Depression is a highly heterogeneous psychiatric disorder with complex pathogenesis influenced by the interplay of biological,psychological,and social-environmental factors.Based on the 2021 edition of the Chinese Guidelines for the Prevention and Treatment of Depressive Disorders,which explicitly identify gender as a significant risk factor for depression onset,this paper systematically reviews the gender-differentiated pathogenesis and therapeutic advances in depression from both traditional Chinese medicine(TCM)and Western medical perspectives.In Western medicine,a large number of studies have demonstrated the sex-specific mechanism of estrogen/testosterone fluctuations and monoamine transmitter system regulation.While in TCM,although the constitution theory proposes that there are significant gender differences in congenital constitution and that qi depression and qi deficiency are associated with susceptibility to depression,current evidence primarily relies on cross-sectional surveys and lacks validation through high-quality RCTs.Compared with Western medicine,the direct research on gender-differentiated antidepressant effects in TCM remains relatively underdeveloped.In future study,it may be possible to deepen and improve the research on anti-depression in TCM from the biological markers of particular constitutions in the gender dimension.This paper advocates establishing a bio-psycho-social integrated intervention model,advancing mechanistic exploration through prospective cohort studies and multi-omics technologies,and promoting precision diagnosis and treatment systems based on gender differences,and to form a three-dimensional diagnosis and treatment and research system that covers biomarkers,social role assessment,and TCM constitution identification,in order to provide a new theoretical framework and a practical pathway for the precise medical treatment of depression.

Objective:To investigate the current status and challenges of pediatric life support training in China and provide references for improving training quality.Methods:A cross-sectional study was conducted to collect data from pediatric life support training centers across the country，covering basic institutional information，training capacity and training faculty，training program funding，as well as existing challenges and issues.The domestic registry of training centers in 2023 was obtained through the American Heart Association's online platform.After contacting and verifying each center，an online questionnaire was distributed，and the aggregated data were statistically analyzed.Results:A total of 42 institutions participated in the survey，including 19 children's hospitals，14 general hospitals，6 maternal and child health hospitals，2 women and children’s hospitals，and 1 training institution.The distribution of training centers showed a concentration in coastal areas，with the top three provinces/municipalities being Guangdong（7/42，16.7%），Zhejiang（6/42，14.3%），and Shanghai（4/42，9.5%）.As of December 31 2023，the 42 institutions had an annual basic life support（BLS）training volume of 8 587 individuals，the median was 120 (100,200)，and an annual pediatric advanced life support（PALS）training volume of 2 448 individuals，the median was 30 (20,50).Among the 42 institutions，there were 598 BLS instructors and 306 PALS instructors.Among the surveyed institutions，24（24/42，57.1%）reported BLS instructor teams comprising fewer than 10 members，and 33（33/42，78.6%）reported PALS instructor teams comprising fewer than 10.Only 7 centers(7/42,16.7%）reported having dedicated funding support.The top three challenges were：training sessions occupying instructors’personal time（27/42，64.3%），low instructor compensation（16/42，38.1%），and issues with the data submission system（16/42，38.1%）.Conclusion:Pediatric life support training centers in China are primarily children’s hospitals，with a geographical concentration in coastal areas，which is also reflected in the distribution of training scale and instructor resources.Most centers have relatively small training scales and limited instructor capacity，with many instructors conducting training during their personal time.These issues may hinder the implementation and effectiveness of training programs.

