Medical institutions, with their clinical practice foundation and abundant human use experience data, have become important carriers for the inheritance and innovation of traditional Chinese medicine(TCM) and the "cradles" of the preparation of new TCM. To effectively promote the transformation of new TCM originating from the TCM clinical practice in medical institutions and establish an effective evaluation index system for the transformation of new TCM conforming to the characteristics of TCM, consensus experts adopted the literature research, questionnaire survey, Delphi method, etc. By focusing on the policy and technical evaluation of new TCM originating from the TCM clinical practice in medical institutions, a comprehensive evaluation from the dimensions of drug safety, efficacy, feasibility, and characteristic advantages was conducted, thus forming a comprehensive evaluation system with four primary indicators and 37 secondary indicators. The expert consensus reached aims to encourage medical institutions at all levels to continuously improve the high-quality research and development and transformation of new TCM originating from the TCM clinical practice in medical institutions and targeted at clinical needs, so as to provide a decision-making basis for the preparation, selection, cultivation, and transformation of new TCM for medical institutions, improve the development efficiency of new TCM, and precisely respond to the public medication needs.
Medicine, Chinese Traditional/standards* ; Humans ; Consensus ; Drugs, Chinese Herbal/therapeutic use* ; Surveys and Questionnaires

OBJECTIVE: To analyze the effect of COVID-19 infection on the mobilization and collection of autologous peripheral blood stem cells in patients with multiple myeloma. METHODS: The general baseline data, treatment factors before mobilization collection, collection status, and treatment overview after collection of autologous peripheral blood stem cells at Beijing Chaoyang Hospital affiliated with Capital Medical University from January 1, 2020 to July 15, 2023 were analyzed. RESULTS: 269 patients underwent mobilization and collection of autologous peripheral blood stem cells. Among them, 32 cases with COVID-19 infection history (COVID-19 group) and 237 cases without COVID-19 infection history (non-COVID-19 group). In the COVID-19 group, 17 cases were treated with chemotherapy (etoposide)+G-CSF, and 15 cases were treated with plerixafor +G-CSF. In the non-COVID-19 group, 214 cases were treated with chemotherapy +G-CSF, 17 cases were treated with plerixafor +G-CSF, and 6 cases were treated with chemotherapy + plerixafor +G-CSF. The number of CD34⁺ cells, collection success rate, and excellence rate in the COVID-19 group and the non-COVID-19 group were ［5.52 (0.94-26.87) vs 4.80 (0.53-37.20)］×10⁶/kg (P =0.610), (93.8% vs 85.2%) (P =0.275), (62.5% vs 49.4%) (P =0.190), respectively. Among 113 patients mobilized with etoposide +G-CSF, the number of CD34⁺ cells, success rate, and excellence rate collected from COVID-19 infection (17 cases) and non-COVID-19 infection (96 cases) were ［7.54 (2.66-26.87) vs 7.78 (2.26-37.20)］×10⁶/kg (P =0.847), (100.0% vs 100.0%) (no P value), (82.4% vs 86.5%) (P =0.655), respectively. Among 32 patients mobilized by plerixafor +G-CSF, the number of CD34⁺ cells, success rate and excellence rate of COVID-19 infection (15 cases) and non-COVID-19 infection (17 cases) were ［3.82 (0.94-7.27) vs 4.11 (0.53-9.05)］×10⁶/kg (P =0.821), (86.7% vs 88.2%) (P =0.893), (40.0% vs 35.3%) (P =0.784), respectively. In 32 patients with COVID-19 infection, the number of CD34⁺ cells collected by etoposide +G-CSF (17 cases) and plerixafor +G-CSF (15 cases), as well as the success rate and excellence rate were ［7.54 (2.66-26.87) vs 3.82(0.94-7.27)］×10⁶/kg (P =0.004), (100.0% vs 86.7%) (P =0.120), (82.4% vs 40.0%) (P =0.014), respectively. By 2023.7.31, 232 patients (86.2%, 232/269) had received transplantation, including 24 patients in the COVID-19 group and 208 patients in the non-COVID-19 group. The median number of CD34⁺ cells infused in the two groups was ［3.67 (2.50-13.44) vs 3.11(1.12-19.89)］×10⁶/kg (P =0.058), the median days of neutrophil engraftment ［11(9-13) vs 11(9-17)］ (P =0.674), the median days of platelet engraftment ［11(0-23), 12(0-43)］ (P =0.279), respectively. CONCLUSION The history of COVID-19 infection did not affect the PBSC mobilization, collection and transplantation of patients with myeloma. In patients with COVID-19 infection, the results of chemotherapy mobilization with etoposide seems to be better than that of plerixafor mobilization, but further research is needed to clarify.
