Gorham-Stout disease(GSD) is a rare osteolytic disorder characterized by spontaneous and progressive osteolysis, along with abnormal angiogenesis and lymphangiogenesis, with no new bone formation. We present a case of a 15-year-old female admitted due to " recurrent right leg pain for 5 years, 11 months after undergoing right femoral fracture surgery". Through comprehensive integration of the patient's clinical phenotype, laboratory tests, imaging findings, pathological examinations, and molecular biological test results, GSD was considered highly likely. A multidisciplinary treatment approach was conducted, including a combination of zoledronic acid and sirolimus to inhibit osteolysis, along with rehabilitation training and orthopedic intervention, providing a personalized and comprehensive treatment strategy.

Tacit knowledge of tongue inspection is content that affects diagnostic results but is difficult to be explicit. Its cognitive characteristics are rooted in xiang thinking and embodiment. It constructs multidimensional associations between tongue manifestations and disease mechanisms through imagery mapping， and it relies on the practitioner's bodily perception， clinical context， and long-term practice for continuous internalization. In response to the neglect of tacit transmission and individual cognitive processes in current traditional Chinese medicine （TCM） tacit knowledge research， an empirical research framework integrating cognitive neuroscience is proposed. Specifically， event-related potential （ERP） and eye tracking （ET） technologies can be used to capture the brain electrical activity and eye movement trajectories of experts and novices in different tongue diagnosis cognitive tasks. By integrating multimodal cognitive data such as behaviorism， ERP components， and ET indicators， the implicit cognitive advantages of experts in the perception， mapping， and decision-making stages of tongue diagnosis are presented， and the possibility of achieving tacit knowledge transformation through visual cognitive transfer training is explored. Exploring empirical pathways to uncover the cognitive mechanisms of tongue diagnosis tacit knowledge is of great significance for the inheritance of traditional Chinese medicine.

ObjectiveTo analyze the volatile components in raw Coptidis Rhizoma， Euodiae Fructus juice-processed Coptidis Rhizoma （Yuhuanglian）， and the processing adjuvant Euodiae Fructus juice， identify marker volatile components in the processed product， and elucidate the material basis changes during the processing with Euodiae Fructus juice. MethodsHeadspace solid-phase microextraction coupled with gas chromatography-quadrupole-time-of-flight mass spectrometry （HS-SPME-GC-Q-TOF-MS） was employed to analyze the volatile components in raw Coptidis Rhizoma， Yuhuanglian， and Euodiae Fructus juice. Chemometric analysis was performed to compare volatile components among samples and screen the marker components. Finally， the relative odor activity value （ROAV） was calculated to investigate odor characteristics. ResultsA total of 127 components were detected， with 27， 75， 84 volatile components identified in Euodiae Fructus juice， raw Coptidis Rhizoma， and Yuhuanglian， respectively. Processing with Euodiae Fructus juice significantly increased the number and content of volatile components. Chemometric analysis revealed significant changes in volatile components among the three sample types， allowing clear discrimination. After processing， 39 components such as methyl octanoate and allyl propionate were introduced， while 34 components including furfural and hexanoic acid increased in content， and 11 components including butyric acid and octanal decreased. Additionally， eight components， including zingiberene， 6-methyl-6-hepten-2-one， and 5-methyl-2-hexanone， were screened as marker components of Yuhuanglian. Moreover， processing enhanced the ROAV values of 2，5-dimethylpyrazine （roasted， nutty， coffee-like aroma）， 3-ethylphenol， and guaiacol （smoky， woody aroma）. Additionally， it incorporated 1-hepten-3-one from Euodiae Fructus juice and the newly generated 1-hexen-3-one， contributing mushroom and cucumber-like odors. The sensory profile of Yuhuanglian integrated nutty， roasted， smoky， and woody notes with the citrus and fruity aroma originally contributed by octanal. ConclusionThe processing with Euodiae Fructus juice introduced components from adjuvant， significantly altering the volatile component profile and enhancing the sensory odor characteristics of Yuhuanglian. This study provides a valuable reference for exploring the material basis of volatile components and establishing processing specifications for Yuhuanglian.

