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.

This paper summarizes the clinical experience in applying jiao （角） medicine to treat diabetes mellitus from the perspective of qi， blood， and fluids. It is believed that impaired spleen transportation and transformation is the key pathomechanism of diabetes， leading to metabolic disturbances in qi， blood， and fluids， and resulting in a sequential pathological progression of "qi → thick fluids → thin fluids → blood". At the qi level， the disease is mainly characterized by spleen qi deficiency and stagnation， and is commonly treated with Hongshen （Panax Ginseng）， Huangqi （Astragalus Mongholicus）， and Baizhu （Atractylodes Macrocephala） to tonify the spleen and regulate qi. At the thick fluids level， the condition manifests as abdominal distension， internal heat， and turbid pathogens， requiring Zexie （Alisma Orientale）， Huanglian （Coptis Chinensis）， and Dahuang （Rheum Palmatum） to clear the spleen and drain turbidity. At the thin fluids level， with qi and yin deficiency and predominant yin damage， Gegen （Pueraria Lobata）， Wuweizi （Schisandra Chinensis）， and Maidong （Ophiopogon Japonicus） are used to nourish yin and generate fluids. At the blood level， where vascular damage is predominant， Shuizhifen （Whitmania Pigra Powder）， Danshen （Salvia Miltiorrhiza）， and Sanqifen （Panax Notoginseng Powder） are applied to activate blood circulation， resolve stasis， and unblock the channels. Clinicians may flexibly select appropriate jiao medicine based on the specific pathological layer affected in each patient.

Peri-implant keratinized mucosa (PIKM) augmentation refers to surgical procedures aimed at increasing the width of PIKM. Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-term peri-implant health. Currently, several surgical techniques have been validated for their effectiveness in increasing PIKM. However, the selection and application of PIKM augmentation methods may present challenges for dental practitioners due to heterogeneity in surgical techniques, variations in clinical scenarios, and anatomical differences. Therefore, clear guidelines and considerations for PIKM augmentation are needed. This expert consensus focuses on the commonly employed surgical techniques for PIKM augmentation and the factors influencing their selection at second-stage surgery. It aims to establish a standardized framework for assessing, planning, and executing PIKM augmentation procedures, with the goal of offering evidence-based guidance to enhance the predictability and success of PIKM augmentation.
Humans ; Consensus ; Dental Implants ; Mouth Mucosa/surgery* ; Keratins

Objective:This study aims to investigate the alterations in m 6A methylation associated with age-related idiopathic pulmonary fibrosis(IPF). Methods:By collecting peripheral blood samples from IPF patients, we investigated the changes in m6A modification levels of total RNA and key regulatory factors in elderly IPF patients.Then, the pulmonary fibrosis models of young and old mice were constructed for verification.A total of 10 IPF patients and 10 healthy controls were selected for this study.The m 6A methylation quantitative kit was employed to assess the m 6A modification levels of total RNA.The expression levels of key m 6A methylation regulators, METTL3, METTL14, and FTO, were quantified using qRT-PCR.Additionally, thirty-two healthy male C57BL/6 mice, comprising 16 mice aged 10-12 weeks and 16 mice aged 6-7 months, were divided into four groups: young control(A), young pulmonary fibrosis(B), aged control(C), and aged pulmonary fibrosis(D), with 8 mice in each group.Mice in groups B and D were intratracheally administered bleomycin to establish a pulmonary fibrosis model, while those in groups A and C received normal saline.Twenty-eight days post-model establishment, the mice were euthanized, and lung tissues were collected for analysis.Histological evaluations were performed using hematoxylin and eosin(HE)staining, Masson staining, hydroxyproline content determination, and immunohistochemistry to assess the extent of pulmonary fibrosis.The m 6A methylation quantification kit was also utilized to measure the m 6A modification levels of total RNA in lung tissue.Furthermore, the mRNA and protein expression levels of the methyltransferase METTL3 were assessed by qRT-PCR and Western blot experiments. Results:The level of m 6A modification was significantly elevated in the aged IPF patient group(0.36±0.03)compared to the control group t=4.882( P<0.05).Furthermore, the expression of METTL3 was markedly higher in the aged IPF patients( t=6.082), while the expression of METTL14 was significantly lower t=17.58( P<0.05).In contrast, the expression level of FTO did not exhibit a significant difference.It is hypothesized that the increased m 6A modification of total RNA in aged IPF patients is closely associated with METTL3.Furthermore, the degree of lung fibrosis in aged mice was more severe than that in young mice.Immunohistochemistry results indicated that TGF-β1 expression was elevated in the lung fibrosis group, with higher levels observed in group D compared to group B( t=5.891, P<0.05), and in group C compared to group A t=4.135( P<0.05).The percentage of positive area for α-SMA was significantly greater in the lung fibrosis mouse model than in the control group t=20.08( P<0.05).The level of m 6A modification was increased in both lung fibrosis groups relative to the normal control group( P<0.05), although no significant difference was found between group D and group B. Overall, METTL3 mRNA and protein expression were upregulated in the lung fibrosis group, with expression in group D being lower than in group B( P<0.05). Conclusions:The level of m 6A modification is elevated in pulmonary fibrosis, and the expression of METTL3 is upregulated in this condition.The downregulation of METTL3 may be associated with the extent of aging, which subsequently exacerbates the progression of pulmonary fibrosis.

