Objective:To examine the risk factors and predictive value of depression following mild acute ischemic stroke in elderly individuals.The aim is to enhance early identification and intervention, ultimately leading to improved prognosis.Methods:A case-control study was conducted on 988 elderly patients with mild acute ischemic stroke.The study collected general population and social data, as well as clinical laboratory data such as blood glucose, blood lipids, and AD7C-NTP in urine.Additionally, the patients underwent assessments using the Montreal Cognitive Assessment Scale(MoCA), National Institutes of Health Stroke Scale(NHISS), Barthel index(BI), Hamilton Anxiety Scale(HAMA), and Hamilton Depression Scale(HAMD).Based on the HAMD depression scale score, the patients were divided into a nopost-stooke depression(NPSD)group and a post-stooke depression(PSD)group.The study then analyzed the related risk factors and predictive value of PSD.Results:A total of 988 patients were eligible for inclusion, with 132 being excluded and 856 being included.The NPSD and PSD groups showed significant differences in age, hypertension, smoking history, education level, and stroke history(all P<0.05).Regarding clinical data, there were statistically significant differences between the two groups in total cholesterol(TC), triacylglycerol(TG), HDL, urinary AD7C-NTP, MoCA, and HAMA scores(all P<0.05).The results of the multi-factor logistic regression analysis revealed that gender( OR=1.975, 95% CI: 1.223-3.190, P=0.005), stroke history( OR=1.352, 95% CI: 0.877-2.086, P=0.042), and HAMA score( OR=1.216, 95% CI: 0.932-1.526, P=0.043)were identified as independent risk factors for post-stroke depression in the elderly.Conversely, MoCA score( OR=0.873, 95% CI: 0.814-0.937, P<0.001)was found to be an independent protective factor.Furthermore, the ROC curve analysis demonstrated that the HAMA score(AUC=0.892, sensitivity: 0.721, specificity: 0.854, cut-off value: 9.5)exhibited significant predictive value, while the other indexes had limited predictive value. Conclusions:Gender, stroke history, and HAMA score have been identified as potential independent risk factors for post-stroke depression(PSD)in the elderly, while MoCA score may serve as an independent protective factor.Notably, HAMA score demonstrates a strong predictive ability for PSD.Early identification of these factors and timely intervention could significantly contribute to improving prognosis.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

AIM:To identify the reasons for not improving visual acuity of patients with diabetic macular edema(DME)and its correlation with optical coherent tomography(OCT)imaging characteristics. They were treated with anti-vascular endothelial growth factor(VEGF)again after an interruption of treatment due to the COVID-19 pandemic.METHODS: Retrospective cases study. A total of 31 patients(40 eyes)with DME and treated with anti-VEGF drugs in the Department of Ophthalmology of the First Affiliated Hospital of Xi'an Jiaotong University between December 2019 and July 2020 were selected. All patients had an treatment history of interruption due to COVID-19. Based on the behavioral standard of best corrected visual acuity(BCVA)at 1mo after re-treatment, they were divided into improved visual acuity group(14 eyes)and non-improved visual acuity group(26 eyes). All patients received comprehensive ophthalmic examinations, including BCVA, intraocular pressure, OCT, fundus photography, and fundus fluorescein angiography(FFA). The central retinal thickness(CRT), hyper-reflective retinal dots(HRD), subretinal fluid(SRF), intraretinal fluid(IRF), disorganization of the inner retinal layers(DRIL)and ellipsoid zone disruption(EZD)were quantified by Image J. The correlation between BCVA and CRT, the number of HRD, the diameter of SRF and IRF, and the height of DRIL and EDZ width at 1mo after treatment were analyzed by Spearman correlation.RESULTS: The proportion of HRD in OCT was significantly higher in the non-improved visual acuity group than that in the improved visual acuity group(χ2=5.43, P=0.0072); There was a positive correlation between the difference of BCVA(LogMAR)and CRT change in DME patients after treatment(rs=0.406, P=0.009); There was a positive correlation between BCVA(LogMAR)and EZD width after treatment(rs=0.358, P=0.023). There was no correlation between BCVA(LogMAR)after treatment and the number of CRT(rs=-0.086,P=0.600)and HRD(rs=-0.115,P=0.482), the diameter and height of SRF(rs=0.102,P=0.530; rs=0.100,P=0.538)and IRF(rs=0.134,P=0.410; rs=-0.014,P=0.932), and the width of DRIL(rs=0.089,P=0.587).CONCLUSION:The probability of retinal HRD was significantly higher in patients with no visual improvement than that in patients with visual improvement after the re-treatment with anti-VEGF due to the treatment interruption during COVID-19. EZD width was also closely correlated to the prognosis of visual acuity. As for these patients, HRD manifestations in OCT should be comprehensively considered, taking intravitreal injection of glucocorticoid as an auxiliary strategy if necessary.

