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.

OBJECTIVE To investigate the mechanism of Shenling baizhu san （SLBZS） in ameliorating ulcerative colitis （UC）. METHODS Mice were randomly divided into normal group， model group， and low-， medium-， high-dose SLBZS groups （3， 6， 12 g/kg）， with 10 mice in each group. Except for the normal group， mice in other groups were given free access to 3% dextran sulfate sodium solution for 7 days to establish UC models. Simultaneously， mice in each group were intragastrically administered corresponding medicinal liquid or double-distilled water once a day for consecutive 7 days. After the last administration， the histopathological morphology of colon tissues was observed； the serum levels of inflammatory factors including tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β） and IL-18 were detected； the total bile acid contents in liver， gallbladder and colon tissues were determined； the expression level of NOD-like receptor family pyrin domain-containing protein 3 （NLRP3） in colon tissues was tested. The expression levels of flora metabolism-related proteins [G protein-coupled receptor 41（GPR41），GPR43，farnesoid X receptor （FXR）， G protein-coupled bile acid receptor 1 （TGR5）， flavin-containing monooxygenase 3 （FMO3）， cytochrome P450 family 27 subfamily A member 1 （CYP27A1）， CYP7A1] in liver or colon tissues， as well as the proteins related to Toll-like receptor 4 （TLR4）/nuclear factor-κB （NF-κB）/NLRP3 inflammatory axis [TLR4， NF-κB， phosphorylated NF-κB （p-NF-κB）， myeloid differentiation factor 88 （MyD88）， NLRP3， apoptosis-associated speck-like protein containing a CARD （ASC）， caspase-1] in colon tissues were measured. RESULTS Compared with the model group， the colon tissue injury and inflammatory cell infiltration were alleviated in medium- and high-dose SLBZS groups. The serum levels of TNF-α， IL-1β and IL-18， total bile acid contents in liver and colon tissues， as well as the protein expression levels of FMO3 and CYP7A1 in liver tissues， TLR4， p-NF-κB， NF-κB， MyD88， NLRP3， ASC and caspase-1 in colon tissues were significantly decreased （P＜0.05）. Meanwhile， the total bile acid content in gallbladder， the protein expression levels of GPR41 and GPR43 in colon tissues， along with CYP27A1， FXR and TGR5 in liver tissues were significantly increased （P＜0.05）. CONCLUSIONS SLBZS may relieve colonic inflammatory injury and ameliorate UC by regulating the expression of flora metabolism-related proteins and inhibiting the abnormal activation of TLR4/NF-κB/NLRP3 inflammatory axis.

Objective To provide basis for the formation of acute exacerbation of chronic obstructive pulmonary disease(AECOPD-STES),the item weight of the syndrome therapeutic evaluation scale for AECOPD-STES was determined.Methods Based on the clinical survey data of 387 AECOPD patients,the random forest method was adopted,and the Spyder integrated development environment.Anaconda navigator software was used to call the"random forest Classifier"in the sklearn package to establish the initial random forest model and calculate the item weights.Factor analysis was used to extract common factors with cumulative variance contribution>80%,and the item weight was calculated according to the cumulative variance contribution and component score coefficient of common factors.The percentage weight method was used to calculate the item weight based on the importance score of each item by 29 experts.Finally,40%,30%and 30%of the above three methods were given respectively to determine the final weight of the items.Results The random forest method showed that the weights of wind cold syndrome,cold Yin syndrome,phlegm heat syndrome,phlegm dampness syndrome and blood stasis syndrome were 0.014-0.170,0.076-0.194,0.017-0.183,0.010-0.183 and 0.069-0.298,respectively.Factor analysis showed that the weights of wind cold syndrome,cold yin Syndrome,phlegm heat syndrome,phlegm dampness syndrome and blood stasis syndrome were 0.030-0.111,0.100-0.182,0.037-0.095,0.022-0.141 and 0.054-0.185,respectively.The percentage weight method shows that the weight ranges of wind cold syndrome,cold yin Syndrome,phlegm heat syndrome,phlegm dampness syndrome and blood stasis syndrome were 0.072-0.102,0.146-0.182,0.057-0.077,0.075-0.111 and 0.115-0.185,respectively.According to the three methods,the weights of wind cold syndrome,cold yin Syndrome,phlegm heat syndrome,phlegm dampness syndrome and blood stasis syndrome were 0.050-0.121,0.117-0.174,0.040-0.117,0.056-0.130 and 0.092-0.188,respectively.Conclusion This study determined the weight of each item of AECOPD-STES,providing a basis for the calculation of syndrome score.

