To thoroughly implement the strategic deployment outlined in the Opinions of the Central Committee of the Communist Party of China and the State Council on Promoting the Inheritance and Innovative Development of Traditional Chinese Medicine regarding research on dominant diseases of traditional Chinese medicine and to uphold the development philosophy of equal emphasis on traditional Chinese medicine and western medicine，the China Association of Chinese Medicine has fully played a leading academic role by systematically organizing and conducting a series of academic youth salons on clinical dominant diseases of traditional Chinese medicine. On September 13，2024，the 36^th Youth Salon on Clinical Dominant Diseases was successfully held in Nanjing，focusing on the advantages of traditional Chinese medicine and the integrative traditional Chinese medicine and western medicine in the diagnosis and treatment of erectile dysfunction （ED）. The conference brought together leading experts from traditional Chinese medicine，western medicine，and interdisciplinary fields，facilitating in-depth multidisciplinary discussions that led to key consensus on optimizing traditional Chinese medicine treatment protocols for ED，researching and developing new drugs of traditional Chinese medicine，and advancing interdisciplinary development in traditional Chinese medicine. This salon systematically sorted out the clinical strengths and distinctive features of traditional Chinese medicine in the diagnosis and treatment of ED. Based on current research foundations and clinical needs，it identified key directions for future scientific layout and scientific research tackling： （1） Standardization of syndrome differentiation system of traditional Chinese medicine for ED. （2） Optimization and standardization of intervention methods of integrated traditional Chinese medicine and western medicine. （3） High-quality clinical research guided by evidence-based medicine. （4） In-depth analysis of the pharmacological mechanisms of traditional Chinese medicine in the treatment of ED. （5） Clinical translation and application promotion of new drugs of traditional Chinese medicine. （6） Interdisciplinary integration and innovation in traditional Chinese medicine. For each research direction，key focus areas，expected objectives，and clinical value were further refined，along with the establishment of a scientifically sound priority funding level evaluation system. Therefore，building on the series of salons on the ED-focused dominant diseases of traditional Chinese medicine，this paper provides standardized guidance for clinical practice of traditional Chinese medicine in ED management，effectively contributing to the high-quality development of traditional Chinese medicine. It serves as a valuable reference for national scientific and technological strategic layout， research and development decision-making in new drugs of traditional Chinese medicine，research topic planning，and clinical guideline formulation.

Intentional tooth replantation (ITR) is an advanced treatment modality and the procedure of last resort for preserving teeth with inaccessible endodontic or resorptive lesions. ITR is defined as the deliberate extraction of a tooth; evaluation of the root surface, endodontic manipulation, and repair; and placement of the tooth back into its original socket. Case reports, case series, cohort studies, and randomized controlled trials have demonstrated the efficacy of ITR in the retention of natural teeth that are untreatable or difficult to manage with root canal treatment or endodontic microsurgery. However, variations in clinical protocols for ITR exist due to the empirical nature of the original protocols and rapid advancements in the field of oral biology and dental materials. This heterogeneity in protocols may cause confusion among dental practitioners; therefore, guidelines and considerations for ITR should be explicated. This expert consensus discusses the biological foundation of ITR, the available clinical protocols and current status of ITR in treating teeth with refractory apical periodontitis or anatomical aberration, and the main complications of this treatment, aiming to refine the clinical management of ITR in accordance with the progress of basic research and clinical studies; the findings suggest that ITR may become a more consistent evidence-based option in dental treatment.
Humans ; Tooth Replantation/methods* ; Consensus ; Periapical Periodontitis/surgery*

