Childhood simple obesity has become a significant public health issue in China. Modern medicine primarily relies on lifestyle interventions and often suffers from poor long-term compliance， while pharmacological options are limited and associated with potential adverse effects. Traditional Chinese Medicine （TCM） has a long history in the prevention and management of this condition， demonstrating eight distinct advantages， including systematic theoretical foundation， diversified therapeutic approaches， definite therapeutic efficacy， high safety profile， good patient compliance， comprehensive intervention strategies， emphasis on prevention， and stepwise treatment protocols. Additionally， TCM is characterized by six distinctive features： the use of natural medicinal substances， non-invasive external therapies， integration of medicinal dietetics， simple exercise regimens， precise syndrome differentiation， and diverse dosage forms. By combining internal and external treatments， TCM facilitates individualized regimen adjustment and holistic regulation， demonstrating remarkable effects in improving obesity-related metabolic indicators， regulating constitutional imbalance， and promoting healthy behaviors. However， challenges remain， such as inconsistent operational standards， insufficient high-quality clinical evidence， and a gap between basic research and clinical application. Future efforts should focus on accelerating the standardization of TCM diagnosis and treatment， conducting multicenter randomized controlled trials， and fostering interdisciplinary integration， so as to enhance the scientific validity and international recognition of TCM in the prevention and treatment of childhood obesity.

ObjectiveTo analyze the epidemiological characteristics of long COVID and to investigate its main influencing factors by examining individuals infected with SARS-CoV-2 between March and June 2022 in two communities in Shanghai, to lay the foundation for further research on the mechanism and clinical treatment of long COVID, and to provide the basis for the development of inexpensive, convenient, and feasible prevention and intervention strategies. MethodsA cross-sectional study was conducted, enrolling 6 410 individuals infected with SARS-CoV-2. Data were collected through a questionnaire survey. The incidence and common symptoms of long COVID were analyzed, along with their associations with demographic characteristics, medical history, and behavioral factors. A logistic regression model was used to identify the major factors associated with the development of long COVID symptoms. ResultsThe overall incidence rate of long COVID among the study population was 13.9%. The most commonly reported symptoms included fatigue (65.1%), attention disorders (23.1%), and cough (16.9%). The analysis showed that having underlying chronic diseases (OR=2.580, 95%CI: 2.165‒3.074), a history of allergies (OR=1.418, 95%CI: 1.003‒1.971), current smoking (OR=1.461, 95%CI: 1.013‒2.079), ever smoking (OR=2.462, 95%CI: 1.687‒3.551), a greater number of symptoms during the acute phase [1 symptom (OR=1.778, 95%CI: 1.459‒2.162), 2 symptoms (OR=2.749, 95%CI: 2.209‒3.409), ≥3 symptoms (OR=7.792, 95%CI: 6.333‒9.593)] and aggravated symptoms during the acute phase (OR=1.082, 95%CI: 1.070‒1.094) were factors associated with a higher risk of developing long COVID symptoms. Additionally, individuals who had consumed alcohol in the past year (OR=1.914, 95%CI: 1.344‒2.684) were more prone to objective long COVID symptoms. Among individuals under 50 years of age, females (OR=1.427, 95%CI: 1.052‒1.943) were more likely to develop objective long COVID symptoms. ConclusionThis study has identified the diversity of long COVID symptoms, which involve multiple organs and systems, including fatigue, attention disorders, cough, and joint pain. It has also revealed associations between long COVID and various demographic factors (e.g., age, gender), personal medical history (e.g., underlying chronic diseases, history of allergies), acute-phase characteristics (e.g., number and severity of symptoms), and behavioral factors (e.g., smoking, alcohol consumption). These findings highlight the need for further research and ongoing surveillance of long COVID and may inform the development of more targeted health management strategies for specific populations.

