To explore the advantages of traditional Chinese medicine （TCM） and integrative TCM-Western medicine approaches in the treatment of diabetic microvascular complications （DMC）， refine key pathophysiological insights and treatment principles， and promote academic innovation and strategic research planning in the prevention and treatment of DMC. The 38th session of the Expert Salon on Diseases Responding Specifically to Traditional Chinese Medicine， hosted by the China Association of Chinese Medicine， was held in Beijing， 2024. Experts in TCM， Western medicine， and interdisciplinary fields convened to conduct a systematic discussion on the pathogenesis， diagnostic and treatment challenges， and mechanism research related to DMC， ultimately forming a consensus on key directions. Four major research recommendations were proposed. The first is addressing clinical bottlenecks in the prevention and control of DMC by optimizing TCM-based evidence evaluation systems. The second is refining TCM core pathogenesis across DMC stages and establishing corresponding "disease-pattern-time" framework. The third is innovating mechanism research strategies to facilitate a shift from holistic regulation to targeted intervention in TCM. The fourth is advancing interdisciplinary collaboration to enhance the role of TCM in new drug development， research prioritization， and guideline formulation. TCM and integrative approaches offer distinct advantages in managing DMC. With a focus on the diseases responding specifically to TCM， strengthening evidence-based support and mechanism interpretation and promoting the integration of clinical care and research innovation will provide strong momentum for the modernization of TCM and the advancement of national health strategies.

Background Kurtosis reflecting noise's temporal structure is an effective metric for evaluating noise-induced hearing loss (NIHL), and its threshold is still unclear. Objective To explore the energy range of kurtosis and the threshold of NIHL induced by kurtosis in this energy rangeMethods Using cross-sectional design, 4631 noise-exposed workers in manufacturing industry were selected. The hearing loss and noise exposure data of each worker were collected. Logistic regression model was used to establish the dose-response relationship between noise exposure and hearing loss and estimate the range of energy effects. Restricted cubic spline model was utilized to analyze the dose-response relationship curves of kurtosis to noise-induced hearing loss (NIHI) and high-frequency noise-induced hearing loss (HFNIHL) under different 8 h equivalent sound levels (L_{EX,8 h}), as well as to estimate the kurtosis effect threshold. Results The logistic regression model analysis showed that the prevalence of NIHI and HFNIHL increased significantly with increase of L_{EX,8 h} for steady noise; when L_{EX,8 h} of non-steady noise was 80-100 dB(A), the risk of hearing loss increased with an increase in kurtosis (P<0.05). The restricted cubic spline model showed that when L_{EX,8 h} of non-steady noise was 0-80 dB(A) or >100 dB(A), there was no significant relationship between kurtosis and NIHI or HFNIHL. When L_{EX,8 h} was 80-100 dB(A), there was a significant nonlinear dose-response relationship between kurtosis and NIHL or HFNIHL (P <0.001), and kurtosis > 28.08 exerted effect in elevating NIHI or HFNIHL. Conclusion The effect threshold of kurtosis on NIHL is 28.08 when non-steady noise levels are in the range of 80-100 dB(A). The effect threshold of kurtosis needs further verification.

Food-derived bioactive peptides (FBPs), particularly those with ten or fewer amino acid residues and a molecular weight below 1300 Da, have gained increasing attention for their safe, diverse structures and specific biological activities. The development of FBP-based functional foods and potential medications depends on understanding their structure‒activity relationships (SARs), stability, and bioavailability properties. In this review, we provide an in-depth overview of the roles of FBPs in treating various diseases, including Alzheimer's disease, hypertension, type 2 diabetes mellitus, liver diseases, and inflammatory bowel diseases, based on the literature from July 2017 to Mar. 2023. Subsequently, attention is directed toward elucidating the associations between the bioactivities and structural characteristics (e.g., molecular weight and the presence of specific amino acids within sequences and compositions) of FBPs. We also discuss in silico approaches for FBP screening and their limitations. Finally, we summarize recent advancements in formulation techniques to improve the bioavailability of FBPs in the food industry, thereby contributing to healthcare applications.
Humans ; Peptides/therapeutic use* ; Structure-Activity Relationship ; Functional Food ; Diabetes Mellitus, Type 2/drug therapy* ; Biological Availability ; Alzheimer Disease/drug therapy* ; Inflammatory Bowel Diseases/drug therapy* ; Hypertension/drug therapy* ; Liver Diseases/drug therapy* ; Bioactive Peptides, Dietary

