ObjectiveThis study aimed to investigate the action mechanism by which Banxia Xiexintang （BXT） inhibits epithelial-mesenchymal transition （EMT） in chronic atrophic gastritis （CAG） rats by regulating the interleukin-17（IL-17）/extracellular regulated protein kinases（ERK）/CCAAT enhancer binding protein β（C/EBPβ）signaling pathway， thereby providing new theoretical evidence for the treatment of CAG with classic traditional Chinese medicine formulas. MethodsA CAG rat model was established by using the combined factor method. After successful modeling， the rats were randomly divided into the model group， low-， medium-， and high-dose groups （0.549， 1.098， 2.196 g·kg^-1， respectively） of BXT， and the positive drug group （vitacoenzyme， 0.3 g·kg^-1）. A normal control group was also set up. After 8 weeks of intervention， the pathological changes of gastric tissue were evaluated. The enzyme-linked immunosorbent assay （ELISA） was used to detect the contents of IL-17， tumor necrosis factor-α （TNF-α）， cyclooxygenase-2 （COX-2）， and C/EBPβ in serum， as well as the contents of EMT markers in gastric mucosal tissue including E-cadherin， N-cadherin， and vimentin. The immunohistochemistry method was employed to determine the localization and protein expression levels of IL-17， p-ERK， and C/EBPβ in gastric mucosal tissue. Western blot was used to detect the protein expressions of C/EBPβ， ERK， and its phosphorylated form （p）-ERK in gastric mucosa. Real-time polymerase chain reaction （Real-time PCR） was applied to measure the mRNA expression levels of ERK， COX-2， and C/EBPβ in gastric mucosa. ResultsCompared with those in the normal control group， the rats in the model group showed gastric mucosal glandular atrophy and inflammatory cell infiltration. The protein and their related mRNA expressions of C/EBPβ， ERK， and p-ERK in gastric mucosa were significantly increased （P<0.05，P<0.01）. The levels of IL-17， TNF-α， COX-2， and C/EBPβ in serum were significantly increased （P<0.01）. The contents of N-cadherin and vimentin in gastric mucosal tissue were significantly increased， while the content of E-cadherin was significantly decreased （P<0.01）. Compared with the model group， after intervention with different doses of BXT， the pathological damage of the gastric mucosa was improved to varying degrees. The protein and mRNA expressions of C/EBPβ， ERK， and p-ERK in gastric mucosa were significantly reduced （P<0.05，P<0.01）. The levels of IL-17， TNF-α， COX-2， and C/EBP β in serum were significantly decreased （P<0.01）. The contents of N-cadherin and vimentin in gastric mucosa tissue were decreased， while the content of E-cadherin was increased （P<0.05，P<0.01）. ConclusionBXT can effectively improve the pathological damage of gastric mucosal tissue in CAG rats. Its action mechanism may be related to reducing the levels of IL-17 and TNF-α in serum， regulating the IL-17/ERK/C/EBPβ signaling pathway and inhibiting the EMT process.

Objective To investigatethe relationship between gastroesophageal reflux disease (GERD) symptoms and clinicopathological characteristics, p53 expression, and survival of Chinese patients with esophageal adenocarcinoma. Methods A total of 3882 patients with esophageal adenocarcinoma, 970 matched patients with esophageal squamous cell carcinoma, and 970 matched patients with gastric cardia adenocarcinoma were included to compare the incidence of GERD symptoms. Patients with esophageal adenocarcinoma were divided into two groups according to the presence and absence of GERD symptoms. The differences in clinicopathological characteristics and p53 expression between the two groups were compared by chi-square test, and the differences in survival between the two groups were compared by landmark analysis. Results The incidence of GERD symptoms increased successively in esophageal squamous cell carcinoma, esophageal adenocarcinoma, and gastric cardia adenocarcinoma. In patients with esophageal adenocarcinoma, the proportions of male, less than 65 years old, lower thoracic tumors, tumors without squamous cell carcinoma, poorly differentiation, early tumors (stage 0-I), and p53-positive tumors in the group with GERD symptoms were higher than those in the group without GERD symptoms; moreover, the long-term survival (≥15 years) was better. Conclusion GERD symptom is an important clinical sign of esophageal adenocarcinoma. It is closely related to specific clinicopathological characteristics, p53 overexpression, and good long-term prognosis.

