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.

Objective: To investigate whether Tuina alleviates fibrotic symptoms in myofascial trigger points (MTrPs) by regulating transforming growth factor (TGF)-β1/Smad3 signaling pathway, thereby deactivating these points. Methods: This study comprised two experimental phases. In phase 1, 27 specific pathogen-free (SPF) grade female Sprague-Dawley (SD) rats were randomized into three groups: control 1, model 1, and Tuina 1 groups. Model 1 and Tuina 1 groups underwent an 8-week MTrPs modeling protocol involving blunt impact and eccentric exercise. After successful modeling, rats in Tuina 1 group received manual pressing on nodules or cord-like taut bands on the medial aspect of the left hindlimb. Pain sensitivity and tissue stiffness were evaluated via pressure pain threshold (PPT) and soft tissue tension (STT). Muscle histopathology and fibrosis were observed using hematoxylin and eosin (HE) and Masson staining. Inflammatory factors in muscle were measured by enzyme-linked immunosorbent assay (ELISA), while immunofluorescence (IF) and Western blot (WB) were used to detect the expression levels of α-smooth muscle actin (α-SMA), collagen Ⅲ, and TGF-β1. In phase 2, 45 SPF female SD rats were randomized into five groups: control 2, model 2, Tuina 2, TGF-β1 inhibitor (TI), and Tuina + TGF-β1 agonist (Tuina + TA) groups. All groups except control 2 underwent standardized MTrPs modeling. Rats in Tuina 2 group received consistent pressing manipulation. TI group received intraperitoneal injections of oxymatrine, while Tuina + TA group received intraperitoneal injections of SRI-011381 hydrochloride followed by the same pressing protocol as Tuina 2 group. WB was used to detect the expression of collagen I, collagen III, TGF-β1, and phosphorylated-Smad3 (p-Smad3)/Smad3. Results: In phase 1, Tuina significantly improved PPT and STT in MTrPs of rats (P < 0.01), reversed pathological damages including disorganized muscle fiber arrangement, abnormal myocyte morphology, and exacerbated fibrosis. In addition, in MTrPs of rats in model 1 group, expression levels of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, and fibrosis markers (α-SMA, collagen I, and collagen III) were upregulated, and all exhibited a significant downward trend after Tuina intervention (P < 0.05 or P < 0.01). This indicates that the therapeutic effects of Tuina are directly associated with reduced local inflammation and fibrosis in MTrPs. In phase 2, compared with model 2 group, rats in TI and Tuina 2 groups had decreased expression levels of TGF-β1 and p-Smad3/Smad3 in MTrPs, alongside reduced levels of inflammatory factors (IL-1β, IL-6, NF-κB, and TNF-α) and fibrosis markers (α-SMA, collagen I, and collagen III) (P < 0.05 or P < 0.01). When co-administered with TGF-β1 agonist, the therapeutic effects of Tuina were significantly attenuated, with rebounded TGF-β1 expression and p-Smad3/Smad3 in local MTrPs, and fibrosis and inflammatory responses were re-exacerbated (P < 0.05 or P < 0.01). Conclusion Tuina can effectively reduce inflammatory responses and fibrosis in MTrPs tissue, and its mechanism is closely related to the inhibition of the TGF-β1/Smad3 signaling pathway, which plays a critical role in Tuina-mediated regulation of MTrPs fibrosis.

OBJECTIVE To explore the mechanism by which Qingre antai decoction improves pregnancy outcomes of threatened abortion rats with blood heat syndrome. METHODS The pregnant rats were randomly divided into normal group， model group， dydrogesterone group （0.002 g/kg）， and Qingre antai decoction group （44.1 g/kg）， with 13 rats in each group. Except for normal group， other groups were given warming-yang Chinese medicine and corresponding drugs intragastrically， once a day， for 12 consecutive days. On the 13th day of pregnancy， a single intragastric administration of mifepristone （5 mg/kg） was performed to establish a model of threatened abortion with blood heat syndrome. On the 14th day of pregnancy， the abortion rate and uterine coefficient were calculated； the pathological morphology of pregnant uterine was observed； the serum levels of 3，5，3′-triiodothyronine （T3）， thyroid hormone （T4）， thyroid stimulating hormone （TSH）， as well as the levels of vascular endothelial growth factor （VEGF） and nitric oxide （NO） in the pregnant uterus were all determined； the expressions of mRNA and protein related to Janus kinase 2 （JAK2）/signal transducer and activator of transcription 3 （STAT3） and phosphatidylinositol 3-kinase （PI3K）/protein kinase B （AKT） pathways were detected. RESULTS Compared with normal group， the model group exhibited endometrial tissue damage， a reduced number of decidual cells， and a significant presence of blood stasis within the uterus； abortion rate， the serum levels of T3， T4 and TSH， the mRNA expressions of JAK2， STAT3 and suppressor of cytokine signaling 3 （SOCS3） as well as protein expressions of p-JAK2， p-STAT3 and SOCS3 in the pregnant uterus were increased significantly （ P ＜0.05）； uterine coefficient， the levels of VEGF and NO in pregnant uterus， mRNA expressions of VEGFR2， PI3K， AKT and endothelial nitric oxide synthase（eNOS）， protein expressions of VEGFR2， PI3K and eNOS as well as phosphorylation level of AKT in the pregnant uterus were significantly reduced （ P ＜0.05）. Compared with model group， the endometrial tissue damage and congestion in the Qingre antai decoction group were significantly improved， and the levels of the aforementioned quantitative indicators were significantly reversed （ P ＜0.05）. CONCLUSIONS Qingre antai decoction can improve the pregnancy outcomes in rats with threatened abortion of blood heat syndrome， the mechanism of which may be associated with inhibiting JAK2/STAT3 pathway and activating PI3K/AKT pathway.

