Diabetic kidney disease（DKD） is a chronic kidney structural and functional disorder caused by diabetes. With the global prevalence of diabetes continuing to rise， DKD has gradually become a major cause of chronic kidney disease and end-stage renal disease（ESRD）， posing a serious threat to patients' quality of life and long-term health outcomes. Studies have shown that apoptosis plays a pivotal role in the development and progression of DKD， with its mechanisms involving abnormal activation of multiple signaling pathways such as Toll-like receptor 4（TLR4）/nuclear transcription factor-κB（NF-κB）/B-cell lymphoma-2（Bcl-2）/cysteinyl aspartate-specific proteinase（Caspase）-3， protein kinase R-like endoplasmic reticulum kinase（PERK）/eukaryotic initiation factor 2α（eIF2α）/activating transcript factor 4（ATF4）/CCAAT enhancer-binding protein homologous protein（CHOP）， phosphatidylinositol 3-kinase（PI3K）/protein kinase B（Akt）/glycogen synthase kinase-3β（GSK-3β）， Janus kinase 2（JAK2）/signal transducer and activator of transcription 3（STAT3）， adenosine monophosphate-activated protein kinase（AMPK）/mammalian target of rapamycin（mTOR） and silent information regulator 1（SIRT1）/tumor suppressor protein 53（p53）， thereby accelerating renal pathological damage in DKD. Extensive evidence-based medical studies have confirmed that traditional Chinese medicine（TCM）， leveraging its unique therapeutic advantages of multi-target， multi-component and multi-pathway approaches， has demonstrated remarkable efficacy and favorable safety profiles in treating DKD. Recent studies have demonstrated that active components of TCM can specifically target and modulate key effectors in apoptotic signaling pathways. Meanwhile， traditional compound formulations exert synergistic effects through multiple approaches such as replenishing deficiency and activating blood circulation， detoxifying and dredging collaterals， tonifying kidney essence， and removing stasis and purging turbidity， thereby comprehensively regulating critical pathological processes including endoplasmic reticulum stress and mitochondrial apoptosis pathways. This combined therapeutic approach of molecular targeting and holistic regulation provides novel strategies for delaying the progression of DKD. Based on this， this paper provides an in-depth analysis of key apoptotic signaling pathways and their regulatory mechanisms， while systematically summarizing recent research advances regarding the therapeutic effects of TCM active components， compound formulations， and proprietary Chinese medicines on DKD through modulation of these pathways， with particular emphasis on their underlying molecular mechanisms. These findings not only elucidate the modern scientific connotation and theoretical basis of TCM in treating DKD but also establish a solid theoretical and practical foundation for promoting the wider clinical application and further research of TCM in the field of DKD treatment.

Stroke is the leading cause of death and disability among adults in China， and its common complications include digestive system abnormalities， cognitive impairment， depression， stroke-associated pneumonia， and hemiplegia. The combination of traditional Chinese and Western medicine has great potential in treating post-stroke complications. Xinglou Chengqitang （XLCQT） is a representative prescription of alleviating the disease in the upper part by treating the lower part. It has definite therapeutic effect and high safety. Clinically， XLCQT is often used to treat stroke and its complications. However， the quantity and quality of clinical trials of XLCQT in treating post-stroke complications need to be improved. Additionally， since the basic research is weak， the material basis and multi-target mechanism for the efficacy of this prescription are unknown. This article reviews XLCQT in terms of the pharmacodynamic basis， medicinal properties， safety evaluation， and progress in clinical research and mechanisms in treating post-stroke complications. This article summarizes 22 key active ingredients of XLCQT in treating acute stroke complicated with syndrome of phlegm heat and fu-organ excess. Among these key active ingredients， resveratrol， kaempferol， luteolin， chrysoeriol， apigenin， （+）-catechin， and adenosine have good pharmacokinetic properties and high bioavailability. The mechanisms of XLCQT in treating post-stroke complications are complex， including inflammatory response， brain-gut axis， hypothalamic-pituitary-adrenal （HPA） axis， intestinal flora， neurotrophic factors， autophagy， oxidative stress， and free radical damage. This review helps to deeply understand the pharmacodynamic basis and mechanisms of XLCQT in treating post-stroke complications and provides a theoretical basis for the clinical application of XLCQT against post-stroke complications and the development of drugs.

