Metabolic dysfunction-associated steatohepatitis （MASH） is a complex liver disease characterized by abnormal fat accumulation in the liver， accompanied by inflammation and hepatocyte injury， and it can gradually progress to liver fibrosis， liver cirrhosis， and even hepatocellular carcinoma. MASH has a complex pathogenesis involving multiple links such as insulin resistance， de novo lipogenesis （DNL）， oxidative stress， and mitochondrial dysfunction. In recent years， mitochondrial pyruvate carrier （MPC） has attracted wide attention as a key molecular target for regulating lipid metabolism. This article systematically reviews the mechanism of action of MPC in MASH， with a focus on how inhibiting MPC expression regulates lipid synthesis and metabolism by reducing DNL production and modulating signaling pathways such as AMPK-ACC， thereby improving liver inflammation. In addition， this article discusses the potential application prospects of MPC inhibitors in MASH treatment， in order to provide new ideas for future clinical research on MASH management.

ObjectiveTo evaluate the effect of neuromuscular electrical stimulation (NMES) on pain, quadriceps strength and motor function of patients after total knee arthroplasty (TKA). MethodsThe databases of CNKI, Wanfang data, VIP, PubMed, Embase, Cochrane, Web of Science and Scopus were retrieved from inception to April, 2025. Randomized controlled trials (RCT) related to the intervention of NMES after TKA were collected. The quality of the included literature was evaluated using the Cochrane Risk of Bias Assessment Tool and the Physical Therapy Evidence Database (PEDro) scale. Meta-analysis was performed with RevMan 5.4. ResultsA total of twelve RCT were included, involving 772 subjects. The PEDro scale score ranged from four to seven. NMES improved postoperative quadriceps muscle strength (SMD = 0.61, 95%CI 0.34 to 0.88, P < 0.001) and knee flexion range of motion (SMD = 1.35, 95%CI 0.30 to 2.41, P = 0.010), and reduced the Timed Up and Go Test (TUGT) time (SMD = -0.86, 95%CI -1.45 to -0.26, P = 0.005). Compared with the control group, the intervention group achieved better outcomes in the 2-Minute Walk Test (2MWT) (SMD = 19.44, 95%CI 10.44 to 30.43, P < 0.001), 3-Minute Walk Test (SMD = 23.57, 95%CI 14.77 to 32.36, P < 0.001), 6-Minute Walk Test (SMD = 42.29, 95%CI 9.71 to 74.86, P = 0.010), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) (SMD = -0.52, 95%CI -1.00 to -0.04, P = 0.040), as well as the Physical Component Summary (PCS) (SMD = 2.90, 95%CI 0.73 to 5.06, P = 0.009) and Mental Component Summary (MCS) (SMD = 2.84, 95%CI 1.40 to 4.28, P = 0.040) of the 36-Item Short Form Health Survey (SF-36). Subgroup analysis demonstrated that two to four weeks after surgery, NMES enhanced patients' quadriceps muscle strength (SMD = 0.90, 95%CI 0.58 to 1.21, P < 0.001), shortened TUGT time (SMD = -1.28, 95%CI -2.57 to -0.02, P < 0.05) and increased walking distance in 2MWT (SMD = 20.43, 95%CI 10.44 to 30.43, P < 0.001). For patients followed up for two to three months, NMES yielded improvements in WOMAC scores (SMD = -0.44, 95%CI -0.79 to -0.09, P = 0.010) and SF-36 MCS scores (SMD = 4.17, 95%CI 2.43 to 5.91, P < 0.001). ConclusionNMES can significantly improve the quadriceps strength and walking ability of the TKA patients two to four weeks after surgery, and enhance the quality of life of patients two to three months after surgery.

