ObjectiveTo elucidate the chemical composition of Danshenyin and its blood components in rats after oral administration. MethodsUltra performance liquid chromatography-quadrupole-time-of-flight tandem mass spectrometry（UPLC-Q-TOF-MS/MS） coupled with PeakView 1.2 software was used to systematically characterize and identify the components of Danshenyin aqueous extract and its migratory components in rat blood after oral administration based on the retention time， quasi-molecular ion peaks， secondary fragmentation ions， and literature reports， and a preliminary compounds identification of Salviae Miltiorrhizae Radix et Rhizoma aqueous extract， the co-decoction of Santali Albi Lignum and Amomi Fructus was carried out to attribute the chemical constituents of the aqueous extract of Danshenyin. ResultsA total of 73 compounds， including 21 phenolic acids， 23 diterpenes， 6 flavonoids， 7 organic acids， 3 volatile oils and 13 others， were identified from the aqueous extract of Danshenyin. And 36 prototypes and 15 metabolites were identified in rat plasma， the major metabolic pathways included reduction， hydration， hydroxylation， demethylation， methylation， sulfation and others， these metabolites were mainly derived from tanshinones and salvianolic acids. ConclusionThe main blood components of the aqueous extract of Danshenyin are salvianolic acids and tanshinones， which may be the material basis of the efficacy. This study can provide reference for pharmacological research， quality control， and clinical application of Danshenyin.

Objective:To analyse the effect of ultrasound-guided percutaneous liver biopsy and the coaxial biopsy needle tract radiofrequency ablation on patients diagnosed with hepatocellular carcinoma who are considered to be at risk of bleeding.Methods:The data of 117 patients with hepatocellular carcinoma who underwent coaxial biopsy needle tract radiofrequency ablation after ultrasound-guided percutaneous liver biopsy in Peking University First Hospital from March 2019 to April 2023 were retrospectively analysed. There were 95 males and 22 females, with the age of (62.0±11.8) years. A comprehensive analysis was conducted on the following variables: the pre-puncture platelet count, the international standardised ratio, anticoagulation therapy, the haemoglobin (Hb) level, the success rate of the liver puncture, the qualified rate of liver puncture specimens, the number of puncture samples, the length of hospital stay, the Hb level after puncture, bleeding within 10 days post-operation, and complications after ablation, including biliary fistula, hemothorax and organ perforation.Results:Among the 117 patients, 60 cases (51.3%) had an international normalized ratio >1.1, 40 cases (34.2%) had thrombocytopenia, that is, <150×10 9/L, and 17 cases (14.5%) received continuous anticoagulation therapy before the operation. It is evident that all 117 patients successfully completed the ultrasound-guided percutaneous liver biopsy, and that all liver biopsy specimens were qualified. The absence of biliary fistula, hemothorax, organ perforation or death in the patients post-ablation was noted. According to the adverse event evaluation criteria, version 5.0, 113 cases (96.6%) were classified as grade 1 and 4 cases (3.4%) were classified as grade 3. The Hb concentration of patients with minor bleeding (grade 1) prior to puncture was (119.7±22.2) g/L, which was significantly higher than the Hb concentration of patients with severe bleeding (grade 3), (76.0±10.4) g/L ( t=3.92, P=0.010). A meticulous examination of the data revealed that there were no statistically significant differences between the two groups with regard to pre-puncture platelet count, pre-puncture international standardised ratio, pre-puncture proportion of receiving anticoagulant drugs, length of hospital stay and number of puncture samples (all P>0.05). Conclusion:For patients with hepatocellular carcinoma who are at risk of bleeding, ultrasound-guided percutaneous liver biopsy followed by coaxial biopsy needle tract radiofrequency ablation can obtain satisfactory liver tissue samples and is relatively safe. There were differences in hemoglobin levels before puncture among patients with different bleeding after puncture.

