The oocyte， as the origin of life， provides half the chromosomes to the embryo and supplies the proteins， substrates， energy， and other support necessary for embryonic development. It is the decisive factor determining the embryo's developmental potential. Infertility caused by reproductive endocrine diseases targets the oocyte as the final target cell. Improving oocyte quality represents a key and difficult point in the field of modern reproductive medicine. The decline of oocyte quality is related to meiosis abnormalities， DNA damage， mitochondrial dysfunction， oxidative stress， and other mechanisms. For oocyte quality problems， there is no unified international guideline to recommend drugs. Because the drug intervention research on oocytes involves strict clinical ethical restrictions， the current relevant research only stays in the animal and in vitro experimental stage and has not yet been applied to the clinic. Traditional Chinese medicine compound formula has a multi-target and multi-pathway regulation mechanism and is widely used in clinics. More and more research began to pay attention to the potential mechanism of traditional Chinese medicine compound formulas in improving oocyte quality. Traditional Chinese medicine compound formula has the advantages of multi-target and multi-channel synergy as well as better safety， individualization， and conformity to clinical ethics in improving oocyte quality. This article systematically reviewed the research progress on traditional Chinese medicine compound formula interventions for oocyte quality， aiming to summarize existing findings and provide recommendations to improve oocyte quality and optimize the clinical diagnosis and treatment of female infertility within traditional Chinese medicine.

The oocyte， as the origin of life， provides half the chromosomes to the embryo and supplies the proteins， substrates， energy， and other support necessary for embryonic development. It is the decisive factor determining the embryo's developmental potential. Infertility caused by reproductive endocrine diseases targets the oocyte as the final target cell. Improving oocyte quality represents a key and difficult point in the field of modern reproductive medicine. The decline of oocyte quality is related to meiosis abnormalities， DNA damage， mitochondrial dysfunction， oxidative stress， and other mechanisms. For oocyte quality problems， there is no unified international guideline to recommend drugs. Because the drug intervention research on oocytes involves strict clinical ethical restrictions， the current relevant research only stays in the animal and in vitro experimental stage and has not yet been applied to the clinic. Traditional Chinese medicine compound formula has a multi-target and multi-pathway regulation mechanism and is widely used in clinics. More and more research began to pay attention to the potential mechanism of traditional Chinese medicine compound formulas in improving oocyte quality. Traditional Chinese medicine compound formula has the advantages of multi-target and multi-channel synergy as well as better safety， individualization， and conformity to clinical ethics in improving oocyte quality. This article systematically reviewed the research progress on traditional Chinese medicine compound formula interventions for oocyte quality， aiming to summarize existing findings and provide recommendations to improve oocyte quality and optimize the clinical diagnosis and treatment of female infertility within traditional Chinese medicine.

Endothelial dysfunction induced by inflammation and oxidative stress represents a critical pathological mechanism in cardiovascular and cerebrovascular diseases, including sepsis and atherosclerosis. Although crebanine has been reported to possess antiinflammatory and analgesic properties, its effects on inflammation and oxidative stress in endothelial cells remain unknown. In this study, we assessed cell viability, apoptosis, and migration using the Cell Counting Kit-8 (CCK-8), flow cytometry, and a wound healing assay, respectively. The levels of reactive oxygen species (ROS) and the expression of inflammatory and oxidative stress markers were determined by qRT-PCR, enzyme-linked immunosorbent assay (ELISA), and Western blotting analysis. Our results demonstrated that crebanine alleviated lipopolysaccharide (LPS)-induced apoptosis and dysfunction in human umbilical vein endothelial cells (HUVECs). Crebanine treatment inhibited the production of pro-inflammatory cytokines (TNF-α, IL-6, IL-1β), ROS, and malondialdehyde (MDA), while it enhanced the activity of the antioxidant enzyme superoxide dismutase (SOD). Mechanistically, crebanine suppressed LPS-induced activation of the NF-κB signaling pathway in HUVECs. Furthermore, the improvement effect of crebanine on the inflammation and dysfunction in LPS-treated HUVECs was reversed by diprovocim, an NF-κB activator.These findings suggest that crebanine ameliorates LPS-induced inflammation and oxidative stress in HUVECs by inhibiting the NF-κB signaling pathway, indicating its potential therapeutic value for treating vascular endothelial dysfunction-related diseases.

