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.

ObjectiveThis paper aims to observe the syndrome improvement and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome）. MethodsThrough a multi-center randomized controlled methodology design，confirmed influenza cases were collected from October 2022 to April 2023 in the pediatrics department of eight hospitals，such as Dongfang Hospital of Beijing University of Chinese Medicine. A total of 180 children with influenza and heat accumulation in the lung and stomach syndrome conforming to the standard were recruited through the clinic. The sick children meeting the inclusion criteria were randomly divided into groups by a block-randomized method. The children in the experimental group were treated with Qingxuan Daozhi formula for five days，and those in the control group were treated with Oseltamivir Phosphate Granules for five days. The primary efficacy indicator was the negative conversion rate of influenza antigen detection. Secondary efficacy indicators were the Canadian acute respiratory illness and flu scale （CARIFS） and the incidence of complications，severe cases， and critical cases. Follow-up observation was conducted on the day of enrollment，48 hours after medication，72 hours after medication， and （6+1） d after medication. ResultsOne hundred and eighty participants were randomly assigned to the experimental group （90 cases） or the control group （90 cases）. All participants were followed up during the study. Comparison of influenza antigen detection results in the primary efficacy indicators showed that the average time of negative influenza antigen conversion in the experimental group was （5.29±1.25） d，and that in the control group was （5.40±1.68） d，without a statistically significant difference. After five days of intervention，52 cases in the experimental group and 51 cases in the control group converted to negative，without a statistically significant difference. CARIFS score results in the secondary efficacy indicators showed that during 72 hours after intervention，there were statistically significant differences between the experimental group and the control group in three dimensions， including headache，muscle soreness， and the need for extra care （P<0.05）. On the （6+1） days after the intervention，the differences in both the experimental group and the control group were statistically significant in 10 dimensions， including sore throat，bad sleep，uncomfortable feeling，poor spirit and fatigue，crying more than usual，the need for extra care，symptom，function，influence on parents，and total score （P<0.05）. The comparison results within the group in the dimensional scores of symptom， function， and influence on parents，as well as the CARIFS total score showed that with the delay of follow-up time，scores of both groups decreased significantly，with a statistically significant difference （P<0.01）. Inter-group comparison results showed that the mean score of the experimental group was higher than that of the control group at the time of enrollment. With the progress of intervention，the score of the experimental group was significantly decreased compared with that of the control group. At the end of follow-up，the mean score of the experimental group was lower than that of the control group，with no statistically significant difference. In terms of the incidence of complications，severe cases， and critical cases， there were no complications，severe cases， and critical cases in the two groups，without a statistically significant difference. ConclusionThe symptom improvement effect and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome） are not inferior to Oseltamivir Phosphate granules， and children's acceptance is better. It can be more widely used in clinical treatment of influenza in children （heat accumulation in the lung and stomach syndrome）.

OBJECTIVE To explore the clinical effect and safety of nicorandil combined with different doses of tirofiban in the treatment of elderly patients with acute ST-segment elevation myocardial infarction （STEMI）. METHODS A total of 162 elderly patients with STEMI admitted to our hospital from June 1， 2022 to June 1， 2024 were retrospectively enrolled. All patients received percutaneous coronary intervention （PCI） and conventional treatment of STEMI， and used nicorandil （5 mg each time， tid） and tirofiban. According to the use of tirofiban， the patients were divided into conventional-dose group （n＝104） and half-dose group （n＝58）. Patients in the conventional-dose group received an intracoronary injection of 10 μg/kg tirofiban， followed by intravenous infusion of 0.1 μg/（kg·min） for 48 h； patients in the half-dose group received an intracoronary injection of 5 μg/kg tirofiban， followed by intravenous infusion of 0.05 μg/（kg·min） for 48 h. Related indexes of PCI （the proportion of patients with grade 3 of thrombolysis in myocardial infarction， no reflow in infarct related artery， percentage decrease in total ST-segment elevation ＞50% on electrocardiogram 2 hours after PCI）， cardiac function parameters before and after treatment （troponin I， N-terminal pro-brain natriuretic peptide contents and left ventricular ejection fraction）， bleeding events during treatment （gingival bleeding， epistaxis， mucosal bleeding， gastrointestinal bleeding） and other adverse events （all-cause death， non-fatal reinfarction， hypotension， ventricular fibrillation， acute heart failure） were compared between 2 groups. RESULTS There were no significant differences in related parameters of PCI， cardiac function parameters after treatment， the incidences of gingival bleeding， epistaxis and gastrointestinal bleeding， the total incidence of bleeding events， or the incidence of other adverse events during treatment between 2 groups （P＞0.05）， but the incidence of mucosal bleeding in the conventional-dose group was significantly higher than the half-dose group （P＜0.05）. CONCLUSIONS The clinical effect of nicorandil combined with half-dose tirofiban in the treatment of elderly patients with acute STEMI is comparable to that of nicorandil combined with conventional dose of tirofiban， but the mucosal bleeding risk of the former is lower than that of the latter. Therefore， patients at risk of mucosal bleeding are more suitable to use the previous regimen.

