[Objective] To investigate the factors associated with alanine aminotransferase (ALT) abnormalities in multi-ethnic blood donors across five Zang autonomous prefectures in the plateau regions of Qinghai Province, and to provide evidence for ensuring blood safety and formulating screening strategies. [Methods] A retrospective analysis was performed on the ALT abnormal test results of blood donors in the Zang autonomous prefectures of Qinghai from 2022 to 2024. The correlations between ALT levels and factors including gender, age, altitude, and infectious markers were investigated. [Results] The overall ALT unqualified rate among blood donors in this region was 9.01%. Significant differences in ALT levels were observed across genders and age groups (P<0.05). Variations in ALT abnormality rates were also noted among different plateau regions (P<0.05). Overall, ALT values exhibited an increasing trend with rising altitude. The average ALT unqualified rates were 11.19% in Zang donors, 7.96% in Han donors, and 4.79% in donors from other ethnic groups (P<0.05). No statistically significant association was observed between ALT abnormality and the presence of HBV/HCV infectious markers (P>0.05). [Conclusion] In the plateau areas of Qinghai, multi-ethnic blood donors have a relatively high ALT levels and ALT unqualified rates, showing distinct regional characteristics. ALT elevation in voluntary blood donors is related to non-pathological factors such as gender, age, and dietary habits, but not to infectious indicators.

With the rapid changes in lifestyle,the prevalence of nonalcoholic fatty liver disease(NAFLD)has become increasingly severe in China,and it has become a major public health concern.With a deeper understanding of this disease,the latest consensus statement has changed the name from NAFLD to MAFLD,and this updated definition transitions from an exclusion-based approach to an inclusive framework,which not only improves clinical diagnostic accuracy,but also highlights the key role of metabolic disorders in the progression of NAFLD.In recent years,the in-depth studies on the mechanism of carcinoembryonic antigen-associated cell adhesion molecule 1-mediated insulin clearance have highlighted the importance of insulin clearance in the development and progression of NAFLD.This article reviews the research advances in the role of insulin clearance in MAFLD.

Akkermansia muciniphila, a probiotic is discovered years earlier, colonizes the human intestinal mucosa. In recent years, researchers have found the correlation between Akkermansia muciniphila and progression of kidney diseases based on the theory of the gut-kidney axis. The abundance of Akkermansia muciniphila in the gut changes during the onset, regression and treatment of renal diseases such as congenital nephrology, chronic kidney disease, complications after renal transplantation. The research on the correlation between Akkermansia muciniphila and renal diseases is still in the initial stage. The review introduces the research progress on the role of Akkermansia muciniphila in renal diseases from three aspects: the biological characteristics of Akkermansia muciniphila, the abundance change in the progression of renal diseases, and their biological effects to provide references for the following research on the mechanisms of Akkermansia muciniphila in renal diseases and the application of clinical renal disease treatment.

With the rapid changes in lifestyle,the prevalence of nonalcoholic fatty liver disease(NAFLD)has become increasingly severe in China,and it has become a major public health concern.With a deeper understanding of this disease,the latest consensus statement has changed the name from NAFLD to MAFLD,and this updated definition transitions from an exclusion-based approach to an inclusive framework,which not only improves clinical diagnostic accuracy,but also highlights the key role of metabolic disorders in the progression of NAFLD.In recent years,the in-depth studies on the mechanism of carcinoembryonic antigen-associated cell adhesion molecule 1-mediated insulin clearance have highlighted the importance of insulin clearance in the development and progression of NAFLD.This article reviews the research advances in the role of insulin clearance in MAFLD.

Akkermansia muciniphila, a probiotic is discovered years earlier, colonizes the human intestinal mucosa. In recent years, researchers have found the correlation between Akkermansia muciniphila and progression of kidney diseases based on the theory of the gut-kidney axis. The abundance of Akkermansia muciniphila in the gut changes during the onset, regression and treatment of renal diseases such as congenital nephrology, chronic kidney disease, complications after renal transplantation. The research on the correlation between Akkermansia muciniphila and renal diseases is still in the initial stage. The review introduces the research progress on the role of Akkermansia muciniphila in renal diseases from three aspects: the biological characteristics of Akkermansia muciniphila, the abundance change in the progression of renal diseases, and their biological effects to provide references for the following research on the mechanisms of Akkermansia muciniphila in renal diseases and the application of clinical renal disease treatment.

