary,secondary,and antral follicles,Bcl-2,and p-mTOR/mTOR protein expression were lower(allP＜0.05).Conclusion The improvement of ovarian function in cyclophosphamide induced premature ovarian failure rats by Dang-gui Shaoyao powder may be related to AMPK/mTOR pathway inhibition.

Objective To analyze the application characteristics,trends,and special advantages of anti-infection research using the Bayesian method,and to provide methodological reference for the development of anti-infection research.Methods PubMed,CNKI and WanFang Data were electronically searched for the studies on anti-infection using Bayesian method published from January 1,2015 to November 21,2023.The relevant information of publication time,anti-infection type,sample size,Bayesian characteristics and Bayesian application pattern were analyzed descriptively and reviewed.Results A total of 86 studies were included,of which 41.9％were observational studies,only 7.0％were enterprise-initiated studies,and 48.8％were mentioning prior information studies.There was no domestic intervention study.The application characteristics and advantages of Bayesian method in intervention study,observational study and pharmacokinetic study are different.In intervention researches and observational researches,the application of Bayesian design decision and the application of Bayesian analysis and estimation accounts for 69.2％and 52.8％at most,respectively.Conclusions The Bayesian method is flexible,can be used for small sample sizes and complex model research,and can deal with uncertainty.In intervention studies in the field of anti-infection in China,the Bayesian method has not been applied widely.Only a handful of studies applying Bayesian method have been initiated by companies.In the future,it is still necessary to promote the advantages and application scenarios of Bayesian methods in the field of anti-infection research and strengthen the standardization of the application of Bayesian method.

Objective To investigate the protective effect of Danggui Shaoyao powder on ovarian function in cyclophospha-mide induced premature ovarian failure rats by regulating the adenosine monophosphate-activated protein kinase(AMPK)/mam-malian target of rapamycin(mTOR)signaling pathway.Methods Seventy-two rats were randomly divided into control group,model group,low-dose Danggui Shaoyao powder(L-Danggui Shaoyao powder,6.11 g/kg)group,medium dose Danggui Shaoyao powder(M-Danggui Shaoyao powder,12.22 g/kg)group,high-dose Danggui Shaoyao powder(H-Danggui Shaoyao powder,24.44 g/kg)group,and H-Danggui Shaoyao San+AMPK agonist AICAR(H-Danggui Shaoyao powder+AICAR,24.44 g/kg Danggui Shaoyao powder+200 mg/kg AICAR)group,with 12 rats in each group.The number of follicles at different stages was observed.ELISA,HE staining,TUNEL kit,and Western blot were used to detect FSH,E2,AMH,LH levels,ovarian tissue pathological changes,cell apoptosis,and expression of AMPK/mTOR pathway related proteins.Results Compared with Con-trol group,the FSH,LH,number of blocked follicles,apoptosis rate,Bax,Caspase-3,and p-AMPK/AMPK protein expression were higher in model group,while E2,AMH,primordial,primary,secondary,and antral follicles,Bcl-2,and p-mTOR/mTOR protein expression were lower(all P＜0.05).Compared with model group,FSH,LH,number of blocked follicles,apoptosis rate,Bax,Caspase-3,and p-AMPK/AMPK protein expression were lower in L,M,and H-Danggui Shaoyao powder groups,while E2,AMH,primordial,primary,secondary,and antral follicles,Bcl-2,and p-mTOR/mTOR protein expression were higher(all P＜0.05).Compared with the H-Danggui Shaoyao powder group,FSH,LH,number of blocked follicles,apoptosis rate,Bax,Caspase-3,and p-AMPK/AMPK protein expression were higher in H-Danggui Shaoyao powder+AICAR group,while E2,AM H,primordial,primary,secondary,and antral follicles,Bcl-2,and p-mTOR/mTOR protein expression were lower(allP＜0.05).Conclusion The improvement of ovarian function in cyclophosphamide induced premature ovarian failure rats by Dang-gui Shaoyao powder may be related to AMPK/mTOR pathway inhibition.

