OBJECTIVE To focus on the classic NOD-like receptor protein 3 （NLRP3）/Caspase-1/gasdermin D （GSDMD） pyroptosis pathway and explore the mechanism by which Huatan qushi huoxue formula （HQHF） inhibits macrophage pyroptosis to ameliorate metabolic dysfunction-associated steatohepatitis （MASH）. METHODS RAW264.7 cells were divided into 5 groups： Control group （10% blank serum）， Model group [10% blank serum+5 μg/mL lipopolysaccharide （LPS）]， HQHF-L group （2.5% drug-containing serum+7.5% blank serum+5 μg/mL LPS）， HQHF-M group （5% drug-containing serum+5% blank serum+5 μg/mL LPS）， and HQHF-H group （10% drug-containing serum+5 μg/mL LPS）. After 24 h of routine culture post-administration， cells and supernatants were collected for assays. Cell morphology was observed via scanning electron microscopy and phase-contrast microscopy； localization and expression of gasdermin D-N （GSDMD-N） were observed by immunofluorescence. Interleukin-1β （IL-1β） and IL-18 contents in supernatants were detected by ELISA； mRNA and protein expressions of NLRP3， Caspase-1， and GSDMD were measured using real-time PCR and Western blot. RESULTS Compared with the Control group， the Model group showed typical pyroptotic morphology （cell membrane bulging and pore formation）， increased aggregation and fluorescence intensity of GSDMD-N on the cell membrane （ P ＜0.05）， significantly increased the contents of IL-1β and IL-18 in cell supernatants （ P ＜0.05）， and significantly up-regulated mRNA and protein expressions of NLRP3， Caspase-1， and GSDMD in cells （ P ＜0.05）. Compared with the Model group， the HQHF-L， HQHF-M and HQHF-H groups showed improved pyroptotic morphology， reduced membrane localization and significantly weakened fluorescence intensity of GSDMD-N （ P ＜0.05）， significantly decreased the contents of IL-1β and IL-18 in cell supernatants （ P ＜0.05）， and significantly down-regulated mRNA and protein expressions of NLRP3， Caspase-1， and GSDMD in cells （ P ＜0.05）. CONCLUSIONS HQHF inhibits LPS-induced macrophage pyroptosis， and its mechanism of improving MASH may be associated with the suppression of the activation of the classical NLRP3/Caspase-1/GSDMD pyroptosis pathway.

Objective:To explore the influence of voice training combined with active breathing and circulation techniques on voice recovery following vocal cord polyp surgery. Methods:A total of 110 patients who underwent vocal cord polyp surgery at our hospital from May 2022 to November 2023 were selected and randomly divided into a control group （n=55） and a combination group （n=55） using a random number table method. During the recovery period, both groups received dietary control and aerosol treatment. The control group participated in voice training, while the combination group received active breathing and circulation techniques in addition to voice training for 2 months. Morphological changes, voice acoustic indicators （Shimmer, Jitter, Maximum Phonation Time[MPT]）, and the Voice Handicap Index （VHI） were compared between the two groups, and clinical efficacy was evaluated. Results:The combination group demonstrated higher clinical efficacy after training compared to the control group, with a statistically significant difference （P<0.05）. The proportion of incomplete closure, abnormal mucosal wave, and supraglottic compensation decreased in both groups after training （P<0.05）. However, there was no significant difference in the proportions of incomplete closure and abnormal mucosal wave between the two groups （P>0.05）. Notably, the proportion of patients with supraglottic compensation in the combination group was lower than in the control group （P<0.05）. After training, the Shimmer and Jitter values decreased in both groups, with the combination group exhibiting lower values （P<0.05）. Conversely, the MPT values increased in both groups, again with higher values in the combination group （P<0.05）. Additionally, after training, the functional, physiological, and emotional scores of the VHI decreased in both groups, with the scores in the combination group lower than those in the control group, demonstrating statistical significance （P<0.05）. Conclusion:Voice training combined with active breathing and circulation techniques has a beneficial effect on recovery following vocal cord polyp surgery. This combined approach significantly improves vocal cord morphology and acoustic indices, alleviates voice disorders, and enhances overall voice recovery.
Humans ; Vocal Cords/surgery* ; Polyps/surgery* ; Voice Training ; Male ; Female ; Voice Quality ; Laryngeal Diseases/surgery* ; Voice ; Middle Aged ; Adult ; Respiration

