Metabolic dysfunction-associated steatohepatitis (MASH), a severe type of metabolic dysfunction-associated steatotic liver disease (MASLD), is a leading etiology of end-stage liver disease worldwide, posing significant health and economic burdens. microRNA-320 (miR-320), a ubiquitously expressed and evolutionarily conserved miRNA, has been reported to regulate lipid metabolism; however, whether and how miR-320 affects MASH development remains unclear. By performing miR-320 in situ hybridization with RNAscope, we observed a notable downregulation of miR-320 in hepatocytes during MASH, correlating with disease severity. Most importantly, miR-320 downregulation in hepatocytes exacerbated MASH progression as demonstrated that hepatocyte-specific miR-320 deficient mice were more susceptible to high-fat, high-fructose, high-cholesterol diet (HFHC) or choline-deficient, amino acid-defined, high-fat diet (CDAHFD)-induced MASH compared with control littermates. Conversely, restoration of miR-320 in hepatocytes ameliorated MASH-related steatosis and fibrosis by injection of adeno-associated virus 8 (AAV8) carrying miR-320 in different types of diet-induced MASH models. Mechanistic studies revealed that miR-320 specifically regulated fibroblast growth factor 1 (FGF1) production in hepatocytes by inhibiting regulator factor X1 (RFX1) expression. Notably, knockdown of Rfx1 in hepatocytes mitigated MASH by enhancing FGF1-mediated AMPK activation. Our findings underscore the therapeutic potential of hepatic miR-320 supplementation in MASH treatment by inhibiting RFX1-mediated FGF1 suppression.

Objective:To construct an integrated early rehabilitation program for healthcare and rehabilitation system based on the information-motivation-behavioral skills (IMB) model and evaluate its application effect in patients treated with total hip arthroplasty (THA).Methods:Construction of the rehabilitation program: An integrated research team was established, composed of head burse of orthopedics, orthopedic nursing specialists, orthopedic surgeons, anesthesiologists, and rehabilitation therapists. Considering the key points of perioperative early rehabilitation of THA patients, an integrated early rehabilitation program was constructed based on the IMB model through literature review and expert panel method. Clinical application of the rehabilitation program: A retrospective cohort study was conducted to analyze the clinical data of 100 THA patients admitted to Qingdao Municipal Hospital from March to December 2023, including 47 males and 53 females, aged 60-85 years [(69.8±5.5)years]. Patients were divided into two groups according to their admission time: 50 patients admitted from March to July 2023, receiving routine care (routine care group) and 50 admitted from August to December 2023, receiving intervention through an early rehabilitation program of an integrated healthcare and rehabilitation system based on routine care (integrated care group). The first postoperative ambulation time and length of hospital stay were compared between the two groups. The Harris hip function score was used to assess hip function in both groups at 3 days, 1, 3, and 6 months postoperatively; the Barthel index was used to assess the daily living self-care capacity in both groups preoperatively, at 1, 3, and 6 months postoperatively. The incidence of complications within 6 months after surgery was compared between the two groups.Results:An early integrated rehabilitation program based on the IMB model comprised 25 specific measures of three domains: information support, motivational intervention, and behavioral skills. All the patients were followed up for 6 months. The first postoperative ambulation time and length of hospital stay in the integrated care group were (1.3±0.5)days and (7.4±2.3)days, shorter than (1.5±0.5)days and (8.5±2.3)days in the routine care group ( P<0.05). There were no statistically significant differences in the Harris hip function scores at 3 days postoperatively or preoperative Barthel index between the two groups ( P>0.05). At 1, 3, and 6 months postoperatively, the Harris hip function scores in the integrated care group were (80.3±6.0)points, (88.6±5.2)points, and (92.5±4.1)points, respectively, higher than (75.1±6.3)points, (84.2±5.7)points, and (88.0±5.2)points in the routine care group ( P<0.01); the Barthel index in the integrated care group were (79.2±8.7)points, (87.7±5.7)points, and (92.3±4.9)points, respectively, higher than (72.1±9.0)points, (83.5±6.6)points, and (88.6±5.0)points in the routine care group ( P<0.01). At 6 months postoperatively, the incidence of complications in the integrated care group was 4% (2/50), lower than 16% (8/50) in the routine care group ( P<0.05). Conclusion:Compared with the routine care, an integrated early rehabilitation program for medical care and health based on the information-motivation-behavioral skills model for THA patients can shorten the first postoperative ambulation time and length of hospital stay, restore hip joint function, improve daily living self-care capacity and reduce the incidence of complications.

