OBJECTIVE To explore the practice and application effect of lean Six Sigma （LSS） management in the cost- benefit management of PIVAS operation in a tertiary comprehensive hospital （hereinafter referred to as “S Hospital”）， providing reference for the operation and management of PIVAS in hospitals. METHODS The five steps （define， measure， analyze， improve and control， i.e. DMAIC） of LSS management were implemented for PIVAS operation cost-benefit of S Hospital， and lean management was implemented for its cost-benefit management elements （human resource cost， medical and health material cost， and all-in-one parenteral nutrition preparation income）. Several intervention measures including personnel training and performance assessment， refined management system of consumables， and doctor’s advice package of full parenteral nutrition were developed. Finally， the overall improvement effect was evaluated by the total benefit， total cost and net benefit of PIVAS. The effects of human resource allocation optimization and improvement were evaluated by the work efficiency， work quality， job satisfaction， turnover rate and accumulated rest days. The effects of consumables cost management were evaluated by the amount of medical and health materials cost. The improvement effects of all-in-one parenteral nutrition preparation income were evaluated by the profit amount， quantity and the proportion of single bottle of parenteral nutrition. RESULTS After implementing DMAIC in S Hospital， the total benefit of PIVAS was increased from （471 366.50±9 201.5） yuan/month to （479 679.50±14 320.14） yuan/month （P＞ 0.05）， the total cost was decreased from （305 878.88±3 201.75） yuan/month to （294 610.59±5 007.33） yuan/month （P＜0.05）， and the net benefit of PIVAS was increased by 11.83% compared with that before the improvement. The work efficiency， work quality and job satisfaction of employees were significantly improved， the accumulated rest days were significantly reduced， and the turnover rate of third-party employees was reduced from 15.0% before the improvement to 7.5% after the improvement. The cost of medical and health materials significantly decreased from （67 826.42±2 812.76） yuan/month before improvement to （56 384.33±4 607.67） yuan/month after improvement （P＜0.05）. The quantity of all-in-one parenteral nutrition was significantly increased from （1 263.75±135.83） group/month before improvement to （2 061.25±89.04） group/month after improvement （P＜0.05）， and the proportion of users of single bottle of parenteral nutrition in total users decreased from 93.25% before improvement to 58.75% after improvement. The profit of all-in-one parenteral nutrition was 63.18% higher than that before implementing DMAIC. CONCLUSIONS The implementation of PIVAS operation cost-benefit management based on DMAIC is conducive to strengthening the cost control of PIVAS and promoting the healthy development of PIVAS.

To develop a guideline terminology system and promote its standardization, thereby enhancing medical staff's accurate understanding and correct application of guidelines.

Alzheimer’s disease (AD) is a central neurodegenerative disease characterized by progressive cognitive decline and memory impairment in clinical. Currently, there are no effective treatments for AD. In recent years, a variety of therapeutic approaches from different perspectives have been explored to treat AD. Although the drug therapies targeted at the clearance of amyloid β-protein (Aβ) had made a breakthrough in clinical trials, there were associated with adverse events. Neuroinflammation plays a crucial role in the onset and progression of AD. Continuous neuroinflammatory was considered to be the third major pathological feature of AD, which could promote the formation of extracellular amyloid plaques and intracellular neurofibrillary tangles. At the same time, these toxic substances could accelerate the development of neuroinflammation, form a vicious cycle, and exacerbate disease progression. Reducing neuroinflammation could break the feedback loop pattern between neuroinflammation, Aβ plaque deposition and Tau tangles, which might be an effective therapeutic strategy for treating AD. Traditional Chinese herbs such as Polygonum multiflorum and Curcuma were utilized in the treatment of AD due to their ability to mitigate neuroinflammation. Non-steroidal anti-inflammatory drugs such as ibuprofen and indomethacin had been shown to reduce the level of inflammasomes in the body, and taking these drugs was associated with a low incidence of AD. Biosynthetic nanomaterials loaded with oxytocin were demonstrated to have the capability to anti-inflammatory and penetrate the blood-brain barrier effectively, and they played an anti-inflammatory role via sustained-releasing oxytocin in the brain. Transplantation of mesenchymal stem cells could reduce neuroinflammation and inhibit the activation of microglia. The secretion of mesenchymal stem cells could not only improve neuroinflammation, but also exert a multi-target comprehensive therapeutic effect, making it potentially more suitable for the treatment of AD. Enhancing the level of TREM2 in microglial cells using gene editing technologies, or application of TREM2 antibodies such as Ab-T1, hT2AB could improve microglial cell function and reduce the level of neuroinflammation, which might be a potential treatment for AD. Probiotic therapy, fecal flora transplantation, antibiotic therapy, and dietary intervention could reshape the composition of the gut microbiota and alleviate neuroinflammation through the gut-brain axis. However, the drugs of sodium oligomannose remain controversial. Both exercise intervention and electromagnetic intervention had the potential to attenuate neuroinflammation, thereby delaying AD process. This article focuses on the role of drug therapy, gene therapy, stem cell therapy, gut microbiota therapy, exercise intervention, and brain stimulation in improving neuroinflammation in recent years, aiming to provide a novel insight for the treatment of AD by intervening neuroinflammation in the future.

