In the context of the rapid development of 5G technology， the development of artificial intelligence （AI） in traditional Chinese medicine （TCM） faces new opportunities and challenges. Focusing on how to uphold tradition while innovating in the development of AI in TCM， starting from the current development status of AI in Chinese medicine， including the integration of four diagnostic methods， syndrome differentiation and treatment， auxiliary diagnosis and treatment， research and development of Chinese herbal medicine， prevention and treatment of diseases， knowledge inheritance， and other aspects， this paper discussed the support of policies and technical advancements， as well as development opportunities such as increased demand for health. Regarding machine ethics， data ethics， regulatory review， and other aspects， it also proposed some suggestions that the training algorithm should be improved to assist medical work； data ownership should be clarified to ensure data security； and an AI ethics committee should be set up to improve the review system， aiming to maximize the advantages of smart healthcare and accelerate the modernization of TCM for the benefit of patients and the service of human health.

Inflammatory bowel disease(IBD)is a chronic and recurrent intestinal disease,and has become a major global health issue.Individuals with IBD face an elevated risk of developing colorectal cancer(CRC),and recent studies have indicated that mitochondrial dysfunction plays a pivotal role in the pathogenesis of both IBD and CRC.This review covers the pathogenesis of IBD and CRC,focusing on mitochondrial dysfunction,and explores pharmacological targets and strategies for addressing both conditions by modulating mitochondrial function.Additionally,recent advancements in the phar-macological modulation of mitochondrial dysfunction for treating IBD and CRC,encompassing mitochondrial damage,release of mitochondrial DNA(mtDNA),and impairment of mitophagy,are thoroughly summarized.The review also provides a systematic overview of natural compounds(such as flavonoids,alkaloids,and diterpenoids),Chinese medicines,and intestinal microbiota,which can alleviate IBD and attenuate the progression of CRC by modulating mitochondrial function.In the future,it will be imperative to develop more practical methodologies for real-time monitoring and accurate detection of mitochondrial function,which will greatly aid scientists in identifying more effective agents for treating IBD and CRC through modulation of mitochondrial function.

Objective To explore the inhibitory effect of Xinhui tangerine peel polysaccharides on the mouse skin fibroblasts so as to understand the underlying molecular mechanism.Methods We separated and purified the components of tangerine peel polysaccharides from Xinhui tangerine peel.C57BL/6 mouse skin fibroblasts were isolated and cultured for the cellular experimental study.We set up a blank control group(normal culture)and low-,medium-and high-dose experimental groups(50,100 and 200 μg/mL tangerine peel polysaccharides).After 24 hours of treatment,cell survival rate was assessed by CCK-8 assay.The mRNA and protein expression levels of collagen type Ⅰ(Col1a1),collagen type Ⅲ(Col1a3),TGF-β1 and ACTA2 in fibroblasts were examined by RT-qPCR and Western blotting.Smad3 was examined by Western blotting.Results The cell survival rate in the blank control group,the medium-and high-dose experimental groups was 100％,(90.54±6.74)％,and(78.90±4.24)％,respectively.The relative expression level of Col1a1 protein was 1.13±0.15,0.57±0.16,and 0.48±0.05,respectively;the relative expression level of Col3a1 protein was 0.81±0.13,0.49±0.11 and 0.50±0.03;the relative expression level of TGF-β1 protein was 1.11±0.15,0.60±0.13,and 0.33±0.11;the relative expression level of p-Smad3/Smad3 proteins was 0.96±0.05,0.75±0.06 and 0.71±0.03.The mRNA expression level of Col1a1 was 1.01±0.17,0.58±0.11,and 0.52±0.12;the mRNA expression level of Col3a1 was 1.01±0.12,0.56±0.19,and 0.65±0.14;the expression level of ACTA2 mRNA was 1.01±0.13,0.24±0.04,and 0.22±0.07;the mRNA expression level of TGF-β1 was 1.00±0.09,0.50±0.10,and 0.49±0.15.The relative expression levels of p-Smad3/Smad3 proteins were 0.86±0.06,0.66±0.06,0.55±0.13,0.43±0.09,0.35±0.06,and 0.27±0.12,respectively,after time-related treatment with high-dose tangerine peel polysaccharides.The above indicators in medium-and high-dose tangerine peel polysaccharide groups showed statistically significant differences compared to those in the blank control group(P＜0.05).Conclusion Tangerine peel polysaccharides can inhibit the cell proliferation and the synthesis of keloid-related genes on fibroblasts by inhibiting TGF-β1/Smad3 signaling pathway.

