Diabetic nephropathy （DKD）， as a common microvascular complication of diabetes mellitus （DM）， is a major cause of end-stage renal disease （ESRD）. Its clinical manifestations include increased urinary protein excretion， thickening of the glomerular basement membrane， and renal tubulointerstitial fibrosis. The pathogenesis of DKD is complex and involves multiple factors， including disordered glucose metabolism， hemodynamic alterations， and oxidative stress. Although modern medical approaches can alleviate certain symptoms， they still have limitations such as insufficient therapeutic targeting and prominent adverse effects. The transforming growth factor-β/Smad （TGF-β/Smad） signaling pathway is not only a tissue fibrosis pathway that has attracted considerable attention in recent years， but also regulates multiple protein molecules， including the glomerular podocyte slit diaphragm protein Podocin， interleukin-1β （IL-1β）， and superoxide dismutase （SOD）， thereby participating in various pathological processes and ultimately mediating renal injury. Flavonoid compounds， owing to their sustained pharmacological effects， broad spectrum of action， and high safety profile， have become ideal candidates for targeted therapy research in DKD. Existing studies have shown that these compounds can exert inhibitory effects on renal fibrosis， alleviate inflammatory responses， protect podocytes， and reduce oxidative stress by regulating the interactions between the TGF-β/Smad signaling pathway and the aforementioned protein molecules， thereby maintaining renal structure and function， reducing proteinuria， and significantly improving DKD lesions. This review briefly outlines the composition and functions of the TGF-β/Smad signaling pathway， elucidates the mechanisms by which this pathway regulates DKD， and focuses on summarizing major studies from the past decade on flavonoid-based interventions in DKD through targeted inhibition of the TGF-β/Smad signaling pathway. Furthermore， it discusses the considerable therapeutic potential of flavonoids in the treatment of this disease， aiming to provide a scientific basis for future clinical prevention and treatment of DKD and to promote the development of targeted drugs.

Objective To explore the clinical characteristics and preventive strategies of severe infusion-related reactions （IRR） caused by cetuximab and provide reference for its safe clinical application. Methods The clinical data of two patients who experienced severe IRR following cetuximab treatment were retrospectively analyzed. With clinical data and relevant literature, the underlying reaction mechanisms were elucidated and corresponding preventive measures were formulated. Results Two patients with malignant tumors received cetuximab infusion after pretreatment, and both developed severe IRR abruptly within minutes of infusion. Symptoms were relieved after drug discontinuation and symptomatic treatment, and the patients were discharged in stable condition. Conclusion Cetuximab-induced severe IRR is acute in onset. Clinically, standardized pre-medication, enhanced monitoring during infusion and implementation of preventive strategies are essential to guarantee medication safety.

Acute lung injury （ALI） is one of the most common and critical diseases in clinical practice， with extremely high morbidity and mortality， seriously threatening human life and health. The pathogenesis of ALI is complex， in which the inflammatory response is a key factor. Studies have shown that NOD-like receptor protein 3 （NLRP3） inflammasomes are involved in ALI through mechanisms such as inflammation induction， increased microvascular permeability， recruitment of neutrophils， oxidative stress， and pyroptosis， playing a key role in the occurrence and progression of ALI. Therefore， regulating NLRP3 inflammasomes and inhibiting the release of inflammatory factors can alleviate the damage in ALI. At present， ALI is mainly treated by mechanical ventilation and oxygen therapy， which have problems such as high costs and poor prognosis. In recent years， studies have shown that traditional Chinese medicine （TCM） can reduce the inflammatory response and the occurrence of oxidative stress and pyroptosis by regulating the NLRP3 inflammasome， thus alleviating the damage and decreasing the mortality of ALI. Based on the relevant literature in recent years， this article reviews the research progress in TCM treatment of ALI by regulating NLRP3 inflammasomes， discusses how NLRP3 inflammasomes participate in ALI， and summarizes the active ingredients， extracts， and compound prescriptions of TCM that regulate NLRP3 inflammasomes， aiming to provide new ideas for the clinical treatment of ALI and the development of relevant drugs.

