BackgroundAlcohol dependence patients are prone to relapse after their attempts to quit drinking， which poses a considerable threat to their physical and mental health and creates a heavy burden on their families. Currently， empowerment education is increasingly being utilized in the rehabilitation management of chronic diseases， but there remains a striking lack of empirical research on the application of "Internet +" empowerment education based on timing it right in alcohol dependence patients. ObjectiveTo explore the impact of "Internet +" empowerment education based on timing it right on patients with alcohol dependence， in order to maximize the reduction in relapse rates， craving for alcohol and severity of anxiety symptoms. MethodsA total of 120 patients who were hospitalized in the Department of Addiction Medicine， Hebei Provincial Mental Health Center from May 2022 to April 2023 and met the diagnostic criteria for alcohol dependence in the International Classification of Diseases， tenth edition （ICD-10） were enrolled， and they were classified into study group （n=62） and control group （n=58） using random number table methods. Both groups received standard medication and routine care. Additionally， study group underwent a 6-month "Internet +" empowerment education based on timing it right. At baseline， all subjects were assessed using Penn Alcohol Craving Scale （PACS） and Self-rating Anxiety Scale （SAS）. Three months and six months after intervention， assessments were conducted using PACS， SAS and Michigan Alcoholism Screening Test （MAST）. ResultsThe relapse rates after three and six months of intervention were both lower in study group than those in control group， with statistically significant differences （χ²=8.575， 8.828， P<0.01）. ANOVA with repeated measures on PACS total score and scores of each item revealed a significant time effect， group effect and time×group interaction effect （F=159.714~837.751， 84.645~393.606， 24.302~137.896， P<0.01）. And significant time effect， group effect and time×group interaction effect were also reported on SAS scores （F=166.237， 65.325， 24.724， P<0.01）. Conclusion"Internet +" empowerment education based on timing it right may help reduce relapse rates， alcohol cravings and severity of anxiety symptoms among patients with alcohol dependence. ［Funded by 2023 Annual Hebei Provincial Medical Scientific Research Project Plan （number， 20231537）］

BackgroundPerceived discrimination has been identified as a main risk factor for depression in maintenance hemodialysis patients. Chronic Illness Rejection and Discrimination Scale （CIRDS） is a measure for assessing perceived discrimination in individuals with chronic disease. However， the Chinese version of CIRDS for maintenance hemodialysis patients has not yet been established. ObjectiveTo translate CIRDS into Chinese version and evaluate its reliability and validity in maintenance hemodialysis patients， so as to provide an effective tool for assessing the perceived discrimination among maintenance hemodialysis patients. MethodsThe Brislin's model for translation， back-translation， cross-cultural adaptation and pre-experimentation was utilized to develop a Chinese version of CIRDS. A coherent of 250 maintenance hemodialysis patients attending Taihe Hospital Affiliated to Hubei Medical College， from July to October 2023 were selected as the research subjects. The formal scale was refined by employing item analysis， exploratory factor analysis and confirmatory factor analysis. The validity of the scale was evaluated using content validity and construct validity. The reliability of the scale was evaluated using Cronbach's α coefficient， test-retest reliability and split-half reliability. ResultsThe Chinese version of CIRDS consisted of 11 items， including 2 factors （perceived discrimination and perceived rejection）. The scale-level content validity index （S-CVI） value was 0.898 and the item-level content validity index （I-CVI） values ranged from 0.875 to 1.000. Two common factors were extracted by exploratory factor analysis and explained 65.41% of the total variance. Confirmatory factor analysis also indicated that the model provided a good fit for the data. The Cronbach's α coefficient of the scale was 0.910， with Cronbach's α coefficients of 0.835 and 0.912 for the perceived discrimination and perceived rejection， respectively. The split-half reliability of the scale was 0.803， and the test-retest reliability was 0.920. ConclusionThe Chinese version of CIRDS has excellent reliability and validity， which can be used to evaluate the perceived discrimination in maintenance hemodialysis patients.

