Changes in biliary system dynamics are closely associated with the development and progression of related diseases， and with the in-depth interdisciplinary research on medical sciences and engineering， the value of biliary biomechanics in clinical diagnosis and treatment has become increasingly important. This article systematically reviews the characteristics of changes in biliary system dynamics under pathological conditions and explores the application value of technologies such as biliary manometry， hydrodynamic evaluation， and experimental simulation in clinical diagnosis， treatment， and postoperative management， so as to deepen the understanding of existing diagnostic and therapeutic modes and provide new ideas for promoting precision medicine for biliary tract diseases.

Infectious diseases occur and evolve through a dynamic contest between pathogenic qi and the body's healthy qi， with marked stage-dependent progression. This paper constructs a whole-course system of syndrome differentiation and treatment based on the theories of "struggle between pathogenic qi and healthy qi" and "relapse due to overexertion after recovery". The former reveals the intrinsic link between the waxing and waning of pathogenic and healthy qi and the evolution of syndromes， guiding stratified interventions during acute stage by discerning the location and nature of pathogenic factors and determining appropriate strategies for eliminating pathogens and supporting healthy qi according to the dynamics of deficiency and excess syndromes. The latter focuses on the recovery stage after infection and disease relapse， emphasizing harmonizing yin， yang， qi and blood to restore functions of zang-fu （脏腑） organs， and combining unblocking， tonifying， and turbidity-dispelling methods to eliminate both new and lingering pathogens. Throughout the whole-course treatment， attention should be paid to dynamic pathogenesis and stage-to-stage coherence， with emphasis on formula-syndrome correspondence， and integration of modern diagnostic and therapeutic measures， to construct individualized strategies bridging disease stages and integrating prevention with treatment， thereby systematically leveraging the integrative strengths of traditional Chinese medicine in the prevention and treatment of infectious diseases.

Infectious diseases occur and evolve through a dynamic contest between pathogenic qi and the body's healthy qi， with marked stage-dependent progression. This paper constructs a whole-course system of syndrome differentiation and treatment based on the theories of "struggle between pathogenic qi and healthy qi" and "relapse due to overexertion after recovery". The former reveals the intrinsic link between the waxing and waning of pathogenic and healthy qi and the evolution of syndromes， guiding stratified interventions during acute stage by discerning the location and nature of pathogenic factors and determining appropriate strategies for eliminating pathogens and supporting healthy qi according to the dynamics of deficiency and excess syndromes. The latter focuses on the recovery stage after infection and disease relapse， emphasizing harmonizing yin， yang， qi and blood to restore functions of zang-fu （脏腑） organs， and combining unblocking， tonifying， and turbidity-dispelling methods to eliminate both new and lingering pathogens. Throughout the whole-course treatment， attention should be paid to dynamic pathogenesis and stage-to-stage coherence， with emphasis on formula-syndrome correspondence， and integration of modern diagnostic and therapeutic measures， to construct individualized strategies bridging disease stages and integrating prevention with treatment， thereby systematically leveraging the integrative strengths of traditional Chinese medicine in the prevention and treatment of infectious diseases.

