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 summarize the clinical features and prognosis of congenital chylothorax and provide a basis for rational diagnosis and treatment.Methods:Clinical data of 11 cases of congenital chylothorax treated in the Department of Neonatology of Women's Hospital, School of Medicine, Zhejiang University from January 2020 to December 2022 were retrospectively collected and analyzed. Intrauterine intervention, clinical manifestations, auxiliary examinations, management strategies, outcomes, and postnatal follow-up were summarized using descriptive statistical analysis.Results:All the patients were born by cesarean section at the gestational age of (35.7±2.2) weeks (32 +1-39 +0 weeks). The male-to-female ratio was 4∶7. Four cases were complicated by fetal edema. Nine cases received intrauterine treatment, including thoracentesis in six cases, thoraco-amniotic shunting in one case, and thoracentesis combined with thoraco-amniotic shunting in two cases. Six patients had mild asphyxia. All 11 patients developed respiratory distress within 24 h after birth and were found with pleural effusion by chest X-ray and ultrasound. After a series of treatments, including chest drainage, respiratory support, sequential nutritional therapy, and octreotide, nine cases were cured and discharged from the hospital, while two cases died of pulmonary collapse after withdrawing treatment (both complicated by fetal edema). No recurrence of chylothorax was reported in the nine patients and their growth and development were normal during a follow-up to 3-22 months after birth. Conclusions:Patients with congenital chylothorax are prone to intrapartum asphyxia and respiratory distress after birth. Most patients can survive and have good outcomes after intrauterine intervention and postnatal comprehensive treatment.

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.

Objective To investigate and evaluate the safety and effectiveness of the Chimney technique in mitral valve reoperation. Methods The clinical data of mitral valve reoperation patients who underwent Chimney surgery in Wuhan Asia Heart Hospital from 2019 to 2021 were retrospectively analyzed. Results A total of 26 patients were collected, including 7 males and 19 females, aged 27-67 (53.46±11.18) years. All patients had previous mitral valve surgery, including 23 mitral valve replacements and 3 mitral valve repairs. All patients received Chimney technique using the ideal artificial sized mitral valve, and 1 patient died of neurological complications in hospital. The cardiopulmonary bypass time and the aortic cross-clamping time were 231.11±77.05 min and 148.50±52.70 min, respectively. The mean diameter of the implanted mitral valve prosthesis was 29.08±0.68 mm, which was statistically different from pre-replacement valve prosthesis size of 26.69±0.77 mm (P＜0.001). The mean transvalvular pressure gradient of the prosthetic mitral valve measured on postoperative echocardiography was 14.77±5.34 mm Hg, which was statistically different from preoperative value of 20.92±9.83 mm Hg (P=0.005). Conclusion The Chimney technique is safe and effective for reoperation in patients with small mitral annuli, which can not only reduce the risk of reoperation, but also obtain larger prosthetic valve implants with good hemodynamic characteristics and clinical outcomes.

Objective To investigate and evaluate the safety and efficacy of the aortic-mitral annular enlargement technique (double annular enlargement) in patients with small-size valve prostheses after prior valve surgery. Methods The clinical data of patients who underwent double valve annular enlargement in Wuhan Asia Heart Hospital from April 2020 to April 2022 were retrospectively analyzed. Results A total of 30 patients were collected, including 2 males and 28 females aged 9-78 (52.71±3.53) years. All patients had previous heart valve surgery, including 1 patient receiving the third heart surgery. All patients were operated on successfully and there were no postoperative in-hospital deaths. There was no postoperative bleeding which needed a secondary open-chest hemostasis, and one patient underwent permanent pacemaker implantation due to postoperative sick sinus syndrome. The mean diameter of the implanted prosthetic aortic valve was 24.23±1.60 mm, which was significantly larger than that of the preoperative aortic valve (21.03±1.90 mm, P＜0.001). The mean diameter of the implanted prosthetic mitral valve was 28.33±1.21 mm, which was significantly larger than that of the preoperative mitral valve (25.43±0.84 mm, P＜0.001). The mean peak gradient difference across the prosthetic aortic valve on postoperative echocardiography was 18.17±6.44 mm Hg, which was significantly lower than that of the preoperative aortic valve (82.57±24.48 mm Hg, P＜0.001). The mean peak gradient difference of the postoperative prosthetic mitral valve was 12.73±5.45 mm Hg, which was significantly lower than that of the preoperative mitral valve (19.43±8.97 mm Hg, P=0.003). Conclusion The double annular enlargement technique is safe and effective for reoperation in patients with a history of valve surgery with a small aortic root to obtain both a larger size prosthetic valve for a larger orifice area and stability of the mitral-aortic valve union, resulting in good postoperative hemodynamic characteristics and clinical outcomes.

