Multiple system atrophy (MSA) is a rare neurodegenerative disease with complex clinical manifestations, presenting substantial challenges in clinical diagnosis and treatment. Its symptoms and the eight extraordinary meridians are potentially correlated; therefore, this article explores the association between MSA symptom clusters and the eight extraordinary meridians based on their circulation and physiological functions, as well as their treatment strategies. The progression from deficiency to damage in the eight extraordinary meridians aligns with the core pathogenesis of MSA, which is characterized by "the continuous accumulation of impacts from the vital qi deficiency leading to eventual damage". Liver and kidney deficiency and the emptiness of the eight extraordinary meridians are required for the onset of MSA; the stagnation of qi deficiency and the gradual damage to the eight extraordinary meridians are the key stages in the prolonged progression of MSA. The disease often begins with the involvement of the yin and yang qiao mai, governor vessel, thoroughfare vessel, and conception vessel before progressing to multiple meridian involvements, ultimately affecting all eight extraordinary meridians simultaneously. The treatment approach emphasizes that "the direct method may be used for joining battle, but indirect method will be needed in order to secure victory" and focuses on "eliminate pathogenic factors and reinforce healthy qi". Distinguishing the extraordinary meridians and focusing on the primary symptoms are pivotal to improving efficacy. Clinical treatment is aimed at the target, and tailored treatment based on careful clinical observation ensures precision in targeting the disease using the eight extraordinary meridians as the framework and core symptoms as the specific focus. Additionally, combining acupuncture, daoyin therapy, and other method may help prolong survival. This article classifies clinical manifestations based on the theory of the eight extraordinary meridians and explores treatment.

Polycystic ovary syndrome （PCOS） is one of the most prevalent gynecological diseases， and its incidence is increasing year by year， seriously affecting the physical and mental health of female patients. The pathogenesis of this disease is complex and has not been fully clarified. At present， PCOS is mainly treated by Western medicine， which， however， has poor efficacy and induces various adverse reactions. Therefore， developing safe and effective therapies has become a difficult problem that needs to be solved. Studies have confirmed that traditional Chinese medicine （TCM） can regulate phosphatidylinositol 3-kinase/protein kinase B（PI3K/Akt）， mitogen-activated protein kinase/extracellular signal-regulated kinase （MAPK/ERK）， Toll-like receptor 4/nuclear factor-κB （TLR4/NF-κB）， transforming growth factor-β （TGF-β）/Smads， secreted glycoprotein/β-catenin （Wnt/β-catenin）， adenosine monophosphate-activated protein kinase （AMPK）， and advanced glycation endproduct/receptor for advanced glycation endproducts （AGE/RAGE） signaling pathways to ameliorate insulin resistance， inhibit inflammation and oxidative stress， regulate endocrine hormone disorders， and intervene in apoptosis and autophagy， thus alleviating the symptoms， slowing down the disease progression， and improving the ovarian function. The treatment of PCOS with TCM has demonstrated definite effects and high safety. Therefore， exploring this disease from cellular and molecular perspectives can provide a theoretical basis for its clinical treatment and new drug development. However， there is a lack of systematic reviews on the modulation of relevant signaling pathways by TCM in the treatment of PCOS. This article reviews the research progress in the treatment of PCOS with the active ingredients and compound prescriptions of TCM by regulating relevant signaling pathways in recent years， with the aim of providing evidence to support the promotion of TCM for treating PCOS in the future.

Objective To provide front-line practitioners with evidence-based guidelines for rapidly estimating the workload of mosquito control operations during mosquito-borne diseases outbreaks,to establish effective response strategies,and to facil-itate efficient deployment of human and material resources. Methods Under the auspices of the Preventive Medicine As-sociation of Hubei Province,a panel of experts was convened to develop the framework for this consensus. The drafting com-mittee conducted a systematic analysis and synthesis of field-based practices relevant to the outlined topics. The document was subsequently reviewed,debated,and refined through multiple rounds of discussions by experts from the Association's Committees on Disinfection & Vector Control and Epidemiology before finalization. Results This consensus document pro-vides recommendations on mosquito control methodologies, labor time estimation, operational organization, implementation strategies,as well as effectiveness evaluation and continuous improvement. Conclusion It offers a scientific basis for e-mergency mosquito control workload calculation and proposes standardized management protocols for organizing response ef-forts. This consensus is instrumental in guiding and improving the control of mosquito-borne diseases across diverse regions.

