Metabolic dysfunction-associated fatty liver disease （MAFLD） is a common chronic liver disease in clinical practice， and macrophages are directly involved in the development， progression， and prognosis of MAFLD. Studies have confirmed that glucose metabolic reprogramming in macrophages directly affects immune function， which in turn affects the local inflammatory environment of liver and hepatocyte metabolism. This article reviews the changes in glucose metabolism of macrophages and the corresponding key molecules in the pathogenesis of MAFLD， in order to provide new targets and strategies for the prevention and treatment of MAFLD in the future.

【Objective】 To establish a risk model for predicting spontaneous rupture bleeding of renal angiomyolipoma (RAML) in order to better assess and deal with the risk. 【Methods】 The information of 436 RAML patients diagnosed during Jan.2018 and Dec.2022 was retrospectively analyzed.According to the inclusion and exclusion criteria, 216 patients were included and divided into the rupture bleeding group (n=35) and non-rupture bleeding group (n=181).The factors influencing spontaneous rupture bleeding were identified using univariate and multivariate analysis, and a nomogram was constructed accordingly with R language.The nomogram was evaluated using Calibration curve and area under the receiver operator characteristic curve (AUC). 【Results】 It was found that clinical manifestations, tumor diameter, tumor convexity, tumor blood supply, and tuberous sclerosis complex (TSC) were significantly correlated with rupture bleeding.The Calibration curve fitted well with the nomogram.The AUC was 0.956 (95%CI: 0.856-0.943), indicating that the nomogram had good statistical performance. 【Conclusion】 The model can effectively predict the risk of spontaneous rupture bleeding of renal angiomyolipoma.

OBJECTIVE To explore the effect mechanism of Eucommia ulmoides on improving postpartum depression in rats. METHODS Pregnant rats were randomly divided into normal group， postpartum depression group， and low-dose and high-dose groups of E. ulmoides （1.34， 2.68 g/kg， calculated by crude drug）， with 10 rats in each group. Except for the normal group， the rats in other groups suffered from fear stress to induce postpartum depression model during pregnancy； at the same time of modeling， the administration groups were given relevant medicine intragastrically， while the normal group and postpartum depression group were given physiological saline intragastrically for 21 days. Postpartum behaviors of rats during the experiment were assessed using the open field test， Morris water maze test and sucrose preference test. Additionally， the levels of corticosterone （CORT） in serum， corticotropin releasing factor （CRF） and urocortin （UCN） in hypothalamus， and adrenocorticotropic hormone （ACTH） in hypophysis were detected； meanwhile， the protein expressions of CRF receptor 1 （CRFR1）， CRFR2， and voltage-dependent anion channel 1 （VDAC1） in hippocampal tissue were measured； the proportions of apoptotic cells and JC-1 high potential cells in hippocampal tissue were determined， and the morphology of hippocampal tissue was observed. RESULTS Compared with postpartum depression group， the high-dose group of E. ulmoides showed improvements in appetite， mental state， and hair color in rats； their body weight had increased； the scores of vertical movement， horizontal movement and self-sorting significantly increased； from the 2ed to 4th day avoidance latency significantly shortened， and the times of crossing the platform and the time of crossing the platform Δ 基金项目国家自然科学基金青年基金项目（No.82204789） significantly increased/prolonged （P＜0.05）； the ratio of glucose and water consumption significantly increased at 20 days of pregnancy and 30 days postpartum （P＜0.05）； the levels of CRF， UCN， ACTH and CORT， phagocytic rate， protein expressions of CRFR2 and VDAC1， and the proportion of apoptosis cells in hippocampal tissue were decreased significantly （P＜0.05）； the proportion of JC-1 high potential cells significantly increased （P＜0.05）， and the phenomenon of edema around neuronal cells was significantly improved. CONCLUSIONS E. ulmoides can improve postpartum depression by inhibiting excessive activation of hypothalamic-pituitary-adrenal axis， decreasing the expression of CRFR2， thereby inhibiting the expression of VDAC1， and decreasing the apoptosis of neuronal cells.

