Based on spleen deficiency-phlegm dampness as the core pathogenesis of obesity， and integrating recent advances in modern medicine regarding the key role of immune inflammation in obesity， this paper proposes a multidimensional pathogenic network of "obesity-spleen deficiency-phlegm dampness-immune imbalance". Various traditional Chinese medicine （TCM） herbs that strengthen the spleen， regulate qi， and resolve phlegm and dampness can treat obesity by improving spleen-stomach transport and transformation， promoting water-damp metabolism， and regulating immune homeostasis. This highlights immune inflammation as an important entry point to elucidate the TCM concepts of "spleen deficiency-phlegm dampness" and the therapeutic principle of "strengthening the spleen and eliminating dampness to treat obesity". By systematically analyzing the intrinsic connection between "spleen deficiency generating dampness， internal accumulation of phlegm dampness" and immune dysregulation in obesity， this paper aims to provide theoretical support for TCM treatment of obesity based on dampness.

Pediatric acute liver failure (PALF) is a rare and critical clinical syndrome with a poor prognosis. Its etiology is complex, with a significant proportion of cases having remained classified as indeterminate or cryptogenic PALF. With the application of high-throughput sequencing technologies, a spectrum of disorders caused by specific genetic metabolic defects and characterized by stress-sensitive Recurrent acute liver failure (RALF) has been gradually unveiled, collectively termed Infantile liver failure syndrome (ILFS). Although the molecular mechanisms underlying the subtypes ILFS1, ILFS2, and ILFS3 differ by involving aminoacyl-tRNA synthetase defects, vesicular transport disorders, and autophagy abnormalities, respectively, they share a common clinical phenotype of RALF triggered by fever or infection. This article has systematically reviewed the clinical phenotypic spectrum, molecular genetic characteristics, differential diagnosis strategies, and therapeutic advances of the three ILFS subtypes, with the goal of improving early clinical recognition and precise intervention, and providing an important reference for evaluating the prognosis of different subtypes.
Humans ; Liver Failure, Acute/therapy* ; Infant ; Diagnosis, Differential

BACKGROUND:Repetitive trans-spinal magnetic stimulation(rTSMS)can inhibit inflammatory responses following spinal cord injury.rTSMS applies magnetic field stimulation to the spinal cord region to modulate neuronal excitability and synaptic transmission,thereby promoting plasticity and repair of the nervous system. OBJECTIVE:To observe the effects of rTSMS on the Toll-like receptor 4(TLR4)/nuclear factor(NF)-κB/NLRP3 signaling pathway after spinal cord injury and explore its mechanism in promoting motor function recovery. METHODS:Male C57BL/6J mice,SPF grade,were randomly divided into sham surgery group,spinal cord injury group,and rTSMS group.The latter two groups of mice were anesthetized and the T9 vertebral plate was removed using rongeur forceps to expose the spinal cord,and the spinal cord was clamped using a small aneurysm clip for 20 seconds to establish the spinal cord injury model.Mice in the rTSMS group underwent a 21-day rTSMS intervention starting on day 1 after spinal cord injury.The stimulation lasted 10 minutes per day,5 days per week with an interval of 2 days.Basso Mouse Scale scores were used to assess motor function recovery in mice after spinal cord injury at 1,3,7,14,and 21 days after spinal cord injury.Western blot was employed to detect the expression of AQP4,apoptotic factors Bax,Bcl-2,CL-Caspase-3,inflammatory factors tumor necrosis factor-α,interferon-γ,interleukin-6,interleukin-4,and the TLR4/NF-κB/NLRP3 signaling pathway related proteins in the injured spinal cord.Oxidative stress assay kit was used to measure the activity of superoxide dismutase,glutathione peroxidase,and malondialdehyde content at the site of spinal cord injury.Immunofluorescence staining was performed to detect the expression of neuronal nuclei(NeuN). RESULTS AND CONCLUSION:The Basso Mouse Scale score in the rTSMS group was significantly higher than that in the spinal cord injury group(P<0.05).Compared with the spinal cord injury group,the rTSMS group showed a reduction in spinal cord water content.The expression of AQP4 protein,malondialdehyde content,and expression of Bax,Bcl-2,CL-Caspase-3,tumor necrosis factor-α,interferon-γ,interleukin-6,and TLR4/NF-κB/NLRP3 signaling pathway related proteins were all decreased in the rTSMS group,while the activities of superoxide dismutase and glutathione peroxidase,as well as the expression of Bcl-2,interleukin-4,and NeuN,were all increased(P<0.05).These results suggest that rTSMS downregulates the expression of proteins related to the TLR4/NF-κB/NLRP3 signaling pathway,alleviating symptoms after spinal cord injury such as spinal cord edema,oxidative stress,apoptosis,and inflammation,exerting neuroprotective effects,and thereby promoting the recovery of hindlimb motor function after spinal cord injury.