Depression is a highly heterogeneous psychiatric disorder with complex pathogenesis influenced by the interplay of biological,psychological,and social-environmental factors.Based on the 2021 edition of the Chinese Guidelines for the Prevention and Treatment of Depressive Disorders,which explicitly identify gender as a significant risk factor for depression onset,this paper systematically reviews the gender-differentiated pathogenesis and therapeutic advances in depression from both traditional Chinese medicine(TCM)and Western medical perspectives.In Western medicine,a large number of studies have demonstrated the sex-specific mechanism of estrogen/testosterone fluctuations and monoamine transmitter system regulation.While in TCM,although the constitution theory proposes that there are significant gender differences in congenital constitution and that qi depression and qi deficiency are associated with susceptibility to depression,current evidence primarily relies on cross-sectional surveys and lacks validation through high-quality RCTs.Compared with Western medicine,the direct research on gender-differentiated antidepressant effects in TCM remains relatively underdeveloped.In future study,it may be possible to deepen and improve the research on anti-depression in TCM from the biological markers of particular constitutions in the gender dimension.This paper advocates establishing a bio-psycho-social integrated intervention model,advancing mechanistic exploration through prospective cohort studies and multi-omics technologies,and promoting precision diagnosis and treatment systems based on gender differences,and to form a three-dimensional diagnosis and treatment and research system that covers biomarkers,social role assessment,and TCM constitution identification,in order to provide a new theoretical framework and a practical pathway for the precise medical treatment of depression.

Objective:To investigate the current status and challenges of pediatric life support training in China and provide references for improving training quality.Methods:A cross-sectional study was conducted to collect data from pediatric life support training centers across the country，covering basic institutional information，training capacity and training faculty，training program funding，as well as existing challenges and issues.The domestic registry of training centers in 2023 was obtained through the American Heart Association's online platform.After contacting and verifying each center，an online questionnaire was distributed，and the aggregated data were statistically analyzed.Results:A total of 42 institutions participated in the survey，including 19 children's hospitals，14 general hospitals，6 maternal and child health hospitals，2 women and children’s hospitals，and 1 training institution.The distribution of training centers showed a concentration in coastal areas，with the top three provinces/municipalities being Guangdong（7/42，16.7%），Zhejiang（6/42，14.3%），and Shanghai（4/42，9.5%）.As of December 31 2023，the 42 institutions had an annual basic life support（BLS）training volume of 8 587 individuals，the median was 120 (100,200)，and an annual pediatric advanced life support（PALS）training volume of 2 448 individuals，the median was 30 (20,50).Among the 42 institutions，there were 598 BLS instructors and 306 PALS instructors.Among the surveyed institutions，24（24/42，57.1%）reported BLS instructor teams comprising fewer than 10 members，and 33（33/42，78.6%）reported PALS instructor teams comprising fewer than 10.Only 7 centers(7/42,16.7%）reported having dedicated funding support.The top three challenges were：training sessions occupying instructors’personal time（27/42，64.3%），low instructor compensation（16/42，38.1%），and issues with the data submission system（16/42，38.1%）.Conclusion:Pediatric life support training centers in China are primarily children’s hospitals，with a geographical concentration in coastal areas，which is also reflected in the distribution of training scale and instructor resources.Most centers have relatively small training scales and limited instructor capacity，with many instructors conducting training during their personal time.These issues may hinder the implementation and effectiveness of training programs.

