Systemic lupus erythematosus （SLE）， a refractory autoimmune disease， is among the dominant diseases where traditional Chinese medicine （TCM） shows advantages in the field of rheumatology and immunology. The China-Japan Friendship Hospital hosted the "46^th Youth Salon on Dominant Diseases （Systemic Lupus Erythematosus）" organized by the China Association of Chinese Medicine， which led to a consensus on "the advantages， challenges， interdisciplinary approaches， and translational achievements of integrated TCM and Western medical approaches in the diagnosis and treatment of SLE." The diagnosis and treatment of SLE currently face several challenges， such as frequent misdiagnosis and missed diagnosis in the early stages， difficulty in achieving treatment targets， multiple side effects from pharmacotherapy， and the lack of management strategies for special populations， all of which hinder the fulfillment of the clinical needs of patients. Integrated TCM and Western medical approaches can improve clinical symptoms such as skin erythema， aversion to cold and cold limbs， fatigue， dry mouth， restlessness， and heat sensation in the palms and soles， thereby improving patients' quality of life. The approaches also help consolidate the efficacy of conventional Western medicine， slow disease progression， reduce relapse rates， address multi-organ involvement， and prevent or treat complications. Additionally， they enhance efficacy and reduce toxicity， prevent the side effects of Western medications， help reduce hormone use， and offer distinct advantages in the individualized intervention of special populations， contributing to the whole-process management of the disease. However， evidence-based medical support for this integrated approach remains limited， and the quality of available evidence is generally low. Common evaluation systems and modern research methodologies should be adopted to clarify the efficacy of TCM in SLE treatment. Efforts should be made to carry out high-quality evidence-based medical research， strengthen the development of fundamental and pharmacological research， and further explain the distinct advantages of TCM in the diagnosis and treatment of SLE. Future efforts should focus on advancing the integration of TCM and modern medicine， incorporating multi-omics technologies， individualized stratification， and other precision medicine concepts， in combination with artificial intelligence. Moreover， interdisciplinary collaboration should be promoted to utilize modern technology in exploring the essence of TCM theories and screening effective formulae， thereby comprehensively improving the diagnosis and treatment of SLE through integrated TCM and Western medical approaches.

Systemic lupus erythematosus （SLE）， a refractory autoimmune disease， is among the dominant diseases where traditional Chinese medicine （TCM） shows advantages in the field of rheumatology and immunology. The China-Japan Friendship Hospital hosted the "46^th Youth Salon on Dominant Diseases （Systemic Lupus Erythematosus）" organized by the China Association of Chinese Medicine， which led to a consensus on "the advantages， challenges， interdisciplinary approaches， and translational achievements of integrated TCM and Western medical approaches in the diagnosis and treatment of SLE." The diagnosis and treatment of SLE currently face several challenges， such as frequent misdiagnosis and missed diagnosis in the early stages， difficulty in achieving treatment targets， multiple side effects from pharmacotherapy， and the lack of management strategies for special populations， all of which hinder the fulfillment of the clinical needs of patients. Integrated TCM and Western medical approaches can improve clinical symptoms such as skin erythema， aversion to cold and cold limbs， fatigue， dry mouth， restlessness， and heat sensation in the palms and soles， thereby improving patients' quality of life. The approaches also help consolidate the efficacy of conventional Western medicine， slow disease progression， reduce relapse rates， address multi-organ involvement， and prevent or treat complications. Additionally， they enhance efficacy and reduce toxicity， prevent the side effects of Western medications， help reduce hormone use， and offer distinct advantages in the individualized intervention of special populations， contributing to the whole-process management of the disease. However， evidence-based medical support for this integrated approach remains limited， and the quality of available evidence is generally low. Common evaluation systems and modern research methodologies should be adopted to clarify the efficacy of TCM in SLE treatment. Efforts should be made to carry out high-quality evidence-based medical research， strengthen the development of fundamental and pharmacological research， and further explain the distinct advantages of TCM in the diagnosis and treatment of SLE. Future efforts should focus on advancing the integration of TCM and modern medicine， incorporating multi-omics technologies， individualized stratification， and other precision medicine concepts， in combination with artificial intelligence. Moreover， interdisciplinary collaboration should be promoted to utilize modern technology in exploring the essence of TCM theories and screening effective formulae， thereby comprehensively improving the diagnosis and treatment of SLE through integrated TCM and Western medical approaches.

