Hepatic stellate cells (HSCs) are the primary fibrogenic cells in the liver, and their activation plays a crucial role in the development and progression of hepatic fibrosis. Here, we report that retinoid X receptor-alpha (RXRα), a unique member of the nuclear receptor superfamily, is a key modulator of HSC activation and liver fibrosis. RXRα exerts its effects by modulating calcium/calmodulin-dependent protein kinase kinase β (CaMKKβ)-mediated activation of AMP-activated protein kinase-alpha (AMPKα). In addition, we demonstrate that K-80003, which binds RXRα by a unique mechanism, effectively suppresses HSC activation, proliferation, and migration, thereby inhibiting liver fibrosis in the CCl₄ and amylin liver NASH (AMLN) diet animal models. The effect is mediated by AMPKα activation, promoting mitophagy in HSCs. Mechanistically, K-80003 activates AMPKα by inducing RXRα to form condensates with CaMKKβ and AMPKα via a two-phase process. The formation of RXRα condensates is driven by its N-terminal intrinsic disorder region and requires phosphorylation by CaMKKβ. Our results reveal a crucial role of RXRα in liver fibrosis regulation through modulating mitochondrial activities in HSCs. Furthermore, they suggest that K-80003 and related RXRα modulators hold promise as therapeutic agents for fibrosis-related diseases.

OBJECTIVE To evaluate the efficacy and safety of rituximab （RTX） in the treatment of primary Sjögren syndrome （pSS）. METHODS Randomized controlled trials （RCTs） on the effects of RTX （trial group） versus placebo （control group） in the treatment of pSS were searched from the Cochran Library， PubMed， Embase， Medline， Web of Science， VIP， CNKI， Wanfang， and other databases during the inception to February 2024. After literature screening and quality evaluation， meta-analysis was performed by using RevMan 5.3 software. RESULTS Seven RCTs were finally included， involving a total of 518 patients. Results of meta-analysis showed that European League Against Rheumatism Sjögren syndrome disease activity index （ESSDAI） score [MD＝－1.17， 95%CI（－1.52， －0.82）， P＜0.000 01] and oral dryness visual analogue scale （VAS） score [MD＝－3.97， 95%CI （－5.08， －2.86）， P＜0.000 01] in the trial group were significantly lower than the control group； unstimulated salivary flow rate [SMD＝0.64， 95%CI（0.41， 0.87）， P＜0.000 01] and Schirmer score [MD＝0.19， 95%CI（0.18， 0.20）， P＜0.000 01] were significantly higher than the control group. There was no statistical significance in response rate [RD＝0.10， 95%CI（－0.04， 0.23）， P＝0.16]， fatigue VAS score [MD＝－12.50， 95%CI（－35.14， 10.15）， P＝0.28]， European League Against Rheumatism Sjögren syndrome patient reported index （ESSPRI） score [MD＝0.33， 95%CI（－0.53， 1.18）， P＝0.46]， Short-form 36 health survey physical component summary （SF36-PCS） score [MD＝0.90， 95%CI（－2.97， 4.78）， P＝0.65]， SF-36 mental component summary （SF36-MCS） score [MD＝0.11， 95%CI（－0.41， 0.63）， P＝0.68]， total salivary gland ultrasound score [SMD＝－1.91， 95%CI（－4.01， 0.19）， P＝0.07] or the incidence of adverse drug reactions [OR＝1.15，95%CI（0.62，2.13），P＝0.66] between 2 groups. CONCLUSIONS RTX has advantages in the improvement of ESSDAI score， unstimulated salivary flow rate， Schirmer score and oral dryness VAS score in pSS patients， and has a good safety profile. However， it did not exhibit significant improvement in fatigue VAS score， ESSPRI score， SF36-PCS score， SF36-MCS score or response rates.

