OBJECTIVE To evaluate the clinical efficacy of Chaihu anxin capsules in the treatment of mild-to-moderate depression， analyze the influencing factors of its efficacy, construct a nomogram prediction model.METHODS Patients with mild-to-moderate depression treated at The First Hospital of Hebei Medical University from May 1， 2023 to March 10， 2025 were retrospectively included and categorized into Chaihu anxin capsules group and milnacipran group according to treatment regimen. Propensity score matching （PSM） was used to balance baseline characteristics， and treatment efficacy was compared after 8 weeks， including 24 Hamilton Depression Scale （HAMD-24） scores and changes， Hamilton Anxiety Scale （HAMA） scores and changes， and treatment response rate after 8 weeks of treatment. Patients receiving Chaihu anxin capsules were further classified as responders or non-responders based on the occurrence of treatment response. Univariate and multivariate Logistic regression analyses were conducted to identify the influencing factors of treatment response， and a nomogram model was constructed to predict the probability of treatment response， its predictive performance was evaluated using receiver operating characteristic （ROC） curves， calibration curves， and decision curve analysis.RESULTS A total of 297 patients were included before PSM， including 196 patients in the Chaihu anxin capsules group and 101 patients in the milnacipran group. After PSM， each group included 44 patients. After PSM， the HAMD-24 scores and HAMA scores at 8 weeks after treatment in the Chaihu anxin capsules group， as well as the HAMD-24 scores in the milnacipran group， were significantly lower than their respective baseline values （ P ＜0.05）； the change in HAMA score in the Chaihu anxin capsules group was significantly greater than that in the milnacipran group （ P ＝0.04）. Multivariable Logistic regression identified age， total bilirubin， and baseline HAMD-24 score as independent predictors of treatment response （ P ＜0.05）. The area under the ROC curve of the constructed nomogram prediction model was 0.72 （95% confidence interval： 0.637-0.799）， and the corrected Brier score was 0.143 （95% confidence interval： 0.112-0.176）； compared with the “all intervention” and “all non intervention” strategies， applying this nomogram prediction model could achieve higher net benefits within the threshold probability range of 8% to 37%.CONCLUSIONS The efficacy of Chaihu anxin capsules in improving mild-to-moderate depression is comparable to that of milnacipran， and it has certain advantages in improving anxiety symptoms； age， total bilirubin， and baseline HAMD-24 score are independent influencing factors for the treatment response of Chaihu anxin capsules. The nomogram prediction model constructed based on these factors has good discrimination， calibration， and clinical applicability.

Alcoholic liver disease(ALD), a major cause of chronic liver disease worldwide, poses a serious threat to human health. Despite the availability of various drugs for treating ALD, their efficacy is often uncertain, necessitating the search for new therapeutic approaches. Traditional Chinese medicine polysaccharides have garnered increasing attention in recent years due to their versatility, high efficiency, and low side effects, and they have demonstrated significant potential in preventing and treating ALD. Emerging studies have suggested that these polysaccharides exert their therapeutic effects through multiple mechanisms, including the inhibition of oxidative stress and the regulation of lipid metabolism, gut microbiota, and programmed cell death. This review summarizes the recent research progress in the pharmacological effects and regulatory mechanisms of traditional Chinese medicine polysaccharides in treating ALD, aiming to provide a scientific basis and theoretical support for their application in the prevention and treatment of ALD.
Humans ; Liver Diseases, Alcoholic/metabolism* ; Polysaccharides/administration & dosage* ; Drugs, Chinese Herbal/administration & dosage* ; Animals ; Oxidative Stress/drug effects* ; Medicine, Chinese Traditional ; Gastrointestinal Microbiome/drug effects* ; Lipid Metabolism/drug effects*

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.