Objective:To evaluate the efficacy and safety of Saccharomyces boulardii ( S. boulardii) as an adjuvant therapy for ulcerative colitis (UC). Methods:Databases including PubMed, Embase, Web of Science, Cochrane Library, Chinese Biomedical Literature Database, CNKI, Wanfang Database, and Chongqing VIP Chinese Science and Technology Journal Database were retrieved from their inception to September 1, 2023. Randomized controlled trials (RCTs) about S. boulardii as an adjuvant therapy for UC were included. The intervention method was S. boulardii monotherapy or as an adjunct to other medications ( Saccharomyces group), while the control group received other medications. The risk of bias of the included studies was assessed by the Cochrane risk of bias assessment tool (RoB 2.0). Primary outcome indicators included overall efficacy, clinical remission rate, and endoscopic remission rate. Secondary outcome indicators included Baron score, Sutherland disease activity index, indicators of intestinal mucosal barrier function, levels of inflammatory cytokines, and overall adverse events. RevMan 5.3 software was used for statistical analysis. RR and MD were taken as effect indicators of count data and measurement data, respectively. Results:A total of 26 RCTs were included, all from China. Among them, 22 studies reported the overall efficacy in UC patients. The results indicated that the overall efficacy of Saccharomyces group was higher than that of the control group (93.5%(943/1 009) vs. 76.8%(771/1 004)), and the difference was statistically significant ( RR=1.20, 95% confidence interval (95% CI): 1.16 to 1.25, P<0.001). And 9 studies assessed the efficacy in patients with mild or moderate UC. The results showed that the clinical remission rate and endoscopic remission rate of Saccharomyces group were both higher that those of the control group (68.1%(581/853) vs. 53.1%(455/857); 54.9%(425/774) vs. 35.5%(273/769)), and the differences were statistically significant ( RR=1.21, 95% CI: 1.14 to 1.25, P<0.001; RR=1.49, 95% CI: 1.28 to 1.73, P<0.001). S. boulardii as an adjunctive therapy could significantly lower the Baron score in patients with UC (7 studies) and mild to moderate UC (5 studies) ( MD=-0.51, 95% CI: -0.68 to -0.33; MD=-0.50, 95% CI: -0.75 to -0.26; both P<0.001). Additionally, S. boulardii as an adjunctive therapy could significantly decrease the Sutherland disease activity index in patients with UC (6 studies) and mild to moderate UC (3 studies), and the differences were statistically significant ( MD=-1.50, 95% CI: -2.26 to -0.74; MD=-0.92, 95% CI: -1.16 to -0.69; both P<0.001). Compared with the control group, S. boulardii as an adjunctive therapy significantly improved intestinal mucosal barrier function and decreased inflammatory cytokine levels in patients with UC and patients with mild to moderate UC (all P<0.05), such as D-lactate ( MD=-2.44, 95% CI: -4.43 to -0.45; MD=-1.47, 95% CI: -2.03 to -0.91), Geboes index ( MD=-0.40, 95% CI: -0.46 to -0.35; MD=-0.39, 95% CI: -0.46 to -0.32), C-reactive protein ( MD=-3.70, 95% CI: -5.65 to -1.76; MD=-3.36, 95% CI: -5.07 to -1.64), and tumor necrosis factor-α levels ( MD=-7.64, 95% CI: -11.27 to -4.01; MD=-7.75, 95% CI: -12.25 to -3.25). There was no statistically significant difference in the incidence of adverse events between Saccharomyces group and the control group (13 studies) (7.8%(47/602) vs. 10.9%(65/596)), RR=0.75, 95% CI: 0.52 to 1.09, P=0.130). Conclusions:The additional use of S. boulardii in the treatment of UC. It can improve the clinical remission rate, alleviate intestinal inflammation, promote the recovery is safe of the injury in intestinal mucosal barrier.

