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 analyze the difference of psoas major muscle morphology and pain degree in patients with different types of lumbar disc herniation ( LDH ) by quantitative CT, and to further explore the relationship between psoas major muscle morphology and pain degree. Methods A total of 120 patients with LDH admitted to our hospital from January to December 2025 were enrolled as study subjects. Based on clinical symptoms and lesion location, they were divided into a simple lower extremity pain group and a lumbar and leg pain group. All patients underwent lumbar CT examination. The psoas major muscle index was used as a CT quantitative parameter, which was calculated as the mean of the maximum cross-sectional areas of both psoas major muscles divided by the cross-sectional area of the L5 vertebral body. This index was measured to reflect psoas major muscle morphology. Pain severity was assessed using the visual analogue scale (VAS). Differences in psoas major muscle morphology and pain severity between the two groups were compared. A Pearson correlation analysis was used to examine the relationship between the psoas major muscle index and pain severity. A linear regression model was used to analyze the independent risk factors affecting pain severity. Results There were no statistically significant differences in sex, age, or body mass index between the two groups (P>0.05). The disease duration was longer and the incidence of anxiety and depression was higher in the lumbar and leg pain group than those in the simple lower extremity pain group (P<0.05). Compared with the simple lower extremity pain group, the lumbar and leg pain group showed lower psoas major muscle index [(0.53 ± 0.05) vs. (0.61 ± 0.07)] and higher VAS score [(4.67 ± 1.10) vs. (3.02 ± 0.89)], and the differences were statistically significant (P<0.05). Pearson correlation analysis revealed a negative correlation between the psoas major muscle index and the VAS score (r=−0.288, P<0.05). Linear regression model analysis indicated that the independent risk factors affecting the VAS score were age, disease duration, LDH type, and the psoas major muscle index. Conclusion Compared with LDH patients with simple lower extremity pain, those with lumbar and leg pain demonstrate a longer disease duration, a higher incidence of anxiety and depression, and a higher severity of psoas major muscle atrophy and pain. The severity of pain is associated with not only advanced age and prolonged disease duration but also the LDH type and psoas major muscle atrophy.

Objective To analyze the difference of psoas major muscle morphology and pain degree in patients with different types of lumbar disc herniation ( LDH ) by quantitative CT, and to further explore the relationship between psoas major muscle morphology and pain degree. Methods A total of 120 patients with LDH admitted to our hospital from January to December 2025 were enrolled as study subjects. Based on clinical symptoms and lesion location, they were divided into a simple lower extremity pain group and a lumbar and leg pain group. All patients underwent lumbar CT examination. The psoas major muscle index was used as a CT quantitative parameter, which was calculated as the mean of the maximum cross-sectional areas of both psoas major muscles divided by the cross-sectional area of the L5 vertebral body. This index was measured to reflect psoas major muscle morphology. Pain severity was assessed using the visual analogue scale (VAS). Differences in psoas major muscle morphology and pain severity between the two groups were compared. A Pearson correlation analysis was used to examine the relationship between the psoas major muscle index and pain severity. A linear regression model was used to analyze the independent risk factors affecting pain severity. Results There were no statistically significant differences in sex, age, or body mass index between the two groups (P>0.05). The disease duration was longer and the incidence of anxiety and depression was higher in the lumbar and leg pain group than those in the simple lower extremity pain group (P<0.05). Compared with the simple lower extremity pain group, the lumbar and leg pain group showed lower psoas major muscle index [(0.53 ± 0.05) vs. (0.61 ± 0.07)] and higher VAS score [(4.67 ± 1.10) vs. (3.02 ± 0.89)], and the differences were statistically significant (P<0.05). Pearson correlation analysis revealed a negative correlation between the psoas major muscle index and the VAS score (r=−0.288, P<0.05). Linear regression model analysis indicated that the independent risk factors affecting the VAS score were age, disease duration, LDH type, and the psoas major muscle index. Conclusion Compared with LDH patients with simple lower extremity pain, those with lumbar and leg pain demonstrate a longer disease duration, a higher incidence of anxiety and depression, and a higher severity of psoas major muscle atrophy and pain. The severity of pain is associated with not only advanced age and prolonged disease duration but also the LDH type and psoas major muscle atrophy.

