Diabetic Peripheral Neuropathy （DPN） is one of the most common and harmful complications of type 2 diabetes. DPN's pathogenesis include high blood sugar-induced oxidative stress， inflammation， and mitochondrial dysfunction. These factors are combined to damage nerve fibers， leading to sensory issues， pain， and numbness. Through a coordinated effect， these factors trigger nerve fiber damage and lead to sensory abnormalities， pain and numbness in limbs， and other symptoms， seriously restricting patients' activities of daily living and mobility. Recent research highlights that cellular senescence plays a critical role in DPN. Cellular senescence is manifested by the loss of cell proliferation ability， and further aggravates nerve damage via oxidative stress， mitochondrial dysfunction， autophagy impairment， inflammatory reaction， and other mechanisms， accelerating DPN occurrence and progression. In terms of medical treatment， current methods focus on blood sugar control， pain relief medicine， and microcirculation improvement， while no therapy has been developed based on cellular senescence. In contrast， traditional Chinese medicine （TCM） shows a unique advantage in DPN prevention and treatment via cellular senescence modulation. TCM emphasizes a holistic approach， as well as syndrome differentiation and treatment， effective in anti-aging and nerve damage repair. Recent studies show that TCM active ingredients， including puerarin， ginsenosides， and berberine， can reduce inflammation， oxidative stress， and apoptosis via signaling pathway regulation， thereby slowing cellular senescence to alleviate nerve damage. Furthermore， TCM compounds such as Buyang Huanwutang， Taohong Siwutang， and Huangqi Guizhi Wuwutang exert synergistic effects on cellular senescence-related pathways to improve nerve health and reduce DPN clinical symptoms. Therefore， this paper reviews the literature related to the interaction between cellular senescence and DPN from the perspective of cellular senescence， summarizing the mechanism of DPN and TCM intervention strategies.

BACKGROUND:Oral submucous fibrosis is a chronic progressive disease that is prone to malignant transformation.Traditional treatment methods are not ideal and have limitations.As an emerging discipline,tissue engineering has opened up a new path for the treatment of oral submucous fibrosis.OBJECTIVE:To review the latest progress in the pathogenesis and treatment of oral submucous fibrosis,and to summarize and analyze the role and research progress of mesenchymal stem cells,bioscaffold materials,and tissue-engineered oral mucosa in oral submucous fibrosis,thereby providing ideas for the research and clinical application of tissue engineering in the treatment of oral submucous fibrosis.METHODS:In October 2024,the first author used computers to search for relevant literature from January 1970 to October 2024 in PubMed and CNKI databases.The search terms were"oral submucous fibrosis,tissue engineering,mesenchymal stem cells,bioscaffold materials"in English and Chinese,respectively.A total of 166 articles were finally included for analysis.RESULTS AND CONCLUSION:(1)The pathogenesis of oral submucous fibrosis is complex,and many factors are closely related to oral submucous fibrosis,but ultimately they promote the development of oral submucous fibrosis by promoting collagen deposition and accelerating fibroblast proliferation.(2)Traditional treatment methods for oral submucous fibrosis have problems such as low patient compliance and unsatisfactory results,and new treatment strategies are urgently needed.(3)Mesenchymal stem cells regulate the pathological microenvironment,reduce inflammation and inhibit the process of fibrosis due to their immunomodulatory and antioxidant properties,providing a new idea for the treatment of oral submucous fibrosis.(4)Biomass materials,as drug and cell delivery carriers,regulate the pathological microenvironment and are used in various fibrotic diseases,providing a new solution for the treatment of oral submucous fibrosis.(5)Tissue-engineered oral mucosa can be used as an autologous mucosa substitute to promote tissue repair,and also provides a basis for the establishment of disease models.(6)Tissue engineering treatment strategy has great potential for achieving comprehensive treatment of oral submucous fibrosis,but its role in the treatment of oral submucous fibrosis has not yet been verified.It is of great significance to explore tissue engineering-based treatment strategies for oral submucous fibrosis in the future.

