Age-related macular degeneration(ARMD)is a progressive visual impairment fundus disease that frequently occurs in individuals aged >55 years. The main risk factors are aging, long-term smoking, genetics, and racial differences. Pathogenesis includes abnormal function of the retinal pigment epithelium, damaged blood-retinal barrier, and abnormal immune function. Currently, intravitreal injection(IVI)of anti-vascular endothelial growth factor(VEGF)drugs is the preferred treatment option for ARMD in clinical practice. However, it also faces challenges such as repeated treatments, high medical costs, and poor patient compliance. The predicament in the treatment of ARMD has given rise to several new treatment options. This article aims to review the treatment methods and progress of dry ARMD and wet ARMD, providing new ideas for addressing the limitations of the current clinical anti-VEGF treatment.

Atherosclerosis is a chronic vascular disease caused by lipid deposition in the inner wall of blood vessels.Ferroptosis is a non-apoptotic form of cell death characterized by iron dependence and lipid reactive oxygen accumulation.Recent studies have shown that ferroptosis is closely related to the occurrence and development of atherosclerosis.This article explained the correlation between ferroptosis and atherosclerosis from the aspects of foam cell formation,endothelial cell death,vascular smooth muscle proliferation and calcification,and believed that ferroptosis runs through its pathological process.By combing the current research status of the mechanism of Chinese materia medica regulating ferroptosis to treat atherosclerosis,it can be seen that TCM monomers and compounds can reduce endothelial cell dysfunction and inflammatory response,slow down oxidative stress levels,and reduce the accumulation of oxidized lipids under the intima of arterial blood vessels by regulating ferroptosis p53,Nrf2 signaling pathway,amino acid metabolism,lipid metabolism,etc.,so that the blood vessels reach homeostasis,which can provide a reference for the exploration of clinical treatment strategies for atherosclerosis.

OBJECTIVE To observe the distribution of pathogens isolated from the endoscopic submucosal dissection(ESD)patients with postoperative pulmonary infections and explore the values of serum C-reactive protein(CRP),interleukin-6(IL-6)and procalcitonin(PCT)in prediction of the pulmonary infection.METHODS A total of 246 patients who received ESD in the First Affiliated Hospital of Wenzhou Medical University from Dec.2022 to Dec.2023 were recruited as the research subjects and were divided into the infection group with 50 cases and the non-infection group with 196 cases according to the status of postoperative pulmonary infection.The sputum speci-mens were collected from the patients of the infection group,the isolated pathogens were identified.The risk fac-tors for the postoperative pulmonary infection in the ESD patients were analyzed.The levels of serum CRP,IL-6 and PCT were compared between the infection group and the non-infection group.The values of the indexes in pre-diction of the postoperative pulmonary infection in the ESD patients were observed.RESULTS Totally 67 strains of pathogens were isolated from the 50 patients with infection,21(31.34％)of which were gram-positive bacteria,37(55.22％)were gram-negative bacteria,and 9(13.43％)were fungi.The no less than 60 years of age(OR=4.785),complication with diabetes mellitus(OR=20.627),operation duration no less than 60 min(OR=19.643)and bedridden time no less than1 week(OR=38.641)were the risk factors for the postoperative pulmonary infec-tion in the ESD patients(P＜0.05).There were significant differences in the levels of serum CRP,IL-6 and PCT between the infection group and the non-infection group(P＜0.05).The sensitivity of the joint detection of serum CRP,IL-6 and PCT was 96.00％in prediction of the postoperative pulmonary infection in the ESD patients,with the specificity 83.67％,the AUC value 0.898,which were superior to the single detection of CRP,IL-6 and PCT(P＜0.05).CONCLUSIONS The ESD patients are at high risk of postoperative pulmonary infection.The gram-negative bacteria are dominant among the pathogens.There are a variety of influencing factors for the postopera-tive pulmonary infection in the ESD patients.The CRP,IL-6 and PCT have certain values in prediction of the postoperative pulmonary infection in the ESD patients.

