Cylindrical Vector Beam Holography without Preservation of OAM Modes.

Orbital angular momentum (OAM) multiplexed holograms have attracted a great deal of attention recently due to their physically unbounded set of orthogonal helical modes. However, preserving the OAM property in each pixel hinders fine sampling of the target image in principle and requires a fundamental filtering aperture array in the detector plane. Here, we demonstrate the concept of metasurface-based vectorial holography with cylindrical vector beams (CVBs), whose unlimited polarization orders and unique polarization distributions can be used to boost information storage capacity. Although CVBs are composed of OAM modes, the holographic images do not preserve the OAM modes in our design, enabling fine sampling of the target image in a quasi-continuous way like traditional computer-generated holograms. Moreover, the images can be directly observed by passing them through a polarizer without the need for a fundamental mode filter array. We anticipate that our method may pave the way for high-capacity holographic devices.

Programable sewage-cleaning technology: Regenerating chitosan biofilms with anti-bacterial capacity via self-purification of water pollutants.

In this paper, a novel programable sewage-cleaning technology for the regeneration of antibacterial nanocomposites via the removal of wastewater pollutants is presented. Montmorillonite (MMT) was encapsulated in poly(vinyl alcohol) (PVA)-enhanced chitosan (CTS) hydrogels to form MMT-loaded nanocomposite biofilms (PCM). The PCM nanocomposite biofilms exhibited increased breaking strength and elongation at break, by factors of approximately 1.38 and 1.40, respectively, compared with those of the pure PVA/CTS biofilms. The maximum adsorption capacity of the PCM nanocomposite biofilms toward tetracycline and Ag(I) is 275.0 and 567.0 mg/g, respectively. The adsorbed nanocomposite biofilms exhibited excellent antibacterial properties against Staphylococcus aureus and Escherichia coli. Meanwhile, the nanocomposite also showed an effective adsorption capacity toward other toxic components, where the highest adsorption capacity is 2748.0 mg/g (for methyl blue). The simulation results indicated that the adsorption behaviors of the malachite green, neutral red, methyl blue, tetracycline, Cu(II), Zn(II), and Ag(I) by the PCM nanocomposite biofilms followed pseudo-second-order kinetic and Freundlich isotherm models. Furthermore, the PCM nanocomposite biofilms are stable in PBS solution but degradable in lysozyme-containing PBS solution, suggesting their potential application in the wastewater treatment as well as antibacterial fields.

Exploring Schizophrenia Classification Through Multimodal MRI and Deep Graph Neural Networks: Unveiling Brain Region-Specific Weight Discrepancies and Their Association With Cell-Type Specific Transcriptomic Features.

BACKGROUND AND HYPOTHESIS: Schizophrenia (SZ) is a prevalent mental disorder that imposes significant health burdens. Diagnostic accuracy remains challenging due to clinical subjectivity. To address this issue, we explore magnetic resonance imaging (MRI) as a tool to enhance SZ diagnosis and provide objective references and biomarkers. Using deep learning with graph convolution, we represent MRI data as graphs, aligning with brain structure, and improving feature extraction, and classification. Integration of multiple modalities is expected to enhance classification. STUDY DESIGN: Our study enrolled 683 SZ patients and 606 healthy controls from 7 hospitals, collecting structural MRI and functional MRI data. Both data types were represented as graphs, processed by 2 graph attention networks, and fused for classification. Grad-CAM with graph convolution ensured interpretability, and partial least squares analyzed gene expression in brain regions. STUDY RESULTS: Our method excelled in the classification task, achieving 83.32% accuracy, 83.41% sensitivity, and 83.20% specificity in 10-fold cross-validation, surpassing traditional methods. And our multimodal approach outperformed unimodal methods. Grad-CAM identified potential brain biomarkers consistent with gene analysis and prior research. CONCLUSIONS: Our study demonstrates the effectiveness of deep learning with graph attention networks, surpassing previous SZ diagnostic methods. Multimodal MRI's superiority over unimodal MRI confirms our initial hypothesis. Identifying potential brain biomarkers alongside gene biomarkers holds promise for advancing objective SZ diagnosis and research in SZ.

