Abstract In recent years, the prevalence of overweight and obesity among children and adolescents has risen rapidly, posing a serious threat to their physical and mental health. To provide scientific, systematic, and standardized weight management guidance for overweight and obese children and adolescents, the study focuses on the core concept of healthy lifestyle intervention, integrates multidisciplinary expert opinions and research findings,and proposes a comprehensive multidisciplinary intervention framework covering scientific exercise intervention, precise nutrition and diet, optimized sleep management, and standardized psychological support. It calls for the establishment of a multi agent collaborative management mechanism led by the government, implemented by families, fostered by schools, initiated by individuals, optimized by communities, reinforced by healthcare, and coordinated by multiple stakeholders. Emphasizing a child and adolescent centered approach, the consensus advocates for comprehensive, multi level, and personalized guidance strategies to promote the internalization and maintenance of a healthy lifestyle. It serves as a reference and provides recommendations for the effective prevention and control of overweight and obesity, and enhancing the health level of children and adolescents.

OBJECTIVE To investigate the effects of Tripterygium wilfordii multiglycoside （TWM） on renal injury in diabetic nephropathy （DN） rats through tumor protein p53/microRNA-214 （miR-214）/UNC-51-like kinase 1 （ULK1） axis. METHODS Male SD rats were randomly divided into normal group （n＝6） and modeling group （n＝28）； the modeling group was fed with high fat and high glucose plus intraperitoneal injection of streptozotocin to establish DN model. The modeled rats were randomly divided into model group， valsartan group [8.33 mg/（kg·d）] and TWM group[6.25 mg/（kg·d）]， with 8 rats in each group. Rats in each group were gavaged with the corresponding medication or normal saline， once a day， for 6 consecutive weeks. After the last medication， liver and renal function indexes [24 h urinary total protein （24 h-UTP）， blood urea nitrogen （BUN）， serum creatinine （SCr）， albumin （ALB）， alanine transaminase （ALT）]， blood lipid indexes （triglycerides， total cholesterol） and blood glucose index （fasting blood glucose） in urine/blood sample of rats were detected in each group. Renal pathologic change was observed， protein and mRNA expressions of p53， ULK1， Beclin-1 and microtubule-associated protein 1 light chain 3 （LC3）， and expression of miR-214 in renal tissue were also determined. RESULTS Compared with the normal group， the renal tubular epithelium of rats in the model group showed obvious edema， cell swelling， accompanied by lymphocyte infiltration； the levels of 24h-UTP， BUN， SCr， ALT and glycolipid indexes， the expressions of p53 protein and mRNA， as well as the expression of miR-214 in rats in the model group and administration groups were significantly increased or up-regulated， while ALB level， LC3-Ⅱ/LC3-Ⅰ， the expressions of LC3 mRNA， the expressions of ULK1， Beclin-1 protein and mRNA were significantly decreased or down-regulated （P＜0.01）. Compared with the model group， the histopathological damage of the kidney in rats was improved in administration groups； the levels of 24 h-UTP， BUN， SCr， ALT and glycolipid indexes， the expressions of p53 protein and mRNA， as well as the expression of miR-214 were all significantly decreased or down-regulated， while ALB level， LC3-Ⅱ/LC3-Ⅰ， the expressions of LC3 mRNA， the expressions of ULK1 and Beclin-1 protein and mRNA were significantly increased or up-regulated （P＜0.01）. CONCLUSIONS TG can alleviate renal damage in DN rats， and improve their liver and renal function， as well as glucose and lipid levels. These effects may be related to the regulation of the p53/miR-214/ULK1 axis and the restoration of cellular autophagy.

