Gastric ulcer （GU） is a high-incidence digestive system disease characterized pathologically by disruption of gastric mucosal integrity， with clinical features including a prolonged course and periodic recurrence. Modern medicine attributes its pathogenesis to the dynamic imbalance between aggressive and defensive factors，while traditional Chinese medicine （TCM） posits its development as closely linked to spleen deficiency. Current therapies combining acid suppressants and antibiotics face challenges such as high recurrence rates，poor mucosal healing，and adverse drug reactions. Long-term use may induce metabolic disturbances like hypergastrinemia and reduced intestinal microbiota diversity. Therefore，exploring safer and longer-lasting therapeutic strategies has become a critical focus. TCM has extensive clinical experience and unique advantages in GU prevention and treatment. Studies demonstrate that the classic formula Shenling Baizhu San exhibits therapeutic properties of "invigorating spleen and tonifying Qi to restore physiological balance and eliminating dampness and regulating middle energizer to unblock Qi movement"， enabling a holistic approach targeting both symptoms and root causes in GU with spleen deficiency as the core pathology by suppressing aggressive factors and strengthening defensive factors. Experimental research reveals its mechanisms involve enhancing the physicochemical barrier of the mucus layer，repairing epithelial barriers and microcirculation，modulating gastric acid secretion and gastrointestinal motility，and regulating microecological barriers and mucosal immunity. Clinical evidence confirms its synergistic effects in promoting ulcer healing，improving Helicobacter pylori eradication rates，and reducing recurrence risks. This review examined the etiology and pathogenesis of GU and systematically evaluated Shenling Baizhu San from three perspectives-clinical application，pharmacological effects， and experimental research-to provide insights for optimizing integrated traditional Chinese and Western medicine protocols and expanding its clinical applications.

Objective:To explore the healing effects of internal heat needle and electroacupuncture on post-stroke shoulder pain and their impacts on serum interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α).Methods:From January 2023 to March 2025, 94 patients with post-stroke shoulder pain admitted to the Affiliated Hospital of Hangzhou Normal University were included and separated into two groups according to a random number table. The 47 cases in the electroacupuncture group adopted electroacupuncture, while 47 cases in the internal heat needle group adopted internal heat needle. The pre- and post-treatment limb function, quality of life, healing effect, visual analogue scale (VAS), and serum IL-6, IL-1β, and TNF-α were compared.Results:After treatment, the Constant-Murley Shoulder Scale (CMS) score, shoulder range of motion (flexion, outward rotation, extension), Fugl-Meyer Assessment-Upper Extremity (FMA-UE) score, and Modified Barthel Index (MBI) in the internal heat acupuncture group were all better than those in the electroacupuncture group:(63.45 ± 10.31) points vs. (56.51 ± 9.15) points, (136.67 ± 32.44)° vs. (109.32 ± 25.01)°, (51.64 ± 12.84)° vs. (42.95 ± 11.72)°, (34.35 ± 10.15)° vs. (29.53 ± 9.82)°, (45.63 ± 10.25) points vs. (39.16 ± 10.43) points, (83.42 ± 16.09) points vs. (74.55 ± 15.83) points, there were statistical differences ( P<0.05). While the levels of serum IL-1β, IL-6, TNF-α, and VAS score in the internal heat needle group were decreased in the electroacupuncture group: (7.39 ± 3.68) ng/L vs. (9.28 ± 4.10) ng/L, (19.25 ± 2.12) ng/L vs. (28.50 ± 2.43) ng/L, (9.55 ± 3.54) ng/L vs. (11.17 ± 3.77) ng/L,(1.69 ± 0.45) points vs. (2.13 ± 0.56) points, there were statistical differences ( P<0.05). The therapeutic effect in the internal heat needle group was significantly higher than that in the electroacupuncture group:93.62% (44/47) vs. 78.72% (37/47), there was statistical difference ( P<0.05). Conclusions:For post-stroke shoulder pain, internal heat needle therapy has a clear healing effect than electroacupuncture, and can effectively reduce the levels of inflammatory factors such as IL-1β, IL-6, and TNF-α in serum.

