Diabetic sarcopenia (DS) is a common but often ignored skeletal muscle complication in individuals with diabetes mellitus. It is characterized by progressive loss of skeletal muscle mass, reduced muscle strength, and impaired physical performance, which may further increase the risk of falls, disabilities, metabolic disorders, and adverse clinical outcomes. Traditionally, DS has been attributed mainly to hyperglycemia, insulin resistance, aging-related muscle decline, and chronic complications of diabetes. However, increasing evidence suggests that lipid metabolic disturbance and pathological lipid metabolic reprogramming are not merely secondary consequences of diabetes, but may actively participate in the initiation and progression of DS. Under diabetic conditions, impaired fatty acid uptake, transport, oxidation, and storage disrupt skeletal muscle metabolic homeostasis, leading to ectopic lipid deposition and accumulation of lipotoxic intermediates. These lipid-derived metabolites can aggravate insulin resistance, impair mitochondrial energy production, enhance oxidative stress, activate chronic low-grade inflammation, and disturb protein synthesis and degradation balance, thereby accelerating skeletal muscle atrophy and functional decline. Lipid metabolic dysregulation may also interact with multiple pathological processes involved in DS, including mitochondrial dysfunction, inflammatory signaling, oxidative damage, impaired autophagy, and gut microbiota imbalance. These mechanisms do not occur independently; instead, they form a complex bidirectional vicious cycle with diabetes-related metabolic disorders. Specifically, mitochondrial dysfunction reduces fatty acid oxidative capacity, which further promotes lipid accumulation and lipotoxicity. Inflammatory activation can impair insulin signaling and muscle protein metabolism, while lipid overload may in turn amplify inflammatory responses. Similarly, gut microbiota dysbiosis and altered microbial metabolites may influence systemic inflammation, lipid metabolism, and skeletal muscle homeostasis. Therefore, lipid metabolic reprogramming provides an important mechanistic perspective for understanding the progression of DS from metabolic disturbance to structural and functional muscle impairment. Exercise intervention is an effective and clinically feasible non-pharmacological strategy for the prevention and management of DS. Both aerobic exercise and resistance training have been shown to improve insulin sensitivity, enhance fatty acid oxidation, increase mitochondrial biogenesis, reduce ectopic lipid deposition, and attenuate lipotoxic metabolite accumulation. These adaptations not only improved glucose and lipid metabolism, but also increased the preservation of muscle mass, muscle strength, and physical function. Moreover, combined exercise strategies may provide complementary benefits by integrating the metabolic advantages of aerobic exercise with the anabolic and functional effects of resistance training. Based on analyses of publicly available datasets and literature evidences, this review systematically summarizes the role of lipid metabolic disorders in the pathogenesis of DS, with particular attention to the molecular mechanisms linking lipid dysregulation to insulin resistance, chronic inflammation, oxidative stress, mitochondrial dysfunction, and gut microbiota disturbance. Furthermore, this review discusses the potential mechanisms by which exercise intervention improves DS through the regulation of lipid metabolic reprogramming, and outlines exercise prescription strategies in terms of modality, intensity, frequency, and duration. Understanding the interaction between lipid metabolism and skeletal muscle dysfunction may provide new theoretical evidence for early identification, mechanistic research, and precision exercise therapy in DS. Overall, targeting pathological lipid metabolic reprogramming through exercise intervention represents a promising and clinically actionable approach for improving muscle health and prognosis in individuals with DS.

