The concept of "spirit" in traditional Chinese medicine （TCM） aligns closely with "the liver governs the designing of strategy". By exploring the relationship between the liver and executive function decline， it is proposed that prolonged liver constraint leads to indecisiveness in strategy designing， which is the initiating factor for executive function decline； liver blood deficiency causes difficulties in executing strategy， which forms an essential foundation for the progression of executive function decline； obstruction in the "liver-du mai-brain" pathway leads to unclear strategy designing， which accelerates executive function decline. This relationship is examined from the perspectives of TCM， modern medicine， and cognitive psychology， aiming to provide insights into addressing executive function decline through treatments focused on the liver.

Traditional Chinese medicine （TCM） compound prescriptions serve as crucial practical embodiments of TCM theoretical frameworks， characterized by their complex multi-component composition and multi-target interactions. The research on the material basis of their pharmacological effects has gradually become the key to promoting the modernization of TCM. In recent years， new ideas and theories regarding the research on pharmacodynamic substance basis of TCM compound prescriptions have been continuously proposed. This review systematically summarizes and reviews analytical techniques such as targeted fishing technology， spectrum-effect relationship analysis， serum pharmacochemistry， network pharmacology， high-throughput screening， and cell membrane chromatography. It is found that these techniques exhibit unique advantages in areas including target-specific analysis， component-pharmacological effect correlation analysis， identification of the material basis in vitro and in vivo， prediction of multi-target mechanisms， efficient screening of active ingredients， and analysis of interactions between cell membrane receptors. These techniques compensate for the shortcomings of traditional research methods， enhance the systematicness and precision of research on pharmacodynamic substance based TCM compound prescriptions， and can provide theoretical support for the promotion and clinical application of TCM compound prescriptions.

Objective:To investigate the influencing factors for the training quality of clinical pharmacy undergraduates in China from multiple dimensions and the problems existing in the current training model, to propose suggestions for improvement, and to provide a reference for improving the training quality of clinical pharmacy undergraduates in China.Methods:Four dimensions of vital importance to the training quality of clinical pharmacy undergraduates in China were summarized based on the results of previous literature research and semi-structured interviews, and a questionnaire was designed to conduct a survey among clinical pharmacy undergraduates. Then based on the problems obtained through feedback, an investigation was conducted among the clinical pharmacists in various provinces across the country. SPSS 25.0 was used to perform a statistical analysis.Results:The influencing factors for the cultivation and development of clinical pharmacy undergraduates included insufficient awareness of their major [18.28% (17/93) of the senior and graduate students still had no understanding or relatively little understanding of their major], a lack of specialty characteristics in undergraduate education of clinical pharmacy [35.91% (107/298) of the students thought that the arrangement of public courses during the undergraduate period of clinical pharmacy was unreasonable or needed improvement], unreasonable arrangement of the contents and time of internship [34.23% (102/298) of the students thought that the experiment and internship arrangement during the undergraduate period of clinical pharmacy was unreasonable or needed to be improved], and inadequate cultivation of learning and scientific research innovation abilities [66.78% (199/298) of the students had not participated in scientific research projects or training, with σ>1 in the statistics of various learning behaviors]. Conclusions:Professional cognition and internship/practice should be taken seriously in the training system of clinical pharmacy undergraduates. Curriculum setting should be optimized to enhance specialty characteristics, and the teaching and training model should be improved to focus on ability training.

Objective:To develop and validate a risk prediction model for cognitive frailty in elderly patients with type 2 diabetes.Methods:A total of 483 elderly patients with type 2 diabetes who visited Tianjin First Central Hospital from June to December 2022 were selected using convenience sampling. They were randomly divided into a modeling group ( n=338) and a validation group ( n=145). Data were collected using a self-designed general information questionnaire, the Short-Form Mini Nutritional Assessment (MNA-SF), the Geriatric Depression Scale-15 (GDS-15), the Frailty Phenotype (FP), the Montreal Cognitive Assessment (MoCA), and the Clinical Dementia Rating (CDR). Logistic regression analysis was performed to identify the influencing factors. A cognitive frailty risk prediction nomogram model was constructed based on the results. The model was validated in the validation group, and its predictive performance and clinical applicability were evaluated using the area under the receiver operating characteristic curve ( AUC), calibration curve, and clinical decision curve analysis. A total of 483 questionnaires were distributed and all were returned as valid, resulting in a 100.0% response rate. Results:The prevalence of cognitive frailty in the 483 elderly patients with type 2 diabetes was 20.3% (98/483). Age, regular exercise, duration of diabetes, HbA1c levels, depression and nutritional status were identified as predictive factors in the model. The AUC of the model was 0.886, and the Hosmer-Lemeshow test showed a χ 2 value of 8.004 ( P=0.433). The optimal cutoff value was 0.335, and the accuracy was 89.0%. Conclusions:The prediction model demonstrates good fit and strong predictive performance, and can intuitively and easily identify elderly patients with type 2 diabetes who are at high risk of cognitive frailty, providing a reference for early screening and intervention.

