Objective: To evaluate the intervention effect of school based salt reduction health education, so as to provide a scientific basis for constructing a more effective and sustainable salt reduction intervention model for children. Methods: According to a randomized controlled trial design, in June 2022, probability proportional to size sampling was used to select 501 second grade students (248 in the control group and 253 in the intervention group) from 10 primary schools in Zhenjiang (intervention group) and 10 primary schools in Yangzhou (control group), Jiangsu Province. An one year school based salt reduction health education intervention was implemented. This included 20 online and 8 offline health education sessions, monitoring of salt consumption in the canteen, and the establishment of a salt reduction environment on campus. The control group received no additional salt reduction interventions. A questionnaire survey and 24 hour urinary sodium test were conducted before and after the intervention. The difference in differences method was used to evaluate the intervention effect. Results: After the intervention, the intervention group showed significant net intervention effects in knowledge aspects, including knowing that primary school students consume less salt than adults ( OR=3.55,95%CI =1.69-7.47), daily salt intake of primary school students ( OR=6.64,95%CI =3.71-11.87), long term high salt intake leading to hypertension ( OR=6.83,95%CI =3.93-11.91), low salt intake not causing hair graying ( OR= 1.66 ,95%CI =1.00-2.75), salt content in food labels ( OR=4.56,95%CI =2.63-7.91), and common high salt foods ( OR=3.39,95%CI =1.87-6.14) (all P <0.05). In terms of attitude, the net intervention effect for having a positive attitude toward using less salt in home cooking was significantly increased ( OR=1.88,95%CI =1.13-3.12, P <0.05). There were no statistically significant net intervention effects for salt reduction related behaviors (all P >0.05). There was no statistically significant difference in the changes of 24 hour urinary sodium between the intervention group and the control group before and after intervention ( P >0.05). Conclusions School based salt reduction health education effectively improves students salt reduction knowledge and attitudes but has a limited effect on behavior change. The home-school collaboration should be strengthened, and the dietary environment should be optimized simultaneously.

This paper systematically reviews the core concepts and lines of theoretical inheritance of major spleen-stomach theories in traditional Chinese medicine （TCM）， including spleen deficiency theory， spleen-stomach damp-heat theory， and liver-spleen disharmony theory. It is found that these theories have all undergone a developmental trajectory characterized by classical foundation， refinement of therapeutic methods， systematization of pathogenesis， and modern innovation. The evolution of spleen-stomach theory has achieved a shift from a singular focus on tonifying the spleen to regulating dynamic middle-jiao （焦） balance， and from localized spleen-stomach regulation to the circular movement of qi involving all five zang organs. In terms of modern disease-syndrome integrative research， spleen deficiency syndrome is shown to be closely associated with impairment of the gastrointestinal mucosal barrier， metabolic disorders， and gene polymorphisms related to Helicobacter pylori-associated gastric diseases. Spleen-stomach damp-heat syndrome is closely linked to hyperactive energy metabolism， inflammatory cytokines， and abnormal expression of aquaporins. Liver-spleen disharmony syndrome is mainly associated with dysregulation of the brain-gut axis and microbiota-related metabolic disorders. It is proposed that future research on spleen-stomach diseases and syndromes should further elucidate their potential multidimensional differential biological characteristics， thereby promoting the modernization of the TCM discipline of spleen-stomach studies.

Objective:To explore the medication adherence of elderly patients with chronic diseases and polypharmacy in rural areas of Hangzhou City and analyze its influencing factors.Methods:From April to July 2023, convenience sampling was used to select rural 240 elderly patients with chronic diseases and polypharmacy in five administrative districts (counties) of Hangzhou as participants. The survey was conducted using the General Information Questionnaire, Social Support Rating Scale, Medication Knowledge and Beliefs Questionnaire, and the Chinese version of the 8-item Morisky Medication Adherence Scale. Multiple linear regression was used to analyze the factors influencing medication adherence in elderly patients with chronic diseases and polypharmacy in rural areas of Hangzhou City.Results:A total of 240 questionnaires were distributed and 220 valid questionnaires were collected, with an effective response rate of 91.67%. Among 220 elderly patients with chronic diseases and polypharmacy in rural areas of Hangzhou City, 135 had poor medication adherence. Multiple linear regression analysis showed that age, educational level, family doctor contract, medication knowledge, and beliefs were the influencing factors of medication adherence in elderly patients with chronic diseases and polypharmacy in rural areas of Hangzhou City ( P<0.05) . Conclusions:The medication adherence of elderly patients with chronic diseases and polypharmacy in rural areas of Hangzhou urgently needs to be improved. Medical and nursing staff should pay special attention to patients who are old, have a low level of education, have not signed a family doctor, and have poor knowledge and beliefs about medication. It is suggested that the contract system for family doctors be further promoted, focusing on health education on medication knowledge and beliefs, to improve medication adherence among elderly chronic disease patients in rural areas.