Objective To investigate the effects of formulated granules of Tianma Gouteng Yin(TGY)on motor deficits in a mouse model of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP)-induced subacute Parkinson's disease(PD)and explore the possible molecular mechanisms.Methods Ninety C57BL/6 mice were randomized equally into 6 groups,including a control group,a PD model group,a NEC-1(6.5 mg/kg)treatment group,two TGY treatment groups at 5 and 2.5 g/kg,and a Madopar(76 mg/kg)treatment(positive control)group.Mouse models of PD were established by intraperitoneal injection of MPTP(30 mg/kg)for 5 consecutive days with the corresponding treatments for 15 days.The mice were randomly selected for motor function tests.Western blotting was used to detect the changes in expressions of TH,α-syn,RIPK1,RIPK3 and MLKL in the striatum of the mice.Network pharmacology analysis and molecular docking studies were performed to explore TGY-mediated regulation of the necroptosis pathway for PD treatment.Results Compared with those in the control group,the PD model mice exhibited obvious motor deficits with significantly increased α-syn protein expression and lowered TH protein expression in the striatum.Treatment with NEC-1 obviously improved motor deficits,inhibited the necroptosis pathway,and alleviated the changes in TH and α-syn proteins in PD mice.Network pharmacology and molecular docking analyses suggested that the therapeutic effect of TGY in PD was associated with the modulation of RIPK1,a key protein in the necroptosis pathway.In PD mouse models,TGY treatment at the two doses significantly improved motor deficits of the mice,increased TH expression,and decreased the expressions of α-syn and necroptosis-related proteins in the striatum.Conclusion TGY can effectively inhibit the necroptosis pathway,increase TH expression and decrease α-syn expression in the striatum to improve motor deficits in PD mice.

Objective:To construct a frailty risk prediction model for elderly patients with CHD based on machine learning, to address the limitations of existing tools and provide evidence-based support for clinical practice.Methods:A retrospective study was conducted on elderly CHD patients hospitalized at the Heart Center of the First Affiliated Hospital of Henan University of Chinese Medicine from September 2023 to March 2024. Meta-analysis and expert meetings were used to identify the risk factors for frailty in elderly CHD patients. Three machine learning algorithms, Logistic Regression, Random Forest, and Support Vector Machine, were used to construct predictive models using R 4.3.1 software. The predictive performance of the models was evaluated using sensitivity, specificity, accuracy, and the area under the receiver operating characteristic curve (AUC).Results:A total of 490 elderly CHD patients were included, with 267 males and 223 females, and an age of (71.02 ± 7.73) years. Among them, 160 patients (32.7%) developed frailty. Of the constructed models, the Random Forest model demonstrated the best predictive performance, with an accuracy of 0.703, recall of 0.629, and F1 score of 0.741, while the AUC was 0.811 (95% CI 0.762-0.850). Conclusions:The Random Forest model exhibited good predictive performance in assessing frailty risk in elderly CHD patients, with high accuracy and reliability. Future external validation studies can further assess its applicability and stability in different populations.

Objective:To evaluate the impact of Diagnosis-Intervention Packet(DIP)payment reform on medical service costs and efficiency for inpatients in public hospitals,and to compare differences between surgical and medical groups.Methods:A quasi-experimental design was employed,using 605 636 discharged patients from a tertiary hospital in Hebei Province between January 2020 and March 2025 as the sample.The difference-in-differences(DID)model was used to analyze the changes in key indicators between the DIP settlement group(intervention group)and the non-DIP settlement group(control group).Results:Total hospitalization costs,out-of-pocket expenses,and medication costs were significantly reduced in the DIP settlement group(P<0.05),while costs for examinations,nursing,laboratory tests,and treatments increased significantly(P<0.05).Material costs increased by 30.7%in the surgical group(P<0.1)and decreased by 19.8%in the medical group(P<0.01).In terms of efficiency,the average length of stay,time,and cost consumption index all decreased(P<0.01),while the proportion of medical services increased(P<0.01).The case mix index(CMI)showed no significant changes.Conclusion:The DIP reform effectively controlled costs and improved efficiency,but it also resulted in cost shifting and departmental disparities.Therefore,it is necessary to optimize cost control and departmental management policies.