Objective:To investigate the correlation between plasma Dickkopf-1 (DKK1) and post-stroke cognitive impairment (PSCI) in patients with acute ischemic stroke.Methods:Consecutive patients with first-ever acute ischemic stroke admitted to the Department of Neurology, Nanjing Jiangbei Hospital from March 2023 to February 2024 were included prospectively. Enzyme-linked immunosorbent assay was used to detect plasma DKK1 within 24 hours of onset. The Montreal Cognitive Assessment Scale was used to evaluate cognitive function at 3 months after onset. A score ≤22 was defined as PSCI. Multivariate logistic regression analysis was used to determine the correlation between DKK1 and PSCI. The relationship between DKK1 and PSCI risks was evaluated through restrictive cubic spline analysis. Results:A total of 205 patients with acute ischemic stroke were enrolled, including 106 males (51.7%), aged 67.0±9.4 years; 61 patients (29.8%) experienced PSCI. Multivariate logistic regression analysis showed that after adjusting for age, gender, education level, and other confounding factors, there was a significant independent correlation between higher plasma DKK1 and PSCI (odds ratio 1.778, 95% confidence interval 1.313-2.408; P=0.001). Subgroup analysis showed that age, gender, etiological classification of stroke, and education level had no significant effect on the above correlation. Restrictive cubic spline analysis showed plasma DKK1 had a linear relationship with the risk of PSCI ( P=0.003). Conclusion:Higher plasma DKK1 level is significantly correlated with PSCI in patients with acute ischemic stroke at 90 days after onset.

Objectives:To investigate the predictive factors of stroke associated-pneumonia (SAP) in patients with acute stroke, develop nomogram and neural network prediction models and verify their predictive performance.Methods:Patients with acute stroke admitted to the First Affiliated Hospital of Kunming Medical University and Zhenxiong County People's Hospital were included retrospectively. Multivariate logistic regression analysis was used to determine the independent predictive factors of SAP, and develop nomogram and neural network prediction models. Receiver operating characteristic curve (ROC) curves were used to validate and compare the predictive performances. Results:A total of 450 patients with acute stroke were enrolled, including 286 males (63.6%), aged 64.28±13.24 years; 344 patientss (76.4%) had ischemic stroke and 106 (23.6%) had hemorrhagic stroke; 128 patients (28.4%) experienced SAP. According to the random number method, they were divided into a modeling cohort ( n=300) and a validation cohort ( n=150). Multivariate logistic regression analysis in the modeling cohort showed that a higher baseline National Institutes of Health Stroke Scale (NIHSS) score, gastric tube placement, use of proton pump inhibitors, heart failure, and higher neutrophil/lymphocyte ratio (NLR) were the independent predictive factors of SAP. ROC curve analysis showed that the area under the ROC curve of the nomogram model for predicting SAP in the modeling cohort and validation cohort was 0.841 (95% confidence interval [ CI] 0.795-0.880) and 0.863 (95% CI 0.798-0.914), respectively. The sensitivity for predicting SAP were 75.00% and 70.45%, respectively, and the specificity was 81.94% and 92.45%, respectively. The area under the ROC curve of the neural network model for predicting SAP in the modeling cohort and validation cohort was 0.847 (95% CI 0.802-0.866) and 0.862 (95% CI 0.796-0.913), respectively. The sensitivity for predicting SAP were 76.19% and 72.73%, and the specificity was 79.17% and 89.62%, respectively. Conclusions:Higher NIHSS score, gastric tube placement, use of proton pump inhibitors, heart failure, and higher NLR are the independent risk factors for SAP in patients with acute stroke. The nomogram and neural network prediction model developed using the above risk factors have higher predictive value for SAP.

Objective To explore the research status and hotspots of umbilical acupuncture over the past 20 years using bibliometric methods,thus to providing references for the subsequent clinical treatment of umbilical acupuncture and studies of the therapeutic mechanism.Methods Literature on umbilical acupuncture published between 2004 and 2024 was retrieved from the CNKI,Wanfang Data Knowledge Service Platform,and VIP Chinese Journal Service Platform.Duplicate check was conducted using NoteExpress 3.9.0 software,and then manual screening was performed.The included literature data were imported into VOSviewer for visualized analysis,including institutional collaboration,author collaboration,and keyword co-occurrence.Results A total of 388 articles were included,comprising 286 original research articles,23 reviews,and 79 dissertations.Annual publication analysis revealed a significant upward trend in umbilical acupuncture research output starting from 2017.Zhejiang Chinese Medical University and Hangzhou Hospital of Traditional Chinese Medicine ranked first in publication volume,and Bao Yehua was the most prolific author.Inter-institutional collaboration remained limited,and author collaborations usually occurred in small-team models.Clinical research was the most commonly-seen keyword,and insomnia and stroke were the diseases being frequently studied.Conclusion Clinical research has become the focus of umbilical acupuncture studies over the past two decades,while mechanism research is still in its early stages.Current research hotspots include the research about insomnia and stroke.

