Precancerous lesions of gastric cancer （PLGC） are a group of pathological changes caused by abnormalities in the structure， morphology， and differentiation of gastric mucosal epithelial cells. Since the early symptoms are hidden and non-specific， PLGC is not easy to be diagnosed and it has often developed into intermediate or advanced gastric cancer once being diagnosed and missed the best time for treatment. Accordingly， the incidence of this disease is increasing year by year， which lifts a heavy burden on the patients. The pathogenesis of PLGC is complex， involving inflammatory microenvironment， bile reflux， glycolysis， autophagy， and apoptosis. Currently， PLGC is mainly treated with anti-inflammatory and endoscopic therapies， which are difficult to curb the development of PLGC. Therefore， seeking a safe and effective therapy is an important topic of modern research. Traditional Chinese medicine （TCM）， characterized by treatment based on syndrome differentiation and a holistic view， exerts effects via multiple pathways， mechanisms， and targets. Recent studies have confirmed that TCM can regulate the phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin （PI3K/Akt/mTOR）， Wnt/β-catenin， Sonic Hedgehog， nuclear factor-κB （NF-κB）， Janus kinase/signal transducer and activator of transcription （JAK/STAT）， hypoxia-inducible factor-1α （HIF-1α）， neurogenic locus notch homolog protein （Notch）， nuclear factor E₂-related factor 2 （Nrf2） and other signaling pathways. By targeting these pathways， TCM can inhibit aerobic glycolysis， reduce oxidative stress， repair the inflammatory microenvironment， regulate cellular autophagy， and promote vascular normalization， thereby delaying or reversing PLGC. However， few researchers have systematically summarized the TCM regulation of PLGC-associated pathways. By reviewing the relevant articles at home and abroad， this paper summarized the roles of the above signaling pathways in the development of PLGC and the research progress in the regulation of signaling pathways by TCM in the treatment of PLGC， with a view to providing a new theoretical basis for the clinical research on PLGC and the drug development for this disease.

ObjectiveTo establish a quality evaluation method for Zhuye Shigao granules（Zhuye Shigaotang） based on fingerprint and determination of index components， and to investigate the therapeutic effect of Zhuye Shigao granules on mice with cold-dampness pestilence attacking lung syndrome. MethodsThe fingerprint of Zhuye Shigao granules was established by high performance liquid chromatography（HPLC）， and the methods for determination of total calcium， orientin， isoorientin， ginsenosides Rg₁， Re and Rb₁ and other 2 index components were established. Fifty ICR mice were randomly divided into the blank group， model group， Zhuye Shigao granules low， medium and high dose groups（9.3， 18.6， 37.2 g·kg^-1·d^-1）， with 10 mice in each group. In addition to the blank group， the model mice with cold-dampness pestilence attacking lung syndrome was prepared by nasal drip of lipopolysaccharide combined with cold-dampness environment. Each administration group was given the corresponding liquid by gavage according to the dose， while the blank group and model group were given the same volume of normal saline by gavage. Then， the body temperature and organ index of mice in each group were measured， hematoxylin-eosin（HE） staining was used to investigate the lung tissue injury of mice in each group， and enzyme-linked immunosorbent assay（ELISA） was used to detect the changes of tumor necrosis factor-α（TNF-α）， interleukin（IL）-lβ， IL-6， IL-10 levels in serum and lung tissue， as well as immunoglobulin（Ig）A and IgM levels in serum. ResultsThe fingerprint similarity of 10 batches of Zhuye Shigao granules was>0.950， and 20 common peaks were calibrated. Seven of them were identified， including peak 11（isoorientin）， peak 12（orientin）， peak 14（apioside liquiritin）， peak 15（liquiritin）， peak 17（apioside isoliquiritin）， peak 19（isoliquiritin） and peak 20（liquiritigenin）. The results of quantitative analysis showed that the content range of each index component in 10 batches of Zhuye Shigao granules was as follows：Total calcium of 9.978-11.294 mg·g^-1， isoorientin of 0.033-0.041 mg·g^-1， orientin of 0.046-0.055 mg·g^-1， ginsenoside Rg₁+ginsenoside Re of 0.748-0.762 mg·g^-1， ginsenoside Rb₁ of 0.151-0.197 mg·g^-1， liquiritin of 1.106-1.366 mg·g^-1， glycyrrhizic acid of 0.904-1.182 mg·g^-1_. Compared with the blank group， the body temperature of mice in the model group was significantly increased， the organ indexes of liver， lung and spleen were significantly decreased， the organ index of thymus was significantly increased， HE staining of lung tissue showed infiltration of inflammatory cells， a small amount of serous exudation was observed in the alveoli， and lung tissue was damaged. After the intervention of Zhuye Shigao granules， the pathological changes were improved compared with the model group. The expression levels of IL-1β， IL-6 and TNF-α were significantly increased， the expression level of IL-10 was significantly decreased in serum and lung tissue. The levels of IgA and IgM in serum were significantly decreased（P<0.01）. Compared with the model group， the body temperature， the organ indexes and immune factor levels in serum and lung tissue of mice in the Zhuye Shigao granules medium and high dose groups were significantly reduced（P<0.05， P<0.01）. ConclusionIn this study， the quality evaluation of Zhuye Shigao granules was carried out based on fingerprint combined with determination of index components， and the fingerprint of four herbs（Lophatheri Herba， Ophiopogonis Radix， Pinelliae Rhizoma and Glycyrrhizae Radix et Rhizoma） in this formula and the determination of 8 index components were established. The therapeutic effect of Zhuye Shigao granules on mice with cold-dampness pestilence attacking lung syndrome may be related to inhibiting inflammatory response and mediating immune regulation.