Clinical data of a patient with alveolar soft part sarcoma (ASPS) treated at Zhongshan Hospital, Fudan University were retrospectively analyzed. The patient was initially diagnosed with abdominal ASPS with multiple lung metastases. After 6 weeks of treatment with nivolumab and ipilimumab, the patient achieved stable disease (SD). In the 7th week, the treatment was changed to a combination of nivolumab (30 mg, d1, q3w), anlotinib (8 mg, d1-14, q3w) and ipilimumab (50 mg, d1, q6w). The patient remained SD at the 12th week. The patient then underwent iliac artery embolization and intensity-modulated radiation therapy for the lesion in the psoas major muscle, while continuing the combination treatment. By the 24th week, the evaluation showed partial remission (PR) of both primary tumor and lung metastases. The patient experienced mild adverse reactions during treatment.

[Objective] To systematically evaluate the therapeutic effect of washed red blood cells and white suspended red blood cells on patients with autoimmune hemolytic anemia, and to provide reference for their clinical treatment. [Methods] CNKI, Wanfang, VIP, PubMed, Embase, Cochrane Library and other databases from the establishment of the database to August 2024 were searched, including the randomized controlled trials of washed red blood cells and white suspended red blood cells in the treatment of autoimmune hemolytic anemia that met the requirements. After literature screening, data extraction and quality evaluation, meta-analysis was performed using Review manager 5.3 software and Stata 15.1 software to analyze the therapeutic effect of blood transfusion in the primary outcome, hematological indicators (Hb, Ret, RBC, and TBIL) of the two groups after blood transfusion and the occurrence of adverse blood transfusion reactions. [Results] After screening, 10 literatures meeting the criteria were retrieved, and a total of 753 patients with autoimmune hemolytic anemia were treated with washed red blood cell infusion in the observation group and white suspended red blood cell infusion in the control group. Meta-analysis suggested that there was no significant difference in the therapeutic effect of transfusion between patients who received washed red cells and those received white suspended red cells[SMD=1.16, 95%CI (0.87, 1.54), P>0.05]. The hematological indexes of the two groups after transfusion (Hb [SMD=0.04, 95%CI (-0.14, 0.22), P>0.05]、Ret[SMD=-0.15, 95%CI (-0.34, 0.03), P>0.05]、RBC[SMD=0.08, 95%CI (-0.10, 0.26), P>0.05] and TBIL [SMD=-0.02, 95%CI (-0.18, 0.15), P>0.05]) and the incidence of transfusion adverse reactions[SMD=0.8, 95%CI (0.47, 1.39), P>0.05] were not significantly different. [Conclusion] Based on the current study, the efficacy and safety of infusion of washed red blood cells and white suspended red blood cells are comparable in patients with autoimmune hemolytic anemia. However, considering the simple preparation process of washed red blood cells and the low price, infusion of washed red blood cells is recommended for patients with autoimmune hemolytic anemia.

