Community-acquired pneumonia （CAP） refers to an infectious inflammation of the lung parenchyma （including the alveolar wall，that is，the broad pulmonary interstitium） acquired outside the hospital. Its common pathogens include streptococcus pneumoniae，respiratory viruses， mycoplasma pneumoniae， and so on. The related factors for the occurrence and development of CAP include patient characteristics （immune function，mucus production and clearance function，coagulation function，physical condition， and comorbidity） and pathogen characteristics （susceptibility，virulence，and antibiotic resistance）. The pathogenesis of CAP lies in immune deficiency，pathogen invasion，inflammatory response disorder，mucus production and clearance disorder， coagulation disorder， and so on. The pathogenesis of CAP in traditional Chinese medicine can be described as "vital Qi deficiency and toxic stasis". Vital Qi deficiency （lack of immunity） is the potential pathogenesis of the disease and easy to be invaded by external pathogens （respiratory pathogens）. Toxic stasis （inflammatory disorder，mucus production and clearance disorder，and coagulation dysfunction） is the key pathogenic factor. Vital Qi deficiency and toxic stasis are intermingled in a state of deficiency and excess，which suggests that the treatment of CAP lies in strengthening vital Qi and eliminating pathogenic factors. This involves strengthening vital Qi in the whole process to consolidate body resistance and nourish promordial Qi. It also involves clearing heat，eliminating phlegm，removing dampness，and dispelling stasis to dispel pathogenic toxins based on the syndrome differentiation. Its action mechanism is to regulate immune and inflammatory responses，resist pathogens，and improve mucus production and clearance， as well as coagulation disorders. Starting from the key pathogenesis of CAP，"vital Qi deficiency and toxic stasis"， this paper discussed the pathogenesis of CAP and summarized the action mechanism of vital Qi strengthening for detoxification in its treatment. It is intended to complement the theoretical system by identifying "vital Qi deficiency and toxic stasis" as the key pathogenesis underlying CAP and the scientific connotation of treating CAP with vital Qi strengthening for detoxification，thereby providing insights for its clinical application.

Chronic obstructive pulmonary disease （COPD） is a chronic respiratory disease that poses a significant threat to global health， exhibiting high morbidity， disability and mortality rate， with its prevention and treatment situation becoming increasingly critical. The pathogenesis of COPD is complex， and the underlying cellular and molecular biological mechanisms remain incompletely elucidated. Programmed cell death （PCD） is the process wherein cells actively undergo demise to maintain internal environmental stability in response to certain signals or specific stimuli. Contemporary medical research indicates that the dysregulation of PCD patterns such as apoptosis， necroptosis， pyroptosis， autophagy， and ferroptosis is closely related to the onset and progression of COPD. Clarifying the molecular mechanisms of PCD in COPD may provide novel perspectives for in-depth understanding and prevention of the disease. Traditional Chinese medicine （TCM） is characterized by holistic regulation. In recent years， extensive research has been conducted in the TCM field focusing on modulating apoptosis， necroptosis， pyroptosis， autophagy， and ferroptosis for the treatment of COPD， yielding remarkable achievements. Therefore， this study systematically explored the molecular mechanism of PCD in COPD and reviewed the potential mechanisms and intervention status of TCM targeting PCD in COPD， aiming to provide insights and references for the clinical prevention， treatment and in-depth research of COPD.

Chronic obstructive pulmonary disease （COPD） is a chronic respiratory disease that poses a significant threat to global health， exhibiting high morbidity， disability and mortality rate， with its prevention and treatment situation becoming increasingly critical. The pathogenesis of COPD is complex， and the underlying cellular and molecular biological mechanisms remain incompletely elucidated. Programmed cell death （PCD） is the process wherein cells actively undergo demise to maintain internal environmental stability in response to certain signals or specific stimuli. Contemporary medical research indicates that the dysregulation of PCD patterns such as apoptosis， necroptosis， pyroptosis， autophagy， and ferroptosis is closely related to the onset and progression of COPD. Clarifying the molecular mechanisms of PCD in COPD may provide novel perspectives for in-depth understanding and prevention of the disease. Traditional Chinese medicine （TCM） is characterized by holistic regulation. In recent years， extensive research has been conducted in the TCM field focusing on modulating apoptosis， necroptosis， pyroptosis， autophagy， and ferroptosis for the treatment of COPD， yielding remarkable achievements. Therefore， this study systematically explored the molecular mechanism of PCD in COPD and reviewed the potential mechanisms and intervention status of TCM targeting PCD in COPD， aiming to provide insights and references for the clinical prevention， treatment and in-depth research of COPD.

