Objective: To explore the potential mechanism of paeoniae radix rubra (PRR) in the treatment of sepsis-associated encephalopathy (SAE) through network pharmacology, molecular docking and molecular dynamics simulation. Methods: The active components of PRR were collected from the TCMSP and HERB databases, and the corresponding targets were obtained from the PubChem and Swiss Target Prediction databases. SAE-related targets were collected from the GeneCards, OMIM, TTD and DrugBank databases, respectively. Common targets between PRR and SAE were identified by intersection analysis. A protein-protein interaction (PPI) network was constructed using the STRING database and core targets were identified using Cytoscape software with four algorithms: MCC, Degree, MNC and EPC. GO and KEGG enrichment analyses were performed using the DAVID database. The top 10 active components ranked by Degree value and the screened core targets were subjected to molecular docking with the core targets, and paeoniflorin, a representative monoterpene glycoside of PRR, was additionally included for supplementary validation. Further, the complex with the lowest binding energy was selected for a 100 ns molecular dynamics (MD) simulation using GROMACS v2020.6 to evaluate the binding stability. Results: A total of 76 active components and 650 corresponding targets of PRR were identified, along with 752 SAE-related targets. 80 overlapping targets between PRR and SAE were identified. Network topology analysis suggested that Baicalein, Kaempferol, Tryptanthrin, n-(4-Chlorobenzoyl)-melatonin, and Albiflorin may represent important active components involved in the therapeutic effects of PRR against SAE. Core targets included ALB, TNF, STAT3, HIF1A, MMP9, etc. GO enrichment analysis obtained 542 terms, and KEGG analysis revealed 110 significantly enriched signaling pathways. The molecular docking results showed that the binding energies between the top 10 active components and core targets were all lower than -5.0 kcal·mol^-1, indicating favorable binding affinity. In addition, paeoniflorin, a representative monoterpene glycoside of PRR, was further included in molecular docking validation and exhibited favorable binding activity with multiple core targets. Molecular dynamics simulation further confirmed the structural stability of the complex. Conclusion: This study preliminarily revealed the potential molecular mechanism underlying the therapeutic effects of PRR on SAE through a multi-component, multi-target and multi-pathway mode, providing a theoretical basis for further pharmacological research.

Objective: To study cinnamaldehyde (cinnamaldehyde, CA) against acinetobacter baumannii in immunosuppressed BALB/c mice (acinetobacter baumannii, AB) pneumonia, providing theoretical basis for the development of new antibacterial drugs.Methods: 180 immunosuppressed AB pneumonia mice were randomly divided into 6 groups, 30 mice in each group, respectively CA high dose group (240 mg·kg^-1·d^-1), CA medium dose group (120 mg·kg^-1·d^-1), CA low dose group (60 mg·kg^-1·d^-1), tigecycline (TIG) positive control group (120 mg·kg^-1·d^-1), tween saline control group (10 mL·kg^-1·d^-1) and model group. Results: Bacterial culture revealed: The bacterial clearance rates of CA treatment group were 80%(24/30), 73.33%(22/30), 50.00%(15/30), 46.66%(14/30), 6.66%(2/30) and 10.00%(3/30) in high dose group, middle dose group, low dose group, TIG positive control group, Tween saline negative control group, respectively. CA treatment groups compared with Tween saline negative control group, model group (P<0.001). Compared with TIG positive control group (P<0.05). Pathological sections showed that in the middle and high dose groups of CA, the alveolar structure tended to be normal, and inflammatory cell infiltration was significantly reduced. In the low dose group of CA, the lung tissue was slightly damaged, and there were still inflammatory cell infiltration and abnormal alveolar structure. In the TIG positive control group, the pathological damage of lung tissue was less severe than that in the model group, but a certain degree of inflammatory infiltration and structural disorder were still seen. The survival rate of mice was 80%(24/30) in CA high dose group, 73.33%(22/30) in CA middle dose group, 50.00%(15/30) in CA low dose group, 46.66%(14/30) in TIG positive control group, 6.66%(2/30) in tween negative control group and 10.00%(3/30) in model group. Conclusion: CA group (high and middle dose) has good antibacterial effect and tissue repair effect on acinetobacter baumannii pneumonia in mice, and can significantly improve the survival rate of mice, and CA is better than TIG. This study will provide theoretical basis for the development of new drugs for CA treatment of acinetobacter baumannii pneumonia.

