Objective To establish a finite element model of the hallux valgus foot and study the stress and displacement changes in the first and second rays of the hallux valgus under different tensile forces.Methods Foot CT images of a patient with hallux valgus were imported into Mimics to reconstruct a three-dimensional(3D)skeletal model of the foot.The 3-matic software was used to mesh the reconstructed model and generate the volume mesh.The optimized model was imported into ANSYS for finite element analysis.The relationship between the tensile forces and the stress/displacement of the first and second rays of the hallux valgus was verified by changing the size and direction of the tensile forces.Results Tensile forces of different magnitudes and directions were applied to the first proximal phalanx.When the force was less than 12 N,with an increase in tension,the displacement of the first phalange changed more significantly.For every 2 N increase in tension,the displacement increased by approximately 1 mm.When the force was greater than 12 N,with an increase in tension,the stress on the first phalange increased,whereas the displacement only changed slightly.In addition,when the magnitude of the force remained unchanged at 12 N and the direction of the force changed at intervals of 15°,the stress and stress distributions of the first and second rays changed with direction,and the displacement also changed accordingly.When the direction of the force was perpendicular to that of the second phalanx,the displacement of the first phalanx increased.Conclusions Finite element analysis technology can vividly and accurately analyze the stress and displacement changes of the first and second rays of hallux valgus under different tensile forces,and it lays a foundation for the design of hallux valgus orthoses.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

In order to judge the future development trend of science and technology, plan ahead and lay out the frontier technology fields and directions, China Association of Chinese Medicine(CACM) has launched consultation projects for collecting "major scienti-fic issues and engineering technology difficulties in traditional Chinese medicine(TCM)" for the industry for three consecutive years since 2019. Up to now, 18 projects have been selected as major issues for research, and some experience and achievements have been made. These projects have been applied in important scientific and technological work such as scientific and technological planning and deployment at all levels of national, local, and scientific research institutions, the selection and cultivation of major national scientific and technological projects, and the construction of innovation bases, giving full play to the role of the think tank advisory committee of CACM. This study reviewed the selection of major issues for the first time, systematically combed its application in the national layout of science and technology, and put forward the existing problems and improvement suggestions, aiming to provide new ideas for further improving the selection of major issues and research direction, providing a theoretical basis and decision support for the national scientific and technological layout in the field of TCM, and promoting scientific and technological innovation to facilitate the high quality development of TCM.
Medicine, Chinese Traditional ; Inventions ; China ; Drugs, Chinese Herbal

Sjögren's syndrome （SS）， a disorder of immune system， is one of the dominant diseases treated by traditional Chinese medicine （TCM）. China Association of Chinese Medicine organized experts in the field of TCM and western medicine rheumatology and pharmacology to discuss the advantages and optimal regimens of TCM for the treatment of SS. The experts generally agreed on the low early diagnosis rate of SS and the lack of targeted therapeutic drugs. In addition， autoimmune abnormality is the key factor in the occurrence of SS and deficiency of both Qi and Yin is the core pathogenesis. SS has unique tongue manifestations， which is expected to allow for the early diagnosis and treatment with integrated traditional Chinese and western medicine. TCM has advantages in treating SS in terms of alleviating clinical symptoms and systemic involvement， individualized treatment， relieving sleep and mood disorders， preventing the occurrence in the early stage， and enhancing the effectiveness and reducing toxicity in the treatment by integrated TCM and western medicine. In general， TCM has advantages in different stages of SS. Internal and external use of TCM， acupuncture， and acupotome are all available options. The optimal regimens should be determined on the basis of pattern identification， stage of disease， and the advantages of TCM. Clinical characteristics and biomarkers of SS should be studied to classify patients， so as to design precision evidence-based TCM regimens for SS. On the basis of unique tongue manifestations of SS， models for early diagnosis and poor prognosis identification of SS should also be established to achieve early prevention and treatment and to improve the prognosis. In the future， we should vigorously carry out high-quality evidence-based medical research on the treatment of SS by TCM and integrated traditional Chinese and western medicine and develop relevant guidelines to optimize and standardize current diagnosis and treatment， thereby laying a basis for clarifying and explaining the advantages of TCM in treating SS.

