OBJECTIVE To focus on the classic NOD-like receptor protein 3 （NLRP3）/Caspase-1/gasdermin D （GSDMD） pyroptosis pathway and explore the mechanism by which Huatan qushi huoxue formula （HQHF） inhibits macrophage pyroptosis to ameliorate metabolic dysfunction-associated steatohepatitis （MASH）. METHODS RAW264.7 cells were divided into 5 groups： Control group （10% blank serum）， Model group [10% blank serum+5 μg/mL lipopolysaccharide （LPS）]， HQHF-L group （2.5% drug-containing serum+7.5% blank serum+5 μg/mL LPS）， HQHF-M group （5% drug-containing serum+5% blank serum+5 μg/mL LPS）， and HQHF-H group （10% drug-containing serum+5 μg/mL LPS）. After 24 h of routine culture post-administration， cells and supernatants were collected for assays. Cell morphology was observed via scanning electron microscopy and phase-contrast microscopy； localization and expression of gasdermin D-N （GSDMD-N） were observed by immunofluorescence. Interleukin-1β （IL-1β） and IL-18 contents in supernatants were detected by ELISA； mRNA and protein expressions of NLRP3， Caspase-1， and GSDMD were measured using real-time PCR and Western blot. RESULTS Compared with the Control group， the Model group showed typical pyroptotic morphology （cell membrane bulging and pore formation）， increased aggregation and fluorescence intensity of GSDMD-N on the cell membrane （ P ＜0.05）， significantly increased the contents of IL-1β and IL-18 in cell supernatants （ P ＜0.05）， and significantly up-regulated mRNA and protein expressions of NLRP3， Caspase-1， and GSDMD in cells （ P ＜0.05）. Compared with the Model group， the HQHF-L， HQHF-M and HQHF-H groups showed improved pyroptotic morphology， reduced membrane localization and significantly weakened fluorescence intensity of GSDMD-N （ P ＜0.05）， significantly decreased the contents of IL-1β and IL-18 in cell supernatants （ P ＜0.05）， and significantly down-regulated mRNA and protein expressions of NLRP3， Caspase-1， and GSDMD in cells （ P ＜0.05）. CONCLUSIONS HQHF inhibits LPS-induced macrophage pyroptosis， and its mechanism of improving MASH may be associated with the suppression of the activation of the classical NLRP3/Caspase-1/GSDMD pyroptosis pathway.

Metabolic dysfunction-associated fatty liver disease （MAFLD） has become the leading chronic liver disease worldwide. As a classic food-medicine homologous Chinese herb， hawthorn fruit has the functions of promoting digestion to resolve food stagnation and activating blood circulation to resolve blood stasis. Modern pharmacological studies have shown that hawthorn fruit and its active components exert diverse pharmacological activities in regulating lipid metabolism， improving insulin resistance， inhibiting inflammatory response， delaying hepatic fibrosis， and protecting hepatocytes. These effects precisely match the “multiple-hit” pathological features of MAFLD， and thus hawthorn fruit shows significant advantages in the prevention and treatment of MAFLD. Drug pair combination is a key strategy in traditional Chinese medicine to enhance efficacy and reduce toxicity. In clinical practice， hawthorn fruit is often combined with Salvia miltiorrhiza， Alisma orientalis， cassia seed， and Poria cocos， and such combination adheres to the principle of “mutual reinforcement and assistance” to enhance efficacy and expand their application in different syndromes of MAFLD. This article systematically reviews the core pharmacological mechanisms of hawthorn fruit in intervening against MAFLD and the research advances in its classic drug combinations， in order to provide a scientific reference for the in-depth development of hawthorn fruit and its combinations and the precise clinical intervention of MAFLD.