Lung cancer is one of the most common malignant tumors. Brain metastasis, especially meningeal metastasis, is a fatal complication of lung cancer. The sensitivity of traditional diagnostic methods for this disease is limited. As a new technology, cerebrospinal fluid liquid biopsy can noninvasively and dynamically detect the molecular characteristics of intracranial tumors. Cerebrospinal fluid directly contacts the central nervous system lesions. It contains more unique and representative tumor-derived molecular information compared with those obtained from other body fluids such as blood for lung cancer meningeal metastasis, thus remarkably improving the diagnosis and personalized treatment of lung cancer meningeal metastasis. This work reviews the research progress on cerebrospinal fluid liquid biopsy in lung cancer brain metastasis and explores its value in guiding targeted therapy, delineating drug resistance, and evaluating prognostic progression to provide new directions for the clinical diagnosis and treatment of lung cancer brain metastasis.

With the increasing severity of bacterial antibiotic resistance， finding new ways to overcome this global challenge has become an urgent task. Chinese medicine， with abundant resources， offers potential for discovering diverse bioactive ingredients to enhance antibiotic efficacy and alleviate the crisis of bacterial antibiotic resistance. This review summarizes bacterial resistance mechanisms， prevention strategies， and the roles and mechanisms of Chinese medicine and its active ingredients in enhancing the efficacy of existing antibiotics. Two major resistance mechanisms—bacterial obstruction of antibiotic uptake and weakening of intracellular antibiotic activity—are introduced， with corresponding prevention and control strategies outlined. Based on the regulatory effects of active ingredients from Chinese medicine on bacteria， their mechanisms for enhancing antibiotic efficacy are categorized into two types， including improving the bacterial uptake of antibiotics and reducing the bacterial resistance to antibiotics. The former mainly enhances extracellular antibiotic uptake by regulating membrane permeability， biofilm formation， and metabolic pathways. The latter weakens intracellular antibiotic resistance by inhibiting efflux pumps and bacterial resistance targets. Furthermore， compound formulas of Chinese medicine， characterized by multi-component， multi-target， and multi-pathway interventions， exert similar antimicrobial effects and mechanisms with active ingredients， offering rich resources for developing antibiotic-enhancing applications. Finally， the review highlights the challenges such as insufficient structural research on active ingredients and potential druggability issues in their application for antibiotic enhancement. This will provide insights for advancing the research on Chinese active ingredients in antibiotic therapy and offers novel strategies to combat bacterial antibiotic resistance.

With the increasing severity of bacterial antibiotic resistance， finding new ways to overcome this global challenge has become an urgent task. Chinese medicine， with abundant resources， offers potential for discovering diverse bioactive ingredients to enhance antibiotic efficacy and alleviate the crisis of bacterial antibiotic resistance. This review summarizes bacterial resistance mechanisms， prevention strategies， and the roles and mechanisms of Chinese medicine and its active ingredients in enhancing the efficacy of existing antibiotics. Two major resistance mechanisms—bacterial obstruction of antibiotic uptake and weakening of intracellular antibiotic activity—are introduced， with corresponding prevention and control strategies outlined. Based on the regulatory effects of active ingredients from Chinese medicine on bacteria， their mechanisms for enhancing antibiotic efficacy are categorized into two types， including improving the bacterial uptake of antibiotics and reducing the bacterial resistance to antibiotics. The former mainly enhances extracellular antibiotic uptake by regulating membrane permeability， biofilm formation， and metabolic pathways. The latter weakens intracellular antibiotic resistance by inhibiting efflux pumps and bacterial resistance targets. Furthermore， compound formulas of Chinese medicine， characterized by multi-component， multi-target， and multi-pathway interventions， exert similar antimicrobial effects and mechanisms with active ingredients， offering rich resources for developing antibiotic-enhancing applications. Finally， the review highlights the challenges such as insufficient structural research on active ingredients and potential druggability issues in their application for antibiotic enhancement. This will provide insights for advancing the research on Chinese active ingredients in antibiotic therapy and offers novel strategies to combat bacterial antibiotic resistance.

Objective:To explore the latent class characteristics of demoralization in severely disabled stroke patients, and analyze the differences and influencing factors of each class by latent class analysis.Methods:Convenience sampling was used to select 335 patients in the Neurointensive Care Unit of three Class Ⅲ Grade A hospitals in Anhui Province from October 2023 to March 2024, and were confirmed to be with post-stroke disability through follow-up as research subjects. General Information Questionnaire and Demoralization Scale-Ⅱ were used for a survey. Latent class analysis was used to identify latent classes of demoralization, and multiple logistic regression was used to analyze the influencing factors of different latent classes.Results:A total of 335 questionnaires were distributed, and 321 valid questionnaires were retrieved. The effective recovery rate of the questionnaires was 95.8%. Demoralization of severe stroke patients with disability was classified into four categories of low demoralization (40.2%, 129/321), moderate demoralization with coping loss (12.1%, 39/321), moderate demoralization with goal loss (21.2%, 68/321), and high disability (26.5%, 85/321). Multiple Logistic regression analysis showed that age, gender, per capita monthly income of the family, whether was the economic pillar of the family, long-term residence, and relationship with cohabitants were the influencing factors of demoralization in severe stroke patients with disability (all P<0.05) . Conclusions:There are four latent classes of demoralization in stroke patients with disability, and age, gender, per capita monthly income of the family, whether they are the economic pillar of the family, long-term residence, and relationship with cohabitants are the influencing factors of demoralization in severe stroke patients with disability.