Objective To establish models for real-time dynamic monitoring of intracellular cytoplasmic adenosine triphosphate(ATP)and mitochondrial ATP levels in cells in order to study the changes in metabolic processes.Methods The lentiviral plasmids of the cytoplasmic chemogenetic green fluorescent protein(GFP)ATP probe(Chemo-G)and those of the mitochondrial-localized chemogenetic GFP ATP probe(mito-Chemo-G)were constructed before being transfected into HEK293T together with the helper plasmids,respectively.Chemo-G and mito-Chemo-G lentiviruses were obtained.HeLa cells were infected with the lentivirus.Puromycin resistance selection and flow cytometry cell sorting were employed to identify and isolate the infected HeLa cells.The growth and GFP expressions of HeLa cells were observed.A live-cell imaging system was used for continuous imaging of the cells,with stimuli added at specific time points to alter intracellular ATP levels to observe changes in the fluorescence intensity of the ATP probe.Results Lentiviral plasmids containing Chemo-G and mito-Chemo-G sequences were constructed.Two cell lines which could stably express Chemo-G and mito-Chemo-G were established that exhibited strong growth and accurate intracellular fluorescence localization.Live-cell imaging revealed that after the addition of 2-deoxy-D-glucose(2-DG)into HeLa-Chemo-G,the fluorescence resonance energy transfer(FRET)/GFP ratio showed a decrease that was partially reversed by the addition of glucose.The FRET/GFP ratio increased after histamine stimulation,but rapidly decreased after the addition of oligomycin.Conclusion The Chemo-G and mito-Chemo-G lentiviral vectors and stably transfected cell lines HeLa-Chemo-G and HeLa-mito-Chemo-G are constructed,which provides reliable experimental models for studying cellular metabolism and changes in intracellular ATP levels.

Banxia Xiexin Decoction has the effect of harmonizing the spleen and stomach,and regulating cold and heat.It is mainly used for the treatment of epigastric fullness of mixed cold and heat in the heart,and has certain advantages in relieving symptoms,reducing recurrence rates,and ensuring safety.This article reviewed the clinical application of Banxia Xiexin Decoction from the perspectives of digestive system diseases,neurological diseases,gastrointestinal tumors,respiratory system diseases,endocrine diseases,dermatological diseases,gynecological diseases,and other diseases.It also summarized the mechanism of Banxia Xiexin Decoction from the aspects of protection of gastrointestinal mucosa,anti-inflammatory and bactericidal effects,immune regulation,regulation of neurotransmitters,anti-tumor effects,blood glucose lowering,and improvement of insulin resistance,providing reference for the in-depth research and application of Banxia Xiexin Decoction.

Objective To explore the action targets and related mechanisms of pogostemon cablin in the treatment of glioma based on network pharmacology and cellular experiments.Methods The active ingredi-ents and action targets of pogostemon cablin were collected by using databases such as the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP)and the Traditional Chinese Med-icine Comprehensive Database(TCMID).The relevant targets of glioma were collected through databases such as Gene Cards and OMIM,and the network diagrams of"drug-target"and"disease-target"were estab-lished by using Cytoscape3.7.1 software.The intersection targets of pogostemon cablin for treating glioma were obtained and STRING database was used to analyzed,and their protein-protein interaction(PPI)net-work diagram was established.Gene Ontology(GO)functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis on key targets were performed by using the DAVID database.In vitro cell experiments on key signaling pathways were conducted,U87 glioma cells were collected and divided into the control group(added to basic culture medium)and the 60,90,120 μg/mL pog-ostemon cablin groups(added to culture medium containing 60,90,and 120 μg/mL pogostemon cablin,respec-tively).CCK-8 assay and wound healing assay were used to detect the proliferation and migration ability of each group of cells,and the protein expression levels of mitogen activated protein kinase 1(MAPK1),recom-binant V-rel reticuloendotheliosis viral oncogene homolog A(RELA)phosphatidylinositol 3-kinase(PI3K),protein kinase B(Akt),phosphorylated-PI3K(p-PI3K),and phosphorylated-Akt(p-Akt)in each group of cells were detected by Western blot.Results A total of 94 main chemical constituents of pogostemon cablin were obtained.According to the screening conditions,9 effective active ingredients,239 drug target proteins,4 526 glioma related genes and 121 drug and disease common targets were identified.Protein interaction net-works discovered that Akt1,c-Jun N-terminal kinase(JUN),MAPK1,RELA,interleukin(IL)-6 and epider-mal growth factor receptor(EGFR)may be the key targets of pogostemon cablin in the treatment of glioma.GO function enrichment analysis identified 1 819 items in biological processes,109 items of cellular compo-nents and 216 items of molecular functions,which involved various aspects such as the positive regulation of the cellular metabolic process,the activity of protein homodimers,kinase activation,and membrane rafts.KEGG pathway enrichment analysis identified 181 related signaling pathways,involving anti-cancer,inflamma-tion,cell apoptosis,endocrine,immune regulation and so on,mainly including the PI3K/Akt pathway,ad-vanced glycation advanced glycation end products(AGE)/recepter for advanced glycation end products(RAGE)pathway,IL-6 pathway,and HIF-1 pathway,TNF pathway and so on.The in vitro experimental re-sults showed that compared with the control group,with the increase of the dose of the alcohol extract of pog-ostemon cablin,the cell activity decreased,the cell migration ability decreased,and the expression levels of MAPK1,RELA,p-PI3K and p-Akt proteins decreased(P＜0.05).Conclusion Pogostemon cablin can syner-gistically inhibit the development of glioma through multiple targets and pathways,and can suppress cell pro-liferation of U87 cells through the PI3K/Akt pathway.

