ObjectiveTo systematically compare the differential regulation of the maternal-fetal interface cell lineages and communication networks in the CBA/J×DBA/2 mouse model of recurrent pregnancy loss （RPL） by the two classic therapeutic methods-tonifying the kidney to stabilize the fetus and invigorating the spleen to stabilize the fetus （Shoutai Wan， Juyuan Jian）-of traditional Chinese medicine （TCM） at the single-cell resolution and clarify their modern scientific connotations. MethodsFemale non-pregnant CBA/J mice were caged with male BALB/c （blank group） and DBA/2 （modeling group） mice separately. Pregnant mice in the modeling group were randomly grouped as follows： high/low-dose Shoutai Wan， high/low-dose Juyuan Jian， model （RPL）， and positive control （dydrogesterone）， with 10 mice in each group. Starting from the day after the detection of the vaginal plug， mice were administrated with drugs or an equal volume of normal saline by gavage for 10 consecutive days. After the intervention， the following indicators were measured. ① Macroscopic evaluation： general conditions， uterine wet weight， embryo loss rate， four coagulation parameters ［prothrombin time （PT）， activated partial thromboplastin time （APTT）， fibrinogen （FIB）， and thrombin time （TT）］， and peripheral blood estradiol （E₂） and progesterone （Pg） levels. The decidua with embryos was stained with hematoxylin-eosin （HE） and evaluated by transmission electron microscopy （TEM）. The expression of B-cell lymphoma-2 （Bcl-2）， vascular endothelial growth factor （VEGF）， angiotensin Ⅱ （AngⅡ）， matrix metalloproteinase-2 （MMP-2）， interleukin-6 （IL-6）， leukemia inhibitory factor （LIF）， CXC chemokine ligand 12 （CXCL12）， and microtubule-associated protein 1 light chain 3 homolog （LC3）Ⅰ/Ⅱ was quantified by Western blot. ② Mechanism analysis at the single-cell level： The decidua with embryos from the blank， model， high-dose Shoutai Wan， and high-dose Juyuan Jian groups （6 mice per group， with 3 single-cell samples per group， totaling 24 mice） were analyzed by the BD Rhapsody™ platform， and the whole-cell atlas was drawn by uniform manifold approximation and projection （UMAP） dimensionality reduction clustering combined with the single-cell mouse cell atlas （scMCA）. The differentially expressed genes （DEGs） and cell interaction networks were analyzed via Gene Ontology （GO）， Kyoto Encyclopedia of Genes and Genomes （KEGG）， and CellChat， and the protein-protein interaction （PPI） map of subtype cells was constructed. The CytoTRACE pseudo-temporal analysis was performed to explore the developmental trajectories of core immune cells （natural killer cells， NK cells） from maternal and fetal sources. Results① Pathological and Western blot results indicated that compared with the blank group， the RPL group showed an increase in the embryo loss rate （P<0.01）， down-regulated expression of Bcl-2， LIF， MMP-2， and Vegf in the decidua with embryos （P<0.05）， up-regulated protein levels of CXCL-12， AngⅡ， and IL-6 （P<0.05）， blocked angiogenesis， apoptosis-inflammation imbalance， and coagulation dysfunction. Both prescriptions dose-dependently reduced the abortion rate and restored the angiogenesis-inflammation balance， and Shoutai pill showed superior performance in restoring the E₂ level to the Pg level （P<0.05）. ② Single-cell transcriptome analysis indicated that compared with the blank group， the RPL group showed differences in multiple key cell populations such as decidual cells， trophoblast cells， endothelial cells， erythroblasts， NK cells， and macrophages at the maternal-fetal interface. Immunity and angiogenesis were the key links in RPL. Compared with the RPL group， high-dose Shoutai Wan reversed the changes of NK cells in the embryonic layer （upregulating the mRNA levels of 17 genes and downregulating the mRNA levels of 29 genes） and macrophages （upregulating the mRNA levels of 117 genes and downregulating the mRNA levels of 53 genes） through the regulation of gene expression. High-dose Shoutai pill regulated the immune cells to affect unfolded proteins， cell adhesion， and programmed cell death， thereby promoting decidualization and angiogenesis and modulating embryo-membrane development. High-dose Juyuan Jian regulated the key subgroups of NK cells （up-regulating the mRNA levels of 9 genes and down-regulating the mRNA levels of 17 genes） and macrophages （up-regulating the mRNA levels of 110 genes and down-regulating the mRNA levels of 81 genes）， which affected decidual inflammation and apoptosis and intervened in glycolysis. ③ The pseudo-temporal analysis and communication network indicated that the communication frequency of the RPL group decreased. High-dose Shoutai Wan restored maternal-fetal tolerance through pathways such as NKG2D， CDH5， GDF， and FASLG. High-dose Juyuan Jian enhanced the IL-6/LIFR/JAK/signal transducer and activator of transcription 3 （STAT3） and desmosome/SEMA6/tumor necrosis factor-like weak inducer of apoptosis （TWEAK） signaling to improve endometrial receptivity. The RPL group showed an increased proportion of toxic dNK7， a decreased proportion of reparative dNK4， and blocked embryo fNK1. High-dose Shoutai Wan down-regulated dNK7 and up-regulated dNK4. High-dose Juyuan Jian inhibited the terminal differentiation of dNK7 and up-regulated LILRB1， thus restoring the balance of cytotoxicity and repair. ConclusionBoth the kidney-tonifying and spleen-invigorating methods are effective in treating RPL. NK and macrophages are the key immune cells in the interaction between the embryo and the membrane. The kidney-tonifying method （Shoutai Wan） has an advantage in regulating the phenotypes of unfolded protein， cell adhesion， and programmed cell death， and shows expression characteristics closer to the physiological state in the regulation of NKG2D and CDH5 signals. The spleen-invigorating method （Juyuan Jian） has an advantage in regulating epithelial-mesenchymal transition （EMT）， angiogenesis， and glycolysis and shows higher communication intensity in the IL-6 and LIFR pathways.