Objective: To analyze the epidemiological characteristics of coronavirus disease 2019 (COVID-19) local infections in Zhejiang Province during the period between March and May, 2022, so as to provide the evidence for COVID-19 control. Methods: The individual investigation data and field epidemiological investigation data of local COVID-19 cases in Zhejiang Province from March to May 2022 were extracted from the National Diseases Prevention and Control Information System of China. The temporal, spatial and population distribution, identification and booster vaccination of local COVID-19 cases were analyzed using a descriptive epidemiological method. Factors affecting the severity of clinical symptoms were identified among local COVID-19 cases using a multivariable logistic regression model. Results: A total of 289 local COVID-19 epidemics occurred in Zhejiang Province from March to May 2022, and all infections were caused by the Omicron variant. A total of 1 598 local COVID-19 infections were reported, including 672 confirmed cases (42.05%) and 926 asymptomatic cases (57.95%), and the 672 confirmed case included 614 mild cases (91.37%), 58 normal cases (8.63%), while no severe, critically ill or dead cases were reported. The mean duration of COVID-zero community, mean duration of COVID-19 epidemics and mean length to COVID-19 peak calculated according to 7 epidemics with 50 and more cases were (6.14±1.07), (13.43±4.39), (3.00±1.63) d, respectively. COVID-19 infection was predominantly detected in centralized quarantine sites (1 105 cases, 69.15%), and 843 cases completed booster immunization of COVID-19 vaccines (52.75%). Multivariable logistic regression analysis showed that age (with ages of 60 years and older as the reference, age of 6 to 17 years, OR=0.111, 95%CI: 0.024-0.508; age of 18 to 44 years, OR=0.341, 95%CI: 0.163-0.713) and booster COVID-19 vaccination (OR=0.219, 95%CI: 0.117-0.410) were protective factors for developing more severe clinical symptoms following COVID-19 infections. Conclusions All local COVID-19 infections were caused by Omicron variant in Zhejiang Province during the period between March and May 2022, and all cases had mild clinical symptoms. Preschool children, middle-aged and elderly residents and individuals that did not complete booster COVID-19 vaccination may had relatively more severe clinical symptoms following COVID-19 infections.

Objective:To investigate the effects of anxiety and depressive symptoms in mediation of pain catastrophizing on disability in patients with low back pain.Methods:A cross-sectional survey was conducted among 97 patients with low back pain in the Changjiang Subdistrict community health center from July to October 2021. Oswestry Disability Index, pain catastrophic subscale in Coping Strategies Questionnaire-24, Generalized Anxiety Disorder Scale-short version, Patient Health Depression Questionnaire-short version were used to evaluate the activity dysfunction, pain catastrophic cognition and anxiety and depression levels of patients,respectively. Path analysis was implemented to test the mediation model, and the indirect effects were assessed using the bootstrap procedure with bias-corrected 95 %CI. Results:Results suggested significant positive correlations among pain catastrophizing, anxiety, depressive symptoms and disability of patients. In addition, both anxiety and depressive symptoms significantly mediated the impact of pain catastrophizing on disability (standardized indirect effects were 0.183 and 0.197, P<0.05). Patients with higher levels of pain catastrophic cognition showed higher levels of anxiety and depressive symptoms (β=0.757, 0.720; P<0.01), and reported more severe motor dysfunction (β=0.241, 0.274; P<0.05). Conclusions:Our findings suggest that anxiety and depression may be the psychological pathways through which pain catastrophizing predicts disability in patients with low back pain. Effective psychological interventions, such as emotion regulation and stress reduction strategies should be considered in treatment and supportive care for patients with low back pain.