Chronic hepatitis B virus (HBV) infection remains a major global public health concern. The persistent presence of intrahepatic covalently closed circular DNA (cccDNA) poses a major challenge to the complete cure of chronic HBV infection. Therefore, identifying reliable and effective serological surrogate markers for cccDNA holds great clinical significance in evaluating antiviral efficacy, predicting prognosis, and guiding the clinical management of chronic HBV-infected patients. In recent years, serum HBV RNA has emerged as a promising non-invasive alternative marker for cccDNA, offering the potential for monitoring disease progression and predicting prognosis in chronic HBV-infected patients. In this review, we summarize recent studies on HBV RNA, highlighting its ability to assess the immune and histological status of patients, and discussing its value in guiding the timing of antiviral therapy. Furthermore, we systematically summarize the clinical significance of HBV RNA in multiple domains: monitoring viral replication, evaluating antiviral treatment efficacy, predicting relapse after treatment cessation, and guiding new antiviral strategies. This review aims to provide clinicians with valuable insights for better utilizing this marker in the clinical management of chronic HBV infection.

OBJECTIVES: To verify whether hesperetin (Hes) alleviates doxorubicin (DOX)-induced cardiotoxicity by reducing inflammation via regulating the AMPK/NLRP3 pathway. METHODS: C57/bl6 mice and H9c2 cells treated with DOX to mimic cardiotoxicity were randomly divided into Sham (or control) group, DOX group, DOX+Hes group, DOX+Hes+compound C (CC, an AMPK inhibitor) group. Cardiac function and myocardial pathologies of the mice were evaluated, and the changes in H9c2 cell morphology and viability were assessed. Lactate dehydrogenase (LDH) activity in mouse myocardial tissues and H9c2 cells was measured using ELISA, and H9c2 cell apoptosis was detected with TUNEL staining. In both H9c2 cells and the myocardial tissues of the mice, cellular expression levels of TNF-α, IL-6 and IL-1β mRNAs and cleaved caspase-3, Bcl2, Bax, IL-1β, IL-18, p-AMPK, AMPK, p-mTOR, mTOR, NLRP3, ASC and caspase-1 proteins were detected using RT-PCR and Western blotting. RESULTS: DOX treatment caused cell swelling, decreased cell viability and increased LDH activity in H9c2 cells, resulting also in significantly increased cell apoptosis and cleaved caspase-3 expression and decreased Bcl2/Bax ratio. The DOX-treated mice showed obvious myocardial fiber swelling and inflammatory infiltration, decreased cardiac function and significantly increased myocardial LDH activity. In H9c2 cells, DOX treatment significantly increased the mRNA expressions of TNF-α, IL-6 and IL-1β and protein expressions of IL-1β and IL-18, lowered the expressions of p-AMPK and p-mTOR, and increased the expressions of NLRP3, ASC and caspase-1. Hes treatment obviously reduced these toxic effects of DOX in H9c2 cells, but its protective effects were blocked by application of compound C. CONCLUSIONS Hes reduces DOX-induced cardiotoxicity by inhibiting inflammation via regulating the AMPK/NLRP3 pathway.
Animals ; Doxorubicin/toxicity* ; NLR Family, Pyrin Domain-Containing 3 Protein/metabolism* ; Mice, Inbred C57BL ; Mice ; Signal Transduction/drug effects* ; Cardiotoxicity ; AMP-Activated Protein Kinases/metabolism* ; Apoptosis/drug effects* ; Cell Line ; Myocytes, Cardiac/drug effects* ; Rats

