The Dunhuang manuscript Fuxing Jue takes the "Tangye Jingfa Tu" as the core of its theory on prescription and compatibility. Its medication principles mainly include the "five elements principle of tonifying and purging" and the "five elements principle of elimination and transformation". Based on the differentiation of deficiency and excess in the five Zang organs， it flexibly applies medicinal properties， usage， and flavor transformation for tonifying and purging， forming its unique method of medication and compatibility. In Taiyin disease， "fullness syndrome" often occurs together with "diarrhea"， and these two conditions also serve as the primary indications for the middle-regulating formulas. Among them， Lizhong Wan （Tang） mainly address Taiyin deficiency. The three Xiexin Tang （Banxia Xiexin Tang， Gancao Xiexin Tang， Shengjiang Xiexin Tang） address Taiyin deficiency accompanied by pathogenic excess. The Sini Tangand Tongmai Sini Tang primarily treat dysfunction of the liver， spleen， and kidney with impaired opening and closing of Taiyin， manifesting as diarrhea. The medicinal flavors of middle-regulating formulas are pungent， sweet， and bitter， acting directly on the spleen of Taiyin. The pungent flavor induces purging of the spleen， sweet flavor tonifies the spleen， and bitter flavor eliminates lumps. When the constituent medicinal units of middle-regulating formulas are unified， the ratio of pungent to sweet flavors reflects the tonic and purgative strength of the formula. In addition， the two decoction methods， "short-term decoction to extract Qi" and "long-term decoction to extract flavor"， also influence the formula's tonifying and purgative effects. Based on the composition of flavors and special decoction methods， this article discusses the differences in the use of middle-regulating formulas for treating "“fullness syndrome" versus "diarrhea". Dysfunction of the spleen can give rise to various diseases. Therefore， middle-regulating formulas are not limited to treating "deficiency， cold， and dampness" syndromes. Later generations of physicians further modified Lizhong Tang to treat "excess， heat， and dryness" syndromes， laying a solid foundation for more flexible and effective clinical application of middle-regulating formulas.

The Dunhuang manuscript Fuxing Jue takes the "Tangye Jingfa Tu" as the core of its theory on prescription and compatibility. Its medication principles mainly include the "five elements principle of tonifying and purging" and the "five elements principle of elimination and transformation". Based on the differentiation of deficiency and excess in the five Zang organs， it flexibly applies medicinal properties， usage， and flavor transformation for tonifying and purging， forming its unique method of medication and compatibility. In Taiyin disease， "fullness syndrome" often occurs together with "diarrhea"， and these two conditions also serve as the primary indications for the middle-regulating formulas. Among them， Lizhong Wan （Tang） mainly address Taiyin deficiency. The three Xiexin Tang （Banxia Xiexin Tang， Gancao Xiexin Tang， Shengjiang Xiexin Tang） address Taiyin deficiency accompanied by pathogenic excess. The Sini Tangand Tongmai Sini Tang primarily treat dysfunction of the liver， spleen， and kidney with impaired opening and closing of Taiyin， manifesting as diarrhea. The medicinal flavors of middle-regulating formulas are pungent， sweet， and bitter， acting directly on the spleen of Taiyin. The pungent flavor induces purging of the spleen， sweet flavor tonifies the spleen， and bitter flavor eliminates lumps. When the constituent medicinal units of middle-regulating formulas are unified， the ratio of pungent to sweet flavors reflects the tonic and purgative strength of the formula. In addition， the two decoction methods， "short-term decoction to extract Qi" and "long-term decoction to extract flavor"， also influence the formula's tonifying and purgative effects. Based on the composition of flavors and special decoction methods， this article discusses the differences in the use of middle-regulating formulas for treating "“fullness syndrome" versus "diarrhea". Dysfunction of the spleen can give rise to various diseases. Therefore， middle-regulating formulas are not limited to treating "deficiency， cold， and dampness" syndromes. Later generations of physicians further modified Lizhong Tang to treat "excess， heat， and dryness" syndromes， laying a solid foundation for more flexible and effective clinical application of middle-regulating formulas.

