With the emergence of unhealthy dietary structures in people’s life， metabolic associated fatty liver disease （MAFLD） has gradually become the most important chronic liver disease in China， and there is also a gradual increase in the cases of MAFLD-associated liver cancer. Adipose tissue not only has the function of energy storage， but also secretes adipokines that play an important role in the development and progression of MAFLD and its associated liver cancer. Studies on the mechanism of adipokines have provided important help for the prevention and treatment of MAFLD， and a large number of studies have shown that the abnormal secretion of adipokines is associated with MAFLD and plays an important regulatory role in the development and progression of liver cancer. Adipokines are not only regulated at the gene level， but they can also interact with genes through specific pathways to co-regulate pathophysiological processes such as inflammation， metabolism， immunity， and cell proliferation in MAFLD and its associated liver cancer. This article reviews the latest studies on the association of adipokines with MAFLD and its associated liver cancer， in order to provide new directions for further research on the pathogenesis of liver cancer.

ObjectiveTo explore the changes in volatile components， total polysaccharides， enzyme activity， and chromaticity value of Myristicae Semen Koji（MSK） during the fermentation process， and conduct correlation analysis. MethodsBased on gas chromatography-mass spectrometry（GC-MS）， the changes of volatile components in MSK at different fermentation times were identified. The phenol sulfuric acid method， dinitrosalicylic acid method（DNS）， and carboxymethyl cellulose sodium salt method（CMC-Na） were used to investigate the total polysaccharide content， amylase activity， and cellulase activity during the fermentation process. Visual analysis technology was used to explore the changes in chromaticity values， revealing the fermentation process of MSK and the dynamic changes of various measurement indicators， partial least squares-discriminant analysis（PLS-DA） was used to explore the differential compounds of MSK at different fermentation degrees， and Pearson correlation analysis was used to explore the correlation between volatile components of MSK and total polysaccharides， enzyme activity， and chromaticity values. ResultsA total of 60 volatile compounds were identified from MSK， the relative contents of components such as （+）-α-pinene， β-phellandrene， β-pinene， （+）-limonene， and p-cymene obviously increased， while the relative contents of components such as safrole， methyl isoeugenol， methyleugenol， myristicin， and elemicin significantly decreased. During the fermentation process， the total polysaccharide content showed an upward trend， while the activities of amylase and cellulase showed an initial increase followed by a decrease， and reached their maximum value at 40 h. the overall brightness（L^*） and total color difference（ΔE^*） gradually increased， while the changes in red-green value（a^*） and yellow-blue value（b^*） were not obvious. PLS-DA results showed that MSK could be clearly distinguished at different fermentation times， and 13 differential biomarkers were screened out. Pearson correlation analysis results showed that the contents of α-terpinene， β-phellandrene， methyleugenol， β-cubebene and myristic acid had an obvious correlation with chromaticity values. ConclusionAfter fermentation， the volatile components， total polysaccharides， amylase activity， and cellulase activity of MSK undergo significant changes， and there is a clear correlation between them and chromaticity values， which reveals the dynamic changes in the fermentation process and related indicators of MSK， laying a foundation for the quality control.

Depressive disorder is a mental illness characterized by poor mood and cognitive dysfunction caused by a range of complicated factors. Antidepressants have strong short-term efficacy in clinical application, yet with significant adverse effects and resistance in long-term use. Essential oils are small molecular compounds mainly composed of monoterpenes and sesquiterpenes, most of which are characterized by aromatic odors, easy permeability through the blood-brain barrier, and low toxic side effects. Volatile oil from traditional Chinese medicine can regulate neurotransmitter monoamine, hypothalamic-pituitary-adrenal axis, brain-derived neurotrophic factor, neuroinflammation and oxidative stress, and intestinal microbiota-gut-brain axis to exert an antidepressant effect through multiple pathways and targets. This review summarizes the main antidepressant chemical components of essential oil of traditional Chinese medicine, their pharmacological mechanisms and clinical application, aiming to provide some reference for further development and clinical application of essential oil of traditional Chinese medicine.

