ObjectiveTo investigate the therapeutic mechanism of Xuefu Zhuyutang （XFZYT） for metabolic-associated fatty liver disease （MAFLD） through integrated network pharmacology and animal experiments. MethodsNetwork pharmacology was utilized to predict the core components， key therapeutic targets， and signaling pathways of XFZYT in the treatment of MAFLD. For animal experiments， a rat model of MAFLD was established by feeding a high-cholesterol diet for 4 weeks. Intervention was then administered with low-dose （2 g·kg^-1） and high-dose （4 g·kg^-1） XFZYT for 2 weeks. Biochemical assays were performed to measure the serum levels of aspartate aminotransferase （AST）， alanine aminotransferase （ALT）， total cholesterol （TC）， triglycerides （TG）， high-density lipoprotein （HDL）， and low-density lipoprotein （LDL）. In addition， the activities of superoxide dismutase （SOD） and catalase （CAT） and levels of malondialdehyde （MDA） and glutathione （GSH） in the serum were measured. The same way was adopted to measure the levels of TC and TG in the liver tissue. Enzyme-linked immunosorbent assay （ELISA） was employed to quantify the serum levels of interleukin （IL）-6， IL-1β， and tumor necrosis factor-alpha （TNF-α）. Histopathological evaluations included hematoxylin and eosin （HE） staining for liver tissue morphology， Oil Red O staining for lipid deposition， and dihydroethidium （DHE） probe staining for reactive oxygen species （ROS） levels. Western blot analysis was conducted to assess the protein levels of AMP-activated protein kinase （AMPK）， phosphorylated （p）-AMPK， nuclear factor erythroid 2-related factor 2 （Nrf2）， heme oxygenase-1 （HO-1）， nuclear factor-kappa B （NF-κB）， and p-NF-κB in the liver tissue. Untargeted metabolomics analysis of the serum was performed by liquid chromatography-tandem mass spectrometry （LC-MS/MS）. ResultsNetwork pharmacology analysis predicted 155 potential targets of XFZYT for MAFLD treatment， with core targets including signal transducer and activator of transcription 3 （STAT3）， protein kinase B1 （Akt1）， TNF， and IL-6. Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment primarily implicated the AMPK signaling pathway. Animal experiments demonstrated that compared with the normal group， the model group exhibited dyslipidemia， hepatic function impairment， pronounced hepatic lipid deposition， and inflammatory manifestations， with elevated serum levels of AST， ALT， TC， TG， LDL， and MDA （P<0.05）， reduced HDL and GSH levels plus decreased SOD and CAT activities （P<0.05）， downregulated protein levels of Nrf2， HO-1， and p-AMPK （P<0.05）， and upregulated protein level of p-NF-κB （P<0.05） in the liver tissue. Compared with the model group， XFZYT intervention groups showed significant amelioration of dyslipidemia and hepatic function impairment， markedly reduced hepatic lipid deposition and inflammatory cell infiltration， decreased serum levels of AST， ALT， TC， TG， LDL， and MDA （P<0.05）， increased HDL and GSH levels plus enhanced SOD and CAT activities （P<0.05）， upregulated protein levels of Nrf2， HO-1， and p-AMPK （P<0.05）， and downregulated protein level of p-NF-κB （P<0.05）. Serum metabolomics revealed 511 differentially expressed metabolites （231 upregulated and 280 downregulated） between normal and model groups， while XFZYT groups versus model group showed 94 differential metabolites （51 upregulated and 43 downregulated）. Among them， 11 metabolites displayed the most significant alterations， with enriched pathways including glycerolipid metabolism， cholesterol metabolism， and insulin resistance， multiple of which demonstrated AMPK association. ConclusionXFZYT alleviates MAFLD by regulating the AMPK signaling pathway and associated metabolic networks.

