Perimenopausal depression （PMD） is an affective disorder that occurs in women during the transition from sexual maturity to old age. It can induce various complications， such as insomnia and cognitive decline. The etiology of PMD is complex. Although multiple hypotheses have been proposed， there is still no unified theory that fully explains its pathogenesis. Research into its mechanisms relies heavily on animal experiments， and establishing reliable animal models is crucial for experimental studies. Appropriate animal models can better simulate human pathophysiological states， rapidly evaluate the efficacy and safety of drugs and intervention methods， grasp the essence of the disease， and uncover its intrinsic connections， thereby exploring more advanced intervention strategies. However， there is a lack of systematic review and summarization of literature related to model construction. Additionally， traditional Chinese medicine （TCM）， adhering to the principles of ''syndrome differentiation and treatment'' and ''holistic concept''， has shown significant efficacy in treating PMD. In recent years， research exploring and analyzing its therapeutic mechanisms has been increasing. Therefore， to gain a clearer and more comprehensive understanding of PMD animal modeling methods and the mechanisms of TCM， this paper reviewed Chinese and English literature on PMD animal models and mechanisms of TCM in PMD treatment. It summarized the construction methods of single-factor and multi-factor PMD models， and discussed the advantages and disadvantages of each modeling approach. Furthermore， it delved into the mechanisms of TCM intervention in PMD， revealing that TCM formulas primarily exert their effects by regulating the hypothalamic-pituitary-adrenal axis， hypothalamic-pituitary-ovarian axis， gut-brain axis， cell signaling pathways， neural circuits， hormone levels， and neurotransmitter levels. This review aims to provide a reference for future research in this field. In summary， by summarizing the progress in the methods for PMD animal model construction and the mechanisms of TCM， the paper seeks to offer new insights into the mechanistic research of TCM intervention in PMD.

ObjectiveTo investigate the risk factors for acute kidney injury （AKI） after liver transplantation， and to establish and validate a risk prediction model， and to provide a basis for early identification of high-risk patients and intervention in clinical practice. MethodsA single-center retrospective study was conducted， and clinical data were collected from 162 patients who received liver transplantation in Liver Transplantation Center of The First Hospital of Shanxi Medical University from March 2020 to June 2025. The patients were divided into AKI group with 69 patients and non-AKI group with 93 patients according to the diagnostic criteria for AKI established by the Kidney Disease： Improving Global Outcomes organization and the presence or absence of AKI within 7 days after surgery. The independent-samples t test was used for comparison of normally distributed continuous data between groups， while the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups， and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups. The univariate differential analysis was used to obtain the factors associated with AKI after liver transplantation， and the multivariate logistic regression analysis was used to identify the independent risk factors and establish a nomogram model； the Bootstrap method with 1 000 repeated samples was used to perform internal validation of the model. The dataset was randomly divided into a training set and a validation set at a ratio of 7∶3， and the receiver operating characteristic （ROC） curve， the calibration curve， and decision curve analysis （DCA） were used to assess the discriminatory ability， calibration， and clinical applicability of the predictive model. ResultsBody mass index （BMI） （odds ratio ［OR］=1.281， 95% confidence interval ［CI］： 1.037　—　1.582， P=0.022）， serum creatinine （OR=1.097， 95%CI： 1.020　—　1.181， P=0.013）， intraoperative blood loss （OR=1.005， 95%CI： 1.002　—　1.009， P=0.004）， and cold ischemia time （OR=0.984， 95%CI： 0.976　—　0.991， P<0.001） were independent risk factors for the development of AKI after liver transplantation. The nomogram prediction model established based on the above factors had an area under the ROC curve （AUC） of 0.964 （95%CI： 0.931　—　0.997）， with an optimal cutoff value of 0.319， a sensitivity of 0.971， and a specificity of 0.903. In the training set （n=113）， the nomogram had an AUC of 0.969 （95% CI： 0.933　—　0.971）， while in the validation set （n=49）， the nomogram had an AUC of 0.941 （95%CI： 0.855　—　0.944）. The calibration curve showed good consistency between the predicted incidence rate and the actual incidence rate， and DCA showed that it had good net clinical benefit. ConclusionBMI， serum creatinine， cold ischemia time， and intraoperative blood loss are independent risk factors for the development of AKI after liver transplantation， and the nomogram prediction model established based on these factors performs well and has a good value in predicting the development of AKI after liver transplantation.

The application of immunosuppressants has significantly reduced the incidence rate of rejection reaction after liver transplantation， but the clinical efficacy of immunosuppressants is greatly affected by individual differences between patients. This article systematically reviews the recent research advances in the interaction between immunosuppressants and gut microbiota， with a focus on the regulatory role and mechanism of intestinal microflora communities on the efficacy of immunosuppressants. Studies have shown that intestinal microbiome is one of the key factors influencing the efficacy of immunosuppressive therapy after liver transplantation. This review aims to provide a theoretical basis for in-depth research in this field and provide new insights for developing individualized immunosuppressive treatment regimens based on the regulation of intestinal microflora.