Cancer incidence in China has been rising steadily,with a particularly heavy burden from several high-prevalence malignancies.Medical examination for cancer plays a critical role in the early detection of cancer,precancerous lesions,and precursor conditions,thereby facilitating timely diagnosis and intervention.Such examination also addresses the growing demand for person-alized cancer screening services among diverse population groups.The development of evidence-based,context-specific cancer screening guidelines is essential to enhance the standardization,quality,and equity of preventive screening practices across the country,ultimately improving out-comes in early cancer detection and treatment.Guided by the Department of Medical Emergency Response of the National Health Commission,the Guidelines for Medical Examination for Cancer in Health Examination Agency(2025 Edition)were developed under the leadership of the National Cancer Center.A multidisciplinary panel of experts formulated the guidelines in accordance with the principles and methodology of the World Health Organization Handbook for Guideline Deve-lopment.The guidelines provide evidence-based recommendations on key clinical domains:target cancers and populations,overall screening workflow,screening protocols,diagnostic technolo-gies,result interpretation,follow-up procedures,and quality control.The primary objective is to standardize cancer screening practices in health examination agency and strengthen China's ca-pacity for prevention and control of high-burden cancers.

The objective of this study was to evaluate the protective effect and possible related mechanisms of Sophora subprostrate polysaccharide(SSP)on intestinal epithelial cell injury in-duced by Tert-Butyl hydroperoxide(TBHP).The optimal dose of TBHP and the safe concentra-tion range of SSP were determined using the MTT method.In this study,IPEC-J2 cells were divid-ed into five groups:the control group,the model group,the SSPL group,the SSPM group and the SSPH group,and the cell morphology,cell survival rate and LDH release rate were observed and measured.The content of intracellular reactive ROS was observed and determined by DCFH-DA staining.The content of MDA in the supernatant and the antioxidant index of cells were determined by the reagent kit.Transcriptome technology was employed to analyze the potential mechanisms by which SSP mitigates oxidative damage in IPEC-J2 cells.The results showed that treatment with 625 μmol/L TBHP for 2 h significantly reduced the activity of IPEC-J2 cells,markedly increased LDH release(P＜0.05),inhibited CAT superoxide SOD and glutathione GPX activities(P＜0.05),and significantly elevated MDA and ROS levels(P＜0.05).Compared to the model group,after SSP treatment,intracellular ROS levels were significantly reduced(P＜0.05),while CAT,SOD,and GPX activities were significantly increased(P＜0.05),and MDA content and LDH re-lease were significantly decreased(P＜0.05)in a dose-dependent manner.Transcriptome analysis revealed that TBHP treatment significantly altered the transcriptional profiles of IPEC-J2 cells,while SSP treatment could restore the transcriptional profiles of the damaged cells to a certain ex-tent.Gene ontology(GO)and Kyoto encyclopedia of genes and genomes(KEGG)indicated that the differentially expressed genes between the CC and TBHP groups were significantly enriched in oxidative phosphorylation,ribosome,and other pathways.Meanwhile,the differentially expressed genes between the SSP and TBHP groups were mainly enriched in oxidative phosphorylation,ap-optosis,glyoxylate and dicarboxylate metabolism,and other pathways.These results suggest that TBHP may disrupt normal oxidative respiration in IPEC-J2 cells by affecting oxidative phospho-rylation and interfering with metabolism pathways involving glycine,serine,and threonine,leading to oxidative damage in intestinal epithelial cells.Conversely,SSP treatment may potentially restore oxidative phosphorylation processes,alleviate lysosomal damage,reduce cell apoptosis,and miti-gate oxidative damage in intestinal epithelial cells through modulation of oxidative phosphoryla-tion,apoptosis,and lysosomal pathways.This discovery provides a theoretical basis for the clinical application of SSP in alleviating oxidative damage in the porcine intestinal tract.

