Nucleotide-binding oligomerization domain (NOD)-like receptor protein 3 (NLRP3) is a cytosolic pattern recognition receptor that recognizes multiple pathogen-associated molecular patterns and damage-associated molecular patterns. It is a cytoplasmic immune factor that responds to cellular stress signals, and it is usually activated after infection or inflammation, forming an NLRP3 inflammasome to protect the body. Aberrant NLRP3 inflammasome activation is reportedly associated with some inflammatory diseases and metabolic diseases. Recently, there have been mounting indications that NLRP3 inflammasomes play an important role in liver injuries caused by a variety of diseases, specifically hepatic ischemia/reperfusion injury, hepatitis, and liver failure. Herein, we summarize new research pertaining to NLRP3 inflammasomes in hepatic injury, hepatitis, and liver failure. The review addresses the potential mechanisms of action of the NLRP3 inflammasome, and its regulation in these liver diseases.
Humans ; NLR Family, Pyrin Domain-Containing 3 Protein/metabolism* ; Inflammasomes/physiology* ; Animals ; Liver Diseases/metabolism* ; Liver/metabolism* ; Reperfusion Injury/metabolism*

ObjectiveTo investigate the effect of video-based educational intervention combined with maternal presence on perioperative adverse outcomes in preschool children undergoing general anesthesia， including cooperation in anesthesia induction， perioperative anxiety， pain and agitation during recovery. MethodsA total of 300 preschool children scheduled for general anesthesia in our hospital from June to December 2023 were randomly assigned to control group （n=150） and intervention group （n=150）. The control group received routine recovery care. For the intervention group， in addition to routine recovery care， a preoperative visit was scheduled one day before surgery. During this visit， mothers were guided to watch anesthesia videos with their children. During the waiting period in the operating room and 30 minutes after awakening， the mothers were guided to accompany the children for more than 30 minutes. Recovery conditions were recorded using the surgical anesthesia information system， and the children’s anesthetic induction compliance， perioperative anxiety， pain， and agitation were evaluated and recorded using the modified Yale Preoperative Anxiety Scale （m-YPAS）， the Induction Compliance Scale （ICC）， the Children’s Pain Behavior Scale （FLACC）， and the Pediatric Agitation and Emergence Delirium Scale （PAED）. ResultsOn the preoperative visit day， there were no statistically significant differences in baseline data between the two groups （P > 0.05）. For perioperative anxiety， the m-YPAS scores of the intervention group were significantly lower than those of the control group， both when entering the operating room waiting area （35.27±6.48 vs. 41.79±6.68， P < 0.05） and 30 minutes after postoperative recovery （20.13±7.05 vs. 35.75±9.51， P < 0.05）. In terms of anesthesia induction cooperation， the ICC scores of the intervention group were significantly lower than those of the control group （1.84±0.95 vs. 3.17±0.62， P < 0.05）， and the proportion of good induction cooperation was significantly higher than that of the control group （24.00% vs. 12.67%， P < 0.05）. There was no significant difference in awakening duration between the two groups， but the intervention group had a significantly shorter length of stay in the post-anesthesia care unit than the control group （0.90±0.29 hours vs. 1.29±0.42 hours， P < 0.001）. For perioperative agitation， the PAED scores of the intervention group were significantly lower than those of the control group （entering in the operating room waiting area： 8.5 vs. 9.2， P < 0.05； 30 minutes after postoperative recovery： 4.2 vs. 7.8， P < 0.05）. In terms of pain scores， the FLACC scores of the intervention group were also significantly lower than those of the control group， both when entering the operating room waiting area （ 5.3 vs. 6.7， P < 0.05； 30 minutes after postoperative recovery： 2.1 vs. 4.9， P < 0.05）. ConclusionsVideo-based educational intervention combined with maternal presence reduces the perioperative anxiety， pain and agitation of preschool children undergoing general anesthesia， and improved the compliance of anesthesia induction. It is recommended to promote this intervention measure in clinical practice.

