This study aims to explore the medication rules and mechanisms of treating chronic renal failure(CRF) by Jinling medical school based on data mining, network pharmacology, and experimental validation systematically and deeply. Firstly, the study selected the papers published by the inherited clinicians in Jinling medical school in Chinese journals using the subject headings named "traditional Chinese medicine(TCM) + chronic renal failure", "TCM + chronic renal inefficiency", or "TCM + consumptive disease" in China National Knowledge Infrastructure, Wanfang, and VIP Chinese Science and Technology Periodical Database and screened TCM formulas for treating CRF according to inclusion and exclusion criteria. The study analyzed the frequency of use of single TCM and the four properties, five tastes, channel tropism, and efficacy of TCM used with high frequency and performed association rule and clustering analysis, respectively. As a result, a total of 215 TCM formulas and 235 different single TCM were screened, respectively. The TCM used with high frequency included Astragali Radix, Rhei Radix et Rhizoma, Salviae Miltiorrhizae Radix et Rhizoma, Poria, and Atractylodis Macrocephalae Rhizoma(top 5). The single TCM characterized by "cold properties, sweet flavor, and restoring spleen channel" and the TCM with the efficacy of tonifying deficiency had the highest frequency of use, respectively. Then, the TCM with the rules of "blood-activating and stasis-removing" and "diuretic and dampness-penetrating" appeared. In addition, the core combination of TCM [(Hexin Formula, HXF)] included "Astragali Radix, Rhei Radix et Rhizoma, Poria, Salviae Miltiorrhizae Radix, and Angelicae Sinensis Radix". The network pharmacology analysis showed that HXF had 91 active compounds and 250 corresponding protein targets including prostaglandin-endoperoxide synthase 2(PTGS2), PTGS1, sodium voltage-gated channel alpha subunit 5(SCN5A), cholinergic receptor muscarinic 1(CHRM1), and heat shock protein 90 alpha family class A member 1(HSP90AA1)(top 5). Gene Ontology(GO) function analysis revealed that the core targets of HXF predominantly affected biological processes, cellular components, and molecular functions such as positive regulation of transcription by ribonucleic acid polymerase Ⅱ and DNA template transcription, formation of cytosol, nucleus, and plasma membrane, and identical protein binding and enzyme binding. Kyoto Encyclopedia of Genes and Genomes(KEGG) analysis revealed that CRF-related genes were involved in a variety of signaling pathways and cellular metabolic pathways, primarily involving "phosphatidylinositol 3-kinase(PI3K)-protein kinase B(Akt) pathway" and "advanced glycation end products-receptor for advanced glycation end products". Molecular docking results showed that the active components in HXF such as isomucronulatol 7-O-glucoside, betulinic acid, sitosterol, and przewaquinone B might be crucial in the treatment of CRF. Finally, a modified rat model with renal failure induced by adenine was used, and the in vivo experimental confirmation was performed based on the above-mentioned predictions. The results verify that HXF can regulate mitochondrial autophagy in the kidneys and the PI3K-Akt-mammalian target of rapamycin(mTOR) signaling pathway activation at upstream, so as to alleviate renal tubulointerstitial fibrosis and then delay the progression of CRF.
Data Mining ; Drugs, Chinese Herbal/chemistry* ; Network Pharmacology ; Humans ; Kidney Failure, Chronic/metabolism* ; Medicine, Chinese Traditional ; China

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

Abstract In recent years, the prevalence of overweight and obesity among children and adolescents has risen rapidly, posing a serious threat to their physical and mental health. To provide scientific, systematic, and standardized weight management guidance for overweight and obese children and adolescents, the study focuses on the core concept of healthy lifestyle intervention, integrates multidisciplinary expert opinions and research findings,and proposes a comprehensive multidisciplinary intervention framework covering scientific exercise intervention, precise nutrition and diet, optimized sleep management, and standardized psychological support. It calls for the establishment of a multi agent collaborative management mechanism led by the government, implemented by families, fostered by schools, initiated by individuals, optimized by communities, reinforced by healthcare, and coordinated by multiple stakeholders. Emphasizing a child and adolescent centered approach, the consensus advocates for comprehensive, multi level, and personalized guidance strategies to promote the internalization and maintenance of a healthy lifestyle. It serves as a reference and provides recommendations for the effective prevention and control of overweight and obesity, and enhancing the health level of children and adolescents.

