Primary cilia—those solitary, microtubule-based projections extending from the surface of most eukaryotic cells—are increasingly recognized not merely as cellular appendages, but as sophisticated signaling hubs. By compartmentalizing specific receptors (e.g., GPCRs) and effectors within a microdomain guarded by the transition zone, these organelles function effectively as high-gain sensors capable of integrating mechanical stimuli with metabolic cues. In this review, we examine the pivotal role of primary cilia across the nervous, bone-vascular, and renal landscapes, arguing for a unified “mechano-metabolic coupling” framework. Here, conserved ciliary modules are not static; rather, they are differentially deployed to uphold systemic homeostasis. Within the central nervous system, we position primary cilia as upstream integrators. We highlight how hypothalamic neuronal cilia concentrate metabolic receptors, such as the melanocortin 4 receptor (MC4R), to interpret energy status. Moreover, the recent identification of serotonergic “axon-cilium synapses” points to a direct mode of neurotransmission, wherein 5-HT6 receptors drive nuclear signaling and chromatin accessibility to rapidly modulate gene expression. Through these mechanisms, central cilia modulate sympathetic tone and neuroendocrine output, effectively establishing the mechanical and metabolic “boundary conditions” under which peripheral organs operate. Dysfunction in these central hubs is linked to obesity and neurodevelopmental disorders, including Bardet-Biedl syndrome. In peripheral tissues, cilia serve as versatile mechanotransducers that convert physical forces into biochemical responses. Regarding the bone-vascular system, we discuss the translation of mechanical loads and fluid shear stress into structural remodeling. In osteoblasts, specifically, ciliary integrity is intrinsically linked to cholesterol and glucose metabolism, fine-tuning the balance between Hedgehog and Wnt/β-catenin signaling to govern osteogenesis and bone repair. A similar dynamic exists in the vasculature, where endothelial cilia sense shear stress to modulate KLF4 expression and endothelial-to-mesenchymal transition—processes critical for valvulogenesis and vascular remodeling. Meanwhile, in the kidney, tubular cilia act as terminal effectors within a “shear-cilia-metabolism” axis. Here, fluid shear stress engages ciliary signaling to trigger AMPK-mediated lipophagy and mitochondrial biogenesis, thereby securing the ATP supply required for solute transport. Notably, dysregulation of this axis leads to metabolic reprogramming and aberrant proliferation, acting as a hallmark driver of cystogenesis in polycystic kidney disease (PKD). Crucially, this review attempts to dissect the often-conflated logic of cross-system integration by distinguishing 3 non-equivalent pathways: direct communication via ciliary extracellular vesicles, though this remains largely hypothetical in long-range signaling; “physiology-mediated cascades”, where ciliary dysfunction in a single organ—such as the kidney—precipitates systemic pathology through hemodynamic and metabolic shifts (e.g., altered blood pressure, fluid volume, or uremic toxins); and “parallel molecular defects”, where shared genetic mutations in ubiquitous components like the IFT machinery cause simultaneous, independent failures across multiple organ systems. Building on these distinctions, we propose a nested-loop model that links central set-points with peripheral feedback via physiological variables. Furthermore, we construct a “causality-to-translation” roadmap that pinpoints structural repair (e.g., targeting IFT assembly) and metabolic rescue (e.g., AMPK activation or autophagy induction) as promising therapeutic avenues. Ultimately, this framework provides a theoretical basis for deciphering the shared pathological mechanisms of multisystem ciliopathies, offering a strategic guide for the development of targeted interventions that go beyond symptomatic treatment.