Objective To analyze the difference of psoas major muscle morphology and pain degree in patients with different types of lumbar disc herniation ( LDH ) by quantitative CT, and to further explore the relationship between psoas major muscle morphology and pain degree. Methods A total of 120 patients with LDH admitted to our hospital from January to December 2025 were enrolled as study subjects. Based on clinical symptoms and lesion location, they were divided into a simple lower extremity pain group and a lumbar and leg pain group. All patients underwent lumbar CT examination. The psoas major muscle index was used as a CT quantitative parameter, which was calculated as the mean of the maximum cross-sectional areas of both psoas major muscles divided by the cross-sectional area of the L5 vertebral body. This index was measured to reflect psoas major muscle morphology. Pain severity was assessed using the visual analogue scale (VAS). Differences in psoas major muscle morphology and pain severity between the two groups were compared. A Pearson correlation analysis was used to examine the relationship between the psoas major muscle index and pain severity. A linear regression model was used to analyze the independent risk factors affecting pain severity. Results There were no statistically significant differences in sex, age, or body mass index between the two groups (P>0.05). The disease duration was longer and the incidence of anxiety and depression was higher in the lumbar and leg pain group than those in the simple lower extremity pain group (P<0.05). Compared with the simple lower extremity pain group, the lumbar and leg pain group showed lower psoas major muscle index [(0.53 ± 0.05) vs. (0.61 ± 0.07)] and higher VAS score [(4.67 ± 1.10) vs. (3.02 ± 0.89)], and the differences were statistically significant (P<0.05). Pearson correlation analysis revealed a negative correlation between the psoas major muscle index and the VAS score (r=−0.288, P<0.05). Linear regression model analysis indicated that the independent risk factors affecting the VAS score were age, disease duration, LDH type, and the psoas major muscle index. Conclusion Compared with LDH patients with simple lower extremity pain, those with lumbar and leg pain demonstrate a longer disease duration, a higher incidence of anxiety and depression, and a higher severity of psoas major muscle atrophy and pain. The severity of pain is associated with not only advanced age and prolonged disease duration but also the LDH type and psoas major muscle atrophy.

GBA1 gene mutation is an important genetic risk factor for Parkinson’s disease (PD). This paper reports a case of a 43-year-old male PD patient carrying a rare heterozygous Thr408Met mutation in the GBA1 gene identified through whole-exome sequencing, leading to a diagnosis of GBA1-associated PD. The patient’s motor symptoms were primarily characterized by bradykinesia and rigidity, without significant cognitive decline. Treatment with low-dose levodopa combined with a dopamine agonist resulted in significant symptomatic improvement.

Multiple system atrophy (MSA) is a rare neurodegenerative disease with complex clinical manifestations, presenting substantial challenges in clinical diagnosis and treatment. Its symptoms and the eight extraordinary meridians are potentially correlated; therefore, this article explores the association between MSA symptom clusters and the eight extraordinary meridians based on their circulation and physiological functions, as well as their treatment strategies. The progression from deficiency to damage in the eight extraordinary meridians aligns with the core pathogenesis of MSA, which is characterized by "the continuous accumulation of impacts from the vital qi deficiency leading to eventual damage". Liver and kidney deficiency and the emptiness of the eight extraordinary meridians are required for the onset of MSA; the stagnation of qi deficiency and the gradual damage to the eight extraordinary meridians are the key stages in the prolonged progression of MSA. The disease often begins with the involvement of the yin and yang qiao mai, governor vessel, thoroughfare vessel, and conception vessel before progressing to multiple meridian involvements, ultimately affecting all eight extraordinary meridians simultaneously. The treatment approach emphasizes that "the direct method may be used for joining battle, but indirect method will be needed in order to secure victory" and focuses on "eliminate pathogenic factors and reinforce healthy qi". Distinguishing the extraordinary meridians and focusing on the primary symptoms are pivotal to improving efficacy. Clinical treatment is aimed at the target, and tailored treatment based on careful clinical observation ensures precision in targeting the disease using the eight extraordinary meridians as the framework and core symptoms as the specific focus. Additionally, combining acupuncture, daoyin therapy, and other method may help prolong survival. This article classifies clinical manifestations based on the theory of the eight extraordinary meridians and explores treatment.

