Objective To identify factors affecting and key environmental factors of the Oncomelania hupensis snail density in the Yangtze River Delta region using machine learning methods. Methods Administrative village-level O. hupensis snail survey data in the Yangtze River Delta (including Shanghai Municipality, Jiangsu Province, Zhejiang Province and Anhui Province) from 2011 to 2021 were retrieved from the Information Management System for Parasitic Disease Control of Chinese Center for Disease Control and Prevention. Environmental factor data were captured from the Google Earth Engine platform, including elevation, slope, terrain, normalized difference vegetation index (NDVI), vegetation type, soil type, total petroleum hydrocarbon (TPH), ammonium nitrogen, inorganic nitrogen, dissolved oxygen, pH of water, chemical oxygen demand (COD) and inorganic phosphorus, and climatic factor data in the study region were retrieved from the Copernicus Climate Data Store, including annual precipitation, aridity index and annual mean temperature (AMT). O. hupensis snail survey data in the Yangtze River Delta region from 2011 to 2021 were randomly divided into a training set (70%) and a test set (30%), and five machine learning models were selected for machine learning model construction and comparative analysis of the O. hupensis snail density using the software R 4.3.0, including random forest (RF), eXtreme gradient boosting (XGBoost), support vector machine (SVM), gradient boosting machine (GBM) and neural network (NN). The XGBoost model was employed to construct a predictive model for the O. hupensis snail density, and the impact of each environmental factor on O. hupensis snail distribution was quantified. The SHapley Additive exPlanations (SHAPs) values were calculated to estimate the average contribution of each variable to the model prediction, and the core environmental factors affecting the O. hupensis snail population density were screened. Results Among the five machine learning models, the XGBoost model exhibited the optimal comprehensive performance, with the coefficient of determination (R²) of 0.855, mean squared error (MSE) of 0.188, root mean squared error (RMSE) of 0.434 and mean absolute error (MAE) of 0.155, respectively. Analysis of factors affecting the O. hupensis snail density with the XGBoost model showed that among the 16 environmental factors, the top four high-impact factors ranked by SHAPs values included annual precipitation, elevation, aridity index and NDVI, with cumulative SHAPs contributions of 75%, which was higher than that of other environmental factors. If NDVI was higher than 0.6, the O. hupensis snail density increased with NDVI and peaked if NDVI was 0.8 (1.60 snails/0.1 m²). The O. hupensis snail density increased with elevation if the elevation ranged from 14 to 40 m, and slowly rose if the annual precipitation ranged from 900 to 1 300 mm, and then increased rapidly to the peak (1.52 snails/0.1 m²) if the annual precipitation ranged from 1 300 to 1 500 mm. In addition, the O. hupensis snail density increased rapidly to the maximum (1.60 snails/0.1 m²) if the aridity index ranged from 0.8 to 1.1, and decreased gradually if the aridity index exceeded 1.1. Conclusions The XGBoost model shows excellent performance in prediction of the O. hupensis snail density and identification of key environmental factors in the Yangtze River Delta region. Annual precipitation, elevation, aridity index and NDVI are key environmental factors affecting the distribution and density of O. hupensis snails in the Yangtze River Delta region.

Copper is an essential trace element in the human body, extensively involved in key physiological and biochemical processes such as antioxidant defense, energy metabolism, neural signaling, and immune regulation. In recent years, increasing research has focused on the potential role of copper dyshomeostasis in the development of chronic diseases. Studies indicate that abnormal copper levels, particularly elevated free copper, may increase the risk of cardiovascular disease, neurodegenerative disorders, diabetes, and cancer by inducing oxidative stress, impairing mitochondrial function, and disrupting immune regulation. Concurrently, copper homeostasis abnormalities have been demonstrated to be closely associated with increased all-cause mortality and accelerated aging. This systematic review comprehensively examined physiological functions, metabolic pathways, and environmental exposure characteristics of copper. It emphasized the epidemiological and mechanistic links between copper metabolism disorders and multiple chronic diseases, while exploring the potential applications of copper ion transporters and chelating agents in disease intervention. This work provides scientific evidence for the prevention, control, and precision treatment of copper-related chronic diseases.

