Sepsis remains a challenge in critical care worldwide，with intestinal microbiome dysbiosis implicated in its onset，progression，and organ dysfunction. Germ-free （GF） and human microbiota-colonized animals，by eliminating confounding from resident microbiota and combining induction methods such as CLP/LPS/live-bacterial challenge with fecal microbiota transplantation （FMT） and mono- or combined colonization，enable causal tests and dissection of microbiota-host interactions and drug mechanisms. This review summarizes the application of GF and related models in sepsis research. At the immune level，TLR-related signaling and pathogen community-induced suppression of IRF3-dependent defense affect innate immunity and pathogen clearance. At the barrier level，reprogramming of tight junction proteins and increased permeability drive gut-derived amplification. At the metabolic level，short-chain fatty acids and bile acids function as metabolic valves influencing GPR/HDAC signaling. At the epigenetic level，EZH2 and histone deacetylation emerge as druggable targets. We further synthesize anti-sepsis evidence for traditional Chinese medicine （TCM），mainly from conventional animals and clinical studies，discussing how formulae （e.g.，Xuebijing，Shenfu，and Huanglian Jiedu Tang） and active constituents （e.g.，berberine，luteolin，ginsenosides，and resveratrol） may act through microbiota-related and direct host pathways，with FMT/metabolite replenishment enabling further causal testing. Finally，we propose a closed-loop GF-humanized-clinical stratification paradigm for integrated evaluation of microecology，epigenetics，immunity，and organ outcomes，providing a translational path for precision prevention and treatment based on TCM and the microbiome.

The term"heat stroke"originates from the integration of modern traditional Chinese and Western medicine.In clinical practice,the complementary advantages of the two medical systems can significantly enhance the clinical diagnosis and treatment level of heat stroke.Through comprehensively analyzes the traditional Chinese medicine(TCM)nomenclature for heat stroke,proposing that heat stroke is a type of sunstroke characterized by intense and pure yang nature,specifically referring to symptoms caused directly or indirectly by hot weather.It can be referenced under the categories of Zhongye,Shuwen,Yinshu/Yangshu,Shujue,and Shufeng for treatment.The article reviews the TCM diagnostic and therapeutic thinking for heat stroke,summarizing its etiology and pathogenesis,including summerheat directly entering the Yangming,heat entering the heart and nutrient-blood aspects,evil combined with water(post-emergency),dual injury of qi and fluid(post-mild recovery),and phlegm-stasis obstructing collaterals(post-severe recovery).Based on years of clinical experience and combining the different clinical manifestations of heat stroke with TCM's four diagnostic methods,the article proposes a treatment plan that integrates Chinese and Western medicine,combining disease differentiation with syndrome differentiation.The main syndromes summarized include high fever with spasms(Yangming heat excess syndrome),diarrhea(Yangming fu syndrome-intestinal sweating),high fever with coma(heat entering the heart-nutrient syndrome),high fever with convulsions(extreme heat generating wind syndrome),heat stroke-induced coagulopathy(heat entering the blood aspect syndrome),edema after fluid resuscitation(Taiyang water retention syndrome),recovery phase(dual injury of qi and fluid syndrome),and sequelae(phlegm-stasis obstructing collaterals syndrome).For treatment,Baihu Jia Renshen decotion combined with Zengye Chengqi decotion is used for nourishing yin and increasing fluids,relaxing tendons,and stopping spasms for Yangming heat excess syndrome;Baihu decotion combined with Zengye decotion for clearing summerheat and nourishing yin for Yangming fu syndrome-intestinal sweating;Qingying decotion for clearing the nutrient aspect and cooling blood,penetrating heat,and nourishing yin for heat entering the heart-nutrient syndrome;Lingjiao Gouteng decotion for clearing heat and cooling the liver,extinguishing wind,and calming spasms for extreme heat generating wind syndrome;Wuling powder for draining and eliminating water retention for Taiyang water retention syndrome;Wang's Qing Shu Yiqi decotion for clearing summerheat and reducing fever,benefiting qi,and generating fluids for dual injury of qi and fluid syndrome;and Sanjia powder for clearing residual heat,resolving phlegm,and removing stasis from collaterals for phlegm-stasis obstructing collaterals syndrome.Starting from TCM theory and linking it with practice,the article combines Western disease differentiation with TCM syndrome differentiation,aiming to provide new ideas for the clinical treatment of heat stroke.