Objective:To analyze the molecular characteristics of the virus in a local outbreak of dengue fever in Jiangsu province in 2023, and to provide a basis for the prevention and control of the outbreak.Methods:Serum samples were collected from suspected dengue patients in the acute phase of the outbreak for virus detection and serotyping by real-time fluorescence quantitative RT-PCR (RT-qPCR). Positive specimens were amplified with full-length genomic fragments and subjected to second-generation sequencing and related evolutionary analyses.Results:Four confirmed cases of dengue were found in Changzhou city, Jiangsu province, from October 18 to 21, 2023, with epidemiological association between the cases, which was recognized as a dengue outbreak. The serum RT-qPCR result of the four cases were all dengue type 1, and the whole genome sequences of three of the cases were obtained. The evolutionary tree of the E gene and the whole genome showed that the three sequences were located in the 3rd branch of the 1-I genotype, which is similar to the genotype 1-I. The genome-wide sequences of the E gene and the genome-wide evolution tree showed that the three sequences were located in the 3rd branch of the 1-I genotype, which is similar to the genome-wide genotype 1-Ⅰ. The E gene and the genome-wide evolutionary tree showed that all three sequences were located on branch 3 of genotype 1-Ⅰ, with high sequence similarity to the dengue virus epidemic strains in Guangdong and Yunnan provinces in 2023. Amino acid variant site analysis showed that there were 16 branch-specific amino acid site changes in the sequences of the three cases, among which the structural proteins, C protein and prM protein, had one variant site each, E protein had two, and the non-structural proteins had the largest number of NS5 variant sites (9).Conclusions:The local outbreak in Jiangsu was caused by dengue fever type 1 virus, with high nucleotide sequence similarity to strains from other regions of China, and amino acid site alterations.

BACKGROUND:At present,hydroxyapatite has been used more and more widely in the field of facial fillers due to its good biocompatibility and low immunity.The main sources are divided into natural extraction and artificial synthesis.However,there are few comparative studies on natural extraction and artificial synthesis of hydroxyapatite,especially the difference in stimulating collagen secretion between the two.OBJECTIVE:To investigate the physicochemical differences between naturally derived and commercially available synthetic calcium hydroxyapatite particles and promoting collagen secretion.METHODS:(1)Natural hydroxyapatite particles from pig bones and two kinds of commercially available synthetic hydroxyapatite particles(denoted as SYN1 and SYN2)were used to characterize the microstructure and surface element content of the three kinds of materials.(2)The three kinds of materials with different mass concentrations(1,5,and 10 mg/mL)were co-cultured with human skin fibroblasts.Cell proliferation was detected by CCK-8 assay.The three kinds of materials at 5 mg/mL were co-cultured with human skin fibroblasts.Cell adhesion was observed by CCK-8 assay and scanning electron microscopy.The expression of type Ⅰ collagen was detected by RT-PCR,ELISA,and western blot assay.(3)Twelve New Zealand rabbits were selected,of which six were subcutaneously injected with a mixture of natural hydroxyapatite and 2％sodium carboxymethylcellulose gel on the back.The remaining six rabbits were subcutaneously injected with a mixture of SYN2 and 2％sodium carboxymethylcellulose gel on the back.The samples were collected 1 and 3 months after injection and stained with Masson and Sirius red.RESULTS AND CONCLUSION:(1)Scanning electron microscope showed that the crystal grains of natural hydroxyapatite particles were more regular and uniform,with holes evenly distributed between particles.The SYN1 grains were smaller and densely arranged,while the SYN2 grains were irregular.The median particle sizes of natural hydroxyapatite particles,SYN1,and SYN2 were 38,24,and 40 pm,respectively.Natural hydroxyapatite contained Mg and Zn,SYN1 did not contain Mg and Zn,and SYN2 did not contain Zn.(2)CCK-8 assay showed that 1 and 5 mg/mL of natural hydroxyapatite and SYN2 promoted the proliferation of human skin fibroblasts,while 5 and 10 mg/mL of SYN1 inhibited the proliferation of human skin fibroblasts.The number of cells adhered to the surface of natural hydroxyapatite particles was more than that of SYN1 and SYN2,and the cells on the surface of natural hydroxyapatite particles spread well,with visible filopodia.RT-PCR,ELISA,and western blot assay results showed that the expression of type Ⅰ collagen in the natural hydroxyapatite particle group was higher than that in the SYN1 group and the SYN2 group.(3)The results of Masson and Sirius red staining showed that the amount of type Ⅰ collagen in the subcutaneous tissue of the natural hydroxyapatite particle group was greater than that of the SYN2 group 1 and 3 months after injection.(4)The results show that compared with synthetic hydroxyapatite particles,natural hydroxyapatite particles have a richer distribution of trace elements and can better promote fibroblast adhesion,proliferation and collagen regeneration.

