This paper summarizes Professor AI Rudi's experience in the diagnosis and treatment of skin pruritus based on the "unity of restoring form， regulating qi， and harmonizing spirit"， employing internal herbal medicine combined with external treatments. It is believed that the core pathogenesis of pruritus is the "imbalance of form， qi， and spirit"， with disturbed spirit as the onset， disordered qi as the key pathogenic factor， and physical changes as the manifestation of the disease. The treatment principle follows "restoring form-regulating qi-harmonizing spirit"， with a combination of internal and external therapies， and differentiation based on deficiency and excess. For excess conditions caused by pathogenic disturbances to the heart spirit， treatment is based on different patterns of wind-heat， damp-heat， and blood-heat， using Sangye （Morus alba）-Sangbaipi （Morus alba cortex）-Longchi （Draconis os） to disperse wind and clear heat， calm the spirit； Difuzi （Kochia scoparia）-Qinghao （Artemisia annua）-Tanxiang （Santalum album） to clear damp-heat and aromatically open the spirit； Mudanpi （Paeonia suffruticosa）-Chuanxiong （Ligusticum chuanxiong）-Shuiniujiao （Bubalus bubalis cornua） to cool the blood， activate circulation， and calm the spirit. For deficiency conditions caused by insufficient nourishment of the heart spirit， treatment is based on patterns of qi deficiency or blood deficiency， using Huangqi （Astragalus membranaceus）-Fuping （Lemna minor）-Wuweizi （Schisandra chinensis） to tonify the qi and stabilize the exterior； Heshouwu （Polygonum multiflorum）-Jili （Tribulus terrestris）-Shouwuteng （Polygonum multiflorum vine） to nourish the blood， moisten dryness， and calm the spirit. External treatments integrate traditional Chinese medicine therapies such as medicinal baths， gua sha， and ear acupuncture， with custom herbal wash formulas for restoring form， jojoba oil gua sha for regulating qi， and ear seed therapy using Wangbuliuxing （Vaccaria segetalis） for harmonizing the spirit， achieving a holistic treatment effect for form， qi， and spirit.

ObjectiveTo investigate the expression level of HBV cccDNA in patients in the convalescence stage of hepatitis B virus-related acute-on-chronic liver failure （HBV-ACLF） and its correlation with HBV markers and liver histopathological changes. MethodsA total of 30 patients in the convalescence stage of HBV-ACL who were hospitalized in The Ninth Hospital of Nanchang from January 2015 to October 2023 were enrolled as liver failure group， and 9 patients with chronic hepatitis B （CHB）， matched for sex and age， were enrolled as control group. The content of HBV cccDNA in liver tissue was measured， and its correlation with clinical data and laboratory markers was analyzed. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and a one-way analysis of variance or the Kruskal-Wallis H test was used for comparison between multiple groups； the Fisher’s exact test was used for comparison of categorical data between groups. A Spearman correlation analysis was performed. ResultsThe liver failure group had a significantly lower content of HBV cccDNA in liver tissue than the control group （-0.92±0.70 log₁₀ copies/cell vs -0.13±0.91 log₁₀ copies/cell， t=2.761， P=0.009）. In the liver failure group， there was no significant difference in the content of HBV cccDNA in liver tissue between the HBeAg-positive patients and the HBeAg-negative patients （P>0.05）； there was no significant difference in the content of HBV cccDNA in liver tissue between the patients with different grades （G0-G2， G3， and G4） of liver inflammatory activity （P>0.05）； there was no significant difference in the content of HBV cccDNA in liver tissue between the patients with different stages （S0-S2， S3， and S4） of liver fibrosis （P>0.05）； there was no significant difference in the content of HBV cccDNA in liver tissue between the patients with negative HBV DNA and those with positive HBV DNA （P>0.05）. For the liver failure group， the content of HBV cccDNA in liver tissue was positively correlated with the content of HBV DNA in liver tissue （r=0.426， P=0.043） and was not significantly correlated with the content of HBV DNA in serum （P>0.05）. ConclusionThere is a significant reduction in the content of HBV cccDNA in liver tissue in the convalescence stage of HBV-ACLF. HBV cccDNA exists continuously and stably in liver tissue and can better reflect the persistent infection and replication of HBV than HBV DNA in serum and liver tissue.

