OBJECTIVE To study the improvement effect and mechanism of Tripterygium wilfordii multiglucoside （TWM） on nephrotic syndrome in rats. METHODS The nephrotic syndrome model was established by intravenous injection of adriamycin via the tail vein. The modeling rats were randomly divided into the model group （distilled water）， prednisone group （10 mg/kg）， and TWM high- and low-dose groups （10 and 5 mg/kg， respectively）. Additionally， blank group （distilled water） without model induction was established. Each group consisted of 9 rats. Rats in each group were administered the corresponding drugs or distilled water by gavage， once a day， for 6 consecutive weeks. The histopathological morphology of kidney tissues in rats was observed； the levels of 24-hour urinary protein （24 h-UTP） and serum biochemical indicators [albumin （ALB）， blood urea nitrogen （BUN）， serum creatinine （SCr）， cholesterol （CHOL）， and triglyceride （TG）] in rats were determined； the levels of oxidative stress indicators [superoxide dismutase （SOD）， malondialdehyde （MDA）] in kidney tissue of rats were determined； expressions of hypoxia-inducible factor-1α （HIF-1α）/microRNA-155-5p （miR-155-5p）/nuclear factor erythriod 2- related factor 2 （Nrf2） signaling pathway-related mRNA and protein in the renal tissues of rats were detected. RESULTS Compared with the blank group， the rats in the model group exhibited disordered renal tissue structure， with a small amount of glomerular necrosis and edema of the renal tubular epithelial cells. 24 h-UTP， serum levels of SCr， BUN， CHOL and TG， MDA content， mRNA and protein expressions of HIF-1α and Keap1 as well as the expression of miR-155-5p in renal tissues were increased significantly （ P ＜0.05）. Serum level of ALB， SOD level in renal tissue as well as mRNA and protein expressions of Nrf2 were decreased significantly （ P ＜0.05）. Compared with the model group， TWM high-dose and low-dose groups exhibited significant improvements in renal injury， with notable reversals in the levels of the above quantitative indicators （ P ＜0.05）. CONCLUSIONS TWM can alleviate oxidative stress-induced damage and thereby improve nephrotic syndrome in rats by regulating the HIF-1α/miR-155-5p/Nrf2 signaling pathway.

ObjectiveThis paper aims to investigate and evaluate the staged efficacy and safety of the representative empirical prescription of the “Zhu Ke Jiao” theory， Qijia Rougan prescription， combined with entecavir in the treatment of hepatic fibrosis in chronic hepatitis B. MethodsA multicenter randomized controlled clinical study was conducted， and 101 patients diagnosed with chronic hepatitis B-related hepatic fibrosis （CHB-HF） who met the diagnosis and inclusion criteria were randomly assigned to an observation group （Qijia Rougan prescription + entecavir） and a control group （entecavir）. The treatment duration was 24 weeks. Liver stiffness measurement （LSM）， fibrosis-4 index （FIB-4）， portal vein diameter， hepatitis B serology， biochemical indicators， hepatic fibrosis markers in serum ［hyaluronic acid （HA）， laminin （LN）， procollagen Ⅲ peptide （PⅢP）， and type Ⅳ collagen （Ⅳ-C）］， and traditional Chinese medicine syndrome scores were used as efficacy evaluation indicators. Efficacy assessments and explorations of different staged subgroups of Qijia Rougan prescription were conducted according to LSM values based on the Metavir pathological staging standard. ResultsA total of 98 cases were included for statistical analysis， with 49 cases in the observation group and 49 in the control group. The general data of the patients in both groups were comparable. Compared with the same group before treatment， the observation group showed a significant reduction in LSM and FIB-4 （P<0.01）， as well as notable improvements in LN， Ⅳ-C， and various TCM syndrome scores （P<0.05， P<0.01）. When compared to the control group after treatment， the observation group demonstrated significant improvements in LSM， FIB-4， and various TCM syndrome score indicators （P<0.05， P<0.01）， indicating that the observation group performed better than the control group. Subgroup analysis of the regression of hepatic fibrosis stages showed that compared to the same group before treatment， the observation group had better improvement in regression of stages F2 and F3 （P<0.05）. When compared to the control group after treatment， the observation group exhibited superior improvement in regression of stage F3 （P<0.05）. No adverse events occurred in either group during the treatment period. ConclusionCompared with entecavir alone， the combination of Qijia Rougan prescription and entecavir significantly improves the degree of hepatic fibrosis and clinical TCM symptoms in patients. The optimal intervention period is primarily during stage F3， which is a potential “interception” point of the “Zhu Ke Jiao” theory.

