OBJECTIVE To systematically evaluate the effects of oral non-peptidic thrombopoietin receptor agonists （TPO-RAs） on hepatic enzyme in adult patients with immune thrombocytopenia. METHODS A comprehensive literature search was conducted in PubMed， Web of Science， CNKI， Wanfang database and the Chinese Medical Association Journal Full-Text Database to collect randomized controlled trials （RCTs） comparing oral non-peptidic TPO-RAs （intervention group） with placebo or conventional therapy （control group）. All databases were searched from their inception to June 2025. After literature screening， data extraction and quality assessment of the included studies， meta-analysis was conducted using RevMan 5.4.1 software. RESULTS Twelve RCTs comprising 1 388 patients were included， with 971 in the intervention group and 417 in the control group. Meta-analysis results showed that there were no significant differences between the two groups in terms of the incidence of hepatic enzyme elevation[OR＝1.24， 95%CI （0.77， 1.99）， P ＝0.37 ] ， the incidence of hepatic enzyme elevation in patients treated for ≥6 weeks[OR＝1.21， 95%CI （0.73， 1.99）， P ＝0.46 ] ， and the incidence of severe hepatic enzyme elevation[OR＝1.39， 95%CI（0.46， 4.20）， P ＝0.55 ] . Subgroup analysis showed that there were no significant differences in the incidence of hepatic enzyme elevation between the intervention group and control group among patients using eltrombopag[OR＝1.57，95%CI（0.85，2.87）， P ＝0.15 ] ， avatrombopag[OR＝0.88，95%CI （0.09，8.46）， P ＝0.91 ] ， and hetrombopag[OR＝1.04，95%CI（0.30，3.65）， P ＝0.95 ] ， respectively. CONCLUSIONS Oral non-peptidic TPO-RAs do not significantly increase the risk of hepatic enzyme elevation in adult patients with immune thrombocytopenia， and show an overall favorable hepatic safety profile.

In-fusion cloning technology,as a revolutionary and efficient molecular biology tool,has been applied in multiple research fields such as basic biology,biotechnology,and biomedicine.In this article,we introduce a teaching reform project suitable for undergraduate students in the course of"Molecular Bi-ology Laboratory",which utilizes in-Fusion cloning technology to construct a prokaryotic expression vector for alkaline phosphatase mutant genes.Through specific teaching cases,we systematically explored the design and implementation of experimental projects,and focused on analyzing the key and difficult points of the teaching content.Our teaching practice has found that the implementation of this educational re-form project has achieved very good results in enhancing students' core biological literacy,bioinformatics skills,research thinking,and innovation abilities.At the same time,the application of this technology can significantly improve the quality of experimental teaching,providing new ideas and practical refer-ences for promoting the reform and innovation of National First-Class Courses.

Objective To explore the value of deep learning image reconstruction(DLIR)combined with"three low(low radiation dose,low contrast dose,and low contrast injection rate)techniques"of spectrum CT with low keV in optimizing the image quality of portal vein for liver cirrhosis.Methods Sixty patients with liver cirrhosis who underwent computed tomography portal venography(CTPV)were selected and randomly divided into standard protocol group(group A,n=30)and"three-low"protocol group(group B,n=30).The group A with 120 kVp,contrast dose of 1.4 mL/kg,injection rate of 4.0-5.0 mL/s,and reconstructed 50%adaptive statistical iterative reconstruction-Veo(ASIR-V)image.The group B with 80 kVp/140 kVp double instantaneous switching gemstone spectral imaging(GSI)scan,contrast dose of 1.0 mL/kg,injection rate of 3.0-3.5 mL/s,and reconstructed 40 keV DLIR-M and DLIR-H images.The quality of portal vein images,effective dose(ED),contrast dose and injection rate were compared between the two groups.Results The ED of(4.10±1.56)mSv in group B was lower than that of(7.88±1.08)mSv in group A(P<0.001),and the contrast dose of(67.26±8.74)mL in group B was lower than that of(99.12±8.84)mL in group A(P<0.001).The injection rate of 3.0-3.5 mL/s in group B was reduced by 25%-30%compared with group A.Group B had the greatest contrast-to-noise ratio(CNR)and signal-to-noise ratio(SNR)of portal vein in the 40 keV DLIR-H.The subjective image quality scores were in good agreement between the two physicians(Kappa value>0.75).The subjective DLIR score in group B was higher than that in group A.Conclusion DLIR combined with"three low techniques"spectrum CT with low keV can improve the image quality of portal vein in liver cirrhosis patients.