ObjectiveTo investigate the current status of health literacy among type 2 diabetes mellitus patients in Shanghai communities, to analyze its correlation with glycemic and lipid metabolic indicators and quality of life (QoL), and to provide an evidence for the development of effective intervention measures. MethodsA follow⁃up survey was conducted among diabetic patients diagnosed at hospitals above the secondary level from March to June, 2023, who were part of a diabetes cohort study jointly established by Songnan Community in Baoshan District and the Shanghai Institute of Endocrinology. Patients were assessed using a simplified evaluation form for diabetes-related health literacy and a QoL scale, and metabolic indicators such as blood glucose and blood lipids were measured. Pearson correlation coefficients were employed to assess the relationship between health literacy levels and metabolic indicators as well as QoL. Logistic regression models were used to estimate the odds ratios (OR) and 95% confidence intervals (CI) for the associations between patients’ health literacy levels, metabolic status, and QoL. ResultsAmong the 932 diabetic patients surveyed, the health literacy level was low, with an average score of (65.2±13.4) points of which (62.6±13.8) points for males and (67.9±12.5) points for females. The average QoL score was (44.1±9.2) points of which (44.0±9.5) points for males and (44.2±8.9) points for females. The achievement rates of HbA1c, total cholesterol (TC), and triglycerides (TG) were 51.6%, 30.3%, and 64.8%, respectively. The TC achievement rate among male patients (37.6%) was significantly higher than that among females (22.8%). Significant differences in HbA1c achievement rates were observed across age groups, education levels, disease durations, and BMI levels (P<0.05). Similarly, significant differences were found in FPG achievement rates across different age groups, annual household incomes, disease durations, and family histories (P<0.05). No statistically significant differences were noted in TG and HDL-C achievement rates across all variables (P>0.05). However, LDL-C achievement rates were significantly higher in patients without complications compared to those with complications (P<0.05). Health literacy showed a significant negative correlation with psychological dimension, treatment dimension, and QoL scores (r=-0.14, P<0.05). After adjusting for potential confounding factors, a significant association was found between patients’ health literacy levels and QoL, but not with metabolic indicators. ConclusionThere is a significant correlation between health literacy levels and QoL among diabetic patients in community settings. Further exploration is needed to identify factors influencing patients’ QoL and glycemic and lipid metabolic indicators.

Objective To develop a self-assessment scale of home volume management for patients with chronic heart failure(CHF),and to test its reliability and validity.Methods With the self-care theory as the theoretical framework,the initial scale was developed through literature analysis,qualitative interview and expert consultation.A questionnaire survey was conducted on 598 patients with CHF who were treated or reviewed in a tertiary hospital in Hangzhou from September 2022 to January 2023 to test the reliability and validity of the scale.Results The exploratory factor analysis extracted 4 common factors with the cumulative variance contribution rate of 61.268％.The results of confirmatory factor analysis showed that the main evaluation indicators were all within the acceptable range of the judgment standard.The item-level content validity index ranged from 0.853 to 1.000;the scale-level content validity index/average was 0.951.The Cronbach's a coefficient,half reliability and retest reliability of the overall scale were 0.930,0.723 and 0.867,respectively.Conclusion The self-rating scale of home volume management for CHF patients has good reliability and validity,and it can effectively assess the level of home volume management for CHF patients.

