Traumatic main bronchus rupture is a relatively rare injury in thoracic trauma, which is extremely critical, with a mortality rate as high as 70% - 80%. The complete rupture and displacement of the traumatic cervical trachea can lead to asphyxia, hypoxia, and cardiac arrest, even death of the patient in a short time. We performed emergency surgery with the support of extracorporeal membrane oxygenation for a case of traumatic cervical tracheal trunk complete rupture and displacement combined with cardiac arrest and achieved a successful rescue. We summarized our experience and found that timely surgical reconstruction of the airway is the key to increasing the traumatic main bronchus rupture survival of patients.
Humans ; Extracorporeal Membrane Oxygenation ; Heart Arrest/etiology* ; Rupture ; Trachea/surgery*

Traditional Chinese medicine (TCM) is a well-accepted therapy for atopic dermatitis (AD). However, there are currently no evidence-based guidelines integrating TCM and Western medicine for the treatment of AD, limiting the clinical application of such combined approaches. Therefore, the China Association of Chinese Medicine initiated the development of the current guideline, focusing on key issues related to the use of TCM in the treatment of AD. This guideline was developed in accordance with the principles of the guideline formulation manual published by the World Health Organization. A comprehensive review of the literature on the combined use of TCM and Western medicine to treat AD was conducted. The findings were extensively discussed by experts in dermatology and pharmacy with expertise in both TCM and Western medicine. This guideline comprises 23 recommendations across seven major areas, including TCM syndrome differentiation and classification of AD, principles and application scenarios of TCM combined with Western medicine for treating AD, outcome indicators for evaluating clinical efficacy of AD treatment, integration of TCM pattern classification and Western medicine across disease stages, daily management of AD, the use of internal TCM therapies and proprietary Chinese medicines, and TCM external treatments. Please cite this article as: Du XR, Wu MY, Tao MC, Lin Y, Gu CY, Wu MF, Cao Y, Chen DC, Li W, Wang HW, Wang Y, Wang Y, Lu HZ, Liu X, Su XF, Li FL. Clinical practice guidelines for the diagnosis and treatment of atopic dermatitis with integrative traditional Chinese and Western medicine. J Integr Med. 2025; 23(6):641-653.
Dermatitis, Atopic/drug therapy* ; Humans ; Medicine, Chinese Traditional/methods* ; Integrative Medicine ; Drugs, Chinese Herbal/therapeutic use* ; Practice Guidelines as Topic

Ferroptosis, a programmed cell death modality discovered and defined in the last decade, is primarily induced by iron-dependent lipid peroxidation. At present, it has been found that ferroptosis is involved in various physiological functions such as immune regulation, growth and development, aging, and tumor suppression. Especially its role in tumor biology has attracted extensive attention and research. Breast cancer is one of the most common female tumors, characterized by high heterogeneity and complex genetic background. Triple negative breast cancer (TNBC) is a special type of breast cancer, which lacks conventional breast cancer treatment targets and is prone to drug resistance to existing chemotherapy drugs and has a low cure rate after progression and metastasis. There is an urgent need to find new targets or develop new drugs. With the increase of studies on promoting ferroptosis in breast cancer, it has gradually attracted attention as a treatment strategy for breast cancer. Some studies have found that certain compounds and natural products can act on TNBC, promote their ferroptosis, inhibit cancer cells proliferation, enhance sensitivity to radiotherapy, and improve resistance to chemotherapy drugs. To promote the study of ferroptosis in TNBC, this article summarized and reviewed the compounds and natural products that induce ferroptosis in TNBC and their mechanisms of action. We started with the exploration of the pathways of ferroptosis, with particular attention to the System X_c^--cystine-GPX4 pathway and iron metabolism. Then, a series of compounds, including sulfasalazine (SAS), metformin, and statins, were described in terms of how they interact with cells to deplete glutathione (GSH), thereby inhibiting the activity of glutathione peroxidase 4 (GPX4) and preventing the production of lipid peroxidases. The disruption of the cellular defense against oxidative stress ultimately results in the death of TNBC cells. We have also our focus to the realm of natural products, exploring the therapeutic potential of traditional Chinese medicine extracts for TNBC. These herbal extracts exhibit multi-target effects and good safety, and have shown promising capabilities in inducing ferroptosis in TNBC cells. We believe that further exploration and characterization of these natural compounds could lead to the development of a new generation of cancer therapeutics. In addition to traditional chemotherapy, we discussed the role of drug delivery systems in enhancing the efficacy and reducing the toxicity of ferroptosis inducers. Nanoparticles such as exosomes and metal-organic frameworks (MOFs) can improve the solubility and bioavailability of these compounds, thereby expanding their therapeutic potential while minimizing systemic side effects. Although preclinical data on ferroptosis inducers are relatively robust, their translation into clinical practice remains in its early stages. We also emphasize the urgent need for more in-depth and comprehensive research to understand the complex mechanisms of ferroptosis in TNBC. This is crucial for the rational design and development of clinical trials, as well as for leveraging ferroptosis to improve patient outcomes. Hoping the above summarize and review could provide references for the research and development of lead compounds for the treatment for TNBC.

