As the core vehicle for preserving and transmitting traditional Chinese medicine（TCM） academic thought and clinical experience， the establishment of a robust quality evaluation system for TCM clinical case reports is a crucial component in the current standardization and modernization of TCM. Based on the practical experience of constructing the China Clinical Cases Library of Traditional Chinese Medicine by the China Association of Chinese Medicine， this study conducted a comprehensive analysis of critical challenges， including insufficient authenticity and unfocused evaluation criteria. It proposed a three-dimensional evaluation framework grounded in the structure-process-outcome logic， encompassing three dimensions of authenticity and standardization， characteristics and advantages， application and translational impact. This framework integrated 12 key evaluation indicators in a systematic manner. The model preserved the academic characteristics of TCM syndrome differentiation and treatment， while aligning with modern scientific research standards， achieving a balance between individualized TCM experience and standardized evaluation. Concurrently， this study provided theoretical foundations and methodological guidance for evaluating the quality of TCM clinical cases， contributing significantly to the inheritance of TCM knowledge， evidence-based practice， and the reform of talent evaluation mechanisms.

Non-alcoholic fatty liver disease （NAFLD） is one of the most prevalent forms of liver diseases globally. Its progression can lead to cirrhosis and end-stage liver disease， and there is currently a lack of effective pharmacological treatments. Adenosine monophosphate-activated protein kinase （AMPK）， as a regulatory hub for maintaining cellular energy homeostasis， can coordinate key cellular processes such as adipogenesis， glucose metabolism， and mitochondrial functions. Its activation exerts metabolic regulatory effects through pathways including inhibiting lipogenesis， enhancing mitochondrial β-oxidation， regulating inflammation and oxidative stress， and promoting autophagy. Accordingly， AMPK emerges as a potential target for the prevention and treatment of NAFLD. Traditional Chinese Medicine （TCM）， with low toxicity， high accessibility， and multi-component， multi-target synergistic effects， has demonstrated unique value in NAFLD treatment， particularly showing notable advantages in regulating the AMPK signaling pathway. Sichuan is known as the treasure house of TCM， and the active components of its authentic medicinal materials such as Coptidis Rhizoma not only reflect regional characteristics in AMPK signaling regulation but also form a multi-level metabolic regulatory network through crosstalk with pathways such as sirtuin 1 （SIRT1） and peroxisome proliferator-activated receptor α （PPARα）. They can achieve specific regulation by directly activating AMPK and modulating upstream and downstream targets， exerting prominent effects in ameliorating hepatic steatosis and inflammation. This study systematically reviews the research findings on TCM for the prevention and treatment of NAFLD over the past five years， elaborating the mechanisms by which TCM treats NAFLD through regulating the AMPK signaling pathway. It aims to provide new perspectives and references for clinical diagnosis and treatment， basic research， and drug development.

Objective To explore the effect of job satisfaction on job burnout among administrative staff in public hospitals and to examine the mediating effect of career growth in this relationship. Methods A total of 384 administrative staff from 20 public hospitals in Tianjin City were recruited as participants using the convenience sampling method. Their job burnout, job satisfaction, and career growth were measured with the Maslach Burnout Inventory, Job Satisfaction Scale, and Career Growth Scale, respectively. A structural equation model was constructed using AMOS 23.0, and the mediating effect was examined with the Bootstrap method. Results The mean scores of job burnout, job satisfaction, and career growth among participants were (43.1±15.4), (14.4±5.7), and (8.3±4.2), respectively. The results of the mediating effect analysis showed that career growth played a significant mediating role between job satisfaction and job burnout among the public hospital administrative staff, with the mediating effect accounting for approximately 22.2% to 52.2% of the total effect. Conclusion Job satisfaction of public hospital administrative staff can directly affect their job burnout, and it can also influence job burnout through the mediating effect of career growth. Effective measures to improve job satisfaction and promote career growth may help alleviate job burnout among administrative staff in public hospitals.

Metabolic dysfunction-associated fatty liver disease （MAFLD） is a chronic liver condition closely associated with dysregulated lipid metabolism， with the central pathological event of mitochondrial dysfunction in hepatocytes. The mitochondrial calcium uniporter （MCU） complex is a key molecular apparatus regulating mitochondrial calcium （mtCa²⁺） homeostasis， and mtCa²⁺ overload due to its dysfunction plays a critical role in the progression of MAFLD. This article systematically elaborates on the pathogenesis of MAFLD， with a particular focus on how the central signaling axis of “MCU complex dysfunction-mtCa²⁺ overload” drives the disease progression of MAFLD by disrupting energy metabolism， activating the adenosine monophosphate-activated protein kinase signaling pathway， triggering the NOD-like receptor protein 3 inflammasome， and inducing cell death. It also points out that traditional Chinese medicine can exert an interventional effect on multiple downstream pathways through various targets and has shown unique advantages and a significant potential in alleviating MAFLD by maintaining mitochondrial homeostasis and targeting the MCU complex， and therefore， it is expected to provide new strategies for the prevention and treatment of MAFLD.

