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.

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”.

Objective To investigate the underlying mechanism of Hongyu Decoction in the treatment of inflammatory bowel disease(IBD)based on serum amino acid metabolism.Methods A total of 50 male C57BL/6J mice were divided into control group,model group,sulfasalazine(SASP)group and Hongyu Decoction low-and high-dosage groups,with 10 mice in each group.Except for the control group,the rest groups were treated with 3%dextran sulfate sodium freely for seven consecutive days to establish the IBD model.The SASP group was given SASP solution at a dosage of 200 mg/kg by gavage,while the Hongyu Decoction low-and high-dosage groups were given Hongyu Decoction freeze-dried powder solution at dosages of 0.5 and 2.0 g/kg respectively by gavage for 11 consecutive days.The general condition was monitored and DAI score were calculated.After the mice were sacrificed,the length of colons was measured,ELISA was used to detect serum TNF-α,IL-1β,IL-17 contents,HE staining was used to observe the morphology of colon tissue,and Alizarin blue staining was used to evaluate the secretion of mucin levels by intestinal epithelial goblet cells,UPLC-MS and multivariate statistical methods were used to analyze the serum amino acid metabolism profiles of mice in the control group,model group and Hongyu Decoction high-dosage group,and differential amino acids were screened.Pathway enrichment analysis was performed on differential amino acids using MetaboAnalyst 5.0.Results Compared with the control group,the DAI score of the model group mice significantly increased(P<0.001),the colon length was significantly shortened(P<0.001),and the serum contents of TNF-α,IL-1β and IL-17 significantly increased(P<0.001);with widespread ulceration of colon tissue,disappearance of mucosal epithelium and intestinal crypt structure,infiltration of lymphocytes and neutrophils,congestion and edema of intestinal mucosa,proliferation of submucosal connective tissue,reduced number of colonic goblet cells and mucin secretion.Compared with the model group,the Hongyu Decoction high-dosage group showed a significant decrease in DAI score(P<0.001),while the SASP group and the Hongyu Decoction low-and high-dosage groups showed a significant increase in colon length(P<0.05,P<0.001),and the serum contents of TNF-α,IL-1β and IL-17 were significantly reduced(P<0.001);the colonic villi were relatively intact,the glands were clear and arranged neatly,the branches of the intestinal crypts were obvious,no obvious edema was observed,and the number of colonic goblet cells and mucin secretion increased.Seven potential biomarkers for IBD in mice were identified through serum metabolomics screening,including tryptophan,serine,glutamate,valine,histidine,methionine and phenylalanine;two potential biomarkers for the treatment of IBD with Hongyu Decoction were identified,namely valine and tyrosine.The results of pathway enrichment analysis showed that the differential amino acids in the model group mainly involved the biosynthesis of phenylalanine,tyrosine and tryptophan,histidine metabolism,cysteine and methionine metabolism,phenylalanine metabolism and arginine biosynthesis;the differential amino acids in Hongyu Decoction high-dosage group mainly involved the biosynthesis of phenylalanine,tyrosine and tryptophan,as well as the metabolism of alanine,aspartate and glutamate,and the biosynthesis of arginine.Conclusion Hongyu Decoction can improve intestinal epithelial damage and inflammatory cell infiltration in IBD mice,protect the integrity of the intestinal mucosal barrier,and may be related to regulating amino acid metabolism in the body.

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.

