Hepatic fibrosis refers to excessive accumulation and abnormal proliferation of fibrous connective tissue in the liver triggered by multiple pathogenic factors， and it may progress to liver cirrhosis， portal hypertension， and liver cancer. The pathological mechanisms of hepatic fibrosis involve hepatocyte injury， inflammatory cell infiltration with the release of inflammatory mediators， hepatic stellate cell activation， and extracellular matrix deposition. Recent studies have focused on mitochondrial dysfunction in disease progression， including the molecular pathways for hepatic fibrosis driven by metabolic disorders， energy deficiency， oxidative stress， mitochondrial dynamic imbalance， and autophagic dysfunction， all of which can induce liver injury. This article reviews the latest advances in hepatic fibrosis， in order to provide new therapeutic strategies for clinical management.

OBJECTIVE To investigate the application and influencing factors of sodium-dependent glucose transporters 2 inhibitors（SGLT-2i） in patients with heart failure with preserved ejection fraction（HFpEF） in the real world. METHODS Data from 358 patients with HFpEF who were hospitalized at the First Affiliated Hospital of Chongqing Medical University from May 2023 to May 2024 were retrospectively collected. The patients were divided into the SGLT-2i group and the non-SGLT-2i group based on whether they were prescribed SGLT-2i upon discharge. Baseline characteristics， comorbidities， and differences in drug treatment were compared between the two groups. Based on univariate analysis， multivariate Logistic regression analysis was performed to identify independent influencing factors of SGLT-2i use in patients with HFpEF， followed by further stratified analysis. RESULTS Among 358 HFpEF patients， the overall utilization rate of SGLT-2i was 33.5%. Combined with type 2 diabetes [OR＝9.063，95%CI（4.924-16.679） ] ， atrial fibrillation [OR＝3.135，95%CI（1.590-6.178） ] ， coronary artery heart disease [OR＝1.888，95%CI（1.072-3.327） ] and the use of loop diuretics [OR＝3.822， 95%CI （1.588-9.200） ] were all independent influencing factors for the use of SGLT-2i in patients with HFpEF （ P ＜0.05）. The results of the stratified descriptive analysis were consistent with those of the multivariate analysis， showing a higher utilization rate of SGLT-2i among patients with concomitant T2DM，atrial fibrillation， coronary artery heart disease， and those receiving loop diuretics （ P ＜0.05）； whereas the utilization rate of SGLT-2i was comparable across patients with different levels of renal function （ P ＞0.05）. CONCLUSIONS In the real-world clinical practice， the utilization of SGLT-2i in patients with HFpEF remains suboptimal， and treatment coverage still needs to be improved. Their use of SGLT-2i is primarily influenced by the presence of type 2 diabetes， atrial fibrillation， coronary artery heart disease， and the use of loop diuretics.

[摘 要] 目的：探讨lncRNA DLEU2通过EZH2/H3K27me3途径调控IKKα介导甲状腺癌（TC）放射性碘抵抗的作用机制。方法：利用TCGA数据库分析TC中DLEU2的表达及其与EZH2的相关性。构建放射性碘抵抗的TPC-1细胞（RR-TPC-1细胞）模型及裸鼠移植瘤模型，通过敲低或过表达DLEU2（si-DLEU2/OE-DLEU2）、抑制EZH2（UNC1999）、过表达IKKα（OE-IKKα）进行干预，采用qPCR、WB、RIP、ChIP、CCK-8、流式细胞术、TUNEL染色及体内成瘤实验检测基因与蛋白表达、表观修饰、细胞增殖、凋亡及肿瘤生长。结果：TCGA分析显示，DLEU2在TC组织中显著上调（P < 0.001），与患者不良预后相关（P = 0.008 4），且与EZH2表达呈正相关（r = 0.390, P < 0.001）；RIP证实EZH2与DLEU2存在相互作用/结合（P < 0.05）。体外实验表明，敲低DLEU2可显著下调RR-TPC-1细胞中EZH2、IKKα表达及H3K27me3修饰水平，抑制NF-κB通路活化（P < 0.05或P < 0.01），抑制细胞增殖、促进凋亡（均P < 0.05）。联合敲低DLEU2与抑制EZH2进一步增强上述效应，而过表达IKKα则可部分逆转上述效应（P < 0.05或P < 0.01）。体内实验进一步证实，敲低DLEU2联合抑制EZH2可显著抑制移植瘤生长，增加肿瘤细胞凋亡（均P < 0.01）；IKKα过表达则部分逆转上述抗肿瘤效应（P < 0.05或P < 0.01）。结论：lncRNA DLEU2通过招募EZH2催化H3K27me3修饰，间接激活IKKα/NF-κB信号并形成正反馈环路，介导TPC-1细胞131I抵抗。

