This paper systematically reviews the core concepts and lines of theoretical inheritance of major spleen-stomach theories in traditional Chinese medicine （TCM）， including spleen deficiency theory， spleen-stomach damp-heat theory， and liver-spleen disharmony theory. It is found that these theories have all undergone a developmental trajectory characterized by classical foundation， refinement of therapeutic methods， systematization of pathogenesis， and modern innovation. The evolution of spleen-stomach theory has achieved a shift from a singular focus on tonifying the spleen to regulating dynamic middle-jiao （焦） balance， and from localized spleen-stomach regulation to the circular movement of qi involving all five zang organs. In terms of modern disease-syndrome integrative research， spleen deficiency syndrome is shown to be closely associated with impairment of the gastrointestinal mucosal barrier， metabolic disorders， and gene polymorphisms related to Helicobacter pylori-associated gastric diseases. Spleen-stomach damp-heat syndrome is closely linked to hyperactive energy metabolism， inflammatory cytokines， and abnormal expression of aquaporins. Liver-spleen disharmony syndrome is mainly associated with dysregulation of the brain-gut axis and microbiota-related metabolic disorders. It is proposed that future research on spleen-stomach diseases and syndromes should further elucidate their potential multidimensional differential biological characteristics， thereby promoting the modernization of the TCM discipline of spleen-stomach studies.

ObjectiveTo investigate the protective effect of liver-targeted fibroblast growth factor 21 （FGF21） overexpression against CCl₄-induced acute liver injury （ALI） and its association with silent information regulator 1/glutathione peroxidase 4 （SIRT1/GPX4） expression and ferroptosis-related markers. MethodsFemale ICR mice （8 weeks old） were randomly divided into Control， CCl₄， adeno-associated virus （AAV）-FGF21， and AAV-FGF21 + CCl₄ groups. Liver-targeted FGF21 overexpression was achieved via tail vein injection of AAV8-FGF21 virus with green fluorescent protein （GFP） labeling. ALI was induced by intraperitoneal injection of CCl₄ （0.3 mL/kg）， with sample collection at 12 hours. Body weight and liver weight were recorded to calculate the liver weight/body weight. Alanine aminotransferase （ALT） and aspartate aminotransferase （AST） levels were measured using a biochemical analyzer. FGF21 expression in liver tissues was detected by immunofluorescence. Hepatic histopathology was evaluated by HE staining. RT-qPCR was performed to assess mRNA expression of ferroptosis and iron metabolism-related genes （ACSL4， PTGS2， HJV， FPN， GPX4）， FGF21， and SIRT1. Protein expression of FGF21， SIRT1， and GPX4 were determined by Western blot. Iron content， malondialdehyde （MDA）， glutathione （GSH）， and superoxide dismutase （SOD） activity in liver homogenate were quantified using assay kits. ResultsCompared with the Control group， the FGF21 mRNA and protein expression elevated in CCl₄ group； serum ALT/AST levels and liver weight/body weigh increased. The HE staining results showed that the liver cell membranes were ruptured. The mRNA levels of ACSL4 and PTGS2， the iron content and MDA levels all increased （P<0.01）. The mRNA levels of SIRT1， GPX4， HJV， and FPN， the GSH level and SOD activity all decreased （P<0.05）， and the protein levels of SIRT1 and GPX4 both decreased （P<0.05）. Compared with the CCl₄ group， the serum levels of ALT and AST in the AAV-FGF21 + CCl4 group were decreased （P<0.01）， and the liver/body ratio of mice decreased （P<0.01）. The results of HE staining showed that the degree of liver injury was alleviated. The mRNA levels of ACSL4 and PTGS2， iron content and MDA level all decreased （P<0.01）， while the mRNA levels of SIRT1， GPX4， HJV， FPN， GSH level and SOD activity all increased （P<0.05）. The protein levels of SIRT1 and GPX4 both increased （P<0.05）. ConclusionFGF21 overexpression is associated with enhanced SIRT1/GPX4 expression and suppression of ferroptosis features， thereby contributing to the alleviation of CCl₄-induced ALI.