Eggshell-Like Carbon Microspheres with Curvature Scheme: Distorted Energy Band and Atomic Charge Waves-Driven High Performance for Zinc-Air Battery.

A metal-free nanocarbon with an eggshell structure is synthesized from chitosan (CS) and natural spherical graphite (NSG) as a cathode electrocatalyst for clean zinc-air batteries and fuel cells. It is developed using CS-derived carbons as an eggshell, covering NSG cores. The synthesis involves the in situ growth of CS on NSG, followed by ammonia-assisted pyrolysis for carbonization. The resulting catalyst displays a curved structure and completely coated NSG, showing superior oxygen reduction reaction (ORR) performance. In 1 M NaOH, the ORR half-wave potential reached 0.93 V, surpassing the commercial Pt/C catalyst by 50 mV. Furthermore, a zinc-air battery featuring the catalyst achieves a peak power density of 167 mW cm-2 with excellent stability, outperforming the Pt/C. The improved performance of the eggshell carbons can be attributed to the distorted energy band of the active sites in the form of N-C moieties. More importantly, the curved thin eggshells induce built-in electric fields that can promote electron redistribution to generate atomic charge waves around the N-C moieties on the carbon shells. As a result, the high positively charged and stable C+ sites adjacent to N atoms optimize the adsorption strength of oxygen molecules, thereby facilitating performance.

Overexpression of sweetpotato glutamylcysteine synthetase (IbGCS) in Arabidopsis confers tolerance to drought and salt stresses.

Various environmental stresses induce the production of reactive oxygen species (ROS), which have deleterious effects on plant cells. Glutathione (GSH) is an antioxidant used to counteract reactive oxygen species. Glutathione is produced by glutamylcysteine synthetase (GCS) and glutathione synthetase (GS). However, evidence for the GCS gene in sweetpotato remains scarce. In this study, the full-length cDNA sequence of IbGCS isolated from sweetpotato cultivar Xu18 was 1566 bp in length, which encodes 521 amino acids. The qRT-PCR analysis revealed a significantly higher expression of the IbGCS in sweetpotato flowers, and the gene was induced by salinity, abscisic acid (ABA), drought, extreme temperature and heavy metal stresses. The seed germination rate, root elongation and fresh weight were promoted in T3 Arabidopsis IbGCS-overexpressing lines (OEs) in contrast to wild type (WT) plants under mannitol and salt stresses. In addition, the soil drought and salt stress experiment results indicated that IbGCS overexpression in Arabidopsis reduced the malondialdehyde (MDA) content, enhanced the levels of GCS activity, GSH and AsA content, and antioxidant enzyme activity. In summary, overexpressing IbGCS in Arabidopsis showed improved salt and drought tolerance.

Ring-Opening Polymerization of Cyclohexene Oxide and Cycloaddition with CO2 Catalyzed by Amine Triphenolate Iron(III) Complexes.

A series of novel amine triphenolate iron complexes were synthesized and characterized using UV, IR, elemental analysis, and high-resolution mass spectrometry. These complexes were applied to the ring-opening polymerization (ROP) of cyclohexene oxide (CHO), demonstrating excellent activity (TOF > 11050 h-1) in the absence of a co-catalyst. In addition, complex C1 maintained the dimer in the presence of the reaction substrate CHO, catalyzing the ring-opening polymerization of CHO to PCHO through bimetallic synergy. Furthermore, a two-component system consisting of iron complexes and TBAB displayed the ability to catalyze the reaction of CHO with CO2, resulting in the formation of cis-cyclic carbonate with high selectivity. Complex C4 exhibited the highest catalytic activity, achieving 80% conversion of CHO at a CHO/C4/TBAB molar ratio of 2000/1/8 and a CO2 pressure of 3 MPa for 16 h at 100 °C, while maintaining >99% selectivity of cis-cyclic carbonates, which demonstrated good conversion and selectivity.

