Based on spleen deficiency-phlegm dampness as the core pathogenesis of obesity， and integrating recent advances in modern medicine regarding the key role of immune inflammation in obesity， this paper proposes a multidimensional pathogenic network of "obesity-spleen deficiency-phlegm dampness-immune imbalance". Various traditional Chinese medicine （TCM） herbs that strengthen the spleen， regulate qi， and resolve phlegm and dampness can treat obesity by improving spleen-stomach transport and transformation， promoting water-damp metabolism， and regulating immune homeostasis. This highlights immune inflammation as an important entry point to elucidate the TCM concepts of "spleen deficiency-phlegm dampness" and the therapeutic principle of "strengthening the spleen and eliminating dampness to treat obesity". By systematically analyzing the intrinsic connection between "spleen deficiency generating dampness， internal accumulation of phlegm dampness" and immune dysregulation in obesity， this paper aims to provide theoretical support for TCM treatment of obesity based on dampness.

ObjectiveTo investigate the effect and underlying mechanism of the Wulao Qisun prescription on pathological new bone formation in ankylosing spondylitis （AS）. MethodsSynovial fibroblasts were isolated from the hip joints of AS patients and observed under a microscope to assess cell morphology. The cells were identified using immunofluorescence staining. The isolated AS fibroblasts were divided into blank group， low drug-containing serum group， medium drug-containing serum group， high drug-containing serum group， and positive drug group. After drug intervention， cell proliferation was measured using the cell counting kit-8 （CCK-8） assay to observe fibroblast growth and determine the optimal intervention time. Alkaline phosphatase （ALP） activity was measured using the alkaline phosphatase assay. Protein expression of osteocalcin （OCN）， osteopontin （OPN）， and runt-related transcription factor 2 （Runx2） was detected by Western blot. The mRNA expression levels of Wnt5a， β-catenin， and Dickkopf-1 （DKK-1） were measured by real-time quantitative polymerase chain reaction （Real-time PCR）. ResultsCompared with the blank group， each drug-containing serum group of Wulao Qisun prescription and the positive drug group inhibited the proliferation of AS fibroblasts and reduced ALP expression （P<0.01）. Compared with the blank group， the low drug-containing serum group of Wulao Qisun prescription downregulated β-catenin mRNA expression （P<0.05）. The medium and high drug-containing serum groups and the positive drug group significantly downregulated Wnt5a and β-catenin mRNA expression （P<0.05， P<0.01）， with the positive drug group showing the most pronounced effect （P<0.01）. The high drug-containing serum group and the positive drug group significantly upregulated DKK-1 mRNA expression （P<0.01）. Compared with the blank group， the low drug-containing serum group of Wulao Qisun prescription inhibited the expression of OPN and Runx2 proteins （P<0.05， P<0.01）， while the medium and high drug-containing serum groups and the positive drug group inhibited the expression of OCN， OPN， and Runx2 proteins （P<0.05， P<0.01）. ConclusionThe Wulao Qisun prescription can inhibit the proliferation and osteogenic differentiation of AS fibroblasts， thereby delaying the formation of pathological new bone in AS. The possible mechanism involves the regulation of Wnt/β-catenin-related gene expression， further inhibiting the transcription of downstream target genes.

Cardiovascular diseases （CVD），a group of common diseases in clinical practice，are witnessing a steady rise in both incidence and mortality rates，posing a challenge to public health. Gualou Xiebai Banxiatang，originating from Synopsis of the Golden Chamber （《金匮要略》），was initially used to treat severe cases of chest impediment. The formula consists of Trichosanthis Fructus，Allii Macrostemonis Bulbus，Pinelliae Rhizoma，and Baijiu. It has a wide range of clinical applications，with therapeutic effects including moving Qi to relieve depression，activating Yang to dissipate mass，and expelling phlegm to alleviate chest congestion. In recent years，clinical research has confirmed that Gualou Xiebai Banxiatang，with or without modification，used alone or in combination with Western medicine，has definite effects in the treatment of CVD such as hyperlipidemia，coronary atherosclerotic heart disease，hypertension，heart failure，and arrhythmia. It can alleviate disease symptoms and reduce the risk of re-hospitalization. Basic research indicates that the mechanisms of Gualou Xiebai Banxiatang include improving endothelial functions，exhibiting anti-inflammatory properties，countering oxidative stress，preventing apoptosis，inhibiting ventricular remodeling，regulating mitochondrial functions，improving hemorheology，and modulating autophagy and neurotransmitters. This article reviews relevant articles in recent years with focuses on the compatibility，clinical application，and mechanism of Gualou Xiebai Banxiatang. This review is expected to provide a theoretical basis for the mechanism research and clinical application of this formula in treating CVD and to offer ideas and reference for in-depth research.