Siwu Decoction is a classic formula for tonifying the blood and activating blood circulation and is characterized by its ability to tonify the blood without leaving stasis and promote blood circulation without harming the vital energy of the body.It is widely used in clinical practice for the treatment of various conditions related to blood deficiency and poor blood circulation,such as anemia,menstrual disorders,and dysmenorrhea.The liver is responsible for governing the free flow of Qi and storing blood,and abnormalities in liver function are associated with various acute and chronic liver injuries.Siwu Decoction can restore liver homeostasis by tonifying the blood,activating blood circulation,nourishing the blood,and soothing the liver.Based on its unique prescription formulation and multiple pharmacological mechanisms,Siwu Decoction has become an important prescription for enhancing liver microcirculation,facilitating hepatocyte repair and regeneration,and alleviating liver injury.This article reviews the effect and mechanism of Siwu Decoction in the prevention and treatment of various liver injuries(including alcoholic liver disease,nonalcoholic fatty liver disease,nonalcoholic fatty liver disease,liver fibrosis,and liver cirrhosis)and discusses existing problems and future research directions.

Objective:Conduct an in-depth investigation into the current status and development needs of infectious disease clinical testing at medical institutions at all levels across the country.Methods:A cross-sectional survey was carried out from January 5, 2023, to June 1, 2023, using a web-based questionnaire distributed to healthcare organizations at all levels nationwide. A total of 3 462 questionnaires were collected, and after quality control and a no-return random sampling process, 2 778 questionnaires were included in the analysis. The research covered basic information about medical institutions, the current emergency response capacity of infectious disease laboratories, the status of the implementation of statutory infectious diseases, the demand for infectious disease testing programs, and the reasons for any lack of implementation. Additionally, the study further analyzed the participation rates of medical institutions at all levels, laboratory accreditation, the presence of infectious disease testing departments, and the testing rates for major infectious diseases.Results:Among the 2 778 questionnaires, the proportions of tertiary, secondary, and primary hospitals were 39.13% (1 087/2 778), 53.20% (1 478/2 778) and 4.46% (124/2 778), respectively. The proportion of specialized infectious disease medical institutions was 8.89% (247/2 778). The proportion of medical institutions with laboratory accreditation was 12.92% (359/2 778). The proportion of clinical laboratory performing infectious disease testing was 98.56% (2 738/2 778). Among the infectious disease pathogens included in the analysis, the implementation rates of testing related to hepatitis B virus, hepatitis C virus, 2019-nCoV, human immunodeficiency virus, and syphilis spirochete were 97.62% (2 712/2 778), 94.85% (2 635/2 778), 93.27% (2 591/2 778), 96.33% (2 676/2 778) and 96.22% (2 673/2 778), respectively. In the research on the demand for clinical infectious disease pathogen testing, the demand for testing of Brucella spp. bacteria and Mycobacterium tuberculosis was 25.50% (90/353) and 8.22% (29/353), respectively. The main factors that did not meet the demand for clinical infectious disease testing were the lack of space in the laboratory to carry out the tests, insufficient manpower, and the absence of a fee schedule, accounting for 44.10% (1 225/2 778), 42.55% (1 182/2 778) and 36.00% (1 000/2 778), respectively.Conclusions:Clinical testing for infectious diseases in our country is mainly carried out in the laboratories of tertiary and secondary medical institutions, which can adequately meet the laboratory testing needs for common infectious diseases. However, there are situations such as limited infectious disease testing projects and insufficient spatial, human, and material resources. Improvements in laboratory construction and methodology can be made according to the actual conditions of each region.

