BACKGROUND:Dysfunction of macrophage efferocytosis can induce local and systemic inflammatory damage and is associated with a variety of obesity-related metabolic diseases.Moreover,compounds targeting efferocytosis have shown good therapeutic effects. OBJECTIVE:By reviewing the effects of obesity on macrophage efferocytosis,to analyze the key mechanism by which obesity inhibits efferocytosis,to summarize the research progress in compounds targeting efferocytosis to treat obesity-related metabolic diseases,so as to provide new ideas for fully understanding efferocytosis and its relationship with metabolic diseases,aiming to provide new strategies for disease prevention and treatment. METHODS:The English search terms were"efferocytosis,metabolism,obesity,obese,atherosclerosis,non-alcoholic steatohepatitis,neurodegeneration,tumor,osteoarthritis,diabetes,compound,medicine,treatment,"which were used for literature retrieval in PubMed and Web of Science.The Chinese search term was"efferocytosis,"which was used for literature retrieval in CNKI,VIP and WanFang datebases.Ninety-nine papers were finally included in the review analysis after a rigorous screening process. RESULTS AND CONCLUSION:In the process of efferocytosis,the"Find me"and"Eat me"processes involving a large number of apoptotic cell derived factors are mainly regulated by apoptotic cells.The efferocytosis factor involved in cytoskeletal remodeling and digestion are mainly derived from macrophages,which are crucial for efferocytosis activity.These results suggest that the"Find me"and"Eat me"factors mainly reflect the condition of apoptosis,and it is more scientific to select the expression of factors involved in cytoskeletal remodeling and digestion when evaluating the efferocytosis activity of macrophages.Obesity inhibits efferocytosis,and shows an inhibitory effect on most digestive factors,but has a stress-induced activation effect on most"Find me,""Eat me"and cytoskeletal recombination factors,which further indicates the decisive effect of digestive stage on efferocytosis and suggests that it is not reliable for some studies to evaluate the efferocytosis based on the increased expression of"Find me"and"Eat me"factors.Targeting cytokines in the digestive phase may be more effective when discussing future intervention strategies targeting macrophages efferocytosis.The efferocytosis activators of macrophages are effective in the treatment of various metabolic diseases,but the efferocytosis inhibitors in tumor tissue show good anticancer effects,suggesting that the role of efferocytosis should be rationally evaluated according to the characteristics of tissue inflammation.Efferocytosis is a relatively new concept proposed in 2003,with a short research history and complex efferocytosis factors.Current studies on obesity and efferocytosis only involve a tip of the iceberg and most of them are at a superficial level and a large number of scientific experiments are needed to further validate the mechanisms.

Objective To explore the effect of vaginal sacrospinous ligament suspension(VSSLS)with uterus preservation in treatment of patients with moderate to severe pelvic organ pro-lapse(POP).Methods A total of 92 patients with moderate to severe POP were randomly divided into control group and observation group,with 46 cases in each group.The control group received va-ginal anterior and posterior wall repair(VAPWR),while the observation group underwent VSSLS.The intraoperative blood loss,operation time and hospital stay were compared between the two groups;the Pelvic Floor Distress Inventory-20(PFDI-20)was used to evaluate quality of life;the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12(PISQ-12)was used to assess conditions of sexual satisfaction degree,dyspareunia,sexual frequency,and perceived control during sexual activi-ty;surgical complications in both groups were recorded.Results The observation group had less intr-aoperative blood loss,shorter operation time,and shorter hospital stay compared with the control group(P＜0.01).After treatment,the observation group had lower scores in all dimensions of the PFDI-20 compared with the control group,and the decreasing range was significantly greater than that in the control group(P＜0.01).After treatment,the observation group had significant higher scores for sex-ual satisfaction degree,sexual frequency and perceived control during sexual activity compared with the control group,and the change in these indicators before and after treatment was also significantly greater in the observation group,while the score for dyspareunia was significantly lower in the observation group,with a significant decrease compared with the control group(P＜0.01).The incidence of complications was significantly lower in the observation group than that in the control group(P＜0.01).Conclusion As a surgical approach for the treatment of moderate to severe POP,VSSLS can significantly improve patient's quality of life.

