The c-Jun N-terminal kinase （JNK） signaling pathway， a key member of the mitogen-activated protein kinase （MAPK） family， plays a central role in the pathogenesis and progression of central nervous system （CNS） diseases by regulating core biological processes such as apoptosis， inflammatory responses， synaptic plasticity， and autophagy. This article sorts out and analyzes relevant literature published domestically and internationally in recent years， summarizing the mechanisms of action of the JNK signaling pathway in common CNS diseases and the research progress in traditional Chinese medicine （TCM） interventions in CNS diseases through the regulation of the JNK signaling pathway. Studies have shown that active components of TCM， such as berberine， paeoniflorin， and astragaloside Ⅳ， as well as compound formulations like Heixiaoyao san， Ditan tang， and Buyang huanwu tang， can exert neuroprotective effects in various CNS disorders， including Alzheimer’s disease， Parkinson’s disease， cerebral ischemia-reperfusion injury， and epilepsy， by inhibiting the aberrant activation of the JNK signaling pathway， thereby alleviating neuroinflammation， oxidative stress， and neuronal apoptosis， while improving synaptic function and cognitive behavioral deficits， regulating autophagy， and maintaining blood-brain barrier integrity.

A 37-year-old male patient was admitted to a certain tertiary hospital in Shanghai on May 10, 2024 due to "sudden cough accompanied by chest pain for 2 days". Smear examination of pleural effusion revealed Gram-positive cocci. A positive result was reported after 3.8 days of anaerobic culture, and the isolate was identified as Parvimonas micra by mass spectrometry. Based on the patient′s medical history, imaging and etiological examination results of pleural effusion, the patient was diagnosed with encapsulated empyema caused by Parvimonas micra infection. After anti-infection treatment with imipenem and linezolid and pleural effusion drainage, the patient improved and was discharged. Whole-genome sequencing analysis revealed that this bacterium carried the drug resistance gene tetM and phylogenetic tree analysis showed that it was closely related to a strain from an apical abscess in South Korea.

In today's society， depression is a kind of highly prevalent chronic mental illness. It leads to a high disability rate and a heavy economic burden. Depression is defined by fundamental symptoms of low mood and diminished pleasure. Its causes and mechanisms remain unclear， and it presents a broad spectrum of symptoms and a persistent nature that significantly impacts both physical and mental well-being. Treatment in Western medicine primarily focuses on alleviating symptoms， yet it entails numerous adverse effects and contraindications. Traditional Chinese medicine （TCM） treatment is based on resolving depression， which is often accompanied by soothing liver， and the key medicine is Bupleuri Radix. Bupleuri Radix associated prescriptions refer to a class of prescriptions using Bupleuri Radix as the sovereign medicinal or having a high dose of Bupleuri Radix， which are widely used in the field of anti-depression. Previous studies from animal experiments， clinical research， and modern pharmacological research have confirmed that Bupleuri Radix associated prescriptions have precise anti-depression efficacy in multiple ways and at multiple levels， but lack a comprehensive and systematic summarization. This paper summarized and analyzed the literature related to the clinical application and mechanism of action of Bupleuri Radix associated prescriptions in anti-depression treatment. The results showed that the anti-depression mechanism of the Bupleuri Radix associated prescriptions （such as Xiaochaihu Tang， Xiaoyao San， Sini San， Chaihu Shugan San， and Chaihu jia Longgu Muli San） was associated with the effects of regulating monoamine neurotransmitters， the brain-derived neurotrophic factor （BDNF）， intestinal flora， and the hypothalamic-pituitary-adrenal （HPA） axis， inhibiting inflammatory responses， and modulating related signaling pathways. Applying them in clinical practice can effectively alleviate patient symptoms， lower the TCM syndrome score and the severity of depression， and also reduce adverse reactions. This underscores advantages of TCM in depression treatment， which offers patients a secure， effective， and more individualized alternative treatment regimen. On this basis， the shortcomings of current studies and the future trend were analyzed. This study aimed to provide an evidence-based medicine basis for the research and development of novel antidepressant medications.

