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.

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 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*

Cervical chylous leakage is rare after central lymph node dissection for thyroid cancer, and the coexistence of chylothorax is even more uncommon. This article reports a case of a 39-year-old female patient who underwent total thyroidectomy and left central lymph node dissection for papillary thyroid carcinoma complicated by follicular adenoma. On the second postoperative day, the patient developed white, milky drainage from the neck, suggesting chylous leakage, and experienced mild chest tightness, cough, and low-grade fever. Chest CT revealed bilateral pleural effusion, with the left side being more severe. On the third day, ultrasound-guided left-sided pleural puncture and drainage were performed and hydrothorax triglycerides and total cholesterol levels were measured, chylothorax were diagnosed as a result.After conservative treatment including a low-fat diet, fasting, nutritional support, neck pressure dressing and negative pressure suctionand closed chest drainage, the patient's condition improved rapidly. The patient was discharged on the 8th postoperative day with full recovery. No recurrence has been observed during follow-up to date.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

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.

Major depressive disorder in adolescents is a serious psychiatric condition characterized by profound impairment in psychosocial functioning. Its primary symptoms include low mood, irritability, and anhedonia. Although pharmacological treatments and psychotherapy are currently recommended as first-line treatments, their effectiveness is limited, and pharmacological treatments may carry the risk of increased suicidal ideation. Therefore, exploring new, effective, and safe treatment options is an urgent priority. In recent years, intermittent theta burst stimulation (iTBS), a novel form of transcranial magnetic stimulation, has shown promising results in treating treatment-resistant depression in adults, drawing growing interest in its potential use in adolescents. iTBS modulates neural activity through magnetic stimulation of the cerebral cortex and has been shown to alleviate depressive symptoms, particularly when targeting the left dorsolateral prefrontal cortex (DLPFC). Given the high neuroplasticity of the adolescent brain during this critical developmental stage, adolescents may exhibit heightened sensitivity to iTBS, resulting in more enduring neuroregulatory effects. Research highlights the importance of precise targeting and individualized adjustment of stimulation intensity for optimal therapeutic outcomes. Additionally, accelerated iTBS (aiTBS) protocols have demonstrated faster clinical effects in treating acute or severe depression in adolescents, improving treatment adherence and partially mitigating suicidal tendencies. This review summarizes recent progress in the application of iTBS in adolescent depression, with a focus on its mechanisms, treatment parameters, and related research. The goal is to provide theoretical support and practical guidance for the clinical application of iTBS in adolescent depression care.