ObjectiveTo characterize the systemically absorbed components of Zhengqi prescription （ZQP） and investigate its therapeutic effects and mechanisms against cancer-related fatigue （CRF） through an integrated approach of network pharmacology and animal experiments. MethodsThe systemically absorbed components of ZQP were identified by ultra-performance liquid chromatography coupled with quadrupole-Orbitrap mass spectrometry （UPLC-Q-Exactive Orbitrap MS）. Network pharmacology was employed to predict the potential targets and signaling pathways involved in the anti-CRF effects of ZQP. A mouse model of paclitaxel-induced CRF， mimicking breast cancer-related fatigue， was established. Mice were administered different doses of ZQP extract. The therapeutic efficacy was evaluated based on fatigue-related indicators， behavioral test results， and energy metabolism parameters. Western blot analysis was conducted to validate the regulation of core signaling pathways. ResultsA total of 48 systemically absorbed components were identified. Network pharmacology analysis revealed 124 intersecting targets （including Akt1） and implicated signaling pathways such as phosphatidylinositol 3-kinase/protein kinase （PI3K/Akt）. Pharmacodynamic studies with the established CRF model demonstrated that ZQP alleviated fatigue symptoms. Specifically， ZQP-treated mice exhibited increased exhaustive swimming time （P<0.05）， prolonged struggling time in the tail suspension test， and enhanced movement duration and distance in the open field test （P<0.05， P<0.01）. Furthermore， ZQP treatment decreased serum lactate and blood urea nitrogen levels （P<0.05， P<0.01）， increased liver and muscle glycogen content （P<0.05， P<0.01）， and upregulated the expression of phosphorylated （p）-Akt and p-PI3K in the gastrocnemius muscle （P<0.05， P<0.01）. ConclusionZQP exerts significant therapeutic effects on paclitaxel-induced breast cancer-related fatigue by regulating the PI3K/Akt signaling pathway. Furthermore， this study provides a preliminary foundation for subsequent quality control of the formula and further investigation into its mechanism against CRF.

Objective To interpret the major updates in the "2026 ACC/AHA Guideline on the Management of Dyslipidemia" and provide guidance for perioperative and long-term lipid management in patients undergoing cardiovascular surgery. Methods Based on the 2026 guideline and relevant cardiovascular outcome studies, this article summarized key aspects of lipid management across the entire life span, PREVENT-ASCVD risk assessment, low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) targets, lipoprotein(a) and apolipoprotein B testing, management of hypertriglyceridemia, and the use of non-statin therapies, while analyzing their clinical implications from the perspective of cardiovascular surgery. Results The 2026 guideline expanded the focus of lipid management from simple cholesterol control to comprehensive, lifelong lipid protein risk management across the entire spectrum. It recommended the PREVENT-ASCVD model, integrated risk-enhancing factors and coronary artery calcium scores to refine risk stratification, re-established LDL-C and non-HDL-C targets, strengthened management of lipoprotein(a), apolipoprotein B, and hypertriglyceridemia, and emphasized early combination lipid-lowering therapy. These updates helped identify residual cardiovascular risks in surgical patients, promoted postoperative lipid target achievement, and supported long-term secondary prevention. Conclusion The 2026 guideline advances lipid management toward precise risk stratification, goal-directed therapy, and longitudinal intervention. Standardized lipid assessment and lipid-lowering therapy should be integrated into perioperative and long-term postoperative management in cardiovascular surgery to improve long-term patient outcomes.