Vertebral refracture following percutaneous vertebral augmentation (PVA) is commonly seen in elderly patients with osteoporotic thoracolumbar compression fractures (OTLCF). It can lead to recurrent pain, loss of vertebral height, progression of kyphosis, and even neurological dysfunction, significantly impairing patients′ quality of life. Current diagnosis and treatment face multiple challenges, including high misdiagnosis rate, difficulty in choosing between surgical and non-surgical treatment options, lack of standardized surgical protocols, interference from intralesional bone cement during procedures, inadequate stability of internal fixation in osteoporotic bone, and suboptimal compliance of anti-osteoporotic therapy. Establishing a standardized diagnostic and therapeutic framework is urgently needed. To standardize the management process and improve outcomes for vertebral refractures after PVA in elderly OTLCF patients, Spinal Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field to develop Guideline for the diagnosis and treatment of vertebral refracture after percutaneous vertebral augmentation in elderly patients with osteoporotic thoracolumbar compression fractures ( version 2025), based on current literature and clinical experience, and adhering to principles of scientific rigor and clinical applicability. A total of 11 recommendations were proposed, encompassing diagnosis, treatment, and rehabilitation of vertebral refracture after PVA in elderly patients with OTLCF, aiming to provide a foundation for a standardized management.

Objective:To develop a treatment-related quality of life scale for Chinese patients with multiple myeloma (MM) and to test its reliability and validity.Methods:The initial scale was constructed through a literature search, Delphi expert correspondence, and cognitive testing. This study conducted a preliminary survey of 379 patients with MM and a formal survey of 865 patients from the hematology departments of 155 hospitals nationwide from February 2024 to March 2024. The final scale was obtained after conducting item analysis and reliability and validity tests on the initial scale.Results:The constructed scale contains 36 items covering six domains: physiological, psychological, social, treatment side effects, general health, and others. In the preliminary survey, the Cronbach’s alpha coefficient of each item ranged from 0.597 to 0.939, and the test-retest reliability was 0.747 ( P<0.001). Exploratory factor analysis extracted eight common factors with a cumulative variance contribution of 60.058%. In the formal survey, the Cronbach’s alpha coefficient of each item ranged from 0.484 to 0.930, and the test-retest reliability was 0.835 ( P<0.001). Confirmatory factor analysis revealed a comparative fit index of 0.750, a root-mean-square error of approximation of 0.090, and a root-mean-square residual of 0.067. Conclusion:The treatment-related quality of life scale for Chinese patients with MM designed in this study exhibited good reliability and validity, reflecting the impact of treatment on the quality of life of patients. This scale can provide a reference to clinicians for assessing the disease status of patients.

