Objective: Patients with atherosclerotic cardiovascular disease (ASCVD) following percutaneous coronary intervention (PCI) are classified as very-high-risk individuals in cardiovascular disease (CVD) risk stratification. The distribution pattern of traditional Chinese medicine (TCM) syndromes in this patient population, as well as its association with blood lipid profiles and clinical prognosis, remains unclear. The present prospective cohort study aims to investigate these correlations, thereby providing insights to enrich the research fields. Methods: We enrolled consecutive patients with ASCVD who underwent PCI at the Integrated Cardiology Unit of China-Japan Friendship Hospital between September 1, 2020 and December 31, 2022. Demographics and clinical characteristics, signs and symptoms defining each TCM syndrome, and fasting venous blood samples were collected at baseline and follow up or upon major adverse cardiovascular events (MACEs). We analyzed the correlation between TCM syndromes, blood lipid profiles, and MACEs, and developed a new joint prognostic model incorporating both TCM syndromes and blood lipids using logistic regression. The analyses were based on detailed baseline and one-year follow-up data. Results: A per-protocol analysis was performed on 586 patients with complete data ultimately. During the one-year follow-up, 174 patients (29.69%) experienced a MACE. We performed statistical analyses on comorbidities, medication, and biochemical indicators across groups defined by TCM syndrome differentiation. When comparing different TCM syndromes, no significant differences were found in age, body mass index (BMI), history of revascularization, comorbidities, family history of CVD, smoking or drinking, or statin intensity (P > 0.05). Patients with intertwined phlegm and blood stasis syndrome exhibited significantly higher levels of total cholesterol (TC, 5.27 ± 1.18 mmol/L, P < 0.001), triglyceride (TG, 1.96 ± 1.33 mmol/L, P = 0.008), low-density lipoprotein cholesterol (LDL-C, 3.35 ± 0.79 mmol/L, P < 0.001), and high-density lipoprotein cholesterol (HDL-C, 1.24 ± 0.81 mmol/L, P < 0.001) compared with those with other TCM syndromes combined. A multivariable logistic regression model was constructed to predict MACEs. The model included TCM syndrome type [with intertwined phlegm and blood stasis as a predictor, adjusted odds ratio (OR) = 1.413, 95% confidence interval (CI): 0.517 – 3.864, P = 0.501], age (adjusted OR = 0.97, 95% CI: 0.955 – 1.001, P = 0.057), male gender (adjusted OR = 0.698, 95% CI: 0.416 – 1.170, P = 0.173), TC (adjusted OR = 1.004, 95% CI: 0.513 – 1.965, P = 0.990), and LDL-C (adjusted OR = 5.825, 95% CI: 2.214 – 15.326, P < 0.001). This model demonstrated good discriminatory ability for MACEs in post-PCI ASCVD patients [the area under the receiver operating characteristic (ROC) curve (AUC) = 0.865, 95% CI: 0.816 – 0.914]. Conclusion The intertwined phlegm and blood stasis TCM syndrome is associated with a distinct atherogenic lipid profile characterized by elevated levels of TC and LDL-C. The prognostic model that incorporates this TCM syndrome type along with conventional lipid parameters (TC and LDL-C) shows good discriminatory ability for predicting MACEs in ASCVD patients after PCI, underscoring the potential clinical utility of integrating TCM syndrome differentiation into CVD risk assessment.

By reviewing modern research and integrating clinical practice， this paper interprets the correlation between "deep heat， deep syncope" and the "macrocirculation-microcirculation" uncoupling in sepsis， alongside its clinical applications in sepsis prevention and treatment. It is considered that "deep heat" corresponds to peripheral vasodilation and the hypermetabolic state at the macrocirculation level， whereas "deep syncope" manifests as hypoperfusion and impaired oxygen utilization at the microcirculation level. These two states interact detrimentally， forming the core contradiction of macrocirculation-microcirculation uncoupling in sepsis. Based on the traditional Chinese medicine （TCM） connotations of "deep heat， deep syncope" and modern medical research， this paper elucidates the systemic pathological evolution of sepsis from the inflammatory cascade to impaired oxygen utilization. Accordingly， the following therapeutic principles are proposed. In the early stage， it is suggested to clear heat and drain fire to vent the constrained yang. In the progressive stage， the focus is put on unblocking the lower jiao （焦） and expelling stasis to dredge the vessels and collaterals. In the recovery stage， the method of regulating and harmonizing yin and yang can be used to smooth the flow of qi and blood.

Fecal microbiota transplantation （FMT） has been widely used in the treatment of gastrointestinal disorders， particularly Clostridium difficile infection， while there are few reports of its application in the diagnosis and treatment of cirrhotic ascites. This article reports a case of a patient with cirrhotic ascites and chronic diarrhea who received FMT with oral capsules， demonstrating significant short-term efficacy without any adverse reactions， in order to provide a reference for the application of FMT in the treatment of liver diseases.

