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.

To evaluate the reliability of flash continuous glucose monitoring(CGM) and itsaccuracy in supporting clinical decision-making after pancreatic surgery.

OBJECTIVE To investigate the mechanism of action of Chaihu Shugan San(CSS)and its absorbed components,Meranzin hydrate(MH)and ferulic acid(FA),on atherosclerosis(AS)and depression.METHODS An AS combined with depres-sion model was established in ApoE-/-mice,which were randomly divided into the blank group,model group,CSS group,MH group,and FA group.AS progression was evaluated through lipid profile analysis(TC,TG,LDL-C,HDL-C),aortic plaque analysis(Oil Red O staining),and cardiac function assessment.Behavioral tests,including the open field test,light/dark box test,tail suspension test,and forced swim test,were conducted to evaluate depressive-like behaviors.Hippocampal neuronal morphology changes were ob-served through Golgi staining.Serum inflammatory cytokines(TNF-α,IL-1β,IL-6),neurotransmitters(5-HT,BDNF),and vas-cular adhesion molecules(VCAM-1)were measured.16S rRNA sequencing was used to analyze the gut microbiome composition.RE-SULTS Compared to the model group,the CSS,MH,and FA treatment groups showed improvements in several areas.First,signifi-cant reduction in AS lesions,lower blood lipid levels,and enhanced cardiovascular function were observed(P＜0.01,P＜0.001).Sec-ond,depressive-like behaviors were improved,with stronger activity and less immobility time.Damage to neuronal dendritic spines was also repaired(P＜0.05,P＜0.01,P＜0.001).Additionally,serum levels of inflammatory cytokines,neurotransmitters,and vascu-lar adhesion molecules were reversed(P＜0.05,P＜0.01,P＜0.001).Finally,gut microbiome α and β diversity were regulated,and beneficial bacteria abundance was increased.CONCLUSION CSS exhibits the best effects in treating both AS and depression.The two absorption components,MH and FA,together contribute to the anti-AS and anti-depression effects.At the same concentration,MH shows better anti-AS and anti-depression effects than FA.

Objective To investigate the predictive value of dual-energy computed tomography(DECT)quantitative parameters in the diagnosis and pathological aggressiveness of lung adenocarcinoma.Methods A total of 174 patients with lung cancer were pro-spectively selected.All patients underwent DECT examination,and the types of lung cancer were determined according to the patho-logical tissue.According to the pathological classification,they were divided into lung adenocarcinoma group(n=99),lung squamous cell carcinoma group(n=47)and small cell lung cancer group(n=28).According to whether the lung adenocarcinoma patients had pathological aggressiveness,they were divided into invasive group(n=34)and non-invasive group(n=65).Receiver operating char-acteristic(ROC)curve was used to diagnose the predictive value of DECT quantitative parameters in the diagnosis and pathological aggressiveness of lung adenocarcinoma.Results The normalized iodine concentration(NIC)and k in venous phase of lung adenocar-cinoma group were higher than those in lung squamous cell carcinoma group and small cell lung cancer group(P<0.05).ROC curve analysis showed that the combined diagnosis value of NIC and k in venous phase was higher(P<0.05).The lobular proportion,vac-uolar proportion,pleural indentation proportion,vascular cluster proportion,effective atomic number(Eff-Z),NIC and k in arterial phase,and NIC and k in venous phase in invasion group were higher than those in non-invasion group(P<0.05).Logistic regression analysis showed that pleural indentation,NIC in arterial phase and NIC in venous phase were risk factors for pathological aggerssive-ness in lung adenocarcinoma patients(P<0.05).ROC curve analysis showed that the combination of NIC in arterial phase and NIC in venous phase had higher value in predicting the pathological aggressiveness of lung adenocarcinoma(P<0.05).Conclusion The combination of NIC and k in venous phase is effective in the diagnosis of lung adenocarcinoma,while NIC in arterial phase and NIC in venous phase have high predictive values for the aggressiveness of lung adenocarcinoma.

