Objective: To assess the causal association between specific oral microbiota and the risk of oral leukoplakia (OLK) using a Mendelian randomization (MR) approach, and to elucidate the potential mediating role of immune cells. Methods: Summary statistics from genome-wide association studies (GWAS) of the oral microbiome, GWAS data for immune cell phenotypes, and GWAS summary statistics for OLK from FinnGen were used. The inverse variance weighted (IVW) method was adopted as the primary approach, and it was supplemented by MR Egger regression, simple mode, weighted median, and weighted mode methods for additional analyses, to investigate the causal relationship between 3 117 types of tongue coating and salivary microbiota, as well as 731 immune cell traits, and OLK. Furthermore, a two-step MR approach was applied to explore the potential mediating role of immune cells in the association between oral microbiota and OLK. Results: IVW analysis revealed causal associations between 15 oral microbial genera and OLK. Among these, Streptococcus, Neisseria, and Catonella were associated with a reduced risk of OLK, with Fusobacterium showing the most significant protective effect (OR = 0.41, P = 0.023). In contrast, genera, including Microbacterium, Campylobacter, and Haemophilus_A, were linked to an increased risk of OLK, with Lancefieldella exhibiting the strongest risk effect (OR = 2.66, P = 0.006). Eleven immune cell phenotypes with potential causal associations with OLK were identified, including four protective and seven risk-increasing factors. Mediation analysis further identified four key mediating pathways: pathogenic genera, particularly Campylobacter_A and Lancefieldella, may promote the development and progression of OLK by upregulating highly activated pro-inflammatory immune subsets such as activated monocytes, B cells, and myeloid cells. Conversely, the potentially protective genus Catonella appeared to exert inhibitory effects on OLK by significantly downregulating dendritic cell subsets. Conclusion This study is the first to reveal, at the genetic level, causal pathways through which specific oral microbial genera influence the risk of OLK by mediating immune cell responses. These findings provide novel insights into the immunopathological mechanisms underlying OLK and offer potential targets for intervention strategies aimed at modulating specific microbial genera or immune cell subsets.

Parkinson's disease （PD） is a chronic progressive neurodegenerative disorder primarily characterized by motor dysfunction. The main pathological features include the loss of dopaminergic neurons in the substantia nigra， abnormal aggregation of alpha-Synuclein （α-Syn）， and the formation of Lewy bodies. However， the exact mechanisms remain unclear. In recent years， the PD incidence has gradually increased， while current treatment methods are limited to symptom alleviation， incapable of halting disease progression， and prone to adverse effects， thus making it urgent to search for medicines effective for PD. Modern research indicates that the Kelch-like ECH-associated protein 1 （Keap1）/nuclear factor E₂ related factor 2 （Nrf2）/antioxidant response element （ARE） signaling pathway is closely related to oxidative stress， neuroinflammation， apoptosis， ferroptosis， and mitochondrial dysfunction， playing a crucial role in the pathophysiological development of PD. A large number of studies have further confirmed that traditional Chinese medicine （TCM） can regulate diseases through a holistic view of Syndrome differentiation and microscopic molecular pathways. With unique advantages， such as multiple targets， multiple pathways， and fewer adverse reactions， TCM provides a new strategy for PD treatment. This article elucidates the mechanism of the Keap1/Nrf2/ARE signaling pathway in the occurrence and development of PD， while summarizing the latest research on PD intervention by TCM monomers， active ingredients， and compounds， as well as acupuncture via the precise targeted regulation of the Keap1/Nrf2/ARE pathway， aiming to provide a reference for clinical medicine development to prevent and treat PD.

