Complement 1q(C1q),as an initiator of the classical complement pathway,is a key regulator in the maintenance of immune homeostasis-a dynamic process by which the immune system orchestrates a cycle of activation,balanced regulation,resolution,and recovery to achieve effective defense while preventing excessive damage.Dysregulation of immune homeostasis represents a common pathological basis for autoimmune diseases,increased susceptibility to infections,and tumor immune evasion.In the tumor microenvironment,C1q exerts dual effects,acting as both a tumor suppressor and a promoter of immune evasion.This review summarizes recent advances in understanding the physiological role of C1q in sustaining immune homeostasis and its involvement in autoimmune disorders,infectious diseases,and tumors,with the aim of providing insights into its immunoregulatory functions and informing the development of diagnostic and therapeutic strategies for related diseases.

Objective To explore the effects of indole-3-acetic acid (IAA) on metabolic dysfunction associated steatohepatitis (MASH) related liver fibrosis and its molecular mechanism. Methods A human-derived 3D liver spheroid was established and free fatty acid (FFA) was added to induce the MASH model. The spheroids were divided into five groups: control group, MASH group, low dose IAA group (FFA＋4 μmol/L IAA), medium dose IAA group (FFA＋20 μmol/L IAA) and high dose IAA group (FFA＋100 μmol/L IAA). Transforming growth factor-β1 (TGF-β1) was administrated to hepatic stellate cell lines LX-2. LX-2 cells were divided into four groups: control group, TGF-β1 group, medium dose IAA group (TGF-β1＋20 μmol/L IAA) and high dose IAA group (TGF-β1＋100 μmol/L IAA). Hematoxylin and eosin staining and Sirius red staining were performed to estimate pathological change. Immunofluorescence was performed to evaluate smooth muscle actin α (α-SMA), COL1A1, β-catenin level. Real-time quantitative reverse transcription polymerase chain reaction was performed to evaluate COL1A1, TGFB, CTNNB1, CCND1, MMP7, ACTA2 levels. Western blotting was performed to evaluate α-SMA and β-catenin level. CCK-8 was performed to evaluate cell proliferation. Wnt pathway agonist CHIR99021 was administrated in rescue experiments. Results FFA treatment successfully induced the MASH phenotype in 3D liver spheroids. Compared with the MASH group, the percentage of collagen area was reduced in all IAA dose groups (P＜0.05), and the expression levels of hepatic stellate cell activation markers α-SMA and COL1A1 were decreased (P＜0.05). In cell experiments, the expression of hepatic stellate cell activation-related genes (TGFB1, ACTA2, COL1A1) in medium dose and high dose IAA groups was lower than that in the TGF-β1 group (P＜0.05), and the cell proliferation level in the high dose IAA group was lower than that in the TGF-β1 group (P＜0.05). Compared with the TGF-β1 group, IAA downregulated β-catenin levels and inhibited the expression of downstream genes in the Wnt pathway (P＜0.05); activation of the Wnt pathway could partially reverse the effects of IAA. Conclusions IAA may inhibit the proliferation and activation of hepatic stellate cells by suppressing the Wnt/β-catenin signaling pathway and alleviate MASH-related liver fibrosis.

Investigator-initiated clinical trials （IIT） are an important part of scientific and technological activities involving human study participants. Among them， high-quality IIT can be used to support the marketing and registration application of drugs， medical devices， and other products when conditions permit. Currently， there is a huge gap between IIT and industry-initiated clinical trials. The use of unlisted products in IIT has problems， such as lack of regulatory support， insufficient research funding support， the need to improve the ability of clinical research management departments， the weakness of professional clinical research teams， and the difficulty of ethics review to match the demands. The challenges could be addressed by improving regulations and conducting pilot trials on a small scale， guaranteeing adequate research funding， strengthening the construction of clinical research management systems， building professional clinical research teams， ensuring the quality of ethical reviews and strict follow-up reviews， shifting from ethical reviews to a system for protecting research participants， and reinforcing training for researchers. Ethics committees should strictly review key points， such as the risk-benefit ratio， informed consent， research funding， compensation for damages， qualifications and equipment of research team members， and management of conflict of interest.

