OBJECTIVE To investigate the protective effects and potential mechanism of alisol B 23-acetate on acute alcoholic liver injury in mice. METHODS Fifty male Kunming mice were divided into the blank group， model group， and alisol B 23-acetate low-， medium- and high-dose groups （10， 20， 40 mg/kg）， with 10 mice in each group. Each group was given relevant drug solution or normal saline intragastrically， once a day， for 2 consecutive weeks. On the 15th day， mice in the blank group were given normal saline intragastrically， while the other four groups were given 12 mL/kg white wine intragastrically， twice at six-hour intervals， to establish an acute alcoholic liver injury model. On the 16th day of the experiment， the liver indexes of mice in each group were calculated； the serum levels of alanine transaminase （ALT）， aspartate transaminase （AST）， total cholesterol （TC）， triglycerides （TG）， malondialdehyde （MDA） and glutathione （GSH） were also determined. The histopathological morphology of their liver tissues was observed and scored. The protein expressions of cytochrome P450 2E1 （CYP2E1）， Kelch-like ECH-associated protein 1 （Keap1）， nuclear factor erythroid 2-related factor 2 （Nrf2） and NAD（P）H： quinone oxidoreductase 1 （NQO1） were measured in liver tissue. RESULTS Compared with model group， mice in each dosage group of alisol B 23-acetate showed varying degrees of recovery in body weight， along with improvements in pathological changes in liver tissues such as inflammatory cell infiltration and fatty vacu oles. Their liver indexes， histopathological scores of liver tissue， serum levels of ALT， AST， TC， TG and MDA， as well as the protein expressions of CYP2E1 and Keap1 in liver tissue， were all significantly decreased （ P ＜0.05 or P ＜0.01）. The serum GSH levels and the protein expressions of Nrf2 （except for the alisol B 23-acetate low-dose group） and NQO1 in liver tissue were significantly increased （ P ＜0.05 or P ＜0.01）， and the changes in the above quantitative indicators showed a dose-dependent pattern. CONCLUSIONS Alisol B 23-acetate can ameliorate acute alcoholic liver injury in mice， and its mechanism may be related to improving antioxidant capacity by regulating the Keap1/Nrf2/NQO1 signaling pathway while simultaneously improving liver lipid metabolism-related indexes.

Kupffer cells (KCs), as residents and sentinels of the liver, are involved in the formation of hepatic fibrosis (HF). However, the biological functions of circular RNAs (circRNAs) in KCs to HF have not been determined. In this study, the expression levels of circRNAs, microRNAs, and messenger RNAs (mRNAs) in KCs from a mouse model of HF mice were investigated using microarray and circRNA-Seq analyses. circDcbld2 was identified as a candidate circRNA in HF, as evidenced by its up-regulation in KCs. Silver staining and mass spectrometry showed that Wtap and Igf2bp2 bind to cirDcbld2. The suppression of circDcbld2 expression decreased the KC inflammatory response and oxidative stress and inhibited hepatic stellate cell (HSCs) activation, attenuating mouse liver fibrogenesis. Mechanistically, Wtap mediated the N ⁶-methyladenosine (m6A) methylation of circDcbld2, and Igf2bp2 recognized m6A-modified circDcbld2 and increased its stability. circDcbld2 contributes to the occurrence of HF by binding miR-144-3p/Et-1 to regulate the inflammatory response and oxidative stress. These findings indicate that circDcbld2 functions via the m6A/circDcbld2/miR-144-3p/Et-1 axis and may act as a potential biomarker for HF treatment.

Objective:To evaluate the therapeutic effects of Yufu ointment for acute radiation-induced skin injury. Methods:We enrolled a total of 104 patients with malignant tumors who developed acute skin injury of grade 2-3 during or after the first course of radiotherapy from June 2019 to February 2023. The observation group ( n=53) and control group ( n=51) received external application of Yufu ointment and Shirun Shaoshang ointment, respectively. We recorded the changes in the grade of skin injury and associated symptoms (such as pain, itching, and burning sensation) and healing speed and time for the two groups. Results:A total of 102 patients completed the study, with 53 cases in the observation group and 49 cases in the control group. The incidence rate of moisture skin lesions in the observation group was significantly lower than that in the control group (62.26% vs. 83.67%, P<0.05). The healing speed of moisture skin ulcerations was significantly faster in the observation group than in the control group (1.67 cm 2/d vs. 0.55 cm 2/d, P<0.05). The observation group had a significantly shorter time to skin injury healing than the control group (10.40 d vs. 14.41 d, P<0.05), significantly different for skin injury of grade 2 (10.21 d vs. 17.57 d, P<0.05) but not for skin injury of grades 2.5 and 3 ( P>0.05). Regarding clinical symptoms, both groups experienced significant reductions in pain and burning sensation scores after treatment ( P<0.05); the grade of itching was significantly decreased for the observation group ( P<0.05), but had no significant change for the control group after treatment ( P>0.05). Conclusions:Yufu ointment can significantly alleviate secondary damage for patients with acute radiation-induced skin injury, by accelerating the healing process and relieving symptoms such as pain, itching, and burning sensation with good tolerability, which deserves further promotion.

