Cold ischemia-reperfusion injury (CIRI) is a major contributor to delayed graft function and long-term graft failure after kidney transplantation.Its pathogenesis involves multiple mechanisms, including energy metabolism disorders, oxidative stress and sterile inflammatory responses.Increasing evidence indicates that immune cells play a central regulatory role in the initiation and progression of CIRI.Damage-associated molecular patterns released during cold ischemia and reperfusion activate innate immunity, leading to the rapid recruitment of neutrophils, macrophages, dendritic cells and amplification of inflammatory cascades.Subsequently, adaptive immune cells, including T cells and B cells, are activated and further contribute to sustained inflammation, disruption of immune tolerance and graft injury.Through cytokine signaling, chemokine-mediated recruitment and antigen presentation, different immune cell subsets form a complex interactive network that ultimately determines the severity and outcome of CIRI.This review summarizes the roles and mechanisms of innate and adaptive immune cells in renal allograft CIRI, highlights their interconnections, and discusses emerging immune cell-targeted therapeutic strategies, aiming to provide a theoretical basis for improving clinical outcomes in kidney transplantation.

Objective:To identify different subtypes of patients with preeclampsia(PE)through clinical liver function index data-driven the cluster analysis,to explore the correlation between liver function of different sub-types and pregnancy complications.Methods:From January 2012 to December 2022,the general data of 2230 sin-gleton pregnant women with PE who underwent prenatal examination and delivered in Fujian Maternity and Child Health Hospital were collected.Using 13 liver function indexes before delivery as baseline variables,all included subjects were classified into subtypes by cluster method.The clinical characteristics of different subtypes of PE patients were compared.Single-factor Logistic regression was used to analyze the risk of pregnancy complications among subtypes.Results:PE patients were divided into 3 subgroups that represented different characteristics of patients' liver function.The first subtype(n=1065)exhibited abnormal liver enzymology index characterized by in-creased alkaline phosphatase(ALP)level.The second subtype(n=648)showed abnormal bilirubin metabolism index with the highest levels of total bilirubin(TBIL),direct(DBIL)and indirect bilirubin(IBIL).The third subtype(n=517)had abnormal liver enzymology indexes with elevated alanine aminotransferase(ALT)and aspartate aminotransferase(AST)levels,abnormal bile acid detection indexes with elevated total bile acid(TBA)levels,and abnormal liver synthesis function indexes with decreased total protein(TP),albumin(ALB),and globulin lev-els(GLB).Significant differences were observed among the three subtypes in age,severe PE,anemia,cardiac dysfunction,and renal dysfunction(P＜0.05).Single-factor Logistic regression demonstrated that the third sub-type had significantly higher risks of intrahepatic cholestasis of pregnancy,fetal growth restriction,premature rup-ture of membranes,and preterm birth compared to the first and second subtypes(P＜0.05),as well as a higher risk of placental abruption than the second subtype(P＜0.05).The first subtype had higher risks of placental ab-ruption and fetal growth restriction than the second subtype(P＜0.05).Conclusions:Cluster analysis could be used to subclassify PE patients by liver function characteristics,so as to identify the occurrence of pregnancy complications.The results had significance for understanding the heterogeneity of PE and promoting individualized management.

With the deepening of the modernization of traditional Chinese medicine(TCM),the analysis of mineralogical features of mineralogical TCM,as an important part of TCM,has received more and more attention.At present,the research of mineral-based traditional Chinese medicine is faced with problems such as confusion of medicinal resources,unclear material basis,and low exclusivity of quality standards,while common analytical techniques have certain limitations in quantitative analysis,sensitivity and comprehensive characterization,which restrict the modernization research of mineral-based medicines and its clinical applications.The advanced mineral identification and characterization system integrates energy spectrum and spectral analysis techniques,combined with efficient data processing algorithms,which can rapidly and accurately analyze mineral components qualitatively and quantitatively,but its application in mineral medicine research is still in its infancy.This article reviews the common analytical techniques for mineral medicine and the potential application of advanced mineral identification and characterization system in the identification of mineral Chinese medicine matrix and quality control.The advanced mineral identification and characterization system can not only accurately distinguish the mineralogical characteristics of mineral medicines,such as the mineral composition,elemental state and embedded characteristics,and provide data support for the research of mineral medicine resources,but also provide scientific basis for the establishment of systematic quality standards,the analysis of the preparation mechanism,the revelation of its potential medicinal effect of the material basis and the control of the risk of heavy metals.

