A portion of patients undergoing implant restoration require bone augmentation procedures to ensure that there is sufficient bone volume around the implant. For the patients with horizontal bone ridge defects at edentulous sites, with or without mild to moderate vertical bone defects, the shell technique serves as a reliable and minimally invasive bone augmentation method with effective space maintenance. The shell technique involves fixating 1 mm cortical bone blocks to the recipient site, using retention screws and filling the gap between the bone block and recipient bed with particulate bone substitute materials, and covering the barrier membrane to achieve bone augmentation. The overlying tension-free soft tissue closure seals the surgical site while local peripheral blood releases osteoclasts and cytokines that gradually degrade the bone block. The rigid fixation of the bone block ensures a stable internal environment for osteogenesis and a new bone regeneration cycle. Although this technique demonstrates favorable bone augmentation outcomes, it is highly technique-sensitive. There are certain differences in the application scenarios and osteogenic processes for autologous and allogeneic bone shells. The selection of bone blocks and particulate bone substitute materials significantly influences the osteogenic biological process and the predictability of bone augmentation results. Complications associated with the shell technique possess distinct characteristics, such as the immunogenicity of allogeneic bone fragments, soft tissue cracking, and bone fragment loosening. Their prevention and subsequent management substantially impact the success rate of osteogenesis. This article delves into the biological mechanisms of osteogenesis in the bone block technique, summarizing the indications, clinical outcomes, classification of bone blocks, and surgical workflow management, as well as complication prevention and management, aiming to provide a reference for the future application and development of the bone shell technique.

The prescription Mahuang Shengmatang in the Treatise on Cold Damage （《伤寒论》） has sparked considerable debate among medical practitioners throughout history， with varying opinions on its indications， pathogenesis described in the text， principle of compatibility， and clinical applications. Both ancient and modern interpreters of Mahuang Shengmatang often focus on herbal compatibility as a primary approach to deduce the pathogenesis and treatment methods. Building upon this foundation， this paper utilizes herbal dosage as a clue to discern the primary and secondary herbs in the prescription. It further analyzes the principle of compatibility based on herbal indications， summarizing the indications and therapeutic principles of this prescription. Ultimately， it reveals the underlying pathogenesis reflected in the text. The internal closure of heat and toxin leads to the stagnation of Qi， preventing Yang Qi from reaching the extremities and causing cold hands and feet. When the pathogenic Qi finds no outlet， it floods both the upper and lower regions of the body， attacking the throat and causing cough with expectoration of pus and blood， and descending to the large intestine to consume Yin fluids， resulting in persistent diarrhea. Based on this pathogenesis， the paper expands the scope of symptoms and signs associated with the prescription， providing a more detailed portrayal of the applicable patient population and enhancing the basis for clinical prescription references. Additionally， the paper presents considerations on several controversial topics， suggesting that the "lower pulse" described in the text refers to the lower limb arterial pulsation， and the symptoms and signs resemble those of septic shock in modern medicine. Therefore， Mahuang Shengmatang should be categorized as a prescription for treating warm diseases and it is not developed by ZHANG Zhongjing. By employing a detailed discussion on the syndrome， pathogenesis， and clinical application in the texts of Mahuang Shengmatang from the dosage， principle of compatibility， and herbal indications， this paper not only enriches the theoretical foundation of Mahuang Shengmatang but also provides a comprehensive perspective and fresh ideas for understanding its clinical application.