Objective:To investigate the clinical efficacy and safety of needle-free and needle-based injections of recombinant human interferon (IFN) -α2a in the treatment of palmoplantar warts.Methods:Patients aged 6 to 75 years with palmoplantar warts were prospectively enrolled from the Department of Dermatology, Zhongda Hospital, Southeast University between March and September 2023, and baseline data were collected. The patients were randomly and equally divided into a needle-free injection group and a needle-based injection group by using a random number table method, and received needle-free and needle-based injections of recombinant human IFN-α2a once every 2 to 3 weeks, respectively, with a maximum of 4 treatment sessions. Efficacy was assessed based on changes in wart size and skin lines under a dermoscope. Pain degrees and adverse reactions were recorded, and patients were followed up for 6 months after the end of treatment. Chi-square test was used to compare the cure rates, recurrence rates, and incidence rates of adverse reactions between the two groups. Logistic regression analysis was employed to identify factors related to the clearance of palmoplantar warts.Results:A total of 160 patients with palmoplantar warts were included, with 80 patients in each group. In the needle-free injection group, there were 45 females (56.2%) and 35 males (43.8%) ; their ages ( M[ Q1, Q3]) were 27 (23, 40) years, and the duration of disease ( M[ Q1, Q3]) was 12 (3, 24) months; warts were located on the hands in 12 cases (15.0%), on the feet in 60 cases (75.0%), and on both sites in 8 cases (10.0%) ; warts measuring ≤ 1 cm in diameter were observed in 71 cases (88.8%), and those measuring > 1 cm were observed in 9 cases (11.3%). In the needle-based injection group, there were 37 females (46.2%) and 43 males (53.8%) ; their ages were 28 (22, 39) years, and the duration of disease was 6 (2, 12) months; warts were located on the hands in 23 cases (28.7%), on the feet in 55 cases (68.8%), and on both sites in 2 cases (2.5%) ; warts measuring ≤ 1 cm in diameter were observed in 67 cases (83.8%), and those measuring > 1 cm in diameter were observed in 13 cases (16.3%). There were no significant differences in gender distribution, age, wart diameters, prior treatment status, or number of warts between the two groups (all P > 0.05). The duration of disease was longer in the needle-free injection group than in the needle-based injection group ( P = 0.041), and the dose of interferon was lower in the needle-free injection group than in the needle-based injection group ( P < 0.001). After treatment, 44 patients (55.0%) were cured in the needle-free injection group, and 39 (48.8%) in the needle-based injection group, with no significant difference in the cure rates between the two groups ( χ2 = 0.63, P = 0.429). Among patients with multiple warts, 54.8% (23/42) were cured in the needle-free injection group, and 47.4% (18/38) in the needle-based injection group, with no significant difference in cure rates between the two groups ( χ2 = 1.28, P = 0.509). The most common adverse reaction was fever or flu-like symptoms (186 instances), which resolved spontaneously in 141 instances and resolved after treatment with oral ibuprofen in 45 instances; the incidence rate of flu-like symptoms was significantly lower in the needle-free injection group (57 instances, 21.6%) than in the needle-based injection group (129 instances, 53.3%; χ2 = 54.63, P < 0.001). The pain score was significantly lower in the needle-free injection group (3.65 ± 1.25 points) than in the needle-based injection group (5.16 ± 1.17 points, t = -7.90, P < 0.001). The logistic regression analysis showed that the duration of disease, lesion sites, patient age, and previous treatment history had no impact on the efficacy in either the needle-free injection group or the needle-based injection group (all P > 0.05) . Conclusions:The efficacy of needle-free and needle-based injections of interferon was similar in the treatment of palmoplantar warts, whereas needle-free injections resulted in less pain and a lower incidence of interferon-related adverse reactions. None of the duration of disease, lesion sites, patient age, or prior treatment status showed significant impact on the efficacy in the two groups.