Objective: To investigate the epidemiological characteristics of human brucellosis in Jiande City, Zhejiang Province from 2005 to 2024, so as to provide the evidence for strengthening the prevention and control of brucellosis. Methods: Data on brucellosis cases and surveillance in Jiande City from 2005 to 2024 were collected through the Chinese Disease Prevention and Control Information System, the annual brucellosis surveillance reports from the Jiande Center for Disease Control and Prevention, and the annual summaries of brucellosis prevention and control efforts. The epidemiological characteristics of human brucellosis were analyzed using a descriptive epidemiological method. Results: A total of 1 125 individuals were monitored in Jiande City from 2005 to 2024, with 18 seropositive cases identified and the seropositivity rate of 1.60%. The average annual seropositivity rate from 2015 to 2024 was 3.35%, which was significantly higher than that of 0.57% from 2005 to 2014 (P<0.05). There were 10 confirmed brucellosis cases and 8 asymptomatic infections, with no reported deaths. The peak incidence occurred between March and August. Among the 16 towns (streets) in Jiande City, 8 reported brucellosis cases. Of the brucellosis cases, 14 were male and 4 were female, with a male-to-female ratio of 3.5∶1. The majority of cases (13 cases) were aged between 40 and 60 years. Occupational exposure was identified in 16 cases, all of whom were infected through direct hand contact with the excreta, secretions, or animal products of infected sheep or cattle. The primary source of infection was sheep, followed by cattle. Five strains of Brucella were isolated and cultured, all identified as Brucella melitensis biovar 3. Conclusions The brucellosis epidemic in Jiande City remained at a sporadic and low prevalence level from 2005 to 2024, with an increasing trend observed from 2015 to 2024. Male occupational groups aged 40 to 60 years were the key population for brucellosis prevention and control, and sheep were the primary source of infection.

Objective:To explore the impact of the two-way referral model on compliance and prognosis in patients with heart failure.Methods:This bidirectional cohort study enrolled chronic heart failure (CHF) patients treated at Qilu Hospital of Shandong University or designated primary hospitals between March 2018 and March 2022. Patients were categorized into two groups based on referral status: two-way referral group (participating in the referral model with≥1 follow-up visit at primary hospitals) and the core hospital group (receiving treatment and follow-up exclusively at Qilu Hospital). Baseline clinical characteristics were collected and compared between groups. Patients underwent followed-up, with primary endpoints including follow-up rate, drug (β-blockers, angiotension converting enzyme inhibitor (ACEI)/angiotensin Ⅱ receptor blockers (ARB)/angiotensin receptor-neprilysin inhibitor (ARNI), sodium-glucose cotransporter 2 inhibitors and mineralocorticoid receptor antagonists) utilization rate and target dose achievement rate. Secondary endpoints encompassed changes from baseline in left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDd), and N-terminal pro-brain natriuretic peptide (NT-proBNP), plus cardiovascular mortality and heart failure rehospitalization. Generalized linear mixed models analyzed longitudinal trends in LVEF, LVEDd, and NT-proBNP levels. Kaplan-Meier curves and Cox regression evaluated LVEF recovery rates, supplemented by subgroup analyses. Multivariate logistic regression was used to identify factors influencing target dose achievement rate for β-blockers and ACEI/ARB/ARNI therapies in CHF patients.Results:A total of 357 patients were enrolled, aged 53 (41, 63) years, including 256 males (71.7%). 157 patients were in the two-way referral group and 200 patients in the core hospital-treated group. Compared with the core hospital-treated group, the two-way referral group had lower baseline LVEF (28 (22, 34)% vs. 31 (23, 36)%, P=0.021) and systolic blood pressure (116 (104, 125) mmHg vs. 121 (109, 134) mmHg (1 mmHg=0.133 kPa), P=0.010). The 12-month follow-up rate of the two-way referral group was higher than the core hospital-treated group (73.8% vs. 56.0%, P=0.004). No significant between-group differences were observed in drug utilization rate of β-blockers, ACEI/ARB/ARNI, or sodium-glucose cotransporter 2 inhibitors during follow-up (all P>0.05), while mineralocorticoid receptor antagonists use showed a declining trend in both groups. Although the core hospital-treated group had higher target dose achievement rates for β-blockers (65.4% vs. 