Chronic heart failure （CHF）， as the terminal stage of various cardiovascular diseases， is characterized by a prolonged course and a high mortality rate， posing a serious threat to human health and life. According to physician Sun Yikui's theory of "Mingmen Dongqi" （dynamic Qi of life gate） in the Ming Dynasty and the modern medicine concept of mitochondrial quality control （MQC）， this paper systematically explores the pathogenic mechanisms and evolutionary patterns of CHF， as well as its intrinsic connection with microstructural homeostasis， and further proposes potential traditional Chinese medicine （TCM） intervention strategies. CHF is often caused by damage to the heart Qi at the early stage. As the disease progresses， prolonged illness affects the kidneys， leading to the dynamic Qi decline of life gate. Further， it results in the failure of the functions of sustaining and consolidating， causing the disintegration of the physical form， which corresponds to mitochondrial kinetic disorders. The deficiency in primary driving force results in impaired Qi transformation， corresponding to mitochondrial autophagy dysfunction， forming a pathological transmission chain of "life gate-mitochondrion" that ultimately leads to myocardial structural disintegration and energy metabolism failure. Modern research indicates that patients with CHF exhibit significant MQC imbalance. Disrupted mitochondrial dynamics lead to network fragmentation， and impaired autophagy causes metabolic blockage， constituting the key microscopic mechanisms underlying ventricular remodeling and pump failure. Chinese herbal medicines， such as those with the effects of warming and tonifying kidney Yang or reinforcing healthy Qi， can intervene in multiple signaling pathways-including PTEN-inducible kinase 1 （PINK1）/Parkin and AMP-activated protein kinase/dynamin-related protein 1 （AMPK/Drp1）-to regulate mitochondrial dynamics and autophagy activity. This repairs damaged MQC networks and improves the microenvironment of myocardial energy metabolism. These intervention strategies align closely with the TCM therapeutic principles of warming and tonifying life gate， replenishing Qi， and activating blood， demonstrating the advantages of holistic regulation based on kidney-centered treatment and mitochondrial-targeted approaches. By integrating the "Mingmen Dongqi" theory with the MQC mechanism， this paper establishes a theoretical framework for the integrated prevention and treatment of CHF， offering new perspectives and insights for clinical practice and future research.

Chronic heart failure （CHF）， as the terminal stage of various cardiovascular diseases， is characterized by a prolonged course and a high mortality rate， posing a serious threat to human health and life. According to physician Sun Yikui's theory of "Mingmen Dongqi" （dynamic Qi of life gate） in the Ming Dynasty and the modern medicine concept of mitochondrial quality control （MQC）， this paper systematically explores the pathogenic mechanisms and evolutionary patterns of CHF， as well as its intrinsic connection with microstructural homeostasis， and further proposes potential traditional Chinese medicine （TCM） intervention strategies. CHF is often caused by damage to the heart Qi at the early stage. As the disease progresses， prolonged illness affects the kidneys， leading to the dynamic Qi decline of life gate. Further， it results in the failure of the functions of sustaining and consolidating， causing the disintegration of the physical form， which corresponds to mitochondrial kinetic disorders. The deficiency in primary driving force results in impaired Qi transformation， corresponding to mitochondrial autophagy dysfunction， forming a pathological transmission chain of "life gate-mitochondrion" that ultimately leads to myocardial structural disintegration and energy metabolism failure. Modern research indicates that patients with CHF exhibit significant MQC imbalance. Disrupted mitochondrial dynamics lead to network fragmentation， and impaired autophagy causes metabolic blockage， constituting the key microscopic mechanisms underlying ventricular remodeling and pump failure. Chinese herbal medicines， such as those with the effects of warming and tonifying kidney Yang or reinforcing healthy Qi， can intervene in multiple signaling pathways-including PTEN-inducible kinase 1 （PINK1）/Parkin and AMP-activated protein kinase/dynamin-related protein 1 （AMPK/Drp1）-to regulate mitochondrial dynamics and autophagy activity. This repairs damaged MQC networks and improves the microenvironment of myocardial energy metabolism. These intervention strategies align closely with the TCM therapeutic principles of warming and tonifying life gate， replenishing Qi， and activating blood， demonstrating the advantages of holistic regulation based on kidney-centered treatment and mitochondrial-targeted approaches. By integrating the "Mingmen Dongqi" theory with the MQC mechanism， this paper establishes a theoretical framework for the integrated prevention and treatment of CHF， offering new perspectives and insights for clinical practice and future research.