Objective To investigate the therapeutic effect of Huangkui capsules on targeted drug-related proteinuria in patients with hepatocellular carcinoma (HCC). Methods A retrospective analysis was conducted on clinical data of HCC patients with targeted drug-related proteinuria from June 2023 to December 2024 at Zhongshan Hospital, Fudan University. According to the treatment plan, patients were divided into the conventional treatment group and the Huangkui combination treatment group (Huangkui capsules combined with conventional treatment), and the clinical efficacy between the two groups was compared. The logistic regression analysis was used to identify the main factors affecting treatment efficacy. Results The Huangkui combination treatment group (n＝29) showed a significantly higher overall effective rate (79.3% vs 42.3%, P＝0.005), and an earlier proteinuria improvement (median time: 3 months vs 6 months, P＝0.008) than the conventional treatment group (n＝26) . The multivariate logistic regression analysis showed angiotensin-converting enzyme inhibitor (ACEI) or angiotensin Ⅱ receptor blocker (ARB) using (OR＝0.190, 95%CI 0.045-0.808, P＝0.025), targeted drug adjustment (OR＝0.132, 95%CI 0.030-0.581, P＝0.007), and Huangkui capsules using (OR＝0.168, 95%CI 0.039-0.730, P＝0.017) were protective factors for treatment efficacy of targeted drug-related proteinuria. Conclusions On the basis of conventional treatment, additive treatment with Huangkui capsules can alleviate targeted drug-related proteinuria faster and more effectively in HCC patients.

ObjectiveTo investigate the therapeutic effects and mechanism of decoctions from four kinds of processed products of Aconiti Radix Lateralis Praeparata（ARLP） in deficiency-cold syndrome. MethodsA total of 36 SD rats were randomly divided into the control group， model group， Shengfupian（SFP） group， Paofuzi（PFZ） group， Heishunpian（HSP） group and Paofupian（PFP） group with 6 rats in each group. Except for the control group， rats in other groups were administered hydrocortisone sodium succinate via intramuscular injection to induce a cold deficiency syndrome model. After 14 consecutive days， each ARLP decoction pieces was administered via continuous gastric lavage at a dose of 12 g·kg^-1·d^-1 for 7 d， while the control and model groups received an equivalent volume of physiological saline. After the end of administration， body weight， spleen weight and thymus weight were measured for calculating the spleen and thymus indexes. Hematoxylin-eosin（HE） staining was used to observe the pathological morphology of adrenal tissue. The fully automatic biochemistry analyzer was used to measure the total cholesterol（TC）， triglyceride（TG）， lactic dehydrogenase（LDH） and lactate（LAC） levels in serum. Enzyme-linked immunosorbent assay（ELISA） was employed to measure the contents of 17-hydroxycorticosteroid（17-OHCS）， cortisol（CORT）， triiodothyronine（T₃）， thyroxine（T₄）， thyrotropin（TSH）， immunoglobulin（Ig） M， IgG， cyclic adenosine monophosphate（cAMP） and cyclic guanosine monophosphate（cGMP）. Western blot was used to measure the protein expression levels of protein kinase A（PKA）， cAMP response element-binding protein（CREB）， silent information regulator 1（Sirt1） and peroxisome proliferator-activated receptor γ coactivator-1α（PGC-1α）. And high performance liquid chromatography（HPLC） was used to determine the content of major alkaloids， followed by Pearson correlation analysis with pharmacodynamic indicators. ResultsAfter modeling， compare with the control group， the model rats exhibited symptoms such as lethargy and loose stools， mild abnormalities were observed in adrenal tissue structure， and both spleen and thymus indices were significantly reduced（P<0.01）. Thyroid， adrenal and immune system functions were suppressed， with decreased serum cAMP level and significantly elevated cGMP level（P<0.01）. Compared with the model group， the adrenal injury by hydrocortisone sodium succinate were repaired and the spleen index were increased significantly in all four ARLP groups（P<0.05， P<0.01）. The thymus index in SFP and PFZ groups were increased significantly（P<0.05）. The contents of T₃， TSH， 17-OHCS and CORT were increased significantly in SFP and PFZ groups（P<0.05）. In addition， the content of IgG in SFP， PFZ and PFP groups were increased significantly（P<0.01）， while the content of IgM in PFZ and HSP groups were also increased significantly（P<0.05）. Regarding the cyclic nucleotide system， PFZ significantly elevated cAMP level while reducing cGMP level（P<0.05）， exhibiting the most pronounced effect among the four decoction pieces. For energy metabolism indicators， PFZ significantly improved abnormal markers including TC， TG， LDH， and LAC（P<0.05）. HSP showed marked improvement effects on TG， LDH， and LAC（P<0.05）. Both PFZ and SFP significantly elevated the expression levels of PKA， CREB， Sirt1， and PGC-1α proteins（P<0.01）. Additionally， the diester alkaloids in ARLP showed a strong positive correlation with TG， IgG， and CORT， a strong negative correlation with LAC， a moderate positive correlation with T₄， and moderate negative correlations with cAMP and spleen index. Monomeric alkaloids showed strong positive correlations with TG and IgG， strong negative correlations with LAC， moderate positive correlations with CORT and T₄， and moderate negative correlations with cAMP and spleen index. However， the content of water-soluble alkaloids showed strong positive correlations with TC， LDH， 17-OHCS， T₃， TSH， and thymus index， moderate positive correlations with cAMP， CORT， T₄， and spleen index， and moderate negative correlation with cGMP. ConclusionAmong different processed ARLP decoction pieces， PFZ processed according to ZHANG Zhongjing's method exhibits the most potent warming and cold-dispelling effects. Its pharmacological actions are mediated through regulating the thyroid， adrenal， immune， cyclic nucleotide systems， and material-energy metabolism pathways. Among these， water-soluble alkaloids show strong or moderate correlations with more indicators of deficiency-cold syndrome and exhibit the highest content in PFZ. Therefore， PFZ processed according to ZHANG Zhongjing's method may exert its warming and cold-dispelling effects through water-soluble alkaloids.

