Objective To systematically analyze the disease burden, long-term trends, and age-sex distribution of major valvular heart disease (VHD) subtypes—rheumatic heart disease (RHD), non-rheumatic valvular disease (NRVD), and non-rheumatic calcific aortic valve disease (CAVD)—in global, Chinese, and US populations from 1990 to 2021, providing evidence for public health strategies and clinical resource allocation. Methods Based on publicly available data from the Global Burden of Disease (GBD) Study 2021, we extracted incidence, mortality, and disability-adjusted life years (DALYs) for VHD from 1990 to 2021. Age-standardized rates (ASRs) were calculated using the GBD 2021 global standard population, and the estimated annual percentage change (EAPC) with its 95% uncertainty interval (UI) was computed for the period. Data from the Agency for Healthcare Research and Quality (AHRQ), the European Society of Cardiology (ESC)/Eurostat surveys, and Chinese national registries were used for trend triangulation and contextual background. Results From 1990 to 2021, the ASR and disease burden of RHD significantly decreased globally and in China (EAPC for DALYs in China: −4.8%, 95%UI: −5.0% to −4.6%). In contrast, the burden of NRVD and CAVD steadily increased in aging populations like those in China and the US, with a higher burden observed in older adults and males. In 2021, the incidence of NRVD and CAVD peaked in individuals aged ≥65 years, with rates being significantly higher in men than in women. RHD burden was concentrated in low socio-demographic index (SDI) regions, whereas NRVD/CAVD burden was strongly associated with high-SDI regions. Conclusion The global VHD epidemiological landscape is transitioning from an RHD-dominant to an NRVD/CAVD-dominant pattern. China faces a dual challenge of a residual RHD burden and a rapidly growing burden of degenerative valvular diseases. Developing tailored screening, prevention, and treatment strategies for different disease subtypes and populations is crucial.

ObjectiveTo establish an objective evaluation system based on the quality characteristics of Gardeniae Fructus without relying on the origin label according to the theory of excellent shape， high quality， and superior effect of authentic medicinal materials， thus providing a scientific basis for the standardization of Gardeniae Fructus. MethodsDifferent batches of Gardeniae Fructus samples were collected from different producing areas. Through herbal textual research and a review of modern literature， fruit length， maximum fruit diameter， and chroma were selected as quantitative indicators to characterize the traditional appearance traits of Gardeniae Fructus. The above indicators were measured by a vernier caliper and a spectrophotometer. Through classical famous prescription data and literature analysis， total iridoid glycosides， total crocus glycosides， and total flavonoids were selected as the core component indicators related to efficacy， and their content was determined. Finally， through cluster analysis， the threshold ranges of the quantitative indicators of excellent shape and high quality were determined， and the applicability of the established evaluation system was verified by the determination of the indicators for each batch of medicinal materials. ResultsThe excellent shape indicators of Gardeniae Fructus were the fruit length-to-maximum fruit diameter ratio ≤1.86， 0°≤h≤45°， and L^*≥ 37.32. The content of total iridoid glycosides， total crocus glycosides， and total flavonoids should be no less than 2.2%， 0.44%， and 0.028%， respectively. The measurement results of different batches of Gardeniae Fructus showed that the evaluation system could effectively distinguish the Gardeniae Fructus samples in line with the traditional cognition of excellent shape and high quality. ConclusionThis study preliminarily constructs an excellent shape and high quality-based quality evaluation system for Gardeniae Fructus， which links appearance traits with chemical indicators and provides a methodological basis for the quality control and scientific grading of this herbal medicine.

