Objective To investigate the distribution of homeostasis model assessment-insulin resistance(HOMA-IR)index and its relationship with metabolic syndrome and inflammatory cytokines in students aged 7 to 14 years. Methods The data of 366 students(n=163 for boys and n=203 for girls) aged 7 to 14 years were collected,including anthropometric parameters (height,body weight,body mass index,waist circumference,hip circumference and waist-hip ratio),blood pressure,total fat mass,fat proportion,fasting blood lipid,fasting blood glucose,fasting insulin and serum levels of inflammatory cytokines such as tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)and interleukin-6(IL-6),and insulin resistance was evaluated by HOMA-IR index. Results The 75 th percentile of HOMA-IR index for boys and girls was 3.62 and 2.88,respectively.Body weight,height,body mass index,waist circumference,hip circumference,total fat mass and fat proportion were positively related to HOMA-IR index(P<0.01).When HOMA-IR index surpassed 75th percentile,age,anthropometric parameters,total fat mass,fat proportion and systolic blood pressure significantly increased in boy and girl students(P<0.05),no significant change occurred in diastolic blood pressure in boy and girl students,the levels of serum TNF-α and IL-6 significantly increased in boy students(P<0.05),while there was no significant change in level of CRP in boy students and levels of CRP.TNF-α and IL-6 in girl students. Conclusion The increase of HOMA-IR index leads to a dramatic increase of anthropometrie parameters,total fat mass,fat proportion and serum TNF-α and IL-6 in boy students,while that results in the increase of anthropometric parameters,total fat mass and fat proportion in sid students,with no significant change in serum inflammatory cytokines.

Objective:To investigate the effect of cornus officinalis glycoside on intestinal mucosal barrier in septic rats and its possible mechanism of action.Methods:A total of 90 Sprague-Dawley (SD) rats were randomly divided into a sham operation group, a model group, a dexamethasone group (10 mg/kg), a low-dose group of cornus officinalis glycoside (12.5 mg/kg), a medium dose group of cornus officinalis glycoside (25 mg/kg), and a high-dose group of cornus officinalis glycoside (50 mg/kg), with 15 rats in each group. Except for the sham surgery group, all other groups of rats were treated with cecal ligation and puncture (CLP) to prepare sepsis models. Drug intervention was administered via tail vein injection, and serum and ileal tissue were collected from rats 24 hours after surgery. Hematoxylin eosin staining (HE) was used to observe the pathological damage of the small intestinal mucosa; Enzyme linked immunosorbent assay (ELISA) was used to detect the levels of intestinal fatty acid binding protein (I-FABP) and diamine oxidase (DAO), markers of mucosal barrier permeability, as well as the levels of small intestinal mucosal secreted immunoglobulin (sIgA) in serum; The FITC Dextran tracer method was used to detect intestinal mucosal permeability; ELISA method was used to detect the expression levels of interleukin-1 β (IL-1β), interleukin-6 (IL-6), interleukin-18 (IL-18), and tumor necrosis factor -α (TNF-α) in serum; Western blot was used to detect the protein expression levels of nuclear transcription factor (NF-κB) p65, p-NF-κB p65, NOD like receptor heat protein domain associated protein 3 (NLRP3), and cysteine containing aspartic protease 1 (caspase-1) in small intestine tissue.Results:HE staining results showed that compared with the sham surgery group, the model group rats had a loss of intestinal mucosal structure, shortened villi, and infiltration of inflammatory cells; Compared with the model group, the intestinal mucosal structure of rats in the middle and high dose groups of cornus officinalis glycoside and dexamethasone group was relatively intact, with tightly arranged villi and reduced infiltration of inflammatory cells. However, the pathological improvement of intestinal mucosal structure, villi arrangement, and infiltration of inflammatory cells in rats in the