OBJECTIVE To evaluate the clinical efficacy and safety of Xiaoyin capsules combined with secukinumab in the treatment of moderate to severe plaque psoriasis. METHODS A retrospective study was conducted on 105 patients with moderate to severe plaque psoriasis who received treatment in the Dept. of Dermatology of Xinxiang Central Hospital from January 2021 to June 2024. According to the treatment plan， they were divided into conventional group（n＝32）， monoclonal antibody group（n＝45）， and combination group（n＝28）. The conventional group was given Calcipotriol ointment+Fluticasone propionate cream+Acitretin capsules； the monoclonal antibody group was treated with secukinumab injection in addition to the treatment of the conventional group； the combination group received oral administration of Xiaoyin capsules in addition to the treatment of the monoclonal antibody group. All patients received at least 12 weeks of treatment. The psoriasis area and severity index（PASI） score， PASI improvement rate， dermatology life quality index（DLQI） score， physician’s global assessment（PGA） score， patient’s global assessment（PtGA） score before and after treatment， and the incidence of adverse reactions during treatment were compared among the three groups. RESULTS Before treatment， there was no statistically significant difference in the above scores among the three groups（P＞0.05）. After treatment， the scores of all three groups of patients significantly decreased compared to before treatment （P＜0.05）； the total PASI score and erythema， scales， affected body surface area score， the total DLQI score and symptom perception， daily activity， social score， the PGA and PtGA scores of the combination group were significantly lower than the other two groups（P＜0.05）； PASI 50（the proportion of patients whose PASI score decreased by ≥50% from baseline， and so on）， PASI 75， and PASI 90 were significantly higher than the other two groups（P＜0.05）； the total PASI score， erythema， and affected body surface area score of patients in the monoclonal antibody group were significantly lower than the conventional group（P＜0.05）， and PASI 75 was significantly higher than the conventional group（P＜0.05）. There was no statistically significant difference in the total incidence of adverse reactions among the 3 groups（P＝0.637）. CONCLUSIONS The combination of Xiaoyin capsules and secukinumab can significantly improve the skin lesions and quality of life in patients with moderate to severe plaque psoriasis， with good tolerability in the short term and no significant increasein the risk of serious adverse reactions.

Although teniposide(VM26)is widely used in the treatment of lymphoma,its poor water sol-ubility,low bioavailability and systemic toxicities still limit its clinical application.Nano-delivery systems are effective in increasing the bioavailability and reducing the toxicity of VM26,but there is an urgent need to overcome the problem of its non-specific targeting.Therefore,in this paper,we designed and constructed a hyaluronic acid-modified teniposide-targeted nano-delivery system(VM26-TNDS),and characterised its drug encapsulation rate,particle size and zeta potential.We also investigated the effects of VM26-TNDS on B-cell lymphoma cells with different expression of CD44 receptor,in terms of cellular targeting,inhibitory effect of proliferation,and induction of apoptosis and necrosis.The results showed that the drug encapsulation efficiency of VM26-TNDS exceeded 85％,and its liquid formulation could be stably stored at 4 ℃ for more than 6 months without precipitation.Based on CD44 receptor expression,Granta-519(high expression),Raji(medium-low expression)and SU-DHL-4(almost no expression)were screened for cellular experiments.Compared with VM26-NDS,the targeted modification could effec-tively reduce the uptake of VM26-TNDS by RAW264.7 and increase the uptake of VM26-TNDS by CD44 receptor-expressing lymphoma cells.The inhibitory proliferative effect and apoptotic necrosis-inducing a-bility of VM26-TNDS were stronger than those of VM26-NDS for Granta-519 and Raji cells,whereas there was no significant difference in the inhibitory effect on proliferation and ability to induce apoptosis and necrosis between VM26-NDS and VM26-TNDS in SU-DHL-4 cells,reflecting the targeting advantage for VM26-TNDS,as expected.However,its toxic effect on B-cell lymphoma cells only reflected the targeting advantage at some concentrations(0.25 μmol/L and 0.5 μmol/L),which met the expectation.The a-bove results indicate that a teniposide-targeted nano-delivery system,VM26-TNDS,has been successfully prepared in this study.VM26-TNDS improves the delivery efficiency of VM26 by targeting human B-cell lymphoma cells expressing the CD44 receptor,thus killing human B-cell lymphoma cells more effectively and overcoming the problem of non-specific targeting in drug delivery to improve the therapeutic effect.Its biological therapeutic effects and mechanisms still need to be proved by more in vitro and in vivo ex-perimental evidence.