ObjectiveTo explore the mechanism of Gancao Fuzitang （GCFZ）in inhibiting the bone destruction of collagen-induced arthritis （CIA） model in mice. MethodThirty male DBa/1J mice were randomly divided into normal group， CIA group， low-dose GCFZ group （GCFZ-L， 2.4 g·kg^-1）， high-dose GCFZ group （GCFZ-H， 4.8 g·kg^-1）， and methotrexate group （MTX， 1 mg·kg^-1）， with six mice in each group. The CIA model was induced by secondary immunization method. The arthritis index of mice in each group was observed and recorded， and the histopathological changes in ankle joint were observed by hematoxylin-eosin （HE） staining. The damage to ankle cartilage was detected by safranin O-fast green staining. Micro-CT scanning was used to detect the bone destruction of ankle joint， and the expression of nuclear factor-κB p65 （NF-κB p65）， p-NF-κB p65， inhibitory-κB kinase α/β （IKKα/β）， and p-IKKα/β was observed by immunohistochemical staining. ResultCompared with the normal group， the CIA group showed manifest joint swelling and increased arthritis index score （P<0.01）. Compared with the CIA group， the groups with drug intervention could inhibit joint swelling and reduce arthritis index score （P<0.05， P<0.01）. As revealed by HE staining and safranine O-green staining， compared with the CIA group， the groups with drug intervention could inhibit synovial invasion and reduce the destruction of articular cartilage. Micro-CT scanning analysis showed that compared with the CIA group， the GCFZ-H group and the MTX group showed reduced bone destruction scores （P<0.01）. The immunohistochemical results showed that compared with the normal group， the CIA group showed increased optical density values of NF-κB p65， p-NF-κB p65， IKKα/β， and p-IKKα/β（P<0.01）. Compared with the CIA group， the GCFZ-H group and the MTX group showed reduced optical density values of NF-κB p65， p-NF-κB p65， IKKα/β， and p-IKKα/β（P<0.05，P<0.01）. In the GCFZ-L group， only the NF-κB p65 optical density value decreased（P<0.01）. ConclusionGCFZ may inhibit bone destruction in CIA mice by regulating the NF-κB signaling pathway.

Objective:To investigate the impact of the interaction between triglyceride-glucose(TyG)and obesity-related anthropometric indices on hypertension risk.Methods:A total of 3 356 permanent residents over 40 years were recruited from Songnan community, Baoshan district, Shanghai. All participants underwent questionnaire surveys, physical examinations, and biochemical parameter tests. TyG-WHR, TyG-WHtR, and TyG-BMI were obtained by multiplying TyG index with waist-to-hip ratio(WHR), waist-to-height ratio(WHtR), and body mass index(BMI), respectively. Logistic regression models were used to investigate the associations of the three indices and hypertension. The interactions of TyG index and obesity-related anthropometric indices on the risk of hypertension were analyzed in different genders.Results:After multivariable adjustment, the fourth quartile of TyG, TyG-WHR, TyG-WHtR, and TyG-BMI demostrated higher risk of hypertension compared with the first quantile, with OR(95% CI)2.93(2.37-3.62), 3.22(2.59-4.01), 4.33(3.46-5.42), and 4.07(3.27-5.06). Two abdominal obesity-related indicators WHR(RERI=1.52, 95% CI 0.12-2.92; AP=0.32, 95% CI 0.06-0.59)and WHtR(RERI=2.41, 95% CI 0.64-4.19; AP=0.39, 95% CI 0.15-0.63; SI=1.88, 95% CI 1.10-3.21)had a biological interaction with TyG index on the risk of hypertension in female, but not in male. Conclusion:The combination of TyG and obesity-related indicators is significantly correlated with the increased risk of hypertension, which may be influenced by gender and fat distribution type.

The Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire was used for appraisal in a newly-built general hospital for all the nursing staff, and they were provided with a six-month safety culture training according to appraisal results.The training has elevated the positive response rate of the nursing staff towards all dimensions of patient safety culture, proving that scientific and reasonable safety culture training is conducive to nurses' perception of patient safety culture.