Objective:To identify the bacteria isolated from sepsis patients in a tertiary hospital in Shanghai and analyze their antimicrobial resistance features.Methods:This study included 439 patients with clinically diagnosed sepsis who underwent microbiological culture in a tertiary hospital in Shanghai from July 2021 to October 2024. Results of microbiological culture and antimicrobial susceptibility testing were retrospectively collected and analyzed. Differences between groups were analyzed using Chi-square test and Fisher′s exact test. Results:The positive rate of microbiological culture was 49.0% (215/439). The positive rate of blood culture was 24.1% (93/386) and 100 strains were isolated from the samples, including 57 Gram-negative bacteria (57.0%). The predominant isolates in blood samples were Escherichia coli, Klebsiella pneumoniae, and coagulase-negative staphylococci. The positive rate of bacterial culture from bronchoalveolar lavage fluid samples was 84.1% (37/44), with Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa being the predominant strains. The positive rate of bacterial culture from urine samples was 35.6% (127/357), with Escherichia coli, Klebsiella pneumoniae, and Enterococcus faecium being the most common. Escherichia coli, Klebsiella pneumoniae, Enterococcus faecium, coagulase-negative staphylococci, Pseudomonas aeruginosa, and Acinetobacter baumannii exhibited high resistance rates to fluoroquinolones [46.8% (29/62)-97.0% (32/33)]. The resistance rates of Acinetobacter baumannii to most commonly used antibiotics were >80.0%. The resistance rates of Escherichia coli and Klebsiella pneumoniae to the third-generation cephalosporins ranged from 41.8% (28/67) to 66.0% (31/47). Carbapenem resistance was observed in 38.1% (24/63)-40.3% (25/62) of Klebsiella pneumoniae isolates, and most of the isolates from bronchoalveolar lavage fluid samples showed a higher resistance rate than those from blood or urine samples ( P<0.05). Conclusions:The positive rate of bacterial culture is nearly 50% in this study, with Gram-negative bacteria being the most common. Six major pathogenic bacteria exhibit high resistance rates to fluoroquinolones. Klebsiella pneumoniae isolates have high resistance rates to the third-generation cephalosporins and carbapenems, with significant differences in the resistance rate between isolates from different samples, and it should be cautious to choose the third-generation cephalosporins and carbapenems in clinical practice.

Objective To investigate the value of flexible subtraction CE-Boost technique combined with low dosage contrast agents for CT pulmonary angiography(CTPA).Methods A total of 68 patients who would undergo CTPA examination due to suspected pulmonary embolism(PE)were prospectively enrolled and randomly divided into study group(n=34)and control group(n=34)using block randomization method.After injecting 25 ml contrast agents at a flow rate of 2.5 ml/s in study group or 50 ml contrast agents at a flow rate of 3.5 ml/s in control group,CTPA scanning were performed with identical parameters.For images in study group,hybrid iterative reconstruction was performed,followed by flexible subtraction CE-Boost post-processing to obtain CE-Boost CTPA.For images in control group,conventional CTPA was obtained with hybrid iterative reconstruction.Subjective and objective evaluations of image quality were compared between groups.Taken the final clinical diagnosis as standard,the accuracy rate of diagnosing PE were compared between groups.Results There were 7 cases of pulmonary artery main trunk PE and 15 cases of pulmonary lobe-level PE in study group,while in control group there were 8 cases and 17 cases.No statistical difference of subjective scores of CTPA was found between groups(P＞0.05).CT values of the main pulmonary artery,bilateral pulmonary artery trunks and lower lobes of both lungs,signal-to-noise ratio or contrast-to-noise ratio in CTPA were not significantly different between groups(all P＞0.05),while no significant difference of the accuracy rate of CTPA for diagnosing PE of pulmonary artery main trunk(100％[7/7]vs.100％[8/8])nor pulmonary lobe-level PE(86.67％[13/15]vs.88.24％[15/17])was detected between groups(all P＞0.05).Conclusion Flexible subtraction CE-Boost technique combined with low dosage contrast agents for CTPA could reduce contrast agent dosage without affecting image quality.

