Background/Aims: Although metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated fatty liver disease (MAFLD) represent the updated nomenclature and diagnostic criteria for nonalcoholic fatty liver disease, studies comparing the prognostic implications of these conditions remain limited. This meta-analysis aimed to quantify the associations among MAFLD, MASLD, and long-term clinical outcomes. Methods: A comprehensive literature search was performed to identify cohort studies that assessed the association of MASLD and MAFLD with all-cause mortality, cause-specific (cardiovascular and cancer-related) mortality, and the incidence of cardiovascular disease in the PubMed, Embase, Web of Science, CINAHL, and CENTRAL databases from inception through October 31, 2024. Pooled hazard ratios (HRs) were calculated for relevant outcomes. Results: We identified 18 cohort studies, comprising 10,653,666 patients with MAFLD from 13 studies and 3,202,447 patients with MASLD from nine studies. MAFLD was significantly associated with an increased risk of overall mortality (pooled HR [95% confidence interval], 1.30 [1.16 to 1.47]) and cardiovascular mortality (1.31 [1.08 to 1.60]; both p<0.01), but not with cancer-related mortality (1.10 [0.97 to 1.24]; p=0.130). Conversely, MASLD was associated with a higher risk for all mortality outcomes: overall mortality (1.34 [1.12 to 1.61]), cardiovascular mortality (1.17 [1.07 to 1.27]), and cancer-related mortality (1.24 [1.19 to 1.29]; all p<0.01). The risk of cardiovascular disease was increased in patients with both MAFLD (1.48 [1.31 to 1.66]) and MASLD (1.33 [1.21 to 1.46]; both p<0.001). Conclusions MAFLD and MASLD were both associated with increased risks of mortality and cardiovascular outcomes. Notably, a significant association with cancer-related mortality was observed for MASLD, but not for MAFLD.

Purpose: This study aimed to develop a digital multimedia-based educational intervention for hematopoietic stem cell (HSC) donors and to evaluate its effects on anxiety, knowledge, attitudes toward hematopoietic stem cell donation, and educational satisfaction. Methods: This quasi-experimental study employed a nonequivalent control group non-synchronized pretest-posttest design. Participants were 60 HSC donors admitted to a general hospital in Seoul, Republic of Korea, between April and December 2024. The participants were assigned to an experimental group (n=30) and a control group (n=30). The experimental group received a digital multimediabased educational intervention in addition to the usual education using a standardized handout, whereas the control group received the usual education only. The intervention was provided in three sessions: on the day of admission (20 minutes), on the day of stem cell collection (10 minutes), and on the day of discharge (10 minutes). Data were collected at admission and discharge using structured questionnaires. Anxiety was analyzed using generalized estimating equations (GEE), knowledge and attitudes using mixed ANOVA, and educational satisfaction using an independent t-test. Results: The experimental group showed significantly lower anxiety (p=.048) and higher knowledge levels (p=.005) than the control group. No significant differences were found between the groups in attitudes toward donation or educational satisfaction. Conclusion The digital multimedia-based educational intervention was effective in reducing anxiety and improving knowledge among HSC donors. This intervention may enhance donors’ understanding of the donation process and support a more positive donation experience. Further multicenter studies with larger samples and longitudinal follow-up measurements are needed to verify the long-term effects and generalizability of the intervention.

A medial closing wedge supramalleolar osteotomy, along with corrections for pes plano-valgus, including medial displacement calcaneal osteotomy, and deltoid ligament repair or reconstruction, is most commonly considered for the joint-preserving surgery of valgus ankle arthritis. In cases of ‘opposing coronal plane deformities,’ however, where the tibial plafond is varus-aligned to the long axis of the tibia and the ground, while the talus is conversely valgus-aligned, medial closing wedge supramalleolar osteotomy may paradoxically risk exacerbating the valgus ankle arthritis. This paper reports the radiological and clinical outcomes of an otherwise healthy, physically active 55-year-old male patient with valgus ankle arthritis and opposing coronal-plane deformities, along with a literature review. The patient underwent joint-preserving surgery consisting of lateral closing wedge supramalleolar osteotomy, fibular osteotomy, medial displacement calcaneal osteotomy, and deltoid ligament augmentation with suture tape. This paper discusses the critical considerations and surgical precautions necessary when deciding on joint-preserving procedures for valgus ankle arthritis.

This study examined sleep-related characteristics among university students and the associations between sleep quality, dietary habits, and diet quality.Three hundred and ninety-three university students (206 men and 187 women) enrolled at universities in the Chungcheong region of Korea participated in this study between November and December 2023. Data on the general characteristics, dietary habits, sleep status, and the Nutrition Quotient (NQ) for adults were collected using a structured questionnaire. The sleep quality was assessed using the Pittsburgh Sleep Quality Index– Korean version (PSQI-K). The participants were classified into a good sleeper group (PSQI-K≤5) and a poor sleeper group (PSQI-K≥6). The dietary habits and NQ scores were compared according to the sleep quality. Compared with good sleepers, poor sleepers had a significantly higher prevalence of eating alone at least once per day (P<0.01) and higher scores for unhealthy dietary behaviors, including overeating, eating quickly, a preference for salty food, skipping meals, and irregular meal timing (P<0.05). Although the total NQ scores and balance and practice domain scores did not differ according to sleep quality, the moderation domain scores were significantly lower among poor sleepers, particularly in men (P<0.05). In conclusion, poor sleep quality among university students was associated with unhealthy dietary habits and lower diet quality related to dietary restraint. These findings highlight the importance of improving sleep quality as a part of health education and dietary intervention programs for university students.