Objective:To construct an integrated early rehabilitation program for healthcare and rehabilitation system based on the information-motivation-behavioral skills (IMB) model and evaluate its application effect in patients treated with total hip arthroplasty (THA).Methods:Construction of the rehabilitation program: An integrated research team was established, composed of head burse of orthopedics, orthopedic nursing specialists, orthopedic surgeons, anesthesiologists, and rehabilitation therapists. Considering the key points of perioperative early rehabilitation of THA patients, an integrated early rehabilitation program was constructed based on the IMB model through literature review and expert panel method. Clinical application of the rehabilitation program: A retrospective cohort study was conducted to analyze the clinical data of 100 THA patients admitted to Qingdao Municipal Hospital from March to December 2023, including 47 males and 53 females, aged 60-85 years [(69.8±5.5)years]. Patients were divided into two groups according to their admission time: 50 patients admitted from March to July 2023, receiving routine care (routine care group) and 50 admitted from August to December 2023, receiving intervention through an early rehabilitation program of an integrated healthcare and rehabilitation system based on routine care (integrated care group). The first postoperative ambulation time and length of hospital stay were compared between the two groups. The Harris hip function score was used to assess hip function in both groups at 3 days, 1, 3, and 6 months postoperatively; the Barthel index was used to assess the daily living self-care capacity in both groups preoperatively, at 1, 3, and 6 months postoperatively. The incidence of complications within 6 months after surgery was compared between the two groups.Results:An early integrated rehabilitation program based on the IMB model comprised 25 specific measures of three domains: information support, motivational intervention, and behavioral skills. All the patients were followed up for 6 months. The first postoperative ambulation time and length of hospital stay in the integrated care group were (1.3±0.5)days and (7.4±2.3)days, shorter than (1.5±0.5)days and (8.5±2.3)days in the routine care group ( P<0.05). There were no statistically significant differences in the Harris hip function scores at 3 days postoperatively or preoperative Barthel index between the two groups ( P>0.05). At 1, 3, and 6 months postoperatively, the Harris hip function scores in the integrated care group were (80.3±6.0)points, (88.6±5.2)points, and (92.5±4.1)points, respectively, higher than (75.1±6.3)points, (84.2±5.7)points, and (88.0±5.2)points in the routine care group ( P<0.01); the Barthel index in the integrated care group were (79.2±8.7)points, (87.7±5.7)points, and (92.3±4.9)points, respectively, higher than (72.1±9.0)points, (83.5±6.6)points, and (88.6±5.0)points in the routine care group ( P<0.01). At 6 months postoperatively, the incidence of complications in the integrated care group was 4% (2/50), lower than 16% (8/50) in the routine care group ( P<0.05). Conclusion:Compared with the routine care, an integrated early rehabilitation program for medical care and health based on the information-motivation-behavioral skills model for THA patients can shorten the first postoperative ambulation time and length of hospital stay, restore hip joint function, improve daily living self-care capacity and reduce the incidence of complications.

Objective To analyze the current situation of depressive symptoms among medical staff in Beijing City and its correlation with symptoms of anxiety, occupational stress and insomnia. Methods A total of 2 687 medical staff from 28 medical institutions in eight municipal districts of Beijing City were selected as study subjects using multi-stage sampling method. The basic situation, depression symptoms, anxiety symptoms, occupational stress and insomnia symptoms were investigated using the National Occupational Health Literacy Monitoring Questionnaire for Key Groups, Patient Health Questionaire-9, 7-item Generalized Anxiety Disorder Scale, Core Occupational Stress Scale, and Self-Sleep Management Questionnaire. Results The detection rate of depressive symptoms was 28.3%, and the detection rates of moderate, moderate-severe and severe depressive symptoms were 18.9%, 6.9% and 2.5%, respectively. The detection rate of anxiety symptoms was 41.3%, and the detection rates of mild, moderate and severe anxiety symptoms were 29.7%, 7.7% and 3.9%, respectively. The detection rate of occupational stress was 26.7%. The detection rate of insomnia symptoms was 36.6%. The results of multivariate logistic regression analysis showed that the risk of depressive symptoms in male medical staff was higher than that in female (P<0.05). The risk of depressive symptoms in night shift staff was higher than that in staff without night shift (P<0.05). The more severe the anxiety symptoms, the higher the risk of depressive symptoms (all P<0.01). The risk of depressive symptoms in medical staff with occupational stress was higher than those without occupational stress (P<0.01). The risk of depressive symptoms in medical staff with insomnia symptoms was higher than those without insomnia symptoms (P<0.01). Conclusion The detection rate of depressive symptoms among medical staff in Beijing City is relatively high. Gender, night shift, anxiety symptoms, occupational stress, and insomnia symptoms were independent risk factors of depressive symptoms.