BackgroundClinical supervision is a critical component in the training and professional development of psychological counselors. Scientifically evaluating the effectiveness of clinical supervision is essential， yet reliable and effective tools for such assessments are lacing in China. ObjectiveTo translate Supervision Evaluation and Supervision Competence （SE-SC） Scale into Chinese version and evaluate its reliability and validity in clinical supervision in China， so as to provide a tool for the evaluation of supervisory effectiveness. MethodsThe SE-SC scale was translated， back-translated and culturally adapted， followed by a pilot survey to develop the Chinese version of SE-SC scale. A total of 42 counselors engaged in clinical counseling and receiving supervision at a counseling center in Shanghai from July 2021 to February 2022 were selected as the study participants. Item analysis was conducted to assess item discrimination， with critical ratio method applied to determine which items retention. Hierarchical cluster analysis was performed to compare the structure of Chinese version with the original scale. Criterion-related validity and convergent validity were used to evaluate the validity of the scale， while Cronbach's α coefficient was used to assess its reliability. ResultsChinese version of SE-SC scale consisted of a total of 28 item， including six clusters. Registered supervisors scored significantly higher than internship supervisors on the total score and on clusters three， four， five and six （t=2.536， 2.747， 5.881， 3.718， 6.090， P<0.05）. The total and cluster scores of the Chinese version of the SE-SC scale were positively correlated with self-rated supervision helpfulness and overall satisfaction （r=0.492~0.758， 0.412~0.815， P<0.01）. The Cronbach's α coefficient for the overall scale was 0.975，with values for the six clusters were 0.938， 0.821， 0.962， 0.871， 0.884 and 0.823， respectively. ConclusionChinese version of SE-SC scale demonstrates good reliability and validity， and it can be considered as a promising assessment tool for evaluating the effectiveness of clinical supervision.

Background The widespread use of herbicides has led to environmental contamination and has implications for human health. The liver is an important organ for the detoxification of environmental pollutants; however, studies on the association between herbicide exposure and liver function are limited. Objectives To investigate the association between baseline serum herbicide levels and changes in liver enzyme levels and liver enzyme abnormalities over a 5-year period in middle-aged and older adults. Methods This study was based on a nested case-control population of type 2 diabetes established in the Dongfeng-Tongji cohort, with a total of 1388 subjects included in this study and followed up for 5 years. Epidemiological data were collected through questionnaires, and baseline serum concentrations of three herbicides (metolachlor, propham, and acetochlor) were measured by gas chromatography-triple quadrupole mass spectrometry. Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were detected at baseline and follow-up visits. The associations between baseline serum herbicide levels and changes in AST and ALT over 5 years were assessed using linear regression models with herbicide levels categorized into quartiles, adjusting for age, sex, education level, smoking status, drinking status, physical activity, body mass index, and new-onset type 2 diabetes occurred during follow-up. The relationship between baseline serum herbicide levels and the risk of liver enzyme abnormalities during follow-up was further analyzed using logistic regression models. Results The positive rates of metolachlor, propham, and acetochlor were all higher than 80%, and their spiked rates of recovery ranged from 73.46% to 106.77%. The mean ± standard deviation of the age of subjects at baseline was (62.7±7.6) years, with 34.1% being male. The median serum levels of metolachlor, propham, and acetochlor at baseline were 0.05, 0.16, and 0.03 ng·mL⁻¹, respectively. There was no significant difference in baseline serum herbicide levels between the normal and abnormal liver enzyme groups at follow-up (P >0.05). The baseline liver enzyme levels and the changes in AST and ALT over 5 years in those who developed abnormal liver enzymes were significantly higher than those in the normal liver enzyme group (P <0.05). The linear regression analysis showed that the changes in AST increased progressively over 5 years in the second, third, and fourth quartiles of propham compared to the lowest quartile group (the second quartile: b=1.49, 95%CI: 0.10, 2.87; the third quartile: b=1.52, 95%CI: 0.14, 2.90; the fourth quartile: b=1.69, 95%CI: 0.31, 3.08; P <0.05). The associations of serum metolachlor and acetochlor with changes in AST were not significant. Additionally, no significant relationships were found between the three serum herbicides and the changes in ALT over 5 years or the risk of liver enzyme abnormalities. Conclusion Serum propham levels in middle-aged and older adults are positively associated with changes in liver enzyme AST, which may have an effect on liver function. More studies are needed to provide scientific evidence for the association between herbicide exposure and liver function.

