OBJECTIVE To investigate the protective effect of 2-dodecyl-6-methoxy-2，5-diene-1，4-cyclohexanedione （DMDD）， an active component from Averrhoa carambola root， on myocardial injury in diabetic mice based on the nuclear receptor coactivator 4/ferritin heavy chain 1/autophagy-related protein 8 （NCOA4/FTH1/ATG8） axis. METHODS The successfully modeled diabetic mice were randomly divided into model group and DMDD low-， medium-， and high-dose （12.5， 25， 50 mg/kg） groups， while an additional non-modeled control group was established， with 6 mice in each group. Each group received the corresponding drug solution or an equal volume of normal saline intragastically once daily for 21 consecutive days. After the administration， the levels of fasting blood glucose （FBG）， serum lactate dehydrogenase （LDH）， and creatine kinase isoenzyme MB （CK-MB） were measured. Myocardial pathological changes， degree of fibrosis， and myocardial cell ultrastructure were observed. Myocardial cell death index and NCOA4 protein positive index were detected. The protein expression levels of NCOA4， FTH1， ATG8， solute carrier family 7 member 11 （SLC7A11）， and glutathione peroxidase 4 （GPX4） in cardiac tissue were measured. RESULTS Compared with model group， each DMDD group showed significant alleviation of cardiac pathological injury and varying degrees of improvement in the myocardial cell ultrastructure. The FBG and serum LDH and CK-MB levels， the myocardial cell death index and NCOA4 protein positive index，the protein expression levels of NCOA4， FTH1， and ATG8 in cardiac tissue were significantly decreased （ P ＜0.001）， while the protein expression levels of SLC7A11 and GPX4 were significantly increased （ P ＜0.001）. CONCLUSIONS DMDD can reduce blood glucose levels， alleviate myocardial histopathological injury， and inhibit cell death in diabetic mice. The mechanism is associated with inhibiting excessive activation of the NCOA4/FTH1/ATG8 axis and reducing ferritinophagy.

OBJECTIVE: This study aims to elucidate the therapeutic potential of osthole for the treatment of atopic dermatitis (AD), focusing on its ability to alleviate chronic pruritus (CP) and the underlying molecular mechanisms. METHODS: In this study, we investigated the anti-inflammatory effects of osthole in both a 2,4-dichloronitrobenzene (DNCB)-induced AD mouse model and tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) stimulated huma immortalized epidermal (HaCaT) cells. The anti-itch effect of osthole was specifically assessed in the AD mouse model. Using methods such as hematoxylin and eosin (HE) staining, enzyme-linked immunosorbent assay (ELISA), western blot (WB), quantitative real-time PCR (qRT-PCR), and immunofluorescence staining. RESULTS: Osthole improved skin damage and clinical dermatitis scores, reduced scratching bouts, and decreased epidermal thickness AD-like mice. It also reduced the levels of interleukin (IL)-31 and IL-31 receptor A (IL-31 RA) in both skin tissues and HaCaT cells. Furthermore, Osthole suppressed the protein expression levels of phosphor-p65 (p-p65) and phosphor-inhibitor of nuclear factor kappa-Bα (p-IκBα). Meanwhile, it increased the protein expression levels of peroxisome proliferator-activated receptor α (PPARα) and PPARγ in HaCaT cells. CONCLUSION These findings indicated that osthole effectively inhibited CP in AD by activating PPARα, PPARγ, repressing the NF-κB signaling pathway, as well as the expression of IL-31 and IL-31 RA.