49.3%, P=0.042) and ACEI/ARB/ARNI (79.8% vs. 65.8%, P=0.046) than the two-way referral group, multivariate logistic regression indicated that the two-way referral model was not a negative predictor for these outcomes (all P>0.05). Both groups showed improved NT-proBNP, LVEDd, and LVEF from baseline (all P<0.001) with no significant difference in trends between groups (all P>0.05). There was no significant difference in the composite incidence (7.6% vs. 6.5%, P=0.674) and cumulative incidence (log-rank P=0.684) of cardiovascular death and heart failure rehospitalization at 12 months between two groups. Conclusion:The two-way referral model demonstrates advantages in improving medication adherence, drug utilization rates, and targetdoseachievement rates among CHF patients. This model not only promotes cardiac functional recovery but also reduces risks of cardiovascular mortality and heart failure rehospitalization, achieving comparable therapeutic and management outcomes to those observed in core hospital-treated patients.

Objective:To explore the impact of the two-way referral model on compliance and prognosis in patients with heart failure.Methods:This bidirectional cohort study enrolled chronic heart failure (CHF) patients treated at Qilu Hospital of Shandong University or designated primary hospitals between March 2018 and March 2022. Patients were categorized into two groups based on referral status: two-way referral group (participating in the referral model with≥1 follow-up visit at primary hospitals) and the core hospital group (receiving treatment and follow-up exclusively at Qilu Hospital). Baseline clinical characteristics were collected and compared between groups. Patients underwent followed-up, with primary endpoints including follow-up rate, drug (β-blockers, angiotension converting enzyme inhibitor (ACEI)/angiotensin Ⅱ receptor blockers (ARB)/angiotensin receptor-neprilysin inhibitor (ARNI), sodium-glucose cotransporter 2 inhibitors and mineralocorticoid receptor antagonists) utilization rate and target dose achievement rate. Secondary endpoints encompassed changes from baseline in left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDd), and N-terminal pro-brain natriuretic peptide (NT-proBNP), plus cardiovascular mortality and heart failure rehospitalization. Generalized linear mixed models analyzed longitudinal trends in LVEF, LVEDd, and NT-proBNP levels. Kaplan-Meier curves and Cox regression evaluated LVEF recovery rates, supplemented by subgroup analyses. Multivariate logistic regression was used to identify factors influencing target dose achievement rate for β-blockers and ACEI/ARB/ARNI therapies in CHF patients.Results:A total of 357 patients were enrolled, aged 53 (41, 63) years, including 256 males (71.7%). 157 patients were in the two-way referral group and 200 patients in the core hospital-treated group. Compared with the core hospital-treated group, the two-way referral group had lower baseline LVEF (28 (22, 34)% vs. 31 (23, 36)%, P=0.021) and systolic blood pressure (116 (104, 125) mmHg vs. 121 (109, 134) mmHg (1 mmHg=0.133 kPa), P=0.010). The 12-month follow-up rate of the two-way referral group was higher than the core hospital-treated group (73.8% vs. 56.0%, P=0.004). No significant between-group differences were observed in drug utilization rate of β-blockers, ACEI/ARB/ARNI, or sodium-glucose cotransporter 2 inhibitors during follow-up (all P>0.05), while mineralocorticoid receptor antagonists use showed a declining trend in both groups. Although the core hospital-treated group had higher target dose achievement rates for β-blockers (65.4% vs. 49.3%, P=0.042) and ACEI/ARB/ARNI (79.8% vs. 65.8%, P=0.046) than the two-way referral group, multivariate logistic regression indicated that the two-way referral model was not a negative predictor for these outcomes (all P>0.05). Both groups showed improved NT-proBNP, LVEDd, and LVEF from baseline (all P<0.001) with no significant difference in trends between groups (all P>0.05). There was no significant difference in the composite incidence (7.6% vs. 6.5%, P=0.674) and cumulative incidence (log-rank P=0.684) of cardiovascular death and heart failure rehospitalization at 12 months between two groups. Conclusion:The two-way referral model demonstrates advantages in improving medication adherence, drug utilization rates, and targetdoseachievement rates among CHF patients. This model not only promotes cardiac functional recovery but also reduces risks of cardiovascular mortality and heart failure rehospitalization, achieving comparable therapeutic and management outcomes to those observed in core hospital-treated patients.

