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.

ObjectiveTo investigate the preventive effect and mechanism of Dendrobium officinale （DO） on non-alcoholic fatty liver disease （NAFLD） by network pharmacology and animal experiments. MethodsDO components in blood after administration were identified and analyzed using ultra-performance liquid chromatography-quadrupole-electrostatic field orbitrap high-resolution mass spectrometry （UPLC-QE-HF-MS/MS）. Network pharmacology and molecular docking methods were employed to obtain active ingredients and potential targets of DO for NAFLD control. High-fat feeds were used to replicate the NAFLD rat model. Biochemical kits were used for detecting the expression levels of blood lipids， hepatic lipids， and liver functions of rats. Hematoxylin-eosin （HE） staining and oil red O staining were employed to observe pathological changes in rat liver， and real-time fluorescence quantitative PCR （Real-time PCR） assay was performed to validate potential targets obtained from the network pharmacology analysis. ResultsA total of 13 DO components were identified in blood， including berberine， dihydrosanguinarine， and oxypeucedanin. A total of 14 potential targets were screened through network pharmacology， including Forkhead box protein O1 （FoxO1）， epidermal growth factor receptor （EGFR）， and insulin-like growth factor 1 （IGF-1R）， involving pathways such as the advanced glycation end product （AGE）/receptor for AGE （RAGE） signaling pathway， blood lipids and atherosclerosis， insulin resistance， and FoxO signaling. The results of animal experiments showed that the NAFLD rat model was successfully replicated. After the preventive treatment with DO for NAFLD rats， the indexes of blood lipids， hepatic lipids， and liver function were normalized； lipid deposition and lesions in the liver were significantly improved； the expression level of FoxO1 mRNA in the liver was significantly reduced （P<0.05）， and the mRNA expression levels of phosphatidylinositide 3-kinases （PI3K）， protein kinase B （Akt）， EGFR， and IGF-1R were significantly increased （P<0.05）. ConclusionDO has a preventive effect on NAFLD rats， and the mechanism of action may be related to the modulation of IGF1R and EGFR targets and activation of the PI3K/Akt/FoxO1 signaling pathway.

OBJECTIVE To study the effects of enteral immune microecological nutrition combined with ω-3 fish oil fat emulsion on postoperative recovery， immune function， liver function and inflammation level in patients with hepatocellular carcinoma resection， as well as the safety of the medication. METHODS A total of 106 patients with hepatocellular carcinoma admitted to our Hospital from June 2020 to December 2023 were selected and divided into control group and study group according to the random number table method， with 53 cases in each group. After undergoing hepatocellular carcinoma resection， control group was given Intacted protein enteral nutrition solution+Enhanced enteral immune microecological nutrition， and the study group was given ω-3 fish oil fat emulsion injection based on the control group. The clinical indicators （postoperative exhaust time， defecation time， postoperative ambulation， and hospital stay）， liver function indicators [alanine transaminase （ALT）， lactate dehydrogenase （LDH）， aspartate transaminase （AST）]， immune function indexes （CD3+ ， CD4+ ， CD8+ ， CD4+/CD8+）， inflammatory factor indexes [tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， IL-6， IL-8]， and indicators of intestinal mucosal barrier [D-lactic acid， intestinal fatty acid binding protein （I-FABP）] were compared between 2 groups， and the occurrence of ADR was recorded. RESULTS Compared with the control group， the postoperative exhaust time， postoperative defecation time， and hospital stay of the study group were shortened significantly， and postoperative ambulation increased significantly （P＜0.05）. After treatment， ALT， LDH， AST， CD8+， inflammatory factors， D-lactic acid and I-FABP of 2 groups were significantly lower than before treatment， and the study group was significantly lower than the control group （P＜0.05）； CD4+， CD3+， and CD4+/CD8+ of two groups were significantly higher than before treatment， and the study group was significantly higher than the control group （P＜0.05）. There was no significant difference in the incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS Enteral immune microecological nutrition combined with ω-3 fish oil fat emulsion injection can shorten the recovery time of patients after hepatocellular carcinoma resection， improve immune function， reduce inflammatory response， and improve liver function with good safety.

Intelligent algorithms， as the core element of artificial intelligence （AI）， have played an irreplaceable and key role in fields such as medical AI-assisted diagnosis and treatment. Meanwhile， they have also presented new features such as the complexity of interdisciplinary integration， the conflict of ethical convergence in science and technology， the duality of risks and benefits coexistence， and the concealment of algorithm black box calculations. These features lead to numerous ethical challenges， such as algorithm bias， data security， and difficulty in tracing responsibility. Therefore， it is urgent to break through these challenges by establishing a micro-ethical institutional system for intelligent medical algorithms， setting up an ethical supervision mechanism for the operation of intelligent medical algorithms， improving ethical norms for data security protection of intelligent medical algorithms， and strengthening ethical standards for the identification of the main responsibility of intelligent medical algorithms.

The investigator-initiated trials （IIT）， as a widely existing form of clinical research both domestically and internationally， have attracted the attention of governments around the world due to the potential legal risks and issues they may cause， and the trend of legal supervision has gradually strengthened. The legal regulation of IIT in China is still in its early stages， with numerous legal issues that need to be clarified and sorted out. Based on the domestic and international legal reviews of IIT， this paper systematically sorted out the current situation of legal supervision of IIT in China and examined the existing issues， including weak legislative rules， incomplete regulatory systems， imperfect protection rules for research participants and informed consent systems， inadequate regulation of conflicts of interest management， and lax legal supervision of ethical review. Furthermore， this paper proposed suggestions for legal regulation of IIT from three perspectives， including strengthening legislation and emphasizing regulation， improving the mechanism for protecting research participants’ rights and interests， and balancing the legalization of IIT and the scientific development of clinical research， with a view to providing references for legal regulatory paths of IIT in China.

