ObjectiveTo explore the potential mechanisms by which Myristica fragrans prevents and treats atherosclerosis （AS）. MethodsThe major active components of Myristica fragrans and their shared targets with AS were obtained from databases. The shared targets were subjected to pathway enrichment analysis and PPI network construction using the ClusterProfile package and the STRING database. Molecular docking between key targets and major active components was performed using AutoDock. Gene expression data from early and late， as well as stable and unstable AS plaques， were used to validate changes of key targets and major pathways during AS progression. Western blot， flow cytometry， YO-PRO-1/PI staining， and TUNEL staining were applied to verify the main mechanisms. ResultsNine active components of Myristica fragrans interacted with 293 AS-related targets， among which eight components acted on an average of 57.0% of the shared targets. Gene ontology （GO） and Kyoto encyclopedia of genes and genomes （KEGG） enrichment analyses indicated that the anti-AS effects mainly involved oxidative stress， inflammation， lipid metabolism， fluid shear stress， and apoptosis pathways. PPI network revealed JUN， CASP3， MAPK3， and AKT1 as key targets mainly involved in regulating apoptosis. Molecular docking showed stable binding conformations and high affinities between major components and these targets. Integrated analysis of gene expression in early and late， as well as stable and unstable AS plaques， showed significant enrichment of leukocyte apoptosis pathways in late and unstable plaques. Cell experiments further confirmed that Myristica fragrans significantly reduced Cleaved-CASP3（P=0.04）and p-MAPK3（P=0.000 3）levels， increased p-AKT1（P=0.004）levels， and inhibited macrophage apoptosis. ConclusionMyristica fragrans potentially interferes with AS development by modulating pathways related to oxidative stress， inflammation， lipid metabolism， fluid shear stress， and apoptosis， with CASP3， MAPK3， and AKT1 serving as key targets mediating its anti-apoptotic and anti-AS effects.

Hepatic fibrosis is a complex dynamic process caused by multiple chronic pathogenic factors， characterized by excessive accumulation of liver extracellular matrix and abnormal liver structure and function. If anti-fibrotic treatment is not performed in time， it can progress to liver cirrhosis and even liver cancer. Hepatic fibrosis has a complex pathogenesis， and previous studies mainly focused on the activation of hepatic stellate cells. Recent studies have shown that myeloid cells have the potential of multi-directional differentiation and can also participate in the development and progression of hepatic fibrosis. This article systematically reviews the role and regulatory mechanism of myeloid cells in hepatic fibrosis， in order to provide a reference for clinical diagnosis and targeted therapy.

Objective: To characterize the serological profile, RHD genetic spectrum, and their frequencies among pregnant women preliminary screened as RhD-negative and weak positive in Qingdao and surrounding areas, and correlate these findings with unexpected antibody detection results, thereby providing testing recommendations and suggestions for such individuals. Methods: Blood samples of pregnant women who were initially identified as RhD negative and weak positive in hospitals in Qingdao and surrounding areas over the past five years were collected. Different cloned IgG anti-D antibodies were used for RhD negative confirmation experiments. RHD genotyping was performed by combining PCR-SSP and Sanger sequencing. Unexpected antibody screening and identification were carried out using test tube method and microcolumn gel card. The immunologic status of newborns delivered by anti-D pregnant women was also tracked. Results: A total of 602 blood samples were collected from pregnant women initially identified as RhD-negative and weak positive. Among them, 569 (94.5%) were confirmed as RhD-negative in the RhD confirmation test, and 33 (5.5%) were D variant phenotype. Except for 4 cases where no definite mutations were found, gene analysis revealed 474 (78.7%) D-negative cases with 5 genotypes (RHD 01N.01, RHD 01N.03, RHD 01N.16, RHD 01N.05, and 1 new allele), 90 (15.0%) Del cases with 2 genotypes (RHD 01EL.01, and RHD 01EL.18), 23 (3.8%) weak D cases with 2 genotypes (RHD 15 and 1 new allele), and 11 (1.8%) partial D cases with 2 genotypes (RHD 06.03.01 and RHD 05.04). Anti-D and complex antibodies containing anti-D were detected in 96 RhD-negative and partial D pregnant women (15.9%). After injection of anti-D immunoglobulin, One O-type RhD-negative pregnant woman delivered a newborn with hyperbilirubinemia. The newborn was typed to be B Del, and anti-D was detected in both serum and eluate. Conclusion: The serological profiles, RHD gene types and frequencies among RhD negative pregnant women in Qingdao and surrounding areas are basically consistent with domestic published data. Pregnancy can stimulate anti-D production in D-negative and partial D individuals. However, anti-D antibody has not been detected in Del type pregnant women. Since anti-D immunoglobulin can binds to Del type red blood cells, its administration is not recommended for Del type pregnant women.

