OBJECTIVE To investigate the mechanism by which Shenfukang capsule （SFK） ameliorates renal interstitial fibrosis （RIF） by regulating macrophage-fibroblast crosstalk via the signal transducer and activator of transcription 3 （STAT3）/Yes-associated protein （YAP） pathway. METHODS RAW264.7 macrophages were induced to polarize with transforming growth factor-β 1 （TGF-β 1 ）. Subsequently， a non-contact co-culture system of macrophages with renal fibroblasts NRK-49F， as well as a non-contact co-culture system of macrophages with YAP-knockdown renal fibroblasts， were established. Cells were treated with low， medium， and high concentrations （4， 8， 16 μg/mL） of SFK， as well as a STAT3 inhibitor （STAT3-I，1.64 μg/mL） and losartan potassium tablets （positive control， 0.28 μg/mL）， for 48 h. After intervention， the protein and mRNA expression levels of CD86， CD163， and STAT3 in macrophages， as well as CD86， F4/80， and STAT3 mRNA， were detected. In co-cultured renal fibroblasts， the protein and mRNA expression levels of α -smooth muscle actin （ α -SMA）， Vimentin， collagen type Ⅰ （Col-Ⅰ）， matrix metalloproteinase-1 （MMP-1）， and YAP were detected. In co-cultured YAP-knockdown renal fibroblasts， the protein and mRNA expression levels of α -SMA， Vimentin， and MMP-1 were also detected. RESULTS Following TGF-β 1 induction， the protein expression levels of CD86， CD163， and STAT3， as well as the mRNA expression levels of CD86， F4/80， and STAT3 in macrophages were significantly increased （ P ＜0.05）. The conditioned medium from polarized macrophages activated renal fibroblasts， as evidenced by significantly increased protein and mRNA expression levels of α -SMA， Vimentin， Col-Ⅰ， and YAP， and significantly decreased protein and mRNA expression levels of MMP-1 in renal fibroblasts （ P ＜0.05）. Treatment with SFK and STAT3-I reversed the changes in the above indicators， with the medium concentration SFK group showing stronge r effects on some indicators than the low and high concentration groups. In the non-contact co-culture experiment of macrophages and YAP-knockdown renal fibroblasts， there were no statistically significant differences in the protein and mRNA expression of α-SMA， Vimentin， and MMP-1 among the groups. CONCLUSIONS SFK can inhibit macrophage-renal fibroblast crosstalk by blocking the STAT3/YAP pathway， thereby delaying the progression of RIF.

OBJECTIVE To explore the influencing factors of Shenfukang capsule in the treatment of chronic kidney disease （CKD） and construct a nomogram prediction model for evaluating its therapeutic efficacy. METHODS CKD patients who were hospitalized from July 2019 to August 2022 in the First Affiliated Hospital of Guangxi Medical University and treated with Shenfukang capsule were selected as study subjects. Clinical data of the patients were collected from the hospital’s electronic medical record system， and they were divided into an effective group and an ineffective group based on treatment outcomes. Lasso-Logistic multivariate regression analysis was used to screen the influencing factors of the efficacy of Shenfukang capsule. Using the effectiveness of Shenfukang capsule treatment as the prediction outcome and the screened influencing factors as predictor variables， a nomogram prediction model was constructed using R software. All patients were randomly divided into a training cohort and a validation cohort. The discriminative ability， calibration， and clinical net benefit of the model were evaluated using the receiver operating characteristic （ROC） curve， calibration curve， and decision curve analysis， respectively. RESULTS Lasso-Logistic regression analysis revealed that concurrent diabetes mellitus， decreased levels of blood urea nitrogen， triglycerides， and serum phosphorus， as well as prolonged prothrombin time and elevated apolipoprotein AⅠ levels， were influencing factors for reduced efficacy of Shenfukang capsule in CKD treatment. The evaluation results of the nomogram prediction model showed that the area under curve values were 0.745 and 0.797 in the training and validation cohorts， respectively， which were close and both exceeded 0.70， indicating stable predictive performance. The calibration curves demonstrated good agreement in both datasets， suggesting satisfactory calibration performance. The clinical decision curves were positioned above the two extreme reference lines， indicating high clinical benefit of the model. CONCLUSIONS Diabetes mellitus， blood urea nitrogen， triglycerides， apolipoprotein AⅠ， serum phosphorus， and prothrombin time were factors associated with the efficacy of Shenfukang capsule in CKD patients. The nomogram prediction model established in this study may provide a basis for rational clinical application of Shenfukang capsule and for improving its therapeutic efficacy in CKD.

