Infectious diseases occur and evolve through a dynamic contest between pathogenic qi and the body's healthy qi， with marked stage-dependent progression. This paper constructs a whole-course system of syndrome differentiation and treatment based on the theories of "struggle between pathogenic qi and healthy qi" and "relapse due to overexertion after recovery". The former reveals the intrinsic link between the waxing and waning of pathogenic and healthy qi and the evolution of syndromes， guiding stratified interventions during acute stage by discerning the location and nature of pathogenic factors and determining appropriate strategies for eliminating pathogens and supporting healthy qi according to the dynamics of deficiency and excess syndromes. The latter focuses on the recovery stage after infection and disease relapse， emphasizing harmonizing yin， yang， qi and blood to restore functions of zang-fu （脏腑） organs， and combining unblocking， tonifying， and turbidity-dispelling methods to eliminate both new and lingering pathogens. Throughout the whole-course treatment， attention should be paid to dynamic pathogenesis and stage-to-stage coherence， with emphasis on formula-syndrome correspondence， and integration of modern diagnostic and therapeutic measures， to construct individualized strategies bridging disease stages and integrating prevention with treatment， thereby systematically leveraging the integrative strengths of traditional Chinese medicine in the prevention and treatment of infectious diseases.

Infectious diseases occur and evolve through a dynamic contest between pathogenic qi and the body's healthy qi， with marked stage-dependent progression. This paper constructs a whole-course system of syndrome differentiation and treatment based on the theories of "struggle between pathogenic qi and healthy qi" and "relapse due to overexertion after recovery". The former reveals the intrinsic link between the waxing and waning of pathogenic and healthy qi and the evolution of syndromes， guiding stratified interventions during acute stage by discerning the location and nature of pathogenic factors and determining appropriate strategies for eliminating pathogens and supporting healthy qi according to the dynamics of deficiency and excess syndromes. The latter focuses on the recovery stage after infection and disease relapse， emphasizing harmonizing yin， yang， qi and blood to restore functions of zang-fu （脏腑） organs， and combining unblocking， tonifying， and turbidity-dispelling methods to eliminate both new and lingering pathogens. Throughout the whole-course treatment， attention should be paid to dynamic pathogenesis and stage-to-stage coherence， with emphasis on formula-syndrome correspondence， and integration of modern diagnostic and therapeutic measures， to construct individualized strategies bridging disease stages and integrating prevention with treatment， thereby systematically leveraging the integrative strengths of traditional Chinese medicine in the prevention and treatment of infectious diseases.

Objective To explore the hearing characteristics and early screening methods of hearing loss in diabetes mellitus(DM)patients.Methods From September 2022 to November 2023,800 DM patients in the Department of Endocrinology in People's Liberation Army General Hospital of Southern Theater Command were enrolled.According to the results of electrical audiometry,they were divided into a normal hearing DM group(n=214)and a hearing loss group(n=586).Binary logistic regression was used to analyze the influencing factors of hearing loss in DM patients.Results Age,homeostasis model assessment of insulin resistance(HOMA-IR),serum creatinine(Scr),urinary albumin/creatinine ratio(UACR)DM duration,hearing loss value,and proportion of DPN,DR,DKD,hypertension,coronary heart disease,perceived hearing loss,DPOAE abnormality and ABR abnormality in hearing loss group was higher than that in normal hearing group(P<0.05).DBP,homeostasis model insulin sensitivity index and estimated glomerular filtration rate(eGFR)were lower than those in normal hearing group(P<0.05).Logistic regression analysis showed that DM duration(OR 0.987,95%CI 0.987～1.002,P=0.001),eGFR(OR 0.974,95%CI 0.964～0.983,P=0.000),and hypertension(OR 0.659,95%CI 0.443～0.980,P=0.040)and coronary heart disease(OR 0.488,95%CI 0.246～0.968,P=0.040)were the influencing factors of hearing loss in DM patients.Conclusions Hearing loss is the complications of DM and is related to factors such as the DM duration.Given the insidious onset of hearing loss,DM patients should undergo a combined hearing screening using multiple methods in the early stage.