ObjectiveTo investigate the protective effect of resveratrol against blood-brain barrier damage in a rat model of cerebral ischemia-reperfusion and to determine whether this effect is mediated by the C-C motif chemokine ligand 3 (CCL3)/C-C chemokine receptor type 5 (CCR5) signaling pathway　Methods　A total of 100 specific pathogen-free (SPF) male Sprague-Dawley (SD) rats, aged 6-8 weeks, were randomly divided into five groups: sham-operated (Sham), model (MCAO), resveratrol-treated (Res), resveratrol+CCR5 agonist (Res+Agonist), and resveratrol+CCR5 antagonist (Res+Antagonist) groups. The MCAO, Res, Res+Agonist, and Res+Antagonist groups were subjected to middle cerebral artery occlusion (MCAO) for 45 min followed by reperfusion to establish the rat model of cerebral ischemia, while the Sham group underwent carotid artery exposure without ischemia. After reperfusion, resveratrol (60 mg/kg) was intraperitoneally injected in Res, Res+Agonist and Res+Antagonist groups, and an equal volume of normal saline was injected in Sham and MCAO groups. Thirty minutes later, CCR5 agonist (20 μg/kg) was injected via the tail vein in the Res+Agonist group, CCR5 inhibitor (1 mg/kg) was injected via the tail vein in the Res+Antagonist group, and the equal volume of normal saline was injected via the tail vein in the Res, Sham and MCAO groups. Thereafter, resveratrol, CCR5 agonist, CCR5 inhibitor, or saline were administered every 24 hours for 3 consecutive days. After modeling, cerebral infarct volume was evaluated by 2,3,5‑triphenyltetrazolium chloride (TTC) staining. Blood‑brain barrier (BBB) permeability was assessed by Evans blue extravasation. Serum levels of the pro‑inflammatory cytokines interleukin‑1β (IL‑1β), tumor necrosis factor‑α (TNF‑α), and CCL3 were measured by enzyme‑linked immunosorbent assay (ELISA). Histopathological changes in brain tissue were observed by hematoxylin and eosin (HE) staining and Nissl staining. Immunofluorescence staining was used to detect the fluorescence intensity of the microglial marker ionized calcium‑binding adapter molecule 1 (Iba‑1) and CCR5. Western blotting analysis was used to detect proteins associated with the CCL3/CCR5 signaling pathway (CCL3, CCR5) in brain tissue, serum pro-inflammatory cytokines [phosphorylated nuclear factor-kappa B (p-NF-κB)] and blood-brain barrier-related proteins [matrix metalloproteinase 9 (MMP9) and occludin]. ResultsCompared with the Sham group, the MCAO group exhibited significantly increased levels of all injury parameters, including cerebral infarct volume, Evans blue extravasation rate in brain tissue, serum levels of the pro‑inflammatory cytokines (IL-1β, TNF-α, and CCL3), the rate of Iba-1- and CCR5-positive immunofluorescence signals in brain tissue, and the protein expression levels of CCL3, CCR5, p-NF-κB, and MMP9 (all P<0.001), accompanied by markedly decreased expression of occludin (P<0.001). HE and Nissl staining revealed pronounced histopathological damage in the MCAO group.Compared with the MCAO group, the Res group showed significant reductions in all the aforementioned injury indicators and a significant increase in occludin expression (P<0.01), together with ameliorated histopathological changes. Compared with the Res group, the Res+Agonist group displayed significantly elevated injury indicators and decreased occludin expression (P<0.05), with aggravated brain tissue damage. In contrast, the Res+Antagonist group exhibited significant decreases in injury indicators and a significant increase in occludin expression (P<0.05), along with further alleviation of histopathological injury. ConclusionResveratrol attenuates peripheral inflammation in cerebral ischemia‑reperfusion injury by targeting the CCL3/CCR5 signaling pathway, thereby exerting a protective effect on the blood‑brain barrier.

Objective: To summarize strategies for improving childhood hypertension, so as to provide evidencebased recommendations for poliymaking and practice childhood hypertension management in China. Methods: From March to April 2024, child health stakeholders from five districts in Hangzhou were selected using a combination of stratified and convenience sampling methods. Data were analyzed using a groundedtheory approach. During the indepth interview phase, six policymakers were interviewed. Focus group discussions were conducted with school administrators, healthcare providers, and parents, comprising a total of 62 participants. Results: Through threelevel coding, 116 initial categories were identified(e.g., "trend of younger age" "difficulty in behavior change"), 35 main categories (e.g., "higher incidence compared to the past" "caused by comprehensive influencing factors"), and 12 core categories (e.g., "epidemic status" "influencing factors"). Finally, the cognitive status, problem analysis, and management strategies of children hypertension were constructed. Conclusion Effective prevention and control of childhood hypertension requires coordinated efforts among governments, schools, families, and society to establish a comprehensive management system, with dynamic monitoring and evaluation to optimize policy implementation.