BACKGROUND:The analgesic effect of stagnant moving needle on myofascial pain syndrome is remarkable,but the analgesic mechanism is still unclear.OBJECTIVE:To investigate the analgesic mechanism of stagnant moving needle acupuncture in the treatment of myofascial pain syndrome.METHODS:Fifty-four SD rats were randomly divided into a blank group(n=16)and a modeling group(n=38).The models of leftmyofascial pain syndrome in the modeling group were prepared by using the method of"striking combined with centrifugal movement".Twelve weeks after modeling,six mice were randomly selected to verify the success of the modeling.The rest of the 32 rats were randomly divided into the model group and the stagnant moving needle group,with 16 rats in each group.The stagnant needle moving group was treated by stagnant moving needle into the local excitation point nodule of the left medial vastus muscle fascia in rats,twice a week,for 4 weeks.The mechanical foot contraction reflex threshold of the leftfoot were measured weekly in the pre/post modeling and post-intervention groups of rats.At 4 weeks after treatment,hematoxylin-eosin staining was used to observe the morphological changes in the muscle tissue of the leftmedial femoral muscle of rats,ELISA was used to detect the levels of substance P and β-endorphin in the serum and the gray matter around the midbrain aqueduct.Immunohistochemistry was used to detect positive expression of microglia markers(Iba-1)and c-fos in the gray matter around the midbrain aqueduct.Western blot assay was used to detect the expression level of brain-derived neurotrophic factor protein in the periaqueductal gray.RESULTS AND CONCLUSION:Compared with the blank group,the mechanical pain threshold of the rats in the model group and the stagnant moving needle group decreased after modeling(P<0.05).After 4 weeks of treatment,the mechanical pain threshold of the rats in the stagnant moving needle group was higher than that in the model group(P<0.05).Hematoxylin-eosin staining results showed that in the model group,the muscle fibers of the leftlower limb medial femoral muscle of rats were disorganized,unequal in thickness,myocytes were enlarged,with inward movement of the nucleus,rounded contracture nodules and tension bands;whereas in the stagnant moving needle group,the muscle fibers were arranged in a neat way,the myocytes were angular,and the contracture nodules were occasionally seen.Compared with the blank group,the expression of substance P in the serum of the model group was significantly higher(P<0.05),while the levels of β-endorphin in serum and substance P and β-endorphin in brain were decreased(P<0.01).Compared with the model group,the level of serum substance P in the stagnant moving needle group was decreased(P<0.05),and the levels of serum β-endorphin and brain substance P and β-endorphin were increased(P<0.05).Compared with the blank group,the positive expression of c-fos and Iba-1 and the protein of brain-derived neurotrophic factor in the model group were increased(P<0.05).Compared with the model group,the positive expression of c-fos in the stagnant moving needle group was increased(P<0.05),and the positive expression of Iba-1 and the protein of brain-derived neurotrophic factor were decreased(P<0.05).These findings suggest that stagnant moving needle may indirectly promote the release of β-endorphin by microglia polarized to the M2 phenotype and increase the excitability of c-fos neurons by inhibiting the activity of microglia in the gray matter around the periaqueductal gray and downregulating the expression of brain-derived neurotrophic factor protein,thereby reducing the degree of central sensitization and effectively relieving myofascial pain syndrome.

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 investigate the underlying mechanism of Hongyu Decoction in the treatment of inflammatory bowel disease(IBD)based on serum amino acid metabolism.Methods A total of 50 male C57BL/6J mice were divided into control group,model group,sulfasalazine(SASP)group and Hongyu Decoction low-and high-dosage groups,with 10 mice in each group.Except for the control group,the rest groups were treated with 3%dextran sulfate sodium freely for seven consecutive days to establish the IBD model.The SASP group was given SASP solution at a dosage of 200 mg/kg by gavage,while the Hongyu Decoction low-and high-dosage groups were given Hongyu Decoction freeze-dried powder solution at dosages of 0.5 and 2.0 g/kg respectively by gavage for 11 consecutive days.The general condition was monitored and DAI score were calculated.After the mice were sacrificed,the length of colons was measured,ELISA was used to detect serum TNF-α,IL-1β,IL-17 contents,HE staining was used to observe the morphology of colon tissue,and Alizarin blue staining was used to evaluate the secretion of mucin levels by intestinal epithelial goblet cells,UPLC-MS and multivariate statistical methods were used to analyze the serum amino acid metabolism profiles of mice in the control group,model group and Hongyu Decoction high-dosage group,and differential amino acids were screened.Pathway enrichment analysis was performed on differential amino acids using MetaboAnalyst 5.0.Results Compared with the control group,the DAI score of the model group mice significantly increased(P<0.001),the colon length was significantly shortened(P<0.001),and the serum contents of TNF-α,IL-1β and IL-17 significantly increased(P<0.001);with widespread ulceration of colon tissue,disappearance of mucosal epithelium and intestinal crypt structure,infiltration of lymphocytes and neutrophils,congestion and edema of intestinal mucosa,proliferation of submucosal connective tissue,reduced number of colonic goblet cells and mucin secretion.Compared with the model group,the Hongyu Decoction high-dosage group showed a significant decrease in DAI score(P<0.001),while the SASP group and the Hongyu Decoction low-and high-dosage groups showed a significant increase in colon length(P<0.05,P<0.001),and the serum contents of TNF-α,IL-1β and IL-17 were significantly reduced(P<0.001);the colonic villi were relatively intact,the glands were clear and arranged neatly,the branches of the intestinal crypts were obvious,no obvious edema was observed,and the number of colonic goblet cells and mucin secretion increased.Seven potential biomarkers for IBD in mice were identified through serum metabolomics screening,including tryptophan,serine,glutamate,valine,histidine,methionine and phenylalanine;two potential biomarkers for the treatment of IBD with Hongyu Decoction were identified,namely valine and tyrosine.The results of pathway enrichment analysis showed that the differential amino acids in the model group mainly involved the biosynthesis of phenylalanine,tyrosine and tryptophan,histidine metabolism,cysteine and methionine metabolism,phenylalanine metabolism and arginine biosynthesis;the differential amino acids in Hongyu Decoction high-dosage group mainly involved the biosynthesis of phenylalanine,tyrosine and tryptophan,as well as the metabolism of alanine,aspartate and glutamate,and the biosynthesis of arginine.Conclusion Hongyu Decoction can improve intestinal epithelial damage and inflammatory cell infiltration in IBD mice,protect the integrity of the intestinal mucosal barrier,and may be related to regulating amino acid metabolism in the body.