This study aims to determine the nephrotoxic effects of 3-monochloropropanel-1,2-diol(3-MCPD)on female and male SD rats.A nephrotoxicity model was established by gavage of dif-ferent doses of 3-MCPD,and 80 SD rats were randomly divided into four groups:the control group(0 mg/kg 3-MCPD),low-dose group(15 mg/kg 3-MCPD),medium-dose group(30 mg/kg 3-MCPD),high-dose group(60 mg/kg 3-MCPD),with half female and half male.The body mass and food intake of the rats were recorded weekly,and the urine and blood and kidney tissues were col-lected after 28 consecutive days of gavage,and the blood erythrocyte count(WBC),white blood cell count(RBC),hemoglobin(HGB),erythrocyte-compaction-transfer-value(HCT),creatinine(CREA),serum urea nitrogen(BUN),and the indexes of blood phosphorus(P)and calcium(Ca)were detected;the level of kidney injury molecule(KIM-1)was measured by ELISA kit;the renal pathological changes was observed by histopathology method;and transcriptome sequencing was used to analyze differential genes in female and male rats.The results showed that 3-MCPD did not significantly affect the growth of male rats,but high doses significantly reduced the weight and food intake of female rats.The high-dose group of 3-MCPD caused a significant decrease in RBC,HGB,and HCT levels in both male and female rats,resulting in a significant increase in KIM-1 and P,and a significant decrease in Ca,but only a significant increase in CREA and BUN in female rats.Histopathology showed that in the high-dose group of male rats,only mild renal tubular dilation,epithelial cell edema,and clear tubular type were observed in the kidneys,while in female rats,a large number of renal sacs,clear tubular type,and interstitial inflammatory cells with fibrosis were observed in the kidneys.Transcriptome sequencing showed 1 712 differentially expressed genes in the high-dose group of female rats and 1 153 differentially expressed genes in the high-dose group of male rats.KEGG enrichment analysis showed that both male and female rats in the high-dose group experienced oxidative stress and cell apoptosis,but 3-MCPD may also participate in the process of kidney damage in females by inhibiting autophagy and inducing iron death pathways.The above results indicate that high-dose 3-MCPD has a more significant nephrotoxic effect on fe-male rats.

OBJECTIVE To observe the effect of early warning mechanisms based on nosocomial infection surveil-lance system on precise prevention and control of spread of multidrug-resistant organisms(MDROs)infections in intensive care unit of neurosurgery department.METHODS The dynamic monitoring was performed in the ICU of neurosurgery department of a three-A general hospital by using real-time surveillance system of nosocomial infec-tion from Jan.2023 to Dec.2023.The warning information was sent to the doctor' station immediately once the MDROs infections were detected,the detection of drug-resistant bacteria was carried out for the relevant personnel and their surroundings,and the precise prevention and control measures were implemented.The impact on the iso-lation rate of MDROs,isolation rate of MDROs from the relevant personnel and surroundings,incidence of noso-comial MDROs infections and incidence of surgical site infection was observed after the measures were taken.RESULTS The carrying rate of MDROs was decreased from 21.80％to 5.74％among the relevant personnel after the precise prevention and control measures were taken(P＜0.05),which was improved remarkably among the doctors(decreasing from 21.43％to 6.07％),nurses(decreasing from 23.68％to 3.98％),nursing workers(decreasing from 25.15％to 8.65％),and cleaning staff(decreasing from 25.49％to 5.05％)(P＜0.001).The isolation rate of MDROs was decreased from 20.77％to 7.12％among the surroundings(P＜0.05),which was decreased most remarkably among head cushions(decreasing from 32.28％to 12.13％),bed rails(decreasing from 16.70％to 3.27％),ventilator panels(decreasing from 23.00％to 6.95％)and bedside floors(decreasing from 31.99％to 9.96％)(P＜0.001).The incidence of nosocomial MDROs infections declined from 3.84％to 1.71％(P＜0.05),with incidence of incision infections decreasing from 4.00％to 1.45％(P＜0.05),the inci-dence of intracranial infections decreasing from 2.38％to 0.56％(P＜0.05).CONCLUSION The detection of drug-resistant bacteria is carried out immediately and precisely for the patients with MDROs infection,relevant personnel and their surroundings by using the real-time surveillance system of nosocomial infection,which achieve remarkable effect on prevention of transmission of MDROs and reduction of incidence of hospital-associated infec-tions and surgical site infections.