Objective: The cross sectional study aimed to identify predominant co-occurrence patterns among six common mental health issues in college students, so as to provide empirical basis for designing targeted interventions. Methods: From October 2024, a total of 9 837 students from 4 universities in Xiangtan City, Hunan Province, participated in the current study by multistage random cluster sampling method. Participants completed self report measures, including the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7 item Scale (GAD-7), Young s Internet Addiction Diagnostic Questionnaire, the Adolescent Insomnia Symptom Self rating Scale, the Ottawa Self injury Inventory, and the Brief Community Assessment of Psychic Experiences Questionnaire. Demographic and co-occurrence characteristics were first compared using Chi square or trend Chi-square tests, followed by application of the Apriori algorithm to mine association rules for primary co-occurrence patterns. Results: The detection rate of co-occuring the common mental health issues was 46.44%. The detection rate was significantly higher in female than in male students (50.42%, 43.61%; χ 2=44.46) and in students from rural versus urban areas (47.22%, 44.60%; χ 2=5.67) (both P <0.05). Significant differences were observed among freshmen, sophomores, juniors, and seniors (46.63%, 48.35%, 45.05% , 43.66%, respectively; χ 2=9.22, P <0.05), although no statistically significant trend was detected ( χ 2 trend =3.75, P = 0.05 ). Association rule mining identified “anxiety + depression” “anxiety + psychotic experiences + depression” and “anxiety + sleep disorder + depression” as the combinations with the highest support. In addition, “anxiety+depression+Internet addiction+psychotic experiences =>sleep disorder (>= refered to the occurrence of the latter item under the condition that the former item occurs)” and “anxiety + depression+Internet addiction=>sleep disorder” were combinations with relatively high confidence. Conclusions Co-occurrence of these mental health issues among college students is high and exhibits diverse patterns. Strategies to address this burden should prioritize integrated interventions that target these specific combinations of factors.

