ObjectiveTo explore the efficacy and mechanisms of Sini San in the treatment of depression and liver injury based on gut microbiota. MethodsThirty-two male Sprague-Dawley （SD） rats were randomly divided into a normal group， model group （M）， Sini San group （MS， 2.5 g·kg^-1）， and fluoxetine group （MF， 2 mg·kg^-1）. Except for the normal group， rats in the other three groups were subjected to chronic unpredictable mild stress （CUMS）. After 8 weeks， the open-field test and sucrose preference test were conducted. Enzyme-linked immunosorbent assay （ELISA） was used to detect serum corticosterone （CORT）， adrenocorticotropic hormone （ACTH）， corticotropin-releasing factor （CRF）， lipopolysaccharide （LPS）， Zonulin， interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， γ-aminobutyric acid （GABA） levels in the hippocampus and prefrontal cortex， and brain-derived neurotrophic factor （BDNF） levels in the hippocampus. Real-time quantitative polymerase chain reaction （Real-time PCR） was used to detect hippocampal BDNF mRNA expression. Serum alanine aminotransferase （ALT） and aspartate aminotransferase （AST） levels were measured using the ultraviolet lactate dehydrogenase method. The ultrastructure of the intestinal epithelium was observed by electron microscopy， and gut microbiota in rat feces were analyzed using 16S rDNA high-throughput sequencing. ResultsCompared with the normal group， the sucrose preference of rats in the model group was significantly reduced （P0.01）， whereas it was significantly increased in the Sini San group compared with the model group （P0.05）. Compared with the normal group， hippocampal GABA protein levels and BDNF mRNA expression in the model group were significantly decreased （P0.05）， and compared with the model group， both were significantly increased in the Sini San group （P0.05， P0.01）. Compared with the normal group， serum LPS and Zonulin levels in the model group were significantly increased （P0.05， P0.01）， and compared with the model group， Zonulin levels in the Sini San group were significantly decreased （P0.05）. No obvious changes were observed in the ultrastructure of the jejunal mucosa among groups. Compared with the normal group， widened and blurred tight junctions， sparse and shortened microvilli， and mitochondrial swelling with cristae disruption in epithelial cells were observed in the ileal and colonic mucosa of the model group， which were markedly improved in the Sini San and fluoxetine groups. The results of 16S rDNA high-throughput sequencing showed that Sini San improved CUMS-induced dysbiosis of Bacteroidetes and Proteobacteria. Correlation analysis indicated that Bacteroidetes and Proteobacteria were significantly correlated with depression-related indicators， liver function， and intestinal mucosal permeability. ConclusionSini San exerts antidepressant and hepatoprotective effects by improving Bacteroidetes and Proteobacteria and inhibiting the increase in intestinal mucosal permeability in CUMS rats.

