The theory of "Yang transforming Qi while Yin constituting form" in the Huangdi's Internal Classic is derived from the application， transformation， movement， and balance of Tao. It is highly condensed， revealing the true meaning of Tao and guiding the changes and progress of all natural things， including diseases. Therefore， the appearance of various physical diseases is the manifestation of Yin-Yang Qi transformation. Sweat pore， formed by the Qi transformation of Yin and Yang， is the nourishing and regulating system. It serves as the hub and channel， assisting in the flow and transformation of Qi， facilitating the exchange of material， energy， and information with the outside world. With sweat pore as the hub and based on the macro-control and holistic thinking of "Yang transforming Qi while Yin constituting form"， this paper explores the microscopic mechanisms underlying chronic liver disease. In combination with the roles of mitochondria， exosomes， and the ultraliver sieve structure in the formation and progression of chronic liver disease， this paper elucidates the close internal relationship between the disease's initial quality， symptom signs， and its physiological and pathological functions under the guidance of this theory. Modern studies have shown that autophagy， intestinal flora disorders， glucose and lipid metabolism disturbances， activation of inflammatory factors， ferroptosis， and other microscopic pathological mechanisms are involved in the occurrence and development of chronic liver disease. The common connotation of the Yin-Yang concept in traditional Chinese medicine （TCM） and the pathological mechanisms in modern medicine is deeply analyzed. The corresponding relevant microscopic mechanisms and the guiding role of the theory of "Yang transforming Qi while Yin constituting form-sweat pore" in the management of chronic liver disease are summarized. Wind medicine promotes growth and transformation through sweat pore. The combination of pungent and sweet medicines facilitates Yang and disperse Yin. The formulas， combining the characteristics of wind medicine and pungent and sweet medicines， fit the principle of "Yang transforming Qi while Yin constituting form-sweat pore". This paper combines both macro and micro perspectives to explain the scientific connotation and microscopic mechanisms of chronic liver disease based on the theory of "Yang transforming Qi while Yin constituting form-sweat pore"， and explore the prevention and treatment of chronic liver disease through the principles， methods， prescriptions， and medicines featured by combination of pungent and sweet medicines， facilitating Yang， activating sweat pore， and dispersing Yin， providing new ideas and reference for the clinical treatment of chronic liver disease.

Objective To analyze the efficacy of modified transvaginal rectal repair(MTVRR)in patients with moderate to severe rectocele(RC).Methods A retrospective analysis was conducted on the clinical data of 21 female patients with RC who underwent MTVRR.The Constipation Scoring System(CSS)scale was used to assess patients'constipation symptoms before surgery and at 3,6,12 and 24 months after surgery,and the efficiency of symptom improvement was recorded.The occurrence of postoperative complications in RC patients was observed.Results All 21 patients successfully un-derwent the surgery,with surgical duration ranging from 25 to 135 minutes,with average of(83.14±30.39)minutes,and hospital stay ranging from 10 to 21 days,with average of(14.10±2.34)days.Postoperatively,one patient was lost during follow-up among 21 patients.The CSS scores of the remai-ning 20 patients were lower than those before surgery,with a statistically significant difference(P＜0.05).The overall effective rates of constipation symptom improvement at 3,6 and 12 months postop-eratively were 100.00％,90.00％and 80.00％,respectively.Among 20 patients,15 patients com-pleted 24-month follow-up after surgery,and the CSS score after surgery was lower than that before sur-gery,the difference was statistically significant(P＜0.05).The CSS scores of the remaining 15 pa-tients were lower than those before surgery,with a statistically significant difference(P＜0.05).The overall effective rate of constipation symptom improvement at 24 months postoperatively was 80.00％among 15 patients.During postoperative follow-up,it revealed that no complications occurred in any patient.Conclusion MTVRR can improve constipation symptoms in patients with RC,demonstra-ting good therapeutic efficacy.