Sarcopenia is a systemic skeletal muscle disease characterized by the gradual decline of muscle mass，strength，and function，and its occurrence and development are related to multiple factors，involving several signaling pathways. Among them，the phosphatidylinositol 3-kinase/protein kinase B（PI3K/Akt） signaling pathway，as a key pathway regulating cellular growth，survival，and metabolism，plays an important role in the formation and development of sarcopenia. Its abnormal activation or deactivation may lead to an imbalance in muscle protein metabolism，resulting in muscle atrophy and reduction. Modern medicine is still in the exploratory stage of treatment for sarcopenia. Traditional Chinese medicine （TCM），with its multi-pathway and multi-target characteristics，has shown increasing advantages in the prevention and treatment of sarcopenia. In recent years，various monomers， extracts，and compound formulas of TCM have been proven to effectively prevent and treat sarcopenia by promoting muscle cell protein synthesis，reducing protein degradation，inhibiting cell apoptosis and inflammatory response，and improving mitochondrial function. This paper reviewed the improvement effects of TCM on sarcopenia based on the PI3K/Akt pathway and explored its specific action mechanisms， aiming to provide new insights for the treatment of sarcopenia with TCM.

ObjectiveTo systematically compare the effects of diverse electromagnetic stimulation protocols on hand function and activities of daily living (ADL) in stroke patients using network meta-analysis (NMA), and screen the optimal stimulation strategy for post-stroke hand dysfunction rehabilitation. MethodsNMA was performed in accordance with the PRISMA-NMA statement. Databases of CNKI, Wanfang data, VIP, CBM, PubMed, Web of Science and Embase were searched from database inception to April, 2026 for eligible randomized controlled trials (RCTs) comparing different electromagnetic stimulation protocols for post-stroke hand impairment. The Cochrane Risk of Bias tool and PEDro scale were used to assess methodological quality of included studies, while the GRADE system was adopted to grade evidence quality of primary outcomes of Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel Index (MBI). After literature screening, data extraction and bias evaluation, RevMan 5.4 and Stata 17.0 were used for meta-analysis and NMA. ResultsA total of 22 RCT involving 17 electromagnetic stimulation protocols were finally included. The PEDro scores ranged from six to ten. The top five protocols for improving FMA-UE score were repetitive peripheral magnetic stimulation (rPMS) + repetitive transcranial magnetic stimulation (rTMS), intermittent theta-burst stimulation (iTBS) + rPMS, iTBS + transcranial direct current stimulation (tDCS), transcutaneous electrical acupoint stimulation (TEAS) and contralaterally controlled functional electrical stimulation (CCFES). tDCS was the most effective on MBI, followed by TEAS and iTBS+rPMS. Evidence quality for FMA-UE and MBI was moderate. Funnel plots suggested low risk of publication bias, and consistency tests verified good coherence between direct and indirect comparisons in network models. ConclusionElectromagnetic stimulation significantly facilitates upper limb and hand functional recovery, and improves ADL in stroke patients. The combined central-peripheral magnetic stimulation protocol may be the most effective on motor rehabilitation, whereas tDCS on ADL.

Regulated cell death （RCD） is a genetically determined， active and programmed form of cell death， mainly including apoptosis， autophagy， ferroptosis， pyroptosis， PANoptosis and other patterns. Dysregulation of RCD plays a pivotal role in the occurrence and progression of sarcopenia. Due to the advantages of abundant targets， diverse mechanisms of action and high safety profile， traditional Chinese medicine （TCM） has attracted considerable attention in regulating RCD， and preventing and treating sarcopenia. Through a review of the mechanisms of RCD in sarcopenia， and recent research progress on how TCM modulates RCD to improve sarcopenia， this paper reveals that single TCM herbs and their extracts （e.g.， Puerariae Lobatae Radix， and extracts of Schisandrae Chinensis Fructus， Myristicae Semen and Cistanches Herba）， active components and effective fractions of TCM （e.g.， resveratrol， polydatin， curcumin）， as well as TCM compound formulas （e.g.， Buzhong yiqi decoction， Erjing pills， Huangqi guizhi wuwu decoction， Shuanghe decoction）， can modulate RCD through multiple pathways， including the inhibition of apoptosis， pyroptosis， ferroptosis and PANoptosis， and the modulation of autophagy， thereby alleviating sarcopenia.

