Attention deficit hyperactivity disorder （ADHD） is often accompanied by tic disorder. The core pathogenesis is considered to be ministerial fire scorching yin and internal stirring of deficient wind， which leads to disharmony between the body and spirit， resulting in clinical manifestations. The treatment principles emphasize nourishing yin fluids， calming ministerial fire， and extinguishing endogenous wind （内风）. The method of nourishing yin fluids is applied throughout the entire treatment process， commonly using ingredients such as Shudihuang （Rehmanniae Radix Praeparata）， Shanzhuyu （Corni Fructus）， Gouqizi （Lycii Fructus）， Wuweizi （Schisandrae Chinensis Fructus）， and Tusizi （Cuscutae Semen）. These are combined with approaches to harmonize the zang-fu organs， primarily including extinguishing liver wind， clearing heart fire， nourishing kidney water， and strengthening spleen earth， thereby stabilizing ministerial fire and extinguishing endogenous wind. Additionally， emotional regulation and smoothing emotional constraint are essential to improve clinical symptoms in children with ADHD comorbid with tic disorder.

Ulcerative colitis （UC） is a chronic inflammatory bowel disease primarily affecting the colon and rectum. With a rising incidence， UC has aroused an increasingly serious public health concern. The etiology and pathogenesis of UC are complex， involving genetic susceptibility， intestinal barrier dysfunction， immune dysregulation， and environmental factors such as diet， smoking， and infection. Current UC therapies face limitations including persistent drug resistance， multiple side effects， and compromised immune function， necessitating the exploration of novel intervention strategies. In recent years， with the continuous advancement of research into UC mechanisms， the Toll-like receptor 4 （TLR4）/nuclear factor-κB （NF-κB） signaling pathway has been revealved as one of the classical pathways involved in inflammation. Being crucial for maintaining intestinal homeostasis， this pathway regulates inflammatory and immune responses by controlling gene transcription， thereby playing a significant role in the occurrence and progression of UC. However， systematic summarization within this field remains lacking. Traditional Chinese medicine （TCM） possesses unique advantages through its multi-target， multi-pathway， and multi-mechanism approaches， being capable of curbing the pathological progression of UC by targeting key molecules in the TLR4/NF-κB signaling pathway. This paper systematically summarizes the mechanisms by which TLR4/NF-κB-related pathways regulate UC， primarily encompassing inflammatory responses， oxidative stress， immune balance， and gut microbiota. It reviews single herbs （e.g.， Rosa roxburghii root and Saposhnikoviae Radix）， active components （e.g.， resveratrol， Tripterygium glycosides， and gypenosides）， herbal extracts （e.g.， Zingiberis Rhizoma extract and Taraxaci Herba extract）， and compound formulas for clearing heat and removing dampness， invigorating the spleen and warming the kidneys， clearing heat and detoxifying， harmonizing the liver and spleen， and treating cold and heat in complexity （e.g.， Huaihua Powder， Shenling Baizhu Powder， and Jiedu Huayu Formula）. The aim is to fully leverage the advantages of TCM in UC treatment and provide novel insights for clinical and pharmacological research on UC.

Ulcerative colitis （UC） is a chronic inflammatory bowel disease primarily affecting the colon and rectum. With a rising incidence， UC has aroused an increasingly serious public health concern. The etiology and pathogenesis of UC are complex， involving genetic susceptibility， intestinal barrier dysfunction， immune dysregulation， and environmental factors such as diet， smoking， and infection. Current UC therapies face limitations including persistent drug resistance， multiple side effects， and compromised immune function， necessitating the exploration of novel intervention strategies. In recent years， with the continuous advancement of research into UC mechanisms， the Toll-like receptor 4 （TLR4）/nuclear factor-κB （NF-κB） signaling pathway has been revealved as one of the classical pathways involved in inflammation. Being crucial for maintaining intestinal homeostasis， this pathway regulates inflammatory and immune responses by controlling gene transcription， thereby playing a significant role in the occurrence and progression of UC. However， systematic summarization within this field remains lacking. Traditional Chinese medicine （TCM） possesses unique advantages through its multi-target， multi-pathway， and multi-mechanism approaches， being capable of curbing the pathological progression of UC by targeting key molecules in the TLR4/NF-κB signaling pathway. This paper systematically summarizes the mechanisms by which TLR4/NF-κB-related pathways regulate UC， primarily encompassing inflammatory responses， oxidative stress， immune balance， and gut microbiota. It reviews single herbs （e.g.， Rosa roxburghii root and Saposhnikoviae Radix）， active components （e.g.， resveratrol， Tripterygium glycosides， and gypenosides）， herbal extracts （e.g.， Zingiberis Rhizoma extract and Taraxaci Herba extract）， and compound formulas for clearing heat and removing dampness， invigorating the spleen and warming the kidneys， clearing heat and detoxifying， harmonizing the liver and spleen， and treating cold and heat in complexity （e.g.， Huaihua Powder， Shenling Baizhu Powder， and Jiedu Huayu Formula）. The aim is to fully leverage the advantages of TCM in UC treatment and provide novel insights for clinical and pharmacological research on UC.