Objective:To observe the clinical effect of lower eyelid blepharoplasty combined with micro-autologous fat transplantation (MAFT) in the rejuvenation of the infraorbital regions.Method:A retrospective analysis was conducted on the clinical data of patients with lower eyelid pouch and tear trough treated with lower eyelid blepharoplasty combined with MAFT in the Department of Plastic Surgery of Affiliated Hospital of Nanjing University of Chinese Medicine from March 2020 to March 2022. Patients seeked medical attention due to lower eyelid pouch and tear trough, with or without skin laxity, and some patients had varying degrees of midface depression. After preoperative examination and evaluation of the patient’s infraorbital area and midfacial depression, appropriate individualized plans were developed.The patient underwent lower eyelid blepharoplasty by transconjunctival approach combined with tear trough MAFT. For patients with low or depressed midface, midface MAFT was also performed, and for patients with skin laxity, skin removal surgery was performed simultaneously. Complications were recorded after the operation. Preoperative and postoperative photos of more than 6 months were taken with the same postion and delivered to the same doctor to grade the patient’s Barton classification (0-3 grades, with higher grade indicating more obvious tear trough deformity). The improvement of tear trough deformity after surgery was assessed, and the global aesthetic improvement scale (GAIS) score was also assessed. The patients evaluated their improvement using the patients aesthetic improvement scale (PAIS) score (GAIS and PAIS are both 1-5 points, with higher scores indicating more significant postoperative improvement). Normal distribution metric data was represented by Mean±SD, and count data was represented by frequency and/or percentage; skewed distribution metric data was represented by M ( Q1, Q3), and compared by rank sum test. Results:A total of 69 patients were enrolled, including 9 males and 60 females, aged 25-45 years, with an average age of 36.7 years. Among them, 35 patients had midfacial depression, and 11 patients had skin laxity. (0.37±0.07) ml (0.2-0.6 ml) of micro-autologous fat was injected into the orbicularis oculi muscle on each side; (0.18±0.06) ml (0.1-0.2 ml) of micro-autologous fat was injected into the subcutaneous layer on each side; (3.80±0.98) ml (3-5 ml) of micro-autologous fat was injected into the deep medial cheek fat compartment and pyriform aperture fat compartment on each side. No serious complications occurred after the surgery. Postoperative follow-up lasted for 6-13 months, with an average of 8.7 months. The patient’s lower eyelid pouch, tear trough deformity, and depression in the midface have all improved, presenting a youthful and smooth appearance from the infraorbital area to the midface. The skin texture in the lower eyelid area had also improved. At the last follow-up, the Barton classification of the lacrimal groove decreased compared with that before surgery, and the difference was statistically significant [grade 0 (0, 1) vs. grade 2 (1, 2), Z=-7.62, P<0.001]. At the last follow-up, the PAIS score of 69 patients was 5 points in 49 cases (71%) and 4 points in 20 cases (29%); doctor’s GAIS score was 5 points in 38 cases (55%), 4 points in 27 cases (39%), and 3 points in 4 cases (6%) . Conclusion:For those patients with aging status of infraorbital region, like lower eyelid pouch and tear trough deformities, the combination of lower eyelid blepharoplasty through the transconjunctival approach and MAFT can achieve good therapeutic effects. This method is safe with a short recovery time.

