OBJECTIVE To investigate the mechanism of Qushi huoxue decoction in improving metabolic-associated fatty liver disease （MAFLD） based on the AMP-activated protein kinase/mammalian target of rapamycin/UNC-51-like kinase 1 （AMPK/mTOR/ULK1） autophagy signaling pathway.METHODS Male C57BL/6J mice were randomly divided into normal group， model group， and low-， medium-， and high-dose Qushi huoxue decoction groups [4.10， 8.20， 16.40 mg/（g·d）]， with 10 mice in each group. Except for the normal group， mice in the other groups were fed a high-fat diet for 12 weeks to establish the MAFLD model. Starting 24 hours after modeling， mice in each group were administered the drug solution or normal saline once daily for 6 consecutive weeks. Serum levels of total cholesterol （TC）， triglycerides （TG）， alanine transaminase （ALT）， aspartate transferase （AST）， low-density lipoprotein cholesterol （LDL-C）， and high-density lipoprotein cholesterol （HDL-C） were detected according to the kit instructions. Hematoxylin-eosin （HE） staining and oil red O staining were used to observe pathological changes in mouse liver tissue. Western blot and immunofluorescence staining were used to detect the expression and positive protein expression related to the AMPK/mTOR/ULK1 autophagy signaling pathway.RESULTS Compared with the normal group， the serum levels of TC， TG， ALT， AST， and LDL-C in the model group were significantly increased， while the HDL-C level was significantly decreased （ P ＜0.01）. HE staining showed obvious steatosis in hepatocytes of the model group， and oil red O staining showed a large amount of lipid droplet accumulation in liver tissue. Western blot and immunofluorescence staining results showed that the expression levels of p-mTOR/mTOR and p62 proteins， as well as the relative fluorescence intensities of p-mTOR and p62 proteins in liver tissue of the model group， were significantly increased/enhanced （ P ＜0.01）， while the expression levels of p-AMPK/AMPK， ULK1， and microtubule-associated protein 1 light chain 3Ⅱ （LC3Ⅱ） proteins， as well as the relative fluorescence intensities of p-AMPK and LC3 proteins， were significantly decreased/weakened （ P ＜0.01）. After intervention with Qushi huoxue decoction， the above pathological changes and abnormal indicators in liver tissue of mice in the low-， medium-， and high-dose groups were significantly reversed， with most indicators showing statistically significant differences （ P ＜0.05 or P ＜0.01）.CONCLUSIONS Qushi huoxue decoction can significantly improve liver pathology， blood lipid levels， and liver function in MAFLD model mice； this improvement may be achieved through the activation of the AMPK/mTOR/ULK1 autophagy signaling pathway.

Objective To explore the prognostic implications of coagulation-fibrinolysis biomarkers in intracerebral hemorrhage(ICH)and to construct a multivariable logistic regression model for individualized risk prediction.Methods A total of 101 ICH patients who were admitted to Nanfang Hospital of Southern Medical University from January 2020 to December 2023 were retrospectively enrolled.These patients were stratified into a poor outcome group(ΔGCS≤0)and a good outcome group(ΔGCS>0)according to the difference in Glasgow Coma Scale(GCS)scores between discharge and admission.Coagulation and fibrinolysis markers collected upon admission were analyzed.The Least Absolute Shrinkage and Selection Operator(LASSO)regression was employed to screen variables.A logistic regression model was constructed using 70%of the cases(the training set),while the remaining 30%were utilized for validation.The performance of the model was evaluated through receiver operating characteristic(ROC)curves,calibration plots,Hosmer-Lemeshow goodness-of-fit test,and decision curve analysis(DCA).Results Univariate analysis indicated that thrombin-antithrombin complex(TAT),D-dimer,and age exhibited significant differences between the two outcome groups(P<0.05).These three variables were selected via LASSO regression and incorporated into the logistic model.The final model equation was expressed as:logit(P)=-6.234+1.132×TAT+0.867×D-dimer+0.699×Age.In the training set,the area under the ROC curve(AUC)was 0.795.The calibration curve demonstrated excellent agreement between the predicted and observed outcomes,with a Hosmer-Lemeshow test P-value of 0.8568.DCA revealed that the model achieved net clinical benefit across a broad range of risk thresholds(0.1～0.8).Conclusions TAT,D-dimer,and age are independent predictors of poor prognosis in patients with ICH.The logistic regression model based on these variables demon-strates favorable discriminatory ability and clinical utility.The nomogram derived from this model enables individu-alized risk assessment and may aid clinicians in early prognostic evaluation and treatment planning.

