This paper reviewed the development history of doctor-patient shared decision-making （SDM） at home and abroad， emphasizing the importance of cross-cultural analysis in constructing a Chinese doctor-patient SDM model. It also delved into the relationship between Western “individualistic” sociocultural values and doctor-patient SDM， as well as the influence of China’s “collectivist” sociocultural values on doctor-patient SDM， revealing significant disparities in doctor-patient SDM models under distinct sociocultural contexts. Although the doctor-patient SDM theory in China originated from the West， this theory requires profound “collision” and adaptation with local Chinese culture to form a localized theory suited to China’s national conditions. Through cross-cultural adaptation and integrating China’s familism tradition and medical ethics concepts， the future construction of the doctor-patient SDM model in China should emphasize family members’ involvement and seek cultural balance to facilitate its widespread application in clinical practice.

Aging has emerged as a cutting edge and hotspot in global life science field， with anti-aging and geriatric disease prevention and treatment becoming critical issues urgently demanding solutions in international medical communities. In the face of the challenge of accelerating global population aging， in-depth exploration of aging mechanisms and the development of effective intervention strategies hold significant scientific and clinical value. This study supported by the national key research and development program of China， employed the essence-Qi-spirit theory of Qiluo doctrine as its guiding framework， focusing on the key scientific issue of the core traditional Chinese pathogenesis of aging， namely "depletion of kidney essence， deficiency of primordial Qi， and impairment of body and spirit". The treatment principle of "tonifying the kidney to replenish essence， harmonizing Yin and Yang， warming and invigorating primordial Qi， and nourishing the body and spirit" was established. Centered on holistic aging， systemic aging， and aging-related diseases， the research integrated multidisciplinary research approaches to construct multi-modal aging models and a multi-dimensional evaluation system， and it utilized multi-omics technologies to deeply analyze aging mechanisms. By systematically reviewing historical kidney-tonifying and anti-aging formulas and combining big data with artificial intelligence technologies， an information database of anti-aging traditional Chinese medicine substance was developed to reveal the differences and synergistic effects of various treatment methods and formulas on anti-aging. Based on this treatment method， the research integrated two millennia of kidney-tonifying medicinal experience to develop the innovative anti-aging traditional Chinese medicine， namely Bazhi Bushen capsules. It was validated that this capsule can delay holistic and systemic aging through multiple targets and mechanisms， thereby elucidating the scientific connotation of the essence-Qi-spirit theory of Qiluo doctrine in guiding anti-aging research from multiple dimensions and providing robust support for leveraging the advantages of traditional Chinese medicine to occupy the commanding heights of international anti-aging research.

Objective To evaluate the efficacy and safety of obinutuzumab(OBZ)in the treatment of refractory primary membranous nephropathy(pMN).Methods The clinical data of 15 patients with refractory pMN who received OBZ treatment in Department of Nephrology of The First Affiliated Hospital of Naval Medical University between Jan.2022 and Sep.2024 were retrospectively analyzed,and they included basic information,relevant laboratory indexes,clinical and immunological outcomes,and adverse events.Results Among the 15 patients with refractory pMN,14(93.3％)were phospholipase A2 receptor(PLA2R)-associated membranous nephropathy(10 cases with positive PLA2R by renal biopsy and 4 cases with no recorded PLA2R results by renal biopsy but with positive serum PLA2R antibodies).During the follow-up period,all 15 patients achieved clinical remission,with 4(26.7％)patients achieving complete remission and 11(73.3％)patients achieving partial remission.Of the 12 patients with positive serum PLA2R antibodies,11 patients had continuously positive serum PLA2R antibodies before OBZ treatment,and 9(81.8％)patients achieved immunological remission after OBZ treatment.All the 15 patients had previously received immunosuppressive therapy,and all of them were classified as refractory pMN,with 7(46.7％)patients having been treated with cyclophosphamide combined with corticosteroids,2(13.3％)patients having been treated with calcineurin inhibitor combined with corticosteroids,11(73.3％)patients having received rituximab.During the treatment,2(13.3％)cases of adverse events were observed:1 patient experienced transient liver dysfunction,and the transaminase returned to normal after discontinuing atorvastatin;another patient developed a positive T-cell spot test for Tuberculosis infection during the intertreatment interval and successfully completed the subsequent OBZ treatment and achieved clinical remission after treatment with isoniazid and rifampicin.Conclusion OBZ demonstrates favorable clinical efficacy in the treatment of refractory pMN,with a low incidence of adverse events.