ObjectiveTo analyze the epidemiological characteristics and influencing factors of SARS-CoV-2 reinfection by conducting follow-up investigations among community residents who experienced their first SARS-CoV-2 infection between March and June 2022, so as to provide a scientific basis for predicting future epidemic trends and adjusting prevention and control strategies. MethodsA cohort study was conducted in Xuhui District, Shanghai. A total of 1 208 individuals with a documented primary SARS-CoV-2 infection between March and June 2022 were enrolled and followed-up longitudinally. Data were collected using structured questionnaire surveys to assess the reinfection rate, incidence density, and clinical manifestations of SARS-CoV-2 reinfection. A logistic regression model was used to analyze the influencing factors of SARS-CoV-2 reinfection. ResultsA total of 497 SARS-CoV-2 reinfection cases were observed among the 1 208 research subjects, with a reinfection rate of 41.14% and an incidence density of 0.63 cases per 1 000 person-days. The cumulative reinfection rates at 6, 9, 12, 15, and 18 months following the initial infection were 0.08%, 15.31%, 19.04%, 33.53%, and 38.25%, respectively. Compared with the primary infection, reinfection was more likely to be symptomatic, with a greater severity of fever, dry cough, sore throat, and runny nose. Being female, younger age, and symptom duration ≥7 days during the primary infection were identified as influencing factors for SARS-CoV-2 reinfection, while a higher socioeconomic status can reduce the risk of SARS-CoV-2 reinfection. ConclusionSARS-CoV-2 reinfection is relatively common and often symptomatic. Age, gender, income level, and the duration of symptoms during the primary infection are identified as infuencing factors for SARS-CoV-2 reinfection. Continuous monitoring of reinfection in the population is recommended, along with the development of effective strategies to mitigate the impact of reinfection.

Objective To investigate the predicting value of cardiac magnetic resonance feature tracking(CMR-FT)for adverse left ventricular remodeling(ALVR)in patients with acute anterior wall ST-segment elevation myocardial infarction(STEMI).Methods The clinical data and cardiac magnetic resonance(CMR)images of 161 acute anterior wall STEMI patients within 1 week and 6 months after emergency percutaneous coronary intervention(PCI)were retrospectively analyzed.ALVR was defined as an increase of left ventricular end-diastolic volume(LVEDV)over 20％at the second CMR examination compared to the baseline.The CMR parame-ters were analyzed by CVI42 post-processing software.The logistic regression analysis was used to screen the independent predictors of ALVR,and the receiver operating characteristic(ROC)curve was used to evaluate the predictive efficiency of ALVR.Results The incidence of ALVR at 6 months was 21.7％(35/161).The logistic regression analysis showed that the left ventricular global circumferential strain(LVGCS)and right ventricular global longitudinal strain(RVGLS)at baseline were independent predictors for ALVR(P＜0.001).When LVGCS was-13.89％and RVGLS was-15.07％at baseline,the sensitivity of predicting ALVR was 0.714 and 0.743,the specificity was 0.833 and 0.810,and the area under the curve(AUC)was 0.806 and 0.835,respectively.The sensitivity of LVGCS combined with RVGLS in predicting ALVR was 0.802,the specificity was 0.952,and the AUC was 0.888.The DeLong test showed that the AUC of LVGCS com-bined with RVGLS in predicting ALVR was significantly higher than that of individuals,and the difference was statistically significant(P＜0.05).Conclusion The LVGCS and RVGLS at baseline are independent predictors for ALVR in patients with acute anterior wall STEMI,their combination can significantly improve the pre-dictive efficiency of ALVR in these patients.

Objective To investigate the mechanism of Shugan Zhixie Prescription in treating irritable bowel syndrome with diarrhea(IBS-D)using network pharmacology;To validate the findings through in vivo experiments.Methods Active components and potential targets of Shugan Zhixie Prescription were identified via the TCMSP database.Disease targets for IBS-D were retrieved from GeneCards,DisGeNET and OMIM databases.The intersection of drugs and disease targets was taken,and the protein interaction network was constructed by using STRING database.GO and KEGG pathways were enriched to identify the key signaling pathways of Shugan Zhixie Prescription in the treatment of IBS-D.The rat model of liver depression and spleen deficiency type IBS-D was established by the method of abnormal hunger and satiety,restraint pinch stress and intestinal perfusion of acetic acid.The rats were intervened with low-,medium-and high-dosage of Shugan Zhixie Prescription respectively for 14 days.Serum contents of diamine oxidase(DAO),interleukin(IL)-8,and IL-18 were measured by ELISA.Protein expressions and mRNA expressions of relevant targets in colonic tissue were detected using Western blot and RT-qPCR.Results A total of 26 active components and 553 targets of Shugan Zhixie Prescription were obtained,and 1 930 targets of IBS-D disease were obtained,with 184 drug-disease intersection targets.The possible mechanism was related to NF-κB,AGE-RAGE,Th17 cell differentiation and other signaling pathways.Animal experiments demonstrated that Shugan Zhixie Prescription could significantly reduce defecation frequency,fecal water content,and inflammatory cytokine levels in model rats.It markedly decreased TLR4 and NF-κB protein expressions(P<0.01),while increased AQP3,AQP8 and Occludin protein expressions in colonic tissue(P<0.01,P<0.05).Conclusion Shugan Zhixie Prescription exerts therapeutic effects on IBS-D through multiple pathways and targets,and the mechanism may be related to inhibiting TLR4/NF-κB signaling pathway and promoting intestinal barrier repair.