Objective:To compare the clinical efficacy of robotic-assisted and fluoroscopy-assisted minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).Methods:A total of 27 patients with lumbar degenerative disease receiving robot-assisted MIS-TLIF (robot-assisted group) treatment in the First Affiliated Hospital of Nanjing Medical University from May 2020 to September 2021 were retrospectively analyzed, including 9 males and 18 females, aged 61.00±9.11 years (range, 41-71 years). Twenty-seven patients who received fluoroscopic-assisted MIS-TLIF (fluoroscopic-assisted group) during the same period were selected as controls, including 16 males and 11 females, aged 56.70±11.97 years (range, 32-76 years). Operation time, intraoperative bleeding, radiation exposure time, postoperative drainage, hospitalization time, visual analogue scale (VAS) for pain, Oswestry disability index (ODI), accuracy of pedicle screw placement, and postoperative complications were recorded. The learning curve of the robot-assisted group was drawn based on the amount of surgery and the operation time by fitting the logarithmic curve.Results:All patients successfully completed the operation and were followed up for 15.44±3.89 months (range, 12-24 months). The operation time, drainage volume, and hospitalization time in the robot-assisted group were 181.44±36.43 min, 43.70±22.04 ml, and 5.04±1.40 d, respectively, which were smaller than 223.22±59.40 min, 74.63±71.86 ml, 6.59±3.04 d in the fluoroscopy-assisted group, and the differences were statistically significant ( P<0.05). The radiation exposure time in robot-assisted group was 77.78±9.81 s, which was larger than fluoroscopy-assisted group (63.78±17.70 s). There were statistically significant differences in lumbar VAS scores between the two groups before and after surgery ( P<0.05), 3 days after operation and the last follow-up was smaller than those before operation. The VAS score on postoperative day 3 in the robot-assisted group was 2.52±0.98, which was less than 3.07±0.87 in the fluoroscopically-assisted group ( t=0.294, P=0.032). In both groups, 108 pedicle screws were placed, and the accuracy of nail placement in the robot-assisted group was 93.5% (101/108), which was greater than that in the fluoroscopically-assisted group 77.8% (84/108), and the difference was statistically significant (χ 2=11.821, P=0.008). By fitting a logarithmic curve to describe the relationship between the number of operations and the operation time of the robotic-assisted group of operators, the results showed that the operation time decreased with the increase of the number of operations, and the operation time fluctuated greatly in the first 10 cases, and then gradually shortened and stabilized after 10 operations. Conclusion:Robot-assisted MIS-TLIF can improve the accuracy of pedicle screw placement, improve the early postoperative pain and shorten the learning curve.

High glucose level, bacterial infection, and persistent inflammation within the microenvironment are key factors contributing to the delay of diabetic ulcers healing, while traditional therapeutic methods generally fail to address these issues simultaneously. Here, we present a spatiotemporally responsive cascade bilayer microneedle (MN) patch for accelerating diabetic wound healing via local glucose depletion and sustained nitric oxide (NO) release for long-term antibacterial and anti-inflammatory effects. The MN patch (G/AZ-MNs) possesses a degradable tip layer loading glucose oxidase (GOx), as well as a dissolvable base layer encapsulating l-arginine (Arg)-loaded nanoparticles (NPs). After wound administration, the base part rapidly dissolved, resulting in prompt separation of the MN tip within the wound tissue, which subsequently responded to the overexpressed matrix metalloproteinase-9 (MMP-9) in diabetic lesions, leading to the responsive release of GOx. The released enzyme catalyzed glucose into gluconic acid and hydrogen peroxide (H₂O₂), which not only reduced glucose level within the diabetic wound, but also initiated the cascade reaction between H₂O₂ with the Arg that was released from NPs, thereby achieving continuous production of NO for 7 days. Our findings demonstrate that a single administration of the MN patch could effectively heal non-infected or biofilm-infected diabetic wounds with the multifunctional properties.

Hepatic fibrosis is a common complication of chronic liver disease， seriously affecting patients' quality of life and leading to severe consequences such as cirrhosis and liver cancer. Modern medicine has made progress in the treatment of hepatic fibrosis， while it still faces certain challenges and limitations. Therefore， seeking new therapeutic strategies is of great clinical significance. The nuclear factor-κB （NF-κB） signaling pathway plays a role in regulating inflammation and immune responses. Recent studies have shown that the NF-κB signaling pathway plays a key role in the occurrence and development of hepatic fibrosis. The abnormal activation of the NF-κB signaling pathway leads to the overexpression of genes related to liver inflammation and fibrosis， thereby promoting the development of hepatic fibrosis. Traditional Chinese medicine （TCM） is a traditional treatment method with unique advantages and potential. In recent years， increasing studies have proved that TCM can treat hepatic fibrosis by regulating the NF-κB signaling pathway. The active ingredients in Chinese herbal medicines can intervene in the activation of the NF-κB signaling pathway to inhibit inflammatory responses， thereby reducing the severity of hepatic fibrosis. This article reviews the mechanisms of TCM in treating hepatic fibrosis via the NF-κB signaling pathway and evaluates the efficacy and discusses the clinical application prospects of relevant Chinese herbs and formulae， aiming to provide references for further research and clinical practice.

Wound healing is a dynamic process that involves a series of molecular and cellular events aimed at replacing devitalized and missing cellular components and/or tissue layers. Recently, extracellular vesicles (EVs), naturally cell-secreted lipid membrane-bound vesicles laden with biological cargos including proteins, lipids, and nucleic acids, have drawn wide attention due to their ability to promote wound healing and tissue regeneration. However, current exploitation of EVs as therapeutic agents is limited by their low isolation yields and tedious isolation processes. To circumvent these challenges, bioinspired cell-derived nanovesicles (CDNs) that mimic EVs were obtained by shearing mesenchymal stem cells (MSCs) through membranes with different pore sizes. Physical characterisations and high-throughput proteomics confirmed that MSC-CDNs mimicked MSC-EVs. Moreover, these MSC-CDNs were efficiently uptaken by human dermal fibroblasts and demonstrated a dose-dependent activation of MAPK signalling pathway, resulting in enhancement of cell proliferation, cell migration, secretion of growth factors and extracellular matrix proteins, which all promoted tissue regeneration. Of note, MSC-CDNs enhanced angiogenesis in human dermal microvascular endothelial cells in a 3D PEG-fibrin scaffold and animal model, accelerating wound healing in vitro and in vivo. These findings suggest that MSC-CDNs could replace both whole cells and EVs in promoting wound healing and tissue regeneration.

