Background Silicosis is a fatal form of pulmonary fibrosis caused by the inhalation of silica dust. Although the underlying pathogenesis remains unclear, and the macrophage-mediated immune response plays a central role in its development. Objective To investigate the expression, functional role, and upstream regulatory mechanism of C-C motif chemokine ligand 22 (CCL22) in silica-induced pulmonary fibrosis. Methods Through bioinformatics analysis, we identified CCL22 as a potential key factor in pulmonary fibrosis. We established in vitro models by stimulating human monocytic leukemia cells (THP-1) and peripheral blood mononuclear cell-derived macrophages (PBMC-m) with crystalline silica (CS). The regulation of CCL22 expression by CS was validated using quantitative real-time polymerase chain reaction (qRT-PCR) and enzyme-linked immunosorbent assay (ELISA). Subsequently, a conditioned co-culture system comprising macrophages and lung epithelial cells (BEAS-2B) was developed to evaluate the effects of CCL22 on lung epithelial cell function. Furthermore, the molecular mechanisms underlying CS-induced CCL22 secretion by macrophages were investigated using bioinformatics analysis, Western blot, specific inhibitors, qRT-PCR, and ELISA. Results Bioinformatics analysis identified CCL22 as a key upregulated molecule in pulmonary fibrosis. In vitro experiments confirmed that CS treatment significantly enhanced CCL22 mRNA transcription and protein secretion in THP-1 and PBMC-m cells (P<0. 0001). In the co-culture system, supernatant from CS-stimulated macrophages with stable CCL22 knockdown significantly inhibited the scratch-healing ability and fibrotic process of BEAS-2B cells, and reversed the epithelial-mesenchymal transition (EMT) phenotype compared to the control group. Mechanism studies found that, compared to other transcription factors such as signal transducer and activator of transcription 3 (STAT3) and nuclear factor-κB (NF-κB), the inhibition of of specific protein 1 (SP1) most significantly attenuated the CS-induced upregulation of CCL22. Furthermore, pathway inhibition experiments demonstrated that inhibiting extracellular signal-regulated kinase (ERK) reduced both CCL22 expression and p-SP1. Conversely, SP1 intervention did not affect ERK activation. Conclusion CS promotes CCL22 secretion by macrophages through the Raf/ERK-Sp1 signaling pathway, thereby driving fibrotic changes in pulmonary epithelial cells.

Primary osteoporosis （POP） is a metabolic bone disease characterized by reduced bone mass， degenerated bone microstructure， and increased bone fragility. Its pathogenesis involves the interaction of multiple factors such as genetics， aging， endocrine， and environment， which remain incompletely elucidated. Mitochondrial dysfunction can lead to insufficient adenosine triphosphate （ATP） production and abnormal accumulation of reactive oxygen species （ROS）， activating oxidative stress and inflammation pathways， thereby inhibiting osteoblast differentiation and promoting osteoclast activation， exacerbating the negative bone metabolism balance in POP. Mitochondrial autophagy， as the core mechanism of mitochondrial quality control， selectively identifies and clears damaged mitochondria to effectively reduce ROS accumulation and energy metabolism disorders， thus maintaining the balance between osteoblast and osteoclast differentiation. It plays a critical role in maintaining bone homeostasis and the prevention and treatment of POP. The traditional Chinese medicine （TCM） theory of Qi transformation shares similarities with the functions of mitochondria in energy generation and substance conversion. The pathological state of Qi deficiency and stagnation may be associated with mitochondrial autophagy dysfunction， and the pathogenic characteristics of combined phlegm and stasis align with the metabolic waste accumulation induced by obstructed autophagy flow. This article explores the correlation of the theory of Qi deficiency and stagnation with mitochondrial autophagy and elucidates its potential role in the pathogenesis of POP. Additionally， considering the pathogenesis features of POP， which involve deficiency causing stagnation and a mixture of deficiency and excess， this article proposes a novel therapeutic approach： tonifying Qi to support the body and unblocking collaterals to resolve stagnation from the perspective of mitochondrial autophagy. This article aims to provide theoretical support and research insights for further exploration of TCM in the prevention and treatment of POP.

