ObjectiveTo develop a novel clinical predictive model for metabolic dysfunction-associated fatty liver disease （MAFLD） based on metabolic markers and anthropometric indicators， and to provide a more effective tool for the early screening and intervention of MAFLD. MethodsA retrospective analysis was performed for 2 824 individuals who underwent abdominal color Doppler ultrasound at Health Examination Center of The First Hospital of Lanzhou University from January 1， 2024 to January 1， 2025， and at a ratio of 7∶3， they were randomly divided into training set with 1 976 patients and validation set with 848 patients. Clinical data， serological markers， and abdominal ultrasound results were collected from all patients， and triglyceride-glucose （TyG） index， triglyceride-to-high-density lipoprotein cholesterol （TG/HDL-C） ratio， and anthropometric indicators were calculated. The independent samples t-test was used for comparison of normally distributed or approximately normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of continuous data with skewed distribution between two groups； the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups. The multivariate logistic regression analysis was used to identify independent predictive factors for MAFLD and intermediate- to high-risk MAFLD. Five risk prediction models were established for MAFLD based on the independent influencing factors， and a nomogram was plotted. The receiver operating characteristic （ROC） curve was plotted to assess model performance， and the area under the ROC curve （AUC） was calculated. The calibration curve was used to evaluate the predictive accuracy of the models， and decision curve analysis was used to assess the clinical practicability of the models. These models were then compared with traditional models. ResultsAmong the 1 976 individuals in the training set， 937 （47.42%） were diagnosed with MAFLD， and 423 （21.41%） were diagnosed with intermediate- to high-risk MAFLD； among the 848 individuals in the validation set， 406 （47.88%） were diagnosed with MAFLD. The multivariate logistic regression analysis showed that male sex （odds ratio ［OR］=0.23， 95% confidence interval ［CI］： 0.13 — 0.39， P<0.05）， waist circumference （OR=1.11， 95%CI： 1.06 — 1.17， P<0.05）， alanine aminotransferase （ALT） >40 U/L （OR=2.24， 95%CI： 1.44 — 3.51， P<0.05）， high-density lipoprotein cholesterol （HDL-C） （OR=0.07， 95%CI： 0.04 — 0.15， P<0.05）， TyG index （OR=8.27， 95%CI： 5.09 — 13.44， P<0.05）， TG/HDL-C ratio （OR=0.84， 95%CI： 0.71 — 0.99， P<0.05）， A Body Shape Index （ABSI） （OR=0.45， 95%CI： 0.39 — 0.52， P<0.05）， and body roundness index （BRI） （OR=2.31， 95%CI： 1.50 — 3.55， P<0.05） were independent influencing factors for MAFLD， and male sex （OR=0.17， 95%CI： 0.10 — 0.31， P<0.05）， age （OR=1.09， 95%CI： 1.07 — 1.11， P<0.05）， hemoglobin （OR=0.98， 95%CI： 0.97 — 0.98， P<0.05）， platelet count （OR=0.81， 95%CI： 0.70 — 0.93， P<0.05）， fasting blood glucose （OR=0.80， 95%CI： 0.71 — 0.89， P<0.05）， triglycerides （OR=0.14， 95%CI： 0.07 — 0.29， P<0.05）， TG/HDL-C ratio （OR=0.78， 95%CI： 0.67 — 0.91， P<0.05）， TyG index （OR=5.26， 95%CI： 3.32 — 8.33）， waist circumference （OR=2.50， 95%CI： 1.72 — 3.61， P<0.05）， ABSI （OR=0.58， 95%CI： 0.51 — 0.66， P<0.05）， and BRI （OR=0.01， 95%CI： 0.00 — 0.21， P<0.05） were independent influencing factors for intermediate- to high-risk MAFLD. Among the five models established， model 5 （incorporating sex， ALT elevation， HDL-C， TyG index， TG/HDL-C ratio， waist circumference， and ABSI） had the best performance， with an AUC of 0.917 （95%CI： 0.905 — 0.929） in the training set and 0.911 （95%CI： 0.892 — 0.930） in the validation set. The calibration curve showed that model 5 had good predictive accuracy， and the decision curve analysis confirmed its clinical practicability. ConclusionThe predictive model for MAFLD constructed based on metabolic markers and anthropometric indicators has good discriminatory ability and can be used to assess the risk of MAFLD. In addition， this study shows that waist circumference， TyG index， TG/HDL-C ratio， ABSI， and BRI are independently associated with intermediate- to high-risk MAFLD， but further studies are needed to confirm their value in predicting liver fibrosis progression.