ObjectiveTo investigate the effects of Tongxinluo capsules on traditional Chinese medicine （TCM） syndrome elements and major adverse cardiovascular events （MACEs） in patients with chronic coronary syndrome of Qi deficiency and blood stasis type. MethodsA multicenter and prospective cohort study was conducted. The intervention of Tongxinluo Capsules was used as the exposure factor， and the patients were divided into an exposure group （integrated traditional Chinese and western medicine treatment group） and a non-exposure group （western medicine treatment group）. The patients were followed up for one year. The TCM syndrome element scores were assessed by using a syndrome element diagnosis scale on the day of enrollment and in the third， sixth， and twelfth months， and the incidence of MACE within one year was recorded. ResultsA total of 186 patients were included， with 128 patients in the exposure group and 58 patients in the non-exposure group. There was no significant difference in baseline data between the two groups. Compared with those in the pretreatment period for each group， the Qi deficiency and blood stasis syndrome scores in the treatment and follow-up period were significantly improved （P<0.05）. Compared with the non-exposure group， the exposure group exhibited significantly decreased Qi deficiency syndrome scores in the treatment and follow-up period （P<0.01） and significantly reduced blood stasis syndrome scores in the sixth month （P<0.05）. In the remaining follow-up period， there was no statistically significant difference between the two groups. Compared with that of the non-exposure group， during the treatment period （the third month）， the difference in Qi deficiency and blood stasis syndrome scores of the exposure group was statistically significant （P<0.05， P<0.01）. At the end of the follow-up period， patients in the non-exposure group had a MACE probability of 6.90% （4/58）， higher than 3.13% in the exposure group （4/58）. Compared with patients with angina pectoris who used conventional medicine， patients administered with Tongxinluo Capsules had a relative risk（RR） of 0.45 ［95%confidence interval（95%CI） 0.12-1.75， P=0.26］. There was no significant difference in the incidence of MACE within one year between the two groups. ConclusionTongxinluo capsules can improve the degree of Qi deficiency in patients with chronic coronary syndrome in the short term， and the improvement effect of blood stasis syndrome appears in the medium and long term. They can better improve the Qi deficiency syndrome in the long term. Within one year， the incidence of MACE in the exposure group was lower than that in the non-exposure group.

ObjectiveTo investigate the effects of Tongxinluo capsules on traditional Chinese medicine （TCM） syndrome elements and major adverse cardiovascular events （MACEs） in patients with chronic coronary syndrome of Qi deficiency and blood stasis type. MethodsA multicenter and prospective cohort study was conducted. The intervention of Tongxinluo Capsules was used as the exposure factor， and the patients were divided into an exposure group （integrated traditional Chinese and western medicine treatment group） and a non-exposure group （western medicine treatment group）. The patients were followed up for one year. The TCM syndrome element scores were assessed by using a syndrome element diagnosis scale on the day of enrollment and in the third， sixth， and twelfth months， and the incidence of MACE within one year was recorded. ResultsA total of 186 patients were included， with 128 patients in the exposure group and 58 patients in the non-exposure group. There was no significant difference in baseline data between the two groups. Compared with those in the pretreatment period for each group， the Qi deficiency and blood stasis syndrome scores in the treatment and follow-up period were significantly improved （P<0.05）. Compared with the non-exposure group， the exposure group exhibited significantly decreased Qi deficiency syndrome scores in the treatment and follow-up period （P<0.01） and significantly reduced blood stasis syndrome scores in the sixth month （P<0.05）. In the remaining follow-up period， there was no statistically significant difference between the two groups. Compared with that of the non-exposure group， during the treatment period （the third month）， the difference in Qi deficiency and blood stasis syndrome scores of the exposure group was statistically significant （P<0.05， P<0.01）. At the end of the follow-up period， patients in the non-exposure group had a MACE probability of 6.90% （4/58）， higher than 3.13% in the exposure group （4/58）. Compared with patients with angina pectoris who used conventional medicine， patients administered with Tongxinluo Capsules had a relative risk（RR） of 0.45 ［95%confidence interval（95%CI） 0.12-1.75， P=0.26］. There was no significant difference in the incidence of MACE within one year between the two groups. ConclusionTongxinluo capsules can improve the degree of Qi deficiency in patients with chronic coronary syndrome in the short term， and the improvement effect of blood stasis syndrome appears in the medium and long term. They can better improve the Qi deficiency syndrome in the long term. Within one year， the incidence of MACE in the exposure group was lower than that in the non-exposure group.