Background Exposure to ozone (O₃) is closely associated with an increased risk of mortality in the population, but this association exhibits regional heterogeneity, and relevant research in northern and central-western China is limited. Hohhot, as a typical city in the northern and western region, has seen a significant upward trend in O₃ concentrations (an increase of 17.9 μg·m⁻³ in 2020 compared to 2016). Studies targeting this region can fill the regional research gap. Objective To evaluate the health effects of ground-level O₃ exposure on resident mortality in Hohhot from 2018 to 2023. Methods Air quality, meteorological, and mortality data in Hohhot from 2018 to 2023 were collected. A time-series analysis based on Quasi-Poisson generalized additive model (GAM) was employed, controlling for meteorological factors, day-of-week effects, and holiday effects, to assess the impact of O₃ on non-accidental mortality, mortality from circulatory system diseases (CSD), and mortality from respiratory system diseases (RSD). Results From 2018 to 2023, the non-accidental, CSD, and RSD mortalities in Hohhot amounted to 89721, 47394, and 11378 cases, respectively. The daily maximum 8-hour average O₃ concentration (O₃-8 h) was 90.00 μg·m⁻³. According to the Class I limit (100 μg·m⁻³) of GB 3095—2012 Ambient Air Quality Standard, the annual average number of days exceeding the standard was 144 d. For single-day lag effects, O₃ had the strongest health impact on non-accidental mortality and CSD mortality on the current day (lag0), with effect sizes of 0.78% (95%CI: 0.33%, 1.24%) and 1.10% (95%CI: 0.50%, 1.71%), respectively. The strongest impact on RSD mortality occurred on the second day (lag2), with an effect size of 1.61% (95%CI: 0.61%, 2.62%). The subgroup analyses showed that for every 10 μg·m⁻³ increase in O₃-8 h concentration, the risk of non-accidental mortality in females increased by 0.70% (95%CI: 0.01%, 1.41%); for CSD mortality, the risk in males and individuals aged ≥65 years increased by 0.73% (95%CI: 0.01%, 1.47%) and 0.76% (95%CI: 0.13%, 1.39%), respectively. During the warm season, statistically significant risks were observed for non-accidental, CSD, and RSD mortalities, with increases of 1.07% (95%CI: 0.54%, 1.60%), 1.31% (95%CI: 0.59%, 2.04%), and 2.27% (95%CI: 1.07%, 3.49%), respectively. In the two-pollutant models incorporating sulfur dioxide (SO₂), nitrogen dioxide (NO₂), carbon monoxide (CO), particulate matter with an aerodynamic diameter of 10 micrometers or less (PM₁₀), and fine particulate matter (PM_2.5), the effect estimates (excess risk) of O₃ remained stable and statistically significant (P<0.05), indicating model robustness. Conclusion Ground-level O₃ exposure in Hohhot increases mortalities due to non-accidental causes, CSD, and RSD, with more pronounced effects during the warm season. Females and individuals aged ≥65 years may be susceptible populations. Therefore, relevant authorities should prioritize the potential health risks of O₃ exposure, particularly to vulnerable groups, and promote targeted prevention and control strategies.

The research on the cardiovascular toxicity of air pollutants is in urgent need of collaborative innovation across multiple models. This paper systematically reviewed the advantages and limitations of four principal research models of cardiotoxicity, including epidemiological model, mammalian model, zebrafish model, and in vitro model. Epidemiological models have been used to demonstrate a significant correlation between exposure to PM_2.5 and both the incidence and mortality of cardiovascular diseases within populations; however, these models face challenges in establishing causal inferences and interpreting individual mechanisms. Mammalian models have been applied to elucidate the pathogenic mechanisms of PM_2.5 at both the systemic and organ-specific levels, yet they encounter difficulties related to interspecies differences and throughput constraints. Zebrafish models, with their transparent embryos and observable development, offer a distinctive opportunity for high-throughput screening and mechanistic investigation of PM_2.5-induced cardiac developmental toxicity. Nonetheless, their cardiac physiological structure diverges from that of mammals, limiting their capacity to accurately model chronic conditions such as coronary heart disease. In vitro models, particularly human heart organoids and chip technologies, have provided profound insights into the direct toxic mechanisms of PM_2.5, including disruptions in calcium homeostasis, cellular senescence, and electrophysiological irregularities at the cellular and molecular levels. Despite these advancements, the complexity and developmental maturity of these models present challenges to their broader application. This paper proposed that the key to overcoming the bottlenecks of single models lies in the construction of an integrated evaluation system that combines “epidemiological studies, mammalian models, zebrafish models, and in vitro models”. By focusing on three aspects, namely model integration, technological convergence, and policy support, it is intended to collaboratively address issues such as standardization of multi-model data, simulation of complex exposure scenarios and susceptible life stages, and transformation pathways. This will provide innovative methodological support for the analysis of the cardiotoxic mechanisms of air pollutants, the assessment of environmental health impacts, and the formulation of precise prevention and control strategies.