Objective:To observe the clinical efficacy of against-lateral correction Tuina(Chinese therapeutic massage)in treating atlanto-axial joint disorder(AAJD)and imaging changes.Methods:A total of 142 patients with AAJD were recruited.They were randomly allocated to a trial group and a control group using the random number table method,with 71 participants in each group.The trial group was treated with against-lateral correction Tuina 3 times weekly.The control group was offered conventional physical traction therapy once daily.The interventions lasted 2 weeks in both groups.The two groups of participants were observed before and after treatment for their changes in the global pain scale(GPS)score,visual analog scale(VAS)score for dizziness assessment,cervical range of motion(ROM)in rotation,and the extent of atlanto-dental displacement.Results:The GPS and VAS scores dropped after treatment in both groups(P<0.05)and were lower in the trial group than in the control group after treatment and at the follow-up(P<0.05).Participants in the trial group achieved a significant increase in the cervical ROM in rotation after treatment and at the follow-up compared to the pre-treatment value(P<0.05)and surpassed the control group(P<0.05);the control group only showed an increase in the left-side rotation(P<0.05).After the intervention,neither the intra-group nor the between-group comparison revealed significant differences in the extent of atlanto-dental displacement(P>0.05),though the trial group presented an improving tendency.Conclusion:Compared to physical traction,the against-lateral correction Tuina method works more significantly in improving pain,dizziness,and ROM in AAJD patients.

Objective:To observe the clinical efficacy of against-lateral correction Tuina(Chinese therapeutic massage)in treating atlanto-axial joint disorder(AAJD)and imaging changes.Methods:A total of 142 patients with AAJD were recruited.They were randomly allocated to a trial group and a control group using the random number table method,with 71 participants in each group.The trial group was treated with against-lateral correction Tuina 3 times weekly.The control group was offered conventional physical traction therapy once daily.The interventions lasted 2 weeks in both groups.The two groups of participants were observed before and after treatment for their changes in the global pain scale(GPS)score,visual analog scale(VAS)score for dizziness assessment,cervical range of motion(ROM)in rotation,and the extent of atlanto-dental displacement.Results:The GPS and VAS scores dropped after treatment in both groups(P<0.05)and were lower in the trial group than in the control group after treatment and at the follow-up(P<0.05).Participants in the trial group achieved a significant increase in the cervical ROM in rotation after treatment and at the follow-up compared to the pre-treatment value(P<0.05)and surpassed the control group(P<0.05);the control group only showed an increase in the left-side rotation(P<0.05).After the intervention,neither the intra-group nor the between-group comparison revealed significant differences in the extent of atlanto-dental displacement(P>0.05),though the trial group presented an improving tendency.Conclusion:Compared to physical traction,the against-lateral correction Tuina method works more significantly in improving pain,dizziness,and ROM in AAJD patients.