Objective: To analyze the structural changes in whole blood and apheresis platelet donations in Chinese Society of Blood Transfusion (CSBT) sentinel units from 2021 to 2025, and to provide evidence for donor recruitment and blood service management. Methods: Aggregated data reported by sentinel sites were collected and stratified according to six indicators: age, sex, donation history, donation volume, donation site, and organization mode. Pearson χ test, Cramer′V coefficient, Cochran-Armitage trend test and simple linear regression were adopted for analysis. Results: A total of 16 256 973 whole blood donations and 1 576 546 apheresis platelet donations were included. Among whole-blood donations, the proportion of donors aged 18-22 years decreased from 27.30% to 10.60%. The proportion of male donors increased from 58.81% to 63.13%; the proportion of people aged 30 and above increased from 58.40% to 75.30%; the proportion of fixed locations rose from 28.37% to 36.57%; the proportion of social groups increased from 21.69% to 39.69%. The 400-mL donations decreased from 62.12% to 53.46%, while individually initiated voluntary donations remained above 50%. Apheresis platelet donations were predominantly from males, individuals aged 30-39 years, and repeat donors; 2-treatment-unit apheresis platelet donations increased from 67.19% to 74.93%, and individually initiated donations accounted for 92.97%-96.02%. Statistically significant overall annual compositional differences were observed for all six indicators (all P<0.001), whereas linear trends for some sub-categories were not statistically significant. Conclusion: In the participating CSBT sentinel units, among whole blood donations, the proportions of donors aged 18-22 years, university-organized group donations, and donations at blood mobiles decreased, whereas the proportions of organizational group donations and donations at fixed venues increased. The apheresis platelet donation cohort is relatively mature and is evolving toward a high-efficiency donation model. Individual voluntary donation remains the primary organization mode for both donation types. Strategies such as youth donor recruitment, optimized layout of fixed donation sites, and retention of repeat donors should be strengthened to improve the resilience of blood supply.

In recent years, gastrointestinal stromal tumors (GIST) have increased incidence and mortality, and most GIST is caused by the activation mutation of the c-KIT gene. Therefore, c-KIT has become a promising therapeutic target of GIST. At present, the drugs approved for the treatment of GIST including imatinib, sunitinib, regorafenib and ripretinib, are mostly prone to developing resistance and accompanied by various degrees of adverse reactions. Therefore, there is an urgent need to develop new c-KIT inhibitors to solve the problem of resistance. In this study, we investigated the anti-tumor effect of a novel c-KIT inhibitor PN17-1 on gastrointestinal stromal tumor GIST-882 cells in vitro. We found that PN17-1 significantly inhibited the proliferation, colony formation and migration ability of GIST-882 cells, and significantly downregulated the protein expression levels of p-c-KIT and its downstream signals p-AKT, p-STAT5 and p-ERK in GIST-882 cells. In addition, PN17-1 induced apoptosis in GIST-882 cells, and the apoptosis may be mainly related to the mitochondrial-dependent endogenous pathway. In conclusion, the novel c-KIT inhibitor PN17-1 is a promising anti-GIST drug, and this study provides new ideas for further development of c-KIT inhibitors in the future.

Objective:To observe the clinical efficacy of against-lateral correction Tuina(Chinese therapeutic massage)in treating atlanto-axial joint disorder(AAJD)and imaging changes.Methods:A total of 142 patients with AAJD were recruited.They were randomly allocated to a trial group and a control group using the random number table method,with 71 participants in each group.The trial group was treated with against-lateral correction Tuina 3 times weekly.The control group was offered conventional physical traction therapy once daily.The interventions lasted 2 weeks in both groups.The two groups of participants were observed before and after treatment for their changes in the global pain scale(GPS)score,visual analog scale(VAS)score for dizziness assessment,cervical range of motion(ROM)in rotation,and the extent of atlanto-dental displacement.Results:The GPS and VAS scores dropped after treatment in both groups(P<0.05)and were lower in the trial group than in the control group after treatment and at the follow-up(P<0.05).Participants in the trial group achieved a significant increase in the cervical ROM in rotation after treatment and at the follow-up compared to the pre-treatment value(P<0.05)and surpassed the control group(P<0.05);the control group only showed an increase in the left-side rotation(P<0.05).After the intervention,neither the intra-group nor the between-group comparison revealed significant differences in the extent of atlanto-dental displacement(P>0.05),though the trial group presented an improving tendency.Conclusion:Compared to physical traction,the against-lateral correction Tuina method works more significantly in improving pain,dizziness,and ROM in AAJD patients.

