As the core vehicle for preserving and transmitting traditional Chinese medicine（TCM） academic thought and clinical experience， the establishment of a robust quality evaluation system for TCM clinical case reports is a crucial component in the current standardization and modernization of TCM. Based on the practical experience of constructing the China Clinical Cases Library of Traditional Chinese Medicine by the China Association of Chinese Medicine， this study conducted a comprehensive analysis of critical challenges， including insufficient authenticity and unfocused evaluation criteria. It proposed a three-dimensional evaluation framework grounded in the structure-process-outcome logic， encompassing three dimensions of authenticity and standardization， characteristics and advantages， application and translational impact. This framework integrated 12 key evaluation indicators in a systematic manner. The model preserved the academic characteristics of TCM syndrome differentiation and treatment， while aligning with modern scientific research standards， achieving a balance between individualized TCM experience and standardized evaluation. Concurrently， this study provided theoretical foundations and methodological guidance for evaluating the quality of TCM clinical cases， contributing significantly to the inheritance of TCM knowledge， evidence-based practice， and the reform of talent evaluation mechanisms.

China emerges as a major country in nuclear energy development and the application of nuclear and radiologic technology. The diagnosis and treatment of acute radiation syndrom (ARS) caused by external irradiation represent a core function in the country′s medical rescue of nuclear and radiological emergencies. Clinically, ARS manifests hematopoietic, gastrointestinal, cutaneous, and central nervous system syndromes, with specific clinical manifestations, signs, severity, and prognosis strongly correlated with radiation dose. China has established a number of national and provincial centers for treating radiation-induced damage. Nevertheless, most medical staff have limited experience in ARS treatment. This consensus presents a summary of recent experience in treating ARS of China. In combination with recommendations from international organizations such as the World Health Organization (WHO), this consensus proposes key evidence of critical clinical issues of ARS, covering all links in the rescue of external irradiation-induced ARS. Initially, clinical diagnosis, syndromes, and severe degrees should be determined based on clinical symptoms and dose estimates. It is necessary to normalize clinical treatment measures for hematopoietic recovery, gastrointestinal injury treatment, infection control, symptomatic treatment, and multi-organ function preservation. To this end, this consensus offers cautions. This consensus provides principles of treatment with traditional Chinese medicine, psychological intervention, and follow-up. Additionally, it highlights multidisciplinary collaboration. It is recommended that this consensus be applied in relevant treatment centers.

China emerges as a major country in nuclear energy development and the application of nuclear and radiologic technology. The diagnosis and treatment of acute radiation syndrom (ARS) caused by external irradiation represent a core function in the country′s medical rescue of nuclear and radiological emergencies. Clinically, ARS manifests hematopoietic, gastrointestinal, cutaneous, and central nervous system syndromes, with specific clinical manifestations, signs, severity, and prognosis strongly correlated with radiation dose. China has established a number of national and provincial centers for treating radiation-induced damage. Nevertheless, most medical staff have limited experience in ARS treatment. This consensus presents a summary of recent experience in treating ARS of China. In combination with recommendations from international organizations such as the World Health Organization (WHO), this consensus proposes key evidence of critical clinical issues of ARS, covering all links in the rescue of external irradiation-induced ARS. Initially, clinical diagnosis, syndromes, and severe degrees should be determined based on clinical symptoms and dose estimates. It is necessary to normalize clinical treatment measures for hematopoietic recovery, gastrointestinal injury treatment, infection control, symptomatic treatment, and multi-organ function preservation. To this end, this consensus offers cautions. This consensus provides principles of treatment with traditional Chinese medicine, psychological intervention, and follow-up. Additionally, it highlights multidisciplinary collaboration. It is recommended that this consensus be applied in relevant treatment centers.

