ObjectiveTo observe the effect of Liuwei Dihuangwan on behavioral impairments in the rat model of autism spectrum disorder （ASD） and explore the mechanism of action. MethodsTwelve SD pregnant rats were intraperitoneally injected with valproic acid （VPA） （10 rats） or normal saline （2 rats）， and male offspring were selected to establish the model of ASD and the control rats. Rats were randomly assigned into model， low-dose （0.75 g·kg^-1） and high-dose （1.5 g·kg^-1） Liuwei Dihuangwan， vitamin D （positive drug， 3.7×10^-5 g·kg^-1）， and blank groups. Each group was administrated with the corresponding concentration of drugs or the same volume of normal saline by gavage for 2 weeks. After the intervention， the three-chamber social test was conducted to evaluate social interaction and social preference. The open field test was carried out to observe spontaneous behavior and anxiety state. Hematoxylin-eosin staining （HE） was used to observe the pathological changes of the prefrontal tissue. Transmission electron microscopy was employed to observe the ultrastructure of mitochondria in prefrontal neurons. Immunofluorescence was used to detect the expression of ionized calcium-binding adapter molecule-1 （Iba-1） in the prefrontal tissue. Enzyme-linked immunosorbent assay （ELISA） was adopted to measure the levels of tumor necrosis factor-α （TNF-α） and interleukin-6 （IL-6）. Western blot was employed to assess the expression differences of phosphorylated adenosine monophosphate-activated protein kinase （p-AMPK）， adenosine monophosphate-activated protein kinase （AMPK）， phosphorylated Unc-51-like autophagy-activating kinase 1 （p-ULK1）， Unc-51-like autophagy-activating kinase 1 （ULK1）， and FUN14 domain-containing protein 1 （FUNDC1）. ResultsCompared with the blank group， the model group spent less time sniffing stranger 1 and stranger 2 in the three-chamber social test （P<0.01） and showed reductions in the total distance traveled， average speed， distance traveled in the central area， and time spent in the central area in the open field test （P<0.01）. In addition， the model group showed extensive apoptosis of neurons， with shrunken nuclei and red-stained cytoplasm， and extensive necrosis of neurons in the prefrontal tissue， mitochondrial swelling， decreased matrix density， disrupted cristae， and autophagic lysosomes in neurons， increases in the rate of Iba-1 positive cells in the prefrontal area （P<0.01） and the levels of TNF-α and IL-6 （P<0.01）， and down-regulation in the expression of p-AMPK/AMPK， p-ULK1/ULK1， and FUNDC1 （P<0.01）. Compared with the model group， low-dose and high-dose Liuwei Dihuangwan and the vitamin D prolonged the time spent sniffing stranger 1 and stranger 2 in the three-chamber social test （P<0.05， P<0.01）， increased the total distance traveled， average speed， distance traveled in the central area， and time spent in the central area in the open field test （P<0.05， P<0.01）， restored the morphology of neurons in the prefrontal tissue， decreased the number of apoptotic cells， alleviated the swelling of mitochondria in neurons， increased the matrix density， mitigated the fragmentation and disorder of cristae， and increased the number of autophagosomes. Moreover， the drugs decreased the rate of Iba-1 positive cells in the prefrontal area （P<0.01）， lowered the levels of TNF-α and IL-6 （P<0.01）， and up-regulated the expression of p-AMPK/AMPK， p-ULK1/ULK1， and FUNDC1 （P<0.01）. ConclusionLiuwei Dihuangwan ameliorate autism-like behaviors and reduce neuronal apoptosis and neuroinflammatory damage in the rat model of ASD by promoting mitophagy mediated by the AMPK/ULK1/FUNDC1 pathway.

