Based on spleen deficiency-phlegm dampness as the core pathogenesis of obesity， and integrating recent advances in modern medicine regarding the key role of immune inflammation in obesity， this paper proposes a multidimensional pathogenic network of "obesity-spleen deficiency-phlegm dampness-immune imbalance". Various traditional Chinese medicine （TCM） herbs that strengthen the spleen， regulate qi， and resolve phlegm and dampness can treat obesity by improving spleen-stomach transport and transformation， promoting water-damp metabolism， and regulating immune homeostasis. This highlights immune inflammation as an important entry point to elucidate the TCM concepts of "spleen deficiency-phlegm dampness" and the therapeutic principle of "strengthening the spleen and eliminating dampness to treat obesity". By systematically analyzing the intrinsic connection between "spleen deficiency generating dampness， internal accumulation of phlegm dampness" and immune dysregulation in obesity， this paper aims to provide theoretical support for TCM treatment of obesity based on dampness.

Objective: To investigate the clinicopathological characteristics and surgical outcomes of adrenal hemolymphangioma,so as to enhance the understanding of this disease. Methods: Clinical and pathological data of 8 patients with adrenal hemolymphangioma admitted to the Department of Urology of our hospital during Jan.2013 and Dec.2022 were retrospectively analyzed,and relevant literature was reviewed. Results: The patients included 5 males and 3 female,median age 54(25-75) years.Adrenal hemolymphangioma was detected in all patients in physical examinations without obvious symptoms.And 4 of the patients had a history of hypertension.Adrenal function test results showed no abnormalities.A total of 9 tumors were identified by imaging examination,including 1 unilateral multiple and 7 unilateral solitary tumors,with a median diameter of 3.6(1.0-5.4) cm.Posterior laparoscopic adrenal tumor resection was performed in 7 cases and robot-assisted laparoscopic adrenal tumor resection in 1 case；all of the tumors were completely removed.The median operation time was 77(53-115) min,median intraoperative blood loss 7.5(2.0-20.0) mL,and median postoperative hospital stay 4(1-7) d.Postoperative pathology showed interwoven deformed and dilated blood vessels and lymphatic vessels in the cystic tumors,with a large amount of lymphoid fluid,lymphocytes and red blood cells.Chronic lymphocyte infiltration was visible between the tube walls.The cystic cavity was partially connected,with flat endothelial cells lining.The pathological diagnosis was adrenal hemolymphangioma.During the median follow-up of 53.5(12.0-106.8) months,all patients recovered well,with stable blood pressure and no tumor recurrence or metastasis. Conclusion: Adrenal hemolymphangioma has no specific clinical symptoms.As adrenal functional tests show no obvious abnormalities,the diagnosis depends on pathological examinations.Popsterior laparoscopic or robot-assisted laparoscopic resection has good efficacy and prognosis.

[Objective] To explore the diagnosis and treatment experience of tension hydrocele. [Methods] The clinical data of 2 patients with tension hydrocele treated in our hospital were retrospectively analyzed.Relevant literature was retrieved to analyze the clinical characteristics of this disease. [Results] Case 1 was diagnosed due to swelling and pain of the left scrotum after trauma for more than one month, which worsened for one day.Physical examination showed high tension in the left scrotum and positive light transmission test.Ultrasound examination revealed that the blood flow signal in the left testis disappeared.Emergency left scrotal exploration and hydrocelectomy were performed.There was no sign of testis torsion during the operation.Case 2 was diagnosed mainly due to hydrocele of the right testis for 1 year, which worsened for 1 week and complicated with testis distension and pain.Physical examination showed high tension in the right scrotum and positive light transmission test.Ultrasound examination revealed that the blood flow signal in the right testis decreased.After 40ml of fluid was extracted under ultrasound monitoring, the blood flow signal in the right testis recovered.Hydrocelectomy was performed the next day.During the follow-up of 8 months, there was no recurrence of hydrocele.A search of domestic and foreign literature showed that there were no reports in domestic literature, while a total of 11 cases were reported in foreign literature. [Conclusion] Tension hydrocele of the testis is a rare emergency of the scrotum.Surgery or decompression should be performed as soon as possible to restore testicular blood supply, and hydrocelectomy should be performed simultaneously or in stages to prevent recurrence.

[Objective] To investigate the efficacy of nephron-sparing surgery (NSS) for the treatment of renal sinus angiomyolipoma and summarize the surgical experience. [Methods] The clinical data and follow-up results of 10 cases of renal sinus angiomyolipoma treated during Sep.2014 and Feb.2022 in our hospital were retrospectively analyzed. [Results] The patients included 1 male and 9 female.The mean tumor diameter was (5.7±2.8) cm.The RENAL score was 8 in 1 case, 9 in 3 cases, 10 in 4 cases, and 11 in 2 cases.Retroperitoneal laparoscopic partial nephrectomy was conducted in 3 cases, robot-assisted laparoscopic partial nephrectomy in 3 cases, and open partial nephrectomy by transabdominal approach in 4 cases.All operations were successful.The median operation time was 225 (97-340) minutes and the median warm ischemic time was 30.5 (5-43) minutes.Two patients underwent renal vein clamping simultaneously, with clamping time of 18 and 29 minutes, respectively.The median estimated blood loss was 200(10-600) mL, and no patients received blood transfusion.The difference between postoperative and preoperative hemoglobin concentration was statistically significant [113 (94-130) g/L vs.136 (95-150) g/L, P=0.041]. The difference between the postoperative and preoperative serum creatinine level was not statistically significant [58(35-89) μmol/L vs. 62(39-77) μmol/L, P=0.722]. One case suffered lymphorrhagia (Clavien-Dindo grade Ⅰ) and recovered with conservative treatment; 1 case experienced local recurrence after a follow-up of 99 months; 9 patients recovered uneventfully without any postoperative complications. [Conclusion] NSS is an effective treatment strategy for renal sinus angiomyolipoma.Complete resection plays a key role.Due to possible recurrence, long-term follow-up is recommended.