AIM: To investigate the effect of luteolin on tissue fibrosis in the filtering area following glaucoma trabeculectomy, and its relationship with the Wnt3a/β-catenin signaling pathway.METHODS: Rabbits were selected to establish a fibrosis model after glaucoma trabeculectomy, and randomly divided into the sham operation group, model group, luteolin-L group and luteolin-H group. Dynamic monitoring of postoperative intraocular pressure was performed in all groups. Slit-lamp biomicroscopy was used to observe postoperative conjunctival morphological changes, conjunctival healing degree, corneal integrity, and anterior chamber inflammatory responses in the filtering bleb area. HE staining was performed to evaluate conjunctival epithelial integrity, subepithelial fibrous proliferation, and inflammatory cell infiltration in the filtering tissues. Masson's trichrome staining was applied to assess collagen deposition and the degree of tissue fibrosis. The expression of α-SMA was observed by immunohistochemical staining. The mRNA and protein expression levels of Wnt3a, Wnt7a, Wnt2b, β-catenin, LC3-I, LC3-II and p62-SQSTM1 in conjunctival tissues of the operative area were quantitatively detected by RT-qPCR and Western blot, respectively.RESULTS:Postoperative dynamic monitoring showed that the luteolin-H group achieved significantly better intraocular pressure control than the luteolin-L group compared with the model group(all P<0.05). Slit lamp observations confirmed that luteolin effectively ameliorated postoperative conjunctival injury, alleviated anterior chamber inflammatory response, and maintained the structural stability of the filtering area. HE and Masson staining revealed that luteolin intervention reduced conjunctival epithelial damage and inflammatory cell infiltration, markedly inhibited fibroblast proliferation, neovascularization and excessive collagen deposition, and significantly delayed the progression of filtering bleb scarring, with stronger effects in the luteolin-H group than luteolin-L group compared with the model group. Immunohistochemical staining demonstrated that luteolin intervention decreased the positive expression rate of α-SMA. Molecular assays indicated that the luteolin-H group had lower expression levels of Wnt3a, β-catenin and LC3-II/LC3-I, and the highest p62-SQSTM1 level in the operative site relative to the model group and luteolin-L group(all PSymbol|@@0.05). No significant intergroup differences were observed in Wnt2b and Wnt7a expression. These findings suggested that luteolin could specifically regulated the Wnt3a pathway and dose-dependently suppressed the activation of the Wnt3a/β-catenin pathway after glaucoma trabeculectomy, downregulated LC3-II/LC3-I expression, upregulated p62-SQSTM1 levels, and inhibited excessive autophagy activation.CONCLUSION: Luteolin can significantly inhibit filtering bleb fibrosis after trabeculectomy, which may reduce the degree of fibrosis via the Wnt3a/β-catenin pathway.

Objective To explore the relationships of job engagement with mental elasticity and resilience in the nurses of burn unit,so as to provide references for the construction of stable nursing team.Methods A total of 159 nurses who were selected from 16 burn centers in 9 provinces and cities such as Shanghai and Jiangsu by convenience sampling from January to April 2024 were enrolled in this study.General data questionnaire,work engagement scale,psychological resilience scales,and medical staff resilience scales were used.Results The total scores of job engagement,mental elasticity and resilience were 34.25±8.59,67.77±12.70,and 74.62±10.51,respectively.The total score and the scores of all dimensions of job engagement were positively correlated with mental elasticity and resilience(P<0.01).Univariate analysis showed that the working years,the number of late night shifts,and children affected the job engagement of the nurses(P<0.05).The optimal scale analysis showed that the number of late night shifts,mental elasticity and stress scores were the main factors affecting the job engagement(P<0.01).The structural equation model showed that both mental elasticity and resilience could directly predict the job engagement,and the path coefficient was 0.372 and 0.387(P<0.01).Mental elasticity indirectly acted on the job engagement through stress resistance,the indirect effect was 0.248,and the mediation effect accounted for 30.8%of the total effect.Conclusion The mental elasticity and resilience of nurses can be improved by optimizing the allocation of human resources and the scheduling structure,so as to increase the job engagement and further stabilize the burn care team.