Objective:To observe the clinical effect of lower eyelid blepharoplasty combined with micro-autologous fat transplantation (MAFT) in the rejuvenation of the infraorbital regions.Method:A retrospective analysis was conducted on the clinical data of patients with lower eyelid pouch and tear trough treated with lower eyelid blepharoplasty combined with MAFT in the Department of Plastic Surgery of Affiliated Hospital of Nanjing University of Chinese Medicine from March 2020 to March 2022. Patients seeked medical attention due to lower eyelid pouch and tear trough, with or without skin laxity, and some patients had varying degrees of midface depression. After preoperative examination and evaluation of the patient’s infraorbital area and midfacial depression, appropriate individualized plans were developed.The patient underwent lower eyelid blepharoplasty by transconjunctival approach combined with tear trough MAFT. For patients with low or depressed midface, midface MAFT was also performed, and for patients with skin laxity, skin removal surgery was performed simultaneously. Complications were recorded after the operation. Preoperative and postoperative photos of more than 6 months were taken with the same postion and delivered to the same doctor to grade the patient’s Barton classification (0-3 grades, with higher grade indicating more obvious tear trough deformity). The improvement of tear trough deformity after surgery was assessed, and the global aesthetic improvement scale (GAIS) score was also assessed. The patients evaluated their improvement using the patients aesthetic improvement scale (PAIS) score (GAIS and PAIS are both 1-5 points, with higher scores indicating more significant postoperative improvement). Normal distribution metric data was represented by Mean±SD, and count data was represented by frequency and/or percentage; skewed distribution metric data was represented by M ( Q1, Q3), and compared by rank sum test. Results:A total of 69 patients were enrolled, including 9 males and 60 females, aged 25-45 years, with an average age of 36.7 years. Among them, 35 patients had midfacial depression, and 11 patients had skin laxity. (0.37±0.07) ml (0.2-0.6 ml) of micro-autologous fat was injected into the orbicularis oculi muscle on each side; (0.18±0.06) ml (0.1-0.2 ml) of micro-autologous fat was injected into the subcutaneous layer on each side; (3.80±0.98) ml (3-5 ml) of micro-autologous fat was injected into the deep medial cheek fat compartment and pyriform aperture fat compartment on each side. No serious complications occurred after the surgery. Postoperative follow-up lasted for 6-13 months, with an average of 8.7 months. The patient’s lower eyelid pouch, tear trough deformity, and depression in the midface have all improved, presenting a youthful and smooth appearance from the infraorbital area to the midface. The skin texture in the lower eyelid area had also improved. At the last follow-up, the Barton classification of the lacrimal groove decreased compared with that before surgery, and the difference was statistically significant [grade 0 (0, 1) vs. grade 2 (1, 2), Z=-7.62, P<0.001]. At the last follow-up, the PAIS score of 69 patients was 5 points in 49 cases (71%) and 4 points in 20 cases (29%); doctor’s GAIS score was 5 points in 38 cases (55%), 4 points in 27 cases (39%), and 3 points in 4 cases (6%) . Conclusion:For those patients with aging status of infraorbital region, like lower eyelid pouch and tear trough deformities, the combination of lower eyelid blepharoplasty through the transconjunctival approach and MAFT can achieve good therapeutic effects. This method is safe with a short recovery time.

Objective To compare the safety and efficacy of emergency balloon dilation angioplasty with emergency stent implantation in treating patients with acute anterior tandem occlusion caused by atherosclerosis at the starting segment of the internal carotid artery.Methods A total of 91 patients with stroke caused by acute anterior tandem occlusion,who were admitted to the First Affiliated Hospital of Hainan Medical College and the Third Affiliated Hospital of Guangzhou Medical University of China within 24 hours after disease onset to receive treatment from January 2018 to October 2022,were enrolled in this study.The patients were divided into balloon dilation angioplasty group(balloon dilation group,n=51)and stent implantation group(stenting group,n=40).The basic clinical data were compared between the two groups.The modified thrombolysis in cerebral infarction(mTICI)grade 2b-3 was defined as a good recanalization.The postoperative 90-day modified Rankin scale(mRS)score of 0-2 points was defined as a good clinical prognosis.Results The good recanalization rate and postoperative 90-day good clinical prognosis rate in the stenting group were 70％and 60％respectively,which were higher than 60％and 52％respectively in the balloon dilation group,and the differences between the two groups were not statistically significant(P=0.361 and P=0.391 respectively).The incidences of symptomatic intracranial hemorrhage(sICH),asymptomatic intracranial hemorrhage(aSICH),and mortality in the stenting group were 10％,32.5％,and 22.5％respectively,which in the balloon dilation group were 11.8％,41.2％,and 17.7％respectively,and the differences between the two groups were not statistically significant(P=1.000,P=0.396,and P=0.564 respectively).Conclusion For the treatment of patients with acute anterior tandem occlusion caused by atherosclerosis at the starting segment of the internal carotid artery,both emergency balloon dilation angioplasty or stent implantation are clinically safe and effective.(J Intervent Radiol,2024,33:593-598)