With the increasing emphasis on patient-centered care and psychosocial support in modern healthcare systems,the role of medical social workers has evolved from auxiliary support to comprehensive participation.They serve as crucial liaisons for the healthcare service,delivering humanistic care for patients.Specially,their service has extended beyond traditional psycho-social counseling and doctor-patient communication to encompass whole-course care,community resource coordination,and pa-tient empowerment across multiple domains.As policies promoting humanistic healthcare and holistic well-being are progressively implemented,the scope of work for medical social workers has deepened and broadened in terms of role positioning and service demands.However,they also encounter significant challenges,including role ambiguity,interprofessional collaboration barriers,and insufficient institutional support mechanisms.To address these challenges,enhanced interprofessional education,evidence-based practice implementation,and policy-driven mechanisms are essential for strengthening their clinical competencies,delinea-ting professional boundaries,and optimizing resource allocation.These synergistic approaches collectively reinforce medical social workers'integral role in advancing humanistic care models while elevating their professional stature within the evolving healthcare ecosystem.

By reconstructing the integrated Chinese and western medicine diagnostic and treatment system， the "Two Reconstructions" theoretical framework establishes a standardized pathway of "classification-staging-syndrome differentiation"， which improves the accuracy of disease identification and strengthens the capacity for full-course intervention； in addition， by reconstructing the modern materia medica system， it innovatively integrates the traditional properties and efficacy of Chinese herbal medicinals with modern pharmacological mechanisms， forming a "state-target co-regulation" precise medication model， and builds a dose-effect theoretical system for prescriptions and medicinals， thereby enhancing both the targeting accuracy and dosage precision of therapeutic interventions. The "Two Reconstructions" theorecitcal framework is a key strategy for enhancing clinical efficacy. It can precisely identify "states" and "targets" for directed intervention， shift the focus of prevention and treatment earlier to enable full-cycle management， establish standardized paradigms for reproducible and evaluable efficacy， and expand the scope of clinical practice to address conditions without typical syndromes and critical illnesses. As a systematic pathway for innovation in TCM， this theoretical framework provides valuable insights and references for promoting the high-quality development of integrative Chinese and western medicine.

BACKGROUND:The pathogenesis of inflammatory bowel disease involves inflammation,immune activation,visceral hypersensitivity,and dysbiosis of the gut microbiota.Inflammation promotes the release of inflammatory mediators by immune cells,damaging the enteric nervous system.Enteric glial cells are an important component of the intestinal nervous system and are excellent cells for studying intestinal neuroinflammation.Primary enteric glial cells play a crucial role in exploring cell therapies for intestinal nervous system diseases.Currently,the methods for obtaining these cells are mostly cumbersome.Therefore,finding a convenient and fast method for extracting this cell is crucial.OBJECTIVE:To establish a method for optimizing the isolation,culture,and identification of mouse enteric glial cells.METHODS:0-7-day-old C57BL/6 neonatal mice were euthanized by excessive inhalation of isoflurane.After soaking in 75％alcohol for disinfection,the duodenum(1 cm below the pylorus to 1 cm above the Qu's ligament)was removed by laparotomy at the midline of the abdomen.A 1 mL syringe was filled with DPBS and the intestinal contents were repeatedly rinsed until the intestine became translucent,and the mesentery and blood vessels were peeled off.The duodenum was cut to a size of 1 mm and digested in 0.25％EDTA trypsin for 20 minutes.Then an equal amount of DMEM/F12 complete culture medium was added to terminate digestion.The liquid was filtered through a 100 μm cell filter,centrifuged,and the cells were resuspended in 1 mL of DMEM/F12 complete culture medium.When the cell adhesion growth density reached 80％,cells were digested for subculture.When cells were cultured to the third generation,glial fibrillary acid protein labeled with enteric glial cells was used for identification by immunofluorescence method.RESULTS AND CONCLUSION:The isolated and cultured cells were full of colloids,with protrusions extending outward and passable.Glial fibrillary acid protein staining was positive.This method can successfully isolate and culture enteric glial cells and is easy to operate,providing a stable model for the study of the pathophysiology of the enteric nervous system.

