Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Septic shock is the primary cause of mortality in sepsis, with its core pathophysiological mechanism being severe ischemia and hypoxia in critical units—composed of microcirculation and the mitochondria of functional cells—resulting from disruptions in blood flow and oxygen flow following a dysregulated host response. Due to the systemically convergent yet clinically heterogeneous nature of the host response, current understanding and management strategies for hemodynamics remain inconsistent, often leading to inadequate resuscitation or overtreatment. To improve the quality of care, based on a systematic review of the "blood flow-oxygen flow" theory, an expert panel emphasizes reevaluating septic shock from an integrated perspective of blood flow and oxygen flow, and has formulated the Expert Consensus on Blood Flow and Oxygen Delivery Phenotyping and Clinical Management of Septic Shock (2025). The consensus proposes that clinical typing of blood flow-oxygen flow should comprehensively consider cardiac function, vascular tone, oxygen flow utilization status in critical units, and disease trajectory, while optimizing subtype identification by integrating host response phenotypes and artificial intelligence technologies. It advocates establishing a continuous assessment system through multi-site oxygen flow monitoring for organ perfusion, peripheral perfusion monitoring, and critical care ultrasound. Under the framework of the "critical care triangle", the consensus promotes the implementation of individualized, bundled management strategies, providing guidance for multiple management points to restore blood flow-oxygen flow matching, reduce the risk of organ failure, and decrease patient mortality.

Transdermal drug delivery offers advantages such as safety, convenience, and high patient compliance. However, the complex structure of the skin and significant individual variability, particularly the barrier function of the stratum corneum, result in generally low bioavailability for topical formulations. The formulation of topical drug products is complex, with numerous factors influencing quality, which requires strict control of product quality. Raman spectroscopy, as a non-destructive vibrational technique, combined with chemometric methods, imaging technology, and other spectroscopic techniques, can be applied to study the key quality attributes of topical drug formulations. The applications of Raman spectroscopy in studies of the crystal form, particle size distribution, excipient research, and in vitro transdermal experiments of topical drug formulations were summarized. In particular, it focused on the use of Raman spectroscopy in the selection of skin samples for in vitro permeation tests, the study of drug spatial distribution in the skin, and the interactions between drugs and the skin.

OBJECTIVE: To provide the experience and demonstration for the transformation of acupuncture-moxibustion techniques standards from Chinese national standards to international standards. METHODS: Questionnaire research, literature research, semi-structured interviews and expert consultation were used. RESULTS: The safety of acupuncture-moxibustion techniques was evaluated through literature research, and based on the results of the questionnaire survey, expert interviews, and expert consultation, 11 main bodies and structure of the former Chinese national standard, Technical Benchmark of Acupuncture and Moxibustion: General Rules for Drafting, were adjusted and optimized in accordance with the requirements of international standard (including the language, normative references, purpose, scope, applicable environment, target population, work team, terms and definitions, general principles and basic requirements, structural elements and text structure, and compilation process); and the first international standard, World Federation of Acupuncture-Moxibustion Societis (WFAS) Technical Benchmark of Acupuncture and Moxibustion: General Rules for Drafting was formulated to specify the general rules for drafting. CONCLUSION The 3 key questions, "international compatibility", "technical operability" and "safety" should be solved technically on the basis of explicit international requirements. It is the core technical issue during transforming the national standards of technical benchmark of acupuncture and moxibustion into international standards.
Moxibustion/methods* ; Acupuncture Therapy/methods* ; Humans ; Translational Research, Biomedical/standards* ; Surveys and Questionnaires ; China ; Benchmarking/standards*

Mechanical pain is one of the most common causes of clinical pain, but there remains a lack of effective treatment for debilitating mechanical and chronic forms of neuropathic pain. Recently, neurotoxin GsMTx4, a selective mechanosensitive (MS) channel inhibitor, has been found to be effective, while the underlying mechanism remains elusive. Here, with multiple rodent pain models, we demonstrated that a GsMTx4-based 17-residue peptide, which we call P10581, was able to reduce mechanical hyperalgesia and neuropathic pain. The analgesic effects of P10581 can be as strong as morphine but is not toxic in animal models. The anti-hyperalgesic effect of the peptide was resistant to naloxone (an μ-opioid receptor antagonist) and showed no side effects of morphine, including tolerance, motor impairment, and conditioned place preference. Pharmacological inhibition of TRPV4 by P10581 in a heterogeneous expression system, combined with the use of Trpv4 knockout mice indicates that TRPV4 channels may act as the potential target for the analgesic effect of P10581. Our study identified a potential drug for curing mechanical pain and exposed its mechanism.

