For a long time， simple asymptomatic renal hematuria has not been taken seriously. Current studies have confirmed that renal hematuria is a risk factor for the progression of renal function， but there is no effective treatment available. Because asymptomatic renal hematuria is highly concealed and lacks typical symptoms， individualized syndrome differentiation in traditional Chinese medicine （TCM） is difficult， making it a challenge in clinical diagnosis and treatment. Although TCM has a long history and solid theoretical basis in the treatment of hematuria， it urgently needs to break through the bottleneck of traditional syndrome differentiation. Based on classical TCM theories， research achievements in modern constitution studies， and relevant clinical and pathological evidence， this article focuses on the decisive influence of age on constitution distribution and its regular association with the evolution of core syndromes， and constructs a three-dimensional diagnostic and therapeutic system of "age-constitution-syndrome". It reveals that the syndrome manifestations of asymptomatic renal hematuria are profoundly shaped by constitution， and that constitution shows a group distribution pattern with age-children often present with deficiency of lung and spleen Qi combined with wind-heat， young and middle-aged individuals often present with deficiency of liver and kidney Yin combined with deficient fire and stasis heat， and elderly individuals often present with deficiency of spleen and kidney combined with cold-dampness and stasis obstruction. By analyzing the common pathogenic mechanisms， outcome characteristics， and internal mechanisms among different age groups， this study provides a basic syndrome framework and core intervention strategies for specific populations in clinical practice， offering a new evidence-based approach to addressing the dilemma of “no identifiable syndrome”.

According to the Qi-blood-body fluid theory and the association between the spleen in visceral manifestation theory of traditional Chinese medicine （TCM） and mitochondria in modern cellular biology， it is proposed that the role of the spleen in generating and transforming Qi and blood is analogous to the energy-producing function of mitochondria—both serving as fundamental power sources for vital activities of the human body. The spleen governs transportation and transformation， playing a critical role in energy metabolism and the digestion and absorption of nutrients. Similarly， mitochondria are vital for maintaining physiological functions such as cellular energy supply， cell survival， and overall human metabolism. Furthermore， spleen deficiency is closely linked to mitochondrial dysfunction. Accordingly， mitochondrial energy conversion and substance metabolism are regarded as the microscopic essence of the spleen's function in transportation and transformation. Spleen deficiency and mitochondrial dysfunction contribute to the formation of pathological products such as phlegm-turbidity and blood stasis. This aligns with the pathogenesis of chronic obstructive pulmonary disease （COPD）， with Qi deficiency as the root cause and phlegm-turbidity and blood stasis as the manifestations. Therefore， the integrative treatment of COPD should follow the therapeutic principle of invigorating the spleen and reinforcing healthy Qi， while also resolving phlegm and removing blood stasis to address both root cause and manifestations. This approach can improve the mitochondrial function， regulate energy metabolism， and reduce oxidative stress levels to alleviate COPD symptoms， slow down disease progression， and improve prognosis. By integrating the holistic concept of TCM with molecular mechanisms of modern medicine， this paper explores the pathogenesis and therapeutic principles of COPD from the spleen-mitochondria correlation. It not only provides a new direction for the modern development of TCM and the integration of Chinese and Western medicine but also offers a theoretical foundation for the integrated treatment of chronic， complex age-related diseases.

According to the Qi-blood-body fluid theory and the association between the spleen in visceral manifestation theory of traditional Chinese medicine （TCM） and mitochondria in modern cellular biology， it is proposed that the role of the spleen in generating and transforming Qi and blood is analogous to the energy-producing function of mitochondria—both serving as fundamental power sources for vital activities of the human body. The spleen governs transportation and transformation， playing a critical role in energy metabolism and the digestion and absorption of nutrients. Similarly， mitochondria are vital for maintaining physiological functions such as cellular energy supply， cell survival， and overall human metabolism. Furthermore， spleen deficiency is closely linked to mitochondrial dysfunction. Accordingly， mitochondrial energy conversion and substance metabolism are regarded as the microscopic essence of the spleen's function in transportation and transformation. Spleen deficiency and mitochondrial dysfunction contribute to the formation of pathological products such as phlegm-turbidity and blood stasis. This aligns with the pathogenesis of chronic obstructive pulmonary disease （COPD）， with Qi deficiency as the root cause and phlegm-turbidity and blood stasis as the manifestations. Therefore， the integrative treatment of COPD should follow the therapeutic principle of invigorating the spleen and reinforcing healthy Qi， while also resolving phlegm and removing blood stasis to address both root cause and manifestations. This approach can improve the mitochondrial function， regulate energy metabolism， and reduce oxidative stress levels to alleviate COPD symptoms， slow down disease progression， and improve prognosis. By integrating the holistic concept of TCM with molecular mechanisms of modern medicine， this paper explores the pathogenesis and therapeutic principles of COPD from the spleen-mitochondria correlation. It not only provides a new direction for the modern development of TCM and the integration of Chinese and Western medicine but also offers a theoretical foundation for the integrated treatment of chronic， complex age-related diseases.

