Ferroptosis is a novel form of programmed cell death that plays a critical role in the body's disease resistance processes. Research has shown that ferroptosis plays a significant role in the pathogenesis of depression. Traditional Chinese medicine （TCM） has unique advantages in the prevention and treatment of depression， and the effective application of ferroptosis theory to guide TCM in the prevention and treatment of depression has become a current research hotspot. This article provides a summary and review of the regulatory mechanisms of ferroptosis， its relationship with depression， and the current research status of TCM in the prevention and treatment of depression based on ferroptosis. It has been found that the occurrence of ferroptosis is related to processes such as iron metabolism disorders， uncontrolled lipid peroxidation， and abnormal amino acid metabolism. Ferroptosis plays an important regulatory role in the onset， progression， and treatment of depression， offering new ideas for therapeutic approaches to the condition. Additionally， research on TCM interventions that regulate ferroptosis to exert antidepressant effects has identified several effective components， such as saikosaponin B₂， luteolin， quercetin， gallic acid， catalpol， turmerone， oxypaeoniflorin， and traditional compound formulas such as Dihuang Yinzi and Xiaoyaosan， as well as acupuncture and moxibustion. These interventions have been shown to exert antidepressant effects by regulating ferroptosis， providing scientific evidence and references for further research into ferroptosis theory and its application in guiding the prevention and treatment of depression through TCM.

The brain-gut axis is an important channel to realize the functional integration of the central nervous system and the enteric nervous system between the brain and the intestine. It is the medium for the occurrence and development of depression and plays an important role in the pathogenesis of depression. From the perspective of modern medicine and TCM, based on the theory of "brain-gut axis", this article discussed the operation method and mechanism of acupuncture at abdominal ring acupoint in the treatment of depression in Zhuang medicine, in order to provide new ideas for acupuncture treatment of depression.

Objective To investigate the disparities in the activities of daily living(ADL)among older adults living in urban and rural areas of Sichuan Province,China and the influencing factors,and to provide a basis for promoting the health of older adults and formulating relevant policies.Methods Using data from the Seventh Health Services Survey of Sichuan Province,we enrolled 7 369 older adults from urban and rural areas and analyzed their ability to perform ADL and the relevant influencing factors.All participants were aged 60 years or older.Chi-square tests and logistic regression were performed to identify the influencing factors.Results The ADL impairment rate among older adults living in urban areas of Sichuan Province was 17.7％,which was higher than the rate of 13.8％among older adults living in rural areas.According to the results of logistic regression analysis,age≥80 years(odds ratio[OR]=3.725;95％CI,2.460-5.639),accidental injuries(OR=2.375;95％CI,1.597-3.532),and good sleep quality(OR=0.420,95％CI:0.289-0.612)were factors influencing ADL among older adults living in urban areas,while age ≥ 80 years(OR=1.867;95％CI,1.459-2.390),being married(OR=0.805;95％CI,0.664-0.976),accidental injuries(OR=1.936;95％CI,1.564-2.397),and participation in social activities(OR=0.417;95％CI,0.352-0.495)were factors influencing ADL among older adults living in rural areas.Conclusion There are differences in ADL impairment rates and the relevant influencing factors between urban and rural older adults in Sichuan Province.These findings underscore the need to consider urban-rural differences when adopting relevant policies and measures.

