OBJECTIVE To establish the fingerprint of Gerbera delavayi and the methods for the content determination of 11 components in G. delavayi. METHODS High-performance liquid chromatography（HPLC）was adopted to establish the fingerprints of 13 batches of G. delavayi（No. S1-S13）， and the similarities were evaluated according to Similarity Evaluation System of Chromatographic Fingerprint of TCM （2012 edition）， while the common peaks were identified. Hierarchical clustering analysis （HCA）， principal component analysis （PCA） and orthogonal partial least square-discriminant analysis （OPLS-DA） were carried out by using SPSS 25.0 software and SIMCA 14.1 software. The contents of neochlorogenic acid， chlorogenic acid， cryptochlorogenic acid， 3，8-dihydroxy-4-methoxy-2-oxo-2H-1-benzopyran-5-carboxylic acid， caffeic acid， 3-hydroxy-4-methoxy-2- oxo-2H-1-benzopyran- 5-carboxylic acid， luteolin-7-O-β-D-glucoside， isochlorogenic acid A， apigenin-7-O-β-D-glucoside， isochlorogenic acid C and xanthotoxin were determined by HPLC. RESULTS The similarities in HPLC fingerprint of 13 batches of G. delavayi were 0.801-0.994； a total of 38 common peaks were identified and 13 common peaks were identified. The results of HCA showed that S1-S5 and S7 were clustered into one group， S6 into one category， S8 into one category， S9 and S11 into one category， S10， S12 and S13 into one category， and the results of PCA were consistent with them. The results of OPLS-DA showed that variable importance values for the projection of peak 7 （chlorogenic acid）， peak 21 （isochlorogenic acid A）， peak 26 （xanthotoxin）， peak 19 （isochlorogenic acid B）， peak 33， peak 13， peak 23 （isochlorogenic acid C）， peak 2 （new chlorogenic acid）， peak 17 （luteolin-7-O-β-D- glucoside） were greater than 1. The above 11 components had good linearity in their respective detection concentration ranges （r was greater than 0.999）. RSDs of precision， repeatability， and stability tests were not more than 2% （n＝6）. The average recovery rates were 92.54%-105.55%， and the RSDs were 0.83%-1.93% （n＝6）. The average contents of 11 components were 0.744， 5.014， 0.646， 0.431， 0.069， 0.582， 0.979， 2.754， 0.157， 1.284 and 2.943 mg/g， respectively. CONCLUSIONS The constructed HPLC fingerprint and content determination methods are simple， accurate and stable， which can provide reference for quality control of G. delavayi. Xanthotoxin， chlorogenic acid， isochlorogenic acid A， luteolin-7-O- β -D-glucoside， isochlorogenic acid C and new chlorogenic acid can be used as markers for G. delavayi.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Severe open tibiofibular fractures account for approximately 28.1% of all open fractures. Among them, Gustilo-Anderson type IIIB/C fractures present significant clinical challenges due to associated bone and soft tissue defects, high infection rates, and risk of amputation. Inadequate preoperative assessment may lead to suboptimal emergency surgical planning or intraoperative complications. Historically, external fixation was often preferred, but this approach has been associated with limitations such as restricted joint mobility, delayed bone union, joint stiffness, and disuse osteoporosis, resulting in poor functional recovery. With advancements of debridement techniques, standardization of antibiotic use, and popularization of early soft tissue coverage, early internal fixation has gained broader acceptance. Nevertheless, controversies persist regarding the choice of fixation method, timing of definitive fixation, use of reamed versus unreamed intramedullary nailing, and necessity of fibular fixation. To standardize the diagnosis and early management of severe open tibiofibular fractures, reduce complication rates, and improve functional recovery, the Society of Microsurgery of the Chinese Medical Association organized a panel of domestic experts to develop the Evidence-based guideline for the diagnosis and early fixation of severe open tibiofibular fractures ( version 2025), using evidence-based methodology. The guidelines provided 12 recommendations covering diagnostic and early fixation strategies of severe open tibiofibular fractures, aiming to provide clinicians with scientifically grounded and standardized guidance.