Subarachnoid hemorrhage (SAH) is the third common type of stroke in the world,and its mortality and disability rates have declined over the past few decades due to the advances in neuroimaging technology and endovascular interventional therapy and promotion of healthy physical examination,but long-term neurological deficits and cognitive impairment of the patients have not significantly improved,which may be related to the white matter injury (WMI) after SAH.Little attention has been paid to WMI after SAH in the past,which may be an important reason for the poor prognosis of the patients with SAH.The neuroin-flammation response is an important pathophysiological process after SAH,and the neuroinflammation after SAH can aggravate WMI.This article reviews the relationship between neuroinflammation and WMI after SAH in order to deepen the understanding of its effects on cognitive function after SAH.

Objective:The transjugular or transfemoral approach is used as a common method for hepatic venous pressure gradient (HVPG) measurement in current practice. This study aims to confirm the safety and effectiveness of measuring HVPG via the forearm venous approach.Methods:Prospective recruitment was conducted for patients with cirrhosis who underwent HVPG measurement via the forearm venous approach at six hospitals in China and Japan from September 2020 to December 2020. Patients' clinical baseline information and HVPG measurement data were collected. The right median cubital vein or basilic vein approach for all enrolled patients was selected. The HVPG standard process was used to measure pressure. Research data were analyzed using SPSS 22.0 statistical software. Quantitative data were used to represent medians (interquartile ranges), while qualitative data were used to represent frequency and rates. The correlation between two sets of data was analyzed using Pearson correlation analysis.Results:A total of 43 cases were enrolled in this study. Of these, 41 (95.3%) successfully underwent HVPG measurement via the forearm venous approach. None of the patients had any serious complications. The median operation time for HVPG detection via forearm vein was 18.0 minutes (12.3~38.8 minutes). This study confirmed that HVPG was positively closely related to Child-Pugh score ( r = 0.47, P = 0.002), albumin-bilirubin score ( r = 0.37, P = 0.001), Lok index ( r = 0.36, P = 0.02), liver stiffness ( r = 0.58, P = 0.01), and spleen stiffness ( r = 0.77, P = 0.01), while negatively correlated with albumin ( r = -0.42, P = 0.006). Conclusion:The results of this multi-centre retrospective study suggest that HVPG measurement via the forearm venous approach is safe and feasible.

【Objective】 To investigate the development of adaptability in children aged 2 - 6, and to explore its influencing factors, so as to provide reference for promoting the development of adaptability in young children. 【Methods】 Data were from the National Nutrition and Health Systematic Survey for Children in China, and 3 319 children aged 2 - 6 and their parents from 28 sites across 14 provinces were recruited in this study.The Development Scale for Children Aged 0 - 6 years (WS/T 580-2017) was used to measure the developmental quotient of children′s adaptive ability, and a survey questionnaire was used to collect relevant information about children and their parents. 【Results】 Among 3 319 children aged 2 - 6, the proportion of slightly low or low level of adaptability, moderate adaptability development, good and excellent adaptability development was 7.68%,66.25% and 26.06%, respectively.The proportion of children aged 5 - 6 with good and excellent adaptability was lower in 3-year-old and 4-year-old groups (χ²=59.29, P<0.05).Multiple stepwise linear regression showed that children′s gender (β=0.06), gestational age of birth (β=-0.05), only child (β=-0.04), left-behind child (β=-0.04), the main caregiver (β=-0.06), and the education level of parents (β=0.09, 0.10), whether parents actively pay attention to children′s emotions (β=-0.06) and whether children play with homemade toys (β=-0.04) were the influencing factors of children′s adaptive development quotient.Girls, full-term children, only children, non-left-behind children, children with parents as main caregivers, parents with a high level of education, parents who often take the initiative to pay attention to children′s emotions, and children who play with homemade toys had a higher level of adaptability development quotient. 【Conclusions】 The development level of adaptability in children aged 2 - 6 in China is mostly above the average level and is related to multiple factors.Targeted intervention work can be carried out on relevant factors in order to promote the development of children′s adaptability.