There are three types of adipose tissue: white adipose tissue that stores energy, brown adipose tissue that expends energy, and beige adipose tissue which results from the browning of white adipose tissue. Research has established that adipose tissue is vital for energy metabolism. However, the complex regulatory mechanisms limit the development of effective therapeutic strategies for obesity and related metabolic diseases. This review explores the characteristics and functions of adipose tissue types, emphasizing the role of central hypothalamic nuclei in regulating peripheral adipose tissue function Additionally, it provides a summary and comparison of current research on leveraging brown and beige adipose tissue thermogenesis as a treatment for metabolic diseases, offering insights for the advancement of targeted therapies for obesity and related disorders.

BACKGROUND:Our previous studies found that the polypeptide of Cornus cervi Colla can promote bone growth,which has a good application prospect in the treatment of bone diseases.However,how Cornus cervi Colla works in the body and the principle are not clear. OBJECTIVE:To study the in vivo distribution and tracing of Cornus cervi Colla using fluorescence labeling and tracer technique. METHODS:Cornus cervi Colla was fluorescently labeled using fluorescein isothiocyanate,and the labeling results were detected by fluorescence imaging and UV spectral scanning.Successfully labeled Cornus cervi Colla was injected into mice by gavage,and the absorption of Cornus cervi Colla into blood was detected by laser confocal microscopy,and the distribution of Cornus cervi Colla in mice was detected by small animal in vivo imager.The distribution of Cornus cervi Colla in the mice was detected by laser confocal microscopy.Samples were taken from serum and bone at the time of the strongest fluorescence,and gel electrophoresis was carried out on serum and bone tissue protein solutions,and the components of Cornus cervi Colla absorbed into target organs were determined by secondary mass spectrometry. RESULTS AND CONCLUSION:The fluorescent markers were successfully separated by dextran gel chromatography,and the fluorescence imaging and ultraviolet spectrum scanning proved that the labeling was successful,and the fluorescence substitution degree of FITC-labeled Cornus cervi Colla was 0.953%.The fluorescence intensity of the components of Cornus cervi Colla in the blood showed that Cornus cervi Colla was most distributed in serum after oral administration for 2 hours.The fluorescence images of mice at different times were the same as those of bilateral femur and tibia,indicating that Cornus cervi Colla could play a role by entering the bone.Compared with UniProt database,secondary mass spectrometry showed that the peptide was a characteristic fragment of decorin.It is proved that decorin in Cornus cervi Colla can enter the bone to play a therapeutic role.

