To summarise the clinical experience of Professor TONG Xiaolin in treating prediabetes combined with overweight or obesity using the method of relieving depression and reducing turbidity. It is believed that prediabetes belongs to the category of "spleen-heat syndrome" in traditional Chinese medicine， and its core pathogenesis is center fullness with internal heat， while obesity is the initiating factor for exacerbating center fullness and internal heat， therefore， it is of great significance to reduce the risk of diabetes by interrupting the transformation between overweight， obesity and glucose metabolism abnormality. It is proposed that the main pathogenesis of prediabetes combined with overweight or obesity is qi depression and turbidity obstruction in middle jiao， with qi depression as the root and turbidity obstruction as the cause， forming a treatment idea with the method of relieving depression and reducing turbidity as the core. In clinic， Dahuang Huanglian Xiexin Decoction （大黄黄连泻心汤） is used as the basic prescription， with a primary focus on directing the turbid downward， supplemented by regulating qi， which embodies the concept of "promoting movement through descent， then figuring out the root of spleen-heat syndrome. Furthermore， the treatment is flexibly modified based on the patient's deficiency-excess syndrome to ensure individualized therapy.

Through the systematic analysis of the current research results on the effectiveness of traditional Chinese medicine（TCM） in the prevention and treatment of diabetes and its promotion dilemma， it is believed that cohort study， as an observational research method， is particularly suitable for evaluating complex and individualized interventions such as traditional Chinese medicine in the prevention and treatment of diabetes. Considering the design features and relevant practices of prospective cohort studies， it is specifically proposed to carry out prospective cohort studies using a modern TCM diagnostic and treatment system for diabetes， centered on "state-targeted differentiation and treatment"， and framed by "classification-staging-syndrome differentiation". Focused on personalized prevention and treatment， long-term multidimensional assessment of therapeutic effectiveness and syndrome changes， this paper gives in-depth exploration of the advantages and value of applying prospective cohort studies in the effectiveness evaluation of TCM in prevention and treatment of diabetes， aiming to provide insights for clinical researches on TCM for diabetes.

Objective:To observe the aging-related trends and age-sensitive changes in postural control reaction time(RT)and movement time(MT)during the adaptive balance after instability. Method:A total of 97 healthy adult subjects aged 20-79 were tested for posture control time using the DE-A somatosensory balance detection system.The test included postural adjustment RT and MT during the adaptive balance(e.g.forward,backward,left and right)tilts of the support surface under static and dynamic balance states.The subjects were sequentially divided into six age groups based on 10-year age intervals,with 16 in Group 1(20-29 years),10 in Group 2(30-39 years),17 in Group 3(40-49 years),18 in Group 4(50-59 years),31 in Group 5(60-69 years)and 5 in Group 6(70-79 years).The age-related trends and age-sensitive changes in postural control RT and MT were observed and analyzed. Result:The postural control RT and MT increased with age.In static balance,all RT and MT indicators were longer in group 6 than in groups 1 to 5,with significant differences compared with groups 1 to 4(P＜0.05)but no significant differences compared to group 5(P＞0.05).All RT and MT indicators were longer in group 5 than in groups 1 to 4,and there were significant differences(P＜0.05).All RT and MT indicators were lon-ger in group 4 than in groups 1 to 3,with a significant difference compared with group 1 in RT when the support surface was tilted to the right(P＜0.05),but no significant differences between groups for the remain-ing indicators(P＞0.05).All RT and MT indicators were longer in group 3 than in groups 1 to 2,with a sig-nificant difference compared with group 1 in MT when the support surface was tilted to the left(P＜0.05),but no significant differences between groups for the remaining indicators(P＞0.05).There was no significant difference(P＞0.05)between group 2 in all RT and in MT compared with group 1.In dynamic balance,all RT and MT indicators were longer in group 6 than in groups 1 to 5,with significant differences compared with groups 1 to 4(P＜0.05)but no significant differences compared with group 5(P＞0.05).All RT and MT indicators were longer in group 5 than in groups 1 to 4,but there were no significant differences(P＞0.05).All RT indicators were longer in group 4 than in groups 1 to 3,with no significant differences compared with group 1 in RT when the support surface was tilted to the left(P＞0.05),while there were significant dif-ferences between groups for the remaining RT indicators(P＜0.05).All MT indicators were longer in group 4 than in groups 1 to 3,with significant differences compared with group 2 in MT when the support surface was tilted to the back and left(P＜0.05),while there were no significant differences between groups for the remaining RT indicators(P＞0.05).All RT indicators were longer in group 3 than in groups 1 to 2,with no significant differences compared with group 1(P＞0.05).All MT indicators were longer in group 3 than in groups 1 to 2,with significant differences compared with group 1(P＜0.05).There was no significant differ-ence between group 2 in all RT and in MT compared with group 1(P＞0.05). Conclusion:The postural control RT and MT during the adaptive balance after instability gradually increase with aging.The deterioration of postural control response time and motion time in static balance may start to become evident around the age of 60,while in dynamic balance,these deteriorations may begin to appear around the ages of 50 and 40,respectively.