Objective To investigate the effects of isoflurane anesthesia on cognitive function and the hippocampal nerve growth factor(NGF)and tyrosine receptor kinase A(TrkA)signaling pathway in Alzheimer's disease(AD)mice,while explore the role of G protein inhibitory α subunit 1/3(Gαi1/3)in this pathway.Methods Twelve wide-type mice and 48 APP/PS1(AD)mice(all males)were respectively assigned into a control group and 4 experimental groups,including AD,AD+postoperative cognitive dysfunction(POCD)group,empty adenovirus group,and Gαi1/3 overexpression group,with 12 mice in each group.Morris water maze and novel object recognition tests were conducted to assess the learning and memory function of each group;Western blotting was applied to detect the expression of amyloid P-protein 1-42(Aβ1-42),IL-6,TNF-α,synaptotagmin-1,synapsin-1,and NGF,p-TrkA,Gαi1/3,and p-Gab1 in hippocampal tissues.Results Compared with the control group and AD group,the avoidance incubation period in the AD+POCD group is significantly extended from days 2 to 4(P＜0.05),enhanced expression of Aβ1-42,IL-6,and TNF-α(P＜0.05),and reduced expression of synaptotagmin-1,synapsin-1,NGF,p-TrkA,Gαi1/3,and p-Gab1(P＜0.05).When compared with the AD+POCD group and the empty adenovirus group,the avoidance latency in the Gαi1/3 overexpression group was significantly shorted on days 2 to 4(P＜0.05),down-regulation of Aβ1-42(2.00±0.39 vs 3.38±0.38),IL-6(1.65±0.37 vs 3.36±0.39),and TNF-α(1.58±0.30 vs 2.90±0.31,P＜0.05),and up-regulation of synaptotagmin-1,synapsin-1,Gαi1/3,and p-Gab1(P＜0.05).Conclusion Isoflurane anesthesia can exacerbate POCD in AD mice,and overexpression of Gαi1/3 can improve cognitive function by activating the phosphorylation of Gab1.

Objective To compare the safety and adverse effects of esketamine alone or fentanyl combined with propofol for interventional occlusion of congenital heart disease in children,so as to provide a more suitable sedation and analgesia plan for these patients.Methods A prospective randomized controlled study was adopted.A total of 104 cases of congenital heart disease,including 53 cases of atrial septal defect(ASD),31 cases of ventricular septal defect(VSD),and 20 cases of patent ductus arteriosus(PDA),who underwent interventional occlusion under general anesthesia while preserving spontaneous breathing from January to March 2025,were taken as the research subjects.The children were divided into two groups by random number table method:esketamine group(group ES)and fentanyl+propofol group(group AP),with 52 cases in each group.The children in the group ES and the group AP were anesthetized by esketamine 0.5 mg/kg and fentanyl 2 ug/kg+propofol 2.5 mg/kg,respectively,and sevoflurane inhalation anesthesia was maintained during the operation.The mean arterial pressure(MAP),heart rate(HR),respiratory rate(RR)and pulse oxygen saturation(SpO2)were recorded at the time of entry(T0),1 min after induction of general anesthesia(T1),femoral artery puncture(T2),occluder insertion(T3),recovery(T4),and 10 min after recovery(T5).The operation time,dosage of sevoflurane,anesthesia induction time and recovery time of the two groups were recorded.The occurrence of adverse events during general anesthesia was recorded,including hypoxemia after general anesthesia induction,respiratory depression and intraoperative body movement,restlessness during the recovery period,and increased secretion during the recovery period.Results There were significant differences in MAP,HR,SpO2 and RR in time points within each group,between two groups,and across the time×group interaction(P<0.05).There was no significant difference in operation time,dosage of sevoflurane,anesthesia induction time,and recovery time between the two groups(P>0.05).The incidence of hypoxemia in the group ES was significantly lower than that in the group AP[1.9%(1/52)vs.28.9%(15/52),χ2=14.477,P=0.000],the incidence of respiratory depression in the group ES was significantly lower than that in the group AP[0.0%(0/52)vs.11.5%(6/52),P=0.027],and the incidence of intraoperative body movement in the group ES was significantly lower than that in the group AP[0.0%(0/52)vs.11.5%(6/52),P=0.027].Conclusions During the three interventional occlusion procedures for congenital heart disease in children,compared with fentanyl combined with propofol injection,esketamine can better maintain the stability of respiratory circulation,and has a lower incidence of adverse events such as intraoperative hypoxemia,respiratory depression and intraoperative body movement.Compared with traditional anesthetic drugs,eketamine can be used as a better choice for sedation and analgesia during interventional occlusion for the three types of congenital heart diseases in children.