ObjectiveTo study the clinical characteristics and influencing factors of rheumatoid arthritis （RA） in the patients with cold dampness obstruction syndrome. MethodsThe RA patients treated in the Department of Traditional Chinese Medicine and Rheumatology of the China-Japan Friendship Hospital from August 2022 to June 2024 were selected. The demographic information， clinical data， laboratory test results， and traditional Chinese medicine （TCM） symptom information were collected for syndrome differentiation， on the basis of which the characteristics and influencing factors of cold dampness obstruction syndrome were analyzed. ResultsA total of 258 RA patients were selected in this study， including 88 （34.1%） patients with cold dampness obstruction syndrome， 53 （20.5%） patients with dampness and heat obstruction syndrome， 31 （12.0%） patients with wind dampness obstruction syndrome， 29 （11.2%） patients with liver-kidney deficiency syndrome， 19 （7.4%） patients with Qi-blood deficiency syndrome， 14 （5.4%） patients with phlegm-stasis obstruction syndrome， 15 （5.8%） patients with stasis obstructing collateral syndrome and 9 （3.5%） patients with Qi-Yin deficiency syndrome. The patients were assigned into two groups of cold dampness obstruction syndrome and other syndromes. The group of cold dampness obstruction syndrome had lower joint fever， 28-tender joint count （TJC28）， and 28-joint disease activity score （DAS28）-C-reactive protein （CRP） and higher central sensitization， cold feeling of joints， fear of wind and cold， cold limbs， and abdominal distention than the group of other syndromes （P<0.05）. The binary logistic regression analysis showed that central sensitization （OR 5.749， 95%CI 2.116-15.616， P<0.001） and DAS28-CRP （OR 0.600， 95% CI 0.418-0.862， P=0.006） were the independent factors influencing cold dampness obstruction syndrome in RA. ConclusionCold dampness obstruction syndrome is a common syndrome in RA patients. It is associated with central sensitization， cold feeling of joints， abdominal distension and may be a clinical syndrome associated with central sensitization.

As a crucial barrier to ensuring blood transfusion safety, blood virus inactivation technology plays an irreplaceable role in addressing the "window period" of detection, the threat of emerging pathogens, and the limitations of detection technologies. This article systematically reviews the current status and technical characteristics of mainstream blood virus inactivation technologies, and conducts an in-depth discussion on the application prospects and challenges of emerging technologies in this field. Among conventional technologies, the photochemical methods (including methylene blue, psoralen S-59/INTERCEPT system, and riboflavin/Mirasol system) have been widely used in clinical practice due to their broad-spectrum inactivation capacity. However, these methods are associated with functional impairment of blood components. The organic solvent/detergent (S/D) method performs excellently in inactivating viruses in plasma products yet is ineffective against non-lipid-enveloped viruses. Short-wave ultraviolet (UVC) direct irradiation technology eliminates the need for chemical additives, though its inactivation efficiency and compatibility with blood components requires optimization. The chemical modification method, while specifically designed for red blood cells, faces safety challenges such as potential immunogenicity. For emerging technologies, cold plasma technology shows great potential owing to its multi-target synergistic inactivation mechanism, though challenges regarding its biocompatibility and selectivity remain. Electrolyzed water technology has the advantages of low cost and operational simplicity, yet in-depth research is needed on the non-specific damage caused by active substances to blood components. Novel photodynamic therapy significantly improves inactivation efficiency by developing high-efficiency targeted photosensitizers and has broad prospects for combined applications with antibodies, nanomaterials, and other substances. Future development trends point to the "combination therapy" strategy, which leverages the synergy of multiple technologies to achieve the optimal balance between efficient virus inactivation and functional prservation of blood components. The development of such technologies needs to shift from "single-method" to "integrated approach", from "inactivation" to "viability preservation", and bridge the translation gap from "laboratory" to "global application". The ultimate goal is to establish a standardized, automated, and cost-controllable comprehensive blood safety assurance system.

