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.

ObjectiveHistorically documented Zhejiang Atractylodis Macrocephalae Rhizoma（Baizhu） possesses premium characteristics such as phoenix-like head and crane-like neck， pronounced sweetness， and fragrant aroma. However， its current market circulation is low， and the processed products with Zhejiang-style characteristics are at the risk of being lost. This study aims to preserve the ancient Zhejiang-style processing techniques and evaluate them using modern scientific methods. MethodsMultidimensional intelligent sensory evaluation was used to digitally characterize the "quality-structure" of the external appearance of nine-steamed and nine-processed Baizhu medicinal materials（intermediate processed products） and the "odor-taste" of the internal quality of its decoction pieces（slices）， and the appearance parameters were digitally characterized by colorimeter， texture analyzer， electronic nose and electronic tongue， the chemical composition was analyzed via ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry（UPLC-Q-TOF-MS/MS）. Then， cluster analysis on the differences in odor between the medicinal materials（intermediate processed products） and decoction pieces（slices） of nine-steamed and nine-processed Baizhu was conducted， as well as the differences in taste between water-soluble and alcohol-soluble extracts of the decoction pieces（slices）， and the correlation analysis of chroma value-alcohol-soluble extract content-component response value. ResultsThe nine-steamed and nine-processed Baizhu had a dark brown to black epidermis， a brownish-yellow to brownish-gray cross-section， a slightly tough texture， a faint odor， and a slightly sweet， bitter and pungent taste. Texture analyzer measurements revealed minimal adhesion and maximum recovery in the middle section of the characteristic processed Baizhu， consistent with the processing endpoint of thorough steaming and cooking. The head section showed the highest internal hardness， elasticity and chewiness， indicating a denser texture in this area. The electronic nose sensor could clearly distinguish the difference between the medicinal materials and its decoction pieces， with a more significant clustering effect at 60 ℃ for 30 minutes compared to ambient temperature headspace for 2 hours， highlighting the significant impact of the baking degree before slicing on the quality. The electronic tongue taste signal map clearly distinguished the differences between water-soluble and alcohol-soluble extracts of nine-steamed and nine-processed Baizhu decoction pieces， and the addition of auxiliary materials during processing could enhance its alcohol-soluble extract content. A total of 82 chemical components were identified in the characteristic processed Baizhu. After processing， the contents of 58 components increased， while 24 components decreased. Correlation analysis revealed significant negative correlations（P<0.01） between ethanol-soluble extract content and colorimetric values of brightness（L^*）， yellow-bule value（b^*）， and total color difference（E^*_ab）. E^*_ab showed marked negative correlations（P<0.05） with the response values of isochlorogenic acid A and C. ConclusionThis study establishes a modern intelligent sensory evaluation model for multidimensional holographic characterization of nine-steamed and nine-processed Baizhu， clarifying the correlation between increased isochlorogenic acid content and the visual color appearance after different steaming cycles， as well as its intrinsic alcohol-soluble extracts. This provides a reference for quality evaluation and processing standards of the Zhejiang-style characteristic processed products.

Objective:To evaluate the application value of interactive learning in enhancing the diagnosis of breast cancer by residents in the department of radiology through training based on the interpretation of breast magnetic resonance imaging (MRI) features by the breast imaging reporting and data system (BI-RADS).Methods:A total of 23 trainees completed BI-RADS standardized reports of 250 cases. These cases were divided into a pre-training group (Group 1) and post-training groups (initial training, Groups 2-4; advanced training, Groups 5-6), forming a total of six groups. The efficacy of interactive learning through course lectures and case-based practice in enhancing their ability in breast cancer diagnosis was analyzed. All trainees generated reports based on the BI-RADS scoring criteria. Interpretation agreement rates, evaluation time, and confidence levels were recorded. SPSS 25.0 was used for independent samples t test, chi-square test, and rank-sum test. Results:During the initial stage of training, the agreement rate of 150 cases reached 80.00%, which was recommended as the endpoint for completion of the initial learning phase. A significant difference existed between Group 4 and Group 1 ( P=0.012) in agreement rate. Statistically significant differences were noted in evaluation time for Groups 5 and 6 before and after advanced training ( P=0.001 and 0.007, respectively). A significant difference in confidence level was observed for Group 5 ( P=0.005). Conclusions:Interactive training based on BI-RADS standardized reporting can improve the diagnosis of breast diseases by residents in the department of radiology, particularly for enhancing the quality of reports for mass-like enhancement breast diseases.

