This paper interprets the disease name related to bi （痹） disease in traditional Chinese medicine （TCM） from the perspective of micropathological phenotypes in knee osteoarthritis （KOA）. By systematically reviewing classical TCM literature on the pathogenesis and clinical features of different subtypes such as damp-retention bi， bone bi， and tendon bi， and integrating these with current research on pathological subtypes of KOA including the synovitis type， cartilage-meniscus type， and subchondral bone type， the study explores the correlation between traditional disease terms and modern micropathological phenotypes. The author proposes subtype classifications of damp-retention bi corresponding to synovial inflammation， bone bi related to abnormal subchondral bone remodeling， and tendon bi representing cartilage and meniscus degeneration. This approach provides a microscopic biological explanation for TCM syndrome differentiation and offers new perspectives for advancing integrative diagnostic and therapeutic strategies in both Chinese and western medicine.

Objective To compare blood flow velocity measurements obtained using two different color Doppler imaging(CDI)devices with linear probes of varying frequencies.Methods CDI measurements were performed in 99 eyes of 50 participants from Shenyang Aier Excellent Eye Hospital using two different CDI devices,Apogee Type3500 and Esaote MyLab 7 eHD.These measurements included peak systolic velocity(PSV),end-diastolic velocity(EDV),and resistance index(RI)of the ophthalmic artery(OA),central retinal artery(CRA),and short posterior ciliary arteries(SPCA).The differences in measurements between the two devices were analyzed using a paired t-test.The level of agreement between the two CDI devices was calculated using the Bland-Altman method,and the concordance correlation co-efficient(CCC)was calculated.Results There was a statistically significant difference between the two CDI devices in the PSV,EDV of the OA,CRA,and SPCA,and RI of the CRA and SPCA.The PSV and EDV of each vessel were higher in Apogee than in Esaote,and the RI of the CRA and SPCA were lower for Apogee than for Esaote(P＜0.05).The CCC demonstrated poor overall concordance ranging from 0.136 to 0.517.Conclusion The consistency of most measurements obtained from both devices is poor.CDI inter-device reproducibility is unreliable,even when the measurements are conducted consecutively by a single experienced ultrasonographer.

Objective To compare blood flow velocity measurements obtained using two different color Doppler imaging(CDI)devices with linear probes of varying frequencies.Methods CDI measurements were performed in 99 eyes of 50 participants from Shenyang Aier Excellent Eye Hospital using two different CDI devices,Apogee Type3500 and Esaote MyLab 7 eHD.These measurements included peak systolic velocity(PSV),end-diastolic velocity(EDV),and resistance index(RI)of the ophthalmic artery(OA),central retinal artery(CRA),and short posterior ciliary arteries(SPCA).The differences in measurements between the two devices were analyzed using a paired t-test.The level of agreement between the two CDI devices was calculated using the Bland-Altman method,and the concordance correlation co-efficient(CCC)was calculated.Results There was a statistically significant difference between the two CDI devices in the PSV,EDV of the OA,CRA,and SPCA,and RI of the CRA and SPCA.The PSV and EDV of each vessel were higher in Apogee than in Esaote,and the RI of the CRA and SPCA were lower for Apogee than for Esaote(P＜0.05).The CCC demonstrated poor overall concordance ranging from 0.136 to 0.517.Conclusion The consistency of most measurements obtained from both devices is poor.CDI inter-device reproducibility is unreliable,even when the measurements are conducted consecutively by a single experienced ultrasonographer.

Osteoporosis and knee osteoarthritis often co-occur and are closely related in terms of epidemiology， clinical symptoms， pathogenesis and other aspects. Therefore， it is necessary to manage the co-morbidity and treat the two as a whole. Based on the overall relationship between wei （痿） and bi （痹） in TCM， it is believed that osteoporosis and knee osteoarthritis have marrow loss and bone atrophy as the core pathogenesis of co-morbidity， and microfractures as the central pathological link. The overall treatment is rooted in boosting kidney， supplementing marrow and strengthening the bones. According to the pathological manifestations of microfractures in the process of co-morbidity， and the different deficiency and excess characteristics of wei and bi， it can be divided into three types， "wei emerging with mild bi"， "wei and bi progressing simultaneously"， and "emphasis on both wei and bi"， for treatment. In terms of "wei emerging with mild bi"， that is the early stage of osteoporosis， the traditional Daoyin （导引） is the main therapy. For "wei and bi progressing simultaneously"， it can be divided into three stages further， including the onset stage， remission stage， and recovery stage of knee pain， treated with Taohong Siwu Decoction （桃红四物汤）， Bushen Huoxue Formula （补肾活血方） and self-made Bushen Qianggu Formula （补肾强骨方） as the main formula respectively. For "emphasis on both wei and bi"， the proven formula， Qianggu Zhitong Formula （强骨止痛方）， is taken as the main prescription.

