N-acetylcysteine (NAC) is an acetylated derivative of cysteine that exerts multiple biological activities, including antioxidant, anti-inflammatory, antimicrobial, and mucolytic effects, and has been widely used clinically for the treatment of respiratory diseases. NAC not only directly scavenges reactive oxygen and nitrogen species and strengthens endogenous antioxidant defenses by promoting glutathione synthesis but also modulates immune responses and suppresses inflammatory signaling pathways such as nuclear factor kappa B, thereby attenuating inflammation. In addition, NAC disrupts biofilm architecture by cleaving disulfide bonds, reduces microbial virulence, and enhances the penetration of antimicrobial agents, conferring robust antibacterial and antibiofilm activities. The initiation and progression of oral diseases—including dental caries, periodontal disease, pulpal-periapical disease, and infectious oral mucositis—are closely associated with pathogenic infection, oxidative stress, and dysregulated immune-inflammatory responses. NAC can inhibit Streptococcus mutans adhesion and biofilm formation, thereby reducing cariogenic virulence; mitigate periodontal tissue destruction through antimicrobial, anti-inflammatory, and antioxidant actions, and may modulate bone metabolism; enhance the clearance of Enterococcus faecalis biofilms and improve the efficacy of antimicrobial therapy; and inhibit the growth and hyphal formation of Candida albicans. Collectively, NAC is emerging as a promising agent for the prevention and treatment of oral infectious diseases. This review systematically summarizes the major bioactivities of NAC, its mechanistic actions in oral infectious diseases, and its therapeutic prospects, with the aim of providing a theoretical basis for future basic and clinical investigations.

Objective:To summarize the applications of machine learning (ML) in sarcopenia research through bibliometric analysis.Methods:Literature on ML applications in sarcopenia research was retrieved on the Web of Science database from its inception to December 2024, along with quality assessment. The CiteSpace software was used to conduct bibliometric analysis of the included literature in terms of publication volume, journals, countries, institutions, authors, co-citations, and keywords.Results:A total of 753 articles were obtained, with 480 being of high quality. There was an overall upward trend in the publication volume from 1999 to 2024. The United States led in total publications (119), with China ranking second (97). At the institutional level, Harvard Medical School led globally (14 publications). Kyung Won Kim had the highest publication count (10), and Alfonso J. Cruz-Jentoft was the most cited author (173 citations). His 2019 paper in Age and Ageing achieved the highest co-citation count. J Cachexia Sarcopenia (with a citation frequency of 208) and Age and Ageing (with a centrality of 0.22) were journals with high impacts in this field. "Body composition" (78 occurrences) was the most frequently occurring keyword apart from the search terms, followed by "computed tomography" (54 occurrences) and "mortality" (47 occurrences). The keyword clustering labels include "prognostic value" (first) and "sarcopenia prediction" (second). Conclusions:Current research hotspots involve applying ML to the diagnosis, risk stratification, prognostic prediction, and health management of sarcopenia. Future trends will focus on its deep integration into comprehensive sarcopenia management and on innovating multimodal data-driven algorithms to improve performance and validation.

Objective To study the change of common bile duct pressure after laparoscopic common bile duct exploration in patients with common bile duct stones.Methods Clinical data of 17 patients with common bile duct stones treated in our hospital from January 2022 to December 2022 were collected.All patients underwent laparoscopic common bile duct exploration and common bile duct pressure measurement.The patients were followed up for 8 weeks after operation,and the common bile duct pressure was measured by indwelling T tube at 2,3,4 and 8 weeks.Results Among the 17 patients,1 patient showed persistent high common bile duct pressure due to residual common bile duct stones.In the remaining 16 patients,there were no significant difference between the initial common bile duct pressure(19.7 cm H2O)and the common bile duct pressure at postoperative(17.0 cm H2O)and week 1(15.5cmH2O)(P＞0.05).There were significant differences between the initial common bile duct pressure and the common bile duct pressure at week 2(13.5 cm H2O),3(12.2 cm H2O),4(11.1 cm H2O)and 8(10.0cmH2O)(P＜0.05).Conclusion Compared to initial common bile duct pressure,the pressure of common bile duct began to decrease significantly from 2 weeks after laparoscopic common bile duct exploration in patients with common bile duct stones.