While programmed cell death ligand 1 (PD-L1) inhibitors have yielded breakthroughs in tumor therapy, their efficacy is constrained by the heterogeneity of the tumor microenvironment and multiple immunosuppressive pathways. In recent years, research has revealed that transforming growth factor-β (TGF-β) synergistically drives tumor cell immune escape with PD-L1 via pathways such as metabolic reprogramming, epithelial-mesenchymal transition, and SOX family factors. Currently, various PD-L1/TGF-β bispecific antibodies (bsAbs) have exhibited promising therapeutic potential in early-phase clinical trials, yet they still confront challenges related to toxicity and drug resistance. This article systematically reviews the mechanisms by which PD-L1 and TGF-β synergistically regulate tumor immune escape, summarizes the clinical research progress of bsAbs, and discusses strategies for novel drug design and biomarker development, with the aim of offering new insights for the development of combined tumor immunotherapy strategies.

The global communication order has been profoundly affected by the revolution in communication technologies in recent years， and the evolution of technology and paradigm revolution has ushered in the era of intelligent communication. A deeply mediatized society has subversively changed the information communication patterns of human society and influenced the forms of resource allocation. With the emergence of novel technological terms such as “cloud computing” “metaverse” and “virtual reality” current mainstream communication and media studies tend to categorize media into the virtual world， often ignoring its ubiquitous， profound， and complex materiality. Across different digital social contexts， the “materiality” of the communication activities for traditional Chinese medicine （TCM） culture， such as the targeted objects， the communication venues， and the relied-upon bodies， profoundly influenced their occurrence， understanding， and continuation. Starting from the media materiality of TCM and regarding it as the “carrier” of excellent traditional Chinese culture， this paper explored the existing problems and countermeasures in the international communication of TCM culture in the digital era. It aimed to transcend media-centrism and strive to explore an innovative paradigm for the digital international communication path of TCM culture featuring “embodiment-embedment-elevation.”

Objective To investigate alterations in interhemispheric functional connectivity(FC)in the cerebral cortices connected via the corpus callosum in patients with Alzheimer's disease(AD),and to explore their relationships with cognitive function and activities of daily living.Methods Resting-state functional magnetic resonance imaging data were collected from 28 patients with Alzheimer's dementia(d-AD),47 patients with mild cognitive impairment(MCI),and 37 healthy controls(HC).Using a trancallosal tract template,32 pairs of homologous cortical brain regions directly connected to 32 subregions of the corpus callosum were selected as regions of interest for interhemispheric FC analysis.Further correlation analyses were performed between FC values in patient groups and their scores on the Montreal Cognitive Assessment-Basic(MoCA-B)Scale and the Activities of Daily Living(ADL)Scale.Results Compared with HC group,both MCI and d-AD groups exhibited hyperconnectivity(significantly increased FC)in interhemispheric non-homologous brain regions.Specifically,hyperconnectivity in the MCI group was scattered across the frontal,parietal,temporal,and occipital lobes,while in the d-AD group,it was concentrated within the precentral and postcentral gyri.Notably,hyperconnectivity involving the prefrontal and occipital lobes in the MCI group showed significant declines in the d-AD group.The interhemispheric homologous FC in the d-AD group reduced more significantly than the MCI group.Additionally,in the d-AD group,2 interhemispheric FC within the prefrontal lobe(between the bilateral orbital parts of the inferior frontal gyrus,and between the left medial frontal gyrus and the right middle frontal gyrus)were correlated with MoCA-B scores,and 2 FC(between the bilateral middle occipital gyri,and between the left inferior parietal lobule and the right middle frontal gyrus)were correlated with ADL scores.Conclusion MCI and d-AD exhibit distinct patterns of interhemispheric FC alterations,and the interhemispheric FC changes in AD patients are non-progressive.The close relationships between interhemispheric homologous/non-homologous FC and MoCA-B/ADL scores in d-AD patients provide an objective basis and reference for clinical neuromodulation.