Systemic lupus erythematosus （SLE）， a refractory autoimmune disease， is among the dominant diseases where traditional Chinese medicine （TCM） shows advantages in the field of rheumatology and immunology. The China-Japan Friendship Hospital hosted the "46^th Youth Salon on Dominant Diseases （Systemic Lupus Erythematosus）" organized by the China Association of Chinese Medicine， which led to a consensus on "the advantages， challenges， interdisciplinary approaches， and translational achievements of integrated TCM and Western medical approaches in the diagnosis and treatment of SLE." The diagnosis and treatment of SLE currently face several challenges， such as frequent misdiagnosis and missed diagnosis in the early stages， difficulty in achieving treatment targets， multiple side effects from pharmacotherapy， and the lack of management strategies for special populations， all of which hinder the fulfillment of the clinical needs of patients. Integrated TCM and Western medical approaches can improve clinical symptoms such as skin erythema， aversion to cold and cold limbs， fatigue， dry mouth， restlessness， and heat sensation in the palms and soles， thereby improving patients' quality of life. The approaches also help consolidate the efficacy of conventional Western medicine， slow disease progression， reduce relapse rates， address multi-organ involvement， and prevent or treat complications. Additionally， they enhance efficacy and reduce toxicity， prevent the side effects of Western medications， help reduce hormone use， and offer distinct advantages in the individualized intervention of special populations， contributing to the whole-process management of the disease. However， evidence-based medical support for this integrated approach remains limited， and the quality of available evidence is generally low. Common evaluation systems and modern research methodologies should be adopted to clarify the efficacy of TCM in SLE treatment. Efforts should be made to carry out high-quality evidence-based medical research， strengthen the development of fundamental and pharmacological research， and further explain the distinct advantages of TCM in the diagnosis and treatment of SLE. Future efforts should focus on advancing the integration of TCM and modern medicine， incorporating multi-omics technologies， individualized stratification， and other precision medicine concepts， in combination with artificial intelligence. Moreover， interdisciplinary collaboration should be promoted to utilize modern technology in exploring the essence of TCM theories and screening effective formulae， thereby comprehensively improving the diagnosis and treatment of SLE through integrated TCM and Western medical approaches.

Systemic lupus erythematosus （SLE）， a refractory autoimmune disease， is among the dominant diseases where traditional Chinese medicine （TCM） shows advantages in the field of rheumatology and immunology. The China-Japan Friendship Hospital hosted the "46^th Youth Salon on Dominant Diseases （Systemic Lupus Erythematosus）" organized by the China Association of Chinese Medicine， which led to a consensus on "the advantages， challenges， interdisciplinary approaches， and translational achievements of integrated TCM and Western medical approaches in the diagnosis and treatment of SLE." The diagnosis and treatment of SLE currently face several challenges， such as frequent misdiagnosis and missed diagnosis in the early stages， difficulty in achieving treatment targets， multiple side effects from pharmacotherapy， and the lack of management strategies for special populations， all of which hinder the fulfillment of the clinical needs of patients. Integrated TCM and Western medical approaches can improve clinical symptoms such as skin erythema， aversion to cold and cold limbs， fatigue， dry mouth， restlessness， and heat sensation in the palms and soles， thereby improving patients' quality of life. The approaches also help consolidate the efficacy of conventional Western medicine， slow disease progression， reduce relapse rates， address multi-organ involvement， and prevent or treat complications. Additionally， they enhance efficacy and reduce toxicity， prevent the side effects of Western medications， help reduce hormone use， and offer distinct advantages in the individualized intervention of special populations， contributing to the whole-process management of the disease. However， evidence-based medical support for this integrated approach remains limited， and the quality of available evidence is generally low. Common evaluation systems and modern research methodologies should be adopted to clarify the efficacy of TCM in SLE treatment. Efforts should be made to carry out high-quality evidence-based medical research， strengthen the development of fundamental and pharmacological research， and further explain the distinct advantages of TCM in the diagnosis and treatment of SLE. Future efforts should focus on advancing the integration of TCM and modern medicine， incorporating multi-omics technologies， individualized stratification， and other precision medicine concepts， in combination with artificial intelligence. Moreover， interdisciplinary collaboration should be promoted to utilize modern technology in exploring the essence of TCM theories and screening effective formulae， thereby comprehensively improving the diagnosis and treatment of SLE through integrated TCM and Western medical approaches.

