ObjectiveTo evaluate the clinical efficacy and economic value of the Jiangsu Traditional Chinese Medicine （TCM） Diagnosis and Treatment Protocol for Dominant Diseases （abbreviated as the Diagnosis and Treatment Protocol） in adult patients with non-severe community-acquired pneumonia （CAP） based on real-world clinical data. MethodsA retrospective real-world cohort study was conducted using electronic medical records of adult patients hospitalized for non-severe CAP from September 1st， 2023 to December 31st， 2024 across 10 TCM hospitals in Jiangsu province. Patients were classified into an exposure group and a non-exposure group based on whether they received Chinese herbal medicine （CHM） according to the Diagnosis and Treatment Protocol. The non-exposure group received only conventional western medicine， while the exposure group additionally received differentiated CHM for at least five consecutive days. Outcomes were compared between two patient groups， including cough resolution rate， sputum resolution rate （assessed by volume， color， and consistency）， incidence of abnormal C-reactive protein （CRP）， incidence of abnormal white blood cell （WBC） count， and radiographic resolution rate of pulmonary infiltrates on chest imaging. Multivariable logistic regression was performed to identify factors influencing clinical efficacy. Subgroup analyses were conducted according to age， gender， smoking status， history of hypertension， and pneumonia severity score （CURB-65）， and the efficacy of treatment for cough and sputum was analyzed within each subgroup. Cost-effectiveness analysis was conducted using cough resolution rate as the outcome measure， evaluating the pharmacoeconomics of the two groups. ResultsA total of 1688 patients were included with 1293 in the exposure group and 395 in the non-exposure group. Compared to the non-exposure group， the exposure group demonstrated significantly higher resolution rates of cough， sputum volume， color， and consistency， as well as a significantly lower incidence of abnormal CRP （P＜0.05）. No statistically significant difference was observed between the groups in terms of abnormal WBC count and radiographic resolution rate of pulmonary infiltrates （P＞0.05）. Logistic regression analysis showed that the cough resolution rate in the exposure group was 1.83 times that of the non-exposure group， while the probabilities of resolution in sputum volume， color， and consistency were 1.37， 2.09， and 1.56 times those of the non-exposure group， respectively （P＜0.05）. Subgroup analyses showed that the exposure group achieved significantly higher cough resolution rates across most subgroups except for populations with a CURB-65 score ≥2 or those with a history of hypertension （P＜0.05）. Specifically， among females， patients aged ≥18 and ＜65 years， non-smokers， those without hypertension， and those with a CURB-65 score of 0， the exposure group showed a higher cough resolution rate than the non-exposure group （P＜0.05）. From an economic perspective， total hospitalization cost， length of stay， antibiotic cost， and CHM cost all differed significantly between groups （P＜0.05）. The cost-effectiveness ratio （CER） was 10,788.80 CNY/case in the exposure group， while 22,513.80 CNY/case in the non-exposure group. This implies that， compared with the exposure group， the non-exposure group incurred an additional 17,302.27 CNY to achieve one case of cough resolution. When the willingness-to-pay threshold ranged from 0 to 50,000 CNY， the probability of economic advantage was consistently higher in the exposure group than in the non-exposure group. ConclusionOn the basis of conventional western medicine， the addition of CHM in accordance with the Diagnosis and Treatment Protocol can effectively improve clinical symptoms， reduce inflammatory markers， promote clinical recovery， and is more cost-effective in treating adults with non-severe CAP.