Objective To explore the metabolic characteristics and related factors in patients with diabetic retinopathy (DR). Methods A retrospective study was conducted on the clinical data of 467 diabetic patients hospitalized at the Affiliated Hospital of Nanjing University of Chinese Medicine from January 2020 to September 2024. The patients were divided into the DR group (n＝150) and the non-DR group (n＝317). Liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were assessed using a transient elastography device, and graded into five levels. Basic data, LSM and CAP grading, and metabolic indicators were compared between the two groups. Univariate and multivariate logistic regression analyses were applied to identify factors influencing DR. Results Patients in the DR group were older than those in the non-DR group (P＜0.001). Compared with the non-DR group, fasting blood glucose (FBG), glycated hemoglobin A_1C (HbA_1C), and triglyceride (TG) levels were higher, while low-density lipoprotein cholesterol (LDL-C) was lower in the DR group (P＜0.05). Significant differences in LSM grading were observed between the two groups (P＝0.006). Multivariate logistic regression analysis revealed that LSM grading (grade 2: OR＝2.127, P＝0.002; grade 3: OR＝2.344, P＝0.030; grade 4: OR＝2.960, P＝0.038), FBG (OR=1.233, P＜0.001), and serum creatinine (OR＝1.013, P＝0.006) were independent factors associated with DR. Conclusions FBG, serum creatinine, and LSM are related factors of DR. In clinical practice, attention should be paid to the coordinated management of blood glucose control, renal function monitoring, and liver fibrosis assessment, with early interventions to reduce the risk of DR.

Objective On the basis of the theory of the tumor metastatic state, this work aims to explore the metastasis trajectories and peripheral immune response patterns in patients with non-small cell lung cancer (NSCLC) receiving vital qi-strengthening and toxin-eliminating therapy (Fuzheng Juandu) and reveal the value of peripheral immunity in assessing vital qi deficiency during metastasis. Methods A retrospective study design was adopted. Patients with NSCLC admitted from January 1, 2018, to October 31, 2025 were enrolled. Data on metastasis status and peripheral immune indices were collected at the follow-up time points of one, two, three, and five years. Group-based trajectory modeling was used to fit metastasis trajectories, and the independent predictors of trajectory grouping were analyzed through multifactor and multiclassification logistic regression. Results A total of 184 patients with NSCLC were included, and three different groups of metastasis trajectories were identified, namely, the low-risk stable (46.74%, n=86), low-risk rising (13.59%, n=25), and high-risk stable (39.67%, n=73) groups. Univariate analysis revealed substantial differences in peripheral immune indices among the three trajectory groups. Multivariate analysis showed that TNM stage, absolute neutrophil count, lymphocyte count, absolute monocyte count, platelet volume, SAA:CRP ratio, and NLR were independent predictors of the low-risk rising group, whereas TNM stage, absolute monocyte count, basophil count, SII, and NLR were independent predictors of the high-risk stable group. Conclusion Under Fuzheng Juandu therapy, patients with NSCLC exhibit three distinct metastasis trajectories, each corresponding to a specific peripheral immune response pattern. Elucidating these peripheral immune response patterns may facilitate the objective quantification of the degree of vital qi deficiency, prediction of future metastasis risk, and providing an important reference for the individualized clinical implementation of Fuzheng Juandu therapy.

Objective:To conduct a baseline review of the best evidence for perioperative fraility management in elderly patients, construct review indicators, systematically analyze obstacle factors and promoting factors, and formulate corresponding change strategies, so as to provide reference for clinical transformation of evidence.Methods:With the Joanna Briggs Institute evidence-based health care model as the guiding framework, the best evidence of perioperative frailty-management in elderly patients was summarized, and the review indicators and review methods were formulated on the basis of the evidence. From April 2024 to May 2024, a baseline review of the hospital system of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, medical staff and patients were conducted to analyze the obstacles in clinical practice and formulate corresponding change strategies, guided by integrated-promoting action on research implementation in health services framework(i-PARIHS).Results:According to 19 best evidence, 20 review indicators were established, among which 10 review indicators compliance rate was less than 60% and higher than 0, 2 review indicators compliance rate was 0. Based on the results of the i-PARIHS evidence-based conceptual framework analysis, the obstacle factors included the evidence content was not specific and inaccessible; lack of knowledge and skills in healthcare; the workload of medical care increased; the patient was old and had weak receptivity, lack of systematic practice process; lack of multidisciplinary communication mechanisms.Conclusions:There is a big gap between the best evidence of perioperative frailties management in elderly patients and clinical practice. Clinical departments need to deeply analyze the obstacles to clinical practice based on the existing clinical environment and resource allocation, and formulate targeted strategies to promote the better integration of evidence into clinical practice.

In recent years,chemical imaging technology has found increasingly broad applications in pharmaceuti-cal analysis,encompassing component distribution analysis,assessment of mixing uniformity,content uniformity e-valuation,polymorphism identification,and studies of drug delivery mechanisms.Chemical imaging has been pro-gressively recognized as an efficient tool for real-time quality control and online analysis.This article provides an o-verview of the chemical imaging guidelines in the Chinese,United States,European pharmacopoeias.The discus-sion aims to promote the application of multi-information fusion technologies in pharmaceutical analysis,enhance regulatory efficiency,and further advance the high-quality development of the pharmaceutical industry in China.

