[摘 要] 目的：探讨绿茶单体表没食子儿茶素没食子酸酯（EGCG）对大鼠肝癌发生过程中肠道菌群结构变化的影响。方法：建立二乙基亚硝胺（DEN）诱导的肝癌大鼠模型。将26只SD大鼠随机分成3组，分别为正常对照组、肝癌组和EGCG干预组。从实验开始第1天起，EGCG干预组每日给予EGCG（40 mg/kg）灌胃，正常对照组和肝癌组给予等量生理盐水灌胃，1次/日，持续至第20周。灌胃结束后，采集大鼠粪便样本，提取DNA，进行高通量16S rRNA V3-V4区测序；处死大鼠，取肝，观察肿瘤形成情况，并计算肝癌发生率。对测序数据进行生物信息学分析：经质控、聚类获得操作分类单元（OTU）表，据此计算α多样性指数（包括Observed species、Chao1、Shannon和Simpson指数），并进行β多样性分析。同时，对物种进行分类学注释，比较各组间菌群组成与丰度差异。结果： EGCG干预组大鼠（8只）肝脏肿瘤形成率明显低于肝癌组（10只）（50% vs 100%， P = 0.023），正常对照组（8只）大鼠无肿瘤发生。在肠道菌群方面，肝癌组操作分类单元（OTU）数量远低于正常对照组（P <0.001），而EGCG干预组OTU数量总体上高于肝癌组（P = 0.021）。α多样性分析显示，肝癌组Shannon指数低于正常对照组（P < 0.05）；此外，与肝癌组相比，EGCG干预组的Observed species指数、Chao1指数、Shannon指数和Simpson指数均显著提高（P < 0.05）。β多样性分析及主坐标分析（PCoA）表明，三组肠道菌群结构存在显著分离（PERMANOVA， R² = 0.3918， P = 0.001），其中EGCG干预组群落结构介于肝癌组与正常对照组之间，并更接近于正常对照组。肝癌组大鼠较正常大鼠肠道菌群中链球菌等潜在致病菌富集，丁酸产生相关菌（如丁酸球菌属、瘤胃球菌属等）丰度显著降低（P < 0.05）。相比之下，在EGCG干预肝癌发生过程中，大鼠肠道菌群结构相对稳定。厚壁菌门/拟杆菌门比值较肝癌组显著提高（P < 0.05），益生菌（如双歧杆菌属、乳杆菌属等）和丁酸产生相关菌（如丁酸球菌属）富集。结论：EGCG干预可降低DEN诱导的大鼠肝癌发生率，并有助于稳定肠道菌群结构，其作用可能与增加菌群多样性、促进益生菌及丁酸产生菌富集、恢复菌群平衡有关。

Objective To investigate the incidence trends and influencing factors of non-alcoholic fatty liver disease (NAFLD) -related cirrhosis in China, predict future disease burden, and provide evidence for public health prevention strategies. Methods Based on the Global Burden of Disease (GBD) 2021 database, we employed joinpoint regression analysis to analyze NAFLD-related cirrhosis trends in China from 1990 to 2021, quantified influencing factors using age-period-cohort modeling, and predicted future incidence through Bayesian age-period-cohort analysis. Results The age-standardized incidence rates (ASIRs) of NAFLD-related cirrhosis showed a persistent increase from 1990 to 2021, with annual percentage changes (APCs) of 0.70% for male and 0.79% for female(both P<0.05). Age-effects revealed a U-shaped variation pattern, peaking in the 60-69 age group. Period effects indicated an incidence peak during 2017-2021. Cohort effects showed the most prominent risk in the 1992-1996 birth cohort. Projections suggested ASIR would further increase to 578.40 and 930.61 per 100 000 population for males and females, respectively, by 2030. Conclusions The disease burden of NAFLD-related cirrhosis continues to worsen in China, with future incidence rates projected to keep rising. Priority attention should be given to middle-aged and elderly populations and sex differences, with targeted prevention and control measures needing to be developed.

