Objective To analyze the difference of psoas major muscle morphology and pain degree in patients with different types of lumbar disc herniation ( LDH ) by quantitative CT, and to further explore the relationship between psoas major muscle morphology and pain degree. Methods A total of 120 patients with LDH admitted to our hospital from January to December 2025 were enrolled as study subjects. Based on clinical symptoms and lesion location, they were divided into a simple lower extremity pain group and a lumbar and leg pain group. All patients underwent lumbar CT examination. The psoas major muscle index was used as a CT quantitative parameter, which was calculated as the mean of the maximum cross-sectional areas of both psoas major muscles divided by the cross-sectional area of the L5 vertebral body. This index was measured to reflect psoas major muscle morphology. Pain severity was assessed using the visual analogue scale (VAS). Differences in psoas major muscle morphology and pain severity between the two groups were compared. A Pearson correlation analysis was used to examine the relationship between the psoas major muscle index and pain severity. A linear regression model was used to analyze the independent risk factors affecting pain severity. Results There were no statistically significant differences in sex, age, or body mass index between the two groups (P>0.05). The disease duration was longer and the incidence of anxiety and depression was higher in the lumbar and leg pain group than those in the simple lower extremity pain group (P<0.05). Compared with the simple lower extremity pain group, the lumbar and leg pain group showed lower psoas major muscle index [(0.53 ± 0.05) vs. (0.61 ± 0.07)] and higher VAS score [(4.67 ± 1.10) vs. (3.02 ± 0.89)], and the differences were statistically significant (P<0.05). Pearson correlation analysis revealed a negative correlation between the psoas major muscle index and the VAS score (r=−0.288, P<0.05). Linear regression model analysis indicated that the independent risk factors affecting the VAS score were age, disease duration, LDH type, and the psoas major muscle index. Conclusion Compared with LDH patients with simple lower extremity pain, those with lumbar and leg pain demonstrate a longer disease duration, a higher incidence of anxiety and depression, and a higher severity of psoas major muscle atrophy and pain. The severity of pain is associated with not only advanced age and prolonged disease duration but also the LDH type and psoas major muscle atrophy.

Objective To analyze the difference of psoas major muscle morphology and pain degree in patients with different types of lumbar disc herniation ( LDH ) by quantitative CT, and to further explore the relationship between psoas major muscle morphology and pain degree. Methods A total of 120 patients with LDH admitted to our hospital from January to December 2025 were enrolled as study subjects. Based on clinical symptoms and lesion location, they were divided into a simple lower extremity pain group and a lumbar and leg pain group. All patients underwent lumbar CT examination. The psoas major muscle index was used as a CT quantitative parameter, which was calculated as the mean of the maximum cross-sectional areas of both psoas major muscles divided by the cross-sectional area of the L5 vertebral body. This index was measured to reflect psoas major muscle morphology. Pain severity was assessed using the visual analogue scale (VAS). Differences in psoas major muscle morphology and pain severity between the two groups were compared. A Pearson correlation analysis was used to examine the relationship between the psoas major muscle index and pain severity. A linear regression model was used to analyze the independent risk factors affecting pain severity. Results There were no statistically significant differences in sex, age, or body mass index between the two groups (P>0.05). The disease duration was longer and the incidence of anxiety and depression was higher in the lumbar and leg pain group than those in the simple lower extremity pain group (P<0.05). Compared with the simple lower extremity pain group, the lumbar and leg pain group showed lower psoas major muscle index [(0.53 ± 0.05) vs. (0.61 ± 0.07)] and higher VAS score [(4.67 ± 1.10) vs. (3.02 ± 0.89)], and the differences were statistically significant (P<0.05). Pearson correlation analysis revealed a negative correlation between the psoas major muscle index and the VAS score (r=−0.288, P<0.05). Linear regression model analysis indicated that the independent risk factors affecting the VAS score were age, disease duration, LDH type, and the psoas major muscle index. Conclusion Compared with LDH patients with simple lower extremity pain, those with lumbar and leg pain demonstrate a longer disease duration, a higher incidence of anxiety and depression, and a higher severity of psoas major muscle atrophy and pain. The severity of pain is associated with not only advanced age and prolonged disease duration but also the LDH type and psoas major muscle atrophy.