Objective To analyze the global pattern, long-term trends, and regional and population heterogeneity in the burden of 375 diseases and injuries and 88 risk factors from 1990 to 2023 using data from the Global Burden of Disease Study 2023 (GBD 2023). Methods Publicly available GBD 2023 estimates were extracted for incidence, deaths, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life years (DALYs), and age-standardized rates at the global level and by socio-demographic index (SDI), GBD region, age group, and sex. Descriptive analysis, ranking comparison, stratified analysis, and trend analysis were performed, and 95% uncertainty interval was used to assess the stability of estimates. Results In 2023, non-communicable diseases were the leading contributor to global DALYs, accounting for 64.39% of DALYs across the three major disease and injury groups (communicable, maternal, neonatal, and nutritional diseases, non-communicable diseases, and injuries), and also had the highest age-standardized DALYs rate. From 1990 to 2023, age-standardized DALYs rates declined for three major disease and injury groups, with estimated annual percentage changes of −2.69%, −0.78%, and −1.47%, respectively. Cardiovascular diseases ranked first by both DALYs and deaths in 2023, whereas respiratory infections and tuberculosis ranked first by incidence. Non-communicable diseases were the leading cause of disease burden across all SDI strata. As the SDI level declined, the burden of communicable, maternal, neonatal, and nutritional diseases, as well as injuries, increased markedly. Behavioral and metabolic risks remained the main contributors to attributable deaths and DALYs. Conclusion From 1990 to 2023, the global burden of disease continues to shift toward non-communicable diseases; however, some regions still face a double burden of infectious, maternal and child, injury-related, and chronic diseases. Integrating deaths, DALYs, YLLs, YLDs, and risk-attributable burden helps identify priority areas for prevention and resource allocation across regions and populations.

Lung cancer is the malignant tumor with the highest morbidity and mortality worldwide. The number of cases and deaths in China also remains at a high level， posing a severe threat to human health. In recent years， although early diagnostic and therapeutic strategies for lung cancer have been continuously optimized， with clinical interventions mainly consisting of surgery， radiotherapy， chemotherapy， targeted therapy， and immunotherapy， the patient prognosis remains unsatisfactory. The core reason is that the mechanisms underlying lung cancer development and progression have not yet been fully elucidated. Therefore， delving into the molecular mechanisms and key regulatory nodes is of great significance for improving diagnostic and therapeutic outcomes. In recent years， traditional Chinese medicine （TCM） and its active components have demonstrated unique advantages and potential in the prevention and treatment of lung cancer through epigenetic regulation. Studies have confirmed that single herbs， compound formulas， and active components of TCM can exert anti-tumor effects by modulating epigenetic pathways such as DNA methylation， histone modification， and non-coding RNAs. These effects include inhibiting tumor cell proliferation， inducing apoptosis， reducing invasive and metastatic capacity， regulating the cell cycle， and modulating the tumor microenvironment， thereby blocking the initiation and progression of lung cancer. Furthermore， TCM shows significant advantages in enhancing the anti-tumor efficacy of chemotherapeutic agents and alleviating treatment-related adverse effects. However， the current research on TCM-based epigenetic regulation of lung cancer remains at a preliminary exploratory stage. Common limitations include the complexity of targets， a predominant focus on crude herbal extracts or single epigenetic modifications， and a lack of systematic elucidation of the synergistic effects among multiple epigenetic modifications and the regulatory networks involving multicellular interactions. This article reviews the epigenetic mechanisms involved in the development and progression of lung cancer and summarizes the basic and clinical research progress in TCM interventions， aiming to offer insights for further elucidating lung cancer pathogenesis and exploring TCM-based therapeutic strategies.

Viral pneumonia in the Lancang-Mekong River Basin exhibits distinct regional epidemiological characteristics and pathogenic mechanisms. Filthy dampness constitutes the core pathogenic factor of the disease here， and the core pathogenesis lies in the yang failing to be stored in the you （酉） position. Clinically， the fundamental therapeutic principle is established as boosting qi to expel filth and guiding yang qi to descend and converge into the you position. In the early stage， the pathogenesis is characterized by the pervasive diffusion of filthy dampness， yang qi floating externally and failing to be stored， and the lung failing to diffuse qi. The treatment focuses on invigorating yang qi to dispel filth and dredging the you pathways， primarily using modified Ganlu Xiaodu Decoction （甘露消毒丹）. In the progressive stage， the pathogenesis involves the tenacious stagnation of filthy dampness， yang constraint transforming into heat， and the rampant spread of heat-toxins. The therapeutic approach shifts to acrid medicinals for opening and bitter medicinals for promoting descent， rectifying healthy qi to expel filth， utilizing modified Dayuan Beverage （达原饮）. In the recovery stage， filthy dampness gradually recedes， accompanied by the depletion of qi and yin， and insufficient kidney yang. The treatment emphasizes supplementing qi and nourishing yin， accompanied by warming yang， with modified Yunv Decoction （玉女煎）.

