Tumors exhibit abnormal glucose metabolism, consuming excessive glucose and excreting lactate, which constructs a tumor microenvironment that facilitates cancer progression and disrupts immunotherapeutic efficacy. Currently, tumor glucose metabolic dysregulation to reshape the immunosuppressive microenvironment and enhance immunotherapy efficacy is emerging as an innovative therapeutic strategy. However, glucose metabolism modulators lack specificity and still face significant challenges in overcoming tumor delivery barriers, microenvironmental complexity, and metabolic heterogeneity, resulting in poor clinical benefit. Nanomedicines, with their ability to selectively target tumors or immune cells, respond to the tumor microenvironment, co-deliver multiple drugs, and facilitate combinatorial therapies, hold significant promise for enhancing immunotherapy through tumor glucose metabolic reprogramming. This review explores the complex interactions between tumor glucose metabolism-specifically metabolite transport, glycolysis processes, and lactate-and the immune microenvironment. We summarize how nanomedicine-mediated reprogramming of tumor glucose metabolism can enhance immunotherapy efficacy and outline the prospects and challenges in this field.

Sepsis is a common critical illness in clinical practice,characterized by rapid progression and high mortality.Its complex pathogenesis remains a major focus and challenge in the field of critical care medicine.Disseminated intravascular coagulation(DIC)is one of the most frequent and severe complications of sepsis,featuring systemic activation of the coagulation cascade and microthrombus formation,significantly increasing the mortality.Coagulation factorⅫ(FⅫ),a serine protease,is considered to have therapeutic potential for thrombosis without impairing normal hemostasis.Study reveal that neutrophil extracellular trap(NET),web-like DNA structures released through a unique process known as NETosis,provide negatively charged scaffolds that promote FⅫ binding and activation,thus triggering the intrinsic coagulation cascade and contributing to a hypercoagulable state.In recent years,increasing attention has been paid to the interaction between NET and FⅫ in sepsis complicated with DIC.These 2 factors play central roles in intravascular thrombus formation and coagulation activation.Beyond their antimicrobial function,NET can aggravate tissue injury and coagulation abnormalities by releasing proinflammatory mediators such as myeloperoxidase(MPO),neutrophil elastase(NE),and reactive oxygen species(ROS).FⅫ activation can further trigger the kallikrein-kinin system(KKS)and activate FⅪ,amplifying inflammation and thrombosis in a vicious cycle.Traditional Chinese medicine(TCM),as a key component of Chinese medical heritage,has demonstrated unique advantages in managing sepsis and its complications.Based on therapeutic principles such as"strengthening healthy qi and eliminating pathogenic factors"and"tonifying qi and activating blood circulation",TCM is believed to regulate immune function and correct coagulation disorders,thereby interfering with the hypercoagulable state mediated by NET and FⅫ,slowing the progression of DIC,and improving clinical outcomes.Several herbs,including Salvia miltiorrhiza,Astragalus membranaceus,Rheum officinale,Ligusticum chuanxiong,and Curcuma longa,have shown anticoagulant,antiplatelet,and anti-inflammatory properties.In addition,compound formulations such as Xuebijing injection and Qingwen Baidu decoction have demonstrated clinical efficacy in improving coagulation parameters,reducing D-dimer levels,and protecting organ function.Although current evidence on the effects of TCM on NET formation and FⅫactivation is still limited,its potential mechanisms and clinical value warrant further investigation.This review summarizes the critical roles and interplay of FⅫand NET in sepsis complicated with DIC and discusses the advances in TCM-based interventions,aiming to provide new perspectives for mechanism-oriented research and integrative therapeutic strategies.