OBJECTIVE To explore the influencing factors of Shenfukang capsule in the treatment of chronic kidney disease （CKD） and construct a nomogram prediction model for evaluating its therapeutic efficacy. METHODS CKD patients who were hospitalized from July 2019 to August 2022 in the First Affiliated Hospital of Guangxi Medical University and treated with Shenfukang capsule were selected as study subjects. Clinical data of the patients were collected from the hospital’s electronic medical record system， and they were divided into an effective group and an ineffective group based on treatment outcomes. Lasso-Logistic multivariate regression analysis was used to screen the influencing factors of the efficacy of Shenfukang capsule. Using the effectiveness of Shenfukang capsule treatment as the prediction outcome and the screened influencing factors as predictor variables， a nomogram prediction model was constructed using R software. All patients were randomly divided into a training cohort and a validation cohort. The discriminative ability， calibration， and clinical net benefit of the model were evaluated using the receiver operating characteristic （ROC） curve， calibration curve， and decision curve analysis， respectively. RESULTS Lasso-Logistic regression analysis revealed that concurrent diabetes mellitus， decreased levels of blood urea nitrogen， triglycerides， and serum phosphorus， as well as prolonged prothrombin time and elevated apolipoprotein AⅠ levels， were influencing factors for reduced efficacy of Shenfukang capsule in CKD treatment. The evaluation results of the nomogram prediction model showed that the area under curve values were 0.745 and 0.797 in the training and validation cohorts， respectively， which were close and both exceeded 0.70， indicating stable predictive performance. The calibration curves demonstrated good agreement in both datasets， suggesting satisfactory calibration performance. The clinical decision curves were positioned above the two extreme reference lines， indicating high clinical benefit of the model. CONCLUSIONS Diabetes mellitus， blood urea nitrogen， triglycerides， apolipoprotein AⅠ， serum phosphorus， and prothrombin time were factors associated with the efficacy of Shenfukang capsule in CKD patients. The nomogram prediction model established in this study may provide a basis for rational clinical application of Shenfukang capsule and for improving its therapeutic efficacy in CKD.

BACKGROUND:The extracellular-regulated protein kinase 5(ERK5)signaling protein is essential for the survival of organisms,and resveratrol can promote osteoblast proliferation through various pathways.However,whether resveratrol can regulate osteoblast function through the ERK5 signaling protein needs further verification. OBJECTIVE:To explore the regulatory effect of ERK5 on the proliferation of MC3T3-E1 cells and related secreted proteins,and to further verify whether resveratrol can complete the above process by activating ERK5. METHODS:Mouse MC3T3-E1 preosteoblasts were treated with complete culture medium,XMD8-92(an ERK5 inhibitor),epidermal growth factor(an ERK5 activator),resveratrol alone,XMD8-92+EGF,and resveratrol+XMD8-92,respectively.Western blot assay was used to detect the expression of ERK5 and p-ERK5 proteins,proliferation-related proteins Cyclin D1,CDK4 and PCNA,and osteoblast-secreted proteins osteoprotegerin and receptor activator of nuclear factor-κB ligand in MC3T3-E1 cells of each group.The fluorescence intensity of ERK5,osteoprotegerin and receptor activator of nuclear factor-κB ligand in each group was detected by cell immunofluorescence staining,and cell proliferation was detected by EdU staining,respectively.The appropriate concentration and time of resveratrol intervention in MC3T3-E1 cells were determined by cell morphology observation and cell counting kit-8 assay. RESULTS AND CONCLUSION:The activation of ERK5 signaling protein could effectively promote the proliferation of MC3T3-E1 cells,up-regulate the osteoprotegerin/receptor activator of nuclear factor-κB ligand ratio.The appropriate concentration and time for resveratrol intervention in MC3T3-E1 cells was 5 μmol/L and 24 hours,respectively.Resveratrol could activate ERK5 signaling protein,thereby promoting osteoblast proliferation and up-regulating the osteoprotegerin/RANKL ratio.All these results indicate that resveratrol can promote the proliferation of MC3T3-E1 cells and up-regulate the osteoprotegerin/RANKL ratio by activating the ERK5 signaling protein.

