Hepatitis B virus （HBV） infection is the primary cause of viral hepatitis and represents a substantial disease burden in China. However， effective and safe agents capable of completely eliminating HBV DNA are still lacking. In modern medicine， anti-HBV strategies mainly target covalently closed circular DNA （cccDNA）， among other mechanisms， and multiple novel drugs are currently under clinical investigation. Traditional medicine has been shown to exert anti-HBV effects through direct pathways， such as blocking viral entry， as well as indirect pathways， including the regulation of programmed cell death. Studies have confirmed that the integration of traditional Chinese medicine （TCM） and Western medicine in treating HBV infection and its related complications offers complementary advantages， particularly in enhancing HBV clearance rates， improving liver function， preventing various complications， and delaying the progression from hepatic fibrosis to hepatocellular carcinoma. This review focuses on advances in anti-HBV research involving TCM， Western medicine， and their integrated application， aiming to provide a basis for integrated HBV therapy and new drug development.

Objective To analyze the incidence rate and risk factors of atrial fibrillation (AF) in elderly patients with chronic obstructive pulmonary disease (COPD). Methods A total of 392 patients with COPD in the hospital were selected from December 2020 to December 2024. Patients' data (medical history, echocardiographic data, etc.) were recorded. The incidence rate of AF in patients was recorded and the patients were grouped according to whether or not they developed AF. The differences were compared between the two groups, and the risk factors of AF occurrence in elderly patients with COPD were analyzed. Results Among the 392 patients with COPD, 127 cases (32.40%) met the diagnostic criteria of AF. There were statistically significant differences in age, pulmonary infection, heart failure, diabetes, smoking history, disease duration, LAD, severe renal insufficiency and coronary heart disease between the AF group and the non-AF group (P<0.05). Multivariate logistic regression analysis suggested that age, pulmonary infection, heart failure, diabetes mellitus, smoking history, disease course, LAD, severe renal insufficiency and coronary heart disease were all risk factors for elderly patients with COPD (OR=1.129, 4.246, 3.955, 4.125, 2.038, 1.112, 1.102, 4.397, and 3.865, P<0.05). Conclusion The incidence rate of AF is high in elderly patients with COPD. Age, pulmonary infection, heart failure, diabetes mellitus, smoking history, course of disease, LAD, severe renal insufficiency, and coronary heart disease are all risk factors for AF.

Background and aims The mechanism of cholestatic liver injury (CLI) is unclear, and effective therapies are lacking. While peroxisome proliferator-activated receptor alpha (PPARα) agonists show potential hepatoprotective effect and pyroptosis is implicated in hepatocellular damage, how PPARα activation mitigates lithocholic acid (LCA)-induced pyroptosis remains unknown. Methods The hepatoprotective effect of PPARα agonists was evaluated in a mouse model of intrahepatic cholestasis induced by LCA. Liver injury was assessed via serum biochemistry, hematoxylin and eosin and TUNEL staining, and electron microscopy. Pyroptosis pathways were analyzed using real-time quantitative polymerase chain reaction, Western blot, and co-immunoprecipitation. Results Combined morphological, histopathological, and biochemical analyses confirmed that PPARα activation protects against CLI. Compared with LCA treatment alone, PPARα activation significantly attenuated the elevation of serum lactate dehydrogenase (LDH), the increased TUNEL-positive cells, and the formation of hepatocyte membrane pores. Mechanistically, PPARα activation suppressed both NOD-like receptor protein 3 (NLRP3) inflammasome-mediated pyroptosis and apoptosis protease-activating factor-1 (APAF-1)/CASPASE-3/GSDME-mediated pyroptosis. Furthermore, PPARα agonist pretreatment inhibited activation of the nuclear factor-kappa B (NF-κB) and forkhead box O1 (FOXO1) signaling pathways. Conclusions PPARα protects against LCA-induced CLI by inhibiting both NLRP3 inflammasome-mediated pyroptosis associated with NF-κB and APAF-1/CASPASE-3/GSDME-mediated pyroptosis associated with the FOXO1 signaling pathway.

