OBJECTIVE To provide a scientific basis for the quality evaluation and clinical application of Qingwen hufei granules. METHODS Fourteen batches of Qingwen hufei granules were used as samples to establish high-performance liquid chromatography （HPLC） fingerprints using the Similarity Evaluation System for Chromatographic Fingerprint of Traditional Chinese Medicine （2012 Edition）. The chromatographic peaks were identified and the similarity was evaluated. Cluster analysis （CA）， principal component analysis （PCA）， and orthogonal partial least squares-discriminant analysis （OPLS-DA） were used to conduct chemical pattern recognition analysis on the 14 batches of samples. Meanwhile， the contents of neochlorogenic acid （NGA）， chlorogenic acid （CHA）， cryptochlorogenic acid （CGA）， forsythoside A （FTA）， 3，5-O-dicaffeoylquinic acid （3，5-O- DA）， 4，5-O-dicaffeoylquinic acid （4，5-O-DA）， and angoroside C （AGC） in the samples were determined by HPLC. RESULTS The methodological investigation results of both the fingerprint and the content determination complied with the relevant requirements. Fourteen common peaks were indicated in the HPLC fingerprints of the 14 batches of samples， and 7 of them were identified [NGA （peak 2）， CHA （peak 3）， CGA （peak 5）， FTA （peak 11）， 3，5-O-DA （peak 12）， 4，5-O-DA （peak 13）， and AGC （peak 14）]； the similarity of each sample was greater than 0.94. The results of CA and PCA showed that the samples could be classified into 3 categories； the results of OPLS-DA indicated that peak 4 （unknown）， peak 11 （FTA）， peak 8 （unknown）， peak 9 （unknown）， and peak 1 （unknown） were the differential components. The content ranges of NGA， CHA， CGA， 3，5-O-DA， FTA， 4，5-O-DA and AGC in the 14 batches of samples were 0.210 4-0.458 7， 0.269 1-0.506 3， 0.228 1-0.461 1， 0.443 9-1.044 6， 0.066 7-0.155 7， 0.062 8-0.143 8， and 0.057 4-0.105 7 mg/g， respectively. CONCLUSIONS The HPLC fingerprint and multi-component content determination methods established in this study are efficient and reliable， and can be used for the quality evaluation of Qingwen hufei granules.

Objective To address the safety challenges arising from the rapid development of nuclear energy and technology, assess the current status of health emergency response capabilities in nuclear radiation emergencies, and promote capacity enhancement. Methods A preliminary evaluation system for health emergency response capability in nuclear radiation emergencies was developed based on a literature review. Two rounds of Delphi expert consultation (n = 20) were conducted, and the analytic hierarchy process was employed to establish judgment matrices for assigning indicator weights. Results The finalized system included six primary indicators (radiation protection capability, triage capability, decontamination and evacuation capability, medical treatment capability, radiation detection capability, and radiation dose estimation capability), along with 29 secondary indicators, such as capability for setting up emergency zones, capability for protecting personnel from internal and external contamination, on-site first aid capability, and personal dose monitoring capability. The expert response rate was 0.95, and the expert authority coefficient reached 0.80. The Kendall’s coefficient of concordance was W = 0.288 (P<0.01) for the first round of expert consultation and W = 0.308 (P<0.01) for the second round. Both rounds demonstrated high agreement among experts, and the consultation questionnaires passed reliability and validity tests. Conclusion By integrating qualitative analysis and quantitative calculation, this study developed a scientifically sound and operationally feasible evaluation system. This system will help identify gaps in health emergency response capabilities and provide scientific guidance and a decision-making basis for optimizing emergency plans and improving the level of health emergency response in nuclear radiation emergencies.

