ObjectiveTo explore the changes in color， odor and chemical components during wine-processing of Chuanxiong Rhizoma（CR）， identify differential markers， and provide a basis for standardizing the process and establishing quality standards. MethodsFifteen batches of CR samples from 4 producing areas were collected. Colorimeter and electronic nose were used to detect the color changes and odor components of CR before and after wine-processing. Multivariate statistical methods including partial least squares-discriminant analysis（PLS-DA）， principal component analysis（PCA）， discriminant factor analysis（DFA） and Fisher discriminant analysis were applied to identify wine-processed CR at different processing stages and establish discriminant models， and differential components were screened out based on variable importance in the projection（VIP） value1. Then， high performance liquid chromatography（HPLC） was employed to detect the content changes of four components（ferulic acid， senkyunolide I， senkyunolide A and ligustilide） during the processing stages. ResultsThe differences of wine-processed CR at various stages were primarily reflected in color parameters L^*（brightness value）， a^*（red-green value） and b^*（yellow-blue value）. Based on chromaticity differences， the color reference ranges were established for moderately processed CR， including L^* of 46.75-48.24， a^* of 5.37-6.07 and b^* of 20.32-21.70. In odor analysis， DFA revealed significant differences among processing stages， and 11 odor markers were identified， with four differential markers（4-hydroxy-3-butylphthalide， isopropyl butyrate， L-limonene and 1-methoxyhexane） based on VIP values. HPLC results showed that there was no significant difference of the four components except for ligustilide in wine-processed CR at different stages. ConclusionThis study achieved rapid identification of wine-processed CR with different processing degrees by electronic sensory technology and differential component content detection， with discrimination accuracy rates of 92.4% and 93.272% for color and odor， respectively. This paper also established the reference ranges of main colorimetric parameters for wine-processed CR at different stages， and four differential components were screened out， providing a basis for standardizing the processing of wine-processed CR and establishing quality standards for this decoction pieces.

ObjectiveTo explore the changes in color， odor and chemical components during wine-processing of Chuanxiong Rhizoma（CR）， identify differential markers， and provide a basis for standardizing the process and establishing quality standards. MethodsFifteen batches of CR samples from 4 producing areas were collected. Colorimeter and electronic nose were used to detect the color changes and odor components of CR before and after wine-processing. Multivariate statistical methods including partial least squares-discriminant analysis（PLS-DA）， principal component analysis（PCA）， discriminant factor analysis（DFA） and Fisher discriminant analysis were applied to identify wine-processed CR at different processing stages and establish discriminant models， and differential components were screened out based on variable importance in the projection（VIP） value1. Then， high performance liquid chromatography（HPLC） was employed to detect the content changes of four components（ferulic acid， senkyunolide I， senkyunolide A and ligustilide） during the processing stages. ResultsThe differences of wine-processed CR at various stages were primarily reflected in color parameters L^*（brightness value）， a^*（red-green value） and b^*（yellow-blue value）. Based on chromaticity differences， the color reference ranges were established for moderately processed CR， including L^* of 46.75-48.24， a^* of 5.37-6.07 and b^* of 20.32-21.70. In odor analysis， DFA revealed significant differences among processing stages， and 11 odor markers were identified， with four differential markers（4-hydroxy-3-butylphthalide， isopropyl butyrate， L-limonene and 1-methoxyhexane） based on VIP values. HPLC results showed that there was no significant difference of the four components except for ligustilide in wine-processed CR at different stages. ConclusionThis study achieved rapid identification of wine-processed CR with different processing degrees by electronic sensory technology and differential component content detection， with discrimination accuracy rates of 92.4% and 93.272% for color and odor， respectively. This paper also established the reference ranges of main colorimetric parameters for wine-processed CR at different stages， and four differential components were screened out， providing a basis for standardizing the processing of wine-processed CR and establishing quality standards for this decoction pieces.

