This study aims to review the current status and development trends of digital TCM (Traditional Chinese Medicine) specimen museums, providing a theoretical basis for their future construction. By systematically organizing literature and materials, practical experiences in platform architecture design, content planning, and technical implementation were summarized. The research results show that digital technology has significant application value in the TCM field. Currently, some Food and Drug Control Institutes have formed diverse construction achievements by integrating regional characteristics with technological innovation. However, current TCM specimen museums generally still face many challenges, such as insufficient digitalization. In conclusion, the digitalization of TCM specimen museums has become an inevitable trend in the industry. Targeted measures are urgently needed to solve existing problems and promote the sustainable development of digital TCM specimen museums. It is suggested to strengthen the standardization of data collection and storage, deepen the integration of technologies such as 3D, AR, and AI into the construction of specimen museums, and at the same time promote the spatial design combining regional culture with TCM. This will help create "one museum with one feature for one region" digital TCM specimen museums, further promoting their sustainable development and facilitating the digital inheritance of TCM.

Objective To analyze the occurrence status of low blood pressure (BP) in patients with refractory heart failure (RHF) and its relationship with comorbidities. Methods A retrospective analysis was conducted on the clinical data of 360 patients with RHF who were hospitalized in department of cardiology of Affiliated Nantong Hospital of Shanghai University from May 2021 to May 2025. These patients were divided into the RHF with BP group and the RHF group based on their blood pressure at admission. The general data and comorbidities were compared between both groups. Multivariate logistic regression analysis was used to identify the risk factors for coexisting BP. Results The heart rate (HR), N-terminal pro-B-type natriuretic peptide (NT-proBNP), blood urea nitrogen, high-sensitivity cardiac troponin T, right atrial diameter, proportion of cardiac function grade IV, use rate of diuretics and prevalence rate of dilated cardiomyopathy (DCM) in the RHF with BP group were higher while the high-density lipoprotein cholesterol (HDL-C), albumin, left ventricular ejection fraction, use rate of lipid-lowering drugs and prevalence rate of coronary heart disease were lower compared to the RHF group, and the differences were statistically significant (P<0.05). Multivariate logistic regression analysis suggested that increased HR (OR=1.685, 95%CI: 1.106-2.569), increased NT-proBNP (OR=1.772, 95%CI: 1.138-2.759), decreased HDL-C (OR=0.605, 95%CI: 0.400-0.917) and DCM (OR=1.956, 95%CI: 1.176-3.255) were independent risk factors affecting BP in RHF patients (P<0.05). Conclusion The incidence rate of low blood pressure in elderly RHF patients is about 19.17%. Increased heart rate, increased NT-proBNP, decreased HDL-C and dilated cardiomyopathy are closely linked to the occurrence of low blood pressure, and they can be used as clinically related factors to identify patients at high risk of low blood pressure.

Objective: To analyze the etiologic distribution of difficult crossmatching and the characteristics of red blood cell antibodies, to summarize compatible transfusion strategies based on serological abnormalities, and to evaluate red blood cell transfusion efficacy and changes in bilirubin levels before and after transfusion. Methods: A retrospective analysis was conducted on difficult crossmatching cases handled by the Department of Blood Transfusion of our hospital from January 2024 to December 2025. Cases that met the criteria for difficult crossmatching determination and had complete data were included in the analysis of the causes and antibody distribution. Patients who completed red blood cell transfusion and had complete hemoglobin (Hb) data before and within 24 hours after transfusion were included in the exploratory subgroup analysis of transfusion efficacy; among them, those who also had total bilirubin and indirect bilirubin data before and after the corresponding transfusion event were included in the bilirubin analysis. According to the main serological abnormal manifestations before transfusion and the actual compatible transfusion management pathways, the cases included in the exploratory subgroup analysis were divided into three groups: the alloantibody-related difficult crossmatching group, the autoantibody-related or autoantibody combined with alloantibody-related difficult crossmatching group, and the ABO blood group identification abnormality-related difficult crossmatching group. The Hb levels before and after transfusion, the Hb increase after transfusion of each unit of red blood cells, and the changes in bilirubin levels before and after transfusion were compared among the groups. Results: A total of 322 difficult crossmatching cases met the predefined criteria, of which 287 were included in the analysis of causes and antibody distribution. There were 183 cases of alloantibody-related difficult crossmatching (63.76%), 54 cases related to inconsistency between ABO forward and reverse typing (18.82%), 44 cases related to autoantibodies (15.33%), and 6 cases related to interference from anti-CD38 monoclonal antibody drugs (2.09%). Among the 183 alloantibody-related cases, 79 cases had only a single alloantibody detected, among which antibodies of the Rh blood group system accounted for 49.37% (39/79). Among single alloantibodies, anti-E was detected most frequently, with 35 cases (44.30%), followed by anti-M with 19 cases (24.05%) and anti-Le with 13 cases (16.46%). A total of 109 cases were included in the exploratory subgroup analysis of transfusion efficacy, including 76 cases in the alloantibodyrelated difficult crossmatching group, 17 cases in the autoantibody-related or autoantibody combined with alloantibody-related difficult crossmatching group, and 16 cases in the ABO blood group identification abnormality-related difficult crossmatching group. The sex distribution and history of previous transfusion differed between cases included in and not included in this analysis. The Hb levels after transfusion in all three groups were higher than those before transfusion, and the differences were statistically significant (P<0.05). The Hb increase per unit of red blood cells did not differ significantly among the three groups (P=0.086). Among 73 cases with paired total and indirect bilirubin data corresponding to the transfusion events, the comparison of changes in total bilirubin among the three groups showed no statistically significant difference (P=0.864), and the comparison of changes in indirect bilirubin among the three groups also showed no statistically significant difference (P=0.914). Conclusion: Alloantibody-related factors were the main causes of difficult crossmatching in this study. Among single alloantibodies, Rh blood group system antibodies, especially anti-E, were relatively common. In the included exploratory subgroup, after individualized compatible transfusion based on the causes of difficult crossmatching, antibody specificities, and crossmatching results, Hb levels were higher after transfusion than before transfusion in all three groups. Within the scope of this study, the magnitude of bilirubin changes did not differ significantly among the different types of difficult crossmatching.