Objective:To summarize the safety and efficacy of thoracoscopic minimally invasive " one-stop" ablation for the treatment of atrial fibrillation(AF).Methods:A retrospective study was conducted on all patients with isolated atrial fibrillation who underwent thoracoscopic radiofrequency ablation combined with left atrial appendage clipping(LAAC) at West China Hospital of Sichuan University from September 2019 to October 2023. Preoperative baseline data, perioperative complications, and 3-month, 6-month, and 12-month postoperative follow-up data were collected and analyzed.Results:A total of 87 patients were included, with a mean age of(60.5±9.0) years old. Among them, 47 were males and 40 were females. Of these patients, 12 had paroxysmal AF, and 75 had persistent AF. Fourteen patients had a prior history of catheter-based radiofrequency ablation, and 11 had a history of transient ischemic attack(TIA) or stroke. All procedures were successfully completed without conversion to open thoracotomy, perioperative mortality, or perioperative stroke events. During the follow-up period, one patient died, no strokes or left atrial appendage reconnection events were observed. The sinus rhythm maintenance rates at 3、6 and 12 months postoperatively were 89.6%(78/87)、82.8%(72/87) and 75.9%(66/87), respectively. Multivariate logistic regression analysis identified a preoperative left atrial anteroposterior diameter>40 mm as an independent risk factor for postoperative AF recurrence. Conclusion:Thoracoscopic minimally invasive ablation combined with left atrial appendage clipping as a " one-stop" procedure is a safe and effective method for the treatment of isolated atrial fibrillation, achieving satisfactory surgical ablation success rates while effectively preventing stroke.

Objective:To explore the key factors affecting health-related quality of life in children with brain tumors following initial diagnosis and to analyze its impact on survival and prognosis.Methods:Seventy-eight pediatric brain tumor patients who participated in a prospective cohort study between June 1st，2016 and June 30th，2021 were included for health-related quality of life assessment and long-term follow-up（median follow-up duration：52 months）.Results:The male-to-female ratio among the 78 children was 1.1：1，with a median age of 7.0（4.0，10.0）years. The scores of the Pediatric Quality of Life Inventory? 4.0 Generic Core Scales（PedsQL? 4.0）were（67.40±18.26）for parent proxy reports and（67.87±20.40）for child self-reports. Cronbach's α coefficients ranged from 0.790 to 0.927，with the intraclass correlation coefficient（ICC）was 0.673. According to the PedsQL? 4.0，impaired quality of life was observed in 50.0% of children by parent proxy report and 52.8% by child self-report，primarily affecting physical and role functioning. In addition，70% of caregivers reported impaired quality of life，with worry being the most prominent issue. Key factors affecting children's quality of life included radiotherapy，tumor stage，annual family income，and parents' marital status，while caregivers' quality of life was influenced by radiotherapy and the child's IgA levels（all P<0.05）. Children with decreased total scores，impaired physical functioning，or impaired emotional functioning on the PedsQL? 4.0 parent proxy report exhibited an increased risk of mortality（all P<0.05）. In multivariate Cox regression analysis，independent prognostic factors included a decrease in the total score on the PedsQL? 4.0 parent proxy report（ HR=6.702，95% CI：1.442-31.151， P<0.05），presence of hydrocephalus（ HR=33.602，95% CI：4.354-259.333， P<0.05），tumor recurrence（ HR=16.846，95% CI：3.158-89.852， P<0.05），and absence of hydrocephalus shunt surgery（ HR=13.428，95% CI：1.761-102.394， P<0.05）. Conclusion:The quality of life of newly diagnosed children with brain tumors is lower than that of healthy children，and quality of life is an important prognostic factor. Quality of life assessment should be an integral component of a comprehensive management program for children with brain tumors.

The European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) have recently updated and published the 2024 ESC guidelines for the management of atrial fibrillation. Based on the latest evidences, the guidelines have been updated in many aspects, such as diagnostic criteria for atrial fibrillation, AF-CARE treatment principles, comorbidities and risk factor management. In particular, there are significant changes in the recommendations for surgical management of atrial fibrillation in the guidelines. Therefore, this paper aims to interpret the content updates of the guidelines in AF-CARE treatment principles, diagnostic criteria and surgical treatment of atrial fibrillation, especially highlighting the updates and new suggestions about surgical treatment of atrial fibrillation.