Objective To analyze the difference of psoas major muscle morphology and pain degree in patients with different types of lumbar disc herniation ( LDH ) by quantitative CT, and to further explore the relationship between psoas major muscle morphology and pain degree. Methods A total of 120 patients with LDH admitted to our hospital from January to December 2025 were enrolled as study subjects. Based on clinical symptoms and lesion location, they were divided into a simple lower extremity pain group and a lumbar and leg pain group. All patients underwent lumbar CT examination. The psoas major muscle index was used as a CT quantitative parameter, which was calculated as the mean of the maximum cross-sectional areas of both psoas major muscles divided by the cross-sectional area of the L5 vertebral body. This index was measured to reflect psoas major muscle morphology. Pain severity was assessed using the visual analogue scale (VAS). Differences in psoas major muscle morphology and pain severity between the two groups were compared. A Pearson correlation analysis was used to examine the relationship between the psoas major muscle index and pain severity. A linear regression model was used to analyze the independent risk factors affecting pain severity. Results There were no statistically significant differences in sex, age, or body mass index between the two groups (P>0.05). The disease duration was longer and the incidence of anxiety and depression was higher in the lumbar and leg pain group than those in the simple lower extremity pain group (P<0.05). Compared with the simple lower extremity pain group, the lumbar and leg pain group showed lower psoas major muscle index [(0.53 ± 0.05) vs. (0.61 ± 0.07)] and higher VAS score [(4.67 ± 1.10) vs. (3.02 ± 0.89)], and the differences were statistically significant (P<0.05). Pearson correlation analysis revealed a negative correlation between the psoas major muscle index and the VAS score (r=−0.288, P<0.05). Linear regression model analysis indicated that the independent risk factors affecting the VAS score were age, disease duration, LDH type, and the psoas major muscle index. Conclusion Compared with LDH patients with simple lower extremity pain, those with lumbar and leg pain demonstrate a longer disease duration, a higher incidence of anxiety and depression, and a higher severity of psoas major muscle atrophy and pain. The severity of pain is associated with not only advanced age and prolonged disease duration but also the LDH type and psoas major muscle atrophy.

Patients with panvascular disease （PVD） often experience bleeding events while receiving standard antithrombotic therapy. Based on the theory of "guarding the channel passages"， the retention of blood stasis is considered as a crucial pathological basis for PVD. The combination of the retention of blood stasis and the failure of the channel passages to contain blood constitutes the core pathogenesis of bleeding events in this condition. According to their pathogenesis and clinical characteristics， bleeding events in PVD are categorized into a bleeding stage and a stable stage. During the bleeding stage， treatment should focus on stanching bleeding and dispersing stasis to restore normal circulation in the channel passages. During the stable stage， treatment should aim to dispel stasis and generate new blood to harmonize the channel passages. In clinical practice， physicians should dynamically weigh the risks of bleeding and ischemia against the intensity of antithrombotic therapy. The ultimate goal is to harmonize qi and blood and ensure that blood remains properly contained within the channel passages， thereby reducing the risk of bleeding events and enhancing overall patient benefit.

OBJECTIVE To formulate Expert Consensus on the Clinical Rational Use of Hemocoagulase Drugs， thereby providing a decision-making basis for the rational clinical application and standardized management of hemocoagulase drugs （hereinafter referred to as “hemocoagulase”）.METHODS Led by Beijing Hospital （National Center for Gerontology）， in collaboration with 34 experts in clinical pharmacy， orthopedics， neurosurgery， emergency medicine， obstetrics and gynecology， gastroenterology， and other relevant fields， the consensus was developed through a systematic review of domestic and international research evidence and clinical practice experience pertaining to 10 clinical practice issues concerning hemocoagulase， followed by in-depth discussion.RESULTS A total of 24 recommendations were formulated， covering the following 10 aspects： the routes of administration and scope of application； dosage under different routes of administration； medication monitoring and management； adverse reaction management； medication monitoring and management in special populations； the combined use of hemocoagulase with common hemostatic drugs and/or hemostatic materials； the use of injectable hemocoagulase to reduce perioperative bleeding； the use of locally applied hemocoagulase to reduce perioperative bleeding； the application of hemocoagulase in reducing non-surgery-related bleeding； and the application of hemocoagulase in reducing trauma-related bleeding.CONCLUSIONS This consensus provides systematic， evidence-based guidance for the clinical application of hemocoagulase， facilitating the standardization of clinical practice， the optimization of dosing regimens， and the assurance of medication safety， thereby improving patient treatment outcomes.