Objective:To explore the correlation between renal function and abdominal aortic hemodynamic parameters based on four-dimensional flow(4D Flow) MRI in patients with chronic kidney disease (CKD).Methods:A cross-section prospective study was conducted on 73 patients diagnosed with CKD at First People′s Hospital of Changzhou between March 2021 and May 2023, as well as 13 volunteers without kidney injury. According to the estimated glomerular filtration rate (eGFR), the subjects were divided into CKD 1-3 stage group ( n=34), CKD 4-5 stage group ( n=39), and control group ( n=13). All subjects underwent 4D Flow MRI examination of the abdominal aorta, measuring pulse wave velocity (PWV), peak velocity, and maximum wall shear stress (WSS) at the proximal plane (Plane_1) and the higher renal artery opening plane (Plane_2) of the abdominal aorta. The differences in 4D Flow MRI hemodynamic parameters among the three groups were compared using a one-way analysis of variance or the Kruskal-Wallis test. The correlation between 4D Flow MRI hemodynamic parameters and eGFR was analyzed by using the Spearman correlation coefficient. The independent influencing factors that affect eGFR were analyzed by using multivariate linear regression analysis. Results:There were significant differences in abdominal aortic PWV and maximal WSS of Plane_1 and Plane_2 among the three groups ( H=10.38, P=0.006; F=11.16, P<0.001; F=4.75, P=0.011). There were no significant differences in the peak velocity of Plane_1 and Plane_2 among the three groups (both P>0.05). Abdominal aortic PWV was negatively correlated with eGFR ( r s=-0.30, P=0.005). There was a positive correlation between the maximal WSS of Plane_1 and Plane_2 with eGFR ( r s=0.39, P<0.001; r s=0.29, P=0.006). Abdominal aortic PWV and maximal WSS of Plane_1 were independent influencing factors of eGFR (b=-4.32, P=0.018; b=132.23, P=0.004). Conclusions:There is an independent correlation between renal function and abdominal aortic hemodynamic parameters based on 4D Flow MRI in patients with CKD, and abdominal aortic PWV and maximal WSS of Plane_1 were independent influencing factors of eGFR.

Skeletal muscle is the largest metabolic and endocrine organ in the body.As the basic unit of skeletal muscle,muscle fiber has high plasticity.Skeletal muscle fibers are mainly divided into oxidative and glycolytic muscle fibers,and muscle fibers type is an important factor affecting the contraction and energy metabolism of skeletal muscle.Understanding the molecular mechanism regulating skeletal muscle fiber type conversion is of great significance for regulating skeletal muscle-related diseases.Mitochondria is the energy factory of cell life activities,and the characteristics of mitochondria,namely the content,shape and distribution of mitochondria,are closely related to the function of mitochondria.The mitochon-drial characteristics of various types of muscle fiber are different,which is related to the difference of en-ergy metabolism of different muscle fiber types.Mitochondrial homeostasis is a dynamic equilibrium process,which is usually regulated by mitochondrial biogenesis,mitochondrial fusion and fission,mito-chondrial autophagy and other processes.These processes not only affect the morphology and quantity of mitochondria,but also affect the metabolic balance of glucose and fatty acids in the body.Many studies have also shown that mitochondria-mediated changes in the substrates of energy metabolism of skeletal muscle affect the type conversion process of skeletal muscle fiber.Exercise is a non-drug treatment that can generally promote the formation of oxidized muscle fibers by maintaining skeletal muscle mitochondri-al homeostasis.In this paper,the mitochondrial characteristics of different types of skeletal muscle fibers and the role of maintaining mitochondrial homeostasis in regulating muscle fiber type conversion were re-viewed.On this basis,the molecular mechanism of mitochondrial involvement in PGC1α,Ca2+and ROS signaling pathways mediated by fiber type conversion of skeletal muscle was summarized.Mitochondria are the energy factories of skeletal muscle,and targeted intervention through understanding their regulato-ry mechanism may be a new direction for the treatment of skeletal muscle-related diseases in the future.

Social working memory (SWM)-the ability to maintain and manipulate social information in the brain-plays a crucial role in social interactions. However, research on SWM is still in its infancy and is often treated as a unitary construct. In the present study, we propose that SWM can be conceptualized as having two relatively independent components: "externally oriented SWM" (e-SWM) and "internally oriented SWM" (i-SWM). To test this external-internal hypothesis, participants were tasked with memorizing and ranking either facial expressions (e-SWM) or personality traits (i-SWM) associated with images of faces. We then examined the neural correlates of these two SWM components and their functional roles in empathy. The results showed distinct activations as the e-SWM task activated the postcentral and precentral gyri while the i-SWM task activated the precuneus/posterior cingulate cortex and superior frontal gyrus. Distinct multivariate activation patterns were also found within the dorsal medial prefrontal cortex in the two tasks. Moreover, partial least squares analyses combining brain activation and individual differences in empathy showed that e-SWM and i-SWM brain activities were mainly correlated with affective empathy and cognitive empathy, respectively. These findings implicate distinct brain processes as well as functional roles of the two types of SWM, providing support for the internal-external hypothesis of SWM.
Humans ; Memory, Short-Term/physiology* ; Male ; Female ; Empathy/physiology* ; Young Adult ; Magnetic Resonance Imaging ; Adult ; Brain/diagnostic imaging* ; Brain Mapping ; Facial Expression ; Social Behavior ; Facial Recognition/physiology* ; Social Perception ; Personality/physiology*