Objective To investigate the distribution and antimicrobial resistance profiles of common pathogens isolated from cerebrospinal fluid(CSF)in CHINET program from 2015 to 2021.Methods The bacterial strains isolated from CSF were identified in accordance with clinical microbiology practice standards.Antimicrobial susceptibility test was conducted using Kirby-Bauer method and automated systems per the unified CHINET protocol.Results A total of 14 014 bacterial strains were isolated from CSF samples from 2015 to 2021,including the strains isolated from inpatients(95.3％)and from outpatient and emergency care patients(4.7％).Overall,19.6％of the isolates were from children and 80.4％were from adults.Gram-positive and Gram-negative bacteria accounted for 68.0％and 32.0％,respectively.Coagulase negative Staphylococcus accounted for 73.0％of the total Gram-positive bacterial isolates.The prevalence of MRSA was 38.2％in children and 45.6％in adults.The prevalence of MRCNS was 67.6％in adults and 69.5％in children.A small number of vancomycin-resistant Enterococcus faecium(2.2％)and linezolid-resistant Enterococcus faecalis(3.1％)were isolated from adult patients.The resistance rates of Escherichia coli and Klebsiella pneumoniae to ceftriaxone were 52.2％and 76.4％in children,70.5％and 63.5％in adults.The prevalence of carbapenem-resistant E.coli and K.pneumoniae(CRKP)was 1.3％and 47.7％in children,6.4％and 47.9％in adults.The prevalence of carbapenem-resistant Acinetobacter baumannii(CRAB)and Pseudomonas aeruginosa(CRPA)was 74.0％and 37.1％in children,81.7％and 39.9％in adults.Conclusions The data derived from antimicrobial resistance surveillance are crucial for clinicians to make evidence-based decisions regarding antibiotic therapy.Attention should be paid to the Gram-negative bacteria,especially CRKP and CRAB in central nervous system(CNS)infections.Ongoing antimicrobial resistance surveillance is helpful for optimizing antibiotic use in CNS infections.