OBJECTIVE To compare the efficacy and safety of different classes of antibacterial agents in hospitalized adult patients with community-acquired pneumonia （CAP）.METHODS PubMed， Embase，the Cochrane Library，Web of Science，CNKI，and Wanfang data were searched from inception to January 1，2026，to identify randomized controlled trials that evaluated different classes of antibacterial agents in hospitalized adults with CAP.After screening the literature， extracting the data， and evaluating the quality of the literature， a network meta-analysis was performed using Stata 18.0.RESULTS A total of 25 studies were included，involving 7 863 patients. In terms of efficacy，compared with carbapenems，penicillins，cephalosporins，macrolides，and pleuromutilins were associated with significantly higher treatment failure rates （ P ＜0.05），carbapenems and traditional tetracyclines were ranked as the top two by the surface under the cumulative ranking curve area （SUCRA）. No statistically significant differences were observed in mortality among the interventions （ P ＞0.05），carbapenems and other quinolones were ranked as the top two by SUCRA. In terms of safety，no statistically significant differences were observed among the interventions in the incidence of adverse events or discontinuation rates （ P ＞0.05）；traditional tetracyclines and novel tetracyclines were ranked as the top two by SUCRA for the incidence of adverse events，while novel tetracyclines and pleuromutilins were ranked as the top two by SUCRA for discontinuation rates.CONCLUSIONS Carbapenems significantly reduced the treatment failure rate in hospitalized adults with CAP. The safety profiles of all antibacterial agents were comparable， with novel tetracyclines showing a more favorable safety profile.

Objective To investigate the impact of continuous nebulization therapy after lung transplantation on pulmonary function and related complications in lung transplant recipients. Methods A retrospective analysis was conducted on the general data of 71 recipients who underwent allogeneic lung transplantation at the Department of Thoracic Surgery, the First Affiliated Hospital of Zhengzhou University, from June 2013 to December 2024. Recipients were divided into observation group (those who continued nebulization therapy for more than 3 months after discharge) and control group (those who discontinued nebulization therapy on their own). The main observation indicators were pulmonary function indicators at 6 months after surgery, including forced expiratory volume in the first second as a percentage of predicted value (FEV₁% pred), forced vital capacity as a percentage of predicted value (FVC% pred), ratio of forced expiratory volume in the first second to forced vital capacity as a percentage of predicted value (FEV₁/FVC% pred), forced expiratory flow at 25%, 50% and 75% of forced vital capacity as a percentage of predicted value, and the percentage of predicted value of corrected carbon monoxide diffusion capacity measured by single-breath method, as well as the ratio of corrected carbon monoxide diffusion capacity to alveolar volume as a percentage of predicted value. Additionally, the annual incidence of postoperative pulmonary infections, survival rate and the rate of no severe airway complications were analyzed. Results At 6 months after lung transplantation, the FEV₁% pred and FVC% pred of the observation group were better than those of the control group [FEV₁% pred was 76% (60%, 91%) vs. 67% (62%, 78%), FVC% pred was (75 ± 13)% vs. (69 ± 11)%, both P<0.05]. The observation group had a lower annual incidence of pulmonary infections compared to the control group (P = 0.023), with a risk of 0.485 times that of the control group. There were no statistically significant differences between the two groups in median survival time and the rate of no severe airway complications (both P>0.05). Conclusions Continuous nebulization therapy after lung transplantation may effectively improve pulmonary function, reduce the annual incidence of pulmonary infections, and play a positive role in the long-term maintenance of pulmonary function.

