Mass spectrometry imaging （MSI） is an emerging molecular imaging technique that combines high spatial resolution and the ability to acquire molecular information. This technology can directly obtain spatial distribution maps of metabolites, proteins, lipids and other molecules in tumor tissues, reveal the abnormal molecular changes during the occurrence and development of liver cancer, and make up for the deficiency of information at the molecular level in traditional imaging （such as CT, MRI）. In liver cancer research, MSI has demonstrated unique advantages and application potential in early diagnosis and screening, precise classification, tumor heterogeneity analysis, and exploration of molecular mechanisms. The principle characteristics of MSI technology and its latest progress in the early diagnosis, classification and molecular mechanism research of liver cancer were reviewed, and the current challenges and future development directions were discussed, which aimed to provide a new perspective and theoretical basis for an in-depth understanding of the pathological mechanism of liver cancer and promoted its precise diagnosis and treatment.

OBJECTIVE To evaluate the long-term efficacy of intra-articular injection of hyaluronic acid （HA）， platelet-rich plasma （PRP）， and micro-fragmented adipose tissue （MFAT） in treatment of knee osteoarthritis （KOA）. METHODS Randomized controlled trials （RCTs） of KOA patients receiving intra-articular injection of the three agents were collected from PubMed， Web of Science， Embase， Cochrane Library， CNKI， Wanfang Data， VIP， Chinese Biomedical Literature Service System，and clinical trial registration platforms. The retrieval time limit was from January 2016 to December 2025. After screening the literature， extracting the data，and evaluating the quality of the literature， network meta-analysis was performed using RevMan 5.3 and Stata MP 16.0 software. RESULTS A total of 31 RCTs involving 2 964 patients were included. For pain relief， after 6 months of treatment， the Visual Analogue Scale （VAS） scores in the PRP+HA and PRP groups were significantly lower than those in the saline and HA groups （ P ＜0.05）， PRP+HA and PRP were ranked as the top two by surface under the cumulative ranking curve （SUCRA）. After 12 months of treatment， the VAS scores in the PRP group were significantly lower than those in the HA and saline groups （ P ＜0.05）， PRP and PRP+HA were ranked as the top two by SUCRA. For functional recovery， after 6 months of treatment， the Western Ontario and McMaster Universities Osteoarthritis Index （WOMAC） scores in the PRP group were significantly lower than those in the HA or saline groups （ P ＜0.05）. After 12 months of treatment， the WOMAC scores in the MFAT， PRP and PRP+HA groups were significantly lower than those in the HA or saline groups （ P ＜0.05）. After 6 and 12 months of treatment， International Knee Documentation Committee （IKDC） scores in the MFAT and PRP groups were significantly higher than the saline group （ P ＜0.05）， and after 12 months of treatment， the PRP group was significantly higher than the HA group （ P ＜0.05）. MFAT and PRP were ranked as the top two by SUCRA for both the WOMAC and IKDC scores. CONCLUSIONS For pain relief， PRP+HA showed a significant advantage at 6 months after treatment， whereas PRP alone demonstrated a notable superiority at 12 months after treatment. For functional recovery， MFAT exhibited a marked advantage at both 6 and 12 months after treatment.

Cholestatic liver disease （CLD） is closely associated with bile acid homeostasis imbalance， oxidative stress， inflammatory responses， mitochondrial damage， and hepatic fibrosis. Nuclear factor-erythroid 2-related factor 2 （Nrf2） can regulate molecules related to antioxidation， detoxification， and bile acid transport， and together with signaling pathways such as farnesoid X receptor （FXR）， silent information regulator 1/AMP-activated protein kinase， and nuclear factor-κB， participates in the development and progression of CLD. This review summarizes the role of Nrf2 in the development and progression of CLD， as well as the research progress on traditional Chinese medicine （TCM） active constituents and formulas/Chinese patent medicine in regulating Nrf2 for the intervention of CLD. The results indicate that TCM active constituents such as terpenoids， saponins， flavonoids， and polysaccharides， as well as formulas/Chinese patent medicine with the effects of heat-clearing and dampness-draining， liver-soothing and choleretic-promoting， and body-strengthening and liver-protecting， can improve bile acid metabolism and transport and alleviate oxidative stress， inflammatory responses， and hepatic fibrosis by regulating Nrf2-related signaling pathways. However， existing studies still primarily judge based on Nrf2 expression， nuclear translocation， and downstream molecular expression changes， and the understanding of the regulatory relationship between Nrf2 and signaling pathways such as FXR， as well as the synergistic mechanisms of multiple constituents in formulas， remains insufficient. Future studies can strengthen gene intervention and functional validation， utilize liver or bile duct organoids， co-culture systems， and other approaches， and combine bile acid profiling and multi-omics analysis to further elucidate the mechanism by which TCM regulates Nrf2 to ameliorate CLD.