The clinical diagnosis and treatment of urinary tract infection has long faced the challenges of insufficient standardization of diagnosis and treatment pathways,irrational use of antimicrobial drugs and high recurrence rate.How to optimize the hierarchical diagnosis and treatment pathway of urinary tract infection,standardize the use of antimicrobial drugs,and reduce the recurrence rate have always been the focus of clinical attention.There is significant heterogeneity in the existing diagnostic criteria for urinary tract infection,which seriously affects the comparability and evidence integration of clinical and research studies.In order to solve the above problems,a consensus on global multidisciplinary diagnostic criteria for urinary tract infection has been formed by international multidisciplinary experts after three rounds of Delphi method.Breaking through the traditional classification framework,the consensus innovatively established a four-dimensional quantitative scoring system including local symptoms and signs,systemic inflammatory response,quantitative analysis of pyuria and urine culture results,and established a hierarchical standard for stepwise urinary tract diagnosis according to the scoring threshold.Based on the key citations related to the consensus,this paper interprets in detail the basis for the selection of core indicators and the establishment of thresholds for the diagnosis of urinary tract infection in the consensus,and focuses on the key issues and implementation paths of the consensus in localization practice.This consensus provides a unified standard for standardizing the clinical diagnosis and treatment of urinary tract infection,improving the homogeneity of clinical research through standardized diagnostic processes,and promoting the standardization of UTI drug research and development and the rational use of antibiotics and precision.

Objective We aimed to evaluate the efficacy and safety of Shengxuebao Mixture in the treatment of cancer-related anemia(CRA)presenting with syndrome of deficiency of liver and kidney combined with syndrome of deficiency of both qi and blood.Methods A randomized,double-blind,placebo-controlled,multicenter clinical trial was conducted.Eligible patients with malignant tumors meeting the inclusion and exclusion criteria were enrolled from 26 hospitals,including Dongzhimen Hospital,Beijing University of Chinese Medicine,Xiaogan Central Hospital,and Yangzhou Hospital of Traditional Chinese Medicine,from June 1,2022,to September 30,2024.Patients were allocated 1:1 to either the experimental group receiving Shengxuebao Mixture or the control group receiving its simulator(placebo)using a block randomization method under double-blind conditions.Both groups received 15 mL orally three times daily for 28 consecutive days.The primary efficacy indicators included the hemoglobin(Hb)improvement rate(RHb)and the traditional Chinese medicine(TCM)syndrome improvement rate(RTCM)at week 4 of treatment.The secondary efficacy indicators encompassed Hb and red blood cell(RBC)count,Karnofsky Performance Status(KPS)score,TCM syndrome score,individual TCM symptom scores,and changes in each of these indicators compared to the baseline period at weeks 2,4,and 6 of treatment.Safety evaluations were conducted at week 4 of treatment.Results A total of 239 patients were enrolled,with 225 cases included in the Full Analysis Set(FAS)(109 in the experimental group vs.116 control group),163 in the Per Protocol Set(PPS)(77 vs.86),and 225 in the Safety Set(SS)(109 vs.116).Baseline characteristics between groups showed no significant differences.Significant differences were observed between the experimental and control groups in RHb at week 4(FAS:49.51%vs.35.24%,P<0.05;PPS:53.25%vs.36.05%,P<0.05)and RTCM at week 4(FAS:61.54%vs.39.62%,P<0.01;PPS:64.94%vs.40.70%,P<0.01).At weeks 2,4,and 6,the experimental group showed greater improvements in Hb and RBC counts than the control group.Additionally,the TCM syndrome scores were lower in the experimental group than in the control group at these time points.Except for week 2 in PPS,the KPS improvement was better in the experimental group than in the control group(P<0.05).The experimental group also demonstrated a greater reduction in scores for individual TCM symptoms such as spiritlessness and weakness,poor appetite and reduced food intake at weeks 4 and 6 compared to the control group(P<0.05,P<0.01).Furthermore,the reduction in vertigo score was more pronounced in the experimental group at week 6(P<0.01).For the score of pale and lusterless complexion,only in the PPS was the reduction from baseline more significant in the experimental group than in the control group at weeks 4 and 6(P<0.05).No significant differences were observed between the experimental and control groups in the incidence of all adverse events or drug-related adverse reactions.Conclusion Shengxuebao Mixture demonstrates significant efficacy in patients with CRA presenting syndrome of deficiency of liver and kidney combined with syndrome of deficiency of both qi and blood,effectively increasing Hb levels,ameliorating TCM syndromes,alleviating clinical symptoms,and enhancing functional status,with no significant difference in adverse drug reactions compared to the placebo.

