Tumor-related insomnia is one of the common complications of tumor patients,which is secondary to tumor disease and related to tumor disease itself or tumor treatment.Combined with the unique pathogenesis of"heat-toxicity internal stagnation"of tumor-related insomnia,the important treatment methods are to clear away heat,attack toxicity,regulate qi and supplement healthy qi.This article explained the research status,etiology and pathogenesis,treatment principles of the disease,in order to provide new ideas and methods for the differentiation and treatment of tumor-related insomnia in TCM.

Tumor-related insomnia is one of the common complications of tumor patients,which is secondary to tumor disease and related to tumor disease itself or tumor treatment.Combined with the unique pathogenesis of"heat-toxicity internal stagnation"of tumor-related insomnia,the important treatment methods are to clear away heat,attack toxicity,regulate qi and supplement healthy qi.This article explained the research status,etiology and pathogenesis,treatment principles of the disease,in order to provide new ideas and methods for the differentiation and treatment of tumor-related insomnia in TCM.

Objective To identify specific behaviors detrimental to language development in parent-child inter-actions among Mandarin-speaking infants and toddlers with language delays,and to provide a foundation for develo-ping parent-involved early intervention programs that enhance language acquisition.Methods A qualitative research design was used,employing interaction analysis and categorical analysis methods.Observations from 30 parent-child interaction videos involving children with delayed language development were analyzed to identify common detrimen-tal behaviors(coding).The validity of the qualitative findings was tested by analyzing 108 parent-child where low-quality parental interactions were identified and provided with five rounds of constructive feedback.Results Two major categories of detrimental behaviors with three aspects and a total of 10 issues were identified:5 issues related to parental interaction skills,3 issues related to mutual influences between parent and child,and 2 issues related to the interaction environment.After 5 rounds of feedback,detrimental behaviors in the 108 parent-child pairs im-proved significantly,with 8 behaviors met the 80％stability standard.Conclusion The study identified and catego-rized behaviors in parent-child interactions that hinder language development in children with language delays.Video-based behavior analysis and feedback can enhance parental interaction skills and create a conductive environ-ment for early language development.

Background:Bushen Zhuanggu Formula(BZF),derived from the classic Yougui Pills,has shown favorable clinical efficacy in treating advanced nontraumatic osteonecrosis of the femoral head(NONFH),particularly by promoting bone repair.However,its underlying mechanisms remain unclear.Objective:This study aimed to explore the mechanisms by which BZF promotes bone repair in advanced NONFH.Materials and methods:A total of 518 potential BZF targets were identified from the ETCM v2.0 database.Transcriptomic profiling of clinical cohorts revealed 485 differentially expressed genes in advanced NONFH patients compared to healthy controls.A drug target-disease gene interaction network was constructed to identify candidate BZF targets involved in NONFH pathogenesis.In vivo experiments were conducted to validate the effects of BZF in a rat model of advanced NONFH.Results:Network analysis identified key pathways associated with blood circulation obstruction,immune-inflammatory imbalance,and abnormal bone metabolism.Protein kinase C alpha(PKCA),Ras proto-oncogene(RAS),mitogen-activated protein kinase 3(ERK),ETS proto-oncogene 1(ETS1),and receptor activator of nuclear factor-κB ligand(RANKL)formed a signaling axis implicated in NONFH pathogenesis.BZF treatment alleviated joint inflammation,preserved trabecular bone morphology,reduced bone loss,and promoted bone repair.Mechanistically,BZF significantly downregulated the expression of PKCA,RAS,ERK,ETS1,and RANKL,improved blood circulation,and inhibited osteoclast activation while promoting osteoblast activation.Conclusion:BZF may promote bone repair in advanced NONFH by enhancing blood circulation and modulating the PKC-RAS-ERK-ETS1-RANKL signaling axis,thereby reversing dysregulated bone metabolism.

Background:Bushen Zhuanggu Formula(BZF),derived from the classic Yougui Pills,has shown favorable clinical efficacy in treating advanced nontraumatic osteonecrosis of the femoral head(NONFH),particularly by promoting bone repair.However,its underlying mechanisms remain unclear.Objective:This study aimed to explore the mechanisms by which BZF promotes bone repair in advanced NONFH.Materials and methods:A total of 518 potential BZF targets were identified from the ETCM v2.0 database.Transcriptomic profiling of clinical cohorts revealed 485 differentially expressed genes in advanced NONFH patients compared to healthy controls.A drug target-disease gene interaction network was constructed to identify candidate BZF targets involved in NONFH pathogenesis.In vivo experiments were conducted to validate the effects of BZF in a rat model of advanced NONFH.Results:Network analysis identified key pathways associated with blood circulation obstruction,immune-inflammatory imbalance,and abnormal bone metabolism.Protein kinase C alpha(PKCA),Ras proto-oncogene(RAS),mitogen-activated protein kinase 3(ERK),ETS proto-oncogene 1(ETS1),and receptor activator of nuclear factor-κB ligand(RANKL)formed a signaling axis implicated in NONFH pathogenesis.BZF treatment alleviated joint inflammation,preserved trabecular bone morphology,reduced bone loss,and promoted bone repair.Mechanistically,BZF significantly downregulated the expression of PKCA,RAS,ERK,ETS1,and RANKL,improved blood circulation,and inhibited osteoclast activation while promoting osteoblast activation.Conclusion:BZF may promote bone repair in advanced NONFH by enhancing blood circulation and modulating the PKC-RAS-ERK-ETS1-RANKL signaling axis,thereby reversing dysregulated bone metabolism.