ObjectiveTo investigate the effect and mechanism of Qingre Sanzhuo decoction in treating gouty arthritis （GA） combined with hyperuricaemia （HUA）. MethodsSixty male SD rats were randomized into normal， model， colchicine （0.5 mg·kg^-1）， and low-， medium-， and high-dose （17， 34， 68 g·kg^-1， respectively） Qingre Sanzhuo decoction groups （n=10）. The rats in other groups except the normal group were treated with the modified method for the modeling of GA combined with HUA. The drug intervention groups were administrated with corresponding drugs by gavage in the afternoon every day and the normal group and the model group were administrated with an equal volume of sterile normal saline by gavage. The level of uric acid （SUA） in the serum was measured 2 h after the last administration. The degree of ankle joint swelling was calculated 0.5， 12， 24， 48 h after modeling， and joint inflammation was scored. The pathological changes of ankle joints were observed by hematoxylin-eosin staining， and the serum levels of tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， C reactive protein （CRP）， and interleukin-18 （IL-18） were measured by enzyme-linked immunosorbent assay. Real-time PCR was performed to determine the mRNA levels of NOD-like receptor protein 3 （NLRP3）， apoptosis-associated speck-like protein containing CARD （ASC）， cysteinyl aspartate-specific protease-1 （Caspase-1）， gasdermin D （GSDMD）， and nuclear factor-kappa B （NF-κB） in the synovial tissue of ankle joints. Western blot was employed to determine the protein levels of NLRP3， ASC， and Caspase-1 in ankle joints. The immunohistochemical method was used to detect the expression of GSDMD and NF-κB in the synovial tissue of ankle joints. ResultsCompared with the normal group， the model group showed increased SUA in the serum （P<0.05）， ankle joint swelling and joint inflammation （P<0.05）， increased number of blood vessels in the synovium， inflammatory cell foci in the synovial bursa， elevated serum levels of TNF-α， IL-1β， CRP， and IL-18 （P<0.05）， and up-regulated mRNA and protein levels of NLRP3， ASC， Caspase-1， GSDMD， and NF-κB in the synovial tissue of ankle joints （P<0.05）. Compared with the model group， the medium- and high-dose Qingre Sanzhuo decoction groups showed reduced SUA in the serum （P<0.05）， alleviated ankle joint swelling and joint inflammation （P<0.05）， lowered serum levels of TNF-α， IL-1β， CRP， and IL-18 （P<0.05）， and down-regulated mRNA and protein levels of NLRP3， ASC， Caspase-1， GSDMD， and NF-κB in the synovial tissue of ankle joints （P<0.05）. However， in terms of ameliorating the pathological changes of ankle joints， only the high-dose Qingre Sanzhuo decoction group showed normal morphology of the synovial membrane of ankle joints and no obvious lesion in the articular cartilage. ConclusionQingre Sanzhuo decoction may play a role in preventing and controlling GA combined with HUA by down-regulating the activity of NLRP3/ASC/Caspase-1 pathway and inhibiting the expression of inflammatory cytokines， such as TNF-α， IL-1β， CRP， and IL-18.