ObjectiveTo establish a model that can quickly identify the aroma components in different parts of Nardostachys jatamansi， so as to provide a quality control basis for the market circulation and clinical use of N. jatamansi. MethodsHeadspace solid-phase microextraction-gas chromatography-mass spectrometry（HS-SPME-GC-MS） combined with Smart aroma database and National Institute of Standards and Technology（NIST） database were used to characterize the aroma components in different parts of N. jatamansi， and the aroma components were quantified according to relative response factor（RRF） and three internal standards， and the markers of aroma differences in different parts of N. jatamansi were identified by orthogonal partial least squares-discriminant analysis（OPLS-DA） and cluster thermal analysis based on variable importance in the projection（VIP） value >1 and P<0.01. The odor data of different parts of N. jatamansi were collected by Heracles Ⅱ Neo ultra-fast gas phase electronic nose， and the correlation between compound types of aroma components collected by the ultra-fast gas phase electronic nose and the detection results of HS-SPME-GC-MS was investigated by drawing odor fingerprints and odor response radargrams. Chromatographic peak information with distinguishing ability≥0.700 and peak area≥200 was selected as sensor data， and the rapid identification model of different parts of N. jatamansi was established by principal component analysis（PCA）， discriminant factor alysis（DFA）， soft independent modeling of class analogies（SIMCA） and statistical quality control analysis（SQCA）. ResultsThe HS-SPME-GC-MS results showed that there were 28 common components in the underground and aboveground parts of N. jatamansi， of which 22 could be quantified and 12 significantly different components were screened out. Among these 12 components， the contents of five components（ethyl isovalerate， 2-pentylfuran， benzyl alcohol， nonanal and glacial acetic acid，） in the aboveground part of N. jatamansi were significantly higher than those in the underground part（P<0.01）， the contents of β-ionone， patchouli alcohol， α-caryophyllene， linalyl butyrate， valencene， 1，8-cineole and p-cymene in the underground part of N. jatamansi were significantly higher than those in the aboveground part（P<0.01）. Heracles Ⅱ Neo electronic nose results showed that the PCA discrimination index of the underground and aboveground parts of N. jatamansi was 82， and the contribution rates of the principal component factors were 99.94% and 99.89% when 2 and 3 principal components were extracted， respectively. The contribution rate of the discriminant factor 1 of the DFA model constructed on the basis of PCA was 100%， the validation score of the SIMCA model for discrimination of the two parts was 99， and SQCA could clearly distinguish different parts of N. jatamansi. ConclusionHS-SPME-GC-MS can clarify the differential markers of underground and aboveground parts of N. jatamansi. The four analytical models provided by Heracles Ⅱ Neo electronic nose（PCA， DFA， SIMCA and SQCA） can realize the rapid identification of different parts of N. jatamansi. Combining the two results， it is speculated that terpenes and carboxylic acids may be the main factors contributing to the difference in aroma between the underground and aboveground parts of N. jatamansi.

This paper summarizes Professor AI Rudi's clinical experience in treating skin abscesses using the method of "three parts and six methods"， which emphasize a combined internal and external therapeutic approach. He identifies retained pathogenic heat in the skin as the key etiological factor and proposes treatment principles tailored to the anatomical location of the lesions. For abscesses in the upper part of the body （head， face and neck）， wind-heat and blood-heat are considered dominant， and the treatment focuses on dispersing the exterior， clearing heat， cooling the blood， and reducing swelling， with custom formulations such as self-fomulated Shufeng Xiaodu Decoction （疏风消毒饮） and Jiedu Xiaozhong Decoction （解毒消肿汤）. For those in the middle part of the body （chest， abdomen， back and upper limbs）， constrained heat and deficiency-heat predominate， and the treatment aims to relieve internal heat stagnation， reduce swelling， and expel toxins， using formulations like self-fomulated Qinggan Jiedu Decoction （清肝解毒汤） and Xiaozhong Erchen Decoction （消肿二陈汤）. For abscesses in the lower part of the body in the （buttocks， perineum and lower limbs）， damp-heat and stagnant heat are the main patterns， and the strategy is to clear damp-heat and resolve blood stasis， with formulations such as self-fomulated Jiedu Simiao Powder （解毒四妙散） and Qingjie Sanyu Decoction （清解散瘀汤）. External therapies are equally emphasized： for unruptured lesions， self-fomulated Wumiao Ointment （五妙膏） is used to detoxify and reduce swelling， while for ruptured lesions， Danhuang Oil （蛋黄油） is applied to promote wound healing and relieve pain.

