ObjectiveTo interpret the main contents of the Expert Consensus on Clinical Application of Yifei Zhike Capsules （hereinafter referred to as the Consensus）， analyze its evidence basis， and explore future research directions， thus providing a reference for rational drug use in clinical practice. MethodsThe core contents of the Consensus are summarized. Focusing on clinical issues， this paper summarizes the recommendations and consensus suggestions in the Consensus and explains them from aspects such as indications， key advantages， usage and dosage， combined medication， contraindications， precautions， and safety. ResultsThe Consensus clearly states that Yifei Zhike capsules can be used for acute or chronic bronchitis， pulmonary tuberculosis and other respiratory system diseases. It for the first time proposes that the applicable TCM syndrome of Yifei Zhike capsules is Qi-Yin deficiency together with combined phlegm and stasis. For different diseases， the Consensus provides specific usage instructions， dosage， and treatment course recommendations， supplementing the contents not covered in the drug instructions. In terms of combined medication， the Consensus emphasizes the principle of using this drug in combination with standardized chemotherapy regimens or conventional Western medicines and the applicability for the treatment of pulmonary tuberculosis and moderate to severe acute or chronic bronchitis. In terms of safety， the Consensus proposes methods for identifying common adverse reactions， drug contraindications， and precautions based on a review of the existing data and preliminarily builds a risk management framework. However， the evidence on which the Consensus is based are mostly early studies， with small sample sizes， which result in the low evidence grades （mainly C and D） of some recommendations. ConclusionThe Consensus provides specific guidance for the clinical use of Yifei Zhike capsules. However， due to the limited quality of the existing research evidence， more high-quality clinical studies are needed in the future to further verify its efficacy， safety， and explore its broader application prospects.

Objective To investigate the correlation between serum galectin-3(Gal-3),fibroblast growth factor-21(FGF-21)and the lung function and and the Modified British Medical Research Council dyspnea in-dex(mMRC)score in invalids with chronic obstructive pulmonary disease(COPD).Methods A total of 79 patients with COPD who received treatment in the hospital from April 2021 to April 2023 were selected as the observation group,and 60 healthy individuals in the hospital during the same period were selected as control group.The expressions of Gal-3 and FGF-21 in serum were detected and compared.The first second forced ex-piratory volume(FEV1),FEV1/forced vital capacity(FVC)and mMRC score in two groups were compared,and the correlation between the expression levels of Gal-3 and FGF-21 and FEV1,FEV1/FVC and mMRC score in COPD patients was analyzed.Results The expression levels of serum Gal-3 and FGF-21 in the obser-vation group were higher than those in the control group(P＜0.05).The pulmonary function indexes in ser-um of observation group were higher than those in the control group,while the mMRC score was lower than that in the control group(P＜0.05).The expression levels of Gal-3 and FGF-21 were positively correlated with FEV1 and FEV1/FVC(P＜0.05),was negatively correlated with mMRC score(P＜0.05).Conclusion The expression of serum Gal-3 and FGF-21 in COPD invalids is abnormal,and the expression levels of serum Gal-3 and FGF-21 in COPD patients were correlated with FEV1,FEV1/FVC and mMRC score,which could be used as important reference indicators for diagnosis and disease evaluation of COPD.

Objective To investigate the establishment and evaluation method of a rat model for cold asthma syndrome during the acute exacerbation phase of asthma.Methods Thirty-two rats were randomly allocated into four distinct groups:normal control group,asthma group,cold asthma group,and Shegan Mahuang Decoction group(SMD).While the normal control group was not subjected to any modeling procedures,the remaining groups were induced to develop asthma by a combination of intraperitoneal injections and atomized inhalation of ovalbumin sensitization solution.Furthermore,to emulate the traditional Chinese medicine syndrome of cold asthma,the cold asthma group and the SMD underwent an additional protocol involving"swimming,cold water consumption,and external cold stimulation."Commencing from the 14th day of the experiment,the SMD received daily gavage administration of Shegan Mahuang Decoction for a consecutive period of 14 days.The cold asthma rat model was comprehensively evaluated from both macroscopic and microscopic perspectives.Results ①Following model induction,both the asthma and cold asthma groups exhibited significant increases in asthmatic behavioral scores,sluggish weight gain,and airway hyperreactivity.Additionally,there was a notable rise in eosinophils(EOS)in the bronchoalveolar lavage fluid(BALF),decreased expression of aquaporin-5(AQP5)in lung tissue,and altered immune balances with reduced Th1/Th2 ratios and elevated Th17/Treg ratios in the spleen.Hemorheological changes included increased whole blood viscosity,relative high-shear,and low-shear indices,alongside a marked decline in erythrocyte aggregation index.The cold asthma group further displayed pronounced cold asthma symptoms,slower weight gain,and more significant increases in whole blood viscosity and low-shear relative index compared to the asthma group.②Administration of SMD alleviated asthmatic behaviors and traditional Chinese medicine syndrome manifestations in cold asthma rats,resulting in enhanced weight gain.SMD also mitigated airway hyperreactivity,reduced EOS percentage in BALF,and ameliorated lung tissue damage and inflammatory cell infiltration.The treatment increased AQP5 expression levels and rectified the immune imbalances of Th1/Th2 and Th17/Treg in cold asthma rats.Furthermore,SMD significantly lowered whole blood viscosity,relative high-shear,and low-shear indices in these rats.Conclusion The research effectively established a model for cold asthma syndrome in TCM through a method that integrates intraperitoneal injection,nebulized ovalbumin sensitization,and a triad of swimming,cold water intake,and external cold exposure.This model consistently displays the symptoms of cold asthma and corresponds with the microscopic pathological alterations seen in asthma,thereby validating the robustness of the model's creation process.