ObjectiveTo reveal the mechanism of Zuogui Jiangtang Jieyu prescription against damage to hippocampal synaptic microenvironment via suppressing glutamate receptor 2 （GluR2）/Parkin signal-mediated mitophagy in rats with diabetes-related depression （DD）. MethodsEighty male SD rats underwent adaptive feeding for 5 days before the study. Ten rats were randomly assigned to the normal group. The model of DD rats was established with the rest by 2-week high-fat diet + streptozotocin （STZ） tail intravenous injection + 28 days of chronic unpredictable mild stress （CUMS） combined with isolation. The rats were randomly divided into a normal group， a model group， a GluR2 blocker group （5 μg·kg^-1）， a GluR2 agonist group （10 μg·kg^-1）， a metformin + fluoxetine group （0.18 g·kg^-1 metformin + 1.8 mg·kg^-1 fluoxetine）， and high- and low-dose Zuogui Jiangtang Jieyu prescription groups （20.52 and 10.26 g·kg^-1， respectively）. The rats in the GluR2 blocker group and the GluR2 agonist group were continuously injected with CNQX and Cl-HIBO in the dentate gyrus of the hippocampus once a week starting from stress modeling， respectively， while the metformin + fluoxetine group and the high- and low-dose Zuogui Jiangtang Jieyu prescription groups were continuously given intragastric administration for 28 d at the same time of stress modeling. Depression-like behavior was evaluated by open field and forced swimming experiments. The levels of serum insulin and adenosine triphosphate （ATP） in hippocampus were detected by biochemical analysis. The levels of 5-hydroxytryptamine （5-HT） and dopamine （DA） in hippocampus were detected by enzyme-linked immunosorbent assay （ELISA）. The autophagosomes of hippocampal neurons were observed by transmission electron microscopy. The morphology and structure of dendrites and spines of hippocampal neurons were evaluated by Golgi staining. Western blot detected the expression levels of GluR2 and Parkin proteins in hippocampus. The expression levels of GluR2， Parkin， regulating synaptic membrane exocytosis protein 3 （RIMS3）， and postsynaptic density protein 95 （PSD95） in the dentate gyrus of the hippocampus were detected by immunofluorescence. ResultsCompared with the normal group， the model group exhibited reduced total activity distance in the open field and increased immobility time in forced swimming （P<0.01）， lowered levels of serum insulin and ATP， 5-HT， and DA in hippocampus （P<0.01）， increased autophagosomes of hippocampal neurons， significantly damaged morphology and structure of dendrites and spines of hippocampal neurons， decreased expression levels of GluR2， RIMS3， and PSD95 in hippocampus， and an increased Parkin expression level （P<0.05， P<0.01）. Compared with the model group， the GluR2 blocker group and the GluR2 agonist group showed aggravation and alleviation of the above abnormal changes， respectively （P<0.05， P<0.01）. The above depression-like behavior was significantly improved in the high- and low-dose Zuogui Jiangtang Jieyu prescription groups to different degrees. Specifically， the two groups saw elevated levels of serum insulin and ATP， 5-HT， and DA in hippocampus （P<0.05， P<0.01）， restrained increase in autophagosomes and damage to morphology and structure of dendrites and spines of hippocampal neurons， up-regulated protein expression levels of GluR2， RIMS3， and PSD95， and down-regulated Parkin expression level （P<0.05， P<0.01）. ConclusionZuogui Jiangtong Jieyu prescription can ameliorate the mitophagy-mediated damage to hippocampal synaptic microenvironment in DD rats， the mechanism of which might be related to the regulation of GluR2/Parkin signaling pathway.

As a patented characteristic medicine of Yi ethnic minority， Pingxuan capsules have the effects of nourishing the liver and kidney， pacifying the liver， and subduing Yang. With the main indications of dizziness， headache， palpitations， tinnitus， insomnia， dreaminess， waist and knee soreness caused by liver-kidney deficiency and liver Yang upward disturbance， Pingxuan capsules are widely used in the treatment of posterior circulation ischemic vertigo， vestibular migraine， benign paroxysmal positional vertigo. However， the current knowledge is limited regarding the efficacy， syndrome differentiation， and safety of this medicine. On the basis of summarizing the experience of clinicians and the existing evidence， this study invites clinical experts of traditional Chinese and Western medicine， pharmaceutical experts， and methodological experts from relevant fields across China to conduct evidence-based evaluation of Pingxuan capsules. The evaluation follows the Specifications for the Development of Clinical Expert Consensus on Chinese Patent Medicines issued by the Standardization Office of the China Association of Chinese Medicine， and reaches 5 recommendations and 16 consensus suggestions. The consensus clarifies the clinical applications， efficacy， dose， course of treatment， combination of medicines， precautions， and contraindications of Pingxuan capsules in the treatment of vertigo and explains the safety of clinical application. This consensus is applicable to clinicians （traditional Chinese medicine， Western medicine， and integrated traditional Chinese and Western medicine） and pharmacists in tertiary hospitals， secondary hospitals， and community-level medical and health institutions across China， providing a reference for the rational use of Pingxuan capsules in the treatment of vertigo. It is hoped that the promotion of this consensus can facilitate the rational use of drugs in clinical practice， reduce the risk of drug use， and give full play to the advantages of Pingxuan capsules in the treatment of vertigo diseases. This consensus has been reviewed and published by the China Association of Chinese Medicine， with the number GS/CACM330-2023.