Objective:To investigate effects of macrophage polarization on PI3K/Akt/mTOR signaling pathway and inflammatory response of vascular smooth muscle cells.Methods:THP-1 cells were induced to become macrophages by phaboate,then treated with LPS and IFN-γ,IL-4 and IL-13 for 48 h,and cultured with fresh medium without serum for 24 h.Supernatant was used as conditioned medium.Vascular smooth muscle cells were divided into control group,M0 medium group,M1 medium group and M2 medium group.CCK-8 was used to detect cell proliferation,flow cytometry was used to detect cell apoptosis,ELISA was used to detect expressions of inflammatory cytokines IL-1α,IL-6 and TGF-β in supernatant of cells,and mRNA and phosphorylated protein expressions of PI3K,Akt and mTOR in vascular smooth muscle cells were detected by RT-qPCR and Western blot.Results:Compared with control group,cell proliferation ability and TGF-β level in supernatant of M0 medium group were significantly decreased(P<0.01),apoptosis rate,IL-1α and IL-6 levels in cell supernatant,mRNA and protein phosphorylation levels of PI3K,Akt and mTOR in cells were significantly increased(P<0.01).Compared with M0 medium group,cell proliferation ability and TGF-β level in supernatant of M1 medium group were significantly decreased(P<0.05),apoptosis rate,IL-1α and IL-6 levels in cell supernatant,mRNA and protein phosphorylation levels of PI3K,Akt and mTOR in cells were significantly increased(P<0.01),the trend was opposite in M2 medium group(P<0.05).Conclusion:Macrophage polarization can regulate expressions of inflammatory cytokines by regulating PI3K/Akt/mTOR signaling pathway,and participate in inflammatory response in atherosclerosis.

Objective:To analyze the pathogen spectrum and epidemiological characteristics of acute respiratory infections in Yantai from 2024 to 2025.Methods:Influenza-like illness（ILI）and severe acute respiratory infection（SARI）patients were enrolled from the national sentinel hospitals for acute respiratory infectious diseases in Yantai between January 2024 and April 2025. Oropharyngeal swab samples were collected and 16 common respiratory pathogens were tested using real-time quantitative PCR. Descriptive epidemiological methods were used to analyze the detection results.Results:A total of 1 499 cases were included in the study，including 1 070 ILI cases and 429 SARI cases. The overall positive rate of respiratory pathogens was 52.57%（788/1 499）. All of the 16 targeted respiratory pathogens were detected，with influenza virus A（FluA），SARS-CoV-2， Haemophilus influenzae（ Hi），and human adenovirus（HAdV）being the predominant pathogens. The co-infection rate was 6.27%（94/1 499），with FluA combined with Hi infection being the predominant type. Statistically significant differences in the positive rates of influenza B virus and SARS-CoV-2 were observed between male and female patients（both P<0.05）. The overall positive rates varied significantly across different age groups（ P<0.001），with the highest rate（64.62%，84/130）observed in the 4-14 year age group. The overall positive rates also varied significantly among different months（ P<0.001），with the highest rate in December（69.93%，107/153）. The overall positive rate was 57.48%（615/1 070）in ILI cases and 40.33%（173/429）in SARI cases，with statistically significant difference between the two groups（ P<0.001）. Influenza viruses and SARS-CoV-2 were the predominant pathogens in ILI cases，whereas HAdV and Mycoplasma pneumoniae were more common in SARI cases. Conclusions:FluA，SARS-CoV-2， Hi，and HAdV are the predominant pathogens causing acute respiratory infections in Yantai from January 2024 to April 2025. The positive rates of respiratory pathogens varies across different gender and age groups，and shows distinct seasonal patterns. There are significant differences in pathogen spectra between ILI and SARI cases.