Objective To investigate the pathological changes of nasal mucosa by intranasal acupuncture, and to explore the possible signal transduction mechanism through the distribution and expression of transient receptor potential vanillic acid receptor 1 (TRPV1)-substance P (SP) axis in nasal mucosa of experimental allergic rhinitis. Methods An animal model of allergic rhinitis was constructed by ovalbumin and aluminium hydroxide gel treatment. Twenty five New Zealand rabbits were randomly divided into normal group, model group, sham acupuncture group, acupuncture Wai Ying Xiang group and intranasal acupuncture group, with 5 rabbits in each group. To observe the effect of intranasal acupuncture on animal behavior, nasal mucosa pathology, eosinophils (EOS) count and IgE content in arterial blood. In addition, HE staining was used to determine the distribution of EOS in nasal mucosa and immunohistochemistry was used to observe the distribution and expression of TRPV1 and SP in nasal mucosa membrane. Results Compared with the model group, the behavioral score of the sham acupuncture group did not decrease significantly, while the behavioral score of the Wai Ying Xiang acupuncture group and the intranasal acupuncture group showed a downward trend, and the decrease degree of the intranasal acupuncture group was more significant. Compared with the normal group, the eosinophil count in the model group increased slightly (P<0.05); Compared with the model group, the number of eosinophils in the intranasal acupuncture group decreased (P<0.05). Compared with the normal group, the serum IgE content in the model group increased significantly (P<0.05). Compared with the model group, there was no significant change in the sham acupuncture group (P<0.05). Compared with the model group, serum IgE content in the Wai Ying Xiang acupuncture group and the internal acupuncture group decreased significantly (P<0.05), but there was no statistical difference between the internal acupuncture group and the Wai Ying Xiang acupuncture group (P>0.05). HE staining found that eosinophilic distribution increased significantly in the model group and the sham acupuncture group compared with the normal group, and the difference was statistically significant (P<0.05). Compared with the model group, the distribution of eosinophil reduced in the nasal acupuncture group and the Wai Ying Xiang group. The difference was statistically significant (P<0.05 ). Immunohistochemical found that TRPV1 and SP expressed significantly in the nasal mucosa of the model group and the sham acupuncture group compared with the normal group, the difference was statistically significant (P<0.05). Compared with the model group, TRPV1 and SP expression decreased significantly in the intranasal acupuncture group and the external yingxiang group, the difference was statistically significant (P<0.05). Conclusion Intranasal acupuncture can alleviate the nasal symptoms of allergic rhinitis model by reducing the Chemotaxis of eosinophils in nasal mucosa and the content of IgE in serum.

Astragali Radix is the elixir for invigorating Qi, with the effects of invigorating Qi, promoting Yang and nourishing the body. With the deepening researches on the chemical constituents of Astragali Radix, it is used more extensively in clinical application. Based on systematic traditional Chinese medicine theory, in this paper, we characterized the effect of Astragali Radix on invigo-rating Qi from the molecular level, and explored the markers of Astragali Radix on invigorating Qi. Through TCMSP and ChEMBL databases, the active components-targets database of Astragali Radix was constructed to clarify the targets(elements) involved in Astragali Radix's Qi invigorating efficacy system. According to the relationship between the targets, the protein interaction network was constructed, and the network modules(structure) were divided according to the theoretic clustering algorithm molecular complex detection(MCODE), and the boundary of the Qi invigorating efficacy system was defined by the pharmacological function of Astragali Radix. The active components of Astragali Radix for invigorating Qi were characterized from the aspects of composition, target and efficacy. The results showed that eight key components of Astragali Radix, such as hederagenin, quercetin, calycosin, formononetin, jaranol, isorhamnetin, astragalosideⅢ, and 9,10-dimethoxypterocarpan-3-O-β-D-glucoside, could act on eight functional modules composed of 17 key targets, and participate in G-protein coupled receptor protein signaling pathway, regulation of lipid metabolic process, positive regulation of nitrogen compound metabolic process, positive regulation of programmed cell death, fatty acid metabolic process and other biological processes to produce pharmacological effects such as regulating immune function, strengthening heart, protecting myocardial cells, improving material metabolism, and antioxidation effects, thus playing the role of invigorating Qi. Based on the systematic Chinese medicine theory, this study explored the effective markers of Astragali Radix at the level of molecular network, which provided new ideas for the interpretation of the effective substance basis of systematic traditional Chinese medicine and the quality control of traditional Chinese medicine. In the future, it can focus on the compatibility research of these components, and then carry out more in-depth studies on the efficacy of Astragali Radix in invigorating Qi, and strengthen the development of the corresponding pharmacological mechanism and related preparations.
Astragalus Plant ; Drugs, Chinese Herbal ; Medicine, Chinese Traditional ; Plant Roots ; Qi