Existentialist philosophy focuses on human existence， explores subjectivity and uniqueness， and highlights the value of human existence. Advanced cancer patients generally suffer immense existential distress， each with their own modes of appearance and numerous possibilities. From the perspective of existentialist philosophy， targeting the group of advanced cancer patients， this paper clarified the analysis of “Dasein” （holistic phenomenon and modes of appearance）. Through recognition （achieving to deepen the inner scope of the subject and object） and comprehension （seeking appropriate “self-knowledge”）， it introduced the planning of variable possibilities. Subsequently， based on the patients’ pre-possessing， pre-seeing， and pre-grasping， explanatory activities were carried out to complete the “self-formation” in the planning. Ultimately， it facilitated the realization of existential meaning in the presupposition and proposed actionable clinical practices （meaning therapy and emotional touch therapy） to alleviate the existential distress of advanced cancer patients.

AIM: To investigate the differences in morphological structure and retinal blood perfusion between the affected eye and the contralateral healthy eye using optical coherence tomography angiography(OCTA)in patients with idiopathic macular epiretinal membrane(IMEM)before and after surgery, and to evaluate the association of these parameters with functional and anatomical outcomes to inform prognostic assessment. METHODS:A prospective study was conducted at Zhejiang Provincial People's Hospital between January 2023 and December 2024. Consecutive patients diagnosed with unilateral IMEM were enrolled; the fellow eye served as an internal control. All participants underwent standardized ophthalmic evaluations, including optical coherence tomography(OCT), OCTA, and color fundus photography. Key quantitative parameters assessed included best-corrected visual acuity(BCVA), central macular thickness(CMT), foveal avascular zone(FAZ)area, vessel density in the inner capillary plexus(ICP), superficial capillary plexus(SCP), deep capillary plexus(DCP), and choroidal capillary perfusion area(CCPA). Measurements were obtained preoperatively and at 1 and 3 mo postoperatively. Correlation analyses were performed between the above parameters and postoperative BCVA and CMT.RESULTS: This study enrolled 30 patients(60 eyes)diagnosed with IMEM, comprising 14 males and 16 females, with a mean age of 65.4±10.8 y.At baseline, IMEM-affected eyes demonstrated significantly reduced BCVA, DCP density, and FAZ area, alongside significantly increased CMT and CCPA, compared with contralateral controls. Following vitrectomy with membrane peeling, CMT decreased significantly at both 1 and 3 mo(both P<0.05)postoperatively; DCP density and BCVA showed significant improvement(both P<0.05). No significant change in FAZ area was observed postoperatively(P>0.05). At 3 mo postoperatively, BCVA of the affected eye was negatively correlated with CMT(r=-0.549, P=0.022). At 1 mo postoperatively, CMT was negatively correlated with preoperative DCP and FAZ, positively correlated with preoperative CMT, and positively correlated with ICP and SCP at 1 mo postoperatively, and negatively correlated with FAZ at 1 mo postoperatively(all P<0.05). Furthermore, CMT at 3 mo postoperatively was negatively correlated with preoperative DCP(r=-0.498,P=0.042).CONCLUSION:In patients with IMEM, the affected eyes exhibit significantly reduced DCP density and FAZ area, alongside increased CMT and CCPA. Following vitrectomy with membrane peeling, CMT decreased progressively, DCP density demonstrated partial restoration, and vision improved gradually. Preoperatively, smaller CMT larger DCP, and FAZ were associated with more favorable surgical outcomes; postoperatively, smaller ICP and SCP densities—combined with a larger FAZ—also correlated with better functional recovery.