Objective To study the therapeutic effect and safety of recombinant human growth hormone in short children born small for gestational age (SGA).Methods Twenty-two short children born SGA were randomly divided into 2 groups and were exposed to different doses of recombinant human growth hormone,which were low dose group [0.1 IU/(kg · d)] and high dose group [0.2 IU/(kg · d)].Treatment was carried out for 2 years.Before and after treatment,height,weight,bone age,insulin-like growth factor 1 (IGF-1),insulin-like growth factor-binding protein 3 (IGFBP-3),growth rate (GV),height standard deviation scores (HtSDS),predicted adult lifetime height (PAH),fasting and postprandial blood glucose,insulin,thyroid stimulating hormone (TSH),T3,T4,and glycosylated hemoglobin were measured.Results Basic value of growth hormone in SGA infant was (2.94 ± 3.27) μg/L.Two years after treatment of growth hormone in high dose group,growth rate [(8.11 ± 1.31) cm/year vs (4.21 ± 0.99) cm/ year],HtSDS(-1.16 ±0.83 vs-3.00 ±0.71),and PAH[(163.68 ±6.76) cm vs (156.54 ±7.39) cm] were significantly higher than those before treatment (F =110.3,30.47,26.20,all P ＜ 0.01).Similar changes were observed in low dose group except for PAH.In high dose group after 2 years of treatment,IGF-1,IGFBP-3 were significantly higher than those before the treatment and the difference was statistically significant (all P ＜ 0.05).Although the plasma levels of IGF-1 and IGFBP-3 in low dose group in 2 years of treatment were significantly higher than those before the treatment,the difference was not statistically significant (P ＞ 0.05).Compared with that before treatment,the added value of IGF-1 had a positive correlation with the added values of growth rate,HtSDS and PAH(r =0.567 4,0.652 4,0.584 3,0.499 8,all P ＜ 0.05).Similar observations were found in low dose group (r =0.437 1,0.405 6 and 0.501 1,all P ＜ 0.05).However,the added value of IGF-1 in low dose group had no correlation with PAH (r =0.200 8,P ＞ 0.05).Compared with that before treatment,2 groups had no differences in fasting and postprandial blood glucose,insulin,TSH,T3,T4 and glycosylated hemoglobin (all P ＞ 0.05).Conclusions Recombinant human growth hormone [0.20 IU/(kg · d)] may significantly increase the growth rate and PAH of short children born SGA,which is a safe and effective strategy for the treatment of short SGA.

Objective To provide reference for developing and perfecting the open resources of national-wide cancer genomics-related data by collecting, systematizing, organizing, sharing and applying the related data of the National Genome Atlas ( TCGA) Program. Methods The technical process, sharing and use of TCGA Program data were in-vestigated. Results TCGA established the whole linkage data management process by cooperating with multiple cen-ters, including tissue sample collection, processing, quality control, sequencing, characteristics analysis, data sharing and application of research achievements. The data were classified according to the related cancer, data types and their processing. The mutation, amplification and deficit of related cancer characteristic genes and the af-fected signaling pathways were studied according to the two sharing mechanisms underlying open access and con-trolled access to the collected data and individual data. Conclusion Studies on TCGA Program can provide experi-ences and reference in data management for the implementation of large scale TCGA Program.

To analyze the test results of five serum markers of hepatitis B virus (HBV) among university freshmen from 2007 to 2012.Among a total of 10 827 freshmen,there were 5 021 freshmen from 2007 to 2009 with all five serum markers.The overall ratio of HBsAg positive was 4.5％,4.8％,4.8％ and 4.0％ for each year.And it had no statistically significant difference.The overall ratio of single-HBsAb positive was 34.8％,37.4％,29.0％ and 37.9％ for each year and the figure of 2008 was lower than those of 2007 and 2009 (P ＜ 0.01).The overall ratio of five markers all negative were 58.3％,55.4％,63.9％ and 55.8％ for each year and the figure of 2008 was higher than those of 2007 and 2009 (P ＜ 0.01).And 34.5％ of HBsAg positive freshmen were HBsAg(+),HBeAg (+),HBcAb (+) and 44.2％ HBsAg(+),HBeAb(+),HBcAb(+).The prevalence ratio of HBsAg for males was higher than that for females (5.1％ vs.3.2％,P ＜0.01).Among 5 806 freshmen tested during 2010-2012,522(9.0％) had a serum level of alanine transaminase (ALT) ＞ 40 U/L,including HBsAg positive (n =12),single anti-HBs positive (n =213) and five negatives (n =288).Approximate 50％ university freshmen have no anti-HBs indicating a low level of immunity.And the students should acquire the knowledge of hepatitis B,improve the ratio of vaccination,strengthen the monitoring and prevent its spread through concerted measures.