Objective: To establish liquid chromatography methods for three index components of Qidan Lixin Pills and thin-layer chromatography methods for three medicinal materials. Methods: The thin-layer chromatography (TLC) method was adopted to qualitatively identify Codonopsis pilosula and Acanthopanax senticosus in Qidan Lixin Pills. The contents of salvianolic acid B, naringin and neohesperidin in Qidan Lixin Pills were determined by high performance liquid chromatography. Chromatographic column: The chromatographic column was Waters XTerra MS C18 5 μm 4.6×250 mm, the mobile phase was acetonitrile -0.1% phosphoric acid aqueous solution (22:78), the detection wavelength was 283 nm, the flow rate was 1.0mL·min^-1, and the column temperature was 30 ℃ . The theoretical plate count, calculated based on the peak of salvianolic acid B, should be no less than 6 000, and calculated based on the peaks of naringin and neohesperidin, should be no less than 3 000. Results: The qualitative identification of Codonopsis pilosula and Acanthopanax senticosus exhibited clear and distinct spots with no interfering signals observed. In the quantitative analysis, salvianolic acid B, naringin, and neohesperidin demonstrated good linearity within the injection ranges of 0.300 3~3.003 1 μg, 0.135 8~1.358 2 μg, and 0.125 6~1.255 5 μg, respectively. The average recoveries were 102.53%, 99.37%, and 100.48%, with corresponding relative standard deviations RSD of 2.20%, 1.23%, and 1.08% (n = 6), indicating satisfactory precision and accuracy. Conclusion: The method established in this experiment has good repeatability, is stable and feasible, and can be used for the quality control of Qidan Lixin Pills.

Objective: To develop and validate machine learning models for predicting prostate cancer risk using clinical data, aiming to identify the optimal model and verify its generalizability across independent domestic and international cohorts, thereby providing a robust tool for clinical decision support. Methods: Clinical data of patients with prostate tumors were obtained from the National Population Health Science Data Center. Following advanced feature selection to eliminate noise, the data were randomly split into training and testing sets at a 7:3 ratio. Five machine learning models were constructed: logistic regression (LR), extreme gradient boosting (XGBoost), random forest (RF), categorical boosting (CatBoost), and K-nearest neighbors (KNN). Model performance was evaluated on the internal test set using the area under the receiver operating characteristic curve (AUC), accuracy, recall, and F1-score. The topperforming model was further validated on an independent external test set comprising international patient data. Finally, shapley additive exPlanations (SHAP) were employed to interpret the feature importance of the best model. Results: Among the five models, XGBoost demonstrated superior performance on the internal test set, with an AUC of 0.894, accuracy of 0.852, recall of 0.825, and an F1-score of 0.834. SHAP analysis revealed that total PSA, alkaline phosphatase, age, creatine kinase isoenzyme, and the free-to-total PSA ratio were the most critical predictive features. Notably, the XGBoost model maintained excellent performance on the independent external test set (AUC: 0.810), confirming its strong generalizability. Conclusion: This study developed a high-performance and interpretable XGBoost-based model for prostate cancer risk prediction. The model exhibited outstanding discriminative ability within the Chinese population and sustained good generalizability in an international cohort. It holds promise as a practical tool to assist clinicians in precise risk stratification and optimization of diagnosis and treatment strategies.

Objective: To explore the structural characteristics of intestinal microbiota in patients with sepsis-associated acute kidney injury (SA-AKI) and analyze its correlation with clinical severity and inflammatory response indicators, so as to provide evidence for elucidating the pathogenesis of SA-AKI and identifying novel therapeutic targets. Methods: A total of 45 patients with SA-AKI were selected as the case group, and 30 healthy individuals were included as the control group. Fecal samples were collected to analyze the α-diversity and β-diversity of the intestinal microbiota as well as the microbial composition. The correlation between the microbiota and clinical indicators was also evaluated. Results: Compared with the control group, the α-diversity (Shannon index and Chao index) of the intestinal microbiota in the casegroup was significantly reduced (P<0.05). The abundance of Proteobacteria was significantly increased in patients of the case group, while the proportions of Firmicutes and Bacteroidetes were markedly decreased. Correlation analysis revealed that the abundance of Enterococcus was significantly positively correlated with both the Sequential Organ Failure Assessment (SOFA) score and serum creatinine levels, whereas the abundance of Faecalibacterium was significantly negatively correlated with interleukin-6 levels. Conclusion: Significant intestinal dysbiosis is present in patients with SA-AKI, characterized by reduced microbial diversity, altered microbial structure, and overgrowth of opportunistic pathogens. This dysbiosis is closely associated with the severity of the disease and systemic inflammatory response. These microbial taxa hold promise as potential biomarkers and therapeutic targets.