ObjectiveTo investigate the association between serum creatinine/cystatin C ratio （CCR） and nonalcoholic fatty liver disease （NAFLD） based on the NHANES database， and to evaluate the potential significance of CCR as an indicator reflecting the metabolic status of the body. MethodsBased on the data from the NHANES database in 1999‍ ‍—‍ ‍2004， a total of 4 217 participants were enrolled and divided into NAFLD group with 1 726 participants and non-NAFLD group with 2 491 participants. CCR was compared between the two groups， and the association between CCR and NAFLD was analyzed. The Wilcoxon rank-sum test was used for comparison of continuous data between two groups， and the chi-square test was used for comparison of categorical data between two groups. The multivariate logistic regression model was used to investigate the association between CCR and NAFLD； CCR was divided into 4 groups based on quartiles， and odds ratio （OR） and 95% confidence interval （CI） in the regression model was calculated with the first quartile as reference. In addition， the restricted cubic spline analysis was used to investigate whether there was a non-linear relationship between CCR and NAFLD， and interaction items were introduced into the Logistic regression model to perform an interaction analysis. Subgroup analyses were performed based on the stratification of variables to investigate the difference in the association between CCR and NAFLD in different populations. ResultsThe non-NAFLD group had a significantly higher CCR than the NAFLD group （Z=-4.76，P<0.01）. The Logistic regression analysis showed that in model 1 without adjustment of variables， CCR was negatively associated with NAFLD （OR=0.993，95%CI：0.989‍ ‍—‍ ‍0.996，P<0.01）， and in model 3 with adjustment of all variables， CCR was still negatively associated with NAFLD （OR=0.986，95%CI：0.981‍ ‍—‍ ‍0.991，P<0.01）. The analysis of CCR based on quartiles showed a significant association between the increase in CCR and the reduction in the risk of NAFLD. In model 3， compared with the individuals with the lowest quartile of CCR， the individuals with the highest quartile of CCR had a significantly lower risk of NAFLD （OR=0.426，95%CI：0.316‍ ‍—‍ ‍0.574，P<0.01）. Further interaction and subgroup analyses showed that the interaction between CCR and age/sex had a statistical significance （P_interaction<0.01 and P_interaction=0.04）. The subgroup analysis based on age showed a more significant association between CCR and NAFLD in the middle-aged population （≤60 years） （OR=0.982，95%CI：0.976‍ ‍—‍ ‍0.987）， and the subgroup analysis based on sex showed a stronger association between CCR and NAFLD in women （OR=0.979，95%CI：0.972‍ ‍—‍ ‍0.986）. ConclusionThis study shows a significant negative association between CCR and NAFLD， and such association is more significant in middle-aged individuals and women.

Epigenetic mechanisms play a crucial role in the development and progression of nonalcoholic fatty liver disease （NAFLD）， especially among lean individuals. The research on related epigenetic mechanisms has provided new clues and directions for revealing the underlying causes and treatment strategies of NAFLD. This article introduces the role of epigenetics in the development and progression of NAFLD among lean individuals in recent years， analyzes the latest research advances in the epigenetics of NAFLD in this population， and briefly describes the basic concepts of epigenetics， including DNA methylation， histone modifications， and non-coding RNA regulation. This article also discusses how epigenetic alterations impact the pathogenesis， disease progression， and treatment strategies of NAFLD in lean individuals.

Objective To investigate the potential mechanisms of action of Huatan Qushi Huoxue Recipe in treating non-alcoholic steatohepatitis(NASH)through network pharmacology and animal experiments.Methods The differentially expressed genes in NASH were obtained from the GEO database.The active components and potential targets of Huatan Qushi Huoxue Recipe were obtained from the TCMSP.The treatment targets were obtained by intersecting the diseases and drug targets.The protein-protein interaction network was analyzed,the drug-active component-target network was constructed,and the enrichment analysis was performed.The key pathways were verified by animal experiments.Results A total of 74differentially expressed genes,97 active components,and 295 potential targets were identified in NASH.Five genes,including JUN,were selected as key targets through intersection.Seven active components,inclu-ding kaempferol and quercetin,were identified.Enrichment analysis revealed that the AGE-RAGE and IL-17 pathways may play a key role in the treatment of NASH by Huatan Qushi Huoxue Recipe.Animal experiments showed that Huatan Qushi Huoxue Recipe could reduce the levels of total cholesterol(TC),triglyceride(TG),and blood glucose(GLU),and down-regulate the expression of RAGE and activator protein 1(AP-1)in the AGE-RAGE and IL-17 pathways,thus,exerting a therapeutic effect on NASH.Conclusion Huatan Qushi Huoxue Recipe can treat NASH by lowering TC,TG and GLU levels and inhibiting the expression of RAGE and AP-1 pro-tein.

Siwu Decoction is a classic formula for tonifying the blood and activating blood circulation and is characterized by its ability to tonify the blood without leaving stasis and promote blood circulation without harming the vital energy of the body.It is widely used in clinical practice for the treatment of various conditions related to blood deficiency and poor blood circulation,such as anemia,menstrual disorders,and dysmenorrhea.The liver is responsible for governing the free flow of Qi and storing blood,and abnormalities in liver function are associated with various acute and chronic liver injuries.Siwu Decoction can restore liver homeostasis by tonifying the blood,activating blood circulation,nourishing the blood,and soothing the liver.Based on its unique prescription formulation and multiple pharmacological mechanisms,Siwu Decoction has become an important prescription for enhancing liver microcirculation,facilitating hepatocyte repair and regeneration,and alleviating liver injury.This article reviews the effect and mechanism of Siwu Decoction in the prevention and treatment of various liver injuries(including alcoholic liver disease,nonalcoholic fatty liver disease,nonalcoholic fatty liver disease,liver fibrosis,and liver cirrhosis)and discusses existing problems and future research directions.