OBJECTIVE To investigate the effects of the split formulas of Biyuan Heji(BYHJ)on paranasal sinus mucosal in-flammation in rats with acute rhinosinusitis(ARS)based on the pathogenesis of"wind-cold transforming into lung-heat".METHODS Unilateral nasal cavity occlusion combined with nasal dripping of Staphylococcus aureus were performed to establish a rat model of ARS.SD rats were randomly divided into blank,model,BYHJ(wind-cold removal+lung-heat removal),lung-heat removal,wind-cold removal,and positive drug groups,with 6 rats in each group.The rats were treated with the corresponding drugs for 7 d and then the samples were collected.HE staining was used to observe the pathological changes of rat paranasal sinus mucosa tissues,ELISA was employed to determine the levels of interleukin-1β(IL-1β),IL-6,IL-8,IL-9,IL-10,and IL-12 in serum,immunohistochemis-try(IHC)was adopted to measure the protein expression of tumor necrosis factor-α(TNF-α)and intercellular adhesion molecule(ICAM-1)in paranasal sinus mucosa tissues,and Western blot was used to detect the protein expression of phosphorylated p38 mito-gen-activated protein kinase(p38 MAPK),nuclear transcription factor-κB p50(NF-κB p50),and NF-κB p65 in paranasal sinus mucosa tissues.RESULTS The acute sinusitis rat inflammation model was successfully established.Compared with the model group,the water drinking,diet eating,and body weight of rats in the BYHJ group,wind-cold removal,lung-heat removal,and positive drug groups were significantly improved,the aggregation of inflammatory cells in the paranasal sinus mucosal tissue was reduced,and the levels of IL-1β,IL-6,IL-8,IL-9,and IL-12 in the serum were significantly reduced(P<0.01),IL-10 content significantly in-creased(P<0.01),the protein expression of TNF-α,ICAM-1,p38 MAPK,NF-κB p50,and NF-κB p65 in the paranasal sinus mucosa was significantly decreased(P<0.01).The comparison between various traditional Chinese medicine groups showed that the decrease of IL-1β,IL-6,IL-8,IL-9,IL-12,TNF-α,ICAM-1,p38 MAPK,NF-κB p50,and NF-κB p65 and the increase of IL-10 in the BYHJ group were better than those in the split formula groups(P<0.01),and the lung-heat removal group was better than the wind-cold removal group(P<0.01).CONCLUSION BYHJ and its split formulas can effectively inhibit the inflammatory response in rats with ARS.

OBJECTIVE To explore the clinical efficacy and possible mechanism of the classic prescription Xinyi Powder in the treatment of allergic rhinitis with lung deficiency related cold.METHODS A total of 189 patients who met the inclusion criteria of al-lergic rhinitis with lung deficiency related cold in the otolaryngology clinic of Jiangsu Province Hospital of Chinese Medicine from Janu-ary 2023 to July 2024 were selected and randomly divided into the experimental group(n=126)and the control group(n=63).The control group was treated with oral loratadine,and the experimental group took Xinyi Powder.Before and after treatment,the TNSS,TNNSS scores and TCM syndrome scores of the two groups of patients were compared to comprehensively evaluate the clinical efficacy.The changes in the patients'quality of life were evaluated in multiple dimensions using nasal VAS and RQLQ scores.The changes in serum IL-4,IL-5,IgE,SP and CGRP expression levels were detected by ELISA.RESULTS After 14 days of treatment,the TNSS,TNNSS,VAS,RQLQ scores and TCM syndrome scores of the two groups of patients were reduced(P<0.01);the experi-mental group was better than the control group in improving the concomitant symptoms such as nasal congestion,runny nose,postnasal drip,and itchy eyes(P<0.05,P<0.01),and it could also significantly improve the symptoms of fear of wind and cold,spontaneous sweating,shortness of breath,and cough with thin sputum(P<0.01),and the total RQLQ score was significantly better than the con-trol group(P<0.01).After treatment,the serum IL-4,IL-5,IgE,SP,and CGRP levels of the two groups of patients were signifi-cantly reduced(P<0.01),and there was no statistical difference between the two groups.CONCLUSION Xinyi Powder can signifi-cantly alleviate the nasal symptoms and systemic concomitant symptoms of patients with allergic rhinitis of lung deficiency and cold type,and significantly improve the quality of life of patients.It may play a therapeutic role by inhibiting the expression of inflammatory factors and neuropeptides and regulating neuroimmunity.