ObjectiveTo observe the real‑world effectiveness and economic outcomes of Weishi Qingjin Formula （苇石清金方， WQF） in the treatment of adult community‑acquired pneumonia （CAP） with phlegm‑heat obstructing the lung syndrome. MethodsBased on a multicenter， real-world retrospective cohort study， clinical data were collected from hospitalized adult patients diagnosed with non‑severe CAP and phlegm‑heat obstructing the lung syndrome in 10 traditional Chinese medicine （TCM） hospitals in Jiangsu province. Patients were divided into an exposure group （those who received oral WQF） and a non‑exposure group （those who did not）. The following outcomes were compared between the two groups before and after treatment， which were remission rates of clinical symptoms including cough， expectoration （sputum volume， color， consistency）， and chest pain， levels of inflammatory markers including C‑reactive protein （CRP） and white blood cell count （WBC）， and the rate of pulmonary inflammatory absorption on chest CT. Subgroup analyses were performed based on age， gender， smoking status， presence of hypertension， and the severity of community-acquired pneumonia （CURB‑65） score， comparing the two groups in terms of cough remission rate， chest pain remission rate， and chest CT absorption rate. For health economic evaluation， cost‑effectiveness analysis was used to calculate the cost‑effectiveness ratio （CER） and incremental cost‑effectiveness ratio （ICER）. Univariate sensitivity analysis and probabilistic sensitivity analysis were performed to test the robustness of the results. ResultsA total of 647 patients in the exposure group and 1491 patients in the non-exposure group were included in the final statistical analysis. There was no statistically significant difference in length of hospital stay， gender， marital status， smoking history， bronchoscopy history， and comorbidities between the groups （P＞0.05）， but age， CURB-65 score， and antibiotic use. The exposure group had significantly higher remission rates of cough and sputum consistency than the non-exposure group （P＜0.05）. After adjusting for confounders using propensity score matching and logistic regression， the cough remission rate in the exposure group was 1.49 times that of the non-exposure group （P＜0.01）. No significant difference was observed between groups in the reduction rates of CRP and WBC， and in the rate of pulmonary inflammatory absorption on chest CT （P＞0.05）. Subgroup analyses revealed that the cough remission rate in the exposure group was significantly better than that in the non-exposure group except for patients aged ≥65 years， smokers， hypertensive patients， those using other type antibiotics or not using antibiotics， and those with a CURB-65 score ≥1 （P＜0.05）. Among smokers， the chest pain remission rate in the exposure group was 4.38 times that of the non-exposure group （P＜0.01）. No significant difference in chest CT absorption rate was found between groups across subgroups of gender， age， hypertension status， or antibiotic type （P＞0.05）. In terms of economic evaluation， CER was 10,877.60 CNY/case in the exposure group and 16,773.10 CNY/case in the non-exposure group. Compared to the exposure group， the non-exposure group incurred an additional 15,034.26 CNY to achieve one case of cough resolution， indicating a more favorable cost-effectiveness profile. Probabilistic sensitivity analysis yielded results consistent with the cost-effectiveness analysis， confirming the robustness of the findings. ConclusionWQF demonstrates significant efficacy in improving cough symptoms in the treatment of adult CAP with phlegm-heat obstructing the lung syndrome， and also exhibits favorable economic benefits.

ObjectiveTo evaluate the clinical efficacy and economic value of the Jiangsu Traditional Chinese Medicine （TCM） Diagnosis and Treatment Protocol for Dominant Diseases （abbreviated as the Diagnosis and Treatment Protocol） in adult patients with non-severe community-acquired pneumonia （CAP） based on real-world clinical data. MethodsA retrospective real-world cohort study was conducted using electronic medical records of adult patients hospitalized for non-severe CAP from September 1st， 2023 to December 31st， 2024 across 10 TCM hospitals in Jiangsu province. Patients were classified into an exposure group and a non-exposure group based on whether they received Chinese herbal medicine （CHM） according to the Diagnosis and Treatment Protocol. The non-exposure group received only conventional western medicine， while the exposure group additionally received differentiated CHM for at least five consecutive days. Outcomes were compared between two patient groups， including cough resolution rate， sputum resolution rate （assessed by volume， color， and consistency）， incidence of abnormal C-reactive protein （CRP）， incidence of abnormal white blood cell （WBC） count， and radiographic resolution rate of pulmonary infiltrates on chest imaging. Multivariable logistic regression was performed to identify factors influencing clinical efficacy. Subgroup analyses were conducted according to age， gender， smoking status， history of hypertension， and pneumonia severity score （CURB-65）， and the efficacy of treatment for cough and sputum was analyzed within each subgroup. Cost-effectiveness analysis was conducted using cough resolution rate as the outcome measure， evaluating the pharmacoeconomics of the two groups. ResultsA total of 1688 patients were included with 1293 in the exposure group and 395 in the non-exposure group. Compared to the non-exposure group， the exposure group demonstrated significantly higher resolution rates of cough， sputum volume， color， and consistency， as well as a significantly lower incidence of abnormal CRP （P＜0.05）. No statistically significant difference was observed between the groups in terms of abnormal WBC count and radiographic resolution rate of pulmonary infiltrates （P＞0.05）. Logistic regression analysis showed that the cough resolution rate in the exposure group was 1.83 times that of the non-exposure group， while the probabilities of resolution in sputum volume， color， and consistency were 1.37， 2.09， and 1.56 times those of the non-exposure group， respectively （P＜0.05）. Subgroup analyses showed that the exposure group achieved significantly higher cough resolution rates across most subgroups except for populations with a CURB-65 score ≥2 or those with a history of hypertension （P＜0.05）. Specifically， among females， patients aged ≥18 and ＜65 years， non-smokers， those without hypertension， and those with a CURB-65 score of 0， the exposure group showed a higher cough resolution rate than the non-exposure group （P＜0.05）. From an economic perspective， total hospitalization cost， length of stay， antibiotic cost， and CHM cost all differed significantly between groups （P＜0.05）. The cost-effectiveness ratio （CER） was 10,788.80 CNY/case in the exposure group， while 22,513.80 CNY/case in the non-exposure group. This implies that， compared with the exposure group， the non-exposure group incurred an additional 17,302.27 CNY to achieve one case of cough resolution. When the willingness-to-pay threshold ranged from 0 to 50,000 CNY， the probability of economic advantage was consistently higher in the exposure group than in the non-exposure group. ConclusionOn the basis of conventional western medicine， the addition of CHM in accordance with the Diagnosis and Treatment Protocol can effectively improve clinical symptoms， reduce inflammatory markers， promote clinical recovery， and is more cost-effective in treating adults with non-severe CAP.