Lung cancer is a leading cause of cancer-related morbidity and mortality worldwide. Coupled with the substantial workload, the clinical management of lung cancer is challenged by the critical need to efficiently and accurately process increasingly complex medical information. In recent years, large language models (LLMs) technology has undergone explosive development, demonstrating unique advantages in handling complex medical data by leveraging its powerful natural language processing capabilities, and its application value in the field of lung cancer diagnosis and treatment is continuously increasing. The paper systematically analyzes that the exceptional potential of LLMs in lung cancer auxiliary diagnosis, tumor feature extraction, automatic staging, progression/outcome analysis, treatment recommendations, medical documentation generation, and patient education. However, they face critical technical and ethical challenges including inconsistent performance in complex integrated decision-making (e.g., TNM staging, personalized treatment suggestions) and "black box" opacity issues, along with dilemmas such as training data biases, model hallucinations, data privacy concerns, and cross-lingual adaptation challenges ("data colonization"). Future directions should prioritize constructing high-quality multimodal corpora specific to lung cancer, developing interpretable and compliant specialized models, and achieving seamless integration with existing clinical workflows. Through dual drivers of technological innovation and ethical standardization, LLMs should be prudently advanced for holistic lung cancer management processes, ultimately promoting efficient, standardized, and personalized diagnosis and treatment practices.

Based on the theory of "disease of both blood and water" in Essentials from the Golden Cabinet （《金匮要略》）， and in combination with the dynamic syndrome evolution of heart failure with preserved ejection fraction （HFpEF）， this paper systematically clarifies the pathomechanism of HFpEF， characterized by yang deficiency as the root， blood stasis as the pivotal factor and water retention as the manifestation. Accordingly， the therapeutic principles have been proposed， which are warming yang and banking up original qi to consolidate the root， activating blood and unblocking collaterals to smooth the mechanism， and promoting urination and regulating pivot to remove the branch. On this basis， a compound formula structure of "one monarch， one minister and one assistant" is established， forming an integrated intervention strategy that synergistically combines the three methods of warming yang， activating blood， and promoting urination through combined classical formulas. Zhenwu Decoction （真武汤）， which warms yang and dissolves rheum， is used to consolidate the root and directly target the source of yang deficiency， serving as the monarch； Guizhi Fuling Pills （桂枝茯苓丸）， which activates blood， promotes urination and unblocks the pivot， assists in interrupting the binding of blood stasis and water retention， serving as the minister； Tingli Dazao Xiefei Decoction （葶苈大枣泻肺汤）， which regulates qi， disperses retained fluids， and eliminates the manifestation， alleviates acute water-retention symptoms， serving as the assistant. This compound formula is warming without being drying， diuretic without being drastic， and dispels stasis without consuming blood， thereby achieving the therapeutic effects of warming yang， activating blood， and promoting urination.

Objective: To investigate whether insufficient nutritional health knowledge can increase the risk of obesity conferred by the surrounding environment, so as to provide a basis for improving the physical health of primary school students by their knowledge of nutritional health. Methods: From May to June 2017, a stratified cluster random sampling method was used to select 3 669 primary school students from 2 primary schools in Shenyang for anthropometric measurements and a student questionnaire survey. School neighborhood environment data were obtained from geospatial analyses conducted by using SuperMap GIS 9D. A self designed questionnaire based on the Chinese Dietary Guidelines (2016) was used to assess individual nutritional health knowledge levels.The frequency of fruit and vegetable intake was divided into four quartiles ( Q 1- Q 4), and the land use efficiency was divided into three quintiles ( T 1- T 3). Multiple Logistic regression and linear regression analyses were employed to examine the relationships between insufficient nutritional health knowledge, school neighborhood environment, and the frequency of fruit and vegetable intake, body mass index (BMI), and perirenal fat thickness (PrFT) among primary school students. Results: After adjusting for age, sex, place of residence, family annual income, parental education level, and physical activity, multiple Logistic regression analysis showed that higher land use efficiency around school ( T 2 and T 3)( OR =1.37, 2.45), the presence of ≥1 shopping mall ( OR =1.43), and ≥1 fruit and vegetable store ( OR =1.51) were associated with a higher frequency of fruit and vegetable intake ( Q 4) (all P <0.05). Multiple linear regression analysis revealed that students attending schools with higher land use ( T 3: β = -0.72 ), ≥1 shopping mall ( β = -0.45 ), and multiple fruit and vegetable stores ( β =-0.33) had lower PrFT (all P <0.05). Interaction analysis indicated that the positive association between school neighborhood environment and fruit and vegetable intake frequency was attenuated by insufficient nutritional health knowledge [ T 3 land use×insufficient nutritional knowledge score ( OR = 0.05); ≥1 shopping mall × insufficient nutritional knowledge score ( OR =0.06); ≥1 fruit and vegetable store×insufficient nutritional knowledge score( OR =0.07)] (all P < 0.05). The negative association between school neighborhood environment and the extreme quartile of PrFT was attenuated by insufficient nutritional health knowledge [ T 3 land use mix×insufficient nutritional knowledge score ( β =2.31); ≥1 shopping mall×insufficient nutritional knowledge score( β =3.59)](both P <0.05). Conclusions The healthy food environment around schools is negatively correlated with the obesity risk among primary school students.However, the association is affected by their insufficient nutritional knowledge. Comprehensive intervention strategies should be implemented to prevent the prevalence of obesity by addressing both individual and environmental factors influencing dietary habits.