ObjectiveThis paper aims to investigate the effect and mechanism of Runmu Xiaoyao powder on mice with dry eye and the syndrome of liver depression-heat syndrome based on the toll-like receptor 4 （TLR4）/myeloid differentiation primary response protein 88 （MyD88）/nuclear factor-κB （NF-κB） signaling pathway. MethodsSixty-six C57BL/6J female mice were randomly divided into a normal group， a model group， a sodium hyaluronate group， and high-， medium-， and low-dose Runmu Xiaoyao powder groups， with 11 mice per group. Except for those in the normal group， mice in the other groups were subjected to mouse models with dry eye and liver depression-heat syndrome by instilling a benzalkonium chloride solution and applying chronic pain stimulation in a dry environment. After modeling， mice in the high-， medium-， and low-dose Runmu Xiaoyao powder groups were administered intragastrically with 29.7， 14.85， 7.43 g·kg^-1， respectively， twice a day for 14 consecutive days. The mice in the sodium hyaluronate group received 5 μL of sodium hyaluronate eye drops in each eye twice daily. The mice in the normal and model groups were administered intragastrically with an equal volume of deionized water. Measurements were taken of tear secretion in mice， irritability scores， corneal fluorescein staining， and histopathological changes in the cornea， lacrimal glands， meibomian glands， and liver tissue. Enzyme-linked immunosorbent assay （ELISA） was used to detect the levels of interleukin-1β （IL-1β） and tumour necrosis factor-α （TNF-α） in serum. Immunohistochemistry （IHC） was used to detect the protein expression of IL-1β and TNF-α in corneal and lacrimal gland tissues. Real-time quantitative polymerase chain reaction（Real-time PCR） and Western blot were employed to detect the mRNA and protein expressions of TLR4， MyD88， and NF-κB p65 in corneal， lacrimal gland， and meibomian gland tissues. ResultsCompared with those in the normal group， mice in the model group exhibited significantly reduced tear secretion， significantly higher irritability scores， and more pronounced corneal fluorescence staining， with marked pathological damage observed in the cornea， lacrimal glands， meibomian glands， and liver tissue. IL-1β and TNF-α levels in serum were significantly elevated. The protein expressions of IL-1β and TNF-α in corneal and lacrimal gland tissues， as well as the mRNA and protein expressions of TLR4， MyD88， and NF-κB p65 in corneal， lacrimal gland， and meibomian gland tissues， were all significantly increased （P<0.01）. Compared with the model group， the sodium hyaluronate group and Runmu Xiaoyao powder groups with different doses exhibited increased tear secretion to varying degrees， alleviated corneal fluorescence staining and histopathological damage， reduced IL-1β and TNF-α levels in serum， and downregulated protein expressions of IL-1β and TNF-α in corneal and lacrimal gland tissues， as well as the mRNA and protein expressions of TLR4， MyD88， and NF-κB p65 in corneal， lacrimal gland， and meibomian gland tissues. The high-dose Runmu Xiaoyao powder group demonstrated a more pronounced effect， with multiple indicators showing superior results compared to those in the sodium hyaluronate group （P<0.05， P<0.01）. ConclusionRunmu Xiaoyao powder down-regulates the TLR4/MyD88/NF-κB signaling pathway activity in the cornea， lacrimal glands， and meibomian glands of model mice with dry eye and liver depression-heat syndrome， thereby suppressing inflammatory responses and mitigating ocular surface tissue damage. The therapeutic effect is dose-dependent， and the high-dose group exerts the most prominent effect.

Cerebral small vessel disease (CSVD) is an important cause of stroke and cognitive impairment, with complex pathogenesis and limited therapeutic options. Although monogenic hereditary CSVD has a low incidence, its well-defined causative genes provide a unique " natural model" for revealing the core molecular pathways of CSVD. Based on previous studys, this article systematically sorts out the newly identified pathogenic genes of monogenic CSVD, such as NIT1, MAP3K6 and ARHGEF15, and precisely identifies core pathophysiological processes including vascular smooth muscle cell dysfunction and extracellular matrix homeostasis imbalance. Furthermore, it reviews the latest advances in genome-wide association studies (GWAS) on sporadic CSVD and its imaging markers, and confirms an overlap in their genetic architectures. Finally, this article discusses the research strategy of integrating multi-omics data such as transcriptomics and proteomics to deeply analyze the biological mechanisms of risk variants, and summarizes the clinical translational value of genetic research in the precision diagnosis, risk stratification, drug target mining and drug repositioning of CSVD.

