Based on the thinking of programmatization and proceduralization， this study integrated traditional Chinese medicine （TCM） classic theories with modern knowledge expression technologies to construct a "formula-symptom" syndrome differentiation thinking model centered on "symptom clustering-main syndrome screening-formula adaptation"， and explored the standardization and intelligentization path of TCM syndrome differentiation and treatment. By establishing the mapping relationship model between formulas and syndromes including quantitative weight analysis of chief， deputy， assistant and envoy medicines， designing the logical hierarchical structure of formula-syndrome decision tree （application of three-level decision tree and fuzzy logic）， and formulating the procedural design of four diagnostic methods （structured collection， correlation model， and dynamic correction mechanism）， the standardization and visualization of the syndrome differentiation process are realized. This model can be transformed into the core data set for artificial intelligence training. Through ternary knowledge graph and machine learning algorithms， it can improve the repeatability of syndrome differentiation and the efficiency of diagnosis and treatment， and implement the strategy of "group model + individual modification" to balance the conflict between quantification and individualization. The core value of this model lies in promoting the objectification and precision development of TCM syndrome differentiation and treatment through the integration of traditional syndrome differentiation thinking and modern system science.

Diabetic nephropathy(DN)is a significant causative factor of end-stage renal disease globally,and its pathogenesis involves dysregulation of multiple cellular and hormonal pathways.Podocytes play crucial roles in the process of DN,with the extent of podocyte injury closely associated with key pathological manifestations of renal damage,such as proteinuria,glomerular filtration rate,and glomerulosclerosis.However,due to the complexity and interplay of mechanisms contributing to podocyte injury,such as oxidative stress,abnormal lipid metabolism,and mitochondrial damage,the precise mechanisms underlying podocyte injury remain incompletely understood.This review integrated the latest research findings from both domestic and international studies on the core mechanisms of podocyte injury in DN.Furthermore,this article summarized the implications of these mechanisms for DN treatment,particularly focusing on potential therapeutic targets and the development of related pharmacological interventions derived from targeting podocyte injury pathways,so as to provide a theoretical foundation for the development of clinical therapeutic strategies for DN.

Objective:To explore the predictive value of MR diffusion kurtosis imaging(DKI)-derived quantitative parameters combined with serum breast cancer susceptibility gene 1(BRCA1)level for postoperative recurrence and metastasis in breast cancer patients.Methods:A total of 73 patients with breast cancer who were treated in our hospital from Mar 2023 to Jan 2024 were selected as the study group,and another 73 patients with benign breast nodules who were treated in the same period were selected as the control group.The quantitative parameters of MR DKI[mean diffusion rate(MD)and diffusion kurtosis(MK)]and serum BRCA1 level were compared between the two groups and among subgroups of the study group with different clinical pathological characteristics,and the correlation was further analyzed.According to the recurrence status within 6 months after surgery,the patients were divided into recurrence/metastasis group(n=24)and non-recurrence/metastasis group(n=49).The MD,MK and serum BRCA1 level were compared between the two groups,and the predictive value was analyzed using the receiver operating characteristic(ROC)curve.Results:MD,MK,and serum BRCA1 level in the study group were higher than those in the control group(P＜0.05).Significant differences in MD,MK,and BRCA1 levels were observed among patients with different differentiation grades,clinical stages,and lymph node metastasis(P＜0.05).MD,MK,and serum BRCA1 level were positively correlated with clinical stage and lymph node metastasis,and negatively correlated with differentiation grades(P＜0.05).The recurrence/metastasis group exhibited higher MD,MK,and BRCA1 levels than the non-recurrence/metastasis group(P＜0.05).The area under the curve of the combined detection of MD,MK,and serum BRCA1 level for the recurrence of breast cancer patients was 0.856,with sensitivity of 91.67%and specificity of 79.59%.Conclusions:The quantitative parameters of MR DKI and serum BRCA1 level are closely related to clinical stages,differentiation degree,lymph node metastasis,and postoperative recurrence and metastasis,demonstrating significant value in early diagnosis,treatment,and prognosis of breast cancer.

Wu Jutong's academic thoughts are inherited from Ye Tianshi and traced back to Zhongjing,and have a unique under-standing and play of the evil invading Shaoyang.Wu Jutong believes that Shaoyang has two major functional characteristics:ascending and pivoting.The principle of treating evil invading Shaoyang is to follow the ascending nature of Shaoyang and restore the pivoting function of Shaoyang.For Shaoyang fire-heat syndrome,follow Shaoyang to ascend and disperse to penetrate heat,and often use light,scavenging and dispersing products;for Shaoyang phlegm-fluid syndrome,creat Xiangfu Xuanfuhua Decoction to benefit the liver and gallbladder and resolve phlegm-fluid;for malaria invading Shaoyang,turn the pivot to stop malaria,and use Xiaochaihu Decoction and Qinghao Biejia Decoction for the treatment;for yin evil invading Shaoyang and Jueyin,Xiao Chaihu Decoction and Bupleurum chinense DC.are often used to turn the pivot of Shaoyang and warm and unchoke Jueyin.The contraindications of Xiao Chaihu Decoction are al-so summarized.

