Diabetic kidney disease （DKD） is one of the most common microvascular complications of diabetes. Traditional Chinese medicine （TCM） plays a unique role in improving clinical symptoms， reducing proteinuria， and delaying the initiation of dialysis. Over time， scholars have held diverse views on the etiology， pathogenesis， and treatment strategies of DKD. This paper systematically reviews the etiology and pathogenesis， syndrome differentiation and treatment， and medication rules of DKD， aiming to provide a reference for clinical practice. Regarding etiology， DKD is closely related to insufficient innate endowment， improper diet， emotional disorders， overexertion， and prolonged diabetes. Its pathogenesis evolves dynamically. Specifically， early stage is characterized by Yin deficiency with dryness-heat and subtle discharge. Middle stage involves both Qi and Yin deficiency with dampness and blood stasis. Late stage presents Yin and Yang deficiency with intrinsic turbidity toxins. Blood stasis and sugar toxicity are the core pathological factors， persisting throughout the disease course and accelerating renal collateral damage and fibrosis. In terms of diagnosis and treatment， contemporary scholars advocate stage-specific treatment， emphasize the integration of prevention and therapy， recommend whole-course management， and support comprehensive TCM and Western medicine approaches. Analysis of medication rules shows that treatment consistently addresses the core principle of deficiency at the root and excess at the surface， strengthens the body while dispelling pathogenic factors， emphasizes promoting blood circulation and removing blood stasis， consolidates the kidney and astringes essence， clears Fu-organs and eliminates turbidity and toxins， invigorates the spleen， replenishes Qi， protects the stomach， and advocates treatment based on pathogenic wind. Further refinement of the academic thoughts of classical TCM masters and research into innovative pathogenesis theories and clinically effective prescriptions are needed to enhance TCM's ability to prevent and treat major clinical diseases， including DKD.

Objective: To evaluate the current situation of thermal environment in primary and secondary school classrooms during winter, and to analyze students thermal comfort needs, so as to provide a basis for improving classroom thermal environment. Methods: From December 16 to 26, 2024, a stratified cluster random sampling method was used to select 90 classrooms from 15 primary and secondary schools in centralized/air conditioned heating areas(Liaoning Province, Tianjin City, Shanghai City) and naturally ventilated areas(Anhui Province and Jiangxi Province)for on site environmental measurement. A questionnaire survey was conducted among 743 students. The differences between groups using the χ 2 test were compared. Based on actual measurement data, a predicted mean vote prepared percentage of dissatisfied (PMV-PPD) model for centralized/air conditioned classrooms and an adaptive model for naturally ventilated classrooms were established, and the thermal neutral temperature and comfort interval were calculated. Results: The average outdoor temperature during on site measurement was 4.00(0.20，7.00)℃. In classrooms with centralized or air conditioned heating systems, the measured average temperature was (19.33±2.59)℃, with a thermal comfort range of 20.35-25.35 ℃ and a thermal neutral temperature of 22.85 ℃. And 13.92% of students reported feeling cold, while 80.80% felt comfortable. In classrooms with natural ventilation, the measured average temperature was (12.26±1.83)℃, with a thermal neutral temperature of 19.67 ℃ and a thermal comfort range of 16.17-23.17 ℃. About 48.33% of students reported feeling cold, and 49.81 % felt comfortable.The results of univariate analysis showed that there were statistically significant differences in shoe thickness, temperature sensation, relative humidity sensation and wind speed sensation between centralized/air conditioned heating areas ( χ 2= 7.01 , 31.47, 13.57, 13.80,all P <0.05). There were also statistically significant differences in school stage for primary and secondary school students, body mass index, classroom location for seat, temperature sensation, relative humidity sensation and wind speed sensation between naturally ventilated areas ( χ 2=42.13, 11.13, 11.04, 60.39, 29.27, 38.46,all P <0.05). Conclusions There are differences in thermal environment and students subjective thermal comfort in primary and secondary schools under different ventilation modes in winter. The temperature standards for heated classrooms should be revised, and differentiated environmental regulation strategies should be adopted based on different ventilation methods to improve students health and comfort levels.