Objective To investigate the expression changes of T-cell exhaustion-related genes in multiple myeloma(MM)and their potential causal relationships.Methods A bidirectional summary-level Mendelian randomization(MR)analysis was used to explore the causal relationship between T-cell exhaustion and MM.The eQTL data and genome-wide association study(GWAS)were used to summarize data,and corresponding single nucleotide polymorphisms(SNPs)were extracted as instru-mental variables.Four methods,namely inverse variance weighted(IVW)method,MR Egger,weighted median,and weighted mode were used to assess the reliability of the causal relationship.The robustness of the results was validated using Cochran's Q heterogeneity test and pleiotropy test.In cel-lular models,RNA interference was used to silence key target genes,and phenotypic changes such as myeloma cell viability,colony-forming ability,and apoptosis were observed to experimentally confirm the causal effects revealed by MR.Results The genes PRDM1,ENTPD1,PTPN11,and HLA-B were involved in the T-cell exhaustion process in MM.The presence of the PRDM1 gene(OR=0.998 5,95％CI,0.997 1 to 0.999 8,P=0.024 6)may reduce the risk of MM,whereas ENTPD1(OR=1.000 4,95％CI,1.000 1 to 1.000 7,P=0.015 8),HLA-B(OR=1.000 4,95％CI,1.000 1 to 1.000 8,P=0.012 4),and PTPN11(OR=1.002 5,95％CI,1.001 0 to 1.003 9,P=0.001 2)were associated with an increased risk of MM.Real-time quantitative polymerase chain reaction showed overexpression of PTPN11 in MM cell lines and patients' samples.By assessing cell viabili-ty,colony formation and detecting apoptosis,it was found that inhibiting PTPN11 promoted apopto-sis in MM cell lines.Conclusion A causal relationship exists between T-cell exhaustion and MM.Targeted interventions against specific T-cell exhaustion-related genes may help reduce the incidence of MM.

Objective:To investigate the clinical characteristics and treatment of human immunodeficiency virus (HIV) negative adult disseminated Talaromyces marneffei (TSM) infection, so as to improve the diagnosis and treatment of this disease.Methods:While two HIV-negative adult patients with disseminated T. Marneffei infection were reported, papers published between 1970 and February 2024 were collected from CNKI, Wanfang and Chongqing Weipu databases, and patient data meeting diagnostic criteria were collected. A total of 34 HIV-negative adults with disseminated T. Marneffei infection were collected. The data of 34 patients with this disease were retrospectively analyzed, and the demographic distribution, systematic signs, examination results, complications, diagnosis and treatment plan and effect of this disease were summarized.Results:Among the 34 patients, the ratio of male to female patients was 21∶13. The median age of onset was 51 years, ranging from 24 to 70 years. The incidence area was more common in the south of China. The most common clinical manifestation was fever. 70.6%(24/34) of patients were misdiagnosed, most often with tuberculosis. The methods of diagnosis were as follows: 26 cases were diagnosed by fungal culture, 5 cases by high-throughput sequencing and 3 cases by direct microscopy. 32 patients received antifungal therapy, 9 were cured, 10 improved, 2 died, 4 relapsed, 4 patients were effective (but the outcome was unknown), 2 patients had poor effect, and 1 patient had unknown effect. Two patients died soon after admission due to rapid disease progression.Conclusions:The symptoms of HIV negative adults infected with T. Marneffei are varied and may involve multiple systems. Infection is often misdiagnosed. Early identification and fungal culture can improve the detection rate. High-throughput sequencing is a relatively mature diagnostic technology.

Objective:To investigate the clinical characteristics and treatment of human immunodeficiency virus (HIV) negative adult disseminated Talaromyces marneffei (TSM) infection, so as to improve the diagnosis and treatment of this disease.Methods:While two HIV-negative adult patients with disseminated T. Marneffei infection were reported, papers published between 1970 and February 2024 were collected from CNKI, Wanfang and Chongqing Weipu databases, and patient data meeting diagnostic criteria were collected. A total of 34 HIV-negative adults with disseminated T. Marneffei infection were collected. The data of 34 patients with this disease were retrospectively analyzed, and the demographic distribution, systematic signs, examination results, complications, diagnosis and treatment plan and effect of this disease were summarized.Results:Among the 34 patients, the ratio of male to female patients was 21∶13. The median age of onset was 51 years, ranging from 24 to 70 years. The incidence area was more common in the south of China. The most common clinical manifestation was fever. 70.6%(24/34) of patients were misdiagnosed, most often with tuberculosis. The methods of diagnosis were as follows: 26 cases were diagnosed by fungal culture, 5 cases by high-throughput sequencing and 3 cases by direct microscopy. 32 patients received antifungal therapy, 9 were cured, 10 improved, 2 died, 4 relapsed, 4 patients were effective (but the outcome was unknown), 2 patients had poor effect, and 1 patient had unknown effect. Two patients died soon after admission due to rapid disease progression.Conclusions:The symptoms of HIV negative adults infected with T. Marneffei are varied and may involve multiple systems. Infection is often misdiagnosed. Early identification and fungal culture can improve the detection rate. High-throughput sequencing is a relatively mature diagnostic technology.

