ObjectiveTo observe the short-term and long-term efficacy of traditional Chinese medicine （TCM） surgical operations in treating mixed hemorrhoids. MethodsA multi-center retrospective cohort study was conducted， collecting clinical data from 17，831 mixed hemorrhoid surgery patients in 8 top-tier TCM hospitals in Jiangsu Province. Standardized and structured datasets were obtained through artificial intelligence models. Patients who underwent western surgical treatment were categorized into the western surgery group （11,646 cases）， and those receiving TCM surgical operations were categorized into the TCM surgery group （6185 cases）. Propensity score matching （1∶1 matching） was used to balance baseline data between groups. The primary outcome was the one-year recurrence rate， and secondary outcomes included the main symptoms （rectal bleeding， degree of prolapse） and secondary symptoms （anal distension， anal edema， wound secretion and exudation， anal stenosis， residual skin tags， perianal itching， and anal pain） measured on days 7， 28， and 60 after discharge. ResultsAfter matching， 2194 patients were included in each group. Symptom scores showed that at 28 days after discharge， the TCM surgical group had superior improvement in rectal bleeding ［OR=5.786， 95%CI （3.092，10.827）］， degree of prolapse ［OR=4.510， 95%CI （1.649，12.333）］， and anal edema ［OR=3.188， 95%CI （1.295，7.845）］ compared to the western surgical group. At 60 days post-discharge， the TCM group still showed advantages in improving rectal bleeding ［OR=5.237， 95%CI （1.077，25.464）］ and anal pain ［OR=11.697， 95%CI （1.186，115.336）］ （P＜0.05）. Long-term follow-up showed that the one-year recurrence rate in the TCM surgery group was 1.1% （8/726）， while that in the western surgery group was 2.3% （10/444）， with no statistically significant difference between the two groups （P＞0.05）. ConclusionBased on real-world data， TCM surgical treatment for mixed hemorrhoids shows significant short-term symptom improvement， particularly in terms of hemostasis， reducing swelling， and alleviating prolapse of anal masses.

The chemical constituents of Commiphora myrrha was investigated by column chromatography on silica gel, ODS, Sephadex LH-20, and semi-preparative HPLC. Their structures were elucidated by comprehensive spectroscopic methods including UV, IR, MS, NMR, as well as ECD calculation. Seven compounds were isolated from the dichloromethane-soluble fraction of C. myrrha and their structures were identified as(1S,2R,4S,5R,8S)-guaiane-2-hydroxy-7(11),10(15)-dien-6-oxo-12,8-olide(1), commipholide E(2), myrrhterpenoid H(3), myrrhterpenoid I(4), myrrhterpenoid E(5), 2α-methoxy-8α-hydroxy-6-oxogermacra-1(10),7(11)-dien-8,12-olide(6), 8,12-epoxy-1α,9α-hydroxy-eudesma-7,11-diene-6-dione(7). Compound 1 was a new compound and named myrrhterpenoid P. Compound 7 was isolated from Commiphora genus for the first time. Compounds 2, 5, and 6 significantly inhibited nitric oxide(NO) production in LPS-stimulated RAW264.7 cells, with IC_(50) values of(49.67±4.16),(40.80±1.27),(47.22±0.87) μmol·L~(-1), respectively [indomethacin as the positive control, with IC_(50) value of(63.92±2.60) μmol·L~(-1)].
Commiphora/chemistry* ; Animals ; Mice ; Resins, Plant/chemistry* ; Sesquiterpenes/isolation & purification* ; Molecular Structure ; Nitric Oxide ; Macrophages/metabolism* ; RAW 264.7 Cells ; Drugs, Chinese Herbal/pharmacology*