Objective This study aims to systematically evaluate the evidence-based medicine of traditional Chinese medicine(TCM)in the treatment of dry eye,analyze its efficacy and differences compared with modern Western medicine treatments,and provide a scientific basis for clinical application.Methods By searching Chinese and English databases(including CNKI,Wanfang Data,PubMed,Cochrane Library,etc.),we included meta-analyses and systematic reviews of TCM treatments for dry eye.Literature was screened according to strict inclusion and exclusion criteria,and relevant data were extracted and integrated for analysis.The Mantel-Haenszel fixed-effects model was used to calculate the relative risk(RR)and mean difference(WMD),with the effect size expressed as a 95％confidence interval,to analyze the efficacy in-dicators of TCM treatment for dry eye.Results A total of 21 articles were finally included,involving various TCM inter-ventions for dry eye(such as Chinese herbal medicine,acupuncture,and TCM external therapies).The results showed that TCM treatment was superior to Western medicine alone in improving the overall clinical efficacy[RR=1.63,95％CI(1.46,1.81),P＜0.05],prolonging tear film break-up time[MD=2.23,95％CI(1.85,2.60),P＜0.05],and increasing tear secretion[MD=1.49,95％CI(1.04,1.94),P＜0.05].In addition,acupuncture,the combination of Chinese herbal medicine and Western medicine,and TCM external therapies all demonstrated unique advantages in improving dry eye symptoms and tear function.Conclusion TCM treatment for dry eye shows significant efficacy in key indicators such as overall clinical efficacy,tear film break-up time,and tear secretion,with a high level of safety.

Objective:To observe the application effect of process refinement intervention mode in patients with gestational diabetes mellitus(GDM),and its impact on self management efficacy and psychological state.Methods:This study was a single-center prospective study,a total of 80 patients with GDM admitted to Tingzhou Hospital of Fujian Province from January 2021 to December 2023 were selected,and they were divided into control group(conventional intervention,n=40)and observation group(conventional intervention combined with process refinement intervention mode,n=40)according to the envelope drawing method.the self management efficacy(self management efficacy scale),Psychological status[Edinburgh postnatal depression scale(EPDS),Pregnancy-Related Anxiety Questionnaire-Revision 2(PRAQ-R2)]and Blood glucose control status(fasting blood glucose,2-hour postprandial plasma glucose)of two groups before and after intervention were compared,and the incidence of postpartum complications was observed.Results:After intervention,scores in various dimensions of self management efficacy in the observation group were higher than those in the control group in all dimensions,the EPDS and PRAQ-R2 scores,fasting blood glucose and 2-hour postprandial plasma glucose in the observation group were lower than those in the control group(P＜0.05).The total incidence of postpartum complications in the observation group was lower than that in the control group(P＞0.05).Conclusion:The process refinement intervention mode can enhance the can enhance the self management ability of GDM patients,reduce negative emotions,effectively reduce blood glucose levels and the rate of occurrence incidence of postpartum complications.

Objective:To analyze the vulvovaginal microecological characteristics of young girls and the impact of age on these characteristics.Methods:A total of 371 young girls aged≤12 years who visited the department of Gynecological,Peking University First Hospital from January 2016 to December 2022 were selected.These girls were stratified into three age groups:＜7 years,7-9 years,and＞9-12 years.Then,the results of their vulvovagi-nal microecology were analyzed.Results:A total of 84 cases(22.6％)were clinically diagnosed with vulvovagini-tis,including 43 cases(43/84,51.2％)of bacterial vaginosis(BV),38 cases(38/84,45.2％)of vulvovaginal can-didiasis(VVC),2 cases(2/84,2.4％)of trichomoniasis vaginalis(TV),and 1 case(1/84,1.2％)of mixed vul-vovaginitis(BV+VVC).It was found that there was a statistically significant difference in VVC infection among different age groups of young girls(P＜0.001),and the infection rate was higher in the＞9-12 years group.Sig-nificant variations were also observed in BV infection among different age groups of young girls(P＜0.001).The infection rate was the highest in the 7-9 years group and the lowest in the＞9-12 years group.Among the 371 patients,165 cases(44.5％)had normal vaginal flora,176 cases(47.4％)had abnormal vaginal flora.Among them,64 cases(17.3％)had BV-type abnormal flora,and 112 cases(30.2％)had non-BV-type abnormal flora.There were 30 cases(8.1％)with flora suppression.The composition ratios of flora suppression,BV-type abnor-mal flora,non-BV-type abnormal flora,and total abnormal flora demonstrated statistically significant intergroup var-iations across age cohorts(P＜0.001).Microecological analysis showed that there were statistically significant differences in the composition ratios of factors such as dominant bacteria(Gram-positive large bacilli)and pH a-mong different age groups(P＜0.001).Conclusions:The composition of the vulvovaginal microecology varies a-mong young girls of different ages,and differences exist in reproductive tract infections across these age groups.Assisting in diagnosis through vulvovaginal microecology can better guide clinicians to provide targeted treatment for reproductive tract infections in young girls,and improve the clinical cure rates.

