Hepatic fibrosis(HF)is a pathophysiological outcome of chronic liver injury and is characterized by excessive accumulation of extracellular matrix protein.A number of studies have confirmed that the signaling pathways formed by transforming growth factor-β1(TGF-β1)and its downstream Smad family play an important role in the occurrence and development of HF,and the traditional Chinese medicine(TCM)research targeting this pathway is currently a hot spot in the reversal of HF.Therefore,taking TGF-β1/Smads signaling pathway as the entry point,this paper reviewed the mechanism of action of TCM compound formula and single drug extract in intervening TGF-β1/Smad pathway and related factors upstream and downstream of the pathway to reverse HF in recent years,revealed the targeted therapeutic effect of TCM,and provided new strategies for clarifying the mechanism of TCM.

Sodium-glucose co-transporter protein 2 inhibitor(SGLT2i)has steadily demonstrated benefits in the treatment of type 2 diabetes complicated with cardiovascular diseases based on evidence-based medicine,but its precise mechanism is yet unknown.We identified type 2 diabetes patients with HFpEF by searching PubMed,Web of Science,China knowledge network(CNKI),and other databases.We then summarized the pathological mechanism of HFpEF caused by type 2 diabetes.At the same time,to link to evidence-based medical,we explored the future of SGLT2i in clinical application.

OBJECTIVE To investigate the efficacy and safety of piperacillin-tazobactam in the treatment of complicated urinary tract infection （cUTI） in adults. METHODS Retrospective analysis was performed on the data of 352 cUTI adult patients in our hospital from January 1， 2021 to December 31， 2023. All patients received piperacillin-tazobactam. The detection of pathogens in patients， the clinical efficacy and microbial clearance rate after treatment， the occurrence of adverse drug reactions and treatment cost were observed in all patients. RESULTS Of the 352 patients， pathogen culture results of 54 patients were detected， mainly Escherichia coli producing extended-spectrum beta-lactamases. The clinical effective rate was 94.3%， the microbial clearance rate was 81.5%， and the incidence of adverse reactions was 1.4%. The percentage of male effective patients in urinary surgery department was significantly higher than invalid patients， while the proportion of transplant treatment and the proportion of patients with concomitant kidney transplantation were significantly lower than invalid patients （P＜0.05）. There was no significant difference in clinical effective rate between the two groups after those patients were divided into target treatment group and empirical treatment group according to the sensitivity of pathogen to piperacillin-tazobactam （P＝0.902 5）. CONCLUSIONS Piperacillin-tazobactam is effective and safe in the treatment of cUTI.

Humans ; PPAR gamma/metabolism* ; Multiple Sclerosis ; Transcription Factors/metabolism* ; Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha

[摘 要] 目的：探讨四个半LIM结构域2（FHL2）蛋白对胶质瘤细胞增殖的影响及其分子机制。方法：利用TCGA和CGGA数据库分析胶质瘤组织中FHL2 mRNA表达水平与患者预后的关系。通过WB法检测人胶质瘤组织标本及人胶质瘤细胞U87、T98G、U251、SNB19、GSC23、A172、LN229、G267和星形胶质细胞NHA中的FHL2蛋白表达水平。利用慢病毒载体构建稳定敲低FHL2的U87细胞和过表达FHL2的SNB19细胞，即U87-shGFP、U87-shFHL2-1#、U87-shFHL2-4#和SNB19-3flag、SNB19-3flag-FHL2组。通过CCK-8法、克隆形成实验检测敲低和过表达FHL2对细胞增殖的影响，免疫共沉淀（Co-IP）和液相色谱-串联质谱（LC/MS）法筛选FHL2在胶质瘤细胞中的相互作用蛋白，并用Co-IP和免疫荧光法验证它们的结合作用和共定位情况。使用酶标仪检测敲低和过表达FHL2细胞内乳酸产量和乳酸脱氢酶（LDH）活性的变化，WB法分析FHL2、LDHA及p-LDHA在正常脑组织和胶质瘤组织中的蛋白表达差异及其相互关系。在过表达 FHL2的SNB19细胞中使用LDHA的小分子抑制剂AT-101，通过CCK-8实验和酶标仪比色法验证FHL2在胶质瘤乳酸代谢中的作用，验证AT-101在胶质瘤中潜在的治疗效果。结果：Co-IP和LC/MS检测发现，FHL2与LDHA在胶质瘤细胞中存在相互作用。FHL2过表达可提高LDHA活性和乳酸生成（均P < 0.001），进而促进胶质瘤细胞增殖（P < 0.001）。相反，敲低FHL2会降低LDHA活性和乳酸产量（P < 0.001或P < 0.05）并抑制细胞增殖（P < 0.001）。AT101能抑制LDHA活性，并显著抑制FHL2促进胶质瘤细胞的增殖，同时恢复磷酸化LDHA（Y10）水平（P<0.01或P < 0.001）。结论：FHL2与LDHA蛋白相互作用，FHL2通过激活p-LDHA（Y10）的表达促进LDHA活性和乳酸产生，进而促进胶质瘤细胞的增殖，靶向这种相互作用可能成为治疗胶质瘤的潜在策略。