Objective To investigate the epidemiological characteristics of malaria and provide a basis for developing improved prevention and control measures. Methods Data were obtained from the Chinese Disease Prevention and Control Information System. Malaria surveillance data for Nanning City from January 1,2023, to December 31,2024, were exported from the Infectious Disease Reporting Information Management Subsystem. The characteristics of the two groups of malaria cases were compared. Results A total of 103 imported malaria cases were reported in Nanning City in 2024, representing a 38.32% decrease compared with the same period of the previous year. No statistically significant difference were observed between cases reported in 2023 and 2024 in terms of average age, gender ratio, proportion of parasite species, and monthly reporting distribution;however, statistically significant differences were found in the proportion of reporting areas and current residence areas(χ2= 13.572 and 10.355, respectively; P = 0.001 and 0.035, respectively). The proportion of cases reported in Shanglin County and the proportion of cases residing in Shanglin County were both lower than those during the same period of the previous year. Conclusions The high aggregation of imported malaria cases in Nanning City has decreased. Medical institutions in areas other than Shanglin County should strengthen their vigilance against malaria.

Objective To investigate the existing nuclear radiation health emergency response capacity of local health systems at nuclear power plant sites in Guangdong Province. Methods The health administrative departments of all nuclear power plants sites in Guangdong Province, along with radiation health protection institutions, designated nuclear radiation treatment hospitals, and township health centers, were selected as the study subjects using the purposive sampling method. A series of standardized questionnaires on the capacities for nuclear radiation health emergency response, developed uniformly by the National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, were adopted to separately investigate the capacities for nuclear radiation health emergency response in the study subjects. Results There were 13 health administration departments, 15 radiological health protection institutions, 18 designated hospitals for nuclear radiation medical response, and 18 township health centers located in the nuclear power plants sites in Guangdong Province. Among the 13 health administration departments, the Health Commission of Guangdong Province met all 15 criteria for nuclear radiation health emergency response capacities. All six prefecture-level health administrative departments possessed more than 10 capacities for nuclear radiation health emergency response, while only one of the six county-level departments had more than 10 such capacities. Among radiation health protection institutions, the provincial-level institution possessed all 18 capacity for nuclear radiation health emergency response; of the six prefectural-level institutions, only four had more than 10 capacities; none of the eight county-level institutions or 18 township health centers possessed more than 10 capacities. Among designated nuclear radiation treatment hospitals, provincial-level institution met all 32 capacities for nuclear radiation health emergency response; of the eight prefecture‑level hospitals, only four meet more than ten such capacities; and of the nine county‑level hospitals and 18 township health centers, none possess more than 10 capacities. Conclusion Provincial- and prefectural-level nuclear radiation emergency capacity in Guangdong Province is adequate, whereas county-level and township health centers have obvious weaknesses in organizational structure, personnel training, equipment reserves, funding, and technical reserves; emergency response capacity needs urgent enhancement.

Objective​ To analyze the current status of nuclear radiation health emergency response capacity in areas of the nuclear power plants in Guangdong Province, and to formulate a construction plan for municipal-level nuclear radiation health emergency response teams. Methods Provincial-, municipal-, and county-level administrative regions in the nuclear power plant host areas of Guangdong Province were selected as the study subjects. A series of questionnaires designed by the National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, were used to assess the capacity of nuclear radiation health emergency response. Based on the findings, a construction plan for municipal-level nuclear radiation health emergency response teams was formulated. Results A total of 13 administrative regions which host nuclear power plants were involved, including one provincial-level, six municipal-level, and six county-level regions. The availability rates of 31 capacity indicators of nuclear radiation health emergency response among 13 administrative regions ranged from 15% to 100%, with an average of 51%. Provincial-level capacity of nuclear radiation health emergency response was relatively well established, county-level radiation monitoring and protection capacity was nearly absent, municipal-level regions possessed basic capacity, but with obvious regional disparities and a general lack of specialized facilities and materials required for the treatment of nuclear radiation injuries, making them the key level for improvement in nuclear radiation health emergency response. The Construction Plan for Municipal-Level Nuclear Radiation Health Emergency Response Teams specifies that the total number of team members should be no fewer than 30 to ensure rapid response and immediate arrival at the scene. The List of Key Professional Equipment proposes the prioritized allocation of five categories of equipment: personal basic equipment, contamination detection and classification equipment, decontamination equipment, medical treatment equipment, and command and logistical support equipment. Conclusion Nuclear radiation health emergency response capacity in Guangdong Province requires further improvement, particularly in standardized development of municipal-level nuclear radiation health emergency response teams. The Construction Plan for Municipal-Level Nuclear Radiation Health Emergency Response Teams defines capacity requirements and provides a list of essential equipment, offering a practical reference for other regions.