China's vast territory has experienced significant climate change trends in recent years,characterized by reduced regional temperature differences and prolonged high-temperature durations.In some areas,summer temperatures can exceed 39℃.Consequently,the incidence of heat stroke has risen annually,emerging as a critical and life-threatening emergency threatening public health.Ethnomedicine,developed through long-term practice across diverse ethnic groups,has cultivated regionally tailored therapeutic approaches for heat stroke based on local climatic conditions and population-specific physiological traits,offering varied treatment options for patients in different areas.However,the absence of unified ethnic medical diagnostic and therapeutic guidelines has constrained the broader application and advancement of these practices.To leverage the unique advantages of ethnic medicine in heat stroke management and enhance clinical standardization,led by the China Medical Association of Minorities:collaborated with authoritative institutions and experts in multi-ethnic medicine.Through systematic collation of ethnic medical experiences in heat stroke prevention and treatment,the team formulated the expert consensus on multi-ethnic medical diagnosis and treatment of heat stroke(2024).This consensus synthesizes shared principles across ethnic medical systems while integrating their distinct theoretical frameworks and clinical practices,yielding scientifically rigorous,practical,and widely applicable recommendations to guide clinical interventions in traditional Chinese medicine(TCM)and ethnic medicine.While ethnic medical systems differ in their etiological and pathophysiological interpretations of heat stroke,they collectively emphasize holistic regulation and adaptive treatment strategies aligned with seasonal and geographical contexts.For instance,TCM,Zhuang medicine,Miao medicine,Mongolian medicine,and Tibetan medicine employ unique methodologies:such as harmonizing qi and blood,balancing body fluids,and dispelling dampness:to address heat stroke through comprehensive interventions.These approaches include oral formulations,external therapies,specialized acupuncture-moxibustion techniques,and herbal baths,demonstrating rich clinical value.The establishment of this consensus lays a foundational framework for the standardized application of ethnic medicine in heat stroke prevention and treatment.It provides innovative insights and practical evidence for optimizing integrated rescue protocols and advancing the evidence-based integration of traditional and modern medical practices.

The term"heat stroke"originates from the integration of modern traditional Chinese and Western medicine.In clinical practice,the complementary advantages of the two medical systems can significantly enhance the clinical diagnosis and treatment level of heat stroke.Through comprehensively analyzes the traditional Chinese medicine(TCM)nomenclature for heat stroke,proposing that heat stroke is a type of sunstroke characterized by intense and pure yang nature,specifically referring to symptoms caused directly or indirectly by hot weather.It can be referenced under the categories of Zhongye,Shuwen,Yinshu/Yangshu,Shujue,and Shufeng for treatment.The article reviews the TCM diagnostic and therapeutic thinking for heat stroke,summarizing its etiology and pathogenesis,including summerheat directly entering the Yangming,heat entering the heart and nutrient-blood aspects,evil combined with water(post-emergency),dual injury of qi and fluid(post-mild recovery),and phlegm-stasis obstructing collaterals(post-severe recovery).Based on years of clinical experience and combining the different clinical manifestations of heat stroke with TCM's four diagnostic methods,the article proposes a treatment plan that integrates Chinese and Western medicine,combining disease differentiation with syndrome differentiation.The main syndromes summarized include high fever with spasms(Yangming heat excess syndrome),diarrhea(Yangming fu syndrome-intestinal sweating),high fever with coma(heat entering the heart-nutrient syndrome),high fever with convulsions(extreme heat generating wind syndrome),heat stroke-induced coagulopathy(heat entering the blood aspect syndrome),edema after fluid resuscitation(Taiyang water retention syndrome),recovery phase(dual injury of qi and fluid syndrome),and sequelae(phlegm-stasis obstructing collaterals syndrome).For treatment,Baihu Jia Renshen decotion combined with Zengye Chengqi decotion is used for nourishing yin and increasing fluids,relaxing tendons,and stopping spasms for Yangming heat excess syndrome;Baihu decotion combined with Zengye decotion for clearing summerheat and nourishing yin for Yangming fu syndrome-intestinal sweating;Qingying decotion for clearing the nutrient aspect and cooling blood,penetrating heat,and nourishing yin for heat entering the heart-nutrient syndrome;Lingjiao Gouteng decotion for clearing heat and cooling the liver,extinguishing wind,and calming spasms for extreme heat generating wind syndrome;Wuling powder for draining and eliminating water retention for Taiyang water retention syndrome;Wang's Qing Shu Yiqi decotion for clearing summerheat and reducing fever,benefiting qi,and generating fluids for dual injury of qi and fluid syndrome;and Sanjia powder for clearing residual heat,resolving phlegm,and removing stasis from collaterals for phlegm-stasis obstructing collaterals syndrome.Starting from TCM theory and linking it with practice,the article combines Western disease differentiation with TCM syndrome differentiation,aiming to provide new ideas for the clinical treatment of heat stroke.

