To thoroughly implement the strategic deployment outlined in the Opinions of the Central Committee of the Communist Party of China and the State Council on Promoting the Inheritance and Innovative Development of Traditional Chinese Medicine regarding research on dominant diseases of traditional Chinese medicine and to uphold the development philosophy of equal emphasis on traditional Chinese medicine and western medicine，the China Association of Chinese Medicine has fully played a leading academic role by systematically organizing and conducting a series of academic youth salons on clinical dominant diseases of traditional Chinese medicine. On September 13，2024，the 36^th Youth Salon on Clinical Dominant Diseases was successfully held in Nanjing，focusing on the advantages of traditional Chinese medicine and the integrative traditional Chinese medicine and western medicine in the diagnosis and treatment of erectile dysfunction （ED）. The conference brought together leading experts from traditional Chinese medicine，western medicine，and interdisciplinary fields，facilitating in-depth multidisciplinary discussions that led to key consensus on optimizing traditional Chinese medicine treatment protocols for ED，researching and developing new drugs of traditional Chinese medicine，and advancing interdisciplinary development in traditional Chinese medicine. This salon systematically sorted out the clinical strengths and distinctive features of traditional Chinese medicine in the diagnosis and treatment of ED. Based on current research foundations and clinical needs，it identified key directions for future scientific layout and scientific research tackling： （1） Standardization of syndrome differentiation system of traditional Chinese medicine for ED. （2） Optimization and standardization of intervention methods of integrated traditional Chinese medicine and western medicine. （3） High-quality clinical research guided by evidence-based medicine. （4） In-depth analysis of the pharmacological mechanisms of traditional Chinese medicine in the treatment of ED. （5） Clinical translation and application promotion of new drugs of traditional Chinese medicine. （6） Interdisciplinary integration and innovation in traditional Chinese medicine. For each research direction，key focus areas，expected objectives，and clinical value were further refined，along with the establishment of a scientifically sound priority funding level evaluation system. Therefore，building on the series of salons on the ED-focused dominant diseases of traditional Chinese medicine，this paper provides standardized guidance for clinical practice of traditional Chinese medicine in ED management，effectively contributing to the high-quality development of traditional Chinese medicine. It serves as a valuable reference for national scientific and technological strategic layout， research and development decision-making in new drugs of traditional Chinese medicine，research topic planning，and clinical guideline formulation.

