arcopenia is a systemic skeletal muscle disorder characterized by a decrease in skeletal muscle mass and progressive decline in function， with multiple signaling pathways involved in its occurrence and development. Among them， the AMP-activated protein kinase （AMPK） signaling pathway， as a key pathway regulating cellular energy homeostasis， plays an important role in the regulation of skeletal muscle metabolism and functional maintenance by improving abnormalities in glucose and lipid metabolism， balancing skeletal muscle protein synthesis and degradation， improving mitochondrial function， promoting autophagy， and inhibiting inflammatory responses and oxidative stress. This article reviews the research progress on how various traditional Chinese medicine （TCM） monomers， including polyphenols， flavonoids， and terpenoids； various traditional Chinese medicine extracts， such as those from Lycium barbarum ， Asini Corii Colla， and Panax quinquefolium ， and TCM compounds， such as Guiqi zhuangjin decoction， Jianpi qiangji granules， and Qigu capsules， intervene in sarcopenia by regulating the AMPK signaling pathway to promote muscle protein synthesis， inhibit protein degradation， improve mitochondrial function， and alleviate inflammation and oxidative stress. Additionally， their molecular mechanisms are explored. The aim is to deeply elucidate the basis of TCM in the prevention and treatment of sarcopenia and to provide theoretical support for the development of related innovative drugs.

ObjectiveTo explore the correlation between the occurrence of cardiovascular events in rheumatoid arthritis（RA） and traditional Chinese medicine（TCM） syndrome. MethodsThe cross-sectional study selected 6713 RA patients from 122 centres nationwide， in which general information such as name， gender， age， height， body weight， and course of disease were collected by completing a questionnaire； patients were classified into eight types of syndrome according to the information of their four examinations，i.e. wind-dampness obstruction syndrome， cold-dampness obstruction syndrome， dampness-heat obstruction syndrome， phlegm-stasis obstruction syndrome， stasis-blood obstructing collateral syndrome， qi-blood deficiency syndrome， liver-kidney insufficiency syndrome， and qi-yin deficiency syndrome. According to the occurrence of cardiovascular events， they were divided into the occurrence group and the non-occurrence group， and the condition assessment data and laboratory examination indexes were recorded. The test of difference between groups was used to analyse the possible risk factors for the occurrence of RA cardiovascular events， and binary logistic regression was used to analyse the correlation between TCM syndromes and RA cardiovascular events. ResultsA total of 6713 RA patients were included， including 256 cases in occurrence group and 6457 in non-occurrence group. There was no statistically significant difference between groups in terms of height， gender， insomnia， appetite， white blood cell（WBC）， hemoglobin（HGB）， platelets（PLT）， rheumatoid factor（RF）， anti-cyclic peptide containing citrulline（CCP）， alanine aminotransferase（ALT）， aspartate aminotransferase（AST）， γ-glutamyl transpeptidase（GGT）， urea creatinine（CREA）， and glucose（GLU）（P＞0.05）. The TCM syndromes between groups showed significant statistic differences（P＜0.05）. Patients in occurrence group had longer disease duration， heavier body weight， and older age； more severe conditions such as disease activity（DAS-28）， number of painful joints（TJC）， number of swollen joints（SJC）， health questionnaire scores（HAQ）， visual analog scores（VAS）， restlessness， and fatigue； higher blood sedimentation rate（ESR）， low-density lipoprotein（LDL-C）， triglyceride（TG）， total cholesterol（TC）， D-Dimer， and lower high-density lipoprotein（HDL-C）（P＜0.05）. The distribution of syndrome types showed that dampness-heat obstruction syndrome accounted for the largest proportion of patients in both groups and was higher in RA cardiovascular events. Logistic regression analysis showed that the occurrence of RA cardiovascular events was strongly associated with dampness-heat obstruction syndrome［OR=5.937， 95%CI （4.434， 7.949）， P＜0.001］. ConclusionThe occurrence of RA cardiovascular events were associated with TCM syndromes， and the probability of cardiovascular events in the RA patients with dampness-heat obstruction syndrome was 5.937 times higher than patients with other TCM syndromes.

