The occurrence of diabetes mellitus （DM） is closely related to insulin resistance and islet β cell dysfunction. Modern studies have found that macrophages are widely present in the liver，fat，skeletal muscle，islets， and other tissues and organs. Macrophage M1/M2 polarization plays an important role in the occurrence and development of diabetes mellitus and its related complications by intervening in inflammatory response，improving insulin resistance，and promoting tissue repair. Most of the traditional Chinese medicines that regulate the activation and polarization of macrophages are Qi-replenishing and Yin-nourishing，heat-clearing， and detoxicating medicinal，which are consistent with the etiology and pathogenesis of diabetes and its related complications. Therefore，by summarizing the mechanisms between macrophage activation，polarization， and insulin resistance in various tissues，this paper reviewed traditional Chinese medicine and its effective components and compounds in improving diabetes mellitus and its related complications through multi-channel regulation of macrophage polarization and regulation of M1/M2 ratio，providing references for the future treatment of DM and its related complications with traditional Chinese medicine.

Glycoprotein non-metastatic melanoma protein B (GPNMB) is a transmembrane glycoprotein that plays an important role in various physiological and pathological processes. In recent years, its role in lung diseases has gradually attracted attention. Studies have found that GPNMB is abnormally expressed in lung diseases and is involved in regulating pathological processes such as inflammatory responses, fibrosis, and tumorigenesis. This article systematically reviews the research progress of GPNMB in common lung diseases such as chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, and lung cancer, and explores its potential as a therapeutic target, providing new insights for the diagnosis and treatment of lung diseases in the future.

The pharmaceutical industry faces challenges in quality digitization for complex multi-stage processes, especially in small-sample systems. Here, an intelligent quality prediction and diagnostic (IQPD) framework was developed and applied to Tong Ren Tang's Niuhuang Qingxin Pills, utilizing four years of data collected from four production units, covering the entire process from raw materials to finished products. In this framework, a novel path-enhanced double ensemble quality prediction model (PeDGAT) is proposed, which combines a graph attention network and path information to encode inter-unit long-range and sequential dependencies. Additionally, the double ensemble strategy enhances model stability in small samples. Compared to global traditional models, PeDGAT achieves state-of-the-art results, with an average improvement of 13.18% and 87.67% in prediction accuracy and stability on three indicators. Additionally, a more in-depth diagnostic model leveraging grey correlation analysis and expert knowledge reduces reliance on large samples, offering a panoramic view of attribute relationships across units and improving process transparency. Finally, the IQPD framework integrates into a Human-Cyber-Physical system, enabling faster decision-making and real-time quality adjustments for Tong Ren Tang's Niuhuang Qingxin Pills, a product with annual sales exceeding 100 million CNY. This facilitates the transition from experience-driven to data-driven manufacturing.

Peri-implant keratinized mucosa (PIKM) augmentation refers to surgical procedures aimed at increasing the width of PIKM. Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-term peri-implant health. Currently, several surgical techniques have been validated for their effectiveness in increasing PIKM. However, the selection and application of PIKM augmentation methods may present challenges for dental practitioners due to heterogeneity in surgical techniques, variations in clinical scenarios, and anatomical differences. Therefore, clear guidelines and considerations for PIKM augmentation are needed. This expert consensus focuses on the commonly employed surgical techniques for PIKM augmentation and the factors influencing their selection at second-stage surgery. It aims to establish a standardized framework for assessing, planning, and executing PIKM augmentation procedures, with the goal of offering evidence-based guidance to enhance the predictability and success of PIKM augmentation.
Humans ; Consensus ; Dental Implants ; Mouth Mucosa/surgery* ; Keratins

Growth factors (GFs) are a class of peptides that facilitate cell growth by binding to specific receptors on the cell membrane. With unique properties, GFs are widely applied in the repair of injured tissue. To address the limitations associated with natural peptide-based GFs and recombinant GFs, researchers have developed diverse GF mimetics. This article offers a comprehensive review on common types of GFs and their applications in tissue repair and summarizes the features of GF mimetics currently under development. The aim is to provide valuable references for promoting the application of GFs in regenerative medicine.
Intercellular Signaling Peptides and Proteins/therapeutic use* ; Humans ; Tissue Engineering/methods* ; Regenerative Medicine/methods* ; Animals ; Wound Healing/drug effects* ; Biomimetic Materials

Objective To investigate the expression of fibroblast growth factor (FGF)19 in neonatal hyperbilirubinemia and its correlation with intestinal flora characteristics and β-glucuronidase (β-GD) activity. Methods Seventy-five neonates with hyperbilirubinemia in Daqing Longnan Hospital from January 2022 to January 2023 were selected as the observation group and 45 neonates with non-hyperbilirubinemia during the same period were selected as the control group.Serum FGF19,total bilirubin and total bile acid levels,intesti-nal flora characteristics and β-GD activity were compared between the two groups.The correlation between FGF19,intestinal flora and β-GD activity with serum total bilirubin level and total bile acid (TBA) level in newborns with hyperbilirubinemia and the correlation between FGF19 with the intestinal flora characteristics and β-GD activity were analyzed by the Pearson method.Results The serum FGF19 level in the observation group was lower than that in the control group,the total bilirubin and TBA levels and β-GD activity were higher,the number of bifidobacterium and Lactobacillus were much less,the number of Escherichia coli was more,and the differences were statistically significant (P<0.05).The FGF19 level and number of bifidobac-terium and Lactobacillus in newborns with hyperbilirubinemia were negatively correlated with the levels of se-rum total bilirubin and TBA levels,while the number of Escherichia coli and β-GD activity were positively cor-related with the levels of serum total bilirubin and TBA (P<0.05).FGF19 in hyperbilirubinemia neonates was positively correlated with the number of bifidobacterium and Lactobacillus,and negatively correlated with Escherichia coli and β-GD activity (P<0.05).Conclusion The serum FGF19 in neonates with hyperbilirubinemia is abnormally low expressed,moreover which is related to intestinal flora disturbance and β-GD activity.