Traditional Chinese medicine for promoting blood circulation and removing blood stasis has been widely used in clinical practice. However, due to the diversity of the composition of traditional Chinese medicine and the complexity of its interaction with human body, it is difficult to apply traditional quality control ingredients to characterize its overall efficacy. Systematic traditional Chinese medicine is an effective method for studying the efficacy of traditional Chinese medicine, embodying the dialectical unity of holism and reductionism. Salviae Miltiorrhizae Radix et Rhizoma is a common traditional Chinese medicine for promoting blood circulation and removing blood stasis. In this study, we constructed a multi-dimensional network of "efficacy-pharmacological efficacy-targets-components" based on systematic traditional Chinese medicine, and discussed the discovery of the efficacy markers of Salviae Miltiorrhizae Radix et Rhizoma for promoting blood circulation and removing blood stasis. Firstly, based on the Chinese medicine efficacy-pharmacology database, the most relevant pharmacological actions(boundary) for promoting blood circulation and removing blood stasis(function) were obtained, and the target sets(structure) of the corresponding pharmacological action were obtained by the DrugBank database. Then, STRING database was used to construct protein-protein interaction network(relationship) of targets related to promoting blood circulation and removing stasis, and key targets(elements) in the network were selected by evaluating topological parameters of targets. Finally, the potential efficacy markers of Salviae Miltiorrhizae Radix et Rhizoma were predicted by molecular docking based on the key targets of promoting blood circulation and removing blood stasis. The results demonstrated that salvianolic acid B, salvianolic acid A, tanshinone Ⅱ_A and tanshinone Ⅰ were the potential markers of Salviae Miltiorrhizae Radix et Rhizoma on promoting blood circulation and removing blood stasis. Salvianolic acid B, salvianolic acid A, tanshinone Ⅱ_A had been reported to have anti-platelet aggregation, anti-thrombotic, cardiovascular protection and some other pharmacological functions. Based on systematic traditional Chinese medicine, we have preliminarily predicted the efficacy markers of Salviae Miltiorrhizae Radix et Rhizoma in promoting blood circulation and removing blood stasis in this study, providing a research method for the discovery of efficacy markers and a reference for the overall quality control of traditional Chinese medicine.
Drugs, Chinese Herbal ; Humans ; Medicine, Chinese Traditional ; Molecular Docking Simulation ; Plant Roots ; Rhizome ; Salvia miltiorrhiza

Objective: To evaluate the performance of a chromogenic agar developed by our laboratory for the isolation and culture of Clostridium difficile (CDCA). Methods: The chromogenic specificity of CDCA was evaluated by inoculation of C. difficile and other standard strains, and the sensitivities of CDSA (BD), CDIF (BioMérieux) and CDCA were determined by the C. difficile standard strains respectively. A total of 120 clinical stool specimens were cultured for C. difficile by three chromogenic media respectively. The colonies were further identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and tpi gene was also detected. The sample which could be identified as C. difficile in any of the three chromogenic medium was defined as true positive. Results: Most of standard strains were inhibited by CDCA, however some Clostridium species including C. clostridiiforme, C. bifermentans, C. tertium and Bacteroides fragilis grew lightly with chromogenic reaction. The sensitivities of CDSA, CDIF and CDCA were 2.0×105 CFU/mL, 8.0×101 CFU/mL and 4.0×10 2 CFU/mL, respectively. Among the 120 samples, 31 (25.8%) were defined as true C. difficile positive samples, while the positive rate of CDSA, CDIF and CDCA were 25 (20.8%), 28 (23.3%) and 26 (21.7%), respectively. There was no significant difference for clinical diarrhea specimens among the three chromogenic media (χ 2 =0.418, P=0.811). In comparison to the standard, the sensitivity, specificity, positive predictive value and negative predictive value were 83.8%, 100%, 100% and 94.7% for CDCA; 90.3%, 98.9%, 96.6% and 96.7% for CDIF; and 80.6%, 100%, 100% and 93.7% for CDSA. Conclusion The CDCA developed by our laboratory could be used to preliminarily isolate C. difficile with good specificity and sensitivity.

Objective: To investigate the effect of ELMOD2 over-expression on the malignant biological behaviors of gastric cancer MGC803 cells, and to study its related molecular mechanism. Methods: GV141-ELMOD2 expression vector was transfected into human gastric cancer MGC803 cells. The mRNA and protein expressions of ELMOD2 were detected by Real-time fluorescent quantitative PCR and WB, respectively. The cell proliferation ability was detected by CCK-8 method. Apoptosis rate was detected by flow cytometry. The cell migration ability was detected by Transwell method. The protein expressions of PCNA, BAX and Bcl-2 and Vimentin were detected by WB. Results:After transfection of ELMOD2 expression vector, the mRNAand protein expressions of ELMOD2 were significantly increased in MGC803 cells (P<0.05). Further studies showed that over-expression of ELMOD2 increased the proliferation and migration ability but reduced the apoptosis rate of MGC803 cells significantly (P<0.05 or P<0.01). The protein levels of PCNA, Vimentin and Bcl-2 in MGC803 cells increased, while the protein level of BAX decreased (P<0.05 or P<0.01). Conclusion: Over-expression of ELMOD2 can promote the proliferation and migration of MGC803 cells and inhibit cell apoptosis. These effects may be achieved by increasing the protein level of PCNA, Vimentin and Bcl-2, and reducing the protein level of BAX.