AIM:To investigate the efficacy and anti-hepatic fibrosis of alfacalcidol combined with ursodeoxycholic acid(UDCA)in primary biliary chol-angitis(PBC).METHODS:Seventy cases of PBC pa-tients with 25 hydroxyvitamin D(25(OH)D3)＜50 nmol/L,admitted to Fenyang Hospital in Shanxi Province from June 2022 to June 2023,who met the inclusion criteria,were randomly divided into 35 cases in the treatment group and 35 cases in the control group.and the treatment group was treat-ed with alfacalcidol combined with UDCA;the con-trol group was treated with UDCA alone;after 6 months of treatment,the patients were examined for 25(OH)D3,platelets,liver function,immunoglob-ulin,liver stiffness(LSM),and adverse drug reac-tions,and the FIB-4 index,APRI score,GLOBE score,and UK-PBC score were calculated.Measurements that satisfied the normal distribution were ex-pressed as(x)±s,and comparisons between the two groups were made with the t-test;those that did not satisfy the normal distribution were expressed as M(P25,P75)was used to express the information,and the Mann-Whitney U test was used to compare the two groups.Response rates were compared with the chi-square test.RESULTS:The response rates in the control and experimental groups after treatment were 42.85％and 71.42％;y-glutamyl transpeptidase(GGT)was 160(128,194)and 85(72,102)U/L;alkaline phosphatase(ALP)was 156(123,264)and 110(56,141)U/L;respectively;im-munoglobulin M(IgM)were 3.51±0.84 and 2.71±0.81 g/L;25(OH)D3 was 40.21±3.25 and 57.06±14.76 nmol/L;respectively,liver hardness was 10.8(8.3,15.1)and 8.9(6.7,12.2)KPa;respectively,and FIB-4 index was 2.28(0.99,3.66)and 1.46(0.97,2.55);respectively,APRI scores were 0.65(0.33,1.09)and 0.30(0.17,0.53);respectively,GLOBE scores were 0.85±0.73 and 0.13±0.51,and UK-PBC scores were 0.024(0.018,0.060)and 0.021(0.012,0.033),and the differences were statistically signifi-cant(all P＜0.05).CONCLUSION:Alfacalcidol com-bined with UDCA significantly increased the treat-ment response rate of PBC patients compared with UDCA alone,and alfacalcidol improved hepatic fi-brosis to a certain extent,contributing to the im-provement of PBC without adverse effects.

With rapid development of information technology,blended teaching model has gradually become mainstream teaching model in most colleges and universities.How to evaluate students'learning effect and analyze factors that affect students'per-formance is a key research direction of this teaching model.Taking blended teaching of Medical Immunology course in Xinxiang Medical University as an example,this paper introduces implementation process and evaluation system of blended teaching,analyzes main factors affecting students'performance and learning effect,and focuses on discussing influence of formative evaluation and"flipped classroom"on students'academic performance.

Objective To investigate the effect of Piezo1 activated by mechanical stress on knee osteoarthritis synovial fibrosis via the extracellular signal-regulated kinase(ERK)1/2 signaling pathway.Methods Twenty-five Sprague Dawley rats were divided into blank,exercise,exercise+GsMTx4,exercise+PD98059,and exercise+GsMTx4+PD98059 groups(n=5 per group).After modeling,serum and synovial tissue were extracted and collagen deposition was evaluated by Sirius red and Masson staining.Expression levels of Piezo1,ERK1/2,phospho(p)-ERK1/2,α-smooth muscle actin(SMA),transforming growth factor(TGF)-β,Collagen Ⅰ,and tissue inhibitor of metalloproteinase(TIMP)-1 were detected by Western blot and reverse transcription-quantitative polymerase chain reaction(RT-qPCR),and the interleukin(IL)-1β,IL-6,and tumor necrosis factor(TNF)-α contents were detected by enzyme-linked immunosorbent assay.For cell experiments,synovial cells were divided into blank,pull,pull+GsMTx4,pull+PD98059,and pull+GsMTx4+PD98059 groups and the above indices were detected in the model cells by Western blot,RT-qPCR,and other techniques.Results Mechanical stress increased collagen deposition in synovial tissues in the rats,and increased the protein and mRNA expression levels of the pathway-related and fibrosis-specific indicators Piezo1,p-ERK/ERK,α-SMA,TGF-β,Collagen I,and TIMP-1(P＜0.05).Piezo1 expression was significantly down-regulated by both inhibitors(P＜0.05),but the ERK inhibitor(PD98059)had no significant effect on Piezo1 gene expression.Levels of serum inflammatory factors were significantly higher in the exercise group compared with the blank group(P＜0.05),and levels were significantly reduced by the inhibitors(P＜0.05).The in vitro experiments showed the same trends as the animal experiments.Conclusions The Piezo1 ion channel can sense mechanical stress and activate the ERK 1/2 pathway to mediate knee synovial fibrosis.