Objective To explore the diagnostic value of hemodynamic and morphological characteristics based on four-dimensional flow magnetic resonance imaging(4D Flow MRI)for unstable saccular intracranial aneurysms(IAs).Methods Seventy-four patients with saccular unruptured intracranial aneurysms(UIAs)who underwent 4D Flow MRI examinations were selected.Morphological and hemodynamic data of the IAs were collected and followed up.According to the follow-up results,patients were divided into stable group and unstable group.Logistic regression analysis was used to identify factors associated with the unstable group,and the diag-nostic performance of the model was evaluated using the receiver operating characteristic(ROC)curves and the area under the curve(AUC).Results The aneurysm diameter,height,width,neck width,and aspect ratio(AR)value in the unstable group were greater than those in the stable group.The wall shear stress(WSS)at the aneurysm neck and the parent artery inflow,as well as the end diastolic velocity(EDV)at the parent artery inflow,were lower in the unstable group than those in the stable group(P＜0.05).Multivariate logistic regression analysis showed that the AR and WSS at the aneurysm neck were independent predictors of unstable IAs(P＜0.05).The combined model of WSS at the aneurysm neck and AR showed an AUC of 0.742[95％confidence interval(CI)0.608-0.875],repre-sented the highest diagnostic performance.Conclusion The hemodynamic characteristics quantified by 4D Flow MRI offer supple-mentary information for risk assessment of IAs.Combining hemodynamic and morphological characteristics is of significant value in identi-fying unstable saccular IAs.

Objective:To observe any effect of combining interactive scalp acupuncture with constraint-induced movement therapy (CIMT) in treating the upper extremity motor function of children with spastic hemiplegic cerebral palsy.Methods:Fifty-seven children with spastic hemiplegic cerebral palsy were randomly divided into a control group of 28 and an observation group of 29. The control group was given conventional rehabilitation and routine CIMT, while the observation group was additionally provided with interactive scalp acupuncture. In the observation group the CIMT lasted for 30 minutes while the needles were retained. Then, after the needles were removed, the family administered simple rehabilitation training for 2.5 hours guided by a rehabilitation therapist. The treatments were administered 5 days per week for 3 weeks as a session, and the whole treatment consisted of 3 sessions. Before, as well as 1 month and 3 months after the treatment, upper extremity motor function in both groups was evaluated using the Melbourne assessment scale 2 (MA2) and the fine motor Peabody developmental motor scales. Muscle tone in the children′s elbow flexors was assessed using the modified Ashworth scale (MAS).Results:After both 1 and 3 months of treatment, the average MA2 scores of both groups were significantly better than those before treatment, with those of the observation group significantly superior to the control group′s averages. After both 1 and 3 months, both groups′ visual-motor integration scores, grasping ability scores and total scores had improved significantly, with those of the observation group significantly better than in the control group, on average. The MAS scores of both groups were also significantly better than before the treatment, but with no significant differences between the two groups at either time point.Conclusions:Interactive scalp acupuncture combined with constraint-induced movement therapy can significantly improve the upper extremity motor functioning and fine motor ability of children with spastic hemiplegic cerebral palsy.

Objective:To observe any effect of combining interactive scalp acupuncture with constraint-induced movement therapy (CIMT) in treating the upper extremity motor function of children with spastic hemiplegic cerebral palsy.Methods:Fifty-seven children with spastic hemiplegic cerebral palsy were randomly divided into a control group of 28 and an observation group of 29. The control group was given conventional rehabilitation and routine CIMT, while the observation group was additionally provided with interactive scalp acupuncture. In the observation group the CIMT lasted for 30 minutes while the needles were retained. Then, after the needles were removed, the family administered simple rehabilitation training for 2.5 hours guided by a rehabilitation therapist. The treatments were administered 5 days per week for 3 weeks as a session, and the whole treatment consisted of 3 sessions. Before, as well as 1 month and 3 months after the treatment, upper extremity motor function in both groups was evaluated using the Melbourne assessment scale 2 (MA2) and the fine motor Peabody developmental motor scales. Muscle tone in the children′s elbow flexors was assessed using the modified Ashworth scale (MAS).Results:After both 1 and 3 months of treatment, the average MA2 scores of both groups were significantly better than those before treatment, with those of the observation group significantly superior to the control group′s averages. After both 1 and 3 months, both groups′ visual-motor integration scores, grasping ability scores and total scores had improved significantly, with those of the observation group significantly better than in the control group, on average. The MAS scores of both groups were also significantly better than before the treatment, but with no significant differences between the two groups at either time point.Conclusions:Interactive scalp acupuncture combined with constraint-induced movement therapy can significantly improve the upper extremity motor functioning and fine motor ability of children with spastic hemiplegic cerebral palsy.

