ObjectiveTo explore the academic characteristics of contemporary renowned Chinese medicine masters in treating diabetic kidney disease （DKD） from the perspectives of principles， methods， formulas， and medications. MethodsIn strict accordance with the Systematic Review of Text and Opinion （SrTO） process developed by the Joanna Briggs Institute （JBI）， an Australian evidence-based healthcare center， the databases including China National Knowledge Infrastructure （CNKI）， VIP Database， Wanfang Data， and China Biomedical Literature Service System （SinoMed） were searched. Based on predefined inclusion and exclusion criteria， text information extraction， quality evaluation， and text information synthesis were conducted sequentially. The data were analyzed and presented in the form of text and figures. ResultsA total of 215 articles related to 43 contemporary renowned experts in the fields of Chinese medicine nephrology and endocrinology were included. The study found that the academic thoughts of these masters in the treatment of DKD are extensive， involving multiple levels such as disease understanding， therapeutic strategies， formula application， and medication use. In terms of disease understanding， the primary pathogenesis is characterized by deficiency in the root and excess in the manifestation. It is emphasized that internal factors， such as congenital endowment deficiency， interact with external factors such as improper diet， emotional disturbances， invasion of exogenous pathogens， and delayed or inappropriate treatment， to jointly induce the disease. This further gives rise to various pathogenetic theories， including obstruction of renal collaterals by blood stasis， toxin-induced damage to renal collaterals， latent wind disturbing the kidney， and internal heat leading to mass formation. In terms of therapeutic strategies and medication use， the principal treatment method is to replenish Qi and nourish Yin. Stage-based and syndrome-differentiated treatments are advocated. Flexible use of insect-derived drugs and wind-dispelling drugs is emphasized， along with proficiency in applying classical formulas and drug pairs. Integrated internal and external treatments， as well as the combined application of multiple therapeutic approaches， are commonly employed for comprehensive management. Meanwhile， the concept of "preventive treatment of disease" is upheld， and individualized long-term management of patients is advocated. ConclusionThrough the SrTO process， the academic thoughts of contemporary renowned Chinese medicine masters in the treatment of DKD have been systematically and standardly synthesized， providing a scientific and standardized basis for future theoretical exploration.

ObjectiveTo explore the academic characteristics of contemporary renowned Chinese medicine masters in treating diabetic kidney disease （DKD） from the perspectives of principles， methods， formulas， and medications. MethodsIn strict accordance with the Systematic Review of Text and Opinion （SrTO） process developed by the Joanna Briggs Institute （JBI）， an Australian evidence-based healthcare center， the databases including China National Knowledge Infrastructure （CNKI）， VIP Database， Wanfang Data， and China Biomedical Literature Service System （SinoMed） were searched. Based on predefined inclusion and exclusion criteria， text information extraction， quality evaluation， and text information synthesis were conducted sequentially. The data were analyzed and presented in the form of text and figures. ResultsA total of 215 articles related to 43 contemporary renowned experts in the fields of Chinese medicine nephrology and endocrinology were included. The study found that the academic thoughts of these masters in the treatment of DKD are extensive， involving multiple levels such as disease understanding， therapeutic strategies， formula application， and medication use. In terms of disease understanding， the primary pathogenesis is characterized by deficiency in the root and excess in the manifestation. It is emphasized that internal factors， such as congenital endowment deficiency， interact with external factors such as improper diet， emotional disturbances， invasion of exogenous pathogens， and delayed or inappropriate treatment， to jointly induce the disease. This further gives rise to various pathogenetic theories， including obstruction of renal collaterals by blood stasis， toxin-induced damage to renal collaterals， latent wind disturbing the kidney， and internal heat leading to mass formation. In terms of therapeutic strategies and medication use， the principal treatment method is to replenish Qi and nourish Yin. Stage-based and syndrome-differentiated treatments are advocated. Flexible use of insect-derived drugs and wind-dispelling drugs is emphasized， along with proficiency in applying classical formulas and drug pairs. Integrated internal and external treatments， as well as the combined application of multiple therapeutic approaches， are commonly employed for comprehensive management. Meanwhile， the concept of "preventive treatment of disease" is upheld， and individualized long-term management of patients is advocated. ConclusionThrough the SrTO process， the academic thoughts of contemporary renowned Chinese medicine masters in the treatment of DKD have been systematically and standardly synthesized， providing a scientific and standardized basis for future theoretical exploration.