Objective To assess the survival vulnerability of Oncomelania hupensis in Jiangxi Province under future climate scenarios, and to identify low-vulnerability areas for its survival in this province. Methods Village-level O. hupensis snail survey and O. hupensis snail control with chemical treatments in Jiangxi Province from 2016 to 2024 were captured from the Parasitic Disease Prevention and Control Information Management System of China Disease Prevention and Control Information System. Climatic data were primarily sourced from the Resource and Environmental Science Data Platform, Chinese Academy of Sciences (http://www.resdc.cn/), including annual average temperature, annual average precipitation, annual accumulated temperature above 10 °C, annual accumulated temperature above 0 °C, annual maximum temperature, annual minimum temperature, and annual average relative humidity, and nineteen bioclimatic variables were downloaded from the WorldClim website (https://www.worldclim.org/), including mean diurnal range, isothermality, temperature seasonality, and so on. Elevation and normalized difference vegetation index were catprued from the Resource and Environmental Science Data Platform, Chinese Academy of Sciences (http://www.resdc.cn/), and distance to rivers was downloaded from the WorldPop website (http://www.worldpop.org), and land use and land cover (LULC) data were downloaded from the Big Earth Data Center, Chinese Academy of Sciences (https://data.casearth.cn/), and nature reserve data were obtained from the China Nature Reserve Specimen Resource Sharing Platform (http://www.papc.cn/). Three Shared Socioeconomic Pathways (SSPs) from the Beijing Climate Center-Climate System Model version 2-Medium Resolution (BCC-CSM2-MR) global climate model were employed as future climate scenarios, including SSP126, SSP245, SSP585, and the biomod2 ensemble model in R package was used to simulate suitable habitats for O. hupensis snails in Jiangxi Province in 2050 and 2070 under these scenarios. A snail survival vulnerability index was constructed based on the area of suitable snail habitats, area covered by snail control through chemical treatment, area covered by nature reserves, and changes in snail habitat fragmentation, and a map of snail survival vulnerability distribution was plotted. Results The real area of snail habitats ranged from 78 486.76 to 85 309.47 hm², and the area of snail control with chemical treatment ranged from 10 138.98 to 13 240.16 hm² in Jiangxi Province from 2016 to 2024. There were 429 to 531 villages detected with snails during the nine-year period, and the number of actually snail-infested villages ranged from 645 to 686. A total of 818 snail-present points and 1 996 snail-absent points were obtained from snail survey records. The best performance of the biomod2 ensemble model was achieved if a weighted mean approach was used as the ensemble strategy, with a true skill statistic value of 0.799 and an area under the receiver operating characteristic curve of 0.957, and modeling identified annual average relative humidity and annual average precipitation as two most influencing climatic variables for snail distribution. Relative to the current areas of suitable snail habitats under present climate conditions, the area of suitable snail habitats was projected to expand by 24.49% to 46.28% in Jiangxi Province under future climate scenarios, and the proportion of nature reserves areas in the areas of suitable snail habitats was projected to decrease slightly from the current 2.77% to approximately 2.52%, while the proportion of areas of snail control through chemical treatment in areas of suitable snail habitats varied from 0.64% to 19.57%, and the percentage of changes in snail habitat fragmentation ranged from 3.86% to 12.23%. Based on these four indicators, the snail survival vulnerability index was estimated to range from –1.96 to 0.62 in Jiangxi Province. The arithmetic mean of the snail survival vulnerability index differed under three SSP scenarios (SSP126, SSP245 and SSP585), with the highest mean value (–0.69) in 2070 under SSP126, and the lowest mean value (–0.78) in 2070 under SSP585. Conclusions The snail survival vulnerability index ranges from –1.96 to 0.62 in Jiangxi Province under future climate scenarios, and the suitable habitats for O. hupensis snails appear an overall tendency towards expansion. Low-vulnerability snail habitats are mainly distributed along the shores of Poyang Lake and the Yangtze River in Jiangxi Province, partially overlapping with nature reserves. Intensified surveillance of O. hupensis snails is recommended in these areas in the future.