Spinal trauma, primarily caused by high-energy external forces, predominantly manifest as vertebral fracture and spinal cord injury. These conditions are characterized by spinal pain, restricted mobility, and sensory and autonomic dysfunction, significantly compromising patients′ quality of life and life expectancy. Current diagnostic and therapeutic practices for spinal fracture remain susceptible to subjective clinical experience, resulting in misdiagnosis, underdiagnosis, and imprecise surgical execution. Similarly, the therapeutic efficacy of spinal cord injury rehabilitation is frequently limited by a lack of personalized treatment protocols. The growing integration of artificial intelligence (AI) in medicine presents novel opportunities to overcome these obstacles. By excelling in image interpretation, data analytics, clinical decision support, and personalized rehabilitation planning, AI has emerged as a prominent focus of modern research. To this end, the authors reviewed the research progress in the application of AI in the diagnosis and treatment of spinal fracture and rehabilitation of spinal cord injury, providing a reference for AI-assisted precision diagnosis and treatment of vertebral fracture and rehabilitation of spinal cord injury.

Lower urinary tract dysfunction (LUTD) is common in children, but treatment is difficult in some cases, and it might causes upper urinary tract damage in the late stage. Recently, botulinum toxin A(BTX-A) has been recommended as an effective procedure for refractory LUTD, which has significantly improved symptoms and reduced the occurrence of upper urinary tract damage in children with LUTD. At present, there is a lack of international consensus on the application indication and dose selection of BTX-A in LUTD children, and the safety and long-term efficacy of repeated BTX-A injection are also clinical concerns. This article reviews the current application perspectives and progress of BTX-A in the treatment of children with LUTD, especially the clinical application indications and methods.BTX-A provides a minimally invasive, safe and effective treatment option for children with LUTD, which can significantly improve clinical symptoms and urodynamic parameters. With the further clarification of indications and the improvement of administration methods, BTX-A will be able to assist more children with LUTD in enhancing their quality of life and lessening their physical and mental burden.

Objective:To analyze the neuropsychological characteristics of patients with chronic heart failure (CHF) complicated by mild cognitive impairment (MCI) and investigate the factors that influence the development of CHF complicated by MCI.Methods:A case-control study was conducted to retrospectively analyze the clinical data of 98 patients with CHF admitted to Baoji Hospital of Traditional Chinese Medicine from January 2019 to October 2020. Based on the Petersen MCI screening criteria, the patients were divided into the MCI group ( n = 48) and the normal cognitive group (NC group, n = 50). The neuropsychological characteristics were analyzed using the Mini-Mental State Examination and the Montreal Cognitive Assessment. The cognitive domain scores of the two groups were tested and compared. Logistic regression analysis was performed to identify the factors influencing the development of CHF complicated by MCI. Results:The total scores of the Mini-Mental State Examination and the Montreal Cognitive Assessment in the NC group were 28.45 ± 1.10 and 27.90 ± 1.35, respectively, which were significantly higher than those in the MCI group (23.50 ± 2.25, 22.95 ± 1.35, t = 13.92, 18.15, both P < 0.001). In addition, the NC group outperformed the MCI group in terms of the number of correct readings, time taken, attention, visuospatial function, memory, and language function ( t = 2.94, 7.29, 3.15, 9.90, 14.69, 4.87, all P < 0.01). The MCI group had a greater proportion of patients who were aged ≥ 65 years, had an education level of junior high school or below, experienced sleep disorders, and were classified as New York Heart Association (NYHA) functional class Ⅲ, compared with the NC group ( χ2 = 4.18, 4.08, 6.88, 4.70, all P < 0.05). Additionally, the cardiac output was lower in the MCI group than in the NC group ( t = 4.70, P < 0.05). Logistic regression analysis revealed that age ≥ 65 years ( OR = 3.904, 95% CI: 1.530-9.963), education level of junior high school or below ( OR = 2.565, 95% CI: 1.571-4.187), sleep disorders ( OR = 3.080, 95% CI: 1.445-6.564), and low cardiac output ( OR = 1.784, 95% CI: 1.168-2.725) were independent risk factors for CHF complicated by MCI ( P < 0.05). Conclusions:Patients with CHF complicated by MCI are more likely to experience impairments in visuospatial function, executive function, attention, language function, and memory. Independent risk factors for CHF complicated by MCI include age ≥ 65 years, education level of junior high school or below, sleep disorders, and low cardiac output.