Objective To explore the role of DNAJC5B in immunotherapy for esophageal squamous cell carcinoma (ESCC). Methods Using the ESCC dataset from The Cancer Genome Atlas (TCGA) database, genes correlated with DNAJC5B expression were identified through Pearson correlation analysis. Subsequently, Gene Ontology (GO) functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed. Additionally, single-cell RNA sequencing (scRNA-seq) data were utilized to analyze the expression of DNAJC5B in different T-cell subsets. The prognostic value of DNAJC5B was evaluated using Kaplan-Meier survival curves, receiver operating characteristic curves, and Cox proportional hazards models. Results DNAJC5B was highly expressed in patients with advanced-stage ESCC, particularly in males. GO and KEGG analyses revealed a significant correlation between DNAJC5B expression and immune-related processes, such as the adaptive immune response and cell surface receptor signaling pathways. Single-cell analysis results indicated that DNAJC5B expression was positively correlated with immune function, with DNAJC5B predominantly accumulating in CD8+ T cells. Kaplan-Meier survival curves showed that the median survival time for patients with high DNAJC5B expression was 681 days, significantly shorter than the 1 361 days for patients with low expression (P<0.05). Furthermore, univariate and multivariate independent prognostic analyses demonstrated that DNAJC5B was an independent risk factor, with hazard ratios (HRs) of 3.577 and 4.114, respectively (both P<0.05). Conclusion DNAJC5B may play a crucial immunomodulatory role in ESCC, particularly in regulating CD8+ T-cell function and tumor immune escape. These findings support the potential of DNAJC5B as a biomarker for the treatment and prognostic assessment of ESCC.

ObjectiveTo screen for and validate key differentially expressed proteins in serum of patients with metabolic dysfunction‑associated fatty liver disease （MAFLD）， and to provide a basis for identifying diagnostic biomarkers and developing intervention strategies for this disease. MethodsA total of 20 patients who were diagnosed with MAFLD in the third affiliated hospital of Chengdu University of Traditional Chinese Medicine from December 2024 to January 2025 were enrolled as MAFLD group， and 20 healthy controls were enrolled as HC group. Demographic data and serum biochemical parameters were collected from both groups. Data-independent acquisition （DIA） quantitative proteomics was used to measure the relative expression levels of serum proteins， and related methods were used to obtain significantly differentially expressed proteins， including the gene ontology functional enrichment analysis， the Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis， protein-protein interaction （PPI） network， Hub node interaction， and weighted gene co-expression network analysis （WGCNA）. Rats were given a high-fat diet to establish a model of MAFLD， and randomly assigned to the control group and model group. Serum biochemical parameters and inflammatory factors were measured， liver histopathological changes were observed， and the protein expression levels of MER proto-oncogene tyrosine kinase （MERTK） and matrix metalloproteinase-9 （MMP-9） in liver tissue were verified. The independent-samples t test was used for comparison of normally distributed continuous data between groups， while the Mann-Whitney U test was used for comparison of non-normally distributed continuous data or data with heterogeneity of variance between groups； the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups. ResultsCompared with the HC group， the MAFLD group had significant increases in the serum levels of aspartate aminotransferase （t=-7.348， P<0.05）， alanine aminotransferase （Z=5.088， P<0.05）， alkaline phosphatase （t=-3.943， P<0.05）， triglyceride （Z=2.070， P<0.05）， and high-density lipoprotein cholesterol （t=3.867， P<0.05）. A total of 3 559 proteins were identified by DIA serum proteomics， among which 160 differentially expressed proteins were mainly enriched in pathways including metabolic disorders， immune inflammatory response， and extracellular matrix remodeling. The PPI network and the Hub node analysis showed that serpin family E member 1， MMP-9， and intercellular cell adhesion molecule-1 were core regulatory proteins. WGCNA showed that the MEyellow module was significantly positively correlated with MAFLD phenotype （cor=0.55， P<0.001）， which was functionally enriched in the efferocytosis pathway. MERTK （P<0.001） and MMP-9 （P<0.001） showed the most significant differential expression in this module. A rat model of MAFLD was successfully established using a high-fat diet， and compared with the control group， the model group had enlarged， yellowish， and greasy liver and disordered structure of hepatic lobules， hepatocyte fatty degeneration， and inflammatory cell infiltration based on HE staining， as well as massive lipid droplet deposition based on oil red O staining， while no obvious fibrous cords were observed in Masson staining. Compared with the control group， the model group had significant increases in the serum levels of aspartate aminotransferase （t=-5.148， P<0.05）， alanine aminotransferase （t=-5.663， P<0.05）， total bilirubin （t=-13.061， P<0.05）， triglyceride （Z=-2.722， P<0.05）， total cholesterol （t=3.588， P<0.05）， and tumor necrosis factor-α （t=-16.741， P<0.05）， as well as significant increases in the protein expression levels of MERTK （t=-11.448， P<0.001） and MMP-9 （t=-10.875， P<0.001） in liver tissue. ConclusionMMP-9 and MERTK are abnormally expressed in MAFLD and may be used as potential diagnostic biomarkers for this disease.