Objective The study aimed to investigate the prevalence of various Traditional Chinese Medicine(TCM)syndromes during the acute phase of ischemic stroke and identify the key symptoms associated with each syndrome.Methods A total of 1011 patients in the acute phase of ischemic stroke were assessed for TCM syndromes using the"Diagnostic criteria for stroke in Traditional Chinese Medicine"within 72 h of symptom onset,on the 7th day post onset,and on the 14th day.R4.2.3 software was utilized to analyze the TCM syndromes and symptoms,as well as to conduct network analysis.Results The incidence of phlegm syndrome was the highest(54.10％,51.18％,49.39％)at 72 h,7th and 14th day of disease onset,respectively,followed by wind syndrome,fire-heat syndrome,blood stasis syndrome,qi deficiency syndrome and excessive yang due to yin deficiency syndrome.The incidence of wind syndrome gradually decreased over time(x2=15.619,P＜0.001).In the network of 44 TCM syndrome entries,TZ-5(pulse)had the highest centrality index(strength=2.4)and was located at the most central position of the network.In the network analysis of different TCM syndrome,TZ-5(pulse)(strength=1.91)was located in the center of the phlegm syndrome network,FZ-1(onset)(strength=1.61)was located in the center of the wind syndrome network,HRZ-2(tongue coating)(strength=1.37)was located in the center of the network in the fire-heat syndrome,XYZ-1(tongue texture)(strength=1.18)was located at the center of the network for the blood stasis syndrome.Conclusion The phlegm syndrome is the most important syndrome in the acute phase of ischemic stroke.Employing network analysis can elucidate the central symptoms of different syndromes and the interconnections between the symptoms,providing new ideas for the identification of ischemic stroke.

Objective The study aimed to investigate the prevalence of various Traditional Chinese Medicine(TCM)syndromes during the acute phase of ischemic stroke and identify the key symptoms associated with each syndrome.Methods A total of 1011 patients in the acute phase of ischemic stroke were assessed for TCM syndromes using the"Diagnostic criteria for stroke in Traditional Chinese Medicine"within 72 h of symptom onset,on the 7th day post onset,and on the 14th day.R4.2.3 software was utilized to analyze the TCM syndromes and symptoms,as well as to conduct network analysis.Results The incidence of phlegm syndrome was the highest(54.10％,51.18％,49.39％)at 72 h,7th and 14th day of disease onset,respectively,followed by wind syndrome,fire-heat syndrome,blood stasis syndrome,qi deficiency syndrome and excessive yang due to yin deficiency syndrome.The incidence of wind syndrome gradually decreased over time(x2=15.619,P＜0.001).In the network of 44 TCM syndrome entries,TZ-5(pulse)had the highest centrality index(strength=2.4)and was located at the most central position of the network.In the network analysis of different TCM syndrome,TZ-5(pulse)(strength=1.91)was located in the center of the phlegm syndrome network,FZ-1(onset)(strength=1.61)was located in the center of the wind syndrome network,HRZ-2(tongue coating)(strength=1.37)was located in the center of the network in the fire-heat syndrome,XYZ-1(tongue texture)(strength=1.18)was located at the center of the network for the blood stasis syndrome.Conclusion The phlegm syndrome is the most important syndrome in the acute phase of ischemic stroke.Employing network analysis can elucidate the central symptoms of different syndromes and the interconnections between the symptoms,providing new ideas for the identification of ischemic stroke.

Plastics have brought invaluable convenience to human life since it was firstly synthesized in the last century. However, the stable polymer structure of plastics led to the continuous accumulation of plastic wastes, which poses serious threats to the ecological environment and human health. Poly(ethylene terephthalate) (PET) is the most widely produced polyester plastics. Recent researches on PET hydrolases have shown great potential of enzymatic degradation and recycling of plastics. Meanwhile, the biodegradation pathway of PET has become a reference model for the biodegradation of other plastics. This review summarizes the sources of PET hydrolases and their degradation capacity, degradation mechanism of PET by the most representative PET hydrolase-IsPETase, and recently reported highly efficient degrading enzymes through enzyme engineering. The advances of PET hydrolases may facilitate the research on the degradation mechanism of PET and further exploration and engineering of efficient PET degradation enzymes.
Humans ; Hydrolases/metabolism* ; Polyethylene Terephthalates/metabolism* ; Plastics/metabolism* ; Ethylenes

