The theory of "Yang transforming Qi while Yin constituting form" in the Huangdi's Internal Classic is derived from the application， transformation， movement， and balance of Tao. It is highly condensed， revealing the true meaning of Tao and guiding the changes and progress of all natural things， including diseases. Therefore， the appearance of various physical diseases is the manifestation of Yin-Yang Qi transformation. Sweat pore， formed by the Qi transformation of Yin and Yang， is the nourishing and regulating system. It serves as the hub and channel， assisting in the flow and transformation of Qi， facilitating the exchange of material， energy， and information with the outside world. With sweat pore as the hub and based on the macro-control and holistic thinking of "Yang transforming Qi while Yin constituting form"， this paper explores the microscopic mechanisms underlying chronic liver disease. In combination with the roles of mitochondria， exosomes， and the ultraliver sieve structure in the formation and progression of chronic liver disease， this paper elucidates the close internal relationship between the disease's initial quality， symptom signs， and its physiological and pathological functions under the guidance of this theory. Modern studies have shown that autophagy， intestinal flora disorders， glucose and lipid metabolism disturbances， activation of inflammatory factors， ferroptosis， and other microscopic pathological mechanisms are involved in the occurrence and development of chronic liver disease. The common connotation of the Yin-Yang concept in traditional Chinese medicine （TCM） and the pathological mechanisms in modern medicine is deeply analyzed. The corresponding relevant microscopic mechanisms and the guiding role of the theory of "Yang transforming Qi while Yin constituting form-sweat pore" in the management of chronic liver disease are summarized. Wind medicine promotes growth and transformation through sweat pore. The combination of pungent and sweet medicines facilitates Yang and disperse Yin. The formulas， combining the characteristics of wind medicine and pungent and sweet medicines， fit the principle of "Yang transforming Qi while Yin constituting form-sweat pore". This paper combines both macro and micro perspectives to explain the scientific connotation and microscopic mechanisms of chronic liver disease based on the theory of "Yang transforming Qi while Yin constituting form-sweat pore"， and explore the prevention and treatment of chronic liver disease through the principles， methods， prescriptions， and medicines featured by combination of pungent and sweet medicines， facilitating Yang， activating sweat pore， and dispersing Yin， providing new ideas and reference for the clinical treatment of chronic liver disease.

Objective: To investigate the correlation between sleep fragmentation and body composition/blood pressure in female students of middle school, so as to provide theoretical guidance for preventing health risks associated with sleep fragmentation. Methods: From September 2022 to December 2023, 505 female students aged 12-15 years in Nanyang City were selected through stratified cluster random sampling and conducted Pittsburgh Sleep Quality Index(PSQI) survey. Participants were divided into Q 1- Q 4 groups based on sleep fragmentation index (SFI) quartiles. Body composition and blood pressure measurements were measured by adopting body composition analyzer and traditional mercury sphygmomanometer, and data were analyzed using χ 2 tests and linear regression. Results: Significant intergroup differences for Q 1- Q 4 were observed with increasing SFI levels for body mass index(BMI), fat percentage, muscle mass, bone mass, trunk fat percentage, systolic blood pressure, diastolic blood pressure, and PSQI total scores ( F =15.25,7.33,8.38,5.97,11.24,16.85,6.87,15.73, all P <0.05). SFI showed positive correlations with BMI, fat percentage, trunk fat percentage, and blood pressure( β =0.37,0.45,0.34,0.42,0.38), but negative correlations with muscle mass and bone mass( β =-0.35,-0.48) (all P <0.05). The χ 2 trend test revealed a significant increase in hypertension detection rates with elevated SFI ( χ 2=42.75, P <0.05). The χ 2 testing demonstrated statistically significant differences in hypertension incidence among different quartiles groups ( χ 2=14.16, P <0.05). After adjusting the significance level, hypertension incidence differences remained significant between Q 1and Q 4 ( χ 2=10.77), Q 2 and Q 4 groups ( χ 2=6.28) (both P <0.008 3). Conclusions Sleep fragmentation correlates significantly with body composition and blood pressure indicators in female students of middle school. Implementing sleep fragmentation interventions is essential for safeguarding female students health in middle school.