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 investigate the mechanism of high mobility group protein 1(HMGB1)-mediated pyroptosis involved in pulmonary vascular remodeling in mice with pulmonary arterial hypertension(PAH).Methods Forty SD mice were divided into control group,PAH group,PAH+HMGB1 neutralizing antibody(HMGB1 Ab)group and PAH+necronecroamide(NSA)group.Except the control group,the remaining 3 groups were treated with hypoxia to establish PAH model.PAH+HMGB1 Ab group and PAH+NSA group were treated with HMGB1 Ab and NSA respectively.After the treatment,the mean pulmonary artery pres-sure(mPAP)and right ventricular hypertrophy index(RVHI)of mice in each group were detected.Hema-toxylin-eosin staining was used to observe the pulmonary histopathological changes and calculate the percent-age of pulmonary artery wall thickness(WT)and the percentage of pulmonary artery wall area(WA).The serum levels of interleukin(IL)-1β and IL-18 were detected by enzyme-linked immunosorbent assay.The ex-pression of gasdermin D(GSDMD)in lung tissues of mice in each group was observed by immunohistochemi-cal staining.Real-time fluorescence quantitative PCR and western blot were used to detect the expression of HMGB1,nucleotide-binding oligomerized domain-like receptor protein 3(NLRP3),apoptosis-associated speck-like protein(ASC),Cysteinyl aspartate-specific proteinase-1(Caspase-1),and GSDMD in lung tissues of mice in each group.Results Compared with control group[(1.81±0.19)kPa,(0.27±0.03)],mPAP and RVHI in PAH group[(3.97±0.41)kPa,(0.41±0.04)]were significantly increased,and the difference was statistically significant(P＜0.05).Compared with the control group,the pulmonary artery wall of PAH group was significantly thickened,and the vascular smooth muscle cells proliferated and hypertrophy.The de-gree of pulmonary artery wall thickening in PAH+HMGB1Ab and PAH+NSA groups was significantly re-duced compared with PAH group.WT and WA in PAH group[(42.06±4.38)％,(50.56±5.24)％]were sig-nificantly higher than those in control group[(23.64±2.46)％,(25.12±2.63)％],the difference was statisti-cally significant(P＜0.05).Compared with control group[(23.56±2.48)pg/mL,(22.68±2.32)pg/mL],se-rum levels of IL-1β and IL-18 in PAH group[(94.51±9.62)pg/mL,(58.21±5.97)pg/mL]were significant-ly increased,and the difference was statistically significant(P＜0.05).Compared with PAH group[(48.57±5.02)％],the positive rate of GSDMD in PAH+HMGB1Ab and PAH+NSA groups[(16.52±1.76)％,(14.62±1.59)％[was significantly decreased,and the difference was statistically significant(P＜0.05).The protein expression of HMGB1,NLRP3,ASC,Caspase-1 and GSDMD in lung tissues of PAH group were sig-nificantly higher than those of control group(P＜0.05).Conclusion HMGB1 neutralizing antibody can in-hibit pyroptosis of PAH mice,thereby reducing pulmonary artery pressure and improving pulmonary vascular remodeling.

Objective To investigate the clinical efficacy of Kangfuxin solution combined with lidocaine and gentamicin in the treatment of oral ulcers. Method A total of 120 patients with oral ulcer admitted to Tongzhou District Maternity and Child Health Care Hospital of Beijing from May 2019 to July 2021 were selected and divided into observation group and control group randomly. 58 patients were treated with lidocaine as a control group and 62 patients in the observation group were treated with Kangfuxin solution combined with lidocaine and gentamicin. The clinical efficacy, including oral ulcer condition, visual analogue scale (VAS score) after 3d and 5d of treatment, inflammatory factor levels and adverse reactions were observed and compared between the two groups before and after treatment. Results The overall effective rate of the treatment group (95.12%) was higher than that of the control group (74.36%) and the difference was statistically significant (P<0.05). The ulcer area, ulcer healing time, and chewing improvement period were remarkably reduced compared with those in the control group (P<0.05). The VAS scores after 3d and 5d of treatment, the levels of tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) and interleukin-6 (IL-6) between the two groups were statistically significant (P<0.05). There was no significant difference in the incidence of adverse reactions (3.22%) between the observation group and the control group (6.90%) (P>0.05). Conclusion Kangfuxin solution combined with lidocaine and gentamicin showed better curative effect on oral ulcer. This treatment regimen could effectively ameliorate various clinical symptoms of patients with oral ulcer, reduce patient pain and downregulate the levels of inflammatory factors, and help patients recover with high safety profile.

Since 2010, the incidence of severe fever with thrombocytopenia syndrome (SFTS) has been increased. Owing the progress in diagnosis and treatment, the overall mortality of SFTS in China has decreased, while the mortality in critical SFTS patients is still high. In order to provide guidance and working procedures for clinicians to diagnose and treat critical SFTS, the National Medical Center for Major Public Health Events invited experts to discuss and formulate this consensus based on their experience and up-to-date knowledge on SFTS.

The development of nanomedicine has recently achieved several breakthroughs in the field of cancer treatment; however, biocompatibility and targeted penetration of these nanomaterials remain as limitations, which lead to serious side effects and significantly narrow the scope of their application. The self-assembly of intermediate filaments with arginine-glycine-aspartate (RGD) peptide (RGD-IFP) was triggered by the hydrophobic cationic molecule 7-amino actinomycin D (7-AAD) to synthesize a bifunctional nanoparticle that could serve as a fluorescent imaging probe to visualize tumor treatment. The designed RGD-IFP peptide possessed the ability to encapsulate 7-AAD molecules through the formation of hydrogen bonds and hydrophobic interactions by a one-step method. This fluorescent nanoprobe with RGD peptide could be targeted for delivery into tumor cells and released in acidic environments such as endosomes/lysosomes, ultimately inducing cytotoxicity by arresting tumor cell cycling with inserted DNA. It is noteworthy that the RGD-IFP/7-AAD nanoprobe tail-vein injection approach demonstrated not only high tumor-targeted imaging potential, but also potent antitumor therapeutic effects in vivo. The proposed strategy may be used in peptide-driven bifunctional nanoparticles for precise imaging and cancer therapy.