This article comprehensively discusses the concept of workplace ostracism, measurement tools, theoretical basis, the current situation of workplace ostracism among nurses, and research on related variables. It proposes targeted strategies to address workplace ostracism among nurses, aiming to reduce the occurrence of workplace ostracism incidents among nurses. This is of great significance for constructing a harmonious work environment and promoting individual mental health.

Objective:To analyze the vulvovaginal microecological characteristics of young girls and the impact of age on these characteristics.Methods:A total of 371 young girls aged≤12 years who visited the department of Gynecological,Peking University First Hospital from January 2016 to December 2022 were selected.These girls were stratified into three age groups:＜7 years,7-9 years,and＞9-12 years.Then,the results of their vulvovagi-nal microecology were analyzed.Results:A total of 84 cases(22.6％)were clinically diagnosed with vulvovagini-tis,including 43 cases(43/84,51.2％)of bacterial vaginosis(BV),38 cases(38/84,45.2％)of vulvovaginal can-didiasis(VVC),2 cases(2/84,2.4％)of trichomoniasis vaginalis(TV),and 1 case(1/84,1.2％)of mixed vul-vovaginitis(BV+VVC).It was found that there was a statistically significant difference in VVC infection among different age groups of young girls(P＜0.001),and the infection rate was higher in the＞9-12 years group.Sig-nificant variations were also observed in BV infection among different age groups of young girls(P＜0.001).The infection rate was the highest in the 7-9 years group and the lowest in the＞9-12 years group.Among the 371 patients,165 cases(44.5％)had normal vaginal flora,176 cases(47.4％)had abnormal vaginal flora.Among them,64 cases(17.3％)had BV-type abnormal flora,and 112 cases(30.2％)had non-BV-type abnormal flora.There were 30 cases(8.1％)with flora suppression.The composition ratios of flora suppression,BV-type abnor-mal flora,non-BV-type abnormal flora,and total abnormal flora demonstrated statistically significant intergroup var-iations across age cohorts(P＜0.001).Microecological analysis showed that there were statistically significant differences in the composition ratios of factors such as dominant bacteria(Gram-positive large bacilli)and pH a-mong different age groups(P＜0.001).Conclusions:The composition of the vulvovaginal microecology varies a-mong young girls of different ages,and differences exist in reproductive tract infections across these age groups.Assisting in diagnosis through vulvovaginal microecology can better guide clinicians to provide targeted treatment for reproductive tract infections in young girls,and improve the clinical cure rates.

Objective To explore the relationship between community health follow-up management and the mental health of the long-term care insurance residents,and to provide a basis for the construction of an integrated community home care service mode for disabled elders.Methods The residents were selected through cluster sampling who participated in LTCI home care from Jan 1 to Dec 31,2021.After a year of participation,the subjects'mental health was assessed face-to-face by trained community doctors using the Self-Rating Anxiety Scale and the Self-Rating Depression Scale.By referring to residents'electronic health records combined with on-site questionnaire survey,community doctors collected the demographic information and health follow-up management provided by primary medical and health institutions.The multivariate logistic regression were conducted to evaluate the association between follow-up care and mental health outcomes.Results The study consisted of 399 LTCI-enrolled individuals,57.64%(n=230)received follow-up care by family physicians.The prevalence of anxiety and depression among participants was 19.80%(n=79)and 67.67%(n=270),respectively.Univariate analysis found that community health follow-up management could underscore the potential impact of follow-up care in mitigating anxiety(χ2=38.926,P<0.001)and depression(χ2=14.598,P<0.001)among LTCI enrollees.Multivariate analysis revealed that follow-up care was an independent protective factor against anxiety(adjusted OR=0.351,95%CI:0.176-0.701,P=0.003).However,follow-up care did not significantly impact depression prevalence.Additionally,LTCI grade and education level were also identified factors influencing the mental health of participants(P<0.05).Conclusion Community health service centers provide health follow-up management that plays a positive role in alleviating the anxiety symptoms of disabled residents under long-term care insurance home care.It is an effective way to improve the quality of LTCI home care services.