Transient receptor potential vanilloid 1 is a non-selective cation channel, which is sensitive to heat, acidic environment and capsaicin. It is widely expressed in sensory neurons and various other tissues, and is closely associated with the development of several orthopedic disorders. Knee osteoarthritis (KOA) is a common degenerative joint disease characterized by articular cartilage degeneration, synovial inflammation and subchondral bone remodeling. In recent years, with the deepening of research, it has been found that Transient receptor potential vanilloid receptor 1 (TRPV1) plays an important role in the pathophysiological process of KOA, affecting the progression of the disease by regulating pain transmission, inflammatory response, ferroptosis of chondrocytes, bone homeostasis and other mechanisms. In recent years, by targeting the TRPV1 channel to maintain the homeostasis of the joint environment, certain breakthroughs have been made in the relief of symptoms and the prevention and treatment of KOA, showing a good application prospect. This review outlines the mechanisms and regulatory pathways of TRPV1 and discusses its roles in chondrocytes, synovial tissue, and subchondral bone, as well as its pathological relevance in the development of KOA. It further summarizes current strategies for targeting TRPV1 in KOA therapy and the progress of related therapeutic interventions. The aim of this study is to expand the treatment of knee osteoarthritis and provide new treatment ideas and strategies for KOA patients.

Objective:To investigate the clinical, cytomorphology, immunocytochemical and molecular features of metastatic melanoma in serosal cavity effusion.Methods:Cytological specimens of 14 patients with melanoma in the chest and abdomen were collected from 2017 to 2023, at the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. SOX10, S-100 protein, PRAME, BRAF V600E, HMB45, and Melan A were detected by immunocytochemical methods. Fourteen cases were tested for routine antibody combinations, including Claudin4, HEG1, Calretinin, CD68, etc. Four of the patients had biopsy or surgical samples of metastatic solid lesions of primary sites, and further next-generation sequencing (NGS) or amplification refractory mutation system (ARMS)-PCR molecular test was performed. In addition, 30 cases of serosal effusion samples were collected as control groups (10 cases of benign mesothelial cell reactive hyperplasia, 10 cases of mesothelioma, and 10 cases of metastatic lung adenocarcinoma).Results:Among the 14 cases of melanoma, there were 7 males and 7 females, with ages ranging from 35 to 86 years, and an average age of 57 years, there 10 cases aged ≥50 years. The tumor cells in the serosal effusion varied in morphology and degree of atypia. SOX10 was positive in all 14 cases (14/14), S-100 protein was positive in 10 cases (10/14), PRAME was positive in 12 cases (12/14), BRAF V600E was positive in 10 cases (10/14), HMB45 was positive in 12 cases (12/14), and Melan A was positive in 13 cases (13/14). In 4 patients with histological correlation, the cytological and histological expression of SOX10, BRAF V600E, and PRAME was positive in all 4 cases (4/4); S-100 protein was positive in 2 cases (2/4); and HMB45 and Melan A were positive in 3 cases (3/4). Using NGS or ARMS-PCR, missense mutations of BRAF V600E were detected in all 4 patients; TERT promoter mutations was detected in 1 case; and CDKN2A terminating mutations and MSI1 deletion mutations were detected in the other case. SOX10, S-100, HMB45, Melan A, PRAME and BRAF V600E were all negative in 30 control samples of serosal cavity effusion.Conclusion:By observing the morphology of tumor cells, immunocytochemical test of several combination markers, especially the expression of SOX10, BRAF V600E and PRAME, can help to improve the positive diagnosis rate of melanoma in serous cavity effusion.