Objective: To determine the clinical efficacy and mechanism of Piwei Peiyuan Pill (PPP) combined with moxibustion for treating patients with chronic atrophic gastritis (CAG) with spleen and stomach weakness syndrome. Methods: Ninety-six CAG patients with spleen and stomach weakness syndrome who met the inclusion and exclusion criteria were enrolled at the Department of Spleen and Stomach Diseases of the Second Affiliated Hospital of Anhui University of Chinese Medicine from June 2022 to December 2023. The patients were randomly divided into a control, a Chinese medicine, and a combined group using a random number table method, with 32 cases in each group (two cases per group were excluded). The control group was treated with rabeprazole combined with folic acid tablets (both thrice daily), the Chinese medicine group was treated with PPP (8 g, thrice daily), and the combined group was treated with moxa stick moxibustion (once daily) on the basis of the Chinese medicine group for 12 consecutive weeks. Gastric mucosa atrophy in the three groups was observed before and after treatment. The gastric mucosal pathological score was evaluated. The Patient Reported Outcome (PRO) scale was used to evaluate the patients′ physical and mental health status and quality of life.An enzyme-linked immunosorbent assay was used to detect serum tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-4, IL-10, IL-37, and transforming growth factor (TGF)-β levels in each group. Real-time fluorescence PCR was used to detect the relative expression levels of signal transducer and activator of transcription 3 (STAT3) and mammalian target of rapamycin (mTOR) mRNA in each group. Western blotting was used to detect the relative expression levels of proteins related to the STAT3/mTOR signaling pathway, and the adverse drug reactions and events were recorded and compared. Results: There was no statistical difference in age, gender, disease duration, family history of gastrointestinal tumors, alcohol consumption history, and body mass index among the three groups of patients.The total therapeutic efficacy rates of the control, Chinese medicine, and combined groups in treating gastric mucosal atrophy were 66.67% (20/30), 86.67% (26/30), and 90.00% (27/30), respectively (P<0.05). Compared to before treatment, the pathological and PRO scale scores of gastric mucosa in each group decreased after treatment, and TNF-α, IL-1β, IL-37, and TGF-β levels decreased. The relative STAT3 and mTOR mRNA expression levels, as well as the relative STAT3, p-STAT3, mTOR, and p-mTOR protein expression levels decreased (P<0.05), whereas the IL-4 and IL-10 levels increased (P<0.05). After treatment, compared to the control group, the pathological score of gastric mucosa, PRO scale score, TNF-α, IL-1β, IL-37, TGF-β content, relative STAT3 and mTOR mRNA expression levels, and relative STAT3, p-STAT3, mTOR, and p-mTOR protein expression levels in the Chinese medicine and combined groups after treatment were reduced (P<0.05), whereas the IL-4 and IL-10 levels increased (P<0.05). After treatment, compared to the Chinese medicine group, the combined group showed a decrease in relative STAT3, mTOR mRNA expression levels, and STAT3, p-STAT3, mTOR, and p-mTOR protein expression levels (P<0.05). Conclusion The combination of PPP and moxibustion may regulate the inflammatory mechanism of the body by inhibiting the abnormal activation of the STAT3/mTOR signaling pathway, upregulating related anti-inflammatory factor levels, downregulating pro-inflammatory factor expression, and increasing related repair factor expression, thereby promoting the recovery of atrophic gastric mucosa, reducing discomfort symptoms, and improving the physical and mental state of CAG patients with spleen and stomach weakness syndrome.

Gene synthesis is an enabling technology that supports the development of synthetic biology. The existing approaches for de novo gene synthesis generally have tedious operation, low efficiency, high error rates, and limited product lengths, being difficult to support the huge demand of synthetic biology. The assembly and error correction are the keys in gene synthesis. This study first designed the oligonucleotide sequences by reasonably splitting the virus genome of approximately 10 kb by balancing the parameters of sequence design software ability, PCR amplification ability, and assembly enzyme assembly ability. Then, two-step PCR was performed with high-fidelity polymerase to complete the de novo synthesis of 3.0 kb DNA fragments, and error correction reactions were performed with T7 endonuclease Ⅰ for the products from different stages of PCR. Finally, the virus genome was assembled by 3.0 kb DNA fragments from de novo synthesis and error correction and then sequenced. The experimental results showed that the proposed method successfully produced the DNA fragment of about 10 kb and reduced the probability of large fragment mutations during the assembly process, with the lowest error rate reaching 0.36 errors/kb. In summary, this study developed an efficient de novo method for synthesizing a viral genome of about 10 kb with T7 endonuclease Ⅰ-mediated error correction. This method enabled the synthesis of a 10 kb viral genome in one day and the correct plasmid of the viral genome in five days. This study optimized the de novo gene synthesis process, reduced the error rate, simplified the synthesis and assembly steps, and reduced the cost of viral genome assembly.
Genome, Viral/genetics* ; Polymerase Chain Reaction/methods* ; DNA, Viral/genetics* ; Bacteriophage T7/enzymology* ; Synthetic Biology/methods*

Traumatic aortic injury (TAI) is an acute, critical, and severe disease, and then combined with multiple organ damage, it is even more dangerous. TAI progresses very rapidly, with a pre-hospital mortality rate of 57%-80%, and even when arriving at the hospital, more than one-third of the patients die within 4 h, and it is the 2nd leading cause of death in individuals aged 4-34 years. In addition, the incidence of TAI combined with injury was 81.4%. Therefore, early diagnosis, expeditious surgery, and timely and effective multidisciplinary cooperation are essential for successful rescue. The authors report 2 patients with acute traumatic aortic dissection combined with multiple organ injuries and treated with emergency endovascular surgery to discuss their clinical characteristics and treatment experience, and to provide experience in the diagnosis and treatment of such patients.
Humans ; Aortic Dissection/surgery* ; Endovascular Procedures ; Multiple Trauma/surgery*