Human naïve pluripotent stem cells (PSCs) hold great promise for embryonic development studies. Existing induction and culture strategies for these cells, heavily dependent on MEK inhibitors, lead to widespread DNA hypomethylation, aberrant imprinting loss, and genomic instability during extended culture. Here, employing high-content analysis alongside a bifluorescence reporter system indicative of human naïve pluripotency, we screened over 1,600 chemicals and identified seven promising candidates. From these, we developed four optimized media-LAY, LADY, LUDY, and LKPY-that effectively induce and sustain PSCs in the naïve state. Notably, cells reset or cultured in these media, especially in the LAY system, demonstrate improved genome-wide DNA methylation status closely resembling that of pre-implantation counterparts, with partially restored imprinting and significantly enhanced genomic stability. Overall, our study contributes advancements to naïve pluripotency induction and long-term maintenance, providing insights for further applications of naïve PSCs.
Humans ; DNA Methylation/drug effects* ; Genomic Instability ; Pluripotent Stem Cells/metabolism* ; Cell Culture Techniques/methods* ; Cells, Cultured

Objective:To evaluate the clinical value of sacral canal posterior wall reconstruction in the treatment of symptomatic sacral canal cysts.Methods:A retrospective cohort study was conducted.The clinical data of 80 patients with symptomatic sacral cysts who underwent surgical treatment at Beijing Friendship Hospital, Capital Medical University, between June 2018 and September 2024 were collected. There were 19 males and 61 females, with an average age of (49.0±11.3) years (ranged from 23-76 years). The patients were divided into the traditional group ( n=30) and the reconstruction group ( n=50) based on the surgical approach. The traditional group underwent the conventional surgical method without reconstruction of the posterior wall of the sacral canal, while the reconstruction group underwent posterior wall reconstruction of the sacral canal. Postoperative observations included the integrity of the sacral canal posterior wall, wound healing, and symptom improvement in both groups. Measurement data with normal distribution were expressed as mean±standard deviation( ± s). Independent samples t-test was used for comparisons of measurement data between groups. Categorical data were compared using the chi-square test or Fisher′s exact test. Ordinal data were analyzed using the Mann-Whitney U test. Pearson correlation analysis was used to assess the relationship between variables. Results:Among the 80 patients, the sacral bone integrity score in the reconstruction group was (1.42±0.49) scores, compared to (3.00±0.00) scores in the traditional group, the reconstruction group showed significantly better results ( P<0.05). Symptom improvement was also significantly different between the two groups ( P=0.038): in the traditional group, 17 patients experienced complete symptom resolution, 6 partial improvement, 7 no improvement, and 0 worsening; in the reconstruction group, 37 had complete symptom resolution, 11 partial improvement, 2 no improvement, and 0 worsening. The effective improvement rate (complete+ partial improvement) in the reconstruction group was significantly better than that in the traditional group ( P=0.012). In terms of wound healing, 76 cases healed well, 4 had delayed healing, and 0 had infections. In the traditional group, 27 healed well, 3 had delayed healing, 0 infections; in the reconstruction group, 49 healed well, 1 had delayed healing, and 0 infections. There was no significant difference in wound healing rate between the two groups ( P=0.146). A significant positive correlation was found between sacral canal posterior wall integrity and symptom improvement ( r=0.288, P=0.010). Conclusion:Sacral canal posterior wall reconstruction significantly improves postoperative anatomical integrity and clinical outcomes without increasing complications, supporting its adoption as a preferred surgical approach for symptomatic sacral canal cysts.