Objective To investigate the effects of Yitangkang on renal ectopic lipid deposition and the PPAR-α/PGC-1α signaling pathway in db/db mice;To explore its mechanism in improving renal injury.Methods Totally 30 db/db mice were divided into model group,Yitangkang group and losartan potassium group(10 mice in each group)using a random number table method.An additional 10 db/m mice were assigned as the blank group.The mice received corresponding interventions for 8 weeks.Body mass,fasting blood glucose(FBG),serum creatinine(SCr),blood urea nitrogen(BUN),and 24-hour urinary protein content were measured,renal morphology and injury were observed using HE,PAS and Masson staining,lipid deposition in renal tissue was observed by oil red O staining,renal ultrastructure was observed by transmission electron microscopy,immunofluorescence staining was used to detect the expressions of CPT1A and Nrf2 in renal tissue,RT-qPCR was performed to assess the mRNA expressions of PPAR-α and PGC-1α,Western blot was used to detect the protein expressions of PPAR-α,CPT1A,PGC-1α,Nrf2,NRF1 and TFAM.Results Compared with the blank group,the body mass and FBG significantly increased in the model group(P<0.05),and the contents of SCr,BUN and 24-hour urinary protein significantly increased(P<0.05);histopathology revealed glomerular hypertrophy,mesangial cell and matrix proliferation,thickened basement membrane,abnormal deposition of interstitial collagen fibers,increased lipid deposition in renal tissue,widespread foot process effacement,reduced foot process density(P<0.05),blurred mitochondrial outer membranes,swollen morphology,and indistinct cristae;mRNA expressions of PPAR-α and PGC-1α significantly decreased(P<0.05),and protein expressions of PPAR-α,CPT1A,PGC-1α,Nrf2,NRF1 and TFAM significantly decreased(P<0.05).Compared with the model group,the body mass and FBG of mice in Yitangkang group significantly decreased(P<0.05),but there was no significant difference in the above indexes in losartan potassium group(P>0.05);the contents of SCr,BUN and 24-hour urinary protein in Yitangkang group and losartan potassium group significantly decreased(P<0.05);the pathological damage and lipid deposition of renal tissue was alleviated,the ultrastructure of podocytes was improved,and the density of podocytes significantly increased(P<0.05);the mRNA expressions of PPAR-α and PGC-1α in renal tissue increased,and the protein expressions of PPAR-α,CPT1A,PGC-1α,Nrf2,NRF1 and TFAM increased,with statistical significance(P<0.05).Conclusion Yitangkang can effectively alleviate renal injury in diabetic nephropathy mice.The mechanism may be related to the activation of PPAR-α/PGC-1α signaling pathway and the reduction of renal lipid deposition and mitochondrial biogenesis.

