This paper systematically reviews the core concepts and lines of theoretical inheritance of major spleen-stomach theories in traditional Chinese medicine （TCM）， including spleen deficiency theory， spleen-stomach damp-heat theory， and liver-spleen disharmony theory. It is found that these theories have all undergone a developmental trajectory characterized by classical foundation， refinement of therapeutic methods， systematization of pathogenesis， and modern innovation. The evolution of spleen-stomach theory has achieved a shift from a singular focus on tonifying the spleen to regulating dynamic middle-jiao （焦） balance， and from localized spleen-stomach regulation to the circular movement of qi involving all five zang organs. In terms of modern disease-syndrome integrative research， spleen deficiency syndrome is shown to be closely associated with impairment of the gastrointestinal mucosal barrier， metabolic disorders， and gene polymorphisms related to Helicobacter pylori-associated gastric diseases. Spleen-stomach damp-heat syndrome is closely linked to hyperactive energy metabolism， inflammatory cytokines， and abnormal expression of aquaporins. Liver-spleen disharmony syndrome is mainly associated with dysregulation of the brain-gut axis and microbiota-related metabolic disorders. It is proposed that future research on spleen-stomach diseases and syndromes should further elucidate their potential multidimensional differential biological characteristics， thereby promoting the modernization of the TCM discipline of spleen-stomach studies.

Objective: To evaluate the intervention effect of school based salt reduction health education, so as to provide a scientific basis for constructing a more effective and sustainable salt reduction intervention model for children. Methods: According to a randomized controlled trial design, in June 2022, probability proportional to size sampling was used to select 501 second grade students (248 in the control group and 253 in the intervention group) from 10 primary schools in Zhenjiang (intervention group) and 10 primary schools in Yangzhou (control group), Jiangsu Province. An one year school based salt reduction health education intervention was implemented. This included 20 online and 8 offline health education sessions, monitoring of salt consumption in the canteen, and the establishment of a salt reduction environment on campus. The control group received no additional salt reduction interventions. A questionnaire survey and 24 hour urinary sodium test were conducted before and after the intervention. The difference in differences method was used to evaluate the intervention effect. Results: After the intervention, the intervention group showed significant net intervention effects in knowledge aspects, including knowing that primary school students consume less salt than adults ( OR=3.55,95%CI =1.69-7.47), daily salt intake of primary school students ( OR=6.64,95%CI =3.71-11.87), long term high salt intake leading to hypertension ( OR=6.83,95%CI =3.93-11.91), low salt intake not causing hair graying ( OR= 1.66 ,95%CI =1.00-2.75), salt content in food labels ( OR=4.56,95%CI =2.63-7.91), and common high salt foods ( OR=3.39,95%CI =1.87-6.14) (all P <0.05). In terms of attitude, the net intervention effect for having a positive attitude toward using less salt in home cooking was significantly increased ( OR=1.88,95%CI =1.13-3.12, P <0.05). There were no statistically significant net intervention effects for salt reduction related behaviors (all P >0.05). There was no statistically significant difference in the changes of 24 hour urinary sodium between the intervention group and the control group before and after intervention ( P >0.05). Conclusions School based salt reduction health education effectively improves students salt reduction knowledge and attitudes but has a limited effect on behavior change. The home-school collaboration should be strengthened, and the dietary environment should be optimized simultaneously.