To summarize the clinical experience of treating idiopathic olfactory disorder from the perspective of heart and lungs. It is believed that the sense of olfaction is based on the nose， rooted in the heart， functioning through the lungs， and conveyed by pectoral qi. The key pathogenesis of idiopathic olfactory disorder lies in the accumulation of pathogenic factors in the heart and lungs， blood vessel obstruction， the failure of the lungs to disperse and descend， and the loss of control of pectoral qi. In treatment， internal and external therapies could be combined. The internal therapy can correct the imbalance of the zang-fu organs， using the self-prescribed Bilong Formula （鼻聋方） to dispel wind and diffuse the lung， invigorate blood and relieving stuffy orifices； the external therapy can clear nasal obstruction， supplemented by intradermal needle embedding at three acupoints， bilateral Yingxiang （LI 20）， bilateral Shangyingxiang （EX-HN 8） and Yintang （GV 29）， and integrated olfactory training for comprehensive treatment.

Aconitines are a group of highly bioactive and toxic compounds found in aconitum species.[1] It is clinically used to treat rheumatism, rheumatoid arthritis, osteoarthritis, and cancer.[2] In folk medicine, aconitine is often soaked in white wine to make medicinal wine, which is used to treat rheumatism, joint pain, and other diseases.[3] Improper use of aconitine can cause adverse effects in the nervous system and digestive system, as well as cardiovascular dysfunction, especially arrhythmia.[4] Because of its high toxicity when it is improperly handled, aconitine has attracted widespread attention.

Objective: To analyze the process of handling a pulmonary tuberculosis(TB) outbreak among senior high school students in a boarding school in Chongqing, as well as to investigate the underlying causes of the outbreak, so as to provide evidence to inform TB prevention and control strategies in school settings. Methods: From November 2023 to April 2024, an epidemiological investigation was conducted into the TB outbreak in a grade 12 class from a boarding high school. Suspected cases were screened using symptom screening, tuberculin skin test (TST), and chest X-ray examinations. Confirmed cases underwent individual epidemiological interviews and sputum culture; Cultured positive mycobacterial strains were subjected to whole genome sequencing after identification as Mycobacterium tuberculosis. Results: A total of 10 active pulmonary TB cases were identified, all from the same class, yielding a student attack rate of 16.67%. Three isolates were culture positive, as well as all strains were of L2 type，and the WGS analysis of the strains suggested a common transmission chain. Excluding the index case, four additional cases were detected through symptom driven health care visits. Notably, 70% of patients presented with "chest tightness and chest pain" symptoms, and 50% had "cough" symptoms,but none were detected during morning health checks or tracking of absences due to illness. A total of 326 contacts were identified and underwent three rounds of screening and one follow up examination. In the initial screening, 35 close contacts from the same class showed strong TST positivity, corresponding to a strong positivity rate of 55.56%, significantly higher than the 20.76% observed among casual contacts ( χ 2=29.80, P <0.01). Among the 35 strongly TST positivvity close contacts and five individuals with moderate TST positivity whose induration had increased by ≥10 mm over two years, none received timely preventive treatment initially; five of them were subsequently diagnosed with active TB within three months. Following this, 25 individuals initiated preventive therapy, resulting in a preventive treatment initiation rate of 62.50%. Among TST negative classmates who converted to strong positivity on repeat TST testing at three months, 75.00% started preventive treatment, but only 22.22% completed the full course. Conclusion Inadequate implementation of morning health checks and cause tracking for absenteeism due to illness, poorly standardized screening procedures, and delayed preventive treatment may have been key factors contributing to the spread of the outbreak.