OBJECTIVE To establish the UPLC fingerprint and the method for multi-component content determination in Jingangteng capsules， and to evaluate its quality by combining chemical pattern recognition analysis. METHODS An UPLC method was established. Separation was performed on a Zorbax SB-C 18 Rapid Resolution HD column， with acetonitrile-0.1% formic acid as the mobile phase for gradient elution.Using the Similarity Evaluation System for Chromatographic Fingerprints of Traditional Chinese Medicines （2012 edition）， UPLC fi ngerprints were established for 10 batches of Jingangteng capsules， and similarity was evaluated. SPSS 22.0 and SIMCA 14.1 software were used to perform hierarchial-cluster analysis and orthogonal partial least squares discriminant analysis （OPLS-DA）， respectively. The same UPLC method was employed to determine the contents of chlorogenic acid， 3，5-dihydroxy-2-methylbenzoic acid-3- O -glucoside （M1）， caffeic acid， astilbin， oxyresveratrol， quercitrin and resveratrol in the 10 batches of samples. RESULTS A total of 17 common peaks were identified in UPLC fingerprints of the 10 batches of samples， of which 7 were identified as chlorogenic acid， M1， caffeic acid， astilbin， oxyresveratrol， quercitrin， and resveratrol. The similarities of 10 batches of samples ranged from 0.820 to 0.985. The results of hierarchial-cluster analysis showed that 10 batches of samples were grouped into four categories： S1-S4 formed one group， S5 and S6 formed another， S7， S8 and S10 formed a third， and S9 formed a fourth， consistent with the OPLS-DA results； the variable importance projection values for peaks 7， 10， 2， 16 （resveratrol）， 13 （oxyresveratrol）， 11， 6 （caffeic acid）， 5 （M1） and 15 （quercitrin） were ＞1. Quantitative analysis results showed that the contents of chlorogenic acid， M1， caffeic acid， astilbin， oxyresveratrol， quercitrin， and resveratrol were 1.650 8-4.213 7， 0.636 2-2.161 7， 0.031 0-0.086 5， 0.239 1-1.069 3， 0.211 9-1.104 0， 0.488 8-2.399 2， and 0.164 0-0.699 8 mg/g， respectively. CONCLUSIONS UPLC fingerprint and content determination methods established in this study are simple to operate， accurate， reliable and reproducible； when combined with chemical pattern recognition analysis， they can be used to evaluate the quality of Jingangteng capsules. Nine components， such as resveratrol， oxyresveratrol， caffeic acid， M1 and quercitrin， may serve as markers of quality variation.

In modern society， the comorbidity of insomnia with amnesia has shown a significantly increasing incidence and become increasingly severe， emerging as a public health issue that endangers people's physical and mental health and quality of life. Anmei Dan （AMD）， originally recorded in the Shishi Milu by CHEN Shiduo in the Qing Dynasty， possesses profound theoretical foundations and distinct clinical advantages in ameliorating insomnia with amnesia. Basic research has unequivocally confirmed its definite therapeutic effects on insomnia with amnesia and revealed partial mechanisms. AMD is therefore a veritable classic prescription embodying the principle of treating different diseases with the same method for insomnia and amnesia. However， few researchers have reviewed the related research progress. This article systematically summarized the theoretical connotations of traditional Chinese medicine in treating insomnia with amnesia， delineated the multi-component material basis of AMD in ameliorating insomnia with amnesia （including various chemical components such as ginsenosides， jujubosides， and salvianolic acids）， and evaluate its multi-dimensional clinical efficacy （e.g.， prolonging total sleep time， improving sleep efficiency， and enhancing memory）. Moreover， it systematically summarizes the multi-pathway mechanisms of action. The results indicate that AMD has a clear material basis， definite clinical efficacy， and a favorable safety profile in ameliorating insomnia and amnesia. AMD may exert the therapeutic effect by regulating sleep-wake rhythms， enhancing synaptic plasticity， inhibiting neuroimmune inflammation， and modulating autophagy， oxidative stress， and energy metabolism. In conclusion， AMD exerts synergistic effects through multi-component， multi-dimensional， and multi-pathway approaches， serving as an important prescription for enriching and developing the theory of treating different diseases with the same method for insomnia with amnesia.

