Childhood simple obesity has become a significant public health issue in China. Modern medicine primarily relies on lifestyle interventions and often suffers from poor long-term compliance， while pharmacological options are limited and associated with potential adverse effects. Traditional Chinese Medicine （TCM） has a long history in the prevention and management of this condition， demonstrating eight distinct advantages， including systematic theoretical foundation， diversified therapeutic approaches， definite therapeutic efficacy， high safety profile， good patient compliance， comprehensive intervention strategies， emphasis on prevention， and stepwise treatment protocols. Additionally， TCM is characterized by six distinctive features： the use of natural medicinal substances， non-invasive external therapies， integration of medicinal dietetics， simple exercise regimens， precise syndrome differentiation， and diverse dosage forms. By combining internal and external treatments， TCM facilitates individualized regimen adjustment and holistic regulation， demonstrating remarkable effects in improving obesity-related metabolic indicators， regulating constitutional imbalance， and promoting healthy behaviors. However， challenges remain， such as inconsistent operational standards， insufficient high-quality clinical evidence， and a gap between basic research and clinical application. Future efforts should focus on accelerating the standardization of TCM diagnosis and treatment， conducting multicenter randomized controlled trials， and fostering interdisciplinary integration， so as to enhance the scientific validity and international recognition of TCM in the prevention and treatment of childhood obesity.

BACKGROUND:Wogonin is a flavonoid extracted from the root of Scutellaria baicalensis.Previous studies have shown that baicalein has protective effects against cerebral ischemia-reperfusion injury,and can also reduce blood sugar and complications in diabetic mice,but its role and mechanism in diabetic cerebral infarction remain unclear. OBJECTIVE:To explore the effect of wogonin on nerve injury in rats with diabetic cerebral infarction and its mechanism. METHODS:Sprague-Dawley rats were randomly divided into six groups:control group,model group,low-dose wogonin group,medium-dose wogonin group,high-dose wogonin group,and high-dose wogonin+Ras homolog gene family member A(RhoA)activator group.Except for the control group,the other rats were established with diabetes and cerebral ischemia models using intraperitoneal injection of streptozotocin and middle cerebral artery occlusion.Low,medium-and high-dose wogonin groups were intragastrically given 10,20,40 mg/kg wogonin,respectively;high-dose wogonin+RhoA activator group was intragastrically given 40 mg/kg wogonin and intraperitoneally injected 10 mg/kg lysophosphatidic acid;control group and model group were given the same amount of normal saline once a day for 7 consecutive days.Rats in each group were evaluated for neurological deficits and their blood glucose levels were measured after the last dose.TTC staining was applied to detect the volume of cerebral infarction.Hematoxylin-eosin staining was applied to observe pathological changes in brain tissue.ELISA kit was applied to detect tumor necrosis factor-α,interleukin-6,malondialdehyde,and superoxide dismutase levels in brain tissue.Western blot was applied to detect the protein expression of RhoA and Rho-associated protein kinase(ROCK)2 in brain tissue. RESULTS AND CONCLUSION:Compared with the control group,the neuronal structure of rats in the model group was severely damaged,with cell necrosis and degeneration,the neurological deficit score,blood glucose level,and infarct volume were significantly elevated(P<0.05),the levels of tumor necrosis factor-α,interleukin-6,and malondialdehyde,and the protein expression of RhoA and ROCK2 in brain tissue were significantly increased(P<0.05),and the superoxide dismutase level was decreased(P<0.05).Compared with the model group,the low-,medium-,and high-dose wogonin groups showed improved neuronal damage,reduced cell degeneration and necrosis,a significant reduction in neurological deficit score,blood glucose level,infarct volume,and the levels of tumor necrosis factor-α,interleukin-6,and malondialdehyde,and the protein expression of RhoA and ROCK2 in brain tissue,and an increase in the superoxide dismutase level(P<0.05).Compared with the high-dose wogonin group,the high-dose wogonin+RhoA activator group significantly weakened the improvement in the above indexes of rats with diabetic cerebral infarction(P<0.05).To conclude,wogonin can improve the blood glucose level in rats with diabetic cerebral infarction,reduce cerebral infarction and nerve injury,and its mechanism may be related to the inhibition of RhoA/ROCK signaling pathway.

