ObjectiveTo investigate the association of the serum levels of Golgi protein 73 （GP73）， hypoxia-inducible factor-1α （HIF-1α）， and matrix metalloproteinase-9 （MMP-9） before and after transcatheter arterial chemoembolization （TACE） with the treatment outcome of patients with hepatitis B virus （HBV）-related hepatocellular carcinoma （HCC）. MethodsA total of 135 patients with HBV-related HCC who received TACE for the first time in The First Affiliated Hospital of Xinjiang Medical University from January 2023 to October 2025 were enrolled as subjects， and the serum levels of GP73， HIF-1α， and MMP-9 were measured before TACE and at 1 month after TACE. According to the treatment outcome after TACE， the patients were divided into remission group and non-remission group. The two groups were compared in terms of general information and the serum levels of GP73， HIF-1α， and MMP-9 before and after treatment. The Logistic regression analysis was used to investigate the influencing factors for the efficacy of TACE， and the receiver operating characteristic （ROC） curve was used to assess the value of the serum levels of GP73， HIF-1α， and MMP-9 before treatment used alone or in combination in predicting the efficacy of TACE. The independent-samples t 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. ResultsAmong the 135 patients after treatment， 78 （57.78%） were enrolled in the remission group and 57 （42.22%） were enrolled in the non-remission group. Before treatment， the remission group had significantly lower serum levels of GP73， HIF-1α， and MMP-9 than the non-remission group （all P<0.05）； after treatment， both groups had reductions in the serum levels of GP73， HIF-1α， and MMP-9， and the remission group had significantly lower levels than the non-remission group （all P<0.05）. The binary Logistic regression analysis showed that increases in the serum levels of GP73， HIF-1α， and MMP-9 before treatment were independent influencing factors for the efficacy of TACE （all P<0.05）. The ROC curve analysis showed that the serum levels of GP73， HIF-1α， and MMP-9 before treatment used alone had an area under the ROC curve （AUC） of 0.799， 0.835， and 0.777， respectively， in predicting the efficacy of TACE， among which HIF-1α showed the highest predictive value， and the combination of these three indicators had an AUC of 0.950， a Youden index of 0.787， an optimal cut-off value of 0.39， a sensitivity of 87.72%， and a specificity of 91.03%. ConclusionTACE can reduce the serum levels of GP73， HIF-1α， and MMP-9 in patients with HBV-related HCC， and patients with a good outcome tend to have greater reductions. The high serum levels of GP73， HIF-1α， and MMP-9 before treatment are independent risk factors for poor short-term efficacy of TACE， and the combination of these three indicators has a relatively high value in predicting the efficacy of TACE.

