Objectives: Sarcopenia, an age-related skeletal muscle disorder, is assessed by handgrip strength, gait speed, and muscle mass, yet population-specific reference data and standardized scores for Asian adults remain limited. We aimed to establish sex- and age-specific normative reference distributions, smoothed centile curves, and modelbased standardized T scores for these indicators in Asian adults. Methods: We retrospectively analyzed adults aged ≥ 40 years attending a tertiary-center Adult Preventive Health Program in 2023–2024. To assess construct validity, we compared sarcopenia indicators across age groups using analysis of variance (ANOVA). Sex- and age-specific reference distributions were estimated using Generalized Additive Models for Location, Scale, and Shape (GAMLSS), from which smooth model-based age-specific centiles (5th–95th) were derived. Individual values were standardized to model-based Z scores and transformed to T scores on an approximate 100-point scale. Asian Working Group for Sarcopenia (AWGS) cut-offs were used in receiver operating characteristic (ROC) analyses to determine corresponding T-score thresholds. Results: Among 8095 participants, model-based mean handgrip strength, gait speed, and skeletal muscle mass were 20.03±5 kg, 1.12±0.37 m/s, and 6.93±1.43 kg/m² in women and 30.69±7.46 kg, 1.12±0.37 m/s, and 8.79±1.95 kg/m² in men. GAMLSS-derived centile curves demonstrated age-related declines in strength and gait speed and milder changes in muscle mass. AWGS cut-offs corresponded to T scores in the mid-40s for strength and gait and around 40–41 for muscle mass. Conclusions We established sex- and age-specific normative values and GAMLSS-based reference distributions, and derived model-based Z and T scores that provide standardized sarcopenia metrics in Asian adults, align with AWGS thresholds, and support detection of muscle decline and risk stratification.

Licochalcone E is a chalcone isolated from Glycyrrhiza uralensis and G. inflata Batal. This study explored the effect of licochalcone E on improving hepatic steatosis in obese mice and evaluated the role of licochalcone E in regulating lipid accumulation in hepatocytes. In vitro, oleic acid–induced hepatocytes were treated with licochalcone E to investigate its effect on lipid metabolic pathways. In animal experiments, male C57BL/6 mice were fed with a high-fat diet (HFD) and treated with licochalcone E by intraperitoneal injection for 12 weeks to assess its effects on biochemical indexes and hepatic steatosis. Furthermore, mice were fed a methionine/choline-deficient (MCD) diet and administered licochalcone E, followed by evaluation of liver fibrosis. Licochalcone E effectively reduced body weight, epididymal and inguinal fat weight, and adipocyte size in HFD-induced obese mice. Licochalcone E treatment of obese mice also reduced hepatic lipid accumulation and improved hepatocyte steatosis. Licochalcone E regulated the expression of lipogenesis- and lipolysis-related genes in the livers of obese mice and increased AMPK phosphorylation and Sirt1 expression in the liver. Licochalcone E also attenuated hepatic inflammation and oxidative stress in obese mice. Furthermore, treatment of MCD-induced mice with licochalcone E reduced the number of lipid vacuoles and the extent of fibrosis and inhibited liver inflammation. In FL83B hepatocytes, licochalcone E could regulate lipogenesis and lipolysis, and increase the phosphorylation of AMPK and ACC. These findings provide new insights into the role of licochalcone E in regulating lipid metabolism and preventing hepatic steatosis.

Objective:To evaluate the safety and efficacy of the TiRobot assisted screw placement in patients with lumbar degenerative diseases.Methods:The clinical data of 165 patients with lumbar degenerative diseases from January 2020 to December 2022 in Beijing Friendship Hospital, Capital Medical University were retrospectively analyze, and all patients were treated with posterior lumbar decompression and instrumentation. Among them, 46 patients were used the TiRobot assisted screw placement during surgery (robotic-assisted group), and 119 patients underwent freehand screw placement by C-arm X-ray machine fluoroscopy (freehand group). The operation time, intraoperative blood loss, complication and skelalgia visual analogue scale (VAS), Oswestry disability index (ODI) before and after operation were recorded. The accuracy of screw placement and rate of proximal facet joint violation were compared between two groups.Results:There were no statistical difference in operation time, intraoperative blood loss and incidence of complication between two groups ( P>0.05). In the two groups, the 3 d VAS and ODI after operation were significantly lower than those before operation, robot-assisted group: (3.33 ± 1.40) scores vs. (6.54 ± 2.00) scores and (16.96 ± 8.03) scores vs. (43.09 ± 5.48) scores; freehand group: (3.56 ± 1.29) scores vs. (6.55 ± 1.65) scores and (18.89 ± 6.74) scores vs. (44.91 ± 4.96) scores, and there were statistical differences ( P<0.01); there were no statistical difference in VAS and ODI before operation and 3 d after operation between two groups ( P>0.05). A total of 234 screws were implanted in robot-assisted group, and 590 screws were implanted in freehand group. The accuracy of screw placement in robot-assisted group was significantly higher than that in freehand group: 80.77% (189/234) vs. 74.58% (440/590), the rate of proximal facet joint violation was significantly lower than that in freehand group: 2.56% (6/234) vs. 7.29% (43/590), and there were statistical differences ( χ2 = 3.56 and 6.68, P<0.05). Conclusions:The TiRobot assisted screw placement for lumbar degenerative diseases is safe and effective. Compared to freehand technique, the TiRobot assisted method demonstrates higher screw placement accuracy and a lower rate of proximal facet joint violation.