ObjectiveTo explore quality difference factors of Perillae Caulis based on the contents of multiple chemical components and comprehensively evaluate the quality. MethodsA total of 32 batches of Perillae Caulis samples were collected from 12 producing areas such as Hebei， Anhui and Guangdong， and their diameter range， epidermis color and producing areas were recorded. Total flavonoids， total phenols， volatile oils， 5 active components and 84 volatile components in 32 batches of samples were quantitatively or semi-quantitatively determined by colorimetry， ultra performance liquid chromatography-photodiode array detector（UPLC-PDA） and gas chromatography-mass spectrometry（GC-MS）. Then the differences between the contents of these components were analyzed by principal component analysis（PCA） and non-parametric test. According to the weights of the index components determined by PCA model， entropy weight-technique for order preference by similarity to ideal solution（TOPSIS） model was constructed to evaluate the quality of Perillae Caulis with different characters and origins. ResultsThere were significant differences in the composition of Perillae Caulis with different diameters， epidermis colors and producing areas， and 9 differential components were screened out， including 6 index constituents（total flavonoids， total phenols， caffeic acid， scutellarin， rosmarinic acid and luteolin） and 3 volatile components（caryophyllene oxide， （-）-humulene epoxide Ⅱ， 14-hydroxycaryophyllene）， of which 6 index constituents were higher in samples with small diameter， purple-brown epidermis and southern origin， while the contents of 3 volatile components were higher in samples with large diameter， dark-brown epidermis and northern origin. A significant difference was shown in the model scores of different diameters， epidermis colors and origins（P<0.05）， and the scores of Perillae Caulis with small diameter and purple-brown epidermis from southern area， especially Guangdong， had a high score. ConclusionThere are significant differences in the composition and content of chemical constituents between different diameters， epidermal colors and production areas of Perillae Caulis， samples showing small diameter， owing purple-brown epidermis， and originating from Guangdong were of higher-quality due to their higher content of 8 key indices.

ObjectiveTo explore quality difference factors of Perillae Caulis based on the contents of multiple chemical components and comprehensively evaluate the quality. MethodsA total of 32 batches of Perillae Caulis samples were collected from 12 producing areas such as Hebei， Anhui and Guangdong， and their diameter range， epidermis color and producing areas were recorded. Total flavonoids， total phenols， volatile oils， 5 active components and 84 volatile components in 32 batches of samples were quantitatively or semi-quantitatively determined by colorimetry， ultra performance liquid chromatography-photodiode array detector（UPLC-PDA） and gas chromatography-mass spectrometry（GC-MS）. Then the differences between the contents of these components were analyzed by principal component analysis（PCA） and non-parametric test. According to the weights of the index components determined by PCA model， entropy weight-technique for order preference by similarity to ideal solution（TOPSIS） model was constructed to evaluate the quality of Perillae Caulis with different characters and origins. ResultsThere were significant differences in the composition of Perillae Caulis with different diameters， epidermis colors and producing areas， and 9 differential components were screened out， including 6 index constituents（total flavonoids， total phenols， caffeic acid， scutellarin， rosmarinic acid and luteolin） and 3 volatile components（caryophyllene oxide， （-）-humulene epoxide Ⅱ， 14-hydroxycaryophyllene）， of which 6 index constituents were higher in samples with small diameter， purple-brown epidermis and southern origin， while the contents of 3 volatile components were higher in samples with large diameter， dark-brown epidermis and northern origin. A significant difference was shown in the model scores of different diameters， epidermis colors and origins（P<0.05）， and the scores of Perillae Caulis with small diameter and purple-brown epidermis from southern area， especially Guangdong， had a high score. ConclusionThere are significant differences in the composition and content of chemical constituents between different diameters， epidermal colors and production areas of Perillae Caulis， samples showing small diameter， owing purple-brown epidermis， and originating from Guangdong were of higher-quality due to their higher content of 8 key indices.

