ObjectiveThe research focuses on developing modeling and evaluation methodologies for an animal model exhibiting spleen deficiency and dampness excess syndrome， with the aim of standardizing such animal models for future reference. MethodsBy conducting a literature search on animal models of spleen deficiency and dampness excess syndrome， relevant publications meeting inclusion and exclusion criteria will be identified based on publication date， data source， types of diseases involved， animal characteristics， modeling methods， modeling duration， macroscopic syndrome assessment indicators， macroscopic quantification indicators， laboratory testing parameters， intervention approaches， positive controls and application context. A database will be established to facilitate the extraction of this information for quantitative analysis， statistical evaluation， and visual representation. ResultsA total of 137 literature articles meeting the standards have been included in the research. The primary animal species used in animal models of spleen deficiency and dampness excess are SD rats. Modeling methods include single-factor， dual-factor composite， and triple-factor composite methods， with various models widely applied in validation of pharmacological effects and mechanistic explorations. Evaluation indices of animal models for spleen deficiency and dampness excess primarily consist of macroscopic syndrome evaluation indicators and macroscopic quantitative indicators. Laboratory testing indicators are mostly related to research areas such as fluid metabolism and gastrointestinal function. The most commonly studied herbal formulas currently include Shenling Baizhu San and Pingwei San， with natural recovery and the use of the western medicine metronidazole as the most frequently used positive controls. ConclusionThe application of animal models for spleen deficiency and dampness excess is gradually increasing， with various modeling methods already simulating the typical characteristics of this syndrome pattern. However， there are still many areas that are worth contemplating and improving. This study aims to provide reference and ideas for the standardization of symptom names in animal models of spleen deficiency and dampness excess， as well as for the improvement of model construction and evaluation systems.

ObjectiveThis study aims to observe the effect of sinomenine （SIN） on fatty acid binding protein 4 （FABP4） in synovial tissue of rats with osteoarthritis （OA） and investigate the therapeutic mechanism of SIN on OA， further providing new ideas for the management of osteoarthritis by traditional Chinese medicine （TCM）. MethodsAn OA rat model was constructed and randomly divided into a control group， an OA group， an OA + SIN-L group （50 mg·kg^-1）， an OA + SIN-M （100 mg·kg^-1）， an OA + SIN-H （200 mg·kg^-1）， and an OA + prednisone （PDN） group （5 mg·kg^-1）. Following surgical modeling for three weeks， an appropriate medication was administered for four weeks. During modeling and administration， a hot plate test was performed to detect the pain and swelling of the knee joints of the rats. The periarticular tissue was collected for arthropathological observation at the end of drug administration. The expression of cleaved Caspase-3， B-cell lymphoma-2 （Bcl-2）， Bcl-2 associated X protein （Bax）， and FABP4 in the synovial tissue of rats was detected by Western blot and real-time quantitative polymerase chain reaction （Real-time PCR）， and the expression and distribution of FABP4 protein in the synovial membrane were detected by immunofluorescence. ResultsCompared with those in the control group， the levels of inflammatory factors and FABP4 in the serum of rats in the OA group were significantly increased （P<0.05， P<0.01）， and joint swelling was significantly elevated （P<0.01）. The thermal pain threshold was significantly reduced （P<0.01）， and the expression of FABP4 protein and the fluorescence intensity were significantly increased （P<0.01）. The synovial tissue exhibited significantly increased inflammatory infiltration， proliferated fibroblasts， and an elevated apoptotic index （P<0.05， P<0.01）. Compared with those in the OA group， the serum lipid metabolism indexes of rats in the SIN administration group gradually returned to normal （P<0.05， P<0.01）， while the levels of inflammatory factors and FABP4 in the serum of rats in the SIN-administered group were significantly reduced （P<0.05， P<0.01）， and joint swelling was significantly decreased （P<0.05， P<0.01）. The thermal pain threshold was significantly elevated （P<0.05， P<0.01）， and the expression of FABP4 protein and fluorescence intensity in the synovial tissue were significantly decreased （P<0.05， P<0.01）. The synovial tissue displayed significantly reduced inflammatory infiltration and a decreased apoptotic index （P<0.05， P<0.01）. ConclusionThe therapeutic effect of SIN on OA may be related to the down-regulation of FABP4 expression， reduction of apoptosis， and inhibition of inflammatory factor expression.

