OBJECTIVE To analyze the prototype components absorbed into blood and brain of Lithocarpus litseifolius leaves， so as to provide a reference for clarifying the pharmacological material basis of its prevention and treatment of central nervous system dis eases. METHODS The ethanol extract of L. litseifolius leaves， as well as the gastric lavage fluid and perfusion solution were prepared. Using rats as subjects， plasma samples of intestinal wall metabolism， intestinal flora metabolism and hepatic metabolism were prepared via in situ intestinal perfusion and closed intestinal loop method； while comprehensive metabolic plasma samples， brain tissue samples， and cerebrospinal fluid samples were collected after intragastric administration. UPLC-HRMS technology was utilized to analyze and identify chemical components and prototype components absorbed into blood and brain of L. litseifolius leaves. RESULTS A total of 66 chemical constituents were identified in L. litseifolius leaves， primarily consisting of flavonoids， organic acids， and others. A total of 16， 13， 11， and 5 prototype components were identified in intestinal wall metabolism， intestinal flora metabolism， hepatic metabolism， and comprehensive metabolic plasma samples， respectively. Additionally， 4 prototype components were detected in brain tissue and 9 in cerebrospinal fluid. Phloridzin， trilobatin， phloretin-2- O -malonyl hexoside， and phloretin were identified as common components across all sample types. CONCLUSIONS Prototype components absorbed into blood and brain of L. litseifolius leaves， such as phloridzin， trilobatin， phloretin， and other components may serve as the pharmacological material basis for their therapeutic effects on central nervous system diseases.

This paper introduces a real-world cohort research model for community-acquired pneumonia （CAP） based on the Jiangsu Traditional Chinese Medicine （TCM） Dominant Diseases Diagnosis and Treatment Data Platform. Firstly， data cleaning is performed by standardizing diagnosis， symptoms， treatment and imaging， intelligently extracting unstructured information， and cleaning and constructing a standardized database. Secondly， for cohort establishment， CAP patients across the province are screened in accordance with CAP diagnostic criteria to build a high-quality disease-specific cohort. Lastly， in terms of protocol design， the characteristics of TCM research and the CAP disease profile are considered to determine appropriate inclusion and exclusion criteria， estimate sample size， define interventions， outcomes and economic evaluations， providing a reference for real-world TCM research on CAP.

This paper introduces a real-world cohort research model for community-acquired pneumonia （CAP） based on the Jiangsu Traditional Chinese Medicine （TCM） Dominant Diseases Diagnosis and Treatment Data Platform. Firstly， data cleaning is performed by standardizing diagnosis， symptoms， treatment and imaging， intelligently extracting unstructured information， and cleaning and constructing a standardized database. Secondly， for cohort establishment， CAP patients across the province are screened in accordance with CAP diagnostic criteria to build a high-quality disease-specific cohort. Lastly， in terms of protocol design， the characteristics of TCM research and the CAP disease profile are considered to determine appropriate inclusion and exclusion criteria， estimate sample size， define interventions， outcomes and economic evaluations， providing a reference for real-world TCM research on CAP.

Low anterior resection syndrome （LARS） is a common complication of sphincter-preserving rectal cancer surgery， and its manifestations change dynamically at different stages. By analyzing and summarizing the clinical symptoms and pathomechanism evolution of LARS across different stages， this paper proposes a staged prevention and treatment strategy using acupuncture. During perioperative stage， the main principle is activating the transport function of the body， supplemented by regulating the mind， with the use of dredging the bowels as needed. During the stoma reversal stage， treatment focuses primarily on fortifying the spleen， with draining dampness as a supplementary method， to help consolidate the intestines. During the radiotherapy or chemotherapy stage， the main focus is reinfor-cing healthy qi， with reducing toxin as an adjunct， to achieve the effect of activating the transport of the pivot. During the survival management stage， treatment primarily focuses on tonifying the kidneys and secondarily on fortifying the spleen， with regulating the corporeal soul as the therapeutic emphasis. Acupoints are selected and combined in accordance with the treatment principles at each stage， and different stimulation methods such as electroacupuncture and moxibustion are applied. An analysis of the mechanisms underlying acupuncture for LARS is also provided， offering a theoretical basis and practical approach for the prevention and treatment of LARS with acupuncture.

