Metabolic associated fatty liver disease （MAFLD） is a chronic liver disease with a rapidly increasing incidence rate worldwide， and its complex pathogenesis is closely associated with O-linked β-N-acetylglucosamine （O-GlcNAc） modification. As a dynamic and reversible post-translational modification of proteins， O-GlcNAc modification is mainly regulated by O-GlcNAc transferase and O-GlcNAcase. O-GlcNAc modification can drive hepatic steatosis， exacerbate insulin resistance， and impair mitochondrial function， thereby leading to the aggravation of metabolic disorders， promoting inflammation response， and driving the progression of MAFLD to metabolic associated steatohepatitis and hepatic fibrosis. This article systematically reviews the latest research advances in the role of O-GlcNAc modification in the development and progression of MAFLD， in order to provide theoretical support and research direction for a deeper understanding of the pathological mechanism of MAFLD and the development of effective therapeutic strategies.

The prevention and treatment of chronic obstructive pulmonary disease （COPD） pose a major global challenge， with difficulties in effectively integrating holistic regulation and precise micro-intervention. The traditional Chinese medicine （TCM） theory of state-target pattern differentiation and treatment advocates the combination of state regulation and target intervention， offering a new paradigm for integrated TCM and Western medicine. This article systematically reviews the theoretical connotations of this theory and constructs a dynamic correspondence framework linking TCM pattern states， signaling pathways， and targeted interventions across different stages of COPD. At the acute exacerbation stage， the phlegm-heat obstructing the lung state is characterized by hyperactivation of the nuclear factor （NF）-κB/NOD-like receptor protein 3 （NLRP3） inflammation pathway， and formulas for clearing heat and resolving phlegm suppress the cytokine storm through multi-component synergy. At the stable stage， the lung-spleen Qi deficiency state is characterized by functional decompensation of the nuclear factor erythroid 2-related factor 2 （Nrf2）/Kelch-like ECH-associated protein 1 （Keap1） antioxidative stress pathway， and therapies for tonifying the lung and spleen repair the essence of Qi deficiency through antioxidative defense and energy metabolism. At the severe/very severe stable stage， the lung-kidney deficiency state is pathologically based on dysregulation of the transforming growth factor （TGF）-β/Wnt repair network and depletion of stem/progenitor cells， and therapies for tonifying the kidney and reinforcing Qi absorption achieve simultaneous regulation of deficiency and stasis by inhibiting aberrant fibrosis and guiding ordered regeneration. These three pathways are not isolated but exhibit dynamic shifts in dominance and cross-talk， constituting the molecular network basis of deficiency causing excess and intermingled deficiency and excess. Furthermore， this article points out the current shortcomings in quantitative evidence， objective syndrome standardization， and coverage of syndrome states， and proposes future directions including building multi-omics databases， conducting biomarker-stratified randomized controlled trials， and developing disease-pattern combined animal models， aiming to provide a theoretical perspective that integrates holism and micro-targeting for precision prevention and treatment of COPD.