Objective To analyze the relationship between cognitive function, motor ability and the risk of falls in patients during the rehabilitation period after stroke. Methods A total of 330 patients with stroke who received rehabilitation treatment in the hospital from February 2022 to February 2025 were classified into fall group (n=105) and non-fall group (n=225) based on the occurrence of falls during rehabilitation period. The clinical data of patients were collected, and the motor function of patients was evaluated by Fugl-Meyer scale, and the cognitive function of patients was assessed by mini-mental state examination (MMSE). Univariate and logistic multivariate regression analyses were applied to analyze the factors affecting the occurrence of falls. Spearman correlation analysis was performed to analyze the relationship between motor ability, cognitive function and risk of falls. Results The proportions of osteoporosis, malnutrition, sleep disorder and history of falls in the fall group were higher while the education level, Fugl-Meyer score and MMSE score were lower compared to the non-fall group (P<0.05). After logistic multivariate analysis, it was found that osteoporosis, malnutrition, sleep disorder, history of falls, low education level, low Fugl-Meyer score and low MMSE score were risk factors for falls in patients during post-stroke rehabilitation period (P<0.05). Correlation analysis indicated that the motor ability and cognitive function in patients during post-stroke rehabilitation period were negatively associated with the occurrence of falls (r=-0.579, -0.438, P<0.001). Conclusion The cognitive function, motor ability of patients in the post-stroke rehabilitation period are closely related to the risk of falls. Clinically, the risk of falls in patients during post-stroke rehabilitation period can be reduced by improving the motor ability and cognitive function.

OBJECTIVE To analyze the expression levels of peripheral blood long non-coding RNA nuclear-enriched abundant transcript 1(lncRNA NEAT1),Toll-like receptor 2(TLR2)and nuclear factor kappa B(NF-κB)in pa-tients with acute respiratory tract infection and their relationship with helper T cell(Th)1/Th2 imbalance.METHODS The clinical data of 120 patients with emergency respiratory tract infection admitted to Changzhou Sec-ond People's Hospital Affiliated to Nanjing Medical University between Jan.2022 and Jan.2024 were retrospec-tively analyzed,the patients were set as study group(n=120),and 70 healthy volunteers who came to the hospi-tal for physical examination during the same period were served as healthy group(n=70).The levels of lncRNA NEAT1,TLR2 mRNA,NF-κB mRNA,CD4+Th1,CD4+Th2 and Th1/Th2 in peripheral blood,and expression levels of Th1/Th2 cell immune homeostasis-associated factors[interferon-γ(IFN-γ),interleukin-4(IL-4)and IFN-γ/IL-4]were compared between the two groups of subjects,Pearson correlation analysis was applied to ex-plore the correlation between the levels of peripheral blood lncRNA NEAT1,TLR2 mRNA and NF-κB mRNA and Th1/Th2 balance and its cellular immune homeostasis-associated cytokines in patients with emergency respira-tory tract infection,and receiver operating characteristic(ROC)curve was used to analyze the predictive efficiency of peripheral blood lncRNA NEAT1,TLR2 mRNA,NF-κB mRNA,Th1/Th2 and IFN-γ/IL-4 for acute respira-tory tract infection.RESULTS The pathogens detected in the study group were predominantly Streptococcus pneu-moniae(30.30％).The levels of peripheral blood lncRNA NEAT1,TLR2 mRNA,NF-κB mRNA,CD4+Th2 and IL-4 in study group were(1.64±0.40),(0.85±0.21),(0.69±0.15),(8.82±2.40)×10-2 and(25.48±6.77)pg/ml,a little higher than those in healthy group,while the levels of CD4+Th1,Th1/Th2,IFN-γ and IFN-γ/IL-4 were(6.87±2.05)×10-2,(0.86±0.45),(52.67±11.89)pg/ml and(2.25±0.94),lower than those in the healthy group(all P＜0.05).Pearson correlation analysis showed that the peripheral blood lncRNA NEAT1,TLR2 mRNA and NF-κB mRNA of subjects with acute respiratory tract infection were negatively corre-lated with Th1/Th2(r=-0.445,-0.316,-0.337,all P＜0.05)and IFN-γ/IL-4(r=-0.454,-0.308,-0.375,all P＜0.05).ROC curve results showed that peripheral blood lncRNA NEAT1,TLR2 mRNA,NF-κB mRNA,Th1/Th2 and IFN-γ/IL-4 had high diagnostic efficiency for respiratory tract infection[the area under the curve(AUG)=0.887,0.924,0.934,0.935 and 0.957 respectively,all P＜0.05].CONCLUSION Peripheral blood lncRNA NEAT1,TLR2 mRNA,NF-κB mRNA,Th1/Th2 and IFN-γ/IL-4 levels have high diagnostic val-ue for acute respiratory tract infection,and lncRNA NEAT1 levels are closely related to TLR2 mRNA,NF-κB mRNA,Th1/Th2 and IFN-γ/IL-4 levels.