Autosomal dominant polycystic kidney disease （ADPKD） is a systemic hereditary renal disorder and can affect multiple organs， and congenital hepatic fibrosis is one of the manifestations of liver involvement and is an important complication of ADPKD. Symptomatic management is currently the main treatment method for this disease， and disease-specific drugs such as tolvaptan have limited indications and cannot correct the underlying genetic defect. This article reports a case of ADPKD with congenital hepatic fibrosis， and sirolimus was identified as the individualized treatment regimen based on peripheral blood functional genomic analysis and drug sensitivity prediction platform. The patient achieved significant improvements in symptoms and quality of life after treatment， with a stable kidney volume. This case shows that functional genomics has a potential value in guiding individualized treatment of rare genetic disorders， which provides new treatment ideas and practice paths for similar patients.

Objective:To analyze research trends, hotspots, and international collaboration in temporomandibular disorders (TMD) from 2010 to 2024 using bibliometric methods.Methods:A total of 4 368 articles published between January 2010 to December 2024 were retrieved from PubMed using the search strategy temporomandibular disorders[MeSH Terms] OR temporomandibular joint disorders[Title/Abstract]. The R package"bibliometrix" was employed to analyze publication statistics, author collaboration networks, and keyword co-occurrence.Results:The annual publication volume in the TMD field increased 3.4-fold from 2010 to 2024, with an average annual output of 291.2 articles. MANFREDINI DANIELE was identified as the most prolific author (74 articles). The Journal of Oral Rehabilitation ranked first in terms of publication quantity (454 articles). The University of S?o Paulo (Brazil) emerged as the leading contributor, followed by Sichuan University (China) globally. Research hotspots predominantly focused on the DC/TMD diagnostic criteria and pain mechanisms. Analysis of international collaboration networks revealed that core authors (e.g., Lobbezoo F, Manfredini D) have driven advancements in the field through multidisciplinary collaboration (dentistry+psychology+medical imaging). The high-frequency occurrence of the imaging keyword "magnetic resonance imaging (MRI)" underscores its pivotal role in diagnosing disc displacement. Chinese institutions (Sichuan University, Peking University) ranked second globally in research output; however, interdisciplinary international collaboration remained limited, with multiple-country publications (MCP) accounting for only 13.0%. Conclusions:TMD research demonstrates interdisciplinary integration, highlighting the need for future emphasis on Asian population studies and innovative diagnostic/therapeutic technologies.

Objective:To compare the preliminary efficacy and adverse events of chemoradiotherapy (CRT) with or without immunotherapy in bladder preservation therapy for localized muscle-invasive bladder cancer (MIBC) confined to the pelvis.Methods:Clinical data of 60 patients with MIBC who received CRT with or without immunotherapy for bladder preservation at the Cancer Hospital, Chinese Academy of Medical Sciences from January 2016 to June 2024 were retrospectively analyzed. Patients were divided into CRT plus immunotherapy group and CRT-alone group. Survival outcomes, bladder function preservation, recurrence and metastasis, as well as early and late radiation toxicities were evaluated. The Mann-Whitney U test was used for between-group comparisons. Overall survival (OS), progression-free survival (PFS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were estimated by the Kaplan-Meier method, and survival rates were compared by the log-rank test. Results:In the CRT plus immunotherapy group ( n=23), the median follow-up was 20 months. The median OS and median PFS were not reached. The 2-year OS, PFS, LRFS, and DMFS rates were 95.7%, 70.7%, 70.7%, and 92.9%, respectively, and 22 patients (96%) preserved normal bladder function. Patients with programmed death-ligand 1 (PD-L1) combined positive score (CPS) ≥1 had significantly higher 1-year PFS rate than those with CPS <1 (100% vs. 66.7%, P=0.004). In the CRT-alone group ( n=37), the median follow-up was 37 months, with median OS and PFS of 68 and 19 months, respectively. The 2-year OS, PFS, LRFS, and DMFS rates were 92.0%, 41.1%, 60.9% and 81.5%, respectively, and 33 patients (89%) preserved normal bladder function. Compared with the CRT-alone group, the CRT plus immunotherapy group showed a significant improvement in PFS ( χ2=4.38, P=0.036), while no significant differences were observed in OS, LRFS, or DMFS (all P>0.05). The incidence of acute hematologic toxicity in the CRT plus immunotherapy group and CRT-alone group were 52% (12/23), 27% (10/37) respectively, and late genitourinary toxicity was 22% (5/23), 8% (3/37), respectively, with no significant differences in overall acute or late toxicities (all P>0.05). Conclusions:For localized MIBC, bladder preservation with CRT combined with immunotherapy significantly improves PFS compared with CRT alone, while maintaining comparable safety. The PD-L1 status may serve as a favorable predictor for immunotherapy efficacy.