Objective To establish normal reference values for the sensory organization test(SOT)for flight crews of different ages from 20 to 50 years old,and to investigate the effect of age on the results of the SOT.Meth-ods A total of 122 flight crew members were divided into three groups of 20～29(n=57),30～39(n=44),and 40～50 years old(n=21).The EquiTest Dynamic Balance System was applied to test the SOT of 122 flight crew members.Equilibrium score,composite equilibrium score,the sensory weighting score of somatosensory,visual,vestibular,and visual preference,the strategy analysis scores,and the center of gravity alignment under six condi-tions were analyzed.Results The equilibrium scores for conditions 1 to 6 were 94.41±1.47,93.27±1.96,92.57±2.74,85.01±5.43,70.62±7.23,and 69.08±7.84,respectively,and the composite equilibrium score was 81.31±3.38.The sensory weighting scores of somatosensory,visual,vestibular,and visual preference were 98.97±2.08,89.57±5.14,73.89±7.95,and 98.84±5.78,respectively.The strategy analysis scores for conditions 1 to 6 were 95.57±1.23,94.87±1.58,93.93±5.12,88.21±4.01,79.49±7.90,and 80.55±6.57,respectively.There were significant differences in equilibrium score and somatosensory sensory weighting scores for condition 2 across age groups in this study,and the differences in other parameters between age groups were not statistically significant.Conclusion This study establishes normal reference values of SOT for flight crews of different ages to provide an objective reference for the selection of flight cadets and the medical evaluation of flight crews'sensory organization ability of balance function.

Objective To investigate extended high-frequency hearing in young adults and to analyse its char-acteristics.Methods A total of 230 freshmen(101 males and 129 females,aged 17-19 years old)from the class of 2023 at the Air Force Medical University underwent audiometric tests,including acoustic impedance,conventional frequency and extended high-frequency audiometry,and distortion product otoacoustic emissions(DPOAE).Ac-cording to the results of extended high-frequency audiometry,the students were divided into normal and abnormal groups,and the hearing thresholds at conventional frequencies were compared between the two groups.Results Of the 230 students,47.83％(110/230)showed abnormal extended high-frequency hearing.The hearing thresholds of the right ear were 1 to 3 dB higher than those of the left ear at most frequencies.The hearing thresholds of the ab-normal group were higher than those of the normal group in the conventional frequencies(P＜0.05).The difference in extended high-frequency thresholds between the two groups increased with higher frequency.Conclusion Ex-tended high-frequency hearing loss occurs earlier,and has a higher prevalence in young adults,and right ear hearing is worse than that of left ear.Extended high-frequency audiometry can be used as a predictive tool for detecting con-ventional frequency hearing loss.

Objective To investigate extended high-frequency hearing in young adults and to analyse its char-acteristics.Methods A total of 230 freshmen(101 males and 129 females,aged 17-19 years old)from the class of 2023 at the Air Force Medical University underwent audiometric tests,including acoustic impedance,conventional frequency and extended high-frequency audiometry,and distortion product otoacoustic emissions(DPOAE).Ac-cording to the results of extended high-frequency audiometry,the students were divided into normal and abnormal groups,and the hearing thresholds at conventional frequencies were compared between the two groups.Results Of the 230 students,47.83％(110/230)showed abnormal extended high-frequency hearing.The hearing thresholds of the right ear were 1 to 3 dB higher than those of the left ear at most frequencies.The hearing thresholds of the ab-normal group were higher than those of the normal group in the conventional frequencies(P＜0.05).The difference in extended high-frequency thresholds between the two groups increased with higher frequency.Conclusion Ex-tended high-frequency hearing loss occurs earlier,and has a higher prevalence in young adults,and right ear hearing is worse than that of left ear.Extended high-frequency audiometry can be used as a predictive tool for detecting con-ventional frequency hearing loss.