Objective: To characterize perioperative dynamic changes in immune-cell phenotypes and inflammatory cytokines in patients undergoing CPB (cardiopulmonary bypass) cardiac surgery, and to explore their associations with postoperative outcomes. Methods: In this prospective cohort study, 120 adult patients who underwent elective cardiac surgery under CPB at West China Hospital from May 2022 to March 2023 were enrolled. Perioperative immune-cell phenotypes and concentrations of 40 inflammation-related cytokines were measured. The primary outcomes were the sequential organ failure assessment (SOFA) score at 24 h after surgery and ΔSOFA (the peak SOFA score within 48 h after surgery minus the preoperative SOFA score). Secondary outcomes included major adverse cardiovascular events (MACE), acute kidney injury (AKI), respiratory failure, severe liver injury, and infection. Results: The mean age of enrolled patients was 57±10 years. Of these, 52% (62/120) were male and 90% (108/120) underwent valve surgery. During the rewarming to the end of CPB, neutrophil counts rapidly increased (7.39×10 /L vs preoperative 3.07×10 /L, P<0.001), with significant upregulation of CD11b (7.30×10 /L vs preoperative 3.05×10 /L, P<0.001) and CD54 (7.15×10 /L vs preoperative 2.99×10 /L, P<0.001). Lymphocyte counts increased at the end of CPB (1.75×10 /L vs preoperative 1.12×10 /L, P<0.001) but decreased significantly at 24 h after surgery (0.59×10 /L vs preoperative 1.12×10 /L, P<0.001). Plasma analysis showed that multiple pro-inflammatory cytokines increased during CPB and remained elevated up to 24 h after surgery; five chemokines and the anti-inflammatory cytokine IL-10 peaked at the end of CPB. The SOFA score increased from 1 (1, 2) preoperatively to 7 (5, 10) at 24 h after surgery, with a ΔSOFA of 6 (4, 8). Within 30 days after surgery, 48 patients (40.0%) developed AKI, 17 (14.2%) developed infection, 4 (3.3%) developed severe liver injury, 3 (2.5%) developed respiratory failure, and 3 (2.5%) experienced MACE. During the 2-year follow-up, 8 patients (6.7%) experienced MACE and 5 (4.2%) died. Conclusion: Multi-organ dysfunction is common after cardiac surgery under CPB (median ΔSOFA, 6), accompanied by perioperative activation of multiple immune-cell subsets and upregulation of pro-inflammatory, anti-inflammatory, and chemotactic mediators. This study provides data-driven evidence and research clues for further investigation of the associations between CPB-related immune perturbations and postoperative organ dysfunction and clinical outcomes.

Objective To systematically evaluate the risk factors for postoperative delirium (POD) in patients undergoing pneumonectomy. Methods PubMed, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP databases were searched from the inception to November 7, 2024 for cross-sectional studies, case-control studies, and cohort studies on POD in patients undergoing pneumonectomy. Two researchers independently screened the literature, extracted data, and evaluated the quality of the literature. RevMan 5.4.1 software was used for meta-analysis. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the literature. Results A total of 12 studies were included, with 5 574 patients. The NOS scores of the literature were all≥6 points. Meta-analysis results showed that age (≥60 years) [OR=2.43, 95%CI (2.01, 2.93), P<0.01], American Society of Anesthesiologists (ASA) classification (Ⅳ) [OR=8.74, 95%CI (5.23, 14.61), P<0.01], history of diabetes [OR=12.81, 95%CI (10.45, 15.71), P<0.01], history of cerebrovascular disease [OR=3.00, 95%CI (2.46, 3.67), P<0.01], depression [OR=7.27, 95%CI (5.46, 9.67), P<0.01], squamous cell carcinoma [OR=4.79, 95%CI (1.83, 12.51), P<0.01], malnutrition [OR=5.25, 95%CI (3.35, 8.25), P<0.01], sleep disorders [OR=2.79, 95%CI (2.28, 3.42), P<0.01], and duration of one-lung ventilation during surgery [OR=1.32, 95%CI (1.11, 1.57), P<0.01] were all risk factors for POD, while high body mass index (BMI) [OR=0.96, 95%CI (0.95, 0.97), P<0.01] was a protective factor for POD. Conclusion Age (≥60 years), ASA classification (Ⅳ), history of diabetes, history of cerebrovascular disease, depression, squamous cell carcinoma, malnutrition, sleep disorders, and duration of one-lung ventilation during surgery are independent risk factors for POD, while high BMI is a protective factor.