Objective:To discuss the characteristics of pulmonary function changes in the pediatric patients with Mycoplasma pneumoniae pneumonia(MPP),the effect of inhaled corticosteroids during the recovery phase on pulmonary function,and the improvement effects of different aerosolized medications on pulmonary function,and to clarify the significance of inhaled corticosteroids in the treatment of MPP pediatric patients during the recovery phase.Methods:A retrospective study was conducted.Sixty-nine MPP children who received inhaled corticosteroids after discharge were selected as treatment group.According to the different medications used after discharge,they were divided into steroid group(receiving inhaled corticosteroids alone,n=42)and combination group(receiving inhaled corticosteroids combined with inhaled long-acting bronchodilators,n=27).Additionally,30 children who did not receive aerosol therapy after discharge during the same period were selected as control group.The general data of the pediatric patients in various groups were collected.The pulmonary function parameters,including forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),ratio of forced expiratory volume in 1 second to forced vital capacity(FEV1/FVC),peak expiratory flow(PEF),and maximal mid-expiratory flow(MMEF),were detected using pulmonary function equipment at the time of entering the recovery phase and 1 month after entering the recovery phase.The changes in pulmonary function of the pediatric patients between control group and treatment group were analyzed.Results:The pulmonary ventilation dysfunction in the MPP pediatric patients was mainly restrictive,followed by mixed.The pulmonary function could be normal or only show small airway dysfunction in some children.In both teatment and control groups,the second pulmonary function parameters including FVC,FEV1,PEF,maximal expiratory flow at 25%of forced vital capacity(MEF25),maximal expiratory flow at 50%of forced vital capacity(MEF50),maximal expiratory flow at 75%of forced vital capacity(MEF75),and MMEF of the pediatric patients were significantly increased compared with the first measurement(P<0.05).Compared with control group,the increase in FEV1/VC at the second measurement of the pediatric patients in treatment group was not significant(P>0.05).The differences in pulmonary function parameters showed an increasing trend in treatment group and control group.The differences in MEF25 and MMEF of the pediatric patients in the treatment group were higher than those in control group(P<0.05).The differences in pulmonary function parameters of the pediatic patients in both steroid group and the combination group showed an overall increasing trend.The differences in FVC,FEV1,FEV1/VC,MEF25,MEF50,and MMEF of the pediatric patients in steroid group were slightly higher than those in combination group.Compared with steroid group,the differences in PEF and MEF75 of the pediatric patients in combination group were slightly higher,but the differences were not statistically significant(P>0.05).The differences in MEF25,MEF50,and MMEF of the pediatric patients in steroid group were higher than those in control group(P<0.05).Conclusion:Both large and small airway functions can be affected in the pediatric patients with MPP,with restrictive ventilation dysfunction being predominant.Airway function can improve during the disease recovery phase.Inhaled corticosteroids during the recovery phase may have a positive therapeutic significance in promoting the recovery of pulmonary function,especially small airway function.The bronchodilators showed no significant effect on improving the pulmonary function during the recovery phase.Therefore,inhaled corticosteroids alone during the recovery phase may promote the recovery of pulmonary function in children with MPP.

As a typical "double heart" disease, the incidence rate of coronary heart disease with anxiety and depression is increasing year by year, which affects the long-term prognosis of the disease and the quality of life of patients. Based on the holistic concept of TCM, the theory of "heart-gallbladder connection" holds that there is a physiological and pathological relationship between the heart and gallbladder. At the same time, the theory of "heart-gallbladder connection" combined with modern medicine points out that disturbances in bile acid metabolism, gallbladder heart reflex, and brain gut bile acid axis are the three key nodes in the development of anxiety and depression in coronary heart disease. Starting from the theory of "heart-gallbladder connection", coronary heart disease combined with anxiety and depression is divided into three syndromes: heart deficiency and timidity, heart gallbladder stagnation, and heart gallbladder fire hyperactivity. Taking the principle of heart gallbladder harmony, the treatment of nourishing the heart and warming the gallbladder, regulating the heart and clearing the gallbladder, and clearing the heart and promoting bile flow is applied to provide a new clinical diagnosis and treatment approach for coronary heart disease combined with anxiety and depression.