Objective To construct a glioma microfluidic chip model to simulate tumor microenvironment for evaluating the medicinal efficacy of anti-glioma traditional Chinese medicines. Methods Glioblastoma cells U251 were seeded into microfluidic chips with different culture modes, and the cell viability and tumour microenvironment within the constructed model were characterized. Fluorescence staining was used to evaluate the effects of the positive drugs temozolomide （TMZ） and docetaxel （DOC） on the cell activity and apoptosis within the model, which was applied to evaluate the medicinal efficacy of the extracts of the herb Scutellaria barbata on gliomas. Results The cells in the constructed U251 microfluidic chip model displayed high viability and were able to mimic the hypoxic microenvironment of tumor to a certain extent. The viability of the U251 cells in the microfluidic chips decreased with the increasing of the concentration of the positive drug, and the viability of the 3D cultured U251 cells was higher than that in the 2D condition （P<0.05）. The intracellular mitochondrial membrane potential decreased with the increasing of the concentration of the positive drug. And the 2 mg/ml Scutellaria barbata extract killed U251 cells to a certain extent and reduced the mitochondrial membrane potential of the cells in the model. Conclusion This study successfully constructed a microfluidic chip model of glioma that could effectively simulate the tumor microenvironment and rapidly evaluate the anti-tumor medicinal efficacy, which provided a new strategy for the medicinal efficacy evaluation and active components screening of anti-glioma traditional Chinese medicines.

Objective: To understand 24 h physical activity levels of children aged 8-9 years in Pudong New Area and to explore its association with metabolic syndrome, so as to provide scientific basis for children s participation in physical activities and reducing the risk of metabolic syndrome. Methods: A stratified cluster random sampling method was adopted to select 13 schools in Pudong New Area, Shanghai. A total of 2 013 primary school students aged 8-9 years old were included as the research subjects. During September 2021 to December 2022, Actigraph GT3X accelerometer, height measuring gauge, electronic sphygmomanometer and waist circumference tape was used to measure physical activity, height, blood pressure and waist circumference, respectively. A total of 5 mL of venous blood was collected from students, and the levels of triglycerides (TG), highdensity lipoprotein cholesterol (HDL-C) and fasting plasma glucose (FPG) were detected, and online questionnaires were conducted. The ttest and oneway ANOVA were employed to compare the differences in 24 h physical activity levels among children with different characteristics. Multivariate Logistic regression was used to analyze the association between the 24 h physical activity levels and metabolic syndrome as well as its components. Results: Among primary school students, the average daily time of moderate to vigorous physical activity (MVPA) was (34.25±13.49)min, the attainment rate was 1.59%. The average daily sleep (SLP) time was (538.27±28.53) min, attainment rate was 1.89%. The detection rates of metabolic syndrome, abdominal obesity (AO), elevated blood pressure (BP), elevated TG, low HDL-C, and elevated FPG were 2.48%, 34.53%, 10.38%, 10.73%, 1.24% and 0.70%, respectively. Multivariate Logistic regression analysis showed that, for every 10minute increase in sedentary behavior (SB) time, the risks of AO, elevated BP, and elevated TG increased by 2% ( OR=1.02, 95%CI =1.01-1.04), 5% ( OR=1.05, 95%CI =1.01-1.08), and 6% ( OR= 1.06, 95%CI =1.02-1.11), respectively ( P <0.05). For every 10minute increase in MVPA time, the risk of metabolic syndrome decreased by 27% ( OR=0.73, 95%CI=0.57-0.93, P <0.05). For every 10 minute increase in SLP time, the risks of AO, elevated BP, and metabolic syndrome decreased by 16% ( OR=0.84, 95%CI =0.80-0.88), 9% ( OR=0.91, 95%CI =0.82- 0.99 ), and 15% ( OR=0.85, 95%CI =0.77-0.94), respectively （P <0.05). Conclusions The time of MVPA and SLP are seriously insufficient among children aged 8-9 years in Pudong New Area. There is an association between physical activity levels and metabolic syndrome as well as its components. Increasing the time of MVPA and SLP is of great significance for maintaining a relatively low risk of metabolic syndrome in children.