Objective To investigate the effect of bone metabolic markers on sarcopenia in elderly patients with type 2 diabetes mellitus (T2DM). Methods A total of 412 patients with T2DM in the department of endocrinology of Nanjing Central Hospital from May 2020 to June 2025 were selected as the research subjects. According to Asian Working Group for Sarcopenia (AWGS) in 2019, these patients were evaluated for skeletal muscle mass index (ASMI), muscle strength, and muscle function, and were divided into a sarcopenia group (84 cases) and a non-sarcopenia group (328 cases). The glucolipid metabolic indexes were detected in both groups of patients, and the bone metabolic markers were evaluated, including procollagen type 1 N-terminal peptide (P1NP), beta-C-terminal telopeptide of type 1 collagen (β-CTX), and 25-hydroxy vitamin D [25-(OH)D]. The factors influencing the occurrence of sarcopenia in T2DM patients were analyzed by logistic regression analysis, and the diagnostic values of bone metabolic markers on sarcopenia in patients with T2DM were assessed by ROC curve. Results The levels of P1NP and 25-(OH)D were lower, while β-CTX level was higher in the sarcopenia group compared to the non-sarcopenia group, with statistical differences (P<0.05). After logistic correlation analysis, it was found that P1NP, β-CTX and 25-(OH)D were all influencing factors for the occurrence of sarcopenia in T2DM patients. ROC curve analysis suggested that combined detection of PINP, β-CTX, and 25-(OH)D had higher diagnostic value, with an area under the curve up to 0.805. Conclusion The abnormal expression of bone metabolic markers is associated with the increased risk of sarcopenia in patients with T2DM. The detection of serum bone metabolic markers expression level is of certain significance for the assessment of diabetes-related sarcopenia.

Objective:To investigate the causal relationship between plasma proteins and spontaneous abor-tion using a two-sample Mendelian randomization method.Methods:Using genome-wide association study(GWAS)data from an Icelandic population as an exposure factor and spontaneous abortion data from the Finn-ish Genetic Research Project(FinnGen)as an outcome,the causal relationship between plasma proteins and the risk of developing spontaneous abortion was analyzed using a Mendelian randomization(MR)study.The inverse variance weighting(IVW)method was used as the primary study method,with MR-Egger,weighted median and weighted mode complementing the results;and sensitivity analyses were performed using Cochrane's Q test,MR-Egger intercept testand leave-one-out method to validate the reliability of the data.Results:Seven plasma proteins were identified as potentially correlated with the risk of spontaneous abortion of which fucosyltransferase 10(FUT10)(OR 0.955,95％CI 0.915-0.996,P=0.034),plexin B2(PLXNB2)(OR 0.947,95％CI 0.902-0.995,P=0.030),and interleukin-11 receptor alpha(IL-11Rα)(OR0.905,95％CI 0.848-0.966,P=0.003)were associ-ated with a reduced risk of SA development,while plasma proteins soluble L-selectin(SL-selectin)(OR 1.076,95％CI 1.021-1.134,P=0.006),Cripto protein(OR 1.039,95％CI 1.008-1.071,P=0.012),dendritic cell-specif-ic intercellular adhesion molecule 3-grabbing non-integrin(DC-SIGN)(OR 1.051,95％CI 1.022-1.082,P=0.001),and protein Z-dependent protease inhibitor(ZPI)(OR 1.035,95％CI 1.001-1.071,P=0.045)levels were positively associated with the risk of developing SA.No heterogeneity or horizontal pleiotropy was detected(Co-chrane's Q test and MR-Egger intercept test,P＞0.05),and leave-one-out analysis showed that there were no individual single-nucleotide polymorphisms that had a large impact on the overall data.Conclusions:This Mende-lian randomization analyses confirmed the causal relationship between multiple plasma proteins and spontaneous abortion,which is potentially clinically valuable for studying the correlation between plasma proteins and spontane-ous abortion.

BACKGROUND:Static stretching effectively improves joint motion amplitude,dynamic stretching effectively improves muscle strength and athletic performance through the post-activation strengthening effect of the muscles.OBJECTIVE:To explore the immediate effects of different stretching methods on knee joint muscle strength and vertical jump performance,and provide theoretical support for seeking the best stretching plan,improving sports performance,and preventing training injuries.METHODS:Thirty healthy college students were randomly recruited.The Biodex isokinetic muscle strength system,Qualisys infrared motion capture system,and AMTI three-dimensional force measurement platform were used to collect knee joint muscle strength and vertical jump data after static quadriceps/hamstring stretching,dynamic quadriceps/hamstring stretching,dynamic quadriceps/static hamstring stretching,and static quadriceps/dynamic hamstring stretching.The peak torque,average power,vertical jump height,peak vertical ground reaction force,and joint motion amplitude of the knee joint were used to evaluate the muscle strength and vertical jump performance of the knee joint.RESULTS AND CONCLUSION:Compared with the static quadriceps/hamstring stretching,dynamic quadriceps/hamstring stretching significantly increased knee joint peak torque,average power,and vertical jump height(P<0.05);dynamic quadriceps/static hamstring stretching and static quadriceps/dynamic hamstring stretching significantly increased knee extension and flexion peak torque and average power(P<0.05).Compared with static quadriceps/hamstring stretching,second peak vertical ground reaction force significantly decreased after static quadriceps/dynamic hamstring stretching(P<0.05);lower limb joint motion amplitude significantly increased after dynamic quadriceps/hamstring stretching(P<0.05).These findings indicate that immediate agonists/antagonistic muscle dynamic stretching and agonists dynamic stretching/antagonistic muscle static stretching significantly improve knee joint muscle strength,vertical jump performance,and joint motion amplitude.A larger joint motion amplitude is beneficial for improving athletic performance and better absorbing ground impact during landing.At the same time,agonists muscle dynamic stretching/antagonistic muscle static stretching is better than agonists/antagonistic muscle dynamic stretching to improve knee joint muscle strength,and agonists muscle static stretching/antagonistic muscle dynamic stretching is beneficial for improving the energy absorption capacity during vertical jumping and reducing the risk of injury during landing.