Objective:To analyze the characteristics,high-risk factors,and maternal fetal outcomes of intrahe-patic cholestasis of pregnancy(ICP)in twin pregnancies,and provide a basis for clinical intervention.Methods:A retrospective analysis was conducted on 791 cases twin pregnant women who gave birth ≥24 weeks of gestation at Changsha Maternal and Child Health Hospital affiliated to Hunan Normal University from January 1,2021 to No-vember 30,2024.According to whether the pregnant women were complicated with ICP,all included twin pregnant women were divided into two groups,with 732 cases in the non ICP group and 59 cases in the ICP group.The differences in clinical characteristics,high-risk factors,and maternal fetal outcomes between two groups were compared,and Logistic regression analysis was used to identify the influencing factors of ICP in twin pregnancies.Results:①Among the women with twin live births who gave birth at ≥24 weeks of gestation,the incidence of ICP was 7.46％(59/791),and the proportion of mildly elevated total bile acid(TBA)was 83.05％(49/59);The inci-dence of ICP was highest at 34-36+6 weeks of pregnancy,accounting for 52.54％(31/59),and the incidence be-fore full-term was 77.97％(46/59);The treatment rate of TBA lowering drugs was 37.29％(22/59),and the inef-fective rate of drug treatment was 68.18％(15/22).②Univariate analysis found that the proportion of preeclamp-sia(PE)and previous cesarean section history in the ICP group was higher than that in the non ICP group,and the difference was statistically significant(P＜0.05).③ Logistic regression analysis suggests that,PE(OR 3.104,95％CI 1.763-5.466)and a history of previous cesarean section(OR 2.252,95％CI 1.039-4.878)were an inde-pendent risk factor for ICP in twins(P＜0.05).④The gestational age at delivery and birth weight of newborns in the ICP group were lower than those in the non ICP group.The premature birth rate,cesarean section rate,and neonatal transfer rate were higher than those in the non ICP group,and the differences were statistically signifi-cant(P＜0.05).Conclusions:PE and previous cesarean section history are high-risk factors for the occurrence of ICP in twin pregnancies.A detailed understanding of past medical history and active prevention of PE are bene-ficial for preventing the occurrence of ICP in twin pregnancies.

Objective To analyze the reasons and influencing factors of ambiguous medical records,and propose targe-ted intervention strategies.Methods The medical records discharged from the Department of Otolaryngology,Head and Neck Surgery of a large Class Ⅲ hospital in Xi'an from January 2023 to December 2023 were retrospectively collected,and the medical records groups and ambiguous medical records were screened through the DRG information platform.The clinical features,defect causes and risk factors of ambiguous cases were analyzed statistically.Results There were 4 124 discharged cases in the year,of which 77 were ambiguous cases,accounting for 1.87％.Compared with the non-ambiguous group,more patients in the ambig-uous group adopted a self-funded approach,experienced a transfer and a longer hospital stay.The proportion of surgery and trau-ma in ambiguous group was higher,but the proportion of tumor patients was lower.Due to DRG grouping rules,64 cases(83.1％)were divided into ambiguous groups,which was the primary direct cause.Binary Logistic regression indicated that self-paid medical treatment(OR=2.2),transfer(OR=4.8),hospitalization ≥7 days(OR=3.1),trauma(OR=15.0),and total cost＞20 000 yuan(OR=1.7)were the risk factors for ambiguous disease cases(P＜0.05),while tumor disease was the pro-tective factor(OR=0.6,P＜0.05).Conclusion The emergence of ambiguous medical records involves many aspects such as clinical diagnosis and treatment,hospital management,health policy and so on,which has an important impact on hospital per-formance and medical insurance fund.Only by strengthening the level of hospital management,improving the quality of informa-tion system,and promoting the coordination and communication between doctors,management and patients,can we effectively re-duce the occurrence of ambiguous medical records.

