Non-alcoholic fatty liver disease (NAFLD), including non-alcoholic fatty liver (NAFL), non-alcoholic steatohepatitis (NASH), and advanced fibrosis, is a leading cause of chronic liver disease worldwide, progressing to cirrhosis and ultimately hepatocellular carcinoma (HCC). Excessive accumulation of fatty acids in the liver triggers multiple forms of hepatocyte death and exacerbates NAFLD progression, with pyroptosis and apoptosis considered key events. Recent studies show that cysteine aspartic acid specific protease-3 (caspase-3) is a central regulator of both pyroptosis and apoptosis in NAFLD. Activated caspase-3 not only directly induces apoptosis but also cleaves the N-terminal domain of gasdermin E (GSDME), disrupts cell membranes, releases inflammatory factors, and thereby mediates pyroptosis. Inhibiting caspase-3 expression in NAFLD can alleviate hepatocyte injury (such as ballooning degeneration), dampen pro-inflammatory signaling, and reduce apoptosis. Caspase-3 acts as a key node coordinating pyroptosis and apoptosis and may serve as a novel therapeutic target for the prevention and treatment of NAFLD.
Non-alcoholic Fatty Liver Disease/metabolism* ; Humans ; Pyroptosis/physiology* ; Apoptosis/physiology* ; Caspase 3/physiology* ; Animals ; Gasdermins

ObjectiveTo improve the quality and service performance of community visual health services in Shanghai, and to establish a set of reasonable and effective evaluation index system for community visual health services. MethodsCentered on the national and Shanghai-based visual health policies and based on the current status and development trends of community visual health service program in Shanghai, the candidate indicators were formed through literature review and expert interviews, firstly. The framework of an evaluation index system was formulated through qualitative research successively, which was further revised and perfected using the Delphi method. Coefficient weights were calculated using the analytic hierarchy process (AHP), culminating in the establishment of the community visual health evaluation index system, lastly. ResultsA total of 22 visual health experts from district-level center for disease control, hospital ophthalmology and leaders in charging of visual health service in community health centers participated in the Delphi questionnaire survey, with a questionnaire recovery rate of 100% and an expert authority coefficient of 0.86, indicating high credibility. After a round of correspondence to experts’ importance ratings and discussions, a comprehensive evaluation index system comprising 3 primary indicators, 12 secondary indicators, and 47 tertiary indicators, along with 5 additional indicators, was finalized. ConclusionAn index system tailored to effective evaluation for community visual health initiatives was drawn up in this study, which can promote the capacity building in community eye health services, facilitating the high-quality development of visual health courses, and enhancing residents’ eye health.

ObjectiveTo investigate the prevalence of cardiovascular diseases and their influencing factors in community-based schizophrenia patients in Shanghai, and to provide a scientific basis for the early identification and prevention of cardiovascular disease in this population. MethodsBased on the Shanghai community cohort with severe mental disorders in 2022, a total of 3 954 community-based schizophrenia patients were identified and included in this study through a stratified cluster sampling method. Basic information and relevant clinical data (including metabolic index data) were collected through questionnaire survey, physical examination and laboratory testing. Univariate analyses were performed using the chi-square tests, and multivariate logistic regression analyses were employed to identify influencing factors of comorbid cardiovascular diseases. ResultsA total of 3 954 community-based schizophrenia patients were included, of which a total of 1 237 (31.28%) patients had comorbid cardiovascular diseases. Multivariate logistic regression analyses showed that age 60 years old or above (OR=5.524, 95%CI: 3.716‒8.214), smoking behavior (OR=1.328, 95%CI: 1.042‒1.692), overweight (OR=1.900, 95%CI: 1.046‒3.451) or obesity (OR=2.678, 95%CI: 1.439‒4.985), elevated blood pressure (OR=1.546, 95%CI: 1.294‒1.846), abnormal fasting blood glucose (OR=1.552, 95%CI: 1.322‒1.823) and high-density lipoprotein cholesterol abnormalities (OR=1.283, 95%CI: 1.025‒1.606) were positively associated with the risk of comorbid cardiovascular diseases in patients with schizophrenia, while educational attainment of college/bachelor’s degree or above (OR=0.640, 95%CI: 0.450‒0.910) and being unmarried (OR=0.552, 95%CI: 0.457‒0.667) were negatively associated with the risk of cardiovascular diseases comorbidity. ConclusionAdvanced age, unhealthy behaviors and lifestyles, as well as abnormalities in blood pressure, blood glucose, and blood lipids, could all increase the risk of comorbid cardiovascular diseases in community schizophrenia patients. It is suggested to strengthen the monitoring and management of these risk factors in this population in the future, so as to achieve early detection, early diagnosis and early intervention of cardiovascular diseases.

