ObjectiveTo explore the role of the histone deacetylase Sirtuin-1 （SIRT1）/p53 signaling pathway in promoting apoptosis of non-small cell lung cancer cells （NSCLC） induced by the co-stimulatory molecule B7 homolog 3 （B7-H3）. MethodsThe GEPIA 2 platform was used for survival analysis of NSCLC patients based on B7⁃H3 gene expression levels. The Gene Enrichment Analysis （GSEA） method was used to analyze the enrichment characteristics of B7⁃H3 molecules in the gene set of cell apoptosis. In the non-small cell lung cancer A549 cell line， B7⁃H3 was knocked down， and the protein expression levels of SIRT1 and p53 were detected by Western blot. B7⁃H3 was overexpressed in A549 cells and the apoptosis rate was analyzed by flow cytometry after Annexin V/PI double staining. Overexpression of B7⁃H3 and knockdown of SIRT1 were performed in A549 cell line. The expression levels of p53 and apoptosis-related proteins B-cell lymphoma/leukemia-2 （Bcl-2） and Bcl-2-associated X protein （Bax） were detected respectively by Western blot. Cell apoptosis rate was analyzed by flow cytometry after Annexin V/PI double staining. ResultsThe overall survival of the B7-H3 high-expression group was significantly lower than that of the low-expression group （P<0.01）. B7-H3 was significantly enriched in the cell apoptosis signaling pathway and the p53 signaling pathway （P<0.05）. Compared with the control group， the expression of SIRT1 was significantly downregulated， and p53 was significantly upregulated in the B7⁃H3 knockdown group （both P<0.001）. Overexpression of B7-H3 significantly up-regulated SIRT1 protein expression （P<0.05）， down-regulated p53 expression （P<0.01）， and markedly increased the Bcl-2/Bax ratio of apoptosis-related proteins （P<0.001）. The results of Annexin V/PI double staining showed that the apoptosis rate of A549 cells with overexpressed B7⁃H3 decreased （the apoptosis rate of the control group was 26.72%±4.13%， while that of the B7⁃H3 overexpression group was 13.87%±0.82%； P<0.01）. In B7-H3-overexpressing cell lines， SIRT1 knockdown significantly reversed apoptosis （P<0.05）， up-regulated p53 protein expression （P<0.001）， and markedly reduced the Bcl-2/Bax ratio （P<0.001）. ConclusionB7-H3 molecule inhibits the apoptosis of non-small cell lung cancer cells via the SIRT1/p53 signaling pathway.

Objective: To compare the in vitro quality differences of leukoreduced pooled concentrated platelets prepared from whole blood preserved at different temperatures and for various durations, determine the safe time window for refrigerated whole blood in platelet preparation, and provide experimental evidence for optimizing blood component preparation procedures and improving the comprehensive utilization rate of blood resources. Methods: A total of 324 units of 400 mL ACD-B anticoagulated whole blood were randomly divided into two groups and stored at 4℃ and 22℃, respectively. The buffy coat was separated at three time intervals: <6 h, 6-12 h, and >12 h (≤18 h) post-collection, and allowed to rest overnight at 22℃. On the following day, the buffy coats from each group were pooled to prepare leukoreduced pooled platelet concentrates (LPPCs). Cell counts were performed, and metabolic parameters including pH, glucose, and lactate levels were measured to evaluate metabolic status. Platelet in vitro function and activation were assessed by thromboelastography (TEG), platelet aggregation rate, and the expression of PAC-1 and CD62P. The differences between the two groups were compared. Results: For pooled concentrated platelets prepared from whole blood stored at 4℃ and 22℃ for <6 h and 6-12 h, there were no significant differences in platelet count, pH, glucose levels, lactic acid levels, thromboelastography (TEG), platelet aggregation rate, or platelet activation rate (P>0.05). With prolonged refrigeration time of whole blood, compared with pooled concentrated platelets prepared from whole blood stored at 22℃ for >12 h but ≤18 h, those prepared from whole blood stored at 4℃ for >12 h but ≤18 h showed a decreased platelet count (1 152.83±180.08 vs 1 368.83±134.86, P=0.040), a significantly increased ADP-induced aggregation rate (26.82±6.59 vs 13.88±10.21, P=0.030), and significantly elevated expression rates of PAC-1 and CD62P (72.64±6.74 vs 63.28±5.97, P=0.030). However, there were no significant differences in pH, glucose content, lactate content, or thromboelastography (P>0.05). Conclusion: There was no significant difference in the in vitro count, function, or activation of pooled concentrated platelets prepared from whole blood stored at 4℃ and 22℃ within 12 hours. However, statistically significant differences were observed between the mixed concentrated platelets prepared from whole blood stored at 4℃ and those stored at 22℃ for more than 12 hours but not exceeding 18 hours. These findings can provide a reference for the preparation methods and clinical application of refrigerated platelets.

