ObjectiveTo investigate the effects of Buzhong Yiqitang on the abnormal expression of pulmonary surfactant-associated protein C （SFTPC） and lung injury induced by chronic intermittent hypoxia （CIH） and the mechanism of action. MethodsForty healthy adult male SPF-grade C57BL/6 mice were randomly allocated into five experimental groups： a normoxia group， a CIH group， and low-， medium-， and high-dose Buzhong Yiqitang groups， with eight mice in each group. During the modeling， mice in the normoxia group were housed under standard oxygen concentrations， while the CIH and all Buzhong Yiqitang groups were placed in a hypoxic chamber for 8 h daily over 35 d. Prior to each chamber session， mice in the low-， medium-， and high-dose Buzhong Yiqitang groups were administered decoctions by gavage at corresponding doses （8.1， 16.2， 32.4 g·kg^-1·d^-1 of crude drug， respectively）， while those in normoxia and CIH groups received an equivalent volume of saline by gavage. The general conditions of the mice were recorded before and after the experiment. Pulmonary function was assessed using a non-invasive detection system. Serum SFTPC levels were measured using enzyme-linked immunosorbent assay （ELISA）. Histopathological changes in lung tissue were evaluated using hematoxylin-eosin （HE） staining. Apoptosis in lung tissue was detected using terminal deoxynucleotidyl transferase dUTP nick end labeling （TUNEL）. Protein expression of SFTPC， B-cell lymphoma-2 （Bcl-2）， Bcl-2-associated X protein （Bax）， protein kinase R-like endoplasmic reticulum kinase （PERK）， phosphorylated PERK （p-PERK）， eukaryotic initiation factor 2α （eIF2α）， phosphorylated eIF2α （p-eIF2α）， activating transcript factor 4 （ATF4）， and CCAAT/enhancer-binding protein homologous protein （CHOP） in lung tissue was analyzed by Western blot. Immunofluorescence staining was employed to assess the expression of SFTPC and CHOP proteins in lung tissue. ResultsCompared to those in the normoxia group， mice in the CIH group showed significantly impaired pulmonary function and increased histopathological lung injury scores （P<0.05， P<0.01）. Serum SFTPC levels increased， while SFTPC expression in lung tissue was reduced （P<0.05， P<0.01）. The rate of apoptotic cells in lung tissue increased， and the expression of endoplasmic reticulum stress markers p-PERK， p-eIF2α， ATF4， and CHOP was upregulated （P<0.05， P<0.01）. Compared with the CIH group， Buzhong Yiqitang intervention improved pulmonary function indicators and decreased the histopathological lung injury scores （P<0.05， P<0.01）. Serum SFTPC levels were decreased， and lung tissue SFTPC expression was recovered （P<0.05， P<0.01）. The apoptotic rate of lung tissue cells was significantly reduced， with downregulation of pro-apoptotic Bax and upregulation of anti-apoptotic Bcl-2 expression （P<0.05， P<0.01）. Activation and expression of p-PERK， p-eIF2α， ATF4， and CHOP were also decreased （P<0.05， P<0.01）. ConclusionBuzhong Yiqitang can alleviate lung injury and improve pulmonary function by reducing lung cell apoptosis and enhancing alveolar surfactant secretion， which may be related to the modulation of the PERK/eIF2α/ATF4/CHOP signaling pathway.

Amoenucles A-F (1-6), six previously undescribed nucleoside derivatives, and two known analogs (7 and 8) were isolated from the culture of Aspergillus amoenus TJ507. Their structures were elucidated through spectroscopic analysis, single-crystal X-ray crystallography, and chemical reactions. Notably, 3 and 4 represent the first reported instances of nucleosides with an attached pyrrole moiety. Of particular significance, the absolute configuration of the sugar moiety of 1-4 was determined using nuclear magnetic resonance (NMR), electric circular dichroism (ECD) calculations, and a hydrolysis reaction, presenting a potentially valuable method for confirming nucleoside structures. Furthermore, 1, 2, and 5-8 exhibited potential tumor necrosis factor α (TNF-α) inhibitory activities, which may provide a novel chemical template for the development of agents targeting autoimmune and inflammatory diseases.
Aspergillus/chemistry* ; Tumor Necrosis Factor-alpha/antagonists & inhibitors* ; Molecular Structure ; Nucleosides/isolation & purification* ; Crystallography, X-Ray ; Animals ; Humans ; Mice ; Magnetic Resonance Spectroscopy