OBJECTIVE To establish evaluation criteria for rational drug use of atosiban in clinic， and to provide reference for rational drug use of atosiban in clinic. METHODS Based on the drug instructions of atosiban acetate injection and related guidelines， the experts of the Evaluation Group of Rational Drug Use formulated the evaluation criteria of rational drug use， including 5 primary indexes and 8 secondary indexes. The weight coefficients of secondary indexes were calculated by analytic hierarchy process （AHP）， and the use of atosiban acetate injection in 190 pregnant women from the Third Affiliated Hospital of Guangzhou Medical University （referred to as “our hospital”） was evaluated retrospectively by technique for order preference by similarity to an ideal solution （TOPSIS）. The evaluation results were divided into three levels including reasonable， basic reasonable and unreasonable application based on the relative approach degree. RESULTS Among 190 pregnant women， 49 （25.8%） were treated with atosiban reasonably， 39 （20.5%） were treated with atosiban basic reasonably， and 102 （53.7%） were treated with atosiban unreasonably. The evaluation results obtained by AHP-TOPSIS method were consistent with the actual situation in clinic. The main problems of the unreasonably use were super indications， unreasonable usage and dosage， over the course of treatment and the lack of proper economic consideration. CONCLUSIONS The rationality evaluation criteria of atosiban’s clinical application are established by AHP-TOPSIS method； the evaluation results obtained by this method are quantifiable， scientific and reliable. The unreasonable use of atosiban is common in our hospital， and the management should be strengthened in clinical application.

Objective To establish a quality control method for Lvxintong Rugao. Methods Ketoconazole, Halcinonide and Neomycin sulfate were identified by TLC. The content of Ketoconazole and Halcinonide were determined by HPLC. The chromatographic column of Agilent ZORBAX SB-C₁₈ (4.6 mm×150 mm, 5 μm) column was used. Methanol-phosphate buffer (pH=7.40, 75:25) was applied as the mobile phase. The detection wavelength was 235 nm. The flow rate was 1.0 ml/min and the column temperature was set at room temperature. Neomycin Sulfate was determined by polarimetric analysis. Results The identification and determination methods showed good specificity. Ketoconazole and Halcinonide displayed good linearity within the range of 1.999~39.98 μg (r=0.999 9) and 0.400 8~8.016 μg (r=0.999 9), respectively. The average recoveries were 97.75% (RSD 0.77%) and 97.57% (RSD 0.84%), respectively. For the determination of Neomycin Sulfate, r=0.999 6 (n=6) in the range of 130.4~2 608 U/ml (n=6). The precision and repeatability of RSD were 1.1% and 1.6%, respectively. The solutions were stable in 6 h and the average recovery was 98.8% (RSD 2.6%). Conclusion The method could be used as the quality control method for Lvxintong Rugao.

Objective:To investigate the feasibility of multipoint core needle biopsy (CNB) at mid-stage to predict the treatment effect of neoadjuvant systemic therapy for breast cancer.Methods:A total of 67 breast cancer cases with indications of neoadjuvant systemic therapy were selected from Mar. 2021 to Nov. 2022.In the fourth cycle of neoadjuvant systemic therapy, core needle biopsy was performed at 3, 6, 9, 12 points of tumor bed and residual tumor foci of breast respectively.The results of CNB were compared with the results of routine pathology of surgery after the completion of neoadjuvant therapy. Matched biopsy and surgical specimens were compared to assess pCR. The accuracy and false negative rate (FNR) of interim pathological assessment were analyzed. The coincidence probability of interim biopsy pathology and pathology of standard surgical excision was verified.Results:The median age of enrolled patients was 49.2 years (21-69 years) .Median maximum tumor diameter before neoadjuvant systemic therapy and residual tumor diameter after neoadjuvant therapy were 40.4 mm (range 21-93mm) and 19.6 mm (range 0-41mm) respectively. A total of 28 patients achieved pCR, and the PCR rates of hormone receptor-positive and HER2-nagative,triple-negative,hormone receptor negative and HER2-positive and hormone receptor-positive and HER2-positive disease were 4/24 (16.7%) ,6/14 (42.9%) ,11/18 (61.1%) ,7/11 (63.6%), respectively. Two cases had no preoperative imaging abnormalities. The results of core needle biopsy pathology of residual tumor lesions in 55 patients were consistent with those of routine post-operation pathology.The results of core needle biopsy pathology of tumor bed of 56 patients was consistent with the routine pathology of surgery. The false negative rate of interim multipoint biopsy pathology of residual tumor foci was 17.9% (12/67). The false negative rate of tumor bed with core needle biopsy was 5.9% (4/67) .Conclusions:CNB guided under ultrasound is feasible in predicting tumor retreat situation in the tumor bed area and residual tumor foci at mid-stage of neoadjuvant therapy. Increasing the number of core needles and improving biopsy techniques may improve the accuracy of pathological evaluation of interim multipoint biopsy.