ObjectiveTo investigate the characteristics of injury deaths and its disease burden in Taizhou City from 2009 to 2022, and to provide a basis for the prevention and control of injury. MethodsBased on the injury death surveillance data of Taizhou City from 2009 to 2022, the age-specific and sex-specific mortality rates, as well as the standardized mortality rates after adjusting China’s standardized population age of residents in Taizhou City were calculated. The crude mortality rate, standardized mortality rate, average years of life lost(AYLL), potential years of life lost (PYLL) and potential years of life lost rate (PYLLR) were calculated using Excel 2013 software. Joinpoint 4.2 software was used to estimate the annual percentage change (APC) and analyze the trends of injury mortality and PYLLR from 2009 to 2022. ResultsFrom 2009 to 2022, the standardized mortality rate of injuries in Taizhou City showed a decreasing trend (APC=-4.876%, P<0.001), with a mortality rate of 64.38/100 000 and a standardized mortality rate of 66.68/100 000. There was a statistically significant difference in injury deaths by genders (χ²=7 520.153, P<0.001). From 2009 to 2022, the PYLL and AYLL caused by injuries in Taizhou City were 587 518 person years and 21.91 years, respectively, with a PYLLR of 7.72%. The PYLLR of injuries showed a decreasing trend (APC=-7.454%, P<0.001), in addition, the PYLLR in urban(APC=-7.123%), rural areas (APC=-10.193%), males (APC=-7.595%) and females (APC=-7.046%) all showed a decreasing trend, all differences were statistically significant(all P<0.001). The top five causes of injury deaths leading to PYLL were traffic accident, drowning, accidental fall, suicide and accidental poisoning. ConclusionIn the last decade, injury has been a major cause leading to premature death among residents in Taizhou, with a higher mortality rate in males than that in females, and different injury characteristics caused by different types of injuries. It is necessary to take targeted injury prevention and intervention measures for different key population groups to effectively reduce the disease burden caused by injury deaths.

Metabolites produced as intermediaries or end-products of microbial metabolism provide crucial signals for health and diseases, such as metabolic dysfunction-associated steatotic liver disease (MASLD). These metabolites include products of the bacterial metabolism of dietary substrates, modification of host molecules (such as bile acids [BAs], trimethylamine-N-oxide, and short-chain fatty acids), or products directly derived from bacteria. Recent studies have provided new insights into the association between MASLD and the risk of developing chronic kidney disease (CKD). Furthermore, alterations in microbiota composition and metabolite profiles, notably altered BAs, have been described in studies investigating the association between MASLD and the risk of CKD. This narrative review discusses alterations of specific classes of metabolites, BAs, fructose, vitamin D, and microbiota composition that may be implicated in the link between MASLD and CKD.

AIM To study the chemical constituents from the leaves of Drynaria fortunei(Kunze)J.Sm.and their antioxidant activity.METHODS ODS-AG-HG,Sephadex LH-20 and semi-preparative HPLC were used for separation and purification,then the structures of obtained compounds were identified by physicochemical properties and spectral data.The antioxidant activity was determined by DPPH mothod.RESULTS Fifteen compounds were isolated and identified as kaempferol-3-O-neohesperidoside(1),dihydrodehydrodiconiferyl alcohol(2),kaempferol-3,7-di-O-α-L-rahmnoside(3),astragalin(4),loliolid(5),trichothecene analogue(6),2,2-[bis-4-(2,3-dihydroxypropoxy)phenyl]propane(7),maculatin(8),trichothecin(9),4-[(Z)-but-2-enoyloxy]-8-chloro-12-hydroxy-7,13-epoxytrichothec-9-ene(10),8-deoxy-trichotecin(11),β-sitosterol(12),daucosterol(13),afzelin(14),samwinol(15).The IC50 values of the leaf and rhizome extracts against DPPH free radicals were(0.072±0.005),(0.287±0.012)mg/mL,respectively.CONCLUSION Compounds 1,2,5-11,15 are isolated from this plant for the first time.The leaves of D.fortunei exhibit strong antioxidant activity.