ObjectiveTo explore the mechanism and pathway of Gandou Fumu decoction （GDFMD） in the development of liver fibrosis in Wilson's disease （WD）. MethodFirst， 30 TX-j mice were randomly divided into the model group， high-dose， medium-dose， and low-dose GDFMD groups， and penicillamine group， with six mice in each group， and another six wild-type mice were used as the normal group. The high-dose， medium-dose， and low-dose GDFMD groups were intragastrically administered drugs of 13.92， 6.96， 3.48 g·kg^-1. In the penicillamine group， 0.1 g·kg^-1 of penicillamine was given by intragastric administration. The model group and the normal group were given equal volume of normal saline， once a day， for four consecutive weeks. Samples were collected four weeks after gavage， and enzyme-linked immunosorbent assay （ELISA） was used to detect type Ⅲ procollagen peptide （PCⅢ）， collagen type Ⅳ （Col Ⅳ）， hyaluronic acid （HA）， and laminin （LN）. Hematoxylin-eosin （HE）， Masson， and picric acid-Sirus red collagen （Sirus Red） staining were used to observe the histopathological changes of liver fibrosis. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）， immunohistochemistry， and Western blot were used to observe the expressions of α-smooth muscle actin （α-SMA） and collagen type Ⅰ （Col Ⅰ）， which were related to the activation of hepatic stellate cells （HSCs）. The expression of miR-29b-3p was observed by Real-time PCR. The expression of Unc-51-like kinase 1 （ULK1） and its downstream-related factors were observed by Western blot. The downstream genes of miR-29b-3p were verified by the dual luciferase reporter gene detection method. ResultCompared with the normal group， the four items of liver fibrosis （PCⅢ， Col Ⅳ， HA， and LN） in the model group were significantly abnormal （P<0.01）， and the pathology was significantly abnormal. The expression of HSC activation-related indicators including α-SMA and Col Ⅰ， as well as α-SMA mRNA and Col Ⅰ mRNA was up-regulated （P<0.05， P<0.01）， and miR-29b-3p expression was down-regulated （P<0.01）. ULK1， p-ULK1， autophagy-related gene 13 （Atg13）， p-Atg13， Beclin-1， FAK family kinase-interacting protein of 200 kDa （FIP200）， activating molecule in BECN1-regulated autophagy protein 1 （AMBKA1）， and microtubule-associated protein 1 light chain 3Ⅱ/Ⅰ（LC3Ⅱ/Ⅰ） were up-regulated （P<0.05， P<0.01）. p62 protein expression was down-regulated （P<0.01）. Compared with the model group， the four items of liver fibrosis in the high-dose， medium-dose， and low-dose GDFMD groups and the penicillamine group were significantly improve （P<0.01）， and the pathological conditions were improved. The expression of HSC activation-related indicators including α-SMA and Col Ⅰ， as well as α-SMA mRNA and Col Ⅰ mRNA was down-regulated （P<0.05， P<0.01）， and the expression of miR-29b-3p was up-regulated （P<0.01）. ULK1， p-ULK1， Atg13， p-Atg13， Beclin-1， FIP200， AMBKA1， and LC3Ⅱ/Ⅰ were down-regulated （P<0.05， P<0.01）， and p62 protein expression was up-regulated （P<0.01）. The prediction software predicted that there was a binding site between miR-29b-3p and ULK1. The dual-luciferase reporter gene detection method indicated that the luciferase activity of the ULK1-WT plasmid-transfected cell group was reduced when miR-29b-3p mimics were co-cultured （P<0.01）. ConclusionGDFMD can regulate ULK1-mediated autophagy by up-regulating miR-29b-3p and further exert its anti-hepatic fibrosis effect in Wilson's disease.

Objective To investigate the effects of N-acetylcysteine(NAC)on liver tissue inflammation,pyroptosis levels,and NOD-like receptor pyrin domain-containing protein 3(NLRP3)inflammasome in rats with alcoholic liver disease(ALD).Methods Male SD rats were divided into a normal group,an ALD model group,a 100 mg·kg-1 NAC group,and a 200 mg·kg-1 NAC group.HE staining was used to observe pathological changes in liver tissue,and TUNEL method was used to detect the apoptosis rate of liver cells.Biochemical kits were used to measure serum levels of aspartate aminotransferase(AST),alanine aminotransferase(ALT),and triglyceride(TG).Normal rat hepatocytes BRL-3A were divided into a control group,a 200 mmol/L alcohol group(model group),a 2 mmol/L NAC group,and a 5 mmol/L NAC group.MTT method was used to detect the survival rate of BRL-3A cells;Western blot was used to detect the protein expression levels of cleaved caspase-1,apoptosis-associated speck-like protein containing a CARD(ASC),N-terminal gasdermin D(GSDMD-N),and NLRP3.Total superoxide dismutase(SOD)activity detection kit and malondialdehyde(MDA)kit were used to measure SOD and MDA levels.ELISA was used to detect IL-1β and IL-18 levels.Fluorometric assay were used to measure reactive oxygen species(ROS)level in liver tissue,and immunofluorescence staining was used to determine ROS level in BRL-3A cells.Results Compared with the normal group,the model group showed diffuse fatty degeneration in the liver,increased serum levels of ALT,AST and TG,elevated levels of IL-1β and IL-18 in liver tissue,increased ROS and MDA levels,and upregulated protein expression levels of cleaved caspase-1,ASC,GSDMD-N and NLRP3,while a decrease in SOD level.Compared with the model group,the NAC groups exhibited reduced fatty degeneration in the liver,decreased expression levels of pyroptosis-related proteins,reduced levels of IL-1β and IL-18,lower ROS and MDA levels,and increased SOD level.Compared with the control group,the model group of BRL-3A cells showed increased levels of IL-1β and IL-18 in the supernatant,elevated ROS and MDA levels in cells,and upregulated pyroptosis-related protein expression,while a decrease in SOD level.These indicators were reversed in the NAC group as compared to the model group.Conclusion NAC suppresses liver tissue inflammation and pyroptosis in ALD rats,possibly through blocking the NLRP3 inflammasome signaling pathway.

