As the core vehicle for preserving and transmitting traditional Chinese medicine（TCM） academic thought and clinical experience， the establishment of a robust quality evaluation system for TCM clinical case reports is a crucial component in the current standardization and modernization of TCM. Based on the practical experience of constructing the China Clinical Cases Library of Traditional Chinese Medicine by the China Association of Chinese Medicine， this study conducted a comprehensive analysis of critical challenges， including insufficient authenticity and unfocused evaluation criteria. It proposed a three-dimensional evaluation framework grounded in the structure-process-outcome logic， encompassing three dimensions of authenticity and standardization， characteristics and advantages， application and translational impact. This framework integrated 12 key evaluation indicators in a systematic manner. The model preserved the academic characteristics of TCM syndrome differentiation and treatment， while aligning with modern scientific research standards， achieving a balance between individualized TCM experience and standardized evaluation. Concurrently， this study provided theoretical foundations and methodological guidance for evaluating the quality of TCM clinical cases， contributing significantly to the inheritance of TCM knowledge， evidence-based practice， and the reform of talent evaluation mechanisms.

Background Pneumoconiosis remains a critical occupational disease in China. As a major industrial province, Hebei historically faced severe challenges regarding this condition. The 1986 national epidemiological survey ranked Hebei sixth in reported pneumoconiosis cases nationwide. Objective To analyze 76 years of pneumoconiosis data (1949–2024) in Hebei Province to provide evidence-based support for prevention and control strategies. Methods Occupational pneumoconiosis cases diagnosed in Hebei from 1949 to 2024 were included. Five-year intervals were used to analyze incidence composition, dust exposure duration, age at first diagnosis, and age at death. A hybrid model, integrating autoregressive integrated moving average (ARIMA) with generalized regression neural network (GRNN), was employed to predict case numbers for the 2025−2030 period. Results A total of 36107 cases of pneumoconiosis were recorded (2.10% female) in Hebei from 1949 to 2024. Stages I, II, and III accounted for 77.35%, 16.45%, and 6.20%, respectively. Silicosis (55.60%), coal workers’ pneumoconiosis (27.24%), and pottery workers’ pneumoconiosis (8.88%) were the predominant types. Observed trends included a shortened dust exposure duration [silicosis: (12.78±7.063) years in 2020–2024] and an increasing age at first diagnosis [(54.01±7.499) years in 2020–2024]. The case-fatality rate was 14.84%, with a rising age at death [(82.26±9.632) years in 2015–2019]. Three incidence peaks (1963, 1984, and 2014) correlated with national policies and industrialization phases. The number of pneumoconiosis cases showed a decreasing trend from 2015 to 2024. Chengde and Tangshan were identified as current high-risk areas. The ARIMA-GRNN model projected annual cases between 416 and 429 during 2025–2030. Conclusion In the past decade，the number of pneumoconiosis cases in Hebei Province had shown a decreasing trend, it is projected to plateau with no significant decline over the next five years. Furthermore, challenges such as the proportion of silicosis remaining high and shortened dust exposure duration remain severe. It is recommended to focus on key regions like Chengde (ore mining) and Tangshan (ceramics industry). A comprehensive strategy integrating stricter regulation, technological controls, model innovation, and targeted interventions should be implemented to achieve a further substantial reduction in pneumoconiosis incidence.

Background Pneumoconiosis remains a critical occupational disease in China. As a major industrial province, Hebei historically faced severe challenges regarding this condition. The 1986 national epidemiological survey ranked Hebei sixth in reported pneumoconiosis cases nationwide. Objective To analyze 76 years of pneumoconiosis data (1949–2024) in Hebei Province to provide evidence-based support for prevention and control strategies. Methods Occupational pneumoconiosis cases diagnosed in Hebei from 1949 to 2024 were included. Five-year intervals were used to analyze incidence composition, dust exposure duration, age at first diagnosis, and age at death. A hybrid model, integrating autoregressive integrated moving average (ARIMA) with generalized regression neural network (GRNN), was employed to predict case numbers for the 2025−2030 period. Results A total of 36107 cases of pneumoconiosis were recorded (2.10% female) in Hebei from 1949 to 2024. Stages I, II, and III accounted for 77.35%, 16.45%, and 6.20%, respectively. Silicosis (55.60%), coal workers’ pneumoconiosis (27.24%), and pottery workers’ pneumoconiosis (8.88%) were the predominant types. Observed trends included a shortened dust exposure duration [silicosis: (12.78±7.063) years in 2020–2024] and an increasing age at first diagnosis [(54.01±7.499) years in 2020–2024]. The case-fatality rate was 14.84%, with a rising age at death [(82.26±9.632) years in 2015–2019]. Three incidence peaks (1963, 1984, and 2014) correlated with national policies and industrialization phases. The number of pneumoconiosis cases showed a decreasing trend from 2015 to 2024. Chengde and Tangshan were identified as current high-risk areas. The ARIMA-GRNN model projected annual cases between 416 and 429 during 2025–2030. Conclusion In the past decade，the number of pneumoconiosis cases in Hebei Province had shown a decreasing trend, it is projected to plateau with no significant decline over the next five years. Furthermore, challenges such as the proportion of silicosis remaining high and shortened dust exposure duration remain severe. It is recommended to focus on key regions like Chengde (ore mining) and Tangshan (ceramics industry). A comprehensive strategy integrating stricter regulation, technological controls, model innovation, and targeted interventions should be implemented to achieve a further substantial reduction in pneumoconiosis incidence.