Objective To explore the correlation between aging and idiopathic pulmonary fibrosis(IPF)and reveal the underlying molecular mechanisms.Methods IPF models were established using young(2-month-old)and aged(18-month-old)C57BL/6J mice by intratracheal instillation of bleomycin(BLM)hydrochloride(2.5 mg/kg)after fully exposing the trachea.The control groups received an equal volume of saline administered in the same manner.Mice were divided randomly into four groups:a young control(Ctrl-Y)group,young model(IPF-Y)group,aged control(Ctrl-A)group,and aged model(IPF-A)group.Histopathological changes were evaluated by hematoxylin-eosin and Masson staining.Collagen type Ⅰ alpha 1 chain(COL1A1),α-smooth muscle actin(SMA),and fibronectin(FN)expression were detected by immunohistochemistry.Cell senescence was detected by senescence-associated beta-galactosidase(SA-β-Gal)staining.Differentially expressed genes were detected by transcrip tome sequencing,followed by gene ontology functional annotation(GO)and kyoto encyclopedia of genes and genomes(KEGG)pathway enrichment analysis.Core gene expression was validated by quantitative reverse transcription-polymerase chain reaction.Results The fibrosis score was significantly higher in the IPF-A group compared with the IPF-Y group(P＜0.05).Expression levels of α-SMA,and FN were significantly upregulated in the IPF-A group versus the IPF-Y group by 36％,and 25％,respectively(P＜0.05).The SA-β-Gal-positive area indicating senescence was significantly larger in the IPF-A group than in the IPF-Y group.Fifty-five senescence-IPF interactive genes were identified,among which Cdkn1a,MMP3,and Pdcd1 were synergistically upregulated in the IPF-A group(P＜0.05).KEGG analysis revealed the activation of signaling pathways such as extracellular matrix(ECM)-receptor interaction,phagosome,cytokine-cytokine receptor interaction,efferocytosis,and PI3K-Akt(FDR＜0.05).Conclusions aging promotes IPF progression,which induces lung tissue senescence.The underlying mechanism may involve ECM remodeling driven by immunosenescence,inflammatory accumulation,and metabolic disorders.

Objective To explore the high-risk factors and prevention strategies for rebleeding in patients with upper gastrointestinal hemorrhage(UGIH)treated with endoscopy,and construct a predictive model.Methods 97 patients with UGIH who experienced rebleeding after endoscopic treatment from January 2020 to December 2023 were selected as the observation group,and another 178 patients with UGIH who did not experience rebleeding after endoscopic treatment admitted during the same period were selected as the control group,both groups were followed up for 1 year after endoscopic treatment.Clinical data of the two groups was compared,the high-risk factors for rebleeding after endoscopic treatment in patients with UGIH were analyzed by multivariate Logistic regression analysis,a predictive model was constructed,and the predictive value of the model for rebleeding after endoscopic treatment in patients with UGIH was analyzed by plotting a receiver operator characteristic curve(ROC curve)to analyze.Results The proportions of patients in the observation group with liver cirrhosis,shock,endoscopic active bleeding,Forrest classification of Ia to Ib,level of blood hemoglobin≤90 g/L,and level of blood platelet≤100×109/L were 55.67%,14.43%,37.11%,62.89%,23.71%,and 23.71%,respectively,which were higher than the control group's 41.57%,2.25%,18.54%,44.38%,3.37%,and 7.87%.The level of serum D-dimer(D-D)of the observation group was higher than that of the control