Objective To investigate the correlation between the clinical characteristics of allergic rhinitis(AR)in adults located in Shenzhen area and the traditional Chinese medicine(TCM)constitutions.Methods A cross-sectional survey of adult AR patients in Shenzhen was conducted.From June 2022 to December 2023,adult AR patients admitted to the Department of Otolaryngology outpatient clinic of Bao'an Traditional Chinese Medicine Hospital Affiliated to Guangzhou University of Chinese Medicine(Shenzhen Bao'an District Hospital of Traditional Chinese Medicine)were selected as the study subjects.The clinical baseline data,Total Nasal Symptoms Score(TNSS),and Total Non-Nasal Symptoms Score(TNNSS)of the patients were collected for the analysis of clinical characteristics,and TCM constitutions were differentiated based on the information collected by TCM constitutions questionnaire.After that,the correlation between the biased TCM constitutions and clinical characteristics were explored by using analysis of variance,non-parametric test and Logistic regression analysis.Results(1)A total of 215 cases of adult AR patients from Shenzhen were included.Most of the patients were male(60.93％),and the patients were usually aged 18-29 years old(accounting for 48.84％).AR in adults often arose in the spring(33.49％)and fall(30.70％).(2)Lung qi deficiency-cold syndrome was the predominated TCM syndrome type of AR in adults,accounting for 40.93％,and then came kidney yang deficiency syndrome(26.98％),spleen qi deficiency syndrome(20.00％),and heat accumulation in lung meridian syndrome(12.09％).Lung qi deficiency-cold syndrome and heat accumulation in lung meridian syndrome were more common in young males,and kidney yang deficiency syndrome was frequently seen in middle-aged and elderly males.(3)The leading three TCM constitution types of AR in adults were qi deficiency constitution(30.23％),yang deficiency constitution(24.65％),and inherited special constitution(15.81％).In adult AR patients with lung qi deficiency-cold syndrome,the commonly-seen TCM constitution types were qi deficiency constitution,inherited special constitution,and balanced constitution.In adult AR patients with spleen qi deficiency syndrome,the commonly-seen TCM constitution types were inherited special constitution,phlegm-damp constitution,and yang deficiency constitution.In adult AR patients with kidney yang deficiency syndrome,the commonly-seen TCM constitution types were yang deficiency constitution,qi stagnation constitution,and inherited special constitution.In adult AR patients with heat accumulation in lung meridian syndrome,the commonly-seen TCM constitution types were damp-heat constitution,yin deficiency constitution,and blood-stasis constitution.The leading five TNSS scores were shown in adult AR patients with inherited special constitution,qi deficiency constitution,yang deficiency constitution,phlegm-damp constitution,and qi stagnation constitution,respectively.And the leading five TNNSS scores were shown in adult AR patients with yang deficiency constitution,inherited special constitution,qi stagnation constitution,yin deficiency constitution,and damp-heat constitution,respectively.(4)The results of statistical analysis showed that the differences in gender among the adult AR patients with various TCM constitution types were not statistically significant(P＞0.05),but the differences in age groups,TCM syndrome types,TNSS scores and TNNSS scores were statistically significant(P＜0.01 or P＜0.001).(5)The results of Logistic regression analysis showed that the TNSS scores and TNNSS scores were all positively correlated with qi deficiency constitution,yang deficiency constitution,and inherited special constitution,and spleen qi deficiency syndrome was negatively correlated with damp-heat constitution,the differences being all statistically significant(P＜0.01 or P＜0.001).Conclusion The onset of AR in adults from Shenzhen area is closely related to age,gender,season,and TCM constitutions.The adult AR patients usually have the biased constitutions,in particular qi deficiency constitution,yang deficiency constitution,and inherited special constitution.In adult AR patients,higher TNSS scores are correlated with inherited special constitution,higher TNNSS scores are correlated with yang deficiency constitution,and the primary TCM syndrome type of lung qi deficiency-cold syndrome is correlated with qi deficiency constitution.