Viral pneumonia is an infectious disease caused by virus invading the lung parenchyma and interstitial tissue and causing lung inflammation， with the incidence rising year by year. Traditional Chinese medicine （TCM） can treat viral pneumonia in a multi-component， multi-target， and holistic manner by targeting the core pathogenesis of pneumonia caused by different respiratory viruses， demonstrating minimal side effects and significant advantages. According to the theory of healthy Qi and pathogenic Qi in TCM， the struggle between healthy Qi and pathogenic Qi and the imbalance between immunity and inflammation run through the entire process of viral pneumonia， and the immunity-inflammation status at different stages of the disease reflects different relationships between healthy Qi and pathogenic Qi. Immune dysfunction leads to the deficiency of healthy Qi， causing viral infections. The struggle between healthy Qi and pathogenic Qi causes immunity-inflammation imbalance， leading to the onset of viral pneumonia. Inflammatory damage causes persistent accumulation of phlegm and stasis， leading to the progression of viral pneumonia. The cytokine storm causes immunodepletion， leading to the excess of pathogenic Qi and diminution of healthy Qi and the deterioration of viral pneumonia. After the recovery from viral pneumonia， there is a long-term imbalance between immunity and micro-inflammation， which results in healthy Qi deficiency and pathogenic Qi lingering. Healthy Qi deficiency and pathogenic Qi excess act as common core causes of pneumonia caused by different respiratory viruses. Clinical treatment should emphasize both replenishing healthy Qi and eliminating pathogenic Qi， helping to restore the balance between healthy Qi and pathogenic Qi as well as between immunity and inflammation， thus promoting the recovery of patients from viral pneumonia. According to the TCM theory of healthy Qi and pathogenic Qi， this article summarizes the immunity-inflammation mechanisms at different stages of viral pneumonia， and explores the application of the method of replenishing healthy Qi and eliminating pathogenic Qi in viral pneumonia. The aim is to probe into the scientific connotation of the TCM theory of healthy Qi and pathogenic Qi in viral pneumonia and provide ideas for the clinical application of the method of replenishing healthy Qi and eliminating pathogenic Qi to assist in the treatment of viral pneumonia.

The research on the mechanism of Chinese materia medica in the treatment of viral pneumonia (VP) is mainly based on the monomer components of Chinese materia medica and TCM compounds. Among them, the monomer components are mainly polyphenols, flavonoids and anthraquinones, which have anti-inflammatory, antiviral, immunomodulatory and antioxidant pharmacological effects. The efficacy of TCM compounds is mainly based on clearing heat, and it has the functions of removing phlegm, removing blood stasis, removing dampness, moistening lung and so on. The intervention of Chinese materia medica in VP mainly involves NF-κB, MAPK, JAK/STAT, PI3K/Akt and other signaling pathways. The mechanism includes regulating oxidative stress, apoptosis, regulating immune function, inhibiting inflammatory response, etc., which can reduce the pathological damage of inflammatory cell infiltration and edema in lung tissue, and achieve the protective effect on lung tissue. The current research models exhibit unclear patterns of syndrome differentiation, and the mechanisms of Chinese materia medica involving multiple targets and pathways are poorly understood. Future research should integrate disease-syndrome combination models to further explore the mechanisms by which TCM regulates multiple targets and pathways, thereby providing insights and methodologies for the treatment of viral pneumonia with Chinese materia medica.

Background Diesel engines are widely used in transportation, agriculture, construction, industry, and other fields. Diesel exhaust, classified as a Group 1 carcinogen, emits particles (DEP) that can penetrate deep into the respiratory tract, posing significant health risks. DEP pollution is particularly severe in confined environments, necessitating effective control measures. Objective Under laboratory simulation conditions, to explore the spatiotemporal distribution characteristics of the mass and number concentrations of DEP as it diffuses indoors and to reveal the effects of ventilation and additional airflow on indoor DEP pollution levels. Methods A diesel engine was placed in a laboratory (length 3.39 m × width 2.85 m × height 2.4 m) with its exhaust emitted from east to west. An air purifier was installed 1 m south of the engine. Eight measurement points (1 m horizontal distance from the exhaust outlet, height: 1 m/1.5 m) were setup to monitor DEP concentrations using portable laser particle sizers. The effects of engine power (4.05 kW vs. 5.15 kW), ventilation (maximum airflow: 600 m³·h⁻¹), additional airflow intensity (low and high), and direction (forward/reverse) on DEP pollution were analyzed. DEP levels of 5 diesel vehicle models were also compared. Results The mass and number concentrations of DEP indoors increased immediately after the diesel engine started. The peak mass concentration time at the eastern measurement point (−1, 0) m opposite to the exhaust direction (17.70 min) was significantly longer than that at the western (1, 0) m (16.20 min), southern (0, -1) m (14.45 min), and northern (0, 1) m (12.70 min) points (P<0.05), with no significant differences between the other points (western, southern, and northern) (P>0.05). The northern point (0, 1) m exhibited the highest DEP mass and number concentration peaks (174.62 μg·m⁻³, 1319.85 p·cm⁻³), significantly exceeding those at the southern (0, −1) m (129.89 μg·m⁻³, 1175.24 p·cm⁻³), eastern (−1, 0) m (140.12 μg·m⁻³, 1120.53 p·cm⁻³), and western (1, 0) m (147.60 μg·m⁻³, 818.62 p·cm⁻³) points (P<0.05), and no significant differences were observed among other points (P>0.05). There were no significant differences in peak DEP mass and number concentrations by measurement heights (P>0.05). Diesel engine power, ventilation, airflow intensity, and airflow direction had no significant effect on the time of peak DEP concentration (P>0.05). However, higher engine power (5.15 kW) produced greater DEP peaks [(186.66±19.29) μg·m⁻³, (1382.79±122.56) p·cm⁻³] than the 4.05 kW engine power [(168.41±12.65) μg·m⁻³, (1284.45±71.30) p·cm⁻³] (P<0.05). The peak mass concentration [(342.04±35.03) μg·m⁻³] and number concentration [(1886.87±57.91) p·cm⁻³] of DEP in the non-ventilated group were significantly higher than those in the ventilated group [(186.66±19.29) μg·m⁻³, (1382.79±122.56) p·cm⁻³] (P<0.001). Forward airflow elevated DEP mass concentrations compared to reverse airflow (287.71 μg·m⁻³ vs. 243.74 μg·m⁻³, t=−2.592, P=0.009), but no effects on DEP number concentration (P>0.05). Significant differences in mass concentration were observed among selected 5 vehicle models (Z=38.109, P<0.001). Conclusion The operation of diesel engines will emit a large amount of particulate matter, causing pollution in enclosed spaces. Diesel engines with greater power have higher levels of DEP pollution emissions. Based on the spatiotemporal distribution characteristics, it is recommended to set the operation position in the reverse direction of exhaust emissions and close to air purifiers, while avoiding the use of additional air flow equipment.

