The linear ubiquitin chain assembly complex (LUBAC), composed of heme-oxidized IRP2 ubiquitin ligase 1-interacting protein (HOIP), haem-oxidized IRP2 ubiquitin ligase-1(HOIL-1), and SHANK-associated RBCK1 homology-domain-interacting protein (SHARPIN), and its specific deubiquitinating enzyme OTULIN, regulates the dynamic balance of Met1-linked linear ubiquitination and maintains ubiquitin signaling homeostasis. Their precise interaction plays a central role in the regulation of nuclear factor-κB (NF-κB) and type I interferon signaling, inflammatory response, and cell survival and death. Dysregulation of the LUBAC-OTULIN axis can lead to aberrant immune and inflammatory signaling, immunodeficiency, and dysregulation of receptor-interacting protein kinase 1-mediated apoptosis or necroptosis. Genetic defects in OTULIN and LUBAC are associated with rare autoinflammatory diseases such as OTULIN-related autoinflammatory syndrome (ORAS) and HOIP/HOIL-1/SHARPIN deficiency, respectively, with complex clinical phenotypes and gene dose correlation. Current treatments primarily rely on glucocorticoids and tumor necrosis factor inhibitors, and hematopoietic stem cell transplantation has shown potential curative value in some patients with severe ORAS. This review summarizes the molecular composition, interaction mechanisms, and pathogenic roles of the LUBAC-OTULIN axis in rare autoinflammatory diseases, providing reference for the development of targeted therapeutic strategies.

Objective: To identify research priorities on physical and mental comorbidity among children and adolescents in Zhejiang Province, so as to provide a theoretical base for improving their physical and mental health. Methods: In May 2025, 77 experts in the fields of health and education from 11 cities in Zhejiang Province were selected by convenient sampling method to participate in the first round of expert consultation. In June, 2025, snowball sampling was used to expand to 194 experts for the second round of consultation, and it was convenient to select 21 students from primary schools to high schools in Zhejiang Province and 29 parents to empower the evaluation criteria. It applied the Child Health and Nutrition Research Initiative (CHNRI) method in a structured process, which encompassed the definition of the research field, generation of research ideas, scoring, and quantitative ranking of priorities. Research ideas were evaluated against 6 predefined criteria: effectiveness, safety, answerability, feasibility, sustainability, and scientific significance. Results: After 2 rounds of structured consultations, 81 research ideas on physical and mental comorbidity among children and adolescents were established and classified into 7 subthemes: epidemiological characteristics and influencing factors, optimization of primary service systems and policies, comprehensive intervention strategies for physical and mental comorbidity, biological mechanisms and clinical research, the impact of education and environment on physical and mental health, special populations and social support, and digital and technology driven disease prevention and intervention. The top 10 research priorities primarily centered on the subdomain of "epidemiological characteristics and influencing factors" (5 items). The top 3 research priorities were "the association between outdoor activity duration and the incidence of common diseases (including mental disorders) among children and adolescents" "the impact of outdoor activity duration on the physical and mental health of adolescents" "comprehensive intervention strategies for myopia, obesity, and their comorbidities among children and adolescents". Conclusion The framework of priority issues in the field of psychosomatic comorbidity of children and adolescents in Zhejiang Province based on CHNRI method provides a reference for optimizing the allocation of provincial research resources.

Attention deficit and hyperactive disorder （ADHD） is the most common neurodevelopmental disorder of childhood. It seriously impairs academic achievement， social interaction， and vocational development， and increases the risk of accidental injury and substance abuse. In some cases， the symptoms may also exert an indirect disruptive effect on public order. Its aetiology involves interactions among genetic， perinatal environmental， and psychosocial factors that cannot be fully disentangled by single clinical studies. Therefore， a systematic evaluation of existing animal models is essential for revealing pathophysiology and developing novel therapies. Using the keywords "attention deficit and hyperactive disorder"， "models， animal"， "validity"， and their English equivalents， we systematically searched PubMed， Web of Science， CNKI， and Wanfang for publications from 2000 to 2025 （retrieving 328 publications） and added further references by citation tracking. Eighty-six rodent ADHD models that provided detailed construction protocols， behavioural assessments， neurobiological mechanisms， or pharmacological data were included and classified into spontaneous genetic， genetically engineered， and environmentally induced paradigms. Their face， construct， and predictive validity were compared. Among spontaneous genetic models， spontaneously hypertensive rats reproduce hyperactivity， impulsivity， and stimulant responses well， yet hypertension and sex differences limit specificity. Acallosal mouse strains link corpus callosum absence to ADHD-like behaviours， but neurotransmitter studies remain scarce. Genetically engineered rodents—including dopamine transporter， neurokinin-1 receptor and mediator complex subunit 23 knockout or conditional gene knockout lines—precisely dissect dopaminergic， noradrenergic， synaptic， or epigenetic pathways， yet generally lack full phenotypic coverage， social-deficit modelling， and comorbidity representation， and are accompanied by adverse effects such as growth retardation or ocular defects. Environmentally induced models employ lead， polychlorinated biphenyls， alcohol， nicotine exposures， 6-hydroxydopamine lesions， neonatal hypoxia， early social isolation， or maternal stress to recapitulate core symptoms. However， dose-schedule standardisation is lacking. Behavioural reversibility diverges from clinical persistence， and non-specific phenotypes such as anxiety or depression are common. Overall， no single paradigm simultaneously achieves high validity across all three dimensions. Currently， ADHD models have progressed from single-factor simulations to multidimensional evaluation， yet significant gaps remain in genetic-background standardisation， sex differences， cross-species translation， and syndrome-differentiation modelling under traditional Chinese medicine. Future directions should integrate genetic， environmental， and epigenetic interactions， establish life-span validation systems， and incorporate computational neuroscience alongside integrative Chinese-Western strategies to enhance clinical relevance and translational utility， thereby providing robust evidence-based support for mechanistic elucidation， drug screening and precision intervention in ADHD.