Humans ; COVID-19/complications* ; Multiple Myeloma/complications* ; Hematopoietic Stem Cell Mobilization ; Transplantation, Autologous ; Granulocyte Colony-Stimulating Factor/therapeutic use* ; Peripheral Blood Stem Cell Transplantation ; SARS-CoV-2 ; Middle Aged ; Peripheral Blood Stem Cells ; Male ; Female ; Cyclams ; Benzylamines

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.

OBJECTIVE: To explore weight-bearing stability of Pilon fracture fixed by external fixator. METHODS: Six ankle bone models (right side) and 4 pairs (8 ankle cadaver specimens) were selected. Pilon fracture model was prepared by using the preset osteotomy line based on Ruedi Allgower Pilon fracture type. Pilon fracture model was built by using a minimally invasive osteotomy. After ankle bone model and cadaver specimen model were fixed with external fixator, axial load was carried out on mechanical loading machine. After ankle bone model and cadaver specimen model were fixed with external fixator, axial load was carried out on mechanical loading machine. Axial loads of 150, 300 and 450 N were applied to ankle bone model, and displacements of fibula fracture blocks, lateral tibia fracture blocks and medial tibia fracture blocks in three-dimensional space (X, Y and Z axes) were recorded by dynamic capture instrument. Axial loads of 300, 600 and 900 N were applied to ankle cadaver model fixed by external fixator. X-ray films of Pilon fracture cadaver model fixed by external fixator under different loading conditions were taken. The anterior tibial angle, tibial malleolar point angle, talus shift value, talus tilt angle, lateral malleolar shift value, lateral malleolar shift value, medial malleolar separation shift value and articular surface step displacement value were measured under different loads by digimizer software. RESULTS: After 150, 300 and 450 N axial loads were applied to Pilon fracture models fixed by external fixator, no loosening or fracture of external fixator was observed, and no loosening, fracture or irreversible plastic deformation of Kirschner needle were observed. The displacement values of fibular fracture pieces on X-axis(around) were 0.032 (-0.022, 0.269), 0.061 (-0.002, 0.427), 0.212(-0.016, 1.223) mm, and the displacement values on Y-axis(above and below) were 0.002(-0.031, 0.103), 0.051(-1.133, 0.376), 0.128 (-1.394, 0.516) mm, and displacement values on Z-axis (front and rear) were -0.003 (-0.130, 0.171), 0.137 (-0.076, 0.433), 0.030(-0.487, 0.478) mm;the displacement values of lateral tibial fractures on X-axis were 0.000(-0.108, 0.027), 0.083(-0.364, 0.050), -0.121(-0.289, 0.165) mm, and displacement values on Y-axis were -0.009(-0.200, 0.025), -0.179(-0.710, 0.084), -0.257(-0.799, 0.027) mm, and displacement values on Z-axis were 0.112(-0.024, 0.256), 0.157(-0.068, 0.293), -0.210(-0.035, 0.430) mm;the displacement values of medial tibial fracture block on X-axis were -0.010(-0.060, 0.013), -0.165(-0.289, 0.056), -0.181(-0.395, 0.013) mm, and the displacement values on Y-axis were -0.036(-0.156, 0.007), -0.104(-0.269, 0.178), -0.245(-0.380, -0.011) mm, and displacement values on Z-axis were -0.005(-0.372, 0.189), -0.012 (-1.774, 0.380), 0.200 (-1.963, -0.540) mm. After 300, 600 and 900 N axial loads were applied to Pilon fracture cadaverous models fixed with external fixators, there were no significant difference in anterior tibial angles, angles of malleolar points of tibia, oblique angles of talus, fracture steps, shift values of talus, lateral shift values of lateral malleolus, lateral shift values of medial malleolus, lateral shift values of medial malleolus between under different loading conditions and those without loading (P>0.05). No loosening or fracture of external fixator as a whole, loosening, fracture or irreversible deformation of Kirschner needle at the local fixed fracture end occurred. CONCLUSION The early weight-bearing external fixator could maintain stability of fracture end and ankle joint, and the maximum weight is not more than 300 N. In clinical practical application, material characteristics of the implant and type of fracture should be selected.