Objective:To construct an integrated early rehabilitation program for healthcare and rehabilitation system based on the information-motivation-behavioral skills (IMB) model and evaluate its application effect in patients treated with total hip arthroplasty (THA).Methods:Construction of the rehabilitation program: An integrated research team was established, composed of head burse of orthopedics, orthopedic nursing specialists, orthopedic surgeons, anesthesiologists, and rehabilitation therapists. Considering the key points of perioperative early rehabilitation of THA patients, an integrated early rehabilitation program was constructed based on the IMB model through literature review and expert panel method. Clinical application of the rehabilitation program: A retrospective cohort study was conducted to analyze the clinical data of 100 THA patients admitted to Qingdao Municipal Hospital from March to December 2023, including 47 males and 53 females, aged 60-85 years [(69.8±5.5)years]. Patients were divided into two groups according to their admission time: 50 patients admitted from March to July 2023, receiving routine care (routine care group) and 50 admitted from August to December 2023, receiving intervention through an early rehabilitation program of an integrated healthcare and rehabilitation system based on routine care (integrated care group). The first postoperative ambulation time and length of hospital stay were compared between the two groups. The Harris hip function score was used to assess hip function in both groups at 3 days, 1, 3, and 6 months postoperatively; the Barthel index was used to assess the daily living self-care capacity in both groups preoperatively, at 1, 3, and 6 months postoperatively. The incidence of complications within 6 months after surgery was compared between the two groups.Results:An early integrated rehabilitation program based on the IMB model comprised 25 specific measures of three domains: information support, motivational intervention, and behavioral skills. All the patients were followed up for 6 months. The first postoperative ambulation time and length of hospital stay in the integrated care group were (1.3±0.5)days and (7.4±2.3)days, shorter than (1.5±0.5)days and (8.5±2.3)days in the routine care group ( P<0.05). There were no statistically significant differences in the Harris hip function scores at 3 days postoperatively or preoperative Barthel index between the two groups ( P>0.05). At 1, 3, and 6 months postoperatively, the Harris hip function scores in the integrated care group were (80.3±6.0)points, (88.6±5.2)points, and (92.5±4.1)points, respectively, higher than (75.1±6.3)points, (84.2±5.7)points, and (88.0±5.2)points in the routine care group ( P<0.01); the Barthel index in the integrated care group were (79.2±8.7)points, (87.7±5.7)points, and (92.3±4.9)points, respectively, higher than (72.1±9.0)points, (83.5±6.6)points, and (88.6±5.0)points in the routine care group ( P<0.01). At 6 months postoperatively, the incidence of complications in the integrated care group was 4% (2/50), lower than 16% (8/50) in the routine care group ( P<0.05). Conclusion:Compared with the routine care, an integrated early rehabilitation program for medical care and health based on the information-motivation-behavioral skills model for THA patients can shorten the first postoperative ambulation time and length of hospital stay, restore hip joint function, improve daily living self-care capacity and reduce the incidence of complications.

Objective:Comprehensive characterization of B-cell phenotypes and spatial distribution in oral lichen planus (OLP) and related oral lichenoid lesions (OLL)(OLP/OLL), with an emphasis on transcriptomic profiling and functional analysis, to uncover the epigenetic mechanisms underlying B cell-mediated immune regulation within the oral mucosal microenvironment.Methods:Single-cell RNA sequencing raw data were sourced from the GSE211630 database, encompassing samples from 2 cases of erosive OLP (EOLP), 3 cases of non-erosive OLP (NEOLP) and 1 healthy control (NORMAL). Following stringent quality control, the data underwent normalization, selection of highly variable genes and batch effect correction. Subsequent analyses included dimensionality reduction and unsupervised clustering to identify distinct cell populations. This study collected pathological specimens from 3 OLP/OLL patients and 3 healthy controls who were treated at the Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from January 2021 to December 2023. Using 10X Genomics Visium HD spatial transcriptomics technology, tissue sections were processed through dewaxing, staining and histological imaging, enabling the reconstruction of nucleic acid structures and the capture of gene expression profiles. Data analysis included quality assessment, gene quantification, normalization, dimensionality reduction and clustering. Furthermore, cell type deconvolution was performed using the robust cell type decomposition algorithm, integrating single-cell transcriptomic data to accurately predict and spatially resolve cell type distributions within the tissue microenvironment.Results:After integrating single-cell data from EOLP, NEOLP and NORMAL, cells were classified into seven major categories: B/plasma cells, endothelial cells, epithelial cells, fibroblasts, myeloid cells, smooth muscle cells and T/natural killer cells. The proportion of B/plasma cells varied significantly among the three groups, accounting for 10.7% (1 693/15 815), 3.8% (833/21 653) and 0.4% (47/11 556) of the total cells respectively. Further clustering analysis of B/plasma cells identified four distinct subpopulations: naive B cells, activated B cells, memory B cells and plasma cells. In the EOLP group, these subpopulations constituted 25.9% (348/1 344), 45.9% (617/1 344), 3.3% (45/1 344) and 24.9% (334/1 344) of the B/plasma cells respectively. In the NEOLP group, they represented 31.6% (195/617), 59.6% (368/617), 0.2% (1/617) and 8.6% (53/617). Howerer, only plasma cells were detected in the NORMAL group. Spatial analysis revealed that B cells were actively involved in the formation of tertiary lymphoid structures (TLS) at various stages in OLP/OLL samples, with a prominent structural organization observed in secondary follicle-like TLS. Within these structures, the expressions of T cells marker gene CD3E and B cells marker gene MS4A1 were significantly elevated. Additionally, in secondary follicle-like TLS, the gene encoding follicular dendritic cell secreted protein, germinal center marker gene B cell lymphoma 6 and the gene for activation induced cytidine deaminase also showed strong expression. In OLP/OLL samples, plasma cell marker gene CD38, immunoglobulin (IGH) G3, IGHG1, IGHM, IGHD, IGHE, imunoglobulin Kappa constant, immunoglobulin alpha 1, immunoglobulin Lambda constant 1 and complement gene C3 all exhibited high levels of expression.Conclusions:Compared to normal mucosa, extensive B-cell infiltration is observed in both OLP and OLL, accompanied by significant differences in B-cell phenotypes and proportions. B cells appear to play a central role in local immune responses, primarily through the formation of TLS. However, the precise functional mechanisms underlying their involvement require further investigation.