Based on the theory of diseased collaterals and the progression pattern of diabetic kidney disease （DKD）， this paper proposes a staged treatment system based on the "three states of kidney collaterals" including collateral distention， collateral bi （痹） and collateral accumulation. In the collateral distention stage， the primary pathogenesis is heat damaging the kidney collaterals and collateral vessel dilation， corresponding to the early state of DKD characterized by hyperfiltration and microalbuminuria； the clearing method is suggested， and Shenling Jiangtang Formula （参苓降糖方） can be used to promote the remission of proteinuria by ameliorating insulin resistance and regulating intestinal microecology. In the collateral bi stage， the core pathogenesis lies in the binding of phlegm and stasis， and the formation of concretions and conglomerations in the kidney collaterals， corresponding to massive proteinuria and the decline of renal function， for which the unblocking method should be taken， using Jinchan Yishen Tongluo Formula （金蝉益肾通络方） and Qingre Xiaozheng Formula （清热消癥方） to alleviate renal pathological damage by regulating the autophagy-lysosome pathway and repairing mitochondrial energy metabolism. The collateral accumulation stage is characterized by the internal retention of turbid toxins and accumulations of concretions in the kidney collaterals， corresponding to renal fibrosis and end-stage renal disease （ESRD）； the dispersion method is suggested， and Yiqi Tongluo Xiezhuo Formula （益气通络泄浊方） and Shenyan Fangshuai Fluid （肾炎防衰液） can be used to inhibit extracellular matrix accumulation and delay the progressive loss of renal function. Collateral deficiency runs through the entire course of the disease and is closely related to cellular senescence and the imbalance of the ubiquitin-proteasome/autophagy system. The concept of the "three states of kidney collaterals" integrates the evolution of traditional Chinese medicine pathogenesis with modern pathological staging， forming a whole-course intervention system of "staging-syndrome differentiation-target-formula"， thereby providing novel insights for prevention and treatment of DKD using integrated traditional Chinese and western medicine.

This paper proposes a five-in-one diagnosis and treatment model of "disease-mechanism-syndrome-symptom-method" based on treatment guided by mechanism differentiation. The model consists of five component including disease identification， mechanism differentiation， syndrome differentiation， symptom differentiation， and the formulation of therapeutic strategies. Disease identification refers to the diagnosis of diseases in both traditional Chinese medicine （TCM） and western medicine， aiming to clarify disease progression rules. Mechanism differentiation focuses on grasping the essential characteristics of the disease. Syndrome differentiation emphasizes the stage-specific features of disease evolution. Symptom differentiation highlights the patient's most urgent complaints and suffering. Finally， a comprehensive therapeutic strategy is developed， including internal medication， external applications， and non-pharmacological therapies. The five components of "disease-mechanism-syndrome-symptom-method" are organized in a sequential and progressive manner， forming an integrated whole that spans the entire diagnostic and therapeutic process.Disease identification represents the starting point， while mechanism differentiation serves as the core， and therapeutic formulation is the endpoint of the model， with the aim of achieving more precise treatment and improving clinical efficacy.

This paper proposes a five-in-one diagnosis and treatment model of "disease-mechanism-syndrome-symptom-method" based on treatment guided by mechanism differentiation. The model consists of five component including disease identification， mechanism differentiation， syndrome differentiation， symptom differentiation， and the formulation of therapeutic strategies. Disease identification refers to the diagnosis of diseases in both traditional Chinese medicine （TCM） and western medicine， aiming to clarify disease progression rules. Mechanism differentiation focuses on grasping the essential characteristics of the disease. Syndrome differentiation emphasizes the stage-specific features of disease evolution. Symptom differentiation highlights the patient's most urgent complaints and suffering. Finally， a comprehensive therapeutic strategy is developed， including internal medication， external applications， and non-pharmacological therapies. The five components of "disease-mechanism-syndrome-symptom-method" are organized in a sequential and progressive manner， forming an integrated whole that spans the entire diagnostic and therapeutic process.Disease identification represents the starting point， while mechanism differentiation serves as the core， and therapeutic formulation is the endpoint of the model， with the aim of achieving more precise treatment and improving clinical efficacy.

