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.

Symptom and syndrome efficacy evaluation scales are indispensable tools for clinical efficacy assessment in traditional Chinese medicine （TCM）， and hold significant value at all stages of new drug research development for spleen and stomach diseases. These scales can provide scientific basis for clinical positioning， efficacy evaluation， and expansion of indications of new drugs. By analyzing the current hotspots and difficulties in research， this study aims to explore the important significance of these scales in the development of new drugs for spleen and stomach diseases， summarize the domestic research progress， and conduct comparative analyses with international studies. Future development trends are also discussed in order to promote the application of symptom and syndrome efficacy evaluation scales in the development of new drugs for spleen and stomach diseases and to advance the moder-nization process of TCM.

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）.

Background: Malignant vasovagal syncope (VVS) is characterized by cardiac arrest lasting more than 3 seconds during a syncope episode or head-up tilt test (HUTT). We aim to conduct a risk assessment for potential malignant VVS before the HUTT by using economic, simple and convenient demographic data, in order to prevent adverse outcomes for pediatric VVS.Purpose: To explore the correlation between demographic factors and pediatric malignant VVS, and verify the value of these factors in early risk assessment for malignant VVS before HUTT, so as to optimize test safety and reduce adverse events. Methods: We conducted a retrospective analysis of the clinical data of 3,734 children who were initially diagnosed with VVS due to unexplained syncope and presyncope. Finally, 122 children who met the diagnostic criteria for malignant VVS were included in the malignant VVS group, and 661 children who did not meet the criteria during the same period were matched as the control group. By analyzing demographic data and other factors, we attempted to clarify the association between these factors and malignant VVS. Results: Linear relationship: age and body mass index (BMI) have independent protective effects on malignant VVS. For every 1-year increase in age and every 1 kg/m2 increase in BMI, the risk of malignant VVS decreases by 12% and 9%, respectively. Nonlinear relationship: When the age is <12.9 years old, for every additional year of age, the risk of malignant VVS decreases by 20%. For ages 12.9 years and above, the efficacy is not significant. There is no significant nonlinear relationship between BMI and malignant VVS. Conclusion Age and BMI are independent protective factors for pediatric malignant VVS. Before the age of 12.9 years, the incidence of malignant VVS gradually decreases with the increase in age, and thereafter there is no significant impact.

ObjectiveTo analyze the composition of respiratory virus pathogen spectrum and epidemiological characteristics among adult influenza-like illness (ILI) cases in Putuo District of Shanghai from 2015 to 2024, to summarize the epidemic patterns of respiratory viruses across different time periods and populations, and to provide scientific evidence for the prevention and control of adult respiratory virus infections in Putuo District of Shanghai. MethodsSurveillance data of 2 273 adult ILI cases from sentinel hospitals under the comprehensive surveillance system for acute respiratory infections in Putuo District of Shanghai from 2015 to 2024 were retrospectively collected. Descriptive epidemiological methods were adopted to analyze the temporal and population distribution characteristics of respiratory viruses, including influenza virus (IFV), respiratory syncytial virus (RSV), adenovirus (ADV), and human metapneumovirus (HMPV). The mixed infection status among different age groups was compared, and the distribution of influenza virus subtypes was described. SPSS 22.0 and WPS Office software were used for statistical analyses. ResultsThe overall detection rate of respiratory viruses in 2 273 adult ILI cases was 43.51%. The detection rate in females (45.48%) was significantly higher than that in males (41.25%), with statistical significance (χ²=4.113, P=0.043). Individuals aged 60 years old and above had the highest detection rate (47.41%) (χ²=8.430, P=0.014). The detection rates in winter (50.41%) and summer (48.42%) were higher than those in other seasons (χ²=47.028, P<0.001). The overall viral detection rate decreased after 2020 (χ²=208.411, P<0.001). Detection rates of various viruses varied by year, with IFV and ADV showing high rates from 2015 to 2019 (all P<0.001), while human coronavirus (HCoV) and rhinovirus/enterovirus (HRV/EV) exhibited higher rates from 2020 to 2022 (all P<0.001). Co-infection with IFV and HCoV was the most common, followed by co-infection with IFV and ADV, together accounting for 50.00% of all mixed infections. During the surveillance period, the detection rate of IFV was significantly higher than that of other respiratory viruses. Influenza B/Victoria lineage predominated in 2021, followed by successive predominance of influenza A(H1N1), A(H3N2), and the co-circulation of the two subtypes from 2022 to 2023. Influenza A(H1N1) re-emerged as the predominant subtype in the first half of 2024. ConclusionFrom 2015 to 2024, respiratory virus infections in adults prevailed in winter and summer, and people aged 60 years old and above were the key high-risk population. The detection rates of respiratory viruses declined after 2020. IFV was the predominant pathogen detected, and different influenza virus subtypes circulated alternately each year.