Objective To explore the application of cell block(CB)technology in the diagnosis of papillary thyroid carcinoma(PTC).Methods A total of 86 patients with thyroid nodules who were treated at Luoyang Central Hospital Affiliated to Zhengzhou University from February 2023 to December 2024 were retrospectively selected.Before the operation,all patients underwent ultrasound-guided fine needle aspiration biopsy.After the biopsy,the specimens were respectively subjected to cell smear(CS)and CB pathological examinations.Using postoperative pathology as the gold standard,the clinical application value of CS,CB,BRAFV600E gene detection,and combined detection in the preoperative diagnosis of PTC was evaluated.Results A total of 86 patients were included.Among them,42 cases were diagnosed as PTC by postoperative pathology,and 44 cases were benign lesions.The sensitivity(73.81％),specificity(97.73％),positive predictive value(96.88％),negative predictive value(79.63％),and accuracy(86.05％)of CB in the preoperative diagnosis of PTC were significantly higher than those of CS.The Kappa consistency test results showed that the consistency between CB pathological results and postoperative pathological results was better than that of CS.Receiver operating characteristic curve analysis indicated that the area under the curve(AUC)of CB was significantly higher than that of CS(0.858 vs.0.743,Z=2.391,P=0.017).Furthermore,the combination of CB and BRAFV600E gene detection further improved preoperative diagnostic performance,with a consistency with postoperative pathological results(Kappa=0.837)superior to other examination methods,and an AUC(0.918)significantly higher than other examination methods.Conclusion CB has significant clinical application value in the preoperative diagnosis of PTC,with diagnostic performance significantly superior to CS.Further combination with BRAFV600E gene detection can significantly improve preoperative diagnostic accuracy.

Objective To analyze the clinical manifestations and diagnostic characteristics of maternal cardiac arrest(MCA)patients,summarize warning symptoms,and provide a basis for the prevention,early identification,and intervention of this event.Methods A retrospective study was conducted.Clinical data of 15 pregnant or postpartum women who experienced cardiac arrest or were transferred to Peking University Third Hospital due to cardiac arrest from January 2012 to December 2023 were collected,including age,comorbidities,causes of MCA,warning symptoms,parameters related to cardiopulmonary resuscitation(CPR,such as time and location of cardiac arrest,initial heart rhythm,electrical defibrillation,medication use,duration of CPR,restoration of spontaneous circulation,and etc.),parameters related to perimortem cesarean delivery(time interval between fetal delivery and cardiac arrest,delivery of infants),clinical outcomes(such as cerebral performance category,length of hospital stay),and multidisciplinary treatment.The main clinical endpoint was patient survival at discharge.The clinical and diagnostic characteristics of MCA were descriptively analyzed,and compare the differences in age,duration of CPR,shockable rhythm,proportion of patients with cardiac arrest occurring prenatally,and length of hospital stay among patients with different prognoses of MCA.Results The median age of 15 MCA patients was 31(30,33)years.A total of 10 cases(66.7%)of patients had concurrent obstetric diseases.Six cases(40.0%)of patients had MCA due to postpartum hemorrhage,which was the most common cause,followed by acute heart failure[2 cases(13.3%)]and pulmonary embolism[2 cases(13.3%)].A total of 12 cases(80.0%)of MCA patients showed obvious warning symptoms before cardiac arrest,with the most common warning symptoms including dyspnea(3 cases,20.0%),consciousness disorders(3 cases,20.0%),and vaginal bleeding(3 cases,20.0%).A total of 12 cases(80.0%)of MCA occurred in late pregnancy.All 15 MCA events occurred within the hospital,with an average of 5(4-6)departments involved in the CPR process.Four patients(26.7%)had an initial heart rhythm of ventricular fibrillation and all received defibrillation therapy,9 patients(75.0%)were treated with adrenaline.Two patients who were over 20 weeks pregnant underwent manual left uterine thrusting intervention during CPR,and both patients were successfully discharged.A total of 12 patients(80.0%)received CPR,of which 7 patients(58.3%)were discharged with good neurological function.A total of 11 patients underwent cesarean section surgery,and the survival rate of fetuses delivered by cesarean section was 83.3%.The duration of CPR in survivors was significantly shorter than that in deceased patients[minutes:7.0(2.0,23.3)vs.144.0(90.0,190.5),P<0.05].Conclusion Postpartum hemorrhage is the most common cause of MCA,and after active treatment,over 50%of patients can achieve good neurological function and be discharged.Comprehensive and effective CPR,strengthened coordination among multidisciplinary teams,and early identification and warning of symptoms are key strategies for improving the prognosis of MCA patients.