This paper summarises the experience in an emergency care of a patient who had a "silent lung" during ventilator-assisted ventilation while in the post-anaesthesia care unit (PACU) after a surgery of cavernous sinus fistula of internal carotid artery. By reviewing nursing records,the emergency nursing interventions were summed up,incluing immediate elimination of mechanical blockage,rapid identification and diagnosis of "silent lung",urgent application of manual balloon pressurisation ventilation to resolve ventilation difficulties and symptomatic medication to relieve airway spasm. A ventilator-assisted ventilation was reinitiated to ensure unobstructed breathing after the condition of patient had been stablised. Lungs were inflated when the condition of patient allowed together without a risk of airway spasm. Then the endotracheal catheter was removed under a deep anaesthesis. After 3 hours of emergency resuscitation,the patient became stable and safely returned to the ward. The patient was discharged 11 days later and was found in good condtion over the 3 months postoperative follow-up.

This paper summarises the experience in an emergency care of a patient who had a "silent lung" during ventilator-assisted ventilation while in the post-anaesthesia care unit (PACU) after a surgery of cavernous sinus fistula of internal carotid artery. By reviewing nursing records,the emergency nursing interventions were summed up,incluing immediate elimination of mechanical blockage,rapid identification and diagnosis of "silent lung",urgent application of manual balloon pressurisation ventilation to resolve ventilation difficulties and symptomatic medication to relieve airway spasm. A ventilator-assisted ventilation was reinitiated to ensure unobstructed breathing after the condition of patient had been stablised. Lungs were inflated when the condition of patient allowed together without a risk of airway spasm. Then the endotracheal catheter was removed under a deep anaesthesis. After 3 hours of emergency resuscitation,the patient became stable and safely returned to the ward. The patient was discharged 11 days later and was found in good condtion over the 3 months postoperative follow-up.

Objective:To establish the Chinese version of (strength, assistance with walking, rise from a chair, climb stairs and falls, SARC-F) scale using the standardized methods and to validate the reliability and validity for sarcopenia screening among elderly population.Methods:Following the recommended procedure by World Health Organization and European Union Geriatric Medicine Society Sarcopenia Special Interest Group, the translation process included forward translation, expert panel, back-translation, pre-testing and cognitive interviewing to generate the final version. In the pilot study, the test-retest reliability, inter-rater reliability, and internal consistency of the Chinese version of SARC-F scale were assessed. In the diagnostic test for clinical validation, the participants were consecutively recruited from communities and hospitals in Beijing and Tianjin between December 2021 and October 2022. The scale administration, anthropometry, and body composition measurement were conducted by trained investigators. Participants with the SARC-F score ≥ 4 were considered at risk of sarcopenia. Diagnostic tests and receiver operating characteristic curve analysis were performed against the definitions of sarcopenia according to European Working Group on Sarcopenia in Older People (EWGSOP2) and Asian Working Group for Sarcopenia (AWGS2019), and the sensitivity, specificity, positive predictive value, negative predictive value and the area under curve were displayed.Results:The Chinese version of SARC-F scale was approved by the author that the translation has expressed the original meaning correctly. The Chinese version of SARC-F had good test-retest reliability (ICC = 0.914), inter-rater reliability ( r = 0.726), and internal consistency ( α = 0.729). There were altogether 1 882 participants included in the clinical validation. According to the diagnostic criteria of EWGSOP2 and AWGS2019, the Chinese version of SARC-F scale had low sensitivity (13.6% and 16.0%) and positive predictive value (44.6% and 35.4%), high specificity (95.1% and 94.7%) and negative predictive value (79.0% and 86.2%), and moderate AUC of 0.619 and 0.616 (all P < 0.001) for sarcopenia screening. Conclusions:The Chinese version of SARC-F scale was of good reliability and validity. The application of SARC-F in the primary healthcare settings would contribute to the early diagnosis of sarcopenia.