Objective:To investigate the clinical and endoscopic characteristics of patients with autoimmune gastritis (AIG).Methods:From January 1, 2013 to December 31, 2023, 73 AIG patients who visited Peking Union Medical College Hospital were retrospectively enrolled. The clinical data of all the patients were analyzed, including gender, age, symptoms, laboratory examination results (such as serum hemoglobin, vitamin B 12, serum iron, gastrin, anti-parietal cell antibody (APCA), anti-intrinsic factor antibody (AIFA), Helicobacter pylori ( HP) infection status; the indicators were judged based on the normal reference value), and endoscopic and histopathological examination results. Descriptive statistical methods were used for statistical analysis. Results:Among the 73 AIG patients, there were 27 males (37.0%) and 46 females (63.0%), with a median age of 57 years old (ranged from 25 to 85 years old). Among the 73 AIG patients, 68 patients received APCA test, with a positivity rate of 88.2% (60/68); 67 patients took the AIFA test, with a positivity rate of 52.2%(35/67); 62 patients underwent both APCA and AIFA tests, of which 22 patients (35.5%) showed double positive. Serum level of vitamin B 12 was detected in 59 patients, and decreased in 27 cases (median level: 0.100 ng/L, mean level: 0.102 ng/L). Gastrin level was detected in 58 patients, and increased in 55 cases (median level: 0.930 ng/L, mean level: 1.203 ng/L). The levels of serum iron and ferritin were tested in 52 patients, the level of serum iron of 5 cases decreased, and the level of ferritin of 17 cases decreased (median level: 780.0 and 26.0 μg/L, mean level: 807.8 and 76.0 ng/L, respectively).Among the 73 AIG patients, the urea breath test was performed in 12 patients, and the result was positive in 6 cases. Endoscopic rapid urease test was performed in 69 patients, and the result was positive in 11 cases (15.9%). Regular blood analysis was performed in 71 patients, 24 cases (33.8%) were diagnosed with anemia, the median age of patients with anemia was 55 years old, and male-to-female ratio was 1∶5. There were 6 cases of iron-deficiency anemia and 5 cases of pernicious anemia. The endoscopic examination results of 73 patients indicated that 65 cases (89.0%) with mucosal atrophy under endoscopy, including 47 cases (64.4%) with mucosal atrophy in the gastric fundus and body, and 18 cases (24.7%) with whole gastric atrophy, more obviously in the gastric body. The pathological examination results showed type Ⅰ gastric neuroendocrine tumor(g-NET) in 35 cases (47.9%). Conclusions:The early clinical symptoms of AIG patients are nonspecific, often present with anemia and vitamin B 12 deficiency. Close monitoring of serological markers including APCA, AIFA and gastrin is essential. For patients diagnosed or suspected with AIG, intervals of endoscopic surveillance should be shortened to prevent the genesis and development of neoplasms such as g-NET.

Objective To summarize the best evidence for the evaluation,implementation,and assess-ment of early rehabilitation exercise for patients with severe traumatic brain injury,provide evidence-based support for clinical nursing and reduce disability and mortality rates.Methods Relevant evidence on early re-habilitation exercise of patients with severe traumatic brain injury from 14 databases or official websites inclu-ding BMJ Best Practice,UpToDate,BMJ Clinical Evidence,the official website of the World Health Organiza-tion(WHO),International Guidelines Collaboration Network(GIN),National Guidelines Library(NGC)in the United States,Scottish Inter Collegiate Guidelines Network(SIGN),JBI Evidence Based Healthcare Knowledge Base,Cochrane Library,PubMed,Embase,Cumulative Index of Nursing and Allied Health Litera-ture(CINAHL),China National Knowledge Infrastructure(CNKI),and Wanfang were retrieved,the latest clinical decisions,guidelines,evidence summaries,expert consensus,systematic reviews,clinical practices,and review results were integrated,the best evidence were extracted,and quality evaluation and classification were conducted.Results A total of 15 articles were included,summarizing 26 best pieces of evidence from six as-pects:early rehabilitation exercise assessment,early awakening rehabilitation treatment therapy,early respira-tory and airway management,early limb activity and muscle joint rehabilitation training,early bladder function training,and early nutritional management.Conclusion This study integrates the best evidence of early reha-bilitation exercise for patients with severe traumatic brain injury,providing evidence-based support for further clinical nursing practice,promoting the rehabilitation process of patients with traumatic brain injury,and im-proving their quality of life.