Objective:To identify the bacteria isolated from sepsis patients in a tertiary hospital in Shanghai and analyze their antimicrobial resistance features.Methods:This study included 439 patients with clinically diagnosed sepsis who underwent microbiological culture in a tertiary hospital in Shanghai from July 2021 to October 2024. Results of microbiological culture and antimicrobial susceptibility testing were retrospectively collected and analyzed. Differences between groups were analyzed using Chi-square test and Fisher′s exact test. Results:The positive rate of microbiological culture was 49.0% (215/439). The positive rate of blood culture was 24.1% (93/386) and 100 strains were isolated from the samples, including 57 Gram-negative bacteria (57.0%). The predominant isolates in blood samples were Escherichia coli, Klebsiella pneumoniae, and coagulase-negative staphylococci. The positive rate of bacterial culture from bronchoalveolar lavage fluid samples was 84.1% (37/44), with Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa being the predominant strains. The positive rate of bacterial culture from urine samples was 35.6% (127/357), with Escherichia coli, Klebsiella pneumoniae, and Enterococcus faecium being the most common. Escherichia coli, Klebsiella pneumoniae, Enterococcus faecium, coagulase-negative staphylococci, Pseudomonas aeruginosa, and Acinetobacter baumannii exhibited high resistance rates to fluoroquinolones [46.8% (29/62)-97.0% (32/33)]. The resistance rates of Acinetobacter baumannii to most commonly used antibiotics were >80.0%. The resistance rates of Escherichia coli and Klebsiella pneumoniae to the third-generation cephalosporins ranged from 41.8% (28/67) to 66.0% (31/47). Carbapenem resistance was observed in 38.1% (24/63)-40.3% (25/62) of Klebsiella pneumoniae isolates, and most of the isolates from bronchoalveolar lavage fluid samples showed a higher resistance rate than those from blood or urine samples ( P<0.05). Conclusions:The positive rate of bacterial culture is nearly 50% in this study, with Gram-negative bacteria being the most common. Six major pathogenic bacteria exhibit high resistance rates to fluoroquinolones. Klebsiella pneumoniae isolates have high resistance rates to the third-generation cephalosporins and carbapenems, with significant differences in the resistance rate between isolates from different samples, and it should be cautious to choose the third-generation cephalosporins and carbapenems in clinical practice.

Objective To investigate the value of flexible subtraction CE-Boost technique combined with low dosage contrast agents for CT pulmonary angiography(CTPA).Methods A total of 68 patients who would undergo CTPA examination due to suspected pulmonary embolism(PE)were prospectively enrolled and randomly divided into study group(n=34)and control group(n=34)using block randomization method.After injecting 25 ml contrast agents at a flow rate of 2.5 ml/s in study group or 50 ml contrast agents at a flow rate of 3.5 ml/s in control group,CTPA scanning were performed with identical parameters.For images in study group,hybrid iterative reconstruction was performed,followed by flexible subtraction CE-Boost post-processing to obtain CE-Boost CTPA.For images in control group,conventional CTPA was obtained with hybrid iterative reconstruction.Subjective and objective evaluations of image quality were compared between groups.Taken the final clinical diagnosis as standard,the accuracy rate of diagnosing PE were compared between groups.Results There were 7 cases of pulmonary artery main trunk PE and 15 cases of pulmonary lobe-level PE in study group,while in control group there were 8 cases and 17 cases.No statistical difference of subjective scores of CTPA was found between groups(P＞0.05).CT values of the main pulmonary artery,bilateral pulmonary artery trunks and lower lobes of both lungs,signal-to-noise ratio or contrast-to-noise ratio in CTPA were not significantly different between groups(all P＞0.05),while no significant difference of the accuracy rate of CTPA for diagnosing PE of pulmonary artery main trunk(100％[7/7]vs.100％[8/8])nor pulmonary lobe-level PE(86.67％[13/15]vs.88.24％[15/17])was detected between groups(all P＞0.05).Conclusion Flexible subtraction CE-Boost technique combined with low dosage contrast agents for CTPA could reduce contrast agent dosage without affecting image quality.

A 37-year-old male patient was admitted to a certain tertiary hospital in Shanghai on May 10, 2024 due to "sudden cough accompanied by chest pain for 2 days". Smear examination of pleural effusion revealed Gram-positive cocci. A positive result was reported after 3.8 days of anaerobic culture, and the isolate was identified as Parvimonas micra by mass spectrometry. Based on the patient′s medical history, imaging and etiological examination results of pleural effusion, the patient was diagnosed with encapsulated empyema caused by Parvimonas micra infection. After anti-infection treatment with imipenem and linezolid and pleural effusion drainage, the patient improved and was discharged. Whole-genome sequencing analysis revealed that this bacterium carried the drug resistance gene tetM and phylogenetic tree analysis showed that it was closely related to a strain from an apical abscess in South Korea.

