This paper summarizes Professor LIU Fengbin's clinical experience in treating autoimmune liver disease （AILD） using the method of nourishing yin and removing stasis based on stage differentiation. He believes that the pathogenesis of AILD generally involves both deficiency in essence and excess in manifestation， with essence deficiency often presenting as liver and kidney yin deficiency， which may progress to spleen deficiency and yang deficiency over time. The excess manifestation commonly includes qi stagnation， blood stasis， damp-heat， and phlegm toxicity. Clinically， he advocates for the treatment principle of nourishing yin and removing stasis. On the foundation of nourishing liver and kidney yin， different pathological factors causing stasis are eliminated according to their nature. Treatment is also tailored to different stages of AILD. In the early and asymptomatic stages， liver qi stagnation and spleen deficiency are prominent， warranting a therapeutic approach of soothing the liver， regulating qi and strengthening the spleen. The modified Chaishao Qizhi Decoction （柴芍气滞汤） is used. During the symptomatic stage， pathogenic factors become more pronounced， often accompanied by a significant deficiency of vital qi， with damp-heat， water retention， and phlegm toxicity as key pathological features. The treatment should focus on strengthening the spleen and dispelling dampness， using modified Sijunzi Decoction （四君子汤） combined with Yinchen Wuling Powder （茵陈五苓散）. In the liver function decompensation stage， vital qi is severely deficient while pathogenic factors persist， with damp-heat， phlegm toxicity， and blood stasis obstructing the liver collaterals. Treatment should focus on nourishing blood， softening the liver， strengthening the spleen， and resolving stasis， using the modified Ruangan Yangxue Decoction （软肝养血汤）. Throughout the treatment process， emphasis is placed on tonifying the liver and kidneys while protecting yin fluids.

OBJECTIVE To study the protective effect and possible mechanism of soybean isoflavones against threatened miscarriage rats. METHODS Female mice were selected to promote estrus and mate with male mice. After pregnancy， they were randomly divided into normal group （purified water， i.g.， n＝10）， model group （purified water， i.g.， n＝9）， positive control drug group （progesterone 4 mg/kg， i.m.， n＝9）， low-， medium- and high-dose soybean isoflavone groups （25， 50 and 100 mg/kg， i.g.， n＝10）. Except for the normal group， the rest were given mifepristone+misoprostol on the 8th day of pregnancy to establish threatened miscarriage model， and then given purified water or drugs， once a day， on days 1-7 and 9-12 of pregnancy， respectively. At 14 days of pregnancy， the rates of fetal protection were counted. Serum levels of β-human chorionic gonadotrophin （β-HCG） and progesterone （P） in rats were detected. Pathological and morphological changes in rat placenta and decidua tissues were observed， and the apoptosis indexes of cells were detected； mRNA and protein expressions of factor of apoptosis related （Fas）， factor of apoptosis related ligand （FasL）， proliferating cell nuclear antigen （PCNA） and heparin binding epidermal growth factor （HB-EGF） were determined in placenta tissues， and mRNA and protein expressions of Fas， PCNA and HB-EGF in decidua tissues were detected. RESULTS In the model group， the placental tissues of rats were hyperemia and dilatation， with fewer and irregular blood vessels； severe stromal edema，inflammatory cell infiltration and iron-choledrin depositionwere observed. Compared with model group， the fetal survival rates， serum levels of β-HCG and P， the expressions of PCNA and HB-EGF mRNA and proteins in the placenta and decidua tissue of soybean isoflavone groups increased significantly （P＜ 0.05）， while pathological changes were improved significantly； cell apoptosis index in the placenta and decidua tissue， the expressions of Fas， FasL mRNA and proteins in the placenta and Fas mRNA and protein in the decidua tissue decreased significantly （P＜0.05）. The effect of soybean isoflavones was dose-dependent （P＜0.05）. CONCLUSIONS Soybean isoflavone has protective effect on threatened miscarriage， the mechanism of which is related to down-regulating the expressions of Fas and FasL mRNA and protein at the maternal-fetal interface， and up-regulating the expressions of mRNA and protein of PCNA and HB- EGF.