Objective To investigate the situation of unconformity of positive and reverse ABO blood typ-ing between outpatient and inpatient patients in the hospital,and explore the reasons for unconformity of posi-tive and reverse ABO blood typing detected by microcolumn gel method.Methods A retrospective analysis was conducted on the medical records of totally 425 patients with ABO blood type mismatch who underwent ORTHO VISION Max testing in the hospital from August 2023 to December 2024.Comprehensive analysis was conducted using various methods including the saline tube method,irregular antibody screening,increas-ing plasma volume,4 ℃ enhancement test,absorption elution,and gene sequencing,etc.Results Among 128 192 cases of ABO blood type tests,425 cases showed unconformity of positive and reverse ABO blood typ-ing,accounting for 0.33％.The causes were as follows:antibody weakening in 316 cases(74.35％),bone mar-row transplantation in 40 cases(9.41％),interference from irregular antibodies in 34 cases(8.00％),antigen weakening in 13 cases(3.06％),subgroups in 10 cases(2.35％),cold agglutinins in 6 cases(1.41％),inter-ference from irregular and autoantibodies in 4 cases(0.94％),auto-sensitization of red blood cells in 1 case(0.24％),and other reasons in 1 case(0.24％).Among 316 cases with antibody weakening,239 cases(75.63％)involved type A(anti-B weakening),61 cases(19.30％)involved type B(anti-A weakening),8 ca-ses(2.53％)involved type O(anti-A weakening),6 cases(1.91％)involved type O(anti-B weakening),and 2 cases(0.63％)involved type O(both anti-A and anti-B weakening).In patients with antibody weakening,the disease distribution was mainly cardiovascular disease in 127 cases(40.19％),a history of tumors in 67 ca-ses(21.20％),kidney diseases in 11 cases(3.48％),and orthopedic diseases in 10 cases(3.16％).Conclusion The main reason for the unconformity of positive and reverse ABO blood typing in the hospital is the weakening of the antibodies,especially the predominance of type A(anti-B weakening).Weakened anti-bodies are predominantly in the distribution of cardiovascular disease.For subtype-induced disturbances,a comprehensive analysis combining serology and gene sequencing is recommended.For disease-induced uncon-formity of positive and reverse ABO blood typing,monitoring the patients should be strengthened.

Adipose tissue is a critical energy reservoir in animals and humans, with multifaceted roles in endocrine regulation, immune response, and providing mechanical protection. Based on anatomical location and functional characteristics, adipose tissue can be categorized into distinct types, including white adipose tissue (WAT), brown adipose tissue (BAT), beige adipose tissue, and pink adipose tissue. Traditionally, adipose tissue research has centered on its morphological and functional properties as a whole. However, with the advent of single-cell transcriptomics, a new level of complexity in adipose tissue has been unveiled, showing that even under identical conditions, cells of the same type may exhibit significant variation in morphology, structure, function, and gene expression——phenomena collectively referred to as cellular heterogeneity. Single-cell transcriptomics, including techniques like single-cell RNA sequencing (scRNA-seq) and single-nucleus RNA sequencing (snRNA-seq), enables in-depth analysis of the diversity and heterogeneity of adipocytes at the single-cell level. This high-resolution approach has not only deepened our understanding of adipocyte functionality but also facilitated the discovery of previously unidentified cell types and gene expression patterns that may play key roles in adipose tissue function. This review delves into the latest advances in the application of single-cell transcriptomics in elucidating the heterogeneity and diversity within adipose tissue, highlighting how these findings have redefined the understanding of cell subpopulations within different adipose depots. Moreover, the review explores how single-cell transcriptomic technologies have enabled the study of cellular communication pathways and differentiation trajectories among adipose cell subgroups. By mapping these interactions and differentiation processes, researchers gain insights into how distinct cellular subpopulations coordinate within adipose tissues, which is crucial for maintaining tissue homeostasis and function. Understanding these mechanisms is essential, as dysregulation in adipose cell interactions and differentiation underlies a range of metabolic disorders, including obesity and diabetes mellitus type 2. Furthermore, single-cell transcriptomics holds promising implications for identifying therapeutic targets; by pinpointing specific cell types and gene pathways involved in adipose tissue dysfunction, these technologies pave the way for developing targeted interventions aimed at modulating specific adipose subpopulations. In summary, this review provides a comprehensive analysis of the role of single-cell transcriptomic technologies in uncovering the heterogeneity and functional diversity of adipose tissues.