low dose group of cornus officinalis glycoside was not significant. The levels of I-FABP and DAO in the serum of the model group rats were significantly higher than those in the sham operation group (all P<0.05), and the level of sIgA in the intestinal mucosa was lower than that in the sham operation group ( P<0.05). The serum levels of I-FABP and DAO in the high-dose and dexamethasone groups of cornus officinalis glycosides were lower than those in the model group (all P<0.05), and the intestinal mucosal sIgA level was higher than that in the model group ( P<0.05). However, there was no statistically significant difference in the serum levels of I-FABP, DAO, and intestinal mucosal sIgA between the low-dose cornus officinalis glycosides group and the model group (all P>0.05). The serum FITC Dextran content in the model group rats was higher than that in the sham operation group ( P<0.05); The levels of FITC Dextran in the serum of rats in the middle and high dose groups of cornus officinalis glycoside and dexamethasone group were lower than those in the model group (all P<0.05), while there was no statistically significant difference in the levels of FITC Dextran in the serum of rats in the low dose group of cornus officinalis glycoside compared with the model group ( P>0.05). The levels of IL-1 β, TNF - α, IL-6, and IL-18 in the serum of the model group rats were higher than those in the sham operation group (all P<0.05); The levels of IL-1 β, TNF-α, IL-6, and IL-18 in the serum of rats in the high-dose and dexamethasone groups of cornus officinalis glycoside were lower than those in the model group (all P<0.05), while there was no statistically significant difference in various indicators between the low-dose cornus officinalis glycoside group and the model group (all P>0.05). The protein expression levels of p-NF-κB p65/NF-κB p65, NLRP3, and caspase-1 in the small intestine tissue of the model group rats were higher than those in the sham operation group (all P<0.05); The protein expression levels of p-NF-κB p65/NF-κB p65, NLRP3, and caspase-1 in the small intestine tissues of rats in the high-dose and dexamethasone groups of cornus officinalis glycoside were lower than those in the model group ( P<0.05), while there was no statistically significant difference in the protein expression levels between the low-dose cornus officinalis glycoside group and the model group (all P>0.05). Conclusions:Cornus officinalis glycoside has a certain improvement effect on intestinal mucosal barrier dysfunction in septic rats, and its mechanism may be related to the inhibition of NF-κ B/NLRP3 signaling pathway activation.

Bone organoids can simulate the complex structure and function of the bone tissues, which makes them a frontier technology in organoid researches. Bone organoids show a tremendous potential of applications in bone disease modeling, bone injury repair, and medicine screening. Although advancements have been made so far in constructing bone organoids with functional structures like mineralization, bone marrow, trabecular bone, callus, woven bone, etc, the researches in this field are confronted with numerous challenges such as lack of standardized construction strategies and unified evaluation criteria, which limits their further promotion and application. To standardize researches in bone organoids, the Orthopedic Expert Committee of Geriatric Branch of Chinese Association of Gerontology and Geriatrics, the Youth Osteoporosis Group of Orthopedic Branch of Chinese Medical Association, the Osteoporosis Group of Orthopedic Surgeon Branch of Chinese Medical Doctor Association, and the Osteoporosis Committee of Shanghai Association of Integrated Traditional Chinese and Western Medicine organized related experts to formulate Expert consensus on the construction, evaluation, and application of bone organoids ( version 2024) based on an evidence-based approach. A total of 17 recommendations were put forth, aiming to standardize researches and clinical applications of bone organoids and enhance their value in scientific research and clinical practice.