Background: and Purpose Vertebrobasilar fusiform aneurysms (VBFAs) carry substantial morbidity and mortality, but optimal management for unruptured VBFAs remains unclear. We compared the safety and efficacy of conservative management (CM), stent-assisted coiling (SAC), and flow diverters (FDs) in patients with unruptured VBFAs, focusing on long-term prognosis. Methods: This study included data from a nationwide Chinese cohort of patients with vertebrobasilar dissecting aneurysms. Inverse probability of treatment weighting (IPTW) balanced confounders across groups. The primary outcome was poor prognosis (modified Rankin Scale score >2). Secondary outcomes included aneurysm rupture, ischemic stroke, compression symptoms, and VBFA-related deaths. Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup and sensitivity analyses were performed. Results: Among 1,115 patients with unruptured VBFAs, 838 (median age, 54 years; 655 men) were included. After IPTW, baseline characteristics were balanced. Median follow-up was 54 months. FD was associated with a lower risk of poor prognosis than CM (OR, 0.48 [95% CI, 0.30 to 0.77]; p=0.002), with no difference between CM and SAC. FD also reduced aneurysm rupture (OR, 0.20 [95% CI, 0.07 to 0.60]; p=0.004) and compression symptoms (OR, 0.30 [95% CI, 0.13 to 0.68]; p=0.004) versus CM. Time-to-event analyses further revealed significant differences in vertebral artery lesions and Type I–II VBFAs, whereas no significant differences were observed in basilar or vertebrobasilar junction lesions or in Type III–IV VBFAs. Conclusions Compared with CM, FD was associated with improved long-term outcomes in unruptured VBFAs, particularly in vertebral artery lesions and Type I–II VBFAs, although residual confounding cannot be excluded.

Objective:To investigate the association between frailty and prognosis of elderly patients in the emergency department, and to validate frailty screening tools suitable for the emergency department.Methods:This was a prospective cohort study. Clinical data of elderly patients over 60 years old treated in the emergency department of Beijing Bo'Ai Hospital from January to December 2021 were collected. The Frailty Screening Questionnaire (FSQ), FRAIL Scale (FRAIL) and Clinical Frailty Scale (CFS) were used to score patients, and patients were divided into frail or non-frail group according to the criteria of the above three scales. Twelve-month all-cause mortality was the primary endpoint, dependence and re-admission to the emergency department within 12 months were secondary outcomes. Receiver operating characteristic curves were used to evaluate the ability of the FSQ, FRAIL and CFS scores to predict the primary and secondary endpoints, and the areas under the curve (AUC) were calculated and compared. Survival analysis was performed using Cox hazard proportional regression model, and relative risk was expressed as hazard ratio ( HR) and 95% CI. Results:A total of 406 patients were included in the study. The AUCs (95% CI) of FSQ, FRAIL and CFS scores for predicting 12-month all-cause mortality were 0.879 (0.844-0.909), 0.838 (0.798-0.872), 0.906 (0.873-0.933), respectively (all P<0.001). The AUCs of 3 scores for predicting secondary endpoints ranged from 0.820 to 0.889 (all P<0.001). Pairwise comparisons of the AUCs showed that the CFS was superior to one or both of the other frailty screening scales in predicting 12-month all-cause mortality and dependence except for re-admission to emergency room within 12 months after discharge (all P<0.05). Cox regression analysis revealed that, after adjusting for sex, age, body mass index and comorbidities, frailty as defined by the FSQ, FRAIL, and CFS scales was independently associated with 12-month all-cause mortality, with the HRadj of 3.267 (95% CI: 2.406-4.435), 2.465 (95% CI: 1.819-3.341), 3.523 (95% CI: 2.648-4.687), respectively (all P<0.001). Conclusions:FSQ, FRAIL and CFS scores can predict adverse outcomes, the CFS is a practical frailty screening tool in the emergency department, and frailty screening can improve the risk stratification of older patients.

Objective To explore the brain damage of SD rats under different time points of hypobaric hypoxia exposure.Methods A rat high-altitube cerebral edema(HACE)model was constructed by simulating an altitude of 6 000 m in a hypobaric hypoxia animal experimental chamber.Thirty-six SD male rats were randomly divided into the control group and the hypobaric hypoxia exposure 3,7 and 14 d groups,with 9 rats in each group.Except for the control group,the rats in each group were continuously exposed to hypobaric hypoxia for 3,7,and 14 d.At the end of the modeling period,serum was collected by blood sampling via the abdominal aorta,and brain tissue samples were taken.The wet-to-dry ratio(W/D)of brain tissue was calculated,and the levels of relevant oxidative enzymes in serum and brain tissue were measured.The expression levels of hypoxia-inducible factor-1α(HIF-1α)and aquaporin 4(AQP4)mRNAs in brain tissue were detected by real-time fluorescence quantitative polymerase chain reaction.Results The W/D of brain tissues in the control group and the group exposed to hypobaric hypoxia for 3,7 and 14 d were 4.46±0.12,4.98±0.16,5.07±0.18 and 4.95±0.07;the superoxide dismutase contents were(111.86±2.45),(90.73±1.48),(79.64±2.56)and(55.33±1.45)U·g-1;the glutathione contents were(126.91±5.18),(125.26±1.53),(56.20±2.17)and(122.73±1.78)μg·mL-1;the malondialdehyde contents were(230.94±2.00),(362.65±3.28),(407.34±3.47)and(237.50±1.59)nmol·g-1;the relative expression levels of HIF-1 α mRNA were 1.00±0,2.99±0.49,4.72±0.49 and 1.91±0.28;the relative expression levels of AQP4 mRNA were 1.00±0,2.62±0.34,8.38±0.84 and 5.27±0.42,respectively.Statistically significant differences were found between the above indexes in the 3,7 and 14 d of hypobaric hypoxia exposure group compared with the control group(P＜0.05,P＜0.01).Conclusion Different time of hypobaric hypoxia exposure can up-regulate the expression of AQPs proteins in HACE rats and cause the disruption of the blood-brain barrier,and the HACE model constructed in the hypobaric hypoxia chamber with 6 000 m intervention for 7 d was more stable.