Objective:To evaluate the clinical efficacy of transmural follicle-activating herbal medicine combined with electroacupuncture in luteinized unruptured follicle syndrome (LUFS).Methods:A randomized controlled trial (RCT) was conducted. Totally 90 LUFS patients in our hospital from November 2018 to January 2021 were selected as the observation subjects, and were divided into three groups using a random number table method, with 30 patients in each group. The Chinese materia medica group was treated with transmural follicle-activating herbal medicine, the acupuncture-medicine combination group was treated with transmural follicle-activating herbal medicine + electroacupuncture, and the Western medicine group was treated with injection of chorionic gonadotropin (hCG). The ovarian blood flow pulsatility index (PI) and resistance index (RI) of patients before and after treatment were observed. Chemiluminescence was used to detect the levels of estradiol (E 2), progesterone (P), and LH. Ovulation, pregnancy, and LUFS recurrence and adverse reactions after treatment were observed, and clinical efficacy was evaluated. Results:The total effective rate of the acupuncture-medicine combination group was 86.67% (26/30), the Chinese materia medica group was 63.33% (19/30), and the Western medicine group was 60.00% (18/30). There was a statistical significance among the three groups ( χ2=6.03, P=0.049). After treatment, there was a statistical significance in ovarian blood flow PI (1.57 ± 0.51 vs. 1.85 ± 0.56 vs. 1.90 ± 0.61, F=2.03), RI (0.48 ± 0.14 vs. 0.57 ± 0.18 vs. 0.62 ± 0.20, F=2.16) ( P<0.05); the serum E 2 [(322.60 ± 62.31) ng/L vs. (289.58 ± 55.45) ng/L vs. (291.17 ± 63.69) ng/L, F=2.26], P [(16.36 ± 4.14) μg/L vs. (13.45 ± 3.68) μg/L vs. (13.71 ± 3.50) μg/L, F=3.58], LH [(27.19 ± 5.04) IU/ml vs. (21.52 ± 4.66) IU/ml vs. (22.58 ± 4.80) IU/ml, F=3.68] levels were compared, and the differences were statistically significant ( P<0.05, P<0.01). The ovulation rate [93.33% (28/30) vs. 66.67% (20/30) vs. 63.33% (19/30), χ2=13.01] and pregnancy rate [53.33% (16/30) vs. 30.00% (9/30) vs. 26.67% (8/30), χ2=6.11], the recurrence rate of LUFS [19.23% (5/26) vs. 47.37% (9/19) vs. 55.56% (10/18), χ2=6.94] in the needle-medicine combination group, the Chinese materia medica group and the Western medicine group after treatment were significantly different ( P<0.05). During the treatment period, there was no statistical significance in the occurrence of adverse reactions among the three groups ( χ2=2.02, P=0.364). Conclusion:The transmural follicle-activating herbal medicine combined with electroacupuncture demonstrates superior efficacy in LUFS management by improving ovarian perfusion and endocrine function, with higher ovulation/pregnancy rates and lower recurrence.