This study aimed to comprehensively examine the association of gallstones, cholecystectomy, and cancer risk. Multivariable logistic regressions were performed to estimate the observational associations of gallstones and cholecystectomy with cancer risk, using data from a nationwide cohort involving 239 799 participants. General and gender-specific two-sample Mendelian randomization (MR) analysis was further conducted to assess the causalities of the observed associations. Observationally, a history of gallstones without cholecystectomy was associated with a high risk of stomach cancer (adjusted odds ratio (aOR)=2.54, 95% confidence interval (CI) 1.50-4.28), liver and bile duct cancer (aOR=2.46, 95% CI 1.17-5.16), kidney cancer (aOR=2.04, 95% CI 1.05-3.94), and bladder cancer (aOR=2.23, 95% CI 1.01-5.13) in the general population, as well as cervical cancer (aOR=1.69, 95% CI 1.12-2.56) in women. Moreover, cholecystectomy was associated with high odds of stomach cancer (aOR=2.41, 95% CI 1.29-4.49), colorectal cancer (aOR=1.83, 95% CI 1.18-2.85), and cancer of liver and bile duct (aOR=2.58, 95% CI 1.11-6.02). MR analysis only supported the causal effect of gallstones on stomach, liver and bile duct, kidney, and bladder cancer. This study added evidence to the causal effect of gallstones on stomach, liver and bile duct, kidney, and bladder cancer, highlighting the importance of cancer screening in individuals with gallstones.
Humans ; Mendelian Randomization Analysis ; Gallstones/complications* ; Female ; Male ; Cholecystectomy/statistics & numerical data* ; Middle Aged ; Risk Factors ; Aged ; Adult ; Neoplasms/etiology* ; Stomach Neoplasms/epidemiology*

Objective To investigate the relationship between the serum red blood cell distribution width(RDW)to albumin(ALB)ratio,the expression of family with sequence similarity 19 member A5(FAM19A5)and leukocyte cell-derived chemotaxin 2(LECT2)with the glucose and lipid metabolism indexes in type 2 diabetes mellitus(T2DM)patients with metabolic syndrome(MS).Methods A total of 119 patients with T2DM were selected as the study group,and patients were divided into the MS group(67 cases)and the non-MS group(52 cases)based on whether they were complicated with MS.Meanwhile,93 healthy individuals who underwent physical examinations in our hospital during the same period were selected as the control group.RDW was detected by an automatic blood cell analyzer,and ALB was detected by an automatic biochemical analyzer.The ratio of RDW to ALB(RAR)was calculated.The serum levels of FAM19A5 and LECT2 were detected by enzyme-linked immunosorbent assay(ELISA).The correlation between serum and glycolipid metabolism indicators was analyzed by Pearson's method.The diagnostic value of serum RAR,FAM19A5 and LECT2 for MS in T2DM patients was analyzed by receiver operating characteristic(ROC)curve.Results Compared with the control group,the study group exhibited significantly higher levels of total cholesterol(TC),triacylglycerol(TG),low-density lipoprotein cholesterol(LDL-C),fasting blood glucose(FBG),serum RAR,FAM19A5 and LECT2,while high-density lipoprotein cholesterol(HDL-C)was significantly lower(P＜0.05).Compared to the non-MS group,body mass index(BMI),duration of T2DM,history of hypertension,blood pressure,waist circumference,TG,fasting insulin(FINS),FBG,glycated hemoglobin(HbA1c),homeostasis model assessment-insulin resistance(HOMA-IR),serum RAR,FAM19A5 and LECT2 were significantly increased,and HDL-C was decreased in the MS group(P＜0.05).Serum RAR,FAM19A5 and LECT2 were positively correlated with TG,FINS,FBG,HbA1c and HOMA-IR,and which was negatively correlated with HDL-C(P＜0.05).The area under the curve(AUC)for the diagnosis of T2DM patients with MS using RAR,FAM19A5 and LECT2 individually were 0.821,0.807 and 0.793,respectively,and the combined AUC was 0.952,indicating that the combined diagnostic efficacy of RAR,FAM19A5 and LECT2 was superior to their individual efficacies(P＜0.05).Conclusion Serum levels of RAR,FAM19A5 and LECT2 are elevated in T2DM patients with MS.These biomarkers exhibit a strong association with indices of glucose and lipid metabolism.The combination of these three markers has significant clinical diagnostic value for T2DM patients with MS.