Objective:To investigate the effect of salidroside on the proliferation and invasion of prostate cancer PC-3M cells and the possible molecular mechanism.Methods:PC-3M cells were treated with different concentrations (0, 50, 100, 150, 200 nmol/L) of salidroside for 48 h, and MTS assay was used to detect the effect of salidroside on the proliferation of PC-3M cells. The PC-3M cells treated with the most obvious inhibitory effect concentration of salidroside were selected as the salidroside group, and the PC-3M cells treated with 0.9% NaCl were selected as the control group. Transwell assay was used to detect the effect of salidroside on PC-3M cell invasion. The expression difference of LINC01207 between prostate cancer tissues and adjacent tissues was analyzed by using GEPIA database. Real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression of LINC01207 and miR-1182 in PC-3M cells after salidroside treatment. Western blot was used to detect the expressions of proliferation and invasion related proteins in PC-3M cells after salidroside treatment.Results:After treated with 0, 50, 100, 150, and 200 nmol/L salidroside, the absorbance values of prostate cancer PC-3M cells were 0.98±0.17, 0.72±0.08, 0.47±0.10, 0.12±0.03, and 0.42±0.05, respectively, and the difference was statistically significant ( F = 42.02, P < 0.05); and 150 nmol/L salidroside had the most significant inhibitory effect. The salidroside group (150 nmol/L salidroside) was performed to do the subsequent experiment. The invasion number of PC-3M cells in the control group and the salidroside group were (80±11) and (36±13), respectively ( t = 5.15, P < 0.05). GEPIA database online analysis showed that the expression of LINC01207 in prostate cancer tissues was higher than that in paracancerous tissues ( P < 0.01). qRT-PCR results showed that the relative expression level of LINC01207 in PC-3M cells of the control group and the salidroside group was (6.2±1.1) and (1.2±0.7), respectively; and the expression of LINC01207 in PC-3M cells of the salidroside group was lower than that of the control group ( t = 7.88, P < 0.01). The relative expression level of miRNA-1182 was (1.00±0.20) and (7.02±0.35), respectively; the expression of miRNA-1182 in PC-3M cells of the salidroside group was higher than that of the control group ( t = 30.07, P < 0.01). Western blot results showed that after PC-3M cells were treated with salidroside, the expressions of cell proliferation proteins CDK2 and cyclin E decreased; the expressions of cell invasion proteins CD147, matrix metalloproteinases (MMP)-2, MMP-9 decreased. Conclusions:Salidroside inhibits prostate cancer PC-3M cell proliferation and invasion by downregulating LINC01207 expression and activating miRNA-1182 expression.

