It is considered that "latent wind in stomach collaterals" is the core pathogenesis underlying the inflammation-caner transformation of helicobacter pylori-associated gastritis （HpAG）. The concept of "latent wind in stomach collaterals" integrates stomach wind theory， latent pathogen theory， and collateral disease theory， referring to wind pathogen deeply hidden in the stomach collaterals， characterized by both external and internal wind pathogen as well as latent pathogen that remain concealed and may be triggered under certain conditions. Accordingly， the Correa cascade is reclassified into four stages including the prodromal stage， progressive stage， transitional stage and carcinogenic stage. In the prodromal stage， the fundamental pathogenesis is described as "wind toxin invading externally with collateral deficiency and stirring of wind". In the progressive stage， wind is accompanied by qi constraint， fire pathogen， and dryness pathogen， manifesting as "wind pathogen complicated by constraint" "wind-fire agitation" and "wind-dryness interaction". In the transitional stage， "wind transforming into phlegm-drool and stomach collaterals being obstructed by stasis" is identified as a critical window for disease reversal. In the carcinogenesis stage， "wind-qi hyperactivity leading to pathological transformation， and collateral damage resulting in abdominal masses" drives tumor progression and metastasis. This paper proposes the treatment principle of "wind-dispelling throughout the entire process and stage-based treatment"， according to the pathological evolution of "collateral deficiency-collateral stagnation-collateral accumulation". In the prodromal stage， it is suggested to dispel wind and resolve toxin， fortify spleen and tonify collaterals； in the progressive and transitional stage， the method of dispelling wind pathogen， clearing phlegm and eliminating stasis should be used； in the carcinogenesis stage， it is suggested to expel wind and remove pathogens from collaterals， disperse concretions and eliminate tumors.

ObjectiveTo investigate the efficacy and safety of Shuganning injection in the treatment of liver injury by observing the clinical outcome of patients with liver injury after treatment with Shuganning injection and comparing it with reduced glutathione （GSH）. MethodsThis study was conducted among 175 patients with liver injury who attended 6 hospitals in China （Beijing YouAn Hospital， Capital Medical University； Nanyang First People’s Hospital； The Second Affiliated Hospital of Xi’an Jiaotong University； The Fifth Medical Center of Chinese PLA General Hospital； The Third Hospital of Hebei Medical University； The Affiliated Hospital of Guizhou Medical University） from April 25， 2019 to February 28， 2022. The patients were divided into experimental group （89 patients treated with Shuganning injection） and control group （86 patients treated with GSH）， and the course of treatment was 4 weeks for both groups. Related indicators were recorded before treatment， after treatment， and after drug withdrawal for 8 weeks， including liver function parameters， blood biochemical parameters， blood lipids， coagulation profiles， liver fibrosis markers， traditional Chinese medicine （TCM） syndrome score， and ultrasound findings， as well as adverse events during treatment. The Wilcoxon rank-sum test was used for comparison of continuous data between two groups， and the chi-square test was used for comparison of categorical data between two groups. The Wilcoxon signed-rank test was used for comparison of observation indicators before treatment， at week 4 of treatment， and after drug withdrawal for 8 weeks. When the efficacy evaluation of TCM syndromes was used as the outcome， a pooled analysis was performed for the effective cases and the markedly effective cases， and a Logistic regression model was used to calculate the odds ratio （OR） and its 95%CI. ResultsAfter 4 weeks of treatment with Shuganning injection， the patients showed significant reductions in TCM syndrome score （P<0.001） and the levels of aspartate aminotransferase， alanine aminotransferase， total bilirubin， and direct bilirubin （all P<0.001） and a significant increase in the level of albumin （P=0.002）， and these significant improvements persisted after drug withdrawal for 8 weeks. Furthermore， compared with the control group， the experimental group had a significantly higher proportion of patients assessed as effective or markedly effective cases （48.31% vs 32.56%， P=0.033）. Compared with the control group， the experimental group had a significantly greater change in TCM syndrome score at weeks 1-4 of treatment and after drug withdrawal for 8 weeks （P<0.05）. At week 4 of treatment， the experimental group had a significantly greater reduction in alanine aminotransferase than the control group （P<0.05）， and at week 8 after drug withdrawal， the experimental group had a significantly greater reduction in alanine aminotransferase and aspartate aminotransferase than the control group （all P<0.05）. One patient in the experimental group （1.12%） experienced an adverse event， which was determined to be associated with the progression of viral hepatitis. ConclusionShuganning injection can effectively improve liver injury， with good long-term efficacy and a low incidence rate of adverse reactions.