ObjectiveTo investigate the role and underlying mechanism of the Wnt/β-catenin signaling pathway in the process of Xiaojinwan （XJW）-containing serum interfering with endothelial-mesenchymal transition （EMT） in human breast cancer MDA-MB-231 cells. MethodsXJW-containing serum was prepared by intragastric administration of XJW （4 g·kg^-1） to SD rats. MDA-MB-231 cells were cultured in vitro. β-Catenin overexpression and knockdown plasmids were constructed and transfected into MDA-MB-231 cells. The optimal XJW-containing serum （4 g·kg^-1） according to previous studies was used for β-catenin intervention and overexpression experiments. The groups for intervention/overexpression experiments included intervention/overexpression blank group， β-catenin intervention/overexpression group， intervention/overexpression blank + XJW group， and β-catenin intervention/overexpression + XJW group. Cell morphology was observed under a microscope. Flow cytometry was used to detect and record apoptosis rates. Western blot was performed to measure apoptosis-related proteins ［B-cell lymphoma 2 （Bcl-2）， Bcl-2-associated X protein （Bax）， and active-Caspase-3］ and EMT-related proteins （E-cadherin， N-cadherin， and vimentin）. Real-time polymerase chain reaction （Real-time PCR） was used to detect β-catenin mRNA expression levels in different groups. ResultsIntervention experiment results showed that compared with the intervention blank group， the β-catenin intervention group and the intervention blank + XJW group showed increased apoptosis rates （P<0.05， P<0.01）， elevated protein levels of Bax， active Caspase-3， and E-cadherin （P<0.05， P<0.01）， and decreased protein levels of Bcl-2 and Vimentin （P<0.05， P<0.01）. β-catenin mRNA expression was reduced in the β-catenin intervention group （P<0.05， 0.63 ± 0.15） and the intervention blank + XJW group （P<0.05， 0.79 ± 0.33）. Compared with the β-catenin intervention group， the β-catenin intervention + XJW group exhibited an increased apoptosis rate （P<0.01）， elevated Bax and active Caspase-3 protein levels （P<0.05， P<0.01）， and decreased Bcl-2， N-cadherin， and Vimentin protein levels （P<0.05）. β-catenin mRNA expression was further reduced in the β-catenin intervention + XJW group （P<0.01， 0.22 ± 0.08）. Compared with the intervention blank + XJW group， the β-catenin intervention + XJW group showed an increased apoptosis rate （P<0.01）， elevated Bax， active Caspase-3， and E-cadherin protein levels （P<0.05， P<0.01）， and decreased Bcl-2， N-cadherin， and vimentin protein levels （P<0.05， P<0.01）. β-catenin mRNA expression was also reduced （P<0.05）. Overexpression experiment results showed that compared with the overexpression blank group， the β-catenin overexpression group exhibited a reduced apoptosis rate （P<0.01）， while the overexpression blank + XJW group showed an increased apoptosis rate （P<0.05）. In the β-catenin overexpression and β-catenin overexpression + XJW groups， Bax and E-cadherin protein levels decreased （P<0.05， P<0.01）， while Bcl-2， N-cadherin， and vimentin levels increased （P<0.05）. In the overexpression blank + XJW group， Bax and E-cadherin levels increased （P<0.05， P<0.01）， while Bcl-2， N-cadherin， and vimentin levels decreased （P<0.05， P<0.01）. β-catenin mRNA expression increased in the β-catenin overexpression group （P<0.01， 7.26 ± 1.03） but decreased in the overexpression blank + XJW group （P<0.05， 0.73 ± 0.14）. Compared with the β-catenin overexpression group， the β-catenin overexpression + XJW group showed an increased apoptosis rate （P<0.01）， elevated Bax and E-cadherin levels （P<0.05）， and decreased N-cadherin and vimentin levels （P<0.05）. β-catenin mRNA expression was reduced （P<0.05， 4.65 ± 1.02）. Compared with the overexpression blank + XJW group， the β-catenin overexpression + XJW group exhibited a reduced apoptosis rate （P<0.01）， decreased Bax and E-cadherin levels （P<0.01）， and increased Bcl-2， N-cadherin， and Vimentin levels （P<0.05）. β-catenin mRNA expression increased （P<0.01）. ConclusionXJW-containing serum inhibits breast cancer cell proliferation by suppressing EMT， which is associated with the regulation of the Wnt/β-catenin pathway.

In 2026， the European Association for the Study of the Liver and the American Association for the Study of Liver Diseases jointly published a Delphi consensus statement on surrogate endpoints and real-world evidence in primary biliary cholangitis. This consensus proposes 16 statements and 42 recommendations centering on the following three most critical issues in the development of new drugs for primary biliary cholangitis： whether liver biochemical parameters and noninvasive assessments of liver fibrosis can be used as surrogate endpoints for clinical outcomes； how real-world data and real-world evidence can complement or support confirmatory studies in a manner compliant with regulatory requirements； how patient-reported outcomes can be standardized for the assessment of quality of life， pruritus， and fatigue. This article provides an excerpt and expert interpretation of the background， methodological framework， core statements， recommendations， and key figures and tables of this consensus， in order to provide a reference for the diagnosis and treatment of primary biliary cholangitis， drug evaluation， real-world study design， and the development of patient-centered clinical endpoints in China.