Humans ; Weight-Bearing ; Biomechanical Phenomena ; External Fixators ; Tibial Fractures/physiopathology* ; Fracture Fixation/instrumentation* ; Male

Eleutherococcus senticosus is one of the Dao-di herbs in northeast China. In this study, the chloroplast genomes of three E. senticosus samples from different genuine producing areas were sequenced and then used for the screening of specific DNA barcodes. The germplasm resources and genetic diversity of E. senticosus were analyzed basing on the specific DNA barcodes. The chloroplast genomes of E. senticosus from different genuine producing areas showed the total length of 156 779-156 781 bp and a typical tetrad structure. Each of the chloroplast genomes carried 132 genes, including 87 protein-coding genes, 37 tRNAs, and 8 rRNAs. The chloroplast genomes were relatively conserved. Sequence analysis of the three chloroplast genomes indicated that atpI, ndhA, ycf1, atpB-rbcL, ndhF-rpl32, petA-psbJ, psbM-psbD, and rps16-psbK can be used as specific DNA barcodes of E. senticosus. In this study, we selected atpI and atpB-rbcL which were 700-800 bp and easy to be amplified for the identification of 184 E. senticosus samples from 13 genuine producing areas. The results demonstrated that 9 and 10 genotypes were identified based on atpI and atpB-rbcL sequences, respectively. Furthermore, the two barcodes identified 23 genotypes which were named H1-H23. The haplotype with the highest proportion and widest distribution was H10, followed by H2. The haplotype diversity and nucleotide diversity were 0.94 and 1.82×10~(-3), respectively, suggesting the high genetic diversity of E. senticosus. The results of the median-joining network analysis showed that the 23 genotypes could be classified into 4 categories. H2 was the oldest haplotype, and it served as the center of the network characterized by starlike radiation, which suggested that population expansion of E. senticosus occurred in the genuine producing areas. This study lays a foundation for the research on the genetic quality and chloroplast genetic engineering of E. senticosus and further research on the genetic mechanism of its population, providing new ideas for studying the genetic evolution of E. senticosus.
DNA Barcoding, Taxonomic ; Eleutherococcus/genetics* ; Base Sequence ; Chloroplasts/genetics* ; Genetic Variation ; Phylogeny

BACKGROUND: Minimal change nephropathy (MCD) is a common pathological type of nephrotic syndrome and is often associated with acute kidney injury (AKI). This study aimed to investigate the clinical characteristics and related factors of AKI in patients with MCD and nephrotic syndrome. METHODS: Patients from Chinese People's Liberation Army General Hospital who were diagnosed with pathological renal MCD with clinical manifestations of nephrotic syndrome were included from January 1, 2013 to December 31, 2017. Patients diagnosed with membranous nephropathy (MN) by renal biopsy from January 1, 2013 to December 31, 2017 are included as a control population. We retrospectively analyzed the clinical and pathological characteristics of patients as well as the percentages and clinical characteristics of AKI in different age groups. We assessed the correlation of pathological characteristics with serum creatinine using multivariate linear regression analysis. RESULTS: A total of 367 patients with MCD were included in the analysis, with a sex ratio of 1.46: 1 (male: female) and an age range of 6 to 77 years. Among all the patients, 109 developed AKI (29.7%), and of these patients, 85 were male (78.0%). In the 586 patients with MN, 27 (4.6%) patients developed AKI. The percentage of AKI in MCD patients was significantly higher than that in MN patients (χ2 = 41.063, P < 0.001). The percentage of AKI increased with age in the MCD patients. The percentage of AKI in patients aged 50 years or older was 52.9% (46/87), which was significantly higher than that [22.5% (63/280)] in patients under 50 years (χ2 = 6.347, P = 