Humans ; Nephrotic Syndrome ; Hematopoietic Stem Cell Transplantation ; Tissue Donors ; Transplantation Conditioning ; Graft vs Host Disease

Central fatigue refers to the central nervous system disease caused by excessive mental pressure or excessive physical activity, which shows a series of fatigue symptoms. The pathological mechanism of central fatigue remains unclear, and the mitochondrial quality control pathway represented by mitophagy is closely related to the occurrence and development of central fatigue. Traditional Chinese medicine considers liver stagnation and spleen deficiency as the key pathogenesis of central fatigue. This paper suggests that oxidative stress may be an important basis for the occurrence of central fatigue, energy metabolism disorders are specific manifestations of liver′s failure of conveyance and dispersion and spleen′s failure of healthy transportation, and the abnormal accumulation of reactive oxygen can be regarded as pathological products of central fatigue. Therefore, based on oxidative stress and energy metabolism, the pathologic mechanism of liver′s failure of conveyance and dispersion and spleen′s failure of healthy transportation in central fatigue from the perspective of mitophagy has a rich theoretical connotation, and provides a theoretical reference for the clinical treatment of central fatigue.

Objective: To understand the prevalence of Lying Flat behaviors and its association with depressive symptoms among Chinese college students, so as to provide a scientific basis for promoting the physical and mental health development of adolescents. Methods: From July to October 2023, three universities were selected through convenient sampling from Jiangxi Province, Liaoning Province and Beijing City, respectively. Selfdesigned questionnaire links were distributed on campus to collect basic information and Lying Flat behaviors among college students, and the Patient Health Questionnaire-9 (PHQ-9) was utilized to screen for students with depressive symptoms. Finally, a total of 4 225 valid questionnaires were obtained. Chisquare was used to compare of report rates of Lying Flat behaviors across different demographic characteristics. Ordered Logistic regression analysis was used to explore the association between Lying Flat behaviors and depressive symptoms, with Z test used to assess variations in the strength of associations. Results: The reporting rates of academic, life, and social Lying Flat were 32.7%, 17.8% and 17.5%, respectively. And 6.7% of the participants were found of all three Lying Flat behaviors simultaneously.Among college students with three Lying Flat behaviors, the constituent ratios of no, mild, moderate and above depressive symptoms were 9.9%, 30.5% and 59.6%, respectively. Additionally, college students who had three Lying Flat behaviors were more likely to show mild, moderate and above depressive symptoms [OR(95%CI)=2.49(1.60-3.87), 7.69(5.01-11.79), P<0.01]. Conclusions Academic Lying Flat behavior is most prevalent among college students. Academic, life and social Lying Flat behaviors are all significantly positively correlated with depressive symptoms. Attention should be paid to the Lying Flat behaviors and college students psychological health conditions to promote their physical and mental health development.