Colorectal cancer(CRC),a highly prevalent malignant tumor worldwide,has shown a continuously increasing incidence,particularly with the rise of early-onset CRC in young populations.Neoadjuvant therapy,as an important strategy for locally advanced CRC,shows significant potential to downstage tumors,improve radical surgical cure rates,and enhance prognosis.In this paper,a 39-year-old male patient with sigmoid colon adenocarcinoma at clinical stage cT4aN2aM0(stage ⅢC)is reported.Genetic testing revealed a mutation in the oncogene KRAS(G13D)and microsatellite stability(MSS).The patient also had significantly elevated carcinoembryonic antigen(CEA),lymph node metastasis,and suspected pelvic implant nodules,with a high risk of invasiveness and potential peritoneal metastasis.Because he had a refractory subtype of CRC with poor response to traditional immunotherapy,the patient was treated with neoadjuvant therapy,comprising CapeOx regimen(capecitabine+oxaliplatin),followed sequentially by sluzumab;after 6 treatment cycles,the tumor shrank significantly,and laparoscopic radical sigmoid colon resection was successfully performed,with no residual(ypT0N0)confirmed by postoperative pathology.This case suggests that for patients with KRAS-mutated MSS CRC resistant to traditional immunotherapy,a combination of CapeOx chemotherapy followed by programmed death-1(PD-1)inhibitors may induce a deep pathological response and provide translational treatment opportunities for locally advanced patients.However,the universality and long-term benefits of this treatment regimen still require further longitudinal studies and clinical follow-up.

Objective:To investigate the staging criteria of renal tuberculosis，and to analyze the diagnostic and therapeutic characteristics as well as prognostic outcomes at different stages.Methods:A retrospective analysis was conducted on the clinical data of 134 patients with renal tuberculosis who were admitted to the Second Hospital of Lanzhou University between January 2019 and December 2023.The study cohort included 62 males and 72 females，with a mean age of（46.63 ± 13.52）years and a mean body mass index（BMI）of（22.85 ± 3.73）kg/m 2. A total of 107 patients resided in rural areas. Sixty patients had a history of pulmonary tuberculosis. Tuberculous lesions were located in the left kidney in 72 cases and in the right kidney in 62 cases. The main presenting complaints included irritative lower urinary tract symptoms in 85 patients and systemic symptoms in 92 patients. Ureteral involvement was observed in 97 patients，bladder involvement in 32 patients，and genital involvement in 9 patients. Based on computed tomography（CT）findings，the number，extent，and degree of renal destruction caused by tuberculous lesions were comprehensively evaluated in axial，coronal，and sagittal planes. The primary staging criteria included lesion diameter（2 cm）and the proportion of renal volume involved by the lesion（one-third，one-half，and two-thirds）. Renal tuberculosis was classified into three stages and six subtypes：Stage Ⅰa，a solitary lesion with a diameter ≤ 2 cm；Stage Ⅰb，a solitary lesion >2 cm or multiple lesions confined within one-third of the renal volume；Stage Ⅱa，lesions involving more than one-third but confined within one-half of the renal volume；Stage Ⅱb，lesions involving more than one-half but confined within two-thirds of the renal volume；Stage Ⅲa，lesions involving more than two-thirds of the renal volume with a glomerular filtration rate（GFR）of the affected kidney <10 ml/min；and Stage Ⅲb，complete renal calcification，presenting as an “autonephrectomy”. Among the 134 patients included in this study，7 were classified as Stage Ⅰa，17 as Stage Ⅰb，20 as Stage Ⅱa，19 as Stage Ⅱb，62 as Stage Ⅲa，and 9 as Stage Ⅲb. The severity of hydronephrosis was graded as follows：mild，renal