Diabetic cardiomyopathy （DCM）， a cardiovascular complication caused by diabetes mellitus， is a major cause of heart failure and even sudden cardiac death in diabetic patients. Traditional Chinese medicine （TCM） posits that the core pathogenesis of DCM lies in internal deficiency and superficial excess， characterized by deficiency of both Qi and Yin combined with phlegm and blood stasis. Modern medical treatments for DCM primarily focus on blood glucose control and symptom alleviation yet lack targeted therapeutic strategies. In contrast， TCM offers a wealth of practical experience and a complete theoretical system， demonstrating definite clinical efficacy and high medication safety in DCM management. As a classic formula for tonifying Qi and nourishing Yin， Shengmaisan comprises Ginseng Radix et Rhizoma， Ophiopogonis Radix， and Schisandrae Chinensis Fructus. It contains multiple bioactive components， including ginsenosides， ophiopogonin， schisandrins， and homoisoflavonoids， which exhibit cardioprotective properties. The therapeutic mechanisms of Shengmaisan-like formulae for DCM involve enhancing myocardial contractility， attenuating myocardial fibrosis， modulating mitochondrial quality control， regulating glucose metabolism， mitigating oxidative stress， and suppressing inflammatory responses. Clinically， Shengmaisan-like formulae not only manage hyperglycemic status but also ameliorate cardiac structural and functional impairments and enhance exercise tolerance in DCM patients， playing a vital role in the prevention， treatment， and rehabilitation of DCM. This paper analyzes the feasibility of Shengmaisan-like formulae in DCM management and synthesizes current research achievements regarding their chemical components， mechanisms of action， and clinical applications， aiming to provide a scientific foundation for the use of such formulae in the treatment of DCM.

Osteoporosis (OP) is a systemic skeletal disease that primarily affects the elderly population, which greatly increases the risk of fractures. Here we report that Kindlin-2 expression in adipose tissue increases during aging and high-fat diet fed and is accompanied by decreased bone mass. Kindlin-2 specific deletion (K2KO) controlled by Adipoq-Cre mice or adipose tissue-targeting AAV (AAV-Rec2-CasRx-sgK2) significantly increases bone mass. Mechanistically, Kindlin-2 promotes peroxisome proliferator-activated receptor gamma (PPARγ) activation and downstream fatty acid binding protein 4 (FABP4) expression through stabilizing fatty acid synthase (FAS), and increased FABP4 inhibits insulin expression and decreases bone mass. Kindlin-2 inhibition results in accelerated FAS degradation, decreased PPARγ activation and FABP4 expression, and therefore increased insulin expression and bone mass. Interestingly, we find that FABP4 is increased while insulin is decreased in serum of OP patients. Increased FABP4 expression through PPARγ activation by rosiglitazone reverses the high bone mass phenotype of K2KO mice. Inhibition of FAS by C75 phenocopies the high bone mass phenotype of K2KO mice. Collectively, our study establishes a novel Kindlin-2/FAS/PPARγ/FABP4/insulin axis in adipose tissue modulating bone mass and strongly indicates that FAS and Kindlin-2 are new potential targets and C75 or AAV-Rec2-CasRx-sgK2 treatment are potential strategies for OP treatment.

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.

According to the pathological characteristics of symptomatic chronic thoracic and lumbar osteoporotic vertebral fracture (SCOVF), the different clinical treatment methods are selected, including vertebral augmentation, anterior-posterior fixation and fusion, posterior decompression fixation and fusion, and posterior correction osteotomy. However, there is still a lack of a unified understanding on how to choose appropriate treatment method for SCOVF. In order to reflect the new treatment concept and the evidence-based medicine progress of SCOVF in a timely manner and standardize its treatment, the clinical guideline for surgical treatment of SCOVF is formulated in compliance with the principle of scientificity, practicability and advancement and based on the level of evidence-based medicine.

The progression of hyperuricemia disease is often accompanied by damage to renal function. However, there are few studies on hyperuricemia nephropathy, especially its association with intestinal flora. This study combines metabolomics and gut microbiota diversity analysis to explore metabolic changes using a rat model as well as the changes in intestinal flora composition. The results showed that amino acid metabolism was disturbed with serine, glutamate and glutamine being downregulated whilst glycine, hydroxyproline and alanine being upregulated. The combined glycine, serine and glutamate could predict hyperuricemia nephropathy with an area under the curve of 1.00. Imbalanced intestinal flora was also observed. , , , , and other conditional pathogens increased significantly in the model group, while and , the short-chain fatty acid producing bacteria, declined greatly. At phylum, family and genus levels, disordered nitrogen circulation in gut microbiota was detected. In the model group, the uric acid decomposition pathway was enhanced with reinforced urea liver-intestine circulation. The results implied that the intestinal flora play a vital role in the pathogenesis of hyperuricemia nephropathy. Hence, modulation of gut microbiota or targeting at metabolic enzymes, , urease, could assist the treatment and prevention of this disease.

Objectives: To establish a geographic information application system for analyzing the spatial and temporal distribution of major infectious diseases in various regions of the world and to assess the risk of importation of those diseases, to China. Methods: We collected and integrated the following information on: 1) outbreaks and areas of epidemics of major infectious diseases in the world from 2000 to 2017, 2) cases of infectious diseases in arriving travelers through active surveillance at international entry-exit ports in mainland China from 2014 to 2016, 3) numbers of annual global international flights and travelers in the country. With the above information, a global space-time distribution database on major infectious diseases was then established, using the technology related to the system. Models regarding technologies on time-space analysis, probabilistic risk assessment and geographic information visualization, were applied to establish a geographic information system on risk assessment of infectious diseases that imported to China. Results: Through integration of information on outbreaks and epidemic areas of 60 major infectious diseases in 220 countries and regions around the world, as well as 42 kinds of infectious diseases identified among the international arrivals in mainland China, a system was then developed. Information on the distribution of major infectious diseases and their potential risks in the worldwide various regions, characteristics of spectrum and disease burden of infectious diseases imported to each province of mainland China were displayed. Thus, risks on importing infectious diseases in each province via air way were able to be evaluated and simulated by the probabilistic risk assessment model, under the information on specific kind of infectious disease, outside China. Conclusion Geographic Information System on Risk Assessment Regarding Infectious Diseases Imported to China provides basic data for epidemiological reconnaissance and assessment on risks of importing infectious diseases outside China, thus would be helpful for the improvement of strategies on surveillance, prevention and control regarding the importing infectious diseases, in China.

