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.

Objective:To explore the latent categories of mental health problems in patients with systemic lu-pus erythematosus(SLE)through latent class analysis,and to analyze the association between these mental health categories and both disease activity and fatigue in patients.Methods:Totally 147 patients with SLE were recruited from February 2022,to December 2023,at the department of Rheumatology,Qilu Hospital of Shandong Universi-ty.Latent class analysis was utilized to identify the latent categories of mental health problems.Multivariate linear regression was employed to analyze the association between these mental health categories and both disease activity and fatigue in patients with SLE.Results:Latent class analysis of four types of mental health problems in patients with SLE revealed two latent categories:a high mental health problems group(n=60)and a low mental health problems group(n=87).Compared to the low mental health problems group,the high mental health problems group showed a positive association with patient self-assessed disease activity(β=0.22)and fatigue(β=0.27).Conclusion:Mental health problems are common among patients with SLE and occur concurrently.Comprehensive management strategies should be selected when implementing psychological interventions.

Objective:To explore the latent categories of mental health problems in patients with systemic lu-pus erythematosus(SLE)through latent class analysis,and to analyze the association between these mental health categories and both disease activity and fatigue in patients.Methods:Totally 147 patients with SLE were recruited from February 2022,to December 2023,at the department of Rheumatology,Qilu Hospital of Shandong Universi-ty.Latent class analysis was utilized to identify the latent categories of mental health problems.Multivariate linear regression was employed to analyze the association between these mental health categories and both disease activity and fatigue in patients with SLE.Results:Latent class analysis of four types of mental health problems in patients with SLE revealed two latent categories:a high mental health problems group(n=60)and a low mental health problems group(n=87).Compared to the low mental health problems group,the high mental health problems group showed a positive association with patient self-assessed disease activity(β=0.22)and fatigue(β=0.27).Conclusion:Mental health problems are common among patients with SLE and occur concurrently.Comprehensive management strategies should be selected when implementing psychological interventions.

Objective To explore the use of T2-fluid attenuated inversion recovery(FLAIR)sequences with a shorter TR to significantly reduce examination time without compromising diagnostic accuracy and image quality,and to obtain satisfactory brain gray and white matter contrast images via adjusting the TE.Methods A total of 60 patients underwent brain MR were selected,and each patient was scanned using two different T2-FLAIR sequences.The scan parameters for sequence A group were TR 9 000 ms,inversion time(TI)2 500 ms,and TE 120 ms.For sequence B group,the scan parameters were TR 6 000 ms,TI 2 000 ms,and TE 120-200 ms(with 20 ms intervals),respectively,and all images data were labeled as B1 to B5.A double-blind method was used to observe the images from both groups,with a 5-point rating scale.The signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR)of brain gray and white matter,and the contrast of brain gray and white matter were measured,respectively.SPSS 26.0 statistical software was used for subjective and objective evaluations of the images from both groups.Results For subjective evaluation,there were statistically significant differences in image quality with TE ranged from 120 to 200 ms in B group(H=41.4,P＜0.05).In pairwise comparisons,images from B3 group(TE 160 ms)showed no statistically significant difference compared to A group in subjective evaluations by two physicians(P＞0.05).For objective evaluation,A group exhibited significantly higher SNR compared to B group.Among the images in B group with TE ranged from 120 to 200 ms,SNR decreased gradually with increased TE,while CNR and contrast increased progressively(P＜0.05).Specifically,there were no statistically significant differences between B3 and A groups in terms of CNR and contrast(P＞0.05).Conclusion T2-FLAIR sequences with a shorter TR can significantly reduce examination time.By adjusting the TE,satisfactory brain gray and white matter contrast images can be obtained.When TE is 160 ms,the contrast of brain gray and white matter is optimal,and the SNR of the images meets the requirements for clinical diagnosis.