OBJECTIVES: To explore the risk factors for malnutrition in patients with ulcerative colitis complicated with pyoderma gangrenosum and establish a nutritional risk prediction model for these patients. METHODS: A total of 277 patients with ulcerative colitis complicated with pyoderma gangrenosum treated from 2019 to 2024 were divided into malnutrition group (n=185) and normal nutrition group (n=92) according to whether malnutrition occurred. The data of 25 potential related factors pertaining to general demography, living and eating habits, and disease-related data were compared between the two groups. Lasso regression was used to screen the risk factors, and a nomogram model was established based on the screened factors and its prediction performance was assessed. RESULTS: The patients in the malnutrition group and normal nutrition group showed significant differences in 21 factors including gender, age, education level, BMI, place of residence, course of disease, and SAS language score (P<0.05). Lasso regression analysis identified 6 factors associated with malnutrition in these patients, namely the duration of ulcerative colitis, activity of ulcerative colitis, duration of pyoderma gangrenosum, number of chronic diseases, SAS score, and sleep quality. The nomogram prediction model established based on these 6 factors had an AUC of 0.992 (95% CI: 0.984-1.000) for predicting malnutrition in these patients, and its application in 14 clinical cases achieved an accuracy rate of 100%. CONCLUSIONS The duration of ulcerative colitis, activity of colitis, duration of pyoderma gangrenosum, number of chronic diseases, anxiety, and sleep quality are closely related with malnutrition in patients with ulcerative colitis complicated by pyoderma gangrenosum, and the nomogram prediction model based on these factors can provide assistance for predicting malnutrition in these patients.
Humans ; Colitis, Ulcerative/complications* ; Malnutrition/etiology* ; Risk Factors ; Pyoderma Gangrenosum/complications* ; Female ; Male ; Adult ; Nomograms ; Middle Aged ; Nutritional Status ; Regression Analysis

Objective:To investigate the clinical efficacy of two-point localized injection of the depressor anguli oris (DAO) muscle combined with pan-platysma microbotox injection of botulinum toxin type A for improving the aesthetic of mouth corner.Methods:A retrospective analysis was conducted on clinical data from patients who received concomitant DAO localized injection and pan-platysma microbotox of botulinum toxin type A for improving drooping mouth corners at the Facial and Neck Plastic Surgery Center and the Limb and Scar Center of Plastic Surgery Hospital, Chinese Academy of Medical Sciences, between December 2022 and June 2025. Botulinum toxin type A was reconstituted to two concentrations: 40 U/ml and 20 U/ml for the combined injection. Patients were instructed to repeatedly perform upward puckering motions to identify the trapezoidal outline of the DAO muscle. Two injection points were uniformly marked slightly medial to the midline of the DAO muscle for dual-target injection (1.5 U each at the middle one-third and lower one-third of the muscle belly). The pan-platysma microbotox for the platysma muscle extended superiorly to a line parallel and 3-4 cm above the mandibular border, innerly to 1 cm beyond the lateral edge of the DAO muscle, inferiorly to the submental area and the anterior neck region above the clavicle, and laterally to the anterior border of the sternocleidomastoid muscle. The injection dose was 0.6 U per point, with 1 cm spacing between points, administered at the superficial subcutaneous layer. Complications were recorded. At 1-month postoperatively, efficacy was evaluated using the global aesthetic improvement scale (GAIS, scores ranging from 5 to 1, representing "much worse" to "very much improved" ) and subjective patient satisfaction (categorized as very satisfied, satisfied, dissatisfied, or very dissatisfied; satisfaction rate was calculated as the percentage of patients reporting very satisfied or satisfied among the total). Patients’ willingness to receive the same treatment in the future was also surveyed. Descriptive statistics were used for analysis.Results:A total of 21 patients were included (1 male, 20 females), with a mean age of (37.1±3.2) years (range: 34-45 years). The treatment procedures were successful. Post-treatment, 4 cases experienced pain and swelling, 8 had neck ecchymosis, and 1 had temporary asymmetry in mouth corner movement, all of which resolved within 2 weeks. The follow-up period ranged from 1 to 6 months (mean: 1.4 months). At short-term follow-up (4-6 weeks after treatment), patients reported a skin "tightening" sensation in the lower face and neck region, noting significant improvement in lower facial and neck contour, sharper bilateral jawlines, and reduced neck wrinkles. Drooping mouth corners were improved. The satisfaction survey showed that 17 patients were "very satisfied" and 5 were "satisfied", resultsing in a subjective satisfaction rate of 100%. Nineteen patients (90.5%) expressed willingness to undergo repeat treatment. The mean GAIS score was 1.45±0.69, with 14 patients achieving "very much improved", 5 patients "much improved", and 2 patients "improved" .Conclusion:The combination of two-point localized injection of the DAO muscle and pan-platysma microbotox injection of botulinum toxin into the platysma muscle effectively improve the aesthetic of mouth corners and lower facial contour through synergistic middle and superficial layer treatment. This approach aligns with anatomical and physiological merits and offers advantages such as minimal invasiveness and rapid recovery, making it applicable for patients with early signs of lower facial aging.