ObjectiveTo observe the real‑world effectiveness and economic outcomes of Weishi Qingjin Formula （苇石清金方， WQF） in the treatment of adult community‑acquired pneumonia （CAP） with phlegm‑heat obstructing the lung syndrome. MethodsBased on a multicenter， real-world retrospective cohort study， clinical data were collected from hospitalized adult patients diagnosed with non‑severe CAP and phlegm‑heat obstructing the lung syndrome in 10 traditional Chinese medicine （TCM） hospitals in Jiangsu province. Patients were divided into an exposure group （those who received oral WQF） and a non‑exposure group （those who did not）. The following outcomes were compared between the two groups before and after treatment， which were remission rates of clinical symptoms including cough， expectoration （sputum volume， color， consistency）， and chest pain， levels of inflammatory markers including C‑reactive protein （CRP） and white blood cell count （WBC）， and the rate of pulmonary inflammatory absorption on chest CT. Subgroup analyses were performed based on age， gender， smoking status， presence of hypertension， and the severity of community-acquired pneumonia （CURB‑65） score， comparing the two groups in terms of cough remission rate， chest pain remission rate， and chest CT absorption rate. For health economic evaluation， cost‑effectiveness analysis was used to calculate the cost‑effectiveness ratio （CER） and incremental cost‑effectiveness ratio （ICER）. Univariate sensitivity analysis and probabilistic sensitivity analysis were performed to test the robustness of the results. ResultsA total of 647 patients in the exposure group and 1491 patients in the non-exposure group were included in the final statistical analysis. There was no statistically significant difference in length of hospital stay， gender， marital status， smoking history， bronchoscopy history， and comorbidities between the groups （P＞0.05）， but age， CURB-65 score， and antibiotic use. The exposure group had significantly higher remission rates of cough and sputum consistency than the non-exposure group （P＜0.05）. After adjusting for confounders using propensity score matching and logistic regression， the cough remission rate in the exposure group was 1.49 times that of the non-exposure group （P＜0.01）. No significant difference was observed between groups in the reduction rates of CRP and WBC， and in the rate of pulmonary inflammatory absorption on chest CT （P＞0.05）. Subgroup analyses revealed that the cough remission rate in the exposure group was significantly better than that in the non-exposure group except for patients aged ≥65 years， smokers， hypertensive patients， those using other type antibiotics or not using antibiotics， and those with a CURB-65 score ≥1 （P＜0.05）. Among smokers， the chest pain remission rate in the exposure group was 4.38 times that of the non-exposure group （P＜0.01）. No significant difference in chest CT absorption rate was found between groups across subgroups of gender， age， hypertension status， or antibiotic type （P＞0.05）. In terms of economic evaluation， CER was 10,877.60 CNY/case in the exposure group and 16,773.10 CNY/case in the non-exposure group. Compared to the exposure group， the non-exposure group incurred an additional 15,034.26 CNY to achieve one case of cough resolution， indicating a more favorable cost-effectiveness profile. Probabilistic sensitivity analysis yielded results consistent with the cost-effectiveness analysis， confirming the robustness of the findings. ConclusionWQF demonstrates significant efficacy in improving cough symptoms in the treatment of adult CAP with phlegm-heat obstructing the lung syndrome， and also exhibits favorable economic benefits.

