OBJECTIVE To explore the efficacy and safety of toludesvenlafaxine in the treatment of patients with major depressive disorder （MDD） with anhedonia. METHODS This retrospective study included 160 patients with MDD with anhedonia who were treated at Hebei Mental Health Center from May 2023 to August 2025. These patients were divided into a control group （ n ＝81） and an observation group （ n ＝79） according to treatment regimens. All patients received transcranial magnetic stimulation therapy. On this basis，the control group was treated with Sertraline Hydrochloride Tablets， while the observation group received Toludesvenlafaxine Hydrochloride Sustained-Release Tablets，with an 8-week continuous treatment course.To compare t he clinical total effective rate， anhedonia remission rate，the severity of depressive symptoms，degree of anhedonia，cognitive function，social function and quality of life between the two groups before and after treatment， the incidence of adverse reactions during treatment was recorded simultaneously. RESULTS After treatment，the total effective rate and anhedonia remission rate of the observation group were significantly higher than the control group （ P ＜0.05）. At the 4th and 8th weeks of treatment， the scores of Snaith-Hamilton Pleasure Scale， Hamilton Depression Rating Scale-17 Items， and Sheehan Disability Scale of both groups were significantly lower than those before treatment in the same group， and the observation group was significantly lower than the control group （ P ＜0.05）； the scores of Montreal Cognitive Assessment and Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form were significantly higher than those before treatment in the same group， and the observation group was significantly higher than the control group （ P ＜0.05）. There was no statistically significant difference in the overall incidence of adverse reactions between the two groups （ P ＞0.05）. CONCLUSIONS Toludesvenlafaxine can significantly improve depressive symptoms， cognitive function， and social function in MDD patients with anhedonia，with good safety.

Objective: To analyze the unregistered treatment situation and its influencing factors among pulmonary tuberculosis patients in Quzhou City, Zhejiang Province from 2017 to 2023, so as to provide a basis for promoting the management of tuberculosis patients and optimizing disease prevention and control strategies. Methods: Data of pulmonary tuberculosis patients including demographic information, etiological results, and mortality status were collected through the China Disease Prevention and Control Information System Infectious Disease Reporting and Surveillance System and the Tuberculosis Management Information System. Pulmonary tuberculosis patients not matched in the Tuberculosis Management Information System were defined as unregistered treatment patients, and the unregistered treatment rate was analyzed. Factors affecting unregistered treatment among pulmonary tuberculosis patients were analyzed using a multivariable logistic regression model. Results: A total of 10 779 pulmonary tuberculosis patients were reported in Quzhou City from 2017 to 2023, including 7 700 males (71.44%) and 3 079 females (28.56%). There were 5 484 cases aged <65 years, accounting for 50.88%. Among them, 630 cases were unregistered treatment, with an unregistered treatment rate of 5.84% (95%CI: 5.42%-6.38%). Multivariable logistic regression analysis showed pulmonary tuberculosis patients aged ≥65 years (OR=1.829, 95%CI: 1.512-2.212) had a higher risk of being unregistered treatment than those aged <65 years; patients with non-local household registration (OR=5.710, 95%CI: 4.724-6.901) had a higher risk than local patients; and patients engaged in housework/unemployed (OR=2.001, 95%CI: 1.421-2.818) or other occupations (OR=2.396, 95%CI: 1.789-3.137) had a higher risk than farmers. The mortality of unregistered treatment pulmonary tuberculosis patients was higher than the registered treatment patients (26.67% vs. 5.02%),with a significantly elevated mortality risk (OR=7.147, 95%CI: 5.738-8.902). Conclusions The unregistered treatment rate among pulmonary tuberculosis patients was well controlled in Quzhou City from 2017 to 2023, but the elderly, patients with non-local household registration, and those engaged in housework/unemployed had a higher risk of unregistered treatment. It is recommended to improve medical and social security policies, strengthen health education on tuberculosis prevention, enhance treatment adherence, and reduce mortality risk.

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.

Objective:To examine the longitudinal relationships between perceived social support,life satis-faction and acceptance by others among relocated residents for poverty alleviation.Methods:A two-wave longitudi-nal survey was conducted with 383 relocated residents from 39 resettlement communities in Guizhou Province,with a six-month interval.Participants completed the Perceived Social Support Scale(PSSS),the Acceptance by Others Scale of the Acceptance of others Scale(AOS),and the Satisfaction With Life Scale(SWLS).Results:T1 PSSS scores positively predicted T2 acceptance by others scores(β=0.20,P＜0.001).T2 acceptance by others scores positively predicted T2 SMLS scores(β=0.45,P＜0.001).Perceived acceptance by others fully mediated the lon-gitudinal relationship between perceived social support and life satisfaction(effect=0.09,95％CI:0.03-0.18).Conclusion:Perceived social support predicts life satisfaction of relocated residents for poverty alleviation through perceived acceptance by others.

