Acute kidney injury (AKI) is a critical clinical condition characterized by rapid renal function decline, with high morbidity, mortality, and healthcare costs. Traditional Chinese medicine (TCM) has shown potential effects on mitigating oxidative stress and programmed cell death in AKI models. Scutellaria barbata D. Don (SB) and Scleromitrion diffusum (Willd.) R. J. Wang (SD), a classic TCM herbal pair exhibited anti-inflammatory and antioxidant activities. Using advanced chromatographic separation technology, we enriched the effective fractions of water extracts from SB-SD, obtaining self-assembled herbal nanoparticles (SB and SD nanoparticles, SSNPs) rich in flavonoids and terpenoids. These SSNPs demonstrated robust antioxidant properties in vitro and mitigated AKI progression in vivo by activating the nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway. Oral administration of SSNPs in mice resulted in absorption into the bloodstream, formation of a protein corona, reduced macrophage phagocytosis, and enhanced bioavailability and renal targeting. Furthermore, we investigated the self-assembly principle of SSNPs using representative flavonoids and terpenoids. Kinetic studies and in situ transmission electron microscopy (in situ TEM) revealed that these compounds self-assemble via supramolecular forces like hydrogen bonding and π-π interactions, forming stable nanostructures. This study elucidates the renoprotective effects and mechanisms of SB and SD, and provides a novel approach for the development of TCM-based nanomedicines, highlighting the potential of nano-TCM in AKI treatment.

Objective To study the etiology of a Chinese family with two cases of recessive non-syndromic hearing loss.Methods The clinical data of the family were collected.DNA was extracted from venous blood sam-ples,and whole-exome sequencing were performed to analyze potential causative deafness genes.Sanger sequencing was performed to verify the gene variants.Results There were 5 people among two generations in this family.The proband(Ⅱ-2,9 years old)and her brother(Ⅱ-3)had sensori-neural hearing loss,while their parents had normal hearing.The whole-exome high-throughput sequencing found that the patient carried two mutations in the CDH23 gene:c.4762C＞T(p.ARG1588TRP)and c.6604G＞A(p.ASP2202ASN).According to the American College of medical genetics and genomics(ACMG)genetic variation classification standards and guidelines,both c.6604G＞A and c.4762C＞T variants were identified as pathogenic.Conclusion The new compound heterozygous mutations c.4762C＞T and c.6604G＞A in the CDH23 gene are highly likely to be the causative factors for deafness in this family.

Hormone receptor positive/human epidermal growth factor receptor 2 negative(HR+/HER2-)breast cancer is the most common breast cancer subtype,accounting for approximately 65%-70%of breast cancers.Endocrine therapy is the cornerstone of adjuvant therapy.Even with standard endocrine therapies,patients may still experience local and/or systemic recurrence.Recently,with the application of cyc-lin-dependent kinase 4/6(CDK4/6)inhibitors,significant breakthroughs and advances have been made in the adjuvant treatment strategies for HR+/HER2-early stage breast cancer.Both the MonarchE and NATALEE studies were phase Ⅲ clinical trials evaluating CDK4/6 inhibitors in combination with endocrine therapy for the adjuvant treatment of HR+/HER2-early stage breast cancer.These two studies confirmed that CDK4/6 inhibitors in combination with endocrine therapy significantly prolonged invasive cancer-free survival(iDFS),providing a new option for the intensive treatment of patients at a high risk of recurrence.Based on this,CDK4/6 inhibitors were first recommended for use in treat-ing high-risk HR+/HER2-early stage breast cancer by the 2025 Committee of the Breast Cancer Society guidelines.Despite its established ef-ficacy,further research is needed to determine the optimal treatment duration,long-term survival benefits,safety management,and cost-effectiveness.In this study,we have systematically reviewed the latest medical evidence of endocrine therapy for HR+/HER2-early stage breast cancer,and discussed the precision treatment strategy,and look forward to future directions such as circulating tumor DNA(ctDNA)dynamic monitoring,treatment"escalation"and"de-escalation,"novel drug combination and post-resistance treatment strategies in the ad-juvant setting to provide scientific reference for clinical treatment.

