ObjectiveTo evaluate the clinical efficacy of Huayu Tongluo Formula （化瘀通络方， HTF） in patients with mid-stage diabetic kidney disease of blood stasis syndrome and explore its potential mechanisms. MethodsA multi-center， randomized， double-blind， placebo-controlled clinical trial was conducted. Ninety patients of mid-stage diabetic kidney disease of blood stasis syndrome were divided into a control group of 46 cases and a treatment group of 44 cases. Both groups received conventional western medicine treatment， the treatment group additionally taking HTF， while the control group taking a placebo of the formula. The treatment was administered once daily for 24 weeks. The primary outcomes included 24-hour urine total protein （24 h-UTP）， serum albumin （Alb）， glycated hemoglobin （HbA1c）， and serum creatinine （Scr）.The secondary outcomes included changes in levels of endothelin-1 （ET-1）， nitric oxide （NO）， vascular endothelial growth factor （VEGF）， and traditional Chinese medicine （TCM） syndrome scores before and after treatment. Clinical efficacy was evaluated based on TCM syndrome scores and overall disease outcomes. Adverse reactions and endpoint events were recorded. ResultsIn the treatment group after treatment， 24 h-UTP， ET-1， and VEGF levels significantly decreased （P＜0.05）， Alb and NO levels significantly increased （P＜0.05）； while the TCM syndrome scores for edema， lumbar pain， numbness of limbs， dark purple lips， dark purple tongue or purpura， and thin， rough pulse all significantly decreased （P＜0.05）. In the control group， no significant changes were observed in any of the indicators after treatment （P＞0.05）.Compared with the control group， the treatment group showed significant reductions in 24 h-UTP， ET-1， and VEGF levels， and increases in Alb and NO levels （P＜0.05）. The TCM syndrome scores for edema， lumbar pain， dark purple tongue or purpura， and thin， rough pulse were all lower in the treatment group than in the control group （P＜0.05）. The total effective rate of TCM syndrome in the treatment group was 59.09% （26/44）， and the overall clinical effective rate was 45.45% （20/44）. In the control group， these rates were 15.22% （7/46） and 8.7% （4/46）， respectively， with the treatment group showing significantly better outcomes （P＜0.05）. A total of 7 adverse events occurred across both groups， with no significant difference （P＞0.05）. No endpoint events occurred during the study. ConclusionOn the basis of conventional treatment of Western medicine， HTF can further reduce urinary protein levels and improve clinical symptoms in patients with mid-stage diabetic kidney disease of blood stasis syndrome. The mechanism may be related to its effects on endothelial function.

Objective To develop an animal model that replicates the clinical phenotype of severe asthma.Methods Ovalbumin(OVA)combined with IL-33 or varying doses of lipopolysaccharides(LPS)was used to explore the construction of a severe asthma mouse model.Established model animals were assessed for lung function,number of inflammatory cells,and lung tissue pathology were assessed.Expression of key genes associated with severe asthma identified from the GEO database were validated in the new model.Results Compared with OVA alone,OVA combined with IL-33 or 5 μg LPS significantly increased airway resistance and the number of inflammatory cells in bronchoalveolar lavage fluid,and aggravated the pathological damage to lung tissues.The expression patterns of key genes in the newly constructed severe asthma models were consistent with those observed in clinical patients with severe asthma.Conclusions The modeling method of combining OVA with IL-33 or LPS(5 μg)can be used to construct experimentalanimal models of severe asthma.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