This consensus was developed by the Orthodontic Society of the Chinese Stomatological Association to provide a systematic, scientific, and practical guideline for informed consent in orthodontic care. Orthodontic treatment is typically lengthy, highly individualized, and involves multiple factors such as growth and development, occlusal function, and facial esthetics. Rapid technological advances and diverse risk profiles make the traditional reliance on orthodontist experience or institutional templates insufficient to ensure patients′ full understanding and autonomous decision-making. To address this, the expert panel conducted extensive reviews of domestic and international guidelines, analyzed representative dispute cases, and performed multicenter patient-clinician surveys. Using a multi-round Delphi method, the group established a standardized informed consent framework covering the initial consultation, treatment, and retention phases. The consensus emphasizes that informed consent is not only a fundamental legal and ethical requirement but also a key step in building trust, improving patient compliance, and enhancing treatment satisfaction. Orthodontists should clearly and comprehensively explain treatment plans, potential risks, uncertainties, and associated costs, while respecting the autonomy of patients or guardians, and maintain continuous communication and dynamic evaluation throughout the treatment process. The release of this consensus provides unified and authoritative guidance for clinical orthodontics, helping to standardize informed consent, enhance its transparency, safeguard patient rights, reduce medical risks, and promote high-quality, sustainable development of orthodontic practice.

Objective:To compare the differences in postoperative upper airway morphology and sleep apnea improvement between low temperature plasma ablation(LTPA)and traditional adenoidectomy(TAC)for severe adenoid hypertrophy in children.Methods:A total of 80 children with severe adenoid hypertrophy combined with obstructive sleep apnea-hypopnea syndrome(OSAHS)admitted to our hospital from January 2021 to January 2024 were randomly divided into two groups:LTPA group and TAC group,each with 40 cases.The study compared the upper airway morphological parameters(nasopharyngeal transverse diameter,sagittal diameter,nasopharyngeal airway volume,etc.),degree of OSAHS symptom improvement(apnea-hypopnea index,lowest blood oxygen saturation,etc.),intraoperative bleeding volume,surgical time,postoperative pain score,and incidence of postoperative complications in both groups before surgery,one week after surgery,one month after surgery,and three months after surgery.Results:The intraoperative blood loss in the LTPA group was significantly less than that in the TAC group,and the operation time was shorter(P＜0.05).Follow-up at 1 week,1 month,and 3 months postoperatively showed that both groups had significant improvements in upper airway morphology parameters compared to preoperative conditions.The increase in transverse diameter,sagittal diameter,and nasopharyngeal airway volume in the LTPA group was greater than in the TAC group(P＜0.05).Both groups also showed significant improvements in sleep-related breathing disorders,with a greater reduction in apnea-hypopnea index in the LTPA group compared to the TAC group(P＜0.05).Postoperative pain scores were lower in the LTPA group than in the TAC group(P＜0.05).The incidence of postoperative complications such as bleeding and nasopharyngeal stenosis was significantly lower in the LTPA group than in the TAC group(P＜0.05).Conclusions:Compared with traditional adenoid curettage,low temperature plasma ablation has the advantages of less surgical trauma,less intraoperative bleeding,less postoperative pain,better recovery of upper airway morphology and more significant improvement of sleep apnea in children with severe adenoid hypertrophy,and can be used as the preferred surgical mode for treating severe adenoid hypertrophy.

OBJECTIVE: To analyze the time characteristics of the Ethos online adaptive radiotherapy (OART) process in clinical practice and provide guidance for the comprehensive optimization of each stage of adaptive radiotherapy. METHODS: The study involved 61 patients with cervical, rectal, gastric, lung, esophageal, and breast cancers who underwent Ethos OART. The mean ± standard deviation of segmental time, total time, and target volume for these patients were tracked. The time characteristics for different cancer types were evaluated, and the average time for target and organ at risk (OAR) modifications was compared with the average target volume for each cancer type. RESULTS: Cervical cancer born the longest total treatment time, while breast cancer had the shortest. For all cancer types except breast cancer, the modification time for target and OAR was the most time-consuming segment. The average time for target and OAR modifications aligned with the trend of the average target volume. CONCLUSION The total treatment time for various cancers ranges from 15 to 35 minutes, indicating room for improvement.
Humans ; Radiotherapy Planning, Computer-Assisted/methods* ; Neoplasms/radiotherapy* ; Female

