ObjectiveTo investigate the value of predictive models established based on machine learning methods in predicting the risk of metabolic associated fatty liver disease （MAFLD）， and to analyze its key risk factors. MethodsA retrospective analysis was performed for the 50 variables of 2 168 healthy individuals who underwent physical examination in Department of Health Assessment， Xiyuan Hospital， China Academy of Chinese Medical Sciences， from January 2021 to December 2024， including body composition， past history， and laboratory tests， and according to whether they were diagnosed with MAFLD or not， they were divided into MAFLD group with 265 individuals and non-MAFLD group with 1 903 individuals. The Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test was used for comparison of categorical data between two groups. Randomly split the research data into a training set and a validation set in a 70% to 30% ratio. Predictive factors were screened from the training set data using univariate analysis， LASSO regression， and multivariate Logistic regression analysis. Predictive models were then constructed using seven machine learning methods： Logistic regression， decision tree， random forest （RF）， eXtreme gradient boosting， light gradient boosting machine， support vector machine， and artificial neural network. Model performance was evaluated by plotting receiver operating characteristic curve for the validation set and calculating the area under the curve （AUC）， sensitivity， specificity， and Youden index for each model. Furthermore， the SHapley Additive exPlanation （SHAP） method was used to analyze the contribution of variables in the optimal model. ResultsThe prevalence rate of MAFLD among the 2 168 subjects was 12.22% （265/2 168）. Smoking， diastolic blood pressure， phase angle， visceral fat area， muscle fat ratio， waist-to-hip ratio， aspartate aminotransferase， non-HDL-C/HDL-C ratio， triglyceride-glucose index， and gallstones were independent risk factors for MAFLD （all P<0.05）. The seven predictive models of support vector machine， eXtreme gradient boosting， decision tree， light gradient boosting machine， artificial neural network， RF， and Logistic regression had an AUC of 0.738， 0.754， 0.757， 0.786， 0.795， 0.796， and 0.815， respectively， in the validation set， among which the RF model had the best discriminatory ability （AUC=0.796， 95% confidence interval： 0.754 — 0.839）， with a sensitivity of 81.01%， a specificity of 63.16%， and a Youden index of 44.17%. The SHAP analysis showed that visceral fat area， waist-to-hip ratio， and diastolic blood pressure were the top three predictive factors in terms of importance. ConclusionThe RF model， constructed based on body composition and clinical indicators， has a good performance in predicting the risk of MAFLD， and its interpretability can help to identify high-risk individuals in the early stage in clinical practice.

Obesity is a chronic low-grade inflammation and a risk factor for diseases such as diabetes， hypertension， dyslipidemia， and malignant tumors， demonstrating an increasingly grim development situation. The nuclear factor-kappa B （NF-κB） signaling pathway is a key signaling pathway involved in the immune response and inflammatory response. In obese individuals， the expression of NF-κB is overactivated， which leads to abnormal inflammatory responses in the body. Therefore， it is expected to alleviate inflammation and treat obesity by regulating the NF-κB signaling pathway， which has been proven effective by a large number of studies. The available studies on the NF-κB signaling pathway mostly focus on tumors， and there is no systematic review of the mechanism of this pathway in mediating obesity and the traditional Chinese medicine （TCM） treatment. We reviewed the research progress in the pathological and physiological processes of obesity mediated by NF-κB signaling pathway and TCM treatment， aiming to give insights into the clinical treatment of obesity with TCM and provide reference targets and research directions for exploring the biological foundations and the development of new TCM preparations.