Objective:To explore the predictive value of MR diffusion kurtosis imaging(DKI)-derived quantitative parameters combined with serum breast cancer susceptibility gene 1(BRCA1)level for postoperative recurrence and metastasis in breast cancer patients.Methods:A total of 73 patients with breast cancer who were treated in our hospital from Mar 2023 to Jan 2024 were selected as the study group,and another 73 patients with benign breast nodules who were treated in the same period were selected as the control group.The quantitative parameters of MR DKI[mean diffusion rate(MD)and diffusion kurtosis(MK)]and serum BRCA1 level were compared between the two groups and among subgroups of the study group with different clinical pathological characteristics,and the correlation was further analyzed.According to the recurrence status within 6 months after surgery,the patients were divided into recurrence/metastasis group(n=24)and non-recurrence/metastasis group(n=49).The MD,MK and serum BRCA1 level were compared between the two groups,and the predictive value was analyzed using the receiver operating characteristic(ROC)curve.Results:MD,MK,and serum BRCA1 level in the study group were higher than those in the control group(P＜0.05).Significant differences in MD,MK,and BRCA1 levels were observed among patients with different differentiation grades,clinical stages,and lymph node metastasis(P＜0.05).MD,MK,and serum BRCA1 level were positively correlated with clinical stage and lymph node metastasis,and negatively correlated with differentiation grades(P＜0.05).The recurrence/metastasis group exhibited higher MD,MK,and BRCA1 levels than the non-recurrence/metastasis group(P＜0.05).The area under the curve of the combined detection of MD,MK,and serum BRCA1 level for the recurrence of breast cancer patients was 0.856,with sensitivity of 91.67%and specificity of 79.59%.Conclusions:The quantitative parameters of MR DKI and serum BRCA1 level are closely related to clinical stages,differentiation degree,lymph node metastasis,and postoperative recurrence and metastasis,demonstrating significant value in early diagnosis,treatment,and prognosis of breast cancer.

Wu Jutong's academic thoughts are inherited from Ye Tianshi and traced back to Zhongjing,and have a unique under-standing and play of the evil invading Shaoyang.Wu Jutong believes that Shaoyang has two major functional characteristics:ascending and pivoting.The principle of treating evil invading Shaoyang is to follow the ascending nature of Shaoyang and restore the pivoting function of Shaoyang.For Shaoyang fire-heat syndrome,follow Shaoyang to ascend and disperse to penetrate heat,and often use light,scavenging and dispersing products;for Shaoyang phlegm-fluid syndrome,creat Xiangfu Xuanfuhua Decoction to benefit the liver and gallbladder and resolve phlegm-fluid;for malaria invading Shaoyang,turn the pivot to stop malaria,and use Xiaochaihu Decoction and Qinghao Biejia Decoction for the treatment;for yin evil invading Shaoyang and Jueyin,Xiao Chaihu Decoction and Bupleurum chinense DC.are often used to turn the pivot of Shaoyang and warm and unchoke Jueyin.The contraindications of Xiao Chaihu Decoction are al-so summarized.

Iron is indispensable for the viablility of nearly all living organisms, and it is imperative for cells, tissues, and organisms to acquire this essential metal sufficiently and maintain its metabolic stability for survival. Disruption of iron homeostasis can lead to the development of various diseases. There is a robust connection between iron metabolism and infection, immunity, inflammation, and aging, suggesting that disorders in iron metabolism may contribute to the pathogenesis of arthritis. Numerous studies have focused on the significant role of iron metabolism in the development of arthritis and its potential for targeted drug therapy. Targeting iron metabolism offers a promising approach for individualized treatment of arthritis. Therefore, this review aimed to investigate the mechanisms by which the body maintains iron metabolism and the impacts of iron and iron metabolism disorders on arthritis. Furthermore, this review aimed to identify potential therapeutic targets and active substances related to iron metabolism, which could provide promising research directions in this field.

YOU Zaijing,a doctor of Wumen region,and a famous expert of Treatise on Pathogenic Diseases, also made great achievements in warm diseases. He cleared the source of cold pathogenic diseases and warm diseases, distinguish the difference between them. He put forward the importance of correcting and understanding the disease nomenclature. He explained the names of warm diseases,wind-warm disonder, pestilence,damp-warm disease,warm toxin and warm malaria.He divided warm diseases into newly acquired warm disease, warm disease caused by incubating pathogens, warm disease mixed with dampness and pestilence.He used pungent and cool natured drugs and the method of regulating lung to treat wind warm diseases.In the treatment of warm toxin, he used the method of venting pathogen with cool-scattered natured drugs. In the treatment of warm disease caused by incubating pathogens,he used the method of clearing away heat, nourishing yin and venting pathogen. In the treatment of dampness-warm disease, he used the method of eliminating dampness and heat separately. In the treatment of pestilence, he took the location of disease as the core.According to the different disease locations of the pestilence, different treatment methods and prescriptions were selected.He listed five methods of treating pestilence and established a theoretical framework for the treatment of pestilence,embodying the thought of guiding the trend along the development.He put forward the theory of Six Channels directing Cold and Warm early.He tried to use the syndrome differentiation of six channels system to direct all exogenous diseases such as cold pathogenic diseases and warm diseases. He was the pioneer advocator of the cold-warm combined theory. His views on warm diseases had a profound impact on later doctors. This paper summarizes his main points, analyzes his theory, and provides inspiration for the diagnosis and treatment of warm diseases.