OBJECTIVE To investigate the pharmacodynamics and related mechanisms of Anmei Dan on hippocampus of mice with coronary heart disease complicated with depression.METHODS The coronary heart disease model combined with chronic and unpredictable mild stress depression model was established,and the mice were randomly divided into blank group,model group,low dose group(1.5 g·kg-1),high dose group(3 g·kg-1)and atorvastatin group(0.3 g·kg-1).Sucrose preference test,open field test and forced swimming test were used to evaluate the behavioral changes of mice.qPCR and ELISA were employed to ascertain the mR-NA expression of interleukin-1β(IL-1β),interleukin-6(IL-6)and tumour necrosis factor-α(TNF-α)in the hippocampus.The changes of neurons and Nissl bodies in CA1,CA3 and DG regions of hippocampus were observed by Nissl staining.The expression of key proteins was detected by Western blot.RESULTS Compared with the blank group,the sucrose preference rate of mice in the model group was decreased(P<0.01),the forced swimming immobility time was extended(P<0.01)and the movement distance in the open field experiment was not significantly changed.The levels of total cholesterol(TC),triglyceride(TG)and low density lipopro-tein cholesterol(LDL-C)were increased significantly(P<0.01)and the level of high density lipoprotein cholesterol(HDL-C)was decreased significantly(P<0.01).The mRNA level and content of IL-1β,IL-6 and TNF-α were significantly increased(P<0.01).The expression of glutamate receptor 1(GluR1),postsynaptic densitin-95(PSD-95),brain-derived neurotrophic factor(BDNF)and phosphorylated calmodulin-dependent kinase(p-CaMKⅡ)in hippocampus was decreased(P<0.01).The expression of cytoskeletal activity regulatory protein(Arc)was increased(P<0.01).In the model group,the cell structure was irregular and differ-ent degrees of damage occurred,the Nissl bodies decreased or disappeared,and the cell membrane broke.Compared with the model group,the sucrose preference rate of mice in each administration group was significantly increased(P<0.01),the immobility time in forced swimming experiment was significantly decreased(P<0.01),and the levels of TC,TG and LDL-C of mice in Anmei Dan groups and atorvastatin group were decreased(P<0.01),while the level of HDL-C increased(P<0.01).The mRNA levels and con-tent of IL-1β,IL-6 and TNF-α in Anmei Dan groups and atorvastatin group were decreased(P<0.01).The expression of GluR1,PSD-95,BDNF and p-CaMKⅡ in hippocampal tissue of Anmei Dan groups were increased(P<0.01),and the expression of Arc was decreased(P<0.01).The morphology and structure of the cells in the Anmei Dan group and the atorvastatin group were improved,with varying degrees of increased Nissl bodies and relatively intact cell membranes.CONCLUSION Anmei Dan can effectively im-prove blood lipids and depression-like behavior of coronary heart disease mice complicated with depression.It can inhibit pro-inflam-matory factors,increase the expression of neurotrophic factors,effectively improve synaptic related proteins,and reduce the damage to neurons,thus effectively preventing the exacerbation of coronary heart disease and depression comorbidity.

