Given the limitations of traditional scientific research methods in revealing the complex and dynamic evolution of disease pathomechanisms， this paper analyzes the current state and challenges of the traditional Chinese medicine （TCM） pathomechanism syndrome differentiation system within the framework of systems thinking. The challenges include insufficient experimental models， low data standardization， complex nonlinear characteristics， and difficulties in integrating expert experience. By leveraging qualitative-quantitative comprehensive integration methods， this paper proposes specific research strategies， including constructing qualitative models of pathomechanism evolution， employing mathematical models for validation and quantitative analysis to reveal pathomechanism patterns， and incorporating a "human-centered" approach to achieve human-machine collaboration. These strategies aim to provide insights for the modernization and development of a new TCM pathomechanism syndrome differentiation system.

Objective: To explore the current status and influencing factors of eating behaviors in adolescents, so as to provide a theoretical foundation for health promotion education among adolescents. Methods: Based on the database from Survey of Chinese Family Health Index (2021), by a random number table method, 1 065 teenagers were selected from the provincial capitals of 22 provinces and 5 autonomous regions in China, as well as 4 municipalities directly under the central government. A general characteristic questionnaire, Patient Health Questionnaire-9 (PHQ-9), Short Form of the Family Health Scale (FHS-SF), 10-item Short Version of the Big Five Personality(BFP-10), Content-based Media Exposure Scale (CM-E) and Sakata Eating Behavior Scale Short Form(EBS-SF) were used to collect information. Multivariate stepwise linear regression analysis was employed to identify and analyze related factors of eating behaviors among adolescents. Receiver operating characteristic was used to validate the predictive ability of the EBS-SF score for overweight and obesity among adolescents. Results: The average scores of BFI-10,C-ME, FHS-SF, PHQ-9 and EBS-SF were (33.08±4.64)(19.20±4.55)(38.48±6.65)(6.09±5.63)(16.75±4.36), respectively. Multivariate linear regression showed that family type (other types), agreeableness, conscientiousness, family health and depression were the main related factors of EBS-SF scores among adolescents( B =2.61,-0.42,0.20,-0.11,0.23, P <0.05).The analysis of receiver operating characteristic curve showed that the EBS-SF scores had a good ability in predicting obesity among male adolescents ( AUC= 0.73, P <0.01). Conclusions Family type, big five personality, family health,depression are the related factors of eating behaviors among adolescents. EBS-SF scores are predictive of obesity in adolescents, which would provide a new perspective for promoting healthy eating habits among adolescents.

Objective To develop a high-performance liquid chromatography(HPLC) method for the determination of residual EDTA disodium salt(EDTA-2Na) content in freeze-dried rabies vaccine(Vero cells) for human use, and to verify and preliminarily apply the method, so as to ensure the content of EDTA-2Na within the safe concentration range.Methods The condition for HPLC was as follows: reverse chromatographic column was adopted, using the mobile phase consisting of 0. 1%phosphate solution as the aqueous phase and 100% methanol as the organic phase at a flow rate of 1. 0 mL/min and a detection wavelength of 242 nm. The injection volume was 20 μL, and the column temperature was 25 ℃. The developed method was verified for suitability, limit of quantitation(LOQ), specificity, linear range, accuracy, reproducibility, and intermediate precision, and the residual EDTA-2Na contents in thr ee batches of bulk of freeze-dried rabies vaccine(Vero cells) for human use were determined using this method.Results The LOQ of EDTA-2Na detected by this method was 0. 490 0 μg/mL. The blank and sample solution had no interference to EDTA-2Na, and the separation degree of the target and adjacent peaks was more than 1. 5. EDTA-2Na showed good linearity in the concentration range of 0. 490 0 to 9. 800 0 μg/mL. The recovery rates of EDTA-2Na in spiked samples at concentrations of 50%, 100% and 150% were from 94% to 113%. The recovery rates of EDTA-2Na in six solutions of reproducibility verification ranged from 100% to 102%, with a relative standard deviation(RSD) of 1%. A total of 12 solutions of intermediate precision verification from different personnel were measured, and the RSD of recovery rate was 2%. In addition, EDTA-2Na was not detected in three batches of samples.Conclusion The developed HPLC has good suitability, specificity, linearity, accuracy, reproducibility and intermediate precision, which is suitable for the determination of residual EDTA-2Na in bulk of freeze-dried rabies vaccine(Vero cells) for human use.

