Hepatic sinusoidal capillarization is the first event in the process of fibrogenesis， and inhibiting hepatic sinusoidal capillarization can effectively improve the pathological process of liver fibrosis. Various studies have shown that traditional Chinese medicine can significantly inhibit hepatic sinusoidal capillarization. This article systematically reviews the effective constituents， monomers， and compound prescriptions of traditional Chinese medicine， summarizes their mechanism of action in inhibiting hepatic sinusoidal capillarization， and analyzes the theoretical core of traditional Chinese medicine in inhibiting hepatic sinusoidal capillarization from the perspective of traditional Chinese medicine， in order to provide ideas and literature support for the treatment of liver fibrosis.

Objective: To investigate the longitudinal association between biological rhythm trajectories and the risk of anxiety, depression, and comorbid symptoms among college students, so as to provide a cumulative empirical basis for early psychiatric tracking and mental health warning systems. Methods: Using random cluster sampling method, a baseline survey was conducted from April to May 2019. One comprehensive university and one medical university were selected in Shangrao City, Jiangxi Province, and Hefei City, Anhui Province, respectively. A total of 1 029 first year college students were recruited as study participants, and four waves of longitudinal follow up were carried out over a period of two years. The Self rating of Biological Rhythm Disorder for Adolescents was used to assess college students biological rhythms, and using the dynamic data from the first two follow ups to construct the trajectory of biological rhythm changes. Mental health outcomes (anxiety and depressive symptoms) at the end of the follow up period were assessed using Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9. Multivariable Logistic regression models were employed to evaluate the independent predictive value of distinct lifestyle rhythm trajectories on the detection risk of long term anxiety, depression, and their comorbid symptoms. Results: The prevalence rates of anxiety, depression, and comorbid symptoms among participants were 23.5%, 22.6%, and 16.7%, respectively. Multivariable Logistic regression analysis showed that, after adjusting for confounding factors such as sex, major, smoking, and alcohol consumption, compared with the persistent low risk reference group of overall biological rhythm, the persistent high risk trajectory group of overall assessment had an increased risk of anxiety symptoms( OR=3.87, 95%CI =2.45-6.11), depressive symptoms( OR=3.18, 95%CI =1.98-5.10), and comorbid symptoms( OR=2.43, 95%CI =1.46-4.04)(all P ＜0.05).Among college students in the elevated overall assessment risk group, the risks of anxiety symptoms ( OR=1.97, 95%CI =1.22-3.17), depressive symptoms ( OR=2.13, 95%CI =1.33-3.42), and comorbid symptoms ( OR=1.81, 95%CI =1.07-3.06) were also increased (all P < 0. 05), and the various risks in the group with increased risks were also higher than those in the group with consistently low risks. Conclusions The dynamic deterioration and persistent disruption of college students lifestyle and behavioral rhythms serve as strong early warning indicators for long term anxiety and depressive symptoms. Mental health screening in colleges and universities should incorporate multi timepoint dynamic tracking of behavioral rhythms, and circadian rhythm regulation should be regarded as a core target for group level mental health interventions.

Objective:To explore the external treatment methods of hemorrhoids based on ancient books and documents; To guide clinical medication.Methods:The relevant articles on external treatment of hemorrhoids using Chinese materia medica included in Zhong Hua Yi Dian (5th edition) were retrieved. Excel 2021 was used to analyze the properties, tastes, meridian tropism, external treatment methods and drug efficacy of Chinese materia medica included in the prescriptions, and the relevant discussion contents were sorted out according to the classification of external treatment methods of hemorrhoids. Results:A total of 255 articles in ancient books were included, involving 165 prescriptions. 146 kinds of Chinese materia medica for external treatment of hemorrhoids were selected. The medicinal properties were mainly cold and warm, the main tastes were pungent, bitter and sweet, and the meridian tropism mainly involved the liver, spleen, stomach, heart, lung and large intestine meridians. Fumigation, application and application are the most widely used external treatment methods. Chinese materia medica efficacy mainly includes heat clearing drugs, surface relieving drugs, resuscitation drugs, astringent drugs, anti venom, anti insect and anti itching drugs, and tonic drugs.Conclusions:Ancient physicians treated hemorrhoids with both cold and heat, and paid equal attention to clearing heat and reducing fire, warming and activating blood circulation. They paid attention to the combination of local medication of lesions and the overall treatment of multiple meridians and multiple viscera, so as to achieve the simultaneous treatment of specimens. The treatment methods were rich, including fumigation and washing method to improve local microcirculation, application method using natural adhesive, coating method focusing on precise administration and ligation method of minimally invasive, forming a unique external treatment system, which can be used for modern clinical reference.