Autophagy is a highly conserved cellular degradation pathway that degrades lipid droplets through a process called"lipophagy".Lipophagy can selectively recognize lipid substances and degrade them,promoting β oxidation and thereby maintaining the balance of intracellular lipid metabolism.The liver regulates lipid droplet metabolism through lipophagy signaling pathways or key molecules,thereby alleviating hepatic steatosis and improving nonalcoholic fatty liver disease(NAFLD).This article reviews the latest advances in the degradation of hepatic lipid droplets through the three autophagic pathways of macroautophagy,molecular chaperone-mediated autophagy,and microautophagy.The major signaling pathways of AMPK/mTOR-ULK1,ATGL-SIRT1,FGF21-JMJD3,and Akt are involved in the regulation of the lipophagy process and help to maintain the homeostasis of lipid metabolism in the liver,so as to provide new ideas for clinical prevention and treatment of NAFLD.

Objective: To compare body composition of girls aged 10 to 15 years with or without onset of menarche in Nanyang, and to provide a reliable basis for effective adolescent health care. Methods: From August to December 2020 and from March to October 2021, cluster random sampling was adopted in 13 areas of Nanyang City to select 1 523 girls. Questionnaire survey and body composition (Japan Bailida MC-180) were conducted. Results: BMI, body fat percentage, trunk fat percentage, muscle mass and bone mass of girls aged 10 to 15 years in Nanyang City gradually increased with age, the water content in the body decreased with age. BMI, fat percentage, trunk fat percentage, muscle mass and bone mass in girls experienced menarche were higher, while water content in the body was lower than those without menarche. Significant difference in BMI between the menarche and without menarche of girls were found in those aged 11 to 15 years( t =2.07, 2.03, 2.43, 2.45, 2.52, P <0.05). Significant differences in fat rate, trunk fat rate, muscle mass and bone mass between the menarche and without menarche were found in girls aged 12 to 15 years fat percentage, trunk fat percentage muscle mass bone mass( P <0.05). Among girls aged 10, 14 and 15 year old, significant difference in body water percentage were observed in the two groups of girls with or without menarche( t =2.75, 2.35, 2.37 , P <0.05). Average age at menarche showed significant urban rural differences among girls aged 10, 11 and 14 year old ( χ 2=4.34, 3.45, 6.73, P <0.05). Conclusion Changes in body composition including BMI, body fat percentage, muscle mass, bone mass and body water percentage during the transition to menarche in girls is helpful to predict menarche in girls. Age of menarche is related to nutritional status, BMI, physical exercise, snack and beverage intake.

Objective: To investigate the age related changes in cervical range of motion (CROM) and its relationship with cervical spondylosis in school students aged 12-18 in Nanyang City, to provide reference for prevention, early diagnosis and treatment evaluation of cervical spondylosis. Methods: Stratified sampling was adopted in 13 counties and districts of Nanyang City and 890 students aged 12-18 were assessed for CROM using the Coda Motion Analyzer. SPSS 19.0 was used to data analyze. Results: A decreasing trend was observed in CROM among boys and girls aged 12-18 years in Nanyang. For boys aged 15 and 18 years old, higher anterior flexion ( t =2.02, 2.70), posterior extension ( t =2.01, 2.81), left flexion ( t =3.51, 2.99), right flexion ( t =5.07, 2.66), sinistral ( t =2.28, 2.92) and dextral ( t =2.91,3.60) were found compared with younger age groups ( P <0.05). Similar findings were found in girls aged 15 and 18-years old [anterior flexion ( t =2.38, 2.20), posterior extension ( t =2.09,2.02), left flexion ( t =2.33, 2.55), right flexion ( t =7.34, 4.60), sinistral ( t =3.73, 2.35) and dextral ( t =2.31, 3.99, P <0.05). Except for the right flexion, the CROM of boys in was higher than that of girls at the same age group. The prevalence of cervical spondylosis showed an increasing trend (boys: χ 2 trend =13.93, girls: χ 2 trend =12.87, P <0.05). Except for 14-year-old group, the prevalence of cervical spondylosis in girls was higher than that in boys, with significant differences observed in 15 and 17-year-old groups ( χ 2=10.35, 9.64, P <0.05). Conclusion With the increase of age, the CROM of male and female students shows a downward trend in general. The prevalence of cervical spondylosis increases with the decrease of CROM. CROM measurement is conducive to the prevention, early diagnosis and treatment of juvenile cervical spondylosis.