Objective To explore the hearing characteristics and early screening methods of hearing loss in diabetes mellitus(DM)patients.Methods From September 2022 to November 2023,800 DM patients in the Department of Endocrinology in People's Liberation Army General Hospital of Southern Theater Command were enrolled.According to the results of electrical audiometry,they were divided into a normal hearing DM group(n=214)and a hearing loss group(n=586).Binary logistic regression was used to analyze the influencing factors of hearing loss in DM patients.Results Age,homeostasis model assessment of insulin resistance(HOMA-IR),serum creatinine(Scr),urinary albumin/creatinine ratio(UACR)DM duration,hearing loss value,and proportion of DPN,DR,DKD,hypertension,coronary heart disease,perceived hearing loss,DPOAE abnormality and ABR abnormality in hearing loss group was higher than that in normal hearing group(P<0.05).DBP,homeostasis model insulin sensitivity index and estimated glomerular filtration rate(eGFR)were lower than those in normal hearing group(P<0.05).Logistic regression analysis showed that DM duration(OR 0.987,95%CI 0.987～1.002,P=0.001),eGFR(OR 0.974,95%CI 0.964～0.983,P=0.000),and hypertension(OR 0.659,95%CI 0.443～0.980,P=0.040)and coronary heart disease(OR 0.488,95%CI 0.246～0.968,P=0.040)were the influencing factors of hearing loss in DM patients.Conclusions Hearing loss is the complications of DM and is related to factors such as the DM duration.Given the insidious onset of hearing loss,DM patients should undergo a combined hearing screening using multiple methods in the early stage.

OBJECTIVE: To investigate the effects of combined platelet-rich plasma (PRP) and arterial supercharging technique on the survival rate and functional restoration of cross-body region skin flaps in rabbits. METHODS: Twelve healthy 6-month-old New Zealand White rabbits were randomly assigned to 4 groups ( n=3): sham group, PRP group, anastomosis group, and combined treatment group. An axial skin flap with an area of 12 cm×6 cm on the inner side of the hind limbs of all animals were prepared, with the saphenous artery as the main blood supply. Following the ligation of both the proximal and distal ends of the saphenous artery across all groups, the sham group received no further intervention, the PRP group was subjected to PRP injection, the anastomosis group underwent in situ end-to-end anastomosis of the distal saphenous artery, and the combined treatment group received both in situ distal saphenous artery anastomosis and PRP administration. Flap survival was evaluated and recorded on postoperative days 1, 3, and 7, with survival rates calculated accordingly. On day 7, flap tissue samples were harvested for HE staining to assess basal tissue morphology. Additionally, immunohistochemical staining was conducted to detect the expression of α-smooth muscle actin (α-SMA), vascular endothelial growth factor (VEGF), and CD31 in the flap tissues. RESULTS: At postoperative day 1, no significant difference in flap survival rates were observed among the 4 groups ( P>0.05). At day 3, the PRP group showed no significant difference compared to the sham group ( P>0.05); however, both the anastomosis and combined treatment groups exhibited significantly higher survival rates than the sham group ( P<0.05), the combined treatment group further demonstrated superior survival rates compared to both the PRP and anastomosis groups ( P<0.05). At day 7, the combined treatment group maintained significantly higher survival rates than all other groups ( P<0.05), while both the PRP and anastomosis groups exceeded the sham group ( P<0.05). HE staining at day 7 revealed persistent inflammatory cell infiltration, sheet-like erythrocyte deposition, and disordered collagen fibers in the sham group. The PRP group showed nascent microvessel formation and early collagen reorganization, whereas the anastomosis group displayed mature microvasculature with resolved interstitial edema. The combined treatment group exhibited differentiated microvessels with densely packed collagen bundles. Immunohistochemical analysis at day 7 demonstrated significantly larger relative area percentages of α-SMA, VEGF, and CD31 positive cells in the combined treatment group compared to all other groups ( P<0.05). Both the PRP and anastomosis groups also showed significantly higher values than the sham group ( P<0.05). CONCLUSION The combination of PRP and arterial supercharging techniques significantly enhances flap healing, potentially through mechanisms involving augmented angiogenesis and improved blood supply.
Animals ; Rabbits ; Platelet-Rich Plasma ; Surgical Flaps/blood supply* ; Graft Survival ; Anastomosis, Surgical/methods* ; Ischemia/surgery* ; Arteries/surgery* ; Skin/blood supply* ; Vascular Endothelial Growth Factor A/metabolism* ; Male ; Skin Transplantation/methods*

