Objective To investigate the distribution characteristics of pathogens causing infections within 90 days after liver transplantation and the influencing factors of infection. Methods Clinical data of 176 recipients who underwent liver transplantation at the Liver Transplant Center of Beijing Friendship Hospital Affiliated to Capital Medical University from September 2021 to August 2024 were retrospectively analyzed. Patients were divided into the infection group (n=124) and the non-infection group (n=52) based on whether they developed infection within 90 days after transplantation. The distribution characteristics of pathogens in infected patients were analyzed. Univariate and multivariate logistic regression analyses were used to explore the influencing factors of infection. Results Among the 176 liver transplant recipients, 124 cases developed 243 episodes of 518 bacterial, fungal, viral or mycoplasma infections within 90 days after transplantation, with an overall infection rate of 70.5% (124/176). The composition of pathogens was mainly Gram-negative bacteria (38.6%, 200/518), followed by Gram-positive bacteria (32.2%, 167/518) and viruses (15.4%, 80/518), and fungi accounted for 13.1% (68/518). Among Gram-negative bacteria, the main pathogen was Klebsiella pneumoniae (6.8%, 35/518), and among Gram-positive bacteria, the main pathogen was Enterococcus faecalis (8.5%, 44/518). Viruses included Epstein-Barr virus (3.7%, 19/518) and cytomegalovirus (3.7%, 19/518), and fungi were mainly Candida albicans (6.8%, 35/518). The most common infection site among the 243 episodes was pulmonary infection (42.0%, 102/243), followed by abdominal infection (22.6%, 55/243) and bloodstream infection (18.1%, 44/243). The infections mainly occurred within 2 weeks after transplantation (60.9%, 148/243). Multivariate logistic regression analysis indicated that preoperative infection within 2 weeks, a high preoperative model for end-stage liver disease (MELD) score, and preoperative sarcopenia were independent risk factors for infection within 90 days after liver transplantation (all odds ratio>1, P<0.05). After multivariate correction, the levels of CD4⁺T cells and CD8⁺T cells within 90 days after surgery were independently associated with the occurrence of infection. Low levels of CD4⁺T cells and CD8⁺T cells might be related to an increased risk of infection. Conclusions The infection rate after liver transplantation is high, and the pathogens are mainly Gram-negative bacteria. The lungs are the most common infection site. Preoperative MELD score, preoperative sarcopenia and preoperative infection within 2 weeks are independent risk factors for infection within 90 days after liver transplantation. Regular monitoring of immune indicators CD4⁺T cells and CD8⁺T cells levels after transplantation is helpful to reduce the occurrence of post-transplantation infection.

To thoroughly implement the strategic deployment outlined in the Opinions of the Central Committee of the Communist Party of China and the State Council on Promoting the Inheritance and Innovative Development of Traditional Chinese Medicine regarding research on dominant diseases of traditional Chinese medicine and to uphold the development philosophy of equal emphasis on traditional Chinese medicine and western medicine，the China Association of Chinese Medicine has fully played a leading academic role by systematically organizing and conducting a series of academic youth salons on clinical dominant diseases of traditional Chinese medicine. On September 13，2024，the 36^th Youth Salon on Clinical Dominant Diseases was successfully held in Nanjing，focusing on the advantages of traditional Chinese medicine and the integrative traditional Chinese medicine and western medicine in the diagnosis and treatment of erectile dysfunction （ED）. The conference brought together leading experts from traditional Chinese medicine，western medicine，and interdisciplinary fields，facilitating in-depth multidisciplinary discussions that led to key consensus on optimizing traditional Chinese medicine treatment protocols for ED，researching and developing new drugs of traditional Chinese medicine，and advancing interdisciplinary development in traditional Chinese medicine. This salon systematically sorted out the clinical strengths and distinctive features of traditional Chinese medicine in the diagnosis and treatment of ED. Based on current research foundations and clinical needs，it identified key directions for future scientific layout and scientific research tackling： （1） Standardization of syndrome differentiation system of traditional Chinese medicine for ED. （2） Optimization and standardization of intervention methods of integrated traditional Chinese medicine and western medicine. （3） High-quality clinical research guided by evidence-based medicine. （4） In-depth analysis of the pharmacological mechanisms of traditional Chinese medicine in the treatment of ED. （5） Clinical translation and application promotion of new drugs of traditional Chinese medicine. （6） Interdisciplinary integration and innovation in traditional Chinese medicine. For each research direction，key focus areas，expected objectives，and clinical value were further refined，along with the establishment of a scientifically sound priority funding level evaluation system. Therefore，building on the series of salons on the ED-focused dominant diseases of traditional Chinese medicine，this paper provides standardized guidance for clinical practice of traditional Chinese medicine in ED management，effectively contributing to the high-quality development of traditional Chinese medicine. It serves as a valuable reference for national scientific and technological strategic layout， research and development decision-making in new drugs of traditional Chinese medicine，research topic planning，and clinical guideline formulation.