Objective To summarize the perioperative nursing experience of a child with Angelman syndrome(AS)complicated with moderate scoliosis undergoing posterior 3-dimensional osteotomy correction,fusion,and internal fixation under general anesthesia.Methods The clinical data of the child with AS and moderate scoliosis who underwent surgical treatment in our hospital on Aug.4,2023,were analyzed.A multidisciplinary team was established upon admission.Relevant literatures and evidences were reviewed to develop and implement a"1+X"nursing plan,which included 2 components:"1"(core perioperative nursing priorities for scoliosis)and"X"(multiple AS-related nursing issues and corresponding strategies).Results The surgery was successful,with stable postoperative conditions and significant improvement in spinal curvature.The child's height increased by 7 cm.Discharge occurred on postoperative day 10,with 100%follow-up compliance.The child regained preoperative independent walking ability during follow-up.Conclusion The"1+X"nursing protocol for AS complicated with scoliosis can effectively ensure perioperative safety and promote recovery,which providing insights for perioperative nursing care of other rare diseases complicated with scoliosis.

Working memory is an executive memory process that includes encoding, maintenance, and retrieval. These processes can be modulated by transcranial alternating current stimulation (tACS) with sinusoidal waves. However, little is known about the impact of the rate of current change on working memory. In this study, we aimed to investigate the effects of two types of tACS with different rates of current change on working memory performance and brain activity. We applied a randomized, single-blind design and divided 81 young participants who received triangular wave tACS, sinusoidal wave tACS, or sham stimulation into three groups. Participants performed n-back tasks, and electroencephalograms were recorded before, during, and after active or sham stimulation. Compared to the baseline, working memory performance (accuracy and response time) improved after stimulation under all stimulation conditions. According to drift-diffusion model analysis, triangular wave tACS significantly increased the efficiency of non-target information processing. In addition, compared with sham conditions, triangular wave tACS reduced alpha power oscillations in the occipital lobe throughout the encoding period, while sinusoidal wave tACS increased theta power in the central frontal region only during the later encoding period. The brain network connectivity results showed that triangular wave tACS improved the clustering coefficient, local efficiency, and node degree intensity in the early encoding stage, and these parameters were positively correlated with the non-target drift rate and decision starting point. Our findings on how tACS modulates working memory indicate that triangular wave tACS significantly enhances brain network connectivity during the early encoding stage, demonstrating an improvement in the efficiency of working memory processing. In contrast, sinusoidal wave tACS increased the theta power during the later encoding stage, suggesting its potential critical role in late-stage information processing. These findings provide valuable insights into the potential mechanisms by which tACS modulates working memory.
Humans ; Memory, Short-Term/physiology* ; Male ; Female ; Young Adult ; Transcranial Direct Current Stimulation/methods* ; Brain/physiology* ; Adult ; Electroencephalography ; Single-Blind Method

The incidence and mortality of colorectal cancer （CRC） in China have been on a steady rise. Current therapeutic approaches can curb the progression of CRC to a certain extent， but issues such as toxic side effects， high metastasis rate， and high recurrence rate cannot be ignored. In recent years， alkaloid components derived from traditional Chinese medicine （TCM） have demonstrated tremendous potential in the prevention and treatment of CRC due to their diverse structures， complex mechanisms， and broad biological activities. Representative alkaloids such as matrine， berberine and evodiamine exert anti-CRC effects through multiple pathways： regulating signaling pathways including Wnt/β-catenin， nuclear factor-κB， signal transducer and activator of transcription 3， and phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin； inhibiting the proliferation， migration， and invasion of CRC cells； inducing cell apoptosis and autophagy； arresting the cell cycle progression； regulating the gut microbiota； suppressing cellular glycolysis； and inducing ferroptosis.

OBJECTIVES: To investigate the effects of periodontitis induced by Prevotella nigrescens (Pn) combined with ligation on cognitive functions in mice. METHODS: Twenty-four C57BL/6J mice were randomly divided into control group, ligation group, and ligation + Pn treatment (P+Pn) group. Experimental periodontitis was induced by silk ligation of the first molars followed by topical application of Pn for 6 weeks. After modeling, alveolar bone resorption was assessed using micro-CT and histological analysis. Learning and memory abilities of the mice were evaluated using open field test (OFT), novel object recognition test (NORT), and Morris water maze test (MWM). Seven weeks after the start of modeling, the mice were sacrificed for examining histopathological changes in the hippocampus using HE and Nissl staining. RESULTS: After 6 weeks of molar ligation, micro-CT revealed horizontal alveolar bone resorption and furcation exposure in the mice, and histological analysis showed apical migration of the junctional epithelium, epithelial ridge hyperplasia, and lymphocyte infiltration, and these changes were obviously worsened in P+Pn group. Alveolar bone height decreased significantly in both ligation groups compared to the control group. Cognitive tests showed that the mice in both of the ligation groups traveled shorter distances in OFT, showed reduced novel object preference in NORT, and exhibited longer escape latencies in MWM, and the mice in P+Pn group had significantly poorer performances in the tests. Histologically, obvious neuronal cytoplasmic degeneration, necrosis, nuclear pyknosis, vacuolation, and reduced Nissl bodies and viable neurons were observed in the hippocampal regions of the mice in the two ligation groups. CONCLUSIONS Pn infection aggravates alveolar bone destruction, accelerates necrosis and causes morphological abnormalities of neuronal cells in the hippocampus to reduce cognitive functions of mice with periodontitis.
Animals ; Periodontitis/microbiology* ; Mice ; Mice, Inbred C57BL ; Cognition ; Alveolar Bone Loss ; Hippocampus/pathology* ; Male ; Inflammation ; Maze Learning