Lung cancer constitutes the most prevalent and lethal malignant tumor in China. Approximately 85% of lung cancer diagnoses correspond to the non-small cell histological subtype [non-small cell lung cancer (NSCLC)]. Despite surgery being the mainstay for early-stage disease, postoperative recurrence remains high and adjuvant chemotherapy offers limited benefit. In recent years, targeted therapy has demonstrated substantial advantages in driver mutation-positive NSCLC. To this end, the Lung Cancer Medical Education Committee of the Chinese Medical Education Association developed guidelines based on a systematic review of evidence through November 2025, using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach and a modified Delphi method. Focusing on epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK), and addressing ROS proto-oncogene 1 (ROS1), B-Raf proto-oncogene serine/threonine kinase (BRAF) V600E mutation, and mesenchymal-epithelial transition factor (MET) exon 14 (METex14) skipping, the guideline covers molecular testing, neoadjuvant/adjuvant therapy, perioperative strategies, minimal residual disease monitoring, and postoperative surveillance. It defines testing requirements, specifies stage-directed and subtype-specific treatments, and standardizes minimal residual disease monitoring. These recommendations emphasize precision and feasibility to improve survival and quality of life.

ObjectiveTo evaluate the quality of clinical practice guidelines and expert consensus statements on knee osteoarthritis （KOA） based on the Appraisal of Guidelines for Research & Evaluation Ⅱ （AGREE Ⅱ）， thus providing a new perspective for clinical selection as well as guideline development and updating. MethodsA systematic search was conducted for KOA-related guidelines and consensus statements published from November 1， 2019 to December 31， 2025. The databases and platforms searched included CNKI， VIP， Wanfang Data， PubMed， Web of Science， the National Institute for Health and Care Excellence （NICE）， SinoMed， Yimaitong， and relevant official websites. Two researchers independently screened the literature， and four researchers used AGREE Ⅱ to score the included documents and completed the quality appraisal after reaching a unified understanding. Subgroup analyses were further performed according to developing organization， document type， medical approach， funding status， and region of development， and longitudinal comparisons were conducted by year of publication. ResultsA total of 23 guidelines and consensus statements were included. The standardized scores of the six AGREE Ⅱ domains， from the highest to the lowest， were clarity of presentation ［（70.36±8.13）%］， scope and purpose ［（67.46 ± 11.44）%］， editorial independence ［（64.50±20.01）%］， rigor of development ［（62.24±15.26）%］， stakeholder involvement ［（55.73±10.29）%］， and applicability ［（53.89±13.17）%］. In terms of overall recommendation， 6 documents were rated as grade A and 17 as grade B. Stratified analyses showed that professional organizations scored higher than comprehensive organizations. The overall scores of traditional Chinese medicine/integrative medicine and Western medicine guidelines （or consensus statements） were similar. Guidelines scored higher than consensus statements. The overall scores were similar between documents with reported funding and those without reported funding. International guidelines scored higher than domestic guidelines. Longitudinal comparisons showed that the largest number of documents was published in 2021. The overall scores were higher in 2021—2022， and some domain scores declined in 2023—2024. Overall， the quality of recent guidelines and consensus statements for KOA showed slight fluctuations， without a clear linear trend. ConclusionThe included guidelines and consensus statements for KOA can generally serve as references for clinical practice. However， the quality across domains remains uneven， and stakeholder involvement and applicability are still weak domains. Future guideline development and updating should further improve methodological standardization and transparency in reporting.