Objective: To systematically evaluate the influencing factors for autism spectrum disorder (ASD) in Chinese children, so as to provide the evidence for risk prediction and intervention of ASD. Methods: The publications pertaining to the influencing factors for ASD in Chinese children were retrieved from CNKI, Wanfang Data, VIP, PubMed and Embase database from inception to August 2024. A meta-analysis was performed using R package version 4.4.1. Sensitivity analysis was performed using the "leave-one-out" evaluation procedure. Publication bias was assessed using Egger regression test. Results: A total of 38 high-quality articles out of 9 015 articles were finally included, covering 149 607 individuals, with 5 974 cases of ASD. The meta-analysis showed that demographic factors including family history of related diseases (OR=14.958), maternal age of ≥35 years (OR=2.287) and parental history of hazardous occupations (OR=3.511); pregnancy-related factors including history of abortion (OR=5.832), no folate supplementation before and during pregnancy (OR=4.566), tobacco exposure before and during pregnancy (OR=2.596), history of other adverse exposures before and during pregnancy (OR=3.533), history of infectious diseases during pregnancy (OR=3.753), history of non-infectious diseases during pregnancy (OR=2.563), psychological problems during pregnancy (OR=3.864), history of medication during pregnancy (OR=6.651), adverse environmental exposures during pregnancy (OR=3.754), severe pregnancy reactions (OR=5.082), abnormal perinatal period (OR=2.987), cesarean delivery (OR=1.659), other perinatal adverse factors (OR=3.856), history of neonatal asphyxia (OR=2.792) and neonatal jaundice (OR=3.687); parenting factors including non-exclusive breastfeeding (OR=2.510), early/excessive screen exposure (OR=3.589) and feeding problems (OR=3.113); and individual factors including being male (OR=3.333) and history of convulsions/epilepsy (OR=7.035) were influencing factors for ASD in Chinese children. Conclusions The prevalence of ASD in Chinese children is primarily associated with 23 influencing factors, including family history of related diseases, history of abortion, no folate supplementation before and during pregnancy, medication during pregnancy, early/excessive screen exposure and history of convulsions/epilepsy.

The concept of harmony between heaven and man is an important concept in TCM. The theory of "harmful hyperactivity and responding inhibition" has been developed and perfected by medical professionals throughout history to explain physiological and pathological changes in humans based on a natural understanding. Guided by the TCM philosophy of "harmful hyperactivity and responding inhibition", it provides guidance for attention deficit hyperactivity disorder (ADHD). Sorting out the complex pathogenesis, it has been found that core pathogenesis of the disease is the excessive damage to the five organs, which leads to the overall state of yin deficiency and yang hyperactivity in the human body. The treatment mainly focuses on regulating the hyperactivity and damage of the organs, restoring the balance of yin and yang, while also taking into account the harm of pathological products. Based on clinical manifestations, the secondary selection of medication for liver and liver hyperactivity and spleen and kidney dysfunction has been determined, while improving the hyperactivity of the external environment, in order to achieve the goal of "tolerance is control", which fully embodies the TCM syndrome differentiation thinking of "unity of heaven and man, holistic concept".