Objective To investigate the frequency and distribution characteristics of gene mutations in children with phenylalanine hydroxylase(PAH)deficiency in Xinjiang.Methods A total of 230 children diag-nosed with PAH deficiency in Urumqi Maternal and Child Health Care Hospital from January 1st,2015 to February 28th,2023 were enrolled in the study.The variation of PAH gene was analyzed and the variation sites of PAH gene in children with different phenotypes were compared.Results A total of 441 PAH gene va-riants were detected in 230 children with PAH deficiency in Xinjiang,with a total detection rate of 95.87％.A-mong them,2 variants were detected in 227 cases,only 1 variant was detected in 2 cases,and 3 variants were detected in 1 case.217 cases were complex heterozygous variants,and 10 cases were homozygous variants.The high-frequency variant loci were c.158G＞A[23.39％(102/441)],c.728G＞A[11.70％(51/441)],c.688G＞A[5.05％(22/441)],c.721C＞T[3.90％(17/441)],c.611A＞G[3.67％(16/441)],c.1238G＞C[3.21％(14/441)].The high-frequency variant loci for classic PKU were c.728G＞A,c.331C＞T,and c.782G＞A;the high-frequency variant loci for mild PKU were c.721C＞T,c.1068C＞A,and c.1301C＞A;the high-frequency variant loci for children with mild HPA were c.158G＞A and c.688G＞A.There were significant differences in the frequency of high frequency mutations among the above three phenotypes(P＜0.05).Conclusion Mild HPA predominates in children with PAH deficiency in Xinjiang.The hotspot loci of the PAH gene in Xinjiang have been clarified,and specific PAH gene loci have been observed in the three different phenotypes,which can provide theoretical basis for prenatal diagnosis and clinical genetic counselling.

Objective:To explore the inhibitory mechanism of herb cake-partitioned moxibustion on tumor growth in colitis-associated colorectal cancer(CAC)based on histone lysine demethylase 4D(KDM4D). Methods:Inbred male Sprague-Dawley rats were randomly divided into a normal group,a CAC group,a herb cake-partitioned moxibustion group,and an inhibitor group.Except the normal group,rats in the other three groups were treated with azoxymethane(AOM)combined with dextran sulfate sodium(DSS)to make CAC rat models.Rats in the normal group and the CAC group did not receive interventions;rats in the herb cake-partitioned moxibustion group received moxibustion at Qihai(CV6)and bilateral Tianshu(ST25),2 cones for one point each time,once a day for 30 d with 1-day rest every week;rats in the inhibitor group received intraperitoneal injection of KDM4D inhibitor,5-chloro-8-hydroxyquinoline(5-c-8HQ),once a day for 30 d.After intervention,the general condition,colon length,tumor number and volume,and histopathological colon changes were observed.The expression of adenomatous polyposis coli(APC),axis inhibitor(Axin),cyclin D1,matrix metalloproteinase(MMP)-7 and MMP-9 mRNAs were detected by real-time quantitative polymerase chain reaction.The proliferating cell nuclear antigen(PCNA),cleaved caspase3,KDM4D,APC,and Axin proteins were detected by immunohistochemistry. Results:Compared with the normal group,the general condition was poor,the colon length was significantly shortened(P<0.01),the number and volume of colonic tumors were increased(P<0.01),the structure of glandular duct was obviously disordered with"back-to-back"and cowall phenomenon,and also high-grade adenocarcinoma formed;the protein expression levels of PCNA and KDM4D were significantly increased(P<0.01),while cleaved caspase3,APC,and Axin were significantly reduced(P<0.01);the mRNA expression levels of cyclin D1,MMP-7,and MMP-9 were significantly increased(P<0.01),while APC and Axin were significantly reduced(P<0.01)in the CAC group.Compared with the CAC group,the general condition was improved,the length of colon was significantly increased(P<0.01),the number and volume of the colonic tumors were reduced(P<0.05),and the colon tissues showed epithelial cell proliferation with enlarged and deep staining nuclei,dysplasia and inflammatory cell infiltration;the protein expression levels of PCNA and KDM4D were significantly reduced(P<0.01),while the cleaved caspase3,APC,and Axin were significantly increased(P<0.01);the mRNA expression levels of cyclin D1,MMP-7,and MMP-9 were reduced(P<0.05),while the APC and Axin were increased(P<0.05)in the colon tissues of rats in the herb cake-partitioned moxibustion group and the inhibitor group. Conclusion:Herb cake-partitioned moxibustion regulated abnormally expressed KDM4D in CAC rats,activated APC and Axin,the upstream molecules of Wnt/β-catenin pathway,inhibited abnormally activated downstream molecules of Wnt/β-catenin pathway.This may be a key mechanism of herb cake-partitioned moxibustion in inhibiting CAC tumor growth.