Objective To compare the application value of indocyanine green(ICG),nano-car-bon,methylene blue(MB)tracing methods,and ICG combined with nano-carbon tracing method in laparoscopic surgery for stage Ⅰ to Ⅱ endometrial cancer according to International Federation of Gynecology and Obstetrics(FIGO)staging system.Methods A retrospective selection of 92 pa-tients who underwent laparoscopic surgery for stage Ⅰ to Ⅱ endometrial cancer was conducted.Based on intraoperative sentinel lymph node(SLN)tracing method,the patients were divided into ICG group(n=24,using ICG tracing method),nano-carbon group(n=22,using nano-carbon tracing meth-od),MB group(n=23,using MB tracing method),and combined group(n=23,using ICG combined with nano-carbon tracing method).Surgical-related indicators,pathological results,and the incidence of complications were compared among the four groups.The detection efficacy of different tracing methods was also compared,using pathological results of surgical specimens as the gold standard.Results There were no statistically significant differences in the SLN resection time,to-tal operative time,and intraoperative blood loss among the four groups(P＞0.05).The number of lymph nodes resected intraoperatively in the combined group was significantly higher than that in the other three groups(P＜0.05).There were no statistically significant differences in the pathological results of surgical specimens(tumor invasion depth＞50％,tumor diameter＞2 cm,tumor invasion of the cervix or lymphovascular space)among four groups(P＞0.05).The complication rates in the ICG group,nano-carbon group,MB group,and combined group were 4.17％,9.09％,8.70％,and 13.04％,respectively,with no statistically significant difference(P＞0.05).Using the pathological results of surgical specimens as the gold standard,the detection accuracy,sensitivi-ty,and specificity of ICG combined with nano-carbon tracing method for SLNs in patients with stage Ⅰto Ⅱ endometrial cancer were 86.96％,90.00％,and 66.67％,respectively.The positive predictive value and negative predictive value were 94.74％and 50.00％,respectively.The detection efficacy of this combined method was higher than that of the other three methods.Conclusion Compared with the ICG,nano-carbon,and MB tracing method,ICG combined with nano-carbon tracing method has a higher application value in laparoscopic surgery for stage Ⅰ toⅡ endometrial cancer.It can accurately i-dentify the status of lymph node metastasis,with a moderate price and simple operation.

Objective To explore the correlation between cardiac remodeling and the occurrence of contrast-associated acute kidney injury(CA-AKI)assessed by echocardiography.Methods A retrospective analysis was conducted on the clinical data of 100 patients with coronary artery disease(CAD)who underwent coronary angiography(CAG)and percutaneous coronary intervention(PCI)from March 2021 to March 2024.The patients were divided into CA-AKI group and non-CA-AKI group according to whether CA-AKI occurred.Baseline data and echocardiographic parameters,inclu-ding left ventricular end-diastolic internal diameter index(LVIDDI),left ventricular end-systolic in-ternal diameter index(LVIDSI),and left ventricular mass index(LVMI),were collected and com-pared between the two groups.Logistic regression analysis was used to screen for independent influen-cing factors of CA-AKI occurrence.Results The level of N-terminal pro-B-type natriuretic peptide(NT-proBNP)in the CA-AKI group was higher than that in the non-CA-AKI group,and the difference was statistically significant(P＜0.001).Compared with the non-CA-AKI group,the CA-AKI group had higher levels of C-reactive protein and glycosylated hemoglobin(HbA1c),as well as a higher proportion of patients with diabetes and anemia,and the differences were statistically significant(P＜0.05).Echocardiographic data showed that LVMI,LVIDDI,and LVIDSI in the CA-AKI group were all higher than those in the non-CA-AKI group,and the differences were statistically sig-nificant(t=2.057,3.429,2.975;P＜0.05).The left ventricular ejection fraction(LVEF)level in the CA-AKI group was lower than that in the non-CA-AKI group,and the difference was statisti-cally significant(t=3.005,P=0.003).Univariate Logistic regression analysis showed that diabe-tes,anemia,inflammation,NT-proBNP,HbA1c,LVMI,LVIDDI,LVIDSI,LVEF,ventricular hy-pertrophy,and ventricular dilation were significantly associated with the occurrence of CA-AKI(P＜0.05).Multivariate Logistic regression analysis results showed that LVMI(OR=3.81;95％CI,1.04 to 8.50;P=0.045),LVIDDI(OR=4.21;95％CI,2.02 to 6.08;P＜0.001),LVIDSI(OR=1.61;95％CI,1.27 to 2.03;P=0.024),ventricular hypertrophy(OR=3.42;95％CI,1.83 to 4.44;P=0.001),and ventricular dilation(OR=2.93;95％CI,1.43 to 3.74;P=0.033)were independent influencing factors for the occurrence of CA-AKI.Conclusion Cardiac remodeling is significantly correlated with the risk of CA-AKI in CAD patients.Clinicians should take protective measures timely for patients with abnormal cardiac structure to prevent the occurrence of CA-AKI.