Flooding Performance and Optimization of Injection Parameters of Nanosized Oil Displacement Agents in Extra-Low-Permeability Reservoirs.

There have been few studies on the role of nanofluids in oil displacement and injection parameters, despite their significant impact on the oil displacement effect. To enhance oil recovery in an ultralow-permeability reservoir, the nanosized oil-displacement agent with nano-SiO2 modified by a silane coupling agent as a main component was selected for the first time in the Changqing oilfield. To assess the performance of the nanofluid, various factors such as particle size, contact angle, interfacial tension, and emulsion stability were taken into consideration. The oil displacement effect of nanofluids was evaluated by a microscopic model and ultralow-permeability core displacement experiment, and its optimal injection parameters were determined. The average particle size of the nano-oil displacement agent is 22-30 nm. It can change the wetting condition of the rock from oil-wet to water-wet and reduce the oil-water interfacial tension. Even at 80 °C, the emulsion formed by the agent remained stable. The oil displacement experiment shows that the nano-oil displacement agent whose injection pressure increases can displace the residual oil trapped in small pores that cannot be affected by conventional water flooding. The injection mode of "nanoflooding agent drive + water drive + nanoflooding agent drive", injection rate of 0.1 mL/min, injection concentration of 0.5%, and injection volume of 0.5 PV (0.25 PV per segment), which can effectively guide the injection of the oil displacement agent, achieve the best oil displacement effect.

Experimental study on I/II/III mixed mode fracture characteristics of a combined rock mass under creep loading.

I/II/III mixed mode fractures of intersecting joint fissures often occur in natural rock masses, and jointed rock masses are prone to rockbursts in deep underground engineering when subjected to long-term crustal stresses. However, most studies of the mechanical mechanisms of these intersected joints have been conducted by simplifying two-dimensional joint model tests. Furthermore, the fracture mechanisms of two-dimensional intersected joints under tension and compression are completely different from those of three-dimensional joints. This paper presents a novel prefabricated specimen with combinations of intersecting joints capable of detecting the failure behaviours of rock I/II/III mixed mode fractures under creep loading. Uniaxial compression and multistage creep tests are performed on prefabricated sandstone specimens with intersecting joints of 0°/0°, 0°/30°, 0°/60°, and 0°/90°. The experimental results show that with the increase in the number of prefabricated intersecting joints, the uniaxial compressive strength and elastic modulus values of the sandstone specimens gradually decrease. In addition, the sandstone specimens experience relatively few AE events and minor axial strain variations in the first creep stage and the second creep stage of the multistage creep test. The axial strain increases sharply due to the sharp increase in the number of AE events in the third creep stage. The 0°/60° sandstone specimen undergoes accelerated creep failure, resulting in mixed X-shaped tensile‒shear rupture. The RA value is high based on the quantification of the creeping cracks using the acoustic emission parameters of the rise angle (RA) and average frequency (AF). The AF values of the 0°/0°, 0°/30°, and 0°/90° sandstone specimens are high. The experimental results show that a larger joint intersection angle leads to greater mutual restraints and greater effects of prefabricated crack propagation in the rock specimens, thus increasing the final failure strength. Finally, based on the acoustic emission count, a characteristic variable D suitable for characterizing the creep damage evolution of a joint rock mass is established. The findings of this paper can facilitate an effective understanding of the creep effect of I/II/III mixed mode fracture and its micromechanism. The research results will have a certain reference value for the detection and risk mitigation of instantaneous and time-delayed rockbursts.

Pharmacologic profile of ITI-333: a novel molecule for treatment of substance use disorders.