The liver is a vital metabolic organ sustaining human life activities， and its dysfunction is closely associated with various liver diseases. In recent years， an increasing number of studies have shown that semaphorins （SEMA） play a significant role in pathological processes such as immune inflammatory response， tumor progression， and fibrosis in liver diseases by interacting with their receptors plexins and neuropilins. This article reviews the expression， functions， and molecular mechanisms of different SEMA in viral hepatitis， hepatocellular carcinoma， liver fibrosis， nonalcoholic fatty liver disease， and hepatic ischemia-reperfusion injury， and it also explores the potential application value of SEMA in the diagnosis and treatment of liver diseases， in order to provide new ideas for precise diagnosis and targeted treatment of liver diseases.

Objective To compare the therapeutic efficacy and identify differences between haploidentical hematopoietic stem cell transplantation combined with mesenchymal stem cells (Haplo-MSC) and umbilical cord blood hematopoietic stem cell transplantation combined with mesenchymal stem cells (UCB-MSC) in mice with bone marrow acute radiation syndrome (ARS). Methods Eight-to ten-week-old CB6F1 mice were exposed to 8 Gy of ⁶⁰Co γ-ray irradiation to establish a bone marrow-type ARS model.The mice were then randomly assigned to three groups: the Haplo-MSC group (haploidentical hematopoietic stem cells combined with MSCs), the UCB-MSC group (umbilical cord blood stem cells combined with MSCs), and a saline control group. The survival rate, peripheral blood cell counts, pathological changes in target organs, colony formation of bone marrow cells, and graft-versus-host disease (GVHD) were observed. Results All mice in the saline control group died within 14 days, with a median survival time of 8.9 days. The 30 day survival rate was 65% in the Haplo-MSC group and 60% in the UCB-MSC group. The Log-rank test showed no significant difference in survival time between the two transplantation groups (P=0.561). At 28 days post-transplantation, no significant differences were observed in WBC, PLT, RBC, or Hb counts between the two groups (P=0.151, 0.733, 0.856, and 0.300, respectively). Pathological changes in bone marrow cells showed that bone marrow failure occurred later in the UCB-MSC group than in the Haplo-MSC group. In contrast, the Haplo-MSC group exhibited faster hematopoietic stem cell engraftment. Furthermore, the numbers of CFU-E, CFU-GM, and CFU-GEMM differed significantly between the two groups (P<0.05). Conclusion Both the Haplo-MSC and UCB-MSC regimens promoted hematopoietic engraftment and reconstitution in mice with lethal-dose radiation-induced bone marrow ARS. However, the onset of bone marrow failure was delayed in mice treated with the UCB-MSC regimen. In contrast, mice treated with the Haplo-MSC regimen showed faster engraftment.

Clonal cell abnormalities represent a shared initiating event for systemic inflammation and organ injury across a spectrum of diseases, with diverse clonal origing including somatic mutations, germline mutations, and aberrant monoclonal immunoglobulin secretion. This review focuses on the clinical features, mechanism studies and therapeutic advances of the diseases, including VEXAS (vacuoles, E1 enzyme, X-linked, autoin-flammatory, somatic) syndrome, GATA2 deficiency, STAT3 gain-of-function (STAT3-GOF)syndrome, secondary hemophagocytic lymphohistiocytosis, and Schnitzler syndrome. It aims to deepen clinical understanding of these diseases and provide references for precision treatment.

