Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Septic shock is the primary cause of mortality in sepsis, with its core pathophysiological mechanism being severe ischemia and hypoxia in critical units—composed of microcirculation and the mitochondria of functional cells—resulting from disruptions in blood flow and oxygen flow following a dysregulated host response. Due to the systemically convergent yet clinically heterogeneous nature of the host response, current understanding and management strategies for hemodynamics remain inconsistent, often leading to inadequate resuscitation or overtreatment. To improve the quality of care, based on a systematic review of the "blood flow-oxygen flow" theory, an expert panel emphasizes reevaluating septic shock from an integrated perspective of blood flow and oxygen flow, and has formulated the Expert Consensus on Blood Flow and Oxygen Delivery Phenotyping and Clinical Management of Septic Shock (2025). The consensus proposes that clinical typing of blood flow-oxygen flow should comprehensively consider cardiac function, vascular tone, oxygen flow utilization status in critical units, and disease trajectory, while optimizing subtype identification by integrating host response phenotypes and artificial intelligence technologies. It advocates establishing a continuous assessment system through multi-site oxygen flow monitoring for organ perfusion, peripheral perfusion monitoring, and critical care ultrasound. Under the framework of the "critical care triangle", the consensus promotes the implementation of individualized, bundled management strategies, providing guidance for multiple management points to restore blood flow-oxygen flow matching, reduce the risk of organ failure, and decrease patient mortality.

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.

Objective: This prospective study evaluated the feasibility of chemical exchange saturation transfer (CEST) MRI for assessing disease activity in thyroid-associated ophthalmopathy (TAO). Materials and Methods: A total of 88 patients with active TAO, 76 with inactive TAO, and 30 healthy controls were enrolled. CEST MRI-derived magnetization transfer ratio (MTR) and MTR asymmetry (MTRasym) at 1 ppm, 2 ppm, and 3.5 ppm were calculated. Clinical data, MTR, and MTRasym values for the extraocular muscles (one representative muscle per eye, yielding two measurements per participant) were compared among the groups. Spearman’s correlation was used to examine associations between imaging parameters and the clinical activity score (CAS) in patients with TAO. Logistic regression analysis was used to identify independent associations between imaging parameters and disease activity in patients with TAO (active vs. inactive). Receiver operating characteristic (ROC) analysis was conducted to evaluate the diagnostic performance for discriminating active from inactive TAO. Results: Patients with active TAO showed lower MTR values (P < 0.001) and higher MTRasym (1 ppm), MTRasym (2 ppm), and MTRasym (3.5 ppm) (all P < 0.001) compared with those with inactive TAO. MTR was negatively correlated with CAS (r = -0.402; P < 0.001), while MTRasym (1 ppm), MTRasym (2 ppm), and MTRasym (3.5 ppm) were positively correlated with CAS (r = 0.369, 0.350, and 0.349, respectively;all P < 0.001). MTR and MTRasym (1 ppm) were independently associated with TAO activity. The areas under the ROC curve (AUCs) for MTR and MTRasym (1 ppm) in discriminating active from inactive TAO were 0.772 and 0.730, respectively. Combining MTR with MTRasym (1 ppm) significantly improved diagnostic performance compared with either parameter alone, achieving an AUC of 0.805 (P = 0.029 and 0.001). Conclusion MTR and MTRasym (1 ppm) were independently associated with TAO activity. Their combination further enhanced diagnostic performance in distinguishing active from inactive TAO, suggesting their potential as quantitative imaging biomarkers to guide treatment in patients with TAO.

Under the current upsurge of cross-disciplinary research between artificial intelligence （AI） and traditional Chinese medicine （TCM）， the inheritance of academic thought in TCM is confronted with the deep-seated predicament of cognitive paradigm dislocation. The existing AI model is based on the classical reasoning mode of formal logic and statistical probability， which is difficult to adapt to the nonlinear and holistic cognitive logic of TCM with image-based thinking and syndrome-differentiated treatment as the core， resulting in systematic misreading and loss of the core essence in digital inheritance. Based on this， this paper proposes to construct a new cognitive model oriented towards the context of TCM. Its essence is not to have AI imitate the thinking of TCM， but to establish an auxiliary understanding framework based on semantic mapping and relational reasoning. It is advocated that the role of AI should be reconstructed from a knowledge substitute to a clinical interactor， and its application boundary in the inheritance of TCM wisdom should be clarified. By establishing the theoretical framework and practical path of human-computer collaboration， this paper aims to provide a scientific basis for realizing the deep integration of AI technology and the academic thought in TCM.