The principle of treating different diseases with the same therapy is the essence of syndrome differentiation and treatment in traditional Chinese medicine （TCM）. It means that when the same pathogenic changes or the same symptoms appear in the development of different diseases， the same principles or methods can be used for treatment. Due to the complexity and high variability of viral pathogenicity， the precise and effective treatment of different types of viral pneumonia （VP） has always been a research focus and difficulty in modern medicine. VP belongs to the category of external-contraction febrile disease， warm disease， and epidemic in TCM. Haoqin Qingdantang （HQQDD） is a representative formula for clearing heat and dispelling dampness in warm diseases， and its intervention in VP caused by various viral infections has significant effects. This study， guided by the theory of treating different diseases with the same therapy， links the related studies on using HQQDD to treat different types of VP and finds that influenza virus pneumonia （IVP）， severe acute respiratory syndrome （SARS）， and COVID-19 all have a common pathogenic mechanism of dampness-heat at different stages of respective diseases. When these diseases are dominated by damp-heat factors， the use of HQQDD yields remarkable therapeutic effects. Modern pharmacological studies have confirmed that HQQDD can inhibit virus replication， reduce fever reactions， inhibit the expression of inflammatory mediators， and regulate immune balance. Moreover， the sovereign medicine in this formula has excellent antiviral activity， and the formula reflects rich scientific connotations of treating VP. According to the theory of treating different diseases with the same therapy and based on the effective treatment practice and modern pharmacological research of HQQDD for different types of VP， this paper mines the underlying TCM theory of treatment with the same therapy， explores the syndrome differentiation and treatment strategy and effect mechanism of this formula for different types of VP， and analyzes the treatment mechanism and characteristics， with the aim of providing evidence and reference for the clinical application and modern research of HQQDD.

Pneumonia is an infectious disease with high morbidity and mortality worldwide， and its damage to the body is not limited to the acute phase. The theory of combination of pathogenic factors emphasizes that the combination of new pathogens and residual pathogens in the body leads to the occurrence of diseases， which generalizes the causes of recurrence during pneumonia recovery. During the recovery stage of pneumonia， pathological changes such as disturbance of immune homeostasis， persistent low-grade inflammation， and microvascular damage continue to affect the body function， impair the health and quality of life of patients， and increase the risk of secondary infection. According to the theory of traditional Chinese medicine （TCM）， pneumonia is caused by deficiency， and Qi deficiency and blood stasis is the core pathogenesis in the recovery stage. At this time， the body is not full of healthy qi and still has residual pathogens， and thus it is susceptible to external pathogenic factors that lead to disease recurrence. As an important part of the TCM philosophy of treating disease before its onset， prevention of recurrence after recovery emphasizes the need for aftercare in the recovery stage to prevent disease recurrence. Based on the pathogenesis theory of combination of pathogenic factors and the pathogenesis of Qi deficiency and blood stasis， this paper discusses the effect and connotation of TCM in regulating immune inflammation and microvascular damage in preventing recurrence of pneumonia during the recovery stage， aiming to develop new ideas for effective prevention and treatment of pneumonia at this stage.