BACKGROUND:Currently,the verification of the precision of personalized bone models is usually performed by methods such as paired t-tests or intraclass correlation coefficient,but such methods often require the production of large batches of models,which do not satisfy the need for immediate use of personalized models. OBJECTIVE:To study the feasibility of establishing the equivalent model to verify the precision of the personalized bone model rapidly. METHODS:Bone CT images of three adults were randomly obtained for reconstruction.3D printing was used to create personalized bone models,and then the personalized bone models were scanned using CT and reconstructed.Mimics was used to compare the reconstructed models of bone CT images with the bone CT images.Geomagic Studio was used to analyze the fitting deviation between the reconstruction model of personalized bone model CT image and the reconstruction model of skeletal CT image.The 3D-printed personalized bone model was measured against the measurement positions and dimensions marked on the reconstruction model of skeletal CT image,and the error was calculated. RESULTS AND CONCLUSION:(1)By comparing the reconstructed bone CT image model with the bone CT scan image,the two were compatible in terms of anatomical structure and morphology,and the contours almost overlapped.(2)By fitting bias analysis,the standard bias was 0.176,0.226,and 0.143 mm in order,and all the results were<0.25 mm.(3)By measuring and calculating the model,the mean relative errors were 0.44%,0.21%,and 0.13%,and all the results were within 5%error.(4)The constructed equivalent model was in line with the basic conditions for making personalized bone models.The established equivalent model met the clinical needs and design requirements,and it was feasible to use the method of the equivalent model to verify the precision of the personalized bone model quickly.(5)This method could provide a targeted and rapid way to verify the precision of personalized bone models.It could achieve the goal of providing immediate clinical use without the need to produce large batches of models compared to conventional methods such as paired t-tests or intraclass correlation coefficient.

Objective:To explore the changes in behavioral indexes and electroencephalogram (EEG) in the stage of temporal memory retrieval under different extraction times.Methods:A total of 30 healthy subjects were randomly selected from Shanghai University of Science and Technology in November 2022. The reaction time and EEG of the subjects in the 1 500 ms stage of temporal memory retrieval were recorded by a reproduction method of time estimation task. The memory error rate, precision, accuracy, and low-frequency power of EEG were calculated, and time-frequency analysis and traceability analysis were carried out. Pearson correlation analysis was used to analyze the correlation between memory error rate, accuracy, θ rhythm, and β rhythm.Results:The main effects of time difference and memory precision between retrieval times were found [ F(3, 1 196) = 2.932, P = 0.033; F(3, 1 196) = 3.191, P = 0.026], and they increased with the extraction times. There was no main effect on memory accuracy, but as the number of extractions increases, the average accuracy increased. With the increase in memory retrieval times, the power of θ rhythm in the left frontal lobe gradually increased [ F(3, 116) = 2.668, P = 0.035], and the average power of β rhythm in the middle frontal lobe gradually decreased [ F(3, 116) = 2.810, P = 0.029]. The differences in current density distribution in the somatosensory cortex (BA7), dorsolateral prefrontal cortex (BA9), and premotor cortex (BA6) increased in the first and second, second and third, and third and fourth memory retrievals ( P < 0.01). The θ rhythm was positively correlated with memory accuracy ( r = 0.258, P < 0.05), and the β rhythm was negatively correlated with memory precision ( r = ? 0.404, P < 0.01). Conclusions:In the stage of temporal memory extraction, increasing the number of temporal memory extraction times can reduce the memory error rate and improve accuracy. Memory accuracy is related to the power of the θ rhythm in the left frontal lobe and the power of the β rhythm in the middle frontal lobe.