Objective To investigate the expression and clinical significance of serum C-C motif chemokine ligand 11(CCL11)and phosphorylated neurofilament heavy chain(pNF-H)in diabetic peripheral neuropathy(DPN).Methods A total of 174 patients with type 2 diabetes mellitus(T2DM)were enrolled as T2DM group,and 87 healthy volunteers who underwent physical examina-tions during the same period were selected as control group.The T2DM patients were divided into DPN group and non-DPN group based on the occurrence of DPN.According to the disease severity[assessed by the Toronto Clinical Scoring System(TCSS)],DPN patients were further classified into mild DPN group,moderate DPN group and severe DPN group.Enzyme-linked immunosorbent assay was used to measure the levels of CCL11 and pNF-H.Pearson correlation analysis was employed to examine the correlations of serum CCL11 and pNF-H levels with TCSS scores in DPN patients.Multivariate uncon-ditional logistic regression analysis was conducted to screen for influencing factors of DPN in T2DM pa-tients.Receiver operating characteristic(ROC)curves were plotted to evaluate the predictive value of serum CCL11 and pNF-H levels for the development of DPN in T2DM patients.Results The serum levels of CCL11 and pNF-H in the T2DM group were significantly higher than those in the control group(P＜0.05).The incidence of DPN in the T2DM group was 47.13％(82/174).The age of the DPN group was significantly older,the disease course was significantly longer,and the levels of fasting blood glucose,HbA1c,CCL11 and pNF-H were significantly higher than those of the non-DPN group(P＜0.05).The serum levels of CCL11 and pNF-H increased sequentially from the mild DPN group to the moderate DPN group and then to the severe DPN group,with statistically sig-nificant differences(P＜0.05).Serum CCL11 and pNF-H levels in DPN patients were positively correlated with TCSS scores(r=0.661 and 0.619;P＜0.001).A prolonged disease duration,high glycated hemoglobin levels,high CCL11 levels and high pNF-H levels were independent risk factors for DPN in T2DM patients(P＜0.05).Thearea under the ROC curve for the combined pre-diction of DPN in T2DM patients by serum CCL11 and pNF-H levels was 0.861,which was greater than those for the individual indicators by serum CCL11(0.751)and pNF-H(0.765)levels(P＜0.05).After 1,000-time bootstrap internal validation through self-sampling,the C-index for the combined prediction was 0.861.Conclusion Elevated serum levels of CCL11 and pNF-H are in-dependently associated with the development of DPN in T2DM patients and increase with the worse-ning of DPN.The combination of these two markers has a high predictive value for DPN in T2DM patients.

Objective To design a training device of the flight crew for plateau normobaric low-oxygen acclimatization so as to enhance the flight crew's ability to adapt to the low oxygen environment after rushing into the plateau and reduce the incidence of acute plateau reaction.Methods The training device comprised a plateau environment simulation controller,a multimodal physiological acquisition system and hypoxia exercise training evaluation software.The plateau environment simulation controller was composed of an environment monitor for plateau acclimatization,two composite sensor sets,a control valve and an alarm device;the multimodal physiological acquisition system was made up of 20 groups of vital signs acquisi-tion devices,with a wearable dynamic ECG and respiration recorder,a wrist oximeter and an arm sphygmomano-meter included in each group.The hypoxia exercise training evaluation software was developed with a B/S architecture,Java language and JetBrains 2020.3.Results The training device proved to have the simulation altitude ranging from 0 to 6 000 m and facilitated simultaneous training of 20 persons for normobaric low-oxygen acclimatization,screening for hypoxia endurance,real-time monitoring of physiological parameters and assessment of training effect,with none of the trainees having acute plateau reaction.Conclusion The training device assists the flight crew for plateau normobaric low-oxygen acclimatization,and can be used for acclimatization training before plateau missions.[Chinese Medical Equipment Journal,2025,46(8):18-24]

