Non-alcoholic fatty liver disease(NAFLD)is a chronic liver disease caused by excessive lipid accumulation in the liver.Its incidence rate is increasing year by year and has become an increasingly serious public healthy problem.The pathogenesis of NAFLD is complex and has not been fully clarified at present.It is mainly related to multiple factors such as genetics,metabolism,intestinal flora and immune response.In order to explore the medication rules and mechanism of action of traditional Chinese medicine(TCM)in the treatment of NAFLD,and to provide references for the treatment of NAFLD with TCM and the research and development of new drugs,this article summarizes the TCM pathogenesis of NAFLD(such as"phlegm and blood stasis interlacing","liver depression and spleen deficiency",etc.)and modern etiology and pathogenesis(such as insulin resistance,lipid disorder,mitochondrial dysfunction,oxidative stress,etc.).The clinical research and experimental data at home and abroad in recent years were integrated to analyze the pathological process of NAFLD intervention by TCM through multiple targets,including improving insulin resistance and lipid metabolism disorders,inhibiting oxidative stress and mitochondrial dysfunction,etc.TCM has shown unique advantages in the prevention and treatment of NAFLD.However,the depth of its mechanism analysis and the level of clinical research still need to be improved.In the future,it is necessary to deepen the mechanism research by combining multi-omics technology to accelerate the modernization development of TCM.

Non-alcoholic fatty liver disease(NAFLD)is a chronic liver disease caused by excessive lipid accumulation in the liver.Its incidence rate is increasing year by year and has become an increasingly serious public healthy problem.The pathogenesis of NAFLD is complex and has not been fully clarified at present.It is mainly related to multiple factors such as genetics,metabolism,intestinal flora and immune response.In order to explore the medication rules and mechanism of action of traditional Chinese medicine(TCM)in the treatment of NAFLD,and to provide references for the treatment of NAFLD with TCM and the research and development of new drugs,this article summarizes the TCM pathogenesis of NAFLD(such as"phlegm and blood stasis interlacing","liver depression and spleen deficiency",etc.)and modern etiology and pathogenesis(such as insulin resistance,lipid disorder,mitochondrial dysfunction,oxidative stress,etc.).The clinical research and experimental data at home and abroad in recent years were integrated to analyze the pathological process of NAFLD intervention by TCM through multiple targets,including improving insulin resistance and lipid metabolism disorders,inhibiting oxidative stress and mitochondrial dysfunction,etc.TCM has shown unique advantages in the prevention and treatment of NAFLD.However,the depth of its mechanism analysis and the level of clinical research still need to be improved.In the future,it is necessary to deepen the mechanism research by combining multi-omics technology to accelerate the modernization development of TCM.

BACKGROUND:Arthroscopic single-row fixation with knotless suture bridge fixation techniques have been commonly used in the treatment of rotator cuff injuries,but the clinical efficacy in rotator cuff injuries combined with osteoporosis is unclear.OBJECTIVE:To investigate the clinical efficacy of arthroscopic single-row fixation versus knotless suture bridge fixation in the treatment of rotator cuff injuries combined with osteoporosis.METHODS:One hundred and twenty-two patients with rotator cuff injuries combined with osteoporosis who underwent arthroscopic treatment admitted to Affiliated Hospital of Xuzhou Medical University between January 2018 and August 2022 were retrospectively analyzed.They were divided into two groups according to the treatment plan.There were 63 patients with single-row fixation(single-row group)and 59 patients with knotless suture-bridge fixation(suture-bridge group).The visual analog scale scores for pain,University of California Los Angeles Shoulder Score,American Shoulder and Elbow Surgeons Score,Constant-Murley score,and shoulder range of motion were compared between the two groups at the preoperative and 1 year postoperative periods.Rotator cuff re-tears were evaluated at 1 year postoperatively using the Sugaya staging criteria.The occurrence of complications was recorded in both groups.RESULTS AND CONCLUSION:(1)All patients received more than 1-year follow-up.No complications such as incision infection and nerve injury occurred in both groups after surgery.(2)Postoperative visual analog scale scores,University of California Los Angeles Shoulder Score,American Shoulder and Elbow Surgeons Score,Constant-Murley scores,and shoulder range of motion were significantly improved 1 year postoperatively in both groups compared with the preoperative period(P＜0.05).Visual analog scale scores,University of California Los Angeles Shoulder Score,American Shoulder and Elbow Surgeons Score,Constant-Murley scores,and shoulder range of motion were better in the suture-bridge group than in the single-row group 1 year postoperatively(P＜0.05).(3)At 1 year postoperatively,the re-tear rate in the single-row group[22％(14/63)]was significantly higher than that in the suture-bridge group[7％(4/59)],and the difference between the two groups was statistically significant(x2=5.777,P=0.016).(4)It is indicated that arthroscopic single-row fixation and knotless suture bridge fixation for rotator cuff injuries combined with osteoporosis both yielded satisfactory clinical outcomes,but knotless suture bridge fixation was more clinically effective,with a lower rate of postoperative retear.

