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.

Myasthenia gravis is an autoimmune disorder characterized by impaired neuromuscular transmission. Thymectomy is one of the therapeutic options for acetylcholine receptor antibody-positive myasthenia gravis patients. The quality of perioperative care is directly associated with surgical safety and patient outcomes. However, there is currently a lack of specialized nursing consensus or guidelines specifically addressing the care of these patients domestically or internationally. To promote the standardization and normalization of perioperative nursing care for myasthenia gravis patients undergoing thymectomy and to ensure treatment efficacy, a panel of 57 experts from relevant fields was convened. Based on evidence-based medicine and clinical practice experience, discussions were held on various aspects including condition assessment, nutritional support, medication management, and airway care, resulting in a consensus with 18 final recommendations by using the Delphi method through two rounds of expert consultation. This consensus aims to provide a scientific reference for the perioperative nursing care of myasthenia gravis patients undergoing thymectomy.

Hepatitis D is a severe infectious disease caused by hepatitis D virus （HDV）， and its clinical manifestation and outcome vary depending on the mode of infection （co-infection and super-infection）. This article systematically elaborates on the etiological markers for HDV， screening strategies for HDV infection， clinical diagnosis， and principles for treatment and management. In addition， it also discusses the challenges in etiological detection of HDV infection from the perspectives of the unique structure of the virus， genotypes， and detection techniques and reviews the new techniques in this field， in order to provide a reference for the clinical diagnosis and treatment of patients with HDV and offer new ideas for the standardization and domestication of etiological detection techniques.

ObjectiveTo construct a nomogram prediction model for non-valvular persistent atrial fibrillation （PeAF） patients with left ventricular hypertrophy （LVH） ， followed by prognostic analysis through follow-up. MethodsThis study retrospectively enrolled 949 patients with newly diagnosed and hospitalized non-valvular PeAF. Among them， 403 patients presented with LVH. The cohort was randomly stratified into a training set （n=665） and a validation set （n=284）. Univariate and multivariate Logistic regression analyses were employed to identify independent risk factors for PeAF complicated by LVH. A nomogram prediction model was subsequently constructed and evaluated for discriminative ability， calibration， and clinical utility using receiver operating characteristic （ROC） curve analysis， calibration plots， and decision curve analysis （DCA）. ResultsSeven independent risk factors were ultimately identified and included in the prediction model： female sex， hypertension， diabetes， red blood cell distribution width-SD （RDW-SD）， body mass index （BMI）， left atrial diameter （LAD）， and left ventricular ejection fraction （LVEF）. The area under the ROC curve （AUC） in the training set was 0.862 （95% CI： 0.834-0.890）， and in the validation set， it was 0.870 （95% CI： 0.829-0.911）， demonstrating excellent predictive performance. ConclusionIndependent risk factors for LVH in PeAF patients include female， hypertension， diabetes， RDW-SD， BMI， LAD， and LVEF. The prediction model built based on this can help early identification of PeAF patients with high risk of LVH. At the same time， the incidence of major adverse cardiovascular events （MACE） is higher in PeAF patients with LVH. Patients with atrial fibrillation combined with LVH may benefit from catheter ablation.

Background/Aims: Dysregulated cholesterol metabolism is a hallmark of hepatocellular carcinoma (HCC) that drives tumor initiation and progression. However, clinical targeting of cholesterol metabolism has yielded limited benefits due to stringent feedback in tumor cells. Identifying a central mediator capable of restoring cholesterol homeostasis within the cell’s intrinsically fine-tuned regulatory framework is urgently needed. Methods: We integrated a proteomic dataset from patients with cholesterol-dysregulated HCC into a global cholesterol metabolic regulatory network to identify potential therapeutic targets for disrupted cholesterol homeostasis. The prognostic significance of the candidate targets was further validated in an independent cohort through immunohistochemistry. Functional and mechanistic studies were conducted in vitro using HCC cell lines and in vivo using mouse models. The pharmacological efficacy of the candidate agent was evaluated in both subcutaneous and orthotopic HCC mouse models. Results: ER lipid raft-associated 1 (ERLIN1), a pivotal regulator of cholesterol metabolism reprogramming, was identified as an independent favorable prognostic indicator in HCC. ERLIN1 constrains HCC progression both in vitro and in vivo by stabilizing the INSIG1–SCAP–SREBP2 axis and maintaining the metabolic balance of intracellular cholesterol. Under hypoxia, impaired factor-inhibiting hypoxia-1-dependent hydroxylation of ASB11 at asparagine residues 90 and 92 enhances ASB11-mediated ERLIN1 degradation. Pharmacological targeting of this axis using zoledronic acid (ZoA) attenuated HCC progression by weakening the ASB11–ERLIN1 interaction and restoring cholesterol homeostasis. Conclusions ERLIN1 represents a druggable metabolic vulnerability in cholesterol-dysregulated HCC. Targeting the ASB11–ERLIN1 axis with the clinically approved ZoA reestablishes cholesterol homeostasis and offers a promising therapeutic strategy to overcome the current limitations of cholesterol-targeted HCC therapies.