OBJECTIVE To explore the effect mechanism of Eucommia ulmoides on improving postpartum depression in rats. METHODS Pregnant rats were randomly divided into normal group， postpartum depression group， and low-dose and high-dose groups of E. ulmoides （1.34， 2.68 g/kg， calculated by crude drug）， with 10 rats in each group. Except for the normal group， the rats in other groups suffered from fear stress to induce postpartum depression model during pregnancy； at the same time of modeling， the administration groups were given relevant medicine intragastrically， while the normal group and postpartum depression group were given physiological saline intragastrically for 21 days. Postpartum behaviors of rats during the experiment were assessed using the open field test， Morris water maze test and sucrose preference test. Additionally， the levels of corticosterone （CORT） in serum， corticotropin releasing factor （CRF） and urocortin （UCN） in hypothalamus， and adrenocorticotropic hormone （ACTH） in hypophysis were detected； meanwhile， the protein expressions of CRF receptor 1 （CRFR1）， CRFR2， and voltage-dependent anion channel 1 （VDAC1） in hippocampal tissue were measured； the proportions of apoptotic cells and JC-1 high potential cells in hippocampal tissue were determined， and the morphology of hippocampal tissue was observed. RESULTS Compared with postpartum depression group， the high-dose group of E. ulmoides showed improvements in appetite， mental state， and hair color in rats； their body weight had increased； the scores of vertical movement， horizontal movement and self-sorting significantly increased； from the 2ed to 4th day avoidance latency significantly shortened， and the times of crossing the platform and the time of crossing the platform Δ 基金项目国家自然科学基金青年基金项目（No.82204789） significantly increased/prolonged （P＜0.05）； the ratio of glucose and water consumption significantly increased at 20 days of pregnancy and 30 days postpartum （P＜0.05）； the levels of CRF， UCN， ACTH and CORT， phagocytic rate， protein expressions of CRFR2 and VDAC1， and the proportion of apoptosis cells in hippocampal tissue were decreased significantly （P＜0.05）； the proportion of JC-1 high potential cells significantly increased （P＜0.05）， and the phenomenon of edema around neuronal cells was significantly improved. CONCLUSIONS E. ulmoides can improve postpartum depression by inhibiting excessive activation of hypothalamic-pituitary-adrenal axis， decreasing the expression of CRFR2， thereby inhibiting the expression of VDAC1， and decreasing the apoptosis of neuronal cells.

Orchitis is a common male genitourinary disorder that significantly impacts patients' life quality.Current treatment strategies have certain limitations and side effects.Ongoing therapeutic strategies focus on the interactions and regulatory networks among pathways and factors involved in the progression of orchitis.The targeted pharmacological agents include inflammatory pathways (p38MAPK, NF-κB, PI3K/Akt), cytokines (TNF-α, IL-6), and the nitric oxide synthase (NOS) system.However, these studies are currently at the animal research stage, and further clinical investigations are necessary to validate their efficacy and safety before clinical use.This article reviews the preclinical animal studies on new treatment methods of orchitis from the aspects of autoimmunity and exogenous microorganism induction, including ketotifen furmarate, aspirin, L-NAME, activin A, cortisol, melatonin, methane, long non-coding RNA MEG3, Abaloparatide, recombinant type Ⅰ interferon, and so on.

