The changes in modern children’s lifestyles and dietary environments have led to children’s cold stagnation syndrome becoming one of the most common pediatric conditions. Traditional Chinese medicine attributes its internal causes primarily to lung-spleen deficiency and weak defensive functions， while external causes predominantly involve invasion by external pathogens such as wind or epidemic qi. The pathogenesis involves either initial food stagnation followed by external contraction or primary external contraction leading to secondary stagnation. Traditional Chinese medicine employs a syndrome differentiation and treatment system， utilizing targeted approaches such as internal therapies （Chinese herbal formulas or patent medicines， such as Youke shengjiang decoction， modified Dayuanyin formula， Huanghua shuangjie decoction， Sanyang qingjie decoction， Banxia xiexin decoction， Xiao’er chiqiao qingre granule， Baoji oral liquid， etc.）， external therapies （massage， acupuncture， acupoint applications）， combined therapies （integrating internal-external treatments or Chinese-Western medicine）， and preventive therapy at the pre-disease stage. These methods demonstrate unique advantages in alleviating clinical symptoms and improving treatment efficacy. However， limitations persist， including insufficient standardization in clinical research and a lack of in-depth mechanistic studies.

Objective:To detect the biological markers related to Alzheimer's disease(AD)in the peripheral blood of AD patients,and to explore the activities and levels of the antioxidant function indexes and the expressions of related genes and proteins in the blood of AD patients and the changes after intervention of selenium-rich food.Methods:The Mini-Mental State Examination(MMSE)combined with electroencephalogram or brain CT and clinician diagnosis were used for screening AD.Fifty-six elderly patients with AD aged 75-90 years old were selected.Among them,28 cases were selected as normal diet group for AD(AD group),and 28 cases were selected as dietary selenium intervention group(Se-AD group).The patients in Se-AD group were given daily dietary selenium supplementation(increaseing dietary selenium by 15-20 μg per day)for 3 months.Meanwhile,30 people with the same age were selected as healthy control group.The activities of serum superoxide dismutase(SOD),cholinesterase(CHE),and glutathione peroxidase(GSH-Px)and the levels of serum malondialdehyde(MDA),homocysteine(Hcy),and nitric oxide(NO)as well as reagent kit the levels of serum β-amyloid protein(Aβ),and microtubule-associated protein(Tau)and phosphorylated microtubule-associated protein(p-Tau)of the subjects in various groups were detected by and enzyme-linked immunosorbent assay(ELISA)method;the expression levels of apolipoprotein E4(ApoE4),presenilin 1(PS1),presenilin 2(PS2),cysteinyl aspartate specific proteinase 3(Caspase3),sorting associated protein receptor 1(SORL1),β-site amyloid precursor protein cleaving enzyme 1(BACE1),hypoxia-inducible factor 1(HIF1),nuclear factor-kappa B(NF-κB),β-amyloid precursor protein(APP),protein kinase C(PKC),and Aβ mRNA in peripheral blood of the subjects various groups were detected by real-time fluorescence quantitative PCR(RT-qPCR)method.Results:Compared with healthy control group,the serum SOD activities of the patients in Se-AD group and AD group were significantly decreased(P＜0.05),while serum CHE activity and the levels of MDA and Hcy were significantly increased(P＜0.05);the serum GSH-Px activity of the patients in AD group was significantly decreased(P＜0.05),and the level of NO was significantly increased(P＜0.05).Compared with Se-AD group,serum CHE activity and the level of Hcy of the patients in AD group were significantly increased(P＜0.05).The expression levels of ApoE4,PS1,Caspase3,BACE1,NF-κB and APP mRNA of the patients in Se-AD group and AD group were significantly increased(P＜0.05),and the expression levels of PKC mRNA were significantly decreased(P＜0.05);the expression level of PS2 mRNA of the patients in AD group was significantly increased(P＜0.05),and the expression levels of Aβ mRNA of the patients in Se-AD group and AD group were significantly increased(P＜0.05).Conclusion:The activities of serum SOD,GSH-Px and CHE and the levels of MDA,Hcy and NO,the levels of Aβ,Tau and p-Tau proteins,and the expression levels of ApoE4,PS1,Caspase3,BACE1,NF-κB,PKC,PS2,Aβ and APP mRNA in peripheral blood of the AD patients may vary and can be used for clinical diagnosis of the AD patients.Selenium-rich food can improve AD to some extent,and its mechanism is related to reducing the oxidative damage of brain tissue and decreasing the expression of AD related genes PS2 and Aβ.