Objective:To explore the effect of autologous fat transplantation based on the fine anatomy of the female perineum and aesthetic standards.Methods:From June 2015 to September 2020, 25 female patients with perineal cosmetology requirements in the Department of Plastic Surgery, the Fourth Affiliated Hospital of Harbin Medical University, aged from 28 to 55 years, with an average of 33.7 years. 50-80 ml of the patient＇s autologous fat were collected and filled according to the perineal anatomy and aesthetic standards. Postoperative anti-inflammatory treatment was implemented and sexual life was forbidden for 2 weeks.Results:25 patients were satisfied with the filling effect immediately after operation. Follow-up for 7 days, 1, 3, and 6 months after operation, 20 of 21 cases underwent pudendal filling operation were very satisfied with the postoperative morphology, and 1 case was less satisfied. Among the 20 cases underwent vaginal filling and labia major filling, 17 cases were very satisfied with the postoperative morphology, 2 cases were satisfied after the operation, and 1 case was less satisfied. Of the 10 cases underwent vaginal and G-spot injection, 6 cases were satisfied after the operation. The morphology was very satisfactory, 2 cases were more satisfactory, and 2 cases were less satisfactory. According to a survey of 25 cases of postoperative sexual life satisfaction, 19 cases (76%) had a significant improvement in their conscious sexual life, 3 cases had a more obvious improvement, 1 case had less improvement, and 2 cases had no conscious improvement.Conclusions:The autologous fat injection based on the fine anatomy and aesthetics of the perineum can significantly improve the aesthetic appearance of the perineum.

Objective:To evaluate the influence of goal-directed volume management based on cardiac output index (CI), intrathoracic blood volume index (ITBVI) and extravascular lung water index (EVLWI) in patients undergoing off-pump coronary artery bypass surgery.Methods:Forty patients (ASA 2 to 3 grade) undergoing off-pump coronary artery bypass surgery in Lanzhou University Second Hospital from January 2017 to December 2018 were selected. The patients were divided into 2 groups by random digits table method with 20 cases in each group: study group (goal-directed fluid therapy treatment with CI, ITBVI and EVLWI) and control group (conventional fluid therapy). The control group was given central venous pressure (CVP) monitoring rehydration, and the study group was given PiCCO hemodynamic monitoring indicators. The CVP, CI, ITBVI and EVLWI for fluid management were measured. Accurate assessment of volume status of patients was done. The study group received goal-directed fluid therapy based on CVP, CI, ITBVI and EVLWI, with the goal of CI in the 3.0 to 5.0 L/(min·m 2) range, ITBVI in the 800 to 1 000 ml/m 2 range and EVLWI in the 3.0 to 7.0 ml/kg range. The heart rate, mean arterial pressure (MAP), urine volume, central venous oxygen saturation (ScvO 2), lactic acid and renal function were monitored. The ventilator withdrawal time, hospitalization in ICU, length of stay, incidence of acute pulmonary edema, incidence of acute renal failure, mortality of 30 d after surgery were recorded and compared between the two groups. Results:Tissue perfusion and urine volume of the study group was significantly improved compared with that of control group ( P<0.05). ScvO 2 of the study group was higher than that of the routine group ( P<0.05). The concentration of lactic acid of the study group was lower than that of the routine group ( P<0.05). The incidences of acute pulmonary edema, acute renal insufficiency and mortality of the study group were lower than those of the routine group (5.0% vs. 15.0%, 5.0% vs. 10.0% and 5.0% vs. 15.0%), and there were statistical differences ( P<0.05). The length of stay and hospitalization in ICU were both lower than those in the control group ( P<0.01). Conclusions:Goal-directed fluid therapy based on CI, ITBVI and EVLWI can effectively optimize the cardiac preload of patients undergoing off-pump coronary artery bypass surgery, improve cardiac output, ensure microcirculation perfusion, maintain the balance of oxygen supply and demand, and reduce the incidence of complications and mortality.

