Hepatic fibrosis is a reversible pathological process in various chronic liver diseases and is closely associated with the development and progression of severe liver diseases such as liver cirrhosis and hepatocellular carcinoma， and it has emerged as a significant global health challenge. In recent years， studies have shown that histone lactylation， a newly discovered epigenetic modification， actively participates in regulating the progression of hepatic fibrosis. This article systematically reviews the core regulatory effect of histone lactylation modification in the interaction between inflammatory microenvironment and hepatic fibrosis， in order to clarify the cascade regulatory mechanism of “inflammation-hepatic fibrosis” and provide new insights for early diagnosis， targeted intervention， and prevention of malignant transformation in hepatic fibrosis.

To explore the advantages of traditional Chinese medicine （TCM） and integrative TCM-Western medicine approaches in the treatment of diabetic microvascular complications （DMC）， refine key pathophysiological insights and treatment principles， and promote academic innovation and strategic research planning in the prevention and treatment of DMC. The 38th session of the Expert Salon on Diseases Responding Specifically to Traditional Chinese Medicine， hosted by the China Association of Chinese Medicine， was held in Beijing， 2024. Experts in TCM， Western medicine， and interdisciplinary fields convened to conduct a systematic discussion on the pathogenesis， diagnostic and treatment challenges， and mechanism research related to DMC， ultimately forming a consensus on key directions. Four major research recommendations were proposed. The first is addressing clinical bottlenecks in the prevention and control of DMC by optimizing TCM-based evidence evaluation systems. The second is refining TCM core pathogenesis across DMC stages and establishing corresponding "disease-pattern-time" framework. The third is innovating mechanism research strategies to facilitate a shift from holistic regulation to targeted intervention in TCM. The fourth is advancing interdisciplinary collaboration to enhance the role of TCM in new drug development， research prioritization， and guideline formulation. TCM and integrative approaches offer distinct advantages in managing DMC. With a focus on the diseases responding specifically to TCM， strengthening evidence-based support and mechanism interpretation and promoting the integration of clinical care and research innovation will provide strong momentum for the modernization of TCM and the advancement of national health strategies.

Background: Both sodium-glucose cotransporters (SGLTs) and Na+/H+ exchangers (NHEs) rely on a favorable Na-electrochemical gradient. Gastrin, through the cholecystokinin B receptor (CCKBR), can induce natriuresis and diuresis by inhibiting renal NHEs activity. The present study aims to unveil the role of renal CCKBR in diabetes through SGLT2-mediated glucose reabsorption. Methods: Renal tubule-specific Cckbr-knockout (CckbrCKO) mice and wild-type (WT) mice were utilized to investigate the effect of renal CCKBR on SGLT2 and systemic glucose homeostasis under normal diet, high-fat diet (HFD), and HFD with a subsequent injection of a low dose of streptozotocin. The regulation of SGLT2 expression by gastrin/CCKBR and the underlying mechanism was explored using human kidney (HK)-2 cells. Results: CCKBR was downregulated in kidneys of diabetic mice. Compared with WT mice, CckbrCKO mice exhibited a greater susceptibility to obesity and diabetes when subjected to HFD. In vitro experiments using HK-2 cells revealed an upregulation of glucose transporters after incubation with high glucose, a response that was significantly attenuated following gastrin intervention. The glucose uptake from the culture medium of cells was altered accordingly. Moreover, gastrin administration effectively mitigated hyperglycemia in WT diabetic mice by inhibition of SGLT2 mediated glucose reabsorption, but this effect was compromised in the absence of CCKBR, as seen in CckbrCKO mice. Mechanistically, gastrin/CCKBR substantially reduced SGLT2 expression in HK-2 cells exposed to high glucose, via modulating Erkuclear factor-kappa B (NF-κB) pathway. Conclusion Our study underscores the crucial role of renal gastrin/CCKBR in SGLT2 regulation and glucose reabsorption, and renal gastrin/CCKBR can be a promising therapeutic target for diabetes.