Objective: To investigate the trajectories of fasting blood glucose fluctuations and their influencing factors among patients with comorbidity of type 2 diabetes mellitus (T2DM), so as to provide the basis for strengthening blood glucose management in this population. Methods: In October 2023, data of patients diagnosed with comorbid T2DM from January to October 2021, including demographic information, lifestyle, health status and fasting blood glucose were collected through the chronic disease health management system of Minhang District, Shanghai Municipality. Fasting blood glucose fluctuation trajectories were analyzed by group-based trajectory model established based on fasting blood glucose values from January 2021 to October 2023. Influencing factors of fasting blood glucose fluctuation trajectories among patients with comorbidity of T2DM were analyzed using a multinomial logistic regression model. Results: A total of 907 patients with comorbidity of T2DM were enrolled, including 472 males (52.04%) and 435 females (47.96%). There were 652 cases aged ≥65 years, accounting for 71.89%. The group-based trajectory model analysis identified three trajectory groups: a low-level stable group (492 cases, 54.24%), a medium-level stable group (287 cases, 31.64%), and a high-level decreasing group (128 cases, 14.11%). Multinomial logistic regression analysis showed that, compared with the low-level stable group, patients with comorbidity of T2DM who had an education level of junior high school or below (OR=1.420, 95%CI: 1.011-1.995) or college degree or above (OR=2.109, 95%CI: 1.249-3.560), as well as those who engaged in regular exercise (OR=1.387, 95%CI: 1.017-1.893), were more likely to be in the medium-level stable group. Patients with comorbidity of T2DM who were overweight or obese (OR=1.675, 95%CI: 1.116-2.513) or had dyslipidemia (OR=3.195, 95%CI: 1.642-6.216) were more likely to be in the high-level decreasing group. Conclusions From January 2021 to October 2023, the fasting blood glucose levels of patients with comorbidity of T2DM exhibited three fluctuating trajectories: low-level stability, medium-level stability, and high-level decline. Compared with the low-level stable group, the medium-level stable group was mainly influenced by educational level and regular exercise. The high-level decline group was primarily affected by overweight/obesity and dyslipidemia.

Aim To establish and evaluate an alternative meth-od for detecting skin sensitization of cosmetics based on local lymph node assay using bromodeoxyuridine(BrdU)with flow cytometry(FCM).Methods(1)25％hexyl cinnamic alde-hyde(HCA)was chosen as a positive control with an acetone:olive oil(4∶1,V/V,AOO)mixture as a vehicle control for the experiment.The dorsal sides of both ears of mice were treated with test solutions on day 1,day 2,and day 3.Brdu solution was injected inter-peritoneally on day 5.On day 6,the bilateral ears and mandibular lymph nodes were excised,and the number of Brdu positive cells was measured by flow cytometry.The stim-ulation index(SI)was calculated to identify whether it was ≥3,in order to establish the method of LLNA:Brdu-FCM.(2)BrdU-FCM test was conducted using a blind method with the fif-teen reference substances listed in OECD TG429 whose skin sensitization potentials were known.The test substances were dissolved in AOO,N,N-dimethylformamide(DMF)or dimeth-yl sulfoxide(DMSO)at three different concentrations.Tests were performed the same as above.SI and EC2.7 were calculat-ed to evaluate whether the test substance was categorized as a skin sensitizer.The reliability and accuracy of the method were validated by comparing the classification of test substances with that in OECD TG429.Results The SI for 25％HCA was 3.9,showing positive in the skin sensitization test.It demonstrated that the LLNA:Brdu-FCM test method was properly implemen-ted.Nine test substances(2,4-dinitrochlorobenzene,4-pheny-lenediamine,cobalt chloride,2-mercaptobenzothiazole,hexyl-cinnamaldehyde,eugenol,phenyl benzoate,cinnamic alcohol,imidazolidinyl urea)were positive,and six test substances(methyl methacrylate,chlorobenzene,isopropanol,lactic acid,methyl salicylate,salicylic acid)were negative.The method was evaluated with sensitivity of 90％,specificity of 100％,positive prediction rate of 100％,negative prediction rate of 83％,false positive rate of 0％,false negative rate of 17％and accuracy of 93％.The LLNA:BrdU-FCM assay could correctly categorize the test substances that were skin sensitizers or non-sensitizers.Conclusion The LLNA:BrdU-FCM assay appears to be a relia-ble predictor of skin sensitization protential of chemicals,and it is expected to an alternative method for identifying skin sensitization as a supplementary in safety evaluation of cosmetic ingredient.

Objective:To conduct a study on pricing by service unit to address the problems of hospice and palliative care pricing and fee system in China.Methods:Combining theoretical research and empirical evidence,this study organized the pricing mechanism of initiative hospice and palliative care services and established a graded and categorized pricing strategy.Empirical research was conducted based on real-world data from 36 pilot institutions in typical areas.Results:This study developed a comprehensive pricing framework for value-based classification price standard of initiative hospice and palliative care services from the perspective of incentive regulation.We proposed a pricing plan based on service units,with inpatient bed fee ranging from 459 to 606 yuan or 459 to 1 102 yuan,and home visit fee ranging from 89 to 264 yuan.Conclusions and suggestions:This study proposes a pricing scheme based on the technique and service value with a gradient fluctuation by service unit,and forms a set of price standards with high economic and technical feasibility,which can provide scientific evidences for solving the pricing problem of hospice care.In addition,there is still a need to establish a multi-level incentive compensation mechanism to motivate all levels and types of organisations and healthcare provider,and to promote the high-quality and sustainable development of hospice and palliative care.