Taxifolin (Tax) has been proved to be a medicinal edible substance with protective effects against alcoholic liver injury, however, its poor hydrophilicity and permeability have hindered the clinical application of Tax. In this study, we prepared taxifolin-phosphatidylcholine/sodium deoxycholate/PVP-K30 micells (Tax-MLs). Box-Behnken test was used to obtain the optimal preparation process, and Tax-MLs were characterised by transmission electron microscopy and fourier transform infrared spectroscopy. Physicochemical parameters such as proximate micelle concentration, equilibrium solubility and oil-water partition coefficient were determined, and the release pattern of Tax-MLs was investigated by in vitro digestion simulation. Alcoholic liver injury model to explore the in vivo efficacy of Tax-MLs. The results showed that the average particle size, polydispersity index (PDI) and zeta potential of Tax-MLs were 36.90 ± 4.57 nm, 0.194 ± 0.01 and -32.6 ± 0.35 mV, respectively, and the uniform size and distribution of Tax-MLs were observed by transmission electron microscopy. The formation of Tax-MLs was proved by differential scanning calorimetry and fourier transform infrared spectroscopy. In terms of physicochemical properties, the solubility of Tax-MLs in water increased by 92.02 times compared with Tax, and its oil-water partition coefficient in water increased from 0.43 to 1.14, which proved that Tax-MLs could improve its solubility and permeability. The in vivo pharmacodynamic results showed that compared with the Tax group, Tax-MLs low, medium and high dose groups showed a significant reduction in liver indices and serum levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) (P < 0.05), and enhanced the activities of superoxide dismutase (SOD) and glutathione (GSH), and lowered the levels of malondialdehyde (MDA) more significantly in the hepatic tissues. Tax-MLs effectively improved drug solubility and permeability, and enhanced the protective effect against alcoholic liver injury. Animal experiments were conducted with approval from the Animal Ethics Committee of Changchun University of Traditional Chinese Medicine (approval number: 2023601).

To explore the effects of different exercise prescriptions on glycemic metabolism in East Asian patients with type 2 diabetes mellitus (T2DM) and to compare the differences in the impact of population characteristics and exercise components on glycemic metabolism.

Growth and development-related diseases result from the interplay of biological, psychological, and social factors. The collaboration between healthcare, sports, and education sectors integrates multidisciplinary resources and strengths to promote standardized diagnostic and therapeutic processes. This approach establishes a comprehensive closed-loop system encompassing early screening and referral, diagnosis and comprehensive evaluation, intervention and support plan formulation, as well as long-term management andoutcome assessment. It provides systematic scientific support for the healthy growth of children and adolescents, shifting disease intervention to the subclinical stage. Against the backdrop of societal informatization and intelligent development, this diagnostic and therapeutic model not only safeguards the holistic health of children and adolescents but also offers novel perspectives and feasible pathways for managing growth and development-related diseases. The implementation of this systematic diagnostic and therapeutic paradigm presents an innovative solution with Chinese characteristics for addressing such conditions, while injecting new vitality into the advancement of national health initiatives.

Childhood is a critical period for growth and development, and the oral microbiota, as the second most diverse microbial community in the human body, plays a pivotal role in maintaining children's health. Recent studies have demonstrated that dysbiosis of the oral microbiota not only contributes to oral diseases such as dental caries and periodontitis but may also influence the development of children's skeletal, nervous, digestive, cardiovascular, and immune systems through mechanisms involving inflammatory responses, metabolic regulation, and cross-organ communication networks. This review systematically examines the role of the oral microbiota in childhood growth and development and, guided by the core principles of the "active health" model, proposes multiple intervention strategies—including probiotics, xylitol, and mouthwashes—to optimize children's health through early oral microbiota modulation.

The growth and development of children is an important stage for health, and its monitoringand intervention are related to the long-term development of individuals. The construction of a standardized and multi-dimensional database of pediatric growth and development-related diseases is an important basis for realizing precise diagnosis and treatment and health management. Based on the needs of clinical practice, this study proposes to establish a specialized database of pediatric growth and development-related diseases that integrates facial phenotypes and clinical diagnosis and treatment information. This study elaborates on the construction process, including data sources, data collection content, and the operation and management of the database; and proposes key points for quality control, including the establishment of quality control nodes, database construction standards, and a full-process quality control framework. The above ensure the integrity, logic and effectiveness of the data, so that the database can provide an objective basis for the screening and diagnosis of pediatric growth and development-related diseases. On the basis of scientific data management and strict quality control, the database will help reveal the patterns of children's growth and development, and promote the level of children's health management.