Objective To investigate the epidemiological characteristics of Mycoplasma pneumoniae(MP)infection among pediatric inpatients with respiratory tract infections(RTIs)at Children's Hospital of Hebei Province,providing evidence for clinical diagnosis and treatment.Methods A retrospective analysis was conducted on 79 546 children hospitalized for RTIs between January 2016 and February 2024.Nasopharyngeal aspirates or deep sputum samples were collected,and polymerase chain reaction(PCR)was used to detect nucleic acids of 13 respiratory pathogens,including MP and adenovirus.The epidemiological trends across different years,seasons,genders,and age groups were analyzed.Results Among the 79 546 enrolled cases(male:47 437,59.6%;female:32 109,40.4%),the MP-positive rate was 17.7%(14 106/79 546),peaking in 2023(28.8%)and reaching the lowest in 2021(7.0%).Except for the period from July 2020 to March 2021 with exceptionally low MP positivity,epidemic peaks consistently occurred between August and February or March of the following year.Seasonal analysis revealed significantly higher MP positivity in autumn and winter compared to spring(P<0.001).Female children exhibited a higher MP-positive rate(20.1%,6444/32 109)than males(16.2%,7662/47 437)(P<0.001).The MP-positive rate increased with age:infancy(3.2%,849/26 741),toddlerhood(9.3%,1935/20 763),preschool(21.2%,3918/18 448),and school-age(54.5%,7404/13 594)(P<0.001).Co-infections with other respiratory pathogens were observed in 37.3%(5264/14 106)of MP-positive cases,with human rhinovirus(HRV)being the most frequent co-pathogen(43.3%,2279/5264 of mixed infections).Conclusion MP is a major pathogen of RTIs in hospitalized children at Children's Hospital of Hebei Province.Infections occur year-round but predominantly in autumn,with higher susceptibility in females and school-age children.Targeted preventive measures should be implemented during peak seasons to mitigate transmission risks.

Given that ovarian stimulation is vital for assisted reproductive technology (ART) and results in elevated serum estrogen levels, exploring the impact of elevated estrogen exposure on oocytes and embryos is necessary. We investigated the effects of various ovarian stimulation treatments on oocyte and embryo morphology and gene expression using a mouse model and estrogen-treated mouse embryonic stem cells (mESCs). Female C57BL/6J mice were subjected to two types of conventional ovarian stimulation and ovarian hyperstimulation; mice treated with only normal saline served as controls. Hyperstimulation resulted in high serum estrogen levels, enlarged ovaries, an increased number of aberrant oocytes, and decreased embryo formation. The messenger RNA (mRNA)‍-sequencing of oocytes revealed the dysregulated expression of lysine-specific demethylase 6b (Kdm6b), which may be a key factor indicating hyperstimulation-induced aberrant oocytes and embryos. In vitro, Kdm6b expression was downregulated in mESCs treated with high-dose estrogen; treatment with an estrogen receptor antagonist could reverse this downregulated expression level. Furthermore, treatment with high-dose estrogen resulted in the upregulated expression of histone H3 lysine 27 trimethylation (H3K27me3) and phosphorylated H2A histone family member X (γ-H2AX). Notably, knockdown of Kdm6b and high estrogen levels hindered the formation of embryoid bodies, with a concomitant increase in the expression of H3K27me3 and γ-H2AX. Collectively, our findings revealed that hyperstimulation-induced high-dose estrogen could impair the demethylation of H3K27me3 by reducing Kdm6b expression. Accordingly, Kdm6b could be a promising marker for clinically predicting ART outcomes in patients with ovarian hyperstimulation syndrome.
Female ; Mice ; Demethylation/drug effects* ; Embryonic Stem Cells ; Estrogens/administration & dosage* ; Gene Expression/drug effects* ; Histones/metabolism* ; Jumonji Domain-Containing Histone Demethylases/metabolism* ; Mice, Inbred C57BL ; Oocytes ; Ovary/drug effects* ; Reproductive Techniques, Assisted ; Animals

To investigate the protective effects and underlying mechanisms of Qin-Zhu-Liang-Xue decoction (QZLX) in atopic dermatitis (AD) and glucocorticoid resistance, we conducted a single-blinded, randomized controlled clinical trial to evaluate the efficacy and safety of this concoction. Network pharmacology analysis was performed and validated through clinical studies. The efficacy, safety, and mechanism of action of QZLX and glucocorticoid receptor (GR) α recombinant protein were assessed in AD mice induced by 2,4-dinitrofluorobenzene (DNFB). Correlation analysis was performed to determine the clinical relevance of GRα. The trial demonstrated that patients who received QZLX showed considerable improvements in their Scoring Atopic Dermatitis (SCORAD) and Dermatology Life Quality Index (DLQI) scores compared with those who received mizolastine at week 4. Network pharmacological analysis identified GRα as a key target for QZLX in AD treatment. QZLX administration increased the serum GRα expression in AD patients, alleviated AD symptoms in mice, decreased inflammatory cytokine expression, and increased GRα expression without affecting liver or kidney function. In addition, GRα recombinant protein improved AD-like skin lesions in DNFB-induced mice. A negative correlation was observed between GRα expression and clinical parameters, including SCORAD, DLQI, and serum IgE levels. QZLX alleviates AD symptoms through the upregulation of GRα and thus presents a novel therapeutic strategy for the prevention of glucocorticoid resistance in AD management.
Dermatitis, Atopic/drug therapy* ; Animals ; Drugs, Chinese Herbal/administration & dosage* ; Humans ; Mice ; Network Pharmacology ; Male ; Female ; Adult ; Receptors, Glucocorticoid/metabolism* ; Disease Models, Animal ; Single-Blind Method ; Middle Aged ; Young Adult