Peptide receptor radionuclide therapy (PRRT) with radiolabeled SSTR2 agonists is a treatment option that is highly effective in controlling metastatic and progressive neuroendocrine tumors (NETs). Previous studies have shown that an SSTR2 agonist combined with albumin binding moiety Evans blue (denoted as ¹⁷⁷Lu-EB-TATE) is characterized by a higher tumor uptake and residence time in preclinical models and in patients with metastatic NETs. This study aimed to enhance the in vivo stability, pharmacokinetics, and pharmacodynamics of ¹⁷⁷Lu-EB-TATE by replacing the maleimide-thiol group with a polyethylene glycol chain, resulting in a novel EB conjugated SSTR2-targeting radiopharmaceutical, ¹⁷⁷Lu-LNC1010, for PRRT. In preclinical studies, ¹⁷⁷Lu-LNC1010 exhibited good stability and SSTR2-binding affinity in AR42J tumor cells and enhanced uptake and prolonged retention in AR42J tumor xenografts. Thereafter, we presented the first-in-human dose escalation study of ¹⁷⁷Lu-LNC1010 in patients with advanced/metastatic NETs. ¹⁷⁷Lu-LNC1010 was well-tolerated by all patients, with minor adverse effects, and exhibited significant uptake and prolonged retention in tumor lesions, with higher tumor radiation doses than those of ¹⁷⁷Lu-EB-TATE. Preliminary PRRT efficacy results showed an 83% disease control rate and a 42% overall response rate after two ¹⁷⁷Lu-LNC1010 treatment cycles. These encouraging findings warrant further investigations through multicenter, prospective, and randomized controlled trials.

Acute kidney injury (AKI) has high morbidity and mortality, but effective clinical drugs and management are lacking. Previous studies have suggested that macrophages play a crucial role in the inflammatory response to AKI and may serve as potential therapeutic targets. Emerging evidence has highlighted the importance of forkhead box protein O1 (FoxO1) in mediating macrophage activation and polarization in various diseases, but the specific mechanisms by which FoxO1 regulates macrophages during AKI remain unclear. The present study aimed to investigate the role of FoxO1 in macrophages in the pathogenesis of AKI. We observed a significant upregulation of FoxO1 in kidney macrophages following ischemia-reperfusion (I/R) injury. Additionally, our findings demonstrated that the administration of FoxO1 inhibitor AS1842856-encapsulated liposome (AS-Lipo), mainly acting on macrophages, effectively mitigated renal injury induced by I/R injury in mice. By generating myeloid-specific FoxO1-knockout mice, we further observed that the deficiency of FoxO1 in myeloid cells protected against I/R injury-induced AKI. Furthermore, our study provided evidence of FoxO1's pivotal role in macrophage chemotaxis, inflammation, and migration. Moreover, the impact of FoxO1 on the regulation of macrophage migration was mediated through RhoA guanine nucleotide exchange factor 1 (ARHGEF1), indicating that ARHGEF1 may serve as a potential intermediary between FoxO1 and the activity of the RhoA pathway. Consequently, our findings propose that FoxO1 plays a crucial role as a mediator and biomarker in the context of AKI. Targeting macrophage FoxO1 pharmacologically could potentially offer a promising therapeutic approach for AKI.