Gut microbiota is the microbial community that is specifically planted in the human gut and interacts with the human body.It plays an important role in the human body by regulating the basal metabolism and immunity of the host to maintain the homeostasis of the human body.Once the intestinal flora is dysregulated,it can lead to multi-system diseases.Hashimoto's thyroiditis is an organ-specific autoimmune disease.The pathogenesis of Hashimoto's thyroiditis is complex and its incidence is increasing year by year,which is gradually becoming a serious public health disease affecting the world.In recent years,the relationship between gut microbiota and bridge onychitis has received extensive attention.A large number of studies have shown that the richness and diversity of intestinal flora in Hashimoto's thyroiditis patients are changed compared with healthy people.Studies have shown that traditional Chinese medicine therapy can play a role in treating this disease by regulating intestinal flora.This article systematically summarizes the relationship between the two and the effect of traditional Chinese medicine on the treatment of bridge onychitis by regulating intestinal flora,so as to provide some reference for research in this field.

Gut microbiota is the microbial community that is specifically planted in the human gut and interacts with the human body.It plays an important role in the human body by regulating the basal metabolism and immunity of the host to maintain the homeostasis of the human body.Once the intestinal flora is dysregulated,it can lead to multi-system diseases.Hashimoto's thyroiditis is an organ-specific autoimmune disease.The pathogenesis of Hashimoto's thyroiditis is complex and its incidence is increasing year by year,which is gradually becoming a serious public health disease affecting the world.In recent years,the relationship between gut microbiota and bridge onychitis has received extensive attention.A large number of studies have shown that the richness and diversity of intestinal flora in Hashimoto's thyroiditis patients are changed compared with healthy people.Studies have shown that traditional Chinese medicine therapy can play a role in treating this disease by regulating intestinal flora.This article systematically summarizes the relationship between the two and the effect of traditional Chinese medicine on the treatment of bridge onychitis by regulating intestinal flora,so as to provide some reference for research in this field.

Objective To study the etiology of a Chinese family with two cases of recessive non-syndromic hearing loss.Methods The clinical data of the family were collected.DNA was extracted from venous blood sam-ples,and whole-exome sequencing were performed to analyze potential causative deafness genes.Sanger sequencing was performed to verify the gene variants.Results There were 5 people among two generations in this family.The proband(Ⅱ-2,9 years old)and her brother(Ⅱ-3)had sensori-neural hearing loss,while their parents had normal hearing.The whole-exome high-throughput sequencing found that the patient carried two mutations in the CDH23 gene:c.4762C＞T(p.ARG1588TRP)and c.6604G＞A(p.ASP2202ASN).According to the American College of medical genetics and genomics(ACMG)genetic variation classification standards and guidelines,both c.6604G＞A and c.4762C＞T variants were identified as pathogenic.Conclusion The new compound heterozygous mutations c.4762C＞T and c.6604G＞A in the CDH23 gene are highly likely to be the causative factors for deafness in this family.

Hormone receptor positive/human epidermal growth factor receptor 2 negative(HR+/HER2-)breast cancer is the most common breast cancer subtype,accounting for approximately 65%-70%of breast cancers.Endocrine therapy is the cornerstone of adjuvant therapy.Even with standard endocrine therapies,patients may still experience local and/or systemic recurrence.Recently,with the application of cyc-lin-dependent kinase 4/6(CDK4/6)inhibitors,significant breakthroughs and advances have been made in the adjuvant treatment strategies for HR+/HER2-early stage breast cancer.Both the MonarchE and NATALEE studies were phase Ⅲ clinical trials evaluating CDK4/6 inhibitors in combination with endocrine therapy for the adjuvant treatment of HR+/HER2-early stage breast cancer.These two studies confirmed that CDK4/6 inhibitors in combination with endocrine therapy significantly prolonged invasive cancer-free survival(iDFS),providing a new option for the intensive treatment of patients at a high risk of recurrence.Based on this,CDK4/6 inhibitors were first recommended for use in treat-ing high-risk HR+/HER2-early stage breast cancer by the 2025 Committee of the Breast Cancer Society guidelines.Despite its established ef-ficacy,further research is needed to determine the optimal treatment duration,long-term survival benefits,safety management,and cost-effectiveness.In this study,we have systematically reviewed the latest medical evidence of endocrine therapy for HR+/HER2-early stage breast cancer,and discussed the precision treatment strategy,and look forward to future directions such as circulating tumor DNA(ctDNA)dynamic monitoring,treatment"escalation"and"de-escalation,"novel drug combination and post-resistance treatment strategies in the ad-juvant setting to provide scientific reference for clinical treatment.