Objective:To construct a predictive model for mortality in patients with multiple trauma combined with thoracic injuries and evaluate its predictive value.Methods:A retrospective cohort study was conducted to analyze the clinical data of 184 patients with multiple trauma combined with thoracic injuries admitted to the International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine from April 2019 to December 2023, including 129 males and 55 females, aged 19-85 years [(46.1±13.7)years]. According to the prognostic outcomes at 3-month follow-up after discharge, the patients were divided into survival group ( n=145) and death group ( n=39). Data were recorded in both groups at admission, including gender, age, and cause of injury, laboratory tests such as systolic blood pressure, oxygen saturation (SaO 2), hemoglobin (Hb), neutrophil-to-lymphocyte ratio (NLR), and lactate, combined injuries such as the number of combined injuries, number of rib fracture, bilateral rib fracture, first-rib fracture, sternum fracture, thoracic vertebral fracture, bilateral pulmonary contusion, bilateral pneumothorax, subarachnoid hemorrhage, subdural hematoma, epidural hematoma, skull fracture, skull base fracture, cervical vertebral fracture, brain herniation, cerebral contusion, lumbar vertebral fracture, pelvic and abdominal cavity hematoma, liver injury, kidney injury, spleen injury, clavicle fracture, scapular fracture, femoral fracture, and pelvic fracture, and injury scores such as shock index (SI), modified shock index (MSI), injury severity score (ISS), revised trauma score (RTS), Glasgow coma score (GCS), and thoracic trauma severity (TTS) score. Univariate binary logistic regression analysis was used to screen for risk factors of death in patients with multiple trauma combined with thoracic injuries. LASSO regression and multivariate logistic regression analysis were employed to identify predictive variables and independent risk factors for mortality in those patients and to construct a regression equation. A nomogram prediction model based on the regression equation was developed using R language. Receiver operating characteristic (ROC) curves were plotted to evaluate the discrimination of the model. The ROC curves were internally validated using the Bootstrap method with 1 000 resamples. The calibration of the model was assessed using the Hosmer-Lemeshow (H-L) goodness-of-fit test. The clinical application value of the model was evaluated using decision curve analysis (DCA) and clinical impact curve (CIC) analysis. Results:There were statistically significant differences between the survival group and the death group in systolic blood pressure, SaO 2, NLR, lactate, number of combined injuries, subarachnoid hemorrhage, subdural hematoma, skull fracture, skull base fracture, brain herniation, liver injury, SI, MSI, ISS, RTS, GCS, and TTS ( P<0.05 or 0.01). The results of the univariate binary logistic regression analysis showed that the above-mentioned related variables except for systolic blood pressure were all significantly associated with death in patients with multiple trauma combined with thoracic injuries ( P<0.05 or 0.01). Five predictive variables, TTS, GCS, brain herniation, ISS, and lactate were obtained in LASSO regression analysis. The results of the multivariate logistic regression analysis showed that GCS ( OR=0.70, 95% CI 0.58, 0.83), brain herniation ( OR=46.18, 95% CI 4.27, 499.26), TTS ( OR=1.71, 95% CI 1.30, 2.24), and lactate ( OR=1.35, 95% CI 1.01, 1.80) were independent risk factors for death in patients with multiple trauma combined with thoracic injuries ( P<0.05 or 0.01). Based on the aforementioned independent risk factors, a regression formula was constructed as follows: P=e x/(1+e x), with the x=-0.36×"GCS"+3.83×"brain herniation"+0.53×"TTS"+0.30×"lactate levels"-11.03. The area under the ROC curve (AUC) of the predictive model for mortality in patients with multiple trauma combined with thoracic injuries based on the equation was 0.97 (95% CI 0.93, 1.00). The AUC was internally validated using the Bootstrap method with 1 000 samples, resulting in an AUC of 0.97 (95% CI 0.91, 1.00). The results of the H-L goodness-of-fit test showed that the bias-corrected calibration curve of the model was in good consistence with the actual curve and both of them were close to the ideal curve. In the evaluation of the clinical application value of the predictive model, the DCA results showed that the predictive model could achieve good clinical net benefit. The CIC results showed that when the threshold probability was greater than 0.7, the model-identified high-risk patients for death highly matched the patients who actually died. Conclusion:The predictive model for mortality in patients with multiple trauma combined with thoracic injuries based on GCS, brain herniation, TTS, and lactate has good predictive performance and clinical application value.