Objective:To analyze the awareness of and factors influencing the adjusted national immunization schedule for the diphtheria-tetanus-acellular pertussis (DTaP) vaccine among grassroots immunization service personnel in China.Methods:Based on the snowball sampling method from January to February 2025, immunization service personnel from all provinces of China were selected from the "Tingting Experts Talk" WeChat platform, with concurrent dissemination through the "National Vaccine-Preventable Diseases Communication Group" WeChat group. The questionnaire included basic demographic characteristics and knowledge of the DTaP vaccine immunization policy (13 questions in total). Respondents who answered ≥10 questions correctly were defined as being aware of the policy adjustment. The multivariable logistic regression analysis was performed to identify factors influencing awareness.Results:A total of 8 030 valid questionnaires were collected from 29 provinces, with a valid response rate of 92.91%. The overall awareness accuracy rates among the Centers for Disease Control and Prevention (CDC) personnel and the point of vaccination (POV) staff were 74.1% and 62.5%, respectively. The awareness rate of the core points of policy adjustment among the research subjects exceeded 90%. Among the questions regarding the operational details of policy implementation, the correct rate of answering questions related to the catch-up vaccination principles was relatively low (37.1%-74.0%). The multivariate logistic regression analysis showed that, compared with those with primary titles, CDC personnel with senior titles had higher mastery of the policy adjustment, with an OR (95% CI) value of 2.238 (1.343-3.730). Compared with those engaged in disease surveillance and immunization strategy research, CDC personnel with other work types had lower awareness of the policy adjustment, with an OR (95% CI) value of 0.404 (0.195-0.833). Compared with those in western regions, with primary titles, and without relevant training, POV staff in central regions, eastern regions, with intermediate titles, with senior titles, with one relevant training session, and with ≥2 relevant training sessions had better awareness of the program adjustment, with OR (95% CI) values of 1.214 (1.085-1.358), 1.412 (1.246-1.600), 1.606 (1.446-1.784), 1.737 (1.443-2.091), 2.254 (1.509-3.366), and 2.674 (1.769-3.981), respectively. Compared with those engaged in information registration/recipient notification, POV staff with vaccination services and other work types had lower awareness of the program adjustment, with OR (95% CI) values of 0.713 (0.633-0.803) and 0.508 (0.427-0.604), respectively. Conclusion:Although grassroots immunization service personnel show an insufficient mastery of certain catch-up vaccination knowledge, they demonstrate a good understanding of overall principles and routine immunization schedules shortly after the policy adjustment, which can effectively ensure an orderly transition between old and new immunization strategies.

Objective To synthesize qualitative studies on the experiences of postoperative lung cancer patients participating in pulmonary rehabilitation,aiming to comprehensively understand the barriers and facilitators influencing their engagement and to provide evidence-based insights for improving rehabilitation adherence.Methods Qualitative studies were retrieved from databases including Web of Science,PubMed,Cochrane Library,Embase,CNKI,Wanfang Data,VIPand Sinomed,with a search period spanning from database inception to January,2025.The methodological quality of eligible studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research.Extracted findings were mapped and synthesized using the Theoretical Domains Framework(TDF)and the Capability-Opportunity-Motivation-Behavior mode(COM-B).Results Ultimately,a total of 11 studies were included,yielding 48 findings.Using the Theoretical Domains Framework(TDF)and COM-B model,facilitators and barriers to pulmonary rehabilitation in postoperative lung cancer patients were mapped and consolidated into 14 categories,culminating in 2 synthesized findings.Conclusion Participation in pulmonary rehabilitation among postoperative lung cancer patients is influenced by multiple factors.Clinicians should develop patient-centered pulmonary rehabilitation plans by considering these factors and incorporating patients' attitudes and perspectives.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

OBJECTIVE To explore the diagnostic value of the guanylate binding protein 5(GBP5)gene in pa-tients infected with Mycobacterium tuberculosis(MTB).METHODS Patients who visited the Fifth People's Hos-pital of Suzhou from Jan.2024 to May 2024,as well as individuals undergoing health examinations during the same period,were selected as the study subjects.Based on the diagnostic criteria,the subjects were divided into active tuberculosis(ATB)group(230 cases),pneumonia group(207 cases),latent tuberculosis infection(LTBI)group(48 cases)and healthy control(HC)group(122 cases).Real-time quantitative reverse transcription poly-merase chain reaction was used to detect the expression level of the GBP 5 gene in the whole blood of the subjects,and receiver operating characteristic(ROC)curves were employed to analyze its diagnostic performance.RESULTS There were statistically significant differences in GBP5 gene expression among the four groups(P＜0.001).The area under the ROC curve(AUC)for GBP5 in distinguishing the ATB group from the HC group,LTBI group and pneumonia group was 0.902,0.813 and 0.745,respectively.In the ATB group,the positive de-tection rate of the GBP5 method was 67.39％,higher than that of Gene Xpert MTB/RIF(62.20％),tuberculosis culture(60.00％)and smear acid-fast staining(35.20％)(P＜0.05).When distinguishing between ATB and LTBI patients,the positive prediction value of GBP5 was 95.09％,higher than that of IGRA testing(79.92％)(P＜0.05).The expression level of GBP5 was negatively correlated with the MTB bacterial load(P＜0.001).CONCLUSIONS The detection of the GBP5 gene has important clinical significance in the auxiliary diagno-sis of tuberculosis and can serve as an effective supplement to existing diagnostic methods for tuberculosis.

Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T _NANC), time to symptom improvement (T _SI), and time of hospital stay (T _HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T _NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.

AIM:To investigate the protective ef-fect of plumbagin(PL)against pulmonary fibrosis(PF)and its possible mechanisms.METHODS:Sixty male C57BL/6 mice were randomly divided into control,bleomycin group(BLM),low dose PL group(1 mg/kg)and high dose PL group(2 mg/kg).The mice PF model was replicated using intratracheal injection of BLM(3 mg/kg),and then PL(1 or 2 mg/kg)was injected intraperitoneally for 3 weeks and the animals were executed.HE and Masson staining were used to observe morphological changes in lung tissue and collagen deposition.The activities or levels of superoxide dismutase(SOD),glutathione(GSH),malondialdehyde(MDA)and hy-droxyproline(HYP)were measured in mouse lung tissue;ELISA for interleukin-6(IL-6)in mouse lung tissue.Immunohistochemical detection of nuclear factor-related factor 2(Nrf2)and reduced nicotin-amide adenine dinucleotide phosphate oxidase 4(NOX4)positive cell expression in mouse lung tis-sue.The expression levels of α-smooth muscle ac-tin(α-SMA),collagen Ⅰ(Col Ⅰ),collagen Ⅲ(Col Ⅲ),IL-6,transforming growth factor-β1(TGF-β1),p-Smad2,Nrf2 and NOX4 were detected by Western blotting.RESULTS:Compared with the BLM group,PL treatment attenuated lung parenchymal and in-terstitial injury and extracellular matrix deposition in mice,reduced HYP content(P＜0.01,P＜0.05),de-creased protein expression of α-SMA,collagen Ⅰand Ⅲ(P＜0.01,P＜0.05),diminished IL-6 secretion(P＜0.01);improved the body's antioxidant capacity(increased SOD and GSH activity and decreased MDA content,P＜0.01,P＜0.05),significantly down-regulated TGF-β1,p-Smad2 and NOX4-positive cells and protein expression(P＜0.01,P＜0.05)and up-regulated Nrf2-positive cells and protein expression(P＜0.01,P＜0.05).CONCLUSION:PL may slow down the PF process by modulating the TGF-β1/Smad2 and Nrf2/NOX4 pathways to attenuate inflammato-ry responses and collagen deposition and improve the body's antioxidant capacity.

Objective:To analyze differences on characteristics of HIV/AIDS knowledge, beliefs and behavior among female college students who reported having sex in Zhejiang Province between 2018 and 2020, and provide reference for HIV/AIDS prevention and control among female college students.Methods:Cross-sectional surveys were conducted in October-November 2018 and November-December 2020 among female college students in 13 universities in 11 cities in Zhejiang Province, and female college students who self-reported having sexual intercourse in the past year were included as study subjects, with sample size estimates of 5 265 and 9 466 for the two surveys, respectively. The factors related to the change of relevant characteristics of the two survey subjects were analyzed. The χ2 test was used for univariate analysis and logistic regression model was used for multivariate analysis.Statistical analyses were performed with SPSS 23.0 software. Results:Of the 17 354 and 20 675 female college students surveyed in 2018 and 2020, respectively, the proportion who self-reported having had sex in the past year was 6.56% (1 139/17 354) and 4.19% (866/20 675). Multivariate logistic regression analysis showed that compared with female college students in 2018, the students who have sexual behaviour, receiving health education class by their university in the past year (a OR=1.57, 95% CI:1.29-1.91), receiving HIV testing promotion by the university in the past year (a OR=2.59,95% CI:2.13-3.14), receiving self-assessment of HIV risk by the university in the past year (a OR=2.97,95% CI:2.43-3.65), high self-efficacyfor condom use (a OR=2.00, 95% CI:1.66-2.41), receiving voluntary counseling and HIV testing (VCT) (a OR=1.81,95% CI: 1.41-2.87), perceived risk of HIV infection (a OR=2.44, 95% CI:1.32-4.54), using condoms whenever having casual sexual behaviour in the past year (a OR=3.35,95% CI:1.66-6.77) were significantly higher in 2020. Conclusions:Compared with female college students in 2018, the proportion of female college students who self-reported sexual activity decreased slightly in 2020, and the proportion of receiving HIV/AIDS lectures or health education classes, the proportion of self-rated at risk of HIV infection, the proportion of receiving VCT, the proportion of using condoms with very high confidence in self-efficacy and condom use had an increased.