Objective To investigate the occurrence of intraoperative frozen section(FS)pathology unclear diagnosis in thyroid carcinoma,seeking clinical factors affecting the pathological accuracy of FS.Methods Retrospective analysis of thyroid cancer patients who underwent surgical treatment at People's Hospital of Daxing District in Beijing from August 2016 to December 2019.Target nodules were divided into FS clear diagnosis group and unclear diagnosis group(including delayed diagnosis group,misdiagnosis group,accidental diagnosis group)according to the results of FS and paraffin section pathological examination.The general information,laboratory test,result of color ultrasound and pathological types between FS clear diagnosis group and unclear diagnosis group were compared.Results A total of 336 cancer nodules were included.The quantity and proportion of cancer nodules in clear diagnosis group,delayed diagnosis group,misdiagnosis group and accidental diagnosis group were respectively 266(79.17%),28(8.33%),21(6.25%)and 21(6.25%).In the delayed diagnosis group,"no exception"thyroid cancer was the most frequently used.Compared to clear diagnosis group,the maximum diameter of cancer nodules in delayed diagnosis group,misdiagnosis group,accidental diagnosis group were smaller(P<0.05);In the delayed diagnosis group,the proportion of aspect ratio>1 was higher(P=0.017),and the proportion of microcalification was lower(P=0.002).In the misdiagnosis group,thyroid peroxidase antibody level was higher(P=0.002).Conclusion Clinical doctors should be familiar with commonly used diagnostic terms for delayed diagnosis and misdiagnosis.When making treatment decisions,full consideration should be given to the possibility of difficult to diagnose diagnosis,especially for patients with small nodules and concurrent chronic lymphocytic thyroiditis.

Objective:To develop a U-Net-based quadruple numerical neural network (QU-Net) model for retinal vessel segmentation and to verify its precision and efficiency in extracting and segmenting retinal vessels from fundus images.Methods:This study used the concept of hypercomplex numbers, the three channels of color images, and a quaternion matrix representing all the information data of the images, which was then used as input for quaternion convolution and quaternion fully connected layers based on the U-Net architecture to form a QU-Net model.The QU-Net model was first tested on the DRIVE, STARE, and CHASE_DB1 datasets and compared with the traditional real-valued U-Net, M-Net, and SU-Net models in terms of accuracy, sensitivity, specificity, precision, F1 score, and Matthews correlation coefficient.Finally, the model was further optimized and the optimized QU-Net model was compared side-by-side with the well-known advanced models to comprehensively evaluate and analyze the efficiency and accuracy of the model in extracting and segmenting retinal blood vessels from fundus images.Results:The results showed that the QU-Net model achieved the following vessel segmentation results: accuracy 0.956 6, sensitivity 0.700 8, specificity 0.987 9, precision 0.595 4 on the DRIVE dataset, accuracy 0.975 5, sensitivity 0.890 7, specificity 0.984 2, precision 0.662 5 on the STARE dataset, and accuracy 0.979 4, sensitivity 0.747 0, specificity 0.990 6, precision 0.596 9 on the CHASE_DB1 dataset.Its specificity was better than U-Net, M-Net and SU-Net models, and its accuracy, sensitivity and precision were not inferior to the three models.After optimization, the sensitivity, precision and F1 value of the QU-Net model were effectively improved on the three datasets while maintaining its original accuracy and specificity.When compared with the performance indicators of other models on the three datasets, it was found that the optimized QU-Net model had good performance in accuracy, specificity, sensitivity, precision, and F1 score, indicating that its vessel segmentation ability was not inferior to the advanced models.Among all the models compared, the optimized QU-Net model had the best F1 score and Matthews correlation coefficient.Conclusions:The QU-Net model proposed in this study expands the data dimension space from the traditional real number space to the complex number space and greatly reduces the loss of data information.The optimized QU-Net model has good efficiency and accuracy in extracting retinal vessel segmentation from fundus images, and has certain advantages in detecting fine vessels.