Objective To explore the protective effect and possible mechanism of modified Shenqi Dihuang Decoction on podocytes in db/db mice based on ROS/NLRP3/GSDMD signaling pathway.Methods Fifty 8-week-old male db/db mice(SPF grade)were randomly divided into the model group,losartan group and TCM low-,medium-and high-dosage groups,with 10 mice in each group.Ten heterozygous db/m mice served as the blank group.Interventions were administered respectively for 12 weeks.The body mass,random blood glucose,serum creatinine,blood urea nitrogen and 24 h urinary protein content were detected,HE,PAS,PASM,Masson and Sirius red staining was used to observe the morphology of renal tissue,transmission electron microscopy was used to observe the ultrastructure of renal tissue,fluorescent probes were used to observe the release of ROS in renal tissue,immunofluorescence staining was used to detect the expression of Nephrin,NLRP3,Cleaved Caspase-1 and GSDMD-N in renal tissue,and Western blot was used to detect the expression of NLRP3,Cleaved Caspase-1,GSDMD-N,IL-1β,IL-18,Nephrin,Podocin,PODXL,WT-1 and Desmin proteins.Results Compared with the blank group,the body mass and random blood glucose of the model group mice significantly increased(P<0.05),and the contents of serum creatinine,blood urea nitrogen and 24 h urinary protein were significantly increased(P<0.05);glomerular hypertrophy,dilation of renal glomeruli and tubules,thickening of basement membrane,matrix proliferation in mesangial area,abnormal deposition of collagen fibers in renal interstitium,accompanied by damage to renal tubular epithelial structure and focal glomerulosclerosis,significant increase in type Ⅰ collagen deposition,extensive fusion of podocyte processes,and scattered electron dense material in the basement membrane or subepithelial layer;the ROS content in renal tissue significantly increased(P<0.05),and the protein expression of NLRP3,Cleaved Caspase-1,GSDMD-N,IL-1β,IL-18 and Desmin significantly increased(P<0.05),the protein expression of Nephrin,Podocin,PODXL and WT1 significantly decreased(P<0.05).Compared with the model group,the body mass and random blood glucose of mice in each dosage of TCM group were relatively stable,the contents of serum creatinine,blood urea nitrogen and 24 h urinary protein decreased;the pathological damage to renal tissue was reduced,the ultrastructure of podocytes was improved,and the density of podocytes increased;the ROS content decreased,and the protein expression of NLRP3,Cleaved Caspase-1,GSDMD-N,IL-1β,IL-18 and Desmin decreased,while the protein expression of Nephrin,Podocin,WT1 and PODXL increased.With the dosage of modified Shenqi Dihuang Decoction increased,the improvement effect gradually strengthened,and the differences in TCM high-dose group was statistically significant(P<0.05).Conclusion Modified Shenqi Dihuang Decoction can protects podocytes in db/db mice,potentially by modulating the ROS/NLRP3/GSDMD signaling pathway.