The term"heat stroke"originates from the integration of modern traditional Chinese and Western medicine.In clinical practice,the complementary advantages of the two medical systems can significantly enhance the clinical diagnosis and treatment level of heat stroke.Through comprehensively analyzes the traditional Chinese medicine(TCM)nomenclature for heat stroke,proposing that heat stroke is a type of sunstroke characterized by intense and pure yang nature,specifically referring to symptoms caused directly or indirectly by hot weather.It can be referenced under the categories of Zhongye,Shuwen,Yinshu/Yangshu,Shujue,and Shufeng for treatment.The article reviews the TCM diagnostic and therapeutic thinking for heat stroke,summarizing its etiology and pathogenesis,including summerheat directly entering the Yangming,heat entering the heart and nutrient-blood aspects,evil combined with water(post-emergency),dual injury of qi and fluid(post-mild recovery),and phlegm-stasis obstructing collaterals(post-severe recovery).Based on years of clinical experience and combining the different clinical manifestations of heat stroke with TCM's four diagnostic methods,the article proposes a treatment plan that integrates Chinese and Western medicine,combining disease differentiation with syndrome differentiation.The main syndromes summarized include high fever with spasms(Yangming heat excess syndrome),diarrhea(Yangming fu syndrome-intestinal sweating),high fever with coma(heat entering the heart-nutrient syndrome),high fever with convulsions(extreme heat generating wind syndrome),heat stroke-induced coagulopathy(heat entering the blood aspect syndrome),edema after fluid resuscitation(Taiyang water retention syndrome),recovery phase(dual injury of qi and fluid syndrome),and sequelae(phlegm-stasis obstructing collaterals syndrome).For treatment,Baihu Jia Renshen decotion combined with Zengye Chengqi decotion is used for nourishing yin and increasing fluids,relaxing tendons,and stopping spasms for Yangming heat excess syndrome;Baihu decotion combined with Zengye decotion for clearing summerheat and nourishing yin for Yangming fu syndrome-intestinal sweating;Qingying decotion for clearing the nutrient aspect and cooling blood,penetrating heat,and nourishing yin for heat entering the heart-nutrient syndrome;Lingjiao Gouteng decotion for clearing heat and cooling the liver,extinguishing wind,and calming spasms for extreme heat generating wind syndrome;Wuling powder for draining and eliminating water retention for Taiyang water retention syndrome;Wang's Qing Shu Yiqi decotion for clearing summerheat and reducing fever,benefiting qi,and generating fluids for dual injury of qi and fluid syndrome;and Sanjia powder for clearing residual heat,resolving phlegm,and removing stasis from collaterals for phlegm-stasis obstructing collaterals syndrome.Starting from TCM theory and linking it with practice,the article combines Western disease differentiation with TCM syndrome differentiation,aiming to provide new ideas for the clinical treatment of heat stroke.

China's vast territory has experienced significant climate change trends in recent years,characterized by reduced regional temperature differences and prolonged high-temperature durations.In some areas,summer temperatures can exceed 39℃.Consequently,the incidence of heat stroke has risen annually,emerging as a critical and life-threatening emergency threatening public health.Ethnomedicine,developed through long-term practice across diverse ethnic groups,has cultivated regionally tailored therapeutic approaches for heat stroke based on local climatic conditions and population-specific physiological traits,offering varied treatment options for patients in different areas.However,the absence of unified ethnic medical diagnostic and therapeutic guidelines has constrained the broader application and advancement of these practices.To leverage the unique advantages of ethnic medicine in heat stroke management and enhance clinical standardization,led by the China Medical Association of Minorities:collaborated with authoritative institutions and experts in multi-ethnic medicine.Through systematic collation of ethnic medical experiences in heat stroke prevention and treatment,the team formulated the expert consensus on multi-ethnic medical diagnosis and treatment of heat stroke(2024).This consensus synthesizes shared principles across ethnic medical systems while integrating their distinct theoretical frameworks and clinical practices,yielding scientifically rigorous,practical,and widely applicable recommendations to guide clinical interventions in traditional Chinese medicine(TCM)and ethnic medicine.While ethnic medical systems differ in their etiological and pathophysiological interpretations of heat stroke,they collectively emphasize holistic regulation and adaptive treatment strategies aligned with seasonal and geographical contexts.For instance,TCM,Zhuang medicine,Miao medicine,Mongolian medicine,and Tibetan medicine employ unique methodologies:such as harmonizing qi and blood,balancing body fluids,and dispelling dampness:to address heat stroke through comprehensive interventions.These approaches include oral formulations,external therapies,specialized acupuncture-moxibustion techniques,and herbal baths,demonstrating rich clinical value.The establishment of this consensus lays a foundational framework for the standardized application of ethnic medicine in heat stroke prevention and treatment.It provides innovative insights and practical evidence for optimizing integrated rescue protocols and advancing the evidence-based integration of traditional and modern medical practices.