Objective:To investigate the effect of transurethral green laser prostate enucleation (GreenLEP) in the treatment of benign prostate hyperplasia (BPH) with detrusor underactivity (DU).Methods:The clinical data of 157 BPH patients treated with GreenLEP at Zhejiang Provincial People's Hospital from June 2019 to June 2020 were retrospectively analysed. The average age of the patients was (73.2±7.9) years old, with disease duration of 4(2, 8) years. Prior to surgery, all patients underwent comprehensive urodynamic studies and prostate ultrasonography (or enhanced MRI). Preoperative prostate volume was 42.1(34.2, 59.4) ml, international prostate symptom score (IPSS) was (27.9±3.4), quality of life (QOL) score was (5.1±0.8), preoperative residual urine volume (PVR) was 40.0(20.0, 80.0) ml, and preoperative maximum urinary flow rate (Q max) was 4.0(2.0, 7.0) ml/s. Patients were stratified into DU and non-DU groups using a bladder contractility index (BCI) threshold of less than 100 to diagnose DU. The cohort comprised 76 individuals in the DU group and 81 in the non-DU group. At the three-month postoperative juncture, a follow-up assessment was conducted on the patients, focusing on the evolution of subjective metrics (IPSS, QOL) and objective parameters (PVR, Q max). This study defined successful treatment outcomes at the 3-month mark as achieving PVR<20 ml and Q max>10 ml/s. Cases not meeting these criteria were categorized as treatment failure. Based on treatment outcomes, receiver operator characteristic (ROC) curve were plotted to identify the optimal cutoff value of BCI for predicting treatment efficacy. Subsequently, DU patients were classified into mild and severe DU groups based on this optimal BCI threshold. The differences of subjective indicators (IPSS, QOL) and objective parameters (PVR, Q max) preoperatively among non-DU, mild DU, and severe DU groups, as well as changes in these indices three months postoperatively were analyzed. Results:All 157 surgeries were successfully completed, with a median hospital stay of 6(5, 8) days. At the 3-month postoperative follow-up, 78 patients were deemed treatment successes and 3 as failures in non-DU group, 64 were successful and 12 failed in DU group. Utilizing ROC curve analysis, the BCI was optimally set at 57.5. This stratification resulted in 56 cases classified as mild DU (57.5≤BCI<100) group and 20 cases as severe DU (BCI<57.5) group. A comparative analysis of the three patient cohorts, revealed no significant statistical variation in terms of age, disease duration, or prostate volume ( P>0.05). In the non-DU, mild DU, and severe DU groups, IPSS were (26.8±3.4), (28.6±3.0), and (30.6±2.4) respectively, QOL sores were (4.9±0.9), (5.2±0.7), and (5.7±0.5) respectively, PVR volumes were 50.0(20.0, 90.0), 20.0(10.0, 50.0), and 60.0(27.5, 165.0) ml respectively, Q max were 4.0(2.0, 7.0), 5.0(4.0, 6.0), and 0(0, 2.3) ml/s respectively. Preoperative IPSS and QOL were significantly lower in the non-DU group compared with mild and severe DU groups ( P<0.05). Mild DU group had lower preoperative IPSS and QOL than the severe DU group ( P<0.05). Preoperative PVR in the mild DU group was less than that in both non-DU and severe DU groups ( P<0.05), but there was no statistically significant difference in preoperative PVR between non-DU and severe DU groups ( P>0.05). Preoperative Q maxof non-DU and mild DU groups was significantly higher than that of severe DU group ( P<0.05), with no significant difference between non-DU and mild DU ( P>0.05). Three months after surgery, IPSS scores of non-DU group, mild DU group and severe DU group were (12.5±4.7), (14.9±3.6) and (18.8±4.1), respectively. QOL scores of the 3 groups improved to (1.1±0.4), (1.2±0.5) and (1.9±1.0), respectively. PVR was 0 in non-DU and mild DU, and 20.0 (19.5, 61.3) ml in severe DU. Q max of the 3 groups were improved to 22.0(18.0, 27.0), 17.0(14.0, 22.3), and 9.0(6.8, 13.0) ml/s, respectively. Significant improvements of subjective symptoms (IPSS, QOL) and objective parameters (PVR, Q max) were observed in non-DU and mild DU group compared with preoperative( P<0.05). Significant improvements of IPSS, QOL and Q max ( P<0.05) but not PVR ( P=0.14)were observed in severe DU group. Additionally, significant differences were noted in PVR and Q max changes among the three groups ( P<0.05), but not in IPSS and QOL changes ( P>0.05). The absolute value of PVR and Q max changes in the non-DU group were higher than those in the mild DU group and the severe DU group ( P<0.05). Additionally, the change of Q max in mild DU group was significantly higher than that in severe DU group ( P<0.05). Conclusions:BPH patients with different degrees of DU can benefit from GreenLEP surgery, but for BPH patients with severe DU (BCI < 57.5), the improvements in PVR and Q max are less than that in the non-DU group.