Objective:To explore the impact of residents′ health literacy on healthcare choices.Methods:This mixed cross-sectional study utilized data from the 2009, 2011, and 2015 waves of the China Health and Nutrition Survey (CHNS), including adults aged≥18 years. Guided by Andersen′s Behavioral Model of Health Services Use and the Knowledge-Attitude-Practice (KAP) framework, variables were collected across three dimensions-predisposing, enabling, and need factors-including gender, marital status, age, education level, employment status, urban/rural residence, health management awareness, income, health insurance coverage, self-rated health, and chronic disease status. A multinomial Logistic regression model was applied to assess the association between health literacy and healthcare choice. Bootstrap analysis was conducted to test the mediating effect of health management awareness.Results:After excluding cases with missing or invalid data, 4 736 valid observations were included. The proportions of choosing township-, county-, and city-level hospitals were 60.60%, 15.08%, and 24.32%, respectively. After adjusting for confounders, health literacy showed a significant effect on healthcare choice ( P<0.05): individuals with higher health literacy were more likely to choose county-level hospitals ( RR=1.035, P<0.05) and city-level hospitals ( RR=1.044, P<0.01). Health management awareness mediated the relationship between health literacy and healthcare choice ( P<0.05). Conclusions:Health literacy significantly influences healthcare choices; individuals with higher health literacy are more inclined to utilize higher-level medical institutions. Furthermore, health literacy affects healthcare choices partly through the mediating role of health management awareness.

Objective:To address the challenges in cultivating young medical researchers, including the lack of initial research funding, insufficient interdisciplinary collaboration, absence of academic exchange platforms, and inadequate talent incentives, this study analyzes the specific practical measures of the new model(Fund-Alliance-Academic activities-Award Model, hereinafter referred to as ″FAAA model″) of A certain medical college in enhancing the innovative capabilities and interdisciplinary research proficiency of young medical talents in initial stage, and evaluates the practical significance of these initiatives.Methods:Through literature review, the inevitability of interdisciplinary integration was examined in the context of China′s developmental needs and medical discipline advancement. Innovative practices under the FAAA model of A certain medical college were retrospectively analyzed, focusing on the construction of a medical youth scientific innovation and development platform.Results:The FAAA model had achieved effective outcomes in improving young researchers′ capabilities, fostering interdisciplinary achievements, expanding academic influence, and advancing talent echelon development, yet required further refinement.Conclusions:The FAAA model effectively addresses critical bottlenecks in the growth of young medical researchers through systematic support mechanisms, significantly enhancing their scientific competitiveness and interdisciplinary innovation capacity. Its practical measures offer referential value for peer institutions. Future efforts should optimize the ″early funding-achievement incubation-national project linkage″ chain, strengthen institutionalized interdisciplinary collaboration, and build a data-driven ecosystem to provide sustainable talent support for medical science and technology innovation.

Obesity, as a chronic recurrent disease, has become a major public health challenge in China. To implement the requirements of the Healthy China Initiative (2019—2030), under domestic guidelines or consensus statements on overweight and obesity, and in alignment with the latest scientific advances globally, the Quality control protocol for adult overweight and obesity screening in health management (examination) institutions (2025 edition) was developed. This protocol was drafted by the Health Management Center of Shanghai Changzheng Hospital and formulated through multiple rounds of deliberation by experts in China’s health examination quality control field. The protocol establishes unified standards for screening facilities, personnel qualifications, and measurement or testing procedures. It defines specific screening items, outlines a standardized screening pathway, and sets requirements for the final medical review, ensuring the scientific validity, effectiveness, and safety of the screening process. The implementation of this protocol will enhance the consistency of weight management practices for adults across health examination institutions and strengthen the quality control of overweight and obesity screening programs.

