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.

Escherichia coli(E.coli)is a key pathogenic bacterium responsible for postpartum endo-metritis,with its colonization in the reproductive tract closely associated with endometrial damage and disruption of the ovarian cycle.This ultimately leads to infertility,causing significant economic losses to the dairy industry.Macrophages play a pivotal role in the inflammatory response.This study aims to investigate the mRNA expression profile of bovine bone marrow-derived macropha-ges following E.coli infection using RNA sequencing(RNA-seq)technology.Additionally,it seeks to identify the biological functions and signaling pathways of differentially expressed genes(DEGs)through Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses.The results demonstrated that E.coli infection induced differential expression of 4 522 genes,with 2 141 upregulated and 2 381 downregulated.These genes were primarily asso-ciated with inflammatory responses,where TLR2,TLR4,NLRP3,and PTGS2 played pivotal roles.PGD2 synthesis was mediated by TLR2,TLR4,and NLRP3.Transcriptome sequencing of bovine bone marrow-derived macrophages infected with E.coli and treated with a PGD2 inhibitor revealed a marked downregulation of TLR2 and TLR4 gene expression.qPCR validation results were highly consistent with the RNA-seq findings.This study elucidates the interactive regulatory roles of TLR2,TLR4,and NLRP3 in conjunction with PGD2,which collectively modulate bovine endome-tritis.These findings offer significant molecular insights that enhance our understanding of the pathological mechanisms underlying bovine endometritis,thereby informing its prevention and treatment strategies.

Objective To analyze the implementation of MPOWER tobacco control policies in different regions and populations in China,as well as the impact of perceptions of tobacco control policies on individual smoking behavior and quit intentions,to promote the fairness of policy implementation and protection for vulnerable groups.Methods A multivariable regression model was constructed utilizing raw data from the China Adult Tobacco Survey to analyze disparities in perceived MPOWER policy implementation among various social demographics and its impact on smoking behavior and quitting intentions.Results Regarding protection from tobacco smoke(P),local economic level,urban-rural divide were significantly correlated with awareness of comprehensive smoking bans.For offering help to quit smoking(O),local tobacco industry revenue and individual age were associated with the doctor's advice for quitting.As to the warning about the harm of tobacco(W),economic level,geography and urban-rural disparity were correlated with the visibility of health warnings.About the tobacco advertising,promotion and sponsorship(E),geography was related to the exposure to tobacco advertisements,local tobacco industry revenue was associated with the tobacco promotion.For tobacco taxes(R),education level and age were significantly correlated with tobacco affordability.People who perceived comprehensive smoking bans(OR=0.69,95%CI:0.59-0.81)was associated with less smoking behavior,while people perceiving tobacco promotional activities(OR=2.51,95%CI:2.00-3.17)were more likely to smoke.Additionally,people who perceived comprehensive smoking bans(OR=1.70,95%CI:1.25-2.31)and health warning(OR=2.09,95%CI:1.48-3.01)had higher intention to quit smoking.Conclusion In economically disadvantaged regions and among specific socially vulnerable groups(such as low-income individuals,rural residents,and the elderly)in China,the perception of tobacco control policy implementation is relatively low,the perception of tobacco control policies can influence smoking behavior and quitting intentions.Legislative and enforcement efforts should be increased targeting these groups with lower perceptions of the policies to enhance the fairness of tobacco control measures.

AIM:To evaluate the pharmacokinet-ics(PK)and pharmacodynamics(PD)of two recom-binant human insulin injection by euglycemic clamp technology in healthy male subjects after a single subcutaneous injection.METHODS:We con-ducted a randomized,open-label,single dose,two period,crossover study.A total of 24 healthy male subjects were enrolled and randomized to receive single subcutaneous doses(0.2 U/kg)of the investi-gational products every period.The PK and PD characteristics were assessed by euglycemic clamp up to 14 hours after dosing.RESULTS:Euglycemic clamp technique was successfully established.C-peptide levels detected at each time point before and after administration indicated that endoge-nous insulin secretion was inhibited in the two groups after administration.The geometric mean ratio of Cmax and AUC0-tand 90％confidence interval(CI)of test preparation and reference preparation under fasting condition were in the range of 80.00％-125.00％.CONCLUSION:The human insulin produced by KP Biotech demonstrated similarity to the reference preparation Humulin? in PK and PD characteristics in healthy Chinese subjects.