Objective:To identify characteristic genes in sarcopenia patients through bioinformatics and machine learning, and to explore the clinical relevance of characteristic genes in the diagnosis of sarcopenia.Methods:The microarray data of GSE25941, GSE38718 and GSE9103 associated with sarcopenia were downloaded from the GEO database, followed by identification of differentially expressed genes (DEGs) associated with sarcopenia. Subsequently, functional analysis of the DEGs was performed using gene ontology (GO) functional annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. The protein-protein interaction (PPI) network was constructed using STRING and Cytoscape, while biomarkers of sarcopenia were identified using LASSO regression and random forest analysis. The diagnostic performance of the characteristic gene was assessed by employing receiver operating characteristic (ROC) curve analysis. Furthermore, the expression levels of biomarkers for sarcopenia were validated using the external validation dataset of GSE28422. Finally, CIBERSORT was employed to analyze the infiltration of immune cells.Results:124 DEGs were identified between control and sarcopenia populations, which were primarily involved in growth factor receptor binding and cytokine activity. KEGG analysis revealed that the DEGs were predominantly associated with signaling pathways such as peroxisome proliferator-activated receptor signaling pathway, adipokine signaling pathway, Jak-STAT signaling pathway, and adenosine 5'-monophosphate (AMP)-activated protein kinase signaling pathway. Through machine learning techniques validated by ROC curve analysis and external datasets, three characteristic genes, namely DMRT2, FAM171A1, and ARHGAP36, were discovered. The infiltration analysis of immune cells revealed the potential involvement of mast cells, CD4 memory T cells, CD8 cells, γδT cells, and neutrophils in the pathophysiology of sarcopenia.Conclusion:DMRT2, FAM171A1 and ARHGAP36 can serve as diagnostic biomarkers of sarcopenia, and are closely related to the pathophysiological process of sarcopenia.

Objective:To evaluate the effect of different blood pressure control levels on myocardial work by left ventricular pressure-strain loop (LVPSL) in elderly hypertensive patients.Methods:Retrospectively, 158 elderly patients with hypertension in Shanxi Bethune Hospital from January to June 2017 were randomly divided into standard anti-hypertensive group ( n=75) and intensive anti-hypertensive group ( n=83). Another 48 cases of age and sex matched elderly without cardiovascular and cerebrovascular diseases and other diseases affecting cardiac function were selected as control group. All patients with hypertension underwent echocardiography at baseline, 12 and 24 months after antihypertensive treatment. The parameters of myocardial work, including global work index (GWI), global constructive work (GCW), global wasted work (GWW) and global work efficiency (GWE), were obtained by LVPSL. The changes of myocardial work parameters were compared between the standard group and the intensive group after 12 and 24 months of antihypertensive treatment. Results:①At baseline, GWI, GCW, GWW of the standard group and the intensive group were significantly higher than those of the control group (all P<0.05). ②After 12 and 24 months of antihypertensive treatment, GWI, GCW and GWW in standard and intensive antihypertensive groups decreased continuously ( P<0.05). ③The GWI, GCW and GWW of the intensive antihypertensive group were lower than those of the standard antihypertensive group at 12 and 24 months after antihypertensive treatment ( P<0.05). ④After 12 months of antihypertensive treatment, the reductions of GWI, GCW and GWW in standard and intensive antihypertensive groups were greater than those in 24 and 12 months of antihypertensive treatment (all P<0.05), and the reductions of GWI, GCW and GWW in intensive antihypertensive group were greater than those in standard antihypertensive group (all P<0.05). Conclusions:Left ventricular systolic function decreases and myocardial work increases in elderly hypertensive patients. Left ventricular systolic function improves after antihypertensive treatment, and the improvement of intensive antihypertensive is more obvious than that of standard antihypertensive treatment.

Objective:To investigate the prevalence of sarcopenia (SAR) in hospitalized patients with lung malignant tumor and to identify the risk factors, so as to inform the nutritional management of lung malignant tumor patients.Methods:This was a cross-sectional study. Adult patients admitted into the lung cancer ward of a Class A tertiary hospital in Beijing from December 2021 to March 2022 were screened for enrollment. Nutritional Risk Screening (NRS) 2002 was applied for eligible patients within 24 hours of admission. Medical history was obtained via questionnaire survey, laboratory test results prior to any intervention were extracted from Hospital Information System and muscle mass was measured using bio-impedance analysis. SAR was diagnosed according to the recommendation from Asian Working Group for Sarcopenia (AWGS) in 2019.Results:Among the enrolled 126 hospitalized patients with lung cancer, the prevalence of SAR was 19.8% (25/126). The prevalence was 19.6% in males and 21.4% in females, with no significant difference. Patients aged 65 years or above showed significantly higher SAR prevalence of 27.4% than those who were young or middle-aged (9.4%, P = 0.013). Older age (OR = 4.43, P = 0.048), lower BMI (OR = 0.644, P = 0.001), lower serum creatinine (OR = 0.931, P = 0.008), comorbidity of chronic obstructive pulmonary disease (COPD, OR = 13.748, P = 0.007) and comorbidity of coronary artery disease (OR = 13.748, P = 0.007) were risk factors for SAR in lung cancer patients. SAR risk was significantly increased in patients ≥ 65 years old and in those with COPD or coronary artery disease. Conclusions:Lung cancer patients showed high prevalence of SAR. For hospitalized patients with lung cancer, especially the elderly, a moderate BMI level and good management of comorbidities including COPD and coronary artery disease may help delay SAR development.

