Hepatic encephalopathy is a difficult and critical disease with rapid progression and limited treatment methods in the field of liver disease， and it is urgently needed to make breakthroughs in its pathogenesis. Selection of appropriate prevention and treatment strategies is of great importance in delaying disease progression and reducing the incidence and mortality rates. This article reviews the theory of “turbid toxin pathogenesis” and related prevention and treatment strategies for hepatic encephalopathy in traditional Chinese medicine/Zhuang medicine， proposes a new theory of “turbid toxin pathogenesis”， analyzes the scientific connotations of “turbid”， “toxin”， and the theory of “turbid toxin pathogenesis”， and constructs the “four-step” prevention and treatment strategies for hepatic encephalopathy， thereby establishing the new clinical prevention and treatment regimen for hepatic encephalopathy represented by “four prescriptions and two techniques” and clarifying the effect mechanism and biological basis of core prescriptions and techniques in the prevention and treatment of hepatic encephalopathy， in order to provide a reference for the prevention and treatment of hepatic encephalopathy.

OBJECTIVE To build a Tibetan-language medication service platform based on “internet+” and evaluate its effect on improving medication compliance and safety of Tibetan patients with chronic disease. METHODS Medication guidance contents of commonly used drugs in the outpatient department were summarized， translated and recorded in Tibetan-language or video to form a “text-audio-video” multi-dimensional “internet+ ” Tibetan-language medication service platform. A total of 387 Tibetan outpatients with chronic disease in our hospital after the implementation of “internet+” Tibetan-language medication service platform （from January 2024 to June 2024） in our hospital were selected as the intervention group， and 387 Tibetan outpatients before the implementation （from January 2023 to June 2023） were selected as the control group. Patients in the control group received conventional window-based Chinese-language medication services， while patients in the intervention group received both conventional window-based Chinese-language medication service and “internet+ ” Tibetan-language medication service. The medication compliance of patients was evaluated using the 12-item Medication Compliance Scale. A six-level causality assessment was conducted as the principles for analyzing adverse drug reactions （ADR） set by the National Center for ADR Monitoring. Additionally， statistics were compiled on the occurrence of ADR that were assessed as “definite”“probable” or “possible” in the causality assessment. RESULTS The proportion （31.0%） of patients with good medication compliance and compliance scores [39.0 （37.0，42.0）] of patients in the intervention group were significantly better than control group [7.0%， 21.0（19.0， 23.0）]（ P＜0.05）. There were no statistically significant differences in the incidence of various types of ADR or the overall incidence between the two groups （P＞0.05）. CONCLUSIONS The “internet+” Tibetan-language medication service platform is constructed successfully； the service can effectively improve the medication compliance of Tibetan-language patients， but its effect on improving the medication safety of patients is limited.

OBJECTIVES: The prevalence of overweight and obesity among children and adolescents continues to rise, becoming one of the most serious global public health issues of the 21st century. Given the differing growth and development environments between urban and rural children, associated risk factors also vary. This study aims to explore the distribution characteristics and influencing factors of overweight and obesity among urban and rural primary and secondary school students in Hunan Province, providing scientific evidence for targeted interventions. METHODS: A stratified, randomized cluster sampling method was used to select participants. A total of 197 084 students from primary and secondary schools across 14 prefectures in Hunan Province underwent physical examinations and questionnaire surveys. Population and spatial distribution characteristics of overweight and obesity were analyzed. Spatial distribution maps and spatial autocorrelation analyses were conducted using ArcGIS. Multivariate Logistic regression was used to identify influencing factors for overweight and obesity. RESULTS: The overall overweight and obesity rates among students in Hunan Province were 14.7% and 10.9%, respectively. Both rates were higher in urban areas than in rural counties (16.0% vs 13.9% for overweight; 12.1% vs 10.2% for obesity). Among both urban and rural students, boys had higher rates of overweight and obesity than girls. Higher-grade students had a higher overweight rate but a lower obesity rate than lower-grade students. In urban areas, the overweight and obesity rates of Han Chinese primary and secondary school students are lower than those of ethnic minority students (both P<0.05). In rural areas, the obesity rate of Han primary and secondary school students is lower than that of ethnic students (P<0.05). Across cities and prefectures, urban overweight and obesity rates ranged from 14.7% to 18.7% and 8.4% to 20.6% respectively, while rural rates ranged from 10.9% to 17.2% and 6.6% to 13.7% respectively. Spatial autocorrelation analysis revealed high-value clusters of overweight/obesity in urban areas of Changde and Zhangjiajie, and in rural areas of Loudi, Huaihua, and Shaoyang. Multivariate Logistic regression showed that gender, school stage, ethnicity, frequency of fresh vegetable intake, and sleep duration were associated with overweight and/or obesity in both urban and rural students. In urban students, frequency of fried food and fresh fruit intake, breakfast habits, physical activity on weekdays and holidays, and screen time on computers were also significant. In rural students, TV viewing time and sedentary duration were additional relevant factors. CONCLUSIONS The situation of overweight and obesity among primary and secondary school students in Hunan Province remains concerning. Greater attention should be paid to regions with high-value clusters of overweight/obesity, and targeted interventions should be developed based on urban-rural differences in influencing factors.
Humans ; China/epidemiology* ; Adolescent ; Male ; Female ; Rural Population/statistics & numerical data* ; Child ; Overweight/epidemiology* ; Students/statistics & numerical data* ; Urban Population/statistics & numerical data* ; Risk Factors ; Prevalence ; Obesity/epidemiology* ; Surveys and Questionnaires ; Pediatric Obesity/epidemiology* ; Schools

