Hepatic fibrosis refers to excessive accumulation and abnormal proliferation of fibrous connective tissue in the liver triggered by multiple pathogenic factors， and it may progress to liver cirrhosis， portal hypertension， and liver cancer. The pathological mechanisms of hepatic fibrosis involve hepatocyte injury， inflammatory cell infiltration with the release of inflammatory mediators， hepatic stellate cell activation， and extracellular matrix deposition. Recent studies have focused on mitochondrial dysfunction in disease progression， including the molecular pathways for hepatic fibrosis driven by metabolic disorders， energy deficiency， oxidative stress， mitochondrial dynamic imbalance， and autophagic dysfunction， all of which can induce liver injury. This article reviews the latest advances in hepatic fibrosis， in order to provide new therapeutic strategies for clinical management.

In recent years, significant progress has been made in pharmacological research on the treatment of ischemic stroke with monomeric components of traditional Chinese medicine, among which flavonoids have shown good neuroprotective effects. This article reviews the regulatory role of flavonoids in the signaling pathway of ischemic brain injury.

Objectives To construct frailty risk prediction models based on logistic regression anal-ysis,decision tree and random forest algorithm in elderly patients with heart failure(HF),and to compare the predictive performance of three models.Methods A total of 426 elderly HF patients hospitalized in the Affiliated Hospital of Nantong University from September 2022 to October 2023 were selected using convenience sampling.Based on the results of frailty assessment,194 of them were classified into the frail group and the other 232 into the non-frail group.The 426 patients were divided into training(299 casses)and testing sets(127 cases)in a 7∶3 ratio.Three prediction models were then constructed in the training set,while the test set was used to validate the results.Area under curve and confusion matrix were used to measure performance of the mod-els.The optimal model was then selected by evaluating the performance on the testing set.Results The area under curve value of the logistic regression model,decision tree model and random forest model in the testing set was 0.898,0.825 and 0.903,with a classification accuracy of 84.25％,77.95％and 83.46％,a sensitivity of 82.76％,68.97％and 82.76％,a specificity of 85.51％,85.51％and 84.06％,a positive predictive value of 82.76％,80.00％and 81.36％,and a negative predictive value of 85.51％,76.62％and 85.29％,respectively.The factors that ultimately affecting frailty in elderly HF patients were age,left atrial diameter,depression,albumin,physical activity level and social support.Conclusion Among the three prediction models,the logistic regression model demonstrates best predictive performance for frailty risk in elderly HF patients than the decision tree and random forest models.

Primary sclerosing cholangitis(PSC)is an autoimmune disease characterized by chronic inflamma-tion and progressive fibrosis that affects both intrahepatic and extrahepatic bile ducts.Despite ongoing research,the under-lying mechanisms of PSC pathogenesis remain incompletely understood.The ductular reaction is not only a key pathologi-cal feature of PSC but also serves as a driving force in its progression.This review examines the promoting effects of the ductular reaction on PSC advancement from multiple perspectives,including the proliferation of biliary epithelial cells,in-flammation,and fibrosis.By providing theoretical insights into the pathogenesis of PSC,this review aims to facilitate the identification of novel therapeutic strategies.

Primary sclerosing cholangitis(PSC)is an autoimmune disease characterized by chronic inflamma-tion and progressive fibrosis that affects both intrahepatic and extrahepatic bile ducts.Despite ongoing research,the under-lying mechanisms of PSC pathogenesis remain incompletely understood.The ductular reaction is not only a key pathologi-cal feature of PSC but also serves as a driving force in its progression.This review examines the promoting effects of the ductular reaction on PSC advancement from multiple perspectives,including the proliferation of biliary epithelial cells,in-flammation,and fibrosis.By providing theoretical insights into the pathogenesis of PSC,this review aims to facilitate the identification of novel therapeutic strategies.