ObjectiveTo explore the underlying mechanism by which the Chinese medicine compound Yitangkang granule（YTK） treats diabetic kidney disease （DKD） by observing its effects on podocyte autophagy through the regulation of phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）/forkhead transcription factor O1 （FoxO1） signaling pathway mediated by silent information regulator 1 （SIRT1） via advanced glycation end products （AGE）/receptor for AGE （RAGE） axis. MethodNinety-six 8-week-old healthy male SPF-grade Wistar rats were selected and randomly divided into blank control group （B）， model control group， high-dose YTK （40 g·kg^-1）， medium-dose YTK （20 g·kg^-1）， low-dose YTK （10 g·kg^-1）， and Western medicine control （20 mg·kg^-1 losartan） groups. The DKD rat model was established by high-fat diet feeding combined with intraperitoneal injection of streptozotocin. After successful modeling， the rats in each group received the corresponding treatments for eight weeks. The levels of superoxide dismutase （SOD）， malondialdehyde （MDA）， glutathione peroxidase （GSH-Px）， and catalase （CAT） were measured according to the instructions of the respective assay kits. Hematoxylin and eosin （HE） staining was used to observe pathological changes in kidney tissues. Immunohistochemistry was employed to detect the average optical density values of α-smooth muscle actin （α-SMA）， fibronectin （FN）， desmin， and nephrin. Western blot analysis was used to measure the expression levels of PI3K， phosphorylated PI3K （p-PI3K）， Akt， phosphorylated Akt （p-Akt）， RAGE， SIRT1， Caspase-3， and FoxO1 proteins in kidney tissues of DKD rats. ResultCompared with the blank control group， the model group showed significantly lower levels of SOD， GSH-Px， and CAT， and significantly higher levels of MDA （P<0.01）. The rats exhibited severe kidney damage. The positive expression of podocyte marker proteins α-SMA， FN， and desmin increased significantly， while nephrin and podocin significantly decreased （P<0.01）. The expression levels of PI3K， p-PI3K， Akt， p-Akt， RAGE， and Caspase-3 proteins were significantly elevated， while SIRT1 and FoxO1 protein levels were significantly reduced （P<0.01）. Compared with the model control group， rats in the YTK treatment groups showed significantly higher levels of SOD， GSH-Px， and CAT， and significantly lower levels of MDA in serum （P<0.01）. The degree of kidney damage was reduced to varying extents. The average optical density values of podocyte marker proteins α-SMA， FN， and desmin were significantly decreased， while nephrin and podocin significantly increased （P<0.01）. The expression levels of PI3K， p-PI3K， Akt， p-Akt， RAGE， and Caspase-3 in kidney tissues were significantly reduced， while SIRT1 and FoxO1 expression levels significantly increased （P<0.01）. The Chinese medicine groups demonstrated a clear dose-response trend. ConclusionYTK may alleviate kidney pathological damage， reduce proteinuria， and protect kidney function in DKD rats， thereby delaying the progression of DKD by improving podocyte autophagy through the AGE-RAGE axis-mediated SIRT1 regulation of the PI3K/Akt/FoxO1 signaling pathway. Additionally， a dose-response relationship was observed in the Chinese medicine groups.

In 2024,the World Health Organization(WHO)released"Ethics and governance of artificial intelligence for health.Guidance on large multi-modal models",which was translated into Chinese for Chinese readers to read and think about,assist in planning the benefits and challenges related to large multi-modal models for health,as well as provide guidance on policy and practice for the appropriate development,provision,and use of large multi-modal models.The WHO consulted 20 leading experts in the field of AI,who identified potential benefits and risks of using AI for health,as well as published six principles agreed upon in a consultative manner for governments,developers,and providers using AI to consider when formulating policies and practices.The guidelines provide governance recommendations that are consistent with the guiding principles for internal enterprise,governments,and international cooperations,which are based on the guiding principles and governance recommendations that consider the unique ways in which humans use AI generated content(AIGC)for health.AIGC is an AI technology in which algorithms are trained on data sets that can be used to generate new content.The guidelines target one type of AIGC,namely the large multi-modal models abbreviated as"LMM",which can accept one or more types of data inputs and generate multiple outputs of data types that are not limited to the input algorithm.It is predicted that LMM will be widely used in various fields,such as healthcare,scientific research,public health,and drug development.LMM are also called"universal base models",although it has not yet been proven that LMM can complete a variety of tasks and purposes.