Gastric precancerous lesions， often presenting as decreased appetite， weight loss， fatigue， epigastric fullness， and upper abdominal pain， pose challenges to treatment and considerably affect patients' quality of life. Pathologically， these lesions are characterized by alterations in the gastric mucosa accompanied by intestinal metaplasia or dysplasia， which markedly elevate the risk of developing gastric cancer. Traditional Chinese medicine （TCM） practitioners have explored various therapeutic approaches focusing on invigorating the spleen， resolving dampness， clearing heat， addressing phlegm accumulation， activating blood， and detoxifying. For contemporary populations suffering from gastric precancerous lesions， our team has innovatively proposed a core pathogenesis theory encompassing deficiency， stagnation， phlegm， stasis， and toxin. Furthermore， our team has developed a comprehensive prevention and treatment framework： Invigorating the spleen and harmonizing the stomach （foundational principles）， balancing and restoring Qi movement （primary objectives）， resolving phlegm and unblocking collaterals （routine practices）， detoxifying and dissipating nodules （critical interventions）， and comprehensive health management （supportive care）. This framework provides a robust theoretical foundation along with practical guidance for preventing and treating diseases related to the spleen-stomach axis. From a pathological perspective， key interventions for managing gastric precancerous lesions include restoring integrity of the gastric mucosae while regulating its microenvironmental conditions and enhancing mucosal circulation， which are integral throughout the entire treatment process. On this basis， a full-course chain of prevention and treatment has been established within clinical practice， encompassing functional gastrointestinal disorders-superficial gastritis-atrophic gastritis-gastric precancerous lesions-prevention and treatment post-endoscopic submucosal dissection. The guiding principles of this treatment approach involve invigorating the spleen， regulating Qi movement， resolving phlegm， unblocking collaterals， and detoxifying. TCM compound formulas such as Jianpi Tongluo Jiedu prescription and Hezhong Xiaopi granules， as well as Chinese patent medicines like Weifuchun and Moluodan， can be used for treating gastric precancerous lesions at different stages. Through medicinal regulation， the state of the gastric mucosa can be improved， and thus the development of gastric precancerous lesions can be curbed from the perspective of full-course prevention and treatment.