Objective To analyze the risk of chronic heart failure(CHF)complicated with deep ve-nous thrombosis by using logistic regression model based on neutrophil and coagulation parame-ters.Methods A retrospective analysis was conducted on 132 CHF patients admitted to our hos-pital from August 2021 to August 2023.According to deep venous thrombosis occurred or not,they were divided into thrombosis group(44 cases)and non-thrombosis group(88 cases).The neutrophil count and coagulation parameters were measured in all subjects after admission.Binary logistic regression analysis was used to construct a prediction model based on neutrophil count and coagulation parameters.ROC curve was plotted to analyze the predictive value of the count and parameters in predicting deep venous thrombosis in CHF patients.Results The thrombosis group had significantly higher serum neutrophil count and D-Dimer(D-D)and fibrinogen(FIB)levels than the non-thrombosis group(P＜0.01),but no statistical differences were observed be-tween them in terms of activated partial thromboplastin time,prothrombin time and thrombin time(P＞0.05).Binary logistic regression analysis suggested that serum neutrophil count and D-D and FIB levels were independent risk factors for deep venous thrombosis in CHF patients(OR=2.778,95％CI:1.672-4.617,P=0.000;OR=12.089,95％CI:4.310-33.903,P=0.000;OR=2.357,95％CI:1.170-4.746,P=0.016),and the prediction model was manifested as logit(P)=-13.908+1.022 × neutrophil+2.492 × D-D+0.857 × FIB.ROC curve analysis showed that the AUC value of serum neutrophil count,D-D and FIB levels alone and combined in predicting deep venous thrombosis were 0.772,0.82 9,0.712 and 0.913,respectively,with a sensitivity of 70.45％,72.73％,47.73％and 81.82％,and a specificity of 80.68％,78.41％,96.59％and 96.59％,separate-ly.The combined prediction model showed better efficiency than the single indicator(P＜0.01).Conclusion Neutrophil count and coagulation parameters are closely associated with the occur-rence of deep venous thrombosis in CHF patients.Early combined determination of the above three indicators can improve the prediction.

Objective To observe the efficacy and safety of Buyi Pishen Prescription combined with alisartan ester tablets in patients with primary chronic kidney disease stage 3(CKD3)with spleen-kidney qi deficiency syndrome.Methods Totally 80 patients were divided into treatment group and control group using a random number table method,with 40 cases in each group.Both groups received basic treatment and alisartan ester tablets(1 tablet/day,once daily,orally).The treatment group additionally received the Buyi Pishen Prescription(1 dosage/day,twice daily,orally).Both groups were treated for 24 weeks.TCM syndrome efficacy and clinical efficacy were evaluated.At 8,16 and 24 weeks,24-hour urinary protein(24 hUpro),serum creatinine(SCr),blood urea nitrogen(BUN),estimated glomerular filtration rate(eGFR)and TCM syndrome scores were measured.Serum oxidative stress markers(SOD,GSH-Px,MDA)were assessed before and after treatment.Blood potassium and liver function were monitored throughout.Results The total effective rate for TCM syndrome efficacy was 82.50%(33/40)in the treatment group and 60.00%(24/40)in the control group(P<0.05),and the treatment group was better than the control group.The total clinical efficacy rate was 77.50%(31/40)in the treatment group and 50.00%(20/40)in the control group,and the treatment group was better than the control group(P<0.05).Compared with before treatment,the treatment group showed a significant decrease in 24 hUpro and SCr at weeks 8,16 and 24,a significant decrease in BUN at weeks 16 and 24,and a significant increase in eGFR at weeks 8,16 and 24(P<0.01);the control group showed a decrease in 24 hUpro at weeks 8,16 and 24 of treatment(P<0.05),a decrease in SCr at weeks 16 and 24 of treatment(P<0.05),and an increase in eGFR at weeks 16 and 24 of treatment(P<0.05).In addition,the treatment group had lower 24 hUpro and SCr at weeks 16 and 24 of treatment than the control group(P<0.05,P<0.01),and higher eGFR than the control group(P<0.05,P<0.01).Compared with before treatment,the total scores of both the treatment group and control group significantly decreased at 16 and 24 weeks of treatment(P<0.01).The total scores of the treatment group were significantly lower than those of the control group at 8,16 and 24 weeks of treatment(P<0.01).Compared with before treatment,both groups showed a significant increase in serum SOD levels(P<0.05,P<0.01)and a significant decrease in MDA levels after treatment(P<0.05,P<0.01).The improvement in the treatment group was more significant than that in the control group(P<0.05).Both groups showed no abnormalities in blood potassium and liver function.Conclusion Buyi Pishen Prescription combined with alisartan ester tablets can reduce the levels of 24 hUpro,BUN and SCr,improve eGFR,alleviate TCM symptoms,and delay CKD progression in CKD3 patients with spleen-kidney qi deficiency syndrome,which can effectively reduce the serum MDA level and increase the antioxidant enzyme SOD level in patients,and its mechanism may be related to improving oxidative stress levels.