Objective:To investigate the prevalence and risk factors of overweight and obesity among Chinese children aged 3-18 years from 11 provinces, antonomous regions, or municipalities.Methods:This national cross-sectional community health survey utilized a multistage stratified cluster-random sampling method to recruit 193 997 nationally representative participants from 11 provinces, autonomous regions, or municipalities between January 2017 and December 2019. All participants underwent physical examinations, and their caregivers completed questionnaires assessing participants′ dietary, lifestyle, familial, and perinatal information. Multilevel multinomial logistic regression models were employed to identify the potential risk factors.Results:The cohort comprised 193 997 children (102 178 boys, 91 819 girls),aged (10±4) years. Overall prevalence rates were 30 574(15.8%)overweight children and 17 217(8.9%) obesity children. Boys exhibited higher overweight and obesity rates than girls (17.0% (17 368/102 178) vs. 14.4% (13 206/102 178), 11.3% (11 553/91 819) vs. 6.2% (5 664/91 819), χ2=249.12,1 578.69,both P<0.001). The detection rates of obesity in Tanner stage 2 and 3 were the highest in boys and girls, with 13.4%(2 231/16 665) and 8.6%(880/10 221) respectively. Risk factors for obesity included parental overweight (paternal OR=2.34 and maternal OR=2.29), annual household income of 100 000-200 000 yuan (compared with<100 000 yuan, OR=1.04), higher paternal education (compared with below high school,high school and a college education OR=1.09,1.14), birth weight >4.0 kg (≤5 and>5 years old OR=1.74, 1.44,respectively), and western food consumption≥1 time/month (compared with<1, 1-2, 3-4,>4 times/month OR=1.36, 1.30, 1.67(≤5 years), 1.19, 1.16, 1.15 (>5 years), respectively) (all P<0.05). Conversely, coarse grain intake≥1 times/week (compared with<1 times/week, every day, 3-4, 1-2 times/week OR=0.74, 0.80, 0.71 (≤5 years), 0.75, 0.87, 0.90(>5 years), respectively, all P<0.05) was associated with reduced obesity risk. Conclusions:Obesity epidemiology in children demonstrates significant heterogeneity across age, gender, geographic regions, and pubertal stages. It is necessary to establish a personalized prevention and control strategy.