China's vast territory has experienced significant climate change trends in recent years,characterized by reduced regional temperature differences and prolonged high-temperature durations.In some areas,summer temperatures can exceed 39℃.Consequently,the incidence of heat stroke has risen annually,emerging as a critical and life-threatening emergency threatening public health.Ethnomedicine,developed through long-term practice across diverse ethnic groups,has cultivated regionally tailored therapeutic approaches for heat stroke based on local climatic conditions and population-specific physiological traits,offering varied treatment options for patients in different areas.However,the absence of unified ethnic medical diagnostic and therapeutic guidelines has constrained the broader application and advancement of these practices.To leverage the unique advantages of ethnic medicine in heat stroke management and enhance clinical standardization,led by the China Medical Association of Minorities:collaborated with authoritative institutions and experts in multi-ethnic medicine.Through systematic collation of ethnic medical experiences in heat stroke prevention and treatment,the team formulated the expert consensus on multi-ethnic medical diagnosis and treatment of heat stroke(2024).This consensus synthesizes shared principles across ethnic medical systems while integrating their distinct theoretical frameworks and clinical practices,yielding scientifically rigorous,practical,and widely applicable recommendations to guide clinical interventions in traditional Chinese medicine(TCM)and ethnic medicine.While ethnic medical systems differ in their etiological and pathophysiological interpretations of heat stroke,they collectively emphasize holistic regulation and adaptive treatment strategies aligned with seasonal and geographical contexts.For instance,TCM,Zhuang medicine,Miao medicine,Mongolian medicine,and Tibetan medicine employ unique methodologies:such as harmonizing qi and blood,balancing body fluids,and dispelling dampness:to address heat stroke through comprehensive interventions.These approaches include oral formulations,external therapies,specialized acupuncture-moxibustion techniques,and herbal baths,demonstrating rich clinical value.The establishment of this consensus lays a foundational framework for the standardized application of ethnic medicine in heat stroke prevention and treatment.It provides innovative insights and practical evidence for optimizing integrated rescue protocols and advancing the evidence-based integration of traditional and modern medical practices.

Sepsis is one of the common diseases in the intensive care unit (ICU),and its pathophysiological mechanism is characterized by a dysregulated host response to infection leading to multiple organ dysfunction. Statistical data indicate that approximately 20.6％ of ICU patients have sepsis. Sepsis is prone to cause gastrointestinal dysfunction and acute damage to organs such as the lungs,heart,and kidneys. During sepsis,the intestinal mucosal barrier,as an essential component of normal intestinal physiological function,effectively prevents harmful pathogens from entering the organs and the bloodstream,thereby reducing the risk of organ damage associated with sepsis. However,due to this vulnerability,the intestine also becomes one of the first organs attacked by bacteria and viruses. Therefore,maintaining the integrity of the intestinal mucosal barrier is crucial for improving the absorption of enteral nutrients in patients with severe sepsis and enhancing their ability against microbial entry into the bloodstream,thereby inhibiting the progression of sepsis,which carries significant clinical importance. The Mongolian medicine Bateri-7 is a commonly used formula in Mongolian hospitals in Inner Mongolia Autonomous Region,known for its antibacterial properties,and is applied in the treatment of inflammatory diseases such as enteritis and pneumonia. This medication is routinely used in our hospital's department of emergency and critical care medicine for treating gastrointestinal dysfunction in sepsis,severe pneumonia,and other intestinal inflammatory diseases. This paper will focus on discussing the definition of sepsis,its pathogenesis,the function of the intestinal barrier,and the therapeutic and protective effects of Mongolian medicine Bateri-7 in addressing intestinal barrier dysfunction in sepsis patients,providing theoretical support for the clinical application of Bateri-7.