The traditional experimental teaching mode of forensic science and biological evidence is mostly confined to experimental operation, which is not capable of cultivating students' comprehensive quality and post competency. Therefore, it is urgent to seek an innovative teaching and training mode. At present, the experimental teaching of forensic science and biological evidence is dominated by teachers. There are some problems, such as insufficient training of students' scientific thinking and innovation ability, single teaching and evaluation model, and disconnection from the practical application. This paper proposes an experimental teaching design scheme of forensic science and biological evidence based on post competency training. The course is implanted in the framework of simulated cases, and the virtual simulation experiment platform and group discussion learning method are used to achieve a training model oriented by social needs and centered on students. In the preliminary study on the students who were trained in this mode of selected sections, we found that, compared with traditional teaching, the time for students to complete the prescribed experimental operation in this teaching mode was shortened by 4 minutes on average, and the average score of theoretical course test case analysis questions was increased by 1.5 points. In conclusion, the instructional design of the experiment teaching forensic science and biological evidence can effectively improve students' post-competency, and it deserves further exploration and application.

Aim To study the proliferation,invasion and migration ability of Quaking(QKI)in gastric cancer(GC)via elucidating the molecular mechanisms associated with QKI in the occurrence and development of GC through bioinformatics.Methods Differential expression analysis of QKI was performed across vari-ous human cancer samples by merging data from the TCGA and GTEx databases.The correlation was ana-lyzed between QKI protein expression and tumor muta-tion burden(TMB)score,microsatellite instability(MSI)score,and ESTIMATE score,and the correla-tion was also explored between QKI protein expression and overall survival(OS),disease free survival(DFS),and progression free survival(PFS).EMT related genes that could encode DECircRNAs were ob-tained through bioinformatics analysis to construct a QKI-EMT-circRNAs regulatory network.The differenti-ally expressed circRNAs and EMT related genes in TMK1 cells were verified.The proliferation,invasion and migration ability of the QKI was studied by using the knockdown system.Results QKI was differential-ly expressed in the vast majority of tumors and was closely related to TMB,MSI,and tumor microenviron-ment(TME);QKI emerged as a high-risk factor for predicting OS,DFS,and PFS in individuals with com-mon human cancers.QKI regulated the splicing of 6 EMT related gene transcripts to form eight circRNAs,all of which were significantly associated with the prog-nosis of gastric cancer patients.Cell experiments showed that compared to normal gastric epithelial cells,only hsa_ccirc_0004015,CALD1,and CDK14 were down-regulated in TMK1 cells.Knocking down QKI inhibited the proliferation,invasion and migration ability of TMK1 cells.Conclusion QKI exerts regu-latory control over the transcription of six EMT-related genes,resulting in the formation of circRNAs,thereby promoting the pathogenesis and progression of GC.QKI is highly expressed in TMK1 cells,and knock-down of QKI can inhibit the proliferation,invasion and migration ability of TMK1 cells.

Aim To explore the potential genes and mechanism of alisol B in the treatment of non-small cell lung cancer(NSCLC).Methods The proliferation and migration of NSCLC cells were detected by CCK-8 and Transwell.Genes of NSCLC and alisol B were col-lected through TCGA and compound gene prediction database,and their intersection genes were obtained.The network of protein-protein interaction(PPI)was constructed by using String database,and the top 20 key nodes were screened out,and the prognosis-related proteins related to the prognosis of NSCLC were screened out by using R language,and the intersection of them was obtained.The potential mechanism of ali-sol B on NSCLC was explored by KEGG and GO en-richment analysis and the relationship between related genes and immune cells,which was verified by cell-lev-el experiments.Results Alisol B inhibited the cell activity and migration ability of NSCLC cells.Five im-portant genes were identified by network pharmacologi-cal analysis:CCNE1,CDK1,COL1A1,COL1A2 and COL3A1.The results of cell experiment showed that al-isol B down-regulated the expression of Cyclin E1,CDK1 and COL1A2 in NSCLC cells.In addition,alisol B could inhibit the expression of COL1A2 and M2 macrophage marker CD206 in macrophages.Conclu-sions Alisol B may inhibit the proliferation of tumor cells by down-regulating CDK1 and Cyclin E1,and may affect the function of macrophages by inhibiting COL1A2,thus regulating the tumor immune microenvi-ronment and inhibiting NSCLC.