Objective:To investigate the clinical efficacy and safety of needle-free and needle-based injections of recombinant human interferon (IFN) -α2a in the treatment of palmoplantar warts.Methods:Patients aged 6 to 75 years with palmoplantar warts were prospectively enrolled from the Department of Dermatology, Zhongda Hospital, Southeast University between March and September 2023, and baseline data were collected. The patients were randomly and equally divided into a needle-free injection group and a needle-based injection group by using a random number table method, and received needle-free and needle-based injections of recombinant human IFN-α2a once every 2 to 3 weeks, respectively, with a maximum of 4 treatment sessions. Efficacy was assessed based on changes in wart size and skin lines under a dermoscope. Pain degrees and adverse reactions were recorded, and patients were followed up for 6 months after the end of treatment. Chi-square test was used to compare the cure rates, recurrence rates, and incidence rates of adverse reactions between the two groups. Logistic regression analysis was employed to identify factors related to the clearance of palmoplantar warts.Results:A total of 160 patients with palmoplantar warts were included, with 80 patients in each group. In the needle-free injection group, there were 45 females (56.2%) and 35 males (43.8%) ; their ages ( M[ Q1, Q3]) were 27 (23, 40) years, and the duration of disease ( M[ Q1, Q3]) was 12 (3, 24) months; warts were located on the hands in 12 cases (15.0%), on the feet in 60 cases (75.0%), and on both sites in 8 cases (10.0%) ; warts measuring ≤ 1 cm in diameter were observed in 71 cases (88.8%), and those measuring > 1 cm were observed in 9 cases (11.3%). In the needle-based injection group, there were 37 females (46.2%) and 43 males (53.8%) ; their ages were 28 (22, 39) years, and the duration of disease was 6 (2, 12) months; warts were located on the hands in 23 cases (28.7%), on the feet in 55 cases (68.8%), and on both sites in 2 cases (2.5%) ; warts measuring ≤ 1 cm in diameter were observed in 67 cases (83.8%), and those measuring > 1 cm in diameter were observed in 13 cases (16.3%). There were no significant differences in gender distribution, age, wart diameters, prior treatment status, or number of warts between the two groups (all P > 0.05). The duration of disease was longer in the needle-free injection group than in the needle-based injection group ( P = 0.041), and the dose of interferon was lower in the needle-free injection group than in the needle-based injection group ( P < 0.001). After treatment, 44 patients (55.0%) were cured in the needle-free injection group, and 39 (48.8%) in the needle-based injection group, with no significant difference in the cure rates between the two groups ( χ2 = 0.63, P = 0.429). Among patients with multiple warts, 54.8% (23/42) were cured in the needle-free injection group, and 47.4% (18/38) in the needle-based injection group, with no significant difference in cure rates between the two groups ( χ2 = 1.28, P = 0.509). The most common adverse reaction was fever or flu-like symptoms (186 instances), which resolved spontaneously in 141 instances and resolved after treatment with oral ibuprofen in 45 instances; the incidence rate of flu-like symptoms was significantly lower in the needle-free injection group (57 instances, 21.6%) than in the needle-based injection group (129 instances, 53.3%; χ2 = 54.63, P < 0.001). The pain score was significantly lower in the needle-free injection group (3.65 ± 1.25 points) than in the needle-based injection group (5.16 ± 1.17 points, t = -7.90, P < 0.001). The logistic regression analysis showed that the duration of disease, lesion sites, patient age, and previous treatment history had no impact on the efficacy in either the needle-free injection group or the needle-based injection group (all P > 0.05) . Conclusions:The efficacy of needle-free and needle-based injections of interferon was similar in the treatment of palmoplantar warts, whereas needle-free injections resulted in less pain and a lower incidence of interferon-related adverse reactions. None of the duration of disease, lesion sites, patient age, or prior treatment status showed significant impact on the efficacy in the two groups.

Objective To design a training device of the flight crew for plateau normobaric low-oxygen acclimatization so as to enhance the flight crew's ability to adapt to the low oxygen environment after rushing into the plateau and reduce the incidence of acute plateau reaction.Methods The training device comprised a plateau environment simulation controller,a multimodal physiological acquisition system and hypoxia exercise training evaluation software.The plateau environment simulation controller was composed of an environment monitor for plateau acclimatization,two composite sensor sets,a control valve and an alarm device;the multimodal physiological acquisition system was made up of 20 groups of vital signs acquisi-tion devices,with a wearable dynamic ECG and respiration recorder,a wrist oximeter and an arm sphygmomano-meter included in each group.The hypoxia exercise training evaluation software was developed with a B/S architecture,Java language and JetBrains 2020.3.Results The training device proved to have the simulation altitude ranging from 0 to 6 000 m and facilitated simultaneous training of 20 persons for normobaric low-oxygen acclimatization,screening for hypoxia endurance,real-time monitoring of physiological parameters and assessment of training effect,with none of the trainees having acute plateau reaction.Conclusion The training device assists the flight crew for plateau normobaric low-oxygen acclimatization,and can be used for acclimatization training before plateau missions.[Chinese Medical Equipment Journal,2025,46(8):18-24]