Core fucosylation, catalyzed exclusively by fucosyltransferase 8 (FUT8), is an evolutionarily conserved post-translational modification that has emerged as a central regulatory hub linking liver homeostasis, chronic disease progression, and malignant transformation. Liver diseases, particularly hepatocellular carcinoma, remain a leading global health burden characterized by late diagnosis, limited therapeutic options, and poor overall survival. While aberrant glycosylation is now recognized as a hallmark of cancer and inflammatory disorders, existing research on FUT8-mediated core fucosylation in liver diseases remains fragmented: the dynamic functional switch of FUT8 from a homeostatic regulator to a pathological driver across the full disease continuum has not been systematically delineated, and the integrated mechanisms by which core fucosylation modulates oncogenic signaling, metabolic reprogramming, and immune evasion remain poorly understood. This review synthesizes recent advances to establish a unified framework for understanding the dual role of core fucosylation in liver physiology and pathology, and evaluates its translational potential for precision medicine. At the molecular level, FUT8’s unique catalytic specificity makes core fucosylation an irreplaceable modification, as evidenced by the perinatal lethality and severe organ dysfunction in Fut8 knockout mice. In hepatocellular carcinoma, genomic amplification of guanosine 5'-diphosphate-fucose biosynthetic enzymes provides metabolic support for aberrant core fucosylation. FUT8 expression is tightly regulated by a multi-layered network: transcriptional activation via Wnt/β‑catenin and wild-type p53, epigenetic upregulation by lncRNAs, post-transcriptional repression by miR-122-5p and miR-34a, and virus-specific induction by hepatitis B virus/hepatitis C virus. Physiologically, core fucosylation maintains liver homeostasis through four core mechanisms: it acts as a molecular switch for epidermal growth factor receptor/hepatocyte growth factor receptor signaling to enable liver regeneration; directs polarized secretion of hepatocyte-derived glycoproteins into bile ducts; modulates cholesterol metabolism via the hepatocyte nuclear factor 1α-proprotein convertase subtilisin/kexin type 9-low density lipoprotein receptor axis; and regulates aging through insulin‑like growth factor 1 receptor signaling. Pathologically, core fucosylation exhibits context-dependent dual functions: in liver fibrosis, FUT8 upregulation in hepatic stellate cells forms a negative feedback loop that limits excessive fibrogenesis; in hepatocellular carcinoma, however, aberrant FUT8 overexpression drives cell-autonomous malignancy by constitutively activating epidermal growth factor/hepatocyte growth factor receptor, transforming growth factor‑β/Smad, and Wnt/β‑catenin pathways, while simultaneously establishing a multi-layered immune evasion network by stabilizing programmed cell death ligand 1 and cluster of differentiation 47, and impairing natural killer cell homeostasis via interleukin‑2 receptor β glycosylation. Clinically, stage-specific core fucosylation biomarkers enable non-invasive monitoring of liver disease progression: low molecular mass kringle-Fc fusion protein outperforms conventional markers for early fibrosis detection, while alpha-fetoprotein-L3 and novel glycopeptides (α‑2‑macroglobulin N‑linked glycosylation site 1424, lumican core fucosylated peptide) significantly improve early hepatocellular carcinoma diagnosis, especially in alpha-fetoprotein-negative patients. Next-generation detection technologies (chemoenzymatic labeling, site-specific mass spectrometry) overcome the specificity limitations of traditional lectin assays. Therapeutically, four promising strategies are emerging: small-molecule FUT8 inhibitors, afucosylated antibodies with enhanced antibody‑dependent cellular cytotoxicity, Fuc-modified targeted drug delivery systems, and core fucose-specific lectins for NASH treatment. The core challenge for clinical translation lies in FUT8’s inherent “double-edged sword” effect, as systemic inhibition disrupts its essential physiological functions beyond pathological roles. Long-term systemic FUT8 blockade not only impairs post-injury liver regeneration by abrogating epidermal growth factor/hepatocyte growth factor receptor signaling but also disrupts cholesterol homeostasis via the hepatocyte nuclear factor 1α-proprotein convertase subtilisin/kexin type 9-low density lipoprotein receptor axis, leading to dyslipidemia and altered bile secretion. Critically, it compromises immune surveillance by destabilizing interleukin‑2 receptor β on natural killer cells, reducing their cytotoxic activity against malignant and virally infected cells, and impairs IgG Fc-mediated effector functions, increasing susceptibility to infections. This fundamental trade-off between therapeutic efficacy and systemic toxicity necessitates a paradigm shift from non-specific global inhibition to precision modulation of pathological core fucosylation. By addressing these critical challenges, FUT8-mediated core fucosylation has the potential to transform liver disease management from late-stage intervention to early detection and precision therapy, ultimately improving patient outcomes and reducing the global burden of liver diseases.