BACKGROUND:Lijin manipulation can promote skeletal muscle repair and treat skeletal muscle injury.However,the formation of fibrosis and scar tissue hyperplasia are closely related to the quality of skeletal muscle repair.To study the regulatory effect of Lijin manipulation on the formation of fibrosis and scar tissue hyperplasia is helpful to explain the related mechanism of Lijin manipulation to improve the repair quality of skeletal muscle injury. OBJECTIVE:To explore the mechanism of Lijin manipulation to improve the repair quality of skeletal muscle injury in rabbits,thereby providing a scientific basis for clinical treatment. METHODS:Forty-five healthy adult Japanese large-ear white rabbits were randomly divided into blank group,model group and Lijin group,with 15 rats in each group.Gastrocnemius strike modeling was performed in both model group and Lijin group.The Lijin group began to intervene with tendon manipulation on the 3rd day after modeling,once a day,and 15 minutes at a time.Five animals in each group were killed on the 7th,14th and 21st days after modeling.The morphology and inflammatory cell count of gastrocnemius were observed by hematoxylin-eosin staining,the collagen fiber amount was observed by Masson staining,the expression of interleukin-6 and interleukin-10 in gastrocnemius was detected by ELISA.The protein and mRNA expressions of paired cassette gene 7,myogenic differentiation factor,myoblastogenin,alpha-actin,transforming growth factor beta 1,and type Ⅰ collagen were detected by western blot and RT-PCR,respectively,and the expression of type Ⅰ collagen protein was detected by immunohistochemistry. RESULTS AND CONCLUSION:Hematoxylin-eosin staining and Masson staining showed that compared with the model group,inflammatory cell infiltration and collagen fiber content decreased in the Lijin group(P<0.01),and the muscle fibers gradually healed.ELISA results showed that compared with the model group,the expression of interleukin-6 in the Lijin group continued to decrease(P<0.05),and the expression of interleukin-10 increased on the 7th day after modeling(P<0.05)and then showed a decreasing trend(P<0.05).Western blot and RT-PCR results showed that compared with the model group,the protein and mRNA expressions of paired cassette gene 7,myogenic differentiation factor,myoblastogenin in the Lijin group were significantly increased on the 14th day after modeling(P<0.05),but decreased on the 21st day(P<0.05);the protein and mRNA expressions of alpha-actin,transforming growth factor beta 1,and type Ⅰ collagen in the Lijin group were significantly decreased compared with those in the model group(P<0.05).Immunohistochemical results showed that the expression of type Ⅰ collagen in the Lijin group was significantly lower than that in the model group(P<0.05).To conclude,Lijin manipulation could improve the repair quality of skeletal muscle injury by inhibiting inflammation,promoting the proliferation and differentiation of muscle satellite cells,and reducing fibrosis.