Objective:To screen differentially expressed long non-coding RNA (lncRNA) in exosomes of the brain extracellular space in mice with traumatic brain injury (TBI) and explore their biological roles in brain injury repair.Methods:Twenty-four C57BL/6J male mice were randomly divided into TBI group and control group with 12 in each group. The TBI group was treated with drill craniostomy followed by hydraulic impact while the control group was treated with drill craniostomy only. The brain tissue samples were collected at 3 hours after TBI. The exosomes from the brain extracellular space were isolated with papain digestion combined with an exosome isolation kit, the appearance of the exosomes was observed by phosphotungstic acid negative staining under a transmission electron microscope, and western blot was used to identify the exosomal marker proteins cluster of differentiation 63 (CD63), tumor susceptibility gene 101 (TSG101) and heat shock protein 70 (HSP70). After exosome identification, RNA libraries were constructed and subjected to library quality control, whole transcriptome sequencing was performed to detect, characterize and annotate lncRNA. Subsequently, the RNA high-throughput sequencing results were verified by randomly selecting five differentially expressed lncRNA. Moreover, the accuracy of the RNA high-throughput sequencing results was verified by qRT-PCR. The differentially expressed lncRNA were screened afterwards. Finally, bioinformatics analysis of differentially expressed lncRNA was performed, i.e., gene ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) signaling pathway analysis were performed based on differentially expressed lncRNA-related genes.Results:(1) Identification of exosomes: the exosomes were cup-shaped with clear and intact membranes and diameters of 30-100 nm. Western blot confirmed the presence of typical exosome markers of the exosomes, such as CD63, TSG101, and HSP70, as well as astrocyte marker glial fibrillary acidic protein (GFAP), all of which were found in the brain tissue. (2) Validation of lncRNA high-throughput sequencing data accuracy: the 4/5 sequencing accuracy indicated that the sequencing results of lncRNAs were largely reliable. (3) Screening of differentially expressed exosomal lncRNAs after TBI: compared with the control group, a total of 442 lncRNA were significantly differentially expressed in the TBI group, including 255 up-regulated and 187 down-regulated lncRNA. (4) Bioinformatics analysis of differentially expressed lncRNAs after TBI: GO analysis showed that the differentially expressed lncRNA mainly involved in cell localization, cognition, learning or memory, were closely related to the composition of the nucleus and organelles and the binding processes of proteins, oxygen, and kinases. KEGG pathway analysis showed that upregulated lncRNA were mainly enriched in the mitogen activated protein kinase (MAPK) signaling pathway, while downregulated lncRNA were mainly enriched in the endocytosis pathway. The pathway relation network showed that MAPK signaling pathway played a key role in downstream regulation.Conclusions:There are significant differences in lncRNA expression profiles of the exosomes in the extracellular spaces of the brain cells in mice with TBI, and the differentially expressed lncRNA may mediate the process of neuronal repair, body prognosis and learning ability recovery after TBI by participating in MAPK and endocytosis signaling pathways.

Objective:To investigate the current status of the implementation of home-based phototherapy (HBPT) in patients with vitiligo, and to analyze management needs among patients receiving HBPT.Methods:A questionnaire survey was conducted on the application of HBPT among patients with vitiligo who visited the outpatient clinic of the Hospital for Skin Diseases, Chinese Academy of Medical Sciences from December 2021 to November 2022. Additionally, the popularization and usage of HBPT as well as needs of patient management were investigated and analyzed in these vitiligo patients.Results:A total of 496 valid questionnaires were collected from 496 patients with vitiligo (241 males [48.5%] and 255 females [51.5%]) . Their ages at visit ranged from 2 to 67 (30.87 ± 12.36) years. The most commonly affected sites were the head and face (52.2%) , followed by hair (32.1%) , hands and feet (31.4%) , trunk (30.2%) , limbs (24.3%) , neck (19.5%) , and perineum (9.9%) . Among the participants, 320 (64.5%) were currently using or had used HBPT, and 352 (70.8%) expressed a willingness to learn more about HBPT usage guidelines and health education. Regarding the repigmentation outcomes after HBPT: among 312 patients, 54 (17.3%) reported complete recovery, 64 (20.5%) were markedly improved, 142 (45.5%) experienced improvement, and 52 (16.7%) showed no response. Adverse reactions occurred in 223 patients (71.5%) , of whom 28 (9.0%) experienced severe adverse reactions. The most desired guiding information was the adjustment method for phototherapy dosage and treatment duration (184/352, 52.3%) ; the most effective way to receive health education information was through verbal education by medical staff (177/352, 50.3%) .Conclusion:For vitiligo patients who were willing to accept and use HBPT, the most desired guiding information was the adjustment method for phototherapy dosage and treatment duration, and verbal health education by medical staff appeared to be the main way to obtain health education information.