Liver fibrosis is a significant health burden,marked by the consistent deposition of collagen.Unfortunately,the currently available treatment approaches for this condition are far from optimal.Lysyl oxidase-like protein 2(LOXL2)secreted by hepatic stellate cells(HSCs)is a crucial player in the cross-linking of matrix collagen and is a significant target for treating liver fibrosis.Mesenchymal stem cell-derived small extracellular vesicles(MSC-sEVs)have been proposed as a potential treatment option for chronic liver disorders.Previous studies have found that MSC-sEV can be used for microRNA delivery into target cells or tissues.It is currently unclear whether microRNA-4465(miR-4465)can target LOXL2 and inhibit HSC activation.Additionally,it is uncertain whether MSC-sEV can be utilized as a gene therapy vector to carry miR-4465 and effectively inhibit the progression of liver fibrosis.This study explored the effect of miR-4465-modified MSC-sEV(MSC-sEVmiR-4465)on LOXL2 expression and liver fibrosis development.The results showed that miR-4465 can bind specifically to the promoter of the LOXL2 gene in HSC.Moreover,MSC-sEVmiR-4465 inhibited HSC activation and collagen expression by downregulating LOXL2 expression in vitro.MSC-sEVmiR-4465 injection could reduce HSC activation and collagen deposition in the CCl4-induced mouse model.MSC-sEVmiR-4465 mediating via LOXL2 also hindered the migration and invasion of HepG2 cells.In conclusion,we found that MSC-sEV can deliver miR-4465 into HSC to alleviate liver fibrosis via altering LOXL2,which might provide a promising therapeutic strategy for liver diseases.

Objective:To understand the current status of personal protection in occupational population at high risk for brucellosis in China and provide evidence for the evaluation of implementation of National Brucellosis Prevention and Control Plan (2016-2020).Methods:Four counties in Shanxi Province and Xinjiang Uygur Autonomous Region were selected to conduct a questionnaire survey in occupational population at high risk for brucellosis from December 2019 to July 2020 by using cross-sectional survey methods.Results:A total of 2 384 persons at high risk for brucellosis were surveyed, and the standardized utilization rate of personal protective equipment (PPE) was 20.13% (480/2 384). The utilization rate of glove, mask, rubber shoe, and work cloth were 38.26% (912/2 384), 31.80% (758/2 384), 32.01% (763/2 384) and 30.87% (736/2 384),respectively. There were significant differences in the utilization rate and standardized utilization rate of the four types of PPE among populations in different age, occupation, educational level and area groups (all P<0.001). The utilization rate and standardized utilization rate of PPE were lower in people over 60 years old, women, farmers, and those with lower educational level. The results of multivariate analysis showed that occupation and area were the influencing factors for the standardized utilization of PPE, the standardized utilization rates of PPE were higher in herdsmen and veterinarians. The standardized utilization rate of PPE in Yanggao County and Huocheng County was significantly higher than that in Zuoyun County and Hunyuan County. Conclusions:The utilization rate of the four types of PPE in occupational population at high risk for brucellosis was not high in China, and the standardized utilization rate was low, lower than the requirement in National Brucellosis Prevention and Control Plan, and there were significant differences among different areas. It is urgent to distribute PPE to occupational population at high risk for brucellosis and carry out health education about PPE utilization. Meanwhile, it is necessary to strengthen information exchange or sharing among different areas.

Objective To explore the professionalization model of nursing management team in an international medical center in a provincial public tertiary hospital.Methods Through literature research and Delphi method,a three-person nursing management team was established respectively in three nursing units:outpatient,first-ward,and second-ward of the center,and then trained professionally to define management boundaries and responsibilities.The training effect was verified by applying the professionalization management in the international medical center.The three nursing teams(nine nurses totally)were compared in terms of leadership,patient satisfaction,and nursing discipline construction before and after the training.Results Following the training,the three teams all exhibited a significant improvement in leadership as well as its dimensions(P＜0.05),and pa-tient satisfaction(P＜0.05).Additionally,care quality,scientific research capacity,and innovation ability were all elevated across the three groups.Conclusion The establishment of a nursing management team and performance of professional training can effectively promote the concept of professionalization management,improve the leadership of nurses,cultivate talent eche-lons,drive the overall development of disciplines and teams,and expand the connotation of nursing culture.For all these bene-fits,this model is suitable for promotion and application among clinical departments.