This paper explored artificial intelligence(AI)in medicine based on fuzzy logic,introduced the significance of AI in medicine in the fields of medicine and medical ethics,and discussed the limitations of traditional AI in handling complex systems and fuzzy fields.It proposed the viewpoint of fuzzy logic as a solution,as well as emphasized the advantages of fuzzy logic compared to classical two-valued logic and the development and application of fuzzy logic in AI in medicine.By expounding the development of fuzzy deontology,it was demonstrated that it provided a new logical framework and operational tool for AI in medicine in addressing normative fields,and can provide support for AI in medicine and ethical decision-making.In summary,AI in medicine based on fuzzy logic is of great significance in dealing with medical ethics and complexity,providing practical relevant support for medical practice and ethical decision-making,and showing its future development prospects when combined with deontic logic.

Objective:To investigate the impact of lifestyle, apolipoprotein E (ApoE) gene, and their interaction on the risk for cognitive frailty in the elderly population in China.Methods:The study participants were from the Chinese Longitudinal Healthy Longevity Survey. The information about their lifestyles were collected by questionnaire survey, and a weighted lifestyle score was constructed based on β coefficients associated with specific lifestyles to assess the combined lifestyle. ApoE genotypes were assessed by rs429358 and rs7412 single nucleotide polymorphisms. Cognitive frailty was assessed based on cognitive function and physical frailty. Cox proportional hazards regression model was used to analyze the association of lifestyle and ApoE gene with the risk for cognitive frailty and evaluate the multiplicative and additive interactions between lifestyle and ApoE gene. Results:A total of 5 676 elderly persons, with median age [ M ( Q1, Q3)] of 76 (68, 85) years, were included, in whom 615 had cognitive frailty. The analysis by Cox proportional hazards regression model indicated that moderate and high levels of dietary diversity could reduce the risk for cognitive frailty by 18% [hazard ratio ( HR)=0.82, 95% CI: 0.68-1.00] and 28% ( HR=0.72, 95% CI: 0.57-0.91), respectively; moderate and high levels of physical activity could reduce the risk by 31% ( HR=0.69, 95% CI: 0.56-0.85) and 23% ( HR=0.77, 95% CI: 0.64-0.93), respectively. Healthy lifestyle was associated with a 40% reduced risk for cognitive frailty ( HR=0.60, 95% CI: 0.46-0.78). ApoE ε4 allele was associated with a 26% increased risk for cognitive frailty ( HR=1.26, 95% CI: 1.02-1.56). No multiplicative or additive interactions were found between lifestyle and ApoE gene. Conclusions:Dietary diversity and regular physical activity have protective effects against cognitive frailty in elderly population. Healthy lifestyle can reduce the risk for cognitive frailty in elderly population regardless of ApoE ε4 allele carriage status.