ObjectiveTo investigate the effect and molecular mechanism of exosomes derived from bone marrow mesenchymal stem cells（BMSC-exos） modified with Bushen Yisui capsule（BSYS）-containing serum on promoting the differentiation and maturation of OLN-93 oligodendrocytes by regulating miR-15b/Wnt signaling pathway. MethodsOLN-93 cells were divided into 5 groups， including the normal（NC） group， BMSC-exos group， BSYS-BMSC-exos group， BSYS-BMSC+LV-miR-15b-5p inhibitor-exos group， and BSYS-BMSC+LV-miR-15b-5p NC-exos group. DiR staining was used to observe the uptake of Exos by OLN-93 cells. The effective dosage of BSYS-BMSC-exos on OLN-93 cells was assessed by cell proliferation and activity assay（CCK-8）. Stable BMSCs lentiviral transfection strains were established to inhibit miR-15b-5p expression in both BMSCs and their exos， and transfection efficiency was verified by real-time fluorescent quantitative polymerase chain reaction（Real-time PCR） detection of miR-15b-5p. The expressions of 2′，3′-cyclic nucleotide 3′-phosphodiesterase（CNPase） and myelin proteolipid protein（PLP） in OLN-93 cells were detected by immunocytochemistry（ICC） and Western blot. The mRNA expressions of miR-15b-5p and Wnt3a in OLN-93 cells were detected by Real-time PCR， and the protein expression of Wnt3a was measured by Western blot. The expression levels of key molecules in the Wnt/β-catenin signaling pathway of OLN-93 cells， including glycogen synthase kinase（GSK）-3β， β-catenin， and T-cell specific transcription factor 4/transcription factor 7-like 2（TCF4/TCF7L2）， were measured by Real-time PCR and Western blot. ResultsDiR-labeled Exos were efficiently taken up by OLN-93 cells. The CCK-8 assay results indicated that 20 mg·L^-1 of BSYS-BMSC-exos exhibited the most significant effect in enhancing OLN-93 cell viability（P<0.01） and this dosage was selected for subsequent experiments. Following lentiviral transfection of BMSCs， Real-time PCR results revealed that miR-15b-5p was significantly suppressed in BMSCs（P<0.01）， and miR-15b-5p was also notably inhibited in BSYS-BMSC-exos（P<0.01）. ICC analysis further revealed an increase in the number of differentiated， mature CNPase and PLP-positive cells following BSYS-BMSC-exos treatment（P<0.01）. Western blot results demonstrated that the protein expression of CNPase and PLP was significantly enhanced with BSYS-BMSC-exos treatment（P<0.01）. Additionally， BSYS-BMSC-exos also increased the expression levels of miR-15b-5p and p-β-catenin proteins in OLN-93 cells， while decreased the mRNA and protein expressions of Wnt3a， as well as the mRNA expressions of β-catenin and TCF4/TCF7L2， and the protein expression level of p-GSK-3β（Ser9） was significantly reduced（P<0.05， P<0.01）. After the transfection of miR-15b-5p inhibitor into BSYS-BMSC-exos， the above effects were significantly diminished（P<0.05， P<0.01）. ConclusionBSYS-BMSC-exos facilitate the differentiation and maturation of OLN-93 cells， and its mechanism is related to the upregulation of miR-15b-5p in OLN-93 cells， which inhibits the expression of Wnt3a and thereby suppresses the Wnt signaling pathway.