Objective:To analyze the hospitalization cost of 116 860 patients under DRG implementation,and explore the effect of charging structure on the profit and loss of cases,so as to provide suggestion for improving the medical insurance"item+disease group".Methods:Descriptive analysis,K-means clustering,and the Hedonic model.Results:(1)The average profit and loss of the cases was 83.12±883.175 yuan.The surplus group was 71 148 cases,accounting for 60.88%,while the loss group was 45 712 cases,accounting for 39.12%.(2)There are seven types of charging structures,and cases are mainly distributed in medium service low goods and low service low goods.The average surplus of low service low goods is the most.The cases of high service high goods had the largest average loss.(3)The Hedonic model shows that the key influencing factors of case profit and loss include the"service-commodity"fee structure,the number of days of hospitalization,whether the operation is performed or not,and the level of the hospital.Conclusion:(1)Systematically evaluate the risk effect of structural adjustment on the micro-allocation mechanism of medical insurance budget;(2)strengthen the monitoring of typical disease expenses/costs and the regular mining of collection and payment data;(3)promote the convergence of the"project+disease group/disease"collection and payment system and promote the reform of doctors'salaries;(4)expand the application scenarios of big data decision support in the regional medical and medical insurance economy.

Objective:To explore the effect of Bian-stone warming and ironing therapy on gastrointestinal blood flow in patients with severe cerebrovascular disease undergoing therapeutic hypothermia.Methods:From January 2023 to October 2024, 92 patients with severe cerebrovascular disease in the Neurosurgical Intensive Care Unit of Xuanwu Hospital of Capital Medical University were selected for the study using convenience sampling method. The patients were divided into a control group and an experimental group of 46 cases each according to the randomized numerical table method. Control group was given routine nursing, and experimental group carried out Bian-stone warming and ironing therapy on the basis of control group. Peak systolic velocity (PSV), end-diastolic velocity (EDV), and time-averaged mean velocity (TAMV) of the superior mesenteric artery of the two groups of patients were monitored before and after five days of intervention, respectively, and the situation of gastric retention and bowel sounds were recorded and compared between the groups.Results:PSV was higher in experimental group than in control group after intervention, and the difference was statistically significant ( P<0.05). The difference in EDV between the two groups was not statistically significant ( P>0.05). TAMV of experimental group was higher than that of control group after intervention, and the difference in TAVM before and after intervention of experimental group was smaller than that of control group, and the differences were all statistically significant ( P<0.05). The number of cases of gastric retention and weakened or disappeared bowel sounds in experimental group was less than that in control group after intervention, and the differences were all statistically significant ( P<0.05) . Conclusions:Bian-stone warming and ironing therapy improves gastrointestinal blood flow rate and reduces feeding intolerance in patients with severe cerebrovascular disease undergoing therapeutic hypothermia.

Objective:To analyze the hospitalization cost of 116 860 patients under DRG implementation,and explore the effect of charging structure on the profit and loss of cases,so as to provide suggestion for improving the medical insurance"item+disease group".Methods:Descriptive analysis,K-means clustering,and the Hedonic model.Results:(1)The average profit and loss of the cases was 83.12±883.175 yuan.The surplus group was 71 148 cases,accounting for 60.88%,while the loss group was 45 712 cases,accounting for 39.12%.(2)There are seven types of charging structures,and cases are mainly distributed in medium service low goods and low service low goods.The average surplus of low service low goods is the most.The cases of high service high goods had the largest average loss.(3)The Hedonic model shows that the key influencing factors of case profit and loss include the"service-commodity"fee structure,the number of days of hospitalization,whether the operation is performed or not,and the level of the hospital.Conclusion:(1)Systematically evaluate the risk effect of structural adjustment on the micro-allocation mechanism of medical insurance budget;(2)strengthen the monitoring of typical disease expenses/costs and the regular mining of collection and payment data;(3)promote the convergence of the"project+disease group/disease"collection and payment system and promote the reform of doctors'salaries;(4)expand the application scenarios of big data decision support in the regional medical and medical insurance economy.