OBJECTIVES: The detection rate of scoliosis among school-aged children has been rising annually, varying by region, and has become a major public health concern affecting both physical and mental health. Its onset is multifactorial, and early screening combined with targeted interventions can alter disease progression. This study aims to investigate the prevalence and influencing factors of scoliosis among primary and secondary school students in Hunan Province, providing scientific evidence for targeted prevention strategies. METHODS: A stratified, randomized cluster sampling method was used to select 281 401 students from 14 prefecture-level cities in Hunan Province for scoliosis screening, physical examination, and questionnaire survey. The chi-square test was used for group comparisons, and trend chi-square test analyzed differences in screening positive rate by age. A multilevel regression model was applied to identify influencing factors, and ArcGIS was used to visualize spatial distribution patterns of scoliosis. RESULTS: The overall screening positive rate for scoliosis among Hunan students was 1.61%. Urban areas had a significantly higher rate than rural counties (2.81% vs 0.98%; P<0.01). The rate was equal between boys and girls (1.61% each). Underweight students had a higher rate than those with normal weight, overweight, or obesity (P<0.01). Stratified by age, urban students aged 6-18 years consistently showed higher positive rates than rural peers (P<0.001). No significant gender differences were observed at most ages (all P>0.05), except at age 11, where the females had a higher rate (1.28% vs 1.02%; P=0.048). After age 11, underweight students exhibited significantly higher positive rates than those with normal or higher BMI(all P<0.05). Across all groups, urban/rural, male/female, underweight/normal/overweight/obese, the scoliosis rate increased with age. By region, the screening positive rate ranged from 0.38% to 3.36%, with the top three being Chenzhou (3.36%), Xiangtan (2.78%), and Hengyang (2.71%), while the lowest was Xiangxi Tujia and Miao Autonomous Prefecture (0.38%). Multilevel regression analysis revealed that age (OR=1.160, 95% CI 1.135 to 1.186) and urban residence (OR=2.497, 95% CI 1.946 to 3.205) were positively associated with scoliosis risk (both P<0.01). Conversely, female gender (OR=0.931, 95% CI 0.874 to 0.993), normal nutritional status (OR=0.751, 95% CI 0.671 to 0.840), overweight (OR=0.513, 95% CI 0.447 to 0.590), obesity (OR=0.418, 95% CI 0.358 to 0.489), and engaging in ≥ 60 minutes of moderate-to-vigorous physical activity 2 to 4 days (OR=0.928, 95% CI 0.865 to 0.996) or 5 to 7 days per week (OR=0.912, 95% CI 0.833 to 0.998) were negatively associated with scoliosis risk (all P<0.05). CONCLUSIONS The prevalence of scoliosis among primary and secondary school students in Hunan Province is relatively high and is significantly associated with age, gender, urban-rural status, nutritional condition, and physical activity frequency. Targeted interventions and enhanced monitoring in high-risk regions and populations are essential to prevent and control scoliosis.
Humans ; Scoliosis/epidemiology* ; Male ; Female ; Adolescent ; China/epidemiology* ; Prevalence ; Child ; Students/statistics & numerical data* ; Rural Population/statistics & numerical data* ; Urban Population/statistics & numerical data* ; Surveys and Questionnaires ; Risk Factors ; Thinness/epidemiology*