ObjectiveTo explore the efficacy and mechanisms of Sini San in the treatment of depression and liver injury based on gut microbiota. MethodsThirty-two male Sprague-Dawley （SD） rats were randomly divided into a normal group， model group （M）， Sini San group （MS， 2.5 g·kg^-1）， and fluoxetine group （MF， 2 mg·kg^-1）. Except for the normal group， rats in the other three groups were subjected to chronic unpredictable mild stress （CUMS）. After 8 weeks， the open-field test and sucrose preference test were conducted. Enzyme-linked immunosorbent assay （ELISA） was used to detect serum corticosterone （CORT）， adrenocorticotropic hormone （ACTH）， corticotropin-releasing factor （CRF）， lipopolysaccharide （LPS）， Zonulin， interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， γ-aminobutyric acid （GABA） levels in the hippocampus and prefrontal cortex， and brain-derived neurotrophic factor （BDNF） levels in the hippocampus. Real-time quantitative polymerase chain reaction （Real-time PCR） was used to detect hippocampal BDNF mRNA expression. Serum alanine aminotransferase （ALT） and aspartate aminotransferase （AST） levels were measured using the ultraviolet lactate dehydrogenase method. The ultrastructure of the intestinal epithelium was observed by electron microscopy， and gut microbiota in rat feces were analyzed using 16S rDNA high-throughput sequencing. ResultsCompared with the normal group， the sucrose preference of rats in the model group was significantly reduced （P<0.01）， whereas it was significantly increased in the Sini San group compared with the model group （P<0.05）. Compared with the normal group， hippocampal GABA protein levels and BDNF mRNA expression in the model group were significantly decreased （P<0.05）， and compared with the model group， both were significantly increased in the Sini San group （P<0.05， P<0.01）. Compared with the normal group， serum LPS and Zonulin levels in the model group were significantly increased （P<0.05， P<0.01）， and compared with the model group， Zonulin levels in the Sini San group were significantly decreased （P<0.05）. No obvious changes were observed in the ultrastructure of the jejunal mucosa among groups. Compared with the normal group， widened and blurred tight junctions， sparse and shortened microvilli， and mitochondrial swelling with cristae disruption in epithelial cells were observed in the ileal and colonic mucosa of the model group， which were markedly improved in the Sini San and fluoxetine groups. The results of 16S rDNA high-throughput sequencing showed that Sini San improved CUMS-induced dysbiosis of Bacteroidetes and Proteobacteria. Correlation analysis indicated that Bacteroidetes and Proteobacteria were significantly correlated with depression-related indicators， liver function， and intestinal mucosal permeability. ConclusionSini San exerts antidepressant and hepatoprotective effects by improving Bacteroidetes and Proteobacteria and inhibiting the increase in intestinal mucosal permeability in CUMS rats.

Qingningsan is the seventh prescription in the Catalogue of Ancient Classical Prescriptions （the Second Batch） issued by the National Administration of Traditional Chinese Medicine. This paper uses the method of bibliometrics to systematically analyze the ancient books that record Qingningsan from the aspects of prescription source， composition， dosage， preparation method， usage， indications， formulation principle， drug processing， and modification， sort out its historical origin， and clarify its key information. The results showed that Qingningsan was first recorded in Chen Fuzheng's Complete Work on Children's Diseases in the Qing dynasty. It was mainly used to treat cough caused by heat accumulation in the heart and lung of children， and it is mainly used to treat children's respiratory diseases with cough and expectoration as the main symptoms， with the indications roughly the same as that of ancient applications. This paper suggests that the prescription can be prepared with 0.42 g honey-fried Mori Cortex （dried root bark of Morus alba）， 0.42 g stir-fried Descurainiae Semen （dried mature seeds of Descurainia sophia）， 0.42 g wine-processed Poria （pale brown or reddish dried sclerotia of Poria cocos）， 0.42 g salt-processed Plantaginis Semen （dried mature seeds of Plantago asiatica）， and 0.21 g stir-fried Glycyrrhizae Radix et Rhizoma （dried roots and rhizomes of Glycyrrhiza uralensis）. The above drugs are pulverized into fine powder and 1.87 g should be taken each time with the decoction of Zingiberis Rhizoma Recens and Jujubae Fructus. This study provides a theoretical basis for the clinical application of the classic formula Qingningsan and the research and development of related preparations.