OBJECTIVE: To compare the effectiveness and advantages of the double reverse traction reduction versus open reduction internal fixation for treating complex tibial plateau fractures. METHODS: A clinical data of 25 patients with Schatzker type Ⅴ or Ⅵ tibial plateau fractures, who met the selection criteria and were admitted between January 2019 and January 2023, was retrospectively analyzed. Thirteen patients underwent double reverse traction reduction and internal fixation (double reverse traction group), while 12 patients underwent open reduction and internal fixation (traditional open group). There was no significant difference in the baseline data (age, gender, injury mechanism, Schatzker classification, interval between injury and operation) between the two groups ( P>0.05). The effectiveness were evaluated and compared between the two groups, included operation time, intraoperative blood loss, incision length, hospital stay, full weight-bearing time, complications, fracture healing, Rasmussen radiological score (reduction quality), knee Hospital for Special Surgery (HSS) score, and knee flexion/extension range of motion. RESULTS: The double reverse traction group demonstrated significantly superior outcomes in operation time, intraoperative blood loss, hospital stay, incision length, and time to full weight-bearing ( P<0.05). Two patients in traditional open group developed incisional complications, while the double reverse traction group had no complication. There was no significant difference in the incidence of complication between the two groups ( P>0.05). All patients were followed up 24-36 months (mean, 30 months), with no significant difference in follow-up duration between groups ( P>0.05). Fractures healed in both groups with no significant difference in healing time ( P>0.05). At 6 months after operation, Rasmussen radiological scores and grading showed no significant difference between the two groups ( P>0.05); the double reverse traction group had significantly higher HSS scores compared to the traditional open group ( P<0.05). At 12 months after operation, knee flexion/extension range of motion were significantly greater in the double reverse traction group than in the traditional open group ( P<0.05). CONCLUSION Double reverse traction reduction offers advantages over traditional open reduction, including shorter operation time, reduced blood loss, minimized soft tissue trauma, and improved joint functional recovery. It is a safe and reliable method for complex tibial plateau fractures.
Humans ; Tibial Fractures/surgery* ; Fracture Fixation, Internal/methods* ; Male ; Female ; Traction/methods* ; Retrospective Studies ; Middle Aged ; Adult ; Open Fracture Reduction/methods* ; Treatment Outcome ; Range of Motion, Articular ; Fracture Healing ; Operative Time ; Length of Stay ; Blood Loss, Surgical ; Aged ; Tibial Plateau Fractures

OBJECTIVES: In recent years, the incidence and detection rate of pancreatic cystic lesions (PCLs) have increased significantly. Endoscopic ultrasound (EUS) plays an indispensable role in the diagnosis and differential diagnosis of PCLs. However, evidence comparing the diagnostic performance of EUS-guided fine-needle aspiration (EUS-FNA) and fine-needle biopsy (FNB) remains limited. This study aims to compare the diagnostic yield, adequacy of tissue acquisition, and safety between EUS-FNA and EUS-FNB in evaluating PCLs to inform clinical practice. METHODS: A retrospective review was conducted on patients with PCLs who underwent either EUS-FNA or EUS-FNB between January 2014 and August 2021. The diagnostic yield, tissue acquisition adequacy, and incidence of adverse events were compared between the 2 groups. RESULTS: A total of 90 patients with PCLs were included (52 in the FNA group and 38 in the FNB group). The diagnostic yield was similar between the FNA and FNB groups (94.2% vs 94.7%, P>0.05). The adequacy of tissue acquisition was 71.2% in the FNA group and 81.6% in the FNB group (P>0.05). No statistically significant difference was observed in the incidence of adverse events between the 2 groups (P>0.05). CONCLUSIONS Both EUS-FNA and EUS-FNB demonstrate equally high diagnostic yields and tissue adequacy in PCLs, with excellent safety profiles. Both methods are safe and effective diagnostic tools for evaluating PCLs.
Humans ; Endoscopic Ultrasound-Guided Fine Needle Aspiration/adverse effects* ; Retrospective Studies ; Female ; Male ; Pancreatic Cyst/diagnostic imaging* ; Middle Aged ; Biopsy, Fine-Needle/adverse effects* ; Aged ; Pancreatic Neoplasms/diagnosis* ; Adult ; Endosonography/methods* ; Pancreas/pathology* ; Diagnosis, Differential