Objective:To investigate the relationship between parent-child relationship and depression from a parent-adolescent dyadic perspective, as well as the mediating effect of self-compassion in their relationship.Methods:In May 2023, a total of 210 pairs of adolescents and their parents from two middle schools in Weifang, Shandong were tested with parent-child closeness scale (PCCS), self-compassion scale short form (SCSSF) and patient health questionnaire (PHQ-9). Descriptive statistics and correlation analysis were performed using SPSS 25.0 software. Mplus 8.3 software was used to test the mediating effect of self-compassion between parent-child relationship and depression by constructing actor-partner interdependence model and actor-partner interdependence mediation model.Results:(1) Adolescents' parent-child relationship (34.81±7.07) was positively correlated with adolescents' self-compassion (43.55±7.66), parental parent-child relationship (36.89±5.92), and parental self-compassion (44.30±6.41) ( r=0.427, 0.215, 0.178, all P<0.01), while negatively correlated with adolescents' depression (12.15±4.37) ( r=-0.375, P<0.05) and parental depression (11.87±4.07) ( r=-0.166, P<0.05). Adolescents' self-compassion was positively correlated with parental parent-child relationship and parental self-compassion ( r=0.179, 0.276, both P<0.01), while negatively correlated with adolescents' depression and parental depression ( r=-0.515, -0.194, both P<0.01). Adolescents' depression was negatively correlated with parental self-compassion ( r=-0.227, P<0.01), while positively correlated with parental depression ( r=0.147, P<0.05). Parental parent-child relationship was positively correlated with adolescents' self-compassion ( r=0.583, P<0.01). Parental depression was negatively correlated with parental parent-child relationship and parental self-compassion ( r=-0.342, -0.377, both P<0.01). (2)Actor-partner interdependence analysis between parent-child relationship and depression showed that adolescents' and parental parent-child relationship negatively predicted their own depression ( β=-0.396, -0.395, both P<0.001), and the actor effects were significant. Both adolescents' and parental parent-child relationship negatively predicted each other's depression ( β=-0.211, -0.223, both P<0.01), and the partner effects were significant. (3)The actor-partner interdependence mediating analysis of self-compassion between parent-child relationship and depression showed that self-compassion played a mediating effect between parent-child relationship and depression in both adolescents and their parents (effect value=-0.190, -0.052, -0.256, -0.019), accounting for 49.48% (-0.190/-0.384), 13.54% (-0.052/-0.384), 61.54% (-0.256/-0.416) and 4.57% (-0.019/-0.416) of the total effect, respectively, which indicated that the actor mediating effects of adolescents and their parents were both significant. Adolescents' and parental self-compassion played mediating effects between adolescents' parent-child relationship and parental depression (effect value=-0.072, -0.067), accounting for 35.29% (-0.072/-0.204) and 32.84% (-0.067/-0.204) of the total effect. Similarly, adolescents' and parental self-compassion played mediating effects between parental parent-child relationship and adolescents' depression (effect value=-0.050, -0.200), accounting for 17.48% (-0.050/-0.286) and 69.93% (-0.200/-0.286) of the total effect, which indicated significant partner mediating effects were both significant. Conclusion:The parent-child relationship of both adolescents and their parents can not only directly influence the depression levels of both parties, but can also indirectly influence depression through the self-compassion of both the adolescents and their parents.