Objective:To visually analyze the research hotspots and development trends of traditional Chinese medicine (TCM) treatment for hypertension combined with anxiety by CiteSpace 6.4.R1 software over the past decade.Methods:The Chinese literatures on the treatment of hypertension combined with anxiety by TCM published between February 2015 and February 2025 were retrieved from CNKI, Wanfang database and VIP database.Visualization analysis was conducted using CiteSpace 6.4.R1 software to visualize the keywords, authors, and author institutions of literatures.Results:A total of 321 articles were included, showing a fluctuating upward publication trend with a peak of 42 articles in 2023. The author's co-occurrence analysis found that the core research team had not yet been formed. Shandong University of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Beijing University of Chinese Medicine, and Nanjing University of Chinese Medicine were the main research institutions. Keyword co-occurrence analysis, keyword clustering analysis, and keyword timeline chart showed that the research field mainly focused on symptom improvement, syndrome differentiation, and treatment methods.Conclusion:In the past decade, there has been an increasing amount of researches on the TCM treatment for hypertension combined with anxiety, with clinical studies remaining research hotspots. In the future, research on TCM treatment for hypertension combined with anxiety should strengthen cooperation among research institutions, form representative core research teams, and further enrich research methods.

BACKGROUND:Synovitis is involved in all stages of osteoarthritis and is a key factor contributing to the development of osteoarthritis.Studies have shown that circular RNA(circRNA)plays an important role in the proliferation,apoptosis and extracellular matrix degradation of synovial cells and chondrocytes.OBJECTIVE:To observe the effects of circRNA SEC24A on the interleukin-1β-induced proliferation,apoptosis,and expression of inflammatory factors in human synovial fibroblasts.METHODS:Human synovial fibroblasts were divided into four groups,including control group,interleukin-1β group,empty vector group,and sh-circSEC24A group.Except for the control group,the other three groups were induced with 10 ng/mL interleukin-1β for 24 hours to establish inflammatory cell models;the empty vector group and sh-circSEC24A group were infected with empty vector virus and lentiviral vector knocking down circSEC24A.CCK-8 assay was used to detect cell proliferation.Flow cytometry was used to detect cell apoptosis.ELISA was used to detect the levels of matrix metalloproteinase-9,matrix metalloproteinase-13,interleukin-6,and tumor necrosis factor-α in cell supernatant.Western blot assay was used to detect the relative expression levels of Bax,Bcl-2,matrix metalloproteinase-9,matrix metalloproteinase-13,casepase3,cleaved-casepase3,casepase8,and cleaved-casepase8 proteins in cells.RESULTS AND CONCLUSION:(1)qRT-PCR results showed that compared with the normal group,the expression of circSEC24A in human synovial fibroblasts induced by interleukin 1β was significantly up-regulated.(2)The absorbance value of cells in the sh-circSEC24A group detected by CCK-8 assay was significantly higher than that of interleukin 1β group and empty vector group(P＜0.05).The apoptosis rate of sh-circSEC24A group detected by flow cytometry was significantly lower than that of interleukin 1β group and empty vector group(P＜0.05).(3)The levels of tumor necrosis factor α and interleukin 6 in the supernatant of human synovial fibroblasts in the sh-circSEC24A group detected by ELISA were significantly lower than those in the interleukin 1β group and the empty vector group(P＜0.01,P＜0.001).(4)Western blot assay results showed that compared with the interleukin 1β group and the empty vector group,the expression of the pro-apoptotic factor Bax protein in the sh-circSEC24A group significantly decreased,and the expression of the anti-apoptotic factor Bcl-2 protein increased significantly(P＜0.05);apoptosis and related activating factors cleaved-casepase3 and cleaved-casepase8 protein expressions were both reduced(P＜0.05).(5)ELISA and western blot assay results showed that compared with the interleukin 1β group and the empty vector group,the sh-circSEC24A group had lower levels of matrix metalloproteinase 9 and matrix metalloproteinase 13 protein(P＜0.05).These findings indicated that the expression of circSEC24A was abnormally increased in human synovial fibroblasts induced by interleukin 1β.Knocking down circSEC24A expression could promote the proliferation of human synovial fibroblasts and inhibit apoptosis,inflammatory factor release,and extracellular matrix degradation,suggesting that circSEC24A may be an important intervention target for early osteoarthritis.

