Based on the theory that "the liver governs the defensive qi"， it is believed that an imbalance in liver qi， leading to abnormalities in the generation， distribution， and circulation of defensive qi， constitutes the core pathogenesis of primary hyperhidrosis. The progression can be summarized as follows， emotional distress， leads to liver constraint， qi stagnation， and impaired liver regulation， resulting in abnormal distribution of defensive qi； qi constraint transforms into fire， leading to hyperactive liver fire， and causing the defensive qi to float upward and fail to be contained； yin-blood depletion and hidden consumption， together with， deficiency of the liver body， result in insufficient generation and upward movement of defensive qi. Treatment should align with the nature and functions of the liver. Xiaochaihu Decoction （小柴胡汤） is used to soothe the liver and regulate qi. Longdan Xiegan Decoction （龙胆泻肝汤） combined with Danzhi Xiaoyao Powder （丹栀逍遥散） is applied to clear the liver and drain fire. Suanzaoren Decoction （酸枣仁汤） combined with Yupingfeng Powder （玉屏风散） is prescribed to nourish blood， enrich the liver， tonify qi and promote the ascending movement of liver qi. In addition， verbal counseling is needed to help patients resolving emotional distress.

Based on the theory that "the liver governs the defensive qi"， it is believed that an imbalance in liver qi， leading to abnormalities in the generation， distribution， and circulation of defensive qi， constitutes the core pathogenesis of primary hyperhidrosis. The progression can be summarized as follows， emotional distress， leads to liver constraint， qi stagnation， and impaired liver regulation， resulting in abnormal distribution of defensive qi； qi constraint transforms into fire， leading to hyperactive liver fire， and causing the defensive qi to float upward and fail to be contained； yin-blood depletion and hidden consumption， together with， deficiency of the liver body， result in insufficient generation and upward movement of defensive qi. Treatment should align with the nature and functions of the liver. Xiaochaihu Decoction （小柴胡汤） is used to soothe the liver and regulate qi. Longdan Xiegan Decoction （龙胆泻肝汤） combined with Danzhi Xiaoyao Powder （丹栀逍遥散） is applied to clear the liver and drain fire. Suanzaoren Decoction （酸枣仁汤） combined with Yupingfeng Powder （玉屏风散） is prescribed to nourish blood， enrich the liver， tonify qi and promote the ascending movement of liver qi. In addition， verbal counseling is needed to help patients resolving emotional distress.

Microglial pyroptosis and neuroinflammation have been implicated in the pathogenesis of sepsis-associated encephalopathy (SAE). OGT-mediated O-GlcNAcylation is involved in neurodevelopment and injury. However, its regulatory function in microglial pyroptosis and involvement in SAE remains unclear. In this study, we demonstrated that OGT deficiency augmented microglial pyroptosis and exacerbated secondary neuronal injury. Furthermore, OGT inhibition impaired cognitive function in healthy mice and accelerated the progression in SAE mice. Mechanistically, OGT-mediated O-GlcNAcylation of ATF2 at Ser44 inhibited its phosphorylation and nuclear translocation, thereby amplifying NLRP3 inflammasome activation and promoting inflammatory cytokine production in microglia in response to LPS/Nigericin stimulation. In conclusion, this study uncovers the critical role of OGT-mediated O-GlcNAcylation in modulating microglial activity through the regulation of ATF2 and thus protects against SAE progression.
Animals ; Microglia/metabolism* ; Pyroptosis/physiology* ; Mice ; Sepsis-Associated Encephalopathy/prevention & control* ; Activating Transcription Factor 2/metabolism* ; N-Acetylglucosaminyltransferases/genetics* ; Mice, Inbred C57BL ; Male ; Mice, Knockout