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective To investigate the relationship between the serum red blood cell distribution width(RDW)to albumin(ALB)ratio,the expression of family with sequence similarity 19 member A5(FAM19A5)and leukocyte cell-derived chemotaxin 2(LECT2)with the glucose and lipid metabolism indexes in type 2 diabetes mellitus(T2DM)patients with metabolic syndrome(MS).Methods A total of 119 patients with T2DM were selected as the study group,and patients were divided into the MS group(67 cases)and the non-MS group(52 cases)based on whether they were complicated with MS.Meanwhile,93 healthy individuals who underwent physical examinations in our hospital during the same period were selected as the control group.RDW was detected by an automatic blood cell analyzer,and ALB was detected by an automatic biochemical analyzer.The ratio of RDW to ALB(RAR)was calculated.The serum levels of FAM19A5 and LECT2 were detected by enzyme-linked immunosorbent assay(ELISA).The correlation between serum and glycolipid metabolism indicators was analyzed by Pearson's method.The diagnostic value of serum RAR,FAM19A5 and LECT2 for MS in T2DM patients was analyzed by receiver operating characteristic(ROC)curve.Results Compared with the control group,the study group exhibited significantly higher levels of total cholesterol(TC),triacylglycerol(TG),low-density lipoprotein cholesterol(LDL-C),fasting blood glucose(FBG),serum RAR,FAM19A5 and LECT2,while high-density lipoprotein cholesterol(HDL-C)was significantly lower(P＜0.05).Compared to the non-MS group,body mass index(BMI),duration of T2DM,history of hypertension,blood pressure,waist circumference,TG,fasting insulin(FINS),FBG,glycated hemoglobin(HbA1c),homeostasis model assessment-insulin resistance(HOMA-IR),serum RAR,FAM19A5 and LECT2 were significantly increased,and HDL-C was decreased in the MS group(P＜0.05).Serum RAR,FAM19A5 and LECT2 were positively correlated with TG,FINS,FBG,HbA1c and HOMA-IR,and which was negatively correlated with HDL-C(P＜0.05).The area under the curve(AUC)for the diagnosis of T2DM patients with MS using RAR,FAM19A5 and LECT2 individually were 0.821,0.807 and 0.793,respectively,and the combined AUC was 0.952,indicating that the combined diagnostic efficacy of RAR,FAM19A5 and LECT2 was superior to their individual efficacies(P＜0.05).Conclusion Serum levels of RAR,FAM19A5 and LECT2 are elevated in T2DM patients with MS.These biomarkers exhibit a strong association with indices of glucose and lipid metabolism.The combination of these three markers has significant clinical diagnostic value for T2DM patients with MS.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective To analyze and compare the clinical effects of upper brachial plexus repair with nerve root stumps and each type of power source nerves,determine the availability of nerve root stumps and the effectiveness and rationality of clinical use.Methods Retrospective analysis was performed for the patients admit-ted to our department from January 2007 to December 2015.The patients were diagnosed with partial or total bra-chial plexus injury.Case data were collected including gender,age,diagnosis,cause of injury,interval between injury and operation,follow-up time,injury type,operation method,gap length between donor and recipient nerve,graft type and length,and complications.In addition,we also examine the adverse events in the donor site.The British Medical Research Council(BMRC)muscle strength evaluation criteria were used to evaluate the patients'deltoid muscle and biceps muscle strength and we also performed disabilities of arm,shoulder and hand(DASH)score.Results A total of 136 patients received brachial plexus repair,112 cases included in the study after 24 cases were excluded.The patients were divided into four groups:22 cases in modified Oberlin surgery group,45 cases in CC7 transfer comebined with huamn acellular nerve allograft group,27 cases in CC7 transfer and direct suture group.There were 14 cases of nerve root stumps repair upper trunk directly or combined with huamn acellular nerve allografting,which including 10 cases of BPAI and 4 cases of stab wound.The effective rate of deltoid muscle strength was 68.2%,71.2%,88.9%and 78.6%,respectively.The muscle strength and effective rate of biceps were 81.8%,60.0%,85.2%and 64.3%,respectively.Subgroup analysis:(1)operative methods for upper brachial plexus injuries:4 cases with stab wounds in the nerve root