AIM:This study aims to investigate the mechanism by which LINC00973 regulates multidrug re-sistance of non-small-cell lung cancer(NSCLC).METHODS:The GEPIA database was employed to analyze the expres-sion levels of LINC00973 in NSCLC and its correlation with patient prognosis in clinical settings.RT-qPCR was utilized to assess LINC00973 expression in various NSCLC cell lines and chemoresistant cells.The migration,invasion,stemness ca-pacity,and drug sensitivity of NSCLC cells with either overexpression or knockdown of LINC00973 were evaluated using wound healing assay,Transwell assay,sphere formation assay,and CCK-8 assay.RNA sequencing was conducted on LINC00973-overexpressing and parental NSCLC cells to identify dysregulated pathways and targets.The LncBase Pre-dicted v.2 and TargetScan databases were used to predict the microRNAs(miRNAs)co-bound by LINC00973 and their target genes.Mimics and inhibitors of candidate miRNAs were synthesized and transfected into NSCLC cells subjected to LINC00973 overexpression or knockdown.Changes in the expression level of LINC00973,and the mRNA and protein ex-pression levels of its target genes were assessed using RT-qPCR and Western blot.RESULTS:Analysis of the GEPIA da-tabase revealed that LINC00973 was significantly up-regulated in lung adenocarcinoma and lung squamous cell carcino-ma,correlating with poor prognosis of NSCLC patients.The LINC00973 expression was elevated in various NSCLC and chemoresistant cell lines(A549/DDP and A549/5-FU).Overexpression of LINC00973 in A549 and H520 cells markedly enhanced their migration,invasion,and stemness capabilities,while concurrently reducing sensitivity to chemotherapy and targeted therapies.RNA sequencing,along with RT-qPCR results,indicated that ATP-binding cassette transporter G5(ABCG5)was activated in LINC00973-overexpressing A549 and H520 cells.Further database analyses and dual trans-fection experiments confirmed that LINC00973 regulated ABCG5 expression through competitive binding with hsa-miR-150-5p.CONCLUSION:LINC00973,which is aberrantly up-regulated in NSCLC specimens and associated with poor clinical prognosis,promotes the expression of ABCG5 through competitive binding with hsa-miR-150-5p.This interaction leads to en-hanced invasion,stemness,and multidrug resistance in NSCLC cells.

OBJECTIVE To explore the distribution of pathogens isolated from the patients with diabetic foot ulcer infection and observe the expressions of stromal cell derived factor-1α(SDF-1α),chemokine receptor 4(CXCR4),procalcitonin(PCT)and C-reactive protein(CRP)in peripheral blood.METHODS A total of 172 patients with dia-betic foot ulcer who were treated in Jinan People's Hospital from Nov.2020 to Dec.2023 were enrolled in the study and were divided into the infection group with 141 cases and the non-infection group with 31 cases.The dis-tribution and drug resistance of the pathogens were statistically analyzed.The levels of SDF-1α,CXCR4,PCT and CRP were compared between the two groups.The value of the joint detection of the four indexes in diagnosis of the diabetic foot ulcer infection was analyzed.RESULTS Gram-negative bacteria were dominant among 152 strains of pathogens isolated from the patients of the infection group.Escherichia coli,Staphylococcus aureus and Staph-ylococcus epidermidis were the predominant species.The E.coli strains were highly resistant to ampicillin and piperacillin;the S.aureus and S.epidermidis strains were highly resistant to penicillin and erythromycin.There were significant differences in the levels of serum SDF-1α,CXCR4,PCT and CRP between the infection group and the non-infection group(P＜0.05);the serum CRP level of the infection group was(15.25±4.65)mg/L,higher than(10.97±3.42)mg/L of the non-infection group(t=4.840,P＜0.001).The area under the curve(AUC)of the joint detection of the four indexes was higher than that of the single detection in diagnosis of the diabetic foot ulcer infection(P＜0.05),with the sensitivity 85.80％,the specificity 87.10％.CONCLUSIONS The gram-nega-tive bacteria are dominant among the pathogens isolated from the patients with diabetic foot ulcer infection.E.co-li,S.aureus and S.epidermidis are the predominant species.The pathogens vary in the drug resistance and are highly resistant to the commonly used antibiotics.There is association between the changes of SDF-1α,CXCR4,PCT and CRP levels and the diabetic foot ulcer infection.The joint detection of the indexes may facilitate the diag-nosis.