Alcohol use disorder(AUD)is a common mental disorder and physiological disease impac-ting millions globally.Although multiple studies have explored the causes and treatments of AUD,its exact mechanisms remain poorly understood.The development of lipidomics technology provides a new perspective for studying AUD and can be used to investigate its biological mechanisms.This review summarizes recent ap-plications and progress of lipidomics in AUD research,as well as its potential value in prevention and treat-ment strategies.

Objective To investigate the level and significance of serum suprabasin(SBSN)in patients with colorectal cancer(CRC).Methods A total of 200 patients with CRC in Nanjing Medical University Af-filiated Cancer Hospital from October 2023 to October 2024 were selected as the CRC group,200 patients with colorectal polyps were selected as the benign bowel disease(BCD)group,and 177 healthy people were selected as the control group.In addition,the serum SBSN levels of 84 CRC patients 7-10 d after surgery were collect-ed.The levels of SBSN in each group were compared,and the relationship between serum SBSN level and clin-icopathological characteristics of CRC patients was analyzed.Multivariate Logistic regression was used to ana-lyze the influencing factors of CRC.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of serum SBSN alone and in combination with carcinoembryonic antigen(CEA)and carbo-hydrate antigen 19-9(CA19-9)for CRC.Results The serum SBSN level in CRC group was significantly high-er than that in BCD group and control group(P＜0.001).Serum SBSN level in CRC patients was associated with TNM stage and lymph node metastasis(both P=0.001),but not with other clinicopathological features(P＞0.05).Serum SBSN,CEA,CA19-9 were independent risk factors for CRC(P＜0.001).ROC curve anal-ysis showed that the area under the curve(AUC)of SBSN alone in the diagnosis of CRC was 0.734,which was higher than that of CEA(0.611)and CA19-9(0.669)alone,and the AUC of the three combined diagno-sis of CRC was 0.816.The sensitivity and specificity were 70.0％and 81.4％,respectively.The serum SBSN level of CRC patients decreased after operation,and the difference was statistically significant compared with that before operation(P＜0.05).Conclusion SBSN is associated with the occurrence,metastasis and progno-sis of colorectal cancer,and has a certain clinical value in the diagnosis and prediction of colorectal cancer.Ser-um SBSN is a potential biomarker for the auxiliary diagnosis of colorectal cancer.