ObjectiveTo evaluate the application effect of morphology driven preparation technique in indirect restoration of posterior teeth. Methods84 patients with dental defects were selected and divided into the control group and the experimental group randomly， with 42 patients in each group （a total of 84 teeth）. Traditional preparation and morphology driven preparation techniques were used to complete dental preparation and adhesive glass ceramic restorations， respectively. The satisfaction， masticatory function， World Dental Federation （FDI） Scores for edge fracture and fixation，edge adaptability index，periodontal bleeding index （BI） and plaque index （PLI） of the two groups of patients were evaluated and various indicator data were recorded and statistically analyzed at 3 and 6 months after restoration completion. ResultsThere was no statistically significant difference in satisfaction between the two groups after 3 and 6 months of repair； Both groups of data showed a significant improvement in masticatory function. There was no statistical difference after 3 and 6 months of repair. However， a statistically significant difference in masticatory function was noted after 6 months of repair compared with before and after 3 months of repair. As the repair time increased， the masticatory effect improved significantly. There was no statistically significant difference in the edge fracture and fixation index between the two groups at 3 months after repair， but there was a statistically significant difference between the two groups at 6 months with the experimental group outperforming the control group（P<0.05）. The edge adaptability， BI， and PLI index were statistically significant between the two groups after 3 and 6 months of repair and the experimental group had a significant advantage （P<0.05）. ConclusionBoth types of tooth preparation techniques can improve patient masticatory function and reach high satisfaction after repair. However， morphology driven preparation technique has significant advantages in edge adaptability， edge fracture and fixation index scores and improve periodontal conditions. This technique is an effective method for improving dental preparation in adhesive indirect restoration of posterior teeth.

ObjectiveTo explore the structural characteristics， biocompatibility， anti-inflammatory and antioxidant properties of hyaluronic acid （HA）/silk fibroin （SF） composite hydrogel scaffolds loaded with epigallocatechin gallate （EGCG）， and to provide a new material basis for the treatment of periodontitis. MethodsThe composite hydrogel scaffolds were constructed by cross-linking HA and SF and loaded with EGCG. The water absorption rate， degradation property and material characteristics were detected by scanning electron microscopy. The cytocompatibility and anti-inflammatory and antioxidant properties were evaluated by in vitro experiments. ResultsThe EGCG-loaded scaffolds exhibited a porous network structure and desirable swelling properties. In vitro experiments demonstrated that the scaffolds possessed good biocompatibility， along with the ability to inhibit the expression of inflammatory factors and scavenge reactive oxygen species. ConclusionThe HA/SF-EGCG composite scaffolds have excellent biocompatibility and dual functional activities of anti-inflammatory and antioxidant， providing a new strategy for improving the clinical treatment effect of periodontitis.

OBJECTIVE To explore the clinical characteristics of Tropheryma whipplei(TW)infection and observe the application of pathogenic metagenomic next-generation sequencing(mNGS)in diagnosis of TW infection.METHODS The clinical data were collected from 1 patient who was diagnosed by mNGS in the Affiliated Hospital of Jining Medical University on Apr.9,2022.The data including the results of laboratory tests and treatment out-comes were summarized,and a literature review was conducted.RESULTS A 50-year-old woman presented to the hospital with chest tightness and chest pain lasting for 3 days,accompanied by dyspnea,palpitations,and expec-toration.The chest plain CT scan and magnetic resonance imaging(MRI)scan suggested a high probability of pul-monary infection.Normal flora were isolated by culture of bronchoalveolar lavage fluid(BALF);TW and human βherpes virus type 7 were detected in BALF by mNGS,with the sequence numbers 327 000 and 9,respectively.The pulmonary symptoms of the patient were improved after joint treatment of the infection with etimicin,levo-floxacin and minocycline.The patient repeatedly sought for medical treatment due to the pain of shoulder joint and limitation of motion.CONCLUSIONS TW is one of major pathogens leading to the infections of systemic multiple systems,and it is necessary to attach great importance to the diagnosis and treatment.The traditional laboratory test method can not achieve ideal diagnosis effect and is more likely to make a missed diagnosis.mNGS is more ac-curate and more efficient than the traditional detection method in diagnosis of TW-induced diseases.Early use of mNGS can make a rapid identification of pathogens and facilitate the reasonable clinical use of antibiotics.It is of great significance for control of the disease progression,improvement of prognosis and prevention of recurrence.