Objective To investigate the effects of dienogest on pain relief and inflammation in endometriosis(EMs),as well as its impact on the brain-derived neurotrophic factor(BDNF)/tropo-myosin receptor kinase B(TrkB)and nuclear factor kappa-B(NF-κB)/NOD-like receptor protein 3(NLRP3)inflammatory pathways.Methods An allograft method was used to establish an EMs rat model.The rats were randomly divided into sham-operated group(n=16),model group(n=16),low-dose dienogest group(n=16),medium-dose dienogest group(n=16)and high-dose dienogest group(n=16).After 7 days of treatment,the implantation volume and writhing response frequency were recorded.Enzyme-linked immunosorbent assay(ELISA),reverse transcription-polymerase chain reaction and Western blotting were employed to measure the expression levels of vascular endothelial growth factor(VEGF),inducible nitric oxide synthase(iNOS),interleukin(IL)-6,IL-1β and tumor necrosis factor(TNF)-α in the EMs rat models.Serum levels of BDNF,TrkB,NF-κB and NLRP3 were detected.Results Compared with model group,dinorgestrel significantly reduced ectopic endo-metrial volume and torsion response of EMs(P＜0.05).Compared with model group,dinorgestrel significantly decreased the expression of VEGF,iNOS,IL6,IL-1 β and TNF-α in EMs model(P＜0.05).In addition,compared with model group,dienogest significantly decreased the expressions of BDNF,TrkB,NF-κB and NLRP3 in ectopic endometrium(P＜0.05).Conclusion Dinorgestrel can relieve EMS-related dysmenorrhea and inflammation,and its mechanism of action may be partly mediated by BDNF/TrkB pathway and NF-κB/NLRP3 pathway.

This paper systematically analyzed the ancient monographs of acupuncture and moxibustion and comprehensive medical books from pre-Qin to 1911， and extracted the data according to the etiology and pathogenesis， treatment principles and methods， acupoint selection， needling and moxibustion， and taboos of needling and moxibustion. The pathogenesis of migraine in ancient books and documents is summarized as "the causes are diverse， and phlegm-dampness is the majority". For treatment， the features include "needling has a sequence， and the root and the branch should be treated separately" and "focusing on tonifying deficiency and drain excess". It is also obtained of the rich ideas of acupoints selection， extensive application records of moxibustion， unique application of bloodletting therapy and clear explanation of acupuncture and moxibustion taboos. All mentioned above is expected to enrich the ideas and methods of modern migraine treatment and improve the clinical effects.

Purpose To investigate the predictive value of 18F-FDG PET/CT radiomic features before treatment for progression free survival(PFS)and overall survival(OS)in diffuse large B-cell lymphoma(DLBCL).Materials and Methods A total of 135 patients with pathologically proven DLBCL in Chinese PLA General Hospital from January 2016 to December 2018 and 18F-FDG PET/CT imaging prior to treatment were retrospectively collected.Patients were randomly divided into training set and test set using 8∶2,and then the training set was divided into training set and verification set using 8∶2 to construct the model.Semi-automatically delineated patients'lymphoma lesions as regions of interest and extracted the features.Univariate COX and least absolute shrinkage and selection operator regression were used to screen the features,and the non-zero radiomic features were obtained and the weight coefficients were used to calculate the Radscore value of each patient,and the predictive value of Radscore on PFS and OS was analyzed.Three models were established using traditional prognostic indicators(metabolic parameters and clinical factors),Radscore and combination.C-index,time-dependent area under the curve and decision curve were used to evaluate the model prediction efficiency.Finally,based on the optimal model,a column diagram was drawn,and the calibration curve was used to verify the efficiency of the column diagram.Results The combined model predicted PFS and OS at 3 and 5 years better than the traditional prognostic index model and Radscore model(Z=0.962 1-2.253 9,all P<0.05).Decision curve showed that the combined model achieved the greatest clinical net benefit.The calibration curve showed that the predicted values of the nomogram were in good agreement with the observed values.Conclusion Radscore is an independent prognostic factor for survival in DLBCL patients.The combined model has great application value in guiding the formulation of clinical individualized treatment plan.