Objective:To investigate the correlation between immune function and age-related pulmonary fibrosis, as well as the potential impact of bacterial lysates on this condition.Methods:Twenty-four healthy male C57BL/6 mice, aged 24, were randomly divided into three groups: a control group(Group N), a pulmonary fibrosis group(Group M), and a pulmonary fibrosis+ bacterial lysis product intervention group(Group P). Mice in Groups M and P were intratracheally injected with bleomycin(5 mg/kg)to induce a mouse pulmonary fibrosis model, while mice in Group N were injected with saline.After modeling, mice in Group P were orally administered 0.4 ml of a bacterial lysis product once a day.After 28 days, lung tissue and blood samples were collected for analysis.Pathological changes in lung tissue were assessed using hematoxylin and tosin staining(HE)and Masson staining and the Ashcroft score.The expression of CD4+ and CD8+ in lung tissue was evaluated using immunohistochemistry.The levels of serum interferon-γ(INF-γ), interleukin-3(IL-13), and immunoglobulin A(IgA)protein were measured using Enzyme-linked Immuno Sorbent Assay(ELISA). The levels of INF-γ and IL-13 mRNA in lung tissue were determined using Real-Time Quantitative Transcription PCR(RT-qPCR). Additionally, the protein expression levels of matrix metalloprotein-9(MMP-9)and tissue inhibitor of metalloproteincise 1(TIMP-1)in lung tissue were assessed using blot analysis.Results:The degree of lung fibrosis was significantly reduced in mice in group P compared with group M when treated with bacterial lysis products.Group M showed a significant decrease in the expression of CD4+ T cells and an increase in the expression of CD8+ T cells( P<0.05)compared to group N. Additionally, the content of IgA was decreased( P<0.05)in group M. On the other hand, group P showed a significant increase in the expression of CD4+ T cells and a decrease in the expression of CD8+ T cells( P<0.05)compared to group M. Furthermore, the content of IgA was elevated( P<0.05)in group P. After bacterial lysis product intervention, mRNA and protein expression levels of IFN-γ were elevated( P<0.05), while mRNA and protein expression levels of IL-13 were reduced( P<0.05). Moreover, protein expression of MMP-9 and TIMP-1 was significantly up-regulated in group M compared with group N( P<0.05), and decreased after bacterial lysis product intervention( P<0.05). Conclusions:It is well-known that immune mechanisms play a crucial role in the development of pulmonary fibrosis.The use of bacterial lysates has been found to effectively regulate immune balance and mitigate the severity of pulmonary fibrosis in elderly mice.

OBJECTIVE To investigate the current situation of pharmaceutical management in compact medical consortium of Guangdong province， and to provide decision-making basis for promoting the high-quality construction and sustainable development of the provincial medical consortium. METHODS A self-designed questionnaire was used to select 50 compact medical consortiums in Guangdong province. The survey was answered by the heads of the pharmacy department of the general hospitals. The survey covered the basic scale of the consortium， the appointment of chief pharmacists， the implementation of pharmaceutical management and pharmaceutical care homogenization within the consortium， the difficulties in promoting the homogenization， and the expected provincial support. Descriptive statistical analysis was performed on the survey results. RESULTS A total of 50 questionnaires were collected， and the effective recovery rate was 100%. There were 16 chief pharmacists （32.00%） in charge of the pharmacy department of the general hospital in the medical consortium. Thirty-seven medical consortiums （74.00%） had established a drug supply support system within the consortium， 35 medical consortiums （70.00%） had carried out pharmaceutical management and coordination work within the medical consortium， 23 medical consortiums （46.00%） had established a clinical medication guidance system， 25 medical consortiums chenwenying2016@163.com （50.00%） had established a bidirectional communication mechanism， and only 8 medical consortiums （16.00%） had developed new models of pharmaceutical care. At present， the difficulties in promoting the homogenization of pharmaceutical management and pharmaceutical care within the medical consortium were mainly found in three aspects： the wide gap in management level of each member unit， the lack and uneven level of pharmaceutical personnel， and insufficient policy support and implementation. Most medical consortiums hoped that relevant departments could promote the homogenization of pharmaceutical work by holding special training courses or special supervision. CONCLUSIONS At present， the compact medical consortium in Guangdong province has achieved initial results in the implementation of the chief pharmacist system， the homogenization of pharmaceutical management and pharmaceutical care. However， it is still necessary to improve the coverage of chief pharmacist appointments in the medical consortium， implement the homogenization of pharmaceutical management， and accelerate the homogenization process of pharmaceutical care.