Objective To explore the diagnostic value of hemodynamic and morphological characteristics based on four-dimensional flow magnetic resonance imaging(4D Flow MRI)for unstable saccular intracranial aneurysms(IAs).Methods Seventy-four patients with saccular unruptured intracranial aneurysms(UIAs)who underwent 4D Flow MRI examinations were selected.Morphological and hemodynamic data of the IAs were collected and followed up.According to the follow-up results,patients were divided into stable group and unstable group.Logistic regression analysis was used to identify factors associated with the unstable group,and the diag-nostic performance of the model was evaluated using the receiver operating characteristic(ROC)curves and the area under the curve(AUC).Results The aneurysm diameter,height,width,neck width,and aspect ratio(AR)value in the unstable group were greater than those in the stable group.The wall shear stress(WSS)at the aneurysm neck and the parent artery inflow,as well as the end diastolic velocity(EDV)at the parent artery inflow,were lower in the unstable group than those in the stable group(P＜0.05).Multivariate logistic regression analysis showed that the AR and WSS at the aneurysm neck were independent predictors of unstable IAs(P＜0.05).The combined model of WSS at the aneurysm neck and AR showed an AUC of 0.742[95％confidence interval(CI)0.608-0.875],repre-sented the highest diagnostic performance.Conclusion The hemodynamic characteristics quantified by 4D Flow MRI offer supple-mentary information for risk assessment of IAs.Combining hemodynamic and morphological characteristics is of significant value in identi-fying unstable saccular IAs.

The difficulty of wound healing in patients is a difficult problem that doctors in all clinical departments may encounter, and there is still no good solution. Resveratrol is a kind of natural active substance, which has anti-inflammatory, antioxidant, antibacterial, and angiogenesis promoting effects, and is a potential drug to promote wound healing. However, the clinical application of resveratrol is limited due to its low bioavailability. In this review, the molecular mechanism of resveratrol in promoting wound healing and its administration methods in wound treatment were reviewed to provide ideas for the redevelopment of resveratrol.

Diabetic retinopathy （DR） is a common complication of diabetes， which causes a great threat to the health of human vision. Recent studies have shown that saponins， polysaccharides and flavonoids in Astragali Radix regulate phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin pathway， silent information regulator 1/nuclear factor erythroid 2-related factor 2 pathway， B-cell lymphoma-2 and other signaling pathways by acting on nuclear factor-κB， hypoxia-inducible factor-1α， glial fibrillary acidic protein， glutamine synthetase， aldose reductase， multiple miRNA and other related targets， so as to exert anti- inflammatory， anti-microangiopathy， anti-neurodegenerative disease and anti-apoptosis， and then achieve the purpose of treating DR.

After the compatibility of Astragali Radix and Atractylodis Macrocephalae Rhizoma, most of the effective components of Astragali Radix increase, and the bioavailability is improved. Compared with the application of the two drugs alone, it can enhance the effects of immune regulation, anti-tumor, diuresis, lung protection, regulation of flora, and intestinal protection. However, the optimal compatibility ratio of Astragali Radix- Atractylodis Macrocephalae Rhizoma pair to exert various pharmacological effects still needs to be clarified. The drug pair and related preparations are mostly used in the treatment of nephropathy, but its mechanism of action needs to be further elucidated.