This study explores whether the current external quality assessment (EQA) level and acceptable bias for basic semen analysis in China are clinically useful. We collected data of semen EQA from Andrology laboratories in the Hunan Province (China) in 2022 and searched for data in the published literature from January 2000 to December 2023 in China. On the basis of these data, we analyzed the coefficients of variation and acceptable biases of different quality control materials for basic semen analysis through robust statistics. We compared these findings with quality specifications based on biological variation from optimal, desirable, and minimum levels of bias to seek a unified and more suitable semen EQA bias evaluation standard for China's national conditions. Different sources of semen quality control material exhibited considerable variation in acceptable biases among laboratories, ranging from 8.2% to 56.9%. A total of 50.0% of the laboratories met the minimum quality specifications for progressive motility (PR), whereas 100.0% and 75.0% of laboratories met only the minimum quality specifications for sperm concentration and total motility (nonprogressive [NP] + PR), respectively. The Z value for sperm concentration and PR+NP was equivalent to the desirable performance specification, whereas the Z value for PR was equivalent only to the minimum performance specification. This study highlights the feasibility of operating external quality assessment schemes for basic semen analysis using quality specifications based on biological variation. These specifications should be unified among external quality control (EQC) centers based on biological variation.
Semen Analysis/standards* ; Humans ; China ; Male ; Quality Control ; Sperm Motility ; Sperm Count/standards*

OBJECTIVE: To analyze the Epstein-Barr virus (EBV) load in different lymphocyte subsets, as well as clinical characteristics and outcomes in patients with hematologic malignancies experiencing EBV reactivation. METHODS: Peripheral blood samples from patients were collected. B, T, and NK cells were isolated sorting with magnetic beads by flow cytometry. The EBV load in each subset was quantitated by real-time quantitative polymerase chain reaction (RT-qPCR). Clinical data were colleted from electronic medical records. Survival status was followed up through outpatient visits and telephone calls. Statistical analyses were performed using SPSS 25.0. RESULTS: A total of 39 patients with hematologic malignancies were included, among whom 35 patients had undergone allogeneic hematopoietic stem cell transplantation (allo-HSCT). The median time to EBV reactivation was 4.8 months (range: 1.7-57.1 months) after allo-HSCT. EBV was detected in B, T, and NK cells in 20 patients, in B and T cells in 11 patients, and only in B cells in 4 patients. In the 35 patients, the median EBV load in B cells was 2.19×10⁴ copies/ml, significantly higher than that in T cells (4.00×10³ copies/ml, P <0.01) and NK cells (2.85×10² copies/ml, P <0.01). Rituximab (RTX) was administered for 32 patients, resulting in EBV negativity in 32 patients with a median time of 8 days (range: 2-39 days). Post-treatment analysis of 13 patients showed EBV were all negative in B, T, and NK cells. In the four non-transplant patients, the median time to EBV reactivation was 35 days (range: 1-328 days) after diagnosis of the primary disease. EBV was detected in one or two subsets of B, T, or NK cells, but not simultaneously in all three subsets. These patients received a combination chemotherapy targeting at the primary disease, with 3 patients achieving EBV negativity, and the median time to be negative was 40 days (range: 13-75 days). CONCLUSION In hematologic malignancy patients after allo-HSCT, EBV reactivation commonly involves B, T, and NK cells, with a significantly higher viral load in B cells compared to T and NK cells. Rituximab is effective for EBV clearance. In non-transplant patients, EBV reactivation is restricted to one or two lymphocyte subsets, and clearance is slower, highlighting the need for prompt anti-tumor therapy.
Humans ; Hematologic Neoplasms/virology* ; Herpesvirus 4, Human/physiology* ; Epstein-Barr Virus Infections ; Hematopoietic Stem Cell Transplantation ; Virus Activation ; Lymphocyte Subsets/virology* ; Flow Cytometry ; Killer Cells, Natural/virology* ; Male ; Female ; B-Lymphocytes/virology* ; Viral Load ; Adult ; T-Lymphocytes/virology* ; Middle Aged