ObjectiveBased on ultra performance liquid chromatography-quadrupole-time-of-flight mass spectrometry（UPLC-Q-TOF-MS/MS）， the combination of serum pharmacochemistry， response profile of absorbed components in serum， network pharmacology and drug-likeness prediction was used to screen the potential active ingredients of Yanghetang against breast cancer. MethodsUPLC-Q-TOF-MS/MS was used to identify the main components in different solvent extracts of Yanghetang， and serum pharmacochemistry was applied to analyze the absorbed components from the serum of female SD rats after 0.5， 1， 2 h of administration. Combined with the response characteristic values of serum drug components obtained from UNIFI 1.8.2， the absorbed prototype components and metabolites were screened to get the absorbed components of Yanghetang with a significant patterns of elimination and growth. Network pharmacology was applied to construct a drug-component-pathway-target-disease network， and molecular docking was performed between absorbed components and key targets of breast cancer， and the drug similarity was analyzed by SwissADME. ResultsForty-two compounds were identified in Yanghetang samples extracted with different solvents， of which 16 compounds were common to the three different extraction solvents（methanol， 50% methanol and water）. The results of drug-containing serum analysis showed that there were 16 absorbed components in serum， including 5 prototypes and 11 metabolites. Network pharmacology results showed that Yanghetang against breast cancer involved 15 key targets such as proto-oncogene tyrosine-protein kinase Src（SRC）， epidermal growth factor receptor（EGFR） and phosphoinositide 3 kinase catalytic alpha polypeptide（PIK3CA）. Molecular docking results showed that 16 potential active ingredients were well combined with the predicted targets. Combined with drug likenesses， 12 compounds in the absorbed components of Yanghetang were considered to have potential for anti-breast cancer activity， mainly including α-pinene and γ-eudesmol and their metabolites， of which one was from Ephedrae Herba， one was from Rehmanniae Radix， and eight were from Cinnamomi Cortex. ConclusionThe chemical components of Yanghetang mainly include polysaccharides， monoterpene glycosides and coumarins， and its prototype components mainly undergo oxidation， hydrolysis and acetylation after entering the blood. Its anti-breast cancer mechanism may be related to the regulation of signaling pathways such as the mitogen-activated protein kinase（MAPK） and phosphatidylinositol 3-kinase/protein kinase B（PI3K/Akt）. The results of this study can lay a foundation for further exploration of Yanghetang in the treatment of breast cancer.

Osteoporosis （OP） is a systemic metabolic disease with a strong correlation with age. The prevalence of osteoporosis is rising annually as a consequence of the growing issue of population ageing. The current treatments for OP have numerous shortcomings. In contrast， traditional Chinese medicine has a long history and a rich species diversity. Furthermore， recent years have seen an increase in the number of studies examining the anti-OP properties of traditional Chinese medicine. This may provide a safe and effective alternative strategy for the treatment of OP. The zebrafish， due to its favourable optical transparency and high homology with human genes， has been extensively employed as an animal research model in the investigation of human skeletal-related disease mechanisms and drug screening. This paper presents a review of anti-osteoporosis studies of traditional Chinese medicine using zebrafish as a model for osteoporosis. It also provides a summary of the experimental evaluation methods involved in such studies， an analysis of the current status of traditional Chinese medicine in the treatment of osteoporosis using zebrafish as a model， and a summary of the mechanism of action and the signalling pathways involved in traditional Chinese medicine in the anti-osteoporosis treatment of zebrafish. The current research status of Chinese medicine in the treatment of OP was analysed， as well as the mechanism of action of Chinese medicine against OP and the signalling pathways involved. Furthermore， the advantages and disadvantages of various zebrafish modelling methods of OP were compared with those of traditional animal models. The objective of this study is to provide a reference for the evaluation method of the zebrafish model in the study of bone-related diseases， as well as for the study of the mechanism of action of traditional Chinese medicine against OP and for the reference of the research and development of new drugs.

Objective:To explore the relationship between childhood abuse, pleasure experience, sleep quality and self-injury behavior in adolescents with depressive disorder.Methods:One hundred and twenty adolescent patients with depressive disorder hospitalized in the Fourth People's Hospital of Hefei City from January 2021 to February 2024 were selected as the study group, as well as 120 healthy controls matched with the patients' age, gender and education level were selected as the control group.The adolescent non-suicidal self-injury assessment questionnaire, Pittsburgh sleep quality index, temporal experience of pleasure scale, and childhood trauma questionnaire were used for assessment. Statistical analysis was performed using SPSS 26.0 software. Independent sample t-test was used for comparison between the two groups. Pearson correlation analysis was used to analyze correlations between scale scores. Chain mediating modeling was used with the PROCESS macro program. Results:The differences of the study group and the control group in childhood abuse ((53.33±15.21), (39.07±11.81), t=8.081, P<0.001), pleasure experience ((85.60±15.77), (67.44±19.46), t=7.941, P<0.001), self-injury behavior ((29.01±9.89), (3.76±0.49), t=8.811, P<0.001), sleep quality ((12.24±4.15), (6.56±4.05), t=10.711, P<0.001), and depression ((30.62±7.97), (5.88±3.28), t=31.451, P<0.001) were all statistically significant. The self-injury behavior of the study group was positively correlated with the sleep quality ( r=0.487, P<0.001) and childhood abuse ( r=0.553, P<0.001), and negatively correlated with the pleasure experience ( r=-0.483, P<0.001). Childhood abuse had a negative predictive effect on pleasure experience ( β=-0.491, P<0.001), there was a positive predictive effect of childhood abuse on sleep quality ( β=0.363, P<0.001), there was a negative predictive effect of pleasure experience on sleep quality ( β=-0.321, P<0.001), there was a simultaneous predictive effect of childhood abuse, pleasure experience and sleep quality on self-injury behaviors predictive effect ( β=0.343, P<0.001, β=-0.211, P<0.001, β=0.208, P<0.001).The total effect of childhood abuse on self-injury behavior mediated by pleasure experience and sleep quality was 0.555(95% CI=0.448-0.663), and the direct effect was 0.343(95% CI=0.219-0.468).The mediating effect of pleasure experience between childhood abuse and self-injury behavior was 0.104(95% CI=0.007-0.196), accounting for 18.74% of the total effect, the mediating effect of sleep quality between childhood abuse and self-injury behavior was 0.075(95% CI=0.028-0.133), accounting for 13.51% of the total effect, and the chain mediating effect of pleasure experience and sleep quality between childhood abuse and self-injury behavior was 0.033(95% CI=0.011-0.060), accounting for 5.95% of the total effect. Conclusion:Sleep quality and pleasure experience exert the chain mediating effect between the childhood abuse and self-injury behavior in adolescents with depressive disorders.