AIM To investigate the protective effects of Shuangyi Qushi Tongluo Capsules(Shuangyi Capsules)on Dexamethasone(Dex)induced osteoporosis in mice.METHODS The C57BL/6J mice were randomly divided into the control group,the model group,the Xianling Gubao Capsules group(1.5 g/kg),and the low-dose,moderate-dose,and high-dose Shuangyi Capsules groups(0.6,1.2,and 2.4 g/kg).The mouse model of osteoporosis was induced by 8-week intraperitoneal injection of Dex sodium phosphate injection(5 mg/kg).The mice had their femur osteogenesis observed with hematoxylin and eosin(HE)staining and tartrate-resistant acid phosphatase(TRAP)staining;their serum alkaline phosphatase(ALP)and osteocalcin(BGP)activities detected by ELISA;their femoral mRNA expressions of Col-Ⅰ,OCN,and OPN detected by RT-qPCR;and their femoral protein expressions of OPG and RANKL detected by Western blot.Upon the MC3T3-E1 cells exposed to Dex and Shuangyi Capsules,their viability was evaluated by CCK-8 assay;their mineralization determined by alkaline phosphatase staining and alizarin red staining(ARS);and their intracellular ROS level detected using DCFH-DA probe.RESULTS Compared with the model group,Shuangyi Capsules groups demonstrated improved fracture of femoral trabeculae and reduced number of osteoclasts;increased serum ALP and BGP activities(P＜0.05,P＜0.01);increased femoral expressions of Col-Ⅰ mRNA and OPG protein(P＜0.05,P＜0.01);and decreased RANKL protein expression(P＜0.05).Compared with the MC3T3-E1 cells stimulated by Dex,those underwent further treatment of Shuangyi Capsules demonstrated increased cell viability and ALP activity(P＜0.05,P＜0.01);increased mineralization and calcium nodule formation;increased expressions of Col-Ⅰ,OCN,OPN mRNA and OPG protein(P＜0.05,P＜0.01);decreased RANKL protein expression(P＜0.05,P＜0.01);and reduced ROS levels.CONCLUSION Shuangyi Capsules ameliorate Dex-induced osteoporosis in mice by suppressing osteoclast overactivation,enhancing osteoblast activity,and stimulating bone formation through modulation of Col-Ⅰ,OCN,OPN mRNA and OPG/RANKL protein levels.

Objective:To establish a stable rat model of sequelae of pelvic inflammatory disease(SPID)with clinical characteristics,and to provide a reliable experimental model for the study of the pharmcological effect and mechanism of SPID.Methods:Twenty-four 7-week-old SD rats were divided into sham operation group,model-A(108 cfu/mL mixed bacterial solution,0.2 mL),model-B(109 cfu/mL mixed bacterial solution 0.2 mL),and model-C(108 cfu/mL E.coli 0.2 mL).The weight of the rat's uterine was weighed and the uterine index was calculated.The automatic hematology analyzer was used to detect the blood routine;hematoxylin-eosin staining(HE)and masson staining were used to detect uterine pathlogical changes in rats.Enzyme-linked immunosorbent assay(ELISA)was used to detect interleukin-1β(IL-1β),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in rat uterine tissue homogenates.Western blot was used to detect the expression of proteins related to NF-κB signaling pathway.Results:Compared with the sham operation group,the uterine index of model-A,model-B,and model-C were significantly increased(P＜0.05,P＜0.01).The levels of WBC and NE in the model-A increased significantly(P＜0.01).The level of LY in model-B decreased significantly(P＜0.01).The levels of IL-1β,TNF-α in model-A,model-B,and model-C were significantly increased(P＜0.01).The levels of IL-6 in model-A and model-B were significantly increased(P＜0.05,P＜0.01).The collagen volume fraction of model-A and model-B were significantly increased(P＜0.01).Mechanism study indicates that the expression levels of p-IKKβ/IKKβ,p-IκBα/IκBα and p-p65/p65 in model-A were significantly increased(P＜0.01),and the expression levels of IκBα/β-actin were significantly decreased(P＜0.01).The expression level of p-IKKβ/IKKβ in model-B was significantly increased(P＜0.01).Conclusions:A stable rat model of SPID that conforms to clinical characteristics can be successfully constructed by combining 0.2 mL of mixed bacterial solution with a concentration of 108 cfu/mL and mechanical injury.This modeling method intervened in the expression of the NF-κB inflammatory signaling pathway.