Objective:Human papilloma virus(HPV)E6/E7mRNA in situ hybridization detection technology was used to explore whether high-grade squamous intraepithelial lesion(HSIL)of cervix with negative high-risk human papilloma virus(HR-HPV)typing test was caused by HPV infection,so as to provide new insights for the accurate diagnosis and treatment of cervical HSIL.Methods:305 tissue samples were collected from patients with HSIL who underwent cervical biopsy or surgical treatment in the Department of Gynecology,Affiliated Hospital of Shandong Second Medical University,from January 2020 to October2022.Patients with negative HR-HPV genoty-ping results(15 cases)were assigned to the study group,while those with positive results(290 cases)served as the control group.RNAscope in situ hybridization was used to detect the expression of HPV E6/E7 mRNA in the two groups,and the expression of HPV E6/E7 mRNA was analyzed by semi-quantitative scoring of staining inten-sity.Immunohistochemistry(IHC)was used to detect the expression of p16 and Ki-67.Results:①Among 305 pa-tients with HSIL,15 patients had negative HR-HPV typing test,with an incidence of 4.9％(15/305).②73.3％(11/15)of the study group showed positive expression of HPV E6/E7 mRNA,which was statistically significant compared with 100.0％(290/290)of the control group(P＜0.001).③The positive expression rate of p16 in the study group was significantly lower than that in the control group(93.3％vs.100.0％,P=0.049),while there was no significant difference in the positive expression rate of Ki-67 between the two groups(100.0％vs.100.0％).④In the samples with histopathological type cervical intraepithelial neoplasia(CIN)2,the overall score of HPV E6/E7 mRNA in the study group was significantly lower than that in the control group,which was statistically significant(P=0.004).In CIN3 samples,although the overall score of HPV E6/E7 mRNA in the study group was lower than that in the control group,there was no statistically significant difference(P=0.158).Conclusions:4.9％of pa-tients with HSIL in cervical cancer screening may be missed or misdiagnosed due to negative HR-HPV typing test.HPV E6/E7 mRNA in situ hybridization detection technology was helpful to reduce the false negative rate of HR-HPV typing test in HSIL,and it may assist in predicting the progression of cervical lesions,so as to provide a new idea for individualized precise treatment.

Objective To verify the predictive performance of the population pharmacokinetic(PPK)model of lacosamide in children reported abroad using real-world case data,the exposure-response relationship was analyzed,and the optimal dosing regimen was simulated.Methods The plasma concentration data and clinical data of 64 children with epilepsy aged 4-13.42 years after oral administration of lacosamide reached a steady state were collected,and the prediction accuracy of foreign models was investigated by goodness-of-fit diagram and intuitive prediction test.The relationship between the daily dose or trough concentration of lacosamide and the clinical efficacy was analyzed,and Monte Carlo simulation was used to evaluate and screen the optimal dosing regimen of lacosamide for different body weight stratification and combinations based on pharmacokinetic parameters.Results The external validation results show that the prediction accuracy of the PPK model for children abroad is good.The pharmacokinetic parameters of lacosamide monotherapy in children with epilepsy were as follows:absorption rate constant(ka)=(2.43±0.04)h-1,apparent volume of distribution(Vd/F)=(22.69±6.00)L,clearance rate(CL/F)=(1.25±0.27)L·h-1,half-life(t1/2)=(12.74±2.40)h.The distribution range of 5％-95％quantile of daily dose of clinically effective cases was 2.5-6.3 mg·kg-1·d-1,and the distribution range of 5％-95％of trough concentration was 1.9-6.7 mg·L-1.The simulation results showed that the optimized dosing regimen of lacosamide recommended in this study could increase the probability of drug concentration reaching the target and ensure the efficacy and tolerability of treatment.Conclusions The prediction performance of the PPK model of lacosamide in foreign children was verified,and the optimal dosing regimen was simulated based on this model,which can provide a reference for clinicians to individualize and rationalize the use of drugs.