OBJECTIVE: Varied acupoint selections represent a potential cause of the uncertainty surrounding the efficacy of acupuncture for knee osteoarthritis (OA). Skin temperature, a guiding factor for acupoint selection, may help to address this issue. This study explored thermal sensitization of acupoints used for the treatment of knee OA. METHODS: This cross-sectional case-control study enrolled cases aged 45-75 years with symptomatic knee OA and age- and gender-matched non-knee OA controls in a 1:1 ratio. All participants underwent infrared thermographic imaging. The primary outcome was the relative skin temperature of acupoint (STA), and the secondary outcome was the absolute STA of 11 acupoints. The Z test was used to compare the relative and absolute STAs between the groups. Principal component analysis was used to extract the common factors (CFs, acupoint cluster) in the STAs. A general linear model was used to identify factors affecting the STA in the knee OA cases. For the group comparisons of relative STA, P < 0.0045 (adjusted for 11 acupoints through Bonferroni correction) was considered to indicate statistical significance. For other analyses, P < 0.05 was used as the threshold for statistical significance. RESULTS: The analysis included 308 participants, consisting of 151 cases (mean age: [64.58 ± 6.67] years; male: 25.83%; mean body mass index: [25.70 ± 3.16] kg/m²) and 157 controls (mean age: [63.37 ± 5.96] years; male: 26.11%; mean body mass index: [24.47 ± 2.84] kg/m²). The relative STAs of ST34 (P = 0.0001), EX-LE2 (P < 0.0001), EX-LE5 (P = 0.0006), SP10 (P < 0.0001), BL40 (P = 0.0012) and GB39 (P = 0.0037) were higher in the knee OA group. No difference was found in the STAs of ST35, ST36, SP9, GB33 and GB34. Four CFs were identified for relative STA in both groups. The acupoints within each CF were consistent between the groups. The mean values of the relative STAs across each CF were higher in the knee OA group. In the knee OA cases, no factors were observed to affect the relative STA, while age and gender were found to affect the absolute STA. CONCLUSION Among patients with knee OA, thermal sensitization occurs in the acupoints of the lower extremity, exhibiting localized and regional thermal consistencies. The thermally sensitized acupoints that we identified in this study, ST34, SP10, EX-LE2, EX-LE5, GB39 and BL40, may be good choices for the acupuncture treatment of knee OA. Please cite this article as: Tu JF, Wang XZ, Yan SY, Wang YR, Yang JW, Shi GX, Zhang WZ, Jing LN, Yang LS, Liu DH, Wang LQ, Mi BH. Thermal sensitization of acupoints in patients with knee osteoarthritis: A cross-sectional case-control study. J Integr Med. 2025; 23(3): 289-296.
Humans ; Osteoarthritis, Knee/physiopathology* ; Male ; Cross-Sectional Studies ; Middle Aged ; Female ; Acupuncture Points ; Case-Control Studies ; Aged ; Skin Temperature ; Acupuncture Therapy

In May 2023, the Chinese Stomatological Association promulgated the group standard of "Standard on Clinical Dental Treatment for Children under General Anesthesia Orsedation". These specifications were formulated through broad-based expert consultation, iterative revisions, and a comprehensive review of relevant literature, incorporating the collective expertise of nationally recognized authorities in the field. The standard establishes a unified evaluation system and clinical guidelines tailored to China's medical context, aiming to regulate related medical practices. This paper aims to provide an in-depth interpretation of the standard, integrating the clinical research and experiences from the Pediatric Dentistry Department of West China Hospital of Stomatology, Sichuan University, in performing dental treatments under general anesthesia in last 12 years. It particularly focuses on interpreting key aspects, including safety considerations, treatment protocol selection, prevention and management of postoperative complication, postoperative follow-up, and oral health maintenance, to provide a reference for medical staffs to understand and apply them in clinical practice.
Humans ; Anesthesia, General ; Child ; Dental Care for Children/standards* ; China ; Postoperative Complications/prevention & control* ; Anesthesia, Dental/standards* ; Practice Guidelines as Topic