The chemical components of Carthami Flos were investigated by using macroporous resin, silica gel column chromatography, reversed-phase octadecylsilane(ODS) column chromatography, Sephadex LH-20, and semi-preparative high-performance liquid chromatography(HPLC). The planar structures of the compounds were established based on their physicochemical properties and ultraviolet-visible(UV-Vis), infrared(IR), high-resolution electrospray ionization mass spectrometry(HR-ESI-MS), and nuclear magnetic resonance(NMR) spectroscopic technology. The absolute configurations were determined by comparing the calculated and experimental electronic circular dichroism(ECD). Six flavonoid C-glycosides were isolated from the 30% ethanol elution fraction of macroporous resin obtained from the 95% ethanol extract of Carthami Flos, and identified as saffloquinoside F(1), 5-hydroxysaffloneoside(2), iso-5-hydroxysaffloneoside(3), isosafflomin C(4), safflomin C(5), and vicenin 2(6). Among these, the compounds 1 to 3 were new chalcone C-glycosides. The compounds 1, 2, 4, and 5 could significantly increase the viability of H9c2 cardiomyocytes damaged by oxygen-glucose deprivation/reoxygenation(OGD/R) at a concentration of 50 μmol·L~(-1), showing their good cardioprotective activity.
Glycosides/pharmacology* ; Flowers/chemistry* ; Drugs, Chinese Herbal/pharmacology* ; Carthamus tinctorius/chemistry* ; Chalcones/pharmacology* ; Animals

In recent years,significant breakthroughs have been achieved in the immunotherapy for Alzheimer's disease.In line with global advancements,two anti-amyloid-β monoclonal antibodies have been approved and successfully launched in China for clinical use.Lecanemab and Donanemab were officially used in June 2024 and April 2025 in China,respectively.In order to standardize the rational and safe application of anti-amyloid-β monoclonal antibodies for Alzheimer's disease in China,this article integrates recom-mendations from the clinical trials and real-world experience from the author's team and domestic peers to further update the recom-mendations for the clinical use of anti-amyloid-β monoclonal antibody based on the 2024 version.It includes indications for therapy,pre-treatment evaluation and preparation,administration protocols and safety measures during treatment,and post-treatment monitor-ing strategies.

With the growing emphasis on maternal and child oral health, the significance of managing oral health across preconception, pregnancy, and infancy stages has become increasingly apparent. Oral health challenges extend beyond affecting maternal well-being, exerting profound influences on fetal and neonatal oral development as well as immune system maturation. This expert consensus paper, developed using a modified Delphi method, reviews current research and provides recommendations on maternal and child oral health management. It underscores the critical role of comprehensive oral assessments prior to conception, diligent oral health management throughout pregnancy, and meticulous oral hygiene practices during infancy. Effective strategies should be seamlessly integrated across the life course, encompassing preconception oral assessments, systematic dental care during pregnancy, and routine infant oral hygiene. Collaborative efforts among pediatric dentists, maternal and child health workers, and obstetricians are crucial to improving outcomes and fostering clinical research, contributing to evidence-based health management strategies.
Humans ; Pregnancy ; Female ; Infant ; Consensus ; Mouth Diseases/therapy* ; Pregnancy Complications/therapy* ; Oral Health ; Infant, Newborn ; Delphi Technique ; Oral Hygiene

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Cervical spinal cord injury without fracture-dislocation (CSCIWFD) is referred to as a special type of cervical spinal cord injury characterized by traumatic spinal cord dysfunction and no significant bony structural abnormalities on imagines. Duo to the high risk of missed diagnosis during the initial consultation, CSCIWFD may lead to progressive neurological deterioration or even complete paralysis, severely impacting patients′ prognosis. Currently, there are no established consensuses over the diagnosis and treatment of CSCIWFD, such as the lack of evidence-based standards for indications of non-surgical treatment and risk of secondary neurological injury, as well as debates over the optimal timing for surgical intervention and indications for different surgical approaches. To address these issues, the Spine Trauma Group of the Orthopedic Branch of the Chinese Medical Doctor Association organized experts in the relevant fields to formulate Diagnosis and treatment guideline for acute cervical spinal cord injury without fracture- dislocation in adults ( version 2025) . Based on evidence-based medicine and the principles of scientific rigor and clinical applicability, the guidelines proposed 11 recommendations covering terminology, diagnosis, evaluation treatment, and rehabilitation, etc., aiming to standardize the management of CSCIWFD.