Objective To construct a nomogram model for prediction of constipation risk in adult patients with cardiovascular disease (CVD). Methods A total of 780 adult patients with CVD admitted to Zhongshan Hospital, Fudan University from June 15, 2025 to August 15, 2025 were prospectively enrolled and randomly divided into a training set and a validation set at a 7∶3 ratio. Risk factors for constipation were identified using the least absolute shrinkage and selection operator (LASSO) and Firth logistic regressions, and a nomogram model was subsequently constructed in the training set. Receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to evaluate the discrimination ability of the model. Calibration curve and decision curve analysis (DCA) were used to assess calibration and clinical applicability. The value of model was evaluated in the validation set. Results Among 780 adult patients with CVD, 391 patients (50.1%) developed constipation. Eleven variables were selected by LASSO regression and Firth logistic regression, and a nomogram model was constructed. The ROC curve showed that the AUCs of the model to predict constipation in adult patients with CVD in training and validation sets were 0.881 and 0.883, respectively. Calibration curves and DCA demonstrated good calibration and predictive performance of the model in training and validation sets. Conclusions The nomogram model based on LASSO-Firth logistic regression demonstrates good predictive performance and may serve as a useful tool for identifying adult patients with CVD at high risk of constipation.

Metabolic associated fatty liver disease （MAFLD） has become one of the most prevalent chronic liver disease worldwide， and its progression to liver fibrosis is a key influencing factor for prognosis and the risk of complications. In recent years， novel drugs， such as selective thyroid hormone receptor-β agonists， glucagon-like peptide-1 receptor agonists， and fibroblast growth factor 21 analogs， have shown preliminary efficacy in the treatment of MAFLD-related liver fibrosis； however， such drugs have limited overall effectiveness， and there is still a lack of ideal therapeutic strategy to address the disease across its different stages. Traditional Chinese medicine （TCM）， with its characteristics of multiple targets and systemic regulation， has shown unique advantages in this field. This article systematically reviews the basic and clinical research on the anti-fibrotic mechanisms of compound TCM prescriptions and their active components in recent years， focusing on the key processes including hepatic stellate cell activation， lipid metabolism disorders， oxidative stress， immune inflammation， and gut-liver axis dysfunction. Meanwhile， it is pointed out that there are still certain issues in current research， including ambiguities in the clarification of mechanisms， a lack of standardized evaluation systems， and the need to improve the quality of clinical evidence. Future research should emphasize the standardization and quality control of TCM herbal preparations and integrate emerging technologies， such as omics analysis， organoid models， and real-world data， to advance TCM intervention of MAFLD-related liver fibrosis toward well-defined mechanisms， clear therapeutic pathways， and robust scientific evidence. TCM is expected to play a vital role in the multi-dimensional targeted intervention and stage-specific management of MAFLD-related liver fibrosis， in order to provide new perspectives and comprehensive solutions for the precise treatment of chronic liver diseases.

Objective: To establish anin vitromodel of ferroptosis induced by Erastin and RAS-selective lethal 3(RSL3) in hepatoma cells, and to provide theoretical basis for the development of novel therapeutic strategies for HCC. Methods: Hepatoma cells(HCCLM3, HepG2, Hep3B, Huh7 and PLC/PRF/5) in logarithmic growth phase were treated with Erastin(0-40 μmol/L) and RSL3(0-10 μmol/L) at double concentrations respectively. After 24 h, CCK-8 method was used to detect cell viability, draw growth curve, calculate IC50, and HCC cells sensitive to inducers were selected for follow-up experiments. The effect of inducer on the state of hepatoma cells was observed under light microscope, and immunoblotting and flow cytometry were used to verify whether the ferroptotic modelin vitrowas successfully constructed. Results: Huh7, Hep3B and HepG2 cells were sensitive to Erastin and RSL3, but HCCLM3 and PLC/PRF/5 were insensitive to Erastin and RSL3. When the concentration of Erastin and RSL3 reached the maximum, the survival rate was still above 65%. Huh7, Hep3B and HepG2 cells were selected for subsequent experiments. Compared with the control group, the expression of Glutathione peroxidase 4(GPX4), a ferroptotic marker, was down-regulated in a concentration-dependent manner. In Huh7, Hep3B and HepG2 cells, lipid reactive oxygen species(ROS) levels significantly increased after 24 h treatment with 10 μmol/L and 20 μmol/L Erastin, respectively; in Huh7 cells, lipid ROS levels significantly increased after 24 h treatment with 0.5 μmol/L and 1 μmol/L RSL3, respectively; in Hep3B and HepG2 cells, lipid ROS levels significantly increased after 24 h treatment with 1 μmol/L and 2 μmol/L RSL3, respectively, compared with control group. Conclusion Huh7, Hep3B and HepG2 cells are highly sensitive to Erastin and RSL3. Huh7, Hep3B and HepG2 cells treated with 10 μmol/L Erastin for 24 h are good models for simulating ferroptosis induced by Erastinin vitro, Huh7 cells treated with 0.5 μmol/L RSL3 for 24 h and Hep3B and HepG2 cells treated with 1 μmol/L RSL3 for 24 h are good models for simulating ferroptosis induced by RSL3in vitro.

