ObjectiveTo investigate the current awareness and optimization recommendations on pneumonia with unknown etiology (PUE) surveillance among Shanghai healthcare professionals, and to provide evidence for the improvement of the surveillance system. MethodsIn December 2024, healthcare professional participants from diverse medical and health institutions were randomly selected within each stratum using a stratified cluster sampling method in all 16 districts of Shanghai for questionnaire surveys on their knowledge and suggestions for optimization of the PUE surveillance system. Descriptive statistics analyses, multivariate logistic regressions, and content analyses were used for data analyses. ResultsA total of 385 survey subjects were involved in the study, including 119 professional staffs from disease prevention and control centers and 266 from medical institutions. Those who understood the case definition for PUE correctly accounted for 67.01% (258/385). Multivariate regression model analyses showed that female gender (aOR=2.22, 95%CI: 1.36‒3.66), professionals from disease control institutions (aOR=2.02, 95%CI: 1.12‒3.72), and those who self-assessed as being familiar with the monitoring system (aOR=2.18, 95%CI:1.23‒3.89) had better understanding of the definition. Overall, 89.61% (345/385) of the survey subjects acknowledged the necessity of the surveillance system. Small number of cases meeting the case definition (54.46%, 214/379), insufficient diagnostic awareness (39.84%, 151/379), and lack of incentives for case reporting (29.29%, 111/379) were major problems for the current surveillance system, with variations observed across different types of institutions. Suggested segments for optimizing the surveillance system included monitoring purpose, case definition, form of monitoring and reporting procedure, organization mechanism, and epidemiological investigation and response. ConclusionThe necessity of PUE surveillance is commonly recognized among healthcare workers. However, the existing system falls short in terms of mastery of case definition and overall surveillance adaptability. There is an urgent need for optimization and improvement to enhance the capacity for preventing and controlling emerging and sudden respiratory infectious diseases.

ObjectiveTo explore the mechanism by which modified Shaofu Zhuyutang inhibits angiogenesis in endometriosis via the vascular endothelial growth factor （VEGF）/phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）/endothelial nitric oxide synthase （eNOS）-nitric oxide （NO） signaling pathway. MethodsEighty-four female SD rats were randomly assigned into blank， sham operation， model， positive control （gestrinone， 0.25 mg·kg^-1）， high-， medium-， and low-dose （30， 15， 7.5 g·kg^-1， respectively） traditional Chinese medicine （TCM， modified Shaofu Zhuyutang） groups. A rat model of endometriosis was established by the autotransplantation method. After successful modeling， rats in the drug intervention groups were administrated with corresponding agents by gavage， and those in the blank， sham operation， and model groups received an equal volume of distilled water. After 28 days of gavage， rats were administrated with oxytocin， and the number and latency period of writhing responses were observed. Serum samples from each group， ectopic lesions from modeling groups， and uteri from blank and sham operation groups were collected. Hematoxylin-eosin staining was used to observe the pathological morphology of endometriotic lesions. Immunohistochemistry was employed to observe the expression of angiogenesis-specific markers cluster of differentiation 34 antigen （CD34） and friend leukemia virus integration-1 （FLI-1）. Enzyme-linked immunosorbent assay and the nitrate reductase method were employed to determine the serum levels of VEGF and NO， respectively. Western blot was employed to measure the protein levels of VEGF， PI3K， phosphorylated PI3K （p-PI3K）， Akt， phosphorylated Akt （p-Akt）， eNOS， and phosphorylated eNOS （p-eNOS）. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was conducted to determine the mRNA levels of VEGF， PI3K， Akt， and eNOS. ResultsThe blank group and the sham operation group had no significant changes in the number and latency period of writhing responses， serum VEGF and NO levels， protein levels of VEGF， p-PI3K/PI3K， p-Akt/Akt， and p-eNOS/eNOS， and mRNA levels of VEGF， PI3K， Akt， and eNOS. The model group showed an increase in the number and a reduction in the latency period of writhing responses， enlargement of ectopic endometrial tissue in the abdominal wall， with stromal hyperplasia， glandular dilation， and increased vasculature. In addition， the modeling led to increased positive expression of CD34 and FLI-1， elevated serum VEGF and NO levels， and up-regulated protein levels of VEGF， p-PI3K/PI3K， p-Akt/Akt， and p-eNOS/eNOS and mRNA levels of VEGF， PI3K， Akt， and eNOS （P<0.01）. Compared with the model group， the gestrinone and high-， medium-， and low-dose TCM groups showed a significant reduction in the number of writhing responses， a significant prolongation of the latency period， reduced ectopic endometrial tissue in the abdominal wall， alleviated pathological damage， and reduced positive expression of CD34 and FLI-1. The gestrinone group and the high- and medium-dose TCM groups showed lowered serum VEGF and NO levels as well as down-regulated protein levels of VEGF， p-PI3K/PI3K， p-Akt/Akt， and p-eNOS/eNOS and mRNA levels of VEGF， PI3K， Akt， and eNOS. Moreover， the low-dose TCM group showed reductions in the serum VEGF level， the protein levels of VEGF， p-PI3K/PI3K， p-Akt/Akt， and p-eNOS/eNOS， and the mRNA levels of VEGF and eNOS （P<0.05， P<0.01）. ConclusionModified SShaofu Zhuyutang can inhibit angiogenesis in endometriosis by antagonizing the abnormal activation of the VEGF/PI3K/Akt/eNOS-NO signaling pathway， thereby preventing the occurrence， development， and deterioration of endometriosis.

