Hepatic fibrosis refers to excessive accumulation and abnormal proliferation of fibrous connective tissue in the liver triggered by multiple pathogenic factors， and it may progress to liver cirrhosis， portal hypertension， and liver cancer. The pathological mechanisms of hepatic fibrosis involve hepatocyte injury， inflammatory cell infiltration with the release of inflammatory mediators， hepatic stellate cell activation， and extracellular matrix deposition. Recent studies have focused on mitochondrial dysfunction in disease progression， including the molecular pathways for hepatic fibrosis driven by metabolic disorders， energy deficiency， oxidative stress， mitochondrial dynamic imbalance， and autophagic dysfunction， all of which can induce liver injury. This article reviews the latest advances in hepatic fibrosis， in order to provide new therapeutic strategies for clinical management.

Objective To investigate the influencing factors of stroke patients with hypertension and their compliance with antihypertensive drugs, and to provide targeted intervention measures for stroke prevention in hypertensive patients.  Methods Using the method of multi-stage cluster sampling, a total of 59,434 permanent residents aged 40 and above were selected from 48 monitoring sites in 9 cities of Hebei Province from December 2019 to December 2020. Unconditional logistic regression analysis was used to explore the influencing factors of stroke complicated with hypertension and the compliance of patients with antihypertensive drugs.  Results Among the 59 434 subjects, the prevalence rate of stroke was 4.33% and the prevalence rate of stroke complicated with hypertension was 82.47%. The results of univariate analysis showed that the proportion of women, rural areas, dyslipidemia, diabetes, obesity, and people with family history of stroke was higher in stroke patients with hypertension, and the difference was statistically significant (P<0.05). Multivariate logistic regression analysis showed that rural areas, dyslipidemia, diabetes, obesity, and family history of stroke significantly increased the risk of stroke, and the OR (95%CI) values were 1.29 (1.03-1.62), 1.39 (1.12-1.72), 1.58 (1.25-1.99), 1.61 (1.22-2.12) and 1.60 (1.26-2.04), respectively. Among stroke patients with hypertension, 92.71% of patients took antihypertensive drugs. It was found that women's compliance with antihypertensive drugs was good, with an OR (95%CI) value of 1.46 (1.01-2.09).  Conclusion The prevalence rate of stroke complicated with hypertension is high in people aged 40 and above in Hebei Province. Hypertensive people should lower blood lipids, control blood glucose, and lose weight as soon as possible to prevent the occurrence of stroke.

Based on the understanding of "kidney storing essence and marrow nourishing bone"， and in combination with the modern pathological characteristics of ankylosing spondylitis （AS）， this paper systematically elucidates the dynamic pathogenesis evolution of "heat bi （inflammatory activity）-marrow deficiency （bone marrow edema）-bone damage （bone structural damage）" in AS. It is proposed that in the heat bi stage， there is kidney deficiency with pathogenic invasion and heat congesting the meridians. In the marrow deficiency stage， heat consumes kidney essence， leading to marrow injury and collateral obstruction. In the bone damage stage， kidney exhaustion and marrow emptiness occur， with phlegm-stasis congealing on bone. Accordingly， a stage-specific treatment strategy for AS is established. In the heat bi stage， treatment focuses on supplementing the kidney and replenishing essence， clearing heat and unblocking collaterals. In the marrow deficiency stage， the main approach is to supplement the kidney and benefit marrow， unblock collaterals and reduce edema. In the bone damage stage， it is suggested to supplement the kidney and replenish essence， benefit marrow and strengthen bone， resolve phlegm and expel stasis.

