China Clinical Cases Library of Traditional Chinese Medicine is built to promote the establishment of a scientific and technological talent evaluation system oriented on innovative value， ability and contribution in the backgroud of breaking the four only and setting new standards required by the document jointly issued by several national administrations and commissions. In the process of the construction， in order to further consolidate the foundation and ensure the quality and authority of case reports， we need to fully understand the origin and development of Chinese medical cases. Therefore， we clarified the development situation of Chinese medical cases by combing the characteristics of ancient and modern case reports， comparing the differences between Chinese and western medical case reports in terms of content and writing requirements， finally formed the main points of systematic case report norms and quality evaluation system， aiming to fully explore the unique advantages of Chinese medical cases in the fields of discipline development， scientific research innovation， clinical practice and guidance， talent evaluation and training， so as to promote its innovative development in a broader direction.

BACKGROUND:Our previous experimental results have shown that hyaluronic acid hydrogel can act as a vehicle for bone marrow mesenchymal stem cell delivery to improve the cardiac function of rats with myocardial infarction. OBJECTIVE:To explore the molecular mechanism of bone marrow mesenchymal stem cells and hyaluronic acid hydrogel in promoting damaged heart repair. METHODS:Bone marrow mesenchymal stem cells from male Sprague-Dawley rats were isolated and cultured,and then hyaluronic acid-encapsulated bone marrow mesenchymal stem cells were cultured in vitro in a three-dimensional manner.A model of myocardial infarction was made by ligating the left anterior descending artery of female Sprague-Dawley rats.After 1 week,the model rats were screened by ultrasonic testing and then eligible ones were randomly divided into four groups:PBS group(n=12),hyaluronic acid group(n=12),bone marrow mesenchymal stem cell group(n=15),and hyaluronic acid-encapsulated bone marrow mesenchymal stem cell group(n=15).At 1 week after ligation,the model rats underwent the secondary thoracotomy followed by corresponding injections into the infarcted region and its marginal zone.The expression levels of matrix metalloproteinase-2,vascular endothelial growth factor,thymosin β4 and c-Kit were examined at post-injection day 1,week 1 and week 2 by western blot assay.At post-injection week 2,immunofluorescence staining was used to detect the differentiation of transplanted cells. RESULTS AND CONCLUSION:(1)The expression levels of matrix metalloproteinase-2 and vascular endothelial growth factor protein in the infarct zone in the bone marrow mesenchymal stem cell group were significantly up-regulated at week 1 compared with the other three groups(P<0.05).At week 2,the hyaluronic acid group had a lower expression of matrix metalloproteinase-2 and vascular endothelial growth factor protein than the other three groups(P<0.05).However,the expression of matrix metalloproteinase-2 and vascular endothelial growth factor protein in the hyaluronic acid+bone marrow mesenchymal stem cell group was not significantly different compared with the bone marrow mesenchymal stem cell group.This was primarily attributable to a prolonged paracrine effect via the controlled release of the hyaluronic acid hydrogel.This prolonged paracrine effect offsets the inhibitory effect induced by hyaluronic acid hydrogel at 2 weeks.(2)Compared with the PBS group,thymosin β4 and c-Kit expression levels in the hyaluronic acid group,bone marrow mesenchymal stem cell group and bone marrow mesenchymal stem cell+hyaluronic acid group were significantly increased(P<0.05).(3)No differentiation of transplanted cells into cardiomyocytes or blood vessels was detected 2 weeks after transplantation.(4)It is indicated that transplanted bone marrow mesenchymal stem cells promote myocardial repair through the paracrine effect,and hyaluronic acid hydrogel prolongs the paracrine effect of transplanted bone marrow mesenchymal stem cells.

This study design of specific identification primers for the ITS2 sequence of F. ussuriensis. The reaction system and conditions were optimized, and PCR-nucleic acid test strips were constructed to realize the visual detection of F. ussuriensis Bark. Through molecular cloning and sequencing technology, we constructed a positive control for F. ussuriensis DNA and formulated quality standards. The established method was evaluated for sensitivity, specificity and reproducibility, and the authenticity of the commercially available samples was identified. Results demonstrated that based on the ITS2 sequences, F. ussuriensis and its mixed forgeries could be distinguished. The PCR products of the authentic F. ussuriensis on test strips showed two bands in the T and C lines, while the pseudo products and negative control showed only one band in the C line, which was consistent with the results of agarose gel electrophoresis. The specificity was 100%, and the sensitivity of the PCR-nucleic acid test strip was up to 0.1 ng·μL^-1, which was 10 times higher than that of the gel electrophoresis assay. 11 out of 16 commercially available samples of F. ussuriensis were qualified, and 5 were unqualified. Collectively, the PCR-nucleic acid test strip method established in this study is specific, rapid, accurate and visualized, which can provide a new technical idea for the detection of F. ussuriensis.