ObjectiveTo investigate the association between serum creatinine/cystatin C ratio （CCR） and nonalcoholic fatty liver disease （NAFLD） based on the NHANES database， and to evaluate the potential significance of CCR as an indicator reflecting the metabolic status of the body. MethodsBased on the data from the NHANES database in 1999‍ ‍—‍ ‍2004， a total of 4 217 participants were enrolled and divided into NAFLD group with 1 726 participants and non-NAFLD group with 2 491 participants. CCR was compared between the two groups， and the association between CCR and NAFLD was analyzed. The Wilcoxon rank-sum test was used for comparison of continuous data between two groups， and the chi-square test was used for comparison of categorical data between two groups. The multivariate logistic regression model was used to investigate the association between CCR and NAFLD； CCR was divided into 4 groups based on quartiles， and odds ratio （OR） and 95% confidence interval （CI） in the regression model was calculated with the first quartile as reference. In addition， the restricted cubic spline analysis was used to investigate whether there was a non-linear relationship between CCR and NAFLD， and interaction items were introduced into the Logistic regression model to perform an interaction analysis. Subgroup analyses were performed based on the stratification of variables to investigate the difference in the association between CCR and NAFLD in different populations. ResultsThe non-NAFLD group had a significantly higher CCR than the NAFLD group （Z=-4.76，P<0.01）. The Logistic regression analysis showed that in model 1 without adjustment of variables， CCR was negatively associated with NAFLD （OR=0.993，95%CI：0.989‍ ‍—‍ ‍0.996，P<0.01）， and in model 3 with adjustment of all variables， CCR was still negatively associated with NAFLD （OR=0.986，95%CI：0.981‍ ‍—‍ ‍0.991，P<0.01）. The analysis of CCR based on quartiles showed a significant association between the increase in CCR and the reduction in the risk of NAFLD. In model 3， compared with the individuals with the lowest quartile of CCR， the individuals with the highest quartile of CCR had a significantly lower risk of NAFLD （OR=0.426，95%CI：0.316‍ ‍—‍ ‍0.574，P<0.01）. Further interaction and subgroup analyses showed that the interaction between CCR and age/sex had a statistical significance （P_interaction<0.01 and P_interaction=0.04）. The subgroup analysis based on age showed a more significant association between CCR and NAFLD in the middle-aged population （≤60 years） （OR=0.982，95%CI：0.976‍ ‍—‍ ‍0.987）， and the subgroup analysis based on sex showed a stronger association between CCR and NAFLD in women （OR=0.979，95%CI：0.972‍ ‍—‍ ‍0.986）. ConclusionThis study shows a significant negative association between CCR and NAFLD， and such association is more significant in middle-aged individuals and women.

Objective: To establish a database of CD36 antigen-negative donors through large-scale screening of apheresis platelet donors in Shenzhen for CD36 deficiency subtypes and blood group distribution, and to assess clinical demand and blood supply capacity through a retrospective analysis of the apheresis platelet donation volumes from 2019 to 2023. Methods: Flow cytometry with fluorescent CD36 monoclonal antibodies was employed to screen platelet/monocyte CD36 deficiency (Type I and Ⅱ), and statistical analyses were conducted using SPSS software (version 27.0). Results: Among 11 603 apheresis platelet donors, 248 (2.14%) exhibited CD36 deficiency, comprising 51 type Ⅰ (0.43%, 51/11, 603) and 197 type Ⅱ (1.70%, 197/11, 603) cases, with significant difference (P<0.001). CD36 deficient platelets were mainly distributed in blood group B (2.28%, 902.3/39 602.1) and AB (2.14, 269/12 544.5), significantly exceeding those in blood group A (1.43%, 667/46 508.4) and O (1.64%, 1 000/60 965.6) (P<0.001). The proportion of donors with 10-100 U from CD36 deficient donors was the highest (51%, 1 446.4/2 838.3). Conclusion: Sustained screening for CD36-deficient donors is recommended to meet the clinical transfusion needs for immunized patients and those requiring antigen-negative products. Regional resource-sharing mechanisms should be optimized to maximize utilization of CD36-deficient platelet inventories.

Apical microsurgery is accurate and minimally invasive, produces few complications, and has a success rate of more than 90%. However, due to the lack of awareness and understanding of apical microsurgery by dental general practitioners and even endodontists, many clinical problems remain to be overcome. The consensus has gathered well-known domestic experts to hold a series of special discussions and reached the consensus. This document specifies the indications, contraindications, preoperative preparations, operational procedures, complication prevention measures, and efficacy evaluation of apical microsurgery and is applicable to dentists who perform apical microsurgery after systematic training.
Microsurgery/standards* ; Humans ; Apicoectomy ; Contraindications, Procedure ; Tooth Apex/diagnostic imaging* ; Postoperative Complications/prevention & control* ; Consensus ; Treatment Outcome