A comprehensive analytical method based on UPLC-MS/MS was developed for the simultaneous determination of thirteen components including three stilbenes (stilbeneglucoside, polydatin, resveratrol), four anthraquinones (emodin, physcion, emodin-8-β-D-glucopyranoside, aloe-emodin), five flavonoids (epicatechin, rutin, hyperoside, astragalin,quercetin) and one phenolic acid (gallic acid) in Polygoni Multifori Caulis.The separation was carried out on a Waters BEH C18 column（2.1 mm×100 mm,1.7 μm）with gradient elution of acetonitrile-water (0.1% acetic acid) at a flow rate of 0.25 mL•min⁻¹, and column temperature was 35 ℃. The target compounds were analyzed by multiple reaction monitoring (MRM) mode. TOPSIS analysis ware performed to evaluate the samples from different areas and commercial herbs according to the contents of thirteen components. The correlation coefficients of all the calibration curves were higher than 0.991 5. The average recoveries ranged from 95.24% to 102.3%, and the relative standard deviations were less than 5%. The result of TOPSIS analysis showed that the comprehensive quality of Polygoni Multifori Caulis sample from Guangzhou was better. The developed method with good repeatability and accuracy was suitable for the simultaneous determination of multiple functional substances, which provided a new basis for the comprehensive assessment and overall control of the quality of Polygoni Multifori Caulis.

Objective:To evaluate the effect of ultrasound-guided subserratus anterior plane block on postoperative analgesia in patients un-dergoing laparoscopic radical gastrectomy.Methods:Sixty patients who underwent elective laparoscopic radical gastrectomy were enrolled between May 2022 and October 2023 at Tianjin Medical University Cancer Institute&Hospital.Patients were assigned into two groups us-ing a random number table method:the control(group C)and the ultrasound-guided serratus anterior plane block(SAPB)(group S).Patient-controlled intravenous analgesia(PCIA)was administered at the end of the surgery.After surgery,visual analogue scale(VAS)of static pain scores was evaluated at 1,6,12,24,and 48 hours.PCIA pump was started at the VAS pain score≥4 after surgery,and sufentanil 0.1μg/kg was intravenously injected when the efficacy was inadequate.The requirement for PCIA use,time to first postoperative anal exhaust,first postoperative out-of-bed activity,first oral intake,and the duration of hospitalization stay were recorded for the two groups.Results:VAS scores were significantly lower at postoperative 1,6,and 12 h in group S than in group C(P<0.05).Additionally,the number of effective uses of PCIA,and rescue analgesia were significantly lower in group S[(6.1±0.4)(2)]than in group C[(18.6±1.4)(17)](P<0.001).The time to first postoperative anal exhaust,first postoperative out-of-bed activity,first oral intake,and duration of hospital stay were shortened in group S than in group C(P<0.05).There were no significant differences in other parameters between these two groups.Conclusion:Ultrasound-guided SAPB can reduce postoperative pain and facilitate fast recovery in laparoscopic radical gastrectomy patients.

Objective:To evaluate the clinical efficacy and safety of Longmu Zhuanggu granule for the treatment of children recurrent respiratory infection due to lung-spleen Qi deficiency. Method:This multicenter stratified， block-randomized， double-blind， double-dummy， positive drug （pidotimod granule） parallel controlled， and non-inferiority trail intended to included 240 children patients and divided them into the experimental group （n=120） and the control group （n=120） at the ratio of 1∶1. Patients in both groups were treated for eight successive weeks and followed up for 12 months. The cure rates， numbers of respiratory infections， average courses of disease， curative effects of traditional Chinese medicine （TCM） syndrome， curative effects of individual symptoms， curative effects of immune indexes， and safety indexes between the two groups were observed and compared. Result:A total of 237 subjects were collected from 10 research centers， including 119 cases in the control group and 118 in the experimental group. There were 236 cases enrolled into the full analysis set （FAS）， 210 into the per-protocol set （PPS）， and 236 into the safety set （SS）. The baseline data of the two groups were not significantly different from each other， indicating that they were comparable. The cure rates of the experimental group and control group were 75.21% （88/117） and 