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.

The occurrence of diabetes mellitus （DM） is closely related to insulin resistance and islet β cell dysfunction. Modern studies have found that macrophages are widely present in the liver，fat，skeletal muscle，islets， and other tissues and organs. Macrophage M1/M2 polarization plays an important role in the occurrence and development of diabetes mellitus and its related complications by intervening in inflammatory response，improving insulin resistance，and promoting tissue repair. Most of the traditional Chinese medicines that regulate the activation and polarization of macrophages are Qi-replenishing and Yin-nourishing，heat-clearing， and detoxicating medicinal，which are consistent with the etiology and pathogenesis of diabetes and its related complications. Therefore，by summarizing the mechanisms between macrophage activation，polarization， and insulin resistance in various tissues，this paper reviewed traditional Chinese medicine and its effective components and compounds in improving diabetes mellitus and its related complications through multi-channel regulation of macrophage polarization and regulation of M1/M2 ratio，providing references for the future treatment of DM and its related complications with traditional Chinese medicine.

Objective:To investigate the efficacy and safety of endovascular therapy (EVT) for early neurological deterioration (END) in patients with minor stroke due to acute anterior circulation large vessel occlusion.Methods:Consecutive patients with mild stroke due to acute anterior circulation large vessel occlusion admitted to Mianyang Central Hospital from October 2015 to October 2023 were included retrospectively. Minor stroke was defined as a baseline National Institutes of Health Stroke Scale (NIHSS) score <6. END was defined as an increase of ≥4 in NIHSS score compared to baseline within 12 hours of onset. According to whether EVT was performed or not, they were divided into EVT group and standard medical treatment (SMT) group. At 90 days after onset, the modified Rankin Scale was used to evaluate the outcome. 0-1 was defined as excellent outcome (primary outcome measure) and 0-2 was defined as good outcome (secondary outcome measure). The safety endpoints included symptomatic intracranial hemorrhage (sICH) within 72 hours after EVT and all-cause mortality within 90 days. Multivariate logistic regression analysis was used to determine the correlation between EVT and clinical outcome. Results:A total of 164 patients with minor stroke due to acute anterior circulation large vessel occlusion were included. Eighty-four patients (51.2%) developed END, of which 52 (61.9%) underwent EVT and 32 (38.1%) received SMT; 60 patients (71.4%) had excellent outcome, and 64 (76.2%) had good outcome. There was no significant difference in demographic and baseline clinical data between the EVT group and the SMT group. The excellent outcome rate of the EVT group at 90 days after onset showed a trend higher than that of SMT group (78.8% vs. 59.4%; χ2=3.680, P=0.055), but there was no significant difference in the good outcome rate and safety endpoints between the two groups. Multivariate logistic regression analysis showed that after adjusting for confounding factors, EVT was significantly and independently associated with excellent outcome at 90 days (odds ratio 4.955, 95% confidence interval 1.331-22.284; P=0.024). Conclusion:For patients with minor stroke due to anterior circulation large vessel occlusion who experience END, EVT may improve their functional outcome without increasing the risk of sICH and mortality.