BACKGROUND:Individuals with chronic ankle instability are prone to inversion ankle sprains during landing.Moderately increasing the foot toe-out angle during landing may reduce the occurrence of inversion ankle sprains,but no studies have directly demonstrated this effect. OBJECTIVE:To explore the effect of increased toe-out angle during landing on the peak inversion angle,peak angular velocity,and the time to peak inversion among individuals with and without chronic ankle instability. METHODS:A total of 60 participants were recruited for this study,including 30 individuals with chronic ankle instability and 30 without chronic ankle instability.The study utilized a simulated sprain apparatus for drop-landing tests,featuring a platform that could tilt forward by 24° and inward by 15°,thus simulating the foot position during an ankle inversion sprain.Participants were required to perform drop-landing tests under two landing conditions:natural landing and toe-out landing,with the latter involving a greater foot toe-out angle,over 150%more than the former.Kinematic data of participants were recorded using a 12-camera three-dimensional motion capture system.Data analysis was conducted using two-way repeated measures analysis of variance and Spearman correlation analysis. RESULTS AND CONCLUSION:(1)Significant main effects of condition were found for peak inversion angle during drop-landing(P<0.001,η2 p=0.270),peak inversion velocity(P=0.015,η2 p=0.098),and peak inversion time(P<0.001,η2 p=0.260);a significant main effect of group was found for peak inversion velocity(P=0.029,η2 p=0.080).(2)There were significant negative correlations between the foot toe-out angle at landing and the peak ankle inversion angle(P=0.021,r=-0.310;P=0.042,r=-0.278)as well as the peak inversion time(P=0.018,r=-0.312;P=0.021,r=-0.309)in both chronic ankle instability and non-chronic ankle instability groups.Moreover,a significant negative correlation was also found between the foot toe-out angle and peak inversion velocity in the chronic ankle instability group(P=0.021,r=-0.312).(3)It is indicated that increasing the foot toe-out angle at landing can reduce the peak inversion angle,peak inversion velocity,and the peak inversion time during landing in patients with chronic ankle instability and non-chronic ankle instability,thereby decreasing the risk of ankle inversion sprains.

Objective:To systematically integrate the real experience of patients with adolescent idiopathic scoliosis during the perioperative period, so as to provide a reference for the formulation of perioperative nursing intervention programs for patients.Methods:Relevant qualitative studies and mixed studies about perioperative real experience of patients with adolescent idiopathic scoliosis were searched in China National Knowledge Infrastructure, Wanfang, VIP, China Biology Medicine, Cochrane Library, Web of Science, PubMed, CINAHL, PsycINFO and Embase databases by computer from the establishment of the database to August 2024. The quality of the literature was evaluated according to the JBI qualitative research quality evaluation standard, and the pooled integration method was used to integrate the results of the included literature.Results:A total of 9 studies were included, and 42 research results were extracted. Nine new categories were formed and synthesized into 4 integrated results: fear, anxiety and confusion about the uncertainty of the surgical results; the physiological state and cognition were changed after operation; the negative experience after surgery affects the rehabilitation process of patients, and patients feel uncomfortable with physical changes; in the face of postoperative discomfort and rehabilitation, the patient self-adjusted and sought support, and looked forward to a source of motivation for rehabilitation.Conclusions:Patients with adolescent idiopathic scoliosis have positive and negative emotional experiences during the perioperative period. Nursing team should pay attention to their psychological changes and take personalized measures to prevent the occurrence of surgical complications, so as to improve the quality of life of patients. Promote the rapid recovery of the patient′s body and mind.

A 62-year-old male, was admitted to the hospital, with a chief complaint of fever lasting over 10 days and leukopenia and thrombocytopenia for 2 days. Ten days prior to admission, the patient experienced intermittent fever without obvious incentive factors. The breath sounds in both lungs were coarse, without accompanying dry or moist rales. Color Doppler Ultrasound indicated mild splenomegaly and multiple lymphadenectasis in the bilateral cervical, axillary, and inguinal regions. Morphological examination of bone marrow cells demonstrated abnormally large blasts, with some of the nuclei being rather irregular and cytoplasmic vacuoles. Immunophenotyping results identified this group of blast cells as immature monocytes. Karyotype analysis of chromosomes showed clonal abnormalities, with 19 out of 20 cells exhibiting near-tetraploid karyotypes, including complex karyotypic abnormalities involving chromosome17.Targeted next-generation sequencing (NGS) detected gene mutations associated with hematological malignancies that have definite or potential clinical significance,including TP53, SRSF2, STAG2, and ARID2, with variant allele frequencies (VAF) of 63.10%, 30.30%, 0.80%, and 0.60%, respectively. Integrating laboratory findings, the diagnosis was diagnosed as AML-M5 at high-risk. After receiving chemotherapy with the regimen of azacitidine combined with venetoclax, the patient passed away more than 20 days later.