Objective To explore the factors affecting the quality of psychological assistance hotline connections in Shaanxi Province, and to provide a basis for optimizing services. Methods A total of 149 calls with suicidal tendencies were included from January to March 2022, and data were collected by 31 trained assessors through standardized questionnaires (general information, suicide risk, emotional intensity, and wiring characteristics). Results The results showed that 56.38% of the callers were female, with age groups concentrated between ≤ 18 years old (29.53%) and 19-34 years old (43.62%). The call duration was mainly between 31 and 45 minutes (50.34%). Operators conducted a suicide risk assessment on the callers, with 38.9% having a comprehensive assessment, 38.9% having an incomplete assessment, and 22.1% having no assessment. The main mental disorders of the callers were depression (48.32%), anxiety (15.44%), and bipolar disorder (14.77%), with 25.50% having comorbidities of ≥ 2 disorders. Emotional scores were as follows: depression (4.11 ± 0.76), sadness (3.97 ± 1.03), and despair (3.78 ± 1.05). There were significant differences in depression, anger, despair, and sadness among the callers with different levels of danger (t=4.79, 3.35, 15.79, 4.24, all P<0.05). Women had higher levels of fear than men (t=3.10, P<0.01). The longer the call duration, the higher the level of despair (t=5.66, P<0.01). Multiple regression analysis showed that incomplete suicide risk assessment by operators (B=-2.36), general procedures for operators' connections (B=5.44), and technical factors (B=2.01) significantly affected the quality of psychological assistance hotlines (all P<0.05). Conclusion Callers with suicidal tendencies generally have serious mental and psychological problems and prominent negative emotions. Strengthening the suicide risk assessment ability of operators and standardizing processes and service attitudes are key to improving the quality of psychological assistance hotlines.

ObjectiveTo verify the therapeutic effect of Yinqi Sanhuang Jiedu decoction （YQSH） on carbon tetrachloride （CCl₄）-induced hepatic fibrosis in mice， and to explore whether its effect was related to the inhibition of neutrophil infiltration and the formation of neutrophil extracellular traps （NETs）. MethodsThe 36 C57BL/6J mice were randomly divided into control group， model group， positive drug silybin （SF） group （55 mg·kg^-1·d^-1）， YQSH-L group， YQSH-M group， and YQSH-H group （8.325， 16.65， 33.3 g·kg^-1·d^-1， respectively），n=6 in each group. Except for the control group， mice in all other groups were intraperitoneally injected with CCl₄ to induce hepatic fibrosis. After successful modeling， each drug administration group was given the corresponding drugs by gavage for eight weeks. Hematoxylin-eosin （HE） staining， Sirius red staining and Masson staining were used to observe the pathological changes of liver tissue. Liver elasticity was detected by a color Doppler ultrasound system. Immunohistochemistry and real-time fluorescent quantitative polymerase chain reaction （Real-time PCR） were performed to detect the protein expression and mRNA levels of C-X-C motif chemokine ligand 1 （CXCL1）， CXCL2 and CXCL5. Neutrophil levels were detected by flow cytometry. The expression of neutrophil elastase （NE） and myeloperoxidase （MPO） positive protein was observed by immunofluorescence. The contents of MPO， NE and CitH3 were detected by enzyme-linked immunosorbent assay （ELISA）. ResultsCompared with the control group， the liver of the model group showed obvious inflammatory cell infiltration and collagen deposition， and the liver elasticity， CXCL1， CXCL2， CXCL5 expression， neutrophil level， and MPO， NE and CitH3 levels were significantly increased （P<0.05， P<0.01）. Compared with the model group， inflammatory cell infiltration and collagen deposition in the liver tissue of mice were reduced after YQSH treatment. Moreover， the liver elasticity was reduced （P<0.01）. The protein expression （P<0.01） and mRNA level of CXCL1， CXCL2 and CXCL5 were decreased（P<0.05，P<0.01）. The neutrophil level was decreased （P<0.01）， the expression of MPO and NE positive protein was significantly decreased（P<0.05，P<0.01）， and the levels of MPO， NE and CitH3 were decreased （P<0.05， P<0.01）. ConclusionThe anti-hepatic fibrosis effect of YQSH may be related to its inhibition of chemokines （CXCL1， CXCL2， CXCL5）， reduction of neutrophil infiltration， and inhibition of NETs generation.