Objective To explore the role of miR-1260b targeting activating transcription factor 6β(ATF6β)in osteogenic differentia-tion of human periodontal ligament stem cells(hPDLSCs).Methods The periodontal ligament tissue was scraped from the third molar extracted from the patient with periodontitis,and hPDLSCs were isolated and cultured.The proportions of positive cells of CD34,CD45,CD29,CD90 and CD105 were detected by flow cytometry,and the expression of vimentin and pan-cytokeratin were detected by immunofluo-rescence staining.The cellular luciferase activities of ATF6β-WT and ATF6β-MUT in the miR-1260b mimic+WT/MUT group(transfected with miR-1260b mimic and ATF6β-WT/MUT)and the mimic-NC group(transfected with miR-NC and ATF6β-WT/MUT)were analyzed by the dual luciferase reporter gene assay.In addition,the cells were divided into the miR-1260b mimic group(transfected with miR-1260b mimic alone),the ATF6β-OE group(transfected with the ATF6β overexpression vector alone),the combined group(transfected with miR-1260b mimic and ATF6β overexpression vector simultaneously),and the NC group(transfected with empty vector).Alizarin red S staining and alkaline phosphatase staining were performed on hPDLSCs in the NC group,the miR-1260b mimic group,the ATF6β-OE group and the combined group.Meanwhile,the mRNA expression levels of miR-1260b,ATF6β,Runt-related transcription factor 2(Runx2),osteocalcin(OCN),and osteopontin(OPN)in each group of cells were detected by qRT-PCR.The protein expressions of glucose-regulated protein 78(GRP78),C/EBP homologous protein(CHOP),and protein kinase R-like endoplasmic reticulum kinase(PERK)in each group of cells were detected by Western blot.Results The flow cytometry detection showed that CD29,CD90 and CD105 on the surface of the isolated and cultured cells were positive,while CD34 and CD45 were negative.Immunofluorescence staining showed that vimentin in the cells was positive and pan-cytokeratin was negative,which was in line with the characteristics of hPDLSCs.Luciferase assay showed that miR-1260b mimic could significantly reduce the luciferase activity of ATF6β-WT(P<0.05),but had no significant effect on the luciferase activity of ATF6β-MUT(P>0.05).After alizarin red S staining,the staining of hPDLSCs gradually deepened after 3 days,5 days and 7 days of culture,suggesting an enhanced osteogenic differentiation ability.With the enhancement of osteogenic differentiation ability of hPDLSCs,the expression of miR-1260b in the cells showed a gradually increasing trend,while the mRNA and protein expression levels of ATF6β showed a gradually decreasing trend(P<0.05).The results of alizarin red S staining and alkaline phosphatase staining showed that the proportions of positive area in the miR-1260b mimic group were higher than those in the NC group(P<0.05),while the proportions of positive area in the ATF6β-OE group and the combined group were lower than those in the NC group(P<0.05).The mRNA and protein levels of ATF6β in the miR-1260b mimic group were lower than those in the NC group(P<0.05),while the mRNA and protein levels of ATF6β in the ATF6β-OE group and the combined group were higher than those in the NC group(P<0.05).The mRNA levels of Runx2,OCN and OPN in the miR-1260b mimic group were significantly higher than those in the NC group(P<0.05).The mRNA levels of Runx2,OCN and OPN in the ATF6β-OE group and the combined group were significantly lower than those in the NC group(P<0.05).The protein expression levels of GRP78,CHOP and PERK in the miR-1260b mimic group were significantly lower than those in the NC group(P<0.05).The protein expression levels of GRP78,CHOP and PERK in the ATF6β-OE group and the combined group were significantly higher than those in the NC group(P<0.05).Conclusion miR-1260b can inhibit endoplasmic reticulum stress level and promote osteogenic differentiation of hPDLSCs by targeting ATF6β.