Escherichia coli(E.coli)is a key pathogenic bacterium responsible for postpartum endo-metritis,with its colonization in the reproductive tract closely associated with endometrial damage and disruption of the ovarian cycle.This ultimately leads to infertility,causing significant economic losses to the dairy industry.Macrophages play a pivotal role in the inflammatory response.This study aims to investigate the mRNA expression profile of bovine bone marrow-derived macropha-ges following E.coli infection using RNA sequencing(RNA-seq)technology.Additionally,it seeks to identify the biological functions and signaling pathways of differentially expressed genes(DEGs)through Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses.The results demonstrated that E.coli infection induced differential expression of 4 522 genes,with 2 141 upregulated and 2 381 downregulated.These genes were primarily asso-ciated with inflammatory responses,where TLR2,TLR4,NLRP3,and PTGS2 played pivotal roles.PGD2 synthesis was mediated by TLR2,TLR4,and NLRP3.Transcriptome sequencing of bovine bone marrow-derived macrophages infected with E.coli and treated with a PGD2 inhibitor revealed a marked downregulation of TLR2 and TLR4 gene expression.qPCR validation results were highly consistent with the RNA-seq findings.This study elucidates the interactive regulatory roles of TLR2,TLR4,and NLRP3 in conjunction with PGD2,which collectively modulate bovine endome-tritis.These findings offer significant molecular insights that enhance our understanding of the pathological mechanisms underlying bovine endometritis,thereby informing its prevention and treatment strategies.

Objective:To investigate the infection rate of cytomegalovirus (CMV) and Epstein-Barr virus (EBV) in patients with severe aplastic anemia (SAA) after intensive immunosuppressive therapy in combination with a thrombopoietin receptor agonist (lST+TPO-RA) as well as assess the clinical impact of treatment.Methods:A retrospective, case series study was undertaken involving patients with SAA who were admitted to Soochow Hopes Hematonosis Hospital, The First Affiliated Hospital of Soochow University, and Zhengzhou Third People′s Hospital from June 2022 to February 2025. Thirty patients with complete CMV and EBV monitoring data after IST+TPO-RA treatment were enrolled. The first activation time of CMV and EBV, the maximum viral load, the first negative conversion time, and blood routine tests within 3 days before CMV and EBV positivity, during the positive period, and within 3 days after turning negative were recorded. The patients were followed up for 9 months after the completion of IST. One-way analysis of variance was used to compare the changes of blood routine before and after virus positivity and after turning negative. The χ2 test was used to compare the viral infection rate and the therapeutic effect of IST between the two groups. Results:The 30 SAA patients comprised 15 males and 15 females with an average age of (40.0±16.9) years. Of the 30 patients, 18 (60.0%) were infected with CMV and 6 (20.0%) with EBV. Among them, 17 cases received rabbit anti-human thymocyte immunoglobulin (r-ATG) treatment (r-ATG group), 13 cases received porcine anti-human lymphocyte immunoglobulin (p-ALG) treatment (p-ALG group). The CMV infection rate was significantly higher in the r-ATG group than in the p-ALG group (15/17 vs. 3/13, χ2=13.03, P<0.001); meanwhile, the rate of EBV infection was only slightly higher in the r-ATG group than in the p-ALG group, and the difference did not reach statistical significance (5/17 vs. 1/13, χ2=2.17, P=0.196). In patients infected with CMV, neutrophil, hemoglobin, and platelet counts were significantly decreased during the infection phase, followed by significant increases after CMV clearance ( F=14.48, 11.38, 4.73; all P<0.05). No significant differences in treatment efficacy were found between the r-ATG and p-ALG groups at 3, 6, and 9 months post-IST (all P>0.05). Conclusions:This preliminary study showed that the incidence of CMV and EBV infection in patients with SAA increased after IST, with CMV infections occurring significantly more frequently than EBV infections. The CMV infection rate was significantly higher in patients treated with r-ATG than in those receiving p-ALG. CMV infection was associated with notable alterations in hematological parameters, highlighting the need for close clinical monitoring.