To promote the standardization and normalization of perioperative care for follicular unit extraction(FUE) hair transplantation, ensure treatment efficacy, and align with advancements in the specialty, the Nursing Branch of the Chinese Association of Plastic and Aesthetics organized a panel of domestic experts. By integrating evidence-based medicine with clinical practice experience, and following thorough discussions, these experts developed the Clinical Practice Expert Consensus on Perioperative Nursing Care for Follicular Unit Extraction (2025). This consensus provides a comprehensive overview of hair transplantation, covering preoperative preparation, surgical procedures, intraoperative coordination, postoperative management, and complication prevention and treatment. It serves as a key reference and guide for implementing standardized perioperative nursing care in FUE hair transplantation.

Objective:To develop an evidence-based nursing practice program based on the Stetler model to extend the lifespan of arteriovenous fistulas (AVF) in maintenance hemodialysis (MHD) patients and evaluate its effectiveness.Methods:An evidence-based nursing practice program was constructed based on the best evidence for extending AVF lifespan in MHD patients. Expert group discussions were held to determine review indicators. A baseline survey was conducted among 100 MHD patients and 42 nurses using covenience sompling at the Blood Purification Center of Wuxi People's Hospital from January to December 2023, to identify barriers and facilitators. In the following year, from January to December 2024, the evidence-based practice was implemented at the same hospital, and the AVF surgical intervention rate and AVF self-management levels of MHD patients were compared before and after the practice.Results:No statistically significant difference was found in the AVF surgery rates before and after the evidence-based practice ( P>0.05) . However, after implementing the evidence-based practice, MHD patients' scores on the AVF self-management scale significantly improved, and the difference was statistically significant ( P<0.01) . Conclusions:The evidence-based practice based on the Stetler model is beneficial for standardizing the clinical management of AVF, reducing the need for surgical interventions, and improving MHD patients' ability to self-manage their AVF.

Objective:To develop an evidence-based nursing practice program based on the Stetler model to extend the lifespan of arteriovenous fistulas (AVF) in maintenance hemodialysis (MHD) patients and evaluate its effectiveness.Methods:An evidence-based nursing practice program was constructed based on the best evidence for extending AVF lifespan in MHD patients. Expert group discussions were held to determine review indicators. A baseline survey was conducted among 100 MHD patients and 42 nurses using covenience sompling at the Blood Purification Center of Wuxi People's Hospital from January to December 2023, to identify barriers and facilitators. In the following year, from January to December 2024, the evidence-based practice was implemented at the same hospital, and the AVF surgical intervention rate and AVF self-management levels of MHD patients were compared before and after the practice.Results:No statistically significant difference was found in the AVF surgery rates before and after the evidence-based practice ( P>0.05) . However, after implementing the evidence-based practice, MHD patients' scores on the AVF self-management scale significantly improved, and the difference was statistically significant ( P<0.01) . Conclusions:The evidence-based practice based on the Stetler model is beneficial for standardizing the clinical management of AVF, reducing the need for surgical interventions, and improving MHD patients' ability to self-manage their AVF.