Objective: There were associations between emotional abuse and neglect (EAN) and depression, but few studies had tested potential mechanisms underlying these relationships. We aimed to provide insights on how (the mediation role of neuroticism), and under what conditions (the moderator role of psychological resilience), led to a higher level of depression. Methods: This study was a cross-sectional study that used a random cluster sampling method. We randomly selected 3,993 participants from four junior middle schools in northern city of China. Participants were asked to complete four self-reported questionnaires, including the Childhood Trauma Questionnaire, Children Depression Inventory-Short Form, Chinese Big Five Personality Inventory Brief Version, and Chinese Resilience Scale. Results: The results showed that neuroticism mediated the associations between EAN and depression. In addition, the mediating effect of neuroticism was moderated by psychological resilience (p<0.05). Conclusion EAN and neuroticism could have an adverse impact on depression, and psychological resilience could alleviate these negative effects as a moderator. Our model suggested psychological resilience could be a particularly effective intervention point for victims of EAN.

Objective: There were associations between emotional abuse and neglect (EAN) and depression, but few studies had tested potential mechanisms underlying these relationships. We aimed to provide insights on how (the mediation role of neuroticism), and under what conditions (the moderator role of psychological resilience), led to a higher level of depression. Methods: This study was a cross-sectional study that used a random cluster sampling method. We randomly selected 3,993 participants from four junior middle schools in northern city of China. Participants were asked to complete four self-reported questionnaires, including the Childhood Trauma Questionnaire, Children Depression Inventory-Short Form, Chinese Big Five Personality Inventory Brief Version, and Chinese Resilience Scale. Results: The results showed that neuroticism mediated the associations between EAN and depression. In addition, the mediating effect of neuroticism was moderated by psychological resilience (p<0.05). Conclusion EAN and neuroticism could have an adverse impact on depression, and psychological resilience could alleviate these negative effects as a moderator. Our model suggested psychological resilience could be a particularly effective intervention point for victims of EAN.

Objective To investigate the value of MRI of the sternal end of clavicle in bone age assessment in Chinese population,especially its applicability in the determination of criminal responsible age.Methods A total of 431 patients aged from 10.00 to 29.99 years with neck or chest MRI were retrospectively collected.According to the Schmeling grading method,the epiphyseal development of the clavicle MRI was divided into five grades.The consistency of methods was evaluated.The correlation and general descriptive analysis between MRI grades and age was analyzed.The sex difference was analyzed.Curve fitting was used to establish a nonlinear model between age and grades.Results The grades of clavicle MRI showed a significant age-related trend(Figure 2),and the correlation was 0.861(0.887 in males and 0.840 in females).Except for grade 1,there was no significant difference between males and females in other grades.The minimum age of male grade 3 was greater than 14 years old,and the minimum age of female grade 3 was greater than 16 years old.The minimum age in grade 4 and grade 5 was over 18 years old in both sexes.The best curve fitting model was cubic model for both sexes(R2=0.805 for men and 0.722 for women).Conclusion Clavicle MRI can be used for the assessment of bone age in Chinese population.Complete epiphyseal plate closure can be used as a reliable indicator for the determination of age at 18 years old,and it is expected to achieve radiation-free forensic bone age assessment.

Objective:To construct a simple score scale for donation-related vasovagal reaction(DRVR)based on Logistic regression model and evaluate its application value.Methods:A retrospective study was conducted on 5000 blood donors from Zhangjiakou Central Blood Station from January 2018 to January 2023.The baseline data of the blood donors were collected.Logistic regression analysis was performed on them to construct a DRVR prediction model.A DRVR simple score scale was built based on the odds ratios.The score intervals were divided into low-risk,medium risk,and high-risk categories,the application value of the scale was evaluated based on the prediction efficacy of Logistic regression model.Results:The incidence of DRVR among the blood donors was 4.12％.The Logistic regression model identified eight independent risk factors for DRVR,including advanced age,female gender,low body mass index,first blood donation,hypotension,low hemoglobin level,long blood collection time,and high blood donation volume(all P＜0.05).A simple DRVR score scale was constructed based on the odds ratio values.The scale scores were divided into three intervals:low-risk(total score＜6),moderate risk(total score 6-11),and high-risk(total score＞11,≤17).The area under the curve(AUC)for predicting DRVR in low-risk,medium risk,and high-risk blood donors based on Logistic regression model were 0.784(95％CI:0.742-0.844),0.806(95％CI:0.752-0.883),and 0.842(95％CI:0.761-0.925),respectively.The consistency indices were 0.794(95％CI:0.705-0.828),0.800(95％CI:0.745-0.852),and 0.839(95％CI:0.782-0.917),respectively.The calibration curves did not deviate from the ideal fit.The results of external validation showed that the receiver operating characteristic curve fittings were relatively ideal(all P＞0.05),and there were no statistically significant difference in AUC(all P＞0.05).Conclusion:The DRVR simple score scale has a relatively ideal ability to distinguish the blood donors and can provide some reference for quickly narrowing the scope of high-risk groups.DRVR simple score scale has certain application value,but still needs to be continuously improved and optimized.