Objective To investigate the expression of calumenin(CALU)in gastric cancer and its effect on metastasis and invasion of gastric cancer,and analyze its relationship with the prognosis of gastric cancer patients.Methods The Cancer Genome Atlas(TCGA)database was used to analyze the expression level of CALU in gastric cancer and its impact on patient prognosis.A total of 102 pairs of gastric cancer and paracancerous tissue samples were collected from 189 gastric cancer patients who underwent partial gastrectomy in First Affiliated Hospital of Army Medical University from January 2018 to December 2022.The expression of CALU in gastric cancer and paracancerous tissues was detected by immunohistochemical assay,and the relationship of its expression with clinicopathological parameters was statistically analyzed.After gastric cancer cells with CALU knockdown and overexpression were constructed,and the efficiencies of knockdown and overexpression were evaluated by Western blotting as well as RT-qPCR.Transwell assay was applied to determine the effect of CALU on the migration and invasion abilities of gastric cancer cells.Results Bioinformation analysis found that CALU was significantly highly expressed in gastric cancer tissues(P<0.05),and its expression level was negatively correlated with the prognosis of patients(P<0.05).Immunohistochemical results showed that the expression level of CALU was obviously highly in gastric cancer tissues than the paracancerous tissues(P<0.01),and its level was positively correlated with the depth of infiltration(P<0.01),lymph node metastasis(P<0.01),and TNM stage(P<0.05).Statistical analysis revealed that the clinical data of 102 patients showed that CALU expression was positively correlated with the TNM stage(P=0.021)and T stage(P<0.001)and N stage(P=0.028).CALU knockdown significantly inhibited the migration and invasion abilities of gastric cancer cells(P<0.01),while over-expression obtained the opposite results.Conclusion CALU is highly expressed in gastric cancer tissues and promotes metastasis and invasion of gastric cancer and thus leads to poor prognosis in patients.

Purpose To explore the role and mechanism by which the forkhead box C1(FOXC1)promoter up-stream transcript(FOXCUT)regulates proliferation and invasion of non-small cell lung carcinoma(NSCLC)cells.Methods Bioinformatic analysis and RT-qPCR were used to quantify FOXCUT expression in NSCLC tissues.After FOXCUT knockdown in NSCLC cell lines,cell proliferation was examined using CCK-8 and EdU assays,and invasion was evaluated by Transwell assay.The expression of E-cadherin,vimentin,N-cadherin,and FOXC1 was detected by Western blot.FOXCUT-silenced H460 cells were constructed using lentiviruses and subcutaneously injected into nude mice to observe tumor growth.To rescue FOXC1 expression,an FOXC1 expression plasmid was transfected into FOX-CUT-knockdown cells.LncBook 2.0,ENCORI,and TargetScan databases were queried to predict miRNAs that inter-act with FOXCUT and FOXC1.Results FOXCUT expression was significantly higher in NSCLC tissues than in normal lung tissues(normal:0.24±0.22 vs NSCLC:0.68±0.76,t=5.94,P＜0.001),and patients with high FOXCUT expression had a poorer prognosis(P＜0.01).FOXCUT interference markedly repressed NSCLC cells' proliferation and invasion(P＜0.01).FOXCUT knockdown significantly upregulated E-cadherin and downregulated vimentin and N-cadherin(P＜0.01).In vivo,FOXCUT-silenced cells formed significantly smaller tumors in nude mice(P＜0.01).FOXCUT knockdown markedly reduced FOXC1 expression(P＜0.01).Overexpression of FOXC1 in FOX-CUT-depleted cells rescued cell proliferation(P＜0.01).Bioinformatic analysis identified 8 miRNAs potentially co-regulated by FOXCUT and FOXC1.Conclusion Knockdown of FOXCUT restrains NSCLC cell proliferation and inva-sion,possibly through suppression of FOXC1 expression.

