Based on Professor YANG Zhen's theory of "qi dynamics of ministerial fire"， this paper systematically elucidates the pathogenesis of jueyin （厥阴） disease and the clinical rationale for applying Wumei Pill （乌梅丸）. Jueyin disease is characterized by dysfunction of the middle earth in regulating qi dynamics and disruption of the pivot mechanism， leading to an upward disturbance of ministerial fire and an underlying pattern of deficiency-cold of true yang， thereby forming a state of cold and heat in complexity. Wumei Pill fully exerts the synergistic effects of sour-astringency， bitter-descending， and acrid-warm medicinals， reflecting the therapeutic principle of regulating the pivot mechanism and restraining the upward rebellion of ministerial fire， with the aim of returning fire to its source and restoring the circulation of qi. Based on the four-dimensional pathological evolution of Jueyin disease， namely disorder of pivot qi harmonization， failure of ying （营）-blood nourishment and containment， loss of yin sustenance and balance， and instabi-lity of ministerial fire， the paper systematically reveals the underlying logic of Wumei Pill in treating different diseases with the same therapeutic principle. In addition， a clinical case of hemoptysis treated with modified Wumei Pill is presented， providing insights into its formulation principles and expanding its application in complex and refractory multi-system diseases.

Based on Professor YANG Zhen's theory of "qi dynamics of ministerial fire"， this paper systematically elucidates the pathogenesis of jueyin （厥阴） disease and the clinical rationale for applying Wumei Pill （乌梅丸）. Jueyin disease is characterized by dysfunction of the middle earth in regulating qi dynamics and disruption of the pivot mechanism， leading to an upward disturbance of ministerial fire and an underlying pattern of deficiency-cold of true yang， thereby forming a state of cold and heat in complexity. Wumei Pill fully exerts the synergistic effects of sour-astringency， bitter-descending， and acrid-warm medicinals， reflecting the therapeutic principle of regulating the pivot mechanism and restraining the upward rebellion of ministerial fire， with the aim of returning fire to its source and restoring the circulation of qi. Based on the four-dimensional pathological evolution of Jueyin disease， namely disorder of pivot qi harmonization， failure of ying （营）-blood nourishment and containment， loss of yin sustenance and balance， and instabi-lity of ministerial fire， the paper systematically reveals the underlying logic of Wumei Pill in treating different diseases with the same therapeutic principle. In addition， a clinical case of hemoptysis treated with modified Wumei Pill is presented， providing insights into its formulation principles and expanding its application in complex and refractory multi-system diseases.

Objective To explore the diagnostic value of soluble C5b-9 (sC5b-9) for delayed graft function (DGF) following kidney transplantation. Methods Clinical data of 49 kidney transplant recipients who underwent sC5b-9 detection at the Second People’s Hospital of Shanxi Province between January 2024 and December 2025 were retrospectively analyzed. Recipients were divided into the DGF group (n=25) and the non-DGF group (n=24) according to the occurrence of DGF. Baseline characteristics and serum sC5b-9 levels were compared between the two groups. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic efficacy of sC5b-9 for DGF. A restricted cubic spline model was adopted to investigate the association between sC5b-9 and DGF. Results Among the 49 recipients, DGF occurred in 25 patients. Compared with the non-DGF group, the DGF group presented a higher proportion of male patients, a higher incidence of adverse transplant outcomes, and elevated final serum creatinine levels (all P<0.05). Within 30 days after transplantation, sC5b-9 concentrations were significantly higher in the DGF group than those in the non-DGF group (P<0.001). ROC analysis revealed that the area under the curve (AUC) of sC5b-9 for diagnosing DGF was 0.81, with a 95% confidence interval (CI) of 0.68-0.92, and the optimal cutoff value was 265.7 ng/mL. Recipients with elevated sC5b-9 (≥265.7 ng/mL) had a significantly higher incidence of DGF than those with low sC5b-9 levels (<265.7 ng/mL) (P<0.001). Recipients with adverse outcomes exhibited significantly higher sC5b-9 levels than those without adverse outcomes (P<0.001), and the AUC of sC5b-9 for identifying adverse outcomes was 0.82 (95%CI 0.63-0.95). A significant nonlinear correlation was observed between sC5b-9 and final serum creatinine (P<0.001). Conclusions Elevated sC5b-9 is correlated with the development of DGF after kidney transplantation and exhibits favorable diagnostic performance. It may serve as a potential biomarker for predicting early allograft dysfunction and adverse outcomes in kidney transplant recipients.