Objective To study the effectiveness of combining antidepressant drug with high-frequency repeated transcranial magnetic stimulation(rTMS)in treating adolescent depression and explore its impact on electroencephalogram.Methods 60 cases of adolescent depression,who admitted to Department of Psychiatry,the First Affiliated Hospital of Kunming Medical University from September to December 2024 were selected and randomly divided into control group and observation group,with 30 cases in each group.Patients of control group were treated with selective serotonin reuptake inhibitor(SSRI),while patients of observation group received the same SSRI treatment in addition to high-frequency rTMS.The treatment lasted for 2 weeks.Both groups were assessed by using 24-item Hamilton depression rating scale(HAMD-24)and depression self-rating scale for children(DSRSC)before the start of treatment and at the end of two weeks of treatment.Adverse reactions were recorded throughout the treatment,and electroencephalogram monitoring was taken before and after treatment.Results Observation group showed a significantly higher treatment response rate compared to control group(P<0.05).After two weeks of treatment,HAMD-24 and DSRSC scores in observation group were notably lower than those in control group(P<0.01).Both groups exhibited improvements in brain wave power(δ,θ,α,β)after treatment(P<0.05),with observation group demonstrating superior β wave power compared to control group(P<0.01).Additionally,a negative correlation was found between α and β wave power in the left frontal region and DSRSC scores in observation group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion Compared with SSRI treatment,rTMS combined with SSRI treatment can more effectively improve depressive symptoms,increase α and β brainwave power,and the combination therapy does not increase the incidence of adverse reactions,demonstrating good safety.

The prevalence of chronic constipation among the elderly is significant, exerting adverse effects on both their physical and mental health.Presently, pharmacological therapy remains the predominant treatment modality for elderly patients with chronic constipation; however, prolonged use can lead to drug dependence, tolerance, and adverse effects.This article systematically reviews non-pharmacological interventions for chronic constipation in elderly patients, both domestically and internationally, aiming to provide a comprehensive reference for clinical practice.

Objective To investigate the diagnostic potential of combining 3.0T magnetic resonance imag-ing(MRI)T2 mapping sequences with serum nesfatin-1 levels for detecting early osteoarthritis(OA)in elderly knees.Methods 97 elderly patients with knee osteoarthritis(OA group)and 52 elderly individuals undergoing physical examinations(control group)were recruited from a hospital between May 2023 and May 2024.Based on X-ray findings,the OA group was further divided into an early-stage subgroup and a non-early-stage subgroup.All participants underwent 3.0T MRI T2 mapping sequence scans to measure the T2 values in the knee cartilage region,and serum nesfatin-1 levels were assessed.Differences in these indicators were compared between groups.Additionally,a receiver operating characteristic(ROC)curve was constructed to evaluate the diagnostic value of these parameters for early-stage knee OA in elderly individuals.Results Among 97 elderly patients with knee OA,35 cases were classified into the early-stage group,and 62 cases were categorized into the non-early-stage group.The T2 values in five cartilage regions of the knee and serum nesfatin-1 levels were significantly higher in the OA group compared to the control group(P<0.05).Moreover,these values were significantly lower in the early-stage group than in the non-early-stage group(P<0.05).The areas under the curve(AUC)for diagnosing early-stage OA using T2 values in knee cartilage regions and serum nesfatin-1 levels ranged from 0.774 to 0.871.Notably,the AUC for combined diagnosis reached 0.939(P<0.05).Conclusion 3.0T MRI using the T2 mapping sequence in combination with serum nesfatin-1 level detection demonstrates high diagnostic value for early OA in elderly patients with knee involvement.

Objective To explore the prognostic implications of coagulation-fibrinolysis biomarkers in intracerebral hemorrhage(ICH)and to construct a multivariable logistic regression model for individualized risk prediction.Methods A total of 101 ICH patients who were admitted to Nanfang Hospital of Southern Medical University from January 2020 to December 2023 were retrospectively enrolled.These patients were stratified into a poor outcome group(ΔGCS≤0)and a good outcome group(ΔGCS>0)according to the difference in Glasgow Coma Scale(GCS)scores between discharge and admission.Coagulation and fibrinolysis markers collected upon admission were analyzed.The Least Absolute Shrinkage and Selection Operator(LASSO)regression was employed to screen variables.A logistic regression model was constructed using 70%of the cases(the training set),while the remaining 30%were utilized for validation.The performance of the model was evaluated through receiver operating characteristic(ROC)curves,calibration plots,Hosmer-Lemeshow goodness-of-fit test,and decision curve analysis(DCA).Results Univariate analysis indicated that thrombin-antithrombin complex(TAT),D-dimer,and age exhibited significant differences between the two outcome groups(P<0.05).These three variables were selected via LASSO regression and incorporated into the logistic model.The final model equation was expressed as:logit(P)=-6.234+1.132×TAT+0.867×D-dimer+0.699×Age.In the training set,the area under the ROC curve(AUC)was 0.795.The calibration curve demonstrated excellent agreement between the predicted and observed outcomes,with a Hosmer-Lemeshow test P-value of 0.8568.DCA revealed that the model achieved net clinical benefit across a broad range of risk thresholds(0.1～0.8).Conclusions TAT,D-dimer,and age are independent predictors of poor prognosis in patients with ICH.The logistic regression model based on these variables demon-strates favorable discriminatory ability and clinical utility.The nomogram derived from this model enables individu-alized risk assessment and may aid clinicians in early prognostic evaluation and treatment planning.