stump repair group;in the modified Oberlin surgery group,22 cases were avulsion injury.The results showed that there were no statistically significant differences between the two groups in the ROM,deltoid muscle strength,biceps muscle strength and DASH score.For the comparison of C5-C8 or TBAI:there is no statistical difference in ROM of shoulder abduction between the nerve root stump repair group and CC7 transfer and direct suture group;the evaluation indexes include angle of elbow flexion,biceps muscle strength and DASH score in CC7 transfer and direct suture group were better than the other two groups,followed by CC7 transfer combined with shenqiao group and nerve root stump repair group.Conclusions This part evaluated and analyzed the clinical effects of various kinds of power sources nerve on the recovery of elbow flexion and shoulder abduction after upper brachial plexus repairing,and determined the avail-ability of nerve root stump and the validity and rationality of its clinical use.Protecting the nerve stump roots may improve the clinical effect of nerve stump utilization and increase the power source nerve in the future.

Objective To analyze and compare the clinical effects of upper brachial plexus repair with nerve root stumps and each type of power source nerves,determine the availability of nerve root stumps and the effectiveness and rationality of clinical use.Methods Retrospective analysis was performed for the patients admit-ted to our department from January 2007 to December 2015.The patients were diagnosed with partial or total bra-chial plexus injury.Case data were collected including gender,age,diagnosis,cause of injury,interval between injury and operation,follow-up time,injury type,operation method,gap length between donor and recipient nerve,graft type and length,and complications.In addition,we also examine the adverse events in the donor site.The British Medical Research Council(BMRC)muscle strength evaluation criteria were used to evaluate the patients'deltoid muscle and biceps muscle strength and we also performed disabilities of arm,shoulder and hand(DASH)score.Results A total of 136 patients received brachial plexus repair,112 cases included in the study after 24 cases were excluded.The patients were divided into four groups:22 cases in modified Oberlin surgery group,45 cases in CC7 transfer comebined with huamn acellular nerve allograft group,27 cases in CC7 transfer and direct suture group.There were 14 cases of nerve root stumps repair upper trunk directly or combined with huamn acellular nerve allografting,which including 10 cases of BPAI and 4 cases of stab wound.The effective rate of deltoid muscle strength was 68.2%,71.2%,88.9%and 78.6%,respectively.The muscle strength and effective rate of biceps were 81.8%,60.0%,85.2%and 64.3%,respectively.Subgroup analysis:(1)operative methods for upper brachial plexus injuries:4 cases with stab wounds in the nerve root stump repair group;in the modified Oberlin surgery group,22 cases were avulsion injury.The results showed that there were no statistically significant differences between the two groups in the ROM,deltoid muscle strength,biceps muscle strength and DASH score.For the comparison of C5-C8 or TBAI:there is no statistical difference in ROM of shoulder abduction between the nerve root stump repair group and CC7 transfer and direct suture group;the evaluation indexes include angle of elbow flexion,biceps muscle strength and DASH score in CC7 transfer and direct suture group were better than the other two groups,followed by CC7 transfer combined with shenqiao group and nerve root stump repair group.Conclusions This part evaluated and analyzed the clinical effects of various kinds of power sources nerve on the recovery of elbow flexion and shoulder abduction after upper brachial plexus repairing,and determined the avail-ability of nerve root stump and the validity and rationality of its clinical use.Protecting the nerve stump roots may improve the clinical effect of nerve stump utilization and increase the power source nerve in the future.

Background/Aims: Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China. Methods: A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators. Results: Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders. Conclusions In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.