Objective The aims of this study were to determine the expression of CXCR family proteins in various subtypes and adjacent tissues of breast cancer and its relationship with prognosis,and to provide a reference for clinical diagnosis,treatment and prognosis of breast cancer. Methods The mRNA expressive profiles of CXCR family proteins in paracancerous tissues and different subtypes of breast cancer tissues were obtained from the TCGA(The Cancer Genome Atlas)database. The prognostic survival analysis of each differentially expressed protein was obtained using the PRECOG website. Results Except for CXCR1,the expression of CX-CR family proteins in breast cancer tissues and adjacent tissues was statistically different( P<0. 05). CXCR2P1,CXCR3,CXCR4, CXCR5 and CXCR6 were highly expressed in breast cancer tissues,CXCR2 and CXCR7 were lowly expressed in breast cancer tis-sues. The expressive levels of CXCR3,CXCR4 and CXCR7 were associated with the prognosis of patients. Conclusion The expres-sions of CXCR3,CXCR4 and CXCR7 in breast cancer tissues and adjacent tissues is significantly different,and its expression is related to the prognosis of breast cancer patients,which may be a potential target for molecular diagnosis or targeted therapy of breast cancer.

Objective To evaluate the effect of obstructive jaundice on the accuracy of left ventricular end-diastolic volume (LVEDV) and stroke volume variability (SVV) in monitoring fluid responsiveness.Methods Thirty patients of both sexes,aged 45-60 yr,weighing 55-70 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,with New York Heart Association Ⅰ,scheduled for elective pancreatoduodenectomy,were divided into 2 groups according to the serum total bilirubin levels:A group (serum total bilirubin ≥ 17 μmmol/L,n =16) and B group (serum total bilirubin＜ 17 μmmol/L,n =14).Six percent hydroxyethyl starch 500 ml was infused over 40 min after anesthesia induction.The parameters of VigileoTM such as cardiac output (CO),SVV,systemic vascular resistance (SVR) and pulmonary capillary wedge pressure and indices measured by transesophageal three-dimensional echocardiography such as LVEDV,left ventricular end-systolic volume,CO',left ventricular ejection fraction (LVEF) and ratio of mitral peak velocity of early filling (E) to early diastolic mitral annular velocity (e',E/e'ratio) were recorded before and after fluid loading.Results Compared with that before fluid loading,SVV was significantly decreased in two groups,and CO,LVEDV,CO'and LVEF were significantly increased in group B,and E/e'ratio was significantly increased in group A (P＜0.05).Compared with group B,CO,SVR,CO'and LVEF were significantly decreased,and pulmonary capillary wedge pressure was increased in group A (P＜0.05).Conclusion Obstructive jaundice causes decrease in the accuracy of LVEDV in monitoring fluid responsiveness and no effect on SVV.

Objective To observe the clinical characteristics of 2 patients with mucolipidosis type Ⅲ. Methods Two sibling patients (a sister and a brother) with mucolipidosis type Ⅲ symptoms and other family members were the research objects, and the changes of their features of hand bone imaging, blood indexes [blood glucose, cholesterol, triacylglycerol (TG), total protein (TP), albumin (Alb)] and body composition were analyzed. Results Except the 2 patients, the bone morphology, blood indexes and body compositions in other 7 family members were under normal conditions. The phalanx intervals of both hands in 2 patients with mucolipidosis type Ⅲwere widened significantly, among them the thumb manifestation was more obvious; the distal segments of phalanxes in both hands became pointed and curved presenting a "claw-like hand" deformity; the metacarpal and distal carpal metaphysis were obviously enlarged, and scaphoid, lunate, trianglar, orbicular, and trapezium and trapezoid bones were loosely arranged at the wrist; the distal ends of ulna and radius were markedly enlarged. Compared to healthy people, the triglyceride levels of serum in the 2 patients were obviously reduced (the percentage of reduction: 57.14% and 41.07% respectively); body mass indexes (BMI), total fat and visceral fat were significantly lowered (BMI reduction percentage:26.81% and 14.55%, total fat reduction percentage: 38.12% and 44.95%, visceral fat reduction percentage: 62.25% and 67.74%, respectively) in the two patients. Conclusion The purpose of studying the biochemistry indexes, imaging characteristics and body compositions is to more deeply understand the clinical symptoms and signs of the 2 sibling patients with mucolipidosis type Ⅲ in a family to provide a theoretical reference.