ObjectiveTo investigate the effect of Naoqingtong decoction （NQT） on the kidney damage and the inflammatory factors NOD-like receptor protein 3 （NLRP3）， apoptosis-associated speck-like protein containing a C-terminal caspase recruitment domain （ASC）， cysteinyl aspartate-specific proteinase-1 （Caspase-1）， interleukin-6 （IL-6）， and tumor necrosis factor-α （TNF-α） in spontaneously hypertensive rats （SHRs）. MethodsTwenty-four SHRs were randomized into a model group， a low-dose （12.9 g·kg^-1·d^-1） NQT （NQT-L） group， a high-dose （25.8 g·kg^-1·d^-1） NQT group （NQT-H）， and a captopril （CTP， 20 mg·kg^-1·d^-1） group， with 6 rats in each group. In addition， 6 homozygous male Wistar-Kyoto rats were used as the control group. The control and model groups were administrated with the same amount of normal saline by gavage for 8 weeks. General behaviors of rats were observed during the intervention period， and the blood pressure was measured periodically. At the end of intervention， the body mass was weighed， and both kidneys were collected and weighed for the calculation of the renal index. Hematoxylin-eosin staining was performed to observe the pathological changes in the kidney tissue. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot were employed to determine the expression levels of NLRP3， ASC， Caspase-1， IL-6， and TNF-α in the kidney tissue. ResultsDuring the experiment period， the control group had normal mental status， food intake， and activity， while the model group showed thinning of hair， loss of luster， reduced activity， loss of appetite， fecal adhesion， and irritability， and some of the skin had scratches or blood scabs. The above symptoms were alleviated to different degrees after 8 weeks of NQT administration. An intelligent non-invasive sphygmomanometer was used to measure the tail artery pressure of rats， which showed that the systolic and diastolic blood pressure of rats in the model group was higher than that in the control group （P<0.01）. Compared with the model group， drug interventions lowered the systolic and diastolic blood pressure （P<0.05， P<0.01）. Compared with the control group， the model group showed severe pathological damage in the kidney tissue， which was alleviated in each drug intervention group. Compared with the control group， the model group showed up-regulated expression levels of NLRP3， ASC， Caspase-1， IL-6， and TNF-α in the kidney tissue （P<0.05， P<0.01）. Compared with the model group， the drug intervention groups showed down-regulated expression levels of NLRP3， ASC， Caspase-1， IL-6， and TNF-α in the kidney tissue （P<0.05， P<0.01）. ConclusionNQT can lower the blood pressure in SHRs by inhibiting the activation of NLRP3 inflammasomes， suppressing renal inflammation， and ameliorating hypertensive kidney damage.

Objective To analyze the influencing factors of malaria infection of labor service exported to overseas in Langfang City, in order to establish a visualization tool to assist clinicians in predicting the risk of malaria. Methods A total of 4 774 expatriate employees of the Nibei Pipeline Project of the Pipeline Bureau from October 2021 to August 2023 were taken as the subjects, and the gender, age, overseas residence area and Knowledge of malaria controlscores of the study subjects were investigated by questionnaire survey, and the possible risk factors of malaria were screened by logistic regression model. At the same time, the nomogram prediction model was established, and the subjects were divided into the training group and the validation group at a ratio of 2:1, and the area under the curve (ROC) and the decision curve were plotted to evaluate the prediction ability and practicability of the prediction model in this study. Results Among the 4 774 study subjects, 96 cases of malaria occurred, and the detection rate was 2.01%. Junior school （OR=1.723，95% CI:1.361-2.173）， and residence in rural areas（OR=2.091，95%CI:1.760 -3.100）were risk factors (OR>1), while protective measures（OR=0.826，95% CI : 0.781 - 0.901） and high malaria education scores （OR=0.872，95% CI : 0.621 - 0.899）were protective factors.The nomogram prediction model results showed that the area under the curve of the nomogram prediction model in the training group was 0.94 (95% CI : 0.85 - 1.00), while the validation group was 0.93 (95% CI : 0.80 - 1.00). The results of the decision curve showed that when the threshold probability of the population was 0-0.9, the nomogram model was used to predict the risk of malaria occurrence with the highest net income. Conclusion The nomogram prediction model (including gender, education, region, protection and malaria education score) established and validated in this study is of great value for clinicians to screen high-risk patients with malaria.