ObjectiveStarting from the etiology， pathogenesis， and treatment strategies of endometriosis and adenomyosis， to integrate and sort out the academic characteristics of contemporary renowned experts and schools in the field of traditional Chinese medicine gynecology. MethodsAccording to the systematic review of text and opinion （SrTO） process developed by the Joanna Briggs Institute （JBI） in Australia， this paper determined literature screening criteria by searching China National Knowledge Infrastructure （CNKI）， VIP， Wanfang， and China Biomedical Literature Database. Information was extracted after literature screening， and quality evaluation was conducted using the JBI Narrative， Text， and Opinion Systematic Review Strict Evaluation Checklist. The JBI Narrative， Opinion， Text Evaluation， and Review Tool Summary Table was used for information synthesis， and data analysis and display were conducted in the form of text and charts. ResultsThe 146 articles related to 39 renowned experts and 19 articles related to 10 schools of thought were included. Research has found that contemporary experts and schools in traditional Chinese medicine gynecology consider blood stasis as the core pathogenesis in understanding the etiology and pathogenesis of two diseases and related infertility. Their viewpoints varied from multiple aspects such as clinical symptom characteristics， meridian circulation location， pathological product evolution， disease duration， emotional psychology， lifestyle habits， preference for food and drink， innate endowment， and acquired injury. In terms of treatment， it was advocated to divide the stage， treat according to different types， adapt to the times， integrate nature and humans， and combine multiple methods to treat comprehensively when necessary. It was also recommended to skillfully use insects， make good use of classic formulas and small prescriptions， pay attention to protecting the spleen and stomach and regulating emotions， and make good use of self-formulated empirical formulas for internal or external use. Besides， individualized long-term management of patients was also advocated. ConclusionThis study applies the SrTO process to systematically summarize the academic ideas of contemporary renowned experts and schools in traditional Chinese medicine gynecology regarding the causes， mechanisms， diagnosis， and treatments of endometriosis， providing a scientific and standardized reference for future theoretical exploration.

Delirium is a common cause and complication of hospitalization in the elderly and is associated with higher risk of future dementia and progression of existing dementia, of which 70% is Alzheimer's disease (AD). AD and delirium, which are known to be aggravated by one another, represent significant societal challenges, especially in light of the absence of effective treatments. The intricate biological mechanisms have led to numerous clinical trial setbacks and likely contribute to the limited efficacy of existing therapeutics. Artificial intelligence (AI) presents a promising avenue for overcoming these hurdles by deploying algorithms to uncover hidden patterns across diverse data types. This review explores the pivotal role of AI in revolutionizing drug discovery for AD and delirium from target identification to the development of small molecule and protein-based therapies. Recent advances in deep learning, particularly in accurate protein structure prediction, are facilitating novel approaches to drug design and expediting the discovery pipeline for biological and small molecule therapeutics. This review concludes with an appraisal of current achievements and limitations, and touches on prospects for the use of AI in advancing drug discovery in AD and delirium, emphasizing its transformative potential in addressing these two and possibly other neurodegenerative conditions.

Purpose To investigate the differential diagnosis of diffusion-weighted imaging(DWI),perfusion-weighted imaging(PWI)and DWI combined with PWI in supratentorial pilocytic astrocytoma(PA)and WHO grade 2 pleomorphic xanthoastrocytoma(PXA).Materials and Methods The conventional MRI,DWI and PWI data of 23 cases of supratentorial PA and 11 cases of PXA(WHO grade 2)in the First Affiliated Hospital of Fujian Medical University from January 2010 to February 2022 were retrospectively analyzed.Supratentorial PA was further divided into lobar PA and non-lobar PA based on the lesion location.The basic data(gender,age,cystic degeneration,homogeneous enhancement,lesion size and meningeal involvement),minimum apparent diffusion coefficient,relative apparent diffusion coefficient and relative maximum cerebral blood volume were compared and analyzed between the two groups.Results The probability of leptomeningeal involvement in PXA(WHO grade 2)(36.3%)was higher than that in supratentorial PA(4.3%,P=0.029).Compared with supratentorial PA and lobar PA,PXA(WHO grade 2)had lower minimum apparent diffusion coefficient,relative apparent diffusion coefficient and higher relative maximum cerebral blood volume(t=-4.398-5.828,all P<0.05).The threshold value of minimum apparent diffusion coefficient to discriminate between supratentorial PA and PXA(WHO grade 2)was 1.09×10-3 mm2/s,and its sensitivity,specificity and area under the curve were 90.91%,83.33%and 0.947,respectively.When the differential diagnosis threshold of relative maximum cerebral blood volume was 1.79,its sensitivity,specificity and area under the curve were 90.00%,100.00%and 0.950,respectively.The area under the curve of DWI combined with PWI was 0.993,which did not significantly improve the diagnostic performance compared with DWI and PWI respectively(Z=1.371,0.928,both P>0.05).In subgroup analysis,the area under the curve of DWI combined with PWI in lobar PA and PXA(WHO grade 2)was 0.988,which did not improve the diagnostic performance compared with DWI and PWI respectively(Z=1.322,0.882,both P>0.05).Conclusion DWI and PWI are helpful in the differential diagnosis of PXA(WHO grade 2)from supratentorial PA and lobar PA,but combining DWI and PWI does not significantly improve the efficacy of differential diagnosis.