AIM: To prepare a novel functionalized upconversion nanomaterial UCNPs-PEG-Tf through an improved method and observe its specific imaging phenomenon to choroidal melanoma cells(OCM-1).METHODS: NaYF4:Yb/Er(Up-conversion nanoparticles, UCNPs)was Prepared and plasma was treated to carboxylate the surface; then amino polyethylene glycol and transferrin(Tf)were respectively loaded to prepare UCNPs-PEG-Tf. Characterized them accordingly, its biocompatibility was tested accordingly, and the specific fluorescence phenomenon of OCM-1 was detected by fluorescence spectrophotometer and inverted fluorescence microscopy.RESULTS: Characterization confirmed successful synthesis of UCNPs, UCNPs-PEG, and further loading of Tf to form UCNPs-PEG-Tf. UCNPs-PEG-Tf showed excellent biocompatibility and emitted significant green fluorescence. Under the same conditions, fluorescence intensity measurement and observations from the inverted fluorescence microscope both demonstrated its significant specificity in imaging to OCM-1 cells.CONCLUSION: The synthesized novel functionalized UCNPs-PEG-Tf nanocomposite showed good biocompatibility and achieve specific imaging to OCM-1 cells.

Diabetic retinopathy(DR)is a late-stage peripheral micro-neurovascular complication of chronic hyperglycemia, leading to blood-retinal barrier impairment and retinal dysfunction. Recent studies have found that diabetic neuroretinopathy(DN)may be one of the earliest events in diabetic retinal alterations. The main features include defective electroretinographic responses in newly diagnosed patients, early self-activation of microglia and Müller cells, reduced activity of neurotransmitters(e.g., DOPA/GABA), and early mitochondrial dysfunction, such as persistent Drp1-Fis1 fission and mtDNA methylation mismatches. Understanding the molecular basis of DN is essential for elucidating its pathogenesis and developing early treatments. This review summarizes pathological changes and mechanisms of retinal function, glial cells, neurotransmitters, mitochondria, and other factors in early diabetes mellitus, in order to provide a theoretical foundation for investigating early DN mechanisms and developing targeted therapies.

ObjectiveTo clarify the anti-inflammatory and lung-protective effects of Yantiao prescription on lipopolysaccharide （LPS）-induced acute lung injury （ALI）， and to explore the impact of Yantiao prescription on the metabolic pathways of arachidonic acid （AA） in vivo. MethodsThirty male C57BL/6J mice were randomly divided into the following groups based on body weight： normal group， model group， dexamethasone group （2 mg·kg^-1）， low-dose Yantiao prescription group （18 g·kg^-1）， and high-dose Yantiao prescription group （36 g·kg^-1）， with 6 mice in each group. The ALI mouse model was established by intraperitoneal injection of LPS. The treatment groups received oral gavage once a day for 7 consecutive days， and serum and lung tissue were collected at the end of the experiment. The content of pro-inflammatory cytokines tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， and interleukin-6 （IL-6） in serum was detected by enzyme-linked immunosorbent assay （ELISA）. Hematoxylin-eosin （HE） staining was used to assess lung tissue pathology. The wet/dry weight ratio （W/D） and myeloperoxidase （MPO） activity in lung tissue were measured. The content of AA metabolites in serum and lung tissue was measured by liquid chromatography triple quadrupole-mass spectrometry （LC-MS/MS）. ResultsCompared with the conditions in the normal group， the content of serum pro-inflammatory cytokines TNF-α， IL-1β， and IL-6 in the model group was significantly increased （P<0.01）. The alveolar structure in mice was severely damaged， with markedly thickened alveolar walls and extensive inflammatory cell infiltration. The W/D ratio and MPO activity in lung tissue were significantly increased （P<0.01）. The content of AA metabolites， including prostaglandin D₂ （PGD₂）， prostaglandin E₂ （PGE₂）， 11（S）-hydroxy-eicosatetraenoic acid ［11（S）-HETE］， and 5-hydroxy-eicosatetraenoic acid （5-HETE） in serum and lung tissue was significantly increased （P<0.05）， while the content of 11，12-epoxyeicosatrienoic acid （11，12-EET） and 14，15-epoxyeicosatrienoic acid （14，15-EET） in serum was significantly decreased （P<0.01）. Compared with the results in the model group， the content of serum pro-inflammatory cytokines TNF-α， IL-1β， and IL-6 in the dexamethasone group， low-dose Yantiao prescription group， and high-dose Yantiao prescription group was significantly reduced （P<0.05）. Mild thickening of alveolar walls， scattered inflammatory cell infiltration， and relatively intact tissue structure with improved alveolar architecture were observed. The W/D ratio and MPO activity in lung tissue were significantly reduced （P<0.01）. The content of AA metabolites PGD₂， PGE₂， 11（S）-HETE， and 5-HETE in serum from the dexamethasone group was significantly decreased （P<0.05）， while the content of 14，15-EET in serum significantly increased （P<0.01）， and the content of 5-HETE in lung tissue significantly decreased （P<0.01）. In the low-dose and high-dose Yantiao prescription groups， the content of AA metabolites PGD₂， PGE₂， 11（S）-HETE， and 5-HETE in serum and lung tissue was significantly decreased （P<0.05）， while the content of 11，12-EET in both serum and lung tissue was significantly increased （P<0.05）. ConclusionYantiao prescription has significant protective effects against LPS-induced ALI， which are related to its regulation of AA metabolic pathways in vivo.