BACKGROUND:Oral submucous fibrosis is a chronic progressive disease that is prone to malignant transformation.Traditional treatment methods are not ideal and have limitations.As an emerging discipline,tissue engineering has opened up a new path for the treatment of oral submucous fibrosis.OBJECTIVE:To review the latest progress in the pathogenesis and treatment of oral submucous fibrosis,and to summarize and analyze the role and research progress of mesenchymal stem cells,bioscaffold materials,and tissue-engineered oral mucosa in oral submucous fibrosis,thereby providing ideas for the research and clinical application of tissue engineering in the treatment of oral submucous fibrosis.METHODS:In October 2024,the first author used computers to search for relevant literature from January 1970 to October 2024 in PubMed and CNKI databases.The search terms were"oral submucous fibrosis,tissue engineering,mesenchymal stem cells,bioscaffold materials"in English and Chinese,respectively.A total of 166 articles were finally included for analysis.RESULTS AND CONCLUSION:(1)The pathogenesis of oral submucous fibrosis is complex,and many factors are closely related to oral submucous fibrosis,but ultimately they promote the development of oral submucous fibrosis by promoting collagen deposition and accelerating fibroblast proliferation.(2)Traditional treatment methods for oral submucous fibrosis have problems such as low patient compliance and unsatisfactory results,and new treatment strategies are urgently needed.(3)Mesenchymal stem cells regulate the pathological microenvironment,reduce inflammation and inhibit the process of fibrosis due to their immunomodulatory and antioxidant properties,providing a new idea for the treatment of oral submucous fibrosis.(4)Biomass materials,as drug and cell delivery carriers,regulate the pathological microenvironment and are used in various fibrotic diseases,providing a new solution for the treatment of oral submucous fibrosis.(5)Tissue-engineered oral mucosa can be used as an autologous mucosa substitute to promote tissue repair,and also provides a basis for the establishment of disease models.(6)Tissue engineering treatment strategy has great potential for achieving comprehensive treatment of oral submucous fibrosis,but its role in the treatment of oral submucous fibrosis has not yet been verified.It is of great significance to explore tissue engineering-based treatment strategies for oral submucous fibrosis in the future.

Objective:To investigate the assoication of amino acid metabolism levels with severity of diabetic peripheral neuropathy(DPN) in patients with type 2 diabetes mellitus.Methods:A retrospective analysis was conducted on 118 patients with type 2 diabetes mellitus who were admitted to Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January to April 2021. Patients were divided into groups according to the Toronto Clinical Scoring System(TCSS), and amino acid profiling was performed. General demographics and biochemical indicators of each group were collected to analyze the relationship between DPN severity and amino acid metabolism.Results:As TCSS scores increased, patients were older and had a longer duration of diabetes. Statistically significant differences in leucine, isoleucine, tryptophan, and phenylalanine levels were observed among the four groups. After adjusting for confounding variables using covariance analysis, when the TCSS score was≥13, the serum phenylalanine level was significantly elevated, and the difference was statistically significant( P<0.05). Multivariate linear regression analysis indicated that TCSS score was an influencing factor for phenylalanine levels( P=0.010). Multivariate logistic regression analysis demonstrated that higher serum phenylalanine levels correlated with higher TCSS scores( OR=1.047, 95% CI 1.011-1.083, P=0.010). Receiver operating characteristic(ROC) curve analysis revealed that serum phenylalanine and the difference between phenylalanine and tryptophan had diagnostic value for severe DPN patients, with areas under the ROC curve of 0.673(95% CI 0.553-0.793, P=0.006) and 0.746(95% CI 0.641-0.852, P<0.001) respectively. Conclusions:The levels of phenylalanine and tryptophan in the serum of patients with type 2 diabetes mellitus are correlated with the severity of DPN. These findings suggest that serum phenylalanine, tryptophan, or their metabolic products may be involved in the pathogenesis and progression of DPN.

Objective:To report construction of Evidence-Based Guidelines for the Diagnosis and Treatment of Distal Radius Fractures in Adults (2024) using the Delphi method.Methods:Literature related to the study of adult distal radius fractures was fully searched for and evaluated. An expert group was established from representative experts from all over the nation. The related clinical issues were established by consulting the experts in the form of electronic questionnaires, strictly following the Delphi research method. After the first draft of Evidence-Based Guidelines for the Diagnosis and Treatment of Distal Radius Fractures in Adults (2024) was written, an expert consultation questionnaire was designed for the recommendation opinions to determine the recommendation strength.Results:The clinical issues were determined by 2 rounds of correspondence based on the Delphi method. For the both rounds of correspondence, the questionnaire recovery rates were respectively 88.68% (47/53) and 98.11% (52/53), and the expert authority coefficients >0.7. According to the screening criteria based on the importance of clinical issues (mean importance score <3.5 points or a coefficient of variation ≥0.25 points and a full score ratio <30%) and expert opinions, a total of 40 clinical issues were deleted in the first round of determination of clinical issues, and a total of 5 clinical issues deleted in the second round of determination of clinical issues. The reliability analysis of the results of the 2 rounds of questionnaires showed that the Cronbach α coefficient was >0.9. In the questionnaire to determine the recommendation strength, according to the screening criteria for the consistency of recommendation strength (consistency ≥ 70%) and expert opinions, a total of 26 recommendations were screened in the first round. In the second round when the remaining 4 recommendations were investigated, one recommendation reached the consistency of recommendation strength ≥ 70%. Eventually, 27 recommendations were formed.Conclusion:The Evidence-Based Guidelines for the Diagnosis and Treatment of Distal Radius Fractures in Adults (2024) constructed using the Delphi method shows good scientific validity, authority, and reliability, providing methodological references for guideline development and research.