Anxiety is a major emotional disorder manifested in the individual's expectation of future threats.The incidence rate of anxiety is about 7.3％,with the highest lifetime prevalence rate among mental health conditions.The mechanism of anxiety overlaps with depression,and anxiety is a typical symptom of various mental diseases or emotional disorders in traditional Chinese medicine.The high rates of comorbidity and disability pose serious threats to people's health.Animal models are important tools for studying anxiety and are of great use for deciphering the pathogenesis of anxiety and for developing drugs.The traditional paradigm of stress-induced anxiety,however,is relatively limited.Based on traditional theory combined with clinical and animal experimental data,we propose a new hypothesis of"insufficiency of ZhiYi'causing anxiety,defined as"an anxiety state induced by the inability of an individual to meet their own needs,limited or lacking after multiple attempts,rendered hindered and powerless by an inability to meet their desires".This hypothesis is more in line with the typical manifestations of despair,lack of pleasure,and social withdrawal in clinical patients,and is supported by traditional theory and experimental data showing"hunger but unable to eat,food but unable to obtain,and gain but not full".Based on this,the established modeling paradigm is easy to apply,with good repeatability and low cost,and can be used to establish anxiety models in rats and mice,to provide a theoretical and model basis for the development and pharmacological evaluation of anti-anxiety drugs.

Objective:To explore the relationship between childhood abuse, pleasure experience, sleep quality and self-injury behavior in adolescents with depressive disorder.Methods:One hundred and twenty adolescent patients with depressive disorder hospitalized in the Fourth People's Hospital of Hefei City from January 2021 to February 2024 were selected as the study group, as well as 120 healthy controls matched with the patients' age, gender and education level were selected as the control group.The adolescent non-suicidal self-injury assessment questionnaire, Pittsburgh sleep quality index, temporal experience of pleasure scale, and childhood trauma questionnaire were used for assessment. Statistical analysis was performed using SPSS 26.0 software. Independent sample t-test was used for comparison between the two groups. Pearson correlation analysis was used to analyze correlations between scale scores. Chain mediating modeling was used with the PROCESS macro program. Results:The differences of the study group and the control group in childhood abuse ((53.33±15.21), (39.07±11.81), t=8.081, P<0.001), pleasure experience ((85.60±15.77), (67.44±19.46), t=7.941, P<0.001), self-injury behavior ((29.01±9.89), (3.76±0.49), t=8.811, P<0.001), sleep quality ((12.24±4.15), (6.56±4.05), t=10.711, P<0.001), and depression ((30.62±7.97), (5.88±3.28), t=31.451, P<0.001) were all statistically significant. The self-injury behavior of the study group was positively correlated with the sleep quality ( r=0.487, P<0.001) and childhood abuse ( r=0.553, P<0.001), and negatively correlated with the pleasure experience ( r=-0.483, P<0.001). Childhood abuse had a negative predictive effect on pleasure experience ( β=-0.491, P<0.001), there was a positive predictive effect of childhood abuse on sleep quality ( β=0.363, P<0.001), there was a negative predictive effect of pleasure experience on sleep quality ( β=-0.321, P<0.001), there was a simultaneous predictive effect of childhood abuse, pleasure experience and sleep quality on self-injury behaviors predictive effect ( β=0.343, P<0.001, β=-0.211, P<0.001, β=0.208, P<0.001).The total effect of childhood abuse on self-injury behavior mediated by pleasure experience and sleep quality was 0.555(95% CI=0.448-0.663), and the direct effect was 0.343(95% CI=0.219-0.468).The mediating effect of pleasure experience between childhood abuse and self-injury behavior was 0.104(95% CI=0.007-0.196), accounting for 18.74% of the total effect, the mediating effect of sleep quality between childhood abuse and self-injury behavior was 0.075(95% CI=0.028-0.133), accounting for 13.51% of the total effect, and the chain mediating effect of pleasure experience and sleep quality between childhood abuse and self-injury behavior was 0.033(95% CI=0.011-0.060), accounting for 5.95% of the total effect. Conclusion:Sleep quality and pleasure experience exert the chain mediating effect between the childhood abuse and self-injury behavior in adolescents with depressive disorders.