Based on the understanding of "kidney storing essence and marrow nourishing bone"， and in combination with the modern pathological characteristics of ankylosing spondylitis （AS）， this paper systematically elucidates the dynamic pathogenesis evolution of "heat bi （inflammatory activity）-marrow deficiency （bone marrow edema）-bone damage （bone structural damage）" in AS. It is proposed that in the heat bi stage， there is kidney deficiency with pathogenic invasion and heat congesting the meridians. In the marrow deficiency stage， heat consumes kidney essence， leading to marrow injury and collateral obstruction. In the bone damage stage， kidney exhaustion and marrow emptiness occur， with phlegm-stasis congealing on bone. Accordingly， a stage-specific treatment strategy for AS is established. In the heat bi stage， treatment focuses on supplementing the kidney and replenishing essence， clearing heat and unblocking collaterals. In the marrow deficiency stage， the main approach is to supplement the kidney and benefit marrow， unblock collaterals and reduce edema. In the bone damage stage， it is suggested to supplement the kidney and replenish essence， benefit marrow and strengthen bone， resolve phlegm and expel stasis.

ObjectiveTo observe the clinical efficacy and safety of Tangning Tongluo tablets in the treatment of nonproliferative diabetic retinopathy （DR）. MethodsFourteen research centers participated in this study， which spanned a time interval from September 2021 to May 2023. A total of 240 patients with nonproliferative DR were included and randomly assigned into an observation group （120 cases） and a control group （120 cases）. The observation group was treated with Tangning Tongluo tablets， and the control group with calcium dobesilate capsules. Both groups were treated for 24 consecutive weeks. The vision， DR progression rate， retinal microhemangioma， hemorrhage area， exudation area， glycosylated hemoglobin （HbA1c） level， and TCM syndrome score were assessed before and after treatment， and the safety was observed. ResultsThe vision changed in both groups after treatment （P<0.05）， and the observation group showed higher best corrected visual acuity （BCVA） than the control group （P<0.05）. The DR progression was slow with similar rates in the two groups. The fundus hemorrhage area and exudation area did not change significantly after treatment in both groups， while the observation group outperformed the control group in reducing the fundus hemorrhage area and exudation area. There was no significant difference in the number of microhemangiomas between the two groups before treatment. After treatment， the number of microhemangiomas decreased in both the observation group （Z=-1.437， P<0.05） and the control group （Z=-2.238， P<0.05）， and it showed no significant difference between the two groups. As the treatment time prolonged， the number of microhemangiomas gradually decreased in both groups. There was no significant difference in the HbA1c level between the two groups before treatment. After treatment， the decline in the HbA1c level showed no significant difference between the two groups. The TCM syndrome score did not have a statistically significant difference between the two groups before treatment. After treatment， neither the TCM syndrome score nor the response rate had significant difference between the two groups. With the extension of the treatment time， both groups showed amelioration of TCM syndrome compared with the baseline. ConclusionTangning Tongluo tablets are safe and effective in the treatment of nonproliferative DR， being capable of improving vision and reducing hemorrhage and exudation in the fundus.

Objective To analyze the clinical and pathogenic characteristics,as well as influencing factors for the prognosis of patients with Candida bloodstream infection(CBSI).Methods Clinical data of 47 CBSI patients in a hospital from January 2015 to September 2024 were collected.Distribution of departments and infection strains,an-timicrobial resistance,and influencing factors for the poor prognosis of patients were analyzed.Results A total of 51 strains of Candida were detected from 47 CBSI patients,mainly from the intensive care unit(ICU;n=25,53.2％),department of intestinal fistula surgery(n=8,17.0％),and department of respiratory medicine(n=4,8.6％),et al.The main detected pathogens were Candida albicans(n=29,56.9％),Candida tropicalis(n=7,13.7％),Candida glabrata(n=6,11.8％),and Candida parapsilosis(n=6,11.8％).Resistance rate of Candida albi-cans to fluconazole was 11.5％(3/26).According to the prognosis results,patients were divided into a good prog-nosis group(n=26,55.3％)and a poor prognosis group(n=21,44.7％).Univariate analysis showed statistically significant differences between patients in the good prognosis group and the poor prognosis group in terms of abso-lute neutrophil count,ICU admission,mechanical ventilation,tracheal intubation,gastrointestinal hemorrhage/per-foration,and surgical treatment(lesion clearance,drainage or unblocking for obstruction)(all P＜0.05).Prelimi-nary multivariate logistic regression analysis showed that gastrointestinal hemorrhage/perforation was a potential risk factor for the poor prognosis in CBSI patients(OR=11.156,95％CI:1.434-86.809,P=0.021).Conclusion The detected CBSI strains are mainly Candida albicans,and gastrointestinal hemorrhage/perforation may be one of the potential risk factors affecting the prognosis of CBSI patients.These patients are generally in critical condition and should be detected and treated as early as possible to improve their prognosis.Due to the small amount of speci-mens,further research is still needed for confirmation.