Purpose To explore the application value of spectral CT vascular optimization technique for laparoscopic right hemicolectomy.Materials and Methods Ninety patients who underwent contrast-enhanced CT with spectral CT before scheduled laparoscopic right hemicolectomy from March to November 2022 in Shengjing Hospital of China Medical University were retrospectively analyzed.The raw images were reconstructed to obtain 120 kVp conventional images and spectral-based virtual monochromatic images(VMIs)at 40,50,60,70 keV.The CT value and image noise of gastrocolic trunk of Henle(GTH),right colic vein(RCV)and ileocolic vein(ICV)were measured.The CT value,image noise,signal noise ratio and contrast noise ratio of VMIs and conventional image were analyzed.The image quality and venous anatomical information of each group were evaluated subjectively with three-dimensional reconstruction technique.Results The CT value[(405.55±103.06)Hu,(406.61±103.42)Hu,402.35(337.95,477.45)Hu],image noise[19.90(12.10,34.55)Hu,21.10(10.95,44.30)Hu,19.70(11.25,44.80)Hu],signal noise ratio[19.46(10.60,36.31),20.16(8.73,37.42),18.49(9.99,36.24)]and contrast noise ratio[53.36(35.92,70.79),52.34(33.73,81.03),56.23(34.69,79.97)]of GTH,RCV,ICV of VMIs at 40 keV were significantly higher than those of conventional image and other VMIs(F/H=268.53,23.17,33.09,198.77,272.51,28.93,25.48,189.62,318.24,29.42,20.13,212.46,all P<0.001).Subjective scores showed that the image quality and vascular visualization of GTH,RCV and ICV at 40 keV were the best.Conclusion Spectral CT can improve the imaging quality and vascular visualization of GTH,RCV and ICV.VMIs at 40 keV has the optimal performance.

Cancer incidence in China has been rising steadily,with a particularly heavy burden from several high-prevalence malignancies.Medical examination for cancer plays a critical role in the early detection of cancer,precancerous lesions,and precursor conditions,thereby facilitating timely diagnosis and intervention.Such examination also addresses the growing demand for person-alized cancer screening services among diverse population groups.The development of evidence-based,context-specific cancer screening guidelines is essential to enhance the standardization,quality,and equity of preventive screening practices across the country,ultimately improving out-comes in early cancer detection and treatment.Guided by the Department of Medical Emergency Response of the National Health Commission,the Guidelines for Medical Examination for Cancer in Health Examination Agency(2025 Edition)were developed under the leadership of the National Cancer Center.A multidisciplinary panel of experts formulated the guidelines in accordance with the principles and methodology of the World Health Organization Handbook for Guideline Deve-lopment.The guidelines provide evidence-based recommendations on key clinical domains:target cancers and populations,overall screening workflow,screening protocols,diagnostic technolo-gies,result interpretation,follow-up procedures,and quality control.The primary objective is to standardize cancer screening practices in health examination agency and strengthen China's ca-pacity for prevention and control of high-burden cancers.

Objective:To compare the application effects of different approaches (bilateral approach, traditional intermediate approach) in laparoscopic radical resection of rectal cancer with preservation of left colonic artery (LCA).Methods:The data of 120 patients undergoing laparoscopic radical resection of rectal cancer from January 2021 to December 2023 were retrospectively analyzed. Based on the different surgical approaches chosen for preserving LCA, 67 patients who underwent traditional intermediate approach to preserve LCA were included in the control group, while the remaining 53 patients who underwent bilateral approach to preserve LCA were included in the study group. The results of the main outcome indicators were recorded and the differences between the groups were compared, including perioperative indicators; lymph node dissection; gastrointestinal hormones (gastrin and motilin) before operation and 2 d after operation; postoperative complications such as anastomotic bleeding, anastomotic leakage, and urinary dysfunction.Results:Compared with the control group, the study group had longer surgical time and more intraoperative bleeding: (132.68 ± 11.24) min vs. (126.54 ± 10.45) min, (78.41 ± 5.35) ml vs. (75.22 ± 5.10) ml, the difference was statistically significant ( P = 0.003 and 0.001). However, there was no significant difference in exhaust time and hospitalization time between the two groups ( P>0.05). There was no significant difference in total lymph node clearance between the two groups ( P>0.05). The number of lymph node dissection in the 253 groups of the study group was higher than that in the control group: (5.18 ± 1.26) pieces vs. (4.35 ± 1.32) pieces, the difference was statistically significant ( P = 0.001). On the second day after surgery, the serum gastrin and motilin in both groups decreased compared to before surgery, but there was no significant difference between the two groups ( P>0.05). The incidence of postoperative urinary dysfunction in the study group was lower than that in the control group: 0 vs. 10.45% (7/67), the difference was statistically significant ( P = 0.015). Conclusions:Compared with the traditional intermediate approach for laparoscopic radical resection of rectal cancer with preserved LCA, the bilateral approach, although having a longer surgical time and slightly more intraoperative bleeding, can effectively clean 253 lymph nodes and reduce postoperative urinary dysfunction.