ObjectiveTo investigate the association of SH2B1 rs7359397 （C>T） polymorphism with the progression to hepatic fibrosis in the elderly patients with metabolic dysfunction-associated steatotic liver disease （MASLD） in Beijing， China， and to provide an important genetic basis for the precise subtyping， prognostic evaluation， and individualized treatment of elderly MASLD patients in China. MethodsA total of 505 elderly patients （aged ≥65 years） who participated in regular physical examination in Mentougou Kuangshan Hospital of Beijing Jingmei Group General Hospital from November 2020 to September 2021 and were diagnosed with MASLD by abdominal ultrasound were enrolled as MASLD group， and 381 elderly population who underwent physical examination in the same community hospital during the same period of time and were not found to have MASLD by abdominal ultrasound were enrolled as control group. FibroScan was used to measure liver fat content and determine fibrosis stage. The 96-well microfluidic chip technique was used to identify SH2B1 rs7359397 polymorphism. The independent-samples t test was used for comparison of normally distributed continuous data between the two groups， and the chi-square test or the adjusted chi-square test was used for comparison of categorical data between the two groups. Univariate and multivariate Logistic regression analyses were used to identify the independent predictive factors for MASLD and its comorbidities. ResultsCompared with the control group， the MASLD group had a significantly younger age and significantly higher levels of waist circumference， hip circumference， waist-hip ratio， body mass index （BMI）， alanine aminotransferase， aspartate aminotransferase， triglyceride， platelet count， and fibrosis-4 （FIB-4） index， as well as a significantly lower level of high-density lipoprotein cholesterol （all P<0.05）. Among the 381 patients in the control group， 264 （69.29%） had genotype CC and 117 （30.71%） had genotype CT+TT， while among the 505 patients in the MASLD group， 317 （62.77%） had genotype CC and 188 （37.23%） had genotype CT+TT， suggesting that the MASLD group had a significantly higher proportion of patients with genotype CT+TT compared with the control group （χ²=4.09， P=0.043）. In the MASLD group， compared with the genotype CC group， the genotype CT+TT group had a significantly lower proportion of patients with FIB-4 ≥2 or atherosclerotic cardiovascular diseases （P<0.05）. The multivariate Logistic regression analysis showed that after adjustment for age， sex， and BMI， carrying T allele was a protective factor against progressive hepatic fibrosis （odds ratio ［OR］=0.481， 95% confidence interval ［CI］： 0.249 — 0.929， P=0.029）. In the subgroups of comorbidities with hypertension， metabolic syndrome， and obesity， genotype CT+TT was associated with a significant reduction in the risk of progressive hepatic fibrosis （hypertension： OR=0.27， 95%CI：0.09 — 0.77， P=0.014； metabolic syndrome： OR=0.30， 95%CI： 0.11 — 0.79， P=0.015； obesity： OR=0.11， 95%CI： 0.03 — 0.48， P=0.003）. After adjustment for age， sex， and BMI， in the patients with MASLD， the patients with genotype CT+TT had a significant reduction in the prevalence rate of atherosclerotic cardiovascular diseases compared with those with genotype CC （OR=0.506， 95%CI：0.336 — 0.761， P=0.001）. ConclusionSH2B1 rs7359397 （C>T） polymorphism is associated with the reduction in the risk of hepatic fibrosis and atherosclerotic cardiovascular diseases in MASLD patients.

Background The power industry is characterized by typical shift work systems, with 24-hour uninterrupted work demands, high intensity and high standard job characteristics, as well as emergent task pressure, which exposes employees to the long-term dual pressure of shift work and occupational stress and may lead to occupational burnout. It not only endangers the physical and mental health of employees, but also threaten the safe and stable operation of the power system. Objective To explore the impact of shift work and occupational stress, as well as their potential interaction, on occupational burnout among employees in power enterprises. Methods From November 2024 to April 2025, cluster sampling was used to select 1378 workers from two power companies in Fuzhou. A self-designed questionnaire, the Effort-Reward Imbalance model, and the Maslach Burnout Inventory were used to investigate the participants’ general information，shift work patterns, occupational stress, and occupational burnout. Statistical analysis was conducted using SPSS 19.0 software. Chi-square test was employed for intergroup comparison. Logistic regression was used to examine the associations between shift work, occupational stress, and job burnout. The multiplicative interaction and additive interaction between shift work and occupational stress on occupational burnout were evaluated. Results A total of 1378 questionnaires were distributed, and 1113 were valid questionnaires, with an effective rate of 80.77%. Among the participants, 37.92% were engaged in shift work, the positive rate of occupational stress was 29.83%, and the positive rate of occupational burnout was 55.80%. The logistic regression analysis showed that after adjusting for confounding factors, the risks of occupational burnout in the non-shift x occupational stress group and the shift x occupational stress group were 1.59 times (95%CI: 1.12, 2.27; P=0.01) and 4.07 times (95%CI: 2.56, 6.45; P<0.01) higher than that in the non-shift x non-occupational stress group. A multiplicative interaction (shift work and occupational stress b=0.75, P=0.01, OR=2.12, 95%CI: 1.18, 3.80) and an additive interaction (relative excess risk ratio=2.24, 95%CI: 0.54, 3.94; attributable fraction=0.55, 95%CI: 0.32, 0.78; interaction index=3.71, 95%CI: 1.47, 9.40) between shift work and occupational stress on job burnout were identified. Conclusion Shift work and occupational stress are risk factors for occupational burnout among employees in power enterprises, and there is a synergistic interaction between these two factors in terms of their impact on occupational burnout.