ObjectiveTo explore the mechanism by which modified Shaofu Zhuyutang inhibits angiogenesis in endometriosis via the vascular endothelial growth factor （VEGF）/phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）/endothelial nitric oxide synthase （eNOS）-nitric oxide （NO） signaling pathway. MethodsEighty-four female SD rats were randomly assigned into blank， sham operation， model， positive control （gestrinone， 0.25 mg·kg^-1）， high-， medium-， and low-dose （30， 15， 7.5 g·kg^-1， respectively） traditional Chinese medicine （TCM， modified Shaofu Zhuyutang） groups. A rat model of endometriosis was established by the autotransplantation method. After successful modeling， rats in the drug intervention groups were administrated with corresponding agents by gavage， and those in the blank， sham operation， and model groups received an equal volume of distilled water. After 28 days of gavage， rats were administrated with oxytocin， and the number and latency period of writhing responses were observed. Serum samples from each group， ectopic lesions from modeling groups， and uteri from blank and sham operation groups were collected. Hematoxylin-eosin staining was used to observe the pathological morphology of endometriotic lesions. Immunohistochemistry was employed to observe the expression of angiogenesis-specific markers cluster of differentiation 34 antigen （CD34） and friend leukemia virus integration-1 （FLI-1）. Enzyme-linked immunosorbent assay and the nitrate reductase method were employed to determine the serum levels of VEGF and NO， respectively. Western blot was employed to measure the protein levels of VEGF， PI3K， phosphorylated PI3K （p-PI3K）， Akt， phosphorylated Akt （p-Akt）， eNOS， and phosphorylated eNOS （p-eNOS）. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was conducted to determine the mRNA levels of VEGF， PI3K， Akt， and eNOS. ResultsThe blank group and the sham operation group had no significant changes in the number and latency period of writhing responses， serum VEGF and NO levels， protein levels of VEGF， p-PI3K/PI3K， p-Akt/Akt， and p-eNOS/eNOS， and mRNA levels of VEGF， PI3K， Akt， and eNOS. The model group showed an increase in the number and a reduction in the latency period of writhing responses， enlargement of ectopic endometrial tissue in the abdominal wall， with stromal hyperplasia， glandular dilation， and increased vasculature. In addition， the modeling led to increased positive expression of CD34 and FLI-1， elevated serum VEGF and NO levels， and up-regulated protein levels of VEGF， p-PI3K/PI3K， p-Akt/Akt， and p-eNOS/eNOS and mRNA levels of VEGF， PI3K， Akt， and eNOS （P<0.01）. Compared with the model group， the gestrinone and high-， medium-， and low-dose TCM groups showed a significant reduction in the number of writhing responses， a significant prolongation of the latency period， reduced ectopic endometrial tissue in the abdominal wall， alleviated pathological damage， and reduced positive expression of CD34 and FLI-1. The gestrinone group and the high- and medium-dose TCM groups showed lowered serum VEGF and NO levels as well as down-regulated protein levels of VEGF， p-PI3K/PI3K， p-Akt/Akt， and p-eNOS/eNOS and mRNA levels of VEGF， PI3K， Akt， and eNOS. Moreover， the low-dose TCM group showed reductions in the serum VEGF level， the protein levels of VEGF， p-PI3K/PI3K， p-Akt/Akt， and p-eNOS/eNOS， and the mRNA levels of VEGF and eNOS （P<0.05， P<0.01）. ConclusionModified SShaofu Zhuyutang can inhibit angiogenesis in endometriosis by antagonizing the abnormal activation of the VEGF/PI3K/Akt/eNOS-NO signaling pathway， thereby preventing the occurrence， development， and deterioration of endometriosis.