This article introduces the novel conceptual framework of small vulnerable newborns (SVN) and delineates three classification approaches. It further analyzes regional disparities in SVN prevalence and examines complex contributing factors encompassing environmental influences, maternal health status, and socioeconomic determinants. Finally, the discussion focuses on SVN management and preventive strategies, emphasizing the critical importance of preconception/prenatal care, nutritional supplementation, and targeted disease interventions in reducing SVN incidence.

Objective:To explore the association between the systemic immune-inflammation index (SII) and obesity metabolic phenotypes, as well as metabolic features in children and adolescents.Methods:A cross-sectional study was conducted using the random cluster sampling method from March 2023 to May 2024. Children and adolescents aged 9-17 years in Guangzhou were surveyed through questionnaires, physical measurements, and blood tests. According to BMI and metabolic status, participants were classified into normal-weight groups [metabolically healthy normal weight (MHNW) and metabolically unhealthy normal weight (MUNW)] and overweight/obese groups [metabolically healthy overweight/obese (MHO/O) and metabolically unhealthy overweight/obese (MUO/O)]. After natural log-transformation of SII values (lnSII), multinomial logistic regression was used to assess the association between SII and obesity metabolic phenotypes, while binary logistic regression was applied to assess the relationship between SII and metabolic phenotypes in the overweight/obese subgroup. Linear regression model and restricted cubic spline (RCS) were employed to examine the relationship between SII and metabolic features among the entire population.Results:A total of 3 749 participants were included. After adjusting for covariates, for every unit increase in lnSII, the risk of MHO/O and MUO/O increased by 93% ( OR=1.93, 95% CI: 1.56-2.40, P<0.001) and 156% ( OR=2.56, 95% CI: 2.02-3.25, P<0.001), respectively. In the overweight/obesity subgroup, for every unit increase in lnSII, the risk of MUO/O increased by 37% ( OR=1.37, 95% CI: 1.01-1.87, P=0.045). Linear regression model and RCS showed that lnSII was positively correlated with systolic blood pressure (SBP) and diastolic blood pressure (DBP) (SBP: β=1.39, 95% CI: 0.67-2.11, P<0.001; DBP: β=1.27, 95% CI: 0.79-1.75, P<0.001). lnSII also had a non-linear relationship with triglyceride ( Pnonlinear=0.032) and high-density lipoprotein cholesterol ( Pnonlinear=0.002). Conclusion:Elevated SII levels are associated with unfavorable obesity metabolic phenotypes, higher blood pressure, and altered lipid profiles in children and adolescents. SII may be a potential driving factor for metabolic heterogeneity in children and adolescents.

Objective:To investigate the clinical characteristics, prognosis, and the impact of different secondary prevention strategies on stroke recurrence in patients with carotid web (CaW)-associated acute anterior circulation large vessel occlusion (LVO).Methods:A retrospective analysis was conducted on 401 patients with acute anterior circulation LVO who underwent mechanical thrombectomy at 2 advanced stroke centers, Xingtai Central Hospital and Xingtai People′s Hospital, from January 2018 to June 2024. CaW was identified using digital subtraction angiography (DSA) and other imaging modalities. Based on the presence of CaW, patients were divided into CaW group and non-CaW group. Differences between the 2 groups in baseline characteristics, clinical features, and clinical outcomes were compared, and long-term follow-up was conducted for the CaW group.Results:Among the 401 patients, the CaW group consisted of 16 patients (4.0%), while the non-CaW group included 385 patients (96.0%). Compared to the non-CaW group, patients in the CaW group were younger [53 (46, 58) years vs 65 (56, 76) years, Z=-3.811, P<0.001], had a higher proportion of M1 segment middle cerebral artery occlusion [13/16 vs 54.0% (208/385), χ2=4.602, P=0.032] and a lower proportion of internal carotid artery terminus occlusion [1/16 vs 40.0% (154/385), χ2=6.024, P=0.014]; the 90-day modified Rankin Scale (mRS) score was significantly lower in the CaW group [1.00 (0, 1.75) vs 3.00 (1.00, 4.00), Z=14.210, P<0.001], and the proportion of patients with favorable functional independence (mRS score 0-2) was significantly higher [15/16 vs 45.7% (176/385), χ2=12.350, P<0.001] in the CaW group; the incidence of pneumonia in the CaW group was significantly lower [2/16 vs 42.6% (164/385), χ2=4.562, P=0.033]. Among the 16 CaW patients, 10 received antiplatelet therapy, 4 underwent carotid artery stenting (CAS), and 2 underwent carotid endarterectomy (CEA). During a median follow-up of 29 months, patients who underwent CAS and CEA had no stroke recurrence, while 2 patients who received antiplatelet therapy had stroke recurrence and subsequently underwent CAS and CEA. Conclusions:The proportion of CaW among patients with acute anterior circulation LVO was 4.0%. The patients with CaW were younger and had a higher proportion of M1 segment middle cerebral artery occlusion. Following mechanical thrombectomy, patients in the CaW group had good functional outcomes. Simple drug therapy may be insufficient to prevent stroke recurrence in CaW patients, and CAS and CEA may be effective therapeutic options.