RATIONALE: Medications are urgently needed to treat symptoms of drug withdrawal and mitigate dysphoria and psychiatric comorbidities that drive opioid abuse and relapse. ITI-333 is a novel molecule in development for treatment of substance use disorders, psychiatric comorbidities, and pain. OBJECTIVE: Characterize the preclinical profile of ITI-333 using pharmacological, behavioral, and physiological assays. METHODS: Cell-based assays were used to measure receptor binding and intrinsic efficacy of ITI-333; animal models were employed to assess effects on opioid reinstatement, precipitated oxycodone withdrawal, and drug abuse liability. RESULTS: In vitro, ITI-333 is a potent 5-HT2A receptor antagonist (Ki = 8 nM) and a biased, partial agonist at µ-opioid (MOP) receptors (Ki = 11 nM; lacking ß-arrestin agonism) with lesser antagonist activity at adrenergic α1A (Ki = 28 nM) and dopamine D1 (Ki = 50 nM) receptors. In vivo, ITI-333 blocks 5-HT2A receptor-mediated head twitch and MOP receptor-mediated effects on motor hyperactivity in mice. ITI-333 alone is a naloxone-sensitive analgesic (mice) which suppresses somatic signs of naloxone-precipitated oxycodone withdrawal (mice) and heroin cue-induced reinstatement responding without apparent tolerance or physical dependence after chronic dosing (rats). ITI-333 did not acutely impair gastrointestinal or pulmonary function (rats) and was not intravenously self-administered by heroin-maintained rats or rhesus monkeys. CONCLUSIONS: ITI-333 acts as a potent 5-HT2A receptor antagonist, as well a biased MOP receptor partial agonist with low intrinsic efficacy. ITI-333 mitigates opioid withdrawal/reinstatement, supporting its potential utility as a treatment for OUD.

Spatial response of urban land use intensity to ecological networks: a case study of Xi'an Metropolitan Region, China.

In the face of the persistent degradation of ecological environments and fragmentation of ecological networks brought about by rapid urbanization, this study focuses on examining the interaction between urban land use intensity and ecological networks in the Xi'an Metropolitan Region (XAMR), China, and their impact on ecological equilibrium and sustainable development. By comprehensively evaluating the changes in land use intensity in XAMR from 2010 to 2020, the aim is to underscore the pivotal role of ecological networks in maintaining urban ecological balance and promoting sustainable development. The findings indicate a transition in land use intensity in the XAMR from low to high concentration, reflecting an intensification in land resource utilization during urbanization. However, the establishment and management of ecological networks can significantly enhance urban ecological security and biodiversity. Notably, this research identified crucial ecological corridors and source areas, augmenting the connectivity of urban green infrastructure and providing vital support for urban biodiversity. Additionally, a significant finding of this study is the spatial spillover effects generated by socioeconomic factors such as the proportion of tertiary and secondary industries and per capita GDP through the ecological network, which have profound impacts on land use intensity in the surrounding areas. These insights offer a novel understanding of the complex interactions within urban ecosystems, emphasizing the importance of incorporating ecological network construction in urban planning. Overall, through a comprehensive analysis of the relationship between the ecological network and land use intensity in the XAMR, this study proposes new directions for urban ecosystem management and land use planning, highlighting the significance of scientific ecological network planning and management in achieving long-term sustainable development in urbanization processes.

Efficacy of Chinese Medicine Treatment Based on Syndrome Differentiation for Primary Insomnia: A Randomized Placebo Controlled Triple-Blinded Trial.