Objective To investigate the therapeutic effects and mechanisms of Aurantii Fructus Immaturus(AFI)on slow-transit constipation(STC)in mice.Methods A STC model was established via intragastric administration of Loperamide Hydrochloride.Successfully modeled mice were randomized into a model group,low-and high-dose AFI groups,a high-dose AFI+Masitinib[tyrosine kinase(c-Kit)inhibitor]group,additionally,a normal group was set up.After intervention,intestinal transit rate,6-hour fecal pellet number,fecal water content,and colonic histomorphology(hematoxylin-eosin staining)were assessed.Enzyme-linked immunosorbent assay(ELISA)was used to measure levels of 5-hydroxytryptamine(5-HT),vasoactive intestinal polypeptide(VIP),substance P(SP),nitric oxide(NO),and nitric oxide synthase(NOS)activity in colon tissue.Quantitative real-time PCR(qRT-PCR)was used to evaluate mRNA expression of stem cell factor(SCF)and c-Kit in colon tissue,Western Blot was used to analyze relative protein expression of aquaporin 3(AQP3),aquaporin 8(AQP8),SCF,and c-Kit in colon tissue.Results Compared with the normal group,there was devere colonic damage observed in the colon tissue of the mice in the model group,the fecal pellet number,fecal water content,intestinal transit rate,colon tissue SP content,c-Kit and SCF gene and protein expression levels were reduced.The contents of 5-HT,VIP and NO,NOS activity and the protein expression levels of AQP3 and AQP8 in colon tissue were increased,and the differences were statistically significant(P＜0.05).Compared with the model group,the colonic injury of mice in the low-and high-does AFI groups showed obvious improvement,the fecal pellet number,fecal water content,intestinal transit rate,colon tissue SP content,c-Kit and SCF gene and protein expression levels were increased,the contents of 5-HT,VIP and NO,NOS activity and the protein expression levels of AQP3 and AQP8 in colon tissue were decreased(P＜0.05).Masitinib partially reversed the laxative effects of AFI(P＜0.05).Conclusion AFI enhances intestinal motility,alleviates colonic injury,and improves defecation in STC mice,potentially via activation of the SCF/c-Kit pathway.

Sacroiliac complex injuries are commonly seen in high-energy pelvic fractures. The injuries make a big difference in treatment patterns due to the diverse injury types, posing considerable challenges in formulating optimal treatment strategies, and hence are persistent clinical difficulties in orthopedic trauma. The clinical management of sacroiliac complex injuries presents several key challenges such as a non-negligible rate of missed diagnoses in associated vascular and visceral injuries, absence of standardized protocols for surgical approaches and reduction-fixation strategies across different injury patterns, and ongoing controversies regarding surgical indications and optimal timing for patients combined with concomitant lumbosacral plexus injuries. Currently, no systematic clinical guidelines are available for the diagnosis and treatment of sacroiliac complex injuries both domestically and internationally. To this end, the Pelvic and Acetabular Surgery Group, Orthopedic Branch, China International Exchange and Promotive Association for Medical and Health Care and Orthopedic Physician Branch, Chinese Medical Doctor Association organized a panel of domestic experts in the field to develop the Clinical guideline for the diagnosis and treatment of sacroiliac complex injuries ( version 2025), based on evidence-based medicine and adhering to the principles of scientific rigor, clinical applicability, and innovation. These guidelines provided 11 recommendations covering diagnosis, therapeutic principles and techniques, management protocols for lumbosacral plexus injuries, outcome evaluation, and postoperative rehabilitation pathways, etc., aiming to standardize the clinical management of sacroiliac complex injuries.

