ObjectiveTo investigate the effects of exogenous nitric oxide （NO） on the accumulation and quality formation mechanism of flavonoids in Scutellariae Radix. MethodsFresh roots of Scutellaria baicalensis were treated with sodium nitroprusside （SNP） solutions at concentrations of 0.0， 7.5， and 20 mmol·L^-1， respectively. Kits and supporting reaction systems were used to determine the following indicators of samples in each group， including （1） reactive oxygen species： changes in the content of nitric oxide （NO）， superoxide anion （O2-·）， and hydrogen peroxide （H₂O₂）， （2） lipid oxidation products： changes in the content of malondialdehyde （MDA）， （3） antioxidant enzymes： changes in the activity of superoxide dismutase （SOD）， catalase （CAT）， and peroxidase （POD）， and （4） metabolic key enzymes and metabolic intermediates： Changes in the activity of phenylalanine ammonia-lyase （PAL） and the content of 1，3-diphosphoglycerate （1，3-DPG）. High-performance liquid chromatography （HPLC） was used to determine the changes in the content of secondary metabolites in flavonoids such as baicalin， wogonoside， baicalein， and wogonin in each group. ResultsCompared with that on day 0， during the treatment with 20 mmol·L^-1 SNP solution， the content of NO， O2-·， H₂O₂， and MDA in fresh roots of Scutellaria baicalensis increased significantly （P<0.01）， by 138.7%， 75.7%， 292.9%， and 140.3% respectively. The activity of SOD， CAT， and POD increased by 100.7%， 41.4%， and 70.4% respectively （P<0.01）， and that of PAL increased by 111.1% （P<0.01）. The content of the secondary metabolites baicalin and wogonoside remained basically unchanged， while that of baicalein and wogonin increased by 401.3% and 457.9% respectively （P<0.01）. The content of 1，3-DPG increased by 165.0% （P<0.01）. In the 7.5 mmol·L^-1 SNP solution treatment group， the stress degree was relatively mild. Compared with that on day 0， the content of NO， O2-·， H₂O₂， and MDA increased by 76.2%， 57.7%， 221.4%， and 99.7% respectively （P<0.01）. The activity of antioxidant enzymes SOD， CAT， and POD increased by 79.5%， 55.6%， and 51.9% respectively （P<0.01）， and that of PAL increased by 69.0% （P<0.01）. The content of baicalein and wogonin increased by 204.7% and 272.2% respectively （P<0.01）， and that of 1，3-DPG increased by 128.0% （P<0.01）. The 20 mmol·L^-1 SNP group showed better performance than the 7.5 mmol·L^-1 SNP group. ConclusionSNP can simulate the physiological state of Scutellaria baicalensis under stress conditions， activate the antioxidant protection mechanism， promote the biosynthesis of flavonoids in Scutellariae Radix， and significantly improve the quality of medicinal materials in Scutellariae Radix.

