Organ fibrosis is a chronic tissue injury caused by multiple causes,and the continuous dynamic progression will lead to abnormal organ structure and function.Recent studies have shown that Chinese materia medica can inhibit organ fibrosis by regulating the PI3K/Akt pathway,which holds potential significance for developing anti-fibrosis strategies.This article systematically reviewed the role of the PI3K/Akt signaling pathway in the entire process of fibrosis,and summarized the potential mechanisms of Chinese materia medica monomers,drug pairs and compounds that can target and intervene in PI3K/Akt signaling transduction in preventing and treating organ fibrosis,in order to provide reference for the intervention of Chinese materia medica in the PI3K/Akt pathway for the treatment of organ fibrosis.

Organ fibrosis is a chronic tissue injury caused by multiple causes,and the continuous dynamic progression will lead to abnormal organ structure and function.Recent studies have shown that Chinese materia medica can inhibit organ fibrosis by regulating the PI3K/Akt pathway,which holds potential significance for developing anti-fibrosis strategies.This article systematically reviewed the role of the PI3K/Akt signaling pathway in the entire process of fibrosis,and summarized the potential mechanisms of Chinese materia medica monomers,drug pairs and compounds that can target and intervene in PI3K/Akt signaling transduction in preventing and treating organ fibrosis,in order to provide reference for the intervention of Chinese materia medica in the PI3K/Akt pathway for the treatment of organ fibrosis.

Objective:To investigate the molecular mechanism by which 2',4'-dihydroxychalcone(D2)inhibits proliferation,migration,and epithelial-mesenchymal transition(EMT)in colorectal cancer cells through miR-7-5p-mediated autophagy.Methods:Human colorectal cancer cell lines HCT-15 and SW620 were treated with D2 at concentrations of 0,12.5,25,and 50 μmol/L.Cell proliferation and clonogenic capacity were evaluated using MTT and colony formation assays.Cell migration was assessed by wound healing and Transwell assays.WB assay was used to detect the expression of EMT-related proteins,autophagy-related proteins,and key components of the PI3K/AKT/mTOR pathway.Autophagosome formation was visualized by immunofluorescence staining.TCGA database and KEGG pathway analyses were performed to evaluate miR-7-5p expression and its association with colorectal cancer.RT-qPCR was used to quantify miR-7-5p expression,and lentiviral transduction was employed to establish stable miR-7-5p knockdown or overexpression cell lines.Results:D2 significantly inhibited colorectal cancer cell proliferation,migration,and EMT(P<0.05 or P<0.01).TCGA and KEGG analyses revealed that miR-7-5p expression was downregulated in colorectal cancer and closely associated with disease progression.D2 treatment(12.5,25,and 50 μmol/L)significantly upregulated miR-7-5p expression in HCT-15 and SW620 cells(P<0.01).At 25 μmol/L,D2 increased the expression of autophagy-related proteins(LC3 and p-ULK1)and inhibited the PI3K/AKT/mTOR signaling pathway(P<0.05),accompanied by increased autophagosome formation(P<0.01).In miR-7-5p-knockdown cells treated with D2,the levels of LC3 and p-ULK1 were significantly reduced compared to D2-only treated cells(P<0.05 or P<0.01).Conclusion:D2 upregulates miR-7-5p to induce autophagy,thereby inhibiting colorectal cancer cell proliferation,migration,and EMT,possibly through suppression of the PI3K/AKT/mTOR signaling pathway.