Objective To observe the effect of exsanguination at jing points and auricular tips on antipyretic effect and inflammation factors level in patients with fever caused by coronavirus disease 2019(COVID-19).Methods A retrospective study was conducted.A total of 521 febrile patients with COVID-19 admitted to the Affiliated Hospital of Nanjing University of Chinese Medicine from January 1 to 10,2023 were selected as the study subjects.The patients were divided into the control group(treated with conventional treatment)and the experimental group(treated with exsanguination of jing points and auricular tips based on the control group)according to whether they received traditional Chinese medicine(TCM)exsanguination treatment.The body temperature before treatment and 30 minutes and 4 hours,24 hours after treatment,the immediate(within 30 minutes)antipyrexia efficiency,the time of body temperature returning to normal,and the levels of inflammatory factors before treatment and 48 hours after treatment were collected,and the differences between the two groups were compared.According to the standard of fever relief≥1℃within 4 hours,the differences of the average onset time of fever and the rate of fever relief at 2.5,3 and 4 hours after treatment were compared between the two groups.Kaplan-Meier curve was drawn to analyze the change of 4-hour antipyrexia rate in the two groups before and after matching.Results A total of 169 cases in the experimental group and 352 cases in the control group were finally included.Because this study was retrospective,there were significant differences in the course of disease and underlying diseases(chronic bronchitis,diabetes,renal insufficiency,hepatobiliary diseases)between the two groups at baseline(all P＜0.05).In order to reduce the differences,the above 4 factors were included in the predictor variables,and a 1∶1 propensity matching was performed to match 166 pairs of case samples,which were comparable.The result showed body temperature of the two groups gradually decreased with the extension of time,and the body temperature of the experimental group was significantly lower than that of the control group at each time point(℃:30 minutes was 38.32±0.22 vs.38.43±0.24,4 hours was 37.67±0.32 vs.38.13±0.51,24 hours was 37.03±0.38 vs.37.14±0.51,all P＜0.05),the immediate antipyrexia efficiency was significantly higher than that of the control time group[63.86%(106/166)vs.44.58%(74/166),P＜0.05],and the time of body temperature recovery to normal was significantly shorter than that of the control group(hours:19.25±7.79 vs.38.90±17.17,P＜0.05).In terms of the 4 hours antipyretic onset dynamic time,the average antipyretic onset time of the experimental group was significantly shorter than that of the control group[hours:4.39(4.11,4.68)vs.7.16(6.71,7.61),P＜0.05],the fever relief rates at 2.5,3 and 4 hours were significantly higher than those in the control group[6.63%(11/166)vs.0.60%(1/166),24.10%(40/166)vs.4.82%(8/166),74.10%(123/166)vs.38.55%(64/166),respectively,all P＜0.05].Kaplan-Meier curve analysis showed that there were statistically significant differences in 4 hours fever reduction rates between the two groups before and after matching(all P＜0.05).In terms of inflammatory factors,high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in the two groups after treatment were significantly lower than those before treatment[hs-CRP(mg/L):control group was 32.03±15.38 vs.79.78±13.34,experimental group was 33.21±16.07 vs.80.03±14.66;TNF-α(μg/L):control group 2.91±0.88 vs.5.09±0.95,experimental group 2.83±0.98 vs.5.10±0.87;IL-6(ng/L):control group was 96.30±48.12 vs.206.48±56.70,experimental group was 94.01±45.13 vs.202.38±55.38,all P＜0.05],but there was no significant difference in the levels of the above indicators between the two groups after treatment.Conclusion Exsanguination at the jing points and auricular tips has a good antipyretic effect in the treatment of fever caused by COVID-19,which can accelerate the antipyretic time,improve the antipyretic efficiency,and reduce the level of inflammatory factors.

Femoral neck fracture (FNF) in the elderly patients is currently a major health challenge worldwide, with excessive consumption of medical resources, high incidence of complications as well as suboptimal outcome and prognosis. Hip joint arthroplasty (HJA) has been the mainstream treatment for FNF in the elderly, but the conventional surgical approaches and techniques are still confronted with a series of bottlenecks such as dislocation, limp and limb length discrepancy. In recent years, direct anterior approach (DAA) for HJA (DAA-HJA) has been a major new choice in the field of joint replacement, which achieves improved clinical effectiveness of HJA in the treatment of elderly FNF, due to the fact that DAA approach involves the neuromuscular interface and accords with the idea of soft tissue retention and enhanced recovery after surgery. However, there is still a lack of unified understanding of standard technique and procedure of DAA-HJA in the treatment of elderly FNF. Therefore, relevant experts from the Hip Joint Group of Chinese Orthopedics Association of Chinese Medical Association, Youth Arthrology Group of Orthopedic Committee of PLA, Orthopedic Committee of Chongqing Medical Association, Branch of Orthopedic Surgeons of Chongqing Medical Doctor Association and Sport Medicine Committee of Chongqing Medical Association were organized to formulate the " Chinese expert consensus on the technical standard of direct anterior hip arthroplasty for elderly femoral neck fracture ( version 2023)" based on evidence-based medicine. This consensus mainly proposed 13 recommendations covering indications, surgical plans, prosthesis selections, surgical techniques and processes, and postoperative management of DAA-HJA in elderly patients with FNF, aiming to promote standardized, systematic and patient-specific diagnosis and treatment to improve the functional prognosis of the patients.