In recent years,immune checkpoint inhibitor(ICI)has led to substantial advances in the treatment of recurrent or metastatic advanced cutaneous melanoma(CM),significantly prolonging overall survival.However,due to the biological heterogeneity across melanoma subtypes,the degree of immune responsiveness varies considerably.In particular,acral melanoma(AM)(the predominant melanoma subtype in Asian populations,including China)has demonstrated limited benefit from ICI therapy,especially in the context of monotherapy.Currently,no systematic staging and standardized treatment guidelines are available for AM,and clinical evidence supporting the use of ICI in this rare subtype remains insufficient.In the neoadjuvant setting,several large phase Ⅱ/Ⅲ international trials in CM,including SWOG 1801 and NADINA,have shown that ICI-based neoadjuvant combination therapy significantly improves pathological response rates compared with traditional adjuvant approaches.Nevertheless,neoadjuvant treatment in AM remains in the exploratory stage.Early-phase clinical studies in resectable stage Ⅲ/Ⅳ AM suggest that toripalimab combined with intratumoral oncolytic virus therapy,or camrelizumab in combination with apatinib and temozolomide,may offer clinical benefit;however,confirmation of long-term survival benefit requires further validation in larger,prospective cohorts.In the adjuvant setting,for AM patients with BRAF mutations,real-world data from China have shown no significant difference in survival outcomes between dabrafenib plus trametinib and programmed death-1(PD-1)inhibitor monotherapy in high-risk resectable stage Ⅲ/Ⅳ disease,although direct head-to-head comparisons are lacking.For patients with resectable stage Ⅲ/Ⅳ wild-type AM,combination adjuvant regimens incorporating PD-1 inhibitors may provide superior recurrence risk reduction and survival benefit compared to monotherapy.In the advanced disease setting,in Chinese populations,the objective response rates of PD-1 inhibitors such as pembrolizumab,toripalimab and penpulimab remain suboptimal in AM.ICI-based combination strategies(including those with chemotherapy,anti-angiogenic agents,dual or triple immune checkpoint blockade)may improve the immune microenvironment and clinical prognosis,but concerns regarding safety and tolerability persist.For patients with ICI-refractory AM,various novel approaches combining immunotherapy,targeted agents and chemotherapy are under investigation.Additionally,several next-generation immunotherapeutic modalities[including T-cell receptor-engineered(TCR-T)therapies,therapeutic cancer vaccines,chimeric antigen receptor T(CAR-T)cell therapy and antibody-drug conjugate(ADC)]are currently in development.This review aimed to provide a comprehensive overview of current clinical evidence on the use of ICI in acral melanoma across the neoadjuvant,adjuvant,and advanced disease settings.We highlighted the efficacy and safety of existing strategies,exploreed emerging combination regimens and predictive biomarkers,and discussed key areas for future research to inform clinical decision-making and optimize outcomes in this challenging melanoma subtype.

Objective To investigate the effect of joint end micro fracture treatment combined with arthroscopy on the long-term effect of ankle joint fusion and the effects on perioperative oxidative stress and complications.Methods 108 patients with end-stage ankle arthritis with internal and external inversion angles with ≤20° matching baseline data from February 2021 to April 2023 were selected.Among them,54 patients underwent arthroscopic ankle fusion as arthroscopic group,54 patients were treated with joint end microfracture combined with arthroscopic ankle joint fusion as improved group.The surgical indexes,perioperative oxidation indexes[malondialdehyde(MDA),total oxidation state(TOS),oxidative stress index(OSI)before surgery,1 d after surgery and 3 d after surgery]and antioxidant indexes[glutathione peroxidase(GSH-Px),superoxide dismutase(SOD),total antioxidant capacity(TAC)before surgery,1 d after surgery and 3 d after surgery]of the two groups were compared.Visual analogue scale(VAS score),American Orthopaedic Foot and Ankle Society(AOFAS score),before surgery,6 months after surgery and 1 year after surgery,excellent and good rate and complications were compared between the two groups,and fusion time and AOFAS score at 1 year after surgery of patients with different internal and external inversion angles were compared between the two groups.Results The intraoperative blood loss in the improved group was less than that in the arthroscopic group,postoperative hospital stay in the improved group was shorter than that in the arthroscopic group,the differences were statistically significant(P＜0.05).The MDA,TOS and OSI levels in the improved group were lower than those in the arthroscopic group on day 1 and day 3 after operation,the differences were statistically significant(P＜0.05).The GSH-Px,SOD and TAC levels in the improved group were significantly higher than those in the arthroscopic group at 1 and 3 days after surgery,the differences were statistically significant(P＜0.05).The VAS score and AOFAS score at 6 months and 1 year after surgery in the improved group were not significantly different from those in the arthroscopic group(P＞0.05).Comparison of the excellent rate of patients in the two groups,the difference was not statistically significant(P＞0.05).The total complication rate of the improved group was significantly lower than that of the arthroscopic group,the difference was statistically significant(P＜0.05).There was no significant difference in AOFAS scores between patients with 10°～20° and patients with＜10° at 1 year after surgery(P＞0.05).The fusion time of patients with internal and external inversion angles 10°～20° was longer than that of patients with＜10°(P＜0.05).Conclusion Joint end microfracture treatment combined with arthroscopy ankle fusion for end-stage ankle arthritis with ≤20° internal and external varus can avoid bone grafting and osteotomy with satisfactory efficacy,and has advantages in reducing intraoperative bleeding and complications,alleviating perioperative oxidative stress,and accelerating postoperative recovery.However,when internal and external varus malformations are obvious,the time of osseous fusion can be prolonged.