OBJECTIVE: To investigate the antioxidant and osteogenic induction capabilities of calcium phosphate nanoflowers (hereinafter referred to as nanoflowers) in vitro at different concentrations. METHODS: Nanoflowers were prepared using gelatin, tripolyphosphate, and calcium chloride. Their morphology, microstructure, elemental composition and distribution, diameter, and molecular constitution were characterized using scanning electron microscopy, transmission electron microscopy, Fourier transform infrared spectroscopy, and energy-dispersive spectroscopy. Femurs and tibias were harvested from twelve 4-week-old Sprague Dawley rats, and bone marrow mesenchymal stem cells (BMSCs) were isolated and cultured using the whole bone marrow adherent method, followed by passaging. The third passage cells were identified as stem cells by flow cytometry and then co-cultured with nanoflowers at concentrations of 0, 0.4, 0.8, 1.2, 1.6, 2.0, 2.4, 2.8, 3.2, and 3.6 mg/mL. Cell counting kit 8 (CCK-8) assay was performed to screen for the optimal concentration that demonstrated the best cell viability, which was subsequently used as the experimental concentration for further studies. After co-culturing BMSCs with the screened concentration of nanoflowers, the biocompatibility of the nanoflowers was verified through live/dead cell staining, scratch assay, and cytoskeleton staining. The antioxidant capacity was assessed by using reactive oxygen species (ROS) fluorescence staining. The in vitro osteoinductive ability was evaluated via alkaline phosphatase (ALP) staining, alizarin red staining, and immunofluorescence staining of osteocalcin (OCN) and Runt-related transcription factor 2 (RUNX2). All the above indicators were compared with the control group of normally cultured BMSCs without the addition of nanoflowers. RESULTS: Scanning electron microscopy revealed that the prepared nanoflowers exhibited a flower-like structure; transmission electron microscopy scans discovered that the nanoflowers possessed a multi-layered structure, and high-magnification images displayed continuous atomic arrangements, with the nanoflower diameter measuring (2.00±0.25) μm; energy-dispersive spectroscopy indicated that the nanoflowers contained elements such as C, N, O, P, and Ca, which were uniformly distributed across the flower region; Fourier transform infrared spectroscopy analyzed the absorption peaks of each component, demonstrating the successful preparation of the nanoflowers. Through CCK-8 screening, the concentrations of 0.8, 1.2, and 1.6 mg/mL were selected for subsequent experiments. The live/dead cell staining showed that nanoflowers at different concentrations exhibited good cell compatibility, with the 1.2 mg/mL concentration being the best (P<0.05). The scratch assay results indicated that the cell migration ability in the 1.2 mg/mL group was superior to the other groups (P<0.05). The cytoskeleton staining revealed that the cell morphology was well-extended in all concentration groups, with no significant difference compared to the control group. The ROS fluorescence staining demonstrated that the ROS fluorescence in all concentration groups decreased compared to the control group after lipopolysaccharide induction (P<0.05), with the 1.2 mg/mL group showing the weakest fluorescence. The ALP staining showed blue-purple nodular deposits around the cells in all groups, with the 1.2 mg/mL group being significantly more prominent. The alizarin red staining displayed orange-red mineralized nodules around the cells in all groups, with the 1.2 mg/mL group having more and denser nodules. The immunofluorescence staining revealed that the expressions of RUNX2 and OCN proteins in all concentration groups increased compared to the control group, with the 1.2 mg/mL group showing the strongest protein expression (P<0.05). CONCLUSION The study successfully prepares nanoflowers, among which the 1.2 mg/mL nanoflowers exhibits excellent cell compatibility, antioxidant properties, and osteogenic induction capability, demonstrating their potential as an artificial bone substitute material.
Animals ; Osteogenesis/drug effects* ; Mesenchymal Stem Cells/drug effects* ; Calcium Phosphates/pharmacology* ; Rats, Sprague-Dawley ; Rats ; Antioxidants/chemistry* ; Cells, Cultured ; Cell Differentiation/drug effects* ; Nanostructures/chemistry* ; Tissue Engineering/methods* ; Bone Marrow Cells/cytology* ; Coculture Techniques ; Tissue Scaffolds/chemistry* ; Male ; Biocompatible Materials/chemistry* ; Cell Survival ; Core Binding Factor Alpha 1 Subunit/metabolism* ; Cell Proliferation

Long-term burden of illness and associated medication usage make osteoporosis(OP) a common complication of respiratory diseases. The pathogenic risk factors and treatment strategies for respiratory diseases related OP are similar to primary OP. However, due to differences in the pathogenesis of each disease, there are distinctions in the characteristics of bone loss and treatment approaches. Therefore, targeted diagnostic and therapeutic plans need to be formulated. This article provides a comprehensive review of secondary OP caused by common respiratory diseases in terms of epidemiological characteristics, related risk factors or possible mechanisms, changes in bone metabolic indexes or characteristics of bone damage, and progress in diagnosis and treatment. The aim of this review is to offer insights into the prevention and treatment of secondary OP related to respiratory diseases and promote the development of a multidisciplinary collaborative approach.