Objective:To investigate the factors influencing the prescribing habits of general practitioners (GPs) in relation to single-pill combination (SPC) antihypertensive drugs.Methods:This was a qualitative study. Using the purposive sampling method, 2 general hospitals (designated as HAZ1-2) and 4 community health service centers (designated as HAS1-4) in Huai′an city, Jiangsu province were selected from April to May 2023. In addition, 4 general practitioners (designated as A-D) were selected as interviewees from each general hospital and center. The selected individuals were interviewed using on-site thematic group interviews. The interview mainly included the principles of clinical selection of SPC antihypertensive drugs; the degree of acceptance of SPC antihypertensive drugs by patients after prescription; the evaluation of SPC antihypertensive drugs and the difficulties existing in their clinical use. The data of the interview were analyzed according to the thematic framework.Results:Twenty-four GPs were interviewed. Four themes and 9 sub-themes were extracted regarding factors influencing GP prescribing of SPC antihypertensive drugs. The study showed that: (1) the prescribing of SPC antihypertensive drugs by GPs according to patients′ specific conditions; (2) the prescribing of SPC antihypertensive drugs by GPs was influenced by factors such as price and drug adjustment; (3) the different evaluations of SPC antihypertensive drugs among GPs; (4) GPs in community health service centers faced many difficulties in prescribing SPC antihypertensive drugs (relatively fewer varieties of SPC drugs in the community, lower patient trust in community GPs, and lower standardization of prescribing by community GPs).Conclusion:The factors influencing GPs′ prescribing of SPC antihypertensive drugs mainly include the patients′ specific situation, price, medication adjustment, attitude of GPs, and some clinical practice problems.

Objective:To investigate the clinical characteristics and risk factors of airway mucus plugging in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods:This was a retrospective cross-sectional study. A total of 322 hospitalized AECOPD patients admitted to the First Affiliated Hospital of Anhui Medical University from February 2023 to February 2025 were enrolled. Based on chest high-resolution computed tomography (HRCT) findings of airway mucus plugging, patients were classified into mucus plugging and non-mucus plugging groups. General and clinical data were collected, including age, sex, disease duration, smoking and alcohol history, comorbidities, number of acute exacerbations in the past year, routine blood tests, biochemical indices, pulmonary function, and pathogen detection. The incidence of airway mucus plugging in AECOPD patients was calculated, and differences in baseline characteristics, laboratory parameters, and pulmonary function between the two groups were compared. Logistic regression was used to identify independent risk factors for mucus plugging, and receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of relevant indicators.Results:Of the 322 enrolled patients, 87(27.02%) were found to have airway mucus plugging. Univariate analysis revealed statistically significant differences between the mucus plug group and the non-plug group in the following parameters (all P<0.05): body mass index (BMI), disease duration, smoking status, Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, modified British Medical Research Council (mMRC) dyspnea scale, COPD Assessment Test (CAT) score, frequency of acute exacerbations, neutrophil percentage, absolute lymphocyte count, lymphocyte percentage, albumin, C-reactive protein (CRP), activated partial thromboplastin time, fibrinogen, fibrin(ogen) degradation products, D-dimer, Aspergillus infection rate, percentage of forced expiratory volume in 1 second to predicted value (FEV 1%pred), ratio of FEV 1 to forced vital capacity (FEV 1/FVC), and percentage of maximal mid-expiratory flow to predicted value (MMEF 75/25%pred). Multivariate logistic regression analysis identified the following as independent risk factors for airway mucus plugs (all P<0.05): elevated CRP ( OR=1.022, 95% CI: 1.013-1.036), decreased albumin ( OR=0.891, 95% CI: 0.825-0.959), Aspergillus infection ( OR=1.774, 95% CI: 1.366-2.317), and reduced MMEF 75/25%pred value ( OR=0.978, 95% CI: 0.964-0.990). ROC curve analysis showed that the combined predictive model incorporating CRP, albumin, Aspergillus infection, and MMEF 75/25%pred had an area under the ROC curve (AUC) of 0.776(95% CI: 0.714-0.838), which was superior to each individual indicator alone, with AUCs of 0.721 for CRP, 0.687 for albumin, 0.579 for Aspergillus infection, and 0.631 for MMEF 75/25%pred. Conclusions:AECOPD patients with airway mucus plugging exhibit higher inflammatory markers, poorer nutritional status, a higher likelihood of Aspergillus infection, worse pulmonary function, and poorer prognosis. Aspergillus infection, elevated CRP, decreased albumin, and reduced MMEF 75/25%pred are independent risk factors for mucus plugs in AECOPD.