Objective:To investigate the changes in spinal cord blood flow (SCBF) caused by spinal osteotomy shortening and its impact on spinal cord function, thereby determining a safe range for osteotomy shortening.Methods:Fifteen healthy male rabbits were randomly divided into three groups: the control group (spinal osteotomy with dura mater exposure only), the shortening 1/3 group (spinal shortening by one-third with dura mater exposure), and the shortening 1/2 group (spinal shortening by one-half with dura mater exposure), with five rabbits in each group. A laser speckle imaging system was used to monitor SCBF and spinal vascular diameter throughout the spinal osteotomy and shortening procedures. SCBF and vascular diameter were recorded postoperatively. Spinal cord function was assessed using intraoperative electrophysiological monitoring, and sensory and motor functions were evaluated using the Reuters score before and after surgery.Results:No abnormalities were detected in the electrophysiological monitoring of any group during the experiment. Laser speckle imaging revealed that, compared to pre-osteotomy levels, some branch vessels began to fade significantly when spinal shortening reached 1/3, and some small branch vessels disappeared in imaging at 1/2 shortening. The postoperative SCBF values for the control, shortening 1/3, and shortening 1/2 groups were 229.71±139.00 PU, 296.84±118.21 PU, and 168.06±76.57 PU, respectively, with significant differences ( F=43.820, P<0.001). The postoperative spinal vascular diameters were 215.39±118.23 μm, 276.47±96.00 μm, and 350.77±90.97 μm, respectively, also showing significant differences ( F=32.150, P<0.001). Postoperative Reuters scores were 1.20±0.45, 2.40±0.55, and 4.00±0.71 for the control, shortening 1/3, and shortening 1/2 groups, respectively, with significant differences ( F=29.600, P<0.001). The shortening 1/2 group had significantly higher scores than both the control and shortening 1/3 groups ( P<0.05). A positive correlation was observed between SCBF and spinal cord blood vessel diameter from pre-osteotomy to 1/3 shortening ( r=0.661, P=0.037). However, SCBF negatively correlated with postoperative Reuters scores from 1/3 to 1/2 shortening ( r=-0.830, P=0.003), whereas spinal cord blood vessel diameter showed a positive correlation with postoperative Reuters scores ( r=0.537, P=0.039). Conclusions:As the degree of spinal shortening increases, the diameter of spinal cord blood vessels gradually expands, while SCBF initially rises and then declines. A positive correlation exists between vascular diameter and SCBF at shortening ratios of <1/3, whereas a negative correlation is observed between SCBF and postoperative Reuters scores at shortening ratios between 1/3 and 1/2. Additionally, vascular diameter correlates positively with postoperative Reuters scores from pre-osteotomy to 1/2 shortening. These findings suggest that spinal cord function can be effectively preserved when spinal shortening does not exceed 1/2.

Objective:This study aimed to compare postoperative pain between minimally invasive coronary artery bypass grafting (MICS-CABG) and conventional CABG for multivessel coronary artery disease, comparing baseline characteristics and perioperative data between the two groups, and analyzing risk factors influencing postoperative pain.Methods:A total of 545 patients undergoing elective off-pump coronary artery bypass grafting (OPCABG) for multivessel coronary artery disease at Beijing Anzhen Hospital from July 2022 to July 2023 were included. There were 397 patients in the conventional CABG group (289 males, 108 females, aged 35-77 years) and 148 patients in the minimally invasive CABG group (121 males, 27 females, aged 37-84 years), with 148 patients in each group after propensity score matching. Pain levels were assessed using the Numeric Rating Scale (NRS) at the first 5 days postoperatively (acute postoperative pain, APP) and at 3, 6, and 12 months postoperatively (chronic post-surgical pain, CPSP). Logistic regression was used to analyze risk factors for CPSP at 3 months postoperatively in both groups. Results:Within 48 hours postoperatively, both groups reported maximum NRS pain intensities at rest (NRS 4.0 vs. 6.0) and during activity (NRS 5.2 vs. 7.5). From the third day after surgery, there were no significant differences in resting pain intensity between the two groups, and from the fourth day after surgery, there were no significant differences in pain intensity during movement. With 60.2% in the conventional group and 92.6% in the minimally invasive group experiencing moderate to severe pain at rest (NRS ≥ 4), and 83.5% in the conventional group and 98.0% in the minimally invasive group experiencing moderate to severe pain during activity (NRS ≥ 4). Immediately after drain removal, there was a significant reduction in pain intensity at rest in the minimally invasive group (pre-drain removal NRS 6.0 vs. post-drain removal NRS 2.7), compared to the conventional group (pre-drain removal NRS 4.0 vs. post-drain removal NRS 2.3). However, there was no significant difference in the reduction of pain intensity during activity between the minimally invasive group (pre-drain removal NRS 7.5 vs. post-drain removal NRS 4.2) and the conventional group (pre-drain removal NRS 6.0 vs. post-drain removal NRS 2.7). At 3 months postoperatively, the incidence of CPSP was 35.9% in the conventional group and 35.1% in the minimally invasive group. At 6 months postoperatively, the incidence of CPSP was significantly lower compared to 3 months in both groups (conventional group 8.7% vs. minimally invasive group 6.8%, P<0.001). In the conventional group, higher Europe SCORE Ⅱ was identified as an independent risk factor for CPSP at 3 months postoperatively, while in the minimally invasive group, higher BMI and postoperative use of flurbiprofen for rescue analgesia were identified as independent risk factors. Conclusion:In patients undergoing minimally invasive coronary artery bypass grafting (CABG), the early postoperative acute pain intensity and incidence were higher than those in the conventional CABG group. After drain removal, there were no significant differences in resting pain intensity between the two groups, but pain intensity during movement remained higher in the minimally invasive group compared to the conventional group. The incidence of chronic pain did not differ between the two groups but decreased significantly from 3 months postoperatively. Conventional CABG patients with high preoperative Europe SCORE Ⅱ scores, high preoperative BMI and severe postoperative acute pain tend to have more chronic pain after minimally invasive bypass surgery.