In the field of dental aesthetics,digital aesthetic design plays a crucial role in helping dentists to predict treatment outcomes vis-ually,as well as in enhancing the consistency of knowledge and understanding of aesthetic goals between dentists and patients.It serves as the foundation for achieving ideal aesthetic effects.However,there is no clear standard for this digital process currently in China and abroad.Many dentists lack of systematic understanding of how to carry out digital aesthetic design for treatment.To establish standardized processes for dental aesthetic design and to improve the homogeneity of treatment outcomes,Chinese Society of Digital Dental Industry(CSD-DI)convened domestic experts in related field to compile this consensus.This article elaborates on the key aspects of digital aesthetic data collection,integration steps,and the digital aesthetic design process.It also formulates a decision tree for dental aesthetics at macro level and outlines corresponding workflows for various clinical scenarios,serving as a reference for clinicians.

Objective To develop a pulmonary rehabilitation training system based on scenario simulation for children with bronchiolitis obliterans,and to explore its application effect.Methods A pulmonary rehabilitation training program for children with bronchiolitis obliterans was constructed,and on the basis of this program,a pul-monary rehabilitation training system based on scenario simulation was developed for children with bronchiolitis obliterans,with real-time monitoring of relevant data.44 children with bronchiolitis obliterans who were hospitalized in the Department of Respiratory Medicine of a tertiary A children's specialized hospital in Hunan Province from January to December 2022 were selected by convenience sampling method,and the subjects were divided into an experimental group and a control group with 22 cases in each group.The experimental group adopted a pulmonary rehabilitation training program based on scenario simulation,and the control group implemented pulmonary rehabili-tation through nurse demonstration and guidance.At pre-intervention,4 weeks,and 12 weeks of intervention,the 2 groups were compared in terms of clinical symptom severity,pulmonary function,adherence to pulmonary rehabilita-tion,and the occurrence of pulmonary rehabilitation-related adverse events.Results There were no shedding cases in the experimental group and a case in the control group,and 22 cases were finally included in the experimental group and 21 cases in the control group.The results of repeated measures ANOVA showed that the comparison of clinical symptom severity and pulmonary function between the 2 groups at different time points was statistically sig-nificant in terms of time,between groups and interaction(P＜0.05).Simple effect analysis showed that after 4 and 12 weeks of intervention,the severity of clinical symptoms in the experimental group was lighter than that in the control group,and the difference was statistically significant(P＜0.001).At 12 weeks of intervention,pulmonary func-tion indexes,such as exertional expiratory volume in the first second,exertional lung volume,and maximum expiratory flow rate,were higher in the experimental group than those in the control group,and the difference was statistically significant(P＜0.001).At 4 and 12 weeks of intervention,the compliance of pulmonary rehabilitation in the experi-mental group was higher than that of the control group,and the difference was statistically significant(P＜0.05).At 12 weeks of intervention,the occurrence of adverse events related to pulmonary rehabilitation in the experimental group was less than that in the control group,and the difference was statistically significant(P=0.026).Conclusion The use of a scenario simulation-based pulmonary rehabilitation training system for children with bronchiolitis obliterans can effectively alleviate the clinical symptoms of children,improve their pulmonary function,increase compliance,and reduce the occurrence of pulmonary rehabilitation-related adverse events.