OBJECTIVE:To provide reference for variety breeding,high yield and high quality cultivation of Momordica cochi-nchinensis. METHODS:Based on Chinese Pharmacopoeia (2015 edition,Vol Ⅰ),HPLC for determining the content of gyp-sogenin 3-O-β-D-glucuronic acid methyl ester in M. cochinchinensis was optimized,the contents of gypsogenin 3-O-β-D-glucuronic acid methyl ester in M. cochinchinensis from 14 production places of 8 provinces were compared,and cluster analysis was conduct-ed. Correlation of longitude,latitude and altitude with content of gypsogenin 3-O-β-D-glucuronic acid methyl ester in M. cochinchi-nensis was analyzed by SPSS17.0 software. RESULTS:Gypsogenin 3-O-β-D-glucuronic acid methyl ester in M. cochinchinensis showed good linear relationship in 0.05-0.5 mg/mL,regression equation was Y=4361.95X+67.3808(R2=0.9997);the limits of quantification and detection were 15.62 ng and 4.67 ng,respectively. Average recovery was 99.76%(RSD=1.36%,n=9). The content of gypsogenin 3-O-β-D-glucuronic acid methyl ester in M. cochinchinensis from 14 production places of 8 provinces had ex-tremely significant differences(P<0.01). Clustering analysis results indicated that M. cochinchinensis from 14 production places of 8 provinces were divided into Ⅰ,Ⅱ,Ⅲ,Ⅳ groups. Contents of gypsogenin 3-O-β-D-glucuronic acid methyl ester in M. cochi-nchinensis of Ⅲ,Ⅳ groups were relatively high,including Guangxi Pingnan,Guizhou Jiangkou,Guizhou Dejiang,Fujian Jian-yang and Hunan Huitong,in which,Guangxi Pingnan,Guizhou Jiangkou,Guizhou Dejiang and Hunan Huitong had high altitude and low latitude,Fujian Jianyang had high altitude. The content of gypsogenin 3-O-β-D-glucuronic acid methyl ester in M. cochi-nchinensis was positively correlated with altitude,while negatively correlated with longitude and latitude. CONCLUSIONS:HPLC is simple,accurate and reproducible for determining the content of gypsogenin 3-O-β-D-glucuronic acid methyl ester in M. cochi-nchinensis,and the determined contents of gypsogenin 3-O-β-D-glucuronic acid methyl ester in M. cochinchinensis from 14 produc-tion places of 8 provinces have reached the standard of Chinese Pharmacopoeia (2015 edition,Vol Ⅰ). Cultivation in Guangxi Pingnan,Guizhou Jiangkou,Guizhou Dejiang,Hunan Huitong and other areas with high altitude and low latitude helps to improve the content accumulation of gypsogenin 3-O-β-D-glucuronic acid methyl ester in M. cochinchinensis.

Objective To investigate the clinical effect of free pre-expanded scapular skin flap for repairing of large size facial and cervical scar .Methods 15 patients suffering from post-burn facial and cervical scar contractures were treated in the Department of Plastic Surgery of Second Affiliated Hospital of Kunming Medical University.The reconstruction was performed in two operative stages .First, the skin incision were made paralleling with the descending branches of the circumflex scapular artery near posterior axillary line and the scapular skin flap was elevated .A 300 to 400 ml kidney -shaped expander was implanted under scapular region skin .The expansion began 1 week post-operatively.After the expander was fully expanded and could supply sufficient flap , the facial and cervical scar was resected and the contracture was released .The pre-expanded scapular flap was harvested and transferred to repair the defects.Then the facial vascular anastomosis with circumflex scapular vascular was performed .The expander was removed and the wound was closed directly .Results The expansion time ranged from 2 to 4 months with the average time of 2.8 months.The flap size ranged from 14 cm ×7 cm to 25 cm ×14 cm. All flaps survived post-operatively and wounds at donor sites healed primarily .The face and neck have good appearance .Conclusions Pre-expanded scapular skin flap is suitable for repairing of larger face and neck scar with good color and thickness match .Expanded skin flap can provide large size flap , leaving less morbidity at the donor sites .

Objective To investigate the clinical effect of free pre-expanded scapular skin flap for repairing of large size facial and cervical scar .Methods 15 patients suffering from post-burn facial and cervical scar contractures were treated in the Department of Plastic Surgery of Second Affiliated Hospital of Kunming Medical University.The reconstruction was performed in two operative stages .First, the skin incision were made paralleling with the descending branches of the circumflex scapular artery near posterior axillary line and the scapular skin flap was elevated .A 300 to 400 ml kidney -shaped expander was implanted under scapular region skin .The expansion began 1 week post-operatively.After the expander was fully expanded and could supply sufficient flap , the facial and cervical scar was resected and the contracture was released .The pre-expanded scapular flap was harvested and transferred to repair the defects.Then the facial vascular anastomosis with circumflex scapular vascular was performed .The expander was removed and the wound was closed directly .Results The expansion time ranged from 2 to 4 months with the average time of 2.8 months.The flap size ranged from 14 cm ×7 cm to 25 cm ×14 cm. All flaps survived post-operatively and wounds at donor sites healed primarily .The face and neck have good appearance .Conclusions Pre-expanded scapular skin flap is suitable for repairing of larger face and neck scar with good color and thickness match .Expanded skin flap can provide large size flap , leaving less morbidity at the donor sites .