AIM: To develop a novel gene-delivery therapeutic based on CRISPR/Cas9 genome editing technology capable of specifically targeting and knocking out the VEGFA gene, thereby achieving sustained suppression of VEGFA expression in retinal pigment epithelial(RPE)cells and providing a new strategy for gene therapy in retinal neovascular diseases.METHODS:Single guide RNAs targeting the human VEGFA gene for knockout were designed, and corresponding recombinant plasmids were constructed. A novel polymer(PTEE)was used to encapsulate the plasmids to prepare a PTEE-loaded anti-VEGFA plasmid(PLAP)gene delivery system. PTEE materials at concentrations of 0.1, 0.2, 0.4, 0.8, and 1.6 μg/μL were co-incubated with ARPE-19 cells, and the biocompatibility of PTEE was evaluated using the cell counting kit-8(CCK-8)assay. Recombinant plasmids expressing green fluorescent protein(GFP)were constructed. Lipofectamine 3000 and jetOPTIMUS®DNA transfection reagents were used as control groups, and PTEE nanomaterials were used as the experimental group to encapsulate the plasmids. When the cell confluence reached 80%, the formulations were transfected into ARPE-19 and 293T cells. GFP expression was observed under light microscopy, and the transfection efficiencies of each group were compared. ARPE-19 cells were induced under hypoxia, and PLAP was transfected into the cells. The expression level of VEGFA was detected by enzyme-linked immunosorbent assay(ELISA)to evaluate the efficacy of this novel gene delivery system.RESULTS: After co-incubation of ARPE-19 cells with different concentrations of PTEE for 24 h and 48 h, no significant effect on cell viability was observed in any group. The transfection efficiency of PLAP in ARPE-19 cells was higher than that in the Lipo3000 and jetOPTIMUS groups, with statistically significant differences(P<0.01). Hypoxia for 6 h significantly induced the upregulation of VEGFA mRNA expression in ARPE-19 cells, and under hypoxic conditions, the PTEE group exhibited a significant inhibitory effect on VEGFA expression(P<0.01).CONCLUSION:PLAP exhibits favorable biocompatibility and prominent VEGFA inhibitory effects in vitro, making it a potential candidate drug for gene therapy of retinal neovascular diseases.

Diabetic retinopathy(DR)is one of the most common and severe microvascular complications in diabetic patients and has become one of the leading causes of blindness worldwide. With the continuous rise in the prevalence of diabetes, in-depth exploration of the pathogenesis of DR and effective intervention measures is of great clinical significance. The mechanistic target of rapamycin(mTOR), as a protein kinase, is widely involved in cellular processes such as growth, metabolism, and autophagy. Research indicates that the mTOR signaling pathway plays a crucial regulatory role in the pathological progression of DR, and its abnormal activity can disrupt retinal cell autophagy function, thereby accelerating cellular damage and disease progression. Autophagy, as an important regulatory mechanism for cellular homeostasis, maintains cellular functional balance by clearing damaged organelles and protein aggregates. This article provides a systematic review of the structural and functional aspects of the mTOR signaling pathway, the molecular regulatory mechanisms of autophagy, and their roles in retinal pathological changes. By summarizing current research findings, the article aims to clarify the key regulatory role of the mTOR-autophagy axis in DR, providing theoretical support for elucidating the molecular pathogenesis of DR and offering potential targets and research directions for developing novel targeted therapeutic strategies, thereby holding significant scientific and clinical value.

The Communist Party of China’s important expositions on Traditional Chinese Medicine （TCM） in the New Era provide an in-depth interpretation of how to understand the value of TCM and how to promote its long-term development and innovation. These expositions are underpinned by a solid theoretical foundation， profound historical origins， and rich practical accumulation. Moreover， they not only demonstrate deep respect for China’s fine traditional culture but also convey earnest expectations for the future development of TCM. Serving as valuable ideological resources and a guide for action for TCM， these expositions contribute to advancing the globalization of TCM and leveraging Chinese wisdom to boost the development of the cause of human health.