Objective:To explore the impact of residents′ health literacy on healthcare choices.Methods:This mixed cross-sectional study utilized data from the 2009, 2011, and 2015 waves of the China Health and Nutrition Survey (CHNS), including adults aged≥18 years. Guided by Andersen′s Behavioral Model of Health Services Use and the Knowledge-Attitude-Practice (KAP) framework, variables were collected across three dimensions-predisposing, enabling, and need factors-including gender, marital status, age, education level, employment status, urban/rural residence, health management awareness, income, health insurance coverage, self-rated health, and chronic disease status. A multinomial Logistic regression model was applied to assess the association between health literacy and healthcare choice. Bootstrap analysis was conducted to test the mediating effect of health management awareness.Results:After excluding cases with missing or invalid data, 4 736 valid observations were included. The proportions of choosing township-, county-, and city-level hospitals were 60.60%, 15.08%, and 24.32%, respectively. After adjusting for confounders, health literacy showed a significant effect on healthcare choice ( P<0.05): individuals with higher health literacy were more likely to choose county-level hospitals ( RR=1.035, P<0.05) and city-level hospitals ( RR=1.044, P<0.01). Health management awareness mediated the relationship between health literacy and healthcare choice ( P<0.05). Conclusions:Health literacy significantly influences healthcare choices; individuals with higher health literacy are more inclined to utilize higher-level medical institutions. Furthermore, health literacy affects healthcare choices partly through the mediating role of health management awareness.

Objective:To address the challenges in cultivating young medical researchers, including the lack of initial research funding, insufficient interdisciplinary collaboration, absence of academic exchange platforms, and inadequate talent incentives, this study analyzes the specific practical measures of the new model(Fund-Alliance-Academic activities-Award Model, hereinafter referred to as ″FAAA model″) of A certain medical college in enhancing the innovative capabilities and interdisciplinary research proficiency of young medical talents in initial stage, and evaluates the practical significance of these initiatives.Methods:Through literature review, the inevitability of interdisciplinary integration was examined in the context of China′s developmental needs and medical discipline advancement. Innovative practices under the FAAA model of A certain medical college were retrospectively analyzed, focusing on the construction of a medical youth scientific innovation and development platform.Results:The FAAA model had achieved effective outcomes in improving young researchers′ capabilities, fostering interdisciplinary achievements, expanding academic influence, and advancing talent echelon development, yet required further refinement.Conclusions:The FAAA model effectively addresses critical bottlenecks in the growth of young medical researchers through systematic support mechanisms, significantly enhancing their scientific competitiveness and interdisciplinary innovation capacity. Its practical measures offer referential value for peer institutions. Future efforts should optimize the ″early funding-achievement incubation-national project linkage″ chain, strengthen institutionalized interdisciplinary collaboration, and build a data-driven ecosystem to provide sustainable talent support for medical science and technology innovation.

Objective To evaluate the economic value of using glucagon-like peptide-1 receptor agonist(GLP-1RA)in combination with metformin for the treatment of type 2 diabetes mellitus(T2DM).Methods Based on 7 randomized controlled clinical trials(RCTs),Markov model was built to simulate the dynamic changes of metformin alone or combined with GLP-1RA in the treatment of T2DM patients without or with complications and death from the perspective of China's health system.Quality-adjusted life years(QALYs)was used as a health output indicator and 3 times China's per capita gross domestic product(GDP)in 2023 was set as the willingness-to-pay(WTP)threshold.The cycle was at the rate of 1 year and a total of 20 years cohort simulation in Markov model was applied to obtain long-term cost and effect of each treatment strategy.The incremental cost-utility ratio(ICUR)was analyzed as the primary evaluation indicator and the sensitivity of cost,utility and discount was performed to test the stability of the results.Results Compared with metformin alone,the ICUR of GLP-1RA including liraglutide,dulaglutide,exenatide,loxenatide,semaglutide combined with metformin were all below the WTP threshold,and the increased cost was acceptable.Extending the simulation time to 30 years or 50 years had no effect on results.The results of probability sensitivity analysis showed that the cost effect of semaglutide 0.5 mg combined with metformin had the highest probability of a cost-utility advantage of 99.7％among all the treatment strategies when WTP threshold was 3 times China's per capita GDP in 2023(268 074 yuan).Conclusion GLP-1RA,including liraglutide,dulaglutide,exenatide,lixisenatide,and semaglutide,at the regular recommended dose combined with metformin,would present higher cost-utility compared to metformin monotherapy.