Objective:To investigate the epidemiological and clinical characteristics of patients with psittacosis, in order to provide a basis for early diagnosis and prevention of the disease.Methods:Clinical data of psittacosis cases reported in 2023 from China Disease Prevention and Control Information System in Daxing District, Beijing were collected, and the patients' general information, epidemiological characteristics, clinical characteristics, imaging examination results, laboratory test results, treatment and prognosis were retrospectively analyzed.Results:A total of 7 cases of psittacosis were reported in Daxing District in 2023, with no clustered infection in households or workplaces. There were 4 males and 3 females, with a median age of 66 years old, and a range of 52 to 82 years old. Epidemiological investigation revealed that 6 patients had a clear history of contact with poultry (4 had first contact with parrots or pigeons, and 2 had long-term exposure to pigeons, parrots or wild birds). The onset time was concentrated in April and May. The primary clinical manifestations included high fever (6 cases), fatigue (4 cases), and chills (3 cases). The imaging examination results showed that inflammatory changes occurred in the unilateral lung of 6 patients, and both lungs were affected in 1 patients. Laboratory test results indicated elevated neutrophill percentage in 6 patients, decreased white blood cell counts in 2 patients, elevated white blood cell counts in 2 patients, and elevated C-reactive protein levels in 7 patients. Metagenomic next-generation sequencing test showed that all seven patients were positive for Chlamydia psittaci. All 7 patients were treated with quinolone or tetracycline antibiotics, with 6 cured and discharged, and 1 died. Conclusion:Psittacosis is usually manifested clinically as high fever, fatigue, and unilateral lung inflammation, often associated with poultry exposure.

Purpose To investigate the value of automated segmentation technique for quantitative study of the volume of each subregion of medial temporal lobe epilepsy(MTLE)with hippocampal sclerosis(HS).Materials and Methods A total of 37 patients with unilateral HS diagnosed by MRI or pathologically confirmed in General Hospital of Ningxia Medical University from January 2021 to May 2023 were prospectively included,including 24 cases of left-sided HS(L-HS)and 13 cases of right-sided HS(R-HS),and 42 healthy volunteers matched in gender and age during the same period were included as a control group.All subjects underwent T1-weighted equal voxel three-dimensional magnetisation-prepared rapid gradient-echo(3D T1 MP-RAGE)scanning.3D T1 MP-RAGE was post-processed by Freesurfer V7 to obtain volume data of the hippocampus and its subregions.The volume data were normalized and the volume asymmetry index was calculated.Within-group and between-group comparisons were performed for standardized volumes of the hippocampus and its subregions,and between-group comparisons were performed for volume asymmetry index values.The diagnostic efficacy of the two indices was assessed and compared using the subject operating characteristic curve and area under the curve.Results The volumes of the hippocampus and its subregions on the affected side were smaller than those on the contralateral side in both the L-HS and R-HS groups,and the volumes of the left hippocampus and its subregions were smaller than those on the right side in the control group,and the differences were statistically significant(t/Z=-15.159-8.324,all P＜0.05).The volumes of the left side of the hippocampus and its subregions in the L-HS group were smaller than those of the left hippocampus and its subregions in the R-HS group and in the control group,and the volumes of the right side of the hippocampus and its subregions in the R-HS group were smaller than those of the L-HS group and the right hippocampus and its subregions of the control group,and the differences were statistically significant(P＜0.05).The differences in the volumes of the right side of the L-HS group and the left side of the R-HS group and the corresponding side of the control group were not statistically significant(P＞0.05).The differences in the volume asymmetry index values of the L-HS group compared with those of the R-HS group and the control group,and those of the R-HS group compared with those of the control group were all statistically significant(P＜0.05).Except for the diagnostic efficacy of volume asymmetry index values of the hippocampus and subiculum in the L-HS group,which was better than that of the volume,and the difference was statistically significant(Z=2.035,1.989,both P＜0.05),the comparison of the volume and volume asymmetry index values of each volume and volume asymmetry index value of the rest of the hippocampus and subregion was not statistically significant(P＞0.05).Conclusion The automatic segmentation technique is of great value for the quantitative study of hippocampus and its subregion volume in MTLE-HS,which can provide more accurate imaging reference for clinical practice.

Digital health education is a crucial means to enhance the accessibility and effectiveness of medical services.The"new digital gap"faced by the elderly population makes them a marginalized group in digital health education and disease management.This paper takes cognitive load theory as its starting point,outlines the theoretical foundation of cognitive load,and systematically reviews the factors that influence cognitive load in digital health education for the elderly and propose corresponding optimization inspirations.The aim is to provide references for optimizing digital education models and program designs for the elderly.