ObjectiveTo explore the role of saikosaponin D （SSD） targeting signal transducer and activator of transcription 3 （STAT3） in inducing apoptosis of bladder cancer cells by computer-aided drug design and experimental verification. MethodThe druggability and biotoxicity of SSD were explored by Bayesian classifier modeling. The information about SSD， the active ingredient of Bupleuri Radix， was searched against the Traditional Chinese Medicine Systematic Pharmacology Database and Analysis Platform （TCMSP）. The targets of SSD were predicted by PubChem， TCMSP， a Bioinformatics Analysis Tool for Molecular mechANism of Traditional Chinese Medicine （BATMAN-TCM）， Coremine， an Encyclopedia of Traditional Chinese Medicine （ETCM）， and SwissTargetPrediction. GeneCards， Therapeutic Target Database （TTD）， and Online Mendelian Inheritance in Man （OMIM） were employed to predict the potential therapeutic targets of bladder cancer. Then， the common targets shared by SSD and bladder cancer were selected for Gene Ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analyses. Molecular docking was adopted to explore the binding affinity and structural stability of SSD with target proteins. Cytoscape 3.9.1 was used to construct the STAT3-drug regulatory network and STAT3-apoptosis regulatory network. UM-UC-3 cells were treated with 0， 5， 10， 15 μmol·L^-1 SSD for 24 h. Then， flow cytometry was used to detect the apoptosis of bladder cancer cells， and Western blot was employed to determine the protein levels of B-cell lymphoma-2 （Bcl-2）， Bcl-2-associated X protein （Bax）， Bcl-2-associated death promoter （Bad）， STAT3， and phosphorylation （p）-STAT3. ResultBayesian classifier modeling and molecular docking showed that SSD had low biotoxicity and bound well to the target protein STAT3 to form a stable protein-ligand complex. There were 282 common targets between bladder cancer and SSD， among which STAT3 was the most central target. The GO enrichment analysis showed that the potential core therapeutic targets involved 3 036 biological processes， 82 cellular components， and 171 molecular functions. The KEGG enrichment analysis showed that the potential core targets were mainly related to the C-type lectin receptor signaling pathway， Toll-like receptor signaling pathway， and cell apoptosis pathway. The STAT3-drug regulatory network and STAT3-apoptosis regulatory network showed that 29 drugs interacted with STAT3， and 27 apoptosis-related genes had a strong correlation with STAT3. Flow cytometry showed that the apoptosis rate increased with the increase in SSD concentration （P<0.05）. Western blotting results showed that SSD down-regulated the protein levels of p-STAT3 and Bcl-2 and up-regulated the protein levels of Bax and Bad in a concentration-dependent manner （P<0.05）. ConclusionSSD has good druggability and low biotoxicity. It may promote the apoptosis of bladder cancer cells by targeting STAT3.