BACKGROUND:Arthroscopic single-row fixation with knotless suture bridge fixation techniques have been commonly used in the treatment of rotator cuff injuries,but the clinical efficacy in rotator cuff injuries combined with osteoporosis is unclear.OBJECTIVE:To investigate the clinical efficacy of arthroscopic single-row fixation versus knotless suture bridge fixation in the treatment of rotator cuff injuries combined with osteoporosis.METHODS:One hundred and twenty-two patients with rotator cuff injuries combined with osteoporosis who underwent arthroscopic treatment admitted to Affiliated Hospital of Xuzhou Medical University between January 2018 and August 2022 were retrospectively analyzed.They were divided into two groups according to the treatment plan.There were 63 patients with single-row fixation(single-row group)and 59 patients with knotless suture-bridge fixation(suture-bridge group).The visual analog scale scores for pain,University of California Los Angeles Shoulder Score,American Shoulder and Elbow Surgeons Score,Constant-Murley score,and shoulder range of motion were compared between the two groups at the preoperative and 1 year postoperative periods.Rotator cuff re-tears were evaluated at 1 year postoperatively using the Sugaya staging criteria.The occurrence of complications was recorded in both groups.RESULTS AND CONCLUSION:(1)All patients received more than 1-year follow-up.No complications such as incision infection and nerve injury occurred in both groups after surgery.(2)Postoperative visual analog scale scores,University of California Los Angeles Shoulder Score,American Shoulder and Elbow Surgeons Score,Constant-Murley scores,and shoulder range of motion were significantly improved 1 year postoperatively in both groups compared with the preoperative period(P＜0.05).Visual analog scale scores,University of California Los Angeles Shoulder Score,American Shoulder and Elbow Surgeons Score,Constant-Murley scores,and shoulder range of motion were better in the suture-bridge group than in the single-row group 1 year postoperatively(P＜0.05).(3)At 1 year postoperatively,the re-tear rate in the single-row group[22％(14/63)]was significantly higher than that in the suture-bridge group[7％(4/59)],and the difference between the two groups was statistically significant(x2=5.777,P=0.016).(4)It is indicated that arthroscopic single-row fixation and knotless suture bridge fixation for rotator cuff injuries combined with osteoporosis both yielded satisfactory clinical outcomes,but knotless suture bridge fixation was more clinically effective,with a lower rate of postoperative retear.

Objective:To investigate the correlation of serum tartrate-resistant acid phosphatase 5b (TRAP-5b), β-collagen degradation products (β-CTX), vitamin D levels and rheumatoid arthritis (RA) complicated with osteoporosis (OP) fractures.Methods:A total of 200 RA patients diagnosed and treated in our hospital from Oct. 2022 to Oct. 2023 were selected. Clinical data of patients were collected, and serum TRAP-5b, β-CTX, vitamin D levels, bone mineral density and bone metabolism markers were detected. They were divided into RA group and RA-OP group according to whether OP fracture occurred. The above indexes were compared and their correlation with osteoporotic fractures in rheumatoid arthritis was analyzed.Results:The levels of serum TRAP-5b and β-CTX in RA patients were higher than those in healthy control group, and the levels of vitamin D were lower ( t=12.27, 20.01, 7.35, P<0.05). There was no statistically significant difference in gender, body mass index, diabetes, hypertension, smoking and drinking incidence between the two groups ( t=1.18, 0.96, 0.55, 1.84, 0.13, 0.30, P>0.05), but there was statistically significant difference in gender composition, serum TRAP-5b, β-CTX, vitamin D and bone metabolism markers between the two groups ( t=2.33, 3.72, 4.94, 5.10, 7.72, 4.77, 2.42, 9.30, 4.01, 6.38, 4.79, P<0.05). Logistic regression analysis showed that the levels of serum TRAP-5b, β-CTX, vitamin D and bone metabolism markers were independent risk factors for OP in RA patients ( P<0.05). Serum TRAP-5b and β-CTX were positively correlated with serum PINP, NTx, PTH, BALP and BGP, respectively ( r=0.811, 0.778, 0.747, 0.675, 0.614; 0.685, 0.513, 0.405, 0.612, 0.518), and negatively correlated with lumbar BMD and proximal femoral BMD ( r = -0.488, -0.512; -0.526, -0.502) ; Serum vitamin D was negatively correlated with serum PINP, NTx, PTH, BALP, BGP ( r=-0.728, -0.640, -0.604, -0.622, -0.545), and positively correlated with lumbar BMD and proximal femur BMD ( r=0.519, 0.492) ( P<0.05) . Conclusions:Serum levels of TRAP-5b, β-CTX and vitamin D are closely related to the occurrence of OP in RA patients. Abnormal increase of serum levels of TRAP-5b and β-CTX and abnormal decrease of vitamin D suggest an increasing risk of OP in RA patients.