Objective To study the effectiveness of combining antidepressant drug with high-frequency repeated transcranial magnetic stimulation(rTMS)in treating adolescent depression and explore its impact on electroencephalogram.Methods 60 cases of adolescent depression,who admitted to Department of Psychiatry,the First Affiliated Hospital of Kunming Medical University from September to December 2024 were selected and randomly divided into control group and observation group,with 30 cases in each group.Patients of control group were treated with selective serotonin reuptake inhibitor(SSRI),while patients of observation group received the same SSRI treatment in addition to high-frequency rTMS.The treatment lasted for 2 weeks.Both groups were assessed by using 24-item Hamilton depression rating scale(HAMD-24)and depression self-rating scale for children(DSRSC)before the start of treatment and at the end of two weeks of treatment.Adverse reactions were recorded throughout the treatment,and electroencephalogram monitoring was taken before and after treatment.Results Observation group showed a significantly higher treatment response rate compared to control group(P<0.05).After two weeks of treatment,HAMD-24 and DSRSC scores in observation group were notably lower than those in control group(P<0.01).Both groups exhibited improvements in brain wave power(δ,θ,α,β)after treatment(P<0.05),with observation group demonstrating superior β wave power compared to control group(P<0.01).Additionally,a negative correlation was found between α and β wave power in the left frontal region and DSRSC scores in observation group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion Compared with SSRI treatment,rTMS combined with SSRI treatment can more effectively improve depressive symptoms,increase α and β brainwave power,and the combination therapy does not increase the incidence of adverse reactions,demonstrating good safety.

Objective To investigate the diagnostic potential of combining 3.0T magnetic resonance imag-ing(MRI)T2 mapping sequences with serum nesfatin-1 levels for detecting early osteoarthritis(OA)in elderly knees.Methods 97 elderly patients with knee osteoarthritis(OA group)and 52 elderly individuals undergoing physical examinations(control group)were recruited from a hospital between May 2023 and May 2024.Based on X-ray findings,the OA group was further divided into an early-stage subgroup and a non-early-stage subgroup.All participants underwent 3.0T MRI T2 mapping sequence scans to measure the T2 values in the knee cartilage region,and serum nesfatin-1 levels were assessed.Differences in these indicators were compared between groups.Additionally,a receiver operating characteristic(ROC)curve was constructed to evaluate the diagnostic value of these parameters for early-stage knee OA in elderly individuals.Results Among 97 elderly patients with knee OA,35 cases were classified into the early-stage group,and 62 cases were categorized into the non-early-stage group.The T2 values in five cartilage regions of the knee and serum nesfatin-1 levels were significantly higher in the OA group compared to the control group(P<0.05).Moreover,these values were significantly lower in the early-stage group than in the non-early-stage group(P<0.05).The areas under the curve(AUC)for diagnosing early-stage OA using T2 values in knee cartilage regions and serum nesfatin-1 levels ranged from 0.774 to 0.871.Notably,the AUC for combined diagnosis reached 0.939(P<0.05).Conclusion 3.0T MRI using the T2 mapping sequence in combination with serum nesfatin-1 level detection demonstrates high diagnostic value for early OA in elderly patients with knee involvement.

The prevalence of chronic constipation among the elderly is significant, exerting adverse effects on both their physical and mental health.Presently, pharmacological therapy remains the predominant treatment modality for elderly patients with chronic constipation; however, prolonged use can lead to drug dependence, tolerance, and adverse effects.This article systematically reviews non-pharmacological interventions for chronic constipation in elderly patients, both domestically and internationally, aiming to provide a comprehensive reference for clinical practice.

Objective:To explore the characteristics of SLCO1B1/ SLCO1B3 gene variants among children with Rotor syndrome (RS). Methods:Four children who were admitted to the Department of Hepatology of Hunan Children′s Hospital between January 2019 and January 2022 were selected as the study subjects. Trio-whole exome sequencing was carried out for the four families, and gel electrophoresis was used to verify an insertional variant of long-interspersed element-1 (LINE-1).Results:Genetic testing has identified three variants of the SLCO1B1 gene, including c. 1738C>T (p.R580*), c. 757C>T (p.R253*) and c. 1622A>C (p.Q541P), and two variants of the SLCO1B3 gene, including c. 481+ 22insLINE-1 and c. 1747+ 1G>A among the children. Three of them were found to harbor homozygous variants of the SLCO1B1/ SLCO1B3 genes, and one has harbored compound heterozygous variants. Sanger sequencing confirmed the existence of all variants, and gel electrophoresis has confirmed the existence of the LINE-1 insertional variant of about 6 kb within intron 6 of the SLCO1B3 gene in all children. Conclusion:The pathogenesis of the RS among the four children may be attributed to the variants of the SLCO1B1/ SLCO1B3 genes. The LINE-1 insertion variant of the SLCO1B3 gene may be common among Chinese RS patients.