ObjectiveTo investigate the effect of Hezhongxiaopi granules （HZXPG） on methylnitronitrosoguanidine （MNNG）-mediated gastric mucosal cell apoptosis and the regulatory effects on the Nicalin （Ncln）-C/EBP homologous protein （CHOP） axis and endoplasmic reticulum stress （ERS）. MethodsThe cell counting kit-8 （CCK-8） assay was employed to examine the inhibitory effect of MNNG on the proliferation of GES-1 cells， and the optimal effective dose of MNNG was selected. Human gastric mucosal GES-1 cells were allocated into the control， model （MNNG， 1.562 5 mmol·L^-1）， and low/high-dose HZXPG （5% and 10% HZXPG-containing serum） groups. Phalloidin staining was employed to detect MNNG-induced morphological changes in human gastric mucosal cells. Terminal deoxynucleotidyl transferase dUTP nick end labeling （TUNEL） assay was adopted to assess cell apoptosis. Annexin Ⅴ/propidium iodide （Annexin Ⅴ/PI） flow cytometry was utilized to measure the alterations in the apoptotic cycle of human gastric mucosal cells. Western blot was performed to determine the expression levels of proteins related to apoptosis， ERS， and the Ncln/CHOP axis. ResultsCompared with the control group， the model group exhibited a reduction in the surface area of GES-1 cells， endoplasmic reticulum （ER） dilation， increased early and late apoptosis rates of gastric mucosal cells， upregulated protein levels of truncated Bid （tBid）， Bcl-2-associated X protein （Bax）， cleaved-cysteinyl aspartate-specific proteinase （Caspase）-3， and cleaved-Caspase-8， and downregulated protein level of B-cell lymphoma-2 （Bcl-2） （P<0.01）. In addition， the expression levels of binding immunoglobulin protein （BiP）， Ncln， and CHOP were upregulated （P<0.01）， with enhanced Ncln expression in the ER and elevated CHOP expression in the nucleus. Compared with the model group， the high-dose HZXPG group showed a significant increase in the surface area of gastric mucosal cells. Both dose groups exhibited inhibited ER dilation and reduced early and late apoptosis rates of gastric mucosal cells （P<0.01）. Low-dose HZXPG decreased the expression of tBid and Bax （P<0.05， P<0.01） and promoted Bcl-2 expression （P<0.01）. High-dose HZXPG reduced the expression levels of tBid， Bax， cleaved-Caspase-3， and cleaved-Caspase-8 （P<0.05， P<0.01） and increased the Bcl-2 expression level （P<0.05）. Furthermore， high-dose HZXPG downregulated the expression levels of BiP， Ncln， and CHOP （P<0.05， P<0.01）， while decreasing the nuclear translocation of CHOP. ConclusionHZXPG alleviates MNNG-induced ERR-mediated apoptosis of gastric mucosal cells by inhibiting the Ncln-CHOP axis， thereby relieving gastric mucosal cell damage caused by precancerous gastric lesions.

Senile chronic atrophic gastritis （SCAG） is a condition characterized by high prevalence， prolonged duration， and difficulty in treatment， along with a significant risk of carcinogenesis. This severely impacts the quality of life among the elderly population in China. The prevention and management of SCAG represent one of the most urgent and prominent needs within the current health care and elderly care sectors. However， existing treatment options are limited， with insufficient mucosal repair following Helicobacter pylori eradication， as well as a lack of effective methods to reverse atrophy or intestinal metaplasia. The primary objectives in treating chronic gastritis in older adults are symptom relief and alleviation of mucosal histological abnormalities. Traditional Chinese medicine （TCM） offers unique advantages for managing patients with SCAG. Therefore， utilizing TCM methodologies underpinned by TCM theory to prevent and treat the progression of SCAG holds considerable clinical significance. Our research team has been dedicated to theoretical， clinical， and fundamental investigations into gastric precancerous lesions and SCAG for an extended period. This article systematically reviews the intricate causal relationship between the spleen-stomach system and aging while elucidating TCM pathogenesis of SCAG as internal deficiency coupled with excess in manifestations. It explores evolutionary patterns of dampness， stagnation， stasis， toxicity， and deficiency and proposes a progressive pathogenic evolution chain： Aging-deficiency of spleen and kidney-imbalance of Qi and blood-phlegm turbidity accompanied by Qi stagnation-accumulation of phlegm， stasis， and toxicity-weakness of stomach collaterals. The core treatment principle emphasizes simultaneous treatment targeting both spleen and kidney as its foundation while employing strategies such as promoting Qi movement to resolve dampness， alongside efforts aimed at removing stasis and detoxifying as primary approaches. Finally， this article summarizes current research achievements in TCM interventions for SCAG， aiming to provide new insights for clinical practice and scientific research in TCM interventions for SCAG.

Ulcerative colitis （UC）， a chronic nonspecific inflammatory bowel disease characterized by unclear etiology， complex contributing factors， and a refractory course with malignant transformation potential， imposes a substantial burden on both individual patients and healthcare systems. There is an urgent need to explore effective therapeutic strategies and pharmacological interventions. Professor LIU Zhen， based on years of clinical practice， proposed a dynamic pathogenesis chain of UC： Spleen deficiency with dampness excess as the foundation， dampness obstruction as the nexus， stasis-toxin interaction as the key， and stasis-toxin damaging intestinal collaterals as the terminal outcome. The treatment， following the progression of deficiency （depression）-dampness-toxin-stasis （toxin）， should focus on invigorating the spleen and resolving dampness. A stage-specific treatment approach is emphasized. During the susceptible stage， prevention is recommended， which relies on regulating the diet， maintaining a positive mental state， and adjusting daily routines to invigorate the spleen and replenish Qi. During the acute attack and remission stages， the treatment should be tailored according to clinical typing and disease severity， flexibly employing therapeutic strategies such as tonifying deficiency， resolving depression， eliminating dampness， clearing heat， detoxifying， arresting bleeding， and resolving stasis in order to interrupt disease progression. In the recovery stage， latent pathogenic factors should be addressed while the postnatal constitutional foundation be preserved to prevent recurrence. According to the TCM principle of treating disease before its onset， a whole-course management path of early protection-interception-stratified care-consolidation has been developed， covering all stages of UC， to inform its clinical prevention and treatment.