Acute kidney injury（AKI）is defined as a clinical syndrome characterized by a rapid decline in renal function over a short period.Oxidative stress，inflammatory responses，and apoptosis play crucial roles in the pathogenesis and progression of AKI.Although symptomatic treatment and renal replacement therapies are widely used in clinical practice，effective therapeutic interventions remain limited.With the rapid advancement of nanotechnology，nanomaterials have demonstrated better potential for application in disease prevention，diagnosis，and treatment.Owing to their unique size effects，tunable surface properties，and excellent biocompatibility，nanomaterials hold great value for targeted drug delivery，anti-inflammatory，and antioxidative therapies，offering new advances in the treatment strategies of kidney diseases.This article summarizes the diagnostic and therapeutic applications of nanomaterials in AKI.

Objective:To report the nationwide surveillance results of pathogenic profiles and antimicrobial resistance patterns of Gram-positive bloodstream infections in China in 2023.Methods:The clinical isolates of Gram-posttive bacteria from blood cultures were collected in member hospitals of National Bloodstream Infection Bacterial Resistant Investigation Collaborative System（BRICS）during January to December 2023. Antimicrobial susceptibility testing was performed using the dilution method recommended by the Clinical and Laboratory Standards Institute（CLSI）. Statistical analyses were conducted using WHONET 5.6 and SPSS 25.0 software.Results:A total of 4 385 Gram-positive bacterial isolates were obtained from 60 participating center. The top five pathogens were Staphylococcus aureus（ n=1 544，35.2%），coagulase-negative Staphylococci（ n=1 441，32.9%）， Enterococcus faecium（ n=574，13.1%）， Enterococcus faecalis（ n=385，8.8%），and α-hemolytic Streptococci（ n=187，4.3%）. The prevalence of methicillin-resistant Staphylococcus aureus（MRSA）and methicillin-resistant coagulase-negative Staphylococci（MRCNS）was 26.2%（405/1 544）and 69.8%（1 006/1 441），respectively. Notably，all Staphylococci remained susceptible to glycopeptide or daptomycin. Staphylococcus aureus demonstrated excellent susceptibility（>97.0%）to cephalobiol，rifampicin，trimethoprim-sulfamethoxazole，linezolid，minocycline，tigecycline，and eravacycline. No Enterococcus exhibiting resistance to linezolid were detected. Glycopeptide resistance was uncommon but more frequent in Enterococcus faecium（resistance to vancomycin and teicoplanin：both 1.7%）compared to Enterococcus faecalis（both 0.3%）. The detection rates of MRSA and MRCNS exhibited significant regional variations across the country（ χ2=17.674 and 148.650，respectively，both P<0.001）. No vancomycin-resistant Enterococci were detected in central China. Institutional comparison demonstrated higher prevalence of MRSA（ χ2=14.111， P<0.001）and MRCNS（ χ2=4.828， P=0.028）in provincial hospitals than that in municipal hospitals. Socioeconomic analysis identified elevated detection rates of both MRSA（ χ2=18.986， P<0.001）and MRCNS（ χ2=4.477， P=0.034）in less developed regions（per capita GDP