Objective To investigate the role of triggering receptor expressed on myeloid cells-1(TREM-1)in ath-erosclerosis induced by chronic intermittent hypoxia(CIH).Methods ApoE-/-mice were randomly divided into blank group,model group and experimental group.The mice in the model group and the experimental group were kept in a hypoxic environment and fed with a high-fat diet.After 4 weeks of high-fat feeding,mice in the experi-mental group were intraperitoneally injected with TREM-1 inhibitor LR12(5 mg/kg)for 8 weeks.After 12 weeks of feeding,the level of serum total cholesterol(TC),low density lipoprotein(LDL),triglyceride(TG),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)and interleukin-10(IL-10)were detected.Histological analysis of aortic TREM-1 expression,plaque area and macrophage level were examined.Results Compared with blank group,the expression of TREM-1 in the aorta of the model group significantly increased(P＜0.05).Com-pared with model group,the aortic plaque,the level of lipids in serum(TC,LDL,TG)and inflammatory factors(TNF-α,IL-1β,IL-10),aortic plaque,the expression of TREM-1 and infiltrating macrophages in aortic plaque of the experimental group were all significantly reduced(P＜0.05).Conclusions TREM-1 is involved in the develop-ment of CIH-induced AS.Inhibition of TREM-1 can alleviate CIH-induced AS and its mechanism is related to the inhibition of macrophage activation.

Objective:To construct a rapid admission evaluation model for medical consumables of same category,and to achieve a balance between scientificity,efficiency and practicality in the management of medical consumables.Methods:Based on the mini health technology assessment(Mini-HTA)model,combined with expert heuristics,a rapid qualitative analysis of the intended use and technical characteristics of the same category of medical consumables were conducted.Expert opinions were solicited through the Delphi method,and a rapid admission evaluation model of same category of medical consumables was constructed.A total of 80 high-value medical consumables of 10 categories in clinical use in Sichuan Provincial People's Hospital from June 2023 to March 2024 were selected,and the traditional admission process method and expert heuristics optimization method were used to make admission decisions for medical consumables,with 40 high-value medical consumables for each method.The differences in the decision-making process and approval time between the two different admission methods were compared and analyzed.Results:The admission decision-making system indicators of the rapid admission evaluation model of medical consumables of same category included 6 primary indicators of clinical efficacy,reliability,economics,values and aspirations,hospital management and corporate services,and 25 secondary indicators.The approval process for medical consumables admission decision-making using the rapid admission evaluation model of medical consumables of same category had been reduced from 10 in the traditional admission process to 2,and the approval time had been shortened from an average of 7.03 days to 2.43 days.Conclusion:The rapid admission evaluation model for the approval of medical consumables of same category based on expert heuristics can significantly optimize the admission approval process of medical consumables,improve the comprehensiveness and transparency of medical consumables admission decisions,and improve the management efficiency of medical consumables.

Denosumab, a human monoclonal antibody, is used for the prevention of malignant tumor-related bone events and the treatment of osteoporosis with high fracture risk. Since its approval in China in 2019, denosumab-related osteonecrosis of the jaw (DRONJ) has attracted increasing attention. DRONJ, similar to bisphosphonate-related osteonecrosis of the jaw, often occurs after tooth extraction and manifests as exposed bone necrosis, purulent discharge, facial swelling and pain, severely impacting patients′ quality of life. However, the perioperative management strategies for DRONJ differ from those for bisphosphonate-related osteonecrosis of the jaw. This article summarizes the perioperative management strategies for high-risk DRONJ patients from aspects such as oral hygiene care, antibiotic use, drug discontinuation during the perioperative period, and surgical strategy selection, aiming to provide guidance for oral surgeons in managing tooth extraction in denosumab-treated patients.

Objective:To assess the effectiveness of a 6-month Ba Duan Jin exercise program in improving the balance of community-dwelling older adults.Methods:A two arms, parallel-group, cluster randomized controlled trial was conducted in 1 028 community residents aged 60-80 years in 40 communities in 5 provinces of China. Participants in the intervention group (20 communities, 523 people) received Ba Duan Jin exercise 5 days/week, 1 hour/day for 6 months, and three times of falls prevention health education, and the control group (20 communities, 505 people) received falls prevention health education same as the intervention group. The Berg balance scale (BBS) score was the leading outcome indicator, and the secondary outcome indicators included the length of time of standing on one foot (with eyes open and closed), standing in a tandem stance (with eyes open and closed), the closed circle test, and the timed up to test.Results:A total of 1 028 participants were included in the final analysis, including 731 women (71.11%) and 297 men (28.89%), and the age was (69.87±5.67) years. After the 3-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 3.05 (95% CI: 2.23-3.88) points ( P<0.001). After the 6-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 4.70 (95% CI: 4.03-5.37) points ( P<0.001). Ba Duan Jin showed significant improvement ( P<0.05) in all secondary outcomes after 6 months of exercise in the intervention group compared with the control group. Conclusions:This study showed that Ba Duan Jin exercise can improve balance in community-dwelling older adults aged 60-80. The longer the exercise time, the better the improvement.