To address the problem of large reconstruction errors in 3D pulse signals caused by excessively small out-of-plane displacement of the contact membrane in the existing traditional Chinese medicine fingertip tactile binocular vision detection technology, this study proposes a 3D pulse image detection method based on subtle motion magnification technology and explores its application in pulse pattern recognition. Firstly, a 3D pulse image detection system based on binocular vision to obtain pulse image signals is developed as experimental data. Then, the phase motion video magnification algorithm is used to amplify the original signals, and the amplified signals are reconstructed in three dimensions to obtain 3D pulse signals. On this basis, nine features are extracted from the 3D pulse signals and features selection is performed using a two-sample Kolmogorov-Smirnov test. Finally, machine learning algorithms such as decision trees and random forests are used to identify the five types of pulse conditions: deep pulse, intermittent pulse, flooding pulse, slippery pulse, and rapid pulse. The experimental results show that compared to the methods without subtle motion magnification technology, the proposed method significantly improves waveform clarity, amplitude stability, and periodic regularity. Meanwhile, the average accuracy in pulse pattern recognition reaches 96.29%±0.26%.
Algorithms ; Imaging, Three-Dimensional/methods* ; Pattern Recognition, Automated ; Medicine, Chinese Traditional ; Motion ; Humans ; Pulse ; Signal Processing, Computer-Assisted ; Machine Learning

Objective:To assess the application value of one-hour post-load glucose (1hPG) for detecting prediabetes among individuals with high risk of type 2 diabetes mellitus (T2DM).Methods:The study was conducted between August 2023 and January 2024, and individuals with a high risk of T2DM were invited to receive an oral glucose tolerance test (OGTT), structural questionnaires, physical measurements, and other biochemical examinations. The fasting, one-, and two-hour glucose and insulin were tested. According to the 1hPG cut point on hyperglycemia suggested by International Diabetes Federation (IDF), normal glucose tolerance (NGT) and prediabetes were further divided into two subgroups, respectively, i.e., NGT with 1hPG<8.6 mmol/L (NGT-1hPG-normal), NGT with 1hPG≥8.6 mmol/L (NGT-1hPG-high), prediabetes with 1hPG<8.6 mmol/L (PDM-1hPG-normal), and prediabetes with 1hPG≥8.6 mmol/L (PDM-1hPG-high). The insulin release curve was drawn by the groups as above. Insulin resistance was evaluated by homeostasis model assessment for insulin resistance (HOMA-IR), and β-cell secretory function was evaluated by homeostasis model assessment for β cell function (HOMA-β)/HOMA-IR. Spearman rank correlation analysis was used to calculate the correlation coefficients among 1hPG, 2hPG and HOMA indices, and Steiger′s Z test was used to compare the difference between two correlation coefficients. Receiver operating characteristics (ROC) curves and area under the curve (AUC) were used to assess the accuracy of 1hPG for detecting prediabetes. Results:A total of 2 469 subjects consisting of 1 485 men (60.1%) and 984 (39.9%) women, with a mean age of (45.76±6.20) years, of which 1 844 (74.7%) had 1hPG≥8.6 mmol/L. The prevalence of 1hPG≥8.6 mmol/L was 46.8%, 93.0% and 99.8% in individuals with NGT, prediabetes and newly diagnosed T2DM, respectively ( χ 2=763.78, P<0.001). The insulin release curve showed that insulin secretion increased rapidly in subjects with NGT-1hPG-high, and peaked at one hour, then decreased rapidly, with a significantly higher level of one- and two-hour insulin than those with NGT-1hPG-normal ( P<0.001). Compared to individuals with NGT-1hPG-normal, the counterparts with NGT-1hPG-high exhibited higher HOMA-IR and lower adjusted HOMA-β ( P<0.001). Spearman rank correlation analysis showed that the correlation coefficient of 1hPG with HOMA-IR was similar to the correlation coefficient of 2hPG with HOMA-IR (0.493 vs. 0.480, P=0.550), while the correlation of 1hPG with adjusted HOMA-β was significantly stronger than that of 2hPG (-0.692 vs. -0.587, P<0.001). Excluding patients with T2DM, according to the cut point recommended by IDF, the AUC of 1hPG≥8.6 mmol/L for detecting prediabetes was 0.731 (95% CI: 0.714-0.748), and the sensitivity and specificity were 0.930 and 0.532, respectively, with the kappa value of 0.45. Conclusion:1hPG is closely related to insulin resistance and islet function, and there′s substantial value for individuals with a high risk of T2DM to detect prediabetes by using the 1hPG cut points recommended by IDF.