Objective To investigate the effect of Huangqi Shengmai Yin(HSY)on myocardial fibrosis in rats with acute myocardial infarction(AMI)by adjusting P2X purinoceptor 7(P2X7R)/NOD-like receptor protein 3(NLRP3)pathway.Methods Sixty rats were divied into a sham operation group and model group(5 groups),with 10 rats in each group.The AMI rat model was constructed by ligating the left anterior descending branch and randomly grouped into AMI group,the HSY-low group(intragastric administration of 1.6 ml/kg HSY),the HSY group(intragastric administration of 6.2 ml/kg HSY),the compound miltiorhiza group(intragastric administration of 300 mg/kg),and the HSY-high+P2X7R agonist-ATP group(intragastric administration of 6.2 ml/kg HSY,and tail vein administration of 10 mmol/L ATP).After the intervention,cardiac function,myocardial injury and inflammatory factor markers were detected.The tissue sections were prepared to examine pathological changes,myocardial fibrosis,type Ⅰ and type Ⅲ collagen(COL1A1,COL3A1).Western blotting was performed to detecte the protein expression of P2X7R,NLRP3,tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),and the expression of activated Caspase-1.Results Compared with the sham surgery group,the AMI group showed an increase in the left ventricular end diastolic diameter(LVEDD),the coatent of brain natriuretic peptide(BNP)and cardiac troponin I(cTn I),fibrosis volume fraction,the positive expression of COL1A1,COL3A1,TNF-α,IL-1β,P2X7R,NLRP3,and activated Caspase-1 proteins(P＜0.05),and a decrease in left ventricular ejection fraction(LVEF)(P＜0.05).The HSY-low group,HSY-high groups,and compound miltiorhiza group showed a decrease in LVEDD,the content of BNP and cTn I,fibrosis volume fraction,the positive expression of COL1A1 and COL3A1,TNF-α,IL-1β,P2X7R,NLRP3,and activated Caspase-1 proteins(P＜0.05),and an increase in LVEF than these in the AMI group(P＜0.05).The HSY-high+ATP group showed an increase in LVEDD,the content of BNP,cTn I,fibrosis volume fraction,the positive expression of COL1A1 and COL3A1,TNF-α,IL-1β,P2X7R,NLRP3,and activated Caspase-1 proteins(P＜0.05),and a decrease in LVEF than those in the HSY-high group(P＜0.05).Conclusion HSY inhibits P2X7R/NLRP3 pathway to alleviate myocardial fibrosis in AMI rats.

Objective To construct a database for molecular mass spectra of toxins and drugs in order to facilitate the management and retrieval of mass spectra for nerve agents,metabolites and other small molecules.Methods Requirement analysis and functional design were performed using software engineering methods.The Spec2Vec algorithm was used for vector representation of mass spectra,while SMILES molecular structures were vectorized using the extended connectivity fingerprint(ECFP).A data storage model integrating structured information and vector representations was established using the Milvus database.Similarity search of mass spectra and molecular structures was conducted via vector similarity comparison and the FlashEntropySearch algorithm.Results The constructed database of mass spectra encompassed over 400,000 entries from such sources as OCAD,NIST,MASSBANK,metabolic products,and natural products of TCM,which was capable of searching for similarities in mass spectra and molecular structures.On a standard server,similarity search of mass spectra took no more than 5 seconds,while that of molecular structures took no more than 1 second.Conclusion The system enables efficient management of complex mass spectra and provides rapid retrieval and comparison of mass spectra-related information through advanced vector indexing technology,offering robust data support and research tools for toxicology and pharmacology.

Objective To evaluate the position of the talus on the axial images of magnetic resonance imaging(MRI)of the ankle joint in patients with chronic ankle instability(CAI)and to identify the indirect signs for diagnosing CAI.Methods Fifty patients hospitalized in our hospital between January 1,2021 and July 1,2023 for chronic ankle instability(CAI)were selected into the experimental group,while 50 counterparts treated in our hospital for other diseases were chosen into the control group.The basic information of both groups was recorded.The internal measurement tools of the Picture Ar-chiving and Communication System(PACS)were used to measure the malleolar talus index(MTI)and two new measurement methods:talus movement index(TMI)and talus comprehensive index(TCI)on the axial images of ankle MRI to evaluate the position of the talus in the ankle mortise.Sta-tistical analysis was then performed.Results There was no significant difference between the two groups in terms of age,sex ratio,affected side ratio,height,weight and body mass index(BMI)(P>0.05).Compared with the control group,the MTI(86.56°±3.54° vs.85.28°±2.77°,P<0.05),TMI(2.00°±2.36° vs.-2.00°±2.54°,P<0.001)and TCI(4.70°±2.98° vs.1.90°±2.01°,P<0.001)of the experi-mental group increased.The area under the ROC curve of TMI and TCI was 0.841 and 0.794,respec-tively.The optimal cut-off points for diagnosing CAI based on TMI and TCI were 0.5° and 4.5°,re-spectively.Conclusion Patients with CAI show changes in the bony structure of the ankle joint.Specifi-cally,on the axial MRI images of the ankle joint,there are simultaneous posterior displacement and internal rotation of the talus,which may be an indirect sign for the diagnosis of CAI.