The theory of constitution in traditional Chinese medicine （TCM） has emerged as a new discipline in recent years. Constitution plays a vital role in the onset，progression，transformation，and prognosis of diseases. At present，some clinical scholars have adopted a novel diagnostic and treatment model of "constitution differentiation-disease identification-syndrome differentiation"，in which constitution is regarded as a core element throughout the diagnostic and therapeutic process. Constitution is closely associated with etiology，onset，pathogenesis，syndrome differentiation，and treatment. Against this background，the construction of animal models based on constitution holds far-reaching significance for advancing clinical research. This paper focuses on the construction and evaluation of rodent models with Qi-deficiency constitution，aiming to explore how to further induce Qi-deficiency syndromes and related disease states on the basis of Qi-deficiency constitution models，thereby developing an integrated animal model that embodies the trinity of "constitution-disease-syndrome". The establishment of this model not only provides a solid experimental foundation for the development of new therapies and drugs in TCM targeting specific constitutions，diseases，and syndromes，but also greatly promotes the modernization and scientific advancement of TCM theory. By comprehensively applying multidisciplinary technologies and methods，the study evaluates the model's validity，reliability，and practicality，with the aim of opening new avenues for future research in TCM and promoting the development of the field.

The theory of constitution in traditional Chinese medicine （TCM） has emerged as a new discipline in recent years. Constitution plays a vital role in the onset，progression，transformation，and prognosis of diseases. At present，some clinical scholars have adopted a novel diagnostic and treatment model of "constitution differentiation-disease identification-syndrome differentiation"，in which constitution is regarded as a core element throughout the diagnostic and therapeutic process. Constitution is closely associated with etiology，onset，pathogenesis，syndrome differentiation，and treatment. Against this background，the construction of animal models based on constitution holds far-reaching significance for advancing clinical research. This paper focuses on the construction and evaluation of rodent models with Qi-deficiency constitution，aiming to explore how to further induce Qi-deficiency syndromes and related disease states on the basis of Qi-deficiency constitution models，thereby developing an integrated animal model that embodies the trinity of "constitution-disease-syndrome". The establishment of this model not only provides a solid experimental foundation for the development of new therapies and drugs in TCM targeting specific constitutions，diseases，and syndromes，but also greatly promotes the modernization and scientific advancement of TCM theory. By comprehensively applying multidisciplinary technologies and methods，the study evaluates the model's validity，reliability，and practicality，with the aim of opening new avenues for future research in TCM and promoting the development of the field.

Mitochondrial dysfunction in chondrocytes is a key pathogenic factor in osteoarthritis (OA), but directly modulating mitochondria in vivo remains a significant challenge. This study is the first to verify a correlation between mitochondrial dysfunction and the downregulation of the FOXO3 gene in the cartilage of OA patients, highlighting the potential for regulating mitophagy via FOXO3 gene modulation to alleviate OA. Consequently, we developed a chondrocyte-targeting CRISPR/Cas9-based FOXO3 gene-editing tool (FoxO3) and integrated it within a nanoengineered 'truck' (NETT, FoxO3-NETT). This was further encapsulated in injectable hydrogel microspheres (FoxO3-NETT@SMs) to harness the antioxidant properties of sodium alginate and the enhanced lubrication of hybrid exosomes. Collectively, these FoxO3-NETT@SMs successfully activate mitophagy and rebalance mitochondrial function in OA chondrocytes through the Foxo3 gene-modulated PINK1/Parkin pathway. As a result, FoxO3-NETT@SMs stimulate chondrocytes proliferation, migration, and ECM production in vitro, and effectively alleviate OA progression in vivo, demonstrating significant potential for clinical applications.