Objective:To investigate the effects of catalpol(cat)on autophagy and apoptosis of alveolar epithelial cells in-duced by Streptococcus pneumoniae(SP)by regulating adenosine monophosphate-activated protein kinase(AMPK)/mammalian target of rapamycin(mTOR)/Unc-51-like kinase 1(ULK1)signaling pathway.Methods:Human alveolar epithelial cells A549 were divided into the following groups:control group,SP group(1×108 CFU/ml),cat low,medium,and high doses groups(0.5,1,2 μg/L),AICAR group(2 μg/L cat+1 mmol/L AMPK activator);CCK-8 method and flow cytometry were applied to detect cell proliferation and apoptosis,respectively;monodansylcadaverine(MDC)staining method was applied to detect autophagy in cells;ELISA was applied to detect the levels of IL-6,IL-1β and TNF-α in the cell supernatant;and Western blot was applied to detect the expressions of Bcl-2 associated X protein(Bax),anti apoptotic factor B cell lymphoblastoma 2(Bcl-2),Beclin-1,P62,microtubule-associated protein 1 light chain 3 Ⅰ(LC3 Ⅰ),microtubule-associated protein 1 light chain 3 Ⅱ(LC3 Ⅱ)and AMPK/mTOR/ULK1 pathway proteins in cells.Results:Compared with control group,the activity of A549 cells and the expression levels of Bcl-2,P62,p-mTOR/mTOR pro-teins in SP group were obviously reduced,the apoptosis rate,autophagy fluorescence intensity,levels of IL-6,IL-1β,TNF-α,the protein expression levels of Bax,LC3 Ⅱ/LC3 Ⅰ,Beclin-1,p-AMPK/AMPK,and p-ULK1/ULK1 were obviously increased(P<0.05);compared with the SP group,the activity of A549 cells and the expression levels of Bcl-2,P62,p-mTOR/mTOR proteins in the low,medium,and high dose cat groups were obviously increased,the apoptosis rate,autophagy fluorescence intensity,levels of IL-6,IL-1β,TNF-α,the protein expression levels of Bax,LC3 Ⅱ/LC3 Ⅰ,Beclin-1,p-AMPK/AMPK,and p-UKL1/UKL1 were ob-viously reduced(P<0.05);the AMPK activator AICAR weakened the inhibitory effect of cat on SP induced autophagy and apoptosis in A549 cells.Conclusion:cat can inhibit SP-induced autophagy and apoptosis in A549 cells,and its mechanism of action may be re-lated to regulating the AMPK/mTOR/ULK1 signaling pathway.