Objective To investigate the antimicrobial resistance of clinical isolates from elderly patients(≥65 years)in major medical institutions across China.Methods Bacterial strains were isolated from elderly patients in 52 hospitals participating in the CHINET Antimicrobial Resistance Surveillance Program during the period from 2015 to 2021.Antimicrobial susceptibility test was carried out by disk diffusion method and automated systems according to the same CHINET protocol.The data were interpreted in accordance with the breakpoints recommended by the Clinical and Laboratory Standards Institute(CLSI)in 2021.Results A total of 514 715 nonduplicate clinical isolates were collected from elderly patients in 52 hospitals from January 1,2015 to December 31,2021.The number of isolates accounted for 34.3％of the total number of clinical isolates from all patients.Overall,21.8％of the 514 715 strains were gram-positive bacteria,and 78.2％were gram-negative bacteria.Majority(90.9％)of the strains were isolated from inpatients.About 42.9％of the strains were isolated from respiratory specimens,and 22.9％were isolated from urine.More than half(60.7％)of the strains were isolated from male patients,and 39.3％isolated from females.About 51.1％of the strains were isolated from patients aged 65-＜75 years.The prevalence of methicillin-resistant strains(MRSA)was 38.8％in 32 190 strains of Staphylococcus aureus.No vancomycin-or linezolid-resistant strains were found.The resistance rate of E.faecalis to most antibiotics was significantly lower than that of Enterococcus faecium,but a few vancomycin-resistant strains(0.2％,1.5％)and linezolid-resistant strains(3.4％,0.3％)were found in E.faecalis and E.faecium.The prevalence of penicillin-susceptible S.pneumoniae(PSSP),penicillin-intermediate S.pneumoniae(PISP),and penicillin-resistant S.pneumoniae(PRSP)was 94.3％,4.0％,and 1.7％in nonmeningitis S.pneumoniae isolates.The resistance rates of Klebsiella spp.(Klebsiella pneumoniae 93.2％)to imipenem and meropenem were 20.9％and 22.3％,respectively.Other Enterobacterales species were highly sensitive to carbapenem antibiotics.Only 1.7％-7.8％of other Enterobacterales strains were resistant to carbapenems.The resistance rates of Acinetobacter spp.(Acinetobacter baumannii 90.6％)to imipenem and meropenem were 68.4％and 70.6％respectively,while 28.5％and 24.3％of P.aeruginosa strains were resistant to imipenem and meropenem,respectively.Conclusions The number of clinical isolates from elderly patients is increasing year by year,especially in the 65-＜75 age group.Respiratory tract isolates were more prevalent in male elderly patients,and urinary tract isolates were more prevalent in female elderly patients.Klebsiella isolates were increasingly resistant to multiple antimicrobial agents,especially carbapenems.Antimicrobial resistance surveillance is helpful for accurate empirical antimicrobial therapy in elderly patients.

Objective To predict the current and future ecological suitability distribution areas of Scutellariae Radix in Shandong Province at present and in the future;To screen the main environmental factors affecting its suitable distribution;To provide a reference for the protection of wild resources and the site selection artificial planting of Scutellariae Radix.Methods Taking Scutellariae Radix as the research object,based on the MaxEnt model,the potential suitable habitats were predicted using 84 distribution points of and 48 environmental factors of Scutellariae Radix,and the main environmental factors affecting the distribution of Scutellariae Radix were explored.Its potential suitable habitat areas were predicted under four greenhouse gas emission concentration scenarios(SSP126,SSP245,SSP370,and SSP585)for the years 2021-2040,2041-2060,2061-2080 and 2081-2100.Results The MaxEnt model was optimized through feature combination and regularization constant parameters,and its predictive ability was good(AUC value of 0.871).The primary driving environmental factors affecting its distribution were the maximum temperature in the warmest month(bio_05),soil gravel content(cf05)and altitude(elev).Under the current climate conditions,Scutellariae Radix is mainly distributed in the hilly areas of central and southern Shandong and some areas of in the hilly areas of Jiaodong.Under the future climate conditions of SSP126,SSP245,SSP370 and SSP585,the areas of suitable habitat of Scutellariae Radix in Shandong will show a decreasing trend.Except for the SSP126,the medium and high adaptation areas of Scutellariae Radix will disappear in the other three modes.Conclusion The results of this study can provide an important reference for the protection,rational utilization and planting layout of Scutellariae Radix in Shandong Province.