Objective:To compare the active respiratory circulation technique (ACBT) with the oscillatory positive pressure expiration technique (OPEP) in terms of their ability to improve pulmonary function and minimize complications after cardiac surgery, seeking to define an airway management strategy for such patients.Methods:A total of 101 patients who had undergone cardiac surgery were randomly divided into an ACBT group ( n=50) and an OPEP group ( n=51). On the 1st day after the operation, in addition to conventional medical treatment and early rehabilitation, the subjects were additionally provided with daily 20-minute sessions of ACBT or OPEP training for seven consecutive days. Before the operation, and on the 3rd and 7th day afterward, lung function was assessed using a pulmonary edema imaging assessment system (RALE), computed tomography and pulmonary function indexes. Any complications were also noted. Six-minute walking distance and the Barthel index quantified exercise endurance and ability in the activities of daily living, respectively. Turbidimetry was used to determine the levels of C-reactive protein in the blood. The duration of mechanical ventilation required, ICU stay time, length of postoperative and total hospital stays were also recorded. Results:On day seven after the operation, the average RALE scores of the ACBT and OPEP groups were (12.40±4.37) and (10.20±4.66), respectively—a significant difference. At the same time point, the incidence of atelectasis in the OPEP group was significantly lower than in the ACBT group. The OPEP group′s average maximum inspiratory pressure was a greater percentage of the predicted value, and its average 6-minute walk and BI score were also better. On the 3rd day after the operation, the incidence of lung consolidation in the ACBT group was significantly lower than that in the OPEP group, on average.Conclusions:The curative effect of ACBT is better than that of OPEP in the first few days after such an operation, but after a week OPEP more effectively restores respiratory muscle strength and relieves pulmonary complications. It is recommended to apply these two techniques in stages to optimize postoperative airway management. RALE scoring is an ideal tool for dynamic monitoring of pulmonary complications after cardiac surgery.

Idiopathic pulmonary fibrosis (IPF), a chronic interstitial lung disease, is characterized by aberrant wound healing, excessive scarring and the formation of myofibroblastic foci. Although the role of alternative splicing (AS) in the pathogenesis of organ fibrosis has garnered increasing attention, its specific contribution to pulmonary fibrosis remains incompletely understood. In this study, we identified an up-regulation of serine/arginine-rich splicing factor 7 (SRSF7) in lung fibroblasts derived from IPF patients and a bleomycin (BLM)-induced mouse model, and further characterized its functional role in both human fetal lung fibroblasts and mice. We demonstrated that enhanced expression of Srsf7 in mice spontaneously induced alveolar collagen accumulation. Mechanistically, we investigated alternative splicing events and revealed that SRSF7 modulates the alternative splicing of pyruvate kinase (PKM), leading to metabolic dysregulation and fibroblast activation. In vivo studies showed that fibroblast-specific knockout of Srsf7 in conditional knockout mice conferred resistance to bleomycin-induced pulmonary fibrosis. Importantly, through drug screening, we identified lomitapide as a novel modulator of SRSF7, which effectively mitigated experimental pulmonary fibrosis. Collectively, our findings elucidate a molecular pathway by which SRSF7 drives fibroblast metabolic dysregulation and propose a potential therapeutic strategy for pulmonary fibrosis.