Objective:To investigate the related factors of hyperuricemia(HUA)in adolescents with bipolar disorder.Methods:Fifty-nine adolescent patients with bipolar disorder and 60 normal controls were select-ed.General demographic and clinical data were collected.Serum uric acid(UA),triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),fasting blood glucose(FPG),fructosamine(FA)and other physiological indices were detected.The Hamilton Depression Scale 17(HAMD-17)and Bech-Rafaelsen Mania Scale(BRMS)were used to evaluate the emotional symptoms of the patients.Results:The detection rate of HUA was higher in the adolescent patients with bipolar disorder than in the normal control group(30.5％vs.18.3％,P＜0.05),and was higher in manic episode than in depressive episode(48.2％vs.20.8％,P＜0.05).Unconditioned logistic regression analysis showed that high level of TG and high BMI were risk factors for hyperuricemia in adolescents with bipolar disorder(OR=2.51,1.34).Conclusion:This study shows that adolescents with bipolar disorder may have a higher risk of HUA than normal controls,and its oc-currence is associated with high TG level and BMI.

Objective To understand the changing composition and antibiotic resistance of bacterial species in the clinical isolates from outpatient and emergency department(hereinafter referred to as outpatients)and inpatient children over time in various hospitals,and to provide laboratory evidence for rational antibiotic use.Methods The data on clinically isolated pathogenic bacteria and antimicrobial susceptibility of isolates from outpatients and inpatient children in the CHINET program from 2015 to 2021 were collected and analyzed.Results A total of 278 471 isolates were isolated from pediatric patients in the CHINET program from 2015 to 2021.About 17.1％of the strains were isolated from outpatients,primarily group A β-hemolytic Streptococcus,Escherichia coli,and Staphylococcus aureus.Most of the strains(82.9％)were isolated from inpatients,mainly SS.aureus,E.coli,and H.influenzae.The prevalence of methicillin-resistant S.aureus(MRSA)in outpatients(24.5％)was lower than that in inpatient children(31.5％).The MRSA isolates from outpatients showed lower resistance rates to the antibiotics tested than the strains isolated from inpatient children.The prevalence of vancomycin-resistant Enterococcus faecalis or E.faecium and penicillin-resistant S.pneumoniae was low in either outpatients or inpatient children.S.pneumoniae,β-hemolytic Streptococcus and S.viridans showed high resistance rates to erythromycin.The prevalence of erythromycin-resistant group A β-hemolytic Streptococcus was higher in outpatients than that in inpatient children.The prevalence of β-lactamase-producing H.influenzae showed an overall upward trend in children,but lower in outpatients(45.1％)than in inpatient children(59.4％).The prevalence of carbapenem-resistant Klebsiella pneumoniae(CRKpn),carbapenem-resistant Pseudomonas aeruginosa(CRPae)and carbapenem-resistant Acinetobacter baumannii(CRAba)was 14％,11.7％,47.8％in outpatients,but 24.2％,20.6％,and 52.8％in inpatient children,respectively.The prevalence of multidrug-resistant E.coli,K.pneumoniae,Proteus mirabilis,P.aeruginosa and A.baumannii strains was lower in outpatients than in inpatient children.The prevalence of fluoroquinolone-resistant E.coli,ESBLs-producing K.pneumoniae,ESBLs-producing P.mirabilis,carbapenem-resistant E.coli(CREco),CRKpn,and CRPae was lower in children in outpatients than in inpatient children,but the prevalence of CRAba in 2021 was higher than in inpatient children.Conclusions The distribution of clinical isolates from children is different between outpatients and inpatients.The prevalence of MRSA,ESBL,and CRO was higher in inpatient children than in outpatients.Antibiotics should be used rationally in clinical practice based on etiological diagnosis and antimicrobial susceptibility test results.Ongoing antimicrobial resistance surveillance and prevention and control of hospital infections are crucial to curbing bacterial resistance.