OBJECTIVE: To investigate the effectiveness of free palmaris longus tendon graft reconstruction in the treatment of gouty tophus erosion lesions in flexor tendon of wrist and hand. METHODS: A retrospective analysis was conducted on 8 patients with gouty tophus erosion lesions in flexor tendon of wrist and hand who underwent free palmaris longus tendon graft reconstruction between June 2017 and December 2023. All patients were male, aged 22-65 years, with an average of 45.9 years. The duration of gout history ranged from 2 to 18 years, with an average of 8.8 years. The duration from the discovery of gouty tophus to operation ranged from 12 to 26 months, with an average of 17.6 months. The gouty tophus eroded the flexor pollicis longus tendon in 4 cases, with Verdan flexor tendon zones being Ⅰ-Ⅱ in 1 case and Ⅳ-Ⅴ in 3 cases. The flexor digitorum profundus tendons were affected in 2 cases for the index finger, 1 for the middle finger, and 1 for the ring finger, all located in zone Ⅳ-Ⅴ. The long axis of the gouty tophus ranged from 2.3 to 4.5 cm, with an average of 3.4 cm. All 8 patients presented with limited finger flexion and extension. Among them, 4 cases were accompanied by median nerve compression symptoms, and 1 case had associated bone and joint destruction in the hand. The total active motion (TAM) of the affected finger was (81.3±30.2)° before operation according to the hand function evaluation criteria for tendon repair by the Chinese Society of Hand Surgery of the Chinese Medical Association, and the functional evaluation was poor. The harvested palmaris longus tendon intraoperatively was 7-9 cm in length. RESULTS: Surgical incisions in all 8 patients healed by first intention, with no infections, graft non-union, or significant adhesion complications. All patients were followed up 8-25 months, with an average of 14.8 months. Numbness symptoms resolved in all 4 patients who presented with median nerve compression symptoms. Patients did not experience wrist pain or other discomfort, and function was not compromised. At last follow-up, according to the hand function evaluation criteria for tendon repair by the Chinese Society of Hand Surgery of the Chinese Medical Association, the TAM of 8 patients was (197.5±55.8)°, which significantly improved when compared with that before operation ( t=11.638, P<0.001); the hand function of 1 patient with gouty tophus in zone Ⅰ-Ⅱ flexor pollicis longus tendon was good, and the other 7 patients were excellent. CONCLUSION Free palmaris longus tendon graft reconstruction demonstrates good effectiveness in treating gouty tophus erosion lesions in flexor tendon of wrist and hand.
Humans ; Middle Aged ; Male ; Adult ; Tendons/surgery* ; Retrospective Studies ; Aged ; Gout/complications* ; Wrist/surgery* ; Plastic Surgery Procedures/methods* ; Hand/surgery* ; Treatment Outcome ; Young Adult

OBJECTIVE: To explore the effectiveness of multi-segment inverted Y-shaped vein transplantation using the anterior lateral malleolar venous network for repair of amputated palm injury distal to the superficial palmar arch. METHODS: Between September 2018 and July 2023, 5 patients with amputated palm injury distal to the superficial palmar arch were treated. There were 3 males and 2 females with an average age of 35.4 years (range, 29-52 years). The time from injury to admission was 1-6 hours (mean, 3.2 hours). The multi-segment inverted Y-shaped vein transplantation in the anterior lateral malleolar venous network were used to repair the common and proper palmar digital arteries; the another anterior lateral malleolar venous network was used to repair the dorsal vein of the hand. The soft tissue defect of dorsal hand in 1 patient was repaired with the pedicled ilioinguinal flap, and the wound at the donor site was directly sutured. Postoperative treatment included anti-infection therapy, antispasmodic therapy, and thrombosis prevention measures. RESULTS: The partial necrosis of the fingertip of the thumb occurred in 1 case, and the marginal necrosis of the abdominal flap after operation occurred in 1 case. The remaining fingers showed good blood supply with normal tension. The incision at donor site of the abdominal flap healed by first intention. All patients were followed up 8-41 months (median, 19 months). At last follow-up, the hand contour was satisfactory; the grasping function, opposition function, and proprioception recovered, and two-point discrimination ranged from 5 to 7 mm (mean, 6 mm). According to the upper extremity function evaluation criteria issued by Hand Surgery Society of the Chinese Medical Association, the functional outcomes were excellent in 3 cases, good in 1 case, and fair in 1 case. CONCLUSION The multi-segment inverted Y-shaped vein transplantation using the anterior lateral malleolar venous network for repairing defects in the common and proper palmar digital arteries distal to the superficial palmar arch offers advantages such as superficial location, flexible harvesting, and high compatibility. This technique has demonstrated favorable outcomes in complex transmetacarpal amputation reconstruction.
Humans ; Adult ; Male ; Female ; Hand Injuries/surgery* ; Middle Aged ; Plastic Surgery Procedures/methods* ; Veins/transplantation* ; Surgical Flaps/blood supply* ; Hand/surgery* ; Treatment Outcome ; Soft Tissue Injuries/surgery*