Objective To identify specific behaviors detrimental to language development in parent-child inter-actions among Mandarin-speaking infants and toddlers with language delays,and to provide a foundation for develo-ping parent-involved early intervention programs that enhance language acquisition.Methods A qualitative research design was used,employing interaction analysis and categorical analysis methods.Observations from 30 parent-child interaction videos involving children with delayed language development were analyzed to identify common detrimen-tal behaviors(coding).The validity of the qualitative findings was tested by analyzing 108 parent-child where low-quality parental interactions were identified and provided with five rounds of constructive feedback.Results Two major categories of detrimental behaviors with three aspects and a total of 10 issues were identified:5 issues related to parental interaction skills,3 issues related to mutual influences between parent and child,and 2 issues related to the interaction environment.After 5 rounds of feedback,detrimental behaviors in the 108 parent-child pairs im-proved significantly,with 8 behaviors met the 80％stability standard.Conclusion The study identified and catego-rized behaviors in parent-child interactions that hinder language development in children with language delays.Video-based behavior analysis and feedback can enhance parental interaction skills and create a conductive environ-ment for early language development.

Cancer cachexia is a complex syndrome caused by multiple factors,which seriously affects the quality of life and prognosis of patients.Its overall pathogenesis is related to the deficiency of spleen qi,insufficiency of kidney essence,internal generation of turbid toxins,and the obstruction of the production of qi,blood and essential qi,which cannot nourish the muscles and bones.Under the guidance of the dynamic diagnosis and treatment system of"spleen and kidney exhaustion as the root cause and internal accumulation of turbid toxins as the manifestation",the overall regulation is carried out from four dimensions:opening and closing the spleen and stomach,nourishing the kidney and promoting transportation,transforming turbid toxins and detoxification,and tonifying qi and nourishing yin.It has shown unique value in the intervention of cancer cachexia and can provide ideas and references for the clinical practice of TCM in treating cancer cachexia.

Background: Bushen Zhuanggu Formula (BZF), derived from the classic Yougui Pills, has shown favorable clinical efficacy in treating advanced nontraumatic osteonecrosis of the femoral head (NONFH), particularly by promoting bone repair. However, its underlying mechanisms remain unclear. Objective: This study aimed to explore the mechanisms by which BZF promotes bone repair in advanced NONFH. Materials and methods: A total of 518 potential BZF targets were identified from the ETCM v2.0 database. Transcriptomic profiling of clinical cohorts revealed 485 differentially expressed genes in advanced NONFH patients compared to healthy controls. A drug target-disease gene interaction network was constructed to identify candidate BZF targets involved in NONFH pathogenesis. In vivo experiments were conducted to validate the effects of BZF in a rat model of advanced NONFH. Results: Network analysis identified key pathways associated with blood circulation obstruction, immune-inflammatory imbalance, and abnormal bone metabolism. Protein kinase C alpha (PKCA), Ras proto-oncogene (RAS), mitogen-activated protein kinase 3(ERK), ETS proto-oncogene 1 (ETS1), and receptor activator of nuclear factor-κB ligand (RANKL) formed a signaling axis implicated in NONFH pathogenesis. BZF treatment alleviated joint inflammation, preserved trabecular bone morphology, reduced bone loss, and promoted bone repair. Mechanistically, BZF significantly downregulated the expression of PKCA, RAS, ERK, ETS1, and RANKL, improved blood circulation, and inhibited osteoclast activation while promoting osteoblast activation. Conclusion: BZF may promote bone repair in advanced NONFH by enhancing blood circulation and modulating the PKC-RAS-ERK-ETS1-RANKL signaling axis, thereby reversing dysregulated bone metabolism.

Cancer cachexia is a complex syndrome caused by multiple factors,which seriously affects the quality of life and prognosis of patients.Its overall pathogenesis is related to the deficiency of spleen qi,insufficiency of kidney essence,internal generation of turbid toxins,and the obstruction of the production of qi,blood and essential qi,which cannot nourish the muscles and bones.Under the guidance of the dynamic diagnosis and treatment system of"spleen and kidney exhaustion as the root cause and internal accumulation of turbid toxins as the manifestation",the overall regulation is carried out from four dimensions:opening and closing the spleen and stomach,nourishing the kidney and promoting transportation,transforming turbid toxins and detoxification,and tonifying qi and nourishing yin.It has shown unique value in the intervention of cancer cachexia and can provide ideas and references for the clinical practice of TCM in treating cancer cachexia.

Objective To analyze the epidemiological characteristics of aggregative vomiting and diarrhea outbreak in Jing'an District of Shanghai in 2017 and 2018，and provide data support for further development of effective prevention and control measures. Methods A descriptive epidemiological method was used to analyze aggregative vomiting and diarrhea outbreak data in Jing'an District in 2017 and 2018. Results A total of 49 outbreaks were reported in Jing'an District in 2017 and 2018，involving 565 cases，with the overall attack rate of 1.89%. The median duration of the outbreak was 5 days and outbreaks mainly occurred in spring and autumn. The attack rate in kindergartens was higher than that in primary and secondary schools, while the total number of outbreak cases in kindergartens was less. The main clinical symptoms of the cases were vomiting, with a higher proportion than that of diarrhea and fever. The vomiting proportion was higher in kindergartens and elementary schools, while the diarrhea proportion was higher in middle schools. Conclusion There were some differences in the epidemic characteristics between kindergartens and primary and secondary schools, therefore different control measures should be adopted according to the characteristics of different institutions. The outbreaks were mainly spread through human-to-human transmission. Early detection and early reporting of epidemics in collective institutions had a positive impact on the control of the spread of the epidemic.