Objective To explore clinical effect of manipulation reduction combined with vertebral plasty on osteoporotic compression fractures(OVCFs).Methods Totally 61 patients with OVCFs treated from January 2022 to March 2024 were randomly divided into self-made spinal locator positioning with manipulation reduction group(treatment group)and traditional Kirchner positioning group(control group).There were 30 patients in treatment group,including 4 males and 26 females,aged from 61 to 87 years old with an average of(73.61±7.17)years old;body mass index(BMI)ranged from 15.24 to 28.89 kg·m-2 with an average of(23.90±3.20)kg·m-2;bone mineral density T value ranged from-4.90 to-2.50 SD with an avergae of(-3.43±0.75)SD;fracture to operation time was 6.50(4.00,10.25)d;10 patients were grade Ⅰ,13 patients were grade Ⅱ,and 7 patients were grade Ⅲ according to Genant classification of fracture compression.There were 31 patients in control group,in-cluding 7 males and 24 females,aged from 61 to 89 years old with an average of(73.63±8.77)years old;BMI ranged from 18.43 to 27.06 kg·m-2 with an average of(23.67±2.35)kg·m-2;bone mineral density T value ranged from-4.60 to-2.50 SD with an avergae of(-3.30±0.68)SD;fracture to operation time was 6.00(3.00,8.00)d;1l patients were grade Ⅰ,9 patients were grade Ⅱ,and 11 patients were grade Ⅲ according to Genant classification of fracture compression.The puncture times,X-ray fluoroscopy times and puncture time between two groups were observed and compared.Visual analogue scale(VAS),Japanese Orthopaedic Association(JOA)and timed up and go test(TUGT)were observed and compared before operation,3 d and 1 month after operation.Results All patients were followed up for 1 to 3 months with an average of(2.10±0.80)months.Puncture times,X-ray fluorosecopy times and puncture time in treatment group were 5.00(4.00,6.00)times,(29.53±5.89)times and 14.83(12.42,21.20)min,respectively,while those in control group were 7.00(6.00,8.00)times,(34.58±5.33)times,22.19(17.33,27.01)min,treatment group was better than those of control group(P＜0.05).There were no significant differences in preoperative VAS,JOA and TUGT between two groups(P＞0.05).VAS,JOA and TUGT in both groups were sig-nificantly improved after opeation(P＜0.05).On the third day after operation,JOA score of treatment group was 23.00(20.75,25.00),which was higher than that of control group 20.00(19.00,23.00)(P＜0.05).TUGT of treatment group was 6.26(5.86,6.57)s,which was better than that of control group 6.90(6.80,7.14)s(P＜0.05).Bone cement leakage occurred with 1 patient in treatment group and 2 patients in control group.Conclusion The optimal scheme of self-made spinal locators for lo-cating descending verteboplasty combined with traditional Chinese medicine reduction manipulation for OVCF patients could reduce the number of intraoperative puncture times,shorten puncture times and reduce number of X-ray fluoroscopy times,and have advantages over the simple positioning of Kirschn's needle in restoring short-term lumbar function and standing and walk-ing ability of postoperative patients.

Non-alcoholic fatty liver disease(NAFLD)is a kind of disease caused by a variety of reasons,which is characterized by steatosis and fat accumulation in liver parenchymal cells.In recent years,the morbidity of NAFLD has been relatively high in China.In the field of traditional Chinese medicine,NAFLD can be classified into the categories of"hepatic mass","abdominal mass"and"concretions and conglomerations".Spleen failing in transportation is the core pathogenesis of NAFLD,and the intervention of NAFLD with the method of activating spleen and resolving accumulation(shortened to Yunpi Huaji method)has achieved good results.In this paper,the clinical research of Yunpi Huaji method for the treatment of NAFLD and experimental research on its therapeutic mechanism in the past 10 years were reviewed.The results showed that the treatment of NAFLD by Yunpi Huaji method can be achieved by oral use of compound preparations and external treatment such as acupuncture,tuina and physiotherapy,and the therapeutic mechanism in the prevention and treatment of NAFLD was through multi-action,multi-target and multiple signaling pathways.The review will provide thoughts for the clinical diagnosis and treatment of NAFLD in traditional Chinese medicine,and will supply theoretical support for the medicine development and mechanism exploration of Yunpi Huaji method for the prevention and treatment of NAFLD.