Objective To investigate the effects of sample transport and sorting system on the detection results of common clinical bio-chemical and immunological items carried out in our laboratory.Methods A total of 25 patients admitted to Zidong Hospital of Jiangsu Provincial Hospital of Traditional Chinese Medicine in June 2024 were included in this study,and four blood samples were collected from each patients using vacuum blood vessels with separation gel containing coagulant.These samples were transferred to the laboratory department through manual transport or pneumatic logistics transmission,and the manual sorting approach or intelligent blood vessel sorting system was used to encode the samples.The effects of different sample transportation methods and sorting methods on the detec-tion results of 46 clinical biochemical parameters,12 tumor markers and 5 thyroid hormone items,which were carried out in our labora-tory,were analyzed and compared.Results No significant change on hemolytic index(HI)was found through pneumatic tube system(PTS)and intelligent blood vessel sorting system(P＞0.05).The results of AST,CK-MB,α-HBDH,and LDH in clinical biochemical parameters following PTS were significantly different from those in artificial transport group(all P＜0.05).Both the results of Cyfra21-1 and NSE in immunological items in the samples after PTS transport were significantly different from those obtained by either manual transport or intelligent sorting system,with statistical significance(all P＜0.05).Conclusion PTS basically meets the requirements of clinical laboratories,but it can lead to the increase of AST,CK-MB,α-HBDH and LDH in clinical biochemistry,as well as Cyfra21-1 and NSE in immunology,which needs to be further improved,refined,and validated in order to meet the clinical requirements.

Objective To investigate the effects of sample transport and sorting system on the detection results of common clinical bio-chemical and immunological items carried out in our laboratory.Methods A total of 25 patients admitted to Zidong Hospital of Jiangsu Provincial Hospital of Traditional Chinese Medicine in June 2024 were included in this study,and four blood samples were collected from each patients using vacuum blood vessels with separation gel containing coagulant.These samples were transferred to the laboratory department through manual transport or pneumatic logistics transmission,and the manual sorting approach or intelligent blood vessel sorting system was used to encode the samples.The effects of different sample transportation methods and sorting methods on the detec-tion results of 46 clinical biochemical parameters,12 tumor markers and 5 thyroid hormone items,which were carried out in our labora-tory,were analyzed and compared.Results No significant change on hemolytic index(HI)was found through pneumatic tube system(PTS)and intelligent blood vessel sorting system(P＞0.05).The results of AST,CK-MB,α-HBDH,and LDH in clinical biochemical parameters following PTS were significantly different from those in artificial transport group(all P＜0.05).Both the results of Cyfra21-1 and NSE in immunological items in the samples after PTS transport were significantly different from those obtained by either manual transport or intelligent sorting system,with statistical significance(all P＜0.05).Conclusion PTS basically meets the requirements of clinical laboratories,but it can lead to the increase of AST,CK-MB,α-HBDH and LDH in clinical biochemistry,as well as Cyfra21-1 and NSE in immunology,which needs to be further improved,refined,and validated in order to meet the clinical requirements.

Objective To analyze the application characteristics,trends,and special advantages of anti-infection research using the Bayesian method,and to provide methodological reference for the development of anti-infection research.Methods PubMed,CNKI and WanFang Data were electronically searched for the studies on anti-infection using Bayesian method published from January 1,2015 to November 21,2023.The relevant information of publication time,anti-infection type,sample size,Bayesian characteristics and Bayesian application pattern were analyzed descriptively and reviewed.Results A total of 86 studies were included,of which 41.9％were observational studies,only 7.0％were enterprise-initiated studies,and 48.8％were mentioning prior information studies.There was no domestic intervention study.The application characteristics and advantages of Bayesian method in intervention study,observational study and pharmacokinetic study are different.In intervention researches and observational researches,the application of Bayesian design decision and the application of Bayesian analysis and estimation accounts for 69.2％and 52.8％at most,respectively.Conclusions The Bayesian method is flexible,can be used for small sample sizes and complex model research,and can deal with uncertainty.In intervention studies in the field of anti-infection in China,the Bayesian method has not been applied widely.Only a handful of studies applying Bayesian method have been initiated by companies.In the future,it is still necessary to promote the advantages and application scenarios of Bayesian methods in the field of anti-infection research and strengthen the standardization of the application of Bayesian method.