Objective To evaluate the viral composition in respiratory samples from hospitalized children with acute respiratory infections in Yancheng，Jiangsu province，between January 2024 and June 2025 using metagenomic next-generation sequencing（mNGS）.Methods:A total of 247 respiratory specimens，including throat swabs，sputum，and bronchoalveolar lavage fluid，were collected from 247 hospitalized children in Yancheng，Jiangsu province，during the study period. The viral composition in these samples was detected and analyzed using mNGS technology.Results:Among the 247 cases，there were 136 cases of pneumonia（including 4 cases of severe pneumonia），45 cases of bronchopneumonia，27 cases of upper respiratory tract infection，and 39 cases of bronchitis. The ages of the patients ranged from 41 days to 14 years，with a median age of 3 years. High-throughput sequencing results showed that the positive detection rate for viruses in the respiratory samples was 89.88%（222/247），The detection rate of viruses causing respiratory tract infections was 69.23%（171/247），With RNA viruses detected in 71.65%（177/247）of the cases and DNA viruses in 43.32%（107/247）. The top three viruses detected were rhinovirus（24.29%，60/247），human herpesvirus 7（HHV-7）（21.86%，54/247），and influenza A H1N1（20.24%，50/247）. The common detected viruses that cause respiratory infections are rhinovirus（24.29%），influenza A virus H1N1（20.24%），RSV（17.81%），metapneumovirus（10.53%），enterovirus（6.88%），parainfluenza virus（6.07%），bocavirus（6.07%），coronavirus（2.43%），and adenovirus（2.43%）. In children with pneumonia，the top two respiratory viruses detected were rhinovirus（19.85%，27/136）and influenza A H1N1（16.91%，23/136）. In children with bronchopneumonia，the main viruses detected were rhinovirus（31.11%，14/45）and respiratory syncytial virus（24.44%，11/45）. In children with upper respiratory tract infections，the main viruses detected were influenza A H1N1（33.33%，9/27）and rhinovirus（25.93%，7/27）. In children with bronchitis，the main viruses detected were rhinovirus（30.77%，12/39）and respiratory syncytial virus（25.64%，10/39）. Among the 4 cases of severe pneumonia，the viruses detected were influenza A H1N1（2/4），respiratory syncytial virus（1/4），and bocavirus（1/4）.Conclusion:mNGS analysis revealed a high positive detection rate of respiratory viruses（89.88%）in hospitalized children with acute respiratory infections in Yancheng，Jiangsu，from January 2024 to June 2025，with influenza A H1N1 and rhinovirus being the most predominant.

Objective:To investigate the current status of maximum tongue pressure (MTP) in cardiac surgery inpatients and analyze its influencing factors, providing a basis for developing personalized nursing measures for high-risk groups.Methods:This cross-sectional study used a convenience sampling method to select cardiac surgery inpatients at Zhongshan Hospital, Fudan University, from January 2022 to April 2023. General and clinical data questionnaires, a swallowing tongue muscle evaluation training device, and a hand dynamometer were used for data collection. The random forest model and Lasso regression were employed to identify key influencing factors, and multiple linear regression was used to analyze the factors affecting MTP.Results:A total of 501 cardiac surgery inpatients meeting the inclusion and exclusion criteria were enrolled, including 308 males and 193 females, with a mean age of (56.94 ± 14.02) years. The mean MTP was (45.92 ± 9.57) kPa. When the lambda (λ) value was 0.181, the model achieved the best fit, identifying 10 key influencing factors in descending order of importance: age, handgrip strength, gender, BMI, N-terminal pro-B-type natriuretic peptide (NT-proBNP), glomerular filtration rate, cardiac function grade, hemoglobin, history of stroke, and history of atrial fibrillation. Age, handgrip strength, low-level BMI, NT-proBNP, and history of stroke were determined as significant factors influencing MTP in cardiac surgery inpatients ( R2 = 0.324, F = 24.92, P<0.05). Conclusions:Nurses should pay close attention to the tongue muscle strength of cardiac surgery inpatients. Early assessment of MTP is essential for older patients, those with low handgrip strength, low BMI, elevated NT-proBNP, or a history of stroke. Targeted early identification and pre-rehabilitation measures should be implemented for patients with weakened tongue muscle strength.