Objective:To investigate epidemiological and clinical characteristics of botulism, and the adverse events among those received botulinum antitoxin treatment.Methods:Patients with discharge diagnosis as botulism in the Second Affiliated Hospital of Xinjiang Medical University were enrolled between 2017 and 2021. The epidemiological and clinical characteristics were evaluated. Infection and mechanical ventilation as in-hospital outcomes according to baseline characteristics were analyzed. Patients with and without the interested outcomes were compared. The adverse outcomes among those received botulinum antitoxin treatment were investigated. Those with and without the adverse outcomes were also compared.Results:Sixty-seven cases of botulism were enrolled, and most cases got sick between January and March (32/67, 47.8%); among them 62 cases were Han ethnicity (92.5%); prevalence was highest in Aksu region (15/67, 22.4%); commonly seen symptoms and signs included fatigue (58/67, 86.6%), dysphagia (48/67, 71.6%), dizziness (42/67, 62.7%), ptosis (42/67, 62.7%), blurred vision (41/67, 61.2%), and limb weakness (35/67, 52.2%). Compared with patients without in-hospital infection ( n=52), patients with in-hospital infection ( n=15) were more likely to have severe botulism (0/52 vs 5/15, χ 2=19.79, P<0.001), diplopia (16/52, 30.8% vs 11/15, χ 2=8.77, P=0.003), dysarthria (17/52, 32.7% vs 11/15, χ 2=7.91, P=0.005), consciousness disorder (1/52, 1.9% vs 4/15, χ 2=10.32, P=0.008). Compared with patients without mechanical ventilation (62/67, 92.5%), patients with mechanical ventilation (5/67, 7.5%) were more likely to have severe botulism (5/5 vs 0/62, χ 2=41.17, P<0.001), and consciousness disorder (4/5 vs 1/62, 1.6%, χ 2=29.58, P<0.001). Among 67 cases of botulism, 19 cases (28.4%) had adverse events after receiving antitoxin treatment, with an average of 6.5 days from the antitoxin treatment beginning to the adverse event onset; among the 19 cases, 18 cases (94.7%) had rash. Age, sex, and severity did not differ between the groups with ( n=19) and without adverse events ( n=48) after receiving antitoxin treatment. Conclusions:Fatigue, dysphagia, dizziness, ptosis were the most frequent symptoms and signs in the botulism in Xinjiang Uygur Autonomous Region, China. Infection was a commonly seen complication of botulism, and proactive prevention and close monitoring were needed. Adverse events after receiving antitoxin were prevalent, and might not be associated with age, sex, and severity of botulism.

Objective:To observe the clinical effect of scraping therapy on lumbar disc herniation (LDH) with different syndromes.Methods:Using the convenient sampling method, a total of 30 non-emergency LDH patients who were admitted to Department of Orthopedics and Traumatology of Yangzhou Hospital of Traditional Chinese Medicine from July 2017 to June 2018 were selected as the research objects. Among them, there were 11 cases of qi stagnation and blood stasis syndrome, 8 cases of damp-heat obstruction syndrome, 7 cases of cold-damp obstruction syndrome and 4 cases of liver and kidney deficiency syndrome. Du meridian, the bladder meridian of Foot Taiyang, as well as Jiaji (EX-B2) in pathological or painful sections, Ashi point, Shenshu (BL 23) , and Weizhong (BL 40) were mainly scraped. The treatment interval is 2~5 days (the marks of scrapping fade) , twice of scrapping as a treatment course and a total of 3 courses involved in the whole treatment. Japanese Orthopaedic Association (JOA) Score, Visual Analogue Scale (VAS) , serum interleukin-1 β (IL-1β) and interleukin-10 (IL-10) were compared before and after scraping.Results:Compared with those before scraping, the JOA score increased, the VAS decreased, the serum IL-1β content decreased and the serum IL-10 content increased after scraping, and the differences were sttaistically significant ( P<0.01) . Among them, the JOA scores of patients with qi stagnation and blood stasis syndrome and cold-damp obstruction syndrome were higher than those of damp-heat obstruction syndrome and liver-kidney deficiency syndrome, and the differences were statistically significant ( P<0.05) . The levels of serum IL-10 in patients with qi stagnation and blood stasis syndrome, damp-heat obstruction syndrome and cold-damp obstruction syndrome were higher than those in patients with liver-kidney deficiency syndrome, and the differences were statistically significant ( P<0.05) . Conclusions:The curative effect of scraping in the treatment of LDH is definite, and the curative effect is better for excessive syndromes.