arcopenia is a systemic skeletal muscle disorder characterized by a decrease in skeletal muscle mass and progressive decline in function， with multiple signaling pathways involved in its occurrence and development. Among them， the AMP-activated protein kinase （AMPK） signaling pathway， as a key pathway regulating cellular energy homeostasis， plays an important role in the regulation of skeletal muscle metabolism and functional maintenance by improving abnormalities in glucose and lipid metabolism， balancing skeletal muscle protein synthesis and degradation， improving mitochondrial function， promoting autophagy， and inhibiting inflammatory responses and oxidative stress. This article reviews the research progress on how various traditional Chinese medicine （TCM） monomers， including polyphenols， flavonoids， and terpenoids； various traditional Chinese medicine extracts， such as those from Lycium barbarum ， Asini Corii Colla， and Panax quinquefolium ， and TCM compounds， such as Guiqi zhuangjin decoction， Jianpi qiangji granules， and Qigu capsules， intervene in sarcopenia by regulating the AMPK signaling pathway to promote muscle protein synthesis， inhibit protein degradation， improve mitochondrial function， and alleviate inflammation and oxidative stress. Additionally， their molecular mechanisms are explored. The aim is to deeply elucidate the basis of TCM in the prevention and treatment of sarcopenia and to provide theoretical support for the development of related innovative drugs.

Regulated cell death （RCD） is a genetically determined， active and programmed form of cell death， mainly including apoptosis， autophagy， ferroptosis， pyroptosis， PANoptosis and other patterns. Dysregulation of RCD plays a pivotal role in the occurrence and progression of sarcopenia. Due to the advantages of abundant targets， diverse mechanisms of action and high safety profile， traditional Chinese medicine （TCM） has attracted considerable attention in regulating RCD， and preventing and treating sarcopenia. Through a review of the mechanisms of RCD in sarcopenia， and recent research progress on how TCM modulates RCD to improve sarcopenia， this paper reveals that single TCM herbs and their extracts （e.g.， Puerariae Lobatae Radix， and extracts of Schisandrae Chinensis Fructus， Myristicae Semen and Cistanches Herba）， active components and effective fractions of TCM （e.g.， resveratrol， polydatin， curcumin）， as well as TCM compound formulas （e.g.， Buzhong yiqi decoction， Erjing pills， Huangqi guizhi wuwu decoction， Shuanghe decoction）， can modulate RCD through multiple pathways， including the inhibition of apoptosis， pyroptosis， ferroptosis and PANoptosis， and the modulation of autophagy， thereby alleviating sarcopenia.

Ischemic stroke （IS） is the second leading cause of death worldwide， characterized by high morbidity and disability rates. Small ubiquitin-related modifier （SUMO） modification， a crucial post-translational modification， plays a vital role in the pathogenesis of IS. This review elucidates the relationship between SUMOylation and IS by detailing how SUMOylation regulates key pathological processes， including neuroinflammation， mitochondrial dynamics， apoptosis， oxidative stress， and angiogenesis. Furthermore， it summarizes potential therapeutic targets of SUMOylation for IS treatment， aiming to provide new directions for clinical management.

Ischemic stroke （IS） is characterized by a high incidence， a high disability rate， and a high mortality rate. Its pathological mechanism is complex， involving oxidative stress， neuroinflammation， glutamate excitotoxicity， blood-brain barrier （BBB） disruption， abnormal autophagy and apoptosis， energy metabolism disorder， ferroptosis， and cuproptosis. Long-term use of conventional clinical drugs is associated with certain adverse reactions. As a classic Chinese herbal medicine for replenishing Qi， Astragali Radix is widely used in the prevention and treatment of IS. Modern research has confirmed that it contains various active components， including total astragalosides， total polysaccharides， and total flavonoids， which exert cerebroprotective effects by regulating signaling pathways such as nuclear factor erythroid 2-related factor 2/heme oxygenase-1 （Nrf2/HO-1）， nuclear factor-κB （NF-κB）， phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt）， adenosine monophosphate-activated protein kinase/mammalian target of rapamycin （AMPK/mTOR）. These effects include anti-oxidation， anti-inflammation， inhibition of excitotoxicity， protection of BBB， regulation of autophagy and apoptosis， suppression of ferroptosis， and improvement of energy metabolism. This article systematically reviews the core pathological links of IS， summarizes the cerebroprotective effects of the main active components， classic herb pairs， and representative compound formulas of Astragali Radix， and analyzes their synergistic intervention patterns against the above pathological mechanisms. Furthermore， this paper discusses the current research limitations in clinical translation， material basis， and emerging cell death modalities， along with future perspectives， aiming to provide a theoretical reference for the clinical application of Astragali Radix and its combinations in treating IS and for the development of new drugs.