Objective:To investigate the effects of omega-3 polyunsaturated fatty acid (n-3 PUFA) supplementation on muscle mass and strength improvement through systematic review and meta-analysis.Methods:Electronic databases, namely Cochrane Library database, MEDLINE, EMBASE, CENTRAL, China National Knowledge Infrastructure, and Wanfang were searched for publications in English and Chinese from database establishment to June 20, 2022. All randomized controlled trials involving any n-3 fatty acid (fish oil capsules, pure fish oil and oral nutritional supplements) interventions for more than 4 weeks among adults aged ≥ 18 years were included in the analysis. The effects of n-3 PUFA on muscle mass and strength were compared with controls using RevMan 5.4. The mean differences (MDs) or standardized mean differences (SMDs) with 95% confidence intervals (CI) were calculated and pooled effects were assessed. The quality of the included studies was evaluated using the Cochrane risk-of-bias tool.Results:27 trials were included, with both healthy adults and patients with various types of cancer, with chronic obstructive pulmonary disease and on hemodialysis due to chronic renal failure. Most trials were judged as "low" to "high" risk of bias. The meta-analysis showed that n-3 PUFA supplementation significantly improved the lean body mass in the group without physical activity intervention compared to the control group, while showing no significant increase in muscle mass or handgrip strength in overall participants. There was no significant difference between intervention and control groups in subgroup analyses based on health/disease condition, intervention duration, route of administration and dosage and risk of bias. However, significant increases in mid-arm muscle circumference (MAMC) and lower body strength (MD = 0.8, 95% CI: 0.26 to 1.34, P = 0.005; SMD = 0.45, 95% CI: 0.21 to 0.69, P = 0.0002) were observed in n-3 PUFA supplement group. Conclusions:This meta-analysis indicates that n-3 PUFA supplementation does not improve muscle mass or handgrip strength in healthy adults as well as patients, but do improve MAMC and lower body strength. The limited sample size and prominent heterogeneity of the included studies impede the extrapolation to clinical practice and warrants individual analysis based on population characteristics. Well-designed large-scale RCTs are required to verify these findings.

Osteochondral defects caused by various factors are still difficult clinical problems. With the development of tissue engineering, the strategies and methods for repairing osteochondral defects in the past decade have made great progress, and some osteochondral tissue stratified stent products have gradually entered the clinical trial stage.. The related articles on tissue engineering for the treatment of osteochondral defects were retrieved by searching databases with key words osteochondral defects, cartilage repair and hierarchical scaffolds. This paper discussed the research status of hierarchical scaffolds in osteochondral tissue engineering during recent five years. In this work, the classification of hierarchical scaffold including monophasic scaffolds, bilayered scaffolds, multilayered scaffolds and gradient scaffolds, are summarized by comparing different experiment researches. Furthermore, the advantages and disadvantages of different types of hierarchical scaffolds were introduced through analyzing relevant studies. Monophasic scaffolds can support the adhesion and proliferation of osteoblasts and chondrocytes, but lack the inherent stratified structure features required for osteochondral regeneration.. Bilayered scaffolds consist of a chondral layer and subchondral layer which base on the biocompatibility of monophasic scaffolds. Biphasic scaffolds are significantly better than monophasic scaffolds in simulating natural cartilage, but the interface between chondral and subchondral layer is poor binding. Compared with bilayered scaffold, trilayered scaffolds are added with an intermediate layer which simulates the calcification of normal cartilage between the two layers, so as to obtain better connection of the bone and cartilage layer. Unlike hierarchical scaffolds, gradient scaffolds provide a gradient connection between the layers, which is more similar to the native osteochondral tissue. In the past five years, the development of osteochondral layered scaffolds mainly depended on the novel structure and fabrication methods of scaffolds. However, correlational clinical studies are quite few. Further high quality and large clinical studies are still required.