1.Effect of lncRNA-TNFRSF13C on hypoxia-inducible factor 1alpha in periodontal cells by modulation of miR-1246
Jing BAI ; Xue ZHANG ; Yan REN ; Yuehui LI ; Xiaoyu TIAN
Chinese Journal of Tissue Engineering Research 2025;29(5):928-935
BACKGROUND:LncRNA-TNFRSF13C,an important factor in B cell development and function,is expressed in periodontal tissues of patients with periodontitis,but the specific mechanism is still unclear. OBJECTIVE:To investigate the mechanism of lncRNA-TNFRSF13C regulating miR-1246 on hypoxia-inducible factor 1α in periodontal cells. METHODS:Human periodontal ligament cells(hPDLCs)were treated with lipopolysaccharide and divided into group A(hPDLCs cell lines without transfection),group B(hPDLCs cell lines transfected with TNFRSF13C NC-siRNA),group C(hPDLCs cell lines transfected with TNFRSF13C-siRNA),group D(hPDLCs cell line transfected with miR-1246 mimics),group E(hPDLCs cell line transfected with miR-1246 siRNA),group F(hPDLCs cell line transfected with TNFRSF13C-siRNA+miR-1246 mimics),and group G(hPDLCs cell line transfected with TNFRSF13C-siRNA+miR-1246 siRNA).The relative expression of lncRNA-TNFRSF13C and miR-1246 in each group was detected by qRT-PCR.Cell counting kit-8 assay was used to detect cell viability.Apoptosis was detected by flow cytometry.Expression of hypoxia-inducible factor 1α and vascular endothelial growth factor proteins was detected by western blot.The correlation between lncRNA-TNFRSF13C and miR-1246 was analyzed by Pearson,and the targeting relationship was analyzed by dual-luciferase reporter assay. RESULTS AND CONCLUSION:There was no significant difference in human periodontal ligament cell activity,apoptosis rate and protein indexes between groups A and B(P>0.05).Compared with group B,hPDLCS cell activity in group C was increased,and apoptosis rate and the expression of hypoxia-inducible factor 1α and vascular endothelial growth factor proteins were decreased(P<0.05).Compared with group C,hPDLCS cell activity in group D was decreased,and apoptosis rate and the expression of hypoxia-inducible factor 1α and vascular endothelial growth factor proteins were increased(P<0.05).Compared with group D,the cell activity of group E was increased(P<0.05).The cell activity in group F was lower than that in group E,and the apoptosis rate was reduced in both groups E and F(P<0.05).Compared with group F,the cell activity of group G was increased,and the apoptosis rate and the expression of hypoxia-inducible factor 1α and vascular endothelial growth factor were decreased(P<0.05).LncRNA-TNFRSF13C was positively correlated with miR-1246(P<0.05).Compared with the TNFRSF13C-siRNA group,the fluorescence activity of miR-1246-wt in the TNFRSF13C-NC group was reduced(P>0.05);compared with the miR-1246-NC group,the fluorescence activities of hypoxia-inducible factor 1α-wt and vascular endothelial growth factor-wt in the miR-1246 mimics group were increased(P<0.05).To conclude,down-regulation of lncRNA-TNFRSF13C can promote the activity of periodontal cells treated with lipopolysaccharide,reduce apoptosis,and inhibit hypoxia-inducible factor 1α and vascular endothelial growth factor.The mechanism is related to the regulation of miR-1246 activity.
