[Objective]To explore the meaning of"the patients who vomited after taking Zhizichi Decoction should discontinue it",thereby providing evidence-based references for its clinical application.[Methods]By organizing,summarizing,and analyzing the diverse academic viewpoints of past medical practitioners regarding"the patients who vomited after taking Zhizichi Decoction should discontinue it",this study examines the medicinal properties and preparation of Gardenia jasminoides(Zhizi)and Sojae Semen Praeparatum(Douchi)found in mainstream pharmacological texts.It also investigates the specific connotations of"the patients who vomited after taking Zhizichi Decoction should Discontinue it"from three perspectives:drug-induced vomiting,misconceptions,and post-medication reactions,combining insights from ZHANG Zhongjing's original text and relevant medical cases by YE Tianshi.[Results]There are primarily three different academic viewpoints regarding"the patients who vomit after taking Zhizichi Decoction should discontinue it":the drug-induced vomiting theory,the misconceptions theory and the post-medication reaction theory.The drug-induced vomiting theory posits that Zhizi or Douchi can lead to vomiting,vomiting is a method and objective of treatment,categorizing Zhizichi Decoction as an emetic.The misconceptions theory argues that Zhizichi Decoction does not induce vomiting and that"the patients who vomit after taking Zhizichi Decoction should discontinue it"does not align with the original intention of Treatise on Febrile Diseases.The post-medication reaction theory claims that Zhizichi Decoction is not an emetic;rather,vomiting is a post-medication reaction,with the key factor being the stagnation of Qi in the upper-Jiao.Therefore,Zhizi and Douchi are used in combination to create a mild bitter and spicy effect to regulate the ascent and descent of Qi,allowing the stagnated heat to be expelled.[Conclusion]The post-medication reaction theory aligns most closely with ZHANG Zhongjing's original intention.Zhizichi Decoction has the efficacy of dispersing and removing obstruction,it functions by promoting the circulation of Qi through its slightly bitter and mildly spicy properties to regulate the ascent and descent of Qi,clearing stagnated heat,which should be classified as an diffusing formula within the"ten prescriptions".Accurate clinical application of this formula hinges on identifying the pathogenic mechanism of Qi stagnation in the uppert-Jiao.

As a major category of occupational hazards in China, physical factors are widely distributed in various industries and affect a large number of workers. The list and diagnostic criteria of occupational diseases caused by physical factors are important basis for occupational disease diagnosis and protection of occupational health rights and interests for occupational populations. This article compares the differences in the list of occupational diseases caused by physical factors at home and abroad, analyzes the problems in the current list of occupational diseases caused by physical factors and related diagnostic standards in China, and puts forward relevant suggestions for further adjusting the list of occupational diseases caused by physical factors, formulating and revising relevant diagnostic standards for occupational diseases, providing reference for improving the classification and catalogue of occupational diseases in China in the future.

