Objective To investigate the therapeutic effects and mechanisms of Yishen Shengyang formula in allergic rhinitis(AR)by regulating the transcription factor BTB and CNC homology 2(Bach2)to promote regulatory T cell(Treg cell)differentiation.Methods AR mouse models were established via ovalbumin(OVA)sensitization and randomly divided into control group,AR model group(AR group),Yishen Shengyang formula group and dexamethasone group.Nasal symptoms were evaluated using behavioral scores;Histopathological changes in nasal mucosa were observed via hematoxylin-eosin and periodic acid Schiff stain;Serum levels of OVA-specific immunoglobulin E(sIgE),interleukin-4(IL-4),and transforming growth factor-β(TGF-β)were measured by enzyme linked immunosorbent assay;Splenic Treg proportions were analyzed via flow cytometry;Bach2 protein expression was assessed by Western blot.Results Compared with control group,AR group mice showed significantly increased behavioral scores(P<0.05),goblet cell hyperplasia,inflammatory infiltration,elevated OVA-sIgE and IL-4 levels(P<0.05),reduced TGF-β(P<0.05),and decreased splenic Treg proportions and Bach2 expression(P<0.05).Yishen Shengyang formula treatment alleviated nasal symptoms(P<0.05),mitigated mucosal damage,decreased OVA-sIgE and IL-4,increased TGF-β(P<0.05),and upregulated Treg proportions and Bach2 expression(P<0.05),with efficacy comparable to dexamethasone.Conclusion Yishen Shengyang formula demonstrates potential therapeutic effects on allergic rhinitis by upregulating Bach2 expression and promoting Treg cell differentiation.This study provides a novel strategy and experimental basis for the traditional Chinese medicine treatment of AR.

Objective To investigate the therapeutic effects and mechanisms of Yishen Shengyang formula in allergic rhinitis(AR)by regulating the transcription factor BTB and CNC homology 2(Bach2)to promote regulatory T cell(Treg cell)differentiation.Methods AR mouse models were established via ovalbumin(OVA)sensitization and randomly divided into control group,AR model group(AR group),Yishen Shengyang formula group and dexamethasone group.Nasal symptoms were evaluated using behavioral scores;Histopathological changes in nasal mucosa were observed via hematoxylin-eosin and periodic acid Schiff stain;Serum levels of OVA-specific immunoglobulin E(sIgE),interleukin-4(IL-4),and transforming growth factor-β(TGF-β)were measured by enzyme linked immunosorbent assay;Splenic Treg proportions were analyzed via flow cytometry;Bach2 protein expression was assessed by Western blot.Results Compared with control group,AR group mice showed significantly increased behavioral scores(P<0.05),goblet cell hyperplasia,inflammatory infiltration,elevated OVA-sIgE and IL-4 levels(P<0.05),reduced TGF-β(P<0.05),and decreased splenic Treg proportions and Bach2 expression(P<0.05).Yishen Shengyang formula treatment alleviated nasal symptoms(P<0.05),mitigated mucosal damage,decreased OVA-sIgE and IL-4,increased TGF-β(P<0.05),and upregulated Treg proportions and Bach2 expression(P<0.05),with efficacy comparable to dexamethasone.Conclusion Yishen Shengyang formula demonstrates potential therapeutic effects on allergic rhinitis by upregulating Bach2 expression and promoting Treg cell differentiation.This study provides a novel strategy and experimental basis for the traditional Chinese medicine treatment of AR.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