Objective:To investigate the efficacy and safety of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for the treatment of BCR::ABL-negative chronic neutrophilic leukemia (CNL) and MDS/MPN with neutrophilia.Methods:This study retrospectively analyzed 12 cases of CNL and MDS/MPN with neutrophilia that underwent allo-HSCT from March 2017 to June 2024, comprising 7 males and 5 females with a median age of 48 ( IQR: 28, 59) years. The 2-year overall survival (OS), disease-free survival (DFS), cumulative incidence of relapse (CIR), and transplantation-related mortality (TRM) rates were analyzed. Complications were also assessed. Results:Of the 12 patients, 6 received matched sibling HSCT and 6 received haploidentical HSCT. All patients had successful engraftment, and the median times of neutrophil and platelet engraftment were 17 ( IQR: 11, 24) days and 15 ( IQR: 9, 28) days, respectively. Grade Ⅱ–Ⅳ acute graft versus host disease (GVHD) and chronic GVHD occurred in 2 and 4 cases, respectively. The 2-year OS, DFS, CIR, and TRM rates were (65.6 ± 16.4) %, (41.7 ± 16.6) %, (47.2 ±18.2) %, and (11.1 ± 11.4) %, respectively, after a median follow-up time of 637 ( IQR: 330, 943) days. One patient died from treatment-related complications due to respiratory failure caused by coronavirus disease 2019. Two patients died due to relapse. Conclusion:Allo-HSCT can be applied as a safe and effective approach to treat CNL and MDS/MPN with neutrophilia.

Objective:To investigate the mosquito-borne viruses carried by mosquito specimens collected from Huachuan county and Huanan county in Heilongjiang province.Methods:Mosquito samples were collected locally in 2023 and processed in the laboratory. Homogenates of the mosquitoes were inoculated into cells for virus isolation, followed by molecular and bioinformatics analyses of the viral isolates.Results:In 2023, ten viral isolates were obtained from Anopheles sinensis specimens collected in Heilongjiang province, China. Among these isolates, one was identified as Culex flavivirus (CxFV), one as Menghai rhabdovirus (MRV), and eight as Nam Dinh virus (NDiV). The phylogenetic analysis showed that CxFV belongs to genotype I and is clustered with the strains isolated from Liaoning province in 2011 and Ningxia Hui autonomous Region in 2019 in the same evolutionary branch, with amino acid similarity ranging from 98.2% to 99.2% and nucleotide similarity ranging from 98.8% to 99.2%. The MRV strain belongs to the same evolutionary subclade as the strain detected in Guangdong, with both nucleotide and amino acid similarity of 98.0%. Eight NDiV isolates clustered with the South Korean isolates on the same evolutionary branch, forming an independent evolutionary sub-branch. The nucleotide similarity among these eight isolates ranged from 98.5% to 99.7%, while the amino acid similarity ranged from 98.1% to 99.7%. In comparison, when matched with other NDiV isolates from China, the nucleotide similarity of these eight isolates ranged from 94.1% to 97.8%, and the amino acid similarity ranged from 93.5% to 97.7%.Conclusions:This study represents the first isolation of CxFV, MRV, and NDiV in Heilongjiang province, China, and the findings provide fundamental data for the prevention and control of mosquito-borne viral diseases in this region.

Objective To summarize the changing prevalence of carbapenem resistance in Enterobacterales based on the data of CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021 for improving antimicrobial treatment in clinical practice.Methods Antimicrobial susceptibility testing was performed using a commercial automated susceptibility testing system according to the unified CHINET protocol.The results were interpreted according to the breakpoints of the Clinical & Laboratory Standards Institute(CLSI)M100 31st ed in 2021.Results Over the seven-year period(2015-2021),the overall prevalence of carbapenem-resistant Enterobacterales(CRE)was 9.43％(62 342/661 235).The prevalence of CRE strains in Klebsiella pneumoniae,Citrobacter freundii,and Enterobacter cloacae was 22.38％,9.73％,and 8.47％,respectively.The prevalence of CRE strains in Escherichia coli was 1.99％.A few CRE strains were also identified in Salmonella and Shigella.The CRE strains were mainly isolated from respiratory specimens(44.23±2.80)％,followed by blood(20.88±3.40)％and urine(18.40±3.45)％.Intensive care units(ICUs)were the major source of the CRE strains(27.43±5.20)％.CRE strains were resistant to all the β-lactam antibiotics tested and most non-β-lactam antimicrobial agents.The CRE strains were relatively susceptible to tigecycline and polymyxins with low resistance rates.Conclusions The prevalence of CRE strains was increasing from 2015 to 2021.CRE strains were highly resistant to most of the antibacterial drugs used in clinical practice.Clinicians should prescribe antimicrobial agents rationally.Hospitals should strengthen antibiotic stewardship in key clinical settings such as ICUs,and take effective infection control measures to curb CRE outbreak and epidemic in hospitals.