Objective:To explore the healing effects of internal heat needle and electroacupuncture on post-stroke shoulder pain and their impacts on serum interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α).Methods:From January 2023 to March 2025, 94 patients with post-stroke shoulder pain admitted to the Affiliated Hospital of Hangzhou Normal University were included and separated into two groups according to a random number table. The 47 cases in the electroacupuncture group adopted electroacupuncture, while 47 cases in the internal heat needle group adopted internal heat needle. The pre- and post-treatment limb function, quality of life, healing effect, visual analogue scale (VAS), and serum IL-6, IL-1β, and TNF-α were compared.Results:After treatment, the Constant-Murley Shoulder Scale (CMS) score, shoulder range of motion (flexion, outward rotation, extension), Fugl-Meyer Assessment-Upper Extremity (FMA-UE) score, and Modified Barthel Index (MBI) in the internal heat acupuncture group were all better than those in the electroacupuncture group:(63.45 ± 10.31) points vs. (56.51 ± 9.15) points, (136.67 ± 32.44)° vs. (109.32 ± 25.01)°, (51.64 ± 12.84)° vs. (42.95 ± 11.72)°, (34.35 ± 10.15)° vs. (29.53 ± 9.82)°, (45.63 ± 10.25) points vs. (39.16 ± 10.43) points, (83.42 ± 16.09) points vs. (74.55 ± 15.83) points, there were statistical differences ( P<0.05). While the levels of serum IL-1β, IL-6, TNF-α, and VAS score in the internal heat needle group were decreased in the electroacupuncture group: (7.39 ± 3.68) ng/L vs. (9.28 ± 4.10) ng/L, (19.25 ± 2.12) ng/L vs. (28.50 ± 2.43) ng/L, (9.55 ± 3.54) ng/L vs. (11.17 ± 3.77) ng/L,(1.69 ± 0.45) points vs. (2.13 ± 0.56) points, there were statistical differences ( P<0.05). The therapeutic effect in the internal heat needle group was significantly higher than that in the electroacupuncture group:93.62% (44/47) vs. 78.72% (37/47), there was statistical difference ( P<0.05). Conclusions:For post-stroke shoulder pain, internal heat needle therapy has a clear healing effect than electroacupuncture, and can effectively reduce the levels of inflammatory factors such as IL-1β, IL-6, and TNF-α in serum.

Scars are classified into 5 types:Superficial scars,hypertrophic scars,atrophic scars,depressed scars,and keloid.These types are primarily characterized by abnormal production of fibroblasts and collagen,as well as the disorderly arrangement of connective tissue.Laser treatment for scars involves the coordinated activation of various signaling pathways and cytokines.However,the exact pathological mechanism for scar formation remains unclear,leading to a lack of radical treatment.Recently,laser treatment has gained popularity as a new minimally invasive approach for scar treatment.The emergence of new theories such as fractional,picosecond laser,and laser-assisted drug delivery has led to continuous advance in laser treatment.Up to now,it has been developed numerous novel treatments,including combined with drug,physical,and other treatments,which have shown superior therapeutic effects.In order to optimize laser treatment in the future,it is crucial to combine new materials with postoperative care.This will help clinicians develop more comprehensive treatment strategies.Therefore,it is important to explore treatment options that have broader applicability.