Objective To investigate the clinical characteristics and prognosis of pneumococcal meningitis(PM),and drug sensitivity of Streptococcus pneumoniae(SP)isolates in Chinese children.Methods A retrospective analysis was conducted on clinical information,laboratory data,and microbiological data of 160 hospitalized children under 15 years old with PM from January 2019 to December 2020 in 33 tertiary hospitals across the country.Results Among the 160 children with PM,there were 103 males and 57 females.The age ranged from 15 days to 15 years,with 109 cases(68.1% )aged 3 months to under 3 years.SP strains were isolated from 95 cases(59.4% )in cerebrospinal fluid cultures and from 57 cases(35.6% )in blood cultures.The positive rates of SP detection by cerebrospinal fluid metagenomic next-generation sequencing and cerebrospinal fluid SP antigen testing were 40% (35/87)and 27% (21/78),respectively.Fifty-five cases(34.4% )had one or more risk factors for purulent meningitis,113 cases(70.6% )had one or more extra-cranial infectious foci,and 18 cases(11.3% )had underlying diseases.The most common clinical symptoms were fever(147 cases,91.9% ),followed by lethargy(98 cases,61.3% )and vomiting(61 cases,38.1% ).Sixty-nine cases(43.1% )experienced intracranial complications during hospitalization,with subdural effusion and/or empyema being the most common complication[43 cases(26.9% )],followed by hydrocephalus in 24 cases(15.0% ),brain abscess in 23 cases(14.4% ),and cerebral hemorrhage in 8 cases(5.0% ).Subdural effusion and/or empyema and hydrocephalus mainly occurred in children under 1 year old,with rates of 91% (39/43)and 83% (20/24),respectively.SP strains exhibited complete sensitivity to vancomycin(100% ,75/75),linezolid(100% ,56/56),and meropenem(100% ,6/6).High sensitivity rates were also observed for levofloxacin(81% ,22/27),moxifloxacin(82% ,14/17),rifampicin(96% ,25/26),and chloramphenicol(91% ,21/23).However,low sensitivity rates were found for penicillin(16% ,11/68)and clindamycin(6% ,1/17),and SP strains were completely resistant to erythromycin(100% ,31/31).The rates of discharge with cure and improvement were 22.5% (36/160)and 66.2% (106/160),respectively,while 18 cases(11.3% )had adverse outcomes.Conclusions Pediatric PM is more common in children aged 3 months to under 3 years.Intracranial complications are more frequently observed in children under 1 year old.Fever is the most common clinical manifestation of PM,and subdural effusion/emphysema and hydrocephalus are the most frequent complications.Non-culture detection methods for cerebrospinal fluid can improve pathogen detection rates.Adverse outcomes can be noted in more than 10% of PM cases.SP strains are high sensitivity to vancomycin,linezolid,meropenem,levofloxacin,moxifloxacin,rifampicin,and chloramphenicol.[Chinese Journal of Contemporary Pediatrics,2024,26(2):131-138]