Objective:To investigate the effect of oxidized-low density lipoprotein (ox-LDL) on contrast-induced renal tubular epithelial cell apoptosis and its mechanism.Methods:Human renal proximal tubular epithelial HK-2 cells were cultured in vitro and divided into four groups using the random number table method, including a control group, an ox-LDL group (50 μg/ml ox-LDL), an iohexol group (100 mg I/ml iohexol) and an ox-LDL+iohexol group (50 μg/ml ox-LDL+100 mg I/ml iohexol). Apoptosis rates were detected using the in situ terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay. Western blotting was used to detect the level of apoptosis by evaluating the presence of cleaved cysteine aspartic acid specific protease-3 (cleaved Caspase-3) protein. Mitochondrial membrane potential was detected using the JC-1 method. Mitochondrial/cytoplasmic cytochrome C (Cyt C) levels were detected by Western blotting to assess mitochondrial damage. Western blotting was used to detect the levels of the mitochondrial fission-related dynamin-related protein 1 (Drp1) and the mitochondrial fusion-related optic atrophy protein 1 (OPA1) to evaluate mitochondrial fusion/fission. Independent sample t test and one-way analysis of variance were used for data analysis. Results:The apoptosis rate [(30.12±3.19)%] and the relative expression of cleaved Caspase-3 protein (0.34±0.07) in the iohexol group were higher than those in the control group [(4.77±1.68)%, 0.23±0.05] ( P<0.05, 0.01). The apoptosis rate [(48.81±4.96)%] and the relative expression of cleaved Caspase-3 protein (0.53±0.05) in the ox-LDL+iohexol group were higher than those in the iohexol group (both P<0.01). The mitochondrial membrane potential (1.61±0.15) and mitochondrial/cytoplasmic Cyt C ratio (1.09±0.14) in the iohexol group were lower than those in the control group (6.15±0.52 and 3.09±0.45) (both P<0.01). The mitochondrial membrane potential (0.27±0.01) and the mitochondrial/cytoplasmic Cyt C ratio (0.24±0.04) in the ox-LDL+iohexol group were lower than those in the iohexol group (both P<0.01). The relative expression of Drp1 protein in the iohexol group (0.49±0.05) was higher than that in the control group (0.29±0.03), the relative expression of long OPA1 protein (0.24±0.03) was lower than that of the control group (0.40±0.03) (both P<0.01). The relative expression of Drp1 protein in the ox-LDL+iohexol group (0.64±0.02) was higher than that in the iohexol group, the relative expression of long OPA1 protein (0.07±0.02) was lower than that in the iohexol group (both P<0.01). Conclusions:ox-LDL can exacerbate contrast-induced renal tubular epithelial cell apoptosis, and its mechanism may be due to an imbalance in mitochondrial fusion and division caused by the contrast agent, leading to the increase mitochondrial damage.

Objective To identify potential drug target genes associated with idiopathic pulmonary fibrosis(IPF)and predict therapeutic candidates using a two-sample Mendelian randomization(MR)approach across the druggable genome.Methods Druggable genome data from the DGIdb database and Finan were integrated to identify overlapping genes.A two-sample MR analysis was performed to infer causal relationships between genes and IPF.Functional enrichment analyses,including Gene Ontology(GO)and Kyoto encyclopedia of genes and genomes(KEGG),were conducted to explore biological pathways.Drug-target interactions were predicted via DSigDB database screening,followed by molecular docking simulations to evaluate binding affinities.Results Among the 2588 overlapping druggable genes,thirty exhibited significant causal associations with IPF(P＜0.05).Four hub genes(NOD2,LATS2,LTA,and TCF7L2)were enriched in IPF-related pathways,notably Hippo and TNF signaling.Six potential therapeutics were identified:oxyphenbutazone,moexipril,α-galactosylceramide,GSK429286A,CGP74514A,and JW-7-24-1.Molecular docking confirmed strong binding affinities between these drugs and their targets.Conclusion This study has identified thirty druggable gene targets and six candidate drugs for IPF.The enrichment of hub genes in key pathways and validated drug-target interactions provide insights into IPF therapies.

Objective To investigate the situation of HIV infection and epidemiological characteristics among voluntary blood donors and pre-transfusion patients in Yuxi prefecture between 2010 and 2021.Methods Da-te collected with the HIV/AIDS Case Reporting Cards and original record of blood station,HIV antibody positive rate,the demographic characteristics,and epidemiological data of blood donors and pre-transfusion patients,were analyzed accordingly,the related date were statistically analyzed.Results The HIV antibody positive ratio were 5.56? and 2.01? among pre-transfusion patients and voluntary blood donors(P<0.001),showing an downward trend year after year.The HIV-positive detection rate among blood donors aged<25 years was significantly higher at 3.72‰ compared to 1.60‰ for those aged≥25 years(P=0.003).Among HIV-positive blood recipients,the proportion of individuals aged 15-24 years(34.62%)was markedly higher than that among blood donors(1.96%),whereas no donors were aged≥50 years compared to 23.53%of recipients(P<0.001).Farmers showed a significantly higher HIV detection rate(3.18‰)than students(2.66‰)and other occupations(1.60‰)(P=0.041).Similarly,individuals with high school education or below showed a higher detection rate(2.52‰)than those with high school education or above(1.45‰)(P=0.045).Among HIV-positive cases,blood donors had a higher proportion of HIV-infected individuals(84.62%)versus AIDS cases(15.38%),whereas the recipients showed the opposite trend:41.18%HIV-infected versus 58.82%AIDS cases(P<0.001).Conclusion In recent years,the HIV positive detection rate in Yuxi area has shown a downward trend,but the occurrence of HIV in Yuxi area is characterized by youthfulness and low education.Among them,HIV infected individuals through same-sex contact account for an important reason for HIV infection.