Objective: To explore the association between dietary patterns during pregnancy and the development of gestational diabetes mellitus (GDM), so as to provide the guidance of diet balance and GDM prevention for pregnant women. Methods: Pregnant women who underwent prenatal examination at the First Affiliated Hospital of Xinjiang Medical University from December 2021 to July 2022 were selected as the subjects. The oral glucose tolerance test (OGTT) was employed at 24 to 28 weeks of gestation to diagnose GDM. The questionnaire of "The Survey on Nutrition and Health of Pregnant Women in China" was used to collect general information, food intake frequency and amount during a month before OGTT. Dietary patterns were determined by factor analysis, and the association between dietary patterns and the development of GDM was identified using a multivariable logistic regression model. Results: Totally 449 pregnant women were included, with a median (interquartile range) age of 31.00 (5.00) years and a median (interquartile range) gestational age of 35.00 (3.00) weeks. There were 7 dietary patterns named potato-cereal pattern, poultry-meat-dessert pattern, milk-egg-aquatic product pattern, mushroom-vegetable-offal pattern, fruit-bean pattern, pickle-wheaten food pattern, and beverage-nut pattern according to the food types with high factor loads. There were 89 cases diagnosed as GDM, with a prevalence rate of 19.82%. Multivariable logistic regression analysis showed that the development of GDM was associated with the poultry-meat-dessert pattern (OR=0.242, 95%CI: 0.086-0.678) and the fruit-bean pattern (OR=0.093, 95%CI: 0.025-0.342), compared with the potato-cereal pattern. Conclusion Compared to the potato-cereal pattern, the poultry-meat-dessert pattern and the fruit-bean pattern may reduce the risk of GDM. Key words： gestational diabetes mellitus dietary pattern pregnant woman low carbohydrate diet

Objective:To explore the strategy of pregnancy in patients with tubal pregnancy (TP) undergoing salpingectomy.Methods:A retrospective cohort study was conducted to analyze the clinical data of patients who underwent hysterosalpingo contrast sonography (HyCoSy) at Reproductive Medicine Center of Peking University Third Hospital from January 1, 2019 to December 31, 2020 due to salpingectomy for TP. Patients were divided into 3 groups according to the time of pregnancy test and infertility history at the time to HyCoSy (TTH), group A: patients with no history of infertility, attempted pregnancy <1 year after TP ( n=33); group B: patients with history of infertility, attempted pregnancy <1 year after TP ( n=22); group C: patients attempted pregnancy ≥1 year after TP ( n=64). The remaining tubal patency and clinical outcome were analyzed. Results:There were no significant differences in age, number of pregnancies, history of repeated TP (RTP), number of antral follicles, pregnancy rate treated with in vitro fertilization (IVF), incidence of RTP in IVF and spontaneous pregnancy, and the time to pregnancy (TTP) from HyCoSy among groups A, B and C (all P>0.05). TTH from salpingectomy in group C [30.0 (20.0, 42.0) months] was significantly longer than that in groups A and B [13.0 (7.5, 16.5) months, 8.0 (7.0, 10.0) months, P<0.001]. The proportion of unobstructed fallopian tubes and the spontaneous pregnancy rate in group A were significantly higher than those in group C [72.7% (24/33) vs. 43.8% (28/64), P=0.025; 42.4% (14/33) vs. 12.5% (8/64), P=0.004], and the IVF treatment rate in group A [30.3% (10/33)] was significantly lower than that in groups B and C [86.4% (19/22), 71.9% (46/64), P<0.001]. The proportion of unobstructed fallopian tubes and the spontaneous pregnancy rate in group B were higher than those in group C, and the differences were not statistically significant (all P>0.05). The time required for spontaneous pregnancy in group A was less than that in groups B and C, but the difference was not statistically significant ( P>0.05). Logistic regression analysis showed that infertility (history/symptom) was a related factor of tubal patency and pregnancy outcome ( OR=0.366, 95% CI: 0.148-0.904, P=0.029; OR=8.504, 95% CI: 2.294-31.519, P=0.014). Conclusion:After salpingectomy on one side, patients without infertility (history/symptoms) can actively try to conceive for 6 months, if they are not pregnant, tubal patency test can be actively performed and decide on fertility strategy; for patients with infertility (history/symptom), IVF was recommended actively without tubal patency evaluation.