Objective To analyze the risk of chronic heart failure(CHF)complicated with deep ve-nous thrombosis by using logistic regression model based on neutrophil and coagulation parame-ters.Methods A retrospective analysis was conducted on 132 CHF patients admitted to our hos-pital from August 2021 to August 2023.According to deep venous thrombosis occurred or not,they were divided into thrombosis group(44 cases)and non-thrombosis group(88 cases).The neutrophil count and coagulation parameters were measured in all subjects after admission.Binary logistic regression analysis was used to construct a prediction model based on neutrophil count and coagulation parameters.ROC curve was plotted to analyze the predictive value of the count and parameters in predicting deep venous thrombosis in CHF patients.Results The thrombosis group had significantly higher serum neutrophil count and D-Dimer(D-D)and fibrinogen(FIB)levels than the non-thrombosis group(P＜0.01),but no statistical differences were observed be-tween them in terms of activated partial thromboplastin time,prothrombin time and thrombin time(P＞0.05).Binary logistic regression analysis suggested that serum neutrophil count and D-D and FIB levels were independent risk factors for deep venous thrombosis in CHF patients(OR=2.778,95％CI:1.672-4.617,P=0.000;OR=12.089,95％CI:4.310-33.903,P=0.000;OR=2.357,95％CI:1.170-4.746,P=0.016),and the prediction model was manifested as logit(P)=-13.908+1.022 × neutrophil+2.492 × D-D+0.857 × FIB.ROC curve analysis showed that the AUC value of serum neutrophil count,D-D and FIB levels alone and combined in predicting deep venous thrombosis were 0.772,0.82 9,0.712 and 0.913,respectively,with a sensitivity of 70.45％,72.73％,47.73％and 81.82％,and a specificity of 80.68％,78.41％,96.59％and 96.59％,separate-ly.The combined prediction model showed better efficiency than the single indicator(P＜0.01).Conclusion Neutrophil count and coagulation parameters are closely associated with the occur-rence of deep venous thrombosis in CHF patients.Early combined determination of the above three indicators can improve the prediction.

Epidural spinal cord stimulation (eSCS) represents an emerging neuromodulation technology that ameliorates motor dysfunction in patients with spinal cord injury, Parkinson's disease, and stroke by activating sensory afferent fibers, enhancing spinal cord neural network integration, optimizing brain-spinal cord information transmission, and inducing neural plasticity. This article reviews the mechanism, electrode implantation, and stimulation parameter of eSCS, and application of eSCS in spinal cord injury, Parkinson's disease, and stroke, aiming to provide valuable insight for its clinical implementation.

Objective To explore the correlation between the triglyceride glucose-waist-to-height ratio (TyG-WHtR) and heart failure (HF) after acute myocardial infarction (AMI),(AMI-HF). Methods Clinical data of AMI patients admitted to Department of Cardiology, Wuhan No.1 Hospital, from January 2020 to January 2024 were retrospectively collected. Triglycerides, fasting glucose, waist circumference, and height data were collected to calculate TyG-WHtR. The correlation between TyG-WHtR and AMI-HF was analyzed by logistic regression analysis. The receiver operating characteristic (ROC) curve was used to analyze the ability of TyG-WHtR in predicting AMI-HF. Results A total of 572 AMI patients were included in the study, of whom 102 (17.8%) AMI patients developed HF within one year after surgery. The TyG-WHtR index in the HF group was significantly elevated compared to the group without HF ([5.5±0.4] vs [4.7±0.3], P＜0.001). Multivariate logistic regression analysis showed that TyG-WHtR was an independent risk factor for AMI-HF. The area under curve (AUC) of 0.78 for TyG-WHtR in predicting AMI-HF (P＜0.001); the AUC of the combination of TyG-WHtR and PCI time in predicting AMI-HF was 0.81 (P＜0.001). Conclusions The TyG-WHtR index is an independent risk factor for AMI-HF and can be an effective indicator for predicting the risk of postoperative HF in AMI patients.