ObjectiveTo verify the therapeutic effect of Yinqi Sanhuang Jiedu decoction （YQSH） on carbon tetrachloride （CCl₄）-induced hepatic fibrosis in mice， and to explore whether its effect was related to the inhibition of neutrophil infiltration and the formation of neutrophil extracellular traps （NETs）. MethodsThe 36 C57BL/6J mice were randomly divided into control group， model group， positive drug silybin （SF） group （55 mg·kg^-1·d^-1）， YQSH-L group， YQSH-M group， and YQSH-H group （8.325， 16.65， 33.3 g·kg^-1·d^-1， respectively），n=6 in each group. Except for the control group， mice in all other groups were intraperitoneally injected with CCl₄ to induce hepatic fibrosis. After successful modeling， each drug administration group was given the corresponding drugs by gavage for eight weeks. Hematoxylin-eosin （HE） staining， Sirius red staining and Masson staining were used to observe the pathological changes of liver tissue. Liver elasticity was detected by a color Doppler ultrasound system. Immunohistochemistry and real-time fluorescent quantitative polymerase chain reaction （Real-time PCR） were performed to detect the protein expression and mRNA levels of C-X-C motif chemokine ligand 1 （CXCL1）， CXCL2 and CXCL5. Neutrophil levels were detected by flow cytometry. The expression of neutrophil elastase （NE） and myeloperoxidase （MPO） positive protein was observed by immunofluorescence. The contents of MPO， NE and CitH3 were detected by enzyme-linked immunosorbent assay （ELISA）. ResultsCompared with the control group， the liver of the model group showed obvious inflammatory cell infiltration and collagen deposition， and the liver elasticity， CXCL1， CXCL2， CXCL5 expression， neutrophil level， and MPO， NE and CitH3 levels were significantly increased （P<0.05， P<0.01）. Compared with the model group， inflammatory cell infiltration and collagen deposition in the liver tissue of mice were reduced after YQSH treatment. Moreover， the liver elasticity was reduced （P<0.01）. The protein expression （P<0.01） and mRNA level of CXCL1， CXCL2 and CXCL5 were decreased（P<0.05，P<0.01）. The neutrophil level was decreased （P<0.01）， the expression of MPO and NE positive protein was significantly decreased（P<0.05，P<0.01）， and the levels of MPO， NE and CitH3 were decreased （P<0.05， P<0.01）. ConclusionThe anti-hepatic fibrosis effect of YQSH may be related to its inhibition of chemokines （CXCL1， CXCL2， CXCL5）， reduction of neutrophil infiltration， and inhibition of NETs generation.

Obesity and its related metabolic diseases have become a major global public health threat, and its rising incidence significantly increases the risk of cardiovascular and cerebrovascular diseases, diabetes and other complications. Pancreatic lipase is a key enzyme that converts food-borne lipids into triglycerides and fatty acids, and the effective inhibition of its activity has become an important strategy for the treatment of obesity. This paper discusses the screening methods of pancreatic lipase inhibitors, and summarizes and reviews the basic principles, advantages and disadvantages and application status of traditional screening methods, modern new screening methods and virtual screening methods. In view of the problems faced by the screening methods of pancreatic lipase inhibitors, future research urgently needs to move towards a collaborative innovation path of multi-technology integration, intelligent screening and complex systematization of traditional Chinese medicine, so as to open up new research paradigms.