Primary osteoporosis （POP） is a metabolic bone disease characterized by reduced bone mass， degenerated bone microstructure， and increased bone fragility. Its pathogenesis involves the interaction of multiple factors such as genetics， aging， endocrine， and environment， which remain incompletely elucidated. Mitochondrial dysfunction can lead to insufficient adenosine triphosphate （ATP） production and abnormal accumulation of reactive oxygen species （ROS）， activating oxidative stress and inflammation pathways， thereby inhibiting osteoblast differentiation and promoting osteoclast activation， exacerbating the negative bone metabolism balance in POP. Mitochondrial autophagy， as the core mechanism of mitochondrial quality control， selectively identifies and clears damaged mitochondria to effectively reduce ROS accumulation and energy metabolism disorders， thus maintaining the balance between osteoblast and osteoclast differentiation. It plays a critical role in maintaining bone homeostasis and the prevention and treatment of POP. The traditional Chinese medicine （TCM） theory of Qi transformation shares similarities with the functions of mitochondria in energy generation and substance conversion. The pathological state of Qi deficiency and stagnation may be associated with mitochondrial autophagy dysfunction， and the pathogenic characteristics of combined phlegm and stasis align with the metabolic waste accumulation induced by obstructed autophagy flow. This article explores the correlation of the theory of Qi deficiency and stagnation with mitochondrial autophagy and elucidates its potential role in the pathogenesis of POP. Additionally， considering the pathogenesis features of POP， which involve deficiency causing stagnation and a mixture of deficiency and excess， this article proposes a novel therapeutic approach： tonifying Qi to support the body and unblocking collaterals to resolve stagnation from the perspective of mitochondrial autophagy. This article aims to provide theoretical support and research insights for further exploration of TCM in the prevention and treatment of POP.

Objective This study aims to investigate the expression, phenotypic changes, and mechanisms of action of guanylate-binding protein 2 (GBP2) in the process of silica-induced pulmonary fibrosis. Methods The expression and localization of GBP2 in silicotic lung tissue were detected by immunohistochemical staining and immunofluorescence. An in vitro cell model was constructed, and methods such as Western blot and real-time quantitative reverse transcription polymerasechain reaction were utilized to investigate the function of GBP2 in different cell lines following silica stimulation. The mechanism of action of GBP2 in various cell lines was elucidated using Western blot analysis. Results GBP2 was highly expressed in the lung tissue of patients with silicosis. Immunohistochemical staining and immunofluorescence have revealed that GBP2 was localized in macrophages and epithelial cells. In vitro cell experiments demonstrated that silicon dioxide stimulated THP-1 cells to activate the c-Jun pathway through GBP2, promoting the secretion of inflammatory factors and facilitating the occurrence of M2 macrophage polarization. In epithelial cells, GBP2 promoted the occurrence of epithelial to mesenchymal transition (EMT) by upregulating Krueppel-like factor 8 (KLF8). Conclusion GBP2 not only activates c-Jun in macrophages to promote the production of inflammatory factors and the occurrence of M2 macrophage polarization, but also activates the transcription factor KLF8 in epithelial cells to induce EMT, collectively promoting the progression of silicosis.
Humans ; Silicosis/genetics* ; Macrophages/cytology* ; Epithelial Cells/pathology* ; GTP-Binding Proteins/physiology* ; Epithelial-Mesenchymal Transition ; Disease Progression ; Cell Line ; Male

