Based on spleen deficiency-phlegm dampness as the core pathogenesis of obesity， and integrating recent advances in modern medicine regarding the key role of immune inflammation in obesity， this paper proposes a multidimensional pathogenic network of "obesity-spleen deficiency-phlegm dampness-immune imbalance". Various traditional Chinese medicine （TCM） herbs that strengthen the spleen， regulate qi， and resolve phlegm and dampness can treat obesity by improving spleen-stomach transport and transformation， promoting water-damp metabolism， and regulating immune homeostasis. This highlights immune inflammation as an important entry point to elucidate the TCM concepts of "spleen deficiency-phlegm dampness" and the therapeutic principle of "strengthening the spleen and eliminating dampness to treat obesity". By systematically analyzing the intrinsic connection between "spleen deficiency generating dampness， internal accumulation of phlegm dampness" and immune dysregulation in obesity， this paper aims to provide theoretical support for TCM treatment of obesity based on dampness.

Objective: To construct a scientific and perfect evaluation index system of infectious disease prevention and control ability in colleges and universities, so as to provide reference tools for colleges and universities to effectively respond to infectious disease. Methods: The initial framework of the evaluation index system of infectious disease prevention and control ability in colleges and universities was constructed by using literature analysis method. Experts familiar with infectious disease prevention and control or school health work were selected to conduct two rounds( n =16，18) of Delphi expert consultation for determining the evaluation index system. Analytical hierarchy process was used to calculate the index weights and combined weights. About 198 prevention and control personnel were conveniently selected from 3 universities in Inner Mongolia Autonomous Region to comprehensively evaluate the evaluation indicators by using fuzzy comprehensive evaluation method. Results: After two rounds of Delphi consultation questionnaire, the effective recovery rates were 80.0% and 90.0%, the expert authority levels were 0.89 and 0.86, the expert harmony coefficients for Kendall W were 0.166 and 0.310, and the variation coefficient of each index was <0.25. Finally, the evaluation index system of infectious disease prevention and control ability of colleges and universities included 4 first level indicators, 14 second level indicators and 75 third level indicators. The weights of prevention and monitoring and early warning, organizational system guarantee, emergency management, rehabilitation and summary were 0.176, 0.476, 0.268 and 0.080, respectively. The top 3 weights of the secondary indexes were 0.623 for infectious disease surveillance and early warning, 0.595 for loss assessment and 0.370 for emergency response. The score of fuzzy comprehensive evaluation of the index system of infectious disease prevention and control ability in colleges and universities was 79.148, suggesting a high level. Conclusion The established evaluation index system of infectious disease prevention and control ability in colleges and universities is scientific and reasonable, which is conducive to provide tool reference for the evaluation of infectious disease prevention and control ability in colleges and universities.

ObjectiveTo construct a macro-evaluation tool for dampness syndrome （DS） animal model， which will provide a basis for experimental research on dampness syndrome in traditional Chinese medicine （TCM）. MethodsConceptual framework of this study was clarified through discussions within the core working group， and dimensions of the evaluation of the animal model of DS were identified according to TCM principles. We searched CNKI， Wanfang， VIP and SinoMed databases from the inception to June 30th， 2023， on experiments involving dampness syndrome animals to create a pool of items about DS animal models. The core items were selected and extracted for factor analysis and cluster analysis. An expert importance rating questionnaire was developed based on the results of the literature review， analyzing the distribution of item scores， importance averages， and coefficient of variation. Through a comprehensive analysis of literature， expert importance scoring， and specific expert opinions， items that did not meet anyone of the criteria of average importance rating ≥2.04， coefficient of variation ≤30%， or literature eva-luation frequency ≥2% were removed， thereafter， the macro-evaluation tool for DS animal model was preliminarily constructed. ResultsSpirit and body state， autonomic activity state， body surface characteristics， diet， urination and defecation， tongue manifestation， and motor behavior assessment were constructed as the seven dimensions in the evaluation of DS animal model. A total of 348 papers about animal experiments were included and analyzed， resulting in a saturated pool of 72 items， which was refined to 38 core items of DS animal models. Factor analysis obtained 16 common factors， which were further clustered into two categories， named dampness transforming from heat syndrome and dampness transforming from cold syndrome. The expert importance scoring showed that the Kendall harmony coefficient was 0.359 （P＜0.05） indicating a high level of agreement， coordination and reliability among the experts. Notably， 50% or more of the experts considered the items thick and greasy tongue coating， unclean perianal area， loose stools， lethargy， unformed stools， and listless expression as very important. The median scores for all items were 2.04（1.73， 2.37）， with a coefficient of variation ranging from 19.73% to 53.38%. After expert evaluation， the macro-evaluation tool for DS animal model in TCM with 33 items and corresponding criteria for assessing the formation of DS models was finally contructed. ConclusionThe Macro-evaluation tool for DS animal model in TCM is highly scientific， credible， and operable， and can be utilized in DS animal experiments after its characteristics are actually evaluated.