Objective:To investigate the epidemiological and clinical characteristics of patients with psittacosis, in order to provide a basis for early diagnosis and prevention of the disease.Methods:Clinical data of psittacosis cases reported in 2023 from China Disease Prevention and Control Information System in Daxing District, Beijing were collected, and the patients' general information, epidemiological characteristics, clinical characteristics, imaging examination results, laboratory test results, treatment and prognosis were retrospectively analyzed.Results:A total of 7 cases of psittacosis were reported in Daxing District in 2023, with no clustered infection in households or workplaces. There were 4 males and 3 females, with a median age of 66 years old, and a range of 52 to 82 years old. Epidemiological investigation revealed that 6 patients had a clear history of contact with poultry (4 had first contact with parrots or pigeons, and 2 had long-term exposure to pigeons, parrots or wild birds). The onset time was concentrated in April and May. The primary clinical manifestations included high fever (6 cases), fatigue (4 cases), and chills (3 cases). The imaging examination results showed that inflammatory changes occurred in the unilateral lung of 6 patients, and both lungs were affected in 1 patients. Laboratory test results indicated elevated neutrophill percentage in 6 patients, decreased white blood cell counts in 2 patients, elevated white blood cell counts in 2 patients, and elevated C-reactive protein levels in 7 patients. Metagenomic next-generation sequencing test showed that all seven patients were positive for Chlamydia psittaci. All 7 patients were treated with quinolone or tetracycline antibiotics, with 6 cured and discharged, and 1 died. Conclusion:Psittacosis is usually manifested clinically as high fever, fatigue, and unilateral lung inflammation, often associated with poultry exposure.

Liver transplantation is a crucial treatment for end-stage liver disease,yet its complexity continues to limit clinical application.With the development of the internet and big data,artificial intelligence(AI)technologies have gradually expanded their use in liver transplantation surgery,covering donor liver evaluation,organ allocation,robot-assisted surgery,and postoperative management,demonstrating significant advantages.However,the application of AI also raises a series of ethical issues,notably fairness in resource allocation,conflicts between technical limitations and the principle of non-maleficence,ambiguous responsibility attribution,patient privacy security,and informed consent.This article systematically reviews the current applications of AI in liver transplantation surgery and the related ethical challenges,aiming to provide a reference for its rational use and sustainable development.

Objective To explore the mechanism of Shanggan granules in suppressing pulmonary inflammation in mice infected with H1N1 influenza virus.Methods A mouse model of pulmonary influenza virus infection was established by nasal inoculation with H1N1 influenza virus.Mice were divided into a normal control group,model group,positive control group,and low-,medium-,and high-dose Shanggan granules groups.Mice were treated for 7 days and then sacrificed,and the body weight and lung wet weight were measured.Pathological changes in the lung tissues were detected by hematoxylin/eosin(HE)staining.Tumor necrosis factor-α(TNF-α),interleukin(IL)-6,IL-8,and transforming growth factor-β(TGF-β)levels in lung tissues were detected by enzyme-linked immunosorbent assay,and superoxide dismutase(SOD),glutathione peroxidase(GSH-Px),and malondialdehyde(MDA)were detected using appropriate kits.Toll-like receptor 4(TLR4)/nuclear factor-κB(NF-κB)inflammatory signaling pathways were detected by real-time polymerase chain reaction,and TANK-binding kinase 1(TBK1)/interferon regulatory factor(IRF)signaling pathway proteins were detected by Western blot.Results Both Shanggan granules and oseltamivir phosphate reduced the lung wet weight(P＜0.05,P＜0.001)in mice infected with influenza virus H1N1 compared with the model group,decreased the infiltration of inflammatory cells in lung tissue,reduced levels of the inflammatory factors TNF-α,IL-6,IL-8,and TGF-β(P＜0.05,P＜0.01,P＜0.001),decreased levels of SOD and GSH-Px in lung tissue(P＜0.05,P＜0.01),and increased MDA levels(P＜0.05,P＜0.01).Shanggan granules and oseltamivir phosphate also reduced TLR4,MyD88,and p38 mRNA levels(P＜0.05,P＜0.01)and expression of TBK1/IRF3/7/NF-κB signaling pathway proteins(P＜0.05,P＜0.01,P＜0.001).Conclusions Shanggan granules may effectively reduce lung injury,lung inflammation,and oxidative stress,via a mechanism related to the down-regulation of TLR4/NF-κB inflammatory signaling pathways.

Objective:To explore the effect of persuasion system-based health intervention in orthodontic patients treated with clear aligners.Methods:From January 2022 to December 2023, convenience sampling was used to select patients treated with clear aligners at the Department of Orthodontics in Affiliated Stomatological Hospital of Nanjing Medical University as participants. Patients admitted from January to December 2022 were included in the control group ( n=60), and those admitted from January to December 2023 were included in the observation group ( n=59). The control group received health guidance based on the theory of knowledge, attitude, and practice. Based on the control group, the observation group added health intervention with the assistance of a persuasion system. After one year of intervention, the oral care self-efficacy, enamel demineralization, periodontal health index (gingival index, plaque index, sulcus bleeding index, probing depth), and restart rate of both groups were evaluated. Results:After the intervention, the scores of the Self-efficacy Scale for Self-care in the observation group were higher than those in the control group, and the difference was statistically significant [ (71.03±1.97) vs. (57.82±2.58), P<0.01]. The enamel demineralization rate, periodontal health index (plaque index, gingival index, sulcus bleeding index, probing depth) score, and restart rate in observation group were all lower than those in control group ( P<0.05) . Conclusions:Persuasion system system-based health intervention can improve the oral care self-efficacy of orthodontic patients treated with clear aligners, alleviate oral health issues during clear aligners, and reduce the restart rate of clear aligner patients.