Objective To explore the effects of spermary on sexual behavior,gonadal development and sperm count production.Methods Fifty-six male zebrafishes of 10-month-old AB strain after fertilization were randomly divided into 7 tanks and set up as the normal group,model group,positive control group(clomiphene citrate group,Wuzi Yanzong Pills group),and Spermary low,medium and high concentration groups,8 fishes in each group.Except for the normal group,cyclophosphamide was given in water solution to establish the zebrafish oligospermia model,respectively.On 9 d of modeling,the positive control group was ad-ministered at a concentration of 0.1 μg/mL in the clomiphene citrate group and 6 μg/mL in the Wuzi Yanzong Pill group;the spermary low,medium and high concentration groups were administered at 200,300,900 μg/mL,respectively.On 16 d of modeling,the normal female zebrafishes were placed in the culture tank of each group in a 1∶1 ratio,and the frequency of tail-chasing was observed and recorded in male and female fishes.The body length,weight,testis weight and sperm count were measured and the statistical analysis was performed by comparing the differences among the groups before and after drug administration(one-way ANOVA).Results Com-pared with the normal group,the frequency of tail-chasing of zebrafishes,body length,body weight,testis weight and sperm count in the model group were significantly decreased(P＜0.05).Compared with the model group,the frequency of tail-chasing of zebrafishes,body length,body weight,testis weight and sperm count in the spermary low,medium and high concentration groups all were significantly increased(P＜0.05),in which the vitality change of sexual behavior in the spermary medium concentration group was most obvious,and the increase of sperms count was most obvious.Conclusion A certain dose of spermary could effectively promote the sexual behavior,gonadal development and sperm count production in male zebrafish with oligospermia.The efficacy of spermary in enhancing the male sexual function and treating oligozoospermia and infertility de-serves to be studied.

Objective To investigate the mechanism and protective effect of Humanin(HN)on rotenone(Rot)-induced toxic damage for dopamine neurons.Methods The Rot-poisened PC12 cell model was constructed,and the control group,the Rot poisening group,the HN pretreated Rot poisening group,and the HN treatment group were set up.ELISA was used to detect the content of HN inside and outside of Rot-infected cells,CCK-8 assay was used to detect cell viability,and ATP detection kit was used to detect the intracellular ATP content.Dichloro-dihydro-fluorescein diacetate(DCFH-DA)assay was used to detect the level of reactive oxygen species(ROS)in cells.Western blotting was performed to detect the expression level of mitochondrial autophagy regulatory proteins Pink1,Parkin,p62,LC3,mitochondrial biogenesis regulatory protein PGC1α,division/fusion regulatory proteins OPA1,MFN2,DRP1,p-DRP1 and antioxidant stress regulatory proteins Keap1 and Nrf2.HBAD-mcherry-EGFP-LC3 adenovirus transfected cells was used to observed the number of autophagosomes and autophagolysosomes.Results The results showed that the intracellular concentration of HN in PC12 in the Rot poisening group was significantly higher than that in the control group(P＜0.05);Compared with the control group,the Rot poisening group had significantly decreased activity of PC12 cells,decreased ATP content and increased production of ROS.After the poisen of Rot in PC12 cells,the expression of Pink1 and p-Parkin,the ratio of LC3Ⅱ/LC3Ⅰ and the expression of p-DRP1 in mitochondrial fusion protein was increased,while the expression of p62,the expression of mitochondrial biogenesis protein PGC1 α,mitochondrial fusion proteins MFN2 and OPA1,and antioxidant stress proteins Keap1 and Nrf2 were decreased(all P＜0.05).The number of autophagosomes and autophagolysosomes in PC12 cells in the Rot poisening group was higher than that in the control group(P＜0.05),and HN pretreatment(20 μmol/L)could significantly improve the changes mentioned above caused by Rot poisening(P＜0.05).Conclusion HN ameliorates Rot-induced toxic damage for dopamine neurons by inhibiting mitophagy and mitochondrial division and promoting mitochondrial biogenesis and fusion,and anti-oxidative stress.