Objective To investigate the clinical efficacy of Jieyu Huatan Xiaoyu Formula(JYHTXYF)in patients with gastric precancerous lesions(GPL)of liver-stomach disharmony type and to observe its effects on the nuclear factor erythroid 2-related factor 2(Nrf2)-Kelch-like ECH-associated protein 1(Keap1)signaling pathway.Methods A prospective study enrolled 100 GPL patients with liver-stomach disharmony syndrome treated at the Department of Gastroenterology,Affiliated Hospital of Tianjin Academy of Chinese Medicine from August 2023 to August 2024.Participants were randomized into control group(n=50,treated with Moluodan Pills)and trial group(n=50,treated with JYHTXYF decoction)for 6 months.Traditional Chinese medicine(TCM)syndrome scores,gastroscopic pathological scores,serum superoxide dismutase(SOD)and malondialdehyde(MDA)levels,along with Nrf2-Keap pathway-related gene/protein expressions were assessed before and after treatment.Results(1)Regarding clinical efficacy,after 6 months of treatment,the total effective rate was 94.00％(47/50)in the trial group and 76.00％(38/50)in the control group.Intergroup comparison(by chi-square test)showed that the efficacy of the trial group was significantly superior to that of the control group(P＜0.05).(2)In terms of traditional Chinese medicine(TCM)syndrome scores,after treatment,the scores for TCM syndromes such as epigastric pain,gastric distension,belching,and poor appetite decreased in both groups compared to those before treatment(P＜0.05),and the reduction in the trial group was significantly superior to that in the control group(P＜0.01).(3)Regarding gastroscopic pathological scores,after treatment,the scores for gastric mucosal atrophy,intestinal metaplasia,dysplasia,and chronic inflammation decreased in both groups compared to those before treatment(P＜0.05),and the reduction in the trial group was significantly greater than that in the control group(P＜0.01).(4)In terms of oxidative stress indicators,after treatment,SOD levels increased in both groups compared to before treatment(P＜0.05),while serum MDA levels decreased(P＜0.05).The magnitude of increase in serum SOD levels and the magnitude of decrease in serum MDA levels in the trial group were significantly greater than those in the control group(P＜0.05 or P＜0.01).(5)Regarding the expression levels of genes related to the Nrf2-Keap signaling pathway,after treatment,the relative mRNA expression levels of Nrf2,NAD(P)H quinone dehydrogenase 1(NQO1),and heme oxygenase-1(HO-1)in gastric mucosal tissue increased in both groups compared to those before treatment(P＜0.05),and the increase in the trial group was significantly greater than that in the control group(P＜0.01).(6)Regarding the expression levels of proteins related to the Nrf2-Keap signaling pathway,after treatment,the relative protein expression levels of Nrf2,HO-1,and mitochondrial superoxide dismutase(SOD2)in gastric mucosal tissue increased in both groups compared to those before treatment(P＜0.05),and the increase in the trial group was significantly greater than that in the control group(P＜0.01).Conclusion JYHTXYF effectively improves TCM syndromes and gastroscopic pathology in GPL patients of liver-stomach disharmony type,elevates serum antioxidant enzyme levels,and upregulates the expression of genes and proteins associated with the Nrf2-Keap1 signaling pathway,thereby enhancing clinical efficacy.The study will provide novel insights and approaches for the treatment of gastric precancerous lesions.