The American Burn Association updated and released the " Clinical practice guidelines on burn shock resuscitation" in December 2023. This guideline is an extension and refinement of the " Practice guidelines on burn shock resuscitation" released in 2008. It mainly provides evidence-based recommendations for acute fluid resuscitation in adults with burn shock. In order to enable clinicians to better apply the 2023 guideline, this article focuses on the interpretation of the guideline.

Objective:To characterize the antimicrobial resistance, resistance machanism and population genetics of Salmonella( S.) Derby in China, preliminarily reveal the population genetic characteristics of S. Derby in China, discover possible transmission patterns or potential transmission pathways, and provide certain reference for strengthening S. disease monitoring and developing prevention and control strategies. Methods:A total of 201 strains of S. Derby from different areas in China were used for the susceptible tests to 16 antibiotics and whole-genome sequencing. Finally, combined with the genome sequences of 134 strains of S. Derby from public databases, 335 strains of S. Derby were used for resistance genotype analysis and multi-locus sequence typing (MLST), and a phylogenetic tree based on the core genome single nucleotide polymorphisms was constructed for evolutionary analysis. Results:The results showed that 201 strains of S. Derby showed resistance to 16 kinds of antibiotics at different levels. The overall resistance rate was 97.51%. The resistance rates to antibiotics varied in S. Derby from different sources (human, animal, and food), the differences were significant (all P<0.05). A total of 38 resistance genes were carried by 335 strains of S. Derby, of which, fosfomycin gene fosA7 was found in all the strains (100.00%) and aminoglycoside genes aac(6')-Iaa accounted for 99.70%. The consistency of resistance genes and phenotypes varied with antibiotics. Except aminoglycosides and chloramphenicol, the consistencies of resistance genes and phenotypes for other antibiotics were high. MLST showed that 334 strains of S. Derby belonged to ST40. Phylogenetic trees indicated the risk for cross-infection between animal and human, food and human, and the possibility of long-distance interprovincial transmission of the bacteria by animal, to which further epidemiological studies are needed. Conclusions:The drug resistance of S. Derby is serious in China and the risk for cross-transmission between human and animal or food exists. It is necessary to establish and strengthen the comprehensive surveillance and risk assessment to prevent the spread of antibiotic resistant strains or elements through animal, food and human chains.

Objective:To establish a matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) assay for the identification of common Salmonella serotypes and provide etiology evidence for the early precise treatment of salmonellosis. Methods:A total of 500 strains were collected from different regions and sources and five predominant Salmonella serotypes ( Salmonella Typhi , Salmonella Paratyphi A , Salmonella Typhimurium , Salmonella Enteritidis , and Salmonella Indiana) of each strain was identified by agglutination test and whole-genome sequencing. The protein complex of the strains was extracted by using optimized pretreatment method to establish the fingerprint database of peptides for each Salmonella serotype. The new serotyping assays were established by using different modules based on the mass spectra database. Additional 155 strains with specified serotypes and variant sources were used to test and evaluate the accuracy of the new typing assays. Results:Five MALDI-TOF MS databases were established, and two new serotyping assays were established via peptide fingerprint mapping/matching and machine learning of the neuronal convolutional network respectively based on the databases. The results showed that the fingerprint matching approach could quickly identify five common Salmonella serotypes in clinical practice compared with the machine learning method, the accuracy of fingerprint matching assay to identify five Salmonella serotypes reached 100.00% and the serotyping can be conducted within a short time (15-20 minutes) and had a good reproducibility, while the machine learning method could not completely identify these serotypes. Moreover the sensitivity and specificity of fingerprint matching assay were all 100.00% respectively, while they were only 82.23% and 95.81% for machine learning method. Conclusion:The established Salmonella serotyping assay based on MALDI-TOF MS in this study can easily, rapidly and accurately identify different serotypes of Salmonella.