The principle of treating different diseases with the same therapy is the essence of syndrome differentiation and treatment in traditional Chinese medicine （TCM）. It means that when the same pathogenic changes or the same symptoms appear in the development of different diseases， the same principles or methods can be used for treatment. Due to the complexity and high variability of viral pathogenicity， the precise and effective treatment of different types of viral pneumonia （VP） has always been a research focus and difficulty in modern medicine. VP belongs to the category of external-contraction febrile disease， warm disease， and epidemic in TCM. Haoqin Qingdantang （HQQDD） is a representative formula for clearing heat and dispelling dampness in warm diseases， and its intervention in VP caused by various viral infections has significant effects. This study， guided by the theory of treating different diseases with the same therapy， links the related studies on using HQQDD to treat different types of VP and finds that influenza virus pneumonia （IVP）， severe acute respiratory syndrome （SARS）， and COVID-19 all have a common pathogenic mechanism of dampness-heat at different stages of respective diseases. When these diseases are dominated by damp-heat factors， the use of HQQDD yields remarkable therapeutic effects. Modern pharmacological studies have confirmed that HQQDD can inhibit virus replication， reduce fever reactions， inhibit the expression of inflammatory mediators， and regulate immune balance. Moreover， the sovereign medicine in this formula has excellent antiviral activity， and the formula reflects rich scientific connotations of treating VP. According to the theory of treating different diseases with the same therapy and based on the effective treatment practice and modern pharmacological research of HQQDD for different types of VP， this paper mines the underlying TCM theory of treatment with the same therapy， explores the syndrome differentiation and treatment strategy and effect mechanism of this formula for different types of VP， and analyzes the treatment mechanism and characteristics， with the aim of providing evidence and reference for the clinical application and modern research of HQQDD.

Task performance is an important concern in ergonomics. Task performance is often affected by adverse ergonomic factors, resulting in health and economic losses. How to utilize effective indicators to evaluate the degree of impact of adverse ergonomic factors on workers' task performance is particularly important. In this paper, we conducted a literature review and analysis on the impact of adverse ergonomic factors on workers' task performance, focusing on summarizing available physiological, psychological, and neurocognitive behavioral function test indicators for evaluating workers' task performance. This summary of existing evaluation indicators provided reference and guidance for future evaluations of the impact of adverse ergonomic factors on workers' task performance.

Eating disorders(ED) are a group of psychiatric disorders related to abnormal eating behaviors, with complex and variable symptoms, frequent crossover of diagnoses among various subtypes, high comorbidity rates, and often difficulties in medical treatment, which seriously affect the quality of life of patients. Understanding ED from a transdiagnostic perspective provides new ideas for treatment. According to the theory of cognitive behavioral therapy, psychological cognitive development is an important maintenance mechanism for the transdiagnosis of ED. Core beliefs, as the deepest level of psychological cognition, play an important role in the development and maintenance of ED. A large number of studies have found that among patients with various subtypes of ED, the core beliefs related to the self involve body shape and weight, achievement/worth, sense of control, and the core beliefs related to the world/others involve unloveability and abandonment influence both eating-related symptoms and comorbidity levels. For the first time, this paper focuses on sorting out the transdiagnostic core beliefs of patients with ED and further clarifying the relationship between transdiagnostic core beliefs and ED symptoms, in order to better understand, prevent and treat ED, then promote recovery and reduce relapse.