Objective To investigate the factors influencing prognosis in patients with acute myocardial infarction complicated with cardiogenic shock undergoing primary percutaneous coronary intervention(PPCI).Methods Patients with acute myocardial infarction complicated with cardiogenic shock who underwent PPCI at our hospital between January 2015 and December 2019 were enrolled.Clinical baseline characteristics,coronary angiography and PCI-related parameters,and mechanical support information were collected.The patients were followed up for one year and divided into survival and death groups based on their survival status within one year.Differences in various factors between the two groups were compared.Results A total of 40 patients were enrolled,including 26 in the survival group and 14 in the death group.There were no differences in baseline data,diagnosis,risk factors,and comorbidities between the two groups.The survival group had a lower heart rate and higher blood pressure trend at admission compared to the death group.Myocardial enzymes were significantly lower in the survival group compared to the death group(median CK peak:496.00(198.25,2 830.00)U/L vs.3 040.00(405.75,5 626.53)U/L,P=0.003;median CK-MB peak:52.65(31.75,219.50)U/L vs.306.00(27.25,489.63)U/L,P=0.006).When comparing coronary angiography and PCI-related indicators between the two groups,the survival group had a higher rate of complete revascularization compared to the control group(53.85％vs.21.43％,P=0.048).The survival group had a higher proportion of extracorporeal membrane oxygenation(ECMO)combined with intra-aortic balloon pump(IABP)support compared to the control group[38.46％vs.7.14％,P=0.034].Conclusions Survival in patients with acute myocardial infarction complicated with cardiogenic shock undergoing PPCI is associated with lower level of myocardial enzymes,ECMO combined with IABP support and complete revascularization.

Objective To investigate the value of interrupter resistance (Rint) pulmonary function testing in the diagnosis of asthma in preschool children,and to compare the significance of Rint pulmonary function testing versus impulse oscillometry (IOS) in the diagnosis of asthma. Methods A prospective study was conducted among 108 children with recurrent wheezing,aged 4 to<6 years,who were admitted from July 2022 to November 2023. According to the treatment outcome,they were divided into an asthmatic group (61 children) and a non-asthmatic group (47 children). Rint pulmonary function parameters and IOS parameters were analyzed for both groups,and the two tests were compared in terms of feasibility and diagnostic value. Results Compared with the non-asthmatic group,the asthmatic group had significantly higher percentage of actual measured value to predicted value for Rint and percent changes in the measured value and predicted value of Rint (P<0.05). The receiver operating characteristic curve analysis showed that the percent change in the predicted value of Rint had an optimal cut-off value of 32.0％ in the diagnosis of asthma in preschool children,with an area under the curve (AUC) of 0.705,a sensitivity of 41.0％,and a specificity of 91.5％ (P<0.05). In terms of the degree of completion,18 children (16.7％) failed to complete the IOS test,but they could successfully complete Rint pulmonary function testing with good quality control. Rint pulmonary function testing and IOS had a similar area under the curve in the diagnosis of asthma in preschool children (P>0.05). Conclusions Rint pulmonary function testing can be used to assist in the diagnosis of asthma in preschool children,with a similar diagnostic value to IOS and a relatively high level of feasibility. A percent change of ≥32％ in the predicted value of Rint in the bronchial dilation test can be used as a cut-off value for the diagnosis of asthma in preschool children.