Rheumatoid arthritis(RA)is an autoimmune disease with an early clinical manifestation of symmetric small joint pain,which gradually worsens and often involves multiple joints,ultimately result ing in arthritic deformities and loss of labor capacity.Molecular signaling pathways have been a focus of research regarding the prevention and treatment of RA,and the progression of RA has been shown to be closely related to various signaling pathways,including the Janus kinase-signal transducer and activator of transcription,mitogen-activated protein kinase,NOD-like receptor protein 3,Toll-like receptor,Wnt,Notch,hypoxia-inducible factor 1-α and vascular endothelial growth factor,programmed death factor 1 and ligand 1,and phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin signaling pathways.Increasing recent studies have investigated the external treatment of RA using traditional Chinese medicines based on the above signaling pathways.In this paper,we review the relevant data and reports to explain the relationship between the above pathways and the pathogenesis and prevention of RA.We also summarize the research result regarding the modulation of these signaling pathways by external treatment with traditional Chinese medicines aimed at preventing and treating rheumatoid joints,with a view to providing a scientific basis for the clinical selection of these treatments.

Objective:To explore the mediating effect of appearance functional internalization between social comparison tendency and body image distress of college students.Methods:From June to September 2023, a cross-sectional survey was conducted among 308 college students with the social comparison tendency scale, the functional internalization questionnaire of college students' appearance and the body image anxiety scale for adolescent students.SPSS 22.0 software was used for common method bias test, descriptive statistics and correlation analysis, Mplus 8.0 was used for structural equation construction, and Bootstrap method was used for intermediary effect analysis.Results:Body image distress (43.86±8.78) was positively correlated with social comparison tendency (35.20±6.04) and appearance functional internalization (38.35±9.68) ( r=0.35, 0.33, both P<0.01).There was also a positive correlation between social comparison tendency and appearance functional internalization ( r=0.51, P<0.01). The effect of social comparison tendency on body image distress was mediated by appearance functional internalization, and the mediating effect value was 0.137, accounted for 35.13%(0.137/0.390) of the total effect. Conclusion:The appearance functional internalization mediates the relationship between social comparison tendency and body image distress.Social comparison tendency can not only directly predict body image distress, but also can predict body image distress, indirectly through appearance functional internalization.

ObjectiveTo evaluate the clinical efficacy and safety of Ganjie Bingmei Tablet （甘桔冰梅片， GBT） in treating acute pharyngitis with wind-heat invading the lung syndrome. MethodsUsing multi-center， rando-mized， double-blind， double-dummy， positive and parallel controlled clinical trial design， 144 acute pharyngitis patients with wind-heat invading the lung syndrome from October 8th， 2022 to March 31st， 2023 were collected and randomly assigned to the treatment group and the control group， with 72 cases in each group. The treatment group was treated by GBT （0.4 g each time， 4 times a day） combined with Ganjie Qingyan Granules （甘桔清咽颗粒， GQG） placebo （10 g each time， 3 times a day）， while the control group was treated by GQG （10 g each time， 3 times a day） combined with GBT placebo （0.4 g each time， 4 times a day）， both for 5 days. The clinical efficacy of the two groups was observed， and the disappearance rate of pharyngalgia and the efficacy regarding TCM syndromes were compared between groups after treatment. The visual analog scale （VAS） score before and after treatment was assessed， and the safety was evaluated. ResultsThe disappearance rate of pharyngalgia in the treatment group was 98.61%（71/72）， significantly higher than 80.56%（58/72） in the control group （P＜0.01）. The VAS scores in both groups significantly decreased after treatment （P＜0.05）， and lower score was found in the treatment group than the control group （P＜0.05）. The total effective rate regarding TCM syndromes was 100% in both groups， but the curative rate was significantly higher in the treatment group（73.61%， 53/72） than the control group （62.50%， 45/72， P＜0.05）. There were no obvious adverse reactions in the both groups. ConclusionGBT is effective and safe in treating acute pharyngitis with wind-heat affecting the lung syndrome.