In recent years,immune checkpoint inhibitor(ICI)has led to substantial advances in the treatment of recurrent or metastatic advanced cutaneous melanoma(CM),significantly prolonging overall survival.However,due to the biological heterogeneity across melanoma subtypes,the degree of immune responsiveness varies considerably.In particular,acral melanoma(AM)(the predominant melanoma subtype in Asian populations,including China)has demonstrated limited benefit from ICI therapy,especially in the context of monotherapy.Currently,no systematic staging and standardized treatment guidelines are available for AM,and clinical evidence supporting the use of ICI in this rare subtype remains insufficient.In the neoadjuvant setting,several large phase Ⅱ/Ⅲ international trials in CM,including SWOG 1801 and NADINA,have shown that ICI-based neoadjuvant combination therapy significantly improves pathological response rates compared with traditional adjuvant approaches.Nevertheless,neoadjuvant treatment in AM remains in the exploratory stage.Early-phase clinical studies in resectable stage Ⅲ/Ⅳ AM suggest that toripalimab combined with intratumoral oncolytic virus therapy,or camrelizumab in combination with apatinib and temozolomide,may offer clinical benefit;however,confirmation of long-term survival benefit requires further validation in larger,prospective cohorts.In the adjuvant setting,for AM patients with BRAF mutations,real-world data from China have shown no significant difference in survival outcomes between dabrafenib plus trametinib and programmed death-1(PD-1)inhibitor monotherapy in high-risk resectable stage Ⅲ/Ⅳ disease,although direct head-to-head comparisons are lacking.For patients with resectable stage Ⅲ/Ⅳ wild-type AM,combination adjuvant regimens incorporating PD-1 inhibitors may provide superior recurrence risk reduction and survival benefit compared to monotherapy.In the advanced disease setting,in Chinese populations,the objective response rates of PD-1 inhibitors such as pembrolizumab,toripalimab and penpulimab remain suboptimal in AM.ICI-based combination strategies(including those with chemotherapy,anti-angiogenic agents,dual or triple immune checkpoint blockade)may improve the immune microenvironment and clinical prognosis,but concerns regarding safety and tolerability persist.For patients with ICI-refractory AM,various novel approaches combining immunotherapy,targeted agents and chemotherapy are under investigation.Additionally,several next-generation immunotherapeutic modalities[including T-cell receptor-engineered(TCR-T)therapies,therapeutic cancer vaccines,chimeric antigen receptor T(CAR-T)cell therapy and antibody-drug conjugate(ADC)]are currently in development.This review aimed to provide a comprehensive overview of current clinical evidence on the use of ICI in acral melanoma across the neoadjuvant,adjuvant,and advanced disease settings.We highlighted the efficacy and safety of existing strategies,exploreed emerging combination regimens and predictive biomarkers,and discussed key areas for future research to inform clinical decision-making and optimize outcomes in this challenging melanoma subtype.

Objective:To analyze the psychometric properties of the short-form Extended Barthel Index (EBI) in assessing ability in the activities of daily living (ADL).Methods:Data describing 295 discharged patients with stroke or traumatic brain injury were collected retrospectively, including their demographics, diagnoses, and functional assessments (EBI, FIM, MBI and MoCA). Then, data on 120 of them were used to construct short-form EBI models based on item-total advantage indices, while the remaining 175 patients served as a validation set to evaluate the acceptability, responsiveness, reliability, validity, and outcome consistency of the models. The optimal model was selected as the recommended short-form EBI.Results:The short-form EBI comprises seven items: personal hygiene, dressing/undressing, wheelchair-bed transfer, walking, social interaction during walking, problem-solving, and memory/learning/orientation, with each item scored 0-4 (total range: 0-28). The short-form EBI demonstrated good acceptability, with median and mean scores near the scale′s midpoint and no significant ceiling or floor effects. Its responsiveness (d=0.19) surpassed that of the original EBI (d=0.14). Moreover, the short-form EBI showed excellent reliability (Cronbach′s α=0.885; SEM=9.11) and validity, explaining 95.4% of the variance in EBI scores (adj. R 2=0.954). Concurrent validity with the EBI was strong (ρ=0.975, P≤0.001), and criterion validity with ρ=0.956 for FIM, 0.889 for MBI, and 0.806 for MoCA. The short-form and the original EBI exhibited good agreement [ICC=0.967 (95% CI: 0.769-0.989); score difference: 6.48±6.56]. Conclusions:The short-form EBI demonstrates excellent acceptability, responsiveness, reliability, validity, and outcome consistency, making it a practical tool for ADL assessment in cases of stroke or traumatic brain injury.