Objective To explore the feasibility of video-assisted thoracoscopic surgery(VATS)in the treatment of congenital pulmonary airway malformation(CPAM)or pulmonary isolation complicated with ipsilateral mediastinal bronchogenic cyst in children.Methods From July 2019 to July 2024,VATS was carried out to treat CPAM or pulmonary isolation with ipsilateral mediastinal bronchogenic cyst in 7 children.A three-hole thoracoscopic surgery via lateral thoracic approach was performed.The patients were placed in a healthy lateral position.The observation hole was located at the intersection of the subscapular line and the 5th intercostal space,and the operating hole was established according to the surgical requirements in combination with the lumboscopic diamond rule.A 5 mm trocar was used for all three holes.The pressure of CO2 pneumothorax was 4 mm Hg and the flow rate was 2 L/min,which was adjusted at any time according to the intraoperative conditions of the children.The operation was mainly designed for lung operation.The pulmonary operation was conducted firstly,and then the bronchogenic cyst was treated.If necessary,block resection was applied to avoid serious complications of trachea.Results All the operations were performed under thoracoscopy without conversion to open surgery.The operation time was 37-191 min(median,101 min).The intraoperative bleeding volume was 1-15 ml(median,5 ml).One case was not given a closed chest drainage tube placed,and the other 6 cases were placed a closed chest drainage for 1-5 d(median,3d).Postoperative pathology showed 5 cases of CPAM combined with bronchogenic cysts,including 4 cases of type 2(bronchiole type)and 1 case of type 3(bronchiole/alveolar type),and 2 cases of extralobular pulmonary isolation combined with bronchogenic cysts.All the 7 cases were followed up for 6-57 months(median,27 months),and chest CT showed no recurrence of lesions.Conclusions CPAM or pulmonary isolation may be accompanied by bronchogenic cysts.Preoperative imaging examination should correspond to surgical observation,and careful exploration should be conducted to avoid missed diagnosis.VATS is safe and feasible for treating CPAM or pulmonary isolation with ipsilateral mediastinal bronchogenic cysts.

Objective:To investigate the mechanism of inhibition for Janus tyrosine kinase,signal transducer and activator of transcription(JAK/STAT)on ferroptosis,myocardial remodeling,and JAK/STAT melatonin receptor 1-nuclear factor E2-related factor 2-glutathione peroxidase 4(MT1-Nrf2-GPX4)signaling axis in rats with heart failure(HF)under echocardiography.Methods:Forty SD rats were selected,and they were randomly divided into blank control group,model group,interleukin-6(IL-6)group and tyrosine phosphorylation inhibitor(AG490)group according to random number table,with 10 rats in each group.HF rat models were established in three groups except the blank control group.The expression levels of JAK/STAT mRNA in myocardial tissue among 4 groups were compared and analyzed.The small animal ultrasound imaging system was used to measure a series of cardiac function indexes included interventricular septum(IVS)thickness,left ventricular posterior wall(LVPWs)thickness,left ventricular posterior wall(LVPWd)thickness,left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)and ejection fraction(EF).The Fe2+concentration and lesions of myocardial tissue,as well as the expressions of MT1,Nrf2 and GPX4 proteins,in the four groups were compared and analyzed.Results:The increases of JAK1 and STAT3 mRNA levels,and Fe2+concentration in the model group,IL-6 group and AG490 group were higher than those in the blank control group,and the protein expression levels of MT1,Nrf2 and GPX4 in them were lower than those in the blank control group,and the differences of the above indicators between the model group and the blank control group were statistically significant(t=11.810,16.250,17.150,10.460,9.272,11.180,P＜0.05),and the differences of the above indicators between the IL-6 group and the blank control group were statistically significant(t=9.834,19.030,16.320,14.450,13.250,14.070,P＜0.05),and the differences of them between the AG490 group and the blank control group were statistically significant(t=8.025,11.050,17.590,4.173,4.179,4.183,P＜0.05),respectively.The levels of STAT3 mRNA level and Fe2+concentration in IL-6 group were higher than those in the model group,and the expression levels of MT1,Nrf2 and GPX4 proteins in that were lower than those in the model group,and the differences were statistically significant(t=2.224,2.582,3.550,3.078,2.624,P＜0.05),respectively.The levels of JAK1,STAT3 mRNA and Fe2+concentration in the AG490 group were lower than those in the model group,and the levels of MT1,Nrf2 and GPX4 in that were higher than those in the model group,and the differences were statistically significant(t=4.052,6.930,8.598,6.247,5.055,6.799,P＜0.05),respectively.The IVS,LVPWs,LVPWd and EF of the model group,IL-6 group and AG490 group were lower than those of the blank control group,and the LVEDD and LVESD of them were higher than those of the blank control group,and the differences of these indicators between the model group and the blank control group were statistically significant(t=13.740,11.100,5.654,7.049,13.440,14.260,P＜0.05),and the differences of them between the IL-6 group and the blank control group were statistically significant(t=16.090,13.140,8.103,9.174,15.940,17.010,P＜0.05),and the differences of them between the AG490 group and the blank control group were statistically significant(t=5.474,4.947,2.682,4.071,8.608,13.300,P＜0.05),respectively.The LVPWd and EF in the IL-6 group were lower than those in the model group,and the LVEDD and LVESD in the IL-6 group were higher than those in the model group,and the differences of them were statistically significant(t=2.417,2.327,2.236,2.818,P＜0.05),respectively.The IVS,LVPWs,LVPWd and EF in the AG490 group were higher than those in the model group,and the LVEDD and LVESD in that were lower than those in the model group,and the differences were statistically significant(t=8.598,7.147,3.514,3.361,4.914,2.970,P＜0.05),respectively.Conclusion:Inhibition of JAK/STAT expression can improve the cardiac structure of HF rats,and relieve ventricular remodeling,and inhibit ferroptosis of cardiomyocyte,and promote the expression of MT1,Nrf2 and GPX4 proteins.