BACKGROUND:The analgesic effect of stagnant moving needle on myofascial pain syndrome is remarkable,but the analgesic mechanism is still unclear.OBJECTIVE:To investigate the analgesic mechanism of stagnant moving needle acupuncture in the treatment of myofascial pain syndrome.METHODS:Fifty-four SD rats were randomly divided into a blank group(n=16)and a modeling group(n=38).The models of leftmyofascial pain syndrome in the modeling group were prepared by using the method of"striking combined with centrifugal movement".Twelve weeks after modeling,six mice were randomly selected to verify the success of the modeling.The rest of the 32 rats were randomly divided into the model group and the stagnant moving needle group,with 16 rats in each group.The stagnant needle moving group was treated by stagnant moving needle into the local excitation point nodule of the left medial vastus muscle fascia in rats,twice a week,for 4 weeks.The mechanical foot contraction reflex threshold of the leftfoot were measured weekly in the pre/post modeling and post-intervention groups of rats.At 4 weeks after treatment,hematoxylin-eosin staining was used to observe the morphological changes in the muscle tissue of the leftmedial femoral muscle of rats,ELISA was used to detect the levels of substance P and β-endorphin in the serum and the gray matter around the midbrain aqueduct.Immunohistochemistry was used to detect positive expression of microglia markers(Iba-1)and c-fos in the gray matter around the midbrain aqueduct.Western blot assay was used to detect the expression level of brain-derived neurotrophic factor protein in the periaqueductal gray.RESULTS AND CONCLUSION:Compared with the blank group,the mechanical pain threshold of the rats in the model group and the stagnant moving needle group decreased after modeling(P<0.05).After 4 weeks of treatment,the mechanical pain threshold of the rats in the stagnant moving needle group was higher than that in the model group(P<0.05).Hematoxylin-eosin staining results showed that in the model group,the muscle fibers of the leftlower limb medial femoral muscle of rats were disorganized,unequal in thickness,myocytes were enlarged,with inward movement of the nucleus,rounded contracture nodules and tension bands;whereas in the stagnant moving needle group,the muscle fibers were arranged in a neat way,the myocytes were angular,and the contracture nodules were occasionally seen.Compared with the blank group,the expression of substance P in the serum of the model group was significantly higher(P<0.05),while the levels of β-endorphin in serum and substance P and β-endorphin in brain were decreased(P<0.01).Compared with the model group,the level of serum substance P in the stagnant moving needle group was decreased(P<0.05),and the levels of serum β-endorphin and brain substance P and β-endorphin were increased(P<0.05).Compared with the blank group,the positive expression of c-fos and Iba-1 and the protein of brain-derived neurotrophic factor in the model group were increased(P<0.05).Compared with the model group,the positive expression of c-fos in the stagnant moving needle group was increased(P<0.05),and the positive expression of Iba-1 and the protein of brain-derived neurotrophic factor were decreased(P<0.05).These findings suggest that stagnant moving needle may indirectly promote the release of β-endorphin by microglia polarized to the M2 phenotype and increase the excitability of c-fos neurons by inhibiting the activity of microglia in the gray matter around the periaqueductal gray and downregulating the expression of brain-derived neurotrophic factor protein,thereby reducing the degree of central sensitization and effectively relieving myofascial pain syndrome.