Objective:To study the impact of early blood concentrations of tacrolimus on the survival of patients after liver transplantation.Methods:Clinical data of 159 patients with liver diseases undergoing classic orthotopic liver transplantation at the Department of Hepatobiliary Surgery, the 900th Hospital of the Joint Logistics Support Force between January 2010 and December 2019 were retrospectively analyzed, including 123 males and 36 females, aged (48.0±12.2) years. According to survival status, patients were divided into the surviving group ( n=108) and death group ( n=51). Inverse probability of treatment weighting (IPTW) was applied to adjust for confounding factors by weighting covariates between the two groups. Univariate and multivariate Cox regression analysis were used to examine the relationship between early tacrolimus concentrations and mortality, and restrict cubic spline (RCS) curves were employed to assess the nonlinear relationship further. Results:After IPTW weighting, multivariate Cox regression analysis indicated that early tacrolimus concentration ( HR=2.479, 95% CI: 1.354-4.537, P<0.001) and preoperative international normalized ratio ( HR=0.358, 95% CI: 0.162-0.792, P=0.011) levels were risk factors for post-transplant survival. The RCS curve revealed that the optimal thresholds for early tacrolimus concentration were 6.30 ng/ml and 8.28 ng/ml ( P<0.001). Patients were therefore divided into the optimal concentration group ( n=60) and the non-optimal concentration group ( n=99). After IPTW weighting, the optimal concentration group comprised 102 cases, and the non-optimal concentration group included 212 cases. The 1-year, 3-year and 5-year survival rates in the optimal concentration group and the non-optimal concentration group were 97.06%, 81.37% and 75.49%, and 86.32%, 64.62% and 50.94%, respecitvely ( χ2=8.37, P<0.001). Conclusion:Early tacrolimus concentration is an independent risk factor for post-transplant survival. A tacrolimus concentration >8.28 ng/ml or <6.30 ng/ml is associated with a relatively higher mortality rate.

Objective To explore the use of T2-fluid attenuated inversion recovery(FLAIR)sequences with a shorter TR to significantly reduce examination time without compromising diagnostic accuracy and image quality,and to obtain satisfactory brain gray and white matter contrast images via adjusting the TE.Methods A total of 60 patients underwent brain MR were selected,and each patient was scanned using two different T2-FLAIR sequences.The scan parameters for sequence A group were TR 9 000 ms,inversion time(TI)2 500 ms,and TE 120 ms.For sequence B group,the scan parameters were TR 6 000 ms,TI 2 000 ms,and TE 120-200 ms(with 20 ms intervals),respectively,and all images data were labeled as B1 to B5.A double-blind method was used to observe the images from both groups,with a 5-point rating scale.The signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR)of brain gray and white matter,and the contrast of brain gray and white matter were measured,respectively.SPSS 26.0 statistical software was used for subjective and objective evaluations of the images from both groups.Results For subjective evaluation,there were statistically significant differences in image quality with TE ranged from 120 to 200 ms in B group(H=41.4,P＜0.05).In pairwise comparisons,images from B3 group(TE 160 ms)showed no statistically significant difference compared to A group in subjective evaluations by two physicians(P＞0.05).For objective evaluation,A group exhibited significantly higher SNR compared to B group.Among the images in B group with TE ranged from 120 to 200 ms,SNR decreased gradually with increased TE,while CNR and contrast increased progressively(P＜0.05).Specifically,there were no statistically significant differences between B3 and A groups in terms of CNR and contrast(P＞0.05).Conclusion T2-FLAIR sequences with a shorter TR can significantly reduce examination time.By adjusting the TE,satisfactory brain gray and white matter contrast images can be obtained.When TE is 160 ms,the contrast of brain gray and white matter is optimal,and the SNR of the images meets the requirements for clinical diagnosis.