Objective: To develop effective alternatives to natural enzymes, it is crucial to develop nanozymes that are economical, resource efficient, and environmentally conscious. Carbon nanomaterials that have enzyme-like activities have been extensively developed as substitutes for traditional enzymes. Methods: Carbide-derived carbons (CDCs) were directly synthesized via a one-step electrochemical method from a MAX precursor using an ammonium bifluoride electrolyte at ambient conditions. The CDCs were characterized by systematic techniques. Results: CDCs showed bienzyme-like activities similar to that of peroxidase and superoxide dismutase. We systematically studied the dependence of CDC enzyme-like activity on different electrolytes and electrolysis times to confirm activity dependence on CDC content. Additionally, the synthesis mechanism and CDC applicability were elaborated and demonstrated, respectively. Conclusion The demonstrated synthesis strategy eliminates tedious intercalation and delamination centrifugation steps and avoids using high concentrations of HF, high temperatures, and halogen gases. This study paves the way for designing two-dimensional material-based nanocatalysts for nanoenzyme and other applications.
Ammonium Compounds/chemical synthesis* ; Carbon/chemistry* ; Electrochemical Techniques ; Enzymes ; Fluorides/chemical synthesis* ; Humans ; Nanostructures ; Oxidation-Reduction

In the clinical practice of rheumatic immune diseases in traditional Chinese medicine （TCM），it`s still unclear about the dominant diseases and breakthrough points. It`s urgent missions to formulate TCM diagnosis and treatment guidelines widely recognized and integrated by traditional Chinese medicine and Western medicine. In order to clarify the dominant diseases and breakthrough points in rheumatism，China association of Chinese medicine initiated a research group covering experts in the field of rheumatism of traditional Chinese medicine and Western medicine. Based on questionnaire survey and on-site discussion，experts had reached the following consensus. Evidence-based medicine research using modern medical methods and scientific methods should be carried out to provide objective clinical evidences. "Four mutuality" were put forward as the basis for the work of integrated traditional Chinese and Western medicine，that is the mutual communication using the exchangeable context，the mutual explanation using common theories，the mutual certification using common standards，and the mutual integration using common means. Key works should focus on solving refractory rheumatism in the future. In terms of dominant diseases and breakthrough points，this paper introduces 21 breakthrough points in 6 dominant diseases，including rheumatoid arthritis，ankylosing spondylitis，Sjogren's syndrome，hyperuricemia and gout，systemic lupus erythematosus and fibromyalgia syndrome. Advice on this discussion can provide valuable references for developing the treatment scheme of rheumatism with TCM and integrated Chinese and Western medicine and clinical practice and scientific research.

Bitter almonds (Semen Armeniacae Amarum) are prone to oil deterioration during storage, so they often require mashing prior to clinical use. To confirm the medical value of bitter almonds "being mashed when used" and to determine the optimal storage conditions for bitter almonds, UPLC-MS/MS was used to perform a comparative study of the chemical composition of bitter almonds in different storage states (mashed and unmashed), storage times (0, 2 and 4 weeks), and storage temperatures (25 ℃ and 4 ℃). A total of 58 substances were identified in bitter almond extracts through literature review, this group's previous work, and a Compound Discoverer software search. Statistically significant differences were found in the chemical composition and content of bitter almonds in different storage states, storage times, and storage temperatures. The results show that the chemical composition of bitter almonds stored unmashed was more stable than that of bitter almonds stored mashed; the chemical composition of bitter almonds stored at 4 ℃ was more stable than that of bitter almonds stored at 25 ℃; and the shorter the storage time, the less the chemical composition changed. Amygdalin, the main medicinal component of bitter almonds, showed statistically significant differences in content under the above three storage conditions, which can be used as a potential quality marker for bitter almonds.