Objective:Retinal vein occlusion(RVO)is the second most common retinal vascular disease worldwide,and the retinal perfusion status is closely related to the prognosis of the disease.Macular perfusion status is particularly correlated with visual acuity.This study aims to investigate the changes in macular perfusion indicators in RVO using optical coherence tomography angiography(OCTA)and analyze the correlation between macular perfusion status and visual acuity. Methods:This cross-sectional study included 41 RVO patients,who were divided into 2 groups based on the occlusion site:18 cases in the central retinal vein occlusion(CRVO)group and 23 cases in the branch retinal vein occlusion(BRVO)group.Additionally,they were categorized into ischemic RVO(23 cases)and non-ischemic RVO(16 cases)groups based on the presence of ischemia(2 eyes were excluded due to hemorrhage obscuring the peripheral retina,making it impossible to confirm the area of non-perfusion).A control group of 29 healthy individuals matched by sex and age was also recruited.Macular perfusion indicators were measured using OCTA,and the correlation between macular perfusion status and visual acuity was analyzed. Results:Compared with healthy eyes,RVO eyes showed an increased foveal avascular zone(FAZ)area and significantly reduced superficial and deep vessel density(P＜0.001).However,there were no significant differences in central foveal thickness(CFT)or macular perfusion indicators between the CRVO and BRVO groups(P＞0.05).The best corrected visual acuity(BCVA)at the logarithm of the minimum angle of resolution(logMAR BCVA)was significantly negatively correlated with both superficial and deep retinal vessel density in RVO eyes(unstandardized coefficient B=-0.039,B=-0.042;P=0.017,P=0.040).The average BCVA in the ischemic RVO group was significantly worse than that in the non-ischemic RVO group(0.82±0.44 vs 0.45±0.29,P=0.007).The ischemic RVO group also had a larger FAZ area(P=0.003)and lower superficial and deep retinal vessel density(P＜0.001,P=0.008,respectively)compared with the non-ischemic RVO group.The severity of macular ischemia did not correspond directly with the peripheral ischemia severity in RVO. Conclusion:Macular perfusion status is significantly reduced in RVO eyes compared to healthy eyes,which negatively impacts and limits visual acuity in RVO patients.Eyes with ischemic RVO have poorer visual acuity and macular perfusion status than those with non-ischemic RVO.OCTA is advantageous for observing vascular morphology and quantifying macular perfusion status,making it an effective tool for assessing disease progression.

Objective:To analyze clinical efficacy and safety of dermabrasion for the treatment of familial benign chronic pemphigus.Methods:Clinical data were retrospectively collected from 6 patients with familial benign chronic pemphigus, who underwent dermabrasion in the Department of Dermatology, the First Affiliated Hospital of Dalian Medical University from February 2019 to July 2020. There were 3 males and 3 females, they were aged from 39 to 65 years, and their disease duration ranged from 10 to 40 years. All the patients were postoperatively followed up for 14 - 34 months. Response rates were calculated, and adverse reactions and recurrence were observed.Results:Dermabrasion was performed on the 6 patients in 55 body areas. After operation, complete recovery was observed in 36 areas (65.5%), marked improvement was noted in 13 areas (23.6%), and moderate improvement was observed in 6 areas (10.9%) ; there were no areas with no response, resulting in an overall response rate of 89.1%. Postoperatively, the patients experienced no obvious discomfort, and only slight hypopigmentation and mild scars remained. During the follow-up of 14 to 34 months, no recurrence was observed in the treated areas.Conclusion:Dermabrasion was safe and effective for the treatment of familial benign chronic pemphigus.

Objective:To analyze the current situation of myopia and its related factors among primary school students in a certain district of Beijing City in 2022, and provide a basis for the risk assessment of myopia among primary school students.Method:In June 2022, a cluster sampling method was used to include 376 third-grade students from a primary school in a certain district of Beijing. A questionnaire survey was conducted to collect basic information about students, including eye usage habits, reading and writing postures, and parents′ myopia conditions. The examination of students′ distant visual acuity and refractive status was performed. A multivariate logistic regression model was used to analyze the related factors of myopia occurrence.Results:The age of 376 primary school students was (8.87±0.417) years old, with 48.40% (182) being male. A total of 196 myopia cases were identified, with a myopia rate of 52.13%. The results of the multivariate logistic regression model analysis showed that students who sometimes read while lying down ( OR=2.003, 95% CI: 1.128-3.555), often read while lying down ( OR=18.853, 95% CI: 4.512-78.778), had outdoor activity time less than 120 minutes per day ( OR=4.937, 95% CI: 2.4464-9.892), were engaged in indoor break activities ( OR=4.995, 95% CI: 2.773-8.996), performed eye exercises less than once per day ( OR=8.710, 95% CI: 4.464-16.995), had a reading distance from the book less than 30 cm ( OR=5.098, 95% CI: 2.410-10.787), occasionally maintained a fist distance from the edge of the desk ( OR=1.918, 95% CI: 1.086-3.385), and had high school desks and tables ( OR=5.325, 95% CI: 1.465-19.359) could have a higher risk of myopia occurrence, compared with those who never read while lying down, had outdoor activity time more than 120 minutes per day, maintained outdoor break activities, performed eye exercises more than once per day, had a reading distance from the book more than 30 cm, always maintained a fist distance from the edge of the desk, and had short school desks and tables. Conclusion:The incidence rate of myopia among primary school students in a certain district of Beijing City. in 2022 is relatively high. The occurrence of myopia is related to insufficient outdoor activity time and poor eye usage habits.