OBJECTIVE To explore the intervention mechanism of Shangke Lengtongtie on cold hyperalgesia in KOA mice based on the HMGB1/CXCL12/CXCR4 signaling axis.METHODS Monosodium iodoacetate(MIA)was used for the intra-articular injec-tion into the knee joint to establish mice model of knee osteoarthritis(KOA).Peripheral blood monocytes were extracted from mice,cultured,and then reinfused into the tail vein of the mice.Subsequently,in vivo animal imaging was used to observe the recruitment sites of these monocytes.The cold hyperalgesia threshold was measured at various time points in each group of mice.Hematoxylin and eosin(HE)staining was used to evaluate the level of synovial pathological changes.ELISA was employed to detect the expression of in-flammatory factors IL-1β,TNF-α,and pain mediators CGRP and Substance P in mouse serum.Western blot and qPCR methods were used to detect the protein and gene expression of cold hyperalgesia-related indicators such as TRPA1,TRPM8,HMGB1,CXCL12,CXCR4,Collagen Ⅰ,and Netrin-1 in synovial tissue,as well as DCC in dorsal root ganglia(DRG)tissue.RESULTS In vivo ima-ging showed that after the monocytes were reinfused into KOA mice,they were recruited to the knee joint area,with the HMGB1 group exhibiting a greater recruitment of circulating monocytes at the knee joint.Additionally,compared to the control group,the KOA group and HMGB1 group showed inflammatory pathological changes in the synovium,increased expression of serum inflammatory factors and pain mediators,reduced cold hyperalgesia threshold,and upregulated protein and gene expression of cold hyperalgesia-related indica-tors in synovial and DRG tissues.The changes were more significant in the HMGB1 group compared to the KOA group(P<0.05).Af-ter treatment with Shangke Lengtongtie or GL intervention,synovial inflammation was alleviated,serum inflammatory factors and pain mediators decreased,cold hyperalgesia threshold increased,and the upregulation of cold hyperalgesia-related indicator protein and gene expression levels was significantly reversed(P<0.05).CONCLUSION Shangke Lengtongtie exerts a beneficial effect on the mitigation of synovitis and cold hyperalgesia in KOA mice,a therapeutic mechanism that possibly mediated through the inhibition of the HMGB1/CXCL12/CXCR4 signaling axis.

Objective:To analyze the effect of migration experiences during working age on the status of chronic disease development among rural older adults.Methods:Based on data from the China Health and Retirement Longitudinal Study(CHARLS),this study applied regression model and group-based trajectory model to examines the impact of migration experience on the status and growth trajectories of chronic diseases among rural older adults.Results:(1)Rural older adults with migration experience are more likely to develop chronic diseases and have a greater number of chronic disease in later life.(2)Rural older adults with migration experiences have a higher starting point and a faster rate of growth trajectory of chronic disease.Suggestions:It is necessary to strengthen occupational protection and health education for the rural-urban migrant population,reinforce the intervention and management of chronic diseases for the returning population,and improve the whole life-cycle medical insurance system,to break the disadvantageous cumulative effect of migration experience on health.

Objective To explore the influencing factors of postoperative pancreatitis in elderly patients with common bile duct stones undergoing endoscopic retrograde cholangiopancreatography(ERCP).Methods 304 elderly patients with common bile duct stones treated with ERCP in our hospital from February 2021 to June 2023 were selected as the study subjects.They were divided into a group with concurrent pancreatitis(n=22)and a group without concurrent pancreatitis(n=282)based on whether postoperative pancreatitis occurred.And the levels of serum lipase,whole blood PLR,and serum CRP were measured before surgery and 3,6,and 24 hours after surgery,respectively.At the same time,the differences in other relevant clinical data between the two groups of patients were compared.Binary Logistic regression was used to analyze the risk factors of pancreatitis after ERCP.Results The serum lipase levels in the concurrent pancreatitis group at 3,6,and 24 hours after the operation were(1060.48±131.23)U/L,(1137.45±126.34)U/L,and(1152.87±135.05)U/L,respectively.The levels of PLR in whole blood were 192.24±29.26,216.45±30.24,and 243.62±38.22 respectively,all of which were higher than those in the group without concurrent pancreatitis during the same period.There was a statistically significant difference between the two groups(P＜0.05).The serum CRP level in the group with pancreatitis was significantly higher than that in the group without pancreatitis at 6 and 24 h after operation(P＜0.05).Body mass index,Oddi sphincter dysfunction,difficulty in intubation,pancreatic development,ERCP operation time＞60 min,multiple entry of the catheter into the pancreatic duct were associated with postoperative pancreatitis after ERCP in elderly patients(P＜0.05).Multivariate Logistic regression analysis showed that after adjusting for confounding factors such as gender,age,BMI,course of disease,and number of stones,Serum lipase at 3 h after surgery,whole blood PLR at 3 h after surgery,serum CRP level at 6 h after surgery,difficulty in intubation and pancreatic development were independent risk factors for pancreatitis after ERCP in elderly patients(P＜0.05).Conclusion Serum lipase,whole blood PLR levels 3 hours after surgery,and serum CRP levels 6 hours after surgery are independent risk factors for pancreatitis after ERCP in the elderly with common bile duct stones.