Objectives To construct frailty risk prediction models based on logistic regression anal-ysis,decision tree and random forest algorithm in elderly patients with heart failure(HF),and to compare the predictive performance of three models.Methods A total of 426 elderly HF patients hospitalized in the Affiliated Hospital of Nantong University from September 2022 to October 2023 were selected using convenience sampling.Based on the results of frailty assessment,194 of them were classified into the frail group and the other 232 into the non-frail group.The 426 patients were divided into training(299 casses)and testing sets(127 cases)in a 7∶3 ratio.Three prediction models were then constructed in the training set,while the test set was used to validate the results.Area under curve and confusion matrix were used to measure performance of the mod-els.The optimal model was then selected by evaluating the performance on the testing set.Results The area under curve value of the logistic regression model,decision tree model and random forest model in the testing set was 0.898,0.825 and 0.903,with a classification accuracy of 84.25％,77.95％and 83.46％,a sensitivity of 82.76％,68.97％and 82.76％,a specificity of 85.51％,85.51％and 84.06％,a positive predictive value of 82.76％,80.00％and 81.36％,and a negative predictive value of 85.51％,76.62％and 85.29％,respectively.The factors that ultimately affecting frailty in elderly HF patients were age,left atrial diameter,depression,albumin,physical activity level and social support.Conclusion Among the three prediction models,the logistic regression model demonstrates best predictive performance for frailty risk in elderly HF patients than the decision tree and random forest models.

Objective:To investigate the quality control of magnetic resonance enterography(MRE)in the diagnosis of intestine diseases,and analyze the factors that affected the imaging quality of MRE,and enhance the imaging quality of MRE through adopted the measures of quality control.Methods:The documents of MRE examinations of 167 patients with intestinal disease who admitted to the 900th Hospital of People's Liberation Army Joint Service Support Force from May 2018 to March 2023 were retrospectively analyzed.The image qualities of all patients were evaluated after they completed clinical and image examinations.The reasons that image quality could not meet the requirement of diagnosis were analyzed.And then,the measures of quality control were proposed.Results:In 167 patients with intestinal disease,the MRE images of 153 patients(91.62%)could meet the requirement of diagnosis.In 14 patients(8.38%)whose MRE images could not meet the requirement of diagnosis,the reason of 3 cases(1.80%)was poor respiratory coordination,and that of 2 cases(1.20%)was there were more severe magnetic sensitive artifacts in images,and that of 1 case(0.60%)was severe intestinal peristalsis leaded to blurred images,and that of 2 cases(1.20%)was the flow void effect from intestinal peristalsis inside of intestinal cavity could not meet the requirement of diagnosis,and that of 4 cases(2.40%)was the intestinal tube without incomplete dilation caused by poor oral filling contrast agent,and that of 2 cases(1.20%)was many residues in intestine due to poor preparation for intestine.Aimed at the factors that MRE images could not meet requirement of diagnosis,we proposed the following quality control measures:①the biphasic contrast agents with favorable safety,without severe adverse reactions,which can fully dilate intestinal cavity,should be selected.②we should do well for the dilation of intestinal tube,and inhibit the intestinal peristalsis and conduct respiratory training.③we should conduct scan with wide field at coronal site,so as to display panorama image of intestine.④The scans of conventionally anatomical sequence and functional imaging sequence on axis position were performed on lesions.Conclusion:MRE technique should choose appropriate contrast agent in the quality control of the diagnosis of intestine diseases,and do well the preparation for patients before examination.Using intraluminal contrast agents,conducting intestinal dilation and optimal imaging technique are essential for obtaining intestinal MRE images with high quality.

Cervical cancer is the leading cause of cancer death in women in the developing countries.The treatment based on surgery,radiotherapy and chemotherapy is often accompanied by intolerable complications.Clinical practice has proved that TCM therapy has a positive effect on the complications related to the treatment of cervical cancer,but there is still a lack of scientific and standardized application reference opinions.Based on Delphi method,our research group constructed and formulated an expert consensus study on the complications related to the treatment of cervical cancer with TCM therapies,so as to provide a reference for clinical treatment of such diseases.