OBJECTIVE To investigate the effect and mechanism of Jingangteng capsules in the treatment of non-alcoholic fatty liver disease （NAFLD）. METHODS Thirty-two SD rats were randomly divided into normal group and modeling group. The modeling group was fed a high-fat diet to establish a NAFLD model. The successfully modeled rats were then randomly divided into model group， atorvastatin group[positive control， 2 mg/（kg·d）]， and Jingangteng capsules low- and high-dose groups [0.63 and 2.52 mg/（kg·d）]， with 6 rats in each group. The pathological changes of the liver were observed by hematoxylin-eosin staining and oil red O staining. Enzyme-linked immunosorbent assay was performed to determine the serum levels of triglycerides （TG）， total cholesterol （TC）， high-density lipoprotein cholesterol （HDL-C）， low-density lipoprotein cholesterol （LDL-C）， alanine transaminase （ALT）， aspartate transaminase （AST）， tumour necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， IL-6， IL-18. 16S rDNA amplicon sequencing and metabolomics techniques were applied to explore the effects of Jingangteng capsules on gut microbiota and metabolisms in NAFLD rats. Based on the E-mail：591146765@qq.com metabolomics results， Western blot analysis was performed to detect proteins related to the nuclear factor kappa-B （NF-κB）/NOD-like receptor family protein 3 （NLRP3） signaling pathway in the livers of NAFLD rats. RESULTS The experimental results showed that Jingangteng capsules could significantly reduce the serum levels of TG， TC， LDL-C， AST， ALT， TNF-α， IL-1β， IL-6， IL-18， while increased the level of HDL-C， and alleviated the hepatic cellular steatosis and inflammatory infiltration in NAFLD rats. They could regulate the gut microbiota disorders in NAFLD rats， significantly increased the relative abundance of Romboutsia and Oscillospira， and significantly decreased the relative abundance of Blautia （P＜0.05）. They also regulated metabolic disorders primarily by affecting secondary bile acid biosynthesis， fatty acid degradation， O-antigen nucleotide sugar biosynthesis， etc. Results of Western blot assay showed that they significantly reduced the phosphorylation levels of NF-κB p65 and NF-κB inhibitor α， and the protein expression levels of NLRP3， caspase-1 and ASC （P＜0.05 or P＜0.01）. CONCLUSIONS Jingangteng capsules could improve inflammation， lipid accumulation and liver injury in NAFLD rats， regulate the disorders of gut microbiota and metabolisms， and inhibit NF-κB/NLRP3 signaling pathway. Their therapeutic effects against NAFLD are mediated through the inhibition of the NF-κB/NLRP3 signaling pathway.

Uric acid is the end product of purine metabolism in the human body. In recent years, the role of uric acid in female fertility and assisted reproductive technology (ART) has gained increasing attention. Dysregulation of uric acid metabolism can lead to hyperuricemia (HUA). HUA is not only closely related to metabolic syndrome and cardiovascular diseases but may also adversely affect female fertility by influencing ovarian function and embryos development. In this review, we explored the role of uric acid in female fertility, including its association with female subfertility, infertility, adverse pregnancy outcomes and metabolic syndrome, as well as its potential impact on ART like in vitro fertilization-embryo transfer and intracytoplasmic sperm injection. Further studies are needed to clarify the threshold and clinical intervention value of uric acid levels in women of childbearing age, providing a basis for reproductive health counseling and personalized pregnancy assistance for HUA patients of childbearing age.

Objective:To summarize the applications of machine learning (ML) in sarcopenia research through bibliometric analysis.Methods:Literature on ML applications in sarcopenia research was retrieved on the Web of Science database from its inception to December 2024, along with quality assessment. The CiteSpace software was used to conduct bibliometric analysis of the included literature in terms of publication volume, journals, countries, institutions, authors, co-citations, and keywords.Results:A total of 753 articles were obtained, with 480 being of high quality. There was an overall upward trend in the publication volume from 1999 to 2024. The United States led in total publications (119), with China ranking second (97). At the institutional level, Harvard Medical School led globally (14 publications). Kyung Won Kim had the highest publication count (10), and Alfonso J. Cruz-Jentoft was the most cited author (173 citations). His 2019 paper in Age and Ageing achieved the highest co-citation count. J Cachexia Sarcopenia (with a citation frequency of 208) and Age and Ageing (with a centrality of 0.22) were journals with high impacts in this field. "Body composition" (78 occurrences) was the most frequently occurring keyword apart from the search terms, followed by "computed tomography" (54 occurrences) and "mortality" (47 occurrences). The keyword clustering labels include "prognostic value" (first) and "sarcopenia prediction" (second). Conclusions:Current research hotspots involve applying ML to the diagnosis, risk stratification, prognostic prediction, and health management of sarcopenia. Future trends will focus on its deep integration into comprehensive sarcopenia management and on innovating multimodal data-driven algorithms to improve performance and validation.