Objective To investigate the clinical characteristics and prognosis of pneumococcal meningitis(PM),and drug sensitivity of Streptococcus pneumoniae(SP)isolates in Chinese children.Methods A retrospective analysis was conducted on clinical information,laboratory data,and microbiological data of 160 hospitalized children under 15 years old with PM from January 2019 to December 2020 in 33 tertiary hospitals across the country.Results Among the 160 children with PM,there were 103 males and 57 females.The age ranged from 15 days to 15 years,with 109 cases(68.1% )aged 3 months to under 3 years.SP strains were isolated from 95 cases(59.4% )in cerebrospinal fluid cultures and from 57 cases(35.6% )in blood cultures.The positive rates of SP detection by cerebrospinal fluid metagenomic next-generation sequencing and cerebrospinal fluid SP antigen testing were 40% (35/87)and 27% (21/78),respectively.Fifty-five cases(34.4% )had one or more risk factors for purulent meningitis,113 cases(70.6% )had one or more extra-cranial infectious foci,and 18 cases(11.3% )had underlying diseases.The most common clinical symptoms were fever(147 cases,91.9% ),followed by lethargy(98 cases,61.3% )and vomiting(61 cases,38.1% ).Sixty-nine cases(43.1% )experienced intracranial complications during hospitalization,with subdural effusion and/or empyema being the most common complication[43 cases(26.9% )],followed by hydrocephalus in 24 cases(15.0% ),brain abscess in 23 cases(14.4% ),and cerebral hemorrhage in 8 cases(5.0% ).Subdural effusion and/or empyema and hydrocephalus mainly occurred in children under 1 year old,with rates of 91% (39/43)and 83% (20/24),respectively.SP strains exhibited complete sensitivity to vancomycin(100% ,75/75),linezolid(100% ,56/56),and meropenem(100% ,6/6).High sensitivity rates were also observed for levofloxacin(81% ,22/27),moxifloxacin(82% ,14/17),rifampicin(96% ,25/26),and chloramphenicol(91% ,21/23).However,low sensitivity rates were found for penicillin(16% ,11/68)and clindamycin(6% ,1/17),and SP strains were completely resistant to erythromycin(100% ,31/31).The rates of discharge with cure and improvement were 22.5% (36/160)and 66.2% (106/160),respectively,while 18 cases(11.3% )had adverse outcomes.Conclusions Pediatric PM is more common in children aged 3 months to under 3 years.Intracranial complications are more frequently observed in children under 1 year old.Fever is the most common clinical manifestation of PM,and subdural effusion/emphysema and hydrocephalus are the most frequent complications.Non-culture detection methods for cerebrospinal fluid can improve pathogen detection rates.Adverse outcomes can be noted in more than 10% of PM cases.SP strains are high sensitivity to vancomycin,linezolid,meropenem,levofloxacin,moxifloxacin,rifampicin,and chloramphenicol.[Chinese Journal of Contemporary Pediatrics,2024,26(2):131-138]

OBJECTIVE To screen and quantitatively analyze differential quality markers (Q-Marker) in Zingiber officinale mixed and triturated with Schisandra chinensis (ZMTS) before and after processing. METHODS HPLC fingerprints of before processing[Z. officinale complicated with S. chinensis (ZWS)]and after processing (ZMTS) (10 batches each) were established. The differences of Q-Markers before and after processing were screened by the chemical pattern recognition method and Q-Marker "five principles",and the contents were determined. RESULTS A total of 14 common peaks were identified in the fingerprints of ZWS,22 common peaks were identified in the fingerprints of ZMTS,and 8 components were identified. Differential Q-Marker were screened by chemical pattern recognition and Q-Marker "five principles",i. e. 6-gingerol,schisandrol A,schisandrol B,8-gingerol,10-gingerol,schisandrin A,schisandrin B,schizandrin C. The average contents of the 8 differential Q-Markers in ZMTS were 229.46,244.48,39.96,44.12,61.17,47.82,100.11 and 9.70 μg/g,respectively. The average contents of the 4 differential Q-Markers (6-gingerol,schisandrol A,schisandrol B,8-gingerol) in ZWS were 112.58,19.01,26.74 and 5.98 μg/g,respectively. CONCLUSIONS In this study,the differential Q-Markers before and after ZMTS processing are screened. The contents of the Q-Markers in ZMTS after processing are higher than those before processing.