BACKGROUND:Ca2+expression in astrocytes has been found to be closely related to cognitive function,and the Ca2+signaling pathway regulated by inositol 1,4,5-trisphosphate receptors(IP3R2)and ryanodine receptor(RYR)2 receptors has become a hot spot in the study of cognitive disorder-related diseases. OBJECTIVE:To investigate the expression of Ca2+signals mediated by IP3R2 and RYR2 in hippocampal astrocytes in animal models of delayed encephalopathy after acute carbon monoxide poisoning,and to explore the possible pathogenesis of delayed encephalopathy after acute carbon monoxide poisoning. METHODS:C57BL mice with qualified cognitive function were selected by Morris water maze experiment and randomly divided into control group and experimental group.An animal model of delayed encephalopathy after acute carbon monoxide poisoning was established by static carbon monoxide inhalation in the experimental group,and the same amount of air was inhaled in the control group.Behavioral and neuronal changes,astrocyte specific marker glial fibrillary acidic protein,IP3R2,RYR2 receptor and Ca2+concentration in astrocytes of the two groups were detected using Morris water maze,hematoxylin-eosin staining,western blot,immunofluorescence double labeling and Ca2+fluorescence probe at 21 days after modeling. RESULTS AND CONCLUSION:In the Morris water maze,the escape latency of the experimental group was significantly longer than that of the control group(P<0.05).Hematoxylin-eosin staining results showed that in the experimental group,the number of hippocampal pyramidal cells decreased,the cell structure was disordered,and the nucleus was broken and dissolved.Immunofluorescence results showed that IP3R2 and RYR2 were co-expressed with glial fibrillary acidic protein in the hippocampus,and the expressions of IP3R2,RYR2 and glial fibrillary acidic protein were up-regulated in the hippocampus of the experimental group(P<0.05).Western blot analysis showed that the expressions of IP3R2,RYR2,and glial fibrillary acidic protein in the hippocampus of the experimental group were increased(P<0.05).Ca2+concentration in hippocampal astrocytes increased significantly in the experimental group(P<0.05).To conclude,astrocytes may affect Ca2+signals by mediating IP3R2 and RYR2 receptors,then impair the cognitive function of mice with carbon monoxide poisoning,and eventually lead to delayed encephalopathy after acute carbon monoxide poisoning.

OBJECTIVE To understand the clinical characteristics of patients with Mycoplasma pneumoniae(MP)infection,and to explore the related factors of mixed infection,to provide theoretical support for the diag-nosis and treatment of MP infection.METHODS The clinical data of patients diagnosed with MP infection in the 305th hospital of PLA from Dec.2023 to Apr.2024 were collected,and the clinical characteristics of patients in-fected with MP were analyzed.Additionally,the impacts of MP mixed infections with other pathogens on the se-verity of the disease were compared,while the relevant influencing factors of MP mixed with other pathogens were analyzed by the logistic regression model.RESULTS A total of 114 patients with MP infection were collected,both genders had 57 cases(50.00％,respectively),60(52.63％)were adults,73(64.04％)had simple MP infection and 41(35.96％)had mixed infection.The clinical manifestations of MP infection primarily included fever and cough,with most fevers being low to medium intensity.Additionally,the biochemical indexes were predominantly within normal ranges,however,the interleukin 6(IL-6)level was relatively high.The abnormalities of chest X-ray examination accounted for 84.21％of the cases.In mixed infection cases,fever,dizziness,fatigue,headache and muscle pain were more prevalent than single MP infection cases(P＜0.05),and CRP level elevated in the mixed infection group(P=0.001),whereas white blood cell level and lymphocyte count decreased compared to the single MP infection group(P＜0.05).Multivariate logistic regression analysis showed that fever(OR=4.112,95％CI:1.046-16.161)and above 46 years old(OR=8.555,95％CI:1.394-52.493)were the rele-vant influencing factors for MP mixed with other pathogens infection.CONCLUSION Clinical features of MP-infected patients are atypical,but IL-6 levels are relatively high.MP is often mixed with viral infections,and fever and above 46 years old are the risk factors for mixed MP infection.