Objective:To explore the medication adherence of elderly patients with chronic diseases and polypharmacy in rural areas of Hangzhou City and analyze its influencing factors.Methods:From April to July 2023, convenience sampling was used to select rural 240 elderly patients with chronic diseases and polypharmacy in five administrative districts (counties) of Hangzhou as participants. The survey was conducted using the General Information Questionnaire, Social Support Rating Scale, Medication Knowledge and Beliefs Questionnaire, and the Chinese version of the 8-item Morisky Medication Adherence Scale. Multiple linear regression was used to analyze the factors influencing medication adherence in elderly patients with chronic diseases and polypharmacy in rural areas of Hangzhou City.Results:A total of 240 questionnaires were distributed and 220 valid questionnaires were collected, with an effective response rate of 91.67%. Among 220 elderly patients with chronic diseases and polypharmacy in rural areas of Hangzhou City, 135 had poor medication adherence. Multiple linear regression analysis showed that age, educational level, family doctor contract, medication knowledge, and beliefs were the influencing factors of medication adherence in elderly patients with chronic diseases and polypharmacy in rural areas of Hangzhou City ( P<0.05) . Conclusions:The medication adherence of elderly patients with chronic diseases and polypharmacy in rural areas of Hangzhou urgently needs to be improved. Medical and nursing staff should pay special attention to patients who are old, have a low level of education, have not signed a family doctor, and have poor knowledge and beliefs about medication. It is suggested that the contract system for family doctors be further promoted, focusing on health education on medication knowledge and beliefs, to improve medication adherence among elderly chronic disease patients in rural areas.

Objective This study aims to use subjective and objective evaluation indicators to accurately calculate the relative weights of various factors that affect blood glucose control in gestational diabetes and provide scientific basis for the formu-lation of clinical nutrition intervention plans and support for the evaluation of blood sugar intervention effects in the late stage of pregnancy.Methods The fuzzy analytic hierarchy process(FAHP)was used to construct a hierarchical model of nutrition man-agement for patients with gestational diabetes,calculate the weights of each criterion layer in detail,and integrate them with the weight adjustment coefficients of scoring experts to form a mathematical model for nutrition management of gestational diabetes.Results Based on 14 valid expert feedback questionnaires,the relative weights of the first,second,and 29 end indicators were calculated.The weights of the first indicators were nutrition assessment indicators for gestational diabetes(0.34142105),formu-lation of nutrition management plans for gestational diabetes(0.331055183),and implementation of nutrition management plans(0.327923333).The largest weights in the second indicators were laboratory indicators(0.110385024)and meal plans(0.117342182).Conclusion The fuzzy analytic hierarchy process can accurately estimate the relative weights of factors affect-ing personalized nutrition management in gestational diabetes,providing a theoretical basis for blood sugar management during the entire pregnancy.

Purpose To explore the application value of spectral CT vascular optimization technique for laparoscopic right hemicolectomy.Materials and Methods Ninety patients who underwent contrast-enhanced CT with spectral CT before scheduled laparoscopic right hemicolectomy from March to November 2022 in Shengjing Hospital of China Medical University were retrospectively analyzed.The raw images were reconstructed to obtain 120 kVp conventional images and spectral-based virtual monochromatic images(VMIs)at 40,50,60,70 keV.The CT value and image noise of gastrocolic trunk of Henle(GTH),right colic vein(RCV)and ileocolic vein(ICV)were measured.The CT value,image noise,signal noise ratio and contrast noise ratio of VMIs and conventional image were analyzed.The image quality and venous anatomical information of each group were evaluated subjectively with three-dimensional reconstruction technique.Results The CT value[(405.55±103.06)Hu,(406.61±103.42)Hu,402.35(337.95,477.45)Hu],image noise[19.90(12.10,34.55)Hu,21.10(10.95,44.30)Hu,19.70(11.25,44.80)Hu],signal noise ratio[19.46(10.60,36.31),20.16(8.73,37.42),18.49(9.99,36.24)]and contrast noise ratio[53.36(35.92,70.79),52.34(33.73,81.03),56.23(34.69,79.97)]of GTH,RCV,ICV of VMIs at 40 keV were significantly higher than those of conventional image and other VMIs(F/H=268.53,23.17,33.09,198.77,272.51,28.93,25.48,189.62,318.24,29.42,20.13,212.46,all P<0.001).Subjective scores showed that the image quality and vascular visualization of GTH,RCV and ICV at 40 keV were the best.Conclusion Spectral CT can improve the imaging quality and vascular visualization of GTH,RCV and ICV.VMIs at 40 keV has the optimal performance.