Objective:To systematically retrieve, evaluate and summarize the best evidence of exercise management for adolescents with type 2 diabetes mellitus (T2DM), so as provide reference for medical and nursing staff to guide patients and their families to exercise.Methods:Clinical decisions, recommended practices, evidence summaries, guidelines, expert consensuses, and systematic reviews on exercise management of adolescents with T2DM were electronically searched on BMJ Best Practice, UpToDate, Registered Nurses' Association of Ontario, National Guideline Clearinghouse, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, International Society for Pediatric and Adolescent Diabetes, Medlive, Joanna Briggs Institute Evidence-Based Health Care Center Database, Cochrane Library, PubMed, Web of Science, Embase, China National Knowledge Infrastructure, WanFang Data, Chinese Biology Medicine Disc, VIP and other databases. The search period was from database establishment to March 2023. After independent literature screening and quality evaluation by two researchers, evidence was extracted, summarized, and graded based on the theme.Results:A total of 10 articles were selected, including three guidelines, three systematic reviews, three expert consensuses, and one evidence summary. Finally, 22 pieces of best evidence of exercise management for adolescents with T2DM were summarized from seven aspects, including contraindications to exercise, exercise form, exercise intensity, exercise frequency, precautions, weight loss goals, family participation.Conclusions:This study summarizes the best evidence for exercise management in adolescents with T2DM. It is recommended that clinical medical and nursing staff should carry out personalized exercise management suitable for patients based on the wishes and preferences of patients and families, actual clinical situations, and support for exercise resources.

Objective:To explore the risk factors of recurrent contralateral hip fracture within 2 years after operation in elderly patients with hip fracture, construct a nomogram prediction model and validate the model.Methods:A total of 601 elderly patients with hip fracture who underwent surgical treatment in Department of Orthopedics in First Hospital of Shanxi Medical University from June 2018 to June 2020 were selected as research objects by the convenient sampling method. They were divided into the modeling set ( n=421) and the verification set ( n=180). According to the incidence of recurrent contralateral hip fracture within 2 years of follow-up, the modeling set was divided into the recurrent fracture group and the normal group, and the clinical data of the two groups were compared. Logistic regression was used to analyze the risk factors for recurrent contralateral hip fracture in elderly patients within 2 years after surgery. R 3.6 software was used to build a risk factor nomogram model for recurrent contralateral hip fracture. Receiver operating characteristic ( ROC) curve and calibration curve were used to evaluate the differentiation and consistency of the model. Results:In 601 elderly patients with hip fracture, the incidence of recurrent contralateral hip fracture within 2 years after surgery was 8.49% (51/601), among which the incidence of modeling set was 8.31% (35/421) and the incidence of verification set was 8.89% (16/180). In the modeling set, the age, female proportion, osteoporosis proportion, combined internal medical disease proportion and malnutrition proportion of patients in the recurrent fracture group were higher than those in the normal group ( P<0.05). Logistic regression analysis showed that gender, age, osteoporosis and combined internal medical diseases were the factors affecting the recurrence of contralateral hip fracture within 2 years after operation in elderly patients with hip fracture ( P<0.05). The equation for constructing a nomogram prediction model was Logit ( P) = -8.521+0.335×age+ 0.116×female +0.341× osteoporosis +0.280 ×combined internal medical diseases. The modeling set predicted the probability of recurrent contralaterial hip fracture according to the nomogram model, and plotted the ROC curve with sensitivity of 0.826, specificity of 0.804, and area under ROC curve ( AUC) of 0.876. The sensitivity of ROC curve of the validation set was 0.788, the specificity was 0.781, and the AUC was 0.830. After internal verification by Bootstrap method, the prediction model of the modeling set and the verification set were well distinguished, and the prediction probability and the actual incidence were well consistent (Hosmer-Lemeshow χ 2=0.462, P=0.674) . Conclusions:Advanced age, female, osteoporosis and combined internal medical diseases are independent risk factors for recurrent contralateral hip fractures in elderly patients with hip fractures within 2 years after surgery. The nomogram model constructed based on this has high predictive efficacy for recurrent hip fractures, which can be used to assess the risk of recurrent fractures and improve the prognosis of patients.