Objective:To investigate teachers' evaluation and willingness and the influencing factors regarding the adoption of the flipped classroom teaching mode in undergraduate pediatrics education.Methods:From December 2022 to December 2024, a questionnaire survey was conducted among the teachers who were responsible for teaching Child Health and Disease（Pediatrics) to the eight-year clinical medicine students at Peking University Health Science Center. Their views, evaluation, and willingness of implementing the flipped classroom teaching mode were investigated. Logistic regression analysis was performed using SPSS 26.0 software to explore the factors influencing teachers' willingness to adopt the flipped classroom teaching mode.Results:A total of 102 questionnaires were collected. Among the teachers, 20.59%（ n=21) believed that the teaching effect of the flipped classroom was better than that of the traditional class, 58.82%（ n=60) considered its effectiveness comparable, and 20.59%（ n=21) found it less effective. The most influential factors affecting the effectiveness of flipped classroom were students' self-learning with online videos [(4.39±0.73) points], student participation in the flipped classrooms [(4.26±0.72) points], the adequacy of teachers' pre-class preparation [(4.18±0.65) points], and the suitability of the teaching content for the flipped classroom [(4.11±0.76) points]. Teachers believed that the flipped classroom significantly enhanced students' autonomous learning ability [(4.11±0.63) points], clinical thinking [(4.04±0.58) points], and expression skills [(3.80±0.61) points]. Additionally, 78.43%（ n=80) of the teachers expressed willingness to continue participating in flipped classroom teaching. Factors influencing teachers' willingness to adopt the flipped classroom included gender, satisfaction with students' classroom participation, and personal experience with the effectiveness of the flipped classroom（ P<0.05). Conclusions:The flipped classroom teaching mode is well-accepted by teachers. Students' classroom participation affects teachers' willingness to continue using the flipped classroom teaching mode. In the future, the content of flipped classroom should be arranged individually according to specific teaching objectives to increase students' classroom participation and promote the cultivation of students' ability.

BACKGROUND:At present,hydroxyapatite has been used more and more widely in the field of facial fillers due to its good biocompatibility and low immunity.The main sources are divided into natural extraction and artificial synthesis.However,there are few comparative studies on natural extraction and artificial synthesis of hydroxyapatite,especially the difference in stimulating collagen secretion between the two.OBJECTIVE:To investigate the physicochemical differences between naturally derived and commercially available synthetic calcium hydroxyapatite particles and promoting collagen secretion.METHODS:(1)Natural hydroxyapatite particles from pig bones and two kinds of commercially available synthetic hydroxyapatite particles(denoted as SYN1 and SYN2)were used to characterize the microstructure and surface element content of the three kinds of materials.(2)The three kinds of materials with different mass concentrations(1,5,and 10 mg/mL)were co-cultured with human skin fibroblasts.Cell proliferation was detected by CCK-8 assay.The three kinds of materials at 5 mg/mL were co-cultured with human skin fibroblasts.Cell adhesion was observed by CCK-8 assay and scanning electron microscopy.The expression of type Ⅰ collagen was detected by RT-PCR,ELISA,and western blot assay.(3)Twelve New Zealand rabbits were selected,of which six were subcutaneously injected with a mixture of natural hydroxyapatite and 2％sodium carboxymethylcellulose gel on the back.The remaining six rabbits were subcutaneously injected with a mixture of SYN2 and 2％sodium carboxymethylcellulose gel on the back.The samples were collected 1 and 3 months after injection and stained with Masson and Sirius red.RESULTS AND CONCLUSION:(1)Scanning electron microscope showed that the crystal grains of natural hydroxyapatite particles were more regular and uniform,with holes evenly distributed between particles.The SYN1 grains were smaller and densely arranged,while the SYN2 grains were irregular.The median particle sizes of natural hydroxyapatite particles,SYN1,and SYN2 were 38,24,and 40 pm,respectively.Natural hydroxyapatite contained Mg and Zn,SYN1 did not contain Mg and Zn,and SYN2 did not contain Zn.(2)CCK-8 assay showed that 1 and 5 mg/mL of natural hydroxyapatite and SYN2 promoted the proliferation of human skin fibroblasts,while 5 and 10 mg/mL of SYN1 inhibited the proliferation of human skin fibroblasts.The number of cells adhered to the surface of natural hydroxyapatite particles was more than that of SYN1 and SYN2,and the cells on the surface of natural hydroxyapatite particles spread well,with visible filopodia.RT-PCR,ELISA,and western blot assay results showed that the expression of type Ⅰ collagen in the natural hydroxyapatite particle group was higher than that in the SYN1 group and the SYN2 group.(3)The results of Masson and Sirius red staining showed that the amount of type Ⅰ collagen in the subcutaneous tissue of the natural hydroxyapatite particle group was greater than that of the SYN2 group 1 and 3 months after injection.(4)The results show that compared with synthetic hydroxyapatite particles,natural hydroxyapatite particles have a richer distribution of trace elements and can better promote fibroblast adhesion,proliferation and collagen regeneration.