Objective To investigate the changing antibiotic resistance profiles of E.coli isolated from patients in the 52 hospitals participating in the CHINET program from 2015 to 2021.Methods Antimicrobial susceptibility was tested for clinical isolates of E.coli according to the unified protocol of CHINET program.WHONET 5.6 and SPSS 20.0 software were used for data analysis.Results Atotal of 289 760 nonduplicate clinical strains ofE.coli were isolated from 2015 to 2021,mainly from urine samples(44.7±3.2)％.The proportion of E.coli strains isolated from urine samples was higher in females than in males(59.0％vs 29.5％).The proportion of E.coli strains isolated from respiratory tract and cerebrospinal fluid samples was significantly higher in children than in adults(16.7％vs 7.8％,0.8％vs 0.1％,both P＜0.05).The isolates from internal medicine department accounted for the largest proportion(28.9±2.8)％with an increasing trend over years.Overall,the prevalence of ESBLs-producing E.coli and carbapenem resistant E.coli(CREco)was 55.9％and 1.8％,respectively during the 7-year period.The prevalence of ESBLs-producing E.coli was the highest in tertiary hospitals each year from 2015 to 2021 compared to secondary hospitals.The prevalence of CREco was higher in children's hospitals compared to secondary and tertiary hospitals each year from 2015 to 2021.The prevalence of ESBLs-producing E.coli in tertiary hospitals and children's hospitals and the prevalence of CREco in children's hospitals showed a decreasing trend over the 7-year period.The prevalence of CREco in secondary and tertiary hospitals increased slowly.Antibiotic resistance rates changed slowly from 2015 to 2021.Carbapenem drugs(imipenem,meropenem)were the most active drugs amongβ-lactams against E.coli(resistance rate≤2.1％).The resistance rates of E.coli to β-lactam/β-lactam inhibitor combinations(piperacillin-tazobactam,cefoperazone-sulbactam),aminoglycosides(amikacin),nitrofurantoin and fosfomycin(for urinary isolates only)were all less than 10％.The resistance rate of E.coli strains to antibiotics varied with the level of hospitals and the departments where the strains were isolated,especially for cefazolin and ciprofloxacin,to which the resistance rate of E.coli strains from children in non-ICU departments was significantly lower than that of the strains isolated from other departments(P＜0.05).The E.coli isolates from ICU showed higher resistance rate to most antimicrobial agents tested(excluding tigecycline)than the strains isolated from other departments.The E.coli strains isolated from tertiary hospitals showed higher resistance rates to the antimicrobial agents tested(excluding tigecycline,polymyxin B,cefepime and carbapenems)than the strains from secondary hospitals and children's hospitals.Conclusions E.coli is an important pathogen causing clinical infection.More than half of the clinical isolates produced ESBL.The prevalence of CREco is increasing in secondary and tertiary hospitals over the 7-year period even though the overall prevalence is still low.This is an issue of concern.

Although no cross protection was observed between different serotypes of foot-and-mouth disease virus(FMDV),there were cross-reactivity between different serotypes of antibodies produced after vaccination,the aim of this paper was to prepare the neutralizing monoclonal anti-body against Foot-and-mouth disease virus(FMDV)serotype O,and to develop the method to dis-tinguish antibody against FMDV serotype O and A based on mAb.The inactivated FMDV serotype O was used as antigen in mAb production,a series of GST fusion overlapping peptides and trun-cated peptides expressed in Escherichia coli were used to identify antigenic epitope recognized by monoclonal antibodies.In order to verify feasibility of the screened monoclonal antibodies in diag-nosis,20 positive serum of FMDV serotype O and A,20 negative serum with known background were detected by blocking ELISA.Results were as follows:five monoclonal antibodies were suc-cessfully screened.The five monoclonal antibodies showed good reactivity with FMDV serotype O,but did not react with FMDV serotype A by Western blot and IFA,these mAbs showed neutrali-zing ability to FMDV/O/MY98/GZBY/2013 by VNT.The same epitope was identified by five monoclonal antibodies,the minimum epitope was145 RGDLQVLA152,Arg145 and Gln149 were key a-mino acids of the epitope.Sequence alignment analysis revealed that the identified epitopes were conserved among most of O type FMDV strains,but Gln149 was mutated among all A,Asia 1 and SAT1-3 type FMDV strains.The mAb-8C5D3 distinguished between antibody of FMDV serotype O and FMDV serotype A by blocking ELISA.The results provided materials for development of O type FMDV antibody detection kit and evaluation of vaccine immune effect.