[Objective]To identify the research hotspots and trends of phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin(PI3K/AKT/mTOR)signaling pathway in the traditional Chinese medicine(TCM)intervention mechanism,in order to provide a new research perspective for TCM mechanism exploration and clinical treatment.[Methods]Literatures related to PI3K/AKT/mTOR signaling pathway in the field of traditional Chinese medicine from January 1,2008 to July 5,2024 were searched in the Web of Science core database and CNKI.After screening,CiteSpace 6.1.R6 software was used to draw the cooperation network map of publishing institutions,keyword co-occurrence,clustering,timeline and burst map,and visual analysis was carried out.[Results]A total of 906 articles were included after screening,and the number of articles was on the rise.China had the most countries,with 543 articles.Nanjing University of Chinese Medicine had the most papers,with 28 papers,of which 9 institutions had more than 15 papers.High-frequency keywords included"cancer""neurodegenerative diseases""oxidative stress""apoptosis",and high-intensity burst terms included"network pharmacology""mammalian target""molecular docking".[Conclusion]Regulating the PI3K/AKT/mTOR signaling pathway through Chinese herbal compound and monomer has broad prospects in the treatment of cancer and neurodegenerative diseases.

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

The enterotoxigenic Escherichia coli (ETEC) infection is a major factor restricting the development of animal husbandry. However, the abuse of antibiotics will lead to the antibiotic residues and emergence of antibiotic-resistant bacteria. The existing vaccines face challenges in stimulating intestinal immunity, demonstrating limited prevention effects. Therefore, it is indispensable to develop a new vaccine that is safe and suitable as a feed additive to activate intestinal immunity. This study constructed yeast-cell microcapsules (YCM) carrying the DNA vaccine against ETEC by genetic engineering. Furthermore, animal experiments were carried out to explore the regulatory effects of feeding YCM on the intestinal immune system and intestinal microbiota. Saccharomyces cerevisiae was selected as the oral delivery vehicle (microcapsules) of the DNA vaccine. The codon-optimized nucleic acid sequence of K88, the main antigen of mammal-derived ETEC, was synthesized, and the yeast shuttle vector containing the corresponding DNA vaccine expression cassette was constructed by DNA recombination. The recombinant strain of YCM was prepared by transforming JMY1. Additionally, the characteristics of the YCM strain and its feasibility as an oral vaccine were comprehensively evaluated by the fluorescence reporter assay, gastrointestinal fluid tolerance assay, intestinal epithelial cell adhesion assay, intestinal retention assessment, antiserum detection, and intestinal microbiota detection. The experimental results showed that the DNA vaccine expression cassette was expressed in mammals, and the recombinant strain of YCM could tolerate up to 8 hours of gastrointestinal fluid digestion and had good adhesion to intestinal epithelial cells. The results of mouse feeding experiments indicated that the recombinant strain of YCM could stay in the intestinal tract for at least two weeks, and the DNA vaccine expression cassette carried by YCM entered the intestinal immune system and triggered an immune response to induce the production of specific antibodies. Moreover, feeding YCM recombinant bacteria also improved the abundance of gut microbiota in mice, demonstrating a positive effect in regulating intestinal flora. In summary, we prepared the recombinant strain of YCM carrying the DNA vaccine against ETEC and comprehensively evaluated its characteristics and feasibility as an oral vaccine. Feeding the recombinant YCM could induce specific immune responses and regulate intestinal microbiota. The findings provide a reference for the immunoprevention of ETEC-related animal diseases.
Animals ; Enterotoxigenic Escherichia coli/genetics* ; Saccharomyces cerevisiae/metabolism* ; Vaccines, DNA/genetics* ; Mice ; Escherichia coli Infections/immunology* ; Escherichia coli Vaccines/genetics* ; Capsules ; Mice, Inbred BALB C ; Female

With the rapid development of medical technology and the continuous increase in public demand for health-care,the stability of talent teams plays a significant role in promoting high-quality development of hospitals,improving medical technology,and innovating scientific research achievements.Essentially,a hospital's overall competitiveness is a competition for high-level talent.With the ongoing reforms in China's medical and healthcare industry and the expansion of the medical market,the loss of high-level talents in public hospitals has become increasingly severe.This issue not only impacts the development of specialized disciplines and the competitiveness of technological innovations,but also brings huge challenges to the high-quality development of hospitals.This study took a tertiary hospital in Jiangsu Province as a case study and analyzed the phenomenon of high-level talent loss through the SWOT model,focusing on the core elements behind talent loss.By examining the incentive and management mechanisms for talent attraction and development,this study employed the SWOT model to enhance the structural framework of public hospital talent teams and proposes relevant countermeasures and recommendations.