Objective To establish a rapid and accurate droplet digital PCR(ddPCR)detection method for detecting Staphylococcus aureus(SA)in laboratory animals and the environment.Methods Using the heat-stable nuclease gene(nuc)of SA as the target gene,a pair of specific primers and probes are designed within its conserved region.Optimize the reaction conditions,test the dynamic range,and evaluate the specificity and stability of the method.Using the same template,test reactions were performed with both ddPCR and real-time quantitative PCR(qPCR)method to assess the interchangeability between the two approaches.Finally,the method is applied to the detection of various clinical samples.Results The kinetic range of the established SA ddPCR method is 100～15 000 copies/μL,with a detection limit of 2.5 copies and a quantification limit of 10 copies;The specificity of this method was tested,and only SA showed positive droplets,while no positive droplets were found for other pathogens;After measuring three parallel samples,the standard deviation and relative standard deviation were calculated.It was found that within the dynamic detection interval of ddPCR,as the target copy number gradually decreased,the relative standard deviation showed an upward trend,but remained below 25％.This result indicates that the detection method has good stability.Conclusions The established ddPCR method for detecting SA has the advantages of high sensitivity,strong specificity,good stability,and good reproducibility.This method can be applied for the detection of SA in laboratory animals.

Objective To establish a rapid and accurate droplet digital PCR(ddPCR)detection method for detecting Staphylococcus aureus(SA)in laboratory animals and the environment.Methods Using the heat-stable nuclease gene(nuc)of SA as the target gene,a pair of specific primers and probes are designed within its conserved region.Optimize the reaction conditions,test the dynamic range,and evaluate the specificity and stability of the method.Using the same template,test reactions were performed with both ddPCR and real-time quantitative PCR(qPCR)method to assess the interchangeability between the two approaches.Finally,the method is applied to the detection of various clinical samples.Results The kinetic range of the established SA ddPCR method is 100～15 000 copies/μL,with a detection limit of 2.5 copies and a quantification limit of 10 copies;The specificity of this method was tested,and only SA showed positive droplets,while no positive droplets were found for other pathogens;After measuring three parallel samples,the standard deviation and relative standard deviation were calculated.It was found that within the dynamic detection interval of ddPCR,as the target copy number gradually decreased,the relative standard deviation showed an upward trend,but remained below 25％.This result indicates that the detection method has good stability.Conclusions The established ddPCR method for detecting SA has the advantages of high sensitivity,strong specificity,good stability,and good reproducibility.This method can be applied for the detection of SA in laboratory animals.

Informal caregivers play an important role in chronic disease management, and their level of caregiver activation directly affects the quality of care and health outcomes of patients with chronic diseases. This article summarizes the concept, assessment tools, current status, influencing factors, and interventions of caregiver activation among informal caregivers of patients with chronic diseases, aiming to provide a reference for research on caregiver activation.

Objective To develop an innovative minimally invasive rotary-cutting surgical system for axillary osmidrosis,and conduct clinical validation.Methods The design concept,technical principles and system composition of the innovative minimally invasive rotary-cutting surgical system for axillary osmidrosis were introduced.A total of 73 patients(146 axillae)with axillary osmidrosis were enrolled as subjects,and underwent surgery using the newly developed surgical system.Clinical validation of the system was performed by evaluating postoperative scarring,odor elimination rate,postoperative complication incidence,and patient satisfaction.Results The study demonstrated favorable clinical outcomes in the following aspects:postoperative scarring,odor elimination rate,postoperative complication incidence,and patient satisfaction.Conclusion The minimally invasive rotary-cutting surgical system for axillary osmidrosis is rationally designed.The rotary-cutting puncture device is safe,effective,minimally invasive,and convenient for axillary osmidrosis surgery,warranting further clinical validation and widespread application.