ObjectiveTo explore the clinical efficacy and safety of Da Chaihutang （DCH） for the treatment of sepsis with Yang syndrome. MethodsA total of 70 patients suffering from sepsis with Yang syndrome were randomly divided into an observation group and a control group， with 35 cases in each group. They both received standard Western medicine treatment. The observation group was additionally given a dose of DCH， which was boiled into 100 mL and taken twice. The control group was additionally given an equal volume and dosage of warm water. The intervention lasted for three days. The 28-day all-cause mortality and the changes in the following indicators before and after intervention were compared between the two groups， including sequential organ failure assessment （SOFA）， acute physiology and chronic health evaluation Ⅱ （APACHE Ⅱ） score，white blood cell （WBC），the percentage of neutrophils （NEU%），C-reactive protein （CRP），procalcitonin （PCT），alanine transaminase （ALT），aspartate transaminase （AST），total bilirubin （TBil），creatinine （Cr），blood urea nitrogen （BUN），acute gastrointestinal injury （AGI） grade，gastrointestinal dysfunction score （GDS），serum intestinal fatty acid-binding protein （iFABP）， citrulline （CR），platelet （PLT），prothrombin time（PT），activated partial thromboplastin time （APTT），fibrinogen （Fib），international normalized ratio （INR），and D-dimer （D-D）. ResultsThere was no significant difference between the two groups regarding 28-day all-cause mortality. After the intervention，SOFA，WBC，PCT，and Cr were significantly decreased， and PLT was significantly increased in the control group （P<0.05）. SOFA，APACHE Ⅱ，NEU%，CRP，PCT，ALT，AST，Cr，BUN，AGI grade，GDS，and serum iFABP and CR were significantly improved in the observation group （P<0.05）. After the intervention，APACHE Ⅱ，PCT，AGI grade，GDS，and serum iFABP in the observation group were significantly lower than those in the control group ，while CR and PLT were higher （P<0.05，P<0.01）. There were significant differences regarding the gap of SOFA，APACHE Ⅱ，AST，TBil，AGI grade，GDS，iFABP，CR， and PLT between the two groups （P<0.05，P<0.01）. There were slight differences regarding PT，APTT，Fib，INR，and D-D between the two groups，which were in the clinical normal range. ConclusionOn the basis of Western medicine， DCH helped to reduce sepsis severity and improved multiple organ dysfunction with high clinical efficacy and safety， but further research on its impact on the prognosis of patients with sepsis is still required.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

As a major category of occupational hazards in China, physical factors are widely distributed in various industries and affect a large number of workers. The list and diagnostic criteria of occupational diseases caused by physical factors are important basis for occupational disease diagnosis and protection of occupational health rights and interests for occupational populations. This article compares the differences in the list of occupational diseases caused by physical factors at home and abroad, analyzes the problems in the current list of occupational diseases caused by physical factors and related diagnostic standards in China, and puts forward relevant suggestions for further adjusting the list of occupational diseases caused by physical factors, formulating and revising relevant diagnostic standards for occupational diseases, providing reference for improving the classification and catalogue of occupational diseases in China in the future.

[Objective]To explore the meaning of"the patients who vomited after taking Zhizichi Decoction should discontinue it",thereby providing evidence-based references for its clinical application.[Methods]By organizing,summarizing,and analyzing the diverse academic viewpoints of past medical practitioners regarding"the patients who vomited after taking Zhizichi Decoction should discontinue it",this study examines the medicinal properties and preparation of Gardenia jasminoides(Zhizi)and Sojae Semen Praeparatum(Douchi)found in mainstream pharmacological texts.It also investigates the specific connotations of"the patients who vomited after taking Zhizichi Decoction should Discontinue it"from three perspectives:drug-induced vomiting,misconceptions,and post-medication reactions,combining insights from ZHANG Zhongjing's original text and relevant medical cases by YE Tianshi.[Results]There are primarily three different academic viewpoints regarding"the patients who vomit after taking Zhizichi Decoction should discontinue it":the drug-induced vomiting theory,the misconceptions theory and the post-medication reaction theory.The drug-induced vomiting theory posits that Zhizi or Douchi can lead to vomiting,vomiting is a method and objective of treatment,categorizing Zhizichi Decoction as an emetic.The misconceptions theory argues that Zhizichi Decoction does not induce vomiting and that"the patients who vomit after taking Zhizichi Decoction should discontinue it"does not align with the original intention of Treatise on Febrile Diseases.The post-medication reaction theory claims that Zhizichi Decoction is not an emetic;rather,vomiting is a post-medication reaction,with the key factor being the stagnation of Qi in the upper-Jiao.Therefore,Zhizi and Douchi are used in combination to create a mild bitter and spicy effect to regulate the ascent and descent of Qi,allowing the stagnated heat to be expelled.[Conclusion]The post-medication reaction theory aligns most closely with ZHANG Zhongjing's original intention.Zhizichi Decoction has the efficacy of dispersing and removing obstruction,it functions by promoting the circulation of Qi through its slightly bitter and mildly spicy properties to regulate the ascent and descent of Qi,clearing stagnated heat,which should be classified as an diffusing formula within the"ten prescriptions".Accurate clinical application of this formula hinges on identifying the pathogenic mechanism of Qi stagnation in the uppert-Jiao.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To detect and study the genetic evolution and biological characteristics of the first imported Zika virus (ZIKV) in a suspected case from Singapore to Sichuan Tianfu airport for inbound transfer on June 28, 2024, and so to provide reference for prevention and control of ZIKV disease.Methods:Serum sample was collected from the inbound transfer passenger, we detected ZIKV RNA using real-time RT-PCR method. The whole genome sequence was obtained through target next-generation sequencing (tNGS). CLC Genomics Workbench software was used for sequence analysis and splicing, and MEGA 7.0 software was used for phylogenetic tree construction.Results:Real-time RT-PCR result showed that the serum sample was positive. The phylogenetic tree which was constructed based on the whole genome sequence of ZIKV indicated the Sichuan strain was located on Asian lineage. Gene homology analysis showed that the homology between Sichuan strain and Asian, African strains ranged from 84.4%-98.6%. The Sichuan strain showed unique molecular features of 139S, 982V and 2634M.Conclusions:The ZIKV strain in Sichuan inbound transfer passenger in June 2024 belongs to the Asian lineage, which agrees with the epidemiological investigation outcome.