AIM:To observe the effect of icariin-astragaloside Ⅳ-puerarin mixture(Yin-Huang-Ge mixture,YHG)on cognitive function and ferroptosis amino acid metabolism pathway in hepcidin(HAMP)knockout APPswe/PS1dE9(APP/PS1 HAMP-/-)mice.METHODS:The mice were divided into 7 groups:negative control(C57BL/6 mice)group,APP/PS1 group,APP/PS1 HAMP-/-group,APP/PS1+YHG group,APP/PS1 HAMP-/-+YHG group,APP/PS1+de-ferasirox(DFX)group,and APP/PS1 HAMP-/-+DFX group,with 6 mice in each group.The YHG and DFX were adminis-tered intragastrically,while the mice in C57 group,APP/PS1 group and APP/PS1 HAMP-/-group were given intragastric administration of distilled water,once a day for 2 months.The iron content in mouse brain tissues was detected by tissue iron kit.The morphological changes of the mitochondria in hippocampal neurons were observed by transmission electron microscopy.Morris water maze was used to detect the learning and memory ability of the mice.The content of neuronal nu-clear antigen(NeuN)in mouse brain tissues was detected by immunofluorescence staining.The expression of glutathione(GSH)in mouse brain tissues was detected by biochemical kit.The expression levels of glutamate-cysteine ligase catalytic subunit(GCLC)and glutamatase 2(GLS2)in mouse brain tissues were detected by Western blot.RESULTS:Compared with C57BL/6 mice,the brain iron content of APP/PS1 mice was significantly increased(P＜0.01),the mitochondria were seriously damaged,the learning and memory ability was significantly decreased(P＜0.05),the brain neurons were seri-ously damaged(P＜0.01),and the expression levels of GSH,GCLC and GLS2 were significantly decreased(P＜0.01).Compared with APP/PS1 mice,the brain iron content of APP/PS1 HAMP-/-mice was significantly increased(P＜0.01),the mitochondria were seriously damaged,the learning and memory ability was significantly decreased(P＜0.05),the brain neurons were seriously damaged(P＜0.01),and the expression levels of GSH,GCLC and GLS2 were significantly decreased(P＜0.05).After treatment with YHG and DFX,the brain iron content was significantly decreased(P＜0.01),the mitochondrial damage was alleviated,the learning and memory ability was significantly increased(P＜0.05),the brain neuron damage was alleviated(P＜0.01),and the expression levels of GSH,GCLC and GLS2 were significantly increased(P＜0.05).CONCLUSION:The YHG can improve the cognitive function of APP/PS1 HAMP-/-mice,and its mechanism may be related to the regulation of ferroptosis amino acid metabolism and the enhancement of antioxidant capacity.