Objective To explore the clinical characteristics of patients with diffuse large B-cell lymphoma (DLBCL) accompanied with KMT2D gene mutation and the impact of its co-mutated genes on prognosis. Methods Clinical data of 155 newly diagnosed DLBCL patients were obtained. The second-generation sequencing method was used to detect 475 hotspot genes, including KMT2D mutation. Patients were divided into the KMT2D mutation group and KMT2D wild-type group based on the presence or absence of KMT2D gene mutation. Clinical characteristics, differences in co-mutated genes, and survival differences between the two groups were compared. Results The frequency of KMT2D mutation was 31%, which is predominantly observed in elderly patients (P=0.07) and less in the double-expressor phenotype (P=0.07). Compared with the KMT2D wild-type group, KMT2D gene mutation was associated with higher co-mutation rates of CDKN2A (OR=2.82, P=0.01) and BCL2 (OR=3.84, P=0.016), while being mutually exclusive with MYC gene mutation (OR=0.11, P=0.013). In univariate survival analysis, no statistically significant difference in overall survival (OS) was found between the KMT2D mutation group and the wild-type group (P=0.54). Further analysis of the prognostic significance of KMT2D with other gene mutations indicated that patients with KMT2D^mutBTG2^mut had poorer OS than those with KMT2D^wt BTG2^mut (P=0.07) and KMT2D^wt BTG2^wt (P=0.05). On the contrary, patients with KMT2D^mut CD79B^mut had better OS than those with KMT2D^mut CD79B^wt (P=0.09), with no prognostic impact observed for other co-mutated genes. Multivariate Cox regression analysis revealed that Ann Arbor stages Ⅲ and Ⅳ (HR=2.751, 95%CI: 1.169-6.472, P=0.02), elevated LDH levels (HR=2.461, 95%CI: 1.396-4.337, P=0.002), Ki-67 index>80% (HR=1.875, 95%CI: 1.066-3.299, P=0.029), and KMT2D^mutBTG2^mut(HR=4.566, 95%CI: 1.348-15.471, P=0.015) were independent risk factors for OS in patients with DLBCL (P<0.05). Conclusion DLBCL patients with KMT2D mutation often have multiple gene mutations, among which patients with a co-mutated BTG2 gene have poor prognosis.

Objective To compare the safety and efficacy of minimally invasive coronary artery bypass grafting (MICS CABG) and traditional CABG in patients with coronary heart disease (CHD) and diabetes mellitus (DM). Methods From 2019 to 2021, the patients who received CABG by the same medical group in the Minimally Invasive Cardiac Surgery Center of Beijing Anzhen Hospital were retrospectively enrolled. According to the surgery methods, the patients were divided into two groups: a MICS CABG group and a conventional group. The perioperative and postoperative follow-up data of patients were collected. The main observation results included all cause death events, myocardial infarction, cerebrovascular, revascularization, and adverse wound healing. Results According to the inclusion and exclusion criteria, 140 patients were enrolled, including 66 patients in the MICS CABG group [56 males and 10 females, aged (61.83±8.94) years], and 74 patients in the conventional group [55 males and 19 females, aged (58.61±8.26) years]. Compared with the conventional group, patients in the MICS CABG group had longer median surgical time (4.50 h vs. 4.00 h, P=0.005), less intraoperative bleeding (600.00 mL vs. 700.00 mL, P=0.020), and a lower rate of secondary debridement and suturing of surgical wounds (4.5% vs. 16.2%, P=0.023). The median follow-up time was 2.54 years. There was no statistically significant difference in the cumulative incidence of major adverse cardiac and cerebrovascular events (7.6% vs. 5.4%), all-cause mortality (0.0% vs. 0.0%), myocardial infarction (3.0% vs. 2.7%), cerebrovascular events (4.5% vs. 2.7%), or revascularization (0.0% vs. 0.0%) between the two groups of patients during the postoperative follow-up (P>0.05). Conclusion MICS CABG can achieve the same revascularization effect as traditional CABG in patients with CHD and DM. MICS CABG can effectively reduce adverse clinical outcomes or complications such as adverse chest wound healing and slow postoperative recovery of body function in patients with DM.