Objective To investigate extended high-frequency hearing in young adults and to analyse its char-acteristics.Methods A total of 230 freshmen(101 males and 129 females,aged 17-19 years old)from the class of 2023 at the Air Force Medical University underwent audiometric tests,including acoustic impedance,conventional frequency and extended high-frequency audiometry,and distortion product otoacoustic emissions(DPOAE).Ac-cording to the results of extended high-frequency audiometry,the students were divided into normal and abnormal groups,and the hearing thresholds at conventional frequencies were compared between the two groups.Results Of the 230 students,47.83％(110/230)showed abnormal extended high-frequency hearing.The hearing thresholds of the right ear were 1 to 3 dB higher than those of the left ear at most frequencies.The hearing thresholds of the ab-normal group were higher than those of the normal group in the conventional frequencies(P＜0.05).The difference in extended high-frequency thresholds between the two groups increased with higher frequency.Conclusion Ex-tended high-frequency hearing loss occurs earlier,and has a higher prevalence in young adults,and right ear hearing is worse than that of left ear.Extended high-frequency audiometry can be used as a predictive tool for detecting con-ventional frequency hearing loss.

Objective:To investigate the safety and efficacy of the artery-first approach pancreaticoduo-denectomy (PD) combined with portal vein/superior mesenteric vein (PV/SMV) resection and reconstruction for pancreatic head malignancies.Methods:A retrospective analysis was conducted on 322 patients who underwent PD with PV/SMV resection and reconstruction at the Hepatobiliary Pancreatic Surgery Department of the First Hospital Affiliated to Naval Medical University between January 2016 and December 2022. Patients were divided into the artery-first approach PD group (AFA-PD group, n=165) and standard PD group (SPD group, n=157) based on surgical approach. Baseline characteristics, surgical outcomes, postoperative outcomes, pathological results and survival data were compared between two groups. Results:Compared to the SPD group, the AFA-PD group exhibited significantly reduced intraoperative blood loss (500 ml vs 600 ml), lower rates of obvious intraoperative blood loss (≥1 000 ml: 25.45% vs 40.13%), and decreased transfusion requirements (26.67% vs 52.87%). Postoperatively, the AFA-PD group demonstrated lower incidence of grade B/C pancreatic fistula (10.30% vs 19.75%) and higher textbook outcome achievement (78.79% vs 66.24%). Pathologically, the AFA-PD group achieved superior lymph node yield (20 nodes vs 18 nodes) and higher R 0 resection rates (79.39% vs 64.33%), particularly at the posterior pancreatic margin (96.97% vs 91.72%, P=0.040), SMA margin (92.07% vs 82.17%), and SMV margin (88.48% vs 78.98%). Multivariate logistic regression identified arterial invasion >180°, venous invasion >180°, lymph node metastasis, and the artery-first approach as independent predictors of R 0 resection. The AFA-PD group showed prolonged median survival (19.17 month vs 15.73 month). All aforementioned differences were statistically significant (all P value <0.05). Conclusions:The artery-first approach PD combined with PV/SMV resection and reconstruction is safe and effective for pancreatic head malignancies, significantly improving R 0 resection rates and patients' survival outcomes.

This study examines the progress and application of Artificial Intelligence (AI) in the prevention and control of infectious diseases within Chinese healthcare institutions. It analyzes the difficulties and challenges encountered during implementation to promote the intelligent transformation and upgrading of infectious disease prevention and control. The results indicate that AI technology has made progress in areas such as infectious disease surveillance and early warning, risk assessment and emergency response, screening and detection, image-based diagnosis and analysis, and health management. Nevertheless, significant challenges remain, including limited application depth and breadth, issues with data quality and privacy protection, insufficient technological maturity and interpretability, potential legal risks, and a shortage of interdisciplinary professionals. To advance the application of AI technology in infectious disease prevention and control and support the modernization of China′s relevant systems, recommendations include strengthening policy support, establishing data standards and robust privacy protection mechanisms, increasing R&D investment, refining laws and regulations, and enhancing the training of interdisciplinary talent.