Objective:To investigate the feasibility and safety of radical thyroidectomy through a small incision in the side neck of the sternocleidomastoid intermuscular approach.Methods:Clinical data of newly treated patients with papillary thyroid carcinoma admitted to the Department of Thyroid-Otolaryngology and Head and Neck Surgery,Sichuan Cancer Hospital from Feb. 2022 to Mar. 2024 were collected. They were divided into SMIA group and LACA group according to surgical methods. In the SMIA group, 52 cases were treated by the sternocleidomastoid intermuscular approach with a small incision on the side of the neck. In the LACA group, 100 cases were treated by the cervical white line approach with a low cut incision on the front of the neck. Clinical data of the two groups, such as perioperative related indicators,postoperative aesthetic effects and postoperative complications were collected. Independent sample t test or Mann-Whitney U test were compared between the measurement data groups. Chi-square test was used for comparison between data sets. Results:There was no significant difference in demographic and clinical characteristics of tumor between the two groups. Compared with the control group,the operation time of the observation group was longer (83.85±18.72minvs71.33±15.50min, t=4.39, P<0.001) , the total postoperative drainage volume was significantly reduced (61.29±41.80ml vs. 99±35.80ml, Z=-4.65, P<0.001) , and the extubation time was significantly shortened (2.81±0.82d vs. 3.19±0.66d, Z=-3.31, P<0.001) , and the difference was statistically significant. There was no difference in postoperative transient hoarseness between the two groups ( χ 2=0.01, P=0.932) . Patient’s self-feeling was followed up one month after surgery. The number of patients with swallowing discomfort in the SMIA group was significantly lower than that in the LACA group ( χ2=4.30, P=0.017) . There was no significant difference between the two groups in neck stiffness ( χ2=3.16, P=0.075) , scar hyperplasia ( χ2=0.04, P=0.840) , and incision aesthetic effect score ( Z=-0.73, P=0.468) . Conclusions:Radical thyroidectomy through a small incision in the side neck of the sternocleidomastoid muscle is a safe, feasible and aesthetic mode of operation. It’s worth promoting in clinical practice,especially for patients with unilateral tumor and early tomur T stage.

Spinal trauma, primarily caused by high-energy external forces, predominantly manifest as vertebral fracture and spinal cord injury. These conditions are characterized by spinal pain, restricted mobility, and sensory and autonomic dysfunction, significantly compromising patients′ quality of life and life expectancy. Current diagnostic and therapeutic practices for spinal fracture remain susceptible to subjective clinical experience, resulting in misdiagnosis, underdiagnosis, and imprecise surgical execution. Similarly, the therapeutic efficacy of spinal cord injury rehabilitation is frequently limited by a lack of personalized treatment protocols. The growing integration of artificial intelligence (AI) in medicine presents novel opportunities to overcome these obstacles. By excelling in image interpretation, data analytics, clinical decision support, and personalized rehabilitation planning, AI has emerged as a prominent focus of modern research. To this end, the authors reviewed the research progress in the application of AI in the diagnosis and treatment of spinal fracture and rehabilitation of spinal cord injury, providing a reference for AI-assisted precision diagnosis and treatment of vertebral fracture and rehabilitation of spinal cord injury.