Aim Based on coronary CT-fractional flow reserve(CT-FFR)combined with machine learning methods,a nomogram prediction model for coronary in-stent restenosis(ISR)was developed to assess the risk of ISR.Methods Retrospective analysis was performed on patients who underwent re-examination after PCI at our hospital from January 2022 to January 2025.According to the exclusion criteria,a total of 210 patients were enrolled,including 100 cases of ISR and 110 cases of non-ISR.The dataset was randomly divided into training and test sets at a 7∶3 ratio.Af-ter univariate analysis to screen potential predictors,LASSO regression was applied to identify feature variables with non-ze-ro coefficients.Subsequently,three machine learning(ML)algorithms including random forest(RF),support vector machine(SVM),and extreme gradient boosting(XGB)were used to rank the importance of the significant factors.The intersection of the top 10 variables from each algorithm was used as input for bidirectional stepwise multivariate Logistic re-gression.An ISR risk score was then constructed and visualized using a nomogram.Results A total of 14 predictive factors were identified through LASSO regression,including diastolic blood pressure,C-reactive protein,triglycerides(TG),N-terminal pro-brain natriuretic peptide(NT-proBNP),low density lipoprotein cholesterol(LDLC),minimum stent diameter＜3 mm,systolic blood pressure,△CT-FFR,CT-FFR,interleukin-6(IL-6),body mass index,glycosylated hemoglobin(HbA1c),history of hypertension,and high density lipoprotein cholesterol(HDLC).Following stepwise screening using three ML algorithms and Logistic regression,six independent risk factors for ISR were identified:elevated△CT-FFR,IL-6,NT-proBNP,TG and CT-FFR values,and minimum stent diameter＜3 mm.The area under the curve for the training set and test set were 0.995(95％CI:0.989～1.000)and 0.965(95％CI:0.927～1.000),respectively.Decision curve analysis demonstrated high net benefit across threshold probabilities of 0～1.00 in the training set and 0～0.92 in the test set.The nomogram integrating these six predictors exhibited high accuracy and clinical utility.Con-clusion The ISR nomogram prediction model based on LASSO-ML combined with CT-FFR technology has high accuracy and clinical utility for ISR.

Objectives:To explore the relationship between plasma big endothelin-1(Big ET-1)level and left ventricular(LV)remodeling assessed by cardiac magnetic resonance(CMR)in patients with hypertrophic obstructive cardiomyopathy(HOCM).Methods:A total of 180 consecutive HOCM patients were enrolled from November 2013 to July 2015 in Fuwai Hospital,Chinese Academy of Medical Sciences.The baseline characteristics of the patients were collected and the plasma Big ET-1 levels were measured.According to LV remodeling index(LVRI),the patients were divided into severe remodeling group(LVRI>1.3 g/ml,n=119)and mild remodeling group(LVRI≤1.3 g/ml,n=61).The Pearson correlation analysis and multivariate logistic regression analysis were conducted to assess the correlations between plasma Big ET-1 level and indicators of LV remodeling.Results:Compared to the mild remodeling group,the plasma Big ET-1 level([0.84±0.30]pmol/L vs.[0.41±0.19]pmol/L),LVRI([1.7±0.3]g/ml vs.[1.1±0.1]g/ml),the extent of late gadolinium enhancement(LGE)([16.8±8.9]g vs.[7.0±6.6]g)were significantly higher in the severe remodeling group(all P<0.001).Pearson correlation analysis revealed that in patients with HOCM,plasma Big ET-1 level were positively correlated with left atrial anteroposterior diameter,interventricular septal thickness(IVS),LV mass(LVM),LVRI,LGE and LV outflow tract(LVOT)gradient and negatively correlated with LV ejection fraction(all P<0.05).Multivariate logistic regression analysis showed that LVM(OR=1.037,95% CI:1.019-1.056,P<0.001)and plasm Big ET-1 level(OR=11.461,95% CI:2.264-58.014,P=0.003)were the independent determinants for severe LV remodeling in HOCM patients.Conclusions:Among patients with HOCM,the plasma Big ET-1 level are markedly higher in those with severe LV remodeling and are positively associated with left atrial anteroposterior diameter,IVS,LVRI,LVM,LVOT gradient and LGE.Elevated Big ET-1 level and LVM are independent determinants of severe LV remodeling in HOCM patients.