Objective To observe the value of ultrasound-guided percutaneous ethanol injection(PEI)combined with microwave ablation(MWA)for treating thyroid benign partially cystic masses.Methods A total of 100 patients with single benign partially cystic mass who would undergo ultrasound-guided ablation treatment were prospectively enrolled.The patients were randomly assigned into PEI group(received PEI combined with MWA sequential ablation)or control group(received simple MWA),each n=50.Data before and after treatments were compared within groups,the therapeutic efficacy were compared between groups after treatments,and the value of sequential ablation was analyzed.Results Ultrasound-guided ablation was successfully performed for all 100 masses.During follow-up,5 cases in PEI group and 3 cases in control group were lost.The operation time of MWA,total MWA energy and patients'pain level during treatments in PEI group were all lower than those in control group(all P＜0.05).Significant difference of thyroid mass volumes were found before and 3,6 and 12 months after treatments in both groups(all P＜0.05).The volume reduction rate(VRR)in PEI group before and 1,3,6 and 12 months after treatments were all higher than that in control group(all P＜0.05).The success rate was 95.56％(43/45)in PEI group and 89.36％(42/47)in control group 12 months after treatments,respectively,without significant difference(P=0.451).There were significant differences of neck aesthetics scores and symptom scores before and 3,6 and 12 months after treatments in both groups(all P＜0.05).The incidence of complications in PEI group was 6.67％(3/45),while in control group was 14.89％(7/47),the former was lower than the latter(P＜0.05).Conclusion Ultrasound-guided PEI combined with MWA sequential ablation had better effect for treating thyroid benign partially cystic masses than single MWA.

BACKGROUND:Current osteoarthritis modeling methods include anterior cruciate ligament transection(ACLT)and ACLT combined with medial meniscal anterior horn resection.ACLT requires excessive postoperative exercise,which is time and labor-intensive.Complete removal of anterior horn of the medial meniscus can cause collateral damage and increase variability in modeling outcomes,requiring higher surgical skills from the surgeon. OBJECTIVE:To modify and simplify the traditional method to create animal osteoarthritis model and compare osteoarthritis symptoms of different modeling methods under a low-load exercise environment. METHODS:Forty-eight Sprague-Dawley rats were randomly assigned in four groups(n=12 per group):sham operation(complete exposure of the knee cavity of the left hind limb followed by suturing the joint cavity and skin),ACLT,ACLT+anterior horn resection(removal of the anterior horn of the medial meniscus)and ACLT+anterior horn tear(anterior horn tear of the medial meniscus).At 4 weeks after modeling,the rats were euthanized and their knee specimens were collected for gross observation,X-ray and CT scans,pathological observation,and PCR detection. RESULTS AND CONCLUSION:Gross observation:Mild meniscal wear was observed in the ACLT group.In the ACLT+anterior horn tear group,severe wear of the lateral condyle articular surface,mild wear of the medial condyle articular surface,severe meniscal wear,and full wear of the medial meniscus were observed.The ACLT+resection group showed severe wear of the lateral condyle articular surface,mild wear of the medial condyle articular surface,absence of the anterior horn of the medial meniscus,and meniscus wear area＞50%.Imaging examinations showed no significant difference among the four groups.However,the anterior tibial translocation sign was observed in the three operation groups and the anterior horn of the medial meniscus was missing in the ACLT+anterior horn resection group.Histopathological section observation:Hematoxylin-eosin,toluidine blue,and Sirius red staining showed smooth joint surfaces in the sham operation group and ACLT group;cartilage damage and matrix degradation were evident in the ACLT+anterior horn tear and ACLT+anterior horn transection groups,with less cartilage damage and matrix degradation in the ACLT+anterior horn tear group.PCR results showed higher mRNA expressions of interleukin 1β,interleukin 6,interleukin 8,tumor necrosis factor α,matrix metalloproteinase 1 and matrix metalloproteinase 3 and lower mRNA expressions of aggrecan in the ACLT+anterior horn tear group and ACLT+anterior horn resection group than in the sham operation group and ACLT group(P＜0.05).The mRNA expressions of interleukin 6,matrix metalloproteinase 1,and matrix metalloproteinase 3 were higher in the ACLT + anterior horn resection group than in the ACLT +anterior horn tear group(P＜0.05).To conclude,ACLT alone is less likely to induce osteoarthritis with obvious cartilage wear.ACLT combined with anterior horn resection or tear of the medial meniscus can induce obvious symptoms of osteoarthritis and achieve similar modeling effects.