The aim of this updated guideline is to provide comprehensive recommendations for the management of gout in patients with common comorbidities, such as chronic kidney disease(CKD), cardiovascular disease(CVD), diabetes, osteoarthritis(OA), and gastrointestinal disorders. This guideline was developed by a multidisciplinary expert panel consisting of specialists in endocrinology, rheumatology, nephrology, cardiology, gastroenterology, and methodology. The development process adhered to standard methodologies, including PICO(population, intervention, comparator, and outcomes) question deconstruction, systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation(GRADE) for evidence and recommendation evaluation, Delphi voting, and expert consensus. The guideline presents 26 evidence-based recommendations addressing 7 clinical questions for patients with hyperuricemia and gout in the context of comorbidities. Key recommendations include the maintenance of strict serum urate targets, particularly for patients with CKD stage≥3, chronic gouty arthritis, and OA, in order to prevent disease progression. In patients with CVD or diabetes, intra-articular triamcinolone is preferred over systemic glucocorticoids. Prioritized anti-inflammatory treatments for patients with CKD, gastrointestinal diseases and OA are recommended. The guideline also introduces emerging therapies, such as interleukin-1 inhibitors and selective urate transport inhibitors, as potential treatment options for refractory cases. The update offers a comprehensive, patient-centered approach to managing gout, particularly in individuals with associated comorbidities. Multidisciplinary collaboration and emerging new treatments and evidence ensure the optimization of the recommendations.

Objective To integrate relevant evidences on postoperative pulmonary infections in patients with aneurysmal subarachnoid haemorrhage so as to provide references for clinical practice.Methods Domestic and international databases were searched,including BMJ Best Practice,UpToDate,Cochrane Library,the U.S.National Guidelines Library,JBI,NICE,Medlive,Embase,CINAHL,Web of Science,PubMed,CNKI,VIP,Wanfang Data,SinoMed and Yiigle for clinical decisions,expert consensus,clinical guidelines,best evidence summaries,systematic evaluations,Meta-analyses,and randomized controlled trials on pulmonary infections in patients with aneurysmal subarachnoid haemorrhage.Literature was screened according to the inclusion criteria.Qualitative assessment was performed,and evidences were extracted.Results A total of 16 articles were included,comprising 2 clinical decisions,7 expert consensus,3 guidelines,3 systematic reviews and 1 RCT.Finally,30 pieces of evidence were obtained in 7 domains:team management,risk assessment,mis-inhalation management,airway management,nutritional support,oral care and rehabilitation.Conclusion The best evidence for the management of postoperative pulmonary infection in patients with aneurysmal subarachnoid haemorrhage summarised in this study can provide references for clinical interventions.Clinical staff should reasonably apply the evidence according to the specific situations.

Objective To develop an animal model that replicates the clinical phenotype of severe asthma.Methods Ovalbumin(OVA)combined with IL-33 or varying doses of lipopolysaccharides(LPS)was used to explore the construction of a severe asthma mouse model.Established model animals were assessed for lung function,number of inflammatory cells,and lung tissue pathology were assessed.Expression of key genes associated with severe asthma identified from the GEO database were validated in the new model.Results Compared with OVA alone,OVA combined with IL-33 or 5 μg LPS significantly increased airway resistance and the number of inflammatory cells in bronchoalveolar lavage fluid,and aggravated the pathological damage to lung tissues.The expression patterns of key genes in the newly constructed severe asthma models were consistent with those observed in clinical patients with severe asthma.Conclusions The modeling method of combining OVA with IL-33 or LPS(5 μg)can be used to construct experimentalanimal models of severe asthma.

Objective To integrate relevant evidences on postoperative pulmonary infections in patients with aneurysmal subarachnoid haemorrhage so as to provide references for clinical practice.Methods Domestic and international databases were searched,including BMJ Best Practice,UpToDate,Cochrane Library,the U.S.National Guidelines Library,JBI,NICE,Medlive,Embase,CINAHL,Web of Science,PubMed,CNKI,VIP,Wanfang Data,SinoMed and Yiigle for clinical decisions,expert consensus,clinical guidelines,best evidence summaries,systematic evaluations,Meta-analyses,and randomized controlled trials on pulmonary infections in patients with aneurysmal subarachnoid haemorrhage.Literature was screened according to the inclusion criteria.Qualitative assessment was performed,and evidences were extracted.Results A total of 16 articles were included,comprising 2 clinical decisions,7 expert consensus,3 guidelines,3 systematic reviews and 1 RCT.Finally,30 pieces of evidence were obtained in 7 domains:team management,risk assessment,mis-inhalation management,airway management,nutritional support,oral care and rehabilitation.Conclusion The best evidence for the management of postoperative pulmonary infection in patients with aneurysmal subarachnoid haemorrhage summarised in this study can provide references for clinical interventions.Clinical staff should reasonably apply the evidence according to the specific situations.