Objective:To compare the efficacy of robot system-assisted versus freehand screw revision for ankylosing spondylitis (AS) with lower cervical fractures.Methods:A multicenter retrospective cohort study was conducted to analyze the clinical data of 57 patients with AS combined with lower cervical fractures admitted to Honghui Hospital Affiliated to Xi'an Jiaotong University School of Medicine, Henan Provincial People's Hospital, Zhengzhou Orthopedic Hospital, and Qilu Hospital of Shandong University, including 46 males and 11 females, aged 38-77 years [(65.4±9.5)years]. Injury segments involved C 3 in 7 patients, C 4 in 13, C 5 in 25, C 6 in 10, and C 7 in 2. All the patients underwent revision surgery, among whom, 22 patients were treated with robot system-assisted cervical pedicle screw placement (robot nailing group, with 190 screws), and 35 with freehand cervical pedicle screw placement (freehand nailing group, with 300 screws). The operative duration, intraoperative bleeding volume, frequency of intraoperative fluoroscopy, incision length, and length of hospital stay of the two groups were compared; the time of single nscrew insertion, the number of single nail revisions, the distance between screws and the anterior cortex, the accuracy of screw placement of grade 0 and grade 0+1 were recorded in the two groups. The visual analogue scale (VAS), Japanese Orthopedic Society (JOA) score, neck dysfunction index (NDI), American Spine Injury Association (ASIA) classification before operation, at 3 days, 3 months after operation and at the last follow-up were compared between the two groups. The complication rate was also noted. Results:All the patients were followed up for 12-16 months [(14.3±2.1)months]. The operative duration, intraoperative bleeding volume, and frequency of intraoperative fluoroscopy were (186.4±12.9)minutes, (486.1±68.6)ml, and (3.4±1.3)times in the robot nailing group, which were shorter or less than (206.7±14.4)minutes, (660.3±45.2)ml, and (13.5±3.6)times in the freehand nailing group ( P<0.01). The incision length was (9.4±2.4)cm in the robot nailing group, longer than (5.6±1.2)cm in the freehand nailing group ( P<0.01), and the length of hospital stay was (3.7±0.4)days, shorter than (4.4±1.4)days in the freehand nailing group ( P<0.01). The length of single nail insertion, the number of single nail revision, and the distance between the screws and the front cortex were (6.5±0.4)minutes, (1.1±0.1)times, and (3.5±1.3)mm in the robot nailing group, which were shorter or less than (11.6±0.2)minutes, (1.5±0.2)times, and (12.4±4.7)mm in the freehand nailing group ( P<0.01). The accuracy of the screw placement in the robot nailing group was 90.0% (171/190) and 95.8% (182/190) with level 0 and 0+1 screws, better than 80.0% (240/300) and 89.0% (267/300) in the freehand nailing group ( P<0.05). There was no significant difference in VAS, JOA score, NDI, or ASIA grading between the two groups before operation ( P>0.05). The VAS, JOA, and NDI scores at 3 days after operation were (3.1±0.6)points, (12.1±1.2)points, and (15.6±2.9)points, respectively in the robot nailing group, which were better than (5.0±1.4)points, (11.3±1.1)points and (22.5±3.7)points, respectively in the freehand nailing group ( P<0.05). No statistically significant difference was observed in the ASIA grade between the two groups at 3 days after operation ( P>0.05). There were no significant differences in VAS, JOA, NDI scores, or ASIA grading between the two groups at 3 months after operation and at the last follow-up ( P>0.05). Compared with those before operation, the VAS, JOA, NDI scores, and ASIA grading were significantly improved at 3 days, 3 months after operation and at the last follow-up in the two groups, which were further improved with the passage of time. Two patients in the robot nailing group had pneumonia, with a complication rate of 9% (2/22), while 2 patients in the freehand nailing group had dural sac rupture and cerebrospinal fluid leakage and 3 had lung infection after operation, with a complication rate of 14% (5/35) ( P<0.05). Conclusion:Compared with freehand nailing, the robot system-assisted nailing revision for AS with lower cervical fracture has more advantages in terms of the operative duration, length of hospital stay, intraoperative bleeding volume, frequency of intraoperative fluoroscopy nailing speed and accuracy, screw holding force, early pain relief, function restoration, and complication rate, despite longer surgical incision.