pelvic separation <2 cm；moderate，2-3 cm；and severe，>3 cm. Prior to treatment，the mean renal pelvic separation was（1.76 ± 0.92）cm in Stage Ⅰa，（1.69 ± 0.81）cm in Stage Ⅰb，and（1.10 ± 0.82）cm in Stage Ⅱa，corresponding to mild to moderate hydronephrosis. All 7 patients in Stage Ⅰa underwent ureteroscopic examination and double-J stent placement，combined with a 6-month short-course anti-tuberculosis regimen consisting of isoniazid，rifampicin，pyrazinamide，and ethambutol for 2 months（intensive phase），followed by isoniazid and rifampicin for 4 months（continuation phase）. Among the 17 patients in Stage Ⅰb，13 presented with hydronephrosis and underwent ureteroscopic examination and double-J stent placement in combination with 6 months of anti-tuberculosis therapy，while 4 patients with isolated renal tuberculosis received anti-tuberculosis therapy alone for 6 months.Of the 20 patients in Stage Ⅱa，4 with hydronephrosis underwent ureteroscopic examination and double-J stent placement plus 6 months of anti-tuberculosis therapy，whereas 16 underwent nephroureterectomy. All 19 patients in Stage Ⅱb underwent nephroureterectomy. Among the 62 patients in Stage Ⅲa，60 underwent nephroureterectomy，while 2 refused surgery and were treated with the 6-month short-course anti-tuberculosis regimen. Of the 9 patients in Stage Ⅲb，8 underwent nephroureterectomy；in 1 patient，surgery was not performed due to severe adhesions in the operative field，and the patient received the 6-month short-course anti-tuberculosis regimen instead. Follow-up assessments included clinical symptoms，erythrocyte sedimentation rate（ESR），serum creatinine，degree of renal pelvic separation，and imaging findings from urinary tract CT. Efficacy was evaluated according to the following criteria：Cure was defined as clinical stability with all of the following conditions：① improvement of systemic symptoms，including absence of flank pain，fever，and lower urinary tract irritative symptoms，with normalization of erythrocyte sedimentation rate（ESR）；② negative urine culture for Mycobacterium tuberculosis；and ③ complete calcification of renal lesions and/or no evidence of tuberculous lesions at other sites. Stable disease was defined as no change in the size or extent of renal tuberculosis lesions. Progressive disease was defined as enlargement or increase in the number of tuberculous lesions or involvement of additional sites. Results:Among the 7 patients in Stage Ⅰa，follow-up imaging after treatment showed a mean renal pelvic separation of（0.44 ± 0.56）cm，which was significantly reduced compared with baseline（ t = 3.909， P = 0.008）. Five patients achieved cure，1 remained stable，and 1 showed disease progression and subsequently underwent nephroureterectomy，resulting in postoperative cure. In Stage Ⅰb，among 13 patients with hydronephrosis，post-treatment imaging showed a mean renal pelvic separation of（0.8 ± 0.75）cm，a statistically significant improvement from baseline（ t = 5.633， P < 0.01）. Six patients were cured，4 remained stable，and 3 experienced disease progression and underwent nephroureterectomy. Of the 4 patients with isolated renal tuberculosis，2 were controlled，and 2 progressed and underwent nephroureterectomy. In Stage Ⅱa，among 4 patients with tuberculous hydronephrosis，post-treatment renal pelvic separation was（1.20±0.98）cm，with no significant difference from baseline（ t = -1.675， P = 0.193）；these patients underwent nephroureterectomy 1-2 years later. The remaining 16 patients without hydronephrosis underwent nephroureterectomy and were cured. All 19 patients in Stage Ⅱb underwent nephroureterectomy；17 were cured，and 2 developed ipsilateral perirenal fluid collections 3 months postoperatively，which resolved spontaneously with the standard 6-month anti-tuberculosis regimen. Among 62 patients in Stage Ⅲa，60 underwent