OBJECTIVES: To investigate the effects of formulated granules of Tianma Gouteng Yin (TGY) on motor deficits in a mouse model of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced subacute Parkinson's disease (PD) and explore the possible molecular mechanisms. METHODS: Ninety C57BL/6 mice were randomized equally into 6 groups, including a control group, a PD model group, a NEC-1 (6.5 mg/kg) treatment group, two TGY treatment groups at 5 and 2.5 g/kg, and a Madopar (76 mg/kg) treatment (positive control) group. Mouse models of PD were established by intraperitoneal injection of MPTP (30 mg/kg) for 5 consecutive days with the corresponding treatments for 15 days. The mice were randomly selected for motor function tests. Western blotting was used to detect the changes in expressions of TH, α-syn, RIPK1, RIPK3 and MLKL in the striatum of the mice. Network pharmacology analysis and molecular docking studies were performed to explore TGY-mediated regulation of the necroptosis pathway for PD treatment. RESULTS: Compared with those in the control group, the PD model mice exhibited obvious motor deficits with significantly increased α-syn protein expression and lowered TH protein expression in the striatum. Treatment with NEC-1 obviously improved motor deficits, inhibited the necroptosis pathway, and alleviated the changes in TH and α‑syn proteins in PD mice. Network pharmacology and molecular docking analyses suggested that the therapeutic effect of TGY in PD was associated with the modulation of RIPK1, a key protein in the necroptosis pathway. In PD mouse models, TGY treatment at the two doses significantly improved motor deficits of the mice, increased TH expression, and decreased the expressions of α-syn and necroptosis-related proteins in the striatum. CONCLUSIONS TGY can effectively inhibit the necroptosis pathway, increase TH expression and decrease α-syn expression in the striatum to improve motor deficits in PD mice.
Animals ; Mice, Inbred C57BL ; Mice ; Necroptosis/drug effects* ; Drugs, Chinese Herbal/therapeutic use* ; Parkinson Disease/drug therapy* ; Disease Models, Animal ; Male

Objective:To investigate the clinical effect of ultrasound bone knife bone window technique combined with viscous bone in mandibular cysts and its impact on postoperative bone defect repair.Methods:60 patients with mandibular cysts who visited our hospital from January 2024 to June 2024 were selected as the study subjects,they were randomly divided into control group(30 cases)and experimental group(30 cases).The control group underwent traditional scraping surgery(without the use of bone defect repair materials).The experimental group used ultrasound bone knife bone window technology combined with adhesive bone treatment.The surgical time,postoperative visual pain simulation(VAS)score,intraoperative blood loss,postoperative swelling degree,and incidence of postoperative complications between the two groups were observed and compared.Bone defect repair was evaluated by cone beam computed tomography(CBCT)at 3 and 6 months postoperatively.Results:There was no significant difference in surgical time,intraoperative blood loss,postoperative swelling degree,and incidence of postoperative complications between the two groups(P＞0.05).The VAS scores of both groups at 3 and 7 d postoperative were lower than those at 1 d postoperative(P＜0.05),and the VAS score at 7 d postoperative was lower than that 3 d postoperative(P＜0.05).The VAS scores in the experimental group were significantly lower than those in the control group at 1,3 and 7 d postoperative(P＜0.05).The HU values and bone repair area ratio in the experimental group at 3 and 6 months postoperative were significantly higher than those in the control group(P＜0.05),and the HU values and bone repair area ratio in the control group and experimental group at 6 months postoperative were significantly increased compared to those at 3 months postoperative(P＜0.05).Conclusion:The combination of ultrasound bone knife bone window technology and adhesive bone treatment for mandibular cysts can significantly reduce postoperative pain,accelerate bone defect repair,and improve bone density and repair quality.Compared with traditional scraping surgery,the use of sticky bone has significant advantages in postoperative bone regeneration and does not significantly increase the risk of complications,making it of high clinical application value.