AIM:Study the effects of icariin-astragaloside IV-puerarin mixture(Yin-Huang-Ge mixture,YHG)on cognitive dysfunction and brain tissue ferroptosis in Alzheimer disease(AD)model mice,and explore its mecha-nism.METHODS:APP/PS1 mice were randomly divided into APP/PS1 group,icariin-astragaloside IV-puerarin mixture(APP/PS1+YHG)group,and idebenone(APP/PS1+IDE)group using a random number table method.C57BL/6J mice of the same age were selected as the normal group.After one month of continuous administration,Morris water maze was used to test the learning and memory abilities of mice.Nissl staining was used to observe the morphological changes in the hippocampus of mice.The ultrastructure of neurons in each group of mice was observed under electron microscopy.West-ern blot was used to detect the expression of FSP1 protein in hippocampal tissue.ELISA detection of coenzyme Q10(CoQ10),CoQ10H2,and 4-hydroxynonenal(4-HNE)content.Biochemical reagent kit is used to detect malondialde-hyde(MDA)content.RESULTS:Compared with the normal group,APP/PS1 mice showed decreased learning and mem-ory abilities,with loosely arranged and irregularly shaped hippocampal CA3 neurons.Hippocampal neurons exhibit mito-chondrial shrinkage,incomplete cristae,and increased membrane density.The expression of FSP1 protein in the brain de-creased(P＜0.05).The levels of CoQ10 and CoQ10H2 were both reduced(P＜0.01).The levels of 4-HNE and MDA in-creased(P＜0.01).After using icariin-astragaloside IV-puerarin mixture and idebenone,the learning and memory abili-ties of mice were improved.The neuronal structure in the hippocampal CA3 region is more tightly arranged and has a regu-lar shape compared to the model group.The mitochondrial structure is relatively clear,the mitochondrial membrane is rel-atively normal,and the cristae are relatively intact.The expression of FSP1 protein in the brain increased(P＜0.05).The levels of CoQ10 and CoQ10H2 both increased(P＜0.05).The levels of 4-HNE and MDA were significantly reduced(P＜0.01).CONCLUSION:The icariin-astragaloside IV-puerarin mixture can improve cognition in AD mice,and its mecha-nism may be related to inhibiting ferroptosis by activating the FSP1/CoQ10 signaling pathway.

AIM:Study the effects of icariin-astragaloside IV-puerarin mixture(Yin-Huang-Ge mixture,YHG)on cognitive dysfunction and brain tissue ferroptosis in Alzheimer disease(AD)model mice,and explore its mecha-nism.METHODS:APP/PS1 mice were randomly divided into APP/PS1 group,icariin-astragaloside IV-puerarin mixture(APP/PS1+YHG)group,and idebenone(APP/PS1+IDE)group using a random number table method.C57BL/6J mice of the same age were selected as the normal group.After one month of continuous administration,Morris water maze was used to test the learning and memory abilities of mice.Nissl staining was used to observe the morphological changes in the hippocampus of mice.The ultrastructure of neurons in each group of mice was observed under electron microscopy.West-ern blot was used to detect the expression of FSP1 protein in hippocampal tissue.ELISA detection of coenzyme Q10(CoQ10),CoQ10H2,and 4-hydroxynonenal(4-HNE)content.Biochemical reagent kit is used to detect malondialde-hyde(MDA)content.RESULTS:Compared with the normal group,APP/PS1 mice showed decreased learning and mem-ory abilities,with loosely arranged and irregularly shaped hippocampal CA3 neurons.Hippocampal neurons exhibit mito-chondrial shrinkage,incomplete cristae,and increased membrane density.The expression of FSP1 protein in the brain de-creased(P＜0.05).The levels of CoQ10 and CoQ10H2 were both reduced(P＜0.01).The levels of 4-HNE and MDA in-creased(P＜0.01).After using icariin-astragaloside IV-puerarin mixture and idebenone,the learning and memory abili-ties of mice were improved.The neuronal structure in the hippocampal CA3 region is more tightly arranged and has a regu-lar shape compared to the model group.The mitochondrial structure is relatively clear,the mitochondrial membrane is rel-atively normal,and the cristae are relatively intact.The expression of FSP1 protein in the brain increased(P＜0.05).The levels of CoQ10 and CoQ10H2 both increased(P＜0.05).The levels of 4-HNE and MDA were significantly reduced(P＜0.01).CONCLUSION:The icariin-astragaloside IV-puerarin mixture can improve cognition in AD mice,and its mecha-nism may be related to inhibiting ferroptosis by activating the FSP1/CoQ10 signaling pathway.