Case report form(CRF)is an important tool to obtain clinical research data.Scientifically designed and properly recorded CRF is of great significance to improve the quality of clinical research.The author summarized the common problems existing in the design and recording of CRF in traditional Chinese medicine(TCM)clinical studies,including:①Delayed design time point.②Unstandardized CRF design,recording and modification.③Imperfect records of combined medication/therapy.④Insufficient quantification of syndrome efficacy indicators and objectification of tongue and pulse.⑤ Insufficient protection of subjects' privacy.⑥ Unstandardized records of adverse events.Accordingly,this paper discusses some solutions to provide reference for other TCM researchers,including:①Advance CRF design time.②Standardize CRF design,recording and modification.③Design drug combinations/therapies according to Clinical Data Acquisition Standards Harmonization(CDASH).④Standardization of syndrome and tongue and pulse.⑤Use of subject identification codes to protect privacy.⑥AE records should vary from study to study.

Objective:To investigate the application and efficacy of personalized expander placement in the single expanded flap auricular reconstruction for microtia.Methods:This study was a prospective cohort study that included patients with microtia who underwent single expanded flap auricular reconstruction in the Plastic Surgery Hospital of Chinese Academy of Medical Sciences between February 2023 and March 2024, according to specific inclusion and exclusion criteria. During the first-stage surgery, the tension and thickness of the skin in the postauricular area were evaluated using a pinch test. The anatomical layer of the expander placement was personalized as follows: (1) for thicker skin, the expander was placed in the subcutaneous layer; (2) for thinner skin, the expander was placed in the subcutaneous layer in the scalp region and in the subfascial layer in the hairless region behind the ear; (3) for areas of thin skin behind the residual ear, the expander was placed in the subfascial layer, with the remainder in the subcutaneous layer. In the second-stage surgery, autologous costal cartilage scaffolds were implanted for ear reconstruction, followed by a third-stage revision surgery. Postoperative follow-up was conducted to record complications. Before the third-stage surgery, two plastic surgeons, who did not participate in the operations, evaluated the aesthetic outcomes of the reconstructed ear using the Likert 4-point scale (1-4 points, with higher scores indicating better aesthetic outcomes).Results:A total of 152 children were included, with 97 males and 55 females; ages ranged from 5 to 13 years old, with a mean age of 6.8 years old. Of these, 89 cases were right-sided microtia, 53 left-sided microtia, and 10 bilateral microtia. In terms of skin characteristics, 35 cases had thick skin, 69 thin skin, and 48 thin skin behind the residual ear. During the first-stage surgery, complications included 15 cases of expander hematoma and 3 cases of expander infection. Both were controlled with symptomatic treatment. No cases of expander exposure occurred. The second-stage follow-up ranged from 6 to 12 months, with a mean of 7.9 months. The thickness of the reconstructed ear skin was appropriate, with well-defined subunits and no exposure of the cartilage scaffold. The aesthetic score for the reconstructed ear was (3.3 ± 0.5) points.Conclusion:The personalized placement of expanders effectively ensured appropriate thickness of the expanded flap in single expanded flap auricular reconstruction, providing good coverage for the rib cartilage framework and significantly enhancing the aesthetic outcomes of the reconstructed ears.

To promote the high-quality development of healthcare in the highland areas and to enable traditional Chinese medicine(TCM)to make a more prominent contribution to the healthcare of the people in these areas,it is imperative to clarify the roles of TCM in the formation of the healthcare system in the past and present,as well as the direction of innovative development of TCM in the plateau in the future.To this end,this paper first systematically reviews the literature to summarize the influence of TCM on the cultural background,theoretical framework,and practical system of Tibetan medicine during its origin,development,and maturation;then,through the example of typical cases,it elaborates on the direct practical applications of TCM in the prevention and treatment of a series of highland diseases from the perspectives of pathogenesis,therapeutic principles,unique drugs,and techniques;finally,it deeply reflects on a series of problems restricting the integration,inheritance,and innovative development of TCM in the highland areas and puts forward targeted suggestions to enable TCM to serve and safeguard the health of people living in the plateaus better together with the local ethnic medicine.