The rapid development of artificial intelligence (AI), especially generative AI (GenAI), has already brought, and will continue to bring, revolutionary changes to our daily production and life, as well as create new opportunities and challenges for diagnostic and therapeutic practices in the medical field. Haihe Hospital of Tianjin University collaborates with the National Supercomputer Center in Tianjin, Tianjin University, and other institutions to carry out research in areas such as smart healthcare, smart services, and smart management. We have conducted research and development of a full-process disease diagnosis and treatment assistance system based on GenAI in the field of smart healthcare. The development of this project is of great significance. The first goal is to upgrade and transform the hospital's information center, organically integrate it with existing information systems, and provide the necessary computing power storage support for intelligent services within the hospital. We have implemented the localized deployment of three models: Tianhe "Tianyuan", WiNGPT, and DeepSeek. The second is to create a digital avatar of the chief physician/chief physician's voice and image by integrating multimodal intelligent interaction technology. With generative intelligence as the core, this solution provides patients with a visual medical interaction solution. The third is to achieve deep adaptation between generative intelligence and the entire process of patient medical treatment. In this project, we have developed assistant tools such as intelligent inquiry, intelligent diagnosis and recognition, intelligent treatment plan generation, and intelligent assisted medical record generation to improve the safety, quality, and efficiency of the diagnosis and treatment process. This study introduces the content of a full-process disease diagnosis and treatment assistance system, aiming to provide references and insights for the digital transformation of the healthcare industry.
Artificial Intelligence ; Humans ; Delivery of Health Care ; Generative Artificial Intelligence

Stem-leaf saponins from Panax notoginseng (SLSP) comprise numerous PPD-type saponins with diverse pharmacological properties; however, their role in Parkinson's disease (PD), characterized by microglia-mediated neuroinflammation, remains unclear. This study evaluated the effects of SLSP on suppressing microglia-driven neuroinflammation in experimental PD models, including the 1-methyl-4-phenylpyridinium (MPTP)-induced mouse model and lipopolysaccharide (LPS)-stimulated BV-2 microglia. Our findings revealed that SLSP mitigated behavioral impairments and excessive microglial activation in models of PD, including MPTP-treated mice. Additionally, SLSP inhibited the upregulation of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX2) and attenuated the phosphorylation of PI3K, protein kinase B (AKT), nuclear factor-κB (NFκB), and inhibitor of NFκB protein α (IκBα) both in vivo and in vitro. Moreover, SLSP suppressed the production of inflammatory markers such as interleukin (IL)-1β, IL-6, and tumor necrosis factor alpha (TNF-α) in LPS-stimulated BV-2 cells. Notably, the P2Y2R agonist partially reversed the inhibitory effects of SLSP in LPS-treated BV-2 cells. These results suggest that SLSP inhibit microglia-mediated neuroinflammation in experimental PD models, likely through the P2Y2R/PI3K/AKT/NFκB signaling pathway. These novel findings indicate that SLSP may offer therapeutic potential for PD by attenuating microglia-mediated neuroinflammation.
Animals ; Panax notoginseng/chemistry* ; Saponins/pharmacology* ; Microglia/immunology* ; Mice ; NF-kappa B/immunology* ; Signal Transduction/drug effects* ; Proto-Oncogene Proteins c-akt/immunology* ; Phosphatidylinositol 3-Kinases/genetics* ; Male ; Parkinson Disease/immunology* ; Mice, Inbred C57BL ; Disease Models, Animal ; Plant Leaves/chemistry* ; Neuroinflammatory Diseases/drug therapy* ; Humans