Objective To investigate the effects of N-acetylcysteine(NAC)on liver tissue inflammation,pyroptosis levels,and NOD-like receptor pyrin domain-containing protein 3(NLRP3)inflammasome in rats with alcoholic liver disease(ALD).Methods Male SD rats were divided into a normal group,an ALD model group,a 100 mg·kg-1 NAC group,and a 200 mg·kg-1 NAC group.HE staining was used to observe pathological changes in liver tissue,and TUNEL method was used to detect the apoptosis rate of liver cells.Biochemical kits were used to measure serum levels of aspartate aminotransferase(AST),alanine aminotransferase(ALT),and triglyceride(TG).Normal rat hepatocytes BRL-3A were divided into a control group,a 200 mmol/L alcohol group(model group),a 2 mmol/L NAC group,and a 5 mmol/L NAC group.MTT method was used to detect the survival rate of BRL-3A cells;Western blot was used to detect the protein expression levels of cleaved caspase-1,apoptosis-associated speck-like protein containing a CARD(ASC),N-terminal gasdermin D(GSDMD-N),and NLRP3.Total superoxide dismutase(SOD)activity detection kit and malondialdehyde(MDA)kit were used to measure SOD and MDA levels.ELISA was used to detect IL-1β and IL-18 levels.Fluorometric assay were used to measure reactive oxygen species(ROS)level in liver tissue,and immunofluorescence staining was used to determine ROS level in BRL-3A cells.Results Compared with the normal group,the model group showed diffuse fatty degeneration in the liver,increased serum levels of ALT,AST and TG,elevated levels of IL-1β and IL-18 in liver tissue,increased ROS and MDA levels,and upregulated protein expression levels of cleaved caspase-1,ASC,GSDMD-N and NLRP3,while a decrease in SOD level.Compared with the model group,the NAC groups exhibited reduced fatty degeneration in the liver,decreased expression levels of pyroptosis-related proteins,reduced levels of IL-1β and IL-18,lower ROS and MDA levels,and increased SOD level.Compared with the control group,the model group of BRL-3A cells showed increased levels of IL-1β and IL-18 in the supernatant,elevated ROS and MDA levels in cells,and upregulated pyroptosis-related protein expression,while a decrease in SOD level.These indicators were reversed in the NAC group as compared to the model group.Conclusion NAC suppresses liver tissue inflammation and pyroptosis in ALD rats,possibly through blocking the NLRP3 inflammasome signaling pathway.

Objective : To investigate the willingness to receive HIV testing in primary health service institutions (PHSIs) among young students in Wuhan City, so as to provide the evidence for improving the detection of HIV testing among young students. Methods: Fifteen PHSIs were sampled using a stratified random sampling method in 14 districts of Wuhan City, and school students at ages of 15 to 24 years were sampled from each district using a convenience sampling method. Participants' demographics, awareness of AIDS-related knowledge, HIV testing and willingness to receive HIV testing were collected using questionnaires, and factors affecting the willingness to receive HIV testing in PHSIs were identified among school students using a multivariable logistic regression model. Results : A total of 301 questionnaires were allocated, and 299 valid questionnaires were recovered, with an effective recovery rate of 99.34%. The respondents included 143 men (47.83%) and 156 women (52.17%), and had a mean age of (19.36±2.40) years; there were 223 respondents with an educational level of diploma and above (74.58%). The awareness of AIDS-related knowledge was 71.57% among the respondents, and 144 respondents had received AIDS-related health education in PHSIs (48.16%). There were 34 respondents that had received HIV testing (11.37%) and 203 respondents that were willing to receive HIV testing in PHSIs (67.89%). The respondents that were unwilling to receive HIV testing in PHSIs were mainly attributed to considering to be unlikely to get HIV infections (82.29%). Multivariable logistic regression analysis showed that school students who knew AIDS-related knowledge (OR=2.797, 95%CI: 1.583-4.941), knew free HIV counseling and testing services in PHSIs (OR=2.070, 95%CI: 1.123-3.814), and had received AIDS-related health education in PHSIs (OR=2.814, 95%CI: 1.573-5.032) were more willing to receive HIV testing in PHSIs. Conclusions There were 67.89% of school students that were willing to receive HIV testing in PHSIs in Wuhan City, and the willingness to receive HIV testing was correlated with the awareness of risk of HIV infections, and awareness and experience of AIDS control services in PHSIs.