Objective: To compare the value of a body shape index (ABSI) and body roundness index (BRI) in predicting non-alcoholic fatty liver disease (NAFLD) among non-obese population, so as to provide a reference for the early identification of populations at high risk of NAFLD. Methods: Adults with a body mass index (BMI) of less than 28 kg/m2 who underwent health check-ups in Xiyuan Hospital of China Academy of Chinese Medical Sciences from 2022 to 2024 were selected as the study subjects. Demographic information, disease history, height, weight, waist circumference, blood pressure, and blood lipid indicators were collected, and ABSI and BRI were calculated. NAFLD was diagnosed using abdominal ultrasound. A multivariable logistic regression model was employed to analyze the relationships between ABSI, BRI and NAFLD among non-obese population. A generalized additive model combined with the penalized spline method was used to fit smooth curves to identify nonlinear relationships, and threshold effects were utilized to determine inflection points. The values of ABSI and BRI in predicting NAFLD among non-obese population were used the receiver operating characteristic (ROC) curve. Results: A total of 1 195 individuals were surveyed, including 345 males (28.87%) and 850 females (71.13%). A total of 348 cases of NAFLD were detected among the non-obese population, with a detection rate of 29.12%. The adjusted ABSI (sABSI) in the NAFLD group and non-NAFLD group were 7.95±0.33 and 8.08±0.34, while the BRI were 3.35±0.79 and 4.15±0.64, respectively, with statistically significant differences between the two groups (both P<0.05). Multivariable logistic regression analysis showed that, after adjusting for demographic information, disease history, blood pressure, and blood lipid indicators, both sABSI (OR=1.932, 95%CI: 1.184-3.158) and BRI (OR=1.594, 95%CI: 1.071-2.360) were significantly associated with NAFLD among non-obese population. Nonlinear positive correlations were observed between sABSI, BRI, and NAFLD among non-obese population. When sABSI≤8.46 and BRI≥2.72, both indices were positively associated with NAFLD. The area under the ROC curve for ABSI and BRI in predicting NAFLD risk among non-obese population were 0.619 and 0.782, respectively, with optimal cut-off values of 0.082 and 3.656, respectively. Conclusions ABSI and BRI show a non-linear relationship with NAFLD among non-obese population. BRI demonstrates relatively better performance in predicting NAFLD risk among this population and can serve as an auxiliary indicator for the early identification of NAFLD among non-obese population.

Objective:To investigate the application value of modified closure of overlap anastomotic common opening in total laparoscopic radical gastrectomy.Methods:The retrospec-tive and descriptive study was conducted. The clinicopathological data of 39 patients with gastric cancer who underwent total laparoscopic radical gastrectomy in Shanxi Hospital of Cancer Hospital, Chinese Academy of Medical Sciences from January 2023 to January 2024 were collected. There were 27 males and 12 females, aged (61±9)years. All patients underwent total laparoscopic radical gastrectomy for gastric cancer, with gastrointestinal reconstruction using overlap anastomosis and a modified closure of overlap anastomotic common opening. Measurement data with normal distribution were represented as Mean± SD, and count data were expressed as absolute numbers. Results:(1) Intraoperative and postoperative conditions. All 39 patients underwent total laparoscopic radical gastrectomy for gastric cancer, with gastrointestinal reconstruction using overlap anastomosis and a modified closure of overlap anastomotic common opening successfully, without conversion to open surgery or thoracotomy. The operation time of 39 patient was (210±52)minutes, with the volume of intraoperative blood loss of (132±55)mL, number of lymph node dissected of 23±11. The time to postoperative first flatus of 39 patients was (3.3±0.3)days, with time to postoperative liquid food intake of (4.4±0.6)days, time to postoperative semi-liquid food intake of (5.2±0.4)days, and duration of postoperative hospital stay of (9.5±3.1)days. (2) Complications. Seven of the 39 patients experienced perioperative complications, including 5 cases with complication classified as Clavien-Dindo grade Ⅱ, and 2 cases with complication classified as Clavien-Dindo grade Ⅲ. After conservative treatment, all patients with complications improved and were discharged. (3) Follow-up. Results of upper gastrointestinal imaging of the 39 patients showed no anastomotic leakage, and all patients were followed up at 1, 3, and 6 months after surgery. There was no other complications, tumor recurrence and metastasis, or mortality during the follow-up period.Conclusion:The modified closure of overlap anastomotic common opening in total laparoscopic radical gastrectomy has good safety and short-term efficacy.