Objective:To investigate the relationship between parent-child relationship and depression from a parent-adolescent dyadic perspective, as well as the mediating effect of self-compassion in their relationship.Methods:In May 2023, a total of 210 pairs of adolescents and their parents from two middle schools in Weifang, Shandong were tested with parent-child closeness scale (PCCS), self-compassion scale short form (SCSSF) and patient health questionnaire (PHQ-9). Descriptive statistics and correlation analysis were performed using SPSS 25.0 software. Mplus 8.3 software was used to test the mediating effect of self-compassion between parent-child relationship and depression by constructing actor-partner interdependence model and actor-partner interdependence mediation model.Results:(1) Adolescents' parent-child relationship (34.81±7.07) was positively correlated with adolescents' self-compassion (43.55±7.66), parental parent-child relationship (36.89±5.92), and parental self-compassion (44.30±6.41) ( r=0.427, 0.215, 0.178, all P<0.01), while negatively correlated with adolescents' depression (12.15±4.37) ( r=-0.375, P<0.05) and parental depression (11.87±4.07) ( r=-0.166, P<0.05). Adolescents' self-compassion was positively correlated with parental parent-child relationship and parental self-compassion ( r=0.179, 0.276, both P<0.01), while negatively correlated with adolescents' depression and parental depression ( r=-0.515, -0.194, both P<0.01). Adolescents' depression was negatively correlated with parental self-compassion ( r=-0.227, P<0.01), while positively correlated with parental depression ( r=0.147, P<0.05). Parental parent-child relationship was positively correlated with adolescents' self-compassion ( r=0.583, P<0.01). Parental depression was negatively correlated with parental parent-child relationship and parental self-compassion ( r=-0.342, -0.377, both P<0.01). (2)Actor-partner interdependence analysis between parent-child relationship and depression showed that adolescents' and parental parent-child relationship negatively predicted their own depression ( β=-0.396, -0.395, both P<0.001), and the actor effects were significant. Both adolescents' and parental parent-child relationship negatively predicted each other's depression ( β=-0.211, -0.223, both P<0.01), and the partner effects were significant. (3)The actor-partner interdependence mediating analysis of self-compassion between parent-child relationship and depression showed that self-compassion played a mediating effect between parent-child relationship and depression in both adolescents and their parents (effect value=-0.190, -0.052, -0.256, -0.019), accounting for 49.48% (-0.190/-0.384), 13.54% (-0.052/-0.384), 61.54% (-0.256/-0.416) and 4.57% (-0.019/-0.416) of the total effect, respectively, which indicated that the actor mediating effects of adolescents and their parents were both significant. Adolescents' and parental self-compassion played mediating effects between adolescents' parent-child relationship and parental depression (effect value=-0.072, -0.067), accounting for 35.29% (-0.072/-0.204) and 32.84% (-0.067/-0.204) of the total effect. Similarly, adolescents' and parental self-compassion played mediating effects between parental parent-child relationship and adolescents' depression (effect value=-0.050, -0.200), accounting for 17.48% (-0.050/-0.286) and 69.93% (-0.200/-0.286) of the total effect, which indicated significant partner mediating effects were both significant. Conclusion:The parent-child relationship of both adolescents and their parents can not only directly influence the depression levels of both parties, but can also indirectly influence depression through the self-compassion of both the adolescents and their parents.

Objective:To investigate the effect of intraoperative protection of the supraclavicular nerve on the healing of clavicular 1/3 mid-shaft fracture.Methods:A retrospective study was conducted to analyze the 83 patients who had been treated for clavicular 1/3 mid-shaft fractures at Department of Orthopaedics, The First Central Hospital of Baoding from June 2021 to March 2022. There were 57 males and 26 females with an age of (48.1±12.8) years. The patients were divided into 2 groups according to whether the supraclavicular nerve was protected or not during operation. There were 39 cases in the observation group (the supraclavicular nerve was protected during operation) and 44 cases in the control group (the supraclavicular nerve was not protected during operation). The incision length, operation time, intraoperative blood loss, hospital stay, visual analogue scale (VAS) pain scores before operation and 3, 6 and 12 months after operation, fracture healing at 3, 6 and 12 months after operation, and postoperative complications were recorded and compared between the 2 groups. Additionally, the number of microvessels in the middle clavicle was recorded and compared between the affected and healthy sides in 8 patients in the observation group at 6 weeks after operation.Results:There was no significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). The operation time for the observation group [(72.2±5.4) min] was significantly longer than that for the control group [(61.1±4.7) min]. The VAS scores at postoperative 3 and 6 months for the observation group [2.7 (2.4, 3.1) and 2.1 (1.9, 2.6) points] were significantly lower than those for the control group [3.5 (3.2, 3.8) and 2.7 (2.4, 2.9) points] ( P<0.05). The fracture healing rates at postoperative 3 and 6 months in the observation group [97.4% (38/39) and 100% (39/39)] were significantly higher than those in the control group [81.8% (36/44) and 86.4% (38/44)] ( P<0.05), but there was no significant difference in the fracture healing between the 2 groups at 12 months after operation ( P>0.05). At 6 weeks after operation, the number of microvessels in the middle clavicle was respectively 85.3±0.7 and 87.1±0.8 in the 8 patients in the observation group, showing no significant difference ( P>0.05). After operation, delayed incision healing occurred in 3 cases in the observation group and in 4 cases in the control group, and abnormal sensation of the skin around the incision occurred in 9 cases in the observation group and in 26 cases in the control group, showing a significant difference between the 2 groups ( P<0.05). Conclusion:Intraoperative protection of the supra-clavicular nerve is beneficial for reduction of early postoperative pain and improvement of early fracture healing, and may have a positive effect on the postoperative reconstruction of microvascular network.