ObjectiveTo establish consensus on Chinese Herbal Medicine (CHM) for rheumatoid arthritis (RA) among 21 Singaporean experts, this study addressed the lack of CHM clinical practice guidelines (CPGs) in Singapore. Despite advancements in RA therapies, the disease's progressive nature and high costs of novel treatments worsen disparities in management and outcomes. The initiative aimed to bridge this gap by developing expert-backed recommendations for CHM use in RA care.MethodsThe group of experts conducted two rounds of Delphi surveys containing 29 items identified from a literature review. Consensus was defined as ≥75% of votes in dichotomized ratings on a five-point ordinal scale for recognition. Items that did not reach consensus were discussed in a focus group with four selected experts.ResultsNineteen experts completed both rounds of Delphi surveys. A consensus was reached for 27 items, which encompassed Chinese medicine rationale, pattern differentiation, management, CHM prescription, and co-effectiveness with pharmacological therapy. Collective expert opinions were formed for the two remaining items. All items received a recognition score 3.5.ConclusionsThe consensus derived from this study provides a foundation for CHM CPGs for RA in Singapore. However, the findings are limited by the demographic composition of the experts and the representativeness of the patient pool.

Objective:To establish a dose-response curve of dicentric chromosomes and centromeric rings (dic+ r) in γ-ray irradiation-induced chromosomal aberrations in human peripheral blood lymphocytes through automated analysis.Methods:Peripheral blood samples from three healthy donors were irradiated in vitro at doses of 0, 0.5, 0.75, 1, 1.5, 2, 3, 4, and 5 Gy and a dose rate of 0.80 Gy/min using a 137Cs γ-ray source. Post-irradiation, lymphocytes were cultured based on standard protocols, harvested using an automatic cell harvester, and prepared on slides using an automatic slide preparation system. dic+ r were analyzed fully automatically using the DCScore software, and a dose-response curve of dic+ r was established through fitting and then validated using the CABAS software. Results:The dose-response curve followed a linear-quadratic model, i. e., y = 0.093 65+ 0.030 21 D+ 0.025 31 D2 ( R2 = 0.999 2), where y was the quantity of dic+ r and D was the absorbed dose of γ-ray irradiation (Gy). Doses to samples for blind validation were estimated using this curve, yielding deviations of less than 24% from the actual irradiation doses. Conclusions:The fully automated analysis of dic+ r in 137Cs γ-ray irradiation-induced chromosomal aberrations, followed by the construction of the dose-response curve, holds significant potential for rapid, high-throughput biodosimetry in large-scale nuclear emergencies.

Objective To investigate the relationship between CT lung volume parameters(CT-LVP)and pulmonary function grade in patients with idiopathic pulmonary fibrosis(IPF)and its prediction of acute exacerbation.Methods A total of 204 patients with IPF were selected and divided into mild group(67 cases),moderate group(72 cases)and severe group(65 cases)according to the semi-quantitative scoring method of high-resolution computed tomography(HRCT).The correlation between CT-LVP and pul-monary function parameters(PFP)were analyzed.The predictive value of CT-LVP for acute exacerbation in severe IPF was ana-lyzed.Results The whole lung volume(WLV),normal lung volume(NLV)and normal lung volume percentage(NLV%)in severe group were lower than those in mild and moderate groups,whereas interstitial lung disease volume(ILDV)and interstitial lung disease volume percentage(ILDV%)were higher than those in mild and moderate groups,with statistical significance(P<0.05).WLV,NLV,ILDV,NLV%,ILDV%showed strong correlations with forced expiratory volume in 1 second percentage(FEV1%),forced expiratory volume in 1 second to forced vital capacity ratio(FEV1/FVC),diffusing capacity of the lung for carbon monoxide percent-age(DLCO%),and residual volume to total lung capacity ratio(RV/TLC).Receiver operating characteristic(ROC)curve analysis showed that the combination of WLV,NLV,ILDV,NLV%and ILDV%had higher accuracy in predicting acute exacerbation,area under the curve(AUC)>0.75(P<0.05).Conclusion CT-LVP is closely related to PFP,and the accuracy of CT-LVP combination in predicting acute exacerbation is high,which provides a theoretical basis for preventing acute exacerbation of IPF.