Vascular aging (VA) is a common etiology of various chronic diseases and represents a major public health concern. Intermittent hypoxia (IH) associated with obstructive sleep apnea-hypopnea syndrome (OSAHS) is a primary pathological and physiological driver of OSAHS-induced systemic complications. A substantial proportion of OSAHS patients, estimated to be between 40% and 80%, have comorbidities such as hypertension, heart failure, coronary artery disease, pulmonary hypertension, atrial fibrillation, aneurysm, and stroke, all of which are closely associated with VA. This review examines the molecular and cellular features common to both OSAHS and VA, highlighting decreased melatonin secretion, impaired autophagy, increased apoptosis, increased inflammation and pyroptosis, increased oxidative stress, accelerated telomere shortening, accelerated stem cell depletion, metabolic disorders, imbalanced protein homeostasis, epigenetic alterations, and dysregulated neurohormonal signaling. The accumulation and combination of these features may underlie the pathophysiological link between OSAHS and VA, but the exact mechanisms by which OSAHS affects VA may require further investigation. Taken together, these findings suggest that OSAHS may serve as a novel risk factor for VA and related vascular disorders, and that targeting these features may offer therapeutic potential to mitigate the vascular risks associated with OSAHS.
Humans ; Sleep Apnea, Obstructive/pathology* ; Aging/physiology* ; Oxidative Stress/physiology* ; Animals

Objective: To comprehensively evaluate the current alanine aminotransferase (ALT) screening strategies and provide a basis for their optimization. Methods: ALT test results of 21 345 blood samples were collected from 33 blood collection institutions. Multiple probability distribution functions were employed to fit the data, and the akaike information criterion (AIC) was used to determine the optimal fitting model. Based on this model, 1 million random samplings were conducted to simulate the final ALT test results of blood donors under different ALT screening strategies, eligibility criteria, and pre-donation ALT detection deviations. A decision tree was subsequently constructed for health economic analysis. Results: The log-normal distribution with a mean of 2.96 and a variance of 0.65 provided the best fit for the data. When the eligibility criteria was 50 U/L and the pre-donation detection deviation was ±20%, not conducting pre-donation testing increased blood donation by 1.14%. When the pre-donation detection deviation was ±20% and the eligibility criteria was raised from 50 U/L to 100 U/L, conducting and not conducting pre-donation testing increased blood donation by 7.59% and 6.60%, respectively. With a eligibility criteria of 50 U/L and a pre-donation detection deviation of ±20%, 1.14% of eligible blood donors would be disqualified from donating blood. Health economic analysis showed that when the eligibility criteria was adjusted to 56 U/L or higher, not conducting pre-donation ALT testing was the dominant strategy; under other conditions, conducting pre-donation testing was the dominant strategy. Conclusion: The selection of ALT testing strategies is a complex process influenced by multiple factors, and it is necessary to adopt an appropriate ALT screening strategy based on specific testing circumstances.

Objective To explore the influence factors of hemorrhagic transformation in the First People's Hospital of Lianyungang in patients with acute anterior circulation ischemic stroke(AIS)after mechanical thrombectomy(MT).Methods We collected the clin-ical data of 354 AIS patients who underwent MT in the Affiliated Lianyungang Hospital of Xuzhou Medical University from January 2019 to December 2023.They were grouped according to the results of cranial CT reviewed in 24-72h after the MT,and the patients who under-went HT were the HT group,with a total of 208 patients,and the patients who did not have HT were the control group,with a total of 104 patients.The clinical differences between the two groups were compared.Measurement data were analyzed using the Mann-Whitney U test,count data were analyzed using the x2 test,and multivariate Logistic regression analysis was used to identify independent risk factors.Results Compared to control group,the patients of HT group were older,had a higher prevalence of atrial fibrillation,higher preopera-tive NIHSS scores,lower platelet counts,higher glycated hemoglobin levels,and a higher proportion of preoperative thrombolytic therapy(P＜0.05).Multivariate logistic regression analysis indicated that hemoglobin(OR=1.02,95％CI:1.01-1.03,P=0.006)and glycated hemoglobin(OR=1.24,95％CI:1.09-1.40,P＜0.001)were independent influence factors for HT.Platelet count(OR=0.99,95％CI:0.99-0.99,P=0.014)was identified as a protective factor against HT.Conclusion Preoperative hemoglo-bin,glycated hemoglobin,and platelet count are all associated with HT following MT.