Objective The research on the standardization of TCM disease names is the basis of mining and sorting out the essence of ancient TCM books,which has important value for promoting the academic innovation of TCM.Methods This study took the names of pediatric diseases in traditional Chinese medicine as an example,and on the basis of collecting and sorting out ancient books,put forward the research principles and methods for the standardization of pediatric disease names in ancient books,aiming at the problems such as the mixed use of diseases,syndrome types and symptoms,polysemy,and the misuse and mixture of variant and traditional characters.The research starts with the establishment of the system framework of the disease to standardize the classification of the disease names,differentiation and analysis of the connotation of disease names,the determination of the preferred term of the disease names,and the determination of the relationship between the upper and lower positions of the disease names.Results A total of 784 pediatric disease names were sorted out from 11 ancient books,and 174 preferred terms were determined after normalization.Conclusion This study puts forward the basic ideas of the standardized research methods of disease names in ancient Chinese medicine books.And it will make the beneficial discussion on the standardized diagnosis and treatment of TCM pediatrics,the improvement of academic level,and the unified establishment of the standardized terminology system of TCM disease names.

Objective:To learn the key driving factors in the management of scientific and technological achievements transformation in public hospitals, so as to provide basis for improving the effectiveness of achievements transformation.Methods:From March to July 2021, 1 226 medical staff from 7 municipal hospitals in Hangzhou were investigated by stratified random sampling. The questionnaire included the main demographic information, the perceived importance and actual performance of the management mechanism(6 dimensions, 18 items)which was scored by Likert 5. Descriptive analysis was carried out and paired samples were compared by t-test, and the difference was significant when P<0.05. Importance matrix analysis was carried out on all items to identify the key driving factors for the transformation of achievements in public hospitals. Results:1 157 valid questionnaires were finally included. The difference between the scores of perceived importance and actual performance of the various management mechanisms was significance( P<0.001). The gap was presented as follows: evaluation mechanism(1.29), investment mechanism(0.88), organization and leadership mechanism(0.87), guarantee mechanism of services(0.44), benefit and distribution mechanism(0.15), incentive mechanism(-0.11). Matrix analysis results showed that, " special funds support" , " grasp market demand and accurately connect" , " formulate corresponding supporting systems" , " professional transformation team with multidisciplinary background" , " classified and multi-level achievement transformation evaluation index system" , " full life cycle management" , " incorporate into central work and key tasks" and " scientific and technological achievement transformation reporting system and application monitoring system" were the key driving factors for the transformation of scientific and technological achievements in public hospitals. Conclusions:The perceived importance of medical staff to the transformation of scientific and technological achievements in public hospitals is acceptable, while the actual performance is relatively weak. The management effectiveness should be improved and give priority to consolidate the management foundation, build index evaluation system, provide the life cycle management service and improve scientific interaction as well as consultation service mechanism.

Bibenzyl is a type of active compounds abundant in Dendrobium. In the present study, we investigated the inhibitory effects of six bibenzyls isolated from Dendrobium species on vascular endothelial growth factor (VEGF)-induced tube formation in human umbilical vascular endothelial cells (HUVECs). All those bibenzyls inhibited VEGF-induced tube formation at 10 micromol x L(-1) except tristin, and of which moscatilin was found to have the strongest activity at the same concentration. The lowest effective concentration of moscatilin was 1 micromol x L(-1). Further results showed that moscatilin inhibited VEGF-induced capillary-like tube formation on HUVECs in a concentration-dependent manner. Western blotting results showed that moscatilin also inhibited VEGF-induced phosphorylation of VEGFR2 (Flk-1/KDR) and extracellular signal-regulated kinase 1/2 (ERK1/2). Further results showed that moscatilin inhibited VEGF-induced activation of c-Raf and MEK1/2, which are both upstream signals of ERK1/2. Taken together, results presented here demonstrated that moscatilin inhibited angiogenesis via blocking the activation of VEGFR2 (Flk-1/KDR) and c-Raf-MEK1/2-ERK1/2 signals.

Some biological characteristics of human bone marrow mesenchymal stem cells (MSCs) cultured in vitro were observed. hMSCs were isolated from bone marrow and purified by density gradient centrifugation method, and then cultured in vitro. The proliferation and growth characteristics of hMSCs were observed in primary and passage culture. MSCs of passage 3 were examined for the purify by positive rate of CD29 and CD44 through flow cytometry. Human bone marrow MSCs showed active proliferation capacity in vitro. The purify of MSCs separated by our method was higher than 90%. It was concluded that hMSCs have been successfully cultured and expanded effectively. It provided a foundation for further investigation and application of MSCs.
Antigens, CD29/analysis ; Antigens, CD44/analysis ; Bone Marrow Cells/*cytology ; Cell Proliferation ; Cell Separation ; Cells, Cultured ; Flow Cytometry ; Mesenchymal Stem Cells/*cytology