Objective To analyze the association between lifestyle and the risk of type 2 diabetes(T2D)among adult residents.Methods The data was sourced from the Shanghai Suburban Adult Cohort and Biobank.A total of 42 096 adult residents who had not developed T2D were recruited from four districts of Shanghai(Songjiang,Jiading,Minhang,and Xuhui)between 2016 and 2019.The follow-up ended on Feb 28,2023.A structured questionnaire was used to collect information on six lifestyle-related items,including smoking,alcohol consumption,BMI,waist circumference(WC),physical activity,and diet.The unhealthy lifestyle scores(UHLS)were calculated by counting the number of all the unhealthy lifestyle items,with a range of 0-6.New-onset T2D events diagnosed by physicians were obtained through the medical information system.Cox proportional hazards regression model and restricted cubic spline model were utilized to evaluate the association between unhealthy lifestyles and the risk of T2D incidence.Results About 28.1%of the participants led 4-6 unhealthy lifestyles.A total of 1 752 new T2D cases were identified during 218 513.4 person-years of follow-up.Analysis of single unhealthy lifestyle showed that abnormal WC(HR=1.5,95%CI:1.4-1.7)and abnormal BMI(HR=1.3,95%CI:1.2-1.5)were associated with an increased risk of T2D.Compared with individuals with a UHLS of 0-1,those with a UHLS of 3 and 4-6 had 30%(95%CI:1.1-1.6)and 50%(95%CI:1.2-1.8)higher risks of T2D,respectively.Each additional unhealthy lifestyle was associated with a 10%increase in T2D incidence risk(HR=1.1,95%CI:1.1-1.2).Conclusion The risk of T2D in adult residents increases with the cumulative number of unhealthy lifestyles.Adult residents with abnormal WC or BMI,or have three or more unhealthy lifestyles accumulated,will increase the risk of new-onset T2D.

Objective:To explore the effect of electric acupuncture combined with Tianding acupoint on the efficacy,syndrome score,and quality of life of post-stroke intractable hiccup(IH).Methods:A total of 102 post-stroke IH patients admitted to our hospital from October 2022 to October 2023 were retrospectively included,and were divided into control group and observation group,with 51 cases in each group.The matched group patients were given conventional acupuncture treatment,while the observation group patients were given conventional electric acupuncture combined with Tianding acupoint treatment.The clinical efficacy,effectiveness,hiccup symptom scores before and Post-treatment,and quality of life score between two groups of patients.Results:The proportion of patients in the observation group who took immediate effect(27.45％vs.5.88％)and the proportion of patients who took effect within 24 hours of the first treatment(60.78％vs.17.65％)were higher than matched group.The average onset time[(32.14±9.72)h vs.(70.34±23.51)h]was significantly shorter than matched group(P＜0.05).The treatment recovery rate of observation group was higher than matched group(80.39％vs.50.98％,P＜0.05),and the total effective rate of treatment was not different from matched group(96.08％vs.86.27％,P＞0.05).Post-treatment,both groups of patients showed a significant decrease in hiccup symptom scores,and there were significant differences at different time points(P＜0.05).The hiccup symptom scores of the observation group patients at 1 d,3 d,and 5 d post-treatment were lower than matched group(P＜0.05).Post-treatment,the overall scores of appetite,mental state,sleep,and quality of life in both groups increased,and the scores in the observation group were higher than matched group(P＜0.05).Conclusion:The combination of electric acupuncture and Tianding acupoint has a significant therapeutic effect on post-stroke IH,which can quickly take effect,improve patients'clinical symptoms,and enhance their quality of life.