Complicated crown root fracture is a serious combined fracture of the enamel,dentin,and cementum in dental trauma.The treatment method is complicated.During the procedure,the condition of pulp,periodontal,and tooth body should be thoroughly evaluated,and a multidisciplinary approach combined with sequential treatment is recom-mended.This case reported the different treatment and repair processes of one case of two affected teeth after complicat-ed crown root fracture of upper anterior teeth,including regrafting of broken crown after flap surgery at the first visit,di-rect resin repair to remove broken fragments,and pulp treatment and post-crown repair at the second visit.After 18 months of follow-up,the preservation treatment of the affected teeth with complicated crown root fracture was achieved.Therefore,fragment reattachment and post-crown restoration are feasible treatment options for children with complicated crown root fracture.

Objective To compare the size discrepancy between ultrasonic and pathological measurement of solitary cN0M0 papillary thyroid microcarcinoma(PTMC),and to explore their correlation with lymph node metastasis.Methods From April 2021 to January 2022,234 patients with solitary cN0M0 PTMC who received thyroid lobectomy or total thyroidectomy in the Department of Thyroid and Breast Surgery of Nanjing University of Chinese Medicine,Affiliated Hospital of Integrated Traditional Chinese and Western Medicine were analyzed retrospectively.The size discrepancy between ultrasonic and pathological measurement were compared,and the risk factors of central lymph node metastasis were analyzed.Results The mean of maximum diameter of PTMC measured by ultrasound was 6.8(range 5.6 to 8.4)mm,which was significantly bigger than that measured by pathology 5.0(range 4.0 to 7.0)mm(P=0.000).Of them,37.2%of the tumor size measured by ultrasound is consistent with pathology,61.1%of the tumor size measured by ultrasound is bigger than that measured by pathology,and only 1.7%of the tumor size measured by ultrasound is smaller than that measured by pathology.There was a linear correlation between the diameter measured by ultrasound and pathology.And the regression equation can be expressed as:pathological diameter=0.799×ultrasonic diameter-0.221.In addition,28.6%patients had central lymph node metastasis.Multivariate Logistic regression analysis showed that the diameter measured by pathology is a risk factor for central lymph node metastasis in patients(OR=17.845,95%CI:2.507-127.025,P=0.004),and the cutoff value is 5.5 mm which corresponded to the diameter measured by ultrasound as 7.2 mm.Conclusions The sizes of solitary cN0M0 PTMC measured by ultrasound and pathology are different but also correlated.PMTC with pathological diameter>5.5 mm with its corresponding ultrasonic diameter as 7.2 mm indicated an increased risk of central lymph node metastasis.

Objective:To investigate the value of systemic inflammatory response syndrome (SIRS), pediatric sequential organ failure assessment (pSOFA) and pediatric critical illness score (PCIS) in predicting mortality of pediatric sepsis in pediatric intensive care units (PICU) from Southwest China.Methods:This was a prospective multicenter observational study. A total of 447 children with sepsis admitted to 12 PICU in Southwest China from April 2022 to March 2023 were enrolled. Based on the prognosis, the patients were divided into survival group and non-survival group. The physiological parameters of SIRS, pSOFA and PCIS were recorded and scored within 24 h after PICU admission. The general clinical data and some laboratory results were recorded. The area under the curve (AUC) of the receiver operating characteristic curve was used to compare the predictive value of SIRS, pSOFA and PCIS in mortality of pediatric sepsis.Results:Amongst 447 children with sepsis, 260 patients were male and 187 patients were female, aged 2.5 (0.8, 7.0) years, 405 patients were in the survival group and 42 patients were in the non-survival group. 418 patients (93.5%) met the criteria of SIRS, and 440 patients (98.4%) met the criteria of pSOFA≥2. There was no significant difference in the number of items meeting the SIRS criteria between the survival group and the non-survival group (3(2, 4) vs. 3(3, 4) points, Z=1.30, P=0.192). The pSOFA score of the non-survival group was significantly higher than that of the survival group (9(6, 12) vs. 4(3, 7) points, Z=6.56, P<0.001), and the PCIS score was significantly lower than that of the survival group (72(68, 81) vs. 82(76, 88) points, Z=5.90, P<0.001). The predictive value of pSOFA (AUC=0.82) and PCIS (AUC=0.78) for sepsis mortality was significantly higher than that of SIRS (AUC=0.56) ( Z=6.59, 4.23, both P<0.001). There was no significant difference between pSOFA and PCIS ( Z=1.35, P=0.176). Platelet count, procalcitonin, lactic acid, albumin, creatinine, total bilirubin, activated partial thromboplastin time, prothrombin time and international normalized ratio were all able to predict mortality of sepsis to a certain degree (AUC=0.64, 0.68, 0.80, 0.64, 0.68, 0.60, 0.77, 0.75, 0.76, all P<0.05). Conclusion:Compared with SIRS, both pSOFA and PCIS had better predictive value in the mortality of pediatric sepsis in PICU.