Objective To observe the effects of Yitangkang on brown fat thermogenesis and mitochondrial biogenesis of PGC1α-NRF1/2-TFAM pathway in db/db mice;To explore its mechanism of regulating glucose and lipid metabolism.Methods Totally 27 six-week-old db/db mice were randomly divided into model group,Yitangkang group(30 g/kg)and liraglutide group(200 μg/kg),another 9 db/m mice of the same age were set as normal group.All groups received intervention with drugs or saline for 6 weeks.The body mass and FBG were measured weekly.After intervention,oral glucose tolerance test(OGTT)was carried out,the contents of serum TC,TG,LDL-C and HDL-C were detected by biochemical analyzer,HE staining was used to observe the morphology of brown adipose tissue(BAT)in scapular region,RT-qPCR and Western blot were used to detect the expressions of UCP1,PRDM16,PGC1α related to BAT thermogenesis and NRF1,Nrf2,TFAM related to mitochondrial biogenesis.Results Compared with the normal group,the body mass,FBG,area under the curve of OGTT and serum TG,TC,LDL-C content of model group significantly increased(P<0.01),the content of HDL-C significantly decreased(P<0.01);the diameter of BAT cells in scapular region was larger,white vacuoles appeared,lipid droplets increased,and the mRNA and protein expressions of UCP1,PRDM16,PGC-1α,NRF1,NRF2 and TFAM in BAT decreased significantly(P<0.01).Compared with the model group,the body mass,FBG,area under the curve of OGTT and serum TG,TC,LDL-C contents of Yitangkang group and liraglutide group significantly decreased(P<0.01),the content of HDL-C increased(P<0.01);BAT cells were smaller in diameter,more closely arranged,more regular in shape,and more abundant in capillary,the mRNA and protein expressions of UCP1,PRDM16,PGC-1α,NRF1,NRF2 and TFAM in BAT increased significantly(P<0.01).Conclusion Yitangkang can regulate mitochondrial biogenesis through PGC1α-NRF1/2-TFAM pathway to activate brown fat in db/db mice and improve glucose and lipid metabolism in db/db mice.

Type 2 diabetes mellitus is a metabol-ic disease characterized by high blood sugar levels.Traditionally,amino acids are primarily viewed as the basic building blocks for proteins and peptide synthesis.However,in recent years,amino acids have gained increased attention as signaling mole-cules that play crucial roles in the maintenance and regulation of metabolic homeostasis.It has been found that there is a close correlation between the metabolism of branched-chain and/or aromatic amino acids and the occurrence or development of type 2 diabetes mellitus.Furthermore,there have been successive reports on the regulation mecha-nism involved.This article will focus on the meta-bolic processes,mechanisms and clinical value of branched-chain and aromatic amino acids in type 2 diabetes mellitus.It will also summarize and pro-vide an outlook on the current state of amino acid metabolism in the treatment of diabetes mellitus,with the aim of offering new ideas for the treat-ment of type 2 diabetes mellitus.