ObjectiveTo investigate the effect of Dendrobii Caulis mixture on cell inflammatory response and apoptosis in diabetic rat with non-alcoholic fatty liver disease（NAFLD） and its possible mechanism. MethodForty male SD rats were randomly divided into blank group and model group of type 2 diabetes mellitus（T2DM） with NAFLD according to body weight. The model was established by high-sugar and high-fat diet combined with intraperitoneal injection of streptozotocin（STZ）， which was randomly divided into the model group， Dendrobii Caulis mixture group（16.67 g·kg^-1·d^-1） and metformin group（100 mg·kg^-1·d^-1） according to blood glucose and body weight， and 10 rats in each group. Rats in each group were administered by continuous gavage for 4 weeks， the blank and model groups were given saline by gavage at 10 mL·kg^-1·d^-1. Fasting blood glucose（FBG）， serum insulin（INS）， glycosylated serum protein（GSP）， triglyceride（TG）， total cholesterol（TC）， high density lipoprotein（HDL-C）， low density lipoprotein（LDL-C）， alanine aminotransferase（ALT） and aspartate aminotransferase（AST） were detected in each group of rats. The liver tissues of rats in each group were stained with hematoxylin-eosin（HE） to observe the pathological changes， and the positive expressions of nuclear transcription factor（NF）-κB， NOD-like receptor heat protein structural domain-related protein 3（NLRP3）， interleukin（IL）-1β and tumor necrosis factor（TNF）-α were observed by immunohistochemistry. Western blot and fluorescence quantitative polymerase chain reaction（Real-time PCR） were used to detect the protein and mRNA expression of B-cell lymphoma-2（Bcl-2）， Bcl-2 associated X protein（Bax）， Caspase-3 and NF-κB p65， NLRP3， IL-1β， TNF-α in liver tissue of rats in each group. ResultCompared with the blank group， FBG， GSP， TC， TG， LDL-C， AST and ALT levels were increased， INS and HDL-C levels were decreased， Bax， Caspase-3， NLRP3， IL-1β， TNF-α protein and mRNA expression were increased in model group， the ratio of p-NF-κB/NF-κB protein increased， the expression of Bcl-2 protein and mRNA decreased， and the positive immunohistochemical expression of NF-κB， NLRP3， IL-1β and TNF-α increased， and the differences were statistically significant（P<0.01）. The morphological structure of the liver was disrupted， and obvious fat vacuoles were seen. Compared with the model group， FBG， GSP， TC， TG， LDL-C， AST and ALT levels of Dendrobii Caulis mixture group and metformin group were decreased， INS and HDL-C levels were increased， and protein and mRNA expressions of Bax， Caspase-3， NLRP3， IL-1β and TNF-α were decreased， the protein ratio of p-NF-κB/NF-κB decreased， the expression of Bcl-2 protein and mRNA increased， and the positive immunohistochemical expressions of NF-κB， NLRP3， IL-1β and TNF-α decreased， and the differences were statistically significant（P<0.01）. The liver morphology and structure were relatively complete， and the fat vacuoles were reduced. ConclusionDendrobii Caulis mixture can inhibit cell apoptosis， reduce inflammatory response and alleviate liver injury in rats with T2DM and NAFLD， the mechanism may be related to inhibiting the activation of NF-κB pathway， blocking the activation of NLRP3 inflammatory vesicles， reducing IL-1β secretion， attenuating Caspase-3 activity and reducing the ratio of Bcl-2/Bax.

Chromatin modification contributes to pluripotency maintenance in embryonic stem cells(ESCs).However,the related mechanisms remain obscure.Here,we show that Npac,a"reader"of histone H3 lysine 36 trimethylation(H3K36me3),is required to maintain mouse ESC(mESC)pluripotency since knockdown of Npac causes mESC differentiation.Depletion of Npac in mouse embryonic fibroblasts(MEFs)inhibits reprogramming efficiency.Furthermore,our chromatin immunoprecipitation followed by sequencing(ChIP-seq)results of Npac reveal that Npac co-localizes with histone H3K36me3 in gene bodies of actively transcribed genes in mESCs.Interestingly,we find that Npac interacts with positive transcription elongation factor b(p-TEFb),Ser2-phosphorylated RNA Pol Ⅱ(RNA Pol Ⅱ Ser2P),and Ser5-phosphorylated RNA Pol Ⅱ(RNA Pol Ⅱ Ser5P).Furthermore,depletion of Npac disrupts transcriptional elongation of the pluripotency genes Nanog and Rifl.Taken together,we propose that Npac is essential for the transcriptional elongation of pluripotency genes by recruiting p-TEFb and interact-ing with RNA Pol Ⅱ Ser2P and Ser5P.