Objective:To establish the HPLC fingerprint of MaRSDenia tenacissima; To evaluate the different origins of MaRSDenia tenacissima by combining chemometric methods.Methods:High performance liquid chromatography (HPLC) method was adopted, with DiKMA C18 column (250 mm× 4.6 mm, 5 μm), acetonitrile-0.05% phosphoric acid aqueous solution as mobile phase gradient elution, flow rate of 1.0 ml/min. The detection wavelength was set at 230 nm, the column temperature was 30 ℃, and sample size was 10 μl. Chromatographic information was imported into the similarity evaluation system for TCM chromatographic fingerprints (2012 version) for similarity analysis. SPSS Statistics 26 was used for system clustering analysis, and SIMCA 14.1 software was used for principal component analysis and partial least squares discriminant analysis (PLS-DA).Results:Totally 12 common peaks were identified. Two chromatographic peaks were identified as tenacissoside G and tenacissoside I. The relative similarity of fingerprints of 15 batches of samples and references ranged from 0.942 to 0.995. When the square Euclidean distance was 20, the samples could be grouped into two categories: S1-S3, S13-S15 were grouped into one category, and S4-S12 were grouped into another category. Principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA) showed that there were significant differences among 15 batches of MaRSDenia tenacissima, and there was a certain correlation with the origin.Conclusion:The results can provide a reference for analyzing the differences of MaRSDenia tenacissima from different producing areas and the quality standards of related formula granules in the later stage.

Objective:To investigate the effect of different ischemic preconditioning (IPC) modes on ischemia-reperfusion (IR) injury of skeletal muscle in rats.Methods:Forty male SD rats were selected to construct the model of IR injury of skeletal muscle by clamping one side of the femoral artery. In the IPC mode, the right femoral artery was clipped for 10 minutes, and reperfusion ensued for 10 minutes after the release of artery clamp. Such preconditioning procedure was repeated 3 times. The rats were divided into conventional IR group, IPC immediate group, IPC24-hour group, IPC48-hour group and sham operation group according to the random number table method, with 8 rats in each group.In conventional IR group, the right femoral artery was clipped for 3 hours and then the artery clamp was released to allow reperfusion for 3 hours. In IPC immediate group, the same treatment as conventional IR group was performed immediately after preconditioning. In IPC24-hour group, the rats received skin suturing after preconditioning and then fed in a cage for 24 hours before the same treatment as conventional IR group. In IPC48-hour group, the rats received skin suturing after preconditioning and then fed in a cage for 48 hours before the same treatment as conventional IR group. In sham operation group, the right femoral artery was bluntly separated but not clipped. At the end of reperfusion, the tibialis anterior muscle tissue, gastrocnemius muscle tissue and serum were collected. The ratio of wet weight to dry weight (W/D) of the tibialis anterior muscle tissue was calculated to evaluate tissue edema. After HE staining, histopathological changes of gastrocnemius muscle were observed and the injury severity of gastrocnemius tissue was scored. Serum levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and malondialdehyde (MDA) were determined by ELISA. Expressions of hypoxia receptor (EGLN1) and hypoxia-inducible factor-1α (HIF-1α) in the gastrocnemius tissue were detected by real-time fluorescence quantitative PCR (qRT-PCR).Results:The degree of tissue edema was reduced under different IPC modes when compared with conventional IR group (all P<0.01). The W/D in conventional IR group, IPC immediate group, IPC24-hour group and IPC48-hour group were 6.05±0.19, 5.70±0.12, 5.25±0.13 and 5.50±0.08, higher than 3.80±0.08 in sham operation group (all P<0.01). IPC24-hour group had the least degree of edema when compared with IPC immediate group and IPC48-hour group ( P<0.05 or 0.01). The muscle fibers in sham operation group were neatly arranged with clear structure, and the muscle fibers in other groups showed different degrees of injury and inflammatory infiltration. The total scores for tissue injury severity in IPC immediate group, IPC24-hour group and IPC48-hour group were (8.15±0.15)points, (6.15±0.38)points and (6.90±0.19)points, lower than (9.60±0.50)points in conventional IR group and higher than (0.16±0.16)points in sham operation group (all P<0.01). The total scores for tissue injury severity in IPC24-hour group and IPC48-hour group were not significantly different ( P>0.05), but both decreased when compared with IPC immediate group ( P<0.05 or 0.01). ELISA showed that the levels of TNF-α, IL-1β and MDA under different IPC modes were higher than those in sham operation group (all P<0.01), and the order from high to low was conventional IR group, IPC immediate group, IPC48-hour group, IPC24-hour group and sham operation group. Levels of IL-1β, TNF-α and MDA in IPC24-hour group were decreased when compared with IPC immediate group and IPC48-hour group (all P<0.05). qRT-PCR showed that the expression of EGLN1 mRNA from high to low was conventional IR group, IPC48-hour group, sham operation group, IPC immediate group and IPC24-hour group and that the expression of EGLN1 mRNA in IPC24-hour group decreased when compared with conventional IR group, IPC immediate group and IPC48-hour group (all P<0.01). The expression of HIF-1α mRNA increased under different IPC modes when compared with sham operation group (all P<0.01), and the order from high to low was IPC24-hour group, IPC immediate group, IPC48-hour group, conventional IR group and sham operation group. The expression of HIF-1α mRNA in IPC24-hour group increased when compared with conventional IR group, IPC immediate group and IPC48-hour group ( P<0.05 or 0.01), but there was no significant difference between IPC immediate group and IPC48-hour group ( P>0.05). Conclusions:Different ischemic preconditioning modes can reduce IR injury of skeletal muscle in rats by reducing tissue edema, inflammatory symptoms and oxidative stress response, among which reperfusion 24 hours after IPC has the best effect on IR injury. EGLN1 and HIF-1α may be involved in IPC to alleviate IR injury of skeletal muscle in rats.