Objective To establish a simple technical procedure for preparing doggybone DNA(dbDNA),and to discuss the distinctions in gene expression and immune response between dbDNA and conventional plasmid DNA.Induced pluripotent stem cell(iPSC)was generated from human peripheral blood mononuclear cells(PBMCs)by using dbDNA.To investigate a protocol for inserting ultra-long DNA fragments into the iPSC adeno-associated virus site 1(AAVS1),concurrently with the integration of the Cas9 expression frame point into the dbDNA-derived iPSC AAVS1 safe harbor,so as to establish a stable cell line that can achieve iPSC gene editing exclusively through the introduction of the single guide RNA(sgRNA)for the targeted gene.Methods A simple dbDNA preparation technique was established through utilization of Phi29 DNA polymerase multiple displacement amplification,protelomerase TelN digestion and covalent ligation,as well as the subsequent removal of the back-bone loop through the action of a restriction enzyme and exonuclease.The efficiency of green fluorescent protein(GFP)was eval-uated following electroporation of the dbDNA-GFP vector and the pMax-dbDNA-GFP traditional plasmid vector into PB-MCs.The mRNA expression of interferon-γ(IFN-γ)in the two groups was quantified by qPCR.The dbDNA reprogramming vectors dbDNA-MOS,dbDNA-KLF4,dbDNA-MYC and dbDNA-BCL were prepared and subsequently transferred into PBMCs to induce reprogramming.The dbDNA-iPSC cell line was identified through morphological analysis,alkaline phosphatase stai-ning,RT-PCR,and detection of pluripotent stem cell markers.The ZFN and TALEN gene editing techniques were employed to insert an 11.5 kb ultra-long DNA fragment containing the Cas9 expression cassette,EGFP reading frame with stop codons in the sequence,a eukaryotic cell screening marker and other elements at the iPSC AAVS1.The identification of the iPSC lines with Cas9 integrated into AAVS1 was conducted through the utilization of red fluorescence detection,genomic PCR reaction and Western blot.The EGFP single-strand homologous repair template and EGFP sgRNA were co-transfected into positive iPSC cell lines to repair the erroneous stop codons in the EGFP gene and to express green fluorescent protein correctly.This approach was undertaken in order to verify the gene editing ability of the Cas9 protein.Results The dbDNA vector was successfully pre-pared and employed for gene expression.The GFP gene expression efficiency of dbDNA was similar to that of traditional plas-mid DNA.The expression level of IFN-γ mRNA in the dbDNA group was lower than that of traditional plasmid DNA group.The iPSC cell lines resembling human embryonic stem cells were successfully obtained,iPSC cell lines with positive alka-line phosphatase staining,pluripotency related gene expression and stem cell pluripotency markers.The ultra-long fragment CRISPR-Cas9 gene editing reporting system was successfully inserted into the safe harbor AAVS1 site of the cell line,and the integrated fragment was successfully inserted into the genome by genomic PCR.Red fluorescent protein was expressed.Cas9 protein expression and EGFP gene recovery was confirmed by Western blot.Green fluorescence was observed.Conclusion A simple technical procedure for the preparation of dbDNA is successfully established.The gene expression efficiency of the dbD-NA vector is comparable to that of traditional plasmid DNA,with less immune response.The dbDNA-derived iPSCs are success-fully obtained,which is confirmed by morphological analysis,alkaline phosphatase staining,RT-PCR,and stem cell pluripotency markers.An 11.5 kb ultra-long DNA fragment is successfully inserted into the iPSC AAVS1 safe harbor to establish a stable iPSC cell line with Cas9-mediated gene editing.

Objective:To explore the prevalence and risk factors of insomnia in Chinese Air Force servicemen deployed to highland areas.Methods:A total of 718 Air Force servicemen deployed to Qinghai-Tibetan plateau were recruited at May 2024.Sleep quality was assessed with the Pittsburgh Sleep Quality Index.Social-demograph-ic,military service,and psychological characteristics were measured with a self-administered general question-naire.Bivariable and multivariable logistic regressions were performed to identify independent risk factors.Missing data were handled by the multiple imputation.Results:The average sleep duration was(6.9±1.2)h and the aver-age PSQI score was(5.9±4.1).Totally 53.8％of participants experienced clinically significant insomnia.The multivariable analysis revealed that age≥35(aOR=4.07,95％CI=1.11-17.76),stressful event(aOR=3.27,95％CI=2.00-5.49),dysfunctional sleep beliefs and attitudes(aOR=2.59,95％CI=1.75-3.85),and caffeine product usage(aOR=1.69,95％CI=1.17-2.43)were risk factors for insomnia,while Tibetan-indigenous ethnic(aOR=0.44,95％CI=0.20-0.91),higher perceived social support(aOR=0.96,95％CI=0.96-0.99),and positive coping style(aOR=0.96,95％CI=0.93-0.99)were protective factors.Conclusion:Air force service-men deployed to highland areas have sufficient sleep time,but reduced sleep quality.Age,exposed to stress event during deployment,dysfunctional sleep beliefs and attitudes,and caffeine product usage are risk factors for insomni-a,while Tibetan-indigenous ethnic,higher perceived social support and positive coping style act as protective fac-tors.