Objective To investigate the mechanism by which angiopoietin-like protein 8(ANGPTL8)regulates vascular smooth muscle cell(VSMCs)apoptosis.Methods An in vitro abdominal aortic aneurysm cell model was established by stimulating human VSMCs(HUSMCs)with angiotensin Ⅱ(AngⅡ).Stable ANGPTL8 knockdown and over-expression VSMC cell strains were generated using lentiviral transfection.TUNEL staining was used to de-tect apoptosis.Western blot analysis was performed to measure the protein expression of ANGPTL8,caspase9,caspase3,Bcl-2,Bax,p53,and PUMA,while RT-qPCR was used to assess mRNA expression of ANGPTL8,Bcl-2 and Bax.Results AngⅡ significantly induced ANGPTL8 expression in HVSMCs in a time-and dose-de-pendent manner(P＜0.05).ANGPTL8 knockdown significantly reduced the expression of apoptosis-related proteins caspase9,caspase3,and Bax,while increased the expression of the anti-apoptotic protein Bcl-2(P＜0.05).Con-versely,ANGPTL8 over-expression markedly induced HVSMCs apoptosis,which was significantly suppressed by treatment with the p53 pathway inhibitor pifithrin-α(PFT-α).Conclusions ANGPTL8 may promote VSMC apop-tosis by activation of p53 signaling pathway.

Intervertebral disc degeneration(IDD) is the pathological basis of spinal diseases. With the development and change of working and living style, IDD gradually presents the trend of younger in recent years. The effective prevention and treatment of IDD has become a hotspot in clinical research. Recent studies have shown that oxidative stress plays an important role in IDD. The disruption of reactive oxygen species balance in cells or the body leads to changes in extracellular matrix and intervertebral disc cell phenotype, which induces oxidative stress of intervertebral disc and leads to IDD. Oxidative stress can affect the development of IDD through apoptosis, autophagy, senescence and extracellular matrix of intervertebral disc. Currently, opioids and drugs for promoting blood circulation and pain relief are commonly used in clinical treatment of IDD, which can alleviate some symptoms to a certain extent, but is easy to induce gastrointestinal and other adverse reactions. Meanwhile, due to the long treatment cycle and poor patient compliance to a certain extent, which brings great difficulties to the treatment. At the same time, traditional Chinese medicine plays an important role in the treatment of IDD due to its advantages of low cost and fewer adverse reactions. With the in-depth research of modern technologies such as molecular biology and network pharmacology, it has been found that traditional Chinese medicine can intervene in the expression of oxidative stress-related functions, namely, slowing down apoptosis, autophagy and degradation of extracellular matrix, etc, to play a role in the treatment of IDD. In this paper, the role of oxidative stress in IDD and the research results on the intervention of traditional Chinese medicine in oxidative stress will be expounded, in order to provide reference for the prevention and treatment of IDD by traditional Chinese medicine.

Obesity and related metabolic syndromes have been recognized as important disease risks,in which the role of adipokines cannot be ignored.Adiponectin(ADP)is one of the key adipokines with various beneficial effects,including improving glucose and lipid metabolism,enhancing insulin sensitivity,reducing oxidative stress and inflammation,promoting ceramides degradation,and stimulating adipose tissue vascularity.Based on those,it can serve as a positive regulator in many metabolic syndromes,such as type 2 diabetes(T2D),cardiovascular diseases,non-alcoholic fatty liver disease(NAFLD),sarcopenia,neurodegenerative diseases,and certain cancers.Therefore,a promising therapeutic approach for treating various metabolic diseases may involve elevating ADP levels or activating ADP receptors.The modulation of ADP genes,multimerization,and secretion covers the main processes of ADP generation,providing a comprehensive orientation for the development of more appropriate therapeutic strategies.In order to have a deeper understanding of ADP,this paper will provide an all-encompassing review of ADP.