nephroureterectomy. Of these，54 were cured；1 developed a urinary tract infection within 2 weeks postoperatively；3 showed contralateral renal disease progression at 3 months；and 1 developed ipsilateral perirenal fluid at 3 months，which resolved spontaneously with standard anti-tuberculosis therapy. One patient developed solitary kidney failure 7 months postoperatively and underwent ureteral stent placement，with disease remaining stable thereafter. Two patients refused surgery and received only anti-tuberculosis therapy；during follow-up，1 patient experienced disease progression and died of disseminated tuberculosis after 1 year，while the other developed contralateral renal involvement at 3 months and received standard 6-month therapy，with disease remaining stable. Among 9 patients in Stage Ⅲb，8 underwent nephroureterectomy and were cured. One patient，with severe adhesions precluding surgery，received anti-tuberculosis therapy alone，and disease remained stable over a 2-year follow-up. Conclusions:The CT-based staging system for renal tuberculosis proposed in this study（three stages and six subtypes）effectively reflects the severity of renal lesions and clearly delineates the clinical characteristics and prognostic outcomes at each stage. Stage Ⅰ patients treated with anti-tuberculosis drugs combined with double-J stent placement demonstrated favorable outcomes and high renal preservation rates. In contrast，Stages Ⅱ and Ⅲ patients showed poor responses to anti-tuberculosis therapy combined with drainage，with a higher risk of disease progression and relatively worse prognosis，highlighting the recommendation for early nephroureterectomy of the affected kidney.

Objective:To explore the effect of autologous vascular graft bridging of the popliteal artery defect to reconstruct the blood supply of leg on survival of lower extremity.Methods:From May 2021 to May 2024, 10 patients with traumatic popliteal artery injury with defect were treated in the Department of Hand and Foot Surgery, Nanhua Hospital Affiliated to University of South China. A retrospective analysis was conducted on clinical data of the patients. Injury sites were: 6 in left lower extremity and 4 in right lower extremity. Causes of injury were: 4 of traffic accident, 2 of heavy object compression, 2 of electric saw, and 2 of falling from heights. Sixe patients had large vessel injury combined with fracture and (or) knee dislocation, and 4 had simple large vessel injury. Six patients had open vascular injury and 4 had closed vascular injury. There were 6 popliteal artery defect and 4 femoral artery defect, with the defects ranging from 5.0 to 10.0 cm in length. Based on the condition of the arterial defect, autologous great saphenous vein (9 patient) and small saphenous vein (1 patient) were taken and prepared to different forms of vascular bridging graft, such as "single crotch-shape" (6 patient), "double crotch-shape" (3 patient) and "triple crotch-shaped" (1 patient) vascular bridging grafts, to have the defects of popliteal artery reconstructed. Scheduled postoperative follow-up was conducted at outpatient clinic and via telephone interviews. Detailed outcomes including the peripheral blood flow, presence of necrosis or ulcer as well as patient satisfaction were recorded.Results:All of the blood vessel anastomoses in 10 patients were successful and the distal blood supply of the affected legs was restored. All of the affective legs survived. Postoperative follow-ups at 3 to 12 months showed good blood flow in the legs without necrosis nor ulcer as well as a high patient satisfaction.Conclusion:The "crotch-shaped" autologous blood vessel graft can timely and effectively reconstruct defected main artery in popliteal fossa, reduce ischemia time of the affected leg, promote extremity survival and restore its function.