Acute kidney injury（AKI）is one of the risk factors leading to death in premature infants.The incidence of AKI showed a upward trend year by year.The pathogenesis may be related to preterm birth with insufficient nephrons，prenatal inflammatory injury and urinary podocyte loss.The occurrence rate of AKI in premature infants increased with the decreasing of gestational age and birth weight.It should be emphasized that AKI in premature infants does not exist independently，but interacts with other organs，such as heart，lung，intestine，brain，and other organs.Moreover，the involvement of these organs may increase the risk of AKI，and so does bloodstream infections.Blood creatinine and urine volume can be used for clinical diagnosis and classification of AKI in premature infants.Glucocorticoids and caffeine can protect kidney in premature infants.Due to the lack of specificity in the treatment of AKI，fluid management and medication are important for the development of AKI.Renal replacement therapy，the common of which are peritoneal dialysis and continuous renal replacement therapy，can be used in severe AKI.

Objective:To study the clinical characteristics and prognosis of necrotizing enterocolitis (NEC) in preterm infants with gestational age (GA) <34 weeks.Methods:From January 2016 to December 2022, preterm infants (GA <34 weeks) with NEC (Bell's stage Ⅱ/Ⅲ) admitted to our hospital were retrospectively analyzed. They were assigned into the conservative group and the surgical group. The perinatal data, clinical characteristics, laboratory results and prognosis were compared between the two groups.Results:A total of 4 526 preterm infants were enrolled. 298 (6.6%) had NEC and 188 were in stage Ⅱ/Ⅲ. 38(20.2%) infants received surgery and the remaining 150 were treated conservatively. Comparing with the conservative group, the surgical group showed higher incidences of the following: small for gestational age, blood in stool or positive fecal occult blood test (FOBT), apnea, poor response, increased heart rate, leukocytosis or leukopenia, thrombocytopenia, mechanical ventilation and elevated C-reactive protein and procalcitonin (all P<0.05). The surgical group also had higher incidences of concomitant shock and need for mechanical ventilation at the time of NEC diagnosis ( P<0.05). During NEC treatment, the surgical group had higher incidence of infectious pneumonia ( P=0.031). At 1, 3, 6, 12 and 18 months of follow-up, the surgical group had higher incidences of insufficient body weight gain ( P<0.05). At 1, 3 and 6 months of follow-up, the surgical group had higher incidences of smaller head circumference ( P<0.05). At 1 and 3 months of follow-up, the surgical group had higher incidences of shorter body length ( P<0.05). However, no significant differences existed in head circumference and body length as age developed ( P>0.05). At 12 months follow-up, no significant difference existed in the incidence of cerebral palsy between the two groups ( P>0.05). Conclusions:Blood in stool or positive FOBT, apnea, poor response and increased heart rate are common in GA <34 weeks preterm infants with NEC. Early diagnosis and identification of those requiring surgery are important. After surgery and later on, the infants may have a catch-up growth with the growth rate of head circumference and body length more pronounced than body weight.