The therapeutic efficacy and possible mechanism of action of superficial needling therapy for knee osteoarthritis(KOA)are reviewed by analyzing relevant medical literature.Superficial needling therapy exerts certain efficacy in treating KOA,and the clinical efficacy could be further improved by combining it with conventional acupuncture,as well as Chinese medicine and other acupuncture methods alone.The therapy of stimulation of meridian qi and invigoration of yang qiare in line with the pathogenesis of KOA.Superficial needling therapy exerts certain effect on KOA by enhancing acupuncture stimulation,enlarging the treatment area,and releasing muscle and fascia.

ObjectiveTo analyze the diversity and structural characteristics of microbial communities in the rhizosphere soil of healthy and diseased Andrographis paniculata and to explore the interactions of soil， plants， and microorganisms during the occurrence of diseases. MethodsThe physicochemical properties of the rhizosphere soil of healthy and diseased A.paniculata were determined， and the composition and diversity of bacterial and fungal communities in the rhizosphere soil were analyzed by Illumina high-throughput sequencing. Furthermore， the correlations between physicochemical properties and microorganisms of the rhizosphere soil were explored. ResultsThe content of total nitrogen， total potassium， and available potassium in the rhizosphere soil of diseased A. paniculata was significantly higher than that of healthy A. paniculata. The alpha diversity and richness （operational taxonomic units） of bacterial and fungal communities in the rhizosphere soil of diseased plants decreased compared with those of healthy plants. The microbial communities in the rhizosphere soil of healthy and diseased A. paniculata showed similar composition but different relative abundance. At the phylum level， the relative abundance of Proteobacteria and Chytridiomycota significantly increased， while that of Bacteroidota significantly decreased in the rhizosphere soil of diseased plants. At the genus level， the relative abundance of Sphingomonas， Pseudomonas， and Bryobacter significantly increased， while that of RB41 showed a significant decrease in the rhizosphere soil of diseased plants. The correlation analysis showed different correlations of microbial phyla with physicochemical properties of the rhizosphere soil between healthy and diseased plants. Organic matter， alkaline nitrogen， available phosphorus， and total potassium were correlated with the relative abundance of some dominant bacterial and fungal phyla in the rhizosphere soil of healthy plants， while available nitrogen and total phosphorus were correlated with the relative abundance of some dominant bacterial and fungal phyla in the rhizosphere soil of diseased plants. ConclusionThere are differences in the diversity and richness of microbial communities in the rhizosphere soil of healthy and diseased A. paniculata. The physicochemical properties of soil may have an impact on the rhizosphere microorganisms of A. paniculata， leading to the development of diseases. The results provide a scientific basis for the prevention and ecological management of A. paniculata diseases.