Objective:To compare the advantages and disadvantages and training costs of different training methods for microsurgical vascular anastomosis, and to provide a basis for establishing a systematic training model and improving surgeons microsurgical skills and clinical competence.Methods:Doctors came from various primary hospitals and exchange groups from foreign hospitals to China, and several groups of data statistics from 2018-2023 were randomly selected for this study. The microsurgical vascular anastomosis training lasted 10 days, including 1 day of theoretical study and 9 days of practical training. A total of 48 doctors were equally divided into group A (one-person operation), group B (two-person cooperation), and group C (two-person cooperation in the first four days and one-person operation in the last five days). The differences in anastomosis time and number of anastomoses between the groups were analysed by one-way ANOVA using the software GraphPad Prism 8.3.0, with P<0.05 indicating that there were statistically significant differences in the variable data. The cost of the three training methods was investigated, and a questionnaire survey of the trainees was conducted. Results:For all the three groups, the speed of anastomosis and the number of anastomoses increased with the course of training. The duration of single-vessel anastomosis was significantly different between groups A and B as well as between groups A and C at all time points except on day 1 (A1 d vs. B1 d, P=0.335; A1 d vs. C1 d, P=0.064; P<0.05 for all the other time points); groups B and C showed no significant differences on day 1 ( P=0.196) and day 3 ( P=0.115) but had significant differences on days 5, 7, and 9 (all P<0.05) in the duration of anastomosis. The number of anastomoses was not significantly different between A1 d and B1 d ( P=0.081), between A3 d and B3 d ( P=0.160), between B1 d and C1 d ( P=0.695), between B3 d and C3 d ( P=0.520), and between A1 d and C1 d ( P=0.123), with significant differences at the other time points (all P<0.05). The training costs were group A > group C > group B. The training questionnaire showed that the proportion of trainees who applied this technique in their daily work was 100.00% (48/48), the proportion of those who wished to participate in the training of this technique occasionally was 100.00% (48/48), the proportion of participants whose institutions had no relevant training conditions was 37.50% (18/48), the proportion of those whose institutions lacked necessary instruments and equipment was 35.42% (17/48), the proportion of those who had difficulties in access to laboratory animals was 68.75% (33/48), and the proportion of inability to carry out relevant training due to the lack of animal experimentation techniques such as anesthesia, preservation, and euthanasia was 91.67% (44/48), indicating that there is a great need for microsurgical vascular anastomosis training. Conclusions:The three training modes have their own advantages and disadvantages. The A mode is suitable for small-scale training. The B mode is suitable for training with adequate funds, a large number of personnel, and a high use frequency. The C mode is the best choice for microsurgical vascular anastomosis training, in which trainees can not only practice the whole vascular anastomosis process but also cooperative skills for anastomosis.

Objective:To examine the longitudinal relationships between perceived social support,life satis-faction and acceptance by others among relocated residents for poverty alleviation.Methods:A two-wave longitudi-nal survey was conducted with 383 relocated residents from 39 resettlement communities in Guizhou Province,with a six-month interval.Participants completed the Perceived Social Support Scale(PSSS),the Acceptance by Others Scale of the Acceptance of others Scale(AOS),and the Satisfaction With Life Scale(SWLS).Results:T1 PSSS scores positively predicted T2 acceptance by others scores(β=0.20,P＜0.001).T2 acceptance by others scores positively predicted T2 SMLS scores(β=0.45,P＜0.001).Perceived acceptance by others fully mediated the lon-gitudinal relationship between perceived social support and life satisfaction(effect=0.09,95％CI:0.03-0.18).Conclusion:Perceived social support predicts life satisfaction of relocated residents for poverty alleviation through perceived acceptance by others.

Objective:To compare the advantages and disadvantages and training costs of different training methods for microsurgical vascular anastomosis, and to provide a basis for establishing a systematic training model and improving surgeons microsurgical skills and clinical competence.Methods:Doctors came from various primary hospitals and exchange groups from foreign hospitals to China, and several groups of data statistics from 2018-2023 were randomly selected for this study. The microsurgical vascular anastomosis training lasted 10 days, including 1 day of theoretical study and 9 days of practical training. A total of 48 doctors were equally divided into group A (one-person operation), group B (two-person cooperation), and group C (two-person cooperation in the first four days and one-person operation in the last five days). The differences in anastomosis time and number of anastomoses between the groups were analysed by one-way ANOVA using the software GraphPad Prism 8.3.0, with P<0.05 indicating that there were statistically significant differences in the variable data. The cost of the three training methods was investigated, and a questionnaire survey of the trainees was conducted. Results:For all the three groups, the speed of anastomosis and the number of anastomoses increased with the course of training. The duration of single-vessel anastomosis was significantly different between groups A and B as well as between groups A and C at all time points except on day 1 (A1 d vs. B1 d, P=0.335; A1 d vs. C1 d, P=0.064; P<0.05 for all the other time points); groups B and C showed no significant differences on day 1 ( P=0.196) and day 3 ( P=0.115) but had significant differences on days 5, 7, and 9 (all P<0.05) in the duration of anastomosis. The number of anastomoses was not significantly different between A1 d and B1 d ( P=0.081), between A3 d and B3 d ( P=0.160), between B1 d and C1 d ( P=0.695), between B3 d and C3 d ( P=0.520), and between A1 d and C1 d ( P=0.123), with significant differences at the other time points (all P<0.05). The training costs were group A > group C > group B. The training questionnaire showed that the proportion of trainees who applied this technique in their daily work was 100.00% (48/48), the proportion of those who wished to participate in the training of this technique occasionally was 100.00% (48/48), the proportion of participants whose institutions had no relevant training conditions was 37.50% (18/48), the proportion of those whose institutions lacked necessary instruments and equipment was 35.42% (17/48), the proportion of those who had difficulties in access to laboratory animals was 68.75% (33/48), and the proportion of inability to carry out relevant training due to the lack of animal experimentation techniques such as anesthesia, preservation, and euthanasia was 91.67% (44/48), indicating that there is a great need for microsurgical vascular anastomosis training. Conclusions:The three training modes have their own advantages and disadvantages. The A mode is suitable for small-scale training. The B mode is suitable for training with adequate funds, a large number of personnel, and a high use frequency. The C mode is the best choice for microsurgical vascular anastomosis training, in which trainees can not only practice the whole vascular anastomosis process but also cooperative skills for anastomosis.