Idiopathic Pulmonary Fibrosis(IPF)is a progressive disease characterized by declining respiratory function and high mortality.Macrophages play a pivotal role in its pathogenesis.Through polarization into pro-inflammatory M1 and pro-fibrotic M2 phenotypes,they contribute to a complex immunoregulatory network.In the early disease stages,M1 macrophage-mediated inflammation causes lung tissue injury,while M2 macrophages drive fibrogenesis by releasing pro-fibrotic factors such as TGF-β.Recent research has revealed that exosomes derived from macrophages serve as carriers for miRNAs,with specific miRNAs(e.g.,miR-328,miR-142-3p)demonstrating significant roles in pulmonary fibrosis.miR-328 promotes fibroblast proliferation and accelerates collagen deposition,whereas miR-142-3p attenuates fibrosis by modulating the TGF-β signaling pathway.Targeted intervention against these macrophage-associated miRNAs shows potential for clinical translation,potentially offering novel approaches for the early diagnosis and targeted therapy of IPF.However,translating these strategies into clinical practice requires overcoming challenges related to production and delivery systems.In conclusion,a deeper understanding of the mechanisms and translational applications of macrophage-derived miRNAs in IPF holds promise for ultimately improving patient prognosis and clinical outcomes.

Objective:To investigate the changes in spinal cord blood flow (SCBF) caused by spinal osteotomy shortening and its impact on spinal cord function, thereby determining a safe range for osteotomy shortening.Methods:Fifteen healthy male rabbits were randomly divided into three groups: the control group (spinal osteotomy with dura mater exposure only), the shortening 1/3 group (spinal shortening by one-third with dura mater exposure), and the shortening 1/2 group (spinal shortening by one-half with dura mater exposure), with five rabbits in each group. A laser speckle imaging system was used to monitor SCBF and spinal vascular diameter throughout the spinal osteotomy and shortening procedures. SCBF and vascular diameter were recorded postoperatively. Spinal cord function was assessed using intraoperative electrophysiological monitoring, and sensory and motor functions were evaluated using the Reuters score before and after surgery.Results:No abnormalities were detected in the electrophysiological monitoring of any group during the experiment. Laser speckle imaging revealed that, compared to pre-osteotomy levels, some branch vessels began to fade significantly when spinal shortening reached 1/3, and some small branch vessels disappeared in imaging at 1/2 shortening. The postoperative SCBF values for the control, shortening 1/3, and shortening 1/2 groups were 229.71±139.00 PU, 296.84±118.21 PU, and 168.06±76.57 PU, respectively, with significant differences ( F=43.820, P<0.001). The postoperative spinal vascular diameters were 215.39±118.23 μm, 276.47±96.00 μm, and 350.77±90.97 μm, respectively, also showing significant differences ( F=32.150, P<0.001). Postoperative Reuters scores were 1.20±0.45, 2.40±0.55, and 4.00±0.71 for the control, shortening 1/3, and shortening 1/2 groups, respectively, with significant differences ( F=29.600, P<0.001). The shortening 1/2 group had significantly higher scores than both the control and shortening 1/3 groups ( P<0.05). A positive correlation was observed between SCBF and spinal cord blood vessel diameter from pre-osteotomy to 1/3 shortening ( r=0.661, P=0.037). However, SCBF negatively correlated with postoperative Reuters scores from 1/3 to 1/2 shortening ( r=-0.830, P=0.003), whereas spinal cord blood vessel diameter showed a positive correlation with postoperative Reuters scores ( r=0.537, P=0.039). Conclusions:As the degree of spinal shortening increases, the diameter of spinal cord blood vessels gradually expands, while SCBF initially rises and then declines. A positive correlation exists between vascular diameter and SCBF at shortening ratios of <1/3, whereas a negative correlation is observed between SCBF and postoperative Reuters scores at shortening ratios between 1/3 and 1/2. Additionally, vascular diameter correlates positively with postoperative Reuters scores from pre-osteotomy to 1/2 shortening. These findings suggest that spinal cord function can be effectively preserved when spinal shortening does not exceed 1/2.