Objective To investigate the prevalence of spotted fever group rickettsiae (SFGR) infections in free-living ticks and among high-risk populations in the southern margin of the Gurbantunggut Desert, Xinjiang Uygur Autonomous Region, so as to provide insights into tick-borne diseases prevention and control in this region. Methods Free-living ticks were collected from five counties (cities) in the southern margin of the Gurbantunggut Desert, Xinjiang Uygur Autonomous Region. Tick species were identified by morphology combined with mitochondrial cytochrome c oxidase subunit Ⅰ (COI) gene analysis. Four target gene fragments of Rickettsia were amplified using a nested PCR assay, including outer membrane protein B (ompB), 17-kDa common surface antigen protein (17kDa), surface cell antigen 1 (sca1), and surface cell antigen 4 (sca4) genes, to detect the prevalence of SFGR infections in tick samples. Positive PCR amplification products were purified, sequenced, and subjected to sequence alignment, and phylogenetic trees were created using the neighbor-joining (NJ) method. Serum samples were collected from individuals at a high risk of tick exposure from six counties (cities, districts) in the southern margin of the Gurbantunggut Desert, Xinjiang Uygur Autonomous Region, and serum levels of anti-R. sibirica IgG antibodies were detected among these individuals using indirect immunofluorescence assay (IFA) and statistically analyzed. Results A total of 287 free-living ticks were collected, and all were identified as Hyalomma asiaticum. The overall prevalence of SFGR infection was 78.40% (225/287) in tick samples, and five Rickettsia species were characterized, including R. sibirica, which shared 99.81% (515/516) sequence homology with the strain detected in Dermacentor sinicus from China; R. massiliae, which shared 99.80% (509/510) sequence homology with the strain detected in Rhipicephalus sanguineus from Ethiopia; R. raoultii, which shared 100.00% (516/516) sequence homology with the strain detected in Hyalomma asiaticum from Xinjiang Uygur Autonomous Region in China; R. africae, which shared 100.00% (524/524) sequence homology with the strain detected in Amblyomma splendidum from Ethiopia; and Candidatus Rickettsia barbariae, which shared 99.80% (499/500) sequence homology with the strain detected in steppe polecats from Xinjiang Uygur Autonomous Region in China, with R. sibirica (33.80% detection rate, 97/287) and R. raoultii (33.10%, 95/287) as dominant species. A total of 1 489 serum samples were collected from individuals at a high risk of tick exposure, and the seroprevalence of antiR. sibirica IgG antibodies was 30.83% (459/1 489). There were no significant differences in the seroprevalence in terms of genders (χ² = 2.23, P > 0.05) or age groups (χ² = 6.45, P > 0.05); however, there was a region-specific seroprevalence rate of anti-R. sibirica IgG antibodies (χ² = 16.05, P < 0.05). Pairwise comparisons showed lower seroprevalence rate of anti-R. sibirica IgG antibodies among high-risk individuals in Midong District of Urumqi City (22.27%, 53/238) than in Wujiaqu City (34.70%, 93/268) and Manas County(37.55%, 98/261) (both P values < 0.05); however, they were not significantly different from those in the other regions (all P values > 0.05). Conclusion Multiple SFGR species are detected in H. asiaticum ticks sampled from the southern margin of the Gurbantunggut Desert, Xinjiang Uygur Autonomous Region, where there is a potential risk of local transmission of spotted fever rickettsiosis.