Objective:To investigate the correlation between relative fat mass(RFM)and Estimated Glomerular Filtration Rate(eGFR)in an elderly hypertensive population.Methods:This cross-sectional study enrolled elderly hypertensive individuals aged 65 years and older from Huai'an city between June 2023 and December 2023.Clinical data for these subjects were collected, and RFM and eGFR were calculated according to established formulas.Subsequently, the subjects were divided into two groups based on their eGFR levels: the eGFR normal group and the eGFR decreased group.Differences between these two groups were compared.Multivariate logistic regression models were employed to analyze the association between RFM and eGFR, and a subgroup analysis was conducted.The predictive value of RFM for renal function decline was evaluated using receiver operating characteristic curves(ROC).Results:Among the 2, 603 subjects, 921(35.4%)were assigned to the eGFR decreased group, while 1, 682(64.6%)were assigned to the eGFR normal group.The proportion of males, married individuals, smokers, and alcohol drinkers, as well as diastolic blood pressureand cultural levels, were significantly lower in the eGFR decreased group compared to the eGFR normal group (all P<0.05). Conversely, the duration of hypertension, proportion of comorbidities, age, fasting blood glucose, triglycerides, low-density lipoprotein cholesterol(LDL-C), relative fat mass(RFM), visceral fat index(VAI), dysfunctional obesity index(DAI), body roundness index(BRI), and conicity index(C-index)were all significantly higher in the eGFR decreased group compared to the eGFR normal group(all P<0.05). After adjusting for confounding factors, multivariate logistic regression analysis revealed that when RFM was treated as a continuous variable, the risk of eGFR decline increased with rising RFM(odds ratio[ OR]=1.035, 95% confidence interval[95% CI]: 1.008-1.063, P=0.010). When grouped according to RFM quartile levels(in ascending order)into Q1(<26.22), Q2(26.22-<30.53), Q3(30.53-<39.26), and Q4(≥39.26), using the Q1 group as a reference, the risk of eGFR decline increased in the Q3( OR=1.691, 95% CI: 1.777-2.430, P=0.004)and Q4( OR=1.743, 95% CI: 1.118-2.717, P=0.014)groups.In the subgroup analysis, gender( P-interaction=0.034)and smoking( P-interaction=0.012)were identified as having significant interaction effects on RFM and the decline in eGFR.In the male subgroup( OR=1.067, 95% CI: 1.027-1.108, Ptrend=0.001)and the smoking subgroup( OR=1.109, 95% CI: 1.026-1.199, Ptrend=0.009), the risk of eGFR decline significantly increased with higher levels of RFM.The restricted cubic spline(RCS)analysis indicated that when RFM exceeded 30.609, the risk of eGFR decline increased with rising RFM levels, demonstrating a non-linear correlation between RFM and the risk of eGFR decline( Pnonlinearity=0.048 5). The ROC curve analysis revealed that the area under the curve(AUC)for RFM in predicting eGFR reduction was 0.635(95% CI: 0.613-0.657, P1<0.001), which was significantly higher than the AUC for VAI(AUC=0.573, 95% CI: 0.550-0.596, P2<0.001), DAI(AUC=0.562, 95% CI: 0.539-0.584, P2<0.001), BRI(AUC=0.564, 95% CI: 0.541-0.587, P2<0.001), and the C-index(AUC=0.536, 95% CI: 0.513-0.559, P2<0.001). Conclusions:Elevated RFM is an independent risk factor for eGFR decline in elderly hypertensive individuals.There exists a significant interaction between gender and smoking with respect to the risk of RFM and eGFR decline.Additionally, RFM demonstrates a notable predictive value for eGFR decline in elderly hypertensive individuals.

This paper elaborated the structural principles,structures and working principles of the A5 type passive training system for hand function through discussed the clinical application of passive training system for hand function in the rehabilitation of patients with stroke.It analyzed a series of occurring common faults during system operation,such as system errors caused by missing components,improper sensitivity settings for spasticity,abnormal connections for equipment,motor failures,jam and pause of robotic hand,and faults of lifting table,and conducted fault analysis for them.After that,this paper proposed corresponding handling strategies and solutions for faults,which included software configuration,calibration and detection of robotic hand sensors,repair of connection fault,and regular maintenance and replacement of system's components.It provided theoretical basis for the maintenance and optimization of the passive training system for hand function.Thus,it can rapid remove troubles,and reduce the equipment's failure rate of passive training system for hand function,and improve the equipment's normal utilization rate,and ensure favorable performance of equipment in long-term use.