Diarrhea-predominant irritable bowel syndrome （IBS-D） is a common digestive system disease with high prevalence and recurrence rates for years， high treatment costs， and serious impacts on patients' quality of life and economic burden. Therefore， it is important to explore new and safe treatment methods. The pathogenesis of IBS-D is complex， in which the gut-brain axis is a key factor. The gut-brain axis， a bidirectional signaling pathway connecting the gastrointestinal tract and the central nervous system， regulates gastrointestinal motility， secretion， and immune responses， playing a key role in the occurrence and development of IBS-D. Up to now， antidiarrheal agents， probiotics， and neurotransmitter modulators are the main methods for the clinical treatment of IBS-D. Although they can partially curb the progression of this disease， the therapeutic effects remain to be improved. Studies have confirmed that traditional Chinese medicine （TCM） has significant advantages in the treatment of IBS-D since it can regulate the gut-brain axis via multiple pathways and targets to improve the gastrointestinal motility and strengthen immune defenses. However， there is a lack of systematic reviews on the regulation of the gut-brain axis by TCM in the treatment of IBS-D. Based on the review of IBS-D-related articles published in recent years， this paper systematically summarized the relationship between the gut-brain axis and IBS-D and the role of TCM in the treatment， providing new ideas for the treatment of IBS-D.

Objective: To explore differences in the factors influencing parents and teachers assessments of preschool children s mental health using the Strengths and Difficulties Questionnaire (SDQ), so as to provide reference for promoting children s mental health. Methods: A retrospective analysis was conducted on the SDQ survey data of 14 763 middle and senior kindergarten children in Nanshan District, Shenzhen, from March to June 2023. Chi square χ 2 tests were used to analyze differences in mental health assessments between parents and teachers. Multivariate Logistic regression was employed to examine the factors influencing parental assessments, and Kappa coefficients were used to evaluate the consistency between parent and teacher evaluations. Results: The positive rate of mental health problems reported by parents (7.2%) was significantly higher than that reported by teachers (6.2%) ( χ 2=254.27, P <0.01). Gender differences revealed that parents reported a lower positive rate for boys (7.9%) compared to teachers (8.5%), whereas for girls, the parental positive rate (6.4%) was higher than that reported by teachers (3.8%) ( χ 2=163.59, 81.26, all P <0.01). Age related differences showed that parental positive rates for 4, 5, and 6 year olds (8.5%, 7.4%, 5.8%) were consistently higher than teachers assessments (6.3%, 6.7%, 5.4%) ( χ 2=41.23, 157.53, 63.67, all P <0.05). Univariate analysis of parental assessments indicated higher positive rates among boys (7.9%), 4 year olds (8.5%), mothers aged 20-35 ( 6.6 %), mothers with high school education or below (9.8%), fathers aged 23-40 (6.4%), fathers with high school education or below (10.3%), and children exposed to secondhand smoke (7.9%) ( χ 2=23.56-235.24, all P <0.01). Multivariate Logistic regression identified lower parental education levels and exposure to secondhand smoke as significant risk factors for abnormal SDQ assessments by parents ( χ 2=2.05, 1.62, 3.15, all P <0.05). The Kappa coefficients for parent-teacher agreement across SDQ subscales and total difficulties ranged from 0.04 to 0.12 (all P <0.01). Conclusions Parental education level and exposure to secondhand smoke are significant factors influencing preschool children s mental health. Differences exist between parental and teacher assessments of children s mental health, and incorporating teacher evaluations can provide a more comprehensive understanding of preschoolers psychological well being.

Objective:Based on the best evidence, formulate the review indicators to promote the initiation and establishment of maternal lactation and carry out clinical review, analyze the barriers and promoting factors of the clinical application of evidence, and formulate countermeasures.Methods:Evidence-based nursing research was used to identify clinical problems, build evidence-based group, systematically search, evaluate and synthesize evidence. On September 1,2023 to December 31 in Affiliated Hospital of Jiangsu University document and delivery of maternal investigation, in Ottawa research application mode as a guide, based on the evidence to review indicators and review method, clear clinical status and evidence gap, combined with the stakeholders interview, using content analysis to analyze barriers and promoting factors, to formulate action countermeasures.Results:In this study, 140 pregnant women were finally included for clinical review, aged from 22 to 42 (30.13 ± 3.69) years. A total of 23 pieces of best evidence were incorporated, leading to the establishment of 29 review indicators. Among these, 20 review indicators showed compliance rates below 60%. The main obstacles based on the results of review and interviews with stakeholders: the evidence content covered perinatal stages but lacked specificity and practical applicability; nurses had insufficient knowledge and faced increased workloads; pregnant/postpartum women lacked essential knowledge and skills, with delayed resolution of lactation issues; the practice environment lacked evidence-based implementation protocols, specialized assessment tools, and professional lactation consultant teams, etc. Promoting factors: the project team had rich experience in evidence transformation; the reform aligned with national policies, high engagement from departmental leaders, and standardized management systems for evidence-based projects in the nursing department; strong motivation among pregnant/postpartum women; the hospital was an infant-friendly hospital with talents needed for evidence transformation.Conclusions:There is a big gap between the clinical status and the evidence of promoting the initiation and establishment of lactation, so nursing staff should make full use of the promoting factors and formulate countermeasures according to the obstacle factors, so as to provide reference for promoting the initiation of lactation and the establishment of relevant evidence to clinical transformation.