The rupture of carotid vulnerable plaques is the core pathological basis for major cardiovascular and cerebrovascular events. However， the insufficient alignment between existing animal models and the clinical disease and syndrome characteristics of traditional Chinese and western medicine has limited research progress. In this study， biomedical databases in China and abroad were systematically searched， and the modeling mechanisms and evaluation systems of carotid vulnerable plaque animal models were systematically assessed based on diagnostic criteria of both traditional Chinese and western medicine. Analysis of the clinical correspondence indicated that existing animal models can be categorized into four types： simple high-fat diet， surgical induction combined with high-fat feeding， genetic engineering combined with high-fat feeding， and drug induction combined with high-fat feeding. Among these， the compound strategy of surgical induction combined with high-fat feeding has become the current mainstream approach， showing good concordance with western medicine. The study found that the double balloon injury rabbit model and the ApoE^-/- mouse carotid artery tandem constriction combined with high-fat feeding model demonstrated a high degree of clinical correspondence with both traditional Chinese and western medicine in terms of vulnerable plaque imaging and pathological features. Nevertheless， existing models still face significant technical limitations in faithfully simulating plaque pathology and in translating findings to clinical applications. To address these challenges， integrating complex comorbidity mechanism construction， multimodal dynamic mechanism monitoring， and collaborative evaluation systems of traditional Chinese and western medicine could enable the development of highly concordant carotid vulnerable plaque disease-syndrome combination animal models. Such models would provide a reproducible experimental platform for targeted drug development to regulate plaque stability and for individualized precision treatment， as well as a theoretical basis for innovation in clinical diagnostic and therapeutic strategies.

Objective:To construct a management program for postoperative home exercise rehabilitation in patients undergoing liver cancer surgery, and to provide guidance for improving home exercise capacity after liver cancer surgery.Methods:A mixed study design was used to summarize the best evidence for a postoperative home exercise rehabilitation program for patients with liver cancer based on a literature review from January to June 2022, and the first draft of a postoperative home exercise rehabilitation program for liver cancer patients was formed after discussion in the research team, and discussed in an expert validation meeting, and the first draft of the program was revised and improved according to the expert′s opinion in combination with clinical practice.Results:This study included 14 articles, including 4 clinical guidelines, 3 systematic evaluations, 2 randomized controlled studies, 3 class experimental research and 2 expert consensuses. And 22 pieces of evidence were included in the summary of evidence, including the principle of exercise, supervision of exercise, type of exercise, time and frequency of exercise, and intensity of exercise. A total of 10 experts participated in the expert validation meeting, with 6 males and 4 females, aged (53.31 ± 10.23) years, with an expert authority coefficient of 0.944, and the final home exercise rehabilitation program for postoperative patients with liver cancer was formed to include six aspects, including pre-exercise assessment, warm-up exercise, whole-body exercise, stretching exercise, organizing exercise, and exercise detection and follow-up.Conclusions:The home exercise rehabilitation program for postoperative liver cancer surgery patients is scientific, practical and feasible, and it is a systematic, standardized and safe exercise management model, which can be used for home guidance of postoperative exercise rehabilitation for liver cancer patients.

Repeated transcranial magnetic stimulation (rTMS) is one of the commonly used brain stimulation techniques. In order to investigate the effects of rTMS on the excitability of different types of neurons, this study is conducted to investigate the effects of rTMS on the cognitive function of mice and the excitability of hippocampal glutaminergic neurons and gamma-aminobutyric neurons from the perspective of electrophysiology. In this study, mice were randomly divided into glutaminergic control group, glutaminergic magnetic stimulation group, gamma-aminobutyric acid energy control group, and gamma-aminobutyric acid magnetic stimulation group. The four groups of mice were injected with adeno-associated virus to label two types of neurons and were implanted optical fiber. The stimulation groups received 14 days of stimulation and the control groups received 14 days of pseudo-stimulation. The fluorescence intensity of calcium ions in mice was recorded by optical fiber system. Behavioral experiments were conducted to explore the changes of cognitive function in mice. The patch-clamp system was used to detect the changes of neuronal action potential characteristics. The results showed that rTMS significantly improved the cognitive function of mice, increased the amplitude of calcium fluorescence of glutamergic neurons and gamma-aminobutyric neurons in the hippocampus, and enhanced the action potential related indexes of glutamergic neurons and gamma-aminobutyric neurons. The results suggest that rTMS can improve the cognitive ability of mice by enhancing the excitability of hippocampal glutaminergic neurons and gamma-aminobutyric neurons.
Animals ; Mice ; Hippocampus/cytology* ; Transcranial Magnetic Stimulation ; Neurons/physiology* ; Male ; Cognition/physiology* ; gamma-Aminobutyric Acid/metabolism* ; Action Potentials/physiology*