ObjectiveTo explore the molecular mechanism of aerobic exercise to improve hippocampal neuronal degeneration by regulating tryptophan metabolic pathway. Methods60 SPF-grade C57BL/6J male mice were divided into a young group (2 months old, n=30) and a senile group (12 months old, n=30), and each group was further divided into a control group (C/A group, n=15) and an exercise group (CE/AE group, n=15). An aerobic exercise program was used for 8 weeks. Learning memory ability was assessed by Y-maze, and anxiety-depression-like behavior was detected by absent field experiment. Hippocampal Trp levels were measured by GC-MS. Nissl staining was used to observe the number and morphology of hippocampal neurons, and electron microscopy was used to detect synaptic ultrastructure. ELISA was used to detect the levels of hippocampal Trp,5-HT, Kyn, KATs, KYNA, KMO, and QUIN; Western blot was used to analyze the activities of TPH2, IDO1, and TDO enzymes. ResultsGroup A mice showed significant decrease in learning and memory ability (P<0.05) and increase in anxiety and depressive behaviors (P<0.05); all of AE group showed significant improvement (P<0.05). Hippocampal Trp levels decreased in group A (P<0.05) and increased in AE group (P<0.05). Nidus vesicles were reduced and synaptic structures were degraded in group A (P<0.05), and both were significantly improved in group AE (P<0.05). The levels of Trp, 5-HT, KATs, and KYNA were decreased (P<0.05) and the levels of Kyn, KMO, and QUIN were increased (P<0.05) in group A. The activity of TPH2 was decreased (P<0.05), and the activities of IDO1 and TDO were increased (P<0.05). The AE group showed the opposite trend. ConclusionThe aging process significantly reduces the learning memory ability and increases the anxiety-depression-like behavior of mice, and leads to the reduction of the number of nidus vesicles and degenerative changes of synaptic structure in the hippocampus, whereas aerobic exercise not only effectively enhances the spatial learning memory ability and alleviates the anxiety-depression-like behavior of aging mice, but also improves the morphology and structure of neurons in hippocampal area, which may be achieved by the mechanism of regulating the tryptophan metabolic pathway.

Objective To explore clinical effect of distal tibial tubercle-high tibial osteotomy(DTT-HTO)in treating knee osteoarthritis(KO A)with medial meniscus posterior root tear(MMPRT).Methods A retrospective analysis was performed on 21 patients with varus KOA with MMPRT from May 2020 to December 2021,including 3 males and 18 females,aged from 49 to 75 years old with an average of(63.81±6.56)years old,the courses of disease ranged from 0.5 to 18.0 years with an average of(5.9±4.2)years,and 4 patients with grade Ⅱ,14 patients with grade Ⅲ,and 3 patients with grade Ⅳ according to Kellgren-Lawrence;14 patients with type 1 and 7 patients with type 2 according to MMPRT damage classification.The distance of medi-al meniscusextrusion(MME)and weight-bearing line ratio(WBLR)of lower extremity were compared before and 12 months after operation.Visual analogue scale(V AS),Western Ontarioand and McMaster Universities(WOMAC)osteoarthritis index,and Lysholm knee score were used to evaluate knee pain and functional improvement before operation,1,6 and 12 months after operation,respectively.Results Twenty-one patients were followed up for 12 to 18 months with an average of(13.52±1.72)months.MME distance was improved from(4.99±1.05)mm before operation to(1.87±0.76)mm at 12 months after operation(P＜0.05).WBLR was increased from(15.49±7.04)％before operation to(62.71±2.27)％at 12 months after operation(P＜0.05).VAS was decreased from(7.00±1.14)before operation to(2.04±0.80),(0.90±0.62)and(0.61±0.50)at 1,6 and 12 months after operation.WOMAC were decreased from preoperative(147.90±9.88)to postoperative(103.43±8.52),(74.00±9.54)and(47.62±9.53)at 1,6 and 12 months,and the difference were statistically significant(P＜0.05).Lysholm scores were increased from(46.04±7.34)before oepration to(63.19±8.93),(81.10±6.41)and(89.29±3.04)at 1,6 and 12 months after operation(P＜0.05).Conclusion For the treatment of varus KOA with MMPRT,DTT-HTO could reduce medial meniscus pro-trusion distance,improve the ratio of lower limb force line,and effectively reduce knee pain and improve knee joint function.