Objective:To reveal the relationship between fat mass and obesity associated (FTO) protein and the occurrence of diseases in patients with polycystic ovary syndrome (PCOS) combined with metabolic syndrome (MS).Methods:A retrospective case-control study was conducted, and general clinical data and laboratory test indicators of 50 PCOS patients (PCOS group) and 54 healthy individuals (control group) were collected from December 2023 to October 2024. The PCOS group was divided into the PCOS without MS subgroup (PCOS+nMS subgroup, n=25) and the PCOS with MS subgroup (PCOS+MS subgroup, n=25) based on whether MS was present or not. The expression level of serum FTO protein was detected by enzyme-linked immunosorbent assay method. The clinical data and metabolic characteristics of PCOS patients were analyzed, as well as the correlation between serum FTO protein level and the occurrence of PCOS with MS. Receiver operating characteristic (ROC) curves were drew to analyze the predictive ability of serum FTO protein level for PCOS combined MS, and the correlation between serum FTO protein level and metabolic status of PCOS patients was evaluated through logistic regression model. Results:The level of serum FTO protein in the PCOS group [57.42 (45.87, 68.53) μg/L], and PCOS+nMS subgroup [48.41 (37.84, 64.30) μg/L] was all significantly higher than that in the control [45.70 (36.41, 52.86) μg/L, P<0.001; adjusted P=0.016]. The expression level of serum FTO protein in PCOS+MS subgroup [60.31 (50.99, 72.28) μg/L] was significantly higher than that in PCOS+nMS subgroup (adjusted P=0.013) and the control (adjusted P<0.001). The serum FTO protein expression level in the PCOS group was significantly positively correlated with body mass index, waist circumference, systolic blood pressure,diastolic blood pressure, low density lipoprotein cholesterol, homeostasis model to assess insulin resistance index (all P<0.05). The expression level of serum FTO protein had a certain predictive value for PCOS, with an area under the curve (AUC) value of 0.725 (95% CI: 0.627-0.824) and a better predictive value for the occurrence of MS in PCOS, with an AUC value of 0.869 (95% CI: 0.762-0.976) as shown by the ROC curve. Multivariate logistic regression analysis indicated that in PCOS patients, the expression level of serum FTO protein had a significant positive effect on the coexistence of MS, ( OR=1.092,95% CI: 1.010-1.180, P=0.026). Conclusion:PCOS patients have higher serum FTO protein levels than healthy women, and PCOS patients with MS have higher serum FTO protein levels than those without MS. The serum FTO protein level has a good predictive value for the occurrence of PCOS and PCOS complicated with MS, and is an independent risk factor for the occurrence of MS in PCOS.

Objective To evaluate the quality of cisatracurium besilate injection produced by domestic manufacturers.Methods A comprehensive evaluation of 104 batches of samples was carried out using statutory testing methods combined withexploratory research,including related substances,1,5-pentanediol diacrylate,residual solvents,genotoxic impurities of benzenesulfonate esters,infrared spectrum,and endotoxin examination.The quality of domestic products and the controllability of current specifications were comprehensively evaluated.Results According to the statutory tests,the qualified rate of 104 batches of samples was 100.0％.The exploratory research showed that the results of related substances in the samples produced by 6 manufacturers were far below the limit,and no genotoxic impurities of benzenesulfonate esters were detected.However,the results showed that there was variability in 1,5-pentanediol diacrylate,as well as residual solvents.Conclusions The quality of the cisatracurium besilate injection is good,and the current specifications should be further improved and unified.It was proposed that the infrared spectrum,related substance,and 1,5-pentanediol diacrylate method be added or revised,and the limit of endotoxin strictly controlled.It was proposed that manufacturers pay attention to the quality of API and control injection production.