Objective To analyze the risk factors for poor prognosis in young and middle-aged patients with acute myocardial infarction (AMI), and to construct a prediction model for poor prognosis based on risk factors. Methods A total of 326 young and middle-aged patients with AMI admitted to Chengdu Third People's Hospital were selected between March 2023 and June 2025, and were followed up for 6 months after discharge. Based on their prognosis status, these patients were divided into a poor prognosis group (n=40) and a good prognosis group (n=286). Clinical data were collected. Univariate and multivariate logistic regression analyses were conducted to identify risk factors for poor prognosis, and a prediction model was constructed. The predictive performance of the model was evaluated using the receiver operating characteristic (ROC) curve. Results Compared with the good prognosis group, the poor prognosis group exhibited a higher proportion of hypertension, higher Global Registry of Acute Coronary Events (GRACE) scores, elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, and higher neutrophil-to-lymphocyte ratios (NLR), whereas the left ventricular ejection fraction (LVEF) was lower (P<0.05). Logistic regression analysis indicated that a high GRACE score, elevated NT-proBNP and NLR levels, and low LVEF were risk factors for poor prognosis (P<0.05). Based on these risk factors, a model was constructed as logit(P)=-18.333 + 0.086 × GRACE score + 0.005 × NT-proBNP + 0.843 × NLR - 0.083 × LVEF. The ROC curve analysis found that the area under the curve of this model in predicting poor prognosis was 0.967, which was higher than that of any single indicator used alone for prediction (z=4.431, 3.712, 3.705, 5.329, P<0.05). Conclusion GRACE score, NT-proBNP level, NLR and LVEF are risk factors influencing poor prognosis in young and middle-aged patients with AMI. The prediction model based on these factors demonstrates good predictive performance.

Employing bibliometric analysis methods， this paper retrieved literature on doctor-patient conversation analysis from the China National Knowledge Infrastructure （CNKI） and Web of Science Core Collection （WOSCC） databases from their establishment to March 18， 2024. It analyzed various characteristics with CiteSpace and explored the research status， hotspots， and frontier trends of doctor-patient conversation analysis through visual analysis. The results found that among the 114 documents from CNKI and 337 documents from WOSCC， the United Kingdom and the United States occupied a core position in the research， while Shanxi University and the University of California system demonstrated outstanding productivity in the Chinese and English databases， respectively. International institutional cooperation was close， whereas domestic cooperation was relatively weak. Several scholars， both at home and abroad， had a considerable number of publications and citations. High-impact papers in China were relatively insufficient， and research themes were diverse. Keyword analysis indicated that research hotspots have shifted toward the role of doctor-patient conversations in constructing patient‐centered doctor-patient relationships， while online medical contexts represented an emerging research content.

OBJECTIVE To optimize the forming process of Kaixin granules and establish its physical fingerprint.METHODS Using particle forming rate， hygroscopicity rate， dissolution rate， and angle of repose as indices， the key process parameters of the granule forming process were determined by Plackett-Burman design. The analytic hierarchy process （AHP） combined with the entropy weight method was used to comprehensively weight the indices， and the forming process of Kaixin granules was optimized and validated by Box-Behnken response surface methodology. A physical fingerprint of Kaixin granules was established based on the following physical indices： angle of repose， Hausner ratio， bulk density， tapped density， moisture content， hygroscopicity ratio， and relative uniformity index， with similarity evaluation was performed. Cluster analysis and partial least squares discriminant analysis （PLS-DA） were performed using SPSS 20.0 and the SPSSPRO online analysis platform， respectively.RESULTS The key process parameters were ethanol volume fraction， ethanol amount， and the drug-excipient ratio. The optimal forming conditions were as follows： ethanol volume fraction of 87%， ethanol amount of 27%， and a drug-excipient ratio of 1∶1. Validation showed that the average comprehensive scores of three batches were 97.82， with an RSD of 0.19%. The similarity of the physical fingerprints of ten batches of Kaixin granules prepared under the optimal forming process were greater than 0.98. The results of cluster analysis showed that the ten batches were divided into two groups： S4， S5， S7， S8 and S10 in one cluster， and S1-S3， S6 and S9 in another. The variable importance in projection values of Hausner ratio， relative uniformity index， bulk density， and moisture content were greater than 1.CONCLUSIONS The optimized forming process is stable and feasible. The established physical fingerprint can effectively characterize the overall physical properties of Kaixin granules. Hausner ratio， relative uniformity index， bulk density， and moisture content are the key physical indices.