Objective:To compare the positioning errors in tracing the body surface markers between radiotherapy placement with or without using the laser positioning coordination system in post-breast conservative surgery patients, and to verify the clinical value of the laser positioning coordination system.Methods:A total of 45 post-breast-conservative surgery patients who underwent radiotherapy in Department of Radiation Oncology of the Affiliated Hospital of Inner Mongolia Medical University from January 2022 to September 2023 were prospectively collected. In the experimental group 1 ( n=15), the initial version of the laser positioning coordination system was employed to trace the body surface markers. In the experimental group 2 ( n=15), the upgraded version of the laser positioning coordination system was adopted to draw the body surface markers. In the control group ( n=15), the body surface markers were traced with conventional approach. All patients were treated with spiral tomotherapy (TOMO), and the error values in the left and right directions ( X), head and foot directions ( Y), ventral and dorsal directions ( Z), and rotation angles (ROLL) before each radiotherapy were recorded. The differences in the positioning errors among the three groups were analyzed by t-test. Results:The positioning errors in the X, Y, Z directions and ROLL in the experimental group 1 were (3.10±2.43) mm, (4.36±3.45) mm, (2.29±2.49) mm and 0.95°±0.88°, and (2.88±2.28) mm, (3.58±2.95) mm, (2.40±2.54) mm, and 0.70°±0.70° in the experimental group 2, and (4.32±3.48) mm, (5.49±4.74) mm, (2.61±3.38) mm and 1.22°±1.16° in the control group, respectively. Statistical significance was observed in the differences of positioning errors in the X, Y directions and ROLL between the experimental group 1 and control group ( t=4.32, 2.89, 2.78, P < 0.001, =0.004, =0.006), respectively. Statistical significance was detected in the differences of positioning errors in the X, Y directions and ROLL between the experimental group 2 and control group ( t=5.20, 5.14, 5.82, all P<0.001). Statistical significance was noted in the differences of positioning errors in the Y direction and ROLL between the experimental group 1 and 2 ( t=2.58, 3.41, P=0.010, 0.001). Conclusion:The laser positioning coordination system-assisted tracing the body surface marking line can significantly reduce the positioning errors in the X and Y directions and ROLL, and the upgraded version of the laser positioning coordination system can further reduce the positioning errors in the Y direction and ROLL compared with the initial version, which is of high clinical application value.

Objective To investigate the current status and awareness of pharmaceutical services in hospitals in Guizhou province and to provide a reference for exploring and carrying out pharmaceutical service fees.Methods The questionnaire was designed by the"wjx.cn"website.Three kinds of questionnaires were designed for pharmacists,doctors,nurses,and patients as the research objects,with corresponding differences in some questions,and promoted on WeChat,Dingxiangyuan,and other network platforms.Results A total of 655 questionnaires were collected,and 639 valid questionnaires were recovered,with an effective recovery rate of 97.56%.324 pharmacists(50.70%),82 doctors and nurses(12.83%),233 patients(36.46%)were surveyed.The average approval score of these three groups of respondents on pharmaceutical service fees was 4.67,4.23,and 4.22,respectively(full score:5).Conclusions Overall,pharmacists'professional services have received support from medical staff and patients.However,patients'pharmaceutical service projects currently focus on dispensing services.The recognition of pharmacists'work and the public's awareness of pharmaceutical services can be improved by enhancing the professional ability of pharmacists,strengthening publicity and guidance,and exploring"Internet+pharmaceutical services",etc.,to promote the sustainable development of pharmaceutical services.