ObjectiveType 2 diabetes mellitus (T2DM) often causes severe hepatic metabolic complications, dominated by metabolic associated fatty liver disease (MAFLD). Persistent hepatic steatosis and oxidative stress further trigger steatohepatitis and progressive liver damage, increasing the mortality risk of diabetic patients. Aerobic exercise effectively improves hepatic lipid metabolism and antioxidant capacity, but poor patient adherence restricts its long-term clinical application. Mitochondrial-derived mitochondrial open reading frame of the 12S rRNA type-c (MOTS-c) is a key peptide regulating insulin sensitivity and hepatic redox homeostasis. This study aimed to explore the protective mechanism of MOTS-c against T2DM-related liver injury and its combined beneficial effect with aerobic exercise via the NRF2/PPARγ signaling axis. This study aimed to investigate whether MOTS-c cooperates with aerobic exercise to alleviate T2DM-associated hepatic oxidative stress and metabolic dysfunction by activating the NRF2/PPARγ axis, and to clarify the molecular and transcriptomic characteristics of their combined intervention. MethodsStable MOTS-c overexpression and knockdown HepG2 cell lines were constructed using lentiviral transfection. An oleic acid-induced cellular lipid accumulation model and NRF2-knockout cell model were applied to verify the NRF2-dependent mechanism ofMOTS-c. Intracellular lipid deposition, triglyceride levels, antioxidant enzyme activities, and the expression of NRF2/PPARγ pathway-related genes and proteins were detected. In vivo, a T2DM rat model with obvious hepatic steatosis was established via a high-fat and high-sucrose diet combined with streptozotocin injection. Model rats received aerobic exercise, MOTS-c intraperitoneal injection, or combined intervention. We detected systemic glycolipid metabolic indicators, hepatic histopathological changes, and the expression of core proteins in the hepatic NRF2/PPARγ axis. Hepatic transcriptomic sequencing was performed to screen differentially expressed genes (DEGs) and enrich key pathways co-regulated by MOTS-c and aerobic exercise. ResultsCellular results showed that MOTS-c overexpression significantly reduced oleic acid-induced lipid deposition, enhanced antioxidant enzyme activity, and upregulated NRF2 and PPARγ expression. Conversely, MOTS-c knockdown aggravated hepatic lipid accumulation and oxidative damage and inhibited NRF2/PPARγ pathway activation. NRF2 knockout completely eliminated the protective effects of MOTS-c on lipid metabolism and redox balance, confirming its NRF2-dependent regulatory mechanism. In T2DM rats, both MOTS-c supplementation and aerobic exercise effectively improved insulin resistance, corrected glycolipid metabolic disorders, and alleviated hepatic steatosis, while consistently activating the hepatic NRF2/PPARγ axis. Compared with single intervention, the combined treatment showed a better improvement trend in hepatic metabolic and oxidative injury, without definitive synergistic effects. Transcriptomic analysis revealed that the co-regulated DEGs of MOTS-c and aerobic exercise were primarily enriched in lipid metabolism and PPAR signaling pathways, with multiple antioxidant and lipid-regulating genes significantly modulated by combined intervention. ConclusionMOTS-c exhibits obvious exercise-mimetic hepatoprotective effects in T2DM. It activates the hepatic NRF2/PPARγ axis to strengthen antioxidant defense, stabilize lipid metabolism, and relieve T2DM-associated hepatic steatosis and oxidative damage. Furthermore, MOTS-c produces additive beneficial effects with aerobic exercise, showing a superior intervention trend on diabetic liver dysfunction. This study identifies the NRF2/PPARγ axis as the core mechanism of MOTS-c-regulated hepatic protection, elucidates the transcriptomic basis of combined intervention, and provides a reliable theoretical basis and potential therapeutic target for clinical intervention in T2DM-complicated MAFLD.

