The advent of an aging society means that bone-related diseases impose a substantial burden on the general population and on healthcare systems,highlighting the need to find new treatment method.The occurrence and progression of such diseases are closely linked to inflammatory responses.Moxibustion,as a traditional external treatment in traditional Chinese medicine(TCM),is well-known for its anti-inflammatory and analgesic effects,and it has also demonstrated remarkable therapeutic efficacy for bone-related diseases.Here we review the impact of moxibustion on inflammatory responses associated with bone-related conditions.The anti-inflammatory mechanism of moxibustion in treating bone-related diseases involves mediating pro-inflammatory and anti-inflammatory factors and related mediators,and regulating signaling pathways(e.g.,nuclear factor-kappa B(NF-κB),Janus kinase(JAK)/signal transducer and activator of transcription(STAT),mitogen-activated protein kinase(MAPK),programmed death receptor-1(PD-1)/programmed death ligand-1(PD-L1),adenosine monophosphate-activated protein kinase(AMPK)/UNC-51 like autophagy activating kinase(ULK1)),the hypothalamic-pituitary-adrenal axis,the activation of immune cells,and autophagy.Despite these findings however,the anti-inflammatory mechanisms underlying moxibustion treatment for bone-related diseases remain poorly understood.Further research utilizing advanced technologies is needed to gain a more comprehensive understanding of the anti-inflammatory mechanisms involved in moxibustion therapy.This approach aims to facilitate better clinical applications and contribute to safeguarding human bone health.

OBJECTIVE To establish and verify the risk prediction models for postoperative multidrug-resistant or-ganisms(MDROs)infections in the liver transplantation patients based on the machine learning algorithms so as to provide bases for identification of the population at high risk of postoperative MDROs infections.METHODS The liver transplantation patients who were retrospectively collected from intensive care Ⅳ database(MIMIC-Ⅳ)and eICU collaborative research database(eICU)were recruited as the research subjects,meanwhile,the patients who underwent liver transplantation in the First Hospital of Shanxi Medical University from Jan.2021 to Jul.2024 were assigned as the external verification group.The variables were selected by Lasso regression,and the models were established based on 7 types of machine learning algorithms such as extreme gradient boosting algorithm and random forest.The predictive performances of the models were evaluated by comparing the areas under receiver operating characteristic(ROC)curves and the accuracy,the characteristic variables were interpreted by Shapley additive explanations(SHAP),and the risk prediction calculator was established.RESULTS A total of 637 pa-tients were finally enrolled in the study,and the incidence of postoperative MDROs infections was 35.79％.Total-ly 15 variables were finally selected for construction of the model.The area under the receiver operating character-istic curve of XGBoost model was 0.82 for the internal test set,0.78 for the external test set;the predictive per-formance of XGBoost model was better than that of the rest of 6 models.SHAP algorithm indicated that the top 5 important predictive factors were as follows:hepatic encephalopathy,length of intensive care unit(ICU)stay,albumin,model of end-stage liver disease(MELD)and total length of hospital stay.CONCLUSION The risk pre-diction models that are established based on the machine learning algorithms have remarkable effect on prediction of the postoperative MDROs infections and can accurately identify the liver transplantation patients at high risk of postoperative MDROs infections,which may provide guidance for the identification of high-risk population and the development of prevention and treatment measures for infections.

OBJECTIVE To establish and verify the risk prediction models for postoperative multidrug-resistant or-ganisms(MDROs)infections in the liver transplantation patients based on the machine learning algorithms so as to provide bases for identification of the population at high risk of postoperative MDROs infections.METHODS The liver transplantation patients who were retrospectively collected from intensive care Ⅳ database(MIMIC-Ⅳ)and eICU collaborative research database(eICU)were recruited as the research subjects,meanwhile,the patients who underwent liver transplantation in the First Hospital of Shanxi Medical University from Jan.2021 to Jul.2024 were assigned as the external verification group.The variables were selected by Lasso regression,and the models were established based on 7 types of machine learning algorithms such as extreme gradient boosting algorithm and random forest.The predictive performances of the models were evaluated by comparing the areas under receiver operating characteristic(ROC)curves and the accuracy,the characteristic variables were interpreted by Shapley additive explanations(SHAP),and the risk prediction calculator was established.RESULTS A total of 637 pa-tients were finally enrolled in the study,and the incidence of postoperative MDROs infections was 35.79％.Total-ly 15 variables were finally selected for construction of the model.The area under the receiver operating character-istic curve of XGBoost model was 0.82 for the internal test set,0.78 for the external test set;the predictive per-formance of XGBoost model was better than that of the rest of 6 models.SHAP algorithm indicated that the top 5 important predictive factors were as follows:hepatic encephalopathy,length of intensive care unit(ICU)stay,albumin,model of end-stage liver disease(MELD)and total length of hospital stay.CONCLUSION The risk pre-diction models that are established based on the machine learning algorithms have remarkable effect on prediction of the postoperative MDROs infections and can accurately identify the liver transplantation patients at high risk of postoperative MDROs infections,which may provide guidance for the identification of high-risk population and the development of prevention and treatment measures for infections.