A 36-year-old male developed unconsciousness and no response to voice stimuli after taking approximately 2 050 mg felodipine (the specific time was unknown). Two hours later, he was sent to the department of emergency by his family and admitted to the hospital. His vital signs showed body temperature 35.1 ℃, pulse 148 times/min, respiration 32 times/min, and blood pressure 65/34 mmHg. Acute drug poisoning, acute toxic cardiomyopathy, acute toxic shock, acute type Ⅱ respiratory failure, acute toxic encephalopathy, and acute renal failure were diagnosed based on the patient′s clinical manifestations combined with laboratory tests results, cardiac ultrasound, chest and abdominal CT scans. Endotracheal intubation connected to a ventilator for invasive assisted ventilation, pressure boosting, and fluid resuscitation were given. At the same time, repeated gastric lavage and enema were performed to remove toxins. Blood perfusion was intermittently and repeatedly administered, and continuous renal replacement therapy was used. The blood concentration of felodipine was 1 298 μg/L at 2 hours after admission, and cardiac arrest occurred at 4 hours. Venous-arterial extracorporeal membrane oxygenation (V-A ECMO) treatment was administered immediately. After 48 hours of ECMO operation, sedatives were discontinued and the patient′s consciousness was improved after 4 hours. On the 5th day of ECMO treatment, his heart rate was 72 beats per minute, and blood pressure was 127/65 mmHg. The blood concentration of felodipine decreased to 2 μg/L. The patient′s vital signs were significantly improved and ECMO supportive treatment was withdrawn. After 26 days of hospitalization, the patient recovered and was discharged.

Objective:To explore the association between the systemic immune-inflammation index (SII) and obesity metabolic phenotypes, as well as metabolic features in children and adolescents.Methods:A cross-sectional study was conducted using the random cluster sampling method from March 2023 to May 2024. Children and adolescents aged 9-17 years in Guangzhou were surveyed through questionnaires, physical measurements, and blood tests. According to BMI and metabolic status, participants were classified into normal-weight groups [metabolically healthy normal weight (MHNW) and metabolically unhealthy normal weight (MUNW)] and overweight/obese groups [metabolically healthy overweight/obese (MHO/O) and metabolically unhealthy overweight/obese (MUO/O)]. After natural log-transformation of SII values (lnSII), multinomial logistic regression was used to assess the association between SII and obesity metabolic phenotypes, while binary logistic regression was applied to assess the relationship between SII and metabolic phenotypes in the overweight/obese subgroup. Linear regression model and restricted cubic spline (RCS) were employed to examine the relationship between SII and metabolic features among the entire population.Results:A total of 3 749 participants were included. After adjusting for covariates, for every unit increase in lnSII, the risk of MHO/O and MUO/O increased by 93% ( OR=1.93, 95% CI: 1.56-2.40, P<0.001) and 156% ( OR=2.56, 95% CI: 2.02-3.25, P<0.001), respectively. In the overweight/obesity subgroup, for every unit increase in lnSII, the risk of MUO/O increased by 37% ( OR=1.37, 95% CI: 1.01-1.87, P=0.045). Linear regression model and RCS showed that lnSII was positively correlated with systolic blood pressure (SBP) and diastolic blood pressure (DBP) (SBP: β=1.39, 95% CI: 0.67-2.11, P<0.001; DBP: β=1.27, 95% CI: 0.79-1.75, P<0.001). lnSII also had a non-linear relationship with triglyceride ( Pnonlinear=0.032) and high-density lipoprotein cholesterol ( Pnonlinear=0.002). Conclusion:Elevated SII levels are associated with unfavorable obesity metabolic phenotypes, higher blood pressure, and altered lipid profiles in children and adolescents. SII may be a potential driving factor for metabolic heterogeneity in children and adolescents.