Objective:To investigate the antidepressant mechanism of Ziziphi Spinosae Semen and Albiziae Flos through network pharmacology,molecular docking,and cellular experiments.Methods:Active compounds and targets were identified using TCMSP,BATMAN-TCM,GeneCards,and OMIM databases,followed by standardization via the Uniprot database.A Venn diagram was created using venn2.1.0,and a protein-protein interaction(PPI)network was constructed with Cytoscape 3.8.2 and STRING to identify core targets.GO functional and KEGG pathway enrichment analyses were performed using R language.Molecular docking was validated using AutoDock Vina,and the key path-ways and targets were verified by constructing an in vitro model.Results:Twelve active components of Ziziphi Spinosae Semen and Albiziae Flos act on 109 potential depression targets.GO and KEGG analyses identified 2,439 and 163 en-tries,respectively.Based on degree value and enrichment level,core targets such as transcription factor JUN,AKT1,IL-6,and pathways including AGE-RAGE and PI3K/AKT were identified.Molecular docking demonstrated a favorable binding affinity between the active components and core targets.Cellular experiments revealed that serum containing Ziziphi Spinosae Semen and Albiziae Flos at low,medium,and high doses alleviated CORT-induced PC12 cell damage,increased Cell viability,and reduced apoptosis rates.It also upregulated PI3K/AKT pathway protein expression and downregulated endoplasmic reticulum stress related apoptotic protein expression,with more pronounced improvements observed in the medium and high-dose groups(all P＜0.01).Conclusion:The antidepressant effects of Ziziphi Spi-nosae Semen and Albiziae Flos are largely achieved by activating the PI3K/AKT signaling pathway and inhibiting exces-sive ERS,which in turn reduces neuronal apoptosis.

Objective To analyze the current status of stroke treatment in the hierarchical medical service network and the impact of referral on prognosis,to optimize the stroke treatment models,and to improve stroke treatment efficiency.Methods Totally 573 patients with acute ischemic stroke who were referred by the hierarchical medical service network in Lishui,Zhejiang Province from January 2020 to December 2022 were selected for analysis of treatment and clinical data.Based on whether they received endovascular treatment at a high-level stroke center,they were divided into an effective referral group(261 cases)and an ineffective referral group(312 cases).Demographic data,influencing factors,clinical characteristics,and laboratory tests were compared between the two groups,and the differences were analyzed by using single-factor analysis,and prognosis of the two groups of patients was assessed.Results Among 573 patients,197 received intravenous thrombolytic therapy and 261 received intravascular therapy.The effective referral rate was 45.55％.The proportion of patients in the effective referral group coronary artery disease and atrial fibrillation proportion is higher(x2=5.34,8.67,P＜0.05),more likely to show dysarthria,gaze,and consciousness disorder(x2=130.1,22.12,22.96,P＜0.05),and the baseline NIHSS score was higher(F=3.25,P＜0.05).Comparing the baseline blood cells counts of the two groups of patients at admission,the effective referral group showed lower eosinophil count,basophil count and lymphocyte(Z=-8.86,-5.39,F=0.598,P＜0.05).As for the prognosis,the proportion of neurological function improvement at discharge in the effective referral group was higher than that in the ineffective referral group.Binary Logistic regression analysis showed that baseline NIHSS score(OR=1.122,95％CI:1.074-1.172),eosinophil(OR=0.085,95％CI:0.013-0.564),and neutrophil count(OR=1.088,95％CI:1.011-1.172)were independent influencing factors for effective referrals.Conclusions The efficiency of the current regional stroke classification and treatment network needs to be further improved.Developing predictive models that include demographic characteristics,risk factors,symptoms,signs,and laboratory tests may help medical staff in stroke prevention and treatment centers quickly identify large vessel occlusion and improve acute ischemic stroke treatment efficiency.

Background Medical insurance payment lists are important evidence for health insurance settlement and the basis for reasonable DRG payments.However,there are currently many quality control defects that affect the correct DRG assign-ment and the reasonable payment of medical insurance funds.Methods This paper adopts a case analysis approach,combined with clinical knowledge,coding specifications,and mapping relationships,to analyze the quality defects of the current medical insurance payment lists in the hospital.Results This paper proposes refined management strategies and suggestions,including strengthening information construction,improving the professional level of quality control personnel,improving the data quality of the front-end medical record homepage,optimizing the mapping relationship of the dictionary library,carrying out clinical com-munication and training,and establishing a closed-loop quality control system for medical insurance payment lists.These strate-gies effectively improve the data quality of medical insurance payment lists and the accuracy of DRG assignment.Conclusion The management of medical insurance payment lists involves multiple links,departments,and technologies and needs continuous improvement to support hospital refined management.