Purpose To investigate the safety and effectiveness of ultrasound-guided microwave ablation(MWA)in the treatment of abdominal wall endometriosis(AWE).Materials and Methods A total of 17 patients(19 lesions)with AWE who underwent MWA in Beijing Friendship Hospital from August 2014 to June 2023 were retrospectively analyzed.Grey-scale and color Doppler flow ultrasonography,and contrast-enhanced ultrasonography were used to observe the lesions before and after treatment.The AWE lesion volume,volume reduction rate,pain relief,and complications were recorded 3,6,and 12 months after treatment to evaluate the treatment efficacy.Results Contrast-enhanced ultrasound showed that all lesions underwent successful treatment with single MWA.The average initial nodule volume was(7.46±5.82)ml,which decreased significantly to(4.32±2.76)ml,(2.47±1.68)ml,(1.72±1.16)ml at 3,6 and 12 months follow-up(t=0.423,P=0.005;t=0.198,P=0.001;t=0.556,P=0.002)with a mean volume reduction rate of(46.18±24.36)%,(61.43±18.72)%,(74.25±13.26)%,respectively.Notably,all 17 patients experienced a significant decrease or complete alleviation of periodic abdominal incision pain at 12-month after treatment.One patient experienced local skin burns after the procedure,while the remaining patients did not experience severe complications.Conclusion MWA is safe and effective for treating AWE,and further research is warranted.

Objective:To investigate the performance of medical students with different cognitive styles and temperament types in the flipped classroom of pediatrics.Methods:A total of 85 medical students of the class of 2018 in eight-year program who studied the course of Pediatrics 2 in West China Medical School, Sichuan University, were selected and received the flipped classroom teaching of pediatrics. The cognitive style figure test was used to investigate the cognitive style of students, and the temperament self-test questionnaire was used to investigate the temperament type of students. The methods such as the cluster analysis, the ANOVA analysis of variance, the Pearson correlation analysis, and the chi-square test were used to describe the distribution of flipped classroom scores and related differences between the students with different cognitive styles and temperament types.Results:There were four temperament types of these students, i.e., choleric and sanguine temperament, sanguine and phlegmatic temperament, melancholic temperament, and choleric temperament, accounting for 28.24%, 23.53%, 27.06%, and 21.18%, respectively. There were two cognitive styles of field independence and field dependence, accounting for 51.76% and 48.24%, respectively. There was a significant difference in flipped classroom scores between the students with different cognitive styles ( t=3.18, P<0.05), while there was no significant difference in such scores between the students with different temperament types ( F=0.38, P>0.05). The correlation analysis showed that the score of phlegmatic temperament was significantly negatively correlated with flipped classroom scores ( r=-0.283, P<0.05), and the score of cognitive test was significantly positively correlated with flipped classroom scores ( r=0.346, P<0.05). Conclusions:In the flipped classroom teaching of pediatrics, it is necessary to flexibly apply specific interaction and evaluation methods in students with different temperament types and cognitive styles and grasp the relationship between cooperative learning and independent learning. The design of different links of flipped classroom should be further improved.