OBJECTIVE To investigate the effect of hyperoside on high glucose-induced excessive proliferation of retinal endo-thelial cells(RECs)and its possible mechanism.METHODS Diabetic retinopathy(DR)models were established in male Sprague-Dawley(SD)rats.DR rats were treated with low-and high-dose hyperoside(DR+L-HY group and DR+H-HY group).Additional-ly,the normal control(NC)group,DR non-intervention(DR)group and DR+calcium dobesilate intervention(DR+CD)group were set up.The differences in the number of RECs in retinal blood vessels were observed and compared among all groups after intervention.In addition,RECs were inoculated into cell culture plates after normal culture and subculture.They were divided into 5 groups according to different treatments:normal glucose(NG)group,high glucose(HG)group,mannitol(MT)group,high glucose+low concentration of hyperoside(HG+H100)group and high glucose+high concentration of hyperoside(HG+H400)group.The activ-ity,cell migration and tubule formation of RECs in each group were detected and compared by CCK-8,cell migration and tubule for-mation assays.Western blot and qPCR were used to detect the expression of NADPH Oxidase 4(NOX4)and thioredoxin interacting protein(TXNIP)in each group.RESULTS The number of RECs in the DR group was significantly increased compared to the NC group(P<0.01).In contrast,the DR+L-HY,DR+H-HY,and DR+CD groups all showed significant decreases in RECs number compared to the DR group(P<0.05,P<0.01),and the reduction of RECs in the DR+H-HY group was significantly greater than that in the DR+L-HY group(P<0.05).Furthermore,the cell activity,migration number and tube formation number of RECs in the HG group were significantly higher than those in the NG group(P<0.05,P<0.01).The protein and mRNA expression levels of NOX4 and TXNIP in the HG group were also significantly higher than those in the NG group(P<0.01).However,the RECs activity,RECs mi-gration number and tube formation number in the HG+H100 group and the HG+H400 group were significantly lower than those in the HG group(P<0.05,P<0.01).The expression levels of NOX4 and TXNIP in both groups were significantly lower than those in the HG group(P<0.05,P<0.01),and the RECs activity,migration number,tube formation number,and the expression of NOX4 and TXNIP in the HG+H400 group were further significantly decreased compared with those in the HG+H100 group(P<0.01).CONCLU-SION Hyperoside could significantly inhibit the high glucose-induced excessive proliferation of RECs.The mechanism may be relat-ed to the inhibition of NOX4/TXNIP activation in high-glucose environment.

Healthcare-associated infection(HAI)is a global public health problem that poses a significant socio-economic burden.Hand hygiene is still considered as one of the most effective measures to prevent the spread of pathogens and reduce the incidence of HAI.This paper systematically reviews the latest progress in hand hygiene-related new products,intelligent monitoring technology,and compliance promotion strategies,aiming to provide scientific basis for the management and optimized scheme of hand hygiene in clinical practice in medical institutions in China,ultimately enhance the hand hygiene compliance of healthcare workers,ensure patient safety,and reduce the burden of HAI.

Objective:To investigate the clinical characteristics and survival outcomes of patients with nasopharyngeal carcinoma (NPC) complicated by multiple primary malignancies (MPCs) in a real-world setting.Methods:A retrospective study was performed on 238 NPC patients with MPCs who received radical radiotherapy at Fujian Cancer Hospital between January 1st, 2004 and December 31st, 2023. The primary endpoints were overall survival (OS) and cumulative survival rate. Survival analysis was conducted using the Kaplan-Meier method with log-rank / Breslow tests, and univariate analysis of prognostic factors was performed using the Cox proportional hazards model.Results:A total of 246 primary malignant tumors were identified in 238 patients, involving 12 organ systems and 39 tumor types. The most common coexisting malignancies occurred in the respiratory and intrathoracic organs [25.2% (62/246)], followed by digestive organ malignancies [22.8% (56/246)], malignancies of the lip, oral cavity, and pharynx [22.8% (56/246)], and thyroid and other endocrine gland malignancies [15.4% (38/246)]. The median OS was 186 months, and the 3-, 5-, and 10-year cumulative survival rates were 90.84%, 85.25%, and 69.45%, respectively. Poorer survival was associated with male sex, age>48 years at onset, locally advanced disease (stage IVA), synchronous MPCs and/or digestive system malignancies, fewer total cycles of chemotherapy, and lack of concurrent or adjuvant chemotherapy.Conclusions:In patients with NPC, MPCs most frequently involve the respiratory system, digestive system, and head and neck organs (including the thyroid). Male sex, older age, locally advanced primary NPC, synchronous and/or digestive system MPCs, fewer chemotherapy cycles, and lach of concurrent or adjuvant chemotherapy were significantly associated with poorer prognosis.