Objective To identify the key influencing factors and role mechanisms of large-scale medical equip-ment allocation decision-making in public hospitals,and to provide a reference basis for optimizing resource alloca-tion strategies.Methods Through searching the literature related to large-scale medical equipment decision-making in public hospitals and combing the policies,the system of decision-making influencing factors was initially screened.The Delphi method and decision-making trial and evaluation laboratory method were used to obtain the key influencing factors of equipment allocation decision-making and to determine the interaction effects among the factors.Results A total of seven cause factors and nine effect factors were screened.Among them,cost-benefit analysis,equipment technical performance,and evaluation of similar equipment were the top three key drivers;leadership emphasis,equipment market price,and equipment supporting facilities were the top three key con-straints.Conclusion Priority be given to strengthening the management of driving factors,mainly by conducting a full-cycle assessment of cost-effectiveness,paying attention to the clinical value output of equipment technical performance,and monitoring regionally similar equipment.A dynamic response mechanism for constraints should be established,mainly to strengthen leadership decision-making,implement a centralized procurement price nego-tiation model and improve the pre-assessment system for ancillary facilities.

Ulcerative colitis(UC)is a recurrent,chronic,nonspecific inflammatory bowel disease.Shaoyao Decoction has shown good efficacy in the treatment of UC,which mainly regulates the balance of cytokines to achieve the purpose of treating UC.This article reviewed the research progress in the mechanism of Shaoyao Decoction in the treatment of UC from two aspects of pro-inflammatory cytokines and anti-inflammatory cytokines.Research has shown that Shaoyao Decoction can regulate the body's immune response,alleviate intestinal inflammation,protect the intestinal mucosal barrier,restore normal structure and function of the colon mucosa through pro-inflammatory cytokines such as tumor necrosis factor-α,interferon-γ,interleukin(IL)-1β,IL-6,IL-8,IL-17,and anti-inflammatory cytokines such as transforming growth factor-β,IL-4,IL-10,IL-13,which can provide reference for UC related mechanism research and clinical treatment.

BACKGROUND: Recent studies have shown that sodium-glucose cotransporters-2 (SGLT2) inhibitors significantly improve major adverse cardiovascular events in heart failure with preserved ejection fraction (HFpEF) patients, but the exact mechanism is unknown. Ferritinophagy is a special form of selective autophagy that participates in ferroptosis. In this study, we aimed to investigate whether ferritinophagy was activated during the occurrence of HFpEF, and whether canagliflozin (CANA) could inhibite ferritinophagy. METHODS: We reared Dahl salt-sensitive (DSS) rats on a high-salt diet to construct a hypertensive HFpEF model, and simultaneously administered CANA intervention. Then we detected indicators related to ferritinophagy. RESULTS: The expression of nuclear receptor coactivator 4 (NCOA4), as well as microtubule-associated proteins light chain 3 (LC3), Bcl-2 interacting protein 1 (Beclin-1) and p62, were upregulated in HFpEF rats, accompanied by the downregulation of ferritin heavy chain 1 (FTH1), upregulation of mitochondrial iron transporter sideroflexin1 (SFXN1) and increased reactive oxygen species (ROS) production. Above changes were diminished by CANA. CONCLUSION Ferritinophagy is activated in HFpEF rats and then inhibited by CANA, leading to HFpEF benefits. The inhibition of ferritinophagy could provide new prospective targets for the prevention and treatment of HFpEF, and provide new ideas for investigating the mechanism of cardiovascular benefit of SGLT2 inhibitors.