Porcine hemagglutinating encephalomyelitis virus(PHEV),a betacoronavirus with a sin-gle-stranded,positive-sense RNA genome,is an important pathogen in the swine industry.It causes porcine hemagglutinating encephalomyelitis(PHE),presenting with symptoms such as vomiting,diarrhea,neurological symptoms,and respiratory distress,particularly in piglets.The virus is asso-ciated with high mortality rates and growth stunting in subclinical cases.PHEV has a well-docu-mented global distribution,with occurrences reported across Europe,South America,North Amer-ica,and East Asia,posing a considerable challenge to the swine industry.This review aims to pro-vide a comprehensive overview of PHE's virological characteristics,epidemiology,clinical and pathological manifestations,mechanisms of infection and pathogenicity,and the current state of di-agnostic techniques.It further evaluates advancements in vaccine and antiviral development,along-side comprehensive prevention and control strategies,contextualized within the framework of the latest foundational research.

Objective To explore the optimal grouping scheme of diagnosis related groups (DRG) for acquired immunodeficiency syndrome(AIDS) patients and develop cost criteria to provide a reference for implementing DRG payment reform in this region. Methods Information on the first pages of 1987 cases of AIDS patients from Nantong AIDS designated hospitals between 2018 and 2022 was collected, the influencing factors of hospitalization costs were analyzed by applying univariate and multiple linear regression and screening out the classification nodes, and the DRG grouping scheme was constructed by using a decision tree model. Results Complications or comorbidities, number of other diagnoses, and case type were used as classification nodes to form a total of 6 case combinations and corresponding hospitalization cost criteria. The difference in hospitalization cost between groups was statistically significant (P<0. 001), the reduction in variation(RIV) value was 51. 0％, and the coefficient of variation(CV) value of each group was less than 1 (0. 33～0. 63), with good inter-group heterogeneity and intra-group homogeneity. Conclusion The grouping scheme constructed based on the decision tree model is more reasonable, and the standard cost can objectively reflect the actual level of medical consumption of patients, providing a reference for improving DRG grouping and cost payment for AIDS patients in the region.

Objective:To systematically review and evaluate prediction models for aspiration risk in enteral nutrition patients, providing a reference for the development and application of future models.Methods:Literature related to prediction models for aspiration risk in enteral nutrition patients was searched in China National Knowledge Infrastructure, Wanfang Data, China Biology Medicine disc, Web of Science, Cochrane Library, Embase, and PubMed, with the search period covering from the inception of the databases to August 30, 2024. Two researchers independently conducted literature screening and data extraction, and the PROBAST tool was used to assess the risk of bias and applicability of the included studies.Results:A total of 18 studies were included, involving 24 prediction models, with sample sizes ranging from 103 to 512 and an event rate of 9.46% to 49.87%. The top six predictive variables reported most frequently were baseline age, history of aspiration, length of nasogastric tube insertion, nutritional risk, impaired consciousness, and Acute Physiology and Chronic Health Evaluation-Ⅱscore. The area under the receiver operating characteristic curve of the models ranged from 0.756 to 0.992. Twelve studies reported model calibration, six studies conducted internal validation only, one study conducted external validation only, and four studies performed both internal and external validation. The overall applicability of the 18 studies was good, but the risk of bias was high, mainly due to improper handling of continuous variables and missing data.Conclusions:The aspiration risk prediction models developed in various studies for enteral nutrition patients show good applicability but carry a high risk of bias. Future efforts should focus on further optimizing the model construction process, internal and external validation, and result analysis to provide more reliable and scientific tools for clinical aspiration risk assessment.

Objective:To understand the distribution of pediatric medical resources and development status within the healthcare institutions of the pediatric alliance in Jilin Province，and to propose practical strategies for promoting high-quality development in pediatric specialties in the region.Methods:The study utilized the Wenjuanxing (a web-based survey platform) to distribute electronic questionnaires to pediatric department heads from 93 alliance-affiliated healthcare institutions. The survey collected data on human resources，outpatient/emergency services，intensive care unit (ICU) capacity，hospital facilities and equipment，and technological capabilities across these institutions from January to December 2023.Results:Among the 93 medical institutions，22 (23.66%) were classified as Grade Ⅲ-A hospitals，53（56.99%）had independent pediatric departments and emergency departments，and 26（27.96%）did not have independent pediatric wards.There were 1 327 pediatricians，including 537 with intermediate professional title（40.47%）and 668 with undergraduate degree（50.34%）.Facilities，equipment，and pediatric technical capabilities varied markedly among institutions in Jilin Province.Conclusion:The professional development of pediatrics in various medical institutions in Jilin Province is uneven，the ability gap is large，and the sources of high-quality medical funding are relatively concentrated.The high-quality development of pediatrics in Jilin Province is still facing great challenges.