Objective To establish normal reference values for the sensory organization test(SOT)for flight crews of different ages from 20 to 50 years old,and to investigate the effect of age on the results of the SOT.Meth-ods A total of 122 flight crew members were divided into three groups of 20～29(n=57),30～39(n=44),and 40～50 years old(n=21).The EquiTest Dynamic Balance System was applied to test the SOT of 122 flight crew members.Equilibrium score,composite equilibrium score,the sensory weighting score of somatosensory,visual,vestibular,and visual preference,the strategy analysis scores,and the center of gravity alignment under six condi-tions were analyzed.Results The equilibrium scores for conditions 1 to 6 were 94.41±1.47,93.27±1.96,92.57±2.74,85.01±5.43,70.62±7.23,and 69.08±7.84,respectively,and the composite equilibrium score was 81.31±3.38.The sensory weighting scores of somatosensory,visual,vestibular,and visual preference were 98.97±2.08,89.57±5.14,73.89±7.95,and 98.84±5.78,respectively.The strategy analysis scores for conditions 1 to 6 were 95.57±1.23,94.87±1.58,93.93±5.12,88.21±4.01,79.49±7.90,and 80.55±6.57,respectively.There were significant differences in equilibrium score and somatosensory sensory weighting scores for condition 2 across age groups in this study,and the differences in other parameters between age groups were not statistically significant.Conclusion This study establishes normal reference values of SOT for flight crews of different ages to provide an objective reference for the selection of flight cadets and the medical evaluation of flight crews'sensory organization ability of balance function.

BACKGROUND:The pathogenesis of inflammatory bowel disease involves inflammation,immune activation,visceral hypersensitivity,and dysbiosis of the gut microbiota.Inflammation promotes the release of inflammatory mediators by immune cells,damaging the enteric nervous system.Enteric glial cells are an important component of the intestinal nervous system and are excellent cells for studying intestinal neuroinflammation.Primary enteric glial cells play a crucial role in exploring cell therapies for intestinal nervous system diseases.Currently,the methods for obtaining these cells are mostly cumbersome.Therefore,finding a convenient and fast method for extracting this cell is crucial.OBJECTIVE:To establish a method for optimizing the isolation,culture,and identification of mouse enteric glial cells.METHODS:0-7-day-old C57BL/6 neonatal mice were euthanized by excessive inhalation of isoflurane.After soaking in 75％alcohol for disinfection,the duodenum(1 cm below the pylorus to 1 cm above the Qu's ligament)was removed by laparotomy at the midline of the abdomen.A 1 mL syringe was filled with DPBS and the intestinal contents were repeatedly rinsed until the intestine became translucent,and the mesentery and blood vessels were peeled off.The duodenum was cut to a size of 1 mm and digested in 0.25％EDTA trypsin for 20 minutes.Then an equal amount of DMEM/F12 complete culture medium was added to terminate digestion.The liquid was filtered through a 100 μm cell filter,centrifuged,and the cells were resuspended in 1 mL of DMEM/F12 complete culture medium.When the cell adhesion growth density reached 80％,cells were digested for subculture.When cells were cultured to the third generation,glial fibrillary acid protein labeled with enteric glial cells was used for identification by immunofluorescence method.RESULTS AND CONCLUSION:The isolated and cultured cells were full of colloids,with protrusions extending outward and passable.Glial fibrillary acid protein staining was positive.This method can successfully isolate and culture enteric glial cells and is easy to operate,providing a stable model for the study of the pathophysiology of the enteric nervous system.

With the increasing emphasis on patient-centered care and psychosocial support in modern healthcare systems,the role of medical social workers has evolved from auxiliary support to comprehensive participation.They serve as crucial liaisons for the healthcare service,delivering humanistic care for patients.Specially,their service has extended beyond traditional psycho-social counseling and doctor-patient communication to encompass whole-course care,community resource coordination,and pa-tient empowerment across multiple domains.As policies promoting humanistic healthcare and holistic well-being are progressively implemented,the scope of work for medical social workers has deepened and broadened in terms of role positioning and service demands.However,they also encounter significant challenges,including role ambiguity,interprofessional collaboration barriers,and insufficient institutional support mechanisms.To address these challenges,enhanced interprofessional education,evidence-based practice implementation,and policy-driven mechanisms are essential for strengthening their clinical competencies,delinea-ting professional boundaries,and optimizing resource allocation.These synergistic approaches collectively reinforce medical social workers'integral role in advancing humanistic care models while elevating their professional stature within the evolving healthcare ecosystem.