ObjectiveTo investigate the mechanism underlying the weight loss effect of electrothermal acupuncture （ETA） in diet-induced obese （DIO） model mice based on the hypoxia-inducible factor-1α （HIF-1α）/sphingosine-1-phosphate （S1P）sphingosine-1-phosphate receptor 3 （S1PR3） signaling pathway-mediated macrophage polarization. MethodsAn obesity mouse model was established by continuously feeding at a high-fat diet （HFD） for 8 weeks. Twenty successfully modeled obese mice were randomly divided into a model group and an electrothermal acupuncture （ETA） group with 10 mice per group， both of which continued to receive the HFD till week 12. Another 10 mice were assigned to the normal group and fed a standard chow diet continuously for 12 weeks. Starting from week 9 of the experiment， mice in the ETA group received electrothermal acupuncture stimulation at Zhongwan （CV12）， bilateral Tianshu （ST25）， and bilateral Zusanli （ST36） for 30 minutes per session， with the instrument current set at （40±0.5）mA and a constant temperature of （40±0.5）℃. Mice in the normal group and the model group were restrained in the same manner for 30 minutes without acupuncture. All interventions were performed once every other day for a total of 4 weeks. Ten hours after the final intervention， the body weight， waist circumference， and body length of mice in each group were measured， and Lee's index was calculated. Serum biochemical analysis was performed to assess fasting blood glucose （FBG）， total cholesterol （TC）， triglycerides （TG）， high-density lipoprotein cholesterol （HDL-C）， low-density lipoprotein cholesterol （LDL-C）， alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， blood urea nitrogen （BUN）， and creatinine （Cr）. Serum leptin （LEP） and adiponectin （ADPN） levels， as well as sphingosine-1-phosphate （S1P） levels in epididymal white adipose tissue （eWAT）， were detected by ELISA. Histomorphological changes in eWAT were monitored via HE staining. Flow cytometry was used to analyze macrophage subtype-related indexes in eWAT， including the total proportion of macrophages， the proportion of M1 macrophages， the proportion of M2 macrophages， and the M1/M2 ratio. Antibody array technology was used to determine the levels of differentially expressed inflammatory factors in eWAT between the model and blank groups， as well as between the ETA and model groups. Western blot and qPCR were used to detect the protein and mRNA expression levels of HIF-1α and S1PR3 in the eWAT， respectively. ResultsCompared to the normal group， the model group showed significantly increased body weight， Lee's index， waist circumference， and FBG， TC， TG， HDL-C， LDL-C， AST， and ALT levels， upgraded LEP and S1P levels， decreased ADPN level and ADPN/LEP ratio， elevated proportion of M1 macrophages and the M1/M2 ratio， reduced proportion of M2 macrophages， and upregulated protein and mRNA expression levels of HIF-1α and S1PR3 （P＜0.05 or P＜0.01）. With the exception of HDL-C， all the abovementioned indicators in the ETA group were significantly improved compared to the model group （P＜0.05 or P＜0.01）. Analysis of differentially expressed inflammatory cytokines revealed that， compared to the normal group， the levels of interleukin-1β （IL-1β）， interferon-γ （IFN-γ）， interleukin-6 （IL-6）， and interleukin-12p70 （IL-12p70） in the eWAT of the model group were elevated； conversely， the levels of interleukin-17 （IL-17）， interleukin-5 （IL-5）， IL-6， and interleukin-23 （IL-23） in the eWAT of the ETA group decreased compared to the model group （P＜0.05 or P＜0.01）. ConclusionETA exerts a weight-reducing effect in obese model mice， and the mechanism may involve inhibition of the HIF-1α/S1P/S1PR3 signaling pathway activation， which shifts macrophage polarization from the M1 to M2 phenotype， thereby alleviating chronic inflammation.

ObjectiveTo investigate the regulatory effect of miR-21-5p in bone marrow mesenchymal stem cell-derived exosome （BMSC-Exo） on angiogenesis through the phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway. MethodsBone marrow mesenchymal stem cells （BMSCs） were isolated from rats， cultured， and divided into negative control group （NC group） and inhibitor group， which were transfected with miR-21-5p negative control and miR-21-5p inhibitor， respectively， and then exosomes were extracted and identified. Exosomes were co-cultured with human umbilical vein endothelial cells （HUVECs）. MTT assay was used to measure cell proliferation （24， 48， and 72 hours）， tube formation assay was used to assess angiogenesis ability， and Western blot was used to measure the protein expression levels of phosphorylated Akt （p-Akt）， total Akt， and vascular endothelial growth factor （VEGF）. The change in the angiogenesis ability of HUVECs was observed after treatment with the PI3K inhibitor LY294002. The independent samples t-test was used for comparison of continuous data between two groups， and a one-way analysis of variance was used for comparison between multiple groups， while the least significant difference t-test was used for further comparison between two groups. ResultsFlow cytometry showed that the third-generation BMSCs showed high expression levels of CD29 （98.18%） and CD90 （97.85%） and a low expression level of CD45 （0.22%）. Quantitative real-time reverse transcription-polymerase chain reaction showed that compared with the NC group， there was a significant reduction in the relative expression level of miR-21-5p in BMSCs after transfection with miR-21-5p inhibitor （0.38±0.05 vs 1.00±0.08， t=11.38， P<0.01）. MTT assay showed that compared with the control group， the 25， 50， 100， and 200 μg/mL exosome treatment groups had a significant increase in the proliferative activity of HUVECs （all P<0.05）， among which 100 μg/mL exosome treatment for 72 hours showed the most significant pro-proliferative effect， while the 400 μg/mL exosome treatment group showed a significant reduction in the proliferative activity of HUVECs （P<0.01）. Tube formation assay showed that compared with the control group and the NC-Exo group， the inhibitor-Exo group showed a significant reduction in angiogenesis ability （both P<0.05）， and compared with the inhibitor-Exo group， there was a further significant reduction in angiogenesis ability after addition of the PI3K inhibitor LY294002 （P<0.01）. Western blot showed that compared with the control group and the NC-Exo group， the inhibitor-Exo group had significant reduction in the protein expression levels of p-Akt and VEGF （all P<0.05）， and compared with the inhibitor-Exo group， the protein expression levels of p-Akt and VEGF further decreased significantly after the addition of LY294002 （both P<0.01）. ConclusionBMSC-Exo targets and activates the PI3K/Akt signaling pathway through miR-21-5p， upregulates the expression of VEGF， and promotes vascular endothelial cell proliferation and angiogenesis.