Targeted protein degradation(TPD)has rapidly emerged as a therapeutic modality to eliminate previously undruggable proteins by repurposing the cell's endogenous protein degrada-tion machinery.However,the susceptibility of proteins for targeting by TPD approaches,termed"degradability",is largely unknown.Here,we developed a machine learning model,model-free anal-ysis of protein degradability(MAPD),to predict degradability from features intrinsic to protein tar-gets.MAPD shows accurate performance in predicting kinases that are degradable by TPD compounds[with an area under the precision-recall curve(AUPRC)of 0.759 and an area under the receiver operating characteristic curve(AUROC)of 0.775]and is likely generalizable to inde-pendent non-kinase proteins.We found five features with statistical significance to achieve optimal prediction,with ubiquitination potential being the most predictive.By structural modeling,we found that E2-accessible ubiquitination sites,but not lysine residues in general,are particularly associated with kinase degradability.Finally,we extended MAPD predictions to the entire proteome to find 964 disease-causing proteins(including proteins encoded by 278 cancer genes)that may be tractable to TPD drug development.

Tetanus consists of neonatal tetanus and non-neonatal tetanus. Non-neonatal tetanus remains a serious public health problem, although neonatal tetanus has been eliminated in China since 2012. Non-neonatal tetanus is a potential fatal disease. In the absence of medical intervention, the mortality rate of severe cases is almost 100%. Even with vigorous treatment, the mortality rate remains 30%-50% globally. These specifications aim to regulate non-neonatal tetanus diagnosis and treatment in China, in order to improve medical quality and safety. These specifications introduce the etiology, epidemiology, pathogenesis, clinical manifestations and laboratory tests, diagnosis, differential diagnosis, grading and treatment of non-neonatal tetanus.

Tetanus consists of neonatal tetanus and non-neonatal tetanus.Non-neonatal tetanus remains a serious public health problem,although neonatal tetanus has been eliminated in China since 2012.Non-neonatal tetanus is a potential fatal disease.In the absence of medical intervention,the mortality rate of severe cases is almost 100％.Even with vigorous treatment,the mortality rate is still 30％-50％ globally.These specifications aim to regulate non-neonatal tetanus diagnosis and treatment in China,in order to improve medical quality and safety.These specifications introduce the etiology,epidemiology,pathogenesis,clinical manifestations and laboratory tests,diagnosis,differential diagnosis,grading and treatment of non-neonatal tetanus.

Tetanus consists of neonatal tetanus and non-neonatal tetanus. Although neonatal tetanus in China has been eliminated since 2012, non-neonatal tetanus remains a serious public health problem. Non-neonatal tetanus is a potential fatal disease, and the mortality rate of severe cases is almost 100% in the absence of medical intervention. Even with vigorous treatment, the mortality rate is still 30~50% globally. In order to standardize the diagnosis and treatment of non-neonatal tetanus in China, this specification is hereby formulated. This standard includes etiology, epidemiology, pathogenesis, clinical manifestations, laboratory tests, diagnosis, differential diagnosis, classification, grading and treatment of non-neonatal tetanus.