The advent of an aging society means that bone-related diseases impose a substantial burden on the general population and on healthcare systems,highlighting the need to find new treatment method.The occurrence and progression of such diseases are closely linked to inflammatory responses.Moxibustion,as a traditional external treatment in traditional Chinese medicine(TCM),is well-known for its anti-inflammatory and analgesic effects,and it has also demonstrated remarkable therapeutic efficacy for bone-related diseases.Here we review the impact of moxibustion on inflammatory responses associated with bone-related conditions.The anti-inflammatory mechanism of moxibustion in treating bone-related diseases involves mediating pro-inflammatory and anti-inflammatory factors and related mediators,and regulating signaling pathways(e.g.,nuclear factor-kappa B(NF-κB),Janus kinase(JAK)/signal transducer and activator of transcription(STAT),mitogen-activated protein kinase(MAPK),programmed death receptor-1(PD-1)/programmed death ligand-1(PD-L1),adenosine monophosphate-activated protein kinase(AMPK)/UNC-51 like autophagy activating kinase(ULK1)),the hypothalamic-pituitary-adrenal axis,the activation of immune cells,and autophagy.Despite these findings however,the anti-inflammatory mechanisms underlying moxibustion treatment for bone-related diseases remain poorly understood.Further research utilizing advanced technologies is needed to gain a more comprehensive understanding of the anti-inflammatory mechanisms involved in moxibustion therapy.This approach aims to facilitate better clinical applications and contribute to safeguarding human bone health.

Ghrelin is a hormone produced by the stomach that regulates energy metabolism after acting on the central nervous system.Cocaine amphetamine-regulated transcriptional peptide(CART)neurons participate in the regulation of feeding behavior and energy balance.It is known that CART neurons are influenced by hormones to regulate energy homeostasis,but whether ghre-lin exerts its pro-appetite function by influencing CART neurons is unknown.Therefore,this study focuses on the role of VMHCART neurons in the regulation of feeding and relative body weight by ghrelin.Firstly,the whole brain expression of CART was determined by immunofluorescence.Then the effect of intraperitoneal injection of ghrelin on the expression of DMHCART neurons was evalua-ted.Finally,the ghrelin was delivered to DMH and the changes of food intake and relative body weight of mice were measured.CART immunoreactive neurons were detected in medial preoptic nucleus(MPA),arcuate nucleus(ARC),dorsomedial hypothalamic nucleus(DMH),thalamic pa-raventricular nucleus(PVT)and raphe nucleus(ROb).Compared with the control group,periph-eral injection of ghrelin significantly increased the expression of DMHC ART immunoreactive neurons(P=0.037 3).DMH long-term injection of ghrelin resulted in an increase in body weight(P=0.004 0)and feed intake(P=0.023 1).The results provide anatomical evidence for the whole brain distribution of CART,which proves that ghrelin affects feed intake and body weight of mice through CART neurons in DMH,suggesting that specific neuron types and regional specificity are involved in ghrelin regulation of feed intake and energy homeostasis.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To investigate the clinical symptoms and psychological health status of migraine patients.Methods A total of 120 migraine patients admitted to Xingtai People's Hospital from September 14,2022 to July 30,2023 were selected and divided into mild pain group(0-3 points,51 cases),moderate pain group(4-6 points,48 cases),and severe pain group(7-10 points,21 cases)according to numerical rating scale.General clinical data,headache impact test-6(HIT-6),patient health questionnaire-9(PHQ-9),generalized anxiety disorder(GAD-7)and Pittsburgh sleep quality index(PSQI)were collected.Results The scores of HIT-6,PHQ-9,GAD-7,and PSQI of migraine patients were(56.33±11.30)points,(3.38±1.51)points,(3.01±0.58)points,and(4.73±0.78)points,respectively.There were statistically significant differences in the duration and total number of headache attacks among three groups(P＜0.05).With the aggravation of headache degree,the duration of headache attacks increased and the number of attacks increased.There were statistically significant differences in the scores of HIT-6 and GAD-7 among three groups(P＜0.05),and the scores of HIT-6 and GAD-7 increased with the aggravation of headache.Conclusion There are differences in the daily life impact,anxiety,pain duration and frequency of migraine in patients with different degrees of migraine.