Purpose To investigate the differential diagnosis of diffusion-weighted imaging(DWI),perfusion-weighted imaging(PWI)and DWI combined with PWI in supratentorial pilocytic astrocytoma(PA)and WHO grade 2 pleomorphic xanthoastrocytoma(PXA).Materials and Methods The conventional MRI,DWI and PWI data of 23 cases of supratentorial PA and 11 cases of PXA(WHO grade 2)in the First Affiliated Hospital of Fujian Medical University from January 2010 to February 2022 were retrospectively analyzed.Supratentorial PA was further divided into lobar PA and non-lobar PA based on the lesion location.The basic data(gender,age,cystic degeneration,homogeneous enhancement,lesion size and meningeal involvement),minimum apparent diffusion coefficient,relative apparent diffusion coefficient and relative maximum cerebral blood volume were compared and analyzed between the two groups.Results The probability of leptomeningeal involvement in PXA(WHO grade 2)(36.3%)was higher than that in supratentorial PA(4.3%,P=0.029).Compared with supratentorial PA and lobar PA,PXA(WHO grade 2)had lower minimum apparent diffusion coefficient,relative apparent diffusion coefficient and higher relative maximum cerebral blood volume(t=-4.398-5.828,all P<0.05).The threshold value of minimum apparent diffusion coefficient to discriminate between supratentorial PA and PXA(WHO grade 2)was 1.09×10-3 mm2/s,and its sensitivity,specificity and area under the curve were 90.91%,83.33%and 0.947,respectively.When the differential diagnosis threshold of relative maximum cerebral blood volume was 1.79,its sensitivity,specificity and area under the curve were 90.00%,100.00%and 0.950,respectively.The area under the curve of DWI combined with PWI was 0.993,which did not significantly improve the diagnostic performance compared with DWI and PWI respectively(Z=1.371,0.928,both P>0.05).In subgroup analysis,the area under the curve of DWI combined with PWI in lobar PA and PXA(WHO grade 2)was 0.988,which did not improve the diagnostic performance compared with DWI and PWI respectively(Z=1.322,0.882,both P>0.05).Conclusion DWI and PWI are helpful in the differential diagnosis of PXA(WHO grade 2)from supratentorial PA and lobar PA,but combining DWI and PWI does not significantly improve the efficacy of differential diagnosis.

OBJECTIVE To evaluate the quality of diagnosis and treatment guidelines and expert consensuses on childhood immune thrombocytopenic purpura(ITP)published domestically and internationally,in order to provide reference for clinical practice and future guideline/expert consensus development and improvement.METHODS A systematic search was conducted across multiple databases,including PubMed,Cochrane Library,Embase,CNKI,Wanfang data,VIP,CBM;additionally,supplementary searches were carried out on websites such as Medlive,the Chinese Medical Association's official website,and National Institute for Health and Clinical Excellence in the UK.The retrieval time ranged from the inception to September 2,2024.Researchers who had undergone systematic training independently evaluated the methodology and report quality included in the guideline/consensus using the Appraisal of Guidelines Research and Evaluation Ⅱ(AGREE Ⅱ)and the Reporting Items for Practice Guidelines in Healthcare(RIGHT).RESULTS A total of 11 guidelines/consensuses were included.The average scores for the six domains of AGREE Ⅱ tool respectively were"range and purpose"[(66.67±17.98)%],"participants"[58.33%(13.89%,73.61%)],"rigor"[(41.81±23.85)%],"clarity"[(69.57±19.35)%],"applicability"[(35.98±17.83)%],and"independence"[27.08%(0,75.00%)];out of 11 articles,9 had a recommendation level of B,2 had a recommendation level of C,and there were no A-level articles.The average reporting rates of the 7 areas in the RIGHT tool were"basic information"[(72.35±12.95)%],"background"[(54.55±15.40)%],"evidence"[(36.36±24.81)%],"recommended opinions"[(53.25±19.20)%],"review and quality assurance"[0(0,25.00%)],"funding and conflict of interest statement and management"[12.50%(0,25.00%)],and other aspects[8.33%(0,50.00%)].In addition,there was no statistically significant difference in the AGREE Ⅱ and RIGHT scores between the guidelines and consensuses(P＞0.05).CONCLUSIONS The overall quality of the guidelines and consensuses included in this study is not high,with a recommended level of B or C.It is recommended that clinical decision-making prioritize referring to the relatively high-quality guideline/consensus among them.The quality of evidence in the existing traditional Chinese medicine guidelines for children with ITP needs to be improved,and there is no integrated guideline/consensus for traditional Chinese and Western medicine.It is recommended to revise or write relevant guideline/consensus according to the requirements of AGREE Ⅱ and RIGHT in various fields to guide clinical practice.