BACKGROUND: The use of potentially inappropriate medications (PIMs) is a major concern for medication safety as it may entail more harm than potential benefits for older adults. This study aimed to explore the prescribing rate, healthcare utilization, and expenditure of older adults using PIMs in China. METHODS: A cross-sectional analysis was conducted using a national representative database of all medical insurance beneficiaries across China, extracting ambulatory visit records of adults aged 65 years and above between 2015 and 2017. Descriptive analysis was conducted to measure the rate of patients exposed to PIM, prescribing rate of each PIM, average annual outpatient visits per patient, average total medication costs for each visit, average annual cost of PIMs for each patient, and average annual medication costs for each patient. Generalized linear model with logit link function and binomial distribution was used to examine the adjusted associations between PIMs and independent variables. RESULTS: In total, 845,278 (33.2%) participants were identified to be exposed to at least one PIM. Patients aged 75-84 years (38.1%, 969,809/2,545,430) and ≥85 years (37.9%, 964,718/2,545,430) were more likely to be prescribed with PIMs. Beneficiaries of the Urban Employee Basic Medical Insurance (UEBMI) and living in eastern and southern regions were more frequently prescribed with PIMs. Compared with patients without PIM exposure (7.5 visits, drug cost of RMB 1545.0 Yuan), patients with PIM exposure showed higher adjusted average annual number of outpatient visits (10.7 visits, β = 3.228, 95% confidence interval [CI] = 3.196-3.261) and higher annual drug costs (RMB 2461.8 Yuan, Coef. = 916.864, 95% CI = RMB 906.292-927.436 Yuan). CONCLUSIONS The results showed that the use of PIM among older adults was common in China. This study suggests that the use of PIM could be considered as a clear target, pending multidimensional efforts, to promote rational prescribing for older adults.
Humans ; Aged ; Cross-Sectional Studies ; Aged, 80 and over ; Male ; Female ; China ; Inappropriate Prescribing/economics* ; Patient Acceptance of Health Care/statistics & numerical data* ; Potentially Inappropriate Medication List/statistics & numerical data* ; Health Expenditures/statistics & numerical data*

Microglia, the resident immune cells in the central nervous system (CNS), rapidly transition from a resting to an active state in the acute phase of ischemic brain injury. This active state mediates a pro-inflammatory response that can exacerbate the injury. Targeting the pro-inflammatory response of microglia in the semi-dark band during this acute phase may effectively reduce brain injury. Shionone (SH), an active ingredient extracted from the dried roots and rhizomes of the genus Aster (Asteraceae), has been reported to regulate the inflammatory response of macrophages in sepsis-induced acute lung injury. However, its function in post-stroke neuroinflammation, particularly microglia-mediated neuroinflammation, remains uninvestigated. This study found that SH significantly inhibited lipopolysaccharide (LPS)-induced elevation of inflammatory cytokines, including interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and inducible nitric oxide synthase (iNOS), in microglia in vitro. Furthermore, the results demonstrated that SH alleviated infarct volume and improved behavioral performance in middle cerebral artery occlusion (MCAO) mice, which may be attributed to the inhibition of the microglial inflammatory response induced by SH treatment. Mechanistically, SH potently inhibited the phosphorylation of serine-threonine protein kinase B (AKT), mammalian target of rapamycin (mTOR), and signal transducer and activator of transcription 3 (STAT3). These findings suggest that SH may be a potential therapeutic agent for relieving ischemic stroke (IS) by alleviating microglia-associated neuroinflammation.
Animals ; Microglia/immunology* ; Mice ; Male ; Mice, Inbred C57BL ; Brain Ischemia/immunology* ; Neuroinflammatory Diseases/drug therapy* ; Neuroprotective Agents/administration & dosage* ; Interleukin-1beta/genetics* ; STAT3 Transcription Factor/genetics* ; TOR Serine-Threonine Kinases/genetics* ; Tumor Necrosis Factor-alpha/genetics* ; Proto-Oncogene Proteins c-akt/immunology* ; Nitric Oxide Synthase Type II/genetics* ; Lipopolysaccharides

By reconstructing the integrated Chinese and western medicine diagnostic and treatment system， the "Two Reconstructions" theoretical framework establishes a standardized pathway of "classification-staging-syndrome differentiation"， which improves the accuracy of disease identification and strengthens the capacity for full-course intervention； in addition， by reconstructing the modern materia medica system， it innovatively integrates the traditional properties and efficacy of Chinese herbal medicinals with modern pharmacological mechanisms， forming a "state-target co-regulation" precise medication model， and builds a dose-effect theoretical system for prescriptions and medicinals， thereby enhancing both the targeting accuracy and dosage precision of therapeutic interventions. The "Two Reconstructions" theorecitcal framework is a key strategy for enhancing clinical efficacy. It can precisely identify "states" and "targets" for directed intervention， shift the focus of prevention and treatment earlier to enable full-cycle management， establish standardized paradigms for reproducible and evaluable efficacy， and expand the scope of clinical practice to address conditions without typical syndromes and critical illnesses. As a systematic pathway for innovation in TCM， this theoretical framework provides valuable insights and references for promoting the high-quality development of integrative Chinese and western medicine.