OBJECTIVE To observe the effect of early warning mechanisms based on nosocomial infection surveil-lance system on precise prevention and control of spread of multidrug-resistant organisms(MDROs)infections in intensive care unit of neurosurgery department.METHODS The dynamic monitoring was performed in the ICU of neurosurgery department of a three-A general hospital by using real-time surveillance system of nosocomial infec-tion from Jan.2023 to Dec.2023.The warning information was sent to the doctor' station immediately once the MDROs infections were detected,the detection of drug-resistant bacteria was carried out for the relevant personnel and their surroundings,and the precise prevention and control measures were implemented.The impact on the iso-lation rate of MDROs,isolation rate of MDROs from the relevant personnel and surroundings,incidence of noso-comial MDROs infections and incidence of surgical site infection was observed after the measures were taken.RESULTS The carrying rate of MDROs was decreased from 21.80％to 5.74％among the relevant personnel after the precise prevention and control measures were taken(P＜0.05),which was improved remarkably among the doctors(decreasing from 21.43％to 6.07％),nurses(decreasing from 23.68％to 3.98％),nursing workers(decreasing from 25.15％to 8.65％),and cleaning staff(decreasing from 25.49％to 5.05％)(P＜0.001).The isolation rate of MDROs was decreased from 20.77％to 7.12％among the surroundings(P＜0.05),which was decreased most remarkably among head cushions(decreasing from 32.28％to 12.13％),bed rails(decreasing from 16.70％to 3.27％),ventilator panels(decreasing from 23.00％to 6.95％)and bedside floors(decreasing from 31.99％to 9.96％)(P＜0.001).The incidence of nosocomial MDROs infections declined from 3.84％to 1.71％(P＜0.05),with incidence of incision infections decreasing from 4.00％to 1.45％(P＜0.05),the inci-dence of intracranial infections decreasing from 2.38％to 0.56％(P＜0.05).CONCLUSION The detection of drug-resistant bacteria is carried out immediately and precisely for the patients with MDROs infection,relevant personnel and their surroundings by using the real-time surveillance system of nosocomial infection,which achieve remarkable effect on prevention of transmission of MDROs and reduction of incidence of hospital-associated infec-tions and surgical site infections.

Thoracolumbar spine fracture often leads to severe pain, functional impairments, and neurological deficits, for which open reduction and internal fixation can effectively restore the spinal structural stability. Open decompression and reduction with internal fixation can help relieve spinal cord compression and improve spinal function in cases of concomitant cord injury. Although spinal stability can be restored through surgery, patients often face chronic pain and functional impairments postoperatively. A postoperative rehabilitation program is critical in optimizing therapeutic outcomes, reducing complications, and minimizing the risk of secondary injuries. However, current rehabilitation methods, such as physical therapy, functional training, and pain management, are confronted with problems in clinical practice, including significant variation in efficacy, poor patient adherence, and prolonged rehabilitation period. There is an urgent need for a unified rehabilitation strategy to address these problems. To this end, the Spinal Trauma Group of the Orthopedic Physicians Branch of the Chinese Medical Association and the Spine Health Professional Committee of the Chinese Human Health Technology Promotion Association organized experts from relevant fields to formulate Evidence-based guidelines for rehabilitation treatment after internal fixation of thoracolumbar spine fracture in adults ( version 2025) by integrating evidences from clinical researches and advanced rehabilitation concepts at home and abroad. A total number of 14 recommendations concerning the rehabilitation treatment with multimodal analgesia, psychological intervention, deep vein thrombosis prevention, core muscle and extremity exercise, appropriate use of braces, early weight-bearing, device-aided rehabilitation exercise, neuroregulatory therapy, rehabilitation team were put forward, aiming to standardize the post-operative rehabilitation process following internal fixation, promote the functional recovery, and enhance patients′ quality of life.