The prevention and treatment of chronic obstructive pulmonary disease （COPD） pose a major global challenge， with difficulties in effectively integrating holistic regulation and precise micro-intervention. The traditional Chinese medicine （TCM） theory of state-target pattern differentiation and treatment advocates the combination of state regulation and target intervention， offering a new paradigm for integrated TCM and Western medicine. This article systematically reviews the theoretical connotations of this theory and constructs a dynamic correspondence framework linking TCM pattern states， signaling pathways， and targeted interventions across different stages of COPD. At the acute exacerbation stage， the phlegm-heat obstructing the lung state is characterized by hyperactivation of the nuclear factor （NF）-κB/NOD-like receptor protein 3 （NLRP3） inflammation pathway， and formulas for clearing heat and resolving phlegm suppress the cytokine storm through multi-component synergy. At the stable stage， the lung-spleen Qi deficiency state is characterized by functional decompensation of the nuclear factor erythroid 2-related factor 2 （Nrf2）/Kelch-like ECH-associated protein 1 （Keap1） antioxidative stress pathway， and therapies for tonifying the lung and spleen repair the essence of Qi deficiency through antioxidative defense and energy metabolism. At the severe/very severe stable stage， the lung-kidney deficiency state is pathologically based on dysregulation of the transforming growth factor （TGF）-β/Wnt repair network and depletion of stem/progenitor cells， and therapies for tonifying the kidney and reinforcing Qi absorption achieve simultaneous regulation of deficiency and stasis by inhibiting aberrant fibrosis and guiding ordered regeneration. These three pathways are not isolated but exhibit dynamic shifts in dominance and cross-talk， constituting the molecular network basis of deficiency causing excess and intermingled deficiency and excess. Furthermore， this article points out the current shortcomings in quantitative evidence， objective syndrome standardization， and coverage of syndrome states， and proposes future directions including building multi-omics databases， conducting biomarker-stratified randomized controlled trials， and developing disease-pattern combined animal models， aiming to provide a theoretical perspective that integrates holism and micro-targeting for precision prevention and treatment of COPD.

Objective: To explore the association between health related behaviors and anxiety, depressive symptoms, and their co-occurrence among junior and senior high school students, so as to provide evidence for developing targeted mental health promotion strategies. Methods: From September to December 2023, a stratified cluster random sampling method was used to select 6 150 junior and senior high school students from 8 districts (counties) in a northwest region of China. The Generalized Anxiety Disorder-7 and Center for Epidemiologic Studies Depression Scale were used to assess anxiety and depressive symptoms, and their co-occurrence. Latent class analysis was used to identify latent classes of health related behaviors among junior and senior high school students, and Logistic regression models were used to analyze the association of the latent category of health related behaviors with anxiety and depressive symptoms, and their co-occurrence. Results: The detection rates of anxiety and depressive symptoms, and their co-occurrence were 8.0%, 22.0%, and 7.3%, respectively, among junior high school students, and 8.3%, 26.6%, and 7.6%, respectively, among senior high school students. Latent classes of health related behaviors were classified into four classes:the comprehensive high risk behavior group (586 students, 9.5%), the Internet addiction group (376 students, 6.1%), the insufficient sleep group (1 151 students, 18.7%), and the low risk behavior group (4 037 students, 65.6%). After controlling for confounding factors such as gender, ethnicity, and monitoring sites, Logistic regression model analysis showed that, compared with the low risk behavior group, the comprehensive high risk behavior group had elevated risks of anxiety and depressive symptoms, and their co-occurrence (junior high school students: OR =3.81, 5.52, 3.88; senior high school students: OR =4.57, 4.12, 5.43; all P <0.05). The Internet addiction group had elevated risks of anxiety and depressive symptoms, and their co-occurrence among junior high school students ( OR =1.89, 2.81, 1.89), and an elevated risk of depressive symptoms among senior high school students ( OR =2.41) (all P <0.05). The insufficient sleep group had an elevated risk of their co-occurrence among junior high school students ( OR =1.47), and elevated risks of anxiety and their co-occurrence among senior high school students ( OR =1.71, 1.99) (all P <0.05). Conclusion Latent classes of health related behaviors among junior and senior high school students are associated with anxiety and depressive symptoms, and their co-occurrence, as well as differences across school stages.