Diabetic kidney disease(DKD)is one of the serious complications of diabetes.Ferroptosis causes pathological damage and is involved in the progression of DKD.How to inhibit ferroptosis and delay DKD is a new academic hotspot.The author's team further enriched and proposed the core pathogenesis theory of"internal heat induced disease"on the basis of the traditional DKD"yin deficiency and dryness-heat"theory,and explained the general development law of DKD.In this article,"internal heat"and"Zhengjia"in the theory of DKD"internal heat induced diseases"are used as the starting point to explore the relationship of the main pathological damage of ferroptosis such as activating inflammatory response,enhancing oxidative stress,promoting fibrosis and so on with the internal mechanism of the theory of"internal heat induced diseases",further explained the scientific connotation of DKD"internal heat induced diseases",in order to provide ideas and theoretical basis for the TCM prevention and treatment of DKD.

Diabetic kidney disease （DKD） is one of the main causes of chronic kidney disease. Both traditional Chinese medicine （TCM） and western medicine have their own advantages in the prevention and treatment of DKD， but there are also many difficulties. By analysis of the difficulties faced by TCM and western medicine in the differentiation and treatment of DKD， based on the theory of "miniature masses in the renal collaterals"， combined with long-term clinical practice， "internal heat leading to mass" is proposed as the core pathogenesis of DKD. Therefore， a trinity model of "disease-syndrome-symptom" for differentiation and treatment of DKD based on the core pathogenesis has been proposed. This model highlights the status of the core pathogenesis of "internal heat leading to mass" in DKD， and conducts a three-dimensional identification from the perspectives of disease， syndrome and symptom， so as to inspire clinical practice.

Objective: To understand the home reading-writing levels among children and adolescents in Shanghai after school, and to explore its association with screening myopia, so as to provide a scientific basis for the prevention and control of myopia. Methods: From April to December 2024, 641 primary and middle school students were recruited from 2 urban schools and 1 rural school in Shanghai to participate in the survey. An illuminance meter was used to measure the illuminance of home reading-writing activities after school. Screening myopia was determined through visual acuity examination and refractive detection under non ciliary muscle paralysis conditions among children and adolescents. A binary Logistic regression model was used to analyze the association between home reading-writing illuminance and screening myopia. Results: The detection rate of screening myopia among children and adolescents in Shanghai was 59.9%. The median home reading-writing illuminance after school was 340.9(112.2, 753.5) lx, and 45.4% was found of less than 300 lx. The family illuminance in the primary school stage [432.0 (136.9, 837.0) lx] was higher than that in the junior high school stage [113.1(53.7, 375.1) lx], and main urban area group [503.9 (212.6, 969.5) lx] was higher than that in the rural group [141.6 (53.7, 416.9) lx], the differences were statistically significant (Z=-7.56, -9.95,both P<0.05). The results of Logistic regression analysis showed that compared with the family illuminance of 150-500 lx, children and adolescents with family illuminance<150 and >500 lx had increased risks of screening myopia detection[OR(95%CI)=1.56(1.01-2.42), 1.74(1.15-2.62),both P<0.05]. Conclusions The home reading-writing illuminance after school is suboptimal. Both excessively low and high home reading-writing illuminance levels are associated with screen-detected myopia. It is necessary for children and adolescents to improve lighting conditions during evening reading-writing activities, and strengthen health education according to different regions and school stages.