Background::Pathological scars are a disorder that can lead to various cosmetic, psychological, and functional problems, and no effective assessment methods are currently available. Assessment and treatment of pathological scars are based on cutaneous manifestations. A two-photon microscope (TPM) with the potential for real-time non-invasive assessment may help determine the under-surface pathophysiological conditions in vivo. This study used a portable handheld TPM to image epidermal cells and dermal collagen structures in pathological scars and normal skin in vivo to evaluate the effectiveness of treatment in scar patients. Methods::Fifteen patients with pathological scars and three healthy controls were recruited. Imaging was performed using a portable handheld TPM. Five indexes were extracted from two dimensional (2D) and three dimensional (3D) perspectives, including collagen depth, dermo-epidermal junction (DEJ) contour ratio, thickness, orientation, and occupation (proportion of collagen fibers in the field of view) of collagen. Two depth-dependent indexes were computed through the 3D second harmonic generation image and three morphology-related indexes from the 2D images. We assessed index differences between scar and normal skin and changes before and after treatment.Results::Pathological scars and normal skin differed markedly regarding the epidermal morphological structure and the spectral characteristics of collagen fibers. Five indexes were employed to distinguish between normal skin and scar tissue. Statistically significant differences were found in average depth ( t = 9.917, P <0.001), thickness ( t = 4.037, P <0.001), occupation ( t= 2.169, P <0.050), orientation of collagen ( t = 3.669, P <0.001), and the DEJ contour ratio ( t = 5.105, P <0.001). Conclusions::Use of portable handheld TPM can distinguish collagen from skin tissues; thus, it is more suitable for scar imaging than reflectance confocal microscopy. Thus, a TPM may be an auxiliary tool for scar treatment selection and assessing treatment efficacy.

Objective To clarify the changes in CXCL5 in serum and gastric tissues of patients with chronic atrophic gastritis(CAG)and precancerous lesions of gastric cancer(PLGC)and to investigate the predictive value of CXCL5 for the diagnosis of CAG and PLGC.Methods This study enrolled 72 participants of CAG admitted to the Department of Splenology and Gastroenterology of the Second Affiliated Hospital of Anhui University of Chinese Medicine from June 2022 to June 2023,with gastroscopy and pathologically confirmed diagnosis,as well as 68 healthy participants who underwent gastroscopy in the same period at our department.We collected clinical information and laboratory results from all participants.The logistic regression analysis methods were used to identify the diagnostic value of serum CXCL5.Furthermore,in order to clarify the role of CXCL5 in the developent of CAG,a total of 15 patients each with CAG,intestinal metaplasia,and dysplasia treated at our hospital from June 2023 to December 2023,and 15 healthy participants were selected.The relationship between the expression of CXCL5 and the degree of clinicopathology was analysed in each group using ELISA,PCR,and immunohistochemistry staining to validate and assess the diagnostic efficacy of CXCL5.Results The study found that several factors were associated with CAG,including family history of tumours,smoking and alcohol consumption history,dietary regularity,Helicobacter pylori infection,the number of lesions,gastric function scores and CXCL5(P<0.05).The ROC curve had an AUC of 1.00 and a Youden index of 0.986,indicating excellent predictive ability.The ELISA results indicated a significantly higher serum CXCL5 expression level in the CAG,intestinal metaplasia,and dysplasia groups compared to the normal group.There was a positive correlation between the serum CXCL5 expression level and the degree of pathology.The PCR and immunohistochemistry staining results indicate that the mRNA and pro-tein expression levels of CXCL5 in gastric tissues of patient groups were significantly higher compared to the nor-mal group.Furthermore,the mRNA and protein expression levels of CXCL5 in gastric tissues were positively correlated with the degree of pathology.Conclusions The results indicate that CXCL5 is highly expressed in the serum and gastric tissues of patients with CAG and PLGC,and its expression level is positively correlated with the degree of pathology.Therefore,CXCL5 could serve as a predictive indicator and a potential therapeutic target for the diagnosis of CAG and PLGC.