Objective To describe the current status of post-traumatic growth among family caregivers of dementia and analyze its influencing factors to provide a reference for the development of post-traumatic growth interventions.Methods A convergent mixed-methods study was adopted.Family caregivers of older adults with dementia who were outpatients at a tertiary hospital and a mental health center in Shanghai from May to December 2024 were conveniently selected for the study.A general information questionnaire,the Chinese-Posttraumatic Growth Inventory,the Simplified Coping Style Questionnaire,the Simplified Chinese Event Related Rumination Inventory,the Connor-Davidson Resilience Scale,and the Social Support Rating Scale were used for data collection.The survey was conducted,and the data were analyzed using multivariate stepwise linear regression.19 family caregivers of dementia patients were interviewed in a semi-structured manner using purposive sampling,and the interview data were analyzed using directed content analysis.Results The dementia family caregivers' post-traumatic growth score was(64.73±11.43).The regression results showed that patients' dementia type,types of comorbid chronic diseases,knowledge of the disease,deliberate rumination,positive coping styles,psychological resilience,and social support were the influencing factors of post-traumatic growth(P＜0.05).Qualitative results:interviews refined 8 themes based on 3 dimensions,including individual factors,family and social factors,and cultural and environmental factors.The integration results indicate that both quantitative and qualitative findings were validated and complemented.Conclusion Dementia family caregivers' post-traumatic growth is low to moderate,and the influencing factors are associated with 3 aspects,namely patient factors,caregiver factors,and socio-cultural factors.Healthcare professionals should pay attention to caregivers' post-traumatic growth and develop personalized interventions based on influencing factors,enhancing their level of post-traumatic growth.

Objective:To conduct bioinformatics analysis by detecting and screening differentially expressed miRNAs in urine exosomes of subjects with damp heat IgA nephropathy, non damp heat IgA nephropathy, and healthy individuals; To explore the role of miRNAs in renal tubulointerstitial fibrosis.Methods:A cross-sectional study was conducted to select 40 subjects with primary IgA nephropathy diagnosed by renal biopsy in the Department of Traditional Chinese Medicine, Zhujiang Hospital of Southern Medical University from November 2021 to February 2023, who were divided into damp-heat group and non-damp-heat group according to TCM constitution, with 20 cases in each group; 10 healthy subjects were also recruited for control observation.High-speed centrifugation and Illumina high-throughput sequencing technology were used to isolate and detect the expression of miRNA in urine exosomes from three groups of people, and their differential expression profiles were constructed. Bioinformatics analysis was performed on differentially expressed genes to determine the main biological functions of differentially expressed miRNAs and the signaling pathways they may participate in.Results:Compared with the non-damp heat group, there were 231 miRNAs with abnormal expression in the urine exosomes of the damp heat group, including 119 up-regulated and 112 down-regulated. Through GO enrichment and KEGG analysis, differentially expressed miRNAs may participate in the occurrence and development of renal tubulointerstitial fibrosis through MAPK signaling pathway, PI3K Akt signaling pathway, Hippo signaling pathway, Ras signaling pathway, Wnt signaling pathway, mTOR signaling pathway, etc., involving biological processes such as cell proliferation, apoptosis, cell deformation (EMT), migration and invasion, and tissue and organ fibrosis. MiR-29c-3p expression levels in the urinary exosome miRNA expression profiles of subjects in the three groups were lower in the damp-heat group, but higher in the non-damp-heat group versus the healthy control group, of which, the damp-heat group was lower than the non-damp-heat group versus the healthy control group ( P<0.01); there was no significant difference between the healthy control group and the non-damp-heat group ( P>0.05）. Conclusion:The expression profile of miRNAs in the urine exosomes of subjects with damp heat IgA nephropathy showed significant changes,that the significant down-regulation of miR-29c-3p may be a key factor in exacerbating tubulointerstitial fibrosis in IgA nephropathy.