OBJECTIVE To analyze the changing trend of hospital-acquired infections(HAIs)in hospitals from 2017 to 2023,and identify the distribution of different departments,infection sites and pathogens,so as to provide a scientific basis for the prevention and control of HAI.METHODS During the study period,the HAI data were col-lected and classified by year,department and infection site.Joinpoint regression model was used to analyze the trend of HAI rate,calculate the average annual percentage change(AAPC),and evaluate the distribution of infec-tion sites and pathogenic bacteria.RESULTS The overall infection situation showed that the average HAI rate was 1.19％,with a trend of increasing first and then decreasing during the study period,and AAPC was 8.33％(95％CI:0.025-0.173).The infection rate was the highest in the emergency department with an AAPC of 13.51％(95％CI:0.074-0.250),while the infection rates in the department of traditional Chinese medicine and orthope-dics were relatively stable.Lower respiratory tract infections accounted for the major proportion,followed by uri-nary tract infections and bloodstream infections.The AAPC for lower respiratory tract infections was 18.64％.The pathogenic analysis showed that bacterial infections were mainly gram-negative bacteria,with Kleb-siella pneumoniae,Pseudomonas aeruginosa,and Acinetobacter baumannii being the most common pathogens causing HAI.CONCLUSIONS The results of the study reveal that significant differences in HAI rates among dif-ferent departments and infection sites,especially the increasing infection rate in the emergency department should be highly concerned.In view of the persistent high incidence of respiratory and urinary tract infections,it is recom-mended to strengthen the relevant prevention and control measures.To effectively reduce the incidence of HAIs,it is necessary to focus on the monitoring and management of drug-resistant pathogens in the future.

Objective:To investigate the prevalence,related factors,and career implications of occupational burnout among resident physicians during standardized training in Inner Mongolia.Methods:This cross-sectional study used convenience sampling to enroll 2 891 resident physicians,assessing them with a self-developed general information questionnaire,socio-psychological scales,and a universal burnout inventory.Latent profile analysis clas-sified participants based on burnout dimensions,while logistic regression models examined the factors influencing burnout and their relationship with career choices.Results:Resident physicians were divided into low(59.0％),moderate(28.9％),and high(12.1％)burnout subgroups.Logistic regression showed that,compared to the low burnout group,significant risk factors included professional master's students(OR=0.44),working＞70 hours weekly(OR=0.63),＞4 night shifts monthly(OR=0.66),anxiety(mild OR=0.49;moderate OR=0.26;se-vere OR=0.14),depression(mild OR=0.38;moderate OR=0.24;severe OR=0.11),insomnia(mild OR=0.51;moderate OR=0.44;severe OR=0.38),low social support(OR=0.23),and low happiness index(OR=0.42).Male residents(OR=1.25)were less likely to experience burnout.High burnout residents were 5.11 times more likely to quit the medical profession.Conclusion:Training intensity and socio-psychological factors signifi-cantly contribute resident physicians' burnout levels,with severe burnout increase career attrition.

Objective To explore the damage results and structural response laws of medical cabins in ships under explosion attack.Methods Firstly,the cabin structure was equivalently regarded as a T-shaped plate frame based on the explosion load theory,then four finite element models for the medical cabins were established with the dimensions(length ×width×height)of 2.8 m×2.6 m×2.3 m,3.2 m×3.2 m×2.4 m,4.2 m×3.2 m×2.5 m and 5.4 m×4.0 m×2.6 m.Secondly,an explosion damage model was constructed using ABAQUS simulation software,and explosion damage simulation was carried out with the explosion locating at the cabin center and the outside of the bulkhead and the explosion energy of 10 kg and 100 kg trinitrotoluene(TNT)equivalent.Finally,the 10 kg and 100 kg TNT explosion damage results were ananlyzed at the cabin center and the outside of the bulkhead.Results At the cabin center,10 kg TNT explosion resulted in local deformation and limited affected area of the large-sized cabin,while 100 kg TNT explosion lead to extensive affected ranges in the functional areas and severe deformation and damage in the small-sized cabin.At the outside of the bulkhead,10 kg TNT explosion gave rise to breaches in some areas of the small-sized cabin and local deformation of the large-sized cabin,while 100 kg TNT explosion caused large breaches in all the cabins.Conclusion The explosion load induces serious deformation and damage and complicated breaches in the cabin with small size and weak structural strength.The cabin with large size and thick bulkhead and stiffener behaves well in explosion resistance,while high equivalent explosions may bring about serious damage to its local structure.[Chinese Medical Equipment Journal,2025,46(1):27-32]