0.013). We observed statistically significant differences in age (43 [27, 59] years vs. 28 [20, 44] years, Z = 5.487, P < 0.001), male (78.0% vs. 51.4%, χ2 = 22.470, P < 0.001), serum albumin (19.9 ± 6.1 g/L vs. 21.5 ± 5.7 g/L, t = 2.376, P = 0.018), serum creatinine (129.5 [105.7, 171.1] μmol/L vs. 69.7 [57.7, 81.9] μmol/L, Z = 14.190, P < 0.001), serum urea (10.1 [6.2, 15.8] mmol/L vs. 4.7 [3.6, 6.4] mmol/L, Z = 10.545, P < 0.001), IgE (266.0 [86.7, 963.0] IU/ml vs. 142.0 [35.3, 516.5] IU/ml, Z = 2.742, P = 0.007), history of diabetes (6.4% vs. 1.2%, P = 0.009), and history of hypertension (23.9% vs. 5.1%, χ2 = 28.238, P < 0.001) between the AKI group and the non-AKI group. According to multivariate linear regression analysis, among the renal pathological features analyzed, renal tubular epithelial cell damage (β = 178.010, 95% CI: 147.888-208.132, P < 0.001) and renal interstitial edema (β = 28.833, 95% CI: 11.966-45.700, P = 0.001) correlated with serum creatinine values. CONCLUSIONS The percentage of AKI in MCD patients is significantly higher than that in MN patients. Patients over 50 years old are more likely to develop AKI. Renal tubular epithelial cell injury and renal interstitial edema may be the main pathological lesions that are associated with elevated serum creatinine in patients with MCD.
Acute Kidney Injury/etiology* ; Adolescent ; Adult ; Aged ; Child ; Cross-Sectional Studies ; Female ; Humans ; Kidney ; Male ; Middle Aged ; Nephrosis, Lipoid/complications* ; Nephrotic Syndrome/complications* ; Retrospective Studies ; Young Adult

Objective::To explore the distribution characteristics of traditional Chinese medicine (TCM) syndromes of critical lesions of coronary heart disease, and determine the classification and diagnostic criteria of syndromes, so as to provide reference for the differentiation and treatment of this disease. Method::Totally 1 000 patients with critical lesions of coronary heart disease treated in the Department of Cardiology, Yunnan Provinceal Hospital of TCM from January 2016 to December 2018 were selected as the subjects by clinical epidemiological research methods. Basic information, diagnosis and treatment of the patients, as well as the information obtained through observation, hearing, inquiry and pulse-taking of TCM were collected. Symptoms, signs, tongue signs, pulse signs and other four diagnostic information, as well as relevant clinical data were collected for mathematical statistics analysis by cluster analysis and factor analysis research methods, and expert group opinions were also included in discussion. Result::First, the results of cluster analysis showed six types of basic TCM syndromes in accordance with the clinically actual critical lesions of coronary heart disease: blood stasis syndrome, phlegm turbidity syndrome, cold congealing heart pulse syndrome, Qi deficiency syndrome, heart-kidney Yin deficiency syndrome, Heart-Yang deficiency syndrome. Second, a factor analysis was carried out on the basis of cluster analysis, and the main syndromes of each basic syndromes were preliminarily determined. Third, because of the duplicate content or the unified combination of different syndromes, the TCM syndromes of the critical lesions of coronary heart disease can be summarized in five categories, namely phlegm turbidity and blood stasis syndrome (368 cases, 36.80%), cold congestion heart pulse syndrome (156 cases, 15.60%), Qi deficiency and blood stasis syndrome (315 cases, 31.50%), Yin deficiency of heart and kidney (91 cases, 9.10%) and Heart-Yang depression (70 cases, 7.00%). The main and secondary syndromes refer to factor analysis results of six basic syndromes. Conclusion::Cluster analysis and factor analysis can be made on TCM syndromes of critical lesions of coronary heart disease to pave the way for the classification of TCM syndromes and the establishment of diagnostic criteria of TCM syndromes of coronary heart disease, with an important clinical significance.