Objective To characterize the changing species distribution and antibiotic resistance profiles of respiratory isolates in hospitals participating in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Methods Commercial automated antimicrobial susceptibility testing systems and disk diffusion method were used to test the susceptibility of respiratory bacterial isolates to antimicrobial agents following the standardized technical protocol established by the CHINET program.Results A total of 589 746 respiratory isolates were collected from 2015 to 2021.Overall,82.6％of the isolates were Gram-negative bacteria and 17.4％were Gram-positive bacteria.The bacterial isolates from outpatients and inpatients accounted for(6.0±0.9)％and(94.0±0.1)％,respectively.The top microorganisms were Klebsiella spp.,Acinetobacter spp.,Pseudomonas aeruginosa,Staphylococcus aureus,Haemophilus spp.,Stenotrophomonas maltophilia,Escherichia coli,and Streptococcus pneumoniae.Each microorganism was isolated from significantly more males than from females(P＜0.05).The overall prevalence of methicillin-resistant S.aureus(MRSA)was 39.9％.The prevalence of penicillin-resistant S.pneumoniae was 1.4％.The prevalence of extended-spectrum β-lactamase(ESBL)-producing E.coli and K.pneumoniae was 67.8％and 41.3％,respectively.The overall prevalence of carbapenem-resistant E.coli,K.pneumoniae,Enterobacter cloacae,Pseudomonas aeruginosa,and Acinetobacter baumannii was 3.7％,20.8％,9.4％,29.8％,and 73.3％,respectively.The prevalence of β-lactamase was 96.1％in Moraxella catarrhalis and 60.0％in Haemophilus influenzae.The H.influenzae isolates from children(＜18 years)showed significantly higher resistance rates to β-lactam antibiotics than the isolates from adults(P＜0.05).Conclusions Gram-negative bacteria are still predominant in respiratory isolates associated with serious antibiotic resistance.Antimicrobial resistance surveillance should be strengthened in clinical practice to support accurate etiological diagnosis and appropriate antimicrobial therapy based on antimicrobial susceptibility testing results.

Chronic pain has emerged as a prevalent medical challenge in contemporary society.Patients suffering from chronic pain frequently develop comorbid psychological disorders,including anxiety,depression,post-traumatic stress disorder,and various psychiatric syndromes.These psychological complications not only affect patients' pain perception and responses,but may also constitute critical obstacles during pain management interventions.Acupuncture is a long-established clinical practice that has demonstrated remarkable efficacy in alleviating diverse pain types and has shown favorable therapeutic outcomes in ameliorating emotional disturbances such as anxiety and depression.The precise mechanisms underlying acupuncture-induced analgesia and anxiolytic effects,however,remain to be fully elucidated.In this context,it is essential to establish suitable and stable animal models to allow in-depth investigations into the pathogenesis of pain-related emotional disorders and the mechanistic foundations of acupuncture.This article presents a comprehensive review of recent literature regarding the selection of experimental animals,model-establishment method ologies,and behavioral-assessment paradigms pertaining to animal model platforms of chronic pain with comorbid anxiety.We also provide an in-depth discussion of research advancements regarding acupuncture intervention parameters,including needling techniques,acupoint selection,treatment duration,and efficacy evaluation within these animal models.This review proposes comprehensive and reference strategies for constructing preclinical animal models to investigate the mechanisms of acupuncture in managing chronic pain with comorbid anxiety,thus supporting scientific advancements in related research fields.