Objective:To investigate the application value of modified closure of overlap anastomotic common opening in total laparoscopic radical gastrectomy.Methods:The retrospec-tive and descriptive study was conducted. The clinicopathological data of 39 patients with gastric cancer who underwent total laparoscopic radical gastrectomy in Shanxi Hospital of Cancer Hospital, Chinese Academy of Medical Sciences from January 2023 to January 2024 were collected. There were 27 males and 12 females, aged (61±9)years. All patients underwent total laparoscopic radical gastrectomy for gastric cancer, with gastrointestinal reconstruction using overlap anastomosis and a modified closure of overlap anastomotic common opening. Measurement data with normal distribution were represented as Mean± SD, and count data were expressed as absolute numbers. Results:(1) Intraoperative and postoperative conditions. All 39 patients underwent total laparoscopic radical gastrectomy for gastric cancer, with gastrointestinal reconstruction using overlap anastomosis and a modified closure of overlap anastomotic common opening successfully, without conversion to open surgery or thoracotomy. The operation time of 39 patient was (210±52)minutes, with the volume of intraoperative blood loss of (132±55)mL, number of lymph node dissected of 23±11. The time to postoperative first flatus of 39 patients was (3.3±0.3)days, with time to postoperative liquid food intake of (4.4±0.6)days, time to postoperative semi-liquid food intake of (5.2±0.4)days, and duration of postoperative hospital stay of (9.5±3.1)days. (2) Complications. Seven of the 39 patients experienced perioperative complications, including 5 cases with complication classified as Clavien-Dindo grade Ⅱ, and 2 cases with complication classified as Clavien-Dindo grade Ⅲ. After conservative treatment, all patients with complications improved and were discharged. (3) Follow-up. Results of upper gastrointestinal imaging of the 39 patients showed no anastomotic leakage, and all patients were followed up at 1, 3, and 6 months after surgery. There was no other complications, tumor recurrence and metastasis, or mortality during the follow-up period.Conclusion:The modified closure of overlap anastomotic common opening in total laparoscopic radical gastrectomy has good safety and short-term efficacy.

ObjectiveTo build an evaluation index system for traditional Chinese medicine （TCM） medicated diet， promoting the scientific and standardized development of medicated diet in TCM. MethodsThe framework of the evaluation index system was constructed through literature review and Delphi expert consultation method. The analytic hierarchy process was used to construct a hierarchical structure model. Pairwise comparisons between the indicators were conducted using the Saaty 1-9 scale method， and the weight of each indicator was calculated using Yaahp 10.3. ResultsThe response rates for the two rounds of expert consultation were 93.33% and 100%， respectively. The Kendall's W coefficients for the first-level and second-level indicators in the second round were 0.270 and 0.281， respectively （both P＜0.001）. Finally， an evaluation index system for TCM medicated diet therapy was constructed， consisting of 6 primary indicators and 27 secondary indicators. The weightings of the primary indicators were as follows： sensory appearance （0.1843）， health value （0.3569）， ingredient compatibility （0.1271）， packaging （0.0370）， production and preparation （0.1005）， and reliability （0.1940）. ConclusionA comprehensive and universally applicable evaluation index system for TCM medicated diet has been developed， taking into conside-rations of color， taste， appearance， efficacy， preparation， quality and others. This system can provide valuable reference for the evaluation of the value of medicated diet as well as its development.