Flow cytometry (FCM) is an interdisciplinary cell analysis technology that integrates optics, fluid dynamics, electronics, and computer science. While FCM is widely utilized in diagnosing and monitoring hematologic malignancies, its application in nonhematopoietic neoplasms (NHN) remains in its nascent stages. However, recent advancements in science and technology have led to the emergence of innovative FCM technologies, such as mass spectrometry flow cytometry (CyTOF) and spectral flow cytometry (SFC), offering promising avenues for their clinical application aiming to assist the clinical diagnosis of NHN patients. This review summarizes the features of fundamentals of traditional FCM, CyTOF, and SFC technologies, along with their applications and future prospective in NHN diagnosis and treatment, aiming to offer updated insights for the continued expansion and utilization of FCM technology in clinical laboratory settings.

Objective:To analyze the global incidence and mortality of cancer from 1990 to 2019.Methods:The Global Burden of Disease Study 2019 (GBD2019) database was utilized to analyze the global incidence and mortality of cancer, the order of incidence and mortality of cancer, the incidence and mortality of different age groups, and the trend of incidence and mortality from 1990 to 2019. Standardized incidence and mortality rates were derived by utilizing the world standard population age structure.Results:In 1990, global cancer cases numbered 10.295 9 million with an incidence rate of 192.45/100 000, leading to 5.732 6 million deaths and a mortality rate of 107.16/100 000. While in 2019, global cancer cases escalated to 23.568 5 million with an incidence rate of 304.60/100 000, resulting in 10.022 8 million deaths and a mortality rate of 129.54/100 000, all higher than those in 1990. In 2019, lung cancer showed the highest incidence rate of both sexes combined in the world (29.21/100 000), followed by colorectal cancer, breast cancer, prostate cancer and gastric cancer. The incidence of lung cancer was highest among males (39.24/100 000), while the incidence of breast cancer was highest among females (51.27/100 000). Lung cancer also had the highest mortality rate worldwide in both sexes combined (26.40/100 000), followed by colorectal cancer, gastric cancer, breast cancer and pancreatic cancer. Lung cancer had the highest mortality among males (35.72/100 000), while breast cancer had the highest mortality among females (17.85/100 000). In 2019, the global cancer incidence rate showed an upward trend with age. The incidence rate was low before the age of 25, and increased rapidly after the age of 25. The incidence rates of both sexes combined, males and females all reached the peak in the age group of over 85 years old, which were 3 084.18/100 000, 4 434.81/100 000 and 2 353.07/100 000 respectively; The incidence rate of females in the age group of 20-50 years old was higher than that of males, but the incidence rate of males in the age group of over 55 years old was higher than that of females. Compared with 1990, the incidence rates of both sexes combined in the age group of over 20, of males over 55 years old, as well as of females over 15 years old, were all higher than those in 2019. In 2019, the global tumor mortality rate showed an upward trend with age. The mortality rate was relatively low before the age of 35, and increased rapidly after the age of 35. The mortality rates for both sexes combined, as well as for males and females, reached the peak in the age group of over 85 years old, which were 1 787.84/100 000, 2 509.87/100 000, and 1 369.99/100 000 respectively; The mortality rate of females in the age group of 20-40 years old was higher than that of males, and the mortality rate of males in the age group of over 45 years old was higher than that of females; For the age of 0-80 years old, the mortality rates for both sexes combined, males, and females were lower in 2019 than 1990, but higher in the age of 85 years old and above. The global standardized incidence rate of cancer showed an overall upward trend, with an average annual increase of 0.30% from 1990 to 2019. The global standardized mortality rate of cancer showed an overall downward trend, with an average annual decrease of 0.60% from 1990 to 2019.Conclusion:From 1990 to 2019, the global standardized incidence rate of cancers shows an overall upward trend, while the global standardized mortality rate of cancers has an overall downward trend, and the global incidence and mortality rate of cancers increases with age. The global burden of cancer disease is still heavy. Lung cancer is the cancer with the highest incidence and mortality rate in the world. The highest incidence rate is lung cancer among males, and breast cancer among females. Different countries or regions need to take corresponding cancer prevention and treatment strategies according to their actual conditions.