Objective: To explore the mediating effects of psychological flexibility and exercise self-efficacy between frailty and social isolation among elderly patients with type 2 diabetes mellitus (T2DM), so as to provide the basis for alleviating social isolation in this population. Methods: From July to November 2024, elderly patients with T2DM aged ≥65 years were selected by using the convenience sampling method from the endocrinology and geriatrics departments of a tertiary hospital in Shanxi Province. Demographic and clinical data were collected using structured questionnaires. Frailty was assessed using the FRAIL Scale, psychological flexibility was measured with the Acceptance and Action Questionnaire-II (AAQ-II), exercise self-efficacy was evaluated via the Chinese version of the Exercise Self-Efficacy Scale, and social isolation was quantified employing the General Alienation Scale. The mediating effects of psychological flexibility and exercise self-efficacy between frailty and social isolation were analyzed using the Process macro program. Results: A total of 300 elderly patients with T2DM were included, with a mean age of (71.16±4.88) years. There are 167 males (55.67%) and 133 females (44.33%). The mean scores for frailty, psychological flexibility, exercise self-efficacy, and social isolation were (2.82±1.59), (28.32±6.95), (5.69±1.20), and (39.27±9.24). Mediation analysis revealed that frailty positively affected social isolation (β=0.227, 95%CI: 0.132-0.323). It also indirectly positively influenced social isolation through psychological flexibility (β=0.165, 95%CI: 0.105-0.234) and exercise self-efficacy (β=0.150, 95%CI: 0.093-0.217), and the chained mediating effect of psychological flexibility and exercise self-efficacy (β=0.066, 95%CI: 0.038-0.100). Conclusion Frailty exacerbates social isolation by diminishing psychological flexibility and exercise self-efficacy among elderly patients with T2DM.

Objective To observe the value of 5.0T MRI for quantifying proton density fat fraction(PDFF)of liver.Methods Liver chemical shift encoded(CSE)MR scanning were prospectively performed using 5.0T,3.0T and 1.5T scanner in 30 volunteers,respectively,and CSE-PDFF were measured.Then MR spectroscopy(MRS)were performed using 5.0T and 1.5T scanner,respectively,and MRS-PDFF were also measured.The consistency of liver PDFF measured on different images was observed,and the value of 5.0T MRI for liver PDFF was analyzed.Results The overall consistencies of liver CSE-PDFF measured with 5.0T,3.0T and 1.5T MR scanner were all good(all ICC＞0.75,all P＜0.001).The consistency of liver CSE-PDFF based on 5.0T and 3.0T,1.5T MR scanner were both good(ICC=0.989,0.992,both P＜0.001).The overall consistencies of CSE-PDFF based on 5.0T MR and MRS-PDFF based on 5.0T and 1.5T MR were both good(both ICC＞0.75,both P＜0.001).CSE-PDFF had good consistency with MRS-PDFF based on same 5.0T MR scanner(ICC=0.988,P＜0.001),and CSE-PDFF based on 5.0T had good consistency with MRS-PDFF based on 1.5T MR scanner(ICC=0.978,P＜0.001).Conclusion 5.0T MRI had high value for quantifying liver PDFF.

Objective To observe the consistency of 5.0T and 1.5T MR spectroscopy(MRS)for quantitating proton density fat fraction(PDFF)of liver.Methods Lipid emulsion models with lipid content of 0,5％,10％,15％,20％,25％and 30％were prepared.1H-MRS were collected using 5.0T and 1.5T MR scanners,respectively,and PDFF were obtained with jMRUI software.Totally 23 people,including 11 cases of fatty liver and 12 healthy adults were prospectively collected,and volume of interest(VOI)in the liver were selected to acquire 1H-MRS,and PDFF were obtained with jMRUI software and corresponding workstation,respectively.The consistencies of PDFF measured with different methods were analyzed.Results PDFF of lipid emulsion models with lipid content of 0,5％,10％,15％,20％,25％and 30％measured with jMRUI software and workstations based on 5.0T and 1.5T 1H-MRS all had good consistencies and being positively correlated,so were PDFF of liver tissue measured with jMRUI software and workstations based on 5.0T and 1.5T 1H-MRS.Conclusion 5.0T and 1.5T 1H-MRS had good consistency for quantitating liver PDFF.Measuring liver PDFF with workstation in clinical practice was helpful to simplifying workflow.

Objective To explore the application of the TST-IGRA two-step method in the screening of close contacts of active tuberculosis patients among three high schools in Jinshan District in 2020-2021，and to provide evidence for improving the prevention and control of tuberculosis in schools. Methods Three school tuberculosis outbreaks in Jingshan District from 2020 to 2021 were included in the present study. After excluding active tuberculosis, tuberculin skin test and γ-interferon release assay (IGRA) were conducted to screen latent infection of Mycobacterium tuberculosis in close contacts, and the necessity of the two-step method was analyzed. Results A total of 362 close contacts were screened in the three outbreaks, and 350 people were tested by TST. Comparing the results of TST and IGRA among different types of close contacts, it was found that the positive rate of TST in teachers was higher than that in students（54.84% vs 20.38%，P<0.05）. The positive rate of TST among students from high-burden areas of pulmonary tuberculosis in Shanghai was higher than that of local students（24.71% vs 18.80%，P<0.05). IGRA detection was performed on those with moderate and strong positive TST results, and the results showed that the positive rate of IGRA in those with strong positive TST results was only 17.7%, with Kappa value of 0.3. Conclusion The prevention and control of tuberculosis in school should strengthen the annual health examination of teachers and staff, promote timely medical treatment for suspected tuberculosis symptoms, reasonably increase the screening frequency of students in high-burden areas of tuberculosis in Shanghai, and collect students’ previous history of tuberculosis exposure. When screening close contacts, after excluding active tuberculosis, it is recommended that TST and IGRA should be combined to determine latent Mycobacterium tuberculosis infection and achieve accurate intervention.