Objective:To evaluate the efficacy of the 45 mg 13C-urea breath test ( 13C-UBT) in the detection of Helicobacter pylori ( H. pylori) infection in adults. Methods:From November 1 to December 18 2021, a total of 255 patients who did 13C-UBT and gastroscopy examination in Wenzhou Central Hospital were recruited. The 13C-UBT was carried out with 45 mg 13C urea tablets by using BreathID, HY-50, and YH-08 H. pylori analyzers, respectively. During gastroscopy, 2 pieces of gastric mucosa tissues were taken from the adjacent part (< 1 cm) of gastric antrum and corpus for the urease test and histopathological examination (the gold standard), and the results were compared with those of 13C-UBT tests. The area under the curve (AUC) of the receiver operating characteristic curve (ROC) was used to evaluate the diagnostic efficacy of the three 13C-UBT analyzers for the detection of H. pylori infection. Kappa consistency test was used to evaluate the consistency of three detection methods. Results:A total of 237 subjects were included in this study. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of BreathID in diagnosing H. pylori infection were 95.34%, 92.91%, 98.96%, 0.992 and 0.905, respectively; the accuracy, sensitivity, specificity, positive predictive value and negative predictive value of HY-50 in diagnosing H. pylori infection were 94.51%, 90.78%, 100.00%, 1.000 and 0.881, respectively; the accuracy, sensitivity, specificity, positive predictive value and negative predictive value of HY-08 in diagnosing H. pylori infection were 91.98%, 91.49%, 92.71%, 0.948 and 0.881, respectively. The Kappa coefficients of the detection values of BreathID, HY-50, and YH-08 analyzers were 0.905, 0.889 and 0.835, respectively. The results of ROC showed that the Yoden indexes of BreathID, HY-50 and YH-08 analyzers were 0.919, 0.908 and 0.842, respectively, and the AUC values were 0.995, 0.993 and 0.969, respectively. Based on the Youden index, when using 45 mg 13C-urea tablets, the optimal preset cut-off values of BreathID, HY-50, and YH-08 with the best accuracy and authenticity in diagnosing H. pylori infection were 3.850, 3.965, and 3.350, respectively. Conclusions:The 45 mg 13C-UBT can achieve satisfactory detection accuracy and specificity for the detection of H. pylori infection in adults. It is recommended to set the cut-off value as an interval range, which can effectively improve the detection accuracy.

Objective:To evaluate the efficacy of the 45 mg 13C-urea breath test ( 13C-UBT) in the detection of Helicobacter pylori ( H. pylori) infection in adults. Methods:From November 1 to December 18 2021, a total of 255 patients who did 13C-UBT and gastroscopy examination in Wenzhou Central Hospital were recruited. The 13C-UBT was carried out with 45 mg 13C urea tablets by using BreathID, HY-50, and YH-08 H. pylori analyzers, respectively. During gastroscopy, 2 pieces of gastric mucosa tissues were taken from the adjacent part (< 1 cm) of gastric antrum and corpus for the urease test and histopathological examination (the gold standard), and the results were compared with those of 13C-UBT tests. The area under the curve (AUC) of the receiver operating characteristic curve (ROC) was used to evaluate the diagnostic efficacy of the three 13C-UBT analyzers for the detection of H. pylori infection. Kappa consistency test was used to evaluate the consistency of three detection methods. Results:A total of 237 subjects were included in this study. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of BreathID in diagnosing H. pylori infection were 95.34%, 92.91%, 98.96%, 0.992 and 0.905, respectively; the accuracy, sensitivity, specificity, positive predictive value and negative predictive value of HY-50 in diagnosing H. pylori infection were 94.51%, 90.78%, 100.00%, 1.000 and 0.881, respectively; the accuracy, sensitivity, specificity, positive predictive value and negative predictive value of HY-08 in diagnosing H. pylori infection were 91.98%, 91.49%, 92.71%, 0.948 and 0.881, respectively. The Kappa coefficients of the detection values of BreathID, HY-50, and YH-08 analyzers were 0.905, 0.889 and 0.835, respectively. The results of ROC showed that the Yoden indexes of BreathID, HY-50 and YH-08 analyzers were 0.919, 0.908 and 0.842, respectively, and the AUC values were 0.995, 0.993 and 0.969, respectively. Based on the Youden index, when using 45 mg 13C-urea tablets, the optimal preset cut-off values of BreathID, HY-50, and YH-08 with the best accuracy and authenticity in diagnosing H. pylori infection were 3.850, 3.965, and 3.350, respectively. Conclusions:The 45 mg 13C-UBT can achieve satisfactory detection accuracy and specificity for the detection of H. pylori infection in adults. It is recommended to set the cut-off value as an interval range, which can effectively improve the detection accuracy.

