ObjectiveTo explore the clinical safety of Feilike Mixture （FLK） in the real world. MethodsThe safety of all children who received FLK from 29 institutions in 12 provinces between January 21，2021 and December 25，2021 was evaluated through prospective centralized surveillance and a nested case control study. ResultsA total of 3 035 juveniles were included. There were 29 research centers involved，which are distributed across 12 provinces，including one traditional Chinese medicine （TCM） hospital and 28 general hospitals. The average age among the juveniles was （4.77±3.56） years old，and the average weight was （21.81±12.97） kg. Among them，119 cases （3.92%） of juveniles had a history of allergies. Acute bronchitis was the main diagnosis for juveniles，with 1 656 cases （54.46%）. FLK was first used in 2 016 cases （66.43%），and 142 juvenile patients had special dosages，accounting for 4.68%. Among them，92 adverse drug reactions （ADRs） occurred，including 73 cases of gastrointestinal system disorders，10 cases of metabolic and nutritional disorders，eight cases of skin and subcutaneous tissue diseases，two cases of vascular and lymphatic disorders，and one case of systemic diseases and various reactions at the administration site. The manifestations of ADRs were mainly diarrhea，stool discoloration，and vomiting，and no serious ADRs occurred. The results of multi-factor analysis indicated that special dosages （the use of FLK）［odds ratio （OR） of 2.642， 95% confidence interval （CI） of 1.105-6.323］，combined administration： spleen aminopeptide （OR of 4.978， 95%CI of 1.200-20.655），and reason for combined administration： anti-infection （OR of 1.814， 95%CI of 1.071-3.075） were the risk factors for ADRs caused by FLK. Conclusion92 ADRs occurred among 3 035 juveniles using FLK. The incidence of ADRs caused by FLK was 3.03%，and the severity was mainly mild or moderate. Generally，the prognosis was favorable after symptomatic treatment such as drug withdrawal or dosage reduction，suggesting that FLK has good clinical safety.

ObjectiveTo explore the changes in volatile components， total polysaccharides， enzyme activity， and chromaticity value of Myristicae Semen Koji（MSK） during the fermentation process， and conduct correlation analysis. MethodsBased on gas chromatography-mass spectrometry（GC-MS）， the changes of volatile components in MSK at different fermentation times were identified. The phenol sulfuric acid method， dinitrosalicylic acid method（DNS）， and carboxymethyl cellulose sodium salt method（CMC-Na） were used to investigate the total polysaccharide content， amylase activity， and cellulase activity during the fermentation process. Visual analysis technology was used to explore the changes in chromaticity values， revealing the fermentation process of MSK and the dynamic changes of various measurement indicators， partial least squares-discriminant analysis（PLS-DA） was used to explore the differential compounds of MSK at different fermentation degrees， and Pearson correlation analysis was used to explore the correlation between volatile components of MSK and total polysaccharides， enzyme activity， and chromaticity values. ResultsA total of 60 volatile compounds were identified from MSK， the relative contents of components such as （+）-α-pinene， β-phellandrene， β-pinene， （+）-limonene， and p-cymene obviously increased， while the relative contents of components such as safrole， methyl isoeugenol， methyleugenol， myristicin， and elemicin significantly decreased. During the fermentation process， the total polysaccharide content showed an upward trend， while the activities of amylase and cellulase showed an initial increase followed by a decrease， and reached their maximum value at 40 h. the overall brightness（L^*） and total color difference（ΔE^*） gradually increased， while the changes in red-green value（a^*） and yellow-blue value（b^*） were not obvious. PLS-DA results showed that MSK could be clearly distinguished at different fermentation times， and 13 differential biomarkers were screened out. Pearson correlation analysis results showed that the contents of α-terpinene， β-phellandrene， methyleugenol， β-cubebene and myristic acid had an obvious correlation with chromaticity values. ConclusionAfter fermentation， the volatile components， total polysaccharides， amylase activity， and cellulase activity of MSK undergo significant changes， and there is a clear correlation between them and chromaticity values， which reveals the dynamic changes in the fermentation process and related indicators of MSK， laying a foundation for the quality control.