BACKGROUND:Intervertebral disc degeneration is the most common cause of low back pain;however,its pathogenesis is not yet fully understood.Therefore,it is imperative to explore new strategies for the prevention and treatment of intervertebral disc degeneration.Single-cell RNA sequencing allows high-throughput sequencing of mRNAs at the single-cell level,revealing cell heterogeneity and specific subgroups.This technology provides deeper insights into the regulatory mechanisms of the development of intervertebral disc degeneration,enhances the identification of potential targets,and promotes the exploration of early diagnosis and treatment.OBJECTIVE:To understand single-cell RNA sequencing and its main processes,and to review the recent research progress in single-cell RNA sequencing in intervertebral disc degeneration over the past few years,exploring its potential applications in the discovery of targeted biomarkers.METHODS:A computerized search of relevant literature published from January 2014 to June 2024 in PubMed,Web of Science,CNKI,and WanFang databases was performed using the search terms"single-cell RNA sequencing,sequencing technology,intervertebral disc degeneration,nucleus pulposus,annulus fibrosus,cartilage endplate"in English and Chinese.A total of 57 articles were finally selected for relevant analysis after duplicate and irrelevant literature was excluded.RESULTS AND CONCLUSION:(1)Single-cell RNA sequencing has emerged as a powerful tool for studying gene expression at the single-cell level.It has identified new cell subpopulations and elucidated their functions in intervertebral disc degeneration,thereby enhancing our understanding of the pathological processes involved in this condition.Several new cell subpopulations in the nucleus pulposus have been identified,including hypertrophic cartilage-like nucleus pulposus cells,effector nucleus pulposus cells,and homeostatic nucleus pulposus cells.These findings elucidate the functions and differentiation pathways of these subpopulations during intervertebral disc degeneration,highlighting variations in their proportions and dominant groups at different stages of degeneration.New subpopulations of annulus fibrosus cells,including the Grem1+and Lum+subpopulations,have been discovered.Grem1+is a resident progenitor subpopulation in the annulus fibrosus,with Sox9 and Id1 as key regulatory factors involved in tissue development and cell differentiation.Nr2f2 and Creb5 may be responsible for the vascularization function of the Lum+subpopulation,providing potential cell sources and regulatory targets for the treatment and repair of intervertebral disc degeneration.(2)Mesenchymal chondrocytes found in the cartilage endplate can be further subdivided into homeostatic,effector,and regulatory subtypes.Homeostatic chondrocytes are primarily involved in ossification and collagen-binding processes,regulatory chondrocytes participate mainly in stimulatory and control responses,and effector chondrocytes are predominantly involved in metabolic processes.(3)Further enrichment of monocytes/macrophages in the immune cells of degenerating disc tissues into monocytes/macrophages for oxidative stress,activated tissues,and homeostasis has deepened the understanding of the different functions of monocyte/macrophage subpopulations during the progression of intervertebral disc degeneration to provide personalized treatments based on specific subpopulations.The review summarizes recent advances in single-cell RNA sequencing for identifying targeted biomarkers in intervertebral disc degeneration,offering new insights into diagnostic and therapeutic strategies.

Objective:To observe the effect of stellate ganglion block(SGB)on the inflammatory response in rats with acute peritonitis,and to explore whether the possible anti-inflammatory mechanism related to the activation of α7nAChR receptor-mediated cholinergic anti-inflammatory pathway.Methods:A total of 36 SD rats were randomly divided into three groups,with 12 rats in each group:sham operation group(S group),acute peritonitis group(AP group)and SGB treatment group(SGB group).2%acetic acid(1 ml/100 g)was intraperitoneally injected to prepare acute peritonitis rat model in AP group and SGB group,and corresponding dose of normal saline was injected into S group.Right cervical sympathetic nerve was separated but not ligated in AP group and S group,the right cervical sympathetic nerve was severed and ligated in SGB group.Abdominal aorta blood samples were collected 24 h after opera-tion,and serum levels of IL-1β,IL-6 and TNF-α were measured by ELISA,pathological changes of peritoneal tissue were observed by light microscope and expression of α7nAChR in peritoneal tissue was measured by Western blot.Results:Compared with S group,se-rum levels of IL-1β,IL-6 and TNF-α in AP and SGB groups were significantly increased(P<0.05).Serum levels of IL-1β,IL-6,TNF-α in SGB group were significantly lower than those in AP group(P<0.05).HE staining of peritoneal tissues in each group revealed that the S group maintained intact peritoneal structure with normal cellular arrangement,while the AP group exhibited disorganized archi-tecture with extensive inflammatory cell infiltration,frequent hemorrhage,and prominent necrotic cells.In contrast,the SGB group displayed only mild inflammatory infiltration with preserved cellular morphology and minimal hemorrhagic or necrotic changes.The ex-pression level of α7nAChR protein in SGB group was significantly higher than that in S group and AP group.Conclusion:SGB can re-duce the inflammatory response of acute peritonitis rats,and its mechanism may be related to the cholinergic anti-inflammatory path-way mediated by α7nAChR.