Objective:To evaluate the effectiveness of virtual case teaching integrating standardized patients (SP) and objective structured clinical examination (OSCE) in enhancing students' clinical thinking and practical skills in experimental exercise therapy course.Methods:In April 2023, 52 students from the 2021 cohort and 54 students from the 2022 cohort of the Rehabilitation Therapy undergraduate program at Xinjiang Medical University were selected and divided into the experimental group and control group according to their classes. In the shoulder joint mobilization experimental class of the exercise therapy course, virtual SP teaching was performed in the experimental group of both cohorts. For the control group, student-led SP teaching was performed in the 2021 cohort, while the traditional "lecture + demonstration" method was used in the 2022 cohort. Upon completion of teaching, theoretical exams, case analysis, practical exams, and a teaching satisfaction survey were conducted on the students. Data were analyzed using the t-test and chi-square test in SPSS 25.0. Results:In both cohorts, the experimental group had similar theoretical exam scores ( P=0.207 and P=0.097, respectively) to the control group, but had higher practical exam scores ( P=0.013 and P=0.002, respectively) than the control group. In the case analysis exam, the experimental group scored higher than the control group in the 2022 cohort ( t=2.84, P=0.006) but similarly to the control group in the 2021 cohort ( t=1.53, P=0.132). All students believed that virtual SP teaching was most engaging. In terms of understanding complex concepts, increasing active participation, and fostering clinical thinking, the 2022 cohort was more satisfied with virtual SP teaching, whereas the 2021 cohort experienced no significant difference between virtual SP teaching and student-led SP teaching. In addition, the 2021 cohort found that student-led SP teaching was more helpful for improving doctor-patient communication skills. Conclusions:The application of virtual SP teaching in the experimental exercise therapy course effectively enhances students' practical skills and case analysis capabilities, contributing greatly to their overall clinical management thinking.

BACKGROUND:Degeneration of nucleus pulposus cells is a key component of intervertebral disc degeneration.Ferroptosis,a novel form of programmed cell death,is closely associated with the onset and progression of intervertebral disc degeneration;however,its precise mechanisms remain unclear.OBJECTIVE:To establish an oxidative stress model in vitro by inducing ferroptosis in nucleus pulposus cells using tert-butyl hydroperoxide and to investigate the mechanisms of tert-butyl hydroperoxide-induced ferroptosis in nucleus pulposus cells,thereby elucidating the role of ferroptosis in the pathogenesis of intervertebral disc degeneration.METHODS:Nucleus pulposus cells were treated with varying concentrations of tert-butyl hydroperoxide(0,25,50,100,and 200 μmol/L),and cell morphology and viability were assessed using fluorescence microscopy and the cell counting kit-8 assay.Interventions with 100 μmol/L tert-butyl hydroperoxide,10 μmol/L RSL3,or dimethylsulfoxide were applied to nucleus pulposus cells,and cell proliferation was evaluated using the EdU assay.The expression levels of ferroptosis-related proteins(glutathione peroxidase 4,ferritin heavy chain 1,PTGS2,and ACSL4)and intervertebral disc degeneration marker proteins(matrix metalloproteinase 13 and Col2A)were analyzed via western blot and immunofluorescence.Additionally,reactive oxygen species and lipid peroxidation levels were quantified using the reactive oxygen species detection kit and C11-BODIPY probe.Mitochondrial morphological changes were observed under transmission electron microscopy.RESULTS AND CONCLUSION:(1)tert-Butyl hydroperoxide treatment significantly reduced the viability and proliferation of nucleus pulposus cells.(2)tert-Butyl hydroperoxide induced typical ferroptosis-related morphological changes in nucleus pulposus cells.(3)tert-Butyl hydroperoxide exposure led to a decrease in the expression of ferroptosis-suppressing proteins glutathione peroxidase 4 and ferritin heavy chain 1,while increasing the expression of ferroptosis-promoting factors ACSL4 and PTGS2.(4)tert-Butyl hydroperoxide elevated intracellular reactive oxygen species production and lipid peroxidation levels in nucleus pulposus cells.(5)Transmission electron microscopy revealed ferroptosis-specific mitochondrial changes in nucleus pulposus cells treated with tert-butyl hydroperoxide,including contraction,reduced cristae,and increased membrane density.(6)tert-Butyl hydroperoxide treatment also resulted in the increased expression of matrix metalloproteinase 13 and decreased expression of Col2A in nucleus pulposus cells.In conclusion,tert-butyl hydroperoxide induces ferroptosis in nucleus pulposus cells,contributing to the development of intervertebral disc degeneration.This process may represent a key pathological mechanism in intervertebral disc degeneration and offers potential targets for developing novel therapeutic strategies.