Objective:To establish an automatic potentiometric method for determination of fluoride in urine.Methods:The fluorine level in human urine was determined by an automatic potentiometric titrator. Methodological experimental analysis of the linear range, detection limit, precision, and accuracy (quality control sample testing and actual sample spiking recovery experiment) of the method were carried out. The determination results of 33 urine samples were compared with those of the national health industry standard Determination of Fluoride in Urine - Ion Selective Electrode Method (WS/T 89-2015).Results:The linear range of the standard curve of urine fluoride in the automatic potentiometric determination method was 0.1 - 10.0 mg/L. The range of linear correlation coefficient ( r) was 0.999 6 to 0.999 9. The minimum detection limit of urine fluoride was 0.01 mg/L (sampling volume was 10.0 ml). The relative standard deviation ( RSD) range for precision experiments was 0.00% to 3.45%. The quality control samples of the national urine fluoride external quality control assessment in 2022 were determined, and the results were within the range of the consensus value. The spiked recovery experiment was carried out, the recovery rate ranged from 100.0% to 104.4%, with a total average recovery rate of 102.1%. The method comparison experiment showed that there was no statistically significant difference between the test results of automatic potentiometric method and the standard method recommended by the national urine fluoride health industry ( t = - 0.90, P = 0.375). Conclusions:A method has been successfully established, achieving automation of the reagent addition and detection process of urine fluoride samples after sampling. It has the characteristics of wide linear range, low detection limit, good precision, and high accuracy, and is suitable for rapid and automatic determination fluoride level of large quantities of urine samples.

Objective:To establish a new method for antimony cerium catalytic spectrophotometric detection (referred to as the new method) of urinary iodine.Methods:By utilizing the efficient catalytic ability of iodine for the oxidation-reduction reaction of antimony and cerium, a new method was applied to conduct linear relationship fitting curve, detection limit, pecision, accuracy and other experiments within the range of 0 - 300 μg/L urine iodine mass concentration. The method was compared with the Arsenic Cerium Catalytic Spectrometric Method (WS/T 107.1-2016) recommended national industry standard.Results:In the range of 0 - 300 μg/L urine iodine mass concentration, the correlation coefficients│ r│ of the fitted curves were > 0.999 0, and the qualitative detection limit was 7.96 μg/L (with a sampling volume of 0.25 ml). Four actual urine samples with different iodine mass concentrations were selected for precision experiments, and the relative standard deviation ( RSD) of the detection precision ranged from 0.96% to 2.87%, all < 5%. The actual urine sample spiked recovery range from 99.62% to 103.88%, with an overall average recovery rate of 101.75%. Two methods were used to detect 30 urine samples, and the difference in results was not statistically significant ( t = 0.68, P = 0.501). Conclusions:The new method has high reaction sensitivity and accuracy, avoiding the use of highly toxic substance arsenic trioxide. The antimony reagent used is safe, and the environmental pollution caused by waste liquid discharge is small. The detection steps are similar to Arsenic Cerium Catalytic Spectrometric Method, the laboratory urine iodine detection personnel do not need special training to operate and use it, which is suitable for the application and promotion of urine iodine detection in grassroots iodine deficiency disorders monitoring work.

Objective:To establish an antimony cerium catalytic spectrophotometric method for determination of iodine in water (referred to as the new method).Methods:Using the fading reaction principle of iodine catalyzed kinetics of antimony cerium to determine the iodine content in water. Methodological evaluations were conducted on the linear relationship, quantitative detection limit, precision, and accuracy (determination of national water iodine first level standard substances GBW09113f, GBW09114f, and addition recovery experiments) of the new method within the range of 0 to 100 μg/L iodine mass concentration. And the method was compared with the determination results of water iodine by arsenic cerium catalytic spectrophotometry recommended by the national iodine reference laboratory (NRL).Results:Within the range of 0 - 100 μg/L iodine mass concentration, the curve correlation coefficient of the new method was greater, and | r| > 0.999 0, and the quantitative detection limit was 0.15 μg/L (the sampling volume was 1 ml), the relative standard deviation of the detection precision of water samples with low, medium and high iodine mass concentrations were less than 2%. The new method had determined the average values of national water iodine first level standard substances GBW09113f and GBW09114f were 8.32 and 54.54 μg/L, respectively, all within the standard value range. The recovery range of standard addition was 92.6% - 99.2%, and the total average recovery was 96.4%. Compared with the NRL recommended method, the difference was not statistically significant ( t = 0.99, P > 0.05). Conclusion:The new method does not require the use of highly toxic substance arsenic trioxide, has high reaction sensitivity and accuracy, and is suitable for the promotion and use of water iodine detection.