Objectives:To investigate the predictive value of Murray's law-based quantitative flow ratio(μQFR)in side branches for long-term clinical prognosis in patients with non-left main bifurcation lesions who underwent simple main branch stenting,and to provide a potential functional assessment standard for intervention decision-making on coronary bifurcation lesions.Methods:A retrospective analysis was conducted in 408 patients with non-left main bifurcation lesions who underwent simple main branch stenting at Lianyungang First People's Hospital and Nanjing First Hospital between July 2018 and January 2021.The study utilized third-generation QFR software to analyze pre-and post-procedure anatomical and functional parameters of the target lesion's main branch and key branches.The primary endpoint was target vessel failure(TVF)events during the 3-year follow-up.Patients were stratified into TVF and non-TVF groups.Baseline characteristics,procedural data,and pre-/post-procedural parameters of target vessels were compared between groups.Multivariable Cox regression was performed to identify predictors of TVF.Diagnostic efficacy of predictors was evaluated using area under the receiver operating characteristic(ROC)curve(AUC)with DeLong's method for comparison.Patients were dichotomized based on the optimal cutoffof post-procedural side branch μQFR,with TVF incidence rates compared via Cox regression and Kaplan-Meier analysis.Results:During 3-year follow-up,54 patients(13.2%)experienced TVF(TVF group),data were compared with 354 patients(86.76%)without TVF(non-TVF group).The TVF group showed higher post-procedural side branch diameter stenosis([32.93±17.80]%vs.[22.62±11.96]%,P<0.001)and lower μQFR(0.80±0.10 vs.0.89±0.07,P<0.001).Multivariate Cox regression identified higher post-procedural side branch μQFR as an independent protective factor against 3-year TVF(per 0.01 increase:HR=0.903,95%CI:0.850-0.959,P<0.001).ROC curves indicated that post-procedural side branch μQFR had moderate diagnostic efficacy for predicting 3-year TVF(AUC=0.769,95%CI:0.678-0.861,P<0.001),with a significantly higher AUC value than post-operative side branch area stenosis and minimal lumen diameter(both P<0.001),the optimal cutoffvalue was 0.84.Multivariate Cox regression and Kaplan-Meier survival analysis revealed markedly higher 3-year TVF rates in patients with μQFR≤0.84 compared to patients with μQFR>0.84(HR=4.007,95%CI:2.342-6.855,P<0.001;28.3%vs.7.9%,log-rank P<0.001).Conclusions:For patients with bifurcation lesions not involving the left main,the immediate post-procedural side branch μQFR could better predict 3-year TVF than anatomical indices.Maintaining post-stenting side branch μQFR>0.84 may optimize clinical outcomes when using a single-stent strategy.

Objectives:To assess the midterm efficacy of distal subapical vertebra posterior shift combined with rotational osteotomy for severe angular kyphosis correction.Methods:A retrospective analysis was con-ducted on the clinical data of 35 patients with severe spinal angular kyphosis who underwent posterior shift combined with rotational osteotomy at distal subapical vertebra in our department from October 2016 to May 2022.There were 23 males and 12 females,the average age was 30.8±12.4 years(15-61 years),with 13 cas-es combined with nerve damage.Follow-up duration ranged from 2 to 6 years(mean 3.5 years).Full-length anteroposterior and lateral X-ray examination of the spine in a standing position was performed before opera-tion,immediately after orthopedic surgery,and at 2-year follow-up,and the kyphotic angle,sagittal vertical axis(SVA),as well as sagittal apex deviation were measured and evaluated.The recovery of neurological func-tion was evaluated by the Frankel classification of neurological function before operation,and at 2 weeks and 6 months after operation.Results:All 35 patients successfully underwent the surgery,resulting in a signifi-cant decrease in the kyphotic Cobb angle from 104.6°±13.2° preoperatively to 32.1°±18.4° postoperatively(P＜0.05),with an improvement rate of 69.3％.Additionally,the SVA decreased from 4.9±4.4cm before surgery to 2.6±1.5cm after surgery immediately(P＜0.05),and the sagittal apex deviation decreased from 10.9±2.0cm to 5.5±1.4cm(P＜0.05).Furthermore,12 out of the 13 patients with nerve damage showed improvement at the fi-nal follow-up assessment,1 case showed no change compared with that before operation.Conclusions:Poste-rior shift combined with rotational osteotomy at distal subapical vertebra in the management of severe angular kyphosis can yield favorable orthopedic outcomes,which serves as a novel surgical option for managing severe angular spinal kyphosis.