Objective:To observe the characteristics of brain functional activity in patients with chronic non-specific low back pain(CNLBP)and to explore the potential mechanism of brain functional remodeling in acupuncture treatment based on resting-state fMRI.Method:The 22 patients with CNLBP were included as the CNLBP group,and 22 healthy subjects(HCs)were included as the HCs group.The visual analogue scale(VAS)for pain,Oswestry disability index(ODI),Japanese Orthopedic Association(JOA)score for lumbar spine were collected before and after acu-puncture treatment in the CNLBP group.Resting-state fMRI data were acquired for all participants.The frac-tional amplitude of low frequency fluctuation(fALFF)values of the different brain regions in CNLBP patients before treatment compared with the HCs group were extracted and correlated with the differences in VAS,ODI,and JOA scores.Result:Acupuncture treatment significantly improved the VAS,ODI,and JOA scores in the CNLBP group(P＜0.001);Before treatment,the CNLBP group showed higher fALFF values in the right orbital middle frontal gy-rus,right anterior cingulate gyrus,left anterior cingulate gyrus and left precuneus compared to the HCs group,while lower fALFF values were observed in the right precentral gyrus/right postcentral gyrus,left precentral gy-rus/left postcentral gyrus,right thalamus,right postcentral gyrus/precentral gyrus,and left thalamus.After treat-ment,the CNLBP group exhibited increased fALFF values in the right precentral gyrus/postcentral gyrus,left precentral gyrus/postcentral gyrus,and left middle temporal gyrus,and decreased fALFF values in the left me-dial superior frontal gyrus,right precuneus/left precuneus compared to pre-treatment.Additionally,pre-treatment fALFF value in the right orbital part of the middle frontal gyrus,right anterior cingulate gyrus and left anteri-or cingulate gyrus in the CNLBP group was negatively correlated with the changes in VAS scores(r=-0.699,P=0.000).Conclusion:Acupuncture treatment can significantly improve pain intensity and lumbar spinal dysfunction in CNLBP.CNLBP has multiple abnormalities in brain functional activities related to pain regulation pathways and the default mode network(DMN),and acupuncture treatment can restore most of these abnormal brain ac-tivities;the characteristic of brain functional activity in the right orbital part of the middle frontal gyrus,right anterior cingulate gyrus and left anterior cingulate gyrus before CNLBP treatment is related to the difference in VAS score,providing a potential imaging biomarker for predicting treatment efficacy.

Objective:To investigate immunotherapy effects and mechanism of BCG and recombinant BCG(rBCG)with c-di-AMP as adjuvant on melanoma in mice model.Methods:Melanoma mice model was established by B16F10 cell subcutaneous injec-tion in groin,and treated with 1×106 CFU of BCG and rBCG by adjacent injection of subcutaneous tumor for 3 times,respectively.Survival of melanotic mice,tumor growth and metastasis were observed.Tumor tissues of mice were isolated to prepare cell suspen-sion,and proportion of immune cells were detected by flow cytometry.Transcriptional levels of immune-related genes in tumor tissues were detected by qRT-PCR.Results:Both BCG and rBCG immunotherapy could significantly inhibit growth in melanoma mice and prolong survival time of mice.rBCG showed better inhibition on metastasis than BCG.Both strains significantly reduced proportion of M2-type macrophages and myeloid-derived suppressor cell associated with tumor growth and metastasis.Both two strains promoted infiltration of lymphocytes in tumor tissues,and rBCG significantly increased proportion of B cells in tumor.BCG immunotherapy upregulated transcription levels of metastasis-related cytokines,while rBCG therapy had no effects on transcriptions of these genes.Conclusion:Both BCG and rBCG have immunotherapeutic effects on melanotic mice,and rBCG with c-di-AMP as adjuvant shows better inhibition on tumor metastasis than BCG,which mechanism was related to regulation of immune response in tumor tissues.