This study employed 16S r RNA gene high-throughput sequencing and metabolomics to explore the mechanism of Angelicae Dahuricae Radix polysaccharides(RP) in the treatment of ulcerative colitis(UC). A mouse model of UC was induced with 2. 5% dextran sulfate sodium. The therapeutic effects of RP on UC in mice were evaluated based on changes in body weight, disease activity index( DAI), and colon length, as well as pathological changes. RT-qPCR was performed to assess the m RNA levels of interleukin(IL)-6, IL-1β, tumor necrosis factor(TNF)-α, myeloperoxidase(MPO), mucin 2(Muc2), Occludin, Claudin2, and ZO-1 in the mouse colon tissue. ELISA was employed to measure the expression of IL-1β and TNF-α in the colon tissue. The intestinal permeability of mice was evaluated by the fluorescent dye permeability assay. Immunohistochemistry was employed to detect the expression of Muc2 and occludin in the colon tissue. Changes in gut microbiota and metabolites were analyzed by 16S r RNA sequencing and ultra-high-performance liquid chromatography coupled with quadrupole-orbitrap mass spectrometry( UPLC-Q-Exactive Plus Orbitrap MS), respectively. The results indicated that low-dose RP alleviated general symptoms, reduced colonic inflammation and intestinal permeability, and promoted Muc2 secretion and tight junction protein expression in UC mice. In addition, low-dose RP increased gut microbiota diversity in UC mice and decreased the relative abundance of harmful bacteria such as Ochrobactrum and Streptococcus. Twenty-seven differential metabolites were identified in feces, and low-dose RP restored the levels of disturbed metabolites. Notably, arginine and proline metabolism were the most significantly altered amino acid metabolic pathways following lowdose RP intervention. In conclusion, RP can ameliorate general symptoms, inhibit colonic inflammation, and maintain intestinal mucosal barrier integrity in UC mice by modulating gut microbiota composition and arginine and proline metabolism.
Animals ; Gastrointestinal Microbiome/drug effects* ; Colitis, Ulcerative/genetics* ; Mice ; Male ; Drugs, Chinese Herbal/administration & dosage* ; Polysaccharides/administration & dosage* ; Angelica/chemistry* ; Humans ; Colon/metabolism* ; Disease Models, Animal ; Mucin-2/metabolism* ; Tumor Necrosis Factor-alpha/metabolism*

Peripheral artery disease(PAD),commonly encountered in vascular surgery,predominantly affects the lower limbs and presents with ischemic symptoms resulting from atherosclerosis.It carries risks of adverse limb events and cardiovascular events.Antithrombotic therapy remains a cornerstone in the management of PAD.This article reviews the evidence and research progress regarding dual-pathway antithrombotic therapy for PAD.Multiple clinical trials have demonstrated that,compared to single antiplatelet therapy,dual-pathway antithrombotic therapy significantly reduces the risks of major adverse limb events and major adverse cardiovascular events without a significant increase in bleeding risk.For high-risk patients,such as those with advanced age,multivessel disease,comorbid coronary artery disease,or those undergoing endovascular revascularization,the benefits of dual-pathway antithrombotic therapy are particularly pronounced.Current clinical guidelines have incorporated dual-pathway antithrombotic therapy into their recommendations,standardized criteria for identifying the most appropriate patient populations remain lacking.Despite its advantages in reducing adverse events,its long-term safety profile and optimal target populations warrant further investigation.

Traditional Chinese Medicine (TCM), as a treasure of the Chinese nation, plays a significant role in maintaining public health. In 2019, the Central Committee of the Communist Party of China and the State Council proposed for the first time the establishment of a TCM registration and evaluation evidence system that integrates TCM theory, "personal experience" and clinical trials (referred to as the "Three-in-One" System) to promote the inheritance and innovation of TCM. Subsequently, the National Medical Products Administration issued several guiding principles to advance the improvement and implementation of this system. Owing to the complexity of its implementation, there are still differing understandings within the TCM industry regarding the positioning of the "Three-in-One" Registration and Evaluation Evidence System, as well as the connotation and value orientation of the "personal experience." To address this, Academician WANG Qi, President of the TCM Association, China International Exchange and Promotion Association for Medical and Healthcare and TCM master, led a group of academicians, TCM masters, TCM pharmacology experts and clinical TCM experts to convene a "Seminar on Promoting the Implementation of the ′Three-in-One′ Registration and Evaluation Evidence System for Chinese Medicinals." Through extensive discussions, an expert consensus was formed, clarifying the different roles of the TCM theory, "personal experience" and clinical trials within the system. It was further emphasized that the "personal experience" is the core of this system, and its data should be derived from clinical practice scenarios. In the future, the improvement of this system will require collaborative efforts across multiple fields to promote the high-quality development of the Chinese medicinal industry.