OBJECTIVE To explore the potential mechanism of Yiqi Wenyang Recipe in the intervention of allergic rhinitis(AR)mice.METHODS C57/BL6 mice were randomly divided into blank,model,Yiqi Wenyang Recipe and Yiqi Wenyang Recipe+EX-527[Sirtuin 1(SIRT1)inhibitor]groups.The AR model of mice was established by ovalbumin based challenge sensitization method,each group received corresponding intervention measures.Assessment of behavioral changes in mice;nasal mucosal lesions were observed by HE and toluidine blue staining;the serum levels of interleukin-4(IL-4),interferon-γ(IFN-γ),and immunoglobulin E(IgE)were measured by ELISA;the expression levels of phospho-Janus kinase 2(p-JAK2),phospho-signal transducer and activator of transcription 6(p-STAT6),phospho-dynamin-related protein 1(p-Drp1),SIRT1,peroxisome proliferator-activated receptor gamma coactivator 1-alpha(PGC-1α)in nasal mucosa were determined by Western blot combined with immunofluorescence;reactive oxygen species(ROS)levels were detected by fluorescent probe method;the morphological changes of mitochondria in the microstructure of na-sal mucosa were observed by transmission electron microscopy.RESULTS Compared with the blank group,the frequency of scratch-ing and sneezing in the model group was significantly increased,and a large number of eosinophils and mast cells were found in the na-sal mucosa(P<0.05);compared with the model group,the nasal allergic symptoms and the level of nasal mucosal inflammatory reaction in the Yiqi Wenyang Recipe group were significantly improved(P<0.05);compared with the Yiqi Wenyang Recipe group,the scratch-ing and sneezing of mice in the Yiqi Wenyang Recipe+EX-527 group increased again,and the counts of eosinophils and mast cells in nasal mucosa increased significantly(P<0.05).Compared with the model group,the levels of serum IL-4 and IgE in the Yiqi Wenyang Recipe group decreased,while the level of serum IFN-γ increased(P<0.05);the serum IL-4 and IgE of mice in the Yiqi Wenyang Recipe+ex-527 group were significantly higher than those in the Yiqi Wenyang Recipe group(P<0.05).Western blot and immunofluo-rescence showed that Yiqi Wenyang Recipe could effectively inhibit the increase of p-JAK2,p-STAT6,p-Drp1(ser616)levels induced by ovalbumin sensitization,as well as the decrease of SIRT1 and PGC-1 α expression(P<0.01);however,the intervention of EX-527 significantly blunted the regulatory effect of Yiqi Wenyang Recipe on the above signaling molecules(P<0.05,P<0.01).The results of transmission electron microscopy and fluorescent probe showed that in the model group,a large number of spherical mitochondria were found in the mitochondria of nasal mucosa,and the level of ROS was significantly increased(P<0.01);;the intervention of Yiqi We-nyang recipe effectively restored the long tubular morphology of mitochondria and reduced ROS level(P<0.01);,while the intervention of EX-527 weakened the above improvement effect(P<0.01).CONCLUSION Yiqi Wenyang Recipe can regulate SIRT1 to activate PGC-1α,and then inhibit Drp1 mediated excessive mitochondrial fission to intervene AR;SIRT1 may be one of the important targets of Yiqi Wenyang Recipe in the intervention of AR.

This study aims to construct and identify the cDNA expression library of 3rd day larva of Echinococcus granulosus.Echinococcus granulosus protoscolex was isolated and collected from the liver of a fresh infected sheep with cysts,and the experimental dogs were infected manually by mouth.On the 3rd day,approximately 1.5 meters of the duodenal jejunum was taken during the au-topsy,and the worm body was dislodged by swinging it in 38-40 ℃ physiological saline,and then the 3-day larvae of Echinococcus granulosus were collected.Total RNA was extracted by TRIzol reagent,mRNA was isolated and purified using PolyATtract? mRNA Isolation Systems.The cD-NA was synthesized by reverse transcription,ligated with pBluescript sk-vector after addition of a 5'junction and introduced into E.coli by electrotransformation to construct a cDNA expression li-brary for 3-day-old larvae of Echinococcus granulosus.The average length of insert cDNA frag-ments was 1.0-1.2 kb.The initial capacity of constructed library was 1.15×107 CFU/mL,titer of amplified library was 1× 1010 CFU/mL,recombination rate was 100％.The constructed cDNA ex-pression library and the inserted fragment size were suitable.This library is expected to be used for screening candidate genes and diagnostic antigen molecules of definitive hosts canine vaccines of Echinococcus granulosus.