Objective: To determine the correlation between obesity related indicators and blood lipid levels among children and adolescents. Methods: A total of 5 812 participants were included. Height, weight, body composition, waist circumference, blood pressure were measured and fasting glucose and blood lipid levels were tested based on a cross sectional survey of children and adolescents 6-17 years in Beijing, 2022-2023. The body mass index (BMI), fat mass index (FMI), body roundness index (BRI) and waist to height ratio (WHtR) were calculated. Linear and Logistic regression were used to analyze the associations between the four obesity indicators (BMI, FMI, BRI, and WHtR) and blood lipids in children and adolescents. The area under the curve (AUC) of the receiver operating characteristic (ROC) was used to evaluate differences in the associations between different obesity indicators with dyslipidemia. Results: Linear regression showed that BMI, FMI, BRI, and WHtR were positively correlated with triglyceride (TG), low density lipoprotein cholesterol (LDL-C), and non high density lipoprotein cholesterol (non HDL-C) levels (boys: β 6-9 years =0.02-0.28, β 10-17 years =0.02-0.37; girls: β 6-9 years =0.02-0.28, β 10-17 years =0.03-0.25), and negatively correlated with the high density lipoprotein cholesterol (HDL-C) level in both genders across age subgroups (boys: β BMI = -0.03, β FMI = -0.04 , β BRI =-0.09, β WHtR =-0.17; girls: β BMI =-0.03, β FMI =-0.04, β BRI =-0.11, β WHtR =-0.20) (all P <0.01). The associations between total cholesterol (TC) and remnant cholesterol (RC) levels with obesity indicators differed significantly by gender and age. The TC level was positively associated with obesity indicators in boys of all ages ( β BMI =0.01, β FMI =0.03, β BRI = 0.08 , and β WHtR =0.16) but only with FMI, BRI, and WHtR in girls 6-9 years of age ( β FMI =0.02, β BRI =0.05, and β WHtR =0.08) (all P <0.05). The RC level had a negative correlation with BRI in boys 10-17 years of age ( β =-0.01) and a positive correlation with BMI in girls 6- 9 years of age ( β =0.00) (all P <0.05). Logistic regression indicated that elevated obesity indicators were significantly associated with higher risks of elevated TG, LDL-C, and non HDL-C levels and a decreased HDL-C level in all gender age stratas (all P <0.01). Only the BMI and FMI in girls 6-9 years of age were significantly related to a high RC ( OR =1.07, 1.07, both P <0.05). ROC analysis revealed that FMI, BRI, and WHtR were more predictive than BMI of elevated TG, LDL-C, and non HDL-C levels. The BMI was superior in predicting a decreased HDL-C level in boys, while no significant difference was detected among indicators in girls. Indeed, all obesity indicators had poor predictive performance for elevated TC, RC, and LDL-C levels in girls (all AUC<0.7). Conclusions Obesity indicators reflecting body fat content and fat distribution are shown to be closely associated with dyslipidemia in children and adolescents with obvious age and gender differences. The FMI, BRI, and WHtR have potential advantages in the early identification of dyslipidemia among children and adolescents compared to the BMI alone.