Objective:To verify the clinical efficacy of using radial extracorporeal shock wave therapy(rESWT)with a combination of low-to-moderate energy flow density(EFD)in the treatment of erectile dysfunction(ED).Method:Thirty-six patients with ED were randomly divided into two groups,with 18 patients in each group.The rESWT group received 16 sessions of rESWT(twice weekly for 8 weeks),while the control group took oral tadalafil 5 mg once daily for 8 weeks.The 5-item International Index of Erectile Function(IIEF-5)and Erection Hardness Score(EHS)were evaluated before treatment,at 1 month and 2 months during treatment,and at 1 month,3 months,and 6 months after the completion of treatment.Result:The overall comparison of IIEF-5 and EHS scores between the rESWT group and the control group at various time points showed significant differences(P<0.001).For the rESWT group,the IIEF-5 score after 1 month of treatment was significantly higher than that before treatment(P<0.001)but lower than that of the control group(P<0.05).After 2 months,it was significantly higher than at 1 month(P<0.001)with no differ-ence compared to the control group(P>0.05).There were no significant differences were observed at the 1-month and 3-month follow-ups compared to the 2-month treatment(P>0.05).At 3 months of follow-up,the score was higher than that of the control group(P<0.05).At 6 months of follow-up,the score was higher than that before treatment(P<0.05).For the control group,the IIEF-5 score,there were no differences be-tween 1 and 2 months of treatment(P>0.05),but both were significantly higher than before treatment(P<0.001).At 1 month of follow-up,the score was lower than at 2 months of treatment(P<0.01).There was no difference in EHS between the rESWT group and the control group(P>0.05),but the rESWT group was treat-ed for 2 months and followed up for 1 month,which was higher than that before treatment(P<0.05).Conclusion:The combined use of low-to-moderate EFD rESWT can achieve the same efficacy comparable to Tadalafil in ED treatment and demonstrates superior durability of response,indicating its broader clinical appli-cation.

This article delves into the importance and urgency of improving the quality of big data on dietary nutrition and chronic diseases within the disease control system. With the continuous rise in the incidence of chronic diseases, enhancing the quality of relevant data has become crucial in addressing public health challenges. The article proposes a series of concrete measures to improve the accuracy, completeness, and usability of the data, drawing on theoretical and technical support. By strengthening data collection, management, analysis, and application, the goal is to establish a high-quality big data system for dietary nutrition and chronic diseases. This will provide solid data support and scientific evidence for formulating targeted prevention and control strategies, supporting policy development, promoting scientific research innovation, and improving public health standards.

Objective:To verify the clinical efficacy of using radial extracorporeal shock wave therapy(rESWT)with a combination of low-to-moderate energy flow density(EFD)in the treatment of erectile dysfunction(ED).Method:Thirty-six patients with ED were randomly divided into two groups,with 18 patients in each group.The rESWT group received 16 sessions of rESWT(twice weekly for 8 weeks),while the control group took oral tadalafil 5 mg once daily for 8 weeks.The 5-item International Index of Erectile Function(IIEF-5)and Erection Hardness Score(EHS)were evaluated before treatment,at 1 month and 2 months during treatment,and at 1 month,3 months,and 6 months after the completion of treatment.Result:The overall comparison of IIEF-5 and EHS scores between the rESWT group and the control group at various time points showed significant differences(P<0.001).For the rESWT group,the IIEF-5 score after 1 month of treatment was significantly higher than that before treatment(P<0.001)but lower than that of the control group(P<0.05).After 2 months,it was significantly higher than at 1 month(P<0.001)with no differ-ence compared to the control group(P>0.05).There were no significant differences were observed at the 1-month and 3-month follow-ups compared to the 2-month treatment(P>0.05).At 3 months of follow-up,the score was higher than that of the control group(P<0.05).At 6 months of follow-up,the score was higher than that before treatment(P<0.05).For the control group,the IIEF-5 score,there were no differences be-tween 1 and 2 months of treatment(P>0.05),but both were significantly higher than before treatment(P<0.001).At 1 month of follow-up,the score was lower than at 2 months of treatment(P<0.01).There was no difference in EHS between the rESWT group and the control group(P>0.05),but the rESWT group was treat-ed for 2 months and followed up for 1 month,which was higher than that before treatment(P<0.05).Conclusion:The combined use of low-to-moderate EFD rESWT can achieve the same efficacy comparable to Tadalafil in ED treatment and demonstrates superior durability of response,indicating its broader clinical appli-cation.

This article delves into the importance and urgency of improving the quality of big data on dietary nutrition and chronic diseases within the disease control system. With the continuous rise in the incidence of chronic diseases, enhancing the quality of relevant data has become crucial in addressing public health challenges. The article proposes a series of concrete measures to improve the accuracy, completeness, and usability of the data, drawing on theoretical and technical support. By strengthening data collection, management, analysis, and application, the goal is to establish a high-quality big data system for dietary nutrition and chronic diseases. This will provide solid data support and scientific evidence for formulating targeted prevention and control strategies, supporting policy development, promoting scientific research innovation, and improving public health standards.