Background/Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) has become an increasingly important health challenge, with a substantial rise linked to changing lifestyles and global obesity. Ursolic acid, a natural pentacyclic triterpenoid, has been explored for its potential therapeutic effects. Given its multifunctional bioactive properties, this research further revealed the pharmacological mechanisms of ursolic acid on MASLD. Methods: Drug target chips and bioinformatics analysis were combined in this study to explore the potential therapeutic effects of ursolic acid on MASLD. Molecular docking simulations, surface plasmon resonance analyses, pull-down experiments, and co-immunoprecipitation assays were used to verify the direct interactions. Gene knockdown mice were generated, and high-fat diets were used to validate drug efficacy. Furthermore, initial CD4+ T cells were isolated and stimulated to demonstrate our findings. Results: In this study, the multifunctional extracellular matrix phosphorylated glycoprotein secreted phosphoprotein 1 (SPP1) was investigated, highlighting its capability to induce Th17 cell differentiation, amplifying inflammatory cascades, and subsequently promoting the evolution of MASLD. In addition, this study revealed that in addition to the canonical TGF-β/IL-6 cytokine pathway, SPP1 can directly interact with ITGB1 and CD44, orchestrating Th17 cell differentiation via their joint downstream ERK signaling pathway. Remarkably, ursolic acid intervention notably suppressed the protein activity of SPP1, suggesting a promising avenue for ameliorating the immunoinflammatory trajectory in MASLD progression. Conclusions Ursolic acid could improve immune inflammation in MASLD by modulating SPP1-mediated Th17 cell differentiation via the ERK signaling pathway, which is orchestrated jointly by ITGB1 and CD44, emerging as a linchpin in this molecular cascade.

OBJECTIVE To investigate the effects of osthole （OST） on renal interstitial fibrosis in diabetic nephropathy （DN） model mice. METHODS The diabetic mice model was established by the tail vein injection of streptozotocin once， and the DN model was established by feeding for 12 weeks after successful modeling of diabetes. Diabetic model mice were randomly divided into model group， low-dose， moderate-dose， high-dose groups （20， 40， 80 mg/kg） of OST， with 10 mice in each group. After successful modeling of diabetes， the mice were given corresponding drugs or solvent （model group） intragastrically， once a day， for consecutive 12 weeks， and the normal control group was set up at the same time. After the last administration， the levels of fasting blood glucose， 24 h urinary protein， serum creatinine （Scr） and blood urea nitrogen were tested in each group. Masson staining was used to observe the deposition of collagen fibers in renal interstitium； the expressions of E-cadherin and vimentin in renal cortex were detected by immunohistochemical staining. The protein expressions of follistatin-like protein 1 （Fstl1） and Snail family transcriptional repressor 1 （Snail1）， the phosphorylation of protein kinase B （Akt） （calculated by p-Akt/Akt） in the renal cortex were detected by Western blot. RESULTS Compared with normal control group， the levels of fasting blood glucose， 24 h urinary protein， Scr and blood urea nitrogen， collagen fiber deposition ratio of renal interstitium， the expression of vimentin， protein expressions of Fstl1 and Snail1， p-Akt/Akt in renal cortex were increased significantly （P＜0.01）， as well as the expression of E-cadherin was decreased significantly （P＜0.01）. Compared with model group， above indexes of OST groups were reversed significantly （P＜0.05 or P＜0.01）. CONCLUSIONS Preventive use of OST can effectively reduce fasting blood glucose level， protect renal function and inhibit epithelial-mesenchymal transition of DN model mice， and delay the progression of renal interstitial fibrosis ， the mechanism of which may be associated with the suppression of Fstl1/Akt/Snail1 signaling pathway.

Objective:To develop an program for training diabetes educators amid normalization stage of novel coronavirus pandemic prevention and control, and provide reference for clinical teaching under special circumstances.Methods:From January 2020 to June 2021, The head member of Diabetes Education and Management Committee of Hunan Health Management Association Xiangya Hospital of Central South University, developed and implemented a program based on core competencies of diabetes educators. It included 26 online courses, one to one education demonstration video with 7 themes, one diabetes conversation map and simulation, and three-week clinical practice. From April 2021 to June 2021, 55 health workers participated in the program. Theoretical tests, video feedback and questionnaires were used to evaluate the trainees′ diabetes knowledge, educational skills and satisfaction with the training program.Results:A total of 55 health workers participated in the program. All the participants completed the online courses and passed the quizzes, the theoretical examination score was (92.93 ± 5.28). Fifty-four participants finished the tasks of clinical practice and obtained the certificate of diabetes educator. Their communication skills and strategies of behavior change were significantly improved ( χ2 values were 4.17 -26.34, all P<0.05), and all of them were satisfied with the program. Conclusions:The training mode based on online training is flexible, convenient and effective,which is suitable for stage of novel coronavirus pandemic prevention and control.