Objective To investigate the current status and influencing factors of anticipatory grief of main caregivers of young and middle-aged patients with advanced liver cancer by cross-sectional survey.Methods A total of 330 caregivers of young and middle-aged patients with advanced liver cancer who were admitted to The Third Affiliated Hospital of Naval Medical University from January 2023 to May 2023 were enrolled as research objects by convenience sampling.A questionnaire survey on general information,anticipatory grief and simple coping style was conducted on these caregivers one day before discharge.Results The score of anticipatory grief of the caregivers was 94.10±22.33.Multiple linear stepwise regression analysis was performed with statistically significant data from the characteristics of the research objects as independent variables and anticipatory grief as the dependent variable,and the result showed that gender,monthly income,educational level,personality self-assessment and coping were main factors affecting anticipatory grief of main caregivers of young and middle-aged patients with advanced liver cancer(all P<0.05).The mean score for positive response was 2.23±0.14,which was negatively associated with anticipatory grief(P=0.041).The mean score for negative response was 1.31±0.24,which was positively associated with anticipatory grief(P<0.001).Conclusion The anticipatory grief of main caregivers of young and middle-aged patients with advanced liver cancer is at a high level.The anticipatory grief is negatively related to positive coping,and positively related to negative coping.The main factors affecting anticipatory grief of main caregivers of young and middle-aged patients with advanced liver cancer are gender,family economic status,educational level,and introverted personality.

PURPOSE: Septic shock is associated with high mortality and poor outcomes among sepsis patients with coagulopathy. Although traditional statistical methods or machine learning (ML) algorithms have been proposed to predict septic shock, these potential approaches have never been systematically compared. The present work aimed to develop and compare models to predict septic shock among patients with sepsis. METHODS: It is a retrospective cohort study based on 484 patients with sepsis who were admitted to our intensive care units between May 2018 and November 2022. Patients from the 908th Hospital of Chinese PLA Logistical Support Force and Nanchang Hongdu Hospital of Traditional Chinese Medicine were respectively allocated to training (n=311) and validation (n=173) sets. All clinical and laboratory data of sepsis patients characterized by comprehensive coagulation indexes were collected. We developed 5 models based on ML algorithms and 1 model based on a traditional statistical method to predict septic shock in the training cohort. The performance of all models was assessed using the area under the receiver operating characteristic curve and calibration plots. Decision curve analysis was used to evaluate the net benefit of the models. The validation set was applied to verify the predictive accuracy of the models. This study also used Shapley additive explanations method to assess variable importance and explain the prediction made by a ML algorithm. RESULTS: Among all patients, 37.2% experienced septic shock. The characteristic curves of the 6 models ranged from 0.833 to 0.962 and 0.630 to 0.744 in the training and validation sets, respectively. The model with the best prediction performance was based on the support vector machine (SVM) algorithm, which was constructed by age, tissue plasminogen activator-inhibitor complex, prothrombin time, international normalized ratio, white blood cells, and platelet counts. The SVM model showed good calibration and discrimination and a greater net benefit in decision curve analysis. CONCLUSION The SVM algorithm may be superior to other ML and traditional statistical algorithms for predicting septic shock. Physicians can better understand the reliability of the predictive model by Shapley additive explanations value analysis.
Humans ; Shock, Septic/blood* ; Machine Learning ; Male ; Female ; Retrospective Studies ; Middle Aged ; Aged ; Sepsis/complications* ; ROC Curve ; Cohort Studies ; Adult ; Intensive Care Units ; Algorithms ; Blood Coagulation ; Critical Illness

Objective:As the " Administrative Measures for Conducting investigator-initiated Clinical Research in Medical and Health Institutions" promulgated, to explore the key points and difficulties in the management of Investigator-Initiated Trials(IIT) in healthcare institutions, and provide basis for promoting the standardization and high-quality management of IIT.Methods:On the basis of policy text research , through literature investigation and working practice, this paper analyzes new requirements of the Management Measures for clinical trials management and puts forward implementation suggestions.Results:The Administrative Measures put forward new requirements for the implementation and management of clinical trials from the aspects of scientific review and ethical review, and carried out intervention research beyond the scope, clinical research management committee responsibilities. Medical and carried institutions need to strengthen the management of the whole process of clinical trials implementation.Conclusions:Medical and health institutions can strengthen clinical trials management by building the organizational structure of clinical trials whole-process management, hierarchical risk management, taking scientific review as the starting point, opening up all aspects of project management, focusing on process management, and strengthening quality control and quality assurance.

China has become the country with the highest global burden of heart failure(HF).Despite the widespread use of prognostic-improving medications today,the mortality rate of HF remains high,reaching 13.7％at one year-particularly among patients with heart failure with reduced ejection fraction(HFrEF).HF interventional device therapy(structural intervention)targets the structural factors underlying HF,including atrial pressure,ventricular remodeling,and valvular intervention.It leverages the heart's intrinsic physiological properties and pathological progression mechanisms to deliver treatments through interventions without external active forces,achieving anatomical or functional repair.This field has emerged as a rapidly growing area and plays an increasingly critical role in HF management.This article provides a comprehensive review and summary of the latest advancements in HF and cardiomyopathy interventional therapy over the past year.It covers various novel technologies and products currently in the research phase,aiming to provide an in-depth analysis of the current status and future directions of HF interventional therapy,and further advance the development of this discipline.