2.Pathogenesis and treatment progress of flap ischemia-reperfusion injury
Bo HE ; Wen CHEN ; Suilu MA ; Zhijun HE ; Yuan SONG ; Jinpeng LI ; Tao LIU ; Xiaotao WEI ; Weiwei WANG ; Jing XIE
Chinese Journal of Tissue Engineering Research 2025;29(6):1230-1238
BACKGROUND:Flap transplantation technique is a commonly used surgical procedure for the treatment of severe tissue defects,but postoperative flap necrosis is easily triggered by ischemia-reperfusion injury.Therefore,it is still an important research topic to improve the survival rate of transplanted flaps. OBJECTIVE:To review the pathogenesis and latest treatment progress of flap ischemia-reperfusion injury. METHODS:CNKI,WanFang Database and PubMed database were searched for relevant literature published from 2014 to 2024.The search terms used were"flap,ischemia-reperfusion injury,inflammatory response,oxidative stress,Ca2+overload,apoptosis,mesenchymal stem cells,platelet-rich plasma,signaling pathways,shock wave,pretreatment"in Chinese and English.After elimination of irrelevant literature,poor quality and obsolete literature,77 documents were finally included for review. RESULTS AND CONCLUSION:Flap ischemia/reperfusion injury may be related to pathological factors such as inflammatory response,oxidative stress response,Ca2+overload,and apoptosis,which can cause apoptosis of vascular endothelial cells,vascular damage and microcirculation disorders in the flap,and eventually lead to flap necrosis.Studies have found that mesenchymal stem cell transplantation,platelet-rich plasma,signaling pathway modulators,shock waves,and pretreatment can alleviate flap ischemia/reperfusion injuries from different aspects and to varying degrees,and reduce the necrosis rate and necrosis area of the grafted flap.Although there are many therapeutic methods for skin flap ischemia/reperfusion injury,a unified and effective therapeutic method has not yet been developed in the clinic,and the advantages and disadvantages of various therapeutic methods have not yet been compared.Most of the studies remain in the stage of animal experiments,rarely involving clinical observations.Therefore,a lot of research is required in the future to gradually move from animal experiments to the clinic in order to better serve the clinic.
3.Mechanism of Lijin manipulation regulating scar formation in skeletal muscle injury repair in rabbits
Kaiying LI ; Xiaoge WEI ; Fei SONG ; Nan YANG ; Zhenning ZHAO ; Yan WANG ; Jing MU ; Huisheng MA
Chinese Journal of Tissue Engineering Research 2025;29(8):1600-1608
BACKGROUND:Lijin manipulation can promote skeletal muscle repair and treat skeletal muscle injury.However,the formation of fibrosis and scar tissue hyperplasia are closely related to the quality of skeletal muscle repair.To study the regulatory effect of Lijin manipulation on the formation of fibrosis and scar tissue hyperplasia is helpful to explain the related mechanism of Lijin manipulation to improve the repair quality of skeletal muscle injury. OBJECTIVE:To explore the mechanism of Lijin manipulation to improve the repair quality of skeletal muscle injury in rabbits,thereby providing a scientific basis for clinical treatment. METHODS:Forty-five healthy adult Japanese large-ear white rabbits were randomly divided into blank group,model group and Lijin group,with 15 rats in each group.Gastrocnemius strike modeling was performed in both model group and Lijin group.The Lijin group began to intervene with tendon manipulation on the 3rd day after modeling,once a day,and 15 minutes at a time.Five animals in each group were killed on the 7th,14th and 21st days after modeling.The morphology and inflammatory cell count of gastrocnemius were observed by hematoxylin-eosin staining,the collagen fiber amount was observed by Masson staining,the expression of interleukin-6 and interleukin-10 in gastrocnemius was detected by ELISA.The protein and mRNA expressions of paired cassette gene 7,myogenic differentiation factor,myoblastogenin,alpha-actin,transforming growth factor beta 1,and type Ⅰ collagen were detected by western blot and RT-PCR,respectively,and the expression of type Ⅰ collagen protein was detected by immunohistochemistry. RESULTS AND CONCLUSION:Hematoxylin-eosin staining and Masson staining showed that compared with the model group,inflammatory cell infiltration and collagen fiber content decreased in the Lijin group(P<0.01),and the muscle fibers gradually healed.ELISA results showed that compared with the model group,the expression of interleukin-6 in the Lijin group continued to decrease(P<0.05),and the expression of interleukin-10 increased on the 7th day after modeling(P<0.05)and then showed a decreasing trend(P<0.05).Western blot and RT-PCR results showed that compared with the model group,the protein and mRNA expressions of paired cassette gene 7,myogenic differentiation factor,myoblastogenin in the Lijin group were significantly increased on the 14th day after modeling(P<0.05),but decreased on the 21st day(P<0.05);the protein and mRNA expressions of alpha-actin,transforming growth factor beta 1,and type Ⅰ collagen in the Lijin group were significantly decreased compared with those in the model group(P<0.05).Immunohistochemical results showed that the expression of type Ⅰ collagen in the Lijin group was significantly lower than that in the model group(P<0.05).To conclude,Lijin manipulation could improve the repair quality of skeletal muscle injury by inhibiting inflammation,promoting the proliferation and differentiation of muscle satellite cells,and reducing fibrosis.