Objective:To visually analyze the research hotspots and development trends of traditional Chinese medicine (TCM) treatment for hypertension combined with anxiety by CiteSpace 6.4.R1 software over the past decade.Methods:The Chinese literatures on the treatment of hypertension combined with anxiety by TCM published between February 2015 and February 2025 were retrieved from CNKI, Wanfang database and VIP database.Visualization analysis was conducted using CiteSpace 6.4.R1 software to visualize the keywords, authors, and author institutions of literatures.Results:A total of 321 articles were included, showing a fluctuating upward publication trend with a peak of 42 articles in 2023. The author's co-occurrence analysis found that the core research team had not yet been formed. Shandong University of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Beijing University of Chinese Medicine, and Nanjing University of Chinese Medicine were the main research institutions. Keyword co-occurrence analysis, keyword clustering analysis, and keyword timeline chart showed that the research field mainly focused on symptom improvement, syndrome differentiation, and treatment methods.Conclusion:In the past decade, there has been an increasing amount of researches on the TCM treatment for hypertension combined with anxiety, with clinical studies remaining research hotspots. In the future, research on TCM treatment for hypertension combined with anxiety should strengthen cooperation among research institutions, form representative core research teams, and further enrich research methods.

The term"heat stroke"originates from the integration of modern traditional Chinese and Western medicine.In clinical practice,the complementary advantages of the two medical systems can significantly enhance the clinical diagnosis and treatment level of heat stroke.Through comprehensively analyzes the traditional Chinese medicine(TCM)nomenclature for heat stroke,proposing that heat stroke is a type of sunstroke characterized by intense and pure yang nature,specifically referring to symptoms caused directly or indirectly by hot weather.It can be referenced under the categories of Zhongye,Shuwen,Yinshu/Yangshu,Shujue,and Shufeng for treatment.The article reviews the TCM diagnostic and therapeutic thinking for heat stroke,summarizing its etiology and pathogenesis,including summerheat directly entering the Yangming,heat entering the heart and nutrient-blood aspects,evil combined with water(post-emergency),dual injury of qi and fluid(post-mild recovery),and phlegm-stasis obstructing collaterals(post-severe recovery).Based on years of clinical experience and combining the different clinical manifestations of heat stroke with TCM's four diagnostic methods,the article proposes a treatment plan that integrates Chinese and Western medicine,combining disease differentiation with syndrome differentiation.The main syndromes summarized include high fever with spasms(Yangming heat excess syndrome),diarrhea(Yangming fu syndrome-intestinal sweating),high fever with coma(heat entering the heart-nutrient syndrome),high fever with convulsions(extreme heat generating wind syndrome),heat stroke-induced coagulopathy(heat entering the blood aspect syndrome),edema after fluid resuscitation(Taiyang water retention syndrome),recovery phase(dual injury of qi and fluid syndrome),and sequelae(phlegm-stasis obstructing collaterals syndrome).For treatment,Baihu Jia Renshen decotion combined with Zengye Chengqi decotion is used for nourishing yin and increasing fluids,relaxing tendons,and stopping spasms for Yangming heat excess syndrome;Baihu decotion combined with Zengye decotion for clearing summerheat and nourishing yin for Yangming fu syndrome-intestinal sweating;Qingying decotion for clearing the nutrient aspect and cooling blood,penetrating heat,and nourishing yin for heat entering the heart-nutrient syndrome;Lingjiao Gouteng decotion for clearing heat and cooling the liver,extinguishing wind,and calming spasms for extreme heat generating wind syndrome;Wuling powder for draining and eliminating water retention for Taiyang water retention syndrome;Wang's Qing Shu Yiqi decotion for clearing summerheat and reducing fever,benefiting qi,and generating fluids for dual injury of qi and fluid syndrome;and Sanjia powder for clearing residual heat,resolving phlegm,and removing stasis from collaterals for phlegm-stasis obstructing collaterals syndrome.Starting from TCM theory and linking it with practice,the article combines Western disease differentiation with TCM syndrome differentiation,aiming to provide new ideas for the clinical treatment of heat stroke.