Objective:To evaluate the long-term protective efficacy of the recombinant Chinese hamster ovary cell-derived hepatitis B vaccine（CHO-HepB）26 years post-vaccination in the rural China.Methods:Zhengding county，Hebei province was designated as a rural monitoring site for CHO-HepB efficacy. Study participants included individuals born between 1997 and 1999 who had completed the three-dose CHO-HepB primary series without booster doses. A cross-sectional survey was conducted in late 2024 using random sampling. Demographic and vaccination history data were collected via questionnaires，and hepatitis B virus（HBV）serological markers were detected using chemiluminescence. Historical surveillance data were integrated to infer infection statuses of HBsAg-positive individuals and evaluate longitudinal trends in anti-HBs seropositivity and antibody titers.Results:Among 178 participants（mean time since vaccination：26.2 years），the seroprevalence rates were 0.6% for HBsAg（95% CI：0.0%-1.6%），64.6% for anti-HBs（95% CI：57.6%-71.6%），and 1.1% for anti-HBc（95% CI：0.0%-2.7%）. Compared to the pre-vaccination baseline HBsAg positivity of 11.3% in children under 10 years of age，the estimated vaccine protection rate was 95%. Two notable cases were identified：one with concurrent HBsAg and anti-HBc positivity and one with anti-HBs and anti-HBc positivity，suggestive of transient HBV exposure（1999—2009）without chronicity. Natural immune boosting was inferred for the latter case based on anti-HBs titer dynamics. Longitudinal analysis of four prior cross-sectional surveys（2005，2009，2013，and 2017）revealed no significant upward trends in HBsAg and anti-HBc positivity（both P>0.05）over 26 years，while anti-HBs seropositivity declined significantly（ P<0.05）from 6 to 26 years post-vaccination. Conclusion:The CHO-HepB vaccine demonstrates sustained immunological persistence and robust long-term protection up to 26 years post-immunization. Continued emphasis on rigorous implementation of mother-to-child transmission prevention strategies is critical for future hepatitis B control.

Objective:To establish a dose-response curve of dicentric chromosomes and centromeric rings (dic+ r) in γ-ray irradiation-induced chromosomal aberrations in human peripheral blood lymphocytes through automated analysis.Methods:Peripheral blood samples from three healthy donors were irradiated in vitro at doses of 0, 0.5, 0.75, 1, 1.5, 2, 3, 4, and 5 Gy and a dose rate of 0.80 Gy/min using a 137Cs γ-ray source. Post-irradiation, lymphocytes were cultured based on standard protocols, harvested using an automatic cell harvester, and prepared on slides using an automatic slide preparation system. dic+ r were analyzed fully automatically using the DCScore software, and a dose-response curve of dic+ r was established through fitting and then validated using the CABAS software. Results:The dose-response curve followed a linear-quadratic model, i. e., y = 0.093 65+ 0.030 21 D+ 0.025 31 D2 ( R2 = 0.999 2), where y was the quantity of dic+ r and D was the absorbed dose of γ-ray irradiation (Gy). Doses to samples for blind validation were estimated using this curve, yielding deviations of less than 24% from the actual irradiation doses. Conclusions:The fully automated analysis of dic+ r in 137Cs γ-ray irradiation-induced chromosomal aberrations, followed by the construction of the dose-response curve, holds significant potential for rapid, high-throughput biodosimetry in large-scale nuclear emergencies.

Objective To investigate the relationship between CT lung volume parameters(CT-LVP)and pulmonary function grade in patients with idiopathic pulmonary fibrosis(IPF)and its prediction of acute exacerbation.Methods A total of 204 patients with IPF were selected and divided into mild group(67 cases),moderate group(72 cases)and severe group(65 cases)according to the semi-quantitative scoring method of high-resolution computed tomography(HRCT).The correlation between CT-LVP and pul-monary function parameters(PFP)were analyzed.The predictive value of CT-LVP for acute exacerbation in severe IPF was ana-lyzed.Results The whole lung volume(WLV),normal lung volume(NLV)and normal lung volume percentage(NLV%)in severe group were lower than those in mild and moderate groups,whereas interstitial lung disease volume(ILDV)and interstitial lung disease volume percentage(ILDV%)were higher than those in mild and moderate groups,with statistical significance(P<0.05).WLV,NLV,ILDV,NLV%,ILDV%showed strong correlations with forced expiratory volume in 1 second percentage(FEV1%),forced expiratory volume in 1 second to forced vital capacity ratio(FEV1/FVC),diffusing capacity of the lung for carbon monoxide percent-age(DLCO%),and residual volume to total lung capacity ratio(RV/TLC).Receiver operating characteristic(ROC)curve analysis showed that the combination of WLV,NLV,ILDV,NLV%and ILDV%had higher accuracy in predicting acute exacerbation,area under the curve(AUC)>0.75(P<0.05).Conclusion CT-LVP is closely related to PFP,and the accuracy of CT-LVP combination in predicting acute exacerbation is high,which provides a theoretical basis for preventing acute exacerbation of IPF.