Disorders of gastrointestinal motility (DGIM) are very common diseases in the department of gastroenterology and the prevalence is increasing gradually. The pathogenesis of DGIM is complex and closely related to Cajal interstitial cells of gastrointestinal tract, brain-intestinal axis and intestinal microecology. So far, a variety of diagnostic techniques have emerged, including esophageal 24 h pH monitoring and impedance analysis, electrogastrography, radionuclide scanning, ultrasound, 13C gastric emptying breath test, hydrogen breath test, defecation contrast, X-ray marker method, high resolution manometry and wireless motility capsules. According to the different pathogenesis of DGIM, treatment methods emerge in an endless stream, such as adjustment of lifestyle, drugs and surgical treatment and so on. Individual treatment should be provided clinically for different patients.

Objective:To investigate the epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with maintenance hemodialysis (MHD) in Jiangsu province during SARS-CoV-2 pandemic in China from December 7, 2022 to January 27, 2023, and to analyze the influencing factors of all-cause death.Methods:It was a multi-center cross-sectional investigation. Structured questionnaire was used to collect patient information by medical staff of each hemodialysis center (room) as investigators. Part of the demography data and laboratory examination data came from the Jiangsu Province Hemodialysis Data Information System. MHD patients from hemodialysis centers (rooms) at all levels of medical institutions and independent hemodialysis institutions in Jiangsu province during the outbreak of SARS-CoV-2 infection were included, and the clinical characteristics and all-cause mortality of confirmed and suspected cases of SARS-CoV-2 infection were analyzed.Results:Questionnaire surveys and data analysis on 57 278 patients in 407 hemodialysis centers (rooms) were completed, accounting for 90.41% of the total number of MHD patients (63 357 cases) in Jiangsu province during the same period. There were 24 038 cases (41.97%) of SARS-CoV-2 infection and 14 805 cases (25.85%) of suspected infection, which were widely distributed in all dialysis centers in Jiangsu province. After clinical classification of 38 843 confirmed and suspected SARS-CoV-2 infection cases, 3 662 cases were severe and critical cases, accounting for 9.43% of the infected and suspected cases. Among the patients who had completed the questionnaires, there were 1 812 all-cause deaths, with an all-cause mortality rate of 3.16%. Multivariate logistic regression analysis showed that elderly (taking ≤50 years as a reference, 51-59 years: OR=1.583, 95% CI 1.279-1.933, P=0.001; 60-69 years: OR=3.972, 95% CI 3.271-4.858, P<0.001; 70-79 years: OR=7.236, 95% CI 5.917-8.698, P<0.001; ≥80 years: OR=11.738, 95% CI 9.459-14.663, P<0.001), male ( OR=1.371, 95% CI 1.229-1.529, P<0.001), and co-infection with hepatitis B virus (HBV) (positive serum HBV surface antigen, OR=0.629, 95% CI 0.484-0.817, P<0.001) were independent influencing factors for all cause mortality. Receiver-operating characteristic curve analysis showed that the area under the curve for male, age and current HBV infection prediction of all-cause death was 0.529 ( P<0.001), 0.724 ( P<0.001) and 0.514 ( P=0.042), respectively, and the cut-off value for age prediction of all-cause death was 65.5 years old. Compared with patients without HBV infection, MHD patients with HBV infection significantly reduced the proportion of severe and critically ill patients, all-cause hospitalizations and all cause deaths when infected with SARS-CoV-2 (4.99% vs. 6.41%, χ2=6.136, P=0.013; 8.90% vs. 11.44%, χ2=11.662, P<0.001; 2.01% vs. 3.37%, χ2=10.713, P=0.001, respectively). Conclusion:The MHD patients in Jiangsu province are susceptible to SARS-CoV-2. Elderly age and male gender are independent risk factors for death in MHD patients during the epidemic, while the HBV infection may be a protective factor for death of MHD patients infected with SARS-CoV-2.