Liver injury, as one of the common clinical manifestations of brucellosis, presents a diversity of pathophysiological mechanisms, pathological manifestations, and clinical features, which may trigger severe organ dysfunction and poor prognostic conditions. This article systematically analyzes the research progress on brucellosis combined with liver injury at home and abroad, focusing on discussing its pathophysiological mechanism, pathological and clinical features, as well as prognostic outcomes, with the aim to provide a solid theoretical basis for the clinical diagnosis, therapeutic strategies, and prognostic management.

Portal hypertensive biliopathy is a secondary condition of intrahepatic and extrahepatic bile duct abnormalities caused by portal hypertension, especially in extrahepatic portal venous obstruction. Most patients may remain asymptomatic for a long time, while a few may present with symptomatic portal hypertensive biliopathy, such as obstructive jaundice, cholelithiasis with or without cholangitis, gastrointestinal bleeding, and others. Such disease is rare in clinical practice and is prone to misdiagnosis and missed diagnosis. Improper treatment can lead to serious adverse consequences. We report a case of unexpected discovery of bile duct dilation due to abdominal pain, which was ultimately diagnosed as portal hypertensive biliopathy based on the medical history, manifestations of portal hypertension, and imaging examinations, especially intraductal ultrasonography.

Metabolic associated fatty liver disease (MAFLD) has replaced non-alcoholic fatty liver disease (NAFLD), emphasizing the core role of metabolic dysfunctions and necessitating a multidisciplinary (MDT) approach for diagnosis and treatment to concurrently manage liver disease and metabolic disorders.Downplaying the non-alcohol label while focusing more on metabolic driving factors allows it to coexist with other liver diseases. The gastroenterology and hepatology department is the initial assessment department, and MDT, which includes endocrinology, nutrition, sports medicine, surgery, and psychology, develops individualized treatment plans. With the aim of halting the progression of the disease (steatosis → fibrosis → cirrhosis) and eventually improving patient prognosis, MAFLD management must be based on metabolic intervention and accomplish "liver disease metabolic co-treatment" through multidisciplinary integration.

Thoracolumbar spine fracture often leads to severe pain, functional impairments, and neurological deficits, for which open reduction and internal fixation can effectively restore the spinal structural stability. Open decompression and reduction with internal fixation can help relieve spinal cord compression and improve spinal function in cases of concomitant cord injury. Although spinal stability can be restored through surgery, patients often face chronic pain and functional impairments postoperatively. A postoperative rehabilitation program is critical in optimizing therapeutic outcomes, reducing complications, and minimizing the risk of secondary injuries. However, current rehabilitation methods, such as physical therapy, functional training, and pain management, are confronted with problems in clinical practice, including significant variation in efficacy, poor patient adherence, and prolonged rehabilitation period. There is an urgent need for a unified rehabilitation strategy to address these problems. To this end, the Spinal Trauma Group of the Orthopedic Physicians Branch of the Chinese Medical Association and the Spine Health Professional Committee of the Chinese Human Health Technology Promotion Association organized experts from relevant fields to formulate Evidence-based guidelines for rehabilitation treatment after internal fixation of thoracolumbar spine fracture in adults ( version 2025) by integrating evidences from clinical researches and advanced rehabilitation concepts at home and abroad. A total number of 14 recommendations concerning the rehabilitation treatment with multimodal analgesia, psychological intervention, deep vein thrombosis prevention, core muscle and extremity exercise, appropriate use of braces, early weight-bearing, device-aided rehabilitation exercise, neuroregulatory therapy, rehabilitation team were put forward, aiming to standardize the post-operative rehabilitation process following internal fixation, promote the functional recovery, and enhance patients′ quality of life.