Objective To investigate the effect of joint end micro fracture treatment combined with arthroscopy on the long-term effect of ankle joint fusion and the effects on perioperative oxidative stress and complications.Methods 108 patients with end-stage ankle arthritis with internal and external inversion angles with ≤20° matching baseline data from February 2021 to April 2023 were selected.Among them,54 patients underwent arthroscopic ankle fusion as arthroscopic group,54 patients were treated with joint end microfracture combined with arthroscopic ankle joint fusion as improved group.The surgical indexes,perioperative oxidation indexes[malondialdehyde(MDA),total oxidation state(TOS),oxidative stress index(OSI)before surgery,1 d after surgery and 3 d after surgery]and antioxidant indexes[glutathione peroxidase(GSH-Px),superoxide dismutase(SOD),total antioxidant capacity(TAC)before surgery,1 d after surgery and 3 d after surgery]of the two groups were compared.Visual analogue scale(VAS score),American Orthopaedic Foot and Ankle Society(AOFAS score),before surgery,6 months after surgery and 1 year after surgery,excellent and good rate and complications were compared between the two groups,and fusion time and AOFAS score at 1 year after surgery of patients with different internal and external inversion angles were compared between the two groups.Results The intraoperative blood loss in the improved group was less than that in the arthroscopic group,postoperative hospital stay in the improved group was shorter than that in the arthroscopic group,the differences were statistically significant(P＜0.05).The MDA,TOS and OSI levels in the improved group were lower than those in the arthroscopic group on day 1 and day 3 after operation,the differences were statistically significant(P＜0.05).The GSH-Px,SOD and TAC levels in the improved group were significantly higher than those in the arthroscopic group at 1 and 3 days after surgery,the differences were statistically significant(P＜0.05).The VAS score and AOFAS score at 6 months and 1 year after surgery in the improved group were not significantly different from those in the arthroscopic group(P＞0.05).Comparison of the excellent rate of patients in the two groups,the difference was not statistically significant(P＞0.05).The total complication rate of the improved group was significantly lower than that of the arthroscopic group,the difference was statistically significant(P＜0.05).There was no significant difference in AOFAS scores between patients with 10°～20° and patients with＜10° at 1 year after surgery(P＞0.05).The fusion time of patients with internal and external inversion angles 10°～20° was longer than that of patients with＜10°(P＜0.05).Conclusion Joint end microfracture treatment combined with arthroscopy ankle fusion for end-stage ankle arthritis with ≤20° internal and external varus can avoid bone grafting and osteotomy with satisfactory efficacy,and has advantages in reducing intraoperative bleeding and complications,alleviating perioperative oxidative stress,and accelerating postoperative recovery.However,when internal and external varus malformations are obvious,the time of osseous fusion can be prolonged.

Objective:To analyze the psychometric properties of the short-form Extended Barthel Index (EBI) in assessing ability in the activities of daily living (ADL).Methods:Data describing 295 discharged patients with stroke or traumatic brain injury were collected retrospectively, including their demographics, diagnoses, and functional assessments (EBI, FIM, MBI and MoCA). Then, data on 120 of them were used to construct short-form EBI models based on item-total advantage indices, while the remaining 175 patients served as a validation set to evaluate the acceptability, responsiveness, reliability, validity, and outcome consistency of the models. The optimal model was selected as the recommended short-form EBI.Results:The short-form EBI comprises seven items: personal hygiene, dressing/undressing, wheelchair-bed transfer, walking, social interaction during walking, problem-solving, and memory/learning/orientation, with each item scored 0-4 (total range: 0-28). The short-form EBI demonstrated good acceptability, with median and mean scores near the scale′s midpoint and no significant ceiling or floor effects. Its responsiveness (d=0.19) surpassed that of the original EBI (d=0.14). Moreover, the short-form EBI showed excellent reliability (Cronbach′s α=0.885; SEM=9.11) and validity, explaining 95.4% of the variance in EBI scores (adj. R 2=0.954). Concurrent validity with the EBI was strong (ρ=0.975, P≤0.001), and criterion validity with ρ=0.956 for FIM, 0.889 for MBI, and 0.806 for MoCA. The short-form and the original EBI exhibited good agreement [ICC=0.967 (95% CI: 0.769-0.989); score difference: 6.48±6.56]. Conclusions:The short-form EBI demonstrates excellent acceptability, responsiveness, reliability, validity, and outcome consistency, making it a practical tool for ADL assessment in cases of stroke or traumatic brain injury.