Objective:To identify different subtypes of patients with preeclampsia(PE)through clinical liver function index data-driven the cluster analysis,to explore the correlation between liver function of different sub-types and pregnancy complications.Methods:From January 2012 to December 2022,the general data of 2230 sin-gleton pregnant women with PE who underwent prenatal examination and delivered in Fujian Maternity and Child Health Hospital were collected.Using 13 liver function indexes before delivery as baseline variables,all included subjects were classified into subtypes by cluster method.The clinical characteristics of different subtypes of PE patients were compared.Single-factor Logistic regression was used to analyze the risk of pregnancy complications among subtypes.Results:PE patients were divided into 3 subgroups that represented different characteristics of patients' liver function.The first subtype(n=1065)exhibited abnormal liver enzymology index characterized by in-creased alkaline phosphatase(ALP)level.The second subtype(n=648)showed abnormal bilirubin metabolism index with the highest levels of total bilirubin(TBIL),direct(DBIL)and indirect bilirubin(IBIL).The third subtype(n=517)had abnormal liver enzymology indexes with elevated alanine aminotransferase(ALT)and aspartate aminotransferase(AST)levels,abnormal bile acid detection indexes with elevated total bile acid(TBA)levels,and abnormal liver synthesis function indexes with decreased total protein(TP),albumin(ALB),and globulin lev-els(GLB).Significant differences were observed among the three subtypes in age,severe PE,anemia,cardiac dysfunction,and renal dysfunction(P＜0.05).Single-factor Logistic regression demonstrated that the third sub-type had significantly higher risks of intrahepatic cholestasis of pregnancy,fetal growth restriction,premature rup-ture of membranes,and preterm birth compared to the first and second subtypes(P＜0.05),as well as a higher risk of placental abruption than the second subtype(P＜0.05).The first subtype had higher risks of placental ab-ruption and fetal growth restriction than the second subtype(P＜0.05).Conclusions:Cluster analysis could be used to subclassify PE patients by liver function characteristics,so as to identify the occurrence of pregnancy complications.The results had significance for understanding the heterogeneity of PE and promoting individualized management.

Objective To investigate the standardized use of anti-tumor drugs in Beijing hospitals in 2024,and put forward relevant policy suggestions on standardizing the use of anti-tumor drugs.Methods In 2024,Beijing Cancer Quality Control Center organized internal medicine and pharmacy experts to conduct a research on the standardized use of anti-tumor drugs in 556 medical records from 60 hospitals.The evaluation content included pathological diagnosis and tumor staging,treatment process and quality control.Results The evaluation of the use of anti-tumor drugs in 60 hospitals in Beijing found that the main problems of non-standardized use of anti-tumor drugs were incomplete or unsigned informed consent forms;incomplete,un-staged or incorrect staging of tumors;lack of adverse reaction evaluation;incomplete records of drug application on the day of treatment;no reasons given for adjustments in drug dosage and administration methods,and incomplete efficacy evaluation.Conclusion It is necessary to strengthen the training and guidance of medical staff,carry out regular quality control inspections,enhance information construction,establish a multi-disciplinary diagnosis and treatment system,and establish a regular follow-up mechanism,so as to further standardize and improve the standard rate of antitumor drug use in hospitals.

With the deepening of the modernization of traditional Chinese medicine(TCM),the analysis of mineralogical features of mineralogical TCM,as an important part of TCM,has received more and more attention.At present,the research of mineral-based traditional Chinese medicine is faced with problems such as confusion of medicinal resources,unclear material basis,and low exclusivity of quality standards,while common analytical techniques have certain limitations in quantitative analysis,sensitivity and comprehensive characterization,which restrict the modernization research of mineral-based medicines and its clinical applications.The advanced mineral identification and characterization system integrates energy spectrum and spectral analysis techniques,combined with efficient data processing algorithms,which can rapidly and accurately analyze mineral components qualitatively and quantitatively,but its application in mineral medicine research is still in its infancy.This article reviews the common analytical techniques for mineral medicine and the potential application of advanced mineral identification and characterization system in the identification of mineral Chinese medicine matrix and quality control.The advanced mineral identification and characterization system can not only accurately distinguish the mineralogical characteristics of mineral medicines,such as the mineral composition,elemental state and embedded characteristics,and provide data support for the research of mineral medicine resources,but also provide scientific basis for the establishment of systematic quality standards,the analysis of the preparation mechanism,the revelation of its potential medicinal effect of the material basis and the control of the risk of heavy metals.