Objective:To establish a risk management system of bedside monitor based on risk assessment management model,and to analyze its application value in the clinical management of critically ill patients in neurosurgery department.Methods:Based on the risk assessment management model,the failure risk index was screened,and the risk management system of bedside monitor was established.A total of 150 critically ill neurosurgical patients admitted to The First Affiliated Hospital of Air Force Medical University from December 2021 to December 2022 were selected and divided into control group and observation group by random number table method,with 75 cases in each group.During the hospitalization of the two groups of patients,30 responsible nurses participated in clinical care,and 16 multifunctional bedside monitors were used to monitor patients'vital signs.The control group received routine nursing management intervention.On the basis of routine nursing intervention,the observation group carried out risk assessment management based on the risk assessment management model of bedside monitor risk management system.The differences in patient monitoring quality score,equipment management quality score and responsible nurse ability score were compared between the two groups.Results:The average scores of respiration,blood pressure,blood oxygen saturation and ECG monitoring quality of the patients in observation group were(37.52±0.26)points,(36.61±1.29)points,(36.56±2.57)points and(38.25±0.56)points,respectively,which were higher than those in control group,the difference was statistically significant(t=43.925,33.150,13.655,32.035,P<0.05).The average scores of performance control quality and operation quality of bedside monitor in the observation group were(95.43±0.46)points and(96.51±0.77)points,respectively,which were higher than those in control group,the difference was statistically significant(t=70.976,35.439,P<0.05).The average scores of nurses in terms of ability of equipment collaboration,equipment use mastery and equipment alarm management in the observation group were(9.43±0.25)points,(8.56±0.64)points and(9.25±0.24)points,respectively,which were higher than those in the control group,the differences were statistically significant(t=92.952,24.455,58.024,P<0.05).Conclusion:The bedside monitor risk management system based on the risk assessment management model can realize the efficient management of bedside monitors for critically ill neurosurgical patients,and improve the operating efficiency and quality of the equipment on the basis of ensuring the life safety of patients.

Objective To investigate the effect of trehalose(Tre)H9C2 cardiomyocytes under oxy-gen-glucose deprivation/reoxygenation(OGD/R)injury and its mechanism of action with the cel-lular model simulating the process of myocardial ischemia/reperfusion injury.Methods H9C2 cells were divided control group,OGD/R group,Tre group(OGD/R+Tre),and combination group(OGD/R+Tre+ML385).MTT assay was used to observe cell proliferation,and lactate de-hydrogenase(LDH)release and Hoechst/propidium iodide staining were employed to evaluate cell membrane damage.Western blot analysis was utilized to detect the expression of nuclear fac-tor erythroid 2-related factor 2(Nrf2)and its downstream related proteins.The generation of re-active oxygen species(ROS)and mitochondrial membrane potential(MMP)were measured to quantify the level of oxidative stress.The expression of apoptosis-related proteins was determined by Western blot analysis.Results In comparison to the control group,the OGD/R group exhibi-ted a significantly reduced cell viability.When compared with the OGD/R group,the intervention of varying concentrations of Tre obviously improved cell viability in a dose-dependent manner(P＜0.01),increased MMP,and up-regulated the expression of glutathione(GSH),Nrf2,hemeo-xygenase 1,and nicotinamide adenine dinucleotide phosphate quinone oxidoreductase 1(NQO1),Bcl-2,and cysteinyl aspartate specific proteinase 3(Caspase-3)(P＜0.05,P＜0.01),and decreased the production of ROS and MDA and the expression of responding element binding protein 1,Bax,Bax/Bcl-2,and cleaved Caspase-3(P＜0.05,P＜0.01).What's more,the combined group ex-hibited significantly higher production of ROS,MDA,increased mRNA levels of TNF-α,IL-1β,and IL-6,and reduced MMP and GSH levels(P＜0.05,P＜0.01),as well as,enhanced expression of Bax,Bax/Bcl-2,and cleaved Caspase-3(1.77±0.08 vs 1.20±0.20,3.41±1.45 vs 0.99±0.15,4.10±1.05 vs 1.79±0.52,P＜0.01),and decreased expression of Bcl-2 and Caspase-3(0.58±0.21 vs 1.23±0.25,0.87±0.25 vs 1.45±0.31,P＜0.01)in comparison with the Tre group.Conclusion Tre can be regarded as an Nrf2 activator that inhibits oxidative stress and apoptosis by activating Nrf2,and thereby ameliorates OGD/R-induced cardiomyocyte injury.