BACKGROUND:Osteonecrosis of the femoral head is a common and disabling disease,which is mainly characterized by microcirculation disorders and bone cell metabolism disorders.Luzhongjiangu decoction was developed by Shandong Academy of Chinese Medicine and used in the form of soup in the clinic,which has good efficacy in the treatment of osteonecrosis of the femoral head.However,its mechanism of action has not been clarified. OBJECTIVE:To study the effect mechanism of Luzhongjiangu decoction on intestinal flora in rats with osteonecrosis of the femoral head based on 16S rDNA sequencing technique. METHODS:The model of osteonecrosis of the femoral head was established in Wistar rats by intragastric administration of retinoic acid.The therapeutic effect of Luzhongjiangu decoction was evaluated by serum hormone,bone histopathology and serum hormone levels.16s rDNA sequencing technique was used to detect the intestinal flora of rats in the blank control group,model group and middle-dose Luzhongjiangu decoction group.The corresponding library was constructed and OTU clustering and microbial community diversity and abundance analysis were carried out to determine the composition of intestinal flora and the changes of species and diversity among groups. RESULTS AND CONCLUSION:Luzhongjiangu decoction could significantly increase the expression of osteocalcin,osteopontin and other osteogenic related factors,alleviate the destruction of bone trabeculae,increase bone mineral density,and had a significant therapeutic effect on osteonecrosis of the femoral head,of which the middle dose group showed the most significant effect.The results of intestinal flora sequencing showed that Luzhongjiangu decoction improved the flora disorder of rats with osteonecrosis of the femoral head to some extent,and screened out different colonies such as Bacillus,Desulfurizans,Desulfurization,Isobacteria,Bifidobacterium and so on;it could up-regulate the abundance of beneficial bacteria such as Bifidobacterium,down-regulate the abundance of harmful bacteria such as Desulfovibrio,and improve the structure of intestinal flora.Functional prediction analysis indicated that Luzhongjiangu decoction could mainly affect amino acid metabolism and energy metabolism.Correlation analysis showed that the differential bacteria of Bifidobacterium and Intestinimonas in the middle dose group of Luzhongjiangu decoction were positively correlated with vitamin D3,estradiol and calcitonin,and negatively correlated with prostaglandin E2.In the model group,Escherichia-Shigella,Desulfovibrio,Globicatella and Streptococcus were positively correlated with prostaglandin E2 and negatively correlated with vitamin D3,estradiol and calcitonin.To conclude,Luzhongjiangu decoction may play a role in the treatment of osteonecrosis of the femoral head by regulating the structure of intestinal flora,up-regulating the abundance of beneficial bacteria and affecting the secretion of vitamin D3,estradiol,calcitonin and prostaglandin E2.

Objective:To investigate the relationship between plasma fluoride content, daily calcium intake and blood cell parameters in children and adolescents.Methods:This study was based on the National Health and Nutrition Examination Survey (NHANES) database of the United States from 2013 to 2016, with 3 684 children and adolescents aged 6 - 19 as the research subjects. Information on plasma fluoride content, daily calcium intake and blood cell parameters from the database were collected. Non-linear relationships between plasma fluoride content, daily calcium intake and blood cell parameters were analyzed using restricted cubic splines. If there was a non-linear relationship, the optimal inflection point was calculated using threshold/saturation effect analysis method. Subsequently, multiple linear regression models were used to analyze the associations among the three, and the modification effect of daily calcium intake (binary classification, stratified by median daily calcium intake) on the association between plasma fluoride content and blood cell parameters was analyzed.Results:There was no non-linear relationship between plasma fluoride content and white blood cell count, hemoglobin content and platelet count ( Pnon-linear > 0.05), but there was a non-linear relationship between plasma fluoride content and erythrocyte count and hematocrit ( Pnon-linear < 0.001). After adjusting for confounding factors, the optimal inflection points of the effects of plasma fluoride content on erythrocyte count and hematocrit were 0.54 and 0.31 μmol/L, respectively. There was no non-linear relationship between daily calcium intake and blood cell parameters ( Pnon-linear > 0.05). After adjusting for confounding factors, for every 1 μmol/L increase in plasma fluoride content, the white blood cell count increased by 0.49 × 10 9/L ( P = 0.009). There was a saturation effect in the association between plasma fluoride content, erythrocyte count and hematocrit: when plasma fluoride content was < 0.54 μmol/L, the erythrocyte count decreased by 0.46 × 10 12/L for every 1 μmol/L increase ( P < 0.001). When plasma fluoride content was < 0.31 μmol/L, the hematocrit decreased by 6.29% for every 1 μmol/L increase ( P = 0.006). The above associations were not statistically significant when plasma fluoride content was higher than the optimal inflection points ( P > 0.05). After stratification according to the median daily calcium intake, in the low-calcium group (daily calcium intake < 0.87 g), for every 1 μmol/L increase in plasma fluoride content, the white blood cell count increased by 0.77 × 10 9/L ( P = 0.001). When plasma fluoride content was < 0.54 μmol/L, the erythrocyte count decreased by 0.41 × 10 12/L for every 1 μmol/L increase ( P = 0.002). When plasma fluoride content was ≥0.54 μmol/L, erythrocyte count decreased by 0.47 × 10 12/L for every 1 μmol/L increase ( P < 0.001). When the plasma fluoride content was < 0.31 μmol/L, the hematocrit decreased by 8.29% for every 1 μmol/L increase ( P = 0.011). The above associations were not statistically significant in the high-calcium group (daily calcium intake ≥0.87 g, P > 0.05). There was an interaction of daily calcium intake and plasma fluoride content on platelet count ( Pinteraction = 0.070), as demonstrated by an increase in platelet count of 12.68 × 10 9/L ( P = 0.013) in the low-calcium group and a decrease in platelet count of 9.05 × 10 9/L ( P = 0.035) in the high-calcium group for every 1 μmol/L increase in plasma fluoride content. Conclusions:The blood cell parameters of children and adolescents are closely related to plasma fluoride content, but not directly related to daily calcium intake. However, the correlation between plasma fluoride content and blood cell parameters varies among different calcium intake populations, and daily calcium intake can modify the association between plasma fluoride content and platelet count.