Objective:To study the impact of early blood concentrations of tacrolimus on the survival of patients after liver transplantation.Methods:Clinical data of 159 patients with liver diseases undergoing classic orthotopic liver transplantation at the Department of Hepatobiliary Surgery, the 900th Hospital of the Joint Logistics Support Force between January 2010 and December 2019 were retrospectively analyzed, including 123 males and 36 females, aged (48.0±12.2) years. According to survival status, patients were divided into the surviving group ( n=108) and death group ( n=51). Inverse probability of treatment weighting (IPTW) was applied to adjust for confounding factors by weighting covariates between the two groups. Univariate and multivariate Cox regression analysis were used to examine the relationship between early tacrolimus concentrations and mortality, and restrict cubic spline (RCS) curves were employed to assess the nonlinear relationship further. Results:After IPTW weighting, multivariate Cox regression analysis indicated that early tacrolimus concentration ( HR=2.479, 95% CI: 1.354-4.537, P<0.001) and preoperative international normalized ratio ( HR=0.358, 95% CI: 0.162-0.792, P=0.011) levels were risk factors for post-transplant survival. The RCS curve revealed that the optimal thresholds for early tacrolimus concentration were 6.30 ng/ml and 8.28 ng/ml ( P<0.001). Patients were therefore divided into the optimal concentration group ( n=60) and the non-optimal concentration group ( n=99). After IPTW weighting, the optimal concentration group comprised 102 cases, and the non-optimal concentration group included 212 cases. The 1-year, 3-year and 5-year survival rates in the optimal concentration group and the non-optimal concentration group were 97.06%, 81.37% and 75.49%, and 86.32%, 64.62% and 50.94%, respecitvely ( χ2=8.37, P<0.001). Conclusion:Early tacrolimus concentration is an independent risk factor for post-transplant survival. A tacrolimus concentration >8.28 ng/ml or <6.30 ng/ml is associated with a relatively higher mortality rate.

Objective:To analyze the clinical and radiographic effectiveness of a calcium silicate-based bioactive ceramic iRoot BP Plus? pulpotomy of immature permanent teeth with complicated crown fracture and to evaluate the factors influencing its long-term success rate.Methods:The digital medical records of patients under 13 years old who had undergone iRoot BP Plus? pulpotomy in the Department of Oral Emergency or the First Clinical Division,Peking University School and Hospital of Stomatology from March 2017 to September 2022 due to complicated crown fracture of anterior teeth,and had taken at least one post-operation apical radiograph were reviewed.The clinical and radiographic information at the initial examination and follow-up period were obtained,including crown color,mobility,percussion,cold test(partial pulpotomy teeth),dental restoration,fistula,swelling or inflammation of the gingival tissue,the formation of apical foramen,pathologic radiolucency and calcification of pulp chamber or root canal obliteration.Data were tested by Fisher exact test and a multiple comparison.Results:In the study,64 patients including 37 males(57.8％)and 27 females(42.2％)with a mean age of 9.1 years were finally enrolled.The total number of permanent teeth that received pulpotomy was 75,and the average follow-up time was 19.3 months.The success rate was 93.1％with the time interval between dental injury and treatment in 24 h,while the success rate dropped to 88.2％with the time intervals beyond 24 h.The time intervals did not significantly affect the pulp survival rate(P=0.61)after pulpotomy(partial or co-ronal).The success rate 6 months after pulpotomy was 96.0％,and one-year success rate was 94.7％.A total of 23 cases were reviewed for more than 2 years after pulpotomy,and 6 cases failed.The mobility had no significant effect on the success rate(P=0.28).Pulp chamber calcification and pulp canal obli-teration were not observed in all the post-operative radiographs.Conclusion:The one year clinical and radiographic success rates obtained in this study indicate that iRoot BP Plus? is an appropriate pulp cap-ping material option for pulpotomy treatment of complicated crown fracture in immature permanent teeth without displacement injuries.This technique has broad promotional value.