The development of broad-spectrum antivirals against human coronaviruses (HCoVs) is critical to combat the current coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its variants, as well as future outbreaks of emerging CoVs. We have previously identified a polyethylene glycol-conjugated (PEGylated) lipopeptide, EK1C4, with potent pan-CoV fusion inhibitory activity. However, PEG linkers in peptide or protein drugs may reduce stability or induce anti-PEG antibodies in vivo. Therefore, we herein report the design and synthesis of a series of dePEGylated lipopeptide-based pan-CoV fusion inhibitors featuring the replacement of the PEG linker with amino acids in the heptad repeat 2 C-terminal fragment (HR2-CF) of HCoV-OC43. Among these lipopeptides, EKL1C showed the most potent inhibitory activity against infection by SARS-CoV-2 and its spike (S) mutants, as well as other HCoVs and some bat SARS-related coronaviruses (SARSr-CoVs) tested. The dePEGylated lipopeptide EKL1C exhibited significantly stronger resistance to proteolytic enzymes, better metabolic stability in mouse serum, higher thermostability than the PEGylated lipopeptide EK1C4, suggesting that EKL1C could be further developed as a candidate prophylactic and therapeutic for COVID-19 and other coronavirus diseases.

OBJECTIVE: To explore biomarkers for early auxiliary diagnosis of pneumoconiosis in coal workers(CWP) and its clinical significance. METHODS: Sixty-nine male coal miners exposed to dust were selected as control group, and sixty-seven CWP male patients were chosen as CWP group by purposive sampling method. Serum samples were collected from subjects of the two groups. The levels of malonaldehyde(MDA) and superoxide dismutase(SOD) were determined by colorimetric method. The enzyme-linked immunosorbent assay was used to measure the level of interleukin-6(IL-6) and tumor necrosis factor alpha(TNF-α). The acetylcholinesterase(AChE) activity was determined by modified Ellman method. The logistic regression model was used to analyze the risk factors of CWP. The receiver operating characteristic(ROC) curve was established to analyze the sensitive indicators in the pathogenesis of CWP. RESULTS: The serum SOD activity decreased(median: 65.1 vs 59.2 kU/L, P<0.05), and the MDA, IL-6 and TNF-α levels increased in the CWP group(median: 4.92 vs 6.68 μmol/L, 129.82 vs 163.18 ng/L, 63.90 vs 70.93 ng/L, P<0.05) compared with the control group. The logistic regression analysis results showed that AChE was the protective factor of CWP, while age, chronic respiratory symptoms, IL-6 and MDA were the risk factors of CWP(P<0.05). The ROC curve showed that IL-6 and MDA can be used as early indicators for the diagnosis of CWP in dust-exposed workers. CONCLUSION: The serum IL-6 and MDA levels can be used as biomarkers for early auxiliary diagnosis of CWP.

How to discover the valuable knowledge from the large amount of prescription data accumulated in the long-term medical practice of traditional Chinese medicine (TCM) is one of the important contents of TCM modernization.Based on the prescription data of Xue' s clinical practice of many years,this paper explored the method of combining TCM network and prescription network to find out Xue' s common core drug combination.Based on 9,584 prescriptions in the Hospital Information System of Guang'anmen Hospital of China Academy of Chinese Medical Sciences,prescription network and drug network were constructed according to the similarity of prescription composition and drug co-occurrence relationship.Using the complex network analysis methods,such as community analysis method,to analyze the prescription and drug compatibility,the results were evaluated and analyzed by Xue and his successors.As a result,through complex network analysis,126 modular prescriptions and 4 TCM modules were obtained.One of the core components of the prescription module included Xiao Chai Hu decoction,Yin Qiao powder,and Sheng Jiang powder compound addition and subtraction.It was in consistent with the drug composition of exogenous febrile prescriptions excavated earlier.In conclusion,using the complex network methods,we can get some core drug combinations prescribed by Prof.Xue,and achieve the common compound core drug combination for treating diseases with certain vantages,laying a foundation for further inheriting and excavating Xue' s effective experience.