Objective:To analyze the research hotspots and trends of exercise treatment of hypertension in China with bibliometrics software of CiteSpace and VOS viewer.Methods:The databases of CNKI, VIP, WanFang Data and the core collection of Web of Science were searched with the key words of exercise therapy, exercise intervention, exercise prescription, sports, movement, high blood pressure, hypertension, etc. Relevant periodical literature in Chinese and English were retrieved from the establishment of the databases to December 31, 2021. The CiteSpace and VOS viewer were used to perform visual analysis of the literature in the field of exercise therapy for hypertension in China.Results:A total of 1 507 literatures were included, including 1 430 in Chinese and 77 in English. In recent years, the number of studies on exercise treatment of hypertension in China showed a fluctuating upward trend. The research institutions were mainly universities and hospitals, high-yield institutions mainly included Beijing Sport University (20 articles), the First Affiliated Hospital of Nanjing Medical University (12 articles), the PLA General Hospital (13 articles) and Shanghai Sport University (11 articles). There was less cooperation between institutions and less cross-border cooperation. The proportion of sports and medical compound researchers in high-yield authors was relatively low (22.2%, 2/9). Keyword clustering could be summarized as three aspects: disease research, research objects and intervention methods. In terms of disease research, “pregnancy outcome”, “blood pressure”, “blood lipid” and “coronary heart disease” had strong burst (burst intensity 3.75, 3.70, 3.52, 3.12); in terms of research objects, “elderly patients” had the strongest burst (burst intensity 3.10); in terms of intervention methods, “exercise prescription”, “aerobic exercise” and “health education” had strong emergence (emergence intensity 6.08, 5.47, 4.01).Conclusions:Research achievements in the field of exercise therapy for hypertension in China are relatively rich in recent years. At present, the main research hotspots are disease research, research objects and intervention methods, and the integration degree of sports and medicine needs to be improved.

Objective:To explore the material basis and mechanism of Linggui Zhugan Decoction in treating hypertension and obesity by means of network pharmacology and molecular docking technique.Methods:The TCMSP was retrieved and the main active components and action targets of Linggui Zhugan Decoction were screened. The GeneCards, OMIM, TTD, DisGeNET and DrugBank databases were used to screen disease-related targets of hypertension and obesity. The Cytoscape 3.9.0 was used to draw Chinese materia medica-composition-intersection target-disease network diagram. The STRING 11.5 database was used to draw PPI network. The cytoNCA plug-in was used to screen core active components and targets. The bioenrichment analysis of GO and KEGG was carried out in the R4.1.2, and the Chinese materia medica-intersection target-path diagram was drawn, and the core active components and core targets were docked in PyMOL and AutoDockTools 1.5.7.Results:A total of 102 potentially active components and 62 intersection targets were obtained, and 8 active components and 7 core targets were screened. Enrichment analysis showed that the key targets were mainly enriched through the signaling pathways of fluid shear stress and atherosclerosis, lipid and atherosclerosis, and AGE-RAGE, which were involved in biological processes such as the response to nutritional levels and the regulation of small molecule metabolism. Molecular docking showed that there were 37 groups with addinity < -7 kcal/mol.Conclusion:The main active components of Linggui Zhugan Decoction are quercetin, kaempferol and naringenin, which may play a role in fluid shear stress and atherosclerosis pathway, lipid and atherosclerosis pathway and AGE-RAGE signal pathway through AKT1, EGFR, IL1B and other targets.