Objective: To explore the application method and clinical efficacy of endoscopic and computerized navigation technology in maxillofacial foreign body removal surgery, and to provide a reference for the clinical application of this technology. Methods: This study, which was approved by the Medical Ethics Committee of the hospital, retrospectively analyzed the data of five patients with maxillofacial foreign bodies who were admitted to Sun Yat-sen Memorial Hospital, Sun Yat-sen University from January 2018 to December 2024. All patients underwent preoperative CT scanning. Intraoperatively, endoscopic and computer navigation techniques were used in combination or separately according to the location, size, and adjacency of the foreign body to important neurovascular vessels. The foreign body was precisely localized by endoscopic magnification and direct visualization, and the optimal surgical path was designed and verified under the real-time guidance of computerized navigation to accurately remove the foreign body. The type of foreign body, location, length and diameter, duration of surgery, length of incision, success rate of foreign body removal, postoperative complications, and follow-up were recorded and analyzed. Results: The foreign body was successfully removed in all five patients with a success rate of 100%. The intraoperative computerized navigation system was accurate in positioning, and the alignment stability was not significantly affected by mandibular movement; the endoscope provided good illumination and exposure of the operative field. All surgical incisions were small, and no serious complications, such as foreign body residue, important neurovascular injury, or infection, occurred after surgery. One month after the operation, the patients were followed up and recovered well. Conclusion The combination of endoscopy and computer navigation or separately assisted technology can provide a clear field and real-time positioning for maxillofacial foreign body removal, effectively avoiding important anatomical structures, thus realizing safe and complete foreign body removal with minimized trauma. This assistive technology significantly improves the accuracy and safety of the operation and has clinical promotion value.

Based on the theory of collateral disease， the treatment of late-stage sequela of cerebrovascular disease is considered to be primarily associated with deficiency and obstruction of cerebral collaterals and dysfunction of the spirit mechanism. Therefore， the fundamental therapeutic principle is to unblock and supplement the brain collaterals. Clinically， the late-stage sequelae of cerebrovascular disease are classified into four patterns， which are malnourishment， deficiency-heat， stasis obstruction， and phlegm clouding of brain collaterals. These are treated respectively with Tiansui Tongqiao Decoction （填髓通窍汤） to supplement essence and nourish the brain through moistening， unblocking and supplementing， Qingnao Touluo Decoction （清脑透络汤） to enrich yin， regulate spirit， and unblock collaterals through clearing and penetrating， Yiqi Tongluo Decoction （益气通络汤） to tonify qi and resolve stasis while softening tendons and unblocking collaterals， and Xinrun Touqiao Beverage （辛润透窍饮） to unblock and tonify yin and yang while unblocking the collaterals through acrid-moistening medicinals. Flexible modification of prescriptions according to individual symptoms was applied， resulting in favorable therapeutic outcomes.

This article summarizes the clinical experience in diagnosing and treating narcolepsy based on the wei qi theory. The key pathogenesis of narcolepsy is considered to be the disharmony of wei qi. In the initial stage， lung， spleen， and kidney deficiency leads to insufficient generation and propulsion of wei qi. In the progressive stage， phlegm-damp and qi stagnation obstruct sanjiao （三焦）， while the interstice of flesh is unrelaxed， and the skin pores are occluded， causing sluggish circulation of wei qi. In the attack stage， pathogens obstruct the upper jiao （焦）， whereas pectoral qi fails to diffuse， and wei qi becomes constrained and blocked in the yin aspect， which may transform into wind or heat and bind with phlegm and stasis， resulting in sudden excessive sleep， cataplexy， dream disturbance， hallucinations， and sleep paralysis. Accordingly， a three-stage differentiation and treatment strategy is proposed， including reinforcing the root and strengthening wei qi in the initial stage with Peiben Shiwei Decoction （培本实卫汤）， resolving phlegm and unblocking the pathways to smooth the flow of wei qi in the progressive stage with Tongjiao Dawei Decoction （通焦达卫汤）， and diffusing wei qi， awakening the spirit， and opening the upper jiao in the attack stage with Xuanwei Xingshen Decoction （宣卫醒神汤）. Clinically， treatment should distinguish deficiency from excess， the primary from the secondary， administer staged and dynamic treatments， and make good use of light， clear， ascending， dispersing， acrid， and aromatic medicinals to restore the movement of wei qi， thereby providing a reference for differentiation and treatment of narcolepsy in traditional Chinese medicine.