AIM:To analyze the expression of se-creted phosphoprotein 1(SPP1)and programmed cell death-ligand 1(PD-L1)in SMARCA4-deficient non-small cell lung cancer,and to provide a scientif-ic basis for the study of the follow-up treatment of this rare pathological type of lung cancer.METH-ODS:The clinical and pathological characteristics of 12 patients with this disease were analyzed retro-spectively,and the patients were divided into two groups of adenocarcinomas and poorly differentiat-ed carcinomas according to their morphological characteristics,and the relationship between the expression of SPP1 and PD-L1 was analyzed in the two groups.RESULTS:SPP1 expression was detect-ed in all patients and Its expression level was signif-icantly higher in the poorly differentiated carcino-ma group compared with the adenocarcinoma group(P=0.015);PD-L1 expression was found in 6/7 patients(5 cases were not measured),compared with the adenocarcinoma group,PD-L1 was also highly expressed in the poorly differentiated carci-noma group(P=0.048)and the PD-L1 difference be-tween the two groups suggested that the results were similar to those of SPP1.CONCLUSION:SMARCA4-deficient non-small cell lung cancer has high positive expression of SPP1 and PD-L1.It was more pronounced in patients with poorly differenti-ated carcinoma.There may be a positive correla-tion between SPP1 and PD-L1 expression in SMAR-CA4-deficient non-small cell lung cancer and the mechanism of the correlation needs to be further verified in subsequent studies.

Objective To establish a simple technical procedure for preparing doggybone DNA(dbDNA),and to discuss the distinctions in gene expression and immune response between dbDNA and conventional plasmid DNA.Induced pluripotent stem cell(iPSC)was generated from human peripheral blood mononuclear cells(PBMCs)by using dbDNA.To investigate a protocol for inserting ultra-long DNA fragments into the iPSC adeno-associated virus site 1(AAVS1),concurrently with the integration of the Cas9 expression frame point into the dbDNA-derived iPSC AAVS1 safe harbor,so as to establish a stable cell line that can achieve iPSC gene editing exclusively through the introduction of the single guide RNA(sgRNA)for the targeted gene.Methods A simple dbDNA preparation technique was established through utilization of Phi29 DNA polymerase multiple displacement amplification,protelomerase TelN digestion and covalent ligation,as well as the subsequent removal of the back-bone loop through the action of a restriction enzyme and exonuclease.The efficiency of green fluorescent protein(GFP)was eval-uated following electroporation of the dbDNA-GFP vector and the pMax-dbDNA-GFP traditional plasmid vector into PB-MCs.The mRNA expression of interferon-γ(IFN-γ)in the two groups was quantified by qPCR.The dbDNA reprogramming vectors dbDNA-MOS,dbDNA-KLF4,dbDNA-MYC and dbDNA-BCL were prepared and subsequently transferred into PBMCs to induce reprogramming.The dbDNA-iPSC cell line was identified through morphological analysis,alkaline phosphatase stai-ning,RT-PCR,and detection of pluripotent stem cell markers.The ZFN and TALEN gene editing techniques were employed to insert an 11.5 kb ultra-long DNA fragment containing the Cas9 expression cassette,EGFP reading frame with stop codons in the sequence,a eukaryotic cell screening marker and other elements at the iPSC AAVS1.The identification of the iPSC lines with Cas9 integrated into AAVS1 was conducted through the utilization of red fluorescence detection,genomic PCR reaction and Western blot.The EGFP single-strand homologous repair template and EGFP sgRNA were co-transfected into positive iPSC cell lines to repair the erroneous stop codons in the EGFP gene and to express green fluorescent protein correctly.This approach was undertaken in order to verify the gene editing ability of the Cas9 protein.Results The dbDNA vector was successfully pre-pared and employed for gene expression.The GFP gene expression efficiency of dbDNA was similar to that of traditional plas-mid DNA.The expression level of IFN-γ mRNA in the dbDNA group was lower than that of traditional plasmid DNA group.The iPSC cell lines resembling human embryonic stem cells were successfully obtained,iPSC cell lines with positive alka-line phosphatase staining,pluripotency related gene expression and stem cell pluripotency markers.The ultra-long fragment CRISPR-Cas9 gene editing reporting system was successfully inserted into the safe harbor AAVS1 site of the cell line,and the integrated fragment was successfully inserted into the genome by genomic PCR.Red fluorescent protein was expressed.Cas9 protein expression and EGFP gene recovery was confirmed by Western blot.Green fluorescence was observed.Conclusion A simple technical procedure for the preparation of dbDNA is successfully established.The gene expression efficiency of the dbD-NA vector is comparable to that of traditional plasmid DNA,with less immune response.The dbDNA-derived iPSCs are success-fully obtained,which is confirmed by morphological analysis,alkaline phosphatase staining,RT-PCR,and stem cell pluripotency markers.An 11.5 kb ultra-long DNA fragment is successfully inserted into the iPSC AAVS1 safe harbor to establish a stable iPSC cell line with Cas9-mediated gene editing.