ObjectiveTo analyze the diversity and structural characteristics of microbial communities in the rhizosphere soil of healthy and diseased Andrographis paniculata and to explore the interactions of soil， plants， and microorganisms during the occurrence of diseases. MethodsThe physicochemical properties of the rhizosphere soil of healthy and diseased A.paniculata were determined， and the composition and diversity of bacterial and fungal communities in the rhizosphere soil were analyzed by Illumina high-throughput sequencing. Furthermore， the correlations between physicochemical properties and microorganisms of the rhizosphere soil were explored. ResultsThe content of total nitrogen， total potassium， and available potassium in the rhizosphere soil of diseased A. paniculata was significantly higher than that of healthy A. paniculata. The alpha diversity and richness （operational taxonomic units） of bacterial and fungal communities in the rhizosphere soil of diseased plants decreased compared with those of healthy plants. The microbial communities in the rhizosphere soil of healthy and diseased A. paniculata showed similar composition but different relative abundance. At the phylum level， the relative abundance of Proteobacteria and Chytridiomycota significantly increased， while that of Bacteroidota significantly decreased in the rhizosphere soil of diseased plants. At the genus level， the relative abundance of Sphingomonas， Pseudomonas， and Bryobacter significantly increased， while that of RB41 showed a significant decrease in the rhizosphere soil of diseased plants. The correlation analysis showed different correlations of microbial phyla with physicochemical properties of the rhizosphere soil between healthy and diseased plants. Organic matter， alkaline nitrogen， available phosphorus， and total potassium were correlated with the relative abundance of some dominant bacterial and fungal phyla in the rhizosphere soil of healthy plants， while available nitrogen and total phosphorus were correlated with the relative abundance of some dominant bacterial and fungal phyla in the rhizosphere soil of diseased plants. ConclusionThere are differences in the diversity and richness of microbial communities in the rhizosphere soil of healthy and diseased A. paniculata. The physicochemical properties of soil may have an impact on the rhizosphere microorganisms of A. paniculata， leading to the development of diseases. The results provide a scientific basis for the prevention and ecological management of A. paniculata diseases.

Objective To evaluate the effectiveness and feasibility of a remote medication treatment management model for elderly patients with chronic disease at home based on mobile technology.Methods A convenient and elderly-friendly mo-bile application(hereinafter referred to as Yaoshiyi APP)was developed,and a remote medication treatment management team consisting of clinical pharmacists from tertiary hospitals,community pharmacists,and community physicians was formed.Patients from communities were selected for practical research,led by pharmacists.Based on the Yaoshiyi APP,patients were subjected to 6 months of medication treatment management practice,and the effectiveness and feasibility of the practice were evaluated.Re-sults The Yaoshiyi APP can be integrated with a variety of medical-grade wearable devices to realize the functions of automati-cally uploading monitoring data,abnormal value reminding,medication reminding,medication consultation,and medication sci-ence popularization.A total of 302 elderly patients with chronic disease at home completed the study.The results showed that phar-macists have identified and intervened in 695 cases of medication-related problems.According to the classification of medication-related problems,the top three were 247 cases(35.5％)of additional treatment,97 cases(14.0％)of unnecessary drug treat-ment,and 93 cases(13.4％)of medication compliance problems.The patient's medication adherence score(Morisky medication adherence scale-8,MMAS-8)increased from(5.85±1.57)at enrollment to(6.74±1.23)6 months after enrollment(P＜0.01).After 6 months of enrollment,the patient's satisfaction with the pharmacist's work reached a score of(4.99±0.08)out of 5.The average reduction in drug costs for patients caused by pharmacists intervening in irrational medication is(20.9±18.0)％.At the end of follow-up,93.4％of patients were proficient in using the Yaoshiyi APP.Conclusion The remote medication treatment management model for elderly patients with chronic disease at home based on mobile technology constructed in this study can ef-fectively improve patient compliance with disease monitoring and medication,ensure rational drug use,reduce medical resource waste,and receive high patient acceptance.

Objective In order to investigate the patients'medical experiences,willingness to use online diagnosis and treatment in the context of"Internet+medical health",and the factors influencing these choice of medical channels.Methods We conducted an online and offline sampling survey through a questionnaire.1 215 questionnaires were distributed,and 1 010 were valid.After looking at the basic details of the survey participants,we used a logistic regression model to find out what affects patients'willingness to see a doctor online.Results Whether patients have solved their own problem,and the degree of help on the Internet play a significant role in the willingness to recommend Internet diagnosis and treatment.In addition,with the de-crease of age,the improvement of education level,the increase of economic development level of the city where the respondents live,and the decrease of medical expenditure in the past year,residents'willingness to use Internet diagnosis and treatment will show a gradually increasing trend.Conclusion Internet diagnosis and treatment in the future still need to further meet the needs of multi-group medical services,improve and perfect service quality and medical insurance management,to achieve"full node"coverage,"full chain"supervision.