Objective:To explore whether microRNA (miRNA) -181b-5p inhibits the proliferation and invasion of cutaneous melanoma cells by targeting pleckstrin (PLEK) .Methods:Bioinformatics methods were used to analyze cutaneous melanoma-associated core genes; dual-luciferase reporter assay was performed to verify the targeted interaction between miRNA-181b-5p and PLEK. Oligo RNA and small interfering RNA (siRNA) were used to regulate the expression of miRNA-181b-5p and PLEK in A375 cells respectively in this experiment, and A375 cells were divided into the following groups in detail: mimic negative control group, miRNA-181b-5p mimic group, inhibitor negative control group, miRNA-181b-5p inhibitor group, PLEK siRNA group, siRNA negative control group, miRNA-181b-5p inhibitor + control siRNA co-transfection group and miRNA-181b-5p inhibitor + PLEK siRNA3 co-transfection group. After 48-hour treatment, qPCR was performed to determine the mRNA expression of miRNA-181b-5p and PLEK in A375 cells, Western blot analysis to determine the PLEK protein expression, and Transwell assay to assess the invasive ability of A375 cells; after additional 24-96 hours of culture, cell counting kit-8 (CCK8) assay was conducted to assess the proliferative ability of A375 cells.Results:PLEK was the core gene for cutaneous melanoma. PLEK expression in the cutaneous melanoma in situ tissues was significantly higher than that in the paracancerous tissues ( P = 0.031) , but lower than that in the metastatic tissues ( P = 0.001) . Compared with human epidermal melanocytes HEMa-LP, the mRNA and protein expression of PLEK significantly increased in A375 cells (mRNA: 3.884 ± 0.156 vs. 0.997 ± 0.010, t = 18.48, P < 0.001; protein: 2.840 ± 0.301 vs. 1.029 ± 0.094, t = 5.47, P = 0.005) , but the miRNA-181b-5p expression significantly decreased in A375 cells (0.333 ± 0.042 vs. 0.967 ± 0.069, t = 7.83, P = 0.001) . Dual-luciferase reporter assay showed targeted binding of miRNA-181b-5p to PLEK. Compared with the mimic negative control group, the miRNA-181b-5p mimic group showed significantly decreased survival rate of A375 cells (48 hours: t = 7.96, P = 0.015; 72 hours: t = 7.50, P = 0.002; 96 hours: t = 7.96, P = 0.001) , and significantly decreased invasive ability of A375 cells ( t = 5.07, P = 0.007) ; on the contrary, the survival rate and invasive ability of A375 cells were significantly higher in the miRNA-181b-5p inhibitor group than in the inhibitor negative control group (survival rate: 24 hours, t =5.38, P = 0.013; 48 hours, t = 5.36, P = 0.013; 72 hours, t =7.63, P = 0.005; 96 hours, t = 5.99, P = 0.004; invasive ability: t = 7.24, P = 0.002) ; compared with the siRNA negative control group, the proliferative and invasive ability of A375 cells significantly decreased in the PLEK siRNA group (proliferative ability: 48, 72, 96 hours, P = 0.015, 0.011, 0.001, respectively; invasive ability: t = 4.93, P = 0.008) ; compared with the miRNA-181b-5p inhibitor + control siRNA co-transfection group, the miRNA-181b-5p inhibitor + PLEK siRNA co-transfection group showed significantly decreased proliferation rate and invasive ability of A375 cells (proliferation rate: 24, 48, 72, 96 hours, P = 0.042, 0.042, 0.037, 0.017, respectively; invasive ability: t = 8.52, P = 0.001) . Conclusion:miRNA-181b-5p can inhibit the proliferation and invasion of cutaneous melanoma A375 cells, likely by down-regulating the PLEK expression.

Objective: To understand participation and attitude towards online public opinion on gender issues among college students. Methods: Using convenient sampling, 450 valid questionnaires were collected from 9 colleges and universities in Xi an, Shaanxi Province, and self compiled questionnaires were used to investigate general demographic information, public opinion concern and participation of gender issues, case attitudes and the impact of online public opinion of gender issues. Results: A total of 371 participants (83.00%) paid attention to such events, and 210 (47.00%) participated in the discussion. Among the 326( 72.90 %) college students who were affected by such events, 62(13.90%) thought that such events had a lasting effect on self emotion, and 54(12.10%) thought that such events had further effects on self emotion, affect their own lives. Attention to and participation in the event(4.58±2.94), positive evaluations of victims(12.01±2.07), negative evaluations of perpetrators(5.99±1.60), and negative emotions(15.90±8.62) in female college students were significantly higher than those of males(3.85±2.67, 11.44± 2.02 , 6.56±1.83, 9.46±9.02)( t=2.76, 2.96, 3.48, 7.71, P <0.05). Conclusion College students have a high degree of attention to social public opinion events on gender issues, with significant gender difference. Schools, media and society should pay attention to the media literacy and mental health among college students.