Objective:To explore the feasibility of obtaining three-dimensional (3D) models of intraosseous and periosteal arteries of hallux phalanx using micro-arteriography with micro-CT scan.Methods:From January 2022 to April 2025, the Department of Orthopaedic, the 988th Hospital of the Joint Logistics Support Force of the Chinese PLA conducted a study on 7 fresh-frozen specimens of distal lower limb (right lower limb) from an 85-year-old male, and both lower limbs from an 82-year-old male, a 78-year-old female and a 66-year-old male in the Department of Human Anatomy & Histology and Embryology, Peking University School of Basic Medical Sciences. Red lead oxide powder (Pb 3O 4) was ground and filtered through a 300 mesh, and then mixed with turpentine at ratios of 1 g ∶ 1.5 ml, 1 g ∶ 1.0 ml, and 1 g ∶ 0.5 ml to prepare lead-based contrast agent suspensions. After thawing the specimens at room temperature, the suspensions were injected via the popliteal artery in ascending order of concentration. After injections, the specimens were fixed in 10% methanal for 2 weeks. The proximal and distal phalanges of the hallux, with the surrounding periosteum preserved intact, were then harvested. The harvested specimens were scanned using micro-CT at an ultimate resolution of 12 μm. Subsequently, Mimics Medical software was used to reconstruct 3D models of the intraosseous and periosteal arteries within the phalanges. Results:Periosteal arteries in the proximal phalanx were primarily distributed near the joint region. A consistently large trunk artery entered from plantar side, supplying most of the diaphysis and head. There was a rich periosteal arterial network on both sides of the distal phalanx, which communicates with each other through the arterial arch in the bone groove. However, trunk intraosseous artery could be absent. Intraosseous arteries in the proximal ends of both the proximal and distal phalanges originated from periosteal arteries. These formed an interconnected arteriosomes and coursed parallel to the articular surfaces.Conclusion:The micro-arteriography acquired by micro-CT scan effectively visualizes intraosseous and periosteal arteries and enables the reconstruction and analysis of 3D models of the arteriosomes. The characteristics of arteriolar distribution provide a theoretical basis for osteotomy or internal fixation procedures involving a hallux phalanx.

Objective:To analyze the learning curve of TiRobot-assisted lumbar pedicle screw fixation (LPSF) by cumulative sum (CUSUM) test method.Methods:The clinical data of 50 patients who underwent TiRobot-assisted LPSF from January 2020 to December 2022 in Beijing Friendship Hospital, Capital Medical University were retrospectively analyzed. CUSUM analysis and learning curve fitting were performed with robot usage time as the main indicator with the time for each step refined (robot registration time, path planning time and guide wire placement time), to select the best learning curve fitting model with the R2 value closest to 1. Using the turning point of the learning curve as the boundary, the learning curve was divided into two stages as learning stage and maturity stage, and then the observation indexes were compared between the two stages. Results:All 50 patients successfully completed the surgery without perioperative complications, with a total of 244 pedicle screws implanted. The total robot usage time and robot registration time showed a gradually decreasing trend with the increase of case number, and the learning curves were successfully fitted and reached their peaks at the seventeenth and thirteenth cases respectively. The entire learning process was divided into learning stage (17 cases) and maturity stage (33 cases) based on the turning point of the learning curve of total robot usage time. The path planning time and guide wire placement time did not show significant changes with the increase in the case number. The total robot usage time, robot registration time and the intraoperative blood loss in the learning stage were significantly higher than those in the maturity stage: (35.35 ± 1.58) min vs. (30.61 ± 0.43) min, (20.83 ± 1.56) min vs. (14.94 ± 0.29) min and 400 (150, 500) ml vs. 200 (110, 300) ml, the guide wire placement time of per screw was significantly lower than that in the maturity stage: 2.00 (1.83, 2.34) min/screw vs. 2.33 (2.13, 2.69) min/screw, and there were statistical differences ( P<0.05 or <0.01). There were no statistical difference in the path planning time, path planning time of per screw, guide wire placement time and the accuracy of screw placement between two stages ( P>0.05). Conclusions:TiRobot-assisted LPSF is a new technology with safety and effectiveness, and it has a relatively short learning curve. To achieve technological maturity, at least 17 surgeries are required with accumulated experience, and the robot registration is the main step of the learning process. After reaching maturity stage, the robot usage time is significantly shortened and intraoperative trauma is significantly reduced while the relatively high screw placement accuracy is ensured.