The Mongolian gerbil currently used as laboratory animals worldwide all originates from China.As early as the 1930s,wild Mongolian gerbils were domesticated and introduced into medical research.Today,they have become recognized multifunctional laboratory animals and are extensively used in various fields such as brain nerve studies,parasitology and microbiology,and oncology,etc.Mongolian gerbils possess unique anatomical characteristics in the basal cerebral arteries,such as a congenital absence of the Willis'circle,making it possible to construct cerebral ischemia or cerebral ischemia-reperfusion injury models with simple procedures of unilateral common carotid artery ligation,while also enabling intra-individual control.These anatomical features also increase their sensitivity to cerebral ischemia and make them more prone to cochlear ischemia,therefore playing a crucial role in the preparation of auditory impairment models.The disease progression and pathological manifestations in Mongolian gerbils show many similarities to those observed in human patients.Researchers have successfully used Mongolian gerbils to develop models of cerebral ischemia,cerebral ischemia-reperfusion,cochlear ischemia,cochlear implantation,and sensorineural hearing loss,achieving significant results.This article focuses on the current methods and assessment indicators for constructing Mongolian gerbils models of cerebral ischemia and auditory impairment.It discusses the advantages and disadvantages of various modelling techniques,and explores their application progress,aiming to provide a theoretical basis and reference for the application of Mongolian gerbils in these two important research areas.

Objective To investigate the reliability and validity of the assessment tools of Brief ICF Core Sets for Arthroplasty of Knee Osteoarthritis in Perioperative Period(ICSAKOPP). Methods From May,2022 to April,2023,320 patients undergoing knee arthroplasty were selected in Peking University Third Hospital,China-Japan Friendship Hospital,Peking University First Hospital and Chinese PLA General Hospital.Trained assessors used Brief ICSAKOPP to evaluate all enrolled patients before arthroplasty,three days(±one day)after arthroplasty,three weeks(±one week)after arthroplasty,and three months(±one month)after ar-throplasty.Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores were recorded at the same time.Five professionals were asked to score all the items of Brief ICSAKOPP,and the content validity index(CVI)was caculated. Results A total of 64 cases were dropped down.CVI of all the items of the Brief ICSAKOPP were above 0.8,with a av-erage CVI of the scale of 0.938.The Cronbach's α coefficient of the Brief ICSAKOPP was 0.813.There was a moderate correlation(r=0.681,P<0.001)between the overall Brief ICSAKOPP and WOMAC scores,as well as body functional dimension score(r=0.668,P<0.001)and activities and participation dimension score(r=0.657,P<0.001). Conclusion Brief ICSAKOPP is good in content validity,internal consistency reliability and criterion validity.

ObjectiveTo investigate the individual factors of postural adjustment reaction time and movement time during adaptive equilibrium. MethodsFrom March to December, 2021, 126 healthy adults aged 18 to 80 years were recruited at the First Medical Center of the General Hospital of the Chinese PLA. The DE-A somatosensory balance detection system was used to detect their postural adjustment reaction time (RT) and movement time (MT) as the platform tilting in multiple directions during standing (static) or walking (dynamic). The ages, genders, body mass index (BMI) and physical activity level of them were investigated. ResultsThe age was the only factor independently associated with dynamic RT and MT in all the directions (β > 0.632, P < 0.05). For static MT, as the platform tilting forward, physical activity level (β = -0.143, P < 0.05), BMI (β = 0.154, P < 0.05) and age (β = 0.663, P < 0.05) were the independently associated factors; as the platform tilting leftward, gender (β = -0.173, P < 0.05) and age (β = 0.647, P < 0.05) were the independently associated factors; and age was the only independently associated factor for other directions (β > 0.571, P < 0.05). For the static RT, age was the only independently associated factor for all the directions (β > 0.615, P < 0.05). ConclusionAge is the most important independently factor related to postural adjustment during adaptive equilibrium, and aging may delay the postural adjustment after instability.