Objective To investigate the status quo and its influencing factors of nurses'organizational silence in 3 Grade A general hospitals.Methods Convenient sampling method was used to investigate clinical nurses in 3 Grade A general hospitals in Xi'an from April to August 2023 by general data questionnaire,nurses'organizational silence questionnaire and hospital magnetic factor scale.Multiple linear regression was used to analyze the influencing factors of organizational silence.Results A total of 855 nurses completed the study.The total silence score of nurses was(56.33±8.55);The total score of hospital magnetic level was(107.63±12.85).There was a negative correlation between nurse tissue silence and hospital magnetic level(r=-0.318,P<0.01).Hospital magnetic level,age,job title and working time were the influential factors of nurses'organizational silence(all P<0.001),which together explained 62.60%of the variation.Conclusions The silence of nurses'tissue and the level of hospital magnetism are in the low-medium level.Nurses are younger in age,lower in professional title,shorter in nursing age and lower in hospital magnetism level,the higher the tissue age level is,the nursing managers can reduce the tissue silence of nurses by improving the hospital magnetism level.

AIM:Bone morphogenetic protein 7(BMP7)reduces the expression of Yes-related protein 1(YAP1)by down-regulating Ajuba level and decreasing extracellular matrix(ECM)deposition.This study aimed to inves-tigate the influence of these factors on modifying the degree of renal fibrosis in rats with diabetic nephropathy.METH-ODS:Eighteen Sprague-Dawley(SD)rats were randomly divided into three groups:the normal control(NC)group,the diabetes mellitus(DM)group,and the DM group treated with BMP7 overexpressing adeno-associated virus(DM+rAAV-BMP7).Each group consisted of six rats.Diabetic kidney disease(DKD)was established in the DM and DM+rAAV-BMP7 groups by injecting 55 mg/kg streptozotocin(STZ)via the tail vein.NRK-52E cells were divided into three groups:the normal glucose(NG)group,the high glucose(HG)group,and the high glucose group treated with recombinant hu-man BMP7(HG+rhBMP7)group.Pathological changes in renal tissues were observed using hematoxylin and eosin(HE)and Sirius red staining.Immunohistochemical staining was performed to examine the expression sites of Ajuba and YAP1 in the renal cortex.Western blot analysis was conducted to determine the expression levels of BMP7,Ajuba,YAP1,colla-gen type Ⅲ(Col-Ⅲ),and fibronectin(FN)in the rat renal cortex and NRK-52E cells.RT-qPCR was used to measure the mRNA levels of Ajuba and YAP1 in the rat renal cortex.RESULTS:Biochemical indices revealed significantly ele-vated levels of blood glucose,serum creatinine,triglycerides,total cholesterol,and 24-hour urinary protein in the DM group compared to the NC group(P<0.05).In the DM+rAAV-BMP7 group,the levels of serum creatinine,24-hour uri-nary protein,triglycerides,and total cholesterol were lower than those in the DM group(P<0.05).Pathological staining demonstrated that the renal interstitium of the DM group exhibited inflammatory cell infiltration,fibrous tissue,collagen fi-ber deposition,disordered renal tubule arrangement,atrophy,and vacuolar degeneration,which were ameliorated in the DM+rAAV-BMP7 group.Immunohistochemistry revealed that Ajuba and YAP1 were mainly expressed in the cytoplasm and nucleus,with high expression in the cytoplasm of the DM group,which was significantly decreased in the DM+rAAV-BMP7 group.Western blot results indicated that the protein levels of FN,Col-Ⅲ,Ajuba,and YAP1 were up-regulated in the DM and the HG groups(P<0.05),but significantly down-regulated in the DM+rAAV-BMP7 group(P<0.05).RT-qP-CR results demonstrated that the mRNA levels of Ajuba and YAP1 were higher in the DM group and significantly lower in the DM+rAAV-BMP7 group(P<0.05).CONCLUSION:The overexpression of BMP7 can ameliorate renal fibrosis in rats with DKD.This effect is likely mediated by the down-regulation of Ajuba,reduction of YAP1 expression,and subse-quent inhibition of ECM deposition.