With the rapid development of medical technology and the continuous increase in public demand for health-care,the stability of talent teams plays a significant role in promoting high-quality development of hospitals,improving medical technology,and innovating scientific research achievements.Essentially,a hospital's overall competitiveness is a competition for high-level talent.With the ongoing reforms in China's medical and healthcare industry and the expansion of the medical market,the loss of high-level talents in public hospitals has become increasingly severe.This issue not only impacts the development of specialized disciplines and the competitiveness of technological innovations,but also brings huge challenges to the high-quality development of hospitals.This study took a tertiary hospital in Jiangsu Province as a case study and analyzed the phenomenon of high-level talent loss through the SWOT model,focusing on the core elements behind talent loss.By examining the incentive and management mechanisms for talent attraction and development,this study employed the SWOT model to enhance the structural framework of public hospital talent teams and proposes relevant countermeasures and recommendations.

To investigate the distribution and development of common allergens in children in Hangzhou area, and to provide an epidemiological basis for the prevention, diagnosis, and treatment of allergic diseases in this area. This study is a retrospective study, selecting 3 524 children who underwent allergen screening at DiAn Medical Laboratory Center (Hangzhou) Co., Ltd. from January 2022 to January 2024 as the research subjects, including 2 012 males and 1 512 females. Among them, there were 1 098 infants (0-1 year olds), 1 673 toddlers (1-3 year olds), and 753 children (3-14 year olds). Immunoblotting was used to detect 21 allergen-specific immunoglobulin E (sIgE) antibodies. The positive rates of various allergens were calculated according to gender, age, and other factors, and the epidemiological characteristics and trends were analyzed. The results showed that the overall positive rate of sIgE was 60.33% (2 126/3 524). The main inhaled allergens were Dermatophagoides pteronyssinus/Dermatophagoides farinae (992, 28.15%), dog dander (295, 8.37%) and cat dander (181, 5.13%). The main food allergens were milk (696, 19.75%), egg white (541, 15.36%) and shrimp (205, 5.83%). Boys had significantly higher sIgE positivity rates than girls for Dermatophagoides pteronyssinus/Dermatophagoides farinae(642, 31.90%, χ2=10.10, P=0.001), house dust(61, 3.02%, χ2=5.12, P=0.024), cat dander(124, 6.16%, χ2=4.06, P=0.044), mold combinations(103, 5.14%, χ2=7.51, P=0.006), and tree pollen combinations(42, 2.07%, χ2=5.44, P=0.020) (all P<0.05); With age, there was a significant increase in positivity rates for house dust mite/dust mite, house dust, mold combinations, milk, and beef (all P<0.05), and a significant decrease in positivity rates for cockroach consumption, egg whites, shrimp, crab, cod, lobster/scallop, and soybeans (all P<0.05), the positive rates of only ingestive allergens decreased significantly ( P<0.001), and the positive rates of only inhalant and mixed allergens increased significantly ( P<0.001). In conclusion,in the Hangzhou area, dust mites are the most common inhalant allergens among children with allergic diseases, while milk is the most common food allergen. Boys are more sensitive to inhalant allergens, and as children grow older, the positive rates for different allergens undergo significant changes. Dynamic monitoring of changes in specific IgE antibodies to various allergens can assist in the diagnosis, prevention, and treatment of allergic diseases.

Objective To analyze the prevalence and risk factors of underscreening among cervical cancer screening participants in Wuxiang County,Shanxi Province in 2019,providing evidence-based support for optimizing mobilization strategies.Methods Data from cervical cancer screening programs conducted between 2019 and 2024 in Wuxiang County were retrospectively collected.The follow-up screening behaviors of women screened in 2019 were analyzed,and factors associated with underscreening were identified.Results A total of 3759 women underwent cervical cancer screening in 2019.Among them,492 women(13.09％)with abnormal primary screening results requiring follow-up in 12 months,yet only 43(8.74％)completed;2154 women(57.30％)with negative liquid-based cytology testing(LCT)results needed re-screening after 3 years,701(32.54％)completed;1113 women(29.61％)with negative HPV/combined results needed re-screening after 5 years,734(65.95％)completed.Overall,2299 women(60.69％)exhibited underscreening.Multivariate analysis showed that underscreening was more likely among community residents than rural residents(OR=2.309,P=0.018),older women(OR=1.065,P＜0.001),those in organized screening compared to opportunistic screening(OR=3.789,P＜0.001),those undergoing LCT(OR=4.607,P＜0.001)or combined screening instead of human papillomavirus testing(OR=3.624,P＜0.001),and those with abnormal screening results(OR=6.859,P＜0.001).Conclusion Substantial proportions of cervical cancer screening participants demonstrate poor adherence to guideline-recommended screening intervals,and particularly need to focus on older women and those with abnormal screening results.Implementation of electronic screening record systems and emphasizing knowledge of periodical screening in health education could enhance compliance with"70％screening coverage"target for cervical cancer prevention.