Interstitial lung disease (ILD) is a heterogeneous disease characterized by diffuse pulmonary parenchyma, alveolar inflammation, and pulmonary fibrosis. At present, there are no ideal tools to diagnose and predict the prognosis of ILD. The application of biological markers can assist in the rapid diagnosis of the disease and guide clinical treatment decisions. Therefore, there is an urgent need for reliable, safety and feasible biomarkers to identify disease progression and treatment of interstitial lung disease, so as to achieve timely, accurate and personalized treatment for patients with interstitial lung disease.

Objective To explore the research current situation of TCM regulation of mesenchymal stem cells through visualization analysis;To summarize the research direction and hotspots.Methods The research literature on TCM regulation of mesenchymal stem cells was retrieved from CNKI,VIP and Wanfang Data from 2003 to 2022.CiteSpace 6.1.R6 software was used to visually analyze the authors,institutions and keywords of the research literature,and clustering analysis and emergence analysis of keywords were carried out.CNKI database was used to make statistics on literature citations.Results A total of 2 404 articles were included in this study,and the research literature on TCM regulation of mesenchymal stem cells showed an overall increasing trend.The main research institutions were Guangzhou University of Chinese Medicine,Gansu University of Chinese Medicine and Liaoning University of Traditional Chinese Medicine,etc.The main authors were Liu Yongqi,Chen Dongfeng and Fan Yingchang,etc.The high-frequency keywords included osteogenic differentiation,proliferation,rat,osteoporosis and icariin.Conclusion The effects of TCM monomer and compounds on the proliferation and differentiation of stem cells is the hot research area in this field,and the osteogenic differentiation of mesenchymal stem cells is an important research trend at present.

Objective:To explore the effect of the isolated organ laparoscopic simulation training teaching mode in laparoscopic partial nephrectomy training.Methods:A 39-hour in vitro organ laparoscopic simulation training for 12 urologists who had previously participated in laparoscopic basic technique training but had not independently completed laparoscopic partial nephrectomy in Peking Union Medical College Hospital. The training was conducted twice a week for 3 months from April to June 2022. Five modules, namely ultrasonic knife separation training, ultrasonic knife cutting training, vascularization training, blunt separation training, and partial nephrectomy and wound closure training, were used to provide targeted training for the decomposition of laparoscopic partial nephrectomy, and each training item was assessed and scored according to the scoring rules. At the same time, a questionnaire was used to find out the level of confidence of the 12 physicians in completing the operation and each step in the procedure, so as to assess the changes in the operational skills and psychological quality of the physicians before and after training using paired t-tests or Wilcoxon paired rank sum tests. Results:After the training, the assessment scores of operations in all surgeons were significantly improved. The training scores of ultrasonic knife separation training, ultrasonic knife cutting training, blood vessel nudity training, blunt separation training, and partial nephrectomy and traumatic suture improved from (8.5±0.3), (6.9±0.3), (4.2±0.4), (6.6±0.4), and (5.6±0.7) to (9.8±0.2), (9.6±0.3), (9.3±0.2), (9.4±0.3), and (9.8±0.2), respectively( P<0.05). The average operation time for the partial renal excision and traumatic suture training improved from (47.5±5.8) minutes to (21.6±5.1) minutes( t=18.72, P<0.001). At the same time, self-confidence in completing the operation was also significantly improved from 2(1, 3) before the training to 4(4, 4) after the training ( Z=-3.002, P =0.003). Conclusions:After laparoscopic simulation training with isolated organs, physicians with no previous experience in partial nephrectomy can become proficient in all steps of the procedure, complete the resection of the renal tumor and suturing of the wound within 30 minutes, and gain confidence in the operation of all steps of partial nephrectomy.