Objective To investigate serum vitamin D levels of healthy children in Beijing and to analyze the factors affecting vitamin D level.Methods Healthy children aged 1-14 years old who underwent physical examination in department of pediatrica,Civil Aviation General Hospital from September 2016 to September 2020 were randomly selected as research objects.Clinical data of the children were collected and a questionnaires survey was conducted.The level of 25-hydroxy vitamin D[25-(OH)D]was detected by liquid chromatography-tandem mass spectrometry.Serum 25-(OH)D levels were compared between different groups(grouped by age,gender,season,outdoor activity time,and vitamin D supplementation).Results A total of 990 children met the inclusion criteria.There were 500 boys and 490 girls,with a mean age of(6.42±3.50)years old.The mean serum level of 25-(OH)D was(28.23±6.74)ng/ml in all the selected children(range,11.70-51.90 ng/ml),(31.99±6.47)ng/ml in young child group,(27.54±6.49)ng/ml in preschool group,and(25.84±5.93)ng/ml in school-age group.The serum level of 25-(OH)D in the young child group was significantly higher than those in the preschool group and school-age group(P<0.05).There was no significant difference in the serum level of 25-(OH)D between the preschool group and school-age group(P>0.05).There were significant differences in the proportions of children with normal 25-(OH)D,insufficient 25-(OH)D and deficient 25-(OH)D among different age groups(P<0.05).There was no significant difference in the serum level of 25-(OH)D between boys and girls in the same age group(P>0.05).There was significant difference in 25-(OH)D levels among different age groups with a same gender(P<0.05).There was no significant difference in the proportions of children with normal 25-(OH)D,insufficient 25-(OH)D,or deficient 25-(OH)D between boys and girls(P>0.05).The level of serum 25-(OH)D and the proportion of children with normal serum 25-(OH)D reached the highest in summer and the lowest in winter.There were significant differences in the serum 25-(OH)D levels and the proportion of children with normal serum 25-(OH)D among different seasons(P<0.05).The serum 25-(OH)D level in children with outdoor activities≥1 h daily was significantly higher than that in children with outdoor activities<1 h daily(P<0.05).There were significant differences in the proportions of normal 25-(OH)D,insufficient 25-(OH)D and deficient 25-(OH)D between children with outdoor activities≥1 h daily and children with outdoor activities<1 h daily(P<0.05).The serum levels of 25-(OH)D in children of never-supplement group and sometimes-supplement group were lower than that in the daily supplement group(P<0.05),and there were significant differences in the proportions of normal 25-(OH)D,insufficient 25-(OH)D and deficient 25-(OH)D among the three groups(P<0.05).Conclusion Vitamin D nutritional status of healthy children in Beijing is good.Serum 25-(OH)D level decreases with age.No difference is found in the serum 25-(OH)D level between boys and girls in every age group.No abnormal vitamin D level is found in young children.The insufficiency and deficiency of vitamin D exist in preschool and school-age children,which needs to be improved.Vitamin D level in children is related to seasons.Sufficient time of outdoor activities and regular supplementation of vitamin D can help improve vitamin D nutritional status in children.

Objective To explore the influencing factors of cognitive impairment in non-dialysis patients with chronic kidney disease(CKD).Methods A total of 60 hospitalized non-dialysis patients with CKD in the Department of Nephrology of Northern Jiangsu People's Hospital Affiliated to Yangzhou University from September 2022 to September 2023 were enrolled as research objects.According to the estimated glomerular filtration rate(eGFR),they were divided into stage 1 to 2 of CKD group[eGFR ≥60 mL/(min·1.73 m2)]with 23 cases,the stage 3 of CKD group[eGFR 30～＜60 mL/(min·1.73 m2)]with 20 cases,and stage 4 to 5 of CKD group[eGFR＜30 mL/(min·1.73 m2)]with 17 cases.The Montreal Cognitive Assessment Scale(MoCA)was used to evaluate the cognitive function of the patients.Basic data and common clinical laboratory in-dicators on hospital admission were collected to analyze the differences in cognitive function levels under different renal function statuses and to explore the influencing factors of cognitive impairment.Results The incidence rates of cognitive impairment in the stage 1 to 2 of CKD group,stage 3 of CKD group,and stage 4 to 5 of CKD group were 47.8％,85.0％,and 94.1％respectively,the median MoCA scored 26,24 and 20 respectively,with statistically significant between-group differ-ences(P＜0.05).Cognitive function was significantly negatively correlated with age(r=-0.634,P＜0.001),blood urea nitrogen(BUN)(r=-0.574,P＜0.001),serum creatinine(Cr)(r=-0.417,P＜0.001),cystatin C(Cys-C)(r=-0.327,P=0.011),serum β2-microglobulin(β2-MG)(r=-0.259,P=0.046),and N-terminal pro-brain natriuretic peptide(NT-proBNP)(r=-0.474,P＜0.001),and was significantly positively correlated with hemoglobin(HB)(r=0.401,P=0.001)and eGFR(r=0.485,P＜0.001).Multivariate Logistic regression analysis showed that age(P=0.006)and NT-proBNP(P=0.041)were influencing factors of cognitive im-pairment in non-dialysis patients with CKD.Receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC),sensitivity,and specificity of age for prediction were 0.860,0.864 and 0.812 respectively,the AUC,sensitivity,and specificity of NT-proBNP for pre-diction were 0.808,0.795 and 0.875 respectively,and the combined prediction of age and NT-proBNP had an AUC,sensitivity,and specificity of 0.893,0.955,and 0.750,respectively.Conclusion As renal function deteriorates,the incidence rate and severity of cognitive impairment in non-dialysis patients with CKD tend to increase.Advanced age,renal function deterioration,high NT-proBNP level,and anemia are associated with the occurrence of cognitive impairment in non-di-alysis patients with CKD,among which age and NT-proBNP are influencing factors for cognitive im-pairment.