Objective:To analyze the differences in routine blood tests and infection markers among elderly AIDS patients with other opportunistic infections, to explore their immune status and inflammatory responses, and to provide new molecular markers for clinical diagnosis.Methods:The study included general indicators, routine blood tests, and infection markers of older HIV patients with other opportunistic infections admitted to Beijing You'an Hospital, Capital Medical University, from January 1, 2014, to December 31, 2024.Statistical analysis was performed using SPSS 27.0 software, with a significance level set at P<0.05. Results:A total of 94 elderly AIDS patients with various opportunistic infections were included in this study.Among them, the majority were co-infected with tuberculosis, accounting for 60 cases(63.83%), followed by 23 cases(24.47%)of AIDS patients co-infected with syphilis.Additionally, there were 7 cases of AIDS co-infected with amoebiasis(7.45%)and 4 cases of AIDS co-infected with monkeypox(4.26%).Almost all cases of combined infections were male, with males comprising 91.3% of AIDS patients co-infected with syphilis and 100% in the other co-infected groups.There were 9 blood routine and infectious markers that exhibited significant differences between patients with HIV co-infected with tuberculosis and those with other opportunistic infections.These markers included lymphocytes(LYM), hemoglobin(HGB), erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), procalcitonin(PCT), T lymphocytes, CD4 + T cells, CD8 + T cells, and the CD4/CD8 ratio( P<0.05).Specifically, the levels of LYM, HGB, T lymphocytes, CD4 + T cells, CD8 + T cells, and the CD4/CD8 ratio in elderly AIDS patients with tuberculosis were significantly lower than those in patients with other co-infections(all P<0.05).Conversely, the levels of inflammatory factors such as PCT, ESR, and CRP were notably higher in the former group(all P<0.05).The receiver operating characteristic(ROC)curve analysis revealed that when LYM was utilized as an individual indicator for the differential diagnosis between AIDS patients with tuberculosis and those with other opportunistic infections, the area under the curve(AUC)amounted to 0.832.However, the CRP/LYM ratio demonstrated the optimal diagnostic performance in differential diagnosis, with an AUC reaching 0.866. Conclusions:The immune function of elderly AIDS patients is further compromised following co-infection with tuberculosis, which is accompanied by a severe inflammatory response.The CRP/LYM ratio shows promise as a hematological molecular marker for differentiating between AIDS patients with tuberculosis and those with other opportunistic infections.

Objective:To analyze the relevant studies on fertility concerns intervention programs for breast cancer survivors of childbearing age, and identify the specific content, outcome indicators and intervention effects of intervention, in order to provide reference for clinical staff to implement relevant intervention.Methods:According to the research method of scope review, the studies on the fertility concerns with breast cancer patients of childbearing age in China National Knowledge Infrastructure, WanFang, VIP, China Biomedical Literature Database, CINAHL, PubMed, Cochrane Library, Web of Science etc. were searched. The search period was from database establishment to May 9, 2024. The included literature was classified and analyzed.Results:A total of 12 articles were included, 9 were randomized controlled trials, 2 were self-controlled before and after studies, and 1 was a prospective cohort study. Fertility concerns intervention programs included group fertility counseling centered on couples, fertility support based on a multidisciplinary team collaboration model, and fertility management based on "Internet + reproductive health". The duration of intervention was usually 4 or 24 weeks. The intervention had different effects on the level of fertility concerns, psychological state and marital status.Conclusions:At present, the intervention programs for fertility concerns of breast cancer survivors of childbearing age reflect the importance, professionalism, immediacy and interactivity, but China is in the initial stage, and there are still shortcomings in multidisciplinary teams, fertility referral system, and Internet platform construction. Future research should build a breast cancer fertility intervention program suitable for our country, and promote its application through the Internet.