Objective:To investigate the prevalence of frailty among elders aged ≥60 years in the Beijing community and analyze the risk factors of frailty.Methods:This is a cross-sectional study. A total of 1936 older persons in Baizhifang Community in Beijing were included between May and September 2023. Their frailty was evaluated by Fried Frailty Phenotype Scale. Mini Nutritional Assessment-Short Form (MNA-SF), Short Physical Performance Battery (SPPB), and Geriatric Depression Scale (GDS) were used to evaluate nutritional status, physical function, and depression, respectively. The prevalence and risk factors of frailty among the elderly in the community were analyzed.Results:A total of 168 individuals met the criteria for frailty, and the prevalence of frailty was 8.7%. Compared to the non-frail group, the frail group was predominantly female (71.4% vs 62.2%; χ 2=5.59, P=0.018), older [(72.1±6.6) vs (69.9±6.0) ages; t=-5.25, P<0.001], unmarried (1.8% vs 0.8%; χ 2=8.60, P=0.014), with lower education levels (10.7% vs 3.5%; χ 2=23.38, P<0.001), poorer self-assessed health (22.6% vs 6.5%; χ 2=69.80, P<0.001), lower MNA-SF scores [(12.2±2.2) vs (13.0±1.4) scores; t=6.29, P<0.001], lower SPPB scores [(8.4±1.9) vs (10.2±1.6) scores; t=14.62, P<0.001], higher GDS scores [(4.0±3.8) vs (1.9±2.1) scores; t=-11.48, P<0.001], and worse vision, hearing, and olfactory functions (48.2% vs 34.1%, 36.9% vs 23.0%, 9.5% vs 3.0%; χ 2=13.37, 16.11, 40.58, all P<0.001). They were also more likely to suffer from hypertension (70.8% vs 56.7%; χ 2=12.52, P<0.001), diabetes (42.3% vs 29.4%; χ 2=12.06, P<0.001), osteoarthritis (46.4% vs 30.3%; χ 2=18.39, P<0.001) and stroke (19.0% vs 13.3%; χ 2=4.28, P=0.039). Logistic regression analysis showed that frailty was independently associated with nutritional status ( OR=0.8, 95% CI: 0.7-0.9, P<0.001), depressive symptoms ( OR=1.1, 95% CI: 1.1-1.2, P<0.001), olfactory function ( OR=2.1, 95% CI: 1.4-3.0, P<0.001; OR=2.9, 95% CI: 1.4-5.9, P=0.003), and physical function ( OR=0.6, 95% CI: 0.6-0.7, P<0.001) after adjusting for covariates. Conclusions:The prevalence of frailty among elderly people in community is relatively high. Frailty in community elders is associated with physical function, psychological function, nutritional status, and olfactory function decline.

Objective:To analyze mobility limitation condition and its relationship with cognitive function in community-dwelling elderly.Methods:In this cross-sectional study, a total of 1 935 older adults aged≥60 years were recruited from May to September 2023 in Beijing Baizhifang Community Health Service Center and its five subordinate health service stations (Baizhifang Hutong health service station, Nancaiyuan community health service station, Youanmen community health service station, Younei West Street health service station and Shuanghuaili community health service station). The Short Physical Performance Battery (SPPB) was used to assess the mobility capacity of the elderly, and the elderly were divided into two groups with SPPB, the elderly with a SPPB≤9 points were grouped into mobility limitation group (645 cases), and the ones with a SPPB≥10 points were considered with normal mobility capacity (1 290 cases). The cognitive function of the older adults was assessed with the mini-mental state examination; and the gender, age, calf circumference, history of chronic disease, frailty status, cognitive function, nutritional status, depression status, hearing and vision condition of the two groups were compared with χ2 test or Mann-Whitney U non-parametric test. Multiple logistic regression analysis was used to analyze the mobility limitation and its relationship with cognitive function in the older adults. Results:Mobility limitation was found in 33.33% (645/1 935) of community-dwelling older adults. The proportions of advanced age, female, hypertension, diabetes, coronary heart disease, stroke, chronic obstructive pulmonary disease, frailty, depression, cognitive impairment, hearing decline, and vision decline in the mobility limitation group were all significantly higher than those in the normal mobility capacity group (31.32% vs 13.41%, 69.92% vs 59.61%, 65.27% vs 54.03%, 33.80% vs 28.60%, 27.91% vs 19.53%, 17.83% vs 11.47%, 10.54% vs 7.36%, 13.18% vs 2.02%, 18.45% vs 6.59%, 14.73% vs 7.75%, 30.54% vs 20.31%, 45.58% vs 30.39%) (all P<0.05). Advanced age ( OR=2.542, 95% CI: 1.977-3.269), female ( OR=1.736, 95% CI: 1.390-2.167), stroke ( OR=1.426, 95% CI: 1.065-1.911), depression ( OR=2.292, 95% CI: 1.656-3.174), cognitive impairment ( OR=1.601, 95% CI: 1.154-2.220), frailty ( OR=5.199, 95% CI: 3.219-8.397) and vision decline ( OR=1.405, 95% CI: 1.124-1.756) were all positively correlated with the mobility limitation in the community-dwelling older adults (all P<0.05). Conclusion:The older adults in the community have a higher risk of mobility limitation, mobility limitation is a positive correlation factor of cognitive impairment.