Sepsis, a life-threatening organ dysfunction caused by an abnormal host response to infection, remains one of the leading causes of mortality in critically ill patients, but there is currently a lack of effective early warning systems and therapeutic strategies for sepsis. In recent years, the interaction between the nervous and immune systems has gained considerable attention. However, the precise mechanisms underlying sepsis-related organ damage and the complex interplay among different organs remain poorly understood. The inflammatory reflex, which involves the central nervous system integrating incoming inflammatory signals and reflexively modulating peripheral inflammatory responses, is a critical interface where the central nervous network regulates peripheral immunity. Modulating the inflammatory reflex to correct immune dysfunction may represent a promising therapeutic breakthrough for sepsis. Nevertheless, the precise mechanisms by which the inflammatory reflex induces changes in both the central nervous system and the peripheral immune system in sepsis, as well as its role in organ damage, remain to be elucidated. To this end, the authors reviewed the researches on the role of the inflammatory reflex in the development and progression of sepsis-related organ damage, aiming to provide novel insights into more effective therapeutic strategies for sepsis.

Ulcerative colitis （UC）， which is characterized by a complex and multifactorial etiology， remains one of the challenging disorders in the international field of digestive system diseases. In recent years， rectal administration preparations have made rapid progress in UC therapeutic applications. This study systematically reviews the dosage forms， mechanisms of action， and clinical applications of rectally-administered preparations for the treatment of UC. It is found that suppositories are the most commonly used dosage forms for rectal administration. The newer suppositories have the advantages of high bioavailability and good stability. Enemas can retain the drug in the intestine as much as possible to achieve the effects of diluting intestinal toxins， cleansing the bowel， and reducing inflammation. Gels can achieve a drug-sustained-release effect and effectively improve intestinal mucosal damage. The mechanism of action of this type of preparation is mainly to inhibit inflammatory cell infiltration， regulate intestinal microbial homeostasis， and increase the expression of tight-junction proteins， so as to play anti-inflammatory， regulate the intestinal bacterial flora， repair the intestinal mucosa， and other efficacies. The diversity of rectal administration forms provides a wide range of choices for the clinical treatment of UC， such as Mesalazine suppositories， Lianshao enemas， and temperature- sensitive gels loaded with drugs for UC.

Objective To explore the clinical application value of multimodal radiomics in differentiating parotid pleomorphic adenoma(PA)from adenolymphoma(AL).Methods The clinical and imaging data of 68 cases of PA and 52 cases of AL were retrospectively analyzed.All patients underwent ultrasound examination,enhanced CT scan and enhanced MRI scan of the neck before the operation.All patients were randomly divided into training group(n=84)and validation group(n=36)according to the ratio of 7∶3.The 3D Slicer software was used to manually draw the lesion area of the preoperative images and perform radiomics feature extraction.The best feature subset was selected to establish the radiomics model,and the diagnostic efficacy of different models was evaluated by the receiver operating characteristic(ROC)curve.Results The study found that age,gender,and smoking history were effective in differentiating parotid PA from AL,and were used to construct a clinical diagnostic model.Eighteen features were selected through dimensionality reduction to establish the radiomics model.A multimodal combined diagnostic model was then constructed by integrating the radiomics model with gender,age,and smoking history.Compared to the clinical model and the radiomics model,the multimodal combined diagnostic model demonstrated the highest area under the curve(AUC)for distinguishing PA from AL in both the training group and the validation group.Conclusion The combination of radiomics based on neck ultrasound,CT,and MRI with clinical characteristics shows significant clinical application value in the preoperative differentiation of PA and AL.