Objective To examine the predictive value of coronary artery calcification score on low-dose helical CT(LDCT)in patients with unstable angina pectoris.Methods One hundred thirty-two patients with unstable angina who underwent LDCT and coronary angiography(CAG)were retrospectively analyzed.Clinical characteristics,calcification scores,and CAG findings were recorded.Patients underwent follow-up to record the occurrence of major adverse cardiovascular events(MACE).Univariate and multivariate analyses were performed to determine the relationship between calcification score and severity of disease.Results(1)LDCT calcification score significantly differed between the no-vessel disease,single-vessel disease,two-vessel disease,and three-vessel disease groups(P=0.001).LDCT calcification score was associated with three-vessel disease on CAG.For each 100-point increase in LDCT calcification score,the probability of three-vessel disease increased by 12％(95％CI 1.04-1.20,P=0.003).Compared with patients with mild calcification(score＜100 Agatston units),patients with moderate(score 100-399 Agatston units)and severe(score≥400 Agatston units)calcification were 3.69 times(95％CI 1.27-10.76,P=0.017)and 5.48 times(95％CI 1.87-16.02,P=0.002)more likely to have three-vessel disease,respectively.(2)Patients with LDCT calcification score≥ 196.05 Agatston units were more likely to have three-vessel disease.The sensitivity,specificity,and accuracy of LDCT calcification score≥ 196.05 Agatston units for diagnosing three-vessel coronary artery disease was 0.72,0.65,and 0.67,respectively;the area under the receiver operating characteristic curve was 0.699.(3)The odds of coronary revascularization during follow-up were 8.23 times(95％CI 1.12-60.67,P=0.039)higher in patients with severe calcification than in those without it.Conclusions LDCT can predict CAD in patients with unstable angina,especially severe disease,and is related to MACE.

Purpose To summarize the clinical pathological and immunohistochemical characteristics of esophage-al carcinoma with ductal differentiation of esophageal gland,and analyze the somatic mutation characteristics,key driv-ing mutation genes,and significantly mutated genes based on whole exome sequencing.Methods The clinicopatho-logical features of 9 cases of esophageal carcinoma with esophageal duct differentiation were retrospectively analyzed,and the immunohistochemistry EnVision two-step method was used to stain them,and 3 of the samples were subjected to whole exome sequencing and data analysis.Results Among the 9 patients,6 were males and 3 were females.The average age was 68.3 years old(61-80 years old).All 9 cases were located in the middle-lower segment of the e-sophagus.The diameter of the lesion was from 1.5 cm to 3.5 cm.Most areas of the tumor had a double-layer epithelial structure,including the inner layer of luminal epithelium and the outer layer of basal epithelium.Focal areas could be seen with keratinization and mucinous cells.Immunohistochemistry showed that CK7 was positive in the inner epitheli-um,while p63 was positive in the outer basal epithelium.S-100,SOX10 and c-myb were all negative,and p53 was mutated(diffuse strongly positive).The results of whole exome sequencing analysis showed somatic mutation character-istics(796 SNV,37 InDel,482 CNV),key driving mutation genes(12),and significantly mutated genes(TP53).No intraepithelial neoplasia was observed on the surface squamous epithelium of all cases,and no Barrett's esophagus or ectopic gastric mucosa was observed.The average follow-up time was 21.9 months(8 days-51 months),with 8 ca-ses surviving and 1 case dying of severe pulmonary infection 8 days after surgery.Conclusion Esophageal carcinoma with ductal differentiation of esophageal gland is a rare epithelial derived malignant tumor of the esophagus,character-ized by unique morphological,immunohistochemical,and molecular changes.