Pharmaceutical patents,as a critical mechanism to incentivize medical innovation,carry complex ethical considerations due to their close association with humans'basic rights to life and health.The conflicts between rights to life and health and patent rights,the imbalance in drug accessibility caused by patent protection,the abuse of the patent system in practice,and the ethical risks of patent information asymmetry together constitute the primary obstacles to the healthy development of pharmaceutical patent ethics.Responsible innovation,as a comprehensive governance strategy,provides theoretical support for the ethical governance of pharmaceutical patents through its framework of anticipation,reflection,deliberation,and responsiveness.Drawing on the practical cases of the Supplementary Protection Certificate system in the European Union and the drug patent linkage system in the United States,this paper explored the methodology for implementing ethical balance under the framework of responsible innovation.Based on these,recommendations were proposed to improve China's pharmaceutical patent ethical governance system,including improving the pharmaceutical patent linkage system and presetting a new patent licensing framework to enhance the orderliness and predictability of pharmaceutical market access;establishing a social impact assessment system and an ethics review committee to continuously reflect on the effects of the pharmaceutical patent system on price,accessibility,and ethics;creating a multi-party consultation platform to promote information sharing and technical cooperation and ensure a balance of interests among all parties;and establishing an emergency response team and optimizing the compulsory licensing procedures to flexibly respond to changes in public health needs.

Allergen immunotherapy（AIT）can alter the natural course of allergic diseases through immunomodulatory mechanisms and maintain the efficacy after completion. The induction of immune tolerance by AIT is considered to be effective treatment and the mechanism involves the participation of a variety of immune cells，including effector T cells，B cells，dendritic cells，innate lymphoid cells，mast cells and basophils. Studies have found that a variety of immune cells in peripheral blood changed during AIT treatment and the changes of some immune cells were related to the efficacy of AIT，which may provide some theoretical reference for practical clinical activities and may become potential biomarkers for predicting and evaluating the efficacy of AIT. This article reviews the changes of peripheral blood immune cells in the treatment of AIT.

Objective:To explore the implementation and effectiveness evaluation of an online-offline blended teaching method based on Outcome-Based Education(OBE)concept in integrated curriculum.Methods:A total of 28 students from Class 1 of the grade 2017 Information Management program,who underwent the traditional classroom teaching method before the reform of the Basic Medical Concepts course,were selected as the control group.Their evaluation was based on final exam scores(70%)and experimental scores(30%).In contrast,29 students from Class 1 of the grade 2019 Information Management program,who experienced the OBE teaching concept combined with online-offline blended teaching after the reform,were selected as the experimental group.Their evaluation included final exam scores(60%),experimental scores(20%),regular performance(10%),and online course performance(10%).The total scores,excellence rates,and course satisfaction were compared between the two groups.Result:The experimental group showed higher total scores,excellence rates,and course satisfaction compared to the control group(P＜0.01).Conclusion:In the teaching of integrated curriculum,optimizing and integrating online resources and offline classroom teaching based on the OBE concept,reforming the teaching evaluation method,and forming a scientific and reasonable comprehensive evaluation system are important ways and measures to achieve better teaching results in blended teaching.

Cancer-related fatigue(CRF)is an adverse symptom associated with cancer and its treatments,with a clinical inci-dence rate ranging from 60%to 90%,severely impacting patients'quality of life.The pathogenesis of CRF is complex,involving the interaction of multiple mechanisms such as inflammatory cytokine dysregulation,neuroendocrine disorders,and mitochondrial dysfunc-tion.Although existing clinical interventions like central nervous system stimulants and exercise interventions can partially alleviate symptoms,they are limited by side effects and applicability constraints.Traditional Chinese medicine(TCM)shows unique potential in the clinical treatment of CRF by exerting a variety of pharmacological effects.Therapeutic approaches including acupuncture,moxibus-tion,traditional Chinese herbal formulations,as well as Chinese herbal preparations and extracts,have been proven to significantly im-prove fatigue status in CRF patients.This article systematically reviews the internal relationship between the modern pathological mech-anism of CRF and the pathogenesis of"consumptive disease"of TCM,and conducts evidence-based evaluation of the existing TCM in-tervention programs,so as to provide a new theoretical basis and treatment strategy for the clinical prevention and treatment of CRF.