group,and the bleeding volume of the observation group was more than that of the control group,the prothrombin time(PT)of the observation group was longer than that of the control group(P<0.05).Multivariate Logistic regression analysis showed that:cirrhosis((O＾R)=2.423,95%CI:1.124～5.224),shock((O＾R)=6.897,95%CI:1.487～31.995),endoscopic active bleeding((O＾R)=2.604,95%CI:1.109～6.118),Forrest grading of Ia to Ib((O＾R)=2.494,95%CI:1.162～5.354),level of blood hemoglobin≤90 g/L((O＾R)=5.270,95%CI:1.797～15.442),level of blood platelet≤100×109/L((O＾R)=5.018,95%CI:1.733～14.531),bleeding volume>189.61 mL((O＾R)=1.025,95%CI:1.016～1.034),PT>15.99 s((O＾R)=1.996,95%CI:1.618～2.460)were both risk factors for rebleeding in UGIH patients after endoscopic treatment(P<0.05).Regression equation model:logit(P)=-18.551+cirrhosis×0.885+shock×1.931+endoscopic active bleeding×0.957+Forrest grading×0.914+level of blood hemoglobin×1.662+level of blood platelet×1.613+bleeding volume×0.025+PT×0.691.The ROC curve for predicting rebleeding in UGIH patients after endoscopic treatment was plotted according to the diagnostic probability logit(P).When logit(P)>0.30,the 95%CI was 0.891～0.955,and the diagnostic sensitivity and specificity were 88.66%and 83.15%,respectively.The area under the curve(AUC)value was 0.923.Conclusion The cirrhosis,shock,endoscopic active bleeding,Forrest grade Ia to Ib,level of blood hemoglobin≤90 g/L,level of blood platelet≤100×109/L,bleeding volume>189.61 mL,and PT>15.99 s are independent risk factors for rebleeding after endoscopic treatment in patients with UGIH.The model constructed based on this has high predictive value,which can be used clinically to provide personalized intervention and treatment for high-risk patients to reduce or avoid the occurrence of rebleeding.

Objective To explore the high-risk factors and prevention strategies for rebleeding in patients with upper gastrointestinal hemorrhage(UGIH)treated with endoscopy,and construct a predictive model.Methods 97 patients with UGIH who experienced rebleeding after endoscopic treatment from January 2020 to December 2023 were selected as the observation group,and another 178 patients with UGIH who did not experience rebleeding after endoscopic treatment admitted during the same period were selected as the control group,both groups were followed up for 1 year after endoscopic treatment.Clinical data of the two groups was compared,the high-risk factors for rebleeding after endoscopic treatment in patients with UGIH were analyzed by multivariate Logistic regression analysis,a predictive model was constructed,and the predictive value of the model for rebleeding after endoscopic treatment in patients with UGIH was analyzed by plotting a receiver operator characteristic curve(ROC curve)to analyze.Results The proportions of patients in the observation group with liver cirrhosis,shock,endoscopic active bleeding,Forrest classification of Ia to Ib,level of blood hemoglobin≤90 g/L,and level of blood platelet≤100×109/L were 55.67%,14.43%,37.11%,62.89%,23.71%,and 23.71%,respectively,which were higher than the control group's 41.57%,2.25%,18.54%,44.38%,3.37%,and 7.87%.The level of serum D-dimer(D-D)of the observation group was higher than that of the control group,and the bleeding volume of the observation group was more than that of the control group,the prothrombin time(PT)of the observation group was longer than that of the control group(P<0.05).Multivariate Logistic regression analysis showed that:cirrhosis((O＾R)=2.423,95%CI:1.124～5.224),shock((O＾R)=6.897,95%CI:1.487～31.995),endoscopic