Objective:Exploring the effect of Pinocembrin(Pino)regulating the Ras homolog gene family member A/Rho associated with curly helix binding protein kinase(RhoA/ROCK)signaling pathway of Ras homologous gene family members on the malignant biological behavior of gastric cancer cells.Methods:Cultivate human gastric cancer cells MGC803 with different concentrations of Pino(0～240μmol/L),detect cell survival rate using CCK-8 method,and screen for the optimal drug concentration.MGC803 cells were rseparated into MGC803 group(Control group),Pino-L group,Pino-M group,Pino-H group,and Pino-H+RhoA agonist CN03 group.The clone formation experiment was applied to detect the number of clones formed of cells in each group.Assessment of cell apoptosis using flow cytometry.Tran-swell invasion and migration experiments were used to detect the number of cells undergoing migration and invasion in each group;Detection of RhoA/ROCK signaling pathway and expression of epithelial mesenchymal transition related proteins in MGC803 cells using Western blot method.Results:Compared with the MGC803 group,the cell survival rate,clone formation number,migration cell number,and invasion cell number were all reduced in the Pino-L group,Pino-M group,and Pino-H group,and RhoA was also present in the cells,ROCK2,The expression levels of vimentin and N-cadherin gradually decreased(P<0.05),while the apoptosis rate and E-cadherin expression level gradually in-creased(P<0.05).The Pino-H+CN03 group reversed the trend of changes in the above indicators).Conclusion:Pino can prevent malignant biological behavior of gastric cancer cells,which may be related to the inhibition of the RhoA/ROCK signaling pathway.