73.95%（88/119）， respectively， with the 95% confidence interval （CI） of difference between the two groups being 1.26% （-9.85%，12.37%） for FAS and 3.81% （-6.28%，13.90%） for PPS. The 95% CI fell within the 10% non-inferiority margin， implying that non-infertility test of the cure rate in the treatment of endpoint disease was valid， and the conclusions of FAS and PPS analysis were consistent. There was no significant difference in the number or course of upper respiratory infection， bronchitis， and pneumonia. The difference in curative effects of TCM syndrome between the two groups after four weeks of treatment was not remarkable. After eight weeks of treatment， the total effective rate of the experimental group was 84.62%（99/117）， statistically higher than 78.15%（93/119） of the control group（χ²=-3.26，P<0.05）. There were no significant differences in the disappearance rates of individual symptoms between the two groups after four weeks of treatment. After eight weeks of treatment， the experimental group and control group exhibited the disappearance rates of 67.50%（54/80） and 47.37%（36/76） for shortness of breath and laziness to speak， 75.00%（54/72） and 53.33%（40/75） for poor appetite， 54.55%（60/110） and 37.84%（42/111） for hyperhidrosis， respectively， with obviously better outcomes observed in the experimental group （P<0.05，P<0.01）. The inter-group comparison revealed significant differences in immune indexes after eight weeks of treatment. As demonstrated by comparison with the situations before treatment， IgA， IgG， IgM， and CD4 did not change significantly after treatment. Except for CD8 in the experimental group (P<0.05), there was no significant difference in other immune indexes before and after treatment There was no significant difference in the incidence of adverse reactions. Conclusion:Longmu Zhuanggu granule is not inferior to pidomod granule in the treatment of children recurrent respiratory infection due to lung-spleen Qi deficiency， and it exhibits good safety， implying its promising clinical application value.

Xiaoji Yinzi is one of the classic prescriptions for treating urinary diseases， originated from the Yan's Prescriptions to Aid the Living （Yan Shi Ji Sheng Fang） written by YAN Yonghe in the Song dynasty. Xiaoji Yinzi is composed of Rehmanniae Radix， Cirsii Herba， Talcum， Akebiae Caulis， Typhae Pollen， Nelumbinis Rhizomatis Nodus， Lophatheri Herba， Angelicae Sinensis Radix， Gardeniae Fructus， and Glycyrrhizae Radix et Rhizoma and has the effects of cooling blood and stopping bleeding， draining water and relieving stranguria. The medical experts of later generations have inherited the original prescription recorded in the Yan's Prescriptions to Aid the Living， while dispute has emerged during the inheritance of this prescription. In this study， the method of bibliometrics was employed to review and analyze the ancient documents and modern clinical studies involving Xiaoji Yinzi. The results showed that Xiaoji Yinzi has two dosage forms： powder and decoction. According to the measurement system in the Song Dynasty， the modern doses of hers in Xiaoji Yinzi were transformed. In the prepration of Xiaoji Yinzi powder， 149.2 g of Rehmanniae Radix and 20.65 g each of Cirsii Herba， Talcum， Akebiae Caulis， stir-fried Typhae Pollen， Nelumbinis Rhizomatis Nodus， Lophatheri Herba， wine-processed Angelicae Sinensis Radix， stir-fried Gardeniae Fructus， and stir-fried Glycyrrhizae Radix et Rhizoma are grounded into fine powder with the particle size of 4-10 meshes and a decocted with 450 mL water to reach a volume of 240 mL. After removal of the residue， the decoction was taken warm before meals， 3 times a day （i.e.， 7.77 g Rehmanniae Radix and 0.97 g each of the other herbs each time）. In the preparation of Xiaoji Yinzi decoction， 20.65 g each of the above 10 herbs are used， with stir-fried Typhae Pollen， wine-processed Angelica Sinensis Radix， stir-fired Gardeniae Fructus， stir-fired Glycyrrhizae Radix et Rhizoma， and raw materials of other herbs. Xiaoji Yinzi is specialized in treating hematuresis and blood stranguria due to heat accumulation in lower energizer， which causes injury of the blood collaterals of gallbladder and dysfunction of Qi transformation. In modern clinical practice， Xiaoji Yinzi is specifically used for treating urinary diseases and can be expanded to treat diseases of the cardiovascular system and other systems according to pathogenesis. The comprehensive research on the key information could provide a scientific reference for the future development of Xiaoji Yinzi.