BACKGROUND:In most species,a bone defect that is longer than 1.5 or 2 times its diameter can be considered a critical bone defect,and when the bone defect volume reaches the critical value,it cannot heal on its own.Currently,there is no uniform standard for the size of critical-sized defects in the osteoporotic femoral condyle of rabbits.OBJECTIVE:To establish a rabbit model with different sizes of bone defects in the osteoporotic femoral condyle and to determine the critical-sized defects of osteoporotic femoral condyle in rabbits.METHODS:Thirty-six 3-month-old female New Zealand white rabbits were randomly divided into ovariectomy group(n=30)and sham operation group(n=6).Rabbits in the ovariectomy group underwent bilateral ovariectomy to establish an osteoporosis model,and then femoral condyle bone defect models of different diameters(diameters were 4,5,6,and 7 mm,and depths were 8 mm)were further established;rabbits in the sham operation group did not undergo ovariectomy.At 8 and 12 weeks after modeling,3 rats were randomly selected from each group for CT scanning and three-dimensional reconstruction to evaluate the healing of bone defects.Afterwards,samples were taken for gross observation and hematoxylin-eosin staining to observe the growth of new bone in the femoral condyle bone defect area.RESULTS AND CONCLUSION:(1)All rabbits survived and moved well after modeling of osteoporosis and femoral condyle bone defect.(2)At 12 weeks after osteoporosis modeling,dual-energy X-ray absorptiometry results showed that the bone mineral density of lumbar vertebrae in ovariectomy group was significantly lower than that in sham operation group(P＜0.05).Hematoxylin-eosin staining showed that the bone trabeculae in the ovariectomy group became thinner and sparse.The proportion of bone tissue area in the ovariectomy group was significantly lower than that in the sham operation group(P=0.00).Micro-CT results showed that the bone tissue parameters of the femoral condyle in the ovariectomy group were significantly different from those in the sham operation group(P＜0.05),and the ovariectomy group showed obvious characteristics of osteoporosis.(3)CT showed that the bone defect in the 4 mm and 5 mm diameter groups was basically completely repaired at 12 weeks after surgery.There was more new bone tissue in the 6 mm diameter group,but the central part of the bone defect was not completely repaired.A small amount of new bone tissue grew in the 7 mm diameter group,and the bone defect was obvious.(4)Gross observation at 12 weeks after surgery showed that the femoral condyle bone defect in the 4 mm and 5 mm diameter groups was completely repaired.Obvious depression was seen in the bone defect area of the 6 mm and 7 mm diameter groups,and the bone defect was not completely repaired.(5)Histological observation at 12 weeks after surgery showed that the bone defect area of the 4 mm and 5 mm diameter groups was completely filled with new bone,and the trabecular structure was irregular;while there were new trabeculae in the periphery of the 6 mm and 7 mm diameter groups,and the bone defect in the central area was still obvious.(6)The results showed that during the 12-week experimental observation period of osteoporotic femoral condyle defects in rabbits,under the condition of the same defect depth of 8 mm,femoral condyle defects with a diameter ≥ 6 mm could not heal on their own,while femoral condyle defects with a diameter＜6 mm were completely repaired.A diameter of 6 mm and a depth of 8 mm can be used as the critical bone defect value of osteoporotic femoral condyle in rabbits.

Objective:To investigate the effect of ERMAP on imiquimod(IMQ)-induced psoriasis-like skin inflammation in mice and its related mechanism.Methods:The experimental mice were divided into 3 groups:Sham group,WT group and ERMAP-/-group,with 9 mice in each group.The Sham group was smeared with Vaseline,and the WT group and ERMAP-/-group were smeared with IMQ to induce psoriatic dermatitis.The severity of IMQ-induced psoriasis lesions in mice were evaluated according to the psoria-sis area and severity index(PASI)and the HE staining pathology score.The expressions of F4/80 and Ki67 in mouse skin lesions were observed by immunofluorescence staining.The relative expressions of IL-1β,IL-6,IFN-γ and iNOS in skin lesions were detected by qRT-PCR.Flow cytometry was used to detect the proliferation and activation of T cells and the proportion of macrophages in spleen.Results:In the IMQ-induced mouse model of psoriasis-like dermatitis,the skin lesions of ERMAP gene knock out mice showed more severe squamous accumulation and skin bulge,more inflammatory cells aggregation and cytokine production,and the proportion of immune cells in the spleen of mice increased compared with the WT group,and the proportion of M1 macrophages increased.Conclu-sion:ERMAP deficiency aggravates IMQ-induced psoriasis-like skin inflammation in mice by enhancing immune response.

BackgroundPost-traumatic stress symptoms （PTSS） is highly prevalent in adolescents who have experienced earthquake， which seriously threatens their physical and mental health， yet there is currently a lack of research on the effects of loneliness， social support and social media use on PTSS among post-earthquake adolescents. ObjectiveTo assess the PTSS among adolescents experiencing MS6.0 Luxian， Sichuan， earthquake on 16 September 2021， and to investigate the effects of loneliness， social support and social media use on PTSS， so as to provide references for the intervention of PTSS among post-earthquake adolescents. MethodsOn November 12， 2021， simple random sampling technique was used to select 2 522 post-earthquake adolescents in Luxian county of Luzhou city in Sichuan province. All subjects were assessed using Post-Traumatic Stress Disorder Checklist for DSM-5 （PCL-5）， Multidimensional Scale of Perceived Social Support （MSPSS）， Short-form UCLA Loneliness Scale （ULS-3） and Social Media Use Scale （SM-10）. Binary Logistic regression was used to determine the factors influencing PTSS among post-earthquake adolescents. ResultsPTSS was detected in 91 （3.61%） adolescents. Binary Logistic regression revealed that perceived social support from family members （OR=0.926， 95% CI： 0.879~0.976） was a protective factor for PTSS among post-earthquake adolescents. Lack of companionship （OR=1.764， 95% CI： 1.141~2.727）， feeling isolated （OR=2.037， 95% CI： 1.282~3.236）， and viewing negative emotional response of disaster victims through social media （OR=1.615， 95% CI： 1.291~2.020） were risk factors for PTSS among post-earthquake adolescents. ConclusionLack of companionship， feeling isolated， and viewing negative emotional response of disaster victims through social media pose a negative impact on PTSS among post-earthquake adolescents， while perceived social support from family members exert a positive impact on PTSS among post-earthquake adolescents. ［Funded by Humanity and Social Science Youth foundation of Ministry of Education of China （number， 22YJC190019）； Natural Science Foundation of Sichuan Province （number， 2023NSFSC1486）］