The polyfoliate perforator flap is a new type of flap that was developed on the basis of the traditional polyfoliate myocutaneous flap, polyfoliate fascial flap and perforator flap. It overturns the traditional idea that the deep fascial vascular network is the fundamental for a survival of the flap, and enables the flaps to achieve the best profile and function of the recipient areas with minimal damage to the donor area. In order to improve the understanding of the polyfoliate perforator flap and further standardise its clinical application, this paper forms a consensus on the definition, classification, indications, operative points and precautions of the polyfoliate perforator flap, so as to provide references in diagnosis and treatment process and practical application for the surgeons.

The polyfoliate perforator flap is a new type of flap that was developed on the basis of the traditional polyfoliate myocutaneous flap, polyfoliate fascial flap and perforator flap. It overturns the traditional idea that the deep fascial vascular network is the fundamental for a survival of the flap, and enables the flaps to achieve the best profile and function of the recipient areas with minimal damage to the donor area. In order to improve the understanding of the polyfoliate perforator flap and further standardise its clinical application, this paper forms a consensus on the definition, classification, indications, operative points and precautions of the polyfoliate perforator flap, so as to provide references in diagnosis and treatment process and practical application for the surgeons.

In order to evaluate the efficacy and safety of Hexue Mingmu tablets in the treatment of diabetic retinopathy（DR） and retinal vein obstruction（RVO）， and to provide a basis for the clinical treatment of ophthalmic diseases， this paper obtained randomized controlled trials（RCTs） of Hexue Mingmu tablets in the treatment of DR and RVO by searching Chinese and English electronic databases and trial registration platforms（up to September 13， 2022）. The risk of bias in the included studies was assessed using RoB2.0， and Meta-analysis was performed using RevMan5.4. A total of 35 RCTs involving a total sample size of 3 261 patients were included. Meta-analysis results showed that compared with conventional western medical treatment alone， the combination of Hexue Mingmu tablets with conventional western medical treatment improved patients' macular thickness｛mean difference（MD） =-39.83， 95% confidence interval（CI） ［-51.60， -28.06］， P<0.000 01｝， improved corrected visual acuity｛risk ratio（RR）_dichotomous=1.09， 95% CI ［1.00， 1.18］， P=0.04； MD_{continuous variable}=0.15， 95% CI ［0.13， 0.17］， P<0.000 01｝， increased effective rate of fundus symptom improvement（RR=1.26， 95% CI ［1.22， 1.30］， P<0.000 01）， improved hemorheology index｛standard mean difference（SMD）=-1.53， 95% CI ［-2.04， -1.01］， P<0.000 01｝， shortened improvement time of fundus symptoms（MD=-5.53， 95% CI ［-5.96， -5.09］， P<0.000 01）， and there was no significant difference on adverse events between the two groups. The results show that treatment of DR and RVO with Hexue Mingmu tablets may improve the macular thickness and hemorheology index of patients， which can significantly enhance the effect of corrected visual acuity and clinical efficiency， and shorten the time to symptom improvement. However， the original literature is of low quality and the pooled results have some limitations. Subsequent studies should try to use uniform standard assessment criteria and testing methods， focus on the rigor of study design and implementation， and pay attention to the key outcomes of this disease and the clinical safety of medication， so as to provide more reliable evidence to support this kind of clinical problems.