Objective: To investigate the incidence and independent risk factors of adverse events (AEs) associated with therapeutic plasma exchange (TPE) in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT), and to provide evidence to support the safe use of TPE in clinical practice. Methods: This retrospective study included 167 allo-HSCT recipients who underwent a total of 385 TPE procedures between March 2022 and December 2023. Patients were divided into two groups according to the occurrence of TPE-related AEs. Baseline characteristics, plasma exchange parameters, and clinical features were collected. Univariate analysis and multivariable Firth logistic regression were performed to identify independent risk factors for AEs. Results: A total of 385 TPE procedures were performed in 167 allo-HSCT patients, and 33 patients (19.8%) experienced TPE-related AEs. Among the 33 patients who experienced AEs, allergic reactions were the most common (n=18, 54.5%), followed by blood pressure fluctuations (n=11, 33.3%) and hypocalcemia (n=4, 12.1%). Most AEs were classified as grade II (n=23, 69.7%), and no grade IV (fatal) events were observed. Univariate analysis demonstrated a significant difference in the incidence of AEs among different hematocrit (HCT) categories (<20%, 20%-30%, and>30%) (Fisher's exact test, P=0.022). Although the overall difference was statistically significant, none of the pairwise comparisons remained significant after Bonferroni correction (adjusted P>0.0167). Multivariable Firth logistic regression identified higher HCT levels, analyzed as a continuous variable (OR=1.07, 95% CI: 1.01-1.13, P=0.020), and TPE performed for cytokine release syndrome (CRS) (OR=9.21, 95% CI: 1.25-78.00, P=0.030) as potential independent risk factors for TPE-related AEs. Receiver operating characteristic (ROC) curve analysis showed that HCT had an AUC of 0.67 (95% CI: 0.57-0.77) for predicting AEs, with an optimal cutoff value of 24.5%, a sensitivity of 60.6%, and a specificity of 75.4%. Using this cutoff, the AEs rate was significantly higher in patients with HCT≥24.5% than in those with HCT<24.5% (37.7% vs 11.4%, P<0.001). Conclusion: A-mong allo-HSCT patients receiving TPE, allergic reactions were the predominant AEs. Higher HCT levels and TPE performed for CRS may be associated with an increased risk of AEs. HCT≥24.5% may help identify patients requiring intensified monitoring, although its discriminatory ability is moderate (AUC=0.67) and it should not be used as a standalone criterion for clinical decision-making. Findings regarding the CRS subgroup require validation in larger cohorts. Optimizing extracorporeal circuit priming and strengthening peri-procedural monitoring may help improve the safety of TPE.

Objective To compare the efficacy of five Blastocystis staining method for staining cells with different morphologies and in different developmental stages to select appropriate staining techniques for specific scenarios and experimental purposes. Methods Blastocystis was stained using Wright-Giemsa, periodic acid-Schiff (PAS), Oil Red O, Nile Red, and Lugol's iodine solution respectively. The staining effects of the five method on Blastocystis were compared. Results Wright-Giemsa staining colored the cytoplasm and nucleus of Blastocystis bluish-purple, with other parts lightly stained; PAS staining rendered Blastocystis cells red; Oil Red O staining showed different structures within Blastocystis in varying intensities of orange-red; Nile Red enabled Blastocystis to fluoresce orange-yellow under a fluorescence microscope; Lugol's iodine solution stained the cytoplasm and nucleus a dark brownish-yellow. Conclusions Wright-Giemsa staining is recommended for clinical diagnosis. For metabolic studies, a combination of periodic acid-Schiff (PAS) staining and Oil Red O staining is suggested; PAS + Oil Red O staining can provide comprehensive morphological evidence for cell metabolism research. Nile Red staining is recommended for dynamic observation of live Blastocystis. Lugol's iodine staining is suitable for preliminary screening of large-scale samples.