Objective To investigate the clinical efficacy of Shuyao Huoxue Tongluo Decoction combined with meridian acupoint massage in treating lumbar disc herniation(LDH)patients with qi-stagnation and blood-stasis syndrome,and to analyze its effects on serological indicators.Methods A total of 120 LDH patients with qi-stagnation and blood-stasis syndrome admitted to Huizhou Hospital of Guangzhou University of Chinese Medicine from December 2023 to December 2024 were enrolled.The patients were randomly divided into control group and study group using a random number table,with 60 cases in each group.The control group received conventional treatment(including lumbar traction and drug therapy)combined with meridian acupoint massage,while the study group received additional Shuyao Huoxue Tongluo Decoction based on the treatment for the control group.Before and after treatment,the scores of traditional Chinese Medicine(TCM)syndrome,Visual Analogue Scale(VAS)scores for pain,Japanese Orthopedic Association(JOA)scores for lumbar function,Oswestry Disability Index(ODI)scores,and serum levels of tumor necrosis factor α(TNF-α)and interleukin 6(IL-6)in the two groups were compared.After treatment,the clinical efficacy was evaluated between groups.Results(1)After 20 days of treatment,the total effective rate was 95.00%(57/60)in the study group versus 81.67%(49/60)in the control group(tested by chi-square test,P＜0.05),demonstrating significantly superior therapeutic effects in the study group.(2)After treatment,both groups showed significant reduction in TCM syndrome scores(P＜0.01),and the study group exhibited markedly decrease compared to the control group(P＜0.01).(3)After treatment,the VAS scores for pain in both groups were significantly decreased compared to those before treatment(P＜0.01),and the study group exhibited obvious decrease of the scores than the control group(P＜0.01).(4)After treatment,JOA scores for lumbar function in both groups were increased(P＜0.05),while Oswestry Disability Index(ODI)scores were decreased(P＜0.05),compared to those before treatment,and the study group demonstrated more significant improvements in both JOA score elevation and ODI score reduction(P＜0.05).(5)For serum inflammatory factors,interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)levels in both groups were significantly reduced(P＜0.05)after treatment,and the study group showed more pronounced decrease in both markers(P＜0.05).Conclusion Compared with meridian acupoint massage alone,the combined therapy of Shuyao Huoxue Tongluo Decoction and meridian acupoint massage is effective on significantly alleviating clinical symptoms,reducing serum inflammatory factors,and enhancing overall therapeutic outcomes in LDH patients with qi-stagnation and blood-stasis syndrome.

Objective To explore the relationship between serum miRNA-126a,miRNA-130b levels and cognitive impairment(CI)in patients with diabetes mellitus(DM)complicated with acute stroke(AS).Methods A retrospective analysis was conducted on 70 DM patients with AS admitted to Wuhan First Hospital from January 2019 to December 2021.Patients were divided into CI group(41 cases)and non-CI group(29 cases)based on the occurrence of CI.Real-time fluorescence quantitative PCR was used to detect the relative expression levels of miRNA-126a and miRNA-130b in peripheral blood.Results Compared with non-CI group,the CI group showed increased albumin(P<0.05)and decreased levels of miRNA-126a and miRNA-130b(P<0.05).Logistic regression analysis showed that albumin(OR=19.045,95%CI=2.001～181.230),miRNA-126a(OR=200.603,95%CI=15.663～2569.162),miRNA-130b(OR=11.770,95%CI=1.966～70.474)were related factors affecting CI occurrence in DM patients with AS.ROC curve analysis showed that peripheral blood miRNA-126a had the highest AUC(0.958)for diagnosing CI in DM patients with AS,with a sensitivity of 97.6%and specificity of 89.7%.The AUC for miRNA-130b(0.669)was lower,with a sensitivity of 73.2%and specificity of 62.1%.Conclusion Decreased expression of peripheral blood miRNA-126a has good diagnostic value for CI in DM patients with AS.