ObjectiveTo explore the current status and issues regarding the application of ancient books in clinical practice guidelines and expert consensus of traditional Chinese medicine （TCM） published in China， and to provide methodological recommendations for the incorporation of ancient books in the development of TCM guidelines. MethodsWe searched China National Knowledge Infrastructure （CNKI）， WanFang Data， VIP， SinoMed， PubMed， Embase， as well as six industry websites including China Association of Chinese Medicine， National Group Standards Information Platform， and Chinese Association of the Integration of Traditional and Western Medicine，etc. TCM clinical practice guidelines or expert consensus issued during January 1st， 2017， to November 26th， 2022 were searched. Clinical practice guidelines or expert consensus that explicitly referred to ancient books were included， and the content regarding the searching for ancient books， sources of access to ancient books， methods of evaluating the level of evidence， methods of evaluating the level of recommendation， and methods of evaluating the evidence for the ancient books were analysed. ResultsA total of 1,215 TCM clinical practice guidelines or expert consensus were retrieved， with 442 articles explicitly mentioning the application of ancient books， including 300 （67.87%） clinical practice guidelines and 142 （32.13%） expert consensus. Sixty of the 442 publications explicitly reported that ancient books searching had been conducted （13.57%）； among these 60 publications 27 （45.00%） explicitly reported ancient books searching strategies， and the most frequent method was manual searching with a total of 24 articles （40.00%）. The most popular search source was Chinese Medical Dictionary， a TCM classics database， with a total of 18 articles. 197 articles （44.57%） explicitly reported the evaluation criteria for the level of evidence， of which 141 articles （71.57%） involved the evaluation criteria for the ancient books； 413 articles （93.44%） mentioned ancient books in the recommendations， and only the source of formula name was mentioned in 409 （99.03%） of the publications. ConclusionThe current application of ancient books in TCM clinical practice guidelines and expert consensus is limited， with issues of non-standard searching and evaluation methods. Standar-dization and uniformity are needed in evidence grading and recommendation standards. Future research should clarify the scope and methods of applying ancient book， emphasize their integration with modern research evidence， and enhance their value and quality in the development of TCM clinical practice guidelines.

BACKGROUND:The study of the lumbar spine and pelvis in patients with Lenke type 5 lordosis is limited to the coronal and sagittal planes,and the three-dimensional relationship between the scoliosis and the pelvis has not yet been clarified. OBJECTIVE:To analyze the effect of lumbar scoliosis on the pelvis in patients with Lenke type 5 lordosis and to study the correlation between the lumbar spine and the three-dimensional spatial position of the pelvis. METHODS:Imaging data of 60 patients with Lenke type 5 lordosis scoliosis admitted to the 3D Printing Reception Center of Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine from January 2019 to September 2023 were retrospectively analyzed,including Cobb angle,coronal pelvic tilt,lumbar lordosis,left and right pelvic hip width ratio(sacroiliac-anterior superior iliac spine),spinal rotation angle,pelvic tilt,sacral slope,pelvic incidence,coronal deformity angular ratio,sagittal deformity angular ratio,C7 plumb line-center sacral vertical line,apical vertebral translation,and coronal sacral inclination.The information was summarized as a database.SPSS 22.0 software was used to analyze the data related to the lumbar spine and pelvis of the patients with Lenke type 5 primary lumbar curvature adolescent idiopathic scoliosis using Spearman's correlation analysis and linear regression. RESULTS AND CONCLUSION:(1)Cobb angle was highly positively correlated with coronal deformity angular ratio,apical vertebral translation,and spinal rotation angle(r=0.91,r=0.841,r=0.736).(2)Coronal deformity angular ratio was highly positively correlated with apical vertebral translation(r=0.737),moderately positively correlated with C7 plumb line-center sacral vertical line(r=0.514),and moderately negatively correlated with sagittal deformity angular ratio(r=-0.595).(3)There was a high positive correlation between lumbar lordosis and sagittal deformity angular ratio(r=0.942)and a moderate negative correlation with coronal deformity angular ratio(r=-0.554).(4)There was a moderate positive correlation between Cobb angle with coronal pelvic tilt and coronal sacral inclination(r=0.522,r=0.534)and a moderate positive correlation between C7 plumb line-center sacral vertical line and coronal pelvic tilt(r=0.507).Apical vertebral translation with coronal pelvic tilt and coronal sacral inclination showed a moderate positive correlation(r=0.507,r=0.506).Lumbar lordosis with sacral slope and pelvic incidence showed a moderate positive correlation(r=0.512,r=0.538).Sagittal deformity angular ratio was moderately positively correlated with sacral slope and pelvic incidence(r=0.614,r=0.621).(5)Studies have found that the relative position of the lumbar spine and the pelvis is closely related in the horizontal,sagittal and coronal planes.When the lumbar spine affects scoliosis and is rotated,the relative position of the pelvis will also change to compensate,which indicates that while correcting scoliosis,the correction of the pelvis cannot be ignored.