To understand the progress of, summarize experiences from, and analyze problems in the national schistosomiasis elimination programme, this article presented the national schistosomiasis epidemiology and surveillance in the People’s Republic of China in 2025. By the end of 2025, Shanghai Municipality, Zhejiang Province, Fujian Province, Guangdong Province and Guangxi Zhuang Autonomous Region maintained the achievement of schistosomiasis elimination, and 7 provinces of Jiangsu, Sichuan, Yunnan, Hubei, Hunan, Anhui and Jiangxi remained at the criteria of schistosomiasis transmission interruption. In 2025, there were 450 counties (cities, districts), 3 203 townships and 26 029 villages endemic for schistosomiasis in China, with a total population of 73.598 million in endemic villages. Among the 450 endemic counties (cities, districts), 421 (93.56%) achieved the criteria of schistosomiasis elimination and 29 (6.44%) reached the criteria of transmission interruption. In 2025, a total of 3 630 874 residents received immunological tests for schistosomiasis across endemic areas in China, with 31 588 seropositives identified (seroprevalence, 0.87%), and a total of 154 293 individuals received parasitological examinations, with 5 egg-positives detected. A total of 26 688 advanced schistosomiasis cases were recorded in China by the end of 2025. Of 529 683 bovines raised in schistosomiasis-endemic villages in China in 2025, 101 637 bovines received immunological tests for schistosomiasis, with 183 seropositives detected (seroprevalence, 0.18%), and 165 654 bovines received parasitological examinations, with no egg-positives identified. In 2025, Oncomelania hupensis snail survey was performed covering an area of 667 524.82 hm² in China, and 176 378.64 hm² O. hupensis snail habitats were identified, including 123.77 hm² emerging O. hupensis snail habitats and 953.71 hm² re-emerging O. hupensis snail habitats. A total of 19 283 schistosomiasis cases received chemotherapy with praziquantel in China in 2025, and 477 450 person-times and 304 279 herd-times received expanded chemotherapy, respectively. In addition, O. hupensis snail control with chemical treatment covered 116 475.10 hm² snail habitats across China in 2025, with an actual area with chemical control covering 68 510.93 hm² and an area with environmental improvements covering 1 101.84 hm². The national schistosomiasis surveillance results indicated that the mean prevalence of Schistosoma japonicum infections was both 0 among humans and bovines in 2025, and no S. japonicum infection was detected in O. hupensis snails. These data showed that the prevalence of schistosomiasis remained low in China in 2025; however, the area of O. hupensis snail habitats stayed high, with an increase in emerging and reemerging O. hupensis snail habitats. It is recommended to improve the surveillance and forecast mechanism for schistosomiasis and precisely implement the O. hupensis snail control programme in high-risk areas.

"Spirit turns but does not reverse； if it reverses， it ceases to turn" originates from the Plain Questions： Discussion on Essential Jade Plates （《素问·玉版论要篇》）. It profoundly summarizes the objectivity of life as a phenomenon subject to the laws of the universe and nature， while also expressing the subjectivity of individuals possessing systematic， stable， and ordered biological rhythms. In light of relevant ancient philosophical insights， the theory of "spirit turns but does not reverse； if it reverses， it ceases to turn" embodies the principles of constant motion in life， change according to dao （道）， orderly progression， and the rule that reversal disrupts continuity. In clinical diagnosis and treatment， one should adopt the therapeutic principle of regulating spirit to promote "spirit turning". Guiding along the trend and acting in accordance with the natural momentum must be adopted to maintain the operation of spirit turning. Adhering to constancy while recognizing variability， and prioritizing harmony above all， should be employed to ensure the orderly progress of spirit turning. Regulating qi movement serves as the driving force behind facilitating spirit turning. This will provide clinical insights and theoretical foundations for treating diseases through the concept of "regulating spirit".

"Spirit turns but does not reverse； if it reverses， it ceases to turn" originates from the Plain Questions： Discussion on Essential Jade Plates （《素问·玉版论要篇》）. It profoundly summarizes the objectivity of life as a phenomenon subject to the laws of the universe and nature， while also expressing the subjectivity of individuals possessing systematic， stable， and ordered biological rhythms. In light of relevant ancient philosophical insights， the theory of "spirit turns but does not reverse； if it reverses， it ceases to turn" embodies the principles of constant motion in life， change according to dao （道）， orderly progression， and the rule that reversal disrupts continuity. In clinical diagnosis and treatment， one should adopt the therapeutic principle of regulating spirit to promote "spirit turning". Guiding along the trend and acting in accordance with the natural momentum must be adopted to maintain the operation of spirit turning. Adhering to constancy while recognizing variability， and prioritizing harmony above all， should be employed to ensure the orderly progress of spirit turning. Regulating qi movement serves as the driving force behind facilitating spirit turning. This will provide clinical insights and theoretical foundations for treating diseases through the concept of "regulating spirit".