Objective To investigate the application value of CT perfusion imaging in patient with traumatic brain injury(TBI).Methods Thirty-seven patients with TBI were included retrospectively and divided into mild,moderate,and severe groups according to Glasgow coma scale(GCS)score.Perfusion parameters of the cerebral hemispheres on the injured side and the contralateral side of the level of basal ganglia were compared.After three months,the correlations between perfusion parameters and GCS score at baseline and Glasgow outcome scale-extended(GOSE)score at follow-up were further analyzed,respectively.Results The injured side of TBI patients showed hypo-perfusion compared with that of the contralateral side.The abnormal perfusion volumes of time to maximum of the residual function(Tmax)>10 s was significantly negatively correlated with GOSE score(ρ=-0.55,P=0.01),and could distinguish the good prognosis group from the poor prognosis group with GOSE score[area under the curve(AUC)=0.82,P= 0.01].In the group of patients undergoing decompressive craniectomy,the abnormal perfusion volumes of Tmax>4 s and Tmax>6 s were significantly associated with GCS score(ρ=0.61,P=0.01;ρ=0.53,P=0.03).Conclusion CT perfusion imaging may be useful in assessing the hemodynamics and severity of TBI,and in predicting the clinical prognosis.

ObjectiveTo study the effects of Buyang Huanwutang on the skeletal muscle injuries in type 2 diabetes mellitus from mitochondrial transport， glucose metabolism， oxidative stress， and inflammation. MethodA total of 60 SPF-grade male C57BL/6J mice were selected in this study. The mouse model of type 2 diabetes mellitus was established with a high-fat diet combined with intraperitoneal injection of streptozotocin. The mice were assigned by the random number table method into blank control， model， high-， medium-， and low-dose （86.5， 43.2， 21.6 g·kg^-1， respectively） Buyang Huanwutang， and metformin （150 mg·kg^-1） groups， 10 mice in each group. During the experiment period， blood glucose and other indicators of mice were measured regularly. At the end of the experiment， skeletal muscle samples were collected and frozen in 4% paraformaldehyde and -80 ℃， respectively. Blood samples were sent for examination. The skeletal muscle was stained with hematoxylin-eosin. The levels of inflammation indicators and reactive oxygen species （ROS） were determined by enzyme-linked immunosorbent assay. The expression of mitochondrial proteins was determined by Western blot and immunohistochemistry. ResultCompared with the blank control group， the model group showcased increased fasting blood glucose， water intake， and food intake （P<0.01） and decreased body weight （P<0.01）. Compared with the model group， metformin and Buyang Huanwutang reduced the fasting blood glucose， water intake， and food intake （P<0.05， P<0.01） and increased the body weight （P<0.01）. Compared with the blank control group， the model group showed rising levels of tumor necrosis factor-alpha （TNF-α）， interleukin-6 （IL-6）， and ROS （P<0.01）， which were decreased by metformin and Buyang Huanwutang （P<0.05， P<0.01）. The skeletal muscle fibers in the model group were generally atrophic and thin， which suggested atrophy and morphological changes of the skeletal muscle， while metformin and Buyang Huanwutang alleviated the pathological changes of the skeletal muscle and restored the morphology of fiber bundles. Compared with the blank control group， the modeling down-regulated the expression of the mitofusin2 （Mfn2） （P<0.01）， which was up-regulated by metformin and Buyang Huanwutang （P<0.05， P<0.01）. Compared with the blank control group， the modeling up-regulated the expression of the dynamin-related protein （Drp1） （P<0.01）， which were down-regulated by metformin and Buyang Huanwutang （P<0.01）. ConclusionBuyang Huanwutang can improve the body weight and attenuate the pathological changes of the skeletal muscle， reduce fasting blood glucose， food intake， and water intake， lower the levels of TNF-α， IL-6， and ROS， down-regulate the expression of Drp1， and up-regulate the expression of Mfn2 in the mouse model of type 2 diabetes mellitus.