Sepsis is one of the common diseases in the intensive care unit (ICU),and its pathophysiological mechanism is characterized by a dysregulated host response to infection leading to multiple organ dysfunction. Statistical data indicate that approximately 20.6％ of ICU patients have sepsis. Sepsis is prone to cause gastrointestinal dysfunction and acute damage to organs such as the lungs,heart,and kidneys. During sepsis,the intestinal mucosal barrier,as an essential component of normal intestinal physiological function,effectively prevents harmful pathogens from entering the organs and the bloodstream,thereby reducing the risk of organ damage associated with sepsis. However,due to this vulnerability,the intestine also becomes one of the first organs attacked by bacteria and viruses. Therefore,maintaining the integrity of the intestinal mucosal barrier is crucial for improving the absorption of enteral nutrients in patients with severe sepsis and enhancing their ability against microbial entry into the bloodstream,thereby inhibiting the progression of sepsis,which carries significant clinical importance. The Mongolian medicine Bateri-7 is a commonly used formula in Mongolian hospitals in Inner Mongolia Autonomous Region,known for its antibacterial properties,and is applied in the treatment of inflammatory diseases such as enteritis and pneumonia. This medication is routinely used in our hospital's department of emergency and critical care medicine for treating gastrointestinal dysfunction in sepsis,severe pneumonia,and other intestinal inflammatory diseases. This paper will focus on discussing the definition of sepsis,its pathogenesis,the function of the intestinal barrier,and the therapeutic and protective effects of Mongolian medicine Bateri-7 in addressing intestinal barrier dysfunction in sepsis patients,providing theoretical support for the clinical application of Bateri-7.

Objective To analyze the distribution and epidemiological characteristics of patients in pre-hospital emergency in Hohhot. Methods The data of 28 325 pre-hospital emergency patients in 7 first-aid stations in Hohhot from January 1st to December 31st in 2016 were analyzed retrospectively. The gender, age, call time, disease spectrum of patients served as investigation elements, the data were collected into Excel 2010 form, and statistical analysis was carried out. Results Among 28 325 pre-hospital emergency patients, there were 15 973 male (56.39%) and 12 352 female (43.61%), with the ratio of male to female of 1.29:1. The age of patients were 1 day-108 years, with the majority of patients aged 51-60 years, which accounting for 16.08% (4 554/28 325). The top 6 of diseases were trauma [33.10% (9 376/28 325)], neurological system diseases [16.81% (4 762/28 325)], circulatory system diseases [12.31% (3 486/28 325)], respiratory system diseases [7.62% (2 159/28 325)], digestive system diseases [5.68% (1 609/28 325)], acute poisoning [5.02% (1 422/28 325)]. The peak period of call for help was 09:00-11:00 (12.55%, 3 554/28 325), and 1 small peak occurred at 15:00-17:00 (11.22%, 3 179/28 325). The highest number of patients with pre-hospital care happened in summer (26.22%, 7 428/28 325), followed by autumn (24.94%, 7 065/28 325) and winter (24.83, 7 032/28 325), and the lowest in spring (24.01%, 6 800/28 325). The peak incidence of traumatic patients was in November (11.13%, 1 044/9 376), the most patients with nervous system diseases were found in October (9.97%, 475/4 762), and the most patients with circulatory system diseases were found in July (11.16%, 389/3 486). Conclusions The first aid patients in Hohhot were mainly suffered from diseases of trauma, nervous system and circulatory system, more men than women, most in 51-60 years old patients, and the summer was the peak season. Therefore, the establishment of trauma center in emergency department, strengthening the health education of high-risk groups and the primary prevention of patients with cardiovascular and cerebrovascular diseases, scientific and effective use of medical resources can improve the success rate of pre-hospital rescue.