The primary approach for clinical treatment of short stature （SS） in children is the use of recombinant human growth hormone （rhGH）. However， the high cost of treatment and the daily injection frequency place a significant economic and psychological burden on the families of affected children. For SS adolescents who have missed the peak growth velocity period of puberty， the use of rhGH alone is also difficult to significantly increase their final adult height. Numerous studies have shown that aromatase inhibitors （AIs） are effective in improving the height of SS boys， especially the combination therapy of AIs and rhGH， which has a better effect. Although the use of AIs may affect the children’s bones， cognitive function， reproductive system and hormone levels， most of these effects are temporary. Since existing research has not fully elucidated its impact on the pubertal changes of girls， it is necessary to fully weigh the benefits and risks when using AIs to treat SS girls in clinical practice. In the future， it is also necessary to carry out pharmacoeconomic research based on the medical environment of China to evaluate the cost- effectiveness of AIs for SS in children.

Liver being substantial Yin and functional Yang maintain normal function of Qi， blood and meridians. In clinical practice， it is often found that pan-vascular lesions with atherosclerosis as the predominant pathological change often co-occur with metabolic dysfunction-associated fatty liver disease（MAFLD）. MAFLD leads to increased risk and worse prognosis for many pan-vascular diseases， including cardiovascular disease. Dysregulation of energy homeostasis disrupts the hepatic homeostasis of body use， and representative drugs to improve metabolism， such as metformin， sodium-glucose co-transporter 2 inhibitors， and glucagon-like peptide-1 agonists， not only have a clear cardiovascular benefit， potential improvement of MAFLD has also been demonstrated. The liver stores blood and the heart pumps blood， and liver diseases affect the heart， that's why the unsmoothness of vessels appears. So the treatment should from the standpoint of liver， restoring liver function， soothing the liver and nourishing heart， activating blood and dredging meridian. It is of great significance to explore in depth the pathogenesis and treatment of pan-vascular lesions caused by MAFLD， and to restore the energy homeostasis by adjusting the balance of liver Yin and Yang.

Liver being substantial Yin and functional Yang maintain normal function of Qi， blood and meridians. In clinical practice， it is often found that pan-vascular lesions with atherosclerosis as the predominant pathological change often co-occur with metabolic dysfunction-associated fatty liver disease（MAFLD）. MAFLD leads to increased risk and worse prognosis for many pan-vascular diseases， including cardiovascular disease. Dysregulation of energy homeostasis disrupts the hepatic homeostasis of body use， and representative drugs to improve metabolism， such as metformin， sodium-glucose co-transporter 2 inhibitors， and glucagon-like peptide-1 agonists， not only have a clear cardiovascular benefit， potential improvement of MAFLD has also been demonstrated. The liver stores blood and the heart pumps blood， and liver diseases affect the heart， that's why the unsmoothness of vessels appears. So the treatment should from the standpoint of liver， restoring liver function， soothing the liver and nourishing heart， activating blood and dredging meridian. It is of great significance to explore in depth the pathogenesis and treatment of pan-vascular lesions caused by MAFLD， and to restore the energy homeostasis by adjusting the balance of liver Yin and Yang.