4.Analysis of the “appeal to nature” argument: taking human gene enhancement technology as an example
Chinese Medical Ethics 2025;38(4):468-475
Since ancient Greece, technology has been viewed as the antithesis of nature, and philosophers have often resorted to the moralistic concept of nature to criticize “unnatural” technologies. In recent years, the “appeal to nature” argument has gradually become one of the arguments for denying the legitimacy of emerging technologies. This argument argues that technology or behavior has no ethical justification because it breaks through pre-existing natural limitations. Human gene enhancement technology breaks the natural restrictions on humans by modifying the human genetic structure, and this transformation makes it the focus of the “appeal to nature” argument. However, the reliability of the “appeal to nature” argument has not been clarified as it should be. This paper analyzed and reshaped the “appeal to nature” argument for human genetic enhancement technology, examined the validity of the argument structure and the reliability of the argument premise of the “appeal to nature” argument, demonstrated the limitations of the “appeal to nature” argument, and freed the development of emerging technologies from the accusations of unreliable “appeal to nature” argument.
5.Management status and influencing factors of disease stabilization in patients with severe mental disorders in Luzhou City, Sichuan Province
Xuemei ZHANG ; Bo LI ; Benjing CAI ; Youguo TAN ; Bo XIANG ; Jing HE ; Qidong JIANG ; Jian TANG
Sichuan Mental Health 2025;38(2):131-137
BackgroundSevere mental disorders represent a major public health concern due to the high disability rates and substantial disease burden, which has garnered significant national attention and prompted their inclusion in public health project management systems. However, credible evidence regarding the current status of disease management and factors influencing disease stabilization among patients with severe mental disorders in Luzhou City, Sichuan Province, remains limited. ObjectiveTo investigate the current management status of patients with severe mental disorders in Luzhou City, Sichuan Province, and to analyze influencing factors of disease stabilization among patients under standardized care, so as to provide evidence-based insights for developing targeted management strategies to optimize clinical interventions for this patient population. MethodsIn March 2023, data were extracted from the Sichuan Mental Health Service Comprehensive Management Platform for patients with severe mental disorders in Luzhou City who received management between December 2017 and December 2022. Information on mental health service utilization and clinical status changes was collected. Trend analysis was conducted to evaluate temporal changes in key management indicators for severe mental disorders in Luzhou City. Logistic regression analysis was employed to identify factors influencing the disease stabilization or fluctuation of these patients. ResultsThis study enrolled a total of 20 232 patients. In Luzhou City, the stabilization rate and standardized management rate of severe mental disorders were 94.89% and 79.36% in 2017, respectively, which increased to 95.33% and 96.92% by 2022. The regular medication adherence rate rose from 34.42% in 2018 to 86.81% in 2022. In 2022, the regular medication adherence rate was 71.80% for schizophrenia, 55.26% for paranoid psychosis, and 51.43% for schizoaffective disorder. Multivariate analysis identified the following protective factors for disease stabilization: age of 18~39 years (OR=0.613, 95% CI: 0.409~0.918), age of 40~65 years (OR=0.615, 95% CI: 0.407~0.931), urban residence (OR=0.587, 95% CI: 0.478~0.720), and regular medication adherence (OR=0.826, 95% CI: 0.702~0.973). Risk factors for disease fluctuation included poor (OR=1.712, 95% CI: 1.436~2.040), non-inclusion in care-support programs (OR=1.928, 95% CI: 1.694~2.193), non-participation in community rehabilitation (OR=2.255, 95% CI: 1.930~2.634), and intermittent medication adherence (OR=3.893, 95% CI: 2.548~5.946). ConclusionThe stability rate, standardized management rate, and regular medication adherence rate of patients with severe mental disorders in Luzhou City have shown a year-by-year increase. Age, household registration status, economic condition, medication compliance, and community-based rehabilitation were identified as influencing factors for disease fluctuation in these patients. [Funded by Luzhou Science and Technology Plan Project (number, 2022-ZRK-186)]
6.The Function of FoxA Gene in Evolution, Development, and Disease
Progress in Biochemistry and Biophysics 2025;52(4):869-881
The FoxA genes belong to a conserved family of transcription factors, that play a crucial role in regulating embryonic development, cellular differentiation, and disease pathogenesis. Initially identified as hepatocyte nuclear factor 3α (Hnf3α), FoxA is pivotal in activating liver-specific genes and contributing to liver morphogenesis. Studies have shown that FoxA proteins interact with specific DNA sequences and nucleosome-bound DNA, altering the local chromatin structure to regulate gene expression. The unique ability has earned them the designation of “pioneer factors”. The FoxA family comprises three members: FoxA1, FoxA2, and FoxA3. FoxA1 is predominantly expressed in endoderm-derived organs such as the lungs, liver, pancreas, and prostate, where it regulates hormone metabolism, cell cycle, and cell proliferation. FoxA2 is primarily expressed in the floor plate of the vertebrate spinal cord, where it plays a key role in establishing the dorsal-ventral patterning of the neural tube. FoxA3 is mainly expressed in the testes, where it regulates germ cell formation. FoxA genes exhibit functional diversity in embryonic development across different species, offering insights into their evolutionary roles. For instance, zebrafish embryos with mutations in the foxa2-/- gene can survive, providing an opportunity to study embryonic development mechanisms. Currently, a growing body of research suggests that FoxA genes are involved in early embryonic development, cancer, and metabolism-related diseases. This paper summarizes the discovery, expression patterns, and biological functions of the FoxA genes while identifying key scientific questions that remain unresolved. It aims to provide readers a solid scientific basis for understanding the molecular mechanisms through which FoxA genes regulate embryonic development and contribute to cancer pathogenesis.