The utilization of optimal orthodontic force is crucial to prevent undesirable side effects and ensure efficient tooth movement during orthodontic treatment.However,the sensitivity of existing detection techniques is not sufficient,and the criteria for evaluating optimal force have not been yet established.Here,by employing 3D finite element analysis methodology,we found that the apical distal region(A-D region)of mesial roots is particularly sensitive to orthodontic force in rats.Tartrate-resistant acidic phosphatase(TRAP)-positive osteoclasts began accumulating in the A-D region under the force of 40 grams(g),leading to alveolar bone resorption and tooth movement.When the force reached 80 g,TRAP-positive osteoclasts started appearing on the root surface in the A-D region.Additionally,micro-computed tomography revealed a significant root resorption at 80 g.Notably,the A-D region was identified as a major contributor to whole root resorption.It was determined that 40 g is the minimum effective force for tooth movement with minimal side effects according to the analysis of tooth movement,inclination,and hyalinization.These findings suggest that the A-D region with its changes on the root surface is an important consideration and sensitive indicator when evaluating orthodontic forces for a rat model.Collectively,our investigations into this region would aid in offering valuable implications for preventing and minimizing root resorption during patients'orthodontic treatment.

Objective To explore the effectiveness of a PBL-CBL teaching model oriented towards competency evaluation after the introduction of standardized patients in orthopedic clinical internship teaching.Methods Eighty-nine medical students undergoing orthopedic internships at our hospital from 2022 to 2023 were divided into an S-PC teaching group and a PC teaching group.Based on Milestones 2.0,a competency evaluation model for orthopedic interns was established,including six primary in-dicators:patient care,clinical knowledge and skills,interpersonal communication,and more.After the course,students were as-sessed according to the established model.Results The S-PC group showed statistically significant differences in scores for pa-tient care,clinical knowledge and skills,interpersonal communication,system-based practice,and practice-based learning com-pared to the PC group(P＜0.05),with all scores in the S-PC group being higher than those in the PC group.Conclusion In-troducing standardized patients into the PBL-CBL teaching model in clinical education significantly enhances the competency of orthopedic interns.

BACKGROUND:Trauma-induced coagulopathy(TIC)due to serious injuries significantly leads to increased mortality and morbidity among elderly patients.However,the risk factors of TIC are not well elucidated.This study aimed to explore the risk factors of TIC in elderly patients who have major trauma. METHODS:In this retrospective study,the risk factors for TIC in elderly trauma patients at a single trauma center were investigated between January 2015 and September 2020.The demographic information including gender,age,trauma parts,injury severity,use of blood products,use of vasopressors,need of emergency surgery,duration of mechanical ventilation,length of stay in the intensive care unit(ICU)and hospital,and clinical outcomes were extracted from electric medical records.Multivariate logistic regression analysis was performed to differentiate risk factors,and the performance of the model was evaluated using receiver operating characteristics(ROC)curves. RESULTS:Among the 371 elderly trauma patients,248(66.8%)were male,with the age of 72.5±6.8 years,median injury severity score(ISS)of 24(IQR:17-29),and Glasgow coma score(GCS)of 14(IQR:7-15).Of these patients,129(34.8%)were diagnosed with TIC,whereas 242(65.2%)were diagnosed with non-TIC.The severity scores such as ISS(25[20-34]vs.21[16-29],P<0.001)and shock index(SI),(0.90±0.66 vs.0.58±0.18,P<0.001)was significantly higher in the TIC group than in the non-TIC group.Serum calcium levels(1.97±0.19 mmol/L vs.2.15±0.16 mmol/L,P<0.001),fibrinogen levels(1.7±0.8 g/L vs.2.8±0.9 g/L,P<0.001),and base excess(BE,-4.9±4.6 mmol/L vs.-1.2±3.1 mmol/L,P<0.001)were significantly lower in the TIC group than in the non-TIC group.Multivariate logistic regression analysis revealed that ISS>16(OR:3.404,95%CI:1.471-7.880;P=0.004),SI>1(OR:5.641,95%CI:1.700-18.719;P=0.005),low BE(OR:0.868,95%CI:0.760-0.991;P=0.037),hypocalcemia(OR:0.060,95%CI:0.009-0.392;P=0.003),and hypofibrinogenemia(OR:0.266,95%CI:0.168-0.419;P<0.001)were independent risk factors for TIC in elderly trauma patients.The AUC of the prediction model included all these risk factors was 0.887(95%CI:0.851-0.923)with a sensitivity and specificity of 83.6%and 82.6%,respectively. CONCLUSION:Higher ISS(more than 16),higher SI(more than 1),acidosis,hypocalcemia,and hypofibrinogenemia emerged as independent risk factors for TIC in elderly trauma patients.