Purpose To investigate the clinicopathological features,diagnostic approaches,and differential diag-nosis of chordoid glioma(CG)and chordoid meningioma(CM)of the central nervous system(CNS).Methods Clinical data from 4 cases of CG and 10 cases of CM were collected.Immunohistochemistry was used to detect the ex-pression of GFAP,EMA,TTF-1,and other markers.Molecular genetic alerations were identified using sequencing techniques and relevant literature was reviewed.Results CG predominantly occurred in the third ventricle but could also arise outside of it.Tumors showed well-defined borders with surrounding tissues.Microscopically,tumor cells were arranged in cords or clusters within a myxoid stroma and expressed GFAP,TTF-1,and other markers.No PRKCA(D463H)mutations were detected in 3 CG cases,however,one case harbored an FLCN ∷ PRKD2 fusion.CM predom-inantly occurred in the supratentorial region but also appeared in the subtentorial area.Histologically,chordoid compo-nents were mixed with classic meningioma features.Chronic inflammatory cell infiltration was noted in the stroma.Tumor cells expressed EMA,PR and SSTR2.One case harbored NF2 mutation and homozygous CDKN2A deletion.Conclusion CG and CM of the CNS shared overlapping morphological characteristics,making histological distinction difficult.Accurate diagnosis required integration of clinical,imaging,immunohistochemical,and molecular pathologi-cal findings.

Objective:To investigate the changes in iodine intake and iodine nutrition trends of pregnant women in a certain district of Beijing, as well as their related influencing factors, to provide a basis for formulating iodine supplementation strategies for pregnant women.Methods:According to the National Monitoring Program for Iodine Deficiency Disorders, a stratified random sampling method was used to select 100 pregnant women (balanced in early, middle, and late pregnancy) for monitoring each year from 2021 to 2024. Based on the salt iodine and urinary iodine levels of pregnant women, combined with their intake of iodine supplements and other medications, a generalized linear model (GLM) was used to analyze the annual trends in salt iodine and urinary iodine levels. Generalized linear mixed-effects models (GLMMs) were employed to evaluate the variations in salt iodine and urinary iodine levels of pregnant women during different pregnancy periods.Results:From 2021 to 2024, a total of 400 pregnant women were enrolled, with salt iodine levels of (19.23 ± 6.18), (21.31 ± 6.41), (22.38 ± 6.86), and (15.87 ± 9.43) mg/kg, respectively. There was a statistically significant differences between different years ( F = 15.21, P < 0.001). By 2024, the proportion of non-iodized salt consumed reached 25.0% (25/100). The median urinary iodine levels in each year were 136.02, 151.27, 117.83, and 122.94 μg/L, respectively, and the differences between different years were statistically significant ( H = 31.89, P < 0.001). The GLM results showed that compared with 2021, the salt iodine level increased by 2.21 mg/kg (β = 2.21, P = 0.038) in 2022, increased by 3.24 mg/kg (β = 3.24, P = 0.002) in 2023, and decreased by 3.28 mg/kg (β = - 3.28, P = 0.002) in 2024. The urinary iodine level decreased by 24.53 μg/L (β = - 24.53, P = 0.030) in 2024. The GLMMs results showed that compared with early pregnancy, urinary iodine levels increased by 33.68 μg/L (β = 33.68, P = 0.008) in middle pregnancy and 43.17 μg/L (β = 43.17, P = 0.001) in late pregnancy. Conclusions:From 2021 to 2024, the iodine intake of pregnant women in a certain district of Beijing shows an overall trend of first increasing and then decreasing, especially with an increase in the proportion of non iodized salt consumption in 2024. And the iodine nutrition status varies during different pregnancy periods. It is necessary to strengthen the promotion of iodized salt and the publicity of iodine deficiency disorders prevention and control, to ensure that pregnant women can obtain sufficient iodine nutrition through other means when their intake of iodized salt is reduced.