Objective:To investigate the effect of Xuebijing injection against blood-brain barrier(BBB)damage in the mice with anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis,and to elucidate its regulatory effect on the imbalance of helper T cells 17(Th17)/regulatory T cells(Treg).Methods:The active immunization models of anti-NMDAR encephalitis in the mice were established using glutamate receptor N1 subunit(GluN1)356-385 antigen peptide,and the serum anti-NMDAR immunoglobulin G(IgG)antibody levels were detected by enzyme-linked immunosorbent assay(ELISA).The healthy mice without modeling were served as control group,and the mice with successful modeling were randomly divided into model group,low dose of Xuebijing injection(XBJ-L)group,and high dose of Xuebijing injection(XBJ-H)group,with 10 mice in each group.After modeling,the mice in XBJ-L and XBJ-H groups were intraperitoneally injected with 5 and 10 mL·kg-1 Xuebijing injection,respectively.The Longa score was used to assess the neurological impairment of the mice in various groups;evans blue(EB)staining was used to determine the BBB permeability;immunofluorescence staining was used to detect the expressions of zonula occludens 1(ZO-1)and Occludin in cerebral cortex of the mice in various groups;Western blotting method was used to determine the expression levels of ZO-1,Occludin,Claudin-5,and neuron-specific nuclear protein(NeuN)in cerebral cortex of the mice in various groups;ELISA method was used to determine the levels of Th17-and Treg-related cytokines including interleukin(IL)-17,IL-22,and IL-10 in serum of the mice;flow cytometry was used to determine the percentages of Th17 and Treg cells in peripheral blood of the mice in various groups,and the Th17/Treg ratio was calculated.Results:The serum of the mice induced with the GluN1 356-385 antigen peptide was positive for NMDAR IgG antibodies,indicating that the models were successfully established.Compared with control group,the neurological impairment score of the mice in model group was significantly increased(P＜0.05),and the EB level in brain tissue was significantly increased(P＜0.05);the fluorescence staining intensities of ZO-1 and Occludin in the cerebral cortex were decreased,and the expression levels of ZO-1,Occludin,Claudin-5,and NeuN proteins in the cerebral cortex were significantly decreased(P＜0.05);the serum levels of IL-17 and IL-22 were significantly increased(P＜0.05),while the IL-10 level was significantly decreased(P＜0.05);the percentage of Th17 cells in peripheral blood was significantly increased(P＜0.05),while the percentage of Treg cells was significantly decreased(P＜0.05),and the Th17/Treg ratio was significantly increased(P＜0.05).Compared with model group,the neurological impairment scores of the mice in XBJ-L and XBJ-H groups were significantly decreased(P＜0.05),the EB levels in brain tissue were significantly decreased(P＜0.05),the fluorescence staining intensities of ZO-1 and Occludin in cerebral cortex were increased,and the expression levels of ZO-1,Occludin,Claudin-5,and NeuN proteins were significantly increased(P＜0.05);the levels of IL-17 and IL-22 in serum were significantly decreased(P＜0.05),and the level of IL-10 was significantly increased(P＜0.05);the percentages of Th17 cells in peripheral blood were significantly decreased(P＜0.05),the percentages of Treg cells were significantly increased(P＜0.05),and the Th17/Treg ratios were significantly decreased(P＜0.05).Compared with XBJ-L group,the neurological function injury score of the mice in XBJ-H group was significantly decreased(P＜0.05),the EB level in brain tissue was significantly decreased(P＜0.05);the fluorescence staining intensities of ZO-1 and Occludin in the cerebral cortex were increased,and the expression levels of ZO-1,Occludin,Claudin-5,and NeuN proteins were significantly increased(P＜0.05);the serum levels of IL-17 and IL-22 were significantly decreased(P＜0.05),and the level of IL-10 was significantly increased(P＜0.05);the percentage of Th17 cells in peripheral blood was significantly decreased(P＜0.05),the percentage of Treg cells was significantly increased(P＜0.05),and the Th17/Treg ratio was significantly decreased(P＜0.05).Conclusion:Xuebijing injection can improve BBB injury,regulate Th17/Treg balance,and thereby alleviate the neurological functional damage in anti-NMDAR encephalitis.

Objective:To compare the differences among four routine lipid testing systems in detecting high triglyceride (TG) serum samples and evaluate the accuracy and consistency of the four homogeneous low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) reagents using vertical auto profile (VAP) as the reference method.Methods:A retrospective study was conducted on 249 serum samples with elevated TG levels collected from the Department of Laboratory Medicine at the Second Xiangya Hospital of Central South University between January and October 2024. TG, total cholesterol (TC), LDL-C, and HDL-C were measured using four homogeneous detection systems: Beckman Coulter (USA), Wako Pure Chemical Industries (Japan), Mindray (China), and Roche Diagnostics (Germany). VAP was used to analyze lipoprotein subfractions, including very-low-density lipoprotein cholesterol (VLDL-C), intermediate-density lipoprotein cholesterol (IDL-C), LDL-C, lipoprotein(a) cholesterol [Lp(a)-C], and HDL-C. The mean coefficient of variation ( CV) across the four systems was calculated for each parameter. Pearson correlation and ordinal logistic regression (OLR) were used to assess correlations between the four HDL-C/LDL-C systems and VAP. Bland-Altman plots were generated to evaluate biases, and deviations were calculated. For parameters with significant deviations, multivariate linear regression and standardized coefficients were used to analyze correlations between biases and lipoprotein subfractions. Based on the Chinese Guidelines for Lipid Management (2023), LDL-C and non-HDL-C treatment goals were categorized into five risk levels (ultra-high, high, moderate, high-risk, and low-risk). VAP results defined LDL-C/non-HDL-C intervals, and the four systems′ concordance in risk classification was evaluated. Samples were grouped into A, B, C, D ( n=63, 62, 62, 62) by TG concentration, and ANOVA, chi-square, and Fisher exact tests assessed intergroup differences. Results:The mean CVs across systems for TG, TC, LDL-C, HDL-C, and non-HDL-C were 2.98%, 1.76%, 18.10%, 5.60%, 2.58%, respectively. Pearson correlations between LDL-C results (Beckman, Wako, Mindray, Roche) and VAP were 0.889, 0.854, 0.899, and 0.973; mean relative deviations were 54.8%, 41.0%, 49.3%, and 3.6%; classification accuracies were 6.0% (15/249), 21.3% (53/249), 9.2% (23/249), and 76.7% (191/249). HDL-C deviations were 18.7%, 15.1%, 11.1%, and 8.7%, with correlations ( r) of 0.883, 0.911, 0.959, and 0.950 (all P<0.001). LDL-C means showed no intergroup differences (A-D), but CV increased with TG levels ( P<0.001). HDL-C means and CVs showed no significant intergroup differences. Beckman, Wako, and Mindray LDL-C results exhibited significant positive biases correlated with TG and VLDL-C (multivariate regression; P<0.05); VLDL-C had the strongest influence (standardized coefficients: 0.820, 0.394, 0.813; P<0.001). Non-HDL-C classifications matched VAP in 92.4% (Beckman), 85.9% (Wako), 94.0% (Mindray), and 93.2% (Roche), with no intergroup differences. Conclusion:For high-TG sera, Beckman, Wako, and Mindray LDL-C exhibited significant positive biases correlated with TG and VLDL-C, while Roche LDL-C showed minimal deviation. TG, TC, HDL-C, and non-HDL-C results showed minimal variation across the four systems. All systems demonstrated comparable accuracy for non-HDL-C compared to VAP. The non-HDL-C measured by the four detection systems demonstrates high accuracy and consistency in atherosclerotic cardiovascular disease risk stratification and lipid-lowering goal assessment, and it is unaffected by TG levels.