Under the current upsurge of cross-disciplinary research between artificial intelligence （AI） and traditional Chinese medicine （TCM）， the inheritance of academic thought in TCM is confronted with the deep-seated predicament of cognitive paradigm dislocation. The existing AI model is based on the classical reasoning mode of formal logic and statistical probability， which is difficult to adapt to the nonlinear and holistic cognitive logic of TCM with image-based thinking and syndrome-differentiated treatment as the core， resulting in systematic misreading and loss of the core essence in digital inheritance. Based on this， this paper proposes to construct a new cognitive model oriented towards the context of TCM. Its essence is not to have AI imitate the thinking of TCM， but to establish an auxiliary understanding framework based on semantic mapping and relational reasoning. It is advocated that the role of AI should be reconstructed from a knowledge substitute to a clinical interactor， and its application boundary in the inheritance of TCM wisdom should be clarified. By establishing the theoretical framework and practical path of human-computer collaboration， this paper aims to provide a scientific basis for realizing the deep integration of AI technology and the academic thought in TCM.

Ulcerative colitis （UC） is a chronic inflammatory bowel disease primarily affecting the colon and rectum. With a rising incidence， UC has aroused an increasingly serious public health concern. The etiology and pathogenesis of UC are complex， involving genetic susceptibility， intestinal barrier dysfunction， immune dysregulation， and environmental factors such as diet， smoking， and infection. Current UC therapies face limitations including persistent drug resistance， multiple side effects， and compromised immune function， necessitating the exploration of novel intervention strategies. In recent years， with the continuous advancement of research into UC mechanisms， the Toll-like receptor 4 （TLR4）/nuclear factor-κB （NF-κB） signaling pathway has been revealved as one of the classical pathways involved in inflammation. Being crucial for maintaining intestinal homeostasis， this pathway regulates inflammatory and immune responses by controlling gene transcription， thereby playing a significant role in the occurrence and progression of UC. However， systematic summarization within this field remains lacking. Traditional Chinese medicine （TCM） possesses unique advantages through its multi-target， multi-pathway， and multi-mechanism approaches， being capable of curbing the pathological progression of UC by targeting key molecules in the TLR4/NF-κB signaling pathway. This paper systematically summarizes the mechanisms by which TLR4/NF-κB-related pathways regulate UC， primarily encompassing inflammatory responses， oxidative stress， immune balance， and gut microbiota. It reviews single herbs （e.g.， Rosa roxburghii root and Saposhnikoviae Radix）， active components （e.g.， resveratrol， Tripterygium glycosides， and gypenosides）， herbal extracts （e.g.， Zingiberis Rhizoma extract and Taraxaci Herba extract）， and compound formulas for clearing heat and removing dampness， invigorating the spleen and warming the kidneys， clearing heat and detoxifying， harmonizing the liver and spleen， and treating cold and heat in complexity （e.g.， Huaihua Powder， Shenling Baizhu Powder， and Jiedu Huayu Formula）. The aim is to fully leverage the advantages of TCM in UC treatment and provide novel insights for clinical and pharmacological research on UC.