Objective:To relate the changes in electroencephalography (EEG) signals after a spinal cord injury (SCI) with functional independence.Methods:The EEG data describing ninety SCI patients in both open and closed eye states were compared with those collected from 45 healthy counterparts. The SCI patients′ EEG data were correlated with their spinal cord independence measure (SCIM) scores at corresponding time points. The SCI patients were divided into a cervical SCI group (SCI-C group) and a non-cervical SCI group (SCI-NC group), with 45 cases in each group. The difference in EEG data between them and its correlation with the SCIM scores were also compared and analyzed.Results:In the eyes-open state, the EEG power in the frontal, central, temporal, and right occipital regions of the SCI group was lower than among the control group, on average. There were significant differences in the δ and θ low-frequency bands. The α1 band power in the frontal and right parietal regions was significantly higher in the SCI group, on average. With the eyes closed the δ band power in the right prefrontal, frontal, left central, and temporal regions of the SCI group was lower than among the control group, while the α1 band power in the right prefrontal, frontal, central, and parietal regions was significantly higher. The reactivity to eye opening of the α1 band in the right prefrontal, frontal, central, parietal, and temporal regions was less in the SCI patients compared to healthy subjects. Among the SCI patients, higher EEG power in the β2 band of the right frontal lobe and the α2 and β bands of the right temporal lobe was significantly positively correlated with higher SCIM scores during the eyes-open measurements. And the higher EEG power in the α2 band of the prefrontal and frontal lobes, the β2 band of the frontal lobe, the α2 band of the right central region, the α2 and β bands of the temporal lobe, and the α2 and β2 bands of the occipital lobe was significantly positively correlated with higher SCIM scores during the eyes-closed state. The subgroup analysis showed that the δ band power in the left temporal lobe and the α2 band power in the parietal lobe were lower among the SCI-C compared with the SCI-NC patients in the eyes-open state. With the eyes closed, the δ band power in the left frontal, left parietal, and left temporal lobes and the α2 band power in the frontal, central, parietal, temporal, and right occipital lobes was significantly lower in the SCI-C group compared to the SCI-NC group, on average. The reactivity to eye opening of the δ band in the temporal lobe, the α2 band in the left prefrontal, frontal, central, parietal, temporal, and right occipital lobes, and the β2 band in the right parietal and left occipital lobes was less in the SCI-C group than in the SCI-NC group ( P≤0.05). Among the SCI-C patients, higher EEG power in the β1 and β2 bands of the right temporal lobe with the eyes open was significantly positively correlated with higher SCIM scores. With the eyes closed, higher EEG power in the α2 and β1 bands of the right prefrontal lobe was significantly positively correlated with higher SCIM scores. Among the SCI-NC patients, higher EEG power in the δ band of the prefrontal lobe, the β1 and β2 bands of the left prefrontal lobe, and the δ bands of the frontal, central, right parietal, and right temporal lobes during the eyes open measurements was significantly positively correlated with higher SCIM scores. Conclusions:The EEG power of cervical and non-cervical SCI patients shows characteristic changes which correlate with their functional independence.

Objective:To determine the weight coefficient of home care service quality indicators for the disabled elderly in Beijing.Methods:In the early stage, our research group has preliminarily constructed quality indicators of home care service for the disabled elderly in Beijing. The importance scores of all indicators were obtained through expert consultation from September to October 2021. Based on the game theory, the subjective and objective weighting methods were integrated to quantify the combinatorial optimization weight assignment of those indicators, in which the subjective weighting was calculated by proportional distribution method, and the objective weighting was obtained by entropy weight method.Results:The subjective weight assignments of the first-level indicators “service conditions”“service process” and “service outcome”were 0.332 2, 0.338 9, and 0.328 9, respectively; the objective weight assignments of the above indicators were 0.332 2, 0.338 9 and 0.328 9, respectively; the combinatorial optimization weight assignment of those indicators were 0.332 2, 0.338 9, and 0.328 9, respectively. Among the second-level indicators, the combination optimization weight coefficients of the top 3 important indicators “patient family evaluation”(1.3),“emergency configuration”(1.4), and“operation process”(2.2) were 0.198 4, 0.198 4 and 0.170 8, respectively. And among the third-level indicators, the combination optimization weight coefficients of the top 5 important indicators“emergency plan”(1.4.1), “humanistic care”(2.2.6), “first aid supplies”(1.4.2), “evaluation of potential resources”(1.3.4), and “means of home visit transportation”(1.2.1) were 0.124 7, 0.075 0, 0.073 8, 0.066 5 and 0.052 7, respectively.Conclusion:The study has successfully conducted the optimization weight assignment of home care service quality indicators for the disabled elderly in Beijing, which indicates that the service conditions and service process are crucial to the quality of service.