BACKGROUND: T-cell lymphoblastic lymphoma/acute lymphoblastic leukemia (T-LBL/ALL) is an aggressive form of hematological malignancy associated with poor prognosis in adult patients. Histone deacetylases (HDACs) are aberrantly expressed in T-LBL/ALL and are considered potential therapeutic targets. Here, we investigated the antitumor effect of a novel HDAC inhibitor, chidamide, on T-LBL/ALL. METHODS: HDAC1, HDAC2 and HDAC3 levels in T-LBL/ALL cell lines and patient samples were compared with those in normal controls. Flow cytometry, transmission electron microscopy, and lactate dehydrogenase release assays were conducted in Jurkat and MOLT-4 cells to assess apoptosis and pyroptosis. A specific forkhead box O1 (FOXO1) inhibitor was used to rescue pyroptosis and upregulated gasdermin E (GSDME) expression caused by chidamide treatment. The role of the FOXO1 transcription factor was evaluated by dual-luciferase reporter and chromatin immunoprecipitation assays. The efficacy of chidamide in vivo was evaluated in a xenograft mouse. RESULTS: The expression of HDAC1, HDAC2 and HDAC3 was significantly upregulated in T-LBL/ALL. Cell viability was obviously inhibited after chidamide treatment. Pyroptosis, characterized by cell swelling, pore formation on the plasma membrane and lactate dehydrogenase leakage, was identified as a new mechanism of chidamide treatment. Chidamide triggered pyroptosis through caspase 3 activation and GSDME transcriptional upregulation. Chromatin immunoprecipitation assays confirmed that chidamide led to the increased transcription of GSDME through a more relaxed chromatin structure at the promoter and the upregulation of FOXO1 expression. Moreover, we identified the therapeutic effect of chidamide in vivo . CONCLUSIONS This study suggested that chidamide exerts an antitumor effect on T-LBL/ALL and promotes a more inflammatory form of cell death via the FOXO1/GSDME axis, which provides a novel choice of targeted therapy for patients with T-LBL/ALL.
Humans ; Pyroptosis/drug effects* ; Forkhead Box Protein O1/genetics* ; Aminopyridines/pharmacology* ; Animals ; Mice ; Benzamides/pharmacology* ; Cell Line, Tumor ; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma/drug therapy* ; Phosphate-Binding Proteins/metabolism* ; Histone Deacetylase Inhibitors/pharmacology* ; Jurkat Cells ; Histone Deacetylases/metabolism* ; Apoptosis/drug effects* ; Gasdermins

Diabetes mellitus (DM) is a major global health issue, with glycated hemoglobin levels serving as the gold standard for evaluating glucose level control in DM patients. However, it has limitations in reflecting glucose oscillations (i.e. glycemic variability, GV). Increasing evidence suggests that GV is closely related to the progression of diabetes complications and patient prognosis. As people realize the importance of avoiding hypoglycemia while achieving target glycated hemoglobin levels in treatment, the clinical significance of GV becomes more obvious. This article systematically reviewed the concept and connotation of GV, summarized the latest research on its role in the complications of diabetes, and revealed the biochemical and pathophysiological abnormalities caused by excessive glycemic oscillation, aiming to provide a theoretical basis for the risk warning and early intervention of DM patients.
Humans ; Blood Glucose/metabolism* ; Diabetes Complications/physiopathology* ; Glycated Hemoglobin/metabolism* ; Hypoglycemia ; Diabetes Mellitus, Type 2/complications*