Objective:To explore the strategy of pregnancy in patients with tubal pregnancy (TP) undergoing salpingectomy.Methods:A retrospective cohort study was conducted to analyze the clinical data of patients who underwent hysterosalpingo contrast sonography (HyCoSy) at Reproductive Medicine Center of Peking University Third Hospital from January 1, 2019 to December 31, 2020 due to salpingectomy for TP. Patients were divided into 3 groups according to the time of pregnancy test and infertility history at the time to HyCoSy (TTH), group A: patients with no history of infertility, attempted pregnancy <1 year after TP ( n=33); group B: patients with history of infertility, attempted pregnancy <1 year after TP ( n=22); group C: patients attempted pregnancy ≥1 year after TP ( n=64). The remaining tubal patency and clinical outcome were analyzed. Results:There were no significant differences in age, number of pregnancies, history of repeated TP (RTP), number of antral follicles, pregnancy rate treated with in vitro fertilization (IVF), incidence of RTP in IVF and spontaneous pregnancy, and the time to pregnancy (TTP) from HyCoSy among groups A, B and C (all P>0.05). TTH from salpingectomy in group C [30.0 (20.0, 42.0) months] was significantly longer than that in groups A and B [13.0 (7.5, 16.5) months, 8.0 (7.0, 10.0) months, P<0.001]. The proportion of unobstructed fallopian tubes and the spontaneous pregnancy rate in group A were significantly higher than those in group C [72.7% (24/33) vs. 43.8% (28/64), P=0.025; 42.4% (14/33) vs. 12.5% (8/64), P=0.004], and the IVF treatment rate in group A [30.3% (10/33)] was significantly lower than that in groups B and C [86.4% (19/22), 71.9% (46/64), P<0.001]. The proportion of unobstructed fallopian tubes and the spontaneous pregnancy rate in group B were higher than those in group C, and the differences were not statistically significant (all P>0.05). The time required for spontaneous pregnancy in group A was less than that in groups B and C, but the difference was not statistically significant ( P>0.05). Logistic regression analysis showed that infertility (history/symptom) was a related factor of tubal patency and pregnancy outcome ( OR=0.366, 95% CI: 0.148-0.904, P=0.029; OR=8.504, 95% CI: 2.294-31.519, P=0.014). Conclusion:After salpingectomy on one side, patients without infertility (history/symptoms) can actively try to conceive for 6 months, if they are not pregnant, tubal patency test can be actively performed and decide on fertility strategy; for patients with infertility (history/symptom), IVF was recommended actively without tubal patency evaluation.

Objective:To evaluate the effects of remazolam and propofol on the hemodynamics during induction of anaesthesia in elderly patients using the area under curve (AUC) method.Methods:Eighty elderly patients of either sex, aged 65-75 yr, with body mass index of 20-28 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, scheduled for elective non-cardiac surgery, were divided into 2 groups ( n=40 each) by using a random number table method: remazolam group (R group) and propofol group (P group). Remazolam 1 mg/ml or propofol 10 mg/ml was slowly and intravenously injected through titration to achieve loss of responsiveness to verbal command. The accumulative areas under the curve below (AUC MAP-) or above (AUC MAP+ ) baseline mean arterial pressure and under the curve below or above 10% of baseline heart rate at the same time (AUC HR-, AUC HR+ ) were calculated within the first 10 min after administration of propofol or remazolam. The use of vasoactive drugs and injection pain were recorded during this period. The intraoperative awareness during the 24-h follow-up after surgery and development of cardiovascular complications, cerebral infarction and oliguria or anuria within 30 days after surgery were recorded. Results:Compared with R group, AUC MAP- was significantly enlarged (the mean difference 59.375 mmHg·min, 95% confidence interval 26.763-91.987 mmHg·min), AUC HR- was enlarged ( P<0.05), and no significant change was found in AUC MAP+, AUC HR+, requirement for vasoactive drugs, frequency of vasoactive drugs, and postoperative complications in P group ( P>0.05). No injection pain or intraoperative awareness was found in two groups. Conclusions:Remazolam is superior to propofol in maintaining hemodynamic stability during anesthesia induction in elderly patients.