Objective:To investigate the clinical and pathological characteristics of primary thoracic synovial sarcoma (PTSS).Methods:Forty-two PTSS cases diagnosed at the Department of Pathology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China from October 2011 to April 2024 were analyzed. All cases were retrospectively studied using hematoxylin-eosin staining and immunohistochemistry. Their clinicopathological features were also reviewed. SS18 rearrangement was assessed in 28 cases using fluorescence in situ hybridization (FISH). Next generation sequencing (NGS) was performed on 8 cases.Results:Among the 42 cases, there were 23 biopsies and 19 surgically-removed specimens. One case was a specimen resected after neoadjuvant chemotherapy. There were 22 males and 20 females, with an age ranging from 6 to 68 years. Twenty-nine cases occured in the lung, 6 in mediastinum, 4 in pericardium, 1 in visceral pleura, and 1 in right atrium. One case did not show any unequivocal primary site. Computed tomography showed the tumors were manifested as a cystic mass, a solid mass, or thickening of the pleura and pericardium. Thirty-two cases had respiratory symptoms, while 19 had pleural effusion. One case had a history of radiotherapy for papillary thyroid carcinoma. Nineteen patients were treated with surgery, while 19 were treated with chemotherapy without surgery. Four patients were diagnosed and discharged, without specific treatment on the record. Morphologically, 1 case was biphasic type, 39 cases were monophasic type, and 2 cases were poorly differentiated type. In addition to the typical morphology of synovial sarcoma, tumors also showed pulmonary bullous changes, stromal collagen hyalinization, hemangiopericytoma-like vasculature, stromal edematous myxoid changes, and microcystic structure. Immunohistochemically, all cases were diffusely positive for TRPS1 (22/22), TLE1 (21/22), CD99 (26/26), SS18-SSX (25/25) and INI1 (12/12), including 3 cases with decreased expression of INI1. Twenty-one cases were focally positive for EMA (21/30), 4 cases for SMA (4/23), 2 cases for S-100 (2/28), and 2 cases (2/35) for CKpan. Twenty-eight cases (28/28) had SS18 rearrangement displaying a split signal on FISH analysis. Eight cases were found to have mutations in SMC1A, NOTCH2, CDK12, SPRY4, BRCA1, STK11, NF2, and PDGFRα genes using NGS. Eighteen of the 29 patients survived and 16 showed disease progression.Conclusions:PTSS is more commonly found in the lungs than other sites and has non-classical morphological features of various types, which need to be differentiated from other tumors. TRPS1 is highly expressed in PTSS and has certain diagnostic values. The diagnosis of PTSS also requires combination of patient′s medical history with thorough imaging studies.

Objective Utilizing patient journey mapping to decipher disease management behaviors,barriers,and needs in young and middle-aged liver transplant recipients,providing implications for self-management optimization and quality of life improvement.Methods Using purposive sampling,12 young and middle-aged liver transplant patients who attended outpatient clinics or were hospitalized in liver transplant center of a tertiary hospital in Qingdao were selected for semi-structured interviews from September to November 2024.Thematic extraction and analysis were performed using Colaizzi's 7-step analysis,ultimately resulting in the development of a patient journey map.Results The journey stages were divided into transplantation decision-making period,transplantation waiting period,perioperative period,and post-discharge management period,and the journey key elements were designed as behaviors,barriers,and needs.A total of 25 themes were extracted,including behaviors(such as referrals to higher-level hospitals,verification of treatment options),barriers(such as lack of decision-making autonomy,health information-seeking barriers),and needs(such as shared decision-making,financial assistance).Ultimately,resulting in a map of the disease management journey for young and middle-aged liver transplant recipients.Conclusion The behaviors,barriers,and needs in disease management among young and middle-aged liver transplant recipients demonstrate distinct phase-specific patterns.Healthcare providers should deliver precise and dynamic interventions tailored to each clinical phase,aiming to foster optimal self-management behaviors,address phase-specific banriers,and meet evolving patient needs throughout the transplant continuum.