Objective:To investigate the application value of self-pulling and latter transection (SPLT) technique in double anti-reflux double-tract reconstruction of totally laparoscopic proximal gastrectomy.Methods:The retrospective cohort study was conducted. The clinicopatholo-gical data of 103 patients with Siewert type Ⅱ adenocarcinoma of esophagogastric junction in clinical stage Ⅰ-Ⅱ who were admitted to Shanxi Cancer Hospital from January 2018 to January 2020 were collected. There were 65 males and 38 females, aged from 45 to 79 years, with a median age of 59 years. Of 103 patients, 49 cases undergoing totally laparoscopic proximal gastrectomy with double-tract reconstruction of SPLT were assigned into the SPLT group, 54 cases undergoing totally laparoscopic proximal gastrectomy with conventional double-tract reconstruction were assigned into the traditional group. Observation indicators: (1) intraoperative situations; (2) postoperative situations; (3) follow-up. Follow-up was conducted by outpatient examination and telephone inter-view to detect postoperative reflux esophagitis of patients up to December 2021. Measurement data with normal distribution were represented as Mean± SD, and the t test was used for comparison between groups. Measurement data with skewed distribution were represented as M(range) or M( Q1, Q3), and the Wilcoxon test was used for comparison between groups. Count data were described as absolute numbers or percentages, and comparison between groups was performed using the chi-square test. Comparison of ordinal data was analyzed using the non-parameter rank sum test. Results:(1) Intraoperative situations: the operation time, digestive tract reconstruction time, volume of intraoperative blood loss, the number of inferior mediastinal lymph nodes dissected, cases with auxiliary incisions for the SPLT group were (261±48)minutes, (26±4)minutes, (114±42)mL, 8.0(6.5,9.5), 1, respectively. The above indicators were (244±42)minutes, (30±6)minutes, (118±46)mL, 5.5(4.0,8.0), 9 for the traditional group, respectively. There were significant differences in the digestive tract reconstruction time, the number of inferior mediastinal lymph nodes dissected and cases with auxiliary incisions between the two groups ( t=-3.34, Z=-4.05, χ2=4.72, P<0.05). There was no significant difference in the operation time or volume of intraoperative blood loss between the two groups ( t=1.87, -0.47, P>0.05). (2) Postoperative situations: duration of postopera-tive hospital stay and cases with postoperative complications were (11.5±2.7)days and 4 for the SPLT group, versus (12.5±4.3)days and 9 for the traditional group, showing no significant difference between the two groups ( t=-1.47, χ2=1.68, P>0.05). There were 13 of 103 patients with postopera-tive complications, including 5 cases of left pleural effusion, 4 cases of anastomotic leakage, 2 cases of mild pneumonia, 1 case of incision infection, 1 case of chylous leakage. Four patients had anasto-motic leakage at the esophagojejunostomy, the abdominal esophagus of whom was invaded by more than 1 cm. During the operation, mediastinal drainage tubes were placed through the abdominal wall. The 4 patients were cured after enteral and parenteral nutrition support and adequate drainage, and the remaining patients with complications were cured after symptomatic treatment. (3) Follow-up: of 49 patients in the SPLT group, 43 cases were followed up for (18±4)months. During the follow-up, 1 case showed reflux esophagitis by gastroscopy, with the incidence of 2.33%(1/43). Of 54 patients in the traditional group, 53 cases were followed up for (17±4)months. During the follow-up, 4 cases showed reflux esophagitis by gastroscopy, with the incidence of 7.55%(4/53). There was no significant difference in the incidence of reflux esophagitis between the two groups ( χ2=0.47, P>0.05). Conclusions:SPLT technology is feasible for double anti-reflux double-tract reconstruction of proximal gastrectomy. Compared with traditional double-tract reconstruction of totally laparos-copic proximal gastrectomy, SPLT technology can reduce the auxiliary incisions, increase the number of lower mediastinal lymph nodes dissected, and shorten the digestive tract reconstruction time.

As a novel post-translational modification(PTM),lysine 2-hydroxyisobutyrylation(Khib)is considered to regulate gene transcriptional activities in eukaryotic cells;however,the functions of Khib-modified proteins in plants remain unknown.Here,we report that Khib is an evolutionarily-conserved PTM in wheat and its progenitors.A total of 3348 Khib sites on 1074 proteins are iden-tified in common wheat(Triticum aestivum L.)by using affinity purification and mass spectroscopy of 2-hydroxyisobutyrylome.Bioinformatic data indicate that Khib-modified proteins participate in a wide variety of biological and metabolic pathways.Immunoprecipitation confirms that Khib-modified proteins are present endogenously.A comparison of Khib and other main PTMs shows that Khib-modified proteins are simultaneously modified by multiple PTMs.Using mutagenesis experiments and co-immunoprecipitation assays,we demonstrate that Khib on K206 of phospho-glycerate kinase(PGK)is a key regulatory modification for its enzymatic activity,and mutation on K206 affects the interactions of PGK with its substrates.Furthermore,Khib modification of low-molecular-weight proteins is a response to the deacetylase inhibitors nicotinamide and tricho-statin.This study provides evidence to promote our current understanding of Khib in wheat plants,including the cooperation between Khib and its metabolic regulation.