Objective:To investigate teachers' evaluation and willingness and the influencing factors regarding the adoption of the flipped classroom teaching mode in undergraduate pediatrics education.Methods:From December 2022 to December 2024, a questionnaire survey was conducted among the teachers who were responsible for teaching Child Health and Disease（Pediatrics) to the eight-year clinical medicine students at Peking University Health Science Center. Their views, evaluation, and willingness of implementing the flipped classroom teaching mode were investigated. Logistic regression analysis was performed using SPSS 26.0 software to explore the factors influencing teachers' willingness to adopt the flipped classroom teaching mode.Results:A total of 102 questionnaires were collected. Among the teachers, 20.59%（ n=21) believed that the teaching effect of the flipped classroom was better than that of the traditional class, 58.82%（ n=60) considered its effectiveness comparable, and 20.59%（ n=21) found it less effective. The most influential factors affecting the effectiveness of flipped classroom were students' self-learning with online videos [(4.39±0.73) points], student participation in the flipped classrooms [(4.26±0.72) points], the adequacy of teachers' pre-class preparation [(4.18±0.65) points], and the suitability of the teaching content for the flipped classroom [(4.11±0.76) points]. Teachers believed that the flipped classroom significantly enhanced students' autonomous learning ability [(4.11±0.63) points], clinical thinking [(4.04±0.58) points], and expression skills [(3.80±0.61) points]. Additionally, 78.43%（ n=80) of the teachers expressed willingness to continue participating in flipped classroom teaching. Factors influencing teachers' willingness to adopt the flipped classroom included gender, satisfaction with students' classroom participation, and personal experience with the effectiveness of the flipped classroom（ P<0.05). Conclusions:The flipped classroom teaching mode is well-accepted by teachers. Students' classroom participation affects teachers' willingness to continue using the flipped classroom teaching mode. In the future, the content of flipped classroom should be arranged individually according to specific teaching objectives to increase students' classroom participation and promote the cultivation of students' ability.

Objective:To analyze the molecular characteristics of the virus in a local outbreak of dengue fever in Jiangsu province in 2023, and to provide a basis for the prevention and control of the outbreak.Methods:Serum samples were collected from suspected dengue patients in the acute phase of the outbreak for virus detection and serotyping by real-time fluorescence quantitative RT-PCR (RT-qPCR). Positive specimens were amplified with full-length genomic fragments and subjected to second-generation sequencing and related evolutionary analyses.Results:Four confirmed cases of dengue were found in Changzhou city, Jiangsu province, from October 18 to 21, 2023, with epidemiological association between the cases, which was recognized as a dengue outbreak. The serum RT-qPCR result of the four cases were all dengue type 1, and the whole genome sequences of three of the cases were obtained. The evolutionary tree of the E gene and the whole genome showed that the three sequences were located in the 3rd branch of the 1-I genotype, which is similar to the genotype 1-I. The genome-wide sequences of the E gene and the genome-wide evolution tree showed that the three sequences were located in the 3rd branch of the 1-I genotype, which is similar to the genome-wide genotype 1-Ⅰ. The E gene and the genome-wide evolutionary tree showed that all three sequences were located on branch 3 of genotype 1-Ⅰ, with high sequence similarity to the dengue virus epidemic strains in Guangdong and Yunnan provinces in 2023. Amino acid variant site analysis showed that there were 16 branch-specific amino acid site changes in the sequences of the three cases, among which the structural proteins, C protein and prM protein, had one variant site each, E protein had two, and the non-structural proteins had the largest number of NS5 variant sites (9).Conclusions:The local outbreak in Jiangsu was caused by dengue fever type 1 virus, with high nucleotide sequence similarity to strains from other regions of China, and amino acid site alterations.

Objective:To investigate whether there are differences in disease outcomes among patients with Crohn′s disease (CD) L4 subtype.Methods:A total of 488 CD patients who were initially diagnosed at the Quzhou People′s Hospital and the Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine from January 2017 to December 2019 were collected. They were divided into L4a, L4b, and non-L4 groups based on disease site classification, and the differences in intestinal complications and first abdominal surgery rates among the three groups were compared.Results:Among the 488 CD patients included in the study, 196(40.2%) were classified as L4 type, with L4b type being the predominant type (28.3%, 138/488). By confirming the time-dependent receiver operating characteristic (ROC) curve, the disease site can predict the surgical rate during follow-up of CD patients. Compared with non-L4 patients, L4b patients had a higher follow-up surgery rate [59.4%(76/128) vs 27.4%(80/292), P<0.001], while L4a patients had a lower rate [10.3%(6/58) vs 27.4%(80/292), P=0.009 6]. At the same time, the recurrence rate of intestinal obstruction in L4b patients during follow-up was significantly higher than that in L4a and non-L4 patients [46.9%(60/128) vs 6.9%(4/58), P<0.001; 46.9%(60/128) vs 11.6%(34/292), P=0.007]. The use of biologics can reduce the surgery rate in L4b patients ( HR: 1.93, 95% CI: 1.03-3.63, P=0.040 6). Conclusions:The incidence rate of L4b is high in newly diagnosed CD patients, and L4b is a high risk factor for poor prognosis of CD, so early use of biological agents is recommended. Accurate classification of disease sites can guide individualized clinical treatment.