Objective:To explore the efficacy and safety of ibrutinib for the treatment of newly treated and relapsed refractory (R/R) lymphoplasmacytic lymphoma (LPL) /Waldenstr?m macroglobulinemia (WM) .Methods:Retrospectively collected clinical data of 98 cases of newly treated and R/R LPL/WM patients who received ibrutinib treatment at the Hematology & Blood Diseases Hospital of the Chinese Academy of Medical Sciences from March 2016 to June 2023, and analyzed their efficacy and safety.Results:A total of 98 LPL/WM patients were included, which consisted of 45 newly treated patients and 53 R/R patients. Of these, 74 were males (75.5%) and the cohort had a median age of 64 (42-87) years. Eighty-eight patients were eligible for efficacy evaluation with a median treatment time of 20.8 (2.1-55.0) months, a major remission rate (MRR) of 78.4%, and an overall response rate (ORR) of 85.2%. The MRR and ORR of the newly treated patients were 78.4% and 86.5%, respectively, whereas the MRR and ORR of the R/R patients were 78.4% and 84.3%, respectively. There were no statistically significant differences in MRR and ORR between the initial treatment and R/R patients (all P values >0.05) . The median follow-up period was 29.1 (2.9-50.3) months and the median overall survival time for newly treated and R/R patients was not reached. The median progression-free survival time was 23.5 (95% CI 10.5-36.5) months and 45.0 (95% CI 34.0-56.0) months, respectively, with no statistically significant differences (all P values >0.05) . There were 25 deceased patients and no deaths were related to ibrutinib treatment. The main adverse reactions of ibrutinib were thrombocytopenia (5.1%) , pneumonia (8.1%) , and hyperuricemia (21.4%) . The incidence of atrial fibrillation was 2.0%. Conclusion:Ibrutinib exhibits good efficacy and safety for newly treated and R/R LPL/WM patients.

Objective To develop a deep learning model for automated age estimation based on 3D CT reconstructed images of Han population in western China,and evaluate its feasibility and reliability.Methods The retrospective pelvic CT imaging data of 1 200 samples(600 males and 600 females)aged 20.0 to 80.0 years in western China were collected and reconstructed into 3D virtual bone models.The images of the ischial tuberosity feature region were extracted to create sex-specific and left/right site-specific sample libraries.Using the ResNet34 model,500 samples of different sexes were randomly selected as training and verification set,the remaining samples were used as testing set.Initialization and transfer learning were used to train images that distinguish sex and left/right site.Mean absolute error(MAE)and root mean square error(RMSE)were used as primary indicators to evaluate the model.Results Prediction results varied between sexes,with bilateral models outperformed left/right unilateral ones,and transfer learning models showed superior performance over initial models.In the prediction results of bilateral transfer learning models,the male MAE was 7.74 years and RMSE was 9.73 years,the female MAE was 6.27 years and RMSE was 7.82 years,and the mixed sexes MAE was 6.64 years and RMSE was 8.43 years.Conclusion The skeletal age estimation model,utilizing is-chial tuberosity images of Han population in western China and employing the ResNet34 combined with transfer learning,can effectively estimate adult ischium age.

Objective To establish the method for content determination of three lignans of Dendrobium Fimbriatum Hook..Methods The lignans in Dendrobium tasselii were identified by high-performance liquid chromatography/multi-stage mass spectrometry(HPLC-ESI/MSn)coupled with ultraviolet absorption spectrometry(UV)coupled with retention time localization of high-performance liquid chromatography(HPLC).The separation was carried out on a Kromasil 100-5 C18 column(4.6 mm×250 mm,5 μm)using a gradient elution of acetonitrile-0.1%formic acid solution as the mobile phase,the volume flow rate was 0.8 mL·min-1 and the column temperature was 35℃,and the mass spectrometry was performed using an ESI ion source with the data collected in the negative ion mode.The HPLC content was determined on the same column as that of MS analysis,with the mobile phase methanol + acetonitrile(V/V=1∶1)-0.01 mol/L ammonium acetate solution,gradient elution,flow rate of 0.8 mL·min-1,column temperature of 40℃,and detection wavelength of 215 nm.Results Syringaresinol di-O-glucoside and(-)-Syringaresinol 4-O-β-D-glucopyranoside and DL-Syringaresinol were identified from Dendrobium fimbriatum Hook.,and the results of content determination showed that the linear ranges of above three components were respectively 0.1701-3.4020,0.1020-2.0400,0.0403-0.8060 μg(r≥0.9995),the average recoveries were in the range of 97.71%-101.67%,and the relative standard deviations(RSDs)were all less than 3.0%.The contents of Syringaresinol di-O-glucoside and(-)-Syringaresinol 4-O-β-D-glucopyranoside and DL-Syringaresinol in the 10 batches of samples were 0.7779-1.3852,0.0734-0.1966,0.0295-0.1882 mg·g-1.Conclusion This research method can provide a reference basis for the quality evaluation method of Dendrobium fimbriatum Hook..