Post-stroke limb movement disorder is a common functional disorder after stroke.Xuming Decoction in Ancient and Modern Records of the Proven is an important prescription of Zhang Zhongjing for treating"stroke prickly heat,the body cannot hold it-self".It has been modified and recorded in many later generations,among which Xiaoxuming Decoction in Important Formulas Worth a Thousand Gold Pieces for Emergency is the most commonly used.With the development of the"internal wind theory"of stroke,the pre-scriptions of Xuming Decoction were gradually criticized and even abandoned because they often used"wind drugs"and were difficult to understand the medical theory of"internal wind".Based on the viewpoints of"wind prevailing and causing movement"and"internal wind being the change of yang qi in the body",the paper proposes the theory of"inducing wind to promote movement"of Xuming De-coction and believes that"wind is qi".At the beginning of stroke,wind-yang is violently hyperactive,and wind prevails and causes movement,resulting in stroke;after stroke,yang qi is weak,wind is defeated and static,and limbs are unable to use.However,"wind drugs"such as Ephedra sinica Stapf and Cinnamomum aromaticum Nees have the functions of generating wind and promoting movement,revitalizing the decadent and the useless,exciting yang qi,harmonizing the ying and wei,and raising and lowering qi.The Xuming Decoction is mainly composed of"wind drugs",which warms the yang and replenishes the qi,generates wind to excite yang qi,and revitalizes the weak;replenishes the yang to induce wind and promote movement,replenishes qi and generates blood;relieves muscles to harmonize the ying and wei,and dredges the limbs;restores the pivot to regulate the axis of the internal organs,unblocks the qi,and promotes the recovery of limb motor function after stroke,providing a theoretical basis for the clinical application of Xuming Decoction.

Senile osteoporosis is a growing public health challenge with significant impacts on the daily life of the elderly population as a result of its hidden nature,high prevalence,and high risk of disability.Suitable animal models that simulate senile osteoporosis are crucial for understanding its pathological mechanism and to facilitate the development of anti-osteoporosis drugs and identify new therapeutic targets.This review considers the most commonly used method for creating animal models of senile osteoporosis,analyzes their advantages and limitations,and discusses research progress in animal models in terms of evaluation indicators,to provide references for research using animal models of senile osteoporosis.

Objective To investigate the effects of Tongyangxiao(TYX)lotion on the healing of infected wounds and the expression of interleukin(IL)-1β and inhibitor of nuclear factor κBα(IκBα)/p65 in rats.Methods Fifty rats were randomly assigned to the model group,potassium permanganate(PP)group,and low-,medium-,and high-dose(TYX-L,TYX-M,TYX-H)groups,with 10 rats in each group.An open infection model of full-thickness skin defects was established,and the rats in each group were treated with the corresponding medicinal solution for dressing changes once a day for a total of 14 days.The wound healing of rats was observed,and immunofluorescence,immunohistochemistry,and Western blotting were used to detect the nuclear translocation rate of p65 and the expression levels of IL-1β,p-IκBα/IκBα,and p-p65/p65 proteins in the granulation tissue.Results Compared with the model group,the wound healing rates of both the TYX-M group and the TYX-H group increased on the 7th day of treatment(P<0.05).Compared with the model group and the PP group,the wound healing rates of the TYX-L group,the TYX-M group and the TYX-H group increased on the 14th day of treatment(P<0.05).On the 7th day of treatment,the expression of IL-1β in the TYX-M group was lower than that in the PP group and the Model group(P<0.05),and the p-IκBα/IκBα ratio in the TYX-H group was lower than that in the PP group and the model group(P<0.05).The nuclear translocation rates of p65 in the TYX-L group,TYX-M group and TYX-H group were lower than those in the PP group and model group(P<0.05).On the 14th day of treatment,the p-p65/p65 ratio in the TYX-H group and the TYX-M group was lower than that in the model group(P<0.05),and the IL-1β in the TYX-L group,the TYX-M group,and the TYX-H group and p-IκBα/IκBα ratio in the TYX-H group were lower than those in the PP group and the model group(P<0.05).Conclusion The mechanism of TYX lotion in promoting the healing of infected wounds was associated with the suppression of the activation of NF-κB signaling pathway and alleviation of inflammatory responses.