active bleeding((O＾R)=2.604,95%CI:1.109～6.118),Forrest grading of Ia to Ib((O＾R)=2.494,95%CI:1.162～5.354),level of blood hemoglobin≤90 g/L((O＾R)=5.270,95%CI:1.797～15.442),level of blood platelet≤100×109/L((O＾R)=5.018,95%CI:1.733～14.531),bleeding volume>189.61 mL((O＾R)=1.025,95%CI:1.016～1.034),PT>15.99 s((O＾R)=1.996,95%CI:1.618～2.460)were both risk factors for rebleeding in UGIH patients after endoscopic treatment(P<0.05).Regression equation model:logit(P)=-18.551+cirrhosis×0.885+shock×1.931+endoscopic active bleeding×0.957+Forrest grading×0.914+level of blood hemoglobin×1.662+level of blood platelet×1.613+bleeding volume×0.025+PT×0.691.The ROC curve for predicting rebleeding in UGIH patients after endoscopic treatment was plotted according to the diagnostic probability logit(P).When logit(P)>0.30,the 95%CI was 0.891～0.955,and the diagnostic sensitivity and specificity were 88.66%and 83.15%,respectively.The area under the curve(AUC)value was 0.923.Conclusion The cirrhosis,shock,endoscopic active bleeding,Forrest grade Ia to Ib,level of blood hemoglobin≤90 g/L,level of blood platelet≤100×109/L,bleeding volume>189.61 mL,and PT>15.99 s are independent risk factors for rebleeding after endoscopic treatment in patients with UGIH.The model constructed based on this has high predictive value,which can be used clinically to provide personalized intervention and treatment for high-risk patients to reduce or avoid the occurrence of rebleeding.

Objective To explore the correlation between aging and idiopathic pulmonary fibrosis(IPF)and reveal the underlying molecular mechanisms.Methods IPF models were established using young(2-month-old)and aged(18-month-old)C57BL/6J mice by intratracheal instillation of bleomycin(BLM)hydrochloride(2.5 mg/kg)after fully exposing the trachea.The control groups received an equal volume of saline administered in the same manner.Mice were divided randomly into four groups:a young control(Ctrl-Y)group,young model(IPF-Y)group,aged control(Ctrl-A)group,and aged model(IPF-A)group.Histopathological changes were evaluated by hematoxylin-eosin and Masson staining.Collagen type Ⅰ alpha 1 chain(COL1A1),α-smooth muscle actin(SMA),and fibronectin(FN)expression were detected by immunohistochemistry.Cell senescence was detected by senescence-associated beta-galactosidase(SA-β-Gal)staining.Differentially expressed genes were detected by transcrip tome sequencing,followed by gene ontology functional annotation(GO)and kyoto encyclopedia of genes and genomes(KEGG)pathway enrichment analysis.Core gene expression was validated by quantitative reverse transcription-polymerase chain reaction.Results The fibrosis score was significantly higher in the IPF-A group compared with the IPF-Y group(P＜0.05).Expression levels of α-SMA,and FN were significantly upregulated in the IPF-A group versus the IPF-Y group by 36％,and 25％,respectively(P＜0.05).The SA-β-Gal-positive area indicating senescence was significantly larger in the IPF-A group than in the IPF-Y group.Fifty-five senescence-IPF interactive genes were identified,among which Cdkn1a,MMP3,and Pdcd1 were synergistically upregulated in the IPF-A group(P＜0.05).KEGG analysis revealed the activation of signaling pathways such as extracellular matrix(ECM)-receptor interaction,phagosome,cytokine-cytokine receptor interaction,efferocytosis,and PI3K-Akt(FDR＜0.05).Conclusions aging promotes IPF progression,which induces lung tissue senescence.The underlying mechanism may involve ECM remodeling driven by immunosenescence,inflammatory accumulation,and metabolic disorders.