ObjectiveTo investigate the effects of jujuboside A （JuA） on the learning and memory abilities and histopathological changes in the rat model of vascular cognitive impairment （VCI） and explore the potential mechanisms by which JuA treats VCI. MethodsA total of 50 male SPF-grade SD rats were randomized into a sham operation group （n=10）， a blank control group （n=10）， and a modeling group （n=30）. The rats in the modeling group underwent bilateral carotid artery ligation （2-VO） for the modeling of VCI. After stabilization， the VCI rats were randomized into model， JuA （20 mg·kg^-¹）， and donepezil （0.45 mg·kg^-¹） groups. After 4 weeks of gavage， the novel object recognition and Morris water maze tests were conducted to evaluate the learning and memory abilities of rats. Nissl staining was employed to evaluate the morphology and number of hippocampal neurons. Real-time PCR was employed to measure the mRNA levels of glycogen synthase kinase-3β （GSK-3β）， cAMP response element-binding protein （CREB）， B cell lymphoma-2 （Bcl-2）， phosphatidylinositol 3-kinase （PI3K）， and protein kinase B （Akt） in the hippocampal tissue. Western blot was employed to quantify the protein levels of GSK-3β， p-GSK-3β， p-CREB， Bcl-2， PI3K， p-PI3K， Akt， and p-Akt in the hippocampal tissue. ResultCompared with the sham operation group， the model group exhibited declines in the learning and memory abilities （P<0.01）， neuronal damage and decreased neurons in the hippocampal CA1 region （P<0.01）， up-regulation in the mRNA level of GSK-3β （P<0.01）， and down-regulation in the mRNA levels of PI3K， Akt， CREB， and Bcl-2， as well as the protein levels of p-PI3K， p-Akt， p-GSK-3β， p-CREB， and Bcl-2 （P<0.01）. In comparison to the model group， both the JuA and donepezil groups demonstrated improvements in the learning and memory abilities （P<0.05， P<0.01）， with reduced neuronal damage and increased neurons （P<0.05， P<0.01）. In addition， the two groups showed down-regulation in the mRNA level of GSK-3β （P<0.01） and up-regulation in the mRNA levels of PI3K， Akt， CREB， and Bcl-2 and the protein levels of p-PI3K， p-Akt， p-GSK-3β， p-CREB， and Bcl-2 （P<0.05， P<0.01）. There were no statistically significant differences between the blank control and sham operation groups in terms of the learning and memory abilities， neuron count， and mRNA and protein levels of PI3K/Akt/GSK-3β pathway-related factors. ConclusionJuA can ameliorate the cognitive impairment in the rat model of VCI by activating the PI3K/Akt signaling pathway， reducing the apoptosis of hippocampal neurons， and alleviating the hippocampal neuronal damage.

Objective:To determine appropriate cutoff values for evaluating hypoxemia severity in patients with obstructive sleep apnea (OSA).Methods:This cross-sectional study selected data from 1, 781 young patients with obstructive sleep apnea (OSA) who underwent polysomnography in the Department of Otorhinolaryngology Head and Neck Surgery of the Sixth Medical Center of PLA General Hospital from January 2015 to June 2023. The cohort included 1, 604 males and 177 females, with a mean age of (32.6±5.3) years. The relationship between the minimum arterial oxygen saturation (MSaO 2) and the prevalence of hypertension in this population was investigated. Subjects were categorized into seven groups based on MSaO 2 levels: Group 1 (MSaO 2≥90%), Group 2 (85%≤MSaO 2<90%), Group 3 (80%≤MSaO 2<85%), Group 4 (75%≤MSaO 2<80%), Group 5 (70%≤MSaO 2<75%), Group 6 (65%≤MSaO 2<70%), and Group 7 (MSaO 2<65%). The prevalence of hypertension in each group was statistically analyzed, and the chi-square test was used to identify significant differences in hypertension prevalence. The diagnostic performance of the new versus traditional grouping methods was evaluated using receiver operating characteristic (ROC) curve analysis. Results:Among the 1, 781 OSA patients, 915 had hypertension. The prevalence of hypertension in Groups 1 to 7 was 27.8%, 42.4%, 52.2%, 54.1%, 59.5%, 70.5%, and 75.4%, respectively. Significant differences in hypertension prevalence were observed between Group 1 and other groups, Group 2 and Groups 5-7, Group 3 and Groups 6-7, and Group 4 and Group 7( χ2=187.94, P<0.001). After merging the groups based on MSaO 2 thresholds of≥90%, 90%>MSaO 2≥85%, 85%>MSaO 2≥75%, and MSaO 2<75%, the prevalence of hypertension in the new groups was 27.8%, 42.4%, 53.0%, and 71.2%, respectively, with significant differences between adjacent groups( χ2=178.99, P<0.001). ROC curve analysis revealed that the area under the curve (AUC) for the new grouping method (0.676) was higher than that for the original grouping method (0.664). Conclusions:As hypoxemia severity increases in OSA, so does the prevalence of comorbid hypertension. Using MSaO 2 cutoff values of 90%, 85%, and 75% to categorize hypoxemia severity appears more appropriate compared to the existing guideline values of 90%, 85%, and 80%.