Objective To explore the effect on the expression of ERα/PGC1α/PPARα pathway,the therapeutic effect of Danhe Liuwei Dihuang Decoction on ovariectomized NAFLD rats was observed.Methods 60 female non-pregnant SPF SD rats were randomly divided into sham operation group(Sham),model group(Model),estrogen group(E2),traditional Chinese medicine high,medium and low dose group(DHR-H/M/L).Sham group was given normal diet after sham operation,and the other groups were given high-fat,high-fructose and high-cholesterol diet(HF/HF/HC)after bilateral ovariectomy to prepare postmenopausal NAFLD model.The Sham group and the Model group were given normal saline by gavage,and the other groups were given corresponding doses of drugs by gavage.The intervention time was 12 weeks,and the experimental period was 14 weeks.The general condition and body weight of rats in each group were recorded.HE staining of uterus was used to observe the morphology of uterus,HE staining of liver and oil red O staining were used to observe steatosis.Serum liver function(ALT,AST)and lipid metabolism indexes(TG,TC)were measured by automatic biochemical analyzer.The levels of serum E2 and free fatty acid(FFA)and the expression of FFA and TG in liver tissue were detected by ELISA.The mRNA and protein expressions of ERα,PGC1α and PPARα in liver tissues were detected by RT-PCR and Western blot.Results Compared with the Model group,by Danhe Liuwei Dihuang Decoction,the body weight and liver weight of ovariectomized NAFLD rats significantly decreased,liver fat deposition significantly decreased,E2 level increased,ALT,AST,TG,TC,FFA and liver tissue homogenate FFA,TG content significantly decreased,liver ERα,PGC1α,PPARα mRNA and protein expression up-regulated(P<0.05 or P<0.01).Conclusion Danhe Liuwei Dihuang Decoction can improve liver steatosis in postmenopausal NAFLD model rats.The mechanism may be related to up-regulating the expression of ERα/PGC1α/PPARα signaling pathway to promote liver FFA oxidation and reduce liver TG deposition.

Objective:To analyze the differences in routine blood tests and infection markers among elderly AIDS patients with other opportunistic infections, to explore their immune status and inflammatory responses, and to provide new molecular markers for clinical diagnosis.Methods:The study included general indicators, routine blood tests, and infection markers of older HIV patients with other opportunistic infections admitted to Beijing You'an Hospital, Capital Medical University, from January 1, 2014, to December 31, 2024.Statistical analysis was performed using SPSS 27.0 software, with a significance level set at P<0.05. Results:A total of 94 elderly AIDS patients with various opportunistic infections were included in this study.Among them, the majority were co-infected with tuberculosis, accounting for 60 cases(63.83%), followed by 23 cases(24.47%)of AIDS patients co-infected with syphilis.Additionally, there were 7 cases of AIDS co-infected with amoebiasis(7.45%)and 4 cases of AIDS co-infected with monkeypox(4.26%).Almost all cases of combined infections were male, with males comprising 91.3% of AIDS patients co-infected with syphilis and 100% in the other co-infected groups.There were 9 blood routine and infectious markers that exhibited significant differences between patients with HIV co-infected with tuberculosis and those with other opportunistic infections.These markers included lymphocytes(LYM), hemoglobin(HGB), erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), procalcitonin(PCT), T lymphocytes, CD4 + T cells, CD8 + T cells, and the CD4/CD8 ratio( P<0.05).Specifically, the levels of LYM, HGB, T lymphocytes, CD4 + T cells, CD8 + T cells, and the CD4/CD8 ratio in elderly AIDS patients with tuberculosis were significantly lower than those in patients with other co-infections(all P<0.05).Conversely, the levels of inflammatory factors such as PCT, ESR, and CRP were notably higher in the former group(all P<0.05).The receiver operating characteristic(ROC)curve analysis revealed that when LYM was utilized as an individual indicator for the differential diagnosis between AIDS patients with tuberculosis and those with other opportunistic infections, the area under the curve(AUC)amounted to 0.832.However, the CRP/LYM ratio demonstrated the optimal diagnostic performance in differential diagnosis, with an AUC reaching 0.866. Conclusions:The immune function of elderly AIDS patients is further compromised following co-infection with tuberculosis, which is accompanied by a severe inflammatory response.The CRP/LYM ratio shows promise as a hematological molecular marker for differentiating between AIDS patients with tuberculosis and those with other opportunistic infections.