Objective:To investigate the clinical efficacy of two-point localized injection of the depressor anguli oris (DAO) muscle combined with pan-platysma microbotox injection of botulinum toxin type A for improving the aesthetic of mouth corner.Methods:A retrospective analysis was conducted on clinical data from patients who received concomitant DAO localized injection and pan-platysma microbotox of botulinum toxin type A for improving drooping mouth corners at the Facial and Neck Plastic Surgery Center and the Limb and Scar Center of Plastic Surgery Hospital, Chinese Academy of Medical Sciences, between December 2022 and June 2025. Botulinum toxin type A was reconstituted to two concentrations: 40 U/ml and 20 U/ml for the combined injection. Patients were instructed to repeatedly perform upward puckering motions to identify the trapezoidal outline of the DAO muscle. Two injection points were uniformly marked slightly medial to the midline of the DAO muscle for dual-target injection (1.5 U each at the middle one-third and lower one-third of the muscle belly). The pan-platysma microbotox for the platysma muscle extended superiorly to a line parallel and 3-4 cm above the mandibular border, innerly to 1 cm beyond the lateral edge of the DAO muscle, inferiorly to the submental area and the anterior neck region above the clavicle, and laterally to the anterior border of the sternocleidomastoid muscle. The injection dose was 0.6 U per point, with 1 cm spacing between points, administered at the superficial subcutaneous layer. Complications were recorded. At 1-month postoperatively, efficacy was evaluated using the global aesthetic improvement scale (GAIS, scores ranging from 5 to 1, representing "much worse" to "very much improved" ) and subjective patient satisfaction (categorized as very satisfied, satisfied, dissatisfied, or very dissatisfied; satisfaction rate was calculated as the percentage of patients reporting very satisfied or satisfied among the total). Patients’ willingness to receive the same treatment in the future was also surveyed. Descriptive statistics were used for analysis.Results:A total of 21 patients were included (1 male, 20 females), with a mean age of (37.1±3.2) years (range: 34-45 years). The treatment procedures were successful. Post-treatment, 4 cases experienced pain and swelling, 8 had neck ecchymosis, and 1 had temporary asymmetry in mouth corner movement, all of which resolved within 2 weeks. The follow-up period ranged from 1 to 6 months (mean: 1.4 months). At short-term follow-up (4-6 weeks after treatment), patients reported a skin "tightening" sensation in the lower face and neck region, noting significant improvement in lower facial and neck contour, sharper bilateral jawlines, and reduced neck wrinkles. Drooping mouth corners were improved. The satisfaction survey showed that 17 patients were "very satisfied" and 5 were "satisfied", resultsing in a subjective satisfaction rate of 100%. Nineteen patients (90.5%) expressed willingness to undergo repeat treatment. The mean GAIS score was 1.45±0.69, with 14 patients achieving "very much improved", 5 patients "much improved", and 2 patients "improved" .Conclusion:The combination of two-point localized injection of the DAO muscle and pan-platysma microbotox injection of botulinum toxin into the platysma muscle effectively improve the aesthetic of mouth corners and lower facial contour through synergistic middle and superficial layer treatment. This approach aligns with anatomical and physiological merits and offers advantages such as minimal invasiveness and rapid recovery, making it applicable for patients with early signs of lower facial aging.

Pancreatic metastases originating in colon cancer are very rare clinically, and there are few reports on their imaging manifestations. In this paper, it improves the diagnosis of the disease by reporting a case of pancreatic head metastases and focusing on the appearance of contrast-enhanced ultrasound.

Objective To investigate the risk factors for pulmonary infection in patients with acute-on-chronic liver failure(ACLF),and to establish a predictive model.Methods A retrospective analysis was performed for 585 ACLF patients who were admitted to Department of Infectious Diseases,The Second Affiliated Hospital of Air Force Medical University,from January 2009 to September 2022,and according to the condition of pulmonary infection after admission,they were divided into infection group with 213 patients and non-infection group with 372 patients.The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups,and the chi-square test was used for comparison of categorical data between groups.The clinical data of these patients were collected.Univariate and multivariate Logistic regression analyses were used to investigate the risk factors for pulmonary infection in ACLF patients and establish a predictive model,and the receiver operating characteristic(ROC)curve was plotted to assess the predictive value of the model.The Hosmer-Lemeshow test was used to evaluate the degree of fitting of the model,and the ROC curve and the area under the ROC curve(AUC)were used to assess the predictive performance of the model.Results Among the 585 patients with ACLF,213 experienced pulmonary infection,with an infection rate of 36.41%.The multivariate logistic analysis showed that upper gastrointestinal bleeding(odds ratio[OR]=2.463,P=0.047),infection at other sites(OR=2.218,P=0.004),femoral vein catheterization(OR=2.520,P＜0.001),and combined use of two or more antibiotics(OR=2.969,P＜0.001)were risk factors for pulmonary infection in ACLF patients.These factors were included in the risk factor predictive model of Logit(P)=-1.869+0.901×upper gastrointestinal bleeding+0.755×infection at other sites+0.924×femoral vein catheterization+1.088×combined use of two or more antibiotics.The ROC curve analysis showed that the model had a good predictive value(Hosmer-Lemeshow χ2=3.839,P=0.698),with an AUC of 0.753(95%confidence interval:0.700-0.772).Conclusion There is a relatively high incidence rate of pulmonary infection in patients with ACLF,and upper gastrointestinal bleeding,spontaneous peritonitis,femoral vein catheterization,and combined use of two or more antibiotics are related risk factors.The model established based on these factors can effectively predict the onset of pulmonary infection in ACLF patients.