Objective:To preliminarily establish a sample clot warning model for coagulation screening tests using 5 machine learning methods.Methods:This cross-sectional study collected 7 401 routine screening test samples from Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, from January 1st, 2015, to August 18th, 2024, including 4 786 clotted (positive) and 2 615 qualified (negative) samples for model development. The dataset was divided into Dataset 1 and Dataset 2 based on a reagent change for APTT in December 2018, with separate models developed for each. An additional 2 493 samples (October 31st to November 8th, 2024) were used to evaluate consistency between the model and manual assessment, while 23 200 samples (October 17th to December 31st, 2024) were used for assessing real-world predictive performance. Five machine learning algorithms were employed to develop the clot prediction model: logistic regression (LR), random forest (RF), extreme gradient boosting (XGBoost), naive bayes (NB), and artificial neural network (ANN), with the ANN model constructed using two different hidden layer and neuron parameter settings. Model selection was based on AUC, accuracy, sensitivity, specificity, F1-score, PPV, and NPV, with the optimal model integrated into the LIS for validation.Results:Among the six models using 5 machine learning algorithms, XGBoost demonstrated the highest performance (AUC=0.961, sensitivity=0.945, F1-score=0.934) and robustness to reagent changes ( Z=-1.333, P=0.113). When deployed, the differences between the model's predictions and manual pre-judgment were statistically significant ( Z=-5.289 to 8.933, all P<0.01). The predictive efficacy indices AUC (95% CI), sensitivity, specificity, and accuracy of the XGBoost model deployed in real-world operation of the LIS were 0.939 (0.918—0.960), 0.958, 0.921, and 0.921 respectively. Conclusion:In this study, a clot warning model for coagulation screening samples was established based on the XGBoost algorithm, and its prediction efficacy is good, providing a foundation for intelligent pre-analytical quality control for coagulation screening tests.

Objective:This study aimed to evaluate to evaluate the performance of equilibrium dialysis combined with liquid chromatography-tandem mass spectrometry (LC-MS/MS) for the accurate measurement of free testosterone in clinical samples. Mthods We conducted a prospective observational study using 161 serum samples from healthy women of reproductive 26(24, 32)years at the Gynecology Outpatient department of Peking Union Medical College Hospital from June to September 2024, and their concentrations were determined. In this study, after equilibrium dialysis of serum samples, free testosterone was extracted from the dialysate using a magnetic bead-based method. It was then directly derivatized using hydroxylamine hydrochloride in situ after elution from the magnetic bead and further quantified by LC-MS/MS.Method:validation assessed linearity, limit of quantification (LOQ), precision, accuracy, matrix effects, and carryover according to established guidelines. Data were analyzed using Origin 2019 and WPS Office 2019.Results:The method demonstrated excellent linearity ( R2>0.99) across 1-250 pg/ml with an LOQ of 1 pg/ml. The coefficients of variation for both intra-day and inter-day imprecision were less than 10% while recovery rates ranged from 92.60% to 99.10%. Matrix effect deviations were all within the range of 6% and carryover was negligible. Conclusions:In this study, the established method of magnetic bead-based extraction followed by in situ derivatization combined with liquid chromatography-tandem mass spectrometry performed well, and could be further applied to the detection of free testosterone concentration in childbearing age women.