Objective: To investigate the dynamic influence mechanism of the interaction between physical exercise and pre-sleep screen time on sleep quality among college students, so as to provide a theoretical basis for sleep health interventions in the population. Methods: From March to April 2025, a convenience sample of 2 075 students was recruited from eight universities in Jiangsu Province to participate in an online survey. Physical exercise was assessed using the Physical Activity Rating Scale-3 (PARS-3), sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI), and pre-sleep screen time behaviors were recorded using a self-designed structured questionnaire. Binary Logistic regression was used to examine the independent associations of physical activity level and pre-sleep screen time with sleep disorders. An interaction effect model was then applied to plot the dose-response relationship among the three variables. Results: The overall prevalence of sleep disorder among college students was 50.3%. Significant differences in the prevalence of sleep disorder were observed across groups of sex, academic discipline, grade, pre-sleep screen time, and physical exercise ( χ 2=42.45, 14.81, 18.99, 113.23, 40.61, all P <0.05). Binary Logistic regression showed that pre-sleep screen time was associated with the risk of sleep disorders (≤15 min: OR =1.70; 16- 30 min : OR =1.91; 31-60 min: OR =3.31; >60 min: OR =5.32), while both moderate ( OR =0.44) and high ( OR =0.57) physical exercise were associated with a reduced risk (all P <0.05). The interaction effect was statistically significant (Wald χ 2= 6.82 , P <0.01). The dose-response curves revealed that, in the low-exercise group, sleep quality deteriorated sharply with increasing screen time (the predicted mean dropped to 28% at the >60 min threshold, P <0.01); in the moderate exercise group, an inverted U-shaped trend was observed, with an optimal window of 16-30 min; and in the high exercise group, a significant buffering effect was found, with the predicted mean remaining at 43% even under >60 min screen exposure, representing a decrease of only 4% compared with the no-screen use group ( P >0.05). Conclusions High screen exposure combined with low physical exercise represents the primary behavioral pattern associated with a high prevalence of sleep disorders. Regular physical exercise can partially offset the negative effects of excessive screen time on sleep.

ObjectiveTo clarify the independent and synergistic effects of dyslipidemia in the progression of hepatic steatosis in metabolic dysfunction-associated fatty liver disease （MAFLD）. MethodsA total of 7 697 participants who underwent physical examination in Beijing Friendship Hospital， Capital Medical University， from January 2022 to December 2024 were enrolled， and finally 2 177 patients with MAFLD were enrolled as subjects. Transient elastography was used to quantify the severity of hepatic steatosis （grades S1-S3）. The multivariable ordinal Logistic regression analysis was used to investigate the independent and synergistic associations of serum triglyceride （TG）， high-density lipoprotein cholesterol （HDL-C）， and low-density lipoprotein cholesterol （LDL-C） with the severity of hepatic steatosis， and their interactions and potential nonlinear relationships with metabolic factors were also examined. One-way analysis of variance or Kruskal-Wallis H test was used for comparison of continuous data between groups， and chi-square test was used for comparison of categorical data between groups. ResultsAn increase in TG （odds ratio ［OR］=1.77， 95% confidence interval ［CI］： 1.48 — 2.10， P<0.001） and a reduction in HDL-C （OR=1.35， 95%CI： 1.11 — 1.65， P=0.003） were independently associated with a greater severity of hepatic steatosis， with the strongest association when both abnormalities coexisted （OR=2.40， 95%CI： 1.87 — 3.07， P<0.001）. The dose-response relationship analysis further revealed a nonlinear threshold effect of TG on hepatic steatosis at the threshold of 1.51 mmol/L （P_nonlinearity=0.001）， below which the severity of steatosis increased more rapidly with the increase in TG concentration （P=0.001）. The subgroup analysis showed that the association between the reduction in HDL-C and the severity of steatosis was observed only in males， young adults （aged <45 years）， and metabolically healthier subgroups （without diabetes， obesity， hyperuricemia or hypertension）. Significant interactions were observed between the presence or absence of obesity and the abnormal levels of TG and HDL‑C （both P_interaction<0.05）. The association of the increase in LDL-C with steatosis was confined to specific subgroups （without obesity or hyperuricemia）. ConclusionThe increase in TG and the reduction in HDL-C are independently associated with the severity of hepatic steatosis in MAFLD. The synergistic effect of blood lipids and their interactions with metabolic factors may further refine risk stratification， so as to provide a basis for precise management of MAFLD.