Objective To evaluate the efficacy and safety of glucagon-like peptide 1 receptor agonists(GLP-1RA)in type 2 diabetes mellitus(T2DM)patients with overweight or obese.Methods PubMed,Embase,Cochrane Library,Ovid,ClinicalTrial.gov,SinoMed,CNKI,WanFang Data and VIP databases were electronically searched to collect randomized controlled trials(RCTs)on the efficacy of GLP-1RA in the treatment of T2DM patients with overweight or obese from January 1,2005 to November 1,2023.Two researchers independently screened the literature,extracted data and evaluated the risk of bias of the included studies.R software was then used for meta-analysis.The level of evidence was assessed by using the GRADE system.Results A total of 71 RCTs were included,including 29 476 patients.The results of Meta-analysis showed that compared with other hypoglycemic drugs,GLP-1RA showed superior effects in improving HbAlc status(WMD=-0.55,95％CI-0.65 to-0.45,P＜0.001)and weight loss(WMD=-2.61,95％CI-3.25 to-1.97,P＜0.001),while the effect on fasting plasm glucose was time-dependent(within 16 weeks:WMD=0.25,95％CI-0.17 to 0.66,P=0.250;16 to 52 weeks:WMD=-0.06,95％CI-0.32 to 0.20,P=0.650;over 52 to 104 weeks:WMD=-1.67,95％CI-1.91 to-1.43,P＜0.001).In terms of safety,the incidence of GLP-1RA's adverse reactions was higher than other hypoglycemic drugs(RR=1.11,95％CI 1.07 to 1.15,P＜0.001);the incidence of hypoglycemia was lower with GLP-1RA than with insulin(RR=0.58,95％CI 0.48 to 0.71,P＜0.001)and similar to oral hypoglycemic drugs(RR=0.83,95％CI 0.58 to 1.19,P=0.310).According to the GRADE assessment,only the certainty of the evidence for the results of the incidence of hypoglycemia was moderate,and the certainty of the evidence for the other results was low.Conclusion Current evidence shows that for T2DM patients with overweight or obese,GLP-1RA especially semaglutide,was more effective in lowering blood glucose,controlling body weight and reducing the occurrence of hypoglycemia than placebo,insulin and oral hypoglycemic drugs.

Objective: To study the relationship between sugar sweetened beverages consumption characteristics and insomnia of college students in Yunnan Province, so as to provide evidence for sleep quality improvement of college students. Methods: A cluster random sampling method was used to select 2 515 college students from two universities (Kunming University and Dali Nursing Vocational College) in Kunming and Dali in Yunnan Province for a longitudinal study, including baseline survey (T1, November 2021) and three follow up surveys (T2: June 2022, T3: November 2022, T4: June 2023). Sugar sweetened beverages consumption of college students was collected by Semi quantitative Food Frequency Questionnaire and insomnia was assessed by Insomnia Severity Index Scale. Sugarsweetened beverages consumption was analyzed by Kruskal-Wallis test. The Mann-Whiter U test and Kruskal-Wallis test were used to compare the detection rate of insomnia in college students with different population characteristics, and the generalized estimating equations model was established to analyze the association between sugar sweetened beverages consumption and insomnia. Results: The reported rate of insomnia among college students from T1 to T4 was 21.2%, 23.6%, 30.5 % and 36.0%, respectively. The median of sugar sweetened beverages consumption per week was 5 (1,9) bottles per person, and there were significant differences in sugar sweetened beverages (carbonated beverages, fruit beverages, tea beverages, milk beverages, energy beverages) consumption among college students with different insomnia status ( χ 2=42.91, 23.67, 29.98, 61.70, 30.82, P <0.01). The analysis of the generalized estimating equation model revealed that the consumption of carbonated beverages ( β= 0.04, 95%CI =0.00-0.08) and the consumption of milk beverages among college students ( β=0.04, 95%CI =0.00-0.09) were correlated with insomnia ( P <0.05). The stratified analysis indicated that consumption of carbonated beverages by female college students was associated with insomnia [ β(95%CI )=0.06(0.01-0.11)]; consumption of milk beverages among college students from middle income family was associated with insomnia [ β (95% CI )=0.05(0.00-0.10)], and consumption of carbonated beverages and fruit beverages from college students with high household economic status were both associated with insomnia [ β (95% CI )=0.35(0.23-0.46), 0.12(0.00-0.24)] ( P <0.05). Conclusion Sugar sweetened beverages, especially carbonated beverages, are associated with insomnia among college students in Yunnan Province.