AIM:This study investigated the potential mechanism of acupuncture regulating adenosine A1 re-ceptor(ADORA1)in the mouse caudate putamen(CPu)to improve neuroplasticity and alleviate inflammatory pain.METHODS:Male C57BL/6 mice were randomly divided into five groups,namely,saline,complete Freund's adjuvant(CFA),acupuncture(MA),acupuncture+ADORA1 shRNA(MA+shRNA),and acupuncture+negative shRNA(MA+NCshRNA)groups.Twenty-one days before modeling,the mice in the MA+shRNA and MA+NCshRNA groups were in-jected with ADORA1 shRNA and control virus into the CPu.Modeling was performed 21 d later by injection of CFA into the right plantar skin of mice in the model and acupuncture groups to induce adjuvant-mediated arthritis.On day 2 after modeling,mice in the acupuncture groups received acupuncture at bilateral"Zusanli"points,30 min per session,once a day,for a total of 7 days.The paw thermal radiation pain threshold was used as an indicator of the effects on pain in the mice.Changes in the protein levels of ADORA1,synaptophysin(SYP),synapsin(SYN)I,SYN II,and brain-derived neurotrophic factor(BDNF)in the CPu were assessed by Western blot,and transmission electron microscopy was used to examine the dendritic structure and synaptic ultrastructure of neurons within the CPu.RESULTS:(1)Compared with the saline group,CFA modeling significantly reduced the thermal radiation pain threshold in mice(P<0.01),as well as the protein levels of ADORA1(P<0.01).Compared with the CFA group,the thermal pain threshold in the MA group in-creased between days 1 and 7 of acupuncture(P<0.05 or P<0.01),and ADORA1 protein levels increased(P<0.01).(2)Compared with the saline group,SYN I,SYN II,and BDNF protein levels were increased in the CFA group(P<0.05 or P<0.01),while relative to the CFA group,the levels of SYN I,SYN II,and BDNF were reduced in the acupuncture group(P<0.05 or P<0.01).No significant changes in SYP protein levels were observed in any of the groups.(3)Golgi staining and Sholl analysis showed that compared with the saline group,there were reductions in the total dendritic length and number of intersection points in the CFA group,while the dendritic spine density increased(P<0.05).Relative to the CFA group,the total dendritic length and the number of intersection points were increased in the MA group,while the dendritic spine density decreased(P<0.05).(4)Transmission electron microscopy revealed that compared with the Sa-line group,the synaptic clefts were narrower in the CFA group,while the density of synaptic vesicles in the presynaptic membrane was increased.Compared with the CFA group,synaptic clefts in the MA group were wider,and synaptic vesi-cle densities in the presynaptic membrane were reduced.(5)Twenty-one days after viral transfection,the thermal pain threshold in the MA and MA+NCshRNA groups increased from day 1 to day 7 of acupuncture relative to the CFA and MA+shRNA groups(P<0.05 or P<0.01),while the expression of ADORA1 was increased in both the MA and MA+NCshRNA groups(P<0.05 or P<0.01).(6)Compared with the CFA and MA+shRNA groups,the protein expression of SYN II and BDNF in the MA and MA+NCshRNA groups was reduced(P<0.05 or P<0.01).No significant changes in SYN I protein were observed in any of the groups.CONCLUSION:Acupuncture on Zusanli point can alleviate chronic pain in CFA-treated mice,potentially mediated by up-regulation of ADORA1 expression in the CPu brain region,thereby improving neuroplasticity.

This paper summarizes Professor WANG Xiuxia's clinical experience in treating hyperprolactinemia using the liver soothing therapy. Professor WANG identifies liver qi stagnation and rebellious chong qi （冲气） as the core pathomechanisms of hyperprolactinemia. Furthermore， liver qi stagnation may transform into fire or lead to pathological changes such as spleen deficiency with phlegm obstruction or kidney deficiency with essence depletion. The treatment strategy centers on soothing the liver， with a modified version of Qinggan Jieyu Decoction （清肝解郁汤） as the base formula. Depending on different syndrome patterns such as liver stagnation transforming into fire， liver stagnation with spleen deficiency， or liver stagnation with kidney deficiency， heat clearing， spleen strengthening， or kidney tonifying herbs are added accordingly. In addition， three paired herb combinations are commonly used for symptom specific treatment， Danggui （Angelica sinensis） with Chuanxiong （Ligusticum chuanxiong）， Zelan （Lycopus lucidus） with Yimucao （Leonurus japonicus） ， and Jiegeng （Platycodon grandiflorus） with Zisu （Perilla frutescens）.