Objective:To validate and optimize the interpretation methods and cut-off values of prolonged activated partial thromboplastin time (APTT) mixing test, in order to elevate the clinical applicational value in differentiating single factor deficiency, positive lupus anticoagulant (LA) and FⅧ inhibitors.Methods:This cross-sectional retrospective study involved 130 cases with single APTT prolongation for unknown reasons who underwent mixing tests in the First Hospital of Jilin University from January 1st, 2022 to December 31st, 2023, including 84 males and 46 females. Rosner index (RI), Percentage correction ("Chang") method, Normal reference interval (NRI) method, differential analysis, post-incubation prolongation time and percentage (including mixed immediately and ) were respectively calculated and analyzed for both immediate mixing and 2-hour post-mixing incubation. According to clinical diagnosis, patients were divided into single factor deficiency (51 cases), positive lupus anticoagulant (LA) (56 cases), and positive factor Ⅷ (FⅧ) inhibitor (23 cases). Receiver operation characteristic (ROC) curve analysis was used to determine the cut-off values for APTT mixing test methods in patients with different reasons for prolonged APTT, which were evaluted and adjusted by AUC, sensitivity, and specificity, and compared with the methods currently used for interpretations.Results:For the single factor deficiency cases, the AUCs of immediate RI index <7.5% and incubated RI index <13.9% were 0.87 and 0.90, respectively, with sensitivities at 87.8% and 83.8%, and specificities at 72.0% and 80.0%, whose combination had sensitivity and specificity at 87.3%, and 94.0%, respectively; the judging accuracy increased from 84.6% (110/130) in currently used rule to 93.1% (121/130). For the positive lupus anticoagulant (LA) cases, the combination of immediate RI index >10.3% and prolonged post-incubation clotting time percentage <9.1% showed 88.5% sensitivity and 99.8% specificity; the judging accuracy improved from 80.0% (104/130) in currently used rule to 86.2% (112/130). For positive FⅧ inhibitor cases, the combination of incubated RI index >17.0% and prolonged post-incubation clotting time percentage >9.1% had 99.8% sensitivity and 100.0% specificity; the judging accuracy increased from 89.2% (116/130) in currently used rule to 94.6% (123/130).Conclusion:This study validated and optimized the interpretation methods and cut-off values for the prolonged APTT mixing test in differentiating single factor deficiencies, prositive FⅧ inhibitors and LA positive cases, significantly improving the judging sensitivity and specificity.

Objective This study aims to develop an early in-hospital temperature management protocol for heat stroke patients and assess its effectiveness,providing guidance for rapid cooling and precise target temperature control.Methods The protocol was developed through a Delphi expert consultation combined with expert panel meetings.A multi-center,non-randomized,historical control study was conducted,utilizing convenience sampling to select heat stroke patients from the emergency departments of 7 tertiary hospitals in Zhejiang Province,China,between June and August 2024 as an experimental group.The protocol was implemented in this group,while the control group consisted of heat stroke patients treated between June and August 2022,prior to protocol implementation.Cooling rates,target temperature attainment rates,and clinical outcomes were compared between the 2 groups.Results The final protocol included 6 primary indicators,23 secondary indicators,and 56 tertiary indicators.After protocol implementation,the experimental group achieved a cooling rate of 0.08(0.05～0.09)℃/min within 0.5 hours,significantly higher than the control group,which had a rate of 0.04(0.02～0.06)℃/min(P＜0.001).The target temperature attainment rates at 0.5 hours and 2.0 hours were 55.93％and 98.31％,respectively,significantly higher than the rates of 15.87％and 61.11％in the control group(P＜0.001).The mechanical ventilation rate,hospitalization rate,ICU admission rate,and mortality rate in the experimental group were 25.42％,61.02％,44.07％,and 8.47％,respectively.Logistic regression analysis revealed that the early in-hospital temperature management protocol significantly reduced the risk of mechanical ventilation and hospitalization in heat stroke patients,with odds ratios(ORs)of 0.294 and 0.300,respectively(both P＜0.05).Conclusion The developed protocol for early in-hospital temperature management in heat stroke patients is scientific,systematic,and practical.It improves cooling rates and target temperature attainment,thereby enhancing the prognosis of heat stroke patients.

Auto-brewery syndrome(ABS)is a rare and easily overlooked disease.Overgrowth of certain high-alcohol-producing fungi and bacteria in the intestine leads to the production of endogenous ethanol that ex-ceeds the liver's maximum metabolic capacity,resulting in an elevated ethanol concentration in the patient's peripheral blood.Even without alcohol intake,patients may exhibit symptoms similar to intoxication,causing various social,occupational,and health-related distress.This article provides an overview of the diagnosis and differential diagnosis of ABS,reveals that gut microbiota dysbiosis is the core of ABS,and introduces multiple intervention strategies involving the regulation of the gut microbiota,including dietary intervention,pharmaco-therapy,probiotic therapy,fecal microbiota transplantation,and phage therapy,with the aim of assisting clini-cians in the early identification and treatment of ABS.