Objective To evaluate the reliability and validity of the Chinese version of the hyperacusis scale and estimate its applicability in the Chinese population.Methods The patients admitted to the Department of Oto-laryngology of Xijing Hospital from June 2017 to December 2017 were surveyed.A total of 300 questionnaires were sent out and 293 valid questionnaires were collected with effective response rate of 97.67％.All participants comple-ted a basic information survey,pure tone audiometry and fill in the Chinese version of the hyperacusis scale.The re-liability and validity of this scale were evaluated.Results Among the 293 respondents,243(82.93％)were compli-cated with tinnitus.A total of 181 cases(61.77％)were subjectively diagnosed with hyperacusis through question-naire survey.According to the scale evaluation,174 cases(59.39％)were diagnosed with hyperacusis,and the Kappa value of conformity test of the two methods was 0.81(P＜0.001).Reliability analysis indicated a Cronbach'sα coefficient of 0.93 for the entire scale.Each dimension had a Cronbach's α coefficient＞0.60.The split-half relia-bility coefficient for the entire scale was 0.86,and for each dimension,it was＞0.60.Exploratory factor analysis of validity suggested that 25 items could be grouped under 4 factors,such as functional part,social part,emotional part and harmonic sensitivity part.These factors had eigenvalues greater than 1,accounting for 59.42％of the total variance.Post-rotation,the 25 items were distributed across the 4 components,with each item having a factor load-ing＞0.40.Confirmatory factor analysis of validity showed model fit parameters as:x2/df=1.98,GFI=0.91,AGFI=0.83,CFI=0.92,TLI=0.89,RMSEA=0.08.Each item had a standardized factor loading＞0.40.Con-clusion The Chinese version of the hyperacusis scale demonstrated strong reliability and validity,making it suitable for use among the Chinese population.

Talents are the main force for the development of traditional Chinese medicine（TCM）， and the construction of TCM talents and the reformation of talent evaluation system are essential to promote the inheritance and innovation of TCM. At present， we are still exploring and developing in the fields of the formulation， implementation and evaluation indicators of TCM talent evaluation system. However， there are shortcomings and difficulties. For instance， insufficient stratification in the evaluation， excessive emphasis on the quantity of achievements， neglecting the quality of the achievements and the actual contribution， imperfect assessment indicators， and the weak characteristics of TCM. Therefore， national ministries and commissions have jointly issued a document requesting to break the four only and set a new standard， in order to promote the construction of a scientific and technological talent evaluation system oriented by innovation value， ability and contribution. For the evaluation of TCM clinical talents， China Association for Science and Technology commissioned China Association of Chinese Medicine to build the China Clinical Cases Library of TCM（CCCL-TCM）， which aims at collecting the most authoritative and representative TCM clinical cases and exploring the advantages of applying clinical cases as masterpiece of achievement in TCM clinical talents evaluation. CCCL-TCM can promote the construction of a talent evaluation system that is more in line with the development characteristics of TCM industry， and to carry out relevant pilot in TCM colleges and institutions across the country in order to promote the reformation of TCM talent evaluation system.

Objective To study the effect and mechanism of action of Yi Sui Sheng Xue Fang(YSSX)in ameliorating chemotherapy-induced renal injury in mice through The Kelch-like ECH-associated protein 1(KEAP1)/Nuclear factor erythroid-derived 2-like 2(NRF2)signalling pathway.Methods A mouse kidney injury model was induced by intraperitoneal injection of carboplatin(40 mg·kg-1).C57BL/6 mice were randomly divided into blank group(0.9％NaCl),model group(kidney injury model)and experimental-L,experimental-M,experimental-H groups(0.53,1.05 and 2.10 g·kg-1·d-1 YSSX by gavage for 7 d).Keap1 and Nrf2 were determined by Western blot;superoxide dismutase(SOD)and malondialdehyde(MDA)activities were determined by spectrophotometry.Results The protein expression levels of Keap1 in blank group,model group and experimental-L,experimental-M,experimental-H groups were 0.26±0.02,0.64±0.03,0.59±0.01,0.45±0.05 and 0.34±0.02;the protein expression levels of Nrf2 were 0.69±0.06,0.35±0.01,0.36±0.01,0.48±0.02 and 0.56±0.01;the enzyme activities of catalase(CAT)were(572.49±912.92),(334.60±4.92),(402.76±9.80),(475.35±5.21)and(493.00±12.03)U·mg-1;glutathione(GSH)were(2.79±0.06),(0.51±0.01),(0.59±0.07),(1.29±0.04)and(1.70±0.08)μmol·L1;SOD were(477.00±4.32),(260.67±6.13),(272.67±2.87),(386.33±3.68)and(395.00±12.25)U·mL-1;MDA were(3.89±0.02),(7.32±0.03),(6.94±0.14),(4.60±0.01)and(4.34±0.02)nmol·mg prot-1.The differences of the above indexes in the model group compared with the blank group were statistically significant(P＜0.01,P＜0.001);the differences of the above indexes in experimental-M,experimental-H groups compared withe model group were statistically significant(P＜0.01,P＜0.001).Conclusion YSSX can activate Keap1/Nrf2 signaling pathway and regulate the oxidative stress state of the organism,thus improving the renal injury caused by chemotherapy in mice.