Postoperative infection is one of the most common complications of tooth extraction.It may manifest as lo-calized infection or develop to systemic infection.Clinically,oral surgeons can prevent postoperative infections by urg-ing patients to strengthen oral hygiene,applying antibiotics in a rational and compliant manner,and choosing appropriate surgical methods for tooth extraction.For the treatment of infection,the oral surgeon should formulate a response strate-gy on the basis of different diagnoses.For local infections such as dry socket,delayed alveolar osteitis,gap infection,and marginal osteomyelitis of the jaws,the infection can be controlled by local debridement,therapeutic use of antibiotics,and incise and drain if necessary.For patients suspected of necrotizing fasciitis,timely extensive debridement should be made to reduce the area of tissue necrosis.For those who have received radiotherapy or anti-resorptive drugs,tooth extraction should follow the recommenda-tions of the relevant clinical guidelines or expert consen-sus to minimize the risk of osteonecrosis of the jaws.For patients with poor systemic health or dysfunction of the immune system,attention should be paid to identifying infective endocarditis and intracranial infection to ensure the life safety of patients.In this study,the author intends to combine lit-erature review and clinical experience to tackle postextraction infection and its prevention to provide a reference for col-leagues on oral and maxillofacial surgery.

Objective:To compare the treatment effect of endoscopic retrograde cholangiopancreatography/endoscopic sphincterotomy plus laparoscopic cholecystectomy (ERCP/EST+ LC) and laparoscopic cholecystectomy plus laparoscopic common bile duct exploration (LC+ LCBDE) for patients with choledocholithiasis combined with gallbladder stones.Methods:Clinical data of 172 patients with choledocholithiasis combined with gallbladder stones treated in Heze Municipal Hospital from March 2018 to March 2021 were retrospectilvely analyzed, including 78 males and 94 females, aged (66.88±9.72) years. According to surgical method, patients were divided into the ERCP/EST+ LC group ( n=86) and LC+ LCBDE group ( n=86). The initial clearance rate of choledochal stones, operation time, intraoperative blood loss and postoperative complications were compared between the groups. Results:The initial clearance rate of the choledochal stones of the ERCP/EST+ LC group is 76.5%(13/17), lower than 96.3%(26/27) of LC+ LCBDE group when the diameter of stones was over 1.2 cm ( χ2=4.07, P=0.044). When the number of choledochal stones were more than 3, the initial clearance rate of the ERCP/EST+ LC group is 78.9%(15/19), lower than that of the LC+ LCBDE group [96.7%(29/30), χ2=3.99, P=0.046]. The operation time of LC+ LCBDE group was longer than that of ERCP/EST+ LC group [(129.07±19.33)min vs. (101.86±27.48)min, t=7.51, P<0.001]. The median intraoperative blood loss of LC+ LCBDE group and ERCP/EST+ LC group was 25.0 (20.0, 30.0) ml and 13.0 (10.0, 15.0) ml, respectively ( Z=916.00, P<0.001). The age, gender, maximum diameter of stones, number of stones, preoperative common bile duct diameter, surgical success rate, postoperative hospital stay, total stone clearance rate, and complication rate were comparable between the groups (all P>0.05). Conclusion:Both LC+ LCBDE and ERCP/EST+ LC are safe and feasible for choledocholithiasis combined with cholecystolithiasis. When the maximum diameter of choledochal stones is ≥1.2 cm or the number of choledochal stones is ≥3, LC+ LCBDE should be favored. When patient is in poor general condition, ERCP/EST+ LC might be more feasible.