Objective To explore the factors affecting the quality of psychological assistance hotline connections in Shaanxi Province, and to provide a basis for optimizing services. Methods A total of 149 calls with suicidal tendencies were included from January to March 2022, and data were collected by 31 trained assessors through standardized questionnaires (general information, suicide risk, emotional intensity, and wiring characteristics). Results The results showed that 56.38% of the callers were female, with age groups concentrated between ≤ 18 years old (29.53%) and 19-34 years old (43.62%). The call duration was mainly between 31 and 45 minutes (50.34%). Operators conducted a suicide risk assessment on the callers, with 38.9% having a comprehensive assessment, 38.9% having an incomplete assessment, and 22.1% having no assessment. The main mental disorders of the callers were depression (48.32%), anxiety (15.44%), and bipolar disorder (14.77%), with 25.50% having comorbidities of ≥ 2 disorders. Emotional scores were as follows: depression (4.11 ± 0.76), sadness (3.97 ± 1.03), and despair (3.78 ± 1.05). There were significant differences in depression, anger, despair, and sadness among the callers with different levels of danger (t=4.79, 3.35, 15.79, 4.24, all P<0.05). Women had higher levels of fear than men (t=3.10, P<0.01). The longer the call duration, the higher the level of despair (t=5.66, P<0.01). Multiple regression analysis showed that incomplete suicide risk assessment by operators (B=-2.36), general procedures for operators' connections (B=5.44), and technical factors (B=2.01) significantly affected the quality of psychological assistance hotlines (all P<0.05). Conclusion Callers with suicidal tendencies generally have serious mental and psychological problems and prominent negative emotions. Strengthening the suicide risk assessment ability of operators and standardizing processes and service attitudes are key to improving the quality of psychological assistance hotlines.

OBJECTIVE To explore the application effect of ticagrelor combined with aspirin antiplatelet therapy in high-risk non-disabling ischemic cerebrovascular events （HR-NICE）. METHODS A total of 232 patients with HR-NICE treated at the First Affiliated Hospital of Nanyang Medical College from January 1， 2023 to January 1， 2025 were retrospectively selected. According to different antiplatelet regimens， the patients were divided into three groups： group A （78 cases） received clopidogrel 300 mg as a loading dose on the first day， followed by clopidogrel 75 mg， qd combined with aspirin 100 mg， qd； group B （69 cases） received ticagrelor 120 mg as a loading dose on the first day， followed by ticagrelor 60 mg， bid combined with aspirin 100 mg， qd； group C （85 cases） received ticagrelor 180 mg as a loading dose on the first day， followed by ticagrelor 90 mg， bid combined with aspirin 100 mg， qd. All groups received dual-antiplatelet therapy for 21 days and were then switched to aspirin monotherapy. The primary outcome [incidence of early neurological deterioration （END）] and secondary outcomes， including incidence of ischemic events within 90 days post-discharge， favorable prognosis at 30/90 days， and incidence of bleeding events within 90 days， were compared among the three groups. Logistic regression was used to analyze the relationship between different antiplatelet regimens and END. Interaction terms between treatment regimen and demographic and clinical baseline characteristics were further included to evaluate the interaction effect between treatment regimen and END risk in different subgroups. Propensity score matching （PSM） was performed for sensitivity analysis. RESULTS For the primary outcome， the incidence of END in group C was significantly lower than that in group A （ P ＜0.05）. For secondary outcomes， there were no statistically significant differences among the three groups in the incidence of ischemic events within 90 days post-discharge， favorable prognosis at 30/90 days （ P ＞0.05）. The incidence of minor bleeding events in groups B and C was significantly higher than that in group A （ P ＜0.05）， while no significant differences were observed among the three groups in moderate or severe bleeding events （ P ＞0.05）. Interaction analysis showed that ischemic cerebrovascular disease， Age-Blood Pressure-Clinical Feature-Duration-Diabetes Score （ABCD2）， REACH risk score， and Essen Stroke Risk Score （ESSEN） had significant interactions with treatment regimen （ P ＜0.05）. Among patients with ischemic cerebrovascular disease， ABCD2≥6 points， REACH risk score≥6 points， or ESSEN≥3 points， regimens B or C were associated with a lower risk of END compared with regimen A. The PSM results were generally consistent with the analysis before matching. CONCLUSIONS Ticagrelor， especially the 90 mg bid regimen， plus aspirin， was associated with a lower risk of END in patients with HR-NICE， but increased the risk of minor bleeding events. Patients with ischemic cerebrovascular disease and higher ABCD2， REACH risk score， or ESSEN may be potential beneficiaries of this combination regimen.