Objective:To explore the core factors of self-management and quality of life (QOL) in patients with chronic obstructive pulmonary disease (COPD) and the internal relationship between these two constructs.Methods:A convenience sampling method was used to enroll 210 COPD patients who visited the Fifth Affiliated Hospital, Sun Yat-sen University from January to December 2022. Data were collected using Self-Management Scale and 36-item Short-Form. A relationship network between self-management and QOL was constructed via network analysis, and centrality indicators and network stability were calculated.Results:A total of 210 questionnaires were distributed, and 205 valid questionnaires were recovered, with an effective recovery rate of 97.6%. Emotional management was identified as the core node in both the overall network and the self-management subnetwork (2.064), while vitality was the core node in the QOL subnetwork (0.730). The relationship between self-management and QOL was mainly manifested through the strong association between emotional management and role-emotion.Conclusions:Emotional management is the core factor in the relationship between self-management and QOL in COPD patients. The overall network of self-management and QOL is influenced by the strong association between emotional management and role-emotion.

Objective To explore the microstructural alterations in the white matter of patients with Parkinson's disease(PD)with depression(PD-D)by Tract-based Spatial Statistics(TBSS),with the aim of identifying neuroimaging biomarkers for early diagnosis.Methods Participants with PD were recruited from the Parkinson Progression Marker Initiative database and categorized into PD-D group(n=50)and PD without depression(PD-ND)group(n=31)based on the Geriatric Depression Scale(GDS-15).Age-and gender-matched healthy volunteers were also included in healthy control(HC)group(n=23).All subjects underwent brain MRI-DTI scans.TBSS was utilized to compare fractional anisotropy(FA),mean diffusivity(MD),axial diffusivity(AD),and radial diffusivity(RD)values among groups and to perform Pearson correlation analysis with clinical PD data.Results Compared with HC group,FA values were significantly reduced and MD values were significantly increased in bilateral cingulate(hippocampus),crus,parahippocampal,inferior fronto-occipital fasciculus,inferior longitudinal fasciculus,uncinate fasciculus,superior longitudinal fasciculus(SLF),SLF(temporal),thalamic radiation and corticospinal tract of PD-D group(all P＜0.05).Compared with PD-ND group,MD values were significantly higher in the left cingulum(cingulate gyrus),left inferior fronto-occipital fasciculus,left SLF,left SLF(temporal),left thalamic radiation and left corticospinal tract of PD-D group,while AD values were significantly higher in the left SLF of PD-D group(all P＜0.05).Correlation analysis revealed that AD values in the left SLF were positively correlated with Epworth sleepiness scale score and GDS-15 score(r=0.192,P=0.043;r=0.443,P＜0.01).MD values in the differential brain regions were negatively correlated with Montreal cognitive assessment scale scores(r=-0.187,P=0.047)and positively correlated with GDS-15 scores(r=0.485,P＜0.01).Conclusion This study demonstrate that TBSS can reveal microstructural changes in the brains of PD-D patients,which may serve as neuroimaging biomarkers and provide guidance for clinical diagnosis and treatment.

OBJECTIVE The non-volatile and volatile chemical components in Yin-Qiao-Qing-Re Tablets were analyzed sepa-rately using ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF-MS/MS)and Gas Chromatography Mass Spectrometry(GC-MS).METHODS The non-volatile components were analyzed using a Waters ACQUITY UPLC BEH C18 column(2.1 mm×100 mm,1.7 μm),with a mobile phase consisting of 0.1％formic acid aqueous solution(A)and acetonitrile(B)for gradient elution,a flow rate of 0.35 mL·min-1,an injection volume of 5 μL,and a column temperature of 30 ℃;the volatile components were analyzed using an Agilent SH-I-5MS column(5％Phenyl Methyl Silox,30 m×250 μm,0.25 μm);the procedure was temperature-programmed,with an injection volume of 1 μL,a split ratio of 10∶1,a flow rate of 1.0 mL·min-1,and an inlet temperature of 200 ℃.RESULTS A total of 134 non-volatile chemical components and 23 volatile components were analyzed and identified from Yin-Qiao-Qing-Re Tablets,among which 49 compounds were confirmed through comparison with reference stand-ards.The non-volatile components mainly include 27 flavonoids,21 organic acids,15 lignans,14 iridoids,12 phenylethanoid glyco-sides,11 saponins,10 alkaloids,5 terpenes,4 amino acids,3 phenylpropanoids,3 nucleosides,3 xanthones,3 phenolic glycosides,2 chromones and 1 carbohydrate.The volatile components mainly include 11 monoterpenes,5 alcohols and phenols,3 alkenes,2 ke-tones,1 ester,and 1 hydrocarbon.CONCLUSION This study rapidly identifies the chemical components of Yin-Qiao-Qing-Re Tablets,laying a preliminary foundation for research on the pharmacodynamic substances of Yin-Qiao-Qing-Re Tablets and the im-provement of quality control standards.