Intestinal pathogenic bacteria utilize their own virulence factors to interfere with the nor-mal function of intestinal epithelial cells and evade clearance by the host immune system through precise gene regulation and expression strategies,thereby causing a variety of diseases.It has been found that the mechanisms affecting the gene expression strategies of pathogens include the toxin-antitoxin system,secretory system,and quorum sensing system.Novel antimicrobial strategies are being developed to interfere with the inherent gene regulatory system of bacteria and inhibit the expression of virulence genes,thus enabling a modest approach to the treatment of intestinal disea-ses.This paper initially discusses the components of innate immunity in the gut,followed by a dis-cussion of the common gene regulatory system of intestinal pathogenic bacteria.This article aims to clarify the mechanisms by which intestinal pathogenic bacteria evade clearance by the innate im-mune system through gene regulation and expression strategies,and to provide new ideas for the treatment of intestinal bacterial diseases.

Objective:To analyze the genetic evolution and molecular characteristics of H7N9 avian influenza virus (AIV) isolated in a live poultry market.Methods:Samples such as poultry feces, sewage, and hair removal machine and chopping board swabs were collected. Real-time fluorescent quantitative PCR was used to detect influenza A virus and H7N9 AIV in the samples. The whole genome of H7N9 AIV was amplified with influenza A virus universal primers and sequenced. BLAST and MEGA X were used for sequence alignment, phylogenetic analysis and molecular characterization.Results:Seven poultry-related environment samples were collected in the live poultry market in Xuchang city in February 2023, and four were positive for H7N9 AIV. The whole genome sequences of three H7N9 AIV isolates were successfully obtained, and the isolates shared high nucleotide identity in different genes (98.37%-100.00%). BLAST analysis showed they were highly identical to H7N9 strains isolated from domestic poultry in China from 2020 to 2021. Genetic evolution analysis showed that the three isolates clustered in the same branch and were closer to the recent environmental isolates than to the recent strains isolated from human or avian. Through comparison with the sequences of the representative strains in different periods, it was found that the isolated strains in this study showed high avian pathogenicity with four amino acids KRAA inserted at the cleavage site; the hemagglutinin receptor-binding site was QSG, which was an avian binding receptor; there was a G186I mutation in hemagglutinin. Mammalian-adaptive mutation E627K was not detected in polymerase basic protein 2. Mutations (R292K and I38T) associated with drug resistance to neuraminidase inhibitor (oseltamivir) and polymerase acidic protein inhibitor (baloshavir) were not detected, suggesting that these isolates remained susceptible to these drugs. A S31N mutation was found in M2 protein, indicating they were resistant to alkamines.Conclusions:The three H7N9 AIV strains isolated in the live poultry market have high avian pathogenicity, but there are no significant increase in mutations related to the binding ability to human receptors, mammalian pathogenicity, viral transmissibility, or drug resistance as compared with previous representative strains causing human or avian infection.