OBJECTIVE To explore the renal protective mechanism of Shenbining granules on IgA nephropathy(IgAN)rats based on mitochondrial quality control system.METHODS IgAN rat model was established by the method of"bovine serum albumin+carbon tetrachloride+lipopolysaccharide".The model rats were randomly divided into model group,prednisone acetate group(6.25 mg/kg),Shenbining equal-dose group(4.1 g/kg)and Shenbining high-dose group(20.5 g/kg).The normal rats were taken as the normal control group,with 12 rats in each group.Rats were given corresponding drugs or distilled water intragastrically in each group,once a day,for 4 consecutive weeks.After the last medication,the 24 h total urinary protein(24 h-UTP)and erythrocyte count in urine were determined,and the levels of serum creatinine(Scr),blood urea nitrogen(BUN),albumin(ALB)and alanine transaminase(ALT)were also detected.The histopathological changes in the kidneys and changes in IgA deposition in the mesangial area of the kidney were observed.mRNA and protein expression levels of PTEN-induced putative kinase 1(PINK1),E3 ubiquitin ligase(Parkin),microtubule-associated protein 1 light chain-3(LC3),dynamin-related protein 1(Drp1)and mitofusin 2(Mfn2)were detected in the kidney tissues of rats.RESULTS Compared with model group,24 h-UTP,urinary erythrocyte count,ALT,BUN and Scr levels,LC3-Ⅱ/LC3-Ⅰ mRNA ratio,mRNA and protein expressions of Drp1 were reduced significantly in prednisone acetate group,Shenbining equal-dose group and Shenbining high-dose group(P＜0.05);ALB level,LC3-Ⅱ/LC3-Ⅰprotein ratio,mRNA and protein expressions of PINK1,Parkin and Mfn2 were increased significantly(P＜0.05);the pathological morphology of kidney tissue in rats was significantly improved,and IgA deposition was significantly reduced.CONCLUSIONS Shenbining granule may reduce renal pathological injury in IgAN rats and protect renal function by activating the PINK1/Parkin pathway,enhancing mitochondrial autophagy,and correcting mitochondrial kinetic disorders.

Objective:To investigate the clinical and immunological characteristics of anti-synthetase syndrome(ASS)patients overlap with rheumatoid arthritis(RA).Methods:A retrospective analysis was conducted on ASS patients with arthritis who were treated at Peking University People's Hospital.Data collected included demographic information,clinical manifestations,laboratory features,lymphocyte subsets in peripheral blood,and treatments.The patients with ASS were divided into two groups based on the presence or absence of RA for comparative analysis.Results:A total of 104 ASS patients with arthri-tis were included,among whom 23.1％(24/104)were diagnosed with RA.The ASS with RA group had a significantly higher incidence of rapidly progressive interstitial lung disease(RP-ILD)(41.7％vs.17.6％,P=0.032),number of tender joints[10(7,14)vs.4(0,8),P＜0.001],number of swollen joints[4(2,8)vs.2(0,4),P=0.012],and rate of bone erosion(47.8％vs.2.5％,P＜0.001)compared with the non-RA group.Levels of platelets[(289.57±68.74)× 103/μL vs.(247.94±77.04)×103/μL,P=0.022],erythrocyte sedimentation rate(ESR)[43(19,59)mm/h vs.18(10,44)mm/h,P=0.019],and C-reactive protein(CRP)[19.20(4.80,55.36)mg/L vs.5.68(1.10,14.96)mg/L,P=0.006]were found significantly higher in the ASS with RA group than those in non-RA group.Analysis of immune cells in peripheral blood mononuclear cell(PBMC)showed that sig-nificantly decreased proportions of CLA+Treg cells[(11.12±4.10)％vs.(17.22±8.49)％,P=0.003],B cells[8.56％(4.80％,11.90％)vs.14.55％(8.75％,20.29％),P=0.025],and nat-ural killer(NK)cells[7.56％(4.65％,13.20％)vs.13.25％(7.46％,19.25％),P=0.045]in the overlap group compared with non-RA group.Proportion of Na?ve Th cells[(52.66±17.66)％vs.(40.76±14.96)％,P=0.033)]was significantly increased in overlap group compared with non-RA group.Overlap group had lower rate of complete clinical response than non-RA group(16.7％vs.43.8％,P=0.031).Conclusion:Among ASS patients with arthritis,those with RA have more severe lung and joint involvement and a lower treatment response rate,highlighting the need for early recognition and aggressive intervention.