Ulcerative colitis （UC） is a chronic inflammatory bowel disease primarily affecting the colon and rectum. With a rising incidence， UC has aroused an increasingly serious public health concern. The etiology and pathogenesis of UC are complex， involving genetic susceptibility， intestinal barrier dysfunction， immune dysregulation， and environmental factors such as diet， smoking， and infection. Current UC therapies face limitations including persistent drug resistance， multiple side effects， and compromised immune function， necessitating the exploration of novel intervention strategies. In recent years， with the continuous advancement of research into UC mechanisms， the Toll-like receptor 4 （TLR4）/nuclear factor-κB （NF-κB） signaling pathway has been revealved as one of the classical pathways involved in inflammation. Being crucial for maintaining intestinal homeostasis， this pathway regulates inflammatory and immune responses by controlling gene transcription， thereby playing a significant role in the occurrence and progression of UC. However， systematic summarization within this field remains lacking. Traditional Chinese medicine （TCM） possesses unique advantages through its multi-target， multi-pathway， and multi-mechanism approaches， being capable of curbing the pathological progression of UC by targeting key molecules in the TLR4/NF-κB signaling pathway. This paper systematically summarizes the mechanisms by which TLR4/NF-κB-related pathways regulate UC， primarily encompassing inflammatory responses， oxidative stress， immune balance， and gut microbiota. It reviews single herbs （e.g.， Rosa roxburghii root and Saposhnikoviae Radix）， active components （e.g.， resveratrol， Tripterygium glycosides， and gypenosides）， herbal extracts （e.g.， Zingiberis Rhizoma extract and Taraxaci Herba extract）， and compound formulas for clearing heat and removing dampness， invigorating the spleen and warming the kidneys， clearing heat and detoxifying， harmonizing the liver and spleen， and treating cold and heat in complexity （e.g.， Huaihua Powder， Shenling Baizhu Powder， and Jiedu Huayu Formula）. The aim is to fully leverage the advantages of TCM in UC treatment and provide novel insights for clinical and pharmacological research on UC.

Objective: To analyze the whole genome characteristics of Salmonella in diarrhea cases in Hohhot City, so as to provide the evidence for the prevention and control of Salmonella infection and rational clinical use of antibiotics. Methods: Salmonella strains were isolated and identified from fecal specimens of acute diarrhea cases at sentinel hospitals for national foodborne disease surveillance in Hohhot City from 2021 to 2023. DNA was extracted for whole genome sequencing. Bioinformatics analysis based on the Microobench Pathogen Genome Analysis System was conducted to determine serotypes, multi-locus sequence typing (MLST), drug resistance genes, and virulence genes. Additionally, 60 Salmonella genomic sequences from different regions across China were downloaded from the NCBI Genome database. A phylogenetic tree was constructed based on core-genome MLST (cgMLST) to analyze the phylogenetic relationship between strains from Hohhot City and those from other regions of China. Results: From 2021 to 2023, a total of 42 Salmonella strains isolated in Hohhot City were classified into 12 serotypes. Salmonella Enteritidis ST11, Salmonella I 4,[5],12:i:- ST34, and Salmonella Typhimurium ST19 were identified as the dominant strains, represented by 13, 10, and 6 isolates, which accounted for 30.95%, 23.81%, and 14.29%, respectively. Seventy-seven drug resistance genes belonging to 12 classes were detected. Among them, 17 Salmonella strains carried amino acid substitutions in the fluoroquinolone resistance-determining region caused by mutations at the gyrA and parC loci. Virulence genes covered all stages of Salmonella pathogenesis, with a predominance of genes associated with adhesion. Phylogenetic tree analysis results revealed that the 42 Salmonella strains from Hohhot City were distributed across evolutionary branches A, B, C, D, and F. They clustered with 60 strains from other regions of China, suggesting potential cross-regional transmission. Conclusions Salmonella strains isolated in Hohhot City exhibited diverse serotypes, carried multiple drug resistance genes and virulence genes, and displayed high genetic diversity. These findings indicate a potential risk of cross-regional transmission, highlighting the need for enhanced surveillance and prevention measures.

ObjectiveTo explore the process and guidelines for ethical review in decentralized drug clinical trials， promote clinical trial progress， and ensure drug development progress. MethodsThe key points of the ethical review were summarized by studying the relevant laws and regulations on decentralized drug clinical trials， analyzing the advantages and challenges of decentralized drug clinical trials， and combining the experience of the ethics committee of the institution in reviewing decentralized drug clinical trials. ResultsRelevant laws and regulations were the basis for the ethical review， and the ethics committee should adopt appropriate review methods based on regulations and hospital ethical standard operating procedures. The ethics committee should focus on the feasibility， applicability， and rationality， the adequacy of informed consent， the protection of rights and interests and privacy of subjects， as well as the qualification and standard operating procedures of electronic platforms for conducting decentralized drug clinical trials. ConclusionDecentralized drug clinical trials are in their early stages and urgently require guidance from relevant laws and regulations. Ethical review is also constantly being refined through exploration. It is necessary to supervise the implementation of responsibilities by all parties， pay attention to the rights and interests of subjects， and gradually promote the implementation of decentralized drug clinical trials.