Objective To explore the correlation between alterations in intestinal microbiota composition and abnormal cytokine expression in patients with gastric cancer. Methods Fecal and peripheral blood samples were collected from 81 patients with gastric cancer (gastric cancer group) and 85 healthy subjects (healthy control group). Fecal bacterial DNA was sequenced through 16S rRNA gene amplicon sequencing, and the serum levels of 17 cytokines were measured with the AimPlex multiplex assay technology: IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-15, IL-17A, TNF-α, TNF-β, GM-CSF, G-CSF, IFN-γ, IP-10, MCP-1, and VEGF-A. Results In the gastric cancer group, the abundances of 11 butyrate-producing bacteria, including certain genera of the Lachnospiraceae family (such as Lachnospira and Roseburia) and Faecalibacterium, considerably decreased. By contrast, the abundances of nine bacterial taxa, including Escherichia–Shigella, Streptococcus, Veillonella, and Parabacteroides, significantly increased. Correlation analysis showed that the decrease in the abundance of butyrate-producing bacteria were significantly negatively correlated with the high expression levels of pro-angiogenic and immunosuppressive cytokines in the gastric cancer group, including IP-10, IL-10, MCP-1, IL-8, IL-6, and VEGF-A. However, the decrease was significantly positively correlated with the downregulation of antitumor immune-related cytokines, including IL-2, IL-17A, IL-1β, TNF-β, and GM-CSF. Conversely, the enriched bacterial taxa exhibited opposite correlation patterns with these cytokines. Conclusion A close correlation is observed between intestinal microbiota dysbiosis and abnormal cytokine expression in patients with gastric cancer. The findings suggest that restoring the intestinal microbiota through fecal microbiota transplantation is a promising strategy for regulating cytokines and is a potential research direction for the adjuvant therapy of gastric cancer.

Cardiotoxicity induced by antineoplastic agents is an important factor affecting the prognosis of cancer patients. This article systematically summarizes the clinical manifestations of cardiotoxicity caused by chemotherapeutic drugs, molecular targeted cancer therapies, and immunotherapeutic drugs, and identifies the core injury mechanisms, including cardiomyocyte apoptosis, oxidative stress, and mitochondrial dysfunction. In Traditional Chinese Medicine (TCM) theory, anticancer drug-induced cardiotoxicity falls under the category of “heat toxins” characterized by dual deficiency of qi and blood, upward flaming of heart heat, stagnation of the heart vessels, and meridian obstruction induced by phlegm-dampness. Therefore, by reviewing the preventive and therapeutic effects and the underlying mechanisms of tonic medicines, interior heat-clearing medicines, blood-circulating and stasis-resolving medicines, phlegm-transforming, cough-suppressing and panting-relieving medicines, and interior-warming medicines, this paper concludes that TCM prevention and treatment of this condition adheres to the formulation principle of “reinforcing healthy qi, removing toxins, and resolving blood stasis”. Its mechanisms of action—including antioxidation effects, regulation of autophagic balance, antagonism of inflammatory responses, and improvement of microcirculation—are highly consistent with modern medical treatment strategies (e.g., dexrazoxane for inhibiting iron-dependent oxidative stress, statins for anti-inflammatory effects). This study provides theoretical support and practical guidance for the collaborative and precise prevention and treatment of anticancer drug-induced cardiotoxicity through the integration of traditional Chinese and Western medicine.

Objective To analyze the infection status and epidemic trends of soil-borne nematode infections in Yubei, Chongqing City, in 2010,2021, and 2022. Methods The local populations from four survey sites of four towns in 2010 and five sites of five towns in 2021 and 2022 were surveyed regarding their basic information using a unified form. Fecal samples of the participants were collected and tested for soil-borne nematode infections using the modified Kato-Katz thick smear method. Results In 2010, 2 049 participants were surveyed, followed by 1 000 participants in 2021 and 2022. The overall prevalence of parasitic infections declined significantly from 3.86% to 0.20%. In 2010, soil-transmitted nematode included hookworms(3.81%) and roundworms(0.29%). In 2021, the infection rates of roundworms and hookworms were 1.70% and 0.10% respectively. Notably, only Ascaris was identified in 2022(0.20%). The≥60 age group consistently exhibited the highest infection rates across all surveys, followed by the 40-59 age group. The infection rates of males in the three surveys were 3.31%,1.92%, and 0.20% respectively, and those of females were 4.37%, 1.46%, and 0.20% respectively. There was no statistically significant difference in the infection rates between males and females. Educational attainment was inversely associated with infection; in 2010, the highest prevalence was observed among those with primary education or below, whereas in 2021, illiterate or semi-literate individuals showed the highest susceptibility. The occupational distribution of infections in 2010 indicated that retirees (8.33%), farmers(4.86%), and homemakers or unemployed individuals(3.45%)were the most affected. However, in 2021 and 2022, farmers emerged as the predominant occupational group with soil-transmitted nematode infections. Conclusions The infection rate of soil-borne nematodes showed a decreasing trend in Yubei, and the infection species changed from hookworms in 2010 to Ascaris in 2022. Farmers, the elderly, and people with low education levels should continue to be the focus of preventive and control efforts.