OBJECTIVE: To assess efficacy of Chinese medicine (CM) on insomnia considering characteristics of treatment based on syndrome differentiation. METHODS: A total of 116 participants aged 18 to 65 years with moderate and severe primary insomnia were randomized to the placebo (n=20) or the CM group (n=96) for a 4-week treatment and a 4-week follow-up. Three CM clinicians independently prescribed treatments for each patient based on syndromes differentiation. The primary outcome was change in total sleep time (TST) from baseline. Secondary endpoints included sleep onset latency (SOL), wake time after sleep onset (WASO), sleep efficiency, Pittsburgh Sleep Quality Index (PSQI) and CM symptoms. RESULTS: The CM group had an average 0.6 h more (95% confidence interval (CI): 0.3-0.9, P<0.001) TST and 34.1% (10.3%-58.0%, P=0.005) more patients beyond 0.5 h TST increment than that of the placebo group. PSQI was changed -3.3 (-3.8 to -2.7) in the CM group, a -2.0 (-3.2 to -0.8, P<0.001) difference from the placebo group. The CM symptom score in the CM group decreased -2.0 (-3.3 to -0.7, P=0.003) more than the placebo group. SOL and WASO changes were not significantly different between groups. The analysis of prescriptions by these clinicians revealed blood deficiency and Liver stagnation as the most common syndromes. Prescriptions for these clinicians displayed relative stability, while the herbs varied. All adverse events were mild and were not related to study treatment. CONCLUSION: CM treatment based on syndrome differentiation can increase TST and improve sleep quality of primary insomnia. It is effective and safe for primary insomnia. In future studies, the long-term efficacy validation and the exploratory of eutherapeutic clinicians' fixed herb formulas should be addressed (Registration No. NCT01613183).

Multifunctional Nanocarrier for Synergistic Treatment of Alzheimer's Disease by Inhibiting ß-Amyloid Aggregation and Scavenging Reactive Oxygen Species.

The excessive depositions of ß-amyloid (Aß) and abnormal level of reactive oxygen species (ROS) are considered as the important pathogenic factors of Alzheimer's disease (AD). Strategies targeting only one of them have no obvious effects in clinic. In this study, a multifunctional nanocarrier CICe@M-K that crosses the blood-brain barrier (BBB) efficiently was developed for inhibiting Aß aggregation and scavenging ROS synchronously. Antioxidant curcumin (Cur) and photosensitizer IR780 were loaded in mesoporous silica nanomaterials (MSNs). Their surfaces were grafted with cerium oxide nanoparticles (CeO2 NPs) and a short peptide K (CKLVFFAED). Living imaging showed that CICe@M-K was mainly distributed in the brain, liver, and kidneys, indicating CICe@M-K crossed BBB efficiently and accumulated in brain. After the irradiation of 808 nm laser, Cur was continuously released. Both of Cur and the peptide K can recognize and bind to Aß through multiple interaction including π-π stacking interaction, hydrophobic interaction, and hydrogen bond, inhibiting Aß aggregation. On the other hand, Cur and CeO2 NPs cooperate to relieve the oxidative stress in the brains by scavenging ROS. In vivo assays showed that the CICe@M-K could diminish Aß depositions, alleviate oxidative stress, and improve cognitive ability of the APP/PS1 AD mouse model, which demonstrated that CICe@M-K is a potential agent for AD treatment.

Tightly focusing metalens based on the high order Bessel function.

We propose a new, to the best of our knowledge, type of metalens of which the phase profile is extracted from the higher-order Bessel function. A light beam passing through this metalens would focus along the circular trajectory and produces a tightly focusing field. Utilizing phase binarization, we provide a method to design the geometric-phase dielectric metasurface both for phase and polarization modulations. We demonstrate two metalenses for circularly and radially polarized output beams at 633 nm, with the measured 0.737λ and 0.616λ focal spots, respectively. Theoretically, it can realize a super-diffraction-limit spot (0.38λ). This work can extend the way of realizing tightly focused optical devices.

Association of Lipoprotein(a) Levels With Myocardial Infarction in Patients With Low-Attenuation Plaque.