Objective To investigate the relationship between the levels of serum suppressor of cytokine signaling 3(SOCS3),growth differentiation factor-15(GDF-15)and liver fibrosis in patients with type 2 dia-betes mellitus(T2DM)combined with non-alcoholic fatty liver disease(NAFLD).Methods A total of 320 patients with T2DM combined with NAFLD who were hospitalized in this hospital from May 2023 to May 2024 were selected as the study group,and another 320 patients with simple T2DM admitted during the same period were selected as the control group.The levels of serum SOCS3 and GDF-15 were determined by en-zyme-linked immunosorbent assay(ELISA).Pearson correlation analysis was used to analyze the correlation between SOCS3,GDF-15 levels and liver fibrosis indicators.Logistic regression analysis was used to analyze the factors affecting the degree of liver fibrosis.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum SOCS3 and GDF-15 for the degree of liver fibrosis in patients.Results Compared with the control group,the levels of serum SOCS3,GDF-15,5,type Ⅲ procollagen peptide,laminin and type Ⅳ col-lagen in the study group were significantly increased(P＜0.05).There were statistically significant differ-ences in the levels of type Ⅲ procollagen peptide,laminin and type Ⅳ collagen between the mild to moderate group and the severe group(P＜0.05).Compared with the mild to moderate group,the levels of serum SOCS3 and GDF-15 in the severe group were significantly increased(P＜0.05).The results of Pearson corre-lation analysis showed that serum SOCS3 and GDF-15 in patients with T2DM combined with NAFLD were positively correlated with type Ⅲ procollagen peptide,laminin,and type Ⅳ collagen(P＜0.05).Serum SOCS3,GDF-1 5,type Ⅲ procollagen peptide,laminin and type Ⅳ collagen are risk factors affecting the degree of liver fibrosis in patients with T2DM combined with NAFLD(P＜0.05).The results of the ROC curve showed that the combined diagnosis of serum SOCS3 and GDF-15 for the degree of liver fibrosis in patients with T2DM complicated with NAFLD had the highest area under the curve(AUC),which was superior to the individual diagnosis of each(both P＜0.05),with a corresponding sensitivity of 69.08％and a specificity of 85.71％.The combined diagnosis of the degree of liver fibrosis in patients with T2DM complicated with NAFLD by serum SOCS3,GDF-15,type Ⅲ procollagen peptide,laminin,and type Ⅳ collagen had the highest AUC,which was superior to the individual diagnosis of each index(all P＜0.001),with a corresponding sensi-tivity of 89.47％and a specificity of 97.02％.Conclusion The levels of serum SOCS3 and GDF-15 are elevated in patients with T2DM combined with NAFLD,.The combined diagnosis of serum SOCS3,GDF-15,type Ⅲ procolla-gen peptide,laminin,and type Ⅳ collagen has a high value in the degree of liver fibrosis in patients.

China emerges as a major country in nuclear energy development and the application of nuclear and radiologic technology. The diagnosis and treatment of acute radiation syndrom (ARS) caused by external irradiation represent a core function in the country′s medical rescue of nuclear and radiological emergencies. Clinically, ARS manifests hematopoietic, gastrointestinal, cutaneous, and central nervous system syndromes, with specific clinical manifestations, signs, severity, and prognosis strongly correlated with radiation dose. China has established a number of national and provincial centers for treating radiation-induced damage. Nevertheless, most medical staff have limited experience in ARS treatment. This consensus presents a summary of recent experience in treating ARS of China. In combination with recommendations from international organizations such as the World Health Organization (WHO), this consensus proposes key evidence of critical clinical issues of ARS, covering all links in the rescue of external irradiation-induced ARS. Initially, clinical diagnosis, syndromes, and severe degrees should be determined based on clinical symptoms and dose estimates. It is necessary to normalize clinical treatment measures for hematopoietic recovery, gastrointestinal injury treatment, infection control, symptomatic treatment, and multi-organ function preservation. To this end, this consensus offers cautions. This consensus provides principles of treatment with traditional Chinese medicine, psychological intervention, and follow-up. Additionally, it highlights multidisciplinary collaboration. It is recommended that this consensus be applied in relevant treatment centers.

Objective To investigate the expression pattern and potential functional mechanisms of hematological and neurological expressed 1(HN1)in ovarian cancer(OC).Methods The gene expression profiling interactive analysis(GEPIA),Kaplan-Meier plotter,and the University of Alabama at Birmingham Cancer Data Analysis Portal(UALCAN)online databases were utilized to analyze the expression profile of HN1 across pan-cancer datasets,as well as its differential expression and prognostic significance in OC.Co-expressed genes of HN1 were identified based on the cancer genome atlas database,followed by functional enrichment analyses using Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathways.Furthermore,the association between HN1 expression and immune cell infiltration in OC tissues was explored by using R software.Results Analysis of the GEPIA database revealed that HN 1 expression was significantly elevated in 20 types of tumor tissues,including OC,compared to normal tissues(P＜0.05).UALCAN data indicated that HN1 expression was markedly higher in poorly differentiated OC patients(P＜0.05).Kaplan-Meier survival analysis showed that patients with high HN 1 expression had significantly shorter progression-free survival,overall survival,and post-progression survival compared to those with low HN1 expression(P＜0.05).GO and KEGG enrichment analyses suggested that HN1 is mainly involved in the regulation of the cell cycle.Immunological analysis demonstrated that HN 1 expression levels were positively correlated with the infiltration of CD4+Th2 cells and dendritic cells in OC tissues(P＜0.05).Conclusion HN1 is highly expressed in OC and may play a role in tumor progression by regulating cell cycle,promoting epithelial-mesenchymal transition,and modulating immune cell infiltration.HN1 has the potential to serve as a novel biomarker for the diagnosis and targeted therapy of OC.