Objective:Using methylation characteristics of human genes to construct machine learning predictive models for screening cervical cancer and precancerous lesions.Methods:Human DNA methylation detection was performed on 224 cervical exfoliated cell specimens from the Cancer Hospital of the Chinese Academy of Medical Sciences, Tianjin Central Hospital of Gynecology Obstetrics, Xinmi Maternal and Child Health Hospital of Henan Province, West China Second Affiliated Hospital of Sichuan University, and Heping Hospital Affiliated to Changzhi Medical College collected during April 2014 and March 2015. The hypermethylated gene fragments related to cervical cancer were selected by high-density, high-association, and hypermethylated gene fragment screening and the LASSO regression algorithm. Taking cervical intraepithelial neoplasia grade 2 (CIN2) or more severe lesions as the research outcome, machine learning predictive models based on the random forest (RF), naive Bayes (NB), and support vector machine (SVM) algorithm, respectively, were constructed. A total of 144 outpatient specimens were used as the training set and 80 cervical exfoliated cell specimens from women participating in the cervical cancer screening program were used as the test set to verify the predictive models. Using histological diagnosis results as the gold standard, the detection efficacy for CIN2 or more severe lesions of the three machine learning predictive models were compared with that of the human papilloma virus (HPV) detection and cytological diagnosis.Results:In the training set of 144 cases, there were 34 cases of HPV positivity, with a positive rate of 23.61%. Cytologically, there were 37 cases diagnosed as no intraepithelial lesion or malignancy (NILM), and 107 cases diagnosed as atypical squamous cells of undetermined significance (ASC-US) or above. Histologically, there were 28 cases without cervical intraepithelial neoplasia or benign cervical lesions, 31 cases of CIN1, 18 cases of CIN2, 31 cases of CIN3, and 36 cases of squamous cell carcinoma. Seven hypermethylated gene fragments were selected from 45 genes, and three machine learning prediction models based on the RF, NB, and SVM algorithm, respectively, were constructed. In the validation set of 80 cases, there were 28 cases of HPV positivity, with a positive rate of 35.00%. Cytologically, there were 65 cases diagnosed as NILM and 15 cases as ASC-US or above. Histologically, there were 39 cases without cervical intraepithelial neoplasia or benign cervical lesions, 10 cases of CIN1, 10 cases of CIN2, 11 cases of CIN3, and 10 cases of squamous cell carcinoma. In the validation set, the area under the curve (AUC) values of the RF model, NB model, SVM model, HPV detection, and cytological diagnosis of CIN2 or above were 0.90, 0.88, 0.82, 0.68, and 0.45, respectively. The DeLong test showed that there was no statistically significant difference in the AUC values between the RF, NB, and SVM models (all P＞0.05), and the AUC values of the RF and NB models were higher than that of HPV detection (both P＜0.01), and the AUC values of the RF, NB, and SVM models were higher than that of cytological diagnosis (all P＜0.01). Compared with the NB model, the sensitivity of the RF model was similar (80.65% vs. 77.42%), but the specificity of the NB model was much higher than that of the RF model (93.88% vs. 73.47%). Conclusion:Among the machine learning prediction models for cervical cancer and precancerous lesions constructed based on human DNA methylation, the NB model has good predictive performance for CIN2 and above lesions, and may be used for screening of cervical cancer and precancerous lesions.

A solid-phase extraction-ultra-performance liquid chromatography-tandem mass spectrometry(SPE-UPLC-MS/MS)method was established for simultaneous determination of 10 kinds of neonicotinoid pesticide residues in aquaculture water.Based on the chemical properties of neonicotinoid pesticides and the matrix characteristics of aquaculture water,suitable temporary storage methods for water samples and appropriate solid-phase extraction columns were selected,and the extraction conditions(including elution solvents and sample loading volumes)were optimized.The method employed acetonitrile and 5 mmol/L ammonium acetate solution(containing 0.1%formic acid)as the mobile phase and an Oasis HLB solid-phase extraction column combined with PSA as a dispersive sorbent for sample purification.The method exhibited good linearity in detection of neonicotinoid in concentration range of 0.2-50 ng/mL(R2>0.99797),with a detection limit of 0.5 ng/L and a quantification limit of 1 ng/L,which were significantly lower than the maximum acceptable method detection limits(9-500 ng/L)for neonicotinoid insecticides in water published by the European Commission.In pond water,rice-fish water,and seawater,the average recoveries of the 10 target analytes were 74.6%-114.1%,with relative standard deviations ranging from 0.3%to 9.6%.Using this method,actual sample tests were conducted on the Pearl River water,Zhaoqing pond water,and Qingyuan rice-fish aquaculture water.The total concentration of five neonicotinoid pesticides in the Pearl River water ranged from 154.8 to 246.6 ng/L,the total concentration of four neonicotinoid pesticides in the Zhaoqing pond water was 95.0-176.1 ng/L,and the total concentration of three neonicotinoid pesticides in the Qingyuan rice-fish aquaculture water was 2.3-11.7 ng/L.This method was simple in operation,highly sensitive,and had strong resistance to interference.It was suitable for detection of trace neonicotinoid pesticides in aquaculture water and could provide technical support for construction of a green aquaculture environment and resolution of international trade disputes.