Objective:To identify independent risk factors for chronic critical illness (CCI) secondary to severe pneumonia and to develop and validate a clinical prediction model.Methods:A retrospective cohort study was conducted using electronic medical records from 415 patients with severe pneumonia admitted between January 2023 and March 2024. Patients were randomly divided into a training set ( n = 290) and a validation set ( n = 125) at a 7:3 ratio. Univariate and multivariate logistic regression analyses were used to identify independent risk factors, and a nomogram was constructed. The model’s discriminative ability, calibration, and clinical utility were assessed using receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA). Results:The overall incidence of CCI was 23.13% (96/415). Multivariate analysis identified five independent predictors: virus infection ( OR = 13.00, 95% CI: 5.07–33.35, P < 0.001), mechanical ventilation ≥72 hours ( OR = 8.06, 95% CI: 3.68–20.09, P < 0.001), neutrophil-to-albumin ratio (NAR) ( OR = 27848, 95% CI: 193.93–5542274.11, P < 0.001), oxygenation index ( OR =1.09, 95% CI: 1.01–1.09, P < 0.001), and age ( OR = 0.94, 95% CI: 0.91–0.97, P < 0.001). The model demonstrated excellent performance in both sets: training set AUC = 0.96 (95% CI: 0.94–0.98), sensitivity 0.93, specificity 0.89, Brier score 0.09; validation set AUC = 0.93 (95% CI: 0.88–0.98), sensitivity 0.89, specificity 0.64, Brier score 0.13. Calibration curves showed high consistency between predicted and observed risks (mean absolute error < 3%), and DCA indicated significant net clinical benefit within the threshold probability range of 15–60%. Conclusions:The developed prediction model integrates etiological, inflammatory, metabolic, and respiratory support parameters and demonstrates outstanding predictive performance (AUC > 0.90). It may serve as a quantitative tool for early risk stratification and intervention in patients with severe pneumonia. Further multicenter external validation and exploration of integrating dynamic biomarker monitoring are recommended.

Bacillus velezensis DJ1 exhibits broad-spectrum antagonistic activity against diverse phytopathogenic fungi, while its biocontrol mechanisms against Fusarium graminearum, the causal agent of maize stalk rot, remain poorly characterized. In this study, we integrated genomics and transcriptomics to elucidate the antifungal mechanisms of strain DJ1. The results demonstrated that DJ1 inhibited F. graminearum with the efficacy of 64.4%, while its polyketide crude extract achieved the control efficacy of 55% in pot experiments against this disease. Whole-genome sequencing revealed a single circular chromosome (3 929 792 bp, GC content of 47%) harboring 12 biosynthetic gene clusters for secondary metabolites, six of which encoded known antimicrobial compounds (macrolactin H, bacillaene, difficidin, surfactin, fengycin, and bacilysin). Transcriptomic analysis identified 243 differentially expressed genes (152 upregulated and 91 downregulated, P < 0.05), which were potentially associated with the antagonistic activity against F. graminearum. KEGG enrichment analysis highlighted activation (P < 0.05) of cysteine/methionine metabolism, pentose phosphate pathway, and polyketide biosynthesis pathways, indicating that DJ1 employed synergistic strategies involving antimicrobial compound synthesis, energy metabolism enhancement, and nutrient competition to suppress pathogens. This study provides a theoretical foundation for developing novel microbial resources and application technologies to combat phytopathogenic fungi.
Fusarium/drug effects* ; Bacillus/metabolism* ; Plant Diseases/prevention & control* ; Antifungal Agents/pharmacology* ; Genomics ; Zea mays/microbiology* ; Transcriptome ; Gene Expression Profiling ; Antibiosis ; Multigene Family ; Multiomics

Forensic medicine has been designated as a first-level discipline,presenting new opportunities and challenges for the development of forensic medicine.Since the 1980s,the establishment of foren-sic medicine discipline and the cultivation of high-level forensic talents have become hot topics in the development of forensic medicine in China.Since the 13th Five-Year Plan,the forensic team of Shanxi Medical University has been aiming at the forefront,proposing the development goals of"Five First-class"and the discipline development path"Six Major Achievements".It has selected benchmark disci-plines,identified gaps in disciplinary development,unified thoughts,formulated completion timelines,concentrated superior resources,assigned tasks to individuals,and created an"Organized Fill-in-the-Blank Format"forensic medicine discipline construction model with the characteristics of the new era.The construction model of forensic medicine has achieved good results in the goals,discipline frame-work,scientific research,talent cultivation,discipline team and platform construction,forming a rela-tively complete discipline construction and management system,and accumulating valuable experience for the construction of first-level discipline and high-level talent cultivation of forensic medicine.