Intervertebral disc degeneration is one of the common causes of chronic low back pain. As a common spinal disease， its clinical symptoms are mainly low back pain and limited function， which seriously affects physical and psychological health. Because of its complex and unclear pathogenesis， the treatment of intervertebral disc degeneration has been the focus of scientific researchers and clinical workers. At present， the treatment of intervertebral disc degeneration mainly includes non-surgical therapy and surgical therapy， which can alleviate the clinical symptoms of patients to a certain extent， but easily induce new complications， and it is difficult to restore the normal physiological function of the intervertebral disc. In recent years， along with the advanced research on matrix metalloproteinases （MMPs） in the tissues of intervertebral disc degeneration， it has been found that MMPs can be used as molecular therapeutic targets. The expression of MMPs in the intervertebral disc tissues can be regulated by reducing the content and composition of the extracellular matrix of the intervertebral disc， so as to slow down intervertebral disc degeneration and even reverse the occurrence of intervertebral disc degeneration. This treatment is expected to delay intervertebral disc degeneration caused by changes in extracellular matrix composition or content. In recent years， with the continuous development of network pharmacology and bioinformatics research， a large number of researchers have explored the treatment of intervertebral disc degeneration by traditional Chinese medicine （TCM） and found that TCM can reduce the degradation of extracellular matrix by inhibiting the expression of MMPs， thus alleviating the symptoms of intervertebral disc degeneration and slowing down the progression of intervertebral disc degeneration. This paper reviewed the research progress of TCM intervention in MMP expression in the treatment of intervertebral disc degeneration， aiming at providing references for the application of TCM in the prevention and treatment of intervertebral disc degeneration.

Objective:To investigate the clinical characteristics, influencing factors and prevention and treatment measures of nosocomial infection in patients with acute myeloid leukemia (AML) (non-acute promyelocytic leukemia) after applying intermediate-high dose cytarabine (Ara-C) chemotherapy.Methods:The clinical data of 80 patients with AML treated with intermediate-high dose Ara-C in the Second Hospital of Shanxi Medical University from March 2013 to January 2020 were analyzed retrospectively. The clinical features of nosocomial infection were summarized and the influencing factors of infection were analyzed by using multivariate logistic regression.Results:A total of 80 patients received 198 times of chemotherapy, and the infection rate was 72.7% (144/198). Infection sites mainly included respiratory tract infection, pulmonary infection, gastrointestinal infection. A total of 45 strains of pathogenic bacterias were detected, among which Gram negative bacilli accounted for 55.6% (25/45), Gram positive cocci accounted for 24.4% (11/45), fungi accounted for 8.9% (4/45) and viruses accounted for 11.1% (5/45). There were no significant differences in infection rate, hospitalization time, neutrophils recovery time and hospitalization expenses between the sterile laminar flow ward and the general ward (all P > 0.05). Multivariate logistic regression analysis showed that infection during induction chemotherapy was independent risk factor of infection ( OR = 5.076, 95% CI 1.978-13.022, P =0.001), and antibiotic prevention was independent protective factor of nosocomial infection ( OR = 0.332, 95% CI 0.136-0.803, P = 0.014). Conclusions:The infection rate of AML patients receiving intermediate-high dose Ara-C chemotherapy is high. During the treatment, we should be alert to the infection during induction chemotherapy and use antibiotics to prevent it in time. For patients undergoing intermediate-high dose Ara-C chemotherapy, strengthening the environmental cleanliness of general wards may achieve the same preventive effect as that of sterile laminar flow wards.