OBJECTIVE T o analyze the distribution and clinical characteristics of carbapenem-resistant organisms(CRO)in the intestinal and respiratory tracts of high-risk ICU patients,and to evaluate the effectiveness of two screening methods:plate screening and Gene Xpert Carba(hereinafter referred to as Xpert Carba).METHODS In-testinal samples(anal swabs,feces)and respiratory samples(sputum,lavage fluid)from 320 patients admitted to the ICU ward of the Fourth Affiliated Hospital of Soochow University from Apr.2023 to Dec.2024 were collected.Plate screening and Xpert Carba methods were used for active screening of CRO strains,and clinical data of patients were collected through electronic medical records.RESULTS The plate screening results indicated that 70 out of 573 samples from 320 patients tested positive for CRO,with a positive rate of 12.22％(70/573).The positive rates for anal swabs,feces,sputum and lavage fluid were 9.26％(20/216),10.39％(8/77),13.02％(22/169)and 18.02％(20/111),respectively.There was no statistically significant difference in the positive rates among different sample types.The predominant CRO-positive organisms detected were Klebsiella pneumoniae in intestinal samples and Pseudomonas aeruginosa in respiratory samples.Among 361 intestinal and respiratory samples tested from 88 patients,plate screening and Xpert Carba screening showed the positive rates of 14.40％(52/361)and 6.37％(23/361),respectively.Analysis of the clinical characteristics of the 31 CRO-posi-tive patients revealed that they were predominantly elderly(average age 69 years),with 51.61％(16/31)having a history of interdepartmental transfers and 48.39％(15/31)having surgerical history.The mechanical ventilation usage rate in the respiratory positive group(58.82％,10/17)was higher than that in the intestinal positive group(0,0/7)and the dual positive group(14.28％,1/7).Compared with Xpert Carba,plate screening had lower screening costs,higher positive rates across different sample types and a broader range of detected bacterial species.CONCLUSIONS The ICU ward is a high-prevalence area for CRO strains,with K.pneumoniae(from in-testinal samples)and P.aeruginosa(from respiratory samples)showing the highest isolation rates.Plate screen-ing boasts lower costs,higher detection rate and broader bacterial species coverage for active screening of CRO strains in the intestinal and respiratory tracts of high-risk ICU patients.