Objective:To study the application of ammonium cerium sulfate spectrophotometry for determination of iodide in water.Methods:Ammonium cerium sulfate spectrophotometry was used to determine the iodine content of tap water and source water in the range of 0 - 20 and 0 - 200 μg/L iodine concentration. The effect of the method was verified in terms of linear range, detection limit, precision and accuracy.Results:In the range of 0 - 20 and 0 - 200 μg/L iodine concentration, the absolute values of linear correlation coefficients were > 0.999 0; the detection limits were 0.18 and 1.02 μg/L, respectively; the coefficient of variation of low, medium and high iodine concentrations in tap water and source water was less than 5%. In the range of 0 - 20 μg/L iodine concentration, the spiked recovery rates of tap water and source water were 90.33% - 110.46% and 92.21% - 102.82%, respectively; in the range of 0 - 200 μg/L iodine concentration, the spiked recovery rates of tap water and source water were 90.14% - 102.62% and 91.36% - 106.18%, respectively. The national first level standard materials GBW09113g and GBW09114g were tested, and the results of water iodine determination were within the given range of the standard materials.Conclusion:Ammonium cerium sulfate spectrophotometry has a wide linear range, high accuracy, and good precision, making it suitable for widespread application in grassroots areas.

Objective:To study the application of antimony cerium catalytic spectrophotometry using a fully automatic biochemical analyzer (hereinafter referred to as this method) in the determination of water iodine.Methods:Based on the principle of antimony cerium reoxidation reduction reaction catalyzed by iodine, the iodine content in water was determined in the range of 0 - 100 μg/L iodine mass concentration. The detection limit, precision and accuracy (determination of standard substances GBW09113j and GBW09114j for iodine composition analysis in water and the experiment of standard recovery) of this method were verified. This method was compared with the arsenic and cerium catalytic spectrophotometry recommended by the National Reference Laboratory for Iodine Deficiency Disorders.Results:Within the range of 0 - 100 μg/L iodine mass concentration, the qualitative and quantitative detection limits of this method were 0.81 and 2.70 μg/L, respectively (sampling quantity was 35 μl). In the precision experiment, the relative standard deviation of water samples with different iodine mass concentrations ranged from 1.2% to 4.0%. The determination results of the standard substances GBW09113j and GBW09114j for iodine composition analysis in water were both within the given standard value range. The standard recovery rates of water samples with low, medium and high iodine mass concentrations ranged from 101.0% to 106.0%, and the total average standard recovery rate was 103.2%. The results of the method comparison experiment showed that there was no statistically significant difference in the results of water iodine determination between the two methods ( t = - 0.78, P = 0.779). Conclusion:This method has a low detection limit, high precision and good accuracy, making it suitable for the detection of large quantities of samples in the monitoring of iodine deficiency disorders.

Objective:To establish a hydride generation atomic fluorescence method using ammonium persulfate as the digestion reagent for determination of arsenic in urine (hereinafter referred to as this method).Methods:The collected urine samples with ammonium persulfate were heated and digested on the tubular electric heating automatic control constant temperature digester (60 holes), with 5% hydrochloric acid solution as reaction medium and current carrier and 1.5% potassium borohydride solution as reducing agent. Arsenic content was determined with a four-channel atomic fluorescence spectrometer. The arsenic standard solution of 0 - 10 μg/L was prepared to determine the standard curve of this method, and the method was evaluated from the detection limit, linear range, correlation coefficient, precision, standard addition recovery experiment, and urine arsenic quality control sample detection. The standard method "Determination of Arsenic in Urine by Hydride Generation Atomic Fluorescence Spectrometry" (WS/T 474-2015, referred to as the standard method) was used for comparison experiments.Results:When the sampling volume was 1 ml, the detection limit of this method (digest with 1 ml 1.5 mol/L ammonium persulfate) was 0.03 μg/L. In the range of arsenic content from 0 - 10 μg/L, the linear relationship between arsenic content and fluorescence intensity was good, and the correlation coefficients ( r) were all 0.999 9. The relative standard deviations( RSD) of the three replicates of urine samples with different concentrations were 1.00%, 0.89% and 0.49%, respectively. Urine arsenic quality control samples were tested, and the test results were all within the range of public values; the overall average recovery was 102.29%, and the recovery range was 92.10% - 108.15%. Compared with the standard method in the determination results of 20 urine samples, the difference was not statistically significant ( t = - 0.40, P > 0.05). Conclusions:The hydride generation atomic fluorescence spectrometry using ammonium persulfate as digestion reagent for the determination of arsenic in urine has the advantages of low detection limit, good precision, high accuracy, small amount of sampling and digestion reagent, simple operation, and less harmful gas generation in sample pretreatment. It is suitable for rapid determination of arsenic in urine in large quantities.