Objective: To determine the value of hyperextension MRI evaluation in determining whether to perform decompression therapy after reduction of reducible atlantoaxial dislocation as well as assess the decompression effect. Methods: A retrospective case series study was conducted to analyze 24 patients with atlantoaxial dislocation admitted to Honghui Hospital affiliated to Xi'an Jiaotong University from May 2015 to May 2017. There were 10 males and 14 females, aged 40-74 years, with an average age of 52 years. There were 14 patients with os odontoideum, four patients with odontoid fracture, and six patients with transverse atlantal ligament rupture. Hyperextension MRI was performed to assess spinal cord compression for all patients. Eight patients with anterior spinal cord compression (Group A) underwent posterior atlantoaxial arch decompression plus atlantoaxial internal fixation reduction and bone graft fusion; 16 patients without anterior compression of the spinal cord (Group B) underwent only atlantoaxial internal fixation reduction and bone graft fusion. Intraoperative and postoperative complications were recorded. Spinal cord compression index and improvement rate of spinal cord decompression were evaluated by routine cervical spine MRI. Japanese Orthopedic Association (JOA) score was used to evaluate the clinical effect. Results: All patients were followed up for 3-24 months, with an average of 9.3 months. There was no nerve or vertebral artery injury during the operation, and no screw loosening occurred after surgery. The spinal cord compression index (0.37±0.18) in Group A at the last follow-up was significantly lower than that before operation (0.73±0.22) (P<0.05), while the index in Group B (0.19±0.20) at the last follow-up was also lower than that before operation (0.61±0.25) (P<0.05). The improvement rate of spinal cord decompression was 67.11% in Group A and 70.61% in Group B. The final JOA score of Group A was (13.29±3.68)points, which was significantly better than the preoperative JOA [(5.61±2.74)points] (P<0.05). The final JOA score in Group B [(14.13±3.45)points] was also significantly better than the preoperative JOA [(7.32±2.90)points] (P<0.05). Improvement rate of JOA was 57.31% in Group A and 59.91% in Group B. Conclusions Hyperextension MRI of cervical vertebra can effectively judge whether the anterior spinal cord is compressed after reduction of atlantoaxial dislocation. It has important clinical significance for decompression treatment during reduction and internal fixation of reducible atlantoaxial dislocation. At the same time, posterior atlantoaxial arch resection and decompression can effectively relieve the compression of the spinal cord after reduction of atlantoaxial dislocation.

Saponins are important components in traditional Chinese medicine (TCM) with significant biological activities, which could be divided into triterpenoid saponins and steroidal saponins according to structures of the aglycone skeletons. This article reviews the in vivo metabolic pathways of some typical natural saponins such as ginsenosides, licorice saponins, saikosaponins, timosaponins and diosgenin glycosides. Saponins often show poor absorbance after oral administration. The in vivo metabolism of saponins generally contain two steps. These compounds usually undergo hydrolysis in stomach and gut. Then they are absorbed into blood and metabolized in liver. The secondary glycosides and the aglycones produced in gastrointestinal tract often show higher bioavailability and better bioactivity, while downstream metabolites in liver are mainly produced by phase I metabolism. Clarification of the in vivo metabolism of bioactive saponins is helpful for the understanding of the effective ingredients in TCM, as well as the discovery of new drugs from natural products.

The "Biofilms, Microbiomes and Oral Diseases: Challenges and Future Perspectives" symposium jointly organized by Penn Dental Medicine and West China School of Stomatology was held on 30 September 2017 at Penn Wharton China Center (PWCC) in Beijing, China. The topics included the pathogenicity of oral biofilms, novel strategies for the control of biofilm-related diseases, oral microbiome and single-cell approaches, and the link between oral diseases and overall health. Researchers from a number of disciplines, representing institutions from China and Penn Dental Medicine, gathered to discuss advances in our understanding of biofilms, as well as future directions for the control of biofilm-related oral and systemic diseases.
Biofilms ; China ; Humans ; Microbiota ; Mouth Diseases ; microbiology

Objective To screen for serum protein differentially expressed between women whose fetuses had congenital heart defects(CHD) and women who had normal fetuses. Methods Serum samples were collected from pregnant women whose fetuses had CHD and those whose fe?tuses had no CHD,including a CHD group of 40 women and a control group of 10 women. The CHD group included 4 subgroups as follows:tetralo?gy of Fallot,ventricular septal defects,persistent truncus arteriosus,and a mixture of relatively rare types of CHD(n=10 each). Samples in the same group were pooled to obtain equal amounts of proteins ,and the iTRAQ proteomic approach was used to identify and quantify the proteins dif?ferentially expressed among these groups. Results We successfully identified 606 proteins,among which 47 showed at least a 1.5?fold difference between the CHD and control groups. Among the 47 proteins,23 and 24 were upregulated and downregulated,respectively. Conclusion Several proteins associated with CHD could be identified by using the iTRAQ proteomic approach ,and various proteins were involved in the pathogenesis of CHD in this study.