【Objective】 To study the annual financial expenditure in blood stations with different scales, and to establish the regression equation between blood collection units and total expenditure. 【Methods】 The annual total expenditure, the per capita cost of serving population, as well as the collection units of whole blood and apheresis platelet of 24 blood stations were collected. The financial expenditure required for collecting 10 000U blood was calculated.The statistical analysis was carried out with SPSS statistical software. 【Results】 From 2017 to 2020, the total annual financial expenditure of 24 blood stations showed an upward trend. The total expenditure among blood stations was different. The per capita cost of servicing population in the areas where the 24 blood stations were located had been increasing year by year. The 24 blood stations were divided into two grades according to the blood collection volume as 50 000 U, and the relationship equation between the blood collection volume and the annual total expenditure had been established. After testing, each equation was effective(P<0.05); There was no difference in the financial expenditure required for collecting 10 000U blood among blood stations with different scales. 【Conclusion】 From 2017 to 2020, the blood stations with an annual collection volume more than 50 000 U demonstrated a higher financial expenditure and the per capita cost of serving population than those <50 000 U. The blood collection volume of blood stations is significantly correlated with the annual total expenditure and the per capita cost of serving population.

Interleukin-27 (IL-27), a heterodimeric cytokine, plays a protective role in diabetes. Ghrelin, a gastric hormone, provides a hunger signal to the central nervous system to stimulate food intake. The relationship between IL-27 and ghrelin is still unexplored. Here we investigated that signal transducer and activator of transcription 3 (STAT3)-mechanistic target of rapamycin (mTOR) signaling mediates the suppression of ghrelin induced by IL-27. Co-localization of interleukin 27 receptor subunit alpha (WSX-1) and ghrelin was observed in mouse and human gastric mucosa. Intracerebroventricular injection of IL-27 markedly suppressed ghrelin synthesis and secretion while stimulating STAT3-mTOR signaling in both C57BL/6J mice and high-fat diet-induced-obese mice. IL-27 inhibited the production of ghrelin in mHypoE-N42 cells. Inhibition of mTOR activity induced by siRNA or rapamycin blocked the suppression of ghrelin production induced by IL-27 in mHypoE-N42 cells. siRNA also abolished the inhibitory effect of IL-27 on ghrelin. IL-27 increased the interaction between STAT3 and mTOR in mHypoE-N42 cells. In conclusion, IL-27 suppresses ghrelin production through the STAT3-mTOR dependent mechanism.

OBJECTIVE: To assess the effect of CPAP therapy on sleep quality and quality of life in patients with moderate or severe OSAHS. METHOD: Seventy-two patients diagnosed as OSAHS by polysomnography (PSG) were assigned to receive CPAP therapy for 3 months. At baseline and three months after treatment patients underwent polysomnography (PSG). Analyze the results of PSG, sleep quality, excessive daytime sleepiness, quality of life and the general well-being. RESULT: The lowest average oxygen saturation and the average blood oxygen saturation improved significantly after CPAP therapy, and the longest sleep apnea time and AHI decreased obviously (P < 0.01). Except body pain, the other seven dimensions of SF-36 improved obviously (P < 0.01); ESS, PSQI and GWB also improved (P < 0.05). CONCLUSION For patients with moderate or severe OSAHS, CPAP therapy can obviously improve the sleep quality, excessive daytime sleepiness, improve patients' life quality and the general well-being.
Continuous Positive Airway Pressure ; Humans ; Oximetry ; Polysomnography ; Quality of Life ; Sleep Apnea, Obstructive ; therapy