BACKGROUND: Lipoprotein(a) (Lp[a]) is associated with an increased risk of myocardial infarction (MI). However, the mechanism underlying this association has yet to be fully elucidated. OBJECTIVES: This multicenter study aimed to investigate whether association between Lp(a) and MI risk is reinforced by the presence of low-attenuation plaque (LAP) identified by coronary computed tomography angiography (CCTA). METHODS: In a derivation cohort, a total of 5,607 patients with stable chest pain suspected of coronary artery disease who underwent CCTA and Lp(a) measurement were prospectively enrolled. In validation cohort, 1,122 patients were retrospectively collected during the same period. High Lp(a) was defined as Lp(a) ≥50 mg/dL. The primary endpoint was a composite of time to fatal or nonfatal MI. Associations were estimated using multivariable Cox proportional hazard models. RESULTS: During a median follow-up of 8.2 years (Q1-Q3: 7.2-9.3 years), the elevated Lp(a) levels were associated with MI risk (adjusted HR [aHR]: 1.91; 95% CI: 1.46-2.49; P < 0.001). There was a significant interaction between Lp(a) and LAP (Pinteraction <0.001) in relation to MI risk. When stratified by the presence or absence of LAP, Lp(a) was associated with MI in patients with LAP (aHR: 3.03; 95% CI: 1.92-4.76; P < 0.001). Mediation analysis revealed that LAP mediated 73.3% (P < 0.001) for the relationship between Lp(a) and MI. The principal findings remained unchanged in the validation cohort. CONCLUSIONS: Elevated Lp(a) augmented the risk of MI during 8 years of follow-up, especially in patients with LAP identified by CCTA. The presence of LAP could reinforce the relationship between Lp(a) and future MI occurrence.

Regulatory effect of Yinchenhao decoction on bile acid metabolism to improve the inflammatory microenvironment of hepatocellular carcinoma in mice.

Hepatocellular carcinoma (HCC) is a malignant tumor with extremely high mortality. The tumor microenvironment is the "soil" of its occurrence and development, and the inflammatory microenvironment is an important part of the "soil". Bile acid is closely related to the occurrence of HCC. Bile acid metabolism disorder is not only directly involved in the occurrence and development of HCC but also affects the inflammatory microenvironment of HCC. Yinchenhao decoction, a traditional Chinese medicine formula, can regulate bile acid metabolism and may affect the inflammatory microenvironment of HCC. To determine the effect of Yinchenhao decoction on bile acid metabolism in mice with HCC and to explore the possible mechanism by which Yinchenhao decoction improves the inflammatory microenvironment of HCC by regulating bile acid metabolism, we established mice model of orthotopic transplantation of hepatocellular carcinoma. These mice were treated with three doses of Yinchenhao decoction, then liver samples were collected and tested. Yinchenhao decoction can regulate the disorder of bile acid metabolism in liver cancer mice. Besides, it can improve inflammatory reactions, reduce hepatocyte degeneration and necrosis, and even reduce liver weight and the liver index. Taurochenodeoxycholic acid, hyodeoxycholic acid, and taurohyodeoxycholic acid are important molecules in the regulation of the liver inflammatory microenvironment, laying a foundation for the regulation of the liver tumor inflammatory microenvironment based on bile acids. Yinchenhao decoction may improve the inflammatory microenvironment of mice with HCC by ameliorating hepatic bile acid metabolism.

Stepwise Synthesis of Low-Symmetry Hexacationic Pyridinium Organic Cages.

An efficient approach was developed for the synthesis of the well-known BlueCage by pre-bridging two 2,4,6-tris(4-pyridyl)-1,3,5-triazine (TPT) panels with one linker followed by cage formation in a much improved yield and shortened reaction time. Such a stepwise methodology was further applied to synthesize three new pyridinium organic cages, C2, C3, and C4, where the low-symmetry cages C3 and C4 with angled panels demonstrated better recognition properties toward 1,1'-bi-2-naphthol (BINOL) than the high-symmetry analogue C2 featuring parallel platforms.

MicroRNA-142-3p alleviated high salt-induced cardiac fibrosis via downregulating optineurin-mediated mitophagy.