Objective To study the effect of IL-22 on the colonic barrier and its relationship with Nrf2 pathway in liver fibrosis mice.Methods The mice were divided into four groups:the control group(CON group),the model group(MOD group),the interleukin-22 group(IL-22 group),and the IL-22+ML385 group(ML385,an inhibitor of Nrf2),with 10 mice in each group,and the modeling cycle was 8 weeks.Liquid feed containing alcohol and carbon tetrachloride olive oil were given intraperitoneally in all groups except the CON group;IL-22 was given on top of this in the IL-22 group;and ML385 was injected intraperitoneally in the IL-22+ML385 group one hour before IL-22 treatment.At the end of modeling,the livers were stained with HE and Masson staining to clarify whether fibrosis occurred in the mice;the feces were collected to detect the cocci to bacillus ratio and observe the growth of intestinal flora;the colons were stained with HE staining,immunofluorescence and immunohistochemistry,and analyzed for the expression of tight junction proteins ZO-1,Occludin,and the Nrf2 pathway proteins(Nrf2,HO-1,and NQO1).The expression of these proteins was analyzed by immunohistochemistry.Results Compared with the CON group,mice in the MOD group showed significant fibrosis in the liver tissue,inflammatory cell infiltration in the colon tissue,and decreased expression of tight junction proteins(P<0.05).No overgrowth of various pathogenic bacteria was seen in fecal media.And there was no significant difference in the bulb-to-bar ratio.Compared with the MOD group,both liver and colon histopathologic damage were reduced in the IL-22 group,and tight junction protein expression was elevated,in addition,the expression levels of Nrf2,NQO1,and HO-1 were also elevated(P<0.05),whereas there was no significant change in the IL-22+ML385 group.Conclusion IL-22 improved the colonic barrier function in liver fibrosis mice,and the mechanism was related to the activation of Nrf2 anti-oxidative stress pathway.

Objective To discover the host factor interacting with severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)papain-like protease(PLpro)and explore the potential mechanism.Methods The second-generation proximity-dependent biotin identification(BioID2)approach combined with mass spectrometry analysis was used to search for the potential host factors.Immunofluorescence and co-immunoprecipitation(Co-IP)assay were used to verify the interactions between DEAD-box helicase 3(DDX3)and PLpro.The influence of PLpro on DDX3-inhibitor of kappa B kinase ε(IKKε)-TANK-binding kinase 1(TBK1)and DDX3-mitochondrial antiviral signaling protein(MAVS)complexes was also investigated by Co-IP.The effect of PLpro on interferon-β(IFN-β)immune pathway and the protease activity on substrates were studied via luciferase activity assay.Results DDX3 could co-locate and interact with PLpro intracellularly.PLpro might possibly inhibit both the formation of DDX3-MAVS complex and the interactions between DDX3-IKK-ε-TBK1.PLpro could negatively regulate type Ⅰ interferon pathway.Overexpression of DDX3 could lead to a significant increase in the cleavage activity of PLpro/PLP-TM that might be significantly decreased in case of inventions with DDX3 expressions.Conclusion DDX3 may be one of the host factors that interact with SARS-CoV-2 PLpro.PLpro negatively regulates IFN-β immune pathway induced by DDX3,which may provide a favorable immune environment for virus replication.

Macroautophagy (referred to as autophagy hereafter) is a major intracellular lysosomal degradation pathway that is responsible for the degradation of misfolded/damaged proteins and organelles. Previous studies showed that autophagy protects against acetaminophen (APAP)-induced injury (AILI) via selective removal of damaged mitochondria and APAP protein adducts. The lysosome is a critical organelle sitting at the end stage of autophagy for autophagic degradation via fusion with autophagosomes. In the present study, we showed that transcription factor EB (TFEB), a master transcription factor for lysosomal biogenesis, was impaired by APAP resulting in decreased lysosomal biogenesis in mouse livers. Genetic loss-of and gain-of function of hepatic TFEB exacerbated or protected against AILI, respectively. Mechanistically, overexpression of TFEB increased clearance of APAP protein adducts and mitochondria biogenesis as well as SQSTM1/p62-dependent non-canonical nuclear factor erythroid 2-related factor 2 (NRF2) activation to protect against AILI. We also performed an unbiased cell-based imaging high-throughput chemical screening on TFEB and identified a group of TFEB agonists. Among these agonists, salinomycin, an anticoccidial and antibacterial agent, activated TFEB and protected against AILI in mice. In conclusion, genetic and pharmacological activating TFEB may be a promising approach for protecting against AILI.