Immune checkpoint inhibitors(ICIs)have revolutionized cancer therapy,but their use is frequently complicated by immune-related adverse events(irAEs),which often require management with corticosteroids or additional immunosuppressive agents.The prognostic impact of these therapeutic strategies in the setting of irAEs has not been systematically elucidated.This systematic review and meta-analysis aimed to evaluate the impact of corticosteroid(CS)and second-line immunosuppressant(IM)use on survival outcomes among patients who developed irAEs during ICI therapy.Following a preregistered protocol(PROSPERO CRD1144835),we systematically searched PubMed,Embase,Web of Science,Cochrane Library,SinoMed,CNKI and Wanfang to identify studies published in the past 10 years(up to May 2025)reporting on the association between CS and IM use and survival outcomes in ICI-treated patients with irAEs.Two reviewers independently performed study selection,data extraction,and quality assessment.Meta-analyses were performed using R software.A total of 11 studies comprising 7 255 patients were included.Meta-analysis showed that CS use versus no use was not significantly associated with overall survival(OS)(HR=0.73,95%CI:0.45-1.18)or progression-free survival(PFS)(HR=0.68,95%CI:0.00-98.01).For post-irAE survival outcomes,higher cumulative CS dose(per 1 000 mg increment)was associated with a mild protective effect on post-irAE OS(HR=0.95,95%CI:0.92-0.98)and post-irAE PFS(HR=0.96,95%CI:0.94-0.99).In contrast to CS alone,IM use in combination with CS was associated with significantly increased risk of disease progression or death for post-irAE OS(HR=1.40,95%CI:1.11-1.76)and post-irAE PFS(HR=1.32,95%CI:1.08-1.62).Sensitivity analyses demonstrated good robustness of the main significant results.Current evidence suggests that CS and IM management strategies may differentially affect survival outcomes in patients with irAEs following ICI therapy.Increased cumulative CS dose is not associated with worse outcomes,whereas the addition of second-line IMs may increase the risk of adverse survival outcomes.Further prospective studies are warranted to optimize irAE management strategies and to balance the risks of immunosuppressive therapy with anticancer efficacy.

Objective To investigate the clinical and MRI imaging features of ovarian endometrioid adenofibroma and to analyze its pathological features in order to promote the diagnostic and differential diagnostic ability.Methods The clinical and MRI imaging features of 5 cases of ovarian endometrioid adenofibroma confirmed by pathology were analyzed retrospectively.Results Among the 5 patients,2 were diagnosed with postmenopausal vaginal bleeding,while the other 3 cases were incidental findings with no obvious clinical discomfort.One patient had elevated estrogen level,but the remaining patients showed no obvious abnormalities in laboratory examinations.All the lesions in 5 patients were cystic-solid masses,MRI showed mixed iso-and hypointensity on T1 WI,and slightly hyperintensity and hypointensity of solid components on T2WI.The solid components showed scattered cystic foci with smooth cyst walls and partial septa.The signal in the capsule was homogeneous.Diffusion weighted imaging(DWI)showed slightly hyperintensity and hypointensity.Contrast-enhanced scans showed gradual enhancement in the solid part of the massed with no enhancement in the cystic areas.Conclusion The clinical manifestations of ovarian endometrioid adenofibroma are non-specific,but MRI manifestations are specific to some extent.The final diagnosis depends on pathological diagnosis.