Objective: To investigate the personnel allocation, structure, and mobility situation of the disease prevention and control (CDC) institutions in Jinhua City, Zhejiang Province from 2018 to 2024, so as to provide insights into strengthening the construction of the talent team within CDC institutions. Methods: Basic information of the personnel in the CDC institutions, Jinhua City were collected through the Basic Information Subsystem of the China Disease Control and Prevention Information System. Composition of age, gender, educational background, major, professional title of the in-service and officially employed personnel, as well as the situation of personnel mobility were analyzed using descriptive methods. Results: A total of 10 CDCs were established in Jinhua City by the end of 2024, including 1 municipal CDC and 9 county (city, district) CDCs, with an approved staffing of 672 people and 621 in-service and officially employed staff. Compared with 2018, the approved number of staff positions in the CDC institutions of Jinhua City increased by 21.30% in 2024, and the number of in-service and officially employed staff members increased by 22.73%. From 2018 to 2024, the number of CDC staff per 10 000 permanent residents in the CDC institutions of Jinhua City, the municipal CDC, and the county (city, district) CDCs were 0.764 to 0.932, 0.142 to 0.173, and 0.623 to 0.759, respectively. From 2018 to 2024, the overall male-to-female ratio in both the municipal CDC and the county (city, district) CDCs decreased from 1.04∶1 and 0.84∶1 to 0.95∶1 and 0.75∶1, respectively. In the municipal CDC, the proportion of staff aged 25-<45 years old increased from 57.45% to 69.02%; the proportion of staff with a bachelor's degree or above increased from 79.79% to 93.81%; the proportion of staff majoring in public health increased from 37.23% to 49.56%; the proportions of staff with various professional titles were relatively stable; 51 staff members joined, all of whom had a bachelor's degree or above; 32 staff members left, among whom 24 retired and 6 were admitted to civil service positions or other units. In the county (city, district) CDCs, the proportion of staff aged 22-<35 years old increased from 30.59% to 37.40%; the proportion of staff with a bachelor's degree or above increased from 71.85% to 89.76%; the proportion of staff majoring in public health increased from 46.60% to 54.33%; the proportion of staff with a junior professional title or below increased from 34.47% to 43.50%; 198 staff members joined, and 194 of them had a bachelor's degree or above; 102 staff members left, among whom 67 retired and 28 were admitted to civil service positions or other units. Conclusions From 2018 to 2024, the number of in-service and officially employed staff in Jinhua CDC institutions increased the academic qualifications and professional composition continue to improve. There are still problems with the number of CDC staff per 10 000 permanent residents being lower than the standard for the personnel establishment in Zhejiang CDCs, a lack of high-level talents, and insufficient personnel stability.

AIM: To explore the efficacy of internal limiting membrane(ILM)flap technique and simple ILM peeling in the treatment of idiopathic macular hole(IMH)and related influencing factors.METHODS: A retrospective cohort study was conducted on totally 32 patients(35 eyes)with IMH who received surgery at our department from January 2023 to November 2024. All the patients simultaneously received phacoemulsification combined with intraocular lens implantation, and they were divided into study group(19 eyes)and control group(16 eyes), with ILM flap technique and simple ILM peeling received in the two groups, respectively. The closure situation of macular hole, best corrected vision acuity(BCVA), and macular structure were observed in the two groups of patients. Furthermore, the correlation of BCVA and healing type of macular hole at the last time of follow-up with each parameter was analyzed.RESULTS: There was no statistical difference between the two groups of patients in preoperative general characteristics(all P>0.05). At the last time of follow-up, the macular hole was heeled in both groups, with 7 eyes of U-shaped heeling, 6 eyes of V-shaped heeling, and 6 eyes of irregular heeling in the study group, and with 13 eyes of U-shaped of heeling, 1 eye of V-shaped heeling and 2 eyes of irregular heeling in the control group(χ2=7.167, P=0.028). The postoperative BCVA was better than preoperative level(all P<0.05), there were no statistical significant differences between the two groups of patients in macular choroidal thickness before and after surgery(P>0.05), but the macular retinal thickness of the study group was thinner than that of the control group(168.11±92.11 vs 235.56±92.18 μm, P=0.03). Pearson correlation analysis indicated that BCVA at the last time of follow-up was positively correlated with the preoperative minimum diameter(r=0.476, P<0.05)and the diameter hole index(r=0.361, P<0.05), and negatively correlated with traction hole index(r=-0.364, P=0.031); Keendall correlation analysis showed that the postoperative closure types positively correlated with the basal diameter(τ=0.296, P=0.029), minimum diameter(τ=0.366, P=0.007), and visual acuity at the last time of follow-up(τ=0.412, P=0.003), while negatively correlated with macular hole index(τ=-0.415, P=0.002)and traction hole index(τ=-0.511, P<0.01). During the follow-up period, neither group of patients experienced postoperative complications.CONCLUSION: Both ILM flap technique and simple ILM peeling are safe and effective in treating IMH. As the smaller the basal diameter and minimum diameter of the macular hole, the larger the macular hole index and traction hole index, the probability of U-shaped heeling after surgery is greater and the visual acuity is better.