Objective:To detect and study the genetic evolution and biological characteristics of the first imported Zika virus (ZIKV) in a suspected case from Singapore to Sichuan Tianfu airport for inbound transfer on June 28, 2024, and so to provide reference for prevention and control of ZIKV disease.Methods:Serum sample was collected from the inbound transfer passenger, we detected ZIKV RNA using real-time RT-PCR method. The whole genome sequence was obtained through target next-generation sequencing (tNGS). CLC Genomics Workbench software was used for sequence analysis and splicing, and MEGA 7.0 software was used for phylogenetic tree construction.Results:Real-time RT-PCR result showed that the serum sample was positive. The phylogenetic tree which was constructed based on the whole genome sequence of ZIKV indicated the Sichuan strain was located on Asian lineage. Gene homology analysis showed that the homology between Sichuan strain and Asian, African strains ranged from 84.4%-98.6%. The Sichuan strain showed unique molecular features of 139S, 982V and 2634M.Conclusions:The ZIKV strain in Sichuan inbound transfer passenger in June 2024 belongs to the Asian lineage, which agrees with the epidemiological investigation outcome.

Purpose: Oligometastatic non–small cell lung cancer (NSCLC) patients have been increasingly regarded as a distinct group that could benefit from local treatment to achieve a better clinical outcome. However, current definitions of oligometastasis are solely numerical, which are imprecise because of ignoring the biological heterogeneity caused by genomic characteristics. Our study aimed to profile the molecular alterations of oligometastatic NSCLC and elucidate its potential difference from polymetastasis. Materials and Methods: We performed next-generation sequencing to analyze tumors and paired peripheral blood from 77 oligometastatic and 21 polymetastatic NSCLC patients to reveal their genomic characteristics and assess the genetic heterogeneity. Results: We found ERBB2, ALK, MLL4, PIK3CB, and TOP2A were mutated at a significantly lower frequency in oligometastasis compared with polymetastasis. EGFR and KEAP1 alterations were mutually exclusive in oligometastatic group. More importantly, oligometastasis has a unique significant enrichment of apoptosis signaling pathway. In contrast to polymetastasis, a highly enriched COSMIC signature 4 and a special mutational process, COSMIC signature 14, were observed in the oligometastatic cohort. According to OncoKB database, 74.03% of oligometastatic NSCLC patients harbored at least one actionable alteration. The median tumor mutation burden of oligometastasis was 5.00 mutations/Mb, which was significantly associated with smoking, DNA damage repair genes, TP53 mutation, SMARCA4 mutation, LRP1B mutation, ABL1 mutation. Conclusion Our results shall help redefine oligometastasis beyond simple lesion enumeration that will ultimately improve the selection of patients with real oligometastatic state and optimize personalized cancer therapy for oligometastatic NSCLC.