[Objective]To explore the relationship between self-assessed health and age-adjusted Charlson comorbidity index(AICC)in older adults,and to further analyze the differences in this relationship across gender groups.[Methods]Based on the China health and retirement longitudinal study(CHARLS)database,this study selected data on basic characteristics,chronic disease status,depressive symptoms,and self-assessed health of older adults aged≥60 years.Chi-square tests were used to perform a preliminary analysis of the association between these factors and AICC scores.A multifactorial ordered logistic regression model was constructed to assess the effects of each influencing factor on AICC,while multiple linear regression analysis was used to explore the linear relationship between self-rated health and AICC scores.Additionally.Stratified analysis by gender was performed to evaluate gender differences.[Results]A total of 10 911 participants were included,with a mean age of 67.40±5.94 years;6 249(57.3%)were male and 4 662(42.7%)were female.The distribution of AICC scores was categorized into low-risk,moderate-risk,higher-risk,and high-risk groups,accounting for 23.5%,50.2%,20.6%,and 5.7%,respectively.Multifactorial logistic regression analysis revealed that self-rated health was negatively associated with AICC in the total population and in the male geriatric group(OR=0.843,95%CI:0.776,0.917,P=0.001),(OR=0.886,95%CI:0.796,0.987,P=0.028),but did not reach statistical significance in the female geriatric group.Linear regression analysis further indicated a significant negative linear relationship between self-rated health and AICC(b=-0.485,95%CI:-0.516,-0.455,P＜0.001).This relationship was consistent in both male(b=-0.356,95%CI:-0.406,-0.305,P＜0.001)and female(b=-0.373,95%CI:-0.435,-0.310,P＜0.001)subgroups,with a stronger negative association in females.[Conclusion]Self-rated health is significantly negatively associated with AICC,and attention should be given to self-rated health in the female geriatric population.Self-rated health can serve as an important tool for identifying elderly group at high risk of comorbidities providing a valuable basis for precise intervention.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

The aim of this updated guideline is to provide comprehensive recommendations for the management of gout in patients with common comorbidities, such as chronic kidney disease(CKD), cardiovascular disease(CVD), diabetes, osteoarthritis(OA), and gastrointestinal disorders. This guideline was developed by a multidisciplinary expert panel consisting of specialists in endocrinology, rheumatology, nephrology, cardiology, gastroenterology, and methodology. The development process adhered to standard methodologies, including PICO(population, intervention, comparator, and outcomes) question deconstruction, systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation(GRADE) for evidence and recommendation evaluation, Delphi voting, and expert consensus. The guideline presents 26 evidence-based recommendations addressing 7 clinical questions for patients with hyperuricemia and gout in the context of comorbidities. Key recommendations include the maintenance of strict serum urate targets, particularly for patients with CKD stage≥3, chronic gouty arthritis, and OA, in order to prevent disease progression. In patients with CVD or diabetes, intra-articular triamcinolone is preferred over systemic glucocorticoids. Prioritized anti-inflammatory treatments for patients with CKD, gastrointestinal diseases and OA are recommended. The guideline also introduces emerging therapies, such as interleukin-1 inhibitors and selective urate transport inhibitors, as potential treatment options for refractory cases. The update offers a comprehensive, patient-centered approach to managing gout, particularly in individuals with associated comorbidities. Multidisciplinary collaboration and emerging new treatments and evidence ensure the optimization of the recommendations.