Objective:To explore the risk factors of severe acute kidney injury (AKI) in septic patients, and to establish an hour-specific prediction model.Methods:Based on the information of septic patients in the Medical Information Mart for Intensive Care-Ⅳ (MIMIC-Ⅳ) database, general information, comorbidities, vital signs, severity scoring system, laboratory indicators, invasive operations and medication use were recorded. The enrolled patients were randomized into a training set and a validation set according to a ratio of 7∶3. AKI was diagnosed according to the guidelines of Kidney Disease: Improving Global Outcome (KDIGO). Based on Lasso regression and Cox regression, the risk factors of severe AKI (AKI stage 2 and stage 3) in septic patients were analyzed and hour-specific prediction model were established. Consistency index (C-index), area under the receiver operator characteristic curve (AUC) and calibration curve were used to assess the predictive efficacy of the model.Results:A total of 20 551 septic patients were enrolled, including 14 385 patients in the training set and 6 166 patients in the validation set. Multivariate Cox regression analysis showed that atrial fibrillation [hazard ratio ( HR) = 1.266, 95% confidence interval (95% CI) was 1.150-1.393], heart failure ( HR = 1.348, 95% CI was 1.217-1.493), respiratory failure ( HR = 1.565, 95% CI was 1.428-1.715), heart rate ( HR = 1.004, 95% CI was 1.002-1.007), mean arterial pressure ( HR = 1.245, 95% CI was 1.126-1.377), lactic acid ( HR = 1.051, 95% CI was 1.025-1.077), simplified acute physiology score Ⅱ (SAPSⅡ, HR = 1.019, 95% CI was 1.016-1.023), serum creatinine ( HR = 1.171, 95% CI was 1.127-1.216), anion gap ( HR = 1.024, 95% CI was 1.010-1.038), serum potassium ( HR = 1.155, 95% CI was 1.079-1.236), white blood cell count ( HR = 1.006, 95% CI was 1.003-1.009) and furosemide use ( HR = 0.414, 95% CI was 0.368-0.467) were independently associated with severe AKI in septic patients (all P < 0.01). The above predictors were applied to construct an hour-specific prediction model for the occurrence of severe AKI in septic patients. The C-index of the prediction model was 0.723 and 0.735 in the training and validation sets, respectively. The AUC for the occurrence of severe AKI at 12, 24, and 48 hours were 0.795 (95% CI was 0.782-0.808), 0.792 (95% CI was 0.780-0.805), and 0.775 (95% CI was 0.762-0.788) in the training set, and the AUC were 0.803 (95% CI was 0.784-0.823), 0.791 (95% CI was 0.772-0.810), and 0.773 (95% CI was 0.752-0.793) in the validation set, respectively. The calibration curves of the two cohorts were in good agreement. Conclusion:The hour-specific prediction model effectively identifies high-risk septic patients for developing severe AKI within 48 hours, aiding clinicians in stratifying patients for early therapeutic interventions to improve outcomes.

Objective To establish a finite element model of the T2-L5 thoracolumbar spine and verify its validity,to provide numerical model support for exploring the dynamic response characteristics and injury mechanism under spinal impact loads.Methods A three-dimensional(3D)finite element model of the T2-L5 thoracolumbar spine was established based on CT scanning data.The load-rotation angle curve of the T12-L1 segment under different moments(flexion,extension,rotation,and lateral bending conditions)was calculated and compared with the data reported in the literature.Free-fall loads at different heights were applied to the finite element models of the T2-6,T7-11,and T12-L5 spine.The peak axial force and bending moment were obtained by finite element simulation analysis and compared with data reported in the literature.Results The maximum rotation angle of the T12-L1 finite element model was-2.24°-1.55° under moments in different directions,which was in good agreement with the literature data.The peak axial force of T2-6,T7-11,and T12-L5 spine finite element models subjected to different free-fall loads was 1.7-5.3 kN,1.3-5.5 kN,and 1.3-7.5 kN respectively,which were within the error range reported in the literature.Stress nephograms of the spine and intervertebral discs showed that the vertebral body was first stressed from the outer edge.The intervertebral disc was subjected to the main load by the nucleus pulposus,consistent with the actual spinal injury mechanism.Conclusions The T2-L5 spine model established in this study can correctly simulate the biomechanical behavioral characteristics of the spine under different working conditions,and the analysis results are effective.