Objective To analyze the factors associated with pain after arthroscopic rotator cuff bridge suture.Methods According to the inclusion and exclusion criteria,the data of 112 patients with unilateral rotator cuff injury who received arthroscopic bridge suture in our department were collected and were investigated in the form of telephone follow-up.In this study,SPSS 23.0 was used to input data and conduct statistical analysis.Logistic regression analysis was used to analyze the correlation between the above influencing factors and postoperative pain.Results A total of 112 patients were included for statistical analysis,single factor analysis revealed,including course of disease,smoking history,preoperative University of California,Los Angeles(UCLA)score,Constant score,numeric rating scale(NRS),size of rotator cuff tear,whether it was full-thickness tear and degree of tendon retraction might be related to postoperative pain(P<0.05).The age,gender,body mass index(BMI),drinking history,diabetes and hypertension were not related to postoperative pain(P>0.05).Multiple linear regression analysis concluded that there were four factors related to postoperative pain,and the correlation degree was preoperative NRS,preoperative UCLA score,tear size and smoking history.Conclusion The causes of postoperative pain after arthroscopic rotator cauff repair are complex and diverse.Analyzing the cause of postoperative pain can effectively reduce the pain of patients and promote the recovery of shoulder joint function.

Objective To explore the effect of transcutaneous electrical acupoint stimulation bracelet at Neiguan acupoint on the postoperative nausea and vomiting after thyroidectomy under general an-esthesia.Methods Seventy-two female patients underwent thyroidectomy,aged 18-50 years,ASA physical status Ⅰ or Ⅱ,were enrolled.The patients were assigned 1 ∶ 1 to two groups by permuted block randomization:the electrical stimulation group and the control group,36 patients in each group.Before an-esthesia induction,patients in both groups wore domestic transcutaneous electrical acupoint stimulation bracelets,and the electrodes were aimed at Neiguan acupoint.The electrical stimulation group started to stimulate Neiguan acupoint,and adjusted the proper intensity to make the patient feel tingling in the related area of the hand.When the bracelet was fixed firmly,turned it off.At the end of the operation,the bracelet was turned on with the stimulation intensity set before induction for 24 hours.Patients in the control group also wore the bracelet for 24 hours,but it was never turned on.The number of cases of postoperative nausea and vomiting(PONV)and the number of remedial cases of antiemetic drugs were recorded.Results Compared with the control group,the incidence of PONV and postoperative vomiting in the electrical stimula-tion group were significantly reduced within 24 hours after surgery(P＜0.05),and the differences were mainly in 1-6 hours after surgery(P＜0.05).There was no significant difference in the rate of remedial ca-ses of antiemetic drugs between the two groups at different time periods.Conclusion Transcutaneous electri-cal stimulation bracelet at Neiguan acupoint can effectively reduce the incidence of PONV within 24 hours after thyroidectomy.