The composition of intestinal microflora is closely related to the occurrence and development of colorectal cancer (CRC). Among them, Fusobacterium nucleatum (Fn) has been proved directly related to the recurrence, metastasis and chemotherapy resistance of CRC. Therefore, it is of great significance for the prevention and treatment of colorectal cancer by the exploration potential anti-Fn drug targets and discovery small molecule drugs. However, no selective anti-Fn small molecule inhibitors have been reported so far as well as their anti-Fn thereby "anti-Fn further anticancer" mechanisms are unclear. Herein, this article reviews the potential therapeutic targets and small molecule ligands of Fn in order to provide a reference for the development of anti-Fn and anti-CRC small molecule drugs.

This study explored a new model of Prostate Imaging Reporting and Data System (PIRADS) and adjusted prostate-specific antigen density of peripheral zone (aPSADPZ) for predicting the occurrence of prostate cancer (PCa) and clinically significant prostate cancer (csPCa). The demographic and clinical characteristics of 853 patients were recorded. Prostate-specific antigen (PSA), PSA density (PSAD), PSAD of peripheral zone (PSADPZ), aPSADPZ, and peripheral zone volume ratio (PZ-ratio) were calculated and subjected to receiver operating characteristic (ROC) curve analysis. The calibration and discrimination abilities of new nomograms were verified with the calibration curve and area under the ROC curve (AUC). The clinical benefits of these models were evaluated by decision curve analysis and clinical impact curves. The AUCs of PSA, PSAD, PSADPZ, aPSADPZ, and PZ-ratio were 0.669, 0.762, 0.659, 0.812, and 0.748 for PCa diagnosis, while 0.713, 0.788, 0.694, 0.828, and 0.735 for csPCa diagnosis, respectively. All nomograms displayed higher net benefit and better overall calibration than the scenarios for predicting the occurrence of PCa or csPCa. The new model significantly improved the diagnostic accuracy of PCa (0.945 vs 0.830, P < 0.01) and csPCa (0.937 vs 0.845, P < 0.01) compared with the base model. In addition, the number of patients with PCa and csPCa predicted by the new model was in good agreement with the actual number of patients with PCa and csPCa in high-risk threshold. This study demonstrates that aPSADPZ has a higher predictive accuracy for PCa diagnosis than the conventional indicators. Combining aPSADPZ with PIRADS can improve PCa diagnosis and avoid unnecessary biopsies.
Male ; Humans ; Prostate/pathology* ; Prostate-Specific Antigen/analysis* ; Prostatic Neoplasms/diagnostic imaging* ; Biopsy ; Nomograms ; Retrospective Studies

Four triterpenoids were isolated and purified from the 95% ethanol extract of Maytenus guangxiensis by silica gel column chromatography, Sephadex LH-20 column chromatography, MCI column chromatography and preparative RP-HPLC. Their structures were determined from their physicochemical properties and spectral data. They were identified as maytguanone A (1), maytguanone B (2), 11α-methoxyurs-12-ene-1β,3β-diol (3), lup-20(29)-ene-3β,11α-diol (4). Compounds 1 and 2 are new triterpenoids, along with compounds 3 and 4 were isolated from M. guangxiensis for the first time. The cytotoxicity of compounds 1, 3 and 4 was evaluated using the MTT procedure with three cancer cell lines. The results show that compound 3 displayed good inhibitory effects against HeLa, with an IC₅₀ of 10.68 μmol·L^-1.