Objective:To investigate the influences of Pinocembrin on inflammatory injury in rats with acute myocardial in-farction(AMI)by regulating TLR4/NF-κB/NLRP3 signaling pathway.Methods:The AMI model was established by coronary liga-tion,and the rats were grouped into Sham group,AMI group,Pinocembrin group(5 mg/kg tail vein injection),TLR4 inhibitor group(TAK-242 group,2.0 mg/kg tail vein injection),the levels of cardiac function indexes(LVEF,LVEDD,LVESD,FS)and serum LDH,cTnⅠ,IL-6,IL-β and TNF-α were detected in rats,TTC staining,HE staining and Masson staining were applied to observe myocardial infarction and myocardial histopathological changes in rats,cardiomyocyte apoptosis was detected by TUNEL method,im-munohistochemistry and Western blot were applied to detect TLR4/NF-κB/NLRP3 pathway-related proteins in rat myocardial tissue.Results:Compared with Sham group,the myocardial infarction area increased,the number of myocardial cells decreased,some myo-cardial fibers were broken,inflammatory cells infiltrated,collagen fibers increased,and the apoptosis rate was obviously increased in AMI group(P<0.05),LVEDD,LVESD,serum LDH,cTnⅠ,IL-6,IL-β,TNF-α levels,myocardial tissue TLR4,MyD88,p-NF-κB p65,NLRP3,Caspase-1 expression levels were obviously increased(P<0.05),while LVEF and FS were obviously decreased(P<0.05);compared with AMI group,the myocardial infarction area of the Pinocembrin group and the TAK-242 group were reduced,the cell damage and inflammatory infiltration were reduced,the necrotic cells were obviously reduced,and the apoptosis rate was obvious-ly reduced(P<0.05),LVEDD,LVESD,serum LDH,cTnⅠ,IL-6,IL-β,TNF-α levels,myocardial tissue TLR4,MyD88,p-NF-κB p65,NLRP3,Caspase-1 expression levels were decreased(P<0.05),LVEF and FS were obviously increased(P<0.05);there was no obvious difference in each index between Pinocembrin group and TAK-242 group(P>0.05).Conclusion:Pinocembrin may at-tenuate myocardial inflammatory injury caused by AMI by inhibiting TLR4/NF-κB/NLRP3 signaling pathway.

Health system performance and its influencing factors are measured from a subjective perspective in the context of high-quality development.Using data from the Chinese Social Survey from 2015 to 2021,this study constructed a health system performance index from the perspective of the sense of acquisition of the population and analyzed the change trends and influencing factors of China's health system performance through a multilayer regression model.The results showed that the comprehensive index of health system performance in China increased by 12.47%(β=6.143,P<0.01)from 41.732 in 2015 to 46.935 in 2021,of which the process index increased by 4.57%(β=2.391,P<0.01)from 43.961 to 45.968,and the outcome index increased from 48.501 to 58.009,an increase of 19.60%(β=11.504,P<0.01).Meanwhile,the sense of access to health system performance showed obvious heterogeneity,with factors such as gender,age,education,marital status,employment status,economic status,type of health insurance and type of area of residence significantly affecting the sense of access to health system performance of residents.The health system performance in China in the context of high-quality development has significantly improved,and the sense of access of residents has significantly increased.However,the improvement in the process dimension of the health system is relatively limited,and"difficult and expensive to see a doctor"remains serious.It's necessary to strength the health system performance of vulnerable groups,as well as rural areas.