Objective:To report the results of bacterial resistant investigation collaborative system（BRICS）on the distribution and antimicrobial resistance profile of clinical Gram-negative bacteria isolates from bloodstream infections in China in 2023，and provide reference for clinical tretment of bloodstream infections and prevention and control of bacterial resistance.Methods:The clinical isolates of Gram-negative bacteria from blood cultures in member hospitals of BRICS were collected during January 2023 to December 2023. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute（CLSI）. WHONET 5.6 and SPSS 25.0 were used to analyze the data.Results:During the study period，11 492 strains of Gram-negative bacteria were collected from 60 hospitals，of which 10 098（87.9%）were Enterobacterales and 1 394（12.1%）were non-fermentative bacteria. The top 5 bacterial species were Escherichia coli（50.0%）， Klebsiella pneumoniae（26.1%）， Pseudomonas aeruginosa（5.1%）， Acinetobacter baumannii complex（5.0%）and Enterobacter cloacae complex（4.1%）. The ESBL-producing rates in Escherichia coli， Klebsiella pneumoniae and Proteus mirablilis were 46.8%（2 685/5 741），18.3%（549/2 999）and 44.0%（77/175），respectively. The prevalence of carbapenem-resistant Escherichia coli（CREC）and carbapenem-resistant Klebsiella pneumoniae（CRKP）were 1.3%（76/5 741）and 15.0%（450/2 999）；32.9%（25/76）and 78.0%（351/450）of CREC and CRKP were sensitive to ceftazidime/avibactam combination，respectively. 94.7%（72/76）and 90.2%（406/450）of CREC and CRKP were sensitive to aztreonam/avibactam combination. Furthermore，57.9%（44/76）and 79.1%（356/450）were sensitive to imipenem/relebactam combination. The prevalence of carbapenem-resistant Acinetobacter baumannii（CRAB）complex was 64.6%（370/573），while more than 80.0% of CRAB complex was sensitive to tigecycline，eravacycline and polymyxin B. The prevalence of carbapenem-resistant Pseudomonas aeruginosa（CRPA）was 17.0%（99/581）. There were differences in the composition ratio of Gram-negative bacteria in bloodstream infections and the prevalence of important Gram-negative bacteria resistance among different regions in China，with statistically significant differences in the prevalence of CREC，CRKP，CRPA and CRAB complex（ χ2=10.6，28.6，10.8 and 19.3， P<0.05）. The prevalence of ESBL-producing Escherichia coli， CREC，CRAB complex and CRKP were higher in provincial hospitals than those in municipal hospitals（ χ2=12.5，9.8，12.7 and 57.8，all P<0.01）. Conclusions:Gram-negative bacteria are the main pathogens causing bloodstream infections in China，and Escherichia coli is ranked in the top，while the trend of Klebsiella pneumoniae increases continuously with time. CRKP infection shows a slow upward trend，CREC infecton maintains a low prevalence level，and CRAB complex infection continues to exhibit a high prevalence rate. The composition and resistance patterns of pathogens causing bloodstream infections vary to some extent across different regions and levels of hospitals in China.

Acute symptomatic osteoporotic thoracolumbar compression fracture (ASOTLF) can lead to chronic low back pain, kyphosis deformity, pulmonary dysfunction, loss of mobility, and even life-threatening complications. Vertebral augmentation is currently the mainstream treatment method for this condition. In 2019, the Editorial Board of Chinese Journal of Trauma and the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association collaboratively led the development of Clinical guideline for vertebral augmentation for acute symptomatic osteoporotic thoracolumbar compression fractures. Six years later, with advances in clinical diagnosis and treatment techniques as well as accumulating evidence in related fields, the 2019 guideline requires updating. To this end, the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association, the Spinal Health Professional Committee of China Human Health Science and Technology Promotion Association, and the Minimally Invasive Orthopedics Professional Committee of Shaanxi Medical Doctor Association have organized experts in the field to develop the Clinical guideline for vertebral augmentation of acute symptomatic osteoporotic thoracolumbar compression fractures ( version 2025) , based on the latest evidence-based medical researches. This guideline incorporates 3 recommendations retained from the 2019 version with updated strength of evidence, along with 12 new recommendations. It provides recommendations from six aspects of diagnosis, pain management, treatment option selection, prevention of postoperative complications, anti-osteoporosis therapy, and postoperative rehabilitation, aiming to provide a reference for standard treatment of vertebral augmentation for ASOTLF in hospitals at all levels.