Objective:To describe the characteristics and the survival status of pneumoconiosis cases reported in Guangzhou City from 1958 to 2018, and to investigate the epidemiological trends of pneumoconiosis. This study is aiming to provide basic data for formulating the guidelines and policies for control of pneumoconiosis, and for evaluating the control effects of pneumoconiosis.Methods:From July 2019 to January 2020, based on the data collected in the pneumoconiosis case cards and database as well as the retrospective follow-up investigate of pneumoconiosis cases, we conducted a descriptive analysis for all the new cases of pneumoconiosis reported from 1958 to 2018 in Guangzhou City. The statistical indices included the number of new pneumoconiosis cases in each decade, types of pneumoconiosis, regional and industrial distributions, survival status, and the change tendency of the diagnosis age and the dust exposure time of pneumoconiosis cases.Results:From 1958 to 2018, a total of 1194 new cases of pneumoconiosis were reported in Guangzhou City, including 1147 males (96.1%) and 47 females (3.9%) . Silicosis (60.1%, 718/1194) and welder's pneumoconiosis (21.5%, 257/1194) were the main types of pneumoconiosis. The top three districts for reporting new cases were Huangpu District (29.0%, 346/1194) , Nansha District (12.6%, 151/1194) and Baiyun District (11.1%, 132/1194) , respectively. The top three industries for reporting new cases were civil engineering construction industry (25.0%, 298/1194) , railway ship aerospace and other transportation equipment manufacturing industry (16.1%, 192/1194) and non-metal mining industry (15.7%, 187/1194) . The diagnosis age for new cases was 47.8 (23.6-79.1) years old, and the dust exposure time was 12.3 (0.4-49.1) years. Both of these two statistical indicators rose first and fell later from 1958 to 2018. As of December 31, 2019, a total of 963 new cases of pneumoconiosis were followed up, of which 467 (48.5%) survived, mainly silicosis (41.3%, 193/467) and welder's pneumoconiosis (43.3%, 203/467) . 496 cases (51.5%) died, and the age of death was 69.9 (32.4-96.9) years old.Conclusion:According to the epidemiological characteristics of pneumoconiosis in Guangzhou, we should focus on key districts and industries in the prevention and control of pneumoconiosis. Besides, the staffs in the occupational disease diagnosis institutions should try the best to collect the complete dust exposure data of new cases of pneumoconiosis. Moreover, the health administrative departments should pay more attention to the management of pneumoconiosis death case reports.

Objective:To describe the characteristics and the survival status of pneumoconiosis cases reported in Guangzhou City from 1958 to 2018, and to investigate the epidemiological trends of pneumoconiosis. This study is aiming to provide basic data for formulating the guidelines and policies for control of pneumoconiosis, and for evaluating the control effects of pneumoconiosis.Methods:From July 2019 to January 2020, based on the data collected in the pneumoconiosis case cards and database as well as the retrospective follow-up investigate of pneumoconiosis cases, we conducted a descriptive analysis for all the new cases of pneumoconiosis reported from 1958 to 2018 in Guangzhou City. The statistical indices included the number of new pneumoconiosis cases in each decade, types of pneumoconiosis, regional and industrial distributions, survival status, and the change tendency of the diagnosis age and the dust exposure time of pneumoconiosis cases.Results:From 1958 to 2018, a total of 1194 new cases of pneumoconiosis were reported in Guangzhou City, including 1147 males (96.1%) and 47 females (3.9%) . Silicosis (60.1%, 718/1194) and welder's pneumoconiosis (21.5%, 257/1194) were the main types of pneumoconiosis. The top three districts for reporting new cases were Huangpu District (29.0%, 346/1194) , Nansha District (12.6%, 151/1194) and Baiyun District (11.1%, 132/1194) , respectively. The top three industries for reporting new cases were civil engineering construction industry (25.0%, 298/1194) , railway ship aerospace and other transportation equipment manufacturing industry (16.1%, 192/1194) and non-metal mining industry (15.7%, 187/1194) . The diagnosis age for new cases was 47.8 (23.6-79.1) years old, and the dust exposure time was 12.3 (0.4-49.1) years. Both of these two statistical indicators rose first and fell later from 1958 to 2018. As of December 31, 2019, a total of 963 new cases of pneumoconiosis were followed up, of which 467 (48.5%) survived, mainly silicosis (41.3%, 193/467) and welder's pneumoconiosis (43.3%, 203/467) . 496 cases (51.5%) died, and the age of death was 69.9 (32.4-96.9) years old.Conclusion:According to the epidemiological characteristics of pneumoconiosis in Guangzhou, we should focus on key districts and industries in the prevention and control of pneumoconiosis. Besides, the staffs in the occupational disease diagnosis institutions should try the best to collect the complete dust exposure data of new cases of pneumoconiosis. Moreover, the health administrative departments should pay more attention to the management of pneumoconiosis death case reports.