Objective To explore the effect of compound active tea of Lithocarpus litseifolius on uric acid levels and kidney function of mice with hyperuricemia nephropathy and to provide an experimental basis for the development of hyperuricemia nephropathy drugs and functional food.Methods A mouse model of hyperuricemia nephropathy was established by administering potassium oxazinate with adenine.Mice were randomly divided into common,model,positive drug(10 mg/(kg·d))and compound active tea of Lithocarpus litseifolius high-,middle-and low-dose groups(10 g/(kg ·d),3.33 g/(kg·d)and 1.11g/(kg·d),respectively).One hour after the last gavage,urine protein(UP)was measured by CBB method,urea nitrogen(UUN)was measured by urease method.Orbital blood pampling,blood was collected for uric acid(UA)analysis by enzyme ratio method,urea nitrogen(BUN)was measured by urease method.The serum contents of interleukin 6(IL-6)and tumor necrosis factor(TNF-α)were measured by ELISA.Take kidney tissue,levels of urate transporter 1(URAT1)and glucose transporter 9(GLUT9)were measured by quantitative fluorescence,kidney histopathological changes were observed by HE stainning.Results Compared with the control group,the model group's levels of UP,UUN,UA,BUN,IL-6,URAT1,ULUT9 and TNF-α were significantly increased(P＜0.01,P＜0.05),and the renal tissue structure was normal.Compared with the model group,the positive group's levels of UP,UUN,UA,BUN,IL-6 and TNF-α were significantly decreased(P＜0.01,P＜0.05),there was little glomerular atrophy or deformation in the kidneys,kidney tubular dilatation was occasionally seen,but there was no inflammatory cell infiltration.Compared with the model group,the high-dose compound active tea of Lithocarpus litseifolius group's UP,UUN,UA,BUN,IL-6,URAT1,TNF-α and GLUT9 levels were significantly decreased(P＜0.01,P＜0.05).The middle-dose compound active tea of Lithocarpus litseifolius group's UP,UUN,UA content,IL-6,URAT 1,GLUT9,BUN and TNF-αwere significantly decreased(P＜0.01,P＜0.05).The low-dose compound active tea of Lithocarpus litseifolius group's UP,UUN,UA,IL-6,URAT1,BUN,TNF-α and GLUT9 levels were significantly decreased(P＜0.01,P＜0.05).Conclusions Compound active tea of Lithocarpus litseifolius can reduce uric acid in mice with hyperuricemia nephropathy and has a certain protective effect on the kidneys.The mechanism may be related to the inhibition of uric acid reabsorption,and the specific mechanistic details should be further investigated.

Objective To analyze the real experiences of patients with inflammatory bowel disease(IBD)during dietary restrictions,providing references for healthcare personnel to guide patients in standardizing dietary restriction behaviors.Methods Purposeful sampling was employed to select 14 patients with IBD who were treated at a tertiary A hospital in Shanghai between October 2022 and February 2023 for semi-structured in-depth interviews.Data were analyzed using the Colaizzi's 7-step method in phenomenological research.Results 4 themes and 13 sub-themes were extracted.Theme 1:facing multiple physiological challenges(hunger,nutritional imbalance,fatigue and muscle atrophy).Theme 2:experiencing negative psychological disturbances(craving and struggle for gourmet food,diminished zest for life and increased anxiety,feeling embarrassed during social activities).Theme 3:adopting various coping strategies(self-adjustment and adaptation to dietary restrictions,satisfying oral desires through various avenues,seeking knowledge and guidance on nutrition).Theme 4:gaining more growth and support(improved symptom and quality of life,enhanced awareness of dietary health,improved ability to manage diet,receiving support from peers and family).Conclusion The experience of dietary restrictions in IBD patients is complex and varied.Nursing staff should prioritize nutritional risk screening for IBD patients,pay attention to their mental health,provide patients with scientific and personalized dietary guidance,and strengthen social and family support to assist patients in better self-management of their diet.