Transarterial radioembolization (TARE) is a widely utilized therapeutic approach for hepatocellular carcinoma (HCC), however, the clinical implementation is constrained by the stringent preparation conditions of radioembolization agents. Herein, we incorporated the superstable homogeneous iodinated formulation technology (SHIFT), simultaneously utilizing an enhanced solvent form in a carbon dioxide supercritical fluid environment, to encapsulate radionuclides (such as ¹³¹I,¹⁷⁷Lu, or ¹⁸F) with lipiodol for the preparation of radiolipiodol. The resulting radiolipiodol exhibited exceptional stability and ultra-high labeling efficiency (≥99%) and displayed notable intratumoral radionuclide retention and in vivo stability more than 2 weeks following locoregional injection in subcutaneous tumors in mice and orthotopic liver tumors in rats and rabbits. Given these encouraging findings, ¹⁸F was authorized as a radiotracer in radiolipiodol for clinical trials in HCC patients, and showed a favorable tumor accumulation, with a tumor-to-liver uptake ratio of ≥50 and minimal radionuclide leakage, confirming the feasibility of SHIFT for TARE applications. In the context of transforming from preclinical to clinical screening, the preparation of radiolipiodol by SHIFT represents an innovative physical strategy for radionuclide encapsulation. Hence, this work offers a reliable and efficient approach for TARE in HCC, showing considerable promise for clinical application (ChiCTR2400087731).

Depression is increasingly prevalent among adolescents and can profoundly impact their lives. However, the early detection of depression is often hindered by the time-consuming diagnostic process and the absence of objective biomarkers. In this study, we propose a novel approach for depression detection based on an affective brain-computer interface (aBCI) and the resting-state electroencephalogram (EEG). By fusing EEG features associated with both emotional and resting states, our method captures comprehensive depression-related information. The final depression detection model, derived through decision fusion with multiple independent models, further enhances detection efficacy. Our experiments involved 40 adolescents with depression and 40 matched controls. The proposed model achieved an accuracy of 86.54% on cross-validation and 88.20% on the independent test set, demonstrating the efficiency of multimodal fusion. In addition, further analysis revealed distinct brain activity patterns between the two groups across different modalities. These findings hold promise for new directions in depression detection and intervention.
Humans ; Male ; Female ; Adolescent ; Case-Control Studies ; Depression/diagnosis* ; Early Diagnosis ; Rest ; Electroencephalography/methods* ; Brain-Computer Interfaces ; Models, Psychological ; Reproducibility of Results ; Affect/physiology* ; Photic Stimulation/methods* ; Video Recording ; Brain/physiopathology*

Objective:To analyze the epidemiological and clinical features of infectious diseases of the central nervous system (CNS).Methods:A cross-sectional study and analysis were conducted to summarize the epidemiological and clinical characteristics of 9 918 patients with CNS infectious diseases, who were diagnosed and treated at 29 hospitals across China from January 1, 2001 to December 31, 2020. Data collected included demographic data, clinical manifestations, health economic indicators, and prognostic outcomes.Results:Among the 9 918 collected cases of CNS infectious diseases, 5 559 were male (56.0%) and 4 359 were female (44.0%), with an onset age of 38 (25, 53) years. Education level: slightly more junior high school education (2 651 cases, 26.7%), and less elementary school education and below (2 181 cases, 22.0%) were found. Occupational distribution: farmers were found predominant (3 215 cases, 32.4%), followed by workers (1 826 cases, 18.4%) and students (1 633 cases, 16.5%). Clinical manifestations: headache (6 074 cases, 61.2%), fever (5 869 cases, 59.2%) and positive meningeal irritation signs (2 273 cases, 22.9%) were the 3 most common clinical manifestations, followed by nausea and (or) vomiting (2 095 cases, 21.1%), impaired consciousness (2 077 cases, 20.9%), psychiatric symptom (1 866 cases, 18.8%) and epilepsy (1 627 cases, 16.4%), etc., and cranial nerve involvement was found in 669 cases (6.7%). Major pathogens included viruses in 6 814 cases (68.7%), Mycobacterium tuberculosis in 1 677 cases (16.9%), common bacteria in 864 cases (8.7%), fungi in 254 cases (2.6%), spirochetes of syphilis in 183 cases (1.8%), parasites in 121 cases (1.2%), and rickettsiae in 5 cases (0.1%). Urban-rural distribution: slightly more cases were found in the countryside (5 418 cases, 54.6%) than in the towns (4 500 cases, 45.4%). Distribution of onset by season: 2 412 cases (24.3%) fell ill in spring, 2 835 cases (28.6%) in summer, 2 187 cases (22.1%) in fall, and 2 484 cases (25.0%) in winter. Health economics: the duration of hospitalization was 15 (8, 27) days, and the cost of hospitalization was 1.53 (0.91, 3.02)×10 000 yuan. Prognosis: 9 531 cases (96.1%) were cured or improved, and 92 cases (0.9%) died. Conclusions:The pathogens responsible for CNS infectious diseases are predominantly viruses. Although the incidence is slightly higher during the summer months, the overall seasonal pattern is not particularly pronounced. These infections are more commonly observed in young and middle-aged males and present with a diverse range of clinical manifestations, contributing to a significant disease burden.