OBJECTIVES: To investigate the regulatory effects of Aurora-A in regulating proliferation, migration, invasion, and epithelial-mesenchymal transition (EMT) of cervical cancer cells and the role of actin-related protein 2/3 complex subunit 4 (ARPC4) in mediating its effects. METHODS: The plasmids pCDH-NC, pCDH-Aurora-A, and shRNA-ARPC4 were used for inducing Aurora-A overexpression or ARPC4 knockdown in HeLa cells. The cells were divided into vector group, Aurora-A overexpression group, Aurora-A overexpression+ARPC4 knockdown group, and Aurora-A overexpression+NF‑κBp65 inhibitor group and transfected with the corresponding plasmids. The proliferation, colony-forming ability, migration and invasion of the treated Hela cells was evaluated using EdU immunofluorescence assay, crystal violet staining, scratch assay, Transwell assay, and Matrigel assay. Western blotting was performed to detect the changes in cellular expressions of EMT-related proteins and expression levels of NF-κBp65 and ARPC4. RESULTS: The expression of ARPC4 was significantly decreased in HeLa cells with Aurora-A knockdown and increased in Aurora-A-overexpressing cells. Aurora-A overexpression obviously promoted proliferation, migration, and invasion abilities of HeLa cells, and these effects was significantly antagonized by ARPC4 knockdown. In Aurora-A-overexpressing cells, the phosphorylation level of NF-κBp65 and the expression level of ARPC4 were increased significantly, and application of the NF‑κBp65 inhibitor obviously lowered the expression level of ARPC4. CONCLUSIONS Aurora-A overexpression upregulates the expression of ARPC4 by activating the NF-κBp65 signaling pathway, thereby promoting migration, invasion and EMT of HeLa cells.
Humans ; Uterine Cervical Neoplasms/metabolism* ; Female ; HeLa Cells ; Epithelial-Mesenchymal Transition ; Signal Transduction ; Cell Movement ; Neoplasm Invasiveness ; Cell Proliferation ; Aurora Kinase A/metabolism* ; Transcription Factor RelA/metabolism* ; Neoplasm Metastasis

Objective To investigate the genetic characteristics and recombination of human-infected sapoviruses(SaVs)worldwide using bioinformatics.Methods The complete genome sequences of SaVs were downloaded from the National Center for Biotechnology Information(NCBI)while high-quality complete genomes were retained for analysis.Molecular phylogenetic trees of SaVs were constructed to analyze their genetic characteristics,followed by recombination analysis of human-infected SaV strains genetype Ⅰ,Ⅱ,Ⅳ,and V(G Ⅰ,G Ⅱ,GⅣ,and GⅤ)with recombination analysis software.Results SaVs exhibited substantial genetic diversity worldwide and infected a wide range of hosts.Human-associated SaVs included G Ⅰ,G Ⅱ,GⅣ,and GⅤ,with GⅤ shared between human and swine hosts.Genetype recombination analysis of SaVs revealed a high frequency of recombination in SaV G Ⅱ strains that involved diverse hosts in the field of SaV G V strains.Recombination breakpoints of the virus were concentrated in the major viral proteins 1(VP1)and minor viral proteins 2(VP2).Conclusion Based on systematic analysis of the genetic characteristics of human-infected SaVs,the genotype distribution and prevalence of SaVs are investigated,the recombination patterns of SaV revealed,and its genetic dynamics highlighted.These findings can offer insights into epidemiological trends of viruses and help devise effective prevention and control strategies.

Objective To quantitatively study the correlation between T1ρ and T2 values of glenohumeral articular cartilage and the degree of rotator cuff injury.Methods A total of 149 patients with rotator cuff injury and healthy volunteers were prospectively selected.All of them underwent MRI routine scanning and T1 ρ and T2 mapping sequences.The degree of rotator cuff injury was graded,and the T1ρ and T2 values of glenohumeral articular cartilage were measured to analyze their relationship.Results With the development of rotator cuff injury grading,the T1 ρ and T2 values of glenohumeral articular cartilage increased.There were statistically significant differences in T1ρ and T2 values of articular cartilage between the different grades of rotator cuff injury(P＜0.001).Conclusion The injury of glenohumeral articular cartilage is aggravated with the severity of rotator cuff injury.The severity of rotator cuff injury can be evaluated by analyzing the T1 ρ and T2 values of glenohumeral articular cartilage.