Objective: To evaluate the therapeutic potential and underlying mechanisms of action of propolis in db/db mice. Methods: The chemical composition of propolis was analyzed using UHPLC-MS/MS. Thirty mice, including six wt/wt and 24 db/db mice, were randomly assigned to four groups (n = 6 per group): control, model, metformin (250 mg/kg), low dose propolis (100 mg/kg), and high dose propolis (HDP; 400 mg/kg). Treatments were administered orally for four weeks. Body weight and FBG levels were recorded weekly, and an oral glucose tolerance test was conducted on the 25th day. Serum levels of FIN, GSP, connecting peptide, AST, ALT, HDL, LDL, TG, and TC were quantified using ELISA. Liver histopathology was assessed using H&E and PAS staining. Western blotting was performed to examine the expression levels of NF-κB, phosphorylated NF-κB, IκBα, pIκBα, and AKT in liver tissues. Results: The top 10 metabolites of propolis were identified in positive and negative ion modes. The HDP group exhibited a significant reduction in FBG levels, body weight, connecting peptide levels, homeostatic model assessment of β-cell function scores, and homeostasis model assessment of insulin resistance scores (all P < .05). GSP levels were significantly reduced in both treatment groups (all P < .001). The HDP group also exhibited a reduction in TC and LDL levels (both P < .05), whereas HDL levels increased in both treatment groups (all P < .05). Liver weight, AST levels, and ALT levels were reduced in both treatment groups (all P < .05). Histological analysis revealed improved liver morphology. Protein analysis demonstrated downregulation of phosphorylated NF-κB and phosphorylated IκB, alongside upregulation of AKT. Conclusion Propolis exhibited significant antihyperglycemic effects in db/db mice, potentially by modulating the AKT and NF-κB signaling pathways, highlighting its potential as a therapeutic agent for diabetes management.

AIM To optimize the extraction process for total polyphenols from Conioselinum vaginatu(Spreng.)Thell.,make component analysis,and evaluate their anti-oxidant,hypoglycemic activities.METHODS The effects of ultrasound,enzymatic hydrolysis,acid hydrolysis,alcohol extraction and hydrolysis processes on the extraction quantity of total polyphenols were investigated,respectively.With extraction temperature,extraction time,ethanol concetration and liquid-solid ratio as influencing factors,extraction quantity of total polyphenols as an evaluation index,the extraction process was optimized by response surface method.HPLC was adopted in the identification of polyphenolic composition and determination of their contents.Subsequently,total polyphenols' scavenging capacities on DPPH,ABTS,OH free radicals,total reducing power and inhibitory capacity on α-glucosidase were determined.RESULTS The highest extraction quantity of total polyphenols was observable when extraction process was employed.The optimal conditions were determined to be 62 ℃ for extraction temperature,54 min for extraction time,69％for ethanol concentration,and 50∶1 for liquid-solid ratio,the extraction quantity of total polyphenols was(9.51±0.2)mg GAE/g.Seven constituents existed in C.vaginatu,among which ferulic acid demonstrated the highest content,followed by that of myricetin,while D-tryptophan content was the lowest.At the concentration of 7.61 mg/L,total polyphenols displayed the scavenging rates on DPPH,ABTS,OH free radicals of 80.70％,85.97％,28.60％,total reducing power of 0.22,and inhibition rate on α-glucosidase of 77.23％,respectively.CONCLUSION This stable and reliable method can be used for the extraction of total polyphenols from C.vaginatum with strong anti-oxidant,hypoglycemic activities.

Acute lateral ankle sprain (ALAS) is one of the most common sport injuries, with high incidence, recurrence and disability rates. Currently, exercise rehabilitation-based non-surgical treatment is the primary management approach for ALAS. However, there remain improper practices such as excessive immobilization or uncontrolled activity, which contribute to recurrent sprains and chronic ankle instability, significantly impairing patients′ athletic function and quality of life. To standardize the non-surgical management of ALAS, improve the cure rates, and reduce the recurrence and disability rates, Chinese Sports Rehabilitation Medicine Training Project of Chinese Medical Association, Foot and Ankle Basics and Orthopedics Group, Orthopedic Branch of Chinese Medical Doctor Association, and Sports Medicine Branch of Jiangsu Medical Association organized relevant experts to formulate Expert consensus on non-surgical treatment for acute lateral ankle sprain ( version 2025), following the principles of scientific vigor, practicality, and innovation. Thirteen recommendations were proposed for standardized treatment protocols across different healing phases, aiming to provide references for standard management of ALAS and improve the therapeutic outcomes.