With the continuous deepening of the concept of precision diagnosis and treatment for lung cancer, how to achieve higher efficiency and accuracy in the screening, diagnosis, and treatment pathways in clinical practice has become an important issue that urgently needs to be overcome. The current clinical difficulty lies in the fact that despite continuous advancements in imaging and molecular diagnostic technologies, there are still limitations in manual efficiency and subjective experience when it comes to massive data analysis and multi-scale feature extraction. Artificial intelligence (AI), especially algorithm systems based on deep learning, is an innovative technology capable of deeply empowering medical big data. This method utilizes algorithms such as convolutional neural networks, combined with radiomics, pathomics, and multi-modal data fusion analysis, demonstrating immense potential in early precise detection and benign-malignant differentiation of pulmonary nodules, digital pathological subtype recognition and non-invasive prediction of driver genes, precise 3D surgical planning and automatic delineation of radiotherapy target volumes, as well as dynamic risk warning during follow-up. This innovative technology provides a brand-new solution for realizing intelligent and individualized lung cancer diagnosis and treatment models. This consensus, based on the latest evidence from evidence-based medicine and combined with the development trends in the AI field and real-world clinical needs, was ultimately formed by gathering the consensus opinions of multidisciplinary experts in radiology, pathology, thoracic surgery, and other fields. The main content covers the application specifications of AI in the three core scenarios of lung cancer screening, diagnosis, and treatment, the technical standards for data collection and algorithm validation, as well as the ethical and regulatory challenges faced at the current stage. It aims to clarify the applicable boundaries of AI as a clinical auxiliary decision support tool, providing scientific guidance and standardized exploration directions for peers currently engaged in or planning to carry out AI-assisted clinical diagnosis, treatment, and translation of lung cancer.

OBJECTIVE To screen and quantitatively analyze the quality marker （Q-Marker） associated with anti-renal fibrosis in Shenqi shenshuai mixture （SQSS）， so as to provide references for the analysis of pharmacodynamic substances and new drug transformation of SQSS. METHODS The chemical components of SQSS were characterized by untargeted metabolomics. Combined with network pharmacology， gene expression omnibus （GEO） and connectivity map （CMAP） databases， the anti-renal fibrosis Q-Markers of SQSS were screened. HPLC-MS/MS was applied to determine the contents of Q-Markers in 10 batches of SQSS. RESULTS A total of 1 319 compounds were identified from SQSS via untargeted metabolomics，and 84 active ingredients with anti-renal fibrosis activity were further screened out， such as formononetin. Nine anti-renal fibrosis Q-Markers were obtained by network pharmacology and GEO database， including berberine， quercetin， honokiol， nicotinamide， daidzein， coumarin， kaempferol， formononetin and amygdalin. The quantitative results showed that the average contents of the above components （excluding amygdalin） in 10 batches of SQSS were 2.523， 1.942， 26.848， 1.415， 0.692， 0.171， 0.374， 7.401 μg/mL， respectively. CONCLUSIONS Nine anti-renal fibrosis Q-Markers of SQSS were screened in this study， and the contents of eight among them were determined. The results can provide a basis for elucidating the pharmacodynamic material basis and promoting the new drug transformation of SQSS.

OBJECTIVE To screen and quantitatively analyze the quality marker （Q-Marker） associated with anti-renal fibrosis in Shenqi shenshuai mixture （SQSS）， so as to provide references for the analysis of pharmacodynamic substances and new drug transformation of SQSS. METHODS The chemical components of SQSS were characterized by untargeted metabolomics. Combined with network pharmacology， gene expression omnibus （GEO） and connectivity map （CMAP） databases， the anti-renal fibrosis Q-Markers of SQSS were screened. HPLC-MS/MS was applied to determine the contents of Q-Markers in 10 batches of SQSS. RESULTS A total of 1 319 compounds were identified from SQSS via untargeted metabolomics，and 84 active ingredients with anti-renal fibrosis activity were further screened out， such as formononetin. Nine anti-renal fibrosis Q-Markers were obtained by network pharmacology and GEO database， including berberine， quercetin， honokiol， nicotinamide， daidzein， coumarin， kaempferol， formononetin and amygdalin. The quantitative results showed that the average contents of the above components （excluding amygdalin） in 10 batches of SQSS were 2.523， 1.942， 26.848， 1.415， 0.692， 0.171， 0.374， 7.401 μg/mL， respectively. CONCLUSIONS Nine anti-renal fibrosis Q-Markers of SQSS were screened in this study， and the contents of eight among them were determined. The results can provide a basis for elucidating the pharmacodynamic material basis and promoting the new drug transformation of SQSS.

To analyze global trends and research hotspots in exercise intervention for overweight and obesity from 2010 to 2024, to provide novel perspectives for comprehensive management research on overweight and obesity.