Objective:To identify the differences in clinical manifestations between Chinese giant cell arteritis (GCA) patients and polymyalgia rheumatica (PMR) patients.Methods:Twelve GCA patients were included during September 2010 to September 2019 in our hospital. Clinical and laboratory data were collected. Twenty-four age and sex-matched pure PMR patients were selected as control. Statistical analysis was performed using Statistical product and service solutions (SPSS) software. The categorical variables were tested by chi square test, and the continuous variables were expressed by mean and standard deviation ( ± s). The comparison between groups was conducted by t-test. P<0.05 was considered statistically significant. Results:In these 12 GCA patients, the onset age was 55-70 (67±7) years old, and male to female ratio was 1∶11. The most common initial symptom of GCA was the same as PMR (7/12, 58%) . Compared with PMR patients, the specific clinical manifestations of GCA patients were scalp pain ( P=0.031), mandibular claudication ( P=0.031) and migraine ( P=0.000). The creatine kinase of GCA (60±27) U/L patients was higher than that in PMR (41±15) patients ( t=1.098, P=0.029). There was no significant difference in other laboratory tests including erythrocyte sedimentation rate, C reactive protein level. Seven of 12 GCA patients were first diagnosed with PMR, then were diagnosed with GCA during follow-up. No obvious differences could be found in clinical manifestations between these 7 patients and 24 pure PMR patients. Through imaging examinations, we found that 9 of the 12 GCA patients had arterial stenosis, 5 had thickened vascular walls, 5 had atherosclerosis, and 2 had rough endometrium. Conclusion:GCA patients and PMR may have similar clinical presentations. The presence of scalp pain, mandibular claudication and migraine during the course of the disease implies that GCA is more likely. Vascular ultrasound, arterial CTA, and positron emission tomograph (PET)/CT play an increasingly important role in the diagnosis of GCA.

Objective:To analyze and compare the features of undifferentiated-typed early gastric cancer (UD-EGC) and gastric mucosa-associated lymphoid tissue(MALT) lymphoma under white light endoscopy (WLE) and magnifying endoscopy-narrow band imaging (ME-NBI).Methods:Data of patients with complete endoscopic images of WLE and ME-NBI in Shanghai General Hospital, Shanghai Jiao Tong University from March 2015 to July 2019 were retrospectively analyzed.Twenty-six UD-EGC patients and seven gastric MALT lymphoma patients in ⅠE1 stage were included, and the characteristics of the two diseases under WLE and ME-NBI were compared and summarized.Results:There were no significant differences in age, sex or infiltration depth of lesions between the two groups.Under WLE, UD-EGC was often manifested as a single lesion located in the lower part of the stomach, with unclear lesion boundaries. While MALT lymphoma lesions were mostly multifocal with clear boundaries, located in the middle of the stomach. Under ME-NBI, the microsurface pattern of UD-EGC showed dilation or disappearance of areas between the recesses, and the spiral microvascular pattern. However, the microsurface pattern of MALT lymphomas were characterized by " cross-road traffic sign" , " pebble sign" , and the presentation of residual glandular duct at the lesion was similar to that of Helicobacter pylori ( HP)-related gastritis. Furthermore, the microvascular pattern of MALT lymphomas often showed " tree like appearance (TLA)" . After HP eradication therapy, the morphology of microsurface pattern and microvascular pattern in the original lesion area gradually returned to normal. Conclusion:UD-EGC and gastric MALT lymphoma showed particular features in the number, site and boundary under WLE, and they showed significantly different microsurface pattern and microvascular pattern under ME-NBI. Differentiation of the two diseases will help reduce the risk of missed diagnosis and misdiagnosis.

Gastric cancer (GC) is known as a top malignant type of tumors worldwide. Despite the recent decrease in mortality rates, the prognosis remains poor. Therefore, it is necessary to find novel biomarkers with early diagnostic value for GC. In this study, we present a large-scale proteomic analysis of 30 GC tissues and 30 matched healthy tissues using label-free global proteome profiling. Our results identified 537 differentially expressed proteins, including 280 upregulated and 257 downregulated pro-teins. The ingenuity pathway analysis (IPA) results indicated that the sirtuin signaling pathway was the most activated pathway in GC tissues whereas oxidative phosphorylation was the most inhibited. More-over, the most activated molecular function was cellular movement, including tissue invasion by tumor cell lines. Based on IPA results, 15 hub proteins were screened. Using the receiver operating character-istic curve, most of hub proteins showed a high diagnostic power in distinguishing between tumors and healthy controls. A four-protein (ATP5B-ATP5O-NDUFB4-NDUFB8) diagnostic signature was built using a random forest model. The area under the curve (AUC) values of this model were 0.996 and 0.886 for the training and testing sets, respectively, suggesting that the four-protein signature has a high diag-nostic power. This signature was further tested with independent datasets using plasma enzyme-linked immune sorbent assays, resulting in an AUC value of 0.778 for distinguishing GC tissues from healthy controls, and using immunohistochemical tissue microarray analysis, resulting in an AUC value of 0.805. In conclusion, this study identifies potential biomarkers and improves our understanding of the pathogenesis, providing novel therapeutic targets for GC.