Objective To explore the value of measuring infrapatellar fat pad(IPFP)and muscle fat fraction(FF)around the knee joint based on iterative decomposition of water and fat with echo asymmetry and least squares estimation quantification(IDEAL-IQ)quantitative technology in patients with knee osteoarthritis(KOA)for the degree of KOA.Methods A total of 106 participants were included in this study.Participants were grouped based on Kellgren-Lawrence grading(KLG),divided into no KOA group,mild KOA group and severe KOA group.The IDEAL-IQ technology was used to measure FF values of IPFP and muscles around the knee joint,the correlation between FF values and KOA was analyzed,and its value in diagnosing KOA was evaluated.Results In severe KOA group and mild KOA group can be observed in the way of lower IPFP FF values and higher FF values muscles around the knee joint.The FF values of IPFP and part of the muscles around the knee joint[vastus medialis muscle(VM),vastus lateralis muscle(VL),semimembranosus(SE),sartorius(SA),medial head of gastrocnemius muscle(Gas(media)),lateral head of gastrocnemius muscle(Gas(lateral))]were correlated with the degree of KOA(r/rs=-0.708,0.737,0.567,0.468,0.280,0.491,0.378),the area under the curve(AUC)for diagnosing KOA were 0.850,0.950,0.842,0.759,0.692,0.763,and 0.725,respectively.Conclusion IDEAL-IQ sequence can quantitatively assess fat infiltration of IPFP and muscles around the knee joint in patients with KOA,and has certain potential to predict the development and severity of KOA.

Objective To explore the effects of L-carnitine combined with citicoline on the therapeutic effect of neonatal hypoxic-ischemic encephalopathy(NHIE)and serum nitric oxide(NO)and endothelin-1(ET-1).Methods A total of 95 children with HIE admitted to the hospital from April 2020 to January 2023 were selected and were divided into observation group(47 cases)and control group(48 cases)by random number table method.The control group was given citicoline,and the observation group was given citicoline combined with L-carnitine.The therapeutic effect was evaluated on 14 days after treatment,and the recovery time of original reflex,muscle tone and consciousness was calculated.The levels of oxidative stress indexes[malondialdehyde(MDA),superoxide dismutase(SOD)]and vascular endothelial function indexes(NO,ET-1)were detected before treatment and 14 days after treatment.Neonatal neurobehavioral score(NBNA)was used to evaluate the neurological function of the children,and the safety of the treatment regimen was ob-served.Pearson correlation analysis was used to analyze the correlation between NBNA and vascular endothe-lial function indexes.Results The total effective rate in the observation group was 91.49％,which was higher than 72.92％in the control group(P＜0.05).The original reflex recovery time,muscle tone recovery time and consciousness recovery time of NHIE children in the observation group were shorter than those in the control group(P＜0.05).There was no significant difference in NBNA scores between the two groups before treatment(t=1.225,P=0.224).After treatment,the NBNA score in the observation group was higher than that in the control group(t=6.223,P＜0.001).After treatment,MDA level decreased and SOD level in-creased in two groups(P＜0.05).After treatment,the level of MDA in the observation group was lower than that in the control group,while the level of SOD was higher than that in the control group(P＜0.05).After treatment,the levels of NO and ET-1 were decreased in both groups(P＜0.05).The levels of NO and ET-1 in the observation group were lower than those in the control group after treatment(P＜0.05).The adverse drug reaction rates in observation group and control group were 17.02％and 8.33％,respectively,and there was no significant difference between two groups(P＞0.05).Pearson correlation analysis showed that serum NO,ET-1 and NBNA score in NHIE children were negatively correlated(r=-0.546,-0.608,P＜0.05).Conclusion L-carnitine combined with citicoline could improve the therapeutic effect of NHIE,shorten the re-covery time of clinical manifestations,and improve nerve function,oxidative stress and vascular endothelial function without increasing drugs and adverse reactions.In addition,vascular endothelial function indexes are negatively correlated with NBNA score,which could be used as auxiliary reference indexes for judging NHIE.