Objective:By analyzing the disease spectrum and composition of inpatients in general surgery department of a children′s hospital in Beijing from January 2018 to June 2024, to understand the impact of the COVID-19 on the number of inpatients in children′s hospitals and the composition of disease types, and to provide scientific evidence for hospital capacity building and medical response after the outbreak of the epidemic.Methods:The hospitalization medical records of children in the general surgery ward of the children′s hospital from January 1, 2018 to June 30, 2024 were collected. SPSS 22.0 software and EXCEL tools were used to analyze the ranking and composition of general surgery diseases in the hospital from three dimensions: different years, different genders, and different age groups. At the same time, the source of children in the hospital was counted by province.Results:Overall, the total number of hospitalized children has shown a significant decrease since 2020, and has since slowly rebounded; Acute appendicitis, inguinal hernia, and common bile duct cyst rank among the top three diseases annually; From a gender perspective, inguinal hernia and acute appendicitis are the most common in male children, while acute appendicitis and common bile duct cysts are the most common in female children; In terms of age, the 1-year-old group has the highest number of patients with inguinal hernia, while the 5-year-old and 10-18-year-old groups have the highest number of patients with acute appendicitis; Compared with 2018-2019, the number of hospitalized children with inguinal hernia decreased sharply in the first half of 2020-2024, and the first priority disease changed from inguinal hernia to acute appendicitis.Conclusions:This study analyzed the disease spectrum and composition of the children′s hospital before and after the COVID-19 epidemic, which has important reference value for the capacity building, resource allocation and epidemic response of the children′s hospital.

Objective:To explore baseline clinical and imaging characteristics of children with neonatal arterial ischaemic stroke based on their long-term motor function prognoses.Methods:A retrospective cohort study was conducted. Clinical data, including magnetic resonance imaging (MRI) and electroencephalogram (EEG) findings, were collected from 31 neonates diagnosed with ischemic stroke admitted to the Department of Neonataology, Maternal and Child Health Hospital of Hubei Province between January 2015 and December 2019. Unified follow-up was conducted between May and July 2024. Long-term motor function outcomes were assessed using the modified Rankin scale(mRS) and categorized into two groups: the good motor function group (mRS score 0-1) and the motor impairment group (mRS score≥2).Baseline clinical and imaging data were summarized for all children, and differences between the two groups were analyzed using the Mann-Whitney U test and Fisher′s exact test. Results:A total of 31 neonates (21 males, 10 females) with an admission age of 1-19 days, all diagnosed within 28 days of birth, were included. At follow-up, 4-8 years after disease onset, 26 neonates (84%) showed good motor function, while 5 (16%) had motor impairments. Compared to the good motor function group, the motor impairment group had higher proportions of females (4/5 vs. 23% (6/26)), main middle cerebral artery (MCA) infarction (4/5 vs. 19% (5/26)), basal ganglia involvement (4/5 vs. 27% (7/26)), corticospinal tract involvement (posterior limb of internal capsule (PLIC) 5/5 vs. 38% (10/26) and cerebral peduncles 5/5 vs. 31% (8/26)) shown by MRI images, and meconium-stained amniotic fluid (4/5 vs. 15% (4/26))(all P<0.05).No significant differences were observed in gestational age, birth weight, abnormalities in muscle tone or primitive reflexes at admission or discharge, or abnormal EEG findings (all P>0.05). Conclusions:Neonatal arterial ischemic stroke commonly manifests as seizures, which are generally controllable, with a relatively stable clinical course and a low incidence of long-term motor impairment. Children with long-term motor impairments are more likely to have main MCA infarction, basal ganglia and corticospinal tract involvement (PLIC and cerebral peduncles), as well as meconium-stained amniotic fluid. This condition is also more commonly observed in females.