Ischemic stroke (IS) is a globally life-threatening disease. Presently, few therapeutic medicines are available for treating IS, and rt-PA is the only drug approved by the US Food and Drug Administration (FDA) in the US. In fact, many agents showing excellent neuroprotection but no blood flow-improving activity in animals have not achieved ideal clinical efficacy, while thrombolytic drugs only improving blood flow without neuroprotection have limited their wider application. To address these challenges and meet the huge unmet clinical need, we have designed and identified a novel compound AAPB with dual effects of neuroprotection and cerebral blood flow improvement. AAPB significantly reduced cerebral infarction and neural function deficit in tMCAO rats, pMCAO rats, and IS rhesus monkeys, as well as displayed exceptional safety profiles and excellent pharmacokinetic properties in rats and dogs. AAPB has now entered phase I of clinical trials fighting IS in China.

PANoptosis is a newly defined type of programmed cell death (PCD), which is triggered by a variety of stimuli and covers three known forms of PCD: apoptosis, pyroptosis and necroptosis. In physiological state, cell death plays an important protective role against pathogen invasion, but its over-activation may aggravate inflammatory response and cause tissue damage. Studies have shown that the occurrence and progression of acute lung injury/acute respiratory distress syndrome (ALI/ARDS), asthma, chronic obstructive pulmonary disease (COPD) and other lung diseases are closely related to PANoptosis. The purpose of this review is to deeply explore the molecular mechanism of PANoptosis and its regulatory factors in lung diseases, in order to discover potential therapeutic targets and provide new targets and innovative ideas for clinical treatment for lung diseases.
Humans ; Lung Diseases ; Apoptosis ; Pyroptosis ; Pulmonary Disease, Chronic Obstructive ; Necroptosis ; Acute Lung Injury

The theory of yin and yang is the modest differentiation thought of the traditional Chinese medicine under the guidance of overall dialectics,and the dynamic changes of yin and yang profit and loss can reflect the life activities of the human body.In the early literature research and clinical practice,the author's team found that the"yang deficiency and yin stagnation"is the key pathogen of colorectal cancer,the yang qi is insufficient,and the metabolites of the yin such as phlegm,wetness and stasis are lost in gasification and accumulate to form a"yin tumor",which is stagnant in the intestine and forms colorectal cancer.Yang Qi is the process of normal cell metabolism to produce energy,Yang Qi is insufficient,the"yin knot"of the thing in the body polymerizes into tumors,The imbalance of yin and yang can cause changes in energy or substance metabolism in the body,and glutamine is one of the amino acid which is the largest consumption of tumor cells,and its metabolic process not only provides a material basis for tumor cell growth,but also creates an acidic microenvironment of hypoxia to promote the proliferation and growth of tumor cells.This paper discusses the characteristics of glutamine metabolism of colorectal cancer cells in detail,aiming to explain the occurrence of colorectal cancer from the pathogenesis of"yang deficiency yin knot",and to explain the scientific theory of traditional Chinese medicine in the treatment of coloral cancer with the principle of Wenyang Tongxia,aiming to provide new ideas and methods for the comprehensive treatment of CRC.

Objective:To compare the correlation and consistency of central corneal thickness (CCT) measured by four different instruments, specular microscope SP-1P, IOLMaster 700, Pentacam HR and RTVue XR-OCT.Methods:A diagnostic test study was performed.A total of 50 right eyes of 50 consecutive outpatients who planned to undergo corneal refractive surgery at Hanyang Aier Eye Hospital from January to May 2022 were included.CCT was measured with the specular microscope SP-1P, IOLMaster 700, Pentacam HR and RTVue XR-OCT, respectively.The differences of CCT measurements by the four instruments were compared.The correlation and consistency between the CCT values was analyzed by Pearson linear analysis and Bland-Altman test, respectively.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Hanyang Aier Eye Hospital (No.HYEYE20221229JM).Written informed consent was obtained from each subject.Results:The mean CCT values measured by SP-1P, IOLMaster 700, Pentacam HR and RTVue XR-OCT were (522.68±30.08), (544.06±32.85), (541.00±31.75) and (528.86±31.60)μm, respectively, with a statistically significant overall difference ( F=5.09, P=0.002).CCT measurements obtained with SP-1P were lower than those obtained with IOLMaster 700 and Pentacam HR, while the IOLMaster 700 measurements were higher than those of RTVue XR-OCT, showing statistically significant differences (all at P<0.05).Pearson correlation analysis revealed significant positive correlations of CCT measurements between SP-1P and IOLMaster 700, SP-1P and Pentacam HR, SP-1P and RTVue XR-OCT, IOLMaster 700 and Pentacam HR, IOLMaster 700 and RTVue XR-OCT, Pentacam HR and RTVue XR-OCT ( r=0.988, 0.980, 0.988, 0.981, 0.982, 0.973; all at P<0.01).Bland-Altman consistency analysis showed that the 95% limits of agreement (95% LoA) for CCT measurements between SP-1P and RTVue XR-OCT, IOLMaster 700 and Pentacam HR were -16.46-6.14 and -10.56-14.48 μm, respectively, with 3(6%) and 2(4%) data points outside the 95% LoA, respectively.The mean difference lines for the CCT measurements were close to 0, indicating good consistency and clinically acceptable differences without statistical significance. Conclusions:CCT values measured with specular microscope SP-1P and RTVue XR-OCT, as well as those measured with IOLMaster and Pentacam HR, are relatively close in patients with low to moderate myopia, show good consistency and can therefore be considered interchangeable.