BACKGROUND:Epidemiologic investigations and some experiments have shown that there is a close relationship between peripheral blood cells and osteoporosis,but the causal relationship between the two at the genetic level is still unclear. OBJECTIVE:To explore the causal relationship between peripheral blood cells and osteoporosis using Mendelian randomization methods. METHODS:Genome-wide association study data sets on peripheral blood cells,overall bone density at different ages,and calcaneal bone density were obtained from databases such as Blood Cell Consortium and MRC Integrative Epidemiology Unit. Blood cells were used as exposure data,with bone density at different ages and calcaneal bone density serving as outcome data. Mendelian randomization analyses were performed using methods such as inverse variance weighting,MR-Egger,weighted median method,and simple median. The results were assessed for heterogeneity,pleiotropy,and sensitivity using Cochran's Q,MR-Egger regression,and Leave-one-out method. The causal relationship between exposure and outcomes was evaluated using β values. RESULTS AND CONCLUSION:Due to the heterogeneity revealed by Cochran's Q test in the Mendelian randomization results,the results of the study were based on the inverse variance weighting method. The inverse variance weighting results showed that when age-specific bone density was used as an outcome,there was a negative causal relationship between white blood cell count and whole-body bone mineral density at the age of 45-60 years[β=-0.07,95％ confidence interval (CI):-0.13,-0.01,P=0.02],a positive causal relationship between monocyte count and whole-body bone mineral density at the age of 45-60 years (β=0.05,95％ CI:0.00,0.10,P=0.037),a negative causal relationship between white blood cell and basophil counts and whole-body bone mineral density over 60 years old (β=-0.04,95％ CI:-0.07,-0.01,P=0.005;β=-0.04,95％ CI:-0.07,-0.00,P=0.038),a positive causal relationship between hemoglobin concentration and hematocrit and whole-body bone mineral density over 60 years old (β=0.04,95％ CI:0.01,0.08,P=0.012;β=0.04,95％ CI:0.00,0.07,P=0.039),and a negative causal relationship between white cell count and whole-body bone mineral density at an undistinguished age (β=-0.10,95％ CI:-0.16,-0.03,P=0.002). When heel bone mineral density was used as an outcome,there was a negative causal relationship between white cell count and heel bone mineral density (β=-0.04,95％ CI:-0.07,-0.01,P=0.016),and a positive causal relationship between hemoglobin concentration and hematocrit and heel bone mineral density (β=0.05,95％ CI:0.01,0.08,P=0.007;β=0.05,95％ CI:0.01,0.08,P=0.004). To ensure the robustness of the results,meta-analyses of Mendelian randomization results of peripheral blood cells and whole-body bone mineral density as well as heel bone mineral density in different age groups were conducted. The results suggested that for every standard deviation decrease in log-transformed white blood cell count,there was a 5％ reduction in the risk of decreased bone mineral density (OR=0.95,95％ CI:0.94,0.97,P<0.001);whereas for every standard deviation increase in hemoglobin concentration and hematocrit,there was a 4％ reduction in the risk of decreased bone density (OR=1.04,95％ CI:1.03,1.06,P<0.001). In conclusion,increased white blood cell count in peripheral blood is a risk factor for bone mineral density;whereas increased hematocrit and hemoglobin concentration are protective factors for bone mineral density.

Objective To explore the regulatory effect of Lingzhu Granules on the PI3K/Akt signaling pathway in the rats with polycystic ovary syndrome(PCOS)accompanied by insulin resistance.Methods Fe-male Sprague-Dawley(SD)rats aged 3 weeks d old were selected to establish the model by using the DHEA method.The intervention treatment was administered by different doses of Lingzhu Granules and the homeostasis model as-sessment of insulin resistance(HOMA-IR)was calculated.The relative expression levels of PI3K,Akt,GSK-3β and GLUT4 mRNA in the ovaries was detected by RT-PCR.The expression levels of PI3K and Akt were detected by Western blot.Results Compared with the model control group,the rat body weight in the medium and high doses Lingzhu Granules groups was significantly reduced(P＜0.05).The fasting blood glucose,fasting insulin and HOMA-IR index in the Lingzhu Granules low,medium and high doses groups were significantly lower than those in the model control group,and the differences were statistically significant(P＜0.01).The mRNA relative expression levels of PI3K,Akt,GSK-3β and GLUT4 in the Lingzhu Granules medium and high doses groups all were higher than those in the model control group(P＜0.05).The relative expression levels of PI3K and Akt in the ovarian tissue in the Lingzhu Granules low,medium and high doses groups were higher than those in the model control group,and the differences were statistically significant(P＜0.05).Conclusion Lingzhu Granules could effectively improve the insulin resistance status of PCOS rats by enhancing the synthesis of PI3K and Akt.