Objective:To evaluate the clinical outcomes of mandibular angle osteotomy combined with wing-shaped genioplasty for the correction of low-angle mandibular prominence with microgenia.Methods:A retrospective analysis was conducted on patients who underwent mandibular angle osteotomy and wing-shaped genioplasty at the Second Hospital of Nanjing between January 2020 and December 2022. Preoperative three-dimensional computed tomography and lateral cephalograms were obtained, and relevant parameters were measured, including the Frankfort horizontal plane to mandibular plane angle (∠FH-MP), the lower lip to soft tissue pogonion angle (∠LiaV-Pog) and the facial height index (FHI). Based on the measurements, surgical experience, and patient preference, the osteotomy lines for the mandibular angle and the wing-shaped genioplasty were designed. During the procedure, mandibular angle osteotomy and wing-shaped genioplasty were performed in accordance with the preoperative surgical plan. The distal genial segment was advanced and inferiorly repositioned according to the predetermined measurements and rigidly fixed to the bilateral mental tubercles using titanium plates and screws. The bone segments resected from the mandibular angle were then longitudinally split into either single- or double-layer bone grafts. These grafts were meticulously implanted into the interpositional gap at the genial region to optimize chin projection and refine the lower facial contour. Postoperative monitoring included assessments of wound healing, complications and lower facial contour. At the final follow-up, lateral cephalograms were taken for remeasurement, and patient satisfaction was surveyed. Statistical analysis was performed using SPSS 22.0 software. Pre- and postoperative data for ∠FH-MP, ∠LiaV-Pog, and FHI were presented as Mean ± SD and compared using paired t-tests, with a P-value < 0.05 considered statistically significant. Results:Twelve female patients, aged 22-35 years (mean 28.3), were included. The follow-up period ranged from 6 to 24 months. All surgical sites achieved primary healing without early complications such as hemorrhage, hematoma, or wound infection. However, all patients experienced transient mental numbness, which resolved within 3 to 6 months. All patients achieved a smooth and natural mandibular contour. CT scans confirmed satisfactory survival of the grafted bone. All patients expressed satisfaction with the aesthetic outcomes. Postoperative measurements of ∠FH-MP, ∠LiaV-Pog, and FHI were (25.2±4.6)°, (24.0±1.2)°, and (52.0±1.3)%, respectively, which were significantly improved compared to the preoperative values of (16.8±5.9)°, (36.5±4.8)°, and (66.0±4.3)% (all P < 0.01). Conclusion:The combination of mandibular angle osteotomy and wing-shaped genioplasty is an effective and safe procedure for correcting low-angle mandibular prominence with microgenia. This technique significantly increases the mandibular plane angle, creates a natural and smooth mandibular contour, and yields stable result with high patient satisfaction.

We report a 19-year-old male patient who developed numbness and weakness in the extremities,bilateral facial paralysis,difficulty swallowing,and slurred speech after the onset of dengue fever.Physical examination revealed decreased superficial and deep sensation below the knees,with absent tendon reflexes in the limbs.Cerebrospinal fluid analysis was normal,and ganglioside-related antibodies were negative.Electromyography showed multiple symmetric peripheral nerve demyelination in the limbs and facial nerves.The patient was diagnosed with Guillain-Barré syndrome.After receiving treatment with immunoglobulin and corticosteroids,his symptoms improved,and he made a good recovery during follow-up.Dengue fever has been rarely reported as a preceding infection of Guillain-Barré syndrome in China.This case report,along with a review of relevant literature,aims to enhance the understanding of the diagnosis and management of this condition.It emphasizes the importance of early diagnosis and treatment by clinicians to avoid misdiagnosis and missed diagnosis of dengue-related Guillain-Barré syndrome.