Objective To understand current epidemic trend of coronavirus disease-2019(COVID-19)in Anhui province in the optimization policy stage,and to analyze the pathogenic characteristics of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)in different population.Methods Using a cross-sectional survey design,from December 19 to 20,2022,an online questionnaire survey was conducted among residents of Anhui province through the official Wechat public accounts of provincial and municipal institutions with high traffic,to collect infor-mation on the incidence and clinic situation of COVID-19.The chi-square test was used to compare the proportion of COVID-19 suspected symptoms in different regions,ages and occupations.Results A total of 69 014 question-naires were distributed and 68 232 valid questionnaires were recovered with an effective rate of 98.97％.The pro-portion of the participants with COVID-19 suspected symptoms in the past 2 weeks was 51.37％,of which 77.88％self-medicated at home.The top three cities were Bozhou,Fuyang and Bengbu.The age group of 15-59 had the highest proportion of COVID-19 suspected symptoms(51.96％).Among various occupations,service providers had the highest proportion of COVID-19 suspected symptoms(61.07％).70.20％of the respondents felt anxious about the infection of SARS-CoV-2 and thought it was more serious than the flu.Conclusion The relatively high number of the infected cases and the anxiety of the people are all challenges faced by Anhui province in the stage of optimizing policies.Under the new situation of the epidemic,it is necessary to continuously monitor the local preva-lent strains and strengthen the monitoring of clinical symptoms of the infected cases,and effectively control the speed of the virus spread through public health policies and various economic and publicity measures,so as not to cause a run on medical resources and excessive excess deaths.

Objective:To investigate the effectiveness of autologous bilateral auricular concha cartilage-modified scaffolds in rhinoplasty.Methods:Retrospectively, 219 patients aged (28.7±5.5) years, 8 males and 211 females, who underwent rhinoplasty at the An Beili Medical Beauty Clinic in Shimen County, Changde City, Hunan Province, from January 2020 to January 2022, were included. Every patient consented to apply modified scaffolds of autologous bilateral auricular concha cartilage for rhinoplasty; 157 received primary rhinoplasty and 62 underwent secondary rhinoplasty repair. To construct the nasal tip morphology, bilateral auricular concha cartilage was excised, symmetrically divided and aligned sutures to form nasal columellar support grafts and anti-tip rotation grafts. Thermoplastic splints and tape were used to fix the dorsum of the nose, and tumescent sponges to fill the nasal cavity. Prophylactic antibiotics were routinely administered after surgery for 48 hours, and depending on how well the wound healed, the stitches were taken out 8 to 10 days later.Results:A local infiltration anesthetic was used throughout the procedure on all 219 patients. The majority of patients had a willow-shaped prosthesis constructed for the dorsum of their noses. A total of 145 patients had silicone prostheses, and 74 patients had expanded polytetrafluoroethylene prostheses. The mean operating duration was (72.92±13.26) minutes. Within 8 to 10 days after surgery, all patients had their sutures taken out, the surgical incisions healed properly, and all 219 patients were satisfied with their nasal appearance in the immediate postoperative period. The nasal tip height was elevated by an average of (4.7±0.5) mm, and the nasal length was extended by an average of (5.7±0.6) mm over the mean follow-up of (14±2) months. Among 219 patients, 96.8% (212/219) of the patients expressed satisfaction with the form of their noses. The postoperative nasal shape, with its naturally elevated nasal dorsum, rounded tip profile, and pronounced tip-defining point, complied with the natural aesthetic criteria. Three patients experienced a chronic nasal infection following surgery, while the remaining four experienced postoperative tip-down rotation.Conclusions:Using bilateral auricular concha cartilage, the tip cartilage modified scaffolding provides a better nasal appearance and tip mobility after rhinoplasty for the patients.