Objective: To explore and analyze the effect of escitalopram oxalate (EO) combined with mirtazapine in patients with bipolar depression based on symptom control and cognitive function improvement. Methods: The research subjects were 100 patients with bipolar depression admitted to the Beijing Fangshan mental health center from June 2021 to June 2025. They were divided into the experimental group (n=50) and the reference group (n=50) by the sealed envelope lottery method. The reference group was treated with EO, while the experimental group was treated with EO combined with mirtazapine. The efficacy, clinical symptoms, cognitive function, sleep quality, and adverse reactions of the two groups were compared. Results: In terms of the total effective rate, the experimental group was higher than the reference group (P<0.05). Eight weeks after administration, the scores of the Hamilton depression scale (HAMD) and the Young mania rating scale (YMRS) in both groups were lower than those before administration, and the scores of the experimental group were lower than those of the reference group (all P< 0.05). Eight weeks after administration, the scores of complete classification and correct response in the experimental group were higher than those in the reference group, while the scores of incorrect response and persistent error were lower than those in the reference group (all P<0.05). Eight weeks after administration, the PSQI scores of both groups were lower than those before administration, and the scores of the experimental group were lower than those of the reference group (all P<0.05). The incidence of adverse reactions between the two groups was not significantly compared (P>0.05). Conclusion: EO combined with mirtazapine can significantly improve the symptoms, cognitive function and sleep quality of patients with bipolar depression.

Objective: To investigate the clinical efficacy of Weichang'an Wan in young adults with diarrhea-predominant irritable bowel syndrome (IBS-D) and its effects on serum IL-6 and TNF-α levels. Methods: Ninety patients aged 15~44 years who met the IBS-D diagnostic criteria were selected and randomly divided into an observation group(45 cases) and a control group(45 cases) using a random generator. The observation group received oral Weichang'an Wan, while the control group received oral pinaverium bromide. Clinical efficacy, serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels before and after treatment were compared between the two groups. Additionally, changes in irritable bowel syndrome quality of life （IBS-QOL）, irritable bowel syndrome severity scoring system （IBS-SSS）, Hamilton anxiety scale (HAMA), and Hamilton depression scale (HAMD) scores before and after treatment were compared. Results: The total effective rate of the observation group was higher than that of thecontrol group (P<0.05). After treatment, the TNF-α level in the observation group was lower than that in the control group (P<0.05). The IBS-QOL score of the observation group was higher than that of the control group, while the HAMA and HAMD scores were lower than those of the control group (P<0.05). Conclusion: Weichang'an Wan can effectively improve clinical symptoms in young and middle-aged IBS-D patients, reduce inflammation levels, alleviate emotional distress, and enhance quality of life.

Immune thrombocytopenia (ITP) is a clinically prevalent acquired hemorrhagic disease. Modern medical treatment is prone to recurrence with uncertain long-term efficacy, while combined treatment with traditional Chinese medicine (TCM) shows significant advantages. Based on TCM theory and the understanding of physicians in successive dynasties, the core pathogenesis of ITP is blood heat as the initiating factor, blood stasis as the central link, and healthy qi deficiency as the fundamental basis. These three factors interweave with qi movement disturbance to form a vicious cycle. Accordingly, a syndrome differentiation-based treatment system centered on Liangxue Jiedu Decoction (Cooling Blood and Detoxifying Decoction) is constructed: in the acute phase, clearing heat, cooling blood and detoxifying are adopted to expel pathogenic factors; throughout the entire treatment course, promoting blood circulation to remove stasis and astringent hemostasis are taken into account; for yin deficiency with blood stasis, nourishing yin and promoting blood circulation are used together; in the chronic phase, tonifying qi, invigorating the spleen and controlling blood are implemented. This system conforms to the pathogenesis of ITP characterized by deficient root and excessive branch as well as intermingled heat and stasis, demonstrates the TCM concepts of syndrome differentiation-based treatment and simultaneous treatment of root and branch and provides theoretical support for clinical treatment.

To Vascular cognitive impairment (VCI) has emerged as a significant health challenge in today's aging societies, with its core pathological basis rooted in cerebral vascular lesions. Blood pressure variability (BPV), an indicator reflecting dynamic blood pressure fluctuations, and cystatin C (Cys-C) levels—a sensitive marker of renal function—have both been demonstrated to be closely associated with VCI. Research indicates that increased BPV impairs renal vascular endothelial cell function, triggering subclinical renal injury and microvascular pathology. This, in turn, elevates Cys-C levels. Elevated Cys-C not only reflects renal damage but may also contribute to systemic vascular inflammation and atherosclerosis. Ultimately, this “renal-originating” damage—initiated by BPV and characterized by renal vascular endothelial dysfunction and altered Cys-C levels—contributes to the onset and progression of VCI through multiple pathways, including exacerbating cerebral small vessel disease (CSVD) andneuroinflammation. This review summarizes research progress on this chain mechanism and explores the potential value of jointly assessing BPV and Cys-C levels for early identification of VCI.