ObjectiveTo establish a model that can quickly identify the aroma components in different parts of Nardostachys jatamansi， so as to provide a quality control basis for the market circulation and clinical use of N. jatamansi. MethodsHeadspace solid-phase microextraction-gas chromatography-mass spectrometry（HS-SPME-GC-MS） combined with Smart aroma database and National Institute of Standards and Technology（NIST） database were used to characterize the aroma components in different parts of N. jatamansi， and the aroma components were quantified according to relative response factor（RRF） and three internal standards， and the markers of aroma differences in different parts of N. jatamansi were identified by orthogonal partial least squares-discriminant analysis（OPLS-DA） and cluster thermal analysis based on variable importance in the projection（VIP） value >1 and P<0.01. The odor data of different parts of N. jatamansi were collected by Heracles Ⅱ Neo ultra-fast gas phase electronic nose， and the correlation between compound types of aroma components collected by the ultra-fast gas phase electronic nose and the detection results of HS-SPME-GC-MS was investigated by drawing odor fingerprints and odor response radargrams. Chromatographic peak information with distinguishing ability≥0.700 and peak area≥200 was selected as sensor data， and the rapid identification model of different parts of N. jatamansi was established by principal component analysis（PCA）， discriminant factor alysis（DFA）， soft independent modeling of class analogies（SIMCA） and statistical quality control analysis（SQCA）. ResultsThe HS-SPME-GC-MS results showed that there were 28 common components in the underground and aboveground parts of N. jatamansi， of which 22 could be quantified and 12 significantly different components were screened out. Among these 12 components， the contents of five components（ethyl isovalerate， 2-pentylfuran， benzyl alcohol， nonanal and glacial acetic acid，） in the aboveground part of N. jatamansi were significantly higher than those in the underground part（P<0.01）， the contents of β-ionone， patchouli alcohol， α-caryophyllene， linalyl butyrate， valencene， 1，8-cineole and p-cymene in the underground part of N. jatamansi were significantly higher than those in the aboveground part（P<0.01）. Heracles Ⅱ Neo electronic nose results showed that the PCA discrimination index of the underground and aboveground parts of N. jatamansi was 82， and the contribution rates of the principal component factors were 99.94% and 99.89% when 2 and 3 principal components were extracted， respectively. The contribution rate of the discriminant factor 1 of the DFA model constructed on the basis of PCA was 100%， the validation score of the SIMCA model for discrimination of the two parts was 99， and SQCA could clearly distinguish different parts of N. jatamansi. ConclusionHS-SPME-GC-MS can clarify the differential markers of underground and aboveground parts of N. jatamansi. The four analytical models provided by Heracles Ⅱ Neo electronic nose（PCA， DFA， SIMCA and SQCA） can realize the rapid identification of different parts of N. jatamansi. Combining the two results， it is speculated that terpenes and carboxylic acids may be the main factors contributing to the difference in aroma between the underground and aboveground parts of N. jatamansi.