BACKGROUND:The patient underwent multiple hypoproteinemia after total hip arthroplasty,which affected postoperative healing and rehabilitation.OBJECTIVE:To investigate and screen the risk factors for hypoproteinemia after total hip arthroplasty,and to establish a nomogram prediction model so as to provide guidance for judging whether hypoproteinemia occurs after total hip arthroplasty.METHODS:A total of 355 patients who underwent total hip arthroplasty were included,and according to whether hypoproteinemia occurred on the first day after surgery,they were divided into 238 cases in the hypoproteinemia group and 117 cases in the normal group,with a hypoproteinemia rate of 67％.Data were collected,including age,gender,diabetes mellitus,hypertension,hyperuricemia,hyperlipidemia,anesthesia method,preoperative leukocytes,preoperative erythrocytes,preoperative hemoglobin,preoperative platelets,preoperative plasma prothrombin time,preoperative activated partial prothrombin time,preoperative international normalized ratio,preoperative thrombin time,preoperative fibrinogen,preoperative erythrocyte sedimentation rate,preoperative C-reactive protein,preoperative D-dimer,preoperative mean corpuscular hemoglobin content,preoperative mean corpuscular volume,operation time,body mass index,preoperative procalcitonin,and preoperative hematocrit.SPSS 27.0 software was used for univariate analysis,followed by R language(4.3.1)to perform least absolute shrinkage and selection operator regression and 10-fold cross-validation of the observation indicators to obtain the intersection of the two risk factors.SPSS 27.0 software was used to perform multivariate binary logistic regression to obtain the final risk factors.The prediction model of hypoproteinemia after total hip arthroplasty was constructed by R language.The receiver operating characteristic curve,calibration curve,and clinical decision curve were constructed to assess the predictive model predictive ability.RESULTS AND CONCLUSION:(1)Univariate analysis,least absolute shrinkage and selection operator regression,and multivariate logistic regression were used to screen out significant differences in age(OR=1.024,P=0.023),preoperative platelets(OR=0.995,P=0.028),and preoperative erythrocyte sedimentation rate(OR=1.031,P=0.045)in judging whether hypoproteinemia would occur after surgery(P＜0.05).(2)The nomogram prediction model was constructed based on the final risk factors screened by multivariate Logistic regression,and the prediction ability of the model was evaluated by constructing the receiver operating characteristic curve,and the area under the calculated receiver operating characteristic curve reached 0.835(95％CI=0.779-0.891),C-index=0.835.A threshold of 0-0.83 could bring better clinical efficacy calculated by the decision curve analysis.The model has good sensitivity and accuracy,which can better identify the risk of postoperative hypoproteinemia for medical staff and patients before total hip arthroplasty.

This case report explores the therapeutic potential of theta burst stimulation (TBS) for cognitive enhancement in individuals with brain injuries. The study presents a 38-year-old male suffering from an organic mental disorder attributed to a traumatic brain injury (TBI), who demonstrated notable cognitive improvements following an intensive TBS protocol targeting the left dorsal lateral prefrontal cortex. The treatment led to significant enhancements in impulse control, irritability, and verbal comprehension without adverse effects. Neuropsychological assessments and brain imaging post-intervention revealed improvements in short-term memory, abstract reasoning, list-generating fluency, and increased cerebral blood flow in the prefrontal cortex. These findings suggest that TBS, by promoting neural plasticity and reconfiguring neural networks, offers a promising avenue for cognitive rehabilitation in TBI patients. Further research is warranted to optimize TBS protocols and understand the mechanisms underlying its cognitive benefits.

Triple-negative breast cancer (TNBC) is a subtype of breast cancer that is challenging to treat and lacks targeted therapeutic drugs in the clinic. Natural active ingredients provide promising opportunities for discovering and developing targeted therapies for TNBC. This study investigated the effects of daurisoline on TNBC and elucidated its potential mechanisms. Using network pharmacology, a correlation was identified between daurisoline, derived from Menispermum dauricum, and breast cancer, particularly involving the Notch signaling pathway. The effects of daurisoline on the proliferation, migration, and apoptosis of MDA-MB-231 and MDA-MB-468 cells were evaluated in vitro. Additionally, the impact of daurisoline on the growth of MDA-MB-231 xenograft tumors in nude mice was assessed through in vivo experiments. Expression levels of Notch signaling pathway-related proteins, including Notch-1, NICD, PSEN-1, Bax, and Bcl-2, were examined using molecular docking and Western blotting to explore the underlying mechanisms of daurisoline’s anti-breast cancer effects. It was revealed that daurisoline could effectively inhibit the proliferation and migration of MDA-MB-231 and MDA-MB-468 cells and promote apoptosis. Furthermore, it significantly reduced the growth of subcutaneous tumors in nude mice. Notably, daurisoline could reduce the hydrolytic activity of γ-secretase by binding to the catalytic core PSEN-1, thereby inhibiting activation of the γ-secretase/Notch axis and contributing to its anti-TNBC effects.This study supported the development of naturally targeted drugs for TNBC and provided insights into the research on dibenzylisoquinoline alkaloids, such as daurisoline.