Objective To explore the teaching model of the "LungSmart" smart healthcare system in clinical pulmonology teaching and its effectiveness in enhancing the clinical reasoning skills of postgraduate students. Methods A single-center, single-group pretest-posttest educational intervention study was conducted among 30 postgraduate students who participated in respiratory medicine-related teaching activities and enrolled in the "LungSmart" smart healthcare course at Shanghai Pulmonary Hospital from 2024 to 2025 academic year. The course was structured around three core components, namely an AI case repository, dynamic simulation, and immediate feedback, and was delivered over 16 weeks with a total of 64 class hours. Teaching effectiveness was assessed using pretest and posttest clinical reasoning ability scores, while students’ acceptance of the course was evaluated using a 5-point Likert questionnaire. Results All 30 students completed the teaching activities and were included in the final analysis. The pretest score was (78.83±6.25) points, and the posttest score increased to (93.50±4.18) points, with a mean improvement of (14.67±7.06) points (95%CI, 12.03 to 17.30), indicating a statistically significant improvement after the intervention (t=11.37, P<0.001). A total of 30 valid questionnaires were collected at the end of the course, with a response rate of 100.0%. The overall satisfaction score was (4.67±0.15) points, and the mean scores for content satisfaction, practical value, interest stimulation, and professional competence were (4.72±0.23) points, (4.53±0.35) points, (4.72±0.39) points, and (4.75±0.43) points, respectively. Conclusion These findings suggest that the clinical teaching model based on the "LungSmart" smart healthcare system is feasible and well accepted, and may help improve postgraduate students’ clinical reasoning ability.

Background Arsenic exposure has been implicated as an important environmental contributor to pulmonary fibrosis, the pathogenesis of which is closely associated with abnormal activation of pulmonary fibroblasts. However, the specific mechanism remain incompletely understood. Objective To examine sirtuin 3 (SIRT3) expression during arsenite-induced fibrotic responses in lung fibroblasts, and to investigate its effects on aerobic glycolysis and profibrotic progression, as well as its underlying mechanisms. Methods Human embryonic lung fibroblasts (HELF) were treated with sodium arsenite (NaAsO₂) at different concentrations (0, 2.5, 5, 10, 20, 40, and 80 μmol·L⁻¹) for 48 h. Cell viability was assessed, and lactate and hydroxyproline (HYP) levels were measured as indicator of glycolytic activity and fibrotic response. Western blot and quantitative polymerase chain reaction (q-PCR) were used to determine the protein and mRNA expression levels of SIRT3, hypoxia-inducible factor 1-alpha (HIF-1α), fibrosis-related genes [Collagen type Ⅰ (Collagen-Ⅰ), and α-smooth muscle actin (α-SMA)], and glycolysis-related genes [pyruvate kinase M2 (PKM2), hexokinase 2 (HK2), and lactate dehydrogenase A (LDHA)]. Results Based on the cell viability results, the NaAsO₂ concentrations of 2.5, 5, and 10 μmol·L⁻¹ for 48 h were selected for subsequent experiments. Compared with the control group, HYP levels were significantly increased in the 2.5, 5, and 10 μmol·L⁻¹ NaAsO₂ exposure groups (P <0.05). The protein and mRNA expression levels of HIF-1α, glycolysis-related genes (PKM2, HK2, and LDHA) and fibrosis-related genes (Collagen-Ⅰ, and α-SMA) were significantly upregulated, whereas SIRT3 protein and mRNA expression levels were significantly down-regulated, in the NaAsO₂ treated groups compared with the control group (P<0.05). SIRT3 overexpression significantly reduced HYP levels and downregulated the protein and mRNA expression levels of HIF-1α, glycolysis-related genes (PKM2, HK2, and LDHA), fibrosis-related genes (Collagen-Ⅰ, and α-SMA) compared with the NaAsO₂ + negative control group (P<0.05). Similarly, HIF-1α knockdown significantly decreased HYP levels and downregulated the protein and mRNA expression levels of glycolysis-related genes (PKM2, HK2, and LDHA) and fibrosis-related genes (Collagen-Ⅰ, and α-SMA) compared with the NaAsO₂ + negative control group (P<0.05). In contrast, simultaneous overexpression of SIRT3 and HIF-1α abolished the inhibitory effects of SIRT3 overexporession, as HYP levels and the expression of glycolysis- and fibrosis-related markers showed no statistically significant differences compared with the NaAsO₂ + negative control group (P>0.05). Conclusion NaAsO₂ exposure could induce profibrotic and glycolysis-related responses in HELF cells, accompanied by SIRT3 downregulation and HIF-1α activation. These findings suggest that the SIRT3/HIF-1α regulatory axis may be a potential target for preventing or attenuating arsenic exposure-related pulmonary fibrotic responses.