This study aims to develop an abdominal acupoint localization system based on computer vision and convolutional neural networks (CNNs). To address the challenge of abdominal acupoint localization, a multi-task CNNs architecture was constructed and trained to locate the Shenque (CV8) and human body boundaries. Based on the identified Shenque (CV8), the system further deduces key characteristics of four acupoints: Shangwan (CV13), Qugu (CV2), and bilateral Daheng (SP15). An affine transformation matrix is applied to accurately map image coordinates to an acupoint template space, achieving precise localization of abdominal acupoints. Testing has verified that this system can accurately identify and locate abdominal acupoints in images. The development of this localization system provides technical support for TCM remote education, diagnostic assistance, and advanced TCM equipment, such as intelligent acupuncture robots, facilitating the standardization and intelligent advancement of acupuncture.
Acupuncture Points ; Humans ; Deep Learning ; Abdomen/diagnostic imaging* ; Neural Networks, Computer ; Acupuncture Therapy ; Image Processing, Computer-Assisted

With the acceleration of aging society in China, acute obstructive suppurative cholangitis (AOSC) in the extremely elderly (≥80 years) patients has become a common and frequent acute abdominal disease, which seriously threatens national strategy of "healthy aging" in China. Endoscopic retrograde cholangiopancreatography (ERCP) is currently the mainstream treatment for AOSC, but emergency ERCP treatment for elderly patients with AOSC is limited. In recent years, laparoscopic surgery targeting laparoscopic transcystic common bile duct exploration (LTCBDE) has been an ideal treatment method, but it has a high surgical risk. The authors′ team has conducted in-depth exploration into the advantages and disadvantages of ERCP treatment, strategies for repairing Oddi sphincter function, selection of laparoscopic surgical methods, and formulation of safety guarantee measures, and has carried out the technical improvements on LTCBDE, aiming to enhance the feasibility and safety of this surgical method in the treatment of AOSC in extremely elderly patients.

In 1861, the missionary William Lockhart founded the Peking Hospital in Beijing. From 1861 to 1863, William Lockhart not only cured a large number of patients in the Peking Hospital but also introduced western surgical techniques, hygiene and disinfection concepts, and medical record management systems. During its operation, the Peking Hospital's unique value can be seen in its sources and modes of financing, scope of services, number of patients treated, and missionary functions. The Peking Hospital served as a vital bridge for the exchange of medical knowledge between the East and the West, and it played a pivotal role in transforming China's modern medical system and modern health concepts, exerting a profound influence on the development of modern medicine.

With the acceleration of aging society in China, acute obstructive suppurative cholangitis (AOSC) in the extremely elderly (≥80 years) patients has become a common and frequent acute abdominal disease, which seriously threatens national strategy of "healthy aging" in China. Endoscopic retrograde cholangiopancreatography (ERCP) is currently the mainstream treatment for AOSC, but emergency ERCP treatment for elderly patients with AOSC is limited. In recent years, laparoscopic surgery targeting laparoscopic transcystic common bile duct exploration (LTCBDE) has been an ideal treatment method, but it has a high surgical risk. The authors′ team has conducted in-depth exploration into the advantages and disadvantages of ERCP treatment, strategies for repairing Oddi sphincter function, selection of laparoscopic surgical methods, and formulation of safety guarantee measures, and has carried out the technical improvements on LTCBDE, aiming to enhance the feasibility and safety of this surgical method in the treatment of AOSC in extremely elderly patients.

Strengthening the construction of traditional Chinese medicine （TCM） discourse system for international audiences is necessary for enhancing cultural soft power， accelerating the construction of trade power， integrating into the global healthcare system， and realizing international scientific and technological dialogues.TCM not only garners widespread attention from the international community but also faces numerous challenges. The external discourse of TCM has fallen into difficulties， including blocked channels of expression， lack of a discourse subject， contextual segregation of discourse， and a narrative information flow deficit. Based on this， realistic approaches to breaking through dilemmas are proposed from four dimensions， that is， strengthening the construction of international standards for TCM to increase its recognition overseas， improving the development of international talent teams to enhance the visibility of TCM abroad， expanding the construction of the TCM service trade system to deepen its contribution overseas， and enhancing the efficacy of international communication of TCM to strengthen its reputation abroad.