Objective:To identify the relationship between the CT arterial radiomics score and the treatment response to neoadjuvant therapy for pancreatic cancer.Methods:The clinical data of 243 pancreatic cancer patients who received surgical resection after neo-adjuvant therapy in the First Affiliated Hospital of Naval Medical University from March 2017 to March 2023 were retrospectively analyzed. Based on the tumor regression grade (TRG), the patients were divided into good response group (TRG 0-1, n=30) and non-good response group (TRG 2-3, n=213). The clinical, radiological and pathological features were compared between two groups. Fully-automated segmentation tool was used for segmenting the arterial CT scan of pancreatic tumor before and after treatment. Python package was applied to extract the radiomics features of tumors after segmentation and the extracted features were reduced and chosen using the least absolute shrinkage and selection operator (Lasso) logistic regression algorithm. Lasso logistic regression formula was applied to calculate the arterial radiomics score. Univariate and multivariate logistic regression models were used to analyze the association between arterial radiomics score and treatment response to neoadjucant therapy. Receiver operating-characteristics (ROC) curve was drawn and area under curve (AUC), specificity, sensitivity and accuracy for evaluating the treatment response were calculated. The clinical usefulness of arterial radiomics score for diagnosing the response of neoadjuvant treatment for pancreatic cancer were determined by decision curve analysis (DCA) . Results:A total of 330 arterial radiomics CT features were obtained, and 9-selected arterial phase features associated with treatment response were determined after being reduced by the Lasso logistic regression algorithm. Univariate analysis showed that the arterial radiomics score, three-dimensional diameter after neoadjuvant therapy, pancreatic contour, T stage, N stage, Peri-pancreatic nerve invasion, lymph-vascular space invasion (LVSI) and invasion of duodenum were all associated with treatment response (all P value <0.05). Multivariate logistic regression analyses confirmed that arterial radiomics score was obviously associated with the neoadjuvant treatment response ( P<0.001). At the cut-off value of 1.93, AUC of the arterial radiomics score for diagnosing neoadjuvant treatment response was 0.92, and the specificity, sensitivity and accuracy was 86.7%, 84.5% and 84.8%. DCA demonstrated that when the percentage for predicting the treatment response by using the arterial radiomics score was >0.2, the patients could benefit from the application of arterial radiomics score for evaluating neoadjuvant therapy response. Conclusions:The arterial radiomics score was strongly correlated with the neoadjuvant treatment response of pancreatic cancer, and can accurately predict neoadjuant treatment efficacy.

Objective:To analyze the pathological findings of ultrasound-guided transplant kidney puncture after renal transplantation and the pathogenesis of different types of diseases.Methods:A retrospective study was conducted to select 257 patients who underwent ultrasound-guided transplant kidney puncture pathology biopsy due to abnormal tests or uncomfortable symptoms at Beijing Friendship Hospital, Capital Medical University from June 2020 to April 2022, and to analyze the pathological results of puncture and the pathogenesis of different types of diseases and puncture-related complications in the post-transplantation patients after transplant kidney puncture biopsy. Measurement data conforming to normal distribution were expressed as mean ± standard deviation ( ± s), and independent sample t-test was used to compare different types of diseases; measurement data did not conform to normal distribution were expressed as median (interquartile distance) [ M( Q1, Q3)], and the comparison between different types of diseases was conducted by non-parametric test. The count data were compared among different types of diseases using Chi-squre test. Results:Among the 257 patients who underwent transplant renal puncture, 93 cases (36.2%) suffered from antibody-mediated rejection (ABMR), 76 cases (29.6%) suffered from IgA nephropathy, 63 cases (24.5%) suffered from T cell-mediated rejection (TCMR), 21 cases (8.2%) suffered from polyomavirus-associated nephropathy (PVAN), and 4 cases (1.6%) suffered from thrombotic microangiopathy (TMA), 16 cases (6.2%) suffered from diabetic nephropathy, and 12 cases (4.7%) suffered from calcineurin inhibitor (CNI) nephropathy. TCMR, TMA and PVAN occurred significantly in the early post-transplantation period (within about 4 years) ( P<0.001), and ABMR occurred significantly in the late post-transplantation period (after about 8 years) ( P<0.001). In terms of time distribution, creatinine abnormality and proteinuria were the main reasons for puncture. Among those diagnosed with PVAN, the time to transplantation was significantly shorter in those who underwent puncture for creatinine abnormality than in those who underwent puncture for proteinuria ( P=0.011). In terms of puncture-related complications, a total of 8 cases were found to have arteriovenous fistulae at the time of review, 2 cases had perinephric hematomas, and 1 case had both of these two puncture-related complications. Conclusions:Transplant renal complications in renal transplant patients mainly include ABMR, IgA nephropathy, TCMR, PVAN, diabetic nephropathy, CNI nephropathy and TMA. In terms of the pathogenesis of different types of diseases after transplantation, post-transplantation PVAN, TMA, and TCMR mostly occur in the early post-transplantation period, while ABMR occurs at a later time. However, it is worth noting that the clinical symptoms of different types of transplantation kidney-related diseases are similar and not typical.