ObjectiveTo analyze the volatile components in raw Coptidis Rhizoma， Euodiae Fructus juice-processed Coptidis Rhizoma （Yuhuanglian）， and the processing adjuvant Euodiae Fructus juice， identify marker volatile components in the processed product， and elucidate the material basis changes during the processing with Euodiae Fructus juice. MethodsHeadspace solid-phase microextraction coupled with gas chromatography-quadrupole-time-of-flight mass spectrometry （HS-SPME-GC-Q-TOF-MS） was employed to analyze the volatile components in raw Coptidis Rhizoma， Yuhuanglian， and Euodiae Fructus juice. Chemometric analysis was performed to compare volatile components among samples and screen the marker components. Finally， the relative odor activity value （ROAV） was calculated to investigate odor characteristics. ResultsA total of 127 components were detected， with 27， 75， 84 volatile components identified in Euodiae Fructus juice， raw Coptidis Rhizoma， and Yuhuanglian， respectively. Processing with Euodiae Fructus juice significantly increased the number and content of volatile components. Chemometric analysis revealed significant changes in volatile components among the three sample types， allowing clear discrimination. After processing， 39 components such as methyl octanoate and allyl propionate were introduced， while 34 components including furfural and hexanoic acid increased in content， and 11 components including butyric acid and octanal decreased. Additionally， eight components， including zingiberene， 6-methyl-6-hepten-2-one， and 5-methyl-2-hexanone， were screened as marker components of Yuhuanglian. Moreover， processing enhanced the ROAV values of 2，5-dimethylpyrazine （roasted， nutty， coffee-like aroma）， 3-ethylphenol， and guaiacol （smoky， woody aroma）. Additionally， it incorporated 1-hepten-3-one from Euodiae Fructus juice and the newly generated 1-hexen-3-one， contributing mushroom and cucumber-like odors. The sensory profile of Yuhuanglian integrated nutty， roasted， smoky， and woody notes with the citrus and fruity aroma originally contributed by octanal. ConclusionThe processing with Euodiae Fructus juice introduced components from adjuvant， significantly altering the volatile component profile and enhancing the sensory odor characteristics of Yuhuanglian. This study provides a valuable reference for exploring the material basis of volatile components and establishing processing specifications for Yuhuanglian.

Jianghuanglian is one of the representative processed products of Coptidis Rhizoma for treating cold syndrome with drugs of heat nature， and ginger is used to restrict the bitter cold of Coptidis Rhizoma， which can be traced back to Bojifang， and it is suitable for stagnation of damp-heat in middle-jiao， cold-heat mutual knots and other symptoms. Jianghuanglian retains the alkaloids， phenylpropanoids and flavonoids of Coptidis Rhizoma， and also introduces gingerol components such as 6-gingerol in ginger， which has pharmacological activities such as anti-inflammatory， antibacterial， anti-tumor， and improving gastrointestinal function. The 2020 edition of Chinese Pharmacopoeia and many local processing specifications have included the traditional processing process and quality standards of Jianghuanglian， but the specific process parameters and quality standards are incomplete， which limits the production and clinical application of this processed product. By summarizing the processing history， process research， quality evaluation， pharmacodynamic and medicinal property changes and application of Jianghuanglian in the past 20 years， there are differences in the processing methods and standards in various provinces and cities， which are mainly reflected in the preparation method， dosage， processing process and quantitative standards of ginger juice. In addition， there are also certain differences in the changes of the main components of Jianghuanglian prepared from ginger or dried ginger， as well as their efficacy and medicinal properties. The research on the processing process of Jianghuanglian plays an important role in improving its quality standards， and this review can provide a reference for improving the quality evaluation system of Jianghuanglian.