Objective:To analyze the characteristics,high-risk factors,and maternal fetal outcomes of intrahe-patic cholestasis of pregnancy(ICP)in twin pregnancies,and provide a basis for clinical intervention.Methods:A retrospective analysis was conducted on 791 cases twin pregnant women who gave birth ≥24 weeks of gestation at Changsha Maternal and Child Health Hospital affiliated to Hunan Normal University from January 1,2021 to No-vember 30,2024.According to whether the pregnant women were complicated with ICP,all included twin pregnant women were divided into two groups,with 732 cases in the non ICP group and 59 cases in the ICP group.The differences in clinical characteristics,high-risk factors,and maternal fetal outcomes between two groups were compared,and Logistic regression analysis was used to identify the influencing factors of ICP in twin pregnancies.Results:①Among the women with twin live births who gave birth at ≥24 weeks of gestation,the incidence of ICP was 7.46％(59/791),and the proportion of mildly elevated total bile acid(TBA)was 83.05％(49/59);The inci-dence of ICP was highest at 34-36+6 weeks of pregnancy,accounting for 52.54％(31/59),and the incidence be-fore full-term was 77.97％(46/59);The treatment rate of TBA lowering drugs was 37.29％(22/59),and the inef-fective rate of drug treatment was 68.18％(15/22).②Univariate analysis found that the proportion of preeclamp-sia(PE)and previous cesarean section history in the ICP group was higher than that in the non ICP group,and the difference was statistically significant(P＜0.05).③ Logistic regression analysis suggests that,PE(OR 3.104,95％CI 1.763-5.466)and a history of previous cesarean section(OR 2.252,95％CI 1.039-4.878)were an inde-pendent risk factor for ICP in twins(P＜0.05).④The gestational age at delivery and birth weight of newborns in the ICP group were lower than those in the non ICP group.The premature birth rate,cesarean section rate,and neonatal transfer rate were higher than those in the non ICP group,and the differences were statistically signifi-cant(P＜0.05).Conclusions:PE and previous cesarean section history are high-risk factors for the occurrence of ICP in twin pregnancies.A detailed understanding of past medical history and active prevention of PE are bene-ficial for preventing the occurrence of ICP in twin pregnancies.

Objective To analyze the reasons and influencing factors of ambiguous medical records,and propose targe-ted intervention strategies.Methods The medical records discharged from the Department of Otolaryngology,Head and Neck Surgery of a large Class Ⅲ hospital in Xi'an from January 2023 to December 2023 were retrospectively collected,and the medical records groups and ambiguous medical records were screened through the DRG information platform.The clinical features,defect causes and risk factors of ambiguous cases were analyzed statistically.Results There were 4 124 discharged cases in the year,of which 77 were ambiguous cases,accounting for 1.87％.Compared with the non-ambiguous group,more patients in the ambig-uous group adopted a self-funded approach,experienced a transfer and a longer hospital stay.The proportion of surgery and trau-ma in ambiguous group was higher,but the proportion of tumor patients was lower.Due to DRG grouping rules,64 cases(83.1％)were divided into ambiguous groups,which was the primary direct cause.Binary Logistic regression indicated that self-paid medical treatment(OR=2.2),transfer(OR=4.8),hospitalization ≥7 days(OR=3.1),trauma(OR=15.0),and total cost＞20 000 yuan(OR=1.7)were the risk factors for ambiguous disease cases(P＜0.05),while tumor disease was the pro-tective factor(OR=0.6,P＜0.05).Conclusion The emergence of ambiguous medical records involves many aspects such as clinical diagnosis and treatment,hospital management,health policy and so on,which has an important impact on hospital per-formance and medical insurance fund.Only by strengthening the level of hospital management,improving the quality of informa-tion system,and promoting the coordination and communication between doctors,management and patients,can we effectively re-duce the occurrence of ambiguous medical records.