Objective To investigate the effect of astragaloside Ⅳ (AS-Ⅳ) on renal ischemia-reperfusion injury (RIRI) and its specific mechanism. Methods Forty-eight rats were randomly divided into 6 groups, with 8 rats in each group: sham operation group (Sham group), RIRI group, RIRI + AS-Ⅳ (10 mg/kg) group, RIRI + AS-Ⅳ (20 mg/kg) group, RIRI + AS-Ⅳ (40 mg/kg) group and RIRI + AS-Ⅳ + Brusatol group [Brusatol is a nuclear factor E2-related factor 2 (Nrf2) inhibitor]. Serum creatinine (Scr) and blood urea nitrogen (BUN) levels of rats were detected using an automatic biochemical analyzer; the pathological damage degree of rats kidney tissue was evaluated by hematoxylin-eosin staining and scored; the levels of superoxide dismutase (SOD) and malondialdehyde (MDA) in rats serum, and interleukin (IL)-1β and IL-18 in rats kidney tissue were detected by enzyme-linked immunosorbent assay; the degree of cell apoptosis was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling; real-time fluorescence quantitative polymerase chain reaction and Western blotting were used to determine the messenger RNA (mRNA) and protein levels of Nrf2/heme oxygenase-1 (HO-1) signaling pathway and cell pyroptosis regulatory factors in rats kidney tissue. Results Compared with the Sham group, the BUN and Scr levels in the RIRI group were increased, the renal function and tissue damage were more severe, the degree of cell apoptosis was aggravated, the MDA level was increased, and the SOD activity was decreased, the Nrf2 and HO-1 protein and mRNA levels were downregulated, the NOD-like receptor protein 3 (NLRP3), Cle-Caspase-1 (the activated form of Caspase-1) and gasdermin D (GSDMD)-N protein levels were upregulated, the NLRP3, Caspase-1 and GSDMD-N mRNA levels were increased, and the release of IL-1β and IL-18 was increased. Compared with the RIRI group, the BUN and Scr levels in rats after AS-Ⅳ treatment were decreased, the degree of renal function and tissue damage was reduced, the degree of cell apoptosis was decreased, the MDA level was decreased, and the SOD activity was increased, the Nrf2 and HO-1 protein and mRNA levels were increased, the NLRP3, Cle-Caspase-1 and GSDMD-N protein levels were decreased, the NLRP3, Caspase-1 and GSDMD-N mRNA levels were decreased, and the release of IL-1β and IL-18 was reduced. Compared with the RIRI + AS-Ⅳ (20 mg/kg) group, the MDA level and SOD activity in rats of the RIRI + AS-Ⅳ + Brusatol group were increased, the Nrf2 and HO-1 protein and mRNA levels were decreased, the NLRP3, Cle-Caspase-1 and GSDMD-N protein levels were upregulated, the NLRP3, Caspase-1 and GSDMD-N mRNA levels were increased, and the release of IL-1β and IL-18 was increased. Conclusions AS-Ⅳ may alleviate RIRI in rats by inhibiting oxidative stress response and pyroptosis, and this mechanism is related to the activation of Nrf2/HO-1 signaling pathway.