Objective To collect data on imported malaria cases in Jiangsu Province from 2019 to 2023 after malaria elimination and to analyze the current epidemic situation and prevention and control measures of imported malaria, discussing future prevention and control strategies. Methods Malaria case information for Jiangsu Province from 2019 to 2023 was extracted and downloaded from the China Information System for Disease Control and Prevention (CISDCP) as well as the Jiangsu Provincial malaria epidemic database. Statistical analysis was conducted using Stata 12.0 and SPSS 16.0 software. Results From 2019 to 2023, a total of 534 cases of malaria were directly reported online in Jiangsu Province, with annual cases numbering 244, 90, 32, 36, and 132 respectively, all being laboratory-confirmed imported malaria cases from abroad. During the COVID-19 pandemic from 2020 to 2022, the number of imported malaria cases significantly decreased, with several months reporting zero cases. Among the 534 malaria cases, the vast majority were individuals who had traveled to countries in sub-Saharan Africa and Southeast Asia for work, business, international studies, or tourism. Over the five years, the median, minimum, and maximum days for patients from onset of illness to health-seeking were 1(0,12), 1(0,8), 0(0,6), 0(0,10), and 1(0,18) days, with a statistically significant difference in health-seeking time among patients (Fisher's exact test, P=0.03). Over the past three years of the COVID-19 pandemic, compared to outside centralized isolation stations, malaria cases within centralized isolation stations were diagnosed in a shorter time (Fisher exact test, P=0.007). A total of 24 severe malaria cases were reported, with no deaths, including 23 cases of P. falciparum and 1 case of P. ovale. Conclusions After the elimination of malaria, imported malaria cases in Jiangsu Province have sharply decreased due to the impact of the COVID-19 pandemic. Malaria cases in centralized isolation stations (CIS) for COVID-19 control of Jiangsu Province are more likely to be promptly diagnosed, and the timeliness from onset to health-seeking among malaria patients returning from high-malaria areas improved. As COVID-19 prevention and control policies adjusted, there has been a sharp increase in imported malaria cases in 2023. It's still necessary to strengthen measures for malaria prevention and control and maintain the capacity to prevent malaria re-transmission in Jiangsu Province.

Objective To investigate the improving effect and mechanism of the traditional Chinese herbal medicine Glabridin(GLA)on cognitive impairment in Parkinson's disease(PD)mice induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP),and its protective effect on the cerebral cortex and hippocampus through affecting the extracellular regulated protein kinases(ERK)signaling pathway involved in the regulation of neural plasticity.Methods A total of 120 C57BL//6N mice were randomly divided into control group,model group,GLA control group and MPTP+GLA low,medium and high-dose groups,with 20 mice in each group.The mouse PD model was established by intraperitoneal injection of MPTP 20 mg/kg,and the control group was injected with the same dose of normal saline.The GLA control group was given 50 mg/kg GLA by gavage;the MPTP+GLA low,medium and high dose groups were given 20,30 and 50 mg/kg GLA by gavage 1 hour after each MPTP administration,once a day for 7 consecutive days.The learning and memory abilities of the mice in each group and the pathological changes of hippocampal tissue were observed,as well as the changes in the contents of tumor necrosis factor-α(TNF-α),interleukin-18(IL-18),malondialdehyde(MDA),superoxide dismutase(SOD),tyrosine hydroxylase(TH)and protein expression levels of phosphorylated-ERK 1/2(p-ERK1/2)in the cerebral cortex.Results Compared with the control group,the levels of MDA and TNF-α,IL-18 in the cerebral cortex of the model group were significantly increased[MDA(nmol/mg):4.68±0.51 vs.2.05±0.22,TNF-α(μg/L):116.87±15.65 vs.48.52±7.83,IL-18(μg/L):57.52±6.89 vs.24.26±1.89,all P<0.05],while the activity of SOD was significantly decreased(U/mg:77.84±7.84 vs.130.89±18.56,P<0.05).Compared with the model group,the contents of TNF-α,IL-18,and MDA in each MPTP+GLA group were significantly decreased,while the activity of SOD was significantly increased(all P<0.05),and the change in the high-dose MPTP+GLA group was more obvious.The learning and memory ability of the high-dose MPTP+GLA group was significantly improved,the number of neurons in the hippocampus tissue decreased,the neurodegeneration was improved,and the glial cell proliferation was reduced.The results of immunohistochemistry showed that compared with the model group,the loss of TH positive cells in the high-dose MPTP+GLA group was significantly reduced[absorbance(A value):cerebral cortex was 39.14±3.25 vs.23.14±3.1,hippocampus was 72.14±4.25 vs.52.16±3.32,both P<0.05],and the expression of p-ERK1/2 positive cells was significantly inhibited(A value:cerebral cortex was 63.91±3.55 vs.88.35±6.41,hippocampus was 73.36±3.52 vs.93.25±6.73,both P<0.05).Western blotting showed that compared with the model group,the protein expression level of cerebral cortex and hippocampus TH in the high-dose MPTP+GLA group was significantly increased(gray value:cerebral cortex was 0.71±0.09 vs.0.53±0.06,hippocampus was 0.68±0.06 vs.0.45±0.03,both P<0.05),and the protein expression level of p-ERK1/2 was significantly inhibited(gray value:cerebral cortex was 0.76±0.10 vs.0.96±0.08,hippocampus was 0.74±0.06 vs.0.96±0.12,both P<0.05).Conclusions The traditional Chinese medicine GLA can improve the learning and memory ability of MPTP-induced PD mice,as well as prevent and treat MPTP-induced neuronal damage and glial cell proliferation.The ERK signaling pathway is associated with neural damage in PD brain tissue.GLA protects the learning and memory ability of MPTP-induced PD mice by inhibiting the ERK signaling pathway.