Objective To analyze and clarify the concept and connotation of care-resistant behavior in dementia patients,so as to provide references for the evaluation and practice of care-resistant behavior in clinical dementia patients.Methods PubMed,Scopus,Web of Science,Cochrane Library,Embase,CINAHL,CNKI,VIP,Wanfang database and Chinese Biomedical Literature Database were systematically searched for the literature on care-resistant behavior in dementia patients.The search time limit was from the establishment of the database to December 2024.Walker and Avant's classical concept analysis method was used to analyze the literature.Results The care-resistant behav-ior in dementia patients included 5 conceptual attributes,including nursing background,perceived threat,unmet needs,lack of understanding and multi-dimensional performance.The antecedent factors include patient factors,care-giver factors,environmental factors and organizational factors.Post-impact includes the impact on patients and the impact on caregivers.Conclusion This study clarified the conceptual attributes,antecedents and post-effects of care-resistant behavior in dementia patients through concept analysis.In the future,researchers should combine the connotation of dementia patients' care-resistant behavior,develop localized assessment tools for dementia patients' care-resistant behavior,and construct targeted intervention programs,so as to improve the quality of nursing staff and enhance the care experience of dementia patients.

Epidermal growth factor receptor(EGFR)gene exon 20 insertion(ex20ins)mutation is a common driver gene activation mutation in non-small cell lung cancer(NSCLC).Tumors harboring this gene mutation are characterized by high heterogeneity,high malignancy,low detectability,poor response to conventional therapies,and poor prognosis.In recent years,significant progress has been made in the study of EGFR ex20ins mutation.The wide application of next-generation sequencing has improved the detection rate.The U.S.Food and Drug Administration(FDA)has approved the relevant indications of amivantamab in NSCLC patients with EGFR ex20ins mutation.A variety of new drugs have also achieved good results in previous studies.This article will summarize the structural characteristics,detection methods and clinical treatment progress of NSCLC patients with EGFR ex20ins mutations,hoping to provide help for the choice of clinical treatment for such patients.

Objective:To investigate the prevalence and risk factors of overweight and obesity among Chinese children aged 3-18 years from 11 provinces, antonomous regions, or municipalities.Methods:This national cross-sectional community health survey utilized a multistage stratified cluster-random sampling method to recruit 193 997 nationally representative participants from 11 provinces, autonomous regions, or municipalities between January 2017 and December 2019. All participants underwent physical examinations, and their caregivers completed questionnaires assessing participants′ dietary, lifestyle, familial, and perinatal information. Multilevel multinomial logistic regression models were employed to identify the potential risk factors.Results:The cohort comprised 193 997 children (102 178 boys, 91 819 girls),aged (10±4) years. Overall prevalence rates were 30 574(15.8%)overweight children and 17 217(8.9%) obesity children. Boys exhibited higher overweight and obesity rates than girls (17.0% (17 368/102 178) vs. 14.4% (13 206/102 178), 11.3% (11 553/91 819) vs. 6.2% (5 664/91 819), χ2=249.12,1 578.69,both P<0.001). The detection rates of obesity in Tanner stage 2 and 3 were the highest in boys and girls, with 13.4%(2 231/16 665) and 8.6%(880/10 221) respectively. Risk factors for obesity included parental overweight (paternal OR=2.34 and maternal OR=2.29), annual household income of 100 000-200 000 yuan (compared with<100 000 yuan, OR=1.04), higher paternal education (compared with below high school,high school and a college education OR=1.09,1.14), birth weight >4.0 kg (≤5 and>5 years old OR=1.74, 1.44,respectively), and western food consumption≥1 time/month (compared with<1, 1-2, 3-4,>4 times/month OR=1.36, 1.30, 1.67(≤5 years), 1.19, 1.16, 1.15 (>5 years), respectively) (all P<0.05). Conversely, coarse grain intake≥1 times/week (compared with<1 times/week, every day, 3-4, 1-2 times/week OR=0.74, 0.80, 0.71 (≤5 years), 0.75, 0.87, 0.90(>5 years), respectively, all P<0.05) was associated with reduced obesity risk. Conclusions:Obesity epidemiology in children demonstrates significant heterogeneity across age, gender, geographic regions, and pubertal stages. It is necessary to establish a personalized prevention and control strategy.