ObjectiveTo investigate the association of menopausal time and menopausal age with the risk of nonalcoholic fatty liver disease （NAFLD）， and to provide a basis for the early prevention and treatment of NAFLD in clinical practice. MethodsRelated data were collected from 373 postmenopausal women who attended the outpatient service of Department of Spleen， Stomach， Liver and Gallbladder Diseases， The First Affiliated Hospital of Henan University of Chinese Medicine， from January 2017 to December 2021， including general information， menopausal age， menopausal time， and presence or absence of NAFLD. The chi-square test was used for comparison of categorical data； the independent-samples t test was used for comparison of normally distributed continuous data between groups， and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between groups. A Logistic regression analysis was used to calculate the association intensity and 95% confidence interval （95%CI） of menopausal time and menopausal age for the risk of NAFLD， and the restricted cubic spline （RCS） method was used to investigate the dose-response relationship between menopausal time/age and the risk of NAFLD. ResultsCompared with the women with normal menopause or late menopause， the women with early menopause had a higher prevalence rate of NAFLD and a higher degree of steatosis and fibrosis （all P<0.05）. After adjustment for the confounding factors such as age and age of menarche， the risk of NAFLD in women with a menopausal time of >3 years was 4.80 （95%CI： 1.93‍ ‍—‍‍ ‍11.95， P=0.001） times that in women with a menopausal time of ≤3 years， and the risk of NAFLD in women with early or late menopause was 8.14 times （95%CI： ‍1.77 ‍— ‍37.58， P=0.007） and 0.09 times （95%CI： 0.03 ‍— ‍0.32， P<0.001）， respectively， that in those with a normal menopausal age. There is a dose-response relationship between menopausal time/age and the risk of NAFLD. Menopausal time is positively correlated with the association intensity of NAFLD， while menopausal age is negatively correlated with the association intensity of NAFLD. ConclusionThe longer the menopause time and the earlier the menopause age， the ligher the risk of NAFLD.

Objective: To investigate the spatio-temporal clustering characteristics of influenza in Ningxia Hui Autonomous Region from 2014 to 2023, so as to provide the basis for strengthening influenza prevention and control. Methods: Data pertaining to influenza cases reported in Ningxia Hui Autonomous Region from 2014 to 2023 were retrieved from the Infectious Disease Surveillance System of the Chinese Disease Prevention and Control Information System, including age, sex, current residence, onset date, and reporting date. The seasonal incidence of influenza was analyzed using seasonal index. The spatio-temporal clustering characteristics of influenza were identified using spatial autocorrelation analysis and spatio-temporal scan analysis. Results: A total of 20 377 influenza cases were reported in Ningxia Hui Autonomous Region from 2014 to 2023, with a male-to-female ratio of 1.15∶1. The majority were children under 15 years, with 10 950 cases accounting for 53.74%. Influenza was highly prevalent in January, February, March, and December, with seasonal indices of 219.06%, 111.00%, 246.65%, and 366.24%, respectively. The average annual reported incidence was 29.55/100 000, among which Pengyang County, Jinfeng District, Dawukou District, Xiji County, and Litong District had higher average annual reported incidence, at 63.99/100 000, 55.71/100 000, 55.70/100 000, 49.49/100 000, and 49.04/100 000, respectively. Spatial autocorrelation analysis showed that in 2023, there was spatial clustering of influenza cases in Ningxia Hui Autonomous Region (Moran's I=0.333, P<0.05), with a high-high cluster in Jingyuan County, while in other years, the distribution of influenza cases was random (all P>0.05). Spatio-temporal scan analysis showed that from 2014 to 2023, there were four space-time clusters in Ningxia Hui Autonomous Region, including one type Ⅰ cluster in Hongsibao District of Wuzhong City, with the clustering period from January 20 to 26, 2014; and three type Ⅱ clusters, mainly in January, February, March and December, covering one area in Shizuishan City, five areas in Guyuan City, one area in Zhongwei City, three areas in Wuzhong City, and four areas in Yinchuan City. Conclusions From 2014 to 2023, children under 15 years were the primary population affected by influenza in Ningxia Hui Autonomous Region, with distinct spatio-temporal distribution characteristics. The peak incidence occurred during the winter and spring seasons, and the main clustering areas were in the southern regions.