Objective This study aims to use subjective and objective evaluation indicators to accurately calculate the relative weights of various factors that affect blood glucose control in gestational diabetes and provide scientific basis for the formu-lation of clinical nutrition intervention plans and support for the evaluation of blood sugar intervention effects in the late stage of pregnancy.Methods The fuzzy analytic hierarchy process(FAHP)was used to construct a hierarchical model of nutrition man-agement for patients with gestational diabetes,calculate the weights of each criterion layer in detail,and integrate them with the weight adjustment coefficients of scoring experts to form a mathematical model for nutrition management of gestational diabetes.Results Based on 14 valid expert feedback questionnaires,the relative weights of the first,second,and 29 end indicators were calculated.The weights of the first indicators were nutrition assessment indicators for gestational diabetes(0.34142105),formu-lation of nutrition management plans for gestational diabetes(0.331055183),and implementation of nutrition management plans(0.327923333).The largest weights in the second indicators were laboratory indicators(0.110385024)and meal plans(0.117342182).Conclusion The fuzzy analytic hierarchy process can accurately estimate the relative weights of factors affect-ing personalized nutrition management in gestational diabetes,providing a theoretical basis for blood sugar management during the entire pregnancy.

Triggering receptor expressed on myeloid cells 2 (TREM2)-mediated microglial phagocytosis is an energy-intensive process that plays a crucial role in amyloid beta (Aβ) clearance in Alzheimer's disease (AD). Energy metabolic reprogramming (EMR) in microglia induced by TREM2 presents therapeutic targets for cognitive impairment in AD. Jiawei Xionggui Decoction (JWXG) has demonstrated effectiveness in enhancing energy supply, protecting microglia, and mitigating cognitive impairment in APP/PS1 mice. However, the mechanism by which JWXG enhances Aβ phagocytosis through TREM2-mediated EMR in microglia remains unclear. This study investigates how JWXG facilitates microglial phagocytosis and alleviates cognitive deficits in AD through TREM2-mediated EMR. Microglial phagocytosis was evaluated through immunofluorescence staining in vitro and in vivo. The EMR level of microglia was assessed using high-performance liquid chromatography (HPLC) and enzyme-linked immunosorbent assay (ELISA) kits. The TREM2/protein kinase B (Akt)/mammalian target of rapamycin (mTOR)/hypoxia-inducible factor-1α (HIF-1α) signaling pathway was analyzed using Western blotting in BV₂ cells. TREM2^-/- BV₂ cells were utilized for reverse validation experiments. The Aβ burden, neuropathological features, and cognitive ability in APP/PS1 mice were evaluated using ELISA kits, immunohistochemistry (IHC), and the Morris water maze (MWM) test. JWXG enhanced both the phagocytosis of EMR disorder-BV₂ cells (EMRD-BV₂) and increased EMR levels. Notably, these effects were significantly reversed in TREM2^-/- BV₂ cells. JWXG elevated TREM2 expression, adenosine triphosphate (ATP) levels, and microglial phagocytosis in APP/PS1 mice. Additionally, JWXG reduced Aβ-burden, neuropathological lesions, and cognitive deficits in APP/PS1 mice. In conclusion, JWXG promoted TREM2-induced EMR and enhanced microglial phagocytosis, thereby reducing Aβ deposition, improving neuropathological lesions, and alleviating cognitive deficits.
Drugs, Chinese Herbal/pharmacology* ; Microglia/drug effects* ; Phagocytosis ; Cognitive Dysfunction/drug therapy* ; Metabolic Reprogramming ; Animals ; Mice ; Cell Line ; Receptors, Immunologic/metabolism* ; Membrane Glycoproteins/metabolism* ; Signal Transduction ; Amyloid beta-Peptides/metabolism* ; Energy Metabolism