Objective:To understand the epidemiological characteristics of human respiratory syncytial virus (HRSV) among acute respiratory infection (ARI) cases in 16 provinces of China from 2009 to 2023.Methods:The data of this study were collected from the ARI surveillance data from 16 provinces in China from 2009 to 2023, with a total of 28 278 ARI cases included in the study. The clinical specimens from ARI cases were screened for HRSV nucleic acid from 2009 to 2023, and differences in virus detection rates among cases of different age groups, regions, and months were analyzed.Results:A total of 28 278 ARI cases were enrolled from January 2009 to September 2023. The age of the cases ranged from<1 month to 112 years, and the age M ( Q1, Q3) was 3 years (1 year, 9 years). Among them, 3 062 cases were positive for HRSV nucleic acid, with a total detection rate of 10.83%. From 2009 to 2019, the detection rate of HRSV was 9.33%, and the virus was mainly prevalent in winter and spring. During the Corona Virus Disease 2019 (COVID-19) pandemic, the detection rate of HRSV fluctuated between 6.32% and 18.67%. There was no traditional winter epidemic peak of HRSV from the end of 2022 to the beginning of 2023, and an anti-seasonal epidemic of HRSV occurred from April to May 2023. About 87.95% (2 693/3 062) of positive cases were children under 5 years old, and the difference in the detection rate of HRSV among different age groups was statistically significant ( P<0.001), showing a decreasing trend of HRSV detection rate with the increase of age ( P<0.001). Among them, the HRSV detection rate (25.69%) was highest in children under 6 months. Compared with 2009-2019, the ranking of HRSV detection rates in different age groups changed from high to low between 2020 and 2023, with the age M (Q1, Q3) of HRSV positive cases increasing from 1 year (6 months, 3 years) to 2 years (11 months, 3 years). Conclusion:Through 15 years of continuous HRSV surveillance analysis, children under 5 years old, especially infants under 6 months old, are the main high-risk population for HRSV infection. During the COVID-19 pandemic, the prevalence and patterns of HRSV in China have changed.

Objective:To understand the epidemiological characteristics of human respiratory syncytial virus (HRSV) among acute respiratory infection (ARI) cases in 16 provinces of China from 2009 to 2023.Methods:The data of this study were collected from the ARI surveillance data from 16 provinces in China from 2009 to 2023, with a total of 28 278 ARI cases included in the study. The clinical specimens from ARI cases were screened for HRSV nucleic acid from 2009 to 2023, and differences in virus detection rates among cases of different age groups, regions, and months were analyzed.Results:A total of 28 278 ARI cases were enrolled from January 2009 to September 2023. The age of the cases ranged from<1 month to 112 years, and the age M ( Q1, Q3) was 3 years (1 year, 9 years). Among them, 3 062 cases were positive for HRSV nucleic acid, with a total detection rate of 10.83%. From 2009 to 2019, the detection rate of HRSV was 9.33%, and the virus was mainly prevalent in winter and spring. During the Corona Virus Disease 2019 (COVID-19) pandemic, the detection rate of HRSV fluctuated between 6.32% and 18.67%. There was no traditional winter epidemic peak of HRSV from the end of 2022 to the beginning of 2023, and an anti-seasonal epidemic of HRSV occurred from April to May 2023. About 87.95% (2 693/3 062) of positive cases were children under 5 years old, and the difference in the detection rate of HRSV among different age groups was statistically significant ( P<0.001), showing a decreasing trend of HRSV detection rate with the increase of age ( P<0.001). Among them, the HRSV detection rate (25.69%) was highest in children under 6 months. Compared with 2009-2019, the ranking of HRSV detection rates in different age groups changed from high to low between 2020 and 2023, with the age M (Q1, Q3) of HRSV positive cases increasing from 1 year (6 months, 3 years) to 2 years (11 months, 3 years). Conclusion:Through 15 years of continuous HRSV surveillance analysis, children under 5 years old, especially infants under 6 months old, are the main high-risk population for HRSV infection. During the COVID-19 pandemic, the prevalence and patterns of HRSV in China have changed.