Objective To evaluate the quality of Xi xiong(Gansu Chuanxiong)based on the combination of intelligent sensory technology,HPLC and HS-SPME-GC-MS.Methods The chromaticity values of 10 batches of Gansu Chuanxiong Rhizoma samples were measured using a colorimeter and clustering analysis was performed;an electronic nose was used to measure the odor of Gansu Chuanxiong Rhizoma,and Loadings and PCA were conducted;According to the method under the Chuanxiaong Rhizoma section of the Chinese Pharmacopoeia,the moisture,ash content and extract were determined;HPLC was used to determine the contents of ferulic acid,chlorogenic acid and ligustrazine;the volatile components were analyzed by HS-SPME-GC-MS;the quality of Gansu Chuanxiong Rhizoma was evaluated by analyzing the correlation between chromaticity value,odor and active components.Results The total color value of Gansu Chuanxiong Rhizoma ranged from 31.210 1±1.193 7 to 43.976 3±0.721 4,at the Euclidean distance of 10,and the 10 batches of Gansu Chuanxiong Rhizoma could be clustered into four categories;Loadings and PCA showed that the higher contribution of sensors W2S,W5S,W2W,W1W and W1S to Gansu Chuanxiong Rhizoma samples,the variance contribution of the first and second principal components was 62.6%and 22.4%,respectively;water,ash and extract in 10 batches of Gansu Chuanxiong Rhizoma all met the standards of Chinese Pharmacopoeia;the HPLC determination results indicated that the content of ferulic acid in Gansu Chuanxiong Rhizoma was greater than 0.192 6%,ligustrazine content was between 0.001 2%and 0.006 1%,chlorogenic acid content was greater than 0.016 4%;HS-SPME-GC-MS results indicated 52 volatile components were identified in Gansu Chuanxiong Rhizoma samples,the olefin compounds were rich in species,phenyphthalide compounds had the highest relative content;the correlation analysis showed that the color values ΔL*,Δb* and ΔE showed a high degree of correlation with ferulic acid and ligusticum tecidate A.Conclusion This study clarifies the intrinsic quality of Gansu Chuanxiong Rhizoma and provides a theoretical basis for research on Gansu Chuanxiong Rhizoma.

Objective To analyze the medication law and compatibility characteristics of TCM compounds for the treatment of myocardial infarction in the national patent database.Methods TCM compounds for treating myocardial infarction were retrieved from CNIPA patent publication website.A prescription database was built using Excel 2019 software to statistically analyze the frequency of medicinal use and their properties,taste and meridian tropism;SPSS Modeler 18.0 software was used to analyze the association rules of drugs;a network of Chinese materia medica co-occurrence was constructed using Cytoscape 3.10.0,and systematic clustering analysis was performed on the Chinese materia medica in the core network.Results A total of 146 patents of TCM compounds were included,involved 440 kinds of Chinese materia medica.High frequency drugs included Salviea Miltiorrhizae Radix et Rhizoma,Chuanxiong Rhizoma,Angelicae Sinensis Radix,Glycyrrhizae Radix et Rhizoma,etc.The main property was warm,the main tastes were bitter,sweet and pungent,and the medicines mostly belongs to the liver meridian,heart meridian and spleen meridians.Commonly used medicinal pairs included Angelicae Sinensis Radix-Chuanxiong Rhizoma,Astragali Radix-Salviea Miltiorrhizae Radix et Rhizoma,Paeoniae Radix Rubra-Angelicae Sinensis Radix,etc.Commonly used tripartite combinations included Paeoniae Radix Rubra-Chuanxiong Rhizoma-Angelicae Sinensis Radix,Carthami Flos-Angelicae Sinensis Radix-Chuanxiong Rhizoma,Carthami Flos-Chuanxiong Rhizoma-Angelicae Sinensis Radix,etc.Clustering analysis showed four types of combinations.Conclusion TCM compound patents for the treatment of myocardial infarction is based on promoting blood circulation,removing blood stasis,and relieving pain,while also using methods such as eliminating phlegm,tonifying qi,warming yang,and nourishing yin.It can provide references for clinical medication.