Objective : To establish an enzyme-linked immunosorbent assay (ELISA) for exosome B7-H3 in plas- ma , and to explore the clinical significance and diagnostic value of exosome B7-H3 in plasma from non-small cell lung cancer (NSCLC) . Methods : The plasma of 70 NSCLC patients (NSCLC group) and 36 healthy controls (HC group) were collected . Exosomes and microvesicles in plasma were separated by ultra-fast centrifuge method , and the expression levels of B7-H3 in plasma exosomes in NSCLC groups and HC groups were compared by Western blot method . In NSCLC group , the expression levels of B7-H3 in plasma exosomes and microvesicles in NSCLC group were compared . A simple and feasible ELISA method was established to detect the expression level of exosome B7 - H3 in plasma by means of polyethylene glycol (PEG) precipitation and its clinical significance was analyzed . Lo- gistic regression model was established to predict plasma-derived exosome B7-H3 as a risk factor , and receiver op- erating characteristic curve (ROC) was used to investigate the diagnostic value of exosome B7-H3 in NSCLC . Results: For exosomes and microvesicles in plasma which were extracted by ultracentrifugation , Western blot results showed that the expression level of B7-H3 in plasma exosomes of NSCLC group was higher than that of HC group (P = 0. 032) , and the expression level of B7-H3 in plasma exosomes was higher than that of microvesicles of NSCLC group (P = 0. 012) . The expression level of exosome B7-H3 in plasma extracted by PEG precipitation was also higher in NSCLC group than that in HC group (P = 0. 024) . The expression level of exosome B7-H3 in plasma of NSCLC patients was not related to gender , age , smoking or pathological type , but was related to T stage (P = 0. 002) , N stage (P < 0. 001) , M stage (P = 0. 010) and AJCC stage (P < 0. 001) . Multivariate Logistic regres- sion analysis identified exosome B7-H3 in plasma as a risk factor for NSCLC . ROC analysis showed that the sensi- tivity of exosome B7-H3 in plasma for the diagnosis of NSCLC (0. 843) was higher than that of carcinoembryonic antigen (CEA) (0. 743) , whereas the specificity (0. 722) was lower than that of CEA (0. 833) . Combined de- tection of exosome B7-H3 and CEA (AUC = 0. 928 , 95% CI:0. 877 - 0. 979) had a higher diagnostic performance for NSCLC . Conclusion B7-H3 in plasma exosomes is related to the cancer staging of NSCLC , and the combined detection of exosome B7-H3 and CEA in plasma is conducive to the laboratory diagnosis of NSCLC .

Objective To observe the mechanism of action of electroacupuncture at Neiguan(PC6)points for alleviating lipopolysaccharide(LPS)-induced myocadial dysfunction in sepsis model mice.Methods Forty-eight male C57BL/6 mice were randomly divided into four groups,namely normal control group,saline+electroacupuncture group,sepsis model group,and sepsis+electroacupuncture group.The rats in the sepsis model group and sepsis+electroacupuncture group were given intraperitoneal injection of LPS(5 mg/kg)to induce the sepsis model.The mice were treated with electroacupuncture immediately after injection.At hour 6 after the LPS intervention,the left ventricular short-axis end-systolic diameter(LVIDs)and fractional shortening(FS)of the left ventricular were monitored by color doppler echocardiography.The levels of inflammatory factors such as tumor necrosis factor alpha(TNF-α)and interleukin 6(IL-6)in serum were detected by enzyme-linked immunosorbent assay(ELISA),and the protein expression levels of Rho-kinase(ROCK)1 and ROCK2,and phosphorylation levels of myosin phosphatase substrate 1(MYPT1)and myosin light chain 2(MLC2)in cardiac tissues were detected by Western Blot.Results Compared with the normal control group,the LVIDs in mice in the sepsis model group was increased(P<0.05),FS was decreased(P<0.05),the levels of TNF-α and IL-6 in serum were all elevated(P<0.001),and the level of phosphorylation of MYPT1,a substrate of ROCK,in cardiac tissues was significantly elevated(P<0.05);compared with the sepsis model group,the LVIDs in the sepsis+electroacupuncture group was decreased(P<0.05),FS was increased(P<0.05),the levels of TNF-α and IL-6 in serum were decreased(P<0.05 or P<0.01),and the phosphorylation level of MYPT1 was significantly reduced(P<0.05),and the protein expression levels of ROCK1 and ROCK2 as well as the phosphorylation level of MLC2 had no significant differences(P>0.05).Conclusion Electroacupuncture at Neiguan points may reduce systemic and local inflammatory reaction levels in mice with sepsis model to improve cardiac function through inhibiting the activation of Rho/ROCK signaling pathway in cardiac tissues,thus producing myocardial protection efficacy.