ObjectiveTo explore the current situation and influencing factors of humanistic care experience among patients visiting traditional Chinese medicine （TCM） outpatient clinics in China， and to provide a basis for optimizing TCM-characterized services in both TCM and Western medicine hospitals. MethodsA multi-center cross-sectional study was conducted using convenience sampling to select 35 hospitals across 13 provinces in China （including 3 TCM hospitals and 32 TCM outpatient clinics in general hospitals）. A total of 3，430 patients were surveyed using the general information questionnaire and the Outpatient Humanistic Care Experience Questionnaire， with data collected via Questionnaire Star. Univariate analysis and multiple linear regression were employed to examine the impacts of patient characteristics， visit characteristics， hospital type （TCM hospital/general hospital）， and geographic region （eastern/central/western） on humanistic care experience. ResultsThe total score of humanistic care experience was 194 （188， 233）. Univariate analysis showed that gender， educational level， current residence， per capita monthly household income， location attribute of medical institutions， number of previous visits to this hospital， payment method of medical expenses， previous hospitalization history in this hospital， frequency of outpatient visits within the past 12 months， self-rated disease severity， familiarity with the outpatient procedures， implementation of the follow-up service provided by the hospital， satisfaction with follow-up services， the grade of the hospital visited， geographical region of the hospital visited， and the department visited had an impact on the humanistic care experience during outpatient visits （P<0.05）. Multivariate analysis demonstrated that educational level （β=0.609， P=0.011）， self-rated disease severity （β=-0.646， P=0.047）， familiarity with outpatient procedures （β=4.784， P<0.001）， satisfaction with follow-up services （β=6.365， P<0.001）， and the grade of the hospital visited （β=-5.487， P<0.001） affected the humanistic care experience in outpatient medical treatment， explaining 24.4% of the total variation. ConclusionHumanistic care experience in TCM outpatient clinics is influenced by multiple factors. It is recommended to optimize the medical treatment process， strengthen doctor-patient communication training， and establish a precise follow-up mechanism， with a focus on improving care perceptions among patients with lower education levels and those attending primary-level hospitals， to refine the TCM-characterized service system.

Objective:To systematically evaluate predictive models for stress urinary incontinence (SUI) in pregnant and postpartum women, providing a reference for model development, application, and promotion.Methods:A comprehensive literature search was conducted in PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, and China Biology Medicine disc for studies on SUI predictive models in pregnant and postpartum women. The search period was from database inception to September 30, 2024. Two researchers independently screened the literature and extracted data according to inclusion and exclusion criteria. The risk of bias in the predictive models was assessed using the prediction model risk of bias assessment tool.Results:A total of 23 studies were included, covering 31 predictive models for SUI, with a combined sample size of 14 473 women. Among them, six models focused on predicting SUI in pregnant women, while 25 models were developed for postpartum SUI. The predictive factors identified in these models were categorized into nine groups, including: general information for pregnant and postpartum women, delivery data, neonatal data, past history, abortion history, lifestyle data, pelvic floor muscle screening results, 2D and 3D ultrasound data, and serological indicators. Among these, age, mode of delivery, parity, body mass index, history of SUI, and neonatal weight were widely recognized as key predictive factors. External validation was performed in five studies. Five studies showed good applicability and low bias risk, except for one study that had limitations in both bias risk and applicability, and the remaining studies exhibited a high risk of bias but demonstrated good applicability.Conclusions:The methodological quality of SUI predictive models for pregnant and postpartum women needs further improvement. External validation remains insufficient. Future model development should be based on large-sample, prospective studies, incorporating appropriate predictive factors and stratifying SUI risk in different populations to enhance clinical applicability.

Objective:To search, evaluate, and summarize evidence regarding strategies to promote pelvic floor muscle contraction (PFMC) function in postpartum women, providing a basis for clinical practice.Methods:A comprehensive search was conducted in computer decision support systems, guideline websites, relevant professional association websites, and English and Chinese databases for evidence related to strategies to promote PFMC function in postpartum women. The sources included guidelines, expert consensus, evidence summaries, systematic reviews, and original studies, with the search period from June 2014 to January 2025. Two researchers independently assessed the quality of the included articles and extracted data for the evidence summary.Results:A total of 24 articles were included: nine guidelines, five expert consensus, three evidence summaries, two systematic reviews, and five original studies. The evidence was summarized across four domains: screening and assessment, team building, intervention strategies, and outcome evaluation, resulting in 25 key pieces of evidence.Conclusions:This study summarizes the best evidence for strategies to promote PFMC function in postpartum women, providing scientific and rigorous evidence for clinical practice. It supports the development of effective training programs to enhance postpartum women's quality of life.