Objectives:To explore the morphological changes of the superficial and deep thoraolumbar paraspinal muscles on both convex and concave sides during rest and contraction states in patients with mod-erate adolescent idiopathic scoliosis(AIS),and their effects on scoliosis angle,to analyze the relations between scoliosis angle and the morphological changes of paraspinal muscles.Methods:21 AIS patients(thoracic Cobb angle 20°-45°,S-shaped with the main curve in thoracic segment,4 males and 17 females,aged 13.9±1.6 years old)treated in our hospital from July 2020 to December 2023 and 21 healthy subjects(7 males and 14 females,aged 14.6±1.4 years old)were prospectively enrolled.The morphological data of thoracolumbar paraspinal muscles were collected with musculoskeletal ultrasound,including the resting thickness and thick-ness during maximum voluntary isometric contraction(MVIC)of superficial erector spinae(ES)and multifidus(MF)muscles of AIS patients on both convex and concave sides(left and right sides of healthy controls).The differences in resting thickness,contraction thickness,change rate of contraction thickness,and total resting thickness and total contraction thickness(ES+MF)of superficial and deep thoracolumbar paravertebral muscles between the two groups were analyzed,and the structural characteristics of the thoracolumbar paravertebral muscles on the convex and concave sides of AIS were analyzed.The correlation between Cobb angle in tho-racolumbar segment and morphological indexes(resting thickness,contraction thickness change rates)of ES and MF muscles was analyzed,and the influence of scoliosis severity on the morphology of superficial and deep paravertebral muscle was further analyzed.Results:In AIS patients,the mean thoracic Cobb angle were 31.62°±7.68°,and mean lumbar Cobb angle were 19.52°±6.48°.Comparing with healthy controls,patients with AIS were significantly different in resting thickness,contraction thickness and thickness change rates of tho-racic paraspinal muscles on both convex and concave sides,and the resting thickness of ES in thoracic seg-ment on concave side was less than that on the convex side,which of MF was less on the convex side than on the concave side(P＜0.01).The contraction thickness of thoracic MF muscles on the convex and concave sides in S-type AIS patients was smaller than that in healthy controls(P＜0.05),while the contraction thickness of thoracic ES muscles on the convex and concave side wasn't statistically different from that of healthy con-trols,and the contraction thickness change rate of ES muscles on the convex and MF on the concave side of thoracic segment in AIS patients was significantly decreased(P＜0.05).There was no significant difference in the total resting thickness of thoracic(convex and concave)paravertebral muscles(ES+MF)between AIS patients and the corresponding segments(left and right)of control group(P＞0.05),and there was no statistically signifi-cant difference in the total resting thickness of thoracic paravertebral muscle between the convex and concave sides of AIS patients(P＞0.05).The total contraction thickness of thoracic paravertebral muscle(ES+MF)in AIS patients was lower than that in control group(P＜0.05).Compared with the control group,the resting thickness,contraction thickness and thickness change rate of lumbar MF muscle on the convex and concave sides in AIS patients were significantly reduced(P＜0.05),and the contraction thickness change rate of the lumbar ES muscle on the concave side was less than that of the control group(P＜0.05).There were no significant differ-ences in resting thickness and contraction thickness between the convex and concave paravertebral muscles in AIS patients(P＞0.05).The total resting thickness(ES+MF)and total contraction thickness(ES+MF)of lumbar(convex and concave)paraspinal muscles in AIS patients were lower than those in control group(P＜0.05).There was a significant negative correlation between the Cobb angle of the main thoracic curve and the rest-ing thickness of the thoracic MF muscle on the concave and the change rate of the contraction thickness of the thoracic ES muscle on the convex in S-type AIS patients(r=-0.53/-0.45,P＜0.05).There was no signifi-cant correlation between the Cobb angle of lumbar segment and the change rates of the resting thickness and contraction thickness of ES and MF muscles on both convex and concave sides(P＞0.05).Conclusions:In pa-tients with moderate S-type AIS,there are different muscle morphological changes in the paraspinal muscles on both convex and concave sides of the main thoracic curve,and the concave paravertebral muscle is more affected by scoliosis;The contraction function of the bilateral deep core stabilizing muscles in the lumbar re-gion is markedly decreased.Different patterns of superficial and deep muscle atrophy and contractility decline may be a key cause of spinal movement disorder and scoliosis progression in AIS patients.

Pyroptosis is a form of programmed cell death that differs from classical apoptosis and passive necrosis.It plays a crucial role in activating innate immune responses,driving local inflam-matory reactions,regulating immune cell activation and infiltration,and remodeling the tumor immune microenvironment.In recent years,the role of pyroptosis in the initiation,progression,and treatment response of urological tumors has garnered increasing attention.Current studies have demonstrated that pyroptosis exhibits dual regulatory effects in various tumors:on the one hand,it exerts anti-tumor effects by inducing lytic death of tumor cells;on the other hand,under specific microenvironmental conditions,the chronic inflammatory response mediated by pyroptosis may promote immune escape,thereby driving tumor progression.This review systematically summarized the similarities and differ-ences in the molecular mechanisms of pyroptosis in three common urological tumors,namely renal cell carcinoma,bladder cancer,and prostate cancer.It also summarized the regulatory networks and po-tential therapeutic targets during tumor initiation and progression.Furthermore,it elucidated the re-search progress on enhancing the efficacy of immune checkpoint inhibitors by modulating pyroptosis pathways,aiming to provide novel strategies and theoretical foundations for the precise treatment of u-rological.