Objective To investigate the standardized use of anti-tumor drugs in Beijing hospitals in 2024,and put forward relevant policy suggestions on standardizing the use of anti-tumor drugs.Methods In 2024,Beijing Cancer Quality Control Center organized internal medicine and pharmacy experts to conduct a research on the standardized use of anti-tumor drugs in 556 medical records from 60 hospitals.The evaluation content included pathological diagnosis and tumor staging,treatment process and quality control.Results The evaluation of the use of anti-tumor drugs in 60 hospitals in Beijing found that the main problems of non-standardized use of anti-tumor drugs were incomplete or unsigned informed consent forms;incomplete,un-staged or incorrect staging of tumors;lack of adverse reaction evaluation;incomplete records of drug application on the day of treatment;no reasons given for adjustments in drug dosage and administration methods,and incomplete efficacy evaluation.Conclusion It is necessary to strengthen the training and guidance of medical staff,carry out regular quality control inspections,enhance information construction,establish a multi-disciplinary diagnosis and treatment system,and establish a regular follow-up mechanism,so as to further standardize and improve the standard rate of antitumor drug use in hospitals.

Objective:To investigate the application and effectiveness of slit-lamp microscope demonstration combined with supervisory clinical teaching in ophthalmology training for general practice residents.Methods:Sixty general practice residents who underwent ophthalmology training in Fifth Affiliated Hospital of Sun Yat-sen University from March 2021 to March 2023 were randomly assigned to 2 groups. In the traditional teaching group ( n=29), the teaching was primarily led by the instructors, and trainees observed and recorded the clinical findings under their guidance; while in the combined teaching group ( n=31), the trainees received integrated slit-lamp microscope demonstration and supervisory outpatient teaching. Both groups underwent a unified exit examination after the training, with the scores based on knowledge, diagnostic skills, comprehensive evaluation and overall performance. Additionally, satisfaction with the teaching process was assessed through questionnaires completed by both trainees and instructors. Results:There were no significant differences in gender composition, age and initial exam scores between the two groups (all P>0.05). Upon completion of the training, the combined teaching group scored higher in ophthalmology knowledge, outpatient diagnostic skills, and overall performance compared to the traditional teaching group (all P<0.05). Satisfaction scores from both trainees and instructors were also higher in the combined teaching group compared to the traditional teaching group (all P<0.05). Conclusion:The use of slit-lamp microscope demonstration combined with supervisory outpatient teaching can significantly enhance the effectiveness of ophthalmology training for general practice residents.

The complex pathophysiological mechanisms between diabetes mellitus and cardiovascular diseases have not yet been fully elucidated， becoming one of the challenges in clinical care. Glucagon-like peptide-1 receptor agonist （GLP1-RA） and sodium glucose cotransporter-2 inhibitors （SGLT2） are clinically used to reduce the cardiovascular risk of patients with diabetes mellitus. Traditional Chinese medicine has diverse biological activities and unique advantages in the treatment of chronic complex diseases due to its multi-component and multi-target effects. Based on recent reports， this paper reviewed the common risk factors of diabetes mellitus and cardiovascular diseases （e.g.， hyperglycemia， insulin resistance， and inflammation）， related targets such as apolipoprotein C-Ⅲ （APOC3）， S100 calcium-binding protein A8/A9 （S100A8/A9）， growth/differentiation factor-15 （GDF-15）， and NACHT， LRR， and PYD domains-containing protein 3 （NLRP3）， advanced glycation end products， insulin resistance， endothelial dysfunction， endoplasmic reticulum stress， mitochondrial dysfunction， and intestinal flora disorder. In addition， this paper summarized the research progress in the treatment of cardiovascular diseases in diabetes mellitus with the active ingredients （e.g.， baicalein， puerarin， curcumin， notoginsenoside， and tanshinone Ⅱ_A）， single herbal medicines （e.g.， Astragali Radix， Ginseng Radix et Rhizoma， Sophorae Flavescentis Radix， Cinnamomi Cortex， and Corni Fructus）， and compound formulas （e.g.， Buzang Tongluo Fang， Yiqi Yangyin Huoxue Fang， Shenqi Fang， Huangqisan， Danggui Buxue Tang， and Liuwei Dihuang Wan） of traditional Chinese medicine. Traditional Chinese medicine mainly treats cardiovascular diseases in diabetes mellitus by reducing inflammation and oxidative stress， ameliorating dyslipidemia and insulin resistance， protecting islet β cell function， repairing endothelial damage， inhibiting smooth muscle cell proliferation， foam cell formation， macrophage polarization， and cardiac hypertrophy and fibrosis， and regulating intestinal flora disorder. These processes involve insulin receptor substrate/ phosphatidylinositol 3-kinase/protein kinase B （IRS/PI3K/Akt）， peroxisome proliferator-activated receptor α/γ （PPAR α/γ）， nuclear factor-kappa B （NF-κB）， adenosine 5′-monophosphate （AMP）-activated protein kinase （AMPK）， hypoxia-inducible factor-1-BCH domain-containing protein （HIF-1-BNIP）， vascular endothelial growth factor/hypoxia-inducible factor-1α （VEGF/HIF-1α） and other signaling pathways. This review is expected to provide a theoretical basis and reference for the treatment of cardiovascular diseases in diabetes mellitus with traditional Chinese medicine.