China's vast territory has experienced significant climate change trends in recent years,characterized by reduced regional temperature differences and prolonged high-temperature durations.In some areas,summer temperatures can exceed 39℃.Consequently,the incidence of heat stroke has risen annually,emerging as a critical and life-threatening emergency threatening public health.Ethnomedicine,developed through long-term practice across diverse ethnic groups,has cultivated regionally tailored therapeutic approaches for heat stroke based on local climatic conditions and population-specific physiological traits,offering varied treatment options for patients in different areas.However,the absence of unified ethnic medical diagnostic and therapeutic guidelines has constrained the broader application and advancement of these practices.To leverage the unique advantages of ethnic medicine in heat stroke management and enhance clinical standardization,led by the China Medical Association of Minorities:collaborated with authoritative institutions and experts in multi-ethnic medicine.Through systematic collation of ethnic medical experiences in heat stroke prevention and treatment,the team formulated the expert consensus on multi-ethnic medical diagnosis and treatment of heat stroke(2024).This consensus synthesizes shared principles across ethnic medical systems while integrating their distinct theoretical frameworks and clinical practices,yielding scientifically rigorous,practical,and widely applicable recommendations to guide clinical interventions in traditional Chinese medicine(TCM)and ethnic medicine.While ethnic medical systems differ in their etiological and pathophysiological interpretations of heat stroke,they collectively emphasize holistic regulation and adaptive treatment strategies aligned with seasonal and geographical contexts.For instance,TCM,Zhuang medicine,Miao medicine,Mongolian medicine,and Tibetan medicine employ unique methodologies:such as harmonizing qi and blood,balancing body fluids,and dispelling dampness:to address heat stroke through comprehensive interventions.These approaches include oral formulations,external therapies,specialized acupuncture-moxibustion techniques,and herbal baths,demonstrating rich clinical value.The establishment of this consensus lays a foundational framework for the standardized application of ethnic medicine in heat stroke prevention and treatment.It provides innovative insights and practical evidence for optimizing integrated rescue protocols and advancing the evidence-based integration of traditional and modern medical practices.

OBJECTIVE To explore the effect of artificial intelligence(AI)-based hand hygiene examination system on raising the accurate rate and qualified rate of hand hygiene tests of the logistics personnel.METHODS A total of 381 logistics personnels who were on duty in the Third Affiliated Hospital of Naval Medical University from Oct.2023 to Mar.2024 were recruited as the research subjects and were organized to take part in the training of hand hygiene theory and operation.The AI hand hygiene examination system was used for the assessment of 5 rounds of seven-step handwashing methods.The accurate rate of each single hand hygiene step and the total quali-fied rate were statistically analyzed before and after the training.RESULTS After the rounds of assessment with the use of AI hand hygiene examination system,the qualified rate of hand hygiene of the 381 logistics personnel was 96.06％after the training,higher than 12.34％before the training(x2=662.053,P＜0.001).The accurate rates of the steps of the seven-step handwashing method increased,and the accurate rates of[4L]left knuckle ro-tational rubbing(x2=347.676,P＜0.001),[4R]right knuckle rotational rubbing(x2=330.724,P＜0.001),[5L]left thumb rotational rubbing(x2=490.733,P＜0.001)and[5R]right thumb rotational rubbing(x2=438.805,P＜0.001)increased remarkably.CONCLUSION As compared with the traditional assessment mode for the seven-step handwashing training,the information technology based on AI hand hygiene examination system can effectively remedy the limitations of the direct monitoring of the observer such as'Hawthorne effect'and inca-pable of retrospective review of performance,and it can remarkably raise the accurate rate of hand hygiene and to-tal qualified rate of hand hygiene of the logistics personnel.