Objective:To investigate the effects of acetabular cup positions on the acetabular side stress in hip dysplasia after total hip arthroplasty (THA) using finite element analysis.Methods:Data were obtained from a 36-year-old female patient with developmental dysplasia of the hip. Three-dimensional finite element models were established for different acetabular cup positions using finite element analysis. Each model was categorized based on the center of rotation into four groups: anatomical rotation center, high rotation center, lateralized rotation center, superior-lateral rotation center. ANSYS software applied loads to the model to simulate the stress around the acetabulum in standing (588 N vertical stress) and walking conditions ( X=325 N, Y=-195 N, Z=1 462.5 N). Quantitative analyses of the relative displacement and stress at the acetabular-bone interface were conducted for each region under the two different loading conditions in all eight models. Results:In the standing position with a cup coverage of 90%, the relative displacement at the acetabular-bone interface was: 45.16 μm for the anatomical rotation center group, 47.57 μm for the high rotation center group, 77.27 μm for the lateralized rotation center group, and 96.13 μm for the superior-lateral rotation center group. Acetabular stress values were 9.07 MPa for the anatomical rotation center group, 11.23 MPa for the high rotation center group, 10.88 MPa for the lateralized rotation center group, and 17.75 MPa for the superior-lateral rotation center group. With a cup coverage of 70%, the relative displacements were 64.15, 65.71, 104.10, and 144.53 μm for the respective groups. The corresponding stresses were 9.30, 11.31, 13.98, and 21.45 MPa. In the walking state with a cup coverage of 90%, the relative displacements at the acetabular-bone interface were 189.67 μm for the anatomical rotation center group, 173.55 μm for the high rotation center group 311.03 μm for the lateralized rotation center group, and 572.93 μm for the superior-lateral rotation center group. The stresses were 39.92, 37.33, 47.92, and 71.94 MPa, respectively. With a cup coverage of 70%, the relative displacements were 239.09 μm for the anatomical rotation center group, 248.83 μm for the high rotation center group, 381.84 μm for the lateralized rotation center group, and 1105.90 μm for the superior-lateral rotation center group. The corresponding stresses were 40.62, 58.42, 56.26, and 3,606.30 MPa.Conclusion:With cup coverage at 70% and 90%, the high rotation center and anatomical rotation center exhibited lower and less frequent relative displacements at the acetabular-bone contact surface.

Objective To investigate the prevalence of occupational diseases and treatment implementation in migrant workers in Hunan,China,and to provide a scientific basis for related departments to develop preventive and treatment measures and social security system for migrant workers.Methods A retrospective investigation was performed in 2015 to collect the information of occupational diseases in migrant workers,and age,type of work,type of occupational disease,and implementation of employment injury insurance for occupation diseases were analyzed.Results The migrant workers with occupational diseases accounted for 50.43％ (11 280/22 368) of all patients with occupational diseases in Hunan,among whom 99.4％ (11 212/11 280) were male workers.The mean age of migrant workers with occupational diseases was 55 years.The types of occupational diseases involved 6 categories such as occupational pneumoconiosis and occupational skin diseases,totaling 42 legal occupational diseases;98.31％ of all migrant workers (11 089/11 280) had occupational pneumoconiosis.The main types of work were underground coal miners (62.42％),heading drivers (29.79％),and haulage workers (2.20％) in coal mines and non-coal mines.A total of 27.25％ migrant workers with occupational diseases (2 072/7 605) enjoyed employment injury insurance,and 20.84％(1 585/7 605) did not receive any medical or life compensations.Conclusion The occupational diseases in migrant workers in Hunan are mainly pneumoconiosis,and a large proportion of those with occupational diseases do not enjoy implementation of treatment.Coal mines and non-coal mines are the high-risk areas for occupational diseases in migrant workers and should be the focus of prevention and control.

Objective To investigate the prevalence of occupational diseases and treatment implementation in migrant workers in Hunan,China,and to provide a scientific basis for related departments to develop preventive and treatment measures and social security system for migrant workers.Methods A retrospective investigation was performed in 2015 to collect the information of occupational diseases in migrant workers,and age,type of work,type of occupational disease,and implementation of employment injury insurance for occupation diseases were analyzed.Results The migrant workers with occupational diseases accounted for 50.43％ (11 280/22 368) of all patients with occupational diseases in Hunan,among whom 99.4％ (11 212/11 280) were male workers.The mean age of migrant workers with occupational diseases was 55 years.The types of occupational diseases involved 6 categories such as occupational pneumoconiosis and occupational skin diseases,totaling 42 legal occupational diseases;98.31％ of all migrant workers (11 089/11 280) had occupational pneumoconiosis.The main types of work were underground coal miners (62.42％),heading drivers (29.79％),and haulage workers (2.20％) in coal mines and non-coal mines.A total of 27.25％ migrant workers with occupational diseases (2 072/7 605) enjoyed employment injury insurance,and 20.84％(1 585/7 605) did not receive any medical or life compensations.Conclusion The occupational diseases in migrant workers in Hunan are mainly pneumoconiosis,and a large proportion of those with occupational diseases do not enjoy implementation of treatment.Coal mines and non-coal mines are the high-risk areas for occupational diseases in migrant workers and should be the focus of prevention and control.