Objective To compare the induction effects of direct treatment with low-temperature plasma(LTP)and treatment with plasma-activated medium(PAM)on immunogenic cell death(ICD)of melanoma cells.Methods After direct treatment of melanoma cell line B16F10 with LTP and treatment of it with PAM for 24 hours,cell viability was detected by MTT assay.Flow cytometry was used to detect cell apoptosis and the expression of calreticulin(CRT)on the cell surface.The adenosine triphosphate(ATP)content in the culture medium was detected by an ATP detection kit.The content of high-mobility group box 1(HMGB1)in the cell culture medium was detected by ELISA.B16F10 cells treated with LTP were co-cultured with immature dendritic cells(DC)DC2.4 cell line,and flow cytometry was used to detect DC surface molecules CD80 and CD86.Results Compared with the control group,both direct treatment and indirect treatment could lead to a decrease in the viability of B16F10 cells,an increase in the apoptosis rate,an increase in intracellular ROS,an increase in CRT expression,and an increase in the secretion of ATP and HMGB1(P＜0.05).At the same treatment time,the expression of CRT and the release of ATP in B16F10 cells directly treated with LTP were higher than those indirectly treated with PAM(P＜0.05).Compared with the DC2.4 group,the expression proportion of the DC cell maturation marker molecule CD80 was significantly increased in LTP-120s group,LTP-180s group,PAM-120s group,and PAM-180s group.The expression proportion of the DC cell maturation marker molecule CD86 was significantly increased in LTP-120s group,LTP-180s group,and PAM-180s group,and the difference was statistically significant(P＜0.05).Conclusion Both direct treatment with LTP and indirect treatment with PAM can induce ICD in melanoma cells.The direct treatment with LTP has a better induction effect.

Objective This is to develop a comprehensive performance evaluation index system for physicians under the DRG system and to conduct practical research.Methods The"cost ratio"is used to establish a"sharing coefficient"to define the distribution of performance among physicians treating the same patient;the Delphi technique is applied to ascertain the weights of evalation index,and the weighted comprehensive index method is utilized to construct the performance evaluation index system for DRG physicians;empirical research on physician performance evaluation is conducted using hospital data.Results Following performance sharing and weighted integration,the basic evaluation indicators and the performance evaluation index of DRG both exhibit an approximate normal distribution between 0～100 points;the performance evalation index of DRG score can be utilized for the overall assessment of physicians,and the strengths and weaknesses of physician diagnosis and treatment can be analyzed based on various dimensional indices and scores.The performance sharing of the evaluation results of the same physician is more accurate than the traditional method,especially for the physicians with more transferred patients.Conclusion Using the"allocation coefficient"to divide the weight of"one patient and multiple doctors"and incorporating the weight into the comprehensive evaluation index system make the results more objective and accurate.The comprehensive performance evaluation index system for DRG physicians,based on the"sharing coefficient"and weighted comprehensive index method,offers a scientific and practical tool for hospital performance distribution management.

Objective To explore the effect of Omaha system continuity nursing on the degree of pain and quality of life in patients undergoing arthroscopic rotator cuff repair.Methods A total of 110 patients who underwent arthroscopic rotator cuff repair at the First Affiliated Hospital of Wenzhou Medical University from September 2022 to May 2023 were selected.They were divided into intervention group and control group according to the random number table method,with 55 cases in each group.Patients in control group were given conventional continuous nursing,while patients in intervention group were given Omaha system continuity nursing.Both groups of patients were intervened for 6 months.The range of motion of shoulder joint,shoulder joint function,degree of pain and quality of life of two groups of patients before and after the intervention were compared.Results After the intervention,the range of motion of shoulder joint in intervention group was significantly greater than that in control group,University of California,Los Angeles shoulder joint score and the 8-item short form health survey were significantly higher than those in control group,and numerical rating scale score of pain was significantly lower than that in control group(P＜0.05).Conclusion Omaha system continuity nursing can improve shoulder joint mobility and function,alleriate pain,and improve quality of life for patients undergoing arthroscopic rotator cuff repair surgery.