Objective:To evaluate the effect of trehalose on oxygen-glucose deprivation and restoration (OGD/R) injury in H9C2 cells and the role of solute carrier family 7 member 11- (SLC7A11)-glutathione peroxidase 4 (GPX4) signaling pathway.Methods:Well-grown H9C2 cells were divided into 4 groups ( n=24 each) by the random number table method: control group (group C), OGD/R group (group O), OGD/R+ trehalose group (group OT) and OGD/R+ trehalose+ erastin group (group OTE). The cells were normally cultured in group C. In O, OT and OTE groups, the DMEM medium was replaced with EBSS medium, the cells were exposed to 5% CO 2-95% N 2 in an incubator at 37 ℃ for 6 h, and then the medium was replaced with DMEM medium supplemented with 6% fetal bovine serum to restore oxygen and glucose supply for 24 h. In group OT, trehalose at a final concentration of 50 mmol/L was added during restoration of oxygen and glucose supply. In group OTE, the SLC7A11 inhibitor erastin at a final concentration of 10 μmol/L was added at 8 h before oxygen-glucose deprivation, and trehalose at a final concentration of 50 mmol/L was added during restoration of oxygen and glucose supply. The cell viability, lactic dehydrogenase (LDH) activity, contents of glutathione (GSH), malondialdehyde (MDA) and iron, and reactive oxygen species (ROS) levels were measured at 24 h of restoration of oxygen and glucose supply. The expression of SLC7A11, GPX4, long-chain fatty acyl coenzyme A synthetase 4 (ACSL4), and ferritin heavy chain 1 (FTH1) was detected by Western blot. The structure of the mitochondrial morphology was observed with a transmission electron microscope. Results:Compared with group C, the cell viability and GSH content were significantly decreased, the LDH activity, contents of MDA and iron, and ROS level were increased, the expression of SLC7A11, GPX4 and FTH1 was down-regulated, and the expression of ACSL4 was up-regulated in group O ( P<0.05). Compared with group O, the cell viability and GSH content were significantly increased, the LDH activity, contents of MDA and iron, and ROS level were decreased, the expression of SLC7A11, GPX4 and FTH1 was up-regulated, and the expression of ACSL4 was down-regulated in group OT ( P<0.05). Compared with group OT, the cell viability and GSH content were significantly decreased, the LDH activity, contents of MDA and iron, and ROS levels were increased, the expression of SLC7A11, GPX4 and FTH1 was down-regulated, and the expression of ACSL4 was up-regulated in group OTE ( P<0.05). Conclusions:Trehalose can inhibit ferroptosis by activating the SLC7A11-GPX4 signaling pathway, thereby attenuating OGD/R injury in H9C2 cells.

Bacteria have posed a threat to human health,and the emergence of super bacteria has made it more difficult to cure bacterial infections in clinical practice.Currently,vaccines are one of the effective means of preventing bacterial infections.With the rapid development of cutting-edge technologies in recent years in such disciplines as biology,medicine,and materials science,various innovative strategies have been provided for vaccine research and preparation.This article summarizes the status quo and prospects of innovative vaccines for treating bacterial infections in recent years,including subunit vaccines,mRNA vaccines and attenuated live vaccine in the hopes of providing data for subsequent development and research of bacterial vaccines.