Objective:To explore the differences in distribution of colorectal cancer-related risk factors between patients with early-onset colorectal cancer (EOCRC) and those with late-onset colorectal cancer (LOCRC) in a Chinese cohort, and to provide reference and guidance for the prevention, diagnosis, and treatment of EOCRC.Methods:Using data from the National Colorectal Cancer Cohort study cohort, 5377 patients with newly diagnosed colorectal cancer (CRC) attending the Department of Colorectal Surgery and Oncology of the Second Affiliated Hospital, Zhejiang University School of Medicine from June 2018 to February 2023 were included in the study cohort. Questionnaires capturing epidemiological features, including lifestyle and dietary habits, were administered. The patients were divided into two groups, the cut-off age being 50 years. Those aged ≥50 years were defined as having LOCRC and those aged <50 years as having EOCRC. Wilcoxon (continuous variates) or χ 2 tests (categorical variates) were performed to compare differences in epidemiological features. Results:A total of 3799 people who had completed the questionnaire were included in this study, 491 of whom had EOCRC and 3308 LOCRC. The response rate to the questionnaire was 70.7%. The median ages of patients in the EOCRC and LOCRC groups were 43 and 66 years, respectively. There was a higher proportion of female patients (48.5% [253/491] vs. 35.8% [1184/3308], χ 2=28.8, P<0.001) in the EOCRC than the LOCRC group. Patients with EOCRC and lower body mass index (medium 22.1 kg/m 2 vs. 22.9 kg/m 2, W=744 793, P=0.005) and lower proportion of abdominal obesity (87.2% [428/491] vs. 93.8% [3103/3308], χ 2=38.3, P<0.001). Patients with EORC significantly less commonly reported a history of hypertension (5.9% [29/491] vs. 41.6% [1375/3308], χ 2=231.8, P<0.001), diabetes (1.4% [7/491] vs. 14.4% [476/3308], χ 2=63.6, P<0.001) and cardiovascular and cerebrovascular diseases (0.8% [4/491] vs. 7.3% [241/3308], χ 2=28.6, P<0.001). However, the proportion of patients with a family history of CRC was significantly higher ( P<0.05) in the EOCRC group (10.2% [50/491] vs. 6.9% [227/3 308], χ 2=6.5, P=0.010]. In terms of lifestyle, patients with EOCRC had shorter sleep duration (median: 8.0 hours vs. 8.5 hours, W=578 989, P<0.001), and were less likely to participate in physical exercise (29.5% [145/491] vs. 38.7% [1281/3308] χ 2=15.0, P<0.001) or engage in physical work (65.2% [320/491] vs. 74.1% [2450/3308], χ 2=16.7, P<0.001). Meanwhile, in the EOCRC group a lower percentage of patients were smokers (29.3% [144/491] vs. 42.7% [1411/3308], χ 2=46.9, P<0.001) and they smoked less (median 17.6 pack/year vs. 30.0 pack/year,W=55 850, P<0.001). Fewer patients in the EOCRC group habitually drank alcohol (21.0% [103/491] vs. 38.0% [1257/3308], χ 2=57.5, P<0.001) or tea (17.5% [86/491] vs. 28.7% [948/3308], χ 2=26.2, P<0.001) than in the LOCRC group. Compared with the LOCRC group, patients with EOCRC had a higher frequency of intake of fresh meat, fresh fruit, eggs, and dairy products and a lower frequency of intake of preserved meat and pickled vegetables; these differences are statistically significant (all P<0.05). There was no statistically significant difference in consumption of fresh vegetables or a high-sugar diet between the two groups (both P>0.05). Conclusions:This study highlights disparities in adverse lifestyle and dietary habits between patients in China with EOCRC versus LOCRC.