Purpose To explore the application value of spectral CT vascular optimization technique for laparoscopic right hemicolectomy.Materials and Methods Ninety patients who underwent contrast-enhanced CT with spectral CT before scheduled laparoscopic right hemicolectomy from March to November 2022 in Shengjing Hospital of China Medical University were retrospectively analyzed.The raw images were reconstructed to obtain 120 kVp conventional images and spectral-based virtual monochromatic images(VMIs)at 40,50,60,70 keV.The CT value and image noise of gastrocolic trunk of Henle(GTH),right colic vein(RCV)and ileocolic vein(ICV)were measured.The CT value,image noise,signal noise ratio and contrast noise ratio of VMIs and conventional image were analyzed.The image quality and venous anatomical information of each group were evaluated subjectively with three-dimensional reconstruction technique.Results The CT value[(405.55±103.06)Hu,(406.61±103.42)Hu,402.35(337.95,477.45)Hu],image noise[19.90(12.10,34.55)Hu,21.10(10.95,44.30)Hu,19.70(11.25,44.80)Hu],signal noise ratio[19.46(10.60,36.31),20.16(8.73,37.42),18.49(9.99,36.24)]and contrast noise ratio[53.36(35.92,70.79),52.34(33.73,81.03),56.23(34.69,79.97)]of GTH,RCV,ICV of VMIs at 40 keV were significantly higher than those of conventional image and other VMIs(F/H=268.53,23.17,33.09,198.77,272.51,28.93,25.48,189.62,318.24,29.42,20.13,212.46,all P<0.001).Subjective scores showed that the image quality and vascular visualization of GTH,RCV and ICV at 40 keV were the best.Conclusion Spectral CT can improve the imaging quality and vascular visualization of GTH,RCV and ICV.VMIs at 40 keV has the optimal performance.

Objective This study aims to use subjective and objective evaluation indicators to accurately calculate the relative weights of various factors that affect blood glucose control in gestational diabetes and provide scientific basis for the formu-lation of clinical nutrition intervention plans and support for the evaluation of blood sugar intervention effects in the late stage of pregnancy.Methods The fuzzy analytic hierarchy process(FAHP)was used to construct a hierarchical model of nutrition man-agement for patients with gestational diabetes,calculate the weights of each criterion layer in detail,and integrate them with the weight adjustment coefficients of scoring experts to form a mathematical model for nutrition management of gestational diabetes.Results Based on 14 valid expert feedback questionnaires,the relative weights of the first,second,and 29 end indicators were calculated.The weights of the first indicators were nutrition assessment indicators for gestational diabetes(0.34142105),formu-lation of nutrition management plans for gestational diabetes(0.331055183),and implementation of nutrition management plans(0.327923333).The largest weights in the second indicators were laboratory indicators(0.110385024)and meal plans(0.117342182).Conclusion The fuzzy analytic hierarchy process can accurately estimate the relative weights of factors affect-ing personalized nutrition management in gestational diabetes,providing a theoretical basis for blood sugar management during the entire pregnancy.