Ubiquitination, a diverse post-translational modification, is carried out by enzymes including E1-activating enzymes, E2-conjugating enzymes, E3 ligases, and deubiquitinating enzymes (DUBs). Ubiquitin itself possesses 7 lysine residues and N-terminal methionine, allowing for the formation of polyubiquitin chains with different lengths and linkages. These chains exhibit various topologies that can be recognized by proteins containing ubiquitin-binding domain, thereby transmitting distinct cellular signals. To unravel the physiological mechanisms associated with ubiquitin, numerous ubiquitin probes have been developed. This review provides an overview of recent advancements in the field of ubiquitin probes, focusing on activity-based and affinity-based probes. Activity-based probes are designed to covalently bind to DUBs, E1s, or E3s, enabling the identification and characterization of these enzymes. Affinity-based probes, on the other hand, selectively bind to ubiquitin-binding domains, facilitating the identification of proteins that interact with ubiquitin. Moreover, this review comprehensively discusses the synthetic methodologies employed for the acquisition of ubiquitin probes. These includes meticulous discussions on the synthesis of individual monomeric modules, the establishment of isopeptide linkages, as well as the incorporation of reactive functional groups. Additionally, the review explores the emerging area of cell-penetrating ubiquitin probes and highlights their latest applications in living cells. These probes incorporate cell-penetrating peptides to enable their internalization into cells, allowing for direct visualization and manipulation of ubiquitin-modified proteins within their native environment. Overall, this review offers insights into the design, synthesis, and applications of ubiquitin probes, highlighting their significance in elucidating ubiquitin-mediated cellular processes.

Objective:To explore the effects of multi-disciplinary team (MDT) participation for residency training in bariatric and metabolic surgery.Methods:A questionnaire was designed considering patient benefits, doctor benefits, and interviewees' background and recognition of MDT. The questionnaire was used to survey 48 residents who rotated to the department of gastrointestinal surgery and participated in the management of patients undergoing bariatric and metabolic surgery in Peking University Third Hospital from February to October 2023. According to the frequency of MDT participation, the residents were divided into two groups (<5 times and ≥5 times). They were evaluated by five superior surgeons, and the scores of the two groups were compared using the independent samples t test. Results:All the 48 residents completed the questionnaire survey. Only 16 residents (33.33%) had been exposed to the knowledge of bariatric and metabolic surgery, and most of the respondents believed that participating in MDT could improve their professional competence ( n=42, 87.50%) and special English proficiency ( n=30, 62.50%). The group of MDT participation ≥5 times had significantly higher scores of knowledge of internal medicine [(7.42±1.09) vs. (5.16±1.28)], knowledge of anesthesia and critical care medicine [(7.11±0.85) vs. (4.93±0.99)], perioperative management [(7.08±0.67) vs. (4.97±1.21)], laparoscopic skills [(6.43±0.83) vs. (4.99±0.65)], and professional knowledge of general surgery [(6.46±0.86) vs. (5.87±0.51)] compared with the group of MDT participation <5 times (all P<0.05). Conclusions:MDT participation in bariatric and metabolic surgery can help residents quickly understand and master relevant knowledge, which is of great significance for increasing the personnel reserve of bariatric and metabolic surgery.

Aim To explore the effects of Lycium berry seed oil on Nrf2/ARE pathway and oxidative damage in testis of subacute aging rats. Methods Fifty out of 60 male SD rats, aged 8 weeks, were subcutaneously injected with 125 mg • kg"D-galactosidase in the neck for 8 weeks to establish a subacute senescent rat model. The presence of senescent cells was observed using P-galactosidase ((3-gal), while testicular morphology was examined using HE staining. Serum levels of testosterone (testosterone, T), follicle-stimulating hormone ( follicle stimulating hormone, FSH ) , luteinizing hormone ( luteinizing hormone, LH ) , superoxide dis-mutase ( superoxide dismutase, SOD ) , glutathione ( glutathione, GSH) and malondialdehyde ( malondial-dehyde, MDA) were measured through ELISA, and the expressions of factors related to aging, oxidative damage, and the Nrf2/ARE pathway were assessed via immunohistochemical analysis and Western blotting. Results After successfully identifying the model, the morphology of the testis was improved and the intervention of Lycium seed oil led to a down-regulation in the expression of [3-gal and -yH2AX. The serum levels of SOD, GSH, T, and FSH increased while MDA and LH decreased (P 0. 05) . Additionally, there was an up-regulated expression of Nrf2, GCLC, NQOl, and SOD2 proteins in testicular tissue ( P 0. 05 ) and nuclear expression of Nrf2 in sertoli cells. Conclusion Lycium barbarum seed oil may reduce oxidative damage in testes of subacute senescent rats by activating the Nrf2/ARE signaling pathway.