Objective:Investigating the efficacy of unilateral adrenalectomy in treatment for primary pigmented nodular adrenocortical disease (PPNAD).Methods:Clinical data of 26 patients with PPNAD treated in our hospital from January 2013 to June 2023 was retrospectively analyzed.There were 11 males and 15 females, with an average age of (19.4±4.7) years. 25 cases presented with typical Cushing's syndrome, and 16 cases were diagnosed with Carney's syndrome. PRKAR1A gene mutation detected in 8 out of 10 cases. CT showed multiple small nodules on bilateral adrenal glands in 14 cases, unilateral small nodules or mild thickening with normal contralateral glands in 8 cases, and no obvious abnormalities in 4 cases. All patients showed autonomous oversecretion of cortisol by endocrine laboratory tests, with a median 24 h-UFC of 408.35 (334.28, 800.78) μg/24 h and decreased level of adrenocorticotropic hormone. All 26 patients underwent laparoscopic unilateral adrenalectomy, with left side adrenalectomy in 8 cases and right side adrenalectomy in 18 cases.Results:The average surgical duration was (85.2±28.7) minutes, with intraoperative blood loss <50 ml in all cases. The median time to drainage tube removal post-operation was 3 (2, 3) days. One patient developed a postoperative pulmonary infection, and 3 patients required postoperative hormone replacement therapy. The median follow-up duration was 64 (31.5, 103.8) months, and all patients showed alleviation of Cushing syndrome clinical manifestations after operations. 19 patients (73.1%) had their 24 h-UFC levels normalized to a median of 42.0 (22.4, 58.3) μg/24 h within 8.5 (5, 46) days post-surgery. 7 patients (26.9%) did not achieve normal 24 h-UFC levels, yet experienced an average reduction of (73.2±10.4)%. 13 patients (50.0%) did not experience recurrence, with a median follow-up of 51 (7, 89.5) months, including two cases without recurrence at 10 years post-surgery. 13 patients showed recurrent increase in postoperative cortisol levels, with a median of 225.6 (188.9, 397.2) μg/24 h. The median time to increased 24 h-UFC post-surgery was 27 (13.5, 50.5) months, with the longest duration reaching 104 months. Among these, 9 cases exhibited clinical signs and symptoms of recurrence, while 4 cases did not. Of the 13 patients with recurrence, 9 underwent contralateral adrenalectomy or subtotal resection, while 4 were observed with follow-up.Conclusions:Unilateral adrenalectomy could be a surgical treatment option for PPNAD. Despite the recurrence in some patients postoperatively, unilateral adrenalectomy could effectively and rapidly reduce cortisol levels in PPNAD patients and alleviate the clinical manifestations of Cushing syndrome.

Interstitial lung disease (ILD) is a heterogeneous disease characterized by diffuse pulmonary parenchyma, alveolar inflammation, and pulmonary fibrosis. At present, there are no ideal tools to diagnose and predict the prognosis of ILD. The application of biological markers can assist in the rapid diagnosis of the disease and guide clinical treatment decisions. Therefore, there is an urgent need for reliable, safety and feasible biomarkers to identify disease progression and treatment of interstitial lung disease, so as to achieve timely, accurate and personalized treatment for patients with interstitial lung disease.

Objective To explore the beneficial effects and mechanisms of neutrophil elastase (NE) and myeloperoxidase (MPO) on lead-induced hepatic inflammation in mice. Methods The specific pathogen free male C57BL/6 mice were randomly divided into four groups： control group, lead-exposed group, NE inhibitor group, and MPO inhibitor group, with three mice in each group. The mice in lead-exposed group, NE inhibitor group, and MPO inhibitor group were intraperitoneally injected with a dose of 10 mg/kg body mass of lead acetate solution, while the mice of control group received an equal volume of 0.9% saline three times per week for four weeks. In the last seven days, mice in both inhibitor groups were intraperitoneally injected with a dose of 40 mg/kg NE inhibitor sivelestat sodium or MPO inhibitor 4-aminobenzoic acid hydrazide (4-ABAH) once per day. Mouse body weight and liver histopathological changes were observed. The mRNA expression of genes associated with inflammation, such as tumor necrosis factor-α (Tnfa), interleukin-1β (Il1b), interleukin-6 (Il6), and nucleotide-binding oligomerization domain-like receptor protein 3(Nlrp3), apoptosis-associated speck-like protein (Asc) and cysteinyl aspartate specific proteinase (Caspase1) in the mouse liver tissues was detected by real-time quantitative polymerase chain reaction. The protein expression of NLRP3, ASC, and CASPASE-1 was detected using Western blotting. Results The activities of mice in all four groups were generally normal, and there was no significant difference in body weight (P>0.05). The results of hematoxylin-eosin staining showed that the cell size of hepatocytes varied in the lead-exposed mice, with indistinct cell boundaries, indicating early inflammatory responses in liver tissues. After intervention with NE or MPO inhibitors, the early inflammatory responses improved in the liver tissues of the mice in both inhibitor groups, with a better improvement observed in MPO inhibitor group compared with the NE inhibitor group. The mRNA expression of Tnfa, Il1b, Il6, Nlrp3, Asc, and Caspase1, as well as the protein expression of ASC, and CASPASE-1 in the livers of mice in the lead-exposed group was higher compared with those in the control group (all P<0.05). Compared with the lead-exposed group, the relative mRNA expression of Tnfa, Il1b, Il6, Nlrp3 and Asc was decreased in the liver tissues of mice in the NE inhibitor group (all P<0.05), while the relative expression of mRNA of Tnfa, Il1b, Il6, Caspase1 and the protein expression of ASC and CASPASE-1 were decreased in the liver tissues of mice in the MPO inhibitor group (all P<0.05). Conclusion Lead induce hepatic inflammation in mice by activating NLRP3 inflammasome. The inhibition of NE or MPO improve the lead-induced hepatic inflammatory responses in mice by alleviating NLRP3 inflammasome activation.