Objective:To investigate the effect of ultrasound-guided lower transverse abdominal muscle plane (TAP) block combined with esketamine intravenous controlled analgesia on postoperative patients with colorectal cancer (CRC) .Methods:A total of 120 CRC patients admitted to Linyi Central Hospital from Aug. 2022 to Aug. 2024 were selected and divided into control group and observation group according to random number table method, with 60 cases in each group. The control group received esketamine intravenous controlled analgesia, and the observation group was combined with TAP under ultrasound guidance on the basis of the control group. The postoperative recovery, pain numerical score (NRS), heart rate and mean arterial pressure of 1h, 8h and 48h were compared between the two groups. The levels of serum interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-1 β (IL-1 β) and adverse reactions were compared before anesthesia (T0), 24h (T1) and 48h (T2) after surgery. Results:The feeding time and the first exhaust time in the observation group were shorter than those in the control group ( P<0.05). The NRS scores of the observation group were lower than those of the control group at 1h, 8h and 48h after operation ( P<0.05). The heart rate and mean arterial pressure of both groups increased at 8h and 48h after surgery, and the observation group was lower than the control group ( P<0.05). Serum IL-6, IL-10 and IL-1 β in both groups were higher than those in T0 at T1 and T2, and IL-6 and IL-1 β in observation group were lower than those in control group, and IL-10 was higher than those in control group ( P<0.05). The incidence of adverse reactions in observation group was lower than that in control group ( P<0.05) . Conclusion:Ultrasound-guided TAP combined with esketamine intravenous controlled analgesia can effectively accelerate the postoperative recovery of CRC patients, reduce the level of pain, and alleviate the inflammatory response of the body, with high safety.

Objective:To investigate how age and nail-tract volumetric bone mineral density (vBMD) are associated with postoperative mechanical performance of proximal femoral nail anti-rotation (PFNA-Ⅱ) fixation for geriatric intertrochanteric fractures using a finite-element analysis.Methods:Fifteen elderly patients with intertrochanteric fracture of the femur were selected for this study. They were 11 females and 4 males and divided into 5 groups based on their ages ( n=3): 55-year-old, 65-year-old, 75-year-old, 85-year-old, and 95-year-old groups. After three-dimensional models of the proximal femur were constructed using the preoperative CT data of their healthy contralateral hip, 31-A1.2 fractures of the AO/OTA type were created and PFNA-Ⅱ fixations simulated. Two loading schemes were created: graded quasi-static axial loads (700 N, 1,400 N, 2,100 N, and 2,800 N) were applied to compute equivalent plastic strain volumes in the femoral head region; displacement-controlled loading was applied to failure to derive load-displacement curves for stiffness and the maximum failure load. Nail-tract vBMD and regional hip vBMDs were measured by quantitative CT. Pearson correlation analysis was conducted to investigate the associations of age and nail-tract vBMD with the aforementioned mechanical indicators. Results:Under the same load, compared with the 55-year-old, 65-year-old, and 75-year-old groups, the plastic strain unit volumes of the fracture models in the 85-year-old and 95-year-old groups increased significantly. Under a load of 700 N, no plastic strain was observed in the fracture models in the 55-year-old, 65-year-old, and 75-year-old groups, while an average plastic strain of approximately 50 mm 3 was observed in the fracture models in the 85-year-old group. Under a load of 2,800 N, the high strain areas in the fracture models in the 85-year-old and 95-year-old groups were mainly concentrated at the tip of the head nail and the junction between the head nail and the main nail. Load-displacement curves showed a marked reduction in the failure load in patients aged ≥85 years. Under loads of 1,400 N, 2,100 N, and 2,800 N, there was a strong association between the nail-tract vBMD and the volume of the plastic strain unit ( r=-0.82, -0.88, -0.89, respectively), which was stronger than those for total-hip vBMD. Conclusions:Finite-element analysis indicates that age and nail-tract vBMD are closely related to local plastic strain and overall stiffness of the proximal femur after PFNA-Ⅱ fixation for the geriatric intertrochanteric fractures. Patients aged ≥85 years old are more prone to plastic yielding, which compromises fixation stability.