Objective To analyze the MR imaging features of patients with general paresis of the insane(GPI),characterized by bilateral hippocampal atrophy,and to explore how to improve the accuracy of early GPI diagnosis.Methods A retrospective analysis was conducted on the clinical manifestations,brain imaging data,diagnosis and treatment of 11 patients with GPI.Results Among the 11 cases,MRI showed that 9 cases had varying degrees of brain atrophy,of which 7 cases showed age-inappropriate brain atro-phy,especially bilateral hippocampal atrophy as the main sign,and the remaining 2 cases showed brain atrophy accompanied by multi-ple abnormal intracranial signals;2 cases only showed multiple abnormal intracranial signals.Conclusion MR imaging findings of GPI often manifests only age-inappropriate brain atrophy,particularly bilateral hippocampal atrophy,a feature that holds significant diagnostic value for early detection with reducing missed diagnosis rate of GPI.

Aim To explore the predictive value of stress hyperglycemia ratio(SHR)for in-hospital mortality and mechanical complications in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods This study constituted a retrospective investigation that collected 995 patients diagnosed with acute STEMI at Suining Central Hospital from June 2019 to July 2023.Comparisons of baseline data were conducted using t-test,Mann-Whitney U test and chi-square test;Logistic regression was used to analyze the association between SHR and the risk of in-hospital mortality and mechanical complications in acute STEMI patients;Restricted cubic spline analysis based on the Logistic re-gression model was utilized to explore non-linear relationship between SHR and the risk of in-hospital mortality and mechan-ical complications;ROC curve was used to evaluate the diagnostic efficacy of SHR;Subgroup analysis was used to assess the predictive efficacy of SHR in each subgroup.Results Patients with high SHR had a significantly higher cardiovas-cular mortality(P=0.007).High SHR was an independent risk factor for in-hospital all-cause mortality(Model 1:OR=3.085,95％ CI:1.719～5.538,P＜0.001;Model 2:OR=2.738,95％ CI:1.4439～5.132,P=0.002),cardiovascular mortality(Model 1:OR=3.406,95％ CI:1.869～6.228,P＜0.001;Model 2:OR=3.053,95％ CI:1.595～5.817,P＜0.001),ventricular aneurysm(Model 1:OR=3.203,95％CI:1.665～6.069,P＜0.001;Model2:OR=3.93,95％CI:1.785～8.663,P＜0.001),cardiac rupture(Model 1:OR=2.461,95％ CI:1.389～4.312,P=0.002;Model 2:OR=2.302,95％ CI:1.214～4.274,P=0.009)and composite endpoint(Model 1:OR=3.719,95％ CI:2.226～6.332,P＜0.001;Model 2:OR=2.919,95％ CI:1.576～5.405,P＜0.001)in patients with acute STEMI.SHR was positively correlated in a linear relationship with the risk of in-hospital all-cause mortality(P for non-linearity=0.250),cardiovascular mortality(P for non-linearity=0.129),ventricular aneurysm(P for non-linearity=0.588),cardiac rupture(P for non-linearity=0.787)and composite endpoint(P for non-linearity=0.399).The SHR had excellent diagnostic efficacy for in-hospital all-cause mortality(AUC=0.694),cardiovascular mortality(AUC=0.697),ventricular aneurysm(AUC=0.706),cardiac rupture(AUC=0.667)and composite endpoint(AUC=0.730),meanwhile SHR predicted efficacy consistently across subgroups.Conclusions High SHR is an independent risk factor for in-hospital all-cause mortality,cardiovascular mortality and cardiac mechanical complications in patients with a-cute STEMI.SHR holds significant predictive value for the prognosis of patients with STEMI.