Objective·To analyze the influencing factors of left ventricular mass index(LVMI)in patients with essential hypertension,and explore the relationship between aldosterone levels and left ventricular hypertrophy(LVH).Methods·A total of 155 patients with essential hypertension,hospitalized in the Hypertension Department of the Northern Campus of Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,from January 2013 to December 2019,and excluded from primary aldosteronism by saline load test(post-saline suppression plasma aldosterone<60 pg/mL),were enrolled.General clinical data(age,gender,smoking status,duration of hypertension,etc.),physical examination data(blood pressure and body mass index),blood biochemistry(renal function,electrolytes,fasting blood glucose,and lipids),urinary sodium,and relevant hormones(basal and activated aldosterone,basal and activated renin,urinary aldosterone,post-saline suppression aldosterone,etc.)were collected.LVMI was evaluated by echocardiography.Pearson correlation analysis was used to assess the linear association between LVMI and each variable.Binary Logistic regression models were applied to screen independent risk factors for LVH.Multiple linear regression models were used to assess the impact of variables on LVMI.Results·The mean age of the 155 patients was(46.85±11.08)years,with 51.6%being male.Pearson correlation analysis showed that LVMI was significantly positively correlated with post-saline suppression aldosterone(r=0.334,P<0.001),age(r=0.184,P=0.032),duration of hypertension(r=0.241,P=0.005),systolic blood pressure(r=0.280,P=0.001),and pulse pressure(r=0.339,P<0.001).No significant correlations were found with diastolic blood pressure,body mass index,fasting blood glucose,total cholesterol,low-density lipoprotein cholesterol,triglyceride,high-density lipoprotein cholesterol,urinary sodium,basal aldosterone,activated aldosterone,or urinary aldosterone.After adjusting for confounders,including gender,smoking history,age,duration of hypertension,body mass index,pulse pressure,systolic blood pressure,fasting blood glucose,and total cholesterol,binary Logistic regression showed that each 1 pg/mL increase in post-saline suppression aldosterone was associated with a 5.1%increased risk of LVH(OR=1.051,95%CI 1.016?1.088,P=0.004).Multiple linear regression identified suppressed aldosterone(β=0.359,P<0.001),duration of hypertension(β=0.168,P=0.046),and pulse pressure(β=0.226,P=0.008)as independent influencing factors for LVMI.Conclusion·Suppressed aldosterone is an independent influencing factor for LVH in patients with essential hypertension.

In October 2023, a patient with locally advanced breast cancer was treated in the Department of Reconstructive Microsurgery, Xuzhou Renci Hospital. Radical mastectomy for breast cancer was performed, and the huge soft tissue defect (40.0 cm×22.0 cm) was reconstructed by a pedicled transverse rectus abdominis myocutaneous flap (TRAMF) combined with a free deep inferior epigastric artery perforator flap (DIEPF) and a free anterolateral thigh perforator flap (ALTPF). The size of the lower abdominal flap was 28.0 cm×11.0 cm, and the size of ALTPF was 30.0 cm×11.0 cm. All flaps survived well with soft texture. Scores of Karnofsky Performance Status (KPS) and Visual Analogue Scale (VAS) were significantly improved at 1 month after the surgery. The patient refused chemotherapy, radiotherapy and other comprehensive treatments at the time. A local cancer recurrence in chest wall was found at 9 months after surgery, the patient was currently under chemotherapy and other comprehensive therapies.

In October 2023, a patient with locally advanced breast cancer was treated in the Department of Reconstructive Microsurgery, Xuzhou Renci Hospital. Radical mastectomy for breast cancer was performed, and the huge soft tissue defect (40.0 cm×22.0 cm) was reconstructed by a pedicled transverse rectus abdominis myocutaneous flap (TRAMF) combined with a free deep inferior epigastric artery perforator flap (DIEPF) and a free anterolateral thigh perforator flap (ALTPF). The size of the lower abdominal flap was 28.0 cm×11.0 cm, and the size of ALTPF was 30.0 cm×11.0 cm. All flaps survived well with soft texture. Scores of Karnofsky Performance Status (KPS) and Visual Analogue Scale (VAS) were significantly improved at 1 month after the surgery. The patient refused chemotherapy, radiotherapy and other comprehensive treatments at the time. A local cancer recurrence in chest wall was found at 9 months after surgery, the patient was currently under chemotherapy and other comprehensive therapies.