7.Improvement effects and mechanism of urinastatin on cisplatin-induced myocardial injury
Jiafu REN ; Pengfei CHEN ; Rong A ; Jing LI
China Pharmacy 2025;36(8):920-925
OBJECTIVE To investigate the improvement effects and potential mechanism of ulinastatin (UTI) on cisplatin (CP)-induced myocardial injury. METHODS Rabbits were used as study subjects and randomly divided into blank group (normal saline 2 mL/d, for consecutive 7 d), CP group (150 mg/m2, on the 1st and 4th day), UTI low-dose/high-dose group (UTIL/UTIH group, UTL 25 000 or 50 000 IU/kg, once a day, for consecutive 7 d), c-Jun N-terminal kinase (JNK) inhibitor group (JNKi group, SP600125 15 mg/kg, on the 1st and 4th day+CP 150 mg/m2, on the 1st and 4th day+normal saline 2 mL/d, on the other 5 days). Except for the blank group, rabbits in the other groups were injected with relevant medicine and/or normal saline via a marginal ear vein on one side. The serum level of cardiac troponin Ⅰ (cTnⅠ) in rabbits on the 1st and 8th days of the detection experiment, as well as the levels of superoxide dismutase (SOD), glutathione (GSH) and malondialdehyde (MDA) in myocardial tissue on the 8th day of the experiment, were all measured in each group. The pathological changes and myocardial cell apoptosis in myocardial tissue were observed, and the protein expressions of B-cell lymphoma-2 (Bcl-2), Bcl-2 associated X protein (Bax), JNK, phosphorylated JNK (P-JNK), mitochondrial fission factor (Mff), and dynamin-related protein 1 (Drp1) in myocardial tissue were all determined. RESULTS Compared with the blank group, the CP group showed significant myocardial injury. The cell apoptotic rate, the levels of cTnⅠ in serum and MDA in myocardial tissue, as well as protein expressions of Bax, JNK, p-JNK, Mff, and Drp1, were all significantly increased or up-regulated, SOD level and protein expression of Bcl-2 significantly reduced or down+regulated(P<0.05). Compared with the CP group, the myocardial injury in rabbits from each drug treatment group showed improvement. The cell apoptosis index, the levels of cTnⅠ in serum and MDA in myocardial tissue, as well as protein expressions of Bax, JNK, p-JNK, Mff (except for UTIL group), and Drp1, were all significantly reduced or down-regulated, while SOD, GSH level and protein expression of Bcl-2 significantly increased or up-regulated (P<0.05); moreover, the improvement in some indicators was significantly better in the UTIH group and the JNKi group compared to the UTIL group (P<0.05). CONCLUSIONS UTI may ameliorate CP-induced myocardial injury, the potential mechanism of which may be associated with antagonizing oxidative stress and inhibiting the JNK/Mff signaling pathway.