Objective:To analyze the epidemiological and clinical features of infectious diseases of the central nervous system (CNS).Methods:A cross-sectional study and analysis were conducted to summarize the epidemiological and clinical characteristics of 9 918 patients with CNS infectious diseases, who were diagnosed and treated at 29 hospitals across China from January 1, 2001 to December 31, 2020. Data collected included demographic data, clinical manifestations, health economic indicators, and prognostic outcomes.Results:Among the 9 918 collected cases of CNS infectious diseases, 5 559 were male (56.0%) and 4 359 were female (44.0%), with an onset age of 38 (25, 53) years. Education level: slightly more junior high school education (2 651 cases, 26.7%), and less elementary school education and below (2 181 cases, 22.0%) were found. Occupational distribution: farmers were found predominant (3 215 cases, 32.4%), followed by workers (1 826 cases, 18.4%) and students (1 633 cases, 16.5%). Clinical manifestations: headache (6 074 cases, 61.2%), fever (5 869 cases, 59.2%) and positive meningeal irritation signs (2 273 cases, 22.9%) were the 3 most common clinical manifestations, followed by nausea and (or) vomiting (2 095 cases, 21.1%), impaired consciousness (2 077 cases, 20.9%), psychiatric symptom (1 866 cases, 18.8%) and epilepsy (1 627 cases, 16.4%), etc., and cranial nerve involvement was found in 669 cases (6.7%). Major pathogens included viruses in 6 814 cases (68.7%), Mycobacterium tuberculosis in 1 677 cases (16.9%), common bacteria in 864 cases (8.7%), fungi in 254 cases (2.6%), spirochetes of syphilis in 183 cases (1.8%), parasites in 121 cases (1.2%), and rickettsiae in 5 cases (0.1%). Urban-rural distribution: slightly more cases were found in the countryside (5 418 cases, 54.6%) than in the towns (4 500 cases, 45.4%). Distribution of onset by season: 2 412 cases (24.3%) fell ill in spring, 2 835 cases (28.6%) in summer, 2 187 cases (22.1%) in fall, and 2 484 cases (25.0%) in winter. Health economics: the duration of hospitalization was 15 (8, 27) days, and the cost of hospitalization was 1.53 (0.91, 3.02)×10 000 yuan. Prognosis: 9 531 cases (96.1%) were cured or improved, and 92 cases (0.9%) died. Conclusions:The pathogens responsible for CNS infectious diseases are predominantly viruses. Although the incidence is slightly higher during the summer months, the overall seasonal pattern is not particularly pronounced. These infections are more commonly observed in young and middle-aged males and present with a diverse range of clinical manifestations, contributing to a significant disease burden.