Instrument separation is a critical complication during root canal therapy, impacting treatment success and long-term tooth preservation. The etiology of instrument separation is multifactorial, involving the intricate anatomy of the root canal system, instrument-related factors, and instrumentation techniques. Instrument separation can hinder thorough cleaning, shaping, and obturation of the root canal, posing challenges to successful treatment outcomes. Although retrieval of separated instrument is often feasible, it carries risks including perforation, excessive removal of tooth structure and root fractures. Effective management of separated instruments requires a comprehensive understanding of the contributing factors, meticulous preoperative assessment, and precise evaluation of the retrieval difficulty. The application of appropriate retrieval techniques is essential to minimize complications and optimize clinical outcomes. The current manuscript provides a framework for understanding the causes, risk factors, and clinical management principles of instrument separation. By integrating effective strategies, endodontists can enhance decision-making, improve endodontic treatment success and ensure the preservation of natural dentition.
Humans ; Root Canal Therapy/adverse effects* ; Consensus ; Root Canal Preparation/adverse effects*

Objective:To explore the mediating effect of job embeddedness and job satisfaction on psycholog-ical capital and organizational silence in clinical nurses.Methods:Totally 412 clinical nurses(145 males and 267 females)were selected and assessed with the Nurse Organizational Silence Assessment Questionnaire(NOSAQ),Psychological Capital Questionnaire-24(PCQ-24),Job Embedding Scale(JES)and Nurses Job Satisfaction Scale(NJSS).SPSS macro program PROCESS and Bootstrap method were used to explore the role of mediation.Results:The NOSAQ scores were negatively correlated with the scores of PCQ-24,JES and NJSS(r=-0.55,-0.59,-0.51,Ps＜0.01).Job embeddedness and job satisfaction played a chain mediating role between psychological capital and organizational silence of clinical nurses(95％CI:-0.26--0.04),and the mediating effect accounted for 14.7％of the total effect.Conclusion:It suggests that organizational silence is closely related to psychological capital,job embeddedness and job satisfaction in clinical nurses.

Objective:To explore the mediating effect of job embeddedness and job satisfaction on psycholog-ical capital and organizational silence in clinical nurses.Methods:Totally 412 clinical nurses(145 males and 267 females)were selected and assessed with the Nurse Organizational Silence Assessment Questionnaire(NOSAQ),Psychological Capital Questionnaire-24(PCQ-24),Job Embedding Scale(JES)and Nurses Job Satisfaction Scale(NJSS).SPSS macro program PROCESS and Bootstrap method were used to explore the role of mediation.Results:The NOSAQ scores were negatively correlated with the scores of PCQ-24,JES and NJSS(r=-0.55,-0.59,-0.51,Ps＜0.01).Job embeddedness and job satisfaction played a chain mediating role between psychological capital and organizational silence of clinical nurses(95％CI:-0.26--0.04),and the mediating effect accounted for 14.7％of the total effect.Conclusion:It suggests that organizational silence is closely related to psychological capital,job embeddedness and job satisfaction in clinical nurses.

Ras-related C3 botulinum toxin substrate 1(RAC1)is a crucial member of the Ras GTPase super-family,exerting an overriding role in cell behaviors such as motility,proliferation and adhesion,and is involved in regu-lating vascular permeability and cellular barrier function.Recently,the significance of RAC1 in the etiology and progres-sion of various pulmonary disorders has garnered increasing attention,which sheds light on lung disease study.In this re-view,we introduce the characteristics of RAC1 systematically and recapitulate its effects and molecular mechanisms in the context of lung tumors,chronic obstructive pulmonary disease,lung injury and pulmonary arterial hypertension,hoping to provide new insights for future pulmonary disease treatment.

Endodontic diseases are a kind of chronic infectious oral disease.Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha.However,it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy(RCT).Recent research,encompassing bacterial etiology and advanced imaging techniques,contributes to our understanding of the root canal system's anatomy intricacies and the technique sensitivity of RCT.Success in RCT hinges on factors like patients,infection severity,root canal anatomy,and treatment techniques.Therefore,improving disease management is a key issue to combat endodontic diseases and cure periapical lesions.The clinical difficulty assessment system of RCT is established based on patient conditions,tooth conditions,root canal configuration,and root canal needing retreatment,and emphasizes pre-treatment risk assessment for optimal outcomes.The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT.These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.