To investigate the association between obesity-related metabolic indices and the risk of knee osteoarthritis(KOA) in middle-aged and older Chinese adults(≥45 years) using data from the China Health and Retirement Longitudinal Study(CHARLS).

Objective:To investigate the effect of ERMAP on imiquimod(IMQ)-induced psoriasis-like skin inflammation in mice and its related mechanism.Methods:The experimental mice were divided into 3 groups:Sham group,WT group and ERMAP-/-group,with 9 mice in each group.The Sham group was smeared with Vaseline,and the WT group and ERMAP-/-group were smeared with IMQ to induce psoriatic dermatitis.The severity of IMQ-induced psoriasis lesions in mice were evaluated according to the psoria-sis area and severity index(PASI)and the HE staining pathology score.The expressions of F4/80 and Ki67 in mouse skin lesions were observed by immunofluorescence staining.The relative expressions of IL-1β,IL-6,IFN-γ and iNOS in skin lesions were detected by qRT-PCR.Flow cytometry was used to detect the proliferation and activation of T cells and the proportion of macrophages in spleen.Results:In the IMQ-induced mouse model of psoriasis-like dermatitis,the skin lesions of ERMAP gene knock out mice showed more severe squamous accumulation and skin bulge,more inflammatory cells aggregation and cytokine production,and the proportion of immune cells in the spleen of mice increased compared with the WT group,and the proportion of M1 macrophages increased.Conclu-sion:ERMAP deficiency aggravates IMQ-induced psoriasis-like skin inflammation in mice by enhancing immune response.

The aging trend is intensifying currently,but there is still a lack of standardized diagnosis and treat-ment schemes for severe infections in elderly people.This paper focuses on the recommendations for immune-related clinical diagnosis and treatment routes as well as the idea of risk stratified diagnosis and treatment for elderly peo-ple,aiming to effectively prevent infectious diseases in elderly people and perform stratified management through systematic and scientific means of immune function monitoring and regulation,so as to enhance the standardized level of diagnosis and treatment as well as clinical treatment effect of infection in elderly people.

Wilson disease is a copper metabolism disorder caused by mutations in the ATP7B gene， which encodes a copper-transporting ATPase β， and can result in multisystem damage. The kidneys are the third most commonly affected organs after the liver and brain. In recent years， numerous diagnostic and treatment guidelines for Wilson disease have emerged. However， most of these focus primarily on hepatic and neurological manifestations and their management， with limited coverage of renal involvement. The high incidence， low awareness， and lack of clinical specificity of Wilson disease-related renal damage （WDRD） have made early detection and intervention particularly challenging in clinical practice. To further optimize the treatment of patients with WDRD， improve clinical diagnosis and management， and enhance patients' quality of life， the Neurology Committee of the Chinese Association of Integrative Medicine， in April 2024， initiated a revision of the first expert consensus on the integrated diagnosis， treatment， and management of WDRD. This effort brought together experts in hepatology， encephalopathy （neurology）， and nephrology from many tertiary-level grade A hospitals and research institutions across China. Through comprehensive literature review and integration of frontline clinical experience， the expert group jointly developed Chinese Expert Consensus on Integrated Chinese and Western Medicine Management of Wilson Disease-related Renal Damage （hereinafter referred to as the "Consensus"）. This article provides a detailed interpretation of the Consensus in terms of diagnostic criteria， traditional Chinese medicine （TCM） syndrome differentiation and treatment classification， and comprehensive disease management， aiming to better guide clinical application. Regarding diagnostic criteria， the Consensus integrates the latest standards in China and abroad， highlights the importance of biochemical diagnosis， and compensates for the limitations of genetic testing. In the area of TCM syndrome differentiation and treatment， the Consensus refines four major syndrome types， introduces a newly defined syndrome， i.e.， phlegm， blood stasis， and heat accumulation， and elaborates on treatment principles， prescriptions， and clinical modification rules for each syndrome. For comprehensive disease management， the Consensus emphasizes multi-dimensional intervention strategies， including diet， exercise， emotional regulation， medication， and medical care， with the goal of maximally controlling the progression of renal dysfunction and helping patients achieve a better quality of life.