OBJECTIVE To analyze the expression levels of peripheral blood long non-coding RNA nuclear-enriched abundant transcript 1(lncRNA NEAT1),Toll-like receptor 2(TLR2)and nuclear factor kappa B(NF-κB)in pa-tients with acute respiratory tract infection and their relationship with helper T cell(Th)1/Th2 imbalance.METHODS The clinical data of 120 patients with emergency respiratory tract infection admitted to Changzhou Sec-ond People's Hospital Affiliated to Nanjing Medical University between Jan.2022 and Jan.2024 were retrospec-tively analyzed,the patients were set as study group(n=120),and 70 healthy volunteers who came to the hospi-tal for physical examination during the same period were served as healthy group(n=70).The levels of lncRNA NEAT1,TLR2 mRNA,NF-κB mRNA,CD4+Th1,CD4+Th2 and Th1/Th2 in peripheral blood,and expression levels of Th1/Th2 cell immune homeostasis-associated factors[interferon-γ(IFN-γ),interleukin-4(IL-4)and IFN-γ/IL-4]were compared between the two groups of subjects,Pearson correlation analysis was applied to ex-plore the correlation between the levels of peripheral blood lncRNA NEAT1,TLR2 mRNA and NF-κB mRNA and Th1/Th2 balance and its cellular immune homeostasis-associated cytokines in patients with emergency respira-tory tract infection,and receiver operating characteristic(ROC)curve was used to analyze the predictive efficiency of peripheral blood lncRNA NEAT1,TLR2 mRNA,NF-κB mRNA,Th1/Th2 and IFN-γ/IL-4 for acute respira-tory tract infection.RESULTS The pathogens detected in the study group were predominantly Streptococcus pneu-moniae(30.30％).The levels of peripheral blood lncRNA NEAT1,TLR2 mRNA,NF-κB mRNA,CD4+Th2 and IL-4 in study group were(1.64±0.40),(0.85±0.21),(0.69±0.15),(8.82±2.40)×10-2 and(25.48±6.77)pg/ml,a little higher than those in healthy group,while the levels of CD4+Th1,Th1/Th2,IFN-γ and IFN-γ/IL-4 were(6.87±2.05)×10-2,(0.86±0.45),(52.67±11.89)pg/ml and(2.25±0.94),lower than those in the healthy group(all P＜0.05).Pearson correlation analysis showed that the peripheral blood lncRNA NEAT1,TLR2 mRNA and NF-κB mRNA of subjects with acute respiratory tract infection were negatively corre-lated with Th1/Th2(r=-0.445,-0.316,-0.337,all P＜0.05)and IFN-γ/IL-4(r=-0.454,-0.308,-0.375,all P＜0.05).ROC curve results showed that peripheral blood lncRNA NEAT1,TLR2 mRNA,NF-κB mRNA,Th1/Th2 and IFN-γ/IL-4 had high diagnostic efficiency for respiratory tract infection[the area under the curve(AUG)=0.887,0.924,0.934,0.935 and 0.957 respectively,all P＜0.05].CONCLUSION Peripheral blood lncRNA NEAT1,TLR2 mRNA,NF-κB mRNA,Th1/Th2 and IFN-γ/IL-4 levels have high diagnostic val-ue for acute respiratory tract infection,and lncRNA NEAT1 levels are closely related to TLR2 mRNA,NF-κB mRNA,Th1/Th2 and IFN-γ/IL-4 levels.

Type 2 diabetes mellitus is a metabol-ic disease characterized by high blood sugar levels.Traditionally,amino acids are primarily viewed as the basic building blocks for proteins and peptide synthesis.However,in recent years,amino acids have gained increased attention as signaling mole-cules that play crucial roles in the maintenance and regulation of metabolic homeostasis.It has been found that there is a close correlation between the metabolism of branched-chain and/or aromatic amino acids and the occurrence or development of type 2 diabetes mellitus.Furthermore,there have been successive reports on the regulation mecha-nism involved.This article will focus on the meta-bolic processes,mechanisms and clinical value of branched-chain and aromatic amino acids in type 2 diabetes mellitus.It will also summarize and pro-vide an outlook on the current state of amino acid metabolism in the treatment of diabetes mellitus,with the aim of offering new ideas for the treat-ment of type 2 diabetes mellitus.

Objective:To summarize the current application status of sarcopenia screening tools among community-dwelling older adults and explore the suitability of various tools in different contexts.Methods:A comprehensive search was conducted in China National Knowledge Infrastructure, Wanfang Data, VIP, China Biology Medicine disc, PubMed, Web of Science, Cochrane Library, and Embase for literature related to sarcopenia screening tools, from database inception to November 30, 2024. Two researchers independently screened the literature and extracted relevant data.Results:A total of 19 articles were included, covering seven screening tools: the Sarcopenia-Five (SARC-F) questionnaire, Sarcopenia combined with Calf Circumference (SARC-CALF), Sarcopenia-Five combined with Elderly and Body Mass Index Information (SARC-F+EBM), Calf Circumference, Ishii score, Mini Sarcopenia Risk Assessment-5 (MSRA-5), and the finger-ring test.Conclusions:Research on sarcopenia screening tools for the elderly population in China is still in its early stages, primarily focusing on the localization of tools developed abroad. Future research should further develop, optimize, and validate screening tools tailored to the characteristics of the Chinese elderly population to support the prevention and management of sarcopenia.