OBJECTIVE T o analyze the distribution and clinical characteristics of carbapenem-resistant organisms(CRO)in the intestinal and respiratory tracts of high-risk ICU patients,and to evaluate the effectiveness of two screening methods:plate screening and Gene Xpert Carba(hereinafter referred to as Xpert Carba).METHODS In-testinal samples(anal swabs,feces)and respiratory samples(sputum,lavage fluid)from 320 patients admitted to the ICU ward of the Fourth Affiliated Hospital of Soochow University from Apr.2023 to Dec.2024 were collected.Plate screening and Xpert Carba methods were used for active screening of CRO strains,and clinical data of patients were collected through electronic medical records.RESULTS The plate screening results indicated that 70 out of 573 samples from 320 patients tested positive for CRO,with a positive rate of 12.22％(70/573).The positive rates for anal swabs,feces,sputum and lavage fluid were 9.26％(20/216),10.39％(8/77),13.02％(22/169)and 18.02％(20/111),respectively.There was no statistically significant difference in the positive rates among different sample types.The predominant CRO-positive organisms detected were Klebsiella pneumoniae in intestinal samples and Pseudomonas aeruginosa in respiratory samples.Among 361 intestinal and respiratory samples tested from 88 patients,plate screening and Xpert Carba screening showed the positive rates of 14.40％(52/361)and 6.37％(23/361),respectively.Analysis of the clinical characteristics of the 31 CRO-posi-tive patients revealed that they were predominantly elderly(average age 69 years),with 51.61％(16/31)having a history of interdepartmental transfers and 48.39％(15/31)having surgerical history.The mechanical ventilation usage rate in the respiratory positive group(58.82％,10/17)was higher than that in the intestinal positive group(0,0/7)and the dual positive group(14.28％,1/7).Compared with Xpert Carba,plate screening had lower screening costs,higher positive rates across different sample types and a broader range of detected bacterial species.CONCLUSIONS The ICU ward is a high-prevalence area for CRO strains,with K.pneumoniae(from in-testinal samples)and P.aeruginosa(from respiratory samples)showing the highest isolation rates.Plate screen-ing boasts lower costs,higher detection rate and broader bacterial species coverage for active screening of CRO strains in the intestinal and respiratory tracts of high-risk ICU patients.

Objective:To establish 30-day of age transcutaneous bilirubin (TcB) reference curves for healthy neonates, and to investigate regional variations in bilirubin dynamics.Methods:A multicenter retrospective cohort study was conducted. A total of 220 950 healthy neonates born at a gestational age of 35-<42 weeks, with a birth weight ≥2 000 g, who did not receive phototherapy within 60 h after birth were recruited. All of them underwent remote TcB monitoring using the Bilibaby remote jaundice monitoring system between August 1 st, 2020 and December 31 st, 2024 in 426 hospitals. TcB data were collected within the period from birth to 30-day of age. The P40, P75, and P95 of TcB values were calculated, and dynamic TcB curves for 30-day of age were constructed. Patterns of bilirubin change, rates of change, and transition outcomes were described. Regional comparisons between South and North were conducted using linear mixed-effects models for TcB trajectories and Pearson′s chi-square test for outcome differences. Results:A total of 220 950 neonates were included, of whom 101 711 (46.03%) were female. Gestational age at birth was (38.75±1.12) weeks, and birth weight was (3 272±417) g. TcB levels increased rapidly within 3-day of age, peaked at 4-6-day of age, with peak values at P40, P75, and P95 of 200.6, 239.7 and 275.4 μmol/L (11.8, 14.1 and 16.2 mg/dl), respectively. TcB levels gradually declined thereafter and stabilized after 13-day of age, with values at P40, P75, and P95 fluctuating between 147.9-159.8, 190.4-200.6, and 231.2-239.7 μmol/L (8.7-9.4, 11.2-11.8, 13.6-14.1 mg/dl), respectively. Notably, among neonates categorized as low-or low-intermediate-risk within 3-day of age, 6 700 (12.76%) progressed to intermediate-high or high risk between 4 and 30 days of age. Before 13-day of age, TcB levels in the southern regions were consistently higher than those in the northern regions ( P=0.039); from 14 to 30 days of age, the overall TcB levels had no statistically difference, but the temporal changes in TcB still showed regional differences (degrees of freedom=3, all interaction P<0.05). Among neonates classified as low-or low-intermediate risk within 3-day of age, 25 326 were from southern regions, of whom 4 254 (16.80%) progressed to intermediate-high or high risk between 4 and 30 days of age. In northern regions, 27 193 neonates were classified as low-or low-intermediate risk within 3-day of age, among whom 2 446 (8.99%) progressed to intermediate-high or high risk. The risk progression between the 2 regions had statistically difference ( χ2=716.49, P<0.001). Conclusions:A TcB percentile curve for neonates within 30-day of age was established, revealing that both the overall TcB level and its temporal trend were higher in southern than in northern newborns. These findings provide baseline data to support continuous management of neonatal jaundice.