Objective:To provide scientific evidence for the prevention and control strategies of noise-induced deafness, to analyze the epidemiological characteristics of the occupational noise-induced deafness diagnostic applicants in Guangzhou city during 2011-2018.Methods:In March 2019, by consulting the occupational disease diagnosis records, we investigated the distribution of all 471 occupational noise-induced deafness diagnostic applicants in Guangzhou Occupational Disease Prevention and Treatment Center from 2011 to 2018. Frequency and constituent ratio were used to describe the distribution.Results:From 2011 to 2018, there were 471 cases of occupational noise-induced deafness diagnostic applicants and 211 of the applicants were diagnosed as occupational noise-induced deafness (44.8%, 211/471) . The new cases were mainly mild (83.9%, 177/211) , with the predilection age of 40.0-49.0 years old (41.7%, 88/211) and the predilection seniority of 5.0-9.9 years (38.9%, 82/211) . Among the new cases, there were mainly males (88.6%, 187/211) . Most of the new cases were distributed in Nansha district (23.2%, 49/211) , Huangpu district (22.7%, 48/211) and Panyu district (21.8%, 46/211) . Besides, in terms of industry distribution, they were concentrated in manufacturing industry (82.0%, 173/211) . The scale of enterprises was mainly medium-sized (42.7%, 90/211) , and the most of their economic type was domestic-funded (40.8%, 86/211) .Conclusion:Although most of the newly diagnosed cases of occupational noise deafness in Guangzhou are mild, they still need to be paid attention to and strengthen the noise industry protection education.

Objective:To provide scientific evidence for the prevention and control strategies of noise-induced deafness, to analyze the epidemiological characteristics of the occupational noise-induced deafness diagnostic applicants in Guangzhou city during 2011-2018.Methods:In March 2019, by consulting the occupational disease diagnosis records, we investigated the distribution of all 471 occupational noise-induced deafness diagnostic applicants in Guangzhou Occupational Disease Prevention and Treatment Center from 2011 to 2018. Frequency and constituent ratio were used to describe the distribution.Results:From 2011 to 2018, there were 471 cases of occupational noise-induced deafness diagnostic applicants and 211 of the applicants were diagnosed as occupational noise-induced deafness (44.8%, 211/471) . The new cases were mainly mild (83.9%, 177/211) , with the predilection age of 40.0-49.0 years old (41.7%, 88/211) and the predilection seniority of 5.0-9.9 years (38.9%, 82/211) . Among the new cases, there were mainly males (88.6%, 187/211) . Most of the new cases were distributed in Nansha district (23.2%, 49/211) , Huangpu district (22.7%, 48/211) and Panyu district (21.8%, 46/211) . Besides, in terms of industry distribution, they were concentrated in manufacturing industry (82.0%, 173/211) . The scale of enterprises was mainly medium-sized (42.7%, 90/211) , and the most of their economic type was domestic-funded (40.8%, 86/211) .Conclusion:Although most of the newly diagnosed cases of occupational noise deafness in Guangzhou are mild, they still need to be paid attention to and strengthen the noise industry protection education.