Objective To investigate the therapeutic effect of gabapentin combined with hemoperfusion on skin pruritus in the patients on maintenance hemodialysis(MHD).Methods A total of 72 patients with MHD complicating moderate to severe skin itching treated in Lianyungang Municipal Oriental Hospital from January 2023 to March 2024 were selected as the study subjects and divided into the observation group and control group by the random number table method,36 cases in each group.On the basis of symptomatic treat-ment,the control group was given hemodialysis 3 times a week and hemoperfusion twice a month;on the basis of the control group,the observation group orally took 1 gabapentin capsule every night,and the patients in the two groups continued to be treated for 12 weeks.The visual analogue scale(VAS)score,Pittsburgh Sleep Quality Index(PSQI)score,molecular toxin level and calcium and phosphorus metabolism were evaluated be-fore treatment,in 4,12 weeks after treatment respectively,and the occurrence of adverse reactions during treatment in the two groups was observed.Results After 4 weeks and 12 weeks of treatment,the VAS and PSQI scores of the observation group were decreased compared with those before treatment,moreover the scores of the observation group were lower than those of the control group in the same period,and the differ-ences were statistically significant(P<0.05);the VAS and PSQI scores after 4 weeks of treatment in the control group were decreased compared with those before treatment,but the difference was not statistically significant(P>0.05);and the VAS and PSQI scores after 12 weeks of treatment in the control group were decreased compared with before treatment,and the difference was statistically significant(P<0.05).After 4 weeks of treatment,the levels of Scr,BUN and β2-MG in the two groups were decreased compared with those before treatment,but the differences were not statistically significant(P>0.05);after 12 weeks of treatment,the levels of Scr,BUN and β2-MG in the two groups were decreased compared with those before treatment and after 4 weeks of treatment,and the differences were statistically significant(P<0.05),but there was no sta-tistically significant difference between the two groups(P>0.05).After 4 weeks of treatment,there was no statistically significant difference in the levels of blood Ca,P and iPTH between the two groups compared with before treatment(P>0.05);after 12 weeks of treatment,except for blood Ca,the levels of blood P and iPTH in the two groups were decreased compared with those before treatment and in 4 weeks of treatment(P<0.05),and the differences were statistically significant(P<0.05),but there was no statistical difference be-tween the two groups(P>0.05).There were no adverse reactions in the control group,and there were 3 cases of drowsiness,1 case of fatigue and 1 case of dizziness at the beginning of treatment in the observation group.The symptoms were mild without treatment and spontaneously relieved in about 1 week.Conclusion Gabap-entin combined with hemoperfusion could quickly and effectively alleviate the itchy symptoms of skin,improve the sleep quality,reduce the uremic toxin levels,and improve the calcium and phosphorus metabolism in MHD patients,with few adverse reactions,and the patients are easy to tolerate.

Objective:To observe the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) at different frequencies on cognitive impairment due to high-altitude hypoxia.Methods:Sixty officers and soldiers displaying cognitive impairment in a hypoxic high-altitude environment were randomly divided into 15Hz, 20Hz and 25Hz groups, each of 20. They were given rTMS at those frequencies for 30 days. Before the stimulation and after 15 and 30 days, event-related potentials, latencies of mismatched negativity (MMN) and P300 signals were recorded. The participants′ cognition was also evaluated using the Montreal Cognitive Assessment Scale (MoCA). Correlation between the electrophysiological indexes and the MoCA scores was computed.Results:After 15 days, all had shorter MMN latencies, higher total MoCA scores and better memory scores. The only significant difference among the three groups was in the average memory scores. After 15 days, MMN latency was significantly negatively correlated with the memory scores in all three groups ( r=0.44 to -0.54). Conclusions:rTMS at frequencies above 15Hz can effectively relieve cognitive impairment, especially memory dysfunction, resulting from high-altitude hypoxia.