8.Association between placental cortisol and neurodevelopment in 3-month-old infants
Shuangjie YU ; Jinfang ZHANG ; Ye LI ; Jing FAN ; Can LIU ; Suzhen GUAN
Journal of Environmental and Occupational Medicine 2025;42(4):420-426
Background During pregnancy, negative emotions such as anxiety and depression may induce cortisol disruption. Cortisol can be transmitted to the fetus through the placental barrier, thereby affecting the neurodevelopment of the offspring. Objective To investigate the relationship between placental cortisol, maternal depression during pregnancy, and neurodevelopment of 3-month-old infants. Methods From September 2022 to September 2023, 171 pregnant women ordered routine prenatal checks at the obstetrics outpatient department of a tertiary hospital in Ningxia were selected using a prospective cohort design. After providing informed consent, these women participated in a questionnaire survey that covered general individual characteristics, prenatal depression, and sleep quality. At birth, placental samples were collected to measure cortisol levels using ELISA kits. Follow-up assessments on the neurodevelopmental of 3-month-old infants were conducted using the Warning Sign for Children Mental and Behavioral Development. LASSO regression analysis was conducted to screen the influencing factors of depression during pregnancy. Huber regression analysis was then applied to assess potential linear relationship between depression during pregnancy and placental cortisol levels. Log-binomial regression was used to analyze the linear relationships between cortisol levels and neurodevelopmental delay in 3-month-old infants. Additionally, a mediation effect model was fitted using R 4.3.3 to assess possible mediating role of cortisol in the association between prenatal depression and neurodevelopmental delay in 3-month-old infants. Results The positive rate of prenatal depression was 33.33%. Nine factors affecting prenatal depression were identified by LASSO regression, including rural residence, high school education or above, extroverted personality characteristics, moderate early pregnancy reactions, baby sex expectation, prenatal anxiety, family dysfunction, exposure to stressful life events during pregnancy, and moderate prenatal sleep quality. The Huber regression model showed a positive linear correlation between prenatal depression and placental cortisol (P<0.05). With or without controlling confounding factors, the results of log-binomial regression modeling showed that cortisol levels were associated with a reduced risk of neurodevelopmental delay in 3-month-old infants (crude model: RR=0.988, 95%CI:
9.Prevalence, influencing factors, and fibrosis risk stratification of metabolic dysfunction-associated fatty liver disease in the health check-up population in Beijing, China
Haiqing GUO ; Mingliang LI ; Feng LIU ; Jing ZHANG
Journal of Clinical Hepatology 2025;41(4):643-649
ObjectiveTo identify the patients with metabolic dysfunction-associated fatty liver disease (MAFLD) among the health check-up population, and to perform stratified management of patients with the low, medium, and high risk of advanced fibrosis based on noninvasive fibrosis scores. MethodsA cross-sectional study was conducted among 3 125 individuals who underwent physical examination in Beijing Physical Examination Center from December 2017 to December 2019, and they were divided into MAFLD group with 1 068 individuals and non-MAFLD group with 2 057 individuals. According to BMI, the MAFLD group was further divided into lean MAFLD group (125 individuals with BMI<24 kg/m2) and non-lean MAFLD group (943 individuals with BMI≥24 kg/m2). Indicators including demographic data, past history, laboratory examination, and liver ultrasound were compared between groups. Fibrosis-4 (FIB-4) score, NAFLD fibrosis score (NFS), aspartate aminotransferase-to-platelet ratio index (APRI), and BARD score were calculated for the patients in the MAFLD group to assess the risk of advanced fibrosis. The independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups. A logistic regression analysis was used to investigate the influence of each indicator in MAFLD. ResultsCompared with the non-MAFLD group, the MAFLD group had significantly higher age (Z=-9.758, P<0.05), proportion of male patients (χ2=137.555, P<0.05), and levels of body weight (Z=-27.987, P<0.05), BMI (Z=-32.714, P<0.05), waist circumference (Z=-31.805, P<0.05), hip circumference (Z=-26.342, P<0.05), waist-hip ratio (Z=-28.554, P<0.05), alanine aminotransferase (ALT) (Z=-25.820, P<0.05), aspartate aminotransferase (AST) (Z=-16.894, P<0.05), gamma-glutamyl transpeptidase (GGT) (Z=-25.069, P<0.05), alkaline phosphatase (Z=-12.533, P<0.05), triglyceride (Z=-27.559), total cholesterol (Z=-7.833, P<0.05), low-density lipoprotein cholesterol (LDL-C) (Z=-8.222, P<0.05), and uric acid (UA) (Z=-20.024, P<0.05), as well as a significantly higher proportion of patients with metabolic syndrome (MetS) (χ2=578.220, P<0.05), significantly higher prevalence rates of hypertension (χ2=241.694, P<0.05), type 2 diabetes (χ2=796.484, P<0.05), and dyslipidemia (χ2=369.843, P<0.05), and a significant reduction in high-density lipoprotein cholesterol (HDL-C) (Z=23.153, P<0.001). The multivariate logistic regression analysis showed that male sex (odds ratio [OR]=1.45, 95% confidence interval [CI]: 1.203 — 1.737), ALT (OR=1.05, 95%CI: 1.046 — 1.062), LDL-C (OR=1.23, 95%CI: 1.102 — 1.373), and comorbidity with MetS (OR=5.97, 95%CI: 4.876 — 7.316) were independently associated with MAFLD. Compared with the non-lean MAFLD group, the lean MAFLD group had significantly higher age (Z=3.736, P<0.05) and HDL-C (Z=2.679, P<0.05) and significant reductions in the proportion of male patients (χ2=28.970, P<0.05), body weight (Z=-14.230, P<0.05), BMI (Z=-18.188, P<0.05), waist circumference (Z=-13.451, P<0.05), hip circumference (Z=-13.317, P<0.05), ALT (Z=-4.519, P<0.05), AST (Z=-2.258, P<0.05), GGT (Z=-4.592, P<0.05), UA (Z=-4.415, P<0.05), the proportion of patients with moderate or severe fatty liver disease or MetS (χ2=42.564, P<0.05), and the prevalence rates of hypertension (χ2=12.057, P<0.05) and type 2 diabetes (χ2=3.174, P<0.05). Among the patients with MAFLD, 10 patients (0.9%) had an FIB-4 score of >2.67, 4 patients (0.4%) had an NFS score of >0.676, 8 patients (0.7%) had an APRI of >1, and 551 patients (51.6%) had a BARD score of ≥2. ConclusionThere is a relatively high prevalence rate of MAFLD among the health check-up population in Beijing, but with a relatively low number of patients with a high risk of advanced fibrosis, and such patients need to be referred to specialized hospitals for liver diseases.
10.Value of third lumbar skeletal muscle mass index in predicting the prognosis of patients with acute-on-chronic liver failure
Yewen HAN ; Jing LI ; Ninghui ZHAO ; Jia YAO ; Juan WANG
Journal of Clinical Hepatology 2025;41(4):698-702
ObjectiveTo investigate the value of third lumbar skeletal muscle mass index (L3-SMI) in predicting the long-term prognosis of patients with acute-on-chronic liver failure (ACLF), and to provide a useful tool for prognostic scoring of ACLF patients. MethodsA retrospective analysis was performed for the data of 126 patients who underwent abdominal computed tomography (CT) scanning and were diagnosed with ACLF in Shanxi Bethune Hospital from December 2017 to December 2021, including clinical indicators, biochemical parameters, and model for end-stage liver disease (MELD) score, and L3-SMI was calculated. The independent-samples t test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data between groups. The receiver operating characteristic (ROC) curve was used to assess the diagnostic value of L3-SMI and other variables (MELD score and Child-Pugh score), and the DeLong test was used for comparison of the area under the ROC curve (AUC). ResultsAmong the 126 patients enrolled, 44 (35%) died within 2 years and 82 (65%) survived. Compared with the survival group, the death group had significantly higher age, incidence rate of ascites, international normalized ratio, MELD score, and Child-Pugh score (all P<0.05) and a significantly lower value of L3-SMI [38.40 (35.95 — 46.29) cm²/m² vs 44.19 (40.20 — 48.58) cm²/m², Z=-2.855, P=0.004]. L3-SMI had an AUC of 0.720 in predicting 2-year mortality in ACLF patients, with a sensitivity of 63.6% and a specificity of 80.5%, and a combination of L3-SMI, MELD score, and Child-Pugh score had a significantly better AUC than a combination of MELD score and Child-Pugh score in predicting 2-year mortality (0.809 vs 0.757, Z=2.015, P<0.05). ConclusionL3-SMI has a high predictive value for the prognosis of ACLF patients, and the combination of L3-SMI、MELD score and Child-Pugh score has a higher predictive value for ACLF patients, and the inclusion of L3-SMI or sarcopenia in the conventional prognostic scores of ACLF patients may increase the ability to predict disease progression.

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