Objective To investigate the potential mechanisms of action of Huatan Qushi Huoxue Recipe in treating non-alcoholic steatohepatitis(NASH)through network pharmacology and animal experiments.Methods The differentially expressed genes in NASH were obtained from the GEO database.The active components and potential targets of Huatan Qushi Huoxue Recipe were obtained from the TCMSP.The treatment targets were obtained by intersecting the diseases and drug targets.The protein-protein interaction network was analyzed,the drug-active component-target network was constructed,and the enrichment analysis was performed.The key pathways were verified by animal experiments.Results A total of 74differentially expressed genes,97 active components,and 295 potential targets were identified in NASH.Five genes,including JUN,were selected as key targets through intersection.Seven active components,inclu-ding kaempferol and quercetin,were identified.Enrichment analysis revealed that the AGE-RAGE and IL-17 pathways may play a key role in the treatment of NASH by Huatan Qushi Huoxue Recipe.Animal experiments showed that Huatan Qushi Huoxue Recipe could reduce the levels of total cholesterol(TC),triglyceride(TG),and blood glucose(GLU),and down-regulate the expression of RAGE and activator protein 1(AP-1)in the AGE-RAGE and IL-17 pathways,thus,exerting a therapeutic effect on NASH.Conclusion Huatan Qushi Huoxue Recipe can treat NASH by lowering TC,TG and GLU levels and inhibiting the expression of RAGE and AP-1 pro-tein.

Objective:Conduct an in-depth investigation into the current status and development needs of infectious disease clinical testing at medical institutions at all levels across the country.Methods:A cross-sectional survey was carried out from January 5, 2023, to June 1, 2023, using a web-based questionnaire distributed to healthcare organizations at all levels nationwide. A total of 3 462 questionnaires were collected, and after quality control and a no-return random sampling process, 2 778 questionnaires were included in the analysis. The research covered basic information about medical institutions, the current emergency response capacity of infectious disease laboratories, the status of the implementation of statutory infectious diseases, the demand for infectious disease testing programs, and the reasons for any lack of implementation. Additionally, the study further analyzed the participation rates of medical institutions at all levels, laboratory accreditation, the presence of infectious disease testing departments, and the testing rates for major infectious diseases.Results:Among the 2 778 questionnaires, the proportions of tertiary, secondary, and primary hospitals were 39.13% (1 087/2 778), 53.20% (1 478/2 778) and 4.46% (124/2 778), respectively. The proportion of specialized infectious disease medical institutions was 8.89% (247/2 778). The proportion of medical institutions with laboratory accreditation was 12.92% (359/2 778). The proportion of clinical laboratory performing infectious disease testing was 98.56% (2 738/2 778). Among the infectious disease pathogens included in the analysis, the implementation rates of testing related to hepatitis B virus, hepatitis C virus, 2019-nCoV, human immunodeficiency virus, and syphilis spirochete were 97.62% (2 712/2 778), 94.85% (2 635/2 778), 93.27% (2 591/2 778), 96.33% (2 676/2 778) and 96.22% (2 673/2 778), respectively. In the research on the demand for clinical infectious disease pathogen testing, the demand for testing of Brucella spp. bacteria and Mycobacterium tuberculosis was 25.50% (90/353) and 8.22% (29/353), respectively. The main factors that did not meet the demand for clinical infectious disease testing were the lack of space in the laboratory to carry out the tests, insufficient manpower, and the absence of a fee schedule, accounting for 44.10% (1 225/2 778), 42.55% (1 182/2 778) and 36.00% (1 000/2 778), respectively.Conclusions:Clinical testing for infectious diseases in our country is mainly carried out in the laboratories of tertiary and secondary medical institutions, which can adequately meet the laboratory testing needs for common infectious diseases. However, there are situations such as limited infectious disease testing projects and insufficient spatial, human, and material resources. Improvements in laboratory construction and methodology can be made according to the actual conditions of each region.