Aim To evaluate the role of the glucose transporter protein 1(GLUT1)-dependent glycolytic in the attenuation of oxygen-glucose deprivation-reoxygen-ation(OGD/R)injury in HK-2 cells by dexmedetomi-dine(Dex).Methods C57/BL6 mice were random-ly divided into three groups(n=6),namely,sham operation group(Sham group),renal ischemia reper-fusion group(I/R group)and Dex group(I/R+Dex group).Serum creatinine(Cr)and urea nitrogen(BUN)were measured,while the levels of key glyco-lytic enzymes HK2,PFKFB3 and GLUT1 were meas-ured.HK-2 cells were cultured and randomised into seven groups(n=6),which was treated with OGD/R,overexpression or interference with GLUT1,Dex and glycolysis inhibitor 2-DG.CCK-8 and LDH activi-ty were used to detect cellular damage.Glycolysis lev-els were detected by lactate and ECAR.The inflamma-tory level was reflected by qRT-PCR for IL-6 and TNF-α.qRT-PCR and Western blot were performed to de-tect the levels of GLUT1,HK2,and PFKFB3.Results Dex significantly ameliorated kidney injury and HK-2 cell injury(P＜0.05).Dex inhibited the OGD/R-induced rise in lactate and extracellular acidification rate(ECAR),as evidenced by suppression of the ex-pression of GLUT1,HK2 and PFKFB3(P＜0.05).In vitro experiments showed that GLUT1 knockdown sig-nificantly improved OGD/R-induced cellular damage.Lactate,ECAR,glycolysis-related mRNAs and pro-teins were inhibited by GLUT1 knockdown(P＜0.05).Significantly,there were no significant differ-ences in above indexes after Dex treatment based on GLUT1 knockdown.Overexpression of GLUT1 abroga-ted the protective effects of Dex,while reversing the inhibitory effects of Dex on the expression of GLUT1,HK2,and PFKFB3(P＜0.05).Conclusions Dexmedetomidine attenuates OGD/R induced injury in HK-2 cells by inhibiting GLUT1-dependent glycolysis.

Objective:To explore the therapeutic methods and drug-symptom patterns of Traditional Chinese Medicine (TCM) for idiopathic pulmonary fibrosis (IPF) at different stages under the guidance of the " three-stage differentiated management" principle.Methods:Under the three-stage principle, 133 IPF prescriptions treated by prof. Yan Jun from 2017.2-2023.12 were analyzed. Disease and category information of each eligible case was entered into the " FangNet" platform. Association and cluster analyses were performed for core herbs, key herb pairs, and symptom-drug relationships, aiming to uncover the clinical medication characteristics and rules in the three stages.Results:(1) Early inflammatory stage: phlegm-stasis harassment, incipient but unformed masses, superficial disease location; priority was dispelling wind, dispersing pathogen, clearing lung and resolving phlegm-commonly used: ephedra, stemona, processed pinellia, peucedanum, armeniaca. (2) Mid injury stage: formed phlegm-stasis, struggle of pathogen and healthy Qi, impaired lung collaterals, obstructive phlegm-stasis, excess pathogen with intact healthy Qi; emphasis on expelling pathogen, resolving phlegm, activating blood and dredging collaterals-e.g., angelica, pheretima, bombyx, scorpio. (3) Late fibrotic stage: healthy Qi deficiency with excess pathogen, phlegm-stasis masses entrenched in collaterals; treatment focuses on tonifying lung and dissolving masses, combining dredging and tonifying to regulate Qi and blood-e.g., pinellia, rhodiola, ginseng, gecko.Conclusions:Phlegm-stasis as excess pathogen and dual deficiency of lung-kidney run through all three stages of IPF. The rise and fall of healthy Qi vs pathogen and the degree of mass formation determine stage-specific therapeutic strategies and drug-pattern adjustments.