Objective To mine adverse drug event(ADE)signals of deucravacitinib,and to guide its rational clinical use.Methods ADE reports reported to the U.S.Food and Drug Administration Adverse Event Reporting System(FAERS)database from the third quarter of 2022 to the third quarter of 2024 were collected,ADE reports with deucravacitinib as the primary suspect drug were selected for analysis.ADE signals were identified using reporting adds ratios method and Bayesian confidence propagation neural networks method.Results A total of 1,777 ADE reports were collected involving 3,258 ADEs.Sixty-two ADE signals were identified,spanning 14 system-organ classifications.The top five ADE signals based on the number of reported cases were acne,oral ulcers,folliculitis,urticaria,and oral pain.The top five ADE signals based on signal intensity were cystic acne,hepatitis A,acne vulgaris,pustular acne,and folliculitis.ADE signals such as pigmenturia,hepatitis A,and gingival swelling were not included in the drug instructions.The median duration of ADEs associated with deucravacitinib was 22 days,with 58.33％occurring within the first month of treatment.Women may have a higher risk of developing acne than men.Conclusions When using deutericolaxitinib,healthcare professionals should focus on skin and subcutaneous tissue disorders,gastrointestinal system disorders,and infections and infestations to monitor the occurrence of acne in female patients.The latent ADEs that are not mentioned in the instructions should be remained vigilant to ensure safe drug use.

Aim To investigate the effect of Senecio scandens Buch.-Ham on inflammatory pain mediated by mast cell P2X7 receptor.Methods Using the ATP-induced foot inflammatory pain,immunofluores-cence and toluidine blue staining techniques were used to investigate whether Senecio scandens has inhibitory effect on P2X7 receptor on mast cells.Using the calci-um ion imaging experimental technology,to explore whether Senecio scandens inhibit the intracellular cal-cium ion enrichment caused by activation of P2X7 re-ceptor on mouse peritoneal mast cell.The whole-cell patch clamp technique was used to investigate whether senecio scandens could inhibit the inward current in-duced by activation of P2X7 receptor on mouse perito-neal mast cell.Results In vivo,Senecio scandens alle-viate ATP induced inflammatory pain(3.9 g·kg-1:P＜0.05),and significantly inhibited the infiltration of P2X7 receptor-positive mast cells(3.9 g·kg-1:P＜0.05).Knockout of mast cell can reduce the analgesic effect of Senecio scandens(3.9 g·kg-1:P=0.645).In vitro.The experiment results show that senecio scandens can significantly inhibit the calcium influx(300 mg·L-1:P＜0.05;1 g·L-1:P＜0.01;3 g·L-1:P＜0.01)and the inward current mediated by P2X7 receptor in mast cell(1 g·L-1:P＜0.01).Conclusion Senecio scandens alleviate inflammatory pain by inhibiting mast cell P2X7 receptor.

Objective To analyze the molecular epidemiology and colistin-resistant genes of carbapenem-resistant Klebsiella pneumoniae(CRKP)by whole-genome sequencing,and to provide reference for clinical diagnosis and treatment.Methods 57 CRKP strains isolated from clinical specimens of hospitalized patients in a tertiary general first-class hospital in Anhui Province from 2021 to 2023 were collected and antimicrobial susceptibility testing was performed.Multilocus sequence typing,capsule serotype,resistance genes,and virulence genes of CRKP strains were analyzed by whole-genome sequencing technique,and single nucleotide polymorphism analysis was conducted on sequences of all strains.Colistin resistance-related genes were amplified by polymerase chain reaction(PCR).Results 57 CRKP strains exhibited resistance to 14 antimicrobial agents,with the exception of tigecycline.The se-quencing results showed that 93.0％(53/57)of CRKP carried blaKPC-2,and the ST11 type CRKP strain had the highest detection rate(51/57,89.5％).Single nucleotide polymorphism clustering analysis showed that the 57 CRKP strains were divided into 11 clone groups,of which 4 clone groups were all ST11-KL64 type CRKP.40(70.2％)CRKP strains carried multiple virulence genes.Five strains of CRKP were colistin-resistant strains,the resistance mechanism involved the insertion of ISKpn26 element at site 70 of the mgrB gene.Conclusion The CRKP strain is primarily characterized by the production of KPC-2 ST11-KL64,with disseminated transmission in intensive care unit.The insertion of ISKpn26 element leading to mgrB gene mutation is related to resistance of CRKP to colistin in this region.