Objective:To investigate the anti-heart failure mechanism of N-acetylcysteine(NAC)in diabetic cardiomyop-athy independent from coronary artery factors.Methods:A total of 40 diabetic mice after heart failure model construction were randomly divided into two groups,NAC group(n=20,NAC 100mg·kg-1·d-1)and control group(n=20,Saline 100 mg·kg-1·d-1).Echocardiography was performed to detect left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular ejection fraction(LVEF),mitral left ventricular early-dias-tolic peak flow velocity/left ventricular late-diastolic peak flow velocity(E/A),isovolumic relaxation time(IVRT)and cardiac output(CO)after 4 weeks.Terminal uridine nick-end labeling(TUNEL)was performed to detect apoptosis in-dex,and Western Blot was performed to detect the expression of extracellular regulated protein kinases(ERK)1/2 after 6 weeks in two groups.Results:Compared to those in control group,mice in NAC group had significant higher LVEF[(40.5±3.4)％vs.(36.9±3.2)％],E/A[(1.5±0.1)vs.(1.4±0.1)]and CO[(10.3±0.6)ml/min vs.(9.9±0.5)ml/min](P＜0.05 or＜0.01);and significant lower LVESV[(23.1±1.3)μl vs.(24.7±1.5)μl],apoptosis index[(31.2±0.5)％vs.(45.1±0.9)％]and the expression of ERK1/2[(2.2±0.2)vs.(3.9±0.1)](P＜0.001 all).Conclusion:NAC exerts anti-heart failure effect by attenuating apoptosis of cardiomyocytes via regulating ERK1/2 pathway.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To analyze the clinical characteristics and prognosis of children with hematological malignancies complicated by secondary hemophagocytic lymphohistiocytosis(HLH).Methods:A total of 67 children with HLH admitted to Jinan Second Maternal and Child Health Hospital between June 2020 and June 2024 were selected.Children without hematological malignancies were divided into the non-combined group,and those with hematological malignancies were divided into the combined group.The clinical characteristics and prognosis of the two groups were analyzed.Results:There were no significant differences in clinical characteristics such as WBC,Hb,PLT between the two groups(P＞0.05).During the follow-up,the 1-and 2-year overall survival(OS)rates for all children were(88.6±4.1)％and(73.1±7.7)％,respectively.In the non-combined group,43 children survived and 6 died,with 1-and 2-year OS rates of(95.2±3.3)％and(77.4±9.3)％,respectively.In the combined group,12 children survived and 6 died,with 1-and 2-year OS rates of(71.8±10.7)％and(62.8±12.6)％,respectively.The OS rate of the combined group was significantly lower than that of the non-combined group(x2=4.787,P=0.029).The 1-and 2-year event free survival(EFS)rates of the combined group were(61.1±11.5)％and(50.9±13.3)％,respectively.Conclusion:Children with hematological malignancies complicated by secondary HLH exhibit complex and diverse clinical characteristics.Although favorable short-term therapeutic effects can be achieved,their long-term prognosis tends to be less optimistic.

Aim To investigate the effect of angioten-sin Ⅱ type 1a receptor(AT1aR)knockout on cardiac dysfunction in rats with obesity and its possible molecu-lar mechanism.Methods SD rats(n=24)were used to generated the whole-body AT1 aR-deficiency rats by sgRNA and the CRISPR/Cas9 system,and the obesity model was constructed by feeding with high-fat diet(HFD).They were divided into four groups:wildtype(WT)and knockout(KO)groups with nor-mal feeding and their respective high-fat diets groups.Color ultrasound diagnostic instrument was uses to e-valuate the cardiac function;oil red O staining was a-dopted to stain the myocardial lipids;RT-PCR was used to detect the levels of GPX4 and Ptgs2 genes in myocardial tissue.Western blot was employed to detect the expression of GPX4,ferritin,Nrf2,HO-1 and NQO1 in rat myocardial tissue.ELISA and other kits were used to determine the lipid contents in serum and myocardium.Results It was found that high-fat feed-ing caused cardiac dysfunction,serum lipid disorders,oxidative stress and ferroptosis in SD rats.However,these changes were attenuated in AT1aR knockout rats fed with high-fat diet.Furthermore,compared with WT-HFD group,KO-HFD rats showed enhanced acti-vation of the Nrf2/HO-1 pathway in the myocardium,reduced ferroptosis,decreased lipid accumulation,and reduced cardiac dysfunction.Conclusion AT1aR knockout can improve HFD-induced cardiac dysfunc-tion by enhancing antioxidant capacity and reducing the degree of ferroptosis.

Intestinal failure(IF)is defined as a severe impairment of intestinal function requiring prolonged intravenous supplementation to maintain health or growth.Chronic intestinal failure(CIF)refers to stable metabolic dependence on parenteral support for months or years.IF is associated with life-threatening complications,and recent advances in its diagnosis and management have deepened the understanding of this condition,facilitating personalized and precision treatment strategies.This review synthesizes current knowledge on CIF,including its definition,classification,diagnostic criteria,and therapeutic approaches and its complications.