Objective To observe the changes of expression of lysyl oxidase family(LOXs)on the retina in acute ocular hypertension(AOH)rats.Methods The SD adult male rats were randomly divided into the control group(CON group)and the AOH group.The rats in the CON group were fed normally without any treatment,and the rats in the AOH group were established AOH model by anterior chamber perfusion.All rats were sacrificed after 2 weeks and retinal tissues were collected.The expression of LOXs[including lysyl oxidase(LOX)and lysyl oxidase-like proteins of LOXL1,LOXL2,LOXL3,LOXL4],and the expression of extracellular matrix(ECM)proteins of Collagen 1/3/4 a1(Col1/3/4 a1),Elastin(Eln),and Fibulin1/4(Fbn 1/4)in the retinal tissues were detected by qRT-PCR.The localiza-tion of LOXs in rat retina was detected by immunohistochemistry.The expression of LOX in retina was detected by Western blot.Results LOXs were expressed to varying degrees in all layers of the rat retina,LOX was mainly expressed in the retinal ganglion cell layer,nerve fiber layer,inner plexiform layer and outer plexiform layer;LOXL1 was mainly expressed in the inner plexiform layer,outer plexiform layer and vascular wall;LOXL2 was mainly expressed in retinal ganglion cell layer,inner plexiform layer and inner nuclear layer;LOXL4 was mainly expressed in the inner plexiform layer and inner nuclear layer;while LOXL3 was only expressed in the vascular wall.Compared with the CON group,the expression of LOX,Col1a1 and Eln in the retina of rats in the AOH group were significantly increased(P<0.05),and there was no significantly significant difference in the expression of LOXL1,LOXL2,LOXL3,LOXL4,Col3a1,Col4a1,Fbn1,Fbn4 mRNAs in the retina of rats between the two groups(P>0.05).Conclusion LOX is highly expressed in the retina of AOH rats,which may be involved in the pathological process of retinal injury caused by high intraocular pressure through ECM remodeling.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.

The aim of this study was to trace to origin of SARS-CoV-2 originating from imported cold-chain products re-sponsible for an outbreak that occurred on September 6-9,2022 in Mawei District,Fuzhou City,Fujian Province,China.Sam-ples from all positively infected persons and one positive sample from a swab of a cold-chain product during the outbreak were collected for gene sequencing.Epidemiological investigations were conducted on all positively infected persons to analyze the chain of transmission of the virus.Nucleic acids were detected by real-time fluorescence quantitative PCR,and the outbreak was characterized by a total of eight positive infections,which were asymptomatic.Whole-genome sequencing of three infected per-sons and one cold-chain product sample identified 75 nucleotides and 55 amino acid mutation sites of the BA.2.3.7 variant,with four highly homologous whole-genome sequences.These results confirmed that the outbreak was caused by exposure to impor-ted cold-chain products carrying the SARS-CoV-2 Omicron BA.2.3.7 strain.

This study was aimed at analyzing the effectiveness of vector control efforts at the 19th Asian Games in Hang-zhou,to provide a reference for future vector control at similar large-scale events.We collected and analyzed vector organism monitoring data for various venues at Asian Games(branch)villages and designated reception hotels(hotels and guesthouses)associated with the Asian Games in Hangzhou from April to October of 2023.Excel 2019 software and SPSS 20.0 software were used to organize the data.Paired t tests(for normally distributed data)or Wilcoxon signed rank tests(for data not nor-mally distributed)were performed,and count data were analyzed statistically with x2 tests.The larva mosquito path index at Asian Games venues peaked in June and then declined month by month.The first circle area of the adult mosquito human trapping index peaked in June,and the second circle area peaked in July.The mosquito indicators reached the corre-sponding control standards before the Asian Games.Moreo-ver,the differences in mosquito density before and after the Asian Games were statistically significant(all P＜0.05).Both the positivity rate and density of flies in rooms reached level A in the first and second circle areas from April to October.The proportion of indoor fly-proof facilities meeting the standards was lowest in May,then gradually increased.The corresponding control standards were reached in the first round in the fourth week of September,and in the second round in the first week of October.The difference in the density of positivity for room flies before and after the Asian Games was statistically significant(all P＜0.05).Rodent density reached the corre-sponding control standards in the second week of September.The proportion of anti-rodent facilities meeting the standards was lowest in June,and then gradually increased.The first round began to meet the corresponding control standards in the fourth week of September,and the second round began to meet the corresponding control standards in the first week of October.Ex-cept for the outdoor rat density path index,which was statistically significant before and after the Asian Games,the other indi-cators showed no statistical significance(P＞0.05).The cockroach density in the first circle area reached level A in all months,and that in the second circle area reached level B in mid-August.Vector control in the Hangzhou Asian Games achieved the ex-pected results,with no vector infringement or local vector-borne infectious diseases occurring.In future vector control for large-scale events,vector density monitoring should be performed as early as possible,and comprehensive prevention and control measures should be taken to maintain low vector density and prevent vector infringement incidents.