OBJECTIVE: To screen the genetic risk factors related to severe hematology adverse effects (AEs) in patients with chronic myeloid leukemia (CML) treated with imatinib (IM), and explore the correlation of single nucleotide polymorphisms (SNPs) in IM drug metabolism and transport pathway gene polymorphism with the risk of severe hematology AEs. METHODS: 172 newly diagnosed Chinese Han patients in CML chronic phase (CML-CP) treated with IM were included and divided into severe hematology AEs group and non-severe hematology AEs group. The demographic characteristics and laboratory test results were compared between the two groups. 11 gene SNP sites in the included subjects were genotyped using SNaPshot multiplex SNPs technique. RESULTS: Compared with non-severe hematology AEs group, the severe hematology AEs group had higher white blood cell (WBC) and EOS% (both P < 0.05), but lower hemoglobin (Hb) and hematocrit (HCT) (both P < 0.01). For rs1045642 of ABCB1 gene, there were significant differences in the distribution of allele frequency and genotype frequency of this loci between severe hematology AEs group and non-severe hematology AEs group (both P < 0.05). Carriers of rs1045642 mutation allele A had an increased risk of severe hematology AEs (OR =2.09, 95% CI : 1.24-3.55, P =0.005). There was a significant difference in the distribution of NR1I2 gene rs3814055 genotype between severe hematology AEs group and non-severe hematology AEs group (P < 0.05). The additive model and recessive model of ABCB1 gene rs1045642 and the recessive model of NR1I2 gene rs3814055 were associated with the increased risk of severe hematology AEs (OR =2.14, 3.28, 5.54, all P < 0.05). CONCLUSION Peripheral blood WBC, EOS%, Hb and HCT in patients with newly diagnosed CML-CP are all related to the risk of severe hematology AEs. ABCB1 gene rs1045642 and NR1I2 gene rs3814055 related to the metabolism and transport pathway of IM are associated with severe hematology AEs after IM treatment in CML-CP patients, and they may be potential molecular markers to predict the risk of severe hematology AEs of CML patients treated by IM.
Humans ; Imatinib Mesylate ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics* ; Polymorphism, Single Nucleotide ; Genotype ; ATP Binding Cassette Transporter, Subfamily B ; Gene Frequency ; Female ; Male ; Middle Aged ; Adult ; Asian People

Bisphenol A (BPA) is a kind of exogenous chemicals presenting in the human living environment widely which affects the action of endocrine hormones in the human body. Numerous studies have shown that BPA has reproductive toxicity in the spermatogenic function damage of the testes through a variety of mechanisms such as interfering with endocrine function, inducing oxidative stress, promoting spermatogonial cell apoptosis, destroying the integrity of the blood-testis barrier, and regulating epigenetic inheritance, thereby destroying male fertility. Relevant studies have shown that TCM can improve male fertility by reversing BPA-induced reproductive damage through multi-component, multi-target and multi-mechanisms. However, there is no systematic review on the mechanism of TCM to reduce the reproductive toxicity of BPA. Based on the existing studies, this article will systematically introduce the mechanisms of BPA-induced reproductive impairment in men and the progress of TCM interventions, with a view to providing reference targets and research directions for the development of new Chinese medicines.
Humans ; Benzhydryl Compounds/adverse effects* ; Male ; Phenols/adverse effects* ; Medicine, Chinese Traditional ; Infertility, Male/chemically induced* ; Testis/drug effects* ; Drugs, Chinese Herbal/therapeutic use* ; Bisphenol A Compounds

China has become the country with the highest global burden of heart failure(HF).Despite the widespread use of prognostic-improving medications today,the mortality rate of HF remains high,reaching 13.7％at one year-particularly among patients with heart failure with reduced ejection fraction(HFrEF).HF interventional device therapy(structural intervention)targets the structural factors underlying HF,including atrial pressure,ventricular remodeling,and valvular intervention.It leverages the heart's intrinsic physiological properties and pathological progression mechanisms to deliver treatments through interventions without external active forces,achieving anatomical or functional repair.This field has emerged as a rapidly growing area and plays an increasingly critical role in HF management.This article provides a comprehensive review and summary of the latest advancements in HF and cardiomyopathy interventional therapy over the past year.It covers various novel technologies and products currently in the research phase,aiming to provide an in-depth analysis of the current status and future directions of HF interventional therapy,and further advance the development of this discipline.