Objective:To investigate the correlation between hearing loss and microvascular complications in diabetes.Methods:This cross-sectional study conducted the data from 572 patients with diabetes hospitalized in the Endocrinology Department of the General Hospital of Southern Theater Command from September 2022 to July 2023. All participants underwent electrical audiometry and acoustic immittance in the ENY department. Based on the audiometric results, participants were categorized into normal hearing group and hearing loss group. Additionally, 572 non-diabetic patients from the outpatient department were enrolled as the non-diabetic group. The general information and laboratory results were collected and compared using t test, rank sum test or χ2 test. Binary logistic regression analysis was used to evaluate the association of diabetic hearing loss with diabetic kidney disease(DKD), diabetic retinopathy (DR), and diabetic peripheral neuropathy (DPN). Results:Among 572 patients with diabetes, 429 suffered from hearing loss and 143 were normal. χ2 test showed significant differences in combined DKD and DPN between two groups, but not in DR. Multivariate binary logistic regression analysis identified DKD and DPN as risk factors for hearing loss, but no correlation was found with DR. Conclusion:Diabetic patients with DKD or DPN should be monitored for potential hearing loss. Early screening and treatment are crucial to prevent severe hearing impairment.

Objective To explore the impacts of compensatory function of the anterior communicating artery(ACoA)on the measurement of blood flow velocity and the degree of stenosis of the non-operative carotid artery in patients with bilateral carotid atherosclerotic stenosis.Methods A total of 161 patients with carotid artery stenosis and the ACoA patency,who underwent unilateral carotid endarterectomy(CEA)from January 2019 to January 2021,were enrolled into this study.Examination was performed using transcranial color-coded Doppler(TCCD)and(or)transcranial Doppler ultrasound(TCD)and confirmed by DSA and(or)CT angiography(CTA).According to whether the ACoA compensation was complete,all patients were divided into complete ACoA group(69 cases)and incomplete ACoA group(92 cases).The peak systolic velocity(PSV)and end-diastolic velocity(EDV)measured by the carotid ultrasound were compared between the complete ACoA group and the incomplete ACoA group before and after CEA.In addition,the results of stenosis degree of non-operative carotid artery evaluated by the ultrasound and DSA or CTA were analysed for the consistency.Results There was no significant difference in age,gender and risk factors for cerebrovascular disease between the two groups(all P＞0.05).Within 1 week after CEA,the PSV([107±35]cm/s,[122±40]cm/s)and EDV([37±12]cm/s,[47±16]cm/s)of the nonoperative carotid artery decreased significantly when compared with those before CEA in both complete and incomplete ACoA patent groups(PSV[177±58]cm/s,[163±54]cm/s and EDV[64±21]cm/s,[76±25]cm/s,all P＜0.01).In the complete ACoA group,the stenosis degrees of non-operative carotid arteries assessed by the CDU were inconsistent with that assessed by the DSA or CTA(Kappa=0.074).Of the 58 patients with mild stenosis assessed by DSA or CTA,55(94.8％)were overestimated as moderate stenosis,and 2(3.4％)were overestimated as severe stenosis.Of the 9 patients with moderate stenosis assessed by DSA or CTA,8 had ultrasound overestimation to severe stenosis.In the incomplete ACoA group,it was highly consistent with that assessed by the DSA or CTA(Kappa=0.920).Of 70 patients with mild stenosis assessed by DSA or CTA,2 cases(2.9％)were overestimated as moderate stenosis by ultrasound.Of the 9 patients with moderate stenosis assessed by DSA or CTA,1 was overestimated by ultrasound to be severe stenosis.Conclusion Non-operative carotid artery PSV and EDV were significantly higher in patients with bilateral carotid artery stenosis with patency and complete compensatory function of ACoA,leading to overestimation the degree of carotid artery stenosis.

OBJECTIVE In the context of the era of innovation and entrepreneurship, the training model of pharmaceutical talents is facing challenges. In order to cultivate overall development of pharmaceutical innovative talents, an in-depth research is carried out from multiple perspectives such as education orientation, education mode and education team. METHODS The research systematically analyzed the concept, system, orientation, channels, plan and cooperation of pharmaceutical talent training to build a new cultivation mechanism which adapts to the national strategic adjustments and social situation changes. RESULTS The research summarized the ideas and formulated a model for cultivating innovative application-oriented pharmaceutical talents which was guided by ideological and political education, oriented towards real issues in the industrial, scientific, and clinical sectors. It emphasized multi-chain collaboration, integrating high-quality resources to promote the enhancement of original innovation capabilities. CONCLUSION The research not only provides experience for the training of pharmaceutical innovative talents in the College of Pharmaceutical Sciences of Zhejiang University, but also provides references for the training of pharmaceutical talents in other universities in China.