Objective: To investigate the sleep quality in patients with burning mouth syndrome (BMS) and its influencing factors, providing a basis for developing sleep intervention measures to reduce the impact of BMS symptoms. Methods: This study was reviewed and approved by the Medical Ethics Committee, and informed consent was obtained from patients. A total of 150 patients with BMS and 150 healthy volunteers were enrolled as subjects in this study. The Pittsburgh sleep quality index (PSQI) was used to assess the sleep quality of patients with BMS. Visual analog scale (VAS) was used to assess the degree of oral mucosal pain, generalized anxiety disorder 7-item scale (GAD-7) was used to assess the frequency of anxiety symptoms, and the patient health questionnaire depression questionnaire (PHQ-9) was used to assess the frequency of depression symptoms. Univariate analysis was performed to identify potential influencing factors affecting sleep quality in patients with BMS, and multiple linear regression analysis was employed to determine independent risk factors. Results: The PSQI score for patients with BMS was 7.61 ± 4.29, which was significantly higher than that of healthy controls (P = 0.016). In the PSQI subscale analysis, patients with BMS exhibited increased sleep latency, decreased sleep duration, and lower sleep efficiency compared to healthy controls (P<0.05). Patients with BMS and comorbid sleep difficulties had significantly higher scores on GAD-7 and PHQ-9 compared to the patients with BMS without sleep difficulties (P<0.001), but there was no significant difference in pain VAS scores between the two (P = 0.068). Multiple linear regression analysis revealed that longer disease duration (>6 months), the presence of systemic concomitant symptoms (such as headache and mental stress), and higher depression scores were identified as independent risk factors affecting sleep quality in patients with BMS. Conclusion For patients with BMS, long course of illness, presence of headaches, high mental stress, and depressive symptoms may be independent factors affecting their sleep quality.

OBJECTIVE: Asthma imposes a significant global health burden. This study examines changes in the asthma-related disease burden from 1990 to 2021 and projects future burdens for 2050 under different scenarios. METHODS: Using data from the Global Burden of Disease 2021 study, we analyzed asthma incidence, prevalence, mortality, and disability-adjusted life years (DALYs) from 1990 to 2021. We projected the disease burden for 2050 based on current trends and hypothetical scenarios in which all risk factors are controlled. Temporal trends in age-standardized incidence, prevalence, mortality, and DALY rates were explored using Annual Percent Change. RESULTS: In 2021, the age-standardized rates for asthma incidence, prevalence, mortality, and DALYs in China were 364.17 per 100,000 (95% uncertainty interval [ UI]: 283.22-494.10), 1,956.49 per 100,000 (95% UI: 1,566.68-2,491.87), 1.47 per 100,000 (95% UI: 1.15-1.79), and 103.76 per 100,000 (95% UI: 72.50-145.46), respectively. A higher disease burden was observed among Chinese men and individuals aged 70 years or older. Compared to the current trend, a combined scenario involving improvements in environmental factors, behavioral and metabolic health, child nutrition, and vaccination resulted in a greater reduction in the disease burden caused by asthma. CONCLUSION Addressing modifiable risk factors is essential for further reducing the asthma-related disease burden.
Humans ; Asthma/mortality* ; China/epidemiology* ; Male ; Female ; Adult ; Middle Aged ; Aged ; Child ; Adolescent ; Global Burden of Disease/trends* ; Child, Preschool ; Young Adult ; Infant ; Cost of Illness ; Disability-Adjusted Life Years ; Prevalence ; Incidence ; Infant, Newborn ; Aged, 80 and over ; Risk Factors

OBJECTIVE: To investigate the association between long-term glycemic control and cerebral infarction risk in patients with diabetes through a large-scale cohort study. METHODS: This prospective, community-based cohort study included 12,054 patients with diabetes. From 2006 to 2012, 38,272 fasting blood glucose (FBG) measurements were obtained from these participants. FBG trajectory patterns were generated using latent mixture modelling. Cox proportional hazards models were applied to assess the subsequent risk of cerebral infarction associated with different FBG trajectory patterns. RESULTS: At baseline, the mean age of the participants was 55.2 years. Four distinct FBG trajectories were identified based on FBG concentrations and their changes over the 6-year follow-up period. After a median follow-up of 6.9 years, 786 cerebral infarction events were recorded. Different trajectory patterns were associated with significantly varied outcome risks (Log-Rank P < 0.001). Compared with the low-stability group, Hazard Ratio ( HR) adjusted for potential confounders were 1.37 for the moderate-increasing group, 1.23 for the elevated-decreasing group, and 2.08 for the elevated-stable group. CONCLUSION Sustained high FBG levels were found to play a critical role in the development of ischemic stroke among patients with diabetes. Controlling FBG levels may reduce the risk of cerebral infarction.
Humans ; Cerebral Infarction/blood* ; Middle Aged ; Male ; Female ; Blood Glucose/analysis* ; Fasting/blood* ; Aged ; Prospective Studies ; Risk Factors ; Diabetes Mellitus/blood* ; Adult ; Proportional Hazards Models