Acute symptomatic osteoporotic thoracolumbar compression fracture (ASOTLF) can lead to chronic low back pain, kyphosis deformity, pulmonary dysfunction, loss of mobility, and even life-threatening complications. Vertebral augmentation is currently the mainstream treatment method for this condition. In 2019, the Editorial Board of Chinese Journal of Trauma and the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association collaboratively led the development of Clinical guideline for vertebral augmentation for acute symptomatic osteoporotic thoracolumbar compression fractures. Six years later, with advances in clinical diagnosis and treatment techniques as well as accumulating evidence in related fields, the 2019 guideline requires updating. To this end, the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association, the Spinal Health Professional Committee of China Human Health Science and Technology Promotion Association, and the Minimally Invasive Orthopedics Professional Committee of Shaanxi Medical Doctor Association have organized experts in the field to develop the Clinical guideline for vertebral augmentation of acute symptomatic osteoporotic thoracolumbar compression fractures ( version 2025) , based on the latest evidence-based medical researches. This guideline incorporates 3 recommendations retained from the 2019 version with updated strength of evidence, along with 12 new recommendations. It provides recommendations from six aspects of diagnosis, pain management, treatment option selection, prevention of postoperative complications, anti-osteoporosis therapy, and postoperative rehabilitation, aiming to provide a reference for standard treatment of vertebral augmentation for ASOTLF in hospitals at all levels.

Objective:To assess the association of single nucleotide polymorphisms (SNPs) of interleukin-23 receptor ( IL-23R) gene with susceptibility to psoriasis. Methods:Two hundred and ten psoriasis patients admitted to Xinxiang Central Hospital from January 2019 to December 2024 were selected as the study group, and 210 healthy individuals undergoing physical examination during the same period were selected as the control group. 3 mL of peripheral venous blood sample was collected from each individual from the two groups, and PCR - Restriction fragment length polymorphism (PCR-RFLP) assay was used to determine the polymorphisms of the IL-23R gene at rs2201841, rs1004819, rs10889677, rs1343151 and rs1495965 loci. Genotypic and allelic distribution of each SNP locus was calculated to assess the association between SNPs of the IL-23R gene with the onset of psoriasis, and the difference in serum IL-23 levels among patients with different genotypes at each locus was compared. This study was approved by the Medical Ethics Committee of Xinxiang Central Hospital (Ethic No. 2024-749). Results:The results showed that the frequency of CC genotype at rs1004819 locus of the study group was significantly higher than that of the control group (26.19% vs. 18.10%, P<0.05), and the frequency of C allele was also significantly higher than that of the control group (54.05% vs. 42.62%, P<0.05). There was no significant difference in allelic and genotypic frequencies between the two groups at rs2201841, rs10889677, rs1343151, and rs1495965 loci ( P>0.05). The dominant and recessive inheritance patterns at the rs1004819 locus are associated with susceptibility to psoriasis ( P<0.05), while the different inheritance patterns at rs2201841, rs10889677, rs1343151, and rs1495965 loci are not associated with psoriasis ( P>0.05). The serum IL-23 levels of patients with CC genotype at the rs1004819 locus were higher than those with CT and TT genotypes ( P<0.05). No significant difference was detected in the serum levels of IL-23 between patients with different genotypes for the rs2201841, rs10889677, rs1343151, and rs1495965 loci ( P>0.05). Conclusion:The polymorphism at the rs1004819 locus of the IL-23R gene is associated with susceptibility to psoriasis, and individuals carrying the CC genotype and C allele have a higher risk of developing the disease.