Gene therapy, harnessing the power of CRISPR-Cas9 and/or DNAzyme systems, stands as a pivotal approach in cancer therapy, enabling the meticulous manipulation of genes pivotal to tumorigenesis and immunity. However, the pursuit of precise gene therapy encounters formidable hurdles. Herein, a near-infrared upconversion theranostic nanomachine is devised and tailors for CRISPR-Cas9/DNAzyme systems mediate precise gene therapy. An ingenious logic DNAzyme system consists of Chain 1 (C1)/Chain 2 (C2) and endogenous lncRNA is designed. We employ manganese modified upconversion nanoparticles for carrying ultraviolet-responsive C1-PC linker-C2 (C₂P) chain and Cas9 ribonucleoprotein (RNP), with outermost coats with hyaluronic acid. Upon reaching tumor microenvironment (TME), the released Mn²⁺ ions orchestrate a trifecta: facilitating endosomal escape, activating cGAS-STING signaling, and enabling T1-magnetic resonance imaging. Under near-infrared irradiation, Cas9 RNP/C₂P complex dissociates, releasing Cas9 RNP into the nucleus to perform gene editing of Ptpn2, while C1/C2 chains self-assemble with endogenous lncRNA to form a functional DNAzyme system, targeting PD-L1 mRNA for gene silencing. This strategy remodels the TME by activating cGAS-STING signaling and dual immune checkpoints blockade, thus realizing tumor elimination. Our theranostic nanomachine armed with the CRISPR-Cas9/DNAzyme logic systems, represents a resourceful and promising strategy for advancing cancer systemic immunotherapy and precise gene therapy.

Objective:To conduct a symptom network analysis in patients with systemic lupus erythematosus (SLE) and identify core symptoms, in order to provide a foundation for the development of precision-based symptom management interventions.Methods:A convenience sampling method was used to recruit 420 SLE patients who received treatment at Shengjing Hospital of China Medical University between November 2022 and July 2023. The SLE Specific Symptom Checklist was administered to these patients. A contemporaneous symptom network was constructed using a Gaussian graphical model, and centrality measures including closeness centrality, betweenness centrality, and expected influence coefficient were calculated to determine the core symptoms within the network.Results:The most commonly reported symptoms among the 420 patients were fatigue (65.7%, 276/420), hair loss (59.8%, 251/420), photosensitivity (56.9%, 239/420), memory impairment (54.5%, 229/420), and facial swelling (52.1%, 219/420). In the symptom network analysis, the most central symptom was photosensitivity (closeness centrality=1.58; betweenness centrality=2.56; expected influence coefficient=1.06), followed by skin fragility (closeness centrality=1.00; betweenness centrality=0.43; expected influence coefficient=1.78), gastrointestinal discomfort (closeness centrality=1.30; betweenness centrality=1.14; expected influence coefficient=0.77), fatigue (closeness centrality=0.50; betweenness centrality=0.70; expected influence coefficient=1.61), and mood changes (closeness centrality=0.65; betweenness centrality=1.14; expected influence coefficient=0.89) .Conclusions:Among the various symptoms experienced by SLE patients, photosensitivity, skin fragility, gastrointestinal discomfort, fatigue, and mood changes emerged as core symptoms that influence and activate other symptoms in the network. Healthcare professionals should tailor symptom management strategies based on patients' self-reported symptom profiles, prioritize intervention targets, and work to reduce the overall symptom burden in individuals with SLE.