ObjectiveTo evaluate the efficacy and safety of transcutaneous electrical acupoint stimulation (TEAS) for muscle atrophy in patients with immobilization after surgical fixation of foot and ankle fractures.MethodsThis was a two-arm randomized controlled trial wherein 80 patients were recruited and divided into control (n = 40) and intervention (n = 40) groups. The control group received conventional orthopedic treatment, whereas the intervention group received TEAS and conventional treatment. The intervention group received TEAS 3 times a week for 30 min each time for 8 weeks. The primary outcomes were muscle thickness (MT) and cross-sectional area (CSA) of the rectus femoris and gastrocnemius muscles, whereas the secondary outcome measure was echo intensity (EI). Data were collected before the fixation operations (baseline assessment) and 4 and 8 weeks after intervention.ResultsCompared with baseline, the MT and CSA were reduced in both groups by the end of treatment, whereas EI increased in both groups. At week 4, the reduction in the rectus femoris CSA in the intervention group was significantly lower than that in the control group (P = .02); however, the between-group differences in the MT and EI (all P .05) were not significant. No serious adverse events were observed in either group.ConclusionOur study showed that TEAS can improve muscle atrophy by attenuating the decline in the muscle CSA. Because this was only a pilot trial, subsequent studies will need longer follow-ups and larger sample sizes.

Objective This study aims to use subjective and objective evaluation indicators to accurately calculate the relative weights of various factors that affect blood glucose control in gestational diabetes and provide scientific basis for the formu-lation of clinical nutrition intervention plans and support for the evaluation of blood sugar intervention effects in the late stage of pregnancy.Methods The fuzzy analytic hierarchy process(FAHP)was used to construct a hierarchical model of nutrition man-agement for patients with gestational diabetes,calculate the weights of each criterion layer in detail,and integrate them with the weight adjustment coefficients of scoring experts to form a mathematical model for nutrition management of gestational diabetes.Results Based on 14 valid expert feedback questionnaires,the relative weights of the first,second,and 29 end indicators were calculated.The weights of the first indicators were nutrition assessment indicators for gestational diabetes(0.34142105),formu-lation of nutrition management plans for gestational diabetes(0.331055183),and implementation of nutrition management plans(0.327923333).The largest weights in the second indicators were laboratory indicators(0.110385024)and meal plans(0.117342182).Conclusion The fuzzy analytic hierarchy process can accurately estimate the relative weights of factors affect-ing personalized nutrition management in gestational diabetes,providing a theoretical basis for blood sugar management during the entire pregnancy.

Objective:To explore the medication adherence of elderly patients with chronic diseases and polypharmacy in rural areas of Hangzhou City and analyze its influencing factors.Methods:From April to July 2023, convenience sampling was used to select rural 240 elderly patients with chronic diseases and polypharmacy in five administrative districts (counties) of Hangzhou as participants. The survey was conducted using the General Information Questionnaire, Social Support Rating Scale, Medication Knowledge and Beliefs Questionnaire, and the Chinese version of the 8-item Morisky Medication Adherence Scale. Multiple linear regression was used to analyze the factors influencing medication adherence in elderly patients with chronic diseases and polypharmacy in rural areas of Hangzhou City.Results:A total of 240 questionnaires were distributed and 220 valid questionnaires were collected, with an effective response rate of 91.67%. Among 220 elderly patients with chronic diseases and polypharmacy in rural areas of Hangzhou City, 135 had poor medication adherence. Multiple linear regression analysis showed that age, educational level, family doctor contract, medication knowledge, and beliefs were the influencing factors of medication adherence in elderly patients with chronic diseases and polypharmacy in rural areas of Hangzhou City ( P<0.05) . Conclusions:The medication adherence of elderly patients with chronic diseases and polypharmacy in rural areas of Hangzhou urgently needs to be improved. Medical and nursing staff should pay special attention to patients who are old, have a low level of education, have not signed a family doctor, and have poor knowledge and beliefs about medication. It is suggested that the contract system for family doctors be further promoted, focusing on health education on medication knowledge and beliefs, to improve medication adherence among elderly chronic disease patients in rural areas.