Objective:To discuss the protective effect of sodium butyrate(NaB)on acute liver injury in the mice induced by lipopolysaccharide(LPS)combined with D-galactosamine(D-Gal),and to clarify its mechanism.Methods:Thirty male Kunming mice were randomly divided into control group,model group,and NaB group,and there were 10 mice in each group.The mice in NaB group were given 200 mg·kg-1·d-1 NaB,while the mice in control group and model group were given an equal volume of sterile water.The mice in model group and NaB group were intraperitoneally injected with 20 μg·kg-1 LPS and 600 mg·kg-1 D-Gal to induce the acute liver injury models.The body weights and liver weights of the mice in various groups were detcted,and the liver index was calculated.HE staining was used to observe the pathomorphology of liver tissue of the mice in various groups;kits were used to detect the activities of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)in serum,and the activities of total superoxide dismutase(T-SOD)and catalase(CAT),and the levels of malondialdehyde(MDA)in liver tissue of the mice in various groups;Western blotting method was used to detect the expression levels of nuclear factor E2-related factor 2(Nrf2)and heme oxygenase-1(HO-1)proteins in liver tissue of the mice in various groups.Results:There were no significant differences in body weights of the mice among various groups(P>0.05).Compared with control group,the liver index of the mice in model group was significantly increased(P<0.01).Compared with model group,the liver index of the mice in NaB group was significantly decreased(P<0.01).The HE staining results showed that the liver tissue of the mice in control group exhibited normal structure,with clear boundaries of hepatocytes,consistent size,radially arranged around the central vein,and the nucleus located in the center of the cells;in model group,the arrangement of hepatocytes was disordered,the cells were swollen,there were multiple foci of hepatocellular necrosis,inflammatory cell infiltration,and hemorrhage;compared with model group,the cells in NaB group showed improved hepatocellular structure and reduced inflammatory infiltration.Compared with control group,the activities of ALT and AST in serum of the mice in model group were significantly increased(P<0.01);compared with model group,the activities of ALT and AST in serum of the mice in NaB group were significantly decreased(P<0.05 or P<0.01).Compared with control group,the activities of T-SOD and CAT in liver tissue of the mice in model group were significantly decreased(P<0.01),and the level of MDA was significantly increased(P<0.01);compared with model group,the activities of T-SOD and CAT in liver tissue of the mice in NaB group were significantly increased(P<0.05 or P<0.01),and the level of MDA was significantly decreased(P<0.01).The Western blotting results showed that compared with control group,the expression levels of Nrf2 and HO-1 proteins in liver tissue of the mice in model group were significantly decreased(P<0.05);compared with model group,the expression levels of Nrf2 and HO-1 proteins in liver tissue of the mice in NaB group were significantly increased(P<0.01).Conclusion:NaB has a protective effect on LPS/D-Gal induced acute liver injury in the mice,and its mechanism may be related to the upregulation of the expressions of Nrf2 and HO-1 proteins and the increas of the activity of oxidant enzyme in liver tissue by NaB,thereby reduces the liver oxidative stress level of liver.

Purpose: Relative energy deficiency in sport (REDs) is a syndrome of physiological and/or psychological functioning experienced by female and male athletes that is caused by exposure to problematic low energy availability. For the prevention and intervention of REDs, awareness of REDs among sports physicians is important, but it is largely unknown. This study aimed to survey the awareness and clinical treatment experience of REDs in sports physicians. Methods: We conducted an online survey to assess awareness of the triad and REDs among sports physicians and members of The Korean Society of Sports Medicine. Results: A total of 69 members (62.2% male, including sports physicians) to this survey. Most participants (84.1%) were aware of the triad compared to fewer with awareness regarding REDs (23.2%). People who knew about the difference between REDs and triad was 33.3%, which was lower than those who did not (66.6%). Only 10.1% of the study subjects had experience treating REDs patients, and the biggest difficulty in treating patients was a lack of information and education (50.7%). It appeared that the most information about REDs was obtained from academic conferences (59.4%). Conclusion This survey found relatively low awareness of REDs among physicians treating athletes and sports professionals. Considering the various negative effects of REDs on athlete health and performance, education and promotion are needed to increase awareness among sports physicians and sports professionals.

Purpose: Relative energy deficiency in sport (REDs) is a syndrome of physiological and/or psychological functioning experienced by female and male athletes that is caused by exposure to problematic low energy availability. For the prevention and intervention of REDs, awareness of REDs among sports physicians is important, but it is largely unknown. This study aimed to survey the awareness and clinical treatment experience of REDs in sports physicians. Methods: We conducted an online survey to assess awareness of the triad and REDs among sports physicians and members of The Korean Society of Sports Medicine. Results: A total of 69 members (62.2% male, including sports physicians) to this survey. Most participants (84.1%) were aware of the triad compared to fewer with awareness regarding REDs (23.2%). People who knew about the difference between REDs and triad was 33.3%, which was lower than those who did not (66.6%). Only 10.1% of the study subjects had experience treating REDs patients, and the biggest difficulty in treating patients was a lack of information and education (50.7%). It appeared that the most information about REDs was obtained from academic conferences (59.4%). Conclusion This survey found relatively low awareness of REDs among physicians treating athletes and sports professionals. Considering the various negative effects of REDs on athlete health and performance, education and promotion are needed to increase awareness among sports physicians and sports professionals.