Objective:To report construction of Evidence-Based Guidelines for the Diagnosis and Treatment of Distal Radius Fractures in Adults (2024) using the Delphi method.Methods:Literature related to the study of adult distal radius fractures was fully searched for and evaluated. An expert group was established from representative experts from all over the nation. The related clinical issues were established by consulting the experts in the form of electronic questionnaires, strictly following the Delphi research method. After the first draft of Evidence-Based Guidelines for the Diagnosis and Treatment of Distal Radius Fractures in Adults (2024) was written, an expert consultation questionnaire was designed for the recommendation opinions to determine the recommendation strength.Results:The clinical issues were determined by 2 rounds of correspondence based on the Delphi method. For the both rounds of correspondence, the questionnaire recovery rates were respectively 88.68% (47/53) and 98.11% (52/53), and the expert authority coefficients >0.7. According to the screening criteria based on the importance of clinical issues (mean importance score <3.5 points or a coefficient of variation ≥0.25 points and a full score ratio <30%) and expert opinions, a total of 40 clinical issues were deleted in the first round of determination of clinical issues, and a total of 5 clinical issues deleted in the second round of determination of clinical issues. The reliability analysis of the results of the 2 rounds of questionnaires showed that the Cronbach α coefficient was >0.9. In the questionnaire to determine the recommendation strength, according to the screening criteria for the consistency of recommendation strength (consistency ≥ 70%) and expert opinions, a total of 26 recommendations were screened in the first round. In the second round when the remaining 4 recommendations were investigated, one recommendation reached the consistency of recommendation strength ≥ 70%. Eventually, 27 recommendations were formed.Conclusion:The Evidence-Based Guidelines for the Diagnosis and Treatment of Distal Radius Fractures in Adults (2024) constructed using the Delphi method shows good scientific validity, authority, and reliability, providing methodological references for guideline development and research.

Objective:To conduct a symptom network analysis in patients with systemic lupus erythematosus (SLE) and identify core symptoms, in order to provide a foundation for the development of precision-based symptom management interventions.Methods:A convenience sampling method was used to recruit 420 SLE patients who received treatment at Shengjing Hospital of China Medical University between November 2022 and July 2023. The SLE Specific Symptom Checklist was administered to these patients. A contemporaneous symptom network was constructed using a Gaussian graphical model, and centrality measures including closeness centrality, betweenness centrality, and expected influence coefficient were calculated to determine the core symptoms within the network.Results:The most commonly reported symptoms among the 420 patients were fatigue (65.7%, 276/420), hair loss (59.8%, 251/420), photosensitivity (56.9%, 239/420), memory impairment (54.5%, 229/420), and facial swelling (52.1%, 219/420). In the symptom network analysis, the most central symptom was photosensitivity (closeness centrality=1.58; betweenness centrality=2.56; expected influence coefficient=1.06), followed by skin fragility (closeness centrality=1.00; betweenness centrality=0.43; expected influence coefficient=1.78), gastrointestinal discomfort (closeness centrality=1.30; betweenness centrality=1.14; expected influence coefficient=0.77), fatigue (closeness centrality=0.50; betweenness centrality=0.70; expected influence coefficient=1.61), and mood changes (closeness centrality=0.65; betweenness centrality=1.14; expected influence coefficient=0.89) .Conclusions:Among the various symptoms experienced by SLE patients, photosensitivity, skin fragility, gastrointestinal discomfort, fatigue, and mood changes emerged as core symptoms that influence and activate other symptoms in the network. Healthcare professionals should tailor symptom management strategies based on patients' self-reported symptom profiles, prioritize intervention targets, and work to reduce the overall symptom burden in individuals with SLE.

Objective:To observe the effect of brain-computer interface exoskeleton(BCI-exoskeleton)on lower limb func-tional for stroke patients,and to explore the impact on the low-extremity function area of motor cortex in-duced by BCI-exoskeleton and its correlation with clinical efficacy.Method:Forty-two subjects with stroke were recruited and equally assigned to brain-computer interface exoskel-eton experiment group(BG,n=14),robotic exoskeleton experiment group(EG,n=14)and conventional con-trol group(CG,n=14)using random numbers generated by computer.Three groups were provided convention-al treatment,experiment groups received BCI-exoskeleton or lower-limb robotic exoskeleton training(LRET)for 4 weeks,respectively.FMA-LE,MBI,Berg and Holden scales were used to evaluate the lower limb func-tions pre-or post-treatment by a blinded assessor.The accuracy of BCI(BCIA),and the changes of α and β band event-related desynchronization(ERD)intensity at Cz channel of EEG were observed to explore its corre-lation with clinical efficacy.Result:All scales in the three groups were improved post-treatment,and the improvement of BG was better than that of EG and CG(FMA-LE:P＜0.001;MBI,Berg,Holden:P=0.001).The BCIA in BG were signif-icantly increased(P＜0.001).And ERD amplitude of Cz channel in BG were significantly decreased(P＜0.001).ERDα(P＜0.05)was significantly correlated with clinical scales and ERDβ had an extremely signifi-cant correlated with clinical scales(P＜0.01).Conclusion:The BCI-exoskeleton training is effective to improve the lower limb function and activities of dai-ly living for patients with stroke,and the effect is better than LRET and conventional rehabilitation.The effica-cy is related to the promotion of ERDα and ERDβ wave band activity in the lower limb functional area of mo-tor cortex,and the clinical efficacy is more closely correlated with ERD amplitude of Cz channel.