Objective:To analyze the current situation of myopia and its related factors among primary school students in a certain district of Beijing City in 2022, and provide a basis for the risk assessment of myopia among primary school students.Method:In June 2022, a cluster sampling method was used to include 376 third-grade students from a primary school in a certain district of Beijing. A questionnaire survey was conducted to collect basic information about students, including eye usage habits, reading and writing postures, and parents′ myopia conditions. The examination of students′ distant visual acuity and refractive status was performed. A multivariate logistic regression model was used to analyze the related factors of myopia occurrence.Results:The age of 376 primary school students was (8.87±0.417) years old, with 48.40% (182) being male. A total of 196 myopia cases were identified, with a myopia rate of 52.13%. The results of the multivariate logistic regression model analysis showed that students who sometimes read while lying down ( OR=2.003, 95% CI: 1.128-3.555), often read while lying down ( OR=18.853, 95% CI: 4.512-78.778), had outdoor activity time less than 120 minutes per day ( OR=4.937, 95% CI: 2.4464-9.892), were engaged in indoor break activities ( OR=4.995, 95% CI: 2.773-8.996), performed eye exercises less than once per day ( OR=8.710, 95% CI: 4.464-16.995), had a reading distance from the book less than 30 cm ( OR=5.098, 95% CI: 2.410-10.787), occasionally maintained a fist distance from the edge of the desk ( OR=1.918, 95% CI: 1.086-3.385), and had high school desks and tables ( OR=5.325, 95% CI: 1.465-19.359) could have a higher risk of myopia occurrence, compared with those who never read while lying down, had outdoor activity time more than 120 minutes per day, maintained outdoor break activities, performed eye exercises more than once per day, had a reading distance from the book more than 30 cm, always maintained a fist distance from the edge of the desk, and had short school desks and tables. Conclusion:The incidence rate of myopia among primary school students in a certain district of Beijing City. in 2022 is relatively high. The occurrence of myopia is related to insufficient outdoor activity time and poor eye usage habits.

Objective To evaluate the diagnostic value of endoscopic ultrasonography(EUS)in the preoperative staging and ductal dilatation of duodenal papillary carcinoma and analyze the factors influencing its diagnostic accuracy.Methods A cross-sectional trial was conducted on the patients with pathologically-diagnosed duodenal papillary carcinoma and undergoing EUS in the First Affiliated Hospital of Army Medical University from January 2018 to August 2023.The diagnostic value of EUS for the preoperative staging of duodenal papillary carcinoma was evaluated using sensitivity,specificity,positive predictive value,negative predictive value,and accuracy.Univariate and multivariate analyses were performed to determine the factors affecting the diagnostic accuracy of EUS.Results A total of 102 patients with duodenal papillary carcinoma were included,including 59 males and 43 females,at a mean age of 62 years,and all of them underwent EUS before diagnosis.The accuracy of EUS for tumor T-staging was 86.27％,the sensitivity and specificity for T1,T2,T3,and T4 lesions were 84.21％,92.31％,85.00％,60.00％,and 95.31％,88.89％,96.34％,and 98.97％,respectively.The positive predictive value for T-staging of T1,T2,T3,and T4 lesions was 91.43％,83.72％,85.00％,and 75.00％,and the negative predictive values were 91.04％,94.92％,96.34％,and 97.96％,respectively.There were 14 patients whose T-staging was incorrectly staged by EUS.The accuracy of EUS in assessing intraductal dilatation was 75.49％,and the sensitivity,specificity,positive predictive value,and negative predictive value for ductal dilatation were 96.97％,66.67％,98.97％,and 40.00％,respectively.In addition,the independent predictors of diagnostic accuracy of EUS for pancreatic duct dilatation were nerve infiltration,tumor size,and T stage;whereas the independent risk factors for diagnostic accuracy of bile duct dilatation were nerve infiltration and alkaline phosphatase.Conclusion EUS has quite higher diagnostic value for preoperative staging of duodenal papillary carcinoma,and nerve infiltration,tumor size,T stage,T stage and alkaline phosphatase may be the influencing factors for its diagnostic accuracy.