Objective:To investigate the predictive value of platelet aggregation rate for early neurological deterioration (END) after intravenous thrombolysis (IVT) in patients with acute ischemic stroke (AIS).Methods:Consecutive patients with AIS received IVT at the Department of Neurology, Haikou Hospital Affiliated to Xiangya School of Medical, Central South University from November 2020 to July 2023 were retrospectively included. The maximum platelet aggregation rate (MAR) was measured using the PL-12 multi-parameter platelet function analyzer. END was defined as an increase of ≥4 from baseline in the National Institutes of Health Stroke Scale (NIHSS) score within 24 h after IVT. The demographic, baseline data, laboratory findings, and imaging results between the END and non-END groups were compared, and the dynamic changes in MAR induced by arachidonic acid (AA) and adenosine diphosphate (ADP) before, immediately after, and 2 h after IVT were observed. Multivariate logistic regression analysis was used to determine the independent risk factors for END. Receiver operating characteristic (ROC) curves were used to analyze the predictive value of MAR for END at different time points. Results:A total of 300 patients were included, aged 64.88±8.82 years, with a median baseline NIHSS score of 11 (interquartile range, 8-15) and the onset-to-needle time was 172.03±53.96 min. Among them, 66 patients (22.0%) developed END. The MAR-AA and MAR-DP levels before, immediately after, and 2 h after IVT in the END group were significantly higher than those in the non-END group (all P<0.05). Multivariate logistic regression analysis showed that MAR-AA (odds ratio 1.098, 95% confidence interval 1.039-1.161; P<0.001) and MAR-ADP (odds ratio 1.100, 95% confidence interval 1.038-1.167; P<0.001) at 2 h after IVT were the independent risk factors for END. ROC curve analysis shows that MAR-AA and MAR-ADP before, immediately after, and 2 h after IVT had good predictive value for END. Among them, the area under the curve corresponding to MAR-AA and MAR-ADP at 2 h after IVT was the largest, with values of 0.745 and 0.710, respectively. The optimal cutoff value of MAR-AA was 39.28%, and the sensitivity and specificity for predicting END were 74.2% and 76.1%, respectively. The optimal cutoff value of MAR-ADP was 43.35%, and the sensitivity and specificity for predicting END were 69.7% and 66.2%, respectively. Conclusion:The MAR measured by PL-12 is closely associated with the risk of END in patients with AIS after IVT treatment, and has good predictive value for END.

Objective:To observe the dynamic changes of soluble programmed cell death protein 1 (sPD-1) and cellular immunity and humoral immunity in patients with sepsis and septic shock, and to explore the relationship between sPD-1 and immunosuppression in sepsis.Methods:This study was a prospective cohort study. Patients with sepsis and septic shock admitted to the ICU of General Hospital of Ningxia Medical University from June 2018 to December 2018 were included as the study subjects, ordinary postoperative patients admitted to the ICU during the same period were included as the non-sepsis group, and healthy volunteers matched in age and sex were included as healthy controls. The sPD-1, lymphocyte count, serum immunoglobulin and lymphocyte subsets of peripheral blood on the first, third and seventh days after admission to the ICU were detected. The changes of sPD-1 and various immune indices in each group were compared, and the correlation between the indices was analyzed. For healthy controls and non-sepsis patients, only blood samples were tested on the day of inclusion.Results:A total of 90 patients [58 males and 32 females, aged (58.36±17.46) years] were included in this study, including 29 cases of sepsis, 31 cases of septic shock, 15 cases of non-sepsis, and 15 volunteers were recruited as healthy control group. The 28-day fatality rate of patients in the sepsis and septic shock groups was 28.3%. On the first day of ICU admission, the sPD-1 concentration were significantly higher in the septic shock group and sepsis group than those in the non-sepsis group and healthy control group [512.64 (216.85, 1039.41) pg/mL vs. 261.90 (191.96, 421.99) pg/mL vs. 191.56 (151.26, 232.66) pg/mL vs. 200.51 (162.14, 241.26) pg/mL, all P<0.05]. The sPD-1 concentration in the septic shock group was significantly higher than that in the sepsis group, and this phenomenon persisted for at least one week ( P<0.05). The lymphocyte count on the first day in the sepsis and septic shock groups were significantly lower than those in the healthy control and non-sepsis groups (all P<0.05), and the lymphocyte count in the septic shock group remained lower levels until the seventh day of ICU admission (all P<0.05). The percentage of lymphocytes and total T lymphocytes in the sepsis and septic shock groups were significantly lower than those in the healthy control and non-sepsis groups (all P<0.05), while the percentage of total B lymphocytes did not differ between groups (all P>0.05). The percentage of CD8+ T lymphocytes on the seventh day of ICU admission in the septic shock group was still significantly lower than that in the sepsis group [(18.36±2.23)% vs. (28.28±2.97)%, P<0.05]. The levels of serum immunoglobulin IgG and IgM were significantly lower in the sepsis and septic shock group than those in the healthy control and non-sepsis groups (all P<0.05), and the IgG and IgM in the sepsis and septic shock groups returned to normal on the seventh day of ICU admission. The area under the ROC curve was used to evaluate the predictive value of sPD-1 on poor prognosis, and the results showed that sPD-1 on the seventh day of ICU had a good predictive value for 28-day prognosis in patients with sepsis and septic shock, and the best cut-off value was 286.52 pg/mL, with a sensitivity of 100.00% and specificity of 56.25%. Conclusions:Immunosuppression occurs in patients with sepsis and septic shock in the early stage, and the duration of immunosuppression in patients with septic shock is prolonged, but humoral immunosuppression plays a major defense in the early stage, and cellular immunosuppression is dominant in the later stage.