Background Air pollution poses a significant threat to children's respiratory health. Baotou, a resource-dependent industrial city in northern China dominated by coal, power generation, and steel industries, has limited evidence on the associations of inhalable particulate matter (PM₁₀), fine particulate matter (PM_2.5), and ozone (O₃) with pediatric pneumonia hospitalizations, particularly with respect to season-specific lagged effects. Objective To evaluate the associations of PM₁₀, PM_2.5, and O₃ with pediactric pneumonia hospitalizations and to examine seasonal variations in these associations in the urban districts of Baotou. Methods A time-series study was conducted using daily data on air pollutant concentrations, meteorological factors, and pediatric pneumonia hospitalizations in Baotou from 2017 to 2022. Generalized additive models were applied to examine single-pollutant associations. Cumulative lag models were fitted to assess delayed and cumulative effects, and season-stratified models were constructed to identify season-specific risks. Two-pollutant and multi-pollutant models were further developed to evaluate the robustness of the observed associations. Results The annual mean concentrations of PM_2.5 and PM₁₀ were 38.62 μg·m⁻³ and 85.44 μg·m⁻³, respectively.PM₁₀ and O₃ were the most frequent primary pollutants, accounting for 32.6% and 30.7% of polluted days, respectively. Significant positive associations with lag effects were observed between air pollutants and pediatric pneumonia hospitalizations. In the full-year model, PM₁₀ showed the strongest association at lag 3 (ER=0.77%, 95%CI: 0.50%, 1.04%), whereas PM_2.5 showed the strongest association at lag 1 (ER=1.85%, 95%CI: 1.23%, 2.48%). Seasonal stratification analyses revealed significant associations for PM_2.5 in both the cold season (lag 1, ER=1.57%, 95%CI: 0.83%, 2.31%) and the warm season (lag 7, ER=1.84%, 95%CI: 0.35%, 3.35%). PM₁₀ showed a significant association at lag 7 in the warm season (ER=0.70%, 95%CI: 0.27%, 1.13%). O₃ exhibited significant acute effects only in the warm season, with same-day exposure (lag 0) associated with an ER of 3.79% (95%CI: 1.92%, 5.69%). The estimated risk contribution ranking was PM_2.5 > PM₁₀ for the full year and the cold season, and O₃ > PM_2.5 > PM₁₀ for the warm season. Cumulative lag analysis revealed that PM₁₀ and PM_2.5 exhibited the strongest cumulative associations at lag07 in the full-year and cold-season models, with ERs of 2.20% (95%CI: 1.68%, 2.72%) and 4.20% (95%CI: 3.01%, 5.40%), respectively, and the associations intensified as the lag period extended. In contrast, O₃ in the warm season showed the strongest cumulative association at lag02, with an ER of 5.37% (95%CI: 3.13%, 7.66%), followed by a rapid decline. O₃ in the cold season showed a significant cumulative association at lag07, with an ER of 5.12% (95%CI: 0.00%, 10.49%). In two-pollutant and multi-pollutant models, the associations of PM₁₀ and O₃ remained stable after adjustment for other pollutants. Conclusion From 2017 to 2022, ambient particulate matter and ozone are significantly associated with pediatric pneumonia hospitalizations in the urban districts of Baotou, with evident lagged effects and seasonal variations. Differentiated prevention strategies should be developed according to seasonal pollutant profiles, with priority given to PM_2.5 control in the cold season and O₃ control in the warm season.

Adolescent idiopathic scoliosis(AIS)is a complex three-dimensional deformity involving coronal,sagittal,and axial planes,with a prevalence that should not be overlooked.With advancements in technology and in-depth research,an increasing number of hospitals and physicians are exploring standardized diagnostic and treatment approaches for AIS.Comprehensive and in-depth understanding is required for AIS,including its etiology,screening and diagnosis,classification,assessment and examination,treatment options,exploration of current focus,and evaluation of quality of life.Such understanding ensures that the diagnostic and treatment are scientific,standardized,and timely.Based on the principles of evidence-based medicine,a consensus on the diagnosis and treatment of AIS is reached after multiple discussions among spinal surgery experts,aiming to provide reference and guidance for clinical practice.