High salt can induce cardiac damage. The aim of this present study was to explore the effect and the mechanism of microRNA (miR)-142-3p on the cardiac fibrosis induced by high salt. Rats received high salt diet to induce cardiac fibrosis in vivo, and neonatal rat cardiac fibroblasts (NRCF) treated with sodium chloride (NaCl) to induce fibrosis in vitro. The fibrosis and mitochondrial autophagy levels were increased the heart and NRCF treated with NaCl, which were alleviated by miR-142-3p upregulation. The fibrosis and mitochondrial autophagy levels were elevated in NRCF after treating with miR-142-3p antagomiR. Optineurin (OPTN) expression was increased in the mitochondria of NRCF induced by NaCl, which was attenuated by miR-142-3p agomiR. OPTN downregulation inhibited the increases of fibrosis and mitochondrial autophagy levels induced by NaCl in NRCF. These results miR-142-3p could alleviate high salt-induced cardiac fibrosis via downregulation of OPTN to reduce mitophagy.

Optofluidic crystallithography for directed growth of single-crystalline halide perovskites.

Crystallization is a fundamental phenomenon which describes how the atomic building blocks such as atoms and molecules are arranged into ordered or quasi-ordered structure and form solid-state materials. While numerous studies have focused on the nucleation behavior, the precise and spatiotemporal control of growth kinetics, which dictates the defect density, the micromorphology, as well as the properties of the grown materials, remains elusive so far. Herein, we propose an optical strategy, termed optofluidic crystallithography (OCL), to solve this fundamental problem. Taking halide perovskites as an example, we use a laser beam to manipulate the molecular motion in the native precursor environment and create inhomogeneous spatial distribution of the molecular species. Harnessing the coordinated effect of laser-controlled local supersaturation and interfacial energy, we precisely steer the ionic reaction at the growth interface and directly print arbitrary single crystals of halide perovskites of high surface quality, crystallinity, and uniformity at a high printing speed of 102 µm s-1. The OCL technique can be potentially extended to the fabrication of single-crystal structures beyond halide perovskites, once crystallization can be triggered under the laser-directed local supersaturation.

The role of traditional Chinese medicine on fracture surgery, hospitalization, and total mortality risks in diabetic patients with osteoporosis.

BACKGROUND: Studies have confirmed that osteoporosis has been considered as one of the complications of diabetes, and the health hazards to patients are more obvious. This study is mainly based on the Taiwan National Health Insurance Database (TNHID). Through the analysis of TNHID, it is shown that the combined treatment of traditional Chinese medicine (TCM) medicine in patients of diabetes with osteoporosis (T2DOP) with lower related risks. METHODS: According to the study design, 3131 patients selected from TNHID who received TCM treatment were matched by 1-fold propensity score according to gender, age, and inclusion date as the control group. Cox proportional hazards analyzes were performed to compare fracture surgery, hospitalization, and all-cause mortality during a mean follow-up from 2000 to 2015. RESULTS: A total of 1055/1469/715 subjects (16.85%/23.46%/11.42%) had fracture surgery/inpatient/all-cause mortality of which 433/624/318 (13.83%/19.93%/10.16%) were in the TCM group) and 622/845/397 (19.87%/26.99%/12.68%) in the control group. Cox proportional hazards regression analysis showed that subjects in the TCM group had lower rates of fracture surgery, inpatient and all-cause mortality (adjusted HR = 0.467; 95% CI = 0.225-0.680, P<0.001; adjusted HR = 0.556; 95% CI = 0.330-0.751, P<0.001; adjusted HR = 0.704; 95% CI = 0.476-0.923, P = 0.012). Kaplan-Meier analysis showed that the cumulative risk of fracture surgery, inpatient and all-cause mortality was significantly different between the case and control groups (all log-rank p<0.001). CONCLUSION: This study provides longitudinal evidence through a cohort study of the value of integrated TCM for T2DOP. More research is needed to fully understand the clinical significance of these results.