Objective:To analyze the epidemiological characteristics of influenza-like illness（ILI）and the genetic evolutionary trends of the hemagglutinin（HA）and neuraminidase（NA）genes of influenza A（H3N2）viruses isolated in Baotou during the 2022-2023 influenza season.Methods:Etiological surveillance data for ILI cases in Baotou during the 2022-2023 influenza season were collected from the China Influenza Surveillance Information System. Descriptive statistical analysis was performed on the data. HA and NA genes of 30 influenza A（H3N2）viruses were sequenced. Amino acid variation sites，glycosylation sites，drug resistance genes，and phylogenetic trees were analyzed using MEGA 11 software and the NextClade online analysis tool.Results:A total of 1 443 ILI specimens were tested，of which 241（16.70%）were positive for influenza viruses. Among the positive cases，influenza A（H3N2）virus-positive cases accounted for 75.93%（183/241）. The nucleotide sequence similarity of the HA gene between the 30 influenza A（H3N2）isolates and the vaccine strains A/Hong Kong/2671/2019（H3N2），A/Cambodia/e0826260/2020（H3N2），and A/Darwin/9/2021（H3N2）ranged from 96.83% to 98.77%，while the amino acid sequence similarity ranged from 94.63% to 99.62%. A total of 14 amino acid variation sites and 11 conserved glycosylation sites were identified in the HA gene. For the NA gene，the nucleotide sequence similarity ranged from 98.37% to 99.65%，and the amino acid sequence similarity ranged from 94.64% to 98.28%. A total of three amino acid variation sites and nine conserved glycosylation sites were found in the NA gene. None of the 30 influenza A（H3N2）isolates had mutations associated with drug resistance，and all belonged to the clade 3C.2a1b.2a.2a.3a.1.Conclusions:During the 2022-2023 influenza season in Baotou，the circulating influenza A（H3N2）viruses belong to the same evolutionary clade as the 2021-2022 vaccine strain A/Cambodia/e0826360/2020（H3N2）. The isolates from different sources share a common evolutionary origin；however，variations are observed across the genome in terms of homology，molecular mutations，and glycosylation patterns.

Objective:To investigate the effects of oridonin on platelet function and related mechanisms.Methods:Washed platelets from healthy adults and mice were incubated with different concentrations of oridonin(2.5,5 and 10μmol/L)in vitro.The surface expression level of P-selectin and the activation of integrin αⅡbβ3 in platelets were detected by flow cytometry,and the aggregation ability of platelets under the stimulation by various agonists was detected by light transmission aggregometry.The expression of P-AKT(Ser473)was detected by protein immunoblotting.Arterial thrombosis model was established in mice with mesenteric injury induced by ferric chloride,and tail hemorrhage model was established by cutting off the tail of mice.The effect of intraperitoneal injection of oridonin(10 mg/kg)on thrombosis and haemostasis was tested.Results:Oridonin inhibited platelet P-selectin expression and integrin αⅡbβ3 activation.In the presence of different stimulants,oridonin inhibited platelet aggregation in a concentration-dependent manner.The phosphorylation level of AKT Ser473 was reduced in the groups treated with different concentrations of oridonin.Oridonin significantly prolonged the time of mesenteric artery thrombosis in mice,but did not affect the tail bleeding time.Conclusion:Oridonin inhibits platelet activation,aggregation,and thrombosis by inhibiting AKT phosphorylation,and may be used as a potential antiplatelet drug.

Aim To investigate the potential role and related mechanisms of protein phosphatase 2Cm(PP2Cm)overexpression in atorvastatin-induced insu-lin resistance.Methods Male C57BL/6J mice,fibro-blast growth factor 21 knockout(FGF21-KO)mice,and wildtype(WT)mice were raised for 12 weeks to construct models.Groups included atorvastatin,con-trol,atorvastatin+PP2Cm overexpression(OE),FGF21-KO+vehicle,FGF21-KO+PP2Cm OE,WT+vehicle,WT+PP2Cm OE.Body weight,fasting blood glucose levels,fasting insulin levels,and intraperitoneal glucose tolerance tests(IPGTT)were measured in 4,8 and 12 weeks.The concentrations of branched-chain a-mino acids(BCAA)in cells,tissues and serum,as well as the mRNA and protein expression of BCAA cat-abolic enzymes,were determined by qRT-PCR,Western blot and ELISA after atorvastatin treatment.Further-more,the effects of PP2Cm overexpression on these in-dicators were explored,and the FGF21 was verified in vivo and in vitro.Results Atorvastatin induced insu-lin resistance in mice,altered insulin,glucose tolerance and increased BCAA levels.PP2Cm overexpression mitigated these changes.In the Atorvastatin+PP2Cm OE group,FGF21 mRNA,protein and concentration were all significantly upregulated.Regardless of PP2Cm overexpression,the knockout of FGF21 signifi-cantly increased BCAA expression levels,both fasting insulin and blood glucose levels were significantly high-er than those in WT group.Conclusions FGF21 may be an important regulator of PP2Cm involved in atorv-astatin-induced insulin resistance.PP2Cm overexpres-sion alleviates the effects of atorvastatin-induced insulin resistance by regulating FGF21.