The classical prescription Yangweitang， derived from Zhengzhi Zhunsheng， is specialized in treating syndromes of chill and fever due to exogenous pathogens， inner-cooling， and malaria， and it has been included in the Catalogue of Ancient Classical Formulas （the First Batch） published by the National Administration of Traditional Chinese Medicine （TCM） in 2018. Through bibliographical research， the relevant ancient books and modern documents were systematically sorted out， and it was found that there were many prescriptions related to the Yangweitang from Zhengzhi Zhunsheng. They were interwoven with Yangweitang from Zhengzhi Zhunsheng and widely used in clinical practice. In order to clarify their history and evolution， this paper combed the historical origin of Yangweitang and its related prescriptions and conducted textual analysis on key information such as semantic composition， herb origin， processing method， and efficacy. A total of 896 pieces of data on Yangweitang from Zhengzhi Zhunsheng were collected. 26 pieces of effective data were included after the screening， involving 17 ancient TCM books. Then， a total of 28 pieces of data on prescriptions related to the Yangweitang from Zhengzhi Zhunsheng were included， involving 23 ancient TCM books for reference. The textual analysis showed that Yangweitang originated from the Renshen Yangweitang recorded in Taiping Huimin Heji Jufang in the Song dynasty. Based on the original formula， medical experts from later generations have modified it into many different versions. A comparative analysis showed that Yangweitang from different generations had similar compositions， and the herb origin and processing method were basically clear. The recommended prescriptions are as follows： 37.3 g of Pinelliae Rhizoma Praeparatum Cum Alumine， Magnoliae Officinalis Cortex（fried with ginger juice）， and frying with rice water Atractlodis Rhizoma， 27.98 g of Citri Exocarpium Rubrum， 18.65 g of Pogostemon cablin leaf， Tsaoko Fructus， Poria， and Ginseng Radix et Rhizoma， and 9.33 g of Glycyrrhizae Radix et Rhizoma. They could be ground into a coarse powder， with 14.92 g for every dose， and they could be orally taken after being decocted with 450 mL of water， 7 g of fresh ginger， and 2 g of Mume Fructus to 270 mL in warm conditions. Yangweitang from Zhengzhi Zhunsheng has the effect of warming the middle and releasing the external， and it can treat many syndromes including spleen and stomach disharmony caused by chill and fever due to exogenous pathogens and inner-cooling， as well as all kinds of malaria. Modern clinical applications mainly focus on chronic atrophic gastritis and other digestive system diseases.