Objective:Of all spontaneous bleeding complications in patients with acute ST-elevation myocardial infarction (STEMI), upper gastrointestinal bleeding (UGIB) is the most common and of specific interest, because it can be prevented by several prophylactic measures. The purpose of this study was to investigate the in-hospital incidence, associated outcomes, and predictors of UGIB after STEMI.Methods:In this retrospective study, we analyzed the records of 2 791 patients with acute STEMI admitted to Beijing Anzhen Hospital Affiliated to Capital Medical University between January 2018 and January 2022. The patients were divided into the UGIB group ( n=61) and non-UGIB group ( n=2 730) according to the presence or absence of upper gastrointestinal hemorrhage, respectively. Baseline clinical conditions, coronary lesions, in-hospital deaths, and in-hospital adverse events were compared between the two groups. Logistic regression analysis was also performed for risk factors that could lead to UGIB. Results:The in-hospital incidence of UGIB after STEMI was 2.2% (61/2 791). Hospital stay was significantly longer in the UGIB group [8(6, 12) days vs. 5 (4, 7) days, Z=3.28, P<0.001] and in-hospital mortality was significantly higher in the UGIB group than in the non-UGIB group (9.8% vs. 0.8%, χ2=0.63, P=0.001). Patients with UGIB were significantly older than those without UGIB (63±11 years vs. 58±11 years, t=-3.75, P<0.001). The serum creatinine level of UGIB patients was significantly higher than that of non-UGIB patients [(80(62, 98) mmol/L vs. 73(64, 84) mmol/L, Z=1.68, P=0.007], the red blood cell count of UGIB patients was significantly lower than that of non-UGIB patients [4.1(3.8, 4.6)×10 12/L vs. 4.6(4.2, 4.9)×10 12/L, Z=2.61, P<0.001], and the hemoglobin concentration of UGIB patients was significantly lower than that of non-UGIB patients [129(109, 141) g/L vs. 141(130, 152) g/L, Z=2.52, P<0.001]. Brain natriuretic peptide levels were significantly higher in UGIB patients than in non-UGIB patients [331(165, 644) ng/L vs. 181(89, 333) ng/L, Z=2.42, P<0.001]. Logistic regression analysis showed that age ( OR=1.045, 95% CI 1.009-1.082, P=0.013); hemoglobin ( OR=1.594, 95% CI 1.150-2.210, P=0.005); hematocrit ( OR=0.181, 95% CI 0.060-0.546, P=0.002); and mean hemoglobin concentration ( OR=0.845, 95% CI 0.752-0.951, P=0.005) were independent risk factors for UGIB in patients with STEMI. Logistic regression analysis of risk factors for in-hospital death revealed that concurrent UGIB was an independent risk factor for in-hospital death in patients with STEMI ( OR=2.954, 95% CI 0.635-13.751, P=0.024). Conclusions:The incidence of in-hospital UGIB in STEMI patients was 2.2%, and the in-hospital mortality rate of STEMI complicated with UGIB increased to 9.8%. Concurrent UGIB was an independent risk factor for in-hospital death in patients with STEMI. The most important predictors of in-hospital UGIB in patients with STEMI were age, hemoglobin, hematocrit, and mean hemoglobin concentration.